WQ0037135_Renewal Application_20240401

Initial Review
Reviewer nathaniel.thorn burg
Is this submittal an application? (Excluding additional information.) *
Yes No
Permit Number (IR) * WQ0037135
Applicant/Permittee U.S. Biosolids, Inc.
Applicant/Permittee Address PO Box 146 Ronda, NC 28670
Is the owner in BIMS? Yes ) No Is the facility in BIMS? Yes No
Owner Type
Facility Name
County
Fee Category Major
Is this a complete application?*
Yes No
Signature Authority
Signature Authority Title
Signature Authority Email
Document Type (if non -application)
Email Notifications
Organization
U.S. Biosolids Class B Residuals Program
Wilkes
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer
Fee Amount
Complete App Date
04/01 /2024
$0
Below list any additional email address that need notification about a new project.
Email Address
Comments to be added to email notfication
Comments for Admin
Comments for RO

Comments for Reviewer
Comments for Applicant

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
Name* Zach Key
Email Address*
[e-mail]
Project Information
.........................
Application/Document Type*
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Phone Number*
3364673550
Modification - Minor
Renewal
GW-59, NDMR, NDMLR, NDAR-1,
N DAR-2
Residual Annual Report
Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
https://edoes.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Permit Type:*
Wastewater Irrigation
High -Rate Infiltration
Other Wastewater
Reclaimed Water
Closed -Loop Recycle
Residuals
Single -Family Residence Wastewater
Other
Irrigation
Permit Number:*
WQ0037135
Has Current Existing permit number
Applicant/Permittee*
U.S. Biosolids, Inc.
Applicant/Permittee Address*
PO Box 146 Ronda, NC 28670
Facility Name*
U.S. Biosolids Class B Residuals Program
Please provide comments/notes on your current submittal below.
Permit No. WQ0037135
U.S. Biosolids, Inc. Class B Residuals Program
Permit Renewal
Wilkes County
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
2024 Renewal W00037135.pdf 95.47MB
Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
* By checking this box, I acknowledge that I understand the application will not be accepted for pre -review until the fee (if required) has
been received by the Non -Discharge Branch. Application fees must be submitted by check or money order and made payable to the
North Carolina Department of Environmental Quality (NCDEQ). I also confirm that the uploaded document is a single PDF with all parts
of the application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature

Submission Date 4/l/2024

PO Box 146 Ronda, NC 28670
336-777-6909
www.usbiosolids.com
Monday, April 1, 2024
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
512 N. SALISBURY STREET
RALEIGH, NORTH CAROLINA 27604
Reference: Permit No. WQ0037135
U.S. Biosolids, Inc. Class B Residuals Program
Permit Renewal Application.
Attached along his letter is the permit renewal application for land application permit WQ0037135.
There are no changes except for the deletion of the Town of Lowell as a residual source.
Your attentions to this permit renewal application is greatly appreciated.
If you have any questions, please contact me at [e-mail] or at my direct line at 336-
467-3550.
Zach Key
U.S. Biosolids, Inc.

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .1100 — RESIDUALS LAND APPLICATION PROGRAM
INSTRUCTIONS FOR FORM: RLAP 06-16 & SUPPORTING DOCUMENTATION
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
sunnorting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This application is for treatment, storage, transport, and/or land application of Class B residuals (may include residuals that
are generated from a water treatment plant or other type facilities) on the proposed or currently approved land application site(s) under
15A NCAC 02T .1100.
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Land Application Program (FORM: RLAP 06-16) Application: (All Application Packages):
❑ Submit the completed and appropriately executed Residuals Land Application Program (FORM: RLAP 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ The Applicant's Certification on Page 5 of this form shall be signed in accordance with 15A NCAC 02T .0106(b). An alternate
person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria in 15A
NCAC 02T .0106(b).
❑ If this project is for a modification of an existing permit, submit one copy of the existing permit.
❑ Please submit this application form at least 180 days prior to the expiration date on the existing permit, or 90 days prior to
operation of proposed facility(ies) for application packages involving new or changes to treatment and storage units.
B. Application Fee (New and Major Modification Application Packages)
❑ Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environmental
Quality (NCDEQ).
Facility Classification New Permit Major Modification'
Major (land are permitted for > 300 acres) F- $1,310 F $395
Minor (land are permitted for < 300 acres) F- $810 F $245
' - A major modification shall be defined as any permit modification that: increases the generating facility's residuals dry tonnage;
adds additional land application areas not previously approved for that particular program [including transferring of field(s) from
one program to another]; adds additional residuals sources; or includes the addition of new treatment or storage units/processes not
previously permitted. There is no fee for minor modifications to a permit.
C. Cover Letter (All Application Packages)
❑ List all items included in the application package, as well as a brief description of the requested permitting action.
D. Environmental Assessments (Maybe Required— See 15A NCAC 1 C .0300)
❑ Submit a copy of the Findings of No Significant Impact (FONSI) or Environmental Impact Statement (EIS). Also, include
information on any mitigating factor(s) from the Environmental Assessment (EA) that impact the construction of the residuals
treatment and storage facilities. An EA may also be required for private systems if any public funds and/or lands are used for
the construction of the subject facilities.
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 1 of 3

E. Operation and Maintenance Plan (New and Renewal Application Packages)
❑ For Modification Application, if there are any changes to the existing plan, submit an updated O&M plan.
❑ Submit the O&M Plan in accordance with 15A NCAC 02T .1110 and include at a minimum:
❑ Operational functions; describe the operation of the program to show what operations are necessary for the program to
function and by whom the functions are to be conducted.
❑ Maintenance schedules; may include equipment calibration, maintenance of signs, etc.
❑ Safety measures; may include safety training program, manuals, signs, etc.
❑ Spill response plan; including control, containment, remediation, emergency contact information, etc.
❑ Inspection plan including the following information;
❑ Names and titles of personnel responsible for conducting the inspections.
❑ Frequency and location of inspections, including those to be conducted by the ORC, and procedures to assure that the
selected location(s) and inspection frequency are representative of the residuals management program.
❑ Detailed description of inspection procedures including record keeping and actions to be taken by the inspector in the event
that noncompliance is observed.
❑ Sampling and monitoring plan including the following information;
❑ Names and titles of personnel responsible for conducting the sampling and monitoring.
❑ Detailed description of monitoring procedures including parameters to be monitored.
❑ Sampling frequency and procedures to assure that representative samples are being collected. Fluctuation in temperature,
flow, and other operating conditions can affect the quality of the residuals gathered during a particular sampling event. The
sampling plan shall account for any foreseen fluctuations in residuals quality and indicate the most limiting times for
residuals to meet pathogen and vector attraction reduction requirements (e.g. facilities that land apply multiple times per
year but have an annual sampling frequency, may need to sample during winter months when pathogen reduction is most
likely to be negatively affected by cold temperatures.
THE FOLLOWING ADDITIONAL ITEMS (G to M) ARE REQUIRED FOR DEDICATED PROGRAM ONLY.
F. Program Determination
❑ Dedicated residuals land application programs are ones in which land application sites meet the criteria in 15A NCAC 02T
.110202). Specifically, a residuals land application program is designated as dedicated if any of the following are applicable:
❑ Any land application site certified for the residuals land application program that receives residuals at rates or frequencies
greater than agronomic rates.
❑ Any land application site certified for the residuals land application program that is used primarily for residuals disposal,
and agricultural crop production is of secondary importance.
❑ Any land application site certified for the residuals land application program that receives residuals through fixed irrigation
facilities or irrigation facilities fed through a fixed supply system.
❑ Please contact the Non -Discharge Permitting Unit if you need any assistance in determining whether your residuals program
falls under the dedicated program definitions.
G. Program Information
Provide an explanation of why a dedicated system is required instead of a conventional non -dedicated system.
❑ Provide an explanation of the dedicated system and its operation.
H. Detailed Site Maps (All New or Modification Application Packages)
❑ Submit three (3) sets of standard size plans and two (2) sets of I V by 17" plans (electronic format is acceptable - Adobe PDF
only). For Modifications, submit plans specific to the modification(s) only.
❑ Plans must include the following minimum items:
❑ A general location map, a vicinity map and a topographic map with contours not exceeding 10 feet or 25% of the total site
relief and showing all facility related structures and fences within the land application area.
❑ The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of the land application site(s).
❑ Delineation of the review and compliance boundaries
❑ Setbacks as required by 15A NCAC 02T .1108
❑ Site property boundaries within 500 feet of all waste treatment, storage, and disposal site(s).
❑ A map showing the entire irrigation area with an overlay of the suitable irrigation area depicted by the soil scientist's
evaluation. The irrigation plans shall show each nozzle/emitter and wetted area (when applicable). Clearly label spray
irrigation zones as they will be operated.
❑ Plans must depict a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT FOR
CONSTRUCTION, etc.) that indicate that they are anything other than final plans. However, the plans may be labeled with
the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 2 of 3

L Project Evaluation and Receiver Site Management Plan (All New Application Packages or Modifications that include new sites)
❑ Submit a project evaluation and a receiver site management plan (if applicable) with recommendations concerning cover crops
and their ability to accept the proposed application rates.
J. Hydrogeologic Report (All New Application Packages or Modifications involving increasing the total design capacity)
❑ Submit a detailed hydrogeologic evaluation in accordance with 15A NCAC 02T .1104(d)(4) and current Division Policy
available at: http://www.ncwater.org/Rules_ Policies_ and_Regulations/. The document shall be signed, sealed and dated by a
qualified professional.
K. Engineering Design Documents (All New or Modification Application Packages with fixed irrigation facilities or irrigation
facilities fed through fixed supply system)
Submit engineering design documents that have been signed, sealed, and dated by a NC licensed Professional Engineer and/or
Professional Land Surveyor in accordance with 15A NCAC 02T .1104(d)(2). For Modifications, submit an updated site map
specific to the modification(s) only.
❑ The design documents must include the following minimum items:
❑ Engineering plans for the facility and equipment except those previously permitted unless they are directly tied into the new
units or are critical to the understanding of the complete process;
❑ Specifications describing materials to be used, method of construction, and means for ensuring quality and integrity of the
finished product including leaking testing; and
❑ Engineering calculations including hydraulic and pollutant loading, sizing criteria, hydraulic profile, total dynamic head
curve analysis for each pump, and irrigation design.
❑ Soil mapping units shown on all disposal sites.
L. Water Balance (All New Application Packages or Modifications that include new sites utilizing fixed irrigation facilities or
irrigation facilities fed through fixed supply systems)
❑ Submit a completed and accurate water balance in accordance with 15A NCAC 02T .I 104(d)(5) and current Division Policy
available at: http://www.ncwater.org/Rules_Policies_and_Regulations/.
M. Property Ownership Documentation (All New or Modification Application Packages involving new and/or relocated treatment
or irrigation components)
❑ Property ownership documentation shall consist of one of the following:
❑ Legal documentation of ownership (i.e., GIS, deed or article of incorporation), or
❑ Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or
❑ An easement running with the land specifically indicating the intended use of the property and meeting the requirements of
15A NCAC 02L .0107(f), or
❑ A written notarized lease agreement signed by both parties, indicating the intended use of the property, as well as a plat or
survey map.
ONE ORIGINAL AND TWO COPIES OF THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL
SUPPORTING INFORMATION AND MATERIALS, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service:
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
TELEPHONE NUMBER: [phone]
By Courier/Special Delivery:
512 N. SALISBURY STREET
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 3 of 3

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .1100 — RESIDUALS LAND APPLICATION PROGRAM
FORM: RLAP 06-16
L APPLICANT INFORMATION:
1. Applicant's name: U.S. Biosolids, Inc.
Applicant type: ❑ Individual 1§ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal E7 State ❑ Municipal ❑ County
Signature authority's name per 15A NCAC 02T .0106: Zach Key Title: President
Applicant's mailing address: PO Box 146
City: Ronda State: NC
Zip: 28670-0146
Telephone number: [phone]
Email Address: [e-mail]
2. Consultant's name: Mq
License Number (for P.E.):
Affiliation: ❑ On Staff ❑ Retained (Firm: )
Consultant's mailing address:
City: State:
Zip: -
Telephone number: (_) _-
Email Address:
3. Agronomist's name:
License Number:
Affiliation: ❑ N/A ❑ On Staff
❑ Retained (Firm: �)
Agronomist's mailing address:
City: State:
Zip: -
Telephone number: (_) _-
Email Address:
4. Soil Scientist's name:
License Number:
Affiliation: ❑ N/A ❑ On Staff
❑ Retained (Firm: =
Soil Scientist's mailing address:
City: State:
Zip: -
Telephone number: (_) _-
Email Address:
5. Fee submitted: (See Instruction B)
IL PERMIT INFORMATION:
1. Application is for (check all that apply): ❑ new, ❑ modified, ® renewed permit
2. If this application is being submitted to renew or modify an existing permit, provide the following:
Permit number: W00037135
Date of most -recently issued permit: 5-7-2019
Date of most -recently certified Attachment A (if different than the permit): 10-11-2023
Date of most -recently certified Attachment B (if different than the permit): 10-11-2023
FORM: RLAP 06-16 Page 1 of 5

III. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing Facility's physical address: 100 Thurmond Drive
City: N Wilkesboro State: NC Zip: 28659
Coordinates: Latitude: 36° 69' 44.37" Longitude: 81° 08' 04.12"
Datum: NAD 83 Level of accuracy:.01
Method of measurement: MAP
2. County where residuals land application program is headquartered: Wilkes
3. List the Operator In Responsible Charge (ORC) and all Back -Up ORCs for the residuals land application program, their
certification numbers, and their affiliations in the following table:
Designation
Name
Affiliation
Certification Number
ORC
Zach Key
U.S. Biosolids, Inc.
27660
Back -Up ORC
Dennis Key
U.S. Biosolids, Inc.
15704
Additional Back -Up
ORCs
if applicable)
David Key
U.S. Biosolids, Inc.
23629
If an ORC and at least one Back -Up ORC are not currently designated for this residuals land application program, provide the
candidates' names, affiliations, and an estimated time schedule for each candidate's completion of the required training school
and certification test:
4. Complete the following tables regarding management of the residuals land application program:
a. Plant Available Nitrogen Summary: Determine the maximum plant available nitrogen (PAN) generated by all residuals
source -generating facilities as currently certified and proposed for certification with this application and list the results in the
following table:
Maximum amount of residuals to be certified: 1800 dry tons per year.
PAN
Pounds of PAN per Dry Ton
(Weighted Average)
Pounds of PAN per Year
Surface
Incorporation
or Injection
Surface
Incorporation
or Injection
First -Year
66.468
71.948
119642
129509
Five -Year Maximum Adjusted
103.9314
108.0
187076
194400
b. Land Application Site Use Summary: Summarize information regarding the land application sites as currently certified and
proposed for certification with this application:
Category
Use
Acres
Comments
Crops
Forest or Plantation
0
Row Crops
42.2
Hay
193.18
Pasture
273.79
Total:
509.17
Methods
Surface
466.97
Incorporation or Injection
42.2
Total:
509.17
FORM: RLAP 06-16 Page 2 of 5

c. Residuals Land Application Summary: Determine the minimum acreage required to land apply the residuals as currently
certified and proposed for certification assuming the scenarios listed in the following table:
Assumed
Application Rate
(lbs PAN/ac yr)
Acres Required Using
First -Year PAN Concentrations
Acres Required Using
Five -Year Maximum Adjusted PAN
Concentrations
Surface
Incorporation or
Injection
Surface
Incorporation or
Injection
50
2392.85
2590.13
3741.5
3888.0
100
1196.4
1295.1
1870.8
1944.0
150
797.6
863.4
1247.2
1296.0
200
598.2
647.5
935.4
972
6. If applicable, provide a plan and a schedule to resolve any known issues that would prevent land application of the proposed
residuals due to the violation of North Carolina Administrative Code (e.g. not enough storage, not enough land, vector reduction
practices not in place, etc.): I
7. Specify type of residuals program (See Instruction F): ® Non -dedicated ❑ Dedicated
If Dedicated, specify the following (check all that apply):
❑ Residuals program contains any land application site(s) that receives residuals at rates or frequencies greater than agronomic
rates, explain;
❑ Residuals program contains any land application site(s) that is used primarily for residuals disposal, and agricultural crop
production is of secondary importance, explain;
❑ Residuals program contains any land application site(s) that receives residuals through fixed irrigation facilities or irrigation
facilities fed through a fixed supply system, explain;
IV. RESIDUALS SOURCE INFORMATION: (Required for all new, renewed, or modified residuals source)
Complete and submit the following Residuals Source Certification and all associated documentation.
4
Residuals Source
Certification
V. LAND APPLICATION SITE INFORMATION: (Required for all new, renewed, or modified land application site)
Complete and submit the following Land Applications Site Certification and all associated documentation.
Im
Land Application Siite
Certification. doc
FORM: RLAP 06-16 Page 3 of 5

Note: Item VI. Applicable to Dedicated Program with fixed irrigation system on1X.
VI. DESIGN INFORMATION FOR FIXED IRRIGATION SYSTEM
1. The irrigation system is: ❑ Spray F1 Drip
2. Disposal system is: ❑ existing A proposed.
3. Minimum depth to mean seasonal high water table (SHWT) within irrigation sites(s) per Soil Scientist's Evaluation: feet
below ground surface. Rules 15A NCAC 02T .0505(p) requires at least one -foot vertical separation between SHWT and ground
surface.
4. Are there any artificial drainage or water movement structures within 200 feet of any irrigation area?
❑ Yes or ❑ No If Yes, please explain if the soil scientist report addresses artificial structures and please indicate if
structures are to be maintained or modified:
5. Loading rates recommended by the Soil Scientist Evaluation:
Soil Series
Fields within Soil Area
Recommended
Loading Rate
in/hr
Recommended
Loading Rate
in/vr
6. Design loading rates are equal or less than the loading rates recommended by Soil Scientist?
❑ Yes or ❑ No If No, explain why 15A NCAC 02T .0505(n) is not met:
7. Non -dedicated System Design (fill in the appropriate information for either a spray or drip irrigation system):
Field / Zone
Design Area
(W)
Number of
Nozzles
Maximum Application
Rate allons/hr
Design Annual Loading
Rate allons/ r
Total
Spray Irrigation Design Element
Plan Sheet
Number
Specification
Pa a Number
Wetted diameter of nozzles
ft
Wetted area of nozzles
ft2
Nozzle capacity
gpm
Nozzle manufacturer / model
/
Elevation of highest nozzle
ft
FORM: RLAP 06-16 Page 4 of 5

Applicant's Certification (signing authority must be in compliance with 15A NCAC 02T .0106):
The applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without proper
closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any active
compliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02T .0105.
® Yes a No, Explain;
I,
(Signature Authority's Name — PLEASE PRINT)
attest that this application for U.S. Biosolids, Inc,.
(Facility Name)
(Title)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that the Division of Water Resources
may not conduct a technical review of this program and approval does not constitute a variance to any rules or statutes unless specifically
granted in the permit. Further, any discharge of residuals to surface waters or the land will result in an immediate enforcement action,
which may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water
Resources should a condition of this permit be violated. I also understand that if all required parts of this application are not completed
and that if all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
Note: In accordance with North Carolina General Statutes § 143-215.6A and § 143-215.6B, any person who knowingly makes any false
statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: G' /��
Date: 4-1-2024
FORM: RLAP 06-16 Page 5 of 5

Operation and Maintenance Plan
U.S. Biosolids, Inc.
Permit No. WQ0037135
In accordance to the requirements set forth by the North Carolina
Department of Environmental Quality NCGS 143-215.1 and 143-215.3(a)
based on 15A NCAC 02T .1 10, U.S. Biosolids, Inc. is implementing this
Operation and Maintenance Plan.
The project manager of the land application event will make sure a daily
check off is performed at the start of each work day. This inspection is to
prevent any spills, leaks, or run-offs.
The daily check -off will consist of inspection the following items:
1. Access to the facility will be controlled with a locked gate and
signs to prevent any unauthorized entry into the complex.
2. All pumps and hose will be checked at the start of each day for
leaks or loose fittings.
3. All tanker valves are closed prior to loading and lids are closed
prior to transport.
4. All dump trailers or dump trucks gates are tightly fastened and
do not leak prior to transport.
5. All on road equipment is check as per DOT regulations for any
safety or mechanical hazards or issues.
6. All equipment is secured at the end of each working day to
prevent any tampering or unauthorized use.
The ORC or back up ORC will inspect the field after each land application
event to make sure all regulations as required by the permit are followed.
Also, the project manager at the end of each working day during a land
application event will make sure that all gates if present are closed.
All samples shall be taken as early as possible before the first application
event of the calendar year to make sure the facility is compliance.
The samples will be taken in a matter that is representative of the residuals
and all grab samples will be mixed prior to be placed in to the containers

that will go to the laboratory. These samples must be collected and
transported as outlined in the Sampling Plan attached to this O&M Plan.
All records of these laboratory results as well as the annual report and
loading rates will be kept on file for a minimum of five (5) years.
Also, in the unlikely event of a spill or unintended release of residuals,
actions should be immediately taken as outlined in a copy of the
spill control plan attached.

U.S. Biosolids, Inc.
Permit No. WQ0037135
SAMPLING PLAN
Annually, if a land application event occurs, grab samples are collected from the
digester. Samples from the digester will be combined to form individual grab samples to be sent
to a laboratory for analysis. If a land application event is to occur in the early part of a calendar
year (i.e. January or early February) these samples may have to be taken in December, so results
can be obtained before the land application event, as some results take 30+ days to receive.
These individual grab samples are collected and tested for fecal coliform analysis,
volatile solids reduction, nutrient analysis, and a TCLP test. These tests will be taken by U.S.
Biosolids, Inc. All samples except for the composite residual sample will be taken to a state
certified laboratory. All samples taken will be taken in the same condition as the residuals are to
be land applied.
The volatile solids will first be attempted to be achieved using option 1 [503.33(b)(1)];
38% volatile solids reduction. This option will be attempted first due to it being the most cost
effective. One sample will be taken at the aeration basin and labeled "B". The next sample will
be labeled "A" and be taken from the digester.
If the option 1 cannot be achieved to meet the volatile solids reduction, a 30 day bench
scale option 3 [503.33(b)(3)] test will be used. This sample will be taken from the digester with
the sample being at least a quart in quantity.
If both option 1 and 3 are used and volatile solids reduction cannot be achieved; the
sludge holding tank will be stabilized using sufficient alkaline to meet option 6 [503.33(b)(6)],
commonly known as lime stabilization.
Fecal Coliform is gathered in seven (7) individual samples and tested to meet the
requirements of [503.32(b)(2)]. This requirement is for the geometric mean fecal coliform
density of the samples be less than two million (2,000,000) MPN per gram. These samples will
be placed in 250ml containers and placed on ice, in a cooler for transport to the laboratory
before 1600 hours (4pm) the same day the samples are obtained.
Annually, if land application occurs, a composite residual sample will be analyzed, prior
to a land application event for:
Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum,
Ammonia Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus,
Potassium, TKN, Sodium
From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption
Ratio (SAR) will be calculated. This sample will be collected in a non -breakable container, at
least one quart in size. This sample will be taken from the digester. This test will be done by a
state approved laboratory.

SPILL CONTROL PLAN- U.S. Biosolids, Inc.
U.S. Biosolids, Inc. Permit No. WQ0037135
In the event of a spill, the following should be taken IMMEDITALY.
1. Make sure all personal and bystanders are safe- if not contact emergency
services
2. Halt the source of the spill- overturned truck, leaking valve, ruptured tank.
3. Contain the spill. Use straw bales or earthen barrier to forma dike to
contain the spill.
4. Cleanup. Employ vacuum trucks, dump trucks, and loaders to remove as
much of the spilled material as possible. Use straw to soak -up the
remaining material. Dispose of the same in a landfill.
5. Flush the roadways with water if needed. If the spill occurred on a tillable
area, till the same into the soil and spread lime if necessary. If a spill occurs
on private property, final clean-up should be to the satisfaction of the
owner.
6. Notification. (This should be done as soon as safely possible.)
A. U.S. Biosolids, Inc. Main Office [phone]

B. North Carolina Department of Environmental Quality
(Call appropriate regional office, the counties covered by each
regional office are listed)
Asheville Regional Office Phone: [phone]
Avery, Buncombe, Burke, Caldwell, Cherokee, Clay, Graham, Haywood,
Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Polk,
Rutherford, Swain, Transylvania, Yancey
Mooresville Regional Office Phone: [phone]
Alexander, Cabarrus, Catawba, Cleveland, Gaston, Iredell, Lincoln,
Rowan, Stanly, Union
Winston-Salem Regional Office Phone: [phone]
Alamance, Alleghany, Ashe, Caswell, Davidson, Davie, Forsyth, Guilford,
Randolph, Rockingham, Stokes, Surry, Watauga, Wilkes, Yadkin
C. County Emergency Services (Sheriff, Fire Dept.) 911
7. Reporting:
The Permittee shall report by telephone to the appropriate Regional
Office, as soon as possible, but in no case more than 24 hours or on the
next working day following the occurrence or first knowledge of the
occurrence of any of the following:
A. Surface disposal of residuals abnormal in quantity or characteristic.
B. Any failure of the surface disposal program resulting in a release of
material to surface waters.
C. Any time self -monitoring indicates the facility has gone out of
compliance with its permit limitations.
D. Any process unit failure, due to known or unknown reasons,
rendering the facility incapable of adequate residual treatment

E. Any spill or discharge from a vehicle or piping system during
residuals transportation.
Any emergency requiring immediate reporting (e.g., discharges to
surface waters, imminent failure of a storage structure, etc.) outside of
normal business hours shall be reported to the Division's Emergency
Response personnel at telephone number [phone], [phone],
or [phone]. Persons reporting such occurrences by telephone shall
also file a written report in letter form within five days following first
knowledge of the occurrence. This report shall outline the actions taken or
proposed to be taken to ensure that the problem does not recur.
8. Spill Prevention. The easiest way to clean a spill is to prevent one.
A. Ensure loading personal watch the vehicle being loaded.
B. Ensure all valves and lids are closed
C. Inspect all seals and replace if necessary.

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 11-15, FORM: DCAR 11-15, or FORM: SDR 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 11-15):
❑ Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 11-15) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
❑ For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
❑ Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
B. Residuals Source -Generating Facility Information:
❑ For each source facility, attach the following:
❑ Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
❑ Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
❑ Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
❑ Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
❑ For each source facility, attach the following:
❑ Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 06-16 Page 1 of 1

RESIDUALS SOURCE FACILITY SUMMARY
Applicant's name: U.S. Biosolids, Inc.
Status
Code
Facility Permit Holder
Facility Name
County
Permit Number
Maximum Dry Tons Per Year
Current n
Proposed
R
Baxter Healthcare
Baxter Healthcare
Corporation
McDowell
NC0006564
100
100
R
Yadkin Valley Sewer
rity
YVSA WWTP
Surry
NCO020567
100
200
R
Town of Spindale
Spindale WWTP
Rutherford
NCO020664
100
100
R
Town of North Wilkesboro
Thurmond St. WWTP
Wilkes
NCO020761
300
300
R
City of Belmont
Belmont WWTP
Gaston
NCO021181
300
300
D
City of Lowell
Lowell WWTP
Gaston
NCO025861
200
0
R
Town of Rutherfordton
Rutherfordton WWTP
Rutherford
NCO025909
100
100
R
Town of Forest City
Forest City WWTP
Rutherford
NCO025984
300
400
R
Town of Dallas
Dallas WWTP
Gaston
NCO068888
100
100
R
City of Marion
Corpening Creek WWTP
McDowell
NCO031879
200
200
'Status Code for source facility are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ D (Deleted)
b The amount of residuals currently permitted for distribution, land application, or disposal (i.e, not applicable to new facility).
SUMMARY FOR FORM: RSC 06-16 Page 1

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: City of Belmont
2. Facility permit holder is: ❑ Federal, 0 State, 0 Local Government, or 0 Private.
Facility permit issued by: ® Div. of Water Resources, Div. of Environmental Health,
or JA Other (explain: _).
3. Facility contact person and title: Tanya Setzer, WWTP Superintendent-ORC
Complete mailing address: PO Box 431
City: Belmont State: NC Zip: 28012
Telephone number: [phone] E-mail address: tsetzer&cityofbehnont.org
4. Facility physical address: 298 Parkdale Drive
City: Belmont State: NC Zip: 28012
Coordinates: Latitude: 35' 13' 50.04" Longitude: 81' OF 03.61"
Datum: NAD83 Level of accuracy: 0.01
Method of measurement: MAP
5. Purpose of the facility:
® treatment of municipal wastewater, treatment of 100% domestic wastewater,
❑ treatment of potable water, treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: _ % industrial and _ % domestic)
other (explain: _ ).
6. Does the facility have an approved pretreatment program: Yes No
7. Facility permitted/design flow: 5 MGD and facility average daily flow: 3.2 MGD
8. Average amount of residuals being generated at this facility _ dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 1.7 Million Gallon Sludge Holding Tank
Type and volume of residuals storage (i.e., outside of residuals treatment units): _
II. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part 503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological N Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: 0 yes ❑ no.
If yes, list the number(s): _
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: n yes Ui no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: PAR and Date of analysis: 4-26-2023
Passed corrosivity test: yes no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: yes no. Flashpoint: 200 OF (> 140°F)
Passed reactivity test: Eyes Eno. HCN: NON mg/kg (<250) & H2S: NON mg/kg (<500)
TCLP Parameter
Limit
(m917)
Result
(mg/7)
TCLP Parameter
Limit
(m917)
Result
(m917)
Arsenic
5.0
0.5
Hexachlorobenzene
0.13
0.013
Barium
100.0
10
Hexachloro-1,3-Butadiene
0.5
0.05
Benzene
0.5
0.05
Hexachloroethane
3.0
0.3
Cadmium
1.0
0.1
Lead
5.0
0.5
Carbon Tetrachloride
0.5
0.05
Lindane
0.4
0.04
Chlordane
0.03
0.003
Mercury
0.2
0.1
Chlorobenzene
100.0
10
Methoxychlor
10.0
1
Chloroform
6.0
0.6
Methyl Ethyl Ketone
200.0
318
Chromium
5.0
0.5
Nitrobenzene
2.0
0.2
m-Cresol
200.0
20
Pentachlorophenol
100.0
10
o-Cresol
200.0
20
Pyridine
5.0
0.5
p-Cresol
200.0
20
Selenium
1.0
0.5
Cresol
200.0
20
Silver
5.0
0.5
2,4-D
10.0
1
Tetrachloroethylene
0.7
0.07
1,4-Dichlorobenzene
7.5
0.75
Toxaphene
0.5
0.05
1,2-Dichloroethane
0.5
0.05
Trichloroethylene
0.5
0.05
1, 1 -Dichloroethylene
0.7
0.07
2,4,5-Trichlorophenol
400.0
40
2,4-Dinitrotoluene
0.13
0.013
2,4,6-Trichloropheno1
2.0
0.2
Endrin
0.02
0.002
2,4,5-TP (Silvex)
1.0
0.1
Heptachlor and its Hydroxide
0.008
0.008
Vinyl Chloride
0.2
0.02
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Waypoint Analytical and Date of analysis: 3-16-2023
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mglkg)
Monthly Average
Concentration Limits
(Class A Only)
(mglkg)
Result
(mglkg)
Arsenic
75
41
16.7
Cadmium
85
39
3.33
Copper
4,300
1,500
329
Lead
840
300
17.7
Mercury
57
17
6.17
Molybdenum
75
n/a
8.33
Nickel
420
420
21.1
Selenium
100
100
16.7
Zinc
7,500
2,800
1880
b. For Surface Disposal Unit (landfill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: = and Date of analysis: =
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
❑ > 0 but < 25
30
200
210
❑ > 25 but < 50
34
220
240
❑ > 50 but < 75
39
260
270
❑ > 75 but < 100
46
300
320
❑ > 100 but < 125
53
360
390
❑ > 125
62
450
420
Result (mg4g)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 3.04 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Waypoint Analytical and Date of analysis: 3-16-2023
Parameter
Result
(mglkg)
Aluminum
43700
Ammonia -Nitrogen
330
Calcium
16500
Magnesium
4130
Nitrate -Nitrite Nitrogen
343
pH (Standard Unit)
6.4
Phosphorus
27900
Potassium
4570
Sodium
5400
Total Kjeldahl Nitrogen
14900
c. Using the results listed in Item IL 5b. above, calculate the sodium adsorption ration (SAR): 1.69
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 30 %. This
rate is a (check one): JW default value, or 0 actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, ex lain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals:
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (15) Year PAN
Five -Year
Maximum Adjusted PAN
(mg1kg)
(mglkg)
Surface
5479
7904.189
Injection/Incorporation
7144
9140.578
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses:
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
71 A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
JJ A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
IR Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
q Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
q Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
q Alternative 4 [15A NCAC 02T.I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 5 [15A NCAC 02T.1106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: composting, i heat drying, II heat treatment,
thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
Alternative 1 [15A NCAC 02T.I 106(c)(01 - Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T.I 106(c)(2 - Process to Si ficantly Reduce Pathogens (PSRP).
Specify one: El digestion air drying, , anaerobic digestion,
❑ composting, or lime stabilization.
c. For Surface Disposal:
11 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
J Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
J Exempt -If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
J Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
5 Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
El Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
El Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
El Alternative 5 [15A NCAC 02T. I 107(a)(5)] - 14-Day Aerobic Processes.
El Alternative 6 [15A NCAC 02T. 1107(a)(6)] - Alkaline Stabilization.
El Alternative 7 [15A NCAC 02T.I 107(a)(7)] - Drying of Stabilized Residuals.
El Alternative 8 [15A NCAC 02T.I 107(a)(8)] - Drying of Unstabilized Residuals.
El Alternative 9 [15A NCAC 02T. I 107(a)(9)] - Injection.
El Alternative 10 [15A NCAC 02T.I 107(a)(10)] - Incorporation.
q Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(b)(2)].
id Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

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Quantitative Justification for Residuals Production Rate:
In the11 last years, the City of Belmont Wastewater Treatment Plant has produced the following
number of residuals in Dry Tons per year.
YEAR
DRY TONS
2013
85.7
2014
99.26
2015
164.98
2016
213.85
2017
116.5
2018
54.04
2019
84.76
2020
40.68
2021
144.82
2022
152.53
2023
97.22
This is an average of 84.03 Dry Tons per year, which is less than the 300 dry tons currently allowed by
permit WQ0003281. This will allow any growth that the Wastewater Treatment Plant may occur during
the next permit cycle.

U.S. Biosolids, Inc.
Permit No. WQ0037135
SAMPLING PLAN
Annually, if a land application event occurs, grab samples are collected from the digester. Samples
from the digesterwill be combined to form individual grab samples to be sent to a laboratoryfor
analysis. If a land application event is to occur in the early part of a calendar year (i.e. January or
early February) these samples may have to be taken in December, so results can be obtained
before the land application event, as some results take 30+ days to receive.
These individual grab samples are collected and tested for fecal coliform analysis, volatile solids
reduction, nutrient analysis, and a TCLP test. These tests will be taken by U.S. Biosolids, Inc. All
samples except for the composite residual sample will be taken to a state certified laboratory. All
samples taken will be taken in the same condition as the residuals are to be land applied.
The volatile solids will first be attempted to be achieved using option 1 [503.33(b)(1)]; 38%volatile
solids reduction. This option will be attempted first due to it being the most cost effective. One
sample will betaken at the aeration basin and labeled "B". The next sample will be labeled "A" and
be taken from the digester.
If option 1 cannot be achieved to meet the volatile solids reduction, a 30 day bench scale option 3
[503.33(b)(3)] test will be used. This sample will be taken from the digester with the sample being at
least a quart in quantity.
If both option 1 and 3 are used and volatile solids reduction cannot be achieved; the sludge holding
tank will be stabilized using sufficient alkaline to meet option 6 [503.33(b)(6)], commonly known as
time stabilization.
Fecal Coliform is gathered in seven (7) individual samples and tested to meet the requirements of
[503.32(b)(2)]. This requirement is for the geometric mean fecal coliform density of the samples be
less than two million (2,000,000) MPN per gram. These samples will be placed in 250ml containers
and placed on ice, in a cooler for transport to the laboratory before 1600 hours (4pm) the same day
the samples are obtained.
Annually, if land application occurs, a composite residual sample will be analyzed, prior to a land
application event for:
Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia
Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus, Potassium, TKN,
Sodium
From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption Ratio (SAR) will
be calculated. This sample will be collected in a non -breakable container, at least one quart in size.
This sample will be taken from the digester. This test will be done by a state approved laboratory.

Waypointo
ANALYTICAL
3/29/2023
US Biosolids Inc
Dennis Key
958 Hoots Road
Roaring River, NC, 28669
Ref: Analytical Testing
Report Number: 23-080-0005
Project Description: Belmont
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Dear Dennis Key:
Waypoint Analytical Virginia, Inc. received sample(s) on 3/21/2023 for the analyses presented in the following
report.
The above referenced project has been analyzed per your instructions. The analyses were performed in
accordance with the applicable analytical method. Sub -contracted testing is noted on the Sample Summary Table
if applicable.
The analytical data has been validated using standard quality control measures performed as required by the
analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all
parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA
(including 40 CFR 136 Method Update Rule May 2012) and NELAC unless otherwise indicated.
Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of
sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time
Refer to sample analysis time for confirmation of holding time compliance.
The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as -
received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to
the samples included in this report.
Please do not hesitate to contact me or client services if you have any questions or need additional information
Sincerely,
&;'-� ­AldA�
Brandi Watson
Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the
analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis.
Page 1 of 7

•
7621 Whitepine Road, Richmond, VA 23237
Waypoint
Main 804-743-9401 0 Fax [phone]
ANALYTICAL www.waypointanalytical.com
Sample Summary Table
Report Number: 23-080-0005
Client Project Description: Belmont
Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID
61416
Belmont
Solids
03/16/202310:30
03/21/2023
61416
Belmont
Solids
03/16/202310:30
03/21/2023
61416
Belmont
Solids
03/16/202310:30
03/21/2023
61416
Belmont
Solids
03/16/202310:30
03/21/2023
61416
Belmont
Solids
03/16/202310:30
03/21/2023
61416
Belmont
Solids
03/16/202310:30
03/21/2023
61416
Belmont
Solids
03/16/202310:30
03/21/2023
61416
Belmont
Solids
03/16/202310:30
03/21/2023
SM-4500-NH3C
WP MTN
9045D
WP MTN
4500NO3F-2011
WP MTN
6010D
WP MTN
SW-7471B
WP MTN
SM-4500-NH3C-TKN
WP MTN
SM-2540G
WP MTN
WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN
Page 2 of 7

Waypointo
ANALYTICAL
46381
US Biosolids Inc
Project Belmont
Dennis Key
958 Hoots Road
Information
Roaring River , NC 28669
Report Number : 23-080-0005 REPORT OFA
Lab No : 61416
Sample ID : Belmont
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Report Date : 03/29/2023
Received : 03/21/2023
Brandi Watson
VALYSIS
Matrix: Solids
Sampled: 3 / 16/ 2023 10:30
Test Results Units MQL DF Date / Time By Analytical
Analyzed Method
Moisture
97.0
%
0.010
1
03/22/2315:43
CJD
SM-2540G
Sulfur
9400
mg/Kg -
dry
333
1
03/25/23 05:46
JTR
6010D
Calcium
16500
mg/Kg -
dry
1670
1
03/25/23 05:46
JTR
6010D
Aluminum
43700
mg/Kg -
dry
167
1
03/25/23 05:46
JTR
6010D
Manganese
823
mg/Kg -
dry
16.7
1
03/25/23 05:46
JTR
6010D
Organic N
148700
mg/Kg -
dry
8333
1
03/28/23 14:00
CALCULATION
Nickel
21.1
mg/Kg -
dry
8.33
1
03/25/23 05:46
JTR
6010D
Lead
17.7
mg/Kg -
dry
10.0
1
03/25/23 05:46
JTR
6010D
Arsenic
<16.7
mg/Kg -
dry
16.7
1
03/28/23 00:13
JTR
6010D
Selenium
<16.7
mg/Kg -
dry
16.7
1
03/25/23 05:46
JTR
6010D
Test
Results
Units
MQL
DF
Date / Time
By
Analytical
Analyzed
Method
Total Solids
3.04
%
0.010
1
03/22/23 15:43
CJD
SM-2540G
Phosphorus
27900
mg/Kg -
dry
167
1
03/25/23 05:46
JTR
6010D
Copper
329
mg/Kg -
dry
16.7
1
03/25/23 05:46
JTR
6010D
Total Kjeldahl Nitrogen
Qualifiers/ DF Dilution Factor
Definitions
149000 mg/Kg - dry 8330 1 03/28/23 14:00 CLP ;M-4500-NH3C-TKI`
MQL Method Quantitation Limit
Page 3 of 7

Waypointo
ANALYTICAL
46381
US Biosolids Inc
Project Belmont
Dennis Key
958 Hoots Road
Information
Roaring River , NC 28669
Report Number : 23-080-0005
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
REPORT OFANALYSIS
Report Date : 03/29/2023
Received : 03/21/2023
Brandi Watson
Lab No : 61416
Sample ID : Belmont
Matrix: Solids
Sampled: 3/16/2023 10:30
Potassium
4570
mg/Kg -
dry
333
1
03/25/23 05:46
JTR
6010D
Magnesium
4130
mg/Kg -
dry
167
1
03/25/23 05:46
JTR
6010D
Sodium
5400
mg/Kg -
dry
833
1
03/25/23 05:46
JTR
6010D
Iron
22900
mg/Kg -
dry
333
1
03/25/23 05:46
JTR
6010D
Zinc
1880
mg/Kg -
dry
41.7
1
03/25/23 05:46
JTR
6010D
Ammonia Nitrogen
<3330
mg/Kg -
dry
3330
1
03/28/23 15:30
CLP
SM-4500-NH3C
Nitrate+Nitrite-N
343
mg/Kg -
dry
167
1
03/23/23 14:36
ZBD
4500NO3F-2011
Cadmium
<3.33
mg/Kg -
dry
3.33
1
03/25/23 05:46
JTR
6010D
Chromium
60.3
mg/Kg -
dry
8.33
1
03/25/23 05:46
JTR
6010D
Mercury
<6.17
mg/Kg -
dry
6.17
1
03/27/23 12:22
FDS
SW-7471B
pH
6.4
S.U.
1
03/27/2317:15
CNB
9045D
Molybdenum
<8.33
mg/Kg -
dry
8.33
1
03/25/23 05:46
JTR
6010D
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 4 of 7

Waypointo
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Client: US Biosolids Inc CASE NARRATIVE
Project: Belmont
Lab Report Number: 23-080-0005
Date: 3/29/2023
Metals Analysis Method 601 OD
Sample 61454 (Tyson Blowntsville)
Analyte: Aluminum
QC Batch No: 1-672212/1-671763
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 61454 (Tyson Blowntsville)
Analyte: Calcium
QC Batch No: 1-672212/1-671763
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 61454 (Tyson Blowntsville)
Analyte: Potassium
QC Batch No: 1-672521/1-671763
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Solids Total Mercury Analysis - CVAA Method 7471A
Sample 61457 (NG5)
Analyte: Mercury
QC Batch No: 1-672319/1-672056
The matrix spike, matrix spike duplicate and the post digestion spike were all outside of the quality control
acceptance ranges. Matrix interference is suspected
Page 5 of 7

WayPAoInt..
NALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 46381
Customer Name: US Biosolids Inc
Report Number: 23-080-0005
Shipping Method
0 Fed Ex 0 US Postal 0 Lab
0 UPS 0 Client 0 Courier
0 Other:
Thermometer ID:
Shipping container/cooler uncompromised?
* Yes
0 No
Number of coolers/boxes received
Custody seals intact on shipping container/cooler?
0 Yes
0 No
Not Present
Custody seals intact on sample bottles?
0 Yes
0 No
Not Present
Chain of Custody (COC) present?
# Yes
0 No
COC agrees with sample label(s)?
# Yes
0 No
COC properly completed
# Yes
0 No
Samples in proper containers?
# Yes
0 No
Sample containers intact?
# Yes
0 No
Sufficient sample volume for indicated test(s)?
# Yes
0 No
All samples received within holding time?
# Yes
0 No
Cooler temperature in compliance?
# Yes
0 No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
# Yes
0 No
Water - Sample containers properly preserved
Yes
0 No
0 N/A
Water - VOA vials free of headspace
0 Yes
0 No
N/A
Trip Blanks received with VOAs
0 Yes
0 No
N/A
Soil VOA method 5035 — compliance criteria met
0 Yes
0 No
0 N/A
F_ High concentration container (48 hr)
F_ High concentration pre -weighed (methanol -14 d)
F_ Low concentration EnCore samplers (48 hr)
F_ Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included? 0 Yes * No
Comments:
Signature: IDavid Lennon Date & Time: 03/21/2023 09:36:40
Page 6 of 7

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Page 7 of 7

PA
PROMPT•ACCURATE-RELIABLE
]LAB 0RATQRIES, INC
WWW.PARItABS.COM
REPORT OF ANALYSES
Attn: ZAC KEY
U.S. BIOS LIDS, INC.
PO BOX 146
RONDA, NC 28670-
SAMPLE NU ER- 146747 SAMPLE ID- BELMONT
DATE SAMP ED- 03Z16/23
DATE RECE VED- 03/16/23 SAMPLER- ZK
TIME RECE VED- 1120 DELIVERED BY- ZK
Page 1 og 1
ANALYSIS
FECAL COL)FORM (GEOM. MEAN)
PROJECT NAME: MAR 23
DATE: 04/26/23
ANALYSIS
METHOD DATE TIME BY
SAMPLE MATRIX- WW
TIME SAMPLED- 1030
RECEIVED BY- DJ
TYPE SAMPI•E- Grab
RESULT UNITS
SM 9221 E 03/16/23 1620 RE 250,495 MPN/g
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PAR
• RELIAE3 i...E
LA..BOR-A"T"o.purs, .ING
2217 Graham Park Drive
PO Box 411483
Charlotte, NC 28241-1483
NC Cert # 20; SC Cert # 99003001
U.S. BIOSOLIDS
T •
BELMONT
A
03/16/23
FECAL COLIFORM, GEOMETRIC MEAN
03=1•
SM 9221 E
146747 1 1
5.030 1 3.17%
158,833.16
2
9,966
3.14%
317,456.02
3
12,500
3.20%
390,724.88
4
7,407
3.51 %
211,037.25
5
7,532
3.18%
236,851.12
6
8,969
3.10%
289,310.00
7
6.994
3.22%
217,217.53

CHAIN OF CUSTODY
Phone [phone]
PROMPT-AAURAT
-RCLIAOLt Fax [phone]
LABORATORIES,
INC
Shipping
8 Mailing:
2217 Graham
Park Drive
Charlotte,
NC 28273
It is essential
that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
Carolina qepartment
of Environmental and Natural Resources.
Company Name I
billing) Comments/ Special Instructions
U.S. Bi
solids, Inc.
Address
PO Bo
146
........
code
—....._�
City, State & zip
Ronda
NC 28670
EL Telephone Number
Point of Contact
Zach
Key 336-467-3550
Sample
Taken By:
01
SIGNATURE PRINTED NAME
ARE SAMPLES
FOR STAT or EPA REPORTING? YES � NO
'Sample Ty
: oW WW _� GWMW ___ HW sal _ Other
m Sample Teat
time of sampling: ° C Sample Temp upon receipt: ° C
"Field Preserved:
Yes No Teflon Liner/Zero Headspace: Yes We
Residual Chorine
_No �
checked at time of sampling (Y/N): Dechlorination Necessary (YIN):
IienY ratfple LID,
sair" I_ocialtim
.-Ni mblerj
comP
Gnob
Pmesetw
SBtiSp
0969Ti a
F ll+ o
fJatelrine
[yeas
D
13 im.�
!"
to a
Fcc.►
i
r
I
S
Relinquished by:
Datef-rime Re iv
3-16-33
d by: / DateMme
03-1&'2-T 11-2
Relinquished V.Date/Time
Received by: Date/Time
C=Composite C =Grab
DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

i
PROMPT.ACCUR TE•RELIABLE
LABORAT RIES, INC
WWW.PAR ABS.COM
REPORT OF ANALYSES
Attn: ZAC KEY
U.S. BIOS LIDS, INC.
PO BOX 14
RONDA, NC 28670-
SAMPLE NU BER- 146746 SAMPLE ID- BELMONT
DATE SAMP ED- 03/16/23
DATE RECE VED- 03/16/23 SAMPLER- ZK
TIME RECE VED- 1120 DELIVERED BY- ZK
Page 1 of 2
ANALYSIS I METHOD
PROJECT NAME: MAR 23
DATE: 04/26/23
SAMPLE MATRIX- WW
TIME SAMPLED- 1030
RECEIVED BY- DJ
TYPE SAMPLE- Grab
ANALYSIS
DATE TIME BY RESULT UNITS
TCLP CHA
CTERISTICS
TCLP
04/04/23
1149
CB
pH VALUE
TCLP
04/04/23
1149
CB
CORROSIVI
Y
TCLP
04/04/23
1149
CB
REACTIVIT
TCLP
04/04/23
1149
CB
FLASH POI
T
TCLP
04/04/23
1149
CB
IGNITABIL
TY
TCLP
04/04/23
1149
CB
PAINT FIL
ER TEST
TCLP
03/23/23
0926
CB
TCLP METALS
TCLP
03/27/23
1158
JR
ARSENIC
TCLP
03/27/23
1158
JR
BARIUM
TCLP
03/27/23
1158
JR
CADMIUM
TCLP
03/27/23
1158
JR
CHROMIUM
TCLP
03/27/23
1158
JR
LEAD
TCLP
03/27/23
1158
JR
MERCURY
TCLP
03/27/23
1158
JR
SELENIUM
TCLP
03/27/23
1158
JR
SILVER
TCLP
03/27/23
1158
JR
TCLP PESTICIDES
TCLP
03/25/23
1558
VC
ENDRIN
TCLP
03/25/23
1558
VC
LINDANE
TCLP
03/25/23
1558
VC
METHOXYCH
OR
TCLP
03/25/23
1558
VC
TOXAPHENE
TCLP
03/25/23
1558
VC
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]
6.6 S.U.
NON
NON
> 200 degrees F
NON
FL
< 0.5 ppm
< 10 ppm
< 0.1 ppm
< 0.5 ppm
< 0.5 ppm
< 0.02 ppm
< 0.1 ppm
< 0.5 ppm
< 0.002 ppm
< 0.04 ppm
< 1 ppm
< 0.05 ppm

PROMPT•ACCUR TE•RELIABLE
LAB! RIES, INC
Page 2 of 2
CONTINUAT ON OF DATA FOR SAMPLE NUMBER 146746
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
CHLORDANEI
TCLP
03/25/23
1558
VC
< 0.003
ppm
HEPTACHLOR
(AND ITS EPDXIDE)
TCLP
03/25/23
1558
VC
< 0.0008
ppm
TCLP HERBICIDES
TCLP
03/29/23
2107
VC
2,4-D
TCLP
03/29/23
2107
VC
< 1
ppm
2,4,5-TP(
ILVEX)
TCLP
03/29/23
2107
VC
< 0.1
ppm
TCLP ORGA
ICS
TCLP
03/28/23
1852
MS
BENZENE
TCLP
03/28/23
1852
MS
< 0.05
ppm
CARBON TE
RACHLORIDE
TCLP
03/28/23
1852
MS
< 0.05
ppm
CHLOROBEN
ENE
TCLP
03/28/23
1852
MS
< 10
ppm
CHLOROFOR
TCLP
03/28/23
1852
MS
< 0.6
ppm
o-CRESOL
TCLP
03/28/23
1852
MS
< 20
ppm
p-CRESOL
TCLP
03/28/23
1852
MS
< 20
ppm
m-CRESOL
TCLP
03/28/23
1852
MS
< 20
ppm
1,4-DICHL
ROBENZENE
TCLP
03/28/23
1852
MS
< 0.75
ppm
1,2-DICHL
ROETHANE
TCLP
03/28/23
1852
MS
< 0.05
ppm
1,1-DICHL
ROETHYLENE
TCLP
03/28/23
1852
MS
< 0.07
ppm
2,4-DINIT
OTLUENE
TCLP
03/28/23
1852
MS
< 0.013
ppm
HEXACHLOR
BENZENE
TCLP
03/28/23
1852
MS
< 0.013
ppm
HEXACHLOR
BUTDIENE
TCLP
03/28/23
1852
MS
< 0.05
ppm
HEXACHLOR
ETHANE
TCLP
03/28/23
1852
MS
< 0.3
ppm
METHYL ET
YL KETONE
TCLP
03/28/23
1852
MS
318
ppm
NITROBENZENE
TCLP
03/28/23
1852
MS
< 0.2
ppm
PENTACHLO
OPHENOL
TCLP
03/28/23
1852
MS
< 10
ppm
PYRIDINE
TCLP
03/28/23
1852
MS
< 0.5
ppm
TETRACHLO
ETHYLENE
TCLP
03/28/23
1852
MS
< 0.07
ppm
TRICHLORO
THYLENE
TCLP
03/28/23
1852
MS
< 0.05
ppm
2,4,5-TRI
HLOROPHENOL
TCLP
03/28/23
1852
MS
< 40
ppm
2,4,6-TRI
HLORPHENOL
TCLP
03/28/23
1852
MS
< 0.2
ppm
VINYL CHLORIDE
TCLP
03/28/23
1852
MS
< 0.02
ppm
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

FPROMPr•AC URAT •RELIABLE
DRIES, INC
Shipping it Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It Is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
Carolina Devartment of Environmental and Natural Resources.
Company Name
U.S. B
Address
PO Bo
—
[billing) Comments/ Special Instructions
osolids, Inc.
146 _..... .....
code
NC 28670
@ Telephone Number
ey 336-467-3550
_
City, State @ zip
Ronda
Point of Contact
Zach
Sample
Taken By:
�j
SIGNATURE C PRINTED NAME Zc Z k_
ARE SAMPL
`Sample Ty
Sample Tern
"Field Pres
Residual Ch
S FOR STATE or EPA REPORTING? YES NO
DW WW 110 GWMW _ HW Sail Other
at time of sampling: ° C Sample Temp upon receipt: ° C
rved: Yes No Teflon LinerlZero Headspace: Yes No n/a
orine checked at time of sampling (YIN): Dechlorination Necessary (YIN):
Neff V.,
Sapmle Location
hiurftber)
compGrab
.i?reeer+r-•
58t llp ...
kiirrte..
abUec�itin
E?r'fTiC4te
(yeas
� rl1 o
p :!a •fr`
C
i
I
i
i
)
Relinquished by:
Daterrime Re v d by: Date rime
3-E21 IIIQa d3-lb , J &&
Relinquished by:
dr
Datelrime Received by: Date(Tirne
C=Composite C =Grab
DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

AK
PLL
PROMPT -ACCURATE -RELIABLE
LABORATORIES, INC
WWW.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
SAMPLE NUMBER- 146748 SAMPLE ID- BELMONT
DATE SAMPLED- 03/16/23
DATE RECEIVED- 03/16/23 SAMPLER- ZK
TIME RECEIVED- 1120 DELIVERED BY- RE
Page 1 of 1
ANALYSIS METHOD
30 DAY BENCH SCALE TEST VAR
PROJECT NAME: MAR 23
DATE: 05/02/23
SAMPLE MATRIX- WW
TIME SAMPLED- 1030
RECEIVED BY- DJ
TYPE SAMPLE- Grab
ANALYSIS
DATE TIME BY RESULT UNITS
03/16/23 1620 RE 3.27 %
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PA48L
C CURATE -RELIABLE
LABORATORIES, INC
WWW. PARLABS. COM
30 Day Bench Scale Extended Aeration Test
Percent Volatile Solids Reduction
U.S. BIOSOLIDS, INC.
BELMONT
146748
03/16/23
04/17/23
Start: End:
TS (
0.1683
0.1644
TS%
1.70%
1.69%
VS ()
0.0965
0.0917
VS%
57.34%
55.78%
y Mass Fraction of Volatile Solids in Liquid Sludge
0.0097455
0.0094264
x Mass Fraction of Fixed Solids in Liquid Sludge
0.0072511
0.0074733
FSVR (Mass Balance)
3.28%
FSVR (Van Kleeck)
3.27%
FSVR (Mass Balance) <15%
YES
FSVR (Van Kleeck) <15%
YES
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] • Fax: [phone]S

PROMPT ACCU RATE• RELIABLE
LABORATORIES, INC
W W W.PARLASS.COM
Collected
D.O.
Crucible
Tare Wt (g)
Sample Wt +
Tare Wt (g)
Liquid Sludge W1
(g)
Oven Temp °C
Date/Time In
Date/Time Out
Dried Sample W1
+ Tare Wt (g)
Dried Sludge Wt (g
Fixed Solids Wt (g
Furnace Temp °C
Date/Time In
Date/Time Out
Burned Sample
Wt + Tare Wt (g)
Volatile Solids Wt (g
TS%
VS%
30 Day Bench Scale Extended Aeration Test
VAR Ontinn 3 PPrrrtAnt Vnlatile Snlids Reduction
CLIENT NAME: , U.S. IBIOSOLIDS,
SAMPLE ID: WMI•
SAMPLE #:
START DATE:
END DATE:
As Received Day 0 Day 7 Day 14 Day 21 Day 28
nzf4aroz n2r9nf91% n3/97191 A&A-1193 nd/1nf23 04/17/23
3.00
3.88
4.12
4.90
5.40
X2
X27
X9
X16
X23
X30
25.0668
17.4243
15.5322
22.6968
15.9252
18.3499
34.9700
27.3263 1
25.3330
32.8597
25.2509
28.0779
9.9032
9.9020
9.8008
10.1629
9.3257
9.7280
106
105
105
107
106
106
03/16/23 16:20
03/20/23 08:50
03/27/23 09:00
04/03/23 09:40
04/10/23 09:30
04/17/23 08:30
03/17/23 16:15
03/21 /23 09:00
03/28/23 09:05
04/04/23 10:00
04/11 /23 09:25
04/18/23 08:45
25.3447
17.5926
15.6969
22.8706
16.0856
18.5143
0.2779
0.1683
0.1647
0.1738
0.1604
0.1644
0.0718
0.0723
0.0764
0.0708
0.0727
�r
550
550
550
550
550
03/21 /23 15:15
03/28/23 15:00
04/04/23 16:00
04/11 /23 15:05
04/18/23 15:20
03/21 /23 16:30
03/28/23 16:00
04/04/23 17:05
04/11 /23 16:10
04/18/23 16:30
17.4961
15.6045
22.7732
15.9960
18.4226
0.0965
0.0924
0.0974
0.0896
0.0917
2.81 %
1.70%
1 1.68%
1 1.71 %
1.72%
1.69%
57.34%
56.10%
56.04%
55.86%
55.78%
yf Mass Fraction of Volatile Solids in Liquid (Feed)
yb Mass Fraction of Volatile Solids in Liquid (Bottom)
Sludge at Start of Test
0.0097455
Sludge at End of Test
0.0094264
xf Mass Fraction of Fixed Solids in Liquid (Feed) Sludge
xb Mass Fraction of Fixed Solids in Liquid (Bottom)
at Start of Test
0.0072511
Sludge at End of Test
9
0.0074733
TS
TS
0.1644
VS
H68
VS
0.0917
Volatile Fraction In: 0.33729 Volatile Fraction Out: 0.33006
P.O. Box 411483 • Charlotte, NC 28241.1483
Phone: [phone] • Fax: [phone]

M.R
LABORATORIES, INC
Shipping & Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
t.arouna ue arrnent of tnvironmemai ana rvamrai rtesources.
Company Name (billing) ! Comments/ Special Instructions
U.S. Biosolids, Inc. —�
Address
I
PO Box 146
City, State Et zip code
Ronda, NC 28670
Point of Contact Et Telephone Number
Zach Key 336-467-3550
Sample
Taken By:
SIGNATURE
PRINTED NAME Z
ARE SAMPLES FOR STATE or EPA REPORTING? YES W NO
`Sample Type: DW WW GWMW _ HW Soil — Other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (YIN): Uechlorination Necessary (YIN):
' C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two conies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 11-15, FORM: DCAR 11-15, or FORM: SDR 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 11-15):
❑ Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 11-15) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
❑ For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
❑ Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
B. Residuals Source -Generating Facility Information:
❑ For each source facility, attach the following:
❑ Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
❑ Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
❑ Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
❑ Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
❑ For each source facility, attach the following:
❑ Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 06-16 Page 1 of 1

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Baxter Healthcare Corporation
2. Facility permit holder is: ❑ Federal, 0 State, 0 Local Government, or 0 Private.
Facility permit issued by: Div. of Water Resources, Div. of Environmental Health,
or Other (explain:
3. Facility contact person and title: Stephen Taylor
Complete mailing address: PO Box 1390
City: Marion State: NC Zip: 28752
Telephone number: [phone] E-mail address: Stephen_d tavlorkbaxter.com
4. Facility physical address: 65 Pitts Station Road
City: Marion State: NC Zip: 28752
Coordinates: Latitude: 35' 50' 16.93" Longitude: 81. 59' 55.21"
Datum: NAD83 Level of accuracy: 0_1
Method of measurement: MAP
5. Purpose of the facility:
n treatment of municipal wastewater, treatment of 100% domestic wastewater,
❑ treatment of potable water, treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: 81 % industrial and 19 % domestic)
other (explain: _ ).
6. Does the facility have an approved pretreatment program: Yes No
7. Facility permitted/design flow: 1_2 MGD and facility average daily flow: 0.8 MGD
8. Average amount of residuals being generated at this facility 95.2 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 2 Digesters-300,000 gallons
Type and volume of residuals storage (i.e., outside of residuals treatment units): _
II. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part 503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological ❑ Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: 0 yes ® no.
If yes, list the number(s): _
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: P yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: PAR and Date of analysis: 2-16-2023
Passed corrosivity test: yes no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: yes no. Flashpoint: 200 OF (> 140°F)
Passed reactivity test: ® yes ao. HCN: NON mg/kg (<250) & H2S: NON mg/kg (<500)
TCLP Parameter
Limit
(mgfi)
Result
(m917)
TCLP Parameter
Limit
(m917)
Result
(mgfi)
Arsenic
5.0
0.5
Hexachlorobenzene
0.13
0.013
Barium
100.0
10
Hexachloro-1,3-Butadiene
0.5
0.05
Benzene
0.5
0.05
Hexachloroethane
3.0
0.3
Cadmium
1.0
0.1
Lead
5.0
0.5
Carbon Tetrachloride
0.5
0.05
Lindane
0.4
0.04
Chlordane
0.03
0.003
Mercury
0.2
0.02
Chlorobenzene
100.0
10
Methoxychlor
10.0
1
Chloroform
6.0
0.6
Methyl Ethyl Ketone
200.0
196
Chromium
5.0
0.5
Nitrobenzene
2.0
0.2
m-Cresol
200.0
20
Pentachlorophenol
100.0
10
o-Cresol
200.0
20
Pyridine
5.0
0.5
p-Cresol
200.0
20
Selenium
1.0
0.1
Cresol
200.0
20
Silver
5.0
0.5
2,4-D
10.0
1
Tetrachloroethylene
0.7
0.07
1,4-Dichlorobenzene
7.5
0.75
Toxaphene
0.5
0.05
1,2-Dichloroethane
0.5
0.05
Trichloroethylene
0.5
0.05
1,1-Dichloroethylene
0.7
0.07
2,4,5-Trichlorophenol
400.0
40
2,4-Dinitrotoluene
0.13
0.013
214,6-Trichlorophenol
2.0
0.2
Endrin
0.02
0.002
2,4,5-TP (Silvex)
1.0
0.1
Heptachlor and its Hydroxide
0.008
0.0008
Vinyl Chloride
0.2
0.02
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Waypoint and Date of analysis: 2-17-2023
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mglkg)
Monthly Average
Concentration Limits
(Class A Only)
(mglkg)
Result
(mglkg)
Arsenic
75
41
9.93
Cadmium
85
39
0.69
Copper
4,300
1,500
176
Lead
840
300
7.59
Mercury
57
17
1.12
Molybdenum
75
n/a
5.5
Nickel
420
420
22.6
Selenium
100
100
3.45
Zinc
7,500
2,800
161
b. For Surface Disposal Unit (landfill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: = and Date of analysis: =
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
❑ > 0 but < 25
30
200
210
❑ > 25 but < 50
34
220
240
❑ > 50 but < 75
39
260
270
> 75 but < 100
46
300
320
> 100 but < 125
53
360
390
> 125
62
450
420
Result (mg4g)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 14.5 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Waypoint and Date of analysis: 2-17-2023
Parameter
Result
(mg1kg)
Aluminum
1490
Ammonia -Nitrogen
2250
Calcium
9860
Magnesium
4830
Nitrate -Nitrite Nitrogen
38.6
pH (Standard Unit)
7.0
Phosphorus
19200
Potassium
10800
Sodium
3900
Total Kjeldahl Nitrogen
83400
c. Using the results listed in Item IL 5b. above, calculate the sodium adsorption ration (SAR): 3.05
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 30 %. This
rate is a (check one): Ji default value, or ❑ actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, ex lain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals:
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (1st) Year PAN
Five -Year
Maximum Adjusted PAN
(mg1kg)
(mg/kg)
Surface
25510.6
40412.71
Injection/Incorporation
26640.6
41251.82
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses:
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
rl A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
JJ A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
14 Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
J Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
E] Alternative 4 [15A NCAC 02T.I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 5 [15A NCAC 02T.1106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: composting, W heat drying, heat treatment,
thermophilic aerobic digestion, beta ray irradiation,
❑ gamma ray irradiation, or I pasteurization.
b. For Land Application of Class B:
Alternative 1 [15A NCAC 02T.I 106(c)(1)] - Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T.I 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, I
air drying, ❑ anaerobic digestion,
El composting, or lime stabilization.
c. For Surface Disposal:
11 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
J Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
J Exempt -If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
J Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
❑ Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
El Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
E] Alternative 4 [15A NCAC 02T. 1107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
E] Alternative 5 [15A NCAC 02T. I 107(a)(5)] - 14-Day Aerobic Processes.
E] Alternative 6 [15A NCAC 02T. 1107(a)(6)] - Alkaline Stabilization.
E] Alternative 7 [15A NCAC 02T. 1107(a)(7)] - Drying of Stabilized Residuals.
E] Alternative 8 [15A NCAC 02T. 1107(a)(8)] - Drying of Unstabilized Residuals.
Alternative 9 [15A NCAC 02T. 1107(a)(9)] - Injection.
Alternative 10 [15A NCAC 02T. 1107(a)(10)] - Incorporation.
q Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(b)(2)].
id Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

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Quantitative Justification for Residuals Production Rate:
Baxter Healthcare produces the following amount of dry tons per year.
2016 136.19
2017 147.03
2018 167.51
2019 160.39
2020 149.68
2021 121.75
2022 144.45
2023 134.63
This is an eight year average of 145.20 Dry Tons per year. As Baxter Healthcare has its own land
application permit that handles all residuals produced inmost years, the 100 dry tons requested in
this permit is more than ample to serve as a backup for Baxter's current land application program.

U.S. Biosolids, Inc.
Permit No. WQ0037135
SAMPLING PLAN
Annually, if a land application event occurs, grab samples are collected from the digester. Samples
from the digesterwill be combined to form individual grab samples to be sent to a laboratoryfor
analysis. If a land application event is to occur in the early part of a calendar year (i.e. January or
early February) these samples may have to be taken in December, so results can be obtained
before the land application event, as some results take 30+ days to receive.
These individual grab samples are collected and tested for fecal coliform analysis, volatile solids
reduction, nutrient analysis, and a TCLP test. These tests will be taken by U.S. Biosolids, Inc. All
samples except for the composite residual sample will be taken to a state certified laboratory. All
samples taken will be taken in the same condition as the residuals are to be land applied.
The volatile solids will first be attempted to be achieved using option 1 [503.33(b)(1)]; 38%volatile
solids reduction. This option will be attempted first due to it being the most cost effective. One
sample will betaken at the aeration basin and labeled "B". The next sample will be labeled "A" and
be taken from the digester.
If option 1 cannot be achieved to meet the volatile solids reduction, a 30 day bench scale option 3
[503.33(b)(3)] test will be used. This sample will be taken from the digester with the sample being at
least a quart in quantity.
If both option 1 and 3 are used and volatile solids reduction cannot be achieved; the sludge holding
tank will be stabilized using sufficient alkaline to meet option 6 [503.33(b)(6)], commonly known as
time stabilization.
Fecal Coliform is gathered in seven (7) individual samples and tested to meet the requirements of
[503.32(b)(2)]. This requirement is for the geometric mean fecal coliform density of the samples be
less than two million (2,000,000) MPN per gram. These samples will be placed in 250ml containers
and placed on ice, in a cooler for transport to the laboratory before 1600 hours (4pm) the same day
the samples are obtained.
Annually, if land application occurs, a composite residual sample will be analyzed, prior to a land
application event for:
Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia
Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus, Potassium, TKN,
Sodium
From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption Ratio (SAR) will
be calculated. This sample will be collected in a non -breakable container, at least one quart in size.
This sample will be taken from the digester. This test will be done by a state approved laboratory.

p AM
PROMPT•ACCUR TE•RELIABLE
LABORATORIES, INC
W W W.PARL.ABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC. PROJECT NAME: FEB 23
PO BOX 146, DATE: 04/19/23
RONDA, NC 28670-
SAMPLE NUMBER- 146486 SAMPLE ID- BAXTER SAMPLE MATRIX- WW
DATE SAMPLED- 02/16/23 TIME SAMPLED- 0800
DATE RECEIVED- 02/16/23 SAMPLER- ZK RECEIVED BY- DJ
TIME RECEIVED- 1320 DELIVERED BY- ZK TYPE SAMPLE- Grab
Page 1 of', 1
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
30 DAY BEN�H SCALE TEST VAR 02/16/23 1530 RE 6.94 %
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PA&F;Z
PROM PT•ACC'.0 RATE -RE LIABLE
LABORA_'x'ORIES, INC
WWW. PARLABS. COM
30 Day Bench Scale Extended Aeration Test
Percent Volatile Solids Reduction
U.S. BIOSOLIDS, INC.
BAXTER
146486
02/16/23
Start: End:
TS )
0.1306
0.1620
TS%
1.34%
1.33%
VS ()
0.1087
0.1263
VS%
83.23%
77.96%
Mass Fraction of Volatile Solids in Liquid Sludge
0.0111464
0.0103719
Mass Fraction of Fixed Solids in Liquid Sludge
0.0022457
0.0029317
, SVR (Mass Balance)
6.96%
SVR (Van Kleeck)
6.94%
FSVR (Mass Balance) <15%
YES
FSVR (Van Kleeck) <15%
YES
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] • Fax: [phone]

PROM PT•F
Collected
D.O.
Crucible
Tare Wt (g)
Sample Wt +
Tare Wt (g)
Liquid Sludge Wt
(g)
Oven Temp °C
Date/Time In
Date/Time Out
Dried Sample Wt
+ Tare Wt (g)
Dried Sludge Wt (g;
Fixed Solids Wt (g
Furnace Temp °C
Date/Time In
Date/Time Out
Burned Sample
Wt + Tare Wt (g)
Volatile Solids Wt (g;
TS%
VS%
L
R
RIES, INC
30 Day Bench Scale Extended Aeration Test
VAR Ontion 3. Percent Volatile Solids Reduction
CLIENT NAME: U.S. BIOSOLIDS, INC.
SAMPLE ID:
SAMPLE #:
START DATE:
END DATE: 03116/23
As Received Day 0 Day 7 Day 14 Day 21 Day 28
A9/4R/9R A911A193 n9/93/23 n w/23 03/09/23 03/16/23
1.65
2.18
3.90
4.33
5.30
X11
X11
X13
X15
X22
X29
21.0398
21.0398
21.8740
23.1875
17.1742
20.1090
30.7918
30.7918
31.6194
33.0012
27.6179
32.2861
9.7520
9.7520
9.7454
9.8137
10.4437
12.1771
107
106
106
106
105
106
2/16/23 15:30
02/16/23 15:30
02/23/23 09:50
03/02/23 10:05
03/09/23 10:10
03/16/23 09:45
2/17/23 15:20
02/17/23 15:20
02/24/23 10:00
03/03/23 10:00
03/10/23 10:30
03/17/23 10:00
21.1704
21.1704
22.0028
23.3153
17.3110
20.2710
0.1306
0.1306
0.1288
0.1278
0.1368
0.1620
0.0219
0.0221
0.0228
0.0292
0.0357
550
550
550
550
550
%
„ �i/�� ,✓ �' ii'
02/17/23 16:00
02/24/23 15:40
03/03/23 14:55
03/10/23 15:20
03/17/23 14:50
02/17/23 17:05
02/24/23 17:00
03/03/23 16:00
03/10/23 16:30
03/17/23 15:55
21.0617
21.8961
23.2103
17.2034
20.1447
0.1087
0.1067
0.1050
0.1076
0.1263
1.34%
1.34%
1.32%
1.30%
4
1.31 %
1.33%
83.23%
82.84%
82.16%
78.65%
77.96%
yf Mass Fraction of Volatile Solids in Liquid (Feed)
Sludge at Start of Test 0.0111464
Mass Fraction of Fixed Solids in Liquid (Feed) Sludge
at Start of Test
0.0022457
TS
0.1306
VS
0.1087
Volatile Fraction In:
0.62112
Yb Mass Fraction of Volatile Solids in Liquid (Bottom)
Sludge at End of Test 0.010371
xb Mass Fraction of Fixed Solids in Liquid (Bottom)
Sludge at End of Test 0.0029317
TS 0.162
VS 0.1263
Volatile Fraction Out: 0.58617
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] • Fax:[phone]

PROMPT -ACC RATE -RELIABLE
LAB
ORA ORIES, INC
Shippin Et Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
Carolina Department of Environmental and Natural Resources.
Company Name (kfill ) Comments/ Special Instructions
V a i vli�SnC .
Address
City, State 8 zip
Ro"dA�(_ 9S6')0
Point of Contact lietephone Number
�a� �• e 33-6'-yb��3SSU
Sample
Taken By: �IGNATURE
PRINTED NAME Ke
ARE SAMPLgS FOR STATE or EPA REPORTING? YES _;�_NO
*Sample Type: DW WW X— GWMW HW Sou Other
Sample Tem� at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Prese ed: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Chl nine checked at time of sampling (Y/N): Dechlorination Necessary (YIN):
Client Sample I.D.
Sample Location / Number)
Comp
Grab
Preserv:
Set Up
DateMme
Collection
DatelTime
Analyses
Requested
c'm
�; 0�rn
G Pic
* C=Composite
DW=Drinking Water

PA
PROMPT -ACC
LAB O RA
LR
,TE•RE LIA BLE
RIES, INC
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSO18670-
IDS, INC. PROJECT NAME: FEB 23
PO BOX 146 DATE: 04/19/23
RONDA, NC
SAMPLE NU ER- 146487 SAMPLE ID- BAXTER
DATE SAMPL D- 02/16/23
DATE RECEI ED- 02/16/23 SAMPLER- ZK
TIME RECEI ED- 1320 DELIVERED BY- ZK
Page 1 of 1 1
SAMPLE MATRIX- WW
TIME SAMPLED- 0800
RECEIVED BY- DJ
TYPE SAMPLE- Grab
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
FECAL COLI ORM (GEOM. MEAN) SM 9221 E 02/16/23 1600 RE 147,184 MPN/g
r
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

F;Z
PROMPT -AC URATE- RELIASUC
LABC7-roltms' IriCC
2217 Graham Park Drive
PO Box 411483
Charlotte, NC 28241-1483
NC Cert # 20, SC Cert # 99003001
. BIOSOLIDS, INC.
IMRXTER
16/23
CAL COLIFORM, GEOMETRIC MEAN
9221 E
1464817 1 1
2
3
4
L'I
55,938
56,713
55,688
57,172
56,883
58,943
39.71 %
39.00%
37.35%
38.71 %
39.16%
37.94%
38.75%
143,456.68
143,420.64
151,835.22
143,859.85
145,994.67
149,928.36
152,111.20

PROMPT -ACC
LABORA
Shipping
2217 Gr
Charlotte,
It is essenti
Carolina De
CHAIN OF CUSTODY
Phone [phone]
RATE -RELIABLE Fax [phone]
ORIES, INC
Et Mailing:
ham Park Drive
NC 28273
I that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
artment of Environmental and Natural Resources.
Company Name (billing)
us
;dme
Comments/ Special Instructions
Address
Pe
City, State fi zip code
AJC
70
Poin of Contact Ft
Telephone Number
L/41- 3S3 0
Sample
Taken By:
IGNATURE
%� PRINTED NAME
ARE SAMPLES
*Sample Type
Sample Temp
**Field Preserved:
Residual Chic
FOR STATt or EPA REPORTING? YES ')( NO
DW WW GWMW HW soil Other
at time of sampling: ° C Sample Temp upon receipt: ° C
Yes No Teflon Liner/Zero Headspace: Yes No n/a
rive checked at time of sampling (Y/N): Dechlorination Necessary (YIN):
rlerrt Sample'fi D.
Sample Location i
umber)
Comp
Grab
Presenr.
Set tfp
Qatefrime -
" Collection'"
Daterrime
a1yses
Requ6sted
b V 0r- r.,
r
r
Relin4 edbY• Uate/Ilme A mecelVe Dx va�cnic
�
Daterrime Received by: L----7 Daterrime
* C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

PLL
PROMPT•ACCURATE-RELIABLE
LABORATORIES, INC
WWW.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
SAMPLE NUMBER- 146485 SAMPLE ID- BAXTER
DATE SAMPLED- 02/16/23
DATE RECEIVED- 02/16/23 SAMPLER- ZK
TIME RECEIVED- 1320 DELIVERED BY- ZK
Page 1 of 2
ANALYSIS METHOD
PROJECT NAME: FEB 23
DATE: 04/06/23
SAMPLE MATRIX- WW
TIME SAMPLED- 0800
RECEIVED BY- DJ
TYPE SAMPLE- Grab
ANALYSIS
DATE TIME BY RESULT UNITS
TCLP CHARACTERISTICS
TCLP
03/06/23
0930
CB
pH VALUE
TCLP
03/06/23
0930
CB
CORROSIVITY
TCLP
03/06/23
0930
CB
REACTIVITY
TCLP
03/06/23
0930
CB
FLASH POINT
TCLP
03/06/23
0930
CB
IGNITABILITY
TCLP
03/06/23
0930
CB
PAINT FILTER TEST
TCLP
03/06/23
1101
CB
TCLP METALS
TCLP
02/27/23
1648
TS
ARSENIC
TCLP
02/27/23
1648
TS
BARIUM
TCLP
02/27/23
1648
TS
CADMIUM
TCLP
02/27/23
1648
TS
CHROMIUM
TCLP
02/27/23
1648
TS
LEAD
TCLP
02/27/23
1648
TS
MERCURY
TCLP
02/27/23
1648
TS
SELENIUM
TCLP
02/27/23
1648
TS
SILVER
TCLP
02/27/23
1648
TS
TCLP PESTICIDES
TCLP
03/01/23
1338
VC
ENDRIN
TCLP
03/01/23
1338
VC
LINDANE
TCLP
03/01/23
1338
VC
METHOXYCHLOR
TCLP
03/01/23
1338
VC
TOXAPHENE
TCLP
03/01/23
1338
VC
6.1 S.U.
NON
NON
> 200 degrees F
NON
NFL
< 0.5 ppm
< 10 ppm
< 0.1 ppm
< 0.5 ppm
< 0.5 ppm
< 0.02 ppm
< 0.1 ppm
< 0.5 ppm
< 0.002 ppm
< 0.04 ppm
< 1 ppm
< 0.05 ppm
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PLL
PROMPT•ACCURATE-RELIABLE
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WWW.PARLABS.COM
Page 2 of 2
CONTINUATION OF DATA FOR SAMPLE NUMBER 146485
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
CHLORDANE
TCLP
03/01/23
1338
VC
< 0.003
ppm
HEPTACHLOR (AND ITS EPDXIDE)
TCLP
03/01/23
1338
VC
< 0.0008
ppm
TCLP HERBICIDES
TCLP
03/01/23
2143
VC
2,4-D
TCLP
03/01/23
2143
VC
< 1
ppm
2,4,5-TP(SILVEX)
TCLP
03/01/23
2143
VC
< 0.1
ppm
TCLP ORGANICS
TCLP
02/23/23
1226
MS
BENZENE
TCLP
02/23/23
1226
MS
< 0.05
ppm
CARBON TETRACHLORIDE
TCLP
02/23/23
1226
MS
< 0.05
ppm
CHLOROBENZENE
TCLP
02/23/23
1226
MS
< 10
ppm
CHLOROFORM
TCLP
02/23/23
1226
MS
< 0.6
ppm
o-CRESOL
TCLP
02/23/23
1226
MS
< 20
ppm
p-CRESOL
TCLP
02/23/23
1226
MS
< 20
ppm
m-CRESOL
TCLP
02/23/23
1226
MS
< 20
ppm
1,4-DICHLOROBENZENE
TCLP
02/23/23
1226
MS
< 0.75
ppm
1,2-DICHLOROETHANE
TCLP
02/23/23
1226
MS
< 0.05
ppm
1,1-DICHLOROETHYLENE
TCLP
02/23/23
1226
MS
< 0.07
ppm
2,4-DINITROTLUENE
TCLP
02/23/23
1226
MS
< 0.013
ppm
HEXACHLOROBENZENE
TCLP
02/23/23
1226
MS
< 0.013
ppm
HEXACHLOROBUTDIENE
TCLP
02/23/23
1226
MS
< 0.05
ppm
HEXACHLOROETHANE
TCLP
02/23/23
1226
MS
< 0.3
ppm
METHYL ETHYL KETONE
TCLP
02/23/23
1226
MS
196
ppm
NITROBENZENE
TCLP
02/23/23
1226
MS
< 0.2
ppm
PENTACHLOROPHENOL
TCLP
02/23/23
1226
MS
< 10
ppm
PYRIDINE
TCLP
02/23/23
1226
MS
< 0.5
ppm
TETRACHLORETHYLENE
TCLP
02/23/23
1226
MS
< 0.07
ppm
TRICHLOROETHYLENE
TCLP
0.2/23/23
1226
MS
< 0.05
ppm
2,4,5-TRICHLOROPHENOL
TCLP
02/23/23
1226
MS
< 40
ppm
2,4,6-TRICHLORPHENOL
TCLP
02/23/23
1226
MS
< 0.2
ppm
VINYL CHLORIDE
TCLP
02/23/23
1226
MS
< 0.02
ppm
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PAR
PRQMPT•ACCU RATE- RELIABLE
LABORATORIES, INC
Shipping Et Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
Carolina Department of Environmental and Natural Resources.
Company Name (billing) Comments/ S ecia
US 0ioShIJs-'fnC.
Address
Po
City, State 8 zip code
P.'da i NC 0A67 0
Point of Contact @ Telephone Number
k Vew .Y�- 90555O
Sample (/
Taken By: SIGNATURE
PRINTED NAME Zc 4 ICl
Instructions
ARE SAMPLES FOR STATE or EPA REPORTING? YES\NO
*Sample Type: DW WW _� GWMW HW soil Other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
**Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (Y/N): Dechlorination Necessary (Y/N):
. * C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

Waypointo
ANALYTICAL
2/28/2023
US Biosolids Inc
Dennis Key
958 Hoots Road
Roaring River, NC, 28669
Ref: Analytical Testing
Report Number: 23-048-0002
Project Description: Baxter
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Dear Dennis Key:
Waypoint Analytical Virginia, Inc. received sample(s) on 2/17/2023 for the analyses presented in the following
report.
The above referenced project has been analyzed per your instructions. The analyses were performed in
accordance with the applicable analytical method. Sub -contracted testing is noted on the Sample Summary Table
if applicable.
The analytical data has been validated using standard quality control measures performed as required by the
analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all
parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA
(including 40 CFR 136 Method Update Rule May 2012) and NELAC unless otherwise indicated.
Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of
sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time
Refer to sample analysis time for confirmation of holding time compliance.
The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as -
received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to
the samples included in this report.
Please do not hesitate to contact me or client services if you have any questions or need additional information
Sincerely,
&;'-� ­AldA�
Brandi Watson
Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the
analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis.
Page 1 of 8

•
7621 Whitepine Road, Richmond, VA 23237
Waypoint
Main 804-743-9401 0 Fax [phone]
ANALYTICAL www.waypointanalytical.com
Sample Summary Table
Report Number: 23-048-0002
Client Project Description: Baxter
Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID
60926
46381
Solids
60926
46381
Solids
60926
46381
Solids
60926
46381
Solids
60926
46381
Solids
60926
46381
Solids
60926
46381
Solids
60926
46381
Solids
02/16/2023 09:00
02/17/2023
02/16/2023 09:00
02/17/2023
02/16/2023 09:00
02/17/2023
02/16/2023 09:00
02/17/2023
02/16/2023 09:00
02/17/2023
02/16/2023 09:00
02/17/2023
02/16/2023 09:00
02/17/2023
02/16/2023 09:00
02/17/2023
SM-4500-NH3C
WP MTN
9045D
WP MTN
4500NO3F-2011
WP MTN
6010D
WP MTN
SW-7471B
WP MTN
SM-4500-NH3C-TKN
WP MTN
SM-2540G
WP MTN
WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN
Page 2 of 8

Waypointo
ANALYTICAL
46381
US Biosolids Inc
Project Baxter
Dennis Key
958 Hoots Road
Information
Roaring River , NC 28669
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Report Date : 02/28/2023
Received : 02/17/2023
Brandi Watson
Report Number : 23-048-0002 REPORT OFANALYSIS
Lab No : 60926 Matrix: Solids
Sample ID : 46381 Sampled: 2/16/2023 9:00
Test Results Units MQL DF Date / Time By Analytical
Analyzed Method
Moisture
85.5
%
0.010
1
02/23/2315:45
FMM
SM-2540G
Sulfur
12300
mg/Kg -
dry
69.0
1
02/22/23 23:38
BKN
6010D
Calcium
9860
mg/Kg -
dry
345
1
02/22/23 23:38
BKN
6010D
Aluminum
1490
mg/Kg -
dry
34.5
1
02/22/23 23:38
BKN
6010D
Manganese
75.2
mg/Kg -
dry
3.45
1
02/22/23 23:38
BKN
6010D
Organic N
81170
mg/Kg -
dry
1724
1
02/27/23 14:00
CALCULATION
Nickel
22.6
mg/Kg -
dry
1.72
1
02/22/23 23:38
BKN
6010D
Lead
7.59
mg/Kg -
dry
2.07
1
02/22/23 23:38
BKN
6010D
Arsenic
9.93
mg/Kg -
dry
3.45
1
02/22/23 23:38
BKN
6010D
Selenium
<3.45
mg/Kg -
dry
3.45
1
02/22/23 23:38
BKN
6010D
Test
Results
Units
MQL
DF
Date / Time
By
Analytical
Analyzed
Method
Total Solids
14.5
%
0.010
1
02/23/23 15:45
FMM
SM-2540G
Phosphorus
19200
mg/Kg -
dry
34.5
1
02/22/23 23:38
BKN
6010D
Copper
176
mg/Kg -
dry
3.45
1
02/22/23 23:38
BKN
6010D
Total Kjeldahl Nitrogen
Qualifiers/ DF Dilution Factor
Definitions
83400 mg/Kg - dry 1720 1 02/27/23 14:00 JPJ ;M-4500-NH3C-TKI`
MQL Method Quantitation Limit
Page 3 of 8

Waypointo
ANALYTICAL
46381
US Biosolids Inc
Project Baxter
Dennis Key
958 Hoots Road
Information
Roaring River , NC 28669
Report Number : 23-048-0002
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
REPORT OFANALYSIS
Report Date : 02/28/2023
Received : 02/17/2023
Brandi Watson
Lab No : 60926
Sample ID : 46381
Matrix: Solids
Sampled: 2/16/2023 9:00
Potassium
10800
mg/Kg -
dry
345
5
02/24/23 04:23
TJS
6010D
Magnesium
4830
mg/Kg -
dry
34.5
1
02/22/23 23:38
BKN
6010D
Sodium
3900
mg/Kg -
dry
172
1
02/22/23 23:38
BKN
6010D
Iron
5900
mg/Kg -
dry
69.0
1
02/22/23 23:38
BKN
6010D
Zinc
161
mg/Kg -
dry
8.62
1
02/22/23 23:38
BKN
6010D
Ammonia Nitrogen
2260
mg/Kg -
dry
690
1
02/28/23 11:00
JPJ
SM-4500-NH3C
Nitrate+Nitrite-N
38.6
mg/Kg -
dry
34.5
1
02/23/23 13:38
ZBD
4500NO3F-2011
Cadmium
<0.690
mg/Kg -
dry
0.690
1
02/22/23 23:38
BKN
6010D
Chromium
44.3
mg/Kg -
dry
1.72
1
02/22/23 23:38
BKN
6010D
Mercury
<1.12
mg/Kg -
dry
1.12
1
02/22/23 15:14
FDS
SW-7471B
pH
7.0
S.U.
1
02/23/2315:30
SAR
9045D
Molybdenum
5.50
mg/Kg -
dry
1.72
1
02/22/23 23:38
BKN
6010D
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 4 of 8

Waypointo
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Client: US Biosolids Inc CASE NARRATIVE
Project: Baxter
Lab Report Number: 23-048-0002
Date: 2/28/2023
Metals Analysis Method 601 OD
Sample 88165
Analyte: Aluminum
QC Batch No: 1-666345/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 88165
Analyte: Arsenic
QC Batch No: 1-665778/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Sample 88165
Analyte: Chromium
QC Batch No: 1-665778/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 88165
Analyte: Iron
QC Batch No: 1-666047/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 88165
Analyte: Potassium
QC Batch No: 1-665778/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 88165
Analyte: Lead
QC Batch No: 1-666047/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Sample 88165
Analyte: Selenium
QC Batch No: 1-665778/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Page 5 of 8

Waypoint".0 -
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Solids Total Mercury Analysis - CVAA Method 7471A
Sample 88961 (JR-1-1)
Analyte: Mercury
QC Batch No: 1-665626/1-665268
The matrix spike, matrix spike duplicate and the post digestion spike were all outside of the quality control
acceptance ranges. Matrix interference is suspected.
Page 6 of 8

WayPAoInt..
NALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 46381
Customer Name: US Biosolids Inc
Report Number: 23-048-0002
Shipping Method
0 Fed Ex 0 US Postal 0 Lab
0 UPS 0 Client 0 Courier
0 Other:
Thermometer ID:
Shipping container/cooler uncompromised?
* Yes
0 No
Number of coolers/boxes received
Custody seals intact on shipping container/cooler?
0 Yes
0 No
Not Present
Custody seals intact on sample bottles?
0 Yes
0 No
Not Present
Chain of Custody (COC) present?
# Yes
0 No
COC agrees with sample label(s)?
# Yes
0 No
COC properly completed
# Yes
0 No
Samples in proper containers?
# Yes
0 No
Sample containers intact?
# Yes
0 No
Sufficient sample volume for indicated test(s)?
# Yes
0 No
All samples received within holding time?
# Yes
0 No
Cooler temperature in compliance?
# Yes
0 No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
# Yes
0 No
Water - Sample containers properly preserved
0 Yes
0 No
N/A
Water - VOA vials free of headspace
0 Yes
0 No
N/A
Trip Blanks received with VOAs
0 Yes
0 No
N/A
Soil VOA method 5035 — compliance criteria met
0 Yes
0 No
0 N/A
F_ High concentration container (48 hr)
F_ High concentration pre -weighed (methanol -14 d)
F_ Low concentration EnCore samplers (48 hr)
F_ Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included? 0 Yes * No
Comments:
Signature: IDavid Lennon Date & Time: 02/17/2023 12:39:16
Page 7 of 8

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Page 8 of 8

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two conies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 11-15, FORM: DCAR 11-15, or FORM: SDR 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 11-15):
❑ Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 11-15) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
❑ For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
❑ Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
B. Residuals Source -Generating Facility Information:
❑ For each source facility, attach the following:
❑ Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
❑ Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
❑ Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
❑ Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
❑ For each source facility, attach the following:
❑ Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 06-16 Page 1 of 1

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Town of Dallas
2. Facility permit holder is: ❑ Federal, 0 State, 0 Local Government, or 0 Private.
Facility permit issued by: JE Div. of Water Resources, Div. of Environmental Health,
or U Other (explain:
3. Facility contact person and title: Bill Trudnak
Complete mailing address: 700 E Holly St.
City: Dallas State: NC Zip: 28034
Telephone number: [phone] E-mail address: btrudnak&dallasnc.net
4. Facility physical address: 700 E Holly St.
City: Dallas State: NC Zip: 28034
Coordinates: Latitude: 35' 18' 27.46" Longitude: 81. 10' 03.07"
Datum: NAD83 Level of accuracy: 0.01
Method of measurement: GPS
5. Purpose of the facility:
treatment of municipal wastewater, treatment of 100% domestic wastewater,
treatment of potable water, treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: _ % industrial and _ % domestic)
other (explain: _ ).
6. Does the facility have an approved pretreatment program: Yes No
7. Facility permitted/design flow: 0.6 MGD and facility average daily flow: 0.202 MGD
8. Average amount of residuals being generated at this facility 40 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: Two 100,000 gallon digesters
Type and volume of residuals storage (i.e., outside of residuals treatment units): Four 85,000 gallons drying beds
II. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part 503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological ❑ Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: 0 yes ® no.
If yes, list the number(s): _
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: I❑ yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: PAR and Date of analysis: 12-11-2023
Passed corrosivity test: yes no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: yes no. Flashpoint: 200 OF (> 140°F)
Passed reactivity test: ® yes ao. HCN: NON mg/kg (<250) & H2S: NON mg/kg (<500)
TCLP Parameter
Limit
(mgfi)
Result
(m917)
TCLP Parameter
Limit
(m917)
Result
(mgfi)
Arsenic
5.0
0.5
Hexachlorobenzene
0.13
0.013
Barium
100.0
10
Hexachloro-1,3-Butadiene
0.5
0.05
Benzene
0.5
0.05
Hexachloroethane
3.0
0.3
Cadmium
1.0
0.1
Lead
5.0
0.5
Carbon Tetrachloride
0.5
0.05
Lindane
0.4
0.04
Chlordane
0.03
0.003
Mercury
0.2
0.02
Chlorobenzene
100.0
10
Methoxychlor
10.0
1
Chloroform
6.0
0.6
Methyl Ethyl Ketone
200.0
51.2
Chromium
5.0
0.5
Nitrobenzene
2.0
0.2
10m-Cresol
200.0
20
Pentachlorophenol
100.0
10
o-Cresol
200.0
20
Pyridine
5.0
0.5
p-Cresol
200.0
20
Selenium
1.0
0.1
Cresol
200.0
20
Silver
5.0
0.5
2,4-D
10.0
1
Tetrachloroethylene
0.7
0.07
1,4-Dichlorobenzene
7.5
0.75
Toxaphene
0.5
0.05
1,2-Dichloroethane
0.5
0.05
Trichloroethylene
0.5
0.05
1,1-Dichloroethylene
0.7
0.07
2,4,5-Trichlorophenol
400.0
40
2,4-Dinitrotoluene
0.13
0.013
214,6-Trichlorophenol
2.0
0.2
Endrin
0.02
0.002
2,4,5-TP (Silvex)
1.0
0.1
Heptachlor and its Hydroxide
0.008
0.0008
Vinyl Chloride
0.2
0.02
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Waypoint and Date of analysis: 12-11-2023
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mglkg)
Monthly Average
Concentration Limits
(Class A Only)
(mglkg)
Result
(mglkg)
Arsenic
75
41
31.3
Cadmium
85
39
6.25
Copper
4,300
1,500
1240
Lead
840
300
54.3
Mercury
57
17
10.2
Molybdenum
75
n/a
15.6
Nickel
420
420
28.1
Selenium
100
100
31.3
Zinc
7,500
2,800
1980
b. For Surface Disposal Unit (landfill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: = and Date of analysis: =
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
❑ > 0 but < 25
30
200
210
❑ > 25 but < 50
34
220
240
❑ > 50 but < 75
39
260
270
> 75 but < 100
46
300
320
> 100 but < 125
53
360
390
❑ > 125
62
450
420
Result (mg4g)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 1.57 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Waypoint and Date of analysis: 12-11-2023
Parameter
Result
(mg1kg)
Aluminum
24900
Ammonia -Nitrogen
6250
Calcium
49600
Magnesium
4010
Nitrate -Nitrite Nitrogen
875
pH (Standard Unit)
7.3
Phosphorus
27200
Potassium
4850
Sodium
3400
Total Kjeldahl Nitrogen
25600
c. Using the results listed in Item IL 5b. above, calculate the sodium adsorption ration (SAR): 0.49
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 30 %. This
rate is a (check one): Ji default value, or ❑ actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, ex lain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals:
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (1st) Year PAN
Five -Year
Maximum Adjusted PAN
(mg1kg)
(mg/kg)
Surface
9805
12930
Injection/Incorporation
13871
16191.6
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses:
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
rl A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
JJ A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
14 Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
J Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
E] Alternative 4 [15A NCAC 02T.I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 5 [15A NCAC 02T.1106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: composting, W heat drying, heat treatment,
thermophilic aerobic digestion, beta ray irradiation,
❑ gamma ray irradiation, or I pasteurization.
b. For Land Application of Class B:
Alternative 1 [15A NCAC 02T.I 106(c)(1)] - Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T.I 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, I
air drying, ❑ anaerobic digestion,
El composting, or lime stabilization.
c. For Surface Disposal:
11 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
J Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
J Exempt -If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
J Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
❑ Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
El Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
E] Alternative 4 [15A NCAC 02T. 1107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
E] Alternative 5 [15A NCAC 02T. I 107(a)(5)] - 14-Day Aerobic Processes.
E] Alternative 6 [15A NCAC 02T. 1107(a)(6)] - Alkaline Stabilization.
E] Alternative 7 [15A NCAC 02T. 1107(a)(7)] - Drying of Stabilized Residuals.
E] Alternative 8 [15A NCAC 02T. 1107(a)(8)] - Drying of Unstabilized Residuals.
Alternative 9 [15A NCAC 02T. 1107(a)(9)] - Injection.
Alternative 10 [15A NCAC 02T. 1107(a)(10)] - Incorporation.
q Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(b)(2)].
id Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

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Town of Dallas, NC
Waste Water Treatment Plant
WQ0020912
Residual Process Description
Influent flows through a bar screen into an extended aeration chamber for a detention time of
24 hours, based on a flow of 300,000 gallons, (if volume is less, time is longer). From the chamber the
sludge flows into energy baffle diffuser in the center of the clarifier. Clarification occurs; floatable scum
is removed by a skimmer arm to a scum trough, then to the digester or the aeration chamber. Activated
sludge is constantly being returned from the clarification process to the chamber.
The supernatant from the clarifier flows through saw tooth weirs into a contact chamber where
it is aerated and chlorinated; then over a v-notched weir flow measuring device; then into an unnamed
tributary of the Long Creek.
Residuals in the bottom of the clarifier unit are either returned to the aeration chamber, or
wasted to the digester for thickening, then held for land application. When volatile solids reduction is
measured at a rate less than 38%, a 30 day bench scale is taken, if unable to pass the 30 day bench, lime
stabilization will be utilized to land apply the residuals. Waste materials left on the bar screen are
removed and taken to the landfill.

QUANTITATIVE JUSTIFICATION
The Town of Dallas, NC has produced the flowing dry tons over the last Thirteen (13) years:
2023 33.19
2022 32.55
2021 11.54
2020 32.91
2019 63.51
2018 67.97
2017 60.25
2016 51.58
2015 52.39
2014 6.65
2013 44.49
2012 49.68
2011 33.76
This comes out to an average of 39.27 dry tons per year. The current amount requested in this
permit renewal package is ample for any growth or increase in residual amounts produced.

U.S. Biosolids, Inc.
Permit No. WQ0037135
SAMPLING PLAN
Annually, if a land application event occurs, grab samples are collected from the digester. Samples
from the digesterwill be combined to form individual grab samples to be sent to a laboratoryfor
analysis. If a land application event is to occur in the early part of a calendar year (i.e. January or
early February) these samples may have to be taken in December, so results can be obtained
before the land application event, as some results take 30+ days to receive.
These individual grab samples are collected and tested for fecal coliform analysis, volatile solids
reduction, nutrient analysis, and a TCLP test. These tests will be taken by U.S. Biosolids, Inc. All
samples except for the composite residual sample will be taken to a state certified laboratory. All
samples taken will be taken in the same condition as the residuals are to be land applied.
The volatile solids will first be attempted to be achieved using option 1 [503.33(b)(1)]; 38%volatile
solids reduction. This option will be attempted first due to it being the most cost effective. One
sample will betaken at the aeration basin and labeled "B". The next sample will be labeled "A" and
be taken from the digester.
If option 1 cannot be achieved to meet the volatile solids reduction, a 30 day bench scale option 3
[503.33(b)(3)] test will be used. This sample will be taken from the digester with the sample being at
least a quart in quantity.
If both option 1 and 3 are used and volatile solids reduction cannot be achieved; the sludge holding
tank will be stabilized using sufficient alkaline to meet option 6 [503.33(b)(6)], commonly known as
time stabilization.
Fecal Coliform is gathered in seven (7) individual samples and tested to meet the requirements of
[503.32(b)(2)]. This requirement is for the geometric mean fecal coliform density of the samples be
less than two million (2,000,000) MPN per gram. These samples will be placed in 250ml containers
and placed on ice, in a cooler for transport to the laboratory before 1600 hours (4pm) the same day
the samples are obtained.
Annually, if land application occurs, a composite residual sample will be analyzed, prior to a land
application event for:
Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia
Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus, Potassium, TKN,
Sodium
From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption Ratio (SAR) will
be calculated. This sample will be collected in a non -breakable container, at least one quart in size.
This sample will be taken from the digester. This test will be done by a state approved laboratory.

PLL
PROM PT-ACCURATE -RE LIABLE
LABORATORIES, INC
W W W.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
SAMPLE NUMBER- 148666 SAMPLE ID- DALLAS
DATE SAMPLED- 12/11/23
DATE RECEIVED- 12/11/23 SAMPLER- ZK
TIME RECEIVED- 1245 DELIVERED BY- ZK
Page 1 of 1
ANALYSIS METHOD
30 DAY BENCH SCALE TEST VAR
PROJECT NAME: DEC 23
DATE: 01/23/24
SAMPLE MATRIX- WW
TIME SAMPLED- 1100
RECEIVED BY- DJ
TYPE SAMPLE- Grab
ANALYSIS
DATE TIME BY RESULT UNITS
12/11/23 1350 RE 4.33 %
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

P)%kF;Z
RROMRT•ACC LI RATE -RE LIABLE
LABORATORIES INC
WWW.PARLABS.C❑M
30 Day Bench Scale Extended Aeration Test
Percent Volatile Solids Reduction
CLIENT NAME:
SAMPLE ID:
SAMPLE #:
START DATE:
END DATE:
U.S. BIOSOLIDS
Start: End:
TS
0.1910
0.2042
TS%
1.89%
1.86%
VS (
0.1380
0.1440
VS%
72.25%
70.52%
y Mass Fraction of Volatile Solids in Liquid Sludge
0.0136850
0.0130895
x Mass Fraction of Fixed Solids in Liquid Sludge
0.0052559
0.0054721
FSVR (Mass Balance)
4.39%
FSVR (Van Kleeck)
4.33%
FSVR (Mass Balance) <15%
YES
FSVR (Van Kleeck) <15%
YES
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] • Fax: [phone]

PiIL
s­ IR
PROMPT- A CCU RATE -RE LIABLE
LABORATORIES, INC
W W W.PARLABS.COM
30 Day Bench Scale Extended Aeration Test
VAR Ontion 3 Percent Volatile Solids Reduction
CLIENT NAME:
U.S. IBIOSOLIDS
SAMPLE ID
SAMPLE #:
START DATE: 11
END DATE:`
� � c
As Received Day 0 Day 7 Day 14 Day 21 Day 28
Collected 12/11/24 12111/24 12/18124 12/26/24 01/02/25 01/08/24
D.O.
Crucible
Tare Wt (g)
Sample Wt +
Tare Wt (g)
Liquid Sludge Wt
(g)
Oven Temp °C
Date/Time In
Date/Time Out
Dried Sample W1
+ Tare Wt (g)
Dried Sludge Wt (g
Fixed Solids Wt (g
Furnace Temp °C
Date/Time In
Date/Time Out
Burned Sample
Wt + Tare Wt (g)
Volatile Solids Wt (g;
TS%
VS%
3.18
3.55
3.94
4.22
4.71
X29
X29
X9
X17
X22
X30
20.1110
20.1110
15.5345
16.0794
17.1771
18.3523
30.1950
30.1950
25,7369
26.2950
27.8097
29.3535
10.0840
10.0840
10.2024
10.2156
10.6326
11.0012
106
105
105
107
106
106
12/11 /24 13:50
12/11 /24 13:50
12/18/24 08:50
12/26/24 09:10
01 /02/25 10:00
01 /08/24 09:40
12/12/24 14:00
12/12/24 14:00
12/19/24 08:55
12/27/24 09:30
01J03/25 09:55
01/09/24 09:50
20.3020
20.3020
15.7255
16.2747
17.3756
18.5565
0.1910
0.1910
0.1910
0.1953
0.1985
0.2042
0.0530
0.0549
0.0549
0.0574
0.0602
550
550
550
550
550
12/13/23 15:00
12/19/24 14:00
12/27/24 15:00
01 /03/25 14:20
01 /09/24 16:45
12/13/23 16:05
12/19/24 15:10
12/27/24 16:10
01 /03/25 15:25
01 /09/24 18:00
20.1640
15.5894
16.1343
17.2345
18.4125
0.1380
0.1361
0.1404
0.1411
0.1440
1.89%
1.89%
1.87%
1.91%
1.87%
1.86%
72.25%
71.26%
71.89%
71.08%
70.52%
Yf Mass Fraction of Volatile Solids in Liquid (Feed)
Yb Mass Fraction of Volatile Solids in Liquid (Bottom)
Sludge at Start of Test
0.0136850
Sludge at End of Test
0.0130895
xf Mass Fraction of Fixed Solids in Liquid (Feed) Sludge
xb Mass Fraction of Fixed Solids in Liquid (Bottom)
at Start of Test
0.0052559
Sludge at End of Test
0.0054721
TS O
0.191
TS O
0.2042
VS
0.138
VS ()
0.144
Volatile Fraction In: 0.38228 Volatile Fraction Out: 0.37914
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] Fax: [phone]

MF3R0MFwT-^CCUFtAT• RCLIAD1-E
LABORATORIES, INC
Shipping 8 Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
N is essential that all information be recorded an this Chain of Custody document for acceptance Dy PAR Laboratories, Inc. and the North
uarouna ue anmenc or envnonmerna aria nawrar nesvurces.
Company Name (billing) Comments/ Special Instructions
U.S. Biosolids, Inc.
Address
PO Box 146
City, State ft zip code
Ronda, NC 28670
Paint of Contact ti Telephone Number
Zach Key 336-467-3550
Sample I�
Taken By: SIGNATURE PRINTED NAME �sl �1 t�,i
ARE SAMPLES FOR STATE or EPA REPORTING? YES W NO
'Sample Type: Dw _ ww X GWMW __, HW _ Sal _ other
Sample Temp at time of sampling: _ ° C Sample Temp upon receipt: 0 C
"Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (YIN): Dechlorination Necessary (YIN):
C=Composite G-Grab DW=Drinking Water WW=Wastewater GWANV=Groundwater Monitoring Well HW=Hazardous Waste

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#: WQ0020912 County: Gaston Year: 2023
Facility Name (as shown on permit):
Land Application Operator:
U.S. Biosolids, Inc.
Town of Dallas
Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year?
❑ Yes ❑ No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals Application Summary:
Total number of application fields in the permit:
2
Total number of fields utilized for land application during the year:
1
Total amount of dry tons applied during the year for all application sites:
33.19
Total number of acres utilizes for land application during the year:
39.2
Part B - Annual Compiance Statement:
Facility was compliant during calendar year 2023 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. ❑r Yes ❑ No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or the
limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies of
laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1105(a) or the Pollutant Loading
Rates in 15A NCAC 02T. I 105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T .I I I I were complied with (applicable to 40 CFR Part 503
regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
11) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as specified
in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the possibility
of fines and imprisonment for knowing violations."
Permittee Name and Title (type or print)
Signature of Preparer*
Signature of Permittee
�K
Date Signature of Land A
Date
1-23-2024
Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T .1102 (26) DENR FORM ACF (12/2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - B
WQ Permit Number: WQ0020912
Facility Name: Town of Dallas
Residual Source WQ # or NCO06688
NPDES #:
WWTP Name: Town of Dallas WWTP
Residual Analysis Data
Laboratory: 1) Waypoint Analytical
2)
3)
4)
5)
Parameter
Limit
Sample or Composite Date
Molybdenum
TotalConc.
• • •
®
11
-----------
Ammonia-Nitrogenl®
• 1
-----------
' For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Preparer *
Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM RSSF (12/2006)

ANNUAL RESIDUAL SAMPLING SUMMARY FORM - B
Report all sampling analysis results for parameters not listed in FORM RSSF that are part of the WQ permit or were analyzed for over the past
calendar year. Use additional forms as needed.
WQ Permit Number: WQ0020912
Facility Name: Town of Dallas
Residual Source NCO06688
NPDES # or WQ#:
WWTP Name: Town of Dallas WWTP
Residual Analvsis Data
Laboratory:
1)
2)
3)
4)
5)
Waypoint Analytical
Parameter
Sample or Composite Date
------------
------------
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Preparer * Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM RSSF - B (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Operator:
Acres Used:
Town of Dallas
WQ0020912
Brenda Mackie Owner:
39.2 Acres Permitted:
Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
Brenda Mackie Predominant Soil Series:
39.2 Site #: M1 Field #:
33.16
CmB2
Ml
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample
or Com-
posite
Date
mom
ow
0
Total
Phos-
phorus
■■■■■■■■■■■■
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
Event
0.85
Arsenic
0.053
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
1 0.000
0.053
Cadmium
0.011
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.011
Copper
2.098
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
2.098
Chromium,0.108
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.108
Lead
0.092
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.092
Mercury
0.017
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.017
Molyb-
0.026
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.026
denum
Nickel
0.048
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.048
Selenium
0.053
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.053
Zinc
3.350
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
3.350
Total
Phos-
46.022
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
46.022
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
1-23-2024
Signature of Land A pher
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Town of Dallas
Land Owner: Brenda Mackie
Operator: Brenda Mackie
Crop 1 Name: Fescue
WQ Permit #: WQ0020912 Field #: MI
Annual Dry Tons Applied: 33.1928 Site #: MI
Predominant Soil Series: CmB2
Crop 1 Max. PAN:
152
Crop 2 Name:
Acres Utilized: 39.2
Acres Permitted: 39.2
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
11rs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
2-2023
130000
1.57
0.217
NCO06688
DRY
0
s
1 0.5
0.3
25600
1 6250
875
4.258
NA
Fescue
4-2023
130000
1.57
0.217
NCO06688
DRY
0
s
0.5
0.3
25600
6250
875
4.258
NA
Fescue
8-2023
130000
1.57
0.217
NCO06688
DRY
0
s
0.5
0.3
25600
6250
875
4.258
NA
Fescue
12-2023
117000
1.57
0.195
NCO06688
DRY
0
s
0.5
0.3
25600
6250
875
3.832
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
01
507000
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
16.605
0.000
Lime Applied
Annuallbs/acre
0.053
0.011
2.098
0.108
0.092
0.017
0.026
0.048
0.053
3.350
46.022 1
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.277
0.068
9.865
1.2
0.769
0.071
0.193
0.576
0.272
21.99
Current Cumulative lbs/ac
0.330
0.079
11.963
1.308
0.861
0.088
0.219
0.624
0.325
25.340
Permitted C. P. L. R.****
36
34
1 1338
1 NA
1 267
1 15
1 NA
1 374
1 89
1 2498
Permit PAN Limit 1 st/2nd Crop
1
1 152
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land'Applier
1-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Facility Name: Town of Dallas WQ Permit Number: WQ0020912
WWTP Name: Town of Dallas WWTP
NPDES Number: NCO06688
Monitoring Period: From l/l/2023 To 12/31/2023
Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed:
Class A:
Alt. A (time/temp) ❑
Alt B (Alk Treatment) ❑
1 Alt. C (Prior Testing)❑
A1t.D (No Prior Test)
I Process to Further Reduce Pathogengs ❑
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost ❑
Heat Drying ❑
Heat Treatment ❑
Thermophilic ❑
Beta Ray ❑
Gamma Ray ❑
Pasteurization ❑
Class B:
JAIt. (1) Fecal Density I
Alt. (2) Process to Significantly Reduce Pathogens ❑
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization ❑
Air Drying ❑
Composting ❑
jAerobic Digestion ❑
Anaerobic Digestion ❑
If applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Parameter
Allowable Level
in Sludge
Pathogen Density
g y
Number o
Excee-
dences
Frequency
of Analysis
Sample
Type
na ytica
Tech -
mcme
Minimum
Geo. Mean
Maximum
Units
Fecal Coliform
2 x 10 to the
6th power
per gram of
total solids
MPN
554480
780870
1159111
MPN/g
0
7
grab
sm9221
CFU
1000 mpn per gram
of total solid (dry
wei ht)
Salmonella bacteria
(in lieu of fecal
coliform)
3 MPN per 4 grams
total solid (dry
weight)
Vector Attraction Reduction (15A NCAC 02T .1107) - Please indicate alternative performed:
Alt.l (VS reduction) ❑
Alt. 2 (40-day bench) ❑
Alt. 3 (30-day bench) 0
Alt. 4 (Spec. Oz uptake) ❑
Alt. 5 (14-Day Aerobic) ❑
Alt. 6 (Alk. Stabilization ❑
Alt 7 (Drying - Stable) ❑
Alt. 8 (Drying - Unstable) ❑
Alt. 9 (Injection) ❑
Alt. 10 (Incorporation) ❑
No vector attraction reduction alternatives were performed ❑
CERTIFICATION STATEMENT (please check the appropriate statement)
❑`' "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have been met."
❑ "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
Zach Key U.S. Biosolids, Inc.
Preparer Name and Title (type or print) Land Applier Name and Title (if applicable)(type or print)
X 1-23-2024
Signature of Preparer* Date Signature of Lan Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM PVRF 02T (12/2006)

PA10L F;Z
PROM PT•ACOLI RATE -RELIABLE
LABORATORIES, INC
W W WYARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
SAMPLE NUMBER- 148665 SAMPLE ID- DALLAS
DATE SAMPLED- 12/11/23
DATE RECEIVED- 12/11/23 SAMPLER- ZK
TIME RECEIVED- 1245 DELIVERED BY- ZK
Page 1 of 1
ANALYSIS
PROJECT NAME: DEC 23
DATE: 01/15/24
ANALYSIS
METHOD DATE TIME BY
SAMPLE MATRIX- WW
TIME SAMPLED- 1100
RECEIVED BY- DJ
TYPE SAMPLE- Grab
RESULT UNITS
FECAL COLIFORM (GEOM. MEAN) SM 9221 E 12/11/23 1420 RE 780,870 MPN/g
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

F:Z
PRO M PT• ACCURATE • RELIABLE
LAB(.3IZATORIES, INC
2217 Graham Park Drive
PO Box 411483
Charlotte, NC 28241-1483
NC Cert # 20; SC Cert # 99003001
"CLIENT NAME:
U.S. BIOSOLIDS
SAMPLE ID:
;SAMPLE DATE:
,ANALYSIS:
ANALYSIS METHO
• • •
•
A:
148665
1
7,511
1.35%
554,480.37
2
11,617
1.00%
1,159,111.94
3
6,636
0.97%
682,051.31
4
11,108
1.43%
776,960.52
5
11,632
1.02%
1,141,157.98
6
8,597
1.43%
600,744.28
7
8,253
1.09%
758,206.62
Fecal Coliform
Geometric Mean=

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MR• rlCLIABLi
LABORATORIES, INC
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
Shipping 13 Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
It is essential that all information be recorded an this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
Carolina Department of Environmental and Natural Resources.
Company Name (billing) Comments/ Special Instructions
U.S. Biosolids, Inc.
Address
PO Box 146
City, State ft zip code
_ Ronda, NC 28670
Point of Contact @ Telephone Number
Zach Key 336-467-3550
Sample
Taken By: _SIGNATURE 7� — _ PRINTED NAME zti
ARE SAMPLES FOR STAT or EPA REPORTING? YES NO
'Sample Type: Dw _ ww >C GWMW — -- Hw soil other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes _No n/a
Residual Chlorine checked at time of sampling (Y/N): Dechlorination Necessary (YIN):
lir>,n63atrfpie9'.D;
SMV* Locaborr;lNumber)
Cornp
Grob
Preserv.
SAt;tJp ', .
- tWArriime
Caebetibn
D'aW irne
Requested
X
f
�
,
rteirnpwsnea by: water t rme rtecenr y: uarer I ime
ReG ished by Date/Time Received by. Daterrime
' C=Composite G-Grab DW=Drinking Water WW=Wastewater GWAiNV=Groundwater Monitoring Well HW-Hazardous Waste

PA&
PROM PT•ACCU RATE -RE LIABLE
LABORATORIES, INC
WWW.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
SAMPLE NUMBER- 148664 SAMPLE ID- DALLAS
DATE SAMPLED- 12/11/23
DATE RECEIVED- 12/11/23 SAMPLER- ZK
TIME RECEIVED- 1245 DELIVERED BY- ZK
Page 1 of 2
ANALYSIS METHOD
PROJECT NAME: DEC 23
DATE: 01/10/24
SAMPLE MATRIX- WW
TIME SAMPLED- 1100
RECEIVED BY- DJ
TYPE SAMPLE- Grab
ANALYSIS
DATE TIME BY RESULT UNITS
TCLP CHARACTERISTICS
TCLP
12/13/23
1618
MP
pH VALUE
TCLP
12/13/23
1618
MP
CORROSIVITY
TCLP
12/13/23
1618
MP
REACTIVITY
TCLP
12/13/23
1618
MP
FLASH POINT
TCLP
12/13/23
1618
MP
IGNITABILITY
TCLP
12/13/23
1618
MP
PAINT FILTER TEST
TCLP
12/23/23
1618
MP
TCLP METALS
TCLP
12/20/23
1656
SM
ARSENIC
TCLP
12/20/23
1656
SM
BARIUM
TCLP
12/20/23
1656
SM
CADMIUM
TCLP
12/20/23
1656
SM
CHROMIUM
TCLP
12/20/23
1656
SM
LEAD
TCLP
12/20/23
1656
SM
MERCURY
TCLP
12/20/23
1656
SM
SELENIUM
TCLP
12/20/23
1656
SM
SILVER
TCLP
12/20/23
1656
SM
TCLP PESTICIDES
TCLP
12/22/23
0631
VC
ENDRIN
TCLP
12/22/23
0631
VC
LINDANE
TCLP
12/22/23
0631
VC
METHOXYCHLOR
TCLP
12/22/23
0631
VC
TOXAPHENE
TCLP
12/22/23
0631
VC
2217,Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax:- [phone]
7.0 S.U.
NON
NON
> 200 degrees F
NON
FL
< 0.5 ppm
< 10 ppm
< 0.1 ppm
< 0.5 ppm
< 0.5 ppm
< 0.02 ppm
< 0.1 ppm
< 0.5 ppm
< 0.002 ppm
< 0.04 ppm
< 1 ppm
< 0.05 ppm

PA&R
PROM PT•ACCU RATE• RELIABLE
LABORATORIES, INC
W W W.PARLABS.COM
Page 2 of 2
CONTINUATION OF DATA FOR SAMPLE NUMBER 148664
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
CHLORDANE
TCLP
12/22/23
0631
VC
< 0.003
ppm
HEPTACHLOR (AND ITS EPDXIDE)
TCLP
12/22/23
0631
VC
< 0.0008
ppm
TCLP HERBICIDES
TCLP
12/20/23
1323
VC
2,4—D
TCLP
12/20/23
1323
VC
< 1
ppm
2,4,5—TP(SILVEX)
TCLP
12/20/23
1323
VC
< 0.1
ppm
TCLP ORGANICS
TCLP
12/18/23
1831
MS
BENZENE
TCLP
12/18/23
1831
MS
< 0.05
ppm
CARBON TETRACHLORIDE
TCLP
12/18/23
1831
MS
< 0.05
ppm
CHLOROBENZENE
TCLP
12/18/23
1831
MS
< 10
ppm
CHLOROFORM
TCLP
12/18/23
1831
MS
< 0.6
ppm
o—CRESOL
TCLP
12/18/23
1831
MS
< 20
ppm
p—CRESOL
TCLP
12/18/23
1831
MS
< 20
ppm
m—CRESOL
TCLP
12/18/23
1831
MS
< 20
ppm
1,4—DICHLOROBENZENE
TCLP
12/18/23
1831
MS
< 0.75
ppm
1,2—DICHLOROETHANE
TCLP
12/18/23
1831
MS
< 0.05
ppm
1,1—DICHLOROETHYLENE
TCLP
12/18/23
1831
MS
< 0.07
ppm
2,4—DINITROTLUENE
TCLP
12/18/23
1831
MS
< 0.013
ppm
HEXACHLOROBENZENE
TCLP
12/18/23
1831
MS
< 0.013
ppm
HEXACHLOROBUTDIENE
TCLP
12/18/23
1831
MS
< 0.05
ppm
HEXACHLOROETHANE
TCLP
12/18/23
1831
MS
< 0.3
ppm
METHYL ETHYL KETONE
TCLP
12/18/23
1831
MS
51.2
ppm
NITROBENZENE
TCLP
12/18/23
1831
MS
< 0.2
ppm
PENTACHLOROPHENOL
TCLP
12/18/23
1831
MS
< 10
ppm
PYRIDINE
TCLP
12/18/23
1831
MS
< 0.5
ppm
TETRACHLORETHYLENE
TCLP
12/18/23
1831
MS
< 0.07
ppm
TRICHLOROETHYLENE
TCLP
12/18/23
1831
MS
< 0.05
ppm
2,4,5—TRICHLOROPHENOL
TCLP
12/18/23
1831
MS
< 40
ppm
2,4,6—TRICHLORPHENOL
TCLP
12/18/23
1831
MS
< 0.2
ppm
VINYL CHLORIDE
TCLP
12/18/23
1831
MS
< 0.02
ppm
LABORATORY
DIRECTOR
��✓
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PROM PT•ACOURAT • RCLIABLE
LABORATORIES, INC
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
Shipping & Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
It Is essential that all information be recorded on VV Chain of Custody document for acceptance try PAR Laboratories, Inc, and the North
i,aronna ue armlent or Cnvrronmenral ano Natural r/eSoUrCes.
Company Name (billing) Comments/ Special Instructions
U.S. Biosolids, Inc.
Address
PO Box 146
City, State & zip code
_ Ronda, NC 28670 _
Point of Contact & Telephone Number --`�
Zach Key 336-467-3550
tiampie
Taken By: SIGNATURE PRINTED NAME Ze K<
ARE SAMPLES FOR STATE or EPA REPORTING? YES KNO
'Sample Type: DW _ ww — C� GWMw — --- Hw soil _ other
Sample Tamp at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon Liner2ero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (Y/N): Dechlorination Necessary (Y/N):
C=Composite G-Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two conies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 11-15, FORM: DCAR 11-15, or FORM: SDR 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 11-15):
❑ Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 11-15) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
❑ For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
❑ Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
B. Residuals Source -Generating Facility Information:
❑ For each source facility, attach the following:
❑ Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
❑ Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
❑ Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
❑ Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
❑ For each source facility, attach the following:
❑ Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 06-16 Page 1 of 1

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Town of Forest City
2. Facility permit holder is: ❑ Federal, 0 State, 0 Local Government, or 0 Private.
Facility permit issued by: ❑ Div. of Water Resources, Div. of Environmental Health,
or Other (explain: M.
3. Facility contact person and title: Tommy Wilson, Superintendent
Complete mailing address: PO Box 728
City: Forest City State: NC Zip: 28043
Telephone number: [phone] E-mail address: tommywilsongtownofforestcity.com
4. Facility physical address: 397 Riverside Drive
City: Forest City State: NC Zip: 28043
Coordinates: Latitude: 35' 19' 36.64" Longitude: 81. 50' 37.85"
Datum: NAD83 Level of accuracy: .01
Method of measurement: MAP
5. Purpose of the facility:
® treatment of municipal wastewater, treatment of 100% domestic wastewater,
❑ treatment of potable water, treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: _ % industrial and _ % domestic)
other (explain: _ ).
6. Does the facility have an approved pretreatment program: Yes No
7. Facility permitted/design flow: 4.95 MGD and facility average daily flow: 1.25 MGD
8. Average amount of residuals being generated at this facility 300 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 500,000 gallons holding basin.
Type and volume of residuals storage (i.e., outside of residuals treatment units): Sludge press with 3,600 square foot
storage building
II. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part 503 or 0 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological 0 Non -Biological
FORM: RSC 06-16 Page 1 of 5

Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: 0 yes no.
If yes, list the number(s): _
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: 0 yes 0 no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: PAR and Date of analysis: 4-6-2023
Passed corrosivity test: yes 71 no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: yes jj no. Flashpoint: 200 OF (> 140°F)
Passed reactivity test: W yes E]no. HCN: NON mg/kg (<250) & H2S: NON mg/kg (<500)
TCLP Parameter
Limit
(mgfi)
Result
(mgfi)
TCLP Parameter
Limit
(mg/1)
Result
(mgfi)
Arsenic
5.0
0.5
Hexachlorobenzene
0.13
0.013
Barium
100.0
10
Hexachloro-1,3-Butadiene
0.5
0.05
Benzene
0.5
0.05
Hexachloroethane
3.0
0.3
Cadmium
1.0
0.1
Lead
5.0
0.5
Carbon Tetrachloride
0.5
0.05
Lindane
0.4
0.04
Chlordane
0.03
0.003
Mercury
0.2
0.02
Chlorobenzene
100.0
10
Methoxychlor
10.0
1
Chloroform
6.0
0.6
Methyl Ethyl Ketone
200.0
20
Chromium
5.0
0.5
Nitrobenzene
2.0
0.2
m-Cresol
200.0
20
Pentachlorophenol
100.0
10
o-Cresol
200.0
20
Pyridine
5.0
0.5
p-Cresol
200.0
20
Selenium
1.0
0.1
Cresol
200.0
20
Silver
5.0
0.5
2,4-D
10.0
1
Tetrachloroethylene
0.7
0.07
1,4-Dichlorobenzene
7.5
0.75
Toxaphene
0.5
0.05
112-Dichloroethane
0.5
0.05
Trichloroethylene
0.5
0.05
1,1-Dichloroethylene
0.7
0.07
2,4,5-Trichlorophenol
400.0
40
2,4-Dinitrotoluene
0.13
0.013
214,6-Trichlorophenol
2.0
0.2
Endrin
0.02
0.002
2,4,5-TP (Silvex)
1.0
0.1
Heptachlor and its Hydroxide
0.008
0.0008
1 Vinyl Chloride
0.2
0.02
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Waypoint and Date of analysis: 2-16-2023
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mglkg)
Monthly Average
Concentration Limits
(Class A Only)
(mglkg)
Result
(mglkg)
Arsenic
75
41
4.35
Cadmium
85
39
2.43
Copper
4,300
1,500
406
Lead
840
300
71.6
Mercury
57
17
1.08
Molybdenum
75
n/a
7.16
Nickel
420
420
16.8
Selenium
100
100
11.2
Zinc
7,500
2,800
1480
b. For Surface Disposal Unit (landfill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: � and Date of analysis: W
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
17 > 0 but < 25
30
200
210
❑ > 25 but < 50
34
220
240
❑ > 50 but < 75
39
260
270
❑ > 75 but < 100
46
300
320
❑ > 100 but < 125
53
360
390
❑ > 125
62
450
420
Result (mglkg)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 15.5 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Waypoint and Date of analysis: 2-16-2023
Parameter
Result
(mg1kg)
Aluminum
21600
Ammonia -Nitrogen
974
Calcium
12100
Magnesium
2630
Nitrate -Nitrite Nitrogen
35.5
pH (Standard Unit)
6.5
Phosphorus
21100
Potassium
2370
Sodium
742
Total Kjeldahl Nitrogen
46300
c. Using the results listed in Item IL 5b. above, calculate the sodium adsorption ration (SAR): 0.63
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 30 %. This
rate is a (check one): Ji default value, or ❑ actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, ex lain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals:
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (1st) Year PAN
Five -Year
Maximum Adjusted PAN
(mg1kg)
(mg/kg)
Surface
14120.3
22404.12
Injection/Incorporation
14607.3
22765.75
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses:
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
rl A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
JJ A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
14 Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
J Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
E] Alternative 4 [15A NCAC 02T.I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 5 [15A NCAC 02T.1106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: composting, W heat drying, heat treatment,
thermophilic aerobic digestion, beta ray irradiation,
❑ gamma ray irradiation, or I pasteurization.
b. For Land Application of Class B:
Alternative 1 [15A NCAC 02T.I 106(c)(1)] - Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T.I 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, I
air drying, ❑ anaerobic digestion,
El composting, or lime stabilization.
c. For Surface Disposal:
11 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
J Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
J Exempt -If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
J Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
❑ Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
El Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
E] Alternative 4 [15A NCAC 02T. 1107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
E] Alternative 5 [15A NCAC 02T. I 107(a)(5)] - 14-Day Aerobic Processes.
E] Alternative 6 [15A NCAC 02T. 1107(a)(6)] - Alkaline Stabilization.
E] Alternative 7 [15A NCAC 02T. 1107(a)(7)] - Drying of Stabilized Residuals.
E] Alternative 8 [15A NCAC 02T. 1107(a)(8)] - Drying of Unstabilized Residuals.
Alternative 9 [15A NCAC 02T. 1107(a)(9)] - Injection.
Alternative 10 [15A NCAC 02T. 1107(a)(10)] - Incorporation.
q Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(b)(2)].
id Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

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{

Quantitative Justification for Residuals Rate:
The town of Forest City produced a maximum of 373.03 dry tons peryear over the last 10 years; this
is lower than the 400 dry tons per year requested in this permit renewal.

U.S. Biosolids, Inc.
Permit No. WQ0037135
SAMPLING PLAN
Annually, if a land application event occurs, grab samples are collected from the digester. Samples
from the digesterwill be combined to form individual grab samples to be sent to a laboratoryfor
analysis. If a land application event is to occur in the early part of a calendar year (i.e. January or
early February) these samples may have to be taken in December, so results can be obtained
before the land application event, as some results take 30+ days to receive.
These individual grab samples are collected and tested for fecal coliform analysis, volatile solids
reduction, nutrient analysis, and a TCLP test. These tests will be taken by U.S. Biosolids, Inc. All
samples except for the composite residual sample will be taken to a state certified laboratory. All
samples taken will be taken in the same condition as the residuals are to be land applied.
The volatile solids will first be attempted to be achieved using option 1 [503.33(b)(1)]; 38%volatile
solids reduction. This option will be attempted first due to it being the most cost effective. One
sample will betaken at the aeration basin and labeled "B". The next sample will be labeled "A" and
be taken from the digester.
If option 1 cannot be achieved to meet the volatile solids reduction, a 30 day bench scale option 3
[503.33(b)(3)] test will be used. This sample will be taken from the digester with the sample being at
least a quart in quantity.
If both option 1 and 3 are used and volatile solids reduction cannot be achieved; the sludge holding
tank will be stabilized using sufficient alkaline to meet option 6 [503.33(b)(6)], commonly known as
time stabilization.
Fecal Coliform is gathered in seven (7) individual samples and tested to meet the requirements of
[503.32(b)(2)]. This requirement is for the geometric mean fecal coliform density of the samples be
less than two million (2,000,000) MPN per gram. These samples will be placed in 250ml containers
and placed on ice, in a cooler for transport to the laboratory before 1600 hours (4pm) the same day
the samples are obtained.
Annually, if land application occurs, a composite residual sample will be analyzed, prior to a land
application event for:
Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia
Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus, Potassium, TKN,
Sodium
From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption Ratio (SAR) will
be calculated. This sample will be collected in a non -breakable container, at least one quart in size.
This sample will be taken from the digester. This test will be done by a state approved laboratory.

Waypointo
ANALYTICAL
2/28/2023
US Biosolids Inc
Dennis Key
958 Hoots Road
Roaring River, NC, 28669
Ref: Analytical Testing
Report Number: 23-048-0001
Project Description: Forest City
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Dear Dennis Key:
Waypoint Analytical Virginia, Inc. received sample(s) on 2/17/2023 for the analyses presented in the following
report.
The above referenced project has been analyzed per your instructions. The analyses were performed in
accordance with the applicable analytical method. Sub -contracted testing is noted on the Sample Summary Table
if applicable.
The analytical data has been validated using standard quality control measures performed as required by the
analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all
parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA
(including 40 CFR 136 Method Update Rule May 2012) and NELAC unless otherwise indicated.
Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of
sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time.
Refer to sample analysis time for confirmation of holding time compliance.
The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as -
received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to
the samples included in this report.
Please do not hesitate to contact me or client services if you have any questions or need additional information.
Sincerely,
Q y
Brandi Watson
Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the
analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis.
Page 1 of 8

•
Waypoint
ANALYTICAL
Report Number: 23-048-0001
Client Project Description: Forest City
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Sample Summary Table
Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID
60925
Forest City
Solids
02/16/2023 10:00
02/17/2023
60925
Forest City
Solids
02/16/2023 10:00
02/17/2023
SM-4500-NH3C
WP MTN
60925
Forest City
Solids
02/16/2023 10:00
02/17/2023
9045D
WP MTN
60925
Forest City
Solids
02/16/2023 10:00
02/17/2023
4500NO3F-2011
WP MTN
60925
Forest City
Solids
02/16/2023 10:00
02/17/2023
6010D
WP MTN
60925
Forest City
Solids
02/16/2023 10:00
02/17/2023
SW-7471B
WP MTN
60925
Forest City
Solids
02/16/2023 10:00
02/17/2023
SM-4500-NH3C-TKN
WP MTN
60925
Forest City
Solids
02/16/2023 10:00
02/17/2023
SM-2540G
WP MTN
WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN
Page 2 of 8

s
7621 0 Whitepine Road, Richmond, WA 23237
Waypoint
Main 804-743-9401 ° Fax [phone]
ANALYTICAL www.waypointanalytical.com
46381
US Biosolids Inc Project Forest City
Dennis Key Report Date : 02/28/2023
958 Hoots Road Information : Received : 02/17/2023
Roaring River , NC 28669
Brandi Watson
Report Number : 23-048-0001 REPORT OFANAL YSIS
Lab No : 60925
Matrix: Solids
Sample ID : Forest City
Sampled:
2/16/2023 10:00
Test
Results
Units
MQL
DF
Date / Time
By
Analytical
Analyzed
Method
Moisture
84.5
%
0.010
1
02/23/2315:45
FMM
SM-254OG
Sulfur
8840
mg/Kg - dry
64.5
1
02/22/23 23:32
BKN
6010D
Calcium
12100
mg/Kg - dry
323
1
02/22/23 23:32
BKN
6010D
Aluminum
21600
mg/Kg - dry
32.3
1
02/22/23 23:32
BKN
6010D
Manganese
346
mg/Kg - dry
3.23
1
02/22/23 23:32
BKN
6010D
Organic N
45280
mg/Kg - dry
1613
1
02/27/23 14:00
CALCULATION
Nickel
16.8
mg/Kg - dry
1.61
1
02/22/23 23:32
BKN
6010D
Lead
71.6
mg/Kg - dry
1.94
1
02/22/23 23:32
BKN
6010D
Arsenic
4.35
mg/Kg - dry
3.23
1
02/22/23 23:32
BKN
6010D
Selenium
11.2
mg/Kg - dry
3.23
1
02/22/23 23:32
BKN
6010D
Test
Results
Units
MQL
DF
Date / Time
By
Analytical
Analyzed
Method
Total Solids
15.5
%
0.010
1
02/23/23 15:45
FMM
SM-254OG
Phosphorus
21100
mg/Kg - dry
32.3
1
02/22/23 23:32
BKN
6010D
Copper
406
mg/Kg - dry
3.23
1
02/22/23 23:32
BKN
6010D
Total Kjeldahl Nitrogen 46300 mg/Kg - dry
Qualifiers/ DF Dilution Factor
Definitions
1610 1 02/27/23 14:00 JPJ iM-4500-NH3C-T0
MQL Method Quantitation Limit
Page 3 of 8

s
7621 0 Whitepine Road, Richmond, WA 23237
Waypoint
Main 804-743-9401 ° Fax [phone]
ANALYTICAL www.waypointanalytical.com
46381
US Biosolids Inc Project Forest City
Dennis Key Report Date : 02/28/2023
958 Hoots Road Information : Received : 02/17/2023
Roaring River , NC 28669
Brandi Watson
Report Number : 23-048-0001 REPORT OFANAL YSIS
Lab No : 60925
Sample ID : Forest City
Matrix: Solids
Sampled: 2/16/2023 10:00
Potassium
2370
mg/Kg - dry
64.5
1
02/22/23 23:32
BKN
6010D
Magnesium
2630
mg/Kg - dry
32.3
1
02/22/23 23:32
BKN
6010D
Sodium
742
mg/Kg - dry
161
1
02/22/23 23:32
BKN
6010D
Iron
19600
mg/Kg - dry
64.5
1
02/22/23 23:32
BKN
6010D
Zinc
1480
mg/Kg - dry
8.06
1
02/22/23 23:32
BKN
6010D
Ammonia Nitrogen
974
mg/Kg - dry
645
1
02/28/23 11:00
JPJ
SM-4500-NH3C
Nitrate+ N itrite-N
35.5
mg/Kg - dry
32.3
1
02/23/23 13:38
ZBD
4500NO3F-2011
Cadmium
2.43
mg/Kg - dry
0.645
1
02/22/23 23:32
BKN
6010D
Chromium
46.7
mg/Kg - dry
1.61
1
02/22/23 23:32
BKN
6010D
Mercury
<1.08
mg/Kg - dry
1.08
1
02/22/23 15:12
FDS
SW-7471B
pH
6.5
S.U.
1
02/23/23 15:30
SAR
9045D
Molybdenum
7.16
mg/Kg - dry
1.61
1
02/22/23 23:32
BKN
6010D
Qualifiers/ DF Dilution Factor MQL Method Quantitation Limit
Definitions
Page 4 of 8

Waypointo
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytica1.com
Client: US Biosolids Inc CASE NARRATIVE
Project: Forest City
Lab Report Number: 23-048-0001
Date: 2/28/2023
Metals Analysis Method 6010D
Sample 88165
Analyte: Aluminum
QC Batch No: 1-666345/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 88165
Analyte: Arsenic
QC Batch No: 1-665778/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Sample 88165
Analyte: Chromium
QC Batch No: 1-665778/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 88165
Analyte: Iron
QC Batch No: 1-666047/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 88165
Analyte: Potassium
QC Batch No: 1-665778/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 88165
Analyte: Lead
QC Batch No: 1-666047/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Sample 88165
Analyte: Selenium
QC Batch No: 1-665778/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Page 5 of 8

Waypointo
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytica1.com
Solids Total Mercury Analysis - CVAA Method 7471A
Sample 88961 (JR-1-1)
Analyte: Mercury
QC Batch No: 1-665626/1-665268
The matrix spike, matrix spike duplicate and the post digestion spike were all outside of the quality control
acceptance ranges. Matrix interference is suspected.
Page 6 of 8

WayPAo0nt..
NALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 46381
Customer Name: US Biosolids Inc
Report Number: 23-048-0001
Shipping Method
0 Fed Ex 0 US Postal 0 Lab
* UPS 0 Client 0 Courier
0 Other:
Thermometer ID:
F
Shipping container/cooler uncompromised?
0 Yes
0 No
Number of coolers/boxes received
I '
Custody seals intact on shipping container/cooler?
0 Yes
0 No
Not Present
Custody seals intact on sample bottles?
0 Yes
0 No
0 Not Present
Chain of Custody (COC) present?
0 Yes
0 No
COC agrees with sample label(s)?
0 Yes
0 No
COC properly completed
0 Yes
0 No
Samples in proper containers?
0 Yes
0 No
Sample containers intact?
0 Yes
0 No
Sufficient sample volume for indicated test(s)?
0 Yes
0 No
All samples received within holding time?
0 Yes
0 No
Cooler temperature in compliance?
0 Yes
0 No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
0 Yes
0 No
Water - Sample containers properly preserved
0 Yes
0 No
0 N/A
Water - VOA vials free of headspace
0 Yes
0 No
0 N/A
Trip Blanks received with VOAs
0 Yes
0 No
0 N/A
Soil VOA method 5035 — compliance criteria met
0 Yes
0 No
N/A
F_ High concentration container (48 hr) F_ Low concentration EnCore samplers (48 hr)
F_ High concentration pre -weighed (methanol -14 d) F_ Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included? 0 Yes 0 No
Comments:
Signature: IDavid Lennon Date & Time: 02/17/2023 12:31:53
Page 7 of 8

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Page 8 of 8

PROMPT•ACCUR TE•RELIABLE
LABORATORIES, INC
W W W.PAR�L AABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSO18670-
IDS, INC.
PO BOX 146
RONDA, NC
PROJECT NAME: FEB 23
DATE: 04/19/23
SAMPLE NU4ER- 146489 SAMPLE ID- FOREST CITY
DATE SAMPL�D- 02/16/23
DATE RECEDED- 02/16/23 SAMPLER- ZK
TIME RECEIVED- 1320 DELIVERED BY- ZK
Page 1 of 1
ANALYSIS
30 DAY BEN H
ANALYSIS
METHOD DATE TIME BY
SCALE TEST VAR 02/16/23 1530 RE
SAMPLE MATRIX- WW
TIME SAMPLED- 0930
RECEIVED BY- DJ
TYPE SAMPLE- Grab
RESULT UNITS
2.91 %
LABORATORY DIRECTOR =?^J
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

F;Z
PROMPT -ACC RATE -RELIABLE
LABORA ORIES' INC
WWW.PA LABS.COM
30 Day Bench Scale Extended Aeration Test
Percent Volatile Solids Reduction
U.S. BIOSOLIDS, INC.
FOREST CITY
146489
• 02/16/23
03/17/23
Start: End:
S
0.1781
0.2070
s%
1.81 %
1.79%
S )
0.1338
0.1527
IVIS%
75.13%
73.77%
y Mass Fraction of Volatile Solids in Liquid Sludge
0.01359881
0.0132052
x Mass Fraction of Fixed Solids in Liquid Sludge
0.0045024
0.0046958
,SVR (Mass Balance)
2.91 %
SVR (Van Kleeck)
2.88%
SVR (Mass Balance) <15%
YES
SVR (Van Kleeck) <15%
YES
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] • Fax: (704) S88-833-S

ML
PROMPT•ACCUR TE•RELIABLE
LABORAT RIES)p INC
WWW.PARLABS.COM
30 Day Bench Scale Extended Aeration Test
VAR C)ntinn 3 PPrr Ant Vnlatile 8nlids Reduction
Collected
D.O.
Crucible
Tare Wt (g)
Sample Wt +
Tare Wt (g)
Liquid Sludge Wt
(g)
Oven Temp °C
Date/Time In
Date/Time Out
Dried Sample Wt
+ Tare Wt (g)
Dried Sludge Wt (g;
Fixed Solids Wt (g
Furnace Temp °C
Date/Time In
Date/Time Out
Burned Sample
Wt + Tare Wt (g)
Volatile Solids Wt (g;
TS%
VS%
U.S. BIOSOLIDS, INC.
FOREST CITY
146489
02/16/23
lip, 03/17/23
As Received Day 0 Day 7 Day 14 Day 21 Day 28
n.J14cro4 n119A11z ns/ns/2s 03/1rt/23 n3117123
R 7/" ' o 2.03
3.66
4.12
4.96
4.99
X12 X2
X14
X16
X23
X30
19.3064 25.0671
20.9079
22.6961
15.9247
18.3494
28.9075 34.9062
30.4728
32.8722
27.3683
29.9130
9.6011 9.8391
9.5649
10.1761
11.4436
11.5636
107 106
106
106
105
106
2/16/23 15:30 02/17/23 14:45
02/24/23 09:50
03/03/23 10:05
03/10/23 10:10
03/17/23 09:45
2/17/23 15:20 02/18/23 15:00
02/25/23 10:00
03/04/23 10:00
03/11 /23 10:30
03/18/23 10:00
19.5336
25.2452
21.0782
22.8772
16.1284
18.5564
0.2272
0.1781
0.1703
0.1811
0.2037
0.2070
0.0443
0.0427
0.0456
0.0533
0.0543
550
550
550
550
550
j
02/18/23 16:00
02/25/23 15:40
03/04/23 14:55
03/11/23 15:20
03/18/23 14:50
02/18/23 17:05
02/25/23 17:00
03/04/23 16:00
03/11/23 16:30
03/18/23 15:55
ti
25.1114
20.9506
22.7417
15.9780
18.4037
0.1338
0.1276
0.1355
0.1504
0.1527
2.37%
1.81 %
1.78%
1.78%
1 1.78%
1.79%
75.13%
74.93%
74.82%
1 73.83%
73.77%
yf Mass Fraction of Volatile Solids in Liquid (Feed) yb Mass Fraction of Volatile Solids in Liquid (Bottom)
R1-1- nt Rtart of Test 0.0135988 Sludae at End of Test 0/0132052
f Mass Fraction of Fixed Solids in Liquid (Feed) Sludge xb Mass Fraction of Fixed Solids in Liquid (Bottom)
at Start of Test 0.0045024 Sludge at End of Test 0.0046958
TS 0.1781 TS 0.207
VS (a) 0.1338 VS (g) 0.1527
Volatile Fraction In:1 0.415081 [Volatile Fraction Out] 0.41212
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] • Fax: [phone]

CHAIN OF CUSTODY
Phone [phone]
PROMPT -ACC AT• RELIas_IM Fax [phone]
LAOAIES., INC
Shipping Et Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
It is essen I that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
Carolina r oartment of Environmental and Natural Resources_
Company Name (billing)
C.
Comments/ Special Instructions
Address
Po 0
ILI6-
City, State 8t zip c
ode h
C no
Point of Contact
Telephone Number
33G,y,; 3Ssc1
Sample 9,Q
Taken By: IGNATURE C4,pc PRINTED NAME /c
ARE SAMPLES FOR STATt or EPA REPORTING? YES 3e 00 NO
*Sample Type: DW WW _ GWMW HW soil other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
**Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (YIN): Dechlorination Necessary (Y/N):
rient:Sampie LA.. '' Sd€"Ltp Cailection`"" "tyres"
Sampte Location / umber) Comp Grab Presenr. Datelrme Date/rime, Requ6sted "
ISI?
Q:Ina rw-. 3ci_ d �OnC
Relinquished by: Daterrime Recei by: Date/Time
Relin uished by: 4 Date rime R ived by: Date rime
C=Composite G�Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

PA&
PROM PT- A CCU RATE- RELIABLE
LABORATQRIES, INC
W W W.PARLiABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
PROJECT NAME: FEB 23
DATE: 04/19/23
SAMPLE NUMBER- 146490 SAMPLE ID- FOREST CITY
DATE SAMPLED- 02/16/23
DATE RECEI�ED- 02/16/23 SAMPLER- ZK
TIME RECEIVED- 1320 DELIVERED BY- ZK
Page 1 of' 1
ANALYSIS
ANALYSIS METHOD DATE TIME BY
FECAL COLI*ORM (GEOM. MEAN) SM 9221 E 02/16/23 1600 RE
SAMPLE MATRIX- WW
TIME SAMPLED- 0930
RECEIVED BY- DJ
TYPE SAMPLE- Grab
RESULT UNITS
6,556 MPN/g
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PAF;Z
-REt-1A8L-C
LABC7T2P}"Z"ORIT3,S, INS
2217 Graham Park Drive
PO Box 411483
Charlotte, NC 28241-1483
NC Cert # 20; SC Cert # 99003001
•
U.S. BIOSOLIDS, INC.
FOREST CITY
•
02/16/23
•
FECAL COLIFORM, GEOMETRIC MEAN
•
• SM 9221 E
146490 1 1
2
3
4
5
2,023
1,884
2,780
2,399
2,457
2,412
1.867
48.45%
34.03%
28.08%
30.17%
33.09%
40.02%
29.22%
4,174.25
5,536.53
9,902.63
7,952.80
7,425.21
6,026.67
6,390.21

CHAIN OF CUSTODY
Phone [phone]
PPROMPT-AACE-RELIABLE Fax [phone]
LABORA ORIES,, INC
Shipping £t Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
it is essent al that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
Carolina D oartment of Environmental and Natural Resources.
Company Name (Aping)
0.5.
,asd)-% nC.
Comments/ S eciai Instructions
Address
Po Q
lye'
City, State It zip code
Roy
(-
Point of Contact E
L
Telephone Number
e 33(— 9
Sample V
Taken By: SIGNATURE PRINTED NAME ZoIck
ARE SAMPLES FOR STATE tor EPA REPORTING? YES /X NO
*Sample Typ : DW WW _X GWMW HW Soil Other
Sample Teml 1 at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Prese ed: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (Y/N): Dechlorination Necessary (YIN):
rterd Same t_D. " Setup CollectFrn' '�iotyses � � ; . s
Sample Location f umber) Comp Grab" Preserv. DaterTrme Date/Time. Requested
wr%* RCa1
7
Relin 'sh by: Daterrime Re by: Dater nme
a-►`�s 0,9-
-��-���`.�
Reli uished by: Daterrime Received by: Daterrime
C=Composite
DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

PA&
PROMPT•ACCURATE-RELIABLE
LABORATORIES, INC
W W W.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC. PROJECT NAME: FEB 23
PO BOX 146 DATE: 04/06/23
RONDA, NC 28670-
SAMPLE NUMBER- 146488 SAMPLE ID- FOREST CITY
DATE SAMPLED- 02/16/23
DATE RECEIVED- 02/16/23 SAMPLER- ZK
TIME RECEIVED- 1320 DELIVERED BY- ZK
Page 1 of 2
SAMPLE MATRIX- WW
TIME SAMPLED- 0930
RECEIVED BY- DJ
TYPE SAMPLE- Grab
ANALYSIS
ANALYSIS
METHOD
DATE
TIME
BY
RESULT
UNITS
TCLP CHARACTERISTICS
TCLP
03/06/23
0930
CB
pH VALUE
TCLP
03/06/23
0930
CB
6.6
S.U.
CORROSIVITY
TCLP
03/06/23
0930
CB
NON
REACTIVITY
TCLP
03/06/23
0930
CB
NON
FLASH POINT
TCLP
03/06/23
0930
CB
> 200
degrees F
IGNITABILITY
TCLP
03/06/23
0930
CB
NON
PAINT FILTER TEST
TCLP
03/06/23
1101
CB
NFL
TCLP METALS
TCLP
02/27/23
1648
TS
ARSENIC
TCLP
02/27/23
1648
TS
< 0.5
ppm
BARIUM
TCLP
02/27/23
1648
TS
< 10
ppm
CADMIUM
TCLP
02/27/23
1648
TS
< 0.1
ppm
CHROMIUM
TCLP
02/27/23
1648
TS
< 0.5
ppm
LEAD
TCLP
02/27/23
1648
TS
< 0.5
ppm
MERCURY
TCLP
02/27/23
1648
TS
< 0.02
ppm
SELENIUM
TCLP
02/27/23
1648
TS
< 0.1
ppm
SILVER
TCLP
02/27/23
1648
TS
< 0.5
ppm
TCLP PESTICIDES
TCLP
03/01/23
1338
VC
ENDRIN
TCLP
03/01/23
1338
VC
< 0.002
ppm
LINDANE
TCLP
03/01/23
1338
VC
< 0.04
ppm
METHOXYCHLOR
TCLP
03/01/23
1338
VC
< 1
ppm
TOXAPHENE
TCLP
03/01/23
1338
VC
< 0.05
ppm
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PLLF;Z
PROMPT -ACCURATE -RELIABLE
LABORATORIES, INC
WWW.PARLABS.COM
Page 2 of 2
CONTINUATION OF DATA FOR SAMPLE NUMBER 146488
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
CHLORDANE
TCLP
03/01/23
1338
VC
< 0.003
ppm
HEPTACHLOR (AND ITS EPDXIDE)
TCLP
03/01/23
1338
VC
< 0.0008
ppm
TCLP HERBICIDES
TCLP
03/01/23
2143
VC
2,4-D
TCLP
03/01/23
2143
VC
< 1
ppm
2,4,5-TP(SILVEX)
TCLP
03/01/23
2143
VC
< 0.1
ppm
TCLP ORGANICS
TCLP
02/23/23
1226
MS
BENZENE
TCLP
02/23/23
1226
MS
< 0.05
ppm
CARBON TETRACHLORIDE
TCLP
02/23/23
1226
MS
< 0.05
ppm
CHLOROBENZENE
TCLP
02/23/23
1226
MS
< 10
ppm
CHLOROFORM
TCLP
02/23/23
1226
MS
< 0.6
ppm
o-CRESOL
TCLP
02/23/23
1226
MS
< 20
ppm
p-CRESOL
TCLP
02/23/23
1226
MS
< 20
ppm
m-CRESOL
TCLP
02/23/23
1226
MS
< 20
ppm
1,4-DICHLOROBENZENE
TCLP
02/23/23
1226
MS
< 0.75
ppm
1,2-DICHLOROETHANE
TCLP
02/23/23
1226
MS
< 0.05
ppm
1,1-DICHLOROETHYLENE
TCLP
02/23/23
1226
MS
< 0.07
ppm
2,4-DINITROTLUENE
TCLP
02/23/23
1226
MS
< 0.013
ppm
HEXACHLOROBENZENE
TCLP
02/23/23
1226
MS
< 0.013
ppm
HEXACHLOROBUTDIENE
TCLP
02/23/23
1226
MS
< 0.05
ppm
HEXACHLOROETHANE
TCLP
02/23/23
1226
MS
< 0.3
ppm
METHYL ETHYL KETONE
TCLP
02/23/23
1226
MS
< 20
ppm
NITROBENZENE
TCLP
02/23/23
1226
MS
< 0.2
ppm
PENTACHLOROPHENOL
TCLP
02/23/23
1226
MS
< 10
ppm
PYRIDINE
TCLP
02/23/23
1226
MS
< 0.5
ppm
TETRACHLORETHYLENE
TCLP
02/23/23
1226
MS
< 0.07
ppm
TRICHLOROETHYLENE
TCLP
02/23/23
1226
MS
< 0.05
ppm
2,4,5-TRICHLOROPHENOL
TCLP
02/23/23
1226
MS
< 40
ppm
2,4,6-TRICHLORPHENOL
TCLP
02/23/23
1226
MS
< 0.2
ppm
VINYL CHLORIDE
TCLP
02/23/23
1226
MS
< 0.02
ppm
LABORATORY DIRECTOR 'I/✓
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

AM
PROMPT -ACCURATE• RELIABLE
LABORATORIES, INC
Shipping 8 Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
Carolina Deoartment of Environmental and Natural Resources.
Company Name (billing)
U.
Address
Po
City, State i3 zip code
go, jo, �C 0
Point of Contact ti Telephone Number
2aCk 336-
I&
Sample
Taken By:
SIGNATURE
13Ss 0
Comments/ Special Instructions
PRINTED NAME <ae-1,
ARE SAMPLES FOR STATE or EPA REPORTING? YES � NO
*Sample Type: DW WW _� GWMW HW soil Other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
**Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (Y/N): Dechlorination Necessary (Y/N):
* C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 11-15, FORM: DCAR 11-15, or FORM: SDR 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 11-15):
❑ Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 11-15) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
❑ For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
❑ Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
B. Residuals Source -Generating Facility Information:
❑ For each source facility, attach the following:
❑ Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
❑ Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
❑ Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
❑ Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
❑ For each source facility, attach the following:
❑ Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 06-16 Page 1 of 1

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: City of Marion, Corpening Creek WWTP
2. Facility permit holder is: ❑ Federal, 0 State, 0 Local Government, or 0 Private.
Facility permit issued by: ❑ Div. of Water Resources, Div. of Environmental Health,
or Other (explain:
3. Facility contact person and title: Tim Horton
Complete mailing address: PO Drawer 700
City: Marion State: NC Zip: 28752-0700
Telephone number: [phone] E-mail address: thortonkmarionnc.org
4. Facility physical address: 3982 Highway 226 South
City: Marion State: NC Zip: 28752
Coordinates: Latitude: 35' 39' 09.72" Longitude: 81. 57' 23.81"
Datum: NAD83 Level of accuracy:.01
Method of measurement: MAP
5. Purpose of the facility:
treatment of municipal wastewater, treatment of 100% domestic wastewater,
treatment of potable water, treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: _ % industrial and _ % domestic)
other (explain: _ ).
6. Does the facility have an approved pretreatment program: Yes No
7. Facility permitted/design flow: 3.0 MGD and facility average daily flow: 09 MGD
8. Average amount of residuals being generated at this facility 76.15 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: Two 780,000 Aeration Basins
Type and volume of residuals storage (i.e., outside of residuals treatment units): 700,000-gallon digester
II. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part 503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological 0 Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: 0 yes ® no.
If yes, list the number(s): _
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: N yes [i no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: Pace Analytical and Date of analysis: 12-10-2020
Passed corrosivity test: yes no. pH: s.u. (2 <pH < 12.5)
Passed ignitability test: yes no. Flashpoint: 200 OF (> 140°F)
Passed reactivity test: ® yes ao. HCN: ND mg/kg (<250) & H2S: ND mg/kg (<500)
TCLP Parameter
Limit
(mgfi)
Result
(m917)
TCLP Parameter
Limit
(mgfi)
Result
(mgfi)
Arsenic
5.0
ND
Hexachlorobenzene
0.13
ND
Barium
100.0
ND
Hexachloro-1,3-Butadiene
0.5
ND
Benzene
0.5
ND
Hexachloroethane
3.0
ND
Cadmium
1.0
ND
Lead
5.0
ND
Carbon Tetrachloride
0.5
ND
Lindane
0.4
ND
Chlordane
0.03
ND
Mercury
0.2
ND
Chlorobenzene
100.0
ND
Methoxychlor
10.0
ND
Chloroform
6.0
ND
Methyl Ethyl Ketone
200.0
ND
Chromium
5.0
ND
Nitrobenzene
2.0
ND
m-Cresol
200.0
ND
Pentachlorophenol
100.0
ND
o-Cresol
200.0
ND
Pyridine
5.0
ND
p-Cresol
200.0
ND
Selenium
1.0
ND
Cresol
200.0
ND
Silver
5.0
ND
2,4-D
10.0
ND
Tetrachloroethylene
0.7
ND
1,4-Dichlorobenzene
7.5
ND
Toxaphene
0.5
ND
1,2-Dichloroethane
0.5
ND
Trichloroethylene
0.5
ND
1,1-Dichloroethylene
0.7
ND
2,4,5-Trichlorophenol
400.0
ND
2,4-Dinitrotoluene
0.13
ND
2,4,6-Trichlorophenol
2.0
ND
Endrin
0.02
ND
2,4,5-TP (Silvex)
1.0
ND
Heptachlor and its Hydroxide
0.008
ND
Vinyl Chloride
0.2
ND
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: ETS, Inc. and Date of analysis: 8-22-2022
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mglkg)
Monthly Average
Concentration Limits
(Class A Only)
(mglkg)
Result
(mglkg)
Arsenic
75
41
16.8
Cadmium
85
39
16.8
Copper
4,300
1,500
538
Lead
840
300
54.4
Mercury
57
17
0.738
Molybdenum
75
n/a
53.1
Nickel
420
420
19.3
Selenium
100
100
16.8
Zinc
7,500
2,800
1450
b. For Surface Disposal Unit (landfill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: _ and Date of analysis: _
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
❑ > 0 but < 25
30
200
210
❑ > 25 but < 50
34
220
240
❑ > 50 but < 75
39
260
270
❑ > 75 but < 100
46
300
320
❑ > 100 but < 125
53
360
390
❑ > 125
62
450
420
Result (mg4g)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 2.6 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: ETS, Inc. and Date of analysis: 8-2-2022
Parameter
Result
(mglkg)
Aluminum
13800
Ammonia -Nitrogen
77
Calcium
18900
Magnesium
5420
Nitrate -Nitrite Nitrogen
157
pH (Standard Unit)
4.9
Phosphorus
19700
Potassium
5450
Sodium
1840
Total Kjeldahl Nitrogen
24700
c. Using the results listed in Item IL 5b. above, calculate the sodium adsorption ration (SAR): 0.53
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 30 %. This
rate is a (check one): JW default value, or ❑ actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, ex lain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals: ia
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (1s) Year PAN
Five -Year
Maximum Adjusted PAN
(mglkg)
(mglkg)
Surface
7582.4
11988.88
Injection/Incorporation
7620.9
12017.47
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses:
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
JJ A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
IN Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
J Alternative 2 [15A NCAC 02T.I 106(b)(3)(13)] - Alkaline Treatment.
d Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
El Alternative 4 [15A NCAC 02T.I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 5 [15A NCAC 02T.1106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: composting, W heat drying, heat treatment,
thermophilic aerobic digestion, beta ray irradiation,
❑ gamma ray irradiation, or pasteurization.
b. For Land Application of Class B.
Alternative 1 [15A NCAC 02T.I 106(c)(1)] - Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T. 1106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, I
air drying, ❑ anaerobic digestion,
El composting, or lime stabilization.
c. For Surface Disposal:
11 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
J Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
J Exempt -If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
J Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
El Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
Alternative 5 [15A NCAC 02T.I 107(a)(5)] - 14-Day Aerobic Processes.
Alternative 6 [15A NCAC 02T. 1107(a)(6)] - Alkaline Stabilization.
Alternative 7 [15A NCAC 02T. 1107(a)(7)] - Drying of Stabilized Residuals.
Alternative 8 [15A NCAC 02T. 1107(a)(8)] - Drying of Unstabilized Residuals.
Alternative 9 [15A NCAC 02T.I 107(a)(9)] - Injection.
Alternative 10 [15A NCAC 02T.I 107(a)(10)] - Incorporation.
El Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(b)(2)].
a Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

QUANTITATIVE JUSTIFICATION FOR RESIDUALS PRODUCTION RATE
The City of Marion has produced the following dry tons over the last 7 years.
2022 96.27 DT
2021 103.37 DT
2020 58.06 DT
2019 145.89 DT
2018 0 DT
2017 94.34 DT
2016 35.13 DT
This comes to an average of 76.15 Dry Tons per year

r

U.S. Biosolids, Inc.
Permit No. WQ0037135
SAMPLING PLAN
Annually, if a land application event occurs, grab samples are collected from the digester. Samples
from the digesterwill be combined to form individual grab samples to be sent to a laboratoryfor
analysis. If a land application event is to occur in the early part of a calendar year (i.e. January or
early February) these samples may have to be taken in December, so results can be obtained
before the land application event, as some results take 30+ days to receive.
These individual grab samples are collected and tested for fecal coliform analysis, volatile solids
reduction, nutrient analysis, and a TCLP test. These tests will be taken by U.S. Biosolids, Inc. All
samples except for the composite residual sample will be taken to a state certified laboratory. All
samples taken will be taken in the same condition as the residuals are to be land applied.
The volatile solids will first be attempted to be achieved using option 1 [503.33(b)(1)]; 38%volatile
solids reduction. This option will be attempted first due to it being the most cost effective. One
sample will betaken at the aeration basin and labeled "B". The next sample will be labeled "A" and
be taken from the digester.
If option 1 cannot be achieved to meet the volatile solids reduction, a 30 day bench scale option 3
[503.33(b)(3)] test will be used. This sample will be taken from the digester with the sample being at
least a quart in quantity.
If both option 1 and 3 are used and volatile solids reduction cannot be achieved; the sludge holding
tank will be stabilized using sufficient alkaline to meet option 6 [503.33(b)(6)], commonly known as
time stabilization.
Fecal Coliform is gathered in seven (7) individual samples and tested to meet the requirements of
[503.32(b)(2)]. This requirement is for the geometric mean fecal coliform density of the samples be
less than two million (2,000,000) MPN per gram. These samples will be placed in 250ml containers
and placed on ice, in a cooler for transport to the laboratory before 1600 hours (4pm) the same day
the samples are obtained.
Annually, if land application occurs, a composite residual sample will be analyzed, prior to a land
application event for:
Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia
Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus, Potassium, TKN,
Sodium
From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption Ratio (SAR) will
be calculated. This sample will be collected in a non -breakable container, at least one quart in size.
This sample will be taken from the digester. This test will be done by a state approved laboratory.

Environmental Testing Solutions, Inc.
Certificate of Analysis
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Project name: Marion WWTP Project number: 220802.517
Collection date: 2-Aug-22
Date received: 2-Aug-22
Sample identification: Sludge l/2 - Grab Sample number: 225836
Parameter
Method
Result
RL Units
Date
Analyzed
Analyst
Footnotes
Arsenic
200.7
<16.8
mg/kg
16-Aug-2z
ECHEM
I
Cadmium
200.7
<16.8
mg/kg
16-Aug-22
LCIIEM
I
Copper
200.7
538
mg/kg
2:-Aug-22
UC:HEM
I
Lead
200.7
54.4
mg/kg
16-Aug-22
ECHEM
1
Molybdenum
200,7
53.1
mg/kg
16-Aur 22
F.CHFM
1
Nickel
200.7
19.3
mglkg
16-A.g.22
ECIII-M
1
Selenium
200.7
<16.8
mg/kg
16-Aug-22
ECHEM
1
Zinc
200.7
1450
mg/kg
2,-Aug-22
PCHEM
1
Aluminium
200.7
13800
mg/kg
23-Aug-22
ECIILM
1
Calcium
200.7
18900
mg/kg
23-Aug-22
ECHEM
1
Magnesium
200.7
5420
mg/kg
17-Aug,-22
ECHEM
I
Potassium
200.7
5450
mg/kg
23-Aug-22
ECIIEM
1
Sodium
200.7
1844)
mg/kg
17-Aug-22
ECHEM
1
Mercury
SW 846 7471. B
0.738
mg/kg
16-Aug-22
ECHEM
I
Total Kjeldahl Nitrogen
351.2
24700
mgikg
s-Aug-22
EC1IT' M
1
Nitrate i Nitrate - Nitrogen
353.2
157
mg/kg
M-ua
LCI IEM
1
Total Phosphorus
200.7
19700
mg/kg
17-Aug-22
ECHEM
1
Total Solids (%)
SM 2540 B
3.01
%
5-Aug-22
ECHEM
1
%Total Solid
SM 2540 G
2.6
%
3-Aug-22
KEK
Ammonia Nitrogen
SM 4500 NI-13 1)
77
38 mg/kg
4-Aug-22
KEK
N- Pav
Calculation
7582
mg/kg
25-Aug-22
KEK
Sodium Adsorption Ratio (SAR)
Calculation
16.7
mg/kg
25-Autc-22
KFK
H
SW 846 904D C
4.9
0.1 S.U.
3-Aug-22
KEK
2
1
-i zz
Footnotes:
RL — Repotting Limit. Values are reported down to the
1. Sample analyzed by Envrio Chemists, Inc.
2. Sample was analyzed out of mold time.
Date reviewed:
Data reviewed by: Kelley E. Keenan
Signature:
This report should not he reproduced, crept in its entirety, without the wi
The results in this report relate only to the san
JV V
f�

F�IT
�?_i
Environmental Testing Solutions, Inc.
Certificate of Analysis
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Project name: Marion WWTP Project number:
Collection date: 21-Feb-22
Date received: 21-Feb-22
Sample identification: Sludge 01 - Grab Sample number:
220221.500
220934
Parameter Method Result RL Units Date Analyst Footnotes
Analyzed
%TS SM 2540 G 2.3 0.10 % 21,17eh-22 KEK
Mulii le "rube Fermentation Procedure SM 9221-L 59800 4.7 MPN 2i-Feb-22 KEK
Sample identification: Sludge #2 - Grab Sample number
220935
Parameter Method Result RL Units Date Analyst Footnotes
Analyzed
%TS SM 2540 G 2.6 0.10 % 21-Feb-22 KEK
Mulitvlc Tube Fermentation Procedure SM 9221-i: 59800 4.7 MPN 21-Fc1r22 KEK
Sample identification: Sludge #3 Grab Sample number: 220936
Parameter Method Result RL Units Date Analyst Footnotes
Analyzed
%Ts SM 2540 G 2.6 0.10 % 2I-Feb-22 KEK
Mulit le Tube Fermentation Procedure SM 922 t-E 85800 4.7 MPN 21-Feb-22 KEK
Footnotes:
RL = Reporting Limit. Values are reported down to the Reporting Limit only.
Date reviewed:
Data reviewed by: Kelley E. Keenan
Signature:
NC Certification Number: 600
SC Certification Number: 99053
NC Drinking Water Certification Number: 37786
This report should not be reproduced, exept in its entirety, without the mTitten consent of Environmental Testing Solutions, Inc.
The results in this report relate only to the samples submitted for analysis.

i
Environmental Testing Solutions, Inc.
Project name:
Marion WWTP
Certificate of Analysis
PO Box 7565
Asheville, NC 28802
Phone: [phone]
Fax: [phone]
Project number: 220228.500
Collection date:
28-Feb-22
Date received:
28-Feb-22
Sample identification:
Sludge #4 - Grab
Sample number:
221074
Parameter
Method
Result
RL
Date Analyst
Footnotes
%TS
SM 2540 G
2.2
0.10
%
28-reb•22 KEK
\4uht le Tube fermentation Procedure SM 9221-E
50600
4,0
MPN
2840-22 KEK
Sample iden ti fication:
Slud a #5 - Grab
Sample number:
221075
Parameter
Method
Result
RL
Units
pate
Analyzed Analyst
Footnotes
%TS
SM 2540 G
1.7
0.10
%
28-Fcb-22 KEK
Muht le Tube Fermentation Procedure SM 9221-E
39100
3.1
MPN
28-Fee-27 KEK
Sample identification:
Sludge #6 Grab
Sample number:
221076
Parameter
Method
Result
RL
Units
Date
Analyzed Analyst
Footnotes
°/uTS
SM 2540 G
1.7
0.10
%
28,Fcb-22 KEK
Mulit le Tube fermentation Procedure SM 9221-E
39100
3.1
MPN
28-Feb-22 KF.K
Sample identification:
Slud a ##7 C rab
Sample number:
221077
Parameter
Method
Result
RL
Units
Date Analyst
Footnotes
Analyzed
%TS
SM 2540 G
1.8
0.10
%
28-Feb•22 KEK
Mulit le Tube Fermentation Procedure SM 9221-E
88200
3.2
MPN
28-Fcb-22 KEK
Footnotes:
ELL = Reporting Limit. Values are reported down to the Reporting Limit only,
Date reviewed:
Data reviewed by:
Signature:
Kelley E. Keenan
NC Certification Number: 600
SC: Certilcation Number: 99053
NC: Drinking Water Certification Number: 37786
This report should not be reproduced, exept in its entirety, without the written consent of Environmental Testing Solutions, Inc,
The results in this report relate only to the samples submitted for analysis.

Analytical Results
U.S. Biosolids Inc
958 Hoots Road
Roaring River, NC 28669
Receive Date: 11/12/2020
Reported: 12/10/2020
For: MARION
Comments:
Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
201112-18-01 TCLP MARION See Attached asNDted 11/1312020 PACE
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cent #37755,
EPA #NC00909
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 30

o PaceAnalyfil
www.pocrlabs.com
Pace Analytical Services, LLC
9800 KmCey Ave. Suite 100
Huntersville, NC 28078
(704 j875-9092
Project. US &o Marion
Pace Project No, 92506084
ANALYTICAL RESULTS
Sample: Sludge
Lab lD: 92506084001 Collected: 11112120 11:30 Received: 11/13/20 O8.55 Matrix, Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters
Results Units Report Limit OF Prepared Analyzed
CAS No. Qual
Chlorinated Herb. (GC) 8151A
Analytical Method. EPA8161A Preparation Method 8151A
Leachate MethodlDate, 1311: 11119,•2D 09.49 Initial pH, 5.72: Final pH, 5
Pace National - Mt. Juliet
2.4,5-TP (Sill
NO mglL 0-00200 1 11i21120 19:09 11/25/20 23:32
93-72-1
2.4-D
NO mglL 0.00200 1 11121/20 19:09 11/25120 23:32
94-75-7
Surrogates
2.4-DCAA(S)
71.4 % 14.0-158 1 11f2112019:09 11i2512023'.32
19719-28-9
OD81 TCLP Pesticides RVE
Analytical Method: EPA 8081E Preparation Method: EPA 3510C
Leachate MethodlDale: EPA 1311; 11124/20 15.55 Initial pH.: Final pH. 5
Pace Analytical Services - Charlotte
gamma-SHC (Lindane)
NO ug1L 0 50 1 11/30120 08:06 llf30/2O 15,11
58-89-9
Chlordane (Technical)
ND ugiL 3.0 1 11130120 08&06 11J30i20 15:11
57-74-9
Endrin
NO ugrL 0.50 t 11130/20 OB-08 11/30120 15:11
72-20-8
Heptachlor
ND ug1L 0.50 1 1113012DOl 11J3012015,11
76-44-8
Heptachlor epoxide
NO ugiL 0.50 1 11130120 08:06 11130120 15:11
1024-57-3
Methoxychlor
NO uglL 1000 1 11/30/20 08,06 11/30/20 15:11
72-43-5
TDxaphene
NO ug/L 3.0 1 11130/2009.06 1113012015:11
8001-35-2
Surrogates
Decachlorobiphenyl (S)
103 °A 10-154 1 11130120 08:06 11/30/20 15.11
2051-24-3
Tetrachloro,m-xylene(S)
26 °h 10-184 1 1113012608:06 11I30l2015:11
877.09-8
8082 TCLP PCBs WE
Analytical Method: EPA 8082A Preparation Method: EPA 351 OC
Leachate MelhodlDate, EPA 1311; 11124Q0 15:55 ln4ial pH. ; Final pH: 5
Pace Analytical Services - Charlotte
PCB-1016 (Aroclor 1016}
NO ug/L 1000 1 11/30120 0739 11130120 1317
12674-11-2
PCB-1221 (Aroclor 1221)
NO uglL 1000 1 11130f2007:39 111301201317
11104-28-2
PCB-1232 (Aroclor 1232)
NO ugil- 1000 1 11/30/20 07.39 11130120 13:17
11141-16-5
PCB-1242 (Aroclor 1242)
NO ug1L 10DO 1 11/30/20 07,39 11130/20 1317
53469-21-9
PCB-1248 (Aroclor 1248)
ND ug1L 1000 1 11/30I20 07 39 11l30120 13:17
12672-29-6
PCB-1254(Aroclor1254)
NO ug1L loco 1 IV301200739 11i3012013:17
11097-69-1
PCB-1260 (Aroclor 1260)
NO ugiL 1000 1 11130120 07.39 11/30120 13,17
11096-82-5
Surrogates
Decachlprobiphenyl (S)
78 % 10-181 1 11/30120 07.39 11130/20 13.17
2051-24-3
6010 MET ICP, TCLP
Analytical Method: EPA 6010D Preparation Method. EPA 3010A
Leachate Methodl0ate'. EPA 1311, 11116120 15:37 Initial pH, ; Final pH: 2
Pace Analytical Services - Asheville
Arsenic
NO mg1L 0.050 1 11118120 02 31 111181201118
7440-38-2
Barium
NO mglL 0.25 1 1111812002'.31 1111812011-.18
7440-39-3
Cadmium
NO mg1L 0.0050 1 1111812002:31 IlYlBI2011:18
7440-43-9
Chromium
NO mgrL 0.050 1 11118120 0231 11118/20 11:18
7440-47-3
Lead
NO ill 0.025 1 11/18/2002,31 1111812011,18
7439-92-1
Selenium
NO mglL 0.10 1 11118,'200231 11:18Y2011.18
77B2-49.2
Silver
NO mg1L 0.025 1 11118120 02.31 11118/20 11:18
7440-22-4
REPORT OF LABORATORY ANALYSIS
T€ds report shall nol be reproduced. axe pt in lull.
Date. 12/08/2020 05:14 PM
without the written consent of Pace Analytical Services. LLC
Page 5 of 27
PO Box 228 a Statesville, NC 28687 * 704/872/4697
Page 8 of 30

�5ceAnalyftca(
4w.p7nI�E7.can
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Klncey Ave. Suite 100
Huniersvilte. NC 28078
)704)875.9092
Project: US Bid Marion
Pace Project No. 92506084
Sample: Sludge
Lab ID: 92506084001 Collected
11/12120 11.30 Received: 11113120 08�55 Matrix: Solid
Resurts reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters
Results Units Report Limit
OF Prepared
Analyzed CAS No. Qual
7470 Mercury, TCLP
Analytical Method: EPA7470A Preparation Method: EPA 7470A
Leachate Method/Daley EPA 1311, 11116120
15:37
Initial pH:: Final d",
2
Pace Analytical Services - Asheville
Mercury
ND mglL
0,00020
1 1111812011:30
110912014:04 7439-97-6
8270E TCLP RVE
Analytical Method, EPA 8270E Preparation Method:
EPA 3510C
Leachate Melhod7Date: EPA 13 11 ; 11124120
15:55
Initial pH'.: Final pH
5
Pace Analytical Services - Charlotte
1.4-Drch€orobenzene
ND ugfL
50.0
1 11f30120 0804
11Q0120 14:40 106-46-7
2,4-DinitrotNuene
NO ugfL
50-0
1 11/3012008-04
1V3012014:40 121-14-2
Hexachlore-1:3-bWaldiene
NO ugiL
50.0
1 1113012008:04
1113012014,40 87-68-3
Hexachlorebenzene
NO ugfL
50.0
1 111301200604
1113012014A0 118-74-1
Hexachloroethane
NO ugfL
50.0
1 11 f30120 08:04
11 i30120 14,40 67-72-1
2-MaIhylphano110-Cresol)
ND ug!L
50,0
1 11130/20 08:04
11.30120 14,40 95-48-7
384-Methyiphencl(mB:pGresol)
NO ugfL
50.0
1 1113012008:04
t113012014.40 15831-10-4
Nitrobenzene
NO ugfL
50,0
1 11;30r20 08:04
11130/21) 14:40 98-95-3
Pentar.Norophenol
NO ugfL
100
1 11130120 08;04
11130120 14:40 87-86-5
Pyridine
NO ugiL
50.0
1 11130/20 08.04
1 V30120 14:40 110-85-1
2.4.5-Trichlorophenol
NO ugfL
50.0
1 11130120 08,04
11130/20 14:40 95-95-4
2,4,6-Trichlorophenol
NO ugfL
50.0
1 11130120 08:04
1V3012l) 14:40 88-06-2
Surrogates
Nitrobenzene-05 (S)
77 %
10-144
1 1V30120 08.04
11OW20 14:40 4165-60-0
2-Fluorobiphenyl(S3
54 %
10-130
1 11/30120 08:04
11130120 14:40 321-60-8
Terphenyl-614 (S)
106 %
34-163
1 11130120 05:04
11130120 14:40 1718-51-0
Phenol-d6 (S)
41 %
10-130
1 11)30f20 08:04
11130120 14'.40 13127-86-3
2-Flucrophenol(S)
58 %
10-130
1 11/30f20 08:D4
11130120 14t40 367-12-4
2.4,6-Tnldromophenoi (S)
75 I
10-144
1 1 V30120 08.04
11130/20 14'.40 118-79-6
8260D MSV TCLP
Analytical Method: EPA 82600 Leachate MethodlDate: EPA 1311; 11123120 17.16
Pace Analytical Services - Chadotte
Benzene
ND ug/L
100
20
lli2412017,22 71.43-2
2-Butanone (MEK)
NO ugfL
201
20
1V2412017:22 78-93-3
Carbon tetrachloride
NO ugfL
10D
20
11124120 17:22 56-23-5
Chlorobenzene
NO ugfL
100
20
11124/20 17:22 108-90-7
Chloroform
NO ugfL
100
20
111241201T22 67-66-3
1,4-Dichlorobenzene
NO ugiL
100
2C
11124120 17:22 106-46-7
1,2.Dichloroethane
NO ugiL
100
2D
11124,2017.22 107-06-2
1,1-Dichloroethene
NO ugfL
100
20
1112412017.22 75-35-4
Telrachloroethene
ND ugfL
100
20
11i24120 17:22 127.18-4
Trichloroethene
NO ugfL
100
20
1112Q2017:22 79-01-6
Vinyl chloride
ND ugfL
100
20
11/24/20 17:22 75-014
Surrogates
1.2-Dichloroethane-d4 (S)
100 %
70-130
20
11/24/20 17:22 17060-07-0
Toluerl (S)
100 %
67-135
20
11/24120 17:22 2037-26-5
4-8romofluorobenzene {S)
98 %
70-130
20
11124J20 I T22 460-00-4
REPORT OF LABORATORY ANALYSIS
This reporl shall nol be reproduced.
except in full,
Date 1210812020 05:14 PM
without the written consent of Pace Anaiytrcal
Services, LLC
Page 6 of 27
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 9 of 30

aceAnal'4io
J
x+rr.pEcelr6a.coa
ANALYTICAL RESULTS
Project. US Bio Marion
Pace Project No.: 92506084
Pace Analytical Services, LLC
9800 Kincey Ave. Suile 100
Huntersville, NO 28078
[phone]
Sample: Sludge LabIp: 92506084001 Collected: 11/12120 11:30 Received: 11113/20 08:55 Matrixr Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any difutions.
Parameters Results Units Report limit OF Prepared Analyzed CAS No. Qual
Percent Moisture
Analytical Method: ASTM D2974.87
Pace Analytical Services - Charlotte
Percent Moisture
93.3 /0
0.10 1
11113/20 19:38
1010 Flashpoint,Closed Cup
Analytical Method. EPA 1010A
Pare Analytical Services - Asheville
Flashpcini
>200 deg F
70-0 1
12106120 14,42
9045 pH Soil
Analytical Method: EPA 9045D
Pace Analytical Services -Asheville
pH at 25 Degrees C
5.9 Std- Units
0.10 1
12107120 16:41
9095 Paint Filter Liquid Test
Analytical Method. EPA 9095B
Pace Analytical Services - Asheville
Free Liquids
Fail
1_0 1
12,102120 16:21
733C S Reactive Cyanide
Analytical Methods EPA 9014 Preparation Method: SW-846 7.3.3.2
Pace Analytical Services - Greensburg
Cyanide. Reactive
NO mglkg
0.99 1 11l18i20 18:23
11119120 18:58
734S Reactive Sulfide
Analytical Method: SM 4500S2F-2011 Preparation Method: SW-846 7.3.4_2
Pace Analytical Services - Greensburg
Sulfide, Reactive
NO mgikg
9.9 1 11/18120 18:23
11118720 18:25
H3
Sample: PCB Lab ID; 92506084002 Collected: 111212011:30 Received'. 1111312008:55 Malrix, Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. QUal
8082 GCS PCB RVE
PCB-1016 (Aroclor 1016)
PCB-1221 (Aroclor 1221)
PCB-1232 (Aroclor 1232)
PCB-1242 (Aroclor 1242)
PCB-1248 (Aroclor 1248}
PCB-1254 (Aroclor 1254}
PCB-1260 (Aroclor 1260)
Surroga tes
Decachdroblphenyi (S)
Date. 12108/2020 05,14 PM
Analytical Method'. EPA 5082A Preparation Methotl: EPA 3510C
Pace Analytical Services - Charlotte
ND
ug1L
2.5
1
1210112010:28 1210212002:16 12674-11-2
ND
ugiL
2.5
1
12VI2010:28 121021200216 11104-28-2
ND
ug1L
2.5
1
12101120 10 28 12102i2002.16 11141-16-5
ND
ug1L
2,5
1
121011201028 12102i2002:16 53469-21-9
ND
ug1L
2,5
1
1210112010:28 12f0212002:16 12672-29-6
NO
ug/L
2,5
1
12101120 10 28 12102/2002.16 11097-69-1
NO
Ug1L
2 5
1
12/01/20 10:28 12/02120 02:16 11096-82-5
42
1!1
10-181
1
1210112010:26 1210212002'.16 2051-24-3
REPORT OF LABORATORY ANALYSIS
Thrs report shall not he repmduced, except in Full,
without the written Consent of Pace Analytical Services. LLC.
Page 7 of 27
PO sox 228 • Statesville, NC 28687 • 704/872/4697
Page 10 of 30

Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Specific Oxygen Uptake Rate
SOUR
Facility Name: Cor enin Cr
Biosolids Permit Number: WO 0019960
Date: 1161
Digester Temperature:
Sampling Date/Time: 1-6-22 122
Sampled By: DM
Analysis Date/Time: 1-6-22 14(
Analyzed By: RGC
Sample Volume:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
1000 milliliters
1.96 % Dry Solids
25 degrees Celsius
25 dearees Celsius
Slope: 0.1
Intercept: 8.2
Correlation Coefficient: 1.0
Oxygen Uptake Rate: 4.11 mg Oxygen/hr
Ambient Specific Oxygen Uptake Rate: 0.21 mg Oxygen/g/hr
Average Temperature: 25 degrees Celsius
Temperature Correction Factor: 0,783526166
Temperature Corrected Specific Oxygen Uptake Rate: 0.16 mg Oxygen/g/hr
Instructions: Enter Data in the Blue Boxes, The Calculation and the Spreadsheet execute automatically.

Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Specific Oxygen Uptake Rate
SOUR
Facility Name: Corpenin
Creek
Biosolids permit Number: WQ 0019960
Date:
1 /7/202
Digester Temperature:
1
Sampling Date/Time: 1-7-22
1246
Sampled By: DS
Analysis Date/Time: 1-7-22
1330
Analyzed By: RGC
Sample Volume:R
100
Total Solids:
1.9
Beginning Temperature:
2
End Temperature:r
2
Dissolved Oxygen Level
Slope: 0.1
Intercept: 8.5
Correlation Coefficient: 1.0
milliliters
% Dry Solids
degrees Celsius
degrees Celsius
Oxygen Uptake Rate: 3.98 mg Oxygen/hr
Ambient Specific Oxygen Uptake Rate: 0.20 mg Oxygen/g/hr
Average Temperature: 25 degrees Celsius
Temperature Correction Factor: 0.783526166
Temperature Corrected Specific Oxygen Uptake Rate: 0.16 mg Oxygen/g/hr
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.

Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Specific Oxygen Uptake Rate
SOUR
Facility Name: Cor enin Cre
Biosolids Permit Number: WQ 0019960
Date: 1 / 1012
Digester Temperature:
Sampling Datefrime: 1-10-22 1313
Sampled By: DS
Analysis Date/Time: 1-10-22 1350
Analyzed By: DS
Sample Volume: 1
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
milliliters
% Dry Solids
degrees Celsius
decrees Celsius
0.0
8.3
1.0
2.60 mg Oxygen/hr
0.14 mg Oxygen/g/hr
25 degrees Celsius
0.783526166
Temperature Corrected Specific Oxygen Uptake Rate: 0.11 mg Oxygen/g/hr
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.

Time
(minutes)
a
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Specific Oxygen Uptake Rate
SOUR
Facility Name: Corpeninq Creek
Biosolids Permit Number: WQ 0019960
Digester Temperature:
Sampling Date/Time: 1/11/22
Sampled By: DS
Analysis DatelTime: 1/11122
Analyzed By: DS
Sample Volume:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature.
Temperature Correction Factor:
1325
14
1000 milliliters
1.96 % Dry Solids
25 degrees Celsius
25 degrees Celsius
0.0
7.5
1.0
2.63 mg Oxygenlhr
0.13 mg Oxygenlglhr
25 degrees Celsius
0.783526166
Temperature Corrected Specific Oxygen Uptake Rate: 0.10 mg Oxygen/g/hr
Instructions: Enter Data in the Blue Boxes, The Calculation and the Spreadsheet execute automatically.

Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Specific Oxygen Uptake Rate
SOUR
Facility Name:!Corgening Creek
Biosolids Permit Number: WQ 0019960
Date: 1 /12/2022
Digester Temperature:, 18
Sampling Date/Time: 1/12/22
Sampled By: IDS
Analysis DateMme: 1/12122
Analyzed By: DS
Sample Volume. -
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
Slope:
Intercept:
Correlation Coefficient:
1425
1
1000 milliliters
1.96 % Dry Solids
25 degrees Celsius
25 degrees Celsius
0.0
7.9
1.0
Oxygen Uptake Rate: 2.55 mg Oxygen/hr
Ambient Specific Oxygen Uptake Rate: 0.13 mg Oxygen/glhr
Average Temperature: 25 degrees Celsius
Temperature Correction Factor: 0.783526166
Temperature Corrected Specific Oxygen Uptake Rate: 7. 0.10 mg Oxygen/g/hr
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.
-Z7 6 L

Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Specific Oxygen Uptake Rate
SOUR
Facility Name:
Biosolids Permit Number:
Date:
Digester Temperature:
Sampling DatelTime:
Sampled By.
Analysis Date/Time:
Analyzed By:
Sample Volume:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
Slope: 0.0
Intercept: 8.6
Correlation Coefficient: 1.0
milliliters
% Dry Solids
degrees Celsius
degrees Celsius
Oxygen Uptake Rate: 2.37 mg Oxygen/hr
Ambient Specific Oxygen Uptake Rate: 0.12 mg Oxygen/g/hr
Average Temperature: 25 degrees Celsius
Temperature Correction Factor: 0.783526166
Temperature Corrected Specific Oxygen Uptake Rate: 0.16 mg Oxygen/g/hr
Instructions. Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.
Z
U

Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Specific Oxygen Uptake Rate
SOUR
Facility Name: Corpening Creek
Biosoiids Permit Number: WQ 0019960
Date: 1 /14/2022
Digester Temperature: 14
Sampling Date/Time: 01/14/22 1145
Sampled By: dm
Analysis Date/Time: 01/14/22 1204
Analyzed By: ssg
Sample Volume:. 1000 milliliters
Total Solids: 1.58 % Dry Solids
Beginning Temperature: 25 degrees Celsius
End Temperature:E 25 degrees Celsius
Dissolved Oxygen Level
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
0.0
8.6
1.0
2.04 mg Oxygen/hr
0.13 mg Oxygen/glhr
25 degrees Celsius
0.783526166
Temperature Corrected Specific Oxygen Uptake Rate: 0.10. mg Oxygen/glhr
Instructions: Enter Data in the Slue Boxes. The Calculation and the Spreadsheet execute automatically.

Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Specific Oxygen Uptake Rate
SOUR
Facility Name: Car en
Biosolids Permit Number: WQ 00
Date:
Digester Temperature:
Sampling Date/Time- 1/15122
Sampled By:IDS
Analysis DatelTime: 1/1
Analyzed By: DS
Sample Volume:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
Creek
1330
0.0
6.5
1.0
milliliters
% Dry Solids
degrees Celsius
degrees Celsius
1.61 mg Oxygen/hr
0.08 mg Oxygenlglhr
25 degrees Celsius
0.783526166
Temperature Corrected Specific Oxygen Uptake Rate:. 0.07 :mg Oxygen/g/hr
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 11-15, FORM: DCAR 11-15, or FORM: SDR 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 11-15):
❑ Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 11-15) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
❑ For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
❑ Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
B. Residuals Source -Generating Facility Information:
❑ For each source facility, attach the following:
❑ Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
❑ Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
❑ Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
❑ Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
❑ For each source facility, attach the following:
❑ Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 06-16 Page 1 of 1

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Town of North Wilkesboro
2. Facility permit holder is: ❑ Federal, 0 State, 0 Local Government, or 0 Private.
Facility permit issued by: ® Div. of Water Resources, Div. of Environmental Health,
or ❑ Other (explain: _).
3. Facility contact person and title: Scott Perry
Complete mailing address: PO Box 218
City: North Wilkesboro State: NC Zip: 28659
Telephone number: [phone] E-mail address: sperry&north-wilkesboro.com
4. Facility physical address: 100 Thurmond Street
City: North Wilkesboro State: NC Zip: 28659
Coordinates: Latitude: 36' 69' 44.37" Longitude: 81° 08' 04.12"
Datum: NAD83 Level of accuracy: 0.01
Method of measurement: MAP
5. Purpose of the facility:
® treatment of municipal wastewater, treatment of 100% domestic wastewater,
❑ treatment of potable water, treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: _ % industrial and _ % domestic)
other (explain: _ ).
6. Does the facility have an approved pretreatment program: Yes No
7. Facility permitted/design flow: 2.0 MGD and facility average daily flow: 0.85 MGD
8. Average amount of residuals being generated at this facility 132 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 1 Million gallon sludge holding tank
Type and volume of residuals storage (i.e., outside of residuals treatment units): 6-50'x50' drying beds
II. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part 503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological N Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: 0 yes ® no.
If yes, list the number(s): _
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: n yes Ui no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: PAR and Date of analysis: 4-26-2023
Passed corrosivity test: yes no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: yes no. Flashpoint: 200 OF (> 140°F)
Passed reactivity test: Eyes Eno. HCN: NON mg/kg (<250) & H2S: NON mg/kg (<500)
TCLP Parameter
Limit
(m917)
Result
(mg/7)
TCLP Parameter
Limit
(m917)
Result
(m917)
Arsenic
5.0
0.5
Hexachlorobenzene
0.13
0.013
Barium
100.0
10
Hexachloro-1,3-Butadiene
0.5
0.05
Benzene
0.5
0.05
Hexachloroethane
3.0
0.3
Cadmium
1.0
0.1
Lead
5.0
0.5
Carbon Tetrachloride
0.5
0.05
Lindane
0.4
0.04
Chlordane
0.03
0.003
Mercury
0.2
0.002
Chlorobenzene
100.0
10
Methoxychlor
10.0
1
Chloroform
6.0
0.6
Methyl Ethyl Ketone
200.0
123
Chromium
5.0
0.5
Nitrobenzene
2.0
0.2
m-Cresol
200.0
20
Pentachlorophenol
100.0
10
o-Cresol
200.0
20
Pyridine
5.0
0.5
p-Cresol
200.0
20
Selenium
1.0
0.1
Cresol
200.0
20
Silver
5.0
0.5
2,4-D
10.0
1
Tetrachloroethylene
0.7
0.07
1,4-Dichlorobenzene
7.5
0.75
Toxaphene
0.5
0.05
1,2-Dichloroethane
0.5
0.05
Trichloroethylene
0.5
0.05
1, 1 -Dichloroethylene
0.7
0.07
2,4,5-Trichlorophenol
400.0
40
2,4-Dinitrotoluene
0.13
0.013
2,4,6-Trichloropheno1
2.0
0.2
Endrin
0.02
0.002
2,4,5-TP (Silvex)
1.0
0.1
Heptachlor and its Hydroxide
0.008
0.0008
Vinyl Chloride
0.2
0.02
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Waypoint and Date of analysis: 3-29-2023
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mglkg)
Monthly Average
Concentration Limits
(Class A Only)
(mglkg)
Result
(mglkg)
Arsenic
75
41
10.4
Cadmium
85
39
2.08
Copper
4,300
1,500
427
Lead
840
300
34
Mercury
57
17
3.83
Molybdenum
75
n/a
5.21
Nickel
420
420
20.8
Selenium
100
100
10.4
Zinc
7,500
2,800
1130
b. For Surface Disposal Unit (landfill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: = and Date of analysis: =
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
❑ > 0 but < 25
30
200
210
❑ > 25 but < 50
34
220
240
❑ > 50 but < 75
39
260
270
❑ > 75 but < 100
46
300
320
❑ > 100 but < 125
53
360
390
❑ > 125
62
450
420
Result (mg4g)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 4.84 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Waypoint and Date of analysis: 3-29-2023
Parameter
Result
(mglkg)
Aluminum
29200
Ammonia -Nitrogen
5480
Calcium
10800
Magnesium
2630
Nitrate -Nitrite Nitrogen
338
pH (Standard Unit)
6.7
Phosphorus
17200
Potassium
3310
Sodium
819
Total Kjeldahl Nitrogen
106000
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 0_4
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 30 %. This
rate is a (check one): JW default value, or 0 actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, ex lain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals:
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (15) Year PAN
Five -Year
Maximum Adjusted PAN
(mg1kg)
(mglkg)
Surface
33234
51965.7
Injection/Incorporation
35974
54000.35
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses:
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
71 A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
JJ A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
IR Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
q Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
q Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
q Alternative 4 [15A NCAC 02T.I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 5 [15A NCAC 02T.1106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: composting, i heat drying, II heat treatment,
thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
Alternative 1 [15A NCAC 02T.I 106(c)(01 - Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T.I 106(c)(2 - Process to Si ficantly Reduce Pathogens (PSRP).
Specify one: El digestion air drying, , anaerobic digestion,
❑ composting, or lime stabilization.
c. For Surface Disposal:
11 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
J Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
J Exempt -If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
J Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
5 Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
El Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
El Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
El Alternative 5 [15A NCAC 02T. I 107(a)(5)] - 14-Day Aerobic Processes.
El Alternative 6 [15A NCAC 02T. 1107(a)(6)] - Alkaline Stabilization.
El Alternative 7 [15A NCAC 02T.I 107(a)(7)] - Drying of Stabilized Residuals.
El Alternative 8 [15A NCAC 02T.I 107(a)(8)] - Drying of Unstabilized Residuals.
El Alternative 9 [15A NCAC 02T. I 107(a)(9)] - Injection.
El Alternative 10 [15A NCAC 02T.I 107(a)(10)] - Incorporation.
q Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(b)(2)].
id Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

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WASTEWATER TREATMENT PLANT PROCESS
The Town of North Wilkesboro operates a 2.0 MGD facility which utilizes an aerobic digestion
process. The facility treats domestic - waste and influent from several industries in North
Wilkesboro. Primary settled solids and final settled solids are pumped into one of two 2.5 million
gallon aerobic digesters or basins. Sludge from the basins are decanted to a thickener where it is
sent to the sludge holding tank after the aehievement of % to % solids. Biosolids are removed
from the sludge holding tank and land applied as needed.
process schematic for the Town of North Wilkesboro wwTP is presented on the following page.

v :)/ U :of cVrJ.3 i 1: au jjoojol t t tl
I UWN UI~ N w
rp l
Clat013
7
o
I
1 k

Quantitative Justification for Residuals Production Rate:
The Town of North Wilkesboro has produced the following Dry Tons of residuals:
2023 243.96
2022 52.33
2021 215.5
2020 174.18
2019 188.21
2018 68.7
This is a 6 year average of 157.15, which is lower than the 300 dry tons requested in this permit
renewal package.

U.S. Biosolids, Inc.
Permit No. WQ0037135
SAMPLING PLAN
Annually, if a land application event occurs, grab samples are collected from the digester. Samples
from the digesterwill be combined to form individual grab samples to be sent to a laboratoryfor
analysis. If a land application event is to occur in the early part of a calendar year (i.e. January or
early February) these samples may have to be taken in December, so results can be obtained
before the land application event, as some results take 30+ days to receive.
These individual grab samples are collected and tested for fecal coliform analysis, volatile solids
reduction, nutrient analysis, and a TCLP test. These tests will be taken by U.S. Biosolids, Inc. All
samples except for the composite residual sample will be taken to a state certified laboratory. All
samples taken will be taken in the same condition as the residuals are to be land applied.
The volatile solids will first be attempted to be achieved using option 1 [503.33(b)(1)]; 38%volatile
solids reduction. This option will be attempted first due to it being the most cost effective. One
sample will betaken at the aeration basin and labeled "B". The next sample will be labeled "A" and
be taken from the digester.
If option 1 cannot be achieved to meet the volatile solids reduction, a 30 day bench scale option 3
[503.33(b)(3)] test will be used. This sample will be taken from the digester with the sample being at
least a quart in quantity.
If both option 1 and 3 are used and volatile solids reduction cannot be achieved; the sludge holding
tank will be stabilized using sufficient alkaline to meet option 6 [503.33(b)(6)], commonly known as
time stabilization.
Fecal Coliform is gathered in seven (7) individual samples and tested to meet the requirements of
[503.32(b)(2)]. This requirement is for the geometric mean fecal coliform density of the samples be
less than two million (2,000,000) MPN per gram. These samples will be placed in 250ml containers
and placed on ice, in a cooler for transport to the laboratory before 1600 hours (4pm) the same day
the samples are obtained.
Annually, if land application occurs, a composite residual sample will be analyzed, prior to a land
application event for:
Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia
Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus, Potassium, TKN,
Sodium
From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption Ratio (SAR) will
be calculated. This sample will be collected in a non -breakable container, at least one quart in size.
This sample will be taken from the digester. This test will be done by a state approved laboratory.

Waypointo
ANALYTICAL
3/29/2023
US Biosolids Inc
Dennis Key
958 Hoots Road
Roaring River, NC, 28669
Ref: Analytical Testing
Report Number: 23-080-0004
Project Description: N Wilkesbur
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Dear Dennis Key:
Waypoint Analytical Virginia, Inc. received sample(s) on 3/21/2023 for the analyses presented in the following
report.
The above referenced project has been analyzed per your instructions. The analyses were performed in
accordance with the applicable analytical method. Sub -contracted testing is noted on the Sample Summary Table
if applicable.
The analytical data has been validated using standard quality control measures performed as required by the
analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all
parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA
(including 40 CFR 136 Method Update Rule May 2012) and NELAC unless otherwise indicated.
Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of
sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time
Refer to sample analysis time for confirmation of holding time compliance.
The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as -
received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to
the samples included in this report.
Please do not hesitate to contact me or client services if you have any questions or need additional information
Sincerely,
&;'-� ­AldA�
Brandi Watson
Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the
analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis.
Page 1 of 7

•
7621 Whitepine Road, Richmond, VA 23237
Waypoint
Main 804-743-9401 0 Fax [phone]
ANALYTICAL www.waypointanalytical.com
Sample Summary Table
Report Number: 23-080-0004
Client Project Description: N Wilkesbur
Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID
61415
N.W.
Solids
61415
N.W.
Solids
61415
N.W.
Solids
61415
N.W.
Solids
61415
N.W.
Solids
61415
N.W.
Solids
61415
N.W.
Solids
61415
N.W.
Solids
03/16/2023 08:00
03/21/2023
03/16/2023 08:00
03/21/2023
03/16/2023 08:00
03/21/2023
03/16/2023 08:00
03/21/2023
03/16/2023 08:00
03/21/2023
03/16/2023 08:00
03/21/2023
03/16/2023 08:00
03/21/2023
03/16/2023 08:00
03/21/2023
SM-4500-NH3C
WP MTN
9045D
WP MTN
4500NO3F-2011
WP MTN
6010D
WP MTN
SW-7471B
WP MTN
SM-4500-NH3C-TKN
WP MTN
SM-2540G
WP MTN
WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN
Page 2 of 7

•
7621 0 Whitepine Road, Richmond, VA 23237
Waypoint
Main 804-743-9401 0 Fax [phone]
ANALYTICAL www.waypointanalytical.com
46381
US Biosolids Inc Project N Wilkesbur
Dennis Key Report Date : 03/29/2023
958 Hoots Road Information : Received : 03/21/2023
Roaring River , NC 28669
Brandi Watson
Report Number : 23-080-0004 REPORT OFANALYSIS
Lab No : 61415 Matrix: Solids
Sample ID: N.W. Sampled: 3/16/2023 8:00
Test Results Units MQL DF Date / Time By Analytical
Analyzed Method
Moisture
95.2
%
0.010
1
03/22/2315:43
CJD
SM-2540G
Sulfur
7060
mg/Kg -
dry
208
1
03/25/23 05:41
JTR
6010D
Calcium
10800
mg/Kg -
dry
1040
1
03/25/23 05:41
JTR
6010D
Aluminum
29200
mg/Kg -
dry
104
1
03/25/23 05:41
JTR
6010D
Manganese
248
mg/Kg -
dry
10.4
1
03/25/23 05:41
JTR
6010D
Organic N
101000
mg/Kg -
dry
5208
1
03/28/23 14:00
CALCULATION
Nickel
20.8
mg/Kg -
dry
5.21
1
03/25/23 05:41
JTR
6010D
Lead
34.0
mg/Kg -
dry
6.25
1
03/25/23 05:41
JTR
6010D
Arsenic
<10.4
mg/Kg -
dry
10.4
1
03/28/23 00:08
JTR
6010D
Selenium
<10.4
mg/Kg -
dry
10.4
1
03/25/23 05:41
JTR
6010D
Test
Results
Units
MQL
DF
Date / Time
By
Analytical
Analyzed
Method
Total Solids
4.84
%
0.010
1
03/22/23 15:43
CJD
SM-2540G
Phosphorus
17200
mg/Kg -
dry
104
1
03/25/23 05:41
JTR
6010D
Copper
427
mg/Kg -
dry
10.4
1
03/25/23 05:41
JTR
6010D
Total Kjeldahl Nitrogen
Qualifiers/ DF Dilution Factor
Definitions
106000 mg/Kg - dry 5210 1 03/28/23 14:00 CLP ;M-4500-NH3C-TKI`
MQL Method Quantitation Limit
Page 3 of 7

Waypointo
ANALYTICAL
46381
US Biosolids Inc
Project
Dennis Key
958 Hoots Road
Information
Roaring River , NC 28669
Report Number : 23-080-0004
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
N Wilkesbur
REPORT OFANALYSIS
Report Date : 03/29/2023
Received : 03/21/2023
Brandi Watson
Lab No : 61415
Sample ID: N.W.
Matrix: Solids
Sampled: 3/16/2023 8:00
Potassium
3310
mg/Kg -
dry
208
1
03/25/23 05:41
JTR
6010D
Magnesium
2630
mg/Kg -
dry
104
1
03/25/23 05:41
JTR
6010D
Sodium
819
mg/Kg -
dry
521
1
03/25/23 05:41
JTR
6010D
Iron
18500
mg/Kg -
dry
208
1
03/25/23 05:41
JTR
6010D
Zinc
1130
mg/Kg -
dry
26.0
1
03/25/23 05:41
JTR
6010D
Ammonia Nitrogen
5480
mg/Kg -
dry
2080
1
03/28/23 15:30
CLP
SM-4500-NH3C
Nitrate+Nitrite-N
338
mg/Kg -
dry
104
1
03/23/23 14:36
ZBD
4500NO3F-2011
Cadmium
<2.08
mg/Kg -
dry
2.08
1
03/25/23 05:41
JTR
6010D
Chromium
41.5
mg/Kg -
dry
5.21
1
03/25/23 05:41
JTR
6010D
Mercury
<3.83
mg/Kg -
dry
3.83
1
03/24/23 13:11
FDS
SW-7471B
pH
6.7
S.U.
1
03/27/2317:15
CNB
9045D
Molybdenum
<5.21
mg/Kg -
dry
5.21
1
03/25/23 05:41
JTR
6010D
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 4 of 7

Waypointo
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Client: US Biosolids Inc CASE NARRATIVE
Project: N Wilkesbur
Lab Report Number: 23-080-0004
Date: 3/29/2023
Metals Analysis Method 601 OD
Sample 61454 (Tyson Blowntsville)
Analyte: Aluminum
QC Batch No: 1-672212/1-671763
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 61454 (Tyson Blowntsville)
Analyte: Calcium
QC Batch No: 1-672212/1-671763
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 61454 (Tyson Blowntsville)
Analyte: Potassium
QC Batch No: 1-672521/1-671763
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Solids Total Mercury Analysis - CVAA Method 7471A
Sample 61415 (N.W.)
Analyte: Mercury
QC Batch No: 1-672040/1-671745
The matrix spike, matrix spike duplicate and the post digestion spike were all outside of the quality control
acceptance ranges. Matrix interference is suspected
Page 5 of 7

WayPAoInt..
NALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 46381
Customer Name: US Biosolids Inc
Report Number: 23-080-0004
Shipping Method
0 Fed Ex 0 US Postal 0 Lab
0 UPS 0 Client 0 Courier
0 Other:
Thermometer ID:
Shipping container/cooler uncompromised?
* Yes
0 No
Number of coolers/boxes received
Custody seals intact on shipping container/cooler?
0 Yes
0 No
Not Present
Custody seals intact on sample bottles?
0 Yes
0 No
Not Present
Chain of Custody (COC) present?
# Yes
0 No
COC agrees with sample label(s)?
# Yes
0 No
COC properly completed
# Yes
0 No
Samples in proper containers?
# Yes
0 No
Sample containers intact?
# Yes
0 No
Sufficient sample volume for indicated test(s)?
# Yes
0 No
All samples received within holding time?
# Yes
0 No
Cooler temperature in compliance?
# Yes
0 No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
# Yes
0 No
Water - Sample containers properly preserved
Yes
0 No
0 N/A
Water - VOA vials free of headspace
0 Yes
0 No
N/A
Trip Blanks received with VOAs
0 Yes
0 No
N/A
Soil VOA method 5035 — compliance criteria met
0 Yes
0 No
0 N/A
F_ High concentration container (48 hr)
F_ High concentration pre -weighed (methanol -14 d)
F_ Low concentration EnCore samplers (48 hr)
F_ Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included? 0 Yes * No
Comments:
Signature: IDavid Lennon Date & Time: 03/21/2023 09:32:04
Page 6 of 7

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Page 7 of 7

F;Z
PROMPT•ACCUR TE•RELIABLE
LABORAT RIES, INC
REPORT OF ANALYSES
Attn: ZAC KEY
U.S. BIOS LIDS, INC.
PO BOX 14
RONDA, NC 28670-
PROJECT NAME: MAR 23
DATE: 04/26/23
SAMPLE NU BER- 146744 SAMPLE ID- N. WILKESBORO
DATE SAMP ED- 03/16/23
DATE RECE VED- 03/16/23 SAMPLER- ZK
TIME RECE VED- 1120 DELIVERED BY- ZK
Page 1 og 1
ANALYSIS
ANALYSIS
METHOD DATE TIME BY
SAMPLE MATRIX- WW
TIME SAMPLED- 0800
RECEIVED BY- DJ
TYPE SAMPLE- Grab
RESULT UNITS
FECAL COLIFORM (GEOM. MEAN) SM 9221 E 03/16/23 1620 RE 637,325 MPN/g
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PAR
•RELIA6LE
LABORA'i"ORIES, INC
2217 Graham Park Drive
PO Box 411483
Charlotte, NC 28241-1483
NC Cert # 20, SC Cert # 99003001
U.S. BIOSOLIDS
• N. WILKESBORO
03/16/23
FECAL COLIFORM, GEOMETRIC MEAN
Fill• SM 9221 E
146744 1 1
2
3
4
5
IV
15,625 1 3.79%
29,814
4.62%
25,439
3.49%
27,603
3.51 %
26,516
4.24%
27,414
4.06%
25,495
3.85%
412,484.07
645,078.46
729,927.62
786,396.69
625.386.96
675,218.64
662,202.61

CHAIN OF CUSTODY
Phone [phone]
MU•Rtt_rn►st- Fax [phone]
LABORATORIES, INC
Shipping Et Mailing:
2217 Gtaham Park Drive
Charlotte, NC 28273
It Is essential that all Information be recorded on this Chain of Custody document for acceptance by PAR Laboratories. Inc. and ttx North
e .eumam uowaum nmuam naiur�i nesvurces.
Company Name (billing) Comments/ Special Instructions
U.S. Bi solids, Inc.
Address - — - —
PO Bo 146
City, State &zip ode
_ Ronda N_C 28670
Point of Contact Ei Telephone Number
Zach �ey 336-467-3550
Sample '0 i
Taken By: SIGNATURE f _ PRINTED NAME Lcc%
ARE SAMPL S FOR STAT or EPA REPORTING? YES NO
'Sample Type: DW Ww GWMW _ HW soil _ other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Ch rine checked at time of sampling (Y/N): Dechlorination Necessary (YIN):
e`r.g
Swr4)* Lbt;atioa
"k*%ber)
Comp
Grab
settrQ ..
Preserv. #lsWrwrwi
:CbNOCtitiit '
DwWTirne
lysea
no n�
c+
y
Keunqutsneo oya/
� uat 3' (6.1 l� �
Kecery a y:
uaten Ime 3'//_ ✓ 2�
! `[' `[ C
Relinquished by.
Dateff me
Received by.
Date/Tirne
C=Composite IG=Grab
DW=Drinking Water WW=Wastewater
GWMW=Groundwater Monitoring Well
HW=Hazardous Waste

PROMPT•ACCUR TE•RELIABLE
LABORAT RIES, INC
WWW.PA ABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOS LIDS, INC. PROJECT NAME: MAR 23
PO BOX 1415 DATE: 04/26/23
RONDA, NC 28670-
SAMPLE NU BER- 146743 SAMPLE ID- N. WILKESBORO
DATE SAMP ED- 03/16/23
DATE RECEIVED- 03/16/23 SAMPLER- ZK
TIME RECEIVED- 1120 DELIVERED BY- ZK
Page 1 or 2
ANALYSIS I
TCLP CHARkCTERISTICS
pH VALUE
CORROSIVI Y
REACTIVIT
FLASH POINT
IGNITABIL TY
PAINT FILTER TEST
TCLP METALS
ARSENIC
BARIUM
CADMIUM
CHROMIUM
LEAD
MERCURY
SELENIUM
SILVER
TCLP PESTICIDES
ENDRIN
LINDANE
METHOXYC LOR
TOXAPHENE
SAMPLE MATRIX- WW
TIME SAMPLED- 0800
RECEIVED BY- DJ
TYPE SAMPLE- Grab
ANALYSIS
METHOD DATE TIME BY RESULT UNITS
TCLP
04/04/23
1149
CB
TCLP
04/04/23
1149
CB
6.4
S.U.
TCLP
04/04/23
1149
CB
NON
TCLP
04/04/23
1149
CB
NON
TCLP
04/04/23
1149
CB
> 200
degrees F
TCLP
04/04/23
1149
CB
NON
TCLP
03/23/23
0926
CB
FL
TCLP
03/27/23
1158
JR
TCLP
03/27/23
1158
JR
< 0.5
ppm
TCLP
03/27/23
1158
JR
< 10
ppm
TCLP
03/27/23
1158
JR
< 0.1
ppm
TCLP
03/27/23
1158
JR
< 0.5
ppm
TCLP
03/27/23
1158
JR
< 0.5
ppm
TCLP
03/27/23
1158
JR
< 0.02
ppm
TCLP
03/27/23
1158
JR
< 0.1
ppm
TCLP
03/27/23
1158
JR
< 0.5
ppm
TCLP
03/25/23
1558
VC
TCLP
03/25/23
1558
VC
< 0.002
ppm
TCLP
03/25/23
1558
VC
< 0.04
ppm
TCLP
03/25/23
1558
VC
< 1
ppm
TCLP
03/25/23
1558
VC
< 0.05
ppm
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PROMPT•ACCUR TE•RELIABLE
LABORAT RIES, INC
Page 2 of 2
CONTINUAT ON OF DATA FOR SAMPLE NUMBER 146743
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
CHLORDANE
HEPTACHLO (AND ITS EPDXIDE)
TCLP HERB CIDES
2,4-D
2,4,5-TP( ILVEX)
TCLP ORGA ICS
BENZENE
CARBON TE RACHLORIDE
CHLOROBEN ENE
CHLOROFOF
o-CRESOL
p-CRESOL
m-CRESOL
1,4-DICHI
1,2-DICHI
1,1-DICHI
2, 4-DINI'I
HEXACHLOF
HEXACHLOF
HEXACHLOF
METHYL E'I
NITROBEN2
PENTACHLC
PYRIDINE
TETRACHLC
TRICHLORC
2,4,5-TRI
2,4,6-TRI
VINYL CHI
ROBENZENE
ROETHANE
ROETHYLENE
OTLUENE
BENZENE
BUTDIENE
ETHANE
YL KETONE
PHENOL
R,ETHYLENE
T.THYLENE
HLOROPHENOL
=ORPHENOL
DRIDE
TCLP
03/25/23
1558
VC
TCLP
03/25/23
1558
VC
TCLP
03/29/23
2107
VC
TCLP
03/29/23
2107
VC
TCLP
03/29/23
2107
VC
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
TCLP
03/28/23
1852
MS
< 0.003 ppm
< 0.0008 ppm
< 1 ppm
< 0.1 ppm
< 0.05 ppm
< 0.05 ppm
< 10 ppm
< 0.6 ppm
< 20 ppm
< 20 ppm
< 20 ppm
< 0.75 ppm
< 0.05 ppm
< 0.07 ppm
< 0.013 ppm
< 0.013 ppm
< 0.05 ppm
< 0.3 ppm
123 ppm
< 0.2 ppm
< 10 ppm
< 0.5 ppm
< 0.07 ppm
< 0.05 ppm
< 40 ppm
< 0.2 ppm
< 0.02 ppm
LABORATORY DIRECTOR 7 ��
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

i
FPT•A C R/T •Ra:L1A0Llt
LABORATORIES, INC
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
Shippino i3 Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
n is essential that all information be recorded on the Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
Carolina artment of Environmental and Natural Resources.
Company Name filing) Comments/ $ ecial Instructions
U.S. BI Solids, Inc.
Address I —1
PO Boys 146
City, State fz zip code
Ronda NC 28670
Point of Contactl@ Telephone Number
Zach iKey 336-467-3550
Sample I
Taken By: SIGNATURE PRINTED NAME Gg 1r,
ARE SAMPLES FOR STATE o EPA REPORTING? YES NO
'Sample Type: ow ww GWMW _ Hw soil other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No nla
Residual Chlorine checked at time of sampling (YIN): Dechlorination Necessary (YIN):
Aettt $ttst{�e`r.Analyan
SampbLotSfiop•GHtiMI—)
Comp
Grab
Preae+v.. O&WTirne
Dalefrime
.
Requeeilted
W; IKeS barn
r
L
Kelm thy: uater I ime Keceiveo b water t Iftte
3 Ib a 03 a
Re4 uished py: DatelTime Received by. Daterr me
• C=Composqe G=Grab DW=Orinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

PLL
PROMPT•ACCURATE-RELIABLE
LABORATORIES, INC
W W W.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
PROJECT NAME: MAR 23
DATE: 05/02/23
SAMPLE NUMBER- 146745 SAMPLE ID- N. WILKESBORO SAMPLE MATRIX- WW
DATE SAMPLED- 03/16/23 TIME SAMPLED- 0800
DATE RECEIVED- 03/16/23 SAMPLER- ZK RECEIVED BY- DJ
TIME RECEIVED- 1120 DELIVERED BY- ZK TYPE SAMPLE- Grab
Page 1 of 1
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
30 DAY BENCH SCALE TEST VAR 03/16/23 1620 RE 1.29 %
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PROM PT•ACCLIRATE• RELIABLE
LABORATORIES, INC
WWW.PARLABS.COM
30 Day Bench Scale Extended Aeration Test
Percent Volatile Solids Reduction
U.S. BIOSOLIDS, INC.
N. WILKESBORO
146745
03/16/23
04/17/23
Start: End:
TS )
0.2713
0.2161
TS%
1.64%
1.65%
VS ()
0.1605
0.1254
VS%
59.16%
58.03%
y Mass Fraction of Volatile Solids in Liquid Sludge
0.0097010
0.0095749
x Mass Fraction of Fixed Solids in Liquid Sludge
0.0066970
0.0069254
FSVR Mass Balance)
1.29%
FSVR (Van Kleeck)
1.29%
FSVR (Mass Balance) <15%
YES
FSVR (Van Kleeck) <15%
YES
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] • Fax: [phone]

PA
PROM PT•ACCU RATE -RELIABLE
LABORATOIUES, INC
W W W.PARLABS.COM
Collected
D.O.
Crucible
Tare Wt (g)
Sample Wt +
Tare Wt (g)
Liquid Sludge Wt
(g)
Oven Temp 'C
Date/Time In
Date/Time Out
Dried Sample Wt
+ Tare Wt (g)
Dried Sludge Wt (g;
Fixed Solids Wt (g,
Furnace Temp °C
Date/Time In
Date/Time Out
Burned Sample
Wt + Tare Wt (g)
Volatile Solids Wt (g)
TS%
VS%
30 Day Bench Scale Extended Aeration Test
VAR Ontion 3. Percent Volatile Solids Reduction
U.S. BIOSOLIDS, INC.
N. WILKESBORO
146745
03/16/23
04/17/23
As Received Day 0 Day 7 Day 14 Day 21 Day 28
n3/1R/23 n3/2n/23 03/27/23 04/03/23 04/10/23 04/17/23
2.96
3.45
3.88
4.61
5.02
X1
X7
X8
X15
X22
X29
21.6895
19.2847
17.1090
23.1870
17.1747
20.1099
30.6470
35.8294
26.3822
32.4573
27.3962
33.2066
8.9575
16.5447
9.2732
9.2703
10.2215
13.0967
106
105
105
107
106
106
03/16/23 16:20
03/20/23 08:50
03/27/23 09:00
04/03/23 09:40
04/10/23 09:30
04/17/23 08:30
03/17/23 16:15
03/21/23 09:00
03/28/23 09:05
04/04/23 10:00
04/11/23 09:25
04/18/23 08:45
22.0925
19.5560
17.2629
23.3279
17.3413
20.3260
0.4030
0.2713
0.1539
0.1409
0.1666
0.2161
0.1108
0.0641
0.0588
0.0696
0.0907
550
550
550
550
550
...
03/21/23 15:15
03/28/23 15:00
04/04/23 16:00
04/11/23 15:05
04/18/23 15:20
03/21/23 16:30
03/28/23 16:00
04/04/23 17:05
04/11/23 16:10
04/18/23 16:30
,o ii oy
"
xw ti
19.3955
17.1731
23.2458
17.2443
20.2006
0.1605
0.0898
0.0821
0.0970
0.1254
4.50%
1.64%
1.66%
1.52%
1.63%
1.65%
58.35%
58.27%
58.22%
58.03%
Yf Mass Fraction of Volatile Solids in Liquid (Feed)
yb Mass Fraction of Volatile Solids in Liquid (Bottom)
Sludge at Start of Test
0.0097010
Sludge at End of Test
0.0095749
xf Mass Fraction of Fixed Solids in Liquid (Feed) Sludge
xb Mass Fraction of Fixed Solids in Liquid (Bottom)
at Start of Test
0.0066970
Sludge at End of Test
0.0069254
TS
0.2713
TS
0.2161
VS
0.1605
VS
0.1254
Volatile Fraction In: 0. 1 Volatile Fraction Out: 1 0.35170
P.O. Box 411483 • Charlotte, NC 28241.1483
Phone: [phone] • Fax: [phone]

F A
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
LABORATORIES, INC
Shipping & Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
It is essential that all information he recorded on this Chain of Custody document for acceptance by PAR Laboratories, Ins ann the North
%,arouna Ue arrment of tnvlronnlental and Naturaf Resources.
Company Name (billing) Comments/ Special Instructions
U.S. Biosolids, Inc.
Address
PO Box 146
City, State 8 zip code
Ronda, NC 28670
Point of Contact Et Tetephone Number
Zach Key 336-467-3550
Sample n _ • 7 ,
aken By: SIGNATURE /i!PRINTED NAME «ti- 1CCS'
ARE SAMPLES FOR STATE or EPA REPORTING? YES >-*�"NO
`Sample Type: Dw _ WW eN.", GWMW HW soil _ Other
Sample Temp at time of sampling: o C Sample Temp upon receipt: ° C
"'Field Preserved: Yes No Teflon Llner/Zero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (Y/N): Dechlorination Necessary (YIN):
Bent Semite' l .D
Semple Location I Nt mbw)
C:ornp
Grab
Set Up
Preserv. Date/Time
Coiled" jiknafyses
DOWTime
Kos byo
�°
I
l
s:� �s i 3v �� h•►.t
l
Keungwsn oy. uatelllme Ke ve y: UateJrtme
3-19— r I, 9 — 03-1; 3 //20
Rellnquis d by Date/Time Received by. Date/Time
• C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW-Groundwater Monitoring Well HW=Hazardous Waste

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two conies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 11-15, FORM: DCAR 11-15, or FORM: SDR 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 11-15):
❑ Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 11-15) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
❑ For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
❑ Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
B. Residuals Source -Generating Facility Information:
❑ For each source facility, attach the following:
❑ Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
❑ Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
❑ Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
❑ Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
❑ For each source facility, attach the following:
❑ Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 06-16 Page 1 of 1

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Town of Rutherfordton
2. Facility permit holder is: ❑ Federal, 0 State, 0 Local Government, or 0 Private.
Facility permit issued by: ❑ Div. of Water Resources, Div. of Environmental Health,
or Other (explain: M.
3. Facility contact person and title: Doug Barrick, Town Manager
Complete mailing address: 129 N. Main St.
City: Rutherfordton State: NC Zip: 28139
Telephone number: [phone] E-mail address: dbarrick&n therfordton.net
4. Facility physical address: 1021 S. Main St.
City: Rutherfordton State: NC Zip: 28139
Coordinates: Latitude: 35' 20' 37.58" Longitude: 81. 57' 25.40"
Datum: NAD 83 Level of accuracy: .01
Method of measurement: MAP
5. Purpose of the facility:
® treatment of municipal wastewater, treatment of 100% domestic wastewater,
❑ treatment of potable water, treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: _ % industrial and _ % domestic)
other (explain: _ ).
6. Does the facility have an approved pretreatment program: Yes No
7. Facility permitted/design flow: 3 MGD and facility average daily flow: 0.4 MGD
8. Average amount of residuals being generated at this facility 37.61 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 450,000 gallon storage tank
Type and volume of residuals storage (i.e., outside of residuals treatment units): _
II. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part 503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological ❑ Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: 0 yes ® no.
If yes, list the number(s): _
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: P yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: PAR and Date of analysis: 6-7-2023
Passed corrosivity test: yes no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: yes no. Flashpoint: 200 OF (> 140°F)
Passed reactivity test: ® yes ao. HCN: NON mg/kg (<250) & H2S: NON mg/kg (<500)
TCLP Parameter
Limit
(mgfi)
Result
(m917)
TCLP Parameter
Limit
(m917)
Result
(mgfi)
Arsenic
5.0
0.5
Hexachlorobenzene
0.13
0.013
Barium
100.0
10
Hexachloro-1,3-Butadiene
0.5
0.05
Benzene
0.5
0.05
Hexachloroethane
3.0
0.3
Cadmium
1.0
0.05
Lead
5.0
0.5
Carbon Tetrachloride
0.5
0.05
Lindane
0.4
0.04
Chlordane
0.03
0.003
Mercury
0.2
0.02
Chlorobenzene
100.0
10
Methoxychlor
10.0
1
Chloroform
6.0
0.5
Methyl Ethyl Ketone
200.0
20
Chromium
5.0
0.5
Nitrobenzene
2.0
0.2
m-Cresol
200.0
20
Pentachlorophenol
100.0
10
o-Cresol
200.0
20
Pyridine
5.0
0.5
p-Cresol
200.0
20
Selenium
1.0
0.1
Cresol
200.0
20
Silver
5.0
0.5
2,4-D
10.0
1
Tetrachloroethylene
0.7
0.07
1,4-Dichlorobenzene
7.5
0.75
Toxaphene
0.5
0.05
1,2-Dichloroethane
0.5
0.05
Trichloroethylene
0.5
0.05
1,1-Dichloroethylene
0.7
0.07
2,4,5-Trichlorophenol
400.0
40
2,4-Dinitrotoluene
0.13
0.013
214,6-Trichlorophenol
2.0
0.2
Endrin
0.02
0.002
2,4,5-TP (Silvex)
1.0
0.1
Heptachlor and its Hydroxide
0.008
0.0008
Vinyl Chloride
0.2
0.02
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Waypoint Analytical and Date of analysis: 6-7-2023
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mglkg)
Monthly Average
Concentration Limits
(Class A Only)
(mglkg)
Result
(mglkg)
Arsenic
75
41
29.4
Cadmium
85
39
5.88
Copper
4,300
1,500
800
Lead
840
300
38.9
Mercury
57
17
10.4
Molybdenum
75
n/a
14.7
Nickel
420
420
25.5
Selenium
100
100
29.4
Zinc
7,500
2,800
1340
b. For Surface Disposal Unit (landfill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: = and Date of analysis: =
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
❑ > 0 but < 25
30
200
210
❑ > 25 but < 50
34
220
240
❑ > 50 but < 75
39
260
270
> 75 but < 100
46
300
320
> 100 but < 125
53
360
390
> 125
62
450
420
Result (mg4g)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 1.65 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Waypoint Analytical and Date of analysis: 6-7-2023
Parameter
Result
(mg1kg)
Aluminum
22800
Ammonia -Nitrogen
10400
Calcium
14300
Magnesium
3760
Nitrate -Nitrite Nitrogen
294
pH (Standard Unit)
6.6
Phosphorus
19300
Potassium
4040
Sodium
2010
Total Kjeldahl Nitrogen
84100
c. Using the results listed in Item IL 5b. above, calculate the sodium adsorption ration (SAR): 0.48
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 30 %. This
rate is a (check one): Ji default value, or ❑ actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, ex lain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals:
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (1st) Year PAN
Five -Year
Maximum Adjusted PAN
(mg1kg)
(mg/kg)
Surface
27604
42147.41
Injection/Incorporation
32804
46008.81
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses:
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
rl A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
JJ A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one o f the followings (except for non -biological residuals):
14 Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
J Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
E] Alternative 4 [15A NCAC 02T.I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 5 [15A NCAC 02T.1106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: composting, W heat drying, heat treatment,
thermophilic aerobic digestion, beta ray irradiation,
❑ gamma ray irradiation, or I pasteurization.
b. For Land Application of Class B:
Alternative 1 [15A NCAC 02T.I 106(c)(1)] - Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T.I 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, I
air drying, ❑ anaerobic digestion,
El composting, or lime stabilization.
c. For Surface Disposal:
11 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
J Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
J Exempt -If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
J Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
❑ Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
El Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
E] Alternative 4 [15A NCAC 02T. 1107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
E] Alternative 5 [15A NCAC 02T. I 107(a)(5)] - 14-Day Aerobic Processes.
E] Alternative 6 [15A NCAC 02T. 1107(a)(6)] - Alkaline Stabilization.
E] Alternative 7 [15A NCAC 02T. 1107(a)(7)] - Drying of Stabilized Residuals.
E] Alternative 8 [15A NCAC 02T. 1107(a)(8)] - Drying of Unstabilized Residuals.
Alternative 9 [15A NCAC 02T. 1107(a)(9)] - Injection.
Alternative 10 [15A NCAC 02T. 1107(a)(10)] - Incorporation.
q Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(b)(2)].
id Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

VICINITY MAP
I's -v- ON
Li
�k
/V
l creek
k
9
Dfl
TOWN OF RUTHERFORDTON WWTP
1021 S. MAIN STREET
RUTHERF4RDTON, NC 28139
fttherforcion
City Waste Water

Rutherfordton Wastewater Treatment Plant
e /
!�
�f
I �
Y �
e'
I
i�
Domestl
whom
Creel,
Chlorine
Contact
Chamber
.r .
,f
1•,f
Effluent
,,v to Stream

QUANTITATIVE JUSTIFICATION
For the past 8 years the Town of Rutherfordton has produced the following Dry Tons
2023 46.51
2022 19.31
2021 45.08
2020 22.00
2019 31.18
2018 8.15
2017 53.61
2016 35.48
This comes out to an eight -year average of 32.67 Dry Tons per year. This is well less of the
currently requested amount of 300 dry tons per year. This will allow for any growth in the
system or inflow rates.

U.S. Biosolids, Inc.
Permit No. WQ0037135
SAMPLING PLAN
Annually, if a land application event occurs, grab samples are collected from the digester. Samples
from the digesterwill be combined to form individual grab samples to be sent to a laboratoryfor
analysis. If a land application event is to occur in the early part of a calendar year (i.e. January or
early February) these samples may have to be taken in December, so results can be obtained
before the land application event, as some results take 30+ days to receive.
These individual grab samples are collected and tested for fecal coliform analysis, volatile solids
reduction, nutrient analysis, and a TCLP test. These tests will be taken by U.S. Biosolids, Inc. All
samples except for the composite residual sample will be taken to a state certified laboratory. All
samples taken will be taken in the same condition as the residuals are to be land applied.
The volatile solids will first be attempted to be achieved using option 1 [503.33(b)(1)]; 38%volatile
solids reduction. This option will be attempted first due to it being the most cost effective. One
sample will betaken at the aeration basin and labeled "B". The next sample will be labeled "A" and
be taken from the digester.
If option 1 cannot be achieved to meet the volatile solids reduction, a 30 day bench scale option 3
[503.33(b)(3)] test will be used. This sample will be taken from the digester with the sample being at
least a quart in quantity.
If both option 1 and 3 are used and volatile solids reduction cannot be achieved; the sludge holding
tank will be stabilized using sufficient alkaline to meet option 6 [503.33(b)(6)], commonly known as
time stabilization.
Fecal Coliform is gathered in seven (7) individual samples and tested to meet the requirements of
[503.32(b)(2)]. This requirement is for the geometric mean fecal coliform density of the samples be
less than two million (2,000,000) MPN per gram. These samples will be placed in 250ml containers
and placed on ice, in a cooler for transport to the laboratory before 1600 hours (4pm) the same day
the samples are obtained.
Annually, if land application occurs, a composite residual sample will be analyzed, prior to a land
application event for:
Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia
Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus, Potassium, TKN,
Sodium
From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption Ratio (SAR) will
be calculated. This sample will be collected in a non -breakable container, at least one quart in size.
This sample will be taken from the digester. This test will be done by a state approved laboratory.

PLL
PROMPT•ACCURATE-RELIABLE
LABORATORIES, INC
WWW.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
PROJECT NAME: JUN 23
DATE: 08/18/23
SAMPLE NUMBER-
147349
SAMPLE ID- RUTHERFORDTON
SAMPLE MATRIX- WW
DATE SAMPLED-
06/07/23
TIME SAMPLED- 1015
DATE RECEIVED-
06/07/23
SAMPLER- ZK
RECEIVED BY- DJ
TIME RECEIVED-
1235
DELIVERED BY- ZK
TYPE SAMPLE- Grab
Page 1 of 1
ANALYSIS
ANALYSIS
METHOD DATE TIME BY
RESULT UNITS
30 DAY BENCH SCALE
TEST
VAR 06/07/23 1530 RE
7.65 %
LABORATORY DIRECTOR Diu~
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PlIr F;Z
PROM PT•ACOURATE• RELIABLE
LABORATORIES, INC
WWW. PARLABS. COM
30 Day Bench Scale Extended Aeration Test
Percent Volatile Solids Reduction
• U.S. BIOSOLIDS
• RUTHERFORDTON
• 147349
• 06/07/23
• 07/06/23
Start: End:
TS ()
0.1903
0.1972
TS%
1.94%
1.93%
VS (g)
0.1497
0.1439
VS%
78.67%
72.97%
y Mass Fraction of Volatile Solids in Liquid Sludge
0.01525571
0.0140853
x Mass Fraction of Fixed Solids in Liquid Sludge
0.0041375
0.0052172
FSVR (Mass Balance)
7.68%
FSVR (Van Kleeck)
7.65%
FSVR (Mass Balance) <15%
YES
FSVR (Van Kleeck) <15%
YES
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] • Fax: [phone]

Pbk
CCU RATE• RELIABLE
LABORATORIES, INC
WWW.PARLABS.COM
Collected
D.O.
Crucible
Tare Wt (g)
Sample Wt +
Tare Wt (g)
Liquid Sludge W1
(g)
Oven Temp 'C
Date/Time In
Date/Time Out
Dried Sample Wi
+ Tare Wt (g)
Dried Sludge Wt (g;
Fixed Solids Wt (g;
Furnace Temp °C
Date/Time In
Date/Time Out
Burned Sample
Wt + Tare Wt (g)
Volatile Solids Wt (g
TS%
VS%
30 Day Bench Scale Extended Aeration Test
VAR Option 3 Percent Volatile Solids Reduction
U.S. BIOSOLIDS
RUTHERFORDTON
147349
06/07/23
07/07/23
As Received Day 0 Day 7 Day 14 Day 21 Day 28
na/n7/23 n6/n7/23 ns/16/23 06/23/23 06/30/23 07/07/23
Rvidw,
1.86
2.99
3.68
4.32
4.60
X9
X9
X12
X2
X16
X23
15.5323
15.5323
19.3069
25.0680
22.6972
15.9252
25.3450
25.3450
29.3312
35.3525
33.2840
26.1415
9.8127
9.8127
10.0243
10.2845
10.5868
10.2163
106
106
107
107
106
106
06/07/23 15:30
06/07/23 16:00
06/16/23 09:45
06/23/23 08:50
06/30/23 09:20
07/07/23 09:40
06/08/23 15:20
06/08/23 16:05
06/17/23 10:00
06/24/23 09:00
07/01/23 09:30
07/08/23 10:00
15.7226
1 15.7226
19.5034
25.2655
22.9015
16.1224
0.1903
0.1903
0.1965
0.1975
0.2043
0.1972
0.0406
0.0483
0.0526
0.0548
0.0533
550
550
550
550
550
i
06/09/23 17:15
06/17/23 15:00
06/24/23 14:45
07/01/23 15:05
07/08/23 15:50
%-
06/09/23 18:20
06/17/23 16:05
06/24/23 16:00
07/01/23 16:10
07/08/23 17:05
15.5729
19.3552
25.1206
22.7520
15.9785
0.1497
0.1482
0.1449
0.1495
0.1439
1.94%
1.94%
1.96%
1 1.92%
1.93%
1.93%
FINNEWIM
78.67%
75.42%
1 73.37%
73.18%
72.97%
yf Mass Fraction of Volatile Solids in Liquid (Feed)
Yb Mass Fraction of Volatile Solids in Liquid (Bottom)
Sludge at Start of Test
0.0152557
Sludge at End of Test
0.0140853
xf Mass Fraction of Fixed Solids in Liquid (Feed)
xb Mass Fraction of Fixed Solids in Liquid (Bottom)
Sludge at Start of Test
0.0041375
Sludge at End of Test
0.0052172
TS ()
0.1903
TS (
0.1972
VS (
0.1497
VS
0.1439
Volatile Fraction In: 0.40552 Volatile Fraction Out: 0.37808
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] • Fax: [phone]

PROMPT•ACnu14AT •REl-IAQLE
LABORATORIES, INC
Shipping It Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
uaro ma ue artment or tnvronmentat ana Naturai rresources.
Company Name (billing) Comments/ Special Instructions
U.S. Biosolids, Inc.
Address
I.
PO Box 146
City, State ft zip code
Ronda, NC 28670
Point of Contact li Telephone Number
Zach Key 336-467-3550
Sample
Taken By:
I y PRINTED NAME 2c-c K410V
ARE SAMPLES FOR STATE i5r EPA REPORTING? YES NO _
'Sample Type: ow ww GWMW _ HW soil Other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon Lineri2ero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (YIN): Dechlorination Necessary (YIN):
SIGNATURE '
' C=Composite G-Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

RLL
PROMPT•ACCURATE-RELIABLE
LABORATORIES, INC
W W W.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
PROJECT NAME: JUN 23
DATE: 07/12/23
SAMPLE NUMBER- 147348 SAMPLE ID- RUTHERFORDTON SAMPLE MATRIX- WW
DATE SAMPLED- 06/07/23 TIME SAMPLED- 1015
DATE RECEIVED- 06/07/23 SAMPLER- ZK RECEIVED EY- DJ
TIME RECEIVED- 1235 DELIVERED BY- ZK TYPE SAMPLE- Grab
Page 1 of 1
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
FECAL COLIFORM (GEOM. MEAN) SM 9221 E 06/07/23 1630 RE 47,755 MPN/g
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

AM
Pjt,-1 FZ
PROM PT -ACCURATE- REL_IABL-E
- BOIZ— "rOPLIES, J C
2217 Graham Park Drive
PO Box 411483
Charlotte, NC 28241-1483
NC Cert # 20; SC Cert # 99003001
U.S. BIOSOLIDS
• RUTHERFORDTON
06/07/23
FECAL COLIFORM, GEOMETRIC MEAN
• r SM 9221 E
1147348
Sample #
1
F. Coliform
911
T. Solids %
1.89%
FC/ gra
48,288.66
2
667
1.98%
33,722.25
3
715
1.72%
41,623.79
4
1,125
1.99%
56,590.82
5
786
1.71 %
45,872.10
6
1,044
1.80%
58,100.23
7
969
1 1.75%
1 55,409.32
Fecal Coliform
Geometric Mean= j

PROMF+r-ACOURAT -RELIABLE
LABORATORIES, INC
Shipping 13 Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
2
Company Name (billing)
U.S. Biosolids, Inc.
Nawral Kesources.
1 Address
i! PO Box 146 I
City, State Et zip code
Ronda, NC 28670
Point of Contact Et Telephone Number
Zach Key 336-467-3550
Sample
Taken By:
SIGNATURE
Comments/ Saecial Instructions
PRINTED NAME LGot.
ARE SAMPLES FOR STATC or EPA REPORTING? YES NO
'Sample Type: Dw wW GWMW _ Hw Sal Other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon LinerlZero Headspace: Yes No nla
Residual Chlorine checked at time of sampling (YIN): Dechlorination Necessary (YIN):
' C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMMV=Groundwater Monitoring Well HW=Hazardous Waste

Waypointo
ANALYTICAL
6/21 /2023
US Biosolids Inc
Dennis Key
958 Hoots Road
Roaring River, NC, 28669
Ref: Analytical Testing
Report Number: 23-159-0007
Project Description: Ruthfordton
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Dear Dennis Key:
Waypoint Analytical Virginia, Inc. received sample(s) on 6/8/2023 for the analyses presented in the following
report.
The above referenced project has been analyzed per your instructions. The analyses were performed in
accordance with the applicable analytical method. Sub -contracted testing is noted on the Sample Summary Table
if applicable.
The analytical data has been validated using standard quality control measures performed as required by the
analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all
parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA
(including 40 CFR 136 Method Update Rule May 2012) and NELAC unless otherwise indicated.
Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of
sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time
Refer to sample analysis time for confirmation of holding time compliance.
The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as -
received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to
the samples included in this report.
Please do not hesitate to contact me or client services if you have any questions or need additional information
Sincerely,
&;'-� ­AldA�
Brandi Watson
Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the
analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis.
Page 1 of 7

•
7621 Whitepine Road, Richmond, VA 23237
Waypoint
Main 804-743-9401 0 Fax [phone]
ANALYTICAL www.waypointanalytical.com
Sample Summary Table
Report Number: 23-159-0007
Client Project Description: Ruthfordton
Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID
62191
Ruthfordton
Solids
06/07/2023
10:15
06/08/2023
62191
Ruthfordton
Solids
06/07/2023
10:15
06/08/2023
62191
Ruthfordton
Solids
06/07/2023
10:15
06/08/2023
62191
Ruthfordton
Solids
06/07/2023
10:15
06/08/2023
62191
Ruthfordton
Solids
06/07/2023
10:15
06/08/2023
62191
Ruthfordton
Solids
06/07/2023
10:15
06/08/2023
62191
Ruthfordton
Solids
06/07/2023
10:15
06/08/2023
62191
Ruthfordton
Solids
06/07/2023
10:15
06/08/2023
SM-4500-NH3C
WP MTN
9045D
WP MTN
4500NO3F-2011
WP MTN
6010D
WP MTN
SW-7471B
WP MTN
SM-4500-NH3C-TKN
WP MTN
SM-2540G
WP MTN
WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN
Page 2 of 7

Waypointo
ANALYTICAL
46381
US Biosolids Inc
Dennis Key
958 Hoots Road
Roaring River , NC 28669
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Project Ruthfordton
Information :
Report Number : 23-159-0007 REPORT OFANALYSIS
Report Date : 06/21/2023
Received : 06/08/2023
Brandi Watson
Lab No : 62191
Sample ID : Ruthfordton
Matrix: Solids
Sampled: 6/7/2023 10:15
Test
Results
Units
MQL
DF
Date / Time
By
Analytical
Analyzed
Method
Moisture
98.3
%
0.010
1
06/14/2317:55
TKM
SM-2540G
Potassium
4040
mg/Kg -
dry
588
1
06/12/23 19:39
JTR
6010D
Sulfur
15200
mg/Kg -
dry
588
1
06/12/23 19:39
JTR
6010D
Calcium
14300
mg/Kg -
dry
2940
1
06/12/23 19:39
JTR
6010D
Magnesium
3760
mg/Kg -
dry
294
1
06/12/23 19:39
JTR
6010D
Sodium
2010
mg/Kg -
dry
1470
1
06/12/23 19:39
JTR
6010D
Iron
27200
mg/Kg -
dry
588
1
06/12/23 19:39
JTR
6010D
Aluminum
22800
mg/Kg -
dry
294
1
06/12/23 19:39
TJS
6010D
Manganese
494
mg/Kg -
dry
29.4
1
06/12/23 19:39
JTR
6010D
Copper
800
mg/Kg -
dry
29.4
1
06/12/23 19:39
JTR
6010D
Zinc
1340
mg/Kg -
dry
73.5
1
06/12/23 19:39
JTR
6010D
Cadmium
<5.88
mg/Kg -
dry
5.88
1
06/12/23 19:39
JTR
6010D
Chromium
41.6
mg/Kg -
dry
14.7
1
06/12/23 19:39
JTR
6010D
Nickel
25.5
mg/Kg -
dry
14.7
1
06/12/23 19:39
JTR
6010D
Lead
38.9
mg/Kg -
dry
17.6
1
06/12/23 19:39
JTR
6010D
Arsenic
<29.4
mg/Kg -
dry
29.4
1
06/12/23 19:39
JTR
6010D
Mercury
<10.4
mg/Kg -
dry
10.4
1
06/12/23 11:25
FDS
SW-7471B
Selenium
<29.4
mg/Kg -
dry
29.4
1
06/12/23 19:39
JTR
6010D
Molybdenum
<14.7
mg/Kg -
dry
14.7
1
06/12/23 19:39
JTR
6010D
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 3 of 7

•
0
Waypoint
7621 Whitepine
Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
ANALYTICAL
www.waypointanalytical.com
46381
US Biosolids Inc
Project
Ruthfordton
Dennis Key
Report Date : 06/21/2023
958 Hoots Road
Information :
Received : 06/08/2023
Roaring River , NC 28669
Brandi Watson
Report Number : 23-159-0007
REPORT OFANALYSIS
Lab No : 62191
Matrix: Solids
Sample ID : Ruthfordton
Sampled: 6/7/2023 10:15
Test
Results
Units
MQL
DF Date / Time
By Analytical
Analyzed
Method
Ammonia Nitrogen
10400
mg/Kg - dry
5880
1 06/21/23 07:00
JPJ SM-4500-NH3C
Nitrate+Nitrite-N
<294
mg/Kg - dry
294
1 06/13/23 15:49
CLP 4500NO3F-2011
Organic N
73710
mg/Kg - dry
14710
1 06/20/23 13:45
CALCULATION
pH
6.6
S.U.
1 06/12/2316:00
CNB 9045D
Total Solids
1.65
%
0.010
1 06/14/23 17:55
TKM SM-2540G
Total Kjeldahl Nitrogen
84100
mg/Kg - dry
14700
1 06/20/23 13:45
JPJ ;M-4500-NH3C-TKI`
Phosphorus
19300
mg/Kg - dry
294
1 06/12/23 19:39
JTR 6010D
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 4 of 7

Waypointo
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Client: US Biosolids Inc CASE NARRATIVE
Project: Ruthfordton
Lab Report Number: 23-159-0007
Date: 6/21 /2023
Metals Analysis Method 601 OD
Sample 85530
Analyte: Aluminum
QC Batch No: 1-687321/1-686988
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 85530
Analyte: Iron
QC Batch No: 1-687321/1-686988
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 85530
Analyte: Potassium
QC Batch No: 1-687321/1-686988
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 85530
Analyte: Magnesium
QC Batch No: 1-687321/1-686988
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 85530
Analyte: Lead
QC Batch No: 1-687321/1-686988
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Page 5 of 7

WayPAoInt..
NALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 46381
Customer Name: US Biosolids Inc
Report Number: 23-159-0007
Shipping Method
0 Fed Ex 0 US Postal 0 Lab
0 UPS 0 Client 0 Courier
0 Other:
Thermometer ID:
Shipping container/cooler uncompromised?
* Yes
0 No
Number of coolers/boxes received
Custody seals intact on shipping container/cooler?
0 Yes
0 No
Not Present
Custody seals intact on sample bottles?
0 Yes
0 No
Not Present
Chain of Custody (COC) present?
# Yes
0 No
COC agrees with sample label(s)?
# Yes
0 No
COC properly completed
# Yes
0 No
Samples in proper containers?
# Yes
0 No
Sample containers intact?
# Yes
0 No
Sufficient sample volume for indicated test(s)?
# Yes
0 No
All samples received within holding time?
# Yes
0 No
Cooler temperature in compliance?
# Yes
0 No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
# Yes
0 No
Water - Sample containers properly preserved
0 Yes
0 No
N/A
Water - VOA vials free of headspace
0 Yes
0 No
N/A
Trip Blanks received with VOAs
0 Yes
0 No
N/A
Soil VOA method 5035 — compliance criteria met
0 Yes
0 No
0 N/A
F_ High concentration container (48 hr)
F_ High concentration pre -weighed (methanol -14 d)
F_ Low concentration EnCore samplers (48 hr)
F_ Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included? 0 Yes * No
Comments:
Signature: lBrandi Watson Date & Time: 06/08/2023 09:54:44
Page 6 of 7

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PAIOLF;Z
PROM PT•ACCLIRATE• RELIABLE
LABORATORIES, INC
W W W.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
PROJECT NAME: JUN 23
DATE: 07/12/23
SAMPLE NUMBER- 147350
SAMPLE ID- RUTHERFORDTON
SAMPLE MATRIX- WW
DATE SAMPLED- 06/07/23
TIME SAMPLED- 1015
DATE RECEIVED- 06/07/23
SAMPLER- ZK
RECEIVED BY- DJ
TIME RECEIVED- 1235
DELIVERED BY- ZK
TYPE SAMPLE- Grab
Page 1 of 2
ANALYSIS
ANALYSIS
METHOD
DATE
TIME
BY
RESULT
UNITS
TCLP CHARACTERISTICS
TCLP
06/20/23
1248
CB
pH VALUE
TCLP
06/20/23
1248
CB
7.3
S.U.
CORROSIVITY
TCLP
06/20/23
1248
CB
NON
REACTIVITY
TCLP
06/20/23
1248
CB
NON
FLASH POINT
TCLP
06/20/23
1248
CB
> 200
degrees F
IGNITABILITY
TCLP
06/20/23
1248
CB
NON
PAINT FILTER TEST
TCLP
06/20/23
1248
CB
FL
TCLP METALS
TCLP
06/15/23
1917
BN
ARSENIC
TCLP
06/15/23
1917
BN
< 0.5
ppm
BARIUM
TCLP
06/15/23
1917
BN
< 10
ppm
CADMIUM
TCLP
06/15/23
1917
BN
< 0.1
ppm
CHROMIUM
TCLP
06/15/23
1917
BN
< 0.5
ppm
LEAD
TCLP
06/15/23
1917
BN
< 0.5
ppm
MERCURY
TCLP
06/15/23
1917
BN
< 0.02
ppm
SELENIUM
TCLP
06/15/23
1917
BN
< 0.1
ppm
SILVER
TCLP
06/15/23
1917
BN
< 0.5
ppm
TCLP PESTICIDES
TCLP
06/16/23
2046
VC
ENDRIN
TCLP
06/16/23
2046
VC
< 0.002
ppm
LINDANE
TCLP
06/16/23
2046
VC
< 0.04
ppm
METHOXYCHLOR
TCLP
06/16/23
2046
VC
< 1
ppm
TOXAPHENE
TCLP
06/16/23
2046
VC
< 0.05
ppm
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PLLF;Z
PROMPT•ACCU RATE- RELIABLE
LABORATORIES, INC
W W W.PARLABS.COM
Page 2 of 2
CONTINUATION OF DATA FOR SAMPLE NUMBER 147350
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
CHLORDANE
TCLP
06/16/23
2046
VC
< 0.003
ppm
HEPTACHLOR (AND ITS EPDXIDE)
TCLP
06/16/23
2046
VC
< 0.0008
ppm
TCLP HERBICIDES
TCLP
06/19/23
2037
VC
2,4-D
TCLP
06/19/23
2037
VC
< 1
ppm
2,4,5-TP(SILVEX)
TCLP
06/19/23
2037
VC
< 0.1
ppm
TCLP ORGANICS
TCLP
06/09/23
2027
MS
BENZENE
TCLP
06/09/23
2027
MS
< 0.05
ppm
CARBON TETRACHLORIDE
TCLP
06/09/23
2027
MS
< 0.05
ppm
CHLOROBENZENE
TCLP
06/09/23
2027
MS
< 10
ppm
CHLOROFORM
TCLP
06/09/23
2027
MS
< 0.6
ppm
o-CRESOL
TCLP
06/09/23
2027
MS
< 20
ppm
p-CRESOL
TCLP
06/09/23
2027
MS
< 20
ppm
m-CRESOL
TCLP
06/09/23
2027
MS
< 20
ppm
1,4-DICHLOROBENZENE
TCLP
06/09/23
2027
MS
< 0.75
ppm
1,2-DICHLOROETHANE
TCLP
06/09/23
2027
MS
< 0.05
ppm
1,1-DICHLOROETHYLENE
TCLP
06/09/23
2027
MS
< 0.07
ppm
2,4-DINITROTLUENE
TCLP
06/09/23
2027
MS
< 0.013
ppm
HEXACHLOROBENZENE
TCLP
06/09/23
2027
MS
< 0.013
ppm
HEXACHLOROBUTDIENE
TCLP
06/09/23
2027
MS
< 0.05
ppm
HEXACHLOROETHANE
TCLP
06/09/23
2027
MS
< 0.3
ppm
METHYL ETHYL KETONE
TCLP
06/09/23
2027
MS
< 20
ppm
NITROBENZENE
TCLP
06/09/23
2027
MS
< 0.2
ppm
PENTACHLOROPHENOL
TCLP
06/09/23
2027
MS
< 10
ppm
PYRIDINE
TCLP
06/09/23
2027
MS
< 0.5
ppm
TETRACHLORETHYLENE
TCLP
06/09/23
2027
MS
< 0.07
ppm
TRICHLOROETHYLENE
TCLP
06/09/23
2027
MS
< 0.05
ppm
2,4,5-TRICHLOROPHENOL
TCLP
06/09/23
2027
MS
< 40
ppm
2,4,6-TRICHLORPHENOL
TCLP
06/09/23
2027
MS
< 0.2
ppm
VINYL CHLORIDE
TCLP
06/09/23
2027
MS
< 0.02
ppm
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

F:Z
PROMPT•ACOURAT •RCL1^nLE
LABORATORIES, INC
Shipping & Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
uarouna ue arrmem or tnwronmentai ano natural resources.
Company Name (billing) Comments/ Special Instructions
U.S. Biosolids, Inc.
Address
PO Box 146 }
k
City, State & zip code
Ronda, NC 28670
Point of Contact @ Telephone Number $
Zach Key 336-467-3550
Sample —
Taken By: SIGNATURE
PRINTED NAME 6kct j(
ARE SAMPLES FOR STATE or EPA REPORTING? YES )�_NO
'Sample Type: ow ww GWMW _ 14W soil other
Sample Temp at time of sampling: o C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (Y/N): Dechlorination Necessary (YIN):
5
• C=Composite G=Grab OW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two conies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 11-15, FORM: DCAR 11-15, or FORM: SDR 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 11-15):
❑ Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 11-15) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
❑ For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
❑ Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
B. Residuals Source -Generating Facility Information:
❑ For each source facility, attach the following:
❑ Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
❑ Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
❑ Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
❑ Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
❑ For each source facility, attach the following:
❑ Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 06-16 Page 1 of 1

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Town of Spindale
2. Facility permit holder is: ❑ Federal, 0 State, 0 Local Government, or 0 Private.
Facility permit issued by: Div. of Water Resources, Div. of Environmental Health,
or Other (explain:
3. Facility contact person and title: Guy O' Connor
Complete mailing address: PO Box 186
City: Spindale State: NC Zip: 28160
Telephone number: [phone] E-mail address: goconnor&spindalenc.net
4. Facility physical address: 101 Ecology Street
City: Spindale State: NC Zip: 28160
Coordinates: Latitude: 35.375789' Longitude:-81.905717'
Datum: NAD83 Level of accuracy: 0.01
Method of measurement: GPS
5. Purpose of the facility:
® treatment of municipal wastewater, treatment of 100% domestic wastewater,
❑ treatment of potable water, treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: _ % industrial and _ % domestic)
other (explain: _ ).
6. Does the facility have an approved pretreatment program: Yes No
7. Facility permitted/design flow: 6.0 MGD and facility average daily flow: 0.75 MGD
8. Average amount of residuals being generated at this facility 50 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: Two 200,000 gallon digesters
Type and volume of residuals storage (i.e., outside of residuals treatment units): _
II. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part 503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological ❑ Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: 0 yes ® no.
If yes, list the number(s): _
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: P yes ® no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: PAR and Date of analysis: 7-12-2023
Passed corrosivity test: yes no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: yes no. Flashpoint: 200 OF (> 140°F)
Passed reactivity test: ® yes ao. HCN: NON mg/kg (<250) & H2S: NON mg/kg (<500)
TCLP Parameter
Limit
(mgfi)
Result
(m917)
TCLP Parameter
Limit
(m917)
Result
(mgfi)
Arsenic
5.0
0.5
Hexachlorobenzene
0.13
0.013
Barium
100.0
10
Hexachloro-1,3-Butadiene
0.5
0.05
Benzene
0.5
0.05
Hexachloroethane
3.0
0.3
Cadmium
1.0
0.1
Lead
5.0
0.5
Carbon Tetrachloride
0.5
0.05
Lindane
0.4
0.04
Chlordane
0.03
0.003
Mercury
0.2
0.02
Chlorobenzene
100.0
10
Methoxychlor
10.0
1
Chloroform
6.0
0.6
Methyl Ethyl Ketone
200.0
20
Chromium
5.0
0.5
Nitrobenzene
2.0
0.2
m-Cresol
200.0
20
Pentachlorophenol
100.0
10
o-Cresol
200.0
20
Pyridine
5.0
0.5
p-Cresol
200.0
20
Selenium
1.0
0.1
Cresol
200.0
20
Silver
5.0
0.5
2,4-D
10.0
1
Tetrachloroethylene
0.7
0.07
1,4-Dichlorobenzene
7.5
0.75
Toxaphene
0.5
0.05
1,2-Dichloroethane
0.5
0.05
Trichloroethylene
0.5
0.05
1,1-Dichloroethylene
0.7
0.07
2,4,5-Trichlorophenol
400.0
40
2,4-Dinitrotoluene
0.13
0.013
214,6-Trichlorophenol
2.0
0.2
Endrin
0.02
0.002
2,4,5-TP (Silvex)
1.0
0.1
Heptachlor and its Hydroxide
0.008
0.0008
Vinyl Chloride
0.2
0.02
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Waypoint and Date of analysis: 6-7-2023
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mglkg)
Monthly Average
Concentration Limits
(Class A Only)
(mglkg)
Result
(mglkg)
Arsenic
75
41
23.8
Cadmium
85
39
4.76
Copper
4,300
1,500
729
Lead
840
300
71.4
Mercury
57
17
7.67
Molybdenum
75
n/a
11.9
Nickel
420
420
37.2
Selenium
100
100
23.8
Zinc
7,500
2,800
1830
b. For Surface Disposal Unit (landfill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: = and Date of analysis: =
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
❑ > 0 but < 25
30
200
210
❑ > 25 but < 50
34
220
240
❑ > 50 but < 75
39
260
270
> 75 but < 100
46
300
320
> 100 but < 125
53
360
390
> 125
62
450
420
Result (mg4g)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 2.14 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Waypoint and Date of analysis: 6-7-2023
Parameter
Result
(mg1kg)
Aluminum
30900
Ammonia -Nitrogen
10900
Calcium
18100
Magnesium
3800
Nitrate -Nitrite Nitrogen
238
pH (Standard Unit)
6.9
Phosphorus
19100
Potassium
4600
Sodium
10400
Total Kjeldahl Nitrogen
62400
c. Using the results listed in Item IL 5b. above, calculate the sodium adsorption ration (SAR): 2.68
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 30 %. This
rate is a (check one): Ji default value, or ❑ actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, ex lain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals:
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (1st) Year PAN
Five -Year
Maximum Adjusted PAN
(mg1kg)
(mg/kg)
Surface
23287
33355.6
Injection/Incorporation
28737
37402.66
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses:
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
rl A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
JJ A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
14 Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
J Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
E] Alternative 4 [15A NCAC 02T.I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 5 [15A NCAC 02T.1106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: composting, W heat drying, heat treatment,
thermophilic aerobic digestion, beta ray irradiation,
❑ gamma ray irradiation, or I pasteurization.
b. For Land Application of Class B:
Alternative 1 [15A NCAC 02T.I 106(c)(1)] - Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T.I 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: ❑ aerobic digestion, I
air drying, ❑ anaerobic digestion,
El composting, or lime stabilization.
c. For Surface Disposal:
11 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
J Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
J Exempt -If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
J Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
❑ Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
El Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
E] Alternative 4 [15A NCAC 02T. 1107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
E] Alternative 5 [15A NCAC 02T. I 107(a)(5)] - 14-Day Aerobic Processes.
E] Alternative 6 [15A NCAC 02T. 1107(a)(6)] - Alkaline Stabilization.
E] Alternative 7 [15A NCAC 02T. 1107(a)(7)] - Drying of Stabilized Residuals.
E] Alternative 8 [15A NCAC 02T. 1107(a)(8)] - Drying of Unstabilized Residuals.
Alternative 9 [15A NCAC 02T. 1107(a)(9)] - Injection.
Alternative 10 [15A NCAC 02T. 1107(a)(10)] - Incorporation.
q Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(b)(2)].
id Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

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ee' �� t�V t' - Sery ces&Pematlefng. !,
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Quantitative Justification of Residuals Production Rate
The Town of Spindale, NC has produced the following dry tons per year:
2023 162.97
2022 102.38
2021 155.43
2020 10.2
2019 120.35
2018 9.12
This is a 6-year average of 93.4 dry tons per year. The Town of Spindale has its own land application
permit that handles all residuals produced most years. The 100 dry tons requested in this permit
renewal will be sufficient for a back up to Spindale's current land application permit.

U.S. Biosolids, Inc.
Permit No. WQ0037135
SAMPLING PLAN
Annually, if a land application event occurs, grab samples are collected from the digester. Samples
from the digesterwill be combined to form individual grab samples to be sent to a laboratoryfor
analysis. If a land application event is to occur in the early part of a calendar year (i.e. January or
early February) these samples may have to be taken in December, so results can be obtained
before the land application event, as some results take 30+ days to receive.
These individual grab samples are collected and tested for fecal coliform analysis, volatile solids
reduction, nutrient analysis, and a TCLP test. These tests will be taken by U.S. Biosolids, Inc. All
samples except for the composite residual sample will be taken to a state certified laboratory. All
samples taken will be taken in the same condition as the residuals are to be land applied.
The volatile solids will first be attempted to be achieved using option 1 [503.33(b)(1)]; 38%volatile
solids reduction. This option will be attempted first due to it being the most cost effective. One
sample will betaken at the aeration basin and labeled "B". The next sample will be labeled "A" and
be taken from the digester.
If option 1 cannot be achieved to meet the volatile solids reduction, a 30 day bench scale option 3
[503.33(b)(3)] test will be used. This sample will be taken from the digester with the sample being at
least a quart in quantity.
If both option 1 and 3 are used and volatile solids reduction cannot be achieved; the sludge holding
tank will be stabilized using sufficient alkaline to meet option 6 [503.33(b)(6)], commonly known as
time stabilization.
Fecal Coliform is gathered in seven (7) individual samples and tested to meet the requirements of
[503.32(b)(2)]. This requirement is for the geometric mean fecal coliform density of the samples be
less than two million (2,000,000) MPN per gram. These samples will be placed in 250ml containers
and placed on ice, in a cooler for transport to the laboratory before 1600 hours (4pm) the same day
the samples are obtained.
Annually, if land application occurs, a composite residual sample will be analyzed, prior to a land
application event for:
Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia
Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus, Potassium, TKN,
Sodium
From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption Ratio (SAR) will
be calculated. This sample will be collected in a non -breakable container, at least one quart in size.
This sample will be taken from the digester. This test will be done by a state approved laboratory.

PLL
PROM PT•ACCU RATE: -RE LIABLE
LABORATORIES, INC
WWW.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
SAMPLE NUMBER- 147352 SAMPLE ID- SPINDALE
DATE SAMPLED- 06/07/23
DATE RECEIVED- 06/07/23 SAMPLER- ZK
TIME RECEIVED- 1235 DELIVERED BY- ZK
Page 1 of 1
PROJECT NAME: JUN 23
DATE: 08/18/23
SAMPLE MATRIX- WW
TIME SAMPLED- 1035
RECEIVED BY- DJ
TYPE SAMPLE- Grab
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
30 DAY BENCH SCALE TEST VAR 06/07/23 1530 RE 4.78 %
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

P11 F;Z
PROM PT- A CCU RATE- RE L IA SUE
LABORATORIES INC
WWW.PARLABS.COM
30 Day Bench Scale Extended Aeration Test
Percent Volatile Solids Reduction
CLIENT NAME: U.S. BIOSOLIDS
SAMPLE ID:
SAMPLE #:
START DATE:
END DATE:
Start: End:
TS (9)
0.2030
0.1986
TS%
1.95%
1.92%
VS (g)
0.1386
0.1311
VS%
68.28%
66.01 %
y Mass Fraction of Volatile Solids in Liquid Sludge
0,01331761
0.0126790
x Mass Fraction of Fixed Solids in Liquid Sludge
0.00618801
0.0065281
FSVR (Mass Balance)
1 4.82%
FSVR (Van Kleeck)
4.78%
FSVR (Mass Balance) <15%
YES
FSVR (Van Kleeck) <15%
YES
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] • Fax: [phone]

PLL
CCU RATE•RELIA E3LE
LABORATORIES, INC
W W W. PARLASS. COM
Collected
D.O.
Crucible
Tare Wt (g)
Sample Wt +
Tare Wt (g)
Liquid Sludge Wt
(g)
Oven Temp °C
Date/Time In
Date/Time Out
Dried Sample Wt
+ Tare Wt (g)
Dried Sludge Wt (g;
Fixed Solids Wt (g)
Furnace Temp °C
Date/Time In
Date/Time Out
Burned Sample
Wt + Tare Wt (g)
Volatile Solids Wt (g;
TS%
VS%
30 Day Bench Scale Extended Aeration Test
VAR nntion 3 Percent Volatile Solids Reduction
CLIENT NAME: U.S. 13110SOLIDS
SAMPLE ID:
SAMPLE #:
START DATE:
END DATE:
As Received Day 0 Day 7 Day 14 Day 21 Day 28
n6m7123 n61n7/23 n6/16/23 06/23/23 06/30/23 07/07/23
2.24
3.65
3.92
4.33
4.96
X10
X10
X13
X3
X17
X24
22.7105
22.7105
21.8743
16.6088
16.9959
22.0138
33.1178
33.1178
32.2246
27.1268
27.4396
32.3537
10.4073
10.4073
10.3503
10.5180
10.4437
10.3399
106
106
107
107
106
106
06/07/23 15:30
06/07/23 16:00
06/16/23 09:45
06/23/23 08:50
06/30/23 09:20
07/07/23 09:40
06/08/23 15:20
06/08/23 16:05
06/17/23 10:00
06/24/23 09:00
07/01/23 09:30
07/08/23 10:00
22.9135
22.9135
22.0740
16.8058
17.1972
22.2124
0.2030
0.2030
0.1997
0.1970
0.2013
0.1986
0.0644
0.0643
0.0660
0.0677
0.0675
550
550
550
550
550
06/09/23 17:15
06/17/23 15:00
06/24/23 14:45
07/01/23 15:05
07/08/23 15:50
06/09/23 18:20
06/17/23 16:05
06/24/23 16:00
07/01/23 16:10
07/08/23 17:05
22.7749
21.9386
16.6748
1 17.0636
22.0813
0.1386
0.1354
0.1310
0.1336
0.1311
1.95%
1.95%
1.93%
1.87%
1.93%
1.92%
68.28%
67.80%
66.50%
66.37%
66.01 %
yf Mass Fraction of Volatile Solids in Liquid (Feed)
yb Mass Fraction of Volatile Solids in Liquid (Bottom)
Sludge at Start of Test
0.0133176
Sludge at End of Test
0.0126790
xf Mass Fraction of Fixed Solids in Liquid (Feed)
xb Mass Fraction of Fixed Solids in Liquid (Bottom)
Sludge at Start of Test
0.0061880
Sludge at End of Test
0.0065281
TS
0.203
TS (
0.1986
VS ()
0.1386
VS ()
0.1311
Volatile Fraction In: 1 0. 1 Volatile Fraction out: 1 0.34380
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] • Fax: [phone]

PROMPT•AC93URAT •RELIARLE
LABORATORIES, INC
Shipping Et Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
Carolina Department of Environmental and Natural Resources.
Company Name (billing) Comments/ Special Instructions
U.S. Biosolids, Inc.
Address
PO Box 146
City, State Et zip code
Ronda, NC 28670
Point of Contact Et. Telephone Number
Zach Key 336-467-3550
Sample 1/
Taken By: SIGNATURE '�ZhA PRINTED NAME
ARE SAMPLES FOR STATEtior EPA REPORTING? YES NO
'Sample Type: Dw WW— GWMW _ HW soil Other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon LinerlZero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (Y/N): Dechlorination Necessary (YIN):
' C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

Waypointo
ANALYTICAL
6/21 /2023
US Biosolids Inc
Dennis Key
958 Hoots Road
Roaring River, NC, 28669
Ref: Analytical Testing
Report Number: 23-159-0008
Project Description: Spindale
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Dear Dennis Key:
Waypoint Analytical Virginia, Inc. received sample(s) on 6/8/2023 for the analyses presented in the following
report.
The above referenced project has been analyzed per your instructions. The analyses were performed in
accordance with the applicable analytical method. Sub -contracted testing is noted on the Sample Summary Table
if applicable.
The analytical data has been validated using standard quality control measures performed as required by the
analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all
parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA
(including 40 CFR 136 Method Update Rule May 2012) and NELAC unless otherwise indicated.
Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of
sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time
Refer to sample analysis time for confirmation of holding time compliance.
The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as -
received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to
the samples included in this report.
Please do not hesitate to contact me or client services if you have any questions or need additional information
Sincerely,
&;'-� ­AldA�
Brandi Watson
Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the
analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis.
Page 1 of 7

•
7621 Whitepine Road, Richmond, VA 23237
Waypoint
Main 804-743-9401 0 Fax [phone]
ANALYTICAL www.waypointanalytical.com
Sample Summary Table
Report Number: 23-159-0008
Client Project Description: Spindale
Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID
62192
Spindale
Solids
06/07/202310:35
06/08/2023
62192
Spindale
Solids
06/07/202310:35
06/08/2023
62192
Spindale
Solids
06/07/202310:35
06/08/2023
62192
Spindale
Solids
06/07/202310:35
06/08/2023
62192
Spindale
Solids
06/07/202310:35
06/08/2023
62192
Spindale
Solids
06/07/202310:35
06/08/2023
62192
Spindale
Solids
06/07/202310:35
06/08/2023
62192
Spindale
Solids
06/07/202310:35
06/08/2023
SM-4500-NH3C
WP MTN
9045D
WP MTN
4500NO3F-2011
WP MTN
6010D
WP MTN
SW-7471B
WP MTN
SM-4500-NH3C-TKN
WP MTN
SM-2540G
WP MTN
WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN
Page 2 of 7

waypANALYTICAL
46381
US Biosolids Inc
Dennis Key
958 Hoots Road
Roaring River , NC 28669
Project Spindale
Information :
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Report Number : 23-159-0008 REPORT OFANALYSIS
Report Date : 06/21/2023
Received : 06/08/2023
Brandi Watson
Lab No : 62192
Sample ID : Spindale
Matrix: Solids
Sampled: 6/7/2023 10:35
Test
Results
Units
MQL
DF
Date / Time
By
Analytical
Analyzed
Method
Moisture
97.9
%
0.010
1
06/14/2317:55
TKM
SM-2540G
Potassium
4600
mg/Kg -
dry
476
1
06/12/23 19:44
JTR
6010D
Sulfur
14800
mg/Kg -
dry
476
1
06/12/23 19:44
JTR
6010D
Calcium
18100
mg/Kg -
dry
2380
1
06/12/23 19:44
JTR
6010D
Magnesium
3800
mg/Kg -
dry
238
1
06/12/23 19:44
JTR
6010D
Sodium
10400
mg/Kg -
dry
1190
1
06/12/23 19:44
JTR
6010D
Iron
25300
mg/Kg -
dry
476
1
06/12/23 19:44
JTR
6010D
Aluminum
30900
mg/Kg -
dry
238
1
06/12/23 19:44
TJS
6010D
Manganese
557
mg/Kg -
dry
23.8
1
06/12/23 19:44
JTR
6010D
Copper
729
mg/Kg -
dry
23.8
1
06/12/23 19:44
JTR
6010D
Zinc
1830
mg/Kg -
dry
59.5
1
06/12/23 19:44
JTR
6010D
Cadmium
<4.76
mg/Kg -
dry
4.76
1
06/12/23 19:44
JTR
6010D
Chromium
106
mg/Kg -
dry
11.9
1
06/12/23 19:44
JTR
6010D
Nickel
37.2
mg/Kg -
dry
11.9
1
06/12/23 19:44
JTR
6010D
Lead
71.4
mg/Kg -
dry
14.3
1
06/12/23 19:44
JTR
6010D
Arsenic
<23.8
mg/Kg -
dry
23.8
1
06/12/23 19:44
JTR
6010D
Mercury
<7.67
mg/Kg -
dry
7.67
1
06/12/23 11:29
FDS
SW-7471B
Selenium
<23.8
mg/Kg -
dry
23.8
1
06/12/23 19:44
JTR
6010D
Molybdenum
<11.9
mg/Kg -
dry
11.9
1
06/12/23 19:44
JTR
6010D
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 3 of 7

waypANALYTICAL
46381
US Biosolids Inc
Project Spindale
Dennis Key
958 Hoots Road
Information
Roaring River , NC 28669
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Report Number : 23-159-0008 REPORT OFANALYSIS
Report Date : 06/21/2023
Received : 06/08/2023
Brandi Watson
Lab No : 62192
Sample ID : Spindale
Matrix: Solids
Sampled: 6/7/2023 10:35
Test
Results
Units
MQL
DF
Date / Time
By
Analytical
Analyzed
Method
Ammonia Nitrogen
10900
mg/Kg -
dry
4760
1
06/21/23 07:00
JPJ
SM-4500-NH3C
Nitrate+Nitrite-N
<238
mg/Kg -
dry
238
1
06/13/23 15:50
CLP
4500NO3F-2011
Organic N
51520
mg/Kg -
dry
11900
1
06/20/23 13:45
CALCULATION
pH
6.9
S.U.
1
06/12/2316:00
CNB
9045D
Total Solids
2.14
%
0.010
1
06/14/23 17:55
TKM
SM-2540G
Total Kjeldahl Nitrogen
62400
mg/Kg -
dry
11900
1
06/20/23 13:45
JPJ ;M-4500-NH3C-TKI`
Phosphorus
19100
mg/Kg -
dry
238
1
06/12/23 19:44
JTR
6010D
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 4 of 7

Waypointo
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Client: US Biosolids Inc CASE NARRATIVE
Project: Spindale
Lab Report Number: 23-159-0008
Date: 6/21 /2023
Metals Analysis Method 601 OD
Sample 85530
Analyte: Aluminum
QC Batch No: 1-687321/1-686988
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 85530
Analyte: Iron
QC Batch No: 1-687321/1-686988
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 85530
Analyte: Potassium
QC Batch No: 1-687321/1-686988
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 85530
Analyte: Magnesium
QC Batch No: 1-687321/1-686988
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 85530
Analyte: Lead
QC Batch No: 1-687321/1-686988
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Page 5 of 7

WayPAoInt..
NALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 46381
Customer Name: US Biosolids Inc
Report Number: 23-159-0008
Shipping Method
0 Fed Ex 0 US Postal 0 Lab
0 UPS 0 Client 0 Courier
0 Other:
Thermometer ID:
Shipping container/cooler uncompromised?
* Yes
0 No
Number of coolers/boxes received
Custody seals intact on shipping container/cooler?
0 Yes
0 No
Not Present
Custody seals intact on sample bottles?
0 Yes
0 No
Not Present
Chain of Custody (COC) present?
# Yes
0 No
COC agrees with sample label(s)?
# Yes
0 No
COC properly completed
# Yes
0 No
Samples in proper containers?
# Yes
0 No
Sample containers intact?
# Yes
0 No
Sufficient sample volume for indicated test(s)?
# Yes
0 No
All samples received within holding time?
# Yes
0 No
Cooler temperature in compliance?
# Yes
0 No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
# Yes
0 No
Water - Sample containers properly preserved
0 Yes
0 No
N/A
Water - VOA vials free of headspace
0 Yes
0 No
N/A
Trip Blanks received with VOAs
0 Yes
0 No
N/A
Soil VOA method 5035 — compliance criteria met
0 Yes
0 No
0 N/A
F_ High concentration container (48 hr)
F_ High concentration pre -weighed (methanol -14 d)
F_ Low concentration EnCore samplers (48 hr)
F_ Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included? 0 Yes * No
Comments:
Signature: lBrandi Watson Date & Time: 06/08/2023 09:56:16
Page 6 of 7

0
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Page 7 of 7

PLI F; Z
PROMPT•ACCURATE-RELIABLE
LABORATORIES, INC
W W W.PARI,ABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
SAMPLE NUMBER- 147351 SAMPLE ID- SPINDALE
DATE SAMPLED- 06/07/23
DATE RECEIVED- 06/07/23 SAMPLER- ZK
TIME RECEIVED- 1235 DELIVERED BY- ZK
Page 1 of 1
ANALYSIS
FECAL COLIFORM (GEOM. MEAN)
PROJECT NAME: JUN 23
DATE: 07/12/23
ANALYSIS
METHOD DATE TIME BY
SAMPLE MATRIX- WW
TIME SAMPLED- 1035
RECEIVED BY- DJ
TYPE SAMPLE- Grab
RESULT UNITS
SM 9221 E 06/07/23 1630 RE 64,932 MPN/g
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PI)k F;Z
PRO IIPT•ACCU RATE• RELIABL-C
I. A. I3 O R-A" r"C7 I E S, I hT C
2217 Graham Park Drive
PO Box 411483
Charlotte, NC 28241-1483
NC Cert # 20; SC Cert # 99003001
U.S. BIOSOLIDS
SPINDALE
06/07/23
FECAL COLIFORM, GEOMETRIC MEAN
• SM 9221 E
A:
147351
1
1,493
%
2.37%
FC/ gram
62,951.68
2
2,003
2.29%
87,437.05
3
2,084
2.45%
85,075.42
4
1,374
2.38%
57,830.70
5
1,444
2.24%
64,438.99
6
1,024
2.24%
45,709.18
7
1,431
2.35%
61,006.81
Fecal Coliform
Geometric Mean= •

PROMPT•ACOUI4AT •RCLIASLE
LABORATORIES, INC
Shipping i3 Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It Is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
Carolina Department of Environmental and Natural Resources.
1
Company Name (billing) Comments/ Special Instructions
U.S. Biosolids, Inc.
Address
PO Box 146
City, State & zip code
Ronda, NC 28670
Point of Contact & Telephone Number
Zach Key 336-467-3550
Sample
Taken By:
SIGNATURE ' A
PRINTED NAME "ti L 0
ARE SAMPLES FOR STATE of EPA REPORTING? YES Y NO
'Sample Type: DW Wyy _ GWMW HW Soil _ other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon Liner2ero Headspace: Yes No n!a
Residual Chlorine checked at time of sampling (YIN: Dechlorination Necessary (YIN):
' C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

PA&R
PROM PT- A CC U RATE -RE LIABLE
LABORATORIES, INC
W W W.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
PROJECT NAME: JUN 23
DATE: 07/12/23
SAMPLE NUMBER-
147353
SAMPLE ID- SPINDALE
SAMPLE MATRIX- WW
DATE SAMPLED-
06/07/23
TIME SAMPLED- 1035
DATE RECEIVED-
06/07/23
SAMPLER- ZK
RECEIVED BY- DJ
TIME RECEIVED-
1235
DELIVERED BY- ZK
TYPE SAMPLE- Grab
Page 1 of 2
ANALYSIS
ANALYSIS
METHOD DATE TIME BY
RESULT UNITS
TCLP CHARACTERISTICS
TCLP
06/20/23
1248
CB
pH VALUE
TCLP
06/20/23
1248
CB
CORROSIVITY
TCLP
06/20/23
1248
CB
REACTIVITY
TCLP
06/20/23
1248
CB
FLASH POINT
TCLP
06/20/23
1248
CB
IGNITABILITY
TCLP
06/20/23
1248
CB
PAINT FILTER TEST
TCLP
06/20/23
1248
CB
TCLP METALS
TCLP
06/15/23
1917
BN
ARSENIC
TCLP
06/15/23
1917
BN
BARIUM
TCLP
06/15/23
1917
BN
CADMIUM
TCLP
06/15/23
1917
BN
CHROMIUM
TCLP
06/15/23
1917
BN
LEAD
TCLP
06/15/23
1917
BN
MERCURY
TCLP
06/15/23
1917
BN
SELENIUM
TCLP
06/15/23
1917
BN
SILVER
TCLP
06/15/23
1917
BN
TCLP PESTICIDES
TCLP
06/16/23
2046
VC
ENDRIN
TCLP
06/16/23
2046
VC
LINDANE
TCLP
06/16/23
2046
VC
METHOXYCHLOR
TCLP
06/16/23
2046
VC
TOXAPHENE
TCLP
06/16/23
2046
VC
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]
7.5 S.U.
NON
NON
> 200 degrees F
NON
FL
< 0.5 ppm
< 10 ppm
< 0.1 ppm
< 0.5 ppm
< 0.5 ppm
< 0.02 ppm
< 0.1 ppm
< 0.5 ppm
< 0.002 ppm
< 0.04 ppm
< 1 ppm
< 0.05 ppm

PLLF;Z
PROMPT•ACCURATE-RELIABLE
LABORATORIES, INC
W W W.PARLABS.COM
Page 2 of 2
CONTINUATION OF DATA FOR SAMPLE NUMBER 147353
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
CHLORDANE
TCLP
06/16/23
2046
VC
< 0.003
ppm
HEPTACHLOR (AND ITS EPDXIDE)
TCLP
06/16/23
2046
VC
< 0.0008
ppm
TCLP HERBICIDES
TCLP
06/19/23
2037
VC
2,4-D
TCLP
06/19/23
2037
VC
< 1
ppm
2,4,5-TP(SILVEX)
TCLP
06/19/23
2037
VC
< 0.1
ppm
TCLP ORGANICS
TCLP
06/09/23
2027
MS
BENZENE
TCLP
06/09/23
2027
MS
< 0.05
ppm
CARBON TETRACHLORIDE
TCLP
06/09/23
2027
MS
< 0.05
ppm
CHLOROBENZENE
TCLP
06/09/23
2027
MS
< 10
ppm
CHLOROFORM
TCLP
06/09/23
2027
MS
< 0.6
ppm
o-CRESOL
TCLP
06/09/23
2027
MS
< 20
ppm
p-CRESOL
TCLP
06/09/23
2027
MS
< 20
ppm
m-CRESOL
TCLP
06/09/23
2027
MS
< 20
ppm
1,4-DICHLOROBENZENE
TCLP
06/09/23
2027
MS
< 0.75
ppm
1,2-DICHLOROETHANE
TCLP
06/09/23
2027
MS
< 0.05
ppm
1,1-DICHLOROETHYLENE
TCLP
06/09/23
2027
MS
< 0.07
ppm
2,4-DINITROTLUENE
TCLP
06/09/23
2027
MS
< 0.013
ppm
HEXACHLOROBENZENE
TCLP
06/09/23
2027
MS
< 0.013
ppm
HEXACHLOROBUTDIENE
TCLP
06/09/23
2027
MS
< 0.05
ppm
HEXACHLOROETHANE
TCLP
06/09/23
2027
MS
< 0.3
ppm
METHYL ETHYL KETONE
TCLP
06/09/23
2027
MS
< 20
ppm
NITROBENZENE
TCLP
06/09/23
2027
MS
< 0.2
ppm
PENTACHLOROPHENOL
TCLP
06/09/23
2027
MS
< 10
ppm
PYRIDINE
TCLP
06/09/23
2027
MS
< 0.5
ppm
TETRACHLORETHYLENE
TCLP
06/09/23
2027
MS
< 0.07
ppm
TRICHLOROETHYLENE
TCLP
06/09/23
2027
MS
< 0.05
ppm
2,4,5-TRICHLOROPHENOL
TCLP
06/.09/23
2027
MS
< 40
ppm
2,4,6-TRICHLORPHENOL
TCLP
06/09/23
2027
MS
< 0.2
ppm
VINYL CHLORIDE
TCLP
06/09/23
2027
MS
< 0.02
ppm
LABORATORY
DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PROMM-ACOURAT • RCLIASLE
LABORATORIES, INC
Shipping Ft Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
Company Name (bitting)
U.S. Biosolids, Inc.
Address
PO Box 146
City, State & zip code
Ronda, NC 28670
Point of Contact & Telephone Number
Zach Key 336-467-3550
Sample ltw'�4
Taken By: SIGNATURE
Comments/ S
PRINTED NAME & �-
I Instructions
ARE SAMPLES FOR STATE or EPA REPORTING? YES X NO
`Sample Type: DW WW y` GWMW _ HW soil Other
Sample Temp at time of sampling: o C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (YIN): Dechlorination Necessary (YIN):
C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 11-15, FORM: DCAR 11-15, or FORM: SDR 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 11-15):
❑ Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 11-15) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
❑ For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
❑ Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
B. Residuals Source -Generating Facility Information:
❑ For each source facility, attach the following:
❑ Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
❑ Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
❑ Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
❑ Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
❑ For each source facility, attach the following:
❑ Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 06-16 Page 1 of 1

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
I. RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Yadkin Valley Sewer Authority
2. Facility permit holder is: ❑ Federal, 0 State, 0 Local Government, or 0 Private.
Facility permit issued by: ❑ Div. of Water Resources, Div. of Environmental Health,
or ❑ Other (explain: _).
3. Facility contact person and title: Nichole Johnston, Executive Director
Complete mailing address: PO Box 828
City: Elkin State: NC Zip: 28621
Telephone number: [phone] E-mail address: Nichole.johnston(&yvsa.org
4. Facility physical address: 200 Marion St.
City: Elkin State: NC Zip: 28621
Coordinates: Latitude: 36' 49' 24.58" Longitude: 80' 49' 57.66"
Datum: NAD 83 Level of accuracy: .01
Method of measurement: MAP
5. Purpose of the facility:
® treatment of municipal wastewater, treatment of 100% domestic wastewater,
❑ treatment of potable water, treatment of 100% industrial wastewater,
treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: _ % industrial and _ % domestic)
other (explain: _ ).
6. Does the facility have an approved pretreatment program: Yes No
7. Facility permitted/design flow: 1.8 MGD and facility average daily flow: 0.805 MGD
8. Average amount of residuals being generated at this facility 85.13 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 300,000 Gallon & 210,000 gallons residuals holding tank
Type and volume of residuals storage (i.e., outside of residuals treatment units): _
II. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
40 CFR Part 503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological N Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: 0 yes ® no.
If yes, list the number(s): _
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: n yes Ui no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: PAR and Date of analysis: 5-10-2023
Passed corrosivity test: yes no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: yes no. Flashpoint: 200 OF (> 140°F)
Passed reactivity test: Eyes Eno. HCN: NON mg/kg (<250) & H2S: NON mg/kg (<500)
TCLP Parameter
Limit
(m917)
Result
(mg/7)
TCLP Parameter
Limit
(m917)
Result
(m917)
Arsenic
5.0
0.5
Hexachlorobenzene
0.13
0.013
Barium
100.0
10
Hexachloro-1,3-Butadiene
0.5
0.05
Benzene
0.5
0.05
Hexachloroethane
3.0
0.3
Cadmium
1.0
0.1
Lead
5.0
0.5
Carbon Tetrachloride
0.5
0.05
Lindane
0.4
0.04
Chlordane
0.03
0.003
Mercury
0.2
0.02
Chlorobenzene
100.0
10
Methoxychlor
10.0
1
Chloroform
6.0
0.6
Methyl Ethyl Ketone
200.0
0.2
Chromium
5.0
0.5
Nitrobenzene
2.0
0.2
m-Cresol
200.0
20
Pentachlorophenol
100.0
10
o-Cresol
200.0
20
Pyridine
5.0
0.5
p-Cresol
200.0
20
Selenium
1.0
0.1
Cresol
200.0
20
Silver
5.0
0.5
2,4-D
10.0
1
Tetrachloroethylene
0.7
0.07
1,4-Dichlorobenzene
7.5
0.75
Toxaphene
0.5
0.05
1,2-Dichloroethane
0.5
0.05
Trichloroethylene
0.5
0.05
1, 1 -Dichloroethylene
0.7
0.07
2,4,5-Trichlorophenol
400.0
40
2,4-Dinitrotoluene
0.13
0.013
2,4,6-Trichloropheno1
2.0
0.2
Endrin
0.02
0.002
2,4,5-TP (Silvex)
1.0
0.1
Heptachlor and its Hydroxide
0.008
0.0008
Vinyl Chloride
0.2
0.02
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Waypoint Analytical and Date of analysis: 4-5-2023
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mglkg)
Monthly Average
Concentration Limits
(Class A Only)
(mglkg)
Result
(mglkg)
Arsenic
75
41
19.2
Cadmium
85
39
3.85
Copper
4,300
1,500
240
Lead
840
300
18.5
Mercury
57
17
6.85
Molybdenum
75
n/a
9.62
Nickel
420
420
17.8
Selenium
100
100
19.2
Zinc
7,500
2,800
523
b. For Surface Disposal Unit (landfill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: = and Date of analysis: =
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
❑ > 0 but < 25
30
200
210
❑ > 25 but < 50
34
220
240
❑ > 50 but < 75
39
260
270
❑ > 75 but < 100
46
300
320
❑ > 100 but < 125
53
360
390
❑ > 125
62
450
420
Result (mg4g)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 2.57 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Waypoint Analytical and Date of analysis: 4-5-2023
Parameter
Result
(mglkg)
Aluminum
49600
Ammonia -Nitrogen
10800
Calcium
11700
Magnesium
3850
Nitrate -Nitrite Nitrogen
192
pH (Standard Unit)
6.7
Phosphorus
33400
Potassium
6580
Sodium
2030
Total Kjeldahl Nitrogen
72300
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 0.066
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 30 %. This
rate is a (check one): JW default value, or 0 actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, ex lain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals:
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (15) Year PAN
Five -Year
Maximum Adjusted PAN
(mg1kg)
(mglkg)
Surface
24042
29442
Injection/Incorporation
36464.75
40474.67
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses:
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
71 A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
JJ A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
IR Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
q Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
q Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
q Alternative 4 [15A NCAC 02T.I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 5 [15A NCAC 02T.1106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: composting, i heat drying, II heat treatment,
thermophilic aerobic digestion, ❑ beta ray irradiation,
❑ gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
Alternative 1 [15A NCAC 02T.I 106(c)(01 - Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T.I 106(c)(2 - Process to Si ficantly Reduce Pathogens (PSRP).
Specify one: El digestion air drying, , anaerobic digestion,
❑ composting, or lime stabilization.
c. For Surface Disposal:
11 Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
J Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
J Exempt -If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
J Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
5 Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
El Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
El Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
El Alternative 5 [15A NCAC 02T. I 107(a)(5)] - 14-Day Aerobic Processes.
El Alternative 6 [15A NCAC 02T. 1107(a)(6)] - Alkaline Stabilization.
El Alternative 7 [15A NCAC 02T.I 107(a)(7)] - Drying of Stabilized Residuals.
El Alternative 8 [15A NCAC 02T.I 107(a)(8)] - Drying of Unstabilized Residuals.
El Alternative 9 [15A NCAC 02T. I 107(a)(9)] - Injection.
El Alternative 10 [15A NCAC 02T.I 107(a)(10)] - Incorporation.
q Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(b)(2)].
id Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

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•.. �1- I . �� : . .. .. .

QUANTITATIVE JUSTIFICATION
For the past 13 years the Yadkin Valley Sewer Authority has produced the following Dry
Tons
2023 113.54
2022 83.17
2021 78.01
2020 44.17
2019 122.04
2018 76.61
2017 13.6
2016 118.93
2015 126.46
2014 154.81
2013 11.8
2012 191.91
2011 43.24
This comes out to a thirteen -year average of 90.63 Dry Tons per year. This is 1 less of the
currently permit amount of 100 dry tons per year. Yadkin Valley Sewer Authority also land
applies on there own land application permit.

U.S. Biosolids, Inc.
Permit No. WQ0037135
SAMPLING PLAN
Annually, if a land application event occurs, grab samples are collected from the digester. Samples
from the digesterwill be combined to form individual grab samples to be sent to a laboratoryfor
analysis. If a land application event is to occur in the early part of a calendar year (i.e. January or
early February) these samples may have to be taken in December, so results can be obtained
before the land application event, as some results take 30+ days to receive.
These individual grab samples are collected and tested for fecal coliform analysis, volatile solids
reduction, nutrient analysis, and a TCLP test. These tests will be taken by U.S. Biosolids, Inc. All
samples except for the composite residual sample will be taken to a state certified laboratory. All
samples taken will be taken in the same condition as the residuals are to be land applied.
The volatile solids will first be attempted to be achieved using option 1 [503.33(b)(1)]; 38%volatile
solids reduction. This option will be attempted first due to it being the most cost effective. One
sample will betaken at the aeration basin and labeled "B". The next sample will be labeled "A" and
be taken from the digester.
If option 1 cannot be achieved to meet the volatile solids reduction, a 30 day bench scale option 3
[503.33(b)(3)] test will be used. This sample will be taken from the digester with the sample being at
least a quart in quantity.
If both option 1 and 3 are used and volatile solids reduction cannot be achieved; the sludge holding
tank will be stabilized using sufficient alkaline to meet option 6 [503.33(b)(6)], commonly known as
time stabilization.
Fecal Coliform is gathered in seven (7) individual samples and tested to meet the requirements of
[503.32(b)(2)]. This requirement is for the geometric mean fecal coliform density of the samples be
less than two million (2,000,000) MPN per gram. These samples will be placed in 250ml containers
and placed on ice, in a cooler for transport to the laboratory before 1600 hours (4pm) the same day
the samples are obtained.
Annually, if land application occurs, a composite residual sample will be analyzed, prior to a land
application event for:
Cadmium, Copper, Lead, Mercury, Molybdenum, Nickel, Selenium, Zinc, Aluminum, Ammonia
Nitrogen, Calcium, Nitrate Nitrogen, Magnesium, % total Solids, pH, Phosphorus, Potassium, TKN,
Sodium
From this information, the Plant Available Nitrogen (PAN) and a Sodium Absorption Ratio (SAR) will
be calculated. This sample will be collected in a non -breakable container, at least one quart in size.
This sample will be taken from the digester. This test will be done by a state approved laboratory.

Waypointo
ANALYTICAL
4/14/2023
US Biosolids Inc
Dennis Key
958 Hoots Road
Roaring River, NC, 28669
Ref: Analytical Testing
Report Number: 23-096-0004
Project Description: YVSA
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Dear Dennis Key:
Waypoint Analytical Virginia, Inc. received sample(s) on 4/6/2023 for the analyses presented in the following
report.
The above referenced project has been analyzed per your instructions. The analyses were performed in
accordance with the applicable analytical method. Sub -contracted testing is noted on the Sample Summary Table
if applicable.
The analytical data has been validated using standard quality control measures performed as required by the
analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all
parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA
(including 40 CFR 136 Method Update Rule May 2012) and NELAC unless otherwise indicated.
Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of
sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time
Refer to sample analysis time for confirmation of holding time compliance.
The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as -
received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to
the samples included in this report.
Please do not hesitate to contact me or client services if you have any questions or need additional information
Sincerely,
&;'-� ­AldA�
Brandi Watson
Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the
analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis.
Page 1 of 7

•
7621 Whitepine Road, Richmond, VA 23237
Waypoint
Main 804-743-9401 0 Fax [phone]
ANALYTICAL www.waypointanalytical.com
Sample Summary Table
Report Number: 23-096-0004
Client Project Description: YVSA
Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID
61653
YVSA
Solids
61653
YVSA
Solids
61653
YVSA
Solids
61653
YVSA
Solids
61653
YVSA
Solids
61653
YVSA
Solids
61653
YVSA
Solids
61653
YVSA
Solids
04/05/2023
10:40
04/06/2023
04/05/2023
10:40
04/06/2023
04/05/2023
10:40
04/06/2023
04/05/2023
10:40
04/06/2023
04/05/2023
10:40
04/06/2023
04/05/2023
10:40
04/06/2023
04/05/2023
10:40
04/06/2023
04/05/2023
10:40
04/06/2023
SM-4500-NH3C
WP MTN
9045D
WP MTN
4500NO3F-2011
WP MTN
6010D
WP MTN
SW-7471B
WP MTN
SM-4500-NH3C-TKN
WP MTN
SM-2540G
WP MTN
WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN
Page 2 of 7

Waypointo
ANALYTICAL
46381
US Biosolids Inc
Project YVSA
Dennis Key
958 Hoots Road
Information
Roaring River , NC 28669
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Report Date : 04/14/2023
Received : 04/06/2023
Brandi Watson
Report Number : 23-096-0004 REPORT OFANALYSIS
Lab No : 61653 Matrix: Solids
Sample ID : YVSA Sampled: 4/5/2023 10:40
Test Results Units MQL DF Date / Time By Analytical
Analyzed Method
Moisture
97.4
%
0.010
1
04/12/2315:13
JLS
SM-2540G
Sulfur
6730
mg/Kg -
dry
385
1
04/12/23 23:43
TJS
6010D
Calcium
11700
mg/Kg -
dry
1920
1
04/12/23 23:43
JTR
6010D
Aluminum
49600
mg/Kg -
dry
192
1
04/12/23 23:43
JTR
6010D
Manganese
396
mg/Kg -
dry
19.2
1
04/12/23 23:43
TJS
6010D
Organic N
61460
mg/Kg -
dry
9615
1
04/13/23 08:00
CALCULATION
Nickel
17.8
mg/Kg -
dry
9.62
1
04/12/23 23:43
TJS
6010D
Lead
18.5
mg/Kg -
dry
11.5
1
04/12/23 23:43
TJS
6010D
Arsenic
<19.2
mg/Kg -
dry
19.2
1
04/12/23 23:43
TJS
6010D
Selenium
<19.2
mg/Kg -
dry
19.2
1
04/12/23 23:43
TJS
6010D
Test
Results
Units
MQL
DF
Date / Time
By
Analytical
Analyzed
Method
Total Solids
2.57
%
0.010
1
04/12/23 15:13
JLS
SM-2540G
Phosphorus
33400
mg/Kg -
dry
192
1
04/12/23 23:43
TJS
6010D
Copper
240
mg/Kg -
dry
19.2
1
04/12/23 23:43
TJS
6010D
Total Kjeldahl Nitrogen
Qualifiers/ DF Dilution Factor
Definitions
72300 mg/Kg - dry 9620 1 04/13/23 08:00 JPJ ;M-4500-NH3C-TKI`
MQL Method Quantitation Limit
Page 3 of 7

Waypointo
ANALYTICAL
46381
US Biosolids Inc
Project YVSA
Dennis Key
958 Hoots Road
Information
Roaring River , NC 28669
Report Number : 23-096-0004
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
REPORT OFANALYSIS
Report Date : 04/14/2023
Received : 04/06/2023
Brandi Watson
Lab No : 61653
Sample ID : YVSA
Matrix: Solids
Sampled: 4/5/2023 10:40
Potassium
6580
mg/Kg -
dry
385
1
04/13/23 21:48
6010D
Magnesium
3850
mg/Kg -
dry
192
1
04/12/23 23:43
TJS
6010D
Sodium
2030
mg/Kg -
dry
962
1
04/12/23 23:43
TJS
6010D
Iron
20900
mg/Kg -
dry
385
1
04/12/23 23:43
JTR
6010D
Zinc
523
mg/Kg -
dry
48.1
1
04/12/23 23:43
TJS
6010D
Ammonia Nitrogen
10800
mg/Kg -
dry
3850
1
04/13/23 13:30
JPJ
SM-4500-NH3C
Nitrate+Nitrite-N
<192
mg/Kg -
dry
192
1
04/11/23 12:51
ZBD
4500NO3F-2011
Cadmium
<3.85
mg/Kg -
dry
3.85
1
04/12/23 23:43
TJS
6010D
Chromium
24.8
mg/Kg -
dry
9.62
1
04/12/23 23:43
TJS
6010D
Mercury
<6.85
mg/Kg -
dry
6.85
1
04/10/23 14:05
FDS
SW-7471B
pH
6.7
S.U.
1
04/11/2311:25
HBT
9045D
Molybdenum
<9.62
mg/Kg -
dry
9.62
1
04/12/23 23:43
TJS
6010D
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 4 of 7

Waypointo
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Client: US Biosolids Inc CASE NARRATIVE
Project: YVSA
Lab Report Number: 23-096-0004
Date: 4/14/2023
Metals Analysis Method 601 OD
Sample 61409 (SB7 (3-5'))
Analyte: Magnesium
QC Batch No: 1-675888/1-675364
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 61409 (SB7 (3-5'))
Analyte: Manganese
QC Batch No: 1-675888/1-675364
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 61409 (SB7 (3-5'))
Analyte: Selenium
QC Batch No: 1-675888/1-675364
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Solids Total Mercury Analysis - CVAA Method 7471A
Sample 93833 (San Elijo)
Analyte: Mercury
QC Batch No: 1-675254/1-674948
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Page 5 of 7

WayPAoInt..
NALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 46381
Customer Name: US Biosolids Inc
Report Number: 23-096-0004
Shipping Method
0 Fed Ex 0 US Postal 0 Lab
0 UPS 0 Client 0 Courier
0 Other:
Thermometer ID:
Shipping container/cooler uncompromised?
* Yes
0 No
Number of coolers/boxes received
Custody seals intact on shipping container/cooler?
0 Yes
0 No
Not Present
Custody seals intact on sample bottles?
0 Yes
0 No
Not Present
Chain of Custody (COC) present?
# Yes
0 No
COC agrees with sample label(s)?
# Yes
0 No
COC properly completed
# Yes
0 No
Samples in proper containers?
# Yes
0 No
Sample containers intact?
# Yes
0 No
Sufficient sample volume for indicated test(s)?
# Yes
0 No
All samples received within holding time?
# Yes
0 No
Cooler temperature in compliance?
# Yes
0 No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
# Yes
0 No
Water - Sample containers properly preserved
Yes
0 No
0 N/A
Water - VOA vials free of headspace
0 Yes
0 No
N/A
Trip Blanks received with VOAs
0 Yes
0 No
N/A
Soil VOA method 5035 — compliance criteria met
0 Yes
0 No
0 N/A
F_ High concentration container (48 hr)
F_ High concentration pre -weighed (methanol -14 d)
F_ Low concentration EnCore samplers (48 hr)
F_ Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included? 0 Yes * No
Comments:
Signature: IDavid Lennon Date & Time: 04/06/2023 09:18:37
Page 6 of 7

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Page 7 of 7

PLLF;Z
PROMPT•ACCURATE-RELIABLE
LABORATORIES, INC
W W W.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
SAMPLE NUMBER- 146898 SAMPLE ID- YVSA
DATE SAMPLED- 04/05/23
DATE RECEIVED- 04/05/23 SAMPLER- ZK
TIME RECEIVED- 1330 DELIVERED BY- ZK
Page 1 of 1
ANALYSIS METHOD
30 DAY BENCH SCALE TEST VAR
PROJECT NAME: APR 23
DATE: 05/10/23
SAMPLE MATRIX- WW
TIME SAMPLED- 1040
RECEIVED BY- DJ
TYPE SAMPLE- Grab
ANALYSIS
DATE TIME BY RESULT UNITS
04/05/23 1600 RE
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]
2.57 %

PA&F;Z
PROM PT- A CC U RATE -RE t_ I AS LE
LABORATORIES, INC
WWW. PARLABS. COM
30 Day Bench Scale Extended Aeration Test
Percent Volatile Solids Reduction
U.S. BIOSOLIDS, INC.
•
YVSA
146898
•
04/05/23
05/04/23
Start: End:
TS (
0.1675
0.1696
TS%
1.49%
1.52%
VS ()
0.1109
0.1073
VS%
66.21 %
63.27%
y Mass Fraction of Volatile Solids in Liquid Sludge
0.0098678
0.0096137
x Mass Fraction of Fixed Solids in Liquid Sludge
0.0050362
0.0055819
FSVR (Mass Balance)
2.55%
FSVR (Van Kleeck)
2.57%
FSVR (Mass Balance) <15%
YES
FSVR (Van Kleeck) <15%
YES
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone:(704) S88-8333 • Fax: [phone]

P A&
PROM PT•ACCU RATE -RELIABLE
LABORATORIES INC
WWW.PARLABS.COM
Collected
D.O.
Crucible
Tare Wt (g)
Sample Wt +
Tare Wt (g)
Liquid Sludge Wt
(g)
Oven Temp °C
Datelfime In
Date/Time Out
Dried Sample Wt
+ Tare Wt (g)
Dried Sludge Wt (g;
Fixed Solids Wt (g
Furnace Temp °C
Date/Time In
Date/Time Out
Burned Sample
Wt + Tare Wt (g)
Volatile Solids Wt (g;
TS%
VS%
30 Day Bench Scale Extended Aeration Test
VAR nntion 3 Percent Volatile Solids Reduction
CLIENT NAME: U.S. IBIOSOLIDS,
SAMPLE ID:
SAMPLE #:
START DATE:
END DATE: 05/04/23
As Received Day 0 Day 7 Day 14 Day 21 Day 28
ndfnj%wa ndinaigi nd/19/23 nd/2n/23 04/27123 05/04/23
2.36
3.81
4.22
4.38
4.91
X3
X4
X10
X9
X16
X28
16.6082
20.3663
22.7100
15.5325
22.6968
21.0994
26.7658 1
31.6049
32.9013
25.5566
32.8158
32.2605
10.1576
11.2386
10.1913
10.0241
10.1190
11.1611
106
106
106
106
106
106
04/05/23 16:00
04/06/23 16:30
04/13/23 09:40
04/20/23 08:50
04/27/23 10:00
05/04/23 09:00
04/06/23 15:45
04/07/23 16:20
04/14/23 09:45
04/21/23 09:00
04/28/23 09:55
05/05/23 09:30
16.8469
20.5338
22.8608
15.6859
22.8486
21.2690
0.2387
0.1675
0.1508
0.1534
0.1518
0.1696
y �,
0.0566
0.0530
0.0555
0.0554
0.0623
550
550
550
550
550
04/07/23 17:00
04/14/23 15:00
04/21/23 14:20
04/28/23 14:15
05/05/23 14:50
%
04/07/23 18:00
04/14/23 16:05
04/21/23 15:30
04/28/23 15:20
05/05/23 16:00
20.4229
22.7630
15,5880
22.7522
21.1617
0.1109
0.0978
0.0979
0.0964
0.1073
2.35%
1.49%
1.48%
1.53%
1.50%
1.52%
66.21 %
64.85%
63.82%
63.50%
63.27%
yf Mass Fraction of Volatile Solids in Liquid (Feed)
yb Mass Fraction of Volatile Solids in Liquid (Bottom)
Sludge at Start of Test
0.0098678
Sludge at End of Test
0.0096137
xf Mass Fraction of Fixed Solids in Liquid (Feed) Sludge
xb Mass Fraction of Fixed Solids in Liquid (Bottom)
at Start of Test
0.0050362
Sludge at End of Test
0.0055819
TS
0.1675
TS
0.169
0.110
VS (
0.10VS 73
Volatile Fraction In: 0.44436 volatile Fraction Out: 0.41625
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] • Fax: [phone]

PPROMPTA&COU.REI.lADLB
LABORATORIES, INC
Shipping Et Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
uarwina ue anmeni or tnvrronmenua anc naiurar resources.
Company Name (billing) Comments/ Special Instructions
U.S. Biosolids, Inc. __..__._
Address
k
PO Box 146jj
City, State & zip code
Ronda, NC 28670
Paint of Contact Et Telephone Number
Zach Key 336-467-3550
Sample
Taken By:
SIGNATURE
T PRINTED NAME 24•L
ARE SAMPLES FOR STATE"or EPA REPORTING? YES 1,�- NO
"Sample Type: DW _ ww GW1MW — HW sal _ Other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ' C
"Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (YIN): Dechlorination Necessary (YIN):
C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

PLLF;Z
PROMPT•ACCURATE• RELIABLE
LABORATORIES, INC
W W W.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
SAMPLE NUMBER- 146897 SAMPLE ID- YVSA
DATE SAMPLED- 04/05/23
DATE RECEIVED- 04/05/23 SAMPLER- ZK
TIME RECEIVED- 1330 DELIVERED BY- ZK
Page 1 of 1
PROJECT NAME: APR 23
DATE: 05/10/23
SAMPLE MATRIX- WW
TIME SAMPLED- 1040
RECEIVED BY- DJ
TYPE SAMPLE- Grab
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
FECAL COLIFORM (GEOM. MEAN) SM 9221 E 04/05/23 1600 RE 1285572 MPN/g
LABORATORY DIRECTOR
f
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

R..
F;Z
PROMPT•ACCURA'TM• Kk E i,.. 1 AtlLC
LA.330R.A"IORIPS, INC
2217 Graham Park Drive
PO Box 411483
Charlotte, NC 28241-1483
NC Cert # 20; SC Cert # 99003001
• U.S. BIOSOLIDS
• YVSA
• 04/05/23
• FECAL COLIFORM, GEOMETRIC MEAN
• • SM 9221 E
•: ID
146897
1
34,766
%
2.62%
FC/ gram
1,325,523.98
2
34,804
2.71 %
1,286,135.61
3
34,785
2.63%
1,324,928.12
4
34,834
2.84%
1,226,544.69
5
33,317
2.50%
1,332,689.52
6
33,397
2.74%
1,218,866.66
7
1 34,173
1 2.65%
1 1,289,551.34
Fecal Coliform
Geometric Mean=

MPR0mPMT-^C=uP"k^,r•RELIANLE
LABORATORIES, INC
Shipping & Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
t;aroima ue artment a tnvwronmentai ana Naturai Resources.
Company Name (billing) Comments/ Special Instructions
U.S. Biosolids, Inc.
Address
PO Box 146
....... __ ........ .......
City, State h zip code
Ronda, NC 28670
Point of Contact 6t Telephone Number
Zach Key 336-467-3550
Sample -1-7
Taken By: SIGNATURE
PRINTED NAME Lce &_ Kc
ARE SAMPLES FOR STATE or EPA REPORTING? YES �C NO
Sample Type: DW WW ` GWMW _ HW Soil Other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (YIN): Dechlorination Necessary (YIN):
' C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

PLLF;Z
PROMPT•ACCURATE-RELIABLE
LABORATORIES, INC
W W W.PARLABS.COM
REPORT OF ANALYSES
Attn: ZACH KEY
U.S. BIOSOLIDS, INC.
PO BOX 146
RONDA, NC 28670-
SAMPLE NUMBER- 146896 SAMPLE ID- YVSA
DATE SAMPLED- 04/05/23
DATE RECEIVED- 04/05/23 SAMPLER- ZK
TIME RECEIVED- 1330 DELIVERED BY- ZK
Page 1 of 2
ANALYSIS METHOD
PROJECT NAME: APR 23
DATE: 05/10/23
SAMPLE MATRIX- WW
TIME SAMPLED- 1040
RECEIVED BY- DJ
TYPE SAMPLE- Grab
ANALYSIS
DATE TIME BY RESULT UNITS
TCLP CHARACTERISTICS
TCLP
04/18/23
1309
CB
pH VALUE
TCLP
04/18/23
1309
CB
CORROSIVITY
TCLP
04/18/23
1309
CB
REACTIVITY
TCLP
04/18/23
1309
CB
FLASH POINT
TCLP
04/18/23
1309
CB
IGNITABILITY
TCLP
04/18/23
1309
CB
PAINT FILTER TEST
TCLP
04/18/23
1309
CB
TCLP METALS
TCLP
04/14/23
1731
BN
ARSENIC
TCLP
04/14/23
1731
BN
BARIUM
TCLP
04/14/23
1731
BN
CADMIUM
TCLP
04/14/23
1731
BN
CHROMIUM
TCLP
04/14/23
1731
BN
LEAD
TCLP
04/14/23
1731
BN
MERCURY
TCLP
04/14/23
1731
BN
SELENIUM
TCLP
04/14/23
1731
BN
SILVER
TCLP
04/14/23
1731
BN
TCLP PESTICIDES
TCLP
04/18/23
1413
VC
ENDRIN
TCLP
04/18/23
1413
VC
LINDANE
TCLP
04/18/23
1413
VC
METHOXYCHLOR
TCLP
04/18/23
1413
VC
TOXAPHENE
TCLP
04/18/23
1413
VC
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]
6.8 S.U.
NON
NON
> 200 degrees F
NON
FL
< 0.5 ppm
< 10 ppm
< 0.1 ppm
< 0.5 ppm
< 0.5 ppm
< 0.02 ppm
< 0.1 ppm
< 0.5 ppm
< 0.002 ppm
< 0.04 ppm
< 1 ppm
< 0.05 ppm

PAL F;Z
PROMPT.
ACCURATE- RELIABLE
LABORATORIES, INC
W W W.PARLABS.COM
Page 2 of 2
CONTINUATION OF DATA FOR SAMPLE NUMBER 146896
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
CHLORDANE
TCLP
04/18/23
1413
VC
< 0.003
ppm
HEPTACHLOR (AND ITS EPDXIDE)
TCLP
04/18/23
1413
VC
< 0.0008
ppm
TCLP HERBICIDES
TCLP
04/19/23
1137
VC
2,4-D
TCLP
04/19/23
1137
VC
< 1
ppm
2,4,5-TP(SILVEX)
TCLP
04/19/23
1137
VC
< 0.1
ppm
TCLP ORGANICS
TCLP
04/11/23
1231
MS
BENZENE
TCLP
04/11/23
1231
MS
< 0.05
ppm
CARBON TETRACHLORIDE
TCLP
04/11/23
1231
MS
< 0.05
ppm
CHLOROBENZENE
TCLP
04/11/23
1231
MS
< 10
ppm
CHLOROFORM
TCLP
04/11/23
1231
MS
< 0.6
ppm
o-CRESOL
TCLP
04/11/23
1231
MS
< 20
ppm
p-CRESOL
TCLP
04/11/23
1231
MS
< 20
ppm
m-CRESOL
TCLP
04/11/23
1231
MS
< 20
ppm
1,4-DICHLOROBENZENE
TCLP
04/11/23
1.231
MS
< 0.75
ppm
1,2-DICHLOROETHANE
TCLP
04/11/23
1231
MS
< 0.05
ppm
1,1-DICHLOROETHYLENE
TCLP
04/11/23
1231
MS
< 0.07
ppm
2,4-DINITROTLUENE
TCLP
04/11/23
1231
MS
< 0.013
ppm
HEXACHLOROBENZENE
TCLP
04/11/23
1231
MS
< 0.013
ppm
HEXACHLOROBUTDIENE
TCLP
04/11/23
1231
MS
< 0.05
ppm
HEXACHLOROETHANE
TCLP
04/11/23
1231
MS
< 0.3
ppm
METHYL ETHYL KETONE
TCLP
04/11/23
1231
MS
< 20
ppm
NITROBENZENE
TCLP
04/11/23
1231
MS
< 0.2
ppm
PENTACHLOROPHENOL
TCLP
04/11/23
1231
MS
< 10
ppm
PYRIDINE
TCLP
04/11/23
1231
MS
< 0.5
ppm
TETRACHLORETHYLENE
TCLP
04/11/23
1231
MS
< 0.07
ppm
TRICHLOROETHYLENE
TCLP
04/11/23
1231
MS
< 0.05
ppm
2,4,5-TRICHLOROPHENOL
TCLP
04/11/23
1231
MS
< 40
ppm
2,4,6-TRICHLORPHENOL
TCLP
04/11/23
1231
MS
< 0.2
ppm
VINYL CHLORIDE
TCLP
04/11/23
1231
MS
< 0.02
ppm
LABORATORY DIRECTOR `- L•r ;= '�/�-�
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

PROMPT•ACOURAT •RCLIAOLE
LABORATORIES, INC
Shipping 8t Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the North
%,araina ue artment or tnwronmentat ano Naturai Resources.
company Name (billing) Comments/ Special Instructions
U.S. Biosolids, Inc. 7__.__r.._.�_
Address
PO Box 146
City, State Et zip code
Ronda, NC 28670
Point of Contact E& Telephone Number
Zach Key 336-467-3550
Sample
Taken By: _SIGNATURE PRINTED NAME
ARE SAMPLES FOR STATE or EPA REPORTING? YES >61 NO
'Sample Type: DW VM GWMW _ HW Soil other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon LinerlZero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (YIN): Dechlorination Necessary (YIN):
' C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources LAND APPLICATION SITE CERTIFICATION
INSTRUCTIONS FOR FORM: LASC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non-DischaL e Permitting
General — This certification provides detailed information of receiving sites for land application of Class B residuals (may include
water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit this certification for review
without a corresponding application form (FORM: RLAP 06-16 or FORM: SDR 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Application Site Certification (FORM: LASC 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ For new or renewed permits, submit the requested information for all land application sites.
❑ For modified permits, submit the requested information for only those sites that are new, transferred or affected by the
proposed modification.
B. Land Application Site Information:
❑ The status of the land application site with respect to this residuals land application program must be provided in table L The
status categories and their corresponding codes are as follows:
♦ New (N) ♦ Renewed (R) ♦ Modified (M) ♦ Transferred (T) ♦ Deleted (D)
❑ Attach the following in accordance with each status code:
Status Code
Required Item
N
R
T
M
County Board
Notification. doc
Land Owner
Agreement
(If applicable)
Setback Waiver
Agreement
An updated vicinity/setback map in accordance with the "Map Guidance
for Residuals Land Application Permits"
✓
✓
✓
A soils and agronomic evaluation in accordance with the "Soil Scientist
✓
Evaluation Policy"
INSTRUCTIONS FOR FORM: LASC 06-16 Page 1 of 3

An updated accounting of the land application site's cumulative
7
�
pollutant loading rates(CPLRs)
Status Code
Required Item
N
I R
T
M
For previously permitted sites without a soil series name indicated in the
Attachment B, submit County Soil Survey Map (or equivalent) clearly
indicate the location of the land application site and in accordance with
the soil map requirements in the "Soil Scientist Evaluation Policy"
Acknowledgement of field transfer from Land Owner (Fields may not
be permitted to multiple Permittees over the same timeperiod)
* This item may be required for land application site with a status code "M", please contact the Division if you need assistant in
determining attachment requirements.
❑ Crop Type should include the most likely crop types for the life of the permit (five years).
❑ Predominant Soils Series Name must be either the name of the soil indicated in Attachment `B" of the existing permit, or
name of the soil series as provided by the licensed soil scientist.
❑ Predominant Soil Mapping Unit or Representative Slope: Either the Soil Mapping Unit or the representative slope of each
site must be provided. The predominant soil -mapping unit must be consistent with the predominant soil series name. Please
note that the soil mapping units are variable between Counties, so care should be taken in properly identifying the correct
mapping unit. If a representative slope is provided, it must be determined accordingly:
❑ For sites previously permitted for use, but do not have an established soil mapping unit (the mapping unit provides
information on both the soil series name and the slope of the soil), the Applicant may determine the representative slope
by using the average slope provided in the County Soil Survey (or equivalent). A soil type with a slope range of 4 - 8%
would have a representative slope of 6%.
❑ New Sites to be permitted must have slopes determined as part of the soils report prepared by a licensed soil scientist.
❑ Acceptable methods for determining location coordinates (i.e., latitude and longitude) and their corresponding codes are as
follows:
• Address Matching (ADD) • Digital or Raw Photo Extraction (EXT)
• Aerial Photography with Ground Control (AER) • Geodetic Quality GPS Survey (GEO)
• Cadastral Survey (SUR) • LORAN-C Navigation Device (LOR)
• Conversion from Coordinate Plane (CP) • Navigation Quality GPS (GPS)
• Conversion from Township -Section -Range (TSR) • Remote Sensing (RS)
• Conversion from Universal Trans Mere (UTM) • Zip Code Centroid (ZIP)
• Map Interpretation by Digital or Manual Extraction (MAP)
C. Waterbody and Classifications Information: (new sites only)
❑ Use an 8.5 by 11-inch copy of the portion of a 7.5-minute USGS Topographic Map to identify the location where the
residuals program activities are planned to occur as well as the closest downslope surface waters as clearly as possible. Each
map portion must be labeled with the map name and number, the identified location, and be of clear and reproducible quality.
❑ Surface water body classifications information may be found at: http://deg.nc.gov/about/divisions/water-
resources/planning/classification-standards/clan sifications
❑ Any questions concerning the waterbody and its classification, please contact the Division's regional offices.
❑ A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
hLtp://deg.nc.gov/contact/regional-offices
❑ General Instructions: There are 17 river basins in North Carolina. Each basin has associated waterbodies with assigned
subbasins, location descriptions, stream index numbers and established classifications.
1. Identify the project area on a 7.5 minute USGS topographical map (an 8.5 x 11-inch sheet showing the project area
should be submitted with the permit application regardless of whether a Stream classification was completed).
2. Determine the names of all the closest down slope surface waters from the project site. For unnamed tributaries, see
Table 1: Unnamed Tributaries Entering Other States or for Specific Basin Areas. Label any unnamed tributaries as
"UT to stream name" as the waterbody name.
3. Open the link http://deg.nc.gov/about/divisions/water-resources/planning/classification-standards/classifications.
❑ Stream Classification Process: One of the options below may be used depending on the known initial project information.
❑ KNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Select proper basin from the List all Waterbodies in Basin sorted report. Sort hydrologically as this will provide
the proper location descriptions if multiple runs.
INSTRUCTIONS FOR FORM: LASC 06-16 Page 2 of 3

2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ KNOWN COUNTY WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Select the proper county from the List all Waterbodies in county, hydrologically report.
2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ UNKNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Use the Clickable basin map to hydrologically sorted list report.
2. Click on the approximate project location to bring up the hydrologically sorted list.
3. Locate the name of the identified waterbody (from General Directions) on the list.
4. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
5. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ Notes on index number and unnamed streams:
Unnamed Streams 15A NCAC 02B .0301(i).
❑ Any stream which is not named in the schedule of stream classifications carries the same classification as that assigned
to the stream segment to which it is tributary (at the point of entry) except:
(A) unnamed streams specifically described in the schedule of classifications;
(B) unnamed freshwaters tributary to tidal saltwaters will be classified "C"; or
(C) after November 1, 1986, any newly created areas of tidal saltwater which are connected to Class SA waters by
approved dredging projects will be classified "SC" unless case -by -case reclassification proceedings are conducted.
❑ The following river basins have different policies for unnamed streams entering other states or for specific areas of the
basin:
Unnamed Tributaries Entering Other States or for Specific Basin Areas
Hiwassee River Basin
Streams entering Georgia or Tennessee shall be classified "C Tr."
Little Tennesse River
Basin And Savannah
River Drainage Area
Streams entering Georgia or Tennessee shall be classified "C Tr." Such streams in the Savannah
River drainage area entering South Carolina shall be classified 'B Tr."
French Broad River
Basin
Streams entering Tennessee will be classified 'B."
Watauga River Basin
Streams entering the State of Tennessee are classified "C."
Broad River Basin
Streams entering South Carolina are classified "C."
New River Basin
Streams entering the State of Tennessee are classified "C."
Catawba River Basin
Streams entering South Carolina are classified "C."
Yadkin -Pee Dee River
Basin
Streams entering Virginia are classified "C," and such streams entering South Carolina are
classified "C."
Lumber River Basin
Streams entering South Carolina are classified "C Sw."
Roanoke River Basin
Streams entering Virginia are classified "C." Except that all backwaters of John H. Kerr
Reservoir and the North Carolina portion of streams tributary thereto not otherwise named or
described shall carry the classification 'B," and all backwaters of Lake Gaston and the North
Carolina portion of streams tributary thereto not otherwise named or described shall carry the
classification "C and B."
Chowan River Basin
Streams entering Virginia are classified "C."
Tar -Pamlico River
Basin
All drainage canals not noted in the schedule are classified "C Sw." except the main drainage
canals to Pamlico Sound and its bays which shall be classified "SC."
Pas uotank River Basin
All drainage canals not noted in the schedule are classified "C."
INSTRUCTIONS FOR FORM: LASC 06-16 Page 3 of 3

LAND APPLICATION SITE CERTIFICATION
Applicant's name U.S. Biosolids, Inc.
Land application sites currently certified: 509.17 net acres and Total to be certified: 509.17 net acres.
L LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Codea
Site/Field
ID
Landowners
O
Lessees or Operator(s)
O
Net Acres
County
Crop(s) s
PO
Predominant Soil
Series Nameb
Mapping Unit
or Rep. Slope°
R
TL1
Eva Lucas
2.5
Wilkes
Corn
Fairview
Fc132
R
TL2
Eva Lucas
3.5
Wilkes
Corn
Fairview
FcB2
R
TL3
Eva Lucas
2.6
Wilkes
Corn
Fairview
FcB2
R
TL4
Eva Lucas
6
Wilkes
Corn
Fairview
FcB2
R
BPI
Kathleen Porter
Joesph Bryant
11.04
Wilkes
Corn
Fairview
FcB2
R
BP2
Kathleen Porter
Joesph Bryant
29.35
Wilkes
Corn
Fairview
FcB2
R
BP3
Kathleen Porter
Joesph Bryant
13.36
Wilkes
Corn
Fairview
FcB2
R
BP$
Joesph Bryant
26.6
Wilkes
Corn
Fairview
FcB2
'Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ T (Transferred) ♦ D (Deleted)
b Soil Series Name (i.e. Appling, Cecil, etc.)
Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is Ce132)
IL WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
TL1
36.2803030
-80.9981030
NAD 83
MAP
Nearest Second
YADO1 12-48-1-(1)
C
C
TL2
36.2790080
-80.9964750
NAD 83
MAP
Nearest Second
YADO1 12-48-1-(1)
C
C
TL3
36.2770720
-80.9946280
NAD 83
MAP
Nearest Second
YADO1 12-48-1-(1)
C
C
TL4
36.2805640
-81.0013360
NAD 83
MAP
Nearest Second
YADO1 12-48-1-(1)
C
C
BPI
36.2778190
-81.0035920
NAD 83
MAP
Nearest Second
YADO1 12-48-1-(1)
C
C
BP2
36.2846640
-81.0113750
NAD 83
MAP
Nearest Second
YADO1 12-48-1-(1)
C
C
BP3
36.2787530
-81.0093610
NAD 83
MAP
Nearest Second
YADO1 12-48-1-(1)
C
C
BP4
36.2761920
-81.0061470
NAD 83
MAP
Nearest Second
YADO1 12-48-1-(1)
C
C
FORM: LASC 06-16 Page 1

LAND APPLICATION SITE CERTIFICATION
Note: Please keep the site information (I.) and waterbody information (II.) of the same field on the same page.
Applicant's name: U.S. Biosolids, Inc.
Land application sites currently certified: 509.17 net acres and Total to be certified: 509.17 net acres.
L LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Codes
Site/Field
ID
Landowners
O
Lessees or Operator(s)
O
Net Acres
County
ry
Crop(s) s
PO
Predominant Soil
b
Series Name
Mapping Unit
or Rep. Slope°
R
LW1
Barbara Walker
14.05
Wilkes
Fescue
Fairview
FcB2
R
LW2
Barbara Walker
8.16
Wilkes
Fescue
Fairview
FcB2
R
LW3
Barbara Walker
17.7
Wilkes
Fescue
Fairview
FcB2
R
DK1
Charles Key
6.36
Wilkes
Fescue
Pacolet
PbB2
R
NMA
Norman McDaniel
9.4
Rutherford
Coin/Wheat/Soybeans
Cecil
CaB2
R
NMB
Norman McDaniel
13.0
Rutherford
Corn/Wheat/Soybeans
Cecil
CaB2
R
NMC
Norman McDaniel
9
Rutherford
Coin/Wheat/Soybeans
Cecil
CaB2
R
NMI
Norman McDaniel
6.2
Rutherford
Fescue
Pacolet
PbB2
a Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ T (Transferred) ♦ D (Deleted)
b Soil Series Name (i.e. Appling, Cecil, etc.)
Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is CeB2)
IL WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
LW1
36.1605030
-80.9281810
NAD 83
MAP
Nearest Second
UT to West Swan Creek 12-51-1-(1)
L"
,
LW2
36.1628530
-80.9292560
NAD 83
MAP
Nearest Second
UT to West Swan Creek 12-51-1-(1)
C
,
LW3
36.1662080
-80.9297810
NAD 83
MAP
Nearest Second
UT to West Swan Creek 12-51-1-(1)
C
DKO1
36.2648670
-80.9696250
NAD 83
MAP
Nearest Second
Big Bugaboo 12-48-(0.7)
'WS-IV
S-IV
NMA
35.3655370
-81.7605040
NAD 83
MAP
Nearest Second
West Fork Sandy Run 9-46-2
C
C
NMB
35.3668490
-81.7624140
NAD 83
MAP
Nearest Second
West Fork Sandy Run 9-46-2
C
C
NMC
35.3820060
-81.7381850
NAD 83
MAP
Nearest Second
West Fork Sandy Run 9-46-2
C
C
NMI
35.3639900
-81.7428410
NAD 83
Map
Nearest Second
U.t to West Fork Sandy Creek 9-46-2
C
C
Note: Please keep the site information (I.) and waterbody information (IL) of the same field on the same page.
FORM: LASC 06-16 Page 2

LAND APPLICATION SITE CERTIFICATION
Applicant's name: U.S. Biosolids, Inc.
Land application sites currently certified: 509.17 net acres and Total to be certified: 509.17 net acres.
L LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Codea
Site/Field
ID
Landowners
O
Lessees or Operator(s)
O
Net Acres
County
Crop(s) s
PO
Predominant Soil
Series Nameb
Mapping Unit
or Rep. Slope°
R
NM2
Norman McDaniel
4.2
Rutherford
Fescue
Pacolet
PbB2
R
FC2
Forest Calton
5.5
Rutherford
Fescue
Pacolet
PbB2
R
FC3
Forest Calton
8.6
Rutherford
Fescue
Pacolet
PbB2
R
FLA1
Frank Lawson
7.2
Rutherford
Fescue
Pacolet
PbB2
R
FLA2
Frank Lawson
16.3
Rutherford
Fescue
Pacolet
PbB2
R
FLB 1
Frank Lawson
2.7
Rutherford
Fescue
Pacolet
PbB2
R
FLB2
Frank Lawson
W
Rutherford
Fescue
Pacolet
PbB2
R
FLB3
Frank Lawson
0
RutherfoA
Fescue
Pacolet
PbB2
a Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ T (Transferred) ♦ D (Deleted)
b Soil Series Name (i.e. Appling, Cecil, etc.)
Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is CeB2)
IL WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
NM2
35.3981680
-81.7605040
NAD 83
MAP
Nearest Second
Sandy Run Creek 9-46-(1)
C
FC2
34.4379570
-81.7986090 "
NAD 83
MAP
Nearest Second
Roberson Creek 9-41-14
WS-V
WS-V
FC3
35.4405620
-81.7941460
NAD 83
ADD
Nearest Second
Roberson Creek 9-41-14
WS-V
WS-V
FLA1
35.3211030
-81.7660030
NAD 83
ADD
Nearest Second
Webbs Creek 9-41-22-(1)
WS-V
WS-V
FLA2
35.3204390
-81.7715640
NAD 83
ADD
Nearest Second
Webbs Creek 9-41-22-(1)
WS-V
WS-V
FLB 1
35.3277170
-81.7651910
NAD 83
ADD
Nearest Second
Webbs Creek 9-41-22-(1)
WS-V
WS-V
FLB2
35.3294190
b1.7711720
NAD 83
ADD
Nearest Second
Webbs Creek 9-41-22-(1)
WS-V
WS-V
FLB3
35.329753°
111.767251-
NAD 83
ADD
Nearest Second
Webbs Creek 9-41-22-(1)
WS-V
WS-V
Note: Please keep the site information (I.) and waterbody information (II.) of the same field on the same page.
FORM: LASC 06-16 Page 3

LAND APPLICATION SITE CERTIFICATION
Applicant's name: U.S. Biosolids, Inc.
Land application sites currently certified: 509.17 net acres and Total to be certified: 509.17 net acres.
L LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Codes
Site/Field
ID
Landowners
O
Lessees or Operator(s)
O
Net Acres
County
s
Crop(s)
PO
Predominant Soil
Series Name b
Mapping Unit
or Rep. Slope°
R
FLB4
Frank Lawson
2.9
Rutherford
Fescue
Pacolet
PbB2
R
FLC1
Frank Lawson
7.6
Rutherford
Fescue
Pacolet
PbB2
R
LB1
Larry Bailey
8.0
Rutherford
Fescue
Pacolet
PbB2
R
LB2
Larry Bailey
_
11.7
Rutherford
Fescue
Pacolet
PbB2
R
LB3
�arry Bailey
Rutherford
Fescue
Pacolet
PbB2
R
LB4
�arry Bailey
Rutherford
Fescue
Pacolet
PbB2
R
LB2
�arry Bailey
Rutherford
Fescue
Pacolet
PbB2
R
LB6
Larry Bailey
Rutherford
Fescue
Pacolet
PbB2
a Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ T (Transferred) ♦ D (Deleted)
b Soil Series Name (i.e. Appling, Cecil, etc.)
Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is CeB2)
IL WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
FLB4
35.3279830
-81.7619030
NAD 83
MAP
Nearest Second
Webbs Creek 9-41-22-(1)
WS-V
WS-V
FLC1
35.3202530
-81.7597640
NAD 83
MAP
Nearest Second
Webbs Creek 9-41-22-(1)
WS-V
WS-V
LB 1
35.3975100
-81.75346AO
NAD 83
MAP
Nearest Second
U.T to West Fork Sandy Creek 9-46-2
C
C
LB2
35.3991130
-81.7563700
NAD 83
MAP
Nearest Second
U.T to West Fork Sandy Creek 9-46-2
C
C
LB3
35.3952990
-81.7571430
NAD 83
MAP
Nearest Second
U.T to West Fork Sandy Creek 9-46-2
C
C
LB4
35.3948940
-81.7571940
NAD 83
MAP
Nearest Second
U.T to West Fork Sandy Creek 9-46-2
C
C
LB5
35.3935330
-81.7545190
NAD 83
MAP
Nearest Second
U.T to West Fork Sandy Creek 9-46-2
C
C
LB6
35.3944250
-81.7545210
NAD 83
MAP
Nearest Second
U.T to West Fork Sandy Creek 9-46-2
C
C
Note: Please keep the site information (I.) and waterbody information (IL) of the same field on the same page.
FORM: LASC 06-16 Page 4

LAND APPLICATION SITE CERTIFICATION
Applicant's name: U.S. Biosolids, Inc.
Land application sites currently certified: 509.17 net acres and Total to be certified: 509.17 net acres.
III. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Codea
Site/Field
ID
Landowners
O
Lessees or Operator(s)
O
Net Acres
County
Crop(s) s
PO
Predominant Soil
Series Nameb
Mapping Unit
or Rep. Slope°
R
MH 2-1
Charlie Killian
28.5
Gaston
Fescue
Cecil
CeB2
R
MH 2-2
Charlie Killian
24.6
Gaston
Fescue
Cecil
CeB2
R
MH 2-4
Charlie Killian
IP
4.3
Gaston
Fescue
Cecil
CeB2
R
MH 2-5
Charlie Killian
23.7
Gaston
Fescue
Cecil
CeB2
R
JH-01
John Harrill
Norman McDaniel
14.1
Rutherford
Fescue
Pacolet
PaC2
R
NM-03
Norman McDaniel
6.6
Rutherford
Fescue
Cecil
CaB2
R
RD1A
Norman McDaniel
4.3
Rutherford
Fescue
Cecil
CaB2
R
RD1B
Norman McDaniel
29.3
Rutherford
Fescue
Cecil
CaB2
a Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ T (Transferred) ♦ D (Deleted)
b Soil Series Name (i.e. Appling, Cecil, etc.)
Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is CeB2)
IV. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
MH 2-1
35° 23' S8"
81° M' E"
NAD 83
MAP
Nearest Second
Dutchmans Creek
WS IV
WS IV
MH 2-2
350 24' 03"
810 03' 06"
NAD 83
MAP
Nearest Second
Dutchmans Creek
WS IV
WS IV
MH 2-4
350 24' 12"
810 02' 38"
NAD 83
MAP
Nearest Second
Dutchmans Creek
WS IV
WS IV
MH 2-5
350 24' 09"
8110 f' M"
NAD 83
MAP
Nearest Second
Dutchmans Creek
WS IV
WS IV
JH-01
35.3640580
-81.7215750
NAD 83
MAP
Nearest Second
Sandy Run Creek 96-46-(1)
C
C
NM-03
35.3638120
-71.7241410
NAD 83
MAP
Nearest Second
West Fork Sandy Run Creek 9-46-2
c
c
RD1A
35.3604380
-81.7387080
NAD 83
MAP
Nearest Second
West Fork Sandy Run Creek 9-46-2
C
C
RD1B
35.3270390
-81.7355470
NAD 83
MAP
Nearest Second
West Fork Sandy Run Creek 9-46-2
C
C
Note: Please keep the site information (I.) and waterbody information (II.) of the same field on the same page.
FORM: LASC 06-16 Page 5

LAND APPLICATION SITE CERTIFICATION
Applicant's name: U.S. Biosolids, Inc.
Land application sites currently certified: 509.17 net acres and Total to be certified: 509.17 net acres.
V. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Codes
Site/Field
ID
Landowners
O
Lessees or Operator(s)
O
Net Acres
County
ry
Crop(s) s
PO
Predominant Soil
b
Series Name
Mapping Unit
or Rep. Slope°
R
RD2
Norman McDaniel
19.6
Rutherford
Fescue
Cecil
CaB2
R
CM-01
Billy Hinson
3.45
Wilkes
Fescue
Fairview
FcB2
R
CM-02
Billy Hinson
6.30
Wilkes
Fescue
Fairview
FcB2
R
SK-01
Stephen Key
_
17.1
Wilkes
Fescue
Fairview
FcB2
R
SK-02
Stephen Key
0.80
Wilkes
Fescue
Fairview
FcB2
R
SK-03
Stephen Key
3.50
Wilkes
Fescue
Codorus
CoA
R
SK-04A
Stephen Key
7.10
Wilkes
Fescue
Fairview
FcB2
R
SK-04B
Stephen Key
3.47
Wilkes
Fescue
Fairview
FcB2
a Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ T (Transferred) ♦ D (Deleted)
b Soil Series Name (i.e. Appling, Cecil, etc.)
Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is CeB2)
VI. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
RD2
35.3576380
-81.7387240
NAD 83
MAP
Nearest Second
West Fork Sandy Run Creek 9-46-2
C
C
CM-01
36.2688970
-80.9618660
NAD 83
MAP
Nearest Second
Big Bugaboo Creek 12-48-(0.7)
WS-IV
WS-IV
CM-02
36.2688970
-80.9618660
NAD 83
MAP
Nearest Second
Big Bugaboo Creek 12-48-(0.7)
WS-IV
WS-IV
SK-01
36.2545590
-80.9457060
NAD 83
MAP
Nearest Second
Big Bugaboo Creek 12-48-(0.7)
WS-IV
WS-IV
SK-02
36.2474500
-80.9471430
NAD 83
MAP
Nearest Second
Big Bugaboo Creek 12-48-(0.7)
WS-IV
WS-IV
SK-03
36.2515970
-80.9483930
NAD 83
MAP
Nearest Second
Big Bugaboo Creek 12-48-(0.7)
WS-IV
WS-IV
SK-04A
36.2546310
-80.9486630
NAD 83
MAP
Nearest Second
Big Bugaboo Creek 12-48-(0.7)
WS-IV
WS-IV
SK-04B
36.2530290
-80.9478190
NAD 83
MAP
Nearest Second
Big Bugaboo Creek 12-48-(0.7)
WS-IV
WS-IV
Note: Please keep the site information (I.) and waterbody information (IL) of the same field on the same page.
FORM: LASC 06-16 Page 6

LAND APPLICATION SITE CERTIFICATION
Applicant's name: U.S. Biosolids, Inc.
Land application sites currently certified: 509.17 net acres and Total to be certified: 509.17 net acres.
VIL LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Codea
Site/Field
ID
Landowners
O
Lessees or Operator(s)
O
Net Acres
County
Crop(s) s
PO
Predominant Soil
Series Nameb
Mapping Unit
or Rep. Slope°
R
SK-04C
Stephen Key
2.73
Wilkes
Fescue
Fairview
FcB2
R
TB-01
Tristen Blevins
14.9
Wilkes
Fescue
Fairview
FcB2
R
TB-02
Tristen Blevins
4.1
Wilkes
Fescue
Fairview
FcB2
N
EL
N
N
N
N
a Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ T (Transferred) ♦ D (Deleted)
b Soil Series Name (i.e. Appling, Cecil, etc.)
Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is CeB2)
VIIL WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
SK-04C
36.2530290
-80.9478190
NAD 83
MAP
Nearest Second
Big Bugaboo Creek 12-48-(0.7)
WS-IV
WS-IV
TB-01
36.2635530
-81.0055660
NAD 83
MAP
Nearest Second
Little Bugaboo Creek 12-48-1-(1)
C
C
TB-02
36.2620960
-81.0069260
NAD 83
MAP
Nearest Second
Little Bugaboo Creek 12-48-1-(1)
C
C
_
00 E', "
.O.'."
NAD 83
ADD
Nearest Second
_
'O r' r— "
.O.'."
NAD 83
ADD
Nearest Second
_
_
O, ' "
-qO.'."
NAD 83
ADD
Nearest Second
_
_
O.' bb "
O.'."
NAD 83
ADD
Nearest Second
_
_
Id. .', "
O.'."
NAD 83
ADD
Nearest Second
_
Note: Please keep the site information (I.) and waterbody information (II.) of the same field on the same page.
FORM: LASC 06-16 Page 7

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids, Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
LBl
No
Fescue
Hay
LB2
No
Fescue
Hay
LB3
No
Fescue
Hay
LB4
No
Fescue
Hay
LB5
No
Fescue
Hay
LB6
No
Fescue
Hay
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Larry Bailey
Address: 2174 Salem Ch Rd.
City: Bostic State: _ NC Zip: 28018
Phone: 1I828-453_-039_6 E-mail address:
Signature: k"', Date:
NORTH CAROLINA, Rutherford COUNTY
I, the undersigned Notary Public do hereby certify that La.-.—,- Bailey _
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the
day of M 0 ro
Signature and seal:
My commission
Lessee's/Operator's Certification:
.a -AJ4
k
Notary Public _
W11kes Court"
ti T
RO����•�
iC AI«Ovk
1 certify that 1 have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail address:
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: Zach Key
Signature: , Date:
FORM: LOA 06-16 Page 3 of 3

Compliance and Review Boundaries:
The compliance boundary is established either 250 feet from the
edge of the residuals application area or 50 feet within the property
boundary, whichever is closest to the application area. The review
boundary is established halfway between the compliance boundary
and the edge of the residuals application area.
b
.0
Buffers
Property Line (50') f
Surface Water (100') r " `A
Perennial Stream (100') �.
House (400') `
House (100')
Well (100')
Legend Well
9 House ' -
Propery Line x Soil Boring �# .'
Field Boundary Surface Water
Perennial Stream ® Unused Area"ias�'}nterforGeographic nfdfn aucn�ar._;r•'sis
=
Bailey, Larry: Compliance and Review Field L81
Parcel: 1619517 -0-
0 140 280 560 Feet
Rutherford County, NC I I I, �- E I , 1
35.3975.-81.7536 North Carolina Stateplane, NAD83

Compliance and Review Boundaries:
The compliance boundary is established either 250 feet from the
edge of the residuals application area or 50 feet within the property
boundary, whichever is closest to the application area. The review
boundary is established halfway between the compliance boundary ,
�nrJ }ho orJno of }ho rocirJu�le �nnlir }inn �ro� _ to
�' r
f e
I
% x
0.6 acres
Buffers
Property Line (50')
Surface Water (100') �x
Perennial Stream (100) ,
House (400')
House (100')
Well (100')
Legend Well
House
Propery Llne x Soil Boring
Fleld Boundary Surface Water
Perennlal Stream ® Unused Area
Bailey, Larry: Compliance and Review Field LB2
Parcels: 0319871, 0326478
0 125
Rutherford County, NC E r ,�
35.3992.-81.757 North Carolii
Field L62
11.7 acres
x 4
pnehAap, N�� Center
3card ,
250
ry'6
Crv� c
S
Y.
;hic•InfornI-Ob-n r aky,s_is. NC
500 Feet
N

Compliance and Review Boundaries:
The compliance boundary is established either 250 feet from the
edge of the residuals application area or 50 feet within the property
boundary, whichever is closest to the application area. The review
boundary is established halfway between the compliance boundary
and the edge of the residuals application area.
A
•
FIELD 1_66 \ ,
acres'
4
lo
s1XI
3 x FIELD LB5 '
t aer s k• t
i �^1 j': �*_-. �• fire .�. _-
w r l
Buffers �#`rEr i ! Az �l iJ•�)``i�ri v R •�, - }, X {r .?ram ,�;,t
Property Line (50') _.y ..i.' 4x► '
Surface Water (100')�
Perennial Stream 100' �'I`` 'rt'.*� ►
House (100') R
* #�•a .��
House (400')ik
f�' '
Legend Well
House
Propery Line x Soll Boring
Field Boundary Surface Water aeh:1ap �C Ce t-" ror �V pgra�,'i" s;�3'r' a yp'jarp��rl i.y:sis t G
Perennial Stream CM Unused Areaoa�d ;� •
Bailey, Larry: Compliance and Review Fields LB3, LB4, LB5, LB6
Pa rce 10319871
0 250 500 1.000 Feet
Rutherford County, NC i I I i r L_ i i

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Larry Bailey
Operator: Larry Bailey
Crop 1 Name: Fescue
WQ Permit #: WQ0037105 Field #: NC-RU-LB
Annual Dry Tons Applied: 35.4808 Site #: I
Predominant Soil Series: PbB2
Crop 1 Max. PAN:
178
Crop 2 Name:
Acres Utilized: 8
Acres Permitted: 8
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
11rs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
qQ °
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
2-2023
112
15.5
1.828
NCO025984
dry
0
s
1 0.5
0.3
1 46300
974
1 35.5
51.610
NA
Fescue
3-2023
70
15.5
1.142
NCO025984
dry
0
s
0.5
0.3
46300
974
35.5
32.256
NA
Fescue
8-2023
48
14.5
0.733
NCO025984
dry
0
s
0.5
0.3
63400
3920
82.8
29.142
NA
Fescue
9-2023
48
14.5
0.733
NCO025984
dry
0
s
0.5
0.3
63400
3920
82.8
29.142
NA
Fescue
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
278
o
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
142.150
0.000
Lime Applied
Annuallbs/acre
0.039
0.021
3.450
0.389
0.566
0.010
0.065
0.147
0.095
12.720
182.508
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.137
0.095
8.979
1.049
2.095
0.031
0.225
0.46
0.548
36.768
Current Cumulative lbs/ac
0.176
0.116
12.429
1.438
2.661
0.041
0.290
0.607
0.643
49.488
Permitted C. P. L. R.****
36
34
1338
1 NA
267
15
NA
74
89
1 2498
Permit PAN Limit 1 st/2nd Crop
1 178
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
�K
Signature dT Land Applier
2-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc. WQ Permit #: WQ0037105 Field #: NC-RU-LB Acres Utilized: 11.7
Land Owner: Larry Bailey Annual Dry Tons Applied: 39.1324 Site #: 2 Acres Permitted: 11.7
Operator: Larry Bailey Predominant Soil Series: PbB2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue Crop 1 Max. PAN: 178 Crop 2 Name: Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
Q
� o�
o
?�
°�
7
?Y
TKN
mg/kg
Z a
o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
3-2023
112
15.5
1.250
NCO025984
dry
0
s
1 0.5
0.3
46300
974
35.5
35.289
NA
Fescue
7-2023
42
14.5
0.438
NCO025984
dry
0
s
0.5
0.3
63400
3920
82.8
17.435
NA
Fescue
10-2023
168
13.7
1.657
NCO025984
dry
0
s
0.5
0.3
70800
730
590
72.816
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
3221
o
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
T2-554ol
o.000
Lime Applied
Annuallbs/acre
0.030
0.014
2.558
0.284
0.390
0.009
0.051
0.112
0.072
9.679
145.391
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.13
0.094
8.324
0.873
1.887
0.016
0.208
0.415
0.52
34.436
Current Cumulative lbs/ac
0.160
0.108
10.882
1.157
2.277
0.025
0.259
0.527
0.592
44.115
Permitted C. P. L. R. * * * *
36
34
1 1338
1 NA
267
1 15
NA
1 74
89
2498
Permit PAN Limit 1 st/2nd Crop
F 178
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
�K
v
Signature of Land Applier
2-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Larry Bailey
Operator: Larry Bailey
Crop 1 Name: Fescue
WQ Permit #: WQ0037105 Field #: NC-RU-LB
Annual Dry Tons Applied: 11.0763 Site #: 3
Predominant Soil Series: PbB2
Crop 1 Max. PAN:
178
Crop 2 Name:
Acres Utilized: 3.1
Acres Permitted: 3.1
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
11-2023
96
13.7
3.573
NCO025984
dry
0
s
0.5
0.3
1 70800
730
1 590
157.040
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
961
0
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
157.0401
o.000
Lime Applied
Annuallbs/acre
0.032
0.013
2.658
0.289
0.364
0.011
0.056
0.121
0.077
10.362
162.929
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.103
0.064
6.81
0.754
1.398
0.011
0.155
1.441
0.308
28.258
Current Cumulative lbs/ac
0.135
0.077
9.468
1.043
1.762
0.022
0.211
1.562
0.385
38.620
Permitted C. P. L. R.****
36
34
1338
1 NA
267
15
NA
1 74
89
2498
Permit PAN Limit 1 st/2nd Crop
178
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
�K
Signature of Land Applier
2-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Larry Bailey
Operator: Larry Bailey
Crop 1 Name: Fescue
WQ Permit #: WQ0037105 Field #: NC-RU-LB
Annual Dry Tons Applied: 9.6917 Site #: 4
Predominant Soil Series: PbB2
Crop 1 Max. PAN:
178
Crop 2 Name:
Acres Utilized: 5.4
Acres Permitted: 5.4
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
11rs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
qQ °
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
11-2023
84
13.7
1.795
NCO025984
dry
0
s
0.5
0.3
1 70800
730
1 590
78.883
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
841
0
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
78.883
1 o.000
Lime Applied
Annuallbs/acre
0.016
0.006
1.335
0.145
0.183
0.006
0.028
0.061
0.039
5.206
81.852
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.111
0.072
7.241
0.735
1.506
0.011
0.166
1.332
0.319
30.547
Current Cumulative lbs/ac
0.127
0.078
8.576
0.880
1.689
0.017
0.194
1.393
0.358
35.753
Permitted C. P. L. R. * * * *
36
34
1338
1 NA
267
15
NA
1 74
89
2498
Permit PAN Limit 1 st/2nd Crop
178
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
/1 4
Signature of rand Applier
2-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Larry Bailey
Operator: Larry Bailey
Crop 1 Name: Fescue
WQ Permit #: WQ0037105 Field #: NC-RU-LB
Annual Dry Tons Applied: 15.2299 Site #: 5
Predominant Soil Series: PbB2
Crop 1 Max. PAN:
178
Crop 2 Name:
Acres Utilized: 4.6
Acres Permitted: 4.6
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
10-2023
132
13.7
3.311
NCO025984
dry
0
s
0.5
0.3
1 70800
730
1 590
145.518
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
1321
0
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
145.5181
o.000
Lime Applied
Annuallbs/acre
0.030
0.012
2.463
0.268
0.338
0.010
0.052
0.112
0.072
9.602
150.982
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.05
0.037
3.023
0.272
0.708
0.005
0.072
0.137
0.158
13.335
Current Cumulative lbs/ac
0.080
0.049
5.486
0.540
1.046
0.015
0.124
0.249
0.230
22.937
Permitted C. P. L. R.****
36
34
1338
1 NA
267
15
NA
1 74
89
2498
Permit PAN Limit 1 st/2nd Crop
1 178
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
�K
Signature of Land Applier
2-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Larry Bailey
Operator: Larry Bailey
Crop 1 Name: Fescue
WQ Permit #: WQ0037105 Field #: NC-RU-LB
Annual Dry Tons Applied: 11.0763 Site #:
Predominant Soil Series: PbB2
Crop 1 Max. PAN:
178
Crop 2 Name:
Acres Utilized: 3.3
Acres Permitted: 3.3
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
10-2023
96
13.7
3.356
NCO025984
dry
0
s
0.5
0.3
1 70800
730
1 590
147.522
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
961
0
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
147.5221
o.000
Lime Applied
Annuallbs/acre
0.030
0.012
2.497
0.272
0.342
0.011
0.053
0.113
0.072
9.732
153.034
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.367
0.047
3.795
0.28
0.867
0.006
0.089
0.169
0.174
17.018
Current Cumulative lbs/ac
0.397
0.059
6.292
0.552
1.209
0.017
0.142
0.282
0.246
26.750
Permitted C. P. L. R.****
36
34
1338
1 NA
267
15
NA
1 74
89
2498
Permit PAN Limit 1 st/2nd Crop
1 178
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
2-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids, Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
TB-01
No
Fescue
Hay
TB-02
No
Fescue
Hay
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Blevin Tristen & Ben e Colby
Address: 1481 Byrd Road
City: Roaring River _ State: NC Zip: 28669
Phone: [phone] E-mail address:
rt 7 ...
Signature: Date: a
NORTH CAROLINA, Wilkes COUNTY
I, the undersigned Notary Public do hereby certify that Colby Benge
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the
day of
Signature and seal:
My commission expi.4- Y - q
Lessee's/Operator's Certification:
i
;FORTH O� ,.
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail address:
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name:
Signature:
Date: 4-1-2024
FORM: LOA 06-16 Page 3 of 3

U.S. Biosolids, Inc.
Permit. WQ003715
Blevins, Tristen
Fields: TB1 & TB2
Wilkes County, NC
(TI,
7
TB2
4.1 ACRES
L
0
�� r•t
�L
TB 1 -
14.9
ACRES,J6
t _ , 7
WhiteS >�4`
r- COMPIANCE AND REVIE W BOUNDARIES:
The compliance boundary is established either 250 feet
from the edge of the residuals application area or 50 feet
O within the property boundary, whichever is closest to the
O application area. The review boundary is established
halfway between the compliance boundary and the edge
o of the residuals application area.
\V
Gr�c y
f Fl 4
law
aw
r4Nft
I Scale 1 "=2661

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids, Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
BP4
No
Corn
Silage
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Inesph Garrett B ant
Address: 1460 GREENHORN ROAD
City: Roaring River State: NC Zip: 28669
Phone:
Signature:
E-mail
NORTH CAROLINA, Wilkes COUNTY
Date: 3- ? t ' ,;'.;
1, the undersigned Notary Public do hereby certify that Joesph Garrett Bryant
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
-1 1 Y�
WITNESS my hand and official seal this the 04.1
day of 1 I 1 ctrc i^� ` ;;; ;,.,.20 -2
Signature and seal:
gg
`�- .�
My commission expires: 9 ",U YS
VfteS
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by thlgtipulatioM and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail address:
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: Z�aach Key
Signature: � z /l Date: - -
2024
FORM: LOA 06-16 Page 3 of 3

BP4_1
7.2 Acres
BP4_2
19.4 Acres
a tt � !
1, —���
t '.
1•
",
S
Southern Soil Builders, Porter Tract - N
BP4
Joesph Garret Bryant W E
1460 Greenhorn Rd. Roaring River, NC
S
0 250 500 750 1000 ft
Parcel: 0606476 I I I I I
Wilkes County, NC
36.2786,-81.0075 North Carolina State Plane, NAD83
Produced: December, 2024
Created by: Joseph Jarvis

ANNUAL LAND APPLICATION FIELD SUM24iARY FORAM
FT.F ASE MA 'l CUPY OF TldiS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR E AC'El FEE LD APPLIED ON
PLACE A "NIA" IN A BLANK OR BOX WHEN NOT APPLIC LBLE.
Facility Name: U.S. Biosolids, Inc. WQ Permit'4.: Field 0: NC-XVK-BP Acres Utilized: 26,6
Land Otsoer: Still= Parser Animal Dr7 Tan_ Applied: 76.0892 Site 1�; 4 Acres Permitted: 26.6
Operator: William Porter
Crop IName: Crm
Predominnw 5oHSeries: FcB2
C'rep 1 ' Ls. PAN: 207
C'atim Exchange C'apaeity (non 503):
Crop'_ Name: Crop 2 Afax. PAN:
u
,2
Vokmeapplied
(enter ooe) Solids!
L4�
Ca. Yds Gallons
%
Solids
VGh®e
APPliedPe
Arne
{ory7anWhc}
RPSMj 1A� ° e5
(h-MES #, NQ#
Fe t., Anirm(Dry
� }
Soil
Card
Wet,
N
P-TC
PaA24
Hrk
v,
m _
t±
�.
TEN
m3rk9
_Z
3 e
nM
Ntma
and
Nitrite
m8't9
PAN ��
NmeofC rop
R.eceamg Rem&al
Apphrabon
Crop 1
Crap 2
Crap 1
Crop
3-2023
377000
4.94
2.960
t3O0020761
dry
0
0.5
03
10MOO
5490
332
190.131
NA
02M
0.000
0.000
0.000
0.000
1
1
1
1 0.000
0.000
0.000
0.000
0.000
0.0W
MIN
0.000
0.000
0.00w
0.000
0.000
0.000
0.000
0.000
0.000
0.00O
0.000
0.0W
O.M
0.000
0.000
0.0m
0.0W
0.000
0.000
0.000
0.000
0.00O
Readnils .ippliratiam totals an FORM FSF supp (aftarh FORM FSF supp to this form):
TGrA s
a
37aooa
As
Cd
Cu
Cr
Fb
H
Mo
Ni
Se
Zn
P
190331
0.00O
Lime Applied
Amaglbslacre
0.059
0.012
2.442
0237
0394
0.022
0.030
0.119
0.059
6.464
96-384
late
lbslac
Pnor Years Cunwlative lbslac
0.379
0.73
13293
2256
1.147
0.07
0.228
3.6
0.2H
29.415
Cent Cunm lative lbsJa.c
0.438
0.742
15.73S
2 A93
1341
0.092
0259
3.719
0.347
35.879
Permitbed C. P_ L. R****
36
34
1339
NA
267
15
NA
74
89
2499
Pemnt PAN Limit 15f 2ndCaap
I 207
°'T rertifs, imder penalty of lass, that tb14 document was preparrd under my direction orSnper H-sionin accordance nith a si-stem designed to assw'e flult
qualified personnel properly gathered and eralwited the information suhinitted. I am aware that there are significant penalties for submitting false
mfOrma tiorl, including the possibihtY of fines and impti-sonment f0r Imotiing fiolat10ns."
*.4plicatim Method: S - Sw4aee, r - Nec tion, E1C - Incorporation
-12-2024 "Volatilization Rate: Smfare - 4,+"r I�ectiaaLTocorporativm - 1.0
SignEtur Of LandApplier Date xxxhMmeralizatioaRates- Compost -0.1,digested-0.2,aembiealb-
digested -0.3, rah sludge -0.4
****C.P.L.R.: Cumulative Pollufaot Loading Rite
DEN FORM FSF (I2f10Q6)

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids, Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
FC2
No
Fescue
Hay
FC3
No
Fescue
Hay
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Forest Calton
Address: 660 Calton Road
City: Bostic State: NC Zip: 28018
Phone:-245-0638 E-mail address: �f
Signature: its _ Date:
NORTH CAROLINA, Rutherford COUNTY
1, the undersigned Notary Public do hereby certify that Forest Javan Calton
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
t)%
WITNESS my hand and official seal this the 111 !Jl0.111440
day of M arc
Signature and seal:
My commission
Lessee's/Operator's Certification:
Y-w-2O.A8
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: Zach
Signature: �� /��L Date: 4-1-2024
FORM: LOA 06-16 Page 3 of 3

Compliance and Review Boundaries:
The compliance boundary is established either 250 feet from the
edge of the residuals application area or 50 feet within the property
boundary, whichever is closest to the application area. The review
boundary is established halfway between the compliance boundary
and the edge of the residuals application area.lk
l. ■ a f
e ew F
-
�' .'`• f
-' - Mission Dr.
• • }
dip fd
# 3�11
# 7 r
r. ",
R i `
y� R Apo-
Ae
_ - ��1X•.-1 J_fYf _-J'� •i. •: �J _aa�.'�Y• �.� �"{e �jy'r `'_ _
4
x
5.5 a crtzTz�
l 5
Buffers
Property Line 04
Surface Water (100')
Perennial Stream 100 #. .fir;
House 40
Legend 11House
Propery Line x Soil Boling
-�—� Field BoundarySurface Water `
Perennial Stream Unused Area
to �{o.Fegra
E-
Calton, F: Compliance and Review, Field 2 Field FC2 & F
Parcel- 1644843
0 250 500 1.000 Feet
Rutherford County, NC
MA
Nov. 2016
Shaffer Soil Services. Inc
A

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Forest Calton
Operator: Forest Calton
Crop 1 Name: Fescue
WQ Permit #: WQ0037105 Field #: NC-RU-FC
Annual Dry Tons Applied: 23.2524 Site #: 3
Predominant Soil Series: PbB2
Crop 1 Max. PAN:
178
Crop 2 Name:
Acres Utilized: 8.6
Acres Permitted: 8.6
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6-2023
70
15
1.028
NCO025984
dry
0
s
1 0.5
0.3
1 57400
700
1 127
35.961
NA
Fescue
7-2023
70
14.5
0.994
NCO025984
dry
0
S
0.5
0.3
63400
3920
82.8
39.533
NA
Fescue
8-2023
48
14.5
0.682
NCO025984
dry
0
s
0.5
0.3
63400
3920
82.8
27.109
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
1881
0
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
102.6031
o.000
Lime Applied
Annuallbs/acre
0.025
0.011
1.869
0.194
0.252
0.007
0.042
0.083
0.050
6.938
107.306
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.088
0.063
5.648
0.759
1.38
0.019
0.153
0.322
0.466
21.946
Current Cumulative lbs/ac
0.113
0.074
7.517
0.953
1.632
0.026
0.195
0.405
0.516
28.884
Permitted C. P. L. R. * * * *
36
34
1338
1 NA
267
15
NA
74
89
2498
Permit PAN Limit 1 st/2nd Crop
1 178
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
�K
Signature of Land Applier
2-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Forest Calton
Operator: Forest Calton
Crop 1 Name: Fescue
WQ Permit #: WQ0037135 Field #: NC-RU-FC
Annual Dry Tons Applied: 24.1788 Site #: 2
Predominant Soil Series: PbB2
Crop 1 Max. PAN:
178
Crop 2 Name:
Acres Utilized: 5.5
Acres Permitted: 5.5
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
t'
Moist)
Precip.
past 24
Hrs.
inches
a
F S
w
o
-
N
`;
TKN
mg/kg
Z a
o E3
ac o
CD
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
3-2022
88
14.5
1.954
NCO025984
dry
0
S
0.5
0.3
1 52500
690
1 46.6
62.267
NA
Fescue
7-2022
110
14.5
2.442
NCO025984
dry
0
S
0.5
0.3
52500
690
46.6
77.834
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
198
01
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn P
140,102T
0.000
Lime Applied
Annuallbs/acre
0.036
0.017
2.822
0.325
0.460
0.005
0.059
1.161
0.080
11.078 196.062
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.069
0.053
4.123
0.598
1.154
0.2
0.122
0.262
0.418
16.01
0
Current Cumulative lbs/ac
0.105
0.070
6.945
0.923
1.614
0.205
0.181
1.423
0.498
27.088
Permitted C. P. L. R.****
1 36
1 34
1 1338
1 NA
267
15
1 NA
374
1 89
1 2498
Permit PAN Limit Ist/2nd Crop
178
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
�� /lv *Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids, Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
JH-01
Yes
Corn
Silage
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: John Harrill
Address: 2269 New House Rd.
City: Ellenboro State: NC Zip: 28040
Phone: [phone] E-mail address: y
Signature: tiJ 11� � 1..1]�- Date: I /�
NORTH CAROLINA, Rutherford COUNTY
I, the undersigned Notary Public do hereby certify that John Harrill
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS mmv hand and official seal this the 1
day of , r f wr a k
Signature and seal:
My commission
Lessee's/Operator's Certification:
W_OI-h2
, 20.
tikes County
1 certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name: Norman McDaniel
Address: 167 McKinney Mill Road
City: Ellenboro State: NC Zip: 28040
Phone: [phone] E-mail address:
Signature: Date:
Permittee's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: Zach Key _
Signature: �4*- �9 Date:
4-1-2024
FORM: LOA 06-16 Page 3 of 3

JH-01
14.1 Acres
Southern Soil Builders, McKinney Tract - JH-01
Hubert R McKinney & John David Harrill III
2269 New House Rd. Ellenboro, NC
"A
A"
4
Buffers
Property Line (50')
Perennial Stream (32.8')
Residence (400')
Legend
Property Line Perennial Stream
Field Boundary A Residence
N
W+ E
S
0 250 500 750 1000 ft
Parcel: 5052
Rutherford, NC
35.3635, -81.7215 North Carolina State Plane, NAD83
Produced: 2024
Created by: Joseph Jarvis

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids. Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
CM-01
No
Fescue
Hay
CM-02
No
Fescue
Hay
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. 1 certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Billy Hinson
Address: 537 Rocky Ford Road
City: Roaring River State: NC Zip: 28669
Phone: [phone] E-mail address:
Signature: Date:
NORTH CAROLINA, Wilkes COUNTY
1, the undersigned Notary Public do hereby certify that _ Billy Hinson
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the
day of 1 + +'r t , 20 :2
Signature and seal:
My commission expi s:
u..q.g ��z�
=� IV Z=
O
Lessee's/Operator's Certification:
1 certify that I have read this Agreement and do hereby agree to abide by the stipulati6p)�, andlie- r,i tions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: Zach Key
Signature: � AQ _ Date: 4-1-2024
FORM: LOA 06-16 Page 3 of 3

Greenhorn Rd'
nr.
Field IA
1.95 Acres
Field_113 Legend
1.5 Acres
Property Line A Residence
IT, Field Boundary ° Well
°'' Stream ® Unused
Buffers
0 Property Line (50') 0 Well (100')
0 Residence - waiver (100') 0 Stream (100')
0 Residence (400')
Southern Soil Builders, McCann Tract N
Billy Hinson
537 Rocky Ford Rd. Roaring River, NC W E
S
0 250 500 750 1000 ft
Parcel: 0605407 I I I I I
Wilkes County, NC Produced: 2024 Created
36.2705,-80.9608 North Carolina State Plane, NAD83 by: Joseph Jarvis

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Carolyn McCann
Operator: Carolyn McCann
Crop 1 Name: Fescue
WQ Permit #: WQ0037135 Field #: NC-WK-CM
Annual Dry Tons Applied: 3.9980 Site #: 1
Predominant Soil Series: FcB2
Crop 1 Max. PAN:
188
Crop 2 Name:
Acres Utilized: 3.45
Acres Permitted: 3.45
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
t'
Moist)
Precip.
past 24
Hrs.
inches
a
F S
w
o
-
N
`;
TKN
mg/kg
Z a
o E3
ac o
CD
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
9-2022
32500
2.95
1.159
NCO020567
dry
0
s
0.5
0.3
1 43000
5170
1 159
32.663
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
01
32500
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn P
32.663
0.000
Lime Applied
Annuallbs/acre
0.039
0.008
0.475
0.057
0.041
4.847
0.019
0.041
0.039
1.198 72.090
Date
lbs/ac
Prior Years Cumulative lbs/ac
0
0
0
0
0
0
0
0
0
0
12-22
2000
Current Cumulative lbs/ac
0.039
0.008
0.475
0.057
0.041
4.847
0.019
0.041
0.039
1.198
Permitted C. P. L. R.****
1 36
1 34
1 1338
1 NA
1 267
1 15
1 NA
374
1 89
1 2498
Permit PAN Limit Ist/2nd Crop
1 188
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land ffpptier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant LoadinI4 Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Billy Hinson
Operator: Billy Hinson
Crop 1 Name: Fescue
WQ Permit #: WQ0037135 Field #: NC-WK-CM
Annual Dry Tons Applied: 13.1188 Site #: 2
Predominant Soil Series: FCB2
Crop 1 Max. PAN:
188
Crop 2 Name:
Acres Utilized: 6.3
Acres Permitted: 6.3
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
1 rs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
7-2023
65000
4.84
2.082
NCO020761
dry
0
s
0.5
0.3
1060001
5480
338
138.410
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
01
65000
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
T38 -4iol
0.000
Lime Applied
Annuallbs/acre
0.043
0.009
1.778
0.173
0.142
0.016
0.022
0.087
0.043
4.705
71.621 1
Date
lbs/ac
Prior Years Cumulative lbs/ac
0
0
0
0
0
0
0
0
0
0
Current Cumulative lbs/ac
0.043
0.009
1.778
0.173
0.142
0.016
0.022
0.087
0.043
4.705
Permitted C. P. L. R.****
36
34
1 1338
1 NA
1 267
1 15
1 NA
1 74
1 89
1 2498
Permit PAN Limit 1 st/2nd Crop
1
1 188
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
44
of Land Applier
2-12-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids, Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
DKl
No
Fescue
Hay
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that 1 am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Charles Key
Address: 958 Hoots Road
City: Roariniz River State: NC Zip: 28669
Phone: 333j'6-957-7878 E-mail address: cdkeyn�ail.com
Signature: a. —A Date: 7_2�
NORTH CAROLINA, Wilkes COUNTY
1, the undersigned Notary Public do hereby certify that _ Charles Key
personally appeared before me this day and acknowledged 1e due execution of the forgoing instrument.
WITNESS my hand and official seal this the
day of MofEi 120
Signature and seal:
My commission
Lessee's/Operator's Certification:
Ll- 9--),o
+vulary public
Wakes COEln+v
.11
.0�
/y C AR 0�
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail address:
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: �iZach Key
Signature: /� Date: 4-1-2024
FORM: LOA 06-16 Page 3 of 3

Southern Soil Builders, Key Tract - DK-01
Charles Dennis & Rada Key
958 Hoots Rd. Roaring River, NC
n
250 500
750 1000 ft
Buffers
0 Property Line (50')
0 House (400')
0 Well (100')
0 Pond (100')
Legend
Property Line • Well
Field Boundary 0 Pond
House
N
W+E
S
Parcel: 0605839
Wilkes County, NC Produced: March, 2019
36.2645,-80.9689 North Carolina State Plane, NAD83 Created by: Joseph Jarvis

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DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids, Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
MH 2-1
No
Fescue
Hay
MH 2-2
No
Fescue
Hay
MH 2-4
No
Fescue
Hay
MH 2-5
No
Fescue
Hay
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
® A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
❑ A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that i am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Charlie Killian
Address. 14109 LUCIA RIVERBEND HWY
City: Mt, Holly State: NC Zip: 28120
Phone: E-mail address -
Signature: iL�Date:
Signature:
NORTH CAROLINA, Gaston COUNTY
I, the undersigned Notary Public do hereby certify that Charlie Killian
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
.1 l
WITNESS my hand and official seal this the
day of M 0._t,
Signature and seal:
My commission expires:
nilllth
(i_ 4.2 $ = Notary Public _
Lessee's/Operator's Certification:
�..., CRC©��
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City;
Phone:
Signature:
Permittee's Certification:
State:
E-mail address:
Date:
Zip: _
i certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: ZachhKe
i 6
Signature: La % Date: 4-1-9094
ell
FORM: LOA 06-16 Page 3 of 3

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ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK .FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Town of Dallas
Land Owner: Charles Killian
Operator. Charles Killian
Crop 1 Name:
Fescue
WQ Permit #: WQ0020912 Field #: MH 02-02 Acres Utilized. 30.1.
Annual Dry Tons Applied: 0.5123 Site #: MH 02-02 Acres Permitted: 30.1
Predominant Soil Series: Cecil Cation Exchange Capacity (non 503):
Crop I Max. PAN: 209 Crop 2 Name: Crop 2 Max. PAN:
1.enter
o
Volume applied
one Solids)
( }
Liquid
Cu. Yds Gallons
o
%
Solids
Volume
Applied per
A
(Dry TonsIAC)
Residual Sources
(NPDES # WQ#,
Fat, Animal
Wye' etc)
Soil
Cond.
wry'
Wet
Moist)
Precip.
Past 24
inches
a
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; 0
TKN
ffvp9
Z a
--
3 o
g 2
mg/kg
Nitrate
and
Nitrite
nxft9
PAN Applied
(Ibslacte)
Name of Crop Type
ReceivingResidual
Application
Crop 1
Crop 2
Crop 1
Crop 2
5-2014
58500
0.21
0.017
WQ0020912
dry
0
s
0.5
03
71400
33300
2
0.956
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM
FSF supp to this form):
)TAIS:
01
5s500
As
Cd
Cu
Cr
Pb
Hg
Me
I Ni
Se
I Zn
P
0.956
0.000
Lime Ap2lied
nnuallbs/acre
0.000
0.000
0.008
0.001
0.001
0.000
0.000
0.000
0.000
0.023
0.830
Date
lbs/ac
for Years Cumulative lbs/ac
0.021
0.021
36
0.008
0.008
34
3.156
3.164
1338
1.366
1.367
NA
0.142
0.143
267
0.005
0.005
15
0.07
0.070
NA
0.18
0.180
374
0.034
0.034
89
4.817
4.840
2498
12-2014
1000
urrent Cumulative lbs/ac
.nnitted C. P. L. R.****
Trmit PAN Limit Ist/2nd Crop
209
certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
talified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
formation, including the possibility of fines and imprisonment for knowing violations."
/-
Signature of Land Applier
*Application Method: S - Surface, IN - Injection, INC - Incorporation
S **Volatilization Rate: Surface - 0.5, InjectionRncorporation -1.0
Date ``** Mineralization Rates: Compost -0.1, anserobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Charles Killain
Operator: Charles Killain
Crop 1 Name: Fescue
WQ Permit #: WQ0037135 Field #: NC-GA-MH-2
Annual Dry Tons Applied: 8.2399 Site #: 4
Predominant Soil Series: CeB2
Crop 1 Max. PAN:
209
Crop 2 Name:
Acres Utilized: 4.3
Acres Permitted: 4.3
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� �
o
Q
� o�
o
N
?�
°�
7
?Y .CD
,
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
8-2023
65000
3.04
1.916
NCO021181
dry
0
s
0.5
0.3
1490001
3330
343
175.181
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
01
65000
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
175.181
0.000
Lime Applied
Annuallbs/acre
0.064
0.013
1.261
0.231
0.068
0.024
0.032
0.081
0.064
7.204
106.913
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.252
0.054
8.415
2.551
0.592
0.022
0.175
0.533
0.262
36.276
Current Cumulative lbs/ac
0.316
0.067
9.676
2.782
0.660
0.046
0.207
0.614
0.326
43.480
Permitted C. P. L. R.****
36
34
1 1338
1 NA
1 267
1 15
1 NA
1 74
1 89
1 2498
Permit PAN Limit 1 st/2nd Crop
1
1 209
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
K
Signature of Land Applier
2-12-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Charles Killain
Operator: Charles Killain
Crop 1 Name: Fescue
WQ Permit #: WQ0037135 Field #: NC-GA-MH-2
Annual Dry Tons Applied: 12.3599 Site #: 5
Predominant Soil Series: CeB2
Crop 1 Max. PAN:
209
Crop 2 Name:
Acres Utilized: 24.6
Acres Permitted: 24.6
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
8-2023
97500
3.04
0.502
NCO021181
dry
0
s
0.5
0.3
1490001
3330
343
45.932
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
01
97500
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
45.932
0.000
Lime Applied
Annuallbs/acre
0.017
0.003
0.330
0.061
0.018
0.006
0.008
0.021
0.017
1.888
28.012 1
Date
lbs/ac
Prior Years Cumulative lbs/ac
1.544
0.193
27.839
7.86
3.472
0.129
0.719
15.447
0.344
86.01
Current Cumulative lbs/ac
1.561
0.196
28.169
7.921
3.490
0.135
0.727
15.468
0.361
87.898
Permitted C. P. L. R. * * * *
36
34
1 1338
1 NA
1 267
1 15
1 NA
1 74
1 89
1 2498
Permit PAN Limit 1 st/2nd Crop
1
1 209
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
W
Signature of Land Applier
2-12-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

Compliance and Review Boundaries: „
The compliance boundary is established
either 250 feet from the edge of the
residuals application area or 50 within the
property boundary, whichever is closest
to the application area. The
.a .
reviewboundary is established halfway
between the compliance boundaryand
the edge of the residuals application area.
OL
�6
NMI
2Lg &W
Property
Surface
Perena-
Lege
:1 - ITA Pi
Field
Pere

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids. Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
FLAT
No
Fescue
Hay
FLA2
No
Fescue
Hay
FLB1
No
Fescue
Hay
FLB2
No
Fescue
Hay
FLB3
No
Fescue
Hay
FLB4
No
Fescue
Hay
FLC1
No
Fescue
Hay
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
❑ A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Forest Calton
Address: 660 Calton Road
City: Bostic State: NC Zip: 28018
Phone:-245-0638 E-mail address: �f
Signature: its _ Date:
NORTH CAROLINA, Rutherford COUNTY
1, the undersigned Notary Public do hereby certify that Forest Javan Calton
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
t)%
WITNESS my hand and official seal this the 111 !Jl0.111440
day of M arc
Signature and seal:
My commission
Lessee's/Operator's Certification:
Y-w-2O.A8
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: Zach
Signature: �� 6__911 Date: 4-1-2024
617
FORM: LOA 06-16 Page 3 of 3

p °
p p
p p p
6 p p p
1.0 ac. ° p
x
3 x 2 x p p
� p
Field 2 X 5 ^ °
15.3 ac. Field 1
7.2 ac. 4 X x 3
X26X r--------------—------- p
X1 X4
Leased to p
Solar Farm p
AtJ ".4 p
p
Buffers
v p Parcel (50')
p House (400')
Church (400')
Well (100')
° p p n ° p Surface Water (100')
Perennial Stream (100')
p p p n n Legend
p ° Propery Line Well
p p ^ Field Boundary
p p _ p p n ° i Perennial Stream Church
t — Surface Water House
® p p p ° X Soil Bore
® Unused Area
Lawson Frank: Buffers Map FLA1&FLA2 0 375 750 1,500Feet
PIN: 1647412
Rutherford County, NC V

a�
X3
Fi
Fields;
X 4 i a 16.7 ac.
aC 2
Fie
Buffers
Parcel (50')
House (400')
■ Church (400')
Well (100')
Surface Water (100')
Perennial Stream (100')
Intermittent Stream (50')
Legend Surface Water
QQ Q
3 .
4 ac.
X1 Q
Q
3 Q
X 4
Z
Q
Q Q L
® Un used Area Q QQ Q Q Q
Propery Line Well Q Q Ins Boundary Church
Perennial Stream
Intermittent Stream House
X Soil Bore
NC One Map, NC Center fo�aeographic Info;tmati3 a JR1lys22
Lawson, Frank: Site Overview FLB1, FLB2 0 375 750 1,500 Feet
PIN: 1630311 FLB3, FLB4
Rut erford u ry, NC North Carolina State lane NAD83

M
In, i�s
X4
IL
v.
Buffers
Parcel (50')
House (400')
Surface Water (100')
Perennial Stream (100')
Legend
Propery Line
Field Boundary O Well
— Perennial Stream A House
Surface Water X Soil Bore
U
� Q
® Unused Area
F1C One Map, NC Centngtor Geographic Information and Analysis, fS 911 Board
Lawson, Fran
PIN 1650543
Rutherford County. NC
p FLC1 0 125 250 500 Feet i Figure 3
North � Caroi lina I State i Zane � NAD83 t 3

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Frank Lawson
Operator: Frank Lawson
Crop 1 Name: Fescue
WQ Permit #: WQ0037105 Field #: NC-RU-FLA
Annual Dry Tons Applied: 23.1126 Site #: I
Predominant Soil Series: PbB2
Crop 1 Max. PAN:
178
Crop 2 Name:
Acres Utilized: 7.2
Acres Permitted: 7.2
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
4-2023
56
15
0.983
NCO025984
dry
0
s
1 0.5
0.3
1 57400
700
1 127
34.363
NA
Fescue
7-2023
48
14.5
0.814
NCO025984
dry
0
S
0.5
0.3
63400
3920
82.8
32.380
NA
Fescue
8-2023
72
14.5
1.221
NCO025984
dry
0
s
0.5
0.3
63400
3920
82.8
48.570
NA
Fescue
10-2023
12
13.7
0.192
NCO025984
dry
0
s
0.5
0.3
70800
730
590
8.452
NA
Fescue
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
1881
o
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
123.764
0.000
Lime Applied
Annuallbs/acre
0.030
0.013
2.236
0.234
0.302
0.008
0.050
0.099
0.060
8.350
128.227
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.096
0.045
5.524
0.77
1.624
0.023
0.144
0.33
0.859
21.72
Current Cumulative lbs/ac
0.126
0.058
7.760
1.004
1.926
0.031
0.194
0.429
0.919
30.070
Permitted C. P. L. R.****
36
34
1338
1 NA
267
15
NA
74
89
1 2498
Permit PAN Limit 1 st/2nd Crop
1 178
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
of Land Applier
2-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Frank Lawson
Operator: Frank Lawson
Crop 1 Name: Fescue
WQ Permit #: WQ0037105 Field #: NC-RU-FLB
Annual Dry Tons Applied: 66.8938 Site #: 2
Predominant Soil Series: PbB2
Crop 1 Max. PAN:
178
Crop 2 Name:
Acres Utilized: 16.7
Acres Permitted: 16.7
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
5-2023
168
15
1.271
NCO025984
dry
0
s
1 0.5
0.3
1 57400
700
1 127
44.446
NA
Fescue
7-2023
170
14.5
1.243
NCO025984
dry
0
S
0.5
0.3
63400
3920
82.8
49.442
NA
Fescue
8-2023
60
14.5
0.439
NCO025984
dry
0
s
0.5
0.3
63400
3920
82.8
17.450
NA
Fescue
9-2023
144
14.5
1.053
NCO025984
dry
0
s
0.5
0.3
63400
3920
82.8
41.880
NA
Fescue
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
542
0
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
153.218
0.000
Lime Applied
Annuallbs/acre
0.037
0.016
2.780
0.290
0.376
0.010
0.062
0.123
0.074
10.355
158.522
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.089
0.049
5.629
0.641
1.354
0.014
0.134
0.27
0.43
22.438
Current Cumulative lbs/ac
0.126
0.065
8.409
0.931
1.730
0.024
0.196
0.393
0.504
32.793
Permitted C. P. L. R.****
36
34
1338
1 NA
267
15
NA
74
89
1 2498
Permit PAN Limit 1 st/2nd Crop
1 178
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
of Land Applier
2-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

.,.:., r.a. LI-.040 ArrLI%_A 1 IV.N F ILLD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Southern Soil Builders, Inc. WQ Permit#: WQ0037135 Field q: FLA2 Acres Utilized: 16.3
Land Owner: Frank Lawson Annual Dry Tons Applied: 55.2129 Site #: FLA2 Acres Permitted: 16.3
Operator: Frank Lawson Predominant Soil Series: 1PbB2 Cation Exchange Capacity (non 503):
Crop I Name: Fescue Crop I Max. PAN: 178 Crop 2 Name: Crop 2 Max. PAN:
_
O
ar
p
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(DryTons/Ac)
Residual Sources
(NPDES #- WQ#.
Fen.. Animal
Waste_ etc)
�`I
Cond.
(Dry-
Wet_
Moist)
Precip.
Past 24
HrS.
�r"es
D
K v
a v__
o n
n o.
'
e
ip
: N
3
� 9
d w
N
TKN
nV*9
z 3
9 c
3 '-
mglkg
Nitrate
and
Nitrite
mgAeg
PAN Applied
(lbs/acre)
NamcofCTop Type
Receiving Residual
Application
Crop I
Crop 2
Crop I
Crop 2
2-2017
150
14.9
1.155
NCO025984
dry
0
s
0.5
! 0.3
51200
1 2880
2.13
36.809
I NA
Fescue
f 3-2017
{ 290
I
{ 14.9
I 2.233
j NCO025984
{ dry
{ 0
{ s
! 0.5
I 0.3
{ 51200
{ 2880
{ 2.13
{ 71.165
{ NA
{ Fescue
{ j
]
0.000
}
}
✓
!
!
#
!
{ 0.000
{ 0.000
`
0.000
!
i
0.000
0.000
}
0.000
I
{
!
}
} 0.000
0.000
I
{
I
( 0.000
{
I
i
l
{
i
1
l
I
{ 0.000
[ 0.000
{
!
I
I
{
{
I 0.000
{
I
{
I
I
I
C
{
{
{ 0.000E
0-000
I
!
0.000
1
I
I
I
{
I
[
I
!
{ omo
{ 0.000
{
!
I {
I
}
! 0.000
I
{
{
I
I
i
{
I
1
k 0.000
{ 0.00o
1 {
I
I
I 0.o00
I
1
I
I
{
I
I
!
1
{ 0.000
{ 0.000
{
{
{
{
I
! 0.000
I
I
I
I
I
I
I
!
I
10.000
0.000
I
0.000
0.000
0.000
Residuals Applications totals on FORM FSFsupp ( attach FORM FSF supp to this form):
TOTALS-
440
0
As
Cd
Cu
Cr
Pb
HP,
Mo
Ni
Se
Zn
P
107.974"0000Lime
ADDlied
Annual
I bs/acre
0.037
0.013
0.050
36
0.017
0.004
0.021
34
2.155
! 0.725
! 2.880
! 1338
0.302
; 0.092
0.394
NA
0-654
{ 0.24
0.894
I 267
0.011
! 0.003
{ 0.014
! 15
0.057
0.019
! 0.076
NA
0-139
} 0.044
0.182
! 374
0.394
! 0.117
{ 0.511
{ 89
9.012
2.501
' 11.513
2498
110.449
{
Date
lbs/ac
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R.**** {
Permit PAN Limit 1 sV2nd Crop
- .r 178 }
_
µI certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
'/ *Application Method: S- Surface, IN - Injection, INC- Incorporation
LL4-) D& __ **Volatilization Rate: Surface - 0.5, Injection/incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobi21ly digested -0.2,
aerobically digested •0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Southern Soil Builders, Inc.
WQ Permit #: WQ0037135
Field #: FLC1 Acres Utilized: 7.6
Land Owner: Frank Lawson
T
Annual Dry Tons Applied: 31.3710
- Acres Permitted: 7.6
Site #: FLC1
Operator: Frank Lawson
Predominant Soil Series: PbB2
Cation Exchange Capacity (non 503);
Crop 1 Name:
Fescue
Crop 1 Max. PAN: 178
Crop 2 Name: Crop 2 Max. PAN:
P
Volume applied
a
Volume
itesidua! Sources
Soil
Precip"
ro
<
_K z � Nitrate PAN q plied Name of Crop Tylx
p Receiving Residua
' _
to )
L, (enter Solids) o
o /o
Liquid
Applied per
(NPDES #, W .
Cond.
Past 24
K
r� �?
w
„ _
TKN o ' and
�+ 0 a (lWacre)
^ = Application
O Solids
Acre
Fen- Animal
D
F ( r"•
Wet
Hrs.
7"
oa �
m^
� »
- Nitrite
- -
, � - m
} 2 Crop 1 Crop 2
Cu. Yds Gallons
(pry T0s/AQ
waste, etc)
Moist)
7
3
a mglkg mgncg MWk9 Crop I Crop
a
4-2017 90 14.9
1.486
NCOD25984
dry
0
s
0.5
0.3 S 1200 2880 2"13 47.368 NA Fescue
8-2017 160 14.9
2.642
NCO025984
dry
0
S
0.5
0.3 51200 2880 2.13 84.210 NA Fescue
0.000
0.000 0.000
0.000
0.000 0.000
0"000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0"000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000 T �
TOTALS:
Residuals Applications
totals
on FORM
FSF
supp ( attach
FORM FSF supp
to this form):
000 Lime ADDhed
2'O' 0
Annuallbs/acre
As
Cd
Cu
Cr
Mo
Ni
e
131.577
_Daie tbs/aG
0.045
.
7.
.
0
0.980 134.3
Prior Years Cumulative lbs/ac
0
0
.
-0
.
-0
0 0
0
0
0
0
Current Cumulative lbs/ac
0.045
0.021
2,625
0.368
0.797 0"013
0.070
0.168
0.480
10.980
Permitted C. P. L. R }�**
36
34
1338
NA
267 15
NA
374
89
2498
Permit PAN Limit lst/2nd
178
Crop
direction or supervision in accordance with a system designed to assure that
"I certify, under penalty of taw, that this document was re ared under m p
qualified personnel properly gathered
and evaluated theinformationsubmitted.
I am awarethatthere are significant penalties for submitting false
information, including the possibility
of fines
and imprisonment for knowing violations."
"Application Method: S - Surface, 1N -Injection, INC -Incorporation
0.5, injection/Incorporation- 1-0
**Volatilization Rate: Surface -
Signature of Land Applier�Y
4
*** Mineralization Rates: Compost -0.1, anserobially digested -0.2,
Date
aerobically digested -0.3. raw sludge -0.4
"""C.P.L.R.: Cumulative Pollutant lAradine Rate
DENR FORM FSF (12/2006

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids, Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
TL1
No
Corn
Silage
TL2
No
Corn
Silage
TL3
No
Corn
Silage
TL4
No
Corn
Silage
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
❑ A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Eva Lucas
Address: 191 Burcham Road
City: Roaring River State: NC Zip: 28669
Phone: ('3'36-957-8091 E-mail address: 2
Signature: &4A Date:
NORTH CAROLINA, Wilkes COUNTY
I, the undersigned Notary Public do hereby certify that Eva Jolly Lucas
personally appeared before me this day and acknowledged the due execution of the forgoing
WITNESS my hand and official seat this the
day of 20
Signature and se;
My commission
Lessee's/Operator's Certification:
4e
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail address:
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: �i Zach Key
Signature: Date: 4-1-2024
FORM: LOA 06-16 Page 3 of 3

Greenhorn Rd.
Southern Soil Builders, Lucas & Bodsford Tract - TL1
Eva J Lucas & Vickie Bodsford
191 Burcham Rd. Roaring River, NC
0 250 500 750 ft
I I I I
North Carolina State Plane, NAD83
Buffers
Property Line (50')�
Land Owner Home (100')
House (400')
Surface Water (100')
hnd
ropertyLine House +
ines 0 Pond
and Owner Home
N
W E
S
Parcel: 0604353
Wilkes County, NC
36.2803,-80.9980
Produced: December, 2018
Created by: Joseph Jarvis

TL2
3.5 Acres
Southern Soil Builders, Lucas & Bodsford Tract - TL2
Eva J Lucas & Vickie Bodsford
191 Burcham Rd. Roaring River, NC
0
250
500
Buffer
0 House (400')
Legend
Field Boundary
Property Line I
h A House
750 ft
NN
VV r E
V
S
Parcel: 0601860
Wilkes County, NC Produced: December, 2018
36.2789,-80.9964 North Carolina State Plane, NAD83 Created by: Joseph Jarvis

TB
2.3 Acres
-.~'���s
Southern Soil Builders, Lucas & Bodsford - TO
Eva ] LUC8S &ViCkie BOdSfn[d
191BurchamRd. Roaring River, NC
0 250 500 750ft
Parce:00O410S
Wilkes County, NC Produced: December,2O18
30.2271, '80.9940 North Carolina State Plane, NAD83 Created by: Joseph Jarvis

Southern Soil Builders, Lucas & Bodsford Tract - TL4 N
Eva J Lucas & Vickie Bodsford
191 Burcham Rd. Roaring River, NC UV E
S
0 250 500 750 ft
I I I I
Parcel: 0606480
Wilkes County, NC Produced: December, 2018
36.2801,-81.0013 North Carolina State Plane, NAD83 Created by: Joseph Jarvis

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DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids, Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
NMA
No
Corn
Silage
NMB
No
Corn
Silage
NMC
No
Corn
Silage
NMl
No
Fescue
Hay
NM2
No
Fescue
Hay
NM3
No
Fescue
Hay
RD1A
No
Fescue
Hay
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids, Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
RD1B
No
Fescue
Hay
RD2
No
Fescue
Hay
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Norman McDaniel
Address: 167 McKinney Mill Rad
City: Elienboro State: NC Zip: 28040
Phone: [phone] E-mail address:
Signature:
NORTH CAROLINA, Rutherfwrd COUNTY
Date:
I, the undersigned Notary Public do hereby certify that Norman McDaniel
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
\`tutu+ �urrr;
WITNESS my hand and official seal this the �. 3�-s- ���ZACyFINy�"
day of __ M arc k
Signature and seal: Z6A
c,
My commission expires:
Lessee's/Operator's Certification:
IvNes�,Y.p�b�r� -
I
re� RROL
1 certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City: _ State: _ Zip:
Phone: E-mail address:
Signature: _ ^ Date:
Permittee's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: Zach Key
Signature:A� Date: , 4-1-2024
. � _
FORM: LOA 06-16 Page 3 of 3

Buffers
0 Property Line (50')
y 0 Perennial Stream (32.8')
0 Residence - Waiver (100')
0 Well (100')
Legend,
Property Line
C Field Boundary x
Perennial Stream
A Residence
0 Well
,r
Aw
r
T S
T 1
Southern Soil Builders, Davis Tract - RD2
Evelyn R. Davis
318 McKinney Mill Rd. Ellenboro, NC
RD2
19.7 Acres
f.
b
46
N - -
W E
S
Parcel: 5043
Rutherford, NC
35.3576,-81.7387
0 250 500 750 ft
North Carolina State Plane, NAD83
Produced: 2024 Created
by: Joseph Jarvis

4.3
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Buffers
0 Property Line (50')
0 Perennial Stream (32.8')
0 Residence - Waiver (100')
0 Residence - No Waiver (400')
0 Well (100')
Legend .�....R�
Property Line
ky Perennial Stream`
fi f �l a • ,�� YW ^�i�� �y�� ,
t Field Boundary
Residence
,
Well
' 11
fit,+',tin •!..
RD1_B
29.3 Acres
Southern Soil Builders, Davis Tract - RD1_A/RD1_B
Evelyn R. Davis
318 Mckinney Mill Rd. Ellenboro, NC
N
W+E
S
0 250 500 750 1000 ft
Parcel: 5042 I I I I I
Rutherford, NC
35.3569,-81.7355 North Carolina State Plane, NAD83
Produced: 2024
Created by: Joseph Jarvis

w
d
�s
NM-03
6.6 Acres
Southern Soil Builders, McDaniel Tract - NM-03
Norman H & Carol A McDaniel
167 McKinney Mill Rd. Ellenboro, NC
Buffer ,
0 Property Line (50')
0 Residence (400')
0 Drainage (25')
Legend
Property Line Drainage
Field Boundary A Residence
u..n
N
W E
S
0 250 500 750 1000 ft
Parcel: 36022 I I I I I
Rutherford County, NC Produced: 2024
35.3637,-81.7240 North Carolina State Plane, NAD83 Created by: Joseph

Compliance and Review Boundaries: : ,.•a
The compliance boundary is established either 250 feet from the
edge of the residuals application area or 50 feet within the property
boundary, whichever is closest to the application area. The review
boundary is established halfway between the compliance boundary
and the edge of the residuals application area.
A
A.
3
t.
411
M�Krn�Py Mil! R
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Buffers
Property Line (50')
Perennial Stream (100')
House (400')
Well
Legend
House
Propery Line X Soil Boring
Field Boundary Surface Water
Perennial Stream ® Unused ArearneMap,NCCenteifor GeographicInformation arid,Analysis.NC
hoard
McDaniel, Norman: Compliance and Review Field NM1
Parcel: 1643242
0 125 250 500 Feet
Rutherford County, NC Ll
35.3644-81.7437 North Carolina Stateolane. NAD83

Compliance and Review Boundaries:
The compliance boundary is established either 250 feet from the
edge of the residuals application area or 50 feet within the property
boundary, whichever is closest to the application area. The review
boundary is established halfway between the compliance boundary
and the edge of the residuals application area.
R
k
-------- - - --
Parcel: 1646617
0 125
Rutherford County, NC L 1_
.. ���• �,s `.�.� 1 '� , - a+ r � { ' gyp..
aV
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• j `CIE., 4� •
. I
Buffers �!,
Property Line (50')
Perennial Stream (100')
House (400')
Legend well
House
- Propery Llne x Soll Boring
Field Boundary Surface Water
Perennial Stream ® Unused Area
Field NM2
250 500 Feet
lino State lane NA083

AVVr
Engineers and Sot Scientists
Agri -Waste Technology, Inc.
501 N. Salem St Suite 203
Apex NC 27502
P: 919.859.0669
www.agriwaste.com
Field NMA & NMB
(Land Application)
Norman McDaniel
Rutherford Co., NC
Parcel # 1635307
N
DavidsonDrawn By Julie
Reviewed By Karl Shaffer
Date 3/1118
Shires Rd
1
Legend
Well -Residence
Well Buffer 100'
Ci Evaluation Boundary 500'
Residence/Church
Residence Buffer400'
Ditch
Surface Water (USGS)
Grass Waterway Buffer 25'
Surface Water Buffer 100'
Parcel Buffer 50'
Parcel/Application Field
0 100 200 400 600 800.
Feet
s }�
MI
®I
,-7
— This map was created for proposed planning purposes only. It is not intended to be used as a plat or survey map of any type."'

Agri -Waste Technology, Inc.
501 N. Salem St Suite 203
Apex NC 27502
P; 919.859.0669
www.agrlwaste.com
Field NMC
(Land Application)
Norman McDaniel
Rutherford Co.. NC
Parcel # 1615530
Drawn By:
Julie Davidson
Reviewed
Date: 3/1/18
By: Kad Shaffer
Dixon Rd
iriri�ir• : .
000
10 t
,w
y,
1
1
1,
Legend
19 Well -Residence
C] Well to be Abandoned
® Well Buffer 100'
Evaluation Boundary 500'
Z\ Residence/Church
O Residence Buffer 400'
Ditch
Surface Water (USGS)
O Grass Waterway Buffer 25'
00 Surface Water Buffer 100'
Application Area
Q No Application Area
Parcel
Parcel Buffer 50'
1\ Ln
1
..`�,•` •tea
9 i00 200 400 600 800
Feet
— This map was created for proposed planning purposes only. It is not intended to be used as a plat or survey map of any type.—

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Norman McDaniel
Operator: Norman McDaniel
Crop 1 Name: Fescue
WQ Permit #: WQ0037105 Field #: NC-RU-NM
Annual Dry Tons Applied: 24.6799 Site #: I
Predominant Soil Series: PbB2
Crop 1 Max. PAN:
178
Crop 2 Name:
Acres Utilized: 6.2
Acres Permitted: 6.2
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
2-2023
99
15.5
2.084
NCO025984
dry
0
s
1 0.5
0.3
1 46300
974
1 35.5
58.864
NA
Fescue
6-2023
66
15
1.345
NCO025984
dry
0
S
0.5
0.3
57400
700
127
47.032
NA
Fescue
7-2023
28
14.5
0.551
NCO025984
dry
0
S
0.5
0.3
63400
3920
82.8
21.935
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
1931
o
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
127.8301
o.000
Lime Applied
Annuallbs/acre
0.036
0.017
2.975
0.323
0.471
0.009
0.060
0.125
0.080
10.846
164.310
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.108
0.087
8.026
0.929
1.837
0.022
0.203
0.411
0.513
32.672
Current Cumulative lbs/ac
0.144
0.104
11.001
1.252
2.308
0.031
0.263
0.536
0.593
43.518
Permitted C. P. L. R. * * * *
36
34
1338
1 NA
267
15
NA
74
89
2498
Permit PAN Limit 1 st/2nd Crop
1 178
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
�k
Signature of Land Applier
2-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Norman McDaniel
Operator: 2 Norman McDaniel
Crop 1 Name: Fescue
WQ Permit #: WQ0037105
Annual Dry Tons Applied: 14.3591
Predominant Soil Series: PaC2
Crop 1 Max. PAN:
Field #: NC-RU-NM
Site #:
158 Crop 2 Name:
Acres Utilized: 4.2
Acres Permitted: 4.2
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
Q
� o�
o
?�
°�
7
?Y
TKN
mg/kg
Z a
o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
2-2023
110
15.5
3.419
NCO025984
dry
0
s
1 0.5
0.3
46300
974
35.5
96.550
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
1101
o
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
96.550
0.000
Lime Applied
Annuallbs/acre
0.030
0.017
2.776
0.319
0.490
0.007
0.049
0.115
0.077
10.120
144.999
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.143
0.108
8.776
0.971
2.145
0.022
0.23
0.468
0.644
36.18
Current Cumulative lbs/ac
0.173
0.125
11.552
1.290
2.635
0.029
0.279
0.583
0.721
46.300
Permitted C. P. L. R.****
36
34
1 1338
1 NA
1 267
1 15
NA
1 74
89
2498
Permit PAN Limit 1 st/2nd Crop
F 158
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
of Land Applier
2-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION N FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORA TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "NIA" IN A BLAND{ OR BOX WHEN NOT APPLICABLE.
Facility Name: Southern Sail Builders, inc. WQ Permit #: WQ00 71 5 Field : A Acres utilized: 9.4
Land Owner: Norman McDaniel
Operator: Norman McDaniel
Crop I Name: Cora -Silage
Annual Dry Tons Applied: 16.0892
Predominant Soil Series: CaB2
site : N -Ru-NM
Crop 1 Max. PAN: 238 Crop 2 Name:
Acres Permitted: 9.4
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
0
Volume applied
(eater one) Sc lidsl
Liquid
Cu. Yds Gallons
°Io
Solids
Volurfle
Applied per
Acre
(Dry Tons/Ac)
1�esidual c�urce�
(NPDES #_ VV( #,
Fen- Animal
Waste, etc)
Sail
C nd.
(Dry.
Vet.
I1 o'st)
1'rc:cip.
fast
Hrs.
inches
�
`2
r1"�
0 W
°
<
� �
r --
� �"
Ti N
mglkg
>
a 3
mglkg
Nitrate
and
Nitrite.
mglkg
PAN Applied
Pp ,
lbslacrc j
Name ol'Crop Type:
Receiving Residual
Application
Crap 1
Crap 2
Crop 1
Crop 2
3-2019
91000
1.95
0.787
NCO25909
dry
0
s
0.5
0.3
72500
10000
320
37.896
NA
Corn
3-2019
77
13A
0"924
NCO025984
dn,
0
s
0.5
0.3
50700
100
357
28.818
NA
Corn
0.000
0.000
0.000
0.000
0.000
U00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0"000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp attach FORM FSF supp to this form):
'IU ALB:
77
91000
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
n
P
66.714
0.000
tr
Lie Applied
Annuallbslaere
0.017 0.008 1.159 0.130 0.172 0.002 0.022 0.053 0.047 3.599 51.282
0.03 0.028 1.578 0.212 0.47 0.002 0.052 0.111 0.228 5.972
0.047 0.036 2.737 0.342 0.642 0.004 0.074 0.164 0.275 9.571
36 34 1338 NA 267 15 NA 374 89 2498
1 238
Date
lbs/ac
Prior Fears Cumulative ]bslac
0
Current Cumulative lbs/ac
Permitted C. P. L. 1.****
Permit PAN Limit 1 stl2nd Crop
"I certify, under penalty of law, that this document was prepared under tier direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
Date
`Application Method: S - Surface, IN - Injections, INC - Incorporation
**Volatilization Rate: Surface - 0.5, 1njectionllncorporation - 1.0
**11 Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loadiniz Rate
DENR FORM FSF 12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Norman McDaniel
Operator: Norman McDaniel
Crop 1 Name: Corn -Silage
WQ Permit #: WQ0037105 Field #: NC-RU-NM
Annual Dry Tons Applied: 52.4691 Site #: B
Predominant Soil Series: CaB2
Crop 1 Max. PAN:
238
Crop 2 Name:
Acres Utilized: 13
Acres Permitted: 13
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
2-2023
158
15.5
1.587
NCO025984
dry
0
s
1 0.5
0.3
1 46300
974
1 35.5
44.804
44.804
10-2023
108
13.7
0.959
NCO025984
dry
0
S
0.5
0.3
70800
730
590
42.129
42.129
11-2023
168
13.7
1.491
NCO025984
dry
0
s
0.5
0.3
70800
730
590
65.534
65.534
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
4341
o
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
152.467
152.467
Lime Applied
Annuallbs/acre
0.036
0.017
3.111
0.347
0.477
0.011
0.061
0.136
0.088
11.803
178.691
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.057
0.053
3.291
0.332
0.901
0.004
0.099
0.209
0.369
13.299
Current Cumulative lbs/ac
0.093
0.070
6.402
0.679
1.378
0.015
0.160
0.345
0.457
25.102
Permitted C. P. L. R.****
36
34
1338
1 NA
267
15
NA
74
89
2498
Permit PAN Limit 1 st/2nd Crop
1 238
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
/l '4
Signature of Land Applier
2-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Norman McDaniel
Operator: Norman McDaniel
Crop 1 Name: Fescue
WQ Permit #: WQ0037105 Field #: NC-RU-NM
Annual Dry Tons Applied: 46.5385 Site #: C
Predominant Soil Series: CaB2
Crop 1 Max. PAN:
209
Crop 2 Name:
Acres Utilized: 9
Acres Permitted: 9
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
2-2023
220
15.5
3.191
NCO025984
dry
0
s
1 0.5
0.3
1 46300
974
1 35.5
90.113
NA
Fescue
4-2023
56
15
0.786
NCO025984
dry
0
S
0.5
0.3
57400
700
127
27.491
NA
Fescue
7-2023
88
14.5
1.194
NCO025984
dry
0
s
0.5
0.3
63400
3920
82.8
47.490
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
3641
o
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
165.0941
o.000
Lime Applied
Annuallbs/acre
0.046
0.023
3.958
0.440
0.642
0.012
0.077
0.168
0.108
14.516
213.295
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.057
0.053
3.291
0.332
0.901
0.004
0.099
0.209
0.369
13.299
Current Cumulative lbs/ac
0.103
0.076
7.249
0.772
1.543
0.016
0.176
0.377
0.477
27.815
Permitted C. P. L. R.****
36
34
1338
1 NA
267
15
NA
74
89
2498
Permit PAN Limit 1 st/2nd Crop
1 209
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
2-23-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
Facility Name: IDS Biosolids, Inc.
Land Owner: Evelyn Davis
Operator: Norman McDaniel
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
WQ Permit #: WQ0037135
Field #:
Annual Dry Tans Applied: 0.72 10 Site #;
Predominant Soil Series: CaB2
N -RU-RD Acres utilized: 4.3
1A Acres Permitted; 4.3
Cation Exchange Capacity (non 503):
Crop I Name:
Fescue
Crop I Max.
PAN;
209
Crop
2 Name:
Crop
2 Max. PAN:
Volume
Precip.
� D
Name. of Crop Type
�,
olur e applied
PP
Residual Sources
Soil
�
".
�-
r
Nitrate
� �
tenter one) ulidsl
%
pA • P
,� feed per
NPDFS #. 1�V
( Q
Cc nd.
Past 24
� �
�_
.�'
� �
TKN
_
``
c
and
PAN Applied
Receiving Residual
0
Liquid
Solids
Acre
Fen- Animal
(Dry`
Hrs.
o a
� �
�
� �
Nitrite
(lbslacre}
,
Application
Cu. ds Gallons
(Dry Tons/Ac)
Waste, etc)
Nloistj
inches
� �
* i
mglkg
mg/kg
mg/kg
Crap 1
Crop 2
Crop 1
Crap 2
8-2020
45500
0.38
0.168
NCO020664
dry
0
s
0.5
0.3
129000
31800
1700
15,681
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp { attach 1wOP.M FSF supp to this form):
TA[.. 01 4550DAs
Cd CLI Cr Pb o Ni Se Zn P 15.681 0.000
7ime Applied
Annual lbslacre
0.008 0.008 0.044 0.021 0.025 0,001 0.021 0.021 0.004 0.105 3.135
0 0 0 0 0 0 0 0 0 0
0.008 0.008 0.044 0.021 0.025 0.001 0.021 0.021 0.004 0.105
36 34 1338 NA 267 15 NA 374 89 2498
209
Date ibslac
Prior Fears CLIMUlative lb lac
12.-2020
2000
Current Cumulative lbslac
Permitted C. P. L. R.****
Permit PAN Limit lstl nd Crop
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
-7-0�*Application Method: S - Surface, IN - Injection, INClid - Incorporation
2,p9ic- "Volatilization hate. Surface - 0.5, Injection/Incorporation 1.0
Signature of Land ppl ier Date
Mineralization Rates: Compost -0.1, anserobiall digested -0.2�,
aerobically digested -0.3, raw sludge -0.4
"" .P.L.R.. Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Evelyn Davis
Operator: Norman McDaniel
Crop 1 Name: Fescue
WQ Permit #: WQ0037135 Field #: NC-RU-RD
Annual Dry Tons Applied: 32.2384 Site #: 113
Predominant Soil Series: CaB2
Crop 1 Max. PAN:
209
Crop 2 Name:
Acres Utilized: 29.3
Acres Permitted: 29.3
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
Q
Volume applied
(enter one) Solids/
Li uid
4
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
CondSoil
.
Moist)
precip.
Past 24
Ms.
inches
a
c� '5
o
*
p
?�
*
o
�
TKN
mg/kg
Z
o 5
as °
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
2-2022
77
14.5
0.321
NCO025984
dry
0
s
0.5
0.3
52500
690
46.6
10.227
NA
Fescue
3-2022
88
14.5
0.367
NCO025984
dry
0
s
0.5
0.3
52500
690
46.6
11.688
NA
Fescue
11-2022
99
14.5
0.413
NCO025984
dry
0
s
0.5
0.3
52500
690
46.6
13.149
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
264
0
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn P
35.065
0.000
Lime App lied
Annuallbs/acre
0.009
0.004
0.707
0.081
0.115
0.001
0.015
0.029
0.020
2.775 49.105
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.066
0.026
0.965
0.092
0.087
0.004
0.064
0.067
0.058
1.773
0
Current Cumulative lbs/ac
0.075
0.030
1.672
0.173
0.202
0.005
0.079
0.096
0.078
4.548
Permitted C. P. L. R.****
36
1 34
1 1338
1 NA
1 267
1 15
1 NA
374
1 89
1 2498
Permit PAN Limit Ist/2nd Crop
1 209
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY of THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: US Biosolids, Inc.
Lard Owner: Evelyn Davis
Operator.. Norman McDaniel
Crop 1 Name: Fescue
WQ Permit #: W00037135
Annual Dry Tons Applied: 7.2099
Predominant Soil Series: CaB2
Field #: NC-RIB-RD
Site #: 2
Crop 1 Max. PAN: 209 Crop 2 Name:
Acres Utilized; 19.6
Acres Permitted: 19.6
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
� Soil applied olurne Residual Sources Preci�- Nitrate
�
(enter one) Solids/ % Applied per (NPDES , W Cond. Past 24 TKIN o and
--� rm 0
Liquid Solids acre Fem, Animal (Dry. Hrs-. C W Nitrite
Cu. Yds Gallons DToot !A Waste, etc) Vl{et. �rrch � 0'
(Dry c} Moist) os M � mglkg mg/kg mglkg
4-2020 214500 0.38 0.173 INCO020664 dry 0 s 0.5 0.3 129000 31800 1700
9- 020 240500 0.38 0.194 NCO0206 4 dry 0 s 0.5 0.3 129000 31800 1700
0.000
{.DOD
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
Tor:;ALS: 45000 Cd Cr Pb o Ali e n P
Annuallbslacre 0.018 0.018 0.096 0,046 0.055 0.003 0.046 0.046 0,009 0.230 6.848
Prior bears Cumulative lbslac 0 0 0 0 0 0 0 0 0 0
Current CUMLIlative lbs/ac 0.018 0.018 0.096 0.046 0.055 0.003 0.046 0.046 0.009 0.230
Permitted C. P. L. R.***` 36 34 13 38 NA 267 15 NA 374 89 2498
Permit PAIN Limit 1 stl2nd Cron
PAIN Applied
lame of Crop Type
Receiving Residual
lbslacre)
Application
Crop 1 Crop 2
C:rop 1
Crap 2
16.218 NA
Fescue
18.184 NA
Fescue
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
34.402 0.000
Lithe
Applied
Date
l bslac
12-2020
2000
209
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
7o
Signature of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
"Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
* * * Minera] ization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0., raw sludge -0.4
****C.P.L.R.. Cumulative Pollutant Loading bate
DE R FORM FSF (12/2006)

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids, Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
BPI
Yes
Corn
Silage
BP2
Yes
Corn
Silage
BP3
Yes
Corn
Silage
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Kathleen Porter
Address: 3573 Greehom Road
City: Roaring River State:
NC
Zip: 28669
Phone: [phone] E-mail address:
Signature: Date: 3-a
NORTH CAROLINA, Wilkes COUNTY
I, the undersigned Notary Public do hereby certify that Eva Jolly Lucas
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
tpo
WITNESS my hand and official seal this the
day of fli art,k
Signature and seal:
My commission expires: L1 - q -
Lessee's/Operator's Certification:
�1111411i�I1J111/j
•;� Fy
Notary Public
Wtlkes county
C
,,O?rHIiCiARO�.
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name: _ Joesnh Garrett Bryant
Address: 1460 GREENHORN ROAD
City: Roaring River State: NC Zip: 28669
Phone:
Signatu
336-469-4233 _ _ mail ddress:
re: _ - Date:
Permittee's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: �iZach Ke•, _
Signature: Date: 4-1-2024
FORM: LOA 06-16 Page 3 of 3

p »
Olt,
}�
" `i0�lf
BPI-2
i fy k k
L Olt
A A ,
BP1-1 7. ;,.
p p
" 10.9 Acres
Ay o p
p `
p
p -
p Buffers
0 Surface Water (100')
0 House (400')
0 Property Line (50')
Legend
Property Line 0 Surface Water
Field Boundary p House t
Southern Soil Builders, Porter Tract - BP1 N
Kathleen G Porter W E
3573 Greenhorn Rd. Roaring River, NC
0 250 500 750 1000 ft S
Parcel: 0606478
Wilkes County, NC I I I I I Produced: 2024
36.2781,-81.0033 North Carolina State Plane, NAD83 Created by: Joseph Jarvis

BP2-2
4.9 Acres
BP2-1
24.5 Acres
2
- wo 1011
1-11001 W�I
A
GCee�ro�r
Southern Soil Builders, Porter Tract - BP2
Kathleen G Porter
3573 Greenhorn Rd. Roaring River, NC
^ A.
_
Buffers
0 Property Line (50')
0 Surface Water (100')
0 Land Owner House 100'
0 House (400')
Legend
Property Line O Land Owner Home
Field Boundary House
Perennial Stream
NN
W E
S
0 250 500 750 1000 ft
Parcel: 0604325 I I I I I
Wilkes County, NC
36.2845,-81.0114 North Carolina State Plane, NAD83
Produced: 2024
Created by: Joseph Jarvis

r
A
Y
Buffers
0 Surface Water
(100')
�r
0 Road (50')
n
0 House (400')
Legend
Field Boundary
0 Pond
House
Southern Soil Builders, Porter Tract -
BP3
Kathleen G Porter
3573 Greenhorn Rd. Roaring River, NC
N
W— E
S
0 250 500 750 ft
Parcel: 0606478 I I I I
Wilkes County, NC
36.2786,-81.0094 North Carolina State Plane, NAD83
Produced: 2024
Created by: Joseph Jarvis

ANNUAL LAND APPLICATION FIELD SUALAL-kRY FORM
PLEASE INLMa A COPY OF THIS BLANK FORM TO BE COAIPLETFD AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N.,A" IN i BLA\`K OR BOX WHEN NOT APPLICABLE.
Facilih- Name: U.S. Biosoilds Inc.
Land Owner: William Porter
Operator: Williiam Poiler
Crop i Name: Corn
WQ Permit v: R'00037135 Field 0: NC-NVK BP Acres Utilized: 11.04
Annual Dry Tow Applied: 55.1722 Site A: 1 Acres Permitted: 11.04
Predominant Soil Series: FcB2
Crop 1 Max. PAN: 207 Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o $
A 2
Volume applied
( enter one) Solids/
Iigaid
Ca. Yds Gallons
%
Solids
Volume
lied
Applied Per
Acre
0(y TM&AC)
Residual Saetces
(I.PDHS s p t2f,
Fert_,Anunt)
Waste, etc)
Soil
Cond.
Wet,2
Moist
PreQP.
Past 33
!Its.
11ch-6
>
_ $
g
c
g
$
?
g
2 It
'3
iIa
rn4`t9
x D
9 �.
Ill
Nitrate
and
Nitrite
11qx9
P�lbse�
Name of Cmp IYPe
ReceiviugResidual
App licaoon
Crop 1
Crop 2
Crop 1
Crop 2
3-2022
299000
295
3 332 1
NCO0305967
dry
0
s
M
03
43000
5170
159
93906
1.A
Cum
11-3032
149500
395
1.666
NCO0305967
dry
0
s
0.5
03
43000
5170
159
46.953
1\A
Coro
0.000
0 000
0 000
0 000
0 000
0 000
0 000
0.000
0.000
j
0 000
0000
0.000
0 000
0.000
0000
0 000
0.000
0 000
0 000
0.000
0.000
0 000
0.000
0.000
0 000
0.000
0.000
0 000
0.000
0 000
Residuals Applicatious totals on FORM FSFsupp ( attach FORM FSF supp to this form):
TOTALS
01
4495o0
As
Cd
Cu
Cr
Pb
HE
Mo,
Ti
Se
Zn
P
140.859
0.00o
Lime Applied
Ammallbs/acre
0.167
0.033
3.049
0.244
0.177
30.902
0.083
0.177
0.167
5.168
310.876
Date
lbsrac
Prior Years CumulativelbVac
0169
0.039
9672
1847
0.873
0.03
0.16
3.103
0.131
34.673
12-22
1000
COITent Cumulative lbstac
0 336
0 072
11.731
2 091
1.049
20.932
0.343
2 380
0.388
29 M
Permitted C. F L- R....
36
34
1338
NA
267
15
NA
374
89
2498
Permit PAN Lint Ist2nd Crop
1 207
"I certifv,under penalty of Ian-, that this document n as prepared under my direction or supertision in accordance Stith a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and implisonment for (mowing tiolations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
2-24-2023 ;'Volatilization Rate: Surface - 0.5, Ini ectionRncorporation - 1.0
-*x Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
Signature of Land Applier Date aerobically digested -0.3, ran- sludge -0.4
ssssC.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1 M006)

l", U-IL LAND APPLICATION FIELD SUMLARY FORIM
PLEASE TLALT A COPY OF THIS BLANK FORI1l TO BE COTIPLETED AND SLBTIITTED FOR EACH FIELD APPLIED ON
PLACE A "NA" IN A BLANK OR BOX 35`$EN NOT APPLICABLE.
Facility Name: U.S Biosolids, Inc R'QPermit 0: X Q0037135 Field 4: NC-ANX-13P :acres Utilized: 29.35 _
Land Owner: William Porter Annual Dry Tons Applied: 70,8416 Site 4: 2 :acres Permitted: 29.35
Operator: W liam Potter
Crop 1 Dame: Corn
Predominant Soil Series; FcB2
Crop 1 Tlam PAN: 207 Crop _ Name:
Cation Exchange Capacity (non 503):
Crop 2 alam PAN:
e t
c
Vobrmeapplied
(enterone)Solads/
Liquid
CuYds Gallons
eo
Solids
4ob�me
APPI dP�
Am
(DryT- Ac)
Residual Sources
(I4PDES ,NQ ,
Fero, Auisal
Nast etc
e' )
Cold
(Dry,
Net,
Moir�l
Precip.
Pass 4
His.
encnas
I'm
o
74
A c
_Q_
$
TSN
m4.tg
Z 3
eta o
9 v
Nitrate
and
N.ke
,rq
PA1:AppBed
(Qfs'aae)
Nan:eofCropType
ReceningR,esidual
Application
Crop1
Crop?
Crop
Crop
3-2023
351000
4.84
2.414
N00020761
dry
0
s
0.5
0.3
106000
5480
338
160.433
NA
Cam
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0 000
0 000
0.000
0.000
0.000
0.000
0 000
0 000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Ll
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp (attach FORS
FSF supp to this forus):
TOTALS
o
3il000
As
Cd
Cu Cr
Pb
HP
Info
Ni
Se
Zn
P
160433
0.0oo
Lime,�trolied
AE=llbs/acre
0.050
0.010
2.058 0200
0.164
0.018
0.025
0100
0.050
5.447
8290t
Date lbslac
Prior Years Cimilative lbs/ac
0.354
0.071
15.194 2.153
1268
0.058
0227
2947
0291
36215
CtuTew Cumrlative lbslac
0.404
0.081
17.252 2.353
1.432
0.076
0,252
3 047
0.3 1
41.662
�
Permitted C. P. L. I` I " *
36
34
1338 77A
267
15
NA
74
89
2498
Permit PAN limit lst2nd Crop
F 207
"1 certify, under penalty of law, that this document i%as prepared under my direction or superiision in accordance pith a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. la m aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for inossing iiolations."
sApplication Method: S - Surface, r - Injection, INC - Incorporation
2-12-202 . 4 **Volatilization Rate: Surface - U, InjectiolIncorporation- 1.0
Signattne of Land Applier Date "" Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobicalh-
digested -03, ran sludge -0.4
";••C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

AM, IL LAND APPLICATION FIELD SUMURY FORIM
PLEASE \LkIT A COPY OF THIS BLANK FORM TO BE COh PLETED AND SUB?%UTIID FOR EACH FIELD APPLIED ON
PLACE?. "N, A" IN A BLAINK OR BOX 11"HEN NOT APPLICABLE.
Facility Name: U.S Biosolids, Inc. R'QPermit'O: N Q0037135 _ Field 4: NC-1VK-BP :acres Uilized: 13.36
Land Owner: William Pater Annual Dry Tons Applied: 15,7426 Site 4: 3 Acres Permitted: 13.36
Operator: W E= Porter
Crop 1 Name: Cain
Predominant Soil Series: FcB2
Crop 1 Max. PAN: 207 Crop _Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
e t
r
Vobimeapplied
(enterone)Solids/
Liquid
CuYds Galbns
e6
Solids
4ohm:e
APPIbdP�
Acre
(DryTasa.Ac)
Residual Sources
(NPDES ,NQ ,
Fert., Auival
Haste, etc )
Cold
(Dry,
DiY
Net.
moistl
Precip.
Post
Firs-
"'Chas
zc
o
U g
3
m a
a
a.
: _Q
8
TKr
ms't9
z 3
a3 3
9 a
^K9z9
Nitrate
and
Nmise
-'J"
PAN Applied
E�a�
( )
NameofCropType
ReceningResidoal
Application
Crop)
Crop2
Crop1
Crop2
3 ?023
79000
4.84
1.178
N00020761
dry
0
s
0.5
0.3
106000
5480
338
78322
NA
Corn
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0 000
0 0O0
0.000
0.000
0.000
0.000
0 000
0 000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORDS FSF supp b this forn):
TOTALS
01
moa
As
Cd
Cu
Cr
Pb
He
Mo
Ni
Se
Zn
P
78.322
0.00o
Lime .kpplied
Annuallbs/acre
0.025
0.005
1.006
0.098
0.080
0.009
0.012
0049
0.025
2.662
40.523
Date
lbac
Pilot Yeas Ctmmlative lbs�ac
0.232
0.044
8.956
1.158
0 766
0.029
0.144
1.315
0.202
21.427
Cmunt Cumilative lbsiac
1 0.257
0.049
9,962
1256
0.846
0.038
0.156
1.364
0,227
24.089
Permitted C. P. L. R.•s•s
136
34
1338
NA
267
15
NA
74
89
2498
Permit PAN Limit 1st2nd Crop
I207
"I certify, under penalty of law, that this document mas prepared under my direction or supersision in accordance pith a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware t1mt there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for lmotsing viola lions."
(� 2-i 2-202 4 s'�pplication Method: S - Surface, IN - Injection, INC - Incorporation
/ _ "Volatilization Rate: Surface - 0.5, Injection -Incorporation - 1.0
Signal cue And Appher Date i" Mineralization Rates: Compost -0.1, anaerobiall- digested -0.2, aerobically
digested -0.3, raw sludge -0.4
";••C.P.L.R.: Cumulative Pollutant LoadingRate
DENR FORM FSF (1212006)

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids. Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
SK-01
No
Fescue
Hay
SK-02
No
Fescue
Hay
SK-03
No
Fescue
Hay
SK-04A
No
Fescue
Hay
SK-04B
No
Fescue
Hay
SK-04C
No
Fescue
Hay
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Step hen Key
Address: 540 DennYville Road
City: _ _ Ronda State: _ NC Zip: 28670
Phone: 336- -9058 _ Email address:_ cowman37 a aol com _
Signature: Date: /�
NORTH CAROLINA, Wilkes COUNTY
1, the undersigned Notary Public do hereby certify that _ Stephen Key
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the 13 _ _
day of
Signature and seal:
My commission
4-Q,3V kJ
'sRY KFI,
coUoN
-_ WllKes
Lessee's/Operator's Certification:
,,,OPT H C
I certify that I have read this Agreement and do hereby agree to abide by the stip"af ti ow restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State: Zip:
E-mail address:
Date:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: �Zaach Ke;'
Signature: �� /1�L Date:
4-1-2024
FORM: LOA 06-16 Page 3 of 3

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc. WQ Permit #: WQ0037135 Field #: NC-WK-SK Acres Utilized: 17.1
Land Owner: Stephen Key Annual Dry Tons Applied: 28.8614 Site #: j Acres Permitted: 17.1
Operator: Stephen Key Predominant Soil Series: FcB2 Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue Crop 1 Max. PAN: 188 Crop 2 Name: Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
Q
� o�
o
?�
°�
7
?Y
TKN
mg/kg
Z a
o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
7-2023
143000
4.84
1.688
NCO020761
dry
0
s
0.5
0.3
106000
5480
338
112.185
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
01
143000
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
112.1851
o.000
Lime Applied
Annuallbs/acre
0.035
0.007
1.442
0.140
0.115
0.013
0.018
0.070
0.035
3.815
58.067
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.028
0.006
1.708
0.256
0.145
0.004
0.018
0.125
0.028
3.427
Current Cumulative lbs/ac
0.063
0.013
3.150
0.396
0.260
0.017
0.036
0.195
0.063
7.242
Permitted C. P. L. R.****
36
1 34
1 1338
1 NA
1 267
1 15
1 NA
1 74
1 89
1 2498
Permit PAN Limit 1 st/2nd Crop
188
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
ff MIA
Signature of'�and Applier
2-12-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Stephen Key
Operator: Stephen Key
Crop 1 Name: Fescue
WQ Permit #: WQ0037135 Field #: NC-WK-SK
Annual Dry Tons Applied: 18.3663 Site #: 4A
Predominant Soil Series: FCB2
Crop 1 Max. PAN:
188
Crop 2 Name:
Acres Utilized: 7,I
Acres Permitted: 7.1
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
7-2023
91000
4.84
2.587
NCO020761
dry
0
s
0.5
0.3
1060001
5480
338
171.940
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
01
91000
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
171.940
0.000
Lime Applied
Annuallbs/acre
0.054
0.011
2.209
0.215
0.176
0.020
0.027
0.108
0.054
5.847
88.993 1
Date
lbs/ac
Prior Years Cumulative lbs/ac
0
0
0
0
0
0
0
0
0
0
Current Cumulative lbs/ac
0.054
0.011
2.209
0.215
0.176
0.020
0.027
0.108
0.054
5.847
Permitted C. P. L. R.****
36
34
1 1338
1 NA
1 267
1 15
1 NA
1 74
1 89
1 2498
Permit PAN Limit 1 st/2nd Crop
1
1 188
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
2-12-2024
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

UZR
O
7.1 ac.
Field 4b
3.47 ac.
Field 3 Field 4c
c. 3.5 a
2.73 ac.
%I;
7
,I
Legend
Property Line Stream
FiPlrl Rniinrlary A RPrirlPnrP
1—I-+ Fence o Well
Buffer
0 Property Line (50') 0 Stream (100')
0 Residence - Waiver (100') 0 Well (100')
0 Residence - No Waiver (400')
Southern Soil Builders, Key & Kirkman Tract N
Stephen D. Key & Byron B. Kirkman
540 Dennyville Rd. Ronda, NC W E
S
0 250 500 750 1000 ft
Parcel: 0605588 I I I I I
Wilkes County, NC
36.2532,-80.9459 North Carolina State Plane, NAD83
Produced: 2024
Created by: Joseph

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit.
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit
this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
❑ Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
❑ Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
❑ A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name: U.S. Biosolids, Inc.
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
LW1
No
Fescue
Hay
LW2
No
Fescue
Hay
LW3
No
Fescue
Hay
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

L STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section II) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1617 Mail
Service Center, Raleigh, NC 27699-1617.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the land
application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of the
equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals land
application event and a copy of the results of each soil analysis.
8. If the soil pH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final soil
pH of at least 6.0, unless an agronomist provides information indicating that the pH of the soil, residuals and lime mixture is suitable for the
specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of nutrients
(e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land application
events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
tern of, and 12 months after termination of, this Agreement.
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land application
site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the posting of
signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods after such residuals land application
events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-month
period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land application
event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land application
event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
III. ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105(hl allows the compliance
boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance boundary provided
the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
❑ A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location of the compliance boundary and attach a map showing the newly proposed compliance
boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Barbara Walker
Address: 4493 Clin man Road
City: Ronda State: NC Zip: 28670
Phone: [phone] E-mail address:
Signature: Date:
NORTH CAROLINA, Wilkes COUNTY
1, the undersigned Notary Public do hereby certify that Barbara Walker
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
+
�� /
WITNESS my hand and official seal this the
day of / / /
Signature and seal:
z-
My commission expires: �'�
Lessee'stOperator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail address:
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official name: ZachhiKey
Signature: /� Date: 4-1-2024
FORM: LOA 06-16 Page 3 of 3

❑A
".
no
Southern Soil Builders, Walker Tract - Field 1
Barbara Walker
4493 Clingman Rd. Ronda, NC
Buffers
0 Property Line (50') 0 Stream (100')
0 House (400') 0 Drain (25')
0 Well (100')
. . . . . . . . . . . .
Legend
— Property Line House
Field Boundary • Well
Perennial Stream ® Unused Area
rain
✓z�iiii Dinar..cirw�rr✓urrr�iiiiin�i/^r,.rs.T/� �
0 250 500 750 1000 ft
I I I I I
N
WJJ�E
S
Parcel: 1300676
Wilkes County, NC Produced: 2024
36.1606,-80.9292 North Carolina State Plane, NAD83 Created by: Joseph Jarvis

�1
FAI
A"
❑�
Southern Soil Builders, Walker Tract - Field 2 N
Warren Lee Walker
4493 Clingman Rd. Ronda, NC W E
S
0 250 500 750 1000 ft
Parcel: 1300676
Wilkes County, NC Produced: December, 2018
36.1634,-80.9289 North Carolina State Plane, NAD83 Created by: Joseph Jarvis

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ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
Facility Name: LDS Biosolids, Inc:.
Land Owner: Lee Walker
Operator: Lee Walker
Crop I Name: Fescue
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
WQ Permit #: WQ0037135
Annual Dry Tons Applied: 31.02
Predominant Soil Series: FeB-Fairview
Crop I Max. PAN:
Field #: NC - -LW
Site #: 2
188 Crop 2 Marne:
Acres Utilized: 8.16
Acres Permitted: 8.16
Cation Exchange Capacity non 503):
Crop 2 Max. PAN:
..:
Volume applied
(enter one) Solids/
Liquid
Cu. ids Gallons
fsx
Solids
Volume
Applied per
pP P
Acre
{pry TonsrAc}moist)
Residual Sources
(NPDFS #, WQ4,
Fert.. Animal
Waste,etc }
oi1
Cord,
(Dry-
, -
ct
Precip.
past 24
1-Irs.
inches
;
_
� �,
S �
� �
�"
� _
�
�
� �
� �
=
�
TKN
,n /X
g g
0
�� �
m !kc
9 9
Nitrate
and
Nitrite
m tk
� 9
PAN Applied
l _�
( b� acre )
Name ofC'rop 'Ty'1�
Receiving c�sidual
Application
Crop 1
P
Crop 2
P
Crop I
P
Crop 2
P
5-2021
11O500
5.4
3.049
NCO020761
dry
0
s
0.5
0.3
44600
7720
415
93.547
NA
fescue
9-202)
65000
2.46
0.817
NCO020567
dry
0
s
0.5
o.a
60400
4840
195
31.514
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.O00
Residuals Applications totals on FORM FSF supp { attach FORM FSF supp to this form):
.1 O AI. :
01
1755001
As
Cd
Cu
Cr
Pb
H g
Mo
Ni
Se
n P
125.060
0.000
Lime me lied
Annual lbs/acre
0.089 0.018 2.534 0.374 0.2.33 0.008 0.053 0.160 0,089 6.706 112.919
0.194 0.038 8.021 1.249 0.674 0.026 0.14 0.487 0.19 19.448
0.293 0.056 10.555 1.623 0.907 0.034 0-193 0.647 0.279 25.154
36 34 133 NA 267 15 NA 1 374 1 99 249
1 188
Date
l bslao
Prior Years Cumulative lbslac
0
Current Cumulative lbslac
Permitted C. P. L. R.
Permit PAN Limit 1 stl2nd Crop L
"I certify, under penalty of law, that this document was Prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting fare
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Lard Applier
'Application Method: S - Surface, IN - Injection, INC - Incorporation
"Volatilization Rate: Surface - 0.5, Injection/incorporation - 1.0
Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
""C.P.L.R.. Cumulative Pollutant Loading hate
DENR FORM FSF (1 /2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids, Inc.
Land Owner: Lee Walker
Operator: Lee Walker
Crop 1 Name:
Fescue
WQ Permit #: WQ0037135 Field #: NC-WK-LW
Annual Dry Tons Applied: 47.9596 Site #• 3
Predominant Soil Series: FeB2-Fairview
Crop 1 Max. PAN:
188
Crop 2 Name:
Acres Utilized: 17.7
Acres Permitted: 17.7
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist
Precip.
Past 24
Hrs.
inches
a
c� S
o
Q
� o�
o
N
?�
°�
7
?Y
TKN
mg/kg
Z a
o
°
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
3-2023
175500
4.84
2.001
NCO020761
dry
0
s
0.5
0.3
1060001
5480
338
133.014
NA
Fescue
10-2023
117000
2.57
0.708
NCO020567
dry
0
s
0.5
0.3
72300
10800
192
34.063
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS
01
292500
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
T67-5771
0.000
Lime Applied
Annuallbs/acre
0.069
0.014
2.049
0.201
0.162
0.025
0.034
0.108
0.069
5.263
116.129
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.27
0.057
8.614
1.374
0.741
0.03
0.188
0.532
0.268
22.401
Current Cumulative lbs/ac
0.339
0.071
10.663
1.575
0.903
0.055
0.222
0.640
0.337
27.664
Permitted C. P. L. R. * * * *
36
34
1 1338
1 NA
1 267
1 15
1 NA
1 74
1 89
1 2498
Permit PAN Limit 1 st/2nd Crop
1
1 188
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
�" Al 2-12-2024 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier
Date
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically
digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: U.S. Biosolids,lnc.
Land Owner: Lee Walker
Operator: Lee Walker
Crop 1 Name: Fescue
WQ Permit #: WQ00037135 Field #: NC-WK-LW
Annual Dry Tons Applied: 10.3948 Site #: 1
Predominant Soil Series: FcB2
Crop 1 Max. PAN:
188
Crop 2 Name:
Acres Utilized: 14.05
Acres Permitted: 14.05
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
Q
Volume applied
(enter one) Solids/
Li uid
4
Cu. Yds Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
CondSoil
.
Moist)
precip.
Past 24
Ms.
inches
a
c� '5
o
*
p
?�
*
o
TKN
mg/kg
Z
o 5
as °
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
6-2022
84500
2.95
0.740
NCO020567
dry
0
s
0.5
0.3
43000
5170
1 159
20.853
NA
Fescue
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
1
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
01
84500
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn P
20.853
0.000
Lime Applied
Annuallbs/acre
0.025
0.005
0.303
0.036
0.026
3.095
0.012
0.026
0.025
0.765 46.028
Date
lbs/ac
Prior Years Cumulative lbs/ac
0.138
0.03
6.039
1.023
0.52
0.02
0.111
0.384
0.135
16.074
0
Current Cumulative lbs/ac
0.163
0.035
6.342
1.059
0.546
3.115
0.123
0.410
0.160
16.839
Permitted C. P. L. R.****
36
1 34
1 1338
1 NA
1 267
1 15
1 NA
374
1 89
1 2498
Permit PAN Limit lst/2nd Crop
F 188
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)