WQ0032723_2023 Residual Annual Report_20240409 (2)

Initial Review
Reviewer
nathaniel.thorn burg
Is this submittal an application? (Excluding additional information.) *
Yes No
If not an application what is the submittal type?* Annual Report
Residual Annual Report
Additional Information
Other
Annual Report Year* 2023
Permit Number (IR) * WQ0032723
Applicant/Permittee City of Reidsville
Email Notifications
Does this need review by the hydrogeologist? * Yes U No
Regional Office Winston-Salem
CO Reviewer
Admin Reviewer Wanda Gerald

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* w. Blake Slaughter
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*
3363424001
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:*
WQ0032723
Has Current Existing permit number
Applicant/Permittee Address*
230 W Morehead St
Facility Name*
City of Reidsville Class A Residuals Program
Please provide comments/notes on your current submittal below.
This was thought to be submitted by Synagro. Although it was not. So it is being submitted late. There was no land applying for 2023.
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.)
COR WTP LA Annual Report 2023.pdf 784.92KB
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
%l% ,��la.Fi^ � 5✓anyiitN
Submission Date 4/9/2024

435 Williams Court, Suite 100
B,ALi more, _MD 21220
-w-w' 6r.synagro.com
APRIL 5, 2024
NCDEQ
Information Processing Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: 2023 Annual Report for Permit No. WQ0032723
Dear NCDEQ:
SYNAGRO
Synagro is submitting this 2023 No -Operations Annual Report on behalf of the City of
Reidsville, NC. During the calendar year 2023, Synagro did not land apply residuals For this
client.
If you have any questions or need additional information, please do not hesitate to contact Blaine
Slaughter at 336-932-4799 or Adam Brigman at 704-650-4341.
Sincerely,
Y-)e}ifdzk Shivax 25
Derrick Shivar
Environmental Compliance Manager
Enclosures
w Blake Slaughter, City of Reidsville
Adam Brigman, Synagro
YOUR PARTNER FORA CLEANER, G EEMER,WORLD

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit #: W00032723 County Rockingham Year 2023
Facility Name (as shown on permit) Reidsville WTP NPDES No. NC0026352
Land Application Operator S3Magro Phone# [phone]
Land application of residuals as allowed by the above permit occurred during the past calendar year?
_YES X NO. If NO, skip Part A, and Part 13 and proceed to Part C. Also, if residuals were generated but not land applied,
please attach an explanation on huw the residuals were handled.
Part A — Residuals Application Summary:
Total number of application fields in the permit:
Total number of fields utilized for land application during the year:
Total amount of dry tons applied during the year for all application sites:
Total number of acres utilized for land application during the year:
Part B — Annual Compliance Statement:
Fa "lity was compliant during calendar year 2023 with all conditions of the land application permit (including but not limited to
itei 1- below) issued by the Division of Water QualityYES NO.
IfNs
se rovide ritten description w the fa ility was not com arj the dates, and e�lain corrective ac a
1.ly sid s app p t w p e s
2. wa di d s e d the a 1 w pl if ) 1h ve it H of
limit speci0 2 3
fle m a
3. Annual soils analysis was performed on each sit ecei g 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 .I 105(a) or the Pollutant Loading
Rates in 15A NCAC 02T .1105(b) (Applicable to 40 CFR Part 503 regulated facilities).
7. All general requirements 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 _ 1111 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 Quality.
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_
i t . Vegetative cover was maintained and proper crop management was performed on eacb site receiving residuals, as specified
in the permit.
12. No nrnoff 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 penaltics for submitting false information, including the possibility of fines and imprisonment for
knowing violations."
Blake Sla liter, WTP Su erintendent
Permittee Name and Title (type or print) S&aude of Pennittee Date
Signature of Preparer*
(if different from Permittee)
Date Signature of Land Applier Date
(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 (1212006)

CLASS A ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORM
WQ PERMIT #: WQ0032723 FACILITY NAME: Reidsville WTP
PHONE:[phone] COUNTY: Rockingham OPERATOR: Synagro
FACILITY TYPE (please check one): ❑ Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
v(] Distribution and Marketing (complete Parts A, B, and C)
Was the facility in operation during the past calendar year? Yes ❑ No D --► If No skip parts A, B, C and certify form below
Part A*: Part B*:
Volume (dry tons) Reci lent Information
p
Month Sources(s) (include NPDES # if Amendment/
applicable) Bulking Agent Residual In Product Out Name(s) Volume (dry tons) Intended use(s)
January
February
March
April
May No Land Application in 2023
June
July
August
September
October
November
December
Total from FORM DMSDF (sup) #REF? #REF! #REF! #REF!
Totals: I Annual (dry tons): 0 0 0 0
Amendments used: I Bulking Agent(s) used:
* If more space is required, attach additional information sheets (FORM DMSDF (supp)): Total Number of Form DMSDF (Supp)
Part C:
Facility was compliant during the past calendar year with all conditions of the land application permit 0 Yes
(including but not limited to items 1-3 below) issued by the Division of Water Resources: ❑ No b, If No, Explain in Narritive
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water Resources.
3. No contravention of Ground Water Quality Standards occurred at a monitoring well.
"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."
Signature of Pennrttee Date
**Preparer is defined is 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
Signature of Preparer**
(if different from Permittee)
Date
DENR FORM DMSDF (1212006)