WQ0011431_Renewal Application_20241010

Initial Review
Reviewer nathaniel.thornburg
Is this submittal an application? (Excluding additional information.) *
Yes No
Permit Number (IR) * WO0011431
Applicant/Permittee Town of Cleveland
Applicant/Permittee Address 302 East Main Street; Cleveland, N.C. 27013
Is the owner in BIMS? Yes No Is the facility in BIMS?
Owner Type
Facility Name
County
Fee Category Minor
Is this a complete application?*
Yes No
Signature Authority
Signature Authority Title
Signature Authority Email
Document Type (if non -application)
Email Notifications
Municipal
Town of Cleveland Class B Residuals Program
Rowan
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer
Fee Amount
Complete App Date
10/10/2024
Yes No
$348
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* Rob Willcox
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*
3363399128
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:*
WQ0011431
Has Current Existing permit number
Applicant/Permittee *
Town of Cleveland
Applicant/Permittee Address*
302 East Main Street; Cleveland, N.C. 27013
Facility Name *
Town of Cleveland Class B Residuals Program
Please provide comments/notes on your current submittal below.
Permit Renewal and Modification Application for Town of Cleveland - WQ0011431
Permit Signing Authority to become current Mayor - Patrick Phifer
Check for Modification to add 19.8 new net acres to be mailed ($348.00)
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.)
24-08 Town of Cleveland Residuals Land Application
62.36MB
Program - Permit Renewal Oct-2024.pdf
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
I IU&VIV
Submission Date 10/4/2024

APPLICATION FOR
RESIDUALS LAND APPLICATION PROGRAM
PERMIT RENEWAL AND MODIFICATION
TOWN OF CLEVELAND WWTP
PERMIT NO. WQ0011431
WMSS Project No. 24-08
Prepared for:
Town of Cleveland
302 East Main Street
Cleveland, North Carolina 27013
Prepared by:
Willcox & Mabe Soil Solutions, PLLC
7231B Summerfield Road
Summerfield, North Carolina 27358
willcox&mabe
SO 1 L SO LUT I ON S
October 2024

willcox&mate
SO I L SOL U T I ON S
October 4, 2024
NCDEQ/DWR
Water Quality Permitting Section
Non -Discharge Branch
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Attention: Non -Discharge Branch
Reference: Application for Residuals Land Application Program
Permit Renewal and Modification
Town of Cleveland WWTP
Permit No. WQ0011431
Willcox & Mabe Soil Solutions, PLLC Project No. 24-08
Non -Discharge Permitting Branch:
Willcox & Mabe Soil Solutions, PLLC (WMSS) is submitting the enclosed Residuals Land
Application Program Permit Renewal and Modification application for the Town of
Cleveland WWTP (Cleveland) on behalf of Cleveland. The permit renewal package
includes information for:
• Renewal of one field (10.0 net acres), Town of Cleveland (Site 1, Field 1).
• Modification to add two fields (19.8 acres), Charles Barber (Site 2, Field 1 and 2).
• Change Permit signing authority from previous Mayor, Danny Gabriel to current
Mayor, Patrick Phifer.
• Current annual volume of 82.0 dry tons to remain the same.
If there is any further information required or questions regarding this application please do
not hesitate to contact Cleveland, Ms. Kelly Rodgers at [phone], or WMSS at (336)
339-9128 for further assistance.
Sincerely,
Willcox & Mabe Soil Solutions, PLLC
i
Martin Mabe
Agronomist
cc: Town of Cleveland
Rob Willcox, L.S.S.
Soil Scientist
Shared\WMSS Projects\2024\24-08 Town of Cleveland\2024 Permit Renewal\24-08 Town of Cleveland Residuals Land Application
Program - Permit Renewal August-2024.doc
Willcox & Mabe Soil Solutions, PLLC / 7231 B Summerfield Road / Summerfield, NC 27358 / Rob 336.339.9128 or
Martin 336.312.1396 / www.willcoxmabesoil.com

TABLE OF CONTENTS
Page 1
APPENDIX TITLE
I RESIDUALS LAND APPLICATION PROGRAM
APPLICATION FORM
(FORM: RLAP 06-16)
OPERATION AND MAINTENANCE PLAN (No Changes)
COPY OF EXISTING PERMIT
(PERMIT NO. WQ0011431)
II RESIDUALS SOURCE CERTIFICATION
• TOWN OF CLEVELAND
(FORM: RSC 06-16)
III LAND APPLICATION SITE CERTIFICATION
(FORM: LASC 06-16)
WATERBODY AND CLASSIFICATION INFORMATION
IV COUNTY BOARD NOTIFICATION
(FORM: CBN 06-16)
Renewal Site
V TOWN OF CLEVELAND (SITE 1, FIELD 1)
LANDOWNER AGREEMENT
(FORM: LOA 06-16)
UPDATED SITE MAPS
UPDATED CUMULATIVE POLLUTANT LOADING RATES
Modification / New Site
VI CHARLES BARBER (SITE 2, FIELD 1 AND 2)
LANDOWNER AGREEMENT
(FORM: LOA 06-16)
SITE MAPS
SOILS AND AGRONOMIC EVALUATION

APPENDIX I
RESIDUALS LAND APPLICATION PROGRAM
APPLICATION FORM
(FORM: RLAP 06-16)
OPERATION AND MAINTENANCE PLAN (Updated)
COPY OF EXISTING PERMIT
(PERMIT NO. WQ0011431)

RESIDUALS LAND APPLICATION PROGRAM
APPLICATION FORM
(FORM: RLAP 06-16)

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 con_ ies of the an_ alication and
suuportin2 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). Renewal and Modification — Modification Fee (<300 acres — $348)
Facility Classification New Permit Major Modification'
Major (land are permitted for < 300 acres) $1,310 $395
Minor (land are permitted for < 300 acres) $810 $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 (May be Required — See 15A NCAC IC .0300) (N/A)
❑ 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) (NO CHANGES — APPENDIX I)
❑ 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. (N/A)
F. Program Determination
❑ Dedicated residuals land application programs are ones in which land application sites meet the criteria in 15A NCAC 02T
.1102(12). 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 I" 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

I. 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: httD://www.ncwater.ore_ /Rules Policies and Reculations/. 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 .I 104(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 .1104(d)(5) and current Division Policy
available at: htto://www.ncwater.orp-/Rules Policies and Reeulations/.
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
ElWritten 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(t), 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/SDecial Deliverv:
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
I. APPLICANT INFORMATION:
1. Applicant's name: Town of Cleveland
Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State ® Municipal ❑ County
Signature authority's name per 15A NCAC 02T .0106: Patrick Phifer Title: Mayor
Applicant's mailing address: 302 East Main Street
City: Cleveland State: N.C. Zip: 27013
Telephone number: [phone] Email Address: clerk @townofclevelandnc.eov
2. Consultant's name: Rob Willcox. L.S.S. License Number (for P.E.): N/A
Affiliation: ❑ On Staff ® Retained (Firm: Willcox & Mabe Soil Solutions. PLLC)
Consultant's mailing address: 7231B Summerfield Road
City: Summerfield State: N.C. Zip: 27358
Telephone number: [phone] Email Address: [e-mail]
3. Agronomist's name: Martin Mabe License Number: N/A
Affiliation: ❑ N/A ❑ On Staff ® Retained (Firm: Willcox & Mabe Soil Solutions. PLLC)
Agronomist's mailing address: 7231B Summerfield Road
City: Summerfield State: N.C. Zip: 27358
Telephone number: [phone] Email Address: [e-mail]
4. Soil Scientist's name: Rob Willcox. L.S.S. License Number: 1098
Affiliation: ❑ N/A ❑ On Staff ® Retained (Firm: Willcox & Mabe Soil Solutions. PLLC)
Soil Scientist's mailing address: 7231B Summerfield Road
City: Summerfield State: N.C. Zip: 27358
Telephone number: [phone] Email Address: [e-mail]
5. Fee submitted: $348.00 (See Instruction B)
II. 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: W00011431
Date of most -recently issued permit: September 13. 2019
Date of most -recently certified Attachment A (if different than the permit):
Date of most -recently certified Attachment B (if different than the permit):
FORM: RLAP 06-16 Page 1 of 5

II1. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing Facility's physical address: Third Creek Church Road
City: Cleveland State: N.C. Zip: 27013
Coordinates: Latitude: 35° 44' 37.7" Longitude: 80° 40' 59.8"
Datum: NAD83 Level of accuracy: one tenth of a second
Method of measurement: MAP
2. County where residuals land application program is headquartered: Rowan
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 Robert P. Willcox, Jr. Willcox & Mabe Soil 13285
Solutions, PLLC
Back -Up ORC Martin E. Mabe Willcox & Mabe Soil Solutions, PLLC 22753
Additional Back -Up
ORCs
(if applicable)
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 Nitroeen Summarv: 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: 82.0 dry tons per year.
PAN Pounds of PAN per Dry Ton
Pounds of PAN per Year
(Weighted Average)
Surface Incorporation
Surface Incorporation
or Injection
or Injection
First -Year 41.18 41.19
3,377 3,378
Five -Year Maximum Adjusted 58.04 58.04 4,759 4,759
b. Land Application Site Use Summarv: Summarize information regarding the land application sites as currently certified and
proposed for certification with this application:
Category
Crops
Methods
FORM: RLAP 06-16
Use
Acres
Comments
Forest or Plantation
Row Crops
Hay
10.0
10.0 - renewed
Pasture
19.8 — proposed
Total:
10.0
29.8
Surface
10.0
29.8
Incorporation or Injection
Total:
10.0
29.8
Page 2 of 5

c. Residuals Land Application Summarv: 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 Acres Required Using Acres Required Using
Application Rate First -Year PAN Concentrations Five -Year Maximum Adjusted PAN
(lbs PAN/ac yr) Concentrations
Surface
Incorporation or
Surface
Incorporation or
Injection
Injection
50
67.5
67.6
95.2
95.2
100
33.8
33.8
47.6
47.6
150
22.5
22.5
31.7
31.7
200
16.9
16.9
23.8
I 23.8
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.):
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.
Residuals Source
Certification APPENDIX II
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.
®
Land Application Siite
Certification.doc APPENDIX III
FORM: RLAP 06-16 Page 3 of 5

Note: Item VI. Applicable to Dedicated Program with fixed irrigation system onlv.
VI. DESIGN INFORMATION FOR FIXED IRRIGATION SYSTEM (N/A)
1. The irrigation system is: ❑ Spray ❑ Drip
2. Disposal system is: ❑ existing ❑ 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(n) 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:
Recommended Recommended
Soil Series Fields within Soil Area Loading Rate Loading Rate
(in/hr) (iWyr)
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
Number of
Maximum Application
Design Annual Loading
W)
Nozzles
Rate (gallons/hr)
Rate (gallons/yr)
1
Total I
Spray Irrigation Design Element Plan Sheet Specification
Number Page Number J
Wetted diameter of nozzles ft
Wetted area of nozzles ft'-
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 13A NCAC 021' .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 ❑ No, Explain;
I, Patrick Phifer Mavor
(Signature Authority's Name — PLEASE PRINT) (Title)
attest that this application for Renewal & Modification to the Town of Cleveland Non -Discharge Permit No. WO0011431
(Facility Name)
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:
1,4c;
;
Date: 0' /,7 °-262;7Z
FORM: RLAP 06-16 Page 5 of 5

OPERATION AND MAINTENANCE PLAN (No Changes)

OPERATION AND MAINTENANCE PLAN
Town of Cleveland
Non -Discharge Permit No. WQ0011431
LAND APPLICATION OF CLASS B BIOSOLIDS
Town of Cleveland Wastewater Treatment Plant (WWTP)
Class B Biosolids Description and Overview
The purpose of the Town of Cleveland Operation and Maintenance Plan is to put into
place a plan that implements the requirements of North Carolina Department of
Environmental Quality (NCDEQ) — Division of Water Resources (DWR) Class B Land
Application Permit (WQ0011431).
1. Operational Functions
The operational functions of this program involve hauling biosolids from the respective
WWTP to the land application sites permitted under NCDEQ-DWR and land applying
the biosolids in accordance with regulatory requirements. Biosolids will be land applied
at or below agronomic rates that are determined using the Realistic Yield Expectations
(RYE) as outlined in the permit. The current land application contractor will also
account for any nutrient sources the landowner/lessee has applied. Some source(s) may
be land applied as either a liquid or cake material utilizing either pumper trucks, vacuum
trucks, tractor trailer, tractor and cake spreader and/or tractor and pull tank. In some
instances, biosolids may have to be injected or surface applied with incorporation
depending upon the pathogen and vector attraction reduction methods employed by the
respective WWTP. Whichever method is utilized to land apply the biosolids, the current
land application contractor will spread evenly and at consistent rates. Biosolids will be
land applied on fields that are used for hay production, grazing, or row crop production
harvested for animal feed. In the case where biosolids are land applied on fields utilized
for grazing, applications rates will be reduced by 25% in accordance with USDA-NRCS
590 Nutrient Management Standards. Grazed fields will be determined by the current
land application contractors Manager on site.
11. Maintenance Schedules
The Town of Cleveland staff is responsible for maintenance of the facilities and
equipment at the respective WWTP's. The current land application contractor is
responsible for maintenance of the equipment associated with the land application
program.

Operation and Maintenance Plan
Town of Cleveland - Class B Biosolids
Permit No. WQ0011431
Safety plans and training are the responsibility of the personnel associated with the land
application program. All employees involved with the land application program will be
required to comply with safety plans and training as applicable to the Class B Biosolids
Permit.
Land application program employees shall be trained, as appropriate, in general
awareness for the protection of water and pollution prevention general practices. This
training will be provided as part of a new employee orientation program or as part of
ongoing environmental awareness training. General refresher training for those
employees involved will be provided in accordance with applicable regulatory or permit
requirements.
III. Spill Response Plan
Includes the following:
• Spill Control Plan (Attached),
• Spill Prevention Plan (Attached),
• Spill Control, Containment and Cleanup Plan (Attached).
IV. Inspection Plan
The land application Operator in Responsible Charge (ORC) or personnel under direct
supervision of the ORC has responsibilities to include daily inspections of WWTP and
land application sites (when land application activities are scheduled). The ORC will
maintain daily record keeping logs of land application activities, inspections of field
applications equipment and maintenance, loading operation, roads, crops, crop
maintenance and harvesting practices. All daily record keeping logs will be coordinated
with the ORC at the end of each day.
In the event that a noncompliance event is observed during any inspection, the ORC of
the WWTP will be immediately notified. The ORC will determine the course of action to
be taken in order to rectify the noncompliance issue. NCDEQ will be notified 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.
At a minimum, these inspections will consist of the following:
• Verify that a biosolids analysis has been collected prior to land application
activities being performed and that it meets the criteria for land application.
• Verify that pathogen and vector attraction reduction data has been collected for
the source to be land applied and that it meets the criteria for land application.
• Verify the crop that is planted or is to be planted on the respective field(s).
0 Confirm that the correct amount of biosolids are being land applied.

Operation and Maintenance Plan
Town of Cleveland - Class B Biosolids
Permit No. WQ0011431
• Confirm that manned equipment has a copy of the permit and the operations and
maintenance plan.
• Check that the field has been properly flagged and that buffers are adhered to.
• Check that proper signage is posted.
• Confirm that records are turned in at the end of each business day.
Inspections will also be conducted by the respective employees of the biosolids
generating facilities (at the source generating facility). The land application
contractor will not be responsible for inspections at the source generating facilities.
These inspections should be conducted by the respective ORC of each facility and
should fall under their own Operations and Maintenance Plans.
V. Sampling and Monitoring Plan
The respective WWTP's Class B Biosolids will be monitored to confirm compliance with
conditions in Non -Discharge Permit No. WQ0011431 to include:
• Toxicity Characteristics Leaching Procedure (TCLP),
• Reactivity, Ignitability and Corrosivity,
• 15A NCAC 02T .1105 Pollutant Limits and nutrient analysis,
• Pathogen and Vector Attraction Reduction requirements,
• Annual Representative Soil Analysis of each field which receives land application
during each respective year.
• Any other applicable Permit conditions.
All sampling and monitoring shall be performed in accordance with the current Permit.
Pollutant concentrations in the Town of Cleveland WWTP Class B Biosolids shall not
exceed the following Ceiling Concentrations (i.e., dry weight basis) or Cumulative
Pollutant Loading Rates (CPLRs):
Ceiling Concentration
Parameter
(milligrams per
CPLR
kilogram)
(pounds per acre)
Arsenic
75
36
Cadmium
85
34
Copper
4,300
1,338
Lead
840
267
Mercury
57
15
Molybdenum
I 75
n/a
Nickel
420
374
Selenium
100
89
Zinc
7,500
2,498
3

Operation and Maintenance Plan
Town of Cleveland - Class B Biosolids
Permit No. WQ0011431
The Town of Cleveland WWTP Class B Biosolids shall be analyzed to demonstrate it is
non -hazardous under the Resource Conservation and Recovery Act (RCRA). The
analyses [corrosivity, ignitability, reactivity, and toxicity characteristic leaching
procedure (TCLP)] shall be performed annually.
TCLP shall include the following parameters (the regulatory level in milligrams per liter
is in parentheses):
Arsenic (5.0)
Barium (100.0)
Benzene (0.5)
Cadmium (1.0)
Carbon tetrachloride
(0.5)
Chlordane (0.03)
Chlorobenzene (100.0)
Chloroform (6.0)
Chromium (5.0)
m-Cresol (200.0)
o-Cresol (200.0)
p-Cresol (200.0)
Cresol (200.0)
2,4-D (10.0)
1,4-Dichlorobenzene (7.5)
1,2-Dichloroethane (0.5)
1, 1 -Dichloroethylene
(0.7)
2,4-Dinitrotoluene (0.13)
Endrin (0.02)
Hexachlorobenzene (0.13)
Heptachlor (and its
hydroxide) (0.008)
Hexachloro-1,3-butadiene
(0.5)
Hexachloroethane (3.0)
Lead (5.0)
Lindane (0.4)
Mercury (0.2)
Methoxychlor (10.0)
Methyl ethyl ketone
(200.0)
Nitrobenzene (2.0)
Pentachlorophenol(100.0)
Pyridine (5.0)
Selenium (1.0)
Silver (5.0)
Tetrachloro ethylene (0.7)
Toxaphene (0.5)
Trichloroethylene (0.5)
2,4,5-Trichlorophenol (400.0)
2,4,6-Trichlorophenol (2.0)
2,4,5-TP (Silvex) (1.0)
Vinyl chloride (0.2)
An analysis shall be conducted on the Town of Cleveland WWTP Class B Biosolids
based on conditions (monitoring frequencies) set forth in Permit No. WQ0011431. The
analysis shall include the following parameters:
Aluminum Mercury
Ammonia -Nitrogen Molybdenum
Arsenic Nickel
Cadmium
Nitrate -Nitrite Nitrogen
Calcium
Percent Total Solids
Copper
pH
Lead
Phosphorus
Magnesium
Plant Available Nitrogen
(by calculation)
Potassium
Selenium
Sodium
Sodium Adsorption Ratio
(SAR)
TKN
Zinc
4

Operation and Maintenance Plan
Town of Cleveland - Class B Biosolids
Permit No. WQ0011431
The Town of Cleveland WWTP Class B Biosolids shall be analyzed to demonstrate
compliance with Pathogen Reduction and Vector Attraction Reduction requirements
based on conditions (monitoring frequencies) set forth in Permit No. WQ0011431. The
current Pathogen Reduction Alternatives and Vector Attraction Reduction Options
utilized are as follows:
Pathogen Reduction: Per 15A NCAC 02T.1106
For Land Application of Class B:
0 Alternative 1 [15A NCAC 02T. 1 106(c)(1)] - Fecal Coliform Density Demonstration
or
Alternative 2 [15A NCAC 02T.1106(c)(2)] -Process to Significantly Reduce Pathogens (PSRP)
Specify one: ❑ aerobic digestion, ❑ air drying, ❑ anaerobic
digestion, ❑ composting, or ® lime stabilization.
Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107
For Land Application of Class B:
Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction
(Aerobic/Anaerobic Digestion).
or
® Alternative 3 [15A NCAC 02T.1107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion)
or
® Alternative 6 [15A NCAC 02T.1107(a)(6)] - Alkaline Stabilization
Attachments: Spill Control Plan
Spill Prevention Plan
Spill Control, Containment and Cleanup Plan
Shared\WMSS Projects\2024\24-08 Town of Cleveland\2024 Permit Renewal\DEQ Forms\O&M Plan - Town of Cleveland
- June 2019.doc
4j

TOWN OF CLEVELAND
SPILL CONTROL PLAN
NON -DISCHARGE PERMIT NO. WQ0011431
THE FOLLOWING ACTIONS MUST BE TAKEN IN THE EVENT OF A SPILL:
1. Halt the source of the spill: Ruptured line, valve, or container / damaged tank or
transport unit.
2. Contain spill: Use straw bales to form a barrier. Straw or hay bales can be obtained
from several sources for this purpose. Soil near the site can also be used to form a barrier
for containment.
3. Clean up: Use land application equipment to recover as much of the material as possible.
After the application equipment has recovered as much of the material as possible, it will
be land applied as per the management plan. A temporary sump pit may be dug in the
containment area to enhance recovery, if necessary.
4. Notification: As soon as possible after a spill occurs notify:
NC Department of Environmental Quality
Division of Water Resources Regional Office
Mooresville Regional Office [phone]
• Fire Department if assistance is required for wash down
5. Management of clean up efforts: The responsible party for land application shall take
immediate charge of the clean up activities. Additional labor will be requested as needed.
6. Reporting: Within 24 hours of a spill the responsible party for land application shall
present a written report detailing the cause of the spill and all action taken in response to
the spill. The Mooresville Regional Office shall be notified in no case more than 24
hours or on the next working day following the occurrence.

SPILL PREVENTION PLAN
The spill prevention plan requires that all equipment used to transport biosolids be subject to
periodic safety inspections. Tires, brakes, lights, and turn signals will be inspected for proper
working order. Each truck will be equipped with safety flares and appropriate signs to be used in the
event of a breakdown. Any deficiencies observed during the safety inspections will result in the
vehicle being removed from service and the responsible parry for land application will be notified so
that these deficiencies can be corrected and documented.
Routes leading from the storage point to the land application sites will be inspected for road
hazards. The road hazards will be documented and the drivers will be informed of the hazards.
Alternate routes will be investigated and routes which minimize road hazards will be selected.
Hazardous situations resulting from rush-hour traffic will be avoided during hauling.
Drivers and management personnel associated with the hauling of biosolids will be instructed in the
spill prevention plan and will be required to attend training sessions. Drivers will be trained in
defensive driving techniques in order to minimize road hazards. A driver who observes a road
hazard will be required to report the hazard to the field superintendent who, in turn, will warn other
drivers. As part of the spill prevention plan, drivers will be required to inspect the safety equipment
of their vehicles on a daily basis. Any deficiency in safety equipment will be noted for corrective
action. Drivers will be trained in the procedures to be taken in the event of a spill that occurs during
the hauling of biosolids. These procedures are discussed in the spill control, containment, and
cleanup plan.

SPILL CONTROL, CONTAINMENT, AND CLEANUP PLAN
Spills that occur during loading or unloading biosolids will occur at the generation point and the
land application sites, respectively. These spills will not involve an environmental hazard or an
over the road hazard and, therefore, will be handled using the equipment that will be available at
either site. Spills that occur over -the -road will be subject to the contingencies contained in the spill
control, containment, and cleanup plan. The equipment used in the spill control, containment, and
cleanup consists of the following:
Vacuum pump, pump truck or tanker truck. A vacuum truck, vacuum pump or tanker truck will
be used to assist with clean-up of biosolids spills.
2. Outside equipment if required
The following personnel will be involved in the spill control, containment, and cleanup.
1. The responsible party for land application will respond to the spill site and make an assessment
of the spill and determine the containment procedures to be initiated and the equipment to be
used to clean up the spill.
2. The responsible party for land application will be responsible for the direction of the cleanup
team.
In the event of a spill, the driver of the truck or application vehicle, if he has not sustained a
debilitating injury, will call the responsible party for land application and report the spill. The
responsible party for land application will notify the appropriate authorities and will also notify the
DWR Regional Office. The driver will set up safety flares and signs to warn motorists of the
hazard. The responsible party for land application will mobilize the necessary equipment and
personnel to the site, and will initiate the containment procedures. When the cleanup team arrives at
the site, the site will be cleaned up according to the contingency plan. Biosolids cleaned up from
the site will be transported to the land application sites where it will be applied in accordance with
the permit. In the event that the driver is incapacitated due to personal injury, the responsible party
for land application will mobilize the cleanup team as soon as the authority's notification of an
incident.

COPY OF EXISTING PERMIT
(PERMIT NO. WQ0011431)

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Director
THE HONORABLE DANNY GABRIEL
TOWN OF CLEVELAND
POST OFFICE BOX 429
CLEVELAND, NORTH CAROLINA 27013
Dear Mayor Gabriel:
NORTH CAROLINA
Environmental Quality
September 13, 2019
Subject: Permit No. WQ0011431
Town of Cleveland RLAP
Land Application of
Class B Residuals
Rowan County
In accordance with your permit renewal request received July 1, 2019, we are forwarding herewith
Permit No. WQ0011431dated September 13, 2019, to the Town of Cleveland for the continued operation
of the subject residuals management program. Please note that this renewed permit shall become effective
on January 1, 2020 (i.e., the day after the expiration date of the existing permit).
Modifications to the subject permit are as follows: Removal of two fields in Rowan County totaling
22.4 acres, those fields being NC-RA-56-01A and -01B.
This permit shall be effective from January 1, 2020 through March 31, 2025, shall void Permit No.
WQ0011431 issued October 24, 2014, and shall be subject to the conditions and limitations as specified
therein. The Permittee shall submit a renewal application no later than October 2, 2024.
Please pay particular attention to the monitoring requirements listed in Attachment A for they may
differ from the previous permit issuance. Failure to establish an adequate system for collecting and
maintaining the required operational information shall result in future compliance problems.
Please note that on September 1, 2018, North Carolina Administrative Code Title 15A Subchapter
02T — Waste not Discharged to Surface Waters was readopted. Accordingly, this permit incorporates the
requirements of these rules, therefore, please take the time to review this permit thoroughly.
The Division has removed the following permit conditions since the last permit issuance dated
October 24, 2014:
➢ Old Conditions I.2. and 1.3. — These conditions have been met and are no longer needed.
➢ Old Condition II.8. — Replaced by Condition II.8.
➢ Old Condition II.10. — Redundant since covered by Old Condition II.1 Li. and Condition
II.1 O.h.
➢ Old Condition H1.1 Lh. —Replaced by Condition III.101.
North Carolina Department of Environmental Quallty Division of Water Resources
J1j/j 512 North Salisbury Street 1 1617 Mall Service Center Raleigh, North Carolina 27699-1617
cux a
a1� 919.707.9000

The Honorable Danny Gabriel
September 13, 2019
Page 2 of 3
➢ Old Condition Ill. 13. —How public access restriction is to be carried out is no longer part of
the permit.
➢ Old Condition IV.8. — Replaced by Condition IV.8.
➢ Old Condition VI.2. —This permit is not voidable, so the condition has been removed.
The following permit conditions are new since the last permit issuance dated October 24,
2014:
➢ Condition II.8. — These are the new setback limits. The differences are that the setback to
surface waters is now 32.8 feet (rather than 100 feet) and that two adjacent properties owned
by the same owner do not require setbacks on the property boundary.
➢ Condition III.101. — Residuals are to be applied at agronomic rates.
➢ Condition 11.10.1. — The watersheds in which residuals are not to be applied.
➢ Condition III.1 l.c. — Land in a dedicated permit site is to be permanently restricted from public
access while permitted.
➢ Condition IV.8. -- Annual reports shall consist of one paper copy and one electronic copy
(PDF).
➢ Condition VIX — Renewal of this permit shall be approved only if annual fees have been paid.
If any parts, requirements or limitations contained in this permit are unacceptable, the Permittee
has the right to request an adjudicatory hearing upon written request within 30 days following receipt of
this permit. This request shall be in the form of a written petition, conforming to Chapter 150B of the North
Carolina General Statutes, and filed with the Office of Administrative Hearings at 6714 Mail Service
Center, Raleigh, NC 27699-6714. Otherwise, this permit shall be final and binding.
The Mooresville Regional Office has noted that the flow, and thus the residuals being produced,
has recently increased. There is concern that the Town of Cleveland does not have enough storage or
permitted land for the increased flow.
There are several steps the Town of Cleveland can take and is taking to meet this additional
production of residuals. These include:
1. Equipment needs for the increased production of residuals (e.g., belt press, additional digester);
2. Increased storage capacity by construction of storage pad or other containment/storage
structures;
3. Acquiring additional land for residuals application;
4. Investigate the possibility to haul septage to another municipality;
5. Addition of the Town of Cleveland as a source for a land applier's permit;
6. Hauling more residuals to the landfill.

The Honorable Danny Gabriel
September 13, 2019
Page 3 of 3
Some combination of these potential steps may be necessary to avoid overapplication of the
residuals on the 10 acres of land owned by the Town of Cleveland. As the Town of Cleveland develops its
strategy for dealing with this, please inform the Mooresville Regional Office [phone]. If additional
land for residuals application is required, it will of course require a modification of the permit.
If you need additional information concerning this permit, please contact Nathaniel Thornburg at
[phone] or nathaniel.thornbura�u�ncdenr.yov.
Sincerely,
mda Culpepper, Director
Division of Water Resources
cc: Rowan County Health Department (Electronic Copy)
Mooresville Regional Office, Water Quality Regional Operations Section (Electronic Copy)
Rob Willcox, LSS — Willcox & Mabe Soil Solutions (Electronic Copy)
Martin Mabe — Willcox & Mabe Soil Solutions (Electronic Copy)
Beth Buffington — Protection and Enforcement Branch (Electronic Copy)
Laserfiche File (Electronic Copy)
Digital Permit Archive (Electronic Copy)
Central Files

THIS PAGE BLANK

NORTH CAROLINA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF ENVIRONMENTAL QUALITY
RALEIGH
LAND APPLICATION OF CLASS B RESIDUALS PERMIT
In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended, and other applicable Laws, Rules, and Regulations
Town of Cleveland
Rowan County
FOR THE
continued operation of a residuals management program for the Town of Cleveland and consisting of the
land application of Class B residuals generated by the approved facility listed in Attachment A to the
approved field listed in Attachment B, with no discharge of wastes to surface waters, pursuant to the
application received July 1, 2019, and in conformity with other supporting data subsequently filed and
approved by the Department of Environmental Quality and considered a part of this permit. The disposal
of residuals is regulated under Title 40 Code of Federal Regulations Part 503. This permit does not exempt
the Permittee from complying with Federal Regulation 40 CFR Part 503.
This permit shall be effective from January 1, 2020 through March 31, 2025, shall void Permit No.
WQ0011431 issued October 24, 2014, and shall be subject to the following conditions and limitations:
I. SCHEDULES
1. The Permittee shall request renewal of this permit on Division -approved forms no later than October
2, 2024. [15A NCAC 02T .0105(b), 02T .0109]
H. PERFORMANCE STANDARDS
The Permittee shall maintain and operate the subject residuals management program so there is no
discharge to surface waters, nor any contravention of groundwater or surface water standards. In the
event the residuals management program fails to perform satisfactorily, including the creation of
nuisance conditions due to improper operation and maintenance, the Permittee shall immediately cease
land applying residuals, take immediate corrective actions, and contact the Mooresville Regional Office
supervisor. [15ANCACO2T.0108(b)(1)(A)]
2. This permit shall not relieve the Permittee of their responsibility for damages to groundwater or surface
water resulting from the operation of this residuals management program. [15A NCAC 02T
.0108(b)(1)(A)]
3. Only residuals generated by the facility listed in Attachment A are approved for land application in
accordance with this permit. [15A NCAC 02T .1101]
WQ0011431 Version 4.0 Shell Version 190710 Page 1 of 12

4. Only the field listed in Attachment B are approved for residuals land application. [G.S. 143-
215.1(a)(9)]
5. Pollutant concentrations in residuals land applied to the sites listed in Attachment B shall not exceed
the following Ceiling Concentrations or Cumulative Pollutant Loading Rates (CPLRs), on a dry
weight basis:
Ceiling
Cumulative Pollutant Loading Rates
Parameter
Concentration
Concentration
Ij (mg1kg)
(kSlha) (lbs/ac)
Arsenic
l� 75
41 36
Cadmium
85
39 34
Copper
4,300
1,500 1,338
Lead
840
300 267
Mercury 57 17 15 i
Molybdenum 75 N/A N/A
Nickel 420 420 374
I Selenium 100 100 89
[_ Zinc 7,500 2,800 2,498 ]
The Permittee shall determine compliance with the CPLRs using one of the following methods:
a. By calculating the existing cumulative level of pollutants using actual analytical data from all
historical land application events of residuals, or
b. For land where residuals application has not occurred or for which the required data is incomplete,
by determining background concentrations through representative soil sampling.
[15A NCAC 02T .1105(a), 02T .1105(b)]
6. Class B biological residuals shall meet the pathogen reduction requirements in 15A NCAC 02T .1106
(b). Exemptions to this requirement shall be specified in Attachment A. [15A NCAC 02T .1106(b),
02T .1106(d)]
7. Class B biological residuals shall meet one of the vector attraction reduction alternatives in 15A NCAC
02T .1107(a). Exemptions to this requirement shall be specified in Attachment A. [15A NCAC 02T
.1107(a), 02T .1107(c)]
WQ0011431 Version 4.0 Shell Version 190710 Page 2 of 12

8. The facilities and sites herein were permitted per the following setbacks:
a. Setbacks for Class B land application sites are as follows
(all di'stances in feet):
Surface
Irrigation
Injection /
Application
Surface
Incorporation
by Vehicle
Application
i. Each habitable residence or place of assembly
400
400
200
under separate ownership:
ii. Each habitable residence or places of assembly
owned by the Permittee, the owner of the land,
0
200
0
or the lessee or operator of the land:
iii. Each property line:
50,
150'
501
iv. Public right of way:
50
50
50
v. Each private or public water supply source:
100
100
100
vi. Surface waters such as intermittent and
perennial streams, perennial waterbodies, and
32.8
32.8
32.8
wetlands:
vii. Surface water diversions such as ephemeral
25
25
25
streams, waterways, and ditches:
viii.Groundwater lowering ditches where the
25
100
25
bottom of the ditch intersects the SHWT:
ix. Subsurface groundwater lowering systems:
0
100
0
x. Each well with exception of monitoring wells:
100
100
100
xi. Bedrock outcrops:
25
25
25
xii. Top of slope of embankments or cuts of two
15
15
15
feet or more in vertical height:
xiii.Each building foundation or basement:
0
15
0
xiv. Each water line:
0
10
0
xv. Nitrification field:
0
20
0
1 Setbacks to property lines are not applicable when the Permittee, or the entity from which the
Permittee is leasing, owns both parcels separated by the property line.
[I 5A NCAC 02T .1108(c)]
9. Class B land application areas shall be clearly marked on each site prior to and during any residuals
application event. [15A NCAC 02T .0110(g)]
WQ0011431 Version 4.0 Shell Version 190710 Page 3 of 12

10. Residuals and other sources of Plant Available Nitrogen (PAN) shall not be applied in exceedance of
agronomic rates. Appropriate agronomic rates shall be calculated using expected nitrogen requirements
based on the determined Realistic Yield Expectations (RYE) using any of the following methods:
a. Division's pre -approved site specific historical data for specific crop or soil types by calculating
the mean of the best three yields of the last five consecutive crop harvests for each field.
b. North Carolina Historical Data for specific crop and soil types as provided by North Carolina State
University Department of Soil Science t iez�t-s ��� i.�ic� 1'.' _fields;+_ ,dex.I� ,). A copy
shall be kept on file and reprinted every five years in accordance with Condition IV.6.
c. If the RYE cannot be determined using methods (a) or (b) above, the Permittee may use the RYE
and appropriate nutrient application rates reported in any of the following documents:
i. Crop management plan as outlined by the local Cooperative Extension Office, the North
Carolina Department of Agriculture and Consumer Services, the Natural Resource
Conservation Service, or other agronomist.
ii. Waste Utilization Plan as outlined by the Senate Bill 1217 Interagency Group - Guidance
Document: Chapter 1
(http://www.ncaer.eov/SWC/tech/documents/9th Guidance Doc 100109.0f).
iii. Certified Nutrient Management Plan as outlined by the Natural Resources Conservation
Services (MRCS). These plans must meet the USDA-NRCS 590 Nutrient Management
Standards (t7p://ft -fp c.sc,eov.usda.aov/NHQ/practice-standards/standards/590 pd1'l.
d. If the RYE and appropriate nutrient application rates cannot be determined, the Permittee shall
contact the Division to determine necessary action.
[15A NCAC 02T .I109(a)(1)(K)]
11. When residuals are land applied to grazed pasture, hay crop realistic nitrogen rate shall be reduced by
25%. [15A NCAC 02T .0108(b)(1)(A)]
12. If residuals land application sites are to be over -seeded or double -cropped (e.g., bermuda grass in the
summer and rye grass in the winter with both crops to receive residuals), then the second crop can
receive an application of PAN at a rate not to exceed 50 pounds per acre per year (lbs/ac/yr). This
practice may be allowed as long as the second crop is to be harvested or grazed. If the second crop is
to be planted for erosion control only and is to be tilled into the soil, then no additional PAN shall be
applied. [15A NCAC 02T .4108(b)(1)(A)]
13. Prior to land application of residuals containing a sodium adsorption ratio (SAR) of 10 or higher, the
Permittee shall obtain and implement recommendations from at least one of the following: 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. 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. The Permittee shall
maintain written records of these recommendations and details of their implementation. [15A NCAC
02T .0108(b)(1)(A)]
14. Residuals land application fields permitted on or after December 30, 1983 have a compliance boundary
that is either 250 feet from the residual land application area, or 50 feet within the property boundary,
whichever is closest to the residual land application area. Any exceedance of groundwater standards
at or beyond the compliance boundary shall require corrective action. Division -approved relocation of
the compliance boundary shall be noted in Attachment B. Multiple contiguous properties under
common ownership and permitted for use as a disposal system shall be treated as a single property with
regard to determination of a compliance boundary. [15A NCAC 02L .0106(d)(2), 02L .0107(b), 02T
.0105(h), G.S. 143-215.1(i), G.S. 143-215.1(k)]
WQ0011431 Version 4.0 Shell Version 190710 Page 4 of 12

15. The review boundary is midway between the compliance boundary and the residual land application
area. Any exceedance of groundwater standards at or beyond the review boundary shall require
preventative action. [15ANCAC 02L .0106(d)(1), 02L .0108]
III. OPERATION AND MAINTENANCE REQUIREMENTS
1: The Permittee shall operate and maintain the residuals management program as a non -discharge system.
[I5A NCAC 02T .1100]
2. The Permittee shall notify the Mooresville Regional Office, telephone number [phone], and the
appropriate local government official (i.e., county manager, city manager, or health director) at least
two business days in advance of a site's initial residuals land application event. [15A NCAC 02T
.0108(b)(1)(A)]
3. The Permittee shall notify the Mooresville Regional Office, telephone number [phone], at least
one business day in advance of conducting any land application activity. Notification shall include the
anticipated application date, time, and field name as listed in Attachment B. Exceptions to this
requirement shall be approved by the Mooresville Regional Office. [15A NCAC 02T .0108(b)(1)(A)]
4. The Permittee shall maintain a Division -approved Operation and Maintenance Plan that shall include:
a. Description of the program, and associated facilities and equipment, in sufficient detail to show
what operations are necessary for the program to function and by whom the functions are to be
conducted;
b. Description of anticipated maintenance of facilities and equipment associated with the program;
c. Include provisions for safety measures, including restriction of access to sites and equipment;
d. Spill control provisions:
i. Response to upsets and bypasses including control, containment, and remediation; and
ii. Contact information for plant personnel, emergency responders, and regulatory agencies;
e. Detailed inspection procedures:
i. Names or titles of personnel responsible for conducting inspections;
ii. Frequency and location of inspections, and procedures to assure that the selected locations and
inspection frequency are representative of the residuals management program; and
iii. Description of record keeping and actions to be taken by the inspector in the event that
noncompliance is observed;
f. Detailed sampling and monitoring procedures:
i. Names or titles of personnel responsible for conducting sampling and monitoring;
ii. Description of monitoring procedures including parameters to be monitored; and
iii. Sampling frequency and procedures to assure that representative samples are 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.
[15A NCAC 02T .1110(a)]
5. Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC)
classification of the residuals management program, the Permittee shall designate and employ a
certified operator in responsible charge (ORC), and one or more certified operators as back-up ORCs.
The ORC or their back-up shall visit the facilities in accordance with 15A NCAC 08G 0204 and shall
comply with all other requirement in 15A NCAC 08G 0204. [15A NCAC 02T .0117, 08G .0204]
WQ0011431 Version 4.0 Shell Version 190710 Page 5 of 12

6. The Permittee shall ensure that a copy of this permit and the Division -approved Operation and
Maintenance Plan is available when land applying residuals. [15A NCAC 02T .1110(b)]
7. The Perm ittee shall ensure that spill control provisions are available when transporting or land applying
residuals. [15A NCAC 02T .1110(a)(4)]
8. Class B residuals shall not be stored or staged at any land application site without prior written approval
from the Division. Class B residuals approved for storage shall be stored or staged in a manner to
prevent runoff of leachate and other wastewaters generated. [15A NCAC 02T .I I I0(c), 02T .I I I O(e)]
9. Adequate measures shall be taken to prevent wind erosion and runoff from the land application sites
listed in Attachment B. [15A NCAC 02T .0108(b)(1)(A)]
10. Class B residuals shall not be land applied under the following conditions:
a. If the residuals are likely to adversely affect a threatened or endangered species listed under section
4 of the Endangered Species Act or its designated critical habitat;
b. If the application causes nuisance conditions;
c. If the land fails to assimilate the bulk residuals or the application causes the contravention of surface
water or groundwater standards;
d. If the land is flooded, frozen, or snow-covered, or is otherwise in a condition such that runoff of
the residuals would occur;
e. Within the 100-year flood elevation, unless the residuals are injected or incorporated within a 24-
hour period following a residuals land application event;
f. During precipitation events, or within 24 hours following a rainfall event of 0.5 inches or greater
in a 24-hour period;
g. If the slope of the land is greater than 10% when liquid residuals are surface applied, or if the slope
of the land is greater than 18% when liquid residuals are injected or incorporated;
h. If the land does not have an established vegetative cover crop unless the land is a Division -approved
no -till site, or the residuals are injected, or incorporated within a 24-hour period following the
application of residuals;
i. If the vertical separation of the seasonal high water table and the depth of residuals application is
less than one foot;
j. If the vertical separation of the depth to bedrock and the depth of residuals application is less than
one foot;
k. If the application exceeds agronomic rates;
1. If the land application sites are located within a WS-I watershed pursuant to 15A NCAC 02B .0212
or within the Critical Area of a WS-11 pursuant to Sub -Item (4)(g) of Rule 15A NCAC 02B .0212,
or within the Critical Area of a WS-III or WS-IV watershed pursuant to Sub -Item (4)(h) of Rules
15A NCAC 02B .0215, and .0216.
[15A NCAC 02T .1109(a)(1)]
WQ0011431 Version 4.0 Shell Version 190710 Page 6 of 12

11. Class B land application sites shall have the following public access restrictions:
a. Public access to public contact sites shall be restricted for one calendar year after a residuals land
application event;
b. Public access to non-public contact sites shall be restricted for 30 days after a residuals land
application event;
c. Public access to land associated with a dedicated land application site shall be restricted
continuously while the land is permitted for active use, and for one calendar year after the final
land application of residuals.
[15A NCAC 02T .1109(a)(2)]
12. Class B land application sites shall have the following harvesting and grazing restrictions:
a. Animals shall not be allowed to graze on land for 30 calendar days after any land application of
residuals;
b. Food crops, feed crops, and fiber crops shall not be harvested for 30 calendar days after any land
application of residuals;
c. Food crops with harvested parts that touch the mixture of residuals and soil and are totally above
the land surface shall not be harvested for 14 months after any land application of residuals;
d. Food crops with harvested parts below the land surface shall not be harvested for 20 months after
any land application of residuals if the residuals remain on the land surface for four months or
longer prior to incorporation into the soil;
e. Food crops with harvested parts below the land surface shall not be harvested for 38 months after
any land application of residuals if the residuals remain on the land surface for less than four months
prior to incorporation into the soil; and
f. Turf grown on land where residuals are applied shall not be harvested for one calendar year after
any land application of residuals.
[15A NCAC 02T .l 109(a)(3)]
13. The Permittee shall acquire from each landowner or lessee/operator a statement detailing the volume
of other nutrient sources (i.e., manufactured fertilizers, manures, or other animal waste products) that
have been applied to the site, and a copy of the most recent Nutrient Management Plan (NUT) for those
operations where a NMP is required by the US Department of Agriculture — National Resources
Conservation Service (NRCS) or other State Agencies. The Permittee shall calculate allowable nutrient
loading rates based on the provided information and use appropriate reductions.
For the purpose of this permit condition, a Crop Management Plan (CMP), Waste Utilization Plan
(WUP) or Certified Nutrient Management Plan (CNMP) shall also be considered a Nutrient
Management Plan. [15A NCAC 02T .0108(b)(1)(A), 02T .1104(c)(3)]
14. Class B residuals shall not be land applied to the fields listed in Attachment B unless the Landowner
Agreement between the Permittee and the respective field owners or lessees/operators of the land
application site is valid. The Landowner Agreements shall expire concurrent with the permit expiration
date of March 31, 2025. [15A NCAC 02T .1104(c)(4)]
WQ0011431 Version 4.0 Shell Version 190710 Page 7 of 12

IV. MONITORING AND REPORTING REQUIREMENTS
1. The Permittee shall conduct and report any Division required monitoring necessary to evaluate this
program's impact on groundwater and surface water. [15A NCAC 02T .0108(c)]
2. The residuals from each source generating facility shall be analyzed to demonstrate they are non-
hazardous under the Resource Conservation and Recovery Act (RCRA). Residuals that test or are
classified as a hazardous or toxic waste under 40 CFR Part 261 shall not be land applied. The analyses
(i.e., corrosivity, ignitability, reactivity, and toxicity characteristic leaching procedure (TCLP)) shall be
performed at the frequency specified in Attachment A, and the Permittee shall maintain these results
for five years. Any exemptions from the requirements in this condition shall be specified in Attachment
A. The TCLP analysis shall include the following parameters, and the Federal regulatory level (mg/L)
is in parentheses:
Arsenic (5.0) 1,4-Dichlorobenzene (7.5) Nitrobenzene (2.0)
Barium (100.0) 1,2-Dichloroethane (0.5) Pentachlorophenol (100.0) j
I Benzene (0.5) 1,1-Dichloroethylene (0.7) Pyridine (5.0)
Cadmium (1.0) 2,4-Dinitrotoluene (0.13) Selenium (1.0)
Carbon tetrachloride (0.5) Endrin (0.02) , Silver (5.0) _
Heptachlor (and its epoxide) f Tetrachloroeth lene 0 7
Chlordane (0.03) (0.008) I Y ( )
Chlorobenzene (100.0) ( Hexachlorobenzene (0.13) Toxaphene (0.5)
Chloroform (6.0) Hexachlorobutadiene (0.5) Trichloroethylene (0.5)
Chromium (5.0) Hexachloroethane (3.0) 2,4,5-Trichlorophenol (400.0)
m-Cresol 200.0 Lead 5.0 2 4,6-Trichloro henol 2.0
o-Cresol (200.0) Lindane (0.4) 2,4,5-TP (Silvex) (1.0)
p-Cresol (200.0) Mercury (0.2) Vinyl chloride (0.2)
Cresol (200.0) j Methoxychlor (10.0)
2,4-D (10.0) Methyl ethyl ketone (200.0)
Once the residuals have been monitored for two years at the frequency specified in Attachment A, the
Permittee may submit a permit modification request to reduce the frequency of this monitoring
requirement. In no case shall the monitoring frequency be less than once per permit cycle.
[15A NCAC 13A .0102(b), 02T .1101, 02T .11051
WQ0011431 Version 4.0 Shell Version 190710 Page 8 of 12

3. The residuals from each source generating facility shall be analyzed at the frequency specified in
Attachment A, and the Permittee shall maintain the results for a minimum of five years. Each analysis
shall include the following parameters:
Aluminum Mercury Potassium
Ammonia -Nitrogen Molybdenum Selenium
Arsenic Nickel Sodium
Cadmium Nitrate -Nitrite Nitrogen Sodium Adsorption Ratio
(SAR)
Calcium Percent Total Solids TKN
Copper pH Zinc
Lead Phosphorus
Magnesium Plant Available Nitrogen
(by calculation)
[15A NCAC 02T .1101]
4. Residuals shall be monitored for compliance with pathogen and vector attraction reduction
requirements at the frequency specified in Attachment A. The monitoring results shall specify the
stabilization process utilized, and demonstrate compliance with the Class B pathogen reduction
requirements in 15A NCAC 02T .1106(b), and one vector attraction reduction requirement in 15A
NCAC 02T .1107(a) shall be met. Any exemptions from the requirements in this condition shall be
specified in Attachment A. [15A NCAC 02T .1106(b), 02T .1107(a), 02T .1111(c)]
5. An annual representative soils analysis (i.e., Standard Soil Fertility Analysis) shall be conducted on
each land application site listed in Attachment B that received residuals during the calendar year. This
analysis shall be in accordance with the soil sampling guidance located in the Sampling Instructions
section of the NC Department of Agriculture & Consumer Services' website
(hap://www.ncaer.eov/aeronomi/yubs.h-tm). The Permittee shall maintain these results for a period of
no less than five years, and these results shall be made available to the Division upon request. Each
Standard Soil Fertility Analysis shall include the following parameters:
Acidity Exchangeable Sodium Percentage Phosphorus
Base Saturation (by calculation) Magnesium Potassium
Calcium Manganese Sodium
Cation Exchange Capacity I Percent Humic Matter Zinc
Copper pH
[15ANCAC 02T .0108(c), 15ANCAC 02T .1111(d)]
6. Representative samples of residuals that are prepared for land application shall be collected and
analyzed. [I 5A NCAC 02T. I I I l(a)]
WQ0011431 Version 4.0 Shell Version 190710 Page 9 of 12

The Permittee shall maintain records for all residual land application events. These records shall
include the following:
a. Residuals source (as listed in Attachment A);
b. Date of application;
c. Location of land application (field name as listed in Attachment B);
d. Approximate acreage applied;
e. Method of application;
f Weather conditions;
g. Dominant soil series;
h. Soil conditions;
i. Proposed crop;
j. Nitrogen Application Rate based on RYES;
k. Volume of residuals applied per acre in gallons, cubic yards, dry tons, or wet tons;
1. Volume of animal waste or other nutrient source applied per acre in gallons, cubic yards, dry tons,
or wet tons;
in. Volume of soil amendments applied per acre in gallons, cubic yards, dry tons, or wet tons; and
n. Annual and cumulative totals applied to each field for the following:
i. Class A and Class B residuals (dry tons per acre);
ii. Animal waste and other sources of nutrients (dry tons per acre);
iii. Heavy metals as specified in Condition II.5. (pounds per acre);
iv. Plant available nitrogen (pounds per acre); and
v. Phosphorus (pounds per acre).
[15ANCAC 02T .0108(c)]
8. One hard copy and one electronic copy of an annual report shall be submitted on or before March I't
The annual report shall meet the requirements described in the Instructions for Residuals Application
Annual Renortink Forms. Instructions for reporting and annual report forms are available at
http://dea.nc. pov/about/divisions/water-resources/water-resources-permits/wastewater-branch/non-
diseharge-permitting-unit/reoorting-forms, or can be obtained by contacting the Non -Discharge Branch
directly. The annual report shall be submitted to the following address:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
[ 15 A NCAC 02T . I 1 11(d)]
9. Noncompliance Notification
The Permittee shall report to the Mooresville Regional Office, telephone number [phone],
within 24 hours of first knowledge of the:
a. Any process unit failure (e.g., mechanical, electrical, etc.) rendering the facility incapable of
adequate residual treatment.
b. Any failure resulting in a discharge to surface waters.
c. Any time self -monitoring indicates the program has gone out of compliance with its permit
limitations.
d. Land application of residuals abnormal in quantity or characteristic.
e. Any discharge from a vehicle or piping system transporting residuals.
Emergencies requiring reporting outside normal business hours shall call the Division's Emergency
Response personnel at telephone number [phone], [phone], or [phone]. All
noncompliance notifications shall file a written report to the Mooresville Regional Office within five
days of first knowledge of the occurrence, and this report shall outline the actions proposed or taken to
ensure the problem does not recur. [15A NCAC 02T .0108(b)(1)(A)]
WQ0011431 Version 4.0 Shell Version 190710 Page 10 of 12

V. INSPECTIONS
1. The Pcnnittee shall perform inspections and maintenance to ensure proper operation of the Permittee's
storage, distribution, and application facilities. [15A NCAC 02T .1110(f)]
2. The Permittee shall inspect the Permittee's residuals storage, transport, and application facilities to
prevent malfunctions, facility deterioration, and operator errors that may result in discharges of wastes
to the environment, threats to human health, or public nuisances. The Permittee shall maintain an
inspection log that includes the date and time of inspection, observations made, and maintenance,
repairs, or corrective actions taken. The Permittee shall maintain this inspection log for a period of five
years from the date of inspection, and this log shall be made available to the Division upon request.
[15A NCAC 02T .0108(b)(1)(A), 02T .1110(f)]
Division authorized representatives may, upon presentation of credentials, enter and inspect any
property, premises, or place related to the land application sites or facilities permitted herein at any
reasonable time for determining compliance with this permit. Division authorized representatives may
inspect or copy records maintained under the terms and conditions of this permit, and may collect
groundwater, surface water, or leachate samples. [G.S. 143-215.3(ax2)]
VI. GENERAL CONDITIONS
1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to a
Division enforcement action. [G.S. 143-215.6A, 143-215.613, 143-215.6C]
2. This permit is effective only with respect to the nature and volume of wastes described in the permit
application, and Division -approved plans and specifications. [G.S. 143-215.1(d)]
3. Unless specifically requested and approved in this permit, there are no variances to administrative codes
or general statutes governing the construction or operation of the facilities permitted herein. [15A
NCAC 02T .0105(n)]
4. The issuance of this permit does not exempt the Permittee from complying with all statutes, rules,
regulations, or ordinances that other jurisdictional government agencies (e.g., local, state, and federal)
may require. [15A NCAC 02T .0105(c)(6)]
5. If the permitted residuals program change ownership, or the Permittee changes their name, the
Permittee shall submit a permit modification request on Division -approved forms. The Permittee shall
comply with all terms and conditions of this permit until the permit is transferred to the successor -
owner. [G.S. 143-215.1(d3)]
WQ0011431 Version 4.0 Shell Version 190710 Page 11 of 12

6. This permit is subject to revocation or modification upon 60-day notice from the Division Director, in
whole or part for:
a. violation of any terms or conditions of this permit or Administrative Code Title 15A Subchapter
02T;
b. obtaining a permit by misrepresentation or failure to disclose all relevant facts;
c. the Permittee's refusal to allow authorized Department employees upon presentation of credentials:
i, to enter the Permittee's premises where a system is located or where any records are required
to be kept;
ii. to have access to any permit required documents and records;
iii. to inspect any monitoring equipment or method as required in this permit; or
iv. to sample any pollutants;
d. the Permittee's failure to pay the annual fee for administering and compliance monitoring; or
e, a Division determination that the conditions of this permit are in conflict with North Carolina
Administrative Code or General Statutes.
[15A NCAC 02T .0110]
7. Unless the Division Director grants a variance, expansion of the facilities permitted herein shall not
occur if any of the following apply:
a. The Permittee or any parent, subsidiary, or other affiliate of the Permittee has been convicted of
environmental crimes under G.S. 143-215.6B, or under Federal law that would otherwise be
prosecuted under G.S. 143-215.613, and all appeals of this conviction have been abandoned or
exhausted.
b, The Permittee or any parent, subsidiary, or other affiliate of the Permittee has previously abandoned
a wastewater treatment facility without properly closing the facility.
c. The Permittee or any parent, subsidiary, or other affiliate of the Permittee has not paid a civil
penalty, and all appeals of this penalty have been abandoned or exhausted.
d. The Permittee or any parent, subsidiary, or other affiliate of the Permittee is currently not compliant
with any compliance schedule in a permit, settlement agreement, or order.
e. The Permittee or any parent, subsidiary, or other affiliate of the Permittee has not paid an annual
fee.
[15A NCAC 02T .0120(b), 02T .0120(d)3
8. This permit shall not be renewed if the Permittee or any affiliation has not paid the required annual fee.
[15A NCAC 02T .0120(c)]
Permit issued this the 13t` day of September 2019
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
nda Culpepper, Director
Division of Water Resources
By Authority of the Environmental Management Commission
Permit Number WQ0011431
WQ0011431 Version 4.0 Shell Version 190710 Page 12 of 12

ATTACMUNT A — APPROVED RESIDUAL SOURCES
Town of Cleveland
Certification Date: September 13, 2019
Permit Number: WQ0011431 Version: 4.0
Monitoring
Monitoring
i Monitoring
Permit
Biological
Maximum
Frequency for
Frequency for
Frequency for
Approved
Owner Facility Name County Number
Residuals
Dry Tons
Non -hazardous
Metals and
I Pathogen &
Mineralization
per Year I
Characteristics
Nutrients 3, s
Vector Attraction
Rate
j
Reductions 4,
M_....._ _
Town of Cleveland Cleveland WWTP Rowan I NCO049867 Yes
82.0 I
Annually
Annually
Annually
0.3
Total
82.0
1. Maximum Dry Tons per Year is the amount of residuals approved for land application from each permitted facility.
2. Analyses to demonstrate that residuals are non -hazardous (i.e., TCLP, ignitability, reactivity, and corrosivity) as stipulated under permit Condition IV.2.
3. Testing of metals and nutrients as stipulated under permit Condition IV.3.
4. Analyses of pathogen and vector attraction reductions as stipulated under permit Condition IV A
5. Monitoring frequencies are based on the actual dry tons applied per year using the table below, unless specified above.
Dry Tons Applied Monitoring Frequency
Dry Tons Applied (metric tons) (short tons per year) (40 CFR 503 and 15A NCAC 02T
.1111(c) )
_ < 290 < 319 Once per year (Annually)
> 290 to < 1,500
>_ 319 to < 1,650
Once per quarter (4 x Year)
? 1,500 to < 15,000 j
>_ 1,650 to < 16,500
Once per 60 days (6 x Year)
> 15,000
> 16,500
Once per month (12 x Year)
If no land application events occur during a required sampling period (e.g., no land application occur during an entire year when annual monitoring is required), then no sampling data is
required during the period of inactivity. The annual report shall include an explanation for missing sampling data. Those required to submit the annual report to United States Environmental
Protection Agency (US EPA) may be required to make up the missed sampling. Contact the US EPA for additional information.
WQ0011431 Version 4.0 Attachment A Page 1 of 1

w
a
N

ATTACHMENT B — APPROVED LAND APPLICATION SITES Certification Date: September 13, 2019
Town of Cleveland — Town of Cleveland RLAP Permit Number: WQ0011431 Version: 4.0
Net
Field Owner Lessee County Latitude Longitude Dominant Soil Series Figures
., - --- Acreage
NC-RA-01-01 Town of Cleveland Rowan 35,7382780-80.666472' 10.0 EnB - Enon 1
Total I 10.0
WQ0011431 Version 4.0 Attachment B Page 1 of 1

REVIEW BOUNDARY shall be established around each land application site
midway between the Compliance Boundary and the perimeter of the
residuals land application area.
COMPLIANCE BOUNDARY: The Compliance Boundary for each land application site
is established at either 250 feet from the residuals land application area or 50 feet
within the property boundary, whichever Is closest to the residual land application area.
V.
T
1
1
4.
t,
\ • lx S, � f
♦' ` i d f
--■ Access Road
t ' ■ ' ♦ Structure
�' ■` ■ Dwelling
Stream
SITE/FIELD TOTALACRES BLIFFEREDACRES NETACRES Pond
1-1 10.9 0.9 10 -
_s Buffer
REFERENCE:
GIS DATA LAYERS WERE OBTAINED FROM ESRI, INC, PLEASE NOTE THIS MAP IS FOR INFORMATIONAL Field Boundary
PURPOSES MY. IT IS NOT MEANT FOR DESIGN, LEGAL, OR ANY OTHER USES. THERE ARE NO
GUARANTEES ABOUT ITS ACCURACY WMSS, PLLCASSUMES NO RESPONSIBILITY FOR ANY
DEOSIONMADEORANYACTIONSTAKENBYTHEUSERBASEDUPONTHISINFORMATION. Property Boundary
1 = soo ` BUFFER MAP FIGURE No.
a
DATE:
06-24-19
MFM VACOAMEMbe TOWN OF CLEVELAND, NC
PROJECT NO: S O I L S O L •: ' i 0 N q NC-RA-1-1
15-03 Ph: 03A LAND APPLICATION PROGRAM

APPENDIX 11
RESIDUALS SOURCE CERTIFICATION
• TOWN OF CLEVELAND
(FORM: RSC 06-16)

RESIDUALS SOURCE CERTIFICATION
• TOWN OF CLEVELAND
(FORM: RSC 06-16)

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
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 ADDlicant shall submit one original and two conies of the application and
suDDorting 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 06-16, FORM: DCAR 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. Residuals Source Certification (FORM: RSC 06-16):
® Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 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 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 " lap Guidance for
R duals Land :-\ ;,i c:ltio;l P rn,it:,".
® 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: Town of Cleveland
Status Facility Permit Holder Facility Name
Code
Town of Cleveland Cleveland WWTP
County Permit Number
Rowan NCO049867
'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 (Le, not applicable to new facility).
Maximum Dry Tons Per Year
Current Proposed
82.0 82.0
SUMMARY FOR FORM: RSC 06-16 Page 1

DWR
State of North Carolina
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 Cleveland
2. Facility permit holder is: ❑ Federal, ❑ State, ® Local Government, or ❑ Private.
Facility permit issued by: ❑ Div. of Water Resources, ❑ Div. of Environmental Health,
or ❑ Other (explain: ).
3. Facility contact person and title: Jodv Bare. WWTP Supervisor
Complete mailing address: 302 East Main Street
City: Cleveland State: N.C. Zip: 27013
Telephone number: [phone] E-mail address:
4. Facility physical address: 625 Third Creek Church Road,
City: Cleveland State: N_C Zip: 27013
Coordinates: Latitude: 35°44' 38" Longitude: 80040' 59.8"
Datum: NAD83 Level of accuracy: nearest tenth of second
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: 60 % industrial and 40 % domestic)
❑ other (explain: ).
6. Does the facility have an approved pretreatment program: ® Yes ❑ No
7. Facility permitted/design flow: 0.27 MGD and facility average daily flow: 0.15 MGD
8. Average amount of residuals being generated at this facility 11 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 2-oxidation ditches totaling 270.000 gallons. 1-80.000 gallon digester
Type and volume of residuals storage (i.e., outside of residuals treatment units): above
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 Pagel 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: ❑
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: ❑ 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: Envirochem and Date of analysis: 5/9/24
Passed corrosivity test: ® yes ❑ no. pH: s.u.
(2 < pH < 12.5)
Passed ignitability test: ® yes ❑ no. Flashpoint: >158 OF (> 140°F)
Passed reactivity test: ® yes ❑no. HCN: <1.0 mg/kg (<250)
& HzS: 0.14 mg/kg (<500)
TCLP Parameter Limit Result
TCLP Parameter
Limit
Result
(mg/1) (mg/1)
(mg/1)
(mg/1)
Arsenic 5.0 <1.0
Hexachlorobenzene
0.13
<0.050
Barium 100.0 <1.0
Hexachloro-1,3-Butadiene
0.5
<0.050
Benzene 0.5 <0.01
Hexachloroethane
3.0
<0.050
Cadmium 1.0 <1.0
Lead
5.0
<1.0
Carbon Tetrachloride 0.5 <0.01
Lindane
0.4
<0.0005
Chlordane I 0.03 <0.02
Mercury
0.2
<0.0002
Chlorobenzene 1100.0 <0.01
Methoxychlor
10.0
<0.0005
Chloroform 6.0 <0.01
I Methyl Ethyl Ketone
200.0
<0.05
Chromium 5.0 <1.0
Nitrobenzene I
2.0
<0.050
m-Cresol 200.0 <0.050
Pentachlorophenol
100.0
<0.250
o-Cresol 200.0 <0.050
Pyridine
5.0
<0.050
p-Cresol 200.0 <0.050
Selenium
1.0
<1.0
Cresol 200.0 <0.050
Silver
5.0
<1.0
2,4-D 10.0 I <0.003
Tetrachloroethylene
0.7
<0.01
1,4-Dichlorobenzene 7.5 <0.050
Toxaphene
0.5
<0.05
1,2-Dichloroethane 0.5 <0.01
Trichloroethylene
0.5
<0.01
1, 1 -Dichloroethylene 0.7 <0.01
2,4,5-Trichlorophenol
400.0
<0.050
2,4-Dinitrotoluene 0.13 <0.050
2,4,6-Trichlorophenol
2.0
<0.050
Endrin 0.02 <0.0005
2,4,5-TP (Silvex)
1.0
<0.003
Heptachlor and its Hydroxide 0.008 <0.0005
Vinyl Chloride
0.2
<0.01
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: Statesville Analvtical and Date of analysis: Mav 30.2019
Parameter
Ceiling
Monthly Average
Result
Concentration Limits
Concentration Limits
(ClassA & ClassB)
(Class A Only)
(mg/kg)
(mg/kg)
(mg/kg)
Arsenic
75
41
<17.9
Cadmium
85
39
<17.9
Copper
4,300
1,500
458
Lead
840
300
<17.9
Mercury
57
17
<1.68
Molybdenum
75
n/a
<17.9
Nickel I
420
420
<17.9
Selenium
100
100
<17.9
Zinc
7,500
2,800
645
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
Arsenic
Chromium
Nickel
Unit to Boundary to
Closest Property Line
(meters, check one)
(mg/kg)
(mg/kg)
(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 I
Result (mg/kg)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 1.07 %.
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: Envirochem and Date of analysis: Mav 9.2024
Parameter Result
(mg/kg)
Aluminum 12,300
Ammonia -Nitrogen 9.35
Calcium 20,500
Magnesium 2,140
Nitrate -Nitrite Nitrogen 7,630
pH (Standard Unit) 6.92
Phosphorus 16,900
Potassium 3,790
Sodium 20,100
Total Kjeldahl Nitrogen 43,200
c. Using the results listed in Item 11. 5b. above, calculate the sodium adsorption ration (SAR): 3.69
[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): ® default value, or ❑ actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, explain 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 (111) Year PAN Five -Year
Maximum Adjusted PAN
(mg1kg) (mg/kg)
Surface 20,592 29,018
Injection/Incorporation 20,597 29,022
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
❑ 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):
❑ Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
❑ Alternative 2 [15A NCAC 02T.1106(b)(3)(B)] - Alkaline Treatment.
❑ Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
❑ 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, ❑ 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, ❑ air drying, ❑ anaerobic digestion,
❑ composting, or ® lime stabilization.
c. For Surface Disposal.
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item H. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item I1.8. below [15A NCAC 02T.1106(a)(2)].
❑ 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).
❑ 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.I 107(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.1107(a)(9)] -Injection.
❑ Alternative 10 [15A NCAC 02T.1107(a)(10)] -Incorporation.
❑ Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.1107(b)(2)].
❑ 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

TOWN OF CLEVELAND
(FORM: RSC 06-16) (ATTACHMENTS)
• VICINITY MAP
• PROCESS FLOW DIAGRAM AND/OR NARRATIVE
• QUANTITATIVE JUSTIFICATION
• SAMPLING PLAN
• ANALYTICAL

!►-,ri'�N,.'*''a�l.�wa_..__. - - '�sF�iia.ne.♦�Eqa•'_.�-..�"'- I�� a♦4.:i� 'ae� .^ � � �� � .. 'v-.�°n"' .-..ay
Legend
Town of Cleveland WWTP ;
Town of Cleveland WWTP
J. ': �'♦�`+ *y � ,' � '� ram.} ti s.'q \ � t
� -.. �1 �.' �; f � r F'•� �Y/,y..w'ya.:f 1F^ ,* + �.k� i`\\ %( y* -�yy a4 y 1 y �i
��.��s 45• f' ,'TRRx;i'Il -. r ,.'�� ���. F-.. �' t ..�,.. "��", e't•ti.`;;�hyPxt �i♦.J°1'. ° 3"f rah+1 ?�.x,`. ✓
`7•:� ''' ,,'4. �? ._�� � : ,� t: �, €� !r'• . d+�Y�`� .X ���♦ � .yw ,y,"� a,\�,�tiar�'�,c,,�':�."� p ���?:•,�, j� • �.,.. `, � s+v t. �y ;�
f". - �1,M lU �♦ iid�C ;may «° rf! •' r =�« ,.
M � - -:. - � .. +,r ♦ , ` < )/h'T 4�: . S: W�, a .?♦ 'W' .k� N !(w �"c��;" . Sl 0 4 �i� �l � i ,'. +k '♦a°°.;� . ,p�i
•_ _. ,w. i7y''�: :1'+t� `," Zr':. ' _,'�kq�, �+ `x`%t�h,`y'(4i���l�i, +.�':���,. pig, `r �'�3+3�*" fr s,« �<,-.saw - 4
.3 1e..1" .�y"' •S:,;;•�` ,„"k �..F','�+r.\;..F �e
'd�.� -/�' 4 ,"r.'F, R� 1,j,{'K'r .9;'•`�Y ' ii\ ;.`:V ♦4Y. .:.1 '..q - •R�'*Y ,J►' �:`
gat t Jtt �QL$ i f'rkrwn"^�j F.�t -t y ;�c�',�,,•.A*aM1:`
a'�fiK tF•• q: a a
M ?`i,�.
' k�1r. , ,{,�i',f �� >' r .''+i, .kc a ,;f z'Y�.R.�.`+ \? `+� t"4- yt �`�!•' J �c •X >:r,�.
g,0�•�f.�-
y. 1AW'y7��y :�.• ``11 ,+ .;t %i4 A } t.: y� s
la�6ti+t ".t:- .: °�•?,, i,^: rr iv.ar I. .♦ ,i.,t+, ..5 ( I'a!':- .yam♦,' s ..;a -- , :s�v�`t,'��"�i
tas s ,k�es �.`, ;.a: t,. ♦;' } :R.� w K`i ;M1L [rk
AMMA
1. Oe.,
t
o • - n . f �, .\ ♦,'► t b..o die s r.. ra t' �iyi. '�'!,'y r �,\ .r ` \' ki } c x, e,'
a / r'st�• kt i-,. aaa Sr' +' - Y ., tIFJ4r-
V'r
' _ .. 1°-r`x¢,y,..P"'t'"7,''''* iAf1^i}'x v.�.f... Yc.•i .j� �a� - y 4t+{psry'$ a a+,tt `e. y ;t 1.
°:,t �''��ijt7' -F `•�'+i'•�'i•£' '•i�(. S:?�i1' iI�';�f"+ •;`' {;,,#�j ft1��1Y1�t .. Sl.' t+K ::;•�`+ `� �4�..�, . _ � {T' ('a.'�
:t . . `, �4 �.�1� ti,f�t• � r:i"• (.,•a ; 1�,�`, + 't t � � *-;� � , :�•°�rty, hl.{�,'h:efi+f�•y` `' "�.'' ,-• ,�+ _� .
�`'^�.r� �y�� _ • �t.,�".��*¢'.� �i+ e l i� 4\' � .7� �,..� rx�l"�'�?4 a i � �..Z �,i
��y`,'y: e �%>1� r •9n �t� fa � :. �' ,,,.i ;,�. � �i ,4 � � � .� x n� '� � � prj ,fit ,4. .r"r y�, .:,,,y`y 'i'„
Y '� r 4��T � s,.�,1���;`�.�'xS ; � `� �y, 'N� • ��M � � A � f �!�,tr`i�`� ��' � ���'j��i,'�;�T�i �v' i}\� __ {q♦�`'+r�i,' ?��p'it�F:
Yfy", r .k,,,1,t" - r is '!.:.a R ".�'�`aa d.�tl•` ,5,+' \.F rC$ +,y4F� s t 4
' '"R��-"q+� ..v'q f-._t• ''Y�1°.. � _.,--s'�i,�: �.. _ t,�'�,��,'�:i ,�_r � i r�f 4:iY�i�`,3
,F ''�"♦.. - {�'+ �' •_` "F��i '? ` X' �h.. N .�+.t4i
�u. A� - � � ''�,-�, ���� ry�A � yi� `,.l^ �,`�+'•C`�'�5f i�r.-tRµ�' � :,k�... � , 1M t ��h �i�( •J? �a� �i
- �r f•.� ,t. � h:: Z'"1` ' .`pk'�?'�' o F" '�s } r�"�'r �,�. sp_ � a � �, y. '•i., r : d�,' ,��y4* P��,�,,- ,
r� fit
R t .Y , x � t , � c I}r` . w-„-.C•'nG y b.
.e' �( r• -h_ _ li• i;�"�C'� �i'-., �'R' •0 1�
. rF
� *' vT. 1957
Al
�. •. 'G � i? ✓/'T':Ft t�.�:f �W } .,. ui;. �.t1!'+ f � �i�� •I' ��' � `j :�1�} ' R �( .;1
,�� \� -1- a `'!,` I., p,, F� R�e� ?'_� ,j�,a� f".t_yk}y.*s;,� ,Q - o � .♦� i�"7.41Yr9�f 'dr�..•�n �. � •N.Y/ � •s4 Ai.
,'4a' �o1 - . $ . °,� . . ��''� .Wi:' ,{`:� >�.♦ s� e•,'h.'E! Yw,r+{{K' yil♦yo►,_ -a-' L..t eri a- �q , i r� t o.l`Y,'f< {� .�
'( r♦'s> ,, ,y `t. ./.j:j,- I�,�s. s`R Tk' ' ! !�."� -. �, ,. _ '_! 1- .'. ✓k � - `` yti
M ;.. �a„��, _ ,*- � � •�J ',��t^,/��,i�g'�♦"t�e,��, = ���TF^7`ir��,gP �1�`� �' i�+h 7. 3_a Y.»A,_v4�'"�f�,.�-• 1�1 '�q ���'�V�'�` ♦ 1 Rw, `f;'1r,,
k - •j.3 { V / �.yc° -r-- j itf 4 �t. �' r� Fr L'dc >! 8 Lt;�v'. e X-S �j.."R•K,N , pr H6.,
M
Y�4=0fp� ( .w.. ,t .. 1743 . _"ate !" .. jy �.. `' ' saq,,to�,p,;` t:, - - 3.' '"� r l t.t �,s �1" rt rj" .+•
ow r.,; f,- , { 3!�(5P!;!4-x �a�. .l• 7s.�S _ - ,: i1` h s"x i, ':z s_ �� .i_:y .t t --t:. .i,
x r - 3 r ►""�q`'`'e.�1`_' •' 7�.': s ,L + (';`rs`"r lif' { i4 i
1001 _ r � ( ..,�+��1°'s�-=' � `1 l,e�i�ei _ ,"",=1j "�+' .� rr v �,. ♦ #♦ �Yr � �,�,�,'".te �i. ,tcR '+� ,��f£� isf,
L
•70
♦ • >A.� P F 6 •� �. g�
i
1 ` I _i'

FIGURE
TOWN OF CLEVELAND WWTP
Bar Screen In cent
A, �.
Sliucr � \
C0xidationDi!:tch#1 t_ RAS ,(0.09 MGt:/ �j°Pf
Final Eff. &
Flow Measurement
QTo Stream 1-4-
r(O1.0
er#1 �WAS
9 MG)
Chlorine
Contact
...
s
v
G
Oxidation Ditch #2
(0,18 MG)
RAS
1
3
Clarifier # 2 PUMPS NVAS
(0.0476 MGj
., Digester
To Sludge
Disposal Q

V. Sampling and Monitoring Plan
• Sampling for this project consists of sampling the soils of the permitted fields in order
to document that the fields are suitable for land application.
• Residuals samples are to be collected at the residuals processing facility by the Land
Application ORC or his designee. This may include nutrient and metal, pathogen,
vector attraction reduction, and TCLP samples. Samples should be obtained by the
Town of Cleveland or their designated representative prior to any land application
activities being performed in order to verify that samples meet regulatory requirements
set forth in the permit. Samples should be collected at the frequency specified in the
referenced permit.
If necessary, the Town of Cleveland or their representative will perform alkaline
stabilization of residuals at the wastewater treatment facility. The Land Application
ORC or his designee will provide documentation of times, temperatures, and pH of the
residuals for the lime stabilization events. The Town of Cleveland or their
representative will provide the alkaline stabilization materials and personnel to
perform this operation and will designate a responsible party for the documentation
that the residuals have passed the alkaline stabilization process.
CAUserslRob WillcoxlOneDrive - Willcox and Mabe Soil Sol utionslSharedlWMSS Projects52024124-08 Town of
Cleveland12024 Permit RenewallDEQ FormslTown of Cleveland O&M Plan -Sampling & Monitoring Section - June 2019.doc6/28/2019

QUANTITATIVE JUSTIFICATION
Town of Cleveland
Wastewater Treatment Plant (WWTP)
Non -Discharge Permit No. WQ0011431
Requested Dry Tons for Renewal — 82.0
LAND APPLICATION OF CLASS B RESIDUALS
• Previously Permitted Dry Tons — 82.0
• Requested Dry Tons for Renewal — 82.0

CLEVELAND WWTP
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater
Treatment Plant
Date Sampled: April 10, 2024
Date Reported: May 9, 2024
Cleveland WWTP
Permit No. WQ0011431
Mineralization Rate 0.3
1.07 % Solids
6.92 pH
Parameter
% MgfKg Dry Weight Pounds/Dry Ton 1
(% x 10,000) (MgfKg x 0.002)
Nitrogen (TKN)
4.320 43,200.000
86.400
Phosphorus
1.690 16,900.000
33.8001
Potassium
0.379 3,790.000
7.580
1
41.1931
PAN (injected)*
2.060 20,596.545
41.1841
PAN (surface)*
2.059 20,591.870
Ammonia Nitrogen
0.001 9.350
0.014
Calcium
2.050 20,500.000
41.000
Calcium Carbonate Eq.
--- --- ---
Magnesium
--- 2,140.000
4.290
Sodium
--- 20,100.000
40.200
Sulfur
--- --- ---
'Nitrate N / Nitrite N
--- 7,630.000
15.260
Barium
--- --- ---
1
SAR I
Chloride
--- ---
3.69
Iron
--- --- ---
Ceiling Concen.
Aluminum
--- 12,300.00
24.600
(Mg/Kg)
Arsenic
--- 17.900 ---
75
Cadmium
--- 17.900
0.036
85
Chromium
--- --- ---
_-
Copper
--- 458.00
0.916
4,300
Lead
--- 17.900
0.036
840
Mercury
--- 1.680 ---
57
Molybdenum
--- 17.900 ---
75
Nickel
--- 17.900
0.036
420
Selenium
--- 17.900 ---
100
Zinc
--- 645.00
1.290
7,500
Envirochem 2024-08312
*Determination of Plant Available
Nitrogen (PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia
N) + Ammonia N + Nitrate N + Nitrite N = % PAN
Surface Application:
(Mineralization Rate)(TKN-Ammonia
N) + (0.5)(Ammonia N) + Nitrate N + Nitrite N =
% PAN
Note: Constituents N.D. (Not Detected) or < detection limits are listed as detection limits
for calculation purposes.

Sample Date
04/10/24
04/10/24
04/10/24
04/10/24
04/10/24
04/10/24
04/10/24
Geometric Mean 11
Town of Cleveland
Non -Discharge Permit No. WQ0011431
2024
Fecal Coliform
MPN/gram dry weight
210,527
468,086
163,462
184,616
309,735
149,123
133,859
Total
Average
210,620
Log
5.32
5.67
5.21
5.27
5.49
5.17
5.13
Environmental Chemists - Report # 2024-083 t2
37.26 1
5.32
Ii Fecal Coliform - MPN/gram dry weight
Geometric Mean of Less than 2,000,000 mets Class B -Alternative 1 Pathogen Reduction
Fecals 2024.xls Page 1

PAN
First -Year
Five -Year Maximum Adjusted
Assumed Application Rate
(lbs PAN/ac-yr)
50
100
150
200
Cleveland WWTP
Permit # WQ0011431
RESIDUALS APPLICATION DATA
82 Dry Tons of residuals to be certified
PLANT AVAILABLE NITROGEN SUMMARY
Pounds of PAN per DT
(Weighted Average)
Surface Incorp. Or Inject.
41.18 41.19
58.04 58.04
Acres Required Using First -Year
PAN Concentrations I
Surface
Incorp. Or Inject.
67.5
67.6
33.8
33.8 i
22.5
22.5
16.9
16.9
Pounds of PAN per Year
Surface Incorp. Or Inject.
3,377 3,378
4,759 4,759
Acres Required Using Five -Year
Maximum Adjusted PAN
Surface Incorp. Or Inject.
95.2 95.2
47.6 47.6
31.7 31.7
23.8 I 23.8

Willcox & Mabe Soil Solutions, PLLC
RESIDUAL PAN CALCULATION
Town of Cleveland
TKN= 43,200 mg/kg
NH3= 9 mg/kg
NO3-NO2-N= 7,630.0 mg/kg
Min Rate= 0.30
PAN= [min.rate (TKN - NH3) + 0.5 (NH3) + NO3-NO21
0.30 43,191 5 7630.00
PAN= 20591.87 mg/kg
Calculate residual nitrogen for years 2,3,4 and 5 following the initial application to determine
the amount of PAN/DT remaining.
2ND YEAR RESIDUAL PAN.
PAN= [min.rate (1st year org. - N 2nd year min. - N]
0.15 43,191 12,957
PAN= 4535.02 mg/kg remaining from 1 st year application
3RD YEAR RESIDUAL PAN
PAN= [min.rate (2nd year org. - N 3rd year min. - N]
0.08 30,233 4,535
PAN= 2055.87 mg/kg remaining from 1 st year application
4TH YEAR RESIDUAL PAN,
PAN= [min.rate (3rd year org. - N 4th year min. - N]
0.05 25,698 2,056
PAN= 1182.13 mg/kg remaining from 1st year application
5TH YEAR RESIDUAL PAN
PAN= [min.rate (4th year org. - N 5th year min. - N]
0.03 23,643 1,182
PAN= 652.92 mg/kg remaining from 1st year application
Residual PAN from years 2 thru 5 after the initial application = 8425.94 mg/kg
Application
Five Year Maximum
Method
First Year PAN
Adjusted PAN
(mg/kg)
(mg/kg)
Surface
20,592
29,018
Incorporation
20,597
29,022
Application
Five Year Maximum
Method
First Year PAN
Adjusted PAN
(lbs/DT)
(lbs/DT)
Surface
41.18
58.04
Incorporation
41.19
58.04

SAR Calculation
Na Ca Mg SAR
9.351 10.968 1.908 3.685
� I
Enter Enter .% TS
Data Na mg/kg
Ca mg/kg
Mg mg/kg
Job Name: Town of Cleveland
Na mg/I Ca mg/I
Mg mg/I
215.07 j 219.35
22.898
Na mil eq Ca mil eq
Mg mil eq
9.351
10.968
1.908
1.07
201001
1
20500
1
2140
_
Page 1

ANALYTICAL & CONSULTING CHEMISTS
Dancor Industrial Services
1410 Jack Davis Road
Monroe NC 28112
Attention:
Lab ID Sample ID:
24-20264 Site: Sludge
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 910.392.0223 Lab ' 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252,473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
info`�i.•environmentalcliemists.com
Date of Report: May 09, 2024
Customer PO #:
Customer ID: 24040006
Report #: 2024-08312
Project ID: Cleveland WWTP
Collect Date/Time Matrix Sampled by
4110/2024 7:35 AM Solid/Sludge Client
Test
Method
Results
Date Analyzed
Chlordane (TCLP)
SW-846 8081 B
<0.02 mg/L
04/16/2024
Endrin (TCLP)
SW-846 8081 B
<0.0005 mg/L
04/1612024
Heptachlor (TCLP)
SW-846 8081 B
<0.0005 mg/L
04/16/2024
Heptachlor epoxide (TCLP)
SW-846 8081 B
<0.0005 mg/L
04/16/2024
Lindane (TCLP)
SW-846 8081 B
<0.0005 mg/L
04/16/2024
Methoxychlor (TCLP)
SW-846 8081 8
<0.0005 mg/L
04/16/2024
Toxaphene (TCLP)
SW-846 8081 B
<0.05 mg/L
04/16/2024
2,4,5-TP (TCLP)
SW-846 8151 A
<0.003 mg/L
04/18/2024
2,4-D (TCLP)
SW-846 8151 A
<0.003 mg/L
04/18/2024
1,4-Dichlorobenzene (TCLP)
SW-8468270E
<0.050mg/L
04/16/2024
2,4,5-Trichlorophenol (TCLP)
SW-846 8270 E
<0.050 mg/L
04/16/2024
2,4,6-Trichlorophenol (TCLP)
SW-846 8270 E
<0.050 mg/L
04/16/2024
2,4-Dinitrotoluene (TCLP)
Sw.e46 8270 E
<0.050 mg/L
04/16/2024
Cresol (TCLP)
SW-846 8270 E
<0.050 mg/L
04/16/2024
Hexachloro-1,3-butadiene (TCLP)
SW-846 8270 E
<0.050 mg/L
04/16/2024
Hexachlorobenzene (TCLP)
SW-846 8270 E
<0.050 mg/L
04/16/2024
Hexachloroethane (TCLP)
Sw-846 8270 E
<0.050 mg/L
04/16/2024
m + p-Cresol (TCLP)
SW 46 $270 E
<0.050 mg/L
04/16/2024
Nitrobenzene (TCLP)
SW-846 8270 E
<0.050 mg/L
04/16/2024
o-Cresol (TCLP)
SW-846 8270 E
<0.050 mg/L
04116/2024
Pentachiorophenol (TCLP)
SW-646 8270 E
<0.250 mg/L
04/16/2024
Pyridine (TCLP)
SW-846 6270 E
<0.050 mg/L
04/16/2024
1,1-Dichloroethylene (TCLP)
SW-846 Method 8260D
<q.01 mg/L
05/02/2024
1,2-Dichtoroethane (TCLP)
SW-846 Method 8260D
<0.01 mg/L
05/02/2024
Benzene (TCLP)
SW-846 Method 8260D
<0,01 mg/L
05/02/2024
Carbon Tetrachloride (TCLP)
SW-848 Method 8260D
<0.01 mg/L
05/02/2024
Report #:: 2024-08312 Page 1 of 4

7envirochem
iff v
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 ' 910.347.5843 Lab/Fax
info;environmentalcheniists.com
Dancor Industrial Services
Date of Report: May 09, 2024
1410 Jack Davis Road
Customer PO #:
Monroe NC 28112
Customer ID: 24040006
Attention:
Report #: 2024-08312
Project ID: Cleveland WWTP
Chlorobenzene TCLP
(TCLP)
sw.84s Method a2600
<0.0 1 mg/L
05/02l2024
Chloroform (TCLP)
SW-846 Method 8260D
<0.01 mg/L
05/02/2024
Methyl ethyl ketone (TCLP)
SW-846 Method 82600
<0.05 mg/L
05/02/2024
Tetrachloroethylene (TCLP)
SW446 Method 8280D
<0,01 mg/L
05/02/2024
Trichloroethylene (TCLP)
SW-846 Method 8260D
<0.01 mg/L
05/02/2024
Vinyl Chloride (TCLP)
SW-846 Method 8260D
<0,01 mg/L
05/02/2024
RCI
Cyanide
SM 4500 CN D-2016
<1 mg/kg
04/15/2024
Sulfide
SM 4500 s D-2011
0,14 mg/kg
04/17/2024
Ignitability
SW 846 method 1010
>158 °F
04/24/2024
pH SW 846 Method 9045D
Result estimated. Analyzed out of 15 minutes hold time.
6.92 units
04/19/2024
Sludge Residuals
Aluminum
EPA 200.7, Rev. 4.4,1994
12300 mg/kg
04/17/2024
Arsenic
EPA 200.7, Rev. 4.4. 1994
<17.9 mg/kg
04/17/2024
Cadmium
EPA 200.7, Rev. 4.4. 1994
<17.9 mg/kg
04/17/2024
Calcium
EPA 2007, Rev. 4.4. 1994
20500 mg/kg
04/17/2024
Chromium
EPA 200.7, Rev. 4.4. 1994
<17.9 mg/kg
04/17/2024
Copper
EPA 200.7, Rev. 4.4. 1994
458 mg/kg
04/17/2024
Lead
EPA 200.7. Rev, 4.4. 1994
<17.9 mg/kg
04/17/2024
Magnesium
EPA 200.7, Rev, 4.4, 1994
2140 mg/kg
04/17/2024
Molybdenum
EPA 200.7, Rev, 4.4, 1994
<17.9 mg/kg
04/23/2024
Nickel
EPA 200.7, Rev 4.4,1994
<17.9 mg/kg
04/17/2024
Potassium
EPA 200.7, Rev, 4.4, 1994
3790 mg/kg
04/17/2024
Selenium
EPA 200.7. Rev. 4.4, 1994
<17.9 mg/kg
04/17/2024
Sodium
EPA 200.7, Rev. 4.4, 1994
20100 mg/kg
04/23/2024
Zinc
EPA 200.7, Rev. 4.4, 1994
645 mg/kg
04/17/2024
Nitrate+Nitrite-Nitrogen
EPA 353.2
7630 mg/kg
04/12/2024
Total Solids (%)
SM 2540 s
1.07 %
04/12/2024
Ammonia Nitrogen
SM 4500 NH3 C-2011
<9.35 mg/kg
04/12/2024
Report # : 2024-08312
Page 2 of 4

Environmental Chemists,
Inc.
envirochem6602
Windmill Way, Wilmington, NC 28405 0 910.392.0223 Lab . 910.392.4424 Fax
.3M
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL& CONSULTING CHEMISTS
info.' environmentalchemists.com
Dancor Industrial Services
Date of Report: May 09, 2024
1410 Jack Davis Road
Customer PO #:
Monroe NC 28112
Customer ID: 24040006
Attention:
Report #: 2024-08312
Project ID: Cleveland WWTP
Total Kjeldahl Nitrogen (TKN)
SM 4500 Norg B-2011 43200 mg/kg
04/12/2024
Total Phosphorus
SM 4500 P (F-H)-2011 16900 mg/kg
04/18/2024
Mercury
SW-846 7471 B <1.68 mg/kg
04/17/2024
TCLP Metals
Arsenic (TCLP)
EPA 200.7, Rev 4.4, 1994 <1.0 mg/L
04/17/2024
Barium (TCLP)
EPA 200.7. Rev 4.4 1994 <1.0 mg/L
04/17/2024
Cadmium (TCLP)
EPA 200.7. Rev 4.4 1994 <1.0 mg/L
04/17/2024
Chromium (TCLP)
EPA 200.7, Rev 4.4 1994 <1.0 mg/L
04/17/2024
Lead (TCLP)
EPA 200.7. Rev 4.4 1994 <1.0 mg/L
04117/2024
Selenium (TCLP)
EPA 200.7, Rev 4.4 1994 <1.0 mg/L
04/17/2024
Sifver (TCLP)
EPA 200,:t. Rev 4 4 1994 <1.0 mg/L
04/17/2024
Mercury (TCLP)
EPA 245 1 <0.0002 mg/L
04/18/2024
Lab ID Sample ID:
Collect DatelTime Matrix Sampled by
24-20265 Site: 1
4/10/2024 7:45 AM Solid/Sludge Client
Test
Method Results Date
Analyzed
Total Solids (%)
SM 2540 B 0.76 %
04/12/2024
Fecal Density
SM9221C E 2014 210527 MPN/g
04/10/2011
Lab ID Sample ID:
Collect DatelTime Matrix Sampled by
24-20267 Site: 2
4/10/2024 7:48 AM Solid/Sludge Client
Test
Method Results Date
Analyzed
Total Solids (%)
SM 254Q B 0.47 %
04/12/2024
Fecal Density
SM92210E-ZA4 468086MPN/g
04/10/2011
Lab ID Sample ID:
Collect DatelTime Matrix Sampled by
24-20268 Site: 3
4/10/2024 7:50 AM Solid/Sludge Client
Test
Method Results Date
Analyzed
Total Solids (%)
SM 2540 B 1.04 %
04/12/2024
Fecal Density
SM 9221C E-2014 163462 MPN/g
04/10/2011
Report U 2024-08312
Page 3 of 4

Y
ill - 17
5rl`
7envirochem All,
ANALYTICAL & CONSULTING CHEMISTS
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
infou:environmentalchemists.com
Dancor Industrial Services Date of Report: May 09, 2024
1410 Jack Davis Road Customer PO #:
Monroe NC 28112 Customer ID: 24040006
Attention: Report #: 2024-08312
Project ID: Cleveland WWTP
Lab ID Sample ID; Collect Date/Time Matrix Sampled by
24-20269 Site: 4 4/10/2024 7:53 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%} SM 2540 B 1.30 % 04/12/2024
Fecal Density SM 9221 C E-2014 184616 MPN/g 04/10/2011
Lab ID Sample 1D: Collect DateITime Matrix Sampled by
24-20270 Site: 5 4/10/2024 7:56 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 1.13 % 04/12/2024
Fecal Density SM 9221C E-2014 309735 MPN/g 04/10/2011
Lab ID Sample ID: Collect DatefTime Matrix Sampled by
24-20271 Site: 6 4/10/2024 7:59 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 1.14 % 04/12/2024
Fecal Density SM 9221C E-2014 149123 MPN/g 04/10/2011
lab ID Sample ID: Collect Datefrime Matrix Sampled by
24-20272 Site: 7 4/10/2024 8:03 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 1.27 % 04/12/2024
Fecal Density SM 9221C E-2014 133859 MPN/g 04/1012011
Comment: Sludge residuals reported on a dry weight basis.
Reviewed by:
i�
Report #:: 2024-08312 Page 4 of 4

Environmental Chemist, Inc., Wilmington, NC Lab ##94 6602 Windmill Way
Wilmington, NC 28405
910.392.0223
Sample Receipt Checklist
Client: b(� n w r Date: "t to Report Number: 2— 4
Receipt of sample:
Echem Pick up VI Client Delivery ❑ UPS ❑ FedEx ❑ Other ❑
❑
YES
NO
N/AI
Were custody seals present on the cooler?
❑
YES
I❑
❑
NO
11 N/A
11.
2. If custody seals were present, were they intact/unbroken?
Original temperature
upon receipt
3 • O °C Corrected temperature upon receipt °C
How temperature taken:
❑ Temperature Blank V Against Bottles
IR Gun ID:
Thomas Traceable
S/N 192511657 IR Gun Correction Factor °C: 0.0
❑
YES
❑
NO
3.
If temperature of cooler exceeded 6°C, was Project Mgr./QA notified?
YES
❑
NO
4.
Were proper custody procedures (relinquished/received) followed?
YES
❑
NO
5.
Were sample ID's listed on the COO
YES
❑
NO
6.
Were samples ID's listed on sample containers?
$1
YES
❑
NO
7.
Were collection date and time listed on the COO
YES
❑
NO
8.
Were tests to be performed listed on the COC?
YES
❑
NO
9.
Did samples arrive in proper containers for each test?
YES
❑
NO
10.
Did samples arrive in good condition for each test?
(Sl
YES
❑
NO
11.
Was adequate sample volume available?'
YES
❑
NO
12.
Were samples received within proper holding time for requested tests?
❑
YES
❑
NO
13.
Were acid preserved samples received at a pH of <2?
❑
YES
❑
NO
14.
Were cyanide samples received at a pH >12?
❑
YES
❑
NO
15,
Were sulfide samples received at a pH >9?
❑
YES
❑
NO
16.
Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L? **
❑
YES
❑
NO
17.
Were Sulfide/Cyanide received at a chlorine residual of <0.5 m/L?
❑
YES
❑
NO
18.
Were orthophosphate samples filtered in field within 15 minutes?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
** Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet.
Sample Preservation (Must be completed for any sample(s) incorrectly preserved or with headspace)
Sample(s) were received incorrectly preserved and were adjusted accordingly
by adding (circle one): H2SO4 HNO3 HCPNaOH
Time of preservation: If more than one preservative is needed, notate in comments below
Note: Notify customer service immediately for incorrectly preserved samples. Obtain a new sample or
notify the state lab if directed to analyzed by the customer. Who was notified, date and time:
Volatiles Sample(s) were received with headspace
COMMENTS:
DOC.QA.002 Rev 1

(F
Analytical & Consulting Chemists
Client: Dancor Industrial Services
ADDRESS: 1410 Jack Davis Road
Monroe, NC 28112
ENVIRONMENTAL CHEMISTS, INC6602 OFFICE:
9m0-39 223FAX9ton910-392-44245
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 info&nvironmentalchemists.com
Sampled By: a d?->�,k �es►�t/
Collection
Sample Identification
Sludge
Date Time Temp
14.10 -N 73519-
COLLECTION AND CHAIN OF CUSTODY
PROJECT NAME: CA e v/,,) r.R,t }, W1✓Tjy REPORT NO: W + O g
CONTACT NAME: Dan Burgess PO NO:
REPORT TO: �� ��„ig�sr PHONEIFAX:
COPY TO: 9, 1, email: [e-mail]
SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL Sludge, ther:
CD D PRESERVATION
Q.
F 'a m C C 1 p W O
m " w ANALYSIS REQUESTED
EQ. o i; o n L E `o J Z) O0 x w Z ¢= w F
y t) u U 4 Z z = = Z ~ 'J O
zz
Q a DQAQ x
Full TCLP/RCI
Site: Gl
4-l0 2V 7 u o c1M
T I
C
I
j
I I
I
I
c ve'k" ,ti, �,
(C)
G
j
X
nutrients/metals
u-,a.sa
yg
0
I G 1
1
1
A
I
I
I
I
I0IGI
41-1o.2417 �i 0 4
C
161G1
I P
V
1
l I �
u-,�_2u1 7S �.�
�
► � 1
116�
�I
aI�
I
I�oXlllll
I
'---�- :;- 4
s U0-1 To
i p
I
I
I
I
xl (
I I
I
I
Ah
re.t,As
NOTICE • DECHLORINATION: Samples for Ammonia, TKN, Cyanide, Phenol and Bacteria
must be dechlorinated (0.5 ppm or less)
In the field at the time of collection. See reverse for Instructions
Transfer
1.
Relinquished By:
Date/Time
( �
l:�)
Received By: },� Date/Time
(�
. M ,-,,,e,>�; "JCl\/t�(Y-V� H —1 Q-QLi I 0
2. _
Temperature when Received °C: Accepted: Rejected: Resample Reques ed:
Delivered By: Received By: _ Date: Cl—Time:
Comments: TURNAROUND:

pj_)kR
> ROM PT- A CCU RATE -RELIABLE
LABORATORIES, INC
W"'WYARLABS.CON1
REPORT Or ANALYSES
Attn: DANIEL BURGESS
DANCOR IND. SERVICES
1410 JACK DAVIS RD
MONROE, NC 28112-
PROJECT NAME: APR 24
DATE: 05/24/24
SAMPLE NUMIBER- 149546 SAMPLE ID- CLEVELAND WWTP SAMPLE MATRIX- SO
DATE SAMPLED- 04/10/24 TIME SAMPLED- 0740
DATE RECEIVED- 04/10/24 SAMPLER- DB RECEIVED BY- DJ
TIME RECEIVED- 1540 DELIVERED BY- RE TYPE SAMPLE- Grab
Paae 1 of 1
ANALYSIS
ANALYSIS METHOD DATE TIME BY RESULT UNITS
30 DAY BENCH SCALE TEST VAR 04/10/24 1630 RE
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte. NC 28273
Phone: [phone] • Fax: [phone]
6.56 %

..
-R❑MPT•ACCIJRATE• 2ELIABI_E
LABORATORIES, INC
WWW.PARLABS.COM
30 Day Bench Scale Extended Aeration Test
Percent Volatile Solids Reduction
'
DANCOR INDUSTRIAL SERVICES
� ' D
CLEVELAND WWTP
~'
149546
'
04/10/24
05/08124
Start: End:
TS (g)
0.0843
0.0803
TS%
I 0.80%
0.79%
VS (g)
0.0580
0.0522
VS%
68.80%
65.01 %
y Mass Fraction of Volatile Solids in Liquid Sludge 0.0054957
0.0051349
x Mass Fraction of Fixed Solids in Liquid Sludge 0.0024920
0.0027642
FSVR (Mass Balance)
6.57%
FSVR (Van Kleeck)
6.56%
FSVR (Mass Balance) <15%
j 1
YES
FSVR (Van Kleeck) <15%
YES
P.O. Box 411483 • Charlotte, NC 28241-1483
Phone: [phone] Fax: [phone]

PiA
ROMPT.ACCURATE• ZELIABLE
L"ORATORIES, INC
W W W.PARLABS.COM
30 Day Bench Scale Extended Aeration Test
VAR Option 3, Percent Volatile Solids Reduction
DANCOR INDUSTRIAL SERVICES
i . CLEVELAND WWTP
0149546
04/10/24
,90'', 05/08/24 ,
Collected
D.O.
Crucible
Tare Wt (g)
Sample Wt +
Tare Wt (9)
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%
As Received
Day 0
Day 7
Day 14
Day 21
Day 28
04M0124
04110124
04i17124
04124124
05/01124
05i08f24
3.10
4.23
4.51
4.68
4.87
X13
X13
X33
X3
X8
X14
17.0800
17.0800
17.4890
16.9122
17.1140
20.9112
27.6338
27.6338
26.6038
27.2148
27.2938
31.0770
10.5538
10.5538
9.1148
10.3026
10.1798
10.1658
107
107
106
106
105
106
04/10/24 16:30
04/10/24 16:30
04117124 09:10 04124124 08:45
05/01/24 10:05
05/08/24 08:30
04/11/24 16:45
04111/24 16:45
04/18/24 09:30
04/25/24 08:55
05102/24 10:15
05109124 09:00
17.1643
17.1643
17.5665
16.9957
17.1903
20,9915
0.0843
0.0843
0.0775
0.0835
0.0763
0.0803
0.0263
0.0247
0.0274
0.0265
0.0281
550
550
550
550
550
04/12/24 14:45
04/18/24 13:50
04/25/24 14:20
05/02/24 15:00
05/09/24 16:00
04/11/24 15:50
04/18/24 15:00
04/25/24 15:30
05/02/24 16:15
05/09/24 17:00
17.1063
17.5137
16.9396
17.1405
20.9393
0.0580
0.0528
0.0561
0.0498
0.0522
0.80%
0.80%
0.85%
0.81%
0.75%
0.79%
68.80%
68,13%
67.19%
65,27%
65.01%
a
I yf Mass Fraction of Volatile Solids in Liquid (Feed)
yb Mass Fraction of Volatile Solids in Liquid (Bottom)
Sludge at Start of Test
0.0054957
Sludge at End of Test
0.0051349
I xf Mass Fraction of Fixed Solids in Liquid (Feed) Sludge
Xb Mass Fraction of
Fixed Solids in Liquid (Bottom)
at Stan of Test
0.0024920
sludge at End of rest
0.0027642
TS (9)
0,0843
I TS (9)
0.0803
VS (g)
0.058
VS (g)
0.05221
(Volatile Fraction Id 0.860001 (Volatile Fraction Oud 0.822911
P.O. Box 411483 • Charlotte, NC 28241.149 3
Phone: [phone] • Fax: (7U4) 58S-8335

.,a
PRO MALT. A CCU RATE• 84LL1Ar7LG
i.ABORATORIBS, 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 Chan 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
Address
ylU Sic IC 1--)", . t
City, State @ zip code
-----_...-----------
Point of Contact @ Telephone Number
Dan t e I - ^ 3 .2� --
Sample
Taken By: SIGNATURE 52,
PRINTED NAME
ARE SAMPLES FOR STATE or EPA REPORTING?
YES NO
'Sample Type: Dyy © t�I-Cic- GWMW HW
Soil
other
Sample Temp at time of sampling: e
_
C Sample Temp upon
receipt:
_
° C
"Field Preserved: Yes ! e No Teflon Liner/Zero Fleadspace: Yes
No
n/a
Residual Chlorine checked at time of sampling (Y/N):
Dechlorination Necessary
(Y/N): !Yp
Client Sample I.D.
(Sample Location I Number) Comp Grab
Preserv.
Set Up Collection
Daterrime Dateffime
Analyses
Requested
lit
4'97e --
-�,•� (� iU-2y
'T uG &n
iielinquish y� DaterTime Received-" DatelTime
Relinquis Datefri Received by' 1 DatelTime _
��6)zs-v'Lo
C=Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

APPENDIX III
LAND APPLICATION SITE CERTIFICATION
WATERBODY AND CLASSIFICATION INFORMATION
(FORM: LASC 06-16)

LAND APPLICATION SITE CERTIFICATION
WATERBODY AND CLASSIFICATION INFORMATION
(FORM: LASC 06-16)

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 conies of the application and
sutmortine documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
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 I. 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:
Required Item
County Board
Notification. doc
i
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
t:caiuiltioll Pol cC,
INSTRUCTIONS FOR FORM: LASC 06-16
Status Code
N R T M
Page 1 of 3

An updated accounting of the land application site's cumulative
pollutant loading rates (CPLRs)
Required Item
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 E\aluation Policy"
Acknowledgement of field transfer from Land Owner (Fields may not
be permitted to multiple Permittees over the same time period)
✓ ✓ �_
Status Code
N R T M
✓ ✓ ✓
* 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 Merc (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: httD:Hdeci.nc.2ov/about/divisions/water-
resources/nlannine/classification-standards/classifications
❑ 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:
httu://deo.nc.2ov/contact/re eional-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.
Open the link htti)://deci.nc.aov/about/divisions/water-resources/Dlanninv/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 CIassifcations 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
Little Tennesse River
Basin And Savannah
River Drainage Area
French Broad River
Basin
Watauga River Basin
Broad River Basin
New River Basin
Catawba River Basin
Yadkin -Pee Dee River
Basin
Lumber River Basin
Roanoke River Basin
Chowan River Basin
Tar -Pamlico River
Basin
Pasquotank River Basin
Streams entering Georgia or Tennessee shall be classified "C Tr." I
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."
Streams entering Tennessee will be classified "B."
Streams entering the State of Tennessee are classified "C."
Streams entering South Carolina are classified "C."
Streams entering the State of Tennessee are classified "C."
Streams entering South Carolina are classified "C."
Streams entering Virginia are classified "C," and such streams entering South Carolina are
classified "C."
Streams entering South Carolina are classified "C Sw."
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."
Streams entering Virginia are classified "C."
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."
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: Town of Cleveland
Land application sites currently certified: 10.0 net acres and Total to be certified: 29.8 net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Site/Field ID
Landowner(s)
Code'
R
NC-RA-01-01
Town of Cleveland
N
NC-RA-02-01
Charles Barber
N
NC-RA-02-02
Charles Barber
Lessee(s) or Operator(s)
Net Acres
County
N/A
10.0
Rowan
N/A
5.2
Rowan
N/A
I 14.6 I
Rowan
Predominant Soil
Crop(s) Mapping Unit
Series Name' or Rep. Slope`
Fescue - Hay Enon EnB
Fescue - Pasture Enon EnB
Fescue - Pasture Cecil CeB2
'Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ T (Transferred) ♦ D (Deleted)
' 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)
II. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude Longitude
Location
Location Method Code
Waterbody Subbasin and
Location Accuracy
Current and Proposed
p
Datum
Stream Index No.
Class
01/01
350 44' 17.8" 800 39' 59.3"
NAD 83
MAP
Nearest tenth of second UT to Third Creek (12-108-20-4)
C
C
02/01
350 49' 22" 800 39' 3.4"
NAD 83
MAP
Nearest tenth of second UT to Beaverdam Branch (12-108-17-(2)
WS-IV
WS-IV
02/02
350 49' 11.3" 800 39' 2.3"
NAD 83
MAP
Nearest tenth of second UT to Beaverdam Branch (12-108-17-(2)
M
i
° ' 11 ° ' 11
NAD 83
ADD
Nearest Second
_
° ' 1 ° ' 11
NAD 83
ADD
Nearest Second
-
-
° ' 11 0 1 11
NAD 83
ADD
Nearest Second
-
° 1 11 0 1 11
NAD 83
ADD
Nearest Second I
_
° ' F, ° ' 11
NAD 83
ADD
I Nearest Second I
-
Note: Please keep the site information (I.) and waterbody information (II.) of the same field on the same page.
FORM: LASC 06-16 Page 1

APPENDIX IV
COUNTY BOARD NOTIFICATION
(FORM: CBN 06-16)

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources COUNTY BOARD NOTIFICATION
INSTRUCTIONS FOR FORM: CBN 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 AD_ Dlicant shall submit one original and two conies of the application and
suDDortine documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This notification is intended to provide the county board in which the land application site is proposed to be located with
general information on the size, location and type of residuals land application proposed to occur in their county, and to give them an
opportunity to comment on the pending permitting request as stipulated in Session Law 2013-340. Notification is not required for
fields deemed permitted to receive Class A residuals under 15A NCAC 02T .1100. Do not submit this document for review
without a corresponding residuals program 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. County Board Notification (FORM: CBN 06-16):
® Submit the completed and appropriately executed County Board Notification (FORM: CBN 06-16). Please do not make any
unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the form may
be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
❑ Prepare a separate County Board Notification (FORM: CBN 06-16) for each county in which the proposed land application
sites are located.
B. Critical Watershed Areas Information:
❑ Under 15A NCAC 02B .0212. no new permitted sites for land application of residuals are allowed within critical watershed
areas. It is the Applicant's responsibility to ensure that the proposed land application sites are not located within these areas.
❑ For more information regarding Water Supply Watershed Protection Program, please visit the Division website at:
httDs://deu.nc. gov/about/divisions/water-resources/water-resources-rules/water-supply-watershed-protection-Dro2ram
❑ If uncertain about whether the proposed sites are located within the critical areas, contact the Division or call [phone].
C. Notification Package Submission:
® Complete and mail the notification letter, source facility summary, land application site summary, and site location maps to
the appropriate County Board by certified mail with a return receipt reauested. It is recommended that a copy of the
notification package also be sent to the County Manager.
❑ The most current publication of the Directory of State and Countv Officials may be downloaded at:
httDs://www.sosnc.aOV/Dublications/direct.asDx
❑ A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
httt)://deu. nc. eov/contact/re2ional-offices.
® The source facility summary shall include: facility name; county where it is located; and the proposed annual dry tonnage
(i.e., a copy of "Residuals Source Facility Summary" is adequate but not required).
® The land application site summary shall include: field ID; acreage; county where it is located; latitude and longitude (i.e., a
copy of "Land Application Site Certification" is adequate but not required).
D. Proof of Submission:
® Attach an 8.5 by 11-inch copy of the return receipt to the back of this attachment prior to submission of the application to the
Division for review.
INSTRUCTIONS FOR FORM: CBN 06-16 Page 1 of 1

M Domestic 111ailOnly
Ir
t.r)
�UFN
fMcl 4PH, A
Certified Mail Fee f1-e C
IT 0 ' 1 J •. V r
Extra Services & Fees (check box, add fee a1 a prb 7(6) 4
❑ Return Receipt (hardeopy) $ 0 _ 11I-I
CO ❑ Return Receipt (electronic) $ 1t%- � 0 r00 Postmark
C ❑ Certified Mail Restricted Delivery $ I f Here
C:3 E] Adult Signature Required $ ♦ - -
r-3 ❑ Adult Signature Restricted Delivery $ 7�l 'trtr
C3 Postage
rn $
M Total Postage and Fees 09 / 12/ 20211
m l$�l 0. 7.
ru Se To
ru . , rr_aty �'r c ---- �tp aF °�"'fx---sSiowE-fS
O Street and Apt. No., or PO Box No. _
/A w.____-r_ IJNLjr--5-T---------
C�ty, State, ZIP+4•

�-LgTIF THIS SE CTIONDELIVERY,
■ Complete items 1, 2, and 3.
A. Signature
■ Print your name and address on the reverse
X ❑ Agent
so that we can return the card to you.
❑ Addressee
■ Attach this card to the back of the mailpiece,
B• Received by (Printed Name)
C. Date of Delivery
or on the front if space permits.
I
1. Article Addressed to:
ROWAN i4 LAN7y 34e p o F
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
041UNTY ebMm1SSjbOj6e_5
134 W. X U MEs S7-:
$/}LIS,P„�4P.�� N.C., �$1.e�' •�
Il I Illill III lIl I II I I ll I I I I l IINII I III I I I II III
9590 9402 6715 1060 8918 00
2. Article Number (Transfer from service label)
k
PS Form 3811, July 2020 PSN 7530-02-000-9053
Q
lT
Ln
D_
lT
C)
Cl
CI
d
CI
m
m
m
ru
ru
C3
3. Service Type
❑ Adult Signature
[1 Priority Mail Expresso
,Adult Signature Restricted Delivery
D Registered MailTm
❑ Registered Mail Restricted
rotted Mail®
Certified Mail Restricted Delivery
Delivery
D Signature ConfirmationTM
❑ Collect on Delivery
❑ Signature Confirmation.
u Collect on Delivery Restricted Delivery
Restricted Delivery
❑ Insured Mail
Insured Mail Restricted Delivery
(over $500)
Domestic Return Receipt
f
C)
C3
..11r. .
.� CI"
E'
in
I..rn)
W
f• Ykc,Yxxs.A• hirtZ
I
�,
�..
_„
Certified Mail Fee
1$
cr
�
:1"
=-
Extra Services & Fees (check box, add fee as appropriate)
Return Receipt (hardcepy) $
0
C)
0 Return Receipt (electronic) $ Postmark
CI
C
❑ Certified Mali Restricted Delivery $ Here
0
C
❑ Adult Signature Required $ _
C)
C)
0 Adult Signature Restricted Delivery $
C3
E3
Postage 1
m
m
$
fr1
M
Total Postage and Fees j
m
m
$
ti
nj
se '
taKd+1 IoA/
ru
C3
rurf
a
wA,✓ j i�DA12D OF _ !'%x _L_oiAul!S
Sfreef and Apt. tdo., or Po Box rJo.
N
rti
_
/34t----•--------------------
c;ty, state, ZIP: 4.-
S 13141E Y. rtl. C. 144

North Carolina Department of Environmental Quality
Pat McCrory Donald R. van der Vaart
Governor Secretary
Date: September 11, 2024
To: Name of Chairman to the Board of County Commissioners: Mike Caskev, Jr.
Complete mailing address: 130 W. Innes Street
City: Salisbury State: N.C. Zip: 28144
County where land application sites are located: Rowan
From: Applicant's name: Town of Cleveland (on behalf of the Division of Water Resources in accordance with Session
Law 2013-340)
Contact person and title: Patrick Phifer, Mavor
Complete mailing address: 302 East Main Street
City: Cleveland State: N.C. Zip: 27013
Telephone number: [phone] E-mail address: clerk@ townofclevelandnc.izov
Subject: Notification of residual land application site proposal
This is to notify you that the Applicant listed above will be submitting an application to the Division of Water
Resources for the land application of residual solids to site(s) located in your county. During this review, the Division
will ensure that all federal and state regulations are enforced. Attached to this form is information regarding residuals -
generating sources and locations of the proposed land application sites. Please forward this letter and its associated
attachments to the appropriate Department within your County (i.e., Health or Environmental Health Department and
Planning Department) if applicable.
More information of the land application sites included in this application will be available at the following
Division of Water Resources Regional Office:
Name of appropriate regional office: Mooresville Regional Office
Complete mailing address: 610 East Center Avenue, Suite 301
City: Mooresville
Telephone number: [phone]
State: N.C. Zip: 28115
Expected date of application submission: 9/18/24
Should you desire to comment on this application, please do so no later than 30 calendar days following the
expected application submission date. If you have any questions or comments about this notification, or if you would like
more information, please contact the appropriate regional office at the telephone number provided above. Thank you in
advance for your attention to this matter.
Enclosures: Source Facility Summary
Land Application Site Summary
Maps
Non -Discharge Permitting Unit
1617 Mail Service Center, Raleigh, North Carolina 27699-1617
Phone: [phone] Internet: htto://oortal.ncdenr.ora/web/wa
An Equal Opportunity 1 Affirmative Action Employer— Made in part with recycled paper
FORM: CBN 06-16

RESIDUALS SOURCE FACILITY SUMMARY
Applicant's name: Town of Cleveland
Status Maximum Dry Tons Per Year
Facility Permit Holder Facility Name County Permit Number
Code2 CurrentProposed
Town of Cleveland Cleveland WWTP Rowan NCO049867 82.0 82.0
'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 (Le, not applicable to new facility).
SUMMARY FOR FORM: RSC 06-16 Page 1

LAND APPLICATION SITE CERTIFICATION
Applicant's name: Town of Cleveland
Land application sites currently certified: 10.0 net acres and Total to be certified: 29.8 net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Predominant Soil
Status
Code"
Site/Field ID
Landowners
(�
Lessees or Operator(s)
O
Net Acres
Count y
s
Crop(s)
pO
Mapping Unit
Series Namee
or Rep. Slope°
R
NC-RA-01-01
Town of Cleveland
N/A
10.0
Rowan
Fescue - Hay
Enon
EnB
N
NC-RA-02-01
Charles Barber
N/A
5.2
Rowan
Fescue - Pasture
Enon
EnB
N
NC-RA-02-02
Charles Barber
N/A
14.6
Rowan
Fescue - Pasture
Cecil
CeB2
Status Code for land application sites are: ♦ N (New)
♦ R (Renewed) ♦ M (Modified)
♦ T (Transferred) ♦ D (Deleted)
n 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)
II. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID Latitude Longitude Location Location Method Code Waterbody Subbasin and Current and Proposed
g' Location Accuracy p
Datum Stream Index No. Class
01/01 350 44' 17.8"
800 39' 59.3"
NAD 83
MAP
Nearest tenth of second UT to Third Creek (12-108-20-4) C C
02/01 35° 49' 22"
80° 39' 3.4"
NAD 83
MAP
Nearest tenth of second UT to Beaverdam Branch (12-108-17-(2) WS-IV WS-IV
02/02
35° 49' 11.3"
80° 39' 2.3"
NAD 83
MAP
Nearest tenth of second
°
NAD 83
ADD
Nearest Second
°
NAD 83
ADD
Nearest Second
°
I °
NAD 83
ADD
Nearest Second
°
NAD 83
ADD
Nearest Second
NAD 83
I
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 1

COPIES OF MAPS FOR NEW FIELDS ARE INCLUDED IN SECTION VI

APPENDIX V
Renewal Site
TOWN OF CLEVELAND (SITE 1, FIELD 1)
LANDOWNER AGREEMENT
(FORM: LOA 06-16)
SITE MAPS
(Vicinity Map)
(Buffer/Setback Map)
UPDATED CUMULATIVE POLLUTANT LOADING RATES

TOWN OF CLEVELAND (SITE I, FIELD 1)
LANDOWNER AGREEMENT
(FORM: LOA 06-16)

State of North Carolina
DW
Department of Environment and Natural Resources KDivision of Water Resources
Division of Water Resources 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 conies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non-Discharee 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 Residuals Source 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: Town of Cleveland
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 Land Use or
(yes/no) Cropping Patterns
NC-RA-01-01 No Fescue (Hay)
Intended Use of Crops
Animal Feed
Residuals Source Special note
(optional) (no-till/over-seed/
pasture)
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

I. 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 parry, 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, 1636
Mail Service Center, Raleigh, NC 27699-1636.
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
term of, and 12 months after termination of, this Agreement.
II. 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(h) 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: 7� 7
_UGGsrlJ
Address: -' f=—/gS 7-
city: State: /L; C" Zip: 27613
7U C G c� 70, � 7 77 1 .�r O @ _h' , Al -f (,i e�,�-i , jtc ,t't✓ fi c, , O v
Phone: E-mail address: �; �.
i
Signature: <; ' ,� J Date: U`f `�� r✓_2y�
r
NORTH CAROLINA, wr-jwv COUNTY
I, the undersigned Notary Public do hereby certify that 0(i 4-vt C."k-
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the A
day of �.i 1'! �).'L1 20
Signature and seal:(a�
My commission expires:
Lessee's/Operator'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:
S ignature: Date:
FORM: LOA 06-16 Page 3 of 3

TOWN OF CLEVELAND (SITE 1, FIELD 1)
UPDATED SITE MAPS
(Vicinity Map)
(Buffer/Setback Map)

N
Clev«I.H)d
Barber
REFERENCE:
GIs DATA LAYERS WERE OBTAINED FROM ESRI, INC. PLEASE NOTE THIS MAP IS FOR INFORMATIONAL
PURPOSES ONLY. IT IS NOT MEANT FOR DESIGN, LEGAL, ORANY OTHER USES. THERE ARE NO =Sri, HERE, Garmin, USGS, Interm
GUARANTEES ABOUT ITS ACCURACY WMSS, PLLC ASSUMES NO RESPONSIBILITY FOR ANY DECISION MET], Esri China (Hong Kong), E
MADE ORANY ACTIONS TAKEN BY THE USER BASED UPON THIS INFORMATION. Field Boundary
OpenStreetMap contributors, and
SCALE:
DATE:
DRAWN BY:
1 " = 2,000 '
09-12-24
MEM
PROJECT NO:
24-08 Ph: 01
♦ t �
W 11cox$ mate
Si�i_ S 0 L U T 1 0 N S
FIGURE NO.
VICINITY MAP
TOWN OF CLEVELAND, NC
NC-RA-1-1
LAND APPLICATION PROGRAM

REVIEW BOUNDARY shall be established around each land application site
midway between the Compliance Boundary and the perimeter of the
residuals land application area. ' q
COMPLIANCE BOUNDARY: The Compliance Boundary for each land application site
is established at either 250 feet from the residuals land application area or 50 feet .: 1
within the property boundary, whichever is closest to the residual land application area.
l
W�,
,M
-•t Q1� j •.r . jar 1 S ,a �. 11i .:,, ,�; � Y `'`<`.
6=, kj�,� ' TS .. �"r 1 „M 'v'.�{ 7'. ✓1 .v�x'r
��. Y-,.. ,li;,. t j' ity�t",,y,•ik,,),`•.'�•. ?Y..r .w. „y?.�Tr P.', ;, :��. �.,;.. , � .-. O{ .��,
ji .� s, � 1;7'�.f�j�) ✓' �'1• 7 �� ° v �'%,� 4 E ri 57� r �•�.s'�4 r ,.+ .��*}7 { ��.
�4, % ix;
?•,kr.-• seµ s
�. ,rt �T �i t � � � �t •rr` .-.l �,.y „�1' j ta� H:
* ti.: i¢ �� . i t i � 1 ��� 4s1 ,t•', 4 -Y��rt � { Y21 .Yh'��.
NC-RA-1-1
ti� s s .,,w f• .r ,y4 a .,
J.
°■ , a°' } 4' Access Road
+ •- :` �• _• �� ; , a A Structure
I a', s � � ;■ , 14 :t4 to ; it{. �,s �' ■ Dwelling
yam■ / y �s @5���' Stream
-,I�� a
SITE/FIELD TOTAL ACRES BUFFERED ACRES NET ACRES r Pond
` NC-RA-1-1 10.9 0.9 10
+• �: ® Buffer
REFERENCE:
GIS DATA LAYERS WERE OBTAINED FROM ESRI, INC. PLEASE NOTE THIS MAP IS FOR INFORMATIONAL Field Boundary -
PURPOSES ONLY. IT IS NOT MEANT FOR DESIGN, LEGAL, ORANY OTHER USES. THERE ARE NO r t.
GUARANTEES ABOUT ITS ACCURACY. WMSS, PLLC ASSUMES NO RESPONSIBILITY FOR ANY DECISION
MADE OR ANY ACTIONS TAKEN BY THE USER BASED UPON THIS INFORMATION. t i Property Boundary
Maxar 4Esr� , Earthstar.Geogra �. � �. or
SCALE: `1 = 500 1 FIGURE NO,
• 4 BUFFER MAP
DATE: 09-12-24 �p
DRAWN BY: MEM WilwAf ble TOWN OF CLEVELAND, NC 2
PROJECT NO: SO I L SOL UTI O N S NC-RA-1-1
11111,. 24-08 Ph: 01 LAND APPLICATION PROGRAM

TOWN OF CLEVELAND (SITE 1, FIELD 1)
UPDATED CUMULATIVE POLLUTANT LOADING RATES

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 Cleveland
WQ Permit #: WQ0011431
Field #: 1 Acres Utilized: 10
Land Owner: Town of Cleveland
Annual Dry Tons Applied: 9.84
Site #: NC-RA-01 Acres Permitted: 10
Operator: Same
Predominant Soil Series: Enon
Cation Exchange Capacity (non 503):
Crop 1 Name: Fescue
Crop 1 Max. PAN: 188
Crop 2 Name: Fescue Crop 2 Max. PAN:
Volume applied
ed Volume
Soil
Residual Sources Preci Y
Cond. 4,0
o 4 z � Nitrate Name of CropType
PAN Applied
° y (enter one)Solids/ % Applied per
(NPDES #, WQ#, Past 24
w TKN o �1 and Receiving Residual
Q Liquid Solids Acre
(Dry, Hrs. n
Fert., Animal
�; - w �o 0 ( lbs/acre)
* �. Nitrite Application
Cu. Yds Gallons (Dry Tons/Ac)
Wet
Waste, etc) inches *
Moist)
mg/kg mg/kg mg/kg Crop 1 Crop 2 Crop 1 Crop 2
0.000
0.000 0.000
0.000
0.000 0.000
Mar-23 99000 0.61 0.252
Town of Cleveland Moist 0 surface
0.5 0.3 292 0.1 61.5 0.075 NA Fescue
0.000
0.000 0.000
May-23 72000 0.61 0.183
Town of Cleveland Dry 0 surface
0.5 0.3 292 0.1 61.5 0.055 NA Fescue
Jun-23 22500 0.61 0.057
Town of Cleveland Dry 0 surface
0.5 0.3 292 0.1 61.5 0.017 NA Fescue
0.000
0.000 0.000
0.000
0.000 0.000
Sep-23 94500 0.61 0.240
Town of Cleveland Dry 0 1 surface
0.5 0.3 292 0.1 61.5 0.072 NA Fescue
Oct-23 99000 0.61 0.252
Town of Cleveland Dry 0 surface
0.5 0.3 292 0.1 61.5 0.075 NA Fescue
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 387000 As
I Cd Cu Cr Pb HR,
Mo Ni Se Zn P 0.294 0.000 Lime Applied
Annuallbs/acre 0.019
0.009 0.095 0.000 0.009 0.056
0.009 0.009 0.009 0.228 2.854 I Date lbs/ac
Prior Years Cumulative lbs/ac 0.205
5.652 27.754 0.261 0.184 0.034
0.686 0.772 0.172 60.614
Current Cumulative lbs/ac 0.224
5.661 27.849 0.261 0.193 0.090
0.695 0.781 0.181 60.842
Permitted C. P. L. R.**** 36
34 1338 na 267 15
na 374 89 2498
Permit PAN Limit lst/2nd Crop
I 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."
*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)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Town of Cleveland
Total Dry Tons Applied (Annual): 9.84
Permit #:
WQ0011431
Cation Exchange Capacity (non 503 only):
Operator:
Town of Cleveland
Owner:
Town of Cleveland Predominant Soil Series: Enon
Acres Used:
10 Acres Permitted:
10
Site #: NC-RA-01
Field #: 1
Residual Analysis
Data (Heavy Metals and Total Phosphorus use
mg/kg, % Solids use Raw Percent #):
Sample or -J
2 1
61 71
81 91 101
111 12
Com-
posite
Date
7/11/23
7/11/23
7/11/23
7/11/23
7/11/23
% Solids
0.61
0.61
0.61
0.61
0.61
Arsenic
0.986
0.986
0.986
0.986
0.986
Cadmium
0.443
0.443
0.443
0.443
0.443
Copper
4.85
4.85
4.85
4.85
4.85
Chromium
Lead
0.443
0.443
0.443
0.443
0.443
Mercury
2.84
2.84
2.84
2.84
2.84
Molyb-
denum
0.443
0.443
0.443
0.443
0.443
Nickel
0.443
0.443
0.443
0.443
0.443
Selenium
0.443
0.443
0.443
0.443
0.443
Zinc
11.6
11.6
11.6
11.6
11.6
Total
Phos-
145
145
145
145
145
nhorus
Annual Leavy Metal Field Loacings (Calculates in lbs/acre):
Total 1
1 31 4]
51
61 71
91 10 j
111 12
DT/Ac./
.81
y
c
App.
Event
2.518
1.831
0.572
2.404
2.518
Arsenic 0.000
0.000 0.005 0.000
0.004
0.001 0.000
0.005 0.000 0.000
0.005 0.000 0.019
Cadmium 0.000
0.000 0.002 0.000
0.002
0.001 0.000
0.002 0.000 0.000
0.002 0.000 0.009
Copper 0.000
0.000 0.024 0.000
0.018
0.006 0.000
0.023 0.000 0.000
0.024 0.000 0.095
Chromium 0.000
0.000 0.000 0.000
0.000
0.000 0.000
0.000 0.000 0.000
0.000 0.000 0.000
Lead 0.000
0.000 0.002 0.000
0.002
0.001 0.000
0.002 0.000 0.000
0.002 0.000 0.009
Mercury 0.000
0.000 0.014 0.000
0.010
0.003 0.000
0.014 0.000 0.000
0.014 0.000 0.056
Molyb- 0.000
0.000 0.002 0.000
0.002
0.001 0.000
0.002 0.000 0.000
0.002 0.000 0.009
denum
Nickel 0.000
0.000 0.002 0.000
0.002
0.001 0.000
0.002 0.000 0.000
0.002 0.000 0.009
Selenium 0.000
0.000 0.002 0.000
0.002
0.001 0.000
0.002 0.000 0.000
0.002 0.000 0.009
Zinc 0.000
0.000 0.058 0.000
0.042
0.013 0.000
0.056 0.000 0.000
0.058 0.000 0.228
Total
Phos- 0.000
0.000 0.730 0.000
0.531
0.166 0.000
0.697 0.000 0.000
0.730 0.000 2.854
phorus
1 certity, 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
DENR FORM MFLSF (12/2006)

APPENDIX VI
Modification Site
CHARLES BARBER (SITE 2, FIELD 1 AND 2)
LANDOWNER AGREEMENT
(FORM: LOA 06-16)
SITE MAPS
(Vicinity Map)
(Buffer/Setback Map)
SOILS AND AGRONOMIC EVALUATION

CHARLES BARBER (SITE 2, FIELD 1 AND 2)
LANDOWNER AGREEMENT
(FORM: LOA 06-16)

State of North Carolina
DWR
Department of Environment and Natural Resources
Division of Water Resources
Division of Water Resources 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 conies of the an4lication 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 Residuals Source 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: Charles Barber
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:
Lease Land Use or Residuals Source Special note
Site/Field ID es/no Cropping Patterns Intended Use of Crops (no-till/over-seed/
(Y ) PP� g (optional)
pasture)
NC-RA-02-01 and 02 No Fescue (Pasture) Animal Feed
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 Pagel of 3

I. 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, 1636
Mail Service Center, Raleigh, NC 27699-1636.
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
term of, and 12 months after termination of, this Agreement.
H. 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(h) 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:i� �� ✓ '`%v' ��
Address: �4� / I`V `� +j�
City: �� 7c�.�-- State: %l �'� Zip: 71"Vj L
Phone: 7 1� mail address- o'yG
Signature: _ /� //�i� C�Vr��>" r1te: 12
NORTH CAROLINA, COUNTY
1, the undersigned Notary Public do hereby certify that e X k J' ! 1&2, - =r'
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the 'A
day of ( 11., 20
Signature and seal
`- j� � iJ
My commission expires: 4 l l ( W Zvi
Lessee's/Operator'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: lowlJ 0 f CL u L.4AJb
Address: 30,2 EAS i- M R7,0 S 71E£7
City: CL606tAtJP� .State: �� Zip: %mil3
Phone: 70Lf ` 7$477'2 E-mail address:
Signature: Date: 07/3/ 1.?02y
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 na e: -A7/LX 4 T Z, e/ —
Signature: � Date: 0 713/ 12024f
FORM: LOA 06-16 Page 3 of 3

CHARLES BARBER (SITE 2, FIELD 1 AND 2)
SITE MAPS
(Vicinity Map)
(USGS Topography Map)
(MRCS Soils Map)
(Buffer/Setback Map)

TOWN OF CLEVELAND — PERMIT NO. WQ0011431
CHARLES BARBER — SITE 02
SOILS AND AGRONOMIC EVALUATION
FIELDS 1 and 2
The Charles Barber Site 02, Fields 1 and 2 are located on the east side of Foster Road,
northeast of the intersection of Foster Road and Needmore Road in Rowan County, N.C.
The surrounding area is primarily forested and agricultural with some residential
development in the near vicinity.
Fields 1 and 2 are currently established with Fescue and are predominantly being used as
pastures for cattle and horses. The topography over the fields ranges from 0 to 10%. Buffer
requirements as required by 15A NCAC 02T.1108 for setbacks will need to be adhered to
and will reduce the useable acreage in these fields. Refer to "Buffer Maps" for specific
buffer/setback requirements and acreage totals.
A field investigation was conducted by a WMSS agronomist and soil scientist on August 22,
2024. Preliminary soils information for this site was obtained from the United States
Department of Agriculture (USDA) Natural Resources Conservation Service (MRCS) Web
Soil Survey (WSS). A WMSS licensed soil scientist advanced hand auger borings on the
proposed fields to characterize the proposed application site (hand auger boring locations are
indicated on Figure 3 — NRCS Soils Map). Soil profile descriptions were performed within
the proposed fields and indicated the fields as suitable according to the criteria outlined in
15A NCAC 02T .1104(c)(2). The predominant soil series associated with Field 1 is most
similar to the Enon series (Fine, mixed, active, thermic, Ultic Hapludalfs). The predominant
soil series associated with Field 2 is most similar to the Cecil series (Fine, kaolinitic,
thermic, Typic Kanhapludults). Soil profile description sheets are contained within this
section of the application indicating the predominant soil series identified within each field.
Both the soils and the crops should be able to assimilate the proposed loadings of liquids,
solids, nitrogen, phosphorus, heavy metals, and salts known to be in the biosolids. This
assessment is based on the residual analysis provided, the planned application rate, proper
crop management guidelines and adherence to permit requirements. Soil pH for mineral
soils should be maintained at levels to ensure optimal crop production. Nitrogen is
considered the most limiting characteristic of the biosolids proposed for application,
however soil tests should be reviewed annually to identify any changes in the nutrient status
of the soil.
Management practices should be evaluated prior to each application to account for changes
in the proposed land use objectives. Crop management guidelines that will be of importance
for this site will be:
• timing of application events with plant nutritional needs and periods of plant
dormancy,
• split application to prevent hydraulic overloading or nutrient leaching,

Town of Cleveland — Permit No. WQ0011431
Charles Barber Site 02 (Fields 1 and 2)
WMSS Proiect No. 24-08. Phase: 01
performance of proper stabilization methods to fit crop and soil needs,
maintenance of proper vegetative cover on more sloping areas with runoff
potential, and
proper coordination between application events and crop harvesting.
The results of the soil analysis for these fields, included in this report, indicate no gross
deficiencies in the fertility of these fields. By using standard agricultural practices for the
management of pines, the operator should see significant benefits from the application of
biosolids. In turn, these well -maintained fields should provide good assimilation of the
plant available nutrients contained in the biosolids and afford an environmentally safe means
of solids disposal and nutrient recycling.
Martin Mabe
Agronomist
a soic Sc,
P. W t 4 4 �F
kr SFArt"_ 0 2�
iD L
a O
o 10ss �o
F NO RTH CP
Rob Willcox, L.S.S.
Soil Scientist
Shared\WMSS Projects\2024\24-08 Town of Cleveland\2024 Permit Renewal\Land Application Site Info\Charles
Barber\24-08 Soil Scientist -Agronomist Report -Charles Barber.doc

le
SCALE:
1 „ = 1,000 ,
DATE:
08-29-24
DRAWN BY:
MEM
PROJECT NO:
Sd+« 0.rve, CAW ch Aid
R�
YMy_ t
a° Ro '
Wllwx&mabe
SOIL SOLUTIONS
S- i" R-, Church Road
= Field Boundary I:
REFERENCE:
GIS DATA LAYERS WERE OBTAINED FROM ESRI, INC. PLEASE NOTE THIS MAP IS FOR INFORMATIONAL
PURPOSES ONLY. IT IS NOT MEANT FOR DESIGN, LEGAL, OR ANY OTHER USES, THERE ARE NO
GUARANTEES ABOUT ITS ACCURACY. WMSS, PLLC ASSUMES NO RESPONSIBILITY FOR ANY DECISION
MADE OR ANY ACTIONS TAKEN BY THE USER BASED UPON THIS INFORMATION.
VICINITY MAP
CHARLES BARBER - SITE NC-RA-2
ROWAN COUNTY, NORTH CAROLINA
FIGURE NO.
1
24-08 Ph:01

I r
NC-RA-2-1
4 <�
NC-RA-2-2
i 7 '
1e - Field Boundary
REFERENCE:
GIS DATA LAYERS WERE OBTAINED FROM ESRI, INC. PLEASE NOTE THIS MAP IS FOR INFORMATIONAL
If PURPOSES ONLY. IT IS NOT MEANT FOR DESIGN, LEGAL, OR ANY OTHER USES. THERE ARE NO
GUARANTEES ABOUT ITS ACCURACY. WMSS, PLLC ASSUMES NO RESPONSIBILITY FOR ANY DECISION
MADE OR ANY ACTIONS TAKEN BY THE USER BASED UPON THIS INFORMATION.
SCALE: 1 „ _ 600 ,
' + FIGURE NO.
DATE: 08-29-24 -- - '-�`' USGS TOPOGRAPHY MAP //�
DRAWN BY: MEM • ' illcO�/& Ipyabe 2
PROJECT NO: SO IL SOL UTIONS CHARLES BARBER - SITE NC-RA-2
hk 24-08 Ph:01 ROWAN COUNTY, NORTH CAROLINA Of

NA
FV
*•'" � �, � .v' �•'
+ + rY
. o .rii
r `j" f'
144
��`+j} .• •i" •�,-+v-' -�! �' yam' ..•�
w , . NC-RA-2-1
k•` , i e
Eli
NC-RA-2-2_01-
1, '.�F'. 1 � [+'' „ .k, ,�;r►►t.��
J r�
CeB2
�•�. � s , i . ,� 4 ;t n tine
Access Road
4• �, �f ^ ``� �, A NRCS Soils Boundary
SOILS LEGEND: ' ` f- ' Field Boundary
Ce132 - Cecil sandy clay loam, 2-8% slope A.
EnB - Enon fine sandy loam, 2-8% slope REFERENCE:
EnC - Enon fine sandy loam, 8-15% slope GIS DATA LAYERS WERE OBTAINED FROM ESRI, INC. PLEASE NOTE THIS MAP IS FOR INFORMATIONAL
McB2 - Mecklenburg clay loam, 2-8% slope PURPOSES ONLY. IT IS NOT MEANT FOR DESIGN, LEGAL, OR ANY OTHER USES. THERE ARE NO
McC2 - Mecklenburg clay loam, 8-15% slope GUARANTEES ABOUT ITS ACCURACY. WMSS, PLLC ASSUMES NO RESPONSIBILITY FOR ANY DECISION
MADE OR ANY ACTIONS TAKEN BY THE USER BASED UPON THIS INFORMATION.
SCALE: 1 n = 600, FIGURE NO.
LI
DATE: 08-29-24 ,%��'�w'y°wy `"��'r_y`� NRCS SOILS MAP
DRAWN BY. MEM •' 11cgx&mW�.. e 3
PROJECT NO: SOIL SO LUT IONS CHARLES BARBER - SITE NC-RA-2
11111 24-08 Ph:01 ROWAN COUNTY, NORTH CAROLINA

REVIEW BOUNDARY shall be established around each land application site
midway between the Compliance Boundary and the perimeter of the ! IV
residuals land application area.
COMPLIANCE BOUNDARY: The Compliance Boundary for each land application site
• is established at either 250 feet from the residuals land application area or 50 feet �'"�+R;'�►`a AL
within the property boundary, whichever is closest to the residual land application area. •�� Z�'
t ' t i, s ` ��
y ` : '✓ D� !
LA
'I.
,�, r NC-RA-2-1
' ' ,
,rh > >10% Slope
Field
NC-RA-2-1
NC-RA-2-2
Total Acres
Buffered Net Acres
6.5
1.3 5.2
17.1
2.5 14.6
19.8
SCALE:
1 „ = 600 ,
DATE:
08-29-24
DRAWN BY:
MEM
PROJECT NO:
24-08 Ph:01
VIN
Structure
Access Road
Field Boundary
® Buffer
Property Boundary
REFERENCE:
GIS DATA LAYERS WERE OBTAINED FROM ESRI, INC. PLEASE NOTE THIS MAP IS FOR INFORMATIONAL
PURPOSES ONLY. IT IS NOT MEANT FOR DESIGN, LEGAL, OR ANY OTHER USES. THERE ARE NO
GUARANTEES ABOUT ITS ACCURACY. WMSS, PLLC ASSUMES NO RESPONSIBILITY FOR ANY DECISION
MADE OR ANY ACTIONS TAKEN BY THE USER BASED UPON THIS INFORMATION.
t FIGURE NO.
willcox&rube
3 G I L S U L U T I C; N S
BUFFER MAP
CHARLES BARBER - SITE NC-RA-2
ROWAN COUNTY, NORTH CAROLINA

WILLCOX & MABE SOIL SOLUTIONS, PLLC
SITE/SOIL EVALUATION
Project No. 2¢-0R,' ;9,A : Ur Phone No. Date: 9/22/ 24--
Location C'/fAezi' Afifz k Pin County: /�duJA/V Property Size
.S T7F D2
Proposed Facility: 7&wAi /Jf /'l r_vR PIAl0 Water Supply: On -Site Well
Described By:
�
/C D-6 1/ at o
Community
Public
Weather:
�Gtll/�/.I�' 141h jM Antecedent Moisture
14,967"
�f C ID I - PAS, .,r t
'�C/EGD Z -
FACTORS
PROFILE PROFILE/ PROFILE
I
/ #/%Coif)-2
Landscape Position %
C _
2- 3" ?C
Horizon Depth I
I O S
— r7 .
Color Munsell
I /Q U/1 4-/3
/U L/2 4`14-
Texture
I S/�/ S G/ _ I I
51 f SG l
Structure
I !.l1C I I
LI/S r
Consistence
I �'JS �!;D- I I
/1S /t f-/
I I I
Boundary
Horizon Depth II
Color — Munsell
Texture
Mottles
Structure
Consistence
Boundary
Horizon Depth III
Color — Munsell
Texture
Mottles
Structure
Consistence
Boundary
Horizon Depth IV
Color — Munsell
Texture
Mottles
Structure
Consistence
Boundary
S - /0
/0 Z%,e .54
c �
hrSblC
31? ^ Z
In14
c IC(
_4/A -A) 42 .5 Z
I
Soil Wetness
Restrictive Horizon
Saprolite
LTAR I I I
Classification I I I-- NI6IV
'7-2-3
2.�l2gl�
G
WsoK
5S sO F�
C�h? -S .Fro f
G✓s'b,(' �i'htJ'S% b�
❑ Evaluation: Auger Boring
❑ Pit
❑ Cut
Surface Water: P/A
PROFILE
2 (7-Cvrl f.
INq
ILEGEND
LANDSCAPE POSITION
R Ridge Interfluve
S Shoulder
L Linear Slope
FS Foot Slope
N Nose Slope
H Head Slope
Cc Concave Slope
Cv Convex Slope
SO G 4
J T Terrace
1441 �'
P Flood Plain
I
ITEXTURE
--
s sand
/X/n Sr
I Is loamy sand
��• S� I"�
I sl sandy loam
1 loam
si silt
sil silt loam
sicl silty clay loam
cl clay loam
scl sandy clay loam
sc sandy clay
sic silty clay
c clay
CONSISTENCE WET
Ns non -sticky
Ss slightly sticky
S sticky
Vs very sticky
Np non -plastic
Sp slightly plastic
P plastic
Vp very plastic
MOIST
vfr Very friable
fr friable
fi firm
vfi Very firm
I STRUCTURE
tt11 ,,
sr7�l%% 7 4R0
I sg single grain
m massive
cr crumb
gr granular
FCJ Z
I sbk subangular blocky
abk angular blocky
pi platy
pr prismatic

WayPAoint
NALYTICAL
9/10/2024
Willcox & Mabe Soil Solutions, PLLC
7231 B. Summerfield Rd
Summerfield, NC, 27358
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Ref: Analytical Testing
Report Number: 24-247-0001
Project Description: Town of Cleveland
Waypoint Analytical Virginia, Inc. received sample(s) on 9/3/2024 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,
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

Waypoint.
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Sample Summary Table
Report Number:
24-247-0001
Client Project Description:
Town of Cleveland
Lab No Client Sample ID
Matrix
66530 02-1
Solids
66530 02-1
Solids
66531 02-2
Solids
66531 02-2
Solids
WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN
Date Collected
Date Received
Method
Lab ID
09/03/2024
6010D
WP MTN
09/03/2024
SW-7471B
WP MTN
09/03/2024
6010D
WP MTN
09/03/2024
SW-7471B
WP MTN
Page 2 of 7

Waypointo
ANALYTICAL
08361
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° fax [phone]
www.waypointanalytical.com
Willcox & Mabe Soil Solutions, PLLC Project Town of Cleveland
7231 B. Summerfield Rd
Information
Summerfield , NC 27358
Report Number:24-247-0001
Lab No : 66530
Sample ID : 02-1
Test
REPORT OFANAL YSIS
Results Units MQL
Report Date : 09/10/2024
Received : 09/03/2024
Brandi Watson
Matrix: Solids
Sampled:
DF Date / Time By Analytical
Analyzed Method
Nickel
8.66
mg/Kg
0.250
1 09/06/24 01:16
TJS
6010D
Mercury
<0.162
mg/Kg
0.162
1 09/10/2411:24
FDS
SW-7471B
Selenium
<0.500
mg/Kg
0.500
1 09/06/24 01:16
TJS
6010D
Test
Results
Units
MQL
DF Date / Time
By
Analytical
Analyzed
Method
Arsenic
1.98
mg/Kg
0.500
1
09/06/24 01:16
TJS
6010D
Cadmium
0.110
mg/Kg
0.100
1
09/06/24 01:16
TJS
6010D
Lead
13.1
mg/Kg
0.300
1
09/06/24 01:16
TJS
6010D
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 3 of 7

Waypointo
ANALYTICAL
08361
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Willcox & Mabe Soil Solutions, PLLC Project Town of Cleveland
7231 B. Summer -field Rd
Information
Summerfield , NC 27358
Report Number :24-247-0001
Lab No : 66531
Sample ID : 02-2
Test
REPORT OFANAL YSIS
Results Units MQL
Report Date : 09/10/2024
Received : 09/03/2024
Brandi Watson
Matrix: Solids
Sampled:
DF Date / Time By Analytical
Analyzed Method
Nickel
8.07
mg/Kg
0.250
1 09/06/24 01:21
TJS
6010D
Mercury
<0.175
mg/Kg
0.175
1 09/10/2411:26
FDS
SW-7471B
Selenium
<0.500
mg/Kg
0.500
1 09/06/24 01:21
TJS
6010D
Test
Results
Units
MQL
DF Date / Time
By
Analytical
Analyzed
Method
Arsenic
2.37
mg/Kg
0.500
1 09/06/24 01:21
TJS
6010D
Cadmium
0.356
mg/Kg
0.100
1 09/06/24 01:21
TJS
6010D
Lead
23.3
mg/Kg
0.300
1 09/06/24 01:21
TJS
6010D
Qualifiers/ DF Dilution Factor
Definitions
MQL Method Quantitation Limit
Page 4 of 7

(D
WayPAoint..
NALYTICAL
Client: Willcox & Mabe Soil Solutions, PLLC
Project: Town of Cleveland
Lab Report Number: 24-247-0001
Date: 9/10/2024
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
CASE NARRATIVE
Metals Analysis Method 6010D
Sample 92379 (SB-14 1.0)
Analyte: Arsenic
QC Batch No: 1-771038/1-770805
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 92379 (SB-14 1.0)
Analyte: Lead
QC Batch No: 1-771038/1-770805
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

Waypoint,Q)
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 0 Fax [phone]
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 08361
Customer Name: Willcox & Mabe Soil Solutions, PLLC
Report Number: 24-247-0001
Shipping Method
0 Fed Ex 0 US Postal 0 Lab
0 Other: i
UPS 0 Client 0 Courier
Thermometer ID:
Shipping container/cooler uncompromised?
# Yes
0 No
Number of coolers/boxes received 1
1
Custody seals intact on shipping container/cooler?
0 Yes
0 No
0 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)?
0 Yes
0 No
COC properly completed
0 Yes
0 No
Samples in proper containers?
0 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?
0 Yes
No
0 Not Present
Cooler/Samples arrived at the laboratory on ice.
0 Yes
No
Samples were considered acceptable as cooling
process had begun.
Water - Sample containers properly preserved
0 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
N/A
F_ High concentration container (48 hr)
F Low concentration EnCore samplers (48 hr)
F_ High concentration pre -weighed (methanol -14 d)
[_ Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included?
0 Yes
0 No
Comments:
Signature: (David Lennon I Date & Time: 09/03/2024 07:36:25
Page 6 of 7

Waylpointo
ANALYTICAL
Grower/Project Information
Town of Cleveland
Charles Barber - Sitc 02
Farm ID I Site02
Credit Card # I
E-mail address
Lab Number
Sample ID (Lab Use
Only)
02 2 I
(
IField ID
7 OCO 1
08361
Willcox 3 Wbe Sod SOIOilOI15, PLLC 09 03 2024
T.nron of Cleveland 07.31 55
Submitted By
:\Ilrrllio ll: 16)h WIIICUs
rob( i)willcoxmabesoil.com
S21VI - Specify Additional
Tests
f B ICL1JFeIMnINaI S JZn
rV111 I ACCOUtIt # 1 iI,ti 6I
lformation
Charge To
Willcox & Nlabc Soil Solution, PLLC
7231E Sunimerfteld Road
Summerfield, N.C. 27358
ICSV I Exp Date. I 1 Phone # I [phone]
Crop Info For Recommendations
Soluble I Additional Intended Yield Alternative Yield
S3M Salts Texture NO, N Tests Crop Goa' Crop Goal Previous Crop
I X sce below Fescue I
X I %cc helow Fescue
I
1 1 I I I
Mehlich 11 Test Packages
S1M - Organic matter, Phosphorus, Potassium, Calcium, Magnesium pH, Buffer pH
Cation Exchange Capacity. and % Base Saturation.
S2M - Test S 1 M plus any hvo of the following Sodium, Sulfur, Boron Zinc.
Manganese, Iron. Copper Each additional test (above two) cost 52 00
S3M - Test S 1 M plus Sodium. Sulfur. Boron, Zinc. Manganese, Copper, and Iron
Special Instructions or Additional Testa
Tests in addition to S3M - Exchangeable Sodium Percentage (ESP), Arsenic, Cadmium,
Lead, I'vtercury, Nickel and Selenium (Soil samples for NC) - Need Liming
Recommendations for crop specific plI and for 6.0
E-mail results to: [e-mail]
1
N4
0
ra� in

CHARLES BARBER (SITE 2, FIELD I AND 2)
SOILS AND AGRONOMIC EVALUATION