WQ0001086_Renewal Application_20241031

Initial Review
Reviewer nathaniel.thornburg
Is this submittal an application? (Excluding additional information.) *
Yes No
Permit Number (IR) * WO0001086
Applicant/Permittee Town of Spring Lake
Applicant/Permittee Address Post Office Box 617; Spring Lake, N.C. 28390-0617
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 Spring Lake Class B Residuals Program
Cumberland
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer
Fee Amount
Complete App Date
10/31 /2024
$0
Below list any additional email address that need notification about a new project.
Email Address
Comments to be added to email notfication
Comments for Admin
Comments for RO
Yes No

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:* WQ0001086
Has Current Existing permit number
Applicant/Permittee * Town of Spring Lake
Applicant/Permittee Address* Post Office Box 617; Spring Lake, N.C. 28390-0617
Facility Name * Town of Spring Lake Class B Residuals Program
Please provide comments/notes on your current submittal below.
Permit Renewal Only for Permit No. WQ0001086
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.)
15-16 Town of Spring Lake Residuals Land Application
54.29MB
Program - Permit Renewal.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
� 1Ur/ter
Submission Date 10/31/2024

APPLICATION FOR
RESIDUALS LAND APPLICATION PROGRAM
PERMIT RENEWAL
TOWN OF SPRING LAKE WWTP
PERMIT NO. WQ0001086
WMSS Project No. 15-16
Prepared for:
Town of Spring Lake
Post Office Box 617
Spring Lake, North Carolina 28390-0617
Prepared by:
Willcox & Mabe Soil Solutions, PLLC
7231B Summerfield Road
Summerfield, North Carolina 27358
willcox&mabe
SO 1 L SOL U T I ON S
October 2024

willcox&mate
SO I L SOL U T I ON S
October 31, 2024
NCDEQ/DWR
Water Quality Permitting
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
Town of Spring Lake WWTP
Permit No. WQ0001086
Willcox & Mabe Soil Solutions, PLLC Project No. 15-16, Phase: 04
Non -Discharge Branch:
Willcox & Mabe Soil Solutions, PLLC (WMSS) is submitting the enclosed Residuals Land
Application Program Permit Renewal application for the Town of Spring Lake WWTP
(Spring Lake) on behalf of Spring Lake. The permit renewal package includes information
for:
• Renewal of seven (7) fields (123.0 net acres), Town of Spring Lake (Site 1, Field 1),
Willie Calvin Brinkley (Site 3, Fields 3-8),
• Delete three (3) fields (27.4 net acres) David Frank Chatellier (Site 5, Fields 1-3),
• Current annual volume of 287.0 dry tons to remain the same,
• Request for updated signature delegation authority.
If there is any further information required or questions regarding this application please do
not hesitate to contact Spring Lake, Mr. Richard Mendez at [phone], or WMSS at
[phone] for further assistance.
Sincerely,
Willcox & Mabe Soil Solutions, PLLC
Martin Mabe
Agronomist
cc: Town of Spring Lake
_�iz 4121YZW�Z_
Rob Willcox, L.S.S.
Soil Scientist
Shared\WMSS Projects\2015\15-16 Town of Spring Lake\Phase 04 - 2024 Permit Renewal\15-16 Town of Spring Lake 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)
NON -DISCHARGE SIGNATURE DELEGATION AUTHORITY
LETTER
(FORM: NDSDAL 09-15)
OPERATION AND MAINTENANCE PLAN (No Changes)
II RESIDUALS SOURCE CERTIFICATION
• TOWN OF SPRING LAKE
(FORM: RSC 06-16)
III LAND APPLICATION SITE CERTIFICATION
(FORM: LASC 06-16)
Renewal Sites
IV TOWN OF SPRING LAKE (SITE 1, FIELD 1)
LANDOWNER AGREEMENT
(FORM: LOA 06-16)
UPDATED SITE MAPS
UPDATED CUMULATIVE POLLUTANT LOADING RATES
V WILLIE CALVIN BRINKLEY (SITE 3, FIELDS 3-8)
LANDOWNER AGREEMENT
(FORM: LOA 06-16)
UPDATED SITE MAPS
UPDATED CUMULATIVE POLLUTANT LOADING RATES

APPENDIX 1
RESIDUALS LAND APPLICATION PROGRAM
APPLICATION FORM
(FORM: RLAP 06-16)
NON -DISCHARGE SIGNATURE DELEGATION AUTHORITY LETTER
(FORM: NDSDAL 09-15)
OPERATION AND MAINTENANCE PLAN (No Updates)

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 An_ Wicant shall submit one original and two con_ ies of the an_ nlication and
suaaortin2 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). (No New Changes)
Facility Classification
Major (land are permitted for > 300 acres)
Minor (land are permitted for < 300 acres)
New Permit Major Modification'
$1,310 $395
$810 $245
I - 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 1 C .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 updates - O&M Plan - Attached)
❑ For Modification Application, if there are any changes to the existing plan, submit an updated O&M plan.
❑ Submit the O&M Plan in accordance with 15A NCAC 02T .1110 and include at a minimum:
❑ Operational functions; describe the operation of the program to show what operations are necessary for the program to
function and by whom the functions are to be conducted.
❑ Maintenance schedules; may include equipment calibration, maintenance of signs, etc.
❑ Safety measures; may include safety training program, manuals, signs, etc.
❑ Spill response plan; including control, containment, remediation, emergency contact information, etc.
❑ Inspection plan including the following information;
❑ Names and titles of personnel responsible for conducting the inspections.
❑ Frequency and location of inspections, including those to be conducted by the ORC, and procedures to assure that the
selected location(s) and inspection frequency are representative of the residuals management program.
❑ Detailed description of inspection procedures including record keeping and actions to be taken by the inspector in the event
that noncompliance is observed.
❑ Sampling and monitoring plan including the following information;
❑ Names and titles of personnel responsible for conducting the sampling and monitoring.
❑ Detailed description of monitoring procedures including parameters to be monitored.
❑ Sampling frequency and procedures to assure that representative samples are being collected. Fluctuation in temperature,
flow, and other operating conditions can affect the quality of the residuals gathered during a particular sampling event. The
sampling plan shall account for any foreseen fluctuations in residuals quality and indicate the most limiting times for
residuals to meet pathogen and vector attraction reduction requirements (e.g. facilities that land apply multiple times per
year but have an annual sampling frequency, may need to sample during winter months when pathogen reduction is most
likely to be negatively affected by cold temperatures.
THE FOLLOWING ADDITIONAL ITEMS (G to M) ARE REQUIRED FOR DEDICATED PROGRAM ONLY.
F. Program Determination N/A
❑ Dedicated residuals land application programs are ones in which land application sites meet the criteria in 15A NCAC 02T
.110202). Specifically, a residuals land application program is designated as dedicated if any of the following are applicable:
❑ Any land application site certified for the residuals land application program that receives residuals at rates or frequencies
greater than agronomic rates.
❑ Any land application site certified for the residuals land application program that is used primarily for residuals disposal,
and agricultural crop production is of secondary importance.
❑ Any land application site certified for the residuals land application program that receives residuals through fixed irrigation
facilities or irrigation facilities fed through a fixed supply system.
❑ Please contact the Non -Discharge Permitting Unit if you need any assistance in determining whether your residuals program
falls under the dedicated program definitions.
G. Program Information N/A
❑ 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) N/A
❑ Submit three (3) sets of standard size plans and two (2) sets of I V by 17" plans (electronic format is acceptable - Adobe PDF
only). For Modifications, submit plans specific to the modification(s) only.
❑ Plans must include the following minimum items:
❑ A general location map, a vicinity map and a topographic map with contours not exceeding 10 feet or 25% of the total site
relief and showing all facility related structures and fences within the land application area.
❑ The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of the land application site(s).
❑ Delineation of the review and compliance boundaries
❑ Setbacks as required by 15A NCAC 02T .1108
❑ Site property boundaries within 500 feet of all waste treatment, storage, and disposal site(s).
❑ A map showing the entire irrigation area with an overlay of the suitable irrigation area depicted by the soil scientist's
evaluation. The irrigation plans shall show each nozzle/emitter and wetted area (when applicable). Clearly label spray
irrigation zones as they will be operated.
❑ Plans must depict a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT FOR
CONSTRUCTION, etc.) that indicate that they are anything other than final plans. However, the plans may be labeled with
the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 2 of 3

I. Project Evaluation and Receiver Site Management Plan (All New Application Packages or Modifications that include new sites)
N/A
❑ 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) N/A
❑ Submit a detailed hydrogeologic evaluation in accordance with 15A NCAC 02T .1104(d)(4) and current Division Policy
available at: httn://www.ncwater.ore/Rules Policies and Regulations/. The document shall be signed, sealed and dated by a
qualified professional.
K. Engineering Design Documents (All New or Modification Application Packages with fixed irrigation facilities or irrigation
facilities fed through fixed supply system) N/A
❑ Submit engineering design documents that have been signed, sealed, and dated by a NC licensed Professional Engineer and/or
Professional Land Surveyor in accordance with 15A NCAC 02T .1104(d)(2). For Modifications, submit an updated site map
specific to the modification(s) only.
❑ The design documents must include the following minimum items:
❑ Engineering plans for the facility and equipment except those previously permitted unless they are directly tied into the new
units or are critical to the understanding of the complete process;
❑ Specifications describing materials to be used, method of construction, and means for ensuring quality and integrity of the
finished product including leaking testing; and
❑ Engineering calculations including hydraulic and pollutant loading, sizing criteria, hydraulic profile, total dynamic head
curve analysis for each pump, and irrigation design.
❑ Soil mapping units shown on all disposal sites.
L. Water Balance (All New Application Packages or Modifications that include new sites utilizing fixed irrigation facilities or
irrigation facilities fed through fixed supply systems) N/A
❑ Submit a completed and accurate water balance in accordance with 15A NCAC 02T .1104(d)(5) and current Division Policy
available at: httr)://www.ncwater.oreJRules Policies and Regulations/.
M. Property Ownership Documentation (All New or Modification Application Packages involving new and/or relocated treatment
or irrigation components) N/A
❑ Property ownership documentation shall consist of one of the following:
❑ Legal documentation of ownership (i.e., GIS, deed or article of incorporation), or
❑ Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or
❑ An easement running with the land specifically indicating the intended use of the property and meeting the requirements of
15A NCAC 02L .0107(f), or
❑ A written notarized lease agreement signed by both parties, indicating the intended use of the property, as well as a plat or
survey map.
ONE ORIGINAL AND TWO COPIES OF THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL
SUPPORTING INFORMATION AND MATERIALS, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service:
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
TELEPHONE NUMBER: [phone]
By Courier/Special 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 .I100 — RESIDUALS LAND APPLICATION PROGRAM
FORM: RLAP 06-16
I. APPLICANT INFORMATION:
1. Applicant's name: Town of Smine Lake
Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State ® Municipal ❑ County
Signature authority's name per 15A NCAC 02T .0106: Jonathan Rorie Title: Town Manager
Applicant's mailing address: P.O. Box 617
City: Snrin2 Lake State: NC Zip: 28390-0617
Telephone number: [phone] Email Address: [e-mail]
2. Consultant's name: Rob Willcox 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: NC 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: NC Zip: 27358
Telephone number: (3) 312-1396 Email Address: [e-mail]
4. Soil Scientist's name: Rob Willcox 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: NC Zip: 27358
Telephone number: [phone] Email Address: [e-mail]
5. Fee submitted: $0.00 (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: W00001086
Date of most -recently issued permit: October 29, 2019
Date of most -recently certified Attachment A (if different than the permit): same
Date of most -recently certified Attachment B (if different than the permit): same
FORM: RLAP 06-16 Pagel of 5

III. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing Facility's physical address: Hares Street
City: SDrinE Lake State: NC Zip: 28392-0617
Coordinates: Latitude: 35° 1 F 47" Longitude: 78157' 58"
Datum: NAD 83 Level of accuracy: nearest second
Method of measurement: MAP
2. County where residuals land application program is headquartered: Cumberland
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 Richard E. Mendez Town of Spring Lake ORC-989275
Back -Up ORC Michael Kevin Criscoe Town of Spring Lake Grade IV 14096 / LA 15683
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 Nitrogen 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: 287 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 25.13 28.96 I
12,567 14,482
Five -Year Maximum Adjusted 38.23 42.06
19,116 21,031
b. Land Application Site Use Summarv: Summarize information regarding the land application sites as currently certified and
proposed for certification with this application:
Category Use
Acres
Comments
(Current)
(Proposed Renewal Acres)
Crops Forest or Plantation
Row Crops
91.9
91.9 (renewed)
Hay
43.4
31.1 (renewed)
Pasture
15.1
0 (renewed)
Total:
150.4
123.0
Methods Surface
150.4
123.0
Incorporation or Injection
0
Total:
150A
123.0
FORM: RLAP 06-16 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
50 251.3 382.3 289.6 420.6
100 125.7 191.2 1 144.8 210.3
150 83.8 127.4 1 96.5 140.2
200 62.8 95.6 72.4 105.2
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 only.
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(D) requires at least one -foot vertical separation between SHWT and ground
surface.
4. Are there any artificial drainage or water movement structures within 200 feet of any irrigation area?
❑ Yes or ❑ No If Yes, please explain if the soil scientist report addresses artificial structures and please indicate if
structures are to be maintained or modified:
5. Loading rates recommended by the Soil Scientist Evaluation:
Soil Series Fields within Soil Area
Recommended Recommended
Loading Rate Loading Rate
(ilo (in/yr)
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
(ft2) Nozzles Rate (gallons/hr) Rate (gallons/yr)
Total
Spray Irrigation Design Element Plan Sheet Specification
_ Number Page Number
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 15A 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;
Jonathan Rorie Town Manager
(Signature Authority's Name — PLEASE PRINT) (Title)
attest that this applicatiom for Town of Smine Lake -
(Facility Name)
has been reviewed by me and is accurate and complete to the best of my knowledge. 1 understand that the Division of -Water Resources
may not conduct a technical review ofthis 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 ofthis 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.
k(k_ — Date:
FORM: RLAP 06-16 Page 5 of 5

NON -DISCHARGE SIGNATURE DELEGATION AUTHORITY LETTER
(FORM: NDSDAL 09-15)

State of North Carolina
Department of Environment and Natural Resources
DWR, Division of Water Resources
I
NON -DISCHARGE SIGNATURE DELEGATION AUTHORITY LETTER
Division of Water Resources FORM: NDSDAL 09-15
AUGUST 14.2024
DIVISION OF WATER RESOURCES
NON -DISCHARGE PERMITTING UNIT
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
To Whom It May Concern:
Subject: Permitting Signature Authority
As an appropriate signing official for Town of Spring Lake (Applicant / Permittee) as designated by 15A
NCAC 02T .0106, 1 hereby delegate authority to sign and certify all permit applications, reports or other
permit related documents to the following staff for the following permit types (i.e., wastewater irrigation,
residuals management, reclaimed water, etc.) and/or permit numbers:
'Position Person Currently in Position
Town Manager Jonathan Rorie
If you have any questions, please contact me at the following:
Permittee/Applicant name: Town of Spring Lake
Title: Mayor
Complete mailing address: 300 Ruth Street
City: Snrine Lake State: N.C. Zip: 28390
Telephone number: [phone]
Permit Type / Permit Number
RLAP / WQ0001086
Email: kia.antliony(iirtownofsprin3lakc cum
Sincerely.
Kia Ant hon
Y
FORM: NDSDAL 09-15 Page I of I

OPERATION AND MAINTENANCE PLAN (No Updates)

OPERATION AND MAINTENANCE PLAN
Town of Spring Lake
Non -Discharge Permit No. WQ0001086
LAND APPLICATION OF CLASS B BIOSOLIDS
Town of Spring Lake Wastewater Treatment Plant (WWTP)
Class B Biosolids Description and Overview
The purpose of the Town of Spring Lake 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 (WQ0001086).
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.
II. Maintenance Schedules
The Town of Spring Lake 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 Spring Lake - Class B Biosolids
Permit No. WQ0001086
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).
• Confirm that the correct amount of biosolids are being land applied.
2

Operation and Maintenance Plan
Town of Spring Lake - Class B Biosolids
Permit No. WQ0001086
• 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. WQ0001086 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 Spring Lake WWTP Class B Biosolids shall not
exceed the following Ceiling Concentrations (i.e., dry weight basis) or Cumulative
Pollutant Loading Rates (CPLRs):
Ceiling Concentration
CPLR
Parameter
(milligrams per
(pounds per acre)
kilogram)
Arsenic
75
36
Cadmium
85
34
Copper
4,300
1,338
Lead
840
267
Mercury
57
15
Molybdenum
75
n/a
Nickel
420 (
374
Selenium
100 I
89
Zinc
7,500 I
2,498
3

Operation and Maintenance Plan
Town of Spring Lake - Class B Biosolids
Permit No. WQ0001086
The Town of Spring Lake 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)
1,4-Dichlorobenzene (7.5)
Barium (100.0)
1,2-Dichloroethane (0.5)
Benzene (0.5)
1, 1 -Dichloroethylene
(0.7)
Cadmium (1.0)
2,4-Dinitrotoluene (0.13)
Carbon tetrachloride
Endrin (0.02)
(0.5)
Chlordane (0.03)
Hexachlorobenzene (0.13)
Chlorobenzene (100.0)
Heptachlor (and its
hydroxide) (0.008)
Chloroform (6.0)
Hexachloro-1,3-butadiene
(0.5)
Chromium (5.0)
Hexachloroethane (3.0)
m-Cresol (200.0)
Lead (5.0)
o-Cresol (200.0)
Lindane (0.4)
p-Cresol (200.0)
Mercury (0.2)
Cresol (200.0)
Methoxychlor (10.0)
2,4-D (10.0)
Methyl ethyl ketone
(200.0)
Nitrobenzene (2.0)
Pentachlorophenol (100.0)
Pyridine (5.0)
Selenium (1.0)
Silver (5.0)
Tetrachloroethylene (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 Spring Lake WWTP Class B Biosolids
based on conditions (monitoring frequencies) set forth in Permit No. WQ0001086. 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 Spring Lake - Class B Biosolids
Permit No. WQ0001086
The Town of Spring 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:
® Alternative 1 [15A NCAC 02T.1106(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. 1 107(a)(6)] - Alkaline Stabilization
Attachments: Spill Control Plan
Spill Prevention Plan
Spill Control, Containment and Cleanup Plan
Shared=MSS Projects\2015\15-16 Town of Spring Lake\Phase 04 - 2024 Permit Renewal\DEQ Forms\O&M Plan - Town
of Spring Lake - August 2024.doc
5

TO WN OF SPRING LAKE
SPILL CONTROL PLAN
NON -DISCHARGE PERMIT NO. WQ0001086
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
Fayetteville 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 party 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:
1. 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.

APPENDIX II
RESIDUALS SOURCE CERTIFICATION
• TOWN OF SPRING LAKE
(FORM: RSC 06-16)
• TOWN OF SPRING LAKE
(FORM: RSC 06-16) (ATTACHMENTS)
• VICINITY MAP
• PROCESS FLOW DIAGRAM AND/OR NARRATIVE
• QUANTITATIVE JUSTIFICATION
• SAMPLING PLAN
• ANALYTICAL

RESIDUALS SOURCE CERTIFICATION
0 TOWN OF SPRING LAKE
(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 An_ 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 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
Re�idnals Lai?d.�;7piicstion P,r;>>its
® 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 SminR Lake
Status
Code
R
Facility Permit Holder Facility Name County Permit Number Maximum Dry Tons Per Year
Current" Proposed
Town of Spring Lake Spring Lake WWTP Cumberland NCO030970 287.0 287.0
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 (i.e, not applicable to new facility).
SUMMARY FOR FORM: RSC 06-16
Page 1

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 Shrine Lake
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: Richard Mendez
Complete mailing address: Post Office Box 617
City: Spring Lake State: N.C. Zip: 28390-0617
Telephone number: [phone] E-mail address: [e-mail]
4. Facility physical address: 350 Harns Street
City: Shrine Lake State: N.C. Zip: 28390
Coordinates: Latitude: 35' 11' 49" Longitude: 78°57' 58"
Datum: NAD83 Level of accuracy: nearest 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: % industrial and % domestic)
❑ other (explain: ).
6. Does the facility have an approved pretreatment program: ❑ Yes ® No
7. Facility permitted/design flow: 1_5 MGD and facility average daily flow: OS MGD
8. Average amount of residuals being generated at this facility 287.0 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 2-Aeration Basins-750.000 each: 2-Clarifiers-213.600 each: 1-Clarifier-442.000: 1-Digester-142.100
Type and volume of residuals storage (i.e., outside of residuals treatment units): 1-Sludge Holding Tank-350.000
II. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
® 40 CFR Part 503 or ❑ 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
® Biological ❑ Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

3. Hazardous Waste Determination:
Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for
facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR
§261.31-§261.33: ❑
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: Meritech, Inc. and Date of analysis: 2/26/24
Passed corrosivity test: ® yes
❑ no. pH: s.u.
(2 < pH < 12.5)
Passed ignitability test: ® yes
❑ no. Flashpoint:
>140 IF (> 140°F)
Passed reactivity test: ®yes Ono. HCN: <0 5 (mg/L)
mg/kg (<250) & H2S: <10 (mg/L)
mg/lcg (<500)
TCLP Parameter
Limit Result
TCLP Parameter
Limit
Result
(mg/1) (mg/1)
(mg/1)
(mg/Z) 11
Arsenic
5.0 <0.100
Hexachlorobenzene
0.13
<0.100 J
Barium
100.0 0.069
Hexachloro-1,3-Butadiene
0.5
<0.100
Benzene
0.5 <0.0100
Hexachloroethane
3.0
<0.100
Cadmium
1.0 <0.020
Lead
5.0
<0.100
Carbon Tetrachloride
0.5 <0.0100
Lindane
0.4
<0.00500
Chlordane
0.03 <0.0250
Mercury
0.2
<0.0200
Chlorobenzene
100.0 <0.0100
Methoxychlor
10.0
<00500
Chloroform
6.0 <0.0100
I Methyl Ethyl Ketone
200.0
<0.100
Chromium
5.0 <0.050
Nitrobenzene
2.0
<0.100
m-Cresol
200.0 <0.200
Pentachlorophenol
100.0
<0.500
o-Cresol
200.0 >0.100
Pyridine
5.0
<0.100
p-Cresol
200.0 <0.200
Selenium
1.0
<0.100
Cresol
200.0 I <0.300
Silver
5.0
<0.050
2,4-D
10.0 I <0.500
Tetrachloroethylene
0.7
<0.0100
1,4-Dichlorobenzene
7.5 <0.100
Toxaphene
0.5
<0.0500
1,2-Dichloroethane
0.5 <0.0100
Trichloroethylene
0.5
<0.0100
1, 1 -Dichloroethylene
0.7 <0.0100
2,4,5-Trichlorophenol
400.0
<0.100
2,4-Dinitrotoluene
0.13 <0.100
2,4,6-Trichlorophenol
2.0
<0.100
Endrin
0.02 <0.00500
2,4,5-TP (Silvex)
1.0
<0.500
Heptachlor and its Hydroxide
0.008 <0.00500
Vinyl Chloride
0.2
<0.0200
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: Meritech, Inc. and Date of analysis: October 4, 2018
Parameter
Ceiling
Monthly Average
Result
Concentration Limits
Concentration Limits
(ClassA & ClassB)
(Class A Only)
(mg/kg)
(mg/kg)
(mg/kg)
Arsenic
75
41
3.06
Cadmium
85
39
1.18
Copper
4,300
1,500
136
Lead
840
300
6.06
Mercury
57
17
0.843
Molybdenum
75
n/a
3.94
Nickel
420
I 420
12.1
Selenium
100
100
21.2
Zinc 7,500 2,800 1,170
b. For Surface Disposal Unit flandrill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: and Date of analysis:
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
❑ >0but <25
❑ > 25 but < 50
❑ > 50 but < 75
❑ > 75 but < 100
❑ > 100 but < 125
❑ > 125
Result (mg/kg)
Arsenic
Chromium
Nickel
(mg/kg)
(mg/kg)
(mg/kg)
30
200
210
34
220
240
39
260
270
46
300
320
53
360
390
62
450
420
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 1.72 %.
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: Meritech. Inc. and Date of analysis: February 26. 2024
Parameter Result
(mg/kg) 11
Aluminum 3,500 l
Ammonia -Nitrogen 3,830
Calcium 42,800
Magnesium 3,680 l
Nitrate -Nitrite Nitrogen < 581
pH (Standard Unit) 7.0 l
Phosphorus 22,800
Potassium 5,630 l
Sodium 3,380 1
Total Kjeldahl Nitrogen 37,400 l
c. Using the results listed in Item Il. 5b. above, calculate the sodium adsorption ration (SAR): 0.55
[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
(mglkg) (mg/kg)
Surface 12,567 19,116
Injection/Incorporation 14,482 21,031
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: N/A
FORM: RSC 06-16 Page 4 of 5

7. Pathoeen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Eauivalent:
❑ 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.1106(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.]106(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 11. 7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item II.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.1107(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.I 107(a)(8)] - Drying of Unstabilized Residuals.
❑ Alternative 9 [15A NCAC 02T.I 107(a)(9)] - Injection.
❑ Alternative 10 [15A NCAC 02T. I 107(a)(1 0)] - Incorporation.
❑ Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.I 107(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 SPRING LAKE
(FORM: RSC 06-16) (ATTACHMENTS)
• VICINITY MAP
• PROCESS FLOW DIAGRAM AND/OR NARRATIVE
• QUANTITATIVE JUSTIFICATION
• SAMPLING PLAN
• ANALYTICAL

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Town of Spring Lake WWTP r
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Figure X-X. Spring Lake WWTP
MacConnell & Associates, P.C. 2-X

QUANTITATIVE JUSTIFICATION
Town of Spring Lake
Wastewater Treatment Plant (WWTP)
Non -Discharge Permit No. WQ0001086
Requested Dry Tons for Renewal — 287.0
LAND APPLICATION OF CLASS B RESIDUALS
• Previously Permitted Dry Tons — 287.0
• Requested Dry Tons for Renewal — 287.0

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 Spring Lake 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 Spring Lake 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 Spring Lake 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.
CA1Jsers1RoblOneDrive for BusinesslSharedMMSS Projects12015115-16 Town of Spring LakelPhase 03 - 2019
RenewallDEQ FormslSpring Lake O&M Plan -Sampling & Monitoring Section - July 2019.doc 7/31/2019

TOWN OF SPRING LAKE WWTP
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater Treatment Plant
Date Sampled: December 14, 2023
SDrin2 Lake WWTP
Mineralization Rate 0.3
Parameter
Nitrogen (TKN)
Phosphorus
Potassium
PAN (injected)*
PAN (surface)*
Ammonia Nitrogen
Calcium
Calcium Carbonate Eq.
Magnesium
Sodium
Sulfur
Nitrate N / Nitrite N
Barium
Chloride
Iron
Aluminum
Arsenic
Cadmium
Chromium
Copper
Lead
1Mercury
(Molybdenum
(Nickel
1Selenium
(Zinc
Permit No. WQ0001086
1.72
% Solids
7.0
pH
%
Mg/Kg Dry Weight
(% x 10,000)
3.740
37,400.000 J
2.280
22,800.000
0.563
5,630.000
1.448
14,482.000
1.257
12,567.000
0.383
3,830.000
4.280
42,800.000
---
3,680.000
---
3,380.000
--
I 581.000
--- II
3,500.00 1
3.060 1
1.180 1
136.00 1
6.060 1
0.843
3.940
12.10 1
21.200 1
1,170.00 1
Pounds/Dry Ton
(Mg/Kg x 0.002)
74.800 I
45.600 1
11.260 1
28.964 1
25.134
7.660
85.600
Meritech, Inc. 121423158
*Determination of Plant Available Nitrogen (PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia N) + Ammonia N + Nitrate N + Nitrite N = % PAN
7.360
6.760
1.162
7.0001
0.006
0.002 1
0.272 1
0.012
0.002 1
0.008
0.024 1
0.042 I�
2.340 11
IJ
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.
SAR 1
0.55
Ceiling Concen.
(Mg/Kg)
75 J
85 1
4,300
840
57
75
420
100
7,500

SAR
SAR Calculation
Na Ca Mg SAR
2.528 36.808 5.275 0.551
Enter r--r\ Enter .% TS
Data Na mg/kg
Ca mg/kg
Mg mg/kg
Job Name: ITown of Spring Lake
Page 1
Na mg/I Ca mg/I Mg mg/I
58.136 736.16 63.296
Na mil eq Ca mil eq Mg mil eq
2.528 36.808 5.275
1.72
3380
42800
3680

Willcox & Mabe Soil Solutions, PLLC
RESIDUAL PAN CALCULATION
Town of Spring Lake
TKN= 37,400 mg/kg
NH3= 3,830 mg/kg
NO3-NO2-N= 581.0 mg/kg
Min Rate= 0.30
PAN= [min.rate (TKN - NH3) + 0.5 (NH3) + NO3-NO21
0.30 33,570 1,915 581.00
PAN= 12567.00 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. - NJ
0.15 33,570 10,071
PAN= 3524.85 mg/kg remaining from 1 st year application
3RD YEAR RESIDUAL PAN
PAN= [min.rate (2nd year org. - N 3rd year min. - NJ
0.08 23,499 3,525
PAN= 1597.93 mg/kg remaining from 1st year application
4TH YEAR RESIDUAL PAN
PAN= [min.rate (3rd year org. - N 4th year min. - NJ
0.05 19,974 1,598
PAN= 918.81 mg/kg remaining from 1 st year application
5TH YEAR RESIDUAL PAN
PAN= [min.rate (4th year org. - N 5th year min. - NJ
0.03 18,376 919
PAN= 507.48 mg/kg remaining from 1st year application
Residual PAN from years 2 thru 5 after the initial application = 6549.08 mg/kg
Application
Five Year Maximum
Method
First Year PAN
Adjusted PAN
(mg/kg)
(mg/kg)
Surface
12,567
19,116
Incorporation
14,482
21,031
Application
Five Year Maximum
Method
First Year PAN
Adjusted PAN
(lbs/DT)
(lbs/DT)
Surface
25.13
38.23
Incorporation
28.96
42.06

PAN
First -Year
Five -Year Maximum Adjusted
Assumed Application Rate
(lbs PAN/ac-yr)
50
100
150
200
Town of Spring Lake WWTP
Permit # WQ0001086
RESIDUALS APPLICATION DATA
287.0 Dry Tons of residuals to be certified
PLANT AVAILABLE NITROGEN SUMMARY
Pounds of PAN per DT
(Weighted Average)
Surface Incorp. Or Inject.
25.13 38.23
28.96 42.06
Acres Required Using First -Year
PAN Concentrations
Surface
Incorp. Or Inject.
251.3
382.3
125.7
191.2
83.8
127.4
62.8
95.6
Pounds of PAN per Year
Surface Incorp. Or Inject.
12,567 19,116
14,482 21,031
Acres Required Using Five -Year f
Maximum Adjusted PAN
Surface Incorp. Or Inject.
289.6 420.6
144.8 210.3
96.5 140.2
72.4 105.2

Contact: Richard Mendez
Client: Town O[Spring Lake
P1l.Box 30ORuth St.
Spring Lake, NC3839O
y�� ~�*�^��^ Inc.�"x����=~.«-uu» u
Ek8v^roD8meDnaU Laboratory
Laboratory Certification No. 165
Revised Report Date:
Drpo/tDate;
Date Sample RcvJ-
K4crhechVYorkUrdez# 121423lS8 Sample: Sludge Storage Composite
� ��� � 7��°D �� Metals
�^»�� ~ ���u^u u°u����xs
Page
212612024
l/8/3O24
1%/l4/2023
12/14/2023
.Parameter
Results
AnalvoioDute
*1
]Dct.Linmit Igg�l�w
Method
Arsenic
<0J00mg/L
12/26/33
0.100 S.O
CPA200.7
Bmium
0.069 mQ/L
12/26/33
0.0SO lVOu
SB42O07
Cadmium
<0.020mA/L
12/20/23
0.020 1.0
DPA2UDJ
Chromium
<0.050me/L
12/26/23
0.050 5.0
EPA 2007
Lead
<0.100 mg/L
13/26/23
0.100 5.0
EP820O.7
Mercury
<0.0200m8/L
12/26/23
0.0200 02
CPA34I1
Selenium
<0]00roA/L
12/26/23
0.108 1.8
OPA2007
Silver
<0.050 mA/l,
12/26/23
0.050 3.0
EPAZ00J
T(`LPArg8D'CS
Pacametex
Results
&nalvxs Date
Reporting Lit
Method
Yu\nb\es8260
Attached
13/28/23
'
8260
Semi Vol. 827O
Attached
1/2/24
'
8270
Other Tests
Parameter
Results
&oalvnlsQote
0eourdoeLiruit
81e1bud
Cyanide, total
«8.500 mg/kg
12/19/23
0,500 Ing/k�
8|�&335.1
Sulfide
<10.0 mg/kg
12/19/23
I8.0o1g/kA
3M450O32D
Flash Point
>140 OF
12/27/23
'
E|'AlO2OC
Cnrnosidvity(pH)
7.0 SU.
12/19/23
1.0- 14.0 3,U.
5N45OOJIB
642TmnmuoRoad, Reidsville, North Carolina 27330

N .
Y`
Contact: Richard Mendez
Client: Town Of Spring Lake
P.O. Box 300 Ruth St.
Spring Lake, NC 28390
Meritech Work Order # 121.4231,58
Meritech, Inc.
Environmental Laboratory
Laboratory Certification No. 1,65
Page: 2
Revised Report Date: 212612024
Report Date: 1/8/2024
Date Sample Rcvd: 12/14/2023
Sample: Sludge Storage Composite 12/14/2023
13 11 - 'TCLP Pesticides & Herbicides
Pesticide - SW-846 8081A
Parameter Results Analvsis Date Det. Limit Reg. Limit Dilution Factor
Endrin
Chlordane
Toxaphene
Methoxychlor
Heptachlor
Lindane
Vermicides - SW-846 8151.A
Parameter
2,4-D
2,4,5=1'P pivex)
Attached - -
Attached - -
Attached - -
Attached - - _
Attached - - -
Attached - -
Results
Attached
Attached
Analvsis Date Det. Limit Reg. -Limit Dilution Factor
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

Meritech, Inc.
Environmental Laboratory
°. Laboratory Certification No.165
}
Page 3
Contact: Richard Mendez Revised Report Date; 212612024
Client: Town Of Spring Lake Relaort Date: 1/8/2024
P.O. Box 300 Ruth St.
Spring Lake, NC 28390 Date Sample Rcvd: 12/14/2023
Meritech Work Order #
121423158 Sample: Sludge Storage Composite
12/14/2023
Parameters
Results
Analysis Date
Renorting limit
Method
% Total Solids
1,72 %
12/15/23
0-100 %
SM 2540B
Volatile Solids
1-32 %
12/15/23
0.100 %
SM 254.0E
Ammonia, Nitrogen
3,830 mg/kg
12/21/23
10.0 mg/kg
EPA 350.1
TKN
37,400 nig/kg
12/.18/23
20.0 nig/kg
EPA 351.2
Nitrite, Nitrogen
<581 mg/kg
12/19/23
581 mg/kg
EPA 353.2
Nitrogen, total
37,400 mg/kg
12/19/23
0.20 mg/kg
EPA 353.2
Aluminum, total
3,500 mg/kg
12/19/23
2.50 mg/kg
EPA 200.7
Arsenic, total
3.06 mg/kg
12/19/23
0.883 nig/kg
EPA 200.7
Cadmium, total
1.18 mg/kg
12/19/23
0.100 nig/kg
EPA 200.7
Calcium, total
42,800 mg/kg
12/19/23
10.0 nig/kg
EPA 200.7
Copper, total
136 mg/kg
12/19/23
1,00 mg/kg
EPA 200.7
Chromium, total
10.8 ing/kg
12/19/23
0.250 mg/kg
EPA 2003
Lead, total
6.06 mg/kg
12/19/23
0.500 mg/kg
EPA 200.7
Magnesium, total
3,680 mg/kg
12/19/23
10.0 mg/kg
EPA 200.7
Mercury, total
0.843 mg/kg
1.2/1.9/23
0,02 ing/kg
EPA 245A
Molybdenum, total
3.94 mg/kg
12/19/23
0.250 mg/kg
EPA 200.7
Nickel, total
12.1 mg/kg
12/19/23
0.500 mg/kg
EPA 200.7
Phosphorus, total
22,800 mg/kg
12/19/23
2.00 mg/kg
EPA 200.7
Potassium, total
5,630 mg/kg
12/19/23
10.0 mg/kg
EPA 200.7
Selenium, total
21.2 mg/kg
12/19/23
0.898 mg/kg
EPA 200.7
Silver, total
<0.025 mg/kg
12/19/23
0.025 mg/kg
EPA 200.7
Sodium, total
3,380 mg/kg
12/1.9/23
20.0 mg/kg
EPA 200.7
"Zinc, total
1,170 nig/kg
12/19/23
0,500 nig/kg
EPA 200.7
PH
7.0 S.U.
12/19/23
1.0 - 14.0 S.U.
SM 4500-I18
Paint filter
Free Liquid Present
12/20/23
I hereby certify that I have reviewed and approve these data. nd-'c---. l C.I. -y- G✓C �<,
Lahoratoxy Representative
642 Tanico Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]

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FNVIRt}N10,ENtAL TFCiiU M.OG ES. W
Curaltaga Falls. Ohio 44223
Date Reported:
12i29/21123
TEL,1330/ 133-8211 PAX: 1,1311) 2.53-4489
Company:
Merited) Enviromuental Laboratories
tlli"I)81i(`: lIflJl: r/N'1+N'..f'C1rC1'..f(Jtlt
Address:
642 1 ontco Rd.
Reidsville NC 27320
Received:
12/20/2023
Projee(#:
Client TD#
121223-69
121223-69
121223-69
121223.69
121223.69
121223-69
121223-69
Client 110
121223-69
121223-69
Client ID#
121423-158
121423-158
12i423.158
121423-158
1121423-158
121423-158
121423-158
Client Ill#
121423-158
121423-158
TCLP Pesticides
Lab 1D# Collected Analyte Rep Lntt Result Units
Matrix Method DF RegLvl Run Analyst
001
121l2/2023 Chlordane, total
0,0250
NO mg/L
Solid
EPA 8081B
10
0.0300
12/2412023
JOB
001
12/12/2023 Toxaphene
0.0500
NO mg/L
Solid
EPA 8081E
10
0.500
12/24/2023
JOB
001
12/12i2O23 Endrin
0.00500
NO mg/L
Solid
EPA 80818
10
0.0200
12/24/2023
JOB
001
12/12/2023 gamma-BHC
0.00500
NO mg1L
Solid
EPA 80816
10
OADO
12/2412023
JOB
001
12/1212023 Heptachlor
0.00500
NO mg/L
Solid
EPA 80818
10
0,00800
12/24/2023
JOB
001
12/1212023 Heptachlor epoxide
0.00500
NO mg1L
Solid
EPA 80818
10
0.00800
12/2412023
JOB
DO1
12/1212023 Methoxychlor
0.00500
NO mg1L
Solid
EPA 8081 B
10
10.0
12124/2023
JOB
TCLP
herbicides
Lab ID# Collected Anaiyle
Rep Lmt
Result Units
Matrix
Alethod
DF
RegLvl
Run
Analyst
001
12/12/20232,4-D
0.500
NO mg1L
Solid
EPA 83210
50
10.0
12/22J2023
M7G
001
12112120232,4,5-TP
0.500
NO mg1L
Solid
EPA8321B
50
1.00
12/22/2023
MTG
TCLP Pesticides
Lab ID# Collected Analyte
Rep Lint
Result Units
Matrix
Method
DF
Regi,vt
Rum
Analyst
002
12/14/2023 Chlordane, total
0,0250
NO mg1L
Solid
EPA 8081E
10
0.0300
12128/2023
JOB
002
12/14/2023 Toxaphene
0.0500
NO mg1L
Solid
EPA 8081B
10
0.500
12r28/2023
JOB
002
12114/2023 Endrin
0,00500
NO mg/L
Solid
EPA 80818
10
0.0200
12/28/2023
JOB
002
12114/2023 gamma-BHC
0,00500
NO mg/L
Solid
EPA 8081E
10
0.400
12128/2023
JOB
002
1211412023 Heptachlor
0.00500
NO mg/L
Solid
EPA 8081E
10
0.00800
12128/'2023
JOB
002
12/1412023 Heptachlor epoxide
0A0500
NO mg/L
Solid
EPA 80818
10
0,00800
12128/2023
JOB
002
12114/2023 Methoxychlor
0.00500
NO mg1L
Solid
EPA 8081B
10
10.0
12/28/2023
JDB
TCIA1
Herbicides
Lab ID#
Collected Analyte
Rep Lau
Result Units
Matrix
Method
DF
Regl.vl
Run
Analyst
002
12/14/2023 2,4-D
0.500
NO mg/L
Solid
EPA 8321 B
50
10.0
12122/2023
MTG
002
12/14/2023 2.4,5-TP
0,500
NO mg/L
Solid
EPA 8321 B
50
1.00
1212212023
MTG
llac,w 4 ul' 17

M, FRF-YO EF (:�T-f3r Thf,
Environmental Laboratories
Laboratory Certificate Y165
client:
Project:
Client Sample ID:
Sample collection:
Meritech Sample 1D
Tot;gin of Spring Lake
Tc.LP
Sludge Storage
12/14/23
121423158
1311 - TCLP Organics
Volatiles: SW-846 8260
Analysis: 12,28/23
i xtmction:
12/20i23
Analyst; VWV
Report Date:
01H05/24
Parntneter
Result
Units
Det, Limit
Ree. Limit
Dilution Factor
Benzene;
< 0.0100
mglL
0.0100
0.50
10
Carbon Tetrachloride:
< 0.0100
mg/1.
0.0100
0.50
M
Chlorobenzene
<0,0100
mgll:
0.0100
100
10
Chlorororm
< 0.0100
mg/L
0.0100
6.0
It)
1.2-Dicltlaroethanc
< 0.0100
mg/L
0.0100
0.50
10
1,1-Dichlomethene
<0,0100
Ingo,
0.0100
0.70
10
Methyl Ethyl Ketone
<0.100
me/I_
0.100
200
10
Tetrachlomethylenc
< 0.0100
mg/1.
0,0100
0,70
10
Trici loroethene
< 0.0100
ntg/t,
UAW W
0.50
10
Vinyl Chloride
<0.0200
mul„
0.020
0.20
10
Senti-Volatiles. SNV-846 8270
Analysis: 01 /02/24
Extraction:
12/ 20/23
Analyst: PM
ltelxtrt Date:
01/05/24
Parameter
Result
units
Det, Limit
Ree. i.,intit
Dilution Factor
1.4-Dichlorobenzenc
<0.100
mg/1-,
0.100
7.5
10
Ilexachlorobenzenc
<0.100
ntg/I..
0.100
0.13
10
14exachloro-1,3-buiadicnc
<0,100
m�Wl,
0,100
0.5
11)
I-Fexachloroethane
<0.100
mg`L
0,100
3.00
10
o-cresol
r0.100
I11C1L
0.100
200
11)
m&p-cresol
<0.200
rnVIL
0.200
200
10
Total cresois
<0.300
111111_
0.300
200
M
Nitrobenzene
<0.100
mg/L
t1,100
2.00
1 ()
Pentachiorophcnol
<0.500
ml;/L.
0.500
100
10
Pyridine
<0.100
mvL
0.100
5.0
M
2 4 S Trichlorophenol
1=0.100
nqA
O. lot)
400
10
2.4.6-Trichloropltcnul
<0.100
nag"L
0,100
2.00
10
2.4-1)initrotolucne
<0.IW
mgil,
b,100
0,13
10
/ herebj7 cerltf' that / haw
reVlf.'wed wid
upproty
these data.
L.uburulan' Rr'/�rtserrfulire
642 Tamco Road Reidsville, NC 27320
[phone] * [e-mail]

Chain of Custody Ree"cord (COO
MERI, INC.
ENVIRONMENTAL LABORATORIES
642 Tamco Rd. Phone: [phone]
Reidsville NC 27320 Fax: [phone]
Email: [e-mail]
www.meritechlabs.com
Sample Location and/or ID #
Sludge Storage
Sampling Dates & Times
Start End
Date Time Date Time
I i I
Client: rc>1"J of ,[� r,N,SZ cC�
Address: P-0 l c) :;?0O
vV • c. �q 9;'3 (---,
NPDES#:-C.;,_q o 3 C) c4 i 6
Phone: q16 -'2A 6"1,3C �
Fax: t
EmaiI:ZL9i 6'*k7-f:
C;bM
Project:
P.O.#S:.
Attention: �:citic,rC r►C4;?�
How would you like your report sent?
Circle all that apply: Email iprererredl , Fax, Mail
Turn Around Time'
`RUSH work needs prior approval.
1std �,13�s1=
i
(Person Taking Sample (Sign/Print):
Camp?I of
Grate? Cont.t Test(s) Required
Ico'41?
I %Solids, %Volatile Solids, Paint Filter
II NH3, TKN, NO2,Ntot (H2SO4)
II Metals-AI,As,Cd,Ca,Cr,Cu,Pb,Mg,Hg
II 1 I j IMo,Ni,Ptot,K,Se,Ag,Na,2n (w/HNO3)
lFullTCLP
j
I I ph
I I I
Lab Use Only
Qn Ice? pH OK?
Yes / No Cl OK?
y I
I I
I
I
i
I Temperature Upon
Receipt:/ �l�f
Method of I "' Dechiorination (<0.5 ppm) of Amonia m, Cyanide, Phenol and TKN samples must be done in the field prior to preservation. "" '
Shipment:
I Comments: Compositor #
attached is a copy of permit requirements please make sure all test are done to permit
UPS
I
requirements
— Fed Ex
I Are these results for regulatory purposes? Yes
No :_1
— Hand Delivery
f R81in�uis�e y.
I �1, ,1-
Date• Time:
�;7,-jyz�
) '
o
-- Other
CRelinquished by:
/
Date: { v Z�me:
7
i /
n
,i
IP.0th�shed by: "�
Date: Time:
, Report results in: mg/L
Recei7drby�i'
I (Received 6y:
(Recejved by Lab: ,)
fig#
/mg/kg i uB/!
Z 1 pafc; _y Time: 7 (j~
Date: Tim : `
Date: Time: �:?�

APPENDIX III
LAND APPLICATION SITE CERTIFICATION
(FORM: LASC 06-16)

LAND APPLICATION SITE CERTIFICATION
(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 An_ nlicant shall submit one original and two couies of the an_ nlication and
suanortine 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
J�
County Board
Notification. doc
Land Owner
Agreement
(If applicable)
�„ j
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
I�aaluatiun Poli��'
Status Code
N R T I M
✓ ✓ ✓
✓ ✓ ✓
INSTRUCTIONS FOR FORM: LASC 06-16 Page 1 of 3

An updated accounting of the land application site's cumulative
pollutant loading rates (CPLRs)
Required Item N
For previously permitted sites without a soil series name indicated in the
Attachment B, submit County Soil Survey Map (or equivalent) clearly
indicate the location of the land application site and in accordance with
the soil map requirements in the "Soil Scientist Evaluation Polio"
Acknowledgement of field transfer from Land Owner (Fields may not
be permitted to multiple Permittees over the same time period)
✓ I ✓
Status Code
R I T M
* This item may be required for land application site with a status code "W', 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) (N/A)
❑ 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://deo.nc.eov/about/divisions/water-
resources/Dlannine/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:
htty://deo.nc.2ov/contact/reeional-offices
❑ General Instructions: There are 17 river basins in North Carolina. Each basin has associated waterbodies with assigned
subbasins, location descriptions, stream index numbers and established classifications.
1. Identify the project area on a 7.5 minute USGS topographical map (an 8.5 x 11-inch sheet showing the project area
should be submitted with the permit application regardless of whether a Stream classification was completed).
2. Determine the names of all the closest down slope surface waters from the project site. For unnamed tributaries, see
Table 1: Unnamed Tributaries Entering Other States or for Specific Basin Areas. Label any unnamed tributaries as
"UT to stream name" as the waterbody name.
3. Open the link htti)://deo.nc.2ov/about/divisions/water-resources/Dlanninp-/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
INSTRUCTIONS FOR FORM: LASC 06-16 Page 2 of 3

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.
2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ KNOWN COUNTY WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Select the proper county from the List all Waterbodies in county, hydrologically report.
2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ UNKNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Use the Clickable basin map to hydrologically sorted list report.
2. Click on the approximate project location to bring up the hydrologically sorted list.
3. Locate the name of the identified waterbody (from General Directions) on the list.
4. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
5. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ Notes on index number and unnamed streams:
Unnamed Streams 15A NCAC 02B .0301(i).
❑ Any stream which is not named in the schedule of stream classifications carries the same classification as that assigned
to the stream segment to which it is tributary (at the point of entry) except:
(A) unnamed streams specifically described in the schedule of classifications;
(B) unnamed freshwaters tributary to tidal saltwaters will be classified "C"; or
(C) after November 1, 1986, any newly created areas of tidal saltwater which are connected to Class SA waters by
approved dredging projects will be classified "SC" unless case -by -case reclassification proceedings are conducted.
❑ The following river basins have different policies for unnamed streams entering other states or for specific areas of the
basin:
Unnamed Tributaries Entering Other States or for Specific Basin Areas
Hiwassee River Basin
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 Spring Lake
Land application sites currently certified: 150.4 net acres and Total to be certified: 123.0 net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Code'
Site/Field
ID
Landowner(s)
Lessee(s) or Operator(s)
Net Acres
County
Crop(s)
R
1-1
Town of Spring Lake
None
8.4
Cumberland
Hay
R
3-3
Willie Calvin Brinkley
None
7.5
Cumberland
Hay
(Sam Brinkley Heirs)
R
3-4
Willie Calvin Brinkley
None
34.3
Harnett
Row Crops
R
3-5
Willie Calvin Brinkley
None
23.7
Harnett
Row Crops
R
3-6
Willie Calvin Brinkley
None
29.9
Harnett
Row Crops
R
3-7
Willie Calvin Brinkley
None
15.2
Harnett
Hay
R
3-8
Willie Calvin Brinkley
None
4.0
Harnett
Hay
D
5-1
David Frank Chatellier
None
9.1
Harnett
Pasture
D
5-2
David Frank Chatellier
None
6.0
Harnett
Pasture
D
5-3
David Frank Chatellier
None
12.3
Harnett
Hay
'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)
11. WATERBODY AND CLASSIFICATIONS
INFORMATION (See Instruction
C):
Site/Field ID Latitude
Longitude
g
Location
Location Method Code
Location Accuracy
Datum
° '11
0 1 11NAD
83
ADD
Nearest Second
° ' 11°
' It
NAD 83
ADD
Nearest Second
° ' 11
° '
NAD 83
ADD
Nearest Second
' It
° ' It
NAD 83
ADD
Nearest Second
° 1 11
0 f it
NAD 83
ADD
Nearest Second
° 1 11
0 1 11
NAD 83
ADD
Nearest Second
° 1 11
° ' it
NAD 83
ADD
Nearest Second
°
° r 11
NAD 83
ADD
Nearest Second
Note: Please keep the site information (I.) and waterbody information (II.) of the same field on the same
page.
FORM: LASC 06-16
Waterbody Subbasin and
Stream Index No.
■.
L
Predominant Soil
Series Nameb Mapping Unit
or Rep. Slope
Wickham I WmB
Vaucluse I VaB
Fuquay
FaB
Fuquay
FaB
Fuquay
FaB
Fuquay
FaB
Fuquay
FaB
Gilead
GaB
Gilead
GaB
Gilead
GaB
Current and Proposed
Class
Page 1

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

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

State of North Carolina
DWR
Department of Environment and Natural Resources
Division of Water Resources
Dtvlslon 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 ADDlicant shall submit one original and two conies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non Di�l7vrge Perrnittinc; 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 I A N "A 2T _ 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 Sarinp Lake
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-tilllover-seed/
(Y ) pp� g (optional)
pasture)
1-1 No Hay 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 Page I of 3

1. 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 11) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCD£NR-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.
11. 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.
I11.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 .01051h1 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.
1V. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
❑ The land application field(s) ID: is currently permitted under another residuals land
application program: Permit Number WO: The land owner hereby acknowledge that by signing this agreement, he/she is
requesting that the field(s) be removed from the previously permitted residuals land application program and transferred into the new
program
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. 1 certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, 1 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: Town gLSorin2 Lake
Address: 300 Ryb Street
City: Sarine Lake State: N. C. Zip: 2a390
Phone: E-mail address:
SignatureDate:
. �... t C)
NORTH CAROLINA,�i�f'Y ICE 1'1G� _ COUNTY
1, the undersigned Notary Public do hereby certify thatjiiJ�0Q p 1 N Ko'(1
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the1
day of _� t A—o p ���P,, • + . ��� .40
Signature and seal: --�" fr 4 .= ' ••!y
My commission expires: ► I 00 : 0:
�G:, VeIIG •: �;
:'L�. •.
Lessee's/Operator's Certification: ``:
CIVDf�`''��
I certify that I have read this Agreement and do hereby agree to abide by the stipulations�andfdAV18ons as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State: Zip:
E-mail address:
Date:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing off) ' I name:
��� /✓�r
Signature: / 1'" - � . _� - .. Date:
V
FORM: LOA 06-16 Page 3 of 3

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

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SCALE: 1 „ = 2,000 ,
FIGURE NO.
♦ i �
DATE: 0$_15_24
VICINITY MAP
DRAWN BY:
�'��—�
1
MEM
PROJECT NO:
Sol L SOLUTIONS
TOWN OF SPRING LAKE PROPERTY
15-16 Ph:04
CUMBERLAND COUNTY, NORTH CAROLINA

REVIEW BOUNDARY shall be established around each land application site "r i��, •, ,t-�
midway between the Compliance Boundary and the perimeter of the RdM
residuals land application area.
COMPLIANCE BOUNDARY: The Compliance Boundary for each land application site
'4is 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.
Oki IL
•.
ltv,
04.
All
L �-�. , r , •.b:: �[� �'. 1 !�� r ..
/ ► /`SI{�tr rc.r7 �4, ' 'r t ; i ,, r t „J s� e•
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- _ = Access Road ''" ' �•ro
,. �,•,... •• sj•.�, �- b,�,,,•., ., FIELD TOTAL ACRES BUFFERED ACRES NET ACRES
® Buffer �' r �'�► �s. 1-1 9.0 0.6 _ 8.4
`•`'; •�� + rr " /' REFERENCE:
Field Boundary - Tom!' '�: 4. GIS DATA LAYERS WERE OBTAINED FROM ESRI AND CUMBERLAND COUNTY GIS. PLEASE NOTE THIS
r ,,p•�,' MAP IS FOR INFORMATIONAL PURPOSES ONLY. IT IS NOT MEANT FOR DESIGN, LEGAL, OR ANY OTHER
Property Boundary r • 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
SCALE: 1 rr = 500 , FIGURE NO.
♦ � 1
DATE: 08-15-24 `/gyp t['�'�}�{jQ��y—��([ �-? BUFFER MAP ^/
DRAWN BY: MEM YYillc "x& 1 !`^be L
PROJECT NO: S 0 1 L S 0 L Li T 1 0 N 5 TOWN OF SPRING LAKE PROPERTY
` 15-16 Ph:04 CUMBERLAND COUNTY, NORTH CAROLINA 4f

TOWN OF SPRING LAKE (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: Spring Lake WWTP
WQ Permit #: WQ0001086
Field #: I Acres Utilized: 8.4
Land Owner: Spring Lake
Annual Dry Tons Applied: 0.0000
Site #: I Acres Permitted: 8.4
Operator: Richard E. Mendez
Predominant Soil Series: Wmb -
Wickham Cation Exchange Capacity (non 503):
Crop I Name: Bermuda
Crop I Max. PAN: 220
Crop 2 Name: Crop 2 Max. PAN:
Volume applied Volume
Residual Sources Precip.
Name of Crop Type
c 7 Nitrate PAN Applied
(enter one) Solids/ % Applied per
Coil
(NPDES #, WQ#, Past 24 m d
E ` TKN 8 and Receiving Residual
O
QLiquid Solids Acre
(Dry,
Fert., Animal Wet Urs.
-- rn w e (lbs/acre)
a. g P. Nitrite Application
Cu Yds Gallons (Dry Tans/Ac)
o
Waste, etc) Moist) inches
mglkg mglkg mg/kg Crop 1 Crop 2 Crop 1 Crop 2
January 0 1.72 0.000
SLWWTP S
0.5 0.3 37400 3830 581 0.000 NA Bermuda
February 0 1.72 0.000
SLWWTP S
0.5 0.3 37400 3830 581 0.000 NA Bermuda
March 0 1.72 0.000
SLWWTP S
0.5 0.3 37400 3830 581 0.000 NA Bermuda
April 0 1.72 0.000
SLWWTP S
0.5 0.3 37400 3830 581 0.000 NA Bermuda
May 0 1.72 0.000
SLWWTP S
0.5 0.3 37400 3830 581 0.000 NA Bermuda
June 0 1.72 0.000
SLWWTP S
0.5 0.3 37400 3830 581 0.000 NA Bermuda
July 0 1.72 0.000
SLWWTP S
0.5 0.3 37400 3830 581 0.000 NA Bermuda
August 0 1.72 0.000
SLWWTP S
0.5 0.3 37400 3830 581 0.000 NA Bermuda
ieptember 0 1.72 0.000
SLWWTP S
0.5 0.3 37400 3830 581 0.000 NA Bermuda
October l 0 1.72 0.000
SLWWTP S
0.5 0.3 37400 3830 581 0.000 NA Bermuda
Jovember 0 1.72 0.000
SLWWTP S
0.5 0.3 37400 3830 581 0.000 NA Bermuda
3ecember 0 1.72 0.000
SLWWTP S
0.5 0.3 37400 3830 581 0.000 NA Bermuda
totalsPbFORM SF supp tZnhis form):
ResTOTALS]
0 0 As
CdrduelsCuplicatioCr 1p,
M(oattachNi Se 0.000 0.000 Lime Applied
Annuallbs/acre 0.000
0.000 0.000 0.000 0.000 0.000
0.000 0.000 0.000 0.000 0.()0() Date lbs/ac
Prior Years Cumulative lbs/ac 4.605
1.394 59.875 3.799 11.063 0.6101
3.482 9.2543 2.9904 179.95 2023 0
Current Cumulative Ibs/ac 4.605
1.394 59.875 3.799 11.063 0.610
3.482 9.254 2.990 179.950
Permitted C. P. L. R.**** 36
34 1338 2677 267 15
16 74 89 2498
Permit PAN Limit 1 st/2nd Crop
1 220
"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."
.r, Ze ZCJ
*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 (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Spring Lake WWTP Total Dry Tons Applied (Annual): 0.00
Permit #: WQ0001086 Cation Exchange Capacity (non 503 only):
Operator: Richard E. Mendez Owner: Spring Lake Predominant Soil Series: Wmb - Wickham
Acres Used: 8.4 Acres Permitted: 8.4 Site #: 1 Field #: 1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or 1
231J
51
61
71
81
J
101
111
12
Com-
posite
Date
12/14/23
12/14/23
12/14/23 12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23 12/14/23 12/14/23 12/14/23
% Solids
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
Arsenic
3.06
3.06
3.06
3.06
3.06
3.06
3.06
3.06
3.06
3.06
3.06
3.06
Cadmium
1.18
1.18
1.18
1.18
1.18
1.18
1.18
1.18
1.18
1.18
1.18
1.18
Copper 1
136
136
136
136
J 136
136
136
136
136
136
136
136
Chromi
10.8
10.8
10.8
( 10.8
M8
10.8
10.8
10.8
10.8
10.8
10.8
10.8
Lead
6.06
G.OG
6.06
6.06
6.06
6.06
6.06
6.06
6.06
6.06
6.06
6.06
Mercury 1
0.843
0.843
0.843
0.843
0.843
0.843
0.843
0.843
0.843
0.843
0.843
0.843
Molyb-
denum
3.94
3.94
I 3.94
3.94
3.94
3.94
3.94 (
3.94
3.94
3.94
3.94
I 3.94
Nickel
12.1
12.1
12.1
12.1
12.1
12.1
12.1
Selenium
21.2
21.2
21.2
21.2
21.2
( 21.2
21.2
Zinc
( 1170
1170
1170
1170
1170
1170
1170
Total
Phos-
22800
22800
22800
22800
22800
22800
22800
nhorus
Annual
Heavy Metal Field
Loadings (Calculate
in lbs/acre):
Total
J
21
31
41
5
j
61
71
DT/Ac./
App.
Event
12.1 12.1 12.1 12.1 12.1
21.2 21.2 21.2 21.2 21.2
1170 11170 1170 11170 1170
22800 1 22800 22800 1 22800 22800
91
10
'111
12
ti
0
m
y
Arsenic
I
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Cadmium
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Copper
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Chromi
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Lead
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Mercury
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Mlyb-
a num
0.000 10.000
0.000
0.000 (
0.000
0.000 10.000
0.000
Nickel
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Selenium
0.000
0.000
0.000
0,000 (
0.000 (
0.000
0.000
0.000'
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 0.000
0.000 10.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Zinc 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
Total
Ph
os- 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
}'horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier Date
0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
0.000 0.000
0.000
DENR FORM MFLSF (12/2006)

APPENDIX V
Renewal Site
WILLIE CALVIN BRINKLEY (SITE 3, FIELDS 3-8)
LANDOWNER AGREEMENT
(FORM: LOA 06-16)
SITE MAPS
(Vicinity Map)
(Buffer/Setback Map)
UPDATED CUMULATIVE POLLUTANT LOADING RATES

WILLIE CALVIN BRINKLEY (SITE 3, FIELDS 3-8)
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 Ann_ licant shall submit one original and two copies of the anWication and
sunnorting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permillinje Util
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 .1 100. 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 Chan=es 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 Sarine Lake
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ics) onto the following land
application sites) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field IU Lease Land Use or Residuals Source Special note
(yes/no) Cropping Patterns Intended Use of Crops (optional) (no-till/over-seed!
pasture)
3-3 No flay 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- I6 Page I of 3

STIPULATIONS:
I. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity lirr 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
he 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 11) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR. Non -Discharge Permitting Unit. 1636
Mail Service ('enter. Raleigh, NC 27099-1636.
5. The Perrnittee 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 1ermittee 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 Perrnittee.
7. The Pcrmittec 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 pf 1 of the land application sitels) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final
soil pl I of at least 6.0. unless an agronomist provides information indicating that the pi I of the soil, residuals and lime mixture is suitable for
the specified crop.
9. The landotvner or his representative and the Permitter 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 Perrnittee 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 hmd 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 silc(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 Pcrmittec, 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 firr the purpose of determining
compliance with the permit: establish monitoring facilities on or near the land application sile(s) as required by the permit: copy any record,
that must be kept under the terms and conditions of the permit: take necessary leachate. surface water. groundwater. (it- soil samples during the
term of' and 12 months after termination of. this Agreement. `
IL RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land
application sitc(s) during active use and for the 12-month period billowing 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 sites) 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 alter 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 all,] are totally above the land surface shall not he 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 it residuals land
application event when the residuals remain on the land surface for lour 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 it 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.
111.ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 021..0107(d) prohibits water supply wells within the compliance boundary. Ilowever. 15A NC'AC 021' .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 flrr field(s) 11):
1Please include the rationale for the requested re -location of the compliance boundary and attach o map showing the newly proposed
compliance boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
IV. ACKNONYLEDCEMENT 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 fiCld(s) be removed from the previously permitted residuals land application program and transferred into the new
program:
(Name of the new program)
FORM: L.OA 06-16 Page 2 of 3

Landowner's Certification:
1 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: Sam Brinkley Heirs ( Willie C. Brinkley)
Address: 85 Brinkley Hill Lane
City: Cameron
State: N.C.
Zip: 28326
Phone: (910) �4j97-0849 n ' ) E-mail address:
Signature) X 1. (1 ._ i�Aa.�V/1 Date:��(t
NORTH CAROLINA, t Lii Y1I t:(l�� C UNTY
1, the undersigned Notary Public do hereby certify that
personally appeared before me this day and acknowledged the due execution of the forgoing instr)ent.
WITNESS my hand and official seal this the
day of
Signature and seal:
i < < < ,l
My commission expires: ,� t" l C, ,C'�C1 i 1 x '� n`R
S.
/ - O z:
Lessee's/Operator's Certification: Z'
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and rrstrictioii5,�gi�de�fdtn.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State: Zip
E-mail address:
Date:
1 certify that I have read this Agreement and/do hereby agree to abide by the stipulations and restrictions as specified herein.
Signingofticia _ria4ne: 0�1> GN �J 4 r� 04 / OviAl kI Iwve;,_j/
1
Signature: �.'7 /TC� ` ` ` 1 i Date:
r
FORM: LOA 06-16
Page 3 of 3

State of North Carolina
DWR
Department of Environment and Natural Resources
Division of Water Resources
Division of Water Resources LANDOWNER 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 tite
permit application. Unless otherwise noted. the Annlicant shall submit one original and two conies of the aonlication and
supporting documentation
For more in jbi-nialion. visit the fValer Quality Permitting Section's Non -Discharge Permitting Unil
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 I5A NCAC 02T .l 100. 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 Snring Lake
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 Residuals Source Special note
Intended Use of Crops (optional) (no-till/over-seed/
(yeslno) Cropping Patterns pasture)
34 No Row Crops Animal Feed
3-5 No Row Crops Animal Feed
3-6 No Row Crops Animal Feed
3-7 No flay Animal Feed -
3-8 No flay 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 0(-16 Page I of 3

1. STIPULATIONS:
I. 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 11) 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 pll of at least 6.0. unless an agronomist provides information indicating that the Ill I 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 )and 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 )and 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.
IL RESTRICTIONS:
I. 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. Foul 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 021 .01051h1 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 (Kr 16 Page 2 of 3

Landowner's Certification:
certify that I am a deeded landowner of the above -referenced land application site(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the land application site(s) on behalf of the
deeded landowners. 1 certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: Sam Brinklev Heirs ( Willie C. Brinklev)
Address: 85 Brinklev Hill Lane
City: Cameron State: N.C. Zip: 2 326
Phone: _ [phone] mail address:
Signature,4IM� Date:
NORTH
NORTH CAROLINA, I,aYY] bf I(.c/� �/ COUNTY
I, the undersigned Notary Public do hereby certify that `1 t II L. 1 , J l Lie t
personally appeared before me this day and acknowledged the due execution of the forgoing (nstr ent.
WITNESS my hand and official seal this the / r�
day of I' 0'-ri , 20 C '
Signature and seal: ni'Ll (.C: l la �!
My commission expires: �� f ,�-i`{J,alvu Za'L,
Lessee's/Operator's Certification:
AND GO
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specll�i°e" herein.
Lessee/operator name:
Address:
City: _ _ State: Zip:
Phone: E-mail address:
Signature: Date:
Permittee's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signingofficial,name: ��`" "� N� �Jtv+�
Signature(- ",_-,.. Date: .1
GI 10-
r
r
FORM: LOA 06-16 Paee 3 of 3

WILLIE CALVIN BRINKLEY (SITE 3, FIELDS 3-8)
UPDATED SITE MAPS
(Vicinity Map)
(Buffer/Setback Map)

i°A,4 Ta
a �
SCALE: 1 " = 2,000 '
DATE: 08-15-24 DRAWN BY: MEM MY111cq `�[(Q� y y
& (be
PROJECT NO: S O I L S O L LI T 1 0 IN 5
15-16 Ph:04
P
�u�p<pp,+rto<n
ins+ pyy
NC 24
NC 87
FFieId 3-343
P
:t
__..
_-'j_
NC 24
NC 87
Field Boundary
REFERENCE:
GIS DATA LAYERS WERE OBTAINED FROM ESRI AND HARNETT COUNTY GIS. 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
VICINITY MAP FIGURE NO.
BRINKLEY TRACT
TOWN OF SPRING LAKE
LAND APPLICATION PROGRAM
HARNETT COUNTY, NORTH CAROLINA
N
J

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 1
within the property boundary, whichever is closest to the residual land application area. �t
,A ♦ it ..l, t�'+.,� �. /; fj��;^i•Yi'Yi�,, ^r.+c-: Yir�+:.v':L.* �••1'.l
iz
'tt 'A
`�, r• , ^1; s f
! �' ^r - •�IG�l�r�+. \ �' �ll"� r� v� y
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+��':t1-����7'ajrr*rl-fIr�.r�\ is ' � • `�.��\�,��A►,�,,'`�'i•.'r# �* l"R �My�;"��f 'y
'� ♦ ti,...'_ �Li,J?�tt'i' ..�' , IF, t i�' r X.. w-•'�.{ ' r t� �' Y
,�i�t Mt•a�.t a 4'�, �. A `.'tt� '� �, '� • j:y �{• 1�r •P- , f tiyt� s+ �. •ice"At
I►J�'.°.°°`� �z��.�- i ,Xi Z.` �`n '�.J T. r�^ � /'�;*,�•rt �,!ry ,\ tf .'M' } �.. M i.. �^
^, °1�\y y'•' y•��y DIY! i�r-s► Serif .k y ..s.Y
.41
yn..� ,•� y!"�i• 'i�r ,�'.*s�>v�., �' �r+"`t�''- ,�'Vt- �.rii '�L', ��s y��� aii►'{�� .�y't'"4 ,�. p >} �'�!''� j
', Cell Tower .+��t # j�^,.•.
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in �. Y#Y`r�TyYM•�^4 s� *�� : � � �-`N � 1_J� — — i:'o� c�' q°� �1�''... �' `r i
^c � s�` •ice y�F
• , t``t,y' M�}^� y rw"A i� to'e. �, �,p^ ,\ t?,��,it ��•,
}
''r k•� ■ �� - Field 3-3 .,k • ;►e. ::,, .r .
etc' LC ti. , ,.1 ,per? .., .►
91.
•'�.'tsi• ice: � '��Y � t �,�� �"`tl'�.
yt e h.4 - ice, . R ie•,' `. •`..,� i `
Walmart ��.,'"�u':�~.'' A►,"#C `,� it R.�
& At -
fir
t ^ , �> R9 Well
w y .• -^ l i�L fr`1 Cd�v {aaj <K' .:� a vi. y '
,'.a y\y_ tt•'L '•?�}°'"f. tl:, t' r 'r '�+.l " Structure
4.
rILI' ' " M 4� o-'S� . r :t '� .t 1v\ .• w;J1s% �' ■ Dwelling
' � - '� �-� '" r '� "` •' '''° _ Access Road
Ike
FIELD TOTAL ACRES BUFFEREDACRES NETACRES,t �:•'° , Pond
r . '' ®Buffer
REFERENCE:•`'. j'' a+•L
r . • t
GIS DATA LAYERS WERE OBTAINED FROM ESRI AND HARNETT COUNTY GIS. PLEASE NOTE THIS MAP Field Boundary
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 Property Boundary
E axar, E star reo'ria
SCALE: 1 500 , FIGURE NO.
BUFFER MAP
DATE: 08-15-24 r BRINKLEY TRACT
DRAWN BY: MEM willcox&mabe TOWN OF SPRING LAKE 2
PROJECT NO: a J 1 S O L J T 1 0 N S LAND APPLICATION PROGRAM
` 15-16 Ph:04 HARNETT COUNTY, NORTH CAROLINA or

i
N
A
y«Rn [hapel CMeN Rmtl
fI
y'
Field Boundary
REFERENCE:
" n
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.
SCALE: 1 �� = 2,000 feet
VICINITY MAP FIGURE NO.
DATE: 08-15-24
-
WILLIE BRINKLEY TRACT
DRAWN BY: MEM
wmllwx&mabe
TOWN OF SPRING LAKE 1
PROJECT NO:
SO I L S O L U T I O N S
LAND APPLICATION PROGRAM
*% 15-16 Ph:04
HARNETT COUNTY, NORTH CAROLINA

N
REVIEW BOUNDARY shall be established around each land application site
midway between the Compliance Boundary and the perimeter of the
residuals land application area.
Legend
• Well
■ Dwelling
A Structure
Pond
Access Road
® Buffer
Field Boundary
r - Property Boundary
SCALE
1 "= 500'
BATE 08-15-24
DRAWN BY MEM
PROJECT NO
15-16 Ph:04
in
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.
FIELD 3-5
FIELD 3-6
FIELD
FIELD 3-7
FIELD
TOTAL ACRES BUFFERED ACRES NET ACRES
3-4
37.7 3.4 34.3
3-5
23.7 0 23.7
F7
3-6
29.9 0 29.9
3-7
17.5 2.3 15.2
3-8
4.0 0 4
TOTAL 107.1
REFERENCE:
GISDATALAYERS WERE OBTAINED FROM HARNETT
COUNTY GIS
WEBSITE PLEASE NOTETHIS MAPIS FOR INFORMATIONAL
PH POSESONLY ITIS NOT MEANT FOR DESIGN, LEGAL, ORANY
OTHER USES THERE ARE NO GUARANTEES ABOUT ITS
ACCURACY WMSS, PLLCASSUMES NO RESPONSIBILITY
FOR ANY DECISION MADE OR ANY ACTIONS TAIKEN BY THE USER BASED
UPON THIS INFORMATION
FIGURE NO
BUFFER MAP
WILLIE BRINKLEY TRACT
TOWN OF SPRING LAKE
LAND APPLICATION PROGRAM
HARNETT COUNTY, NORTH CAROLINA /

WILLIE CALVIN BRINKLEY (SITE 3, FIELDS 3-8)
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: Spring Lake WWTP
WQ Permit #: WQ0001086
Field #: 3 Acres Utilized: 7.5
Land Owner: Willie Calvin Brinkley
Annual Dry Tons Applied: 8.0690
Site #: 3 Acres Permitted: 7.5
Operator: Richard E. Mendez
Predominant Soil Series: VaB-Vaucluse
Cation Exchange Capacity (non 503):
Crop 1 Name: Bermuda
Crop 1 Max. PAN: 220
Crop
2 Name: Small Grain Crop 2 Max. PAN: 100
Volume applied Volume
Soil Preci
Residual Sources P•
Cond.
c
9. z Nitrate Name of CropType
o PAN Applied
I
(enter one) Solids/ % Applied per
(NPDES #, WQ#, past 24 b
m TKN and Ibs/acre Receiving Residual
( )
Q Liquid Solids Acre
Fert., Animal Wet' Hrs. o
* a
9 P. Nitrite Application
Cu Yds Gallons (Dry TonslAc)
Waste, etc) Moist) Inches tj
mglkg mglkg mglkg Crop 1 Crop 2 Crop 1 Crop 2
January 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
February 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
March 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
April 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
May 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
June 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
July 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
August 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 U00 NA Bermuda
ieptember 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
October 112,500 1.72 1.076
SLWWTP S
0.5
0.3 37400 3830 581 Na 27.041 Sm. Grain
uovember 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
December 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form): i
TOTALS:
0 112500 As
Cd Cu Cr Pb Hg
Mo
Ni Se Zn P 0.060 27.041 Lime applied
Annuallbs/acre 0.007
0.003 0.293 0.023 0.013 0.002
0.008
0.026 0.046 2.518 49.059 Date lbs/ac
Prior Years Cumulative lbs/ac 0.71
0.075 10.531 0.538 0,901 0.023
0.175
0.736 0.266 54.11 2023 600
Current Cumulative lbs/ac 0.717
0.078 10.824 0.561 0.914 0.025
0.183
0.762 0.312 56.628
Permitted C. P. L. R.**** 36
34 1338 2677 267 15
16
74 89 2498
Permit PAN Limit I sV2nd Crop
1 220 100
"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."
YL41A�- ma-�3
/
1 �Y
*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, anaeroblally digested -0.2,
aerobically digested -0.3, raw sludge -0.4
*`C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM *
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Spring Lake WWTP Total Dry Tons Applied (Annual): 8.07
Permit #: WQ0001086 Cation Exchange Capacity (non 503 only):
Operator: Richard E. Mendez Owner: Willie Calvin Brinkley Predominant Soil Series: VaB-Vaucluse
Acres Used: 7.5 Acres Permitted: 7.5 Site #: 3 Field #: 3
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #r):
Sample or
1
2
31_4.j
5]
61_J
81
91
101
111
12
Com-
posite
Date
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
% Solids
1.72
1.72
1.72
132
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
Arsenic
3.06
3.06
3.06
3.06
3.06
3.06
3.06
3.06
3.06
( 3.06
3.06
3.06
Cadmium
1.18
118
1.18
1.18
1.18
1.18
1.18
1.18
1.18
1.18
1.18
1.18
Copper
136
136
136
136
136
!
136
136
136
136
136
136
136
Chromium
10.8
10.8
10.8
10.8
10.8
10.8
10.8
10.8
10.8
10.8
( 10.8
10.8
Lead
6.06
( 6.06
6.06
6.06
( 6.06
6.06
6.06
( 6.06
6.06
6.06
6.06
6.06
Mercury
0.843
0.843
0.843
0.843
0.843
0.843
0.843
0.843
0.843
0.843
0.843
0.843
Molyb- I
denum
3.94
3.94 I
3.94
, 3.94
3.94
3.94
3.94
3.94
I 3.94
3.94
) 3.94
'
3.94
Nickel
12.1
12.1
12.1
12.1
12.1
( 12.1
12.1
12.1
12.1
12.1
12.1
12.1
Selenium,
21.2
21.2
21.2
21.2
212
21.2
21..2
21.2
21.2
21.2
21.2
21.2
Zinc
1170
1170
1170
1170
1170
1170
1170
, 1170
1170
1170
1170
1170
Total
Phos
22800
22800
22800
22800
22800
22800I
I
22800
(22800
22800I
22800
22800
22800
I
phorus
Annual
eavy Metal Field
Loadings
(Calculated in lbs/acre):
Total
1f
21
31
_4j
5 j
_ 6 j
L-71
-81
91
i 0
111
12
DT/Ac./
App.
Event
1.08
Arsenic
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.007
0.000
0.000
Cadmium
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.003
0.000
1 0.000
Copper
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.293
0.000
1 0.000
Chromiumy
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.023
0.000
0.000
Lead
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.013 1
0.000
0.000
Mercury
0.000
0.000
0A00
0.000 1
0.000
0.000 1
0.000
0.000
0.000
0.002
0.000
0.000
Myb-
denum
0.000
10.000 10.000
0.000
!
0.000
10.000 I
0.000
10.000
0.000)
0.008
,
0.000
I 0.000
Nickel
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 (
0.000
0.026
0.000
0.000
Selenium,
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.046
0.000
( 0.000
Zinc
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
2.518
0.000
0.000
Tota
Phosl I
0.000
I O.000 I
U.000
0.000 (
U.000
0.000 I
0.000
0.000
0.000 149.059
0.000 I
0.000
phone
0.007
0.003
0.293
0.023
0.013
0.002
0.008
0.026
0.046
2.518
49.059
"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".
f
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "NIA" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Spring Lake WWTP WQ Permit #: WQ0001086 Field #: 4 Acres Utilized: 34.3
Land Owner: Willie Calvin Brinkley Annual Dry Tons Applied: 0.0000 Site #: 3 Acres Permitted: 34.3
Operator: Richard E. Mendez Predominant Soil Series: FaB-Fuquay Cation Exchange Capacity (non 503):
Crop 1 Name: N/A Crop I Max. PAN: N!A Crop 2 Name: N/A Crop 2 Max. PAN: NIA
Volume applied Volume Soil Preci Z Nitrate Name of CropType
PP Residual Sources Cond. P d ° p PAN Applied
a0i � (enter one) Solids/ % Applied per (NPDES #, WQ#, Past 24 N ' m � � g TKN o and Receiving Residual
9 Solids Fert., Animal Hrs. w N' fD 0° ° (Ibs/acre)
ro Li Liquid Acre (Dry' ° : g �. Nitrite Application
Q Cu. Yds Gallons (Dry TonslAc) Waste, etc) Wet
inches °a mglkg mgtkg mg/kg Crop 1 Crop 2 Crop 1 Crop 2
January 0 1.72 0.000 SLWWTP S 0.5 0.3 37400 3830 581 0.000 0.000
February 0 1.72 0.000 SLWWTP S 0.5 0.3 37400 3830 581 0.000 0.000
March 0 1.72 0.000 SLWWrFP S 0.5 0.3 37400 3830 581 0.000 0.000
April 0 1.72 0.000 SLWWTP S 0.5 0.3 37400 3830 581 0.000 0.000
May 0 1.72 0.000 SLWWTP S 0.5 0.3 37400 3830 581 0.000 0.000
June 0 1.72 0.000 SLWWTP S 0.5 0.3 37400 3830 581 0.000 0.000
July 0 1.72 0.000 SLWWTP S 0.5 0.3 37400 3830 581 0.000 0.000
August 0 1.72 0.000 SLWWTP S 0.5 0.3 37400 3830 581 0.000 0.000
ieptember 0 1.72 0.000 SLWWTP S 0.5 0.3 37400 3830 581 0.000 0.000
October 0 1.72 0.000 SLWWTP S 0.5 0.3 37400 3830 581 0.000 0.000
Vovember 0 1.72 0.000 SLWWTP S 0.5 0.3 37400 3830 581 0.000 0.000
December 0 1.72 0.000 SLWWTP S 0.5 0.3 37400 3830 581 0.000 0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS: 0 0 As Cd Cu Cr Pb H,g Mo Ni Se Zn P b.boo 0.000 Lime Applied
Annuallbs/acre 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Date lbs/ac
Prior Years Cumulative lbs/ac 0 0 0 0 0 0 0 0 0 0 2023 0
Current Cumulative Ibs/ac 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
Permitted C. P. L. R.**** 36 34 1338 2677 267 15 16 74 89 2498
Permit PAN Limit lst/2nd Crop N/A I N/A
"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 personne roperly 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." t� *Application Method: S - Surface, IN -
Injection, INC Incorporation
(S-- 24 214 **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 (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Spring Lake WWTP Total Dry Tons Applied (Annual): 0.00
Permit #: WQ0001086 Cation Exchange Capacity (non 503 only):
Operator: Richard E. Mendez Owner: Willie Calvin Brinkley Predominant Soil Series: FaB-Fuquay
Acres Used: 34.3 Acres Permitted: 34.3 Site #: 3 Field #: 4
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or 1
21
31
J
51
61
71
8
91
101
111
12
Com-
posite
Date
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23 12/14/23 12/14/23
% Solids
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
Arsenic
3.06
' 3.06
3.06
3.06
3.06
3.06
3.06
3.06
I 3.06
3.06
3.06
3.06
Cadmium
L 18
1.18
1.18
( 1.18
1.18
1.18
1.18
1.18
I 1.18
1.18
I 1.18
1.18
Copper I
136
I 136
136
I 136
136
136
I 136
136
136
( 136
136
136
Chromi
10.8
10.8
,
10.8
10.8
10.8
( 10.8
I 10.8
I 10.8
, 10.8
10.8
10.8
10.8
I,eadj
6.06
6.06 I
6.06
6.06
6.06
I 6.06
I 6.06
I 6.06
I 6.06
6.06
I 6.06
6.06
Mercury 1
0.843
0.843
0.843
10.843
10.843
10.843
10.843
( 0.843
10.843
( 0.843
( 0.843
0.843
Molyb-
denum I
3.94
3.94
3.94
3.94
3.94
1 3.94
I 3.94
Nickel I
12.1
I 12.1
I 12.1
12.1
I 12.1
12.1
( 12.1
Selenium I
21.2
I 21.2
I 21.2
I 21.2
21.2
21.2
I 21.2
Zinc 11170
1170
1170
11170
1170
1170
1170
Total
Phos-
22800
22800
22800
22800
22800
22800
22800
phorus
Annual .
eavy Metal Field
Loadings (Calculated in lbs/acre):
Total
1121
31
41
51
s f
7J
DT/Ac./
App.
Event
3.94
3.94
3.94
3.94
3.94
12.1 I
12.1
12.1
12.1
12.1
21-2 I
21.2
21.2 I
21.2
21.2
1170
1170
1170
1170
1170
22800
228001228001 22800 22800
81 ` s j 101 11
Arsenic 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
Cadmium
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Copper
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
Chromiurr
0.000
0.000 10.000
0.000
0.000
0.000
0.000 10.000
0.000
0.000 10.000
0.000
0.000
Lead 0.000 0.000 0.000 0.000 0.000 0.000 ( 0.000 0.000 ( 0.000 0.000 10.000 0.000 0.000
Mercury 0.000 0.000 0.000 0.000 0.000 0.000 0.000 10.000 10.000 ( 0.000 0.000 ( 0.000 0.000
Molyb-
denum 0.000 10.000 0.000 0.000 0.000 10.000 0.000 0.000 0.000 ( 0.000 0.000 0.000 0.000
enum
Nickel 0.000 0.000 0.000I0.000I0.000I0.000I0.000 0.000 0.000I0.000 0.000 0.000 0.000
Selenium 0.000 0.000 0.000 0.000 10.000 10.000 10.000 10.000 10.000 10.000 , 0.000 10.000 0.000
Zinc 0.000 0.000 0.000 0.000 0.000 10.000 0.000 10.000 10.000 0.000 0.000 10.000 0.000
Total
Ph
os- 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
„phOIUS
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
imprisonmeent for knowing violations".
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACII FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Spring Lake W WTP
WQ Permit #: WQ0001086
Field #: 5 Acres Utilized: 23.7
Land Owner: Willie Calvin Brinkley
Annual Dry Tons Applied: 0.0000
Site #: 3 Acres Permitted: 23.7
Operator: Richard E. Mendez
Predominant Soil Series: FaB - Fuquay Cation Exchange Capacity (non 503):
Crop 1 Name: N/A
Crop I Max. PAN: N/A
Crop 2 Name: N/A Crop 2 Max. PAN: N/A
Volume applied Volume
Residual Sources Co it Precip.
�y
Name of Crop Type
o 9. Z 1 Nitrate PAN Applied
q (enter one) Solids/ % Applied per
(NPDES #, WQ#, Past 24
" 'd
° R TKN o and Receiving Residual
H. o (Ibs/acre) g
C Liquid Solids Acre
Fett., Animal Wes' Hrs.
R
"
* w' g P. Nitrite Application
Q
Cu. Yds Gallons (Dry Tons/Ac)
Waste, etc)
Moist) inches
" y
o' "
p 0 mglkg mgAg mg/kg Crop I Crop 2 Crop 1 Crop 2
January 0 1.72 0.000
SLWWTP
S
0.5 0.3 37400 3830 581 0.000 0.000
February 0 1.72 0.000
SLWWTP
S
0.5 0.3 37400 3830 581 0.000 0.000
March 0 1.72 0.000
SLWWTP
S
C.5 0.3 37400 3830 581 0.000 0.000
April 0 1.72 0.000
SLWWTP
S
0.5 0.3 37400 3830 581 0.000 0.000
May 0 1.72 0.000
SLWWTP
S
0.5 0.3 37400 3830 581 0.000 0.000
June 0 1.72 0.000
SLWWTP
S
0.5 0.3 37400 3830 581 0.000 0,000
July 0 1.72 0.000
SLWWTP
S
0.5 0.3 37400 3830 581 0.000 0.000
August 0 1.72 0.000
SLWWTP
S
0.5 0.3 37400 3830 581 0.000 0.000
ieptember 0 1.72 0.000
SLW WTP
S
0.5 0.3 37400
3830 581 0.000 0.000
October 0 1.72 0.000
SLWWTP
S
0.5 0.3 37400
3830 581 0.000 0.000
I
'4ovember 0 1.72 0.000
SLWWTP
S
0.5 0.3 37400
3830 581 0.000 0.000
December 0 1.72 0.000
SLWWTP
S
0.5 0.3 37400 3830 581 0.000 0.000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS]
0, 0 As
Cd Cu Cr Pb
Hg
Mo Ni Se Zn j P I 0.000
0.000 Lime Applied
Annuallbs/acre 0.000
0.000 0.000 0.000 0.000
0.000
0.000 0.000 0.000 0.000 0.000 Date Ibs/ac
Prior Years Cumulative lbs/ac 0
0 0 0 0
0
0 0 0 0 2023 0
Current Cumulative lbs/ac 0.000
0.000 0.000 0.000 0.000
0.000
0.000 0.000 0.000 0.000
Permitted C. P. L. R,**** 36
34 1338 2677 267
15
16 74 89 2498
Permit PAN Limit Ist/2nd Crop
N/A I N/A
"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
v
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:
Spring Lake WWTP
Total Dry Tons Applied (Annual):
0.00
Permit #:
WQ0001086
Cation Exchange Capacity (non
503 only):
Operator:
Richard E. Mendez
Owner:
Willie Calvin Brinkley
Predominant Soil Series:
FaB -
Fuquay
Acres Used:
23.7
Acres Permitted:
23.7
Site #:
3
Field #:
5
Residual Analysis Data (Heavy
Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or _!
��! �
41
� _ 181
91
101
11
12
Com-
posite
Date 12/14/23
12/14/23 12/14/23
12/14/23
12/14/23
12/14/23 12/14/23
12/14/23 12/14/23 12/14/23
12/14/23
12/14/23
% Solids 1.72
1.72 1.72
1.72
1.72
1.72 1.72
1.72 1.72
L72
1.72
1.72
Arsenic 3.06
3.06 3.06
3.06
3.06
3.06 3.06
3.06 3.06
3.06
3.06
3.06
Cadmium 1.18
1.18 1.18
1.18
1.18
1.18 1.18
1.18 1.18
1.18
1.18
1.18
Copper 1 136
1 136 136
136
136
136 136
136 136
136
136
136
Chromium 10.8
1 10.8 10.8
1 10.8
10.8
( 10.8 10.8
10.8
10.8
10.8
10.8
10.8
Lead 1 6.06
6.06 6.06
6.06
6.06
6.06 6.06
6.06
6.06
6.06
6.06
6.06
Mercury 0.843
0.843 0.843
0.843
0.843
0.843 0.843
0.843
0.843
0.843
0.843 ,
0.843
Molyb- 3.94 I
denum
3.94
3.94
3.94
I 3.94
3.94 3.94
3.94
3.94
I 3.94
3.94
3.94
Nickel 12.1
12.1
12.1
12.1
12.1
12.1 12.1
12.1 12.1
12.1
12.1
12.1
Selenium 21.2
21.2 21.2
21.2
21.2
21.2 21.2
21.2
21.2
21.2
21.2
21.2
Zinc 1170
1170 1170
1170
1170
11.70 1170
1170
' 1170
1170
1170
1170
Total
Phos- 22800
22800
22800
22800
22800
22800 22800
22800
22800
22800
22800
22800
Fhorus
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total 11
21 31
_4]
7] J 91
`10
111
12
DT/Ac./
c
App'
Event
Arsenic 0.000
0.000 0.000
0.000
0.000
0.000 0.000
0.000 0.000
0.0o0
o.0o0
0.000
0.000
Cadmium 0.000
0.000 0.000
0.000
0.000
0.000 0.000
0.000 0.000
0.000
0.000
0.000
0.000
Copper 0.000
0.000 0.000
0.000
0.000
0.000 0.000
0.000 0.000
0.o00
0.000
0.000
0.000
Chromium 0.000
0.000 0.000
0.000
0.000
0.000 0.000
0.000 0.00o
0.000
0.000
0.000
0.000
Lead 0.000
0.000 0.000
0.000
0.000
0.000 0.000
0.000 0.000
0.000
0.000
0.000
0.000
Mercury 0.000
0.000 0.000
0.000
0.000
0.000 0.000
0.000 0.000
0.000
0.000
0.000
0.000
Molyb- 0.000 10.000
denum
0.000
0.000
0.000
0.000
0.000 10.000
0.000
0.000 10.000
(
0.000
0.000
Nickel 0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000 0.000
0.000
0.000
0.000
0.000
Selenium 0.000
0.000 0.000
0.000
0.000
0.000 ( 0.000
0.000 0.000
0.000
0.000
0.000
0.000
Zinc 0.000
0.000 0.000
0.000
0.000
0.000 0.000
0.000 0.000
0.000 (
0.000
0.000
0.000
Total
Phos- 0.000
0.000 0.000
0.000
0.000
0.000
0.000
0.000 0.000
0.000
0.000
0.000
0.000
phorus
NiI 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".
_X4L5r1
✓
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Spring Lake WWTP
WQ Permit #: WQ0001086
Field #: 6 Acres Utilized: 29.9
Land Owner: Willie Calvin Brinkley
Annual Dry Tons Applied: 0.0000
Site #: 3 Acres Permitted: 29.9
Operator: Richard E. Mendez
Predominant Soil Series: FaB-Fuquay
Cation Exchange Capacity (non 503):
Crop 1 Name: Bermuda
Crop 1 Max. PAN: 220
Crop
2 Name: Small Grain Crop 2 Max. PAN: 100
Volume applied Volume
Soils.
Residual Sources Precip.
o
Z Nitrate Name of Crop Type
p yp
o (enter one) Solids/ % Applied per
Cond. 4
(NPDES #, WQ#, Past 24
w
TKN o and PAN Applied Receiving Residual
Q Liquid Solids Acre
Fert., Animal We ' Hrs.
* P*
$ ao o (Ibs/acre)
E Nitrite Application
Cu. Yds Gallons (Dry Tona/AC)
Waste, etc) * 0
Moist) Inches
o'
❑
'
c mglkg mg/kg mg/kg Crop 1 Crop 2 Crop 1 Crop 2
January 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
February 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
March 0 1.72 0.000
SLWWTP S
OS
0.3 37400 3830 581 Na 0.000 Sm. Grain
April 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
May 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
June 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
July 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
August 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
ieptember 0 1.72 0.000
SLWWTPS
0.5
0.3 37400 3830 581 0.000 NA Bermuda
October 0 1.72 0,000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
Vovember 0 1.72 0.000
SI,WWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
December 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
Residuals Applications totals on FORM FSF
supp ( attach FORM FSF supp to this form):
TOTALS:
0
0 As
Cd Cu Cr Pb Hl;
Mo
Ni Se Zn 1 P 0.000 0.000 Lime kpplied
Annuallbs/acre 0.000
0.000 0,000 0.000 0.000 0.000
0.000
0.000 0.000 0.000 0.000 Date lbs/ac
Prior Years Cumulative lbs/ac 0.0149904
0.003 1.0757 0.0531 0.0015 0.0023
0.0114
0.6955 0.015 4.86 2023 0
Current Cumulative lbs/ac 0.015
0.003 1.076 0.053 0.002 0.002
0.011
0,696 0.015 4.860
Permitted C. P. L. R.**** 36
34 1338 2677 267 15
16
74 89 2498
Permit PAN Limit Ist/2nd Crop
1 220 1 100
"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, includi the possibility of fines and imprisonment for knowing violations."
f
�2
*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: Spring Lake WWTP
Total Dry Tons Applied (Annual):
0.00
Permit #: WQ0001086
Cation Exchange Capacity (non 503 only):
Operator: Richard E. Mendez
Owner:
Willie Calvin Brinkley Predominant
Soil Series:
FaB-Fuquay
Acres Used: 29.9 Acres Permitted:
29.9
Site #:
3
Field #:
6
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw
Percent #):
Sample or
71
8j J
101
Ill
12
Com-
posite
Date 12/14/23 12/14/23 12/14/23 12/14/23
12/14/23
12/14/23 12/14/23
12/14/23 12/14/23
12/14/23
12/14/23
12/14/23
% Solids 1.72 1.72 1.72 1.72
1.72
1.72 1.72
1.72 1.72
1.72
1.72
1.72
Arsenic 3.06 3.06 3.06 3.06
3.06
3.06 3.06
3.06 3.06
3.06
3.06
3.06
Cadmium 1.18
1.18 1.18
1.18
,
1.18
1.18 118
1.18 1.18
1.18
1.18
1.18
Copper 136
136 136
136
136
136
136
136 136
136
136
( 136
Chromium, 10.8 10.8 10.8 ( 10.8
10.8
10.8
10.8
10.8 10.8
10.8
10.8
10.8
Lead ( 6.06 6.06 6.06 6.06
6.06
6.06 6.06
6.06
6.06
( 6.06
6.06
6.06
Mercury 0.843 0.843 0.843 0.843
0.843
0.843 0.843
0.843
0.843
0.843
0.843
0.843
Molyb-
denum,
I 3.94 3.94
I 3.94 3.94
3.94
I 3.94
I 3.94
3.94
3.94
3.94 I
3.94
3.94
Nickel 12.1 111
12.1 12.1
12.1
( 12.1 12.1
12.1
12.1
( 12.1
12.1
12.1
Selenium 21.2 21.2
21.2 ( 21.2
21.2
21.2 21.2
21.2 21.2
21.2
21.2
( 21.2
Zinc 1170 1170 1170 1170
1170
1170 1170
1170 1170
1170
1170
1170
Total
Phos-
22800
22800
22800 22800
22800
22800
22800
22800
22800
22800
22800
22800
phorus
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total 11 21 31 41
51
61 ?j
_8j 91
101
111
12
DT/Ac./
o
APp-
��-
Event
Arsenic 0.000 0.000 0.000 0.000
0.000
0.000 0.000
0.000 0.000
0.000
0.000
0.000
0.000
Cadmium 0.000 0.000 0.000 0.000
0.000
0.000 0.000
0.000 0.000
0.000
0.000
0.000
0.000
Copper 0.000 0.000 0.000 0.000
0.000
0.000 0.000
0.000 0.000
0.000
0.000
0.000
0.000
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 0.000 0.000
0.000
0.000 0.000
0.000 0.000
0.000
0.000
0.000
0.000
Mercury ( 0.000 0.000 0.000 0.000
0.000
0.000 0.000
0.000 0.000
0.000
0.000
0.000
0.000
Molyb-
0.000 0.000
0.000 0.000
10.000
0.000 10.000
0.000 0.000 +
0.000
0.000
0.000
0.000
denum
Nickel
0.000 0.000
0.000 0.000
0.000
0.000 0.000
0.000 0.000
0.000
0.000
0.000
0.000
Selenium 0.000 0.000 0.000 0.000
0.000
0.000
0.000
0.000 0.000
0.000
0.000
0.000
0.000
Zinc 0.000 0.000 ( 0.000 0.000
0.000
0.000
0.000
0.000 0.000
0.000
0.000
0.000
0.000
Total
Phos-
0.000 0.000
0.000 0.000
0.000
0.000
0.000
0.000 0.000
0.000
0.000
0.000
0.000
phorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered
and evaluated the
information submitted. I am
aware that there are significant penalties for submitting false information,
including the possibility
of fines and
imprisonment for knowing violations".
Signature of Land Applier U
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Spring Lake WWTP
WQ Permit #: WQ0001086
Field #: 7 Acres Utilized: 15.2
Land Owner: Willie Calvin Brinkley
Annual Dry Tons Applied: 24.5296
Site #: 3 Acres Permitted: 15.2
Operator: Richard E. Mendez
Predominant Soil Series: FaB-Fuquay
Cation Exchange Capacity (non 503):
Crop 1 Name: Bermuda
Crop 1 Max. PAN: 220
Crop
2 Name: Small Grain Crop 2 Max. PAN: 100
Volume applied Volume
��
Residual Sources Cord. Precip.
o
T Nitrate PAN Applied Name of Crop Type
enter one Solids/ a Applied
N q ( ) /o pp per
(NLPDES #, WQ#, Past 24 rob
%n °
m I,
`;
� m. TKN and (1bs/acre) Receiving Residual
Liquid Solids Acre
Fert., Animal VD✓CL' Hrs.
w'
* N q P. Nitrite Application
Q Cu. Yds Gallons (Dry Tons/Ac)
ante, etc) Moist) inches * °
°p
mg/kg mg/kg mg/kg Crop I Crop 2 Crop 1 Crop 2
January 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
February 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
March 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
April 126000 1.72 0.595
SLWWTP S
0.5
0.3 37400 3830 581 14.944 NA Bermuda
May 76500 1.72 0.361
SLWWTP S
0.5
0.3 37400 3830 581 9.073 NA Bermuda
June 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
July 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
August 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
ieptember 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
October) 67500 1.72 0.319
SLWWTP S
0.5
0.3 37400 3830 581 Na 8.005 Sm. Grain
Vovembet 72000 1.72 0.340
SLWWTP S
0.5
0.3 37400 3830 581 Na 8.539 Sm. Grain
December 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
0 342000 As
Cd Cu Cr Pb fig
Mo
Ni Se Zn P 24.016 16.545 Lime Applied
Annuallbs/acre 0.010
0.004 0.439 0.035 0.020 0.003
0.013
0.039 0.068 3.776 73.589 Date lbs/ac
Prior Years Cumulative lbs/ac 0.588
0.158 21.853 1.112 1.883 0.43
0.343
1.524 0.535 106.374 2023 900
Current Cumulative Ibs/ac 0.598
0.162 22.292 1.147 1.903 0,433
0.356
1.563 0.603 110.150
Permitted C. P, L. R,**** 36
34 1338 2677 267 15
16
74 89 2498
Permit PAN Limit Ist/2nd Crop
1 220
"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 violations."
luj_�L 010", J**Volatilization
rfo�r-knowing
3/7 "J1 _26Zq
*Application Method: S - Surface, IN- Injection, INC - Incorporation
I
Rate: Surface - 0.5, Injection/Incorporation -1.0
Signature of Land Ayer
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:
Spring Lake WWTP
Total Dry Tons Applied (Annual):
24.52
Permit #:
WQ0001086
Cation Exchange
Capacity (non 503 only):
Operator:
Richard E. Mendez
Owner:
Willie
Calvin Brinkley
Predominant Soil Series:
FaB-Fuquay
Acres Used:
15.2
Acres Permitted:
15.2
Site #:
3
Field #:
7
Residual Analysis Data (Heavy
Metals and Total Phosphorus
use
mg/kg, % Solids use Raw Percent #):
Sample or 11
''
-1
_4j
te��J61
7181
91 101
111
12
Com-
posite
Date 12/14/23
12/14/23 12/14/23 12/14/23
12/14/23
12/14/23
12/14/23
12/14/23
12/14/23 12/14/23
12!14/23
12/14/23
% Solids 1.72
1.72 1.72
1.72
1.72
1.72
1.72
1.72
1.72 1.72
1.72
1.72
Arsenic 3.06
3.06 3.06
3.06
3.06
3.06
3.06
3.06
3.06 3.06
3.06
3.06
Cadmium 1.18
1.18 1.18
1.18
1.18
1.18
1.18
1.18
1.18 1.18
1.18
1.18
Copper 136
136 136
136
136
136
136
136
136 136
136
136
Chromium 10.8
10.8 10.8
10.8
( 10.8
10.8
10.8
10.8
10.8 10.8
10.8
10.8
Lead 6.06
6.06 6.06
6.06
6.06
6.06
6.06
6.06
6.06 6.06
6.06
6.06
Mercury 0.843
0.843 0.843
0.843
0.843
0.843
0-843
( 0.843
0.843 0.843
0.843
0.843
Molyb- 3.94
denum
3.94
3.94
3.94
3.94
I 3.94
( 3.94
I 3.94
I 3.94 3.94 I
3.94
3.94
Nickel 12.1
12.1
12.1
12.1
12.1
12.1
12.1
12.1
12.1 12.1
12.1
12.1
Selenium 21.2
21.2 I 21-2
21.2
21.2
21.2
21.2
21.2
21.2 21.2
21.2
21.2
Zinc 1170
1170 1170
1170
1170
1170
1170
1170
1170 1170
1170
1170
Total
Phos- 22800
22800
22800
22800
22800
22800
22800
22800
22800
22800
22800
22800
phorus
Annual Heavy Metal Field Loadings (Calculate
in lbs/acre):
Total 11
21 31
41
5j
61
71
81
91 101
111
12
DT/Ac./
y
c
APP-
14
Event
0.59
0.36
0.32
0.34
Arsenic 0.000
0.000 0.000
0.004
0.002
0.000
0.000
0.000
0.000 0.002
0.002
0.000
0.010
Cadmium 0.000
0.000 0.000
0.001
0.001
0.000
0.000
0.000
0.000 0.001
0.001
0.000
0.004
Copper 0.000
0.000 0.000
0.162
0.098
0.000
0.000
0.000
0.000 0.087
0.092
0.000
0.439
Chromiumr 0.000
0.000 0.000
0.013
0.008
0.000
0.000
0.000
0.000 0.007
0.007
0.000
0.035
Lead 0.000
0.000 0.000
0.007
0.004
0.000
0.000
0.000
0.000 0.004
0.004
0.000
0.020
Mercury 0.000 10.000
0.000
0.001
0.001
0.000
0.000
0.000
0.000 0.001
0.001
0.000
0.003
Molyb- 0.000
denum
0.000 0.000
0.005
0.003
0.000
0.000
0.000
0.000
I 0.003 +
0.003 10.000
0.013
Nickel 0.000
0.000 0.000
0.014
0.009
0.000
0.000
0.000
0.000 0.008
0.008
0.000
0.039
Selenium ( 0.000
0.000 0.000
0.025
0.015
0.000
0.000
0.000
0.000
0.014
0.014 (
0.000
0.068
Zinc 0.000
0.000 0.000
1.391
0.845
0.000
0.000 (
0.000
0.000
0.745
0.795 10.000
3.776
Total
Phos-
0.000
0.000 0.000
27.112
16.461
0.000
0.000
0.000
0.000
14.524
15.492
0.000
73.589
qhorus
certify, under penalty of law, that
this document
was prepared
un
er 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".
.�..
3-1 sz�
Signature of Land Applier
Date
DENR FORM MFLSF (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: Spring Lake WWTP Total Dry Tons Applied (Annual): 11.30
Permit #: WQ0001086 Cation Exchange Capacity (non 503 only):
Operator: Richard E. Mendez Owner: Willie Calvin Brinkley Predominant Soil Series: FaB-Fuquay
Acres Used: 4 Acres Permitted: 4 Site #: 3 Field #: 8
Residual Analysis Data (Heavy Metals and Total Phosphorus
'''
hosphorus use mg/kg, % Solids use Raw Percent #):
Sample or 1 21 J J 61 71 _8j 91 101 111 12
Com-
posite
Date 12/14/23 12/14/23 12/14/23 12/14/23 12/14/23 12/14/23 12/14/23 12/14/23 12/14/23 12114/23 12/14/23 12/14/23
% Solids
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
1.72
Arsenic
3.06
3.06
3.06
3.06
3.06
3.06
3.06
3.06
3.06
3.06
3.06
3.06
Cadmium
1.18
1.18
1.18
1.18
1.18
1.18
1.18
1.18
1.18
1.18
1.18
1.18
Copper
136
136
136
( 136
( 136
136
136
136
136
136
136
136
Chromiutq
10.8
10.8
10.8
10.8
10.8
10.8
( 10.8
10.8
10.8
10.8
10.8
10.8
Lead 1
6.06
6.06
6.06
6.06
6.06
6.06
6.06
6.06
6,06
6.06
6.06
6.06
Mercury
0.843
0.843
0.843
0.843
( 0.843
0.843
0.843
0.843
0.843 '
0.843
0.843
0.843
Molyb-
enum
denum
3.94
3.94
3.94
3.94
I 3.94
3.94
I 3.94
3.94
3.94
3.94
3.94
( 3.94
Nickel
12.1
12.1
12.1
12.1
12.1
12.1
12.1
12.1
12.1
12.1
12.1
12.1
Selenium
21.2
21.2
21.2
21.2
21.2
21.2
21.2
21.2
21.2
21.2
21.2
211
Zinc
1170
1170
1170
1170
1170
1170
1170
1170
1170
1170
1170
1170
Total
Phos-
22800
22800
22800
22800
22800
22800
22800
22800
22800
22800
22800
22800
phorus
Annual Heavy
Metal Field Loadings (Calculated
in lbs/acre):
Total
j
41
51
6j
7]
81
9 j
101
111
12
DT/Ac./
_1121
_3
c
App.
y
Event
0.403
0.726
1.694
Arsenic
0.000
0.000
0.000
0.000
0.002
0.000
0.000
0.000
0.000
0.004
0.010
0.000
0.017
Cadmium
0.000
0.000
0.000
0.000
0.001
0.000
0.000
0.000
0.000
0.002
0.004
0.000
0.007
Copper
0.000
0.000
0.000
0.000
0.110
0.000
0.000
0.000
0.000
0.198
0.461
0.000
0.768
Chromium
0.000
0.000
0.000
0.000
0.009
0.000
0.000
0.000
0.000
0.016
0.037
0.000
0.061
Lead
0.000
0.000
0.000
0.000
0.005
0.000
,
0.000
0.000
0.000
0.009
0.021
( 0.000
0.034
Mercury
0.000
0.000
0.000
0.000
0.001
0.000
0.000
0.000
0.000
0.001
0.003
0.000
0.005
Molyb-
denurn
denum
0.000
0.000 10.000
0.000
0.003
10.000
10.000
0.000
0.000
0.006
0.013
0.000
0.022
Nickel
0.000
0.000
0.000
0.000
0.010
0.000
0.000
0.000
0.000
0.018
0.041
( 0.000
0.068
Selenium
0.000
0.000
0.000
0.000
0.017
0.000
0.000
0.000
0.000
0.031
0.072
0.000
0.120
Zinc
0.000
0.000
0.000
0.000
0.944
0.000
0.000
0.000
0.000
1.699
3.965
, 0.000
6.608
Total
Phos-
0.000
0.000
0.000
0.000
18.397
0.000
0.000
0.000
0.000
31115
77.268
0.000
128.780
phorus
certify,
under
penalty o
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)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACII FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Spring Lake WWTP
WQ Permit #: WQ0001086
Field #: 8 Acres Utilized: 4
Land Owner: Willie Calvin Brinkley
Annual DryTons Applied: 11.2965
Site #: 3 Acres Permitted: 4.0
Operator: Richard E. Mendez
Predominant Soil Series: FaB-Fuquay
Cation Exchange Capacity (non 503):
Crop 1 Name: Bermuda
Crop 1 Max. PAN: 220
Crop
2 Name: Small Grain Crop 2 Max. PAN: 100
Volume applied Volume
c
Soil
Residual Sources PreciP•
Cond. b
o
9. Z Nitrate Name of Crop Type
PAN Applied P YP
(enter one) Solids/ % Applied per
(NPDES #, WQ#, Past 24 ro d
pry, 0
w
�° w TKN aoa and ( Ibs/acre) Receiving Residual
'4.
QLiquid Solids Acre
Fert., Animal Hrs.
c
* Q Nitrite Application
Waste, etc)
0
Cu. Yds Gallons (Dry TonsIAC)
Moist) inches
ts
a mglkg mg/kg mglkg Crop 1 Crop 2 Crop 1 Crop 2
January 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
February 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
March 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
April 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
May 22500 1.72 0.403
SLWWTP S
0.5
0.3 37400 3830 581 10.140 NA Bermuda
June 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
July 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
August 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
September 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 0.000 NA Bermuda
October 1 40500 1.72 0.726
SLWWTP S
0.5
0.3 37400 3830 581 Na 18.252 Sm. Grain
,4ovember 94500 1.72 1.694
SLWWTP S
0.5
0.3 37400 3830 581 Na 42.589 Sm. Grain
December 0 1.72 0.000
SLWWTP S
0.5
0.3 37400 3830 581 Na 0.000 Sm. Grain
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
0 157500 As
Cd Cu Cr Pb HR
Mo
Ni Se Zn P 10.140 60.841 Lime Applied
Annuallbs/acre 0.017
0.007 0.768 0.061 0.034 0.005
0.022
0.068 0.120 6.608 128.780 Date lbs/ac
Prior Years Cumulative lbs/ac 0.512
0.038 6.943 0.376 0.674 0.01
0.1
1.102 0.1545 35.428 2023 1575
Current Cumulative Ibslac 0.529
0.045 7.711 0.437 0.708 0.015
0.122
1.170 0.274 42.036
Permitted C. P. L. R.**** 36
34 1338 2677 267 15
16
74 89 2498
Permit PAN Limit Ist/2nd Crop
1 220 ( 100
"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 possi ' 'ty of fines and imprisonment for knowing violations."
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*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization
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Rate: Surface - 0.5, Injection/incorporation -1.0
Signature of La pplier
Date
*** Mineralization Rates: Compost -0.1, anserobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)