HomeMy WebLinkAboutWQ0000838_Attachments A & B Certification_20180420Water Resources
ENVIRONMENTAL QUALITY
April 20, 2018
JASON SMITH —VICE PRESIDENT
GRANVILLE FARMS, INC.
POST OFFICE BOX 1396
OXFORD, NORTH CAROLINA 27565
Dear Mr. Smith:
ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Interim Director
Subject: Attachment A and B Certifications
Permit No. WQ0000838
GFI RLAP
Granville County
In accordance with your permit modification request received December 22, 2017, and subsequent
additional information received March 8, 2018, we are forwarding herewith modified Attachments A and
B certified April 20, 2018, to Granville Farms, Inc. for the subject residuals program.
These certifications are being issued to modify Attachments A and B by:
1. Addition of two residual facilities to Attachment A totaling 20 dry tons per year, those sources
being Avocet WWTP (NC0055051) and Westfall (WQ0028798).
2. Addition of six fields in Nash County totaling 94.96 acres, those fields being HM -01 and -02;
and LF -A, -B, -C and -D.
3. Addition of nine fields in Vance County totaling 122.79 acres, those fields being MJ -01 to -09.
4. Addition of Footnote 55 in Attachment B stating that an updated Landowner Agreement is
required before residuals may be applied on Fields JC -06 and -07 in Nash County since the
land has changed ownership.
The modified Attachments A and B shall be effective from the date of certification until September
30, 2021 (i.e., expiration date of the current permit), shall void Attachment B of Permit No. WQ000083 8
issued October 11, 2016 and Attachment A that was previously certified on May 11, 2017, and shall be
subject to the conditions and limitations as specified therein, as well as those specified in the above -
referenced permit. Please replace Attachment B of Permit No. WQ0000838 that was issued October 11,
2016 and Attachment A that was certified on May 11, 2017, with these modified Attachments.
Please note that only the maps for new land application sites are attached to this letter. It is the
Permittee's responsibility to ensure that a complete permit is created by inserting these documents into the
previously issued permit.
- Nothing Compares
State of North Carolina I Environmental Quality I Water Resources I Water Quality Permitting I Non -Discharge Permitting
1617 Mail Service Center I Raleigh, North Carolina 27699-1617
919-807-6332
Mr. Jason Smith
April 20, 2018
Page 2 of 2
If any parts, requirements, and/or limitations contained in this certification or modified
Attachments are unacceptable, you have the right to request an adjudicatory hearing upon written request
within 30 days following receipt of the certification. This request shall be in the form of a written petition,
conforming to Chapter 150B of the North Carolina General Statutes and filed with the Office of
Administrative Hearings at 6714 Mail Service Center, Raleigh, North Carolina 27699-6714. Unless such
demands are made, this permit shall be final and binding.
If you need any additional information concerning this matter, please contact Troy Doby at (919)
807-6336 or troy.doby�kncdenngov.
Sincerely,
Linda Culpepper, Interim Directo
Division of Water .Resources
cc: Granville County Health Department (Electronic Copy)
Raleigh Regional Office, Water Quality Regional Operations Section (Electronic Copy)
C. Scott Carpenter — SoilPlus (Electronic Copy)
Digital Permit Archive (Electronic Copy)
Central Files
ATTACHMENT A — Approved Residual Sources
Granville Farms, Inc.
Certification Date: April 20, 2018
Permit Number: WQ0000838 Version: 3.2
WQ0000838 Version 3.2 Attachment A Page 1 of 4
Monitoring
Monitoring
Monitoring
Permit
Biological
Maximum
Frequency for
Frequency for
Frequency for
Approved
Owner
Facility Name
County
Number
Residuals
Dry Tons
Non -hazardous
Metals and
Pathogen &
Mineralization
Per Year 1Vector
Characteristics 2
Nutrients 3,5
Attraction
Rate
Reductions 4,5
South Granville Water &
SGWASA WTP
Granville
02-39-107
No
319
Once per permit
See Table
None 6
NA
Sewer Authority
City of Henderson
Kerr Lake Regional WTP
Vance
02-91-010
No
200
Once per permit
Annually
None 6
NA
Town of Enfield
Town of Enfield WTP
Halifax
04-42-025
No
50
Once per permit
Annually
None"
NA
Mallinckrodt, LLC
Mallinckrodt WWTP
Wake
CHEM
Yes
790
Annually
See Table
See Table
0.3
Consolidated Diesel
Consolidated Diesel
Nash
NIA
Yes
20
Once per permit
Annually
Annually
0.3
Aqua North Carolina, Inc.
Governor's Club WWTP
Chatham
NC0000088
Yes
40
Not Required
Annually
Annually
0.3
Town of Spring Hope
Spring Hope WWTP
Nash
NCO020061
Yes
50
Once per permit
Annually
Annually
0.3
Town of Louisburg
Tar River Water Reclamation
Franklin
NCO020231
Yes
319
Once per permit
See Table
See Table
0.3
Facility WWTP
City of Henderson
Henderson WRF
Vance
NCO020559
Yes
800
Once per permit
See Table
See Table
0.3
Town of Warrenton
Warrenton WWTP
Warren
NCO020834
Yes
319
Once per permit
See Table
See Table
0.3
Town of Enfield
Enfield WWTP
Halifax
NCO025402
Yes
100
Once per permit
Annually
Annually
0.3
South Granville Water &
SGWASA WWTP
Granville
NCO026824
Yes
650
Once per permit
See Table
See Table
0.3
Sewer Authority
City of Raleigh Public
Neuse River WWTP
Wake
NCO029033
Yes
1,000
Annually
See Table
See Table
0.3
Utilities Department
Kittrell Job Corps Center
Kittrell Job Corps Center
Vance
NCO029131
Yes
10
Not Required
Annually
Annually
0.3
City of Rocky Mount
Tar River Regional WWTP
Edgecombe
NCO030317
Yes
800
Annually
See Table
See Table
0.3
Johnston County
Central Johnston County
Johnston
NCO030716
Yes
100
Annually
Annually
Annually
0.3
WWTP
Aqua North Carolina, Inc.
Neuse River Village WWTP
Wake
NCO038784
Yes
15
Not Required
Annually
Annually
0.3
Duke Energy Progress Inc.
Shearon Harris Nuclear
Wake
NCO039586
Yes
15
Not Required
Annually
Annually
0.3
Power Plant
Knightdale Estates MHP
Knightdale Estates MHP
Limited Partnership
WWTP
Wake
NCO040266
Yes
15
Not Required
Annually
Annually
0.3
Aqua North Carolina, Inc.
Barclay Downs
Wake
NCO040606
Yes
10
Not Required
Annually
Annually
0.3
Town of Bunn
Bunn WWTP
Franklin
NCO042269
Yes
75
Annually
Annually
Annually
0.3
WQ0000838 Version 3.2 Attachment A Page 1 of 4
ATTACHMENT A — Approved Residual Sources
Granville Farms, Inc.
Certification Date: April 20, 2018
Permit Number: 'WQ0000838 Version: 3.2
WQ0000838 Version 3.2 Attachment A Page 2 of 4
Monitoring
Monitoring
Monitoring
Permit
Biological
Maximum
Maximum
for
Frequency for
Frequency for
Approved
Owner
Facility Name
County
Dry Tons
Pathogen &
Mineralization
Number
Residuals
Per Year iVector
Non -hazardous
Metals and
Attraction
Rate
Characteristics z
Nutrients s, s
Reductions'° s
Nature Trails Association CLP
Nature Trails MHP WWTP
Chatham
NCO043257
Yes
20
Not Required
Annually
Annually
03
Fearington Utilities Inc.
Fearington Village WWTP
Chatham
NCO043559
Yes
100
j Not Required
Annually
Annually
0.3
Aqua North Carolina, Inc.
Hawthorne Subdivision
Wake
NCO049662
Yes
80
Once per permit
Annually
Annually
0.3
WWTP
Aqua North Carolina, Inc.
Cole Park Shopping Center
Chatham
NCO051314
Yes
10
Not Required
Annually
Annually
0.3
WWTP
River Mill COA, Inc.
River Mill WWTP
Wake
NCO056278
Yes
10
Not Required
Annually
Annually
0.3
Aqua North Carolina, Inc.
Avocet WWTP
Wake
NCO055051
Yes
10
Not Required
Annually
Annually
0.3
Aqua North Carolina, Inc.
Cross Creek Mobile Estates
Wake
NCO056391
Yes
10
Not Required
Annually
Annually
0.3
Aqua North Carolina, Inc.
Carolina Meadows WWTP
Wake
NCO056413
Yes
75
Not Required
Annually
Annually
0.3
Aqua North Carolina, Inc.
Mallard Crossing WWTP
Wake
NCO058505
Yes
15
Not Required
Annually
Annually
03
Aqua North Carolina, Inc.
Lake Ridge Aero Park
Durham
NCO059099
Yes
10
Not Required
Annually
Annually
0.3
WWTP
Pope Industrial Park II Ltd
Pope Industrial Park
Wake
NCO060526
Yes
t0
Not Required
Annually
Annually
0.3
Partnership
Aqua North Carolina, Inc.
Beachwood WWTP
Wake
NCO060577
Yes
10
Not Required
Annually
Annually
0.3
Carolina Water Service, Inc.
Amherst Subdivision WWTP
Wake
NCO061638
Yes
10
Not Required
Annually
Annually
0.3
of NC
Aqua North Carolina, Inc.
Woodlake try Club
Moore
NCO061719
Yes
25
Not Required
Annually
Annually
0.3
WWTP
Carolina Water Service, Inc.
Kings Grant Subdivision
Wake
NCO062219
Yes
10
Not Required
Annually
Annually
0.3
of NC
WWTP
Aqua North Carolina, Inc.
Crooked Creek WWTP
Wake
NCO062715
Yes
40
Not Required
Annually
Annually
0.3
Aqua North Carolina, Inc.
Briarwood Farms WWTP
Wake
NCO062740
Yes
30
Not Required
Annually
Annually
0.3
Aqua North Carolina, Inc.
Witdwood Green WWTP
Wake
NCO063614
Yes
15
Not Required
Annually
Annually
0.3
Clarke Utilities
Deer Chase WWTP
Wake
NCO063746
Yes
10
Not Required
Annually
Annually
0.3
Carolina Water Service, Inc.
Willowbrook WWTP
Wake
NCO064378
Yes
10
Not Required
Annually
Annually
0.3
of NC
WQ0000838 Version 3.2 Attachment A Page 2 of 4
ATTACHMENT A — Approved Residual Sources
Granville Farms, Inc.
Certification Date: April 20, 2018
Permit Number: WQ0000838 Version: 3.2
1. Maximum Dry Tons per Year is the amount of residuals approved for land application from each permitted facility.
2. Analyses to demonstrate that residuals are non -hazardous (i.e., TCLP, ignitability, reactivity, and corrosivity) as stipulated under permit Condition IV.2.
3. Testing of metals and nutrients as stipulated under permit Condition IV.3.
4. Analyses of pathogen and vector attraction reductions as stipulated under permit Condition IV A.
WQ0000838 Version 3.2 Attachment A Page 3 of 4
Monitoring
Monitoring
Monitoring
Permit
Biological
Maximum
Frequency for
Frequency For
Frequency for
Approved
Owner
Facility Name
County
Number
Residuals
Dry Tons
Non -hazardous
Metals and
Pathogen &
Mineralization
Per Year 1
Characteristics
Nutrients 3,5
Vector Attraction
Rate
Reductions','
Aqua North Carolina, Inc.
Neuse Colony WWTP
Johnston
NCO064564
Yes
150
Not Required
Annually
Annually
0.3
Town of Kenly
Kenly Regional WWTP
Johnston
NCO064891
Yes
319
Ouce per permit
See Table
See Table
0.3
Aqua North Carolina, Inc.
Tradewinds WWTP
Wake
NCO065714
Yes
10
Not Required
Annually
Annually
0.3
Franklin County Public
Franklin County WWTP
Franklin
NCO069311
Yes
319
Once per permit
See Table
See Table
0.3
Utilities
Clarke Utilities
Whippoorwill Valley WWTP
Wake
NCO073318
Yes
15
Not Required
Annually
Annually
0.3
City of Raleigh Public
Little Creek WWTP
Wake
NCO079316
Yes
150
Annually
Annually
Annually
0.3
Utilities Department
City of Rocky Mount
Tar River WTP
Nash
P WSID
No
319
Not Required
See Table
None
NIA
0464010
City of Rocky Mount
Sunset WTP
Nash
PWSID
0464020
No
319
Not Required
See Table
None'
NIA
Aqua North Carolina, Inc.
The Preserve at Jordan Lake
Wake
WQ0018146
Yes
20
Not Required
Annually
Annually
0.3
Aqua North Carolina, Inc.
Colvard Farms
Orange
WQ0019569
Yes
10
Not Required
Annually
Annually
0.3
KRJ Inc.
Rockbridge Subdivision
Wake
WQ0024320
Yes
10
Not Required
Annually
Annually
0.3
Aqua North Carolina, Inc.
The Legacy at Jordan Lake
Wake
WQ0024844
Yes
20
Not Required i
Annually
Annually
0.3
Old North State Water
Briar Chapel Development
Chatham
WQ0028552
Yes
30
Not Required
Annually
Annually
0.3
Company, LLC
Aqua North Carolina, Inc.
Westfall WWTP
Chatham
WQ0028798
Yes
10
Not Required
Annually
Annually
0.3
Aqua North Carolina, Inc.
Hasentree Golf Community
Wake
I WQ0033816
Yes
50
Not Required
Annually
Annually
0.3
Total
8,108
1. Maximum Dry Tons per Year is the amount of residuals approved for land application from each permitted facility.
2. Analyses to demonstrate that residuals are non -hazardous (i.e., TCLP, ignitability, reactivity, and corrosivity) as stipulated under permit Condition IV.2.
3. Testing of metals and nutrients as stipulated under permit Condition IV.3.
4. Analyses of pathogen and vector attraction reductions as stipulated under permit Condition IV A.
WQ0000838 Version 3.2 Attachment A Page 3 of 4
ATTACHMENT A — Approved Residual Sources
Granville Farms, Inc.
5. Monitoring frequencies are based on the actual dry tons applied per year using the table below, unless specified above.
Dry Tons Applied
short tons per ear
Monitoring Frequency
Established in 40 CFR 503 and 15A NCAC 02T.1 111
<319
IN=
=>319 - <1,650
1/ Quarter 4 times per ear
—>1.650 - <16,500
1160 Das 6 times per ear
=>16,500
1/month 12 times per ear
Certification Date: April 20, 2018
Permit Number: WQ0000838 Version: 3.2
6. Class A water treatment plant residuals are exempt from meeting the pathogen & vector attraction reduction requirements in Condition IVA, provided they are not mixed with residuals that have
been generated during the treatment of domestic wastewater, the treatment of animal processing wastewater, or the biological treatment of industrial wastewater. The Class A water treatment plant
residuals must be treated and processed in a manner as to not meet the definition of "Biological Residuals" as defined in 15A NCAC 02T. 1102(6).
If no land application events occur during a required sampling period (e.g. no land application occur during an entire year when annual monitoring is required), then no sampling data is
required during the period of inactivity. The annual report shall include an explanation for missing sampling data. Those required to submit the annual report to EPA may be required to
make up the missed sampling, contact the EPA for additional information and clarification.
WQ000083 8 Version 3.2 Attachment A Page 4 of 4
ATTACHMENT B - Approved Land Application Sites
Granville Farms, Inc.
Certification Date: April 20, 2018
Permit Number: WQ0000838 Version: 3.2
Field/ Site
Owner
Lessee
County
Latitude
Longitude
Net
Acreage
Dominant Soil
Series
Footnotes
4801 -WP -01
Cooper, Jeanne Watson; Keith, Patricia W.
Pyle, Bill
Franklin
36.0653001
-78.4797001
22.20
CaB - Cecil
1
4801 -WP -02
Cooper, Jeanne Watson; Keith, Patricia W.
Pyle, Bill
Franklin
36.067964°
-78.4756641
36.83
PaC2 - Pacolet
1
4801 -WP -03
Cooper, Jeanne Watson; Keith, Patricia W.
Pyle, Bill
Franklin
36.073464°
-78.4767530
6.87
WeB - Wedowee
2
4801 -WP -04
Cooper, Jeanne Watson; Keith, Patricia W.
Pyle, Bill
Franklin
36.0728330
-78.4737530
30.38
PaC2 - Pacolet
2
JM -01
William H. Moss Trustee; Moss, Jim
Pyle, Bill
Franklin
36.034767°
-78.472556°
4.92
CaB - Cecil
3
JM -02
William H. Moss Trustee; Moss, Jim
Pyle, Bill
Franklin
36.034394°
-78.4699330
11.39
CaB - Cecil
3
JM -03
William H. Moss Trustee; Moss, Jim
Pyle, Bill
Franklin
36.032667°
-78.4701140
7.00
CaB - Cecil
3
JM -04
William H. Moss Trustee; Moss, Jim
Pyle, Bill
Franklin
36.032686°
-78.467053°
2.65
CaC - Cecil
3
JM -05
William H. Moss Trustee; Moss, Jim
Pyle, Bill
Franklin
36.034700°
-78.464750°
9.85
CaC - Cecil
4
JM -06
William H. Moss Trustee; Moss, Jim
Pyle, Bill
Franklin
36.038425°
-78,464806°
9.59
CaC - Cecil
4
JM -07
William H. Moss Trustee; Moss, Jim
Pyle, Bill
Franklin
36.0407640
-78.465028°
6.82
CaC - Cecil
4
JM -08
William H. Moss Trustee; Moss, Jim
,Pyle, Bill
Franklin
36.0326060
-78.4645920
2.27
CaC - Cecil
4
JM -09
William H. Moss Trustee; Moss, Jim
Pyle, Bill
Franklin
36.027111°
-78.487156°
24.50
CaB - Cecil
5
MP -01
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Franklin
35.936208°
-78.3562671
1.08
VaB - Vance
6
MP -02
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Franklin
35.935617°
-78.357017°
1.85
WeB - Wedowee
6
MP -03
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Franklin
35.936711°
-78.360267°
9.61
WeB - Wedowee
6
MP -04
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Franklin
35.936003°
-78.360403°
0.61
WeB - Wedowee
6
MP -05
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Franklin
35.936947°
-78.3651780
2.31
WeB - Wedowee
7
MP -06
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Franklin
35.935567°
-78.365772°
2.22
HeB - Helena
7
MP -12
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Franklin
35.9379580
-78.3574330
7.57
VaB - Vance
7
MP -13
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Franklin
35.938606°
-78.3550440
1.87
VnB - Varina
6
MP -14
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Franklin
35.936617°
-78.3542971
0.90
WeB - Wedowee
6
Total for Franklin County
203.29
WQ0000838 Version 3.2 Attachment B Pagel of 8
ATTACHMENT B - Approved Land Application Sites
Granville Farms, Inc.
Certification Date: April 20, 2018
Permit Number: WQ0000838 Version: 3.2
2009-01
Shufler, Robert Elmo
Granville
36.387800°
-78.651900°
13.33
Georgeville
8
2009-02
Shufler, Robert Elmo
Granville
36.387200°
-78.655000°
58.72
Georgeville
8
2009-03
Shufler, Robert Elmo
Granville
36.384022°
-78.649136°
22.33
Georgeville
9
2009-04
Shufler, Robert Elmo
Granville
36.381061°
-78.655958°
17.89
Enon
9
375-01
W. T. Gannt & Sons
Granville
36.213300°
-78.763100°
10.42
Herndon
10
375-02
W. T. Gannt & Sons
Granville
36.208900°
-78.762200°
17.16
Enon
10
375-03
W. T. Gannt & Sons
Granville
36.201900°
-78.761900°
6.31
Enon
11
375-04
W. T. Gaunt & Sons
Granville
36.198538°
-78.761426°
34.67
Georgeville
I I
4801 -JI -1-01
Daniel, Gene Taylor; Sarah M. Daniel Trust
Granville
36.188603°
-78.738903°
7.02
VaB - Vance
15
4801 -JH -02
Mangum Heirs I1 LLC
Granville
36.183081'
-78.731561°
3.59
HeB - Helena
12,13
4801 -JH -03
Mangum Heirs 11 LLC
Granville
36.179392°
-78.729331°
9.25
HeB - Helena
13,14
4801 -JH -04
Mangum Heirs II LLC
Granville
36.176717°
-78.728006°
2.59
HeB - Helena
14
4801 -JH -05
Mangum Heirs Il LLC
Granville
36.184531°
-78.730422°
17.14
HeB - Helena
12, 13
4801 -JH -06
Mangum Heirs II LLC
Granville
36.177486°
-78.725397°
10.27
HeB - Helena
13,14
4801 -JH -07
Mangum Heirs 1I LLC
Granville
36.1788220
-78.7276140
6.00
HeB - Helena
13
4801 -JH -08
Kraynik, Anita Daniel; Daniel, Gene Taylor
Granville
36.188603°
-78.738903°
13.94
VaB - Vance
15
GF -001
Granville Farms Inc
Granville
36.482239°
-78.728236°
46.74
GeC - Georgeville
16
GF -002
Granville Farms Inc
Granville
36.482103°
-78.724736°
31.44
GeB - Georgeville
16
GF -003
Granville Farms Inc
Granville
36.481706°
-78.720914°
28.25
GeC - Georgeville
16
GF -004
Granville Farms Inc
Granville
36.476006°
-78.718278°
43.32
GeB - Georgeville
17
GF -004A
Granville Farms Inc
Granville
36.477267°
-78.722169°
11.04
HTB - Herndon
17
GF -005
Granville Farms Inc
Granville
36.471681°
-78.7130690
18.02
GeC - Georgeville
18
GF -005A
Granville Farms Inc
Granville
36.469736°
-78.710597°
5.58
GeC - Georgeville
18
GF -006
Granville Farms Inc
Granville
36.474406°
-78.726781 °
75.73
GeB - Georgeville
19
WQ0000838 Version 3.2 Attachment B Page 2 of 8
ATTACHMENT B - Approved Land Application Sites
Granville Farms, Inc.
Certification Date: April 20, 2018
Permit Number: WQ0000838 Version: 3.2
GF -007
Granville Farms Inc
Granville
36.473325°
-78.723417°
21.43
GeB - Georgeville
19
GF -007A
Granville Farms Inc
Granville
36.473728°
-78.721278°
2.96
HrB - Herndon
19
GF -008
Granville Farms Inc
Granville
36.468897°
-78.725678°
25.36
EnI3 -Enon
17, 19, 20
GF -009
Granville Farms Inc
Granville
36.470778°
-78.721131°
29.09
GeB - Georgeville
20
GF -010
Granville Farms Inc
Granville
36.466103°
-78.717969°
26.27
EnB - Enon
20
GF -011
Granville Farms Inc
Granville
36.485656°
-78.737989°
46.97
NaB - Nason
21
GF -012
Granville Farms Inc
Granville
36.487475°
-78.735850°
7.19
NaB - Nason
2l
GF -012A
Granville Farms Inc
Granville
36.487847°
-78.738872°
1.41
EnB - Enon
21
Total for Granville County
671.43
8015-02-01
Fisher, Linda Eileen
Halifax
36.174031°
-77.882122°
19.44
AaA - Altavista
22
8015-02-02
Fisher, Linda Eileen
Halifax
36.171956°
-77.883422°
19.46
WeB - Wedowee
22
8015-02-03
Fisher, Linda Eileen
Halifax
36.172497°
-77.886817°
7.36
AaA - Altavista
22
8015-02-04
Fisher, Linda Eileen
Halifax
36.172836°
-77.8895670
11.49
StA - State
22
8015-02-05
Fisher, Linda Eileen
Halifax
36.171358°
-77.888225°
0.92
StA - State
22
8015-02-06
Fisher, Linda Eileen
Halifax
36.1702750
-77.8873970
7.04
WcB - Wedowee
22
8015-02-07
Fisher, Linda Eileen
Halifax
36.168425°
-77.885361°
29.31
Well - Wedowee
22
8015-02-08
Fisher, Linda Eileen
Halifax
36.169528°
-77.8827080
13.68
WeB - Wedowee
22
JTB-02
Bryant, John Truette
Halifax
36.179889°
-77.8149140
4.85
AaA - Altavista
23
JTB-03
Bryant, John Truette
Halifax
36.178817°
-77.813783°
1.16
WeB - Wedowee
23
JTB-04
Bryant, John Truette
Halifax
36.179547°
-77.813142°
6.90
AaA - Altavista
23
JTB-05
Bryant, John Truette
Halifax
36.178736°
-77.813453°
5.28
StA - State
23
JTB-06
Bryant, John Truette
Halifax
36.178547°
-77.812994°
9.85
StA - State
23
JTB-07
Bryant, John Truette
Halifax
36.1791940
-77.8125670
10.67
WeB - Wedowee
23
Total for Halifax County
147.41
WQ0000838 Version 3.2 Attachment B Page 3 of 8
ATTACHMENT B - Approved Land Application Sites
Granville Farms, Inc.
Certification Date: April 20, 2018
Permit Number: WQ0000838 Version: 3.2
7823-01
Edwards, William Odell Irrevocable Trust; Durham, Melanie E.
Trustee
Edwards, Randy
Johnston
35.736125°
-78.355089°
34.80
WoB - Wedowee
24
7823-02
Edwards, Randy; Pen Dell LLC
Johnston
35.731875°
-78.355808°
24.35
WoB - Wedowee
24
7823-03
Edwards, Randy; Pen Dell LLC
Johnston
35.729208°
-78.353881°
17.37
MaB - Marlboro
24
7823-05
Edwards, William Odell Irrevocable Trust; Durham, Melanie E.
Trustee
Edwards, Randy
Johnston
35.7256310
-78.3575080
21.87
MaB - Marlboro
25
7823-06
Edwards, William Odell Irrevocable Trust; Durham, Melanie E.
Trustee
Edwards, Randy
Johnston
35.732614°
-78.348653'
16.34
MaB - Marlboro
26
7823-06A
Edwards, William Odell Irrevocable Trust; Durham, Melanie E.
Trustee
Edwards, Randy
Johnston
35.731625°
-78.346789°
5.76
VrB - Varina
26
7823-07
Edwards S. Q. Heirs
Edwards, Randy
Johnston
35.750189'
-78.375511°
2.87
VrB - Varina
27
7823-08A
Edwards S. Q. Heirs
Edwards, Randy
Johnston
35.752328°
-78.374186°
19.08
VrB - Varina
27
7823-08B
Edwards S. Q. Heirs
Edwards, Randy
Johnston
35.753481°
-78.370275°
44.38
VrB - Varina
27
BC -06
Creech, Jeffrey Brent; Creech, Billy E.
Johnston
35.784631°
-78.309528°
4.60
WoB - Wedowee
28
JL -01
Culbreth, Jane Rene Lee; Lee, Jimmy Keith
Johnston
35.7898080
-78.2853390
5.37
McB - Marlboro
29
JL -02
Culbreth, Jane Rene Lee; Lee, Jimmy Keith
Johnston
35.792556°
-78.284636°
6.28
McB - Marlboro
29
JL -03
Culbreth, Jane Rene Lee; Lee, Jimmy Keith
Johnston
35.793956°
-78.284211°
5.43
McB - Marlboro
29
JL -04
Culbreth, Jane Rene Lee; Lee, Jimmy Keith
Johnston
35.792961°
-78.281211°
6.50
McB - Marlboro
29
JL -05
Culbreth, Jane Rene Lee; Lee, .Timmy Keith
Johnston
35.791311°
-78.279878°
1.18
McB - Marlboro
29
JL -06
Culbreth, Jane Rene Lee; Lee, Jimmy Keith
Johnston
35.791139°
-78.280847°
2.75
McB - Marlboro
29
JL -07
Culbreth, Jane Rene Lee; Lee, Jimmy Keith
Johnston
35.791625°
-78.282447°
4.96
NnB - Nason
29
JL -08
Culbreth, Jane Rene Lee; Lee, Jimmy Keith
Johnston
35.787278'
-78.280478°
2.80
McB - Marlboro
29
Total far Johnston County
226.69
4801 -CH -01
FWB Children's Home Inc.
Deans, D. Scott
Nash
35.817586°
-78.2124970
21.31
GeB - Georgeville
30
4801 -CH -02
FWB Children's Home Inc.
Deans, D. Scott
Nash
35.817586'
-78.212497°
7.90
GeB - Georgeville
30
4801 -CH -03
FWB Children's Home Inc.
Deans, D. Scott
Nash
35.817925°
-78.2082890
13.79
Gee - Georgeville
30
4801 -CH -04
FWB Children's Home Inc.
Deans, D. Scott
Nash
35.8226440
-78.2101000
45.69
GeB - Georgeville
30,31
WQ0000838 Version 3.2 Attachment B Page 4 of 8
ATTACHMENT B - Approved Land Application Sites
Granville Farms, Inc.
Certification Date: April 20, 2018
Permit Number: WQ0000838 Version: 3.2
4801 -CFI -05
FWB Children's Home Inc.
Deans, D. Scott
Nash
35.8228000
-78.210000°
10.68
GeB - Georgeville
30
4801 -CH -06
FWB Children's Home Inc.
Deans, D. Scott
Nash
35.8238080
-78.2064190
9.60
GeB - Georgeville
31
4801 -CH -07
FWB Children's Home Inc.
Deans, D. Scott
Nash
35.8236920
-78.2033530
15.52
GeB - Georgeville
31
4801 -CH -08
Deans, Donald E; Deans, Anita W.
Deans, D. Scott
Nash
35.8248330
-78.199397°
23.82
GeB - Georgeville
31
4801 -CH -09
FWB Children's Home Inc.
Deans, D. Scott
Nash
35.822119°
-78.2047970
16.41
GeB - Georgeville
30,31
4801 -CH -10
Deans, Donald E; Deans, Anita W.
Deans, D. Scott
Nash
35.8213300
-78.190508'
11.25
GeB - Georgeville
32
4801 -CH -11
Deans, Donald Scott
Nash
35.8238110
-78.1928140
5.45
GeB - Georgeville
32
4801 -CH -12
Deans, Donald E; Deans, Anita W.
Deans, D. Scott
Nash
35.8190190
-78.190800°
11.97
GeB - Georgeville
32
8015-01-02
Fisher, Dorothy C.
Fisher, Linda
Nash
36.0814810
-78.033581°
35.35
GeB - Georgeville
33
8015-01-03
Fisher, Dorothy C.
Fisher, Linda
Nash
36.0834330
-78.034178°
17.00
GeB - Georgeville
33
BC -01
Creech, I Brent; Creech, Allison H.
Nash
35.7794830
-78.2434530
10.36
GeC - Georgeville
34
BC -02
Creech, J Brent; Creech, Allison H.
Nash
35.7816110
-78.2441670
11.48
GeB - Georgeville
34
BC -03
Creech, J .Brent; Creech, Allison H.
Nash
35.784075°
-78.2407610
5.44
GeC - Georgeville
34, 35
BC -04
Creech, J Brent; Creech, Allison H.
Nash
35.7873780
-78.2401500
6.95
GeB - Georgeville
35
HM -01
Sutton, Don; Sutton, Willa Rae B.
Howard Moore
Nash
36.0997780
-77.9255830
27.13
NaC - Nankin
48
HM -02
Sutton, Don; Sutton, Willa Rae B.
Howard Moore
Nash
36.1016030
-77.922094°
28,38
GeC - Georgeville
48
JC -01
Sykes, Wilton G.; Sykes, Ida
Carpenter, Jack
Nash
35.9965190
-78.0855420
10.62
WeB - Wedowee
36
JC -02
Sykes, Wilton G.; Sykes, Ida
Carpenter, Jack
Nash
35.994275°
-78.0876220
4.88
WeB - Wedowee
36
JC -03
Sykes, Wilton G.; Sykes, Ida
Carpenter, Jack
Nash
35.9966750
-78.0834030
11.31
WeB - Wedowee
36,37
JC -04
Sykes, Wilton G.; Sykes, Ida
Carpenter, Jack
Nash
35.9985971
-78.0848920
3.05
WeB - Wedowee
36
JC -05
Sykes, Barbara W.
Carpenter, Jack
Nash
36.0002940
-78.080772°
3.31
WoA - Worsham
36,37
JC -06
Lewis, Lisa Sykes
Carpenter, Jack
Nash
35.9988610
-78.0756690
15.32
WeB - Wedowee
37,55
JC -07
Lewis, Lisa Sykes
Carpenter, Jack
Nash
35.9990000
-78.0774060
6.11
WeB - Wedowee
37,55
JC -08
Sykes, Barbara W.
Carpenter, Jack
Nash
35.9960690
-78.0784640
4.44
WeB - Wedowee
37
WQ0000838 Version 3.2 Attachment B Page 5 of 8
ATTACHMENT B - Approved Land Application Sites
Granville Farms, Inc.
Certification Date: April 20, 2018
Permit Number: WQ0000838 Version: 3.2
LF -A
Fisher, Linda
Nash
36.1315030
-77.9566830
8.50
GeB - Georgeville
49
LF -B
Fisher, Linda
Nash
36.128897°
-77.9547690
11.05
GeB -- Georgeville
49
LF -C
Fisher, Linda
Nash
36.1271390
-77.9530670
10.12
WkA - Wickham
49
LF -D
Fisher, Linda
Nash
36.0246810
-77.8994670
9.78
BoB - Bonneau
50
LS -01
Sykes Farms of Nash County LLC; Sykes, Lervem
Nash
36.0130440
-78.1011670
4.51
WeB - Wedowee
38
L5-02
Sykes Farms of Nash County LLC; Sykes, Lervem
Nash
36.011439°
-78.1004310
5.89
WeB - Wedowee
38
LS -03
Sykes Farms of Nash County LLC; Sykes, Lervem
Nash
36.0102810
-78.099406°
22.45
WeB - Wedowee
38,39
LS -04
Sykes Farms of Nash County LLC; Sykes, Lervern
Nash
36.0081000
-78.103008°
12.79
WeB - Wedowee
38
L5-05
Sykes Farms of Nash County LLC; Sykes, Lervem
Nash
36.013033°
-78.1052890
13.27
WeB - Wedowee
38
LS -06
Sykes Farms of Nash County LLC; Sykes, Lervem
Nash
36.012269°
-78.095836°
4.96
WoA - Worsham
38
LS -07
Sykes Farms of Nash County LLC; Sykes, Lervem
Nash
36.0104220
-78.097042°
8.19
WeC - Wedowee
38,39
L5-08
Sykes Farms of Nash County LLC, Sykes, Lervem
Nash
36.006331°
-78.0961390
10.73
WeB - Wedowee
39
LS -09
Sykes Farms of Nash County LLC; Sykes, Lervem
Nash
36.0031360
-78.0961170
11.80
WeB - Wedowee
39
LS -11
Sykes Farms of Nash County LLC; Sykes, Lervem
Nash
36.0100030
-78.0642670
7.84
WeB - Wedowee
40
L5-12
Sykes Farms of Nash County LLC; Sykes, Patsy B.
Sykes, Lervem
Nash
35.9575830
-78.0885970
5.11
NoB - Norfolk
41
LS -13
Sykes Farms of Nash County LLC; Sykes, Ida; Sykes, Lervem;
Sykes, Wilton G.
Nash
35.9976100
-78.0833330
8.99
WeB - Wedowee
42
LS -14
Sykes Farms of Nash County LLC; Sykes, Lervern
Nash
36.0013000
-78.0822110
0.80
WeB - Wedowee
42
LS -15
Sykes, Ida; Sykes, Wilton G.
Nash
35.9988500
-78.0855190
1.67
WeB - Wedowee
42
LS -16
Sykes Farms of Nash County LLC; Sykes, Lervern
Nash
36.0006330
-78.0890110
8.76
WeB - Wedowee
42
Total for Nash County
561.73
CM -01
Moss, Dorothy E.
Moss, Clifton
Vance
36.214003°
-78.463300°
17.99
CeB2 - Cecil
43
CM -02
Moss, Dorothy E.
Moss, Clifton
Vance
36.209394°
-78.463817°
2.39
CeD2 - Cecil
43
CM -03
Moss, Dorothy E.
Moss, Clifton
Vance
36.213661°
-78.457319°
5.33
WkE - Wilkes
43
CM -04
Moss, Dorothy E.
Moss, Clifton
Vance
36.211675"
-78.463119°
5.91
WkC - Wilkes
43
WQ0000838 Version 3.2 Attachment B Page 6 of 8
ATTACHMENT B - Approved Land Application Sites
Granville Farms, Inc.
Certification Date: April 20, 2018
Permit Number: WQ0000838 Version: 3.2
CM -05
Moss, Dorothy E.
Moss, Clifton
Vance
36.210939°
-78.460706°
3.27
WkC - Wilkes
43
CM -06
Moss, Dorothy E.
Moss, Clifton
Vance
36.209267°
-78.460281°
4.55
WkC - Wilkes
43
CM -07
Moss, Dorothy E.
Moss, Clifton
Vance
36.209811°
-78.462581°
2.51
WkE - Wilkes
43
CM -08
Moss, Dorothy E.
Moss, Clifton
Vance
36.208850°
-78.466203°
3.63
CeB2 - Cecil
43
CM -09
Moss, Dorothy E.
Moss, Clifton
Vance
36.204656°
-78.429908°
21.57
WeD - Wedowee
44
CM -10
Moss, Dorothy E.
Moss, Clifton
Vance
36.204267°
-78.427917°
4.83
ApB - Appling
44
CM -11
Moss, Dorothy E.
Moss, Clifton
Vance
36.203322°
-78.426986°
5.04
WeD - Wedowee
44,45
CM -12
Moss, Dorothy E.
Moss, Clifton
Vance
36.205089°
-78.423472°
5.32
WeD - Wedowee
45
CM -13
Moss, Dorothy E.
Moss, Clifton
Vance
36.203375°
-78.424622°
7.72
ApB - Appling
44,45
CM -14
Moss, Dorothy E.
Moss, Clifton
Vance
36.201767°
-78.421394°
18.84
ApB - Appling
45
MJ -01
Triple S Farms & Services, LLC
Mickey Jackson
Vance
36.470851°
-78.429453°
10.19
CeB2 - Cecil
51
MJ -02
Triple S Farms & Services, LLC
Mickey Jackson
Vance
36.471636°
-78.431769°
4.59
CeB2 - Cecil
51
MJ -03
Triple S Farms & Services, LLC
Mickey Jackson
Vance
36.467744°
-78.432181'
20.42
CeB2 - Cecil
51
M]-04
Triple S Farms & Services, LLC
Mickey Jackson
Vance
36.468969°
-78.435803°
26.04
CeB2 - Cecil
51
MJ -05
David M. Coghill
Mickey Jackson
Vance
36.471542°
-78.437844°
5.69
CeB2 - Cecil
52
MJ -06
David M. Coghill
Mickey Jackson
Vance
36.470997°
-78.440392°
10.21
CeB2 - Cecil
52
MJ -07
David M. Coghill
Mickey Jackson
Vance
36.468025°
-78.442844°
6.79
CeB2 - Cecil
52,54
MJ -08
David M. Coghill
Mickey Jackson
Vance
36.471403°
-78.446881°
17.98
ApB - Appling
53
MJ -09
David M. Coghill
Mickey Jackson
Vance
36.475531°
-78.445703°
20.88
CeB2 - Cecil
53
Total for Vance County
231.69
BC -05
Creech, Bill
Creech, J. Brent
Wake
35.7856640
-78.3133530
11.43
WmB - Wedowee
28
MP -07
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Wake
35932386°
-78.3656610
1.17
DuB2-Durham
7
MP -08
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Wake
35.931703°
-78.366908°
6.88
AsB2 - Appling
7
MP -09
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Wake
35.930439°
-78.366003°
6.04
DuB2 - Durham
7
WQ0000838 Version 3.2 Attachment B Page 7 of 8
ATTACHMENT B - Approved Land Application Sites
Granville Farms, Inc.
Certification Date: April 20, 2018
Permit Number: WQO00O838 Version: 3.2
MP -10
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Wake
35.9312750
-78.3691280
2.57
As132 - Appling
7
MP -1 I
Howard Vance Phillips Life Estate; Phillips, Howard Vance
Phillips, Charles Marshall
Wake
35.931708°
-78.370256°
2.80
AsB2 - Appling
7
Total for Wake County
30.89
1677-01
Limer, Craig Rodgers
Warren
36.3506000
-78.1803000
11.38
31B - Cecil
46
1677-02
Limer, Craig Rodgers
Warren
36.350600°
-78.170000°
54.64
31B - Cecil
46
RE -01
Buffaloe Creek Farms L L C; Earnhardt, Karen W.; Earnhardt,
Warren
36.315681°
-78.048628°
10.70
70B - Wedowee
47
Robert
Buffaloe Creek Farms L L C; Earnhardt, Karen W.; Earnhardt,
RE 02
Warren
36.317136°
-78.055314°
23.02
70B - Wedowee
47
Robert
Buffaloe Creek Farms L L C; Earnhardt, Karen W.; Earnhardt,
RE -03
Warren
36.320094°
-78.055492°
20.26
35B2 - Pacolet
47
Robert
Buffaloe Creek Farms L L C; Earnhardt, Karen W.; Earnhardt,
RE -04
Warren
36.321803°
-78.056653°
3.07
3 I - Cecil
47
Robert
RE -05
Buffaloe Creek Farms L L C; Earnhardt, Karen W.; Earnhardt,
Warren
36.322308°
-78.058072°
3.71
31B - Cecil
47
Robert
Totalfor Warren County
126.78
Total
2,199.91
1 to 47. See Figure Ito 47, respectively (10/11/2016 permit)
48 to 53. See Figure 48 to 53, respectively.
54. A reduced setback from a residence under separate ownership has been approved for this land application site. Residuals may be land applied within 100 feet of the residence owned by
David M. Coghill (10505 NC Highway 39 North, Henderson, NC 27565), regardless of whether a surface or a subsurface application method is used.
55. As of 6/21/2016 the deeded owner of this field is Lisa Sykes Lewis of 3119 Bass Road, Nashville, NC 27856. To apply residuals on this field, a new Land Owner's Agreement (LOA)
must be in place with two copies sent to the Non -Discharge Permitting Unit, 1617 Mail Service Center, Raleigh, NC 27699-1617.
WQ0000838 Version 3.2 Attachment B Page 8 of 8
N
I
Z
Legend
[!2Appiication Boundary
® Buffer
► Ditch
[:]Field Boundary
House
Pond
❑ Property Boundary
i► Stream
i well
I"icld 2
Heid 1
W.
MAU' -1
rUross„Ac:
The Compliance Boundary shall be
located 50 feet within the property line
or 250 feet from the edge of the
disposal area, whichever is closet to the
source. The Review Boundary shall be
located halfway in between the property
line and the Compliance Boundary.
field 2
31.8 Gros Ac.
-18.38 Net _14.
&A
M.
400 200 0 400
Feet
Scale: 1 inch = 400 feetr TT HM FIELDS 1-2 BUFFER MAP Fre
Drawn b,,: DM SOIL IL PL I ' GFI Land Application Permit (WQ0000838)
Reviewed by: CSC <;al�”" I lilliardston, North Carolina 48
Date: October'17 Soil Plus Project # 200705.D10
4�
I
S
11 .51Aw
83.
`lt.=,�.
i
11.74 Gro 'sq Ac.
11.23 Net Ac:
IRA,,Gsc s`s,Ac.
1-3-0.7" N'et, Ac..
lA$end
[Application Boundary
Buffer
Ow- Ditch
❑Field Boundary
The Compliance Boundary shall be
House
located 50 feet within the property line
Pond
or 250 feet from the edge of the
s:
[:]Property Boundary
disposal area, whichever is closer to the
source. The Review Boundary shall be
Ob- Stream
located halfway in between the property
4.00 200 0
400
0 well
cine and the Compliance Boundary.
Feet
Scale: 1 inch = 400 feet
yT� PL
� 1L PL U s
LF FIELDS A -C BUFFER MAP
Figure
Drawn
GFI Land Application Permit
by: DM
(WQ0000838)
49
Reviewed by. CSC
Aventon, North Carolina
Date: November '17
Soil Plus Project # 200705.1310
E
e�)'.78
D
Ne r Ac.
r �f
amend $€
MApplication Boundary
® Buffer
► Ditch
❑ Field Boundary The Compliance Boundary shall be
House located 50 feet within the property line
[� Pond or 250 feet from the edge of the
❑ Property Boundary disposal area, whichever is closer to the
source, The Review Boundary shall be
F Stream located halfway in between the property
t Well line and the Compliance Boundary.
400 200 0 400 I
Feet
Scale: 1 inch = 400 feet LF FIELD D BUFFER MAP Figure
Drawn by: DM _ SOIL PLUs GFI Land Application Permit (WQ0000838)
Reviewed by: CSC Red Oak, North Catolina 50
_.
Date: November'17 Soil Plus Project # 200705.D10
H
W E
6
F�J
Field 5
10.3,Gross Ac.
5:69 Net Ac.
Ik
Field 4
30J,7- Gross. Ac,
26:04 Net Ac -
•
A
Field 2
10-2 .1c.
4.51 Net .1c,
Field 3'
21:.6- Gross ,:�c:
20.4a NaAj�-_
4
0
Field 1.
1 �7 Gross,
10.19,Net t
fl
4
1-9-a
Application Boundary
® Buffer
0- Ditch
❑ Field Boundary
The Cornpliance Boundary shall be
House
located 50 feet within the property line
Pond
or 250 feet from the edge of the
❑ Property Boundary
disposal area, whichever is closer to the
source. The Review Boundary shall be
i►o Stream
located halfway in between the property
400 200 0
400
Well
line and the Compliance Boundary.
Feet
Scale: 1 inch = 400 feet
�Y
SOIL R � PL�_
MJ FIELDS 1-4 BUFFER M"
Figure
Drawn by: DM
.�%
GFI Land Application Permit (WQ0000838)
Reviewed b : CSC
Henderson, North Carolina
51
Date: October'17
Soil Plus Project # 200705.D10
S
49
field 7
6.96 Gross - c-�
6.79 1�'e[ Kc'.
Lxgcnd
Application Boundary
® Buffer
► Ditch
Field Boundary
House
Pond
❑ Property Boundary
W° stream
0 Well
k
A
r
The Compliance Boundary shall be
located 50 feet within the property line
or 250 feet from the edge of the
disposal area, whichever is closet to the
source. The Review Boundary shall be
located halfwa in be th
W
10
m
X1,'"r -.,
Y
101-3 Gxms.,Ac.
5:G9 Ncet,A
• t 1. �� A % % �y/ff r
O,
M1
M
h
0
p [ween a pxoperty 4.00 200 0 400
line and the Compliance Boundary. Feet
tale: 1 inch = 400 feet g� g� MJ FIELDS 5.7 BUFFER MAP Figure
Drawn by: DM - A 1 � JL L �" s� GFI Land Application Permit (WQ0000838)
Reviewed by: CSC 4901 = Henderson, North Carolina 52
Date: October'17 Soil Plus Proiect # 200705.D10
LWmd
[!2Appiication Boundary
® Buffer
1` Ditch
❑Field Boundary
House
Pond
❑ Property Boundary
0- Stream
4. Well
Scale: 1 inch = 400 feet
Drawn by: DM
Reviewed by: CSC
Date: October '17
!fid 1.1eld 9
c3 27.:27'�ro�s:llc.
�0:88�N'etxAc.
Field 8.
20:18 Gross,.Ac.
17.98, Ne
_t Ac.
Field 8
400 200 0 400
Feet
1•icld 6
1.0-9 Gross Ac.
10.21 Net Ac.
The Compliance Boundary shall be
located 50 feet within the property line
or 250 feet from the edge of the
disposal area, whichever is closer to the
source. The Review Boundary shall be
located halfway in between the property
line and the Compliance Boundary.
MJ FIELDS 8-9 BUFFER MAP Figure
PL I- IS GFI Land Application Permit (WQ0000838)
Henderson, North Carolina 53
Soil Plus Project # 200705.D10
,'�'a .0'"
State of North Carolina
Department of Environment and Natural Resources
Division of Water Quality
SETBACK WAIVER AGREEMENT ATTACHMENT
For Land Application of Residual Solids (FORM: SWAA 10-06)
(THIS FORM MAY BE PHOTOCOPIED FOR USE AS AN ORIGINAL)
The Division of Water Quality (Division) will not accept this attachment unless all the instructions are
followed. Failure to submit all required items will lead to additional processing and review time.
For more information, visit our web siteat.hui//h2p,enr,statc.nc,vs/raulmairzhtml
INSTRUCTIONS TO THE APPLICANT:
A. Attachment Form:
✓ Do not submit this attachment form for review without its corresponding residuals program
application form (FORINT: NDRLAP 10-06).
✓ Any changes to this attachment form Will restilt in the application package being returned.
B. Prepare a separate attachment form for each property from which a waiver from 15A NCAC 2T
.1108(b)(2)(for habitable residences or place of public assembly) is being sought.
✓ Any other setbacks required by 15A NCAC 2T .1108; other than those referenced above, cannot be waived
through execution of this attachment form.
✓ A copy of the completed and appropriately executed attachment form must be provided to the property owner.
AGREEMENT TO WAIVE THE SETBACK REQUIRED BY 15A NCAC 2T .1106(b)(2)(habitable residences)
The undersigned property owner hereby permits:
Applicant's name: Granville Farms. Inc
Complete mailing address of applicant: P.O. Sox 1396
City.- Oxford State: North Carolina Zip: 27565
Telephone number: 919 690-8000 Facsimile number: 914) 690-1157
E-mail address:
hereinafter referred to as the Permittee, to land apply residuals within 100 feet (i.e., cannot be less than 100
feet) of the residence or place of public assembly located at the following:
Location address of property: 10505 NC Highway 39 North
City: Henderson State: NorthCarolins Zip: 27537
This Agreement. shall remain in effect for the length of the Division of Water Quality's (Division) permit for
the residuals land application program and shall be renewed each time this permit is renewed. In addition,
this Agreement shall only remain in effect for as long as the undersigned property owner owns the property
described herein.
The undersigned property owner agrees to abide by this Agreement until such time as written notification,
given 30 calendar days in advance, modifies or cancels this Agreement.
® I certify that I an a deeded property owner of above -referenced property and am authorized to make decisions
regarding this property on behalf of other deeded property owners. Furthermore, I certify that I have read and
understand this Agreement and do hereby grant permission to the Permittee to land apply residuals to land
application site(s) as specified herein.
Property owner name: David M. Coahflt
-
Signature:���: Date: - -d Li t"1
FORM: SWAA 10-06 Page 1 of I Attachment Order 3-d