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Home My WebLink AboutWQ0031725_Annual Report_20190304ANNUAL LAND APPLICATION CERTIFICATION FORM WQ Permit#: WQ0031725 County: McDowell Year: 2018 Facility Name (as shown on permit): Baxter, Healthcare Corporation Land.Application Operator: Southern Soil Builders, Inc. Phone: _ 336-957-7871 Land application of residuals as allowed by the permit occurred during the past calendar year? F Yes 0 No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were generated but not land applied, please attach an explanation on how the residuals were handled. rart A - Residuals Application Summarv: Total number of application fields in the cri-nit: 10 Total number of fields utilized for land application during the year: 10 Total amount of dry tons applied during the year for all application sites: 167.51 Total number of acres utilizes for land application during the year 69.6 Part B Annual rmmn,annn Facility was compliant during calendar year 2018 with all conditions of the land application permit (including but not limited to items 1-13 below) issued by the Division of Water Resources. RYJ Yes l No If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action taken. 1) Only residuals approved for this permit were applied to the permitted sites. 2) Soil pH was adjusted as specified in the permit and lirne was applied (if needed) to achieve a soil pH of at least 6.0 or the limit specified in the permit. 3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies of laboratory results are attached. 4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached. 5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3) copies of certified laboratory results are attached. 6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1 105(a) or the Pollutant Loading Rates in 15A NCAC 02T. I 105(b) (applicable to 40 CFR Part 503 regulated facilities). 7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part 503 regulated facilities). 8) All monitoring and reporting requirements in 15A NCAC 02T .1 1 1 1 were complied with (applicable to 40 CFR Part 503 regulated facilities). 9) All operations and maintenance requireients in the permit were complied with or, in the case ofa deviation, prior authorization was received fi•orri the Division of Water Resources. 10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are attached to include appropriate actions and remediations. 1 1) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as specifies] in the permit. 12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred. 13) All buffer requirements as specified on the permit were maintained during each application of residuals. Part C - Certification: "I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting f , e information, including the possibility of fines and imprisonment for knowing violations.,, Permittee Name and Title (type or print) — 2�7 ' S nature of Permittee Date Signat e of Prepares* Date Signature of Land pplier Date (if different from Permittee) (if different from Permittee and Preparer) * Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T. 1102 (26) DFNR FnI:RM AC`.F I1qi?nnFi ANNUAL RESIDUAL SAMPLING SUMMARY FORM Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - B WQ Permit Number: WQ0031725 Facility Name: Baxter Healthcare Corporation Residual Source WQ # or WQ0031725 NPDES #: WWTP Name: Baxter Healthcare Corporation Residual Analvsic Data Laboratory: 1) Waypoint 2) 3) 4) 5) Parameter- (mg/kg) Conc. Limit (m /ka)a Sample or Composite Date 1-4-2018 Percent Solids (%) NA 13.56 Arsenic 75 4.96 Cadmium 85 2 Copper 4,300 99 Chromium NA 81.2 Lead Mercury 840 57 7.83 0.4 Molybdenum 75 5.43 Nickel 420 24 Selenium 100 5 Zinc 7,500 81.5 Total Phosphorus NA 13300 TKN NA 82500 Ammonia -Nitrogen NA 7300 Nitrate and Nitrite r- NA 23.5 Ll aul la" UIaIJVaaI laujinjub uiv GClttng concentranon rtmns ustea to this torm are not applicable. Reference the individual permit for metals limits. "I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." Signature6f PrWrer * *Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26) Date ANNUAL RESIDUAL SAMPLING SUMMARY FORM - B Report all sampling analysis results for parameters not listed in FORM RSSF that are part of the WQ permit or were analyzed for over the past calendar year. Use additional forms as needed. WQ Permit Number: WQ0031725 Facility Name: Residual Source NPDES # or WQ#: Baxter Healthcare Corporation WQ0031725 WWTP Name: Baxter Healthcare Corporation Residual Analvsis Data Laboratory: 1) Waypoint 2) 3) 4) 5) Parameter Sample or Composite Date Potassium Magnesium ---------- Aluminum "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 knowinLr violations." Date *Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26) DENR FORM RSSF - B (12/2006) ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): Permit #: WQ0031725 Cation Exchange Capacity (non 503 only): Operator: y)' P Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: Acres Used: 5.5 Acres Permitted: 5.5 Site #: DP Field #: Residual Analysis Data Sample or Com- posite Date 1 ; 1/4/18 z % Solids 13.56 Arsenic 4.96 Cadmium 2 Copper 99 Chromium 81.2 Lead 7.83 Mercury 0.4 Molyb- denum 5.43 Nickel 24 Selenium 5 Zinc 81.5 Total Phos- 13300 vy Metals and Total Phosphorus use m % Solids use Raw Percent 12.09 FcC2 IA 0 Annual Total DT/Ac./ App. Event Heavy Metal Field 2 2.20 Loadings 3 (Calculated 4 j 5 in lbs/acre): . 6 7 g 9 F 10 1 11 I lu, o W. Arsenic 0.022 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.022 Cadmium 0.009 0.000 0.000 0.000 0.000 0, 000 0.000 0.000 0.000 0,000 0.000 0.000 0.009 Copper 0.435 0.000 0.000 0,000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0. 000 0.000 0.000 0.000 0.435 �hromium 0.357 0.000 0.000 0.000 .0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.357 Lead 0.034 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.034 Mercury Molyb- 0.002 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0 000 0 002 denum 0.024 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.024 Nickel Selenium 0.106 0.022 0.0 00 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.006 0.0 00 0.1 66 Zinc 0.358 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0_.000 0.000 0.000 0.000 0.022 Total 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.358 Plios- horus 58.493 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 58.493 "I certify, under penalty of law, that this document was prepared under my direction with a system designed to assure that or supervision in accordance qualified personnel properly gathered and evaluated the I am aware that there are significant information submitted. penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations". Sign VureoFLand Applier Date -� DENR FORM MR RF (igr)nna� ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 3.53 Permit #: WQ0031725 Cation Exchange Capacity (non 503 only): Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2 Acres Used: 1.6 Acres Permitted: 1.6 Site #: DP Field #: 1B Residual Analvsis Data (Heavy 1VMetale anA Tn+nl IDU hn.,,, .. Sample or Com- posite Date 1/4/18 2 3 4 -____ 5� -___ r 6 7j F", i8 , iv Uv,iva 9� uxx�ary 10a re[lCI1L3�): 11; 12 % Solids 13.56 Arsenic 4.96 Cadmium 2 Copper 99 Chromium 81.2 Lead 7.83 Mercury 0.4 Molyb- denum 5.43 Nickel 24 Selenium 5 Zinc 81.5 Total Phos- horUS Anneal 13300 Neay., N4a*,al Ti.ola T ,,.,a:.. 17_1_7_1-_ Total 111 luJ/auut;): 2 3 R DT/Ac./ -lj 5 6 7 8J 9 10 11 j 12 __3 App. a� Event 2.21 Arsenic 0.022 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.022 Cadmium 0.009 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.009 Copper 0.437 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.437 Chromium 0.359 0.000 0.000 0.000 0.000 0..000 0.000 0.000 0.000 0.000 0.000 0.000 0.359 Lead 0.035 0.000 0.000. 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.035 Mercury 0.002 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.002. denumMolyb denum 0.024 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.024 Nickel 0.106 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.106 Selenium 0.022 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.022, Zinc 0.360 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.360 Total Phos- horus 58.733 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.0 00 0.000 0.000 0.000 58.733 "I certify, under penalty of law, that this document was prepared under my direction with a system designed to assure that qualified personnel properly gathered and evaluated or supervision the in accordance information submitted. 1 am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations". /� �`15`�o1h Signature of Lai 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: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 6.65 Permit #: WQ0031725 Cation Exchange Capacity (non 503 only): Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2 Acres Used: 3 Acres Permitted: 3 Site #: DP Field #: IC Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #): Sample or 1 2 3 4 5 6 7 8 9 10 1 12 Com- posite Date 1 /4/ 18 % Solids 13.56 Arsenic 4.96 Cadmium 2 Copper 99 Chromium 81.2 Lead 7.83 Mercury 0.4 Molyb- denum 5.43 Nickel 24 Selenium 5 Zinc 81.5 Total Phos- 13300 horus Annual Heavy Metal Field Loadings (Calculated in lbs/acre): Total ? 2 3� 4 j 5 1 6 7 8 9 10 11 12 App, o i Event 2.22 in Arsenic 0.022 -0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.022 Cadmium 0.009 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.0 00 0.000 0.000 0. 000 0.009 Copper 0.439 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.439 Chromium 0.360 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.360 Lead 0.035 0.000 0.000 0.00.0 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.360 Mercury 0.002 0.000 0.000 0.000 0.0.00 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.002 035. Molyb- denum 0.024 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.024 Nickel 0.106 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.106 Selenium 0.022 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.022 Zinc 0.361 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.361 Total Phos- 58.946 0.000 horus 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 58.946 "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 pplier - D--Date -- DFNR FnRnn nnFi RP iioionnn� ANNUAL, METAI_,S FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field I_,oading Summary Form to be submitted in Annual Report Facility Name:, Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 19.98 Permit #: WQ0031725 Cation ExchangeCapacity (non 503 only): Operator: Douglas PopCacit p Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2 Acres Used: 9.6 Acres Permitted: 9.6 Site #: DP Field #: ID Residual Analysis Data Sample or LIJ 2 Com- posite Date 1/4/18 %Solids 13.56 Arsenic 4.96 Cadmium 2 Copper 99 Chromium 81.2 Lead 7.83 Mercury 0.4 Molyb- denum 5.43 Nickel 24 Selenium 5 Zinc 81.5 Total Phos- 13300 Annual Heavy Total DT/Ac./ App. Event 2.08 Arsenict 0.021 Cadmium 0 008 Lead Mercui Molvb 0.412 0.338 0.033 0.002 Metals and Total Phosphorus use Metal Field Loadings (Calculated in lbs/acre): 21 7377 1 a a 1 111 1 111 1 111 1 111 1 !11 1��1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 ! 111 1 111 1 1!1 1 111 1 111 ! 111 1 111 1 111 1 111 1 111 1 111 1 !11 1 111 1 111 1 111 1 111 1 111 1 111 ! 1 1 111 ! 111 1 111 1 111 1 111 WIN Nickel Selenium Zinc Total 0.100 7021 0.339 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.0.00 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Phos- horns 55.355 0.000 0.000 0.000 0.00.0 0.000 0.000 "1 certify, under penalty of law, that this document was re a d % Solids use Raw Percent #): • `�i1 I 1111 1 111 1 111 1 111 1 111 1 1 I 111! 1 111 1 111 1 111 1 111 1 11: ' 1 111 1 111 1 111 1 111 1 111 1� I 1111 1 111 1 111 ! 111 1 111 1 : I 1111 1 111 1 111 1 111 1 111 1 1 I 1111 1 111 1 111 0.000 1 111 1 11 1 111 1 111 1 111 0.000 1 111 1 1 1 111 1 111 1 111 1 111 1 111 1 11 1 111 1 111 1 111 1 111 1 111 1 1 1 111 1 011 1 111 1 111 1 111 1 • 1 111 1 111 1 111 1 111 1 111 p p re un , n or superv>ts�on m accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. 1 am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations". Signs 0 of Lan Applies -- 1-Date 5 nFNR MPRA NAPI cP f iomnnax ANNUAL. METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 18.79 Permit #: WQ0031725 Cation Exchange Capacity (non 503 only): Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcB2 Acres Used: 5.877 Acres Permitted: 5.877 Site #: DP Field #: 3-Corn Residual Analysis Data Sample or? 2 Com- posite Date 1/4/18 % Solids 13.56 Arsenic 4.96 Cadmium 2 Copper 99 Chromium 81.2 Lead 7.83 Mercury 0.4 Molyb- 5.43 Nickel 24 Selenium 5 Zinc 81.5 Total Phos- 13300 Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #): Annual Heavy Metal Field Loadings (Calculated in lb. Total L2 3 5 1 6 DT/Ac./ App. Event 3.20 Arsenic 0.032 0.000 0.000 0.000 0.000 0.000 Cadmium (T013 0.000 0.000 0.000 0.000 0.000 Copper 0.633 0.000 0.000 0.000 0.000 0.000 Chromium 0.519 0.000 0.000 0.000 0.000 0.000 Lead 0. 550 0.000 0.00.0 6.000 0.000 0.000 Mercury 0.003 0.000 0.000 0.000 0.000 0.000 Molyb- denUlll 0.035 0.000 0.000 0.000 0.000 0.000 Nickel 0.153 0.000 0.000 0.000 0.000 0.000 Selenium 0.032 0.000 0.000 0.000 0.000 0.000 Zinc 0.521 0.0 00 0.000 0.000 0.000 0.000 Total Phos- 85.040 0.000 0.000 0.000 0.000 0.000 phorus acre): 1 111 0 111 1 111 1 111 0.000 1 111 1 111 1 111 1 111 1 111 0.000 1 111 l i 1 111 1 111 1 111 1 111 1 111 1 111 1. 1 111 1 111 1 111 1 111 0.000 1 111 1 1 111 1 111 1 111 1 111 0.000 1 111 1 1 1 1 111 1 111 1 111 1 111 0.000 1 111 1 11 1 111 1 111 1 111 1 111 1 111 1 111 1 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 0.000--, 0.000 11 1 111 111 1 1 1 111 1 111 1 111 1 111 1 ill 1 111 1 1 101 1 111 1 111 1 111 0 111 1 111 1 1, "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 pAi plier Date DENR FORM MFI RF (19i,)nnm ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: Permit #: Operator: Acres Used: Baxter Healthcare Corporation Total .Dry Tons Applied (Annual): WQ0031725 Cation Exchange Capacity (non 503 only): Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: 6.983 Acres Permitted: 6.983 Site It. DP Field #: Residual Analvsis Data (Heavy Metals nnrl'r.f.i ,..-n- o. _r 25.00 FcB2 3-Grass Sample or COIII- posite Date 1, 1/4/18 2 3 4 5 6 _ 7 -f -S, 8 tV 9 10 1\Z2VV 1 WZI 1 1 i vulit tf); 12 % Solids 13.56 - Arsenic 4.96 Cadmium 2 Copper 99 Chromium 81.2 Lead 7.83 Mercury 0.4 Molyb- denum 5.43 Nickel 24 - Selenium 5 - zinc 8 1 .5 Total Phos- horus Annual 13300 Neavv MPtal F;nIA r Total DT/Ac./ App. Event 3.58 --- ---- - -_..- 172 •..••»•.•.n.5v 3 ��.wa,.uaaavu 4 111 lU5/ilGi-C�: L6J 7 8 9 10 11� 12 W. Arsenic 0.036 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.036 0.014 0.709 Cadmium 0.014 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Copper 0.709 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 �Ilromium 0.581 0.000 0.000 0.0 00 0.000 0.000 0.000 , 0.000 6.0 00 0.000 0.000 0.000 0.000 0.000 0.000 0.581 0.056 Lead 0.056 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Mercury Molyb- 0.003 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 6.0 00 0.000 0.003 denum 0.039 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.039 Nickel 0.172 0.000 0.000 0.000 0.000 0:000 0.000 0.000 0.000 0.000 0.000 0. 000 0.172 Selenium 0.036 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.036 Zillc O.S84 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 O.000 0.000 0.584 Total Phos- horus 95.228 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 95.228 ".I certify, under penalty of law, that this document was prepared under my direction or supervision with a system designed to assure that in accordance qualified personnel properly gathered and evaluated the I am aware that there are significant for information submitted. penalties submitting false information, including the possibility of fines and imprisonment for knowing violations". Signature of Land Applies Date DENR FORIVI 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: Permit #: Operator: Acres Used: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): WQ0031725 Cation Exchange Capacity (non 503 only): Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: 8.7 Acres Permitted: 8.7 Site #: DP Field #: Residual Analysis Data (Heavy Metals and Tnral 1Phnenhn-...ten o. a-1LJ_ -__- T, ,-, 24.09 FcB2 4 Sample or Com- posite Date 1-, 1 /4/ 1 g 2 • 3 4 -_ __ .. ____ 5 _ „__.,l___.._ 6 ..,, „,,., 7 ..mob, •w�! 8 V "VLlUa 9 UaG 10 JLNIav1' i GA-CCIIL 11� tt): 12 % Solids 13.56 - Arsenic 4.96 - Cadmium 2 Copper 99 - Chromium 81.2 Lead 7.83 - Mercury 0.4 Molyb- denum 5.43 Nickel 24 - Selenium 5 - Zinc 81.5 Total Phos- horns Anneal 1=Tnavnr 13300 Mo+.l F;-la r Total DT/Ac./ App. Event 2.77 F2 3J 4 V 5 6 7, 8 9J 10 11 ! 12 s Arsenic 0.027 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.027 0.011 0.548 Cadmium 0.011 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Copper Chromium 0.548 0.450 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0. 000 0.450 0.043 Lead 0.043 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Mercury Molyb- denum 0.002 0.030 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.002 0.000 0.000 0.000 _ 0.030 Nickel 0.133 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.133 0.028 0.451 Selenium 0.028 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Zinc Total Phos- horns "I certify, 0.451 73.655 under 0.000- 0.000 penalty of 0.000 0.000 law. that 0.000 0.000 th;a 0.000 0.000 0.000 0.000 0.000 0.000 ___ 0.000 0.000 _.-_ _ 0.000 0.00 0 0.000 0.000 0.000 73.655 ---- I--1------- ••.r •...-L U V� a�purvlslon 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 HY-acl �- Date DENR FORM MR RF (1,)i?nnrN ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): Permit #: WQ0031725 Cation Exchange Capacity (non 503 only): Operator: Douglas Poplin g p Owner: Douglas Poplin Predominant Soil Series: Acres Used: 15.9 Acres Permitted: 15.9 Site #: DP Field #: Residual Analysis Data Sample or_' 1 2 Com- posite Date 1 /4/ 18 % Solids 13.56 Arsenic 4.96 Cadmium 2 Copper 99 ;hromium 81.2 Lead 7.83 Mercury 0.4 Molyb- '- 5.43 Nickel Selenium Zinc Total Phos- Annual TotT DT/Ac./ App. Event i rseruc Cadmium Copper hroIII 1UIT Lead Mercury Molvb- 24 5 81.5 13300 2.21 eavy Metals and Total Phosphorus use Metal Field Loadi (Calculated in lbs/acre): 51 61 IMMIRM1 111 1 111 1 11• 1 111 1 111 1 111 1' 1 111 I 1 111 1 111 1 111 , 1 .1 1 111 1 111 1 111 1 111 1 1 1 111 1 111 1 111 1 111 ! 1 11 1 11 e 1 111 1 111 1 111 1 1 � 1 111 1 111 1 111 1 111 Nickel 0.106 0.000 0.000 0.000 0.%o 0 Selenium 0.022 0.000 0.000 0.000 0.000 0 Zinc 0.361 0.000 0.000 0.000 0.000 0 Total Phos- 58.892 0.000 0.000 0.000 0.000 0 I1oruS "I certify, under penalty of law, that this document wa 35.20 FCC2 S % Solids use Raw Percent #): 111 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 0.0010 0.000 1 111 1 111 1 1 1 11• 111 0 111 1 111 1 111 1 111 1 111 1 111 1; 111 111 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 0.000 0.000 1 111 1 111 1 111 1 .1 1 1 1 11 111 1 111 1 111 1 111 1 111 0.000 1 111 0.024 111 111 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 11 1 111 1 111 1 111 1 1. 0.022 1• ; ;• 111 1 111 1 111 1 111 1 111 1 111 1 111 - -r-- Illy "If-CULIU11 on in accordance with a system designed to assure that qualified personnel properly gathered and evaluated ther information submitted. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations". - :%� "Y Signature of Land Applier Date nFNR F(1RRA RAM QC �47�7nnr_� ANNUAL METALS FIELD LOADING SUMMARY .FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: Baxter.Healthcare Corporation Total Dry Tons Applied (Annual): 12.31 Permit #: WQ0031725 Cation Exchange Capacity (non 503 only): Operator: Douglas .Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2 Acres Used: 5.5 Acres Permitted: 5.5 Site #: DP Field #: 6 Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, %, Solids use Raw Percent #): Sample or 1 2 3 4 5 6 7 8 9 10 1 7 12 Com- pos ite Date I /4/ 18 % Solids 13.56 Arsenic 4.96 — Cadmium 2 Copper 99 :hromium 81.2 Lead 7.83 — Mercury 0.4 Molyb- �__..___ 5.43 Nickel 24 Selenium 5 Zinc 81.5 Total Phos- 13300 Annual Tot 17 DT/Ac./ App. Event Arsenic Cadmium k-opper Chromiur Lead Mercury Molyb- Metal Field Loadings (Calculated in lbs/acre): 2.24 1 1 1 111 1 111 1 111 1 111 1 11• 1 111 1 111 1 111 1 111 1 1 011 1 111 1 111 1 111 1 .' 1 111 1 111 1 111 1 111 1 1 1 111 1 111 1 111 1 111 1 11 1 111 1 111 1 111 1 111 1 1 � 1 111 1 111 1 111 1 111 Nickel 0.107 0.000 0.000 0.000 0.000 Selenium 0.022 0.000 0.000 0.000 0.000 Zinc 0.365 0.000 0.000 0.000 0.000 Total Phos- 59.557 0.000 0.000 0.000 0.000 horns "I certify, under penalty of law, that this document w 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 1 111 1 111 1 111 1 111 1 111 0.000 1 111 1 11 1 111 1 111 1 111 1 111 1 111 0.000 1 111 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 1 11 1 111 1 111 1 111 1 111 1 111 1 110 1 111 0.024 0.000 1 111 1 111 1 111 1 111 1 111 1 111 1 1 1 111 1 111 1 111 1 /11 1 111 1 lil 1 111 1 1 1 111 1 111 1 111 1 111 1 111 1 111 t 111 1 1 111 1 111 1 111 1 111 1 111 1 111 1 111 • 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". SignatLll'e of Land A lien pP l- I:r-)"/ y .Date DFNR FnRnn RAFI cP rioionna% ANNUAL, METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 9.85 Permit #: WQ0031725 Cation Exchange Capacity (non 503 only): Douglas Po lin Operator: Dou g P Owner: Douglas Poplin Predominant Soil Series: FcC2 Acres Used: 4.4 Acres Permitted: 4.4 Site #: DP Field #: 7 Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #): Sample or 1 2 3 4 5 6 7 . 8 9J 10 1 12 Com- posite Date 1 /4/ 18 % Solids 13.56 Arsenic 4.96 Cadmium 2 Copper 99 �hromium 81.2 Lead 7.83 Mercury 0.4 Molyb- _ 5.43 Nickel 24 Selenium 5 Zinc 81.5 Tota I Phos- 13300 Annual Heavy Total 1 D'1•/Ac./ App. Event 2.24 0 Metal'Field Loadings 2 3� (Calculated 4 0.000 0.000 0.000 0.000 0.000 0.000 5 0.000 0.000 0.000 0.000 0.000 000 .0 in lbs/acre): qj 0.000 0.000 0.000 0.000 0.000 0.000 L7J- 0.000 0.000 0.000 0.000 0.000 0 000 8 0.000 0.000 0.000 0.000 0.000 0 000 91 0.000 0.000 0.000 0.000 0..000 0 000 10 0.000 0.000 0.000 0.000 0.000 r, 11 0.000 0.000 U.000 0.000 0.000 12 -3 o iv y Arsenic 0.022 0.000 0.000 0.000 0.022 Cadmium 0.009 0.000 0.000 0.000 0.009 Copper �hromium 0.443 0.364 0.000 0.000 0.000 0.000 0.000 0.443 0.000 0.364 Lead 0.035 0.000 0.000 0.000 0.035 Mercury 0.002 0.000 0.000 Molyb- denum 0.024 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 00 0.000 0.000 0.000 0.002 Nickel 0.107 0,000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.024 0.000 0.000 0.000 0.000 0.000 Selenium 0.022 0.000 0.000 0.000 0.000 0.000 0.000 0.107 0.000 0.000 0.000 0.000 0.000 0.022 Zinc 0.365 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 _ 0.000 0.365 Total Phos- horus 59.557 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 59.557 "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 I am aware that there are significant for information submitted. penalties submitting false information, including. the possibility of fines and imprisonment for knowing violations". _ Signature of Land Applier Date DENR FORM MFLSF (19/9nnn) 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: Baxter Healthcare WQ Permit #: WQ0031725 Field #: 1A Acres Utilized: 5.5 Land Owner: Douglas Poplin Annual Dry Tons Applied: 12.0971 Site #: DP Acres Permitted: 5.5 Operator: Douglas Poplin Predominant Soil Series: FcC2 Cation Exchange Capacity (non 503): Crop 1 Name: Fescue Crop 1 Max. PAN: 158 Crop 2 Name: Cron 2 Max. PAN - • s Volume applied PP Volume Residual Sources Soil Cond. Precip. D c < o 3 - z D Nitrate Name of Crop Ty e P P c = (enter one) Solids/ oho Applied per PP P {NPDES #. WQ#, Past 24 g 4 � w - ;u � � TKN �' o and PAN Applied Receiving Residual 0 Liquid Solids Acre Fert., Animal (Dry- Hrs. o m � - N' CD w I F. x 0° o o Nitrite ( lbs/acre) Application Cu. Yds Gallons (Dry Tons/Ac) Waste, etc) Wet, Moist) inches s =. * _� o # o o mg/kg mg/kg mg/kg Crop 1 Crop 2 Crop 1 Crop 2 9-2018 57.37 13.56 1.191 WQ0031725 dry 0 s 0.5 0.3 82500 7300 23.5 62.498 NA Fescue 10-20181 48.56 1 13.56 1.008 W00031725 dry 0 s 0.5 0.3 82500 7300 23.5 52.901 NA Fesuce . 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.006 6.000 0.000 0.000 0.000 0.000 0.000 0.000 Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form): TOTALS: 105.931 01 As Cd Cu Cr Pb Hg Mo Ni I Se Zn P 115.3991 0.000 Lime Applied, Annuallbs/acre 0.022 0.009 0.435 0.357 0.034 0.002 0.024 0.106 0.022 0.358 58.493 Date Ibs/ac Prior Years Cumulative lbs/ac 0.138 0.042 2.359 1.5 0.208 0.007 0.1 0.537 0.084 4.149 0.160 0.051 2.794 1.857 0.242 0.009 0.124 0.643 0.106 4.507 36 34 1338 NA 267 15 NA 374 89 2498 . . 0 Current Cumulative lbs/ac .Permitted C. P. L. R.**** Permit PAN Limit ]st/2nd Crop 158 ...%,, L,Ay, u.,uc, Ncuarty V, 14w, Lnai Hits uocument was prepares unaer 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 thPro nra gignifipant Nanaltipe fnr g11hmitting f21$- information, including the possibility of fines and imprisonment for knowing violations." � % w Signature of Land Applier /-/5 , Date *Application Method: S - Surface, IN - Injection, INC - Incorporation **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0 *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically digested -0.3, raw sludge -0.4 ****C.P.L.R.: Cumulative Pollutant Loading Rate 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: Baxter Healthcare WQ Permit #• WQ0031725 Field #: 1B Land Owner: Douglas Poplin Annual Dry Tons Applied: 3.5333 Site #: DP Acres Utilized: 1.6 Operator: Douglas Poplin Predominant Soil Series: FcC2 Acres Permitted: 1.6 Cation Exchange Capacity (non 503): Crop l Name: Fescue Crop 1 Max. PAN: 158 Crop 2 Name: Crop 2 Max. PAN: Volume applied Y (enter one) Solids/ % Volume Applied per Residual Sources (NPDES #. WQ#. Soil Cond. Precip. Past 24 > < o ;° 3 ° z D Nitrate pAN Applied Name of Crop Type o CZ Liquid Solids. Acre Fert.. Animal (Dry, Hrs. = o _ N K � - TKN o o co and ( lbs/acre) Receiving Residual Cu. Yds Gallons Dry Tons/Ac) Waste, etc ) Wet, m _, = * x N Nitrite Application 10-2018 30.94 - - Moist) inches mg/kg mg/kg mg/kg Crop ] TCrop 2 Crop ] Crop 2 _ t t t t ________ t t t► F t t► _- MALIZE► ► _- __ t ► �' __�_____OW, t I off my, M1 �� t► __--__ t rt� tIt _- TOTALS: 30.941 01 1 Annuallbs/acre Prior Years Cumulative lbs/ac Current Cumulative lbs/ac Permitted C. P. L. R.**** As 0.022 0.136 0.158 36 Residuals Applications totals on FORM FSF supp ( attach FORM FSF Cd I Cu I Cr I Pb I HQ I Mo I Ni I Se 0.009 0.437 0.35901,0#350.002 0.024 0.106 0.022 0.04 2.218 1.3750.007 0.094 0.497 0.081 0.049 2.655 1.7340.009 0118 0603 0103 34 1338 NA15 NA '74 0.000 0.000 supp to this form): I Zn P 115.864 0.000 0.360 58.733 3.833 4.193 Lime Applied Date lbs/ac 0 - � 2498 Permit PAN Limit Ist/2nd Crop 89 158 "I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for ]crowing violations." *Application Method: S - Surface, IN - Injection, INC - Incorporation (' A 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 I ANNUAL LAND APPLICATION FIELD SUMMARY FORM PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON PLACE A "N/A" IN A,BLANK OR BOX WHEN NOT APPLICABLE Facility Name: Baxter Healthcare WQ Permit #: WQ0031725 Field #•- 1C Land Owner: Douglas Poplin Annual Dry Tons Applied: 6.6486 Site #•• DP Acres Utilized: 3 Operator: Douglas Poplin Predominant Soil Series: FcC2 Acres Permitted: 3 Crop 1 Name: Fescue Crop 1 Max. PAN: 158 Cation Name: Exchange Capacity (non 503): Crop 2 Crop 2 Max. PAN - Volume applied o c (enter one) Solids/ c /o Volume Applied er pp p Soil Residual Sources Precip. D (NPDES #, WQ#• Cond. past 24 o z z> 4 Nitrate PAN Applied Name of Crop Type Y o Liquid Solids Q Acre (Dry. = �• Fert., Animal Hrs. o w , TKN rro o and Receiving Residual (]bs/acre) Cu. Yds Gallons (Dry Tons/Ac) Waste, etc Wet' ? o' ) * °* �' ,�-, Nitrite Application 12-2018 58.22 ];-5 i Moist) inches - o _ mg/kg mg/kg mg/kg Crop 1 Crop 2 Crop 1 Cro 2 1 / 11 ® f 111 1® _____ 1 111 1 111 1 I l f ___ 1 11 1 ____�___ 1_- __ i 1i 1 __ �- 1 111 0.000 1 0.000 Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form): r0TALS:J 58.221 01 1 As Cd I Cu I Cr I Pb I Hg Mo Ni Se I Zn P 116.278 0.000 Lime Applied 4nnuallbs/acre 0.022 0.009 0-439 0.360 0.035 0.002 0.024 0.106 0.022 0.361 58.946 ?rior Years Cumulative lbs/ac 0.717 0.054 2.889 L75 0.243 0.009 0.118 0.638 0.1 5.247 Date ]bs/ac �urrent Cumulative lbs/ac 0.739 0.063 3.328 2.I ]0 0.278 0.011 0.142 0.744 0.122 5.608 0 'ermitted C. P. L. R.**** 36 34 1�38 NA 267 15 NA 374 89 2498 'ermit PAN Limit lst/2nd Crop 158 `I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that lualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties Tor Submitting false nformation, including the possibility of fines and imprisoni,,;enttor knowing violations." *Application Method: S - Surface, IN - Injection, INC - Incorporation eI **Volatilization Rate: Surface - 0.5, lgjection/Incorporation - 1.0 Signature of Land Applier Date Yxx Mineralization Rates: Compost -0.1, anaerobially digested -0.2, aerobically digested -6.3, raw sludge -0.4 ****C.P.L.R.: Cumulative Pollutant Loading Rate 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: Baxter Healthcare WQ Permit #: WQ0031725 Field #•• 1D Land Owner: Douglas Poplin Annual Dry Tons Applied: 19.9802 Acres Utilized: 9.6 Operator: Douglas Poplin Site #: DP Acres Permitted: 9.6 Predominant Soil Series: FcC2 Cation Exchange Capacity (non 503): Crop 1 Name: Fescue Crop I Max. PAN: 158 Crop 2 Name: Crop 2 Max. PAN: Volume applied o „ Volume Soil Residual Sources Precip. D o � z ? Nitrate (enter one) Solids/ c /o Applied per pp p (NPDES #, WQ#, Cond. past 24 � 2 = TKN P yP PAN Applied Name of Crop Type r) Liquid Solids Acre Fert., Animal (Dry, Hrs. T _ ��^ a and ( lbs/acre) Receiving Residual Cu. Yds Gallons (DryTo:.s/Ac, Wet. a - x ;, Nitrite Waste, etc o ) Application 11-2018 174.96 13.56 2.081 Moist) inches 2o' mg/kg mg/kg mg/kg WQ0031725 dry 0 Crop 1 Crop 2 Crop 1 Crop 2 0.000 s 0.5 0.3 82500 7300 23.5 109.198 NA Fescue 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 o.000 0.000 0.000 0.000 000o o.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 o.000 0.000 0.000 Residuals Applications totals on FORM FSF supp ( attach FORM FSF 0.000 0.000 -0TALS:J 174.961 01 1 As I supp to this form): Cd I Cu I Cr I Pb I Ha I lVlo Ni annuallbs/acre 0.021 Se Zn P 0.008 0.412 0.338 0.033 0.002 0.023 0.100 109.198 0.000 Lime Applied 'rior Years Cumulative lbs/ac 0.135 0.021 39 55.355 0.333 0.039 2.194 1.378 0.214 0.005 0.092 0.48 0.066 Date I lbs/ac :urrent Cumulative 1bs/ac 0.156 3. 0.047 2.606 1.716 0.247 0.007 0.115 0.580 0.087 3.972 0 'ermitted C. P. L. R.**** 36 34 1338 NA 267 ]5 NA 374 89 'ermit PAN Limit 1 st/2nd Crop 2498 158 J 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 signi ;cant penalties for submitting fake a oirination, including the possibility of fines and imprisonment for knowing viola_..,ndo . s." *Application Method: S - Surface, IN - Injection, INC - Incorporation -1h; **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 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: Baxter Healthcare WQ Permit #: WQ0031725 Field #: 3-Corn Acres Utilized: 5.877 Land Owner: Douglas Poplin P Annual Dry Tons Applied: 18.7845 Site # Dp Acres Permitted• 5.877 Operator: Douglas Poplin Predominant Soil Series: Fc132 Cation Exchange Capacity (non 503): Crop_ 1 Name: Corn Crop 1 Max. PAN: 214 Crop 2 Name:Crop 2 Max. PAN Volume applied Volume Soil < o � Residual Sources Precip y z a o(enter c one) Solids/ /o Applied per pp p (NPDES #, WQ#, Cond. Past 24 coo ' y w TKN q' Nitrate PAN Applied Name of Crop Type P yP Cu � Liquid Solids Acre Fert.. Animal (Dry` Hrs. o R - �; cro o and (]bs/acre) Receiving Residual Cu. Yds Gallons in Tons/Ac) Waste, etc) Wet, _. ^Na 13 �- Nitrite Application 3-2018 54.64 13.56 1.062 WQ0031725 Moist) dry inches 0 o J mg/kg mgNo mg/kg Crop 1 Crop 2 Crop l Crop 2 4-2018 109.85 1 - - Inc 1 0.3 82500 7300 23.5 63.457 NA Corn o.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form): 0.000 0.000 TOTALS: 164.491 01 As Cd Cu I Cr Pb I Hg Mo Ni I Se I Zn I P Annuallbs/acre 0.032 0.013 0.633 0.519 0.050 0.003 0.035 0.153 191.032 0.000 Lime Applied Prior Years Cumulative lbs/ac 0.363 0.113 0.879 4.09 0.546 0.017 0.032 0.521 85.040 Date lbs/ac Current Cumulative lbs/ac 0.395 0.126 1.512 4.609 0.596 0.020 0.236 1.268 0.536 12.623 10-2018 4000 Permitted C. P. L. R.**** 36 34 0.271 1.421 0.568 13.144 Permit PAN Limit 1st/2nd Crop 1338 NA 267 15 NA 374 89 2498 214 "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 jualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false rormation, including the possibility of fines and imprisonment for knowing violations." � �S _ *Application Method: S -Surface, 1N -Injection, INC -Incorporation ' �C'� **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0 Signature of Land Applier Date *** Mineralization Rates: Compost A. 1, anaerobially digested -0.2, aerobically digested -0.3, raw sludge -0.4 ****C.P.L.R.: Cumulative Pollutant Loading Rate 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: Baxter Healthcare WQ Permit #• WQ0031725 Field # " • 3-Grass Acres Utilized: 6.983 Land Owner: Douglas Poplin Annual Dry Tons Applied: 25.0118 Site # DP Acres Permitted: 6.983 Operator: Douglas Poplin Predominant Soil Series: FeB2 Cation Exchange Capacity (non 503): Crop l Name: Fescue Crop l Max. PAN: 194 Crop 2 Name: Crop 2 Max. PAN: Volume applied Volume Soil e K o = Residual Sources Precip. > z D c (enter one) Solids/ o /o Applied per (NPDES #, WQ#, Cond. Past 24 c X 5' = � R - Nitrate PAN Applied pp Name of Crop Type O Liquid p 7 Solids Acre Fert., Anima] (Dry, Hrs. � _ �• o _ C° ;, TKN d 9 °O and ( lbs/acre) Receiving Residual Cu. Yds Gallons (Dry Tons/Ac) Waste, etc ) Wet' w o # _= N g ; Nitrite Application 2-2018 57.07 13.5b 0.933 WQ0031725 Moist) inches J mg/kg mg/kg mg/kg Crop 1 Crop 2 Crop ] Crop 2 3-2018 161.95 13.56 2.649 WQ0031725 dry dry 0 0 s 0.5 0.3 82500 7300 23.5 48.968 NA Fescue s 0.5 0.3 82500 7300 23.5 138.959 NA Fescue off 1 1 f f 1 11 ! 1 off laigNINNIV1 ■ 1 111 an 1 111 0.000 0.000 Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form): roTALs: 219.02 o As Cd Cu I Cr I Pb I Ha Mo Ni I Se Zn P 1187.9271 0.000 Lime Applied Annual lbs/acre 0.036 0.014 0.709 0.581 0.056 0.003 0.039 0.172 0.036 0.584 95.228 Prior Years Cumulative lbs/ac 0.35] 0.117 b.195 3.995 0.536 0.017 0.242 1.172 0.545 0.584 1. Date Ibs/ac Current Cumulative lbs/ac 0.387 0.131 6.904 4.576 0.592 0.020 0.281 1.420 0.581 13.168 0 ?ermitted C. P. L. R.**** 36 34 1338 NA 267 15 NA 374 89 2498 'ermiT PAN Limit Ist/2nd Crop - l94 `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 lualified personnel properly gathered and evaluated the information submitted. I am aware that there are Significant penalties for submitting false reformation, including the possibility of fines and imprisonment for knowing violations." t *Application Method: S - Surface, IN - Injection, INC - Incorporation 5 -766 **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_ 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: Baxter Healthcare WQ Permit #• WQ0031725 Field #• 4 ' Acres Utilized: 8,7 Land Owner: Douglas Poplin Annual Dry Tons Applied: 24.0925 Site # DP Acres Permitted: 8.7 Operator: Douglas Poplin Predominant Soil Series: FcB2 Cation Exchange Capacity (non 503): Crop 1 Name: Fescue Cro 1 Max PAN 194 o -a r) Cu 02 O 5-2018 6-2018 p Crop 2 Name: Crop 2 Max. PAN: Volume applied Volume Soil (enter one) Solids/ o Residual Sources Cond. Precip. z Name of CropType /o Applied per (NPDES #, WQ#, Past 24 r, Nitrate yp (D PAN Applied Liquid Solids Acre P A • (Dry, ;• a _ CD R TKN aq O and 111/ Receiving Residual Cu. Yds 137.53 73.44 ert., mmal Hrs. o = ( s acre) Wet. * S R * R g M. Nitrite Application Waste, etc _ G8110nS (Dry Tans/Ac) ) Moist) inches O mg/kg mg/kg n A C ] 13.56 1.805 WQ0031725 13.56 0.964 WQ0031725 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 TOTALS: 210.97 0 AS Residuals App I Cd Cu Annuallbs/acre 0.027 0.011 0.548 Prior Years Cumulative lbs/ac 0.268 0.083 4.451 ::urrent Cumulative lbs/ac 0.295 0.094 4.999 'ermitted C. P. L. R.**** 36 34 1338 'ermit PAN Limit Ist/2nd Crop � 9 9 dry 0 s 0.5 0.3 82500 1 7300 23.5 dry 0 s 0.5 0.3 82500 1 7300 F 2-3.5 tions totals on FORM FSF supp ( attach FORM FSF su Cr I Pb I Hg I Mo Ni Se 0.450 0.043 1 0.002 0.030 0A33 0.028 2.975 0.377 0.013 0176 1.023 0.123 3.425 0.015 0.206 0.151 NA 267 15 NA 374 89 rop 94.716 50.578 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 p to this form): Zn P 1145.294 0.451 73.655 9.081 9.532 2498 ftFesuce 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Lime Applied Date lbs/ac 0 194 `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 lualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false nformation, including the possibility of fines and imprisonment for knowing violations." *Application Method: S - Surface, IN - Injection, INC - Incorporation /S'act **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 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: Baxter Healthcare WQ Permit #• WQ0031725 Field #• 5 Acres Utilized- 15.9 Land Owner: Douglas Poplin Annual Dry Tons Applied: 35.1972 Site #• DP Acres Permitted: 15.9 Operator: Douglas Poplin Predominant Soil Series: FcC2 Cation Exchange Capacity (non 503): Crop 1 Name: Fescue Crop 1 Max. PAN: 158 Crop 2 Name: Crop 2 Max. PAN: _ Volume applied PP ° enter one Solids/ _ ( ) ° Liquid Cu. Yds Gallons o /o Solids Volume Applied per Acre ,Dry Tons/Ac) Residual Sources (NPDES #, WQ#. Fert., Animal Waste_ etc) Soil Cond. (Dry, Wet M01$t) Precip. Past 24 Hrs. inches y a - �' o `- 3 �' " N• 0 TKN mg/kg z D - o rm o co J mg/kg 6-2018 81.96 13.56 0.589 WQ0031725 dry 0 s 0.5 0.3 82500 7300 7-2018 114.77 13.56 0.824 WQ0031725 dry 0 s 0.5 0.3 82500 7300 8-2018 111.48 13.56 0.801 WQ0031725 dry 0 s 0.5 0.3 82500 7300 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 1'0•I'ALS:J 308.211 01 Annual lbs/acre Prior Years Cumulative Ibs/ac �urrent Cumulative lbs/ac Permitted C. P. L. R.**** Residuals App As Cd I Cu 0.022 0.009 0.438 0.235 0.07 3.778 0.257 0.079 4.216 36 34 1338 Nitrate and Nitrite mg/kg 23.5 23.5 23.5 PAN Applied ( lbs/acre) Crop 1 30.885 43.249 42.009 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 ications totals on FORM FSF supp ( attach FORM FSF supp to this form): Cr I Pb I H.R I Mo Ni I Se I Zn P 116.144 0.360 0.035 0.002 0.024 0.106 0.022 0.361 58.892 2.44 0.338 0.012 0.15 0.876 0.095 7.776 2.800 0.373 0.014 0.174 0.982 0.117 8.137 NA 267 15 NA 374 89 2498 Crop 2 NA NA NA 0.000 0.000 0.000 0.000 0.000 01000 0.000 0.000 Name of Crop Type Receiving Residual Application Crop 1 Crop 2 Fescue Fesuce Fescue Lime Applied Date I lbs/ac 10-2018 2000 'ermit PAN Limit 1st/2nd Crop 158 `I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that Iualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false nformation, including the possibility of fines and imprisonment for knowing violations." *Application Method: S - Surface, IN - Injection, INC - Incorporation **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0 Signature of Land Applier Date xxx 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 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" 1N A BLANK OR BOX WHEN NOT APPLICABLE. Facility Name: Baxter Healthcare WQ Permit #•• WQ0031725 Field #• Land Owner: Douglas Poplin Annual Dry Tons Applied: 12.3129 Acres Utilized: 5.5 Operator: Douglas Poplin Site #: DP Acres Permitted: 5,.5 Predominant Soil Series: FcC2 Cation Exchange Capacity (non 503): Crop 1 Name: Fescue Crop 1 Max. PAN: 158 Crop 2 Name: Crop 2 Max. PAN: Volume applied ° Y Volume Soil Residual Sources Precip. o 3 Z enter one Solids/ o c ( ) /o ° Applied per PP P Cond. v> (NPDES #, WQ#, Past 24 ' Nitrate �' a TKN Name of Crop Type PAN Applied Liquid Solids p Acre (Dry, _ �• Fert., Animal Hrs. o = = ry w 0 o and Receiving Residual ( lbs/acre) Cu. Yds GeIIOnS (Dry Tans/Ac) Wet _. Waste, etc) _ * _� N g Nitrite Application 1-2018 89.73 13.56 I M3 Moist) inches WQ0031725 dry 0 c 5 0 mg/kg mg/kg mg/kg Crop 1 Crop 2 Crop 1 Crop 2 2-2018 18.09 1 13.56 1 0.376 s WQ0031725 dry 0 0.5 0.3 82500 7300 23.5 97.751 NA Fescue 0.000 s 0.5 0.3 8-500 7300 23.5 19.707 NA Fescue om 0.000 0.000 O.t)0o 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 o.000 o.000 0.000 o.000 o.000 0.000 o.000 o.000 - 0.000 o.000 o.000 0.000 0.000 0.000 Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form): 0.000 0.000 r0TALS:1 107.821 01 1 As Cd I Cu I Cr I Pb I Ha I Mo Ni Se Zn P Annuallbs/acre 0.022 0.009 0.443 0.364 0.035 0.002 0.024 117.458 0.000 Lime Applied 'rior Years Cumulative lbs/ac 0.327 0.097 5.373 3.682 0.497 0.014 0.107 0.022 0.365 59.557 0.207 1.028 Date lbs/ac �urrent Cumulative lbs/ac 0.349 0.106 54816 4.046 0.532 0.016 0.11 10 868 0.231 0 'ermitted C. P. L. R.**** 36 34 1338 NA 267 1.135 0.134 11.233 'ermit PAN Limit 1st/2nd Crop 15 NA 374 89 2498 158 `I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that lualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false nformatinn inrl„di.-.g fhc p •ti �- cr •••�•��•••s ross;u;,;Ly o, i,nes and imprisonment for knowing violations." j _ _ *Application Method: S - Surface, IN - Injection, INC - Incorporation If �- V �Si **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 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: Baxter Healthcare Land Owner: Douglas Poplin Operator: Douglas Poplin Crop I Name: Fescue WQ Permit #: WQ0031725 Field #: 7 Acres Utilized: Annual Dry Tons Applied: 9.8519 Site #• DP Acres Permitted: Predominant Soil Series: FcC2 Cation Exchange Capacity (non 503): Crop 1 Max. PAN: 158 Crop 2 Name: Crop 2 Max. PAN: 4.4 4.4 ° L Volume applied Volume Residual Sources Soil Cond. Precip. D � < o K - z D Nitrate Name of Crop Type P yP .� C) c (enter one) Solids/ % Applied per PP P (NPDES #. WQ#. Past 24 � � X ^ _ TKN d and PAN Applied Receiving Residual 1 ° Liquid Solids Acre Fert.. Animal (Dry, Hrs. = o' 0 w - * N Zi ry - M CD y. J Nitrite { ]bs/acre) Application Cu. Yds Gallons Dry Tcns/Ac, Waste. etc) Wet, Moist) inches o = mg/kg mg/kg mg/kg Crop 1 Crop 2 Crop 1 Crop 2 1-2018 86.27 13.561 2.239 WQ0031725 dry 0 s 0.5 0.3 82500 7300 23.5 117.477 NA Fescue 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0:000 0.000 a.000 0.000 0:000 0.000 0.000 0.00.0 0.000 0.000 0:000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form): TOTALS: 86.271 01 As Cd Cu Cr Pb Hg Mo Ni Se Zn P 117.4771 0.000 Limepplied Annuallbs/acre 0.022 0.009 0.443 0.364 0.035 0.002 0.024 0.107 0.022 0.365 59.557 Date lbs/ac Prior Years Cumulative lbs/ac 0.267 0.289 3b 0.075 0.084 34 4.168 4.611 1338 2.74 3.104 NA 0.378 0.413 267 0.013 0.015 15 0.166 0.190 NA 0.978 1.085 374 0.109 0.131 89 8.312 8.677 2498 10-2018 2000 ;Current Cumulative lbs/ac Permitted C. P. L. R.**** Permit PAN Limit 1st/2nd Crop 158 J certAy, under penatry of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel prope_rl_y gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false information, including the rPossihility of fines and in:^Nris me t r - on for .or knowing violations." Signature of Land Applier Date *Application Method: S - Surface, IN - Injection, INC - Incorporation **Volatilization Rate: Surface - 0.5, Injection/Incorporation - 1.0 *** Mineralization Rates: Compost -0.1, anserobially digested -0.2, aerobically digested -0.3, raw sludge -0.4 ****C.P.L.R.: Cumulative Pollutant Loading Rate 11LV/GV I Nutrient Management in North Carolina Realistic Yields for FCC2: Fairview sandy clay loam, 5 to 15 percent slopes, moderately eroded in Wilkes County Realistic Estimated Phosphorus Crop Nitrogen Nitrogen Removal Yield Factor Rate (Ibs/acre) (Ibs P205/acre) B..arle...........y (Grain . .. ... ... .. ) ................................................................................................................................................I...... .............. .54 Bushels . 1.49 81 T 21 _ Corn(Grain) 106 Bushels ........................................................ 0.92 .................................................................................................................................................. 97 46 Corn (Silage) 16 Tons . 10.9 174 54 Cotton 520 Pounds 0,081 42 15 Sorghum (Silage) 13.6 Tons 7.6 103 41 Oats (Grain) 68 Bushels 1.13 77 17 Peanuts 0 Pounds 0 0 0 Rye (Grain) 40 Bushels 2.01 80 13 Small Grain (Silage) 7,2 Tons 11.1 80 39 Sorghum (Grain) ................................................................................................................................ ........................................................................................................................................................................................................................................................................................................................ 40 CWT 1.72 69 30 Soybeans(Double Cropped) 27 Bushels 0 0 ......................................................................................................................................................................................................................................................................................... Soybeans (Full Season) 32 Bushels 22 ....................................................................................................................................................................................................................................................................................................................................................................................................................................................... 0 0 26 Soybeans (Double Cropped - Manured) ................... 27 Bushels 3.89 106 Soybeans (Full Season - Manured) .................................................................... 32 Bushels 3.89 124 22 Tobacco (Burley) • • �•••.................. ............................................................................................................................................................................................. 0 Pounds 0.074 0 26 o acco,(Flue Cured) ................. .................................................................................................................................................. .................................................................................................................................................................................................................................. 2080 Pounds 0.029 60 0 Triticale (Grain) ............................................................................................................................................................................................................................................................. 56 Bushels 1,52 85 10 TropicalCorn (silage) ................................................................................................................................................................ ............................................................................................................................................................................................................................................ 16 Tons 6.5 104 19 Wheat(Grain)........................................................................................................................................................................................................................................................................... ........................... _........................ ................................ ................................................ 40 Bushels 2.01 80 54 ...................................................... . Bahiagrass(Hay) . ...................................................................................................................................................................................................... 2.8 Tons 44 123 20 ........................................................ Caucasion/Old World Bluestem (Hay) 2.8 Tons 44 32 Common Bermudagrass (Hay) 2.8 Tons 44 123 33 Dallisgrass (Hay) 2.8 Tons 44 123 123 34 Fescue (Hay) 3.6 Tons 44 158 37 Hybrid Bermudagrass (Hay) 3.6 Tons 44 158 57 Hybrid Bermudagrass overseeded with Rescuegrass 0 Tons 44 44 (Hay) 0 0 Mixed Cool Season Grass (Hay) 2.6 Tons 44 114 Orchardgrass (Hay) 2.8 Tons 44 123 37 Pearl Millet (Hay) 3 Tons 49 147 41 Rescuegrass (Hay) 0 Tons 44 0 40 Sorghum Sudan (Hay) 3.4 Tons 49 167 0 TimothyGrass (Hay) ................................. ........ ..................................................................................................... Tons 44 ... .............. ...................................`...�................................................... . .0 ............................................................................................. �............... 0 Dr. -David Crouse is responsible for the development and maintenance of the Realistic Yield reporting tool. http://yields.soi l.ncsu.edLdi ndex.php#county �ro Nutrient Management in North Carolina Realistic Yields for FcB2: Fairview sandy clay loam, 2 to 8 percent slopes, moderately eroded in Wilkes County Realistic Estimated Phosphorus Nitrogen Nitrogen Removal Crop Yield Factor Rate (Ibs/acre) (Ibs P205/acre) Barley (Grain) ............................................................................................................................................................................................ 67 Bushels . 1.49 99 25 Corn (Grain) ........................................................................................................................................................................................................... 129 Bushels ............................................................................................................................................. 0.92 119 57 Corn Silage ( 9 ) 19.6 Tons 10,9 214 ........................................................................................... 67 Cotton 637 Pounds 0.081 52 18 Sorghum (Silage) 16.7 Tons 7.6 127 50 Oats (Grain) 83 Bushels 1.13 94 21 Peanuts 0 Pounds 0 0 0 Rye (Grain) 49 Bushels 2.01 98 16 Small Grain (Silage) 8.8 Tons 11.1 98 48 Sorghum (Grain) .......... ... ............................. .......................................................................... ................................ ...................... .................. 49 CWT ................................ 1.72 84 37 Soybeans (Double Cropped) ....................................................... _...... ................ ............. ............................................................ ........... ..................... ............ 33 Bushels ................ .......................... ......_................................................................ .................................................................................................... 0 .............................. 0 ,............................ ..................................................... 27 Soybeans (Full Season) ..................................................................._................................................................................................................._............................................................................................................................................................................................................................................................... 39 Bushels 0 ............................... ............................ 0 ........................................ ........................... ............... . 31 Soybeans (Double Cropped - Manured) ...................................................................................................................................................................................................................................................................................................................................................................................................................................... 33 Bushels 3.89 130 27 Soybeans (Full Season - Manured) 39 Bushels 3.89 ................................................................................................................................................................................................ ............................... 152 31 Tobacco (Burley) ................................................................................................................................................................................... . 0 Pounds . ...... ............................. .................................. 0.074 ................... ............ .......................................... 0 ..................................................................... . 0 Tobacco (Flue Cured) .........................................................................................................................................................._................................................................................................................................................................................................................................. 2548 Pounds 0.029 74 13 Triticale (Grain) ............................................................................................................................................................................................................................................................................................................................................................................................................ 69 Bushels 1.52 104 23 Tropical Corn (Silage) ..................................................................................................................................................................................................................... 19.6 Tons 6.5 127 67 Wheat (Grain) ......... ........ ................................................ ........................................................................... ............................. .................. 49 Bushels ......................... _........ 2.01 98 25 Bahiagrass (Hay) ........ . 3.4 Tons ................................... ................................................................. 44 ............................................................................................................... 151 . 39 Caucasion/Old World Bluestem (Hay) 3.4 Tons 44 151 41 Common Bermudagrass (Hay) 3A Tons 44 151 42 Dallisgrass (Hay) 3.4 Tons 44 151 45 Fescue (Hay) 4.4 Tons 44 194 69 Hybrid Bermudagrass (Hay) 4.4 Tons 44 194 54 Hybrid Bermudagrass overseeded with Rescuegrass 0 Tons 44 0 0 (Hay) Mixed Cool Season Grass (Hay) 3.2 Tons 44 140 45 Orchardgrass (Hay) 3.4 Tons 44 151 50 Pearl Millet (Hay) 3.7 Tons 49 180 49 Rescuegrass (Hay) 0 Tons 44 0 0 Sorghum Sudan (Hay) ...... ............. ..... ............................ .............. ......... ............................................................ ................................ ................. 4,2 Tons ............................ 49 204 58 Timothy Grass (Hay) .................................................................................................................................................................................................................................................................................................. 0 Tons 44 0 0 I:)r. David Crouse is responsible for the development and maintenance of the Realistic Yield reporting tool. http://yi el ds. soi I .ncsu.eduli ndex.php#county 212 Page: 1 of 2 Report Number: 18-008-0201 Account Number: 46381 Send To: Southern Soil Builders Dennis Key 958 Hoots Road Roaring River, NC 28669 Lab Number: 57974 Sample Id : Baxter F_" V 0 ANALYTICAL ra Proiect : Baxter REPORT OFANAL.YSIS 7621 Whitepinc `a.Cad, Richrnand, VA 2"SZ237 W sWV-way??o'snfanaly-6ca,_cofn Date Sampled: 1/4/2018 12:45:00 Date Received: 01/08/2018 00:00 Date Reported: 01/15/2018 Total Solids * 13.56 135600 100.0 R D 01/08/2018 15:15 SM-254OG Moisture * 86.43 100.0 R D 01/08/2018 15:15 SM-254OG Total Kjeldahl Nitrogen 8.25 82500 50.0 R D 01/09/2018 09:00 SM-4500-NH3C-TKN Total Phosphorus 1.33 13300 100 MOS 01/11/2018 13:47 6010C Total Potassium 0.30 3030 100 MOS 01/11/2018 13:47 6010C Total Sulfur 0.96 9600 100 MOS 01/11/2018 13:47 6010C Total Calcium 0.57 5670 100 MOS 01/11/2018 13:47 6010C Total Magnesium 0.24 2370 100 MOS 01/11/2018 13:47 6010C Total Sodium 0.21 2130 100 MOS 01/11/2018 13:47 6010C Total Iron 5910 100 MOS 011111201813:47 6010C Total Aluminum 1100 100 MOS 01/11/2018 18:45 6010C Total Manganese 44.4 5.00 MOS 01/11/2018 13:47 6010C Total Copper 99.0 5.00 MOS 01/11/2018 13:47 6010C Total Zinc 81.5 5.00 MOS 01/11/2016 13:47 6010C Ammonia Nitrogen 0.73 7300 50.0 R D 01/09/2018 09:00 SM-4500-NH3C Organic N 7.52 75200 50.0 01/09/2018 09:00 CALCULATION Nitrate+Nitrite-N <23.5 23.5 MMT 01/15/201813:02 450ONO3F-2011 All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis. wir- �� o X 6ew Pauric McGroary Agronomist Page: 2 of 2 Report Number: 18-008-0201 Account Number: 46381 Send NU: Southern Soil Builders Dennis Key 958 Hoots Road Roaring River, NC 28669 Lab Number: 57974 Sample Id : Baxter Total Cadmium Total Chromium Total Nickel Total Lead Total Arsenic Total Mercury Total Selenium pH * Total Molybdenum 5.81 <2.00 81.2 24.0 7.83 4.96 <0.400 <5.00 Comments: 5.43 NC CERT#257, SC CERT#9300 7001 SULFUR AND ORGANIC NITROGEN NOT FOR COMPLIANCE PURPOSES. ANALYTICAL DrCjE�t :Baxter REPORT OFANALYS/S )62:i bIINterfne Roav, Ric :mond, VA 2'237 P0,ain 804-742-94401 n NIX 804-271-G4446 E•, iJ�.v.v�aapoinTrna?y;cs4.co:r? Date Sampled: 1/4/2018 12:45:00 Date Received: 01/08/2018 00:00 Date Reported: 01/15/2018 2.00 MOS 01/11/201813:47 6010C 5.00 MOS 01/11/201818:45 6010C 5.00 MOS 01/11/201818:45 6010C 5.00 MOS 01/11/201818:45 6010C 3.00 MOS 01/11/201813:47 6010C 0.400 MOS 01/11/201816:36 SW-7471 B 5.00 MOS 01/11/201813:47 6010C 1.00 R D 01/09/2018 09:00 SW-9045D 5.00 MOS 01/11/201818:45 6010C All values are on a dry weight basis except as noted by asterisk. Detection limit on all N series is on a wet basis. pw« Pauric McGroary Agronomist SAR Sodium Absorption Ratio Na: Sodium (Mg/L) Equivalent weight: 23 Ca: Calcium (Mg/L) Equivalent weight: 20 Mg :Magnesium (Mg/L) Equivalent weight: 12 Milli Equivalent = Mg/L / Equivalent weight Na M /L Ca M /L Mg(Mg/L) 288.82 768.85 1 321.37 I Na ME I Ca ME I Mg (ME) 1 12.55739 1 38.4425 1 26. 78083 SAR= Na Milli Equivalent/[0.5 X (Ca Milli Equivalent + Mg Milli equivalent)]0.5 power SAR = 2.1 8-938 (From Mg/L entered above) SAR= 2.199451 (From ME entered below) Na ME Ca (ME) Mg (ME) 12.56 1 38.44 1 26.78 The amount of exchangeable sodium ions vet amount of exchangeable calcium & magnesiu Permitting guidance is if greater than 10 requi PAN Mineralization Rate TKN 0.3 I 82500 NIi3 NO3 NO2 7300 23.5 0 PAN Surface 26233.5 mg/kg 52.467 Ibs/dry ton 0 Ibs total PAN #DIV/0! Ibs PAN/acre PAN Injection 29883.5 mg/kg 59.767 Ibs/dry ton 0 Ibs total PAN #DIV/0! Ibs PAN/acre Dry Tons/1000 gal. 0.565452 1st year PAN Surface lbs. 0 1st year PAN Injected Ibs. 0 Ibs./acre Surface #D1V/0! Ibs./acre Injected #DIV/0! :evima1 Total Jam_ I 1 lJldl ury Acres Solids tnng)vewr I A 1' 0.1356 I I i::i i U vli MR(TKN-NH3)+ + .5(NH3)+NO3+NO2 =mg/kg mg/kg x .002 =Ibs/dry ton MR(TKN-NH3) + 1(NH3)+NO3+NO2 =mg/kg mg/kg x .002 =Ibs/dry ton 1000 X 8.34 X %solids X sp. gravitV 2000 0 "=dry tons/1 000gal. -1 Analytical Results Southern Soil Builders 958 Hoots Road .Roaring River, NC 28669 Receive Date: 01/04/2018 Reported: 08/22/2013 For: Baxter Comments: Geometric Mean 2025 MPN/g Sample Number Parameter Sample ID Result 180104-15-01 Fecal Coliforms 1 Unit Method Analyzed Analyst 180104-15-01 Percent Solids 1 3623 MPN/g SM9221cE-2006 01/05/2018 WC 180104-15-02 Fecal Coliforms 2 13.8 % SM2540B-1997 01/05/2018 WC 180104-15-02 Percent Solids 2 593 MPN/g SM92210E-200s 01/05/2018 WC 180104-15-03 Fecal Coliforms 3 13.5 % SM2540B-1997 01/05/2018 WC 180104-15-03 Percent Solids 3 3546 MPN/g SM92210E-2006 01/05/2018 WC 180104-15-04 Fecal Coliforms 4 14.1 % SM2540B-1997 01/05/2018 WC 180104-15-04 Percent Solids 4 2500 MPN/g SM92210E-2006 01/05/2018 WC 180104-15-05 Fecal Coliforms 5 13.6 %SM2540B-1997 01/05/2018 WC 180104-15-05 Percent Solids 5 809 MPN/g SM92210E-2006 01/05/2018 WC01/05/2018 180104-15-06 Fecal Coliforms 6 13.6 %SM2540B-1997 WC 180104-15-06 Percent Solids 6 3650 MPN/g SM92210E-200s 01/05/2018 WC01 180104-15-07 Fecal Coliforms 7 13.7 a/o SM2540B-1997 /05/2018 WC 180104-15-07 Percent Solids 7 2481 MPN/g SM92210E-2006 01/05/2018 WC01/05/2018 180104-15-08 % Volatile Solids A 13.3 %SM2540B-1997 WC 180104-15-09 % Volatile Solids B 0.76 % SM254oc 01/05/2018 WC 1.56 % SM2540G 01/05/2018 WC Respectfully submitted, Dena Myers NC Cert #440, NCDW Cert #37755, EPA #NC00909 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 5 VS in 0.0156 VS out 0.0076 VSFR= 0.516748 VSFR= (0.0156 - 0.0076) / (0.0156 - (0.0156 * 0.0076)) Condition of Receipt Sa I mp e Number 180104-15-01 Temp on Arrival: 3 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Sample Number 180104-15-02 Temp on Arrival: 3 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Sample Number 180104-15-03 Temp on Arrival: 3 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Sample Number 180104-15-04 Temp on Arrival: 3 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Sample Number 180104-15-05 Temp on Arrival: 3 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms .� Sodium Thiosulfate Received on Ice Sample Number 18010.4-15-06 Temp on Arrival: 3 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 2 of 5 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice Sample Number '180104-15-07 Tern on Arrival: 3 Parameter Schedule: Percent Solids Received on Ice Parameter Schedule: Fecal Coliforms Sodium Thiosulfate Received on Ice PO Box 228 . Statesville, NC 28687 • 704/872/4697 Page 3 of 5 rn to �z to N o Client: ^ `f Address: ® ® sSTATESVILLEANALYT-rr_AL O^ 0 " Ka 122 Coup Strcct P.O. Box 228 I • to A ..., K. - d$ t; t q c7oaj aii-a69� 00 Contact Person: LD Phone # FAX# 00 PO AtChain of (� Customer Requisitioned by: (Tlma Date) CU Custody Record z Sampled Sa Sample IDA Lab ID ti Time rnP Data Sampled (Grab only) (Grab Only) slbpa watrtx WW Parameters requested for analysis c� �� 15t2! r1: n•, I-Y-/ pr../ v . o 6,4 } 11, y� 00 ✓_-DY N o O Relinquished jby:" Received by: Relinquished by: Received by: Composite Sampling f1- Time begin am, pm Date Time end am, pm Date _/_/ Composite Samp1jng#2: Time begin am, pm Date Time end am, pm Date Time �'�y am, v pate �t / Sampled by: �.r p^ Timed am, pm Date l 1 / Transported by: 7_Y�_ T Time am, pm Date _/_ j Holding times met: V Time am, pm Date ___/_/ Compliance work: Non-compliance work: Lab Comments: Samples Transported On Ice: Initials: rn LD �z LO N O LO, 00 a) rn n o_ r- 00 l0 00 N U Z ul O +J m 41 U) 00 N N X O m 0 a Analytical Results Southern Soil Builders 958 Hoots Road Roaring River, NC 28669 Receive Date: 11/01/2018 Reported: 12/03/2018 For: Baxter Comments: T ppy�7� Sample Number Parameter Sample ID Result Unit Method 181101-21-01 Corrosivity Baxter See Attached SW-846 Analyzed Analyst 181101129-01 Ignitability Baxter 11/07/2018 Meritech 181101-21-01 Reactivity Baxter See Attached 1010M 11/07/2018 Meritech 181101-21-01 TCLP See Attached SW-846 11/07/2018 Meritech Baxter See Attached as Noted 11/07/2018 Meritech Respectfully submitted, 4 Dena Myers NC Cert #440, NCDW Cert #37755, EPA #NC00909 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 1 of 7 Condition of Receipt Sample Number 181101-21-01 Temp on Arrival: 2.3 Parameter Schedule: Reactivity Received on Ice Parameter Schedule: Corrosivity Received on Ice Parameter Schedule: Ignitability Received on Ice Parameter Schedule: TCLP Received on Ice PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 2 of 7 v O 03 0 x N N 00 r+ v rD to z n N 00 rn 00 V • V m w 00 v O N V � Ol lD V Client: i 1f _ - STATFS VYLLE ANALYT)Q1 L Address: , F --- — Q � 15 gj l Iry b 122 Court Street • P.O. Box 228 Statesville, NC 2,468i D` !r� �Y` 1o"^2;) ('�' J— -b (704) 8724697 ,., Contact Person: UPhone # 2?L nc� no,.e FAX# .7��_r. __ --- PO # `. ✓ ✓v - io 1 f V _ ✓ ifi T� - o -rt v I �..Cl-:l1R UI Requisitioned by: (True _"--Date)) r rtwr:�erivae Custady Record Customer Samplo IDx Lab -ID s ---•-- Time Sampled (Grab OnIYI Date Sampled o (Grab Only) I Matr x P',umoiucr5 rutucsted rnr;mal.•si� t+�i, w :oo�.r, _ _ _ jr-�-apt �Nv Relinquished by: �( Received by: Relinquished by: Received by: Composite Sampling #I - Time begin _.-_ am, pm Date _/_1_ Time end am, pm Date Composite Sampling #2- Time begin am, pm Date _/ / Time end __ am, pm Date Time) 5 am, pm Date ILI ! 1_o Sampled by: z� ��y-- Time t1556 am, pm Date Transported by: �+k Time am, pm Date _/_/ �. Holding times met: Time am, pm Date C I' Lab Comments: omp lance work. Non-compliance work: Samples Transported On Ice: Initials: Meritech, Inc. . Environmental Laboratory Laboratory Certification No. 165 _ 1 Contact: C. Little Client: Statesville Analytical 122 CourtSt Statesville, esville, NC 28677 Report Date: Project: Southern Date Sample Rcvd: Page 1 11/30/201.8 i Soil (Baxter) 1.1/6/2018 Meritech Work Order # 11.061.8130 Sample: 181101.21.01. Grab ' 11/1/201.8 ! - 1311 - TCLP Metals Parameter Results Analysis Date Dec, Limit Reg. i9 hod Arsenic Barium <0.100 mg/I 11/8/2018 0.100 5.0 1iPA 200.7 j Cadmium <0.050 mg/L <0.020 mg/L I1./8/2018 11/8/2018 0.050 100.0 0.020 EPA 200.7 Chromium Lead <0.050 m 1, g/ 11 8 201.8 / / 1.0 0.(lS0 �.0 5 EPA 200.7 'EPA 200.7 Mercury <0.1.00 mg/L <0,02 mg/L 11/8/2018 11/13/2018 0.100 5.0 0.02 EPA 2:00.7 i Selenium Silver 0.116 mg/L 1.1/8/2018 0.'2 0.100 1.0 EPA 245.1 , EPA 20.7 <U.USU mg/L 11/15/2018 0.050 �•0 EI A 2000.7 � - TCLP Organics Parameter Results Analysis Date Reporting Linrit Method ' Volatiles 8260 Attached 11/13/2018 Semi Vol.8270 Attached 11/2-0/2018 8260 8270 Other Tests Parametei Results Analysis at Rv99-r-tinp, Limit Method Cyanide, total Sulfide <0.500 mg/kg 11/14/2010 0.500 m l(g g/ 6 EPA 33S.4• i 1 nitabill g ty 1.84 m 1< g/ g Will Not Ignite 1.1. 12 201£1 / / 11/14/2018 10.0 mg/kg, SW 84.6 9038 ` Corrositivity (pH) 7.7 S.U. 11/18/2018 1.0 - 14.0 S.U, EPA 1030 r SM 4�00 1IB i 642 Tamco Road, Reidsville, North Carolina 27320 tel.(336)342-474.8 fax.(336)342-1.522 i PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 4 of 7 Meritech, Inc. - _ ]Environmental Laboratory Laboratory Certification No. 165 Contact; C. Little Page 2 Client; Statesville Analytical Report Date: 11/30/201.8 122 Court St Statesville, NC 28677 Project: Southern Soil (Baxter) Date Sample Rcvd; 11/6/2018 Meritech Work Order #i 1.1:061.13130 Sample; 181101.21.01 Grab :t1/1/2018 1311 - TCLP Pesticides &. Herbicides Pesticide - SW-B4 8081A Pa rain etet Endrin Chlordane Tomphene Methoxyclilor Heptachlor Lindane Results Analysis _Date Det. Limil Reg. Limit Dilution Factor <0.002 mg/L 11/14-1.6/1.8 0.002 0.02 <0.003 mg/L 11/14-16/18 0.003 0.03 <0.050 mg/L 11/14-16/18 0.050 0.5 <1.00 mg/L 11/14•-16/18 1.00 10.0 <0.0008 mg/l. 11/14-16/18 0.0008 0.008 <0.040 ing/L 11/14-16/18 0.040 0,4 Herbicides - S_W-8 '�6 8151A 1 1 1 1. 1 1 Parameter ----peter Resi — -� Analysis Date ,imit a =. Limit Dilution Factor 2,4-D <1.0 mg/1, 11/14-1.6/18 1..0 2,4,5-TP (Silvex) <i).10 m L 10.0 1 g/ 11/14-1.6/18 .0.10 :1-.0 1 1 Iter•eby CertiP that I hrive reviewed and approve these data. Laboratory Representative 642 Ta111CO Road, Reidsville, North Carolina 27320 tel.(336)342-4.74.8 fax.(336)342-1522 PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 5 of 7 0 MERI TECH, INC;. Environmental Laboratories Laboratory certificate #165 Client: Statesville Analytical Project: Sonlhern Soil (Baxter) Client Sample ID: 181101-21-01 Sample Collection: 1 1/01/18 Writech Sample Ill: 110618110 1311 - TCLP Organics Volatilcs: S14'-846 8260 Analysis: 1 1/13/18 Analyst. VWV rx U,lct i on: 1 1 /07/ 18 RcptlrtDate: 11/19118 Yar3nietei Result LIniq DO. Limit Reg, Llinit Dilution Racinr Benzene CarbunTetrilehloride 1-0.0100 mg/I., 0.0100 0.50 10 Chlorobenzene <O.UIUU mg1L U.U]OU 0.50 lU Chlorolbrm <:O.01.00 0.0100 mg/L, 0.0100 lU0 IU 1,2-Dichloroethr,ne < 0.0100 mg/L mg/1., 0.0100 6.0 10 III-Dichloroelhenc c, 0.0100 mg']-, 0,0100 0.0100 0. 10 114 Methyl Ethyl Keton 0.864 in /L 0,70 0 10 Tetrnchloroeti, lene Y <O,D100 ge mg/L U.10o 0.0I00 200 '10 '17•ichlor'uclllenc <(I,OJOo m L 0.0100 0.70 0.50 10 Vinyl C:hloricle < 0.0200 mg/L• 0,020 0.20 10 10 Semi-VolatlIcs: SW-846 8270 Analysis: 1.1/20/18 Analyst: pM lxtracti on: 11/07/'18 Report Dale: 11/21/18 Plramcter 1,44Achl01-01L)en7e11e Result Unils Det. Unlll Reg. Limit Dilution Factor. Hemoblor•obcnrene <0.100 0.1 UO mg/L• 0.100 7.5 10 Ilexachloro-1,3-butadiene <0.100 mg/L n,g/I- 0.100 0.100 0.13 10 1-lex,whloroethane =t).100 n, L O.lOU 0.5 3,00 l0 o-cresol M&P-cresol <0.100 m�L 0.100 200 10 10 Total cresols <0,200 ❑19/ !� 0.200 200 10 <0.300 nlg/L U.3U0 200 10 Poillabcnxenc Penclinell ropilenul •<0.100 •�O.5o0 mg/L 0.1 DO 2.00 10 Pyridine <o.100 mg/L nlg/I., Q.5Q0 100 10 2,1I,5-Ti.id) loro henol P �<0, IOU rng/l, 0.100 5.0 to 2',4,6-Trtchlorophenol <0.IOo n,g/L o. 100 0.100 400 10 2,4-Diuilrololucne '••0.100 mg/L 0.100 2.00 10 0.13 10 / herehY cel•lify (Il(1L I ham replelpe(I and approve IAese (i(rla. / —�- I/«+vtss- LV Uti Laboratory Represenl(rlipe 642 Tameo Road * Reidsville, NC 27320 (336) 342-4748 * info@meritechlabs.com PO Box 228 • Statesville, NC 28687 • 704/872/4697 Page 6 of 7 sst,a Chain of Custody Record (COC) NPDES#• a-kysylUfA&�1b4►`1 ` hone: Address: 122 n (,ET SE Fax: tS rn�`tur, WC Z�' o Emaii:_ Project:% a 1" SPI t P,O•#: Attention: Turn AroundTirne" "RUSH work needs prior approval, How would you like your report sent? Char es A oiy Std(10 s) 3-5 Da•s 24-48 Hrs Circle all that apply: Email (preferred) , Fax, Mail I�iIERIT'ECH INC.Client: 1 ENVIRONMENTAL LABORATORIES r'. 642 Tamco Rd. Phone: 336-342-4748 Reidsville NC 27320 Fax: 336-342-1522 Email: info@meritechiabs.com www.meritechiabs.com Sample Location and/or ID # Sampling Dates & Times Person Taking Sample(Sigri/Print): Lab Use Only Start End Comp? Grab? #of Cont. Test(s) Required es N Yes / No pH OK - CI OK? Date Time Date Time 1 thl . V—EwmhlI Temperature Upon Receipt: Method of """ Dechlorination (<0.5 ppm) of Ammonia, cyanide, Phenol and TKN samples must be done in the field prior to preservation,. ""* S Shipment: Comments: Compositor # Jug# UPS Fed Ex rr--�� Are t es rdults for regulat purposes? Yes 'Q, No J ' g/ g/ g g/ Report feSUItS In: m L m k u L p mJ! �;. Hand Delivery/ Other Relinquished by: j t l .' 1 ate ' /' _me: �7 �^�{ U Yl 7(/ Relinquished b /� / Vie: T' Received , / pat !,�` Time: G / O'-'! u Received by. Date: Time: Relinquished by: Date: Ti e: Received D e: � �; Ti e•• 14 1 ;r'?r 00 00 N U Z ai co 00 N rV X 0 on 0 a- ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules) Facility Name: Baxter Healthcare Corporation WQ Permit Number: WWTP Name: Baxter Healthcare Corporation NPDES Number: Monitoring Period: From 1/1/2018 To 12/31/2018 WQ0031725 NC0006564 Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative nerformed- Class A: Alt. A (time/teinp) Alt B (Alk Treatment) [ Alt. C (Prior Testing)D AIt.D (No Prior Test) rocess to Further Reduce Pathogengs I If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens": Compost ( Heat Drying El Heat Treatment. El Therinophilic L. Beta Ray Li Gamma Ray D Pasteurization El Class B: JAIL (1) Fecal Density 21 Alt. (2) Process to Significantly Reduce Pathogens If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens": Vl Lime Stabilization j� Air Drying Composting L3 jAerobic Digestion 0 Anaerobic DigestionL ...... .....,.:...... .......:....... " ........ ... .... If applicable to alternative performed (Class A or Class B) complete the following monitoring data: Parameter Allowable Level Pathogen Density g y Number o Frequency Sample na-lytica in Sludge Exnee- of Anal sis y . Type Tech - Minimurnbeo. Mean Maximurr Units _ ni Le 2 x 10 to the 6th power MPN 593 2025 3650 MPN/g 0 7 grab sm9221 per gram of Fecal Coliform total solids CFU 1000 mpn per gram of total solid (dry weight) Salmonella bacteria 3 MPN per 4 grams (in lieu of fecal total solid (dry coliform) weight v Ccwr Huraction .Reduction (15A 1NCAC 02T .1107) - Please indicate alternative nerfnrmerl. Alt..) (VS reduction) Alt. 2 (40-day bench) ® Alt. 3 (30-day bench) El JAIL 4 (Spec. Oz uptake) I. Alt. 5 (14-Day Aerobic) ® Alt. 6 (Alk. Stabilization Q Alt 7 (Drying - Stable) U JAIL 8 (Drying - Unstable) l Alt. 9 (Injection) 1I Alt. 10 (Incorporation) 0 No vector attraction reduction alternatives were performed L� CERTIFICATION STATEMENT (please check the appropriate statement) "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the vector attraction reduction requirement in 15A NCAC 02T .1107 have been met." "I certify, under penalty of law, that the pathogen requirements in 15A NC.AC 02T .1106 and the vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note if you check this statement attach an explanation why you have not met one or both of the requirements.) "This determination has been made under my direction and supervision in accordance with the system designed to ensure that qualified personnel properly gather and evaluate the information used to determine that the pathogen and vector attraction reduction requirements have been met. I am aware that there are significant penalties for false certification including fine and imprisonment." Aa `Ore CfDlln '8e- E/6 Dennis Key Southern Soil Builders, Inc. Prepar r Name and Title (type or print) Land Applier Name and Title (if applicable)(type or print) Signat e of Pi parer* Date of APplien (if applicable) DateSign *Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1 102 (26) DENR FORM PVRF 02T (12/2006) NCDA&CS Agronomic Division Phone: (919) 733-2655 Website: www.ncagr.gov/agronomi/ Report No. FY19-SL004329 Predictive Client: `\ l '2 Doug Poplin Advisor: 594 Austin Little Mtn Rd Zach Key Southern Soil Builders, Inc. z 4 Soil ReportMehlich-3 Extraction Ronda, NC 28670 958 Hoots Rd ° c Roaring River, NC 28669 Sampled County: Wilkes Links to Helpful Information Sampled: 09/05/2018 Received: 09/10/2018 Farm: Not Provided Completed: 09/20/2018, Client ID: 160157 Advisor ID: 231531 Sample ID: DP1A Recommendations: Lime Nutrients (lb/acre) More Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: 1- Fescue/OGrass/Tim, M 0.0 120-200 0 0 0 0 0 0 0 0 Note: 12 2 - 0.0 Test Results [units - W1V in g/crrr3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral HM% WN CEC' BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-1 Na ESP SS-1 NO3-N 0.66 0.96 15.2 89 1.6 6.3 551 334 58 20 49 185 124 513 513 1409 0.2 1 Sample ID; DP1 B Recommendations: Lime Nutrients (lb/acre) More Crop (tonslacre) N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: 1- Fescue/OGrass/Tim, M 0.0 120-200 0 0 0 0 0 0 0 0 Note: 12 2 - 0.0 Test Results [units - W/V in 9/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-1 Na ESP SS-1 NO3-N 0.46 0.95 13.5 90 1.4 6.4 286 151 59 25 52 155 104 727 727 879 0.2 1 Sample )D: DP1C Recommendations: Lime Nutrients (lb/acre) More Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B Information Lime History: 1- Fescue/OGrass/Tim, M 0.0 120-200 0 0 0 0 0 0 0 0 Note: 12 2 - 0.0 Test Results [units - W/V in g/ctrr3; CEC and Na in meq/100 cm3; NO3-N in mgldlo]: Soil Class: Mineral 11M o vtii'vCEC 13070 Ac pi-i P-i A-i Ca o nng o S-i ivin-i ivin-An ivin-Ai2 Zn-t Zn-Al Gu-i Na Mor SS-i ivu3-11Y i 0.56 1.01 12.0 86 1.6 6.2 226 80 60 23 43 271 176 641 641 1366 0.2 2 North Carolina [A, Tobacco Trust Fund Commission Reprogramming of the laboratory -information -management system that makes this report possible is being funded through a grant from the North Carolina Tobacco Trust Fund Commission. Thank you for using agronomic services to manage nutrients and safeguard environmental quality. Steve Troxler, Commissioner of Agriculture I NCDA&CS Agronomic Division Phone: (919) 733-2655 Website: www.ncagr.gov/agronomi/ Report No. FY19-SL004329 Doug Poplin Page 2 of 4 Sample ID: DP1D Recommendations: Lime Nutrients (lb/acre) Crop (tons/acre) Lime History: 1- Fescue/OGrass/Tim, M 0.0 N P2O5 120-200 0 K2O Mg S Mn Zn Cu B More Information 2- 0.0 10 0 0 0 0 0 0 Note: 12 Test Results [units - WIV in g/cmR; CEC and ":a In meq/100 cm3; NO3-N in mg/drn3]: I Soil Class: Mineral Hm1io VVII-V CEC BS% AC H P- p ! K-I ° o Ca /° iF1g /° S-i Mn-i firm -Ali Mn-Al2 Zn-I Zn-AI Cu-I Na I ESP SS-1 NO3-N 0.51 1.01 10.7 85 1.6 6.2 201 77 57 25 50 246 162 522 522 647 0.2 2 Sample ID: DP2 Recommendations: Lime Nutrients (lb/acre) Lime History: Crop (tons/acre) 1 -Corn, silage 0.8 N P2O5 K2O M9 S Mn Zn Cu More Information 180-220 0 0 0 0 0 0 0 0 0 Note:3 2- 0.0 Test Results [units - WN in g/crn3; CEC and Na in meq/100 crnr ; NO3-N in mg/drrr3]: Soil Class: Mineral HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS -I NO3-N 0.46 0.99 7.8 75 2.0 5.6 179 136 48 18 64 163 115 208 208 638 0.2 3 Sample ID: DP3C Recommendations: Lime Nutrients (lb/acre) Crop (tons/acre) Lime History: 1-Fescue/OGrass/Tim, M 1.8 N P2O5 120-200 0 K2O Mg S Mn Zn Cu B More Information 2- 0.0 0 0 0 0 0 0 0 Note: 12 Test Results [units - WN in g/cnr3; CEC and Na in meq/100 cmr ; NO3-N in mg/drn3]: Soil Class: Mineral HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.71 0.93 8.0 63 2.9 5.0 332 109 37 ' 19 133 123 91 507 507 554 0.2 3 Sample ID: DP3G Recommendations: Lime Nutrients (lb/acre) Lime History: Crop (tons/acre) 1- Corn, silage 0.0 N P2O5 180-220 K2O Mg S Mn Zn Cu B More Information 2- 0.0 0 160 0 0 0 0 0 0 Note: 3 Test Results [units - WN in g/cn�; CEC and Na in meq/100 crn3; NO3-N in mg/do]: Soil Class: Mineral HM% W/V CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N I 0.41 0.94 9.7 83 1.7 6.1 89 22 51 31 68 94 71 424 424 449 0.2 2 I NCDA&CS Agronomic Division Phone: (919) 733-2655 Website: ronomi/ Report No FY19-SL004329 Doug Poplin Page 3 of 4 Sample ID: DP4 Recommendations: Lime Nutrients (lb/acre) Lime History: Crop (tons/acre) N P2O5 1- Fescue/OGrass/Tim, M 0.0 120-200 0 K2O Mg S Mn Zn Cu B More Information 2 - 0.0 80 0 0 0 0 0 0 Note: 12 ,Test Results [units - WN in g/crrr3; CEC and Na in meq/100 cm3; NO3-N in mg/drrr3]: Soil Class: Mineral HM% Wni CEC BS;o Ac pH P-i K-1 Ca% Mg% S-1 Mn-I ruin-A11 Mn-Al2 Zn-1 Zn-AI Cu-I Na ESP SS-1 NO3-N 0.46 1.03 13.5 90 1.4 6.5 175 31 56 33 58 98 69 1025 1025 690 0.2 1 Sample ID: DP5 Recommendations: Lime Nutrients (lb/acre) Lime History: Crop (tons/acre) N P2O5 1- Fescue/OGrasslTim, M 0.8 120-200 K2O Mg S Mn Zn Cu B More Information 0 2- 0.0 60 0 0 0 0 0 0 Note: 12 Test Results [units - WN in g/cO; CEC and Na in meq/100 cm3; NO3-N in mg/dni3]: Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.46 1.02 9.9 79 2.1 5.6 130 40 51 26 59 104 79 531 531 510 0.2 2 Sample ID: DP6 Recommendations: Lime Nutrients (lb/acre) Crop (tons/acre) N P2O5 Lime History: 1-Fescue/OGrass/Tim, M 0.0 120-200 0 K2O Mg S Mn Zn Cu B More Information I 2- 0.0 0 0 0 0 0 0 0 Note: 12 Test Results [units - WN in g/cO; CEC and Na in meq/100 cmr3; NO3-N in mg/dO]: Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N 0.51 1.05 11.2 88 1.4 6.2 73 89 58 26 49 138 97 640 640 481 0.2 2 Sample ID: DP7 Recommendations: Lime Nutrients (Ib/acre) Lime History: Crop (tons/acre) N P2O5 1- Fescue/OGrass/Tim, M 1.0 120-200 K2O Mg S Mn Zn Cu B More Information 0 2- 0.0 10 0 0 0 0 0 0 Note: 12 Test Results [units - WN in g/cO; CEC and Na in meq/100 cm3; NO3-N in mg/dnft Soil Class: Mineral HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N I 0.56 1.05 9.4 77 2.1 5.5 302 78 57 17 52 155 110 513 513 998 0.2 2 Medical Products neater February 27, 2019 Division of Water Resources Information Processing Unit 1617 Mail Service Center Raleigh, NC27699-1617 RE: 2018 Annual Land Application Report Permit No. WQ0031725 Baxter Healthcare Corporation McDowell County Please find the enclosed annual land application report for calendar year 2018. No non- compliance or other irregular events occurred in 2018. If you have any questions or require additional information, please contact me at 828-756-6636. Sincerely Corey Carpentier Sr. Environmental Engineer Attachment: 2018 Land Application Report (3 copies with enclosures) Cc: EHS File Copy