WQ0011431_Renewal Application_20190701

INITIAL REVIEW
Reviewer Thornburg, Nathaniel
Project Number* WQ0011431
SUBMITTAL DATED: 6/28/2019
Project Contact Information
Rease provide inforrration on the person to be contacted by MB Staff regarding electronic submittal, confirmation of receipt, and other issues.
......................................................................................................................................................................................................................................................................................................................................................................................................
Name * Rob Willcox
Email Address*
rob@Wllco)Tnabesoil.com
Project Information
Application Type* r
New
r
Renewal
r
Annual Report
Permit Type * r
Wastewater Irrigation
r
Other Wastewater
r
Closed -Loop Recycle
r
Single -Family Residence
Wastewater Irrigation
Is a paper copy of the application being submitted?*
r Yes r Nor N/A
Permit Number WQ0011431
currently has project
Applicant\Permittee * Town of Cleveland
Facility Name * Town of Cleveland WWTP
Phone Number*
336-339-9128
r Modification (Major or Minor)
r Additional Information
r Other
r High -Rate Infiltration
r Reclaimed Water
r Residuals
r Other
Please provide comments/notes on your current submittal below.
Please attach all information required or requested for this submittal to be review here.
Application Form Engineering Rans, Specifications, Calculations, Etc.)
15-03 Town of Cleveland Residuals Land
Application Program - Permit Renewal June-2019- 39.44MB
signed.pdf
upload only 1 R7F docurrent. IVUltiple documents rust be corrbined into one R7F file.

For new and modification permit applications, a paper copy may be required. If YGL' have any questions
about what is required, please contactthe reviewer or Tessa Monday. If a aaoe- a1,o1:cation is required,
be advised, applications accepted far pre -review until both the paper and eIect-c-i_ col. es -,ave been
received. The paper copy shall include the following:
o Application Form
o All relevant attachments (cales, soils
report, specs, etc.)
o One full-size engineering plan set
o One 11x27" engineering plan set
o One extra set of specifications
o Fee (if required)
Mailing address:
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
By U.S. Postal Service
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
By Courier/Special Delivery:
�----------------------------------------------------------------------------
---------------------------
❑ivision of Water Resources
i Division of Water Resources
-------------- - ---- ----- -----------------------------------
Non -Discharge Branch
1---------
Non -Discharge Branch
1617 Mail Service Center
i Aft: Nathaniel Thornburg, 90 Floor, O f`uce #942W
Raleigh. NC 27699-1617
512 N. Salisbury St.
Far questions or problems contact Tessa Monday [e-mail] or 919.707.3560.
* I;W By checking this box I acknowledge that I understand the application will not be accepted
for pre -review until the paper copy (if required) and fee (if required) have been received by
the Non -Discharge Branch. I also confirm that the uploaded document is a single PDF with
all parts of the application in correct order (as specified by the application).
Signature
Submission Date 6/28/2019

APPLICATION FOR
RESIDUALS LAND APPLICATION PROGRAM
PERMIT RENEWAL
TOWN OF CLEVELAND WWTP
PERMIT NO. W00011431
WMSS Project No. 15-03
Prepared for:
Town of Cleveland
Post Office Box 429
Cleveland, North Carolina 27013
Prepared by:
Willcox & Mabe Soil Solutions, PLLC
7231 B Summerfield Road
Summerfield, North Carolina 27358
willcox&mabe
5 0 1 L S❑ L U T 10 N S
June 2019

willcoX&'l abe
SOIL SOLUTIONS
June 28, 2019
NCDEQ/DWR
Water Quality Permitting Section
Non -Discharge Permitting Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Attention: Non -Discharge Permitting Unit
Reference: Application for Residuals Land Application Program
Permit Renewal
Town of Cleveland WWTP
Permit No. WQ0011431
Willcox & Mabe Soil Solutions, PLLC Project No. 15-03
Non -Discharge Permitting Unit:
Willcox & Mabe Soil Solutions, PLLC (WMSS) is submitting the enclosed Residuals Land
Application Program Permit Renewal application for the Town of Cleveland WWTP
(Cleveland) on behalf of Cleveland and BioGreen Services, Inc. (BioGreen). The permit
renewal package includes information for:
Renewal of one field (10.0 net acres), Town of Cleveland (Site 1, Field 1).
Current annual volume of 82.0 dry tons to remain the same.
If there is any further information required or questions regarding this application please do
not hesitate to contact Cleveland, Ms. Cathy Payne at [phone], or WMSS at (336)
339-9128 for further assistance.
Sincerely,
Willcox & Mabe Soil Solutions, PLLC
Martin Mabe
Agronomist
cc: Town of Cleveland
Rob Willcox, L.S.S.
Soil Scientist
Shared\WMSS Projects\2015\15-03 Bio-Green Services\Phase 03A - Cleveland Permit Renewal\15-03 Town of
Cleveland Residuals Land Application Program - Permit Renewal June-2019.doc
Willcox & Mabe Soil Solutions, PLLC / 7231 B Summerfield Road / Summerfield, INC 27358 / Rob 336.339.9128 or
Martin 336.312.1396 / www.willcoxmabesoil.com

TABLE OF CONTENTS
APPENDIX TITLE
Page 1
RESIDUALS LAND APPLICATION PROGRAM
APPLICATION FORM
(FORM: RLAP 06-16)
OPERATION AND MAINTENANCE PLAN (Updated)
COPY OF EXISTING PERMIT
(PERMIT NO. WQ0011431)
II RESIDUALS SOURCE CERTIFICATION
• TOWN OF CLEVELAND
(FORM: RSC 06-16)
III LAND APPLICATION SITE CERTIFICATION
(FORM: LASC 06-16)
Renewal Site
IV TOWN OF CLEVELAND (SITE 1, FIELD 1)
LANDOWNER AGREEMENT
(FORM: LOA 06-16)
UPDATED SITE MAPS
UPDATED CUMULATIVE POLLUTANT LOADING RATES

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

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

State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .1100 — RESIDUALS LAND APPLICATION PROGRAM
INSTRUCTIONS FOR FORM: RLAP 06-16 & SUPPORTING DOCUMENTATION
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This application is for treatment, storage, transport, and/or land application of Class B residuals (may include residuals that
are generated from a water treatment plant or other type facilities) on the proposed or currently approved land application site(s) under
15A NCAC 02T .1100.
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Land Application Program (FORM: RLAP 06-16) Application: (All Application Packages):
® Submit the completed and appropriately executed Residuals Land Application Program (FORM: RLAP 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
® The Applicant's Certification on Page 5 of this form shall be signed in accordance with 15A NCAC 02T .0106(b). An alternate
person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria in 15A
NCAC 02T .0106(b).
® If this project is for a modification of an existing permit, submit one copy of the existing permit.
® Please submit this application form at least 180 days prior to the expiration date on the existing permit, or 90 days prior to
operation of proposed facility(ies) for application packages involving new or changes to treatment and storage units.
B. Application Fee (New and Major Modification Application Packages)
10 Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environmental
Quality (NCDEQ). (Renewal Only — no requested changes)
Facility Classification
New Permit
Major Modification 1
Major (land are permitted for > 300 acres)
$1,310
$395
Minor (land are permitted for < 300 acres)
$810
$245
' - A major modification shall be defined as any permit modification that: increases the generating facility's residuals dry tonnage;
adds additional land application areas not previously approved for that particular program [including transferring of field(s) from
one program to another]; adds additional residuals sources; or includes the addition of new treatment or storage units/processes not
previously permitted. There is no fee for minor modifications to a permit.
C. Cover Letter (All Application Packages)
® List all items included in the application package, as well as a brief description of the requested permitting action.
D. Environmental Assessments (May be Required — See 15A NCAC 1 C .0300) (N/A)
❑ Submit a copy of the Findings of No Significant Impact (FONSI) or Environmental Impact Statement (EIS). Also, include
information on any mitigating factor(s) from the Environmental Assessment (EA) that impact the construction of the residuals
treatment and storage facilities. An EA may also be required for private systems if any public funds and/or lands are used for
the construction of the subject facilities.
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 1 of 3

E. Operation and Maintenance Plan (New and Renewal Application Packages) (UPDATED — APPENDIX I)
❑ For Modification Application, if there are any changes to the existing plan, submit an updated O&M plan.
❑ Submit the O&M Plan in accordance with 15A NCAC 02T .1110 and include at a minimum:
❑ Operational functions; describe the operation of the program to show what operations are necessary for the program to
function and by whom the functions are to be conducted.
❑ Maintenance schedules; may include equipment calibration, maintenance of signs, etc.
❑ Safety measures; may include safety training program, manuals, signs, etc.
❑ Spill response plan; including control, containment, remediation, emergency contact information, etc.
❑ Inspection plan including the following information;
❑ Names and titles of personnel responsible for conducting the inspections.
❑ Frequency and location of inspections, including those to be conducted by the ORC, and procedures to assure that the
selected location(s) and inspection frequency are representative of the residuals management program.
❑ Detailed description of inspection procedures including record keeping and actions to be taken by the inspector in the event
that noncompliance is observed.
❑ Sampling and monitoring plan including the following information;
❑ Names and titles of personnel responsible for conducting the sampling and monitoring.
❑ Detailed description of monitoring procedures including parameters to be monitored.
❑ Sampling frequency and procedures to assure that representative samples are being collected. Fluctuation in temperature,
flow, and other operating conditions can affect the quality of the residuals gathered during a particular sampling event. The
sampling plan shall account for any foreseen fluctuations in residuals quality and indicate the most limiting times for
residuals to meet pathogen and vector attraction reduction requirements (e.g. facilities that land apply multiple times per
year but have an annual sampling frequency, may need to sample during winter months when pathogen reduction is most
likely to be negatively affected by cold temperatures.
THE FOLLOWING ADDITIONAL ITEMS (G to M) ARE REQUIRED FOR DEDICATED PROGRAM ONLY. (N/A)
F. Program Determination
❑ Dedicated residuals land application programs are ones in which land application sites meet the criteria in 15A NCAC 02T
.110202). Specifically, a residuals land application program is designated as dedicated if any of the following are applicable:
❑ Any land application site certified for the residuals land application program that receives residuals at rates or frequencies
greater than agronomic rates.
❑ Any land application site certified for the residuals land application program that is used primarily for residuals disposal,
and agricultural crop production is of secondary importance.
❑ Any land application site certified for the residuals land application program that receives residuals through fixed irrigation
facilities or irrigation facilities fed through a fixed supply system.
rl Please contact the Non -Discharge Permitting Unit if you need any assistance in determining whether your residuals program
falls under the dedicated program definitions.
G. Program Information
❑ Provide an explanation of why a dedicated system is required instead of a conventional non -dedicated system.
❑ Provide an explanation of the dedicated system and its operation.
H. Detailed Site Maps (All New or Modification Application Packages)
❑ Submit three (3) sets of standard size plans and two (2) sets of I I" by 17" plans (electronic format is acceptable - Adobe PDF
only). For Modifications, submit plans specific to the modification(s) only.
❑ Plans must include the following minimum items:
❑ A general location map, a vicinity map and a topographic map with contours not exceeding 10 feet or 25% of the total site
relief and showing all facility related structures and fences within the land application area.
❑ The location of all wells (including usage and construction details if available), streams (ephemeral, intermittent, and
perennial), springs, lakes, ponds, and other surface drainage features within 500 feet of the land application site(s).
❑ Delineation of the review and compliance boundaries
❑ Setbacks as required by 15A NCAC 02T .1108
❑ Site property boundaries within 500 feet of all waste treatment, storage, and disposal site(s).
❑ A map showing the entire irrigation area with an overlay of the suitable irrigation area depicted by the soil scientist's
evaluation. The irrigation plans shall show each nozzle/emitter and wetted area (when applicable). Clearly label spray
irrigation zones as they will be operated.
❑ Plans must depict a completed design and not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT FOR
CONSTRUCTION, etc.) that indicate that they are anything other than final plans. However, the plans may be labeled with
the phrase: FINAL DESIGN - NOT RELEASED FOR CONSTRUCTION
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 2 of 3

I. Project Evaluation and Receiver Site Management Plan (All New Application Packages or Modifications that include new sites)
❑ Submit a project evaluation and a receiver site management plan (if applicable) with recommendations concerning cover crops
and their ability to accept the proposed application rates.
J. Hydrogeologic Report (All New Application Packages or Modifications involving increasing the total design capacity)
❑ Submit a detailed hydrogeologic evaluation in accordance with 15A NCAC 02T .1104(d)(4) and current Division Policy
available at: http://www.ncwater.ory/Rules Policies and -Regulations/. The document shall be signed, sealed and dated by a
qualified professional.
K. Engineering Design Documents (All New or Modification Application Packages with fixed irrigation facilities or irrigation
facilities fed through fixed supply system)
❑ Submit engineering design documents that have been signed, sealed, and dated by a NC licensed Professional Engineer and/or
Professional Land Surveyor in accordance with 15A NCAC 02T .1104(d)(2). For Modifications, submit an updated site map
specific to the modification(s) only.
The design documents must include the following minimum items:
❑ Engineering plans for the facility and equipment except those previously permitted unless they are directly tied into the new
units or are critical to the understanding of the complete process;
❑ Specifications describing materials to be used, method of construction, and means for ensuring quality and integrity of the
finished product including leaking testing; and
❑ Engineering calculations including hydraulic and pollutant loading, sizing criteria, hydraulic profile, total dynamic head
curve analysis for each pump, and irrigation design.
❑ Soil mapping units shown on all disposal sites.
L. Water Balance (All New Application Packages or Modifications that include new sites utilizing fixed irrigation facilities or
irrigation facilities fed through fixed supply systems)
❑ Submit a completed and accurate water balance in accordance with 15A NCAC 02T .1104(d)(5) and current Division Policy
available at: http://www.ncwater.or /g Rules_ Policies_ and Regulations/.
M. Property Ownership Documentation (All New or Modification Application Packages involving new and/or relocated treatment
or irrigation components)
❑ Property ownership documentation shall consist of one of the following:
❑ Legal documentation of ownership (i.e., GIS, deed or article of incorporation), or
❑ Written notarized intent to purchase agreement signed by both parties with a plat or survey map, or
❑ An easement running with the land specifically indicating the intended use of the property and meeting the requirements of
15A NCAC 02L .0107(fl, or
❑ A written notarized lease agreement signed by both parties, indicating the intended use of the property, as well as a plat or
survey map.
ONE ORIGINAL AND TWO COPIES OF THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL
SUPPORTING INFORMATION AND MATERIALS, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service:
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
TELEPHONE NUMBER: [phone]
By Courier/Special Deliverv:
512 N. SALISBURY STREET
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: RLAP 06-16 Page 3 of 3

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .1100 — RESIDUALS LAND APPLICATION PROGRAM
FORM: RLAP 06-16
I. APPLICANT INFORMATION:
1. Applicant's name: Town of Cleveland
Applicant type: ❑ Individual ❑ Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
❑ Federal ❑ State ® Municipal ❑ County
Signature authority's name per 15A NCAC 02T .0106: Danny Gabriel Title: Mayor
Applicant's mailing address: Post Office Box 429
City: Cleveland State: N.C. Zip: 27013
Telephone number: [phone] Email Address: [e-mail]
2. Consultant's name: Rob Willcox, L.S.S. License Number (for P.E.): N/A
Affiliation: ❑ On Staff ® Retained (Firm: Willcox & Mahe Soil Solutions, PLLC)
Consultant's mailing address: 7231B Summerfield Road
City: Summerfield State: N.C. Zip: 27358
Telephone number: [phone] Email Address: rob(a)willcoxmabesoil.com
3. Agronomist's name: Martin Mahe License Number: N/A
Affiliation: ❑ N/A ❑ On Staff 0 Retained (Firm: Willcox & Mahe Soil Solutions, PLLC)
Agronomist's mailing address: 7231B Summerfield Road
City: Summerfield State: N.C. Zip: 27358
Telephone number: [phone] Email Address: martinna,willcoxmabesoil.com
4. Soil Scientist's name: Rob Willcox, L.S.S. License Number: 1098
Affiliation: ❑ N/A ❑ On Staff ® Retained (Firm: Willcox & Mabe Soil Solutions, PLLC)
Soil Scientist's mailing address: 7231B Summerfield Road
City: Summerfield State: N.C. Zip: 27358
Telephone number: [phone] Email Address: rob(a)willcoxmabesoil.com
5. Fee submitted: $0.00 (See Instruction B)
II. PERMIT INFORMATION:
1. Application is for (check all that apply): ❑ new, ❑ modified, renewed permit
2. If this application is being submitted to renew or modify an existing permit, provide the following:
Permit number: W00011431
Date of most -recently issued permit: January 1, 2015
Date of most -recently certified Attachment A (if different than the permit): July 24, 2017
Date of most -recently certified Attachment B (if different than the permit): _
FORM: RLAP 06-16 Page 1 of 5

III. RESIDUALS LAND APPLICATION PROGRAM INFORMATION:
1. Residuals Processing Facility's physical address: Third Creek Church Road
City: Cleveland State: N.C. Zip: 27013
Coordinates: Latitude: 35' 44' 37.7" Longitude: 80' 40' 59.8"
Datum: NAD83 Level of accuracy: one tenth of a second
Method of measurement: MAP
2. County where residuals land application program is headquartered: Rowan
3. List the Operator In Responsible Charge (ORC) and all Back -Up ORCs for the residuals land application program, their
certification numbers, and their affiliations in the following table:
Designation
Name
Affiliation
Certification Number
ORC
Sherrill Ray Gambill
Bio-Green Services, Inc.
985951
Back -Up ORC
Denise Gambill Harrison
Bio-Green Services, Inc.
989912
Additional Back -Up
ORCs
(if applicable)
_
If an ORC and at least one Back -Up ORC are not currently designated for this residuals land application program, provide the
candidates' names, affiliations, and an estimated time schedule for each candidate's completion of the required training school
and certification test:
4. Complete the following tables regarding management of the residuals land application program:
a. Plant Available Nitrogen Summary: Determine the maximum plant available nitrogen (PAN) generated by all residuals
source -generating facilities as currently certified and proposed for certification with this application and list the results in the
following table:
Maximum amount of residuals to be certified: 82.0 dry tons per year.
PAN
Pounds of PAN per Dry Ton
(Weighted Average)
Pounds of PAN per Year
Surface
Incorporation
or Injection
Surface
Incorporation
or Injection
First -Year
34.33
34.60
2,815
2,837
Five -Year Maximum Adjusted
51.32
51.59
4,208
4,230
b. Land Application Site Use Summary: Summarize information regarding the land application sites as currently certified and
proposed for certification with this application:
Category
Use
Acres
Comments
Crops
Forest or Plantation
Row Crops
Hay
10.0
Pasture
hm-
Total:
10.0
Methods
Surface
10.0
Incorporation or Injection
Total:
10.0
FORM: RLAP 06-16 Page 2 of 5

c. Residuals Land Application Summary: Determine the minimum acreage required to land apply the residuals as currently
certified and proposed for certification assuming the scenarios listed in the following table:
Assumed
Application Rate
(lbs PAN/ac yr)
Acres Required Using
First -Year PAN Concentrations
Acres Required Using
Five -Year Maximum Adjusted PAN
Concentrations
Surface
Incorporation or
Injection
Surface
Incorporation or
Injection
50
40.6
40.9
62.1
62.4
100
20.3
20.4
31.1
31.2
150
13.5
13.6
20.7
20.8
200
10.1
10.2
15.5
15.6
6. If applicable, provide a plan and a schedule to resolve any known issues that would prevent land application of the proposed
residuals due to the violation of North Carolina Administrative Code (e.g. not enough storage, not enough land, vector reduction
practices not in place, etc.):
7. Specify type of residuals program (See Instruction F): ® Non -dedicated ❑ Dedicated
If Dedicated, specify the following (check all that apply):
❑ Residuals program contains any land application site(s) that receives residuals at rates or frequencies greater than agronomic
rates, explain;
❑ Residuals program contains any land application site(s) that is used primarily for residuals disposal, and agricultural crop
production is of secondary importance, explain;
❑ Residuals program contains any land application site(s) that receives residuals through fixed irrigation facilities or irrigation
facilities fed through a fixed supply system, explain;
IV. RESIDUALS SOURCE INFORMATION: (Required for all new, renewed, or modified residuals source)
Complete and submit the following Residuals Source Certification and all associated documentation.
I R_
Residuals Source
Certification APPENDIX II
V. LAND APPLICATION SITE INFORMATION: (Required for all new, renewed, or modified land application site)
Complete and submit the following Land Applications Site Certification and all associated documentation.
IR
Land Application Siite
Certification.doc APPENDIX III
FORM: RLAP 06-16 Page 3 of 5

Note: Item VI. Applicable to Dedicated Program with fixed irrigation system on1X.
VI. DESIGN INFORMATION FOR FIXED IRRIGATION SYSTEM (N/A)
1. The irrigation system is: 0 Spray 0 Drip
2. Disposal system is: ❑ existing a proposed.
3. Minimum depth to mean seasonal high water table (SHWT) within irrigation sites(s) per Soil Scientist's Evaluation: feet
below ground surface. Rules 15A NCAC 02T .0505(p) requires at least one -foot vertical separation between SHWT and ground
surface.
4. Are there any artificial drainage or water movement structures within 200 feet of any irrigation area?
❑ Yes or L] No If Yes, please explain if the soil scientist report addresses artificial structures and please indicate if
structures are to be maintained or modified:
5. Loading rates recommended by the Soil Scientist Evaluation:
Soil Series
Fields within Soil Area
Recommended
Loading Rate
in/hr
Recommended
Loading Rate
in/ r
6. Design loading rates are equal or less than the loading rates recommended by Soil Scientist?
Yes or ❑ No If No, explain why 15A NCAC 02T .0505(n) is not met: t-
7. Non -dedicated System Design (fill in the appropriate information for either a spray or drip irrigation system):
Field /Zone
Design Area
(ft2)
Number of
Nozzles
Maximum Application
Rate ( allons/hr)
Design Annual Loading
Rate ( allons/ r
■
Total
Spray Irrigation Design Element
Plan Sheet
Number
Specification
Pa a Number
Wetted diameter of nozzles
ft
_
Wetted area of nozzles
ft2
Nozzle capacity
gpm
-
Nozzle manufacturer / model
Elevation of highest nozzle
ft
FORM: RLAP 06-16 Page 4 of 5

Applicant's Certification (signing authority must be in compliance with 15A NCAC 02T .0106):
The applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without proper
closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any active
compliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02T .0105.
0 Yes E] No, Explain;
I, Danny Gabriel Mayor
(Signature Authority's Name — PLEASE PRINT) (Title)
attest that this application for Renewal to the Town of Cleveland Non-Discharize Permit No. W 0011431
(Facility Name)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that the Division of Water Resources
may not conduct a technical review of this program and approval does not constitute a variance to any rules or statutes unless specifically
granted in the permit. Further, any discharge of residuals to surface waters or the land will result in an immediate enforcement action,
which may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water
Resources should a condition of this permit be violated. I also understand that if all required parts of this application are not completed
and that if all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
Note: In accordance with North Carolina General Statutes § 143-215.6A and § 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed $10,000 as well as civil penalties up to $25,000 per violation.
t
Signature: Date: r
FORM: RLAP 06-16 Page 5 of 5

CLEVELAND WWTP
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater Treatment Plant
Date Sampled: April 15,2019
Cleveland WWTP
Mineralization Rate 0.3 2.28 %Solids
5.65 pH
Permit No. WQ0011431
Parameter
%
Mg/Kg Dry Weight
(% x 10,000)
Pounds/Dry Ton
(Mg/Kg x 0.002)
Nitrogen (TKN)
4.382
43,817.500
87.635
Phosphorus
0.033
330.000
0.660
Potassium
0.251
29510.000
5.020
PAN (injected)*
1.730
17,299.283
34.599
PAN (surface)*
1.716
17, 164.195
34.328
Ammonia Nitrogen
0.027
270.175
0.540
Calcium
3.230
329300.000
64.600
Calcium Carbonate Eq.
---
---
---
Magnesium
---
29330.000
4.660
Sodium
---
99474.000
18.948
Sulfur
---
---
---
Nitrate N / Nitrite N
---
39964.910
7.930
Barium
---
---
---
Chloride
---
---
---
Iron
---
---
---
Aluminum
---
4%000.00
98.000
Arsenic
---
0.402
---
Cadmium
---
1.570
0.003
Chromium
---
---
---
Copper
---
591.00
1.182
Lead
---
0.430
0.001
Mercury
---
0.658
---
Molybdenum
---
14.500
---
Nickel
---
16.10
0.032
Selenium
---
0.440
---
Zinc
---
19399.00
J
2.798
1
1
I
Statesville Analytical 190415-17-01
*Determination of Plant Available Nitrogen (PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia N) + Ammonia N + Nitrate N + Nitrite N = % PAN
Surface Application:
(Mineralization Rate)(TKN-Ammonia N) + (0.5)(Ammonia N) + Nitrate N + Nitrite N = % PAN
Note: Constituents N.D. (Not Detected) or < detection limits are listed as detection limits
for calculation purposes.
SAR
2.07
Ceiling Co
(MO/Kq
75
85
49300
840
57
75
420
100
79500

Willcox & Mabe Soil Solutions, PLLC
RESIDUAL PAN CALCULATION
Town of Cleveland
TKN=
43,818
mg/kg
NH3=
270
mg/kg
NO3-NO2-N=
3,964.9
mg/kg
Min Rate=
0.30
PAN= [min.rate (TKN - NH3) + 0.5 (NH3) + NO3-NO21
0.30
431547 135 3964.91
PAN=
17164.20
mg/kg
Calculate residual nitrogen for years 2,3,4 and 5 following the initial application to determine
the amount of PAN/DT remaining.
2ND YEAR RESIDUAL PAN
PAN= [min.rate (1st year org. - N 2nd year min. - NJ
0.15 43,547 139064
PAN= 4572.47 mg/kg remaining from I st year application
3RD YEAR RESIDUAL PAN
PAN= [min.rate (2nd year org. - N 3rd year min. - NJ
0.08 305483 4)572
PAN= 2072.85 mg/kg remaining from I st year application
4TH YEAR RESIDUAL PAN
PAN= [min.rate (3rd year org. - N 4th year min. - NJ
0.05 251911 21073
PAN= 1191.89 mg/kg remaining from I st year application
5TH. YEAR RESIDUAL PAN
PAN= [min.rate (4th year org. - N 5th year min. - NJ
0.03 235838 11192
PAN= 658.31 mg/kg remaining from I st year application
Residual PAN from years 2 thru 5 after the initial application = 8495.52 mg/kg
Application
Five Year Maximum
Method
First Year PAN
Adjusted PAN
(mg/kg)
(mg/kg)
Surface
17,164
251660
Incorporation
179299
259795
Application
Five Year Maximum
Method
First Year PAN
Adjusted PAN
(lbs/DT)
(lbs/DT)
Surface
34.33
51.32
Incorporation
34.60
51.59

SAR Calculation
! Na mg/I
Ca mg/I
Mg mg/I
216.0072
736.44
53.124
Na Ca Mg SAR
i
9.392 1 36.822 i 4.427 2.068
Na mil eq
Ca mil eq
Mg mil eq
9.392
36.822
4.427
nter Enter . o T
2.28
_1
Data Na mg/kg
9474
i
Ca mg/kg32300
Mg mg/kg
2330
:
Job Name: I Town of Cleveland j
i
Page 1

Cleveland WWTP
Permit # WQ0011431
RESIDUALS APPLICATION DATA
82 Dry Tons of residuals to be certified
PLANT AVAILABLE NITROGEN SUMMARY
PAN
Pounds of PAN per DT
(Weighted Average)
Pounds of PAN per Year
Surface
Incorp. Or Inject.
Surface
Incorp. Or Inject.
First -Year
34.33
34.60
2,815
2!)837
Five -Year Maximum Adjusted
51.32
51.59
4,208
4,230
Assumed Application Rate
(lbs PAN/ac-yr)
Acres Required Using First -Year
PAN Concentrations
Acres Required Using Five -Year
Maximum Adjusted PAN
Surface
Incorp. Or Inject.
Surface
Incorp. Or Inject.
50
56.3
56.7
84.2
84.6
100
28.2
28.4
42.1
42.3
150
18.8
18.9
28.1
28.2
200
14.1
14.2
21.0
21.2

OPERATION AND MAINTENANCE PLAN (Updated)

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

Operation and Maintenance Plan
Town of Cleveland - Class B Biosolids Permit No. W00011431
Safety plans and training are the responsibility of the personnel associated with the land
application program. All employees involved with the land application program will be
required to comply with safety plans and training as applicable to the Class B Biosolids
Permit.
Land application program employees shall be trained, as appropriate, in general
awareness for the protection of water and pollution prevention general practices. This
training will be provided as part of a new employee orientation program or as part of
ongoing environmental awareness training. General refresher training for those
employees involved will be provided in accordance with applicable regulatory or permit
requirements.
III. Spill Response Plan
Includes the following:
• Spill Control Plan (Attached),
• Spill Prevention Plan (Attached),
• Spill Control, Containment and Cleanup Plan (Attached).
IV. Inspection Plan
The land application Operator in Responsible Charge (ORC) or personnel under direct
supervision of the ORC has responsibilities to include daily inspections of WWTP and
land application sites (when land application activities are scheduled). The ORC will
maintain daily record keeping logs of land application activities, inspections of field
applications equipment and maintenance, loading operation, roads, crops, crop
maintenance and harvesting practices. All daily record keeping logs will be coordinated
with the ORC at the end of each day.
In the event that a noncompliance event is observed during any inspection, the ORC of
the WWTP will be immediately notified. The ORC will determine the course of action to
be taken in order to rectify the noncompliance issue. NCDEQ will be notified as soon as
possible, but in no case more than 24 hours or on the next working day following the
occurrence or first knowledge of the occurrence.
At a minimum, these inspections will consist of the following:
• Verify that a biosolids analysis has been collected prior to land application
activities being performed and that it meets the criteria for land application.
• Verify that pathogen and vector attraction reduction data has been collected for
the source to be land applied and that it meets the criteria for land application.
• Verify the crop that is planted or is to be planted on the respective field(s).
• Confirm that the correct amount of biosolids are being land applied.

Operation and Maintenance Plan
Town of Cleveland - Class B Biosolids
Permit No. W00011431
• Confirm that manned equipment has a copy of the permit and the operations and
maintenance plan.
• Check that the field has been properly flagged and that buffers are adhered to.
• Check that proper signage is posted.
• Confirm that records are turned in at the end of each business day.
Inspections will also be conducted by the respective employees of the biosolids
generating facilities (at the source generating facility). The land application
contractor will not be responsible for inspections at the source generating facilities.
These inspections should be conducted by the respective ORC of each facility and
should fall under their own Operations and Maintenance Plans.
V. Sampling and Monitoring Plan
The respective WWTP's Class B Biosolids will be monitored to confirm compliance with
conditions in Non -Discharge Permit No. WQ0011431 to include:
• Toxicity Characteristics Leaching Procedure (TCLP),
• Reactivity, Ignitability and Corrosivity,
• 15A NCAC 02T .1105 Pollutant Limits and nutrient analysis,
• Pathogen and Vector Attraction Reduction requirements,
• Annual Representative Soil Analysis of each field which receives land application
during each respective year.
• Any other applicable Permit conditions.
All sampling and monitoring shall be performed in accordance with the current Permit.
Pollutant concentrations in the Town of Cleveland WWTP Class B Biosolids shall not
exceed the following Ceiling Concentrations (i.e., dry weight basis) or Cumulative
Pollutant Loading Rates (CPLRs):
Parameter
Ceiling Concentration
(milligrams per
kilogram)
CPLR
(pounds per acre)
Arsenic
75
36
Cadmium
85
34
Copper
4,300
1,338
Lead
840
267
Mercury
57
15
Molybdenum
75
n/a
Nickel
420
374
Selenium
100
89
Zinc
7,500
2,498

Operation and Maintenance Plan
Town of Cleveland - Class B Biosolids
Permit No. WO0011431
The Town of Cleveland WWTP Class B Biosolids shall be analyzed to demonstrate it is
non -hazardous under the Resource Conservation and Recovery Act (RCRA). The
analyses [corrosivity, ignitability, reactivity, and toxicity characteristic leaching
procedure (TCLP)] shall be performed annually.
TCLP shall include the following parameters (the regulatory level in milligrams per liter
is in parentheses):
Arsenic (5.0)
1,4-Dichlorobenzene (7.5)
Nitrobenzene (2.0)
Barium (100.0)
1,2-Dichloroethane (0.5)
Pentachlorophenol (100.0)
Benzene (0.5)
1 1-Dichloroethylene
(0.7)
Pyridine (5.0)
Cadmium (1.0)
2,4-Dinitrotoluene (0.13)
Selenium (1.0)
Carbon tetrachloride
Endrin (0.02)
Silver (5.0)
(0.5)
Chlordane (0.03)
Hexachlorobenzene (0.13)
Tetrachloroethylene (0.7)
Chlorobenzene (100.0)
Heptachlor (and its
hydroxide) (0.008)
Toxaphene (0.5)
Chloroform (6.0)
Hexachlor -1,3-butadiene
Trichloroethylene (0.5)
Chromium (5.0)
Hexachloroethane (3.0)
2,4,5-Trichlorophenol (400.0)
m-Cresol (200.0)
Lead (5.0)
2,4,6-Trichlorophenol (2.0)
o-Cresol (200.0)
Lindane (0.4)
2,4,5-TP (Silvex) (1.0)
p-Cresol (200.0)
Mercury (0.2)
Vinyl chloride (0.2)
Cresol (200.0)
Methoxychlor (10.0)
2,4-D (10.0)
Methyl ethyl ketone
(200.0)
An analysis shall be conducted on the Town of Cleveland WWTP Class B Biosolids
based on conditions (monitoring frequencies) set forth in Permit No. WQ0011431. The
analysis shall include the following parameters:
Aluminum
Mercury
Potassium
Ammonia -Nitrogen
Molybdenum
Selenium
Arsenic
Nickel
Sodium
Cadmium
Nitrate -Nitrite Nitrogen
Sodium Adsorption Ratio
(SAR)
Calcium
Percent Total Solids
TKN
Copper
pH
Zinc
Lead
Phosphorus
Magnesium
Plant Available Nitrogen
(by calculation)

Operation and Maintenance Plan
Town of Cleveland - Class B Biosolids
Permit No. W00011431
The Town of Cleveland WWTP Class B Biosolids shall be analyzed to demonstrate
compliance with Pathogen Reduction and Vector Attraction Reduction requirements
based on conditions (monitoring frequencies) set forth in Permit No. WQ0011431. The
current Pathogen Reduction Alternatives and Vector Attraction Reduction Options
utilized are as follows:
Pathogen Reduction: Per 15A NCAC 02T.1106
For Land Application of Class B:
Alternative 1 [15A NCAC 02T.1106(c)(1)] -Fecal Coliform Density Demonstration
or
® Alternative 2 [15A NCAC 02T.1106(c)(2)] -Process to Significantly Reduce Pathogens (PSRP)
Specify one: aerobic digestion, air drying, 0 anaerobic
digestion, I composting, or I lime stabilization.
Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107
For Land Application of Class B:
® Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction
(Aerobic/Anaerobic Digestion).
or
Alternative 3 [15A NCAC 02T.1107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion)
or
® Alternative 6 [15A NCAC 02T.1107(a)(6)] - Alkaline Stabilization
Attachments: Spill Control Plan
Spill Prevention Plan
Spill Control, Containment and Cleanup Plan
Shared\WMSS Projects\2015\15-03 Bio-Green Services\Phase 03A - Cleveland Permit Renewal\DEQ Forms\O&M Plan -
Town of Cleveland - June 2019.doc
k,

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

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

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

COPY OF EXISTING PERMIT
(PERMIT NO. WQ0011431)

WaterResources
ENVIR011IM-eNTAL. QUALiTY
iff,,y 24, 201.7
THE HONORABLE DANNY GABRIEL
Tw& NL OF CLEVE LAND
POSTOFFICE Box 429
CLEVELAND,, NORTH CAROLINA 2,7013
Dear Mayor Gabriel-,
ROY COOPER
Govei-�m,),r
MICI-LAEL S. REGAN
& JAY ZIMMERNIAN
Subject.- Attachment B Certification
Permit No. W'QOO 11431
Town of Cleveland RLAP
Rowan County
In accordance witb your pemiit modificat-ion request received July 3, 2017, and subsequent
additional information received July 1-0, 2017, we are fonvarding herewith a 1-nodified Attachment B
certified July 24, 2017, to the Town of Cleveland for the subject residuals progrwi.
This certification is being lssucdtoniodifp Attaclinicnt.B by: Change of ownership of field NC-
RA-01-0L
This niodified Attachment B shall be effective, from the date of certiflication until December 3 11
2019 (i.e., expiration date of the currentperm-it), shall void Attachment B of PermitNo. W'Q001 1431 issued
I
October 24, 201.4 that was previouslY certified on April 27, 2017, arid shall be subject to the conditions and
lim itations as specified therein, as well as those specified in -the above -referenced permit. Please replace
the Attachment B of Pen -nit No. WQ001 1.431 that was certified on April 27., 201-7 with this modified
,.AAtachment B.
Please note that the maps issued previously are still, applicable to this permit. It is the Permitte e's
responsibility to ensure that a complete permit is created by inserting only this arriended Attachment B
into the previously issued pemilt,
Ira . parts, requirements, and/or limitations contained in this certifileation or modified Affachment
B are unacceptable, you have the right to request an adjudicatory hearing, upon written request within 30 4:7
da S following rje.celiptof the certification, This request shall be in the formtng
of a written petition, conforming
y
to Chapter 150B of the North Carolina G(Meral Statutes and filed with the Office of Administrative Hearingos
't �
at 6714 Mail Service Center, Raleigh, North Carolina 27699-6714, Unless such demands are made, this
permit shall be final and binding.
ny ennutreun",
1617 Mad Sorvlice Center 1,R,,:t'Leigh,, North. Cuo'lina 27699­1617
919.-807-6332

In accordance with the provisions of Article 21 of Chapter 143, General Statutes of North Carolina as
amended., and other applicable Laws, Rules, and Regulations
PERMISSION IS HEREBY GRANTED TO
rW-1
-t-own. of Cleveland
Rowan County
FOR THE
continued operation of a residuals management program for the Town of Cleveland and consisting of the
land application of Class B residuals generated by the approved facilities listed in Attachment A to the
approved sites listed in Attachment B with no discharge of wastes to surface waters, pursuant to the
application received July 8, 2014, and in conformity with other supporting data subsequently filed and
approved by the Department of Environment and, Natural Resources and considered a part of this permit.
The use and disposal of residuals are regulated under Title 40 Code of Federal Regulations Part 503. This
permit does not exempt the Permittee from complying with the federal regulations.
This permit shall be effective from January 1, 2015 until December 31, 2019, shall void Permit No.
WQ001 1431 issued January 25, 2006 and shall be subject to the following specified conditions and
limitations:
Im SCHF-DES
I e No later than six months prior to the expiration of this permit, the Permittee shall request renewal of
this permit on official Division forms. Upon receipt of the request, the Division will review the
adequacy of the facilities described therein, and if warranted, will renew the permit for such period of
time and under such conditions and limitations as it may deem appropriate. Please note Rule I SA
NCAC 02T .0105(d) requires an updated site map to be submitted with the permit renewal
application.
2. The permittee shall be in full compliance with the regional of5ce notification requirements
established in Condition 111-3. by February 1, 2015.
3. The permittee shall be in full compliance with the signage requirements established in Condition
111. 13. by June 1, 2015.
-a---, a . ^ T 't r - 1 1% P& Qhol I Afr-rzinn ]AMM Page I of 12

L V 1_1149"
I The subject residuals management program shall be effectively maintained and aperated at all times
so there is no discharge to surface waters, nor any contravention of groundwater or surface water
standards. In the event the facilities fail to perform satisfactorily, including the creation of nuisance
conditions due to improper operation and maintenance, the Permittee shall immediately cease land
applying residuals to the site, contact the Mooresville regional office supervisor, and take any
immediate corrective actions.
2. This permit shall not relieve the Permittee of their responsibility for damages to groundwater or
surface water resulting from the operation of this residuals management program.
3. Only residuals generated by the facilities listed in Attachment A are approved for land application iri
accordance with this permit.
4. Only the sites listed in Attachment B are approved for residuals land application.
5. Pollutant concentrations in residuals applied to land application sites listed in Attachment B shall not
exceed the following Ceiling Concentrations (i.e., dry weight basis) or Cumulative Pollutant
LoadinLy Rates XPLRs):
Parameter
Ceiling Ceiling Concentration
(milligrams per kilogram)—
CPLR
(pounds per acre)
Arsenic
75
36
Cadmium
SS
34
Copper
41300
u 1,338
Lead
840
267
Mercury
57
15
Molybdenum
75
n/a
Nickel
420
374
Selenium
100
89
Zinc
77500
2,498
The Permittee shall determine compliance with the CPLRs using one of the following methods:
a. By calculating the existing cumulative level of pollutants using actual analytical data from all
historical land application events of residuals, or
b. For land where residuals application have not occurred or for which the required data is
incomplete, by determining background concentrations through representative soil sampling.
6- Residuals that are land applied shall meet Class B pathogen reduction requirements in 15A NCAC
02T.1 l06 (a) and (b)(2). Exceptions to this requirement shall be specified in Attachment A.
7. Biological residuals (i.e. residuals generated during the treatment of domestic or animal processing
0
wastewater, or the biological treatment of industrial wastewater, and as identified in Attachment A)
that are land applied shall meet one of the vector attraction reduction alternatives in 15A NCAC 02T
.1 107(a)- Exceptions to. this requirement shall be specified in Attachment A.
8. Setbacks for Class B land application sites shall be as follows:
WQOO 114331 Version 3.0 'Rh�11 Ver6cm 1 AAI')A

Setback by application type
(feet)
Setback Description
Vehicular
Irrigation
Surface
Surface
Injection
Application
Application
Incorporation
Habitable residence or place of public assembly
under separate ownership or not to be maintained as
400
400
200
part of the project site
Habitable residence or places of public assembly
owned by the Permittee, the owner of the land, or the
0
200
0
lessee/operator of the land to be maintained as pan
of the pEo ject site
Property lines
50
150
50
Public right of way
50
50
50
Private or public water supply
100
100
100
Surface waters (streams — intermittent and perennial,
100
100
50
perennial waterbodies, and wetlands)
Surface water diversions (ephemeral streams,
25
100
25
wateryvays, ditches)
Groundwater lowering ditches (where the bottom of
25
100
25
the ditch intersects the SHWT)
Subsurface groundwater lowering system
0
100
0
Wells with exception to monitoring wells
100
100
100
Bedrock outcrops
25
25
25
Top of slope of embankments or cuts of two feet or
15
15
15
more in vertical height
Building foundations or basements
0
15
0
Water lines
0
10
0
Swimming pools
100
100
100
Nitrification fields
0
20
0
9. Land application areas shall be clearly marked on each site prior to and during any residuals
application event.
M Bulk residuals and other sources of Plant Available Nitrogen (PAN) shall not be applied in
Nitrogen
exceedance of agronomic rates. Appropriate agronomic rates shall be calculated using expected
Z-7
nitrogen requirements based on the determined Realistic Yield Expectations (RYE) using any of the
following methods:
a. Division's pre -approved site specific historical data for specific crop or soil types by calculatinc,
CI
the mean of the best three yields of the last five consecutive crop harvests for each. field.
b. North Carolina Historical Data for specific crop and soil types as provided by North Carolina
State University Department of Soil Science (Litt ://iiLit.rierits.soil.nesu.edu/viela's/index.PLIP).
A copy shall be kept on file and reprinted every five years in accordance with Condition IV.6.
c. If the RYE cannot be determined using methods (a) or (b) above, the Permittee may use the RYE
and appropriate nutrient application rates reported in any of the following documents:
1 Office, the North
i Crop management plan as outlined by the local Cooperative Extension Of
Carolina Department of Agriculture and Consumer Services, the Natural Resource
Conservation Service, or other agronomist.
.11 ^ JAAT7A Paiie 3 of 12

ii• Waste Utilizatiou Plan as outlined by the Senate Bill 1217 Interagency Group - Guidance
Document: Chapter I
'.,P-ovLSWC/tecii/doeLimeats/ 9tiI Quidance Doc 100 109.,pLij).
iiio Certified Nutrient Management Plan as outlined by the Natural Resources Conservation
Services (NRCS)- These plans must meet the USDA-NRCS 590 Nutrient Management
Standards (t :tp-.//ftR- c.sc.e gy u�sda.�ov/�N-1-1­�l/`,)r�actic�c-�,,t�and�aa L.,,/§ _t�jn4ard )Qpd
d. If the RYE. and appropriate nutrient, application rates cannot be determined, the 'Perrnittee shall
contact the Division to determine necessary action.
11. When residuals are land applied to grazed pasture, hay crop realistic nitrogen rate shall be reduced by
25% in accordance with the USDA-NRCS 590 Nutrient Management Standards.
'11 If land application sites are to be over -seeded or double -cropped (e.g., bermuda grass in the surnmer
and rye grass in the winter with both crops to receive residuals), then the second crop can receive all
application of PAN at a rate not to exceed 50 pounds per acre per year (lbs/ac/yr). This practice may
be alloured as long as the second crop is to be harvested or grazed. If the second crop is to be planted
for erosion control only and is to be tilled into the soil, then no additional PAN shall be applied.
13. Prior to land application of residuals containing a sodium adsorption ratio (SAR) of 10 or higher, the
Permittee shall obtain and implement recommendations from at least one of the following: the local
Cooperative Extension Office; the Department of Agriculture and Consumer Services; the Natural
Resource Conservation Service; a North Carolina Licensed Soil Scientist-, or an agronomist. The
recommendations shall address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a
mechanism for maintaining site integrity and conditions conducive to crop growth. The Pen-nittee
t:7 9 �
shall maintain written records of these recommendations and details of their implementation.
14. The compliance boundary for fesidual land application sites shall be specified in accordance with
ISA NCAC 02L .0107(b). These sites were individually permitted on or after December 30, 1983;
therefore-, the compliance boundary is established at either 250 feet from the residual land application
area, or 50 feet within the property boundary, whichever is closest to the residual land application
area. An exceedance of groundwater standards at or beyond the compliance boundary is subject to
rernediation action according to 15A NCAC 02L .0106(d)(2) as well as enforcement actions in
accordance with North Carolina General Statute 143-215.6A through 143-215.6C. Any approved
relocation Of the COMPLIANCE BOUNDARY will be noted in Attachment B.
15. In accordance with 15A NCAC 02L.0 108, the review boundary shall be established midway between
the compliance boundary and the residual land application area. Any exceedance of groundwater
standards at the review boundary shall require action in accordance with 15A NCAC 02L .01064
t. The residuals management program shall be properly maintained and operated at all times. The
program shall be effectively maintained and operated as a non -discharge system to prevent any
contravention of surface water or groundwater standards.
2. The Mooresville Regional Office, telephone number [phone], and the appropriate local
government official (i.e., county manager, city manager, or health director) shall be notified at least,
48 hours prior to -the initial residuals land application to any new land application site. Notification to
the regional supervisor rvisor shall be made from 8:00 a.m. until 5:00 p.m. on Monday through Friday',
regional State Holidays.
WQOO 11431 Version 3.0 She]] Version 140324 Dutvj� A -%P 11

3. The Mooresville Regional Office shall be notified via einail or telephone, [phone], at least 24
hours prior to conducting any land application activity, Such notification shall indicate at a
t:) 3
minimum, the anticipated application times, field U)s, and location of land application activities. If it
becomes necessary to apply to additional fields due to unforeseen events, the Regional Office shall be
notified prior to commencing the application to those fields.
4. The Permittee shall maintain an approved Operation and Maintenance Plan (O&M Plan) pursuant to
15A NCAC 02T 1110. Modifications to the O&M Plan shall be approved by the Division prior to
utilization of the new plan- The O&M Plan, at the rninimurn, shall include --
a) Operational functions;
b) Maintenance schedules,
c Safety measures;
d) Spill response plan.;
e) Inspection plan including the following information.-
i. Names and/or titles of personnel responsible for conducting the inspections;
ii. Frequency and location of inspections, including those to be conducted by the ORC, and
procedures to assure that the selected location(s) and inspection frequency are representative
of the residuals management program;
iii. Detailed description of inspection procedures including record keeping and actions to be
taken by the inspector in the event that noncompliance is observed pursuant to the
noncompliance notification requirements under the monitoring and reporting section of the
permit;
f) Sampling and monitoring plan including the following information:
0
i. Names and/or titles of personnel responsible for conducting the sampling and monitoring;
p 7
i L Detailed description of monitoring procedures including parameters to be monitored;
iii. Sampling frequency and procedures to assure that representative samples are being collected.
Fluctuation in temperature, flow, and other operating conditions can affect the quality of the
residuals gathered during a particular sampling event. The sampling plan shall account for
any foreseen fluctuations in residuals quality and indicate the most limiting times for
residuals to meet pathogen and vector attraction reduction requirements (e.g. facilities that
land apply multiple times per year but have an annual sampling -frequency, may need to
sample during winter months when pathogen reduction is most likely to be negatively
affected by cold temperatures).
5. Upon the Water Pollution Control System Operators Certification Commission's (WPCSOCC)
classification of the facility, the Permittee shall designate and employ a certified operator in
responsible charge (ORC) and one or more certified operators as back-up ORCs in accordance with
I SA NCAC 08G .0201.. The ORC or their back-up shall visit the facilities in accordance with 15A
NCAC 080. 0204, or as specified in the most recently approved O&M plan (Le., see Condition HL
4.), and shall comply with all other conditions of 15A NCAC 08G. 0204. For more information
regarding classification and designation requirements, please contact the Division of Water
Resources' Technical Assistance & Certification Unit at [phone].
6. 'then the Permitted land applies bulk residuals, a copy of this permit and a copy of O&M Plan. shall
be maintained at the land application sites during land application activities.
7. When the Permittee transports or land applies bulk residuals, the spill control provisions shall be
maintained in all residuals transport and application vehicles.
8. Residuals shall not be stored at any land application site, unless written approval has been requested
and received from the Division.
1% 1 It A ^ 1 49 r fl In Qliall Vareinn ldnl?A Paia_e 5 of 12

9. When the Pemiittee land applies bulk residuals, adequate measures shall be taken to prevent wind
erosion and surface runoff from conveying residuals from the land application sites onto adjacent
properties or into surface waters,
10- When the Perrnittee land applies bulk residuals, a suitable vegetative cover shall be maintained on
land application sites onto -which residuals are applied, or application shall be in accordance with the
crop management plan outlined by the local Cooperative ]Extension office, the Department of
Agriculture and Consumer Services, the Natural Resource Conservation Service, or an agronomist
and as approved by the Division,
It. Bulk residuals shall not be land applied under the following conditions:
a. If the residuals are likely to adversely affect a threatened or endangered species listed under
section 4 of the Endangered Species Act or its designated critical habitat;
b. ,If the application causes prolonged nuisance conditions;
c. If the land fails to assimilate the bulk residuals or the application causes the contravention of
surface water or groundwater standards;
d. If the land is flooded, frozen or snow-covered, or is otherwise in a condition such that runoff of
the residuals would occur;
e. Within the 100-year flood elevation., unless the bulk residuals are injected or incorporated within
a 24-hour period following a residuals land application event;
f. During a measurable precipitation event (i.e., greater than 0.01 inch per hour), or within 24 hours
following a rainfall event of 0.5 inches or greater in a 24-hour period;
9. If the slope is greater than 10% for surface applied liquid residuals, or if the slope is greater than
18% for injected or incorporated bulk liquid residuals;
h- If the soil PH is not maintained at 6.0 or greater, unless sufficient amounts of lime are applied to
achieve a final soil pH of at least 6.0 0, or if an agronomist provides information indicatina that the
PH of the soil, residuals and lime mixture is suitable for the specified crop, Any pproved
variations to the acceptable soil pH (6.0) will be noted in this pen -nit;
i. If the land does not have an established vegetative cover unless the residuals are incorporated or
injected within a 24-hour period 'following a residuals land application event. Any field that is in
a USDA no -till program shall be exempted from meeting this vegetative cover requirement;
If the vertical separation between the seasonal high water table and the depth of residuals
application is less than one foot
k. If the vertical separation of bedrock and the depth of residuals application is less than one foot;
12. The following public access restrictions apply to residual land application sites:
a. Public access to public contact sites (e.&, golf courses, parks, ball fields, etc.) shall be restricted
for 365 days after a residuals land application event;
b. Public access to non-public contact sites shall be restricted for 30 days after a residuals land
application evellt.
13. Public access controls shall include the posting Of signs with a minimum area of 3 square feet (e.g
-n shall indicate the activities conducted at each site, permit number, and name and
1.5' x 2'). Each sign
contact information, including the Permittee or applicator's telephone number. Signs shall be posted
in a clearly visible and conspicuous manner at the entrance to each land application site during a land
application event, and for as long as the public access restrictions required under J11. 12 apply.
14. The following harvesting and grazing restrictions apply to residual land application sites after each
land application event:
WQOO 1143 1 Version 3 -0

Harvesting and Grazing Description
Restricted
Duration
Animals shall not be allowed to graze during land application activities and
restricted period. Sites that are to be used for grazing shall have fencing to
30 days
prevent access after each land application event.
Food crops, feed crops and fiber crops shall not be harvested for.-
30 days
Turf grown on land where residuals have been applied shall not be harvested for:
12 months
Food crops with hairvested parts that touch the residual/soil mixture and are
totally above the land surface (e.g., tobacco, melons, cucumbers, squash, etc.)
14 months
shall not be harvested for:
When the residuals remain on the land surface for four months or longer prior to
incorporation into the soil, food crops with harvested parts below the land
20 months
surface (e.g., root crops such as potatoes, carrots, radishes, etc.) shall not be
harvested for:
When the residuals remain on the land surface for less than four months prior to
incorporation into the soil, food crops with harvested parts below the land
38 months
surface shall not be harvested for: I
15. The Permittee shall acquire from each landowner or lessee/operator a statement detailing the volume
of other nutrient sources (i.e., manufactured fertilizers, manures, or other animal waste products) that
have been applied to the site, and a copy of the most recent Nutrient Management Plan (NMP) for
those operations where a NMP is required by the US Department of Agriculture — National Resources
Conservation Service (NRCS) or other State Agencies. The Permittee shall calculate allowable
nutrient loading rates based on the provided information and use appropriate reductions.
For the purpose of this permit condition, a Crop Management Plan (CMP), Waste Utilization Plan
(WUP) or Certified Nutrient Management Plan (CNMP) shall also be considered a Nutrient
Management Plan.
16. No residuals shall be land applied unless the submitted Land Owner Agreement Attachment (LOAA)
between the Permittee and landowners or lessees/operators of the land application site is in full force
and effect. These agreements shall be considered expired concurrent with the permit expiration date,
and shall be renewed during the permit renewal process.
C;
I Any Division required monitoring (including groundwater, plant tissue, soil and surface water
analyses) necessary to ensure groundwater and surface water protection shall be established., and an
acceptable sample reporting schedule shall be followed.
2. Residuals shall be analyzed to demonstrate they are non -hazardous under the Resource Conservation
and Recovery Act (RCRA). The analyses [corrosivity, ignitability, reactivity, and toxicity
characteristic leaching procedure (TCLP)l shall be performed at the frequency specified in
Attachment A. and the Permittee shall maintain these results for a minimum of five years. Any
exceptions from the requirements in this condition shall be specified in Attachment A.
.­_­ — �F ^ ^ Q"11 Xlxnrjz;nn IAWZ)A Page 7 of 12

The TCLP analysis shall include the following parameters (the regulatory level in milligrams per liter
is in parentheses). -
Arsenic (5.0)
1)4-D ich foro, benzene (7.5)
Nitrobenzene (2.0)
Barium. (100-0)
1,2-Dichloroethane (0.5)
Pentachlorophenol (100.0)
Benzene (0.5)
1:? 1 -Dich loroethylene (0.7)
Pyridine (5.0)
Cadmium (1.0)
2.4-Dinitrotoluene (0.13)
Selenium (1.0)
Carbon tetrachloride (0.5)
Endrin (0.02)
Silver (5.0)
Chlordane (0,03)
Hexachlorobenzene (0.13)
Tetrachloroethylene (0.7)
Chlorobenzene (100.0)
Heptachlor (and its hydroxide)
(0.008)
Toxaphene (0.5)
Chloroform (6.0)
Hexachloro-1,3-butadiene (0.5)
Trichloroethylene (0.5)
Chromium (5.0)
Hexachloroethane (3.0)
2,4,5-Trichlorophenol (400.0)
m-Cresol (200.0)
Lead (5.0)
2,426-Trichlorophenol (2-0)
o-Cresol (200.0)
Lindane (0.4)
2,4,5-TP (Silvex) (1.0)
p-Cresol (200,0)
Mercury (0.2)
Vinyl chloride (0.2)
Cresol (200.0)
Methoxychlor (10.0)
274-D (10.0)
Methyl ethyl ketone (200.0)
Once the residuals have been monitored for two years at the frequency specified in Attachment A,
I
the Permittee may submit a permit modification request to reduce the frequency of this monitoring
requirement. In no case shall the monitoring frequency be less than once per permit cycle.
3. An analysis shall be conducted on residuals from each source generating facility at the frequency
specified in Attachment A, and the Permittee shall maintain the results for a minimum of five years.
The analysis shall include the following parameters --
Aluminum
Mercury
Potassium
Ammonia -Nitrogen
Molybdenum
Selenium
Arsenic
Nickel
Sodium
Cadmium
Nitrate -Nitrite Nitrogen
Sodium Adsorption Ratio
(SAR)
Calcium
Percent Total Solids
TKN
Copper
pH
Zinc
Lead
Phosphorus
Magnesium
Plant Available Nitrogen
(by calculation)
4. Residuals shall be monitored for compliance with pathogen and vector attraction reduction
requirements at the frequency specified in Attachment A, and at the time indicated in the sampling
and monitoring sections of the approved O&M plan. The required data shall be specific to the
stabilization process utilized,, and sufficient to demonstrate compliance with the Class B pathogen
reduction requirements in 15A NCAC 02T .1106 (a) and (b)(2), and one vector attraction reduction
requirement in 15A NCAC 02T .1107 (a) shall be met. Any uccptions from the requirements in this
condition shall be specified in Attachment A.
WQOO 1143 1 Version -3. 0 et- -il I An2�A - -1 ­

5. An annual representative soils analysis (i.e., Standard Soil Fertility Analysis) shall be conducted OD
each land application site listed in Attachment B on which a residuals land application event will
occur in the respective calendar year. This analysis shall be in accordance with the "Guidance on Soil
Sampling" located in the Sampling Instructions section of the NC Department of Agriculture &
Consumer Services, website (http://www.neagr.goviagronomi/pLibs.htm). The Permittee shall
maintain these results and a description of the sampling methodologies used to determine soil fertility
for a period of no less than five years, and shall be made available to the Division upon request. At a
minimum, the Standard Soil Fertility Analysis shall include the following parameters:
Acidity—___ Exchan eable Sodium Percentage
Phosphorus
Base Saturation (by calculation) Magnesium
Calcium Potassium
P�aCse Exell"
S �t
Manganese Sodium
Cation EY ,,change Capacity Percent Humic Matter, Zinc
Copper
pH
6. Laboratory parameter analyses shall be performed on the residuals as they are land applied, and shall
be in accordance with the monitoring requirements in 15A NCAC 02B �0505.
7. The Permirtee shall maintain records tracking all residual land application events. At a minimum,,
these records shall include the following:
a- Source of residuals;
b. Date of land application;
c. Location of land application (i.e., site, field, or zone number as listed in Attachment B);
d. Approximate areas applied to (acres);
e. Method of land application;
f. Weather conditions (e.g., sunny, cloudy, raining, etc.);
g. Predominant Soil Mapping Unit (e-g., CbB2);
h. Soil conditions (e.g., dry, wet, frozen, etc.);
j. Type of crop or crops to be grown on field;
j. Nitrogen Application Rate based on RYEs (if using data obtained from the North Carolina State
University Department of Soil Science Website, the printout page shall be kept on file and
reprinted every five years);
k. Volume of residuals land applied in gallons per acre, cubic yard per acre, dry tons per acre, or wet
ton per acre;
1. Volume of animal waste or other nutrient source applied in gallons per acre, dry ton per acre, or
wet tons per acre;
m. - Volume of soil amendments (e.g., lime, gypsum, etc.) applied in gallons per acre, dry ton per
acre or wet tons per acre, and
m Annual and cumulative totals in dry tons per acre of residuals as well as animal waste and other
sources of nutrients (e.g,, if applicable), annual and cumulative pounds per acre of each heavy
metal (e.g., shall include, but shall not be limited to, arsenic, cadmium, copper, lead, mercury,,
molybdenum, nickel, selenium, and zinc), annual pounds per acre of PAN, and annual pounds per
acre of Phosphorus applied to each field.
Qh.:.J1 Pa2e 9 of 12

9. Three copies of an annual report shall be submitted on or before March I". The annual report shall
meet the requirements described in the Instructions for Residuals AP_ R
Forms. �Kg �Ortinlg
Instructions for reporting and annual report forms are available at
or can be obtained by contacting the Land
Application Unit directly. The annual report shall be submitted to the following address
Division of Water Resources
In -formation Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
9. Noncompliance Notification
The Permittee shall report by telephone to the Mooresville Regional Office, telephone number (704)
0
663-1699, as soon, as possible, but in no case more than 24 hours or on the next working da following the occurrence or first knowledge of the occurrence of any of the following: y
a. Any occurrence with the land application program resulting in the land application I of significant
amounts of wastes that are abnormal in quantity or characteristic.
b. Any failure of the land application program resulting in a release of material to surface waters.
Z:1
c. Any time self -monitoring indicates the facility has gone out of compliance with its pen -nit
I im itations,
d. Any process unit failure, due to known or unknown reasons, rendering the facility p
incaable of
adequate residual treatment,
e- Any spill or discharge from a vehicle or Piping system during residuals transportation.
Any emergency requiring immediate reporting (e.g., discharges to surface waters imminent failure of
a storage structure etc.
outside normal business hours shall be reported to the, Division's Emergent
Response personnel at telephone number (800) 662-y
7956, [phone], or [phone].PersonF
reporting such occurrences by telephone shall also file a written report in letter form within five das
following first knowledge of the occurrence. This report shall outline the actions taken or y
proposed to
be taken to ensure that the problem does not recur,
V. ESPECTIOINS
The Permit -tee shall provide adequate inspection and maintenance to ensure proppanon of the
er oer
sub . ect facilities and shall be in accordance with the approved O&M Plan.
9
2. Prior to each bulk residuals land application event, the Permittee or his designee shall inspect the
residuals storage, transport and application facilities to prevent malfunctions. facility deterioration
and operator errors resulting in discharges, which may cause the release of wastes to the
environment, a threat to human health or a public nuisance. The Permittee ha maintain an
inspection log that includes, at a minimum tt shall , the date and time of inspection, observations made, and
any maintenance, repairs, or corrective actions taken. The Permittee
for a periodshall maintain this inspection. log
Division upon request., Of five years from the date of inspection, and this log shall be made available to the
Any duly authorized Division representative may, upon Presentation of credentials, enter and inspect
any property, premises or place on or related to the land application sites or fa i ties permitted
at any e cl 0 'ere
determining Compliance with this permit; may inspect or
reasonable time for the purpose of dete herein
cOpy any records required to be maintained under the terms and conditions of this permit; and may
collect groundwater, surface water or leachate samples.
WQOO 114 31 Version 3.0 Shp-11 Vptrzin-n I Anl')A

V 1
GENERAL,CONDITION'S
1. Failure to comply with the conditions and limitations contained herein may subject the Permittee to
an enforcement action by the Division in accordance with North Carolina General Statutes 143-
215.6A to 143-215,6C.,
1 This permit shall become voidable if the residuals land application events are not carried out in
accordance with the conditions of this permit.
This permit is effective only with respect to the nature and volume of residuals described in the
permit application and other supporting doCLImentation.
4. The issuance of this permit does not exempt the Permittee from complying with any and all statutes,
rules,, regulations, or ordinances,, which may be imposed by other jurisdictional government agencies
(e.g., local, state, and federal). Of particular concern to the Division are applicable river buffer rules
in 15A NCAC 02B .0200; erosion and sedimentation control requirements in 15A NCAC Chapter 4
and under the Division's General Permit NCGO 10000; any requirements pertaining to wetlands under
15A NCAC 02B .0200 and 0214.0500; and documentation of compliance with.Article 21 Part 6 of
Chapter 143 of the General Statutes.
5. In the event the residuals program chancres ownership hip or the Permittee changes their name, a formal
permit modification request shall be submitted to the Division. This request shall be made on official
Division forms,, and shall include appropriate documentation from the parties involved and other
supporting documentation as necessary. The Permittee of record shall remain fully responsible for
maintaining and operating the residuals program permitted herein until a permit is issued to the new
owner.
6. This permit is subject to revocation or unilateral modification upon 60 days notice from the Division
Director, in whole or part for the requirements listed in 15.A NCAC 02T.0 I I Oo
7. Unless the Division Director grants a variance, expansion of the permitted residuals program
contained herein shall not be granted if the Peri-nittee exemplifies any of the criteria in 15A NCAC
02T .0 1 20(b).
8. The Permittee shall pay the annual fee within 30 days after being billed by the Division. Failure to
pay the annual fee accordingly shall be cause for the Division to revoke this permit pursuant to 15A
NCAC 02T.0 I 05(e)(3).
Permit issued this the 24hday of October 2014
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
Thomas AAeeder, Director
-___ ^__
DJVIS144 Water Resources
By Authority of the Environmental Management Commission
Permit Number WQ0011431
1 *9 ;rw-,. e% f% I I Alb A F __- —.._ I A Qh.-11 X/Prc;nn I AA I ?,d Pate 11 of 12

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M=9)
Strearn x — x - Fence Ed OnSiteHouse
Drain L - PropertyLine Outbuilding
-.- . I
Pond ApplicationArea UnsuitablIce
UtZ01
I inch = 660 feet
(all locations approximate)
The compliance boundary is established -
either 250 feet from the residuals applicat
area or 5-0 feet within the property bouriclar-y----
whichever is closest to the application area.
The review boundary is established r-nid-ay
between the compliance boundary and the
perimeter of the residuals applicati-co area.
F e, re t
0 160320 640 960 1, 2 86'

Legend
Stream
Drain
S-3urf2ceWater
x — x - Fence
R-4
Propertyl-ine "'N, OnSiteWell
AppllcationAre2 M Unsuitable
OnSiteHouse
Outbuilding
A R A2 d a Am ftr IM
I inch = 660 feet
(6/1 locations approximate)
The compliance boundary is established at
either 25G feet from the residuals application
area or 50 feet within the property boundar�
whichever is closest to the application area,._,,
The review boundary is established midway
between the compliance boundary and the
perimeter of the residuals application area -
Feet
0 160320 640 960 1.28C

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

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

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 11-15, FORM: DCAR 11-15, or FORM: SDR 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 11-15):
® Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 06-16) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® For new or renewed permits, submit a separate certification for each source facility.
® For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
® Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
B. Residuals Source -Generating Facility Information:
® For each source facility, attach the following:
® Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
® Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
® Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item I. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
® Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
® For each source facility, attach the following:
® Laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
® Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.
INSTRUCTIONS FOR FORM: RSC 06-16 Page 1 of 1

RESIDUALS SOURCE FACILITY SUMMARY
Applicant's name: Town of Cleveland
Status
Code a
Facility Permit Holder
Facility Name
County
Permit Number
Maximum Dry Tons Per Year
Current b
Proposed
Town of Cleveland
Cleveland WWTP
Rowan
NCO049867
82.0
82.0
a Status Code for source facility are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ D (Deleted)
b The amount of residuals currently permitted for distribution, land application, or disposal (i.e, not applicable to new facility).
SUMMARY FOR FORM: RSC 06-16 Page 1

L 1 0
&61J It
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
FORM: RSC 06-16
L RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: Town of Cleveland
2. Facility permit holder is: ❑ Federal, N State, 0 Local Government, or 0 Private.
Facility permit issued by: FlI Div. of Water Resources, Div. of Environmental Health,
or Q' Other (explain: M.
3. Facility contact person and title: Paul Land, WWTP Operator
Complete mailing address: PO Box 429
City: Cleveland State: N.C. Zip: 27013
Telephone number: [phone] E-mail address:
4. Facility physical address: 625 Third Creek Church Road
City: Cleveland State: N_C Zip: 27013
Coordinates: Latitude: 35' 44' 38" Longitude: 80' 40' 59.8"
Datum: NAD83 Level of accuracy: nearest tenth of second
Method of measurement: MAP
5. Purpose of the facility:
❑ treatment of municipal wastewater, ❑ treatment of 100% domestic wastewater,
❑ treatment of potable water, ❑ treatment of 100% industrial wastewater,
® treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: 60 % industrial and 40 % domestic)
❑ other (explain: ).
6. Does the facility have an approved pretreatment program: ® Yes ❑ No
7. Facility permitted/design flow: 0.27 MGD and facility average daily flow: 0.15 MGD
8. Average amount of residuals being generated at this facility 11 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: 2-oxidation ditches totaling 270,000 gallons, 1-80,000 gallon di eg ster
Type and volume of residuals storage (i.e., outside of residuals treatment units): above
II. RESIDUALS QUALITY INFORMATION (See Instruction C.):
1. Specify if residuals are regulated under:
® 40 CFR Part 503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological 0 Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: 0 yes no.
If yes, list the number(s): _
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: 0 yes 0 no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: Pace Analytical and Date of analysis: 5/28/19
Passed corrosivity test: yes no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: yes no. Flashpoint: >200 OF (> 140°F)
Passed reactivity test: Eyes Ono. HCN: <39.1 mg/kg (<250) & H2S: <391 mg/kg (<500)
TCLP Parameter
Limit
(mg/l)
Result
(Mg/7)
TCLP Parameter
Limit
(Mg/1)
Result
(Mg/1)
Arsenic
5.0
<0.05
Hexachlorobenzene
0.13
<0.05
Barium
100.0
<0.25
Hexachloro-1,3-Butadiene
0.5
<0.05
Benzene
0.5
<0.10
Hexachloroethane
3.0
<0.05
Cadmium
1.0
<0.005
Lead
5.0
<0.025
Carbon Tetrachloride
0.5
<0.10
Lindane
0.4
<0.0005
Chlordane
0.03
<0.003
Mercury
0.2
<0.0002
Chlorobenzene
100.0
<0.10
Methoxychlor
10.0
<1.0
Chloroform
6.0
<0.10
Methyl Ethyl Ketone
200.0
<0.20
Chromium
5.0
<0.05
Nitrobenzene
2.0
<0.05
m-Cresol
200.0
<0.05
Pentachlorophenol
100.0
<0.10
o-Cresol
200.0
<0.05
Pyridine
5.0
<0.05
p-Cresol
200.0
<0.05
Selenium
1.0
<0.10
Cresol
200.0
<0.05
Silver
5.0
<0.025
2,4-D
10.0
<0.002
Tetrachloroethylene
0.7
<0.10
1,4-Dichlorobenzene
7.5
<0.05
Toxaphene
0.5
<0.003
1,2-Dichloroethane
0.5
<0.10
Trichloroethylene
0.5
<0.10
1, 1 -Dichloroethylene
0.7
<0.10
2,4,5-Trichlorophenol
400.0
<0.05
2,4-Dinitrotoluene
0.13
<0.05
2,4,6-Trichlorophenol
2.0
<0.05
Endrin
0.02
<0.0005
2,4,5-TP (Silvex)
1.0
<0.002
Heptachlor and its Hydroxide
0.008
<0.0005
Vinyl Chloride
0.2
<0.10
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Statesville Analytical and Date of analysis: May 30, 2019
Parameter
Ceiling
Concentration Limits
(ClassA & ClassB)
(mg1kg)
Monthly Average
Concentration Limits
(Class A Only)
(mg1kg)
Result
(mglkg)
Arsenic
75
41
0.402
Cadmium
85
39
1.57
Copper
4,300
1,500
591
Lead
840
300
18.9
Mercury
57
17
0.658
Molybdenum
75
n/a
14.5
Nickel
420
420
16.1
Selenium
100
100
<0.44
Zinc
7,500
2,800
1,399
b. For Surface Disposal Unit (landrill): Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: _ and Date of analysis: _
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
> 0 but < 25
30
200
210
❑ > 25 but < 50
34
220
240
❑ > 50 but < 75
39
260
270
> 75 but < 100
46
300
320
❑ > 100 but < 125
53
360
390
❑ > 125
62
450
420
Result (mg/kg)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 2.28 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Statesville Analytical and Date of analysis: May 30, 2019
Parameter
Result
(mg/kg)
Aluminum
49,000
Ammonia -Nitrogen
270.175
Calcium
32,300
Magnesium
2,330
Nitrate -Nitrite Nitrogen
3,964.91
pH (Standard Unit)
5.65
Phosphorus
330
Potassium
2,509
Sodium
9,473.68
Total Kjeldahl Nitrogen
43,817.5
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 2.06
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: 30 %. This
rate is a (check one): 0 default value, or ❑ actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, explain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals: _
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (11h Year PAN
Five -Year
Maximum Adjusted PAN
(mg/kg)
(mg/kg)
Surface
17,164
25,660
Injection/Incorporation
17,299
25,795
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses: _
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/Land Application of Class A or Equivalent:
A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
Alternative 1 [15A NCAC 02T.I 106(b)(3)(A)] - Time/Temperature Compliance.
Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 4 [15A NCAC 02T.I 106(b)(3)(D)] - No Prior Testing for Enteric Virus/Viable Helminth Ova.
Alternative 5 [15A NCAC 02T.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: composting, 0 heat drying, rq heat treatment,
thermophilic aerobic digestion, ❑ beta ray irradiation,
gamma ray irradiation, or ❑ pasteurization.
b. For Land Application of Class B:
Alternative 1 [15A NCAC 02T.I 106(c)(1)] - Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T.I 106(c)(2)] - Process to Significantly Reduce Pathogens (PSRP).
Specify one: aerobic digestion, air drying, Q anaerobic digestion,
composting, i I lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II. 7a. above.
Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II. 7b. above.
Exempt -If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
El Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
11 Alternative 1 [15A NCAC 02T.I 107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
[J Alternative 2 [15A NCAC 02T.I 107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
❑ Alternative 3 [15A NCAC 02T.I 107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
❑ Alternative 4 [15A NCAC 02T.I 107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
Alternative 5 [15A NCAC 02T.I 107(a)(5)] - 14-Day Aerobic Processes.
Alternative 6 [15A NCAC 02T.I 107(a)(6)] - Alkaline Stabilization.
Alternative 7 [15A NCAC 02T.I 107(a)(7)] - Drying of Stabilized Residuals.
Alternative 8 [15A NCAC 02T.I 107(a)(8)] - Drying of Unstabilized Residuals.
Alternative 9 [15A NCAC 02T.I 107(a)(9)] - Injection.
Alternative 10 [15A NCAC 02T.I 107(a)(10)] - Incorporation.
Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.1107(b)(2)].
id Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

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

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Wastewater Treatment Plant (WWTP)
Non -Discharge Permit No. WQ0011431
Requested Dry Tons for Renewal — 82.0
® Previously Permitted Dry Tons ® 82.0
e Requested Dry Tons for Renewal ® 82.0

V. Sampling and Monitoring Plan
Sampling for this project consists of sampling the soils of the permitted fields in order
to document that the fields are suitable for land application.
Residuals samples are to be collected at the residuals processing facility by the Land
Application ORC or his designee. This may include nutrient and metal, pathogen,
vector attraction, reduction,, and TCLP samples. Samples should be obtained by the
Town of Cleveland or their designated representative prior to any land application
activities being performed in order to verify that samples meet regulatory requirements
set forth in the permit. Samples should be collected at the frequency specified in the
referenced permit.
If necessary, the Town of Cleveland or their representative will perform alkaline
stabilization of residuals at the wastewater treatment facility. The Land Application
ORC or his designee will provide documentation of times, temperatures, and pH of the
residuals for the lime stabilization events. The Town of Cleveland or their
representative will provide the alkaline stabilization materials and personnel to
perform this operation and will designate a responsible party for the documentation
that the residuals have passed the alkaline stabilization process.
C: Wse rskRob\OneD rive for Business\SharedMMSS Projects\201 5kl 5-03 Bio-Green Services\Phase 03A - Cleveland Permit
RenewalXDEQ FormsXTown of Cleveland O&M Plan -Sampling & Monitoring Section - June 2019.doc 6/28/2019

Analytical Results
Bio Green Services
383 Potts Road
Advance, NC 27006
Receive Date: 04/15/2019
Reported: 06/26/2019
For: Cleveland Digestor
Comments:
Sample Number Parameter Sample ID Result
190415-17-01
30 Day Benchscale
Cleveland
190415-17-01
Aluminum
Cleveland
190415-17-01
Ammonia Nitrogen
Cleveland
190415-17-01
Arsenic - Solid
Cleveland
190415-17-01
Cadmium ICP
Cleveland
190415-17-01
Calcium
Cleveland
190415-17-01
Copper
Cleveland
190415-17-01
Lead
Cleveland
190415-17-01
Magnesium
Cleveland
190415-17-01
Mercury Solid
Cleveland
190415-17-01
Molybdenum
Cleveland
190415-17-01
Nickel
Cleveland
190415-17-01
Nitrate/Nitrite -
Cleveland
Solids
190415-17-01
PAN
Cleveland
190415-17-01
pH
Cleveland
190415-17-01
Potassium - Solid
Cleveland
190415-17-01
SAR
Cleveland
190415-17-01
Selenium
Cleveland
190415-17-01
T. Phosphorous
Cleveland
190415-17-01
TCLP
Cleveland
190415-17-01
TKN
Cleveland
190415-17-01
Zinc
Cleveland
Unit Method Analyzed Analyst
13.3
%
EPA625-R-92/0
04/15/2019
WC
49000
mg/kg
EPA 200.7 rev4.4 1994
04/29/2019
MD
270.175
mg/kg
SM4500NH3BE-1997
04/16/2019
CL
0.402
mg/kg
SM3113 B-2004
04/30/2019
MD
1.57
mg/kg
EPA 200.7
04/24/2019
M D
32300
mg/kg
EPA 200.7
04/24/2019
MD
591
mg/kg
EPA 200.7
04/29/2019
M D
0.43 mg/L
SM3113B-2004
04/17/2019
MD
2330
mg/kg
EPA 200.7
04/24/2019
M D
0.658
mg/kg
SM311213-2011
04/26/2019
MD
14.5
mg/kg
EPA 200.7
04/29/2019
MD
16.1
mg/kg
EPA 200.7
04/29/2019
M D
3964.91
mg/kg
SM450OF/A
05/01 /2019
CL
210.7
mg/L
Calculation
05/02/2019
CL
5.65
Std. Units
SM4500HB-2011
04/16/2019
MD
2510
mg/kg
EPA200.7
04/22/2019
Meritech
2.06
%
Calculation
05/02/2019
CL
<0.44
mg/kg
EPA 200.7
04/30/2019
MD
330
mg/L
SM450OPE-2011
04/25/2019
CL
See Attached
as Noted
04/16/2019
PACE
43817.5
mg/kg
SM4500Norg B-2011
04/17/2019
CL
1399
mg/kg
EPA 200.7
04/29/2019
MD
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 45

Sample Number Parameter Sample ID Result Unit Method Analyzed Analyst
wwwuwn�
190415-17-01 Percent Solids Cleveland 2.28 % SM254OB-2011
190415-17-01 Sodium - Solid Cleveland 9473.68 mg/kg SM 3111 B
Respectfully submitted,
("
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
04/16/2019 IVID
04/18/2019 IVID
PO Box 228 • Statesville, NC 28687 * 704/872/4697
Page 2 of 45

Condition m� �*��~��~,. Receipt
~u_~Sample Number 190415-17-01 Temp on Arrival: 3.2
Parameter Schedule:
Nitric Acid Received onIce
Chemicals in containers, lab
Received onIce
Chemicals in containers, lab
Received onIce
Chemicals in containers, lab
Parameter Schedule: Arsenic -SoUd
Nitric Acid
Parameter Schedule:
Nitric Acid
Parameter Schedule:
Nitric Acid
Parameter Schedule:
Nitric Acid
Parameter Schedule:
Received onIce
Chemicals incontainers, lab
Copper
Received onIce
Chemicals in containers, lab
Lead
Received onIce
Chemicals in containers, lab
Selenium
Received onIce
Chemicals in containers, lab
Nitric Acid Received onIce
Chemicals in containers, lab
Parameter Schedule: Sodium
Nitric Acid Chemicals incontainers, |ob
Received onIce
Parameter Schedule: Sodium - Solid
Nitric Acid Received onIce
Chemicals in containers, lab
Parameter Schedule:
Nitric Acid Received onIce
Chemicals in containers, lab
Parameter Schedule:
Received onIce
Chemicals in containers, lab
PDBox 22O°Statesville, NC28G07°7O4/072/4G97

Parameter Schedule:
Parameter Schedule:
Received on Ice
Chemicals in containers, lab
Received on Ice
Chemicals in containers, lab
Parameter Schedule: Percent Solids
Received on Ice
Parameter Schedule: pH
Received on Ice
Chemicals in containers, lab
Parameter Schedule:
Received on Ice
Parameter Schedule: TCLP
Received on Ice
Parameter Schedule: TKN
Sulfuric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule: T. Phosphorous
Sulfuric Acid Received on Ice
Chemicals in containers, lab
Parameter Schedule:
Parameter Schedule:
Received on Ice
Received on Ice
Parameter Schedule: Potassium
Received on Ice
Chemicals in containers, lab
PO Box 228 ® Statesville, NC 28687 • 704/872/4697
Page 4 of 45

Parameter Schedule: Potassium ® Solid
Chemicals in containers, lab
Received on Ice
Parameter Schedule: Nitrate/Nitrite
Received on Ice
Chemicals in containers, lab
Parameter Schedule: Nitrate/Nitrite ® Solids
Chemicals in containers, lab
Received on Ice
P® Box 228 9 Statesville, NC 28687 ® 704/872/4697
Page 5 of 45

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The TCLF1 analysis shall include the following parameters (the regulatory level in milligrams per liter
is in parentheses):
Arsenic (5.0)
1,4-Dichlorobenzene (7.:)')
Nitrobenzene (2.0)
Pentachlorophenol (100.0)
Barium (100.0)
1,2-Dichloroethafie (0.5)
Benzene (0.5)
1, 1 -D ich loroethylene (0.7)
Pyridine (5.0)
Cadmium (i .0)
1,4-Dinitrotoluene (0. 13)
Selenium (1.0)
Carbon tetrachloride (0.5)
Endrin (0.02.)
Silver (5�0)
w.
Chlordane (0.03)
Hexachlorobenzene (0.13)
Tetrachloroethylene (0,7)
Chlorobenzene (100,0)
Heptachlor (and its hydroxide)
Toxaphene (0,115)
Chloroform (6.0)
il 14exacliloro-t.3-1)utadiene(0,5)t--
Trichloroethylene(0.55)
Chromium (5.0)
Hexach]OTOCIhane (3.0) 2.4,5-Trichlorophenol (4WO)
rn-Cresol (200.0')
Lead (5.0)
1),4,6-Trichlorophenot
o-Cresol (200.0) Lindane (0,4) 2,4,S-T1 (Silvex) (1.0)
p-Cresol (200.0) Mercury (0,121) Vinyl chloride (0,2)
Cresol (200.0) Mlethoxvchlor (1100)
.1,-1-D (10,0) Meths vh\i ketone (200.0)
Once the residuals have been monitored for Mlo years at the frequency specified in Attachment A.
the Permittee may submit a permit modification request to reduce the frequency of this monitoring
requirement, In no case shall the monitoring frequency be less than onu per permit cycile.
as An analysis shall be conducted on residuals from each sou"%-e generating facilit-y at the frequency
specified in Attachment A, and the Perminee shall maintain he results for a minimurn of five years.
The analysis shall include, the fbllo�� ink;
Aluminum
mercury
Potassium
Ammonia -Nitrogen
Molybdenum
Selenium
Arsenic
N Icke I
SodIUM
Sodium Adsorption Ratio
Cadmium
Mt -.ate -Nitrite Nitrogen
(SAR)
Calcium
PercentTo-tal Solids
TKN
Copper
PH
Zinc
Lead
Phosphorus
Plant Available Nitrogen
i
Magnesium
(by calculation)
4e Residual's shall be monitored for compliance %,ith pathogen and vector attraction reduction
requirements at the frequency specified in Attachment A. and at the time indicated in the sampling
and monitoring sections of the approved O&M plena. The required data sha-11 be specific to the
stabilization process utilized, and sufficient to demonstrate compliance with thr. Class 'R pathonen
reduction requirements in 15A NCAC 02T .1 106- (,ti) and (b){.2}, and one vector attraction reduCtion
requirement in 15A NCAC 021' .1107 (a) shall be met. Any exce-Intions fTorn the requirements in this
condition shall be spccificd in Attachnicnt A.
WQ001 1431 Version 3.0 1c,"n'.01 lAn'I'lil

Meriftech, Inc.
Environmental Laboratory
Laboratory Certification No. 165
Contact: C. Little Report Date: 5/1/2019
Client: Statesville Analytical
122 Court St
Statesville, NC 28677 Date Sample Rcvd: 4/18/2019
Meritech Work Order # 04181972 Sample: 190415.17.01 Grab 4/15/2019
Parameter Results Analvsis Date Reuortine Linflt
Potassium, total ST2 nig/L 4/22/201.9 1.00 mg/L EPA 200,7
I hereby certify that I have reviewed and approve the.ve data.
Lab ra-61--Y Re' prese n ta t! ve
642 Tamco Road, Reidsville, North Carolina 27320
tel.[phone] fax.[phone]
P® Box 228 ® Statesville, NC 28687 ® 704/872/4697
Page 8 of 45

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PO Box 228 ® Statesville, NC 28687 ® 704/872/4697
Page 9 of 45

ceAnalytical
www.pacelabs.com
Crystal Little
Statesville Analytical, Inc.
122 Court Street
PO Box 228
Statesville, NC 28687
RE: Project: 190415.17.01
Pace Project No.: 92425692
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Dear Crystal Little:
Enclosed are the analytical results for sample(s) received by the laboratory on April 16, 2019. The
results relate only to the samples included in this report. Results reported herein conform to the most
current, applicable TNI/NELAC standards and the laboratory's Quality Assurance Manual, where
applicable, unless otherwise noted in the body of the report.
Some analyses have been subcontracted outside of the Pace Network. The subcontracted
laboratory report has been attached.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Tyriek Hooks
[e-mail]
[phone]
Project Manager
Enclosures
: hkoo,
4A', REPORT OF LABORATORY ANALYSIS
k
121 This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 1 of 36
PO Box 228 * Statesville, NC 28687 * 704/872/4697
Page 10 of 45

Analytical
wwwpa"41abs, com
Project: 190415.17.01
Pace Project No,: 92425692
Pennsylvania Certification lDs
1638 Roseytown Rd Suites 2,3&4, Greensburg, PA 15601
Missouri Certification 235
ANAB DOD-ELAP Rad Accreditation #: L2417
Montana Certification Cert0082
Alabama Certification #: 41590
Nebraska Certification #*, NE-OS-29-14
Arizona Certification M AZ0734
Nevada Certification #: PA01457201 &-1
Arkansas Certification
New Hampshire/TNI Certification #- 2976,17
California Certification #: 04222CA
New Jersey/TNI Certification #' PA051
Colorado Certification #. PA01 547
New Mexico Certification #: PA01457
Connecticut Certification 4: PH-0694
New York/TNI Codification #: 10888
Delaware Certification
North Carolina Certification #: 42706
EPA Region 4 DW Rad
North Dakota Certification #: R-190
Flodda/TNI Certification #-, E87683
Ohio EPA Rad Approval: #41249
Georgia Certification #: C040
Oregon/TNI Certification #. PA200002-010
Guam Certification
Pennsylvania/TNI Certification #: 65-00282
Florida; Cod E871149 SEKS WET
Puerto Rico Certification #-, PA01457
Hawaii Certification
Rhode Island Certification #'. 65-00282
Idaho Certification
South Dakota Certification
Illinois Certification
Tennessee Certification #. 02867
Indiana Certification
Texas/TNI Certification #: T104704188-17-3
Iowa Certification #-, 391
Utah/TNI Certification #: PA014572017-9
Kansas/TNI Certification 4: E-10358
USDA Soil Permit #: P330-17-00091
Kentucky Certification #'. KY90133
Vermont Dept, of Health: ID# VT-0282
KY WW Permit #. KY0098221
Virgin Island/PADEP Certification
KY WW Permit #: KY0000221
Virginia/VELAP Certification #: 9526
Louisiana DHH/TNI Certification #-. LA180012
Washington Certification #: C868
Louisiana DEQ/TNI Certification #. 4086
West Virginia DEP Certification #: 143
Maine Certification #: 2017020
West Virginia DHHR Certification #. 9964C
Maryland Certification #. 308
Wisconsin Approve List for Rad
Massachusetts Certification #. M-PA1457
Wyoming Certification #: 8TMS-L
Michigan/PADEP Certification #: 9991
Charlotte Certification lDs
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
South Carolina Certification #. 99006001
LOLlisiana/NELAP Certification # LAI 70028
Florida/NELAP Certification #-. E87627
North Carolina Drinking Water Certification #: 37706
Kentucky LIST Certification #: 84
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Virginia/VELAP Certification #-1 460221
North Carolina Wastewater Certification 9: 12
Asheville Certification lDs
2225 Riverside Drive, Asheville, NC 28804 North Carolina Wastewater Certification #: 40
Florida/NELAP Certification E87648 South Carolina Certification 99030001
Massachusetts Certification M-NC030 Virginia/VELAP Certification 460222
North Carolina Drinking Water Certification #: 37712
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC,
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 2 of 36
PO Box 228 * Statesville, NC 28687 ® 704/872/4697
Page 11 of 45

.-OWN
",-,..,6ceAna1yfica1
wwwpac;elabs,com
Project: 190415.1T01
Pace Project No.: 92425692
Pace Analytical Services, LLC
9800 Kincey Ave, Suite 100
HUntersville, NC 28078
[phone]
Anarlytes
Lab ID Sample ID Method
Analysts
Reported
Laboratory
92425692001 190415.17.01 EPA 8081 B
SEM
9
PASI-C
EPA 8082A
SEM
8
PASI-C
EPA 8082A
SEM
8
PASI-C
EPA 601 OD
SH1
7
PASI-A
EPA 7470A
JMW1
I
PASI-A
EPA 8270E
BPJ
18
PASI-C
EPA 8260D
CLAW
14
PASI-C
ASTM D2974-87
KDF
I
PASI-C
EPA 101 OA
SMK
1
PASI-A
EPA 9045D
SMK
1
PASI-A
EPA 9095B
MD W
1
PASI-A
EPA 9014
PAS
1
PASI-PA
SM 450OS2F-00
PAS
1
PAS1--PA
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC- Page 3 of 36
PO Box 228,* Statesville, NC 28687 * 704/872/4697
Page 12 of 45

cemalyticab 9.
wvvwpacelabs'com
ANALYTICAL RESULTS
Project: 190415.17.01
Pace Project No.: 92425692
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
HUntersville, NC 28078
[phone]
Sample. 190415.17.01
Labll): 92425692001
Collected: 04/15/19 10:00
Received: 04/16/19 13:55 Matrix: Solid
Results reported on a "dry weight" basis and are adjusted for percent
moisture, sample size and any dilutions.
Parameters
Results Units
Report Limit DF
Prepared Analyzed CAS No. Qual
8081 TCLP Pesticides RVE
Analytical Method: EPA 8081
B Preparation Method: EPA 351 OC
Leachate Method/Date: EPA 1311; 04/23/19 12.30 Initial
pH.- 4.68; Final pH: 5
gamma-BHC (Lindane)
ND ug/L
0.50 1
04/24/19 12:09 04/25/19 20:53 58-89-9
Chlordane (Technical)
ND ug/L
3.0 1
04/24/19 12:09 04/25/19 20:53 57-74-9
Endrin
ND ug/L
0.50 1
04/24/19 12:09 04/25119 20:53 72-20-8
Heptachlor
ND ug/L
0.50 1
04/24119 12:09 04/25/19 20:53 76-44-8
Heptachlor epoxide,
ND ug/L
0.50 1
04/24/19 12:09 04/25119 20:53 1024-57-3
Methoxychlor
ND ug/L
1000 1
04/24/19 12:09 04/25119 20:53 72-43-5
Toxaphene
ND uq1L
3.0 1
04/24/19 12-,09 04/25/19 20:53 8001-35-2
Surrogates
Decachlorobiphenyl (S)
96
%
10-138
1
04/24/19 '12:09 04/25/19 20-53 2051-24-3
Tetrachloro-m-xylene (S)
84
%
10-110
1
04/24/19 12.09 04/25119 20:53 877-09-8
8082 GCS PCB
Analytical Method: EPA 8082A
Preparation Method.
EPA 3546
PCB-1016 (Aroclor 1016)
ND
ug/kg
1300
1
04/18/19 16,18 04/24/19 05:03 12674-11-2
PCB-1221 (Aroclor 1221)
ND
uglkg
1300
1
04/18/19 16:18 04/24/19 05:03 11104-28-2
PCB-1232 (Aroclor 1232)
ND
ug/kg
1300
1
04/18119 16:18 04/24/19 05:03 11141-16-5
PCB-1242 (Aroclor 1242)
ND
ug/kg
1300
1
04/18119 16:18 04/24/19 05,03 53469-21-9
PCB-1248 (Aroclor 1248)
ND
ug/kg
1300
1
04/18/19 16:18 04/24119 05:03 12672-29-6
PCB-1254 (Aroclor 1254)
ND
ug/kg
1300
1
04/181119 16:18 04/24/19 05,03 11097-69-1
PCB-1260 (Aroclor 1260)
ND
ug/kg
1300
1
04/18/19 16:18 04124/19 05,03 11096-82-5
Surrogates
Decachlorobiphenyl (S)
79
%
10:-130
1
04/18/19 16.18 04/24/19 05:03 2051-24-3
8082 TCLP PCBs RVE
Analytical Method: EPA 8082A
Preparation Method: EPA 351 OC
Leachate Method/Date, EPA 1311;
04/23/19 12,30 Initial
pH- 4.68,- Final pH, 5
PCB-1016 (Aroclor 1016)
ND
ug/L
1000
1
04/24/19 12:09 04/25/19 23:39 12674-11-2
PCB-1221 (Aroclor 1221)
ND
ug/L
1000
1
04/24/19 12:09 04/25/19 23:39 11104-28-2
PCB-1232 (Aroclor 1232)
ND
ug/L
1000
1
04/24119 12:09 04/25119 23.39 11141-16-5
PCB-1242 (Aroclor 1242)
ND
ug/L
1000
1
04/24/19 12:09 04/25119 23,39 53469-21-9
PCB-1248 (Aroclor 1248)
ND
ug/L
1000,
1
04/24/19 12:09 04/25/19 23:39 12672-29-6
PCB-1254 (Aroclor 1254)
ND
ug/L
1000
1
04/24/19 12:09 04/25/19 23:39 11097-69-1
PCB-1260 (Aroclor 1260)
ND
ug/L
1000
.1
04/24/19 12:09 04125119 23:39 11096-82-5
Surrogates
Decachlorobiphenyl (S)
92
%
10-132
1
04/24/19 12:09 04/25/19 2339 2051-24-3
6010 MET ICP, TCLP
Analytical Method:
EPA 601 OD
Preparation Method:
EPA 301 OA
Leachate Method/Date. EPA 1311;
05/01/19 18:34 Initial pH: 6.7; Final pH: 4,5
Arsenic
ND
mg/L
0,050
1
05/03/19 1239 05/04/19 16:08 7440-38-2 Ig
Barium
ND
mg/L
0,25
1
05/03/19 12:39 05/04119 16:08 7440-39-3 1g
Cadmium
ND
mg/L
0.0050
1
05103119 12:39 05/04119 16,08 7440-43-9 Ig
Chromium
ND
mg/L-
0.050
1
05103119 12:39 05/04/19 16:08 7440-47-3 19
Lead
ND
mg/L
0.025
1
05/03119 12:39 05/04/19 16:08 7439-92-1 1g
Selenium
ND
mg/L
0.10
1
05/03/19 1239 05/04/19 16:08 778249-2 lg
Silver
ND
mg/L
0.025
1
05/03119 12:39 05/04/19 16:08 7440-22-4 1g
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LLC, Page 4 of 36
P® Box 228 e Statesville, NC 28687 9 704/872/4697
Page 13 of 45

ucue A 1"Unlytical
wwwpacelabs.com
ANALYTICAL RESULTS
Project- 190415,17.01
Pace Project No.: 92425692
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: 190415.17.01 Lab ID: 92425692001 Collected. 04/15/19 10.00 Received: 04/16/19 13.55 Matrix: Solid
Results reported on a "dry weight' basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. (dual
7470 Mercury, TCLP Analytical Method: EPA 7470A Preparation Method: EPA 7470A
Leachate Method/Date: EPA 1311; 05/01/19 18:34 Initial pH. 6.7; Final pH: 4.5
Mercury
8270E MSSV TCLP Sep Funnel
1,4-Dichlorobenzene
2,4-Dinitrotoluene
Hexachloro-1,3--butadiene
Hexachlorobenzene
Hexachloroethane
2-Methylptienol(o-Cresol)
3&4- M ethyl phenol (m&p Cresol)
Nitrobenzene
Pentachlorophenol
Pyridine
2,4.,5-Trichlorophenof
2,4,6-Trichlorophenol
Surrogates
Nitrobenzene-d5 (S)
2-Fluorobiphenyl (S)
Terphenyl-d14 (S)
Phenol-d6 (S)
2-Fluorophenol (S)
2,4,6-Tribromophenol (S)
Benzene
2-Butanone (MEK)
Carbon tetrachloride
Chlorobenzene
Chloroform
1,4-Dichlorobenzene
12-Dichloroethane
1,1-Dichloroethene
Tetrachloroethene
Trichloroethene
Vinyl chloride
Surrogates
1,2-Dichloroethane-d4 (S)
Toluene-d8 (S)
4-Bromofluorobenzene (S)
Percent Moisture
Percent Moisture
Date: 05/28/2019 05:00 PM
ND mg/L 0,,00020 1 05102/19 16:48 05/03119 14:11 7439-97-6 Ig
Analytical Method, EPA 8270E Preparation Method: EPA 351 OC
ND
ug/L
50,0
1
04/24/19 22:40 04125119 18,36 106-46-7
ND
ug/L
50,0
1
04/24/19 22:40 04/25119 18:36 121-14-2
ND
ug/L
50.0
1
04/24/19 22.40 04/25/19 18:36 87-68-3
ND
ug/L
50.0
1
04/24/19 22:40 04/25/19 18:36 118-74-1
ND
ug/L
50.0
1
04/24/19 22:40 04/25/19 1&36 67-72-1
ND
ug/L
50.0
1
04/24/19 22:40 04/25/19 18,36 95-48-7
ND
ug/L
50.0
1
04/24/19 22:40 04125/19 18:36 15831-10-4
ND
ug/L
50.0
1
04124/19 22,40 04/25/19 18,36 98-95-3
ND
ug/L
100
1
04/24119 22A0 04/25/19 18:36 87-86-5
ND
ugIL
50,0
1
04/24/19 22;40 04/25/19 18:36 110-86-1
ND
ug/L
50.0
1
04/24/19 22:40 04/25/19 18.36 95-95-4
ND
ug/L
50.0
1
04/24/19 22:40 04/25/19 18:36 88-06-2
50
%
12-102
1
04/24119 22:40 04/25/19 18:36 4165-60-0
71
%
13-107
1
04/24/19 22;40 04/25/19 18,36 321-60-8
113
%
21-132
1
04/24/19 22:40 04/25/19 18:36 1718-51-0
7
%
10-110
1
04/24/19 22:40 04/25/19 18:36 '13127-88--3 S2
5
%
10-110
1
04/24/19 22,40 04/25/19 1836 367-12-4 S2
17
%
27-108
1
04/24/19 22.40 04/25/19 18:36 118-79-6 S2
Analytical Method,
EPA 8260D
ND
ug/L
100
20
04/26/19 03:11 71-43-2
ND
ug/L
200
20
04126/19 03-11 78-93-3
ND
ug/L
100
20
04/26119 03.11 56-23-5
ND
ug/L
100
20
04/26/19 03:11 108-90-7
ND
ug/L
100
20
04/26/19 03:11 67-66-3
ND
ug/L
100
20
04/26/19 03:11 106-46-7
ND
ug/L
100
20
04/26/19 03:11 107-06-2
ND
ug/L
100
20
04/26/19 03:11 75-35-4
ND
ug/L
100
20
04/26/19 0111 127-18-4
ND
ug/L
100
20
04/26/19 03:11 79-01-6
ND
ug/L
100
20
04/26/19 03:11 75-01 A
103
%
70-130
20
04/26/19 03:11 17060-07-0
108
%
67-135
20
04/26/19 03:11 2037-26-5
103
%
70-130
20
04/26/19 03:11 460-00-4
Analytical Method: ASTM D2974-87
97.5
%
0.10
1
04/16/19 17:45
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC,
Page 5 of 36
P® Box 228 ® Statesville, NC 28687 ® 704/872/4697
Page 14 of 45

ceAnalytical
w1mpacelabs,corn
FIIINXTIMWA061149N��
Project: 190415,17.01
Pace Project No., 92425692
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: 190415.17.01
LablD: 92425692001 Collected: 04/15/19 10:00 Received: 04/16/19 13:55 Matrix: Solid
Results reported on a "dry weight' basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters
Results Units Report Limit DF Prepared Analyzed CAS No.
1010 Flashpoint,Closed Cup
Analytical Method: EPA 101 OA
Flashpoint
>200 deg F 70.0 1 04/28119 14A4
9045 pH Soil
Analytical Method: EPA 9045D
pH at 25 Degrees C
6.7 Std. Units 0,10 1 04/29/19 11:23 H3
9095 Paint Filter Liquid Test
Analytical Method. EPA 9095B
Free Liquids
Fail 1.0 1 04/18/19 17,55
733C S Reactive Cyanide
Analytical Method: EPA 9014 Preparation Method- SW-846 7.3.3.2
Cyanide, Reactive
ND mg/kg 39,1 1 04122/19 17:39 04/22/19 18:54
734E Reactive Sulfide
Analytical. Method: SM 4504S2F-00 Preparation Method, SW-846 73.4.2
Sulfide, Reactive
ND mg/kg 391 1 04/22/19 17:39 04/22/19 17,48
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LLC,
Qual
Page 6 of 36
P® Box 228 o Statesville, NC 28687 o 704/872/4697
Page 15 of 45

;e u^ n Ar-t -n a 'n, a ly Aca
wwwpacelabscurry
Project: 190415.17.01
Pace Project No.: 92425692
QC Batch: 472928 Analysis Method: EPA 7470A
QC Batch Method: EPA 7470A Analysis Description: 7470 Mercury TCLP
Associated Lab Samples- 92425692001
METHOD BLANK- 2563088
Associated Lab Samples, 92425692001
Parameter Units
Mercury mq/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 0.00020 05/03/19 13,55
Pace Analytical Services, LLG
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE: 2565344
Spike LCS LCS % Rec
Parameter Units Conc. Result % Rec Limits Qualifiers
Mercury mg/L 0,0025 O.0024 95 80-120
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2565345 2565346
MS MSD
92425680001 Spike Spike IVIS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Mercury nig/L ND 0.0025 0.0025 0.0026 0,0026 104 103 75-125 2
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date- 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LLC. Page 7 of 36
PO Box 228 e Statesville, NC 28687 e 704/872/4697
Page 16 of 45

-1?
41of" 11
A
`�v. ",flakeAnalyfical
wwwpacelabs.com
Project, 190415.17,01
Pace Project No.: 92425692
QC Batch: 472926 Analysis Method: EPA 601 OD
QC Batch Method: EPA 301 OA Analysis Description: 6010 MET TCLP
Associated Lab Samples, 92425692001
METHOD BLANK: 2563088
Associated Lab Samples, 92425692001
Parameter
Arsenic
Barium
Cadmium
Chromium
Lead
Selenium
Silver
Matrix: Water
Blank
Reporting
Units
Result
Limit
Analyzed Qualifiers
rng/L
ND
0.050
05/04/19 15;38
mg/L
ND
0.25
05/04/19 15:38
mg/L
ND
0.0050
05/04/19 15:38
mg/L
ND
0,050
05/04/19 15:38
mg/L
ND
0.025
05/04/19 15.38
mg/L
ND
0.10
05/04/19 15:38
mg/L
ND
0.025
05/04119 15:38
LABORATORY CONTROL SAMPLE:
2565337
Parameter
Units
Arsenic
mg/L
Barium
mg/L
Cadmium
mg1L
Chromium
mg/L
Lead
mg/L
Selenium
mg/L
Silver
mg/L
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Spike
LCS
LCS
% Rec
Conc.
Result
% Rec
Limits Qualifiers
2.5
2,3
92
80-120
2.5
2.3
93
80-120
2.5
2A
94
80-120
2.5
2A
94
80-120
2.5
2.3
91
80-120
2.5
24
97
80-120
1.2
1.2
96
80-120
MATRIX SPIKE & MATRIX SPIKE DUPLICATE:
2565338
2565339
MS
MSD
92422459001
Spike
Spike
MS
MSD
MS
MSD
% I-Rec
Parameter
Units
Result
Conc.
Conc.
Result
Result
% Rec
% Rec
Limits
RPD Qual
Arsenic
mg/L
ND
2.5
2.5
2.3
2-3
94
92
75-125
2
Barium
mg/L
0.74
2.5
2.5
3.2
3.1
97
95
75-125
1
Cadmium
mg/L.
ND
2.5
2.5
2.4
23
95
94
75-125
2
Chromium
mg/L.
ND
2.5
2.5
2A
2.3
96
94
75-125
2
Lead
mg/L
ND
2.5
2.5
2,3
2.3
92
91
75-125
2
Selenium
mg/L
ND
2.5
2.5
2.4
2.4
97
96
75-125
1
Silver
mg/L
ND
12
1.2
1.2
1,2
96
95
75-125
1
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date., 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LIC. Page 8 of 36
PO Box 228 e Statesville, NC 28687 ® 704/872/4697
Page 17 of 45

ceAnalytical
wwwpacelabs.com
Project: 190415,17.01
Pace Project No.: 92425692
QC Batch: 471650 Analysis Method: EPA 8260D
QC Batch Method: EPA 8260D Analysis Description: 8260D MSV TCLP
Associated Lab Samples: 92425692001
METHOD BLANK: 2559314
Associated Lab Samples: 92425692001
Parameter
Units
Matrix: Water
Blank Reporting
Result Limit
Analyzed Qualifiers
M-Dichloroethene
ug/L
ND
5.0
04/26/19 01-29
1,2-Dichloroethane
ug/L
ND
5.0
04/26119 01,29
1,4.-Dichlorobenzene
ug/L
ND
5.0
04/26/19 01:29
2-Butanone (MEK)
ug/L
ND
10.0
04/26/19 01:29
Benzene
ug/L
ND
5.0
04/26/19 01:29
Carbon tetrachloride
ug/L
ND
5,0
04/26/19 01:29
Chlorobenzene
ug/L
ND
5.0
04/26/19 01:29
Chloroform
ug/L
ND
5.0
04/26/19 01-29
Tetra ch loroethene
ug/L
ND
5,0
04/26119 01.29
Trichloroethene
ug/L
ND
5.0
04/26/19 01:29
Vinyl chloride
ug/L
ND
5,0
04/26119 01:29
1,2-Dichlor,oethane-d4 (S)
%
104
70-130
04/26/19 01 :29
4-Bromofluorobenzene (S)
%
102
70-130
04/26/19 01-29
Toluene-d8 (S)
%
112
67-135
04/26/19 01:29
Pace Analytical Services, LLG
9800 Kincey Ave. Suite 100
HUntersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE:
2559313
Spike
LCS
LCS
% Rec
Parameter
Units
Conc.
Result
% Rec
Limits Qualifiers
1,1-Dichloroethene
ug/L
50
46.6
93
70-130
1,2-Dichloroethane
Ug/L
50
45A
91
70-130
1,4-Dichlorobenzene
ug/L
50
49.3
99
70-130
2-Butanone (MEK)
ug/L.
100
123
123
64-135
Benzene
ug/L
50
48-5
97
70-130
Carbon tetrachloride
ug/L
50
47.3
95
70-130
Chlorobenzene
ug/L
50
48.9
98
70-130
Chloroform
ug/L
50
417
87
70-130
Tetra ch loroethen e
Ug/L
50
51A
103
69-130
Trichloroethene
ug/L
50
51.6
103
70-130
Vinyl chloride
ug/L
50
42.0
84
70-131
1,2-Dichloroetl1ane-d4 (S)
%
92
70-130
4-Bromofluorobenzene (S)
%
93
70-130
Toluene-d8 (S)
%
93
67-135
MATRIX SPIKE& MATRIX SPIKE DUPLICATE- 2559315 2559316
MS MSD
92425692001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc., Result Result % Rec % Rec Limits RPD Qual
1,1-Dichloroethene ug/L ND 400 400 381 410 95 103 70-154 7
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result,
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LIC, Page 9 of 36
PO Box 228 ® Statesville, NC 28687 9 704/872/4697
Page 18 of 45

jceAna1y6crW'
wwwpacelabs. Coln
MMM
Project: 190415.17.01
Pace Project No.: 92425692
MATRIX SPIKE & MATRIX SPIKE DUPLICATE:
2559315
MS
92425692001
Spike
Parameter
Units
Result
Conc.
1,2-Dichloroethane
ug/L
ND ~
400
1,4-Dichlorobenzene
ug/L
ND
400
2-Butanone (MEK)
ug/L
ND
800
Benzene
ug/L
ND
400
Carbon tetrachloride
ug/L
ND
400
Chlorobenzene
ug/L
ND
400
Chloroform
ug/L
ND
400
Tetra ch loroethen e
ug/L
ND
400
Trichloroethene
ug/L
ND
400
Vinyl chloride
ug/L.
ND
400
1,2-Dichloroethane-d4 (S)
%
4-Bromofluorobenzene (S)
%
Toluene-d8 (S)
%
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
HUntersville, NC 28078
[phone]
2559316
MSD
Spike
MS
MSD
MS
MSD
% Rec
Conc.
Result
Result
% Rec
% Rec
Limits
RPD
400
381
384
95
96
70-137
1
400
411
433
103
108
70-133
5
800
852
830
107
104
60-139
3
400
421
437
105
109
70-151
4
400
427
469
107
117
70-143
9
400
412
424
103
106
70-138
3
400
352
386
86
94
70-139
9
400
415
424
104
106
59-143
2
400
459
450
115
112
70-147
2
400
434
436
108
109
70156
1
91
89
70-130
96
96
70-130
96
95
67-135
Results presented on this page are in the units indicated by the "Units" column except when an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date, 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LLC.
Page 10 of 36
PO Box 228,* Statesville, NC 28687 ® 704/872/4697
Page 19 of 45

AI
www.pacefabs.com
Project: 190415.17,01
Pace Project No.: 92425692
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875--9092
QC Batch: 471215
Analysis Method: EPA 8081 B
QC Batch Method: EPA 351 OC
Analysis Description- 8081 TCLP Pesticides
RV
Associated Lab Samples: 92425692001
METHOD BLANK: 2555379
Matrix- Water
Associated Lab Samples, 92425692001
Blank Reporting
Parameter
Units
Result Limit
Analyzed
Qualifiers
Chlordane (Technical)
ug/L
ND 3.0
04/25/19 20:40
Endrin
ug/L
ND 0.50
04/25/19 20.40
gamma-BHC (Lindane)
ug/L
ND 0,50
04125/19 20--40
Heptachlor
ug/L
ND 0,50
04/25/19 20:40
Heptachlor epoxide
ug/L
ND 0.50
04/25/19 20-40
Methoxychlor
ug/L
ND 1000
04/25/19 20:40
Toxaphene
ug/L
ND 3.0
04/25/19 20,40
Decachlorobiphenyl (S)
%
93 10-138
04/25/19 20:40
Tetrachloro-m-xylene (S)
%
64 10-110
04/25/19 20:40
LABORATORY CONTROL SAMPLE: 2557097
Spike LCS
LCS %
Rec
Parameter
Units
Conc. Result % Rec Limits
Qualifiers
Endrin
ug/L
1.2 1.1
89
20-134
gamma-BHC (Lindane)
ug/L
12 11
87
20-118
Heptachlor
ug/L
1.2 I'D
81
20-142
Heptachlor epoxide
ug/L
1,2 I'll
91
22-133
Methoxychlor
ug/L
3.8 37J
97
44-150
Decachlorobiphenyl (S)
%
93
10-138
Tetra ch loro-m-xylene (S)
%
82
10-110
MATRIX SPIKE SAMPLE: 2557098
92425245001 Spike
MS
IVIS
% Rer,
Parameter
Units
Result Conc.
Result
% Rec
Limits Qualifiers
Endrin
ug/L
ND 1.2
1A
86
21-133
gamma-BHC (Lindane)
ug/L
ND 11
1.0
83
24-119
Heptachlor
ug/L
ND 1.2
0.95
76
16-128
Heptachlor epoxide
ug/L
ND 1.2
1,0
81
50-150
Methoxychlor
ug/L
ND 3.8
3.5J
94.
50-1150
Decachlorobiphenyl (S)
%
82
10-138
Tetrachloro-m-xylene (3)
%
77
10-110
SAMPLE DUPLICATE'- 2557099
92425245002 Dup
Parameter Units Result Result RPD Qualifiers
Chlordane (Technical) ug/L ND ND
Endrin ug/L ND ND
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05128/2019 05:00 PM ,vithout the written consent of Pace Analytical Services, LLC. Page 11 of 36
PO Box 228 e Statesville, NC 28687o 704/872/4697
Page 20 of 45

aceAnalytical
wwwpacefabsecom
Project: 190415.17,01
Pace Project No.., 92425692
SAMPLE DUPLICATE: 2557099
Parameter
gamma-BHC (Lindane)
Heptachlor
Heptachlor epoxide
Methoxychlor
Toxaphene
Decachlorobiphenyl (S)
Tetrachloro-m-xylene (S)
Units
ug/L
ug/L
ug/L
ug/L
ug/L
92425245002 Dup
Result Result
ND
ND
ND
ND
ND
93
93
RPD Qualifiers
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville-,, NC 28078
[phone]
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT ®F LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05-00 PM without the written consent of Pace Analytical Services, LLC. Page 12 of 36
PO Box 228 9 Statesville., NC 28687 e 704/872/4697
Page 21 of 45

-1
'00-0 7
vewwpacelabs, corn
Project: 190415.17.01
Pace Project No.: 92425692
Pace Analytical Services, LLC
9800 Kincey Ave, Suite 100
HUntersville, NC 28078
[phone]
QC Batch: 470280
Analysis Method: EPA 8082A
QC Batch Method-, EPA 3546
Analysis Description. 8082 GCS PCB
Associated Lab Samples: 92425692001
METHOD BLANK: 2553290
Matrix: Solid
Associated Lab Samples: 92425692001
Blank Reporting
Parameter
Units
Result Limit
Analyzed
Qualifiers
PCB-1016 (Aroclor 1016)
ug/kg
ND 33.6
04/24/19 07:08
PCB-1221 (Aroclor 1221)
ug/kg
ND 33,6
04/24/19 07:08
PCB-1232 (Aroclor 1232)
ug/kg
ND 33.6
04/24/19 07:08
PCB-1242 (Aroclor 1242)
ug/kg
ND 316
04/24/19 07:08
PCB-1248 (Aroclor 1248)
ug/kg
ND 33,6
041124/19 07-08
PCB-1254 (Aroclor 1254)
uglkg
ND 33.6
04/24/19 07:08
PCB-1260 (Aroclor 1260)
ug/kg
ND 33.6
04/24/19 07:08
Decachlorobiphp.nyl (S)
%
86 10-130
04/24/19 07-08
LABORATORY CONTROL SAMPLE: 2553291
Spike LCS
LCS %
Rec
Parameter
Units
Conc. Result % Rec Limits
Qualifiers
PCB-1016 (Aroclor 1016)
uglkg
169 164
97
35-130
PCB-1260 (Aroclor 1260)
ug/kg
169 129
76
46-130
Decachlorobiphenyl (S)
%
91
10-130
MATRIX SPIKE SAMPLE: 2553292
92425960001 Spike
IVIS
MS
% Rec
Parameter
Units
Result Conc.
Result
% Rec
Limits Qualifiers
PCB-1016 (Aroclor 1016)
uglkg
ND 206
.......
174
......
85
10-130
PCB-1260 (Aroclor 1260)
ijg/kg
ND 206
125
61
10-130
Decachlorobiplienyl (S)
%
71
10-130
Results presented on this page are in the units indicated by the "Units" COILIMn except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LLC., Page 13 of 36
PO Box 228 ® Statesville, NC 28687 * 704/872/4697
Page 22 of 45

A
c e /4 na lXica
wwpacelabs.com
Project: 190415.17,01
Pace Project No.: 92425692
QC Batch: 471354 Analysis Method: EPA 8082A
QC Batch Method: EPA 351 OC Analysis Description., 8082 TCLP PCB RV
Associated Lab Samples, 92425692001
METHOD BLANK: 2555379
Associated Lab Samples: 92425692001
Parameter
Units
PCB-1016 (Aroclor 1016)
ug/L
PCB-1221 (Aroclor 1221)
ug/L
PCB-1232 (Aroclor 1232)
ug/L
PCB-1242 (Aroclor 1242)
ug/L
PCB-1248 (Aroclor 1248)
ug/L
PCB-1254 (Aroclor 1254)
ug/L
PCB-1260 (Aroclor 1260)
Ug/L
Decachlorobiphenyl (S)
%
Matrix: Water
Blank
Reporting
Result
Limit
Analyzed Qualifiers
ND
1000
04/26/19 00.04
ND
1000
04126/19 00.04
ND
1000
04/26/19 00:04
ND
1000
04/26/19 00:04
ND
1000
04/26119 00-04
ND
1000
04/26/19 00:04
ND
1000
04/26/19 00:04
89
10-132
04/26/19 00:04
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE. 2557804
Spike LCS LCS % Rec
Parameter Units Conc. Result % Rec Limits Qualifiers
PCB-1016 (Aroclor 1016) ug/L. 25 ND 90 38-113
PCB-1260 (Aroclor 1260) ug/L 25 ND 76 35-120
Decachlorobiphenyl (S) % 98 10-132
MATRIX SPIKE SAMPLE:
2557805
92425245001
Spike IVIS
IVIS
% Rec
Parameter
Units
Result
Cork, Result
% Rec
Limits Qualifiers
PCB-1016 (Aroclor 1016)
ug/L
ND
25 ND
82
19-142
PCB-1260 (Aroclor 1260)
ug/L
ND
25 ND
64
19-142
Decachlorobiphenyl (S)
%
77
10-132
SAMPLE DUPLICATE. 2557806
92425245002
Dup
Parameter
Units
Result
Result RPD
Qualifiers
PCB-1016 (Aroclor 1016)
ug/L
ND
ND
PCB-1221 (Aroclor 1221)
ug/L
ND
ND
PCB-1232 (Aroclor 1232)
ug/L
ND
ND
PCB-1242 (Aroclor 1242)
ug/L
ND
ND
PCB-1248 (Aroclor 1248)
ug/L
ND
ND
PCB-1254 (Aroclor 1254)
ug/L
ND
ND
PCB-1260 (Aroclor 1260)
ug/L
ND
ND
Decachlorobiphenyl (S)
%
91
76
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LLC. Page 14 of 36
1
PO Box 228 e Statesville, NC 28687 * 704/872/4697
Page 23 of 45

ceAnalyfical
wwwpacelab&com
Project: 190415,17,01
Pace Project No.: 92425692
QC , Batch: 471352 Analysis Method: EPA 8270E
QC Batch Method: EPA 351 OC Analysis Description: 8270E TCLP MSSV
Associated Lab Samples: 92425692001
METHOD BLANK: 2555379
Associated Lab Samples'. 92425692001
Parameter
Units
2,4,6-Tribromophenol (S)
%
2-Fluorobiphenyl (S)
%
2-Fluorophenol (S)
%
Nitrobenzene-d5 (S)
%
Phenol-d6(S)
%
Terphenyl-d14 (S)
%
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
HUntersville, NC 28078
[phone]
Matrix. Water
Blank
Reporting
Result
Limit
Analyzed Qualifiers
90
27-108
04/25/19 10-33
67
13-107
04/25/19 10:33
18
10-110
04/25/19 10:33
68
12-102
04/25/19 10:33
10
10-110
04/25/19 10:33
85
21-132
04/25/19 10:33
LABORATORY CONTROL SAMPLE,
2557796
Spike
LCS
LCS
Parameter
Units
Conc.
Result
% Rec
1,4-Dichlorobenzene
ug/1-
500
317
63
2,4,5-Trichlorophenol
ug/L
500
393
79
2A6-Trichlorophenol
ug/L
500
412
82
2A-Dinitrotoluene
Ug/L
500
430
86
2-Methylphenol(o-Cresol)
ug/L
500
302
60
3&4-Methylphenol(m&p Cresol)
ug/L.
500
265
53
Hexachloro- 1,3--butadiene
ug/L
500
260
52
Hexachlorobenzene
ug/L
500
424
85
Hexachloroethane
ug/L
500
232
46
Nitrobenzene
ug/L
500
362
72
Pentachlorophenol
ug/L
1000
737
74
Pyridine
uq1L
500
179
36
2,4,6-1-ribromophenof (S)
%
92
2-1Wluorobiphenyl (S)
%
77
2-Fluorophenol (S)
%
40
Nitrobenzene-d5 (S)
%
76
Phenol-d6(S)
%
24
Terphenyl-d14 (S)
%
88
% Rec
Limits Qualifiers
10-110
39-108
40-104
42-109
31-110
30-110
10-110
39-121
10-110
32-101
18-108
10-110
27-108
13-107
10-110
12-102
10-110
21-132
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05:00 PM without the written consent of Pace Analytical SenAces, LLC, Page 15 of 36
PO Box 228 ® Statesville, NC 28687 ® 704/872/4697
Page 24 of 45

aCuMInlanlyfical
www�p,,ICelabs.com
Project: 190415.17.01
Pace Project No.: 92425692
QC Batch: 469764 Analysis Method: ASTM D2974-87
QC Batch Method, ASTM D2974-87 Analysis Description: Dry Weight/Percent Moisture
Associated Lab Samples: 92425692001
-----------
SAMPLE DUPLICATE: 2550987
92425391001 Dup
Parameter Units Result Result RPD Qualifiers
Percent Moisture % 20.5 2000 2
SAMPLE DUPLICATE: 2550989
Parameter
Percent Moisture
92425692001 Dup
Units Result Result RPD Qualifiers
% 975 97A 0
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LLC. Page 16 of 36
1
PO Box 228 ® Statesville, NC 28687 e 704/872/4697
Page 25 of 45

",,"Pace Analytical
wwwpacelaces. coat
Project: 190415.17.01
Pace Project No.: 92425692
QC Batch: 471992 Analysis Method: EPA 1010A
QC Batch Method: EPA 1010A Analysis Description: 1010 Flash Point, Closed Cup
Associated L.ab Samples: 92425692001
SAMPLE DUPLICATE: 2561048
92426441001 Dup
Parameter Units Result Result RPD Qualifiers
Flashpoint deg F >200 >200
Pace Analytical Services, LLG
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result,
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date- 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LLC, Page. 17 of 36
P® Box 228 * Statesville, NC 28687* 704/872/4697
Page 26 of 45

A 200,
-ac'eAnalytical
wwwpacelbbs,rcom
Project- 190415.17.01
Pace Project No.: 92425692
QC Batch: 471999 Analysis Method: EPA9045D
QC Batch Method, EPA 9045D Analysis Description: 9045 pH
Associated Lab Samples., 92425692001
SAMPLE DUPLICATE: 2561062
Parameter
pH at 25 Degrees C
SAMPLE DUPLICATE,,- 2561063
Parameter
pH at 25 Degrees C
92425490001 Dup
Units Result Result RPD Qualifiers
Std. Units 5A 5.5 2 H3
92426076004 Dup
Units Result Result RPD Qualifiers
Std. Units 7.4 7A 0 H3
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LLC. Page 18 of 36
PO Box 228 ® Statesville, NC 28687 9 704/872/4697
Page 27 of 45

C Ie e a Analytical
wwwpacelabs,com
Project: 190415.17,01
Pace Project No.: 92425692
OC Batch: 470323 Analysis Method: EPA 9095B
QC Batch Method; EPA 9095E Analysis Description: 9095 PAINT FILTER LIQUID TEST
Associated Lab Samples: 92425692001
SAMPLE DUPLICATE.- 2553508
92425692001 Dup
Parameter Units Result Result RPD Qualifiers
Free Liquids Fail Fail
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LLC.
Page 19 of 36
PO Box 228 o Statesville, NC 28687 o 704/872/4697
Page 28 of 45

11
11-,-.,-,AaceAna1ytica1
wwwpace tabs. corn
A&I
Project: 190415.17,01
Pace Project No,: 92425692
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
HUntersville, NC 28078
[phone]
QC Batch: 339303
Analysis Method:
EPA 9014
QC Batch Method: SW-846 7.3.3.2
Analysis Description:
733C Reactive Cyanide
Associated Lab Samples- 92425692001
METHOD BLANK- 1651467
Matrix: Solid
Associated Lab Samples: 92425692001
Blank Reporting
Parameter
Units
Result Limit
Analyzed Qualifiers
Cyanide, Reactive
mg/kg
ND
1.0 04/22/19 18:38
LABORATORY CONTROL SAMPLE: 1651468
Spike LCS
L.CS % Rec
Parameter
Units
Conc. Result
% Rec Lit -nits Qualifiers
Cyanide, Reactive
mg/kg
99,4 ND
0 0-8
SAMPLE DUPLICATE: 1651469
30289318001 Dup
Parameter
Units
Result Result
RPD Qualifiers
Cyanide, Reactive
mg/kg
ND
ND
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LLC.. Page 20 of 36
PO Box 228 * Statesville, NC 28687 ® 704/872/4697
Page 29 of 45

0a
j/ Analytical
wwwpacelabscam
Project- 190415.17.01
Pace Project No.: 92425692
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QC Batch: 339302
Analysis Method:
SM 4500S2F-00
QC Batch Method: SW-846 73.4.2
Analysis Description:
734E Reactive Sulfide
Associated Lab Samples: 9242,9692001
METHOD BLANK: 1651463
Matrix: Solid
Associated Lab Samples: 92425692001
Blank Reporting
Parameter
Units
Result Limit
Analyzed Qualifiers
Sulfide, Reactive
rn.g/kg
ND
10 04/22/19 17:48
LABORATORY CONTROL. SAMPLE: 1651464
Spike LCS
L.Cs % Rec
Parameter-
Units
Conc. Result
% Rec Urnits Qualifiers
Sulfide, Reactive
mg/kg
199 35,8
18 0-52
SAMPLE DUPLICATE: 1651465
30289318001 Dup
Parameter
Units
Result Result
RPD Qualifiers
Sulfide, Reactive
mq/kg
ND
ND
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05-00 PM without the written consent of Pace Analytical Services, LLC. Page 21 of 36
P® Box 228 9 Statesville, NC 28687 e 704/872/4697
Page 30 of 45

acceAnalytical
wvilwpacelabscom
Project: 190415,17,01
Pace Project No.: 92425692
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
DF - Dilution Factor-, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit,
TNTC - Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit,
MDL­ Adjusted Method Detection Limit.
PQL - Practical Quantitation Limit,
RL - Reporting Limit - The lowest concentration value that meets project requirements for quantitative data with known precision and
bias for a specific analyte in a specific matrix.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration,
Consistent with EPA guidelines, unrouncled data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not. detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether..
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-NitrosodiphenylarTiine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute,
LABORATORIES
PASI-A Pace Analytical Services -Asheville
PAST-C Pace Analytical Services - Charlotte
PASI-PA Pace Analytical Services - Greensburg
ANALYTE QUALIFIERS
1g The temperature in the TCLP/ZHE extraction area was outside the method required range of 21-25 degrees C,
H3 Sample was received or analysis requested beyond the recognized method holding time.
S2 Surrogate recovery outside laboratory control limits due to matrix interferences (confirmed by similar results from sample
re -analysis).
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05.00 PM without the written consent of Pace Analytical Services, LLC.
Page 22 of 36
PO Box 228 ® Statesville, NC 28687 ® 704/872/4697
Page 31 of 45

11 )!2a A Cc; nalytkal
wwwpacelabs,com
Project, 190415,1 7,01
Pace Project No.: 92425692
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Lab ID
Sample ID
QC Batch Method
QC Batch
Analytical Method
92425692001
190415.17.01
EPA 351 OC
471215
EPA 8081 B
92425692001
190415.17.01
EPA 3546
470280
EPA 8082A
92425692001
190415.17.01
EPA 351 OC
471354
EPA 8082A
92425692001
190415.1T01
EPA 301 OA
472926
EPA 601 OD
92425692001
190415.17.01
EPA 7470A
472928
EPA 7470A
92425692001
190415.17,01
EPA 351 OC
471352
EPA 8270E
92425692001
190415.17.01
EPA 8260D
471650
92425692001
190415.17.01
ASTM D2974-87
469764
92425692001
190415.17.01
EPA 1010A
471992
92425692001
190415.17.01
EPA 9045D
471999
92425692001
190415AT01
EPA 9095B
470323
92425692001
190415.17.01
SW-846 T3.3.2
339303
EPA 9014
92425692001
190415.17.01
SW-846 7.3.4.2
339302
SM 4500S2F-00
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/28/2019 05:00 PM without the written consent of Pace Analytical Services, LIC,
Analytical
Batch
471416
470695
471417
473223
472965
471456
339409
339407
Page 23 of 36
P® Box 228 e Statesville, NC 28687 e 704/872/4697
Page 32 of 45

Document Name:
Sample Condition Upon Receipt(SCURI
Docurnent Revised: February 7, 2018
Pa I of 2
Document No.:
F-CAR-CS-033-Rev.06
-
Issuing Authority*
Pace Carolinas Quality Office
Laboratory receiving samples:
Asheville Eden [J Greenwood HuntersvilleEl RaleitzhF1
LAI
-.0 W0# zwzlz
: 4ft24Z
Clien Name:
Project
Courier:
OUPS
OFed Ex ( 1i5P5 M []Client
Commercial [3Pace Dither:-
9242SS92
Custody Seal Present? Des 0No Seals Intact? [3Yes ONo
Date/Initials Person Examining Contents.
Packing Material.- ElBubble Wrap 08ubble Bags []None Other
Biological Tissue Frozen?
Therrhometer:
'OIRGun lot 92TO48 Type of Ice. []Wet Divue
E]Yes []No n.N/A
[]None
Cooler Ternp (*Q: Correction Factor, Add/Subtract ("Q 0.0
Cooler Temp Corrected (.*C):
Temp should be above freezing to 6"C
[DSamples out of temp criteria. Samples on ice, cooling process
USDA Regulated Soil (O'N/A, water sample)
has begun
Did samples originate in a quarantine zone within the United States- CA, NY, or SC (check maps)?
f"_1VaC
Did samples originate from a foreign source (internationaliv,
Comm ents/Discrepa n cy.,
Chain of Custody Present?
r7l
1"T
No
EIN/A
1.
-Samples Arrived within Hold Time?
ayes
ONo
[]NIA
2.
-Short Hold Time Analysis (<72 hr.)?
Flyes
QNo._
_ON/A
3.
-Rush Turn Around Time Requested?.
YesQNo ON/A
4.
Sufficient Volume?
(]No
QN/A
S,__,__
Correct Containers Used?
OYes'
ONo
[]t4/A
6,
-Pace Containers Used?
OYes
ONO
Containers Intact?
_QNIA
Yes No ON/A
7,
Dissolved analysis:. Samples Field Filtered?
0yes
Na
E]
NIA
C]
R.
Sample Labels Match COC?
ZYes
ONO
[]N/A
9i
-includes Date/Time/Its/Analysis Matrix:
10'.
Headspace in VOA Vials (>5-6mm)? Elye5 No t4/A
Trip Blank Present?
[,Yes
ONO
[3iqlA
11.
Trip Blank Custody Seals Present?
r-11 At
mrto
dN/A
COMMENTS/SAMPLE DISCREPANCY
. . . . ..........
CLIENT NOTIFICATION/RESOLUTION Lot ID of split containers:
Person contacted:
Date/Time:
Project Manager SCURF Review-,
Date:
Project Manager SRF Review:
Date:
Field Data Required? FlYes [:]No
Page 24 of 36
PO 8®x 228 e Statesville, NC 28687 9 704/872/4697
Page 33 of 45

/
Document Name:
Document Revised., February 7, 2018
Pr
A?Ce, AMIOMI
Sample Condition Upon Receip_t(SCUR)
Page I of 2
Document No.:
Issuing Authority: --
F-CAR-05-033-Rev,06
Pace Carolinas Quality Office
*Check mark top half of box if pH and/or clechlorination is
verified and within the acceptance range for preservation
samples.
Exceptions: VOA, Coliform, TOC, Oil and Grease, DRO/8015 (water) DOC, LLHg
"Bottom half of box is to list number of bottle
7'rojec"Wo# so 92,425692
pM; TIH Due Date: 04/30/19
C�JCMT: 92—States"'
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Sample ID
Type of Preservative
PH upon receipt
Date preservation adjusted
Time presentation
adjusted
Amount of Preservative
added
t - 0 in
Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form wlll 6e sent to the North Carolina DFHNR Certification Office (i,e.
Out of hold, incorrect preservative, out of ternp, incorrect containers,
Page 25 of 36
PO Box 228 e Statesville, NC 28687 ® 704/872/4697
Page 34 of 45

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PO Box 228 ® Statesville, NC 28687,9 704/872/4697
Page 35 of 45

, A NALYTICAL REPORT
'PakeAnal ytical
April 25, 2019
Pace Analytical - Huntersville, NC
Sample Delivery Group:
L1090481
Samples Received:
04/18/2019
Project Number:
92425692
Description:
190415.17,C)l
Site'.
001
Report To:
-ryriek Hooks
9800 Kincey Avenue, Suite 100
1-11-Intersville, NC 28078
4
Ditire Report Reviewed By.-
N a n cy M c La i n
c
Project Manager
Results re ate onY, to the iterls iesteCf Or cal!bf aled and a,
e-P1 % ' -c-u, ded vaes. "'is test !?Post shalloo. Di' repfoduc-od, OXC(Mt i;l fL,11, V'Afh here, app�icabllo' sarmolnng Conduc.ted Dy pa(�o out wriflen app�tcmfl of trK, IfIll")"DI'W'01Y VVI
I
is perfixm(-"(! pc.?r guidancr,-.. provided 1 i laboratoty 0'andard oc)(nating prl'xrAures 060302, 060303, and 06101304.
ACCOUNT: PROJECTSDG- DATE/TIME. PAGE.
I
Paf-e Analytical - Huntetsvdk,, INC 92425692 L1090481 04/25'1011 121-31 1 of 10
PO Box 228 e Statesville, NC 28687 ® 704/872/4697
Page 36 of 45

TABLE OF CONTENTS
te S 2
w
Ss: Sample Summary 3
Cn: Case Narrative 4
Sr: Sample Results 5
190415.17.01 L1090481-01 5 ]n
QC: QW-flity (-.ont[rol Surnrnaty 6
ChIr,'winat(,:-�d, Acid F-Ierbi--id�',-;s IGC) by IN ethod 811- IA 6
GI: Glossary of Terms 7
F
Sc.,- Sample Chain Of CLIstody 9 LEI
F7S 7, 1
ACCOUNT -
Pace Aj ialyfl,,'-)! - H � svoke, NC
Page 28 of 36
PROJECT- SM DATEMME: PAGE.
92425692 1-109048", 04/2519 35 2 10
PO Box 228 ® Statesville, NC 28687 9 704/872/4697
Page 37 of 45

SAMPLE SUMMARY
C't Hrwjnci
190415,17.01 1-10904-81-01 Waste 0 1 i 9 E0 08
mc,th"od Batch Diluflon Preparation Analysis Analyst Locat.or
datc,/tinic, date/timp
Pieparation by Method 1311 WG1270126 1 04/22/19 20:03 04/22/19 20;03 CGD Mt, Juliet, TN
Chlorinated Acid Herbidd(n (GC) by Mcthod 8151A WG1270887 1 04/24/19 OT35 04,1124/19 22,.28 KLM Mt. Jullot, TN
ACCOUNT,
Pi;ice Analfyflcai - Hurittfsvdk-,,, NC
Page 29 of 36
PROJECT: SDG- DATE/TIME., PAGE'
3 of 10 92425692 L109,048' 0 4 19, 3'-1 i
PO Box 228 e Statesville, NC 28687 * 704/872/4697
Page 38 of 45

'01
CASE NAtP2-,,a,T1VE
All sample aliquots were received at the correct temperature, in the proper containers, with the
appropriate preservatives, and within method specified holding times, unless qualified or notated within
the report. Where applicable, all MDL (LOD) and RDL (LOQ) values reported for environmental samples
have been corrected for the dilution factor used in the analysis, All Method and Batch Quality Control
are within established criteria except where addressed in this case narrative, a non-conformance forryi
or properly qualified within the sample results. By my digital signatUre below, I affirm to the best of nay
knowledge, all problerns/ariornalies observed by the laboratory as having the potential to affect the
quality of the data have Been identified by the laboratory, and no information or data have been
knowingly withheld that would affect the quality of the data,
[7—
El
Nancy McLain
Project M,--i n a g'e r
Page 30 of 36
ACCOUNT: PROJECT: SDG,, DATE/TIME. PAGE'
Pace Anoily Uccil - NC 92425692 L10901181 04/251") 1112:34 of 10
PO Box 228 * Statesville, NC 28687 ® 704/872/4697
Page 39 of 45

190415.17.01 SAMPLE RESULTS - 01
Coflectpd date/time: 04/15/19 10,00 L1090481
j1....'
P I 4e!_1 c)! I I-) Y M I o c! --�
Result Qualifier
Prep
Batch
Analyte
date / hme
TCLP Extraction
4/22/2019 3,03-07 PM
WG1270126
Fluid
1
4/22/2019 8,03:07 PM
WG1270126
Initial pH
6.37
4/22/2019 8:031-07 PM
WG1270126
Final pH
4,86
4/22/2019 &03:07 PM
WG1270126
Chdon!"'fated Add by iod
815"A
Analyte
Result Qualifier
mg/l
RDL Limit
rng/l ing/l
Dilution
Analysis
Mate; tirne
Batch
2,4,5-TP (Sil-vex)
ND
0.00200 1
1
04/24/2019 22,28
WG 1, 27083-7
2,4-D
ND
0,00200 10
1
04124/2019 22:28
WG12 7088-7
Acid
72,
14.0-1,58
041'2412019 22,28
W G 12 7 083'3 7
c
21-1
1 c
ACCOUNT;
P ac c,, Analyflic-al - Hlumeisvffle. NC
Page 31 of 36
PROJECT: SDG-, DATE/TIME: PAGE:
92/1-25-692 L1090.481 04/251119 12:'35 0 of 10
PO Box 228 ® Statesville, NC 28687 e 704/872/4697
Page 40 of 45

4
'A i
WG1270887 QUALITY CONTROL SUMMARY iN L
Chlorinated Acid Herhicides (GCj by Method 8151A L,0904 31.01
--------- --- . . ....... . . . .. . .............. . ......... . . ......
(MD) R-3140171,082-1 04/24/19 14A33
MD Result W Oualifier MB MDL MD RDL
Analyte fria/1
2,4-D U 0.00()66)7 000200
2,4,5-TP (Silvexl U 0,000616 7 0 00200
(S) 2, 4-Dioiluj (wheii34A ell,", 66 6
Aleid 14 6 158
(LCS)R3405082,2 04/241191457
Spike Amount LCS Result LCS Rec. Rec. Limits LCS Qualifier
Analyte mg/1 11-1,cd
2,4--D 0,0500 0.0417 81-1 500-120
2,4,:'-Tp
0, 0 5 01 0 0 0406 81 50, 0 125
ophe;;J4 Ac eric 85") illy, 6 158
Aoc!
(OS) L109036,101 04/24,19
15,26 - (NrIS) R04050182-3 04/24119 15' 9 - (MSD) R34015-082
4 04/24/19 15,53
SpikeAmount
Original Result MS Result MSD Result
MS Rec,
MSD RecDilution Rec, Limits MS Qualifier MSD Qualifier RPD RPD Limits
Analyte
mg/!
l"'ic"I rng I i-110
q 06
2,4-D
0,V)00
N D 0,05010 O.0448
100
89,6 1 5 01, 0 Al 2 0 11.0 20
2,4,5-,TP (&Ivex)
00500
ND 0,03-'95 0,0350
79,0
700 1 50 0-125 121 20
61' 2,4
Ac;d
80,6
72 2
ACCOUNT:
Pic -& An a I � ! f c ,-Al 11 ue-sv i I I (�. NC
En
Page 32 of 36
PnOJECT. SDG: DATE/TIME PAGE.
9 2,12 156 9 2 1-1090491 ('W25/19 K")�35 eoflc
PO Box 228 is Statesville, NC 28687 e 704/872/4697
Page 41 of 45

GLOSSARY OF TERMS -Z' r
Gui(jje to Reachrily �_.irid Undel-Std1_11dilIg YOLA L�ibor-�',iLory Repc')(
T"he information below is designed to better* xi.,.lain the various 1EIMIS used in you.r report s
eof analytical resull�s from the Laboratory. phis is not
intended as a cornf--yrehensive explanation, and if YOU have additional questions please contact your project representative.
Abbreviations and Definitions
MDL
Method Detection Limit.
ND
Not detected at the Reporting Limit (or MDL where applicable).
RDL
Revorted Detection Limit.
Rec.
Recovery.
PPD
Reiative Percent Difference.
En
SDG
S,.-in-iple Delivery (..,roup.
(S)
SUH-0gate (Surrogate Standard) - Aiwflytes added to every blank, sample, Laboratory Control Sarnple/Duplicate and
Matrix Spike/Duplicate, used to evalUale analytical efficiency by rneasuring recovery. Surrogates are not expecLed 11-0 be
defected in all e-nvironincantal media,
U
Not detected at the Reporting Limit (or MDL where applicable).
Analyte,
The n�_-jmc. of the particular compound or analysis per, - ormed, Some Analyses and Methods will have multiple analytes
reported.
if the sample matrix contains an interfering material, the sample preparation volunne or we. ighit varies differ from the
standard, or if concentrations of analytes in the sample are higher than the highest limit of concentrati on that the
DilUti0f)
Laboratory can aMlral report, reort, the sarnple n-jay be diluted for analysis. If'a value different than 1 is used in this field, the
'
result reported has already been corrected' for this fac"tot.
rm
Thc.-se are the target O'C') recoveiy ranges or '7,, diff.& ence value that the. laboratory has historically determined as normial
Limits
for the rnethod and analvte being reported, Successful CC Sample analysis will target all analytes recoverecl of-
clul.-)IIcatexd within t1hese ranges.
_
Original Sample
The non -spiked sample in the Dreg !'.-J-aich used to determine the Relative Percent Difference (RIDDI from a qU6111ty central
fir,
s'arnplo The Onciinal Snmplo may not be included v.,ithin the reported SDG.
This column provides a letter and/01 number designation that corresponds to additional information concerning the result
QUalifier
reported. If a Qualifier is present, a definition p,er Qualifier is provided within the Glossary and Definitions page and
potentially a discussion of possible implications Of the Qualifier in the Case Narrative- if applicable,
I
The actual analytical final result (corrected for any sample specific characte rlstics) reported for Your sarnpic, If there was
no measurable result returned for a specific ana!yte, the reSUIt in this COIUrnn may state "ND" (Not Detected) or "BDL"
Result
(Below Detectable Levels). The information in the results column shot.fld always be accompanied by either an MDL
(tvlothod Detection Limit) or RDL (Reporting Detection Urnit) that defines the lowest value that the laboratory could detect
or report for tillis analyte.
Uncertait-ity
(Radiochemistry)
Confidence, level rat sigma.
A brief discUssion about. the included sample results, including a dt5cussion of any non -conformances to protocol
Case Narrative (Cn)
observed either at sample receipt by the laboratory from the field or during th-e- analytical process. If present, there
be a section in the Case Narrative to diSCUS'S the meaning of any data qualifiers U'Sed in the report.
Quiality Control
1-his sectioln of the report includes the results of the laboratory quality control analyses required by procedure or
C
SUrnnIal'y (0)
analytical methods to assist in evaluating the validity of the results reported for your sarnj.-)Ies. These ;analyses are not
being performed on your samples typically, but on laboratory generat:=:d material.
This is the docurnent created ini the field when your SFAITIPIeS Were initially collected, This is used to verifythe time and
Sample Chain of
date of coilection, the person collecting the samples, and the anal�,se5 that, the laboratory iS requested to perform. Ti'lls
ci-Istody (Sc)
chain of custody also documents all persons (excluding con-irnercial shippers) that helve I lad control or possession of the
sm-riples fium the time of collection until deliveiy to the I'--fl_)o1aL0[y for reanalysis,
This section of your rcpoit will provide the. results of . all testing performed on your sariplus. These results are provided
P
Sarnple Results (Sr)
by sample ID iand are- separated by the analyses perforry)6d on each sample. The head et line of each anaiysis section for
each sample will provide the name and method number f)t the analysis reported,
c
Sample Surnmary (Ss)
This section of the. Analytical Report deffines tine specific- analyses performed for each sample ID, including the dates and
times of preparation and./or analysis.
G 1- lc- I I 'I I C-t I'
D(::�scro+iol
The rernainder of this page intentionally left blank, there are no qUalifiers applied to this SDG.
ACCOUNT-
Ana�ytic',0 - NC
Page 33 of 36
PROJECT: SDG: DATE/TIME., PAGE:
92425692 L1090481 04,12"519 12 31� 7ol 10
P® Box 228 e Statesville, NC 28687 ® 704/872/4697
Page 42 of 45

I I
ACCREDITATIONS & LOCATIONS LAU,
Pace National is the only environmental lahioratoiy accredited/certified to support your work nationwide from onr� location. One phone ull), one point of contact, one laboratory- No other lib is as
accessible or pr epared to handle your needs throughout the Country. Our Capacity and capability from our single location laboratory is comparable to the collective totals of the network
laboratories in our industry. The most significant benefit to our one location design is the design of our laboratory campus. model is conducive to accelerated productivity, decreasing
turn -around time, and preventing cross contamination, thus protecting sample integrity, Our focus on prerniurn quality and prompt >ervis e allows us to be YOUR LAO OF CHOICE.
Not, all certifications held by the laboratory are applicabip to the results reported in the attached report.
Accreditation is only applicable to the test methods specified on each scope of accreditation held by Pace National,
...
Alabama
..... ...
40660
Nebraska
NE-OS-15-05
Alaska
17-026
Nevada
TN-,03-2002-34
Arizona
AZ0612
New Hampshire
2975
Arkansas
88-0469
New Jersey-NELAR
TNO02
California
2932
New Mexico'
rit
Colorado
TNO0003
New York
11742
Connecticut
PH-0197
North Carolina
Env375
Florida
E87487
North Carolina'
DW21704
Georgia
NELAP
North Carolina
41
Georgia
923
North Dakota
R-140
Idaho
TNO0003
Ohio--VAP
CL0069
Illinois
200008
Oklahoma
9915
Indiana
C-TN-01
Oregon
TN200002
Iowa
364
Pennsylvania
63-02979
Kansas
E-10277
Rhode Island
LA000356
Kentucky"
90010
South Carolina
84004
Kentucky
16
South Dakota
nia
Louisiana
A130792
Tennessee
2006
Louisiana
LA180010
Texas
T104704245-18-15
Maine
TNO002
Texas'
LAB0ISS2
Maryland
324
Utah
TNO0003
Massachusetts
M-TNO03
Vermont
VT2006
Michigan
9958
Virginia
460132
Minnesota
047-999-395
Washington
C847
Mississippi
TNO0003
West Virginia
233
Missouri
340
Wisconsin
9980939910
Montana
CERT0086
Wyorning
A2LA
A2LA - ISO 17025
146101
AIHA-LAP,LLC EMLAP
100789
A2LA - ISO 17025'3
1461,02
DOD
1461,01
Canada
1461,01
USDA
P330-15.,00234
EPA-Cr ypto
1'NO0003
'DiinkingWater 2, Underground Storage'Tanks 1Aquatic Toxicity 'CIIO.M.icalf'Microbiologi,,-,31 51VIold "Wastewater n/a Accreditation not ap
Pace National has sixty-four client support centers that provide sample pickup and/or the delivery of sampling supplies. If YOU Would like assistance from one of our support offices, please contact
out, main office, Pace National performs all testing at our central laboratory.
4P
­'4
'Al
N
4f
ACCOUNT:
Poce, Aridk/tic�al - 1'­1tfate!,vflk,.', NC
PROJECT: SDG,. DATE/TIME:
92425692 1-1,119048i 04,12',>(19 12:35i
Page 34 of 36
PAGE:
8 0i I()
PO Box 228 ® Statesville, NC 28687 e 704/872/4697
Page 43 of 45

Chain of Custody
Workorder, 924f2'5692 Workorder Nimrzn, 1 -7 n -i
;acIeAna1yVcaI'
2 t 09 Pago 35 of 36
PO Box 228 ® Statesville, NC 28687 ® 704/872/4697
Page 44 of 45

Page 36 of 36
PO Box 228 • Statesville, NC 28687 ® 704/872/4697
Page 45 of 45

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

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

State of North Carolina
DWR
Department of Environmental Quality
Division of Water Resources
Division of Water Resources LAND APPLICATION SITE CERTIFICATION
INSTRUCTIONS FOR FORM: LASC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of receiving sites for land application of Class B residuals (may include
water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not submit this certification for review
without a corresponding application form (FORM: RLAP 06-16 or FORM: SDR 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documcntation listed
below.
A. Land Application Site Certification (FORM: LASC 06-16):
® Submit the completed and appropriately executed Land Application Site Certification (FORM: LASC 06-16) form. Please
do not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments
to the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
® For new or renewed permits, submit the requested information for all land application sites.
❑ For modified permits, submit the requested information for only those sites that are new, transferred or affected by the
proposed modification.
B. Land Application Site Information:
® The status of the land application site with respect to this residuals land application program must be provided in table I. The
status categories and their corresponding codes are as follows:
♦ New (N) ♦ Renewed (R) ♦ Modified (M) ♦ Transferred (T) ♦ Deleted (D)
® Attach the following in accordance with each status code:
Status Code
Required Item
N
R
T
M
✓
County Board
Notification.doc
+'
I
.
Land Owner
Agreement
(If applicable)
I A
I'
V
V/
V/
V/
Setback Waiver
Agreement
An updated vicinity/setback map in accordance with the "Map Guidance
for Residuals Land Application Permits"
✓
✓
✓
A soils and agronomic evaluation in accordance with the "Soil Scientist
Evaluation Policy"
✓
INSTRUCTIONS FOR FORM: LASC 06-16 Page 1 of 3

An updated accounting of the land application site's cumulative
pollutant loading rates (CPLRs)
Required Item
Status Code
N7
R
T
M
For previously permitted sites without a soil series name indicated in the
Attachment B, submit County Soil Survey Map (or equivalent) clearly
✓
indicate the location of the land application site and in accordance with
the soil map requirements in the "Soil Scientist Evaluation Policy"
Acknowledgement of field transfer from Land Owner (Fields may not
be permitted to multiple Permittees over the same time period)
* This item may be required for land application site with a status code "M", please contact the Division if you need assistant in
determining attachment requirements.
❑ Crop Type should include the most likely crop types for the life of the permit (five years).
❑ Predominant Soils Series Name must be either the name of the soil indicated in Attachment `B" of the existing permit, or
name of the soil series as provided by the licensed soil scientist.
❑ Predominant Soil Mapping Unit or Representative Slope: Either the Soil Mapping Unit or the representative slope of each
site must be provided. The predominant soil -mapping unit must be consistent with the predominant soil series name. Please
note that the soil mapping units are variable between Counties, so care should be taken in properly identifying the correct
mapping unit. If a representative slope is provided, it must be determined accordingly:
❑ For sites previously permitted for use, but do not have an established soil mapping unit (the mapping unit provides
information on both the soil series name and the slope of the soil), the Applicant may determine the representative slope
by using the average slope provided in the County Soil Survey (or equivalent). A soil type with a slope range of 4 - 8%
would have a representative slope of 6%.
❑ New Sites to be permitted must have slopes determined as part of the soils report prepared by a licensed soil scientist.
❑ Acceptable methods for determining location coordinates (i.e., latitude and longitude) and their corresponding codes are as
follows:
• Address Matching (ADD)
• Aerial Photography with Ground Control (AER)
• Cadastral Survey (SUR)
• Conversion from Coordinate Plane (CP)
• Conversion from Township -Section -Range (TSR)
• Conversion from Universal Trans Merc (UTM)
• Map Interpretation by Digital or Manual Extraction (MAP)
• Digital or Raw Photo Extraction (EXT)
• Geodetic Quality GPS Survey (GEO)
• LORAN-C Navigation Device (LOR)
• Navigation Quality GPS (GPS)
• Remote Sensing (RS)
• Zip Code Centroid (ZIP)
C. Waterbody and Classifications Information: (new sites only)
❑ Use an 8.5 by 11-inch copy of the portion of a 7.5-minute USGS Topographic Map to identify the location where the
residuals program activities are planned to occur as well as the closest downslope surface waters as clearly as possible. Each
map portion must be labeled with the map name and number, the identified location, and be of clear and reproducible quality.
❑ Surface water body classifications information may be found at: hLtp:Hdeq.nc.gov/about/divisions/water-
resources/planning/classification-standards/classifications
❑ Any questions concerning the waterbody and its classification, please contact the Division's regional offices.
❑ A list of the Division's regional offices, their county coverage, and their contact information may be downloaded at:
http://deq.nc.gov/contact/regional-offices
❑ General Instructions: There are 17 river basins in North Carolina. Each basin has associated waterbodies with assigned
subbasins, location descriptions, stream index numbers and established classifications.
1. Identify the project area on a 7.5 minute USGS topographical map (an 8.5 x 11-inch sheet showing the project area
should be submitted with the permit application regardless of whether a Stream classification was completed).
2. Determine the names of all the closest down slope surface waters from the project site. For unnamed tributaries, see
Table 1: Unnamed Tributaries Entering Other States or for Specific Basin Areas. Label any unnamed tributaries as
"UT to stream name" as the waterbody name.
3. Open the link http:Hdeg.nc.gov/about/divisions/water-resources/planning/classification-standards/classifications.
❑ Stream Classification Process: One of the options below may be used depending on the known initial project information.
❑ KNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Select proper basin from the List all Waterbodies in Basin sorted report. Sort hydrologically as this will provide
the proper location descriptions if multiple runs.
INSTRUCTIONS FOR FORM: LASC 06-16 Page 2 of 3

2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ KNOWN COUNTY WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Select the proper county from the List all Waterbodies in county, hydrologically report.
2. Locate the name of the identified waterbody (from General Directions) on the list.
3. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
4. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ UNKNOWN BASIN WHERE CLOSEST DOWN SLOPE SURFACE WATER IS LOCATED
1. Use the Clickable basin map to hydrologically sorted list report.
2. Click on the approximate project location to bring up the hydrologically sorted list.
3. Locate the name of the identified waterbody (from General Directions) on the list.
4. For multiple listings of the same waterbody name in the report, select and verify the location description. The term
"source" in the description means the beginning of the waterbody segment (most upstream point).
5. Record all Basins, Stream Index Numbers and Classifications applicable to the project.
❑ Notes on index number and unnamed streams:
Unnamed Streams 15ANCAC 02B .0301(i).
❑ Any stream which is not named in the schedule of stream classifications carries the same classification as that assigned
to the stream segment to which it is tributary (at the point of entry) except:
(A) unnamed streams specifically described in the schedule of classifications;
(B) unnamed freshwaters tributary to tidal saltwaters will be classified "C"; or
(C) after November 1, 1986, any newly created areas of tidal saltwater which are connected to Class SA waters by
approved dredging projects will be classified "SC" unless case -by -case reclassification proceedings are conducted.
❑ The following river basins have different policies for unnamed streams entering other states or for specific areas of the
basin:
Unnamed Tributaries Entering Other States or for Specific Basin Areas
Hiwassee River Basin
Streams entering Georgia or Tennessee shall be classified "C Tr."
Little Tennesse River
Basin And Savannah
River Drainage Area
Streams entering Georgia or Tennessee shall be classified "C Tr." Such streams in the Savannah
River drainage area entering South Carolina shall be classified "B Tr."
French Broad River
Basin
Streams entering Tennessee will be classified "B."
Watauga River Basin
Streams entering the State of Tennessee are classified "C."
Broad River Basin
Streams entering South Carolina are classified "C."
New River Basin
Streams entering the State of Tennessee are classified "C."
Catawba River Basin
Streams entering South Carolina are classified "C."
Yadkin -Pee Dee River
Basin
Streams entering Virginia are classified "C," and such streams entering South Carolina are
classified "C."
Lumber River Basin
Streams entering South Carolina are classified "C Sw."
Roanoke River Basin
Streams entering Virginia are classified "C." Except that all backwaters of John H. Kerr
Reservoir and the North Carolina portion of streams tributary thereto not otherwise named or
described shall carry the classification "B," and all backwaters of Lake Gaston and the North
Carolina portion of streams tributary thereto not otherwise named or described shall carry the
classification "C and B."
Chowan River Basin
Streams entering Virginia are classified "C."
Tar -Pamlico River
Basin
All drainage canals not noted in the schedule are classified "C Sw." except the main drainage
canals to Pamlico Sound and its bays which shall be classified "Sc."
Pasquotank River Basin
All drainage canals not noted in the schedule are classified "C."
INSTRUCTIONS FOR FORM: LASC 06-16 Page 3 of 3

LAND APPLICATION SITE CERTIFICATION
Applicant's name: Town of Cleveland
Land application sites currently certified: 44.3 net acres and Total to be certified: 10.0 net acres.
I. LAND APPLICATION SITE INFORMATION (See Instruction B):
Status
Codes
Site/Field ID
Landowners
O
Lessees or Operator(s)
O
Net Acres
County
ty
s
Crop(s)
pO
Predominant Soil
Series Nameb
Mapping Unit
or Rep. Slope
R
NC-RA-01-01
Guy Byrd
10.0
Rowan
Fescue
Enon
EnB
D
NC-RA-56-o1A
Hodge, Ira Franklin
10.3
Rowan
Fescue
Lloyd
LdB2
D
NC-RA-56-01B
Hodge, Ira Franklin
11.8
Rowan
Fescue
Enon
EnB
N
N
N
EL
I
N
N
a Status Code for land application sites are: ♦ N (New) ♦ R (Renewed) ♦ M (Modified) ♦ T (Transferred) ♦ D (Deleted)
n Soil Series Name (i.e. Appling, Cecil, etc.)
Mapping Unit must be consistent with those used in the County Soil Survey (i.e. for a 2-8% slope Cecil in Anson County the mapping unit is CeB2)
II. WATERBODY AND CLASSIFICATIONS INFORMATION (See Instruction C):
Site/Field ID
Latitude
Longitude
Location
Datum
Location Method Code
Location Accuracy
Waterbody Subbasin and
Stream Index No.
Current and Proposed
p
Class
01/01
350 44' 17.8"
800 39' 59.3"
NAD 83
MAP
Nearest tenth of second
UT to Third Creek (12-108-20-4)
C
C
.°..
.°..
NAD 83
ADD
Nearest Second
_
NAD 83
ADD
Nearest Second
_
a° M F "
a M M'
NAD 83
ADD
Nearest Second
M ["
.°.."
NAD 83
ADD
Nearest Second
W W "
it M'
NAD 83
ADD
Nearest Second
_
_
° '
M'
NAD 83
ADD
Nearest Second
_
_0
= F = F'
�°..
NAD 83
ADD
Nearest Second
_
Note: Please keep the site information (I.) and waterbody information (I1.) of the same field on the same page.
FORM: LASC 06-16 Page 1

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

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

D-1 WR
Division of Water Resources
State of North Carolina
Department of Environment and Natural Resources
Division of Water Resources
LAND OWNER AGREEMENT
FORM: LOA 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted, the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting_ Unit
General — This document is an agreement between the Applicant and land owner(s) of residuals receiving sites for land application of
Class B residuals (may include water treatment plant or other type residuals) in accordance with 15A NCAC 02T .1100. Do not
submit this agreement for review without a corresponding application form (FORM: RLAP 06-16).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Land Owner Agreement (FORM: LOA 06-16):
Submit the completed and appropriately executed Residuals Source Certification (FORM: LASC 06-16) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
Prepare a separate agreement for each set of land application sites that are owned or operated by an entity other than the
Applicant.
A copy of the completed and appropriately executed agreement must be provided to the landowner and the lessee/operator.
AGREEMENT FOR THE LAND APPLICATION OF RESIDUALS TO PRIVATELY OWNED LAND
The undersigned landowner or his representative hereby permits:
Applicant's name:
Town of Cleveland
hereinafter referred to as the Permittee, to land apply residuals from the following facility(ies) onto the following land
application site(s) (i.e., see attached setback maps) in accordance with the stipulations and restrictions as given in this
Agreement:
Site/Field ID
Lease
(yes/no)
Land Use or
Cropping Patterns
Intended Use of Crops
Residuals Source
(optional)
Special note
(no-till/over-seed/
pasture)
NC-RA-01-01
No
Fescue (Hay)
Animal Feed
The landowner or his representative receives, in consideration, full use of the nutrient value of the applied residuals while the
Permittee receives, in consideration, the use of the land application site(s) described above for the disposal of the residuals.
This Agreement shall remain in effect for the length of the Division's permit for the residuals land application program and
shall be renewed each time this permit is renewed.
The undersigned landowner or his representative and the Permittee agree to abide with the following restrictions and
stipulations until such time as written notification, given 30 calendar days in advance, modifies or cancels this Agreement.
FORM: LOA 06-16 Page 1 of 3

I. STIPULATIONS:
1. The landowner or his representative shall not enter into any additional residuals application contracts or agreements with another permitted
entity for the site(s) specified by this Agreement.
2. Should the landowner or his representative lease or otherwise permit the use of the land application site(s) to a third party, the landowner shall
be responsible to ensure that the third party agrees and complies with the terms and conditions of this Agreement.
3. The landowner or his representative shall adhere to the provisions of this Agreement until all of the site restrictions (under Section 11) are met.
4. Notification of cancellation of this Agreement shall be immediately forwarded to NCDENR-DWR, Non -Discharge Permitting Unit, 1636
Mail Service Center, Raleigh, NC 27699-1636.
5. The Permittee must request and obtain a permit modification from the Division prior to a transfer of the land application site(s) to a new
landowner. In addition, the current landowner shall give a notice to the new landowner that gives full details of the residuals applied at the
land application site(s).
6. The Permittee has provided the landowner or his representative with information and data concerning the residuals land application program,
including an analysis of constituents of the residuals, residuals application methods, schedules for typical cropping patterns, a description of
the equipment used by the Permittee.
7. The Permittee will provide the landowner or his representative with a copy of the residuals permit prior to commencement of any residuals
land application event and a copy of the results of each soil analysis.
8. If the soil PH of the land application site(s) is not maintained at 6.0 or greater, sufficient amounts of lime shall be applied to achieve a final
soil PH of at least 6.0, unless an agronomist provides information indicating that the PH of the soil, residuals and lime mixture is suitable for
the specified crop.
9. The landowner or his representative and the Permittee will agree on residuals application rates and schedules based on crop patterns, results of
soil samples, and the permitted application limits.
10. The landowner or his representative will provide the Permittee with information regarding the amount and analysis of other sources of
nutrients (e.g., fertilizer, unregulated animal waste, etc.) that have been applied to the land application site(s).
11. The landowner or his representative will inform the Permittee of any revisions or modifications to the intended use and cropping patterns for
the land application site(s) prior to each planting season to enable the Permittee to amend this Agreement and schedule residuals land
application events at appropriate periods.
12. Specific residuals land application area boundaries shall be clearly marked on the land application site(s) by the Permittee, the landowner, or
his representative prior to and during a residuals land application event.
13. The landowner or his representative hereby authorizes the Permittee, local officials, and State officials or their representatives to; enter and
inspect any property, premises, or place on or related to the land application site(s) at any reasonable time for the purpose of determining
compliance with the permit; establish monitoring facilities on or near the land application site(s) as required by the permit; copy any records
that must be kept under the terms and conditions of the permit; take necessary leachate, surface water, groundwater, or soil samples during the
term of, and 12 months after termination of, this Agreement.
11. RESTRICTIONS:
1. Appropriate measures must be taken by the Permittee and/or the landowner or his representative to control public access to the land
application site(s) during active use and for the 12-month period following a residuals land application event. Such controls may include the
posting of signs that indicate the activities being conducted at the land application site(s).
2. Animals shall not be grazed on the land application site(s) for a 30-day period following a residuals land application event. Land application
sites that are to be used for grazing shall have fencing that will be used to prevent access during these periods a.4
,.'(-.r such residuals land
application events.
3. Food crops, feed crops, and fiber crops shall not be harvested for a 30-day period following a residuals land application event.
4. Food crops with harvested parts that touch the residuals/soil mixture and are totally above the land surface shall not be harvested for a 14-
month period following a residuals land application event.
5. Food crops with harvested parts below the surface of the land shall not be harvested for a 20-month period following a residuals land
application event when the residuals remain on the land surface for four months or longer prior to incorporation into the soil.
6. Food crops with harvested parts below the surface of the land shall not be harvested for a 38-month period following a residuals land
application event when the residuals remain on the land surface for less than four months prior to incorporation into the soil.
7. Turf grown on land where residuals are applied shall not be harvested for a 12-month period following a residuals land application event.
HL ALTERNATIVES FOR WATER SUPPLY WELLS INSIDE THE COMPLIANCE BOUNDARY: (please check one)
15A NCAC 02L .0107(d) prohibits water supply wells within the compliance boundary. However, 15A NCAC 02T .0105Uh allows the
compliance boundary to be placed closer to the waste disposal area, such that the water supply well is situated outside of the compliance
boundary provided the groundwater standards can be met at the newly -established compliance boundary. Please mark one of the following;
F-1 A re -defined compliance boundary is needed for field(s) ID:
(Please include the rationale for the requested re -location
compliance boundary to the application package)
® A re -defined compliance boundary is not needed for this site.
of the compliance boundary and attach a map showing the newly proposed
IV. ACKNOWLEDGEMENT OF FIELD TRANSFER: (if needed)
El The land application field(s) ID: , is currently permitted under another
residuals land application program; Permit Number WQ: The land owner hereby acknowledge that by signing this
agreement, he/she is requesting that the field(s) be removed from the previously permitted residuals land application program and transferred
into the new program;
(Name of the new program)
FORM: LOA 06-16 Page 2 of 3

Landowner's Certification:
I certify that I am a deeded landowner of the above -referenced Iand application sitc(s) and am authorized to make decisions
regarding the use of the land application site(s) on behalf of other deeded landowners OR that I am otherwise authorized, through
a power of attorney or other legal delegation, to make decisions regarding the use of the Iand application site(s) on behalf of the
deeded landowners. I certify that the above -referenced land application site(s) are not included in any waste disposal contract or
agreement with another municipality, contractor, or other permitted entity. Furthermore, I certify that I have read this Agreement,
understand the stipulations, restrictions, alternatives for water supply wells inside the compliance boundary, acknowledgement of
field transfer, and do hereby grant permission to the Permittee to land apply residuals to the land application site(s) as specified
herein.
Landowner name: pp "T
1 O W �Y jl� R�`t L. I E\i ('A ajl a
Address: 4h bo x- ,)� 9
city: (I Le-- [ a== n 6- State: N
Phone:
Signatu
NORTH CAROLINA, f� 1) W ai1 COUNTY
zip: _ 2 7- I
I, the undersigned Notary Public do hereby certify that r Dn r} tl C�Ckb rid
personally appeared before me this day and acknowledged the due execution of the forgoing instrument.
WITNESS my hand and official seal this the C-2 6 _�±
day of , 20
Signature and seal: ��� �� _tv
MOM. SEAL
My commission expires: CAP _t C C) LATHY GRAHAM PAYNE
swan un
My Comm. UP
Lessee's/Operator's Certification:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Lessee/operator name:
Address:
City:
Phone:
Signature:
Permittee's Certification:
State:
E-mail
Date:
Zip:
I certify that I have read this Agreement and do hereby agree to abide by the stipulations and restrictions as specified herein.
Signing official
Signature:
Date: t? 27 r /
FORM: LOA 06-16 Page 3 of 3

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

SITE/FIELD TOTAL ACRES BUFFERED ACRES NET ACRES
1-1 10.9 0.9 10
REFERENCE:
GIS DATA LAYERS WERE OBTAINED FROM ESRI, INC. PLEASE NOTE THIS MAP IS FOR INFORMATIONAL
PURPOSES ONLY. IT IS NOT MEANT FOR DESIGN, LEGAL, OR ANY OTHER USES. THERE ARE NO
GUARANTEES ABOUT ITS ACCURACY. WMSS, PLLC ASSUMES NO RESPONSIBILITY FOR ANY
DECISION MADE OR ANY ACTIONS TAKEN BY THE USER BASED UPON THIS INFORMATION.
SCALE: 1 " = 500
DATE: p6-24-19[~�_}(�{jy_]}
DRAWN BY: MEM * *'I1`-"Ji ry`'^* ' "�
SOLU7IDNS
Ph:
REVIEW BOUNDARY shall be established around each land application site
midway between the Compliance Boundary and the perimeter of the
residuals land application area.
COMPLIANCE BOUNDARY: The Compliance Boundary for each land application site
is established at either 250 feet from the residuals land application area or 50 feet
within the property boundary, whichever is closest to the residual land application area.
L�
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BUFFER MAP
TOWN OF CLEVELAND, NC
NC-RA-1-1
LAND APPLICATION PROGRAM
I
Access Road
♦ Structure
■ Dwelling
Stream
Pond
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Field Boundary
Property Boundary
FIGURE NO.

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

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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:
Town of Cleveland Total Dry Tons Applied (Annual):
WQ0011431 Cation Exchange Capacity (non 503 only):
Bio-Green Services, Inc. Owner: G Byrd Predominant Soil Series:
SO
Acres Permitted: 1.0 Site #: NC-RA-01 Field #:
117.81
Enon
1
Residual Analvsis Data (Heavv Metals and Total PhosDhorus use miALY. % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
5/23/18
2
3
4
5
6
7
PT
9
10
11
12
Solids
2.04
Arsenic
5.88
Cadmium
0.98
Copper
630
Chromium
0.05
Lead
1.274
Mercury
0.706
Molyb-
denum
7.35
Nickel
25.2
Selenium
2.45
Zinc
1323.5
Total
Phos-
horus
22902
Annual
Heaw Metal Field Loadings
(Calculated in lbs/acre):
Total
TF
31
6
7
8
qj
101
111
12
DT/Ac./
_jj
o
App.
Event
11.78
Arsenic
0.139
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.139
Cadmium
0.023
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0:023
Copper
14.844
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
14.844
Chromium
0.001
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 '
0.001
Lead
0.030
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.030
Mercury
0.017
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.017
Molyb-
0.173
0.000
0.000
0.000
0.000
0.000
0.000
0. 000
0.000
0.000
0.000
0.000
0.173
denum
Nickel
0.594
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.594
Selenium
0.058
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.058
Zinc
31.185
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
31.185
Total
Phos-
539.617
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
######
Chorus
1. cerilIy, unuer penalty of iaw, tnat tnis aocument was prepares unaer my airection or supervision in accoruance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
Date
DEAR FORM MFLSF (12/2006)