WQ0023197_Residual Annual Report 2014_20150213

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#: WQ0023197 County:
Facility Name. (as shown on permit):
Land Application Operator:
Chatham Year: 2014
Performance. Ribers, Inc.
EMA Resources Inc:. Phone: [phone]
Land application of residuals as allowed by the permit occurred during the. past calendar year?
0 Yes R1 No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were.:
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals Application Summary:
Total number ,of application fields in the permit:
1
Total number of fields utilized for land application during the year:
0.
Total amount of dry tons applied during the year for all .application sites:
-0
Total number of acres utilizes for land application during the year:
0
cart n - annual Compiance Statement:
.Facility was compliant during calendar year 2014 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Quality. Yes El No
If no please, provide a written description why the facility was not'compliant, the dates; and explain corrective action
taken.
1)-Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.-0 or
the:limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
-of laboratory results are attached.
4) =Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported.during the year as required and three (3)
copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .I 105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .1105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8)-All monitoring and reporting requirements in i5A NCAC 02T .l I I I were complied with(applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements -in the permit were complied with or, in the case of a deviation, prior
authorization was received -from the Division of Water Quality.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
11). Vegetative cover was -maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify,. under penalty of law, that the above -information is, to the best of my knowledge and belief, true; accurate,
and complete. I am aware that there, are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowine violations."
Don Peterson - Plant Manager
Permittee Name and Title (type or print)
a,� t
Signature of Permittee Date
1/23/2015
Signature of Preparer* Date. Signature of Land Applier , . _ _ Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40. CFR Part 503.9 (r) .and.15A NCAC 02T .1102 (26) DENR FORM ACF (12/2006)

Performance ',0Fibers
February 12, 2015
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Aquifer Protection Section
Land Application Unit
1636 Mail Service Center
Raleigh, North Carolina 27699-1,636
Subject: 2014 Annual Land Application Certification
Performance Fibers, Inc.
New Hill, North Carolina
Land Application Permit #WQ0023197
In accordance with the reporting requirements under 15A NCAC 02T .1111(d)
and Section 111.7 of the facility's Land Application Permit (#WQ0023197),
attached are three (3) copies of the Annual Land Application Certification Form
(DENR Form ACF) for the Performance Fibers, Inc. New Hill, North Carolina
facility, representing the WTP Alum Residuals Land Application Program
activities for the 2014 reporting year.
During the 2014 calendar year, there was no land application of residual solids at
the Performance Fibers, Inc. facility as indicated on the attached form.
If you should have any questions or require any additional information, .please
don't hesitate to contact me.
Best Regards,
Marty R. Stewart
HSE Leader, North America
Performance Fibers, Inc.
[phone]
Marty. [e-mail]
Attachment: DENR Form ACF
RECEIVEDIDERDWRI
FEB I A "015
WatarQual
Perddfly 9L
338 PEA RIDGE ROAD NEW HILL, N.0 27562 1 TEL [phone]
www,performancefibers.com

Performance "bers Performance Fibers
INVOICE 7401 Statesville Blvd.
SHIPPING ORDER Salisbury, N.C. 28147
NO: 22438
DATE: 2/12/2015 SHIPPER TYPE: B SHIPPER
SHIP TO: NCDENR DWR
1636 MAIL SERVICE CENTER Originator: M STEWART 7046392197
CostCenter: 0799 Phone Ext:
Ship From Location: SALISBURY
RALEIGH NC 27699 USA WBSElement: Acct:
Attn: PO No: B35945
Phone: Ext: Requisition:
ITEM DESCRIPTION QUANTITY UNIT PRICE AMOUNT
,CTION TO BE TAKEN:
7
Evaluation
❑
Exchange
❑
.Credit
❑
Repair
❑
Fabrication, Work
Buyer: Raney, Mike
Phone:[phone]
ReturnAuthorization:
SHIPPED:
❑
Common Carrier
❑
Invista Truck
❑
Air
❑
Sea
❑�/
UPS
❑
Vendor Truck
Other
❑ _ Vendoor Must Advise Cost
Befre Proceed With Workl
__ __•__ _M j
Invista Contact:
Phone:[phone]
Freight:
❑ Collect
❑�/ Prepaid
NO PIECES: 1
TOTAL WEIGHT: 1
REASON:
'❑-'Overshipment
❑ Damage
❑ Out of Specification
❑ Cannot Identify
❑ No on PO/Incorrect Material
0 'Other - N/A
INSURED: ❑ Yes ❑d No
Amount: $0.00
BILL OF LADING:
CARRIER: UPS
SHIP DATE: 2/12/2015
J CARRIER SIGNATURE:
PACKING LIST ------------------