MAPPED

AUG 2 9 2016

By:.

LAND APPLICATION SITE

SUSAN G. POOTON

MASGP 5-8

MADISON COUNTY

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VIRGINIA POLLUTION ABATEMENT PERMIT APPLICATIONFORM D: MUNICIPAL EFFLUENT AND BIOSOLIDS

PART D.VI; LAND APPLICATION AGREEMENT - BIOSOLIDS AND INDUSTRIAL RESIDUALSf>US<9L+-> c^^^

i -\ Qy - I b between v^ill; oi. rrv Poo+c>r\ rgferrsd toA. This land application agreement is mads onhere as "Landowner", and _, Rec'/c Systems, Inc ., referred to here as the "Psrmittse". This agreementremains in effect until it is terminated in writing by either party or, with respect to those parcels that are retained bythe Landowner in the event of a sale of one or more parcels, until ownership of all parcels changes. If ownership ofindividual parcels identified in this agreement changes, those parcels for which ownership has changed will nolonger be authorized to receive biosolids or industrial residuals under this agreement.

Landowner:The Landowner is the owner of record of the real property located inthe agricultural, silvicultural or reclamation sites identified below in Table 1 and identified on the tax map(s)attached as Exhibit A.

tAfli<AfctOr» , Virginia, which includes

Table 1. : Parcels authorized to receive biosolids, water treaiment residuals or other industrial sludges

Tax Parcel ID Tax Parcel ID Tax ParceUD Tax Parcel ID

c\- 38ct- S3 A

D Additional parcels containing Land Application Sites are identified on Supplement A (check if applicable)

Check one: , 0^ The Landowner is the sole ownerof the properties jdentifiecl herein.~a-Th^L:ancJ6wTie7Ts^rTe^fTnultrple"owMrs^f;th-rprop-^rtie"3-i(JeT?ti

In the event that the Landowner sslls or transfers all or part of the property to which biosolids have been appliedwithin 38 months of the latast data of biosolids application, the Landowner sha!!:

1, Notify the purchaser or transferee of the applicable public access and crop management restrictions nolater than the data of the property transfer; and : . . , ,

2. Notify the Permittee of the sale within two weeks following property transfer,

The Landowner has no other agreements for land application on the fields identified hersin. The Landowner willnotify the Permittee immediately if conditions change such that the fields are no longer available to the Permitteefor application or any part of this agreement becomes invalid or the information herein contained becomesincorrect.

The Landowner hereby grants permission to the Permittee to land apply residuals as specified below, on theagricultural sites identified above and in Exhibit A. The Landowner also grants permission for DEQ staff to conductinspections on the land identified above, before, during or after land application of permitpurpose of determining compliance with regulatory requirsments^aRpticabjeto suchapplicatioh. ; 'Class B biosolids Water treatment residuals . Food processing waste . Other industrial sludaesa Yes D No B Yes D No . .....,,. .E^s^.-DNo .'. , B Yes. , D No,~^^ft^~-^ ^J.,7 "'" i^!A^^^^ ' 2^'^A^s"^L

.Su^ ^ . :p^^ A^c^ ^&>ofe0 . &^^]k- M. 22^V0Landowner - Printed Name, Title Signaturs ; /: Maiiing^ldrBss & F)hone Number

^0-9^7^065Permittee:Reeve Systems. Inc , the Permittes, agrees to apply biosolids and/or industrial residuals on the Landowner's land In the

manner authorizsd by the VPA Permit Regulation and in amounts not to exceed the rates Identified in the nutrient managementplan prsparsd for each land application field by a parson certified in accordance with §10. 1-104. 2 of the Code of Virginia,

The Permittee agrees to notify the Landowner or the Landowner's dasignee of the proposed schedule for land application andspscifically prior to any particular application to tha Landowner's land. Notice shall include the source of residuals to be applied.

LJ i rSVicW^G ina uOCUH~(6ri ^3/ 535iyniny SiynSlOr/ SliZFOnL y' iG ifia p5 i'5(jH SiyHiHy rOF idHuOWnor aOO'v'8. i w'lii fTidKy d Cupy ^ ln!;>

document(s) available to DEQ for review upon request. (Do not check this box if the landowner signs this agreement)

,.LA"^b^ PO Box 562 Reminaton, Virginia 22734Permittee - Authorizad Rsprasentativs

Printed Name

Rsu 9/14/2012

STgnalura Mailing Addrsss

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FARM DATA SHEET

SITE NAME: Susan G. Pooton COUNTY: Madison

OWNER:William Russell Jr. or Susan

Gallihugh PootonOPERATOR: Susan G. Pooton

OWNER'S

ADDRESS:

269 Nethers Road

Sperryville, VA 22740

OPERATOR'S

ADDRESS:

269 Nethers Road

Sperryville, VA 22740

OWNER'STELEPHONE:

540-987-8065 OPERATOR'S TELEPHONE: 540-987-8065

GENERAL FARMTYPE: Hay/Pasture CELL PHONE: 540-407-7095

# CATTLE:12 Beef Cattle20 Horses

EMAIL:

LAGOON or SLURRY: None LATFTUDE: 38. 55

TOPO QUAD: Old Rag Mountain LONGITUDE: -16. 2. 51

COMMENTS: Please check all fields for rock outcrops and drainage areas prior to field operations

BB-^

RECYC SYSTEMS, INCFIELD DATA SHEET

Field

Identification

Gross

Acres

Environmentally Sensitive Soils

Water Table

BedRock/Shallow Surf/Leach Freq Flood

HydroMap

Tax

Map #

FSA

Tract #

MASGP 5 10.2

Ad Nov. -MayAIA Dec. -Apr.Cn Nov. -Apr.

Ad Nov.-MayCn Dec.-Apr. RA08 TM 9-38

T 2658F 1

MASGP 6 7.6Ad Nov. -MayCn Nov.-Apr.

Ad Nov.-MayCn Dec.-Apr. RA08 TM 9-38

T 2658F 2

MASGP 7 5.8

Ad Nov.-MayAIA Dec. -Apr.Au Dec.-MayRk Nov. -May Ad Nov.-May RA08

TM 9-38TM 9-38A

T 2658F 22

MASGP 8 4.3

AIA Dec.-Apr.Au Dec.-MayRk Nov.-May RA08

TM 9-38TM 9-38A

T 2658F 23

TOTAL ACRES INSITE 27.9

VIRGINIA POLLUTION ABATEMENT PERMIT APPLICATION: PART D-VI LAND APPLICATION AGREEMENT

Landowner Coordination Form

This form is used by the Permittee to identify properties (tax parcels) that are authorized to

receive biosolids and/or industrial residuals, and each of the legal landowners of those tax parcels. ALand Application Agreement-Biosolids and Industrial Residuals from original signature must be attached

for each legal landowner identified below prior to land application at the identified parcels.

Permittee: Recyc Systems Inc.

County or City: Madison Co.

Please Print

Site Name: Susan G. Pooton

Signature not required on this page

Tax Pa reel ID(s) Landowners (s)

9-38 William Russell Jr. or Susan Gallihugh Pooton

9-38A William Russell Jr. or Susan Gallihugh Pooton

Recyc Systems. InC. (Biosolids Land Application)

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MASGP 5-8

VICINITY MAP tfA

;. (Biosolids Land Application)

VICINITY MAP '!'A

cInCi (Biosolids Land Application)

9.41

9-39A

CS>

9-35

Tcoc ^Aftk

9-38A 26$

0<*v^'*

237

a

9-38

1S-12

9-37

9-36

1Scale: 1"= 660 ft. MASGP 5-8

TAX MAP '!'A

ADJOINING LANDOWNERS

Susan G. Pooton

MADISON COUNTY

Tax Map I Parcel # Owner Name(s)

15

3535A363739

39A4142

12

John J. or Maria T. GuevremontJane A. Edelen

Deborah Jane Wilson and Mark A. Moorstein Tmstees

Glenn W. Ritchey Jr.Zaven S. or Alidz Khachaturian

Linwood A. or Mary W. StaubLinwood A. or Mary W. StaubJohn P. or Maria A. Heckman

Wachovia Bank NA and Phillip S. Shatz Trustee c/o PDS Tax Services

msa InC. (Biosolids Land Application)

Soil Map-Madison County, Virginia, and Rappahannock County, Virginia

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Scale: 1 "= 660 ft.

SOIL MAP N

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Legend For Site Plan

Symbol

^^k-

. .

. .

, . . I

T^ ^ ./. N

Feature

House and Well

Well or Spring

Streams or Surface Water

Wet Spot

Trees and Woods

Private Drive

Rock Area/Rock Outcrop

Severely Eroded Spot

Sink Hole

State Road

Fence/ Field Boundary

Property Line

Minimum Setback

200 feet from occupied dwelling *100 feet from water supply wells or springs

100 feet from water supply wells or springs

35 feet with 35 foot vegetatect buffer100 feet without vegetated buffer

25 feet from rock outcrops50 feet from limestone rock outcrops

18 Inch minimum depth of soil

100 feet from open sinkholes50 feet from closed sinkholes

10 feet from side of roadway

100 feet from property line

SL

!YiVF .

Slope

Frequent Flooded Soil

Hashed out Area

15% maximum

No application

*Buffer can be reduced or waived upon written consent from landowner.

IflCi (Biosolids Land Application)

\ ^/riS, l^', / //Permitted f:

SITE PLAN I

5.;. (Biosolids Land Application)

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Scalo; 1"= 2000 ft.

TOPOGRAPHIC MAP X