A novel sewage sludge treatment process is developed in which sludge anaerobically phosphorus (P) released with the temperature control/ultrasonic treatment and recovery with human urine are incorporated to a conventional anaerobic/aerobic (A/O) process. The results showed that temperature affected the anaerobic P release and the maximum orthophosphate (PO43–P) release rate was 21.68 mg PO43–P/(g MLVSS.h) at 20 °C. The optimal specific energy of ultrasonic treatment was 15,000 kJ/kg TS, at which the solubilization degree of soluble chemical oxygen demand (SCOD) was 37.93%, which verified that the anaerobic sludge flocs were broken and the organic matter was obviously released. Human urine and P-rich sludge stream could be verified as a feasible way of P recovery in the form of struvite. The output of P in the combined A/O treatment process consisted of three pathways (i.e., effluent wastewater, sewage sludge, and P recovery). The influent P could be recovered by 22.84% and about 1.48 g/d potential struvite could be recovered from the anaerobic sludge flow using 0.27 L/d-human urine. The mass balances of COD and nitrogen (N) indicated that the combined A/O process also improved the organic mineralization and the removal of N.

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