WQ0023511_Regional Office Historical File Pre 2018

29
NUMBER:
FACE LITY NAME:
) P ra
atr
Point:
NON DISCHARGE WASTEWATER MONITORING REPORT
Effluent:
toring Point. Effluent: l Influent:
uent Flow For This Month Generated At This Facility:
Daily Rate
(Fiow)into
Treatment
5y'stern
Average
Daily Maximum
y Minimum
hly Limit(s)
Composite (C) / Grab (G)
Operator in Responsible Charge (ORC):
Check Box if ORC Has Changed 0
Certified Laboratories (1
Person(s) Collecting Sampies:
flail ORIGINAL and TWO COPIES to:
)ENR
ion of 'Water Quality
TTN: information Processing Unit
617 Mail Service Center
".AL'EIGH. NC 27699-1617
Residual 00-5
Chlorine 20°C
delName:
NH3•N
Surface
Yes,
MONTH
ater (SW):
No:
Grade:.
ORC Certification Nurnberg
(2)_
GNsUI E OF OPERATO IN RESPONSIBLE CHARGE)
BY TH#S 'SIGNATURE, I CERTIFY THAT THIS REPORT IS ACLU
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
TE

NON DISCHARGE WASTEWATER MONTORING REPORT
Facility Status°
Please answer the following questio
I Does all monitoring data and sampling frequencies meet permit requirements?
Compliant (Y,Nt
if the facility is non -compliant, please explain :in the space below the reason(s) the facility was not in compliance
with its permit. Provide in your explanation the date(s) of the non-compiiance and describe the corrective action(s)
taken. Attach additional sheets if necessary.
"I certify, under penalty of law, that this document. and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete am aware that there are significant penalties for submitting
false information, including the possibility of fines and imprisonment for knowing violations."
Parameter Codes
le
(Na e of Signin Official -Please print o
°
Position or Ti
22,1-cf75 -3
(Phone Number)
2 Ar 'er:
22 nce
oat rm, Tol
0094 -ionductivi
42 Copper
N4renTo1
2 NO3
0 0 N
9Scwn
00931 SAR
00746 Sulfpde
27 Camm
009116 Calcium
00940 Chloride
50060 Chlorine, Total
iseolued
3116 Fecal coil:cern
0105 Lead
00927 :Magnesium
Reskauat 71900 Mercury
4 Chromium 00670 NH39SN
40 COO 00067 Nickel
Parameter Code assistance may be obtained by calling the Water Quality Land Application Unit at (919) 715-6'189.
G
PAN (Part Available)
00400 pH
32730 Phenols
00665 Phosphorus, Take:
0295 TDS
p0 I 0 Temperature
00625
00680 TOC
00500 ISSITSR
(Permit Exp, Qate)
37 o turn
45 Se heable MI
0076 Turbidity
1092 Zee
The monthly average for Fecal COitform is to be reported as a GEOMETRIC mean Use ni e noted i
facillt\i's permit for reporting data,
• If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28.050 131,(2)(D),
re ona
DENR FORM NOMR-1 (1112005)

PERMIT NUMBER:
FACILITY NAME:
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE, USE ADDITIONAL PAGES AS NEEDED,
WQ0023511
Daily Loading (Inches)
Maximum Hourly Loading (inches)
12 Month Floating Total (Inches)
Avarage Weekly Load ties)
rgt1 Our At FaUty«
Y No:
Woodland Heights Elementary School
MONTH:
February
COUNTY:
Page / of -2--
YEAR: 2011
REDELL
Formulas:
tvoume,Appr,ed (gallons) x 0,136 (cubic feetigallont x 1.2 (inches/fool)] / [Area Sprayed (acres) x 43,560 (square feet/acre)J OR
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallonstacreiinch))
Daily Loading (incnes) / Fans Irrigated tminutes) /60 (minutes/hour)) Monthly Loading (Inches) = Sam of DV), Loadings (inches)
= Sum of this months Monthly Loading (inches) and previous 1 months Monthly Loaning& (inches)
=/lontht Loaing(inchesenanthi / Nornder al days in Ole rnonU month)f x 7 (day lit)
id Irrigadori Occur On This Ffeld:
Y : D
A
II 2
21
2
23
24
25
ATHER CONDMON
Ye ir
anplkatMn
PrecIptta.
°F) inch*
2 Month F
A
r Codes: C-clear, PC -party cloudy, Cl-cloudy, R-raln, Sn-snow, SI-sleet
ra
Lagoon
board
feet
F
NU
R:
Id
Occur On This Fed:
No:
One
FIELD NU ER:
AREA SPRAYI
V R CROP;
PERMTTED HOURLY
PER
YEARLY
Volume Time
• Iied irrgated
Na
Deity
oadi
u
er
2
Maximun
Hourly
Loading
nchQs
Spray Irrigation Operator in Responsible Charge (ORC): DENNIS GRYDER
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to;
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
AREA SPRAYED (acres):
OVER CROP:
PER
Volume
Aulied
gallons
989073 Check Box if ORC Has Changed: 0
HOURLY
YEARLY RAT
Time
nutos
Natural I
OE4
26
Maximum
Daily Hourly
oadlng Lotiding
nchos 1nth5s
nche
Phone: [phone]
IGNATURE OF OPERATOR IN RE PONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE,
DENR FORM NDAR-1 (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Faciktv Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box, )
1. The application rate(s) did not exceed the limit(s) specified in the permit
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit
4. All buffer zones as specified in the permit were maintained during each application.
5, The freeboard in the treatment andior storage lagoon(s) was not less than the limit(s)
specified in the permit,
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance arid describe the corrective action(s) taken, Attach
additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations,"
ireceo - Statesville Schools
(Perrnittee-Please print or type)
P.O. Box 911
NC States8688
Permittee Address}
i4/1,' /kr 3- I (0- It
(Name of Signin Official -Please print or type)
al& OliqV-2AA4zc,
(Position or Title)
704-873-3755 ,--7-73
(Phone Number) (Permit Exp. Date
signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28,0506
bp by
DENR FORM NDAR-1 (5/2003)

29
ER1IT NUMBER:
FACILITY NAME:
Point:
tanitoring Poin
s Threr' Efflu
�par"atce .
Arrer✓aw
Tine
NCO
Av
Daily Maxi u
NON DISCHARGE WASTEWATER MONITORING REPORT
Effluent
rThSit
)aiPy Rate
(Flow) into
Treatment
5/stem
50050
nfluent:
Effluent:
nth Generated At Tv
moo V soot('
HR ® GALL( t5 UN
Gaily Mini
Monthly Limit(s) 11111111111.111
Composite (C) / Grab (G)
Operator in Responsible Charge (ORC):
Check Box if ORC Has Changed,
Certified Laboratories (1)"
Person(s) Collecting Samples: CDC.:)
/tail ORIGINAL. and TWO COPIES to:
)ENR
)iv)sion of Water Quality
tTTN: Information Processing Unit
617 Mail Service Center
nit". 774Q4_1F17
Re.si 1 aV
€:t orlie
uent:
Facili
Page f
MONTH: f'' WW1 YEAR; /J
COUNTY: /2 9. ://
'Surface Water (SW): !SW C©de/Name:
Yes: I _I No:
Fecal
eocdrorm
(Gen.metrtc
Meaknl
rade:
ORC Certification Number:
(2):
(SIGNATURE OF ©PERATi IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
ANO COMPLETE TO THE BEST OF MY KNOWLEDGE.

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
1. Does all monitoring data and sampling frequencies meet permit requirements?
if the facility is non -compliant, please explain in the space below the reason(s) the facility was not n compliance
with its perrrit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s)
taken. Attach additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that ail qualified personnel properly gathered and
evaluated the information submitted, Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted 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 passibility of fines and imprisonment for knowing violations"
tee -Please print or typ
Paramete
Codes:
icia1-Pease print or type)
(PhoneNumber) (Permit Exp.
Arsenic
22
4 CoWorm, Total
0094 Ccduc4y
27 Canum
9 _cum
40 Chloride
50060 Chtohne, Iota;
Residual
01034 Chromium
00340 COD
42 Copper
is.solve e.n
Lead
00927 Magnesium
71900 Mrcuv
NitrP en, Total 009 SoPiurn
r402&t403 00931 SA
NO3
OGe
PAN (PlaM Avalla
30400
32730 Phenols
37 Potassium
00545 Setheabe Master
745 Sulfi
70295 IC
TKN
TOC
R
00076 T'urtaidrty
01092 Zinc
Parameter Code assistance may be obtained by calling the Water Quality Land Application Unit at [phone]
The montnly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use Only the units designateddesgnate JhjQjn
facililis permit for reportinq data.
• If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28.0506 (b)(2)(D).
DENR FORM NDMR1 0.1/2005).

0
PERMIT NUMBER:
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE An TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
WQ0023511
FACILITY NAME. Woodland Heights Elementary School
Daily Loading (Inches)
metzlinun Hourly Loading (inches)
12 Marsh Floating Total (inches)
eekl dl
Id ImlgationOccur At This Facility:
Yes: 0 No:
WEATHER CONDITIONS
Temper-atu Storage
virleathe? at Preciptta- Lagoon
Code* appncation non Free -boar
Formulas
MONTH: February
Page / of 2-
YEAR: 2011
COUNTY: IREDELL
x [Volume Appried (gallons) x 0.12,36 (cubic feet/gallon) x 12 brichesifon011[Area Sprayed (acres) x 43,560 (square teet/acre1) OR
r Volume Applied (gallons )/ (Area Sprayed (acres) x 27,152 (gagensfacre-4nct91
Deily Loading iimties) / frill.* Irrigated, (minutes) /60 phiroutes/houri) Monthly Loading (inches) -= SUM of Daity Loadings (iricnieSi
Sum Of this month's Monthly Loading (hcries) and preWouS 11 mortals Monthly Loadings (inches)
ad41Plebe / Number of da sn the month (days/rttonthN x 7 (days/week)
Did Irrigation Oour On This Id: Did Irrigation Occur on This Field:
Yes: 0 No; cl Yes: 0 No: Ej
Total Gallons/Monthly Loadln Mche
12 Month Floating Tota
Average Weekly Loading (Inches
Volume
ea er Codes: C-clear, PC -partly cloudy, Cl-cloudy, R-raln,
FIELD NUMBER:
AREA SPRAYED (acres):
COVER CROP:
One FIELD NUMBER: Two
1.9 AREA SPRAYED (acres): 1.68
Natura) 1)tter COVER CROP: Natural litter
PERMITTED HOURLY RATE (inches): 0.4 PERMITTED HOURLY RATE (inches): 0.4
PERMITTED YEARLY RATE (inches): 26 PERMITTED YEARLY RATE ch
axirnum
Time Daily Hourly Volume
ated LoaHn oad A
n-snow, SI-sleet
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Mali ORIGINAL and TWO COPIES to;
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
0 00
0
DENNIS GRYDER
989073 Check Box if ORC Has Changed:
TURE OF OPERATOR
BY THIS SIGNATURE, I CERTJIY Tft
TO THE BEST OF MY KNOWLEDGE.
Daily
Loading
inches
0 00
0
26
ax mum
Hourly
Loading
inches
Phone: [phone]
PONSOBLE CHARGE)
T THIS REPORT IS ACCURATE AND COMPLETE
DENR FORM NDAR-1 (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box, )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the pe
4. All buffer zones as specified in the permit
maintained during each application.
5. The freeboard in the treatment and/or storaoon(s) was not Less than the limit(s)
specified in the permit.
Page
Co
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken, Attach
additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete, 6 am aware that there are significant penalties for submitting false information„ including the possibility of fines
and imprisonment for knowing violations."
2 -.,." t
($ignaturd f Pdrhrtittee)* Date
ell • tetesville Schools
(Per Please print or type)
P.O, Box 911
Statesville, NC 28687
(Permittee Address)
(Name of Signing ftciai-Please print or type)
(P
n or Title
7i74-f37 7
(Phone Number)
1l3112009
(Permit Exp. Date)
• if signed by other than the permittee, delegation of signatory authority must be on rile with the state per 15A NCAC 2B4O506 (b)(2)(D),
DENR FORM NDAR-1 (5/2003)

0
NON DISCHARGE WASTEWATER MONITORING REPORT
Page
FACILITY NAME:
onitoring Point. E
eter Monitoring Point:
There Effluent F1c w For T
2aC-C n
aily Maximum
wily Minimum
Curly Hate
4F§,qwl ri
TeeMmen¢
S warn
G;ac is
Composite (C) / Grab (G)
uent:
h GeneThis Fa
Operator in Responsible Charge (ORC):
Check Box if ORC Has Changed;
Certified Laboratories (1):
Person(s) Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
Resia;ua,r
Cwprune
3O0-5
20°C NH'
MONTH,,
Jrface Water
ORC Certifi
Fecal
form
Grade:
on Number:
(2)•
C -/Z YEAR: U I CI
COUNTY::�
Phone: �w"7"s l _
GNATURE C+F OPERA OR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDM'R-1 (t 1,200.5)

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
1, Does all monitoring data and sampling frequencies meet permit requirements?
C.0ompl la nt Y,N1
If the facility s non -compliant, pease explain In the space beicw the reason(s) the facaIty was not n cor7piiance
with its permit. Provide h your explanation the date(s) of the non-compliance and describe the corrective action(s)
taken. Attach additional sheets if necessary
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supeniision in accordance with a system designed to assure that all qualified personnel properly gathered arid
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and beIlef, true, accurate, and complete. I am aware that there are significant penalties for subrmttmg
false information, inciudng the possibilIfy of fines and imprisonment for knowing violations "
(Signature
`,/,‘
(Permittee-Please print or type)
V(.7(
ermittee Address)
Parameter Codes:
-7)
(Name of Sgnin
,l1),
(Position or Title
—72C,t 23 A-5
(Phone Number)
0 0, 2 A& smi2..
1022 Boron
00310 0005
3 '11 Co41orrn, Tora2
01027 Cadmwm
00916 Barcwm
40 Cmioncse
50060 CMarme Taai
ResdurM
210714 Chronoom
00340 COC
00094 CondootOrity
01042 0o0041
6
lr$SCd
51 Led
Coltfor
00927 Magnesium
7190C, Mercury
00612 NH3asr4
01067 Nicisel
500 \klroger, 701
B06130 NO2E.N00
00620 NO3
0 929 Sodium
00931 54.R
110745 Suif,Oe
4 0 pH
3 72
p
r
oenois
70295 705
0:0 55 Pnospnorus,
130007 PcnassAJm
00545 Set6eable Mafter
00530 T55,I75R
00076 TurPta162
01097 Zino
47)
(Permit Exp Date)
Parameter Code assistance may be obtained by ca mg the Water Quality Land Application Unit at (919) 7'15-6189
The monthly average for Fecai Cokform, fs to be reported as a GEOMETRIC mean, Lise onlithe units designated the re7ortin
fardito's ermit for reportnqd
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28,0506 (b)(2)(D),
DEiNR FORM NOMR-1 (1112005)

NON -DISCHARGE APPLICATION REPORT Page
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE, USE ADDITIONAL PAGES AS NEEDED,
Did
A
PERMIT NUMBER:
FACILITY NAME:
Daily Loading (inch®
maximum Hourly Loading (inches)
12 Month Floating Total (inches)
Avenge Weekly Loading Inches)
Occur At This Fa
ATHER CONDITlO
ty:
at Preclp
W00023511
Woodland Heights Elementary School
MONTH;
Formulas:
[Volume AppSl3ed (gallons) x 0.1336 (cubicfeet/galfen) x 12 ('inches/Toot)] / [Aca
Volume Applied (gallons); [Area Sprayed (acres} x 27,152 (galrorosfacre•inch)p
= Daily Loading (inches} / [Time Irrigated (minutes) / 6© (minutes/hour)) Monthly
= Sum or this months Monthly Loading (inches) end previous 11 months Monthly Loadings ('riches)
lalcanth/r Loading (f()c eMoonth) t Number e1 days [rt tho month (days/month)) x 7 (daystwat/ka)
0
D#d
nation Occur On Thls Field
PER
Volume
Applied
oaitons
YEARLY
T
Spra
d
December YEAR: 2010
COUNTY: IREDELL
43, iD (s (ogre 1t 8t ort/J,) t7R
Loading (Inchaa) m of Da➢y Loading,
on Occur On Thls Field
0,4 PERIIeIITTED HOUR
26
twsaxtmun
Daily Hourly
oading I } oading
P
Volume
Applied
Y RAT
nche
26
tttsaxtmut
Time Daily Hourly
#gated Load#nq Loadln
0.00
12 Month Floating Total (inches)
Wea
Average Weekly Lriing (Inches}
Codes: C•clear, PC -partly cloudy, CI -cloudy, R-raln, Sri -snow, SI-sleet
Spray Irrigation Operator In Responsible Charge (ORC):
ORC Certification Number:
DENNIS GRYDER.
969073 Check Box if ORC Has Changed,. 0
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Nlai'I Service Center
RALEIGH, NC 27699-1617
00
Phone: [phone]
SIGNATUFE OF OP OR IN PONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIF THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-t (5f2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Status:
Please indicate (by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: r'f a requirement does not apply to your facility put (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit, Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
N
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. f am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations,"
- Statesville Schools
Name of Sign
(Perrnittee-Please print or type) (Position or Title)
P.Q, Box 911
Statesville, NC 28687
(Phone Number)
704-873-3755 - (-
(Permit Exp. Date)
(Permittee Address)
• If signed by other than the perrnittee, del ion of signatory authority must be on file with the state per 15A NCAC 2E1.0506 (b)(2)(D),
DENR FORM NDAR-1 (5i2003)

MBER:
ACIL-FY NAME:
ON DISCHARGE WASTEWATER MONITORING REPOR1V
Trfiuent:
P a rame ter Monitoring: Point:
II,:Vas There Effluent Ftow F- -
Operate!.
tarrine'31
-Timm e
2400
Cks
CRc
on
Site?
DaMti Rate
(FoThaiii into
Treatment
GALLONS
nf
:ffluerf nfluent L. Surface
.th Geriered At This I- /: Yes:
pH'
UNIT.
Operator in Responsible Charge (ORC):
Check Box if CRC Has Changed:
Certified Laboratories
Person(s) Collecting Samples:
Mail ORIGINAL and TWO COPIES to
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
oc)91.01-1:-
Residua
ratniorme ZO'C
MG/t_
NH3-
e f
MONTH: EAR:
Fecal
Clifom
'Geo-metric
Mean*/
Grade:
ORC Certification Number:
SD
COUNTY,
F-W Name:
(2)
(tZNATURE OF OPERATOR RESPONSIBLE CHARGE)
BY THIS SIGNATURE, CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE
OENR FORM NDMR-1 (1 1;7005)

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
I. Does afl monitoring data and sampling frequencies meet permit requirements?
If the facility is non -compliant, please exan in the space deibw the reason(s) the facility was not in compliance
with iits permit. Provide in your explanation the date(s) of the non-oompiiance and describe the corrective action(s)
taken. Attach additional sheets necessary.
"I certify, under penalty of taw, that this document and all attachments were prepared 'cinder my direction or
supervision in accordance with a system designed to assure that aN qualified personnel properly gathered and
evaluated the information submitted, Based on my inquiry of the person or persons who manage the system, or
those persons directly resiponsble fcr gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submtting
false information, including the possibility of fines and imprisonment for knowing violations."
ase print or type)
ke
(Permittee Addr
Parameter Codes:
f Sitg/n7g Official-P ease print or type)
11-0
of. 01P' 41106AA2AC-6.---T:
(Position or Title)
(Phone Number)
01032 Arsenic
0'1022 eacca
4Chairrior To.
64 Con ochirdi
00310 5005 01042 Copper
1027 Cearraium
10 6 Calcium
•40 Chiorid
00300 Cispolved Crigen
NilroGerc Tola
hiC32&Naii
50060 Chloncrai Total
Residual
01034 Coraihium
06340 COD
.3106 Fecal CorPorm
61051
363922 Siairesciou
T 603 Mesa:cirri
00610 NH3aSN
WOOS PAN Two Ava(ae)
Cti4 Oa OH
3273,0 'Phenols..
30665P3030ocrosi Taral
0(1937 PVaSSIUM
61067 P(ckai
00545. Seilleatie Mader
000:63 Tacricseratere
0,06625 TKN
006 TOC
30530 Sr7 R
01092 Zinc
(Permit Exp. Date
Parameter Code assistance may be obtained by calling the Water Quality Land Application Una at (919) 7156189.
The mon¢hly average for Fecal Coliforrr is to be reported as a GEOMETRIC mean. Use oriv the units designated In the r..j.DC
rtlflq
facAty`s permit for reporting d.ata.
f signed by other than the permittee, delegation of signatory authority, must be on file with the state per 15A NCAC. 28,.0506 (b)(2)(0).
DENR FORM NOk1R-1 (11/2005)

PERMIT NUMBER:
FACILITY NAME:
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE, USE ADDITIONAL PAGES AS NEED
WQ0023511
Woodland Hein hfs Elementary School
Formulas:
MONTH:
D,
November
Page / of
YEAR: 2010
COUNTY: IREDELL
Daily Loading (Inches) _ (Volume Appiiad (gallon(cubic feet/gallon) s 12 (uncnaslfoot)) / (Area Sprayed (acres) x 43,5e0 (square feeUacre)( OR
s Volume Applied (gallons) r (Area Sprayed (acres) s 27,152 (,galbns/acre-0 h)]
Maximum Hourly Loading (Inches) = Daily Loading (inches) r (Time Irrigated (minutes) 16J (minuteslhour)1 Monthly Loading (inches) = Sum a
.12 Month Floating Total (inches) = Sum of this month's Monthly Loading (uncnes) and previous 41 montn`s MonRNy Loadings (inches)
Avery se iAll#ekl',y Loatlin. un ties Cihih' Load- t ;uathes"an a f Cf3:urt bee f d s In Iha fr: tth d s5rand 7 d
Occur A
;nny;
No:
ATHER CONDITION
2 Mtnatthl Flo
To tin
Storage
Lagoon
sae boar
Average Weekly Loading (inches),
Did Irrigattin Occur On Thls Field:
Yes: (0 No:
FIELD NUMBER:
COVER CROP:
PERMITTED HOURLY RATE (Inches).
PERMITTED YEARLY RATE Inches
Volume
Applied
gallons
Weather Codes: C-clear, PC•partly cloudy, CI -cloudy, R-rain,
Time
Irrigated
minutes
now, Si -sleet
spray Irrigation Operator in Responsible Charge (ORC);
ORC Certification Number:
Mall ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
ax mum
Hourly
oading
inches
DENNIS GRYDER
airy. F.o
d Irrigatlaan Occur On This Field:
COVER CROP:
PERMITTED HOURLY RATE (incltieal.
PERMITTED YEARLY RATE inches
Volume
Applied
gallons
Time
Irrigated
minutes
Daily
Loading
inches
0
Phone: [phone]
989073 Check Box if ORC Has Changed:
GNATURE OF OPERATOR IN RESIBt_E CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR•1 (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
FaCHfty Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements. (Note: if a requirement does not apply to your facility put (NA) in the
compliant box )
1, The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit
4. All buffer zones as specified in the permit were maintained during each application,
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit
,N)
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken Attach
additional sheets if necessary,
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that ail qualified personnel properly gathered and evaluated the information
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations."
redeII - Statesville Schools
(Permittee-Please print or type)
P,0, Box 911
Statesville, NC 28687
(Permittee Address)
(Name o Sig
(Position or Title)
704-873-3755
(Phone Number)
/2-16- /0
-Please print or type)
;1/44t-31/42,4(e-
/2oo
Perrnit Exp. Dat
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 26,0506 (b)(2)(D).
DENR FORM NDAR-1 (5/2003)

PERIN T NUMBER:
FACTLtTf NAM
oPa
ter Monitoring'Point:
Tha ere Effluent Flc+r For
Arrival'
T:irme
1400
Average
Daily Il+taxirnu al
Cully htinirnuna
Monthly Lirrait(s)
CompGrab (G
NON DISCHARGE WASTEWATER MONITORING REPORT
Daily Rate
(Flow) into
Treatment
System
Effluent:
onth Genera
Inf
At 'This
00100 50060
Operator in Responsible Charge (ORC
Check Box if ORC Has Changed:
Certified Laboratories (1
Person(s) Collecting Samples:
+tail ORIGINAL and TWO COPIES to:
)ENR
)ivision of Water Quality
TTN: Information Processing Unit
617 Mail Service Center
uent
Foci
Residual 5C?D-
Cair:rine 20°C
Page
Y
COUNTY:
NI7-N TSS
MONTH:
Fecal
Colitorm
{Gea=meal.
Mean")
MG/L /100ML
Grade:
ORC Certification Number:
(2)
S+6TUR,E OF OPERATOR #N I �ONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
1 Does all monitoring data and sampling frequencies meet permit requirements?
If the facility is non. -compliant, please explain in the space below the. reason(s) the facility was not in compliance
with its permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s)
taken_ Attach additional' sheets if necessary,
certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted 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 knowing violations."
(Permittee Address)
01002 Arsenic
01022 6Ctron
00310 E3C05
0102'7 Cadmium
00916 Catown
00940 Chtoride
50060 Chlorine, Total
Residual
01034 Chromium
00340 COD
Parameter Codes:
04 CoWorm, Total
94 Conductivity
,01042 Copper
00300 Dissolved Oxyg,en
31616 Fec1 Col4rm
ead
00927 Mgeum
_ 71900 Mercury
00610 NH3asN
fi7 Nickel
(Position or Tit
769q-P73-
(Phone Number)
00600 Narogen, 'Total
NO28.NO3
00620 NO3
00556 0-Grease
W009'PAN (Plant Ava2ebe)
00400 pH
_
32730 Phenols._
00665 Phosphorus, Total
00937 Potassium
00545 Settleable M40er
00929 turn
00931 SAR
C0745 Suaide
70295 TDS
eralure
00625 TKN
OC
00530 TSS,
00070 Turbidity
01092 Zinc
Parameter Code assistance may be obtained by calling the Water Quality Land Appbcation Unit at [phone],
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use chiy the units designated in the r
facility's permit for reporting data.
• If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (b)(2)(D).
DENR FORM NDMR-1 (11/2005

PERMIT NUMBER:
FACILITY NAME:
Daily Loading (Inches)
Maximum Hourly Loading (inches)
12 Month Floating Total (inches)
Average Weekly Loading (inch
Did
Ye
A
T
E
2
27
28
29
30
31
Total Gallons/Monthly Loading (inches)
. _
12 Month Floating Total (inches)
ion Occur At This Facility: Dld IrrigationOn This Field:
El No: 0 Yes: 0 No:
OTHER CONDITION
storage
Laqoon
Me.
AverageWeekly Loa in(Inthes)
FIELD NUMBER:
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPUCATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED,
W00023511
Woodland Heights Elementary School
MONTH:
Page
October YEAR: 2010
COUNTY: IREDELL
Formulas:
= [Volume Applied (gallons) x 0.1336 (cubic feriggalien).x 12 (inches/foot)) / [Area Sprayed (acres) x 43,560 (sward feet/eve)) OR
Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 [gallons/acre-inch)]
= Daily Loading (inches)! [Time Irrigated (minutes) / 60 (minules/hourA Monthly Loading (Inches) = Sum. 01 Daiily Loadings (inches)
Sum of his menles Monlhly Loading (inches) and previous. 11 month's Monthly Loadings (inches)
[Month! Loading (inches/month umber of days in the rrich• month) x 7 (day . k)
One
d lrrlgatiors Occur On This Field:
Yes: 0 No:
FIELD NUMBER:
Two
AREA SPRAYED
AREA SPRAYED re :
68
OVER ROp:
Na ura lltter
PERMITTEDHOURLY RATE (i h 0,4
P
RMI
Volume
Applied*
I na
D YEARLY RA
Time
riqated
inu a
Daily
COVER CROP:
Naturat titte
RMtTTED HOURLY RATE (inches):
es): 26 PERMITTEDYEARLY RAT
es
aximu
Hourly Volume Time
oading Applied trrigated
mlnut
nches):
OA
26
atlmun
Daily Hourly
ding Loading
0.0
n h
* Weather Codes: C-clear, PC -partly cloudy, Cl-cloudy, R-raln, Sn-snow, SI-sleet
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
DENNIS GRYDER
989073 Check Box if ORC Has Changed: El
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
Phone: 7 -873-37
(S /NATUR E OF OPERATOR VESPONSIBLE CHARGE)
I
BY THIS SIGNATURE, I CER Y THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE,
DENR FORM NDAR-1 (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit,
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment andlor storage lagoon(s) was not less than the limits)
specified in the permit.
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit, Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations,"
ville Schools
(Permittee-Please print or type)
P.0, Box 911
Statesville, NC 28687
(Permittee Address)
.Or,,
(Name of Sign
(Position or Title
704-873-3755
(Phone Number)
/)_-
ase print or type)
/1
1 /31 /2009
(Permit Exp. Date)
• If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (b)(2)(D).
DENR FORM NDAR-1 (5/2003)

7
28
291
Fi
i Parame
!'Nt:'STher
Avera
BER:
ANT;
in. Point.
nits ring 'P
Effluent F
NON DISCHARGE WASTEWATER MONITORING REPORT
lnffuert [
Irffiuent + Inoue
nth Gd At This Fa
Dairy Rate
peratnr IF@ow)into
fxr�eCbn n Treatment
Site S,rote r PH
HRS GALLONS UNIT
Dairy ua
Daily Miflarnu
Monthly Lirrait
orr polite (C) t Grab
Operator in Responsible Charge (ORC)
Check Box if ORC Has Changed: iD
Certified Laboratories (1):%,_a`a`l St%N4l�
Person(s) Collecting Samples:
flail ORIGINAL. and TWO COPIES to:
IENR
livision of Water Quality
TTN: Information Processing Unit
617 Mail Service Center
ALEIGH, NC 27699-1617
F4
20°C NH
MONTH::.
star (SWI: C fly Code/Nae:
Fecal
ad*for
Grade;
ORC Certification Number:
(2).
R.-
Phone-2)9 2 -576
GNATURE OF OPERATOR IN R.;SPONCHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
1. Does all monitoring data and sampling frequencies meet permit requirements.
CompUan (Y,N)
if the facility is non -compliant, please explain in the pace below the reason(s) the facility was notnOt in campance
with its permit. Provide in your explanation the date of the non-compliance and describe the corrective action(s)
taken. Attach additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all: qualified personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted 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 knowing violations,"
(Permittee Address)
Parame
Codes:
Position or Tit
(Phone Number)
/ 'Wei-- /0 //CM
g Official-Plepse print or type)
Arsenic
01022 Boron
0
04 Co0fcrrn, fo
0094 Crn0uctitv
42 C pp r
&imium 00300 Dissolved Oxygen
alchjm 31516 Fc1 Coifrrn
hforide 0 05
00600 Mr° n, Tola
00830 NO2&NO3
NO3
00556 Oil -Grease
0 40
PAN (Plant Availatrle)
929 iurn
93t SAR
745 Sui6
200 TDS
Temparalur
28 TK
50060 Chlorine, Total
Residual 71000 Mecury
034 Chrorruunn
00340 COO
7 Monesiv
NH3asN
01067 Nickel
.730 Pheno s
osproruo.
7 Potassium
Settleable Malt
(Permit Exp Date
Parameter Code ass lance may be obtained by calling the Water Quality Land Appllcation UnitUmt al [phone].
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. UseDnly the units designated in the reporting,
facility's permit for reporting data.
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28.0506 ib)(2)(D),
DENR FORM NDMR-1 (11/2005)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE, USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0023511
FACILITY NAME: Woodland Heights Elementary School
MONTH: September
Rage
YEAR', 2010
COUNTY: IREDELL
Formulas:
Daily Loading (inches) = [Volume Applied (gaBI ns) tt 6.1336 (cubic feet/gallon) x 12 ompesrfoot)l! Idvse Sprayed (acres)* 43360 {square feet/acre)) OR
Volume Applied {gallons) / (Area Sprayed (acres) x 27,152 (galfone/acre•:inch))
Maximum Hourly Loading (inches) = Daily Loading (inches) / ),Time irrigated (minutes) / 60 (r inulesrhour)) Monthly Loading (Inches) Sum of Daily Loadings (inches)
12 Month Floating Total (inches) _ Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weekly Loading (Inches) a )Monthly Loatling (inches/month) / Number of cars in the month {days/month)] x 7 par/weak)
Old Irrigation Occur At This Facility: Did Irrigation Occur On This Field: IDId Irrigation Occur On This Field:
Yes; 0 No: , D Yes: D No: 0 Yes: Q No; 0
FIELD NUMBER One FIELD NUMBER: Two
EATHER CONtWrlON
31
Total Gallons/Monthly Loading (Inches)
0.00
0.00
12 Month Floating Total (inches)
Average Weekly Loading (Inches)
• Weather Codes: C-clear, PC -partly -cloudy, CI -cloudy, R-rain, San -snow, SI-sleet
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:.
Mall ORIGINAL and TWO COPIES to;
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
0
DENNIS GRYDER
989073 Check Box if ORC Has Changed: 0l
GNATURE OF OPERATOR IN RE
BY THIS SIGNATURE, I CERTIFY TH,
TO THE BEST OF MY KNOWLEDGE.
Phone: [phone]
INSIBLE CHARGE)
THIS REPORT IS ACCURATE AND COMPLETE
DENR FORM NDAR_ (5l"2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements. (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s),
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment andior storage lagoon(s) was not less than the limit(s)
specified in the permit.
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
c
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations."
(Signature of P
cZ/tAL1Mr/0//c/(1)
Date (Name of Sign' g Official -Please print or type)
lredell Statesville Schools
(Permittee-Please print or type)
P,O. Box 911
Statesville, NC 28687
(Permittee Address)
;r-.
(Position or Title)
704-873-3755
(Phone Number)
(Permit Exp. Date)
• If signed by other than the permit -tee, delegation of signatory authority must be on Me with the state per 15A NCAC 28.0506 (b)(2)(D),
DENR FORM NDAR- 2O03)

PERMIT NUMBER:
FACILITY NAME:
Daily Loading (Inches)
Maximum Hourly Loading (inches)
12 Month Floating Total (inches)
AVeraga Weekly Lbadtrdg (inch j
Occur At This Facl
Yr
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED„
Q0 2
Woodland Heights Elerrbentary School
MONTH: Ault us
YEAR:
COUNTY: IREDELL
2t 10
Formulas:
[Volume Applied {gallons) x 0,1336 (cubic feet/gallon) x 12 (rncrlssnoct)l / [Area Sprayed (acres) x 43,560 {square 1eeVscre)I OR
z Volume Applied (peons) / [Area Sprayed (acres) x 2-7,1 g2 (gations/4cre•inch))
ri Daily Loading finches) / [time Irrigated (minutes) / 6© (minutes/hour)] Monthly Loading (inches) Sun, of Dairy Loadings (inches)
Sum o1 this manth`s MonthN Loading (Inches) and previous 11 monlh"s Monthly Loadings (inches)
(ManahlyLoad' ng(inches 11orif,)/l4uflibecrofday siay on (daystweek)
Did
This Field:
Occur On This Field:
Yes: D N
A
fi
9
4
20
2
4
2
2
ATHER CONDITION:
Code"
To
on
12
Avel
Code
nth Flo
ly Load
FIELD NUMBER
On
NUMBER
T va
AREA SSPiED lac
COVER CROP
Natural lilts
PER MCTTEIHOURLY
PERMITTED Y
Volume
Applied
Clear, PC -partly cloudy, CI -cloudy, R-rain,
RLY
Time
Irrigated
minutes
now, SI-slee
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Mall ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699.1617
Daily
oading
4
2
taxlmun
Hourly
oading
nct1ea Iric
OEOO
0
DENNIS GRYDER
PRAYED lac
OVER +CROP:
PERMITTED HOURLY
PERttI1TTEO YEARLY RA
Volume
Aiiled
989073 Check Box if ORC Has Changed:
N RE OF OPERATOR IN RESP
BY THIS SIGNATURE, I CERTIFY THAT
TO THE BEST OF MY KNOWLEDGE.
Natural Bite
Time Daily
:]pared Loadln
A
REPORT IS ACCURATE AND COIWIPLET
26
llazlmuh
Hourly
Loading
DENR FORM NDAR-t (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements, (Note: ifa requirement does not apply to your facility put (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the perti
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations,"
II . Statesville Schools
(Permittee-Please print or type)
P.O. Box 911
Statesville, NC 28687
(Permittee Address)
(Name of Signi
444'tie
Official -Please print or type)
1#z_d• i-hcA, / Ilia A 4(
(Position or Title)
704-873-3755 1i31/2009
(Phone Number) (Permit Exp. Date)
• if signed by other than the permtttee, delegation of signatory authority must be on file with the state per 15A NCAC 28,0606 (b)(2),10)„
DENR FORM NDAR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
Page
2
2
ER NUMBER:
FACILITY NAME:
ng Paint: Effluent:
ar teter Monitoring Point: Effluent:
nrtu
There Etluent. F(ow For This Month Generated At T
Operate
2400 Time ter
ally Maximum
ally Minimum
y
Daily Rate
(F1ow,i into
Treatmern
System
At ON
omposite (C) 1 Grab (G
ph
UNITS
Re idual'
cniorin
UG/L
Operator in Responsible Charge (ORCX1r2.41(, eS
Check Box if ORC Has Changed: ❑
Certified Laboratories (1) ag
Person(s) Collecting Samples:
NH3 #N
M G/F_
Tss
alviL
MONTH:
Fecal
Ca(ilor,
(Geo-nietri
Mean'i
Grade:
Certification Nurnber:
(2):
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
COUNTY:
SW Code
YEAR:C'
Phon
--(SIGNATURE OF OPERATC7FIN RESPONSIBLE CHARGE
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
ACCURATE
DENR FORM ,NDMR-1 (1 li2005)

NON DISCHARGE WASTEWATER MONITORING REPORT
FadHty Status:
Please answer the following question;
1. Dees all monitoring data and sampling frequencies meet permit requirements?
if the facility is non-comphant, please explain in the space below the reason(s) the facility was not in compliance
with its perrnit Provide in your explanaton the date(s) of the non:-cornpliance and describe the corrective action(s)
taken. Attach addiUonal sheets if necessary
"I certrfy, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted 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 pcsstlirty of fines and imprisonment for knowng violations."
ee-Please p nt or type)
100' Arsenit.
• i 22 Doran
osio anors 1042 Copper
(Position or Tftle
-2-2tf42)
(Phone Number)
Parameter Codes
3504 Cofiform, Tata
00094 Concloctivity
.2.7 OacirroLm 00300 0,ssolved Oxycjen.
916 Cak:..a.a:ri 3
9.40 ChIcri,le
50050 CrOorine, Ict
a9nesit.11
71900 Mercury
0 034 D. torn,om 0 0 NH3asN
57 Nickel
W009 FAN Pliit Avada
00400 H
32730 Phenols
00.1Phospnow . Total
00937 RE) $51t.o
eat eMUer
00500 N509en,
006)0 NO2a.NO3
00620 NO3
0 929 So lorn
0093, SeR
00745 Solr,de
00556 Oil-GteaS 70295 1.05
Temperature
TKN
700.
00530 755115R
77 • o
092 .Zit
3- 3 1t.
-
(Permit Exp, Date)
Parameter Code assista.nce may be obtained by calling the L'iater Quality Land ApphcaUcrz Unit at (919) 715-.6189.
The monthly average for Fecal Cortorm s to he reported as a GEOMETRIC mean. Use only the uflitS designated in the rec0rtinq
mit :Porting, data.
if signed by other than the permittee, deIegati
of signat©
a
hority must be on file with the state per 15A NCAC 28 0506 (b)(2)(D),
DENR FORM NDMR,1 (11/2005)

IT NUMBER:
FACILITY NAME:
IPar
°d_7s T
NON DISCHARGE WASTEWATER MONITORING REPORT
MONTH: ( YEAR:
Page
rMon• Poingt: E. cent nCGenete AtTis Fac fit ' rf e'a`ater(EV4Nn rS` C©der"Name:
nftluen t
a€tor�rr Pont Effluen Influent
e Efftuent Flow For This .vl a
°�
5605O iO4
Operator
71meOn
y Max
[laity Mini
Monthly Limits
Composite (C)
Treat zart
G
Operator in Responsible Charge (ORC),
Check Sox if ORC Has Changed-
Certified Laboratories
Person(s) Collecting Samples:
Mail ORIGINAL and TWO COPIES to
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
Mat
i
Fecal
C e�iCla'
Grade:
ORC CertitiCati In Number
IGNATU'RE OF OPEF' ATC!' IN RESP°
BY THIS SIGNATURE„ I CE`.TIFY THAT
AND COMPLETE TO THE BEST OF MY
Phone'
DENR FORM NOMR-'t (I t,2005).

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status;
Please answer the following question:
1. Does all monitoring data and sampling frequencies meet permit requirements?
if the facility is non -compliant, lease explain in the space below the reason(s) the facility was not in compliance
with its permit. Provide in your explanation the date(s) of the nen-compliance and describe the corrective actcns.)
taken. Attach additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. am aware that there are significant penalties for submitting
false information, including the possibility of fines and imprisonment for knowing vrclatfons."
e-P ease p nt or type)
Pararnete
des:
"Dr, Keith 7-11)-10
(Name of Si nin Official -Pease print or type)
Phone Number)
27 Ca9rnm
6 C Icium
00940 Chloride
50060 Chlorine, Totai
Residual
4 Chromium
31504 Colifor , To14I
000 4 Conductivity
01042 Copper
Dissolved
erai Coliform
01051 L0
00027 magnesium
71900 Merour,
0610 14H34sN
v t)9 PAN (Pl9r4 Avail 'wore
00 pH
32730 hervols
00625 TK'N
00660 IOC
00.665 Phosphorus, Total 90530 TSSITSR
C0037 Potassium
076 .TurtiOi
00340 COO
Niokeil
5 Settleable Matter 01092 Zinc.
Parameter Code assistance may be obtained by calling the Water C.'iwaOy Land Application Unit at [phone],
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC meani Use only the u ns designatedjn the
faiollity's permit for reporting data,
6f signed by other than the permittee, delegation of signatory authority must be on
ith the state per 15A NCAC 28.0506 (b)(2)(D),
DENR FORM NDMR-1 1112.005)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE, USE ADDITIONAL PAGES AS NEEDED.
Page of
PERMIT NUMBER1
Q0023511
:ntary School
Formulas:
May Loading (inches) (Volume Applied (palms) x 0.1336 rcufuc feeVgallcn) x 12 dinchesanotll I [Are e Sprayed (sees} x 43560 (square feeVacre)l OR
= Volume Applied [ a lor's} r[Area Sprayed [acres) x 27,152 (gaeonsiacre-oncnhl
Maximum Hourly Loading (inches) = deity Loading (inches} 1 [Time lingered (minutes) 60 Iminutsshour11
12 Month Floating Total (inches) = Sum of this Month's Menthuy Loading (inches) and previoumnre11 o hla MonthlyL
Avara�eWaelll Ltiatllnc lnclaes` = M nih_t, L0adtn+ kdle _
Did Irrigation Occur On This Field:
Yes:.
FIELD NUMBER: one
AREA SPRAYED (acre
COVER CROP:I Natural title
PERMITTED HOURLY RATE ((ruches): 0,4
PERMITTED YEARLY RATE inches.: 26
MONTH: July YEAR; 2010
FACILITY NAME:
A
T
4
20
21
22
23:.
24
2
2t,
2T
Woodland Heigh
TITER CONDITION
Temper -a
at
pnaci
appticatlon tit
(°F)„ 3r1c1
onthly Loadlrtl2 (in+cttes
12 Month Floating Total (Inches
Average Weekly Loading (inc
Codes: C-clear, PC•partty cloudy, CI loud R
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number: 989073 Check Box if ORC Has Changed:
Ele
Volume
Applied. ,,-
gallons
Time
Irrigated
minutes,
Monthly Loading (inches) = Sum of Dairy Loadings (ancirtes)
ydngs (inches)
d seek,
d Iritcatlon Occur On This Fi
ax mum
Hourly
Loadin
COUNTY: IREDELL
FIELD NUMBER:
AREA SPRAYED acres'
COVER CROP: Natur
PERMITTED HOURLY RATE (in
PERMITTED YEARLY RATE to
Volume
A.,+lied
Mal( ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
DENNIS GRYDER
r-
Time
sled
0
Phone:
SIGNATURE OF OPERATOR IN R :PCINSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACC
TO THE BEST OF MY KNOWLEDGE,
0.4
26
ax muna
Hourly
oadlnt
704-573 3755
ATE AND COMPLETE
DENR FORM NDAR•l (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box, )
I. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment andior storage lagoon(s) was not less than the limit(s)
specified in the permit
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additionai sheets if necessary.
Page
c
Y
"I cerjtyunier perialty‘of Raw, that this document and all attachments were prepared under my direction or supervision in
accoMe*ith am designed to assure that all qualified personnel properly gathered and evaluated the information
, submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
, complete, I am aware that there ale significant penalties for submitting false information, including the possibility of fines
, - and imprisonment for knowing violations."
(Signature
p- Dr. 4441,.
eer Date
lredell - Statesville Schools
(Name of Signing
CIS1
1/1A; tier k-
fficial-Please print or type)
(Permittee-Please print or type) (Position or Title)
RO, Box 911
Statesville, NC 28687
704-873-3755 1131/2009
(Phone Number) (Permit Exp. Date)
(Permittee Address)
" If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28,0506 (b)(2)(D).
OENR FORM NDAR-1 (5/2003)

UMBER.
ACILITY NAME_
NON DISCHARGE WASTEWATER MONITORING REPORT
U�
F(oav 4lonitoring Point: Effluent:
nitraring Pcaint: Effiuen
nfluent:
MONTHS j,(,,fq
Page
(taent ?_.J Suater ISW): )' ' Code/Name.
ere Effluent Flca v For This Month Generated At This Faciiity: Yes: No
Average
Daily Maximum
Daily Minimum
Daily Rate
(Flow) onto
Treatment
System
GALLONS
Grab (G)
UNITS
Operator in Responsible Charge (ORC),
Check Box if ORC Has Changed: E]
Fetal
coFf©rm
(Geo-mefrie
TSS Mean')
n©©Ml
Grade:
ORC Certification Number:
Certified Laboratories (1): rl I'Aw- e, '4' (2):
Person(s) Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
ne:
IGNATURE OF OPERATON RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE,
DENR FORM Nb(tr1R-1 ('E 1k''2005)

NON DISCHARGE WASTEWATER MONITORING REPORT
FacilityStatus:
Please answer the folio ing question:
1. Does all monitoring data and sampling frequencies meet permit requirements?
lt the facilityis non -compliant, please exofain in the space below the reason(s) the facility was nct in compliance
with its permit. Provide in your explanation the date(s) of the non-c,o,mpliance and descnbe the corrective action(s)
taken. Attach additional sheets if necessary.
certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I at aware that there are significant penalties for submitting
false information, including the possibility of fines and imprisonment for knowing violations,"
(Permittee Add ess)
Parameter Codes:
(Name of Sig
Phone Number)
Mr\ ffe r- -7- 9- (0
Official -Please print or type)
02 Arsenic
01022 E3dron
10
01027 Cadmium
oog6 Cacurrii
ride
006Chfoone, To1ai
Residual
4 Chromkm
340
1504C138olm, Toial
00094 Ccnductivity
042 Copper
71
500 Nrc9en, Toial
00630 N028NO3
0001s50tved Qx11
ec31 Ccili
Magnesium
emu,/
7 Nickel
2(1 NO.2
0
566 L,i1•,(7,rease
4
00931 SAR
PAN (Planl Avaiiable)
2730 Phrts
Phosoodrusi Total
37 Poliassiu
45 SeWeable Mauer
745 uifide.
7,2295 TO
00G10 Temperature
00625 TKN
T
0 TSStTSR
00076 Tuddidily
0 I D92 Zinc.
Parameter Code asststan0e may be obtained by calling the Water Quality Land Application Unit at [phone].
The monthly average tor Fecal Coljorm is to be reported as a GEOMETRI.C. mean. Use only the units d • ated tn the reporting
facility's permit for reporting clata
• If signed by other than the permittee, delegation of signatory authority must he on file with the state per 15A NCAC 28.0506 (b)(2)(D),
DENR FORM NOMR-1 (1172C05)

PERMIT NUMBER:
FACILITY NAME:
Daily Loading (inches)
Maximum Hourly Loading (Inches)
12 Month Floating Total (Inches)
Average Weekly Loading {Inctges}
d trrigat"ron Occur At This Factfltt+;�+:
Yes: IEl
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED,
WQ0023511
Woodland Heights Elementary School
Formulas:
MONTH: June
YEAR: 2010
COUNTY: IREDELL
[Volume Applied (gallons) x 0..1338 (cubic feet/gallon) x 12 Iinches/foot)] 1 [Area Sprayed (acres) x 43,560 (square feet/acre)] OR
Volume Applied (gallons) f [Area Sprayed (acres) x 27,152 (gallons/acre inch))
= Daliy Loading (inchesl 1 [Time irrigated (minutes) 160 (minulesmourl] Monthly Loading (Inches) = Sum of Daily Loadings (inches)
= Sum of this months Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
oacting (inchesimonth) / f4umber of days in the mcrrih (daysttnonth)) x 7 (dayelweek)
Did Irrlgatlon Occur On This Field: Did In Occur On This Field:
Yes: C No:
th
Ye
No:
7
d
4
7
20
21
2
2'3
24
2
2
2
2
29
Total GallonslMon
d6ng (Rnches)
2 Month Floating Total (Inches)
Average Weekly Loading (litche:
FIE Lti NUMBER:
FIELD NUMBER:
Two
AREA SPRAYED (a
9
AREA SPRAYED
68
COVER CROP
Natural Iihe
PERMITTED HOURLY RATE inches 0,4
r Codes: C-clear, PC -partly cloudy, Ct-cloudy, R-
In, Sn-snow, Sl-slee
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
0, 00
0
DENNIS GRYDER
COVER CROP
Natural iitte
PERMITTED HOURLY RATE inch
989073 Check Box if ORC Has Changed:
C
0.00
0.4
26
Maximum
Hourly
Loading
inches
Phone: [phone]
(SIGNA URE OF OPERATOR IN RES NSS BALE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND CO
TO THE BEST OF MY KNOWLEDGE.
PLETE
DENR FORM NDAR-1 (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment andfor storage lagoon(s) was not less than the limit(s)
specified in the permit.
Y N
1Y
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit, Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken, Attach
additional sheets if necessary:
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations.
(Signatu of P ttiql)*
Ireaell - Statesville Schools
7- '7- 10
Date
(Permittee-Please print or type)
P.O. Box 911
Statesville, NC 28687
Permittee Address)
(Name of Signing
(Position or Title
704-873-3755
ficiaIPIe
(Phone Number)
7- ( 0
e print or type)
1/31/2089
(Permit Exp. Date)
• If signed by other than the perrnittee, delegation of signatory authority must be an file with the state per 15A NCAC 26.0506 (b)(2)(0).
DENR FORM NDAR-1 (WON)

FlowMonit©ring Poi
Effluent: Enunt:
ameter Monitoring Pola�t.
This
There Effluent Flow
Time
me On
So¢e
nth8y t
Campo
NON DISCHARGE WASTEWATER MONITORING REPORT
Page — ,
MONTH: J fis YEAR:
iJ
Effluent. Influent: ;Surface water a'SVv}: :S ' Code/Name
h Generated .At This Faiaty' e==5: i No
rJaaraa 1 OGr1 k5s tab
Oaaly Rate
Into
Treatment
Operator in Responsible Charge (ORC):
Check Box if ORC Has Changed:
Certified Laboratories (1):
Person(s) Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
DENR-GtCATURE OF Of'E .4,TO RESPOI't&P-; tiONXt tctE
Division of Water Quality BY THIS SIGNATURE, I CERTIFY THAT THIS REPet4terACCURATE
ATTN: Information Processing Unit AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
1617 Mail Service Center°
RALEIGH, NC 27699-1617
Res#dual 900-5
20°C ti EPA T,SS
Fec4u
Grade:
ication Number:
I2)°
DENR FORM NDMR-1 (11,'2LO )

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
I. Does all monitoring data and sampling frequencies meet permit requirements?
If the facility is ncn-compliant, please expin in the space below the reason(s) the facility ,vas not in compliance
with its permit Provide in your expl'anatIon the date(s) of the non-compliance and ciesorte the corrective action(s)
taken Attach additional sheets It necessary
"I certify. under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system„ or
those persons directly responsible for gathering the information., the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete I am aware that there are significant penalties for submitting
false informatlon, including the possibflity of fines and imprisonment for knowing violations."
Permit Add e
Parameter Codes:
47
Nanie of Sighing Officia1Pease print or
LYF rAp-
(Position or Title)
'7 6/ ce'25 5-151
(Phone Number)
02 Arsenic
01029 Boron
00110 8005
01027 Cadrnium
G0016 Caicium
00940 Chicand e
.53060Oniorice,
Resideai
3 504 CoeforreL Total
0094 Cencliucrenty
01 • CP Pa r
00.300 DissoNed Cgen
31616 Peal Caliierm
01051 Lead
00927 Ma.gnesiem,
7 SGO Merci,N,
0 02,4 Chromium
00340 COC
Parameter Code assist
10 N9t34s51
60 iiroGen, Tole!
00630 N026N33
00620 NO3
0055€ Oii-Grea%e
W009 PAN LP/art Avabie)
00400 P
32 730 Phence3
20665 Pirespccires. Toiai
00037 Pc1assiern
S udiurn
03031 SAR
00745 586de
70205 TO'S
00/110 'Temperaiere
03625 71<N
00680 TOC
00530 TSSZISR
00075 Turtidily
(Permit Exp. Date(
061 00545 SelSeatie Maaer 013.2 Zinc
ay be obtained by calling the Water Quality Land Application Unit az [phone],
The monthly average for Fecal Ccliforrn is to be reported as a GEOMETRIC mean. Use ote units designated in the repontind
factlityis permit for reporting data.
If signed by other than thepermittee, delegation of signatory autho
be on fite the state per 1 SA NCAC 2B4O506 (bI(2)(D)
DENR FORM NOMR-1 (11/2005)

rof 2_,
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE, USE ADDITIONAL PAGES AS NEEDED,
PIIIFIFF-PERMIT NUMBERNON-DISCHARGE APPLICATION REPORT Page /
: WQ0023511 MONTH: May YEAR: 2010
FACILITY NAME: Woodland Heights Elementary School COUNTY: IREDELL
Daily Loading Om:11190
Maximum Hourly Loading (inches)
12 Month Floating Total (inches)
Average Weekly Loading {Inches)
Formulas.:
[Volume Applied (gallons) x 0,1336 (cubic feel/gallon) x 12 (inches/65001J Area Sprayed (a.cres) x 43,560 (square fee1/0cire)1 OR
r Volume Applied fgailons) .1[Area Sprayed (acres) x 27,152 (galianstacfeAnctia
ir Daily Loading (inches) / Rime Irrigated (minutes) / 60 (minutes/hour)) Monthly Loading (Inches) - Sum of Daily Loadings (inches/
Sum of this month's Monthly Loading (inches) end previous 11 month's Monthly Loadings (inches)
Loadirg /inches/month) / Number of days in the month (dayslmonth)) K 7 (claystweek),
d Irrigation Occur At This Faciiity: Did Irrigation Occur On Thls Field: Did Irrigation Occur On This Field:
Yes: L1 No: 0 ¥es 0 No: El yes: 0 No:
WEATHER N ON
A
T
E
31
Total Gallons/Monthly Loading (Inches)
12 Month Floating Total (inches)
retlxer
ode'
Temper-etu
at
application
CFI
Pm: pito.
don
inches
Averae
FIELD NUMBER. One NU
AREA SPRAYED (acres): 1 9
COVER CROP.: Natural litter
PERMITTED HOURLY RATE Inches : 0 4
PERMITTED YEARLY RATE (inches
Volume
Applied
gallons
3002
2718
2917
2773
Time
Irrigated
minutes
Daily
Loading
Inches
0,06
0, 5
0,06
0.05
#DIVIOi
0,11
0 11
0 10
0.06 0.12
Proco,,,„
W0/80G
0.
Codes: C-clear, PC -partly cloudy, Cl-cloudy, R-rain, Sn-snow, SI-sleet
0
T
AREA SPRAYED (acres): 1 68
COVERCROP: Natural litter
PERMITTED HOURLY RATE inches : 0,4
PERMITTED YEARLY RATE (Inches):
Volume
Applied
gallons
2804
2889
2465
13253
Spray Irrigation Operator in Responsible Charge (ORC): DENNIS GRYDER
ORC Certification Number:
989073 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
Time
Irrigated
minutes
Daily
Loading
inches
0,06
0.06
0.05
.0
#0 WO!
0.13
0,12
0.10
Phone: [phone]
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the f'acitity has been compliant
with the following permit requirements'. (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
Co
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s) Y
specified in the permit.
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with it=
permit, Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those rsons directly responsible
for gathering the information, the information submitted 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 knowing violations."
7-1 o
(Signature of rniittee)* Date
iredeh'I - Statesville Schools
(Perrnittee-Please print or type)
P.0. Box 911
Statesville, NC 28687
(Permittee Address)
"LMr ✓tcr
(Name of Sign it Official -Please print or type)
CIR. OF MAINTENANCE
(Position or Title)
704-873-3755
(Phone Number) (Permit Exp. Date)
1/31/2009
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (b)(2)(D).
OENR FORM NDAR•1 (5/2003)

Page
/ of
A
NON DISCHARGE WASTEWATER MONITORING REPORT
NUMBER:
ITY NAME:
in Point: Effl :ent: influent:
eter Monitoring P
MONTYEAR:
nfluent: L iSt rfa e Water )SW): i.d SW CcdetName:
There Effluent Flcev F`. r `: is Manth Generated At This Facility: es: No:
00400
Arrival
T+me
Z400
Average
Daily Maximum
©wily Minimum
Qaliy Race
iR {F''to`w.vI tom
on ' Treatment
omposite (C) ! Grab
Operator in Responsible Charge (ORC): \
Check Box if ORC Has Changed: C]
sSdaaait 50j-5
11 tin a 20°C, NHZ,N
G1'i '6vi # MG/1 MG,
Fecal
Ccliform
(Geo-metric
Grade: 7 Phone?.J
ORC Certification Number:
Certified Laboratories (1):94E50/7t r / l-f / ---
Person(s) Collecting Samples; Op #ca'Z
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
(2):
7
GNATURE OF OPERA rO" IN RESPONSIBLE CHAR
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS A
ram? ' AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DRAT
DENR FORM NDMR-1 (I 12005)

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
1. Does all monitoring data and sampling frequencies meet permit requirements?
If the fa.ciiity is noncomp1'iant, please explain in the space belovw the reason(,$) the facstity was not un o nptlance
vv°ith its permit, Provide in your explanation the date(s) of the non-compliance and describe the corrective s)
taken. Attach additional sheets if necessary,
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted, Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the 'information submitted 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 knowing violations.°
Dr y ,i itde - 3/z3/t0
(Name of Signifn,g Official -Please print or type)
A
Parameter Codes:
Cop4 r n, Tcla
(Position
V1' V - 7
(Phone Number)
N0r'c^pin, i01a
2
00094 Cran+3uc4 0y
Pi
42
p
7
of
N+02dNI
00620 NO
96 alciern 31616 r"ec
40 Chlorsde 01051 Lea
nne, TcPa
Resie0aii
n
vVQ09 P,;N {Plan!. Availabl
00400 pH
32730 Phenols
Phesnnoars. To
01034 chrc iur 00 10 NH3asN
00340 c00 .i 01067 Nickel
7
aso.
00545 Settle
e Pvtatt
00075 Terbi02y
01092 Zinc
(Permit Exp. Date)
Parameter Code assustance may be obtained by calling the Water Quality Land Application Unit at r',9tgj
The monthiiy average for Fecal Coliform is to he reported as a GEOMETRIC mean. use only the units designated in the repertinq
faculty's permit for reportin.q data
• If signed by other than the permittee, delegation of signatory authority must be an file with the state per 15A NCAC 2B.0506 (b)(2)(D).
DENR FORM NDMR-1 (1 2t}05)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
Page
PERMIT NUMBER: WQ0023511 MONTH:
FACILITY NAME: Woodland Heights Elementary School
February YEAR: 2010
COUNTY: IREDELL
Formulas:
Daily Loading {inches) _ [Volume Applied (gallons) x 0.133e (cubic feet/gallon) x 12 (incheslroot)l 1 [Area Sprayed [acres} x 43,560 (square feel/acre)) OR
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / [Time irrigated (minutes) / 60 {n nutas.fiour)[ Monthly Loading (Inches) - Sum of Dairy Loadings (inches)
12 Month Floating Total (inches) -Sum of this month's Monday Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weekly Loading finches) =ifd#onthiy Loading(inohe$tmenth(1 Number of days s5 t e eons/ (days(lnonth))x 7 fdashwas//)
ur On This Field:
gatiaan Occur At This Facility:
No:
Did
Tgat
Yes
N
Did lrrlgation Occur On This Field:
Yee:
N
F
R:
FIELD NUMBE
Tiro
AREA SPRA
AREA SPRAYED Ise
OVER CROP
Natu
COVER CROP:
Natural I
PERMITTED HOU
Y RATE li
h
0.4 PERMITTED HOURLY RAT
4
A
EATHER CONDITiO
ER
ARLY
TE
26
PERMITTED YEARLY
Temper-etcStorage ximLI
l"ti at eon Volume Time Daily Hourly Volume Time Daily Hourly
pplicatIon Froe.boa + Applied Irrigated Loading Loading Applied irrigated Loading Loading
E rest gallons minutes inches Inches shons minutes inches inches
1C 2 r 5 0 0 0.00 #DIV/0! 0 0 0.00 #DIVI0!
0 0 0.00 #DIV/0! 0 i 0.00 #DIV/0!
t # 3438 29 0.07 0.! 7 14 3353 31 0.07
2
To
5
2 i
ce®
thly
2 Month Floating Total Ilnch
Average Weekly l.oadir (inches)
0.12
0.14
0.11
0,12
0.13
#DIV/0!
0.12
#DIV/O!
#DIV/01
#DIV/0!
#DIV/0!
#DIVIO!
3217
3037
2385
2639
2527
0
3744
0
0
0
0
0
2438
0,07
0.07
0.05
0,06
0,©6
0,00
0.08
0.00
0,00
0.00
0.00
0.00
0.05
2 0.0 Ir 5 22 0.15
30 0.07 0.14 226 0 0.07 0.14
0 26 0,06 0.14 332
202
0.1400917 '.
0.1478
e
Codes: C-clear, PC -partly cloudy, CI -cloudy, R-rain, Sn-snow, SI
Spray Irrigation Operator in Responsible Charge (ORC): Dennis Gryder
ORC Certification Number:
989073 Check Box if ORC Has Changed: 0
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
Phone: [phone]
ATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
Tb"THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR•1 (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit,
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the perrnit.
Iant N
Y
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations."
Iredell - Statesville Schools
(Permittee-Please print or type)
P.O. Box 911
Statesville, NC 28687
Permittee Address)
tr-
(Name of Signi fficial-Please print or type)
DIRECTOR OF MAINTENANCE
(Position or Title)
704-873-3755
(Phone Number) (Permit Exp. Date)
3/31/2014
• If signed by other than the perrnittee, delegation of signatory authority must be on file with the state per 15A NCAC 28,0506 (b)(2)(D),
DENR FORM NDAR-1 (5/2003)

T NUMBER:
FACILITY NAME:
NON DISCHARGE WASTEWATER MONITORING REPORT
Page
MONTH:J .J04t YEAR: Z7
CO
nitoring Point:
arameter Monitoring Point:
as There Effluent Flow For Thi
Effluent:
uent:
onth Generated AtTh
No
Opera tt
TVme 0
Site
axumum
wily Mcnimum
ontnt' Llrr&it15
Gafily Rale
CRC (Flow) iettc
cn Trea¢ment
"ails S4"EBf§6
GA ONS
Composite (C) I Grab (G)
Operator in Responsible Charge (ORC):
Check Box if ORC Has Changed:
Certified Laboratories (1): 6-1171
Reid� al ( 80©-5
Chicxune 20'C
Person(s) Collecting Samples: z%5L=f2 , `fig
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
NH3>N T"S;
hiG L �P IMG{L
U
Fecal
r.03N1L
Grade:
ORC Certification Number:
(2):
SIGNATURE OF GPETOR IN RESPONSIBLE CHAI GE
BY THIS SIGNATURE, l ERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDMR- 1 (I 1 2005)

NONDISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
1. Does all monitoring data and sampling frequencies meet permit requirements?
If the facil ty is non -compliant, please explain in the space below the reason(s) the facility was not in compliance
with its permit, Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s)
taken, Attach additional sheets if necessary.
"9 certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted, Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. am aware that there are significant penalties for submitting
false information, including the possibility of fines and imprisonment for knowing violations,'"
(Signature o Pe
Per ee-Pleas
(Permittee Ad
Parameter Code
Dr. tA.A_ a I //1v- 02-2L 6
(Name of Signing 0 ial-Please print or type)
(Position or Title)
(Phone Number)
01002 Arsenic
011022 Boron
4 Coliform, Taal
00094 Conducfanty
01042 Copper
003 0 ,S5Clved Oxy
2'7 Cdmm cir
00916 Calcium
00940 Chloride.
50360 Chlorine, Toial
Residual 7100 Merntiry
610 N.1-13asN
01067 Nickel
31.616 Fecal Coliform
0105.1 Lead
00927 Magnesium
05034 Chromium
00340 COD
00600 Nitoogeni tolal
00630 NO2
00558 ii-Grease
WC309 PAN (Pfani Available
00400 pH
32730 Phenols
65 Phosphorus, Tata
O. 7 Po1asium
45 Seilleable Mailer
00929 Sodium
00931 SAR
00745 Sulfide
70295 TOS
00010 Temperalure
0,0625 TKN
00680 TOG
76 TurCidny
Znc
(Permit Exp. Date
Parameter Code assistance may be obtained by calling the Water Quality Land Application Unit at (919) 7156189.
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only the units designated in the reporting
facIlity's permit for reoortinq data.
• If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 213.0506 (b)(2)(D),
DENR FORM NOMR-1 (1112005)

LL "�
tCZ
W
a. I
as
Qf
LLlCw
059
0
co
z
0
0
EL.
©c
a
U=, •
N7T4'la%3:lf[01ail: E

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Page of
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compttant
with the following permit requirements: (Note: ifa requirement does not apply to your facility punt (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
c
EY
rY
°"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information„ the information submitted 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 knowing violations."
Iredeli - Statesville Schools
(Permittee•Piease print or type)
P,0. Box 911
Statesville, NC 28687
(Name of Signin
f� v
Please print or typ
DIR OF MAINTENANCE
(Position or Title)
704-873-3755
3/31/2014
(Phone Number) (Permit Exp. Date)
(Permittee Address)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0505 (b)(2)(D).
DENR FORM NDAR-1 (5/2003)

T NUMBER:
FACILITY NAME:
Poin
Morhtorrng Point:
Thore EftiuentFor Thus ,
Operator
are Cn
Sae
Avrage
y x
inimum
Monthly Limit(s
on
ite
ornposite ( Grab (G
Operator in Responsible Charge {ORC):
Check Box if ORC Has Changed,
Certified Laboratories (1):
Person(s) Coll tiny Samples:
NON D SCHARGE WASTEWATER MONITORING REPORT
Effluent.
EffiueninfIiert:
1 nth GeneraedAt Ts
00400 .50060 0v,.3r, 0050 closzp
Respclual 0CC-5
pH Chlorine 29°0 N.H3.N
UNITS UGL ?..1 ciPL MC;IL
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Process ng Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
urface
T$3
MONTH:
31616
Fecal
Ccliform
(Geo-rnelr,c
Meacol
/0014IL
Grade-
ORC Certification Number:
(2):
Pa
t1Lr3A_ YEAR
COUNTY:
ThJ
oV Code/Name:
Phone2
Or7
NATURE OF OPE IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE,
DENR FORM NDMR-1 (1!120051

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
1. Does all monitoring data and samplingfrequencies meet permit requirements?
If the facility is non -compliant please explain in the space te;ow the reason(s the facity was not in compiance
;with its permit Provide ;n your exp4anation the date(s) cf the non-compliance and describe the corrective actcr(s)
taken. Attach adOWcnai sheets if necessary,
certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted; Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information; the information submitted is, to the best of my
knowledge and belief, true, accurate, and compete. I am aware that there are significant penaities for submitting
false inforrnatiop, including the possibility cf fines and irnprisonment for knowing \./ciatons,"
Date
5Y145-1/jitc SC edS
(PermitteePease print or type)
,cq ,1(4,0"if
/f/.
ittee Address)
(Per
Parameter Codes:
2cid
Official -Please print or type)
vvimet.
(Position or Title)
756
(Phone Number) (Permit Exp.
02 Arsenic
1022 epron
50310 5.000.5
31504 Coriform, Tol'a
00094 Cooducthoof
0'1042 Copper
00500 Ngrogeo, Total.
00630 NO2&.NO3
00624 NO3
00929 sot
00931:
007 Suifibe
01027 Caarrium
00
Calvurr
00440 Cnicride
50660 Chicrwe, Tole
Resilual
01034 Chrom.k.Jrn
00340 CCP:
00300 mcci-vea Ory9e0
31016
eoarCoOpfro
IC
010E7 Nickel
C0556 Cii,Grea
oV00.9 ,:Pfant Avatiao e) 00010 Temperature
00400 pH
32730 Pnpis
0665 eticsellerus. 1".ot&
009.37 POtd,SSWrrl
545 Se0leat0e M8llr
IOC
0530 SITSR
0076 TurtNiclir,
01042 .7.1.e.c
Parameter Code assistance may be obtained by calling the Water Quality Land Application Unit at [phone].
The monthly average for Fecal Coliform is to he re,;Dorted as
faudity's permit for reporting data.
• if signed by other than the permittee, delegation of signatory au
a GEOMETFUC mean. Use only the units designated in the reporting
thortty must be on file with the state per 15A NCAC 2E3 0506 (b)(2)(D).
OENR FORM NDMR-1 511/2005

!Fir
PERMIT NUMBER:
Daily Loading (Inches)
Maximum Hourly Loading (inches)
12 Month Floating Total (Inchon)
Average Weekly Loading (Inches)
d irrigation occur At. This Faciltty:
Yes: El No: ❑ Vas: [p1 No: 0 Yes:
FIELD NUMBER:
A
T
4
5
T
HER CONDITIONS
Weather
Code'
C
R
C
C
I C
iy CL
CL
0 t C
1' CL
2.
Temper-ature
at Prectptta-
application lion
0
42
0
0,5
55 1.25
38 0
38 0.2
43
45
49
5
AREA SPRAYED (acres):
COVER CROP:
PERMITTED HOURLY RATE (Inch
PERMITTED YEARLY RATE (Inch
Volume
Applied
Time
Irrigated
gaiions minutes
2830
2260
2535
2853
3525
3946
21
23
21
23
28
32
One
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
WQ0023511
FACILITY NAME Woodland Heights Elementary School
MONTH: December
Formulas:
(Volume Applied (gallons) x 01336 (cubic feet/gallon) x 12 (inttresrMira }} 1(Area S
= Volume Applied (gallons} J (Area Sprayed (acres) x 27,152 (gaslacre-inch))
COUNTY:
Page / of 2_
YEAR: 2009
IREDELL
uare feet/acre)] OR
Daily Loading (inches) / Rime Irrigated (minutes) / 60 (minutes/bour}) Monthly Loading (Inches) = Sum of Dairy Loadings {inches)
= Sum of this monlh's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
_ (Monthly Loading (inchesshrfe/ tfl) / Number of days to the month (dasfnonth)) x 7 (dayslwee$)
Did Irrigation Occur On This Field: Did Irrigation Occur On This FI
D NUMBER
1.9 AREA SPRAYED (acres):
Natural litter
Daily
Loading
inches
0.05
0,04
0.05_.
COVER CROP:
No: ❑
Two
1.68
Natural litter
0.4 PERMITTED HOURLY RATE (inches
26 PERMITTED YEARLY RATE, (inches
Maximum
Hourly Volume Time
Loading Applied Irrigated
inches 9allans minutes
0,16 2848 20
0,11
0,14
2420
2244._.
22
22
0.06 0.14 2500 23
0,07 0,15 3016 28
0.08 0,14
37
6
Daily
adding
inches
0.06
0.4
26
Maxin1u
Hourly
Loading
Inches
0.19
0.05 0.14
0.05 0.13
0,05
0.07
0.08
0.14
4 CL
CL
6 C
C
SN
41
50
40
33
0.45
0
0
2453
2640
2713
3580
20
21
27
29
0.05
0.14
0,05 0.16
0.05 0.12
0,07 0.14
0 C
21 C
22
23
4
32 0.25
34
HOLIDAY
HOLIDAY
HOLIDAY
2350
2172
23
21
2262 26
2021 18
2430 22
2903 27
0.05 0,12
0,04 0,12
2440 22
2234 22
0.05 0.11
0.04 ©:15
0.05 0.15
0.06 0.14
0,05 0,15
0.05 0.13
7
C
C
CL
2
21
2.5
0
0
Tatai aallons/M+anthiy Loading (in
12 Month Fioatinc Total (Inches
2421 _. ..
3923,
3444
43645
24
29
0.05 0.12
0.08 0,12_
0.07 0.14
0.85
2541 25
3718 37
3035 29
40408
0,06
0.08
0.13
0.07 0.14
0.89
Average Weekly Loading (Inches)
Weather Codes: C-clear, PC -partly cloudy, Cl-cloudy, R-rain
0.1909049
n-snow, SI-sleet
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Dennis Gryder
989073 Check Box if ORC Has Changed:
Mall ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mall Service Center
RALEIGH, NC 27699-1617
0.1998915
Phone: [phone]
R
N RESPONSIBLE CHARCSE
FY THAT THIS REIN ?gi1t1(ALt 71 11 'IklitIJCWIM
EDGE. `,'ttr '(; ,==`1 ,.7)(.:,
DENR FORM NDAR-1 (5J2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit
2. Adequate measures were taken to prevent wastewater runoff from the site(s),
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
n
IY
Y
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations."
I- lie- /0
(Signe Date
dell - Statesville Schools
(PerrnitteePlease print or type)
P 0. Box 911
Statesville, NC 28687
(Permit -tee Address)
k'eduk. ril ito-to
(Name of Sign
Official -Please print or type)
DIRECTOR OF MAINTENANCE
(Position or Title)
704-873-3755
1/31/2014
(Phone Number) (Permit Exp. Date)
If signed by other than the permit -tee, delegation of signatory authority must be on file with the state per 15A NCAC 28,0506 (b)(2)(D),
•""
DENR FORM NDAR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
FACILITY NAME;
Monitoring Point: Effluent:
eter Monitoring Point: Effluent
Operate,'
ArNvai
Time
2400
31
Average
Daily Maximum
Daily Minimum
Monthly Limit(s)
Effluent Flow For This • n
Operator
TjrneOn
Site
on
ite
Composite (C) / G
50050
Dany Rate
(Fiow) into
Treatment
Systern
GALLONS
Iueflt
uent:
nerated At This Faclicy:
1 oo5lo
UNITS
Residual BCO-5
Thioricie 20C
GP_
Operator in Responsibre Charge (ORC):a—D
Check Box if ORC Has Changed:
Certified Laboratories (1
Person(s) Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALE(GH, NC 27699-1617
E
Gt.
MONTH:
Yes,
00530 I 1 1
Fetal
Cofilprri
Geo.rneinc
TSS Mean')
ORC Certification Number:
(2):
CQUN
SW Code/Na
Phone:
87
XLi
NATURE OF OPERA/TOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE
DENR FORM NOMR-1 0 1;2005)

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
1, Does all monitoring data and sampling frequencies meet perrnft requirements?
ff the facility is nor -compliant, please explain in the space below the reasons) the facty° was not in compliance
h its permit Provide in your explanation the dates) of the non-compliance and describe the corrective actions)
taken. Attach additional sheets if necessary
certify, under penalty of law„ that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted 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 knowing violations."
(Permittee Address)
Parameter Codes:
YLil MI ri/ -6-- ice / l�
('Name of SigninhOfficial-Pleaseprint or type)
(Position or Title)
-( 3 -.375
(Phone Number}
4
0 Nddrogen Toia
01022
027
rt
4
N
45 Sul
R
ahu
ued x en
00556 ©id
6 Fecal %U
PA N IPkanl A
O0010 Temperature
4
Ctitonne. Iota
.e0uduat
7
7 hiago
4
327
5 TKN
0 TOC
PhcrsprttltU'S, T
20510 TSS/TSR
01034 Chremlum
00340 COD
QUb a NN 1
01067 NIckef
00545 5ol1Ieabke Ma
76 TUrt d1
s2 zinc
Parameter Code assistance en ay be obtained by calling the Water Quality Land Application Unit
715-5189.
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only the units designated in the reporting
facility's permit for reaorfing data.
gned by other than the permittee, delegation of signatory authority must be on file with the state per i8A NCAC 28,0506 (b)(2)(D).
DENR FORM NDMR-1 (11✓2005)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
Page % of
PERMIT NUMBER:
FACILITY NAME:
WQ0023511
Daily Loading (Inches)
Maxirnum Hourly Loading (inches)
12 Month Floating Total (Inches)
Alnerattr We Loading ixnchael
n
c
At This Facility
No:
W©ociland Heights Elementary School
MONTH: April
YEAR: 2010
COUNTY: IREDELL
Formulas:
(Volume Applied (galkrns) x 0.1336 (cubic feet/gallon) x 12 (inches/foal)] / [Area Sprayed (acres) x 43,580 (square feet/acre)) OR
Volume Applied (gallons) I (Area Sprayed (acres) x 27,152 (gallons/acre-Inch))
= Daily Loading (inches) / (rime Irrigated (minutes) / 60 (minutes/our)] Monthly Loading (inches) = Sum of Gaily Loadings (inches)
= Sum of this mronth's Monthly Loading (Inches) and previous 11 month's Monthly Loadings (inches)
[Monthly Loadin (inchesimoreh) / Numttar of days ira ltaa rilo�nt31(dayslmonttr}) x 7 ('dayaAa kj
Old Irrigation Oc
Yee: r= i
On This Field
Did
Igation Occu
Yes: C7l
On Th
Field:
A
4
0
4
9
20
2
ATHER CONDI
ON
Code'
PC
C
22 C
C
4
2
2
27
28 C
Total Gall
a
PP'
P
eon
0
5
0
4
60
67
0
0
7
54
0
0
.7
0
0
0
7 0
0.25 6
50 0
0
60 0 7
0 022 7
64 0
2 Month Floatln)a T
n
Average Weekly Loading (inche
Codes: C-clear, PC -partly cloudy, C
F
NU
One
FIELD NUMBE
Two
AREA SPRAYED (a
COVER CROP
Natural litre
AREA SPRAYED (ac
COVER CROP:
6
Natural litke
PER 1i9TTED HOURLY RATE (inches,,): 0.4 PERMITTED HOURLY RATE (in
PER14
Volume
Applied
YEARLY RAT
Time
Irr)» ated
Daily
oadin
gall cane minutes Inch
270
2000
2
2
237 2
26
Maximum
Hourly
Loadin
0.05 0
0.04 0
0 005 0.10
0 0.05 0
0 0,07 0.14
0
0
005 27
2403 22
3146
2002 2
2736 2
4
67
7
5
oudy, R-raln, Sn-snow, SI-
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
0.06 0.12
0.04 0,
0.05
0.07
0.10
0,14
0.06 0
0.06 0
0.06 0
05 0
0.06 0.12
04 0.11
0,03 0
0,0 0.12
0,4
PERMITTED YEARLY RATE In chetr : 2
axmu
Volume Time Daily Hourly
A
minutes
24
23
25 0.05
2
0.07
27 0.07
h
0
0.
0
0.12
0,
0.12
0.1
0.13
0.15
29 0.07 0.15
28 0,07 0.14
20 0.04 1 0
0 0.07
21 0
5 0.0
24 0.0
0.08 0.13 3t377 30 0.07
0.06 0.12 2746 30 0.
04 4940
.242512 02447
DENNIS GRYDER
989073 Check Box if ORC Has Changed: El
IGNATURE OF OPERATOR IN RE
BY THIS SIGNATURE, I CERTIFY AT
TO THE BEST OF MY KNOWLEDGE.
0
0
0,
0.12
Phone: [phone]
3LE CHARGE)
REPORT IS ACCURATE AND COMPLETE
DENR FORM NDAR-1 (5T2(d03)

NON-D1SCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements' (Note: if s requirement does not apply to your facility put (NA) in The
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
S. The freeboard in the treatment andlor storage lagoon(s) was not less than the limit(s)
specified in the pemnit.
Co n Y,N)
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
perrnit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations."
(Signature
Iredell - Statesville Schools
Date
r. /3-1 0
(Name of Signing Official -Please print or type)
D'a?
(Permittee-Please print or type) (Position or Title)
P.O. Box 911
Statesville, NC 28687
(Permittee Address)
704-873-3755 1 /31 /2009
(Phone Number) (Permit Exp. Date)
If signed by other than the perrnIttee, delegation of signatory authority must be on file with the state per 15A NCAC 2E3.0506 (b)(2)(0).
DENR FORM NDAR4 (5/2003)

PERMIT NUMBER:
FACILITY NAME.,
onrinq Poi
Ef
NON DISCHARGE WASTEWATER MONITORING REPORT
MONTH tAo
s There Effluent F1Cw For This Month Gen
lredval Dady Rate
'Time Operator SRC : lFio into
2400 1 me On on Treatment
wBo*ek Side Situ Sys:ern
'NRS YIN a LLONS
Average
Dail
ally Minimum
nthly
Composite (C) / Grab (G
Operator in Responsible Charge (ORC):
Check Box if ORC Has Changed:
Certified Laboratories (1
Person(s) Collecting Samples;
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
COUNTY:
Page / of
YEAR:
Code/Nary e:
Phone,"i 7
Tt is Fa alNo:
ORC Certi
ation Number:
(2):
--(SIGNATURE OF OPERATOR I J RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDMR-1 (1112005)

NON DISCHARGE WASTEWATER MONITORING REPORT
(Permittee-Please print or type)
drYkitiv
(Permittee Ad
01002 *Arsenic
01022 Boron
00210 8005
27 Cadmium
00016 Ca1crtu
00940 061060
503*60 Caloore
. Tol4I
Residual
134 Chromium
40 COD
Facility Status:,
Please answer the following question:
1. Does all monitoring data and sampling frequencies meet permit requirements?
Co pli Y,N)
If the facility is non -compliant, please explain ir the space below the reason(s) the facility was not in compliance
with its permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s)
taken, Attach additional sheets if necessary.
:11/60 /C3 00
44-
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel property gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the informaticn„ the information submitted 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 knowing violations,"
(
Date (Name of Signingpfficial-Please print or type)
(Position or Title)
-P-/
(Phone Number) (Permit Exp. Date)
Parameter Codes:
31504 Colirorm, rola
00094 Conductivity
01042 Copoer
00300 Dissatyed Oxygen
Fecai Colfom
01051 Lead
00927 Magnese.ao
1900 erCury
00610 NH33sN
09600 Narogen Tolal
90630 NO2&NO3
556 04Grease
. , .
W009 PAN (Plant Available)
00490 pH
32730 Phenols
9066.5 Phosphorus, Total
90937 Potassium
00929 Sodium
00931 SAR
00745 Suifitle
70295 IDS
00010 Temperature
00625 TXN
0068C) TOC
00530 065(761
00076 'Turbidity
01067 Nickel
054
eltleable MalIer
01092 Zinc
Parameter Code assistance may be obtained by calling the Water Quality Land Application Unit at [phone].
The monthly average for Fecal Coliform is to be reporled as a GEOMETRIC mean Use only the units designated in the reporting
fac.ility's permit for reporting data,
• if signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2E3.9506 (13)(2)(D).
DENR FORM NCMR-1 (11/2095)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
Page / of
PERMIT NUMBER:
FACILITY NAME:
WQ0023511
Daily Loading (inches)
Maximum Hourly Loading (inches)
12 Month Floating Total (Inches)
Average WeeklyLoadIng tInches1
d irrigation Occur At This Fac
Y
A
FATHER CONDITION
peratu
at
39
0
CID
0,23
Woodland Heights. Elementary School
MONTH: March
COUNTY:
YEAR: 2010
IREDELL
Formulas:
[Volume Applied (gallons) x 0.133E (cubic feoUgellon) x 12 (inches/fool)] f (Area Sprayed (acres) x 43,550 (square feet/acre)) OR
= Volume Applied (gallons) / Area Sprayed (acres) x 27,152 (gallons/acre-Inch)]
= £laity Loading (inches) /'(Time Imgated (minutes) 60 (minutestho r)] Monthly Loading (Inches) = Sum of ©ally Loadings (inches)
,: Sum of this months MonU14y Loading (Inches) and previous 11 month's Monthly Loadings (inches)
[Mon1S'}1y Load'mg (+mctxes/marllh) / Number of dajs in tita mondt (daysfmpnthhj x 7 (dayameak)
Did Irrtgatiota Occur On This Field; Did irrigstltrn Occur On This Field:
GI Vas: No: © Yes. i Nta:
Storage
4
he
FIELD NUMBER
AREA SPRAY
OVER CROP
PERMITTED H©URLY RATE (1nCh
PERMITTED YEARLY RATE Until
Volume Time Daily
Applied Irrigated Loadin
[lots Dino
3378
4274
9
ne FIELCI NU ER:
exintun
Hourly
oading
inches
5 0.08 0.14
23 0.06 0.15 2{86r 2
2566 20 0.05 0.15 2636 2
20 0,03 0.10 2330 19
19 0.04 0.14 2286 22
25 Q.Q6 014 2450 25
25 00 2129 1
24 Q.0 0.12 21'i5 21
T'
0.0
0►,0
0.0
0.0
4
0,16
0.14
0.13
0,13
23 0.05 0.14 2240 23 0.05 0.1
32 0.08 0.14 2969 3© Q.Q7 0.13
27 0.06 0.13 3040 0,07 0.13
22 0,05 0.15 2Q45,._.._ ® 0,04___ 0.13
20 0.05 0.14 1960
(l 0.04 0.'
20 0.04 0.12
20 0.05 0.14
20 0.04 0
0 0.00IIVIO
20 0,05 0.
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
2038
2047
2002
2009
1928
20
20
17
20
20
0.04 0.13 2CI00 2
7
0,28432
5207
DENNIS GRYDER
0.1
0.1
0.1
0.1
0.1
0.00 DIVl01
0,04 0
4
0.27586
989073 Check Box if ORC Ha»s Changed: 0
Mall ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
/d
SIGNATURE OF OISERAT9 IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I C R'TIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
Phone:
704-873 3755
60430
onth Floating b .ch
Average Weekly Loading (inches)
Codes: C-dear, PC -partly cloudy, CI -cloudy, R•ra
DENR FORM NDAR-1 (5I2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment andlor storage lagoon(s) was not less than the limit(s)
specified in the permit.
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
Page
Comiant (Y.N
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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
arid imprisonment for knowing violations,"
(
Date 0
(Signature ittee)*
Iredell - Statesville Schools
(Permittee-Please print or type)
P.0. Box 911
Statesville, NC 28687
e 4/- 16--1°
(Name of Signing fficial-Please print or type)
R. OF MAINTENANCE
704-873-3755
(Phone Number)
(Perm ttee Address)
lif signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28.0506 (13
(Permit Exp. Date)
2
D),
DENR FORM NDAR-1 (5/2003)

NON DISCHARGE ViASTEWATER MONITORING REPORT
RAT NUMBER:,
FACILITY NAME:
1Fiqaw Monito,rin Effk;ent,
-srameier Monitoring Point:: Effluent:
Ther,_4 Effluent Fle‘A: ;7 Dr 7 'Ns Mipntli ,11;er,erstec s
,17,10.01P0:011
s :0,90; 5990:95
-0? .:00000-00
Combos (C) a (GI,
hifluerlt.-
age_ e"
NIONTH: ftfPti. „ t/L.t-t YEAR:
COUNTY- r/2,,;;;L4
-^~
:IC 000:10::
Si1Ni
sscsiu, :)070.161...1D :47 .1.1 310,5,05 0 0 C0.60,01 .,, 1:010r, 00,0 ,
Ressts„10 BOC 0
007:s0.00:0(0000 00, : 21:01-101: L
UM'S MCP -
Operator in Responsible Charge (ORO
Check Box if ORC Has, Changed,
Certified Laboratories 06'714
Person(sl Collecting Samples',
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Uni
1617 Mail Service Center
RALEIGH, NC 27699-1617
M
,71711f.
Grade,
ORC Certification Number:
(2):
I- —77
Phone:
ooe
-(516ATURE OF OPERATOR tN RESPONSft3LE C)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE,
DENR FORM NOMR, 1 CI 1;20135)

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Pease answer the following question:
1, Does all monitoring data and sampling .frequenc5es meet permit requirements?
ccmp aCft,N;t
771
te facibtys non -compliant, :please ex;-; Jrl the space te!ow the re;,:isor,(s? the f.,-I,-eTty was rc r zompance
,A,Th its permit, 1:0.\,,icfe :r, tit:0'03 exptarkeon the date(s) tne no,n-1-;rrpltance and des:rte the Parree,tc.e ancrqs)
,aken Attach addlti.crasheets n&:essarf
`1 certify, under penalty ,pf ].aw, that this document and an attachments were prepared under my direct!Ortor
supenison in accordance a system designed to assure that ad qualified personnel properly gathered and
evaluated the information submitted Eased on my lnquiry of the person Or .persc,,n.s.whc.) manage the system, or
those persons directly responsible for c,'atibering the r-lformarob,n, the Informaion, subrnitte,d is, to the es: of my
knt:wlede and te!ef, true, acc,Jrate, and c.cmplete. I am aware that there are slgnifik:ant penalties for .submnc;
faise information, Thcluding the possrblhty lines and Hmorisonment for knovImg vicTations,"
Signature of Pe
:'-
(Permittee-Please print or type
(Permatee Addre
Date
Parameter Codes,
(Position Title
(Phone Number)
p ease print or type)
0 I out 43-setsc
t504 Csittostm. istdi
00,000 Morogem Total
01022 ests00
00094 Costisstsity
occiao No2&Nraa
00310 SCO5
01027 C atststsmst
01042 D ost 4t-
00620 NO3
00929 Sodium
0093t 9443
00 745 Sudide
00399 Ossmdt4ed t,')xytt:Ett,ttt
)09 IS Statstsms , SISIS Pecat 0,74dsmst
CS2,943 Cmcmtte 01051 Lead
705.56 Oti-CdetStte 70'20d, IDS
Vdtt2,C9 PA' ;Rttatlt .4,t3titable't aCtO Iet7Idett1tt,tre
00409 34 00625 ItsN
5.X5t° Crionse Istat 043927 tsiddstdstsm
Res,dtsat 7t090 Met -CLAN,
,31,a34 cimmrstss C9519 tMDttasst
co34e cod
32720 Pttes,7703 00689 IOC
010.6.7 Ntck
0066,5 Pttospostrus Istm 005702 ISS7779
00037 Potassium 00079 Purtstdity
00545 Dt'ttstledtz,td. Ntattet
ttt.tt
-
(Permit Exp, Date)
Parameter Code ass[stance may be obtame,f by caihog the VVater Quaky Land Applica.tio,o Unit at '919) 715-6189.
The monthlyaverage for FT.e::a Os forno - be reported as a GEOMETRIC mean Use only the units destgnated to the reporting
trap:0 ty's permit bor-e' .data.
• If sjgned by other than the perrnittee, delegation of sign.atory authority P1USt be on file tAith the state per 15A. NCAC 2B.0506 (b)(2:40).
ERR FORM NDMR-1 (1112005)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
Page
Maximum Hourly Loading (inches)
12 Month Floating Total (inches)
Average Weekly Loading (inches) Mon4h6
Did irrigation Occur At This Facility:
Yes: Ca No:
28
29
30 C 55 0.25
31
Iota, Gallons/Monthly Loading
PERMIT NUMBER:
FACILITY NAME:
WQ0023511
Woodland Heights ElementarySchoo
MONTH:
November YEAR: 2009
COUNTY: IREDELL
Formulas:
Daily Loading Onches) = 'Volume Applied (gailons) x 0 1336 (cubic leetigallon} K7 Om:hes/toot)) [Area Sprayed (acres) x 43.,560 (square teel/ace)] OR
= Volume Applied (gallons) f !Area Sprayed tacre0 x 27,152 (galionsiacre..inchil
Daly Loading (inches (Ttme in-igatad rriinotes)/60 (rmnulesinOurtl. Monthly Loading (inches) , Sun of Daily Loadings (tnc-Mes)
Sum of this month's Monthly Loadog (i.nches) and previous, 11 month's Momhly Loadings (inches)
Loading Qncheshrionth) / Number of days in. the. month (days/month)] x 7 (clayshveeRi
Did Irrigation Occur On This Field: Did Irrigation Occur On This Fi I
Yes: No: ri Yes: ri
FIELD NUMBER:I One
AREA SPRAYED (acresJ:
COVER CROP:! Natu a
PERMITTED HOURLY RATE (inches):
EATHER CONDITIONS PER ED YEARLY RATE ch
Temper -atom
at
application
OLIDAY
Prectpda..
on
'nchee
0
0
01
0.25
2
Storage
Lagoon
F oa
nth Floating Total n h
Average Weekly Loading (inches
Volume
A lied
gallons
2574
2686
2591
2529
2939
5000
HOLIDAY
HOLIDAY
45350
Time
frr ated
Daily
Loaclin
No::2]
FIELD NUMBER: Two
AREA SPRAYED
COVER CR
1.68
P: Natural Itte
0,4 PERMITTED HOURLY RATE inch
26 PERMITTED YEARLY RATE(nchos
ax mum
Hourly
Luariln
inches inches
0 06
0 10
#VALUEI
VALUE
VALUE!
#VALUEI
eather Codes: C-clear, PC -partly cloudy, CI -cloudy, R rapit, Sn-snow, SI- et
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
(114
0 14
0.12
#DIV/01
#DIV/01
0.14
0.14
0.14
0.14
0,12
#VALUEI
#VALUE!
Volume
A dled
gallons
2733
2579
2538
2562
2735
Time
Irri ated
Daily
Loadin
minutes inches
26 0,06
0.14 3586 30
44330
Dennis Grvder
989073 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
(SIGNATURE OF OPERATOR IN RESPONSILE
BY THIS SIGNATURE, I CERTIFY THAT THIS,RE
TO THE BEST OF MY KNOWLEDGE.
0,05
0 05
0 05
0.00
0.06
0.06
0.06
0.06
0 2266027
ax mum
Hourly
Loadin
inches
#DIVIOI
#011/101
0 14
0,13
0.13
0 13
Phone: [phone]
HARGE)
20ik•ATE AND COMPLETE
DENR FORM NDAR-1 (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant.
with the following permit requirements; (Note: if a requirement does not apply to your facility put (NA) in the
compliant box, }
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
Comiliant Y,N)
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit.. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken, Attach
additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations,"
redeI - Statesville Schools
(Permittee-Please print or type)
RO. Box 911
Statesville, NC 28687
(Permittee Address)
it t //t.'
(Name of Signing 0tjiciaIPIease print or type)
DIRECTOR OF MAINTENANCE
(Position or Title)
704-873-3755
3/31/2014
(Phone Number) (Permit Exp. Date)
" If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 213.0506 (h)(2)(D),
DENR FORM NDAR-1 (5/2003)

NON DISCHARGE WASTEWATER MMONITORING REPORT
MONTH -
NA
r Monitor Effluebb r Pi' 3r L . t ,5. de Narie'
.. ... 'U r7t
at r in Respon,ibUe Charge (3RCi.
Check ear 113Rw Has C;hanjed
!:«'rtifiau l.,ab4r3i,orfi'S
Gritje:
'umber:

NON DiSCHARGE "ASTEVVATER MONITORNG REPORT
FdchtyStatusi
Please answer the following question:
1 Does all :monitoring data and sampling frequencies meet perm t requirements?
non-cornplianI. c;ease .t1 11'7e !..re 7eascris, rc.!
its pe7n-H: Ptict„incte •r",! your ckpkanctichit the ,:taceinsi
taxeri „Attach acctikicinal 3heet5 hecassary
Ochnepha
heitty t;'der penalty of litIN that this document and all .3ttelChine.nts were prepare.:d Jrniier ditectior
sy„,per,nsion in accordance with a system tieisngned to assure that all qualified perac.,nrel propel-1,j gathered, and
eyaluated the information subrritted Based on my rit,iclulry cf the p.,ersch perscfis who manage the system cir
those persons directly responstle for gathenng the nformatiorty the inicrmathon submitted is, to the. best of my
kithckNlecice,anct l4eliteftrue, accurate arid complete I 3,eiare that there are skgrhiticant penalties for subfritterkg
falsr3rO1 ittticiliakitiiktig the possib,lity of fines and irriphschment kicr les-10,4147g ',.,,lc)atons."
/V- /5- zlY
(Name of -Please print or typei
111 7i4-1
tPerrnittee Addr s)
31!CC.:24
{Phone Number)
Parameter Codes
010:22 Boron
8552325
5122' 3:3231m33-3
33;52
0094 Cooduonntr
256550 345rocen
2!042 52:35pot32
OC.3350 Crosonreo 535-55352,
CC9 Jon
335 5 35552!: 55535:553T,1
203.342 .325:2553
00630 4O28,5403
3050'0 N053
3055.6' .',7-4-77,5e55:55
553'22 Sodnron
! 35231 SAR.
ViC,I9 PAN Ptam
0533252i5 N
3125 nati 304202 33,
500E23 333ni,,,„!
;,7)C'E327 7-lag '77'
51334 05335355,53
02340 OCC
355'3
" !:16- 3543ke!
32 530 'ThESI,Dis
535E235 33,5553o:ors 7353i
45 5:3455352
'2295
5:3755"':2 5.3052255ann53
-354:350 25"C
iLKY,,,"27 47""",t3S5iL;fr
.005,17! mver
3C535 522:3' 55,
'05 5 5 5 0530
al 522 '
Parameter ,Code assost3rce heay etta:reti b z!akIng the 4".haten 0!Ja,r!,‘ Lard t,:'t,4thLh:oxion •-; 15-6,
ave.r14e 4e::r FneCht31! ss 2IS 3 GEOMETP:e: Te?..eue 15 're ee2s.2-er,.:,
tt"tet.
3,t3nehl b!y other than the perrnwee, de(egathen of shtttpateri ttiutht.nli must be en °!ii,e. ith the 03te ctler 15A NC AO 283 2hrt:h)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED
Page / of
RMIT NUMBER:
VVQ0023511
MONTH:
FACILITY NAME: Woodland Heights Elementary Schoot
Formulas:
Daily Loading (inches) Noiame Apolrec (gakrsj 339 (cut5c, feetigalVN 11,ctleSit1)!IIA(
Volume Applied 1,3911,Dr,..S [Area Sprayed ac.re..s 2715Z, Lgallonslacre-mcM1
Maximum Hourly Loading (inches) Daily oact ng rams)," inme imgated immutes)160 (mmt.asMm,y1
12 Month Floating Total (inches) . Sum. ihis monlfrs MoMMy ',D3d,ng t,/,:o-res)arvl pre'om;,S 11iiMontNy
Average Weekly Loading (inches) v. iMctniy Loacing ImcMesimpflthh, Number' aays e mc,rtn rcailiroomM x
Dt rrigation Occur At This Facility: Did Irrigation Occur On This Field:
Yes: L7:1 No Li Yes. [3 No: El
WEATHER CONDITIONS
Wea her
ode'
Temper -at
at
application
CF)
51
0 25
5 °rage
Lagoon
Free -board
reet
5
Total Gallons/Monthly Loading linche
12 Month Floating Total (inche
FIELD NUMBER, One
AREA SPRAYED acres
COVER CROP:,
PERMITTED HOURLY RATE inches
PERMITTED YEARLY RATE inches :
2130
2429
3058
2179
3166
55866
Time
Irrigated
minutes
26
29
Daily
Loading
inches
0,06
0 07
0 05
0 04
Average Weekly Loading (inches) 0 24436
Codes: C-clear, PC -partly cloudy, CI -cloudy, R-rain, Sn-snovv, 51-sleet
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699.1617
Oct bet -
YEAR: 2009
COUNTY: IREDELL
Sprayel ,acres 43 560 (Square Text.aced OR
Monthly Loading (inches) SQm tCM/
Leadm4s Ommes:,
7 dayst,eve,ex,
Did Irrigation Occur On This Field:
Yes: E.)
aXIMUM
Hourly
Loading
inches
0 14
0 14
0 13
0 14
Dennis Gryder
D NUMBER:
AREA SPRAYED (acres
COVER CROP:
PERMITTE
No: L2
Two
Natural litter
PERM1TTED YEARLY RATE inches):
Volume
Applied
gallons
2700
2286
2476
3199
51219
989073 Check Box if ORC Has Changed:
Time
Irrigated
minutes
27
Daily
Loading
inches
0 06
0 06
0 04
0 04
0 05
0 05
0.07
aXIMUI71
Hourly
Loading
inches
0,13
0.13
0,20
0:13
0 14
0.13
0 14
0 13
0 14
0 05 0 14
0,04 0„14
0 06 0 14
0 06 0 14
0 07 0 14
Phone: [phone],
SitIATtXE OF OPERATOR 1N RES ttSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT VS ACCURATE AND COMPLETE
10 THE BEST 01 MY KNOWLEDGE

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate t by inserting Y(es). or Nio) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: rf a requirement does not apply to your facility pot (NA) in the
compliant box )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s),
3 A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application,
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit,
Comp Y,N)
y
If the faciGity is non -compliant, please e.xplain in the space below the reason the facility was not in co pliance with its
permit, Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary
certify, under penalty of law, that this document and all attachments were prepared under my direction or supervisi
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the Information
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations.'
(Signature o
WOO - Statesville Set cis
Date
(Permi -P e se print or type)
P0 Box 911
(Permi
Statesville, NC 28687
Address)
/(` 1)7
(Name of rcial-Please print or type)
DIRECTOR OF MAINTENANCE
(Position or Title)
3,31t20 1 a
(Phone Number) (Permit Exp. Date)
704-873-3755
' If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2(10506 (b)(2)(Dl.

NON DiSCHARGE WASTEWATER MONTORNG REPORT
NUMBER:
FACIUTY NAME:
Mor;torm' Point; Efffuerrt, ;nfiuent: " I
.....
..--*
-.Paramet. er Mon;toring Po;n1 , t.;en.. .; Influ,7±;',I.:
There S'ff;uent z•-!,....„,;;;Se
MCNH
I i '
1 ! ......... . _
# € .
. DA:0y RIlte .
Orator 1 PC' : 1II'I II4I,,II 'III,II I
Ti„ On 1 On 1 rr'q'.31frer0, I'7,,i'S,I1 441, a C 0.3 i i
FARS Y!!!, 1 GAL :LC v.3! i LJNt':'
!..G4o,netr,
V, 1,4 1 ,I1:00MI-
7 0!
A4era.ge
;Daily Maximum
(Daily Minimum
Mart'fliy. Limits
C ompos )
Operator in ResponsIble Charge iCR.0).
Check Bo.< if ORO' Hi3S Ch3nged
Certified Laborare 1)
Sarnpfs. !!!';
Mad OP, and 1'1%10
DENR
;Nater Quaftt-J
ATTN kTion'nat;on PrOC!,53!Ni!!,4 Unit
R;;;!...E;,;:;;--i, C.', 27699-1'517
Gra,ye:
ORO Certificat.Npn 3urlb;-14r •
;2,
, I
OPER,1,7:24 P E3p,-;;NsIBLE CHARC,E,
PE. .7;. r Ti4„;\ TH.I5 REPORT
00UNTY•
SCodelNar7.,4:
-
Ph.one.:
•-7
„"'

NON DiSCHARGE WASTEWATER MONITORINGREPORT
Facility Status.
Please answer the foIIowug questiow
1, Does all rnort:toring data and sampling fre.quencies meet permit requirements?
2222.ai122 s non-com:pliant. (c..cpse ex,zionh ff the 3p2-3(17.2 21e,P22.1i 1,35 rot lh chcfh-2-Cfahce
perT11q. Proyde icur hhe Pate,. .cf t,he hcrhocrnpdance 3h,c, ,ceschze the actfcrh s:
/4\,:ta.ch acfc.cra. shees
"I certify' under penalty Of favv, that this dcopment and ,all attachments we,re prepared under my drectiorf or
supe.rvis.for nace-or:jar:cc, ,,vith a system chesgred to assure tat ailfeo personrel properly gathered and
evaluated the flfo-ration submfted, Ba.sed on my inquiry pf the person or pe.r3ons who manage the systern. or
those persons direotly responstle for gatherulg the infornatich, the Thformanon sjrcrrjtted is, to the test -3f my
khoAdedpe and cehef, true, accurate. an,P ccfrp[ete. I am aware that there af-e sigthficant penates for suornittIng
false irformation, rn.clud,ricl the possibihty of' flea and Imphsorrnent for KII-C`vving vr,.:,1,3tons
7
(Signature o
LL
ease print or type
13C-4,241
(Permit ee Add e
Date
op
Parameter Cades.
- Z
Sign g 0 -Please p nt or type)
{Position or fitle)
Phone Number)
7:,C2
pc:0!2 3,10C.23,
0E91.6 Ca,Pear-
00.740 727,tcr71,..?
1 OC.927
006(557; 540105;055n
^ ColOor^^^,^1. Totai
5a0,5,2572 50,1a,,m
^:106.2,0 NO,?&NO3 e52:425 SAR
!GC: ^^.7.7%27.,et" 0(362C 2Y174.5 3uifitle
310'05 ,50,5(5.3: 0000555 V5,275.,27,g
1,,0534
12417C 2C73:12.5 TX%
11:5,55 51-25525,
017;34 27-777.7"70..;c7
002-121; 722,,7
a2l^^.^:^5." 17.Mai 7SS2-5R
;',7,-153,Lan 5,50000 5,55t-5,50ty
OC^r.45 3t7e.
:;7:177;.e. ^353:S'7:377.0e. plat: oe epia-iaeP, Cr, PaIwp; 55:3, ,1323t.,e2 :733233 55, 5.2a2c! 4,',3:3223.33::. u223: 2;1:3 715-315;
it Exp Date)
7-35e 2222-1521; ave,23,3,35,; 3223 ;5e2221: 3723;5325-2 2;5: 222253: 3S a „„ aa: 2 22 2 „,-
a e 731 e_tif2;33.13 el::: 35 5 aLL
sp,red ar L:Pon the perrniLtee, de1,:e.ja1 el' sppe,vearr mase ara Ntth t.17 e sa231e per 15..A 2B 25273 b 2'222:

PERMIT NUMBER;
FACILITY NAME;
Daily Loading (inches)
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED;
VVQ0023511
Maximum Hourly Loading finches)
12 Month Floating Total (inches)
Average Weekly Loading {inches].
I. Irriga1ion Occur At This Facility:
Yes: El No:
A
T
E
4
0
EATHER CON ITION
Weather
Code'
Temperature
at
application
(°F)
66
62
64
68
OLIDAY
C 72
CL 66
CL 64
C 62
Woodland Heights Elementary School
MONTH:
Formulas:
NOlume Applied (gallons) X. 0 1336 rcubc teet/gallorqx135nnnesrfoot.11 [Area
▪ Volume Applied (gallons; fr,Area Sprayed (acres) 21.152' (ganonsracrenchyi
-4 Daily Loading rinches)1 -1-;rne i-ngated (minutes) r 60 rminuresrbour-ii
n Sum of tens rnorrh's Monthsty (inches) and previous 11 montrCS Monthly
[Maly Loading cincnesimnnttli Number of days in the mante ,;daysfroonthA
Did Irrigation Occur On This Field:
[i] Yes: 1:-] No;
iorage
agoon
o-board
feet
7
7
7
7
7
7
7
AREA
FIELD NUMBER:
PRAYED
COVER CROP;
One
.9
Natural litter
PERMITTED HOURLY RATE {inches):
PERMITTED YEARLY RATE inches :
Volume
Applied
gallons
2605
Time
Irrigated
minutes
Daily
Loading
inches
September
Page
YEAR; 2009
COUNTY: IREDELL
Sprayed (acres) 43 560 (square eetiacreji OR
Monthly Loading (inches) Sum z1 Dairy Loadings (mines)
Loadings Onches)
7 (daysnrveek;
aximum
Hourly
Loading
inches
0 13
0.14
0 13
Did Irrigation Occur On This Field:
Yos LJ No:
FIELD NUMBER:
AREA SPRAYED
COVER CROP:
T.]
Two
PERMITTED HOURLY RATE (inches):
PERMITTED YEARLY RATE inches:
2646
Time
Irrigated
minutes
25
26
27
31
Daily
Loading
inches
0 05
0 06
0 06
0 09
0 07
0,00
0,06
aximum
Hourly
Loading
inches
0 13
0 14
0 13
0 17
Total Gallons/Monthly Loading (inches)
12 Month Floating Total (Inches)
0,40
AverageWeekly Loading (inche 0 09367 2
ther Codes: C-cle r, PC -partly cloudy, CI -cloudy, R-rain, Sn-snow, SI-sleet
20726
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
ATTN. Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
30767
Dennis Gryder
989073 Check Box if ORC Has Changed:
[7;
Phon
-STGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFYHAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOVVLEDGE.
0 1572724
5
DENP. NDAiR

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION S1TE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the .following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit,
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment andlor storage lagoon(s) was not less than the limit(s)
specified in the permit.
Comliant Y,N)
IY
Y
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken,. Attach
additional sheets if necessary,
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the inforrnation, the information submitted 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 knowing violations."
freclell - Statesville Schools
(Per • ee-Please print or type)
P.O. Box 911
Statesville, NC 28687
r ' 2 Z
Name of Signin Official -Please print or typo
DIRECTOR OF MAINTENANCE
(Position or Title)
704-873-3755
3/31/2014
(Phone Number) (Permit Exp. Date)
(Permittee Address)
• If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 26,0506 (b)(2)(D),
P PCP P 2',533

ER:
NAME:
t1it4-, 1:'ta Pr,
1 fit;.
Average
rnpos to
H. RGE STEW .TER M s G3TOR REPORT
u nt: 101
r in Re,pons€idle Charge {OPCj:
Check Box ,f w R Has Changed
M.ad OR',G NAL and 14'VO L PIES, tr',
i..�EN(
t7!n.5.rn rJf'r"dater Qua 1"y
Al -TN Ir,forniation
y1 `bl.aai er'df 2 ..:eni'r
NO 2
T 1i3 a. , .A"•� . 1 CER r -.4 ' THP3 REPORT °"T 1.3
AND E 7'0 B &TS r M EOC�0E

NON DISCHARGE WASTEWATER 1TORING REPORT
Facility Status,:
Please answer the following guest
I. Coes all monitoring data ,and sampling frequencies meet permit requirements?
Campihant
non-corrs,jiant !J-The „ne r€-:A.SCIsi S. 'Alas
r 3. 'C7,43,3 1335333r3-33Cr353C115331D515." th?? 171':C.j:Cr,..
:333 k s"eets
under penalty cf3 that the !document .and all 3ttachmer45 ',r.rere prepareP under my direotion or
supervs =or accordance wth a system desrgneri to assure tat all qualifled personnel properly gathered and
evaluated the ,nformat:Dri subrni.tteq. Based On My inquiry of the person or persons who manage the systern1 !or
those !persons directly respons;ble for gathenng the inforrnation. the !rfchmatlorr sulornited ls to the test
lKnorwledilirand P;elief true, aosiorate, ard complete I am aware risat tnere are s,gr,ficant penalties f:or 3
false information ,nclurisng the 3ossib;l4 hnes diipnsom!rent for knov,nng
ee-Please print or typ
(Narne a
4334.4).±2—
(Position or Title
(Phone Numbe
Parameter Codes:
01002 4,5333,44:
13102'3 153c3,433n.
,303"3, 5,33:535
.3'.5041 5,33330,51-D, 'Dm
13353094 5,443.4434D4333
3,33,42. Cob4,454-
333431D,434,3 '333:33053 2,534,335eb C3054`5,40,
50354342 Cdscf,4353,3
:453,60,33 N44,33;4343 3,53143
3433530 NOZ&NO3
"5,333
:350.55,5 045,533N3a333
.,53505,53 5'43'553433,s 4333433D335 45333 5455533553;44,4
icial-Please print or type)
-
3
33C4433 3,433ftor,
3C'45 S4i543,4.
30295 ss'S
3,433a 35:453,5
2.nosznc.r 535,433
230535 353S.335D
3-3 b
33.3.3 ,435-531.44
Seweazie 'babes 53335 b4,5
(Permit Exp Dat-
Pararnehar Cadde asa sdance may .had ddadhg hde a%;:ade. CL.,..aata Land Addaai:a:ar 'addr, 33'
-Thiarddha 343453333,35 3, F' • 7"C'''13" 33,3b43 rru nre
,f a:Tdehd by other than rahe pe,rmo,dade. 3e,.egaz.7:ad af s,,,ratara dJ',hord-a rrust rae r ad...ra Der "bi,,A. NO01573, 2B

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Ti-HERE :AE rAic APPucATHON FIELDS PER PAGE, USE A.DCITIONAL PAGES AS NEEDED
L
PERMIT NUMDER,
FACiLi TY NAME LL.)136-)C.
Formulas:
paw,' L3adog = , Letma Pptmeht 5€0
:ipmtme Swaywi,mpept "27
MaX:rturn Howdy Lowtatg Lechest , Dam, 'r"-,;417,1,1 heroes', Montedy Leading (Mhhest Tlte L
12 Mitmth Fidatiod Total fmcheth - -7Cr:1' V,',T.07,1, AlC1e-5,
4emmge "VVeettfy Loahttmg One hes llr 14 11Number' ef tee:me:me 14.,-,,meiyerhp om,epp,ek:
rii1ONTH:
COUNTY:
YEAR: (P.C....,
rcgation Ockir4l1vi1dhow,
1 1irl irrigation C1c,our On This F eki:
Yes:
20
21
22
31
EMi-4ER N0IT0N
We,itNer
'Temper -were
al: appl,,catior,
Prettpla
Von.
11
Stcrade
Lmwtee
FLee.board
heel
Total iialionsiMc:millly Liaading Jophesi
12 Month FicatingT 3ItinC,Ileg)
Average li'leekiy t...mhtmg
o , r This Field:
• No: X:
FIELD NUMBER
RE',SPRAiYED (acres
COVE
PERMITTED HOURLYRATE
PERMITTED YEARLY RATE iinches):!
Vi):Iurne
:Applied
galYsiris
Time Daily
Irrigated oadm
T-- MInutes
. .
VY Codes: C-clear„P2 p3rll,chmdly, CHdloudy, ,SI
trpc;f1V5
Spray Irrigation Operator in Responsible Charye tfl.'
ORC Certifin catioNumber: )6" Check Bog ORC Has Changed:
FIELD NUMBER:i : :p
AREA SPRAYED (:acresH
OVER CROP
PERMITTED HOURLY RATE (inches). j
PERMITT
Maximum
Hourly Time
dn Applied Irrigated:
-1(-..heS dahons tr.-lutes
i'‘,13an 11 ORIGINAL d Fix° 2o,,,PIE5
ATTN Non-Dis,:harg Ciamphancie Unit
DENR
Divis.ion of Water C.hiiality
1,317 Mad Servicqii Cen,..er
RALEIGH, NO 27699-1617
YEARL," ATE nncheSi:
—aximum
Hourly
:::papridet;1-12s
Daily
adin:
P h on
TtPERATO:it'd ESPONSIHLE CetAh?,OE",
B rHIS Si5NATUPE THAT THIS REP.PP 1. E E
TH•EMl K1,,TLTPMEOP3E

NUN431 (..:HARGE APPL UATIUN RE"
SPRAY IRRIGATION SITE(S)
aciiaty Status:
PieaSe ncircate ; ffv n
With the followtr t)err>
raorf ciriari c tc. . )
ihet,trer t.he ``ar:jib? ^..
5 T r
T. The application rates) did not exceed the limit(sl specified in the permit,
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the sites} in accordance with the permit.
3. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s)
specified in the permit.
If the facI t' s non�cort pfiari
permt Pr, -=I de in y
additional sheets if n
as not Tess than the limit(s)
pia;n in tl"e space telcuy the reason)
e omplrant
NA r tr e
Y N)
was not ;n compliance with
is
" 1 Certify, tender penalty of law, that ihl5 dccur ent and ail attar"'Ines^ts were ;prepared order my iiirestnan or supervision in
dance with a system designed ;to assure that alf qualified personnel property rated the information
utted Based 'un ;my inquiry of the; person or persons who tannage the system, cr's",_sie pons directly resportiatie
for ,ar ering the information, the lnicroiat+on submitted is. to the -beset of my knw et e. and belief, trste. 3C.Cturate and
corn p6ere I am aware that there are S:ctndficant penalties for s5.,brnittiny false information, including the possitnlo {
an:i
jName
(Position or Title
(Phone Number)
vrvr I
(Permittee Address
(Permit Exp. Date)
other than the perrnuartee, delegation of signatory authority must '3e unit tide with the, state: per I5A NCA. 29.0506 (h){.){©}.

'7 NLI'MBER:
FACIUTY NAME:
Mon torThg
NON DSCHRGE WASTEWATER MONITORING REPORT
M ON 7H
ararneter Monitoring Pomt. Efe 30.race. Water ($20,1'
5e. t: ': ,Ht4ettitt) 5.0teitti t 10:11-0 t CtOti.'ttti tt7C Ft 'tt I .3...Ii.ti ' .
- . .. .
J t
tDperator 1 ORC '
rae gi
HRS
A eraq.,..
. ady Maximum
Calty Minimum
Morthly Limit(
Composite (C Grab (C7
0,4*,
t er, t
. I
, I I',2tIIII I.
f Rt4etteetzeetli t tett-ICC t3 it
._. ...
Cperator n Responsible Charge (CRC).
Check Box {f ORO Has C.hanged
Certified Laboratones
Samples
ORAG1NAL. and PNO C..-OPIES to
DENR
D.fision ofWate.r Quality
ATTN, Pnf)rmation Procising Uni .
'Hi! 7 Mail S'r./6:„-.0 Cent.er
R..ALEGH, NO 27699-1,317
Grade.
ORO Cer'hcatoii Number;
2) a
COUNTY
'.6P2ce-
EAR.
Phone:771Y-, 1:7-37q;
7
-S'IGN.ATURE OF OP 73R IN RESPONSfBLE CHARGE
THIS 3 A JRE1 0 ER 7 F."? THAT THUS REPORT 13
AND COMP.....FIE TO THE BEST OF Mr K.NO'"NLED(3E.

NON to HARE WASTEWATER tiOilTOR!,NG REPORT
Please answer the following question:
1. Cces ail r onitorang data and sa=merlin
of law, that t ss document and ai i
dance e with a system des,ge d to a
?at*rt ubm tte.d Based g,n my it
lm,
Parameter Codes:
p^M1rr ' I e
gG"d,'th.
arsons t. o, manage the sa'
is, to the best of my
hone Number)
e print or type'
4
sC e W b e tia* _..ne s'3=a per 1 SA NOAC wB .,

PERMIT NUMBER:
FACILITY NAME:
Daily Loadin
Maxim mrn Hourly Loading (inches
12 Month Floating Total (inches
Average Weekly Loading (inches
id Irrigation Occur At This Facility
Yes: {] No:
0
Ai
4
6
12
13
14
17
2
D'.
Precipi
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
W00023511
Woodland Heights Elementary School
MONTH: July
COUNTY:
Formulas.
inches) > ivoiume Applied fgaik rs➢ x 0 1136 cubic TeeVgalsoni ,r 12 (inchestloot)1 J Are Sprayed tacres) x 4356C
Volume Applied (gallons) d{area Sprayed (acres) x27,152 (gallons'acre,rtrch1)
Daily Loading Cinches)/ [Time Inigaied (manytes) Y 60 . minutssrhour„I
Z�um of this month"s MQruthiy Loading (Inches) and previous 11 mosrih's Monthly Loadi
. [M'onlnly Loading (tnch'esirnonth) a Number of nays in the month (days�rmenr'hJJ a 7' Isla
torag
Total Gallons/Monthly Loading (inches)',
Floating Tota1(inches)'
Average Weekly Loading (inches)'
Did Irrigation Occur On This Field:
Yes. ❑ No: 0)
FIELD NUMBER; One
Page
YEAR: 2009
IREDELL
Monthly Loading (inches) =Sun-1 c1 Daily Loadiggs onchesj
s Oncnesi,
Did Irrigation Occur On Thos Field:
Yes: r
FIELD NUMBER'
AREA SPRAYED acres :'
AREA SPRAYED acres
COVER CROP:
1.9
Natural litter
0.4
26
Maximum
Hourly
Loading
inches
COVER CROP:
Two
1.68
04
26
Maximum
Hourly
Loading
inches
r Codes: C-clear, PC -partly cloudy, CI -cloudy,
n-snoav, SI-s1
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
989073 C
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
Dennis Gryder
k Box if QRC Has Changed:
—[StGNATURE OF OPERATOR IN
Phone: 704ry87;
PON ISLE CHARGEI
BY THIS SIGNATURE I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE
DEN r ORM N4.>R , . _,x 03',

MON-DISCHARGE APPLICATION REPORT Page
SPRAY IRRIGATION SITE{S)
Facility Status:
Please indicate ( by riserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note if a requirement does not apply to your facility put (NA) in the
compliant box )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application,
5. The freeboard in the treatment and/or storage lagoon(s) was riot less than the limit(s)
specified in the permit.
ComIiant Y,N)
Iy
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not n compliance with its
permit, Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision n
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated theinformation
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief,. true, accurate. and
complete. am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
lrej Statesvflle Schools
(Permittee-Please print or type)
P.O Box 911
Statesville, NC 28687
(Permittee Address)
Signing0 -P ease print or type)
Dr of mamteflance
(Position or Title)
704-873-3755 3/31/2014
(Phone Number) (Permit Exp. Da
" If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28,0506 (b)(2)(D).
DE NR FORM NDAR-1 ll5-2Tn1

y U r : 4,3 r KUI'I: L5 I' IH I f`I { tr`IHr`k„t.
NON DISCHARGE WASTEWATER MONITORING
REPORT
MONT '___ _
ERMIT NUMBER:
FACILITY NAME:
ira Point:
u
i in Pit: E Iu rt ra
gent Fiuw F+�r Thus ficrnt t Genes tad Tht,
Or4nrof ()RC
Time On ©n
§Ne Site?
Monthly Lirnit(sl
P
Operator in Responsible Charge
Cheek Box If ORC Has Chen
Certified Laborstorie9 t1
➢erson(si Collecting Samples:
Mail ORIGINAL and TWO COPIES to:.
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mall Service Center
RALEIGH, NC 27699-1617
f'04-b
Grade:
ORC Certification Number:
YEAR:
POt4 BL 1c CHA:
BY THIS SIGNATURE, 1 CEf TIFY THAT THIS REPORT IS ACCURATE
ANC COMPLETE TO THE BEST OF MY KNOWLEDGE,

-2009 07:43 FROM:ISS MAINTENANCE 704-973°-5475
TO: 7046636040 P. oE1'©12
1REoELL.STATESVI LLE.SCI&LS
ADMINISTRATIVE ANNEX
114? SALISBURY ROAD
STATESVILLE, NC 286?`
70-873-373S
704-$73-5475
p7th8111, I55.k12.nc.uS

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED
Page
PERMIT NUMBER':
FACILITY NAME;
WQ0023511
Woodland Heights Elementary School
Form
Daily Loading (inches)
Maximum Hourly Loading )cinches)
12 Month Floating, Total (inches)
Average Weekly Loading (inches)
MONTH: .Iu
!Volume App1seo.(gaylans'y 3 7 133fi (cubic fe.eV9allpny, x 12;enchesM tq),°)Afea Sprayed
= Volume Applied (gallons) 7 )Area Sprayed (acres): 27.152 (ga➢Ohs/acre-inch)V
Daily Loading tdnches}V [Time ft'ngakedd fmin4Jtesj,`minutes,tour01 Monthly Loading finches) t SoOl FOaa° t.;aa'ad iS {ihas�es}
Burn of this m©nth's Monthly Loading (inches) and previous 41 month's Modally, Loadings ilncnesl
[Muynthl . Loading (si[ocneslnaonthy 1 Number of days rn themonth (tlays/dronth', t 7S5aysM+ee9
Did' Irrigation Occur On phis Field: Did irrigation t7ccur On This Field:
Yes: No: 0._.. Yes: 0 No: 11
Two
COUNTY:
YEAR: 2009
IREDELL
,Did Irrigation Occur At This Facility:
Yes: E3 No;
0
A
T
WEftTHER CON
at
FIELD NUMBER:
EA SPRAYED a
5 2500
>t 2500
2500
iI;
74
2500
2500 25
2500 25
2500 25
0
2500 2
es't x 43,550 isquare feeUacre)) (H2
ELD NUMBER:
AREA SPRAYED acre
Time
Irrigated
minutes
25 0005 0,12200 2
25 0,05 0,12 2500 2
25 0 05 0 12 2500
0.05 5.12 2500
0,00 # 1IV/0!
25 0.05 ti.12 2500 2
05 i.12 2500 2
0 12 2500 2
0,12 2500 2
#I IV/0! 0
#©IV/0!
0,12
DIV/0!
#DIV10!
0.12
0
2500
0
1.6
Daily
Loading
inches
xtntul
ou rly
dint
fChes
0.05 0 13
0.05 0
DIV/
0.13
0,13
005
0 c 5
0.05
0 00
0 #DIV/0
0.13
0.I 0 #DIV/©
0.f10 #DIV/0i
0.05 0.13
22 822500 25 0.05 0.12 2500
+ 2000 20 0,i14 0 12 20010 20 0.04_ _ $
C 1 80 0
tlonslMonthly Loading
2 Month Floating Total (Inches
2
00
0.5
29500
0.65
Average Weekly Loading (incites)
• Weather Codes: C-clear, PC -partly cloudy, Ckcloudy, R-ran, 5rt
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Dennis Gryder
"f
989073 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
NATURE OF OPERATOR IN R
BY THIS SIGNATURE, l CERTIFY THAT THIS
TO THE BEST OF MY KNOWLEDGE,.
07958',
704-873-3755
NC DENR MRO
DWQ - A : uifer Protection

NON-D1SCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate( by inserting Y(es) or N(o) in the appropnate box) whether the facility has been compliant
with the following permit requirements (Note if a requirement does not apply to your facility put (NA) in the
compliant box )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment andlor storage lagoon(s) was not less than the limit(s)
specified in the permit.
Y
If the facility i:s non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary,
1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted_ Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information„ the information submitted 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 knowing violations,"
ignature of Pe
Iredeit - Statesville Schools
7— 2 r er
Date
(Permittee-Please print or type)
P.Q.
Statesville, NC 2
(Permittee Address)
L.
(Name of Sign
Official -Please print or type)
DIRECTOR OF MNTENANCE
{Position or Title)
704-873-3755
(Phone Number)
1'31,2009
(Permit Exp. Date)
If signed by other than the permittee, delegation of signatory authority mut be on file with the state per 15A NCAC 2E3,0506 (b)(2)(D).
DENR ;OM NDAR, :5,20C2,

NON DISCHA
Monito,nng Po rtEfftuent.: Influent:
IASTEIATER MONITQRN3 REPORT
MON YEAR ,
COUNTY' -77
rarneter Monitoring Pc3int: Effluent: X- Influent: 'Nater (S'Ar' C r„leiN?.rne:
,Na-+.7; There Effluent Plow- Rc„r 7-7"`AS "rt6s
C7,44 C4;:,".74,) onsz
8C0,5
RS i GALL.ONS UNITS MOO
Cafly Maximum
CaftyWnimum
Monthly Limit(s)
Composite (C); Grab
Operatarn Re.sc„,onsibie ar (ORC!, tz_70‘-i,k
(heck Box if ORO Has r,:lianged
Certified Laboratories
PerSz,M5 Cotlecting
Maii ORIGINAL. and TWO COPIES to
D.ENR
DIvrs.ion of Water Qual(ty
ATTN Information ProcQssing Unit
1,517" 1„4d Cn°t--.„r
PAL 'E ,F.:3* H., NC 27599-1 1 7
Grade:
OF Cemfication Number:
„
' k'GN,A.7URE OPER.A.7',DP„ CHAR,C1E.
B THiS SiG'4ATURE. I 0 ER rJ---r" THAT THIS REPORT IS AATE
-21P E T E. TO THE -9 E,STOF K.JNI CAN E

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status
Please answer the following question:
1, Does all mon onng data and sampling frequencies meet permit requrrements?
Drilphant(Y,N)
e :re facedqv ee- neji-corrpliant, le,.Lease e.,ezean the space 'De -ow ere iea8,:,:rq,s, "'a,,Ieetei
,iyniMi its permit Prev!de 7; „-Pur eiq,:!araticin 'Me :Pate, s o' the rornippihnpudhce, aro pas:rt.:a, the cored:
taken. .Attach additioniai sheets If necessary
dehtfy under peraity of ra at ti-hs document ar,d3 tachments were prepared dnder my direction or
supernslon in accordance with a system desugred to as that ail quahfied personrel properly gathered and
evaluated the informaton SUbmitted. Based on my inquiry' of the person or persons who manage the system, or
those,. persons directly responsible for getheinng the .,nformation the .mformation subrrittei'd is,. to tre best of my
knowiede and b.&iet true apicurate and complete 1 arm avyare tnat there are signifii:ant. penalties for submtmg
fehse information, mcluqu'IQ the piosshipdhpv cif fines and imphschnment for knoyylrg vicniations "
Paramete
odes:
7- /- c'
se print or type)
(1,44116.-
Arser,c
.0'504 0004,e:eel.
003,94 C00duch,Lty
OC-3,0 BOCS “14:::: Cupner
01•77, Cad,r,Lee CC200 C,see:eGed ":;veqee
Geg 2-7ake"Gre
31616 ,G0ecat Coiftcrm
Ndvi:ger 7,;-:Aa[ 00GZS SzCia..xn
OC:53C No2a,NO3
X620 NO3
C4t-::;reaze
DC 3,3 1 5 PeR
00 745 S eaale
9 PAN ,Plank 1
CA:,940 Cicr,:te •Lead
c0340 0 77D
CC9Z-:" Mares,,,rn
,303
C.;=C4h0 ze;
700:0$ 77,073
0G0 7,err,Pi.4--3ture
fX€25 7,(N
3ze20, 007,6,30
,r0f,G3,;i5 Phosc;r7ere4
PoLassq,01
01067 NeGKee 0054.3 Selfieacre %darer
7,92 ZeG_
- /
(Permit Exp, Date)
Parar'149 i9AsA;Stance mai ne ottAAneA 'AA .7::Aihns, L.AndA Arw., At
T,e mOntr:A 3Aer Age C.;A:.Aft', :e r-ear arS'i art.t.S aa,aaa:1,Taaa,
diana,
f 3,A.gned by other than the p,errnatee. Ci;e1iNdt.10,11 "L)j 341at.;;Dri=i 1h Ir t,trust be on flle wAtti ,,he state per 15A NCAC: 25

Pr
PERMIT NUMBER:
FACILITY NAME.
Daily Loading (inches)
Maximum Hourly Loading (inches)
t2 Month Floating Total (inches)
Average Weekly Loading Sinches)
Did Irrigation Occur At This Facility.
Yes:
A
T
E
CL
4
9
2
No:
ATHER CONDITIONS
pp lc
73
56
60
68
68
pit
n
TH
E ARE
W00023511
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
APPLICATION FIELDS PER PAGE, USE ADDITIONAL PAGES AS NEEDED.
Woodland Heights Elernen
MONTH: Ma
COUNTY
Page
YEAR,'
IREDELL
Formulas:
▪ [Volume Applied fgaticvas, x tJ V336 (cuhfc feet:gallon) x 12, dochesl00lj1 %(Area Sprayed {acres' x 43,34 O g squere teeUactell OR
▪ Volume Applied gallons) t [Area Sprayed iacreal u 27,152 (galen$lacre-urch})
Daily I.aaddrtg enct-resJ ,arrgaond;n,siutass o0,trnrusesrresur,ll Monthly Loading ('inches) al 0a0w
= Surd of this r0Unth`s Mc7nlh€y Lua(tng (inches} and prevanus 11 Fnonth'd Monthly 1 oadrncla (inches)
(racnti oautu y tir'rcahe's/month) a Number of days 6'1 the month days[ n*nthl) ,, 7 opy:em-eekl
Did Irrigation. Occur On This Field: Did irrigation Occur On This Field;
Yes: IT
FIELD NUMBER.
AREA PRAYED (acres):
COVER CROP.
P
Volume
No:
One
1.9
Natural litter
TTED HOURLY RATE (inches): 0.4
ITTED YEARLY RATE ,Inches: 26
xmul
Time Daity Hourly
Fine -board A Irrigated loading Lcsadir
utssinches inches
5
2500 25 0.05.. 0,12
Volume
drr g
Yes: No:
FIELD NUMBER:
AREA 'SPRAYED Sacres):
COVER CROP: Natur
PERMITTED HOURLY RATE (inches):
2009
0
8
2e
0.4
PERMtTTEDD YEARLY RATE (inches): 26
imum
Time Daily Hourly
A tied Irrigated Loading
talletns minutes inches
2500 25 0.05
2500 2 ,05i 0,12
5 2500 25 0.05 0.12
4 CL 6 0 5
CL 70
5
5
63 0
25003 2 0.05 0.12
2500 25 0.0
250
25 0.0
Loading
Inches
0.13
0
0
2500 25
0.05 0.
2500 25 0.05 0.12
2500 25 0.05 0.12
2500 25
0.12
2500 25 0 OS 0.12
2500 25 0.0.5 0,12
2500 25
25
25 0.05 0
2500 25 0.05 0
2500 25 0.0 0
2500 25 0.05 0,12
2500 25 0.05 0.12
2500
2500
25 0.05 0.13
25 O05 0
2500
2500
2500
2500
2500
25 0.05 0.13
25 0.05 0.13
25 0 05 0 13
25 0 05 0.
25 0 05 0.13
2500 25
2500
2500
2500
25
25
25
0.
0 05
0.05
0.05
0.1
0.1
0.1
0
2500 25 0,05 0.12
24
2500 25 0.05 013
25-1OLIDAY
26 CL
27 R
28 CL
2S CL
1,75
0.25
2500
2500
2500
25
25
25
0.05
005
005
0.12
0.12
0.12
25 005 0.12
2500 25
2500 25
256t1 25
0.05
0.05
005
2500 25 0 0
013
0.13
0.13
0.
Total Gallons/Monthly Loading (inch
00100
12 Month Floating Total (inches)
Average Weekly Loading (inches)7�
` Weather Codes: C-clear, PC -partly cloudy, CI -cloudy, R-ra4n
97
0
n-snow, SI-
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:',}
Mail ORIGINAL and TWO COPE
ATTN: Non -Discharge Com
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
0 2473414
Phone: 704 87
,21870191,
DENNIS GRYDER
o>r if ORC Has Changed:
URE OF OPERA OR iN R2SPONSIBLE CH.A $E).,
GNATURE, I CERTIFY THAT THIS REPORT IS ACCURA
EST OF MY KNOWLEDGE,
30,9
•'`1 ILETE
DEW? FORM NOAR-1 , :2rs:?;:.

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box whether the faci6'sty has been compliant
with the following permit rem. ote. If a requirement does not apply to your facility put (NA) )n the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the s
in accordance with the permit.
4. AO buffer zones as specified in the permit were maintained during each application,
5. The freeboard in the treatment and/or storage lagoon(s) was not Tess than the limit(s)
specified in the permit.
Co
If the facility is non -compliant, please explain in the space below the reason(s) the faculty was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken, Attach
additional sheets it necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations."
(Signature of"ermittee)` Date
REDELt. STATESVILC
(Permittee-Please print or type)
P.Q. Box 911
Statesville, NC 28687
s
ter.
(Name o
lreb 6 q-CY
Official -Please print or type)
DIRECTOR OF MAINTENANCE
(Position or Title')
704-873.3755 1 /1 f J2009
(Phone Number) (Permit Exp. Date)
(Permittee Address)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 1 SA NCAC 2B4O506 ibl(1)(D).
DENR FORM NE

NON DISCHARGE WASTEWATER MONITORIN,1 REPORT
Pasas
ttl
"RMlT NUMBER
FACILlTY NAME
/11
Mr1trin9 Ponnya , trifle sts
5tfflarneter MstraltocingPcsint, Effluent' fflfluenta
Tie Effluent For TElis h Gettentfest At" , -es r ac.:ttry
tto..
15
1-
7
sE
25
2'
sc,
31
,• vss
arrzvat
Opluswfor
nmo T1
CiOCX Site
HRS :'"N•
Atierage
Daily Maximum
arty Minimum
hly Limit(s
Composite
24:16)
"-a
):74:::,:t; • 5C:it:it:: :Xi" V-
e„gsEttstai aCtt-5
•Ztt"::
SINttttF.t. • NV:IL
Operatar in Responsible Charge (ORC):,
Check Box tf ORC Has chang.ec1
Certified Labr3tre 1r
Persrinils) C(*tectintj Samples:
Mad ORIGlNAL. and TWO COPE.S to.
DENR
Division of Water Quality
ATTN.. Information Processmg Uott
1617 Mail Servioc., Center
ALEIGH, NC 27699.-1617
MONTH: j
W'ates ,EsfiCs.
)
75 3
L 7 tstt.S4'„
, . .
No,
Grade:
OPC Certification Nualber
COUNTY,
EAR
CodeiNaratE
-73TrINATURE CF OPERA7L, : IN RESP
BY THIS SIGNATURE. :CERTIFY THA
AND COPE"TO ThE eEs t:tiP N1t.
-72:6.tt,0)
Phone:
E ORT IS Att7.:OU „. tt
NC.:: DE rj:F?. mRo
ry„,vo nte CV on
.:7,„ Eta tttt 7 '7:5

NON D1SCHRGE WASTEWTER MONITORING REPORT
Facilit
Please answer the following question:
1, Does a moMtoring da)s and samplinq '?requeno)es meet permit requirements?
Jv-
.N-npLiant
if tide facOty is non -compliant r,)1,easo exotEo):::) Ofe a:ace pw fne fecascro a toe fa:Oa, 1623a0, rod ir ocrocii3:60332
6663h its cerrro Pdaidde in your exonariafidd tae diatena, of tile i6063r6-62C6r13Pila,1633e, ar)o aesdarice tne correctioe actoorna
',akar: Attach additionai sneei:s if recesoodi
ca7f\ 1,10z,
certify under periaity cif that frus 0,.iddia.aafent and aH attachments were prepared under rdy direction dr
sapersion In accordance ',Nith syst,eroi iesigneci to, assure rriat all quahfied persiannei. prdipeny gathered ard
evaluated the iriformafjidn subratted Based pin my inquiry' of the person or persons wto manage the s'istem, or
those persons directly responsibie for gaitherafg the... tnfarrnatppro the information soffrfitfed is, tic the best of my
kriovveiage and beiief true, accurate. and con-Oete ars aware t at there are cid,c,if'ioant penat es for si.itfoitting
fase information. iraiudinq the possibiiiv of fines and irdcrisoironent. for knowirc viciations,"
(Perm tee Address)
Para,
Co
es
(Name of Sign
C/L
or Title)
hone Number)
cal -Please print or typei
TFA
01302 Ars6666:
, 022 P0r66
6(3612 806
310064 00341620n fatal
)4. ':20,10.c0300
21042 C62c0er
32;0'23 3616v66366 00300 Ofr"3scive62 :20,6,ger
2219 6 '66`,a636606 3- fr41
66396421 0603-26e
6'651 16ead
5,6'C6•0 °Monne., Tolci[ 3C3i36 M636,6r..es2660
,3136s66,641 661623,626r3
0'234 0nrC,1",,,,,71
1
363340 6
2'3436
0t3800 r,543en33661ai 30929 S00110n
Cef530 '6C2&NO3 ..03,;661 SAR
3164220 N 03 3616 3304.1e
666656,014-0663ase 666296 ios
36003 PAN (Pant .660ar666 664616 Tem,oer.366,66
0:64660 ! 22625
32660 6,6e362:s
CC665 PhOSCthatiJ5:..136tal
366636 P36,3666,61
3062'6 Se613t33 mat 666
roc
c5306L 3866306"
2(1065 Turbt20x__
03392 Z0,c
(Perrnt Exp. Date)
Parameter Code; 355052am:a may be ottamed to, aaH2.'a; 'A ate6 Ouafty Laod Apcj663t33:',r, 3: (919: i;
The MOlf0162:e average for Ea cat 1:00;f6:3—r ,t..71. t e as 3 ,,1ETP.j0: iff ea-, di dayiL:Iliff,___.2„alifLiana tea rf 3°3 e
sjoO,I.ity:o31erT7.1!.. 11 lecciata4aafa
aagned by other than thQ, pemmittee, defepaion Of 4Al1at:Q0/: 303th63(614 must be an file wail tate stata per '15.A NC,AC 2560.506 (Ba2aCa
3406
;033V6

tart.°°
J.N.
AUG
SEPT.
1T.
NOV.
DEC.
A HT .
2008
-422.5 7, .5659.0
57,5 7.156
45.5M 3.5® 7.1563
40.0 25.
7.1
7 . :: /L.5- 7,15644
NO
12.1 GJ 6. 7.15 61.
7.151.5
7.1560.8
1 7.7660
7 7.151.2

8-2009 12:88 FROM I55 MAINNTEN iNCE 704-873-5475
TO:7 4663604Q P0 1%k3Q2
1REDELL-STATESV1LLE.SCWO 3LS
ADMINISTRATIVE ANNEX
147 SALLSBURY ROAD
STATESVILLE NC 286r
704-873-3755
704-873-5475
pat rallOss,k12.rt,c,us
Fa!,Number:

VON OiSCHARGE
o‘At Morutc.,,rinci Point: Eff t nflu
Nicriitchng Point1u 3
Fo.,r ThiS
s.:,TEVIATER MONITORING R
MONTH
II
. t n 4,
' treannent
I
'i. HSTS !, T.lki GAL .,.",":‘,A,'S .
A .
frA;'050 DCA.0.".= ' 5:ein '3CGTO, , 006•
, o 4-7) -771
, 2
3
24
25
(.)
verage
Daity
CAW): Min'imurn—
M'JntKay Lirnit(s
Composite (C) t Grab (Cs)
„. .
I Res,dn'a., 3:0,,i j
„:.G.G" • Nn.G.AN ::, ,:.:
• ::::::,
1
MLi
roh
Operator' in Re.sponsble 'Charge (ORC): ' Grade; 27— Phone:
Check Box if OR C Has: °hanged, Ll
iDertified Labora)nes 1-77:51-4L,
Collectmg Sarnple,s
Mad ORdt.IINAL and TWO COPIES to
DENP
Dsion of Watex Quality
ATTN, Inforrnat“),n Processing Unit
MaJ Ser\irce Center
RALEIGH, NC 27699-1617
-112- /tic"
ORC Certification Number:
d2)'
:2" /5,4'
--KS1G-NXTURE Ctzt CPER„4 TO RESPON StELE CHARGE
BY THiS SIGNA TrJRE,. .CERTFFY THAT THS REPORT IS AOCLdR.,A7E
4,NO MPLE7E, TC„, THE BE3T Ni.`r KNOWLEDGE
r-- r

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer tie following question:
1 Does ail monitoring dai:a ard sampling frequanoies meet errnit rqurer-rits7
Contbkant ,Y,Nt
fac,:,To-' non-coirpiant 7-;E: rehaschshs rash rt-27 cshehasee
pehT Prepiett:.,iStlartat.tttrt 77-?. ar hcrsh:esh-spoarce ard desor :re e‘sshects ancres
taker, ,A.ttac:r, acs:::leflas sheets It necessary'
- A kat'l
/ —
"1 eertfsi under oenaity of a 4 dpeurreht and aif athachments were prepared under my threceen
supervish3n n accordanceitr o system clesgred to assure that ail qualified personnel propery gathered ard
evaluated the !riterrhation sJernitted Based on my incquIri of the person or persons who manage tile syv,em, or
those person3 direotly resporsble fer gatherind the Iroar,orh the irformation subrnir,ed is: to the besr cr on-y
knoo„viedge and belief., YE aceurate. and compiete. arn aNare that !.here are siQrstScant penatJes ;'or see''
fa,se richmahor, inciuding the possindny cf fines and lir,2,rischment tor knowrg 'velat:ohs "
1 1/
(Signature:6f Perrnitteer
type)
Add
01002 ,P,,rS.epp-7:
:1:22 8,31-7.71
003 SC,C5
0.C,916 Carz:urr=
,3074,4'd.
Date
Para
31 4
eCctt,4 ttttrnit,vr,,,t't
0P1174.2 Conner _700
te,
C'Crj',:::C (S,S,,:qVeg 3,y(vg kr1
316'6 i-eca: C7,Ppfprrn WQP,14 PAN 'PLarl.Pvaidar.-Pe. Pern,':.,er-vure
'Narne of Sign T1 al -Pease pnfl
,CGO-ILLE„'
tFoston or Title)
(Phone Number)
°Geo() Natt,,ceaa •ttaat.
C0,3,30 NO2&NCQ
0062tt NO3
aG29 Socx,m
sAR
:0715 Suffide_
TOS
SatiO ,Thp,-)cr,e
7•!,30,3 Mer-cLry
t7PP7',1-7P Ptt,:t0
01.2.6'0 Nu3asN,
olc67
P7047,77-P
cot365 TJtal
00937
Steme3c,emwter
rrnit Exp, Date)
Pat-ameter Code assavaaratae may tae catataa:e, tata ti-aa a; at,Ett3 1 1 AtacLttata,ar Lin:t3 ,91';15 3
The 77Ortha aaterag',It 'eccA--e.j 13 a GiFt.::%I.E.7 R rttbatt
::tat3
• b'y other than the perrnAtee. atlegat.icn sit:joattant authcritty rnust be on fde ,N41-1 the state per 15A NCAO 29:35,06

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
Page
of
A'
f
24
PERMIT NUMBER„ W0002351 1
FACILITY NAME:
Woodland Heights EleiTtentary School
MONTH:.
April
COUNTY:
Formulas:
Daily Loading (Inches) [Volume Appbred (ga7o-s) 2 1334 (c.ubrc feeUgauldn) x 12 (n trestCnxP)f t f.Ar a prayed tacres} x 43 560 is are reeliacre,l OR
= Vo urne Applied {gaf7©ms) 7 (Area Sprayed (acres) x 27,E 52 (ganonsSacre-rnchq
Maximum Hourly Loading (inches) - Daly Leading innches) l ETimre Irrigated {rnrnwtesl 7 50 (,mfnulesrngrrxg
12 Month Floating Total (inches) - Stun of Ihs rmonth's Monl5ly Loa4rng (inches) and previous + i merars Mnnfhty Load,
A Nerage Weekly Loading (inches) = [Ft nthly Load ng (rrchesfrn ah)! Nu nt t r of nays in the mrrnth (daYst manlfr3i art 7 {da
Occur At'This Faci
id lrnga
Y
occur On This F
FIELD NUMBER:
AREA SPRAYED (a
N
Monthly Loading (inches) = Sum o
Did
YEAR; 2009
IREDELL
n Coeur On This Field:
No:
h
AREA SPRAYEDecrre: 1.63
COVER CROP: Natural litter COVER CROP: Natural lilts
PERMITTED HOURLY RATE (inche j. 3.4 PERMITTED HOURLY RATE {tnchesp:
ED YEARLY RATE Inches): 26 PERMITTED YEARLY RATE 'WEATHIER CONDIT'ION5 PERMITT RATE
Maximum
attrer Volume Tlme Daily Hourly Volume Time Daily
ode° Applied Irri ated Lttadln Loading Applied Irri ated Load"[n Lo<
gaitons aninutes anches inches gallcrzzs minutee lnchea fnp
00 2 0.05 0.12 2500 25 0,05 0
2500 0.05i 0.05 t
0.12
0.3 3 2500 25 0 05 Q.12 005
4
26
Maximum
Hourly
PC 250 0 .I 5 it l
r ►E 0.05 +>
4
4 � III 05r
0. ft� �
®e 25 0.05 02 2500 2
2500 25 0 05 0.12 2500 2
012 250
0 2 e 0.12 2500 2
25013 25 0.05 0.12 250025
05 0.'12 2500
0.12 250i25
20C} 2 0®'i2500 2
0.05 0
0,05 0
0.05
0.05
0.05
0
0
To
ns/MoI
y
each
nche
00f70
000
2 Month Floating To
nch
Average Weekly Loading,{inches)'. 0.225092
• Weather Codes: C•clear, PC -partly cloudy, Cl-ct©udy,R-rain, Sn-snow, SI-sleet
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
Dennis Gryder
2555662
Phone: [phone]
989073 Check Box if ORC Has Changed:
GNATURE OF OPERATOR I RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE,
DENP FORMlNDAR-f (5)2003i

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been 1.-,ompliant_
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s),
3. A suitable vegetative cover was maintained on the site(s) in accordance with the pennit
4. All buffer zones as specified in the permit were maintained during each application,
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
nt Y,N)
If the facility is nen-compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit Provide in your explanation the date(s) of the non-compliance and describe the corrective acton(s) taken Attach
additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations,"
'24
(Signature of Pe
6 7
Date
ell - Statesville Schools
(Permittee-Please print or type)
P.O.Box 911
Statesville, NC 28687
(Permittee Address)
(Name o ing Official -Please print or type)
Drof maintenance
(Position or Tit(e)
704-873-3755
(Phone Number) (Permit Exp. Date)
111/2009
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per I5A NCAC 2f10506 (b)(2)(D).
DENR FORM NOAR-1 (512003).

UT NUMBER:
FACILIT7 NAME:
'Firtnw n;
H'"terameter Moretortntr,1PoTnt.:
nt,s Thetre Etruent
. 1
13
int:
fiRS F 10,4
2
ve a ge
Daily rtirlaxirnum
u,
ontlfy Lim
Composite Grab
NUN L LtiArU I3 ITNA I t KE'r'L)
flu t:
MONT"'
Etf r r11 t 3„nntace 'Netter S
s M 'titi ..;,,enera ac: No:
, g,ecal
F,F909Y0. 9,1999 : • : it9r:C! ! Res,99,,a i SCE), 5 1 , Coaorrl
TreVrnent
Mean' Svsze71 pH ri 'Li
— ----. __
,.`,,,SG,L i 1,:.-_0_ ; MS,'`,_ ,7,,L ,100ML.
Operator in Responsible
Check Box rf ORC Has (Changed
Certified Laboratories
Persams; Collecting Samples.,
IMaA ORIGINAL. and TWO COPIES to:
DENR
Division of Water Quality
ATTN: In.forrnation Processing Unit
1617 Nlai Service Center
RALE-7,IGH, NC 27699-1617
Grade:
OR Certification Number.
COUNTY':
Rho('
7
_
SINA'UR OF OPERATO- IN ;ESPONSIELE CHARGE
B!,THIS Sk:iN.ATURE, OE Fr THAI THIS REPORT IS ACcuR,A7-a
A No comP1_ETE TO THE BEST F M"( KN,D'AiLEOGE..

Facs��it Status:
Please ans
NON DISCHARGE WASTE TER MON'ITCR? G REPORC T
the following question:
1. aces 7.i iron g da�a and sa.mpvs'ng frequent, '! meet
nd nejief,
(Name of Signin

TH
Page / of
PERMIT NUMBER:
FACILITY NAME
Daily Loading (inches)
Maximum Hourly Loading (Inches)
12 Month Floating Total (inches)
Average Weekly Loading (inches)
'gation Occur At This Factiny;
Yes: 0 No:
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
RE ARE TWO APPLICATION FIELDS PER PAGE USE ADDITIONAL PAGES AS NEEDED.
WQ0023511
dland H
Soho°
MONTI+
COUNTY: IREDELL
Formulas:
[Volume Applied (gaCians) x 0 1336 (Wbic feet/gallero 12 4rochest1oot4 / [Area Sprayed (acres) x 43,560 (square feet/acre)] OR
Volume Applied (gallons) ( [Area Sprayed (acres) x 27, '52 (.gallonsiacreAnch)1
Daily Loading. (inches) / [Time engated (rmnules1.( 60 Lminutesihouol Monthly Loading (Inches) Sum of Da(ly Loadings (incheS)
= Sum of this montres Montrity Loading (metes) and previous 11 monfil's MoMhly Loadings (incheC
[Menthe,/ Loading linctlesendrilN / Number of days tn frie month (days/month)] s 7 (daystoreek)
Did Irrigation Occur On This'Irri
gationdoctiir On ThisFielcV
Yes: e. No: 0 Yes No:
FIELD NUMBER, ne ELD NUMBER Two
A Tmpar-atu
T ether
at
Code'
application
OF1
Precipi
inches
1,75
•0,1
0
0
0
Storage
Lagoon
e-hoa
19 4
0 4
Volume
Applied
gaiions
2500
2500
2500
2500
2500
2500
2500
2500
2500
2500
2500
COVER CROP: Natural litter
PERMITTED HOURLY RATE (inches): 0,4
PERMITTED YEARLY RATE (inches): 26
Maximum
Time Daily Hourly
Irrigated Loading Loading
minutes inches inches
0,05
0,05
0,05
0,05
0,05
0.05
0.05
0.05
0,05
0,05
0 05
0 05
0 05
0,12
0 12
0.12
0.12
0 12
0,12
0,12
0.12
0 12
0,12
COVER CROP: Nature! litter
PERMITTED HOURLY RATE (inches): 0 4
PERMITTED YEARLY RATE (inches): 26
Maximum
Volume Time Daily Hourly
Applied Irrigated Loading Loading
gallons minutes inches inches
2500
2500,
2500
2500
2500
2500
2500
2500
2500
2500
2500
2500
2500
2500
2500
05 0,12 2500
2500 25 0 05_ 0.12 2500
2500 25 0 05 0,12 2500
Total Gallon reldlonthiy Loading (inches) 50000
12 Month Floatlolg Total (inches)
0 97 50000
Average Weekly di inches) 0 2187019
Weather Codes: C-clear, PC*partly cloudy, CI -cloudy, R-rain, Sn-snow, SI•sleet
Spray Irrigation Operator in Responsible Charge (ORC);
ORC Certification Number:
Dennis Gryder
0 05
0.05
0,05
0,05
0.05
0 65
0 05
0 05
0 05
0 13
0,13
0,13
0,13
0,13
0 13
0 13
0 13
0 13
0.13
0 13
0,13
25 0 05 0,13
25 0 05 0 13
989073. Check Box if ORC Has Changed: El,
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
1
(SIGNA E OF OPERATOR IN
P 9TfttS SIGNATURE, I CERTIFY T
tb $tE BEST OF MY KNOWLEDGE
1 10
0 2473414
Phone: [phone]
BLE CHARGE
RE
TE
WC6ENR"tvRO
OWO

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements (Note, if a requirement does not apply to your facility put (NA) in the
compliant box,
1. 1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
Co
Y
Y
If the facility is non -compliant, please explain in the space below the reason(s) the faciIit was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken, Attach
additional sheets if necessary,
"I certify, under penalty of law, that this document and an attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations,"
Ire:Jeff Statesvilf
(Perrnittee-Please print or type
P O. Box 911
Sta esvi e, NC 28687
(Perrnittee Address)
Dr-. 1E4' — 0?
(Nan,e of Signihg Official -Please print or type)
(Position or Title)
704-873-3755
(Phone Number)
1/3112009
(Permit Exp. Date)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2a0506 (b)(2)(D)
DENR 'FORM NDAR-1 (512003)

NON DISCHARGE WASTEW TER OMIT©RI G REPORT
FAc LITY NAME:
ator in IResponsible Charge (CRC):
Check Box if ORC Has Changed.
Certified Laboratories (11
Persons; °fleeting Samples.
Mail ORIGINAL and TWO COPIES to
DENR
Division of Water Quality
ATT,N: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 7699-1617
(2)
AT�iRE F a^PE ATCR i RESPCNSI LE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
ANC DMPI_ETE TO THE BEST OF h!"f KNOWLEDGE

NON DISCHARGE °ASTEWATER ONITORING REPORT
Ilty status:
Please answer the following question:
1. Does all monitoring data and sarnpling frequencies meet permit requires » nts`>
wiitiri its permit. P: uv de
taken Attach
under ceni
sJperQls;on in accordance =rwat,h a ststerrt de
the_ information subm;tted Based on my enquiry of the person or persons. who mana
:ns is€["':?= i4y resnonsib ""�`w' f;:�r gathering the Inl_o€mati1.n, the information submitted is, .to
and belief, 4rue and nd compete, I am aware that her are s n _._....w.___.
the pros `:I f`ne aid €n pr.5tsr':,ment for knowing `Jio6
Ian
(Perrnittee Address)
(Phone Number) (Perrnit Exp,
Para rs eter Codes:
1o;io"a' arserry�w
T•>t.au L
N irtn�r'€
r. ;t for iortirn i3ta
If signed by ether than the uermittee, desegati ,rr signatory a
CL;alltt Linn
t be an the wiht the state per 15.1 NOA0 2

Pir PERMIT NUMBER:
FACILITY NAME:
Daily Loading (inches)
Maximum Hourly Loading (inches)
12 Month Floating Total (inches}
Average Weekly Loading (tones).
Did Irrigation Occur At this Facility:
2
22
Yes: 2 No:
WEATHER CONDITIONS
Teroper-atu
Akiaitter
at
Code'
application
Prec pita.
non
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE, USE ADDITIONAL PAGES AS NEEDED,
WQ0023511
Woodland Heights Elementary School
MONTH:
Page
January YEAR: 2009
COUNTY: IREDELL
Formulas:
fvetunie Applied tgallons Ct )3.36 (c»I))c teetigallorq A 12 (ifIcesJoetAl!Area Sprayed tacres) x 43 560 {•square feeriacre)i OR
Volume Applied (gallons)/ Sprayed (acres) x 27,752 (gaik)nsiacte,r)ch))
Daily Loading (inches} [T)me ringated, r)itruges) / 60 irMnutesihotir;,1 Montt,ly Loading finches) = Surn of Caiiy Loadings (inches)
Sam Dflrlis monlh's Monthly Loading (incnes} and eye,ous 11 montt)*$ Mcraely LOadIng& GricheS`i
fMonlhly Loading cknEt00sIT:71,h Number of days in the Mrh (1aysfrnont0Oj x 7 IdaysAvee)()
Dd Irrigation Occur On This FielcV. 0diivaton Occur On This Field:
0 . ,
Yes: D No: El Yes: D No: Ej
FIELD NUMBER: One
AREA SPRAYED (acres): 1 9
OVER CROP: Natural litter
PERMITTED HOURLY RATE (inches): 1
PERMITTED YEARLY RATE inches: 26
Storage
LagoonVolume
ree-boa • A..
Time Daily
Loadl
hes
1. d
inutes
0 2 2000 0 04
57 000 0 04 0
5 00 0. 0
4 500 2 0 05
4 5 2 0 05
2000 18 0 04
250 2 0 05 0
1 4 2000 0 04 0
HOLIDAY
000
000
2000
2000
2000
0.
23—ij
FIELD NUMBER:
AREA SPRAYED (acres :
COVER CROP:
Two
1.68
Natural litter
PERMITTEO HOURLY RATE (inches):
PERMITTED YEARLY RATE inch
Volume
A ..fled
gall n
2000
13 2000
3 2000
2500
3 2500
2000
2540 2
20
2000
2500 2
200
000
000
000
Total Gallorra/Monthly Loading (inches) 34500 0 67 34500
12 Month Floating Total (Inches)
. , .
Average Weekly Loading (inches) - 0 1509043
" Weather Codes: C-clear, PC -partly cloudy, CI -cloudy, R-rain, St -snow, Si -sleet
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Mail ORIGINAL and TWO COPIE
ATTN: Non -Discharge Compl
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
Dennis Gryder
989073 Check Box if ORC Has Changed:
En/E
B
etAr::s T
NC DENRnr,Ifi0
DINQ utter Protection'
7
/,
0.4
Maximum
Daily Hourly
oadn. Loadtn.
es inc
0, 5
0.04 015
004 0 15
0 05 0,14
0 05 8.14
O. 0.15
0 4
.04 O. 5
0,04
0 05
0 05
4
,04
0 04
0.04
0,04
0 1706656
0.15
0,14
Phone: [phone]
E OF OPERATOR IN ESPON BLECHARGEy
.IGNATURE, I CERTIFY THAT THIS REPORT IS ACCORATBAND COMPLETE
ST OF MY KNOWLEDGE,
DENR FORM NDAR- I 5./2001,)

NON -DISCHARGE APPLICATION REPORT Page
SPRAY IRRIGATION SITE(S)
Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements, (Note if a requirement does not apply to your facility put (NA) in the
compliant box, )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s),
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment andlor storage lagoon(s) was not less than the limits)
specified in the permit,
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary,
Cotta.it'atat Y,N)
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering' the information„ the information submitted 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 knowing violations."
r`7
(Signature df;Permittee)`
Iredefl - Statesvi to Schools
(Permittee-Please print or type
P.Q. Box 911
Statesville„ NC 28687
Date (Name of Signi g 0
e punt or t
aintenance
(Position or T
704-873-37;85
(Phone Number)
(Permit Exp. Date)
(Permittee Address)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (h)(2)(0).
DENR FORM NDAR-1 l5120003}

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Report to
GROUNDWATER SECTION
CHAIN OF CUSTODY (COC) RECORD
DENR1DWQl LABORATORY (cheek one): I X 1 CENTRAL ( ARO 1 1 WirRO
Page
tvestlgation of: Soil Groundwater Incident No.
paint name)
54 Dorms completed by: MA.RGARET FINLEY Sample collector's signature:
Field storage conditions and location (when 'applicable):
Lab Lse Only
LAI3 NO..
PIE ➢D QUAD. NO,
ODCATTON
SAMPLED
R
OF
AMPL D CONTAINERS
Rehinatushe.
y
Relinquished by
I Date Tire Received by (signature):
Date
Time I. Rea eived by (signa
Tune Received by (sig,nar ure):
ud ot'Sitiptraertk (circie one) State Cou Hand-delivcred Federal Express UPS Other:
Sealed by:
and Conditions: Margaret Finley.
Date
Tune
Dace
Time
Time
T. OR. TO'RY CHOF CUSTODY -
1. B UMBERS
FRO, . THROUGH
NUMBER
BOTTLES
ab Use Only
'ALYSES
REQUESTED
Broken by:
1
DATE TIME
QAlFarms+:Sarnple ReccivIng'CDC loan GW
4/ O/O1dbs

IT NUMBER.
FACILITY NAME:
NON DISCHARGE WASTEWATER MONITORING REPORT
MONTH:
Monitoring Point: Etf!Gent„
iParameter Monitcring Point:
's There Effluent F!ow For sMo
20
21
22
23
24
25
26
2.
2
111u
Effluen: 7ent 1:'SLrface Water !
ith Generated:
11040a
.„.50
:r
riMe
Ooeratz,r CPC
T,Ine :arl '31
Sae.
H
22r2CL_V,2-225r3
—
,13WMaxmum
Daily Minimum
Monthly Limit(s)
Composite (C) Grab
. —
DaRr P3ze ; „ .
1-,r,74;rmer
GALL.ONS UN] U102.
3 71
Operator in Responsible Charge (OR
Check Box. if ORC Has Changed.
Certified Laboratories CIL_
Person(s) Collecting Samples:
Ma ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATT.N: Information Processing Unit
1617 Mad Service Center
R.ALEIGH, NC 27699-1617
, 5
r0r,...caE
•
755 Meao-,
L 1 DOM L
CodeiNarie:
M R 2 ;109
informaiion E rong
`DWICY'S
Grade
'cation Number:
(2):
NATURE OF 0 E
Phone:7C/
N RESPONSIBLE CHARGE
BY THIS SIGNATURE, I CE TIFY THAT THIS REPORT IS .ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEOGE.
;10'0";`0-":0

NON DISCHARGE WASTEWATER M 3NITCtRING REPORT
Statu
Please answer the following question:
1 Does all moni
non -co
pror•de
dw.;ona .
orr
data and sampling frequenci
hant. please
t ne,w essar�
s;sr
r
tad the informauon submitted
those persons directly responsible for gath
and be,hef, true. accurate: and o
the posstb l
(Perrnittee Address
Parame
meet permit requ rements?
nd all attachments were prepa,
assure that all qualtfed pers nne p
qurn1 of the person or persons 'who manag
nformataon the inf.:rrnatiLon submi
I am afvare that there are sOjnific,
d :[-nprspromerli for knowing vor,q,ancoos
Codes:
(Name of Signin
(Position or Title) l
(Phone Number)
4Cr
gathered and
m.o,
he best of my
for so M tr,rr>,
ws r6 ae<caa,Opsform
0C4pfr
C1,2,34. •. eFn�^t^..m.,
CLCLO
e b'f other than the permTttee, delegation o.f soToaton, juthort'r' mast be on fce with
SA NCAO 2 0SE 6 c..bk(?

PERMIT NUMBER:
FACILITY NAME:
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED,
WC0023511 MONTH: February
oodland Heights Elementary School
Page
YEAR: 2009.
COUNTY: IREDELL
Formulas:
Daily Loading (inches) - [Volume Applied (gallons(x 0.1336 (pubic feet/gallon) x 12 (inc'nestfoot'il / EArea Sprayed (acres)) x 43,550 (square feetfacreli OR
Volume Applied (gallons) ! [Area Sprayed (aces) x 27,152 (gallonsfacre=incn)I
Maximum Hourly Loading (Inches) = tJaily Loading (inches) / [Tome nigated (minutes) i 6r7 (minutesThour)1 Monthly Loading (inches) := Sunor ()ably Loadings Nnches)
12 Month Floating Total (inches) = Sum of this month's IMcrt5ly Loading (inches) and previous "'t monthi's. Monthly Loadings (incnesi
Average Weekly Loading (inches) [Monthly Loading (iinches/month) i Number of days in the month [daysinnonth}1 x 7 (days/dveek)
pld Irrigatlam Occur At 'This. Facility: Did Irrigation Occur On This Field: Did Irrigation Occur On This Field:
Yea: No: Yes: No: Yes:No:
FIELD NUMBER,: 217e FIELD NUMBER:I Two
PRAYED acres : 1.9 AREA SPRAYED acres :
1.68
ATHER CONDITIONS
A T lMlathar T®mPat atu . P
E Code' appllcatlen
44
34 0.2
21 0 ..
23 0
PC tl
a
48 44
0
22
23 C 40 0
24 C 34 0
25 C 42 0
i 26 CL 47 0
i 27' CL 54 0
31
Total Gallons/Monthly Loading
storagt
Lagoon
Free -beat
4
4
4
4
EA
COVER CROP: Natural litte
PERMITTED HOURLY RATE (inches):'.
PERMITTED YEARLY RATE inches :
Volume Time
At(alied Irri.ated
1.1
Daily
Loadin
04
26
Maximum
Hourly
Loadin..
200 18 0.04 0 2000 18 0.04 0.15
2000 18 0,04 0,13 2000 18 0,04 0.15
0 0.00 #DIV/O! 0 0,00 #DIV10!
0 0.00 #DIV/01 0 0,00 1 DIV/0!
Iw0
2000
2500
2500
0
2500
2500
18 0.t4
18 0.04
0,00
23 0.05
23 0.05
23 0.05
0.00
23 0.05
23 0.05
©.13
#DIV/0!
0,13
0.13
0.13
#DIV101
0.13
0,13_
2500 23 0.05 0.13
2500 23 0.05 0.'13
2500 23 0.05 0.13
2500 23 0,05 0.13
0.00 #DIV/01
0
00 0,69
2500 23 0.05 0,14
r
2000 8
2000 K
0
2500
2500
0
2500 2
2500
2500
2500
0
0.05 0,14
r
0.04 0.15
0.00 #©IV/OI
0.05 0.14
0.05 0.14
0,05 0.14
0,00 #DIV/O!
0.05 0.14
0.05 0.14
0.05 0.14
0.05
0,05
0,05
0,00
0.78
0.14
0.14
0.14
©IV/t
12 Month Floating Total (in
Average Weekly Loading (inches)
Codes: C-clear, PC -partly cloudy, Cl-cloudy
aid, Sn-snow, SI
Spray Irrigation Operator in Respansibte Charge (ORC):
ORC Certification Number:
Mail ORIGINAL and TVVO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
0.1552784
Dennis Gryder
989073 Check Box if ORC Has Changed:
01756124'
Phone: [phone]
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
8Y THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR--1

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status,
Please indicate ( by inserting Y(es) or N(o) in the appropriate box) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box,
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the sit
(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
Y,N)
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit, Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken, Attach
additional sheets if necessary.
"°I certify„ under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations."
(Signature of Pet" nitter
tredell - Statesville Schools
Date
(Permittee-Please print or type)
P.O. Box 911
Statesville, NC 28687
(Name of Signing tffic'ial-Please print or type)
i3ir,of maintenance
(Position or Ti
704-873-3755
1/3112009
(Phone Number) (Permit Exp. Date)
(Permittee Address)
• if signed by other than the permittee, delegation of signatory authority must be on file with the state per 1SA NCAC 28,0506 (b)(2)(0).
DENR FORM NDAR-1 ;,5 2003;

NON DISCHARGE WASTEWATER MONITORING REPORT
T NUMBER:
FACILITY NAME:
Moait:rtncg Pint Etfiuent`
Meter Mt nitoring Pornt: Effiu
There Etuent FRo° Por This MonthG
0a4y R3T*
(rl7+w! ie(i7
Tre,mrnent
HRS P Y=ti
Average
ity Maximum
ity Miru mum
nthi Laratit(s.
:orrposite IC
Operator in Pesponsubl
Check Box if OR, -
Certified Laboratories I
Persorisi Collecting Samples-
ar
UN615
Ch irge (ORC r '
Has Changed -
Mail ORIGINAL and TWO COPIES to:
DENR
OivISion otf Water Quality
ATTiN. Infornfation Processi
1617 Marl Service Center
PALEIGht, INC 27699.1617
Unit
MONTH:
YEAR:
relater±S&1: rbCacdeNarne
Phone:
ORC Ce
C;NATURE OF OPENtELE CHARGE}
BY THIS SIGNATURE, V +ETiFY THAT THIS REPORT IS ACCURATE.
AND COMPLETE TO THE BEST OF MY KNOWLEDGE,

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status
Please answer the folio ing question:
1. Does all monitoring data and sampling frequencies meet permit requirements?
the facility is non-coman, Piease exPlaln ,n the sPace beiow the Teasoin: the i.actlfti was notnc n compliance
with its permit ProvIde in your explanation the date.Js) of the noin-compHance and de,,sctibe the porreotive actJcin(s)
taken Attach adc;tional sheets if necessary
1 certify, under penalty of law, that this document and af attachments were prepared under my direction or
auPerilsian in accordance 'Nati') a system idesgned to assure that af qualified .personnel properly gathered and
evaluated the information submitted Based on my inquiry' of the person or persons who manage the system, or
those persons directly responsible for gathering the information„ the intcriation submitted is, to the best of my
kriaedge and behef, true, accurate and compete I am aware that there are 'significant penalties for submitting
false information including the ;possibility of fines and irm.-)nsonment for knowing viciaNDrt$
(Signature o
{PermtteePIease print or type)
)„ ;1//li
-);-
7/6itii-i
(Permittee Address)
Parameter Codes:
(Name of Sign' g Offici
(Position or Ti e)
.P ease print or type
Phone Number)
01092 Arsenic 504 asessiom
esosin
N1!1109en, TWa '3•092gSzcm
30094. CiaiseusissitiFL5Niiiia322iira(223
60 0.9 is:242 Caisimm
99620 raaa
09209 DissiiieemPOYScien
aeg :3 assiu 1,77 316' 5 FeCal COI4Ven
093040 Chissias 01..aifiP Leas)
500633 '.,:hlafule. laetai
Res -Asia]
00927 Marysesissim
3.1.9922i Mercury
mesimeape
07:267 ematei
220931 54.5
003.505.6 331..23sease
`1.232209 5.05 iPiam esesaMei
33555 7C,
30010 5jr4
004.00 H 0062:5 i"KN
.32735 Poessas i a 0680 C.,
09555 smospossois. 20520 3335735
3,0930` Potassium
Seigeassise mase,
30035 Iarnslite
.31092 Zino
- 3 7---(-)
(Permit Exp. Date)
Parameter Code assistance mat" be at -ladled bs calkog ete d'iater (data tity Land A;;:canon Una at. r919" 71336 r
The tal orttoot ayer,3gie far Pedai Coatroom ors ta de '5,•7330e73 id 3 a GEOMETRIC meter. oktora n Tie reccirt•riji
s permit report:rota data
• If signed by other than the perrnittee delegation of signatoryauthority must be on .11.e with the state. per 15A NCAC 2E3,9506 ta5(2)(E)7.
COrtarreP rPotrarrOA Na:11,1P,"1

Pr
PERMIT NUMBER:
FACILITY NAME:
0
A
T
E.
4
4
6
22
24
2
28
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
WC10023511
Daily Loading (inches
Maximum Hourly Loading (inches)
12 Month Floating Total (Inches)
Average Weekly Loading (inches)
gatlon Occur At Thls Facility;
Yes: Ej
WEAT
waathe
Code'
CL
CL
CL
CL
CL
C
Tota
Woodland Heicghts Elementary School
Formulas:
MONTH: December
YEAR:
COUNTY: (REDELL
2008
[Volume Applied t9ollu?evs) ft 1 (Adbrc ieetigatNcnt x 12 pnchesloopl / (Area Sprayed (acres) x 13,560 {square leetla✓=re}J OR
= Volume Applied (gallons)) (,Area Sprayed (acres) x 27,152 (gallonsfacre-inch)J
. Daily Loading (v_nches/ r [7rme irrigated (minutes✓vim (mrnuteslhour/J Monthly Loading (inches) . Sum of Davy'.,oadings (inches}
- Sum of this months Monthly Loaning (inches) and prevous 11 rnonth's Monthly Loadings {N1Ghesj
[Monthly Loacldng yncne&fm€onih) / Number of days rn the monlh (days/m(10hf] x 7 idaysMreeky
Did Irrigation Occur On This Field:.
E] Yes: 0 No: _ 0
No. •
HER CONDITIONS
Temperratu Y.
at
application
(,F)
Praciplt
1.1
0
FIELD NUMBER:
AREA SPRAYED acres)
COVER CROP'
One
1,9
Natural litter
PERMITTED HOURLY RATE (Inches):
P
Sic rage
Lagaon Volume
Frae-hoard Applied'
fee$ gallons
O.4
ED YEARLY RATE "inches : 2
Time Daily
igated Loadin
linutit5 s ehes
2000 16
2000
2000
16
6
n
0.04
0.04
0.04
aximurn
Hourly
oadhsa
es
0.15
0
5
2000 16 0.04 0.15
2000 16 0,04 0,15
2000 16 0.04 0,15
2500 20 0.05 0.15
Did Irrigation Occur On This Field:
Yes; 0
FIELD NUMBER:, Two
AREA SPRAYED (acres):1.68
Natural litter
PERMITTED HOURLY RATE (inc
COVER CROP:
PERMITTED YEARLY RAT
Volume
Applied
gallons
2000
2000
2000
2000
16
Time
igated
In
6
45 0.2 4 2500 20 0.05 0.15 2500 20
54 0 4 2500 20 0,05 0,15 2500 20 Y
45 0,2 4 2500 20 0,05 0.15 2500 ' 20 i
50 0,1 4 2500 20 0,05 0,15 2500 20 .
57 0 4 2500 20 0,05 0,15 2500 20
HOLIDAY
50 0
44
50
Gallo
onthly
in
n
12 Month Floating Tcrtat dlnches
Average Weekly Loading tinche
2500 20
2500 20
2
500 20 0,05 0,15
2500 20 0,05 0,15
2500 20 0,05 0.15
44
her Codes: C-clear, PC -partly cloudy, Cl-cloudy, R-rain, Sn-snow, Sl-sle
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Mail ORIGINAL and TWO
ATTN: Non -Discharge
DENR
Division of Water Dual
1617 Mail Service Cen
RALEIGH, NC 27699-1
20
20
No:
0 04
0.04
0, 04
0.4
26
0,00 #DIV/0!
0.05
0.1953997
#DIVf01
#DIV,r0!
Phone: [phone]
0
4644
enns Gryder
2500
2500
2500
39500
989073 Check Box if ORC Has Changed:
NATURE OF OPERATOR t•s RESPONSIBLE CHA
THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
THE BEST OF MY KNOWLEDGE,
DENR FORM NDAR-1 (52803)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( byinserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements, (Note: if a requirement does not apply to your facility put (NA) in the
compliant box, )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment andfor storage lagoon(s) was not less than the limit(s)
specified in the permit,
Pag
Y,N)
ff the facility is non -compliant, please explain in the space below the reason(s) the facility was not in co ipliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations,"
(Signature o
mittee)*
Iredell - Statesville Schools
(Permittee-Please print or type)
P.O. Box 911
Statesville, NC 28687
Date
)(e,
(Name of Si ning Official -Please p n Pe)
inenaric
(Po • i
704-873-3755
(Phone Number)
1/31,2009
(Permit Exp. Date)
(Permittee Address)
If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B4O506 (b)(2)(0).
DENR FORM NUAR.1 512003)

NON DISCHARGE WASTE ATER MONITORING REPORT
NUMBER:
FACILITY NAME.
ow Monitorin« Point: E luent: ent: �r
Pararrvetr ilonitorinci join
Was There Effluent Flow For T
A T"N» Operator Cf2C
T 24 Trine On a o�
27'
2€3
29
3Q
h Cenerated At This Faci
HRS YrN 1' CALLCNS U
auy tvlanirnu
Monthly Lirrrit
Operator in Responsible Charge (ORC):
Check Box if ORC Has Changed„
Certified Laboratories
Persons) Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mad Service Center
RALEIGH, NC 27699-1617
R.eScdua
G7iorxna
MONTH;
e Water (SW): d W CodelNa
Fecal
Cofiform
Coo -metric
H3-i5E TOS
Grade.
ORC Certification Number:
(2):
rl/
NATURE OF OPERAT+.R IN RESPONS6£3LE CHAR
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT TE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
Page or
DENR FORM NCMP-1 = 2005

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
1. Does all monitoring data and sampling frequencies meet permit requirements?
If the facility is non -compliant, please explain in the space beiic.',w the reason(s) the facilit,,, was not in cc,,moli .rice
with its permit_ Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s)
taken, Attach additional sheets if necessary
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted 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 knowing vioianions
(SignatureLt
of rmittee)*
/
(Per ee-Please print or type
01202 Arsenic
01022 8ron
00310 6005
01027 C42miw
00916 Caitkon
Date
Parameter Codes:
Con
42 Copper
CO Dissokel Oxygen
r.
ekit
(Name of Sign
er
-Please print or type)
(Position or Title
CN-81,7-754257--
(Phone Number) (Permit Exp.
00630 NOO&NO3
00626NO3
in.iciiise CM -Grease
3', Fecal Ccliform •,".e22,09 PAN i'Plant AvailaCie,!
00940 Chloride 51 e
50060 Grecnne. Intai
009
Rear:10M 7 90
01004 Chromium
7 Maoresu
Mercu
0040C
3273C Phen0s
Ps9hQfli. Tma
00929 Sa6urn
00931 SAI
0074 Su490e
702q5 75S
20012 Tenrcermve
GO 25 TKN
00680 TOC
00530 7 StICSR
10 00S37 00076 7ur9194
30340 COD 01067 Nicked
00545 Selheahle Maher
01092 Zinc
Parameter Code assistance may be obtained by c 11 ng the Water Quality Land ii19blicati3n Unit at [phone].
The monthly average for Fecal Coliform s to be reported as a GEOMETRC mean, Use druid the units designated in he r0rtnq
facIlltyls Dermit for reporting data.
• if sgned by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (hlt2)(D).
DENR FORM N0MR-1

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE„ USE ADDITIONAL PAGES AS NEEDED.
Page
of
PERMIT NUMBER:
FACILITY NAME:
WQ0023511
Woodland Heights Elementary School
Formulas:
MONTH; November
COUNTY:
Daily Loading (inches) [Volume Applied (gallons) x.0.1335 (cubic feet/gallon) x 12 (incheslloot)) I [,area Sprayed (acres) x 43.560 (square feeuacreil
Volume Applied ('gallons) Y [Area Sprayed (acres) x'27,152 (gationsiacre-inch))
Maximum Hourly Loading (inches) - Daily Loading (inches) / [Time irrigated (minutes) / 50 (minutes/hour)]
12 Month Floating Total (inches) •= Sum of this mont'h"s Monmly Loading (inches) and previous 11 month's Mont
Average Weekly Loading (inches) = [Monthly Loading (inches/month) / Number of days kn the month (daysfmonth)
rr'dation Occur At This Facility:
Yes: ® No: © - Yes. Q No: 0
ATHER CONDITION
60
65
22
26
27
28
38
HOLIDAY
HOLIDAY
Did Irrigation Occur On Tilts Field:
FIELD NUMBER: One
AREA SPRAYED (acres):, 1.9
COVER CROP: Natural litter
PER 94 t'i'TD HOURLY RATE
PERMITTED' YEARLY RATE (inches
Volume
A • Iced
Time
rf±ated
Daily
oadi
7 (days
0.4
26
Maximum
Hourly
Loadin
Monthly Loading (inch
OR
YEAR: 2008
IREDELL
ation occur On This Field:
Yes: Q No:,
FIELD NUMBER:( Two
AREA SPRAYED acres : 1.68
COVER CROP: Natural Utter
PERMITTED HOURLY RATE (inches): 0.4
in
26
Maximum
Hourly
Loading
inches
2500 20 0.05 0.15 2500 20 0.05 0.'16
1000 8 0,02 0.15 1000 6 0.02 0.10
2000 16 0.04 0,1 200016 0,04 0.16
2000 16 0.04 0.15 2000 16 ' 004 0.16
2000
2000
2000
2000
2000
2000
2500
16 0.04 0.15 2000 - 0.04 0.16
16 0 04 0.15 2000 6 0,04 0.16
16 0.04 0.15 2000 16 0.04 0.16
16 0.04 0.15
1 0.4 0.15
16 0.04 0.15
20 0.05 . 0.15
2500 20
2500
Average Meekly Loading (Inches)
:odes: C-clear, PC -partly cloudy, CI -cloudy,
n, an -snore, 51-
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
0.0
0.05
0.05
57
0
5
0.15
0.15
0.15
2000 16
2000 16
2000 16
2500 20
2500
2500
2500
2
0.04
0.04
004
0.05
00 0.65
0.16
0,16
0.16
0.16
0.16
0.16
0.16
Dennis Gryder
0.1507958
Phone: [phone]
989073 Check Box if ORC Has Changed:
0
TURE OF OPERATO RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CE IFY THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR•1 (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status;
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements° (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s)specified in the permit
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
Page
Comphattt(VN)
Y
If the facility is non omplient, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary,
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that a/I qualified personnel properly gathered and evaluated the information
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations."
iredell - Statesville Schools
(Permittee-Please print or type)
P 0 Box 911
Statesville, NC 28687
Dirof maintenance
(Position or Title)
704-873-3755
(Phone Number) (Permit Exp. Date)
1/31/2009
(Permittee Address)
• it signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28,0506 (b)(2)(D),
DENR FORM NDAR-1 (5/2003)

PERMIT NUMBER:
FACILITY NAME
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE, USE ADDITIONAL PAGES AS NEEDED.
WQ0023511
Daily Loading lincnesl
Maximum Hourly Loading linchesi
12 Month Floating Total linches
AVOra e Weekly Loading (inches)
DidIrrigation Occur At This Facility:
Yes: E,1 No:
VVoodland Heights Eementary School
MONTH: October
COUNTY:
Page /4 of
e-6
YEAR: 2008
IREDELL
Formulas,
• AnVii.no t'.ganom *. 1336 icultn:', feefiletionC8.1.1 Area Svayed cacres x 43,560 (square l'eettac.Fell OR
Vcourne ikpOe3. i,garions! rlArea Sorayed ,:acre'5) x' 27 152..,,9ag3niiac.,e4r.,:enyj
Cady Loading Onc.nns,,,'7,rne Vngafed 6.,:mrnutes,dnaLr;:r Monthly Loading (inches) Sum of Da Ny •l_oadl:ngs (Lnr.nell
• of ins monch's Montrr,' Loading Ond-vas) and pre..k,,OUS I hioneny Loackng3 Oncnes't
• Monlbly Loading nnonestrnonth r Number of days311327rnn[n (day!./menthij A 7 (daysiweek.)
Irrigation Occur On This Field:
Did Irrigation Occur On This Field:
Yes : 11,„a No: Yes; E
FIELD NUMBER. One FIELD NUMBER:
AREA SPRAYED (acre
ATHER CON 'TIC;
Weather
Cede
Temperature
at
ahOlIcation
(°F)
70
57
hrecipea.
tkm
inches
Storage
Lagoon
Free -boa
feet
5
5
Total Gallonsfiglon fy Loading riches)
COVER CROP:
PERMITTED HOURLY RATE (inches),
PERMtTTEO YEARLY RATE nchest„
Volume
A Ned
gallons
2500
2500
2500
2500
2500
2500
2500
2500
2500
2500
57500
26
Maximum
Time Daily Hourly
o di
inches
0.05
0.05,
0 05
0 05
0 05
0 05
0.05
0,05
20
20
20
20
20
20. 0.05
20 0.05
age ek ding nches 0 2515
er Codes; C-clear, PC -partly cloudy, CI -cloudy, R-rain, Sri -snow, SI-sleet
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Malt ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
FtALEIGH, NC 27699.1617
0,15
0,15
0,15
0,15
0,15
0 15
0.15
0 15
0 15
0 *15
Dennis Gryder
COVER CROP:
PERMITTED HOURLY RATE (inches):
PERMITTED YEARLY RATE Inches:
Volume
A lied
gallons
2500
2500
2500
2500
2500
2500
2500
2500
2500
2500
57500
Check Box if ORC Has Changed:
(SIGNATURE 0 pp,
BY THIS SIGNA
TO THE BEST
Time
Irri ated
minutes
20
20
Daily
Loadin
inches
0.05
0.05
0 05
0 05
0 05
0.05
0 05
0 284442
No:
Two
1.68
Natural litter
OA
26
Maximum
Hourly
Loadin.
inches
0,16
0,16
0 16
0 16
0 16
0.16
0 16
0 16
0 16
0 16
0 16
Phone: [phone]
TOR IN RESPONSIBLE CHAR
CERTIFY THAT THIS REPORT
OWLEDGE
RATE AND COMPLETE
DEN k IV!
r)'. 1 Int r""i0tOL '" r
NDAR (5/2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Yes 1 or N(o) in the appropriate box 1 whether the facility has been compliant
with the following permit requirements (Note gf a requirement cdoe.s not 'apply to your factfity put (NA) in the
compliant box )
1, The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment andfor storage lagoon(s) was not less than the limit(s)
specified in the permit.
Y
If the facility is non -compliant, please explain in the space bOow the reasonts) the facility was not in compance with its
permit, Provide in your explanation the date(s) of the non-cornbkance and describe the corrective actlons• taken. Attach
additiana4 sheets if necessary
centify, under penalty of law. that this document ana. all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information. submitted is, to the best of my knowledge and belief, true, accurate, and
complete, t am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations,"
(Signature of Pe
Date
PermteePease print or type)
P 0 Box 911
Statesviile, NC 28687
(Permittee Address)
(Name o Signing Official -Please print or type
ar.of maintenance
(Position or Title)
704-873-3755
113112009
(Phone Number) (Permit Exp. Date)
*if signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2E3,0506. (b)(2)(D).
DENR FORM NOAR-1 (512003)

NON DISCHARGE WASTEWATER MONITORING REPORT
FACILITY NAME:
Fiow Monitorin Point Effluent:
Parameter Monitoring Point: Effluent:
SuaC
Was There Effluent Flow For This Month Generat d At This Facility:
YaS
0051 0
14
aporetor
Arrtva
'rime
2400
C.:MON
Operator
Time Cr
Sice
HRS
Average
Daly Maximum
Daily Minimum
Monthly Limit(s)
Composite (C) I Grab (G)
petty Rate
into
Treatment
Systa.rn
Influent;
00400 50060 00310
Residtta
Chloritte
UNMS U341
Operator in Responsible Charge (ORC):
Check Box if ORC Has Changed: [2:
Certified Laboratories
Person(sI Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
Page /,
MONTH: (';')C-Yre;667/1--- YEAR:
COUNTY:
Fecai
Coliform
(.'‘aea-metnc-
Nie a n'}
PIDGML
Grade:
ORC Certification Number:
12):
, t
--(SIGNATURE OF QPERAR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE
DENR FORN,1 NDL,1i7.- ,

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question;
1. Does all monitoring data and sampling frequencies meet permit requirements?
If the facility is non.compliant, please explain in the space beicii,v :he reason si the facility was not in compliance
i,vith its permit Provide in your explanation the dates of the non-compliance and describe the correctisiie
taken Attach additional sheets if necessary actrs
Compliant(Y,N)
"1 ,centify, under penatty of law, that this document and all attachments Were prepared under my direction or
supervision in accordance.wth a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, trueaccurate, and compete t am aware that there are significant penalties for submitting
false information, including the possibility of fines and irriprisionment for knowing vicfations
(Permittee-P ease pri
(Pe
Address
'02 Arseree
01022 Boron
06310 3535
01027 Cadrreum
00916 C 41C11_10:7
06940 CnicOde
50060 Cetanne,
Re 501eal
01034 Cer0fr eye
f.
Parameter ode :
31504 C5Worre Taw
4 CONItiC6VitY
0 042 Copper
00300 Cess5leee Oxygen
15 rectal Ceeforre
>5 ea
00927 Mageeseen
71900 Mercur,..
00610 NH.3a.siN
00343 COD
011367 Nick
(Name o
4:
(Position or Title)
-70-
(Phone Numbe
00600 tettrogen 7Peal
00630 N502NO3
00620 NO3
30530 025035e42e
Ve030. PAN left eNal5a39ei
22730 Peenois
02565 05,0505e0res Total
.7570.337 PC,f CISSWI
OG 45 Setheable Mailer
29 55,05.0n
09931 &AR
00745 Sett15e
70205 TE.t°
00010 T ern perat ere
00525 TKN
066E0 70C
00530 TSSITSR
09092 205.5
.7tL,
(Permit Exp. Date)
Parameter Code assistance may be obtarred calrg the Water Quaiity Land .Appli.cat[or- Umt a! ,:919) 7'156189
facthry's permit for repartee data
The montbly average for Fecal Cofiforrn to be reported as. a GEOMETRIC mean Use oNy ups designated In zbe rebor!boi
• If signed by other than the perrnittee„ dele aIlon of signatory authority must be on file with the state per 15A NCAC 2E3.0506 ib(2)(0).
C057.7eR. F00) FR1.3 .1,40,,',1r

NON DISCHARGE
ATER MONITORING REPORT
PERMIT NUMBER: MONT � ., a 411H YEAR
FACILITY NAME:
rp�ra�z�a
Arrovat
Time
24O1
rruent: it riuet'at:
onitoran Pornt: Effluent. Intiuent.
fftuent F?or+v For T s Month Generated At This Facil
O pera9tar
Time On
Site
Average
ally Maximu
ails Minim
Gallp Rate
CRC ;Fi.owl rnto
on Treatment
COM
Operator in Responsible Charge (ORC
Check Box if ORC Has Changed:
Certified Leboratories
Person1s) Catiecting Sarnples.
Mail ORIGINAL and TWO COPIES to:
DENR
Div9sion of Water Quality
ATTN: information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
F �a�au
Calilorm
iGeo,PTICIPC
Grad
ORC Certification Number:
2l
aa
ATURE OF OPERATOR IN R SPON fBLE CHARGEI
BY THIS SIGNATURE, I CERTIF'(frHAT THIS REPORT IS ACCURATE
ANO COMPLETE TO THE BEST OF MY KNOWLEDGE_
COUNTY:
Code/Name:
Phone: iL.3Lt
DENR FORM NDMR..-t =,'7_2 f.f=_.r

NON DISCHARGE WASTEWATER MONITORING REPORT
F "ItStatus:
Please answer the following question:
1. Does all monitoring data and sampling frequencies meet permit requirements?
If the facility is non -compliant, please explain ri the space below the reasoms, the facility W35 not In comp.arce
,v,th its permit Provide 17 your explarat'on the. dates) ofthe non-compoance and desmbe the correctrie actron(s.
taken. Attach adcticral sheets t necessary
"I certify, under penalty of law, that !hos document and all attachments were prepared under my directron
or
supervIslon in accordance with a system designed to assure that all quae,d personnel properly gathered and
evaluated the Informafton submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
know]edge and belleftrue, accurate, and ct.'omplete. am aware that there are sgnificarit penalties for submitting
false mfcvmation, ncluding the posstility of fires and imprisonment for knowing violations
(Per e -Please print or typ
/0-1, _)'91-19V64,7
(Permittee Addr ss
010C2 ArsenvA
022 Boron
0:1310 9005
ParameterCodes:
3 t NA Cohlon Ti
00094. Conductivtly
04.7.42 Copper
Cadfrov30,30C 0,sd 3riger,
i
00916 0aoz.:,,,4r; 30516 Peca4
R0940 Conde
500R0 Chionne, ToIM
Pesduaa
001:34 Otlfor.,surn
0.1'05 Lead
00927 magne.sturn
10340 coo
900, Pttert.'L.f.),,t
0",'067 Ntcoi.
Zr
(Name of Sng
(Position or Title)
TX14 Q?
(Phone Number)
Narogem 75*0*5
0063C NO2&403
CC620 NO3
005.56' OtIRRrease
30309 PAN ;"PfarT. Availan
ial-Please print or type
00929 Sq.&
0093 SAN
00745 Sulfide
Doc to Tem!nerame
034 CC
32.730 Phenols
03355 Phosphon,5 tratai
00625 TKN
00380 IOC
dosdo rststdse
00930 Potass,t,Ari 0505 Tur'ciday
053545 Malter 01M92 LIR;
(Permit Exp. Date
Parameter Cade assistance M aioeobtaired by calling the Wate," Quality Land Appiitt...atiOrt unit at ;919.) 715-6
The monthly average. for Fecai Coltforns is to se reported as a GEOMETRK," mean Use orty the units designatea m the tggtarttna
taptityse oermrt ferhoporturtrd data.
•if signed by other than the permittee, deleg*3ion at s*gntory authordy must be an file with the state per 15A NCAO 26.0506 (b)(2)(13,)
DENR., FORM N0.M.R.1 1 1.200.5,..

NON -DISCHARGE APF LIGATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TVVO APPLICATION FIELDS PER PAGE, USE ADDITIONAL PAGES AS NEEDED.
riIiiIBi-
; WQ0023511 MONTH: September
FACILITY NAME.
Daily Loading (inches)
Maxlrttum Hourly Loading (inches)
12 Month Floating Total (inches}
Awecaa t eeidv Loadino tinche
cur At Thi
Temper-ature
at
appllcalion
(°FI
R
CL 64
C f 68
C 65
y
No:
ntfaly Loatht g
FI
T
Woodland Heights Be entary Sohcoi
Formulas:
-- L30.1nroe Apptled:galenst s 0 3336 !'cLib.3.`1etl11arl0r1, Q 12 5313,neorto533i `Akrea :1
acearrte Applied (deeded, r = ,ree Sprayed iderest n27 152 ,;xa u. siec e ,*cn'.
Daly Leedrmg. (inCne'^s i .ire rrrelaten ;s'nrsule.40 t,rv1 t 1.o?ti,rles;nersn
Sum Of OM rnei?tr's Marinly Ldadse.g Anches) and provons 1 . mrar*tn s Mon7rity ti�
Averalge 1tsPeekly Loading (inch
er Codes: C•clear, PC -partly cloudy,
at
ur On T
s Fiel
FIELD NUMBER
AREA SPRAYED (acres):
COVER CROP:
PERMITTED HOURLY RAT
PERMITTED YEARLY RAT
Volume
A. plied
gallons
Time
Irriated
inutes
HOLIDAY
2500 20
2500 20
2500 2
2500 20
250C 20
2500 20
2500
2500
2500
2500 20
No:
Natural it
Daily
Loadin
inches
COUNTY:
YEAR: 2006
IREDELL
w ai`ed. 4Cees., 3 42 5,60 113Ed no "et9papre„e
0,4
26
rlaximu
Hourly
Loadin
0,05 0 15
0 05 0.15
0,15
0.1' 5
0 15
0.05 10.15
0.05
0.05
0.05 0.15
0146854
dy, R.rain, Sn-5nawa, Sl-sleet
Spray Irrigation Operator in Responsible Charge (ORCi:
ORC Certification Nu
Mali ORIGINAL and TWO C©PIE
ATTN: 'Non -Discharge Cornp$i n
rP
DENR
Division of Water Qualityr
1617 Mail Service Center
RALEIGH, NC 27699.1617
OR
Monthly Loading )inches) <= sum of Y."it y _ ,ad nys .,.:An,$)
Did
nrs Gryder
ation Occur On This Fieid
N
FIELD NUMBER
AREA SPRAYED (acres')
COVER CROP. Natural Iitte
PERMITTED HOURLY RATE (tnctre )
FERMITTED YEARLY RATE °inches :I
Volume
A
tlallos't5
2500
2500 20
2500
2500
2500 20
969073. Check Box if ORC Has Changed:
NATURE OF OPERATOR IN R
BY THIS S>GNATURE. I CERTIFY AT
TO THE BEST OF MY KNOWLEDGE.
Daily
aadin
ax mul
Hourly
ctadin
inches
0.05 0.16
Phone. 704-8
E CHARGE(
HIS FIEPORT IS ACCURATE AND
DENR ,13:2023:

NON-D1SCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate by 'inserting Y(es) or N(o). in the appropriate box J whether the facility has been compliant
with the .following permit requ rements (iVot.e. if 5. requhroment does not apply to your facility ,out (NA) in The
compliant box,
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit,
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon( not less than the limit(s)
specified in the permit.
If the facility s non -compliant, please explain in the space below the reason(s) the facility was not in compliance witn its
permit, Provide in your explanation theldate(s, o ho non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"I certify, under penalty of iaw, that this document and ail attachments were prepared under rny direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted, Based on my inquiry of the person or persons villa manage the system, or those persons directly responsible
for gathering the riforrnation, the information submitted is, to the test 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 knowing violations."
Iredeil Statesville Soboo;s
(Permittee-Please print or type)
P 0 Box 911
Statesville, NC 29687
(Permittee Address)
lejefinfrt
(Name of Sig
4//e
ng Official -Please print or type)
al of maintenanCe
(Position or Title)
704-873-3755
(Phone Number) (Permit Exp. Date)
If signed by other than the permittee, delegation bf signatory authority must be on file with the state per 15A NCAC 2E3.0506 Ihg2g0,.
DPNR .551IC01.

,Ftcw
Para ter Mom
T NUMBER:
FACILIrt" NAME.
NON DISCHARGE WASTEWATER MONITORING REPORT
Page.
MONTH:LX EAR
COLN
tonngPo4it: EfflLent.. nfuent
iSurface Water (SW):
Was Ther Effluentlow Fr Thi h GnPr3tedAtYhs Facility: Yes: : ' No.
ao5O a i 500 1 0 G r 0 ('5 31Y5
--.4.-
Operatnel
R Arrees4 r Gate/ Rate ff
r rrPross Man , r r ecM i
7 Me OperatoCRC
2400. anise on C
an Tresement r Resnitiar SOD-5 rl er1r:LefTitne
Croak r• Sae r Gael s System r Cnrorine r 2r,r,C NRSOS I Tr3S 1 Means. r
a N MI S r'GALLONS r rerrreL ,r MaL r Mal, ! reG,L rearOM r
Operator in Responsible Charge (ORC::, „
Check Box if ORC Has Changed.
Certified Laboratories
Person(s:i Collecting Samples.:
Maii ORIGINAL and TWO COPIES to
OENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
ORC Crtficaofl
6- -
Grade:
yV Code/Name
Phone-
---TSTr3NATURE OF OPERATOR J SPONSLE CHARGE)
BY THIS SIGNATURE, CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE,
preNR FORM NOMR,

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
1. Does all monitoring data and sampling frequencies e permit requirements?
if the faciiity is non -compliant. cease exicrain in the space beiciw the reasons i the facty was rict ir, ch.impliandre
whhhi its ,perimir Provde, r your expiaration the datershj of the noh-dompiance and ,Jesdrite the correctrye action
zaken„Attach adotionai sheets if neoessan,
certify, er penalty of Jaw, that th3s document and attachments were prepared Jrici,er mv directkon or
supervision in acicunri'iii'-'nfre iAnth a system designed to assure that all qualified pet -sonnet properly gathered and
evaluated the informat;on suc)i-hiPteid Based on my inqufry of the person or persons who manage the
those persons directly responsible for gatneHitig the informaticsin, the, Tiformation submitted is t.-."; `i,he best pf mv
knowiedge and iceiief toe accurate and dicirridiate am aware that mere are significi,:nz periaitizihr, or si pirhttinig
faise inform,ation, inciuding the possly of fines and imprisorimil. ;'7-4 'd!Oiat.!OnS
(Permittee-Please print Or 7.y pe
1/4---
(Permittee Addres)
1..)ate
6,14c4i5
Paramete
d es:
hyt, 9- /2-e P
(Name of Signin Official-P(ease print or type)
ykliE ocx:
(Position or Title)
Phone Number)
91002 Arsern3
230.40,
013310 33305
31-22" 334214.34,434
4337;g1•3 73944221.
2139431 373-3002e
01051 Le .4
3'304 Coalorrn, '17m"a3
036100 .0f"-33 r1, o al
3433394 Cor30113cTi34y 0,013133 NC25N1313
C4:2 ,734)Der
-3 7620 NO3
33033 :,s42P3e217.333632.3 3255(5 734-3rease
. -
00929 3230[40,
00g34 349
lainde
,,3.3Z95 TOS
.31516 c4 73.:00.31, I 3'439 Pru A49 007J emparavana
013420 ,3334 00325 7145
100360 Z3:333130. 734ai
R3-1111311L34,-
01324 "31-4044402 .
043342 Coo
49-211 %Tacna:4'434n
32'30 P3e.32-31s
aces° rOC
7'1322 :",let33.3..,
037610 r33P2as3i
01067 Mc:Kai
99655 P0c.s90os s 147533 757179342
21793' Po 42,s43 3907131 773r2423
23.3545 S2,e,Ma953 01002 Zinc
Parameter lode asssance 77a7 59=atnet9 caling the Vliaer- Qualfty Land Appflcavcr, Unit at 715-513';
The monthly average for Fecai Cciliform is to be reporiteiJ as a GEOMETRI,C, theari, bjse 079JO9 arihs desicriated 79the 7'er:chin-hi
permit tor recortni4 data,
7 if signed by other than the permittee, d&e.gation of s;goatory authonty crust be on fiie with the state per 15A NCAC. 29..0506 i'b)(2i'D:r.
r:1:-"NR FOPMN332.1

U: I°ti4bbibL1+4L1
PERMIT NUMBER:
FACILITY NAME.
fJAOIy LaufIna polo')
AEnxlonum Hourly Leaf©lap (1nchep)
12 bloom %Alling Trod cloches)
Armege What Loading nchoo
D1efirtuoion occur -1 This AO 4y:
Yss; Pia:
NON -DISCI !ARGE APPLICATION REPORT
SPRAY IRIATIN SITE(S)
THERE ARE TWO APPLICATIONN FIELDS PER PAGp U$ Aoc m©NAL PAGES AS NEEDED,.
MONTH;
Formulas:
• mourr+r nppr,Aj (weans) K 0.131R teubl4 feeemmient rt 12 frr:..�, ..,,
VOI11Rm Accoo1PAslkn!l! W 9
t� PreYe©S•cresl r 37,te,2 {pcannereon
• Do y I 000ng {Warx1Os) (time Ir5oeind fro4.1u1eel fCO fs inotooftxr)I
Sum of 110 tre+Kh°e Marotrsy Lrnuplip klcl'ten AM; hlarr%1rAf 44ndOng (Inchnnl
• [Men , Lc�oon f : Cm11,t, m 11 'ref Mnr,Ehhr taal6npa t.Ypcfmn)
C '!f(c'issnn<,�tnl ! Ntmetber of a A ut ton mCvtt
Ole stfon Occur On h R Feld:
Yes, No:
n
Spray irrigation Operator in Responsible Charge (QRC);
ORO Certification Number:
Rdail' ORIQfNAL and Two COPIES to:
ATTN: N©n•Dlscharge Compliance Unit
DENR
Division of Water Qu& Iy
1617 Mali Service Center
RALEIGH, NC 27699-1617
9
Maximum
Hourly
L©Adln
ftls Gre
COUNTY:
)k Box ifORC Has Changed:
F3Y T
TO THE tiFST OF MY KNOWt,EDOf ,,
Phone:
• Mg, m oe+lr Laaeh)
Nature I litter
704-873.3755
COMPLETE
DENR FORM NDAR•I (50aa3)
0.4

IiH1NItNHNet
b 1`5-:,4 (`D
I U : (U4bb:5bk141O
NGN•DISCNARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
by h'tsortinq Y(ea) or N(ct) in the approprte box ) whether the facility has been azmulient,
permit requirements, (Note, if a rgqu(n9 yrenr dogs nor apply to your fncikfy put (NA) in the
1. The application rate(e) did not exceed the limit(s) specified In the permit.
Z. Adequate nleaeuree were takers to prevent wastewater runoff from the sfts(r!).
3. A cult able vegetative cover wax maintained an the steels) In accordance with the permit,
4, All buffer zone* as specified in the permit %We miIntainsd during each application,
5. The freeboard In the treatment anther storage tegoon(s) wths not fees than the limit(s)
specified in the permit.
If the facility Is U inS please eq
permit Provide In your explanation the dat
additional sheets ff necessary
accordance with e s
submitted, Based on my inqui.,,
forgathering the information, the in._m„u,w„,,.
complete, I am aware that there are signifIcen
and imprisonment far knowing violations."
Pam`
apace below the reason(a) the facility was not In compliance with its
nran•cornpritanoe and describe the corrective action(s) taken. Attach
d ail eriachrnents were prepared unM
at eh qua heed personnel properly, pathereQ
or persons who menage the system, er those
ubrnffted Is, to the best of my knowledge and
peneities for submitting false Information, fncl
Qw
y direction or aupervislon in.
nd evaluated the information
one directly responsible
true, accurate, and
possibility of fines
704,-873'-37
(Phone Number)
• if signed by other than the permit/es, delegation of srgnatory Authority must be on file Wei the mete par 15A SICAC Z8„Botha (b){2}(0),
©ENR FORM NCAR•1 (Sr2003)

PERMIT NUERMN
FACtITY NAME:
There Effluent Flo
Daily Maximum
Lally Minimum
Monthly Limit(s)
NON SCHARGE WASTEWATER MONITORING REPORT
Effluent Influent:
This Month Generated At Tcili
Da,ly Rae,
into
Operator Operator in Responsible Charge (ORC):
Check Box if CRC Has Changed.
Certified Laboratories (1
Persontsl Collecting Samples
Mail ORIGINAL and TWO COPIES to
OENR
Division of Water Quality
ATTN- Information Processing Unit
16t7 Mail Service Center
RALE1GHa NC 2.7699-1617
MONTH �� ) (
YEAR.
COUNTY: 17Ccr1C;
ce Water iSW 1 SW Cod&Name-.
ORC Certification Number:
E OF T% tN RESPONSIBLE CHARGE)
E3Y THIS SIGNATURE, I CERTIFY THAT THIS REPORT 15 ACCURATE
ANC) COMPLETE TO THE BEST OF MY KNOWLEDGE,

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
1, Does ail monitoring data and sampling frequencies meet permit requirements?
If the facility is non -compliant, please e.xplain in the space 'below the reason: the facthty was not in cornphance
w,th its permit. Provide tn your explarauon the date(s) of the non-compliance and desonbe the corrective action(3
taken Attach additional sheets if necessary
oertify, under pe.naity of law, that this document and all attachments were prepared under my dire.ctioh
or
supecvislon in accordance \NNW a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted Based on my lhquiry of the person or persons vo rnar.age the system, cr
those persons directlyresbonsibe for gathering the informatlon, the information submitted is, to the best of my
kncwiedge ard bellef, true accurate, and compLete am aware that there are signIficant penalties for subrmttmg
false information, „noluding the possibty of fines and imphsonment for known g vlolatlons
(Permittee-Please print or
lq 5,41:sLc
Ak,
(Permi(tee Addriess)
Parameter odes.
N-0
of Sqni q Qfficiai-Please print or type)
(Position or Title)
(Phone Number)
01302 !Arsenic
0.1022 8sran
005
0C940 Chnie
- 2,222
Res.chlai
31504 023-l4orm, TlaJ
00094 Gi
01.2142 220.pc..er
300 Otsscsvess arygen
3166 19c41 2222.10arrn
.30.51 Lead
80920 Magrsessen
71900 %lemur?
00630 NiVcIen, Toral
009271 ScaiLm
C.0630 N0213.003
00
20
0.22556 01407r-ease
00911 SAR
00.74:5
2C'295 TC.S.
',440c.r, PAN 'P'ant 49a7acle1 .20010 Iem9e2.30re
0041°O.
32203 2227eripis
22655
00925 TKN
0058C. 300
30533 399035171
2,2734 Chromisrn
0340 COE.'
0.16 107434$0
01067 NicKei
CCTV Pctassiurn
0.003 Tatectily
00545 3eWeate. May.er 0002 Zires
(Permit Exp,Date)
Parameter Cade assistance may be cared by calling the Viiater Qsaiity. Land Appiication Unit at i:919:i 715.-6139
The monthly average for Fecal C.:olitorcri s fn., ne "epor-t-ed as a C9EOMETP,[0. mean. lvise ority the U rots designated in he "cootn0
.er. Ht. for
if sigred by other than the permitteedeegaton of signatory authority must be on file withthe ab4 par 15A NCAC 28.0506 .(b)(21iD,
DR NP. FORM NDMR1 11112C95i.

NON DISCHARGE WASTEWATER MONITORING REPORT
T t Ltt+FLER:
FACilTY NAME:
Flow Moatraring Point: Effluent: Inftent:
Pa rtue r Monit©ring Point: Effiuent_ _ InFluent:
Nas There Effkient FScw For This Month Generated At This Faciii
pera'a s'
Average
ty Maximum
i1y Mwnimum
lthly Limit(s)
Dan? Rate
t,Ftowt N t7
Treatment
posite (C) f Grab (G)
Operator in Responsible Charge (ORC):
Check Box if ORC Has Changed:
Certified Laboratories (1 J_„,1t5(,,
Person(s; Collecting Samples
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RA.LEIGH, NC 27699-1617
MONTH. l N a EAR:
COUNTY
ce Code/Name:
Fecal
Grade:
Number:
.,NATURE JE LiPERATO INRESPONSIBLECHARGE;(
BY THIS SIGNATURE„ I CERTIFY THAT THIS REPORT i5 ACCURA T E,
AND COMPLETE TO THE BEST OF MY KNOWLEDGE,
0E\ Fe F t 'Ut :-' 2Z05,

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
1. Does all monitoring data and sampling frequencies meet permit requirements?
f the facd]ty is non -compliant, please explain in the space be:cw he reason(s: the faciiiity 'i,vas not n complance
vth ts perm q Provide n your explaraton the datey3i of the nor -compliance and descnce the correctio.e acticrms
taken Attach additional sheets if necessary
detfy. LIrider penalty of law, that this document and all attachments were prepared under my direction or
spe.n.on in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the Information submitted, Based on my Inquiry of the person or persons who manage the system. or
those persons directly responsible for gathering the information, the informat[or subintted s to the best ipf myi
knowle.dge and P6ieif, true, accurate, and ciomplete I am aware that there, are sigroficiant penalties for submittIng
false infcrmaton, tricuding the possibllity of fines and imprisonment for 'knowing iyiloators,"
ermitteer
(Permi ee-Please print or type
/fc:477 ,
(Perrnittee Addrie
Date
A cols
Parameter Codes:
(Position or Ti
70-14
(Phone Number)
icial-Please print or type)
010( 2 Arsemc
0,022 2,t)ton
504 ccgiform. TaJ
00064 SnrinkAnggy
3070 90025 0 042-3 C006ner
227027, CadmAnnOOOO Degsmgen Orogen
00916 Sakcarm
0C94O Cnicncle,
g 162 nnual 707,Mgr,
07 051 ilugan
00600 NOT6c;e.n. 14 30929 Sod03m
0030 NO2&NO3 00931 SAP
00820 NO3
00556 003rgage
n,12309 P
00400 6H
i'ar4 AV agaMer,
ce3 ,Thicmcg Tomi
Pegegual
nog27 mannngurm
.0,0e, Mercury
32720 sccenrS6
00745 Surficle
70295 7255
000,0 Temperature
30525 Tk7g
cciaao 77302
00650 Pcr,766303c0A, Trc65 00530 TSSI7SP
00304 Cmgmum
Cei37,0 NH3a6N
00007
00340 SOO
alC67 N grAel
lurvl 70075 T05n55
30543 Sergegrie matter 01092 7016.
(Permit Exp. Date)
Parameter Code assi.stance may be octa,ned by calling the v'-iaer Ouarty Lan d.,Apphcardor firm at 919:, 715-513?,
rae montniy average for Fecal Co[iform pe reported as a GEOMETRl0 mear-;U .orhei the Units desiqriateiti in the reQcntiint;
ty's permit 077 reportrq data
• if siGiried by other than the permittee, d eabon af signatary authorty must be on fie with the state per 1.5A NICAC: 2E3,0535
DENR FOFSM NOM:R-1 01%20,0,5,

b IdUI'N: 1bb MH1N I bNHNUt
PERMIT NUMBER;
FACILITY NAME:
L14 - b
I U.: (Oqbb,JbLl'li
NON -DISCHARGE APPLICATION REPORT
SPRAY THERE ARE TWO APPLICATION FIELDS PER PAGE, IRRIGATION USE ADD@TIONAL PAGES AS NEEDED.
0
dry School
Glally LcMAt (Inch**, , Formulae:
I ik'hfums A♦7 arld Naia1'on8 M i} 13la f ,a Iry Von) , 12 (,nchommalli IAren 9 PraP•d ("M1e1k] x 43,602 i1194,0e raaVeenrl] OR
Maximum W Volume rVoked (ca+w rtnl 6 Et6Yax l @ ] a 27,152 f,aattoniYxro.Inch71
Y Lwaifnp (Inches) c Davy toadhg Ihlcra.7 r rims tmpoml InirwneaS ! 5a fmmufaaa,m,w)I
12 IMai ii Fr.rlttrg Toted (@ncI1.K] Awn a rut etc. ^a Mony,1Y L k1 Icnc,w) and prwleas ° t mcMlre Monet.Monthly Ay S11'aat, m Ir�SdFi ,... Y Cce�nnr, ri�n,�. Loeding {Inzllla�'} 'sum of Nov ry4+p► maim)
ItrddA�e'
MONTH: Jul
COUNTY:
IRE DEL L
2006
WEATHER CONC
a Preclplub
rN
Spray irrigation Operator In Responsible Charge (ORC):
ORC Certification Number:..
Mail ORIGINAL anti TWO COPIES too
ATTN: NomDiecharpe Compliant© Unit
DENR
Division of Water Quality
1817 Mall Service Canter
RALEIGH, NC'27698.16t7
FIELD IMBER:
AREA SPRAYED (acres):
COVER CROP:
PERMITTED HCIN tII
PERMITTED YEAR
7 CltNrck Box If ORC Has Clyan@Icd:
A f21 rIF OPERA
BY THIS SIGNATURE, I CERTIFI! T 1 rrls R SpglT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
Phalle: 734473-3755
DENR Ft

S
Please indicate ( by in ling Y(s) or N(p) in the appropriate box ) whether the facility has been gatneulat_ corno#ant box,
with the following permit requirements: (NOW d a requirement does not app4, fo your facility put (NA) in the
1. The application rattly's) dld not exceed the errata) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from MG site(s),
3. A suitable vegetative cover was rnaintsined on the site(a) in accordance with the permIt.
4. Ali buffer zones as speclriod le the permit were maintained during each application.
5. The freeboard tn the treatment andfor storage lagoonwas not lees than the timit(s)
specified In the permit.
tf the facility is
permit Provide tn ur xp
additional sheets if necesse
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SIT(S)
please explain In the space below the reason(s) the faciflty was not in compliance with its
tin the dete(s) or the non-compliance and describe the corrective ection(s) taken. Attach
cartifYi under Penaof IRV,, that this document and all attachments were prepared under my dinsction or supervision iI.
n
accordance With a system designed to assure that nil qualified personpei properly gathered and evaluated the Inform °
submkted, BaSed on my inquiry of the person or persons who manage the system, or those persons directly responsibfe
for gathering the information, the information submitted is, to tha bast of my knowledge and belief, true, accurate, end
and imprisonment for knowing violations."
complete, arn aware that there are significant penalties for submitting felse information, including the possibility of fines
704-873-37,55
(Phone Number)
'" ft stood by ether than the pernIftmo, delegation of olgnatory ainnorIty moot be on filo wftn ftko state per 15A NCAC 2€1„C508 0)12)44
it2oo9
EXP. Date)
eStift FORM WAR-1 (612001)

FROM:ISS MRINTENANCE
,77
Mat
7047873-5475 TO:7046636040 P.001/005
IREDELL-STATESVILLE
ADMINISTRATIVE ANNEX
1147 SALISBURY ROAD
STATESVILLE NC 29677
704-873-3755
704-873-5475
ema:parhallptss..k12.nc.us

PERMIT NUMBER
FACILITY NAME; ,
NON DISCHARGE WASTEWATER MONITORING REPORT
Pa 343
MONH1YEAR,
UN TY:
'
.F3ow • n Point: E uent, n uenr: ;
..; .
Prmeter Montonnont: ue fnfluenInfluent rf.,,ac' r iSW T 'CodeiName
. _
Was ThereEffiuent Pow For Ts Monthd At T is Facility'. Yes: No:
3
Operator I
ArrwAI I
Time i Operator i ORC 1
.2400 rope art 1 on
S,IIHT I HRS I irsN
„0.
)
Average
Daily Maxrnijni
Daily Minimum
Morthv • r
posite
Grab
Gaily Page
into
TreaNinert
aos,duai
CrOorme ,
Piroio
UNIT'S UG.a.
Operator n Responsible Charge (ORCi
Check Box if ORC Has Changed:
Certified Laboratories (1): (4-
Person(s) Coilecting Sampies:
Mail ORIGINAL and TWO COPIES to:
DENR
Division. of Water Cluaiity
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
00610 i ,C53 36I5
Foolk
C'oProrre
800,5 (-Irto.rrten
I NH4 TSS NreanS
Mat. mG3L MGL )ML
Grade,
ORC Cerfatori Number
+12
- fin.cnc: n
Phone
IGNATURE OF OPERATON RESPONSIBLE CHARGE)
BY THIS SIGNATURE, 4 CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MO KNOWLEDGE.
oEN.P, FoRm NDMR-1. 200'5,

NON DISCHARGE WASTEWATER MONITORING REPORT
Page 44IM
Facility Status:
Please answer the following question:
Compliant 'Y
1, Does all monitoring data and sampling frequencies meet permit requirements?
if the facIl[ty. vs non -co ant, piease exprarn the space beic:,,,v the feasomis., the fachty was nct r compHarce
=t'h its permit, Pr de n your expraration .the date(s of the hon-compkance and ,describe the (30rrec,,tiu,e acton(s)
taken. Attaer ad6tIona sheets t ne.cessar!
"1 uruier penalty of law that this iccumer,t and :311 attachments Were 2reparad ..ihde.r d rectl.cn ;3r
pen or in accordance 'With a system ds jred to assure t-at al,,uaotied onn pop1 jaiC ea ad
evaluated the information submitted Based on my inquiry of the person or persons wno manage the syste.m, or
those persons threctly re.sponsible for Jeeririg the r-Iformatior the informarJon Sticmitted is, id the best of my
knowjedge and Pellet' true accurate and comp ete am aware that there are slghtfluart penaltes for s,,UrruttIng
fa!se informancr, Including the possib,kty of Fines and imprsorment for krowog plat[os
/
(Signatu of P
Permittee-Please print or type
Permittee Addre
e of Sgrvrig Official -Please print or type)
(PostiOn or Title)
(Phone Number (Permit Exp. Date)
Parameter Codes
0 Z A r%elatc
CbC'22 '9,9029
903 t 0 30075
0-7227 badrbiam
00915 Caicium
000$40). ON00-de
77d0c rade TN a
edde90- 3333
1 024 70 daarraurr
Canda0 00C
.1994 0,99fortn. To a
04.2
01067 Neeke.
00609 Nttr-99-eb.
N-02.&.NO3
OCKK20 NO0
00555 07,09,9ase
00929 So.."..burn
0927 SA
20745 0=29191e
7:2`295 Tps
4,21339 PAN tPtz343„99 ad able) C9)010 Tam.9e9b3309
30.4.00 Ce62,25 TKN
32'90 :7-7b9990
006E59 b99.9sbnoNs, "T79aL
00545 Se09.babNI Mare!
6ec, 3300
7030 "rssrrs9
.3•!092 Z)00
winnommouimanmowirrenem.
Pararrietiar Code 3SSbstance hilay3 )red cailing the '4`13ter Qualit'y jrLd. Unit at 9'1•9"i 71 5-61 9
The average for Fecal Coiifour ,5 te "eporte,J as a GEOMETRIC rrear Use ors1;-r's?. unt-sslessqrateci !r the rec:,ortinc,.
facdity's permit for reoCtling data
if signed by other than the perrnittee, deegation of signatory authonty r.1-tust be on file with the state per 15A NCAC .25,0506 (b)(2)(0).
L:g:NOR — ';13cs,

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED,
WQ0023511
Woodland Heights Elementary School
MONTH:
June YEAR:
COUNTY IREDELL
2008
Formulas:
niatome apoiten .(ganOnS% [[":336 un.[Pic teet[gall!OP:),K Onotesiloos); f (Ares [Sprayed acres) [g.4:t,56[(3 tsguare taetfacre)1 OR
Volume Applied (gai[ors [[ [Area Serayeo i[ar,res) 27,1S2 [!gai[onsfacovonclul
Dal y Loaning Oncnes;,,[ Firne [[osgatne Minutes) 60 ',,mmitesihoUr)1 Monthly Loading (inches) - Sum of Dr i'y Loadings [Onores
- Sum of nun months rttoninty:Lading OnOnes[1, and proocus trontto's Montnis, Loadings Onunes)
Okla-0[1y Loading (Mt:hes/tn.w51 nornUet of days tri the month (days/Month)] .* 7 tdayslweekt
PERMIT NUMBER.:
FACILITY NAME:
Daily Loading (inches)
Maximum Hourly Loading (inches)
12 Month Floating Total (inches)
Avera Weeky Loading
Did Irrigation Occur At This Facitity:
Yes: E No:
WEATHER CONDITIONS
ea her
Code
Ternper-atu
al
application
Precipi
tiOn
Average Weekly Loading (inches)
Cod
Did Irrigation Occur On Thls Field:
Yes: 2 No.
FIELD NUMBER:
COVER CROP:
PERMITTED HOURLY RATE (inches):
PERMITTED YEARLY RATE inches
Volume
A Iled
gallons
Time
Irri • ated
4787 60
1532 20
1835
1827
25626
Daily
Loadin
Maximum
Hourly
Loadin
0 03 0 09
Did lrrrgation Occur On This Field:
Yes: r2 No:
HELD NUMBER:
AREA SPRAYED acres :
COVER CROP:
PERMITTED HOURLY RATE (inches):
PERMITTED YEARLY RATE inches:
Volume
A lied
gallons
4787
1532 20
Time
Irri ated
Daily
Loadin
0 04
riummitaracium asamaimumin
rt-siwom.- wow- -0 ma mummen
111111111.1111■1111111111111111111111111111111111
II ill INNIIIIIIIIIINNI111111
1111111111111111111111111111111111111111
111111111111111111111•1111111
Prn""Emi41111111111111111111
111111111111=1.111111.11111111111111111111111111111M
0 04 0 12
IMO
INN
Maximum
Hourly
Loadin
ly Cloudy, C - udy, R-rain, Sn- SI-s
Spray Irrigation Operator in Responsible Charge lORC}:
QRC Certification Number:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
0 1158254
0 11
Dennis Gryder
5452
25626
073 Check Box if ORC Has Ch ged:El
0,04
0.130993
41forrnaW)r, 1-1''rocessing Un4
DWOlBOG
(SIGNATURE OF OPERATOR IN RE0NSiSLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE,
DENH FORM NOAR-1 (512003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by insert g Y(s) or N(o) in the appropr te box ) whether the facility has been compliant
with the following permit requirements(Note if a requirement does not apply to your facility put (NA) in the
compliant box, )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
Compliant(Y,N)
if the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken, Attach
additional sheets if necessary
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that ail qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations.'
rmitteer Date (Name of S
Ired0 - Statesville Schoois
(Permittee-Please print or type)
P O. Box 911
Statesvffle NC 28
Address)
14, -7— cr-
Official-Please print or type)
Dr of m mtenance
(Position or Title)
704-873-3755
(Phone Number)
1131,2009
(Permit Exp. Date)
*If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2E1,0506 (b)(2)(D).
DENR FORM NDAR-1 (5,'2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
ERMBT NUMBER: 'C`:' t ° MCNTH'
FACILITY NAME:
McanstarirsPort Effluent: J Influent:
ar*rteter Monitoring Paint: EftIuent: Influents
There Effluent Poow F ,r This Month Generated At This Facdlit
pera
.Arme:g
rime ageratnr ,RC
• 240J . rime an on
Mock Site a<cM?
r.arda, 21 BCD-5
PH_ i CrflorMit 200a LL r'H,rW
MiL
Average
fly Maximum
Comp
Operator 6n Responsible Charge (ORC),:
Check Box if CRC Has Changed
Certified Laboratories (1
Person(s) CoHecting Samples:
Mail ORIGINAL and TWO COPIES to:
DENR
Division of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-161
C oli.torm
(Geo rnecr,c
MC.1 •'1,013ML
Grade:
Number:
Phone. 7CL,
GNATURE CF iPER,ATu`" IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE
DENR FORM ,`aDMP- r, ' "2005,

NON OISCHARGE WASTEWATER `tONNT©RING REPORT
Faci{ity Status:
Please answer the following question:
1. Does all monitoring data and sampling frequencies meet permit requirements?
f e fa ,iity' rs rlon-compliant, lea e e oiain in the space
ith its perm t. Pt'vv de ;in your exp anation the date(s) of the non-c
taken Attach aca:ticnai sheets if necessary
prance and descr,be the corrective attic
Certify. under penai'ty of law, that tdhrs document and ail attach der my dfr
s pen»s:Cn 'rn accordani:e'Nlth a system designed to assure that all qua i€lieu" p Bonne: properly ga
e' alLated the nformation submitted Based on my ingwrj of the, person or persons a' h manage th
ttw. persons d+re. 'e p;� .g gathering the Inform, o" the In nr tE n =. R te•the �,.rs�.n; � �.tiy. r- s, �rsible for y.at e. itn�� at, r:_ f_ rna c, s�� n_tt d� s, to `, e U
'age and belief true, accurate. . and oompet..ei am a`N3. re that there are s c-inticant pe
tmation. rni=.I d( i' ti e p asib. of flans and .rrp r s fnrreC t for k(ncy..n
(Permittee Address
Para
Pa:rarneter Code ass; nerce gray De of rn:n:ed
e
Codes:
(Name of Signig
(Position or Title)
'') 3
(Phone Number)
On4)2 pH.
32'"10 Phenols
i31;=,•' r..Nr+s sssrsc
.4aiitt
ase print or type)
d by other than the perrnittee, deiegatron of signatory authority must be on fife with the state per 15A NCAC 28,05i16 (ta}t2i(pi
n NR . •"` FAIR- . 2(7)65.

PERMIT NUMBER:
FACILITY NAME:
Daily Loading (inches)
Maximum Hourly Loading finches)
12 Month Floating Total (inches
Average Weekly Loading (inches)
Itt Irrigation Occur At This Facility
Yes No:
ATHER ON IT ON
Temper-atu
at
application
1°F)
65
OLIDAY
C 80
28 R 70
29 CL 70
30 C 68
31
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE USE ADDITIONAL PAGES AS NEEDED.
YVQ0023511
Woodland Heights Elementary School
(-JIVE° TH
May
Pa; /
YEAR: 2008
COUNTY: IREDELL
Formulas;
NoiLme Applied igalions1x 0 133.5 ub. feaugeOn) 2Wichettfoot.1)1L4re,a Sprayed (acresL 43.560 ,,sQuare teeliat-ro). OR
Volume Appct aa'ilonsF (Area Sprayed. (acre,s} x 27,152 ,ga1ionsiarre,nclij
Cady Loading (inches.) ,!1,71rne irngated ;rnnules)r 110(rmnutesthour Monthly Loading (inches) Sum, .Qt paiiy LS3dIng$
rfle
Surn.of MI5 rnoottr's N1ontttly Loading (facies) and previous 11 monlh'a MorlNy Loacings 10-Iches,
A.lonth.iyLotlin9 nceVmonth}i 11t.grroter ti days n I.he month 0,3ysimon111).],x11( (days/week)
Did Irrigatidn Occur On This Field Did Irrigation Occur On 'This Field:
Yes: :71,71 ;, No: Yes: ;i].; No:
FIELD NUMBER: One FIELD NUMBER:{ Two
GA go
Lagoon
Free -board
feet
5.5
0 5 5
0 1 5 5
0 7 5 5
0 5 5
Total GallonsiMonthly Loading (inches)
12 Month Floating Total (inches)
Average ekly LoadingLoadrng Vnch
er Codes: C-clear, PC:iartly cloudy,
Spray Irrigation Operator in Re
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
ATTN; Non -Discharge Compliance
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
AREA SPRAYEDAacresy 1 9 AREA SPRAYED acroj 1 68
COVERCROP:
PERMITTED HOURLY RATE (inches):
PERMITTED YEARLY RATE inches):
Volume
Applied
gallons
1983
Time
Irrigated
minutes
20
5259 60
1615 20
20
20
20
1595
1549
1993
1844
1724
c oudy,
C1
12:7727.7.3
Daily
Loading
inches
0 10
0 03
0 03
0 03
0 04
0 10
0 03
0 03
0 03
0 03
0 03
Maximum
Hourly
Loading
inches
0 12
0,10
0 09
0.09
0,11
0.07
0,06
0,04
0 09
0 10
0 10
0 10
0 10
0 09
COVER CROP; Natural Iitt
PERMITTED HOURLY RATE irlches)
PERMITTEO YEARLY RATE incbes
Volume
Applied
gallons
1983
5259
1615
1595
1256
4139
3834
5130
1724
1736
42231
Time
Irrigated
minutes
Daily
Loadini
inches
0 12
0 04
0 03
0,08
011
0.04
0.04
0,04
Maximum
Hourly
Loadin
inches
0 04 C 12
0 03 0 10
0.18472 0,20
Dennis Gryder
Check Box if ORC Has Changed.
NATURE OF OPE TOR IN ESPONS18LE
BY THIS SIGNATURE, I CERTIF THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE,
Phone:
704-873-3755
DENR FORM NDARD (512003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(os in the appropriate box whether the facility has been compliant
with the following permit requirements. (Note_ if a requirement does not apply to your facility put (NA) in the
compliant box, )
1, The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the sites) in accordance with the perm
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit,
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
"I certify, under penalty of law, that thus document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted, Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted 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 knowing violations
Date
redeio - Statesville Schools
(Permittee-Please print or type)
P.Q. Box 911
ville, NC 2868`
Address
(Name of Sig r" g 0fficiat-Please print ar type
er once
(Position or Title)
704-873-3755
(Phone Number)
n31;2009
(Permit Exp. Date)
If signed by other than the permittee, delegation of sEgnetory authority must be on file with the state per 15A NCAC 2B.0506 (b((2',
DENR FORM ND.AR-1 (5,2003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
Page
d'
PERMIT NUMBER:
FACILITY NAME-
WQ0023511
Woodland Freights Elementary School
MONTH: April YEAR: 2008
COUNTY:
IREDELL
Formulas:
Daily Loading (incltesl * C./fauns) _4ppeed Igaksnsi 1336 ,;cut),. feeVgaabnn M v': onznesitaow +`(,r+rea Scrayrsd €arras) 43.560 (sgulare IeeYacred) OR
Volume Appluerd ygallonsi / [Ai ea Sprayed !acres} r 27t552 (gallyn3Jaue-mchl1
Maximum Hourly Loading (inches) pally Loading Roches)/(Tome Irrigaterl (mmutes) ! 60 (mndiesteouryi
12 Month Floating Total (inches) = Sum of Bads morals s Monthly Leading tingles) and aresigis s c m nth s l9 t t'
teklly Loading Iwnclssej = ( onthy Lsa3dfrng iuichesr 0ttlh; d Nurik oP is a t r utsi Gays nrhlI
Av
Y
EATHER
Facility
No:
ONDITION'S
Temper -afar
at
application
C F)
4
Storage
55
5.5
5,5
0nsi l+ rlthty Loading (inch
2 Month Floating Tw tal (In
d
it7
Ur On This Field:
FIELD NU
AREA SPRAYED
R.
COVER CROP:
One
Natural li
PERMITTED HOURLY RATE {inches):
PERMITTED YEARLY RATE Cloches
Volume
A +lied
1569
1575
1291
108&
1055
933
1757
2169
2163
2192
Ti
minutes
20,.
0.06
0.02
0.02
0 02
er
04
26
imu
Hourly Volume
Loading A
Monthly Loading (Inches) = sure uw Daily Loadings (inches).
a { nn�eal
d
gation Occur On Tlias Field
Yes:
P
No: I
E
EA SPRAYED tacresl. 1.6
COVER CROP: Na
ITTED HOURLY RATE
PERMITTED YEARLY RA
0.19 3225
0.06 1086
0.06 1055
0.05 933
0.10 1757
0.13 0,13 6815
0.04 013 2278
Average Watrkly Loading (inches,} : 0.17258
ather Codes: C-clear, PC -partly cloudy, Cl-cloudy, F -rain, Sn-snow, Sl-slee
0.13 2169
0.13 2163
0.13 2192
0.12 2127
0 13 2225
Spray Irrigation Operator in Responsible Charge (ORC): Dennis Gryder
ORC Certification Number
Mall ORIGINAL and TWO COPIES
ATTN: Non -Discharge Compl
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
MAY 1
2076
Time
989073 Check Box if ORC Has Changed: C 3
0
BY
TO
ion
C..
E OF OPERATOR IN RESPONSIB E CHARGE)
NATURE„ I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
ST OF MY KNOWLEDGE
Daily
d Lo
003
0.03
0.03
Hourly
oadin
02 0 06
0.05 i.14
0.05 0.14
005 0.1
0.05
0.1951809
DENR FORM NOA

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
Page
Facility Status:
Please indicate ( by inserting Y(es) or NO) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: tf a requirement does not apply to your facility put (NA) in the
compliant box )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s)
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit
c
Y,N)
Y
If the facilitys non -compliant, please explain in tfle space below the reason(s) the facility was not in comp ance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken, Attach
additional sheets if necessary.
"I certify, under penalty of law, that 'this document and at attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the nformation, the information submitted 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 knowing 'violations."
redeu Staiesvil(e Senaals
(Permittee-Please print or type)
P 0, Box 91'1
Statesville. NC 28687
(Permittee Address)
ft" /At' I , i2
(Name of Signi g Official -Please print or type)
Orr o
(Position or Title)
704-873-3755
(Phone Number)
Lena
1131/2009
(Permit Exp. Date)
• If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 28,0506 (14(2)(D),
DENR FORM NOAR-1 (5/2003)

1
T NUMBER:
NAME:
NON DISCHARGE WASTEWATE N TORING REPORT
COUN TV
Page ,.;;J
YEAR
(Faw MontrngPofnt Effluent 4 nfluent
Parameter Monitoring Point: Effluent I Influent l'aurfac War ISW T SW Code/No e:
Was There Effluent Flow For This th Genera dA This Facility: No:
erator
Arnvai
rime Operator
T 24.00 rime cn
toCk San
Av
Daily Maximum
Daily Minimum
Monthly Limit(s1
CRC
Site tr
sO4O3 OC3 O.1O 15t6
0.14 Rate i Fec,0 't 'Z,
ow) into ' Cutitono
,
Treatment 1 Restduai 800.5 (Gotmnetrte
Systorn pH 1 Cl'Ione. 20°,0 PaH.1-N Meara!
GALLONS UM5 G1L WM- Wit MGL 1WM
11 '772--
Composite ICIGrab
Operator in Responsible Charge (ORC)':'
Check Box if ORC Has Changed,
Certified Laboratories
Person(s) Collecting Samples
Mali ORIGINAL and TWO COPIES to:
OENR
Division of Water Quality
ATTN, Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
Grade,
ORC Certification Number:
(2):
hon
NATUREQF 0PERA0R E PONSI8LE CHARGE)
BY THIS SIGNATURE, 1 CERFY THAT THIS REPORT IS ACCURATE-.
AND COMPLETE TO THE BEST OF MY KNOWLEDGE
DENR. FORM NDMR- 1 2.0Cii)

NON DISCHARGE WASTEWATER MONITORING REPORT
Facility Status:
Please answer the following question:
1. Does all monitoring data and sampling frequencies meet pemt requirements?
Cornplia
If the facil ty s non -compliant, please e.xolatn in the space below the reason(s:the facA4y was not in compliance
with its permit. Prcn,vide in your explanation the date(s} of the non-compliance and describe the correctIve actIon(s)
taken_ Attach adcidtiona sheets if necessary
"I certify under penalty of law, that this document and all attachments were prepared under my direction or
superslor, ,n accordance with a system designed to assure that all qualified personnel properly gathered and
evaIuated the nforrration submitted Based on my nduTy of the person or persons who manage the system, or
those persons directly responsible frgathenng the information, the informaNcr, submitted is, to tne best of my
knowledc,'e and behef, true, accurate and complete I am aware that there are s;grificant penalt,Jes for sbmItung
faise information including the posstPillty of fines anp I'mprsonment for knowing vLoiaiNons "
Parameter Codes:
11 j_
(Name of Sign ng Official -Please print or type)
C1L-7 11 41,7 C,
(Position or Title)
7.74/
(Phone Number)
C2 knew;
31022 Saran
003!3 SOL15
nitt307 Cadmium
3504 COWOrm, Tratai
30094_ Cciruatiticaitaty
6042. Cr
5000C Dissnityea Oxygen
309 6 7 al.C-um 31616 ';eCai Cak,rm
30040 3376nrcle
500613 Tintartuat Twat
Pentanat
105 Lead
C09Z" Mat nesturn
1900 Mercury
31004 CnrorMurn
70340 733D
110613 NHtlasN
10600 NOT 'Fa at
00630 NO2atta0
006211 "503
00556 On -Grease
30929 Sawn
301431 SAP,
013745 Suattaa
70095 7135
313,7309 PAN iiPtant Awatiantet
0400 nin
32730 Phianuis
0050 Tainnerature
00625 rKN
30680 TOG
00530 713131T0P
00665 Pnpnunus. "taw
01067 Nick
3C937 Potassnan
00076 Turththly
00545 Selneatite Main
t5092 Zinc
(Permit Exp. Date)
Parameter Code assnstance may be obtaine,z 0y calltmg r V.iater 5Ja0ty Land A;-,435catcn Usti at (9'13 715-6'3;
The trontNy average for Foos°slid's= s io. se reported as a GEOMETRIC Seas Use ordijihe urds destoratect
ti4odity: permit tor t,ppordorsg data
•If signed by other than the p-ermittee„ delegation of sgnatoruthcrity rnust be on file with the stat per 15A NCAC 25.0506 (b)i2)(D)
DENR FORM taDMR,

RM9T NUMBER:.
FACtUT r NAME:
NON DISCHARGE WASTEWATER MONJTORING REPORT
Dad'? Rate
xF1owl into
Trealmenl
HR5 1 YiN taAL
Average
Daily Maximum
Daily Minimum
mpco-site (C) ' Grab (G
MONTH:
YEAR:
COUNTY
Cnf(uent: Se Water (SW?: ? W Code/Name:
ted At Thws Facility: Yes: No
5oae0 00310
NH3.N
Fecal
Operator in Responsible Charge (ORCL
Check Box if ORC Has Changed:
Certified Laboratories (1):
Persons) Collecting Samples:
Mail ORIGINAL and TWO COPIES to:
DENR
t ivision of Water Quality
ATTN: Information Processing Unit
1617 Mail Service Center
RALEIGH, NC 27699-1617
Grade:
©RC Certification Number:
Phone y,!3'
NATURE OF ©PERATOIN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE_
CENR FOPAI N©MP. i !, 1.20051

PERMIT NUMBER:
FACILITY NAME:
NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE, USE ADDITIONAL PAGES AS NEEDED,
WQ0023511
oodland Heights Ele
ul
Daily Loading (inches) - [Verume ,applied igalkom4 K D.1226 (Gublc featiy$IVo
Volume Appllea (gallons) a )Area Sprayed {acres) K 2
Daily Loading (inches) r {Lrre Yfrhgated limenules) ! 60(
School
Maximum Hourly Loading (inches)
12 Month Floating Total )inches) - Soon 01 this month's Monttnly Loaoir g Iincdeesl and pro wious t € 3no"ii1'S Monthly Loaaings (inchesp
Average Weekly Loading Cinches) - lMonthiy Loading (inches/month) f Numoer of days m the rnaran jdaysart entnl[ x 7 ids ystwveeki.
MONTH:
Did Irrigation Occur At This Facility:
Yes: No:
WEATHER CONDITIONS
at
appiica
50
51
45
4! ! 6
45
HOLIDAY
HOLIDAY
Lagoon
CL 45 0.6 6
Total GallonsiMonthly Loading (inches)
12 Month Floating Total (Inches)
Average Weekly Loading (inches)
Did Irrigation Occur On This Field:
Yes: E
FIELD NUMBER:I
AREA SPRAYED acres :
COVER CROP:
ITTe •
1948
1897
1812
1494
1456
1520
20
Did irrigation Occur On This Field:
No: 0 Yes:
One FIELD NUMBER;,
9 AREA SPRAYED acres :'
COVER CROP: N
PERMITTED HOURLY RATE (in
PERMITTED YEARLY RATE (in
Natural litter
he !+
!!
0,03
0.03
0.00
0,00
0.03
0.00
0.60
5
26
Maximum
Hourly
Loading
Inches
0.13
0,13
0.10
0.15
#DIV/01
Volume
Applied
9267
2285
1685
2649
Time
Irrigated
minutes
20
20
20
20
#DIV/0I
0,11 1948 20
0.11 2
DIV/0
009
0,0
0.0'1
2 20
7 20
1003
1494
1456
9 1520
#DIV/0!
#DIV/01
009
#DIV/0!
1584
31027
Daily
Loading
inches
0.20
05
0,04
0.06
March
COUNTY:
Page
YEAR: 2008
IREDELL
(square feeifacrel) 4R
Monthly Loading (inches) =Sum of Daily Loadings (nnciesp
No: ❑.
Two
1.68
ur
0.00
0,04
0.04
0.04
0.04
t0
.
03
68
0.1534
0.41
Maximum
Hourly
Loading
inches
0.17
#DIV/0!
0.13
0.12
0.12
0,12
0.11
0,10
0.10
0.10
*Weather Codes: C-clear, PC -partly cloudy, CI -cloudy, R-rain, Sn-snow, SI-sleet
Spray Irrigation Operator in Responsible Charge (ORC):
ORC Certification Number:
Dennis Gryder
989073 Check Box if ORC Has Changed:
Mail ORIGINAL and TWO COPIES to:
ATTN; Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
Phone: 7'04-873-3755
Ail3RE OF OPERATOR IN RESPP NSI LE CHARGE)
BY THIS SIGNATURE, I CERTIFY THA THIS REPORT IS ACCURATE AND COMPLETE
TO THE. BEST OF MY KNOWLEDGE,
DENR FORM NOAR-1 (512003)

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION S1TE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements- (Note: if a requirement does not apply to your facility put (NA) in the
compliant box )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s),
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
Com.11ant Y,N)
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken Attach
additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system„ or those persons directly responsible
for gathenng the information, the information submitted 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 knowing violations."
(Signature of P
Statesviile Schao
(Name of Signi Official -Please print or type)
Dr of marntenance
(Permi e-Ple e print or type) (Position or Title)
P.0, Box 911
Statesville, NC 28687
(Permitt Address)
704-873-3755 1/31/2009
(Phone Number) (Permit Exp. Date)
If signed by other than the perrnittee, delegation of signatory authority must be on file with the state per 15A NCAC 28,0506 (b)(2)(8),
DENR FORM NDAR-1 (512003)

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORM
Facitify Name:
Permit Name ('if differe
Facility Address:
Contact Person:
1;R+'ell LocationfSite Name:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit):
Well Depth:'
Depth to Water Level azs4e fL below measu
Measuring Point is ft, above land surface
point
m—�
Volume of water pumped/bailed before sampling:
pl
etals were collected
LABORATORY INFORMATION'
Date sample analyzed:
PARAMETERS NOTE. Values
COD 00335
Conform: MF Fecal 31616
Conform: MF Total 31504
e
uld r
YES
Sl1F.i
T FORM ON YE Ll Q4" PAP EL ONLY
County
Telephone#: :'`„
No, of wells to be sampled:
Date sample collected;
Well Diameter
Screened Interval:
Relative M.P. Elevation:
gallons
NO and field acidified. YES El NO
Laboratory Name:„
t dissolved and colloidal concentrations.
mgfL Nitrite (NO2) as N 00615
/100mL Nitrate (NO3) as N 00620
/100mL Phosphorus. Total as P 0066.5
Orthophosphate 70507
Al -Aluminum a1105
Ba - Barium C1007
Ca ,.. Calcium 00916
Cd - Cadmium 01027
Chromium'; Total 01034
Cu - Capper 01042
Fe - Iron 01045
Hg - Mercury 71900
K - Potassium 00937
Mg - Magnesium 00927
Mn - Manganese Otass
(Note: Use MPN reeet?xrd for highly terdl7id samples)
ved Solids:Total 70300
pH (Lab) d0d03
TOC 00660
Chloride 00940
,Arsenic 01002
Grease and Oils 00552
Phenol 32730
Sulfate 90945
ficC snductance 000ss
Total Ammonia 00610
(Ammonia Ndrn,rpen, NH, as N, Anyhesn Nd
mg/L
units
mg/L
mg/(.,
ugIL
mg/L
ug/L
mg/L
EtMhos
TKN as N 00625
mg1L
7
to 5
mg/L
mg/L
uglL
mg/L
ug1L
ug/L
mg/L.
uglL
ug/L
mglL
mg/L
L
PERMIT Num 7 Expiration D
TYPE OF PERMITTED OPERATION BEING MONITORED
High Strength
Advanced Pretreatment
Sand Filter
Potable Water Backwash
FIELD ANALYSES:
pH 00400 ,,-)--units
Spec. Cond, 00094:
Odor 00085:
Appearance
Pb - Lead most
Zn - Zinc a1092
Industrial Process
O Gravity Feed
O Pressure Dispersal
O Other
Certification No.
,µMhos
uglL
rng/L
Other (Specify Compounds and Concentration Units):
ORGIS C$; (by , GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT..).
Lab Report Attached? 0 Yes (1) 0 No (0)
VOC 76732
method #
method #
method #
, method #
ELL
AS
Y at
e of°
piing,
check
here
tri the best of my kncw,dedge and beteef, th
d laboratory. I am aware, that there are sigl
produce.
tnclattcrr

ELL
WAS
DRY at
e of
Wing,
heck
ere:
N
GROUNDWATER QUALITY MONITORING
COMPLIANCE REPORT FORM
FACILITY INFORM,( TION
Facility Name:
Permit Name (if different
Facility Address:
):C fit:
Contact Person
6fVell Location/Site Name:
SAMPLING INFORMATION
ID NUMBER (from Permit);.
Depth:
to Water Level 82546: r'.,�
se P not i:dt atly
ow measuring point
siring Point is , above land surface
Volume of water pumped/bailed before sampling: .. gallons
samples frlf rrletals vuere collected unfiltered: YES © NO
ORATORY INFORMATION
Date sample analyzed:
.PARAMETERS NOTE: Values
COD 00335
alifrrorm: MF Fecal 3161s
hould reflect dissotvs
mgfL
/100mL
/100mL
Coliform: MF Total 31504
Note.. Use PA N nne ft ed tv- hrgely tweed samples)
)rssohred Solids:Total 7©3©©
pH (Lab) 00403
TOC ooeao
Chloride 00940
Arsenic 01002
Grease and Oils 00552
Phenol 32730
Sulfate 00945
Specific Conductance 00095
Total Ammonia 00610
(Ammmnra Nitrogen. NH, as N,
TKN as N 00625
mg/L
ni
mgfL
ug/L
mgfL
Mhos
mgfL
mg/L
S LI
ripe
unty
Telephone#:.
No, of wells to be sampled:
QI' PAPER ONLY
Mali +arlginaf;;
and '1 copy+ to::
Date sample collected:
WeII Diameter-
Screened Interval:
Relatwe M.P_ Elevation:
d field actdifi
Laboratory Name:
and colloidal concentrations.
Nitrite (NO2) as N orm15
Nitrate (NO3) as N 00620
Phosphorus: Total as P noses
Orthophosphate 7m507
Al - Aluminum o1105
Ba - Barium c1oa7
Ca - Calcium 60916
Cd Cadmium 01027
Chromium: Total moil
Cu - Copper 01042
Fe - Iron 01045
Hg - Mercury 71so0
K Potassium m©e3z
141g - Magnesium 00927
Mn - Manganese Glo55
Ni - Nickel olos7
y that, to the best of trey knowledge and belief, the information subnaite wd
certA ed Iabtaracar .tam awaa e treat there are s anifltat t enaltees f sr : e'r
Arrthrarized Asaentt Name a T
51
toes produced us rr ap roved methods of analysts by a
YES LINO
1rg1L
mgfL
mgfL
nagtL
mgfL
ug/L
mg/L
uglL
ugL
PERMIT Numb
TYPE OF PERMITTED OPE
High Strength
Advanced Pretrea
Sand Filter
Expiration Date:
ItTION BEING MONITORED
El Industrial Process
Gravity Feed
1 Pressure Dispersal
Potable Water Backwash Other:,
FIELD ANALYSES:
pH norm .- units Temp. ©nrnc
Spec, Cond. copra:
Odor amiss:
Appearance
Pb - Lead Clod
Zn - Zinc m1092
Certification No.
ugiL
mgiL
Other (Specify Compounds and Concentration Unts).
mg/L ORGANICS: (by GC, GC/MS, HPLC)
ug/L (Specify test and method #. ATTACH LAB REPORT.)
ug/L Lab Report Attached? L Yes (1) 0 No (0)
mg/L VOC 78732: , method #
method #
ug/L method #
ug/L , method #
mg/L.
and tricot the labaratorl
AI or d

n Units):
REPORT.)
No (tl)
If WELL
WAS
DRY at
time of
sampling,
check
here.
GROUNDWATER QUALITY' MONITORING:
COMPLIANCE REPORT FORM
FA 'TY FOR
Facility Name:
Permit Name (if diffo
Facility Address.
Contact Person: ! L l -
Well Location/Site Name:
UE1IT FORM ON YLLQ
PAPER O
and -1c
Tetepho
No. of wells to be sampled:
PUN FO - •TtON
WF�I L ID NUMBER (from Permit :
Depth: �tt.
Depth to Water Level 82548: ) ft. below measuring poi
Measuring Point is lit, above land surface
Volume of water pumped/bailed before sampling:
Sam•les for; metals were_ collected unfiltered" (I DYES
TORY INFORMATION
natyzed: L.. -;4-
TERS NOTE; Values should rieftec dislscslved a
COD 00335
Caliform: MF Fecal 31616
Conform: MF Total 31504
04414 Use MPN meted' Inc NON t bd 4441050
olved Solids:Total 70300 t
pH (Lab) 00403
TOC ooe o .icon mg/L
mg/L
units
Chloride now mg/L
Arsenic olooz ugfL
Grease and Oils Pass? mg/L
0`
Phenol 32730 ug/L
Sulfate posits mg/L
Qom Conductance 0oµMhos
Total Ammonia o0610 / mg/L
1Amn©nia NBrngen; NFiyas �J; Ammon" NderCigen Tn tb
TKN as N 00625 mg/L
T1
Date sample collected::
W II Diameter: ?
nt Screened Interval: L, 2 lit., to
Relative MP Elevation:Z.—
gallons
] NO and field acidified„
Laborato
d colloidal concentrate
Nitrite (NO2) as N 00615
Nitrate (NO3) as N 00620
Phosphorus: Total as P C066s
Orthophosphate 7o507
Al Aluminum D1'105
Ba - Barium 01007
Ca - Calcium 00916
Cd - Cadmium 01027
Chromiurn. Total oia-1a ug/L
Cu - Copper 01042 mg/L
Fe - Iron o104s up/L"
Hg -- Mercury 71900 ug/L
K - Potassium 00937 mg/L
Mg - Magnesium 0os27 mg/L
Mn - Manganese gloss ug/L
1 01067 ug/L
PERM,fT'Nurnbe+ ; ;..w'F Etpiration Date:
TYPE OF PERMITTED OPERATION BEING MONITORED
0 St pith 0 Industrial Process
Q Advanced Pretreatment 0 Gravity Feed
0 Sand Fitter 0 Pressure Dispersal
0 Potable Water Bacllvwra�sh Q Other
ho,
A
FIELD ANALYSES:
pH 004©LY. 52,units
Spec. Cond. 00094:
Odor 00085:
Appearance
Pb - Lead 01051
Zn Zinc 01092
µMhos
n No.
Other (Specify Compounds and Co
ORGANICS. (by GC, GC MS, HPLC)
(Specify test and metla+od #. ATTACH
Lab Report Attached? © Yes (1)
VOC 78732 method #
lethod #
method #
method #
ug/L`
mg/L
Artie

WAS
DRY at
ime of
emoting,
Icheck
here
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATIQ
Facit'ity Name:
"Permit Name (if differen
.Facility Addles
e
act Perso
Location/Sate Name:
AMPL9Nt INt=ORI4rtATIQN
D NUMBER
Depth.
Depth to Water Levels 4e
Measuring Point is
tt. below m
Please Pnnt Clearly or
t`✓��1i1.
using point
bove land surface
Volume of water pumped/bailed before sampling:
PI
for metals vuere collected unfi
t30RATORY INFORMATION
e sample analyzed:
YE
t YELI.i/ PAPER ONLY
Mali origin
and 'I copy t
County
Te ephone#71j
No. of wells to be sapled.
Date sample collected;._ —
Well Diameter:
Screened Interval,
Relative MP, Elevation.
gallons
NO an
id' ded:'YE
Laboratory Name
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
Coliform: MF Fecat 31616
Coliform. MF Total 31504
(Note; Use MP' rvw.tthott for tghiy turbid saurlplini
otved Solids:Total 70300
pH (Lab) 00403
TOG 00640
Chloride 00940
Arsenic 01002
Grease and Oils 0o552
Phenol 32730
Sulfate 00'945
Specific C
tance co095
mg/L
mglI�.
ug/L
.. mg/L
ug/L
Total Ammonia 08610
(flRnrionia tuittnapetn. Ni, as N.
TKN as N 00625
t cerury 1naio ro tr
DWQ-certified la
rng/L
1Mhos
mg/L Nitrite (N07) as N ooals
/100mL Nitrate (NO3) as N 00620
/100mL Phosphorus: Totat as P 00665
Orthophosphate 70507
mglL Al - Aluminum 01105
units Ba - ,Barium 01007
Ca - Calcium 00916
Cd - Cadmium 01027
Chromium: Total 01034
Cu - Copper 01012
Fe - Iron mods
Hg - Mercury 7190a
K - Potassium 00937
Mg - Magnesium 00927
Mn - Manganese 90o5s
mg/L a ,.,,.,.t i - Nickel 01o67
ge and belief, the informattoa si ".kited `sn the r l
that there are significant, perals x for submitting
to
ft.
NO
mg/L
mg/L
rng/L
rng/L
mg/L
ug/L
mg/L
uglL
ug/L.
mg/L
ug/L
ug/L
mg/L
mg/L
ug/L
rate, and c-
inclsadlnp
PERMIT Num rt ti ;�, � / Expiration D
TYPE OF PERMITTED OPERATION BEING MONITORED
L� High Strength 0 Industrial Process
C1 Advanced pretreatrrrent [7 Gravity Feed
�l Sand Filter ❑ Pressure Dispersal
Potable Water Backwash 0 Othe
FIELD ANALYSES:
pH uorux7:,4die)i. units
Spec. Cond., 00094
Odor 00os.s A/c
Appearance
Pb Lead 01051
Zn - Zinc 01092
Temp, 00010
Certification No.
Other (Specify Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? L Yes (1) a No (0)
VOC 75732'
nplete. and that the laboratory analytlr
p s5'abalily of fines and mpr soxm-nen
ure
r
, method #
method #
method #
method #

Fiel
F OUND'WATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
E
Facllit
Perrni
F
Conte
ldenttFtl
eE (epth: _r�.
greened Interval
ap11t ttt Water Level:, �...
ea urtng Point (M.P.) is:
atltans tat water pumpsdl Il
anetysie: pM�
P RANI (Se
COD .
CoWorm: MF Fecal
CoWorm: MF Total
(Note: Us* MPN method tot highly I
Dissolved Solids: Total
pH (when analyzed) ..__
TOC
N arrrher (from Permit);
ft. Weil t)iarneler:
rl. tlowt rreastri
tt. ado re fond st
lstctre ttctrrtplirrg:
Specific dofiur
SUBMIT FORM f)N Y LLi1i } PAPER
FOC Green ter Tt tf#fftnt
t sack t ne: Infltten
Effluent
M.P. Elevation In ff,:
tie sample collected„ lj
pees for metals were collected unfiltereYES
rng/I Nitrite (NO2) as N
-/100m1 Nitrate (NO3) as N
_l1OOml 'Phosphorus; Total as P
Orthophosphate
AI - Aluminum
Chloride ..-
Arsenic
Grease and Oils
Phenol
Sulfate
Specific Condu
Total Ammonia
TKNasN
IVY-9
Rev, 93/2000
mg/1
mg/i
mgh
ance . uMhos
mg/I
mg/I
mg/1
_units pa - Barium
°
'mg/I Ca - Calcium,
mgll Cd - CadmiurTl__---
mg/1 Chromium: Total w..
Cu - Copper.
Fe -Iron
Ng - Mercury _.
K - Potasslu
Mg - Magnesium
Mn - Manganese
NLY
r AfTMEMT OF VIROHMEHT rT NAT1JRAL RESOURCES
ATER QUAIJTY Di I5IQN, GROUNDWATER SECTION
t341 MAIL SERVICE CENTER
tStl C 27691f-T639 Pt one tlf r 2
PE? 1IT M:
Non-()ischarg
NPOES
©1
RATI
uIC
ATE:
ERATI©N BEING MONITORED
Remedtalican: Infiltration Gall
Values should reflect dlssotved aril
colloidal concentrations:
ample analyzed:
ory Name:
!cation Nb,
Idifled
mg/I
mg/I
mg/I
mg/I
mg/l
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/i
mg/I
mg/1
mgA
YES 140)
Ni - Nickel
Pb - L.ead.
Zn - Zinc
Ammonia Nitrogen
Other (Specify Compounds and Cancan
n Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method if, Attach tab report.)
Report Attached? Yes, ?, (1) No (0)
VOC method e =
.__ method 0
: method N

4AAAAARAAAAAA
I?
g A
00
14 *4 f•I .4 .14 14 v..4
I, VI
f4en
6 6 ci
v v v
0
0
Pat
0
2 g
0 6 6 6 6 6
AgW',72g
6 6. ci 6 6 6 6 6 6 6
VY Y V 'WU V V
00
Oh CN gg;gg et AAA A AN6 AAAA A
a a a
VI
X g
0 0 0
AAA AA AAAAAAAA
4, AA AA4.,94,4 A A4,44,4
6Akg-A,A AAA AkkA
0 0 0 0 0 0 0 0 0 1.4
q q
6 6 6 <3
ev 4D,
ev X re, fq ev 6 6 ,c; 6 6 62 el 6 6 6 6 6 6 6 6 _,0 6 6; 6 +6 .6 6 6 6 6
00
v V 'V V V V V V V.4. V V V V V
V V V VY

Am l00ll z
trix: GnoundWte
G
Lab
yam *
0:20
012 A
*

ROUNDWVATER QUALITY MONITORING:
©MPLIANCE REPORT F J►RM
Facility Name:,
Permit Name (It di
Name:
e !dent;
Well Depth:
Screened Into
Depth to Water Level:
Measuring Point (M.P.) Is:
Gallons of water pump
Field analysis: pH.�
Temp.
UlklkT 1'Ret1 ON YE
i ms Coon .
Telephfarte
_ No. of Welk tc
ft. Wei l Dlerrteter: in.
measuring point.
Sampled:
roundw r Trety1n ent
One: Influen
Effluent
land surface, Welative M.P.. E rr ttkc+n In
re sampling: : _ Data sample collected:
pecilic Conductance _._._ ` .. uMt ns
°C, Odor it/(..;?1).( Appearance i`h
ARAMETEHS (Samples for
COD
Coliform: MF Fecal
Coliform: MF Total
Mote: Use MPN mlrlhod for highly fur
Dissolved Solids: Total
pH (when analyzed) _. .w._
TOC
Chloride
Arsenic
Grease and Oils
Phenol
Sulfate
Specific Conductance
Total Ammonia
TKN as N
de
d unfiltered_
rng/l
/1 00mt
/ldpml
mc/l
units
rng/l
rng/1
rr 9/
mg/1
mg/1
mg/1
uMhos
mg/1
mg/l
YES
Nitrite (NO2) as N
Nitrate (NO3) as N
tPhosphorus: Total a
Orthophosphale
Al - Aluminum
Ba Barium
Ca - Calcium
Cd - Cadmium
Chromium: Total
Cu - Copper
APE,
NLY
PERM'
Non-'Uischalr
NPDES
PAfTMENT OF ENVIRONMENT & NATURAL RESt URGES
OJALJTY DIVISION, GROUNDWATER SECTION
GAIL SEFIV'ICE CENTER
C 3! t► 't(MI
P 11a
OPERATION BEING MONITORED
Remedialion: Infiltration Gallery
Plernedkatian:
bulor _M Land
NOTE Values should reflect disso
colloidal concentrations.
gate Sample analyzed:
Laboratory Name:
Certification Nb.
and field acidified , .. YES
Ni - Nickel.
Pb Lead
Zn - Zinc
Ammonia Nitrogen
Other (Specify Ccrrnpounds and Concentration Units)
Fe Iron
Rg - Mercury
K - Potassium
Mg Magnesium
Mn Manganese
/.
Sludge
lt0)
ORGANICS: (GC,GC/MS,HP
(Specify taw and method N. A
Report Attached? Yes
VOC : method
Method
h lab report.)
No (0)
method M zi
r?„ Z.'AC ,;;'ncl Ct!1t$ r?"°a", ci1lCl Ord, t Ile ilk C teltd:Frio 1is<
4tr: II?. t Uit:rg ,ark ;,atvlr,:f,ca 1 Irv`>;?rs;itl+cey:, for a't
GW59
Rev, 03/2000

Description: 1001115-6.1
Matrix: Ground Water
Project: General Subcontract
ANALYTICAL RESULTS
Lab Sample ID; C013954-01,
Sampled:11/15/10 09:45
Sampled ey: Client
www.encolabs.com
Received: 11/18/10 12:00
Work Order C013954
Volatile Organic Compounds by GCMS
Maire KOS number' Resifts Ma Walls L2f M. NAL litatch Method &mined Ix Rates
1;1 42.751-radihorgethane [6.30-20-61 < 0.40 ugh. 1 0.40 1,0 0902023 EPA 826C6 11122/10 1.840 /KG
1,1,1-Triztdoroalwine [71.55-6] < 0.27 Ka 1 0.27 1,0 0K22023 EP-A 82608 11/22/10 1840 33011
111,22-Tetrachiardethane [79-34-5] < 0,33 ug/L 1 0.33 1.0 61122023 EPA 82608 11/22/10 19:„40 .18G
)3,2-1-ddllorertfthafie [79-00-5] < 0.37 i29/L 1 0.37 11.0 01(22023 EPA 82606 11/22/10 1840 /KG
1,1-013kroettione [75-34-3] < 0.33 ugh_ 1 0.33 1..0 01E22023 EPA 8260B 11122/10 19;40 JKG
1,1.*30h0yoefttene [75-35-41 < 0.24 oak 1 004 1.0 0422023 EPA 82603 11/22110 18:40 381
1,1-04thldropropene [563-58-81 < 0.32' ugh 1 0.32 1,0 08221323 EPA 82606 11/22/10 19:40 AG
1.2.3-7redonobenzene [87-61-6) < 0,25 ugh 1 0,25 1.0 14122023 EPA 8260e 11/22/1019:40 310G
1,2,3-Trehicrepropa,ne [96-18-4] < 0.55 ug/L 1 0.55 1.0 01(02023 EPA 82686 .11/22/10, 19:40 /KG
12,4-InI0orb0enzeoe [120-82-1] < 0.36 ug/L 1 0,36 1,0 0K22023 EPA 82608 1422/10 19:40 /KG
11,4-Trtnillfylberizend [95-63-6] < 0.20 14/1. 1 0.20 1.0 OK22023 EPA 82606 11122/10 19,40 3813
42-01brogno-3-chlo4opf0Pa135 106-12,81 < 0,.48 ugh 1 are 1.0 0422023 EPA 82605 1102/10 19:40 3KG.
1,2-)20warneediane [106-93-4] c 0,42 iigh. 1 0,4.2 1.0 0822023 EPA 132606 11/22/10 19:40 3KG
3
[95-50-11 < 0.27 ugh- 1 007 1.0 0K22023 EPA 52608. 11122/10 19:40 186
1,2-1/kfiluttetharte [107-06-2) < 0.65 ugh. 1 0,65 1.0 6122023 EPA 82606 11/22/1019:40 3KG
1,7-0K21lom3r0p4ne. [78.87-51 < 0,20 ug/L. 1 0.20 1.0 '0E22023 EPA, 82606 11122110 19:40 /KG
1„3,5-Trimethytbedzene (1011-67-8) < 0,25 ugh. 1 025 1,0 0122023 EPA 826013 11/22/10 19:40 )KG
1,3-117151130nobenzese [541-73-1] < 0.30 ug/L 1 0.30 1.0 622023 EPA 82606 11/22/10 19:40 3KG
1,3-Ektikr064j4arte [142-28-91 < D.32 uan- 1 0,32 1.0 0102023 EPA 82608 111221 ID 19.°,40 31(8
1,4-011thlon81enzene 1106-48°71 < 0.38 Ki/1 1 0.38 1,0 01122023 EPA 82605 11/22/10 18,40 JKG
2,2-Dichicrupredase [594-20-71 c .0,55 ugh- 1 0.55 1.0 0822023 'EPA 62608 1102/10 19:40 3KG
2-Butdisurie [711-93-3] < 1.0 u0JL 1 1.0 5.0 01122023 EPA 82608 11/22/10 1.9:40 .3KG
2-01broetlfyl 34891 Ethef 410-75411 < 0,94 4011 2 0.94 5,0 0K22023 EPA 8260B 11/22/1019:40 .1KG
2 -200futoluene 195-49-5) < 0.20 ugh 1 .0.70 1.0 6122023 EPA 82606 11/22/10 19:40 3KG
2-narartane [591-70,5] < 0.69 AO- 1 0.69 5.0 0K22023 EPA, 826013 11122/10 19:40 3813
4-Ohloratolvene [106-43-4] < 0,25 i-10/1. 1 0.25 1.0 0822023. EPA 82608 11/22110 19:40 JK.G
4-11impruddli34uene [99-87-6) < 0.26 ug/L 1 0.26 1.0 0E22023 EPA 82605 1102/10 19:40 JKG
4-04e03912-pentanerie [108- 10-11 < LI 119/1 1 1.1 5.0. 0E22023 EPA 52608 11/22/1019:40 3906
Acetone [67-64-I] 11 ugh. 1 1.5 5.0 010.2023 EPA 826138. 11/22/10 19:40 .1KG
Benzene (71-43-2) < 0.20 ugh 1 020 1.0 OK220 23 EPA B2608 11/22/10 19:40 /KG:
• benzene [I08-06-1] < 0.28 u9/1 1 012e Lo .0e221723 EPA 826013 11/22/10 19:40 11CG
BrEffrichliommethane (74-97-5) < 0.42 Lvit. 1 0.42 1.,0 01122023 EPA. 82608 11/22/1019:40 JKG
Orcrnodlicitorafriethane. [75-27-4] < 0.37 ug/L 1 0.37 1.0 0K22023 EPA 82606 11/22/10 19:40 IKG
• [75-25-2] < 871 ugh. 1 0,71 1.0 01122023 EPA 82636 11/22/10 191.40 1KG
Euarnufnethone [74-83-9] c 0,49 119/1 1 0,49 1,0 0122023 EPA 82606 1102110 1940 /KG
Carbon disulfide [75-15-0) < 0,54 ug/L 1 0.54 5.0 0122023 EPA 821100 1,1/22110 19:40 .11/4
CArtxr teirectAxwie [56-23-5] < 0.3E ugh 1 0,38 1.0 0122023 EPA. 62606 1102/10 19:40 JKG
Crforoderuene 1108-90-71 < 0„ 27 59/1- 1 0.27 1.0 0K22023 EPA 8,2608 11/22/10 19:40 JKG
Chlordethane [75-00-31 < 0.30 ugh 1 0130 1.0 0K22023 EPA 8260B 11122/1.0 19:40 J1KG
Chian:Akan' 167-66-31 0.67 2 ugh. 1 0.20 1,0 01420.23 EPA 82608 11/22/10 19:40 385
chiorarnethane [74-87-3] c 0.34 ugl 1 0.34 1.0 0K22023 EPA 82608 11/22/1019:40 JICG
ch-1,2-Dkhiaroethene 1{156-59-21 < 0,36 99/1- 1 0,36 1.0 5K22023 EPA 82606 1 v2z•te 19AO JKG
06-1,3-De8oroproperre 110061-01-9 < 0. a asft. i o_ze re 0822e23 EPA 82605. 102/10 i9-140 190G
016:015,0015.3rnet1ane [124-48-1] < 0.32 ug/L 1 0,321.0 0K72023 EPA 826013 11/22/10 1.9'.40 .1KG
Ditromarremane [74-95-3] < 0.37 1 0,37 1.0 O1(:?2023 EPA 826019 11/22/10 18'A0 IKG
Diehlorodfficorornethane 1.76,71-81 < 038 48/1_ 1 0138 1.0 0822023 EPA 82608 1./22110 19:443 ArG
Ethybenzene [100-41-4) < 0.20 ugh_ 1 0.20 1.0 04Q.2023 EPA 82600 11122/10 19.:40 ' era
ilexaclux0Ouladlene [87-68-31 < 0.35 ug/L1 0,35 1.0 0122023 EPA 82608 .1102110 19:45 /KG
Page 4 of 28

0
AA A f A AA A AA A A A A
PPPPPP 9 9 p PPPPPPPP
eee etc A
9'9 5'
oob 0000 o
0.• 1.• !-•
< < <
a a aat;aao
"
t6tttttt
g'g
1
0 0,
, -
ttt t

Sa

3rROUNDWATER QUALITY MONITORING:
JMPLUANCE REPORT FORM
EI
Facility Name: i),
Permit Name (If differen
F'ac (thy Address:
.x'>•. t
4w��ru
Contact Person:
Well L©Cation, Site Name:
d
Well Depth:
Screened Interval:
Depth to Water Level''
Measuring Point (MP.)
Gallons of water pumps
Field analysis: pH_
Temp
CO D
ColifortTT: MII Fecal T ....w..____.
Coliform: MF Total
(Nola: Una rNPP4 method for PrIghly turbid
Dissolved Solids: Total
pH (when analyzed) _ ..
TOC_
Chloride ..
Arsenic
Grease and
Phenol
Sulfate
Specific Conductance
Total Ammonia
TKN as N
umber (frorra Per
TFORri NY PAPER N
wraunt ate
Telephone
No. of Wells to
uring point.
Y TYpe
uent
uent
nd surface. Relative M.P_ Elevation in N.
before sampling:. !- '" Date sample collected: JF
. Specific C dt lance
"C, Odor
Appearance
plea for metals were collected unfiltered YES
mg/I
/1 f 0ml
lOOm1
mg/I
units
_ mg/1
GW-59
Rev. 03/2000
Nitrite (NO2) as N
Nitrate (NO3) as N
'Phosphorus: Total as P
Orthophosphate
Al - Aluminum
Eta - Barium
Ca Calcium_
PARTAIENT OF ENVIRONMENT 8 NATURAL RESOURCES
AUT.( ENVISION, GROUNDWATER SECTION
E cesrER
P
PEt tMtIT M: "?(PIRA"I tti N DAT
UIC_
PEIMITTEQ OPERATION BEING MONITORED
.� t egoon
Spray Feld
Rotary t2isti
Reriation_ Infiltration Gallery
Rernedlation: rt
Land r‘ppticeil n.ci Sludge
Values should rafts
colloidal eoncentratl
e sample analyzed:
Laboratory Name:
Certification Nb.
NO and field
ved and
n s,
mg/I Cd - Cadmium
-
mg/I Chromium: Total
m Cu - Copper_,__
m Fe - Iron mg/1
mg/I Hg - Mercury mg/1
uMhos K - Potassium- rng/I
mg/I Mg - Magnesium mg/1
mg/I Mn - Manganese mg/i
mg/1
mg/I
mg/I
mg/i
mg/I
mg/1
mg/1
mg/1
mg/1
YES
Nickei
Pb - Lead
Zn - Zinc . _
Ammonia Nitrogen,
Other (Specify Compounds and Concentration Units)
N©)
ORGANICS: (GC,t3C/MS,HPI.C)
(Specify tact and method M. Ali
Report Attached? Yea,
VOC : method N
method M zx
method M
port)
No (0)

\ / \ \ \ \ ((\ (\ / A.
A (\ \ \

Description: 1001115-6,4
Matrix: Ground Water
Project: General Subcontract
tab Sample ][a: C013954-07
Sampled: 11j 15/ 10 10:32
Sampled By: Client
Received: 11/18/10 12:00
Work Order: C:013954
Volatile Organic Compounds by GCMS
Naptenalene. [91-20-3)
nButyl Benzene (104-51-83
n-PrepyliBenzenrt [103-65-1]
o-Kylene [95'47 5]
sex:Zoe/tenxene [135-98-8]
Styrene (100-G2-5)
le t-Butylteuene [9B-O6.-61
Tetnrchicenenene 1127.18--
Toluene (108-88-31
trans-1,2-01thforcethene [156-60-5]
trans-1,3-[JidNareprcpene [10061-02'5J
Tecrilareethene [79-01-61
Trknbr¢llu narretrone [75-69-4)
Virry1 c11Ynride [75-01-43
Xy1ene3 (Total) [1330-20-73
rauffie ss
Page 20 of 28
Results
< 0.38
< 0.'39
< 0.20
<. 0.30
0,27
< 0.29
< 0.26
< 0.28
< 0.36
< 0.27
< 0.34
< 0.38
< 0.38
< 0.28
< 0,30
< 0.40
DE Ill& MEL AY NOME
ug/L 1 0,38 1.0 0822023 EPA 82608 11/22/10 2108 JKG
ug/L 1 0.39 1.0 08221123 EPA 82605 11/22/10 21:08 JKG
vgf L 1 0.20 1,0 0K22023 EPA 82600 11/22/10 21:08 JKG
ug1L 1 0.30 1,0 01Q2023 EPA 8260e 11/22/10 21:08 JKG
ug/L 1 0..27 1.0 0122023 EP6. 82608 11122/ 10 21:08- JKG
NIL 1 0.24 1,0 0K22023 EPA 82600 11/22/10 21:08 186
ugiL 1 0,26 1.0 0K22023 EPA 82600 1.1122/10 21:08 JKG
ug/L 1 0,28 1.0 0822023 EPA 8260E 11/22/10 21:08 JKG
ug/L 1 0,36 1.0 OK22023 EPA 82608 11/22410 21:08 JKG
L 1 0,27 1.0 0122023 EPA 82606 11/22/10 21:08 JKG
uq/L. 1 0,34 1,0 0K22023 EPA 82ti08 11/22/'10 21:08 JKG
uo/L 1 0.38 1.0 0822023 EPA 82606 1112.2110 21:08 - JKG
ug/L 1 0.38 1.0 0822023 EPA 82606 11/22110 21:08 ACG
ug/L 1 0,28 40 0022023 EPA 82605 11/22/10 21:08 JKG
u9/1.. 1 0.30 1.0 01:22023 EPA 8250E1 11/22/16 21:08 JKG
084. 1 0.40 1.0 0K22023 EPA 8260E 11/22/10 21:08 JKG
1►4 % Roc ib Roc its 6aiY 1 Allaiy a By
51 1 .5't7t7 102% 51-122 072217.0 EPA 71:00 EKG
�wz
48
50,0 84 9/ 68-117 02,27023 E3PA 82680 12137/1021.i19 YCG
50.0 9146 69-110 0/72023 EPA 82608 11/2271021;00 ArG

GROUNDWATER QUALITY MONITORING:
COMPLIANCE AT REPORT
EACft'i11=�!1
F&Oily learns,
Permit Name
Facility Address:
Conia
u
Telephone it
No. of Wells la bo Sampled:
'APER
Idenli oilcan N Imber
Welt Depth:
Screened Interval:
Depth to Water Uwe!:
Measuring Point (MP,.
Gallons 01 water purnpe
Field analysis: pH
Tern
PARAMETER . ('Sennpies for
COD
Cctiform: Mt= Fecal
Coliform: MF Total
(Note: Use RWN method for flighty turbtq
Dissolved Solids: Total
pH (when analyzed)
TOC
Chloride - ..
Arsenic
Grease and Oils
Diameter.
ft,
measuring po
above land side
sampling_
pacific Conductance
C, Odor A ' I
Phenol
Sulfate
Specific Condu
Total Arnmania
TKN as N
GW•59
Rev, 03/2000
Appearance
Taictltmertt Systtr
uent (9
tent
YES No
Nitrft+e (NG2) as N � mg/I
Nitrate (NO3) as N r mg/I
'Phosphorus: Total as P l mg/I
Orthophosphate _ mgll
Al - Aluminum mg/
f la - Barium_ W . _ry mg/I
Ca - Calcium_ mg/1
Cd Cadmium_ mg/I
Chromium Total mg/I
Cu - Copper . mg/I
Fe - Iron mg/I
Hg - Mercury _ mg./1
mg/I
m
Mn - Manganese malt
K - Potassium
Mg - Magnesium_
PENIMIT N:
Non -Discharge
NPRES
Y fi't=RMiTT D GPEI TION BEING MONITORED
Remedlalion: Infiltration Gallery
Spray lField Remeastion: _.
Rotary Distrihrt to , Land Apphca%lan of Sludge
Other: .
!PARTMENT OF ENVIRONMENT & NATURAL REsoURCES
R QUALITY O1VlSION, GR©UNOWATER SECTION
AIL SERVICE CENTER
CON, IC 27892-11i318 P
IFIATION DATE:.
Values should reflect dissolved and
&dal concentrations.
natyz
Name. w
Lion NS.
cldlfled ,. YES
Ni - Nickel
Pb • Lead
Zn - Zinc
Ammonia Nitrogen
Other (Specify Compounds and Conentretion Units)
ORGANICS: (GG,©C/MS,HPLC)
(Specify test end method #. Attach lab report.)
Report Attached? Yes ✓ (1) No (0)
VOC : method M
�.,.. . method .R .. _
d 1

Melhy%cne chlcrucle [75-09-21
Page 9 o:" `228
Description: 10011.15- a-2
Matrix: Ground Water
Project: General 5uboon
Lab SampleID: C013954-03
Sampled: 11/ 15/ 10 10:05
Sampled By: Client
Received: 11/ 18/ 10 12:00
Work ©order. C013954
Volatile Organic Compounds by GCMS
Results flag Raba RE MI2L MB,L &tit MAW Mahon' Ole liolda
1,1,1,2-T < 0.40
ug/1 1 c,40 1.0 0K.2.2023 EPA 82600 I1/22/10' 20.10 JKG
1,1„1-Trlcnlceceth,ane (71-55-6J -< 0.27 u9/1 1 0,27 1.0 0K22023 EPA 82606 11/22/10 20:10 JKG
1,1„2,2•Tetractdarcethane [79-34-5] < 033 ug/L. 1 0,33 1,0 01(22023 EPA 82606 11/.2213020,10 J1CG
1,1,2-Tr11i11croetllane [79.00-5] c 0.37 ug/L 1 0.37 1,0 0K22023 EPA 82608 S1/22/10 20:10 JKG
1,1-Diehlatx(ltane [75-34-31 < 0.33 Kill 1 0.33 1.0 0K22023 EPA 82600 1 I /22/10 20:10 JKG
141-01r111oloethenle [75-35-9] < 0.24 ug/L 1 0.24 1.0 @K22023 EPA 82603 11172210 20:1,0 /KG
1,1-Dehlor probeee [563.58.6] < 0.32 ug/L 1 0,32 1,0 01(22023 EPA 82600 11222210 20.10 JKG
1,2,3-lechlaro3enmre [87-61-6[ < 0,25 ug/L 1 0.25 1.0 34(22023 EPA 8260E 11/22/10 20:10 JKG
142„3-7,141$ ,1e/ span [96-36-71 < 055 ug/L. 1 0,55 1.0 01(22423 EPA, 82608 13/22/ 10 20:10 JKG
1.2,4-Tnchicrotek ,e (120-82• 1[ < 0.36 u<yL 1 0.36 1.0 0K21023 EPA 8260E 1122Z/10 20.10 3KG
1,2.,4-Tra'relhryt enzme ['955.53,51 e 0,20 ug/l 1 0,20 1.0 01422023 .EPA 82606 11222110 20,'10 )KG
1,2-0Lronxr3-chbroceopane [9,5-1238] < 048 u0/L 1 0,48 1.0 0K'<2023 EPA 82608 11/22/10 20:10 .1KG
1,2-11d have [106-93-1] < 0.42 uo/1. 1 0.42 1.0 411C2.2023 E:PA $2606 13/22/10 20:10 JKG
1,2-0ielecYtkenaene [95.50-1 J < 0,27 ug/1 1 0, 27 1,0 01(22023 EPA 826(1B 11/21/ 10 20:10 JKG
J,2- /chlorcethane [107-IXr21 < 0-65 ug/L 1 0.65 1.0 Ca32023 'EPA 82606 11,422/10 21' 1:10 JKG
1,2-De tlaroprepane [78-87-5] < 0.20
ug/1 1 0.10 1.0 0422073 EPA 82608 l l/22/ 10 2010 3KG
1,3,5-Trynethylbenzeyte [108-57-8j < 0.25 ug/L 1 0.25 1,0 04(22023 EPA 8260B 11122/ 10 20:10 JKG
1,3-Palk t a [543.73-1I <0,30 ug/L 1 0.30 1.0 04(2.1023 EPA82600 11/7711010:10. 31/G
1,3-Dichk 'opn <ne [112.218.1) < 0,32 u93/1 1 0.32 1.0 0002023 EPA 82608 11/22/10 4t10 JKG
1,4 ctenz a [10646.71 < 0,38 ug/1. 1 0.38 1.0 (K22023 EPA 82608 1622/10 20:10 1KG
`594-20-7] < 0.55
ug/l ¢ 0,55 1.0 0K22023 EPA 82606 11/22,110 20'10 3KG
2-Bu1a. /1Br43"3'3 < 1.0 ug/L 1 1.0 5.0 OK27023 EPA 82.606 11/22/10 20:10 3KG
2,0140roeth,y11,90y1 Ether [110-75.8] < 0,94 4/9/1. 1 0,94 5.0 0S22023 EPA 82606 11/22/10 20;10 3KG
2-Qkyrobeuene [95-49-83 < 0.20 ug/L 1 0.20 1.0 042.2023 EPA 82606 11/22/10 70:10 3KG
21texarrrne [591-78-61 < 0.69 ug/L 1 0 69 5,0 2123 EPA 82608 11/27/10 20:1,0 JKG
4<:hlorolnlorile [106-413.-4 < 0.25 ug/L 1. 0425 1,0 0/2.2023 EPA 82606 11/72/ l0 20;10 JKG
4-.50onc"+t uluene [99-87-83 < 0.26 KW I. 1 0.26 1,0 OK,22023 EPA 82606 11/22J10 20:10 JKG
9-Methyl2-pentanone [106-10-1) < 1,1 ugh 1 1.1 5.0 0K22023 EPA. 8260B 11/22/1020'.10 JKG
Acetone [67'44.1] 74.7 ug/L 1 1,5 5,0 0E21023 EPA 82606 11/22710 20:10 3KG
Benzene [7 8..43-23 < 0.20 ug/L 1 0.20 1.0 0122023 EPA 82608 11/27/10 20./10 JKG
Brcteatenxrne (108-86-1] <0'.2$ uo/L 1 0,28 1,0 0 221123 EPA 826436 10221020,10 JKG
Brarerhirrrar'rreleane [74-97.51 < 1342 "" u40.. 1 0.42 1.0 0K2202.3 EPA 82606 S Y22/ 10 20:10 JKG
Brorrloclieleurorreahane 175.27-4] < 0.37 ug/'L 1 0.37 1,0 0E27023 EPA 82600 11/22210 20;10 JKG
B+Errokern [75-25-2] < 0.71 k10/3 3 0.71 1,0 0522023 EPA 82600 11222/10 20:10 JKG
Brmoleettlane [79-83-9] < 0.49 ug/L 1 0.499 1.0 422023 EPA 82600 11/22/10 20,10 )11G
Carton [75-15-01 < 0.54 .00. 1 0.59 5.0 0432723 EPA 8260E 11/24410 20:10 JKG
Carbon tetradllnrde [56-23-5] < 0,38 11g/l 1 4338 1.0 0K22023 EPA 82606 11/22/10 20:10 JKG
Chiolotxszete [108-90-7] c 0.27 ugh, 1 0.27 1.0 0K22023 EPA 82608 11/22/10 20:10 JKG
Chlorrlethane (75-00-3) < 0.30 <(y3 1 030 1.0 01(22023 EPA 82608 11,r22/10 20:10 )KG
Cher:Worm {67-66r3) 0.63 J u433 3 0.20 1.0 0K22023 EPA 82608 11/22/10 20-10 JKG
C eeneethane [74-87-3) < 0_34 ug/L 1 0,34 1.0 0K12023 EPA 82600 1 +
L 73/SO 20..10 JKG
cis-1,,2.Okla mean a [156-59-2] c 0.36 ug/L 1 0.36 1,0 0122023 EPA 82606 11/23/10 20:10 3cG
c75`1,39`id pprope to [10061-01-51 < 0,28 ug/L 1 0,28 1.0 01C22023 EPA 82606 11/22/10 20-10 JKG
DiG.RT'lhbronehare. [124-48.1] < 0,32 ug/L 1 0.32 1.0 0/G'2023 EPA 82600 11222110 20:10 7KG
Ditrornornethane [74-95-3) < 0,37 kg/1 '1 0.37 1.0 31522023 EPA 64606 31/22/40 20:1.0 JKG
Lech [25.71 $ < 0.38 uglt
1 0,38 1.0 0*22023 EPA82608 1,1/22/70.2010 JKG
Etir41P1Pnerann / 1 _8 ,4 . 0,20 141/L 1 0.20 1.0
0(32023 E5882600 1.1122710 20:10 7K33
< 0.35 ug/L 1 0.35 1,0 01C22023 EPA 02600 11/22/10 20:10 73(5
< 0-74 u3/1 1 0.24 1.0 0522023 EPA 826013 11/22/10 10/10 3(5
<" 0.48 ug/L 1 0.48 2.0 01:72021 EPA 62606 i 1/22/Iq 20:10 JKG
0,53 ug/l- 1 0.5:3 1.0 COC72423 EPA 82, .. 1,1222/10 20'.10 1KG

NO and fi
1. ,
P11
ATER QUALITY MONTORING:
CE REPORT
EASSl1 LIYAN
Facility Name
Pennil. Name
pity
Cont
Well
d tnNurrtber
Well Depth:
Screened Interv+
Depth to Water Level
Measuring Point (M.P.) IS:
Gallons of Water pumpe
Feld analysis: rlti._
Temp.
PARAmi
Coliform: MF Fecal .ro. , /100ml
Colitorm: MF Total ._ 11 OOml
(Nate: %rq MPN method far highly turbtrt $ tset
Dissolved Solids: Total _ __ mg/I
phi (when analyzed) _ units
TOC _,_ _ mg/I
Chloride 2_ __. 4 _. _ mg/I
Arsenic ____ mg/l
Grease and Oils _ mg/I
Phenol m911
Sulfate mg/I
Specific Conductance . .0 uMhos
Total Ammonia _ __„_ mgli
TKN as N rngil
SU it+tlT FORM ON Y i i / 1 APE t ONLY
Caunt�.-' fir'
_ Telephone A: '
No. of Wells to rrrnpl
et ttv ITmet sunng pal
1. above land surface.
etore sampling .j
lative M.,P. Eio 3r
atq pie collected:
plea for metals were collected unfiltered ,,�.. YES
Nitrite (NO2) as N _
Nitrate (NO3) as N
iPhosphorus: Total as P_
Orthophosphate... _ mg/I
Ai Aluminum _ mg/l
pa - Barium .
gl
Ca - Calcium_ mg/I
Cd - Cadmium mg/I
Chromium: Total mg/l
Cu - Copper rng/I
Fe • iron � _ mgll
Fig - Mercury . mg/I
K - Potassium_ mg/I
mg/I
9/1
PARTMENT OF
"QUALITY DIVIS
AIL SERVICE Ct.Nrtp.
, 1c 27649-16
PERMIT IS:
Non -Discharge
NPDES _
ATuttAt Rtrstti
dATER SECTION
one:
,EXPIFIATIO DATE: _
TION BEING MONfTORED
Ren diation: Infiltration Gallery
Spray Field =Rerned tin: w
Rotary Distributor Land Application ril Sludge
Others
OTE;, Values should reflect dissolved and
colloidal concentrations.
Dale sample analyzed;
Laboratory Name:
Certification Nb.
Mg - Magnesium _
Mn Manganese
Id acidified �, YES
mg/I Ni - Nickel
mg/I Pb - Lead
mg/I Zn - Zinc
Ammonia. Nitrogen
Other (Speclty Compounds an
N©)
Concentrat
Units)
ORGANICS: (GC,GC/MS,FIPLC)
(Specify
Repar3 �rl��� atF. Attach iota raperl.j
ROC (1) No (0)

ROUNDWATER QUALITY MONITORING:
OMPLIAi`OE REPORT FORM
tLILY IN Q M !Tl�tl r r.►
Faciame°.
Permit Name (if dil
dress:. �..
Con
d
Well Death.
Screened Interval:.
Depth to Water L.evet: _"..
measuring Point (M.P.) is:
Gallons of water pump g/b.
Field analysis: pH._
Temp.
PABAf ET
tt. taeltwv rte aeuting
tt. above land surf,
td before eerrtplirt
Specs& Condutla
Z"C. Odor
U8M T CiRtai4 N Y APER ONLY
aunty
Telephone :
No. of Wells to
f clative P. Elevation ll'
Da �t �ple collected:
uMhrs
A�str lnce—.O4(. fr-k
(Samples for metals were collected unfiltered _ YES
COD .
Collform: MF Fecal -�
CoIiform: MF Total
mg/I
/1 Ooml
11 OOml
(Nate: Uwe MPH rn ttrod for highly fur, Wilk)
Dissolved Solids: Total __ mg/I
pH (when analyzed) w,._ units
TOC _ . i mg/i
Chloride �.h...,.....mg/I
Arsenic mg/1
Crease and Oils mg/I
Phenol mgfl
Sulfate mg/1
Specific Conductance _ _ __ _ uMhos
Total Ammonia � mgll
TKNasN... mg/I
Nitrite (NO2) as N
Nitrate (NO3) as N
1Phosphorus: Total as P
Orthophosphate
Al - Aluminum
PER IT M; ES r I► 4ATION ATE;
Non -Discharge ~ s UfC
NPOES
I R.MJrI._ .I C OPERATION TIEING MONITORED
.. — Lsgovn Renteaftaliort: Infiltration Gallery
Sl ra' Field rlemedlat tw:
Values should reflect dissolved and
colloidal concentrations.
^ x ) Dale sample analyzed;
Laboratory Name:
Certification Nb.
d eotdfffed YES
mg/I
mg/I
mg/I
mg/I
mg1
Eta - Barium mg/I
Ca - Calcium_ mg/I
Cd - Cadmium _ _ mg/
mg/
mg/
Chromium: Total
Cu - Copper
Fe - Iron mg/
Fig - Mercury _. mg/
K - Potassium- . ,. mg/
Mg - Magnesium mg/I
Mn Manganese rn�
Ni - Nickel_
Pb - Lead
Zn - Zinc
Ammonia Nitrogen
Other (Specify Compounds an Concentration Units)
NO)
ORGANICS: (GC,©C/MS,HPLC)
('Specify test end method O. Attach lab report.)
Report Attached? Yes ; _ (1) No ,(0)
VOC : method
method +r
method 0 tt
toy t, 9xa. ari'c^rr
GW-59
rev, 03/2000

GROUNDWATER QUALITY MONITORING:
OMPLIANCE REPORT FORM
F MATk
F scatty
Permit Name (It ditteren
Fac1ity Addr 7
Contact Person;r1—
Well Location/ Site Name:
Welt Identification N b
Welt Depth, _ r:
Screened Interval:
Depth to Water Level: swing poin
Measuring Point (M.P.) ft. aboe land suri/ace.
Gallons of water pumped/balled before eampling
Field analysis', pH.. Specific Cend
Temp. °C, Odor PC"'
U8M1T HDRMN Y
on
Telephone 4t:701--S2417.5
No. of Wells to be Sampled:L-1-
yo Typo
ft, Well DI
eAl3AMETERS (Samples for metals
COD
Golliorm: MF Fecal /100mi
Coliform MF Total _/100m1
(Nair: Uwe PaPH rosihad tot highly tuf
Dissolved Solids: Total mg/I
pH (when analyzed) units
TOC mon
Chloride rriga
Arsenic mg/1
mg/1
moil
Specific Conductance uMhos
Total Ammonia mg/I
TKN as N moil
Appearan
were collected unfiltered
moll
Grease and Oils
Phenol
Sulfate
On. 0 Influent
a Effluent
.P. Elevation In It:
collected; 7-2-
YES
Nitrite NO2) OS N
Nitrate (NO3) as N moll
tPhosphorus: Total as P_7-''< __ _ mgil
Orthophosphate mg/I
Al - Aluminum ______mg/l
Ba - Barium_ mg/1
Ca - Calcium _ mon
CcI - Cadmium moil
Chromium' Total mg/1
Cu - Copper moll
Fe -Iron atoll
Ng -Mercury mg/I
K - Potassium — mg/1
mg/1
mg/1
N Y
PERMIT to:
Non-Dischar
NPDES
H
NATURAL RESOURCE'S
ATER SECTiON
PH Lel
EXPIRATION DATE-3
)23C1 uic
OPERATION BEING MONITORED
Remecastion: Infiltration Gallery
ray O4 Pernedation:
Rotary Di lot Ap lication ai Siticitait
Other: -A? ...LioZt<2--.
Values should reflect dissolved and
colloidal concentratiorts
me ample ana
boralory Name:
Nb.
Mg - Magnesium
Mn - Manganese
and Be
diffed
YES NO
Ni - Nicksl -- mg/1
Pb - Lead mg/I
Zn - Zinc
mon
Ammonia Nitrogen mon
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/TvIS,HPLC)
(Specify test and method e. Attach lab report)
Report Attached? Yea (1) No (0)
VOC method
: method if
method to
f 0 iy h ttw tJ •.:1; • v 3yr tJ n t1,T4 rclpqr111.11,up, .ps'xtg' ;trul 3t UN, 1,'!".*,r,11051,N,1o."-ti 4 kVi1k
17 AT 0'1 Li t f1 111 ,t tp, I A[M1 L,Vbi y LCM Jtcd trIrarn for %tit,rrhIlir r) 1lnil wnifical)
Ph!,i 01101:J5i ,tilm nnT

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
F SALLTYJN1QAMAT
Facility tsJarne:_it?:alli.
Permit Name (If differenq2
Facility Address:
Contact Persorr..
Well Location., Sate Name:
dent'
ell Depth:
Screened Interval:
Depth to Water Level:
Measuring Point (M.P.) iv
Gallons of water pumps
Field analysis: pH.
Temp,
rnpled:
SUBMIT FORM ON Y
County
Telephone #:
No of Wells to be
1er in.
8. below measurn point,
It above nd surface Relative MP, Elevation In ft_
ing:-31-77Dal
SpecCooduct)ance UMhL
"C, Odor Apearnnce
pleas for metals
o F Total
Note: Use MPN method for highly tur
Dissolved Solids: Total ___-,
pH (when analyzed)
TOC _
Chloride
Arsenic
Grease and Oils
Phenol
Sulfate
Specific Conductance
Total Ammonia
TKN as N mg/I
were collected un YES
mg/I Nitrite (NO2) as N
Odrni Nitrate (NO3) as N
00ml lPhosphorus: Total as
Orthophosphate
Al - Aluminum mg/I
pa - Barium, _ mgll
Ca - Calcium mg/I
Cd Cadrnium mg/I
mg/I
rag/1
ed;
mg/I
units
mg/I
mg/I Chromium' Total
mg/I Cu - Copper
mg/I Fe - Iron
Hg - Mercury
K - Potasslu
Mg - Magnesium
Mn - Manganese
APER ONLV
PARTMENT Qf
AUTY
ENVIRONMENT 6 NATURAL. RESOURCES
YtSIOM. GROUNDWATER SECTION
PERMtT V: XPI A ATE:
Non -Discharge IC
NPDES
TyPE_OF PERMITTED OPERATON BEING MONITOR
Lagoon Remediatiort InitRiaUui, Galtery
Spray Field nemetliation:
Rotary Dist! Land ' n nl Sludge
. Other:
OTL Values !should reflect dissolved and
colloidal concentrations.
e sarnpa analyzed:
aboratory Name;
edification NI).
mg/I
uMhos
mg/I
d II Id acidified LYES
mg/I Ni - Nickel
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
NO)
_ rnio
Ph - Lead mg/I
Zn - Zinc mg/I
Ammonia NI rogen.. <IC?, c) mg/I
Other (Spool/ Compounds and Concentration Units)
ORGANICS: (GD,GC/MS,HPLC)
(Specify test and method O. Attach tab noport.)
Report Attached? Yee (1) No (0)
mg/I VOC : method N
mg/I
: method *
: method 1.
ot my Llott, P 0/./-,r tldf,• rep IS icuP, ;:nd ,./E' '4Eit 91i/ './11-1hy,hr -It
1.1 ',ft' Pi ki! OtHIV:.•-; t.;‘,a1 NC1tI i; /,;r1 t.qt? (r trtr,. I V 111M, C011iCd LAA)r4.21-,--y ,,t.tn 1W3WA 0ty twt ',/ottf/1/':,1011.-'1t trol'',kr"titiVAP Thrr)11.Vf- 'trm Lt'tt"
p!:H wty o trhJ 1J rn/ ,11! krt./hv ttvtl,thxpt.,
GIN-51)
03/2000

SUBMIT FORM ON N'LLQ..W PAPER ONLY
MMIT.P.1.1.11.3=i3aVIM
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Cle
FAQIL1T
It
F�cilfly Name:
Permit Name (if diftere;
liy Address:
-1243;5(
Conat Person:
lionl Site Name:
„
Hy or Type
Telephone ti:-,20•/':'"
No. of Wells to
Wen Identification_ furnber (from Permit): JLL
Weil Depth: _ 0, Well Diameter:
Sat:toned Interval: ft. to 0,4-7'
Depth to Water Levelft, below measuring point.
Measuring Point (M,P.) is: tt. above land surface, Relative M.P. Elevation in ft.
Gallons of water pumpeiatalled before Dale proof° collected
led;
Tte
Fieid analysis: . Specific Cohductaoce /e7Y uMhos
Temp.-_,1"C, Odor /k
form: ME Fecal
rrn: MF Total
ted u
mg/I
/100m1
/100MI
(Note: Use INtPN method tor highly hob,
Dissolved Solids: Total
pH (when analyzed)
TOO
Chloride
Arsenic mg/I
Grease and Oils mg/)
Phenol
Sulfate mg/1
Specific Conductance uMhos
Total Ammonia _ mg/I
TKN as N mg/I
mg/1
units
mg/1
mg/1
Appearance
Ma 1
to:
Spray Field
notary Distribulor
Other: -
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER OUAL/TY DIVISION. GROUNDWATER SECTION
1130 MAIL SERVICE CENTER
MIEIGNk NC 276WtI911 Phohe: (9194 7'33.3;21
EXPIRATION DATE:,
UIC
Eli OPERATION BEING MONITORED
Remediation: infiltration
Rernediatioh
Land Application ol Stu
Values should reflect dissolved and
colloidal concentrations.
Dale sample anal -
Laboratory Name: ---
Certification Nb.
ftItered,VES NO and field acidified
Nitrite (NO2) es N mg/I
Nitrate (NO3) as N
'Phosphorus; Total as P
Orthophosphate
Aluminum
Ea -Barium.
Ca - Calcium
Cd - Cadmium
Chromium: Total, 11
Cu-Copper
Fe • Iron
Hg - Mercury
K Potassium__
Mg Magnesium
Mn - Manganese
mg/I
mgll
mg/I
mgti
mg/I
mg/I
mg/I
mg/I
mg/l
mg/I
mg/1
mg/I
mg/1
mg/t
YES
Ni - Nickel__
Pb - Lead.,
Zn - Zinc
Ammonia Nitrogen A
Other (Specify Compounds and Concentra n Units)
ORGANICS: (GC,GeRviS,HPLG)
(Specify test and method Attach lab report.)
Report Attached? Yes___(i) No (0)
VOC method
method
method 0
...M.. • le
62:110
initteeler kirsiwteed Agent) Nile*
GW-59
Rev, 03/2000
as print or type

1
GMOUN(WATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
l Y. tNE�
Facility Name
Permit Name (II oil'
acuity Address -
(enact Person:.
Well Location/ Site Name:
dentN
trpth: _ _.._._.W
d Interval:
Depth to Water Levei: - t
Measuring Point (M.P.) is:
Gallons of water pumped.ib
Field analysis: .pH._ -
Tern
RM CAN Y
SUBMIT
c unTy.
Telephone #
No of Welts to
. ttelow rTierteuring point.
It. above land surface. 1
before Sampling:
Specific Conducllnce
°C, Odor
Appearance
PAPER ONLY
PE tMIT it:
I�lrtn Ilischarge
DEPARTMENT OF EVltt'Ott
WATER OUAUTY t71VIS ON, t
1636 MAIL SERVICE CENTER
,... Gti C 2 69: 16
& NATURAL RESOURCES
iOWATER SECTECNN.
P . rr• 91: 733. ., 1
IN GATE; ,9M
D OPERATION EiEING MONITORED
Bern er:Mon: Infiltration Gallery
Pelnedlation:
LandA sfrheaUon of Sludge
Values should reflect dissolved and
colloidal concentrations.
!#t sample anal
boratory Name:
iltcution Nb. ...21
PARAMETERS (Samples for metals were collected entittertrd_ YES NO end field acidified
mg/I Nitrite (NO2) as rng/I
/1O0mt Nitrate (NO3) as N _ mgll
/100ml tPhosphorus: Tot € i as P M' r mg/I
Orthophosphate mg/I
mg/I Ai - Aiuminum_ mg/I
units t3a - Barium ..mm. ._._ mg/I
mg/I Ca - Calcium .._ _ __ rngrl
mg/I Cd - Cadmium mg/
rng/I Chromium: Total « ... mg/
mg/1 Cu - Copper mg/
mg/I Fe - Iron mg/
mg/1 Kg - Mercury mg/
_ uMhos K - Potesslurn
„ mg/I Mg - Magnesium _
_ mg/I Mn - Manganese
COED
Coliform: irAF Fecal
Coliform: MF Total
(Nolo: Us* MPH niglhod tea highly 1
Dissolved Solids: Total
pH (when analyzed)
TOC w..
Chloride...,
Arsenic
Grease and Oils
Phenol
Sulfate
Specific Conductance
Total Ammonia
TKN as N .. r
GW-59
kii6
Rev, 03/21000
YES NO)
Ni - Nicktal� ,
Pb Lead:_
Zn - Zinc
Ammonia Nitrogen
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify teat and method O. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC method M -_
method .N
method N

Sif8lh1T
OUNDWATER QUALITY MONITORING:
PLIANGE REPORT FO
Facility Name:1
Permit Name (If di
Facility Address:
Conte
Well Location/ Site Na
Well Id nttfcation N
Wet! Depth:
Screened Interval:
Dorrth to Water Levet
Measuring Point (M.P.) IS:
Gallons of water pumpal.I
Field analysis: pH ._. 1.
Tem
e A9AMET_ERS (S
COD
Conform: MF Fecal ___
CoIit arm MF Total
(Ploys; Use RIM mothoel for nighty yr rbt[t
Dissolved Solids: Total .w..
pH (when analyzed)
TOC m
Chlori,. _ mg/1
Arsenic _ _ 4 mg/1
Grease and Oils _ mgll
Phenol _ __ _r_ mg/1
Sulfate m
Specific Conductance uMhos
Total Ammonia mg/I
S KN as N ,. .. mg/I
County
Telephone
No. of Wells to be Sampled.
RM ON Y I ' PAP I» R ON
Dlameter:
measuring point,
above land surface. Relative
re sampling II
Date
Specific Conductance —%'}
C, Odor / 'LC)) A
plea for
Fa Groundvrltter Treatment Systems
per.0 Influent (98)
Effluent (99)
t.P, Itlevatlien In
mole coil+ cted: 2-
d unfiltered_ .y
Nitrite (NO2) as N
Nitrate (NO3) as N ,
4Phosphorus: Total as P
Orthophosphate
rng/I Al - Aluminum
units Ba - Barium _.
Ca - Gaiclum
Cd - Cadmium_ _. mg/1
Chromium: Total mg/I
Cu - Copper mg/I
PARTMENT OF l: tllRtfl:Ml lrT & NATURAL RESOURCES
kr rt tatiALtT°i' 1}I tAl6tt„ G OUMDWATER SECTION
tB l!IIAfL SERVICE 1GEi ER
Phone: (919' 7TT3.3 31
Non-Qisch E�UI lO'�l'DATE•
FtMIT e:
PI
3rge
NPDES . _ n_-_m__.
TYPE OF PERMITTED C'PE I TION BEING MONITORED
Lagoon Fty*nte i aVon: Inllliratlon Gallery
Spray Field rlartsallaa9idn:
-
Rotary I slrlt y 1Car Land Apphceli©n of Sludge
Other
Values should reflect dissolved and
colloidal concentrations.
Certifies
ample analyzed:
Name: _
Nb.
NO rind field acidified
mg/I
mg/I
mg/I
mg/I
mg/I
mg/1
Fe - Iron rngfl
Hg - Mercury mg/I
K - Potassium_ _ mg/I
Mg - Magnesium mg/1
Mn - Manganese mg/
Ni - NickAl.-.,_
Pb Lead
Zn - Zinc
Ammonia Nitrogen
Other (Specify Compounds and Concenlrat3on Units)
ORGANIC s: (GC,GC/NIS,HPLC)
(Spicily teat and method #l. Attach lab report.)
Report Attached? Yes (1) No .. (0)
VOC : method ar
- method #1
. method ##

GROUNDWATER QUALITY MONITORING4
COMPLIANCE REPORT FORM
IIYJN_E9_11.MA
y Marne:II:41'
Permit Nance (It dill
Addratss'm
Contact P ern:.
Well Location/ Site Name:
VVeti tdenW calm! Number (frotrrr Per
Well Depth: ll.. m. .,. ft. We
Screened Interval:
Depth to Water Lever
Measurtng Point (M.P.
Gallons of water own
Feld analysis: pH _ z
Temp.
unng point,
ft. above land surface. R
d ll$ed bete re eampiing ;,� �"I`
Specifi+ oncfuctance
C, Odor I Af
IARA$ (SempleItected unf
CO ,. mg/I
Cotitorm: MF Fecal . / /10omi
Coliform: MF Total . _ /1O4ml
(Motes: Ilia MPH mother' for highly .mpleo)
Dissolved Solids: Totalm.
pH (when anaiyz
TOC
Chloride
Arsenic
Grease and Oils mg/I
Phenol _. ._. _ mg/t
Suttat , mg/1
Specific Conductance
Total Ammonia
TKN as N . .,
GW•5B
Rev, 03/2000
units
mg/1
mg/i
mg/t
uMhos
* . mg/I
mg/I
U8MIT FORM 1N APER ONLY
prfrrl Clearly or type
pd..��
T
twee M_P. El+evtafion it
cta aarr�ple �lecte d
PE tMtT $:
taw l e hair taelk,
pray Field
Rotary pistrlhu1or
tat
tRTMEtV"r0 EN IRt 1M1^Nr 1i NATURAL RESOURCES
ER �ttaAt la'! fltrltr t0ti, q;ROUNOWATER SECTION
EXPIRATIDATE:
AMC
OPERATION BEING MONITORED
Remedlati©n: Infiltration Gallery
Pemedlatbon:
pliCatIon of StudOe
Vetoes should reflect dissolved and
colloidal concentrations.
tear sample anal
boralory Name:
trtticlalion NO.
tared YES NO and field acidified
Nitrite (NO2) as N _ ., : mg/I
Nitrate (NO3) as N c mg/I
4Phosphorus: Total as P } _ mg/I
Orthophosphate __ mg/I
mg/I Ai - Aluminum mg/1
Ba - Barium
Ca - Calcium_ ,
Cd - Cadmium
mggfl
mg/1
Chromium: Total_ mg/1
Cu - Copper _._._ mg/1
Fed Iron _r mg/I
Kg - Mercury mg/I
K - Potassium mg/I
Mg - Magnesium _ .. mg/"I
Mn - Manganese mgl
YES
Ni - Nickel_
Pb Lead
Zn - Zinc
NO)
Ammonia Nitrogen
Other (Specify Compounds and Ccanc
ORGANIC B'< (GC,GC/MS,HPLC)
(Specify test and method It. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC method #
method M
: method 0

GROUND t + UALrTY M C IT
il4PL+i', �RCiri T POPM
Ni - NMOe1
Pb Lead
Zn -Znc
Ammonia n
Other (Amoy Cad d o C i
KMMIMZ

GROUNDWAT R QUALITY MONITORING:
CQN, PE,1l4NCE REPORT F
Facility Ns
Petra
MFT�
II To
n anl^e1)
T3
T
TXNasN
SUBMIT M CN ELL
EXPIRP TI$ t�F TEz
GIC
Te��
No. of Was to be
Cd-rrilur
Chrt'$n T
Cu
Fe . iron ORO
I�- Mammy
X- Potassium .... � � ' Y
mMg - Magnesharn w vrt
m Mn - Manganese . _ w �
r

COD
Co Moen:
Caw= MF Total
(Ptaiim Use Wilt method tor highly Aurp'
Dissolved Soli) Tim
pH when analyzed)_._
Chlorid
Arsenic
Greuse and ago
Phenol
Sulfate
Specific Conductance.
Total Ammonia
T14N :ta N ,_
GV4r-SO
Ci.112001)
N 'YELL r PEER LY
Pb
Total as P Zn - Zinc . rn
Ammonia
Al .. A uOther (SpsdkCanpounds mad t a)
E
a - Barlum,
Ca - Calcium rn�
Cd rrt�
Chromium: T�
Cu - Copp.
F - Iron OROAtCS: �G+ 1smat.o)
H9 - MettitirY laa ru�ld #. Attach port)
K - Pot
Mg -Magnesium
Mn - ,Mass -

�0
GR DWATCR QUALITY MONtT0 N
PI IAE REP w :- T FORM
F
Pere* Name (It
wi
CO
TB
Olean IN. WIN method foilighly
Dissolved Solids: Total
pH (when analyzed)._
TOC
Chlorlds
Arsenic
Grease and Oils
Phenol
Sulfate
SPoCitic Qctance
Total Ann.n nia
Ti(4 see N
DEPARTMENT OP it s
WAt EA =limn MEWLa
ssaa NAIL $IR1 scM Vann
NIA (N 3)
IPCIJ • T
Chs^il :T
Cu .
Fe • lresP .. Q
H$ - Mercury m
K
Coneankati n tom)
A� tare l
Yee (t) Na

r—
SU T
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FAaUTYJNE
Facility Nam
Permit Name
Faci
41
ConIa1 Peron
Well Location/ Site Name:
flrent)
Id
Number (trom Per
Well Depth:
177-171‘.'1,-
ziounty
or:
Screened Interval: it, t
Depth to Water Levet: :2-2— ft. be ow measuring point.
Measuring Point (M.P.) It, above land sut1ac.
Gallons of warerTpeummpp.eid/b„ alled.be:zorsarn, 1:1177:,_3 A
Fed analysis: pH , . Specific Conductance _
Telephone t.
No. of Wetls to be Sampled;
,P, E
Ttement Val
Influent (98
uent (99)
ton ft,:
Date sample collected:
_ uMhos
arance k f?
ONLY
ARTMENT OFENVIRONMENT & NATURAL RESOURCES
.al_frr DIVISION., GROUNDWATER SECTION
At.
IT 0:
'sonar
YPIRAT N DATE:,
OPERATION BEING MONITORED
Lagoon eernediation: Infilualion Gallery
Spray Field nernediation:
Rotary DjsIrlbuter Land Applicallon ol Sludge
01110r: - "Ir2,Cire7-'e/
DTE; Values should reflect dissolved and
colloidal concentrations.
to sample analyzed: /
Laboratory Name: -
Cadilication Nb.
BARANginias (Samples for metals were collected unfiltered YES
Conform: ik Fecal
Coliform: MF Total _
(Note: Use MPN mathad far hIghly turbid maniples)
Dissolved Solids: Total mg/I
pH (when analyzed) units
TOC mg/1
mg/i
mg/1
Chloride
Arsenic
mg/1 Nitrite (NO2) as N
10Orn1
/lOOml
Grease and Oils _____ mg/I
Phenol mg/I
Sulfate _ mg/1
Specific Conductance ____ uMhos
Total Ammonia . mg/1
TKN as N __ mg/1
Nitrate (NO3) as 11 , mg/I
tPhosphorus: Total as P mg/I
Orthophosphate mg/I
Al - Aluminum mg/1
Ba - Barium
Ca - Calcium mg/1
Cd - Cadmium - mgl
Chromium' Tots mg/
Cu - Copper, _, mg/
Fe • Iron Mg/
Hg - Mercury
K - Potassium_
Mg - Magnesium
Mn - Manganese
mg/
mg/
mg/I
mg/I
NO and field acidified JLYES NO)
mg/1 Ni - Nickel_ _ mg/I
Pb - Lead mg/I
Zn - Zinc
Ammonia Nitrogen C, mg/I
Other (Specify Compounds and Concentration Units)
ORGANIC (GC.GCAMS,HPLC)
(Specify test and method N. Attach lab report.)
Report Attached? Ye& (1) No (0)
VOC method
method #
: method #
C%i Iy 01, II. 1C1'11i 41ot my4 U Lt 1 i L IE4r 11,01J poTy,,trt u; Pup, acri•pu!p., ;Ind cry111,...1,„:. einJ fl il Illt? 9,1!..4:':',mtor,;," an:11°,4-11
t CJ! LAr :I '1:(;;O!. (W11..)0`.1111,,r v LA:m)unlohed Lbur4topy 1 am aNups 1Put hat, for rAibrrirthrl til'•(‘! frihrrn'itOri
HI Or( lc;r 1h8 nol;Irg) r,
GW-511
Rev, 03/2000

GROUNDWATER QUALITY Mi3NITORING:
COMPLIANCE REPORT FOR
Facility Name:
Permit Name
Address -
Con act Person: -
Well Location/ 'Site Name:
4rYelr Identification Number (fro
Well Depth:
Screened Interval:
Depth tat Water Level:
Measuring Point (M.P.) is:
Gallons of water pumps
Feld analysis: pH
Tem
MF Fecal
MF Total
(Plate: Um NPN moehod far highly Iurbi t�s)
Dissolved Solids: Total __. _JCP`
pH (when analyzed)..
TOC
Chloride
Arsenic
Grease and Oils
Phenol
Sulfate
Specific Conductance
Total Ammonia
TKNasN._
u
un
SUBMIT FORM ON
rft +t"e�eirry or Type
C aunty
Telephone
No. of Wells to tte Seismpled:
Reuling point.
before sampling:
Conduct.
°C. o ,/?. i`)i-
P, Elevations Ir
stale r*trllrtrted:
ce
es for metals were collected unfiltered ...,YES
Nitrite (NO2) as N
Nitrite (NO3) as N
tPhosphorus: Total as P
Orthophosphate
Al - Aluminum
pa - Barium TM
Ca - Calcium_
Cd - Cadmium
Chromium' Total
Cu - Copper
Fe - iron
Hg - Mercury
K - Potassum
Mg - Magnesium
Mn - Manganese
PAPER ONLY
PERMIT M:
Non-
NPDES
RONMENT 6 NATURAL RESOURCES
ON, Ge0UNDWATER SECTION
EX rr"tf ATION DATE:
U I C
TYPE OF "EI;MUrTED OPERATION BEING MONITORED
Lagoon Aernediation: Infiltration Gailery
Spray Field Remediatlon:
Rotary rMstrIbutof Land Application of StudQe
Other:L.%� ... �tl ra1•1r,1
Values should reflect dissolved and
colloidal concentrations.
ample analyzed:
ry Name:
Lion Nb.
and field acidified YES
mg11 Ni - Nickel
rngli Pb - Lead
mgll . Zn - Zinc
mg/I Ammonia Nitro f n ,
NO)
(Spacffy Compounds and Concentra
ORGANICS: (GC,GC/MS,HPI-C)
(apathy test and method ff. Attach lab report.)
Report Attached? Yes. (1) No (0)
VOC . method 0 =
method M
method N
Units)
a 9 I`yr ,a 1; t;
ii"�; Iq°tiJri3icrlitC'-ij 1.I�.f) ¢t�ilrrrl:it�t1�'1,
GW-59
IllikRev. 03l2000

(Note: Ur. NIPN method fat highly wrbld samples)
Dissolved Solids: Total mg/I
PH (when ananal
.-lyzed)..____ units
TOC _ _ mg/I
Chloride _. mu mgli
Arsenic _._.__......, mg/1
Grease and Oils _ mg;1
Phenol _ �.. mg/I
Sulfate mg/1
GROUNDWATER QUALITY MONITORING
COMPLIANCE REPORT FORM
Fadhly Warne
Permit Name
IilitY
Conte
Weil Location/ Sate
Wait Identi
Well Depth; _
Screened Interval;
iT t
Depth to Wafer Level' . 7 ft. be
Measuring Point (M.P.) is: _? . 11. above to
Gallons of water purnpnballed before stamp!
Field analysis: pH.Specific Cana
Temp, °C, Oder �,+....
wring
SUBMIT
RN
For Green Trefltlii rlt
influent
Ell #uent
taco. Reta iirvsr +I.P. Elevation Ir
©ale earnpie ,wilted:
opce . /e -'. iMhrrs
Aparancei°.�/
pies for metals were collected unfiltered _YES N©
COO ,__....._ _ .
Caliform: MF Fecal _<,
Coirform: MF Total
Specific Conductance
Total Ammonia
TKNasN__._
PAPERONLY
PER
Non-Discharg
NPDES
JAE
PARTMENT OF ENVIRONMENT & I+iATURAL RESOURCES
iTER ALITT ENVISION, GROUNiI'VIiATER SECTION
EXPIRATION DATE:
ill N BEING MONITORED
Ren ettiation: infiltration Gallery
RemerflatilOn: 4 _
Land Application nr Sludge
Values should reflect dissolved and
colllaidal concentrations,
Hate sample analyzed;
Laboratory Name: W
Certification N,.
and field
mg/I Nitrite (NO2) as N _ _ img
/1 OCml Nitrate (NO3) as N \ _ rng
/100mi (Phosphorus: Total as P .. _ . mg/I
Orthophosphate mg/I
Al - Aluminum u mg/I
pa - Barium mg/I
Ca - Calcium.. mgll
Cd - Cadmium mg/I
Chromium' Total mg/l
Cu - Copper mg/I
Fe - Iron _ mg/I
Fig - Mercury - _ mg/I
uMhos K Potassium mg/I
mg/I Mg - Magnesium _ ._.. mg/1
mg/1 Mn - Manganese , mg/I
m:nlr��
(fell (I3a.,,rrx ire :,hjr"u0".3rlt
YES ND)
Ni - Nickel_...__.m_.m..__.,
Pb - Lead
Zn - Zinc
Ammonia Nitrogen_
Other (Specify Compounds and Concentration Units)
ORGANICS. (GG,GC/MS,HPLC)
(Specify test and method 4..Attach lab report.)
Report Attached? Yes, (1) No (0)
VOC method Ir

GROUNDWATER QUALITY MIGNIT'
COMPLIANCE REPORT FORM
1U11Y INEQ. 1 !1AT
Facility Name:
Permit Name (if di
dent tiara Number
W Depths:
Screened Interval:... "
Depth to Water Level:
Measuring Pont (MR.) Is.
Gallons of water pummeballed
Field analysis:
Per
Weil Diameter
ft.
urine per
iLI
ING:
;elunty
Telephone
No, of We
N Y PAPERONLY
to be Sampled:
otuid t+ r Tr tm*n1
Ortlt; tI Influlen
Effluent
nd surface. t stative M P, E
before eampiing; S Lf Dale earnple col (vied:
Specific Cdance _./WuMhns
°C, Odor , "?I Appearance
PAIAMEt3S (Semple; for metals were cofloated
mg/1
Collorm: t Fec:al 1Opmi
Colifotm: MF Total q. /100m1
(Nolo: Use MPH method kir highly turbid samples)
Dissolved Solids: Total di 2-- mg/I
pH (when analyzed) _, units
TOC ntgll
Chloride _ � mg/1
Arsenic . - mg/1
mg/1
Specific Conductance _ __uMhos
Total Artlmonla _____ mg/I
TKN as N mg/I
Grease and Oils
Phenol
Sulfate
fltererd__Y
NO
Nitrite (NO2) as N
Nitrate (NO3) as N
'Phosphorus: Total as P
Orthophosphate
Al - Aluminum _
pa - Barium
Ca - Calcium .
Cd - Cadmium
Chromium. Total
Cu - Copper . rng/
Fe • Iron rng/
Hg - Mercury _ mg/
K - Potassiurrm.. mg/
Mg - Magnesium ..__ . _ rngll
Mn - Manganese
PEF1MIT M:
Nan- Dischar
NPDES >,
TYPE OF P F MITT I
._ Lagoon
Spray Field
Rotary G?islrlbul.
Other:�(,�
ENT OF ENVIRONMENT 3 NATURAL RESQURCES
llAUT! ttIVISION, GROUNDWATER SECTION
iCENTER
EXPIRATION
UIC_
OPERATION TIEING MONITO
Rernediation:Infiltration
Remedlation:
Apphcarian ol Sludge
Values should reflect dissolved and
colloidal concentrations.
hater earttple anal
Laboratory Name:
Certification Nb.MIL
and field acidifiedYES
_ mg/1 Ni - Nicked_._._._.,
mg/I Pb - Lead
mg/I Zn - Zinc
mg/I Ammonia Nitrogen
mg/1 Other (Spec fy Compounds an
mg/1
my_.._v..
rng/ -
N©)
niralion Units)
ORGANICS: (GC,GC/MS1HPt.C)
(Specify test and method #. Attach ab report.)
Report Attached? Yes . (1) No (0)
VOC : method A
Jw
��ry: t,':,5 err llrr°, rrzmrt: tt to !
GW -58
Rev, 03/2000

P'ABAMEI FRS (Samples for metals were collected unfiltered
COD rng/I Nitrite (NO2) as N
Col orris: MF Fecal „ i� ,1IOrni Nitrate (N3) as N
Coliform: MF Total __ lOOml iPhasphorus: Total as P
Orthophosphate
Al - Aluminum
Eta - Barium
Ca - Calcium
mg/I Cd Cadmium
mg/I Chromium: Total
mg/I Cu Copper
mg/i Fe • Iron
rng/t Hg - Mercury
uMhos K - Potassium
mg/I Mg - Magnesium
mall Mn - Manganese
dlfled YES
Ni '- Nickel_
Ph - L"eac .
Zn -Zinc
Ammonia Nitrogen
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test end method #. Attach lab repor}4
Report Attached? Yes. (1) No ./ (0)
VOC , method N = 21G p
method #t
method
SLi MIT FORM 3N Y
OUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY l MAesa
Facility Name. �...l
Pbrrnit Name(If dilltrtrrt t x.:_�.�
rrn'tact Pet on .
Well Location/ Site Nam
Leo ldent' ttarr arrntber (
Well Depth: _
Screened !Memel:
Depth to Water Level:
Measuring Point (M.P.) Is:_.
Gallons of water pum
Field analysis: pN _ "�
Temtt.
Telephone .
Na. ple
_ft. to.
ft. bemww mea,swing paint,
ft. above and surface. Relative M.P. Elevafi
before sampling: Date Date sample collected:
, Specific C'%f� uWins
°C, Odo L&W A
Ttttlleltt
intiuent
affluent
(Note: Um MiPN method tear highly turb
Dissolved Solids: Total __ mgil
pH (when analyzed) _ �' _units
TOC „-.., y m i
Chloride .
Arsenic
Grease and O is
Phenol
Sulfate
Specific Conductance..
Total Ammonia _
TKN as N
NLY
PE MIT N:
Non-Discharc
NPDES
PARTMENTOF ENVtRONNENT 6 NATURAL RESOURCES
trEtt OUAI_ttY DIVIlON, GROUNDWATER SECTION
MAIL SERVICE CENTER
itsIt ; C 27626-t635 P}►drrsws."t¢
y 'Field
ry DistrIbutor l.artd App$icattan of Sludge
Other:
EXPIRATIt N DATE:
UIC
ERATION BEING MONITORED
Rerner:Me n: In1Hlration Gallery
Remsdiation: _
µ Values should reflect dissolved and
colloidal concentrations.
ample analyzed:
ry Name:
lion Nb.
fw.sti ..
t8"5y fit,
: t 6lp r e,

GROUNDWATER QUALITY M
CO 011PLUANCE REPORT FOR
AT4
Facility Na
Permit Name (it d
cility Arkiress
Icrr1.
Contact Person:
Well Location/ Site Nam
dentt t
Well Depth:
Screened Interval:
Depth to Water Level'
Measuring Point (M.P.
Gallons of water purnped/b lied be
Field analysis: pH.___6i .
Terri
1A T.1
Cal _�
Conform: MF Fecal
Conform: MF Total
Nurnt.ter
(Note: Use MPN method tour highly turbidearnttes)
Dissolved Solids: Total
pH (when analyzed)„._.
._..
TOC
Chloride
Arsenic
Grease and 01
mg/I
units
mg/1
mg/I
Phenol mg/l
Sulfate mgfl
Specific Conductance _ __ uMhos
Total Ammonia _mg/I
mg/I
TKN as N
NITQRINC:
Sample. for metals were col
d itlt ONfQ PAPER ONLY
Please Print hearty' ar Typo
Fcrr r tttltttftttrrtt r Tr ttll)rtt ry i
ne: tnrfiuent l
IiIuent
a
2
cted unfiltered ✓YES
mg/1 Nltrlte (NO2.) as N
/100rrtl Nitrate (NO3) as N
/104mt 'Phosphorus; Total as P
Orthophosphate
AI - Aluminum
pa - Barium
Ca - Calcium _ �._.......
Cd - Cadmium ..
Chromium: Total
Cu - Copper__._._
Fe - Iron ._
Fig - Mercury
K - Potassium_
Mg - Magnesium
Mn - Manganese
T M:
-Discharge
E
PARTMIENT OF
OUALWf D4
lift MAIL SERVICE
A.ItrUtC276
RONMENT & NATURAL RESOURCES
ON, GROUNDWATER SECTION
NT6R
EXPIRATION DATE:- S +
OPERATION BEING MONITORE°
—Rernedialion: Infiltration Gallery
Spray Field , Remedlaticri:
RoIary �trl a tzar . Land Application ol Sludge
Other,
NOTE; Vales should
I
colloidal concentrations,.
ate Sample analyzed;
Laboratory Name:
tt�tion Nb.
d and
and field acidified YES ` NO)
1:�'-r- , mg/I Ni - Nickel__.. _
___ mg/1 Pb - Lead
!i .Cij rng/l Zn - Zinc
mg/I Ammonia Nitrogen <(J55----
mg/i Other (Specify Compounds and Cancan
_ mg/I .�
mg/I
.mg/
mg/
mg/
mg/
mg/
mg/
mg/I
mg/1
tion Units
ORGGANICS: (GC.©C/MS,HPLC)
(Specify to tlrt end method N. Attach lab repo
�rnethv
Report A +�ed? Yes
N(1)
No
VOC�aZ ! G'6
: method fr
: method w
is id !Cr kr...00'��,J
,ubirki rr)t,tl,r:
GW-59
Rev, 0312000

GROUNDWATER QUALITY Mi NITORING:
COMPLIANCE REPORT FORM
FAVLITYJI4
F acilily Name:
Permit Name
Ad4t
n
ATI
Well Leathery' Site Name:
Weft feertftrt
Well Depth:
Screened Interval:
N rrr tier (fro
SU8MtT
tea► PrIr1f lectrfy or Tye,
Depth to Water Level: ;? fl. l elct measuring point,
Measuring Point (MP.) is: il. strove land surface. Belat
Gallons of water pu_ Tripe lied before aarrtplrnrg:._5e
Field analysis: pH 7� Specific Conduct
Temp, C.:a °C, Odor lti�''r Apper
pies for metals were collected unfiltered°__.
COD_
Coliform: MF Fecal ..
Coliform: MF Total
mg/I
/100rnt
_ 11 00mI
Mote: Use NM method fcer hlehty turbid lam
Dissolved Solids: Total
pH (when analyzed),___,
TOC
Chloride �.
Arsenic
Grease and Oils
mg/I
units
mg/I
mg/I
mg/1
mg/1
Phenol mg/1
Sulfate ._ Tagil
Specific Conductance — uMhos
Total Ammonia p mg/1
TI<N as N .. mg/I
Nitrite (NO2) as N
Nitrate (NO3) as N
iPhospharus: Total as P
Orthophosphate
Al - Aluminum
pa - Barium
Ca - Calcium
Cd - Cadmium
Chromium: Total �* ,
Cu - Copper
Fed Iron
Fig - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese
PAPER ONLY
GW59
Rev, 031'2000
PEWIT W:
Non -Discharge
NPDES
TYPE OF P I _
Lagoon
4 Spray' Field
flotery
Other:
7L_
EXPIRATION 17ATE:
_.. ulc_
M.fTT D OPERATION BEING MONITORED
Rerrrediat,on: Infiltration Gallery
Remedlation:
lr ncl phcallan of Sludcte
'2_1
Values should reflect dissolved and
colloidal concentrations.
le 5ample analyzed:
aboratory Name:
aet4lflcalien NI).
field acidified
mg/I
mg/I
mg/I
mg/I
mgll
mg/I
mg/I
mg/I
mg/1
mg/I
rag/1
mg/I
mg/I
mmg/1
w NO)
Ni - NickQl_
Pb - Lead.
Zn - Zinc
Ammonia Nitroc en, <-0
Other (Specify Compounds and C©ncentraiieln Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test end method a, Attach lab repo
ROC Report cited? Yee.. (1) No
method N _
: method #
rrtethod a �+

GROUNDWATER QUALITY M
COMPLIANCE REPORT FORM
I IT
Facility Name_
Permit Name (11 dil
F ility Add e :
Cont
Well Location/ Site Name:
efl ldentafrltiorr Number (from Perml
Well Depth: __.ft, Weil Diameter_
Screened Interval:. _ 2° ft, to ft.
Depth to Water Level:., 7 fL, below measuring point.
Measuring Point (M.P.) is: 2- It. above land surface.
GaHarts of water purnodrbaffed before sampling:
Field analysis: pH._ 1 _ , Specific Conducts
Temp. 'Z-~(. °C, Odor '" :C)
NITORING:
5U
3N Y$.W PAPER ONLY
see Prirtt Cie or Typo
County
Telephone A
No. of Weds to be
A
plea for metals were collected unfiltered__
Colfform: MF Feca
Coliform: MF Total _.
(Note: tip MPN method far highly turbid •ampiem)
Dissolved Solids: Total ., mg/I
pil (when analyzed) -units
4
TOC mg/I
Chiortie '> mg/1
Arsenic
_ mg/1
Grease and 011s mg/
Phenol _ mg/1
Sulfate mg/1
Specific Condu
Total Ammonia
TKN as N
nce.
uMhos
mg/I
"ant
fnfitacrn
ffiuent
mg/l Nitrite (NO2) as N .._w.
/100mi Nitrate (NO3) as N
/100ml (Phosphorus: Total as P
Orthophosphate
Al - Aluminum
pa - Barium _ _*
Ca - Calcium.
Cd - Cadmium _
Chromium: Total
Cu - Copper
Fe Q iron
Hg - Mercury
, Potassium
Mg - Magnesium
Mn - Manganese
PARTMENT ENVIRONMENT & NATURAL RESOURCES
VISION, GROUNDWATER SECTION
CtNT R
ri- a P91ton4: j91pl 73.3- z 1
PEA IT 0:
Non -Discharge
NPDES
TYPE OF PEt3MtTTED k P
Lagoon
Spray Field
notary ri strbutc3r
Values
colloidal
CJate sample anal'
Laboratory Name:
Certification Nb.
RATION DATI,_43... j /
_tJIC..
TION BEING MONTT
Flernediation: Infiltration
rra ticn.
uld reflect dissolved and
oncentratfons.
and field acidified .:, YES
/) 7 mg/I Ni - Nickel_
mg/I Ph - L.ead
mg/I Zn - Zinc
mg/I Ammonia Nitrogen �� S
mg/i Other (Specify Compounds and Concentration Units)
mg/1
mg/
rng/
mg/
mg/
mg/
mg/
mmg/I
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method N. Attach lab report;}
Report Attached? Yet. (1) No
VOC ,[ �(k' method =
method
method #I
e: nisi°,, t?'t..t, tCa 11 C' t..r, ,G cat riv!
GW59
Rev, 03/2000

Report to: M RQ
GROUNDWATER 'SECTION
CHAIN OF CUSTODY (COC) RECORD
NC DENRIDWQ LABORATORY (check one) ( X J CENTRAL [ 1 ARO i 1 WaRO
Investigation of:
Sat pie collector (pri
and GW-54 forms completed by: MARGARET FINLEY Sample collector's si
Groundwater
conditions and locati©❑ (when applicable):
e Onty
O.
quish
A PLE D QUAD, NO,
szgna
hed by (sagrta.
'ATION
Time
ved by (
Received by (sigrtatu
d of Shipment (circle one3 State Cour Hand -delivered Federal Express
Sealed by:
ecuriry Type and Conditions: Margaret Finley,
TII 4LAI 0Ra^4TORY CHAIN OF CUSTODY
QA\Forrns Sampie Receig1COC faun GW
Broke
Page i of
Incident No.
NUMBER
DATE TIME OF
SAMPLED SAMPLED CONTAINERS
Other:
Date
Date
Time
Time
4/10/01dbs

: ;N.:1 RO GROUNDWATER SECTION
CHAIN OF CUSTODY (COC) RECORD
DENR[DWQ LABORATORY (cheek one): [ X CENTRAL [ [ ARO 1 j WaRO
Page
,
or !nvestigation of: Soil Groundwate;-'-,
1 —
Sampie collector (print name)
and GW-54 forins completed by: MARGARET FINLEY Sample collector' - gnature:
sicrage. conditions and loca.tion (when applicable):
!se only
LA
SAMPLE.1D
QLU), N LOCATION
it.tt
cr.')
Incident ,No.
DATE
SAMPLED
71( I 74., ci
c-Y
1-4 •r!
Am,/ tmvtt 11-zilL("!:.
r!.,)
rttstr!.0\ ttt .:2- r.7,c1
TIME
SAMPLED
1,e I ci
N ABER
OF
CONTAINERS
PL5
RePacuisnec by (signature):
Rc (signature):
Retinduist.ei by e):
Method of Shipment (cucie onet
.1"
Securizy Type and Cniti inS:
Date
-.
Date
ri Date
t
e Rcceived bsgi turc):
Received by (sig.nartire):
Date
Date
rirne Retcived by (signatur
Hand -delivered Federal Express -UPS Other:
Sealeci by:
Adrgaret Fintey
rINTRALABORATORy CHAIN OF CUSTODY - Lab Use Only
LAB NUMBERS NIINSIBER i ANALYSES
FROM THROUGH BOTTLES REQUESTED
Broken by:
RELINQUISH.ED
RECEIVED
BY:
Date
Time
Ttine
DATE TIME
itt) ‘Prmrstit:CS:Imrt Prittri tt.tiri Cl1C form
4 flI rihq

GROUNDWATER FIELD
cation code
County
AB FORM
Quad No Serial No,
Lat. Long.
Report To: ARO, FRO CMRO RRO, WaRO, WIRO,
WSRO, Kinston FO Trust, Central Off., Other:
Shipped by: Bus Courier and Del., Other.
Collector(s): r
FIELD ANALYSES
pH noo
Temp.lo
Appearance
Field Analysis E3y:
LABORATORY ANALYSES
Spec. Cond.r
°C Odor
SAMPLE TYPE SAMPLE PRIORITY
, Water Routine
O Soil [J Emergency
O Other
.Chain of Custody
Purpose:
Date s Time IC, `'C Baseline, Comilla
Owner )
at 25°C Location or Site tt..) f a>e
Description of sampling point
Sampling Method
Remarks
1 mg/L t)iss. So ds 703m 0
0D H¢61h 340 L Flucrnde 951
0T3l.cw 33fi rmgiL hNardness Total0 mg/L
Ccklft rrt': MF F.al 31616 110tlrnt Hardness (ml¢rr1 oarb) 902 mg,lL
oGfcr- MF Total 31a04 11Q30atG Phenols 3 730 ug/1
TOC 680 mg(L Specii C Grarld 9 pMtics/cm
Residue, Total Suspended 530 mg1L Sulfide 745
H 403 u..-.._.nits
Alkalinity to pH 4.5 410 mgit.
Alkalinity 4o pH 6.3 415
Carbonate 445 mg/L
TSicarbonate 440 mg/L
Carbon dioxide 405 mg/L
Chloride 940 "_. mg/L.
mi Chroum: t .w...-�r._,__. _.. _...,�..�._...�..�.._._ _.. mi e,�...iex 1032 ug(L
Color, True 80 CU
Cyanide 720
b Comments
mg/L
NH.asN610
TKN as N 625
NO, + NO, as N 630 mg/L
P. Total as P 665 mg/L
Nitrate (NO), as N) 620 mg/L
Nitrite (NO), as N) 615 my L
Ag-S6ver45566
AI-Alurrrnurn 4tti557
• As -Arsenic 46551
43a-t3anu•m 46558
Ca-Caiclaamt 46552
Gd-Cadmium 46559
Cr-Chromium 46559
its. Goppet 46562
Fe -Iron 46563
Fig -Mercury 71900
K-Potassium 46555
Mp«Madnesiurrl 46554
North Caro)ina
Department of Environment and Natural Resources
ON OF WATER QUALITY -GROUNDWATER SECTION
Lab Number__ ,..
Date Received Time:.
Rec"d By: From:Bus, Courier, Hand Del.,
Other:
Data Entry By: Ck:
Date Reported:
ST, Pestiipide Study, Federal Trust, Other:
u /L Cirganophosphorus Pesticides.
• t Nit o en PestirrdeS
tr L Acid. Herbicides
mq/L PCBs
n-Manganese 46566' a lV
Sodium 46556 m,/L
Ni-Nickel
Pb-Lead 46564
ug/L.
Selenium ug/L
4656i ugLI-
Semivclatile Organics
TPH--Diesel Range
Volatile Gr anics OAbottlle)
TPH-Gasoline Range
TPH-BTEX Gasotir
ature on arrival (°C):
GW-54 REV 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in bleak.

GROUNDWATER FIELD/LAB FORM
Location code 4I 4i
County
Quad No Serial No,
Lat Long
Report To ARO, FRO(07CLIZRO, WaRO, WiRO,
\--
WSRO, Kinston FO, Fed, Trust, Central Off,, Other.
Shipped by: Bus(e7Mtir, Hand Del„ Other:
Collector(s): r- F,T,1 ,r,-) _
FIELD ANALYSES
pH 400 ii.,,, , ' , Spec, Cond 94 3 ...2 at 25°C
Temp 10 ,-;: ) °C Odor
Appearance tr—cii - 1'
Field Analysis By: i.:, r P.' / (''''
LABORATORY ANALYSES
PE
Chain of Custody
SAMPLE PRIORITY
Routine
Emergency
BOD 310 mg/1„
COD High 340
,OD Low 335 mg/L
oliforrn. MF Fecal 31616 /100m1
dorm MF Total 31504 /100m1
TOC 680 mg/L
Turbidity 76 NTU
Residue, Total Suspended 530 mg11„
pfi 403 units
Alkalinity to pti 45 410 mg/t.
Alkalinity to pH 83 415 mg/L.
Carbonate 445 mg/L
rbenate 440 rng(L
ton dioxide 405 mg/L
, loride 940 rng/L
ChromiumHex 1032 ugIL
Color: True 80 CU
Cyanide 720 ing/L
Lab Comments,
Date 72//
Solids. 70300
Fluoride 951 rngrL
Hardness Total 900 mg/L
Hardness (non-carb) 902 rng/L
Phenols 32730 ug/I
Specific Cond, 95 pMhos/cm
945 mg/L
.11ficle 745
North Carolina
Department of Environment and Natural Resources
DIVIStON OF WATER QUAL1TY-GROUNDWATER SECTION
Lab Number
Date Received
Rec'd By:
Other:
Data Entry By: Ck:
Date Reported:
Time:
From:Bus, Courier, Hand Del„
Pupose:
Time / Baseline, Complain , harice,,,L' ST, Pesticide Study, Federal Trust, Other:
Owner kytid.?„,_"e,
Location or Site
Description of sampling point
c,
Sampling Method ) arriple Interval
Remarks
Oil and Grease rng/L
NH, as N 610
TKN as N 625 mg/L
NO2 + NO, as N 630 mg/L
P: Total as P 665 mg/L
Nitrate (NO, as N) 620 mgfL
Nitrite (NO2 as N) 615 mg/L
iPi.Kriping fume, r hemp etc jr
Ag-Silver 46566 ud
Al -Aluminum 46557
As -Arsenic 46551 u9,11-
Be-Barium 46558 ug/L
Ca -Calcium 46552 mg/L
Cd-Cadmium 46559 ug/L
r-Chromium 46559 ug/L
Cu-Copper 46562 ugit
re-lron 46563
Hg-Mercury "71900
K-PotaSsium 46555 mg/L
Mg -Magnesium 46554,
Mn-Manganese. 46565
Na-Sodium 46556 rtigLI
Ni-Nickel (ALL
• Ph -Lead 46564 tfg_71_
Se -Selenium
46567
Orgnochlorine Pesticides
Organophosp.herus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
)ivolatde Organics
TPFVDiesei Rae
Volatile Organics (VOA bottle)
T PH -Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival ("C)
GW-54 REV 7(03
For Dissolved Analysis-s
it filtered sample and wn
"".." n block

GROUNDWATER FIELD/LAB FORM
Location code
County
Quad No Serial No.
Lat. Long:
Report To: ARO, FRiRO,,FttRO, WaRO, VViRO,
WSRO, Kinston FO, Fed. Trust, Central Off., Other:
Shipped by: Bu jrTrHand Del., Other: Purpose:
Collector(s):0--i / e--f.,. Date Time Baselin
FIELD ANALYSES Owner 7777 i—.e.,4
PH 400_,:5-,, '7 Spec. Cond.94 at 25°C Location or Site Lt--) 4--'•' e5
TernP•io / -/ , `i' °C Odor r'i A/ ,r) ,:::,,,, Description of sampling point
Appearance ,',:) 0-'„4.1.-.. ,--). Sampling Method
Field Analysis Byl_ ( FJ)) (.,!, ,;„ .., I Remarks
a er
Other
Chain of Custody
SAMPLE PRIORITY
Routine
Lil Emergency
LABORATORY ANALYSES
800 310 mg/I_ Diss Solids 70300
North Carolina
Department of Environment and Natural Resouces
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Lab Number
Date Received
Rec'd By:
Other:
Data Entry By:
Date Reported:
Time:
m:Bus, Courier,
Hand Del.,
Ck:
npliance, AJST, Pesticide Study, Federal Trust, Other',,,,_
47.; 4)
"``
Sample Interval
(Pumping lume, r lemp , etc
Ay -Silver 46566 ug L 1, anochlorine Pesticides
OD High 341) mg/L Fluoride 951 mg/L Al-Alummurn 46,557 ualL
COD Low 3.35 mg/ Oness- Total 900 ing/L As-ArserSc 46551
Coliform: MF Fe-ca 3.1616 /100rni ! Hardness (non -Garb) 9.02 mg/L. Ba-Barium 46558 "..!9!1-•
14orm MF Total 31504 /100mi Phenols 32730 ug/t Ca -Calcium 46552
0 mg/ Specific Cnnd 95 uMhos/cm Cd-Cadmium 46559
Turtd dy 76! NTU S ate 945 Eng/L Cr-Chromium 46559
Residue, Total Suspended 530 mg)L, Sulfide 745 Cu-Copper 46562
Fe -iron 46563 IJ
Oil and Grease mg/L Fig -Mercury 71900 u.971.
pH 403 units K-Potassium 46555 (122/1-
Alkalinity to pH 4.5 419 mg/L Mg,Magnesium 46554 rnIL
— _
Alkalinity to pli 8.'3 415 mg/L Mn-Manganese 46565 ug/L.
• .______
arbonate 445 mg/L ' NH, as N 610 mg/L Na-Sodium 46556
Bicarbonate 440 mg11, s N 625 mg/L N-t..tickel
orb n dioxide 405 _ mg/L NO2 t NO3 as N 630 mg/L ! P -Lead 46564 u
Chloride 940 mg/L P: Total as P 665 mg/L Se -Selenium u
Chromium: Fie,x 1032 uglt: Nitrate (NO:, as N) 620 mgIL , Zn-Zinc 46567 Y9111--
oior. 'True ,80 CU Nitrite /NO as N) 615 mg/L
. _
Cyanide 720 mg/L.
. _
Lab Comments
Orianophosphorus Pesticides
Nitrole.0 Pesticides
Acid Herbicides
PCBs
Semivolatite Organics
PH -Diesel Rari
Volatile Organics CV:OA bottle)
TPH-Gasoltne Range
TPH-BTEX Gasoline Range
1 AB USE ONLY
Temperature on arrival (QC).
GW-54 REV. 7/03
For Dissolved Analysis-subout filtered sample and write 'DIS" in bi

rGROUNDWATER FiELD/LAB FORM
Location code .?-t
County
Quad No Sena l No,
Lat, Long
t
Report To, ARO, FRQ107--.:9„RNO, WaRO, WiRO,
Noah Carolina
Department of Enwonment and Natural Resources
ID V SION OF WATER QUALITY-GROUNOVVATER SECTION
SAMPCEIYPE
_ -
SAMPLE PRIORITY
Water JR Routine
El Soil 0 Emergency
Li Other
Chain of Custody
WSRO, Kinston FO, Fed. Trust, Central Off., Other:
Shipped by EujC--757,)-land Del:, Other_
Collector(s) : Date
FIELD ANALYSES
pH ,100
Temp io , 7
Appearance e:'
Field Analysis By. or')
LABORATORY ANALYSES
Spec. Cond. at 25°C
°C Odor -7
Purpose:
e•Yme j -72-4 c Baseline, Com I
Owner
Location or Site
Description of sampling point
Sampling Method 1 )
molt_
,OD High 340 mg/I
COD Low 335 mg/L.
Colitorm: MF Fecal 31616 /10,0m1
CoI4orrn MF Total 31504 /100mt
TOC 660 rrigiL
urbidity 76 NTU
Residue, Total Suspended 5.30 mg/L
pH 403 units
Alkatie41,0 pH 4.5 410 mg/L
Alkatiriily to pH 8,3 41.5 mg/t..
Carbonate 445 mo/L
' Bicarbonate 440 mg/L.
Carbon dioxide 405 mo/L
Chloride 940 mod,
Chromium: Hex 1032 ug/L
Color: True BO CU
'yanide 720 mg/L
Lab Comments
Remarks
Lab Number
Date Received
Rec'd By:
Other:
Data Entry By:
Date Reported:
Time:
From:Bus, Courier, Hand Del.,
Ck:
pliapige.ALIST, Pesticide Study, Federal Trust, Other:
/
5'47/7
- ierT, 44f
.baury c Sample Interval
(pm.
Diss. Solids 70300 mg/L
Fluoride 951
Hardness* Total 900
Hardness (non-carb) 902 mg/L
Phenols 32730 ugly
Specific Cond. 95. pMhosicm
45
Sulfide 745
Oil and Grease mg7L
NI-13as N 610
TKN as N 625
NO2 + NO3 as N 63
mg/L
nngit
mg/L
P: Total as P 665 mg/L
Nitrate (NOas N) 620 mg/L
!Nitrite (NO2 as N) 615
Ag-Silver 46566
Al -Aluminum 46557 1191-
s-Arsenic 46551
Ba-Barourn 46558 ufL
--a-Galcium 46552 rog7L
Cd-Cadmium 46559
Cr-Chromium 46559
Cu Copper 46562
Th-lion 46563
Hg Mercury 71900
K,Potassium 46555 rn9j-
Mg-Magnesium 46554 mg/L
Mn-Manganese 45.565 ug71.
a -Sodium 46556 mg/L
Ni-Nickel ug/L
Pb-Lead 46564 ug/L
Se. -Selenium u/L
Z 1-Zinc 46567 1.1971„
(Pumping lime, air temp , etc,)
ug/L Organochlorine Pesticides
Organophospborus Pesticides
Nitrogen Pesticides
Acid Herbicides
P1
Semivolatile Organics
IPH-Diesel Range
Volatile Organics (VOA bottle),
TPH-Gasoline Rang_t, _
TPH-BTEX Gasoline Ranig!
B USE ONLY
Temperature on arrival (°C)
GW-54 REV.. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in block.

Report to: 1i\,1RQ
GROUNDWATER SEc'rloN
CHAIN OF CUSTODY (COC) RECORD
TORY (check one): [ X 1 CENTRAL
l: carnua sti;itirrta af; Soil
co( ecto'r
firRTtS corn
Relsrt eai5laed
d by
Water
0 k WaRO
I ET FINLEY Sample collector 's signatur
ons and. Iracation (when applicable):
inquiasized by (signature):
d of Sai,prn
and Conditions:
D. NO.
Sealed by:
Margaret Finley,
OCATlON
Date Time
Date
Date
Da<V.°,FE
A �IPLED
Page of
Incident No.
Date
'ed by (signature) Date
caved by (signature)_
Hand -delivered Federal Express UPS Other:
NTRALABORaTORY iHAIN OF CUSTODY - Lab Use Only
LAB NUMBERS NUMBER ANALYSES REL,tNQUIISI-TED
FROM THROU(r:H BOTTLES REQUESTED BY:
CONTINER
4/1 0/0 1 dbs

GROUNDWATER QUALITY M
COMPL DANCE REPORT FOR
!NF�� A
rracliily Name:.
Permit Name 01 ott t :
f=�tlitywtrtsS . �:
Co
Weil Location/
h to Water Level:
rang Pont (MP.
t1S of water pumpe0
t real Fels: pH
Temp
Samples for me
'ontarm. %4' Fecal ._a«
Conform: MF Total
(Hoer Lla IAPN method lot P t hty
Dissolved Solids: Total rµ
pH (when analyzed) x.
TOG
Chlorine
Arsenic
Grease and Oils
Phenol.
Sulfate _.
Specific Conductance
Total Ammonia
TKNasN
ITORI
SUBMIT FORM SIN YL!QW PAP E.l ONLY
PERMIT
Non-Discha%
TeI+e
No a of
tale were collected unfl
mg/I
/100ml
l I GOmi
_ mg/I
units
mg/I
mg/I
mg/I
uMhos
mg/I
mgll
tls to be Sampled:
Other:.
uen'
P Eieva
IteredY'
Nitrite (NO2) as N
Nitrate (NO3) as N
IPhasphorus: Total
Orthophosphate ;.
Ali - Aluminum
&al - Barium
Ca Calcium
Cd - Cadmiumn
Chromium: Total
Cu - Copper
Fe Iron
- Mercury
K Potasslu
Mg - Magnesium
Mn - Manganese
DEPARTMENT Of E$VII1+CtI
WATER QUALITY DIVIS10I4
1336 MAIL SERVICE Ct rrs
.11 7.9 1535
ENT A NATllraAL RESOURCES
ROUNDWATER SECTION
Pho . s 'St16 7 -3 1
E IS tf ATION DATE /
EITATIN BEING MONITORIEO
I ett diason: In1IIIration Gaiters/
houtd reflect dissetVrd and
ncentrat1vns.
Id acidifies
mgli
_ mg/I
Ni - Nickel --M
Pb - Lewd
Zn - Zinc
Ammonia Nitrogen..
Other (Specify Cortpcwnl
ORGANIC$ C G S IfP l
(Specify te*t artd *hod A. A�oh
Repoli Attached " Ye:� . (t
VOC : method l
method Ir
. e . method it .. ,.
lab report.)
No (0)

hl
ORGANICS:
(Specify test at:nd method i, Attach laic report.)
Report Attached? Ye& (1 No -,(0)
VOC method
._.u,.. method Ir
method e at
Units)
GROUNDWATER QUALITY MONITORING
COMPLIANCE REPORT FO
FAIOLIXY.l1
Facility Name°.�
Permit. Name (it dittr nt ,
Facility
Contact el rt.� L r Ir'
pth:
d interval:
Water Caryl:
u Point (M.P.
Gallons of water puma
Plaid analysis: pH.
Te
(Sap
COD
Coliferm: MF Fecal
Colifn: MF Total
Mow Us* MPP. method Poi Ihi¢hty wwrtsid
Dissolved Solids: Total ..
pH (when analyzed)
TOC..
Chloride
Arsenic
Grease and Oils
Phenol
Sulfate
Specific Cpnduciance
Total Ammonia
TKN as N
IhOat.
LIMIT
N Y W PAPER +t NLY
County)
Tete�lne
Na. of Webs to Ise !arftpled:
Relatry M va an in 11..: _.
date sample collected: a-,/2
PERMIT
Non -Discharge
NPDES.
TYPE OF PER MtT `El I t
Lagoon
Spray Field
Rota rlr 1 istt bt
Other:
NATURAL tt' i tJ
WATER SEM"1Q�N
IA"rION DATE:
TIGN IEPNG MONITORED
Fte�psii n: tniiitratlon Gallery
Values should redact dissolved and
colloidal concentrations.
ample anal
story 'Name:,
lsation Nle
_YES Nf and field acidified r AYES
Nitrite (NO2) as N � ,. mg/l Ni - Nickel
Nit to
(NO3) as N -f-- mg/1 Pb - Lead
tPh sPl:laotai as P. �m mgli Zn - Zinc
Orte mg/I Ammonia Nitrogen
Al Aluminum mg/I Other (Specify Compounds
Pa Barium mgil
Ca - Calcium_ , mg/1
Cd - Cadmium mg/I
Chromium:: Total mg/I
Cu - Copper_ mg/I
Fe - Iron mg/I
Ng - Mercury...mgil
K Potassium.;
mg/1
rng/I
M - Magnesium
Mn Manganese
11
1r)1, ;cr 1°,•ere1 ken

9 1EN45 FROM;ISS MAINTENANCE 704-873-5475
TOz7046636040 P. p
IRED -STATESvILLE SCHCSOLS
ADMINfS'TRATIVE ANNEX
1147 SALJSSURY ROAD
STATESVIL! E NC 295 '
704-873-3 7 S5
704-873-5475
rril: patftefleass. J 'f 2. rtG. us

Ptt
te
Al - Aluminum i�§�rffiNGirr ��
Barium_
de end
Ca
Cadmium_ -
Chromium Total
�.m
Fe - Iron
Copper OR A
tvR@3vu y . .. - (Spi My test and �n' thod . A
K. Potassium__
Mg - Magmas _ OC
mod? Y
Mn - Manganese_ tr
GROUNDWA
OMPUAC
Fety,
Permit
py'iy
QUALITY MNTRING:
PORT FORM
Moog: IJ.. MM4 method f03 otowaly loud .
Dissolved Solids:Total frign
3
pH (when analyzer) _TOC
Chloride
Arsenio
Grease and Oils
Phenol
Sulfate ._.�
Specific Conductance _
Total Ammonia
TKN Us ,N
units
INO
roe
miVfl
Mhos
mai
mgol
(0)

n
GROUNDWATER QUALITY Id lir N TQft)NG:
COMPLIANCE REPORT FORM
F ,c lly Nam
P'rnnid Karns (it delta
F
MF Fecal
MF Total
wow uwx l►,ly method far highly hirlil
Dino Soikis; Tel
pH (when analyzed) _
TOC
Chloride._
Arsenic
Grease and Oils
Phenol
Sldlate
Specific Conduct nee . .
Total Ammonia
TKN as N
IT
�a t AitJA.Rl
X ANTF:.
Value* should refloat dlatalvad and
colloidal cc lcentrallons.
ample etslyted;.
tory Narrla:
bation Nj.
aldtflad
l 02) as N —_
(NO3) as hi
s: Tidal as F
lhsphate .,_
- Aluminum , rota!
urn ._�� g4
*um mg4
Cu C pper frigh
Fe - its rrtgli
Hg - Mercury n gfi
K - Potassium. mgf
Mg - Magneaitttn rn94
Mn - Manganese� . mg/
r4i - tither
Ply - Leaf
Zn - Zinc
Ammonia Nitrogen
Other (SSpaclfy Compounds and oneentralipn Unit;
ORGANICS (GC GO MS„HPLc)
(Spsclly is and elstlhod I. Attach lab report.)
Report Attached? Ye(1) No . (0) VOC method
: method N

Sulfate
GROUNDWATER QUALITY MONITORING
COMPLIANCE REPORT FORM
EntLiTY INFO IrlATLQ.14
Facility Narne:_ct&a.1131—
Pemlit Name (if differen1.
sy'
F, i Acklre - * YZ :74'
:?1 t rneld
)
t Person:
I0
flhfkLIorNumber
th:
d Interval: fi to ft.
h to Water Level: 7 ft below measuring point.
.4,
For Groundwater 'Treatment Systems
Check One: El Influent (98)
n Effluent (99)
swing Pont (MP) is: ft, above land surface., Relative M Elevation in ftt.
Uaflon.s of water pt
Field analysis: pH
Tem
(Se p
pews sampling: , Specific Conduc
rc Odor
///71-
_ Data sample collected:
tance
•-•...
Conform: ME Fecal 00m1
Coliform: MF Total
(Near Use MPH method Int alphly turbid samples)
Dissotved Solids: Total mg/I
pH (when analyzed) units
TOC rng/I
Chloride mg/I
Arsenic mg/1
Grease and Oils mg/I
Phenol mg/I
mg/I
uMhos
mg/I
Specific Condu
Total Ammonia
TKN as N
d unfiltered YES
Nitrite (NO2) as N mg/I
Nitrate (NO3) as N 2mg/I
4Phosphorus: Total as mg/1
Orthophosphate mg/
Ai - Aluminum Mg/1
mg/I
Ba - Barium
Ca - Calcium
Cd - Cadmium
Chromium* Total
Cu - Copper
Fe - Iron
NO and field acidified
—
p I,
Hg - Mercury
K Potassium
Mg - Magnesium
Mn - Manganese
mg/I
mg/1
mg/1
mg/II
mg/I
mg/1
mg/1
mg/I
mg/1
mg
/1
PETIMIT 0:
Non -Discharge
NPOES
ARTUENT OF ENVIRONMENT 1 NATURAL RESOURCES
ALITY DIVISION GROUNDWATER SECTION
EflVCE CENTER
fk NC 99-18Se
EXPIRATION DATE: P1
TYPE o_F PERMITTED OPERATION BEING MONfTOR
Lagoon
Spray Fiekl
Rotary Di
Other:
Rafael:Ration: Infiltration Gallery
Remelt:teen:
Lend Application of Stuck*
NOTE; Values should reflect dissolved and
colloidal concentrations.
Dale sample analyzed:
Laboratory Name: ..LN.
Certification N b.
Ni - Nickel mcjil
Pb - Lead mg/1
Zn - Zinc mg/I
Ammonia Nitrogen < (,_) ing/1
Other (Specify Compounds and Concentration ()nib)
ORGANICS: (GC.GC/MS,HPL C)
(Spaelly tart and method S. Attach lab report)
Report Attached? Yee (1) No - (0)
VOC method N =
method 0 =
: method 0
ir3h 13 t:°' c,3 my ro::!°,-*irl /' k'f .re TrOd oni rocKirt q;trui% and 'Rit Ilteltn.1.10,1!./ tv'n" n'r,1,112,'(1
1 U it dLv 14.yr,11.1 li 1(' r y LIC„ ro) tit?it tx rc 11 iTh t r r fDr ',tit:11111r11 un
101 ,tnp,n ;11ffl0flt (iy.
GW.59
Rev, 03/2000

GROUNDWATER QUALITY MONIT
COMPLIANCE REPORT FORM
ATI
Facility Name.
Permit Name (It
Con'tedt Perm
Well Location/ Site Name:
Welt Identification Number
Welt Depth
Screened Interval:
Depth to Water Level: ,.
Measuring Point (M.P.) is:
Gallons tN water purnpedrbalied
Feld analysis: pH -
COD
ft. above land sumac
before sampling: r'
, Specific Conductance
Ternp. °C, Odor - A
Coliform: F= Fecal
Conform: MF Total
(Nolo: Use MPP. mothod for highly turbid Nam
Dissolved Solids: Total
pH (when analyzed)TOC
Chloride W _
Arsenic
Grease and Oils
Phenol
Sulfate -_
Specific Condu
Total Ammonia
TKN es N
mg/I
unlls
rngll
mg/I
mg/1
m
uMhos
mg/I
mg/I
SUBM'Ir FORM i N Y
P. Elevation In n.:
PAP
A Tilt(
ATI=mR flltA
VNATURAL RESOURCES
WATER SECTION
Pr
PERMIT M; PI RATION DATE
Non-DischargeG ) 3 -4 UIC
NPDES
TYPE OF PERM! R3PE TION BEING MONITORED
Lagoon �Rerneolatian: infiltration Gallery
Spray Field P is :
Aotarystriu1
Men
n of 5tudpe
Values should reflect dissolved and
colloidal concentrations.
analyzod:
Name:
Ceriilafn Nb,
) 7,c
d unfiltered, _r YES N and field. acidified
Nitrite NO2) as N _ = rng/1
Nitrate (NO3) as N _ . mg/I
lPhos 9
pharus: Total as P , � :� . mg/I
Orthophosphate mg/I
Al - Aluminum mg/I
mg/1
Ca - Calcium_ mg/I
Cd - Cadmium mg/I
Chromium: Total rng/I
Cu - Copper mg/I
Fe - Iran
Ng - Mercury _
K - Potassium
Mg - Magnesium
Mn - Manganese �.
pa - Barium
YES
Ni - Nicker
Pb - Lead
Zn - Zinc
Ammonia Nitrogen_
Other (Specify Compounds and Concentration Units)
NO)
mg/I ORGANICS: (C3C,t 1 +MSFtPLC)
mg/1 Report
test is rtd nwsthcad ll, Attach lab report.)
m port Attached? Yes _ (1) No .. _AO)
mg/I `
VOC method N
mgll - method #
method 0
:e<�1 s rr iri i]
lrAltit;:: tf " 4171'r ui3 r,

GROUNDWATER QUALITY MONIToRIN
COMPLIANCE REPORT FORM
'It.ILY_4NEQ AT4 . .
Facility Name:.
Permit Name (If ditf r nt
ity
denNumber (flro
pth:
ned Intermit:
P'nt (M.P.) is;
of water pumpedfba
aiysis: pH
Temp,
SUBMIT R ON Y W PAPER ONLY
Sarno
'eliA+ rneasuring paint.
above land surtape. Relat M.P. Elevation (r
anit sampling: /l1.- date sample collected:
each Conductance_ ukthos
Appearanoai� ..
Treatment Systems
fnfluent (98)
effluent (99)
Samples for p metals were 'collected urerittera YES NO
Cod <LO mg/I Nitrite (NO2) as N 2
Coliforrn. Il decal I
Coliform: MF Total
(Note: the FIPN method lee highfy turbid s
Dissolved Solids: Total
pHO(when ) .
analyzed
Chloride
Arsenic ...
Grease and Oils
Phenol
Sulfate
Specific Conductance ._
Total Ammonia
TKN as N
/100rni
/100ml
,PEA T $:
Non -Discharge
NPDES,
TYPE OF PI AhtITTEQ
Lagoon
Splay Field
Rotary Qisute
Other: r.. JP
£Nrr A NATURAL A£SOttilCES
UN WATER SECTION
PIRATION DATE ' .
UIC
"ERsTION BEING MONiTQRE©
. a Reiatian: Infiltration Gallery
Remeritafico:.
Lend Apphea
Values should reflect dissolved and
colloidal concentrations.
7-6
e analyzed:
ry Name: --St
tonN6.�_��
field acidified
mg/1 Ni - Nickel
Nitrate (NO3) as N -- rng/l Pb - Lead
4Phosphorus: Total as P_ 17 mg/I Zn - Zinc
Orthophosphate
mgll Al - Aluminum,
units Pa - Barium„
mg/1 Ca - Calcium
mg/I Cd - Cadmium w -.
mg/1 Chromium Total
mg/1 Cu - Copper
mg/I Fe - Iron
mg/I Hg - Mercury .,..
uMhos K - Potassium
mg/I Mg Magnesium
- mess Mn Manganese
PIE,f P1.10,:t'•,,.'Sricn CutiT fie, i
mg/1 Ammonia Nitrog
mg/I Other tSpectly Compounds and Concentration Units)
mg/I
mg/1
mg/1
mg/I
mg/I
mg/I
mg/1
mg/I
mg/I
mg/I
ORGANICS: (GG,GC/MS,HPLC)
(Specify test and method N. Attact
Report Attached? Yee, (1)
VOC : method it
: method #
: method #►
ab report.)
No ,(0)

d unfiltered YE
Nitrite (NO2) a
Nitrate (NO3) as N
(Phosphorus: Total a
Orthophosphate
Al - Aluminum
units
mg/1
mgrl
Ttt
=?// UIC__
PA'RTMENT
OUTALI V WISP
AIL SERVICE CENTS
NC37eS1}ill e
NATtllfpL At ttf
tot WATER SECTION
Phone;010) 733,3Zz1
EXPIRATt tN DATE:
EfTION BEING M©NiTQRED
Renredation: Infiltration Gallery
Spray Field Remediation:
Rotary distributor land Aet tic
Other:
t Valuer should reflect dissolved and .
colloidal concentrations.
Dale sample analyzed: - 27-4V?
Laboratory Name:
Certification Nb.
Ba - Barium
Ca - Calcium
Cd - Cadmium__
Chromium' Total
Cu - Copper
Fe - Iron
Fig - Mercury
- Potassium
Mg - Magnesium . ...
Mn - Manganese
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name
Permit Name (if differen
Person:
rttiflr attf Number
Depth:
ned Interval:
Depth to Water Level: � fl. below measuring pint.
Measuring Point (M.P.) is: _Z- ft. above land surface. Relative M_P. El atratiart In rt.:
Gallons of water pumpedibailed before sampling: Data sample collected: /
Field analysis: pH Specific Conductance .
Tom-. C, Odor .., _ Appearance
SUBMIT FORM (N Y P'APEi ONLY
P,rilnI Cl erIy r Typn
Sarno]
uen
uent
EAKTER; (Semple
COD
Coliform: MF Fecal
Conform: MF Total
(Nola:Ups ltf'PN method for highly turbid sipmpr+r)
Dissolved Solids: Total
pH (when analyzed)
TOC _
Chloride
Arsenic
Grease and Oils
Phenol
Sulfate ..
Specific Conductance ._ u
Total Ammonia
TKN as N
GW-59
Rev. Q3/200Q
difIed . ----YES
mg/I Pb- Ni - NickeLear 1._ l
mg/l
mg/I Zn - Zinc
mg/I Ammonia Nitro ..- .
mg/1 Other (Specify C
mg/Ivmtaoclnds and Concentration Units)
mg/I
mg/I
mg/I ORGANIC $: (GC,GCIMS,HPLC)
mgll (Specify test end method N. Attach lab report.)
mg/I Report Attached? Yes ... (1) No (0)
--- mg/I VOC : method rf
mg/I
. method N s
: method#.
1
NO)

GROUNDWATER QUALITY MONITORING:
COMPUA►NCE REPORT FORM
Facility Name
Permit Name (if dillererw
IdNum
WeJ1 D
Screened Interval:
Depth to Water Level:
Measuring Point (M.P.)
Gallons of water pumps
Feld analysis: pH
T!
COD
Colifar
Coliform: MF Total
(Noel: Use MPH mrah©d for highly turbot
Dissolved Solids: Total �' mg/I
pH (when analyzed) units
TOC .- mg/I
Chloride mg/I
Arsenio...
U8M T F RM ON YELLOW
y Type
? ` Tel #:
No. of Wefts to
m Perm!
ft.. Weft Dla
ft to S
ft. behtw measuring .
-- ft. above land surf ce. R+ar M.P. Erati�__
Iled before sampling: / /i Date sample cotlecte
Specific Conduclance os
Odor -----W
Grease and Oils
Phenol.
Sulfate m
Specific Conductance uMhos
Total Ammonia mg/I
TKN as N
m i
mgli
/1 OOrnl
/1 oOmi
GW-59
Rev, 03/2000
mg/1
mg/1
mg/1
Bred YES
Nitrite (NO2} as
Nitrate (NO3) as
a4Phasphorus: Tot
Orthophosphate
Al - Aluminum
Ba - Barium
Oa - Calcium
Cd - Cadmium
Chromtu�rn: Total
Cu - Copper
Fe - Iron
Hg - Mercu
K Potassi
Mg - Magnesium
Mn - Manganese
u
ER ONLY
t �rlRofaesrfa & NATURAL RESOURCES
AI.TT^r Tt1VISION, GR N°WATER SECTION
xf3.3?21
PERMIT N: (PII'tATI
Non -Discharge 0Cl . U10
NPOES _
N DATE:
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon _Remediation: Infiltration Gallery
Spray Field Remediation: de
Rotary Distributor Land f tfr attcn ©i Stue
Other:
NOTE: Values should r Itlsct dissolved and
colloidal concentrations.
Dale sample analyzed:
ory Name:
Certification Nb.
NO and field acidified
N mg/I
N mg/I
as f' mg/I
mg/I
mg/1
9/1
'`rrlgJl
_YES
Ni - Nickel._
Pb - Lead
Zn - Zinc ._.. .
Ammonia Nitro
Other (Speedy Corrtpotertda and Cetrac
ORGANICS: (GC.acitoismPL:C)F:., in .,.,,,
(Spea'Ify fast and method S. Attach l b etattrt.)
I Report Attached? Yes, . , (1) No (0)
VOC L.-- : method w =�: { - ...
:. method If
: method fl
aI ftL,_it I,7.
a i:<sI 1 ".1 t 7°

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FO
FACIttiT
Facility Name:
Permit Name (it differe
Faclit
lscatir n Number {Irctnta P
nterl: /i� ft.
Point (M.P.) is:
Gal r7s of water pumpecybal
Field analysis: pH
Te
4"C
SUBMIT I RM ON Y, Or PAPER ONLY
Sa�a9: lr
tier Trrtt�ll
One IJ tnfluen
Fff(u nt
Relative P. Eie r
_ Date a ornnle col
PARAMETERS (Semple, for metals were collected unfiltered
COD
Coliform: MF Fecal
Coliforrn: MF Totc'tl
(Note: Use MPN method for
Dissolved Solids: Total _ mg/1
THC when analyzed) units
O
Chloride
Arsenic
Grease and Oils
Phenol
Sulfate
Specific Conductance_ _ uMhos
Total Ammonia. mg/I
TKN as N a mg/I
mg/1
mgfi
mg/I
rmgrl
mail
GW-59
Rev, 03//2000
ARTMENT Ot ENVIRONMEP4T & RA
QtJAIJTY tifvFSlON GR©ATEtt SI
AIL SEnvics CENTrR
It, (VC 27e9f-153e Phone: (91IYI 7-31.1,43.1
PI AMIT II: EXPIR ATI+ iN ©ATE:.
Non-�'h€ rge ; C_
NPDES
TYPE OF PE' MITTi Eli OPERATION BEING M©Nr rOREQ
. Lagoon Renteillation: Infiltration Gallery
Spray Field _ Rerrredfation:
Rotary i sirIbutcx Land Appt
Other.
Values should reflect dissolved and
colloidal corrcentrallons.
Dale sample analyzer
alratcary Name:..
ation Nb.
tIddfled
mg/I Nitrite (NO2) as N mg/I
/1oOrnl Nitrate (NO3) as Ns mg/I
/lOOml •tPhosphorus: Total as P a 4 mg/l
Orthophosphate . mg/I
A1- Aluminum mg/1
8a - Barium_ mg/1
Ca - Calcium mg/I
Cd - Cadmium-- mg/I
Chromium: Total mgM
Cu - Copper mg,l
Fe - Iron mg/I
mgll Hg - Mercury _ mg/I
K - Potassium - mg/1
Mg -Magnesium W,.-. .. - mg/I
Mn - Manganese t mg/I
YES
Ni - Nickel
Pb - Lead
NO)
Zn - Zinc ..
Ammonia Nltrogan
Other (Specify Compounds and Grarrc
ORGANICS: (qac/Ms,HPt.c)
(Specify test end method N. Attach lab report.)
Report Attached? Yes. 1 No .,(0)
VOCQ J : method M, -.Li a
method #�
. method Il

Sulfate
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
AT
Facility Nam °
Permit Name (If differ
F
n°
rmn
WeI ft: ft. W
Interval: II*(4-49 ft. to
Depth to Wafer Level: ft. below measuring point.
Measuring Point (M.P.) ft, above land surf
Gallons of water pumpajj before sampling:
Field analysis: pH aL Specific Conduct
Temp. Odor A
SUBMIT PORM ON Y
County
taw
Telephone ft; 7
No, of Wetis to be Sampled:
COD
Colliorm: ME Fecal
Conform: MF Total
Moto: %too PAM method he Nob,
Dissolved Solids: Total
pH (when analyzed)
TOC
Chloride
Arsenic
Grease and Oils
Phenol
u
Specific Conductance uMhos
Total Ammonia mg/I
TKN as N mg/I
unfiltered_ YES
Nitrite (NO2) as N -
Nitrate (NO3) as N mg/I
4Phosphorus: Total as P.
Orthophosphate mg/I
mg/ Al - Aluminum mg/I
units pa - Barium mg/l
mg/I Ca - Calcium mg11
mga Cd - Cadmium mg/I
mg/I Chromium' Total mg/I
mg/ Cu - Copper mg/I
mgA Fa - Iron
mg/I
mg/I Hg Mercury mg/I
K Potassiu mg/1
Mg - Magnesium mg/I
Mn - Manganese mg/I
Influent (9
uent (99)
PAPER ONLY
PERMIT e:
Non -Discharge
E
TYPE QE PEBMITTED OPERATION BEING MONITORED
Lagoon Rernediation: Infiltration Gallery
Spray Field Rertiediaticer _
Rotary flsk1buior Land ApplioalIon of Sludge
Other V21
PARTMENT OF ENVIRONMENT & NATURAL RESOURCES
TER ouriLrn' DIVISION, GROUNDWATER SECTION
4 L SERVICE CENTER
It NC 2 6I13IL!
ATION DATE:
UIC
NOTE; Values should reflect dissolved and
colloidal concentrations.
Dale sample analyzed:
Laboratory Name:
Certification Nb.
NO and field acidified YES
Ni - Nickel
Pb - Lead
Zn - Zinc
Ammonia Nitrogen
Other (Specify Compounds
mgA
mf
mg/i
mg/I
and Concentration Units)
ORGANICS: (GC,GCNIS,HPLC)
(Specify test and method it, Attach lab report)
Report ched? Yes (1) No 0
yoc method 0 2_/0
: method
; method 0 vi
th th0 tal`.?..3i orrlY t::,ID"-`',J,..,17jN anti 1"411:01 t.iP0(7t;r11!;;:iTt tr) (1.45 rep Qrt tqa=!„. EV:;i711*,te, and ayllf21Lqi.., Vtiat Iht? iaboritIctry yll W.'n Weld' OA
4.1:'.1n11 by .3 14t.ult! Cfatcrpfinti OW() t)E,M)c(:).11,1ted 1;,;,[xx-(.3ry 8,1.1 avv..3thtjt th;ice mciracaill foi stibrnmirl1 frult00,
GW-59
Rev. 03/2000
rrnittoo tor Au
slum
Ice (ait id Avert!)
rn
as prim
PO
te
alLki,,Juo,"; oi and anprc,,onm.7..?rit r

GROUNDWATER QUALITY MON
COMPLIANCE REPORT FORM
FACILITY IN A
Facility Name.
Permit Name (it d'ilterettt
Contact Pe
fdsrndr�ticarr ttu r (from laermlt}.
Depth: .-. , f1. Weft
Measuring Pont (M.P.
Gallons of water pump cffbaited be
Field analysis: pH S
COD,
Coliform: MF Fecal
Coliform: MF Total
TORING:
Tel
No, of
I6 MEswing
and surfa
(Samples for metals were collected until
rng/l
/14Oml
/100ml
(Nate: Use INPN method for highly turbr s pNsl
Dissolved Solids: Total mg/I
pH (when analyzed) units
TOChloride mgi
Arsenic
Grease and Oils
Phenol
Sulfate
Specific Conductance
Total Ammonia
TKN as N
GW-59
Rev. 03/2000
rngli
mg/1
mg/img
rng/l
uMhos
mg/I
mg/I
SUBMIT FORM GN Y
Sampled:
tared YES
Nitrite (NO2) es N
Nitrate (NO3) as N
'Phosphorus: Total as P
Orthophosphate
Al Aluminum
8a - Bariufn
Ca - Calcium
Cd - Cadmium
Chrcxrtium: Total
Cu Copper
Fe•Iron
Ng - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese
APER iNt-Y
hange
NPDES
DEPARTMENT OF ENVIRONMENT & NATURAL ersouicEs
WATER DUALITY DIVISION, GROUNDWATER SECTION
MAIL SERVICE CENTER
A ee. NC 276 -16 _ Phone- f91 -
XPtRATlON DATE:
_UIC.
TION BEING MONITORED
Remediation: Infiltration Gallery
_ R +edlaficn:
d Application of Sludge
NOTE; Values should reflect dissolved and
colloidal concentrations.
Data sample analyzed:
Let rrsttory Name: 1
Cerltf atitYn Nb.
dldtflett .,, YES ,.. NO)
rtIgr'I Ni - Nickel
rng/I Pb - Lead
mgJl Zn - Zinc .. ,
rnl Ammonia Nitrogen
Other (Specify Compounds and Cancentraticar
ORGANICS: (GC,GC/MS,HPLC}
(Specify test and method fr. Attach lab report.)
Report Attached? Yet (1) No (0)
VOC I .� method N (r i P
method .M
method fr m

SUBMIT Rl l ON I GW PAPER ONLY
GROUNDWATER QUALITY MQNITORIN
COMPLIANCE REPORT FORM
Facility Name:
Permit Name (If
F pity Addres
uciti
Contact Pertor
Well Location/
►+" iderttlftdatt{n Number (fr+arr
Well DeptEt..-�
Screened I ntel: ID
Depth to Water Level: /41
Measuring Point (M.P.) IS'Gallons of water pump d/bailted
Field analysis: pH
Temp.
PAR
COD
Cofiform: MF Fecal
Spec'tflc Go
Tel
No. of Wells to
Sampled:,�y`-
For Groundwater DaNmeni Systo
Check One; 0 Influent (9fl
al Effluent (99)
P. Elevation in ft.:
a collected:
uMbos
A�er�rr� + .
Samples for metals were collected unfiltered AYES
mg/I Nitrite NO2) as N
/1Oaml Nitrate (NO3) as N
/1t Oml •iPhosphorus; Total as P
Orthophosphate
Al - Alurninum
Ba - Barium
t✓a - Calcium
Cd Cadmium
Chromium: To
Cu - Copper
Fe • Iron
Hg - Mercu
K - Potassi
Mg Magnealu
Mn Manganes
Cc►lilorm: MF Total
(Note: Ulm NIPN method her highly turbid
Dissolved Solids: Total
pH (when analyzed)
TOC
Chlorid = Jt
Arsenic
Grease and Oils mg/I
Phenol mgll
Sulfate mg
Specific Conductance . uMhcos
Total Ammonia mg/I
TKNasN .,, m
AASURAL tt�it icl
Ate DMS ON, Rt tft4t7ytATER SE TId?i!i
i�'!..fv zreey yetl��(
EX AT N DATE:,
_UIC
'DES
PE QF EPEIT.ATION BEING MONSTORED
i a on Remad aI on: Inf Itratlon Gallery
NOTE Values should reflect dissolved and
colloidal concentrations.
Dale sarnpte anal
©ry Name:
ti+ n NS.
m
units
mg/I
mg/I
mg/1
ail my ;r'rk ' °'? 4.1 ti1
<_: I c.a",Its C srd
lui.Ilja.. ":ra1 #"r p;Q :,wt_ kt+ rat I+:a a; ar l d rprrsbtrlrrri nt tr?r I ; a,ry�i 7 l sir°rltirt
G'
Rev. 03/2000
mg/I
mg/I
mg/I
mg./
mg/1
rrngll
mg/l
mg/l
mg/l
mg/I
mil
mg/I
idifled YES
mg/I Ni - Nicker
Pb Least
Zn - Zinc
Ammo
Other
NO)
ORGANtHPt.C7
(Spottlly ttfstt and trnetf ,. Attach lab report)
Report Attached? Yes (1) NO (0)
VOC. method 0 xi
�. method #
d#�

SUB IT FORM ON YELL C'UlI' PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Ctl-tTY flN
!INFOT't
Facility Name:- _
Permit Name Of differen
Facility Address.
Contact Person: ° ' '.' Tetetittt n
Welt Location/ Site Name: No.
tderltl
Depth:
Screened Inte
Depth to Water
Measuring Point (M.P.)
Gallons of water pump_eAbal
Field analysis: pH _
Il ftannete
r rttlta euri
ve fand sl
r!
Odor . A
EARAMgTERS (Samples for metals were sofas
COD
Conform: MF Fe(
Coliform: MF Total
(Note: Use MPN method for highly t
Dissolved Solids: Total
pH (when analyzed)
Chloride
Arsenic
Influen'
Effluent -
unfiltered. .�'" -YES
Nitrite (NO2) as N
Nitrate (NO3) as N
tPhosphorus; Total
Orthophosphate
mg/I A1- Aluminum
units 8a - Barium
mall Ca - Calcium
mg/l Cd - Cadmium
mg/l Chromium: Total
mg/I Cu Copper
mg/i Fe - Iron
Hg - Mercury
K - Potasslu
Mg - Magnesium
Mn - Manganese
Grease and Oils
Phenol
Sulfate m
Specific Cond I+ tance uMhoe
Total Ammonia m
TKN as N mgn
GW-59
Rev, 03/2000
+t:;^nii.r;y twig
PERMIT k:
Non -Discharge'
NPDES
TYPE OF EE?
Spray Field
Rotary :Dialributor
Other:
EXPIRATION ©ATE:. G-.
uIC
RATION BEING MONITORED
Remedlation; Infiltration Gallery
Remediatiat:. .
Values should retied dts
colloidal concentrations.
ample analyzed:
ry turns:
red and
ttr�n Nb. �.
4
NO and field actdtfiedrrigti
mg/I
rng/I
mgn
m
m
NO)
Ni - Nickel
Pb - Lead
Zn - Zinc
Ammonia
Other ('
ORGANICS: (Gc,QCIMS,IiPtc)
(Specify test and method tM. Attach lab report.)
Report Attached? Yes. _ (1) No (0)
VOC : method R
" method
method e

GROUNDWATER QUALITY
COMPLIANCE REPORT FO
Facility Name:
Permit Name (tf di1f
Facility Addresat:
Well Identfcati Numb r frrslt i lrrr li
Well Depth:
Screened Interval: (o
Depth to Water Level: a� fl, below
Measuring Point (M.P_) is: 7 ft. avr
Gallons of water perm led before s
Field analysis: pH Sped
Temp -
SUBMIT FORM
f�rtf .`laaarrY +ear" 't°Y,
li ampl�ed.
nu Tr ttt nt
Otani Influer�
PAPER CINLY
PERIMIT II;
Non -Discharge
NPOES
PARTMENT of OW
ATV oUAUTY DIVISION, ROUNOWATER SECTION
AIL SEIWICE CENTER
It NC 910-1 Ply
ATONAL Rtw5OURCE3.
EXPIRATION DATE:
2,77)
DrEE OF PERMITTED ERATION BEING M thllT llREi?
Lawn Rerr dialio,i: infiltration Gallery
. Spray Feld Reined ticn:
Rotary Dial rltaartor Larsd Application ©i Sludge
, t//01
Values should
colloidal column
ample analyzed:
ry Nama:
n Nb.
far metals were collected unflftered '" .'YES NO el d fold
mg/I Nitrite (NO2) as N
loomt Nitrate (NO3) as N
1OOmI IPhosphoru� s: Total as
urd .euarwtsl Orthophosphate
Ai - Aiumfnum
Ba Barium u�
Ga - Calcium.
Cd Cadmium
Chromium. Tol
Conform: MF Total ..
(Nate: use IIPN rr•,h©d for n
Dissolved Solids: Total
pH (when analyzed) units
TChloride nit
Arsenic
Grease and Oifs Cu - Copper
Phenol Fe - Iron
Sulfate . - Mercury
Specific Conductance K - Potassi
Total Ammonia Mg - Magnesi
TKN as N Mrr - Manganese
NITORING:
asuring point.
tnd surface. Relat
Iptirsg; / tt 0as
onductance
GW-59
Rev, 03/2000
mg/I
mgarl
m
uMhos
. mg/I
ations.
difled --, YES
mgfl Ni - Nickel - w mg/I
mg/I Pb - Lead mg/I
mg/I Zn - Zinc mg/'I
mg/I Ammonia N trt i rt -- mgif
argil Other (Spec►ly`C ,ds and G Units)
nd,
ORGANICS: (GC,QCIMS,hHPLC)
(Specify teat and method S. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method ft 4$
: method tN
method e

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FAcIPT
Facility Name:
Permit Name Cif diff
y
Contact Person:
Well Location/ Site Na
Well Identification Nu
Weil Depth:
Screened Inrva: IL to
Depth to Water Level: ,7 fi.beJowmeasuringpnt.
Measuring Point (M.P.) is:. '2- it. above land surface Retative M.P. Elevation In ft.:
Gallons of water pumped/bailed before sampling: Date sample collected:
Field analysis: pH 49'L Specific Conductance
Temp.°C. Odor
SUBMIT FORM ON Y
County
Telephone 0:7,
No. of Wells lo be
PAPER
COD
Conform: MF Fecal
Co!nom MF Total
(Note: Use MPS method for highly tu
Dissolved Solids: Total mga
pH (when analyzed) units
TOC
kumwonrillmommwenk mg/1
Chloride
mga
Arsenic mg/I
Grease and Oils mg/I
Phenol mg/1
Sulfate mga
Specific Conduetance uMho
Total Ammonia mg/I
TKN as N _.mg/1
A
PARAMETERS (Samples for metals were collected unit I
.mg/I
/1 00mi
/ 00mI
Influen
Effluent
are
Nitrite (NO2) as N
Nitrate (NO3) as N
4PhOsphorus: Total as
Orthophosphate-
- Aluminum
- Barium
Ca - Calcium
Cd Cadmkst
Chromium' Tots.
Cu - Copper
Fe - Iron
Fig - Mercury
K Potassiu
Mg - Magnesium
Mn - Mangan
* '
NLY
PARTMENT QP ENVIRONMENT A NATURAL RESOURCES
DUALITY DIVISION, GROUNDWATER SECTION
PEAMIT :
Non -Discharge
NPDES
ATIO
ATE:
TYPE OF PEFIMITTED OPERATION BEING MONITORED
Lagoon „Remediation: Infiltration Gallery
Spray Field ,fl
slues should reflect dissolved and
colloidalconcentrations.
Date sample analyzed:
Laboratory Name:
Certification Nb..
d field acidified IfES NO)
rngii Ni - Nickel rngn
rrign Pb - Lead mga
mg/ Zn - Zinc mga
mg/I Ammonia Nitrogen < (-7, 5 mgn
u
mg Other (Specify Compounds and ConcentratiOr Units)
rng/1
mg/1
mgfl
mg/I
mga
mga
mg/I
mg/I
mg/I
mg/I
ORGANICS: (oc,Gcm1S,I1Pt.0)
(Specify test and method O. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC method N
method #
method #
evaLly th.it, in tho to.3I at my no iand Liequi, 1?16t r Ile' I'M :t1 kw?:utmtd n9.1,4 repurf 5UR, 2,C,-114%.to., and compi..,!e, ,„trd Mat :hi' ia!,;',;r,i1cry ari'ry Nen' 0111 WV', PMIJC°I'd
L)!Anri VI;p1 ird.p1 u! y .v Nw C ()V:i7.1 C tl) cot 10.7(1 Lkor,,,tory 1Arri ;Awatc 11,at ait ,m4 rt iNal,-allti-; for 1ubrni5rl Likr,
01 tirk,,, and rinpriYaluient for 1,01,),v1.19
GW59
Rev, 03/2000
rrilf tr.*"

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
SUUMU FORMON
Typo
Facility Name:
Permit Name (If differentt:
Facility Address:
0'9/4(514 qC
contacrPersom
Weil Location/ Site Name:-
;It; "Tric-
Telephone e: 76-
WeN klantificatitINUR tber (irom Permit; For Groundwater Treitment Systems
Well Depth: -4, ft. Well Darnehr Check One: El Influent (98)
Screened Interval: U. to
Depth to Water Level: %ft, below measuring point
ft. above land surfu,m.
before sampling: /J
Specific Conductance
Terrip, °C. Odor
Measuring Point (M.P.)
Gallons of water pumps
Field analysis:
Samples f
OD
Conform: MF Fecal
Conform: MF Total
{Holm Use SIM Ittelhod fur highly turbid s
Dissolved Solids: Total _
pH when analyzed) CT7
TO
Chloride
Arsenic
Grease and Oils
Phenol
Sulfate
Specific Conductanc
Total Ammonia
TKN as N.
_ No, of Wells to be Sampled:
_ mg/I
units
rngil
mutt
mg/I
rn9/1
mckfI
uMho8
mg/I
mg/I
g Effluent (99)
Relative KR Elevation In ft:
Oulu sample collected:
__Whoa
Appearance _
ad YES
mg/I Nitrite (NO2) as N
rnl Nitrate (NO3) as N
rn 4Phosphorus; Total as P
Orthophosphate
Ai - Aluminum
- Barium
Ca - Calcium
NO
cd - Cadmium
Chromium: Total
Cu - Copper_
Fe - Iron
Hu - Mercury
K l'otasslu
Mg • Magnesium
Mn - Manganese_
N Y
04011'04E1ff Of: EliVitiON14044 d NATURAL RESOURCES
t 4 itUALITY DlVIOt1, (iflOUritIWAILII SECTION
AIL SERVICE cLN-(411
-1 b
,...,;,:!;/(X./P1_1-1A();(1;li)t,1 DATE:
NPOES
IY,POF fatal -Hat OPERATION BEING mom-For-1m
Laipoo Intatretion Gallery
Spay Field ilernediaften: „„ —
notary Qttorreutui Applicelion Sliryer tuFn
KM;
end ft
rrig/1
mO/I
mg
MEVI
mg/I
rnuil
__ mg/I
mg/I
r no/I
_ rnryl
rrig/I
Values houId ;enact tilsecieed end
colloidal couicamtratione.
1711)10 analyzed /
,
ry Name:,
lion
oldifi d „, YES NO)
Ni Nickel„
Ph - Lead,
n- Zinc _
Ammonia Nitrooen_
Other (Specify Cortic)tlb and Concord
!Ulf,
ORGANICS: (GG,GOMS,IIPLC)
(Specify ttiliTt and method a. Attach lab report)
Report Attached? Yes(1) No (0)
VOC
: method rf
method #
; method Al g . •
• '^ lt 7e, ot rny "let V .1k. Ilikrnr ..41101 LULMAIOCi 1'1 NIP* nirort is Irun, ir:iltddlo, and con loloto ore;111.11 I1 IOOT;110TV STIOlytell itn, WI'', 111h1T<I':' Li
dt^,11^/,'-.^ tip th u n DINO (•°,10'It'f'y DEM) c(Jrt 40211 I, ,boratrint t Arti aoktio It lle..tow,E,qdcafflpunNtiaii for cuturatnr)llico int Irt rt ; ,itt,rayflu 4dImire,,,run(Int for kro.viriu voidLyio
GW.60
Rev. 0312000
rin

R ESEARCIh t ANA►LyTicA►t
LAboRAToRk s, INC.
Analytical/Process Consultations
Analysis,l r Selected Parameters and Water Sample Identified as 070626
tdie Artadl tical Prated collected 26 June 20O7
Volatile Organics
EPA Method 6230 D
Patrartreter
.-Dichloroetharue
-,2-©ich1oropro�
toreform
: richloroethanc
1,I--Dichlaroprapent
Carbon Tetrachloride
:Benzene
2-Dichloroc bane
Trsc ome there
2-Dichloropropane
ichloropropane
dibrormnrthane
Toluene
I , t „-Trichloroerbauae
,3-Dichaoropropa©e
Tetrachloroethene
1eI,I,2'.Tetrachloroeh nc
L,1,242-Tetrachlorotthatre
Trichloroprapane
Sechlarobwadiene
Brotrrtrbenzene
E'thy (benzene
Styrene
Brammi'"brm
p-lsopropyttoluene
N-Buiylbenzene
Naphthalenic
1,3,5-Trimethylbenzcne
1,2,4-Trirrethylbenzene
1,24-Trichlorobenzene
2, 3- Trichlo ro benzene
C ` iorobcazene
Chlor©toluene
4fihlor©tflhxne
Tert-Bwylbentzene
utylbenzene
tchlaroaenzene
htorobenzene
i-Prnpylbenzene
N-Propylbenzene
Ie3-Dichlorobenzene
Dibromnchloronaehuae
Diclilcirodifluorortrethane
Chlororrthane
Vinyl Chloride
Bron anmethane
Chloroethane
Trichlorotluoromethane
1, l-Dichloroeehene
Merthylerr Chloride
Trans- 1,2-Dichlaraerhere
Cis- 12-Dichloroethene
Bro m©dichtororuethane
Brorrnc:hioromethane
Cis- l,3-Dichloropropene
Trans- I ,3-©ichloropropene
Total Xyienes
;Methyl-Tert-Butyl ether (MTBE)
isopropyl ether (IPE)
Dilution Factor
Sanpk hivmder
Sarnpie Uate
Smoak Time (hrs)
Below Quanritation Li
Quanritation 070626 070626 070626 070626
Limit 1 1.1 11.2 1 i, 3 1 1-4
JmelL1 (rneLl (mg/L) (m a°Li lmgfl4
0,0010 SQL SQL SQL BQ
0.0010 SQL SQL SQL
0.0010 SQL SQL SQL
0.0010 SQL SQL SQL
0,0010 SQL SQL SQL BQL
0.0010 SQL, SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.:010 SQL SQL SQL SQL.
0.00100 SQL SQL SQL SQL
0t0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.O010 SQL SQL SQL SQL
0,0010 SQL SQL SQL SQL
0,0010 SQL SQL BQL SQL
0.0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0,0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0 0010 SQL SQL BQL:. SQL
0.0010 SQL SQL SQL. SQL
0,0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL. SQL
0,0010 BQL BQL SQL BQL
0.O010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0,0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.0010 SQL BQL SQL SQL
0.0010 BQL SQL SQL SQL
0,00110 SQL SQL SQL SQL
0.0010 SQL SQL-:... SQL SQL
0,0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.0010 BQL SQL SQL SQL
0.00LQ SQL. SQL SQL SQL
0.0010 SQL. SQL SQL SQL
0.0010 SQL SQL SQL BQL
0.0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.0010 BQL SQL SQL BQL
0.0010 SQL SQL SQL SQL
0,00)0 SQL SQL SQL SQL
0.00i0 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL
0.0010 SQL SQL SQL SQL.
0.0011) SQL SQL SQL SQL
0,0010 SQL SQL SQL SQL
0.0010 SQL SQL BQL SQL
0.0050 SQL SQL SQL SQL
0.0050 BQL SQL SQL BQL
592763 592764 592765
06/26/07 0626/07 06/26(07
1030 1100 1130
592766
06/26/07
1200
milligrams per Law = parts per

GROUNDWATTEin QUALITY IVI NI
COMPLIANCE REPORT FORM
1LITY.INF MAT1 1l
Facility Name:
Perrnit Name (If clltterolai}
Facility Address:
try,4‘:-
July ,..
ilepina
.m.mm No. of Wel
Wen Idteritificat3on NUMbor (t
Weft Depth:
Screened Interval:r„„"°`a
Depth to Water Level:. rr
Measuring Point (MEP.) is: ,
Gallons of water pumpatvp
la
Field analysis:
Temp,
dIINC
Perrntt; _.._.. w..
Well DIa,rneter n.� at, r l
to
elow rnoasurtty trrairtt. u. ,
tt. above land surtat rr. tlrrlati�re M.i
afore sampling,
Specific Conductances . „_ ...,„.<,....,. ,.. .
°C, Odor ._ e .. Appearance
E'ARAMgT f1 (Ssrnpkia tro-r mauls were cnnllectecf
COI] I'nittl
Coliforrn: MF Fecal `�, „ ...._/1 OOrn1
Coliferm: MF Total _vwm. ._._.__ 11 {)(lrrll
(Hole: Ups MPN method fer highly turbid ism
Dissolved Solids: Total
pH (her analyzed)TO. .
Chloride
Arsenic
Grease andOils
Phenol
Sulfate
Specific Conductance
to the! be,zit tit my l:d"
Olftldl th.(.'
G W 59
Rev, 031'2000
)NI..Y
OEPAS EN Of -
lest LB (MAI 1Y DIwy"tU rt, tariUytlitlyk AI"E'it
l tttl LtAIL SERVICE Q:L UE
t dctlt 1�vww a ry r�treM
Al IONf4ATE:
Non -Discharge
k_at)cxr
... Spray Fold.., r.11e�n
Rotary li rlt:f
Mixer: s _a
RESOURCES
Nil MONITORED
rarr. t�rtPttracrr t alter
„.l o d ApplicatIan isf
tIOI . Values should reflect dissolved end
colloidal coat entreticew
VED
i ,11 IA
acidified S
it t)j
y dad,
9/ Ili
...� __._
ntt�l 111 - l
r:rtl art - Zinc ,_ .
rr4gll
mrrmonia Nitroirrtl
trri (Other (Specify C otrrpoundt. awl Coulsontreittrn
mgI
OFi(sANt(3.S tc7i,r,
(Spccfy test omit '44101110d rr. AItaclt lab report.).
Ht l')nrt Attoectyertt° �r�eY ._, -(1)
Vat;
F M N YJl ' PAP t
tc Sanpled:
Star Tttltm�t Sytltbtr
influent (9
luent (99)
ttrenct YES
Nitrite (NO2) as N
Nitrate (NO) as N
tPhosphorus: Total as P
Orthophosphate
Al Aluminum.._
Barium
r.
C.;4 Gta'Ira ttm ..,
(; 1 Galdrnium ..
(,`iresttitli�P. Total�...._�._.._.
urnw
anese V._
lrt trt tt

RESEARCh & ANItlyTICAt
LAbORATORiESr INC.
Analytical/Process Consultations
lemicai Analysis for Selected Parameters and Water Sample Identified as 070626
Statesville Anal *cal Pro*ect collected 26 June 2007
Volatile Organics Quantitaticn 070626 070626 070626 070626
EPA Method 6230 t) Limit 11.1 11.2 11.3 1 1.4
Parameter
Diehiornettiane
-Dichieroptcpane
ESElliotoionn
I , Triehloroctirene
, -Dichloropro pene
Carbon Tetrachloride
Benzene
DichloroeLharie
Trichloroethene
2- Dichloropropane
DtbrorrionvEthan0
idliterte
I, Trichloroethane
1 ii-D ichloropropane
fetrachloroethene
LE! J E2-Torachloroethanc
!, I i2.2-Tetrachioroetharte
!,.2.E.3,-Tnchloropronane
Hexachlorobtaadiene
Brorrribenzene
Erhylbenzene
Styrene
Brotraorrn
p-Iwpropyltoluene
N-Btaylbenzene
Naphthalene
/ E.3,5-Tritnethy !benzene
1 s2,4-Trirneillylbertzene
E2,4-Trich1oro benzene
1 Triehlorobenzette
Chloroberizene
2 -Chloroto luene
-1.-Ci0orercoluerie
Fert-Bury1benzene
Sec-BLaylhenzene
.,4-Dichloroberzene
1,2 D ichlorobenzene
E.Propyibenzene
N-Propyibenzene
I , 3 D Ichlo ro benzene
Dhrrri,ch1oronthne
.
Dichloradifitiornarthan e
Chloromethane
Vinyl Chionde
Stomotnethane
Chlowethane
Trichlornfluotomth.ane
l-Dichlorsetherie
Methylene Chloride
Trans- I ,24Dichloroethene
Cis -I ,2-Dichlowethene
Bronxidtchloromethane
Bromochlorourthane
C L3-Dichloropropene
Trans-L3-Dichloroplopene
Total Xylenes
:Methyl-Tert-Butyl ether (MTBE)
Isopropyl ether (ISE)
Dilution Factor
(malL) f rngit. tmeitI
0.00 ICE SQL
0.001 0 SQL
0.00E0 SQL
0.0010 SQL
0LO010 SQL
0.0010 SQL
0.00 1.0 BQL
0.0010 SQL
(Via) Li SQL
0.0010 SQL
, 000)0 SQL
0.00 10 SQL
0,00 10 SQL
0.0010 SQL
0,00 10 SQL
0.00 E 0 SQL
0.0010 SQL
0 .0010 SQL
0 0 SQL
0,0010 SQL
0..0010 SQL
0.0010 SQL
0.00 10 SQL
0.00 10 SQL
0,00,10 SQL
0.00 10 SQL
0,00 1.0 SQL
0.0010 SQL
EIE- 0.00 10 SQL
0.00 10 BQ L
0.0010 SQL
0.0010 SQL
0.00 10 SQL
0.00 10 SQL
0,00 10 SQL
0.00 10 SQL
0.00 10 SQL
0.00 10 SQL
0,00 0 SQL
0.0010 SQL
0,00 10 SQL
0.0010 SQL
0.00E0 SQL
0.0010 SQL
0,0010 SQL,
0,00.10 SQL
0,0010 SQL
0.00 10 SQL
0,0010 SQL
0,0010 SQL
0..0010 SQL
0.00 ! 0 SQL.
0 00 0 SQL
0.00E0 SQL
0..0010 SQL.
0.0010 SQL
0.0050 BQL
0.0050 SQL
SQL SQL SQL
SQL SQL SQL
SQL. SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
BQL SQL. SQL
SQL. SQL SQL
SQL SQL SQL
SQL SQL SQL
BQL SQL SQL.
SQL SQL SQL
SQL SQL SQL
SQL BQL SQL
SQL SQL BQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL- - SQL SQL. -
SQL SQL SQL
SQL,. SQL SQL
SQL.. SQL SQL.
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL, SQL
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL. SQL SQL
SQL SQL SQL
SQL. SQL. SQL
SQL. SQL SQL
SQL SQL SQL
SQL SQL SQL.
SQL SQL SQL
SQL SQL SQL
SQL SQL SQL
SQL. SQL SQL
SQL SQL SQL
SQL BQL SQL
t• i I
Sample NUffiber 592763 592764 592765 592766
Sample Date 06/26/07 06)26/07 06126/07 06126/07
Sample Time (hrs) 1030 1100 130 1200
Below Quantization Limits
rrigit 4-- rnilltgrams per Liter pans per mill ton(ppm)

GROUNDWATER QUALITY MON
COMPLIA
L fl:PORT F-ORM
ttPj
Facillly Name;
Permit Name (If cflifiertt,
Contact
Wry Location./ Site Name:
We Identification Number (fromit):
W
Screened Interval:...,�° W..._
Depth to Water Level:„
Measuring Point (AA,P.) is:..
Well Diameter: „,
,_.__2_2 `,_ It.
w measuring poialt
ve land surface.
Gallons of water pumpecj/tfaited before sampling:
Field analysis: pH .„.. f u .v ._... Specific Conductance.
Temp.._ ..._. _. °C, Odor __ Appearance
ON
yearly or Type
COD
ColifarMF Fecal _
Califorrn: MF Total
(Nola: Use RAPN method her highly Iurbrq San%
Dissolved Solids: 'Total
pH (when analyzedT)... �c
_
Chloride ,
Arsenic
Grease and Oils
Phenol
Sulfate
Speclflc Conductance
Total Ammonia _ _. .
TKN as Nw.w_.
GW59
Rev, 03/2000
ere collected uurtllered..,....,.__YES
rrrg/i
_Il 0Orrtl
/Mimi
mull
_units
nig/I
rmgll
mg/1
�_. mg/1
mg/1
mg/1
iMhos
ntg/I
- Lead
nonia Nitrogen _
Snooty C xx-poilit(it and r r nc o-rrtrai n t rails)
t`tr.GANICS: (e t ,c3(.(M ;,ItFLC)
(Specify teat arrcl rtlerUtod M. Attach lab report.
'Avoid Attached? Yes __(1) No
VC C rrrtiIhud # ::
mpied:
Treatment sytattb
Infltt rnt (9
fluent (9
in ft:
cN:
Nitrite (NO2) as N
Nitrate (NO3) as N
tPhcsphorus: Total as P
Orthophosphate__ ___
Al - Aluminum
I la - Barium,
Ca - Calcium
Cti - Cadmium_
Chrornkin- Total
Cu - Copper
f=c - Iron_
NO
'Al Lit (JNL_Y
'eAlt7MrtENT OP: VflUNI
At'Eii t ttAMY POMP:
its A SERVICE QIRMA
1I tC rseltt teat
NAT'OIRAL RESOURCES
WATER SECTION
Al ION I )A 1 E:
N on-N isc err. t : I (JRC;;
1YPL;..i2 eLIiMll 1 t U 1
A riclff it 1NJI'�; Nvwa t N"Te
._-__.__.Rente;]'. ielr'iltl Il l'
1lerl octal t:.w
- LA rd Alir)liu.t Ioiti u:,•S t�V
caNtr�trNa�l coatA*ntrettr7n8,
and field acidified YES ,,,_,_a„ NO)
mg/ i`i N11+ri
rnt
nig/
mg/
mg/
- Mercury .._ rng/
as&lufI3� _ mg/
n ° Manganese _ �.� , mg/

RESEARCII . ANAL'yTICA
LA ORATORIES, INC.
Analytical/Process Consultations
iemical Analysis far Selected Parameters and Water . ample identified its 71 626
Statesville Anal deal Pra ect. collected 26 June 2007,
Volatile Organics Quanritatiun
EPA !Method 6230 D Limit
ameter (ott>✓ L l
1.-Dichioroetttane 0,0010
Dichloropropane 0,0010
Chloroform. 00010
,I.-Trachloroe thane 0.001)
1,l Dichlompropear 0)1)010
Carbon Tetrachloride 0 0010
Benzene t),4701L1
1,2-i]ichloroethane 0.1,0 d Li
TnichLoroetbene 0.01110
-Dich1oropropane 0.0010
Dibrornometharte 0,0010
Toluene 0.0010
I , I,2-Tnchloroerltane 0.0010
i,3-Dichloropropane 0,0010
Tetrachloroethene 0,0010
. L 1,2-Teichloroethane ik 0010
1,1.2.2-Tetrachloroetharte 0.0010
tnchloro,propane 0.0010
l iexachlorobutndiene 0,0010
Brotmbetrzene 0.0010
Ethylbenzene 0,0010
Styrene 0.0010
Brorroform 0.0010
p-lse.propyltoluezu 0,0010
N-Butyibenzzene 0.0010
Naphthalene 0-0010
Trimethylberrtene 0,0010
1,2.3-Trimethylbenzene 0,0010
1,2,4-Trichlorobenzenc 0.0010
'_,3•Trick'orobenzene 0.0010
Chlorobenzene 0.0010
'_- hloroto'luene 1.001.0
4-ChlonstoMere 0.00 I
Tert-,Sutyllxnzene 0,0010
Sox;-Butylbenzene 0.0010
10
a-D tchloraberrzene 0.001.0
1,2-Dichlorobenzene 0.00 10
1-Prcpyibenzene 0 00 IC)
N-Propylbenzene 0.0010
l .3-Dichlorobenzene 0.0010
Dibromochlorornetbanc 0,0010
DichlorodiLiurrronthan 0.001.0
Chloromethane 0.0010
Vinyl Chloride 0_0010
Bromomethaoe 0.0010
Chlonachane 3.001 ty
Trichlomfluoromethai a 0,0010
1, •Dichloroethene 0.0010
Methylene Chloride 0.0010
Trans I ,2-©ichloroethene 0.0010
Cis- i ,2-Dichloroethette 0,0010
Brom©dichloronetha+e 0,00 I0
8grotrochloromethane 0,0010
Cis 1.3-Dichturopropene 0,0010
'Trans- l tailor° propene 0.0010
Total Xylenes 0.00 10
Methyl-Tert-Butyl eater (MTBL) 0,0050
isopropyl ether (I PE) 0.0050
Dilution Factor
070626
1.1.1
{me,LI
B
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
SQL
BQ L.
BQ
SQL
SQL
SQL
BQ L
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Sample Number 592763 5927'i 592765 592766
Sample Date 06/26'0 7 06/26/07 06126/07 06(26(07
SamDle Time (hrs) 1030 1 100 1130 1200
Below Quantitation Limits
mgi L = milligrams per Litre = parts per trtillion{ppm)

GROUNDWATLF QUALITY MQNITOBIN ,u
COMPLIANCE REPORT FORM' _
EAcif.ITYIN 10 hlrrr�u i;rint
a s r d�d �
Facility Name:
Permit Name (It ditterer t
Ftitt Addres s- �?
Narne:
tt nt�atic��ra her {tr
It Depth: _____
Screened Interval:
Depth to Water Level: ,
Measuring Point (IwAai'. y is:_
Gags of water pumpettbal
Fieldanalysts: pH__
far
_.._
Ccrlifot7ri: MF Taut!
FORM CAN Y_Y
refit Permit) Ertaratrrareter ttttlat
__tl, Well Dlarneter are k On D to luern
tt. to ..� �' It. Effluent
FL below meastrrirt rant,
ft. above land surface. !Wall »r`► M.P_ Etevtttiod are C1.:
before attracting: _ ample coIleated;
, Specific Conductance _..m_._ xrMhos
Temp. .__ °C Odor _. Appaairance
pies ter metals were rsottected unfiltered_
rr1f�li
OQrnl
_/14Qnrl
(Nam: Ure MPN method tar highly turbid samplrii
Dissolved Solids: Total
pH when analyzed) - units
TO
Chloride _
wa __ a m _ rrltili
Arsenic w� rngll
Grease and Oils mg/1
Phenol__.
Sulfate
Specitia Conductance
Total Ammonia Y._.
TKN as N ,_
Gam"-t`sfl
Rev, 0 000
_ uMhos
mg/I
Nitrite (NO2) as N
Nitrate (NO3) as. N
'Phosphorus: Total as
ARTNttbiitrVLh
ATEH 0UALITY 1 1 Isla
ilIAIL. SER4r1
PE1?tvIT Ir:
Nnn-IfischrarCLaumo
le '(4
'WIDE 5
TYP ;y f.'t t:i iflft
__ Spray i°rant)
__. . Holm), rii.;irrkYrrtc
Arlrllrtrl. RESOURCES
rATE K SI r TION
rdr nAlF
ISrEr NTIC I l I EING MONMTOREO
f°i �ruetaiFtiiCr�t; loriftration Gallery
L,Hrtiri' ltlrarr
t '`att att ,itd rr';flact tiles aver tend
c:ali trfwl coucentrationa.
tltit sample analy;
kstt�ratrry Narrrrt; ..
'erttttt atitrrr
p me
Orthophos hate !1
Al - Aluminum _�__._._„ �
Be •µ Barium . rncj)l
C ° f rllc,iarrn � mg/I
ta,t - Cadmium_ ..�
Chromium: Total
Cu - Copper_.
Fe - Iron .__
Ig - Mercury
K Potassivarri..
Mtn - Magnesium m.___._._...µM._._a...
Mn - Manganese._.._.,
rngli
mg/I
°�Il�l►
rng!►
r+l
911
rng/I
YES.
Nicktal
Laski.
'Zinc
Ammonia is NitroiUtsrt..._w
Otlrc r (S'luacify Carr polindf3 ant Co -antra tsr rY Uniti)
ORGANICS,
(Specify test and rrratikOd 4. Attach mats report.)
Report Attached? Yt s „ „ (1) No (0)
`10 . rrirrt11ou rl -
method N
melhad
LNIiiltn

RESEARCh & ANAL'TiCAL
LA. ORATOR1E5, INC.
Analytical/Process Consultations
hem cal Analysis for Selected Parameters and Water Sample Icfenti ed a. -06:'6
1 Statesville Anal 'cal Pro'ec collected 26 June 2007
Volatile ©r,ganics Quantitar on 070626 070624 470,26
EPA Method. 6230 D Limit 11.1 11 2 11.3
Parameter
(,?-Dichloroethane
2,11-DichloroprQpane
Chloroform.
1, I,1- Toichiaroetluvre
l,[-Dichloropropene
Carbon Tetrachlormde
Benzene
,'2-Dichloroeetnane
Trichioroethene
I ,_' -Di chloropropanc
Dibrormmethane
Toluene
1,1,2-Trichloroet.eane
1,3-Dichloroprapane
Tetrachloroethene
1.1,1,2-Tetrachloroeticane
1,1,2.2-Tetrachloroethane
1,2,3--irichioroprepare
Hexachlorobutadiene
Brorrebenzene
Ethyibenzerte
Styrene
Bnamof-orm
p-IsopropyltoLucne
N-Butylbenzene
Naphthalene
1,3,3-Trimethy[benzene
1,2,4-Trimethylbenzene
1,2,4-Trichlorobenzene
! ,2.3-Trichlorobenzene
C hlorobenzene
Chlorotolueue
4-Chloratoiuene
Tert-Burylbenzene
Sec Burylbenzene
t .4- D ichlorobenzetne
I -Dichlorobenzene
1-Pr pylbcnzene.
N-Propylbenzene
1.3-Dichlorobertzene
Di bromochl oro ern thane
Dichlurodi fluororrr thane
Chlorotnethane
Vinyl Chloride
Brotrtornethane
Chloroetftane
T ri c lnl oroflux ro rrtcthane
l,!-Dichloroethene
Methylene Chloride
Trans- I p-Dicbloroethene
Cis- 1,2-Dichloroetheue
Bromodichloromethane
Bromochtorotnethane
Cis- 1,3-Dichloropropene
Trans- 1,3-D ichloropropene
Total Xylenes
Methyl -Teri -Butyl ether (MTBE)
Isopropyl ether (IPE)
Dilution Factor
drnErL (roajG) Lmei'L) grn i
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Sayable Number 592763 592764 592765 592766
Sample Date 06/26/07 06/26/07 06/26/07 06/26/07
Sumpie T1me Orre) 1030 1100 1130 1200
= Selow Quanaitation. Limits mgr`1_ = milli pet Lites = parts per rrtillion(ppml

s
n
GROUNDWATER QUALITY
COMP CE REPORT FO
DRITORING:
MF Fecal
Total
mow' for
Dissolved Solids; Total
pH (when t lryzed)
Chloride
Arsen]C
Grease and Otis
Phenol
Sulfate
l
rnp11 Nitrate I
MOON Nitrate NO3
_F1OOI O '4'hosphons: TOW as P
Orthophosphate
mg'1 Ai - Aluminum
u � . Barium
rnitiCalcium
mga Cd-Cadmium
rntyl
--� men
inn
Mi
Specific Ccrnduc1vrice
Total AMITIOTI18
TI'(N as NI
Chromium: Total _ W
Cu - Copper
Fe - Iron
l - Mercury
rhos K
Mn-
YES i+tQ)
ORGANICS: (Gc,c alliSMPLCI
(Spirally m*t aasf method L. Attach lab it}
Report Attached Y (1) No......(0)
R
t a

GROUND !WATER QUALITY MONITORING
CONIPLCE REPORT FORM.
Facility
Parma N
PAR
SUBN T FORM ON
+i tt 3) as N
4P t t — Total as
fig - Mercury
Tlt a N
ta.;r
i.mr 'fa% t
d.
0
CtflS1HP1.Cj
ad S. Attach lab repart.)
Ve (1) No ... (0)
: reared I

ermr:R=

SU8MiT
GROUNDWATER QUALITY MONITORING:
P N E' REPORT FORM
Facility Nm
Parnell Nam
Nitres N0 } as N
Nitrate (NO3 a N
AP : Total its P
Pl
Total Ammon
TKNasN_
Y
colloidal concentrations.
Ni - Maw_
Pb -
Zn - Zinc
Ammonia Namig„
Cesar (Sptt1y Compuu+ds and Concentration Units)
nd .
ORGANIC : (GC,G01 S.HPLC)
(foully teat and method it. Attach lab report.)
Attached? Ye�_(1) No (0)
'&t
method d it

JUN-2 -2007 07:34 FRN`1:ISS N1A'INTENANCE.
704-973-5475 TO:754663 40
Fro
tom
Y:
IREDELL-STATESVILLE SCOLS
ADMINISTRATIVE ANNEX
1147 SA1 ISBURY ROAC
STATESVILLE, NC 28677
704-873-3755
704-873-5475
erne: pathallCit5s.1d2.nc.us
Iredell eville Schools
Fax Number;
70441734475
Pages Including cover page:

rIr
2007 07: 57 FR
SS MAINTENANCE 704-875-5475 TO:7046636040 P.001/002
IREDELL-STATESV1LLE SCk5OLS
ADMINISTRATTVE ANNEX
1147 SALISBURY ROAD
STATESVILLE, NC 2.8677
704.873.3755
704-873-5475
email: pathsllt isak12,nc.us
T
Company*
Irsclel -S
cols
Pages India
2-
g cover page:
Comments:

r-KUI9 lbb FIHINItTNHNI f1 4 'di" 74f5
Ana Resu s
!radell Statesville Schools
1147 Salisbury Road
Statesville
Entered 2/27/2007
Reported: 3/12/2007
Sample Remark
ample la P
NC 28677
For: WHES
I U ; f 04bbb4:J'=416
Units 14lefhod l Analyzed Ana t t
070227-10 Chloride l 'V #1 <10 rng/L M4S OCIC 2i27r07 MD
070227-10 Fecal CoIlform WW MW#1 <1 CFU/100mL SM9222D 127/07 MD
070227-10 NH3N MW#1 <0.1 mg/L SM4500NH3- 3/5/17 MD
070227-10 NO3NO2 WW MW041 0.125 mglL SM4500EF 3/7/07 CL
070227-10 pH MW#1 7.01 STD units SM45OOHB 2/27/07 CL
070227-10 T. Phosphorus !MW#I 3,2 mg/L SM4500PE 3/2/07 CL
070227-10 TDS MW#1 88 mg/L SM2540C 3/2/07 MD
070227-10 TOC MW#1 2.8 mg&L EPA415.1 3/4/07 PACE
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA NC00909
PO. Box 228 * Statesville, North Carolina 28687. 70 72/46I 7

GROUNDWATER DUALITY MONITORING:
COMPUANCE REPORT FORM
Field anatysls:
umb
Temp. ,
S
COD mgA
Coliform: MF Fecal /100ml
Coliform: MF Total 1100M1
(Hale: due MPN method at MOO tt
Dissolved Solids: Total ,- mg/1
pl-i (when analyzed)_ units
Chloride < mgA
Arsenic mg/I
Grease and Oils mg/I
Phenol mg/1
Sulfate mg/1
Specific Conductance uMhos
Total Ammonia mg/)
TKN as N rn9/I
SUBMfl FORM ON YELLOW
Please P4*1 C
z-Zi.t Air?
Te
No. a
ft. Wen Dkmeter 2in.
tt.
km measuring point.
For Grourkbater Treatment Systems
Check One: El Influent (98)
-131 Effluent (99)
ve land surface. AoIativ MP, Elevation in 11.:
sampling: 7 _ Date sample oollectect
, Specific Conductance Mhos
4'0, Odor Appearance
pies for metals were collected unfiltered YES
Nitrite (NO2) as N
Nitrate (NO3) as N
tPhosphorus: Total as P
Orthophosphate
Al - Aluminum
Ba - Barium
da- Calcium
Cd - Cadmium
Chromium: Total
Cu Copper
Fe Iron
Hg - Mercury
K Potassi
Mg - Magnesiur
Mn - Manganese.
LR ONLY
PARTMEPiT OF ENVIRONMENT & NATURAL RESOURCES
miry DIVISION. GROUNDWATER SECTION
MAIL E CENTER
PailiArr EXPIRATION DATE:
Narraischarga -
NPDES
TYPE OF PFMJTTEQ OPERATION BEING MONITORED
Lagoon Rernetaatiorc Infiltration Gallery
Spray Field Remo/Om _
Rotary
Other:
uIc-
plicatlan
ol Sludge
r7
OTE; Values should reflect dissolved and
colloidal concentrations.
analyzed:
n N /—/510-
idtnee YES 2Sh... NO)
Ni - Nickel mg/i
Pb - Lead mgA
Zh - Zinc mgil
Ammonia Nitrogen <.(), i„.-.' mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GO,GCNISJIPLC)
(Specify test and method 0. Attach lab repert)
Report Attached? Yes (1) No _ 0
VOC : method 0 ). j I
: method /
: method #
Ur' "rLA r rot..)rt CCIi1:13k1+12, krif iaL'Oral:CAY alt,i
• " '..iirrArjr.r".cr,ri 41,t [1Liirire r•i'r trITOL;c:rinl rrtrilrillors 1r3r irLorrrr, frirlivrrittr:41, :
for
GW-s9
Rev, 03)2000
Or •
ck:

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
EC1UTYINFOflMA
Facility Name:
Permit Name (If dill!!
Address:_
Weft
t Parson:
tdrttffcaiIor Number
Measuring Point
Gallons of water
Field analysis: pH.
Temp.
P
/0)
mit :
• specific Conducta
°C, Oci-or
PARAMETERS (Samples for metals wore coil
COD
Conform: ME Fecal
Coliform: MF Total
(Rolm Use MPH method for highly turbid sam
Dissolved Solids: Total 77
pH (when analyzed)
TOO
Chloride
Arsenic
mg/I
units
rrig/I
mg/I
mg/1
Grease and Oils mg/I
Phenol mg/I
Sulfate
Specific Conductance.
Total Ammonia
TKN as N
uMhos
mg/I
mg/I
SUBMIT
County
Tel
No_ of Wells to
unfitterrd..YES
Nitrite (NO2) as N
Nitrate (NO3) as N
YE
OW PAPER ONLY
EPARTMEUT
ATE A
'A
PERMIT 0:
Non-Dischafge
ATURAL REsouRCES
ATER SECTION
Pitons:191r 74
RATION DATE:
NPOES
TYPE OF PERMITTEE) OPERATION BEING IVIONITOREO
Lagoon Remediation: Infiltration Gallery
Spray Field Reinaliatice:
Rotary Orittrthut Land Application ol Sludge
Other: 0-4
- Values should reflect dissolved and ,
colloidal concentrations,
air, sample analyzed:
Laboratory Narne•
Certification Nb-
and field acidified YES
g/l Ni Nickel
mg/1 Pb Lead
iPhosphorus: Total as P mg/I Zn - Zinc
Orthophosphate mg/I Ammonia Nitrogen Le,
Al - Aluminum mg/I Other (Spicily Compounds and Concentration Units)
mg
Ca - Calcium mg/I
Cd - Cadmium rniVI
NO)
Ba Barium
Chromium: Total
Cu-Copper
Fe Iron
Hg- Mercury
K - Potassium
Mg - Magnesiurn
Mn - Manganese
mg/I
mg/I
mg/I ORGANICS: (GO,GCNIS,HP1.C)
mg/ (Spicily test and method 5. Attach lab report.)
mg/1 Report Attached? Yes (1) No (0)
mg/I VOC method
mg4 : method 0 z=
: method 0
te.`t the. 01 1 1 1ddra!ftd1 tddidT-',. rod r:"1 rQpdri ifue „mut ttidt 4tt arIttihil,JC.:11611:1 lc"net,
t:Att•A',11ti riipdiv'tilkd„.; for rItildrmit1 1rd 5.{? intlir0111DO,
dri.iN'YN.:1119,72:rd -

GROUNDWATER QUALITY M+I
COMPLIANCE REPORT FORM
Facility Name: -
Permit Name (If tIfsr:n ,
Ftihr Addrst-
ysl's: pH _ t
Temp..
PARAMETERS (Samples for metals were
COD
Coliform: MF Fecal T
Coiiform: MF Total
(Nolo: Use MPN method for Mealy tur f,+P4+s)
Dissolved Solids: Total / if rng/J
pH (when analyzed) units
TOC rngil
Chlorite <
Arsenic rngll
Grease and Oils mg/i
Phenol mgil
Sulfate _ , mg/I
Specific Conductance
Total Ammonia.
TKNasN
uMhos
mg/1
mg/1
UBMtT FOR
TORING:
t C/'aerfy crr Ty
Tel
No. of y
r `rerr
Influen
Effluent
ott?d: ' r
collected unfiltered Y
Nitrite (NO2) as N
/10Cml Nitrate (NO3) as N
/10Oml '4Phosphorus: Total as P
Orthophosphate
Al - Alumn(num
P.
PE??MIT r:
Non-Disoliarg
NPDES
AT1N DATE:
„U(C
TYPE OF PMITI„.Q. OPERATION BEING
- Lagoon temediation:
- Spray Field
Rotary test L� Ietl
Other:.*
Values should refls+ot d'I
dt�tlrrldal concsntratior►a
a - Barium
Ca - Calcium
Cd - Cadmium
Chromium; Total
Cu - Copper_
Fe - iron
- Mercury mg/I
K - Potassium
Mg - Magnesium
Mn - Manganese
e:,�` h.rt ).^dm:•��,�;,°sir;'.
YES
Ni - Nickel.
Pb - Lead
Zn Zinc
Ammonia Nitrogen-45./C
Other !Specify Compounds and Cone*
owed and
NITORED
s@ion Gallery
ORGANICS: (GC,QC/MS,H'PI,C)
(Specify tart and method #- Attach lab repo
Report Attached? Year ,, (1) No
VOC _
� r method 0 )
: method M
: method#�

GROUNDWATER QUALITY MONITORING:
COMPUANCE REPORT FORM
Facility Narne:�lt
Permit Name (ii citere
o Water Levlel:.,
Poifat (M,P.)
Field �Iysis. p
T
PARAMETBS (Samples for
COD
Conform: MF Fecal
Conform: MF Total
(NOW Uwe 111PF1 msnvad for highly turbid sarttplrrrr
Dissolved Solids: Total mg/l
pH (when analyzed) ,.. .units
TOC
rng/1
Arsenic
Grease and Oils
Phenol
Sulfate
Specific C
Total Ammon
TKN as N
4C, Q for
^..III*u
SUBMIT Rfl CN Y
ltir uen
Eflint
Riga .P.
Date sample col/acted:
u
AP ER ONLY
AURGES
10fi, GROtlfii3vVA'n
PERMIT e. EXPII AI ION DATE:
UIC
NPOES
TYPE QF PERMITTED EPIATION BEING MONITORED
agoan Remediiallon: Infitreeen Gallery
spray Field , Rereedlallo t _ t .,
Rotary DistrIbutrrr 1 nd Application al Studge
Other:
aloes should ref
dissolved and
colloidal concentrations.
e anaizeld:
Name.
Nb.
unfiltered X YES " t ld acldlflad
Nitrite (NO2) as N mg/1
Nitrate (NO3) as N = f mgll
Phosphorus: Total as P mg/I
Orthophosphate mg/I
Al - Aluminum_ mg/I
Ba - Barium mgol
a - Calcium_ n9
Cd - Cadmium
Chromium: Total mg/I,
Cu - Copper mg,
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potaslsi mg/I
Mg - Magnesium mg/I
Mn - Manganese. mg/I
YES NO)
Ni - Nickel
Pb - Lead
Zn - Zinc
Ammonia Nitrog
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,I1PLC)
(Spicily test and method 1I. Attach lab report.)
Report Mac/lad? Yea, (1) No
VOC _7 7 _ . method M}
method 0
: method 1f m

GROUNDWATER QUALITY MONITORING:
COMPUAI I+OE REPORT FORM
Facility Nam`
Permit Name IIf di
pum
pH
Temp.
PARAM
COD
Conform: MF Fecal
Coliiform: MF Total
(Nat*: Woo limn# method far highly turbid
Dissolved Solids: Total -)0l2,
pH (when analyzed) units
TOC M,. .
Chloride G�?a mg/I
Arsenic mgI
Grease and Oils mg/l
Phenol mgll
Sulfate r .
Specific Conductance
Total Ammona
TKN as N
SU
Tel
No. of W
Diameter r ;
ft.
measuring point.
e land surface. Relative MWP_ Eieuatian in
l74. Data sample collected:
ON Yww PAPER ONLY
HtPMF
and field acidift
Nitrite (l02) as N
mgfl
Nitrate (NO3) as N mg/i
°4Phosphorus: Total as P m
Orthophosphate mcii
Al - Aluminum mgli
Ba - Barium
CrnilA
a - Calcium=.
Cd ..
Ch
Cu - Co;
mgfl Fe - Iron
mg/ Hg - Meru
uMhos K - Potassltn .
argil Mg - Magne lun- -_
9n Mn - Mang
EHATION E
Remedial
YES
Ni - Nickel.
Pb -Land
Zn - Zinc
Ammonia Nit
Other (Spedly
NIT©REO
ttcan t3Mary
Coma
ORGANICS: (aC,t3Clkis,HPt .C)
(Specify tact and method t. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method A
method lE in
method 0

GROUNDWATER QUALITY M+QNIT©RIN
OMPUANCE REPORT FORM
T FORM tN
t11tI ei
Effluen
rra Relative _P._
Date
CO©
Collfoft: ME Fecal
Coliform: MF Total
Molt: Use iMPN m thod for highly
Dissolved Solids: Total mgel
pH (when analyzed) units
TOC _
Chloride � .. mgil
rrtgif
Arsenic
Grease and Oils " mgil
Phenol mg/l
Sulfate . m
Specific Conductance
Total Ammonia , uMhtas
'KN as N r .. mg/I
mg/1
Gt+Y-tip
Rev, 03/2000
mg/I
anttatered� Y
Nitrite (NO2) its N
Nitrate (NO3) as N,.
4P
: Total as P
P IT #: PtRCATiClN DATE:
Ntln-Ehsch f , `m `3� UIC
NPOES
TYPE Q *EFATiON BEING MONITORED
t wtt Bert Inttitration Gallery
Rennet! _
Values should reflect dissolved and .
cobaldat concentrations.
ampte analyz
Laboratory Name:
Certification N.
Cd - Cadmium
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury
lC - P©tassi
Mg - Magnesium
Mn - Manganese
YES
Ni - Nickel_
A Pb - Lead
Zn - Zinc ..
Ammonia Ni_
Other (Specify Compounds and Concentration Units)
Slue
33.
tV
0
Sri
Qrri
r-
ORGANICS: (GC,©CNIS,HPt,C)
(Specify test and method S. Attach lab report.}
Report Attached? Yeat._ (1) No
VOC : method N zis
. method NMI
method it at

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
EACti.ITY nls"Q . MATiC?ly
Facility Name:.
Permit Name (if
F
Field anaiys
PAHAPOLTER (S
COD
Collform: MF Fecal
C©liform: MF Total
(Nolen US MPH method for highly turbid
Qissohved Aids: Total
TC(Cwhen analyzed)
Chiit
Arsenic
Grease and Oils
Phenol
Sulfate
Specific Conductance
Total Ammonia
TKN as N
/1 00m1
/100m1
mg/!
units
_,. mg/I
mga
rnmg
m
_ uMhos
mg/I
GW5p
Rev. CC°
mg/i
SUB iT EORY I.t. W PAPER ONLY
Tel
No_ of 'e
For
Yi
Nitrite (NO2) as N mgJ1 Ni - Nickel
Nitrate (NO3) as N mg/i Pb - Leas
.4Phasphorus: Total as A mg/I Zn - Zinc
Orthophosphate mg/I Ammonia Nita
Al - Aluminum
13)a - Barium mgoll Other (Specify Compounds and Concentration Unita)
Ca - Calcium;. mg/1
Cd - Cadmium
Va
Date sample analyz
ratory Name:
Certification NIl.
EXPIRATION DATE:
UIC
d reflect dissolved and .
entrations.
0 end field ecidifiad
mg/1
Chromium: Total mg/1
Cu - Copper mg/)
Pe - Iron mg/1
Mercury
Potassilt �
Mg - Magnesium... w mg
Mn Manganese % , mg/i
YES
NO
ORGANICS: (oc,©C/MS,PIPLC}
(Specify teat end method O. Attach leb report.)
Report Attached? Yea (1) No (0)
VOC : method N
method toal
method $
Uit:rx°;:re
for nutynnrillri
3i^ an,
Alfj

GROUNDWATER QUALITY
COMPUANCE REPORT FO
Facility Nan
Permit Name
SUBMIT FORM III YELLOWPAPER ONLY
NTORING:
. Telephone #I.l
No_ of Wells to be
Well I+t ntiflcation Lumber (from
Depth:
tntenret:
Level:
(M.P.) is:_
Field
PARAMETERS (Sarnp
COD
Conform: ME Fecal
Collitorm.: MF Tel
(Holm Use *MN method for highly turbid tsmptssl
Cissotved Solids: Total
pH (when analyzed)
TOC <r);
Chloride
Arsenic
Grease and Oils
Phenol
Sulfate
Specific Conductance uMhos
Total Ammonia _ mg/I
TKN as N mg/I
units
rrtg/i
mg/I
mg/I
mg/
rogil
lrlttuen
Eftfuent
PERiVirr EXPIRATION DA°E:
NPDES
OF PE j )T D DPEl ATION RFJNG TOPED
Rentettlatlau� lydiltration Garry
NOTE,' Values should reflect dis
colloidal concentrations.
YES and field
Nitrite (NO2) as N
Nitrate (NO3) as N
itPhosphorus: Total as P.
Orthophosphate
Aa - Aluminum
Ca - Barium
Ca - Calcium.
Cd - Cadmium
Chromium: Total
Cu - Copper
Fe • Iron
Hg - Mercury
K - Potitselt
Mg - Magnesium
Mn - Manganese
Y
Ni - Nickel
Pb - Lead.
NO)
Zn - Zinc
Ammonia NIhoi�J
Other (Specify Compounds and Concertintl Un
ORGANICS: (GC,GCNIS,FIPI.C)
(Specify test and method I. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC . method c►
: method it a
: method lt<
y CZra1) r :rt,

GROUNDWATER QUALITY MONITORING:
OMPUANCE REPORT FORM
Facility Name:
Permit Name
PH
Ts
PARAM
COD
Conform: MF Fecal
Coliform: MF Total
(Raw U.. UM method far highly turbid .a ,pq=)
Dissolved Sol: Total
p1(hen analyzed)
Chloride
Arsenic
Grease and 0
Phenol
Sulfate
Specific Conductance
Total Ammonia
TKN as N
YES N©)
Ni - Nictaei_
Zn - Zinc
Ammonia Nitrogen _.
Other (Specify Comps and �r
ORGANICS: (aGt ,GC,IMS,HPLC)
(Special test end method ii- Attach Jab report.)
Report Attached? Yes (1) No (0)
VOC method Azio
method #+.
un
un
SUSMIT Rhri ON ,YI LLC W PAP I R ONLY
.N 47F ht T lk ATURAI RESOURCES
At ITt tlt�lotl, +G r LlriDWATER SECTION
ER� c�a
!' S lS1 133.321
TYPE OF P ER +IIT D OPERATION BEING IUfONITCRED
Later Renredialian: Infiltration Gallery
Relrle diaioin:
Rotary or land App Don 01 Sludge
�( a y.j
Values should reflect dissolved and
colloids! concentrations.
YES - ,,tom and
Nitrite (NO2) as N
Nita 'l (NO3) as N
rPhosphorus: Total as P
Orthophosphate
Al - Aluminum
Ea - Barium
de - Calcium
Cd - Cadmium
0
Mg - Magnesium . m�
Mn - Manganese 9�
Chromium: Total
Cu - Copper
Fe Iron
Fig - Mercury.
K - Potassium
cAorr.a [.!o<p4;(1 CSC

IT
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Te<
No. of
Weti Depth; ft. yet Diameter.
`71-5— ft
• measuring point
Moasug Point (M.P.) isi ft. above land surfa . Relative M.P. Elevation In ft.:
in(p Date sample collootee
ON
Field
Ti
PARAMETERS (Samples for metals were collected unfiltsredYES
COD mg/I Nitrite (NO2) as N
Conform: MF Fecal I /100rril Nitrate (NO3) as N
P 1..Y
NATURAL. RESOURCES
ROUNDWATEFt SECTION
Pt,onit: (UP)
EXPIRATION DATE:
UIC
NPDES
TYPE OF PERMITTED
11..apoon
Spay Foie
notary Distributor
Other;
Values should reflect dissolved and,
colloidal concentrations.
Coliforrm MF Total /100mi 4Phosphorus: Total as P
pH (when analyzed).
TOC
Chloride
Arsenic
(Nolo Us. 11111.1 method far Nighty turb17 Orthophosphate
Dissolved Solids: Total Al - Aluminum
Ba - Barium
Ca - Calcium
Cd Cedmiu
Chromium: T
Cu Copper
Fe - Iron
Hg - Mercury
K Potasel
Mg - Magn
Mn-M
mg/I
units
mg/I
m4
Grease and Oi
Phenol
Sulfate
s
mg/I
man
MC11
Specific Conductance 'Mhos
Total Ammonia mgI
mgll
TKN as N
analyzed:
mgM
mg/I.
mg/1
mg/I
mg4
mg
mg
.mg/I
mgfl
rng
mg
mg
mg/1
mg/1
YES
Ni -
Pb - Le
Zn Zinc
Ammonia Nitro
Other (Specify Compounds a
is)
ORGANICS: (GC.GCA4S,HP1.0)
(Specify tam and method *. Attach lab report.)
Report Attached? Yea (1) No (0)
VOC : method 1
: method
method •
• •• • • .
ce.-flly Th., It., to int t e 4ny !M-ViCfl ttiA"-:$, report tr.; Irtrr% and c:ottl:!1•ItAt.,,t, ittai ttltit tfttit laboratory anttlytonaltVila IAL71; IP•4:1CiLICCA
t\toi ttt [f.ti DWO Cc:In-a:J., it- laborory t am ameife vzr,„11 th. are r ;nfcau p•nittfltot:;t; for Ettibrrillirm 1115e trinitiviton,
, liTrAndot.„) the t•Io trij and 41-1,714 t3r trtolahotkt::t
GW-59
Rev, 03P2000
NC :„IENF,et MRC
DWQ - Aquifer Protection

GROUNDWATER QUALITY
COMPLIANCE REPORT FO
Facility Name:„
Permit Name (It
PARAM 'Eft (Saeapies for
COD
Cottforrn: MF Fecal
Coliforni: MF Total
(Hole: Ups SIPN method for hishrr
ICNITORING:
hit
Dissolved Solids: Total
phi (when analyzed)
TCC.
Chltxlde
Arsenic
Grease and Oils
Phenol
Sulfate
Specific Conducta
units
9I
Total Ammonia mg�
TKN as N
T
of Type
Telepthdn.
No. of Wells to be
cent
YE
Nltdte NO2)(as N
Nitrate (NO3) as N
iPhosphorus: Total as P
Orthophosphate
Al - Aluminum
Ba - Barium
+a - Calcium
Cd - Cadmium
Chramiurn: Too
Cu - Copper
Fe - Iron
- Mercury
K - Potassi
Mg - Magness
Mn - Manganes
rna3 ()W ( )rrn
Y
Phone- f91®j T--nZ;
tATiON DATE
utc
OF PERMITTED OPERATION BEING lv iNr TORE©
_Remediarj if -Mallon Gallery
Reriyec9stlan:
Date sample analed
t a boreto y Via• "' : 'r
err N.
i' and leld acidified YES
Rigil Ni - Nickel
mng/l Pb - Lead_
mg�l Zn - Zinc
mg/I Ammonia. Nitrogen
Other (Specify Compounds and ��anlration U
DRGAhiIC$: (GGGCIMS,HPLC)
(Specify List and method O. Attach lab
Report A tched? Ye (1) No
J
VOC �method #
method #
ory. Gsn:=tfyi
ii,E, n for .nub-

GROUNDWATER QUALITY MONITORING:
PUANCE REPORT FORM
Facility mama:.
Permit Name (if
Field,
PARAM
COD
Co itorrn: MF Fecal
Coliform MF Total ,
S (Samples for
(Holm Use ION method for ► ighly air
Dissolved Solids: Total
T (when analyzed)
units
mgVl
Chloride :: mg/
Arsenic: mg/I
Grease and 0iis mg/I
Phenol rng
Sulfate m
Specific Conductance __ uMho
Total Ammonia _ mg/I
TKN as N - mg/I
u
USMIT FORlwt ON YELLOW P
Please Prl
AYES
Nitrite (NO2) as N
Nitrate (NO3) as N
•tPhosphorus: Total as P
Orthophosphate
Al - Aluminum
lea - Barium
Ca - Calcium
Cd - Cadmium..
Chromium: Total
Cu - Copper
Fe - Iron
Fig - Mercury
K - Potassium.-_ ___ m
Mg - Magnesium mg/I
Mn - Manganese mg/I
ONLY
NATURAL RESOURCES
►WATER secr!t
cF$i ilTiE€) OPERATION BEING MONITORED
i3se+c ion: Infiltration Gallen/
�._.._�. %medalist
Values should reflect dissolved and
colloidal concentrations.
Mampie analyzed:
Name: 5'1T4*c
Nb. 0
I(idled _ YES
/1�
0
Ni - Nickel _, mg/i
Pb - Lead _ mg/1
Zn - Zinc mg11
Ammonia Nitrogen <c m
Other (Specify Compounds and Concentration Units)
ORGANIC
(Specify test and rrroth
Report Attached? Ye
VOC"Di_.•
me

GROUNDWATER CUALUTX
COMPLIANCE REPORT FO
Facility NaJr:i. E
Permit Name (if dlffe
Field
PARAMETERS (Samples for
COD
Coliform: MF Fecal
Colitorm: MF Total
(Kota: Use NPR harthod Mr highly tnxbi
Dissolved Solids: Total
p(when analyzed)
Chloride
Arsenic
Grease and flee
Phenol
Sulfate
Specific Conductance u
Total Ammonia
TKN as N
ONITORIN
vI
rx<ert' th,ttotr,
ppr{ Twe
Cd - Cadmium M..�
No_ of
SUI AfiiT FORM ON
YEWS
Nitrite (NO2) as N
Nitrate (NO3) as N _ r/i
{Phosphorus: Total l s P . mgll
Orthophosphate mgll
Al - Aluminum mgli
unt1s Bat - Barium
Calclurrt mg/1
rngil
Chromium: Total
Cu - Copper rng/l
mgl
Fe • iron
mgI
Hg- Mercury mg/1
K - Potlsssiurn mgll,
Mg - Magnesium
Mn - Manganese
PA ER ONLY
& NATURAL RESOURCES
�Dt�tATER SECTION
NPDES
TifPg OF E'ER IITTED 3PERATiON BEING MO TOPED
Lagoon Remmetealion: Inaitration Gallery
Spray Field , Rem►e re
Rotary Distributor Land Application of Sludge
Other, iThr::
�PIRATlON DATE,
w . o UIC
YES
Ni - Nickei,_
PD - Lead
Zn Zinc
Ammonia Nitrogen
Wither (Specify Compounds and Concentration Units)
ORGANICS: (GC,GCJMS,HPLC)
(Specify test and method s. Attach lab rep
Report Attached? Yea _(1) No T (0
VOC r7 p1-- : method N
.., method a 1r
method s
-rrt:fts;

Letter of
Transmittal
Piedmont Design Associates, P.A.
125 East Plaza Drive, Suite 101
Mooresville, NC 28115
[phone]
Fax: [phone]
Email: ddecaron;: dapa.com
To:
NCDENR
610 E. Center Ave. Ste 301
Mooresville, NC 28115
Attn: Peggy Finley
DATE
July 10, 2006
COPIES
Job Number: 03-03-07
Woodland Heights Elementary School
Iredell County, NC
NO.
2
2
Monitoring `elI ""As-f3ui
GW-1 Form
DESCRIPTION
These are transmitted
El For approval U Approved as submitted 0 Resubmit fl copies for app.
0 For your use El Approved as noted © Submit Ej copies for dist.
Z As requested El Returned for Eli Return 0 corrected prints
corrections
0 For review & comment
LJ FOR BIOS DUE:
REMARKS
ease iet us know i`you need a thing e1.
Signed:
cc: File
David M. D:a on
0
NC DENR MR
D Q - Aquifer Protection

07 / 10 / 2006
13:50 MCCALL BROTHERS 4 7046641778
NO.690 P002
CONSTRUCTION RECO
North Carolina - Department of Environment
WELL CONTRACTOR (INDIVEDVAL) NAME (prim
WELL CONTRACTOR COMP ANY NAME
STATE WELL CONSTRUCTION PERMITO
1' 1
Cif Vie:able)
;Division of Water Quality - Groundwater Section
CERTIFICATION ;L.1 1
?lion # 17,q)P7-/T-P47
1. WELL USE (.cck Applicable Box): Residential 0 Municipal/Public D Industrial 0 Agricultural 0
Monitoring "E' Recovery 0 Heat Pump Water Injection 0 Other 0 If Other, List Use
2. WELL LOCATION:
Nearest Tosyn:FIN, tee t/
e,c2-C-h, 72. ko,
Name., Numbers, Comnswrity, Subdivitice, Lot No., hp Cock)
3. OWNER: TRCO C.44 4?
Address
(StVert or RoutNo.)
CcywTwn state
Arca code- now °umbel-
4, DATE DRILLED -10
5. TOTAL DEPTH: Y6--
6. DOES WELL REPLACE EXISTINGWELL? YES 0 NO
7. STATIC WATER T,FVEL Below Top of Casing: 2./
"t" if Above Top of Casing)
S. TOP OF CASING IS 0, 0 FT. Above Land Surface'
*Top °teasing terminated atior below Lad sachet requires k
variance la accardaa ce Vitt ISA NCAC 2C .01.15.
9. YIELD (gpm); NET OD OF TEST
10. WATER. ZONES (depth):
11_ DISINFECTION: Type ifl/4
12. CASING:
Depth ilna' roe
From (n? T02.5- FL
Isma To Ft,
From To Ft,
13. GROUT Depth
Front T 0_
From__ To Ft,
14, SCREEN: Depth
From X6-- To 3- Ft.
From To Ft.
15. SAND/GRAVEL PACK:
Depth
From 2. To 9'6--
From To
1 DO
CONS
Wan Thickness
0
Slot Size
izLvtlLa ,
im in.
Topographic/Land se
[Midge °Slope DValley
(deck appropriate box)
Latitudeflongitude of well location
Latitudelongitude source:
From To
p
.5-
•Se:77
Show directio
two State Roads or Co
numbers and convnon road names,
'4+
CONSTR.L7CltD TN ACCORDANCE WT111 15A NCAC 2C, WR( 1
A COPY OF MS RECORD HAS BEEN PROVIDED TO THE WELL OWNER,
ude the road
OPP1SON C
A
Submit the original to the Division of Water Quality, Groundwater Section, 1636 Mail Service Center - Rsielgta, NC
27699-1636 Phone No. [phone], within 30 days. OW -I REV. 07/2001

NCDENR
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor
iredell-Statesville Schools
1147 Salisbury Road
Statesville, NC 28677
Attention: Dr, Kenny Miller
Dear Dr. Miller:
Coleen H. Sullins
sion of Water Qua lity
Dee Freeman
Secretary
March 16, 2010.
RE: Inspection Report
Woodland Heights Elem, School
Surface Irrigation System
Permit No. W00023511
Iredell County
Enclosed you will find the report for the inspection that I conducted at the school's wastewater treatment
and disposal facility on March 9, 2010. The report should be self-explanatory but please feel free to
contact me if you have any questions.
It is my understanding that connection of the school to the Town of Mooresville's municipal sewer system
is close at hand. As stated in Condition V1.7. of your permit, upon proper closure of the existing treatment
system, a permit recission request must be submitted to the Division. Your request should be directed
to:
Jon Risgaard, Supervisor
Land Application Unit
Aquifer Protection Section
Mail Service Center 1636
Raleigh, North Carolina 27699-1636
Should you have any questions, please call me at 704/235-218 or contact me via email
tz. [e-mail],
Sincerely
Peggy Finley
Environmental Specialist
MAF/woodland hgts schl inspect rpt 3-9-10
Division of Water Quality / Aquifer Protection Section / Mooresville Regional Off)+:.e Phone: [phone] Fax: (704) 66
610 East Center Avenue, Suite 301, Mooresville, NC 28115 Customer Service 1-677-623-6748 Internet; www.ncwaterquallty.©rg
One
Nort tCarolit
040 ralh

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Beverly Eaves Purdue, Governor
Dee Freeman, Secretary
Coleen FL Sullins, Director
NON -DISCHARGE COMPLIANCE INSPECTION
SURFACE IRRIGATION
GENERAL INFORMATION
Owner: Iredell-Statesville Schools
Permit # WQ0023511
Issuance Date: 2/12/04
Permittee Contact: Dr, Kenny Miller
County: Iredell
Project Name: Woodland Heights Elem.
Expiration Date: 1/31/17
Telephone No:: 704/873-3755
ORC Name: Dennis Gryder Cert #SI989073, WW-2 8187
Email address: [e-mail] Telephone No.: 704/902-0427 (c)
Backup ORC Name: Walter (Ronnie) Byrd Cert #VVW-1 10947
Reason for inspection
X ROUTINE COMPLAINT FOLLOW-UP Facility Start-up
Inspection Summary: (additional comments may be inc uded on attached ages)
Although there has been significant improvement, the treatment plant continues to generate
effluent with total nitrogen concentrations above the average yearly limit of 15 mg/I. A pump
station has been built next to the treatment plant and reportedly, the school's wastewater will
be pumped to the Town of Mooresville's WWTP in the near future.
Fallen trees and excessive underbrush still need to be removed from the drip fields,
is a follow-up inspection necessary yes X no
Inspector Name/Title Peggy F n ey, Environmental Spec., Maria Schutte, Senior Environmental Tech
Tel No. 704/235-2183 Fax No. 704/663-6040
Date of Inspection: 3/10/09
Surface Irrigation Page 2

Prr
Permit #WQ0023511
TCPe
Activated Sludge Spray, low rate
_X Activated Sludge Drip, low rate
Lagoon Spray, Low Rate
Lagoon Drip, Low Rate
Treatment
Y Are treatment facilities consistent with those outlined in the current permit.
Y Do all treatment units appear to be operational. If no, note below.
Influent pump station
Y All pumps present, operational
Y Bar screen, maintained
Y Bars evenly spaced
Back-up power
Flow measurement — Influent NA
s flowmeter calibrated annually?
s flowmeter operating properly?
_ Does flowmeter operate continuously?
Does flowmeter record flow?
Does flowmeter appear to monitor accurately?
N
Bypass structure present
Free of excessive debris
Bars excessively corroded
Flow Measurement — Water -Use Records
Y Is water use metered?
Are the daily average values properly calculated?
Disinfection
Y Is the system working? Y_ Is the system properly maintained?
Y Tablets Gas Liquid Y UV
Y If tablets, proper size? N Present in cylinders?
If gas/liquid, does cylinder/tank storage seem safe?
Y_ Is contact chamber free of sludge, solids and growth?
Comments: Three of the four cylinders were noted to be empty of tablets.
Flow Measurement — Effluent
_Y_ Is the flowmeter calibrated annually?
_ Y Is the flowmeter operating properly?
Y Does the flowmeter monitor continuously?
Y Does the flowmeter appear to monitor accurately?
Surface Irrigation Page 3

Permit WQ0023511
Effluent Storage
• LAGOON SEPTIC TANK(s} ABOVE GROUND TANK
OTHER
Number of months storage1 Spill control plan on site
Above ground tank Aerated Mixed
In ground tank Aerated Mixed
Storage Lagoon
Check any/all that apply
Y Influent structure (free of obstructions)
N Banks/berms (are there signs of seepage, overtopping, down cutting or erosion)
N Vegetation (is there excessive vegetation on the lagoon bank
• Liner (if visible, is it intact)
NA Baffles/curtains (in need of repair)
Y Freeboard (>2 feet from overtopping)
Y Staff gauge (clearly marked)
N Evidence of overflow (vegetation discolored or laying down/broken)
N Unusual color (very black, textile colors)
N Foam (are antifoam agents used)
Y Floating mats (sludge, plants, inorganics)
NE Excessive solids buildup (from bottom)
NA Aerators/mixers operational (if present)
Y Effluent structure (free of obstructions, easily accessible)
Comment: The depth of sludge at the bottom of the lagoon has not yet been
evaluated.
Residuals NA
storage/treatment
Disposal (final end use)
Y Is the application equipment present and operational?
N _ Is application equipment in need repair?
_NA_ Spray heads calibrated this past year?
Y Are cover crops the type specified in permit?
N_ Is cover crop in need of improvement?
N Signs of runoff? N Signs of ponding? N Signs of drift?
Comments: Fallen trees and underbrush still need attention.
Surface Irrigation Page 4

Permit #WQ0023511
Y Are buffers adequate?
N Is the acreage specified in the permit being utilized?
N Are there any limiting slopes in disposal fields?
NA Are restrictions for use of these areas specified?
Y Is permit being followed?
Y Is site access restricted in accordance with permit?
Comments: Only 3.58 acres (zones 1 and 2) are being utilized. Zones 3 and 4 were
reserved for when the middle school came on line.
Recordkeepina
Y Is permit available upon request?
_Y_ Are flow rates less than permitted flow?
Y Are monitoring reports present: NDMR _ NDAR
_Y Are operational logs present? Y Complete?
Y� Are lab sheets available for review?
Y Do lab sheets support data represented on NDMR or NDAR?
Y Are all samples analyzed for the required parameters?
Y Is field parameter certification required?
N Are there any 2L GW quality violations?
Are annual soil reports available?
Y Is the operation and maintenance manual present? Complete?
N Has DWQ received any complaints regarding the facility in the last 12 months?
Comment: *Soil samples have been collected but the report has not yet been received.
Daily flow rates must be reported on the NDMR. PAN in lbs. per acre must be
calculated and recorded on the N©MR.
Groundwater Monitoring
Y_ Does the permit require monitoring wells? If so,
Y are the monitoring wells properly installed according to the permit?
are the wells properly identified?
are the wells damaged?
Comment: A water level meter is still needed for sampling events.

n
xi
Pam: �75
wiv
039
No t Cal°Iina
Toha tr Trust } and Coma
1stQN3p lT FF 0.0 70-90 20-40 0 0 0 0
.2 i rai rci,E 0.0 7 20 4G t7 tb i
P•l Kd ca% Aiar4 ,fin«Af L e r i C S d 14 ?r-h m7+•N
47 44,0 0 i i 4^ 80
N Pais KM Zs
Lstfine: liardwnod,E 0.0 70-90 it 30 0 0 0 0
Ltd ca Leo o» a i 3 1 0 tM 0 0
Reprogrs
0
ucrn.rrrarrragarrr
through a grant
m that makes this report possibia Is being funded
North Carolina. Tobacco Trust Fund Comrnissim
rate serwlcxs to 'nonage nutrients and safeguard env mental quality.
Stew Trader, Commissioner ofAgricultore

MAR-12-2010 09:53 FR17M:ISS MAINTENANCE 704-873-5475
TDB:7046636040
P.981/006
iREOELL•Si`ATI:SV1 LLE.S
ADMINISTRATIVE ANNEX
1147 SALISBUR'' ROAD
STA"rSSVILLE NC 286°
704 873-3755
704-873.5475
�'rr+a�►: ralCtSs.k12.r1C.uS

rD
a AI7t (mevirled Oc *ribber 2©c
MPLE TYPE r
uth a Sample Anaiys
3 HeavyMetals Test ($25 per sample)
Test for repMated sates only — t applIceble for homeowners I
SAMPLE INFORMATION
FAR
fti7. CF SMAPLES
COUNTYtwhere collerle
PAYMENT AMovia
nor Heavy Mints only)
( ) CHECK (payable to NC€OA&CS)
( ) ESC1OWACCOifNT (enter acct. na
SOIL SAMPLE INFORIATIOIV
NCDA&CS Agronomic Division Soil Testing Section
Mailing Address: W40 Mail Service Center, Raleigh NC 27699-1040
Physical Address (UPSIFedEx): 4300 Reedy Creek Road, Raleigh. NC 27607
Phone: [phone] Web Address; wwwwncagr-gov/agronorn1
GROWER INF}Rik4Aill (please p
STATE
P&ASE PRov7DE E-MAIL ADDRESS
SAMPLE
IDENTIFICATION
Muzak yott j ©r rsing agromantic services to
LIME APPLIED
PAST 12 MONTliS
Ton9lAcre IAonth Year
age nutrients ands:
u *mist a crop COD
FIRST CROP
guard envirantnental quark
FOR OFFICE USE ONLY
DATE REC'D
ER RECIPIENT
Sfev�e.. TroxZq
ZIP
stde of form
SECOND CROP
Cnrrtrrtkssianer of Agriculture

Field fnfermeatiou
Ilene; (9119)
Applied Limy
Pad{ a 411* 5 u
0,0 70-90 20-40 e 0 0 0 it
rail 71S t9 b U €t 11
CEC Bilii Ac f -r �Ar 1,1 r Af Cu.1 54 S -I Mai-!? MA' I( Na
7 4. i 1.6 51 a 47 Wit,{} i .i7 1 1 45 i1d 0..1
Appl d L►t Recommendatieas
r ,lfa i t 77A asp or Pear Pit tirC1 Crt S n fee l srlc
lit Crop liardwoocl,E 0 0 70-90 10-30 0 0 0 0 II
2nrct Crop 1-12n1 oad,Er d1#1 a 0- 10-30 0 0 1) 0 t #.
C£C RS% Ac pii Rf
5.7 70 0 t.7 5 3 0
rust Fuld arunisstun
(2) r rr C .p £ 4 NQ1-N MI -N Na
3 3t} 73 0 2
boratory-information-rnanagernent system that makes this report possible 1s f ing funded
through a grant from the North Carolina Tobacco Trust Fund Commission,
c scrvirt t e rlfro& nutrients and safeguard emvronmcrnxtl q ralrry,
Sloe Trader, CoramAsltrner of Agriculture

N014.3-15-2010 08:29 IFRO'M:ISS MRINTENR•ICE 704-873 3475
tredell
TO: 7045F36 40 F. EEC 1'Q03
e Se
Career Academy & Technical Sc©i
350 Old Murdock Road
Troutman, NC 28166
Phone: [phone]
Cog
w
Learning

Prillirir-
.i,
v..'
North Carolina Department of Environment and Natural Resources
Beverly Eaves Perdue
Governor Division of Water Quality
NCDENR
lredell-Statesville Schools
1147 Salisbury Road
Statesville, NC 28677
Attention: Dr, Kenny Miller
Dear Dr. Miller:
Coleen H. Sullins
Dee Freeman
Secretary
March 31, 2009
RE: Inspection Report
Woodland Heights Elem, School
Surface Irrigation System
Permit No, WQ0023511
Iredell County
Enclosed you will find the report for the inspection that I conducted at the school's wastewater treatment
and disposal facility on March 10, 2009. The report should be self-explanatory however I would like to
emphasize a few points.
The present treatment configuration, which was instituted in May of 2008, has resulted in some reduction
in total nitrogen in the effluent, However, the permit limit of 15 mg/I per year on average has yet to be
achieved, Barbara Sifford, the technical wastewater consultant for the Mooresville Region, also
conducted an evaluation and will be providing you with additional recommendations for achieving de -
nitrification,
Proper sampling procedures help ensure the validity of the laboratory testing that is required by the
permit. Prior to collecting groundwater samples, it is important to purge the monitoring well of standing
water so that "fresh" groundwater can be obtained for the samples. The collector needs to determine
how much standing water needs to be purged from the well, This can be best accomplished with a water
level indicator Mr. Gryder reported that he did not have such equipment.
Fallen trees and an increasing amount of underbrush were observed on the drip fields, This material can
damage drip lines and interfere with the operator's ability to identify leaks. It should be removed.
Should you have any questions, please call me at 704/235-2183 or contact me via email
@peggy [e-mail],
Sincerely
Peg Finley
Environmental Sp cialis
MAF/woodland hgts inspect rpt 3-10-09
One
NorthCarolii
Division of Water Quality 1 Aquifer Protection Section 1 Mooresville Regional Office Phone [phone] Fax [phone]
610 East Center Avenue, Suite 301, Mooresville, NO 28115 Customer Service 1-877-623-6748 Internet. www ncwaterquality org v.

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Beverly Eaves Purdue, Governor
Dee Freeman, Secretary
Coleen H. Sullins, Director
NCDENR
NON -DISCHARGE COMPLIANCE INSPECTION
SURFACE IRRIGATION
GENERAL INFORMATION
Owner: lredell-Statesville Schools County: Iredell
Permit # W00023511 Project Name: Woodland Heights Elenn,
Issuance Date: 2/12/04 Expiration Date: 1/31/09
Permittee Contact: Dr, Kenny Miller Telephone No: 704/873-3755
ORC Name: Dennis Gryder Cert #51989073, WW-2 8187
Email address: [e-mail] Telephone No.: 704/902-0427 (c)
Backup ORC Name: Walter (Ronnie) Byrd Cert #WW-1 10947
Reason for Inspection
X ROUTINE COMPLAINT FOLLOW-UP Facility Start-up
Inspection Summary: (additional comments may be included on attached pages)
Although there has been some improvement, the treatment plant continues to generate
effluent with total nitrogen concentrations above the average yearly limit of 15 mg./1, The drip
fields are in satisfactory condition but fallen trees and excessive underbrush needs to be
removed,
A Grade 111 operator has not yet been hired to oversee the system.
A water level meter is needed for proper sampling of the monitoring wells.
Is a follow-up inspection necessary X_yes no
Inspector Nameriitle: Peggy Finley, Environmental Spec alist
Tel. No, 704/235-2183 Fax No, 704/663-6040
Date of Inspections: 3/10/09

SIion
P P F urface irriga>
Permit #WQ0023511
Type
Activated Sludge Spray, low rate
X Activated Sludge Drip, low rate
Lagoon Spray, Low Rate
Lagoon Drip, Low Rate
Treatment
N Are treatment facilities consistent with those outlined in the current permit.
N Do all treatment units appear to be operational. If no, note below.
Page 2
Comments: Currently, one of the two treatment trains is being used. The ABF towers are not
in service,
Influent pump station
Y All pumps present, operational
Y Bar screen, maintained
_Y Bars evenly spaced
Back-up power
Bypass structure present
Free of excessive debris
Bars excessively corroded
Comment: The bar screen has been relocated to the EQ basin and consists now of a basket-
like trash rack,
Flow Measurement —Influent NA
Is flowmeter calibrated annually?
Is flowmeter operating properly?
Does flowmeter operate continuously?
Does flowmeter record flow?
Does flowmeter appear to monitor accurately?
Flow Measurement — Water -Use Records
Y Is water use metered?
Are the daily average values properly calculated?
Disinfection
Y _ Is the system working? Y Is the system properly maintained?
Y Tablets Gas Liquid _ Y_ UV
Y If tablets, proper size? Y Present in Cylinder(s)?
If gas/liquid, does cylinder tank storage seem safe?
Y Is contact chamber free of sludge, solids and growth?
Flow Measurement — Effluent
_Y Is the flowmeter calibrated annually?
Y Is the flowmeter operating properly?
Y_ Does the flowmeter monitor continuously?
Y Does the flowmeter appear to monitor accurately?

Surface Irrigation Page 3
Permit #WQ0023511
Effluent. Storage
X LAGOON SEPTIC TANK(s) ABOVE GROUND TANK OTHER
Number of months storage 1 Spill control plan on site
Above ground tank Aerated Mixed
In ground tank Aerated Mixed
Storage Lagoons
Check any/all that apply
Y Influent structure (free of obstructions)
N Banks/berms (are there signs of seepage, overtopping, down cutting or erosion)
N Vegetation (is there excessive vegetation on the lagoon bank
• Liner (if visible, is it intact)
NA_ Baffles/curtains (in need of repair)
Y Freeboard (>2 feet from overtopping)
Y Staff gauge (clearly marked)
N Evidence of overflow (vegetation discolored or laying down/broken)
N Unusual color (very black, textile colors)
N Foam (are antifoam agents used)
Y Floating mats (sludge, plants, inorganics)
NE Excessive solids buildup (from bottom)
�NA Aerators/mixers operational (if present)
Y Effluent structure (free of obstructions, easily accessible)
Comment: The depth of sludge at the bottom of the lagoon has not yet been evaluated,
Residuals
storage/treatment
Disposal. (final end use)
Y Is the application equipment present and operational?
_N� Is application equipment in need repair?
NA_ Spray heads calibrated this past year?
Y_ Are cover crops the type specified in permit?
N_ Is cover crop in need of improvement?
_N Signs of runoff?
N Signs of ponding?
Comments: Fallen trees and underbrush need attention.

Surface Irrigation Page 4
Permit #WQ0023511
Y Are buffers adequate?
N Is the acreage specified in the permit being utilized?
N Are there any limiting slopes in disposal fields?
NA Are restrictions for use of these areas specified?
Y Is permit being followed?
N Is there evidence of runoff or drift?
Y Is site access restricted in accordance with permit?
Comments: Only 3.58 acres (zones 1 and 2) are being utilized. Zones 3 and 4 were
reserved for when the middle school came on line,
Recordkeepinq
Y Is permit available upon request?
Y Are flow rates less than permitted flow?
Y Are monitoring reports present: NDMR NDAR
Y Are operational logs present? Complete?
Y Are lab sheets available for review?
Y Do lab sheets support data represented on NDMR or NDAR?
Y Are all samples analyzed for the required parameters?
Y Is field parameter certification required?
N Are there any 2L GW quality violations?
Y Are annual soil reports available?
Y Is the operation and maintenance manual present? Complete?
N Has DWQ received any complaints regarding the facility in the last 12 months?
Comment:
Groundwater Monitoring
Y Does the permit require monitoring wells? If so,
Y_ are the monitoring wells properly installed according to the permit?
N are the wells properly identified?
N are the wells damaged?
Comment: On February 12, this inspector collected duplicate groundwater samples
during the operator's sampling of the monitoring wells. it was noted then that
construction details were not visible on the monitoring well tags. The operator does
not have a water level meter. A meter is necessary to determine how much water to
bail from the well prior to sampling.

gronontte ufvts110n
S0i Test Report
"S 1'011 O R trCl '1?e1RS
agronoma/
Iredell Statesville
A.11n,. Dent (iryder
1147 Salisbury Rd
States%Jlk, NC 28625
"0(11'L\Nl) I11?lGllTS
lredellCatmy
Agronomist Comments
d Information _._.
e Crop
t Results
Snit Class 11111%
MIN 042
Applied Lime Recommendations
No }'r Tip°1 , C�_._ _...�.�.�._K
rop orrear
1st Crop,
0
GEC RS% Ac pH 1'-I K-1 Ca% Mg% Mn-1 Mn-
6.0 62.0 2.3 5..1 1) 54
Applied Lime Recommendations
No .a_Yr I7,4 Crop or Fear
1>t Crop: I lartlwood,l
CF,C R S% a4 c
70,0 1,1
17,11 1 196
rue
Ca% Mg°
18.0
P20s
70-90
70-4)0
s1
it
ii
AI(I)i n-A1(2) Zn-I in -Al Cu-!
22 22 118
' 1%414-1 Na
oI

I 0 (.,0Z LL ZI Z. I 69 0" 0 1 0 c(i 1,74,,: 0 0Z ftls 90- 1 (7:1'0 NIN
Vq/N o /-8'8" PT) /1/41Z (7)/V-ulf (1)/V-ulf Pultit %ek %v-) p.v 1-d %SW ,xrd %.11/11 gsvid
SijWJ 3S)J
I I
I I
,P,/ ,d,) 8" Ulf 119 8' 111 07Y
0 0 0 OZ-0 06-01. 0' 0
0(r0L WO
107d N
0
am/7
I 08 ( 1/01 LZLF 178Z 1 1
//,‘, V-I/AP.S'Y is i-n111-uZ (01-v-u -u I-uW %814I %ud
I I
461AlchN
)11(d :(00 p117
TpOOMILIril (10,1:)
JIMA JO (NO (//1 d,(
suoimpuatutuoaaN j_atun panddV
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0,17, 0 I 'c 0' I 0) )0t 70 NI
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0 0 0 0 07 0
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uomrpumatuo3aR auun pa!Iddid uopuuojui
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Agronomic Division Phone: [phone]S Weh Site: wvAvaicagr.com/agrononti/
„ .
Grower tredell Statesville Schools
Attn: Dent Gryder
11 Test Report Statesville, NC 28625
1147 Salisbury Rd.
10,/26/200o N C 1WslOrN FOR OVFN YEAk;,'S Agrotionlist Coalmen is
rarm WI(ES
tredell County
kid Information
)lied Lintel Recommendatio.ns
„„. ample Na Last (..'Iwp Jki Fr 7'/4 0*(0 or Year limeP2075
I St („:rop: Ilardwood,E 0,0 70-00
flardwouil,M 0 80-120 70_60
es( Results
11 Class 101% VI'
MIN 0.22 Nft
!yid Information
..„
/note No„ Las," Cr('
21'1,1)
.2st Results
Ca%
(.) 3 70 0 1,9 5.3 0 58 51 0 1.5 0 09 208
AppIlied Lime Recommendations
1(20
10-30
Report No: 09360
Copies /O:
- S
S Co lit 11 /tin See Nide
0 00 11
0 0 0 1
CEC B.S% /le p1!K-1 .Mg% Mn-1 Mn-A1(1)Mn-41121 In-! Zn-41 Cu-1 S-1 „SS-1 NO3-N 1,114-iV
1976
Yr TA' Crop or Year Lime P205 100 S Zn ,Vole
"17
Isl Crop Hardwood,k 01 0 0 70-90 20 0 0 0 0 0 I 1
211o1 Crolv Hardwood,N10 0-I20 70-90 0 0 0 0 0
Ciass /Of% 1Y/17. (IC .11,S% p H P-.1 K-1 Ca% Mg% Mn-! i'lltt-41(1)Mn-i, (2) Zn-1 Zn-Al Cu-1 8.1 SS -I iV03-,V ,V114. NfiN 0 32 1.07 6,3 03,0 21,3 5 1 0 50 43.0 16.0 1014 122 122 108 168

CDA&CS Agronoms 1040 Mail er ce Center, Ra eigh NC 27699-104
eagr.coni/agronorni
Understanding the Soil Test Report
www.ncagrcomfagronomi/ustr htm
FORESTRY, TREES / SEED
(Crop Codes 133, 134, 137, 142-146)
Steve Troxler, Commissioner of Agriculture
The current soil pfl and the am.ount of lime required for optimum tree and seed production are
crucn:il parts of your soil test 'report. The target pH for crops in this category is 5.5, except for
hardwood seed, 'which have a target pH of 6.0. The lime recommendation depends on soil acidity,
soil class and target pH.
Rates for lime and fertilizer are given in tons per acre and pounds per acre, respectively, Lime
and phosphorus are most beneficial when incorporated into the soil prior to planting. Surface
application is appropriate on established sites when recommended. Under extremely acid.
conditims, applying, lime is just as important as applying appropriate amounts of fertilizer,
Local agricultural advisors can help you select a fertilizer grade that fits report recommendations,
'Note II:Nu rsy:Tv Cror s—Co nc r and Field, which accompanies this report, contains additional
information regarding lime a.nd fertilizer.
Recommendations for phosphorus and potassium decrease as P-I and/or K-.1 values increase.
Use the following guidelines to evaluate the relationship between soil test index and expected
crop response to applied nutrients.
Soil Test Index Crop Response to Nutrient Application
-.. ix Rofi,
0-10 Very Low
11-25 Low
16--50 Medium
51-100 High
100+ Very High
r
"11
s thorus Potassium
Very High Very High
Fiigh High
.Medium *
None 1...„,ow-None
Norio None
Ala ga ese
Very High
High
None
None
None
Zinnppe
Very High Very High
High High
None None
None None
None None
ponse decreases as soil, test index increases.
Soil Test Report Abbreviations
MIN
M-0
ORG
W/V
CEC
BS%
Ac
pH
P-1
K-I
Ca%
Mg%
Mn4
Mn-AI
n4
Zn-AI
Cu4
4
N0,-N
NH4N
Na
ppM
KO
mineral soil class
mineral -organic soil class
organic soil class
percent humic matter
weight per volume of soil
cation exchange capacity
percent of CEC occupied by bases
acidity (decreases as pH increases)
current soil pH
phosphorus index
potassium index
percent of CEC occupied by.
calcium
percent of CEC occupied by
magnesium
manganese index
manganese availability index
zinc index
zinc availability index
copper index
sulfur index
soluble salt index.
nitrate nitrogen (ppm)
ammonium nitrogen (ppm)
sodium
phosphate
potash
boron
Ibt1000
July 200
200 copies of
his public document were printed at a c
0
o
12
p
et Copy

)A&CS Agronomlc Div ion
40 Mail Service Center, Raleigh NC 27699-1 40
3-2655
Understanding the Soil Test Report
w.ncagrcom/agronomi
www.ncagrcomiagronomi/uyrst.htm Steve Troxier, Commissioner of Agriculture
This cover sheet briefly explains the measurements, abbreviations and units found on
N(1)A&CS soil test reports. For more details, visit www.neagrcomiagronorni/uyrst.htm, Along
with the report and this cover sheet, you probably also received one or more trifold Notes thai.
address nutrient issues relevant to the erop(s) specified on your information sheens).
The 'Fest Results" section of the report lists values for up to 21 factors. The first seven Fsoil
class, .1-1.M?!.i, W/V, C EC, BS'Ir„A.c and pill describe the soil and its degree of acidity. The other
14 I1'-1., K-1, CaYii, Mg %, ,Mn.-1, .Mn-Al ( Mn.-A.1 (2), Zn-1, Zn-Al, Cu-1, Si, SS -I, NO,-N,
Na] indicate levels of plant nutrients or other fertility measu„retnents.
If testing indicates that soil pH is too low for the crop(s) you indicated, there will be a lime
-e 'nendation on your report. The recommendation is given in units °faller M (lb/1000 fe)
or F (ton/acre). For best: results, mix the lime into the top 6 to 8 inches of soil several months
before planti n.g. For no -till or established plantings where this is not possible, apply no more
than 50M. (or 1 to I.5T) at one time, even if your report recommends more. You can apply the
rest in similar increments every six monthuntil the full rate is applied.
Fertilizer recontmendations for small areas, such as home lawns/gardens', appear in
parentheses after the lime recommendation and are listed in units of lb/ 1000 ft2. If you cannot
find the exact fertilizer recommended., visit www.ncagr.corniagronomitobpart4.htmffs to lind
information that may help oii choose an ,alternate grade. Refer also to /1 Houlecurneiry Guide
to Ferri/Le); available at www.ncagr.comilagronornitpdffilesisfn8.pdf.
Fertilizer recommendations fbrfield crops or other large areas are listed separately' for
each n iitrient to be added (in units of I blacre unless otherwise specified). NCD,A&CS soil. reports
Novick treconunendat ion ibr N (and sometimes for II) that is based on researehltield studies
G' the crop being grown, not on soil test results, K-1 and P-1 values are based on test„rou Its and
should he SO, If thexi rite not, follow the fertilizer recommendations given NO(N is analyzed
request only. SS -.I levels appear only on reports for green„house soil or problem samples,
Farmers and other commercial producers sh.ould pay speciat attention to mieronutrient
.`,C, pHS, Sp/d. C or Z notations appear on the soil report, refer to SNote:' ..S'eeondarrNiarielitS
and illicrotiirtrieniS (CD:C.10SM Wi.th your report) or visit www.ncagrcomiagronornilpdffilesist$note.
pdf. I n_gencral, homeowners do not need to be concerned about micronutrients„
Report Abbreviations
Ac ex.changea,ble acidity
13 boron
BS% % ('EC occupied by basic cations
Ca° io CEC occupied by calcium
CEC cation exchange capacity
Cu-I copper index
HM% percent humie matter
K-1 potassium index.
potash
M pounds per 1.000 square feet
Mg % % CEC occupied by magnesium
MIN :mineral soil class
.Mn-Al manganese availability index
Mn-1 manganese index
M-0 mineral -organic soil class
N nitrogen.
Na sodium
NO,-N nitrate nitrogen
ORG organic soil class
p1/1 current soil pH
P-1 phosphorus index.
„0, phosphate
ppm parts per million
S4 sulfur index
SS-1 soluble salt index
tons per acre
'W/V weight per volume (gleiM)
lti-A/1 zinc availability index
Zn-1 zinc index
2007 50,000 copies of this public document were printed at a cost of $1018,38 or $0,02 per copy,

NCDENR
North Carolina Department of Environment and Natural Resources
Division of Water Quality
Beverly Eaves Perdue Coieen H. Sullins
Governor Director
Dr, Kenney Miller
Iredell-Statesville Schools
1147 Salisbury Road
Statesville, NC 28625
Nlarch 31. 2009
Subject: Woodland Heights Elementary School
Technical Assistance Evaluation
Permit No. WQ0023511
Iredell County
Dee Freeman
Secretary
Dear Dr. Miller:
A.t the request of Ms. Peggy Finley, Aquifer Protection Section of the Mooresville Regional Office,
accompanied Ms. Finley on the inspection on March 10, 2009 to evaluate the operations of the treatment.
facility. 1 have 'reviewed the previous technical. assistance report from May 2007 and the information
submitted by Mr. Tim Bannister to Piedmont Design in December 2007. Both of these evaluations concur
that the facility has never been operated with an anoxic zone. This means rentovingthe diffuser aeration
from one of the tanks and placing mixers to keep the biological solids in suspension but not aerated. The
dissolved oxygen level has to be below 0..51-ng/I to accomplish &nitrification. This is total destruction of
the nitrate compounds produced when ammonia nitrogen and organic' nitrogen are decomposed.
On March 27. '2009.. I meet with Mr. Dent Gryder to discuss the operational changes and process
control. strategies to monitor the nitrification — denitrifieation process. Mr. (iryder will have to purchase
mixers and change the piping one more time. Since the facility is constructed with dual trains 'we can use.
one for aeration and one for the anoxic zone. If results are achieved before end of school, this year we can
make this a more permanent fix for next schooi year during the summer months. After reviewing all the
analytical data for the facility past operations have achieved nitrification but not denitrification.
Additional alkalinity may have to be added for the completion of this stage, the results on the previous
attempts indicate that this could become a limiting factor.
This treatment system could make and excellent science project for high school chemistry -biology
classes. This is a real world nitrogen cycle, and may be able provide interest in environmental areas for
the students to continue their careers in this profession. This is the type of treatment that is necessary to
reduce the nutrient loading on our rivers and streams in the future. The lagoon could also be used as a.
created wetland treatment system to further reduce the nitrates as a fertilizer for the water plants.
Mooresville Regional Office
Location: 610 East Center Ave:, Suite 301 Mooresville, NC 26115
Phone: [phone] t Fax: [phone] Customer Service: 1-877-623-5748
Internet virntotriateroualit)i.org,
Al, Equal 0,Oportoo4y Atfrnmulive Astion Empk)yer — 50% Re G1xW Posl Consumer nave!
One.
NorthCarana
1aturally

This 11 require at i tintu cof aplta1 tt'
pl ted by the end of spring break, and We can beg".
This will provide One month of operational data before s
1spectrc report is ertc 1. s l;. It op. car p ua° sty°t' 1t:as ata} r'
)6.
It
3 u ara
•Tchiaia1•t»
.0 „ :Dell cl 1. t .tes illc htatal
ota alc1 l lu d t , I: si ntt b\ s. 1 urusk°;
M\uit"Lr 1'rctticrttico-sIltt p Iztl
Ltd
lid be to hate this cilia;
changes starti g :April p0, )09,
the summer.
p
Office
m

Permit, t"a` 0023
t;
County: irecfell
Region: Moores
Compliance Inspecon Repo
Effective: 02.12,t04 Expiration: g
Effective:
Person: Terry K Ho tic ay
Dire offs to Facility.
From Rea Ailey School and vU.6f;a s an F3.ds travel ^est or: Br
ee :h Tree Rd Travel -"ۥmite. The ertrani to th piece is on .he
SystemClassifications:
Primary CRC: Denris,r'4'3'
Secondary ORC(s);
Expiration'
Owner: ire"elt-ttesv=i€fs chic s
Facility: ',petard Heigh ts lementary,=tvli de Schad
288 Forest Lake
Tina: Sups, crtero'e
On -Sit epresentat 5
Re6ater Per
e
e Rd, Turn
Certificati
6nspennon Date: 03r1012009
Primary Inspector Bartars ;lord
Secondary inspectors':
Entry Time: 1G. i0 AM Exit Time: 1 .8tt Pr,t
Reason for inspect€on: Rote n:
Per rriit inspection Type: Surface igal rr
Facility Status: 0 Compliant Not orrrpt€art
Question Areas:
t i ceilareaus Questions Treater ent-
Treatment Clarifiers Treatment ReEurn pumps
(See ttachment ary)
Phone:
4
Phone: i T4-off
inspection Type: Tee Rai Assists
reatnt Filters Trees'
t Activa:rrd Ett
Page 1

Perim t: 4 wit ? t Owner-acilikyt
Insp ction Date: 3;30a. 09 tns ton Type,
ville Schools
pistan .e
Reason for Visit: R e
inspection Summary;
e'

Permit: SN1q0023511 Owner - FaddiNG dedea-Stateswile Schools
Inspection Date; 0111,12009
Type
intatration System
Reuse (Quahty)
Actropted Sludge Opp, LR
Activated Sludge Spray, HR
&ogle Family Spray, 1..R
Activated Sludge Spray, LR
Lagoon Spray, LR
Single Family Drip
RecycletReuse
Inspection Type: 'Tecarscat Assistance
Reason for Visit Routype
Yes No NA NE
Treatment
cy
Are Treatment facilides consistent with those authred in the current perrn0
Do ad treatment undo appear to IPCperadonal9 pf no, note below.)
Comment, Bio-Filters are not in service Second parallel aeration train was out of
service, The plans itidicate that one train has a capacity of approximately 12,000
gallons, with a daily average flow of 5,000 gallons per day this would give a detention
time of 48 hours. Denitrification could be accomplished in this time frame.
fl
Treatment ActivatedSILidge
is the aeration mecharosm operable?
Is the aeration basin thoroughly mRed9
Is the aeratson equipment easily accessed?
ts Dissolved Oxygen adequate?
n
Yes No NA NE
Onrin
Are Setdeometer results acceptable'?
is addvated sudge an acceptable color,
Comment: if a true anoxic zone gem dissolved oxygen is established in an aeration
basin denitrificabon. can be achieve.d
Treatment Clarifiers
Are the weirs etiert
Are the weds free of sohds and alga09
is the scum removat system operatt30da9
Es the scorn remora systettl aceess1le9
is the shydge Laanket at an acceptable level;
Yes No NA NE
$ 0 0
n
• n n
n n n
n n
n n
Yes No NA NE
Page 3

Perry it; 'a,$ 00235 1
Iraspectaon Date.
Owner Facility: Srsd Il- k (€sswila
n Type:
Reason for Visit:
he effluent from the clarifier free of e cress we solids?'
Comment: Too much air to have any, den
Treatment Return pumps
they in place?
Are theta pratfocal?
Comment:
Treatment Filters
Is the finer media press as?
hR., airs=
dt
the ccrraVt size and rtrpe
r operatics"`.
Is the ei awning acceptadie
Is t e olear,.v alh fire
ofe:
lids?
cation,
rnud yyel fren of ex e s:s€ae'°lids and filer ediap
baErc°dasl
g
cguenk y, appear a
uffl
n n
Yes No NA NE
Comment. Filters are not beige used and' therefore should be removed trcm the
permit. if the anoxic zone can be configured soon with the addition of a mixer the plant
can be monitored for compliance before school ends this June and if this does not
acheive satisfactory results then additional changes could be made by fail provided the.
sever line is not available by this time.
Yes Nc NA NE
i" o fol
• Cl
O 00s
I�0ri
rj f�l
D D D
o o
4

GROUNDWATER FIELD/LAB FORM
Location code :3
County
Quad No Serial No.
Lat. Long,
Report To: ARO, FRFWO, WaRO, WiRO,
WSRO, Kinston FO, Fed. Trust, Central Off., Other:
Shipped by:land Del., Other:
Collector(s):
HELD ANALYSES
pH 4o0
Temp.io
Appearance
Field Analysis By:
LABORATORY ANALYSE
aoo 0
COD High 340
COD Low 335
Coliforrn; MF Fecal 31616
Coliform: MF Total 31504
TOG 860
Turbidity 76
Residue, Tott Suspend
pH 403
Alkalinity to pH 4,5 410
Alkalinity to pH 8,3 415
Carbonate 445
nate 440
Carbon dioxide 405
Chloride 940
Chromium: Hex 1032
Color: True 80
Cyanide 720
Lab Comments
Spec. Cond.
°C Odor
m /
mgiL
/100m1
/100ml
mg/L
NTU
0
units
m,q/L
mgii
mg/L
mg/L
mg/L
ug/L
cu
mg/L
Date
SAMPLE
ater
Soil
Other
Purpose:
e e:7 Baseline, Com
Owner •e-i
at 25°C Location or Site
Description of samplin
Sampling Method
Remarks
Solids 70300
Fluoride 951
Hardness. Total 900
Hardness (non-carb) 902
Phenols 32730
Specific Cond, 95
Sulfate 945
Sulfide 745
01 nd Gre
TKN as N 625
No2 + NO as N 630
P: Total B5 P
h
mg/L
mg/L
mg/L
ug/l
mgiL
mg/L
mg/L
mg/L
mg/L
mg/L
Nitrate (NO2as N) 620 mg/L
Nitrite (NO2 as N) 615 mg/L
lain ,
Ag-Silver 46566
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SCTION
Lab Number et G-01 ct
Date Received
Rec'd By:
Other:
Data Entry By:
Date Reported:
13 C) Time:
From:B
Ck:
and Del,,
o plianTh..UST, Pesticide Study, Federal Trust, Other:
Sample Inte a
(Pumping lime, eir ternp,, etc)
Al -Aluminum 46557
As -Arsenic 46551
Be -Barium 46558
Ca -Calcium 46552
Cd-Cadmium 46559
Cr-Cflromium 46559
Cu-Copper 46502
Fe -Iron 46563
Hg-Mercury
K-Potassium 46555
Mg -Magnesium 46554
Mn-Manganese 46565
Na-Sodium 46556
Ni-Nickel
Pb-Lead 46564
Se -Selenium
Zn.-Zinc 46567
ug/L
ug/L
ug/L
ugLt.,
mg/t
u
ug/L
ug/L
u
ug/L
mg/L
ugIL
u
Or.15 oc lonne Pe
Organophosphorus Pesticid
Nitrogen Pesticides
1lAcid Herbicides
PCBs
e ivolatile n"
IPH.Diesel Range
Volatile OrganicsAyoA bottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Rang
E ONLY
Temperature on arrival("
GW-54 REV 7/03 For Dissolved Analysls-submit filtered s
ple and write "DIS" in block.

WC(DWQ_ Laboratoly Section Wesufts
County:
River Basin
Report To MROAP
IREDELL
Collector: P FINLEY
Region: MR0
Sample Matrix; GROUNDWATER
Loc, 'Type: MONITORING WELL
Emergency Yes/No
COC Yes/No yEa
Location
3P49W00023511
VisitID
Loc. Descr.: IREDEL
Collect Date: 02/1212009
TAT
VILLE SCHOOLS
Collect Time:.
12:10
Sample ID:
PO Number #
Date Received:
Time Received:
La hworks LoginID
Date Reported.
Report Generated:
Sample Depth
AB40606
9G0192
02/13/2009
08:15
SMATHIS
3/5/09
03105/2005
Sample Qua
ers nd Comments
D NR MRO
nvvc, Pmfeeinn
Routine Qualifiers,
For a more detailed description of these qualifier codes refer to www.dwqIab.org under Staff Access
A -Value reported is the average of two or more determinations
81-Countable membranes with <20 ctiltbnies; Estimated
2- Counts from ail filters were zero,
3- Countable membranes with more thari 60 or 80 ciolonies: Estimated
B4-Filters have counts of both >60 or 80 and < 20; Estimated
5-Too many colonies were present, too numerous to count (TNIC)
J2- Reported value failed to meet CC criteria for either precision or accuracy: Estimated
J3-The sample matrix interfered with the ability to make any accurate determination; Estimated
6-The lab analysis was from an unpreserved or improperly chemically preserved sample Estimated
N1-The component has been tentatively identified based on mass spectral library search and has an estimated value
LAB
NI3-Estimated concentration is <1 POL and >MDL
NE -No established POL
P-Elevated POL due to matrix interference and/or sample dilution
01-Holding time exceeded prior to receipt at lab;
Q2- Holding time exceeded following receipt by lab
PQL- Practical Q.uarititation Limit -subject to change due to instrument sensitivity
U- Samples analyzed for this compound but not detected
X1- Sample not analyzed for this compound
Laboratory Section» 1623 Mal) Service Center, Ra igh, NC 27699-1623 [phone]
Page 1 of 2

Location. ID:
Loc. Descr,.
Visit ID
3P49 W ©0023511
IREDELL STATESVILLE SCHOOLS
�a6nratay Section des t is
Sample ID
Collect Date
Collect' Time::
AB40606
02112/2009
12;10.
CAS # Analyte Name
PQL
Result Qualifier Units
A,r
y
Appraweet y /Da
mple temperature at receipt by lab
Method Reference
0.9
DSAUNDERS
2/13// 9
SMATHIS
21'13/09
MIC
TOC In liquid
Method Reference
APHA53108.201h
2.0 2 U
ADEXTER CGREEN
2/25/09 3/4/09
WET
Ion Chromatography
Method Reference
EPA 300.0
TITLE_ mg/L
Total DIssalved Solids
Method Reference
APHA254
AWILLIAMS MOVERMAN
2125/09 3/2/09
12 44 mgiL A
2/ 13109
CORE EN
2/26119
Chloride
Method Reference
EPA 300.0
2.,3 mg/L
AWILLIAMS
2/21/09
3/2/09
AN
Fluoride
Method Reference EPA 300.0
Sulfate
Method fireerence
NUT
NH3 as N In liquid
Method Reference
EPA 300.0
Lec10-107-06-1-J
0,4 0.4 U mOPL AWILLIAMS MOVERMAN
2/25109
3/2/C9
2.0 2.0 U mg/L AWILLIAMS
2 25/09
MOVE(
3/2o9
A
0.02 0,02 U
mg/L as N MAJAY/ CGREEN
2/13109 7/26;09
Total K eldaFtI N as N In Itgtltd . 0,2 02 U mgiL as N MOVERMAN CGREEN
Method Reference Lacha11C7-05-2•H 2/17/09 3/3/09
NO2+NO3 as N In liquid 0.02 0,02 U mg/L as N MAJAYI
Method Reference tact0.107-04.1-c 2/13r79
Phosphorus total as P lf3 liquid
Method Reference LaC70-115-01-1EF
[;GREEN
2/2f+109
0.02 0.13 rng/L as P GE/ELK CGRF',0N
200/09 2t20ti11L
Laboratory Section?> 1623 Mail Service Center, Raleigh, NC 27699-16.23 [phone]
Page 2 of 2

GROUNDWATER FIELD/LAB FORM
Location code
County Quad No No Serial No.
Lat. Long.
Report To: ARO, FRO IRO, WaRO, WiRO,
WSRO, Kinston FO, Fed. Trust, Central Off, Other:
Hand Del„ Other:
Shipped by: Bus
Collector(s):
FIELD ANALYSES
pH 400
Temp.io 15.!
Spec. Cond.
°C Odor_______
Appearance
Field Analysis By: f F-/
LABORATORY ANALYSES
BOD 310
COD High 340
mg/L
mg/L
COD Low 335
Colitorm, MF Fecal 3
Conform: MF Total 31504
)(TOC 680
Turbidity 76
mg/L
/100m
1100m1
mg/L
NTU
Residue, Total , uspended 530 mg/L
pH 403
Alkalinity to pH 4,5 410
AlkalinityLo pH 8,3 415
Carbonate 445
units
mg/L
Bicarbonate 440
mg/L
mg/L
mg/L
Carbon dioxide 405 mg/L
Chloride 940
mg/L
Chromium' Hex 1032
Color True 60
-----
Cyanide 720
Lab Comments
/L
CU
SAMPLE TYPE
Water
Ej Soil
Other
Purpose:
Date 74/ •-.) c Time //ors" Baseline, Co
Owner
25°C Location or Site
ollds 7
e."
Description of sampling poin
Sampling Method
Remarks
PI
North arolin
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
la,
urno,•neI
Lab Number
Date Received
Rec'd By:
Other:
Data Entry By,
Ck:
Date Reported:
ST, Pesticide Study, Federal Trust, Other:
le one)
m
Fluon e
Hardnss Total 900
g/
mg/L
Hardness non-carb) 902 mg
P enols 32730
Soaclfic Cond
45
uMboslc
m
Sulfide 74
mg/
d
ase
mg/L
NH3. as N
TKN as N 62
mg
NO2+ NO, as N
P: Tota
Ni
ate
NO.1 as N) 620
mglL
mg/L
Write NO2 as N) 615
L
Ag-Sdver 4
Al-AlumMum 465 7
As -Arsenic 48551
Ba-Barium 46558
CaCaICILJfl46552
Cd-Cadmium 46559
Cr.-Chromium 4.8559
u-Copper 4
Fe -Iron 4
Hg- ercury 71900
K-Potassium 46555
nesium 46554
anese 46565
NaSodium 4
mole lnterva
(Pumping time, air temp , etc )
ug
ug/L
ug/L
ug/L
mg/L_
_ ug/L
ug/L
Ni-NIckel
Pb-Lead 46564
e-seenium
ug/L
ug/L
ug/L
mg/L
uglL
u /
Zn-Zinc 46567
GW-54 REV 7/03 For Dissolved Ana ysssubm filtered sample and write 'DIS n block,
u
ug
ug/L
Organochlorine Pesticdes
Organophosphorus Pesticides
Nitrogen Pesticides
Add Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Ranee
Volatile Organics (VOA bothei_
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival (QC): 0 ,C1\

WC (DWQ La6oratoly Section Results
County:
River Basin
Report To
Collector
Region:
Sample Matrix:
Loc., Type:
IREDELI
MRQAP
P FINLEY
M RO
GRO D T
MONTORINg WELL
Emergency Yes/No
COC Yes/No
Location ID: 3P49WQ0023511
VisitlD
Lac, IREDELL STATESV LLE SCHOOLS
Collect Date, 0211212009
Collect Time::
1115
Sample ID:
PO Number #
Date Received:
Time Received
Labworks Logine
Date Reported:
Report Generated:
Sample Depth
A B40607
9G0193
02/13/2009
08:15
SMATHIS
3/5/09
0310512009
0
Sample Qualifiers and Comments
Routine Qualifiers
For a more detailed description of these qualifier codes refer to wwwdwq1alo,org under Staff Access
A -Value reported is the average of two or more determinations
Di -Countable membranes with <20 colonies; Estimated
82..; Counts from, all filters were zero
B3- Countable membranes with more than 60 or 60 colonies; Estimated
(la -Filters have counts of both >60 or 60 and < 20; Estimated;
B5,-Ton many colonies were present; too numerous to count (TNTC)
J2- Reported: value failed to meat QC criteria for either precision or accuracy; Estimated
.13-The sample matrix interfered with The ability to make any accurate determination, Estimated
J6-Thr,) lab analysis was from an unpreseived or improperly chemically preserved sample; Estimated
Ni-The component has been tentatively identified based on mass spectral library search and has an, estimated value
LAB
NI,Estirriated concentration is <POL and NAM_
NE -No established PQL
P-Elevated PQL due to matrix interference endlor sample dilution
Q1-Holding time exceeded prior to receipt at lab
G2- Holding time exceeded following receipt by lab
PQL- Practical Guantitation Limit-sutbect to change due to instrument sensitivity
U- Samples analyzed for this compound but not detected
X1- Sample not analyzed for this compound
Laboratory Section» 1623 Mall Service Center, Raleigh, NC 27699-1623
Page 1 of 2

Location BD:
Loc. Descr.:
Visit ID
3P49W00023511
IREDELL STATESVILLE SCHOOLS
PVC (dWQ, crlorataec ior. hest s
Sample ID A640607
Collect Date:
Collect Time::
02/12/2009
1115
CAS # Analyte Name POL Result Qustlftler Units Analyst/Date Approved By /Date
Sample temperature at receipt by lab
Method Reference
MCC
TOC In IIquld
Method Reference
ARNA53100-20th
0.9 °C DSAUNDERS SMATHIS
2//13r09
2f 13/09
2.0 2 U
ADEXTER
2125/©9
CGREEN
3/4/09
WET
lon Chromatography
Method Reference EPA 300,0
TITLE_
mg/L
AWILLIAMS MOVERMAN
2/25/09 3/2109
Taal Dlasotved Solids I
MethodReference
Chlorlde
Method Reference
F
Method Reference
ARH 253CY •'t9TH
EPA 30©,0
EPA 300.0
AWILLIAMS
2/ 13/139
2/26N9
2.1
AWILLIAMS
2/25/09
MOVERMAN
3r2/09
0.4 U mg/L AWILLIAMS MOVERMAN
2/25/09
NUT
Sulfate
Method Reference
r
NH3 es N In Ilquld
Melted Reference
Total KJeldehl N es N In
Method Reference
EPA 3C0 0
L9c 1 i1.107-09-1-J
L7uhni107.06-2-ffe
2_0
0,02
0,2
2.ti U
mg/L
AWIL.L/AMS
2/2'9,,03
3/2109
MGV:;k'RMAN
3/2/C9
0.02 U mg/1 as N MAJAYI CGF/FF'N
2/11//09 2/26/'09
02 U mg/L as N MOVFRMAN CGREEN
2/17.109 3/3/09
NO2+NO3 as N In Ilqu
M9Ir/0d Reference
Lar 10-107-01-1-e
0.02 0,02 mg/L as N
MAJAYI
2111'09
CGREEN
2/251009
Pha+hwran tiilOI as P h'n Hquid 0,02 0.54 mg/L es P GL3ELK Jc IREI N
Method Reference Lac10-11501-1EE
2/19109
2I25/09
n 1623 Niaih Service Center, Raleigh, NC 27699rc1623 919I 733-3906 Page 2 of 2

GROUNDWATER FIELD/LAB FORM
Location code
County
Quad No Serial No.
Lat. Long,
Report To: ARO, F' 0, WaRO, WiRO,
WSRO, Kinston FO, Fed. Trust, Central Off., Other:
Shipped by: Bu nee Hand Del., Other:
Collector(s):
FIELD ANALYSES
pH 408
Temp.ici
Appearance
Field Analysis By:
LABORATORY ANALYSES
BOD 310
COD High 340
COD Low 335
Coiiforrn MF Fecal 31616
Coliform MF Total 31504
TOC 680
Turbidity 76
°C Odor
AMP TYPE
Water
o
o
SoIl
Other
Chain of Custody
Purpose:
Time Baselin
Date
SAMPLE PRIORI
Routine
Emergency
Spec. Cond. g4 at 25°C Location or Site L'‘) eD
Description of sampling point
Sampling Method
Remarks
mg/L
mg/L
rng/L
/100ml
/100m1
mg/L
NTU
Residue, Total Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
..,..... ,,,.,
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440
Carbon dioxide 405
Chloride 940
Chromum Hex 1032
Color' True 80
Lab Com
ems
CU
mg/L
Diss, Sods 70300
Fluoride 951
Hardness: Total 900
Hardness (non-carb) 902
Phenols 32730
Specific Cond, 95
Sulfate 945
Sulfide 745
Olt and Grease
NH, as N 610
KN as N 625
NO2 + N0,1 as N 630
P Total as P665
Nitrate (N0,0 N) 62
Nitrite (NO? as N) 615
rngiL
mg/L
ug/I
uMhos/cm
mg/L
mg/L
mg1L
mg/L
mg/L
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Date Received t2
Rec'd By:
Other:
Data Entry By.
Date Reported:
Ck:
ST, Pesticide Study, Federal Trust, Other:
'e.e)
A -Silver 4
(Pumping lime, air temp., etc,
u
A-Auniinum 46557
As -Arsenic 46551
Ba-Barium 46558
Ca-Catcum 46552
Coi-Cadmium 46559
Cr-Chromium 46559
Cu-Copper 46562
Fe- ron 46563
Hg cury 71900
K-Potassium 46555
Mg -Magnesium 46554
Mn-Manganese 46565
Na-Sodium 46556
p 46564
Se -Selenium
ug/L
ug/L
vg/L
IL
mLL
Zn-Zinc 46567
u
ug/L.
Organochlorine Pesticides
rganophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
PC
5em1v01at95 Organics
TPH-Diesei Range
Voiatde Organics (VOA bot6a2
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
--- Temperature on arrival ("C),
- 4 REV 7/03 For Dissolved Analysts -submit f0tered ample and write "
" in block.

WC (DWQ
a
story Section esur
Countyi
River Basin
Report To MROAP
IREDELL
Collector, P FINLEY
Region: MR0
Sample Matrix; GROUNDWATE
Loc, Type: MONITORINO WELL
Emergency Yes/No
COC Yes/No
VisitID
Loc. Descr.: IREDELL STATESVILLE SCHOOLS
°cation ID' 3P49WQ0023511
Collect Date' 02/13/2009
Sample ID:
PO Number #
Date Received:
Time Received:
Labworks LoginID
Date Reported
Report Generated.
tie it Time:: °MO
mole Depth
AB40606
900194
0211312009
0Eb15
SMATHIS
3/5/09
0.1/05/2009
Sample Qualifiers and Comments
)
MR0
rotectio
Routine Qualifiers
For a more detailed description of these qualifier codes refer to www.dwqlab,org under Staff Access
A-Valtie reported is the average of two or more deterrntnations
BliiCountable membranes with <20 colonies; Estimated
B2- Counts from all 'filters were zero.
3- Countable membranes with more than 30 or BO colonies; Estimated
B4.-Fitters have counts of both >60 or 80 and < 20; Estimated
BS-Too rna.ny colonies were present; too numerous to count (TNTC)
J2- Reported value failed to meet QC criteria for either precision or accuracy t Estimated
,13.The sampte matrix interfered with the ability to make any accurate determination; Estimated
6-The tab analysis was from art unpreserved or mproperty chemically preserved sample, Estimated
NitiThe component has beententatively identified based on mass spectral library search end has an estimated value
LAB
N3-Esttmated concentration is < PQ1, and >MDL
NE -No established PQL
P-Elevated PQL due to matrixinterference and/or sample dilution
01A-folding time exceeded prior to receipt at lab,
Q2- Holding time exceeded fallowing receipt by lab
PQL- Practical. Quantitation Limit -subject to change due to instrument sensitivity
Li- Samples analyzed for this compound but not detected
XI- Sample not analyzedfor this compound
Laboratory SeGIloas>
1623 Mail Service Cont8r, Ratalgh, NC 27699-1623 9 7333908 Page 1 of 2

on ID-
c. Descr.:
Visit I'D
3P49WQ0023511
IREDELL STATESVILLE SCHOOLS
Q
a oorato
Section Wesu
Collect Date:
Collect Time':
AB40608
02/13/2009
00;00
CAS
Analyte Name
PQL
Result Qualifier Units Anely5VCate Approved By /Date
WET
Sampie temperature et receipt by lab
Method Reference
0.9
'C
DSAUNDER..
2119./09
2.1=9
TOC In Ilquid
Method Reference
lon Chromatography
Method Reference
APPA5310E-20th
EPA 300,0
2.0
2 U mg/L
ADEXTER CGREEN
2/25/09 3/41C9
TITLE_
AWILLIAMS MOVERMAN
2./25/99 912.'09
Total Dissolved Solids liquid
Method Reference APPI A2540C- T
2
AvVILLIAMS
213109
COREEN
2/20/09
Chloride
Method Reference
EPA 300 C
2,6
NUT
Fluoride
Method Reference
ulf
Method Reference
Ni13 es N In liquid
Method Reference
Total I N es N in 6qu
Method Reference
0.4
EPA KO 0
AvVILLIAMS mOvEpmAN
2/25109 3/2/0u
0.4 U mg/L AWILLIAMS MOVERMAN
2/25/09 3/2/09
EPA 300 0
Lac10-107,061,/
LachatiC7-06-2.H
2.0
2.0 U
AMLL1AMS
2125/09
MOVERMAN
312/09
C 02
0.02 U
mg/L as N
MAJAYI
2t13o9
CGREEN
2/26,09
0.2 U
NO2+NO3 as N in liqu
Method Reference Lac10-107-0c-te;
0 02
0.03
mg/L as N
MOVERMAN CGREEN
2117+09 3/3/09
MAJAYI
2,f13/09
CGPEEN
2/26/09
Phosphorus tobil as P in liquid
Method Reference Lac1011501-1EF
0 02
7.0
mg.IL as P GE3ELK
2)19/09
CGREEN
2/2///00
La
ct » 1623 Mall Service Center, Raleigh, NC 733 39082 of 2

GROUNDWATER FIELD/LAB FORM
°cation code
County
Quad No Serial No.
Lat. Long.
Report To: ARO, FRO MRO RO, WaRO, WiRO,
WSRO, Kinston FO Trust, Central Off., Other:
Shipped by: BUS Coune and DeL, Other:
Collector(s)
FIELD ANALYSES
pH 4co
Tempi() 2,co °C Odor
Appearance es
Field Analysis By:
LABORATORY ANALYSES
BOD 310
COD High 340
OD
Coitorrn MF Fecal 31616
CaUform NW Total 31504
TOC 680
Turbidity 7
0
mg/L
NTU
Residue, Total Suspended
mg/
pH 403
Alkalinity to pH4 5 410
Alkalinity lo pH 6,3 415
Carbonate 445
units
mg/L
nate 440
m L
rbon dioxide 405
m
hioride 94
hromium, Hex 10
olor True BO
nide 720
Lab Comments
m
ug/L
CU
mg/L
SAMPLEPE
Water
Soil
Other
hain of Custody
Purpose:
Date 4/.2401 Time )c)I-ac> Baseline, Co
Owner
Spec. Cond.94
.AMPLE PRIOR
Routine
0 Emergency
at 25°C Location or Site
Description of sampling point
Sampling Method r
(Purrn)bttC
Remarks
(Pumping time, arr temp., etc„)
Dise, Solids 70300
Fluoride 951
Hardness: Total 900
Hardness (non-carb) 902
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Lab Number
Date Received
Rec'd By:
Other:
Data Entry
Tim
Frorn:Bus our
Ck:
OcT
nd Del.,
Date Reported:
T, Pesti ide Study, Federal Trust, Other:
ne)
1.5
Phenols 32730
Specific Cond, 95
Sulfate 945
Sulfide 745
!Oil and Grease
mg/I_
ug/I
osl
cm
rngiL
mg/L
mgil
NH3 as N 610
TKN as N 625
N NO3 as N 830
Total as P 665
Nitrate (NO3as N) 820
Nitrite (NO3 as N) 615
mg/L
mgrL
mglL
mg/L
Aa Silver 45566
Ai -Aluminum 46557
As -Arsenic 46551
Ba-Barium 46558
Ca -Calcium 46552
u
d-Cadmium 46559
Cr-Chromium 46559
u-C pper 46562
Fe -Iron 46563
ercury 71900
K-Potasslum 46.555
agneslum 46554
n-Manganese 46565
Mum 46556
Ni-Nickel
ugIL
ug/L
mg/I_
ug/L
u
9
u_giL
ua/L
mg&
mg/L
uafL
mg/L
uJL
Pb-Lead 48564
lenium
Zn-Zinc 46567
ug
u
Organochlorine Pesticides
Organophosphorus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
SemivoIatile Organics
TPH-Diesel Range_
iVolatile OrganicsAVGA bottle!
TPH-Gasoline Range
TPH-BTEX Gasoline Range
kALLLE ONLY
Temperature on arrival ('C):
GW-54 REV 7
For Dissolved Anatysissubmit filtered sample and write "DIS" in block,

aborato
ection Kesucts
County:
River Basin
Report To MROAP
IREDELL
Collector: P FINLEY
Region: mRq
Sample Matrix: GROUNDWATER
Loc, Type: MONITORINGWELL
Emergency Yes/No
COC Yes/No
Location ID:
YES
3P49WQ0023511
VisitID
Loc, Descr.: IREDELL STATESVILLE SCHOOLS
Collect Date:
02/12/2009
Collect Time: -
10:40
Sam
Sample ID:
PO Number 8
Date Received:
Time Received:
Labworks LoginID
Date Reported!
Report Generated:
e Depth
AB40609
9G0195
02113/2009
08:15
SMATHIS
3(5/09
03/05/2 09
Sample Qualifiers and Comments
Routine Qualifiers
For a more detailed description of these qualifier codes refer to www,dwelab.org under Staff Access
A -Value reported is the average of two or more determinations
1-Countable membranes with <20 colonies; Estimated
Counts from all filters were zero.
63- Countable membranes with more than 60 or 80 colorties Estimated
4-Fitters have counts of both >60 or 80 and <20; .Estimated
5-Too many colonies were present; too numerous to count (TNTC)
J2. Reported value:failed to meet CC .enteria for either precision or accuracy: Estimated
J3-The sample matrix interfered with the ability to make any accurate deterrranation Estimated
J8-The lab analysis was from an unpreserved or mproperly chemically preserved sample: Estimated
Ni-The component has been :tentatively identified based on mass spectral library search and has an estimated value
N3-Estimated aricentration is < PQL and >MDL
NE -No established PQL
P-Elevated PQL due to matrix lnterference and/or sample dilution
Di -Holding time exceeded prior to receipt at lab,
Q2- Holding time exceeded following receipt by lab
PQL- Practical Quantitation Lind -subject to change due to instrument sensitivity
U- Samples analyzed: for this compound but not detected
X1.. Sample not analyzed for this compound
LAB
Laboratoev S
>a 1
e Center, Raleigh, NC 27699-1623 [phone]
Page 1 of 2

Location ID:
c. Descr.;
Visit ID
3P49W00023511
IREDELL STATESVILLE SCHOOLS
Section
CAS #
IC
Se le ID AB40609
Collect Date.
Collect Time.
02712/2009
10:40
Analyte Name PQL Result Quaiflor Unit AnaiystiDate Approved By /Date
tpe mperature at receipt by lab
Metnnd Reference
0.9, IDSAIJNDERS SMATHIS
2,1303
3#30
TQC In liquid
Method Reference
APHA5310B-221h
2.0
2 U
WET
Ion Chromatography
Method Reference
EPA 300.0
TITLE_
m0/L
ADEXTER CGREEN
2/25/09 3/4/09
AWILLIAMS MOVERMAN
2/254'9 3/2/09
Total Dissolved Solids In Ilquld 12
Method Reference APHA2540C,1EITH
AWILLIAMS CGREEN
22)3/09 2/06/09
lodde
Method Reference
Fluoride
Meinotl Reference
EPA 300.0
EPA 300.0
1 0 4.6
AWILLIAMS MOVERMA
2/25109 3r2f05
04
04
AMELIA
2/25/00
MOVERMAN
3/2/0g
UT
Sulfate
memee Reference
EPA 300,0
2.0 2,4 mg/L AWILLIAMS
2i25/09
MOVERMAN
:1,2109
NH3 as N In liquid 0.02 0.02 U ntiVL as N MAJAYI CGREEN
Method Reference L9c10-107,06-1,-.1 2)13/09 2/26/09
Total Kjeldatil N as N in lIquld 0.2 1,3 mg/L as N MOVERMAN CGREEN
Method Reference Lachat107-06-2-H 2/17(00 3/3/09
NO2+NO3 as N In Ilqu 0.02
Method Reference Lac 10-4 07,04,-1-c
0.04 moil as N
Phosphorus_lotal a P In liquid 0.02 5.6
Method Reference Lac10-115-01-10.F
P
MAJAYI CGREEN
2r13/09 2,25/00
GBELK CGREEN
209,00 2/2Gi0.0
SoctI0n1. 1623ervIce Center, Raleigh, NC 27699-1623 [phone] Page 2 of 2

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
NON
TAII
NCDENR
-DISCHARGE COMPLIANCE INSPECTION
GENERAL INP OR AL4770N
City/Town/Owner; Iredell Statesville Schools
Permit WQ 0023511
Issuance Date: 2/17/04
Permittee Contact. Dr. Kenny Miller
ORC Name: Dennis (iryder
Back-up ORC: Steve Pope
Reason for Inspection
X ROUTINE COMPLAINT
County: Iredell
Project: Woodland Heights Elem. School
Expiration Date: I/31/09
Telephone No. 704/873-3755
Telephone No. 704/ . 5 11
Tele-phone No. 704/873-3755
FOLLOW-UP OTHER
Type of inspection
Collection System X Surface Irrigation Sludge Other
Inspection Summary: (additional comments may be included on attached paRes
The facility is generally well maintained. Records are generally in order.
The treatment plant was reconfigured for recirculation of the waste stream last April in an effort
to address the high total nitrogen concentrations in the effluent. However, this has not corrected
the problem. Annual nitrogen concentrations average 55.5 mg/L. This is a violation of the
permit and was pointed out to the operator.
Is afollow-up inspection necessary no
Inspector Name/Title Peggy Finley, Hydro Tech II
Tel. No. 704/235-2183 Fax No, 704/663-6040
Date of Inspection: 3/9/07

Surface Irrign 'on
Permit #WQ 0023511
Type
Activated. Sludge Spray, lowv rate
Activated. Sludge Spray, igh rate
Activated Sludge Drip, lowv rate
Lagoon Spray, low rate
X Lagoon Drip, low rate
Reuse (Golf Courses)
Recycle /Reuse
Single Family Spray, low rate
Single Family- Drip
Treatment
N Are treatment facilities consistent wvitl those outlined in the current permit.
Y Do all treatment units appear to be operational. If no, note below.
Page 2
Comment: both trains being utilized; a nitrifcatianldenitrifictir►n recirculation component has
been added; bin -filter towers are still off-line
nfluent pump station
Y all pumps present. operational
Y Bar screen. maintained
Y Bars evenly spaced
N� Back-up power
Y Are floats/controls operable'?
Y Are alarms operational?
Y
Y
Flow Measurement.- Influent
Y Flow meter present'?
Y Is flow meter operating properly?
Y is flow meter calibrated annually?
Does flow meter monitor continuouslyF?
Does flowrneter appear to monitor accurate!
!Measurement — Water-C.1se Records
water use metered'?
Are daily averages properly calculated?
;Bypass structure present
Free of excessive debris
Bars excessively corroded
General Housekeeping acceptable''
Are audio/visual alarms available?
Is telemetry required?
Record flow?

Surface Irrigation Page 3
Permit #W°Q 0023511
Disinfection
Y Chlorine C.IV
Y is the system working?
Y _._ If tablets, proper size? ,Y present in eyclinder(s)?
if gas, does cylinder storage appear to be safe?
If bulbs, are replacement bulbs on hand?
Y Is contact chamber free of sludge, solids and growth?
Comment; a dechlorination tank is also in -line
Flow Measurement — Effluent
Y_ isflow meter present? Y Is it operating properly?
Y_ Is flow meter calibrated annually?
Y Does flow meter monitor continuoulf'?
Effluent Storage
X LAGOON SEPTIC T ANK(s)_ _A.BOV}" :iROUNt) TANK__
Number of months storage l Spill control plan on site
Storage Lagoon
(check anylall that apply)
Y Influent. structure (free of obstructions)
N_ Banks/berms (are there signs of seepage, overtopp
down cutting or erosic n)
N Vegetation (is there excessive vegetation on the lagoon bank
Y Liner (it visible, is it intact)
NA Baffles/curtains (in need of repair)
Y Freeboard (>2 feet from overtopping)
N* Staff gauge ( clearly marked)
N Evidence of overflow (vegetation discolored or laying down/broken)
N Unusual color (very black, textile colors)
N Foam (are antifoam. agents used)
Y Floating mats (sludge, plants, inorganics)
N Excessive solids buildup (from bottom.)
NA A.eratorsrmixers operational (if present)
1' Effluent structure (Free of obstructions, easily accessible',
Comments: * A staff gauge with clear markings must be installed
Residuals
storage/treatment

Surface irritation Page
Permit #\VQ002 3 511
Disposal (final end use)
_N__ Is application equipment in need ofrepair?
Are buffers adequate?
Are cover crops the type specified in permit'
is cover crop in need of improvement`?
Signs of runoff`?
Signs of ponding?
he acreage specified in the permit being utilized?
Is the application equipment present and operational?
N Are there any limiting slopes in disposal fields?
_Y Are restrictions for use of these areas specified?
N Is permit being followed?
N Is there evidence of runoff or drift?
Y Are monitoring wells called for in permit present?
Y Is site access restricted in accordance with permit?
N.
Reeordkeeping
Y is permit available upon request?
N Are monitoring reports present:: N.DNIR NT)A.I
Arc lab sheets available for review?
Do lab sheets support data represented on NDMIZ. car NDAR?
Y If G\V monitoring, have (iW-59s been submitted?
Are all samples analyzed for all required parameters`:i
Are there any 2L violations`?
Are flow rates less than permitted flow?
Are application rates adhered to?
Y Are annual soil reports available?
Y Are operational logs present?
Y Are operation and maintenance records present?
Y Are operation and maintenance records complete`?
N Has I) 'Q received any complaints regarding the foci➢its' in tl
N
Y
Y
Groundwater M©nit©ring
Y _ Does the permit require monitoring wells? If so,
Are the monitoring wells properly installed according to the permit?
Are the monitoring wells properly located?
Are the \Yells properly identified?
N Are the wells damaged?
NE — not examined
NA -= not applicable
2 months?

Compliance Inspection Report
Permit: WC:100235Q Effective: 02112/04 Expiration: 01/31109 Owner: trade11-Statekvlle Schools
SOC: Effective: Expiration: Facility: Woodland Heights Elementary/Middle School
County; adek
288 Forest Lake Blvd
R
Region: Mooresville
Mooresville NC 28117
Contact Person: Terry K Halliday Phone: [phone]
Directions to Facility:
Primary ORC: Dennis Wayne Gryder
Secondary °Et(e):
OreSite Representative(s):
Related Permits
inspection Date: O5/09/2007"
Primary Inspector: Dort Price
Secondary itispector(e):
Certification: 989073 Phone: [phone]
Entry Time: 10:00 AM Exit Time: 01C0 PM
Reason for Inspection: Other
Permit Inspection Type: Surface irrigation
Facility Status: 0 Compliant Not Compliant
Phone: [phone]
Inspection Ty Technical Assistance
Question Areas:
Miscellaneous Quest ons Treatment
Treatment Clarifiers Treatment Return pumps
(See attach
ent summary)
Treatment Filters Treatment Activated Sludge
Page 1

Permit: 'NO0023511 Owner - Iredell-Statesville Schools
Inspection Date: 05/09/2007
Inspection Type: Technical Assistance Reason for Visit: Other
Inspection Summary:
The Technical Assistance was conducted at the request of facility staff/ORC, Mr, Dennis Gryder. The facility was
experiencing difficulty in removing Total Nitrogen, facility has an annual average limit of 15 mg/L prior to discharge to the
holding lagoon before the drip irrigation system. On -site system includes the following:
- Aerated equalization Basin; - 2 parallel extended aeration (package) VVVVTP's with diffused aeration,
"Geyser" RAS/WAS air lift pumps (1 geyser pump on 1 of the Package plants was disconnected at the time of the
Technical Assistance) - "Hopper" type secondary clarifiers and - Tertiary Bio-filters(not in use during the Technical
Assistance)
In order for the facility to meet the limitation of 15 mg/L Total Nitrogen prior to discharge to the holding lagoon the system
should try one of two options. Number 1 would be to operate the system as it is set up, but in order to meet the Total
Nitrogen limit the facility must have an Aerobic area (the existing Aeration basin) and an Anoxic area (doesn't have) and
settling. The aerobic area would be for nitrification (conversion of ammonia to nitrates) and the Anoxic area would be for
de -nitrification
(conversion of the nitrates to nitrogen gas and oxygen). The current configuration of the system does not allow for an
Anoxic area , all DO's taken of the system were greater than 4 mg/L, and on -site alkalinity measurements indicated the
system was not using any alkalinity, an Anoxic area DO must be maintained between 0.2 and 0.5 mg/L AND NO HIGHER
than 0,5 mg/L,To accomplish will require some piping modifications, getting all RAS/WAS pumps back into service, and
getting an "Anoxic" area developed in the system.
Number 2 option would be to re -configure the flow pattern and put the aerated bio-filters in service.The bio-filter should
consist of a mixed media base. This base should have 3 inches of 0.27 mm garnet, 9 inches of 0.5 mm sand, and 24
inches of 1.50 mm antracite (coal). Mixed media filters have been used as downflow, packed beds for denitrification.
Almost complete denitrification is possible at flows of 1.5 gpm/sq. ft. at temperatures of 10 degrees C,, and at 3 gpm/sq, ft.
at temperatures of 20 degrees C. Settling basins downstream of denitrification units will need to have an overflow rate of
less than 1000 gpd/sq. ft. at peak flow. Any and all return scum and sludge should go back to the denitrification tank.
Information was left with Dennis Gryder regarding nitrification and de -nitrification using either a bio-filter or Aerobic/Anoxic
system. The facility will be re-classified based upon the Total Nitrogen limit, and be raised to a Class 3 WWTP with drip
irrigation system, based on this Dennis and/or someone &se knowledgeable of the system should attend the next
available grade 3 operators school. It is also suggested to have a DO meter, pH meter, and alkalinity/ammonia test strips
available on -site at the facility so the operator can complete process control testing for the system. In order for the system
to consistently meet the total Nitrogen limit a process control program will have to be implemented in addition to using one
of the two options mentioned earlier.
Page: 2

Permit: WQ0023511 Owner - Facitity. Iredell-Statesville Schools
inspection Date: €35/0912007 Inspection Type: Technical Assistance Reason for Visit: Other
Type Yes No NA NE
Reuse (Quality) 0
Lagoon Spray, LR
Infiltration System
Single Family Spray, LR
Activated Sludge Spray, LR
Activated Sludge Spray, HR
Recycle/Reuse
Single Family Drip
Activated Sludge Drip, LR
Treatment Yes No NA NE
Are Treatment facilities consistent with those outlined in the current permit? ■ 0 0 0
Do all treatment units appear to be operational? (if no, note below,) 0 • 0 0
Comment: The ABF (Aerated Bio-filters) were not in service during the Technical
Assistance,
Treatment Activated Sludge Yes ° NA NE.
Is the aeration mechanism operable? • 0
Is the aeration basin thoroughly mixed? ■ 0 0 0
Is the aeration equipment easily accessed? • 0 0 0
is Dissolved Oxygen adequate? ■ 0 0 0
Are Settleometer results acceptable? 0 0 0 •
Is activated sludge an acceptable color? 12000
Comment: The DO (dissolved oxygen) level measured in the Aeration Basin was
between 7 and 8 mg/I. The DO level measured in the Aeration Basin serving as the
"Anoxic Reactor" was greater than 4 mg/I. The DO level in the anoxic reactor should be
no higher than 0.5 mg/I, and will require the operator to have a DO meter on -site at all
times to insure the control tolerance.
Treatment Clarifiers
Are the weirs level?
Are the weirs free of solids and algae?
Is the scum removal system operational?
0
0
0
0
■
Yes No NA NE
■ 0 0 0
■ 0 ❑ 0
0 ■ 0 0
Is the scum removal system accessible? ■ 0 0 0
■ D O
Page:3
Is the sludge blanket at an acceptable level?

Permit: WO0023511 Owner - Facility: Iredell-Stalesville Schools
Inspection Date: 05109/2007
inspection Type: Technic& Assistance Reason for Visa: Other
Is the effluent from the clarifier free of excessive solids?
Comment: At the time of the Technical Assistance one RAS air-lift pump was
disconnected on one of the two WWTP's, to try and create an Anoxic zone for
denitrification ( and Total Nitrogen removal) to occur,The sludge blanket in both
WWTP's secondary clarifier's was over 3 feet deep and had a black septic color.
Treatment Return_pumps
Are they in place?
Are they operational?
Comment: One RAS air lift pump was taken out of one of the two VWVIP's. The other
RAS pumps were operational, but the VVVVTP was not working as it should to remove
"TOTAL NITROGEN",
Treatment Filters
is the filter media present?
ls the filter media the correct size and type?
is the air scour operational?
is the scouring acceptable?
is the clear well free of excessive solids?
Is the mud well free of excessive solids and filter media?
Does backwashing frequency appear adequate?
Comment: Treatment Filters (ABF-Aerated Bio-Filters) were not in-service at the time
of the Technical Assistance, A means to get the filters in service and ability to feed
"Methanol" or another suitable carbon source should be provided to get the filters
working as they should.
E000
Yes No NA NE
0•00
0•00
Yes No NA NE
MOOD
•000
0•100
CI • OD
O E00
O E00
O E00
Page: 4

Michael F. Easley, Governor
1 William G Ross Jr, Secretary
North Carolina Department of Environment and Natural Resources
Alan W. Klimek, P.E. Director
Division of Water Quality
lredell/Statesville Schools
Post Office Box 911
Statesville, North Carolina 28677
Attention: Terry K. Holliday, Superintendent
AQUIFER PROTECTION SECTION
March 7, 2006
RE: Spray Irrigation Inspection Report
Permit No. WQ0023511
Wastewater Surface Irrigation
Woodland Heights Elementary School
iredell County, N.C.
Dear Dr, Holliday:
Enclosed you will find a report on the inspection that was conducted by staff of this office on February 13,
2006. The report should be self-explanatory but a few items are worth noting.
The treatment system is not operating as permitted. The aerated biological filter (ABF) towers, which are
designed to provide tertiary treatment, are not online. Such a change to the treatment system requires a
permit modification. Concentrations of nitrate in the effluent are significantly higher than normal. It is my
understanding that housekeeping activities have contributed to an overload of ammonia. In addition to a
change in housekeeping practices, an engineering re-evaluation needs to be made in order to resolve
these problem matters. Please contact Nathaniel Thornburg at 919/715- 6160 or via email at:
[e-mail] for guidance.
Several documentation deficiencies were found, along with an improperly located monitoring well. These
items were detailed in a Notice of Violation issued March 1, 2006.
Should you have any questions, feel free to call me at 704/235-2183 or contact me via emall at:
[e-mail],
Sincerely,
PegFinIey
Hyd °geological Technician
Enclosure: Inspection Report
Cc: Dr. Kenny Miller, Dir. of Maintainence, IredelliStatesville Schools, 1147 Salisbury Rd,
Statesville 28625
MAF/inspectionsiwoodland hgts schl 2-13-06
One
NorthCarolti
Division of Water Quality Aquifer Protection Section Mooresville Regional Office Phone[phone] Fax: [phone]
610 East Center Avenue, Suite 301, Mooresville, NC 28115 Internet: http://qw,ehnr state,nc.us 'attire!

State of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
Michael F. Easley, Governor
William G. Ross, Jr., Secretary
Alan W. Klimek, P.E., Director
NON -DISCHARGE COMPLIANCE INSPECTION
GENERAL INFORMATION
City/Town/Owner: lredell/Statesville Schools
Permit # WO 0023511
Issuance Date: 2/12/04
Permittee Contact: Terry Holliday, Superintendent
ORC Name: Tim Bannister
24hr Contact Name: Dennis Gryder
County: Iredell
Expiration Date 1/31/09
Telephone No. 704/924-2028
Telephone No, 704/821-8841
Tel, No. 704/902-0427
Reason for Inspection
X ROUTINE COMPLAINT FOLLOW-UP
OTHER
Type of inspection
Collection System X Drip lrrigation Sludge Other
Inspection Summary: (additional comments may be included on attached pages).
The school campus has been designed to initially house elementary age students, with the
provision for an adjacent middle school in the future. While both treatment trains are in
operation, only two of the four drip fields are currently in use. No problems were noted
regarding application. The treatment plant, which began operating at the beginning of the
current school year, is having problems with denitrification. This appears to be due, in part,
to the over -use of ammonia based cleaning products. Changes have been made to the
treatment system without approval of the Division. One of the monitoring wells has been
improperly located. A review of the file revealed several deficiencies with regard to
documentation as required by the permit.
Is a follow-up inspection necessary _X yes no
Inspector Names/Title Peggy Finley, Ellen Huffman
Tel. No. 704/663-1699 Fax No. 704/663-6040
Date of Inspection: 2/13/06

Spray Irrigation Page 2
Permit #WQ0023511
lips_
Activated Sludge Spray, Iow rate
Activated Sludge Spray, high rate
Activated Sludge Drip, Iow rate
Lagoon Drip, Iow rate
Reuse (Golf Courses)
Recycle /Reuse
Single Family Spray, Iow rate
Single Family Drip
Infiltration System
Other
Treatment
Y Are treatment facilities consistent with those outlined in the current permit.
N Do all treatment units appear to be operational. If no, note below.
Comment: ABF towers have been taken off-line. Effluent nitrate concentrations
consistently measure > 25 mg/L.
Lagoons
Wet Weather Lagoon (check any/all that apply)
Y Influent structure (free of obstructions)
N Banks/berms (are there signs of seepage, overtopping, down cutting or erosion)
N Vegetation (is there excessive vegetation on the lagoon bank
Y Liner (if visible, is it intact)
NA_ Baffles/curtains (in need of repair)
_
Y Freeboard (>2 feet from overtopping)
Y Staff gauge ( clearly marked)
N Evidence of overflow (vegetation discolored or laying down/broken)
N Unusual color (very black, textile colors)
N Foam (are antifoam agents used)
N Floating mats (sludge, plants, inorganics)
N Excessive solids buildup (from bottom)
NA Aerators/mixers operational (if present)
Y Effluent structure (free of obstructions, easily accessible)
Comments: Lagoon contents have been kept at an extremely low level. Increasing volume
(applying less effluent) would enhance overall treatment.

Spray Irri atian
Permit #WQ 002351
Influent pump station
Y All pumps present, operational
Y Bar screen, maintained
Y Bars evenly spaced
N Back-up power
Bypass structure present
Y Free of excessive debris
E Bars excessively corroded
Aeration Basins
Y aeration pattern even across surface of unit
Y easily accessed
Clarifiers
Y weirs level scum rack operational easily accessible
Filters
Y rnedia present air scour operational clear well free of solids
Page 3
Residuals N/A
storage/treatment (if storage is greater than 24 months, Surface Disposal permit?)
Disinfection
Y Is the system working?
Y Is it adequately maintained?
Comment: There is also a 500-gal. dechlorinator
Effluent Storage
X LAGOON SEPTIC TANK(s) ABOVE GROUND TANK OTHER.
Number of months storage 5 day Spill control plan on site
Lagoon: Is lagoon lined? _Y
Disposal (final end usel
N Is application equipment in need of repair?
Y Are buffers adequate?
Y Are cover crops the type specified in permit?
N Is cover crop in need of improvement?
N Signs of runoff?
N Signs of ponding?
N Is the acreage specified in the permit being utilized?
Y Is the application equipment present and operational?
N Are there any limiting slopes in disposal fields?
Y Are restrictions for use of these areas specifed?
N Is permit being followed?
N Is there evidence of runoff or drift?

Spra Irrigation
` Are monitoring wells called for in permit present?
Y Is site access restricted in accordance with rrnit9
Comments; Only '/2 of the drip fields are currently receiving application. The remaining
acreage will be use when the future middle school is built. Three wells have been installed
but none has been located as an upgradient well. Well tags were attached to all wells.
Recorcikeeping
NIs permit available upon request?
* Are monitoring reports resent;
Y Are operational logs present?
Are lab sheets available for review?
Do lab sheets support data represented on NDWIR or
NA Are annual soil reports available"
Y Are operation and maintenance records present? Complete?
N Has received any complaints regarding the facility in the last 12 months?
Comment: * These records are kept in the Maintamence Dept, office and were not
available for review on the day of the inspection.
Review of the permit file maintained in the MRO revealed that incorrect forms were being
submitted for NDMRs,

Michael F. Easley, Governor
Williarn G. Hass Jr., Secretary
North Carolina Department of Environment and Natural Resources
Gtrileen H. Sullins, Director
Division of Water Quality
SURFACE WATER PROTECTION
June 5, 2007
Mr, Terry K. Holiday, Superintendent
Iredell — Statesville Schools
P.O. Box 911
Statesville, N.C. 28677
Ashevirle Regional Otrce
AND NAT NA
SUBJECT: May 9,, 2007
Technical Assistance Inspection
Woodland Heights Elementary School
`"uTP
Permit No: WQ0023511
Iredell County
Dear Mr. Holiday:
Enclosed please find a copy of the Technical Assistance Inspection form from the
inspection conducted on May 9, 2007, The Technical Assistance Inspection was conducted
by Don Price of the Asheville Regional Office. The facility was not found to be in
Compliance with permit WQ0023511 at the time of the TechnicalAssistance due to
operational issues noted in the inspection report.
Please refer to the enclosed inspection report for these and additional observations
and comments, if you or your staff have any questions, please call me at [phone].
Sincerely,
—2
Enclosure
(. x
P Consultant
cc: Dennis Gryder, Iredell — Statesville Schools, ORC
Central Files
Mooresvilleville Regional Office Files
2090 U.S. Highway 70, Swanranoa, NC 287"78 Te&ephoner (828) 296.45500 t- (828)2
men Service i 877 623-b248

Permit:
S :
Countyredell
Region: MooresviIlz
Compliance Inspection Report
Effective: 02/1 104 Expiration. 01£ 1 09 wrier; !tedell-State ville Soho
Effective: Expiration: Facility. Woodiarrd Herghts Bet
288 Forest Labe Blvd
Contact Person: TerHolliday
Directions) to Facility.
Primary O : Dennis Wayne Gryder
Secondary ORC(s):
Ortite Represents f.
ReidRelated Permits:
Inspection Date: 01 992 7
tive(s
Primary inspector. Don Price
Secondary inspectors;
or restate NC 281 `17
Phone. 704 9 t. tJ
ertificabor: 99 073 Phone® 711r1 81:1-37 55
Entry Tirtr : 10:00 AM Exit Time: 1 tltl PM
Reason for Inspection: Other
Permit Inspection Type: Surface igat arrir
Not Corr pliant
023511
Facility Status: 0 Compliant
Question Areas:
Miscellaneous Clopstiors Treatment
Treatment Clarifiers Treatment Return pumps
attachnt sum
ary
s
Tres,
ectiran Type: Technical Asi
ent Filters
88v i-45i
Tr
.tivrr!e�`w
Page: 1

r"nx|t:vv0002,1e,1
*wpe*mv,omto: 0s4,19/2007
Owner 'Faoxxv�/euell-ntamsville Sclioms
Inspection TypoTeclinical Ass�stancp
Reason for Visit: Other
Inspection Summary:
The Technical Assistance was conducted at the request nffacility staff/ORC. K8r, Dennis Grydec The facility was
experiencing difficulty in removing Total Nitrogen, facility has an annual average limit of 15 mg1I_ prior to discharge to the
holding lagoon before the drip irrigation system, On-niitmsystem includes the following:
' Aerated equa|izaUun Basin; '2 parallel extended aeration (pm*Kage)VVVVTPswith diffused aeration,
"Geyser" RASNVAS air lift pumps (1 geyser pump or) 1 of the Package plants was disconnected at the time of the
Technical Assistance) - "Hopper" type secondary clarifiers, , and - Tertary Bio-filters(not in use during the Technical
|norder for the facility tomeet the limitation oy15mg/LTotal Nitrogen prior hzd|ochor ehoUheho|cUnglagoon(honystem
should try one of two options, Nurnber 1 would be to operate the systern as it is set up, but in order to meet the Total
Nitrogen limit the facility must have an Aerobic area (the existing Aeration basin) and an Anoxic area (doesn't have) and
settling. The aerobic area would be for nitrification (conversion of ammonia to nitrates) and the Anoxic area would be for
de -nitrification
(conversion of the nitrates to nitrogen gas and oxygen). The current configuration of the system does not allow for an
Anoxic area . all DO'm taken of the system were greater than 4 m0/L^ and on -site alkalinity measurements indicated the
systern was not using any alkalinity, an Anoxic area DO must be maintained between 0.2 and 0.5 mg/L AND NO HIGHER
than 0.5 mg/LTo moopnnpUyh will require some pming mmdificatimns, getting all RAS8WAS pumps back into sem|oe, and
getting an"Aomdc'area developed iuthe system.
Number 2option to re -configure the flow pattern and put the aerated bio-filters in service.The bio-filter should
consist of a mixed media base, This base should have 3 inches of 0.27 mrn garnet, 9 inches of 0,5 mm sand, and 24
inches of 1.50 mm antracite (coal), Mixed media filters have been used as clownflow, packedbeds for den}thficahon
Almost complete denitrifioahoninpossible atflows of1.5VpnVoq I'L attemperatures of1OdegrensC.anda{3gpm/oq, ft.
at temperatures of 20 degrees C. Settling basins downstream of denitrification units will need to have an overflow rate of
less ihmn1ODQgpd/oq, ft. at peak flow. Any arid all return scum and sludge should go back to the denitrification tank,
Information was left with Dennis Gryder regarding nitrification arid de -nitrification using either a bio-filter or Aerobic/Anoxic
system. The facility will be re-classified based upon the Total Nitrogen |\m|t, and be raised to e Class 3 VVVVTP with drip
irrigation systern, based on this Dennis and/or someone else knowledgeable of the system should attend the next
available grade 3 operators school, It is also suggested to have a DO meter, pH nnetor, and alkalinity/ammonia test strips
available on -site at the facility so the operator, can complete process control testing for the system. In order for the system
to consistently Trieet the total Nitrogen limit a process control program will have to be implemented in addition to using one
*fthe two options mentioned earlier,
Page: 2

PPIPPir
Permit; VVQOO23511 Owner - Facility: Iredell-States fl e S
inspection date. 05/09�12007 Inspection Type: Technic Assistance
Type
Reuse (Quality)
Lagoon Spray, LR
infiltration System
Single Family Spray, LR
Activated Sludge Spay, LR
Activated Sludge Spray, HR
Recycle/Reuse
Single Family Dr
Activated Sludge ©dp, LR
Treatment
Are Treatment 'faci€itie s consistent with those outttned in the current permit?
Do aPl treatment units appear to be operational? (if no; note below
Comment: The ABF (Aerated Bio-filters) were not in service during the Technical
Assistance,
Treatment Activated sludge
Is the aeration mechanism operable?
is the aeration basin thoroughly mixed?
Is the aeration equipment easily accessed?
Is fissoPved Oxygen adequate?
Are Settleometer results acceptable?
Isactivated sludge an acceptable color?
Reason for Visit; Ott)
Comment: The DO (dissolved oxygen) level measured in the Aeration Basiru w as
between 7 and 8 mgll. The ©Q level measured in the Aeration Basin serving asthe
"Anoxic Reactor" was greater than 4 mg/I, The DO level in the anoxic reactor should he
no higher than 0.5 mg/l, and will require the operator to have a DO meter on -site at alt
times to insure the control tolerance.
Treatment Clarifiers
Are the weirs level?
Are the weirs free of solids and algae?
6o flee scum removal system operational?
as the scum removat system access#ble?
Is the sludge blanket at an acceptable level?
Yes No NA NE
C1
n
■
Yes No NA NE
Ell
■ n 0
Ytrs No
A
Yes No NA NE
• f0l01
■ rsinr:I
n ■ n n
•nnl,�?
Q 1 a 0 r;1

Pero tt'.
Feel! y
te:s~ iHe cheois
trp.sp.ct on Type: 1r cPprtrcat Asoistaro
Re
on for Visit: titter
ofexcessrve scuds?
Comment t the time of the Technical Assistance one RAS air-lift pump was
disconnected on one of the two 's, to try and create an Anoxic zone for
c# :nitrification ( and Total Nitrogen removal) to occt.tr,The sludge blanket in both
vTP's secondary clarifier's was over 3 feet deep and had a black septic color.
tiesat fi tttr°n '.. in ps
Are tie? operational'?
(2 )ul xrer t:' One RAS a
RAS pumps were opened
"TOTAL NITROGEN".
Treat trtnt Filters
ter media present-
e filter media the :.r CEC' ':,',t s ^d type?
u t1 p was
but the
Oi
i ttee epf ex{ e
yen
ken ort`
la
of one of the two Mg Ffts. The other
trot working as it should to remove
oUds and filter reds ?
Does back v stwinlg fr ptry appear adequate'
( tarttrrtent:: Treatment Filters -AeratedBid-Filters) were not in-service at the time
f ttie Technical Assistance. A -means to get the filters in service and ability to feed
"Methanol" or another suitable carbon source should be provided to get the filters
working as they shotald,.
Yes No
rA NE
D
i 1`
Yes No NA NE
I fl i
L f'
n
Page; 4