_20171231 (5)

Facility Name:
WELL DATA -TABULATION
POLLUTION SOURCE MONITORING SITE
5 . , ;, .,h 'rm//
Pollution Source (lagoon, landfill, etc.) G,»T
Permit No:
Non -Discharge:
Well Const.:, 2
Sampled. By:
NPDES:
DHS:
County:
Latitude: 3 /x5
Longitude: ? /�
Grout Gravel/Sand
Interval Pack
(ft-ft) Interval
(ft-ft)
Draw a diagram on the reverse side of this form showing map location of the site and the
location (direction and distance) of each well with respect to the pollution source and to
each other. Indicate sampling schedule, parameters and any changes to schedule.
GW-51
Revised 8/20/84

meters
T bs
roc
Mn
�'b

12m 000
Surly
Imes -he
y a unchecked
are shown
LIIPA ea AND weMAGNETIC NORTH
xCON«a<»ww « ea!
0°
dakgmm
CONTOUR INTERVAL 20 FEET
NA «uy Gzcoe « VERf<« UAIUM
«<«
THIS MAP COMP Wahl NR o,# MAP ACCURACY sANDAPD
FOR SALE BYUSGEOLOGICAL SURVEY, RSTok wRGNA 22092
A FOLDER DESCRIBING mmGwacm±s AND SYMBOLS IS AVAILABLE ON REQUEST

FROM: Kim T. Nbss
c/© The City of Kings Nbunta±n
1013 North Punt Ave.
Kings Mountain,North Carolina 28086
Isar Sir
I have enclosed 5 new forms that have been completed for the Pilot Cree W.P:C.F.
Monitoring Wells.
I went ahead an filled out new forms for these wells by coping the last forms
that were submitted July 29,1988.
If you would please, submit me more forms for the future monitoring of these
wells.
I apologize for the trouble that this has caused, if I can be of any futher
help, please contact me at the Pilot Creek W.P.C.F. 704-739-7131.

EMORAND'
TO:
DIVISION OF ENVIRONMENTAL MANAGEMENT
ASHEVILLE REGIONAL OFFICE
GROUNDWATER SECTION
February 18, 1987
Bob Cheek, Permits and Compliance Unit Supervisor
Groundwater Section
FROM: Diane Eskenasy, Hydrogeological Technician
Groundwater Section
SUBJECT: Additions to the Water Quality Monitoring Network
City of Kings Mountain
Non -Discharge Permit No. 14069
Cleveland County
and City of Shelby
NPDES Permit. No. NC0027197
Cleveland County
0
Three new 1 monitor wells, located at the Pilot Greek. Waste-
water Treatment Plant in Kings 'Mountain, Cleveland County, should be added
to the water quality monitoring network. The well numbers are. Q73v1, Q73v2,
Q73v3.
Four new pollution monitor wells, located at the City of Shelby Water
Treatment Plant, Cleveland County, should also be added to the water quality
monitoring network. These well numbers are Q74g5, Q74g6, Q74g7, and Q74g8.
Well records, maps, and tabulation sheets are enclosed.
DE/ar
Enclosure

111111DIVISIC=EIRTEWr
FOR OFR USE ONLY
Quad. No. " Serial No.
OF NATURAL i RCES AND COMMUNITY DEVELOPMENT
tiOhMAENTAL MANA©EMEATf - GROUNDWATER SECTION
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR (/-r9
DRILLER REGISTRATION NUMBER
1. WELL LOCATION: (Show sketch of the tocataon below)
Nearest Town:
(Road, Commu
2. OWNER
ADDRESS
y or Town
1)7
3, DATE DRILLED
6,
ate 71p Code
USE OF WELLfQ�.'.
4. TOTAL DEPTH CUTTINGS COLLECTED C] Yes
5. DOES WELL REPLACE EXISTING WELL? Li Yes gi No
6. STATIC WATER LEVEL. Z/) FT. © above TOP OF CASING,
belo
TOP OF CASING IS / Y ... FT. A 3OVE LwAND SURFACE:
7, YiFLD (9pm): METHOD OF TEST
8 WATER ZONES (depth).
9. CHLORINATION- Type
1U. CASING:
Amount
Depth Diameter
til.A.4ir I From / To _2_// Ft . ,£.__
M ?,t"rom / To /
mit From
1. GROUT-
M I,li
fit4$ P.. From
MI.J tt3
12. SCREEN:
To-.2 Ft. -
Thickness
eight/Ft.
Depth Matertdi,L Method
To Ft.J�a r e+.�..
To ze F1 ., _..
(depth Diameter Slot Size Material
Mtn t From _' To. J % Ft. .7 in, /d in.
M!wl tt2 F :,rjm J / To 3 r _ Ft. n? in. /0 i
tiv)4,3 From ,n7/ To .I/ Ft. 2 in, _._/0
13. GRAVEL PACK.
M+J i From /
iF1 W t•/From
1'1Lit) 43
14. REMARKS:
Depth
Size
To 3/ FL
To 3 ( Ft.,
3 /
Material
Lat. _ 1 ! Lon . 8t124q3 Pc
Minor Basin
in Code
Header Ent., GW-1 Ent.
STATE WELL CONSTRUCTION
PERMIT NUMBER: 1Z —
County; �-FT✓ Vt
Depth
From To
(Sho
or o
It A,
r�
It additional space is nee
t
DRILLING LOG
Formation Description
ed use back oflorm.
LOCATION K
v�irection and distance from
h rnap reference points)
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCO DA
STANDARDS, AND THAT A COPY OF THIS RECORD HAS
TH 15 NCAC 2C, WELL C©NSTRUCp"ION
OWNER.
Revised 11/84
SIG I '" E OF C• T ACTOR OR AGENT
DATE
Submit original to Division of Environmental Management and copy to well owner.

CUuU4rt`_

ALKALINITY CaCO
To pH 8.3
To pH 4.5
Aluminum
Arseni c
Bicarbonate
Cadml um
Carbonate
Chloride
C3hromi urn, riexaval ent
Chromium, Total
COD
Cali form, Fecal
arm, Total
Cyani de
dissolved Solids
Fluoride
Hardness as CaCO
Hardness, Non -carbonate
�.o5a
Lead
Manganese

Ca In:
DATE SA%PLE
Ni
a
en Kjeldahl
Ni
organic Scan
Phenols
Phasphonus, Total
Potassium -
St
di
ci c induc°itan
Sul fate
Sulfite
Zinc
0
Copper
7

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Location
ation Number
+� Fk
Well Diameter
Depth to Water Level
Measuring point
Gallons of water pumped
Field Analysis: pH
Date Sample Collected
Laboratory Name
COD »
Coliform: I fiF Foca
Coliform: MF Total ...
Dissolved Solids: Total
pH (when analyzed)
TOC
Chloride
Arsenic
Grease and Oils
Hardness: Total
Phenol
Sulfate ,w
Sample (Screened
Env lrl of ental Management Division
Groundwater Section
P.Q. Box 2768.7
Raleigh,N.0 27611
[phone]
We Dep
Interval ,,,Z'j Ft, To
Ft.
Ft.
below measuring point. (before sampling)
eet above land surface
bailed before sampling
S Specific Conductanc
Cou
y
Permit Number:
Non-Disch
NPDES
Water Use .�..
In ection Well
Well Construction Ma,
Other
uMhos Temp. l - C Odor
Date Lab Sample Analyzed
Certif
on No.
NO2 as N mg/1
/ 10 ml NO3 as N a ..° mg/1
/100m1 Phosphorus; Total as Pu mg/I
mg/I Al - Aluminum mg/1
units Ba - Bariummg/1
mg/I Ca a.. Calcium .. mg/1
mg/I Cd - Cadmium. _mg/I
mg/I Chromium: Total mg/1
mg/I Cu - Copper mg/1
mg/1 Fe - Iron »_ mg/I
mg/I Hg - Mercury .ti.. mg/I
rng/I K - Potassium _ mg/1
uMhos Mg - Magnesium_ mg/1
mg/1
mg/1
Specific Conductance
Total Ammonia(NH3 t NH
TKN as N
1 CERT
mg/I Mn _ Manganese
mg/I Na _ Sodium
RT`w°S UE AND ACCURATE,
OF PERMITTEE CCR AUTHOFULED AGENT*)
Ni - Nickel w mg/I
Ph - Lead mg/I
Zn - Zinc mg/I
Pesticides/Herticides (Specify Compounds)
Va. ue'.a should reflect t t'a' c
ug/I
ug/1
ug/l
ug/1
ug/1
ug/I
ug /1
ug/1
ug/1
ittra tl ons

cE
MAY I ;r 90

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Wall Loca
Well Identi
ation Number
Weil Diameter
Depth to Water L'
Measuring point is..�
Gallons of water pumped
Sa
Environmental Manaq+etent Divls,ltrt
Groundwater Section
P.O. Box 27687
Rateigh,N.C. 27811
(91`9)733-5O83
Depth t Ft,
ple (Screened) Interval 21, Ft. To .31 Ft.
ft, below measuring t. (before sampling)
above land surface
baits<d before sampling
Field Analysis: pH Specific Conductance
Date Sample Collected Ap L. y 1"�A(..) . Do
yt,
Laboratory Name E. 1 ' -L
COD mg/I
Coliforo: MF Fecal / 1OOml
Coliform: MF Total /100ml
Dissolved Solids: Tomg/1
pH (when analyzed) units
TOC . + mg/I
Chloride mg/1
Arsenic _mill
Grease and Oils mg/1
Hardness: Total _ mg/I
Phenol mg/I
Sulfate mg/1
Specific Conductance .... uMhos
Total Ammonia(NH3 t NH 4) .. mg/I
TKN as N mg/I
fERT1 Y T
SIGN
Revitec 7/
NO2 as N
NO3 as N mg/i Pb - Lead
Phosphorus: Total a P mg/I Zrr — Zinc mg/l
Ai - Aluminum mg/1 Pesticides/Herbicides
l3a - Barium mg/I
Ca - Calcium mg/1
mg/1
County
Permit Number, . ,.
Non -Discharge
NPDES
Water Use
Injection Wel
Well Construct A
Other a ....
uMhos Temp, 14
ab Sample Analyzed
Certification No,
e C Odor
Apizat. Le
Cd - Cadmium
mg/I
Ni - Nickel
Chromium: Total mg/I Other (S,ec
Cu - Copper mg/t
Fe Iron mg/l
Hg Mercury mg/I
K - Potassium ,. mg/1
Mg - Magnesium mg/1
Mn - Manganese mg/t
Na - -Sodium. mg/I
EPOi°'t t TRUE AND ACCURATE.
TT EF i:GR AUTHORIZED .AGE-N
Sp
tfy
Note:
Values should
ompounds)
ug/I
ug/1
-ug/I
ug/1
ug/I
ug/1
ug/l
ug/'1
-.ug / I

THE CITY OF KINGS MO
NORTH CAROTIN
P.0, ROX 429 * KINC,S MOUNTAIN', NOR f-i'ccclRQLL•
C i rr
KYLE K SMITH
MAYOR
DAIP, : January 30,1990
Environmental Management Division of C of oat
FROM : Kin T. MDss, Supervisor of Pilot Creek W.P.C.F.
SiIBJI" : ?`nitorinq Well Analysis for November 29,1989
I
.r71
Below is the Pilot eek W.P.C.F. ?bnitoring Tells re
ameter Manganese sampled on November 29,1989.
#1 M nganese - .56 mg/1
#3 gaese - 1.9 mg/1
#4 Manganese 1.8 mg/1
#5 Manganese - 5.3 rr /1
I apologize for the delay in --
There was some confusion between the
Parameters, Magnesium and Manganese in
The History
n
s for the
ing these results on this parameter.
ratory and myself on the two
performing these analysis at that time.
1 City

COMPLIANCE t IONITOR NG
REPORTFOR
Facility Name
Address
Well Location
Well Identification Number
Well Diameter 2`
Depth to Water Level
Environmental Management Division
Groundwater Section
P.O, Box 27687
Raleigh,N.C. 27811
[phone]
Well Depth ) Ft.
Sample reened 2,, 7, Ft, To -.1 Ft.
ft. below measuring point. (before sampling)
Measuring point is 2, feet above land surface
Gallons of water pumped bailed before sampling
Field Analysis:
pH Specific Conductance
Date Sample Collected
Laboratory Name
COD
Coliform: MF Fecal
Coliform: MF Total
Dissolved Solids: Total
pH (when analyzed)
TOC43,
mg/I
/1OOm1
/ 1OQml
mg/l
units
mg/I
Chloride mg/I
Arsenic _ mg/1
Grease and Oils mg/I
Hardness: Total
Phenol .w
Sulfate__
Specific Conductance
Total Ammonia(NH3 t NH 4)
TKNasN
CERTIFY AT TH
G W - 5'
OF PE
Rvied 7/85
mg/I
_ mg/1
mg/I
uMhos
mg/I
uMhos Temp.
Date Lab Sample Analyzed
County
Permit Number:
Non -Discharge .. .
NPDES
Water Use
Injection Well
Well Construction
Other
o C Odor
Certification No.
NO as N
No3as N
Phosphorus: Total as
Al - Aluminum
Ba - Barium
Ca - Calcium
Cd Cadmium_.
Chromium: Total
Cu - Copper
Fe _ Iron
Hg - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese._ ..
mg/I Na - Sodium ._
EPORT IS TRUE AND ACCURATE.
AITH0'
mg/f
mg/I
'... mg/1
mg/I Pesticides/Herbici
mg/I
_rng/I
mg/I
mg/I other (S
mg/I
mg/1
mg/I
mg/I
�mg/1
mg/I
mg/I
AGENT*) hA1t
Note:
Ni - Nickel
Pb .. Lead
Zn - Zinc _rng/I
s Specify Compounds)
ug/I
ug/1
ug/I
ug /I
ug/1
ug/I
ug/1
_ug/1
µ ug/l
lAppearance
iu
Values; a;hould reflect total conce

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Wefl Location
Well identification Numbe
Welf Diameter
Depth to Water Level
Measuring point is
feet above land surface
Gallons of water pumped/bailed
Field Analysis:. pH
Date Sample Collected �d i
Laboratory Name
COD
Coliform: MF Fecal
Colrform: MF Total
Dissolved Solids: Total
pH (when analyzed)
TOC .a
Chloride
Arsenic .
Grease and Oils
Hardness: Total
Phenol
Sulfate
Specific Conductance
Total Ammorsa(NH3 t NH4)
TKN as N
t CERT
before sampling
Specific Conductance
/ 100ml
/1Qoml
mg/I
units
mg /I
mg/I
mg/I
mg/1
mg/I
mg/I
mg/I
uMhos
mg/1
mg/I
Environmental Managetttent Division
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
County
Permit Number: = -m ) 4
Non -Di scharge
NPDES t
Depth Ft. Water Use
Ft, To FL Injection Well
below measuring point. (before sning) Well Construction . .
Otherw
Temp,
Date Lab Sample Analyzed
Certification No,
NO2 as N rng/l Ni - Nickel
NO3 as N mg/l
Phosphorus: Total as P mg/I
AI - Aluminum mg/I
Ba - Barium rrtg/I
Ca - Calcium mg/I
Cd - Cadmium ,mg/I
Chromium: Total . mg/I
Cu - Copper _ mg/I
Fe - Iron rttg/f
fig - Mercury p,r1
K - Potassium
Mg - Magnesium
Mn - Manganese
Na - Sodium_ mg/I
RT IS TRUE AND ACCURATE,
OR AUTHORIZED AGENT*)
Pb - Lead
Zn _ Zinc ,. .. rng/I
Pesticides/Herbicides (Specify Compounds)
ug/I
ug/I
ug/I
ug/I
ug/1
ug/I
ug/I
ug/I
ug/1
Other (Specify)
Note:
Values should reelect total concentrations
An Ina ISE
** Submit blue and r+en c

11 1. l
COMPLIANCE MONITORING
REPORT FORM
Fa Name
Address
Location
Identification Number
Well Diameter
Environmental Management Division
Groundwater Section
P.O, Box 27687
Ralei,gh,N.C, 27611
[phone]
Screened) Interval
Depth to Water Level 4 Fr ft. below measuring
Measuring point is A feet above land surface
Gallons of water pumped/bailed before sampling
Field Analysis: pH L 21.0 Specific Conductance
Date Sample Collected . A 4,04 s I 1cZ `1
Laboratory Name MM. 6,
point. (before
Depth $ Ft.
Ft. To. Ft.
)
Temp. ),' °C
Non -Di sch
NPDES
Water Use
Injection Well
Well Construction
Other .
Odor Appearance
Date Lab Sample Analyzed iYlAI.;C
tC t
Certification No.
COD mg NO2 as N v� mg/I
Coliform: MF Fecal /t'BOml NO3 as N mg/I
Colitorrn: MF Tonal _ / 100ml Phosphorus: Total as P mg/I
Dissolved Solids: Total ��_� mg/I AI. - Aluminum mg/I
pH (when analyzed) - units Ba - Barium mg/I
TOC mg/I Ca - Calcium mg/I
Chloride mg/I Cd - Cadmium mg/I
Arsenic mg/I Chromium: Total�mg/I
Grease and Oils mg/I Cu Copper mg/t
Hardness: Total mg/I Fe - iron mg/1
Phenol mg/I Hg - Mercury mg/1
Sulfate mg/I K - Potassium rng/I
Specific Conductance uMhos Mg - Magnesium mgJI'
Total Ammortia(NH3 t NH) mg/t Mn - Manganese mg/I
TKN as N rng/i Na - Sodium __ mg/I
I CERT,'."f THAT`THt S REPORT IS TRUE AND ACCURATE.
E s
EE (OR AUTHORIZED AGENT*)
04 3/88
Ni - Nickel
Pb - Lead
Zit - Zinc mg/I
Pesticides/Herbicides (Specify Compounds)
ug/i
ug/1
/t
/
ug/I
ug/1
wit
Values should reflect to concentration

trNTY N . "A MEN 1 NATURAL RE u w„ maw
OUAD 'a . NO.,w; COMMUNITY ` DEVELOPMENTDEVIELOPMENT ATE H VD , ;' Time
LAT- or4G., �r ;;� DEisei ad d �, �Frsr u sr
m,
GRO IRS WATER FEELLT�A " RM Other �.
tit A »� °°@ , i D. t W iRc
hinatctt r Other �
$A PRIORI Y DATA TRY
MEMERGENCY DATE 'P RT` <,e
Ship
0OLLE01 UA(`S):
APO
Owner
Spee,
T M PURPOSE:BAE AtGti, iM'L ANCE. E4ER
1f Odor t:1lira dlrr
karUn e Taste mpI(t .Etuth
d Afl ysito I%y:
LABORATORY A ALY ES
TuflIdlty, 76
1t.I`siwit'v
Ch ami utr1,
h" C
point
e t Analysis �ui;�ti��C(i�te��dd p
Nita Y IieadquarterG Pink uc toy Re+ 4o Ye(I t
um
Acid
2 quo
EATr&6a1# a

COUNTY(DEPARTMENT OF ,NATURAL RESOD
QUAD NO, :SEM AL NO & GOlvimUNITY DEVELOPMENT
L A T. 5--,; (6'. L ON (f/ E M
. GROUNDWATER HELD/AB FORM
Repor t1 AR. FRO, MR(), Rpo, WaRO, wiRo,
SAMPLE PRIOR!TY
vvsHo, Kinston - Qther
ROUTINE EmERGENcy
shipped by: Bus, Courier, .0ther
00LLECT0R() i DATE
FIELD ANALYSES
0114ao Spec, Cond.9.4
Temp,i0 1)0 0dor
pearance — Taste
Owner
LAB NU' BEP
DATE RECE1VE0
r,lec'd by:
Other _
DATA ENTRY FY:
DATE PEPOF4TED:
TIME o PURPOSE- BASELINE, COMPLAU\r, COMPLIANCE, LUST, OTHER
(ciro,o)
4
ai 250C Location or r,te /
De
/
scripti on ;'l sampl ing poi nt
Samplino Method
rptimp., baiter, aid Analyss By: Remarks
LABORATORY ANALYSES
210
COO High 340
COO Low 335
ColllormMF tiers! 31616
COOiO4,rmol4F -7Po'al 31504
TO(( 660
Turbidity 76
NTI.,
9)1 403
Altgalintly tp pH 4,5 410
Atkallntty to old 6.3 415 mg/l
Carbonate 445 m0t1
BiCartocanaka 440 org/1
Arsenic -Jute! 1002
Carbon taloorldia 406
11
441
Chloride 940 rrogil
cnidsmidisiiidex
Color:True BO
Cyarilde 720
r6gii
Lab Commen s°
7 +S. plc)' 70200
ott
Fluoftde 951 m
11ar4ln44T0lI) 900 rrogil
lardness (non -cart), 902 1616/1
Themols 32730 utuil
bectlic Cond. 95 00.6,as/corn
Sulfate 945 0114/)
ullide 745
NH3 as N 610 mdit
TKN411 N 625 maN
4402 +7403 as N 630
...—
P:Totat as P 6.55 digs
GW-54 Revised 7 85
05 Dissolved
White copy -
lysis SuLIlIl fi
dquatlers
Chromium:Total 1034
Cu - Copper 1042
Fe - Iran
Hp o Mer644y 71900
114 Magnesium 9;77
Sarnole inter va
11
(pumping lirip, ati- temp,
koln Manganese 1055 aufl
a - 513Oura 929 r-ogiN
- Nickel 1067
Pb Lead 1051
Se - SeharOopm 114
- Z,he 109?
ecl sample and wd
copy - Region Ye
hlSlck
apy - Lab
)143a.norn.-03t10,,, Pesticides
Apip 4)er4(4eide6
ase Nept,at Extraciatoo OfgamoCs
Asia 54Na6table OrgarolCS
Otgadtds tvCda 40011O10
ti2 Di(1dis tha (5144)

rar r\►
COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address.
Well Location
Environmental Management Dfvis3on
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
Well Identification Number I Well Depth '` Ft.
Ft.
Well Diameter tl`
Sa.
ple (Screened
nterval A 1 Ft.
To
Depth to Water Level %a ft. below measuring point. (before
Measuring point is feet above land surface
Gallons of water pumped/boiled before sampling
Field Analysis: pH
Date Sample Collected
Laboratory Name 6-
Specific Conductance
Date Lab Sample Anaivzed . !` 4 %Q7+�'1
0
ng )
County
,---Vi--./4(v0
Permit Number: J4o
Non -Discharge
NPDES
Water Use
Injection Well
Well Construction
Other
CO© mg/I NO as N
Coliform: MF Fecal /10Ornl
Coliform: MF Total /100ml
Dissolved Solids: Total mg/I
pH (when analyzed) units
TOC mg/1
Chloride mg/I
Arsenic mg/I
Grease and Oils mg/1
Hardness: Total mg/I
Phenol m g /I
Sulfate mg/I
Specific Conductance uMhos
Total Ar monia(NH3 t NH4) mg/f
TKN as N mg/I
I CERTIF,, THAT THIS REPORT IS TRUE AND ACCURATE,
GW-59
riled 3/88
Temp. . T C Odor
rri
Certification No,
mg/I
NO3 as N mg/I
Phosphorus: Total as P mg/I
Al w Aluminum mg/I
Ba - Barium mg/I
Ca - Calcium _ - mg/I
Cd - Cadmium � rang/I
Chromium: Total mg/1
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury rrag/I
K - Potassium mg/I
Mg - Magnesium mg/I
Mn - Manganese w rng/I
Na - Sodium mg/I
TTEE (O1 AUTHOFU EIJ AGENT*)
Ni - Nickel
Pb - Lead
Zn - Zinc
Appearance
<t✓� Q/
0,034
0, Of mg/I
Pesticides/Herbicides (Specify Compounds)
ug/I
ug/I
ug/I
Other (Specify) ug/I
ug/I
tag /t
ug/I
ug/t
ug/I
Note;
Values should reflect total. concentrations
and green copie

COUNTY PARTM NT OF NATURAL RESOUR AP3 NUM
QUAD NO sERrAt.14O & COMMUNITY DEVELOPMENT DATE RECEIVED
LAT. LONG. . k DEM Rec'd" by From: Bus4,41cUrier.
GROUNDWATER FIELD/LAB FORM Other
Report' to;
W R'O, Kinston FO
FIELD ANALYSES
PH 400
WaRO, W RO,
SAMPLE PRIORITY
ROUTINE 0 EMERGENCY
DATE :` c.aT. TIME PURPOSE: BASELINE, COMPLAINT
Ccirc
Sriec. Cohd„94
Odor _ FJascrttstl an of,sampl
Barnplinq I
AnaFysi,s By:
LABORATORY ANALYSES
Lab Comment
Remarks
AI - .Alu'minurm t 105
Ni - Nbckei 10667
Analys l
h
adquartors' Pink o al y '` e for Yellow copy
ATA ENTRY t3Y-.,....w,T,v},`.n . .
GATE FTEIPORTEIJ rP�•
OMF'LI ANCE
ug11

For Investigation of
ision of Env i onmental M gement
GROUNDWATER SECTVON
CHAIN OF CUSTODY RECORD,
a �
Incident No.
Samples collected and GW-64 forms completed by:
ab Only
Lab No.
uad
No,
j
Location Date
ak
No. of
Time Containe
nquished by(Signature)
Rel.
ethod of Shipment:
Seal by:,,
curity Type and Condition: Lock by:
Lab No. NFO.
From Through Containers
eived bySignatur
Re,, by
LAB U
Analysis
E ONLY
Relinquished by
Broken by:
Open by:
Received by
Da
/ Time
/
GW-63
Note. Gr"sginai sent with shipment
Copy retained by collector

THE CITY OF KINGS MOUNTAIN
NORTH CAROLINA
P. G. BOX 429 • KINGS MOUNTAIN, NORTH CAROLINA 2808 • 70d•739-9591
INCORPORATED 1874
y 10,1.119
TO: : Ms. Kay Dechant qround T+'ater Section
FIOM : Ms. 'Kim T. "loss, c/o The City of Kings Mountain Pilot Creek W.P.C.F.
STITIPT1' : Follow - u on Monitoring ,*bl.1s `or Landfill r The Pilot Creek W.PC.F.
Ms.
Pbolosed is the follow -
Pilot Creek landfill Ffini.tnring wells
1991.
If you should have any questions
to contact me at the Pilot creek W.P.C.F. 7 4
parameter
elay►ad in our
this matter
9-7131.

sornnmsnhin1 tssMi
700 UNIVERSITY COMMERCIAL PL,
FIARLOTTE, NC 26213
704 • 597,6454
kiln Nobs
City of kings
319 Fulton
Kings Ilounti-,ir
Tuber
03111
0I'134r0
I.I IMr'7 2 i}
31616
00951
r0'26,0
00610
00625
III. 620
0) 556
00,100
32730
00665
00500
00520
0I r07C
9 l'. Io r t;''
Plul4tker
28086
POT/5 0 20C
CLIL, [ .25N I.;.>.t_ r
Uy nida, Tot,-11
Et_Ic'{l. Coliforrll,�
Fluoride,
Er4L-,05, (Dot erg
nitrogen,
r4i1 F ogerl.,
Nitrogen, I` l3trate, L-r i1„`aril:^
011 it Grease
pH roari;r
Pha.rl7 ild�.
Phosphorus,
Residue, l•otiil
e 1duo,, Total Nf.ari11,..D."+.;r.=r„
Tur NTH
01105 Aluminum, Tot it Cr
01002 14.SerDic ,
01007 Lttzrium, Tot; 1 ii .;1
01027 Czidirriulta Total.
00916 Ca1ciurrt
01I024 Chromium,
01042 Copper Tot«1
01045 Iron, To
01051. Lead,
Il09 7 I: ynosiuri1
010155 Ma4rl(')iir1C. +e„,
71900 Moccu,'
01067 Nickel, Ti1'l;it1
00937 f' o f. '; w. o r l,.I
r,.111 ?`Sors,Lr.n.1ukq,
01077 to 1 1..>, o r
00929 Sodiui;to, Tot: 1
i01.C., .' Za.i
Cer,,.
1
1„
i, osult;s
Number of Sami-'105: 5
1.Pilot Crook NW 61
Pilot Crook MW 02
Pilot Creek ,?1W 43
4,. Pilot Creek MW nd
5. Pilot Crook NW 05
U2,,tc heretr-tc d;. 04/21/88
;t;rd» ,04/O$/88
vr:d z 04/08/88
t oct
d.
GROUNDWATER SECTION
RALEIGH, NC
'SOURCE TESTING + AME3YENT AIR WATER ! WASTEWATER i F(AZARL©US WASTES INDUSTRIAL HYGIENE i GROUNDWATER 1 CONSULTING

COMPLIANCE MONITORING
REPORT FORM
Facility Name County
Address
Well Location NPDES
Well Identification NumberWell Depth Ft. Water Use
Well Diameter a it Sample (Screened) Interval R I Ft. To 3 1 Ft. Injection Well
Depth to Water Level t5 . 21.D ft. below measuring point. (before sampling) Well Construction
Measuring point is 14- D feet above land surface Other
Gallons of water pumped bailed before sampling ( -O ...) —
Field Analysis: pH (9.40 Specific Conductance uMhos Temp. )4:3
Date Sample Collected 00-0g, 1319 gr7 Date Lab Sample Analyzed
Laboratory Name E.. t':Ii • 5. LAZO a rA-1'02 Li , C1-I A RLK17-- N.0 . Certification Na
Environmental Management Division
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
Permit Number *17)(tM
Non-Dischar
COD mg/I
Coliform: MF Fecal 00m1
Coliform: MF Total /100ml
Dissolved Solids: Total mg/I
pH (when analyzed) units
TOC mg/I
Chloride mg/1
Arsenic mg/l
Grease and Oils mg/1
Hardness: Total mg/f
Phenol mg/I
Sulfate mg/I
Specific Conductance uMhos
Total Ammonia(NH3 t NH 4) mg/I
TKN as N mg/I
ICERTt THISR
NO2 as N mg/I
NO3 as mg/I
Phosphorus: Total as P mg/I
Al - Aluminum mg/1
Ba - Barium mg/I
Ca - Calcium mg/I
Cd - Cadmium mg/I
Chromium: Total mg/1
Cu - Copper mg/1
Fe - Iron mg/I
Hg - Mercury g/I
K - Potassium g/I
Mg - Magnesium mg/I
Mn - Manganese 33 mg/I
Na - Sodium mg/I
PORT IS TRUE AND ACCURATE.
OF PERMITTEE
GW-59Rd 7 RS
R AUTHORIZED AGENT*)
Odor MON. Appearanc
4. g
Ni - Nickel
Pb - Lead
Zn Zinc
mg/I
mg/I
mg/I
Pesticides/Herbicides (Specify Compounds)
Other CSpecify)
ug/1
ug/I
ug/I
ug/1
ug /1
ug/I
ug/I
ug/I
ug/I
Note:
Values should reflect total concentrations
* See back tor instructions
**Subrhit btue and green coris to address above

Laboratory Name
COD mg/I
Coliform: MF Fecal /100m1
Coliform: MF Total /100m1
Dissolved Solids: Total mg/I
pH (when analyzed) units
TOC mg/1
Chloride mg/I
Arsenic mg/I
COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Location
Well Identification Number
L.nvironmental management uivislue
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27811
[phone]
Well Depth
a 41
Well Diameter Sample (Screened) Interval R I Ft. T
Ft
Ft.
Depth to Water Level 15 . 10 ft. below measuring point (before sampling)
Measuripoint is
feet above land surface
N—
Gallons
nc) P
Gallons of water pumped bailed before sampling()
Field Analysis: pH 640 Specific Conductance uMhos Temp. 14.3
County
Permit Number:
Non -Discharge
Date Sample Collected OCIOP.., 3ftgr7
F.: M.S. L fZ. 4.'reD2—Li 0-1-1A c•frf. N.C.
Date Lab Sample Analyzed
!,k
NPDES NC QOic131
Water Use NOM 7--
Injection Well
Well Construction
Other
Odor NO
Appearan
Certification No. 1g
NO as N mg/I Ni - Nickel
NO as N mg/I Pb - Lead P. 1 CI
Phosphorus: Total as P mg/I Zn - Zinc
Al - Aluminum mg/I Pesticides/Herbicides (SPeoily
Ba - Barium mg/I
Ca - Calcium mg/I
Cd - Cadmium
Chromium: Total
Grease and Oils ... Cu - Copper
Hardness: Total Fe - Iron
Phenol Hg - Mercury
Sulfate K Potassium
Specific Conductance Mg - Magnesium
Total Ammonia(NH3 t NH 4) Mn - Manganese.
TKN as N Na Sodium
I CERT HIS R PORT IS TRUE AND ACCURATE.
St A
mg/I
mg/I
mg/I
mg/I
uMhos
mg/I
mg/I
or PERMITTEE (OR AUTHORIZED AGENT*)
mg/I
mg/I
rng/I
pounds)
ug/l
/A-4-
e :14t.
/7'7)6 (.0i
„---
( /72:'
e
-1
.1"
9 Revi,cori 7

COMPLIANCE MONITORING
REPORT FORM
Fa . Name.
Address
Location
Identification Number
Well Diameter. -8 d7
Depth to Water Level
Measuring point is
Environmental Management ©ivfsion
Groundwater Section
P.O. Box 27687
Raleigh,N C. 27811
[phone]
Sample (Screened) Interval
ft. below measurin
feet above land surface
Gallons of water pumped bailed before sampling
Field Analysis: pH w 1 Specific Conductande
Date Sample Collected
Laboratory Name
COD_
Coflforrn: MF Fecal
Coliform: MF Total
/1OQml
/ 1 OOm1
Dissolved Solids: Total :, i __, mg/I
pH (when analyzed) units
TOC x . _.. mg/I
Chloride mg/I
n
Arsenic mg/I
Grease and Oils mg/I
Hardness: Total mg/I
Phenol mg/I
Sulfate_mg/I
Specific Conductance uMhos
Total Ammonia(NH3 t NH 4) mg/I
TKN as N mg/I
.cEFITF`Y T AT T�pH
E OF PERMI
GW-59 fg+ed 7/85
NO
elt Depth r _Ft.
AI Ft. To ,; 1 Ft,
poin
:before sampling)
County
Permit Number: "
Non -Discharge
NPDES,-:,,
Water Use
Injection Well .�. .
Well Construction
Other .
NO3 as N�.. . .
Phosphorus: Total as. P
Al - Aluminum
Re - Barium
Ca - Calcium
Cd - Cadmium
Chromium; Total
Cu ., Copper.
Fe - Iroro
Fig - Mercury
K - Potassium
Mg - Magnesiuo
Mn - Manganese
Na - Sodium
PO TRUE TRUE AND ACCURATE,
mg/I
mg/1
mg/I
mg/1
mg/I
mg/1
mg/1
mg/I
mg/I
mg/I
mg/1
mg/1
mg /1
mg/1
mg/1
EE O AUTHORIZED AGENT*) D'AT
Ni- Nickel
Pb - Lead
Zn -- Zinc
�mg/l
mg/I
Pesticides/Herbicides (Specify Compounds)
ug/I.
ug/I
ug/t
ug/1
ug/I
ug/1
ug/I
ug/1
Other (Sp
Note:
Values
* * z„'r uh)m t
n
oeiee'i

UNTY N.C. OEPARTM T CIF NATURA SOURC sat
UAL) NO. 4t tU a Ct Ma UN(TY DEV L. MLNI ATF REG iV s Time,
DEM F? 'cY Y y. r r leer hair
GROUNDWATER' FIELD/LA t t r
SAMPLE R OR TDATA 'MIRY Ya ..���
t Kin t ry rO Y
TYN #.& CYO N Y AEEC REPORTED:
� by: %are,tsCaTast,0trrt
Lr ' on �>. r '� ,, 0ATT �N �" �.. .. T-1��:9�:W Ft,Y"�.��5'': ��TiTT� kCXi°. "4�iFp�,:;,�h�i"g_-� �k��E�'�;1P� � E.�,b'�"�
FIELD ANALYSES
uY Spec. Cr nd
Temp, ° ` Oeio
Appears Ta
t s Id AtHad 3 Tt
ABORATORY ALY ES
AtlkitilM y to 4.5 41
Afk" Vlirify Ea pHmt 8,y,4
445
440
of �I00
YfTtrs ce 80
20
ab CommY'n'tY
wwner
p, tta°i p.
3
ud P u
Stb4
q!ara tk't4S
f
4mn4
©Y52f5 0 d Ana ys :xdiY:tt1Y Y YYE3t rnpt n w to "Et n b ooi
to spy $"3 tYCYTfc %Y lnk' (7t1Y i t 97 T Y t'Nk i.
n ri ts15 q A6Rktii:d?Y!
ACrer, 1-Ytt"f

pT �[ BAR II NT NATURAL L E rEU
�iY 1' yam.. �K.. � t. A��:�k §1 ."' �""�r� 5 � ...e:,.
QUAD NCB E A NO, 'OMMUNITY DIEVELOPME OKI� ".EE WED .4,: Tim
LAT. LONG, '.. 1) 1u9 c: rt b Fr srrr. ca& ri r
�NDWATER FIEL "r"AR
� ttar
,SAMPLE I b I Y ATAENTRY Y
EE_Sntrar ;E Ettt€r Y
EUTE ttEEaEzN �TATE E' EPORT"k3
tstiEaI by: BusUr�ra EEtEr
::JE BVE n v;r : DATE " i , TIME PURPOSE: ESA ME t.. Ef , £ I MANGE ILE1�T`, E°I9E 1'
Tte_Lp ANALYSES014
T`Er, ttt
Con „
p tag
(pump
AR" At ¢trn
d 94e+''dcl
9P i :1 st8 34 Or '
ty ?b NTU ulfak k45n
Odd
A40dgt tt 4 4
e,. 445
4
440nri4d8 a s N `trk .crr dB
Pt^Cc
4 >t E '7
E73 as N ki
d Ana y ubr Et Ettrrr r rnp ar
4'<; tpJB. t':a ti'x'fi+'±4t4bd Organ
Y. t 0

COMPLIANCE MONITORING
REPORT FpRivi
Facility Name
Address
Locatic�:n
Identification Numbers
l atom
Depth to W
ing p
r .. . .a Samcreenod)
er Level :��` tt below meat
nt is , feet above 'Iand surface
Gallons of water pumped bailed before sampling
Field Analysis: pHSpecific Conductan
Cale Sample Collected I�F�
Laboratory Name
CO
CColiforrl; MF Fecal
Conform: MF Total
Dissolved Solids Total
Env$ronniental Management lvissoundwater
Pt Box 2',.`
lateigh,N.C, 278„i
1-3 r a xi
County
Permit Number.,
Non -Discharge
PCFS
aeptli „ Water Use
Injection Welt
tore sampl g Well ConstructionOther
i
"ell
Ft. To Ft;;
ing point. (be
NO2a N
/100m1 NC3 as N
/1OOml Phosphorus. Total
mg/I AI - Aluminum, mg/I Pesticides/Herbic
uMhos ;Temp.
ate ,I-ab Sample Analyzed
pH (when analyzed) units
TOC . mg/I
Chloridrng/I
Arsenic mg/I
Grease and Oils mg/I
Hardness: Total mg/I
Phenol
Sulfate_ mg/I
Specific Conductance uMhos
Total Ammonia(NH3 r NH mg/I
TKN as N mg/1
I CE
g/l Hg Mercury
K - Potassium.
Mg - Magnesium
Mn - Manganese
Na - Sodium
IEPORT IS TRUE AND ACCURATE
RI1ITTEE COR AUTHO IZED AGENT*)
g/l
Ba - Barium
Ca - Calcium
Cd - Cadmium
Chromium; Total
Cu - Copper mg/I
Fe - Iron mg
g/"I
Odor N Appearance 0-1-1-AR
ication No.
Ni - Nickel
Pb - Lead
.mg/I. Zn - Zinc ,mg/1
y Compounds)
ug/l
ug/l
ug/l
ug/1
ug/I
ug/1
ug/1
ug/l
erg/I
otal concentr oins
above

TY QF ICINGS MOUNTAIN
NORTH CAROLINA
129 • K NGS MOUNTAIN, NORTH CAROLINA 28086 • 704-739-9591
INCORPORATED 1874
DECEMBER 16 ,, 1987
:font
North Carolina 28086
TO: Ms. ay Dechant.
Division of Euv°irct
Groundwater Sea L i n
59 Wood'f i n Place
P.O. Box 370
1sheviile,Nortl C'j
Dear Ms. Dech ary t:.
Enclosed copies of Tic:. City of
Creek's Landfill Well nnn lc rsuit_s.The results were run on
the wells with ou "` re', sampldevices which cs re picked up
Frith PVC Pipe with ;. c_ w :: ; check valve Those results
indicate that our paral,leLer LI. td has came down within li
but our parameter tO I =a. t t. out o,w limits, which we
like tosu99est
well samples wh
s t i 1.1 o u t of tC
labo
I have s ubia
Environmenta_
to have an
within our t,a:r,cat.f it
do not understand wht,N
I am now in tlac., ;iroc oS
that we
ounta,in Pilot
La ora;ic >s and would
to take xt set of
seeing how we are
1.II. L a -_ Pn. ;meter Nansanese tra this.
t,-_tayi cause.
to the 1)i"vis:I.'>'r of
Section at. would like
this cause for Not -Compliance

L a bora tory Name
COD
Conform: MF Fecal
Conform: MF Total _
Dissolved Solids: Total mg /I
PH (when analyzed) units
TOC mg 11
Chloride_ mg/I
Arsenic mg/I
Grease and Oils mg/I
Hardness: Total mg/l
Phenol mg/I
Sulfate mg/I
Specific Conductance uMhos
Total Ammonia(NH3 t NH 4 mg/I
TKN as N mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE,
COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address L kJ
Well Location
Environmental Management Division
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27811
[phone]
Well Identification Number
Well Diameter Sample (Screened) Interval Ft, To Ft,
Depth to Water Level ft. below measuring point, [before sampling)
Measuring point is feet above land surface
Gallons of- water pumped bailed .before sampling _
Well Depth 31_,Ft
County
Permit Number:
Non -Discharge
NPDES
Water Use
Injection Well
Well Construction
Other
Field Analysis: pH Specific Corv:;uctance uMhos Temp. . C Odor Appearance
D 2ite Sample Collected DLI.te Lab Sample Analyze-.1
Certification N
mg/I NO2 as N ingli Ni - Nickel ,...... ....... mg /I
.../100m1 NO 3 as N _,„ mg/I Ph - Lead . ;rng/1
/100ml Phosphorus: Total as P mo Zn - Zinc _mg/I
Ai. - Aluminum mg/t Pesticides/Herbicides [Specify Compounds')
Ba - Barium mg/1 ug/I
mg/I ug/I
mg/I :,, _ug/1
mg/I Other (Specify) ....____ug/1
Cu - Copper mg/I X. _ ug / I
Fe - Iron .mg/1 ug/I
Hg - Mercury mg/l ug/I
K - Potassium mg/I ug/I
Mg - Magnesium mg/I .ug/I
Mn - Manganese, mg/I
Note:
Na - Sodium, mg/I
- Calcium
Cd - Cadmium
Chromium: Total
SIGNATURE OF PERMITTEE (OR AUTHORIZED AGENT*) dATE
r4VV—SQ PrpAvio.r1 7
Values should reflect total concentrations
* See hack tor instruction:3
**Submit blue, and green copies to address above,

COUNTY
QUAD NO,, ` EERtAL NO.
LAT,
Report tut r"RC, Rtt, MRO, RRO, WaNC, WiRO,.
WSR0, Kinston 4C) Other
pped by Burs, Goon r, Other
L LPAT T ENT OF NATURAL RESOU CF
a� LT OY DEVELOPMENT
rT
GROUNATATER FIELD/LABFIELD/LAB FORM
SAMPLE PRIORITY.
",s ROUTINE EMERGENCY
LAB3tER`
DATE t L:CHV t {y i t Tune.
Rt a"et `T Ercu o ,
Other
DA1A ENTRY BY,
DATE REPORTED:
COLLECTOR(G,h DATE t T 4E RIuRPi 0E BASELINE, C CLtPLAINT,GC)€Vt LPANC;E„ Ll9E' OTHER
rc e ark )
HELD ANALYSES Owner
0H400-- ...Spec. bond" 3si . u at aS G Locati or
PIP'-tt? uC Odor fps r r on fit ' ,i
Appearance Taster - Satrtiiiri i irthuc
u
Analysis By:"rrtarh
air temp, et
Sample 4rxt
LABORATORY ANALY rES
dneaS Taf
Rd5
NH3 as N.
TKN as N
NC/2 i NO3 as IV 630
Lab Common
(pumpin
t o 5torin # t3vtdes
h
Ora ni s lVOA Narita

t mom
COMPLIANCE MONITORING
REPORT FORM
Facility Nagle
Address
Well Location
Well identificati
Well Diameter
n Number
Depth to Water Level
Measuring point is feet above land surface
Gallons of water pumped/baited before sampling if 64"'°
Field Analysis: pH ' Specific Conductance uMhvs Temp. 4.4 ©C Odor ANA/ - Appearance
Sample (Screened)
Environmental Management Divlslon
Groundwater Section
P.Q. Box 27687
Raleigh,N.C. 27611
[phone]
Depth
S Ft. To
Ft.
__Ft.
NO
Date Sample Collected
Laboratory Name r A,+r
COD ...
Coliform: MF Fecal
Coliform; MF Total
Dissolved Solids: Total >..
pH (when analyzed)
TOC
Chloride
Arsenio.
Grease and Oils
Hardness: Total
Phenol
Sulfate
Specific Conductance
Total Ammonia(NH3 t NH4
TKNasN
vleerd 3/88
ft. below measuring point. (before sampling,)
Date Lab Sample Analyzed
County
Permit Number:
Non -Discharge
NPDES .,.�
Water Use
Injection We
Weil Construction
Other (AND
A/ . r Certification No,
NO as N rng/I
mg/I
mg/I
mg/I
/ 100ml
/ 1ppml
mg/1
units
mg/1
mg/I
mg/I
mg/I
mg/I
mg/I
mg /1
uMhos
mg/I
mg/1
NO as N
Phosphorus: Totalas
Al - Aluminum
Ba - Barium
Ca - Calcium
Cd - Cadmium
Chromium: Total
Cu - Copper
mg/I
mg/l
mg/I
mg/I
rng/I
mg/I
Fe - Iron mg/I
l-ig - Mercury mg/I
K .a Potassium mg/I
Mg -• Magnesium mg/I
Mn - Manganese _ �,) � _ mg/I
Na - Sodium mg/I
ORT IS TRUE AND ACCURATE.
TTEE (OR AUTHORIZED AGENT*)
Ni - Nickel
Pb - Lead � rng/1
Zn - Zinc mg/I
Pesticides/Herbicides (Specify Compounds)
u9 /1
ug/I
ug/i
ug/I
ug/I
_ug/I
ug/I
ttg/I
Other (Sp
city)
Note:
Values should reelect total concentrations

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Location
Well Identification Number
Well Diameter
Depth to Water Level
Measuring point is.
Date Sample Col
nmental N +1arlale+^nent Division
Groundwater Iection
P.O. Box 27687
Raleigh,N.C. 27811
[phone].
C pun
Perm
Depth
creened) Infernal Ft. T
below measuring point; (before sa
t above land surface
_Ft
F t.
ing )
Gallons of water pumped bafled before sampling t) .
Field Analysis: pH Grad / . Specific Conductance .. uMhos Temp.
Date Lab Sample Analyzed
cted
Laboratory Name I : Irt iliIt it .. i
Y
t Number
Non -Discharge
NPDES !'O'.C1`g,6"--1
Water Use i Or-)
injection Well
Well Construction
Other .Hn F7t
NP1oitw N Certiification No,
COD _ mg/I NO2 as N mg/I Ni - Nickel a--, . _.._.mg/I
Cdiiform: MF sepal _ /1OOrnl NO3 as N mg/I Pb Lead _rng/t
Conform: NW iota/100ml Phosphorus; Total as P mg/I Zn - Zinc mg/I
Dissolved Solids: Total. mg/I Al - Aluminum mg/I Pesticides Herbicides (Specify Compounds)
pH (when analyzed) , units l3a . Barium mg/I ug/I
TOC mg/I Ca - Calcium , mg/I ��_ .. ..,, ug/I
Chloride �� � mg/I Cd - Cadmium ...__._�s . mg/I ug/I
Arsenic mg/I Chromium: Total _ mg/1 Other (Specify) ug/I
Grease and Oils mg/I Cu�l� Copper mg/I o AtiI,e = `..._:uq/I
Hardness. Total mg/1 Fe - Iron mg/I ug/l
Phenol mg/l Hg _ Mercury �.. g/I a j
-1 a eYwSlr..rvwvmw�.wn� 'X"4°'1@``'a"
. ,
mg/I K - Potassium mg/I I�i .., . � mug/I
Specific Conductance uMhos Mg - Magnesium .mg/I
mg/I Mn - Manganese PV+ mg/I
Note:
TKN as N mg/i Na - Sodium_ mg/I
ERT Fc;' THAT THIS EPORT IS TRI JE AND ACCURATE.
Sulfate
Total Ammonia(NH3 t NH4)
PI
RE OF PE TT (OR AUTHORIZED AGENT*)
GW-59 Red 7/85
Values s
ub it blue
ti g 71,Ple$ t()

C0ur TY
QUAD NO.
LAT. r ...
Report to: A
WSRO, Klotst
Shipped by:, Bus
SAL N
R0, fM'RO, (IRS
° t h e r
hurler, Otter
COR...t.:ECTOR(S):
FIELD ANALYSES
400 spec
Teme,i0 _oc
Appearance —
DATE.
N.. EPARTMENT OF :NATURAL E U CES AID`NU I,..
& COMMUNITY DEVELOPMENT DATE BEDS " ED ` 3w ; Tune
DEM Rem'd y ' � Rr«a r. Bus -Courier
GROU WA I,EI(r AB FORM other «,n
AMPLE PALO C3_TY° DATA ENTRY' fax: _t .t
ROUTINEEl 0 11 Ro .;NCY DATE•': 'REPORTED;M .... .,:;.
TIME PURPtu«SE„ BASELINE, COMPLAINT, tvOMPLIANS,.r; LUST, OTHER
(,1rc"Ie an?—"
Owner _
and,94 at 25`)C Location or ,sile,
Odor Description of samtattttJ pint
Taste— aameting Method
(pump. d a6'
Field Analysis By,
IABORATORY ANALYSES
Alkalo�atty %t'b�i
Alkalinity to" to kk
CraCttditi te 445
t ar onAte 440
Lab Comments'
4Revised 7/
rks
Cpumprin ,air temp et ,
'1tK-N :es N
Naze.
a t« a Ana1ysis
py eadqu rte;r
Ag - u06drear 1077
Chirp:4) r Total 1034
Ce Copper A042
Fe '°" iron 'I045 utg/t
-a,- t"eck�sd."`V CNft7�V
traced tarrtple at(d
k -coy _ Re ioaa
Acid Herditldes

COUNTY
QUAD NO, _vt' SERIAL N
LAT. k yw,. t LONG,
Report to,
WSRO, Kinston FU
FRO, MRO, PRO, WaRO, WiRO,
Other
;hipped by: Ties, CourrEvn
, Other
COLLE( TOFi(S): a t m�`., e,.h. DATE
FIELD ANALYSES
PH4047 Spec, Cond, 94 at"2.5°C
Ternp.10 °C Odor
Appearance Taste .. . _ .
Field Analysis By: ..
LABORATORY ANALYSES
3" 1 O
t;ou P-1Reh 34G3
r?hW 4 €, top
A: a1fnCty Pf VI1r5.4�0 �5
A.£kattnet5r_ to dM P3,3 415 rk't
CatbWnote 445, mNg/I
t&tlda it4C£
dm"urs1;Her 1O32
©rCtrue 60�
Lab Comments:
GVV-:tiil Revised'7/85
ARTMENT OF
COMMUNITY DEVE OPMENT
DEM
GROUNDWATER FIELD/LAB FORM
SAMPLE PRIQRPTY
0 ROUTINE EIIE'RGEC JGY
TIME — PURPOSE: BASELINE, COM
n or s
Description of sa€1plin
IpLl•fl(t Method
p
tpu�+'ip, b
LAB &4Ukl; R
DATE RECEIUE,D
_ From: Bo
Giber
'ATA
DATE. REPORTED:'"
PLIANCE, LUST, OTHER ,
vat
(pur ptn ti"rrae, air temp,
D s p ued Analysis, -
White copy Headquarters
AI Alumuiuvn 1105
8a - aar£um 1007
Ca al0terh did
tt
Yellow copy Lab
bch9drina Peat d
11
Acid Nardiciden
Neutra➢ Fxiractab"Oe Orgltini
able

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Location
Well identification Number
Well Diameter
Depth to Water
Measuring point is
onnt i Management DINs on
Groundwater Section
O Box 2 T 87
Raleigh,N.C. 2 611
g33-3
County
Permit Number
Non -Discharge
NPDES
Depth Water Use
pte (Screened) Interval Ft. To�1 Ft Injection Well
below measuring point. (before sampling) Well Construction
t above land surface
9,
Gallons of water pumped bailed before sampling
Field Analysis: pH .
Date Sample Collected
Laboratory Name
COD mg/I NO
Colif frt
MF Fecal
Colitorm: MF Total
Dissolved Solids: Total
PH (when analyzed) .M._
TOC
Chloride
Arsenic
Grease and Oils
Hardness: Total
Phenol
Sulfate
Specific Conductance
Total Arnmonia(NH3 t NH 4)
TKN as N
I CERT
14
Speci
GW-5
Sf GNP
Revise
E OF PER
7/85
Conductar
/ 100ml NO
Other <. LANO FI L .' I.°
uMhos Temp, t J t ° C Odor
Date Lab Sample Analyzed
Certihcaticrn No.
..� Appearance SaUktliO4
as N „wr. mg/I Ni Nickel mg/I
mg/I Pb - Lead mg/I
/ 1pdrnl Phosphorus: Tctat as P mg/I Zn Zinc mg/I.
mg/I Al - Aluminum mg/I Pesticides/Herbicides (Specify Compounds)
units Ba - Barium _mg/I ugfl
as N
Ca -° Calcium mg/I ug/I
Cd - Cadmium :_ r: mg/I _.ug/I
Chromium: Total mg/I Other (Specify) ug/I
Cu - Copper rng/I ug/I
mg/I Fe - Iron mg/I ug/I
mg/I Hg - Mercury_ mg/I g/k
mg/I K - Potassium u. mg/I ug/I
..uMhos Mg - Magnesium �-e. tg/ug/l
mg/I Mn - Manganese
mg/i Na - Sodium
EPOAT IS TRUE' AND ACCURATE,
TTEE (OR AUTHORIZED AG
Values hould reflect
* See Oadk for it
blue and gTe
ncentrat
addre-ss above

COMPLIANCE MONITORING
REPORT FORM
Facility Name
j Address
Well Location
Well Identifica
Well Diameter
Depth to Water Level
Measuring point is
ft. below measuring point. (before s
RO feet above land surface
Environmental Management Division
Groundwater Section
P.O. Box 27887
Raleigh,N.C. 27611
[phone]
County J LAN 0
Permit Number:
Non -Discharge
NPDES
Well Depth I Ft. Water Use
eened) Interval "rti Ft, To - _ Ft, In,iection Well
piing)
Gallons of water pumped bailed before sampling
Field Analysis: pH Specific Conductance uMhos Temp.
Date Sample Collected _ •_ Da#e Lab Sample Analyzed
Laboratory Name e ._ _'�. Certification No.
COD
Well Construction
Other . `..; r.t —
Odor Appearance
Colitorm: MF Fecal
Coliform: MF Total
Dissolved Solids: Total
pH (when analyzed)
TOC
Chloride
mg/I NO2 as N mg/I
/ lggml NO3 as N mg/I
Arsenic
Grease and Oils
Hardness: Total
Phenol
Sulfate- m-�
Specific Conductance
Total Ammonia(NH3 t NH 4)
TKN
I CERTIYITHAT THIS
SIGNA ,TIE OF PE
r w_5o RL1Y�C© a/QC.
Ni - Nickel .._�. ., mg/I
Pb - Lead .. ____ _ °� mg/I
_ /1tl©nnl Phosphorus: Total as P mg/I Zn - Zinc _mg/I
mg/l Al - Aluminum mg/I Pesticides/Herbicides (Specify Compounds)
units Ba - Barium mg/I ug/I
mg/I Ca - Calcium mg/I • u /I
mg/I Cd - Cadmium_ mg/I ug/l
mg/l Chromium: Total mg/I Other (Specify) ug/I
mg/I Cu - Copper mg/i ug/i
mg/l Fe - Iron mg/I,
mg/I Hg - Mercury `ng/I
mg/I.K . P©ta slum `: . mgii , _ �•..
uMhos Mg - Magnesium* mg/I
mg/I Mn - Manganese _ mg/I,
ingli I`rrtg/vl 0::.
EPORT IS TRUE AND ACCURATE.
TTEE (OR. AUTHORIZED AGENT*)
DATE
ug/I
ug/I
ug/I
ug/I
ions
* See hack tor instructions
** Subrrlit blue and green copies to address above.

COMPLIANCE MONITORING
REPORT FORM
Facility Name tl j 0
Address 1013 N©Z11A-
rAGS
PiKCRC.144N
Well Location
Well Identification Number
Well Diameter
'l3NIA
Environmental Management Division
Groundwater Section
P.Q. Box 27687
Raleigh,N.C. 27611
[phone]
County
Permit Number:
gaG Non -Discharge
NPDES
pth 31 Ft. Water Use
Sample (Screened) Interval_ a } Ft. To t_3 1 Ft. Injection Well
ft. below measuring point. (before sampling)
Measuring point is 14,0 feet above land surface
Gallons of water pumped bailed before sampling rtrtnn Ix1
Field Analysis: pH �•Z 1 Specific Conductance uMhos Temp. 14.8 aC Odor NON Appearance UQQ. "t
Date Sample Collected DC`-b377-R 13 I98`1 Date Lab Sample Analyzed
Laboratory Name LAZU.A 0Q 4 J
Depth to Water Level
COD
mg/1
Coliform: MF Fecal / 1©3ml
Coliform: MF Total / 1©Oml
Dissolved Solids: Total mg/I
pH (when analyzed) units
mg/1
Chloride mg/I
Arsenic mg/I
Grease and Oils mg/I
Hardness: Total mg/I
Phenol mg/I
Sulfate mg/I
Specific Conductance uMhos
Total Ammonia(NH3 t NH 4) mg/I
TKN as N . mg/I
TOC
SIG' E OF PER
Gw-59 Revis
REPORT
C�7
Well Construction
Other ._ - iN1F4`
Certification No. 9
NO2 as N mg/I Ni - Nickel mg/I
NO3 as N mg/I Pb - Lead f V mg/I
Phosphorus: Total as P mg/I Zn - Zinc mg/I
AI - Aluminum rng/I Pesticides/Herbicides (Specify Compounds)
Ba - Barium mg/I ug/l
Ca - Calcium mg/i . ug/I
Cd - Cadmium rig/I ug/l
Chromium: Total g/I Other (Specify) ug/I
Cu - Copper _ .. mg/I ug/I
Fe - Iron mg/I ug/I
Hg - Mercury VI ug/I
K - Potassium mg/I ug/I
Mg - Magnesium mg/I ugli
Mn - Manganese t'*._ mg/I
Na - Sodium mg/1
S TRUE AND ACCURATE,.
TTEE (OR AUTHORIZED AGENT''*)
Note:
Values should reflect total concentrations
* See back for instructions.
**Submit blue and green copies to address above.

Environmental Management Division
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
Well Depth 3.1 Ft.
Well Diameter a)."
Sample (Screened) Interval A1 Ft To C. 't Ft.
Depth to Water Level 1?, ft. below measuring
point. (before sampling)
Measuring point is 14,3 feet above land surface
Gallons of water pumped bailed
Field Analysis: pH Z 1
Date Sample Collected 0
Laboratory Name
COD mg/l
Conform: MF Fecal / 100ml
Coliform: MF Total /lQ©ml
Dissolved Solids: Total mg/I
pH (when analyzed) units
mg/I
Chloride mg/I
Arsenic mg/I
Grease and Oils mg/I
Hardness: Total mg/I
Phenol mg/I
Sulfate mg/I
Specific Conductance uMhos
mg/I
TKN as N mg/I
TOC
COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Location
Well Identification Number
Total Ammonia(NH3 t NH 4)
E OF PER
before sampling `�--df`
County 0 -. \1 1._ N1,1
Permit Number: t 211V'
cA
Non -Discharge
NPDES ,.
Water Use
Injection Well
Well Construction
Other . LAN�t►--
Specific Conductance uMhos Temp. A4 oC Odor NCR ,. Appearance IV1i,v00.
8 Date Lab Sample Analyzed
A"►2e1}Pti2,-t=C. Certification No. 9 Z
NO2 as N _ mg/I Ni - Nickel _.. ._
NO3 as N mg/I Ph - Lead
Phosphorus: Total as P mg/I Zn - Zinc mg/I
Al - Aluminum mg/I Pesticides/Herbicides (Specify Compounds)
Ba - Barium mg/I ug/I
Ca - Calcium mg/I ug/I
mg/I
mg/I
Cd - Cadmium mg/I ug/I
Chromium: Total ,mg/I Other (Specify) ug/I
Cu - Copper mg/I ug/1
Fe - Iron mg/I ug/I
Hg - Mercury mg/I ug/I
K - Potassium mg/l ug/I
Mg .. Magnesium mg/I ug/I
Mn - Manganese E mg/I
Na - Sodium mg/I
REPORT IS TRUE AND ACCURATE.
AUTHORIZED AGENT*)
Note:
Values should reflect total concentrations
* See back tor
instst:4,.tl its
** Scbrrot bILe d green comet, 8o address above.

COMPLIANCE MONtTORtNG
REPORT FORM
Fac
y Name
Address
Well Location
Well Identification Number
Well Diameter
(Sere
n
I~rtvlronmental Managemerit Division
Groundwater Section
P.O. Box 27687
Raleigh.N.C. 27611
(91 9)733-5R83
Well Depth
d) Interval Ft. To_=
Depth to Water Level I4.. ft. below measuring point.(bef
Measuring point is feet above land surface
Gallons of water pumped bailed before sampling rl(Ilk‘\
Field Analysis: pH Specific Conductance
Date Sample Collected
Laboratory Name
COD .
Coliform: MF Fecal
ttA�l � tt
mg/1
/ 1OOml
C©liform: MF Total /'100ml
Dissolved Solids: Total - mg/I
pH (when analyzed) units
Q�.
TOC
A't°: mg/I
Chloride mg/I
Arsenic mg/l
Grease and Oils mg/I
Hardness: Total _ -_ _ _ mg/I
Phenol _mg/I
Sulfate mg/I
uMhos
Total Ammonia(NH3 t NH 4) . mg/I
TKN as Nmg/l
I CERT&fit' f a l CIS IE;PI FIT IS TRI
Specific Conductance
re sam
F t.
,Ft.
ing )
uMhos Temp.
County
Permit Numbe
Non-Disch
NPDES
Water Use
Injection W
Well Construction
Other ,_ 1-44tekTri
Date Lab Sample Analyzed
Certllicatct No.
NO2 as N . �. mg/
NO3 as N
Phosphorus Total as P
Al - Aluminum
Ba - Barium
Ca - Calcium
Cd _ Cadmium
Chromium: Total
Cu - Copper
Fe - iron
Hg - Mercury
K - Potassium.
Mg - Magnesium .._. r
Mn - Manganese,
Na Sodium
AND ACCURATE.,
SIGNAT PERMITTEL (OH AUTHQEIILD ACCENT *
Pled 7
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
rrtg/I
mg/I
mg/I
mg/1
mg/I
Ni «. Nickel
Pb - Lead
Zn Zinc .. mg/l
Pesticides/Herbicides (Specify Compounds)
... _._ ug/I
ug/I
ug/1
ug/1
er (Sp
cify)
sh, uld reflect total conce
lens
dress above,

COMPLIANCE MONITORING
REPORT FORM
IfY
Fa Name
Address
a
Environmental Management Di
Groundwater Section
P,O, Box 27687
Raleigh,N.C. 27e 11
[phone]
Well Identification Number 1.
Well Diameter
Depth to Water Level „ .?
Measuring point is feet
Gallons of water pumped baffle
Field Analysis: pH
Date Sample Collected
Laboratory Name
COO
Conform: MF Fecal .,.. / 100ml
Coliform: MF Total / 100mr
Dissolved Solids: Total,, mg/I
pH (when analyzed) units
mg/I
Sample (Screened) Interval
T O C P`r-c,s;,4k_
Chloride.
Arsenic
Grease and Oils
Hardness: Total
Phenol
Sulfate
Specific Conductance ,
Total Ammonia(NH3 t NH
T K N as N
SIGNATM°'; E
GW-59 Revised 7/
mg/I
mg/I
uMhos
mg/I
_ mg/I
County ,._.\
Permit Number:
Non -Discharge --
NPDES
Water Use
Injection Wel
Well Construction
Other
Odor
No.
Ni - Nickel
mg/1 Pb - Lead
Appearance, C:.11.aw
P mg/i Zn - Zinc mg/I
mg/l Pesticides/Herbicides (Specify Compounds)
mg/I ug/I
mg/I ug/1
mg/I , _ug/I
mg/I then (Speclfy ug/I
mg/1 tact
mg/I 0+4
mg/I .. ug/I
mg/I ug/I
mg/Iug/I
mg/I
mg/I
Wel Depth
Ft.
Ft,
Ft.
ft. below measuring point. (before sampiing)
bove Land surface
sampling.
Conductance
rng/I
mg/I
ab Sample Analyzed
ion
NO2 as N mg/I
NO 3 as N
Phosphorus: Total as
Al - Aluminum
Ba - Barium
Ca - Calcium ,.
Cd Cadmium,_.
Chromium: Total
mg/I Cu - Copper
mg/I Fe - Iron
Hg - Mercury
K - Potassium
Mg - Magnesium_.
Mn - Manganese.
Na - Sodium
EPOBT IS TRUE AND ACCURATE.
Note:
Values sh )uld. renect
* S e back lot
* utA4rFpt t A ry

tER1.L tk
tts, s t , Rt40, 3t C, WiRO,.
k4irlstrr k"
t(:d no tTt 4ti'
COL..EµCTOR(S)o
HELD ANALYSES
PH40(1 Spec'
rrrtp.,10
C.
LABORATORY ANA YSES
AIM. ,3t n t rrr r1Wi
AIKa��1pP5 t4a
'el Ct,on 445
eir
4 vtk7
her
N533
b� 3
2'S°C
N.C. °)I'PAR ENT Of NATURAL R S
COMMUNITY ITY LOPM NI
D
C;1 R O WAVATER`
Phan., i5 ;32
N 610
I. A
Tjl t tTEIRGVNQY
tt Pink
P aR 6t c3.tp
Cheaaspphaae ha��xre Pesti
Aci
0A battle)
ikho
MB 8ATE
d dry r° .-' rtrtr: Gta
Other
OATS - TAB Y
, T t: t: hORT C),
A I °r , Ire0
�tirnp? n9
7e42 iFg."t ..
tvr a v `> trr00 u4,1
ml
hi
re ?a y t b

C 00 N T Y
QUAD NO
LAT,
Rctport to.
WSRO, Kinston F0
pped .by; Bus
GOLLECTCJR(S);
FIELD ANALYSES
Trolnp.ip
4NO
CVte
Spec. Cond
oC
Odo
WaRO, WiRO,
G i lrifJNI1 V DOVE' 1,, ENT,
DEM
GROU9 fi WATER 'FIEL:D]L,AB FORM
SAMPLE PIORtTY
.,F C71 1' R G E N CTY
Lt3 PitM�EtT —�
(`7ATE REC"E1V,P
"Fibs:"d by Front: Rug Cttlrtar`„
,Other o•
DATA "NTRY BY
DAIIv REPORTED:
DATE , TIME. PURPOSE". F3ASFLINL, COMPLAIN" UST, OTHER
(biroI�
_ at 259C
Appearance— Taste
Field Analysis
LABORATORY ANALYSES
4
13 41304
teatSn111+ Ta pH 4 410
ApH 8„3 4-15
ert a 1e#e 44,
F3s4e rkrollns,t8 440
Arse•r'it1 i s1'4 SCiti3
t4rk r 1s4i z 405
"1wt4nP3az 940
Lab Cornrnen
owner ,
L0c 1iot1 of site
Description:. of sarnpatn.cg point
,Sampling Method
t1U04ide 931
Hardnesxi,1`r4t0I 900
sl.lflstry➢902
Pher,014 32730
S[ S1l? to n41
NH3 er4
54 Revised 7/8.5
NO3 4R
d Ana
Flea dr tt
^ Silver 1077
_Sample interval
AI Alternu nilrn 1103
K - P3,145 rrslurn 937
Ni
47

DATE
Owner
'4QPART HEMTU At .'� NUM
,
& COMMUNITY DEVELOPM NT T ATE IlECL. 9t, C) o Time
Tl "a by: TT BL:-
GROUNDNALATER FIELD IAB��--
SAMPLE PRIO Ty DATA EN`NTRY BY. t<
fOUTtNF 0 L,LNCEY DATE REPORTED;:. _ T.
S e�
`ttT. f�tJRfi t��.R; EA�t"1 6T.'E CEET�'LAtNT. t2!�fd{,,,,L1JETTu OTFiFR -,. -...
wWr.°Treff en
t E°C LO ati 0n or Si
gnO
()LINTY
QUAD NO.
LAT.
Report to
WSRO, Ktnslor
Shipped b
COLLECTOR(
FIELD ANA
y
AL NO,
4RO, RRO, WaRO, WI O,
ti thee
Odor
Taste
LABORATOpY ANALYSES
504
Turbid a `t NTU
4a2 unb
Asktiwft ta.ta 4
Al k
445
440
Arc.Tci'9a+.E" I002
Oarerre dtoxi e 405
erOoride 940
Chrurni lm rlex
Geed rye ?2:0
4'
tart le aytd
y " R agt
TuPI rig
ABGr' HAt

COUNTY.
QUAD NO,
LAT
'n: tdn
Ohl ed by: tau:
COLLECTOE Si
FIELD ANALY
:F1400 Spec, t Crtd,44
TernpP.11`) oG
Ft 0, 1 tt0,, Ri 0> WuRCt W RO
F` itr
s, C rier, O er
DATE
Odor
Appearance— ... Taste
[€ 1d Analy eus By: _ . ..
LABORATORY ANALYSES
8005 310
4
N C E LPART ENT F'NA AL R' # C LAB:NUMBF , ,h
UAL N mo w COMMUNITY 'Y DEVELOPMENT GATE RECEIVED .,, T
LONG,tirr C I Reed b FraTrs, thus-tw`'ourier
GR .} Nt"'WATER FIELDit AB FORM t h r
SAMPLE PRIORITY DATA ENTRY BY: OK:
OUTM 0 E t'EN EI Y DATE REPORTED.
TIME'
PURPOSE: RA;E LiFiE Cf ttPLAtt T, 0MPLIANC Lx1..
Owner
LoC3 ion or site
Lrt trr ,TtjtiD, G t d prltaTt
hod
Cpu rn p
(pumpin tirr , atr temp„ etc.)
Hardnes:Teta1� :r
HardnessCnon`c
/155rn1.,; Phanats 3272O
m9It
y 76 N T C1
P.
mg/I
Specific: Corm, :95
SUIfi814 945
hit
44
Tkhi as
2
NO2 + N0;j as N t30
Pal€Jte➢ as p d55
L'nts;
Sample Interval
harps Peatac,idea

T l�f1�l Y r � ���� '� ARTM NATURAL ESOU': LAB NI�IEI;`E
CAD NO.i 1 A1. NO COCOMMUNITY DEVELOPMENT GATE RECEIVEI /Time
... w
,LAtl EReed y uT1Couv rie
CRO NDWATER FIELD/LAB FORM Other
Report ICY Alt I , MRO,, tti t, ;aRO 1 C,
�n.SAMPLE PRIORITY DATA ENTRY BY: GK...
ENSUE), K1nulon
...., `6UTINE 0 EMERGENCY DATE E TE
Sh'Ipped .by: N ,, ourli,Cri ,tt3 t w
CCLLEGT0R(S7:. DATE . Tif�9E a
DATE rF,fn.�7 :'���'`� a't� s,- . �: C�', t'tit�t'C7SE; �A3EL:II+IE, 3:i4tt�C Ai1°dT� �iV6Li,�R^J1�E„ �I.tl:Sx" CIfR-lEf3
(circle
FIELD ANALYSES
40 and ._ ui oC z c uttrrn or site , ..
Tempo, Ed e cri- Lion tsi salttpiin
i1�—= - _ - - p g p
Appearance ..e ..- I` tte Sx tliplirt Meth-od
[put
s, Sarnple interval
Field d?;nahysi By: ._. - .. .- .. - � _ Yri�ries
LABORATORY RY ANALYSES
140Y)5 310 to tt 1ss. 3ralid,
340
r1814 ray i mgfl
316'8b Jti71Tr+ P Hardnays (non,eb.arb$ 902
"04
Turbidity 76 NTU
PH 4
TAI¢�a1
4,5 .41.
units
Alka71 n`¢y IC3 1Pt 5. - 4
t. aduortlute 445
440
A rSOT
C-©l ur,
Cya nl. d o
nnla 3c7;9i7 u
Sutn 74
ug/l 1K15
P1-t
rnp7
NO24NO3 us to
d Analysis
H'eal1quaarte
4
41 - Aluminum
u:
Na "otsu
N
4
4
42
um U a:
d 1051
47
aPP etc,).
t8
rrpi 'andTt t in btt
I2 •, tar ron Y eI ow opy, t

NORTH CAROLINA DEPARTMENT OF NATURAL R1 ICES AND COMMLINITV DEVELOPMENT
DIVISION OF EN'VIROMMENTAL MANAGE'k,..,w , GROUNDWATER SECTION
P.o, BOX 27687 - RAL,EIGF1,N.C, 27611, PHONE (61e) 733-5Q83
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR
DRILLER REGISTRATION NUMBER
Quad. No. Serial No. 374
Last, 31 '. Long.2 ZhiltPc
Minor Basin
in Code
Header Ent, t l" -1 Ent.
TATE WELL CONSTRU
PERMIT NUMBER:
t. WELL LOCATION: (Show sketch of the location below)
Nearest Town;
(Road, Community,
City or Town
3. DATE DRILLED /AO /47
4. TOTAL DEPTH _I/ _ CUTTINGS COLLECTED 0 Yes
5. DOES WELL REPLACE EXISTING WELL? El Yes S No
6. STATIC WATER LEVEL;. �� FT, ® above TOP OF CASING,
a below
TOP OF CASING LS ��.�.�.L_ _ FT. ABOVE LAND SURFACE.
7. YIELD (gpnn)-
8. WATER ZONES tdepthi):
9. CHLORINATION:
10, C A. S'i N (�
Depth
T o _ - F t,.
To F t..
To.. -Et.
11,(ROIJT
To,
12, SCREEN:
Ft.
Depth
From _ d .._...__ To F 1
. Ta.. From ____ To_ ._, Ft.
13, GRAVEL PACK:
From
From To
14. REMARKS:
Depth
To / Ft.
METHOD OF TEST
Amount
�y{al Thickness
Diameter or Weight/
Size
2,No
Method
Material
County: _
Depth
DRILLING LOG
From To Formation Description
I ddi
LOCATION SKET
(Shoav , rect:on Ind distance from at� "? t D Slate Roads,(4
or Oth^ rrsa r&ecence pconl . 7
,g- J /
t DO HEREBY CERTIFY THAT THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15 NCAC 2C, WELL CONSTRUCTION
STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER,
4
SIGNATURE of CONTRACTOR OR AGENT ;LATE
Submit ©riginat to Division ut Environmental Management andl copy to well owner,.

e« ee
o,aunchecked
o are shown
DAND eaMAECNORTH
`ION za-TER w aez
SCALE £24
:O&TOUR mi
NTNAT(gnU«
FEET
)wum or as
THIS MAP COMPLIES WITH NA «,# yarACCURACY StANOARDS
m R SALE BY C SGEOLOGICAL SURVEY, RESTON, vR? yA 22092
A FOLDER DESCRIBING TOPOGRAPHIC MAPS AND SYMBOLS mAVAILABLE ONRmaa
dEADPAN

COO IPITI
DATE SP1PEEf
NITY, Tt H
HiC FBONAT
MINI DE
DISSOLVED SO
NESS, NON -CARBONATE

D T S, "IPEEr?
N'IT AMA
NITF X E
ORGANIC SCAN
PHOSPHU
SEUM
SII�E
S+ DI UN
SECIFIC
SULFATE
ZINC

Cou•
Aluminum 4 0 0
Arsenic
Bicarbonate
Cadmi urn
Calcium
Carbonate
on aced Hydrocarbon
Chroxavalent
Ch romi um, Total
Coliform, Fecal
orm, Total
Cyan i de
dissolved Solids
uo ri de
ardness as CaCO
Magnesium
Manganese
Mercury

TE A.'SPLE
7
,. 1a O . 0
Nitrogen, Keldahl €.
ate & N
O i c Scan
Phenol s
Phosphorus, Total

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Location
Well Identification Number
Well Diameter
Depth to Water L
Measuring point
Gallons of water pumped
Field Analysis: pH C.
Date Sample C©liected
Laboratory Name
CDD..
Coliformw MF Fecal
Coliform: MF Total
Dissolved Solids: Total
pH (when analyzed)
TOCr.
Chloride
Arsenic
Grease and Oils
Hardness; Total
Phenol
Sulfate
Specific Conductance _
Total Ammonia(NH3 t NH 4)
TKN as N
I CERTIFYTHAT THIs REPOR1
/100ml NO3 as N
Environmental Management Di
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
Sample (Screened) Interval
tt. below measuring point. (before sampling)
above land surface
d before sampling
Specific nc
Depth
Ft. To
Date Lab
uMho
Sample
Ft.
Ft,
Temp,
Analyzed
Certification No.
iaion
County
Permit Number:
Non -Discharge
NPDES
Water Use ...
Injection Weli
Well Construction
Other
mg/I NO2 as N mg/I
mg/I
/lO0m1 Phosphorus Total as P mg/I
trig/I Al - Aluminum mg/I
units Be - Barium , . e� mg/I
mg/1 Ca - Calcium mg/I
mg/I Cd Cadmium__ _v_ mg/I
mg/I Chromium: Total
mg/I Cu - Copper mg/I
mg/I Fe -, Iron mg/I
mg/l Hg - Mercury mg/I
mg/l K - Potassium .,.. mg/I
uMhos Mg - Magnesium mg/I
mg/I Mn - Manganese mg/1
mg/l Na ,. Sodium mg/I
S TRUE AND ACCURATE.
TTEE (OR AUTHORIZED AGENT*)
Odor
Appearance
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Pesticides/Herbicides (Specify Compounds)
C) th.e
rN
Values she
d reflect total conct n
See bal* tear i;'Psta'
•Subtelt blue an
Boll
ug/I
ug/I
ug/I
ug/I
ug/1
_ug/I
�ug/I
erg /I
ug/I
ns

COMPLIANCE 14 ON1TORING
REPORT FOR
Facility Name
Address
Location
Well Identification Number
Well Diameter'_
Depth to Water Level .. . ,
Measuring point is
Gallons of water pumped bailed
Field Analysis: pH 14 ' ^1 Specific Conductance
Date Sample Collected
Laboratory Name
COD
Coliformv MF Fecal
Coliform: MF Total
Dissolved Solids: Total
pH (when analyzed)
TOC
Chloride
Arsenic
Grease and Oils
Hardness: Total.��
Phenol
Sulfate
fnvlron
rental Management Divisl to
groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
I Depth t ._ .Ft.
e (Screened) Interval 21 Ft.
-.... Ita below measurin
feet above land surface
before sampling
/1OOml
/100rnl
mg/I
units
mg/I
mg/I
�mg/I
mg/t
mg/I
.mg/I
mg/I
Specific Conductance-,uMhos
Total Ammonia(NH3 t NH 4) w mg/I
TKN as N mg/I
point. (before sampling)
uMhos Temp,
Date Lab Sample Analyzed
County
Permit Number:. 4-.O L
Non-Dischare
NPDES
Water Use
Injection We
Welt Construe
Other ,
ion
NO2 as N mg/I
NO3 as N msg/I
Phosphorus: Total as P mg/I
Al - Aluminum ritg/I
Ba - Barium_ . k mg/I
Ca - Calcium rng/I
Cd - Cadmium mg/I
Chromium: Total. mg/I
Cu - Copper mg/l
Fe Iron
Hg - Mercury
K - Potassium
Mg - Magnesium
Mn _ Manganese
Na - Sodium
HIS REPORT IS TRUE AND ACCURATE.
AUTHORIZED AGENT*)
mg/I
mg/I
mg/I
mg/I
Odor
No,
Ni - Nickel mg/I
Pb - Lead
Zn - Zinc mg/l
Pesticides/Herbicides (Specify Compounds)
Other '(Specify)
Note:
Value hou1d reflect total concen
* See b8ek or e; ^,fret ns
ug/I
ug/I
ug/I
ug/I
ug/l
ti ... ug/I
4eubmi1 'd4ue a+'td gr`ti

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Location
Well Identification Numbe
Well Diameter ,t .� e (Screened) Interval
Depth to Water Level ; ft below measuring point. (before sampling)
Measuring point is 2 feet above land surface
Gallons of water pumped bailed before sampling
FieldAnalysts: pH
Date Sample CoClected
Laboratory Name
COD mg/I
Conform: MF Fecal ._ , . / 1OOml
Conform: MF Total /10Oml
Dissolved Solids: Total ° mg/I
pH (when analyzed) units
TOC ti mg/I
Chloride mg/I
Arsenic mg/I
Grease and Gibs mg/I
Hardness: Total mg;/l
Phenol mg/I
mg/1
Specific Conductance uMhos
mg/I
mg/I
Ertvironmental Management Division
Groundwater Section.
P.O. Box 27687
Raleigh,N.C, 27611
[phone]
Sulfate
GPAtS
Total Ammonia(NH3 t NH4
TKN as N
CERT
GW'-59 Peat d
Specific Conductance uMhos Temp.
.? 'fit. i' Date Lab Sample Analyzed
County
Permit Number:
Non -Mischa
NPDES
Water Use
Injection Well
Well Construction°
Other
C Odor NO
Appearance
Certltication No. c'
NO2 as N mg/I
NO3 as N mg/I.
Phosphorus: Total as P mg/I
Al - Aluminum. mg/I
Ba - Barium mg/I
Ca - Calcium mg/I
Cd - Cadmium ��,� „ mg/I
Chromium: Total __. _ _. mg/I
Cu - Copper mg/I
Fe - Iron mg/I
Fig - Mercury
K Potassium_
Mg - Magnesium
Mn - Manganese,.
Na - Sodium
THIS REPORT IS TRUE AND ACCURATE,
F PERMITTLE OR AUTHORIZED AGENT'k) /DA="TE
mg/I
mg/I
mg/I
mg/I
mg/I
Ni - Nickel
Pb - Lead
Zn Zinc
mg/I
Pesticides/Herbicides (Specify Co
Note;
Values should raft
a. See back tor s ast'rracti
total concentration
* * Submit blue and re en copies to f(Id

COMPLIANCE MONITORING
REPORT FORM
ri.
Facility Name
Address
Well Location
Well Identification Number fell Depth
Well Diameter
Sample (Screened) Interval Ft. To
Environmental Manageft+srtt Ili
Groundwater Section
P.Q. Box 2768`'
Raleigh,N.C. 27611
[phone]
Depth to Water Level
1. below measuring point, (before
Measuring point is feet above and surface
Gallons of water pumped/balled before sampling
Field Analysis: pH
Date Sample Collected
Laboratory Name
COD
Colifor
MF Fecal
Coliform: MF Total
Dissolved Solids: Total
pH (when ;analyzed)
TOC
Specific
i
Ft.
Ft.
ng )
It ton
County
Permit Number:
Non -Disc
NPDES
Water Use
Injection Welt
Well Construction
Other :1\A
Conductance uMhos Temp, ,x C Odor
Date Lab Sample Analyzed
mg/I
/ l©0ml
-/tOQml
mg/I
units
mg/I
Chloride mg/I
Arsenic mg/I
Grease and Oils rng/t
Phenol mg/I
Hardness: Total
mg/I
Sulfate _ mg/I
Specific Conductance uMhos
Total Amn ia(NH3 t NH . mg/t
T K N as N _.. rrm g /I
Efl,4FY THAT T
.w, . E OF
d 3/88
. 1.% Certification No„
NO2 as N ..... ti mg/I Ni - Nickel _ mg/I
NO 3 as N.._ ..._.. _ mg/'I Pb - Lead D4" mg/1
Phosphorus: Total as P ..mg/I Zn Zinc _ mg./I
A - Aluminum mg/I Pesticides/Herbicides (Specify iC antpounds)
Ba - Barium mg/I ug/I
Ca - Calcium mg/I ug/I
Cd Cadmium mg/I ug/t
Chromium: Total .__mg/1 Other IS ►ecify) ug/I
Cu - Copper - mg/f ug/I
Fe - iron
rrrg/1 � � ° ugfl
Hg - Mercury ug/I
K - Potassium g/1 ug/I
Mg , Magnesium rng/l ug/I
Appearance .. ;
Mn - Manganese mg/I
Na - Sodium mg/I
S.R_PORT IS TRUE AND ACCURATE.
EE (OR AUTHORIZED AGENT*)
Note:
Values should reflect total concentrations
Illitsuctiont
** Submit blue and green cables only to address above.
Wws

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Location
Well Identification Number
Well Diameter
Sa
Depth to Water Level
Measuring point is g
Gallons of water pumped
bailed before sampling
Environmental Management Division
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
Depth ��... Ft.
(Screened) Interval Ft. To Ft.
ft, below measuring point, (before sampling
feet above land surface
43.16
Co
Permit Number;
Non -Discharge
NPDES
Water Use LOA}.
Injection Well
Well Construction
Othera,
Field Analysis: pH '' ,6gv Specific Conductance ullt is Temp. ,,. oC Odor Appearance
Date Sample Collected .I4-r d '3))„I .` Date Lab Sample Analyzed MAO-C.14 3
Laboratory Name .k L C 1.1.)t PCB r
COD.
Coliform: MF Fecal
Coliform: MF Total
Dissolved Solids: Total
pH (when analyzed)
TOC
CertificationNo.
rng/I NO2 as N mg/1
/ 100mi NO3 as N mg/1
/ lOOml Phosphorus: Total as P mg/I
mg/I AI - Aluminum mg/t
units Ba - Barium , mg/1
mg/I Ca - Calcium mg/I
Chloride f mg/I Cd - Cadmium mg/I
Arsenic mg/I Chromium: Total mg/1
Grease and Oils mg/1 Cu - Copper mg/I
Hardness: Total mg/I Fe - Iron mg/1
Phenol mg/I Hg - Mercury g/1
Sulfate mg/I K - Potassium _ mg/I
Specific Conductance - uMhos Mg - Magnesium mg/I
Mn - Manganese . mg/I
Na - Sodium mg/I
T IS TRUE AND ACCURATE.
Total Ammonia(NH3 t NH 4) . mg/I
TKN as N mg/I
I CERTIFY,-T1W T
RE
2ftjalgthE
Submit blue
Ni - Nickel . mg/I
Pb - Lead ,.mg/1
Zn - Zinc , ._ _.,. mg/I
Pesticides/Herbdes (Specify Compounds)
ug/l
ug/I
ug/I
Gtttet (Specify) ug/I
ug/I
ug/I
ug/I
ug/I
Note:
Values should reflect total concen
only to address above.

COUNTY
OUAD NO
LAT.
feporl
WSA°, Kurtistcr7
Shio©ed by;
COLLECTOR('):
FIELD ANALYSES
Field Analysis;
Lk)
SERI AL
LONG.
MRC, PRO, WaRO, W'IRO.
N.0 )[PARTMEN t OE NATURAL RESOL
& COMMUNITY DEVELOPMENT'
DEM
GROUND
A13 FORM
PLE PRIORITY
EMERGENCY I
LAE3 NUMBER t —
)ATE RECEIVED
Rec"d by.
Other
DATA ENTRY 3Y; ,
),ATE RF,P0RTEDurs tl
TIME PURPOSE. BASELINE. L, r,IPLAI13T°;, COGPL.I \;ar.r, ,ru4_1..LY. , 0THu' e=
(giro .k
/ rl
Owner .,tea r .,-E � �a � ". _�: `^�� � ,� �.r �lrE T y'�; /I,
1.7F"4 Ct CJ - . Spec. i..F o~ Est .. .�..�.... l L' 0 Location or
nip. 10 ...-- C Odor _ Descr
Appearance Taste Sampl}no tv
Remarks
DATE
LABORATORY ANALYSES
i COD low 3.75
T sr
TOC 680
7ur©3aioy T7t, nT$
Alk.�aii ally
Alkali
BicarUovate 44
A
• Carbon dh rr1e
Chloride 940
G
yenlde 720
Lab C©mrmersts
rT
7
What -cars) 3r32
mp/I
Phenols 32730
745
NH3 as N 610
TKI4 as N 625
NO NO 77 N 6
d A
w It
Aq = 9llvaa, 1077
Alum ,um 1 7©5
73a - Barium 1007
GO Cadmium 1027 c
1034 .�
a
01
y
K-Pal4SSiun, 33
axp - Mapneseum 92'7
Manganese 1655
Na - 'Sotllum 929
77 - Nicket 1067
„$0 - Seler'aa7 rm t 747
2n Zinc to”
upn
54 Revised
Y
YeUoww cony ab

°LINT
QUAD N
LAT,,
Report
WSRO, Kinr
Shipped by: Bus, (uu
(;:OLLEGTOR(S):
I.C. .PART1;
AL NO, COM
ARO, ERdv), RO, RHO, 4rt RO, WIRO„
�t l Other .:.
HELD ANALYSES
pH4(J(aSpet. Gand,94
Tempi to Ci Odo
Appearance
p-eid Anaiysi
LABORATORY ANALYSE
COD "cii'uh 34
C7.00:Low C3
Col lOrrri.Mk`
SIT OE NATURAL RESOURCES
UNITY DEVELOPMENT
0
GROUNDWATER FIE::).LAB FORM
A IPLE P 'I /TY
0 ROUTINE E tEEC(JEEaC
Owner
ks
C aA`l-toinkAt Tarat .564 27�3(
445
440
.Aruecic;T
4i31'",.....
orATrue o.3
Cyanide 720
Lab Com
T4J. $ij 30;4 4
unt
LAB NUMBER
DATE RECEIVED, "" Time :)
by r. ° . From' Bus -Courier
DATA ENTRY BY:
DATE :REPORTED:
BASELINE, COMPLAINT, COMPLIANCE,
(circle one)
Al At l "B5dri�d
CE T i-i w R
(pumping tirrr air t mp, etc.)
i._Ortienacnlar+rne Pestic1A*u
Acid
VOA bottil
odd, ;;T$ -.
NO2* 403 au N 630

it onel
COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Loca
Well Identification Number Well Depth .?1., . Ft.
Well Diameter err ie (Screened) fnterval 1 Ft, To .- 1 Ft.
Depth to Water Level fl, below measuring point. (before sampling)
Measuring point is I feet above fend surface ,,
Gallons of water pumped bailed before sarnplini_
Field Analysis: pH 6:7 Specific Conduc
Environmental Management Division
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
I
Date Sample Collected
Laboratory Name .+rNfA
COD mg/I
Califorrn; MF Fecal / 1OOm1
/ t OOml
mg/I
Cotiforrn: MF Total
Dissolved Solids: Total
pH (when analyzed)
TOC
Chloride
4.0
mg/I
mg/I
Arsenic mg/I
Grease and Oils mg/I
Hardness: Total mg/1
Phenol mg/I
Sulfate u mg/1
Specific Conductance ,uMhos
Total Ammonia(NH3 t f f mg/1
TKN as N mg/I
County
Permit Numbe
Non -Discharge . ,
NPDES
Water Use
Injection Well
Well Construction
Other
Temp. 4 c ° C Odor
ab Sample Analyzed
Certification No.
mg/I
mg/1
Phosphorus: Total as P mg/I
Al - Aluminum mg/I
units Ba - Barium W mg/I
_mg/I
mg/1
_mg/I
.�, .. mg/l
mg/1
g/I
mg/1
NO2 as N
NO3 as N.
Ca - Calcium
Cd Cadmium
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury
K - Potassium
Mg - Magnesium ,.
Mn _ Manganese
Na - Sodium
ERTIFY TAT THtSe 3EPORT IS TRUE AND ACCURATE.
RMJTTEE (OR AUTHORIZED AGENT*)
vised 3/88
mg/1
App a aranc
Ni Nickel _ . l mg/1
Pb . Lead mg/1
Zn - Zinc mSi/I
Pesticides/Herbicides CSpec ty Cort`tponds)
ug/1
ug/l
Other (Specify) .. ug/I
ug /I
ug ll
ug/I
..ug/f
ug/I
rcte•
Values should reflect tc►talcrs►centrattons

COMPLIANCE "MONITORING
REPORT FORM
Facility Name
Address
Well Location
Well Identification Number
Well Diameter
Depth to Water Level .K
Measuring point is
Sample (Screened)
ft. below me
above land surface
Environmental Management Division
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
Well Depth
�.. Ft. To
urine point. (before
Ft,
Ft.
mphng )
Gallons of water pumped bailed before sameting
Field Analysis.. pH 1=t Specido Conductan
e Sample Collected inAIRC_.iA ..
Laboratory Name
CO ,,. ,
NO2
CoMot : MF Fecal ../1OOm1 NO
Conform: MF Total
Dissolved Solids: Total
pH (wen analyzed) ...-
TOC
Chloride.
Arsenic
Grease and Oils
Hardness: Total
Phenol
Sulfate
Specific Conductance �.
Total Ammonia(NH3 e NH
TKN as N.. �.
/100ml
s N,
Phosphorus: Total
mg/I Al Aluminum
units Sa - Barium
mg/t
mg/1
mg/I
mg/I
mg/I
_mg/I
mg/I
uMhos
mg/l
rng/I
EPORT IS TR
Ca - Calcium.
Cd - Cadmium_
Chromium: Total
Cu — Copper
Fe - Iron
Hg - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese, i tl1`If
Na - Sodium
w` AND ACCURATE,
OR Ai.,tTHHORIZEU AGENT*)
Temp..
Analyzed
County
Permit Nu r fiber:
Non Discharge
NPDES t O±
Water Use
Injection Well
Well Construction
Other
OdorAppearance
Certification No.
mg/I Ni Nickel
mg/I Ph - Lead t. atk/t
P mg/l Zn - Zinc mg/1
des (Specify Co pounds)
ug ✓1.
Pesticides/Herbi
mg/f
mg/I
rrrg/l
mg/I
mg/1
mg/1
mg/l
mg/I
SCE back t"s:rr
iubmit hlu u
1ruc
IC
g /1
ug/I
u'g /1
ua
/

0U•P,JTY
QUAD NO,
LAT,
Report t© R a FAT),
WWSRO, Kir'r Trt FO
Shipped by: Bus
COLI.EOTOR(S)DATE
FIELD ANALYSES
pH4Up Spec. Conc,,4
Appeatance
T'Refet Analysis By:
a t 25°C
Taste n
LABORATORY ANALYSES
Lab Comments:
GW11-54 Revi&ed 7/ ':R
ARTMENT Of NATURAL R LAB NUM
COMMUNITY DEVELOPMENT GATE
D E M,
GROUNDWATER HELI)/LAB FORM Other
SAMPLE PRIORITY
', ROUTINE
0 EhtERCENoY
TIME
Owner
Location or site -,
OaascriptUon of sampling point
Sam9lintt Method
u q b
tptp
Remark
air temp, eats;.)
A"&A ENTRY BY.;,„ OAK:
DATE AEPQRTEL:'/°
PURPOSE* BASELIN-Ra„ COMPLAINT, IANL.t LUST, OTHER ,..
(circte
ler. s f4 rs to mQil
rear rtrre z§i repti
tKe�4rea� T to port 919/1
bare neeee ( onirar5,) ttq�' re9/I
Peeeole 9279it u©il
Specific Cond. 95 ukihes}crn7
` ui t a to 9 A to vt Jt
5ultfee '145 Su l#
Anat
Cu Copper 1042
Fe iron ieefi
y - Headqurters Pints copy - Rados Yeo copy
bn
Sas® i ?ta ia" B i:xiaae8ad fa
Acid Fxiractahle Organics

G1Y°
QUAD Np,..
LAT '7i
CReporLdotkA @ f H(J. M RO R
VV>r3o, k,",in on FC .tt�r
;,hipp o by; 8,u5, Gourior. Oth
DEPARTmENT OF NALU At SOUR
C M UNITY DEVELOPMENT
DEm
rNt)WA `tR I"I I I JI A
SAMPLE RI IIT
TINE.
CY
(A
DATA NIA? : ,:.
DAZE 13 O STET):
CCLLLC"TUFTdrle `LTR9 AsELLo OTHER
FIELD E
94
n or
ptt - _ riz _e er �t6 u f r eo,n point
App
,,Arta8y
Lab ;
440
r?�
Gp r tdd4c^ rapid Acid Exdrandot6i6
r 4 h - e�a3r i ` rx trc� 16W4
b4 .i eira dr ltt t sir DR cAved At ys u it t te'r?ci P
Wh to u i Fieadquarte r PCs ctcrpy w. R
sa.6(66 do is
d"narp®NbR dsr6dsns dVOA bnft14)
r i s+� to b1fiu
6 rtyLab

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Location
Well Identification Nu
Well Diameter
Depth to Water bevel
Measuring point is, �� #ea
Gallons of water pumped bai
Field Analysis: pH s,
Envirsnmental Management pivl-lion
Groundwater Section
P.U. Box 27687
Raleigh,N.C. 27611
[phone]
Date Sample Collepte
Laboratory Name
COD
Coliforrn: MF Fecal
Coliform: MF Total /lutaml Phosphorus: T©ta
Dissolved Solids: Total
pH (when analyzed)
TOC 4,3
Date Lab Sample Analyzed
Certifiation No,
mg/I Ni - Nickel mg/I
/ 1OOml NO3 as N mg/I Pb - Lead .� s -mg/1
Zinc mg/I
cides/l lerbicides (Specify Compounds)
ugfl
ug/1
ug/l.
_pg/I
ug/1
ug/I
ug/I
/I
ug/l
as P
mg/I Zn
mg/l Al - Aluminum mg/I Pe
units
mg/1
Chloride mg/I
Arsenic mg/I
Grease and Oils mg/I
Hardness: Total mg/I
Phenol mg /1
mg/I
Specific Conductance uMhos
Total Ammonia(NH3 t NH 4) mg/I
TKN as N rang/I
Sulfate__
II Depth
(Screened) Interval t Ft. To
below ° measuring point (before sampling ).
above land surface
d before samplingLO
`-�
Specific Conductance uMhos Temp, 1
mpl
Injection We
Well Construction
Other . At4i) �..
Odor w. Ntafil" Appearance ENT'. t .l4S*.at et
mg/I NO2 as N
I CERTIFY'
GW-59
County
Permit Number;
Non -Discharge.
NPDES
Ft Water Use
Ft.
Ba Barium rrtg:
Ca Calcium rtg/l
Cd - Cadmium mg/1
Chromium: Total mg/I ©the
Cu - Copper mg/1
Fe on mg/I
Hg - Mercury
K - Potassium.,
Mg - Magnesium
Mn - Manganese
Na - Sodium mg/I ..
REPORT IS TRUE AND ACCURATE.
OF PERMIT=
R AUTHORIZED AGENT DATE.
✓1
Note:
Vakie<s shoat t"t re
* See h tck for rstrt oll
Sukrrta triaro rt'aal ate'
pec
y)
torte
ntrtions
eddresz, above.

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Environment& Management Division
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
ikt„I'2„ t"aciei,‘
Well Location
County
Permit Number:
Et,
Non -Discharge
Well deritifscaton Number Well Depth Ft Water Use
Well Diameter
Sample (Screened) Interval -‘‘ Ft. To Ft. Injection Well
Depth to Water Level tt„ below measuring point (before sampling) Well Construction
Measuring point is feet above land surface Other
Gallons of water pumped bailed before sarnPkbg
Field Analysis pH SoecifIc Conductance
Date Sample Collected
Laboratory Name
Mhos Temp,
0
Odor Appearance
Date Lab Sam0e, Analyzed
Certification No,
COD mg/I NO2 as N mg/I Ni - Nickel mg/I
Conform: MF Fecal /100m1 NO 3 as N mg/i Pb - Lead mg/I
Conform: MF Total /100m1 Phosphorus. Total as P mg/I Zn - Zinc mg/I
Dissolved Solids: Total mg/I Al - Aluminum mg/I Pesticides/Herbicides (Specify Compounds)
pH (when analyzed) units Be - Barium mg/I ug/I
TOC mg/I Ca - Calcium mg/I ug/I
Chloride mg/1 Cd - Cadmium_ mg/l ug/I
Arsenic mgll Chromium: Total mg/I Other (Specify) ug/I
.'f',':' ,•'-
Grease and Oils mg/l Cu - Copper mg/I ug/l
Hardness: Total mg/I Fe - Iron mg/I ug/I
Phenol mg/I Hg - Mercury mg/I ug/I
Sulfate mg/I K - Potassium mg/I ug/I
Specific Conductance uMhos Mg - Magnesium mg/I ug/I
Total Ammonia(NH3 t NH4 mg/I Mn - Manganese mg/I
Note:
TKN as N mg/I Na - Sodium mg/I
Values should reflect total concentrations
I CERTIFY,THAT THIS REPORT IS TRUE AND ACCURATE.
\„......-- * See back lor instructions
i, et, /A) * * Submit blue and green copies to address above,
SIGNATURE OF PERMITTEE (OR AUTHORIZED AGENT*)
nw-s9Rv1 'i/AS
DATE

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address looy
1114G.5 NINA
Well Location
Well Identification Number Well Depth 6 Ft.
Sample (Screened) Interval 901 Ft. To .3 ) Ft.
Environmental Management Division
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27811
[phone]
rstev>
1\10Th e
Well Diameter A "
Depth to Water Leve 1bO ft. below measuring point. (before sampling)
Measuring point is 119.0 feet above land surface
Gallons of water pumped bailed before sampling (1-12—)
Field Analysis: pH 1 2. Specific Conductance uMhos Temp.
Dale Sample Collected DafoZ---lcz 13 ican Date Lab Sample Analyzed
Laboratory Name E. 111.3 . LAZorziA14.61.LA 0,1-kAikU:s11--5 N.C. Certification No. IT 92
COD mg/I
Coliform: MF Fecal /100m1
Colitorm: MF Total /100m1
Dissolved Solids: Total mg/I
pH (when analyzed) units
TOC mg/I
Chloride mg/I
Arsenic mg/I
Grease and Oils mg/I
Hardness: Total mg/1
Phenol mg/I
Sulfate mg/I
Specific Conductance uMhos
Total Ammonia(NH3 t NH 4) mg/f
TKN as N mg/I
SIGNA E PERMITTEE (
ow-59 Revise
County OA.=
Permit Number:
Non -Discharge
NPDES
Water Use
Injection Well
Well Construction
Other 1-RROF11-1--
Odor 1.001+37i Appearance P4Ut0041
NO2 as N mg/1 Ni - Nickel mg/I
NO3 as N mg/I Pb - Lead O It mg/I
Phosphorus: Total as P mg/I Zn - Zinc mg/I
Al - Aluminum mg/I Pesticides/Herbicides (Specify Compounds)
Ba - Barium mg/I ug/I
Ca - Calcium mg/. ug/I
Cd - Cadmium mg/i ug/I
Chromium: Total mg/I Other (Specify) ug/I
Cu - Copper mg/I ug/I
Fe - Iron mg/I ug/I
Hg - Mercury _Lrrig/I ug/I
K - Potassium . mg/I ug/I
Mg - Magnesium mg/l ug/I
Mn - Manganese mg/I
Na - Sodium mg/I
T IS TRUE AND ACCURATE.
R AUTHORIZED AGENT*)
Values should retlect tatat concentrations
* See back for instructions
**Subtnit blue and green copies to address above.

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Location _ t]
Environmental Management D
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
Well Identification Number
Well Diameter
Depth to Water Level
Well Depth
mple (Screened) Interval Al Ft,
Measuring point is L'. l fe
Gallons of water pumped ha
Field Analysis: pH
Date Sample Collected
Laboratory Name
To
Ft.
Ft.
ft, below measuring point. (before sampling)
above land surface
d before sampling
Specific Conductance
COD
Conform: MF Fecal
Caliform: MF Total
Dissolved Solids: Total
pH (when analyzed)
TOC
Chloride
Arsenic
Grease and Oils
Hardness: Total
Phenol �_-
Sulfate
Specific Conductance
Total Ammonia(NH3 t NH4
TKNasN.
I CERTIFY T
SIGNAT""'"'E
59 Revised 7
uMhos
Date Lab Sample
PC
/100m1
/100ml
mg/I
units
mg/1
mg/I
mg/I
mg/1
mg/I
.mg/1
mg/I
uMhos
mg/I
mg/I
PER
vision
County
Permit Number:
Non -Discharge
NPDES NC OO t
Temp.
Analyzed
Certification No,
Water Use \10
Injection Well
Well Construction
Other
NO2 as N
NO3 as N..
Phosphorus: Total as P
Al - Aluminum
Ba - Barium
Ca * Calcium ..
Cd - Cadmium
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury
K - Potassium.
Mg - Magnesium
Mn - Manganese
Na - Sodium
PORT IS TRUE AND ACCURATE,
TTEE (`R A
HOt IZF:D AGENT*)
Odor
Appearance ML Z
LIt
mg/I Ni - Nickel mg/I
rng/I Ph - Lead �L_mg/i
mg/I Zn Zinc mg/1
mq/I Pest'ic'ides/Herbic'ides (Specify Compounds)
mg/I ug/l
mg/I ug/l
mg/l _ ug/l
mg/1 Other (Specify) ug/I
mg/I ug/I
mg/I ug/I
g/I ug/I
mg/I ug/I
mg/I ug/I
mg/I
mg/1
Note:
Values should reflect total r oncentratiorus
* see back for idi tr�,x Clans
* * Sohrnif blue and omen oo ies to ddress above.

COMPLIANCE
REPORT FOR
Facility Narne
Address
Well Location
Well Identification Number
Well Diameter
Depth to Water Level
Measuring point is ,.
Gallons of water pumped b
Field Analysis: pH
Date Sample Collected
Laboratory Name
COD
CoIiform: MF Feca
Conform: MF Total
Dissolved Solids: Total
pH (when analyzed)
TOC
C'hlorid_
Arsenic
Env ronmental Management Divi ion
Groundwater Section
P.O. Box- 27687
h,N.C: 27611
733-5083
ned) Interval
1 Depth F t.
Ft To _,,��.._ Ft
below measuring point. (before sampling)
yet above and surface
lied before sampling
Specific Conductar
. r7
A
/ 100ml
/1oOml
rng/l
Grease and Oils mg/I
Hardness: Total mg/I
Phenol mg/I
mg/I
mg/f
Specific Conductance uMhos
Total Ammonia(NH3 t NH
TKN as N
Sulfate_
GW-59 Re
E OF PER
7/85
Date Lab
hos Temp.
p1e Analyzed
Certification No.
County
Permit Number
Non -Discharge
NPS
Water Use
Injection Well_
Well Construe
Other vi
mg/1 Ni Nickel
mg/I Pb - Lead 1101
P.:. mg/I Zn Zinc .
mg/1
mg/r
mg/I
mg/I
,mg/1
mg/I
mg/1
mg/I
.. �.. __ mg/I
, mg/I
mg/1
m g /l Na - Sodium _ mg/I
EPORT IS TRUE AND ACCURATE,
NO2 as N
NO3 as N
Phosphorus: Total
Al - Aluminum
units Ba - Barium
Ca Calcium
Cd - Cadmium
Chromium: Total
Cu - Copper ..._
Fe - Iron
Hg , Mercury _
I< w Potassium,
Mg - Magnesium
mg/l Mn - Manganese �..
TTEE OR AUTHORIZED AGFN1F *) (DA E
_mg/I
Pesticides/Herbicides (Specify Compounds)
ug/i
ug/I
ug/I
ug/1
l
1.1944.
lug /I
ug/1
ug /1
ues attnuWd reflect tot concentra
ns
adds"esr s b vo..

Field Anafysls:
Dale Sample Coil
abaratory Name
Cbo..
---Coliform: MF Focai
Conform: MF Total
Oissolved Solids,. Total
pH (when ana.fyzert),_ .... _-
TOO
Chloride ,.
Arsenic
Grease and oils
Hardness: Total
Phenol _ M..
Sulfate -
Specific Conductance
Total Ammonia(NH3 t NH 4)
TKN as N
Environmental Management Division
Groundwater Section
P.Q. Box 21681
Aa eigh,N.c 27611
[phone]
Ft.
iened intervat,
ft below,measuring point. (b
land- surface
re Sampling
Specific Conductance
/ 1OOml
/ 100rnf
mg/1
units
mgi
m g /I
m+g/1
mg/l
mg/I
mg/1
— mg/I,
uMhos
mg/I
mg/1
1 CIER F AT THIS REP
EOF.
:G1#1-5f f l+ wised 7/85
uMhos Temp.
Count
Permit Num
Nor Di
NILES
Water Us
Inction.4e:I1
1+'ell. Construction
Other
,charge_ .. w
ab Sample Analyzed
Certification' No
Not as .N , ��..,.� mg/f
NO as N mg/I.
Phosphorus: Total as P rz_A�_.._ . �, .. mg/1
At - .Aluminum mg/I
Ba _. Barium mg/1
Ca - Calcium ... _r. rnig/I
Cd - Cadmium mg/I,
Chromium: Total - mg/I
Cu - Copper ,� .. mg/I
Fe - Iron mg/1
Hg - Mercury �.. �. rng
Potassium. oW..... . ... trig/I
Magnesium mg/1
n - Manganese - ,_. mg/'i
Na - Sodium. mg/I
,RT IS TRUE AND ACCURATE
TTEE 0
AU-TH0RI2
AGENT*)
N1' Nicket ...,.
Pb-- Lead
Tn' - Zinc
Pesticides/Herbicides (Specify Compounds)
ug/I
..w ,,.w.., ug/I
ug/1
Note;
Values sho
See lock fiat
'1 hue

WS130,
Shipped by: tau
COLLI TOR( );
FIELD \NALY;SES
pH 400 .' . Spec. Cand, 94 a t 2'5°C tracata n or tt
Terrrp.10, °C Odor_.,,_ Description al amnG(in$T point
Appearance , s Sampling Method'
Field Analysisf3yt. Pnrnarks _ .
DATE'
TA
COMMUN
GROUNDWATER FIELD/LAB FORM
SAMPLE PRIORITY
R.O~tJTI NF "Y
LAE,ORATORY ANALYSES
COO '1.3iniv 33S
t'. onto0634 ` vocal t '8Ya ,t➢0d3 t'YF
tEfit 4rn;14f/ Total T1504 /ToOnut-
TeiTtcrrtGty 78 t1T10
pit 403
Alhal$nIW T4 %3fT 4. 4'i'C1
Alkalinity to KPH nil 415
aMonate 445'..
et<:aL nags- 440
Arayrnitt.Trvta3 1002
W-84 Rev( ed 1 85
BASELINE, COMPLA
(c
LAB NUMBER 8
DATE RECEi :.
Rec"d b
Other
DATA ENTRY BY:
DATE REPORTED:
T,... C
Owner
fariiinikastr#ktat 900
9,12
0 d A„d � t a rit *Ttt in bi+
t g Hetiat to at - t3 t t ca ea Y I t ;+ y^ v t
IACN0 a. LUST'„ OTHER
ta.bt0 or
Ptem 4Ta4 t rrt y $ti OA 0010ee)

DEPARTMENT OF NATURAL. RESOURCES'.
# « NO.( COMMUNFTY L) VE1O ML T
C
,LIELD ANALYSES
PH400 Spec.. i
Tt «
Appearance
F ib«a Analysis
y.
LAE3051,49-CiPkY ANALY ANALES
L as tit
Turbidity
44 4
AiiaA«i its t t# 4 4E
445
44,0
44 405
ae 50
4an ti 7
NO N0,3
MATE 'IVED
Roc 'Ii't «Ire ta: F
UNDW UI D/L> C F r ,
SAMPLE POfILTy DATA 4T«
[3—lieStiTINEY DATE LP) T t):
d Analy «5
Ft adquart
poi n
LA NT PEA r E«t Nx` L °«", OTHER
mP
,AG�be;4 xixkcdtIcls
Neutral Extreclabt5 OrQAnIss.
brOmbethans d?
A bm1
At - 19 s€aan 11
A -bra b�
IOy Re
1027
Yet

UNTY rr 3 PART MENT Of NATURAL
QUAD NO �SERIAL & COMMUNITY DEVELOPMENT
LAT. m SONG: DEM
R WATER rtE L JLA RM
i t acart t04 3, A t 1t : t»fi „ ' aRO,
SAMPLE PRIORITY
- Kiu skean 0 )ther
OUT INr .� Eit{ait'Y
d by: Bus 3�tsix ,
Bond
tame
c0 Analysis 3y'
xtbtikY NTU
ki 40
A}tYviiy f as 4,.
AiR FEnity to
440
or Ti
yqm€c3e "t20
Aid, NUM
.ATE RECEIVED
Ruse.
'Other
DATA ENTRY Y
DATE PORTED:
CATS 4 '; TiD i is t 1ia i F AS i tti C7 N LA NT, (COMPLt D L 't `, C�TF f R
on MJi aptiii k kq%
tx1ethod
(putYlp
puping

of N° , N.C. EPA T ENT OF NATURAL OU CES A NUM F tt
OUAD MAL NO. <.,W : COMMUNITYDEVELOPMENT DATE tTECUV ED °x Time
L, T. LONG. ,x DEM tYy, From* t -Cou
CROUN WATER L
Ftr tl it C1 «` F RO,. t�T t FFtTa a3 Tt,-:WIR g.
AMPLE P RITY ATA ENTRY BY: t :.
4�t „akansttTrt'k
OUTINE t:,MER }EN SATE EP RTE :
Shipped by.
t LLk T C CS DATE x TIME .a . PURPOSE, FTASFi.9LNE, t MP AUNT APLVANC,E OTHER
4.0
t rpare
F° id An, y
O
pee_ Gored
C7do
LCOC) Low 161#4. h4 a F,r3 �zr
{.SO4 J1C?ca¢114'" t<'h r31kH "3;^'7
C""bt3
r;6A 6� itY u3 3+i-3 3,3 415
Ar,4U
5 S'tdtaXti'r• 405,
tlhi3 4 N C ru
7KN §a- N 62:.7 ..
N© t N0hl ztt
P;?u8t§"$ sca P:6 65
d ArFaly
He
5t iraPFtn Poirot'
Sam
urri # 71i tFral , air t p,
A� 3ry r FP7 U # i� :©rp
Al - Aluminum 1105
gaca loto3 1034
r1per 1042
tY 4rt4::
ruty
Me*
1092
w4 mP an rrltF 't t " irl atout
y TT4rF4r4 t3Y4rr Yatsy r;Lrl
.tdo4

t C UNTY yT:7s t.. t. �. r%, . ; A:R TMENT NATU
QUAD NO, ry tt1A.t NO ,t3, c` 'ilwi$ JNtTY DEVEL E
LT, .„.,,,"�"�
GUNDWATLFt E A "0
Report to:A G, F �, RRO, ` aRi , ti IRO, SAMPLE PRIORITY
WSAG, Kinstot6 FO 9th
ROUTINE ANDY..'
Ud,
;TO
FIELD ANALYSES
q�-4 .Sec. -Uond.
4
Te Odor
AKrt7oaat a Tam
lon cat ;ai
hod
FiepCt Analyi ..., rrkark
4:>OO H Qh;
Alkalinity
4t5
du "7'
9,45
idBPi'eYa 745.E
Q d` ,A r a, I ys'I`A <
copy -- Headqua
Time
',t
DATA E.6 TAY BY:
DATER PORTED
t?twiPLA NT st kt FB Cd LUST', T Ht, R
np tnt i i I
air Titp„
A bOnie

TO
GROUNDWATER
Bab €W
Grata
itydrot n
`.Ol
At14titions t
. stt4
"tt� k#t
t tt ew e
't`tt. t
chn
:Quality y otzitartug..
ice,
. ` gat ne two The t
and to , sheet s
t
nib Ate t Th4 slid

WELL DATA TABULATION
Facility Name: �' )/,)
POLLUTION SOURCE MONITORING SITE
/
Pollution Source (lagoon, landfill, etc.)l,;t
Permit No:
Non -Discharge:
Well Const.:
Sampled By:
Well No.
NPDES:
DHS:
County:
Latitude:
Longitude:
Quad No:
Grout Gravel/Sand
Interval Pack
(ft-ft) Interval
(ft-ft)
Draw a diagram on the reverse side of this form showing map location of the site and the
location (direction and distance) of each well with respect to the pollution source and to
each other. Indicate sampling schedule, parameters and any changes to schedule.
GW-51
Revised 8/20/84

of ed% e.
-e
to n.c�.

rapr,
wrichecked
e shown
LTM GRID AND I973 MA N€InC NORTH
L"71`„CUNAT1OP AT CENT(
CON TOUR INTERVAL 20 FEET
NATIONAL (.;E{:JLDN To::: VERtK`AL tOA3'U:.M vI- ti.v+
THIS MAP COMPLIES WITH NATIONAL MAP ACCLIRAL:.
FOR SALE BY U. S. GEOLOGICAL SURVEY, RESTON, VIRCONIA 22092
A FOLDER DESCRIBING T©P©GRAPHIG MAPS AND SYMBOLS IS AVAfLABLC ON REQUEST

CAROUNA DEPARTMENT OF NATURAL JRCES AND COMMUNITY DEVELOPMENT
71VIS1ON OF SAL MANAGEMENT - OFIOUNDWATER !SECTION
P,O. BOX 27687 - RALE1GH .C. 27811, PFKIIE W11)) 733-608S
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR 4'0
DRILLER REGISTRATION NUMBER
1, WELL LOCATION: (Show sketch of the location below)
Nearest Town:
(Road, Community, or Subdivision
2. OWNER 6,7"
or Town State
3. DATE DRILLED �" USE OF WEL
4,. TOTAL DEPTH w, ., CUTTINGS COLLECTED © Yes 21;lo
5. DOES WELL REPLACE EXISTING WELL? El Yes © No
6. STATIC WATER LEVEL_ / �'FT, 0 above TOP OF CASING,
below
TOP OF CASING IS / , w FT. ABOVE LAND SURFACE.
7. YIELD (gpm):
8. WATER ZONES (depth):
9, CHLORINATION: Type
10. CASING:
METHOD OF TEST
Amount
Wall Thickness
Depth Diameter or Weight/FT Material
From _ To
From _ To
From .. To — Ft.
1 1. GROUT:
Depth
From To Ft.
From ...,a. To _ FI.
SCREEN:
Depth
Diameter Slot Size
From To . .1 Ft. .2 '
From , To_,. Ft.
From __ _ To__,,, Ft, _ in,
13, GRAVEL PACK:
Depth
From, /- To,
From To_,
14. REMARKS: _;-
Size
Ft„
Material
I DO HEREBY CERTIFY THAT THIS WELL WAS CONSTR
STANDARDS, AND THAT A COPY OF THIS RECORD HAS '.
TE WELL CONSTRUCTION
RMIT NUMBER: �- ©iglif4;//7`j
County
Death
From To
Cts
Formation Description
It addonal soave is needed use back of form.
L ATIONKETCH
(Show direction and distance from at least twvo State Roads,
or other map reference points)
IN ACCO
NCE H NCAC 2C, WELL CONSTRUCTION
O';r'ER..
vlsed 11/84
SI c "" URE
Submit original to vMelon of Environmental Management and copy to well owner.
OR AGE DATE

NOV
7
Grow idwater ection
DIVISION OF ENVIRONMENTAL MANAGEI Wife Reg" 2 (
GROUNDWATER SECTION
November 16, 1987
MEMORANDUM
TO: Arthur Mouberry
THROUGH: Bob Cheek (t.
FROM: Bill Reid
SUBJECT: City of ngs Mountain
Pilot Creek WWTP
Aeration Basin Improvements
Cleveland County
AC0020737/GW 87184
(Randy Jones:DEM SERG Review Engineer)
The Groundwater Section has reviewed. the
subject permit application and recommends issuance of the
permit with the following' conditions:
1. Within 90 days of permit issuance, two (2) monitor
wells shall be installed downgradient of the
existing lagoons. The location. and construction
details for these wells must be approved by the
Asheville Regional Office, from which. a well
construction permit must be obtained.
2. The two (2) new monitor wells and the existing
upgradient well (No. Q73V1) must be sampled every
March, July and November for the following
parameters:
NO
Toal Ammonia
TDS
Water Level (measured prior to sample
collection)
TOX (In November Only)
Total Suspended Solids (initial sampling of
new wells only)
pH
TOC
Chloride
Total Coliform
The analytical methods used far TOX must be
capable of detecting the total of all halogenated
organic compounds present at a concentration of

State of North Carolina
Department of Environment, Health, and Natural Resources
Mooresville Regional Office
jarnes G. Martin, Governor
'illiarn W. Cobey, Jr., Secretary
Albert F. Hinton„ Regional Manager
DIVISION OF ENVIRONMENTAL MANAGEMENT
December 12, 1991
Mr. Alexander Berkley
W.K. Dickson & Company, Inc.
1924 Cleveland Avenue
Charlotte, North Carolina 28203
RE: Pilot Creek WWTP
Extension Request
Cleveland County, N. C.
Dear Mr. Berkley:
Per our phone conversation of December 9, 1991, and your
written request, the Division has approved an additional 45 day
extension for the subject site assessment.
If you have any questions regarding this matter, I may be
reached at [phone].
Sincerely,
Tony L. McManus
Hydrogeological Technician
TLM/kr
P.©, Box 950, 919 North Main Street, Mooresville, N.C. 28115-0950 • Telephone [phone] • FAX [phone]
An Equal Opportunity Affirmative Action Employee

December 9, 1991
Mr, Tony McManus
Division of Environmental Management.
Mooresville Regional Office
919 North Main Street
Mooresville, North Carolina 28115
Re: Monitoring Wells
Notice of Violation
Pilot Creek WWTP
WKD #92044.10
Dear Mr, McManus:
As discussed with you today, December 9, 1991, we are requesting a
second time extension of 45 days to the September 12, 1991 Notice of Violation
of Permit Conditions for Permit Numbers NC0020737 and GW87184 on behalf
of the City of Kings Mountain,
The City has authorized us to do additional testing at the monitoring wells
073V3 through Q73V5. The samples will be split and sent to three different
laboratories for testing of the violations reported on September 12, 1991. Once
we have reviewed this data, we will be able to make our recommendations to
the City for remedial actions.
If you have any questions or need any further information, please advise.
Sincerely,
W. K. DICKSON & CO., INC.
CAB/dgm
cc: Mr. Tom Howard, P. E.
C. Alexander Berkeley

19. Because of the thickness of sludge and the relative high permeability of the
underlying sediments, the combination of the thickness and type of cover material
and the degree of compaction must result in an permeability no greater than 1 x
10 cm/sec.
20. Prior to any sludge disposal, the permittee must install one upgradient and two
downgradient monitor wells at locations and of a construction approved by the
staff of the Asheville Regional Office , from which well construction permits must
be obtained.
1. The wells shall be sampled, within 48 hours of completion and thereafter every
March, July and November for the following:
TDS
TOC
Mn
Pb
Cl
Total Halogenated Compounds (November only)
eaters Levels (measured prior to sampling)
22. In the event that an. analyses shows the presence of hangenate
analytical report.
d compound(s), the
types and concentrations of those compounds must be determined and included in the
Permit issued this the 30th day of December, 1986.
NORTH CAROLI:NA. ENVIRONMENTAL MANAGEMENT COMMI.SI'
R. Paul, ,«, _ °' ctor
Division of Envi.ronnental Management
By Authority of the Environmental. Management Commission
Permit No. 14069 '

SMFTH
MAYOR
THE CITY OF KINGS MOUNTAIN
4f*ek
NORTH CAR9,4W),
P.0, BOX 429 • KINGS MOUNTAIN, NORTH CAROLIN4A4(06 • 704-734-0333
pteuiber 25, 199
N.C. Dept. of EH&NR
Environmental Management Div.
919 N. Main Street
Mooresville, NC 28115
Attn. Mr. Tony McManus
1991
A. WOOD
FICE:
SUBJECT: Permit No. NC0020737
Monitoring Wells
As per our conversation of Friday, September 20, we are
in the process of attempting to isolate and solve the reason
for exceeding the permit limits on these wells.
Wells number 3, 4, and. 5 were resampled yesterday. Re-
sults will besent to your attention as soon as available.
I hope that this will eliminate the total coliform limit,
exceedence. I believethe samples were contaminated by our
personnel failing to give enough consideration. to the
construction work which was/is going on very near wells 4
and 5.
We have instructed. our contract lab to run tests on the
dissolved solids in well number 5 to establish the content.
We are also asking the W.K.Dickson Co., our consulting
engineers, to have their soils -groundwater people assist us
in gathering information, establishing a cause, and
implementing a solution to the dissolvedsolids and chloride
problems.
We will keep you informed as we proceed on this matter,
and will not hesitate to ask for, or accept, input from your-
self or others in your office.
cc: Tom Howard
George Wood
W.K.Dickson Cc.
Sincerely,
Walt 011is
Water/wastewater Dir.
The Historical City

State of North (:anolina - ve
Department of Natural Resources and Community Development
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James G. Martin, Governor December 30, 1986
S. Thomas Rhodes, Secretary
The Honorable John Henry Moss, Mayor
City of Kings Mountain
P.O. Box 429
Kings Mountain, N.C. 28086
Dear Mayor Moss:
R. Paul Wilms
Director
SUBJECT: Permit No. 14069
City of Kings Mountain
Pilot Creek Wastewater Treatment Plant
MuCuill Wastewater Treatment Plant
Sludge Disposal Landfill
Cleveland County
In accordance with your application received August 14, 1986, we are forwarding
herewith Permit No. 14069, dated December 30, 1986, to the City of Kings Mountain for
the construction and operation of the subject water treatment plant sludge disposal
landfill.
This permit shall be effective from the date of issuance until January 31,
1992, and shall be subject to the conditions and limitations as specified therein.
If any parts, requirements, or limitations contained in this permit are
unacceptable to you, you have the right to request an adjudicatory hearing upon
written request within 30 days following receipt of this permit. This request must be,
in the form of a written petition, conforming to Chapter 1508 of North Carolina
General Statutes, and filed with the Office of Administrative Hearings, Post Office
Drawer 11666, Raleigh North Carolina 27604.
If you wish to have, the hearing before the Hearing Officer with this
Department, you must indicate in the petition that you waive the right to have the
contested case conducted by a Hearing Officer in the office of Administrative
Hearings, and wish to have the matter conducted in the Department of Natural Resources
and Community Development. Unless such demands are made this permit shall be final
and binding.
Pollution Preven.tion Pays
PO Box 27687, Raleigh, North Carolina 276t1-7687 Telephone 919-7
An Equal Opportunity Affirmative Action Employer

One (1 set of approved plans and specifications is being forwarded to you. If
you need additional information concerning this matter, please contact Mr. Donald
Safrit, telephone No. 919/733-5083, ext. 179.
Cc:
Cleveland County Health Lepartm nt
Asheville Regional Supervisor
Dennis R. Ramsey
Mr. Bob Cheek
W. K. Dickson & Company, Inc.
Since r y yours,

NORTH CAROLINA.
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPARTMENT OF NATURAL RESOURCES AND COMMUNITY DEVELOPMENT
RALEIGH
PERMIT
For the discharge of Sewage, Industrial Wastes, or Other Wastes
In accordance with the provisions of Article 21 of Chapter 143, General
Statutes of North Carolina as amended, and other applicable Laws, Rules, and
Regulations
PERMISSION IS HEREBY GRANTED TO
City of Kings Mountain
Cleveland County
FOR THE
construction and operation of a sludge disposal landfill consisting of a
twenty-three (23) acre site adjacent to the Pilot Creek Wastewater Treatment Plant to
serve the Pilot Creek and McGuill Wastewater Treatment Plants with no discharge to
the surface waters of the State,
pursuant to the application received August 19, 1986, and in conformity with the
project plan, specifications, and other supporting data subsequently filed and
approved by the Department of Natural Resources and Community Development and
considered a part of this permit.
This permit shall be effective from the date of issuance until January 31,
1992, and shall be subject to the following specified conditions and limitations:
This permit shall become voidable unless the facilities are constructed in
accordance with the approved plans, specifications and other supporting data.
This permit is effective only with respect to the nature and volume of waters
described in the application and other supporting data.
The facilities shall be properly maintained and operated at all times.
4. This permit is not transferable..
5. In event the facilities fail to perform satisfactorily including the creation of
nuisance conditions, the Permittee shall take such immediate corrective action as
may be required by this Division, including the construction of additional or
replacement wastewater treatment or disposal facilities.
6. This permit shall become voidable in the event of failure of the trenches to

properly contain the landfilled sludge and may be rescinded unless the facilities
are installed, maintained and operated in a manner which will protect the assigned
water quality standards or the surface waters and ground waters.
7. Reports on the operations of the sludge disposal landfill shall be submitted to
the Asheville Regional Office at regular intervals and in such form and detail as
may be required by this Division.
The Permittee, at least six (6) months prior to the expiration of this 'Permit,
shall request its extension. Upon receipt of the request, the Commission will.
review the adequacy of the facilities described therein, and in indicated, will
extend the Permit for such period of time and under such conditions and.
limitations as it may deem appropriate.
9. Adequate facilities shall be provided to prevent surface runoff from carrying
any disposed or stored material into the receiving stream.
10. The issuance of this permit shall not relieve the City of Kings Mountain of the
responsibility for damages to surface or ground waters resulting, from the
operation of this facility.
1T. The facilities shall be effectively maintained and operated as a non -discharge
system to prevent the discharge of any wastewater resulting from the operation of
this facility.
12. No type of sludge other than that from the McGuill and Pilot Creek Wastewater
Treatment Plants shall be placed in the sludge disposal landfill.
13. Adequate provisions shall be taken to prevent wind erosion and surface runoff
from conveying pollutants from the sludge disposal area onto the adjacent
property and/or surface waters.
14. In any future transfer of this land, a notice shall be given to the ne
that gives full details as to the materials applied or incorporated at
o%
his
15. A minimum of two (2) feet of cover shall be applied to the sludge landfill.
trenches.
16. The following total cumulative loading shall not be exceeded:
17. The
sha
Metal lb/ac
Pb 500
Zn 250
Cu 125
Ni 125
Cd 4.4
nimum buffer maintained between property lines and sludge disposal trenches
be seventy-five (75) feet.
18. The maximum depth of the sludge trenches shall be ten (10) feet. The maximum
width of the, bottom of the trenches shall be eight (8) feet and the maximum width
of the top of the trenches shall be fifty-eight (58) feet.

Because of the thickness of sludge and the relative high permeability of the
underlying sediments, the combination of the thickness and type of cover material
and the degree of compaction must result in an permeability no greater than 1 x
10 cm/sec.
20. Prior to any sludge disposal, the permittee must install one upgradient and two
downgradient monitor wells at locations and of a constructionapproved by the
staff of the Asheville Regional Office , from which well construction permits must
be obtained.
21.. The wells shall be sampled, within 48 hours of completion and thereafter every
March, July and November for the followings
TDS C1
TOC Total Halogenated Compounds (November only)
Mn Waters. Levels (measured prior to sampling)
Pb
22. In the event that an analyses shows the presence of halogenated compound(s), the
types and concentrations of those compounds must be determined and included in the
analytical report.
Permit issued this the 30th day of December, 1986.
NORTH CA1t0LINA ENVIRONMENTAL MANAGEMENT COMMISSION
R. Paul 1 i.lrms, Directo
Division of Environmental Management
By Authority of the Environmental Management Commission
Permit No. 14069

CottNT CT C- v t L A + ca
ALUMINUM
ARSENIC
BARIUM
CARBONATE
GAL CI UM
CARBONATE
ORM TOTAL
CYANIDE.
DISSOLVED SOLIDS
III UOR.I DE
HARDNESS, CaCO3
fiARDNESS NO CA ONAT
AS
GNESIUM
RURY

CoJ;r
DATE S11"1'LEr?
A LIMIT" r. TO pR
ALKALI NITY, TO
ALUMINUM
ARSENIC
BARIUM
7
E3I CARBONATE
CADMIU
CI U
CARBONATE
!CHLORIDE
CHROMIUM, TOTAL
COD
ORM1CA
'P?M TQT. L,
COPPER
DE
DISSOLVED SOLIDS
FLUORIDE
.HARDNESS , CaCO3
ARi7NESS, NON -CARBONATE
Ou
7

COU;; M
ORGANIC SCAN
PHOSPHORUS, TOT
POTASSIUM
SODI
SPECIFIC CONDUCTANCE
SULFATE

COMPLIANCE Ir ONITORING
REPORT FORM
Fadil'ity Name
Address
Well Location
WeII Identifica
Well Diameter rt
Depth to Water
Measuring point i
Gallons of water pumped bailed before sampling
Field Analysis:
Environmental Management Division
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
pH
Date Sample Cdllecte
at oratory Name
COD
Colifor
F Fecal
Conform; MF Total
pint (Screened) Interval,
Depth
Ft. To
ft. below measuring point. (before
feet above land surface
j Ft.
Ft,
ampIing )
* 1 Specific Conductance uMhos. Temp.
Dissolved Solids: Total
pH (when analyzed)
TOC
Chloride
Arsenic
3C Pictv
mg/I
/ 1©©ml
/ 1 apml
rng/I
units
mg/I
mg/I
mg/I
ase and Oils mg/l
Hardness: Total mg/I
Phenol mg/I
Sulfate mg/I
Specific Conductance uMhos
Total Ammona(NH3 t NH ) mg/I
TKN as N mg/I
I CERTIFY/74T THIS
GW-59
1. t 3
County
Permit Number
Non -Discharge
NPDES
Water Use
Injection Well
Well Construction
Other
Date Lab. Sample Analyzed
I.....
Odor jL Appearance
Certification No,
NO2 as N /l Ni. - Nickel ......... W
g.. _... trtgll
NCB as N mg/I Ph - Lead mg/I
S
Phosphorus: Total as P . mg/I Zn - Zinc mg/I
Al - Aluminum mg/I Pesticides/Herbicides (Specify Compounds)
Sa - Barium mg/I ug/I
Ca - Calcium mg/I � �. ug/l
Cd - Cadmium mg/I z4 u /I
Chromium: Total mg/I ug/I
Cu - Copper . mg/I.ug/I
Fe - Iron - mgll°;`' ug/I
Hg - Mercury mg/Iug/I
K - Potassium mg/I ug/I
Mg - Magnesium mg/I ug/I
Mn - Manganese r mg/I
Na - Sodium mg/I
EPI TiSJRUE AND ACCURATE.
TEE (OR AUTHORIZED AGENT*)
Other
Note:
Values should reflect total concen
bac. Ir
** Submit blue a
at10fs
pies to f,3ddre.8,tt above.

r

COMPLIANCE MONITORING.
REPORT FORM
eellitName
Address.
°cation
rlentifica
Diameter
to Wale
asuring point is
Gallons of water pump
Field .Analysis:
Date Sample Col
Laboratory Name
COD
Conform:
on Number
d ib a
Env! onmental Management I
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
(919 733-508 3
Depth f l=f
eneci) Interval 21 Ft. To a_ Ft,
Ian measuring point. (before sampling)
d surface
sampling.
c Conducta
Date
NO as N
tvision
County
Permit Number:
Non -Disc
NPDES
Water Use
Injection Well
Well Construe
Other
ge
ri
ranie
ab Sample Analyzed.�a?
uteCertiicatian
/100ml NO 3 as N._..a
aliforrm: MF Total /100m1 ' Phosphorus: Total
old Solids: Total mg/i Al - Aluminum
pH (when analyzed) units a - Barium
TOC ,.. rng/t Ca - Caicium mg/I
hloride �.v.- �. mg/l Cd :admium- rng/I
Arsenic mg/I Chromium: Total ng/1
ase and Oils mg/I Cu - Copper m /
p
F Fecal
Hardness: Total
Phenol _,
Sulfate
Specific Conductance
Total Ammonia (N H3 t NH
rrwg/I Fe - Iron
mg/I Hg - Mercury . u
mg/t 1< Potassium
ga
9
mg/I
uMhos Mg - Magnesium mg/I
mg/I Mn Manganese1. m9/1
TKN as N mg/I Na. - Sodium
i CEI TIF S REPORT IS TRUE AND ACCURATE,
GNA T E OF PE
lsxd`7/86
OR AUTHORIZED AGENT*) DI 'E
No.
Ni Nickel mg/1
Pb - Lead
Zn Zinc -mg/I
Pesticilesllerltolclea Specify Compounds)
u9/l.
refleC_t total concentr
ug/I
ug/I
ug/I
ug/I
ug/l
ug/I
ug /1
ug/l

COMPLIANCE MO ITOR1NG
REPORT FORM
Facility Name
Address
Weft Location
Well Identification Number t Well Depth Ft,.
Well Diameter
Depth to Water
Measuring point is
Gallons of water pumped b1
Field Analysis: pH
Date Sample Collected
Laboratory Name A
COD
Sample (Screened) tntervat i Ft. To _. Ft,
t. below measuring point. (before cart piing'
above land surface
d before sampling„
Specific Conductance
tqFct Date
ab
uMhos Temp.
Sample Analyzed
Certifi
mg/t NO as N
Environmental Managetraent Division
Groundwater Section
P.O. Sox 27687
Ralei,gh,N.C, 27611
[phone]
County "?w
Permit Number
Non -Discharge
NPDES CO
Water Use
Injection Well
Well Construction
Other
Odor
ion No,
Coliform: MF Fecal /t0Om1 NO3 as N mg/1
Coliform: MF Total /1o0rni Phosphorus: Total as P .., mg/1
ssotved.Solids: Total mg/1 Al - Aluminum
rrrW I
H (when analyzed) units Ba - Barium mg/t
TOC 17
mg/1 Ca - Calcium mg/
Chloride , _ . 3(0. mg/t Cd - Cadmium . mg/i
Arsenic mg/i Chromium: Total mg/I
Grease and Oils mg/I Cu - Copper mg/I
Hardness: Total mg/1 Fe - Iron
,��� - mg/i
Phenol - mg/I Hg - Mercury rng/l
Sulfate mg/I K .. Potassium mg/1
Specific Conductance _ uMhos Mg - Magnesium
Total Ammonia(NHS r NH ). mg/I Mn - Manganese mg/1
TKN as N w . „ ,.. - mg/i Na - Sodium mg/I
I CER 'tF1' 'HAT THIS REPORT IS TRUE AND ACCURATE,
E OF PERI ITTEE` (OR AUTHORIZED AGENT*)
Re t:sle d 7 /8 a
lN� Appearance
Ni ,. Nickel
Pb - Lead
Zn - Zinc
Pesticides/Herbicides (Specify Compounds)
ug/l
,. ug/l
ug/1
ug/1
ug/l
ug/1
_ug/I
Other (Spec
CROW
Neste.
values should
back liir m tructicrns
fl co i-ek3

COMPLIANCE MONITORING
REPORT FORM
miummemomommummmeamea
Facility Name
Address
W
W
1 Diem
[cation
fertttication Numb
Sample (Screened
Envfrpnmental Management
Groundwater Sectioi
P.O. Box 27687
Raleigh,N.C. 27811
[phone]
Depth to Water Level , t ft, below measuring point, (before sampling )
Measuring point is feet above land surface
Gallons of water pumped/bailed before sampling
Field Analysis: pH L2 L
Date Sample Collected
Laboratory Name
COF..�....
Specific Conduc
Colifarm: MF Fecal �a.... �. /1OOml
Conform: MF Total
Dissolved Solids: Total: mg/1
pH (when analyzed) units
TOC _._ �, � rtmg/I
Chloride,... a - mg/I
Arsenic mg/1
Grease and ©ifs mg/I
Hardness: Total mg/I
Phenol _ mg/I
Sulfate_ , __ .. mg/1
Specific Conductance uMhos
Total Amrnor l(NH3 t NH 4 mg/I
TKN as N mg/I
I CE
anc
ion
County
Permit Number:
Non -Discharge
NPDES
Water Use
tniection Well
ufvtfas Temp, (.#
ate Lab Sample Analyzed
i AG Ce
Well Construction
Other
Odor
ton No.
NO2 as N mg/I
NO3 as N mg/1
Phosphorus: Total as P _ . ... _. mg/I
Al - Aluminum mg/1 Pesticides/Herticides
Ba - Barium mg/I
Ca - Calcium mg/I
Ni - Nickel, ._
Pb - Lead
Zn - Zinc
Appearance
y Connpounds)
ug/1
ug/1
ug/1
ug/I
ug /l
ug/I
ug/I
ug/I
.ug/1
Cd - Cadmium
Chromium: Total_ �.,_. mg/I Other (Specify)
Cu - Copper moil
Fe - Iron mg/I
Hg - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese
Na - Sodium mg/I
THAT THE REPORT IS TRUE AND ACCURATE.
A "E. OF
v sed 3/88
EE (OR AUTHORIZED AGENT*)
g/I
Nate:
Values s Could reflect tatet concentra
IstEinstruptions.
blue and green copies only to address above.

COD mg/I
Cobform: MF Fecal / 1OQml
Coliform: MF Total / 100mt
m g/I
pH (when analyzed) units
mg/I
mg/I
Arsenic _ mg/I
Grease and Oils mg/1
Hardness: 'Total mg/I
Phenol mg/I
Sulfate mg/I
Specific Condttatrrce uMhos
Total Amrnonia(NH3 t NH 4) mg/I
TKN as N mg/I
TOC
Chloride ...
mommoimummummommumminum
COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Locatto
Well identifica
Well Diameter
Depth to Water Level
Measuring point
Environmental Management Division
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
Depth
ample (Screened) Interval g.) Ft. To
ft, below measuring point. (before
bove land surface
before sampling
Gallons of water pumped/bail
Field Analysis: pH .94- Specific Conductance
Date Sample Collected AtAiZa i-k 311 I c4 2 G1 Date Lab Sample Analyzed
Cs C114fan,
Laboratory Name
uMhos Temp. 1.
Dissolved Solids: Tote
on Nu
34,0
County timAN�
Permit Number:
t ot.9
Non -Discharge
NPDES 4' :OC)
Water Use L
Injection Well
Well Construction
Other
Odor
,A1C.
Certifr`cation No.
NO2 as N mg/I
NO3 as N mg/I
Phosphorus: Total as P .._ mg/I
Al - Aluminum mg/I
Ba - Barium mg/I
Ca - Calcium mg/1
Cd - Cadmium mg/I
Chromium: Total_ .mg/1
Cu - Copper mg/t
Fe - Iron mg/I
Hg - Mercury _mg/I
K - Potassium mg/I
Mg. -w Magnesium
Mn - Manganese
Na - Sodium
CERTIFY,-TI^tAT ,TH$'S REPORT IS TRUE AND ACCURATE.
6 ./14-)
TTEE (OR AUTHORIZED AGENT*)
A "'E OF
vi sod 3788
4
D TE
mg/1
mg/I
mg/I
Appearance
Ni - Nickel
Pb - Lead .�
Zn - Zinc
Pesticides/Herbicides (Specify Co
Other (Specify)
Note:,
valu4 should reflect total conce lrations
mg/I
mg/I
mg/I
ounds)
wit
ug/I
ug/I
ugll
ug/1
_ug/I
ug /I
ug/I
.ug/I
ks.
l�l
bruit blue and green copies only to address above.

prt t • FPO,
SR IInst0
h1 p u by, Co , Court
COL TOP (G :
FIELD ANALYSES
PISpeoc
c
t,I TY WC. E 'a R MEN1 OF NATURAL OURCES I.,AE3 I t:I I IITI
U,A0 NO, , ,.:. s A : NO0 COMMUNITY i)E EEOPME DATE RECEsIvCI Tire
r". I Cn o. }, ED I`v1 by. ;I m, Lro 13 Cowler
GROtINDWATER FIE L& '' r R .OR tlp r.
RR0 WaRO, WiR,
5 AMPLE P0 TY DATA ENTRY_ ; C9 t
"''ROUTINLJ EsT RCENC?" .,. DATE REPORTED.
)(tor
Owner
A inaTarac i"a t - Ssw ink
[fall Analysi E3y. I; ioar'I
'000t alp
To
Pt.
ab Comments:
;SE; BASELINE, 0UMPLAIN;T, CCI I LI ,r CE, ImLIS OTHER
circle. on
f'i 4 .k ` rnp h '3 p". o Qn
(pump; I ilp r. lc.)
c 1tT;I I. r I Iss lyacT An aPy i spsl nIt t urrta b
r y Itrr trap a
White
liar - ,ra :b.ssrr�
htitY n Yepy
u all
air'" tP
Oros li pstnhor s Ppmllci des

COUNTY
QUAD NO.
LAT. :.l
Report I
WSRO,
Shipped by: Bj
COLLECTOR(S),
AL NC
LONG.
0, LIRO. Rf°3C1, 'WaRO, WiF7O,
FIELD ANALYSES
O the
`I' DATE
44 100 Spec. Cond,94
1p'1Q
Appearance
Field Analysis
Odor
Taste
at 25°C
LABORATORY ANALYSES
Chlorite 9.0
Chrom vm;Hes 1072
Lab Comments:
4
N,C )EPARTMEN"1 OF NATURAL RES©L /c5
& COMM'UNiT'Y DEVELOPMENT
r ) E 1V1
GROI NDWATER FIELD/LAB FORM
SAMPLE PRIORITY
ROUTMNE El EMERGENCY
()Wrier
LoG.9$I
Descr
Sampling Method
Remarks
PURPOSE: BASELINE, C1 Rt AIN
(ctr
vQ/I
mg/1
A© ;>i.i'uor 1017
Se E9arounr, 1007
CQ - Caamdum 1027
Chromium; Tolal 1034
Cu m CO0rttla 1042
Fe • iron inFt5
119 Mercwy 7I00]
Po
LAB NUMBER u
DATE RECEIVED
Rec"d by
Other —.. ..
DATA ENTRY BY:
DATE REPORTED:
Manganese 105S 1„j O uq/R
0a - SoAdvm 929
Noc0el 1067 Upf`r.
1092
Pur0aat0 e. lv` A ttTle.t •_., N
d cai0Tpl/ ano write "4 tS•, i'Tr Mock
copy - Reglcar7 Yellow copy - Lab
(FOB)

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Location
4tletf Identification Number
Weil Diameter
Depth to Water Level
E nvlronmental Management Division
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
(819) 7 33-322' 1
4.Ciri Well Depth Ft.
"". Sample (Screened) Interval „II Ft, To
J- ft, below measuring point. (before
Measuring point is w, ., feet above land surface .�
Gallons of water pumped/bailed before sampling (3)
Field Analysis: pH
Date Sample Collected Date Lab Sample Analyzed
Laboratory Name Certification No.
COD mg/I NO2 as N mg/I Ni - Nickel
Colifo►m: MF Fecal / 1 OOml NO3 as N mg/I Pb - Lead
Coliform: MF Total /100ml Phosphorus: Total as P _ mg/I' Zn - Zinc
Dissolved 'Solids: Total V7o) mgil Al - Aluminum mg/l Pesticides/Herbicides (Specify Compounds)
pH (when analyzed) units Ba - Barium mg/I _ ug/I.
TOC /I Ca Calcium __
g mg/I _ ugil
Chloride m ��. mg✓I Cd - Cadmium mg/I ug/I
Arsenic mgM Chromium; Total mg/I Other ((Specify) ug/I
Grease and Oils mg/I Cu _ Copper mg/I ug/I
Hardness: Total mg/I Fe - Iron mg/I Y O'_c)o U ug/t
Phenol mg/I Hg - Mercury mg/I ug/I
Sulfate mg/f K - Potassium .mg/1 ug/l
Specific Conductance ;, uMhos Mg - Magnesium mg/I ug/I
Total Amrnoraia(NH3 t NH4) mg!! Mn - Manganesemg/I
TKN as N mg/I Na - Sodium mg/I Note;.
I CERTIFYT THIS REPORT IS TRUE AND ACCURATE.
. r7
Ft.
ng)
Count
y
Permit Number:
Non -Discharge
NPDES �.
Water Use
Injection Well
Well Construction
Other ... t4./O"
vlari d 3/88
Specific Conductance
uMhos Temp,
EE (OR AUTHORIZED AGENT*)
Odor
?'A- Appearance
Values should reflect total concentrations

COUNTY
QUAD NO.073✓5— SERIAL NO, CV
LAT. ' _ LONG. SS Z Cc 5
Report to �Ra FRtT, t„1RO, RRO. WaRO, WIRO,
WSRO, Kinston FC) Other
Shipped by: Bus„ her
COLLECTOR(S):
FIELD ANALYSES
01400 C1 0 . (ond.94 a 25°C
,PART rtENT OF NATURAL RESOUR y.3
& COMMUNITY DEVELOPMENT
DEM
GROUNDWATER FIELD/LAB FC R
r _SAMPLE PRIORGTY
ROUTINE l"t=1ECE' it_14
LAB NUM R 9
DATE.PIE E °
d by
+, T`
DAB 1 REPORTED:
/1f?/FS' TJMF PURPOSE: BASELINE, CBJMPLAkrdT,
(circle
Location or site
Temp.10 °C) Odor Description of sampl
Appearance
Taste Sarnplino Method
Field Analysis By:. Remarks
LABORATORY ANALYSES
0t.ion a4
Cniifdrm; MF Fecal 31616
0
4
I
nity to
,w14f A.alinl CY tc ,dH P.3
4
hat*Rc;totar 1002
Corudn ca9a4Fda 405
Chromlam;Ha% 1032 LIp
Cyanid* 720
mpOi
p,
F'tltly.aficya 951
Hardness:Tntal 900 m0/1
Hai-dnpss (hon-caril) 902 r^y rnpll
Phenols 32730 ,.,/ uoil
Soectl'ic Con0. 95 4Mhos/cm7
4
Suilide 745
NH3 a.sN610
TKN 4s N 625
+ NO
N 63(1
P 665
Lab Cornmenls;
p irrlping time, wr lerl[1, etc.)
74?
,ce#orine Peetleqdes
0,Q4n07htle0hOrus Peel
icidas
GROUNDWATER SECT
RALITGHI, NC
lysis st
dquarters
copy - R
e and write * IS i s block
icn Yellow copy - Lab

COUNTYN,C. :PARTMENT OF NATURAL RESOUR
OUAO NO V4 SERIAL NO,� � & COMMUNITY DEVEIOPIMENT
LAT. 3,5" . ( LONG. DEM
Report
WSRO,
Shipped by, Bus,
COLLECTOR(S).
FIELD ANALYSES
011400
MRO, RRO, WaRO,
Other
Other
Spec ConcL 94 a I 25c)C
Temp,. "e Odor
Appearance
'Field Analyses By:
'Taste
LABORATORY ANALYSES
COD Hugh 340
FecaB 316'l6 /100m1
GoI Torre:h4F Total 11504 /100rrr
TOC G80
idity Tf,
pH 401 units
4,5 410
Carbonate 441
eicarti3onale 440
A
C brbon dEoxlde 405
Chlar904 9.10
6rY9iuriu;Hex 1032
True 80
title 72©
GRC)UNDWATER FIELD/ LAB FORM
SAMPLE PRIORITY
ROUTINE: Er,01ERGErEs`t'
TIME
Owner
Location or site
Desc
OaiOf 01 Lam
Remarks
pumP b
� 1 NT
(circle
LAP NUMBER
DATE RECEIVE
by;
uouiier
her
DATA ENTRY B
DATE REPORTED�+ ,
` ampI'e lotervcal
(pumping
Fluoride 951
Har1deess;TotaI 900
Hardness (non -cub) 902
Or©ar01 r1Iortne Pesticides
Orgenophosphorus Pesla tides
23 198t
Lab Comments:
GW'b4 Revised 7/85
Anal
ed sam
!t copy , Headquarters Pints copy - Re
n block,
Lab

toic�Ai , ERO, Mr40, RRO, WaRO, WiRO,
Ktrt~ICid t,:O Other
d by'„ Bus, Courier,
COLL.ECTOR(S)t
FIELD ANALYSES
pH400 SOec, r'sdn, 4 ,
Tern To - " '0C Odor
Appearance— Taste _, .
Field Analysis Bye
ABORATORY ANA
Alkalinity Co pH 4,5 410
4ti .r,6Vl l 15 Cali BaS 415
arlludlt7Ee 4 45
5rxu@sonea 440..
Arse
di 6b46ta 4ri5
Lab Comments:
Organics
NeC. DEPA 'R FN°TOF NATURAL RES URCES LA F NUMBER"8
& COMMUNITY DEVELOPMENT C)A'TE RECEI
DEM R®c'd by: From: bus-Ctaurir.
GROUNDWATER FIELD/LAB FORM Other
SAMPLE PRIORITY DATA ENTRY BY:
El` ROUTINE=, T' iEr ENti; Y DATE* El TiviTED:
TIME, _ _ RCREOCE.: BASELINE, C:UMPLA.ENT, t,,OMPL1A
(circle ian3
Owner
Location or site
Description of sampling p Pr
Sra11 1dna.Method •
tpumta, Et
Olas, Solis 1 '70,30g
17lu0ride 9$1
'Hatd,r11101a1Total 900
UST, OTHER R „,
A9 - Silver 1077 ug/I M17rganV#?hYt rit GY Pesticides
AI - Aluminum 1105
,Acid Hard6
Cadrium 102"7
1034 up6E Mesa P hietalrei Elltrsdla.bre Organics,
1042
104:5 u5/I
y 71500.
Na - So daurn s2s
Pdi - rdlr'h l 106:7
' Pb _ trmad 1051
0
ugll

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Location
Well Identification Number
Well Diameter rt�
Depth to Water Level
Measuring point is fe
Gallons of water pumped ba
Field Analysis: pH
Date Sample Coll
Laboratory Name
COD . ,:..-
Conform: MF Fecal
County C 1 SU z
Permit, Number: �I
Non -(Discharge
N P D'E S
Well Depth $ Ft. Water Use d .
eened) Interval Ft. To_3.1___Ft. Injection Well
ft. below measuring point. (before sampling) Well Construction
above land surface Other
before sampling
Specific Conductance
Environmental Ivvianagement Division
Groundwater Section
P.O. Box 27687
Raleigh,N_C. 27611
[phone]
uMhos Te
Date Lab Sample Analyzed
NO2 as N
OOmI NO3 as N
ofiform MF Total /100rm1 Phosphorus: Total
d Solids: Total l
pH (when analyzed)
TOC
Chloride
Arsenic
Grease and Oils trig/t
Hardness: Total mg/I
Phenol . mg/I
Sulfate mg/1
Specific Conductance uMhos
Total Ammonia(NH3 t NH 4) mg/I
TKN as N mg/I
I CERY T
TURF OF PER
d 7/85
as
P
Odor
Appearance
�" • Certification No.
mg/1 Al - Aluminum mg/I
units Ba Barium mg/I
mg/I Ca - Calcium mg/I
Cd - Cadmium ...m mtg/I
Chromium: Total ,, mg/I
Cu - Copper mg/I
Fe Iron rng/l
Hg - Mercury mg/I
K - Potassium mg/1
Mg - Magnesium mg/I
Mn - Manganese )" mg/I
Na - Sodium mg/I
EPOI T IS TRUE AND ACCURATE.
TTEE COIF AUTHORIZED AGENT*)
aAR
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Pesticides/Hrbicides (Specify Compounds)
ug/I
pecify)
ug /1
ug/1
u
ug
Note:
Values sho
See back for instruct
**Submit b ue and gre n opi e
ns
above„

DIVISION OF ENVIRONMENTAL MANAGEMENT
ASHEVILLE REGIONAL OFFICE
GROUNDWATER SECTION
June 7, 1988
MEMORANDUM
T'O: Bob Cheek, Permits and Compliance Unit Supervisor
Groundwater Section
Milton Ussery, Hydro geological Technician
Groundwater Section
SUBJECT: Additions to the Water Quality Monitoring Network
City of Kings Mountain
Non -Discharge Permit No. 14069
Cleveland County
Two new compliance monitor wells, located at the Pilot. Creek Waste-
water Treatment Plant in Kings Mountain, Cleveland County, should be added
to the water quality monitoring network. The well nuinbers are Q73v4 and
Q73v5.
Well records, maps, and tabulation sheets are enclosed.
MU:ar
Enclosures

WELL DATA TABULATION
POLLUTION SOURCE MONITORING SITE
Facility Name: F° 4)
Pollution Source (lagoon, landfill, etc.) L)
Permit No:
Non -Discharge:
Well Const.:
Sampled By:
Well No.
Date
Installed
Total Diam.
Depth (in)
(ft)
NPDES:
County:
Latitude:
Longitude:
DHS: Quad No:,,,,;,)
Screen(S)/
Open hole
(OH)
(ft-ft)
Grout
Interval
(ft-ft)
Gravel/Sand
Pack
Interval
(ft-ft)
Remarks
Draw a diagram on the reverse side of this form showing map location of the site and the
location (direction and distance) of each well with respect to the pollution source and to
each other. Indicate sampling schedule, parameters and any changes to schedule.
GW-51
Revised 8/20/84

a edje,
rc
to
u n,
serer
TDs
rat
Mrs
Pb
�4fic LJa f4� r

Y
,graphs
,nes where •
.„-n is unchecked
are shown
UTM GRID AND 1973 MAGNET C NORTH
E)ECoNATION At CENTER or SHEET
SCAL.,m
CONTOUR INrE.RV
NA010NA c,.,E0O (7i 'V Rr
20 F C E. T
TH0S MAP COMPLWES W TH NATIONAL. MAP ACGURAUY IANLtARDS
FOR SALE BY U. S, GEOLOGICAL SURVEY, RESTON, VIRGINfA 22092
A OLDER DESCRIBING TOPOGRAPHIC MAPS ANE) SYMBOLS IS AVAILABLE ON REQUEST

(Road, Comm
2. OWNER
ADDRESS
NORTH CAFROLINA DEPARTMENT Of NATURAL RE ES AID CONIVIUNITY DEVELOPMENT
DWISION OF ENVIRONMENTAL MANAGEMENT - GROUNDWATER SECTION
P.O. SOY 27657 - RALEb ULC. 27611 PHONE [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR ei
4,71 Z?
FOR OFFICE USE ONLY
STATE WELL CONSTRUCTION
DRILLER REGISTRATION NUMBER PERMIT NUMBER ' 6247'g- 4,02-, ?C4 13
1. WELL LOCATION: (Show sketch of the location below)
Nearest Town: __ x� _� r rw. nr�t.e County:
Death
Town State Zip Code
3, DATE DRILLED g4rJSE OF WELL r. -4/Q 1/9
4, TOTAL DEPTH , , CUTTINGS COLLECTED Yes alo
5. DOES WELL REPLACE EXISTING WELL? 0 Yes 8-No
6. STATIC WATER LEVEL: /7 FT. 0 above TOP OF' CASING,
I8belo
TOP OF CASING 15 le. FT. ABOVE LwAND SURFACE,
7. YIELD (9Pm): METHOD OF TEST
S. WATER ZONES (death
9. CHLORINATION: Type Amount
O. CASING:
Wall Thickness
Depth Diameter or Weight/FL
From T 0 � i
'' ,
_ Ft_ ,,
From To . Ft.
From
It, GROUT:
To Ft.
/ Depth Maten
From .,,.r To_/ r" Ft.
From
12. SCREEN,
To
Ft.
Method
Depth Diameter Slot Size t rater'al
From 7., To � Ft. et-
1
From . To ._ Ft.
From To Ft.
13. GRAVEL PACK:
Depth
From 'To
Ft.
Size
J
From To Ft..
14. REMARKS:
Material
I DO HEREBY CERTIFY THAT THIS WELL WAS STTE,
STANDARDS, AND THAT A COPY OF THIS RECORD
GW-1 Revised 11/84
needed use back of form.
LOCATION SKETCH
(Show direction and distance from at least Iwo State Roads,
or other map reverence points)
CE ilTH 15 NCAC 2C, WELL CONSTRUCTION
OWNER.
A( ENT DATE
Environmental Management an copy to well owner.

COUNTY
DATE Ef
ALKALINITY TO III 9
INITY, TOH H
ALUMINUM
ARSENIC
BARIUM
BICARBONATE
CALCIUM
CARBONATE
CHLORIDE
LIFCRM FECAL
LT ©RM, TOTAL
EPER
AMIDE
SSOLVED SOLIDS
FLUORIDE
ARDNESS, CaCO3
HARDNESS, NON -CARBONATE
ACNESI L04
MERCURY

WHIISSYLOd I
OHdSOHd
OW1Hd

Coj:
DATE SA!I ' .Er?
ALKALINITY TO •H 4
ALKALINITY, TO
ALUMINUM
ARSENIC
BARI Ur
ONATE
CHLORIDE
CHROMIUM TOTAL
COD
CCLI ORM ECL
7LIFORM, TOTAL
COPPER
CYANIDE
DISSOLVED SOLIDS
UUORI'DE
ME RC URY

DATE SNIP .ED
NITR7t EN
ITRATE & NITRITE
ORGANIC SCAN
PROSPFIORUS, TOT_
POTASSIUM
NIU
SILVER
SODIUM
SPECIFIC CONDUCTANCE
S LTLFATE
TOC (UNFILTERED)
ZINC

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Location
Well Identification Number
Well Diameter
Depth to Water Level
Measuring point is_
Gallons of water pumped
Field Analysis: pH
Date Sample Cotlected
Laboratory Name
COD
Coliform' MF Fecal
Conform: MF Total
Dissolved Solids* Total
pH (when analyzed)
TOC
Chloride
Arsenic
Grease and Oils
Hardness. Total
Phenol
Sulfate ..�.�
Specific Conductance
Total Ammonia(NH3 t NH 4) ..
TKN as N
I CERTIFY.,"THAT THIS
E OF PE
Gwr_59
Environmental Management Division
Groundwater Section
P.G. Box 27687
Raleigh,N.C, 27611
019)733--5083
Screened) Interval
It. below men
and surface.
before sampling
Specific. Conductance
Date
surin
NO as N
NO as N
/100m1 Phosphorus Total as P
mg/I
rn g
mg/l
mg/I
mg/1
mq/I
mg/I
mg/I
uMhos
mg/1
mg/1
point. (before sampling )
County
Permit Number:
Non-Discharge
NPDES
Water Use ,..,—
Injection Well
Well Construction
Other .. .
mg/I Ni - Nickel
mg/I Pb - Lead
w _ mg/I Zn - Zinc
Al - Aluminum mg/I Pesticides/H
Ba - Barium mg/I
Ca. - Calcium - _ moil
Cd Cd - Cadmium mg/1
Chromium: Total mg/I
Cu - Copper _ mg/I
Fe - Iron mg/I
Hg - Mercury . __._ mg/1
K - Potassium_ mg/I
Mg - Magnesium mg/I
Mn - Manganese - . mg/1
Na _ Sodium a mg/l
EPORT IS TRUE AND ACCURATE.
°TEE (OR AUTH0
ZED AGENr°*)
Othe
rbci
(Specify
mg/I
rng/1
mg/I
pounds)
ug/1
ug/I
. ug/l
ug/1
ug/I
, ug
_ugll
ug/I
ug/I
'o
Note,
Values sticautci reflect total concentrations
* See back. P or 6 rlstrur is cans
**Submit: WOO told grr en cow t7iv' to atidrr .,a rbcave.

Date Sample. Collected
Laboratory Name
COD
Coliform: MF Fecal
Coliform: MF Total
lissolved Solids: Total ��.�..
pH (when analyzed)
COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Well Location
Welf identification Numbe
Well Diameter
Depth to Water Leve
Environmental Management tivi
Groundwater Section
P.O. Box 27687
Rateigh,N.C. 27611
[phone]
. y Sample, (Screened) Interval
ftw below measuring pain
Measuring point is_ feet above land surface
Gallons of water pumped bailed before samplingg
Field Analysis: pH Lo 14. Specific Conductance
1
Ft, To Ft.
(before sampling)
uMhos Temp.
Date LabSample. Analyzed
CF �[ti-.....LA?Ce
NO, as N
/ 100ml NO3 as N
_/1O0m1 Phosphorus. Total as P
mg/I Al - Aluminum
units Ba - Barium
TO'C mg/I
Chloride mg/I
Arsenic rrig/I
and Oils mg/I
Hardness: Total
Phenol
Sulfate ..
Specific Conductance
Total Ammonia(N1-13 t NH 4)
TKN as N
I CERTIFY
(GNAT
W9 levied
REPO
TTEE
mg/1
mg/I
mg/I
,uMhos
mg/1
mg/I
Ca « Calcium,,.
Cd - Cadmium._,_,.
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury
K - Potassium
Mg - Magnesium,
Mn - Manganese
Na r Sodium
T IS TRUE AND ACCURATE,
0P AUTHORIZED AGENT*)
on
County
Permit Number:
Non -Discharge
NPDES
Water Use
In ection Well
Well Constructi
Other . .
mg/I
mg/1
Ni - Nickel mg/1
Pb - Lead mg./I
g/I Zn - Zinc mg/1
Pesticides/Herbicides (Specify Compounds)
mg/1
mg/1 Othe
mg/1
mg/1
mg/1
mg/I
mg/I
Specify)
Note„
Values s.
* `gee back for i n
ug/I
ug/I
ug/l
ug/I
u
ug /1
ug/I
of l concentrati
Subrrnt blue and green crIgies to a.

COMPLIANCE MONITORING
REPORT FORM
Facility Narne
Address
ovation
dentificatiran Number
eter
Depth to Water L
easuring point is,
Gallon: of water pump
Field Analysis: pH
Date Smpte. Collected
y Name
el
Screened) Interval
ft. below measurin
feet above land surface
d baited before sampling
Specific Conducts
COD
Conform: MF Fecal
Cohforrn: MF Total
Dissolved Solids: Total
pH (when analyzed)
TOC
Chloride
Arsenic _m _
Grease and Oils ____ mg/I
Hardness: Total �-- mg/I
Phenol mg/I
Sulfate
Specific Conductance ,.
Total Ammonia(NH3 t NH4)
TKN as N
GW-
mg/1
uMhos
mg/1
mg/l
4
nrnental Management Division
Groundwater Section
P.O. Box 27687
Raleigh,N.C. 27611
[phone]
County
Permit Numbe
Non-Discha
NPDES
I1 Depth r Ft. Water Use
Ft. To Injection WeIl
point. (before sampling) Well Construction
Other m=„
uMhos Temp.
Date Lab
imple Analyzed
o C Odor
anon No,
mg/1 NO2 as N � mg/I Ni - Nickel
/ 100rnl NO3 as N
DOmi Phosphorus: Total
mg/I Pb - Lead
1141A.p p e a
s P mg/I Zn - Zinc
mg/I Al - Aluminum mg/I Pesticides/Herbicid
units Ba - Barium mg/I
mg/I Ca Calcium mg/J
mg/I Cd - Cadmium
mg/I Chromium: Total mg/I
Cu - Copper mg/I
Fe - Iron mg/I
Hg Hg - Mercury ..... mg/I
K - Potassium mg/I
Mg - Magnesium ,. mg/I
Mn - Manganese _._. u., mg/I
Na Sodium mg/I
REPORT IS TRUE. AND ACCURATE.
Qthe
(Specify)
Note;
Values shoo
* SO4, back nE>tructV0
mg/I
mg/I
pecify Compounds)
ug /1
ug/I
. ug/I
ug/I
ug/1
ug /I

COMPLIANCE MONITORING
REPORT FpRm
Fa N
Addr
ocation
Identification Number
Diame
Depth to Water Level
Measuring point is
Gallons of water pumped bail
Field Analysis: pH t•\ Specific Conduc
Date Sample Collected
Laboratory Name .,A, (.4y
Env ro mental Management. Divf
groundwater Section
P.O Box 27687
Raleigh,N.G. 27611
[phone]
Sample (Screened) Interval
ft. below measuring p
above land surface
d before sampling
COD
Coliform: MF Fecal
Conform: MF Total
Dissolved Solids: Total
pH (when analyzed)
Ft. To
(before sa
Ft
Ft.
ling )
ance uMhos Temp
Date Lab Sample Analyze
ion
County
Permit Number:
Non -Discharge
NPDES )t"
Water Use
Injection Well
M r
Well Construction
Other
Odor
tication No.
Appearance
27.2
mg/I NO2 as N mg/I Ni - Nickel
/100ml NO3 as N mg/I Pb - Lead
/100ml Phosphorus: Total as P mg/l Zn - Zinc
mg/I Al - Aluminum mg/I Pesticides/H
units Ba Barium mg/I
TOC I I mg/I
Chloride mg/I
Arsenic mg/I
Grease and Oils - mg/I
Hardness: Total ,.
Phenol
Sulfate.
Specific Conductance
Tot& Ammonia(NH3 t NH
TKN as N
CE'.if Fy TI ty-
Ca - Calcium
Cd - Cadmium,....
Chromium: Total.
Cu - Copper
mg/I Fe - Iron
mg/I Hg Mercury.
mg/I K - Potassium..-,
uMhos Mg - Magnesium
mg/I Mn - Manganese
mg/I Na Sodium
ORT IS TRUE AND ACCURATE.
0 AI.ATFIOI (ZED AGENT*)
ng/I
mg/I
mg/1
mg/I
mg/I
mg/I
mg/I
mg/1
mg/I
ntg/1
mg/I
mg/I
bicides (Specify Compounds)
ug/l
Other (Specify)
Note:
%/aiues s,
* `3oe back or
ug/I
ug/I
ug /l
ug/1
eug/l
ug/I
ug/I
ug /1
r'uu t3
ns
* * ubrnu't Ohio :,.114.1 green n u :rple a to address ad aup.

N::. fiEPARTNIEINgT NATURAL
E
AL 0 COMMUNITY DEVELOPMENT
ARO, `LI C?, tvtl 0 RRO,
1T ed by, Lugs, Ccurl rw Other
Lei T4{R: W•< ?Ti
FIELD ANALYSE
tiAitt ratae Cnr, atL
Tr,1Tt1=9Ct^ «oC Odor ;
Ap d Tdra .._ .. 'Ta"ste
ldtd Analysts By:
A ORATORY "ANALYSES
C Iit srrr.tir ca1a1 515o
at hiataate 445
tda 520
mg/
ROUNl,:: WAT"E EIEI I.. LAB
SAMPLE PRIORITY
ORM
R UTINE EMETIGEtIC
TIME PURR
Trtegttts
A LNL COMPLAIC T,
LAB NUM
V, ... T i me x t.
DATE I4ECEI VED
Reed by; ,. r From: I us -Courier
Other
DATA, ENTRY BY: '. CK; -..w
DATE REPORTED:
sarnp pantod
.tpurrtp, bait
uMhosl
Ag - lPvga 1T
Total 1114"
NIckef
ua/I
" In black
copy * Lab
ABBE,t r? ._ OTHER
pie Interval
ping timer ; air te

COUNTY
QUAD NC) SERIAL NO,KJ-4145/215
Z,
LAT,
LONG '2-4- ,I-_
Report io/AR(7„/FRO, MRO, RRO, Wa 0, WiR0,
WSRO, Kina5lon FO -,ther
Shipped by: Bu
coLLEcToR(s),
FIELD ANALYSES
1400 Spec. Cond.94 al 25°C
DATE
NJ_ )EPARTMENT OF NATURAL RESO
& COMMUNITY DEVELOPMENT
DEM
GROUNDWATER FIELD/LAB F
SAMPLE PRIORITY
0-- ROUTINE E EMERGEN
TIN1E
PURPOSE:
Owner .. (
Location or site
!4,)
LAI3 f:11.„)!..1f3M
DATE RECEIVED. /-7/7
Rec'd by:
Other
DATA. r tTRY BY:
DATE REPORTED:
BASELINE, COMPLAIN COMPLIANGt, l_US7. OTHER
(cirle one)
C I V'
{t7,1-
r 0 rit077,; rr,{tti-
T emp,10 or Odor Description of sampling point
Appearance Taste
Sampling Melhod
7Vf7L-
urnp, bailer, etc.)
Fietd Analysis By: Remarks
LABORATORY ANALYSES
SOD5 310
rng/l
COD High 340
mg/I
COD Low 135
rrigil
Colitormitmf Fecal 37616
/100ml
Cotilorrntailf Total 31504
/10Orni
T
Turbidity 76
!OW'
PH 403
units
Alkalinity 1° pH 4,5 413
mg/1
Alkalinity to pH 8,3 415
71g/1
Carbonate 445
mg/1
Bicarbonate 440
rrig/I
Arsenic:7°1AI 1002
ug/1
Carbon dioxide 405
mg/I
Chloride 940
mg/I
Chromiurn:Hea 1032
ug/i
ColorTrue 80
Pt -Co
Cyanide 720
rng/1
Lab Commenis:
Diss,Sol7ds 70300
Fluoride 951
Hardness:To141 900
(non-carb) 902
Phenols 32730
Specific Coml, 95
Sulfate 945
Sullide 745
MOP
rrig/I
mg/i
ug/I
uht nos/cm?
mg/I
ragil
NH3 as N 610
mg/1
TKN as N 625 rng/I
NO2 1. NO3 as N 630
PiTclat as P 665
mg/I
Ag - Silver 1077
AI - Aluminum 1105
58 6arium 1007
Groundwater Saato9
SaMble fltery A3b601e, R
5,1egiOnal titIce
14,
(puniping lerVit),,
Cs - Calcium 916 mg/I
- Cadmium 1027
Chrbmiurn.,Total 1034
<a o
Cu - Copper 1042
Fe - Iron 1045
‹)c.;
Hg - Mercury 71900
ug/1
ug/I
ug/t
ugil
ug/I
K - Potassium 937 rng/I
Mg - Magnesium 927
gahochlorine Prr,Oc:des
Orgaeophoschorus Pe07 0itd05
Acid Herdicides
ase I Neulral Exirectable 0rga.71 C
Acid Extractable Organics
ft
urgeabie OrganiCs DrOA bottle)
rnp/I 1,2 - Dibromoelhane tEDS)
- Manganese 1055 aq0 ug/I
Na - Sodium 929 mg/I
Ni - Nickel 1067
Pb Lead 1.051
- Selenium 7147
Zo Zinc 1092
07/
At% A.,ea
't'ttt,tt t
k.2
Revised 7/85
For Dissolved Analysts sui;mi.1 fit+er©d sample and write 'DIS• in block
While copy - Headquarters Pink copy - Region Yellow copy - Lab

CO© mg/I
_/1b0ml
Coliform: NIF Total /lndml
Dissolved Solids: Total mg/I
pH (when analyzed) --- unit;
TUC mg/I
Chloride
g/I
Grease and Oils rng/t
Hardness: Total mg/I
Phenol mg/I
Sulfate w mg/I
l c it "- 1
COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
Location
Identification Number
Diameter _ -...
to Water
r ring point is
lions of water pumpe
Field Analysis: pH
Date Sample Collected
Laboratory Name
En irtr onmental Manege:nte;nt Division
Groundwater Section
P.O Box 27687
I aleigh,N.C. 27611
(919)73.3-3221
Well Depth
Sampie (Screened) Interval. A ) Ft. To
lt. below ;measurin i point, (before
feet above and surface
bailed before sampling
Conductance _ dI
Lab Sa
Col%form
MF Fecal
Arsenic
veal :,..
Specific Conductance
Total Arrmtoria(NH3
TKN as N
I CERTIFY T
E
d 3/88
County
Permit Number, 4019
-9
Non -Discharge
NPDES N Cc
Ft. Water Use __,. L)AT
Ft. Injection Well _.
tng) Well Construction
Other Kid
Temp.
Analyzed
Odor i Appearance
Maize
Certiticatlon No.
NO2 as N m.. �... mg/I
NO as N .. mg/I
Phosphorus: Total as P mg/I
Al - Aluminum mg/l
Ba - Barium_ ... , mg/I
Ca - Calcium mg/I
Cd - Cadmium mg/I
Chromium Total .... mg/I
Cu - Copper mg/I
Fe - Iron mr /I
Hg - Mercury
K - Potassium
uMhos Mg Magnesium
mg/I Mn - Manganese
mg/1 Na - Sodium
THIS F31 aP}RT IS TRUE AND ACCURA tl.
TTEE°(OR AUTHORIZED AGENT*)
mg/t
mg/I
mg/I
mg/I
:WAWA
** Submit blue
Ni - Nickel
Pb Lead
Zn -- Zinc
Pesticides/He
Other (Specify)
Note:
Values should reflect totat
mg/l
mg/1
mg/1
des (Specify Corr pounds)
ug /I
ug/I
ug/I
ug/1
ug/I
„.ug/1
ug/1
Asheville R viarl l
toes

1L,I.C__
COMPLIANCE MONITORING
REPORT FORM
it
Facility Name
Address
Welt Location
Well tdentificat Depth F t.
Well Diameter _ Sample (Screened) Interval _; _ Ft. To �31 Ft.
Depth to Water Level /' ft. below measuring point. (before sampling)
Measuring point is feet above land surface
Gallons of water pumped/bailed before sampling
Field Analysis: pH 7,4) -,.. Specific Conductance uMhos Temp,
Date Sample Collected �.� Date Lab Sample Analyzed
Laboratory Name _'"A.A„', Cer
CO© rrrg/t NO2 as N
Coliforme MF Fecal /1O6rnl NO3 as N
Coliform: MF Total /1o0rnl Phosphorus: Total a P
Dissolved Solids. Total mg/l Al - Aluminum
pH (when analyzed) units Ba - Barium
TOC � mg/I Ca - Calcium
Chloride._� mg/I Cd - Cadmium.,-.�.- mg/I
Arsenic _ mg/I Chromium: Total mg/I
Grease and Oils mg/l Cu - Copper mg/I
Hardness: Total mg/1 Fe - Iron mg/I
Phenol mg/t Hg - Mercury mg/I
mg/1 K Potassium _ mg/I
Specific Conductance uMhos Mg - Magnesium _ . mg/I
Total Ammo a(NHa t NH4) .._ --W - mg/I Mn - Manganese timg/I
TKN as N mg/t Na - Sodium mg/I
I CERTIFY THAT
Environmental Management Division
Groundwater Section
P.Q. Box 27687
Raleigh,N.C. 27611
[phone]
Sulfate
tWeed
PORT IS TRUE AND ACCURATE,
TTEE (OR AUTHORIZED AGENT*)
County
Permit Number:..
Non -Discharge
NPDES
Water Use
Iniection Well-- ,
Well Construction e
Other �..�
©C Odor
Appearance
cation No,
mg/1 Ni - Nickel
mcg/I Pb - Lead
mg/I Zn . Zinc
mg/1 Pesticides/Heroic des (Specify Compounds)
mg/I ug/I
mg/l ug/I
ug/t
Other (Specify) .. ,. ug/I
ug/l
ug/l
_.. ug/l
. , ug/l
.ug/I
ox
Note:
Values should reflect total converttrations

COUNTY
QUAD NO
LAT.
:R1 AL
LONG.
Report t©:1ARC$ FRO, ItPO, RRO, WaRO, WiRO,
1WSF O, Kinston FO Other ..
Shippod by. Bus, Courier,.
COLLECTOR(SJ:
FIELD ANALYSES
pH400 Spec.
Temp.")
QC
Appearance _
N.C. DEPART' I NT OF NATURAL' RESOURCES
& COMMUNITY DEVELOPMENT
DEM
GROUNDWATER FIELD/LAB FORM
SAMPLE PRIORITY
ROUTINEEMERGENCY
TIME
Owne
at 25°C o rttcan or site
Description of sampli
Field Analysts F3y, Remarks.
LABORATORY ANALYSES
4
1t�
504
urbidtly 79 NTU.
rn
Alka$1 City to pH ft,3 415 ..
to 445
le 440
Arsarictictel 1002 ug
a rbon ;dioxide 405
mg
4
ya 0
GW-54 Revised 7/85
rag/1
ug!
LAB` NU'M
DATE REGV'ED
Rec"d byt ..,� ..v
Other.
DATA ENTRY BY:
DATE REPORTED:
PURPOSE; BASELINE, COMPLAINT
(circle
Liss„ Solids 70300
IFA.UO(1de 951
To1at 900
Herrin
Phenols 32'730
Specific t,;fst"ict,
u AAhostc rn
ulidte 045 ro9l1
de 7•+t5 rn9,1
sN9i10
TKN
'NO2 i NO
P.'Tot'e1 ds P 665
.For Diasoly c Analysis
White' copy Headquarters Pink copy - t;er lon Yellow copy Lab
Ag - Si1Ve, 1077
ug/I
uQ/1
tTptdt 1034
Cu 0prser .7042
Fe
45
d sarrapie and write 0 S' in block
Time
0 rTtar+©
Orga,Pep
Acid Herdtctdes
Acid Extractable Org
Per bib Or g8 Rce iVi7A bottle

COMPLIANCE MONITORING
REPORT FORM
Facility Name
Address
ation .IAN_
icati;on Number
Well Diameter ,� �- Sample (Screened) Interval
Depth to Water Level ft. below measuring
Measuring point is feet above land surface
Gallons of water pumped bailed before sampling
Environmental Managernent Div
Groundwater Section
P.O. Box 27687
Ralegh,N.C. 27611
[phone]
Field Analysis pH
Date Sample. Collected
Laboratory Name
COD
Conform: MF Fecal
Coliform: MF Total ,...�.
Dissolved Solids: Total
pH (when analyzed)
TOC
Chloride
Arsenic
Grease and Oils
Hardness: Total .,
Phenol
Sulfate M,,
Specific Conductance
Total Amrnonia(NH3.i NH ,)
TKN as N
ERTI -V TRAT THIS
Depth
F t.
ion
County
Permit Number.
Non -Discharge
NPDES
Water Use
Ft. To Ft. Injection Well
oint. (be ore sampling) Well Construction F.
Other.
Specific Conductance uMhos Temp.
mole Analyzed
Certifi
oat
. m/I NO2 as N
/ 1 OOml NO3 as N.
/100ml Phosphorus: Total as P_.
mg/I AI - Aluminum
units Ba - Barium
mg/i Ca Calcium
g/I Cd - Cadmium
g/I Chromium: Total
g/I Cu - Copper
g/I Fe - Iron
gJl Hg - Mercury ..
mg/I K - Potassium
uMhos Mg - Magnesium
mg/I Mn - Manganese Ni
mg/l Na - Sodium
PORT IS TRUE AND ACCURA(E.
r
TTEE (OR AUTHORIZED AGENT°*)
mg/I
mg/I
mg/l
mg/I
m g/ I
mg/I
mg/I
mg/I
Odor Nzut,r! Appearan
ion No,
Ni Nickel mg/I
Pb -. Lead mg/I
Zn - Zinc _nig/I
Pesticides/H1erbicides (Specify Compounds)
_ ug/I
ug/l
ug/I
ug/I
ug/l
ug/I
ug/I
ug/1
Not
Values
* Soo' back taxi
US
* * Subrotnt btlu€ and at non c°opies,
above.

James G. Martin,
State of North Carolina
Department of Natural Resources and Community Development
Division of Environmental Management
512 North Salisbury Stit: t • Raleigh North Carolina 27611
December 30, 1986
S. Thomas Rhodes, Secretary
The Honorable John Henry Moss, Mayor
City of Kings Mountain
P.O. Box 429
gings Mountain, N.C. 28086
Dear Mayor Moss:
R, Paul Wilms
Ditrctor
C 70
SUBJECT: Permit No. 14069
City of Kings Mountain
Pilot Creek Wastewater Treatment Plant
MuCuill Wastewater Treatment Plant
Sludge Disposal Landfill
Cleveland County
In accordance with your application received August 14, 1986, we are forwarding
herewith Permit No. 14069, dated. Dacember 30, 1986, to the City of Kings Mountain for
the construction and operation of the subject water treatment plant sludge disposal
landfill.
This permit shall be effective from the date of issuance until January 31,
1992, and shall be subject to the conditions and limitations as specified therein.
If any parts, requirements, or limitations contained in this permit are
unacceptable to you, you have the 17.ight to request an adjudicatory hearing upon
written request within 30 daysfollowing, receipt of this permit. This request must he
in the form of a. written petition, conformingto Chapter 150B of North Carolina
General Statutes, and filed with the Office of Administrative Hearings, Post Office
Drawer 11666, Raleigh North Carolina 27604.
If you wish to have the hearing before the Hearing Officer with this
Department, you must indicate in the petition that you waive the right to have the
contested case conducted by a Hearing Officer in. the office of Administrative
Hearings, and wish to have the matter conducted in the. Department of Natural Resources
and Community Development. Unless such demands are made this permit shall be final
and binding.
Polizitorm Prevoi
P(.). Rdax. 27687% Rakcgli, Nordn Carolina 276P.,7667 kkphont... 733,-791:5

19. Because of the thickness of sludge and the relative high permeability of the
underlying aediments, the combination of the thickness and type of cover material
andthe degree of compaction must result in an permeability no greater than 1 x
10 cm/sec.
20. Prior to any sludge disposal, the permittee must install one upgradient and two
downgradient monitor wells at locations and of a construction approved by the
staff of the Asheville Regional Office , from which well construction permits must
be oblained,
21. The wells shall be sampled, within 48 hours of completion and thereafter every
March, July and November for the following:
TDS Cl
TOC -Total Halogenated Compounds (November only)
Mn Waters Levels (measured prior to sampling)
Pb
. In the event that an analyses shows the presence of halogenated compound(s), the
types and concentrations of those compounds must be determined and included in the
analytical report.
Permit issued this the 30th day of December, 1986.
NORTR CAROLINA ENVIRONMENTAL MANAGEMENT COMMISSION
/ R. Paul s, Direc
Division of Environmental. Management
By Authority of the Environmental Management Commission
Permit No, 14069

NORTH CAROUNA DEPART1 &WrOF NATI
DIVISION OF ENVIRONMENTAL IAANAr :',ENT - GROUNDWATER WATER SECTION
P.O. BOX 27687 RALEIGH,N.C, 27611, PHONE [phone]
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR aQ✓-t.yr
DRILLER REGISTRATION NUMBER
FOR OFFICE USE ONLY
d. No. Q 73 .V E. Serial No. _.348
35 i$ Ay Lollg: 912{r.3 Pc
in or Basin
in Code
Header Ent.
G'W-1 Ent..
STATE WELL CONSTRUCTION
PERMIT NUMBER: 2z- M -Q43$
1, WELL LOCATION: (Show sketch of the location below)
Nearest Town.
(Road,. Community, o
2. OWNER
ADDRESS
3. DATE DRILLED
4.TOTAL DEPTH
ify or Town
USE OF WELL 1a '
CUTTINGS COLLECTED Q Yes
5. DOES WELL REPLACE EXISTING WELL? © Yes gNo
6_ STATIC. WATER LEVEL: - _.._ FT. 0 above TOP OF CASING,
below
TOP OF CASING IS_ it FT. A OVE LAND SURFACE.
7. YIELD (yprn); METHOD OF TEST
1 WATER ZONES (depth):
CHLOPONA 1 ION
11+4
F4a 3 From
t;? GRAVEL PACK:
Depth
To_
To.._7f
To 3 /
Depth
HWtEi From ! To r'
MW 'a'From //
t1 e# / F'
14, REMARKS:
Amount
Wail Thicknes
Diameter or Weght/Ft, Materiai
Demeter Slot Size Material
( in.
FL_.
100 HEREBY CERTIFY THAT THIS WELL
C
Material
AS CONSTR
STANDARDS, ANTS THAT A COPY OF THIS RECORD HAS
S
Submit orictina
T
County:
Depth
From To
N AC
ING LOG
Formation Description
adarteonal 1:pac:e is needed use back of loan.
DA
tTH 15
OWNE
OR OR AGENT
CAC 2C, WELL. ESONSTRI,ICTION
GW-1 RCvrStoj 11/84
Fm.4errun pnan Ll r:y„nrnc,,-t ,fled x

IRCES AND COMMUNITY DEVELOPMENT
DIVISION OF EN1rIRik'NTAL MAI V_!T— CIROuNDWATEF1 SECTION
P.O., BOX 27887 — RALEIOH,N.C, [78T 1, PHONE (a161) 733-8989
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR
DRILLER REGISTRATION NUMBER
1. WELL LOCATION (Show sketch of the Iocation below)
Nearest Town:
(Road. Co
2. OWNER
ADDRESS
unity, or Subdivision an
uteN
.m
ty or Town
Zip Code
3. DATE DRILLED ! /i1/ 7 USE OF WELL 0 lt!!
4, TOTAL DEPTH _. 31 CUTTINGS COLLECTED Yes
5. DOES WELL REPLACE EXISTING WELL? LJ Yes No
fy
6, STATIC WATER LEVEL. FT, p above TOP OF CASING,
t � ikG hr f)w
T ;1 Qr CASiNC u;`-> f7 AC30v:' LAND SURFACL
7. YIELD igpm): , h90Tt1OD OF TEST
Ei, WATER ZONES (cteplh)
3_ CilfCIFIYNA'TION,
Dept,} Diameter
Morn
13 GRAVEL PACK
De;,th
From L_ To
F"rom m, „ To
14 REMARKS,
inor Basin
in Code
®Oder Ent. GWV-1 Ent,
STATE WELL CONSTRUCTION
PERMIT NUMBER: .t.2 -d off `f 6i1 /Y,,-¢ ag
County:
Depth
Frorn To
Ft,
Size
M0IUOd
Matert,a
in. PVC
Formation Description
iq,ta;=ac tra r :1t a
Y'/a1Ck
c.�orr,
00 HEREBY CERTIFY' 1"HA1 THIS WELL WAS CONSTRUCTED IN ACCORDANCE WITH 15 NCAC 2C, WELL CONSTRUCTION
STANDARDS, AND THAT A COPY OF THIS RECORD HAS BEEN PROVIDED TO THE WELL OWNER_
GW-1 Revises 11/81
SIGNATURE OF CONTRACTOR OR AGEN
Submit original IO Division of Lnvironnal Ma
enl and cony tr+ wolf Owner.

Hvtl I H 4AHUuNA OEPTkENT OF NAB wcES ANO COMMUNITY OE1
INYRR40N OF ENVIRONMENTAL MO _ IA&f - 13RC>IllPOWATER SECTION
P.O. BOX 27e117 - RALEXIIpN.C. 27611. MOW caiei 733.808a
E ONLY C
No, 0 7 313 Serial No. ,,, ,.,57 4
WELL CONSTRUCTION RECORD
DRILLING CONTRACTOR;]
DRILLER REGISTRATION NUMBER
(Road, Com
2. OWNER
ADDRESS
5S) l2- Long. t Z447 Pc
Basin
n Code
r Ent,
TATE WELL CONSTRUCTRON
1 Ent
PERMIT NUMBER: i 2 SL4 ( -1►1 /41 -s16J
WELL LOCATION: (Shaw sketch of the location below)
Nearest Town: County.
Depth
City or Town State
3. DATE DRILLED USE OF WEL
4, TOTAL DEPTH 3/ I CUTTINGS COLLECTED D Yes
5. DOES WELL REPLACE EX
6. STATIC WATER LEVEL:
TOP OF CASING IS_.
7. YIELD (gpm):
h WATER ZONE
ode
NG WELL? E Yes No
_ FT. 0 above TOP OF CASING,
®. below
FT. ABOVE LAND SURFACE.
5. CH LO lL1.AT1ON: Type
t 0 CAMP;+
rrom
Depth
o
METHOD OF TEST
To— _ _Ft.
Amount
Depth Diameter
Ft
from To F1.
13 GRAVEL PACK
Depth Size
From 1I r To 3% F1,
From To Ft. ,
14. REMARKS: Z, r a/.a.
I DO HEREBY CERTIFY THAT THIS WELL WAS
Material
Method
Material
From To
LOCATION
r'OIL reference rornis)
ING LOG
tion Description.
0 Slate Roads..,(
�p.
TRUCTED IN ACCORDANCE WITH '15 NCAC 2C, WELL CONSTRUCTION
STANDARDS, AND THAT A COPY OF THIS RECORD HAS SEEN PROVIDED TO THE WELL OWNER.
SIGNATURE OF CONTRACTOR OR AGENT DATE
GW-1 Revised 11184 Submit original to Division of Environmental Management and copy to well owner.

State of North Carolina
Department of Environment, Health, and Natural Resources
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James. C. Martin, Governor December 1, 1989 R.Paul . Wilms
William W. Cobey, Jr, Secretary Direct -co
Mr. Walter C. 011is
P.O. Box 429
Kings Mountain, NC 28086
Dear Mr. 011is:
Subject: Permit No. NO0020737
Kings Mountain -Pilot Creek WWTP
Cleveland County
In accordance with your application for discharge permit received on May 5,
1989, we are forwarding herewith the subject State - NPDES permit. This permit is
issued pursuant to the requirements of North Carolina, General Statute 143-215,1 and
the Memorandum. of Agreement between North Carolina and tbe US Environmental Protection
Agency dated December 6, 1983.
If any parts, measurement frequencies or sampling requirements contained in
this permit are unacceptable to you, you may request a waiver modification pursuant
to Regulation 15 NCAC 28 .0508(b) by written request to the Director identifying the
specific issues to be contended. Unless such request is made within. 30 days following
receipt of this permit, this permit shall be final and binding. Should your request
be denied, you will have the right to request an adjudicatory hearing.
Please take notice that this permitis not transferable. Part II, D.3.
addresses the requirements to be followed in case of clr in ownership or control of
this discharge.
This permit does not affect the legal requirements t.o obtain other permits
which may be required by the Division. of Environmental MUnagement. or permits required
by the Division. of Land Resources, Coastal Area ManagemenL Act or any other Federal or
Local governmental permit that may be required.
If you have any questions concerning this permit, pin'Ao contact Ms, Luta
Harris at telephone number 919/733-5083,
cc: Mr. Jim Patrick, EPA
Asheville Regional Office
PO. Box 27687, Raleigh, North Carolina 27611-7687 "Tdcohonc 91Q-733-7015

DIVISION OF ENVIRONMENTAL MANAGEMENT
ASHEVILLE REGIONAL OFFICE
GROUNDWATER SECTION
October 19, 1987
MEMORANDUM
TO: Nargis Toma
FROM: Kay Dechant
SUBJECT: Compliance Monitoring
City of Kings Mountain Pilot Creek
Wastewater Treatment Plant
Sludge Landfill
Permit No. 14069
Cleveland County
As requested in my letter dated October 13, 1987, to Kim Moss of
the subject facility, the monitor wells have been resampled for lead
and manganese.
During telephone conversation with Kim Moss on October 19, 1987,
learned that the facility has been collecting samples with bailers
constructed of lead. Instructions were given to resample the wells
in November using bailers constructed of a suitable material.
KD:ar

MEMORANDUM
TO:
FROM:
SUBJECT:
DIV
SION OF ENVIRONMENTAL MANAGEMENT
GROUNDWATER SECTION
November 21, 1986
Arthur Mouberry
Bob Cheek "+3C
Sludge Disposal by Subsurface Trenches
City of Kings Mountain, Cleveland County
APN-6191/ Review Engineer: Don Safrit
The Groundwater Section would recommend permit approval,
based on the amended proposal submitted by the consulting engi-
neers under cover letter dated October 13, 1986, with the fol-
lowing:
(1) The maximum depth of the sludge trenches shall be ten
(10) feet.
(2) Because of the thickness of sludge and the relative
high permeability of the underlying sediments, the
combination of the thickness and type of cover mate-
rial and the degree of compaction mint result in a
permeability no greater than 1 x 10 cm/sec.
(3) Prior to any sludge disposal, the permittee must
install one upgradient and two downgradient monitor
wells at locations and of a construction approved by
the staff of the Asheville Regional Office, from
which well construction permits must be obtained.
(4) The wells shall be sampled, within 48 hours of
completion afid thereafter every march, July and No-
vember for the following:
TDS Cl
TOC Total Halogenated Compounds (November only)
Mn Water Levels (measured prior to sampling)
Pb
(5) In the event that an analyses shows the presence of
halogenated compound(s), the types and concentrations
of those compounds must be determined and included in
the analytical report.
BC/ls
cc: Roy Davis/Don. Link
Don Safrit
Central Files
Groundwater Files

State of North Carolina
Department of Natural Resources and Community Development
Asheville Regional Office
s C. Martin, Governor
DIVISION OF ENVIRONMENTAL MANAGEMENT
GROUNDWATER SECTION
October 13, 1987
CERTIFIED MAIL
RETURN RECEIPT' REQUESTED
Ms. Kim T. Moss
The City of Kings Mountain
P. O. Box 429
Kings Mountain, North Carolina 28086
Dear Ms. Moss:
S. Thornas Rhodes, Secretary
Subject: Groundwater Compliance Monitoring
City of Kings Mountain -Pilot Creek
Wastewater Treatment Plant, Sludge Landfill
Permit No. 14069
Cleveland County, North Carolina
Review of compliance monitoring data from the three monitor wells at the.
subject site indicates violations of water quality standards for lead and
manganese. Violations were noted on both the. March 15, 1987, and July 24,
1987, sample dates.
As stated in NCAC Title 15, Subchapter 2L .0202 (b), the underground
water quality standard for lead is .05 mg/1 and for manganese, .05 mg/1.
All three wells shall be resampled for the parameters in violation within
seven days of receipt of this notice. Submit the sample results on the blue
and green copies of the compliance monitoring report forms (GW-59) to the
Groundwater Section in Raleigh.
Please call me and report the sample results or if you have any questions
at 704-253-3341.
KD:ar
Sincerely,
21/
Kay Dechant.
6lydrogeological Technician
cc: Naris Toma
Interchange Building 59 Woodin 'Place, PC). Box 370, Asheville, N.C. 28802•0370 • Telephone 704-254
An Equal Opportunft i 4Frmat ve Action Employer

State of North arolina
Department of Natural Resources and Cornmunit° Development
N,heviHe PA C )ilicc
in, pcavernor S. Thomas Rhodes,, Secretary
DIVTON C)i' ENV1Rc)NMENTAL MANAGEMENT
tiROIINDWATE SECTION
1987
rn Moss
:y of Kings Mount in
Creek Wastewater rl'reatm nt i'1 tiara
P. 0. Box 429
Kings Mountain, North Carolina 28086
Compliance
City of Kin
Permit
Cleveland Cc untty, North Carolina
Dear Ms. Moss:
In order for the Groundwater Section to review and process compliance
monitoring reports in a consistent manner, please send the report fortes
directly to the Groundwater Section
of the form, Submit the blue and f;
white copy for your files. If an a
th1s
in your behalf, notify them
in Raleigh at the address at the top
een copies to Raleigh and keep the
ent is authorized to submit the forms
procedure.
If you have any questions o` comments regarding compliance monitoring,
please contact me or Don Link at [phone].
KD:ar
cc: Nary e Toma_a
nr Be,iildiro� 59
Sincerely,
Kay Dechant
Hydrogeoiogi.ca1 Techni
Placer P.(7. Box 370, Ashley ill C. 2a802 )37O • 'Telephone [phone]
rr�Ratave Actkn

State of North Carolina
Department of Natural Resources and Community Development
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carol na 27611
James G,. Martin, Governor December 30, 1986 R. Paul Wilms
S. Thomas 'Rhodes, Secretary Director
The Honorable John Henry Moss, Mayor
City of Kings Mountain
P.O. Box 429
Kings Mountain, N.C. 28086
SUBJECT: Permit No. 14069
City of Kings Mountain
Pilot Creek Wastewater Treatment Plant
MuGuill Wastewater Treatment Plant
Sludge Disposal Landfill
Cleveland County
Dear Mayor Moss:
In accordance with your application received August 14, 1986, we are forwarding
herewith Permit No. 14069, dated December 30, 1986, to. the City of Kings Mountain for
the construction and operation:of the subject water treatment plant sludge disposal
landfill.
This permit shall be e fectlye from the date of issuance until January 31,
1992, and shall be subject to the conditions and limitations as specified therein.
If any parts, requirements, or limitations contained in this permit are
unacceptable to you, you have the right torequest an adjudicatory hearing upon
written request within 30 days following receipt of this permit. This request must be
in the form of a written petition, conforming to Chapter 150B of North Carolina
General Statutes, and. filed with the Office of Administrative Hearings, Post Office
Drawer 11666, Raleigh North Carolina 27604.
If you wish to have, the hearing before the Bearing Officer with this
Department, you must indicate in the petition that you waive the right to have the
contested case conducted by a Hearing Officer in the office of Administrative
Hearings, and wish to have the natter conducted in the Department of Natural Resources
and. Community Development. Unless such demands are made this permit shall be final
and binding.
Poitutuin
po. Eiox 276V, R.A1c1,01, .N1orth Camisna. :1760-7(47 It1e.,74x.y-tc 919.733-7015

One (1) set of approved plans and specifications is beinarwarded to you. If
need additional information concerning this matter, please contact Mr. Donald
telephone No. 919/733--5083, ext. 179.
Sincer4y yours,
cc: Cleveland. County Health Department.
Asheville Regional Supervisor
Dennis R. Ramsey
Mr. Bob Cheek
W. K. Dickson & Company, Inc.

NOR T 1 CAROL NA
ENVIRONMENTAL MANAGEMENT COMMISSION
DEPAI. TENT OF NATURAL RESOURCES AND COMMUNITY' DEVELOPMENT
RALEIGH
FERMI T
For the discharge of Sewage, Industrial Wastes, or Other Wastes
In accordance with the provisions of Article 2l of Chapter 143, General
Statutes of North ollna as amended, and other app'lable Laws, Rules,, and
Regulations
PERMISSION IS HEREBY GRANTED TO
City of Kings Mountain
Cleveland County
FOR THE
construction and operation of a sludge disposal landfill consisting of a
twenty-three (23) acre site adjacent to the Pilot Creek Wastewater Treatment Plant to
serve the Pilot Creek and McGuill Wastewater Treatment Plants with no discharge to
the surface waters of the State,
pursuant to the alplication received August 19, 1986, and in conformity with the
project plan, specifications, and other supporting data subsequently filed and
approved by the Department of Natural Resources and Community Development and
considered a part of this permit.
•
This permit: shall be effective from the date of issuance until January 31,
and shall he subject to the following specified conditions and .limitations:
This permit shall become voidable unless the facilities are constructed in
accordance wt:h the approved plans, specifications and other supporting, data.
This permit is effective only with respect to the nature and volume of waters
described in the application, and other supporting data.
3. The facilities shall be properly maintained and operated at all times,
This permit is not transferable.
In. event the facilities fail to. perform satisfactorily including the creation of
nuisance conditions, the Perm.ittee shall take such immediate corrective action as
may be required by this Division, including the construction of additional or
replacement wastewater treatment or disposal_ facilities..
This permit s'ha11 become voidable in the event of failure of the trenches to

properly contain the landfilled sludge and may he rescinded unless the facilities
are installed, maintained and operated in a manner which will protect the assigned.
water qualitystandards or the surface waters and ground waters.
7. Reports on the operations of the sludge disposal. landfill shall be submitted to
the Asheville Regional Office at regular intervals and in such form and detail as
may he required by this Division.
8. The Permittee, at least six (6) months prior to the expirationof this Permit,
shall request its extension. Upon receipt of the request, the Commission will
review the adequacy of the facilities described therein, and in indicated, will
extend the Permit for such period of time and under such conditions and
limitations as it may deem appropriate.
9. Adequate, facilities shall be provided to prevent surface runoff from carrying
any disposed. or stored material into the receiving. stream.
10. The issuance of this. permit shall not relieve the City of Kings Mountain of the
responsibility for damages to surface or ground waters resulting fromthe
operation of this facility.
11. The facilities shall he effectively maintained and operated as a non -discharge
system to prevent the discharge of any wastewaterresulting from the operation of
this facility.
12. No type of sludge other than that from the McCuill and Pilot Creek Wastewater
Treatment Plants shall be placed in the sludge disposal landfill.
13. Adequate provisions shall be taken to prevent wind erosion and surface runoff
from conveying pollutants from the sludge disposal area onto the adjacent
property and/or surface waters.
14. In any future transfer of this land, a. notice shall be given. to the new owner
that gives full details as to the materials applied or incorporated at this site.
15. A minimum of two (2) feet of cover shall be applied to the sludge landfill
trenches.
16. The folio total cumulative loading shall not be exceeded:
Metal
Pb
Zn
Cu
Ni
Cd
lb/ac
500'
250
125
125
4.4
17. The minimum buffet maintained between property lines and sludge disposal trenches
shall be seventy-five (75) feet.
18. The maximum depth of the sludge trenches shall be ten (10) feet. The maximum
width of the bottom of the trenches shall be eight (8) feet and the maximum width
of the top of the trenches shall be fifty-eight (58) feet.

19. Because of the thickness of sludge and the relative high permeability of the
underlying sediments, the combination of the thickness and type of cover material
and the degree of compaction must result in an permeability no greater than 1 x
10 cm/sec.
4 . Prior to any sludge disposal, the permittee must install one upgradient and two
downgradient monitor wells at locations and of a construction approved by the
staff of the Asheville Regional Office , from which well construction permits must
be obtained.
21 The wells shall be sampled, within 48 hours of completion and thereafter every
March, July and November for the following:
TDS Cl
TOC Total Halogenated Compounds (November only)
Mn Waters Levels (measured prior to sampling)
Ph
. In the event that an analyses shows the presence of halogenated compound(s), the
types and concentrations of those compounds must be determined and included in the
analytical report.
Permit issued this the 30th day of December, 1986.
NORTH CAROLINA ENVIRONMENTAL MANAGEMENT COKMIS' N
R. Paui Wilins, Directo
071e-' Division of Environmental Management
By Authority of the Environmental Management Commission
Permit No. 14069

State of North Carolina
Department of Natural Resources and Community Development
Division of Environmental Management
512 North Salisbury Street • Raleigh, North Carolina 27611
James G. Martin, Governor
S. Thomas Rhodes, Secretary
August 19, 1986
MEMORANDUM TO; Mr, William L.:Meyer
Solid and Hazardous Waste Management Branch
FROM:
SUBJECT:
Gil Vinzani, Supervisor
State Engineering Review Unit
APN008191
City of Kings Mountain
Sludge Landfill
Cleveland County
R. Paul Wilms
Director
The City of Kings Mountain has requested. a non -discharge permit for construc-
tion and operation of a sludge landfill for disposal of generated sludge from
their wastewatertreatment facility. Asper the agreement between our departments,
I am hereby requesting your review and comments on the attached documents.
A copy of the Procedure and Criteria for Waste Determination hasbeen
forwarded to the applicant as per your request. The completed form will be
forwarded to you upon receipt.
Please review this information, todetermine if it is nonhazardous and non-
toxic and provide our office with your comments. If questions arise, please
call Mr. Donald Safrit at this number 919/733-5083.
Enclosure
Prctrntron Pay,
RO Fox 27687, kaleigh, North (:laroltha 27611-7687 Trtephone 919-77,1,7015
Art brord Opporamitv Athrnrive kaion kthployer
R (* Fl V E D
w.rr Qt4 Diviotl
hAJO
kaitOc."1.41 ()I'M,: a

State of North Carolina
Department of Natural Resources and Community Development
Asheville Regional Office
James G. Martin, Governor
S. Thomas Rhodes, Secretary
DIVISION OF ENVIRONMENTAL MANAGEMENT
Water Quality Section
June 13, 1985
Mr. Wayne Kimbrell, Director of Public Works
pity of Kings Mountain
1013 North Piedmont Avenue
Kings Mountain, North Carolina 28086
Subject: Non -Discharge Permit
Sludge Landfill
City of Kings Mountain
Cleveland County, North Carolina
Dear Mr. Kimbrell:
In response to your telephone inquiry, please find enclosed:
Non -Discharge Permit Applications; only one completed multi -copy
form needs to be submitted. (Form has been altered so as not to
require preparation of a duplicate.)
2. Portions of Title 15 North Carolina Administrative Code outlining
substantiating materials to be included with the permit application.
Two sets of plans and two sets of supporting documentation must be
submitted.
The primary consideration in operation of a sludge landfill will be con-
trol of leachate and protection of groundwaters. Items addressing these
concerns are not dealt with in great detail in the Administrative Code since
very few owners of wastewater treatment facilities operate their own landfills.
In order to insure that all necessary accompanying items are included in your
application package, I would suggest having your consulting engineer contact
Mr. Gil Vinzani, Leader, State Permit Group, at telephone number 919-733-5083
for a list of specific items which must accompany your Non -Discharge Application
for the proposed sludge Iandfill.
Interchange, Building, 59 'Woodfin Place, P0, Box 370, Asheville, N.C, 28802-0370 • 'Telephone [phone]
An Equal Opportunity Affirmative Action Employer

Mr. Wayne Kimbrell
Page 2
June 13, 1985
Should there be questions or a need for assistance in compiling and filing
the application or other information, please contact me. Forward the completed
package to me and I will prepare the necessary staff reports and send them along
with your submittal to the central office for review and permit action.
S 'ncerely,
(;;;;;)-
James R. Reid
Environmental Chemistry Consultant
JRR:dk
Enclosures
cc: Don Link

DIVISION OF ENVIRONMENTAL MANAGEMENT
GROUNDWATER SECTION
August 21, 1986
MEMORANDUM
TO: Don Link
FROM: Len Bramble
SUBJECT: Application for Renewal/Amendment of Existing Permit
X New Permit
Facility Name : City of Kings Mountain
County : Cleveland
Type of Project : Sludge Landfill
Applicable Permit Numbers : APN 008191
GW 86132
We have received a copy of the above referenced application,
which was sent to your regional office for comment on or about
August 19, 1986.
You should review the application package for completeness
and adequacy of relevant information and submit your request
for additional information to me (via telephone or memo) by
August 28, 1986 so that all required information can be requested
from the applicant at one time. A copy of our formal request to
the applicant for additional information will be provided to you.
If you do not require additional information from the
applicant to complete your evaluation of the project, you should
review the application package and submit your comments to me by
September 11, 1986.
If a copy of the application package has not been made
available to your gffice, PLEASE LET ME KNOW.
cc: Permit Issuance Files
LB/ls/RONOTIF

REVIEW BY:
0014
FIELD INVESTIGATION BY:
FACILITY NAME:
TOWN:
LOCATION:
TYPE OF DISPO($ pSYSTEM ( DFILL +ALA tN
Ci ucieLl (b � '►J
WASTE PHYSICAL CHARACTERISTIC:
DESCRIPTION OF FACILITY:` g Ckere�..
GROUNDWATER SECTION
DIVISION OF ENVIRONMENTAL MANAGEMENT S EP 1 61986
RECORD OF WASTE DISPOSAL PERMIT APPLICATION RE�N� WATER SECTION
�t1.EiGH, M. C.
DATE:
DATE:
COUNTY:
ETC) : S LLB
DESIGNED CAPACITY
CHEMICAL ANALYSES AND OTHER DATA AVAILABLE: (CHECK THOSE APPLICABLE AND ATTTACH COPIES):
0 AMBIENT GROUNDWATER QUALITY (WATER TABLE) EJ RAW WASTE THER
'AMBIENT GROUNDWATER 9LALITY (ARTESIAN) TREATED WASTE
NAME OF NEAREST STREAM: Q C C DISTANCE: .(j(�
DISTANCE TO NEAREST WELL: 1 DEPTH: U k PUMPING RATE: No
PROPOSED METHOD FOR PREVENTING GROUNDWATER CONTAMINATION: tLLT((u y .. IrsperS a
STRU TURE, LITHOLOGY AND PERMEABILITY Of SURFIC AL MATERIALS: dos
L f fN i t r� Ml .aA
HYDRAULIC RELATIONSHIP BETWEEN WATER TABLE AND ARTESIAN AIUIFERS:
DEPTH TO BEDROCK:
r
1
DEPTH TO SEASONAL HIGH WATER TABLE:
MONITORING FACILITIES NEE,pED (ATTACH SKETCH):
ULE AND PARAMETER REQUIRED:
GW 48
Revised 7/84