WQ0005603_Historial GW Forms

• GVV59A COMPLIANCE REPORT FORM Permit # WQOW5603
(Submit one each motiltoring period with GW-59 forms)
I
Enter date monitoring results were due. 1 N 31, E ) Will this monitoring report (GW-59 and GW-59A)
YES
be submitted after the established due date?
NO
Z
x
Was any required information missing on the CW-59 report forms?
YES
No
IF the answer to question 1 or 2 is "YES", list in the space provided below the well is Mication numbers) and
x
explain the problems encountered in obtaining the required information.
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
YES
NO
identification plate, area overgrown, etc.)? If the answer is "Yes ", contact the Regional ofce for guidance.
x
4
Are any monitored constituents equal to or above the established standards?
If the answer to question 4 is "NO", skip to section B.
YES
x
NO
If the answer to question 4 is "YES" list the affected wells individually with constituents) and concentrations)
exceeding standards in the space provided below.,
MW #12 TDS 720 MGA MW M2 LEAD 0.033 MG/L
MANGANESE S.I4 MG/L MANGANESE 0.744 MG/L
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
YES
NO
same constituent(s) in the same wells) in the last two years?
x
If the answer to question 5 is "NO", skip to section 8.
If the answer to question 5 Is "YES", list in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reported, and sample collection date for each the
occurrence (for last two years).
ti
Are the monitoring well Listed in section S located at or beyond the review boundary?
YES
NO
if the answer is "YES", a groundwater qualityx
AL
"Noe, Ama
OFFICE 1MAMEDJATELY FOR GUIDANC. If thanswer is monitoringCONTACT
b Improperly
Y A p Y
located, contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving:this
YES
NO
groundwater quality problem?
if the answer to question 7 is 'YES", describe those actions in the space provided below.
If the answer to question 7 Is "NO". contact the Regional Office within 90 days• an evaluation may be
re uired to determine the f act the waste dls asal s m Js havdn .at tits v'eecand com dance
boundaries surroundin rrrrlttee to once of flotation
fines.. and/or penal fes.
Division of Water Resources
MAY 21 2015
MAY 2 6 2015
ROC
INF MATtORSECTION
SS1NG UNr
g
The person compieting thr--t_hg /� onitgring re ort should sign beJaw and submit this
form with GW-59 forms fo regiri $(. f ' d'> �t Yl sr J�a
tled t the:top of the current GW--59 form.
Asheville Regional Ofii�e
�tiere�,yacknowl�edg�that�t�"s`�Ewve inforrrta`ti�nras eua r�"'�"`cI}�ie'r�f�"`" ot�" (�"`�� ±is
report,(Comphanc i Report
Signature of Permit .(or Authorized Agent) Date
MV-59A 17J8/7-403

MW #2 MANGANESE 1.38 mg/I AUGUST 2013
MANGANESE 1.44 MG/L APRIL 2014
LEAD 0.59 MG/L APRIL 2104
LEAD 0.005 MG/L AUGUST 2014
MANGANESE 1.23 MG/L AUGUST 2014
LEAD 0.043 MG/L DECEMBER 2014
MANGANESE.1.20 MG/L DECEMBER 2014
MW #12 MANGANESE 2.85 MG/L APRIL 2013
TDS 654 MG/L APRIL 2013
MANGANESE 4.06 MG/L AUGUST 2013
TDS 590 MG/L AUGUST 2013
MANGANESE 4.19 MG/L APRIL 2014
TDS 587 MG/L APRIL 2014
TDS 680 MG/L AUGUST 2014
MANGANESE 4.56 MG/L AUGUST 2014
TDS 672 MG/L DECEMBER 2014
MANGANESE 2.39 MG/L DECEMBER 2014
MW #13 TDS 561 MG/L AUGUST 2014

'SUBMIT FORM ON YELLOW PAPER ONLY -
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility Name: COATS AMERICAN
Permit Name (if different):
WIII - - _ M 28752 County -. - MCQ�
Coriteyt person: Qd11LIP PIiTMAN tee , Telephone C.
Well Location/ Site Name: Mw lln/A h Pond- No. of Wells to be
Well Identification Number (irons Permit): PAW #10 for GmundwaterTreatimi Systems
Well Depth: 18 fl: Well Diameter, 2 in. Check One: ❑ Influent (98)
Screened interval: N/ 1ft. to N A - It. Cj Effluent (99)
Depth to Water Level: _2 ft. below measuring point.
Measuring Point(M.P.) is:. 2-3.. It. above land surface. Relative M.P. Elevation in it.:
Gallons of water pumped/balled before sampling: 3 Date sample collected; 1 15
Field -analysis: pM 7.80 , Specific Conductance " uMhoa
12 Temp. °C, Odor Appearance
PARAMETERS (Samples for metals were colledted
COD _
mg/l
Conform: MF Fecal
/100m1
Coliform: MF Total
/100mi
(Note: Use ?APR mstbad for highly turbid samples)
Dissolved Solids: Total 4123125
139 mg/i
pH (when analyzed) A121LI5
7.3 units
TOC _M26 15
51.0 mgll
Chloride _ 4LZ915
Is mg/I
Arsenic 41 slis
<0.005 m A
9
Grease and Oils
mgn
Phenol
rng/f
Sulfate 4127ZI5
27.8 mgA
Specific Conductance
uMhos
Total Ammonia
mg/l
TKN as N
mg/l
OP ENVIRONMENT & NATURAL RteSOUMCES
TY UIViSiON,'QROUNDWATER SECTION
PERMIT M W0005603 E?(pIRATiON DATI=:
Noil•biacharge UIC
NPOE8
APE OR paRM1 OPERATION BEING MONITORED
Re
rrtedlatfan: infiltration t3a►lery
Spray Field Rwadiatian:
Rolaty Distributor Land Application of Sludge
Other.
Ham Values should reflect dissolved and
colloidal concentrations. -
Date sample analyzed: SEE BELOW
Laboratory Name: H
Certificatlori No,
YES NO -and field acidified
Nitrite (NO2) as N
MI
Nitrate (NO3) as N
mI
Phosphorus: Total as P9/27/15 ,� mg/I
Orthophosphate
m /l
At - Aluminum 4/20/15
<0.050 mg/i
Ba - Barium AIII <0.005 mg/I
CS - Calcium 28 15 <0 50 U_
Cd - Cadmlum 4/28/15
mg/1
<_010iff
Chromium: Total _a/28/15
<0.005 rmi-igg/
Cu - Copper
mg/l.
Fe - iron
mg/I
Hg - Mercury
mg/l
K - Potassium
mg/I
g
Mg - Magnesium 9128/1s
<o.,s�
Mn - Manganese 4,13,8115'
<o oo5 mg/I
YES N(5j
N1- Nickel IF <0.00s m�li
Pb : Lea 5 5 rng/i
Zn - Zinc mg/I
Ammonia Nitrogen mgli
Other (313ecily Compounds and Concentration Units)
5 <0.005 M
SODlu...M 4/30 15 52.6 MG L
ORGANICS: (GC,GC/MS,NPLC)
(81pbelly test and method & Attach•lab report.)
Report Attached? Yes (t) No (0)
VOC : method 0 a
method # _ -

GROUiVDWATE 3 QUALITY MONiTORING:
COMPLIANCE REPORT FORM
'SUBMIT FORM ON Y t t n + PAPER ONLY
Print Clearly or Type
Facility Name: -COATS AMERICAN
Permit Name (it different):�
Fanhily Addrman- 630 AMERICAN THREAD RD
Well Location/ Site
County n ICUONVELL
Telephone l#: 828.-756-4111
No. of Wells to be Sampled: _,„ 7
Well Ideritilloation Number (from Permit): MW #11R
Well Depth: 30 ft. Well Diameter: 2 in. For Oroundw4terTr"Imentsyll ms
Screened interval: N/A It, to Check One: ❑ Influent (e8)
7.3 . 111i1Ar ._ tt. CI Effluent (99)
Depth to Water Level ft. below measuring point
Measuring Point (M.P.) is:_2_, R. above land surface. Relative M.P; Elevation in fL: .
Gallons of water pumped/bailed before sampling: ,...33' Date sample collected: .421 1!
Fieldsnalysis: pH 8•44 Specific Conductance uMhos
Temp. 15 °C.Odor Appearance
PARAMETERS (Samples for metals were coile6ted
COD
Coliform: MF Fecal
/1 onm
Coliform: Mf Total
/100ml
(Note: Use MPH method for highly turbid simples)
Dissolved Solids: Total 123/15 229 mg/i
pH (when analyzed) AJ21LIS
8.3 units
TOC 9126/15
<1.0 mg/l
Chloride 4127/15
Y2.3 mg/t
Arsenic 4/2s/15
<0.005 mg/1
Grease and Oils
milli
milli
Sulfate AWI't s -- _
34 5 mg/I
Specific Conductance
uNlhos
Total Ammonia
milli
TKN as 14
mg/1
WtVARTMENT OF ENVIRONMENT 3 NATURAL RE9.OURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION.
r:
i636 MAIL SERVICe ita N
PERMIT tf; WQ000$603
Non -Discharge EXPi'RATION DATE:
-NPD-ESU_eUIG
QE l!W% 7T= OPERATION BEING MQNiTOR'ED
.........._lagoon ROMediallon: Infiltration gallery
$P ray Field � Remedlailm:
Aolaryr Cfttdbutor Land Application of Sludge
Other.
lei - Yalues should reflect dlssoived and
colloidal concentralloRe,
Date sample analyzed! SEE BELOW
Laboratory Name:
Certification No. 50
unfiltered, _ XYES NO
and field aeldff
Nitrite (NO2) as N
mg/i
Nitrate (NO3) as N
mg/f
Phosphorus: Total as p 4lUjI5 0_22 m /1
Orthbohosphate
mg I
9/
AI - Aluminum.4/ a ji5
0.144 mg/i
Ba - Barium _a/2a/15
0 o3s
Ca - Calcium 413!2SES
34 0g/�
Cd - Cadmium 4 _-_
. m f
Chromium: Total 4/28/15'
<o.005 mg/1
Cu - Copper
mg/I
Fe - iron
mg/l
Fig - Meroury
mg/1
K - Potassium -----------.-
Mg -Magnesium a 28 15 -
16.1 mg/l
Mn - Manganeseyalla5`
<0•005mg/I
led YES up)
NI - Nickel 4 2s/is <0.005 �
Pb?. Lead-4=15 < '" mg/�
Zn - Zino mg/1
Ammonia Nitrogen_mgfl
Other (Specify Compounds and Concentration Units).
SF
4 28/15 . ' .Niltly mnngM
SQDIUM IG/L 4/28/15
ORGANIC$; (Gc,i3C/Ms,Hnt.c)
(Specify test and imifhgd 8. Attach lab report.)
RePOrt Attached! Yes—(1) No -(p)
VOC : method #
- method

'SUBMIT FORM ON ]I,EUM PAPER ONLY
GROUNDWATER QUALITY MONITORING:
Please Print Cleariv or
Facilily Name: COATS AMERCIAN-
Permit Name (if dlfferent):
•••{.Y� .• IY\. caioc � County MCDOWELL
Contact Person: PHILLIP PiTTMAN Telephones- 82_._..8-7 1;
Well Location/ Site Name: #12 No. of Wells to be Sampled:
Well identification3 umber(fromPermit). MW#12_ ForGrountlwsterTreatment5ysterrte
Weil Depth: N A ft. W ll Aiameter .2.. _ in- Check One: Ci Influent (98)
Screened interval; ( ft. to / It. p Effluent (99)
Depth to Water Level: 8.3 It. below measuring point.
Measuring Point (M.P.) is 2.6 It. alcove land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/leaked before sampling: 2.5 Dais sample collected: 4.21 .15
Field-saalysis: pH 7.14 , Specific Conductance' ' Umhos
Temp. -13 °C, Odor Appearance
OF
1 RESOURCES
SECTION
PERMIT #: W40005603 EXIsIFaATIOiV HATE: -
Non -Discharge Ulc
NPD98
nQ��aJ Li:.I OPERATION BEING MONiTOREt l
lagoon Rernedlallon: InfH►ratlon Gallery
Spray Field .,._..�Romedl ke,
Rotary Distributor �.-._- • Land Application of Sludge
NOTE: Values ahouId reflect dissofved and
colloidal concentrallons,, '
t)ate sample analyted: SEE BELOW
Laboratory Name:
Certilica#on No. 50 --
PARAMETERS (Samples for metals were ooiledted unfiltered X YES No
and field acidified
COD
Caliform: MF Fecal
mg/1-Nitrite
/i OOml
(NO2) as N
Nitrate (NO,3) as N
/
mgI
Coliform: MF Total
/100ml
m
Phosphorus: Total as P 1s o.27 mg/l
(Note: Use MPH method for highly turbid samples)
Orthophosphate
Mfl
Dissolved Solids: Total 4/23/15
720 trig/I
Al - AlUminum 4 28 15
0.077 mg/I
PH (when analyzed) 4/
6.9 units
Ba - BariUm4/28/15
0.172
�i29 m�
TOC.ALM115
Chloride27/15
2.15 mg/I
6.0 mg/i
Ca - Calcium
Cd . Cadinlurti-4/28/15
< , mg/t
mg/I
Arsenic 4/20115
Grease and Oils
<0.005 mgil
mg/1
Chromium-, Total _4/28/15L
Cu - Copper.$
<0 005 m /I
Phenol
Sulfate 4/27/15
mgi!
<10 mgli
_
Fe -Iron
Hg -Mercury
m g/I
mg/I
Specific Conductance -
uMhos
K - Potassium
m
___._ mg/i
Total Ammonia
TKN as N
mg/f
Mg - Magnesium 4/2s/15
1s.3 mg/I
mg/
Mn -Manganese
, mg/I
G W-59
Rev. 0312000
YES
NI - Nickel 4 2s/15.- 0.009 mgll
Pb - Lead_4/2s/is <0 005 MO
Zn - Zinc mg/t
Ammonia Nitrogen mg/I
Other 18pecify Compounds and Concentration Units)
SODfUM G/L
ar3f1/1� 134 MG L
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report,)
Report Attt;ched? Yes, , �() Na . (0)
VOC : method #
method #
method #

SUBMIT FORM ON YEjji = PAPER ONLY
GROUNDWATER QUALITY MONITORING:
ca-ma-1I 111`tf'UC1MA I Isaa Please Print Clearly or Type
Facility Name: -OATS AM RI 4N
Permit Name (if different):
Facility Address:S30 AMERICAN THREAD RD
`e�' 28752
County-MmWLLI
Contact Person: PHILLI"ITTIVIAN Telephone #: [phone]
Well Location/ Site Name: - MW13/EFFLUENT No. of Weiis to be Sampled. 7Well Identlitcation Number (from Permit): MW #13 ForGGs bimdweter Treetlnsnl.9 t iiii
Well Depth: 15• ft. Well Diameter. _ in, y
bi
Screened Interval: N A _ it. to N A it. Check One: I3 Influent (90)
Depth to Water Level: 8 ft. below measuring point. Effluent ($9
Measuring Point (M.P.) is: 2.6 It. above land surface. Relative M.P: Elevation In fit.: _
Gallons of water pumped/balled. before sampling: 3 ' Date sample collected: 15
Field•analysis: pH_ 6.68 Specific Conductance uMhos
Temp. --34 . -0. Odor Appearance
OF ENViRONMENT & NATURAL RESOURCES
tY b "2-1. V, GROUNDWATER SECTION
PERMIT #; W00005603 EXPIRATION DATE:
Non-Dtscherge D{O
NPDES
X.
TOP Lagoon
. gOPERATION BEING MONITORED
X. -
Helnedlailon: Intlitration t3atiety
_.. _ Spray Field _._ RliriitxNation
R018ri D18111butor � Land Appliontion of Sludge
NOTE: Values should refiect dissolved and •
Colloidal coneentrailons.
Data sample analyzed: SEE BELOW
Laboratory Name: -
Certification No. _50
PARAM YERa (Samples for metals were colledted unfiltered YES NO
COD Xmg/l
and.lield acidified
Conform: MF Fecal
/100ml
Nitrite. (NO2) as N
Nitrate (NO3) as N
mg/I
Coliiorm. MF.Total
Use MPH
/100mi
Phosphorus: Totai as P4L2VZ o.24mg/l
g
(Note: tndthod for highly turbid samples)
Dissolved Solids: Total 4/23/15 149 mg/I
Orthdphosphat@
Al - Aluminum VMS
0.0 mg/1
pH (when analyzed) 4LZ1115
TOC 4/26/15
6.4 units
<1.0
Ba - Barium 0.026 mg/1
mg/I
CS
Chloride 4J27/15
Arsenic
mg/1
C mg/i
- C81CiWtr14 28 15
Cd - Cadmlu - 4 28 15
1 ,
mg/I
mg/i
_4/28L15
Grease and Oils
<0.005 mg/I
mg/i
Chromium: Total412s/15�
Cu -Capper
<0.005
mg/I
Phenol
Sulfate 4/22/1s
mgli
<10 mg/l
Fe -iron
Hg - Mercury
mg/1
mg/l
Specific Conductance -
Total Ammonia
uMhos
K - Potasslu •
mg/I
mg/i
TKN as N,
mgll
Mg - Magnesium 9/?a/15
to 8
mg/I
Mn - Manganese�2s/1- `. o rng/1
YES -
C)
'Ni-- Nickel 4 28/15
<0.005
moll
Pb - Lea
Zn • Zinc
o.00s`
AmmOhia Nitrogen
mi
mgA
Othor (specify Compounds and Concentration
units)
LENIUM V28115
20 5 MG L
ORGANIC$: (GC,G' C/MS,H0LC)
(SO601fY test and mathod #. Attach
lab report.)
Report Attached? Yea tt)
No (p)
VOC method d a
method #
method # f

'SUBMIT FORM ON yIJ■(■Qtij( PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
rs s.aLl i 1 rNI:UHMw r 1UN PJease Print Clearly or Type
Facility Name: COATS AMERICAN
Permlt Name (it different);,
■�■/'■ ■ • -11V G0I ✓i County WOUWELL
AN
Contact Person:-PHILLIP P17TM" l 1 Telephone #: [phone]
Well Location/ Site Name: MW #14/AERATION No. of Wells to be 8ampfad:.
Well ldenttficaU15 Number (from Permit): MW #14 �rGrountlweter Trtelmeiif Sytiteinr
Well Depth: ft. Wen Diameter 2 in. Cheek One: ❑ influent 98'
Scr*eened Interval: N/A6 . ft. to N/A - IL, p Effluent (99)
Depth to Water Level: ft. below measuring point.
Measuring Point (M.P.) Is:_ 2.6 ft. above land surface. Relative M.P. Elevation In ft.: _-
Gallons of water pumped/balled before sampling: 3 Date sample collected: 4 21 15 .
Field,analysts: pH 6.9 , Specific Conductance - Umhos
Temp. 13 °C, Odor Appearance
OF ENVIRONHIENT A NATURAL RESOURCES
TV.- DIVISION, GROUNDWATER SECTION
PERMIT #;
Ncn•Qtsoharge WQ0006503
EXPIAA710N• DATE:
- U(C
NPDES
'T-Q-- R— iMIx= OPERATION BEING I+AONITORED
x - Lagoon �.._.._Remsdtatlon: Infiitration Gallery
sPmy Field Helnedietlon:
Rotary Distributor — Land Application of Sludge
_:._.-. Other,'
NAIL Values should refiect•dissolved and
colloidal conrenttatlonst. •
Data sample aneWed: sFF RFI pW
Laboratory Name: C
Ceftificatfori No: 50
AAAAME'TERS (Samples for metals; were collected unfiltered X YES —NO
and "old acidified
COD
mg/l
Nitrite (NO2) as N
mg/I
Coliform. MF Fecal
/100MI
Nitrate (NO3) as N
Coliform: MF Total /100ml
Phosphorus: Total SS P 4 27 15 <0.16m
(Note: Use MPH msihod for highly turbid
samples)
QrthOphasph$te
mg/l
Dissolved Solids: Total4/2a/i
s 321 mg/l
Al - Aluminum
0.214 mg/I
pH (when analyzed) 4aW/
6.8 units
Ba —Barium 412glis
0-090 mg/l
TOC 26I15
179 M9/1
Ca - .Calciurft_-4/30/15
61. mg/I
Chloride 4/27/15
5.0
cmg/i
Cd - Cadmturri 4/2a/15
<0.00
'2 mg/l
Arsenic 4/28/15
-and
<0005 mg/I
Chromium; Total 4/28/15'
<0.005 mg/I
Grease Oils
m9/1
Cu - Copper
._ —. mg/l
Phenol
Sulfate 4/27/15
mg/1
<10 mg/I
Fe - Iron
Hg - Mercury
mg/1
mg/€
Specific Conductance
uMhos
K - Potet;(;jum
mg/I
Total Ammonia
mg/l
Mg - Magne9lum 4/30/15
34.3
TKN as N
mg/I
Mn - Moganese�8/.15•
0.182 nig
PNILLIP PITTMAN
GW-59
R ev. D3/2000
YES NO) -
Ni - Nickel4/28/15 <0.005 .mgA
Pb?, Lead 4/2s/is <o 0�3 MO
Zn - Zinc mg/t
Ammonia Nitrogen mgti
Other (Speci(y Compounds and Concentration Units)
M 4 28 15
to nnq Mr /1
SnnllfM� q/2g 15 131 MG
ORGANICS: (GC,Gc%MS,HPL0)
.(Speclfy test and Method C Attach lab report.)
Relwrt Attached? Yes (I) No (0)
VOG : method #
method #
method #
MAY 18, 2015

SUBMIT FORM ON YELLOW PAPER ONLY -
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Print Clearly or
Facility Name: MATS _AMERICAN
Permit Name (ii different):
Facility Address: 630 AMERICAN THREAD RD
MAt nti "� �t5 21MEW County MCDOWELL
Contact Person: PHILLIP PITTMAN_ rw) — Telephone M 828-756-4111
Well Location/ Silo Name: MW ff15/ASH POND No. of Wells to be Sampled: 7
Well Identification Number (from Permii:) POIt?rOu-_.9yatem I
ft
Well Depth. 16 . Wndwffiar
et1 Diameter; 2 in. ne: ❑ ite Treatment 98
Screened. Interval: - N/A _ ff. ro N/A it. Check L7 Effluent �)
Depth to Water Level: ft. below measuring point. 99)
Lftasuring Point (M.P.) Is: 2.6 It. above land surface. Relative M:P. Elevation In fl.:
Gallons of water pumped/balled before sampling: _a Date sample collected: 4 21/15
Field -analysis: pH 6.89 - Specific Conductance ' Umhos
Temp. 15 ' aC, Odor Appearance
IMENT 8 NATURAL FIESOURCE3
t3R0uNDWATER SECTION,
PERMIT #, Wg0005603 EXPIRATION iOtd DATE;
Non -Discharge UIC-
NPDES
12S OE P 1if4�17rr�r1
-�--_....e OPERATION BEiNG MONITORED
Lagoon infiltration eallery
SPIRY Field Remediatton
Rotary D1stt1bu10r „___ .-.Land Applioatlon of sludge
_..- .... 01her.
NQM Values should re�fiect dissolved and
colloidal concentratfotys.-
Data sample analyzed:
Laboratory Name: R TE
Certification No,
PApQM�ERS (Samples for metals were aofledted unfiltered. 9 rYES NO
and field acidified
COD -
Coliform: MF Fecal
mg/I
/100ml
Nitrite. (NO2) as N
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
Mg/I
(!`Tote: Use MPH mdlhod for hIgW turbid samples)
Orthophosphate
mg/I
�
Dissolved Solids: Total M23/15
pH (when analyzed) 4/21/25
358 mg/i
6.8 units
Al - Aluminum s/.211JIS _
Ba - Barium
<0 05o
mg/l
TOC 4/26/15
2.08 mg/1
Ca - CalcIUtn_4130/15
0.090
80.2
mg/I
mg/I
Chloride 4/27/15
45.0 mg/t
Cd - Cadmium 4/213/15
<6.-f F
mg/I
Arsenic 4/28/15
50.025 mg/I
Chromium: Total J28/15
<0.005
mg/I
Grease'and Oils
mg/l
CU = Copper ._
mg/I
g/
Phenol
Sulfate _412711E
mg/I
20.7 mg/I
Fe - Iron
Hg - Mercury
mg/1
S ecific Conductance
p
uMhds
K - Patasstum
"--M24/—
mg/t
mg/I
Total Ammonia
TKN >1s N
mg/i
Mg - Magne9lUlt'1 4 28 15 ,;
25.7
mg/1
-
mg/t
Mh - Manganese 4J28hss
0 03
_
mg/t
- YES ND)
'Ni - Nicks 4 28 is <0005
mgA
Pb - Lea<0 005
zn - zinc
. mg/I
Amrhonfa Nitrogen
tfigl!
Other (specify Compounds and Concentration Units)
_.SELENIUM 4 28 15 en
Da_ MG/L
—sonrr t-- nn-� -._. 4/28J15 17
2 MG/L
ORGANICS: (G.C;fJC/MS,HPLC)
(Specify test and Method N. Attach lab report.)
Report Attached? Yes 0) No (o)
VOC method # =
method #
method # c

W v ffjq6i';-Tav'wCH-
. _ fit£'.
P�)ST 4.%F KCEE BOX 0556 - #5 PINEWOOD PL.A.c A DP,
GRANITE FALLS. PWORT11 CA OLINA 28630
[phone]
SAMPLE: Coats America (MW#02) COLLECTION DATE: 4/21/2015
PERMIT #: COLLECTION TIME: 07:34
ADDRESS' Coats America (Wells) RECEIVED DATE: 4/21/2015
P.O. Box 368 RECEIVED TIME: 12:45
Marion, NC 28752
REPORTED: 5/12/2015
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TDS
111
mg/L
4123115
lag
Chloride
8.5
mg/L
4127/15
lag
T. Phosphorus
0.27
mg/L
4/27/15
jdg
TOC
see attached
Sulfate
see attached
metals
see attached
pH
7.8
su's
4/21115
lag
3
LOG ID: 1504-393 REPORTED BY: NC CERTIFIED LA.B # 50
Tony Gragg, Lab Supervisor

I
POST OFFICE BOX 1 Q55 . 45 PINE1,A/OOD PLAZA 08.
GRANITE. FALLS, fi10RIt I CARO LINA 26630
(828) 39644444
SAMPLE: Coats America (MW#10) COLLECTION DATE: 4/21/2015
PERMIT #: COLLECTION TIME. 07:39 j
ADDRESS: Coats America (Wells) RECEIVED DATE: 4/21/2015 '!
F.O. Box 368 RECEIVED TIME: 12:45
Marion, NC 28752
REPORTED: 5/1212015
ANAL YSI S ".
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TOS
139
mg/L
4/23/15
lag
Chloride
5.8
mg/L
4127/16
lag
T. Phosphorus
<0.16
mg/L
4/27/15
jdg
TOO
see attached
Sulfate
see attached
metals
see attached
pH
7.3
su's
4121115
lag
LOG ID: 1504-394 REPORTED BY: NC CERTIFIED LAB # 50 j
Tony Gragg, Lab Supervisor

py
POST 0FRCE BOX 1056 • 05 PINEWOOD PLAZA DR.
GRAM TE FALLS, NORTH CA910UNA 28630
[phone]
SAMPLE: Coats America (MW#11) COLLECTION DATE.
4/21/2015
PERMIT#: COLLECTION TIME.,
07:44
ADDRESS: Coats America (Wells) RECEIVED DATE:
4121/2015
P.O. Box 368 RECEIVED TIME:
12:45
Marion, NC 28752
REPORTED:
5/12/2015
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TDS
229
mg/L
4123115
lag
Chloride
12.3
mg1L
4/27/15
lag
T. Phosphorus
0.22
mg/L
4/27115
jdg
TOC
see attached
Sulfate
see attached
metals
see attached
pH
8.3
su's
4/21115
lag
LOG ID: 1504-395 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

wo raw6rcaq
POST OF ICE BOX 1056 - #5 PINEWOOD PLAZA DR.
GRANITE PALLS, NORTH GAROL&JA 28630
[phone]
SAMPLE: Coats Arberica (MW#12) COLLECTION DATE.- 4/21/2015
PERMIT COLLECTION TIME: 07:50
ADDRESS: Coats America (Wells) RECEIVED DATE: 4/21/2015
P,O. Box 368 RECEIVED TIME: 12:45
Marion, NC 28752
REPORTED. 5/12/2015
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TDS
720
mg/L
4/23/15
lag
Chloride
6.0
mg/L
4127/15
lag
T. Phosphorus
0.27
mg/L
4127/15
jdg
TOC
see attached
Sulfate
see attached
metals
see attached
pH
6.9
su's
4/21/15
lag
LOG ID: 1504-396 REPORTED BY: NC CERTIFIED LAB # 50
fp, 6a"
Tony Gragg.. Lab Supervisor

TECH L00,51"i1c.
NOTSH 1,
POST OFF;CE BOX !056 • #E5 Plr4IEWO,00 Pi A7A DR
GRANjTE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE.• Coats America (MW#13) COLLECTION DATE., 4/21/2016
PERMIT#., COLLECTION TIME: 07:55
ADDRESS: Coats America (Wells) RECEIVED DATE: 4/21/2015
P.O. Box 368 RECEIVED TIME: 12:45
Marion, NC 28752
REPORTED: 5/12/2015
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TOS
149
mg/L
4123/15
lag
Chloride
<5.0
mg/L
4/27/15
lag
T. Phosphorus
0.24
mg/L
4127/15
jdg
TOC
see attached
Sulfate
see attached
metals
see attached
pH
6.4
su's
4/21/15
lag
LOG ID: 1504-397 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, 1,ab Supervisor

IM Ts am TECH 1r;.
POST OFFICE BOX 1056 , #5 PINEWOOD OOD PLAZA DP
GRANITE FALLS, NORTH CAFxC14„EN'A 23630
[phone]
SAMPLE: Coats America (MW#14) COLLECTION DATE:
4/21/2015
PERMIT #. COLLECTION TIME:
08.00
ADDRESS: Coats America (Wells) RECEIVED DATE:
4/21/2015
P.O. Box 368 RECEIVED TIME:
12:45
Marion, NC 28752
REPORTED:
5/12/2015
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TDS
321
mg/L
4/23115
lag
Chloride
<5.0
mg/L
4/27/15
lag
T. Phosphorus
<0.16
mg/L
4/27I15
jdg
TOC
see attached
Sulfate
see attached
metals
see attached
pH
6.8
su's
4/21/15
lag
LOG ID: 1504-398 REPORTED BY: NC CERTIFIED LAB II 50
fe� ("
Tony Gragg, Lab Supervisor

trig:.
POST OFFICE SOX 1056 • 05 DINEW000 PLAZA CDR.
i
GRAIN11TE FALLS, MOFI```H Ari0€j'ANA 28630
E
[phone]
SAMPLE: Coats America (MW#15) COLLECTION DATE:
t
4/21/2015 s
PERMIT #: COLLECTION TIME.
08;05
ADDRESS: Coats America (Wells) RECEIVED DATE:
4/21/2015
P.O. Box 368 RECEIVED TIME.,
12:45
Marion, NC 28752
REPORTED:
5/12/2015
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TbS
358
mg/L
4/23/15
lag
Chloride
<5.0
mg/L
4/27115
lag
T. Phosphorus
0.21
mg/L
4/27/15
jdg
TOG
see attached
Sulfate
see attached
metals
see attached
pH
6.8
su's
4/21/15
lag
LOG ID: 1504-399 REPORTED BY: NC CERTIFIED L11B # 50
fbi. y
Tony Gragg, Lab Supervisor

RESEARCh & ANAI,yTICAI,
LA ORATORIES, INC.
For: Water Tech Labs, Inc.
P.O. Box 1056
Granite Falls, NC 28630
Attn: Joe Gragg
Report of Analysis
5/1/2015
�y NC#34 Z:CA
NC tt37701 ?
Sri )kiD AN�';�+4ti
Client Sample ID:
Site:
Coats MW2
Water Tech Labs
Lab Sample ID:
Collection Date:
3415-01 <
4/21/2015 7:34
Aluminum, Total
EPA 200.7
2.74
mg/L
0.05
AA
4/28/2015
Arsenic, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Barium, Total
EPA 200.7
0.100
mg/L
0.005
AA
4/28/2015
Cadmium, Total
EPA 200.7
<0.002
mg/L
0.002
AA
4/28/2015
Calcium, Total
EPA 200.7
18.9
mg/L
0.5
AA
4/28/2015
Chromium, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Lead, Total
EPA 200.7
0,033
mg/L
0.005
AA
4/28/2015
Magnesium, Total
EPA 200.7
9.96
mg/L
0.5
AA
4/28/2015
Manganese, Total
EPA 200.7
0.744
mg/L
0.005
AA
4/28/2015
Nickel, Total
EPA 200.7
0.008
mg/L
0.005
AA
4/28/2015
Selenium, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Sodium, Total
EPA 200.7
10.7
mg/L
0.5
AA
4/28/2015
Sulfate
SM 4500 SO4 E-1997
<10
mg/L
10
KL
4/2712015
Total Organic Carbon
SM 5310 B-2000
<1.0
mg/L
1
CC
4/26/2015
NA = not analyzed
.._ ....................... .... ............ .___..._,._............_ .. - — -.-.................._....._ ...... _-. .. .............
P.O. Box 473 106 Short Street Kernerswile, North Carolina 27284 Tel; 336-996-2841 Fax: [phone] www.randalabs.com Page 1
ral coa basic v1d

RESEARCH ANA[YTiCA1 Report of Analysis
LA 4RATORIESF INC. 5I1/2015
For: Water Tech Labs, Inc.
h��`1G: iA ctYrf'�•,.�
P.O. Box 1056
�'�;•��,�.,
Granite Falls, NC 28630
tt NC #34Cn
Attn: Joe Gragg
w NC U770.1
.•
+011
a A tl
Client Sample ID: Coats MW10
Lab Sample ID:
3415-02
Site: Water
Tech Labs
Collection Date:
4/21/2015
7:39
yPar'a'trie#ew Ike i
od ��pf��ie Limit Anal `st Anaysls DateiTlme K
rya .�1"
r-.—.-
Aluminum, Total
EPA 200.7
<0.050
mg/L
0.05
AA
4/28/2015
Arsenic, Total
EPA 200,7
<0.005
mg/L
0.005
AA
4/28/2015
Barium, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Cadmium, Total
EPA 200.7
<0.002
mg/L
0.002
AA
412812015
Calcium, Total
EPA 200.7
<0.500
mg/L
0.5
AA
4/28/2015
Chromium, Total
EPA 200.7
<0.005
mg1L
0.005
AA
4/28/2015
Lead, Total
EPA 2003
<0.005
mg/L
0.005
AA
4/28/2015
Magnesium, Total
EPA 200.7
<0.500
mg1L
0.5
AA
412812015
Manganese, Total
EPA 2007
<0.005
mg/L
0.005
AA
4128/2015
Nickel, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Selenium, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Sodium, Total
EPA 2003
52.6
mg/L
0.5
AA
4/30/2015
Sulfate
SM 4500 SO4 E-1997
27.8
mg/L
10
KL
4/27/2015
Total Organic Carbon
SM 5310 B-2000
<1.0
mg/L
1
CC
4/26/2015
NA = not analyzed
__..__......_...__..... _.... _._..._.. _ __— __,....._._..,._.__.....__..,..........._......--........................................ _._..... __.... _._................................ ..__....._._.....-__... - _.... _--- .___....__..._...,_.__.._.. ... __..
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com Page 1
ral coa basic Od

RESEARCIi & ANA1yTICA[ Report of Analysis
L A oRATORIES, INC. 5/1/2015
�1{iUllll0t
For: Water Tech Labs Inc.
••'••••••.
•� ,�'
• �•�•
P.O. Box 1056
``~
Granite Falls, NC 28630'
c �•
Z:Cn
to NC#34
w NC #37701
Attn: Joe Gragg
Client Sample ID: Coats MWi 1 R
Lab Sample ID:
3415-03
Site: Water Tech
Labs
Collection Date:
4/21/2015 7:44
C
r�its���.��e �Unni Anayst C�naivstaDateRimeu,_
,
Aluminum, Total
EPA 200.7
0.144
mg/L
0.05
AA 4128/2015
Arsenic, Total
EPA 200.7
<0.005
mg/L
0.005
AA 4/28/2015
Barium, Total
EPA 200.7
0.035
mg/L
0.005
AA 4/28/2015
Cadmium, Total
EPA 200.7
<0.002
mg/L
0.002
AA 4128/2015.
Calcium, Total
EPA 200.7
43.0
mg/L
0.5
AA 4/30/2015
Chromium, Total
EPA 200.7
<0.005
mg/L
0.005
AA 4/28/2015
Lead, Total
EPA 200.7
<0.005
mg1L
0.005
AA 4/28/2015
Magnesium, Total
EPA 200.7
16.1
mg/L
0.5
AA 4/28/2015
Manganese, Total
EPA 200.7
<0.005
mg/L
0.005
AA 4/28/2015
Nickel, Total
EPA 200.7
<0.005
mg/L
0.005
AA 4/28/2015
Selenium, Total
EPA 200.7
<0.005
mg/L
0.005
AA 4/28/2015
Sodium, Total
EPA 200.7
15.2
mg/L
0.5
AA 4/28/2015
Sulfate
SM 4500 SO4 E-1997
34.5
mg/L
10
KL 4/27/2015
Total Organic Carbon
SM 5310 B-2000
<1 A6
mg/L
1
CC 4/26/2015
NA = not analyzed
- .....-- ----- ................................................... ....... ............. ..... ......... ...... ...... . _.... --- ... _:. - - _
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] www,randalabs.com Page 1
ral coa basic vld

RESEARCh ANA1YTICA[
LA ORATORIfSr INC.
Report of Analysis
5/1/2015
•' �►a err �•.
For: Water Tech Labs Inc.
O`G .•••••C•••.1,�'i
P.O. Box 1056
�7
Granite Falls, NC 28630
4 I
o
��NC#34 OZ*-Cp:
Attn: Joe Gragg+
:• NC #37701
•�
Client Sample ID: Coats MW12
Lab Sample ID: 3415.04
Site: Water Tech Labs
Collection Bate: 4/21/2015 7:50
Aluminum, Total
EPA 200.7
0.077
mg/L
0.05
AA
4/28/2015
Arsenic, Total
EPA 200.7
<0.005
mg/L
0,005
AA
4/2812015
Barium, Total
EPA 200.7
0.172
mg/L
0.005
AA
4/28/2015
Cadmium, Total
EPA 200.7
<0.002
mg/L
0.002
AA
4/28/2015
Calcium, Total
EPA 200.7
129
mg/L
0.5
AA
4/30/2015
Chromium, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Lead, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Magnesium, Total
EPA 200.7
18.3
mg/L
0.5
AA
4/28/2015
Manganese, Total
EPA 200.7
.5.14
mg/L
0.005
AA
4/30/2015
Nickel, Total
EPA 200.7
0.009
mg/L
0.005
AA
4/28/2015
Selenium, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Sodium, Total
EPA 200.7
134
mg/L
0.5
AA
4/30/2015
Sulfate
SM 4500 SO4 E-1997
<10
mg/L
10
KL
4/27/2015
Total Organic Carbon
SM 5310 B-2000
2.15
mg/L
1
CC
4/26/2015
NA = not analyzed
_......... -.._..... :........._._....-_._................ ........ ._...__............ _..----------._:_ .._.__.--....... ... .._ ......... ..--._ --- ......... .....
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel: [phone] Fax: [phone] www.randalabs.com Page 1
ral coa basic v1d

RESEARCh & ANA[YTlCA1 Report of Analysis
LA ORATORIES, INC. 5/1/2015
For: Water Tech Labs, Inc, ,w,+*.C,�s'+6 f.tri
P.O. Box 1056 a2�
Granite Falls, NC 28630 ;�
.. . ca NC t#34
Attn: Joe Gragg _NCtt37701
''�t1!ltits'"
Client Sample ID: Coats MW13
Lab Sample ID:
3415-05
Site: Water Tech Labs
Collection Date:
4/21/2015• 7:55
;" . `' "..,�a
l ry 1
1 nays Anajr� sDa#etTame
Aluminum, Total
EPA 200.7
0,051
mg/L
0.05
AA
4/28/2015
Arsenic, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Barium, Total
EPA 200.7
0.026
mg/L
0.005
AA
4/28/2015
Cadmium, Total'
EPA 200,7
<0,002
mg/L
0.002'
AA
4128/2015
Calcium, Total,
EPA 200.7
15.5
mg/L
,0.5
AA
4/28/2015
Chromium, Total.
EPA 2001
<0.005
mg/L
0,005
AA
4/2812015
Lead, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Magnesium, Total
EPA 200.7
10.8
mg/L
0.5
AA
4/28/2015
Manganese, Total
EPA 200.7
0,006
mg/L
0.005
AA
4/28/2015
Nickel, Total
EPA 200.7
<0.005
mg/L
0.005.
AA
4/28/2015
Selenium, Total
EPA 200.7
<0:005
mg/L
0.005
AA
4/28/2015
Sodium, Total
EPA 200:7
20.5 .
mg/L
0.5
AA
4/28/1015
Sulfate
SM 4500 SO4 E-1997
<10
mg/L
10
KL
4/27/2015
Total Organic Carbon
SM 5310 B-2000
<1.0
mg/L
1
CC
4/26/2015
NA = not analyzed
... _... __...................... _..... _...... . _ — .. ...................... ..................... _...... ...
P.O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel. [phone] Fax: [phone] www.randalabs.com Page 1
ral coo basic v1d

RESEARCh ANA1yTlCAt
LAORATORIESF INC.
For: Water Tech Labs, Inc.
P.O, Box 1056
Granite Falls, NC 28630
Attn: Joe Gragg
Report of Analysis
5/1 /2015
pltu�uiiii
441
NC434
NC #37701
Client Sample ID: Coats MW14
Lab Sample ID:
3415-06
Site: Water Tech Labs
Collection Date:
4/21/2015
8:00
Aluminum, Total
EPA 200.7
0.214
mg/L
0.05
AA
4/28/2015
Arsenic, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Barium, Total
EPA 200.7
0.090
mg/L
0.005
AA
4/2812015
Cadmium, Total
EPA 200.7
<0.002
mg/L
0.002
AA
4/28/2015
Calcium, Total
EPA 200.7
61.8
mg/L
0.5
AA
4/30/2015
Chromium, Total
EPA 200.7
<0,005
mg/L
0.005
AA
4/28/2015
Lead, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Magnesium, Total
EPA 200.7
34.3
mg/L
0.5
AA
4/30/2015
Manganese, Total
EPA 200.7
0.182
mg/L
0.005
AA
4/28/2015
Nickel, Total
EPA 200.7
<0.005
mg/L
0.006
AA
412812015
Selenium, Total
EPA 200.7
<0.005
mg/L
0,005
AA
4/28/2015
Sodium, Total
EPA 200.7
13.1
mg/L
0.5
AA
4/28/2015
Sulfate
SM 4500 SO4 E-1997
<10
mg/L
10
KL
4/27/2015
Total Organic Carbon
SM 5310 B-2000
1.79
mg/L
1
CC
4/2612015
NA = not analyzed
_
Pwo.-_-.— ..... ..... 2' '7"2 ...__........._...__..._ -- --- -
,Bax.—473 106—Short— Street----Kernersville..., North_ Caro{ina___8.4.. Tel: [phone] Fax: [phone] www.randalabs.com Page 1
ral coa basic v1d

RESEARCii & ANALyT-ICA't
LA ORATORIES? ITC.
For: Water Tech Labs, Inc.
P.O. Box 1056
Granite. Falls, NO 28680
Attn: Joe Gragg
Report of Analysis
5/1 /2015
"00 Gib rJ
:a
M NC 434
;~ NC #37701
Client Sample ID:
Site:
Coats MW15
Water Tech Labs
Lab Sample ID:
Collection Date:
3415-07
4/21/2015 8:05
a r,X
etho ' "a.,�
eK rtr Liriit s s ltatel7lme
, -
zAnai
y=Anal
Aluminum, Total
EPA 200.7
<0.050
mg/L
0,05
AA
4/28/2015
Arsenic, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Barium, Total
EPA 2007
0.090
mg/L
0.005
AA
4/28/2015
Cadmium, Total
EPA 200.7
<0.002
mg/L
0.002
AA
4/28/2015
Calcium, Total
EPA 200.7
80.2
mg/L
0.5
AA
4/30/2015
Chromium, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Lead, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Magnesium, -Total
EPA 200.7
25.7
mg/L
0.5
AA
4/28/2015
Manganese, Total
EPA 200.7
0,603
mg/L
0.005
AA
4/28/2016
Nickel, Total
EPA.200.7
<0.005
mg/L
0:005
AA
4/28/2015
Selenium, Total
EPA 200.7
<0.005
mg/L
0.005
AA
4/28/2015
Sodium, Total
EPA 200.7
17.2
mg/L
0.5
AA
4/28/2015
Sulfate
SM 4500 SO4 E 1997
20.7
mg/L
10
KL
4/27/2015
Total Organic Carbon SM 5310 B-2000
2.08
mg/L
1
CC
4126/2015
NA =not analyzed
,_....... .......:.., --___- .. _...__ . _._....-- — -- — . _ _:.m _ ......._-._---- . — _........_.._ . ......—_.... ........ _...,....:
P:O. Box 473 106 Short Street Kernersville, North Carolina 27284 Tel, 336=996-2841 Fax: [phone] www.rantlalabs.com Page 1
ral coa basic v1d

CHAIN OF CUSTODY - Analytical Request
Client Name:40--a.p�,
Address:
Report to:
Phone:
PO Number:.��
Preservatives
y
Sample Identification
b
v
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z
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x_
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RS
U
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M
N
U
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L
w
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Ir
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Z
K
0 7
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(3
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k10
7Z7
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K
14P491
t
.- 111101111114 .wan
e_-
Temperature ("C) y
Received on Ice:
Y / N
Seated Cooler.
Y / N
Samples Intact Y / N
Additional Comments:
WATER TECH LABS, INC
PO BOX 1056
GRANITE FALLS, NC 28630
PHONE: [phone]
Project Name:
Project Number:
Requested Analyses
/ 7-
< 0.2
Upon
Field Temp. (C°) Comments
[Inman
MMEM
30000
3®E®N
13MOME
OMMEE
Sampler. Signature
Tinted Name of Sampler
,ipnature of Sampler. Q_

CHAIN OF CUSTODY - Analytical Request
Client Name:
Address:
:Report to:
Phone:
PO Nu rtber:
4
nci
Sample Identification
z
U
on A"
EM
Received on ice: Y 7 N
Sealed Cooler: Y / N
Samples Intact Y / N
Preservatives
U
N
0
os
U
::
+
U
E0M
'c
v
N'
c
x
WATER TECH LABS, INC.
PO BOX 1056
GRANITE FALLS, NC 28630
PHONE: [phone]
Project Name:
Project Number:
pH Checked Upon
C12 < 0.2 ma/1 Won
Field Temp. (C°) I Comments
Printed Name of Sampler: .SQ m , I ud4f I.S
Signature of Sampler: 'i t It I q—" )

F' (GW-59A COMPLIANCE REPORT FORM Permit # WQ0005603
(Submit vote each nronitoring'period with GW-59 forms.)
Enter date monitoring 'results were due, tl[ao� is �i Will this monitoring report (GW.59 and Gy�.gg,q�
be submitted after the established due date?
WWas any required information missing on the Cw•-59 report farms?
!F the answer tob question 1 or 2 is "YES ;list in the space provided below the well identification numbers) and
explain the problems encountered in obtaining the required information.
3 Arc any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
ldrntiflcation plate, area overgrown, etc.)? If the answer is `•}'es cotuact the Regional Office forbttidartce.
4 Are any monitored constituents equal to or above the established standards?
!f the answer to question 4 is "NO" skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below,
MW #12 TDS 672 MG/L MW #2 LEAD 0.043 MG/L MW #14 MANGANESE 1.25 MG/L
MANGANESE 2.39 MG/L MANGANESE 1.20 MG/L
CHLOROFORM 10.1 PPB
x
YES I,Nb
x
18
S For the constituents identified In question 4 above, have standards been exceeded previously for the 1'ES NO
same constituent(s) in the same well(s) In the last two years?
x
!f the answer to question 51s NO", skip to section 8.
If the answer to question 5 Is "YES" list in the space provided below, each we# with constituent(s) exceeding
standards, concentration(s) sported, and sample collection date for each occurrenee (for the last years),
SEE ATTACHED PAPER
b Are the monitoring wells listed in section 54ocated at Tor
If the answerls "YES", a groundwater quality problem maybe oc
OFFICEIMMEDIATELYFOR GUIDANCE. If the answer Is "NO'; m
located, contact the Regional Office.
7
boun
l..1/f Y ! H 1, ► r rtt-tt�GtONAL
g wells may be Improperly
Is the perrrittee implementing previously approved actions required by the Division involving this
groundwater quality problem?
If the answer to question 7 is 'YES-, describe those actions in the space orovidarl t„�1nU.
Iftha ancu,nr #--..--A2__ ._ ...._..
The person completing this portion ((SW-59A) of the monitoring report should sign below and submit "this
form with GW-59 forms for required wells to the address provided at the top of the current Giv :5o Fes,_
ua[e
NO
x
NO
GNV-59A 12/812OD3

MW #2 MANGANESE 1.38 MG/L AUGUST 2013
MANGANESE 1.44 MG/L APRIL 2014
LEAD 0.59 MG/L APRIL 2014
LEAD 0.005 MG/L AUGUST 2014
MANGANESE 1.23 MG/L AUGUST 2014
MW #12 MANGANESE 2.85 MG/L APRIL 2013
TDS 654 MG/L APRIL 2013
MANGANESE 4.06 MG/L AUGUST 2013
TDS 590 MG/L AUGUST 2013
MANGANESE 4.19 MG/L APRIL 2014
TDS 587MG/L APRIL 2014
TDS 680 MG/L AUGUST 2014
MANGANESE 4.56 MG/L AUGUST 2014
MW #13'TDS 561 MG/L AUGUST 2014

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Narne*, COATS AMER"N
Permit Name (if different):
Facility Address: 630 AMERICAN THREAD RD
MARION 28752
, (Ca y(zip)
Contact, Person:--- PHILLIP PITTMAN
Well LoCdtion/,$1tp Name: Ww #10 ---------------
SUBMIT FORM OMYELLOW PAPER ONLY,
Please Print Clearly or
County - - MCDOWELL
Telephone #: [phone]
No. of Wells to be Sampled: 7
.vveiiio.entiticatton-Number,(from Permit): Mw#10. For Groundviater Tn!itinent systems, I
Well Depth: 18 fti Well DiaMeter,-,2. in. One: (rifluent (98)
,Screened Interval: NIA ft. toN/A Chec 'k
Dq0th to W ' ateirlevel: j5_L-_ft. below measuring point171 Effluent (99)
.
MeaswifigPoirit (M.P..) is: — ft. above land surface. Relafive:M.P. Elevation in ft.:
Gallons of water-pumped/balled before sampling. --!_ Date sample collected'i
,Field analysis. pH 6 5 Specific Conductance Umhos
Temp. 8
q. Odor Appearance
11401VIintm. I)EVAnTmENT OF- ENVIRONMENT & NATURAL RESOURCES
WATER GUALITY DIVISION,.GROUNDWATER SEC71ON
166 MAIL SERVICE CENTER
-Phone: Q19) 733-3221
3 'PERMIT #: W00005603 EXPIRATION bATE:.
'Non-DischArge
-NPDES
JYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon -Remedialion: Infiltration Gallery
Spray, Fieto
Rotary Distributor Land Application of, Sludge,
Other",,
NOTE- 'Values should reflect dissolved and,
colloidal. concentrations:
Date,sample analyzed: — SEE BELOW
Laboratory Name: = = WATER TECH
Certification No. 50
(Sample's for metals were collected unfiltered X - YES NO
and field acidified
COD
M911
1 1 00MI
Nitrite (NO2) as U
Nitrate (NO, '), as. N.
3 - —
mg/1"
. - mg/I
Colitbrm:MF Fecal ..­.
Cohf6rm:'MFT6taI
/I 06MI
Phosphp.rUs:,T0tal as PIZ/22/14"
�0.16rn9/l
(Note Use MPN method ' lor highly turbid samples)
OrthophosphateDissolve,d
SohdS:. Total 12/10/14
145, m 9/1
Al -Alurbintifty 12/11/14
'0.131 mg/1
pf+ (When, analyzed) 12/9/14
7.3
—units.
Ba - Barium'-,'12/11114
<0.005 M
911TOC
,"
,12/11/14
1M644
mg/I
mg/l,
Pa -CalckM 12/11/14�
Cd - Cadmium 12L11114
'
<0.500 mg/OhIdide:
.
<0.002 n91I
Ars'ej*12ji1/34
<D.005
tT
'
Chromium:(�tal12/11/14
<0.065 Mg/l
Grease and.011s,
Mg/1
Cu - Copper
nign
Pbenol
mg/1
Fe, -iron
mg/l
Sulfate 12l1Ua_
30.9 fn
-Hg - MercUry
Mg/l
Specific Ocinductance
_uMhos
K Potassium
M911
,,Total Ammonia,
i*ng/1
Mg -MagnesJurn 12/11/14
<O.'500
M g/l
TKN as N
mg/i
Bain -Manganesd 1241/14
40.005
mg/(
YES NO)
N! - Nickel12/11/14
Pb - Lead 12/11/14
<0,005 rng/I
Zn - Zinc
_MCl/l
Ammonia Nitrogen,
Mg/l
Other (Specify Corripounds and Concentration units)
SELENIUM .12/11114
<5.55s MG
SODIUM 12/11/14
40.7 MG/L
ORGANICS: (GC,GC /MS HPLQ
.(Specify test:an4 method lf. Attach
lab report)
-RipportAttachdd?
No_(0)
VOC method it
s26o B
method-#

SUBMIT FORM ON YEu_ow PAPER ONLY
GROUNDWATER QUALITY MONITORING:
Please Print Clearly or Type
Facility Name: ATSAMERICAN
Permit Name (if different);
Facility Address: 630 AMERICAN 714RFAD RD
,MARION 011-3 NC 28752 fVICDOWELL
t°gy) t oy tz �l County
Contact Person: PHILLI PITTMAN Telephone #: a7aas6 4111
Well Location/ Site Name: �� 11R/ASH POND No. of Wells to be Sampled: 7
(from .Patmf[)
Well tden#iffcaiion Number (from Per Mw ra111tFor Groundwater Treatmelit Systems
Well Depth: so tt. Well Diameter. 2 in.
Screened Interval: N/A ft. to NIA ft. ChecicOne: ❑ Influent (9$)
?epth to Water Level: 7.6 tt. below measuring point. 0 Effluent (99)
Measuring Point (M.P.) is: it. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 3 Date sample collected: 12/9/14
Field analysis: pH, 8 8 , Specific Conductance UMhos
Temp.. ,g °C, Odor Appearance
DEPARTMENT OF- ENVIRONMENT & NATURAL RESOURCES
'WATER QUALITY DIVISION; GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT f#: W00005603 EXPIRATION DATE:
Non -Discharge Vic
NPDES
TYPE OF PEfiM= OPERATION BEING MONITORED
x Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations:
Date sample analyzed: SEE BELOW
Laboratory Name: WATER TECH
Certification No. so
PARR IE ERR (Samples for metals were collected unfiltered x YES NO
and field acidified
COD
mg/t
/1DOml
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/l
mg/I
Coliform: MF Fecal
.Coliform: MF Total
/1 OOmi
Phosphorus: Total as P 12/22/14
0.18 rn
(Mote: Use MPN'metttod for highly turbid samples)
'SOlidst
OrihophOSplaate
lilg
DissolvedTotal 22/10114
226 rngll.
At - Aluminum 12/11/14
0.202 rn
pH" (when analyzed) 12/9/14
8.3 units
Ba - Barium 12/11/14
0.033 mg/l
TOC 12/11/14
<1.0 mg/1i
7.3
Ca - (" 61C1Um 12/11/14
23.6
---
Chloride 12116/i4
Arsenic _12/ii11a .
m,g/t
<0.005 mgil
Cd.- -Cadmium 12 13f74
Chromium: Total 12/11/14
mgA
�
<0.005 mg/l
Grease and Oilsmg/l
Cu;- Copper
mg/l
Phenol
Sulfate 12/11/14
26.2 mg//I
Ng -foie Mercury
mg/I
Specific Conductance
Total Ammonia
utVlhos
K -Potassium
mg/l
TKN as N
mg/l
Mg - Magnesium 12/11/14
17.1 mg/t
mg/i
Mn - Manganese _12a1/1a
<0.005 mg/l
-YES NO)
Ni - Nickel-z/11/14
<0.005 mg/l
Pb . L.eaci 12/11/14
<0.005 mtgA
Zn Zinc
Mgt[
Ammonia Nitrogen
mg/l
Other (Specify Compounds and Concentration Units)
SELENIUM 12/12/14
<0.005 MG/1
SODIUM 12/11/14,
15.9 Wr
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes x (1) No _____ (0)
VOC n : method # = 9260 B
: method #

SUBMIT -FORM ON YELL 0 'PER W_PA_ -ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
please Pant Clearly.0r,
Facillty Name-1 COATSAMERICAN.
Permit Narnei (if,0jffqfenQ:..,
Facility Ad0res!.k_ 630 AMERI.CAN THREAD RD
CoUnly—
C. M
MCDOWELL
(Cgy)
ntact Person: PHILUP PW4��,il_ (rip)
Telephone If, 828-756-4111
W40-Lo(rAtion/ Site Name:- - mw12/—""N1 No. of Wells to be Sarn pl6d: 7
Well Ir P.
mity mw4fii
deritlfl:7 Zri un�ber(from-"P_er For, Groundwater Trptinant Systems
Well Depth:, it. Well'Djarrieter. -z- in, Check.One- 0
Screened Interval: NIA ft. IO__2L/_A- fL-
*th t 11 Effluent (99)
o Water Level: fl. below measuriog.point, i
0
Mbasudn' P int;(M-P-) is: ft. above land surface. R61ative M.P. Efe'vation.in, . ft.,
,
Gallons of watEir. Pumped/bailed before scampting: 4-5
bate sample collected: .. I21IL14
Field analysis., Specific'Cor;dUctance
uMhos
Temp. QC, Odor
Appearance
DEPARTMENT OF'90VIRONMENT & NATURAL RESOURCES
WATER QUALITY DjvISION,, GROUNDWATER SECTION
1636 MAIL SERVtCE.CENTER
wQ000s603 EXPIRATION DATE:
P-0ischarne.. Ulc.
TYPE -OF EERW= OPERATION BEING �MONITORED
x Lagoon —Rernediation: Infiltration Gallery
Spray Field Reffiediation.
Rolaiy Distributof Land Application of. Sludge
Other
NOTE: Values should reflect dlssalved and
cot loidat concentrations.
Date sample analyzed: SEE BELOW
'Laboratory Name: WATER TECH
Certification No. 50
E!ARAM,gjERaA$amples for Metals were collected unfiltered X YES NO
and field acidified'
—'YES NO)
COP
�Cbfiform: MF Fecal
Mg/i
m
/IQQ 1,
Nitrite (NO2.) as N
ltrate (NO3) a,
N s N
mg/l
mg/1
Ni � Nickel 12/ft/14
Pb Lead It/11/14
0.011
eo;005
Cldljfbim: M'FTotaI
_/1,00IT11
PhbSphdrus:Totalas' '2/'/"
2-22, mg/I
-
Zn -Zinc
M -co
(Npt0:.Usa MPN:mathcd'far highly turbid samples)
Dissolved, Solids: Total 1-2/10/14. 672,
Oft6 hosphate-
p
mg/1
Ammonia Nitrogen,,,.
m 1,
pH (whbn analyzed) 12/9114
mg/I
7.2 units
At - AlUmInUM 12/12114
Ba - Barium
0.083 1`119A
0.166
Other (specify Compounds and Concentration Units)
2.53 mg/j,
i0.0
. .12/1112
Qa,- CajCibn`]� 12/11114 -
Mg/l
68.2 M
, 9/1
12L11114
<0.0 05 MG/L
Arsenic-
r4 I
Cd,- CadMium,1VM/14'
<0,002 M 9/1
12/11/24
1
L2.9 MG/L
jzLimm
.
<0.00S
Chroin,
ium: TotaVIVII/14
<0.005 mgj1
Oroase'and 01 Is'
mg/1
Cu - Copper
mg/I
Phenol
Sulfate 1'2lL1a4_
mg/I
<10
-mg/I
F6 - fron
Hg - Mercury
mg/I
ORGANICS: (Gc,'
GCIMS,HPLC)
Specific. Cond.uctance
uMhos
K - Potasslu
mg1l
I
(Specify test and method #. Attach
'Report Attahed? Yes�1
lab report.)
N0)
Total A Orita
TKN
mg/
!Ag- agneslum12/11/14
mg/l
VOC method# =
8260E
�mg
asN
mg/11
Mn - Manganese. 12111/14
2.39 mg4
method It

SUBMIT FORM ON YELLQW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility'Narkie: COATSAMERICAN
Permit Name (it different):
------
Facility AddresS: 630AMERICAN THREAD RD
MARION NC 28752
(Car) isuea> ice) County MCDOWELL
Contact Person; PHILUP PITTMAN
Telephone #:82s-756-4111
Well Location/ Site Name: MW 13JEFFLUENT
No. of Wells to be Sampled: 7
Well Identification Number (from Permit): MW a13
Well Depth: is it. Well Diameter
in.
For Groundwater Treatment systems
y
Check,One:13 Influent (98)
Screened Interval:—_WA_ft. to N A it.
Q
Depth to Water Level: 1o.z ft. below measuring point.
Effluent: (99)
Measuring Point (M.P.) is: It. above land surface.
Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 2
Date sample collected: 1z/9/14
Field analysis: pH, 6-5 _ _ , Specific Conductance
I ' umhos
Temp. 14 °C, Odor
Appearance
MTMENT OF 'EHVIFIONMENT & NATURAL RESOURCES
:R QUALITY DIVISION, GROUNDWATER SECTION
MAIL SERVICE CENTER
PERMIT #: WQ0005603 EXPIRATION DATE:
NOn-Discharge UIC
NPDES
IYPP QFPRMITTED OPERATION BEING MONITORED
x . Lagoon Remedialion: infiltration Gallery
Spray Field Rernedlation:
Rotary Distributor - —Land Application of Sludge
Other. _
NOTF: Values should reflect dissolved and,
colloidal concentrations.
Date sample analyzed: SEE BELOW
Laboratory Narna: - w4jER T
Certification No. 50
PARAMETERS. (Samples for metals were collected unfiltered X YES NO
and field acidified
CO©.
mg/1
/100ml
Nitrite'(NO2) as N
Nitrate (Nos) as N
mg/l
mg/l
Goliform: MF Fecal
Coliform: MF Total
/100ml
Phosphorus: Total as P 12/22/14
6.19
mg/I
;Mate: Use h1PN method for highly turbid samples)
Orthophosphate
m t
Oissolved,Solids: Total 12/10/14
mg/l
Al - Aluminum 12/11/14
0.056
mg/l
pH (when analyzed) 12/9/14
6`9 units
Ba - Barium 12/11/14
0.032
TOC i2e 1/14 yi6/ 4
ChlChloride1zJ
2.62 mg/l
c mg/1
. Ca - Calcii Tj 12/11/14
Cd - .Cadmium-12111/14
11.3
mg/l
m i
9/
<0.002
Arsenic 12/11/14.
<0.005 mg/I
Chromium: Total 12/11/14
<005
mg/l
Grease and Oils
mg!!
Cu -Cro apper
mg/l
Phenol
Sulfate 12/11/14
12.1 mg/I
F(g _ lMercury
m
Specific Conductance
uMhos
K - Potassfurn
mg/I
Total Ammonia
ITI
Mg - Magnesium 12/11/14
7.60
mg/l
TKN as N'
mg/l
Mn - Manganese 12/11/14
0.175
mg/I
YES NO)
Ni - Nickel 12111/14
0.007 mg/l
Pb - Lead 12%11/14
<0.005 mqA
Zn - Zinc
mg/l
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration"Units)
SELENIUM 12/11/14
0.005 MG/L
SODIUM 12/11/14
57.9 MG/L
ORGANICS: (GC.GC/MS,HPI_C)
(Specify test and method #. Attach lab report.)
Report Attached?. Yes x (1) No (0)
VOC : method # = 8260 B
method #

SUBMIT FORM ON YE,LLQ V
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FOCI ITY INFQRP11ATFOPI
Please Print Clearly or.7yps
Facility Name: COATS AMERICAN
Permit Name. (if different):
Facility Address:. 630 AMERICAN THREAD RD
tSuaat},
MARION NC 28752
County MCDOWELL
(City) (swm) - txwt
Contact- Person; PHILLIP PITI'MAN
Welt Location/ Site Name: - MW 14/AfRAT10N
Telephone #: [phone]
No. of welts to be Sampled: 7
Well, Identihcatian Number (horn Fermft): MW #14
Tom sI
Well Depth- 1s it. WeDiameter.2
ScEeened Interval . NIA
in.
F0C Groundwater Treatment Systems
Check One: ❑. Influent 98
t
ft. to /A
N it
Depth to Water Level: 7.5 ft. below measuring point.
0 .Effluent (99)
Measuring Point (M.P.) is: • It. above land surface.
Relative AtI P. Elevation in #t.:
Gallons,of water pumped/bailed before sampling: 3
Date sample collected: 12/9/14
t=ieldanalysis: pN s.$ _, ., Specific.Conductarice
ulv4hos
Temp. 14 *C, Odor
Appearance
ONLY ,
QEPARTMENT OF 'ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: WQ0005603 EXPIRATI DATE:
Non-Dischargp UIC
NPDES
T-Y' E QF PE_ R ]±En OPERATION BEING MONITORED
x Lagoon Rernediation: infiltration Gallory
Spray Field Remediation
Rotary Distributor land Application of Sludge
Other
MTE: Values should reflect dissolved and •
colloidal concentrations.
Date sample analyzed: SEE BELOW
Laboratory Name: WATER TECH
Certification No. so
pA�AI M (Samples for metals were collected unfittered X YES NO
COD
and field acidified
Coliform: MF Fecal
f>igil
1100Ml
Nitrite (NO2) as N
Nftra�te (NO3) as N
m f
mg
Cotiform: MF Total
t10Qml'
Phosphorus: Total as ,P.12/22/14
<6.16 mg/1
(Note: Use MPN method for highly turbld samples}
Dissolved Solids: Total rrtglf
Ortl Iopho$phatra'
mg/l
12,10/14
pt'f..(when. analyzed) 12/9/14
444
7.1- units
AI - Aluminum 12/11/14
Ba - Barium _12/11/14
o.a76 tng4
TOC 12/11/14
Chloride
3.87 fllg/l
Ca _ Calcitlrrt 12/11/14 .
0.129 mg/I
61,9
�visiz4
Ar$@rIIC 12 11 14
fng/t
<0.005 i�ngtl
Cd - Cadmiumiu��4
Cf rtitillttm: Total 12 11/14
<0 002 mj
<0.005 m l
Grease -and Oils
mg/1
Cu. = C€ipper
9+�
mg/I
Phenol
Sulfate 12 11/14
specific
mg/I
<10T mg/i.
Fe - Iron..
H9 - Mercury
mg/I
mg/I
Conductance
uMhos.
K - Potassium
mgli
Total Ammonia
l`KN as N
mg/I
Mg h a r�esltim iz111n4
<o:aos
mgli
Mn - Manganese 12t11/14.
1.25 mg/I
YES Np)
Ni - Nickel_ 12/11/14 <0.005 mg/l
Pb - Lead 12/11/14 0:011 11 mg/l
Zn = Zinc mgA
Ammonia Nitrogen mg/l
Other (specify Compounds and Concentration Units)
SELENIUM 12111114
<O.0o5 MG L
SODIUM 12111/14
43.6 MG/L
ORGANICS: (GC,GC/MS,HPLC)
(Specify test 'and method #. Attach lab report.)
Report Attached?. Yes x (1) No (0)
VOC
method' # = szso B
method #

SUBMIT FORM ON YELLOIAr PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Prinf Clearly or Type
Facility Name: COATS AMERICAN
Permit Name (if different): _
Facifity Address: 630 AME& N THREAD RD
tSuset) ._... _
LLtViARION NC 28752 County MCDOWELL ~- ~
tc4r) ts+�u+) - [Zip)
Contact Person: PHtLLIP PITFMAN Telephone 9: 828as6-4221
Well Location/ Site Name: _ _MMI ASH POND No. of Well to be Sampled 7
twain Pc t
'Well Identification Number (from ,Permit): MW ##15 1:or Groundwater TreatattQnt°Systems
Well Deptlt. 16 it. Well Diameter: 2 in. Check One: ❑ Influent (98)
Screened Interval: N/A It. to N/A it. ❑Effluent (99)
Depth to Water Level: 9.3 ft. below measuring point.
Measuring Point (M.P.), is: It. above land surface. Relative M.P. Elevation in ft.:
Gallons of water puri)ped/bailed before sampling: 1 Date sample collected: 1z/9/14
'seid analysis: pH 6.7
, Specific Conductance uMhos
Temp. 19 °G, Odor Appearance
DEPARTMENT OF 'ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL. SERVICE CENTER
PERMIT. #: WCL0005603 EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE OF PERMITTi=n OPERATION BEING MONITORED
x Lagoon Remediation: infiltration Gallery
Spray Field
Rotary Distributor
Other:
Refnediation:
land Application ot'Sludge
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: SEE BELOW
Laboratory Name: WATER TECH
Certification No. 50 _
PARAME,TERS'(Samples for metals were collected unfiltered x . YES NO
and field acidified
COD
.m9/1
/100m!
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/l
mg/i
Coliform: MF Fecal
Cofiform: MF Total
/100ml
Phosphorus: Total as P_jZj2V
4 0.21
mg/l
(Note: Use IAPN method for highly turbid samples)
Orthophosphate,
mgl
Dissolved -Solids: Total 12/10/14
366 mg/I
Al - Aluminum 12/11/14
0.038
m I
H when analyzed) 12/9/14'
P ( Y ?----
7.0 units
Ba -Barium _12/11/14
Doss
M 9/1
T0C _12/11/24
Chloride 12/16/14
2.07
mg/l
Ca - Calcium
mg/l
_
Arsenic 12/
Off
<5.0 mg/l
<0.005 mg/l
Cd . Cadmium__ 12/11/14
Chromium: Total 12/11/i4
<0;002 � 1
<o.005 mg I
Grease and C3its
mg/l
Cu -Copper
mg/I
Phenol
Sulfate 12/11/14
mg/I
Fe -Iron
mg/t
Specific Conductance
<10 mg/I
umhos
Hg - Mercury
K - Potassium
mg/1
mg/1
Total Ammonia
mg/1
Mg -- Magnesium 12 11114
32.3
mg/l
TKN as-'N
mg/I
Mn- Manganese 1211i/la
a635
mg/1
YES NO)
Ni - Nickel 12/11/14
<0.005 mg/l
Pb - Learj_12/21/14
<6.005 mg/l
Zn - Zinc
mg/l
Ammonia Nitrogen
mg/l
Other (Specify Compounds and Concentration Units)
SELENIUM 12/11/14 <0.005 MG/L
SODIUM 12/11/14 �- — 9.27 MG/L
ORGANICS: (GC.GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes x (1) No (0)
voc : method # c 8260 S
method #1

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility Name: COATS AMERICAN
Permit Name;(ddifferprit):
, MARION NC 28752 MCDOWELL
't Person:— ; - County-,
on QPHILL11 PITTWW"
C Telephone [phone]
Well Location/ -Site Nama.- SEVIER BACK -GROUND
No. Of Wells to be Sampled:.
Well entiFUZ Number (from Permit), MW#2
Well Depth: __ 75 For Gmundwater Treatinent $Ystems
en, -!—in.
Seteened Interval. N/A Chec'k0ne:E] inf luent (98)
ft. to WA_ It.
Depth to Water Level:_-34-r. It. bel6w I 1 11 1 easuring point, 0 Effluent (99)
Measuring Point (M.P.) is: 7_3it. above land surface. Relative M.P. Elevation In ft.:
TGallons.of Water 06rhp6ftailed before sampling: _.e2_ Date sample dollected,
Fiqldanalysis: pH 8:0 ,'Specific Conductance: ttfvihos
"Temp. 7 . OC, Odor
Appearance
PEPARTMEiff OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #.,'W- Q0005603
EXPIRATION DATE:
N6n-Oischarne_
UIC
NPDF
`TYPE _QE_P_E,R_M_J=
OPERATION BEING MONITORED
Lagoon
-Remediation: Inliftration Gallery
Spray Field
Remedlation:
HOIM Distributor
Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sampleanafyzeq: SEE BELOW
'Laboratory-NaMe. WATER TECH
Certification No,, 50.
RARAM9tEAFtf($ampi.es for metals were collpcted unfilteredI a .COD -L—YES' , —NO and field acidified
,C0fff6TM-', MF'F06al
rpgll
/I OOMI
Nitrite - -N
(NO2) as
Nitrate (NO ).as N:
3
mg/l
mg4
�C011fo.rn,W. Total
/100,ml
Phosphorus: Totaictis P���
- mg
(Note '! use hiph. method for highly turbid -samples)
Dissolved Si Total 12/10114 !`4 IT1911
Orthloph osphate,_ .
All - Aluminum 12i11/14
mgA
i.06
(when anialyk6d). 12/9/14
18 units
'Barium 12/1
Ba IDA-
M 9/1
'0.123 M 9/1
.,0
T _G - i2/11/24 " . . , -
Chloride:
<1.0
Ca ­Calcibm i2t1144
35.1. M 9A
Ar,senj(.- 12/11/14,..
itt 1.
7
'005 ITI 911
Cd - Cadmium 121i1/14 I
Chromi6rn: Total 1za1/141-
<0.002:mgA,
0.6o7mg/1
.GreAso:�ind' .,its
Phenolg/l
mg/l
Cu - C'Oppe
m
Sulfate -12 14
<10
m19/1
Fe - Iron
-Hg - Mercury
mg/l
mg/1
Specific, Conductance
uMh
— 0$,
K­ Potassfu
mgA
TotafAmmonia
;
. mg/l
Mg�,_ Magnesium. gtil/i 4
19.2 mg/1
TKN as N .
.
mg/l
I 1
Mn. Manganese. U/Ii/14
1.2 1 0
mg/1
YES — NO)
Ni- Nickel 1?111114_ 0.010 - mg/I
Pb - Lea H12111/14 oO.04
Zn - Zinc mg/l
Ammonia Nitrogen mWl
Other (Specify Comp'ounds'.and Concentration Units)
SELENIUM 12/11/14
MG/L
SODIUM. 11/14
11.3 MG/L
ORGANICS: (GC,GC/MS.HPLC)
(Specify test and. method #. Attach' lab report.)
Report Attached? Yes -A—(!) No (0)
voc Method #f = 8260 B
method-#

;tiq�illitgl
RESEARCh & ANA1yTICAL�ur''�J•
bORATWES, INC. ,,;� •• •
� cr 1- z :'
Analytical/Prooess Consultations B
t •
�f •......, Cj 4
Water Tech Labs, Inc. Date Sample Collected 12/09/14
P.O. Box 1056 Date Sample Received : 12/11/14
Granite Falls, NC 28630 Date Sample Analyzed 12/11/14
Attn: Joe Gragg Date of Report 01/02/15
Analyses Performed by : CC -KL -AA
Lab Sample Number
--------------------
801287
Parameter Storet # Results
TOC (00680) 2.07 mg/1
Sodium,Tot (00929) 9.27 mg/l
Selenium,Tot (01147) <0.005 mg/1
Sulfate (00945) <10 mg/l
Aluminum,Tot (01105) 0.038 mg/l
Arsenic,Tot (01002) c0.005 mg/l
Barium,Tot (01007) 0.088 mg/l
Cadmium,Tot (01027) <0.002 mg/l
Chromium,Tot (01034) <0.005 mg/l
Calcium,Tot (00916) 72.1 mg/l
Lead,Tot (01051) <0.005 mg/l
rHagnesium,Tot (00927) 32.3 mg/1
Manganese,Tot (01055) 0.635 mg/l
Nickel,Tot (01067) <0.005 mg/l
--------------------
Clients Sample Source COATS AMERICA
Number MW15
Time Collected (Hrs) 1000
P.O. Box 473. 106 Short Street - Kernersvilla, North Carolina 27284. 336-996-2841 , Fax [phone]
www.rendelabs.com

RESEARCh & ANA[YTiCAL
F- -I- L:A ORATORVS, INC.
Analytical/Process Consultations
Water Tech Labs. Inc.
Date Sample Collected ;
22/09/14
P.O. Box 1056
Date Sample Received :
12/11/14
Granite Falls,
RTC 28630
Date Sample Analyzed
: 12/11/14
Attn: Joe Gragg
Date of Report
01/02/15
Analyses Performed by
CC -KL -AA
Lab Sample Number
--------------------
801286
Parameter
Storet #
Results
TOC
(00680)
3.87 mg/l
Sodium,Tot
(00929)
43.6 mg/l
Selenium,Tot
(01147)
<0.005 mg/l
Sulfate
(00945)
<10 mg/l
Aluminum, Tot
(01105)
0.476 mg/l
Arsenic,Tot •
(01002)
<0.005 mg/l
Barium,Tot
(01007)
0.129 mg/l
Cadmium,Tot
(01027)
<0.062 mg/l
Chromium,Tot
(01034)
<0.005 mg/l
Calc um,Tot
(00916)
61.9 mg/l
Lead,Tot
(01051)
0.011 mg/J.
Magnesium,Tot
(00927)
37.4 mg/1
Manganese;Tot
(01055)
1.25 mg/l
Nickel,Tot
(01067)
<0.005 mg/l
Clients Sample Source COATS AMERICA
Number MW14
Time Collected Mrs) - 1 0930
P.O. Box 473. 106 Short Street • Kernersville, North Carolina 27284.336-996-2841 • Fax [phone]
www.randolobs.com

-
RESEARch & ANA1.'�T(CAL
LAbORATORIES,, INC.
NC41
Anelytical/Process Consultations
M
+t,NED AN��
�•}'
Water Tech Labs, Inc.
Date Sample Collected
12/09/14.
P.O. Box 105.E
Date Sample Received
12/11/14
Granite Palls,
NC 28630
Date Sample Analyzed
12/11/14
Attn: Joe Gragg
Date of Report
01/02/15
Analyses Performed by
CC -KL -AA
Lab Sample Number
--------------------
801285
a aC �.-.qC SSR L^�==��sC��aaa.-:c��Cvcca��-����c=��accaa�cc�-�
---•---��rc_�_�....--.-...-.-tee=
Parameter
Storet ##
Results
TOC
(00680)
2.62 mg/l
Sodium,Tot
(00929)
57.9 mg/l
Selenium,Tot
(01147)
<0.005 mg/l
Sulfate
(00945)
12,1 mg/1
Aluminum,Tot
(01105)
0.056 mg/l
Arsenic,Tot
(01002)
40.005 mg/1
Barium,Tot
(01007)
0.032 mg/1
Cadmium,Tot
(01027)
<0.002 mg/1
Chromium,Tot
(01034)
<0.005 mg/1
Calcium,Tot
(00916)
11.8 mg/1
Lead,Tot
(01051)
<0.005 mg/l
Magnesium,Tot
(00927)
7.60 mg/l
Manganese,Tot
(01055)
0.175 mg/l
Nickel,Tot
(01067)
0.007 mg/1
--------------------
Clients Sample Source COATS XMERICA
Number MW13
Time Collected (Hrs) 0923
P.O. Box 473 • 106 Short Street @ Kernersville, North Caroline 27264. 336-996.2841 • Fax [phone]
www.randetabs.com

tttuuurf�
RESEAR�Ch & A,NA1.YTiCA +'
LZORATORiES INC.
>Nc134
_
Analytical/Process Consultations
Water Tech Labs. Inc. Date Sample Collected 12/09/14
P.O. Box 1056 Date Sample Received 12/12/14
Granite Falls, NC 28630 Date Sample Analyzed : 22/11/14
Attn:, Joe Gragg Date of Report : `01/02/15
Analyses Performed by CC -KL -AA
Lab Sample Number
--------------------
801284
Parameter Storet # Results
TOC (00690) 2.53 mg/l
Sodium,Tot (00929) 72,.9 mg/l
Selenium,Tot (911.47) 40.005 mg/l
Sulfate (00945) <10 mg/l
Aluminum,Tot (01105) 0.083 mg/l
Arsenic.,Tot (01002) <0.005 mg/1
Barium,Tot> (01007) 0.16.6 mg/l
Cadmium,Tot (01027) <0,002 mg/l
Chromium,Tot (01034) <0,005 mg/l
Calcium,Tot (0091(5) 68.2 mg/l
Lead,Tot (01052) <0.005 mg/l
Magnesium,Tot (00927) 18.6 mg/l
Manganese',Tot '(01055) 2.39 mg/l
Nickel,Tot (01067) 0.011 mg/l
--------------------
Clients Sample Source COATS AMERICA
Number MW12
Time Collected (Hrs) 0910
P.O. Box 473. 106 Short Street • Kernersville, North Carolina 27284.336-996-2641 • Fax [phone]
www.randelabo.com

eir►►►►4r
RESEARCh & ANAL}/TICAi
UbORATOMES, INC. •`•r`r� ' '� �" �'�'� ''• +qM
t
Analytical/Process Consultations M NC #34 :
a
3/ aCtd.,
Water Tech Labs. Inc. Date Sample Collected 12/09/14
P.D. Box ,1056 Date Sample Received 12/11/14
Granite Falls, NC 28630 Date Sample Analyzed 12/11/14
Attn.: Joe Gragg Date of Report 01/02/15
Analyses Performed by CC -KL -AA
Lab Sample Number
--------------------
801283
a a�aa x as as tea= ac an a c^.^.c o n o== o�vo � c as a. a c a a a a C a a c c a c c c a c a G as a s aes c as a a a eases aaa as a
Parameter Storet # Results
TOC (00680) <1.0 mg/l
Sodium,Tot (00929) 15.9 mg/1
Selenium,Tot (01147) <0.005 mg/1
Sulfate (00945) 26.2 mg/1
A.luminum,Tot (01105) 0.202 mg/1
Arsenic,Tot (01002) <0.005 mg/1
Barium,Tot (01007) 0.033 mg/1
Cadmium,Tot (01027) <0.002 mg/1
Chromium,TOt (01034) <0.005 mg/1
Calcium,Tot (00916) 23.6 mg/1
Lead,Tot (01051) <0.005 mg/1
Magnesium,Tot (00927) 17.1 mg/1
Manganes'e,Tot (01055) <0.005 mg/1
Ni.ckel,Tot (01067) <0.005 mg/1
--------------------
Clients Sample Source COATS AMERICA
Number MW11R
Time Collected (Hrs) 0900
P.O. Box 473 • 1 OB Short Street • Kernarsvllle, North Carolina 272B4 , 336-996.2841 • Fax [phone]
www.randelabs.aom

RESEARCh & A►NALYACA1
LkORATORVS, INC.
Analytical/Process Consultations
z H0 #34
Water Tech Labs. Inc.
Date Sample Collected
12/09/14
P.O. Box 1056
Date Sample Received
12/11/1.4
Granite Falls,
NC 28630
Date Sample Analyzed
12/11,/14
Attn: Joe Gragg
Date of Report
01/02/15
Analyses Performed by
CC -KL -AA
Lab Sample Number
--------------------
801282
Parameter
Storet #
Results
TOC
(00680)
<1.O mg/1
Sodium,Tot
(00929)
4.0.7 mg/1
Seleriium,Tot
(011417)
<0.005 mg/1
Sulfate
(00945)
30.9 mg/1
Aluminum,Tot
(011:05)
0,131 mg/1
Arsen c,Tot
(01002)
<0.005 mg/l
Barium,Tot
(01007)
<0.005 mg/l
Cadmium,Tot
(01027)
<0.002 mg/1
Chromium,Tot
(01034)
<0.005 mg/l
Calcium,Tot
(00916)
<0,500 mg/1
Lead,Tot
(01051)
<0,005 mg/1
Magnesium,Tot
(00927)
<0.500 mg/1
Manganese,Tot
(01055)
<0.005 mg/1
Nickel,Tot
(01067)
<0.,005 mg/1
--------------------
Clients Sample Source COATS AMERICA
Number W410
Time Collected (Hrs) 090'0
P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27284. 338-99B-2841 • Fax [phone]B
wwwirandalabs.com

TICA�
♦ '�f{{{lttfl��� t
I,
LbCRATWES, INC.
`•.e.Q....RESEARch&ANA1y�r,r
�
"1�%ZMO
��ft'
NC 04
Analytical/Process Consultations
Cw
Water Tech Labs. Inc.
Date Sample Collected :
12/09/14
P.O. Box 1056
Date Sample Received
12/11/14
Granite Falls, ITC 2863.0
Date Sample Analyzed
12/11/14
Attn: Joe Gragg
Date of Report
01/02/15
Analyses Performed by
CC -KL -AA
Lab Sample Number
--------------------
801261
Parameter Storet #
Results
TOC (00680)
<1.0 mg/l
Sodium,Tot (00929)
11,3 mg/l
Selenium,Tot (01147)
<0,005 mg/1
Sulfate (00945)
<10 mg/1
, Aluminum,Tot (01105)
2.06 mg/1
Arsenio,Tot (01002)
<0.005 mg/1
Barium,Tot (01007)
0.123 mg/l
£admium,Tot. (0102.7)
<0.002 mg/1
Chromium,Tot (01034)
0.007 mg/1
Calcium,Tot (00916)
35.1 mg/l
Lead, Tot {01051}
0,043 mg/1
Magnesium,Tot- (00927)
19.2 mg/1
Manganese,Tot (01055)
1.20 mg/l
Ni.ckel,Tot (01067)
0,010 mg/1
--------------------
Clients Sample Source COATS AMERICA
Number MP72
Time Collected (Hrs) 0855
R 0, Box 473 a 106 Short Street • Kernersvilla, North Carolina 27284.336-.996-2841 " Fax [phone]
www.randelabs.com

i
CHAIN OF CUSTODY = Analytical Request
Client Name: 0 �S e
Address:
Report .to:
Phone:
PO Number:
Preserval
Sample IdentificationIt
TV
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U
cc
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WATER TECH LABS', INC,
PO8OX,1056
GRANITE PALLS, NC' 2863.0
PHONE: (828) 396=44444
Project Name:
Project Number:
Requested Analyses
pH Checked Upon Receipt
0I2 < 0.2.mg/l, U on: Recei t
!� 47
j I
Field Temp. (C°) Comments
zs
tik✓ 1'- 4 y "L
7,
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®���—�®MMMM®O® M
Sample Condition Upon Receipt Relinquished By Company Date - Time Accepted By Company Date Time
r r �
i'�'i1®-'�k✓'�"/'...�"i ' L. III
VIF
NNW®
Sampler Name and Signature Date
Printed Naffne of Sampler's
' M 1

' � F
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CHAIN OF CUSTODY -Analytical Request
Client Name:(]
Address:
i
Report to::
Phone:
PO Number: A°11
WATER TECH LABS, INC.
PO BOX 1056,
GRANITE FALLS, NC 28630
PHONE: [phone]
Project Name:
Project Number:
pH Checked Upon
:12.< 0.2 rnnll I Innn
v 'n c ;1
Sample Identification ti `'�
w 0' A +
�5 U U ai. M Q
Field Temp. (C') Comments
m a f► i-q:t 1 X1k, k
It 11
low
M
}
2-
x F x
114
Temperature (°G)'
/a 1
Received on Ice: Y / N -
Sealed Cooler. Y / N
Samples lotact Y / N
AdditionalComments: • - r . r . _
Printed Name of Sampler..rQ` ! 1$ y1q.
Signature of Sarnpler,

qufMirgy�
UboRxtoRi s, 1rqc.
Analyttcd/Procm ccimc,tfsmorss
rnsruafs°c
Chemical Anatysisfor Seleded Parameters and Water Sample ldMtffl-ed as Coats American
A Water Tech Labs Ine. Pro ect colledEd 09 December 2014
I. Volatile Organics Quantitation
EPA Method 8260 B Limit MW2 MW10 MwllR MW12 MWi3 MW14 Arwi3
Parameter j lob 1pgn �b j�n Ipp
Acitone 25 BQL BQL SQL BQL BQL SQL BQL
Acrolein 100 BQL BQL BQL BQL BQL BQL BQL
Actyotvuile 100 BQL BQL BQL BQL BQL BQL BQL
Bemene 0,s BQL BQL BQL BQL BQL BQL BQL
Sromoheav= 0:3 BQL BQL BQL BQL BQL BQL BQL
Bromochhrroamthane 0,5 BQL SQL BQL BQL BQL BQL BQL
Bra modirNarontetbane 0.5 BQL BQL BQL BQL BQL BQL BQL
Bromafonn 1.0 BQL BQL BQL BQL BQL BQL BQL
Bronwaidhsne 1.0 SQL BQL BQL BQL BQL BQL BQL
2-Butaalono 25 BQL BQL BQL BQL BQL BQL BQL
Carbon Disulfide 5.0 BQL BQL BQL BQL BQL BQL BQL
Carbon Tettachlcride 0.5 BQL BQL BQL BQL BQL BQL BQL
Chlmobeame 0;51 BQL BQL RQI BQL BQL SQL BQL
CMoroetbaae 110 BQL BQL BQL :BQL. BQL BQL BQL
2-Clrloroetbyl viayl ether 5.0 BQL BQL BQL SQL BQL BQL BQL
( tilotnform 05" r= l0 i ` 3 BQL BQL BQL BQL BQL BQL
BQL BQL BQL BQL BQL BQL BQL
2-Chlomtn�tene 0,5 BQL BQL BQL BQL BQL BQL BQL
4-CHozatoluene, 0.5' BQL BQL BQL BQL BQL BQL BQL
Cis-1,2-11ahtoroethene PA BQL BQL BQL BQL BQL BQL BQL
Chi-1,3-Vchloropropens 0.5 BQL BQL BQL- BQL BQL SQL BQL
la-Dibromo-3-CWoxopmpcne(DBCP) 5.0 BQL BQL BQL SQL BQL BQL BQL
1,2Dibromedume (BDB) 0.5 BQL BQL BQL BQL BQL BQL BQL
Dibromocblommetbana 03 BQL BQL BQL BQL BQL BQL BQL
Dlbmmomethsno 03 BQL SQL BQL BQL BQL BQL BQL
1,2-Mclil robcnzena a's BQL BQL BQL BQL BQL SQL BQL
1.3-Dichlatoliemene U BQL B.QL BQL- BQL BQL BQL BQL
1;4-Dichlorobemene a's BQL BQL BQL BQL BQL BQL BQL
1,17Dichlareethaae Q5 BQL BQL SQL BQL BQL BQL BQL
1,2-Dichletoetbape 0:5 BQL BQL BQL SQL BQL BQL BQL
M-Dicwtoethetae 0,3 IBQL BQL BQL BQL BQL BQL B.QL
D chlarofoutomethane 0:3 BQL BQL BQL BQL BQL BQL BQL
1,2-131chtnuipuipane 0.5` BQL BQL BQL - BQL BQL BQL BQL
1,3-Dicblpropropano 0.5 BQL BQL BQL BQL BQL BQL, BQL
2,2-Dichkrbpiopano 0.5 SQL SQL SQL BQL BQL BQL BQL
M-➢ichloropmpene 0:3 BQL BQL BQL BQL BQL BQL BQL
Ethyl 'Bea mo 0.5, BQL BQL BQL BQL BQL BQL BQL
2-11exana w 5:6 BQL BQL BQL BQL BQL BQL BQL
B!B . 0.3- BQL BQL BQL BQL BQL BQL BQL
I-Propylbenzene 0.5 SQL BQL BQL BQL BQL BQL BQL
4 Methyl-2-Pa>itanone 5.0 BQL BQL BQL BQL BQL BQL BQL
Methylltaiide 1.0 BQL BQL BQL BQL BQL BQL BQL
*efticw Chloddat 5,0• BQL BQL BQL BQL BQL ;BQL BQL
MTBB a, BQL BQL SQL SQL BQL BQL BQL
Naphthalene 0.5 BQL BQL BQL BQL BQL BQL BQL
M-Butyl iwane 0:5BQL BQL BQL BQL BQL BQL BQi
N-Prarpy 0's BQL BQL BQL SQL SQL BQL BQL
p-150propyitolueno 0.5: BQL -BQL BQL BQL BQL BQL BQL
3eo-Butylbenzene 0.5 BQL BQL BQL BQL BQL BQL SQL
Styrene Ms BQL BQL BQL BQL BQL BQL SQL
'Geri-Butyibenzwe 0.5 BQL BQL BQL BQL BQL BQL BQL
1,1,1,24euaehloroetl 0.5 BQL BQL BQL BQL BQL BQL- BQL
1,1;2,2.Teirarlt wathsne a's BQL BQL BQL SQL BQL BQL BQL
Tct=M'crottlime 0,5 BQL BQL BQL BQL BQL BQL BQL
Toluene , 0.3 BQL BQL BQL BQL BQL BQL BQL
Trans 1,2-IilChtolnetl o5 BQL . BQL; BQL BQL BQL BQL BQL
Trans-0-Alcbloropropene 0S BQL BQL BQL BQL BQL BQL BQL
Trans-1,4-Dicbiuro-2-butene 5,0 BQL BQL HQL BQL BQL BQL BQL
1.2,3-Ttiohlowbetnena 0:5 'SQL BQL BQL BQL BQL BQL• SQL
1,2,4-TiUblorobemem M SQL SQL BQL BQL BQL BQL. BQL
1112-Trkhloroetbaae 05 SQL BQL BQL BQL BQL SQL BQL
1,1,2-Triohlo'moae etb0:5 BQL BQL BQL BQL BQL SQL BQL
Ti cb1ometbeue 0.5 BQL BQL, BQL BQL BQL BQL BQL
Tdchlowntioniounhano 0.5- SQL BQL, BQ4';14" BQL BQL BQL BQL
1,2,3-Triottipropanc 0.5 SQL SQL BQL " BQL BQL BQL BQL
1;24.Ttitnethylhenzene 0.5 BQL BQL BQL BQL BQL BQL BQL
1,3,5-Trimeithylbenzene, 0,5 BQL BQL BQL BQL BQL BQL BQL
Vinyl ACerate 1.0 SQL BQL BQL BQL BQL. BQL. BQL.
Vbtyl Ckbrlde, 0.5 SQL BQL BQL SQL BQL BQL BQL
TouJXytmsa 1.0 BQL BQL BQL BQL BQL BQL SQL
DilutionFaacr i
Sample Number 901281 801282 A01283 801284 841285 801286 901287
SwupleDatte 12/09114 17109114 12f09114 12109h,l 12/09/14 12/091114 12109114
Sample Tune (bra) 0855 0900 0910 0916 0923 0930 1000
Aria" NM' NM NM 1w NM 23m NM
DateAnalyzed12/16/14 12/16/I4 12/161/4 12/17/144 12117A4 12/17/14/2117/14
Time Anab med 2233 2305 2337 0009 0041 0113 0146
SarrogateRecovery Rant is
DBFM (70-130%) ' 108% 104% 1 t I% 114% 111°la 107°!o l I4%a
Toluene-dil (70-130%) 104% 980/0 111% 100% 103% 97% 97%
4=BFB (70-1300K) 93% 93% 960/o 960/6 99% 101% 101%
BQL a BCkw Q.Mf ewtiM Limits ppb Q pact perr hcltiott

POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALL. NORTH IAROLINA 28630
[phone]
SAMPLE.- Coats America (MW#16)
PERMIT ff.,
ADDRESS: Coats America (Wells)
P.O. Box 368
Marion, NC 28752
COLLECTION DATE:
12/9/2014
COLLECTION TIME:
10:00
RECEIVED DATE:
1-2/9/2014
RECEIVED TIME•
11:50
REPORTED:
12131120,14
LOG- ID: 1412-172 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab, 8upervisor

SAMPLt-* Coats Amedca.(MW#14) COLLECTIONDATE: 121912014
PERMIT A: COLLECTION TIME: 09:30
ADDRESS: Coats America (Wells) RECEIVED DATE.* 12/9/2014
P.O. Box 368 RECEIVED TIME: 11:50
Marion, NC 28752
REPORTED: 12131/2014
LOG -1D.*' 1412-171 REPORTED BY: NC CERTIFIED LAB # 50
Ton'y Gragg, Lab Su-p'qryjS0r

POST OFFICE BOX 1056 - #5 PINEWOOD PLAZA 08.
GRANITE FALLS, NORTH CAROLINA 28WO
[phone]
SAMPLE: Coats America (MW#1 3) COLLECTION DATE: 12/9/2014
PERMIT A. COLLECTION TIME. 09:23
ADDRESS: Coats America (Wells) RECEIVED DATE: 12/9/2014
P.O. Box 368 RECEIVED TIME: 11:50
Marion, NC 28752
REPORTED: 12/31/2014
ANAL YSIS,
ANALYSIS
PESULTS� --'-UNIT
----- -----
TDS
282
mg[L
12/10/14
lag
Chloride
<5.0
mg/L
12/16/14
lag
T. Phosphorus
0.19
mg/L
12/22/14
jdg
TOC
see attached
Sulfate
see attached
metals
see attached
pH
6.9
su's
12/9/14
lag
Vods
see attached
LOG ID: 1412-170 REPORTED BY: NC CERTIFIED LAB # SO-
fb� *
Tony Gragg, Lab Supervisor

POST'OFFICE BOX, 1056 PINEW000 PLAZA DR.
GRANITE MLS. NORTH CAROLINA 2W30
(k8) 3964444
SAMPLE., Coats America (MW#1 2) COLLECTION DATE: 12/9/2014
PEIRMITA. COLLECTION TIME., 09:16
ADDRESS: Coats America (Wells) RECEIVED DATE., 12/9/2014
P.O. Box 368
Ma . rion, NC 28752 RECEIVED TIME., 1150
1 REPORTED: 12/31/2014
LOG ID: 14,12-169
PEPORTED BY: NC CERT1FIED LA13 # 50
T60y Gragg, Jab,Superivlsor

q
PO aTO/tj+pF/��Fpp'IpC ' arz [[4 �y� !�§ ply j }yy�4t€�yi[pEj�i`� OtO#�,Dy PLAZA p, DR.
(828) 30&4444
SAMPLE: Goats America (MW#1.1,) COLLECTION DATE. 12/9/2014
PERMIT #: COLLECTION TIME 09:10
;ADDRESS: Coats America (Wells) RECEIVED DATE.` 12/9/2014,
P.Q. Box 368 RECEIVED TIME., 11:50
Marion, NO. 28752
REPORTED. 12/31 /20:14
TDS 216 mg/L 12110/14 lag.
chloride 7.3 mg/L 12/16/14 tag
T. Phosphorus 0.18 mg/L 12122/14 jdg
TOC see attached'
Sulfate see attached
metals see attached
OH 8.3 sWs 1279/14 tag
voc's see attached
4��#S'''� � r :.�� ��,. 1'- � t '�.. "� "x �"n''�., � b +t-'�` '� �•'^�" a ",, r«- r `�a 'T n } �a� ".x �s
.-4-
m�, 4 }` i -`�-?s`�r ;1'�
.., 4�, zI i�ZN
..R
1 MISS--,
sus z .� �a ss ^•- "``.#."tax s `�, m fir: ar , € � tP �'� ` � '� e §� { ^ � . �*€ � � r �� ��
LOG -ID 1412-168 REPORCEIi.BY: NC CERTIFIED LAB I# 5i
Tony Gragg, Lab Supervisor

MOTE C 0 LORS.inc.
POST OFFICE BOX 1056 - #5 PfNEWOOD PLAZA DR.
GRANITE FALLS; NORTH ' CAROLINA. 9,8630
[phone]
SAMPLE, 'Coats Ah,iOka (MW#1 0)
PERMIT
ADDRESS., Cdaits America (Wells)
P.Q. PDX 36p
Marion;, NC 287512
-COLLEGTIDNDATE:
12/9/2014
C,Q4LEQT10,N-.T,1ME.-.
09:00
RECEIVEUDATE-
12/9/2014
RECEIVED 77ME,."
11 :50
REPORTED:
12/3112014
7A4, M.
TOAY"Grag& La
b, Slpoorvisor

MCH LONSinc,
yr POST OFFICE BOX 1056. - #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
(824) 3964444
,.SAMPLE., Coats Amedca (MW#02) COLLECTION DATE: 12/9/2014
PERMITM
COLLECTION TIME., 08:55
ADDRESS: Coats America (Wells' RECEIVED DATE., 12/9/2014
P.O. Box,368
RECEIVED TIME. 11:50
'Marion, NC 28752
TDS
108
mg/L
12110/14
lag
Chloride
9.8
mgiL
12116/14
lag
T. Phosphorus
0.41
mg/L
12122/14
-jd§
TOC
see attached,
Sulfate
gee attached
metals
see attached
PH
su's
12/9/14
lag
tee attached
LOG Q 1412-166 REPORTED BY' NC CERTIFIED LAB .50
Uny GfuggjLab Supervisor

GW;-59A COMPLIANCE REPORT FORM Permit # WQ0005603
(Submir one each monitoring perlod with 0b-59 forms.)
i
1
Enter.dte monitoring resuits were due. { 9/30/14 1 Will this monitoring report (GW-59 and GW-59A)
YES
NO
be submitted after the established due date?
X
2
Was any•required information missing on the GW-59 report forms?
YES
NO
IF the all to question 9 or 2 is YES ; list in the space provided below the wel; identification number(s) and
explain the problems encountered in obtaining the required information.
i
! ;
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, tmJDeked or missing cap, missing
YES
NO
identifications plate, area overgrown, etc.)? If the answer is "Yes ", contact the Regional Office for guidance.
X
4
Are any monitored constituents equal to or above the established standards?
YES
NO
if the an wer to question 4 is NO°, skip to section 8.
If the an, ever to question 4 is "YES" list the affected wells individually with consdtuent(s) and concentration(s) ,
exceedin'Rstandards in the space provided below.
MW #121 TDS 680 mg/I MW #13 TDS 561 mg/I MW #2 Total Lead 0.050 mgJl
Manganese 4.56 mg/I Manganese 1.23 mg/1
1
I
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
YES
NO
same co�tstituent(s) in the same well(s) in the last two years?
x
If the answer to question 5 is 'NO", skip to section 8,
If the answer to question 5 is "YES'; list in the space provided below, each well with constituent(s) exceeding
standard$, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
MW #2 jLead 0.59 mg/1 April 2014 MW #12 TDS 587 mg/I April 2014
I:Manganese 1.44 mg/I April 2014 TD5 654 mg/
April
013
Manganese 4.19 April 2014
;Manganese 1.38 mg/1 August 2013 TDS 590 mg/I August 2013 Manganese
85 m
Jl Ap
i Manganese 4.06 mg/I August 2013
2
6
Are the ronitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
x
If the an wer is "YES", a groundwater quality problem maybe occurring. CONTACT THE REGIONAL
OFFICE.IMMEDiATELY FOR GUIDANCE. If the answer is "NO". monitoring. wells maybe improperly
located; ontact the Regional Office.
i
7
Is the pernmittee implementing previously approved actions required by the Division• involving this
YES
NO
groundwater quality problem?
if the answer to question 7 is "YES", describe those actions in the space provided below.
If the answer to question 7is "NO", contact the Regional Office within 90 days, • an evaluation maybe
required %o determine the Impact the waste disposal.system is havin
at the retj etG-andxofri' lFai%i
boundaries surrounding this facility. Fallure to do so may subiect the permittb(iE&•a-Nbtill of io tion
fines, and/or penalties.
SEP 16'2014
ii �C�)!7%^.p`l 'l'.j p:% ji �:
g
The person completing this portion (GW-59A) of -the monitoring report should sign below and submit this
form with; G W-59 forms for required wells to the address provided at the top of the current GW-59 form.
1
1 hereby aicknowiedge that thewabove Info�matlon was eye uaf?dtand the lnformafTon sub tied w"th�is mow@
sieport,;(Cmp13e, Redport GW 59A) lsitrue a d complete to the best of my,krxowledge,,xrr _..'
. .. ,.,...._, J
9/11/14
E;g
fED
Signature of Permitte ' orAuthorized Agent) Date
RE
Division cfWater
lesout
f
:es
SEP 2 2 2014
GW-$9A 12/8/2003
Water Quality Regional Operations
Asheville Regional Office

SUBMIT FORM ON YELLOW: PAPER. ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or
Facility Name: COATS AMERICAN
Permit Name (if different):
Facility Address' 630 AMERICAN THREAD RD
MARION (SUceq NC 28752 McDOWELL
COUr1t
(sine) (�)
Contact Person: PHILLIP PITTMAN
Telephone 0: 828a56=4111
SEVIER BACKGROUND
Well Location/ Site Name:
No. of Wells to be Sampled: 7 .
Well Identification Number (from Permit): MW #z
Foi Groundwater Treatmeni Systems
Well Depth: 75 ft. Well Diameter-.,6
in•
Check One: ❑ In (98)
Screened Interval: N/A ft. to N/A ft.
0
Depth to Water Level: 35.4 ft. below measuring point.
Effluent (99)
Measuring Point (M.P.) is: 2.3 ft. above land surface.
Relative M.P. Elevation.in ft.:
Gallons of water pumped/bailed before sampling: 67
Date sample collected: 8-14-14
Field analysis: pH _ 6 91 Specific Conductance
uMhos
Temp. 15.8 'C, Odor
Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION,. GROUNDWATER SECTION
163E MAIL.SERVICE CENTER
F'tRtViIT #: w40005603
EXPIRATION DATE:
Non=Discharge
UIC
NPDES
TYPE OF PERMITTED
OPERATION BEING MONITORED
X . Lagoon
Remediation: Infiltration Gallery
Spray Field
Remediation:
Rotary Distributor
Land Application of Sludge
Other.
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: SEE BELOW
Laboratory Name: WATER TECH
Certification No. 50
PARAMETERS (Samples for metals were collected unfiltered X YES NO
and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P8/25
0.31 mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
m/I
g
Dissolved Solids: Total 8/15 110
mg/I
Al - Aluminum 8/22
3.54
TOCw 8/ 6 analyzed) $/14 7.9
units
Ba - Barium 8/22
n 16a ml
g/
<1.0
mg/I
Ca - Calcium 8/22
�a' mg/I
Chloride 8/22' 7.25
mg/I
8zz
Cd - Cadmium /
<o 002 Mg/I
Arsenic _8/22 0.007
mg/l
Chromium: Total 8/22
<0.005 Rj l
Grease and Oils
mg/I
Cu - Copper
mg/1
Phenol
mg/I
Fe - Iron
mg/I
Sulfate 8/22 12.0
mg/I
Hg -Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium 8/22
20.1 mg/I
TKN as N
mg/l
Mn - Manganese 8/22
1.23 mg/1
YES NO)
Ni - Nickel_8122
0.012 mg/I
Pb - Lead. 8/22
0.050 mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units) _
SELENIUM 8/22
<0.005mg/I
SODIUM 8/22
12.9 mg/I
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes . (1) No . (0)
VOC method # =
method ii =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING -
COMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility Name: COATSAMERICAN
Permit Name (if different):
Facility Address: 630 AMERICAN THREAD RD
I5ueeq
MARION NC 28752 County McDO WELL
(Chy)• Iswb) (Twl
PHI PITTMAN 828-156-4111
Contact Person; Telephone #:
Well Location/MW 10/ASH POND 7 Site Name: No. of Wells to be Sampled:
Well Identification Number (from Permit): Mwttlo
`For Groundwater Treatment Systems
Well Depth: 18 it. Well Diameter•. 2 in. Check One: ❑ Influent (98)
Screened Interval: NIA ft. to N/A ft. 0 Effluent 99
Depth to Water Level: 15.3 ft. below measuring point. )
Measuring Point (M.P.) is: 2.3 ft. above land surface. Relative M.P. Elevation in It.:
Gallons of water pumped/bailed before sampling: Date sample collected: 8-14-14
Field analysis: pH _ 6•44 , Specific Conductance uMhas
. Temp. 16.0 'C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION. -GROUNDWATER SECTION
.PERMIT #: WQ0005603 EXPIRATION DATE:
Non -Discharge UIC
NPDES
.TYPE OF PERMITTED OPERATION BEING MONITORED
X Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rofary Distributor Land Application of Sludge
Other,
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: SEE BELOW
Laboratory Name: WATERTECH
Certification No. 50
PARAMETERS (Samples for metals were collected unfiltered X YES NO
'and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/1
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P B/2s <0.16 mg/I
(Note; Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total 8/11 179
mg/I
Al -Aluminum 8/22 .
0.060 mg/I
pH (when analyzed) 8/14 6i0
units
Ba -Barium 8/zz
o.00s mg/1
TOC
mg/I
Ca - Calcium 8/22
�s01i mg/I
Chloride 8/22' <5.0
mg/I
Cd - Cadmium 8/22
<0.o02 mg/I
Arsenic 8/22 <0.005 mg/l
Chromium: Total 8/22
<0.005 mg/l
Grease and Oils
mg/l
Cu - Copper
mg/I
Phenol
mg/l
Fe - Iron
mg/I
Sulfate 8/22 49•1
mg/I
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium 8/22
<0.500 mg/l
TKN as N
trig/I
Mn - Manganese 8/22
<0.005 mg/I
GW-59
Rev. 0372000
YES NO)
Ni - Nickel_ 8/22
<0.005 mg/I
Pb - Lead 8/22
<0.00s mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
SELENIUM 8122
<0.005mg/I
SODIUM 8/22
71.0 mg/I
ORGANICS: (GC,GCIMS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes . (1) No (0)
VOC : method # =
method # =
- rilethod'#

SUBMIT F6RM ON YELL W.PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility Name: COATS AMERICAN
Permit Name (if different):
MARION "-" NC 28752 County McDOWELL
is+rJ PHILLIP:PITTMAPI�awt lzw) 828-756-4111
Contact Person: Telephone #:
Well Location/ Site Name: MW 11R/ASH POND No. of Wells to be Sampled: 7
Ilrom Permit
Well Identiiication Number from Permit: MW #11R
( ) For Groundwater Treatment'SysCelms
Well Depth: 30 it. Well Diameter 2 in. Check One: ❑ Influent (9$)
Screened Interval: N/A it. to _N/A . it. 0 Effluent (99)
Depth to Water Level: 7.7 it. below measuring point.
Measuring Point (M.P.) is: 2 ft. above land surface. Relative M.P. Elevation in It.:
Gallons of water pumped/bailed before sampling: 3 Date sample collected: 8/14/14
Field analysis: pH 7•88 , Specific Conductance Umhos
. Temp. 17.5 'C, Odor Appearance
DEPARTMENT OF ENVIRONMENT A NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1536: MAIL SERVICE CENTER
.PERMIT #: WQ0005603 EXPIRATION DATE:
Nori-Discharge UIC
NODES
'TYPE OF PERMITTED OPERATION BEING MONITORED
_X _ Lagoon Remediation: infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other.
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: SEE BELOW
Laboratory Name: WATER TECH
Certification No. 50
PARAMETERS (Samples for metals were collected unfiltered X YES NO
and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100m1
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P 8/25
0.17 .mg/I
(Note: Use MPH method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total 8/15
224 mg/I
Al - Aluminum 8/22
0.574 mg/l
phi (when analyzed) 8/14
8.0 units
Ba - Barium s/22
0.044 mg/I
TOO 8 26
1.25 mg/I
Ca - Calcium 8/22
_42.6 mg/I
Chloride 8/22
<5.0 mg/I
Cd - Cadmium 8/22
<0,002 mg/I
Arsenic 8/22
a5
<0.0mg/I
Chromium: Total 8/22
<0.005 mg/1
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/l
Sulfate 8/22
34.4 mg/l
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/l
Total Ammonia
mg/1
Mg - Magnesium 8/22
23.6 mg/l
TKN as N
Tng/1
Mn -Manganese 8/22
<0.005 mg/I
YES NO)
Ni - Nickel 8/22
<0.005 mg/I
Pb - Lead 8/22
<0.005 mg/I
Zn - Zinc
mg/1
Ammonia Nitrogen
mg/i
Other (Specify Compounds and Concentration
Units)
SELENIUM 8/22
<0.005 mg I
SODIUM 8/22
16.7 mg/I
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC method # =
method # =
:.-method-# _._.._.__..__..___...__....._...

SUBMIT FORM ON
QW PAPER ONLY
I - DEPARTMENT OF ENVIRONMENT 6 NATURALRESOURCES
GROUNDWATER QUALITY MONITORING: WATER QUALITY DIVISION, GROUNDWATER SECTION
1616 MAIL:SERVICE CENTER
COMPLIANCE REPORT FORM Rol Kir;u .Mr 97AGG-19olp 1010%799_979,
Facility Name: COATS AMERICAN
Permit Name (if different):
Facility Address: 630 AMERICAN THREAD RD
28752
tC°Yt PHILLIP PITTMAI�"�t (ZIP)Contact Person:
Well Location/ Site Name: MW 12/EFFLUENT
Print Clearly or'Type
County McuuvvtLL
Telephone #: [phone]
No. of Wells to be Sampled: 7
07— moll
Well Identification Number (from Permit): MW #12 For Groundwater Treat'menl Systems
Well Depth: 13 ft. Well Diameter: 2 in. Check One: ❑ Influent (98)
Screened Interval: N/A ft. to N/A ft. Effluent (99)
Depth to Water Level: 10.1 it. below measuring point.
Measuring Point (M.P.) is: 2.6 ft. above land surface. Relative M.P. Elevation in ft.'
Gallons of water pumped/bailed before sampling: 1 Date sample collected: 8/14/14
Field analysis: pH 6.67 , Specific Conductance Umhos
Temp. 17.7 °C, Odor Appearance
PERMIT #: WQ0005603 EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
X Lagoon Remediation: Infiltration Gallery
Spray Feld Remediation:
Rotary Distributor —Land Application of Sludge -
Other.
NOTE: Values should reflect dissolved and.
colloidal concentrations.
Date sample analyzed: SEE BELOW
Laboratory Name: WATER TECH
Certification No. 5o
PARAMETERS (Samples for metals were collected unfiltered X YES NO
and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
1100ml
Nitrate (NO3) as N
mgll
Coliform: MF Total
/100ml
Phosphorus: Total as P Ms
0.24 mg/I
(Note:.Use MPN method for highly turbid samples)
Orthophosphate
mg/1
Dissolved Solids: Total 8/15
680 ntgA
Al - Aluminum 8/22
0.135 mg/I
pH (when analyzed) 8/14
6.8 units
Ba - Barium 8/22
0.205 mg/1
TOC 8/26
1,94. mg/I
Ca - Calcium 8/22
111 mg/I
Chloride 8/22 '
<5.0 mg/I
Cd - Cadmium 8/22
<0.002 mg/1
Afsenic 8/22
<n.n05 mg/I
Chromium: Total. 8/22
<0.005 mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate 8/22
<10 mg/I
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg%l
Mg - Magnesium 8/22
18.8 mg/(
TKN as N
mg/I
Mn - Manganese 8/22
4.56 mg/l
GW-59
Rev, 03/2000
YES NO)
Ni - Nickel 8/2a 0.010 mg/I
Pb - Lead 9/22 <0.005 mg/1
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds.and Concentration Units)
SELENIUM 8/22 <0.005 mg/1
SOnluM 8122 111 mg/I
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC_ : method # =
method # =
9/11/14

SUBMIT FORM ON YELLOW PAPER ONLY ,
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print clearly or Type
Facility. Name: COATS AMERICAN
Permit Name (if different):
s (ueeq
,MAR ON NC 28752 County. McDOWELL,
(city)' PHILLIPRITTMAW''°) trro) 828-756-4111
Contact Person: Telephone.#:
Well Location/ Site Name: MW 13/INFLUENT No. of Wells to be Sampled:.
Well Identification Number (from Permit): rviw IT IS For Groundwater Treatment Systems
Well Depth: 15 it. Well Diameter: 2 in.: Check One: ❑ lnfiuent (98)
Screened Interval: N/A it. to N/A fL 0 Effluent (99)
Depth to Water Level: 11.2
ft. below measuring point.
Measuring Point (M.P.) is: 2.6 it. above land surface. Relative M.P. Elevation.in ft.:
Gallons of water pumped/bailed before sampling: 1 Date sample collected: 8/14/14
Field analysis: pH 6.12 . , Specific Conductance uMhos
Temp. 17.5 QC, Odor Appearance
ENVIRONMENT & NATURAL RESOURCES
DIVISION, GROUNDWATER SECTION
:E CENTER
PERNIIT #: WQ00056021 EXPIRATION DATE:
Non -Discharge UIC
NRDES
TYPE OF PERMITTED OPERATION BEING MONITORED
X Lagoon Remediation: Infiltration Gallery
Spray Feld -Remediation:
Rolary Distributor Land Application of Sludge
Other.
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: SEE BELOW
Laboratory Name: WATER TECH
Certification No. 50
PARAMETERS (Samples for metals were coilected unfiltered X YES NO
and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100m1
Phosphorus: Total as P 8/25
0.67 mg/I
(Note: Use MIPN method for highly turbid samples)
Orthophosphate
mg/1
Dissolved Solids: Total 8/15
561 mg/I
Al - Aluminum 8/22
0.1.95 mg/l
pH (when analyzed) 8114
6.3 units
Ba - Barium 8122
0.112 mg/I
TOC 8/26
2.58 mg/I
Ca - Calcium 8/22
33.6 mg/I
Chloride 8/22 '
. e.75 mg/I
Cd - Cadmium 8122
<0.002 mg/l
Arsenic 8122
<0.005 mg/I
Chromium: Total 8/22
<0.005 mg/1
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron.
mg/l
Sulfate J22
<.10 mg/I
Hg -. Mercury
mg/1
Specific Conductance
uMhos
K - Potassium
mg/l
Total Ammonia
mg/1
Mg : Magnesium 8/22 .
22.2 mg/l
TKN as N
mg/I
Mn - Manganese 8/22
0.753 mg/l
YES NO)
Ni - Nickel 8/22
<0.005 mg/I
Pb - Lead 8/22
<0.005 mg/I
Zn - Zinc
mg/l
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
SELENIUM 8122
<0.005 m01
SODIUM 8/22
144 mg/I
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method C Attach lab report.)
Report Attached? Yes -(I) No (0)
VOC method #,=
method # =
,rluv. ualeuuu

SUBMIT FORM ON YELLOW PAPER.ONLY
DEPARTMENT OF ENVIRONMENT 3 NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: WATER QUALITY DIVISION,. GROUNDWATER SECTION
.1634 MAIL SERVICE CENTER
COMPLIANCE REPORT FORM :'Rat F(r-i .Nf 97aao-Into oh. . 10,0%799_9991
Please Print Clearly or Type
Facility dame: COATS AMERICAN
Permit Name (if different):
Facility Address: 630 AMERICAN THREAD RD
(Sireaq
MARION . NC _ 28752
County McDOWELL
liar) PHILLIP PITTMANIs"10) lro)
Contact Person:
Telephone#: [phone]
Well Location/ Site Name: MW 14/AERATION
No. of Wells to be Sampled: 7
.. trom Permlq ;
Well Identification Number (from Permit): MW #14
For Groundwater Treatment Systems
Well Depth: 15 ft. Well Diameter: 2
in.
Check One: ❑ Influent (98)
Screened Interval: NIA ft. to N/A ft.
1 ❑ Effluent (99)
Depth to Water Level: 7.5 ft. below measuring point:
Measuring Point (M.P.) is: 2.6 ft. above land surface.
Relative M.P. Elevation in It.:
Gallons of water pumped/bailed before sampling: 3
Date sample collected: 8/i4/14
Field analysis: pH 6.44 , Specific Conductance
. ' -uMhos
Temp. 16.8 aC, Odor
Appearance
PERMIT #: WCQ0005603 EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE OF PERMITTED. OPERATION BEING MONITORED
X Lagoon Remediation: Infiltration Gallery
Spray Feld Remediation:
Rotary Distributor _Land Application of Sludge
Other.
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: SEE BELOW
Laboratory Name: WATER TECH
Certification No. so
PARAMETERS (Samples for metals were collected unfiltered X YES NO
and field acidified
COD
,mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P 8/25 0.28 mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total 8/15
405. rng/l
Al -Aluminum 8/22
0.464 mg/l
pH (when analyzed) s/14
6.7 units
Ba - Barium 8/22
0.132 mg/I
TOC 8/26
2.93 mg/I
Ca - Calcium 8/22
64.4 mg/I
Chloride 8/22'
.
<s.0. mg/I
Cd - Cadmium 8/22
<0.002 mg/I
Arsenic s/z2
<0.005 mg/I
Chromium: Total 8/22
<0.005 mg/I
Grease and Oils
mg/I.
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate. 8/22
<10 mg/l
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/1
Mg -Magnesium 8/22
38.4 mg/l
TKN as N
mg/I .
Mn - Manganese 8/22
0.997 mg/l
GW-59
Rev. 0312000
YES NO)
Ni - Nickel 8/22
<0.005 mg/I
Pb - Lead 8/22
<0.005 mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
SELENIUM 8/22
<0.005 mg/I
_ SODIUM 8/22
35.7 me
ORGANICS: (GC,GC/MS,HPLC) -
(Specify test and method #. Attach lab report.)
Report Attached? Yes —(I) No (0)
VOC method # =
method # =
___._.._.....�..._._...__.__-____..method..ly=-­_.....,..._..__ �....___,.._.... _.

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATE13 QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility Name: COATS AMERICAN
Permit Name (if different):
Facility Address: 630 AMERICAN THREAD RD
MARION tsuee�l NC 28752
County McDOWELL.
Icily( PHILLIP PITTMAR"' (zip)
Contact Person:
Telephone #: [phone]
Well Location/ Site Name: MW WASH POND
No. of Wells to be Sampled: 7
from Pe Q
Well Identification Number (from Permit): Mw#15
:
For Groundwater Treatment'Systems
Well Depth: 16 it. Well Diameter: 2
in.
Check One: 0 Influent (98)
Screened Interval: N/A ft. to N/A. fL
13 Effluent (99)
Depth to Water Level: 9.2 ft below measuring point.
Measuring Point (M.P.) iss_2.iz ft. above land surface.
Relative M.P. Elevation.in ft.:
Gallons of water pumped/bailed before sampling: 1
Date sample collected: 8/14/14
Field analysis: pH 6.37 Specific Conductance
uMhos
Temp. 18.1 °C, Odor
Appearance
DEPARTMENT OF ENVIRONMENT S NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636.MAIL SERVICE CENTER
#f: WQ0005603 EXPIRATION DATE:
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
X. Lagoon Remediation: Infiltration Gallery
Spray -Field Remediation:
Rotary Distributor Land Application of Sludge
Other.__
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: SEE BELOW
Laboratory Name: WATER TECH
Certification No. 50
PARAMETERS (Samples for metals were collected unfiltered X YES NO
and field acidified
. YES NO)
COD
mg/I
Nitrite (NO2) as N
mg/I
Ni - Nickel 8/22 <0.005 mg/I
Coliform: MF Fecal
/1 OOml
Nitrate (NO3) as N
mg/I
Pb - Lead 8/22 <0.005 mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P 8/25 <0.16 mg/I
Zn - Zinc . mg/1
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/1
Ammonia Nitrogen mg/I
Dissolved Solids: Total 8/15
364, Mg/I
Al - Aluminum 8/22
0.056 mg/I
Other (Specify Compounds and Concentration Units)
pH (when analyzed)_ 8114
6.6 units
Ba -Barium 8/22
0.126 mgA
-J OC 8/26
1.82 mg/I
Ca - Calcium 8/22
85.9 mg/I
SELENIUM 8/22.' <0.005 mg/1
Chloride 8/22
<5.0 mg/I
Cd - Cadmium 8/27
<0,002 mg/I
SODIUM 8/22 10.9 mg/I
Arsenic 8/22
<0.005 mg/I
Chromium: Total 8/22
<0.005 mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
ORGANICS: (GC,GC/MS,HPLC)
Sulfate 8/22
<10 mg/I
Hg - Mercury
mg/I
(Specify test and method #. Attach lab report.)
Specific. Conductance
uMhos
K - Potassium
mg/I
Report Attached? Yes (1) No (0)
Total Ammonia
mg/I
Mg - Magnesium 8/22
36.6 mg/I
VOC method # -
TKN. as N
rIg/I
Mn - Manganese 8/22
0.781 mg/I
method # =
GW-59
Rev. 03/2000

ldfiTERiTECH iLRDS./tic.,
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
(828) 3964444
SAMPLE. Coats America (MW#02)
PERMIT A
ADDRESS: Coats America (Wells)
P.O. Box 368
Marion, NC 28752 '
ANA.YSJ
i9NALY IS .,
:.'I SULTS'
;UNITS:'
TDS
110
mg/L
Chloride
7.25
mg/L
T. Phosphorus
0.31
mg1L
TOO
<1.0
mg/L
Sulfate
12.0
mg/L
metals
see attached
pH
7.9
su's
COLLECTION DATE:
8/14/2014
COLLECTION TIME:
08:45
RECEIVED DATE:
8/14/2014
RECEIVED TIME.,
15:00
REPORTED:
9/5/2014
8114/14 leg
LOG 10: 1408-215 REPORTED BY: NC CERTIFIED LAB # 50
fv�-
Tony Gragg, Lab Supervisor

IdRrERe rjFCH L11e5.l c.
POST OFFICE BOX 1056 a #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#10) COLLECTION DATE.
8/14/2014
PERMIT#. COLLECTION TIME.
•08:55
ADDRESS: Coats America (Wells) RECEIVED DATE:
811412014
P.O. Box 368 RECEIVED TIME.,
15:00
Marion, NC 28752
REPORTED.
9/5/2014
ANA :Y-8-1S ....
l E5Ul:7S. '
: 1IV1 5:;:...:.
oA-TE .. ..
: A1VtliYS7 ,.
TDS
179
mg/L
8/15/14
lag
Chloride
<5.0
mg/L
8/22/14
lag
T. Phosphorus
<0.16
mg/L
8/25/14
Jdg
TOC
<1.0
mg/L
8/26/14
Sulfate
49.1
mg/L
8/22114
metals
see attached
pH
6.9
su's
8/14/14
lag
7
LOG ID: 1408-216 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

URrEfF rECH LRDS.1nc.
POST OFFICE BOX 1056 • I15 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#11) COLLECTION DATE:
8/14/2014
PERMIT A COLLECTION TIME.,
09:10
ADDRESS: Coats America (Wells) RECEIVED DATE.,
8/14/2014
P.O. Box 368 RECEIVED TIME.,
15:00
Marion, NC 28752
REPORTED:
9/5/2014
r '5.:.
ANA �'StS .`.
;`. RESULTS .,
IJIVI S .
:..DATE
Af�fA�.�'ST .: .
TDS
224
mg/L
8/15114
lag
Chloride
<5.0
mg/L
6122/14
lag
T. Phosphorus
0.17
mg/L
8125/14
1dg
TOC
1.25
mg/L
8/26/14
Sulfate
34.4
mg/L
8122/14
metals
see attached
pH
8.0
su's
8/14/14
lag
LOG ID: 1408-217 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

1dRTKR rcCH LRDS.lnc.
POST OFFICE BOX 1056 - #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
(828) 3964444
SAMPLE: Coats America (MW#12) COLLECTION DATE:
8/14/2014
PERMITA' COLLECTION TIME:
09:25
ADDRESS: Coats America (Wells) RECEIVED DATE:
8/14/2014
P.O. Box 368 RECEIVED TIME.,
15:00
Marion, NC 28752
REPORTED:
9/5/2014
ANA4Y-SIS
RESULTS
LINTS -
AN, IYST
TDS
680
mg/L
8/15/14
lag
Chloride
<5.0
mg/L
8/22114
lag
T. Phosphorus
0.24
mg/L
8/25114
1d9
TOC
1.94
mg/L
8/26/14
Sulfate
<10
mg/L
8/22114
metals
see attached
pH
6.8
su's
8/14114
lag
LOG ID: 1408-218 REPORTED BY: NC CERTIFIED LAB # 50
f�600
Tony Gragg, Lab Supervisor

'KCH L.RDS-inc.
POST OFFICE BOX i05B • ,#5 PINEWOOD PLAZA0H.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#13) COLLECTION DATE:
-8/14/2014
PERMIT A COLLECTION TIME:
09:35
ADDRESS: Coats America (Wells) RECEIVED DATE:
811412014
P.O. Box 368 RECEIVED TIME:
15:00
Marlon, NC 28752
REPORTED:
9/5/2014
iVAi- y
' RE%kTS
UNITS
l A?"1=
ANALYST. .
TDS
561
mg/L
8/15/14
lag
Chloride
9.75
mg/L
8/22/14
lag
T. Phosphorus
0.67
mg/L•
8/25/14
Idg
TOC
2.58
mg/L.
8/20/14
Sulfate
<10
mg/L
8/22/14
metals
see attached
pH
6.3
su's
8/14/14
lag
LOG ID: 1408-219 REPORTED BY: NC CERTIFIED LAB # 50
f�*
Tony Gmgg, Lab Supervisor

ii j rff jq rvCH L1185.1nc-
POST OFFICE BOX 1056 • 95 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#14) COLLECTION DATE.,
8/14/2014
PERMIT #: COLLECTION TIME:
09:45
ADDRESS: Coats America ,(Wells) RECEIVED DATE:
8/14/2014
P.O. Box 368 RECEIVED TIME.
15:00
Marion, NC 28752
_
REPORTED-
9/5/2014
:.AM
ANAL YtIS
RESULTS
:. UNIT-
DA7-,E� ...
ANALYST
TDS
405
mg/L
8115/14
lag
Chloride
<5.0
mg/L
6/22/14
lag
T. Phosphorus
0.28
mg/L
8/25/14
Idg
TOC
2.93
mg/L
8/26114
Sulfate
410
mg/L
8/22/14
metals
see attached
pH
6.7
su's
8/14114
lag
LOG ID: 1408-220 REPORTED BY: NC CERTIFIED LAB # 5
Tony Gragg, Lab Supervisor

1dfirKjR4TffCH L1185-inc,
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH GAROLINA 28630
[phone]
SAMPLE: Coats America (MW#15) COLLECTION DATE:
8/14/2014
PERMIT #: COLLECTION TIME:
09:55
ADDRESS: Coats America (Wells) RECEIVED DATE:
8/14/2014
P.O. Box 368 RECEIVED TIME:
15:00
Marion, NC 28752
REPORTED:
9/5/2014
,4N,4.LYSI `
...1 Stl�TS..
UNIT-9
DAIrE
<AIVALYSr
TDS
364
mg1L
6/15114
lag
Chloride
<5.0
mg/L
8122/14
lag
T. Phosphorus
<0.16
mg1L
8t25/14
)dg
TOC
1.82
mg/L
8/26/14
Sulfate
<10
mg/L
8/22/14
metals
see attached
pH
6.6
su's
8/14114
lag
LOG ID: 1408-221 REPORTED BY: NC CERTIFIED LAB # 50
fll�
Tony Gragg, Lab Supervisor

RESf:ARCh & ANALYTICAL'
L boRAToRics' INC.
AnalyHcal/Process Consultations
August 27, 2014
Water Tech Labs
P.O. Box 1056
Granite Falls, NC 28630
Attention: Joe Gragg
Project Name: Coats American
I: Miscellaneous
MW2
MW10
MW11R
MW12
MW13
MW14
MW15 Date
Parameters
unit Results
Results
Results
Results
Results
Results
Results Analyzed
TOC
mg/I. <1.0
<1.0
115
1.94
2.58
2.93
1.82 08/26/14
Sample Number
792536
792537
792538
792539
792540
792541
792542
Sample Date
08/14/14
08/14/14
08/14/14
08/14/14
08/14/14
08/14/14
08/14/14
Sample Time
0845
0855
0910
0925
0935
0945
0955
mgf L = milligrams per I iter =parts per million (ppm) < = Less than or below detection limit

�'++�rrllrl/dt�t
RESEARCh & ANALyTiCA1
LABORATORIES, INC.
Analytical/Process Consultations » 's
W.- ZED
Water Tech Labs. Inc. Date Sample Collected 08/14/14
P.O. Box 1056 Date Sample Received 08/22/14
Granite Falls, NC 28630 Date Sample Analyzed 08/22/14
Attn: Joe Gragg Date of Report 09/02/14
Analyses Performed by AA -KL
Lab Sample Number
--------------------
793163
Parameter ^�^^-Storet # Results
Magnesium,Tot (00927) 20,1 mg/1
Lead,Tot (01051) 0.050 mg/1
Manganese,Tot (01055) 1.23 mg/1
Aluminum,Tot (01165) 3.54 mg/1
Calcium,Tot (00916) 34.7 mg/l
Chromium,Tot. (01034) <0.005 mg/l
Cadmium,Tot (01027) <0.002 mg/1
Nickel,Tot (01067) 0.012 mg/l
Sodium,Tot (00929) 12.9 mg/1
Selenium,Tot (01147) <0.005 mg/1
Barium,Tot (01007) 0,164 mg/l
Arsenic,Tot (01002) 0.007 mg/l
Sulfate (00945) 12.0 mg/1
Clients Sample Source
Number
Time Collected (Hrs)
--------------------
MW2
COATS
0845
P.O, Box 473 • 106 Short Street • Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone]
www.randalabs.com

ANAty
RESEARCh & ANA[YTICA1 .•••"""'•••• '�.
pry ` LAbORATORiES INC. owl4
N0#34 Z'
Analytical/Process Consultations li
Water Tech Labs. Inc. Date Sample Collected 08/14/14
P.O. Box 1056 bate Sample Received 08/22/14
Granite Falls, NC 28630 Date Sample Analyzed 08/22/14
Attn: Joe Gragg Date of Report 09/02/14.
Analyses Performed by AA -KL
Lab Sample Number
--------------------
793164
Parameter T Storet # Results
Magnesium,Tot (00927) <0.500 mg/l
Lead,Tot (01051) <0.005 mg/l
Manganeae,Tot (01055) <0.005 mg/1
Aluminum,Tot (01105) 0.060 mg/1
Calcium,Tot (00916) <0.500 mg/l
Chromium,Tot (01034) <0.005 mg/1
Cadmium,Tot (01027) <0.002 mg/l
Nickel,Tot (01067) <0.005 mg/l
Sodium,Tot (00929) 71.0 mg/1
Selenium,Tot (01147) <0.005 mg/l
Barium,Tot (02007) 0,005 mg/l
Arsenic,Tot (01002) <0.005 mg/1
Sulfate (00945) 49.1 mg/l
--------------------
Clients Sample Source MW10
Number COATS
Time Collected (Hrs) 0855
I
P.O. Box 473. 106 Short Street • Kernersville, North Carolina 27284.336-996-2841 • Fax [phone]
www,randslabs.com

a�3
{
RESEARCh & ANALyTICA[
f a
LAbORATORIE5, INC..
Analytical/Process Consultations
Water Tech Labs. Inc.
Date Sample Collected
08/14/14
P.O. Box 105.6
Date Sample Received
08/22/14
Granite Falls,
NC 28630
Date Sample Analyzed ;
08/22/14
Attn: Joe Gragg
Date of Report
09/02/14
Analyses Performed by
AA -KL
Lab Sample Number
--------------------
793165
Parameter^-^^
Storet #
Results
Magnesium,Tot
(00927)
23.6 mg/1
Lead,Tot
(01051)
<0.005 mg/1
Manganese,Tot
(01055)
<0.005 mg/l
A1uminum,Tot
(01105)
0,574 mg/l
Calcium,Tot
(00916)
42.6 mg/l
Chromium,Tot
(01034)
<0.005 mg/1
Cadmium,Tot
(01027)
<0.002 mg/1
Nickel,Tot
(01067)
<0.005 mg/l
Sodium,Tot
(00929)
16.7 mg/l
Selenium,Tot
(01147)
<0.005 mg/1
Barium,Tot
(01007)
0.044 mg/l
Arsenic,Tot
(01002)
<0.005 mg/l
Sulfate
(00945)
34.4 mg/1
Clients Sample Source
Number
Time Collected (Hrs)
--------------------
'MW11R
COATS
0910
P 0, Box 473 • 106 Short Street - Kernersville, North Carolina 27284.336-996-2841 • Fax [phone]
www.randalabs.com

+��4�«urrrr�ri
RESEARCh & ANALyTICAB
C r
LAbORATORVS, INC. {MeOR
� y�
Analytical/Process Consultations
�1'+ NED MARV -W,
Water Tech Labs. Inc. Date Sample Collected OB/14/14
P.O. Box 1056 Date Sample Received 08/22/14
Granite Falls, NC 28630 Date Sample Analyzed 08/22/14
Attn: Joe Gragg Date of Report 09/02/14
Analyses Performed by AA -KL
Lab Sample Number
--------------------
793166
Parameter Storet # Results
Magnesium,Tot (00927) 18.8 mg/1
Lead,Tot (01051) <0.005 mg/1
Manganese,Tot (`01055) 4,56 mg/1
Aluminum,Tot (01105) 0.135 mg/l
Calcium,Tot (00916) ill mg/1
Chromium,Tot (01034) <0.005 mg/1
Cadmium,Tot (01027) <0.002 mg/1
Nickel,Tot (01067) 0,010 mg/1
Sodium,Tot (00929) 111 mg/1
Selenium,Tot (01147) c0.005 mg/1
Barium,Tot (0 10 07) 0.205 mg/1
Arsenic,Tot (01002) <0.005 mg/l.
Sulfate (00945) <10 mg/1
'Clients Sample Source
Number
Time Collected (Hrs)
---------------
MW12
COATS
0925
P.O. Box 473 • 106 Short Street - Kernersville, North Carolina 272a4 336-996-2841 • Fax [phone]
www.randalabs.com

RESEARCh & ANA1yTICA1 ••', �'�&.......,,, � ''�
- LAbORATORIES, INC. t.
to NC Z.
Analytical/Process Consultations + �,..0,�
Water Tech Labs. Tnc.
Date Sample Collected
08/14/14
08/22/14
P.O. Box 1056
Date Sample Received
Date Sample Analyzed
08/22/14
Granite Falls,
NC 28630
Date of Report
09/02/14
Attn: Joe Gragg
Analyses Performed by
AA -KL
Lab Sample Number
793168
Parameter y r�Storet
#^ `w
Results
Magnesium,Tot
(00927)
38.4 mg/1
Lead,Tot
(01051)
<0.005 mg/l
Manganese,Tot
(01055)
0,997 mg/l
Aluminum,Tot
(01105)
0.464 mg/1
Calcium,TOt
(00916)
64.4 mg/l
Chromium,Tot
(01034)
<0.005 mg/l
Cadmium,Tot
(01027)
e0.002 mg/1
Nickel,Tot
(01067)
<0.005 mg/l
Sodium,Tot
(00929)
35.7 mg/l
Selenium,Tot
(0`1147)
<0.005 mg/l
Barium,Tot
(01007)
0,132 mg/l
Arsenic,Tot
(01002)
<0.005 mg/1.
Sulfate
(00945)
<10 mg/l
Clients Sample Source
Number
Time Collected (Hrs)
--------------------
MW14
COATS
0945
P. 0. Box 473 1 106 Short Street • Kernersville, North Carolina 27284.336-996-2841 • Fax 336-996-D326
www,rBndatabs.com

�'���{{1111111II
r
RESEARch & ANAiyTICA1 i4 r0��.� ,......� ,,,!/., +o
A
' LAbORATORIES, INC. o ;
NCB �_ .,
"- Analytical/Process Consultations +�
G `d/R�ZO�;
Water Tech. Labs. Inc. Date Sample Collected : 08/14/14
P.O. Box 1056 Date Sample Received : 08/22/14
Granite Falls, NC 28630 Date Sample Analyzed 08/22/14
At Joe Gragg Date of Report : 09/02/14
Analyses Performed by : AA -KL
Lab sample Number
--------------------
793169
Parameter Storet # Results
Magnesium,Tot (00927) 36.6 mg/l
Lead,Tot (01051) <0.005 mg/1
Manganese,Tot (03.055) 0.781 mg/l
Aluminum,Tot (01105) 0.056 mg/l
Calcium,Tot (00916) 85.9 mg/1
Chromium,Tot (01034) <0.005 mg/l
Cadmium,Tot (01027) <0.002 mg/l
Nickel,Tot (01067) <0.005 mg/l
Sodium,Tot (00929) 10.9 mg/l
Selenium,Tot (01147) <0,005 mg/1
Barium,Tot (01007) 0.126 mg/l
Arsenic,Tot (02002) <0.005 mg/1
Sulfate (00945) <10 mg/l
Clients Sample Source
Number
Time Collected (Hrs)
--------------------
MW15
COATS
0955
P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27264 • 336-996-2841 • Fax [phone]
www.randalabs,00m

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vvv=O7a L.11M LIA-INUE JKEPORT FORM Permit # L)g 0,6
(Submit one each monitoring period with GW=59 forms.)
1
Enter date monitoring results were due. Will this monitoring report (GW-59 and GW-59A)
be. submitted after the established due date?
YES
NO
2
Was any required information missing on the GW-59 report forms?
YES
NO
iF the answer to question 1 or 2 is 'YES", list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the required information.
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
identification plate, area overgrown, etc.)? If the answer is "Y'es ", contact the Regional Once for guidance.
YES
NO
4
Are any monitored constituents equal to or above the established standards?
YE
NO
If the answer to question 4 is "NO'; skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below:
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
same constituent(s) in the same well(s) in the last two years?
YES
NO
If the answer to question 5 is "NO", skip to section 8.
If the answer to question 5 is "YES", list in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
if the answer is "YES", a groundwater quality problem maybe occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells maybe improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
groundwater quality problem?
YES
NO
If the answer to question 7 is 'YES", describe those actions in the space provided below.
If the answer to question 7 is "NO", contact the Regional Office within 90 days: an evaluation may be
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surrounding this facility Failure to do so may subject the permittee to a Notice of Vioiation
fines, and/or penalties.
g
The person completing this portion (GW--59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
1 hereby acknowledge thafthe above Information was evaluated and the ]nfocirtiation submitted�n#hls ,tin
report..(Complta Repgrf rGW9A) Is true and comple4e to it►e best ofkrnowledge �/_ - _.
OPP
Signat of Permitte rAuthorized Agent) Date
j
GW-59A 12/8/2003

GW 59-A COMPLIANCE REPORT FORM
ANSWER TO QUESTION #4
MW #2
LEAD O.OS9 MG/L
MANGANESE 1.44 MG/L
NICKEL 0.016 MG/L
MW #12
TDS S87 MG/L
MANGANESE 4.19 MG/L
ANSWER TO QUESTION #5
MW #2
MANGANESE 1.38 MG/L (AUGUST 2013)
MW #12
TDS S90 MG/L- (AUGUST 2013)
MANGANESE 4.06 MG/L (AUGUST 2013)
TDS 6S4 MG/L (APRIL 2013)
MANGANESE 2.85 MG/L (APRIL 3013)

GROUNDWATER QUALITY MONIT
COMPLIANCE REPORT FORM
FACILITY INFORMATION
Facility Name: `-Lt - .
Permit Name (if different): -
Facility Address:
Contact Person: ' l It I t
Well Location/ Site Name:
SUBMIL
�g ON YE
61s 6� F43`�t`u
N Ga+`��Si°° "
201Q
Please PrAVbleaay or Type
Telephone #:5s-i7 Flo -Lj I I I
No. of Wells to be, Sampled: _
Well Identification Number (from Permit): & -
Well Depth: 9 For Groundwater Treatment Systems
P ft. Well Diameter: in.
Screened Interval: >UA it. to 11i ,j ft Check One: ❑ Influent (98 )
El
Depth to Water Level'. - � ft. below measuring point. Effluent (99)
Measuring Point (M.P.) is: 9, 3 ft. above land surface. Relative M.P. Elevation in fit.:
Gallons of water pumped/bailed before sampling: (00 Date sample collected:
Field analysis: pH (D: , Specific Conductance uMhos
Temp. 1_�1_°C, Odor Appearance
PAPER ONLY
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH NC 27699-1636 Phone:
M 919) 733-3221
PERMIT #: I,t C OC (oU3 EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE F PER OPERATION BEING MONITORED
Lagoon Reinedialion: Infiltration Gallery
Spray Field Remediation:
Rotary oislributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: ;5Pe 3t'lr2 �4
Laboratory Name: 1 eP,h
%
Certification No.
PARAMETERS (Samples for metals were collected unfiltered--l_YE5 NO
COD
mg/I.
Nitrite (NO2) as N
and field acidified
m /1
Coliform:
MF Fecal
Coliform: MF Total
/100ml
Nitrate (NO3) as N
mg/I
g
/100ml
Phosphorus: Total as P
P '� -� , �W— mg/I
(Note: Use MPH method for highly turbid
samples)
Orthophosphate
m /l
Dissolved Solids: Totals -I-) Q mg/1
AI - Aluminum y-Is
s,Ib mg/I
pH (when analyzed) y-10
TOC
(Di? units
� (
Ba - Barium LI-) S
C3 � t-13 mg/I
_
Chloridee -,�5
� mg/1
Ca - Calcium_y-15
'�'1 b mg/I
_L] _U
Arsenic -q-15
: S mg/I
C01 mg/l
Cd - Cadmium 4 -15
Chromium: Total, LI-IS
mg/I
m /I
Grease and Oils
mg/I
Cu - Copper
mg/1
g
Phenol
Sulfate
mg/I
Fe - Iron
mJ/l
Specific Conductance
mg/I
uMhos
Hg -Mercury
K - Potassium
mg/I
Total AmmoniaKN N
mg/I
Mg = Magnesium �-15
mg/I
mg/I
mg/I
Mn -Manganese-�1- IS
1 mg/I
YES NO)
Ni - Nickel. I mg/1
Pb - Lead W -15 C�(Nscli mg/I
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab r_eport.)
Report Attached? Yes (1) No (0)
VOID method # =
method #. _

:SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: Ccial5 Arne l`('u n
Permit Name (if different):
Facility Address: 1p7n�ir�1P e '�� ,� T hd P<< �� �dt
t11r ] 6 1,,� (5lreeq
(c lY) n� C -7 a. County -- fl'Zc.,rnt� �e i 1
1'i,i \\ i � i it ca vt (zip) 0
Contact Person:_, 1 Telephone #:��5-i�1�-•+-} li 1
Well Location/ Site Name: w 1 U h i�i^ nr1 No: of Wells to be Sampled:
(Irom Permll)
Well Identification Number (from Permit): (Y) L,u i Ca For Groundwater Treatment Systems
Well Depth: 1 2 it. � Well Diameter: _� in. Check One: ❑ Influent (98)
Screened Interval: �jT_ It. to � j � tt. C7 .Effluent (99)
Depth to Water Level: ) S� Z ft. below measuring point.
Measuring Point (M.P.) is:Q � -3 ft. above land surface. Relative M.P. Elevation in fit.:
Gallons of water pumped/bailed before sampling: Date sample collected: -/O -I q
Field analysis: pH , Specific Conductance ' uMhos
Temp. 1 1 °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER.
RALEIGH, NC 27699-1636 Phone: [phone]ss
PERMIT #: L-� C1 CC(Z It G EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 5ee 0r-, ,.)
Laboratory Name: Us)a W i p CI h
Certification No. 5 f�
PARAMETERS (Samples for metals were collected unfiltered)� YES NO and field acidified
COD mg/I Nitrite (NO2) as N mg/I
Coliform: MF Fecal /100ml Nitrate (NO3) as N mg/I
Coliform: MF Total /100ml Phosphorus: Total. as P 41-:)y C,ge\ m if
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total q • 15
1 r S mg/I
pH (when analyzed) 9 -1 c) -5,9 units
TOC y-15
4� 1.0 m /I
Chloride y- o�S
45: O mg/I
Arsenic �4 -1 S
c:Cs mg/I
Grease and Oils
mg/I
Phenol
g
Sulfate _q- 15
mg/l
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
Orthophosphate
9
m /I
g/I
Al -Aluminum LH S
Ba - Barium L4--.1 S
d, �:�;;z
9/I
Ca - Calcium L1-►5}.k.a
, g/I
Cd - Cadmium L4-IS'
< "cs2 g/I
Chromium: Total LI -IS
{e .c5 pSmg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium Y-15
3• - g/I
YES NO)
Ni - Nickel q-i5 so oGSmg/I
Pb - Lead L4-- l5 4n,005- mg/I
Zn -Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ZpLq �• 4.
�C\i iim Li — iS 'at�i Mtf i v�
r�
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # _
method
method#=
eer[K that. to 1hR hpst of my knnwlorfno onri r,euor III—
i..v.......r .., w..4 �!Y •L!- __

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION - Please Print Clearly or Type
Facility Name:. CcCn,�s AY-nPft�Carn
Permit Name (if different):
Facility Address:jp_3D d
Contact Person: I'Ditt it
Well Location/ Site Name:
County I r" IJQk Qe l 1
Telephone M IM -9510-L1 I I I
No. of Wells to be Sampled:.,. 0 =
Well Identification Number (from Permit): m 11 R For Groundwater Treatment Systems
Well Depth: _ 3c) ft. Well Diameter.. 9 in. Check One: ❑ Influent (98)
Screened Interval: AT ft. to � ft. ❑Effluent (99)
Depth to Water Level: �_ft. below measuring point.
Measuring Point (M.P.) is:�q_ It. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: —_ Date sample collected: L4 - ir`;-• 1�1
Field analysis: pH D ,.l Specific Conductance uMhos
. Temp. --E-L_°C, Odor Appearance
' DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WFIALEIGH—NC
ATER QUALITY DIVISION, GROUNDWATER SECTION
36 MAIL SERVICE CENTER
27699-1636 Phone: [phone]
PERMIT #: WO C(Y05t-,� EXPIRATION DATE:
Non -Discharge U IC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: ee 13o01.0
Laboratory Name: Gk-lk e 'Tech
Certification No. — 5("
PARAMETERS (Samples for metals were collected unfiltered --YES NO
and field acidified
COD
mg/I
/100ml
Nitrite (NO2) as N
Nitrate (NO3) as N
mg /1
Coliform: MF Fecal
Coliform: MF Total
/100ml
m/I
Phosphorus: Total as P y-ZL( ZD,*1 mg/I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total -15 a�
Orthophosphate
mg/I
mg/I
pH (when analyzed) i) - I O 9 `7 units
41-IS
Al - Aluminum y-)S
Ba - Barium W-15
0 14(C'`) mg/I
r) (DR mg/I
TOG
1 o mg/I
Ca - Calcium W-IS
3ru mg/I
Chloride LI- S
Arsenic 1.
9.0 mg/I
40 005 mg/I
Cd - Cadmium ►,�;
Chromium: Total L4-K
S1),co� mg/I
{o o5 mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
Sulfate
mg/I
mg/I
Fe -Iron
Hg - Mercury
mg/I
m /I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium �-1-I5
a313 mg/I
TKN as N
mg/I
Mn - Manganese.9-5
<o •cos mg/I
GW-59
Rev. 0312000 Signature of Perm' ee for Aulhori Ag
YES No)
Ni - Nickel "O'coS mg/I
Pb - Lead id -IS 4('s'oa"; mg/I
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
JCJ�i �;r14
M �
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOID : method # =
method # =
method # =
or type

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: —
Permit Name (if
Facility Address:
Contact Person: i'Ili I I
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County l 1 111: Fix le I /
Telephone #: _ 1h$ - 95(c -LI 1 l
No. of Wells to be Sampled:.._ I
Well Identification Number (from Permit): f ) \-) l For Groundwater Treatment Systems
Well Depth: 13 it. Well Diameter: LS in. Check One: ❑ Influent (98)
Screened Interval: :J A r� ft. to "0 f) it. ❑ Effluent (99)
:
Depth to Water Level ' ft. below measuring point.
Measuring Point (M.P.) is: O • to ft. above land surface. Relative M.P. Elevation in fit.:
Gallons of water pumped/bailed before sampling: -1 s -5 Date sample collected: i -1
Field analysis: pH Aa-(—, Specific Conductance uMhos
. Temp. Q °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: L Qa OU" alp C` .3 EXPIRATION DATE: _
Non -Discharge UIC-
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other: __
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: See. , f)aLZ
Laboratory Name: TP Ch
Certification No. S�
PARAMETERS (Samples for metals were collected unfilteredX_YE5 NO and field acidified
COD
mg/I
/100ml
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/I
mg/I
Coliform: MF Fecal
Coliform: MF Total
/100ml
Phosphorus: Total as P �I �Ll Q
mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
m /1
Dissolved Solids: �-I-15 SS9 mg/I
Al - Aluminum LHS 0'0q�
mg/I
pH (when analyzed) L.I•-IO
b, to units
Ba - Barium -15 C", W`-)
mg/I
TOC _LI -15
1 I <�q mg/I
l7, 5 mg/I
Ca - Calcium _14-IS 1 o.
Cd - Cadmium.
mg/I
mg/I
Chloride L4 -QS
LI
Arsenic -15
4 o• o(::S mg/I
Chromium: Total 4 - I S cos-
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
Sulfate LI-15
g
z l �,o mg/I
Iron
Hg - Mercury
mg/I
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - MagnesiumiInQ
mg/I
TKN as N
mg/I
Mn - Manganese. G q , lei
mg/I
YES NO)
Ni - Nickel ' -1S 0100q mg/I
Pb - Lead '-I - IS <r QQ5 mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
r:rliDn-, 'Y -1 5 'Ct t �, C
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #.. Attach lab report.)
ReportAttached? Yes (1) No (0)
VOC method # =
method # =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING: 1 ' DEPARTMENT OF ENVIRONMENT & 14ATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
COMPLIANCE REPORT FORM 1636 MAIL SERVICE CENTER
4CILITY INFORMATION Please Print Clearly or Type
RAL"L NC 27t399-1.636 Phone: [phone],
Facility Name:--L
Permit Name (if di
Fa,Qility Address:_
Contact Person: 9'1)011
Well Location/ Site Name:
County. I L l C IA')( L)P t 1
Telephone M '' r
No. of Wells to be Sampled:
Well Identification Number (from Permit): M LO For Groundwater Treatment Systems
Well Depth: �J ft. Well Diameter: _al in. Check One: ❑ lnflUent (98)
Screened Interval: . N r it. to __�} A ft. Effluent (99)
Depth to Water Level: ft. below measuring point.
Measuring Point (M.P.) is: 9--ko ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: _"— Date sample collected: -10-
14
Field analysis: pH S_ , Specific Conductance uMhos
Temp. __L9_1°C, Odor Appearance
PERMIT #: W Q Ot ©5l 103 EXPIRATION DATE:
Non -Discharge U IC
NPDES
TYPE F PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: _ ep
Laboratory Name: QC•h
Certification No. _ ��]c'
PARAMETERS (Samples for metals were collected unfilteredX_YE5 NO
and field acidified
COD
mg/I
/100ml
Nitrite (NO2) as N .
Nitrate (NO3) as N
mg /I
Coliform: MF Fecal
Coliform: MF Total
/100ml
m/I
g
Phosphorus: Total as P A -1 () , t m /I
(Note: Use MPH method for highly turbid
samples)
Orthophosphate
mg/I
Dissolved Solids: Total )I-isI (05mg/l
Al-AlurninumI-
O U ( mg/I�5
pH (when analyzed) L1 -Ire
TOG i-1-
S.1 units
Ba - Barium >_ - 5
< I 1 t' mg/1
/1s > mg/I
Ca - Calcium I_ -
Cd - Cadmium IL -
i 1 mg/I
o to mg/I
Chloride I 2)',5
Arsenic U-1 S
<0(00S mg/I
Chromium: Total LI -15'
�IDC� mg/l
Grease and Oils
mg/I
Cu _ Copper
mg/I
Phenol
m /1
F I
YES NO)
Ni - Nickel_ 44-1.c� 41:3,CuS mg/I
Pb - Lead y -1 S c7 `CAS mg/I
Zn - Zinc mg/l
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
4,ty>
Sulfate 4-1.5
m-4
He Mercury
mg/I
mg/I
ORGANICS: (GC,GC/MS,HPLC)
Specific Conductance
Total Ammonia
uMhgs
Kg Potassium
mg/I
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
TKN as N
mg/I
mg/I
Mg - Magnesium'- -15'
Mn - Manganese'A--15
''1, mg/I
D
VOC :method #
1 VCX9 mg/I
; method # =
method # =
F;T=Tl If• 1 • llPA
ai I111-f l 1 1 1

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: t-- l_(_ 1 D
Permit Name (if different):
Contact Person:1/411 111 p
Well Location/ Site Name: —
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County. MC' CbLk.a(�) I
Telephone #: 2N
No. of Wells to be Sampled:
Well Identification Number (from Permit): For Groundwater Treatment Systems
Well Depth:. � 5 it. Well Diameter: in. Check One: ❑ Influent (98)
Screened Interval:.��_ it. to \� ft. El Effluent (99)
Depth to Water Level: `�l=G ft. below measuring point.
Measuring Point (M.P.) is: q— L- ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: -5 Date sample collected:
Field analysis: pH_L-- 1 Q , Specific Conductance uMhos
Temp. ___i�__°C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: WQ DMS(063 EXPIRATION DATE:
Non -Discharge U IC
NPDES
TYPE F PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 5eF
Laboratory Name: I Qnee( -Te c-h
Certification No. Sr)
PARAMETERS (Samples for metals were collected unfilteredYES NO
and field acidified
COD
mg/I
/100ml
Nitrite (NO2) as N
Nitrate (NO3) as N
m /I
Coliform: MF Fecal
Coliform: MF Total
/100ml
mg/I
Phosphorus: Total as P�- o o aD mgg/I
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total -1S ?,SSA
Orthophosphate
m/I
mg/I
pH (when analyzed) tni. '-) units
AlAI - Aluminum 14-H
Ba - Barium U -19'
C,bb mg/I
LL)RS m /1
9
TOC 4-1- 15
`�.S
010R mg/I
Ca - Calcium .-IS
r• 5, mg/I
Chloride � `i ' •
Arsenic LI - 1 S
LSj O mg/I
�0,0mg/I
Cd -Cadmium � 1-15
Chromium: Total L1-15
�. C� � ,n`� m /I
npC
Grease and Oils
mg/I
Cu -Copper
- , mg/I
g
mg/I
Phenol
Sulfate �1-1,5
mg/I
t� O mg/I
Fe - Iron-
Hg - Mercury
m /I
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium Li-15
mg/I.
TKN as N
mg/I
Mn - Manganese_( -1 5
mg/I
—YES NO)
Ni - Nickel -1-15 40,00s mg/I
Pb - Lead !A -)5 4 Q I E ,5 m9/1
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ltan; ttiU-1S 4 r-jt r 11
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes -(I) No (0)
VOC : method # =
: method # =
method #
--

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION ' Please Print Clearly or Type
Facility Name: Ct'a n A me C I Cn(`�
Permit Name (if different):
Facility Address: 0-210 Ayy) Ci can ' tI 'c' d 2C
mnc i h() Rofeeq
iCay) �) C i .a e Q' 9 S `D County C Ch a \e, 11
Contact Person: A� . tl (Zip)
.Telephone #: �S�� � `��5t� ..y I I 1
Well Location/ Site Name: PO wIld , No. of Wells to be Sampled:
(Iro Permll)
Well Identification Number (from Permit): py-)j.0 1. For Groundwater Treatment Systems
Well Depth: Iln ft. Well ,ra Diameter: in. Check One: ❑ Influent (98)
Screened Interval: t% O ft. to � ft. 0 Effluent (99)
Depth to Water Level: ft. below measuring point.
Measuring Point (M.P.) is:0 ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 9,25 - 5 Date sample collected: A -ID --U
Field analysis: pH Ce D , Specific Conductance ' uMhos
Temp. f 2 °C, Odor Appearance
PERMIT #: (A)
Non -Discharge
DEPARTMENT OF ENVIRONMENT $ NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
EXPIRATION DATE:
UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
✓ Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
0. 000 5t0�
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 'bee. jam, r) U c,3
Laboratory Name: _ t L)Q— - P r Tl'C 11
Certification No. (1
PARAMETERS (Samples for metals were collected unfiltered ✓ YES NO and field acidified
COD mg/I Nitrite (NO2) as'N mg/l
Coliform: MF Fecal /10.Oml Nitrate (NO3) as N m /I
Coliform: MF Total /100ml Phnsnhnrrlc• Total nc D zl _�i1 1 ri .11� .....gr,
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total u-) 5 -2) 1L mg/I
pH (when analyzed) _I4-Ic7 ( units
TOC 14 -15 i , 33 mg/I
Chloride 47-a5 S, n mg/I
Arsenic _y I S mg/I
Grease and Oils mg/I
Phenol /I
Orthophosphate m /l
Al - Aluminum u-15 t°>,�'�� mg/1
Ba - Barium L) - I S a .( i mg/I
Ca - Calcium_L4 -15 'l 1 mg/I
Cd - Cadmium. f-1-IS 4 o , ©(7yD mg/1
Chromium: Total 9-1 5 c)S mg/I
Cu - Copper mg/I
YES NO)
Ni - Nickell--15 46, S m I
Pb - Lead- 4-1- IS < D mil
Zn - Zinc 9/
mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units) .
Sulfate I-1-1
Specific Conductance
p
Total Ammonia
TKN as N
�.I �� mg/l
g
uMhos
mg/I
mg/I
He - iron
g Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese y_ Is ' (i ,�ujp
mg/l
m9/I
mg/I
m /I
g
mg/}
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes
VOC (1) No (0)
method # =
method # =
method #
1 • .U91 KUMr .
IRI�w

rle
ECH Lfifi
i lnc.
POST OFFICE BOX 1056 < #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
(828) 3964444
SAMPLE: Coats America (MW#02) COLLECTION DATE:
4/10/2014
PERMIT #. COLLECTION TIME:
08:39
ADDRESS: Coats America (Wells) RECEIVED DATE:
4/10/2014
P.O. Box 368
RECEIVED TIME.,
14:00
Marion, NC 28752
REPORTED:
5/6/2014
ANALYSIS
RESULTS
UNITS.
DATE
ANALYST
TDS
98
mg/L
4115/14
lag
Chloride
5.8
mg/L
4125/14
lag
T. Phosphorus
0.56
mg/L
4/24/14
jdg
TOC
<1.0
mg/L
4/15/14
Sulfate
12.1
mg/L
4/15/14
metals. '
see attached
pH
7.7
su's
4/10/14
lag
' OG ID: 1404-219 REPORTED BY: NC CERTIFIED LAB #
Tony Gragg, Lab Supervisor

fiffiTEROrcH myssinc.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR,
GRANITE FALLS, NORTH CAROLINA 26630
[phone]
SAMPLE: Coats America (MW#10) COLLECTIONDA.TE:
4/10/2014
PERMIT #: COLLECTION TIME:
08:46
ADDRESS: Coats America (Wells) RECEIVED DATE.
4/10/2014
P.O. Box 368 RECEIVED TIME.,
14:00
Marion, NC 28752
REPORTED:
5/612014.
ANALYSIS
UNITS
DATE1
ANALYST
TDS.
138
mg/L
4/15/14
lag
Chloride
<5.0
mg/L
4/25/14
lag
T. Phosphorus
0.20
mg/L
4/24/14
Jdg
TOC
<1.0
mglL
4/16114
Sulfate
38.3
mg/L
4/15/14
metals
see attached
pH
7.1
su's
4/10114
lag
LOG ID: 1404-220 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

HrER6rECH LJVHS
i11C.
POST OFFICE BOX 1056 • 95 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
'SAMPLE: Coats America (MW#11) COLLECTION DATE:
4/10/2014
PERMIT #: COLLECTION TIME:
08:55
ADDRESS: Coats America (Wells) RECEIVED DATE.'
4/10/2014
P.O. Box 368
RECEIVED TIME.,
14:00
Marion, NC 28752
REPORTED.,
5/6/2014
AN.YSlS
ANALYSIS
RESULTS
UNITS-
DATE
ANALYST
TDS
209
mg/L
4/15114
lag
Chloride
22.0
mg/L
4/25114
lag
T. Phosphorus
<0.16
mg/L
4/24/14
Jdg
TOC
<1.0
mg/L
4/15/14
Sulfate
33.4
mg/L
4/15/14
metals
see attached
pH
8.7
su's
4/10/14
lag
LOG ID: 1404-221 REPORTED BY: NC%.CERTIFIED I.AB # 50
fok"'t
Tony Gragg, Lab Supervisor

1dfiTE'R4rrCH
./RC.
POST OFFICE BOX 1056 • 45 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#12) COLLECTION DATE. '
4/10/2014
PERMIT #: COLLECTION TIME.,
09:02
ADDRESS: Coats America (Wells) RECEIVED DATE:
4/10/2014
P.Q. Box 368
RECEIVED TIME:
14;00
Marion, NC 28752
REPORTED:
5/6/2014
AALYSI`
.
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TDS
587
mg/L
4/16/14
lag
Chloride
17.5
mg/L
4/25/14
lag
T. Phosphorus
0.20
mg/L
4/24114
Jdg
TOC
1.84
mg/L
4115/14
Sulfate
<10.0
mg/L
4/15/14
metals
see attached
pH
6.9
su's
4/10/14
lag
LOG ID: 1404-222 REPORTED BY: NC CERTIFIED LAB N 50
Tony Gragg; Lab Supervisor

wwrRincH
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA OR,
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#13) COLLECTION DATE: 4/10/2014
PERMIT #: COLLECTION TIME. 09:10
ADDRESS: Coats America (Wells) RECEIVED DATE.' 4/10/2014
P.O. Box 368 RECEIVED TIME: 14:00
Marion, NC 28752
REPORTED: 5/6/2014
AN LYSI
ANALYSIS
RESULTS
VNITS
DATE
ANALYST
TDS
165
mg/L
4115114
lag
Chloride
<5.0
mg/L
4/25/14
lag
T. Phosphorus
0.19
mg/L
4/24/14
idg
TOO
<1.0
mg/L
4/15114
Sulfate
18.9
mg/L
4/15/14
metals
see attached
pH
6.6
su's
4110/14
lag
LOG ID: 1404-223 REPORTED BY: NC CERTIFIED LAB # 50
f&l ("
Tony Gragg, Lab Supervisor

jqR4rr H Lfi85Jnc.
• it i
POST OFFICE BO7 1056 • 45 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
(828) 3964444
SAMPLE: Coats America (MW#14) COLLECTION IDA TE:
4/10/2014
PERMIT #: COLLECTION TIME:
09:15
ADDRESS: Coats America (Wells) RECEIVED DATE:
4/10/2014
RO. Box 368 RECEIVED TIME
14:00
Marion, NC 28752
REPORTED:
5/6/2014
N YSI
ANALYSIS
RESULTS
UNITS'
(DATE
ANALYST'.
TDS
329
mg/L
4/15/14
lag
Chloride
<5.0
mg/L
4/25/14
lag
T. Phosphorus
0.22
mg/L
4/24114
Jdg
TOG
2.08
mg/L
4/15/14
Sulfate
<10.0
mg/L
4/15/14
metals
see attached
pH
6.9
su's
4/10114
lag
LOG ID: 1404-224 REPORTED BY: NC CERTIFIED LAB #
Tony Gragg, Lab Supervisor

unnen4reCH LAMM..
POST OFFICE BOX 1056 - #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#15) COLLECTION DATE:
4/10/2014
PERMIT A- COLLECTION TIME:
09:20
ADDRESS: Coats America (Wells) RECEIVED DATE:
4/10/2014
P.O. Box 368
RECEIVED TIME:
14:00
Marion, NC 28752
REPORTED.
5/6/2014
;ANALYSIS
ANALYSIS
RESULTS
UNITS .
DATE
ANALYST
TDS
311
mg/L
4/15/14
lag
Chloride
<5.0
mg/L
4/25/14
lag
T. Phosphorus
<0.16
mg1L
4/24/14
jdg
TOO
1.33
mg/L
4115/14
Sulfate
<10.0
mg/L
4/15114
metals
see attached
pH
6.8
su's
4/10114
lag
LOGID: .1404-225 REPORTED BY: NC CERTIFIED LAB # 50
fll�"
Tony Gragg, Late Supervisor

• ttt�llllllll
_. RESEARCh & ANA1)/TICA1 ���`b` � acyr;�►.,,�
...
£` Ub0RAT0RIES, INC. �`4` ''��t ►��ti,��.
w•0 i
t: Analytical/Process Consultations NC#34 z,
�°o+� p��D1A��►+ �+o�
Water Tech Labs. Inc. Date Sample Collected 04/10/14
P,O, Sox 1056 Date Sample Received 04/15/14
Granite Falls, NC 28630 Date Sample Analyzed 04/15/14
Attn: Joe Gragg Date of Report 04/25/14
Analyses Performed by CC -KL -JC
Lab Sample Number
--------------------
783125
Parameter Storet # Results
TOC <1-0 mg/l
Sulfate (00945) 12.1 mg/l
Aluminum,Tot (01105) 5.10 mg/l
Arsenic,Tot (01002) 0.007 mg/l
Harium,Tot (01007) 0,173 mg/l
Cadmium,Tot (01027) <0,002 mg/l
Chromium,Tot (01034) 0.008 mg/l
Calcium,Tot (00916) 37.6 mg/l
Lead,Tot (01051) 0.059 mg/1
Magnesium,Tot (00927) 20.0 mg/l
Manganese,Tot (01055) 1.44 mg/l
Nickel,Tot (01067) 0.016 mg/l
Selenium,Tot (01147) <0.005 mg/l.
Sodium,Tot (00929) 12.3 mg/l
--------------------
Clients Sample Source MW2
Number COATS AMERICAN
Time Collected (Hrs) 0839
P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27284. 336-996-2841 • Fax [phone]
www.randalabs,00m

RESEARCH & ANA[.yTICAL 4�1�& ANSI Y��
LABORATORIES INC.
Y _ _ NC #34 z:
Analytical/Process Consultations
++ •• �R C'tp `�,,�,
t101
.Water Tech Labs. Inc. Date Sample Collected ; 04/10/14
P.O. Box 1056 Date Sample Received 04/15/14
Granite Falls, NC 28630 Date Sample Analyzed 04/15/14
Attn: Joe Gragg Date of Report 04/25/14
Analyses Performed by CC -KI, -JC
Lab Sample Number
--------------------
783126
Parameter Storet # Results
TOC <1.0 mg/1
Sulfate (00945) 38.3 mg/1
Aluminum,Tot (01105) 0.134 mg/l
Arsenic,Tot (01002) <0.005 mg/l
Barium,Tot (01007) 0.009 mg/1
Cadmium,Tot (01027) <0.002 mg/l
Chromium,Tot (01034) <0.005 mg/1
Calcium,Tot (00916) <0.500 mg/1
Lead,Tot (01051) <0.005 mg/l
Magnesium,Tot (00927) <0.500 mg/l
Manganese,Tot (01055) <0.005 mg/l
Nickel,Tot (01067) <0.005 mg/1
Selenium,Tot (01147) <0.005 mg/1
Sodium,Tot (00929) 59.3 mg/l r
4 t`
----------------- 7--
Clients Sample Source MW10
Number COATS AMERICAN
Time Collected (Hrs) 0846
P.O. Box 473 - 106 Short Street • Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone]
www.randalabs,com

RESEARCh & ANA1yTICA1
LAbORATWES, INC.
NC MIX zc
Analytical/Process Consultations a
Water Tech Labs. Inc. Date Sample Collected 04/10/14
P.O. Box 1056 Date Sample Received 04/15/14
Granite F'alls., NC 28630 Date Sample Analyzed 0.4/15/14
Attn: Joe Gragg Date of Report 04/25/14
Analyses Performed by CC -KL -JC -AA
Lab Sample Number
--------------------
783127
Parameter Storet # Results
TOC <1.0 mg/l
Sulfate (00945) 33.4 mg/1
Aluminum,Tot (01103) 0.462 mg/1
Arsenic,Tot (01002) <0,005 mg/1
Barium,Tot (01007) 0.038 mg/1
Cadmium,Tot (01027) <0.002 mg/l
Chromium,Tot (01034) <0.005 mg/l
Calcium,Tot. (00916) 43.0 mg/l
Lead,Tot (01051) <0.005 mg/l
Magnesium,Tot (00927) 23.0 mg/1
Manganese,Tot (01055) <0.005 mg/l
Nicicel,Tot (01067) <0.005 mg/l
Selenium,Tot (01147) <0.005 mg/l
Sodium, Tot (00929) 16.2 mg/1
--------------------
Clients Sample Source Z MW11R
Number COATS AMERICAN
Time Collected (Hrs) OB55
P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27264 • 336.996-2B41 • Fax [phone]
www.randalabs.com

. 4 RESEARCh & ANALyTICA1
c(l
-- LAb®RATWES, INC.
3
Analytical/Process Consultations
r
� i •� ti
ANA®A 10
Water Tech Labs. Inc. Date Sample Collected 04/10/14
P.O. Box 1056 Date Sample Received : 04/15/24
Granite Falls, NC 28630 Date Sample Analyzed 04/15/14
Attn: Joe Gragg Date of Report 04/25/14
.Analyses Performed by CC -KL -JC -AA
Lab Sample Number
--------------------
783128
Parameter Storet # Results
TOC 1.84 mg/1
Sulfate (00945) <10.0 mg/l
Aluminum,Tot (01105) 0.028 mg/l
Arsenic,Tot (01002) <0,005 mg/l
Barium,Tot (01007) 0.147 mg/1
Cadmium,Tot (01027) <0.002 mg/l
Chromium,Tot (01034) <0.005 mg/l
Calcium,Tot (00916) 102 mg/1
Lead,Tot (01051) <0.005 mg/l
Magnesium,Tot (00927) 16.2 mg/l
Manganese,Tot (01055) 4.19 mg/l
Nickel,Tot (01067) 0,009 mg/l
Selenium,Tot (01147) <0.005 mg/l
Sodium,Tot (00929) 89.1 mg/1
--------------------
Clients Sample Source MW12
Number COATS AMFRICAN
Time Collected (Hrs) 0902
P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone]
www.randalabs.com

L
r= RESEARCh & ANA[yTYCA1
LABORATORIES, INC.
Analytical/Process Consultations
Water Tech Labs. Inc.
Date Sample Collected
: 04/10/14
P.O. Box 1056
Date Sample Received
04/15/14
Granite Falls,
NC 28630
Date Sample Analyzed
04/15/14
Attn: Joe Bragg
Date of Report
04/25/14
Analyses Performed by
CC --KL -JC -AA
Lab Sample Number
--------------------
783129
Parameter
Storet #
Results
TUC
<1.0 mg/l
Sulfate
(00945)
18.9 mg/1
Aluminum,Tot
(01105)
0,101 mg/l
Arsenic,Tot
(01002)
<0.005 mg/1
Barium,Tot
(01007)
0.029 mg/l
Cadmium,Tot
(01027)
<0.002 mg/l
Chromium,Tot
(01034)
<0.005 mg/l
Calcium,Tot
(00916)
11.8 mg/l
Lead,Tot
(01051)
<0.005 mg/l
Magnesium,Tot
(00927)
7,88 mg/l
Manganese,Tot
(01055)
0.022 mg/l
Nickel,Tot
(01067)
<0.005 mg/l
Selenium,Tot
(01147)
<0.005 mg/l
Sodium,Tot
(00929)
41.6 mg/1
--------------------
Clients Sample Source MW13
Number COATS AMERICAN
Time Collected (Hrs) 0910
P.O. Box 473 • 106 Short Street • Kernersvi Ile, North Carolina 27284 • 336.996.2841 • Fax [phone]
www.randalabs.00m

RESEARCh & ANA1YTICAL
LABORATORIES, INC.
Analytical/Process Consultations
Water Tech Labs. Inc.
Date Sample Collected
04/10/14
,P.O. Box 1056
Date Sample Received
04/15/14
Granite Falls,
NC 2BG30
Date Sample Analyzed
04/15/14
Attn: Joe Gragg
Date of Report
04/25/14
Analyses Performed by
CC -KL -JC -AA
Lab Sample Number
--------------------
783130
Parameter
Storet #
Results
TOC
2.08 mg/l
Sulfate
(00945)
<10.0 mg/l
Aluminum,Tot
(01105)
0.260 mg/l
Arsenic,Tot
(01002)
<0.005 mg/1
Barium,Tot
(01007)
0.085 mg/l
Cadmium,Tot
(01027)
<0.002 mg/l
Chromium,Tot
(01034)
<0.005 mg/1
Calcium,Tot
(00916)
65.0 mg/l
Lead,Tot
(01051)
<0.005 mg/l
Magnesium,Tot
(00927)
42.0 mg/l
Manganese,Tot
(01055)
0.521 mg/1
Nickel,Tot
(01067)
<0.005 mg/l
Selenium,Tot
(01147)
<0.005 mg/1
Sodium,Tot
(00929)
18.4 mg/l.
Clients Sample Source
Number
Time Collected (Hrs)
--------------------
MW14
COATS AMERICAN
0915
P.O. Box 473 • 106 Short Street • Kernersville, North Caroline 27284 • 336-996-2B41 • Pax 336-996-0328
www.randelabs.com

RESEARCh St ANA1yTiCAI s,••`(:)�&ALdr;''
......
LAbORATORIES, INC.
Analytical/Process Consultations rt t a•
07
*er'�i�i�f�U ANP�� d•i�
Water Tech Labs, Inc. Date Sample Collected: 04/10/14
P.O. Box 1056 Date Sample Received 04/15/14
Granite Falls, NC'28630 Date Sample Analyzed : 04/15/14
Attn: Joe Gragg Date of Report 04/25/14
Analyses Performed by CC -KL -JC -AA
Lab Sample Number
--------------------
763131
Parameter Storet # Results
TOC 1.33 mg/l
Sulfate (00945) <10.0 mg/l
Aluminum,Tot (01105) 0.032 mg/l
Arsenic,Tot (01002) <0.005 mg/l
Barium,Tot (01007) 0.090 mg/1
Cadmium,Tot (01027) <0,002 mg/1
Chromium,Tot (01034,) <0.005 mg/l
Calcium, Tot (00916) 72.5 mg/1
Lead,Tot (01051) <0.005 mg/1
Magnesium,Tot (00927) 32.4 mg/1
Manganese,Tot (01055) 0.240 mg/1
Nickel,Tot (01067) <0.005 mg/l, v
Selenium,Tot (01147) <0.005 mg/l
Sodium,Tot (00929) 6.47 mg/l
--------------------
Clients Sample Source MW15
Number COATS AMERICAN
Time Collected (Hrs) 0920
P.O. Box 473 • 106. Short Street • Kernersville, North Carolina. 27284 • 336-996-2641 • Fax [phone]
www.randelabs.wrn

CHAIN OF CUSTODY - Analytical Request
Client Name: Ufi -5
Address:
Report to:
Phone:
PO Number: i� p(•+ rV3 we I is
WATER TECH LABS, INC.
PO BOX 1056
GRANITE FALLS, NC 28630
PHONE: [phone]
Project Name:
Project Number:
Requested Analyses
pH Checked Upon Receipt
Preservatives
Cl2 < 0.2 mgA Upon Receipt
Sample Identification
tV
p
v
b
U
U
z-!
U Q
.�
0
+ O
Y
1
�cnC7
.2
N
.-
0
aR , �
0
r
L
Cd
x � y
Feld Temp. (C') Comments
iili
f
- . .
Temperature (°C)
_
d
/S
Received on Ice:
Y/ N
Zc J
d
f
Sealed Cooler:
Y / N
rl
Samples Intact
Y / N
Additional Comments:
Printed Name of Sampler.
d ,t
) !,,
Signature of Sampler:

CHAIN OF CUSTODY - Analytical Request
Client Name: CM s
Address:
Report to:
Phone:
PO Number: 3Ylbnhci C4 � 5
WATER TECH LABS, INC.
PO BOX 1056
GRANITE FALLS, NC 28630
PHONE: [phone]
Project Name:
Project Number:
Requested Analyses
r
VA 111163 to]
Sample Identificaffou1
�
�
W
Field Temp-
Sampie`Condit on Upon
Receipt
Relinquished Sy
Company'
^
i7 to `
Time
,-,
Accepted By
Company
Date
Time
_ -
� S
I�
WM
IM
Additional
Sampler Name and
Signature
Date
Printed Name of Samp]-
Signature of Sampl
a

i ,r C/ruva rernut # U)(.�) JklJOUX) D
(Submit one each monitoring period with GYV=59 forms.)
1
Enter date monitoring results were due. p` Will this monitoring report (GW-59 and GW-59A)
YES
NO
be. submitted after the established due date?
2
1 ri n =sue-
Was any required information missing on the GW-59 report forms? r ;p �i,;q 1 H V] L1
r) �,..
$ y 0
O
a y _I _ .
iF the answer to question 1 or 2 is 'YES", list in the space provided below the well'!ldelnti icafion number(s) and
,
explain the problems encountered in obtaining the required information.-
. U? F E 6 10 2014
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked=or'missing cap; m►ssmg
�- ES
NO
identification plate, area overgrown, etc.)? If the answer is "Y'es• ", contact the Regional Ojf1ce for guidance.
4
Are any monitored constituents equal to or above the established standards?
YES
O
If the answer to question 4 is `NO", skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituents) and concentration(s)
exceeding standards in the space provided below. ,� dYl� rnU-) ly
nrlLL) mw l J
i D S (O' Q mb� Dim afvs e 0-341 L ci d v f0 3-L V`)onlcantls e- r11an(Cpnest
090
�, Q�1es� �� m9 `9I� t✓,c� s"1 �^���� O,g�s 3h�
0 5
5
For tH constituents identifi din question 4 above, have standards been exceeded previously for the
YES
NO
same constituent(s) in the same well(s) in the last two years?
If the answer to question 5 is `NO", skip to section 8.
If the answer to question 5 is "YES", list in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reportedand sample collection date for each occyirrence (for the last two years).
71
705 5 q)m�yi,� prla�tc gnrs� I3` n��'�- % 1 0S
N m�� ,o� m f-
6
Are Me monitoring wells listed in section 5 located at or beyond the review boun ry?
YES
]NO
If the answer is "YES", a groundwater quality problem may be occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells maybe improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
YES
NO
groundwater quality problem?
If the answer to question 7 is "YES, descri a ose actREQ) provided elow.
If the to 7 is "NO",
answer question cont ct the NK 4 90 da s• an evaluation ma be
required to determine the impact, the wa to disposal s stem is havin at the eview and compliance
boundaries surroundin this facility. Failure to do so may sub"ect the ermi ee to a Notice of Violation
fines, and/or penalties. FEB 1 4 4
FEB 0 4 2014
Water 6ualihl Regional Operations
Asheville Re tonal Office i�`1A RQUALPSECT€ N
NMRAhltTm«wmim Io
g
The person completing this portion (GW-59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
hereby ackno�rlec)ge thattheaEiove�info�mation Nas evaluathd"'�nd the`3nfo IR7a io�`s"'� "•� �'y'
i' t n ubmltted n #hls i
Come jiiotttae best "
:re ort: Iiarice Re o 9A) istrue and complet of msknovvled eg.
Signature of Perini to or Authorized e-nt) Date
es
GW-59A 12/8/2003
tr<.

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:-
Permit Name (if,i
Facility Address:
Contact Person:
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County I I Iv L)UI ) ('A I
Telephone #: "' �
No. of Wells to be Sampled:
Well Identification Number (from Permit): it'd W 'IA-9—
Well Depth: 30 ft. Well Diameter:
Screened Interval: AM A ft. to ft.
Depth to Water Level: "I 1 2ft. below measuring point.
Measuring Point (M.P.) is:_5_ it. above land surface.
Gallons of water pumped/bailed before sampling: �3
Field analysis: pH 9 > Specific Conductance
. Temp. , °C, Odor A
For Groundwater Treatment Systems
in. Check One: ❑ Influent (98)
El Effluent (99)
Relative M.P. Elevation in #t.:
Date sample collected: j
ppearance
PARAMETERS (Samples for metals were collected unfifte
COD mg/I
Coliform: MF Fecal /100m1
Coliform: MF Total /100m1
(Note: Use MPH method for highly turbid samples) ` ,
.R C�V
Dissolved Solids: Total mg/I
pH (when analyzed) i'�,1 IM CA, a units
TOC l';4J 71
I ,' mg/I
Chloride I i1
.I
�
3 mg/I
Arsenic _i
:)
o'dO`amg/I
Grease and �ils
Phenol
mg/I
mg/I
Sulfate
mg/I
Specific Conductance
Total Ammonia
TKN as N
uMhos
mg/I
mg/I
Rev. 03/2000
Umhos
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH. NC 27699-1636 Phnnac 191 M 779-19,
PERMIT #: LAJO 60'Sb EXEXPIRATION DATE -
Non -Discharge UIC
NPDES
TYPE QE PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: _ 5ee % Oow
Laboratory Name: 2C -T61Qh
Certification No. _ sc)
red__,4i,_YES NO and field acidified
Nitrite (NO2) as N mg/I
Nitrate (NO3) as N mg/I
Phosphorus: Total as P �o�ng/l
Orthophosphate mg/I
Al - Aluminum _16t 9 i`-] ; 9�`'7 mg/I
Ba -Barium I R 1 I `I �� mg/I
Ca - Calcium P mg/I
Cd - Cadmium i 1 /r��(3fi� mg/i
Chromium: Total I'a ®^ W5 mg/I
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potassium mg/I � Mg - Magnesium �� mg/I
Mn -Manganese lad i'! ' ' 0IQ mg/l
YES NO)
Ni- Nickel � `1 t SG 1�6 mg/I
Pb - Lead i t'7 G1CaJ'a mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
; cd l taco'
t
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. At ach lab report.)
ReportAttached? Yes 1 } No (0)
VOC method # = q%oo r
method # =
method # =

GROUNDIWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: , t:.0�
Permit Name (if;different):
Facility Address: PC)
Contact Person: Pt1l I1
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County I f tL r LJl t' i I
Telephone #: Z S11ri=d
No. of Wells to be Sampled:
Well Identification Number (from Permit): YYlta!•-] - For Groundwater Treatment Systems
Well Depth: 13 ft. Well Diameter. Q in. Check One: ❑ Influent (98)
Screened Interval; N)� A ft. to T ft. ❑ Effluent (99)
Depth to Water Level: 10 ft. below measuring point.
Measuring Point (M.P.) is: a L10 it.'above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: r� , S Date sample collected: °
Field analysis: 'pH (a, , Specific Conductance ' uMhos
. -Temp. I °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: L'JQo L)()S(.e03
Non -Discharge
NPDES
EXPIRATION DATE:
UIC
TYPE OF PERMITTED OPERATION BEING MONITORED
iz�l agoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: e 2 Be,low
Laboratory Name: f. C
Certification No. S(�
PARAMETERS (Samples for metals were collected unfiltered_NL_YES NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MFFecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF'Total
/100m1
Phosphorus: Total as P
g/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total 10'�
mg/I
Al- Aluminum 1Q) ij-i b- 0st1
mg/I
pH (when analyzed)
units
Ba - Barium , r Q
mg/I
TOC IrAla"I 01, S
mg/I
Ca - Calcium -I
mg/I
Chloride _L�)1�' )'pie `
mgll
Cd -Cadmium 1
`� C� �i��-
mg/I
Arsenic _ _)a V 1`1 <o,oas
mg/I
Chromium: Total '%J11.1 40'W5
mg/1
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate 1a I-ql 1 t a
mg/1
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium 11) "�
mg/I
TKN as N
mg/I
Mn - Manganese i° !r
171, (r'! i
mg/I
YES NO)
Ni - Nickel i,3--li I � 0,019 mg/I
Pb - Lean ia I I `D 4.010mg/I
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
5�'l er<� van IA1 tij:j
I-?P f)-,c, G
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes i/(1) No (0)
VOC : method # _ 9 auto B
method # =
method # =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
NAGILI I Y iNl-UHMATIUN Please Print Clearly or Type
Facility Name: Locks AyAp i(-Or)
Permit Name (if different):
Facility �/Address: ` o) C7X L/)
Mu
A\ t on y (Sireel) A
(Cny)� I I }'(state) (tip) County
Contact Person: ) c� `?1+11 vtc�rt Telephone #: 99's-'IS(0`Ll! i t
Well Location/ Site Name:'. er TnT1QPrd No. of Wells to be Sampled:
Well Identification Number (from Permit): '(Y1W 1:� For Groundwater Treatment Systems
Well Depth: Is ft. Well Diameter: Z in. Check One: ❑ Influent (98)
Screened Interval: ti'iA ft. to O A ft. El Effluent (99)
Depth to Water Level: 9• 11 ft. below measuring point.
Measuring Point (M.P.) is: '�•U ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 3 Date sample collected:
Field analysis: pH , Specific Conductance uMhos
. Temp. t °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT I£ NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT#: W(A, B00 (o03 EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application -of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: See e law
Laboratory Name: _ r t a i in
Certification No —
PARAMETERS
PARAMETERS (Samples for metals were collected unfiltered_4—YES NO and field acidified
COD mg/I Nitrite (NO2) as N mg/I
Coliform: MF; Fecal /100ml Nitrate (NO3) as N mg/I
Coliform: MF Total /100m1 Phosnhorus- Tntnl as P I I ILI A.2 mn/I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total )�)l
19,- QIQ mg/I
pH (when analyzed) r:
, units
Chloride I a 11
I� a � mg/I
Arsenic I �.) i `'I
4 0 Ot% mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate 1r0r)
mg/I
Specific Contluctance
- uMhos
Total Ammonia
mg/I
TKN as N
mg/l
Orthophosphate
mg/I
Al - Aluminum.) 9
l 19 0 ,1 ',)&-
mg/I
Ba - Barium IQ
10 b,©q
mg/I
Ca - Calcium 12 4 117
mg/I
Cd - Cadmium b-ll 40-00E-
mg/I
Chromium: Total 40100S
mg/I
Cu - Copper
mg/1
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium )012)
mg/I
Mn - Manganese ). i"� " 0.66S-1
ma/I
YES NO)
Ni-Nickel ,. 0, 0,6. mg/I
Pb - Leant !a , V:) mg/1
Zn - Zinc mg/l
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
�0-1-PA1yry� ja�� 4—om5
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
ROC ReportAftached? Yes V (1) No (0)
method # = Aj c�tGC� r
method # =
method # =
GW-59
Rev. 0312000
ee
Clk4-)

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:_,
Permit Name (if' diff
Facility Address:
vn^ _ - . - I
Contact Person: 'I'1 lit I
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County Iy V� IX)tjSP 1
Telephone #: 2skg _r7 c�(o `
No. of Wells to be Sampled:
Well Identification Number (from Permit): rbt,_� )LI
Well Depth: ) it. Well Diameter: Z in
Screened Interval: ft. to ft.
Depth to Water Level: D 13ft. below measuring point.
Measuring Point (M.P.) is: gAo ft. above land surface. Re
Gallons of water pumped/bailed before sampling:
Field analysis: pH Lo-1 , Specific Conductance
. Temp. q °C, Odor AP
For Groundwater Treatment Systems
Check One: ❑ Influent (98)
❑ Effluent (99)
lative M.P. Elevation in ft.:
Date sample collected: 13
pearance
PARAMETERS' (Samples for metals were collected unfiltered
COD mg/I Nitri
Coliform: MF Fecal /100ml Nitr
Coliform: MF Total /100ml Pho
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
°
{ mg/I
pH (when, analyzed)
-1 units
TOC 1q, i�l
� , R S mg/I
Chloride iR * i R
4 S,; f') mg/I
Arsenic l
�1
4otQ�� mg/I
Grease and bils
mg/I
Phenol
mg/I
Sulfate 1@14D
410, 6 mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
uMhos
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT
Non -Discharge
NPDES
EXPIRATION DATE:
UIC
TYPE OF PERMITTED OPERATION BEING MONITORED
L Lagoon Remedialion: Infiltration Gallery
Spray Field Remediafion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: _ iwflow
LaboratoryName: ? A la kj_A
Certification No. b
V'YES NO and field acidified
to (NO2) as N mg/l
ate (NO3) as N mg/I
sphorus: Total as P 1'3 i I 1 0100 mg/I
Orthophosphate �— mg/1
Al - Aluminum ISI P-1 3I ' mg/I
Ba - Barium `� i 0 mg/I
Ca - Calcium 13 mg/I
m Cd - Cadmiu`, 1, 1. mg/I
Chromium: Total t611D ° b rODI mg/I
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potassium mg/I
Mg - Magnesium 171 g mg/I
Mn - Manganese I t -;S R3. mg/I
YES NO)
Ni - Nickel f !a-)1
0,( i 3 mg/I
Pb- Lead Ia)'1 `
0,mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,Gr-/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes V (1) No (0)
VOC : method #.=
method # =
method # =
Rev. 03/2000

GROUNDjWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: %-
Permit Name (if� differe
FMc litx Address: I
Contact Person-, '{mil I I!
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County I ►1 '�- �Jllt t i P.
i Telephone #: -11 SLI-e
No. of Wells to be Sampled:
Well Identification Number (from Permit): 1 5 For Groundwater Treatment Systems
Well Depth: I to it. Well Diameter-: � in. Check One: ❑ Influent (98)
Screened Interval: l ft. to ft. El Effluent (99)
Depth to Water Level: A.
+ 9 ft. below measuring point.
Measuring Point (M.P.) is: `LU ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 1 TS Date sample collected:
Field analysis: .pH ( Specific Conductance ' uMhos
. Temp._°C, Odor Appearance
DEPARTMENT OF ENVIRONMENT $ NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: bi a (jW
Non -Discharge
NPDES
b3EXPIRATION DATE:
UIC
TYPE PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field
Rotary Distributor
Other:
Remediation:
Land Application of Sludge
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: See 1Pj LW
Laboratory Name: Ocr_La .-(,p�
Certification No. c�'�,
PARAMETERS (Samples for metals were collected unfiltered 'VYES NO
and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
J100ml
Phosphorus: Total as P-)PL d+g/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total
'
1 a mg/I
Al - Aluminum
` mg/1
pH (when anal zed) ,
l �h units
Ba - Barium
t mg/I
TOC ) `�
i t `'1 mg/I
Ca - Calcium I,
mg/I
Chloride 1 l
s "o mg/I
Cd - Cadmium i
Ga. )Z mg
Arsenic I !2 PID
n•005 mg/I
Chromium: Total
19
40,005 mg
Grease and Oils
mg/I
Cu - Copper
mg
Phenol
mg/I
Fe - Iron
mg/l
Sulfate i T
t: mg/I
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/1
Total Ammonia
mg/I
Mg - Magnesium -IrA
t
m /l
g
TKN as N
mg/I
Mn -Manganese �
+ �� � mg/1
YES NO)
Ni-Nickel I off' !� < 0 f 0 S mg/I
Pb - Leads f `'"r1 mg/I
Zn - Zinc mg/l
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GClMS,HPLC)
(Specify test and method #. At ach lab report.)
ReportAttached? Yes1) No
VOC : method # _ %Ia(pL
method # =
method # =
tui r uuaunaeu Hgeny Name ano -tit e;.Allease print or type
Rev, D3/2000
Signature of Permiltee (or Aulhonzea-,vgent) ,� (Dale)

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:
Permit Name (if different):
Facility_Address: ?t
Contact Person: �_' 1)% 1 t `i
Well Location/ Site Name'.
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County I 1 + — 14 )I b} `- 1.
Telephone M '� -r , .
No. of Wells to be Sampled:
Well Identification Number (from Permit): M1'3.i ;4
Well Depth: ft. Well D'ameter: � in
Screened Interval: ;01 1$ ft. to /U A ft.
Depth to Water,Level: `'� ft. below measuring point.
Measuring Point (M.P.) is:a13 ft. above land surface. R
Gallons of water pumped/bailed before sampling: IQ
Field analysis: pH (Q qQ Specific Conductance
. Temp. �°C, Odor Ap
For Groundwater Treatment Systems
Check one: ❑ Influent (98)
El Effluent (99)
elative M.P. Elevation in ft.: _
Date sample collected: I,9 -
pearance
PARAMETERS (Samples for metals were collected unfilte
COD mg/I
Coliform: MF Fecal /100m1
Coliform: MF Total /100ml
(Note: Use MPN method for highly to bid samples)
Dissolved Solids: Total JQL4
mg/I
pH (when alyzed) (a:
units
NY-)
TOC ( o-
'
mg/I
Chloride
i S �-S IC>
mg/I
Arsenic,
`�i
mg/I
Grease and ils
mg/I
Phenol
mg/I
Sulfate R I I I 40d•©
mg/I
Specific Conductance uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Rev. D312000
uMhos
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: i ` 0005 -31 EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE PF PERMITTED OPERATION BEING MONITORED
NZ Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: See 1' �, Lj
Laboratory Name: WOk-1 F C 'P S2 0, 4 9014
Certification No. 'Sci
red____�N YES NO and field acidified
Nitrite (NO2) as N mg/I
Nitrate (NO3) as N mg/I
Phosphorus: Total as P i 046 mg/I
Orthophosphate mg/I
Al - Aluminum '"1 ' mg/I
Ba - Barium mg/I
Ca -Calcium it `� mg
Cd -Cadmium 1• I M 40• mg/I
Chromium: Total 1� 0,a)S mg/I
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potassium mg/I
Mg - Magnesium j�� mg/I
Mn - Manganese 1 0 N mg/I
YES NO) "'�'ie"�'''��"`. 'A"')
Ni - Nickel I� 1 t� COR mg/I
Pb - Lear) !`� na,)i � mg/I
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
,- d '1 LO O� j�nel ksl
t
ORGANICS: (GC,GC/MS,HPLO)
(Specify test and method #. Attach lab report.)
Report Attached? Yes �1) No (0)
VOC method # = ?Rub 6
method # =
method # =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility Name: L -5
Permit Name (if diff,p�eynt): ri
Well Identification Number (from Permit): For Groundwater Treatment Systems
Well Depth: 11� it. Well Diameter.- _ in. Check One: ❑ Influent (98)
Screened Interval: ft. to roN ^ ft.
ElEffluent (99)
Depth to WaterLevel:_ft. below measuring point.
Measuring Point (M.P.) is: a a it. above land surface. Relative M.P. Elevation in #t.:
Gallons of water pumped/bailed before sampling: Date sample collected: 19 P91
i
Field analysis: pH t4: A ; Specific Conductance ' uMhos
Temp. �t� °C, Odor Appearance
PARAMETERS (Samples for metals were collected unfilteredYES
COD mg/I
Coliform: MF Fecal /100ml
Coliform: MF Total /100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total iWls� 1V
mg/I
pH (when analyzed) 1 ') lo;H
units
TO I M1;T1 �— 4,1 �G
mg/I
Chloride
! T" 45,6
mg/I
Arsenic IQ
l e r 00S
mg/I
Grease and b ils
mg/I
Phenol
mg/l
Sulfate ?sU=L-
mg/I
Specific Con uctance uMhos
Total Ammonia
mg/I
TKN as N
mg/I
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC 27699-1636 Phone: t9191 733-19:
PERMIT #: U,) a0C, 0 S0 )_.3 EXPIRATION DATE:
Non -Discharge U IC
NPDES
TYPE O.F PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field
Rotary Distributor
Other:
Remedialion:
Land Application of Sludge
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: See Ze_�ticll
Laboratory Name: I -Ire
Certification No. sn
NO and field acidified
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P I 0 : L22mg/I
Orthophosphate
Al - Aluminum jq)F-1 0,9��
mg/I
mg/I
Ba - Barium i,,A I i ")
mg/I
Ca -Calcium t 1 t'l L/7"s�Ot
mg/I
Cd - Cadmium tr' 1 Q <o boo-
mg/I
Chromium: Total 41DUS
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/l
K - Potassium
mg/I
Mg - Magnesium f i'— 40 ,5W
mg/I
Mn - Manganese_ IST) 19' 41)a OaS
mg/I
YES NO)
Ni -Nickel t' - 1 f : b n mg/I
Pb - Lean / f`-? L -I'O s mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
4 6ef��� P1^
1
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes X (1) No (0)
VOC : method # = � GkIAO R
method # =
method # =
Rev, 03/2000

1dfiTffR6TJ9CH-117C.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS. NORTH CAROLINA 28630
[phone]
SAMPLE.
Coats America (MW#02)
COLLECTION DATE:
12/17/2013
PERMIT #:
COLLECTION TIME:
08:56
ADDRESS:
Coats America (Wells)
RECEIVED DATE:
12/17/2013
P.O. Box 368
RECEIVED TIME.
14:00
Marion, NC 28752
REPORTED:
1 /16/2014
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TDS
104
mg/L
12/18/13
lag
Chloride
<5.0
mg/L
12/18/13
lag
T. Phosphorus
0.40
mg/L
1/3/14
jdg
TOC
1.62
mg/L
12/27/13
Sulfate
<10.0
mg/L
12/27/13
metals
see attached
pH
7.5
su's
12/17/13
lag
P.ECEI ED/DENROAR
JANI 0 0 20 14
Water Quality Regiond
Operations Cecuion
LOG ID: 1312-321 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

,* E
u s- .lrtc.
POST OFFICE BOX 1056 , #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE. Co
is America (MW#10) COLLECTION DATE:
12/17/2013
PERMIT #.
COLLECTION TIME:
09:00
ADDRESS: Coats
America (Wells) RECEIVED DATE:
12/17/2013
P.C.
Box 368 RECEIVED TIME:
14:00
Mai
ion, NC 28752
REPORTED:
1 /16/2014
-
ANALYSIS£Y
ANALYSIS
RESULTS
UNITS :
DA-TE - ::
ANALYST
TDS
128
mg/L
12/18/132
lag
Chloride
<5.0
mg/L
12/18/13
lag
T. Phosphorus
0.22
mg/L
1/3/14
jdg
TOC
<1.0
mg/L
12/27/13
Sulfate
30.4
mg/L
12/27/13
metals
see attached
pH
6.8
su's
12/17/13
lag
LOG ID: 131
Division f Water EDrces
F E S 1 4 2014
I Water Qualit
Asheviy Regional Operations
lle Regional Office
REPORTED BY: NC CERTIFIED LAB # 50
S" k
Tony Gragg, Lab Supervisor

.Inc.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE., Coats America (MW#11) COLLECTION DATE 12/17/2013
PERMIT #. COLLECTION TIME., 09:16
ADDRESS: Coats America (Wells) RECEIVED DATE: 12/17/2013
P.O. Box 368 RECEIVED TIME., 14:00
Marion, NC 28752
REPORTED: 1 /16/2014
ANALYSIS:
RESULTS ; ..UNITS �
TDS
209
mg/L
Chloride
22.3
mg/L
T. Phosphorus
0.36
mg/L
TOC
1.76
mg/L
Sulfate
57.9
mg/L
metals
see attached
pH
8.5
su's
LOG ID: 1312-323
z• —
DATE ANALYST
12/18/13
lag
12/18/13
lag
1/3/14
jdg
12/27/13
12/27/13
12/17/13
lag
REPORTED BY: NCCERTIFIED LAB # 50
fo�
Tony Gragg, Lab Supervisor

TER6TECH.
µ .Inc.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#12)
COLLECTION DATE:
12/17/2013
PERMIT #:
COLLECTION TIME:
09:26
ADDRESS: Coats America (Wells)
RECEIVED DATE:
12/17/2013
P.O. Box 368
RECEIVED TIME:
14:00
Marion, NC 28752
REPORTED:
1 /16/2014
t
TDS
672
mg/L
12/18/13
Chloride
13.3
mg/L
12/18/13
T. Phosphorus
0.25
mg/L
1/3/14
TOC
2.55
mg/L
12/27/13
Sulfate
11.2
ma/L
12/27/13
metals
see attached
pH
7.1
su's
12/17/13
,
ANALY
lag
lag
jdg
lag
LOG ID: 1312-324 REPORTED BY:
NC CERTIFIED LAB # 50
7
Tony Gragg, Lab Supervisor

URTER6TECH Lowfizinc.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#13) COLLECTION DATE.,
12/17/2013
PERMIT #: COLLECTION TIME:
09:31
ADDRESS: Coats America (Wells) RECEIVED DATE:
12/17/2013
P.O. Box 368 RECEIVED TIME.,
14:00
Marion, NC 28752
REPORTED:
1 /16/2014
_
--
��A�Ysrs �
, • V
ANAL-;YSIS
: ' "'RESULTS _
UNITS;
-"DA- TE:r
ANALYST
TDS
219
mg/L
12/18/13
lag
Chloride
6.3
mg/L
12/18/13
lag
T. Phosphorus
0.38
mg/L
1/3/14
jdg
TOC
1.23
mg/L
12/27/13
Sulfate
26.2
mg/L
12/27/13
metals
see attached
pH
6.6
su's
12/17/13
lag
LOG ID: 1312-325 REPORTED BY: NC CERTIFIED LAB # 50
fft.-t' * -
Tony Gragg, Lab Supervisor

TKR679CH .III c.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#14) COLLECTION DATE:
12/17/2013'
PERMITA- COLLECTION TIME:
09:44
ADDRESS: Coats America (Wells) RECEIVED DATE:
12/17/2013
P.O. Box 368 RECEIVED TIME:
14:00
Marion, NC 28752
REPORTED:
1 /16/2014
ANALYSIS
AN;4LYSIS
RESULTS .
UNITS
DATE
ANALYST
TDS
397
mg/L
12/18/13
lag
Chloride
<5.0
mg/L
12/18/13
lag
T. Phosphorus
0.40
mg/L
1/3/14
jdg
TOC
2.95
mg/L
12/27/13
Sulfate
<10.0
mg/L
12/27/13
metals
see attached
pH
7.0
su's
12/17/13
lag
LOG ID: 1312-326 REPORTED BY: NC CERTIFIED LAB # 50
1
Tony Gragg, Lab Supervisor

MOTER6TECH LANS-117C.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#15)
COLLECTION DATE:
12/17/2013
PERMIT #.'
COLLECTION TIME.,
10:06
ADDRESS., Coats America (Wells)
RECEIVED DATE.,
12/17/2013
P.O. Box 368
RECEIVED TIME.,
14:00
Marion, NC 28752
REPORTED:
1/16/2014
TDS
305
mg/L 12/18/13
lag
Chloride
<5.0
mg/L 12/18/13
lag
T. Phosphorus
0.33
mg/L 1/3/14
jdg
TOC
1.79
mg/L 12/27/13
Sulfate
17*0
m,/L 12/27/13
metals
see attached
pH
6.6
su's 12/17/13
lag
j
2—
LOG ID: 1312-327 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

RESEARCh & ANA1YTICAt
Ubo AT®f ks, INC.
Analytical/Process Consultations
January 8, 2014
Water Tech Labs
P.O. Box 1056
Granite Falls, NC 28630
Attention: Joe Gragg
Project Name: Coats American
J��, U A!VALYT� �rrr
#34 Mi
11• Miscellaneous
MW2
MW10
MW11R '
MW12
MW13
MW14
MW15
Date
Parameters
Unit
Results
Results
Results
Results
Results
Results
Results
Analyzed
Aluminum, Total
mg/L
1.11
0.232
0.187
0.221
0.138
3.31
0.135
12/31/13
Arsenic, Total
mg/L
0.006
<0.005
<0.005
<0.005
<0.005
<0.005
<0.005
12/31/13
Barium, Total
mg/L
0.060
0.008
0.068
0.174
0.039
0.151
0.109
12/31/13
Cadmium, Total
mg/L
<0.002
<0.002
<0.002
<0.002
<0.002
<0.002
<0.002
12/31/13
Chromium, Total
mg/L
<0.005
<0.005
0.005
<0.005
<0.005
0.005
<0.005
12/31/13
Calcium, Total
mg/L
17.9
<0.500
116
107
15.7
78.3
70.5
12/31/13
Lead, Total
mg/L
0.015
<0.005
0.032
<0,005
<0.005
0.014
0.007
12/31/13
Magnesium, Total
mg/L
9.32
<0.500
36.5
17.2
10.3
49.8
24.9
12/31/13
Manganese, Total
mg/L
0.341
<0.005
0.008
4.67
0.057
0.883
1.50
12/31/13
Nickel, Total
mg/L
0.008
0.040
0.014
0.012
0.005
0.013
<0.005
12/31/13
Selenium, Total
mg/L
<0.005
<0.005
<0.005
<0.005
<0.005
<0.005
<0.005
12/31/13
Sodium, Total
mg/L
8.79
55.1
21.1
139
69.7
34.7
12.9
01/03/14
Sulfate
mg/L
<10.0
30.4
57.9
11.2
26.2
<10.0
17.0
12/27/13
TOC
mg/L
1.62
<1.0
1.76
2.55
1.23
2.95
1.79
12/27/13
Sample Number
775168
775169
775170
775171
775172
775173
775174
Sample Date
12/17/13
12/17/13
12/17/13
12/17/13
12/17/13
12/17/13
12/17/13
Sample Time
----
----
----
----
----
----
----
mg/L = milligrams per Liter = parts per million (ppm) < = Less than or below detection limit

w=
LAb®•g
6Cs INC.
CCtt-W•r
o
°N H34 zi
Analytical/Process Consultations
��!aECpA' •� r0
Chemical Analysis for Selected Parameters and Water Sample Identified as Coats American
(A Water Tech Labs, Inc. Project, collected 17 December 2013)
I. Volatile Organics
Quantitation
EPA Method 8260 B
Limit
MW2
MW10
MW11R
MW12
MW13
MW14
MW15
Parameter
(ppb)
JRpb)
(Anb)
IPebl
(aobl
(nnbl
lrebl
(nnb)
Acetone
25
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Acrolein
100
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Acrylonitrile
100
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Benzene
0.5
BQL
BQL
BQL
0.23 J
BQL
BQL
BQL
Bromobenzene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Bromochloromethane
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
ne Bromodichlorometha
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Bromoform
1.0
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Bromomethane
I.0
BQL
BQL
BQL
BQL
BQL
BQL
BQL
2-Butanone
25
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Carbon Disulfide
5.0
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Carbon Tetrachloride
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Chlorobenzene
0.5
BQL
BQL
BQL
0.46 J
BQL
BQL
BQL
Chloroethane
1.0
BQL
BQL
BQL
BQL
BQL
SQL
BQL
2-Chloroethyl vinyl ether
5.0
BQL
BQL
BQL
BQL
BQL
BQL -
- BQL
Chloroform
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Chloromethane
1.0
BQL
BQL
BQL
BQL
BQL
BQL
BQL
2-Chlorotoluene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
4-Chlorotoluene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Cis-1,2-Dichloroethene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Cis-1,3-Dichloropropene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,2-Dibromo 3-Chloropropane(DBCP)
5.0
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,2-Dibromoethane (EDB)
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Dibromochloromethme
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Dibromomethane
0.5
SQL
BQL
BQL
BQL
BQL
BQL
BQL
1,2-Dichlorobenzene
0.5
BQL
BQL
BQL
0.18 J
BQL
BQL
BQL
1,3-Dichlorobenzene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,4-Dichlorobemene -
0.5
BQL
BQL
BQL
0.14 J
BQL
BQL
BQL
1,1-Dichloroethene
0.5
BQL
BQL
BQL
0.181
BQL
BQL
BQL
1,2-Dichloroethme
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,1-Dichloroethene
0.5
BQL
BQL
BQL
0.13J
BQL
BQL
BQL
Dichloroflouromethane
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,2-Dichloropropane
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,3-Dichloropropane
0.5
BQL
BQL
BQL _
BQL
BQL
BQL
BQL
2,2-Dichloropropene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,1-Dichloropropene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Ethyl Benzene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
2-Hezanone
5.0
BQL
BQL
BQL
BQL
BQL
BQL
BQL
RE
0.5
BQL
SQL
BQL
BQL
BQL
BQL
BQL
1-Propylbenzene
0.5
BQL
BQL
BQL
0.12 J
BQL
BQL
BQL
4-Methyl-2-Pentanone
5.0
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Methyl Iodide
1.0
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Methylene Chloride
5.0
BQL
BQL
BQL
BQL
BQL
BQL
BQL
MTBE
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Naphthalene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
N-Butylbenzene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
N-Propylbenzene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
p-Isopropyltoluene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Sec-Butylbenzene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Styrene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Tert-Butylbenzene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,1,1,2-Tetrachloroethane
015
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1, 1,2,2-Tetrachloroetbane
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Tetrachloroethene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Toluene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Trans-1,2-Dichloroethene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Trans-1,3-Dichloropropene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Trans-1,4-Dichloro-2-butene
5.0
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,2,3-Trichlorobenzene
0.5 -
' BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,2,4-Trichlorobemene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,1,1-Trichloroethane
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,1,2-Trichloroethane
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Tichloroethene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Trichloro➢uoromethahe
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,2,3-Trichloropropane
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,2,4-Trimethylbenzene
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
1,3,5-Trimethylbemene
0.5
BQL
BQL
BQL
BQL
' BQL
BQL
BQL
Vinyl Acetate
1.0
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Vinyl Chloride
0.5
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Total Xylenes
1.0
BQL
BQL
BQL
BQL
BQL
BQL
BQL
Dilution Factor
I
I
I
I
I
I
I
Sample Number
775168
775169
775170
775171
775172
775173
775174
Sample Date
12/17/13
12/17/13
12/17/13
12/17/13
12/17/13
12/17/13
12/17/13
Sample Time (hrs)
----
----
----
----
----
---
Analyst
NM
NM
NM
NM
NM
NM
NM
-Date Analyzed
12/28/13
-12/28/13
12/28/13
12/28/13
-12/31/13
12/31/13
12/31/13
Time Analyzed
0315
0346
0417
0449
1605
1637
1709
Surrogate Recovery
Range
DBFM
(70-130%)
102%
103%
87%
104%
105%
105%
110%
Toluene-d8
(70-130%)
98%
98%
96%
98%
93%
95%
89%
4-BFB
(70-130%)
99%
95%
96%
96%
92%
98%
94%
BQL - Below Quantitation Limits
ppb = pwl per billion

CHAIN OF CUSTODY - Analytical Request
Client Narne: �'p C, co r,
Address:.
Report to:
Phone:
PONunber: B)Or) Jo(i'n LA vl
u
WATER TECH LABS, INC.
. PO BOX 1056
GRANITE FALLS, NC 28630
PHONE. [phone]
Project Name:
Project Number:
Requested Analyses :J
pH Checked —Upon Receipt
Preservatives
C12 < 02
g/1 Upon Receipt
Saiiiple Ideatification
0
z
0 12,
0
C/I
5
J
N
7-
U
0
V
A
tl
0
010
1-4
'r
5
0
M
C/)
Z
z
Field Temp. (C*)
Comments
ry-N LI-15
X,
Temperature (*61
7
1;-130
Received on Ice:
Y / N
L
7 Ova
ISealed Cooler:
Y / N
ISanples Intact:
I Y / N
Additional Comments:
L- W-211plidir-Marfie and,Signature-.-.
-
Printed Name of Sampler:
Sam bucl�t.
Signature of Sampler:
13-1 -)3
A

CHi IN OF CUSTODY - Analytical Request
Client Name: 0.0ah Amp u(y r
Address:
Report) to:
Phone
P O Ntinzb er:
WATER TECH ]CABS, INC.
PO BOX 1056
GRANITE FALLS., NC 28630
PHONE: [phone]
Project Name:
Project Number:
Requested Analyses
.I / 7 / � pH Checked Upon Receip
Preservatives
Cl2 < 0.2 mg/I Upon Receip
}
4,.
'
Sample Identification
N
•9
d
!
�
O
z
o
boo
N
U
o�
cd
J1
DO
�
1
F, `.
�
�
Cd
z
Field Temp. (C°)
Comments
i
is-1743
0:06
r
X
X
x
X
i
.f
..
o
12-30
Temperature (, C)
Received on Ice:
Y / Nlad
77
12 j
�CLS
Sealed Cooler,:
Y / N
Samples Intact
Y / N
Additional Comments;
• - - • • -
-
Printed Name of Sampler: uckginS
Signature of Sampler.60L
�A

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:
Permit Name (if
Facilitv Address:
Contact Person: 'I'Q1111
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County t rI' UL)L>JC I I
Telephone #:2A -`]S(o y 111
No. of Wells to be Sampled:.._
Well Identification Number (from Permit): M W d,@ For Groundwater Treatment Systems
Well Depth: - is it. Well Diameter: (c in. Check One: ❑ Influent (98)
Screened Interval: A)l A- ft. to �_ it. ❑ Effluent (99)
Depth to Water Level:—Qft. below measuring point.
Measuring Point (M.P.) is:-al-1-3 ft. above land surface. Relative M.P. Elevation In ft.:
Gallons of water pumped/bailed before sampling: (00_ Date sample collected:
Field analysis: pH-1 , Specific Conductance uMhos
Temp. I'- °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: LtW 00005003 EXPIRATION DATE:
Non -Discharge U IC
NPDES
TYPE PF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation: �®
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: DPP CAP �.
Laboratory Name: Wa}pr=f-P^1�
Certification No. Sn
PARAMETERS (Samples for metals were collected unfilteredX_YE5 NO
and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100m1
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P 9-Z-7
0.33
mg/I
(Note: Use MPN method for highly turbid samples)
" Orthophosphate
mg/I
.Dissolved Solids: Total S-Q Cho mg/I
Al- Aluminum 'R-rl
y, 19
mg/I
pH (when analyzed)
units
Ba - Barium 9 -']
d .14%
mg/I
TOC 4'--1
< 1 O mg/I
Ca - Calcilim �-']
30-o
mg/I
Chloride 9 -26
-7. o mg/I
Cd - Cadmium Q `7 4.O. 00z.-
mg/I
Arsenic 16 -r1
0. MCI mg/I
Chromium: Total 2-1
o•ooto
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate
mg/I
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium
IS-1
mg/I
TKN as N
mg/I
Mn - Manganese $-7
1 "39
mg/I
YES NO)
Cn
9 r!
Fu
m
co
D
M
Uoi
Ni- Nickel _%- `7 6 . r Iq rag I ..
Pb - Lead '7 O ; 0�53 mg/I
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
Selenium 5 -_9 4D.OL:55 ,Q
5o,AiJrh a-:1
ORGANICS:. (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
ROC Report Attached? Yes (1) No (0)
method # =
method #
method #

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: Coc345 AmerimtA
Permit Name (if different):
Facility Address: TO ,k as
mcicioe\ Mreel) A)C 9-82509 C
ICnY) Sal) (ZtD) County rn �yW e.1 1
Contact Person: 11 t Q Telephone #: _q88 -` S 6-411 1
Well Location/ Site Name: W t No. of Wells to be Sampled: _
prom em,Iq
Well Identification Number (from Permit): M W IQ For Groundwater Treatment Systems
Well Depth: 1$ ft. Well Diameter: 7-in- Check One: ❑ Influent (98)
Screened Interval: 0 A it. to to Pl ft. ❑ Effluent (99)
Depth to Water Level:_12. ft. below measuring point.
Measuring Point (M.P.) is: 4 j 3 ft. above land surface. Relative M.P. Elevation In ft.:
Gallons of water pumped/bailed before sampling: 3 Date sample collected: �-
Field analysis: pHto— S , Specific Conductance umhos
. Temp. .Ito OC, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER OUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC 27699-1636 Phone: [phone]Z
PERMIT #: W G? O00-5k0&3 EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other: _ -
NOTE: Values should reflect dissolved and .
colloidal concentrations.
-/ Date sample analyzed: e �P1t)L-)
Laboratory Name: L. er -3-er h
Certification No. __ SO
PARAMETERS (Samples for metals were collected unfiltered YES NO
and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/1
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MFTotal
/100ml
Phosphorus: Total as P%•27 40.Ito mg/l
(Note: Use MPN method for highly turbid samples)
Orthophosphate
nag/I
Dissolved Solids: Total 2-9 1 mg/l
AI - Aluminum 9`) 0.1 9 mg/I
pH (when analyzed) 5--h
lc�'� units
Ba -Barium • I
0 .0 3 mg/I
TOC %- 71
� 1.o mg/I
Ca - Calcium V -r1
4 co , 50() mg/I
Chloride %- Zt e
5 . o Mg
Cd -Cadmium 9- - 7
40 . 00 Z mg/I
Arsenic 4s-'•1
40.005mg/I
Chromium: Total %-7
�� 00S m /I
9
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
rl
mg/1
Fe - Iron
mg/I
Sulfate %-
mg/l
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium 9 -7
1-0-Sop mg/I
TKN as N
mg/I
Mn - Manganese_` `1
0. oo 5 mg/I
YES NO)
Ni - Nickel- S-r] 0 rOCxl mg/1
Pb - Lead - rJ Co,OoK mg/(
Zn - Zinc mg/1
Ammonia Nitrogen mg/1
Other (Specify Compounds and Concentration Units)
SelPniurv� -'� 40 0 5 ma IQ
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method.# =
method #
method # _

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: COOL "s A1rerinctr\
Permit Name (if d[Werent -
Facility Address: 01 3toT5 _
Contact Person: w13,11
Well Location/ Site Name:
County m� L&we 11
Telephone #: g98 '15(c -y 11 l
No. of Wells to be Sampled:_
Well Identification Number (from Permit): MW l I R For Groundwater Treatment Systems
Well Depth: 30 ft. Well Diameter: Z in. Check One: ❑ influent (98)
Screened Interval: �A ft. to pil A ft.
Depth to Water Level: 5 El Effluent (99)
p �_ft. below measuring point.
Measuring Point (M.P.) is: d it. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 3 Date sample collected: 'r' -6 -13
Field analysis: pH '1 11 , Specific Conductance UMhos
Temp. 19 °C, Odor Appearance
PARAMETERS (Samples for metals were collected
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total g-G 210 mg/I
pH (when analyzed) 'R-la
-7 -7 units
TOC -4 -r]
,1.0 mg/I
Chloride 9.210
S .'O mg/I
Arsenic _19-9
4t)•UoS mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate �' •`1
S9 -lo mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH. NC 27699-16ns phnnc- 1Q1 M 777_99'
PERMIT #: t.O© 0003( Q3 EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE 9F PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 5ee, f3Plo
Laboratory Name: . LA�ker -feed
Certification No. 56
feredy YES
NO and field acidified
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as
P9-2'i ZI mg/I
Orthophosphate
mg/I
Al -Aluminum 4- -9
0 IZS mg/I
Ba - Barium 9 -'1
0 , 0LI(0 mg/I
Ca - Calcium V -9
02;-9 mg/I.
Cd - Cadmium-Fs-'1
40• 002- mg/I
Chromium: Total
<0.005 mgll
Cu - Copper
mg/I
Fe - Iron
mg/l
Hg - Mercury
mg/I.
K - Potassium
mg/I
Mg - Magnesium Ov-:j
-41.9 mg/I
Mn - Manganese-9-1
40-005mg/I
YES NO) '
Ni - Nickel 0 Zy mg/1
Pb - Lead;s 4 0. Oo S mg/1
Zn - Zinc mg/1
Ammonia Nitrogen mg/1
Other (Specify Compounds and Concentration Units)
1 T% . Z nno 1. 4
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
method # =
method # =

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: L—t7
Permit Name (if differen
ContactPerson:'YUI III
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County f I lk- t—.Dwy( t
Telephone #: _aw -115(1) -4.
No. of Wells to be Sampled:
Well Identification Number (from Permit): M W -12 For Groundwater Treatment Systems
Well Depth: 13 ft. Well Diameter- a in. Check One: ❑ Influent (98)
Screened Interval: .N A ft. to M A it. ❑ Effluent (99)
Depth to Water Level: ft. below measuring point.
Measuring Point (M.P.) is: a.(o ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 9- Date sample collected:
Field analysis: pH 61 � , Specific Conductance ' uMhos
Temp. 19 'C, Odor Appearance
DEPARTMENT OF ENVIRONMENT 8, NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: W Q 0W S(003
Non -Discharge
EXPIRATION DATE:
UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field
Rotary Distributor
Other:
Remediation:
Land Applicalion of sludge
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: See Selo
Laboratory Name: LCUi1eL Tcar)
Certification No. SO
PARAMETERS (Samples for metals were collected unfiltered_VYES NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P_9-2-7 0• �5mg/I
(Note: Use MPN method for high[
turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total
- mg/I
Al - Aluminum �- `7 0.1 t y
mg/I
pH (when analyzed)'Ato
(o,R units
Ba - BariumC)ISd
mg/I
TOC'R - 9
2,2-2 mg/I
Ca.- Calcium
mg/I
Chloride (k •26
5.0 mg/I
Cd - Cadmium
Arsenic 9.9
4-0•00S mg/I
Chromium: Total -S-9 <0,U05
mg/I
Grease and Oils
mg/l
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate is - q
•6 mg/I
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/1
Total Ammonia
mg/I
Mg - Magnesium
mg/I
TKN as N
mg/I
Mn - Manganese W • 7 LA , O(o
mg/I
-322
YES NO)
Ni - Nickel- S - "] 0, O%S mg/1
Pb - Lead YS '' 1 40, S mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
1141
O,
Cen
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
method #
method #

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: 0—m-A5 Amerimtan
Permit Name (if djif�rent)*
Fa4ity_Address: ` d COX apgs
Contact Person: VD1 1I1
Well Location/ Site Name:
County 1 r lc k10t.R.)e U
Telephone #: 2k—
No. of Wells to be Sampled:
Well Identification Number (from Permit): JM ( ) -13 For Groundwater Treatment Systems
Well Depth: 15 ft. Well Dia eter•: Z in. Check One; ❑ Influent (98)
Screened Interval: Ail A ft. to eJj A it. ❑ Effluent (99)
Depth to Water Level:�_ft. below measuring point.
Measuring Point (M.P.) is:Z-•V ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: Date sample collected: g _13
Field analysis: pH 6• X, Specific Conductance uMhos
Temp. % % °C, Odor Appearance
PARAMETERS (Samples for metals were collected
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPN method for high) turbid samples)
Dissolved Solids: Total 'i•Q( Zllo
pH (wh n analyzed) Q - b
W •rl
mg/I
• 1 units
TOC
1.31 mg/I
Chloride Sr • Zto
<5.O mg/I
Arsenic 4--')
40-05o5 mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate 4's •'�
Ztp•O mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT#: LA )I60050o3
Non -Discharge
NPDES
e:
EXPIRATION DATE:
UIC
TYPE aF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: SPe 13e1O1 )
Laboratory Name:. _ Wa-t er -I-eC h
Certification No. 5o
IeredI/YES
NO and field acidified
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as
PS -V7 40.1 bmg/I
Orthophosphate
mg/I
Al - Aluminum_ 1
O•L)24 mg/I
Ba - Barium �—
O •U 0 mg/1
Ca - Calcium
III Mg
Cd -Cadmium
Zmg/I
Chromium: Total •
rl n Ioy5 mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium -9
mg/I
Mn - Manganese
O , Z. mg/I.
YES NO)
Ni - Nickel_ $t �,0 mg/I
Pb - Lean_ g • 73 C • QCK5 mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
r \'1 o n, • h 4 o a'S rY1�S o
ORGANICS: (GC,GC/MS.HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC method # =
method # =
� RO►tifllfha4 In the hac► of .nu Ln nudn.l..........� t-..r...c a�._ :-�----"— __-'- _-... _ .. .. _ . method#

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: • L;UC11
Permit Name (if different):
Facilitv Address:_
Contact Person: � 1�r1J 1111
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
„0- �$ County f11C G)W t?11
�l Telephone #: 5�2�-r7Jn-�111
406 ' on No. of Wells to be Sampled:
Well Identification Number (from Permit): Mt,J - tij
Well Depth: lS 'it. Well Diameter: Z
Screened Interval: � A ft. to NIA ft.
Depth to Water Level: to ft. below measuring point
Measuring Point (M.P.) is: 2•• to ft. above land surface.
Gallons of water pumped/bailed before sampling: 3
Field analysis: pH._12 , Specific Conductance
1
For Groundwater Treatment Systems
in. Checkone: ❑ Influent (98)
❑ Effluent (99)
Relative M.P. Elevation In ft.:
Date sample collected: �- -(a - 13
uMhos
Temp. $ °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH NC 27699-1636 Phone: [phone]
PERMIT #:LA-)&0()UcS(D6,3 EXPIRATION -DATE:
Non -Discharge UIC
NPDES
TYPE F PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infillrallon Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: _ 3pe )3e) LJ
Laboratory Name: -_ waked 'Tee h
Certification No.— e)
PARAMETERS (Samples for metals were collected unfiltered__1%.ZYES NO and field acidified
COD
mg/l
Nitrite (NO2) as N
mg /I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
m/I
g
Coliform: MF Total
/100mI
Phosphorus: Total as P �-2''] t:�Z1
mg/I
(Note: Use MPN method for highl turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total .Q
�- (o
a4p mg/I
O l
Al - AluminuW1,
mg/I
pH (when analyzed)
g •rl
(c�. R units
Ba - BariumO- I t-1
mg/I
TOC
t-I,g(a mg/I
Ca - CalciumS,
mg/I
Chloride • ac(e
$
5.0 mg/f
Cd - Cadmiu02
mg/I
Arsenic -�1
40.005 mg/I
Chromium: T<O .OUS
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
Sulfate �- r1
mg/I
fo1. t` mg/I
Fe - Iron
Hg - Mercury
m /I
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
TKN as N
mgll
Mg - Magnesium -g - `7 3S
mg/I
mg/I
Mn - Manganese_%-`l Q, S70
mg/I
YES NO)
Ni - Nickel �'�
Pb - LeZ ' 9
b , c� 2�(1 mg/1
mg/I
Zn - Zinc mg/1
Ammonia Nitrogen mgll
Other (Specify Compounds and Concentration Units)
_6eNeniom TEI�.OfJ
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #.Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
method #

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Names
Permit Name (if
Contact Person: 9i 1 1111
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County I t 11-i LX�), 3t? t I
Telephone M %'r7
No. of Wells to be Sampted:
Well Identification Number (from Permit): DOLO -'1
Well Depth: 1-6 ft. Well Diameter: Z in
Screened Interval:_ it. to ft.
Depth to Water Level: to - q ft. below measuring point.
Measuring Point (M.P.) is: 2• �o ft. above land surface. Re
Gallons of water pumped/bailed before sampling:
Field analysis: pH (0- L , Specific Conductance
Temp. - —°C, Odor At)
For Groundwater Treatment Systems
Check One: ❑ Influent (98)
❑ Effluent (99)
lative M.P. Elevation in #t.:
Date sample collected:-13
uMhos
)earance
PARAMETERS (Samples for metals were collected unfilte
COD mg/I
Coliform: MF Fecal /100m1
Coliform: MF Total /100m1
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total S-9 (oo m9 /l
pH (when analyzed) lz�- (o
(o• k-o units
TOC c6 • I
3.30 mg/I
Chloride _S' -2 Cc
46. mg/I
Arsenic a • q
4o•oo-s mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
• to mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
PERMIT #: W
Non -Discharge
DEPARTMENT OF ENVIRONMENT $ NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
EXPIRATION DATE:
UIC
NPDES
TYPE F PERMITTED OPERATION BEING MONITORED
Lagoon Remediallon: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed:
Laboratory Name: ("
Certification No. 0
red V YES NO and field acidified
Nitrite (NO2) as N mg/I9
Nitrate'(NO3) as N m /I
Phosphorus: Total as PS •21 404to mg/I
Orthophosphate mg/I
Al -Aluminum 0a -'"1 0 q y mg/I
Ba - Barium 18 • 2 mg/I
Ca - Calcium -Tl -7G . mg/I
Cd - Cadmium S_ •' 1 4o • OOZmg/I
Chromium: Total �•'-7 LO.oCS mg/I.
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury m /I
K - Potassium mg/l
Mg - Magnesium g • r1 26 • mg/I
Mn - Manganese_g _� t "L mg/I
3-3
YES NO)
Ni - Nickel_ �s • `� �, pJ S _ mg/I
Pb - Leari'R • rj O •[�\� mg/I
Zn - Zinc. mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
���� �•r] 2..2 mat 0
�e 1•e� iy cr 8• -`1 � � tx�2 n�
�t
ORGANICS: (GC;GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC method # =
method # =
method # =

GW-59A COMPLIANCE REPORT FORM
Permit # UJ® M05&o03
(Submit one each monitoring period with GW-59 forms.)
1
Enter date monitoring results were due. ( -12 --13) Will this monitoring report (GW-59 and GW-59A) YES NO
be submitted after the established due date?
2
Was any required information missing on the GW-59 report forms?
YES
NO
IF the answer to question 9 or 2 is "YES', list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the required information.
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
YES
NO
identification plate, area overgrown, etc.)? If the answer is "k'es ", contact the Regional Ofce forguidance.
4
Are any monitored constituents equal to or above the established standards?
YES
NO
If the answer to question 4 is NO", skip to section B.
If the answer to question 4 is "YES" list the affected wells individually with constituents) and concentration(s)
exceeding standards in the space provided below. M W # ly W Z
Mw12 7 D S 54b��.SL Lead C�.os3^►��.R
DS 59orna',A,
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
YES
NO
same constituent(s) in the same well(s) in the last two years?
If the answer to question 5 is "NO", skip to section 8.
If the answer to question 5 is "YES". list in the space provided below, each well with constituents) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
M��- n^ W-t� m w 41 %
+}-12-1.3 14-q-13 y-4-13
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
if the answer is "YES", a -groundwater quality problem may be occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells may be improperly
located, contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
YES
NO
groundwater quality problem?
If the answer to question 7 is "YES", describe those actions in the space provided below.
If the answer to question 7 is "NO" contact the Regional Office within 90 days; an evaluation may be
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surrounding this facility. Failure to do so may subject the permittee to a Notice of Violation
Fines, and/or penalties.
g
The person completing this portion (GW-59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
I hereby ackn.' e e thatAh6,f-above 1iiG nation wasy'Rfil' ated and the infocimatiQn submltied�n ibis wtitt�
a
;report (Comp,ian Report GW 59A} !s true d complete to theLbest of my knowle(ge
„wti',#
Signa a of Permittee Authorize Agent) Date
GIB'-59A 12/8/2003

,
id
Pr,rR6Tx.cn Ln
POST OFFICE BOX 1056 - #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#02) COLLECTION DATE. 8/6/2013
PERMIT #. -COLLECTION TIME. 07:45
ADDRESS., Coats America (Wells) RECEIVED DATE. 8/6/2013
P.O. Box 368 Marion, NC 28752 RECEIVED TIME: 14:30
REPORTED: 9/4/2013
.
ANALYSIS;`
ANALYSIS
RESULTS
UNITS :
DATE . -
-.'ANAL
TDS
96
mg/L
8/9/13
lag
Chloride
7.0
mg/L
8/26/13
lag
T. Phosphorus
0.33
mg/L
8/27113
jdg
TOC
<1.0
mg/L
817/13
Sulfate
124
mg/L
817/13
metals
see attached
pH
7.4
su's
816/13
lag
LOG ID: 1308-106
REPORTED BY: NC CERTIFIED LAB # 50
fl�.
Tony Gragg, Lab Supervisor

w#wrzwR6TvcHLR' S.Inc.
POST OFFICE SOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
(828) 3964444
SAMPLE: Coats America (MW#10)
COLLECTION DATE:
8/6/2013
PERMIT A
COLLECTION TIME.
07:56
ADDRESS: Coats America (Wells)
RECEIVED DATE.,
8/6/2013
P.O. Box 368
RECEIVED TIME:
14:30
Marion, NC 28752
REPORTED.,
9/4/2013
ANAL)
ANALYSIS:
RESULTS .
UNITS-
TDS
120
mg/L
Chloride
<5.0
mg/L
T. Phosphorus
<0.16
mg/L
TOC •
<1.0
mg/L
Sulfate
26.4
mg/L
metals
see attached
pH
6.7
su's
IS,
DATE
ANALYST,
8/9/13
lag
8/26/13
lag
8/27113
jdg
817/13
817/13
8/6/13
lag
LOG 1D. 1308-107 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
(828)3964444
SAMPLE., Coats America (MW#1 1)
COLLECTION DATE.-
8/6/2013
PERMIT
COLLECTION TIME:
08:02
ADDRESS., Coats America (Wells)
RECEIVED DATE:
8/612013
P.O. Box 368
RECEIVED TIME.
14:30
Marion, NC 28752
REPORTED.,
9/4/2013
HA. LYSIS
:,.
--A
ANALYSIS
. &L-.-.
IRES T
'S.
UNITS
%7�
ANALYST
TDS
210
mg/L
819/13
lag
Chloride
5.0
mg/L
8/26/13
lag
T. Phosphows
0.21
mg/L
8/27/13
idg
TOC -
<1.0
mg/L
8/7/13
Sulfate
38.6
mg/L
8/7/13
metals
see attached
pH
8.4
stfs
8/6113
lag
LOG JD: 1308-108 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

wiwTvR6rr- cH 1 s./nc.
POST OFFICE BOX 1056 • n5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
(828) 3964444
SAMPLE: Coats America (MW#12) COLLECTION DATE: 8/6/2013
PERMITA- COLLECTION TIME. 08:13
ADDRESS., Coats America (Wells) RECEIVED DATE: 8/6/2013
P.O. Box 368 RECEIVED TIME." 14:30
Marion, NC 28752
REPORTED. 9/4/2013
ANALYSIS:
ANALYSIS: , .
RESULTS
UNITS :...
DATE
ANALYST
TDS
590
mg/L
8/9/13
lag
Chloride
5.0
mg/L
8/26113
lag
T. Phosphorus
0.25
mg/L
8/27113
jdg
TOG -
2.28
mg/L
8/7/13
Sulfate
58.0
mg/L
817/13
metals
see attached
pH
6.8
su's
8/6/13
lag
LOG ID: 1308-109 REPORTED BY: NC CERTIFIED LAB # 50
f�(Aliff
Tony Gragg, Lab Supervisor

vrxR6rtrcHLan,
POST OFFICE SOX 1056 - #5 PINEWOOD PLAZNDR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#13) COLLECTION PATE: 8/6/2013
PERMIT A COLLECTION TIME: 08:19
ADDRESS: Coats America (Wells) RECEIVED DATE: 8/6/2013
P.O. Box 368 RECEIVED TIME: 14:30
Marion, NC 28752
REPORTED. 9/4/2013
ANALYSIS
;
ANALYSIS
RESCILFS
UNITS
DATE
ANALYST .;
TDS
216
mg/L
8/9/13
lag
Chloride
<5.0
mg/L
8126113
lag
T. Phosphorus
<0.16 '
mg/L
8/27/13
jdg
TOC
1.31
mg/L
817/13
Sulfate
26.0
mg/L
8/7/13
metals
see attached
pH
6.2
su's
8/6/13
lag
LOG ID: 1308-110 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

URrAwCH .r/nc.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE., Coats America (MW#1 4)
COLLECTION DATE:
8/6/2013
PERMIT#.
COLLECTION TIME:
08:24
ADDRESS., Coats America (Wells)
RECEIVED DATE.,
8/6/2013
P.O. Sox 368
RECEIVED TIME.,
14:30
Marion, NC 28752
REPORTED:
91412013
ANALYSIS;
LTS
RESU
-UNITS.
DATE
ANALYST
TDS
546
mg/L
8/9/13
lag
Chloride
<5.0
mg/L
8126113
lag
.T. Phosphorus
0.21
mg/L
8/27113
jdg
TOC
4.96
mg/L
8/7113
Sulfate
61.1
mg/L
8/7/13
metals
see attached
pH
6.8
su's
8/6/13
lag
LOG ID: 1308-111 REPORTED BY: NC CERTIFIED LAB # 50
f�'. *
Tony Gragg, Lab Supervisor

r
warm R rcH I a— s-c_
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
(828) 3964444
SAMPLE: Coats America (MW#15) COLLECTION DATE: 8/6/2013
PERMIT A COLLECTION TIME: 08:33
ADDRESS., Coats America (Wells) RECEIVED DATE: 8/6/2013
P.O. Box 368 RECEIVED TIME.- 14:30
Marion, -NC 28752
REPORTED: 9/4/2013
AN�4LYSIS
ANALYSIS
RESULTS :.
UNITS '
DATE
ANALYST:.
TDS
360
mg/L
8/9/13
lag
Chloride
<5.0
mg/L
8/26/13
lag
T. Phosphorus
<0.16
mg/L
8/27/13
jdg
TOC
3.30
mg/L
817/13
Sulfate
65.6
mg/L
8/7/13
metals
see attached
pH
6.7
su's
816113
lag
LOG ID: 1308-112 REPORTED BY: NC_ CERTEFIED LAB # 50
Tony Gragg, Lab Supervisor

RESEARCh & ANA1yTiCA[
LABORATORIES, INC. 4
„ ¢ •+ o : cn
NCf34
- Analytical/Process Consultations
BRED
Water Tech Labs. Inc. Date Sample Collected : 08/06/13
P.O. Box 1056 Date Sample Received : 08/07/13
Granite Falls, NC 28630 Date Sample Analyzed : 08/'07/13
Attn: Joe Gragg Date of Report : 08/14/13
Analyses Performed by : AP -KL -JC
Lab Sample Number
764566
Parameter Storet # Results
TOC (00680) <1.0 mg/1
Sulfate (00945) 124 mg/l
Magnesium,Tot (00927) 15:7 mg/1
Lead,Tot (01051) 0.053 mg/l
Manganese,Tot (01055) 1.38 mg/1
Aluminum,Tot (01105) 4.19 mg/l
Calcium,Tot (00916) 30.0 mg/l
Chromium,Tot (01034) 0.006 mg/l
Cadmium,Tot (01027) <0.002 mg/l
Nickel,Tot (01067) 0.019 mg/l
Sodium,Tot (00929) 9.70 mg/l
Selenium,Tot (01147) <0.005 mg/l
Barium,Tot (01007) 0.148 mg/l
Arsenic,Tot (01002) 0.009 mg/l
--------------------
Clients Sample Source COATS AMERICAN MW2
Number
Time Collected (Hrs) 0745
P.O. Box 473. 106 Short Street - Kernersville, North Carolina 27284.336-996-2841 - Fax [phone]
www.randalabs.com

RESEARch & ANAIYTICAI.
LAbORATORIES, INC.
Analytical/Process Consultations
Cs C
*RED A%
Water Tech Labs. Inc.
Date Sample Collected :
08/06/13
P.O. Box 1056
Date Sample Received :
08/07/13
Granite Falls,
NC 28630
Date Sample Analyzed :
08/07/13.
Attn: Joe Gragg
Date of Report :
08/14/13
Analyses Performed by :
AP -KL -JC
Lab Sample Number
--------------
764567
Parameter
Storet #
Results
TOC
(00680)
<1.0 mg/l
Sulfate
(00945)
26.4 mg/l
Magnesium,Tot
(00927)
<0.500 mg/l
Lead,Tot
(01051)
<0.005 mg/1
Manganese,Tot
(01055)
<0.005 mg/l
Aluminum,Tot
(01105)
0.137 mg/l
Calcium,Tot
(00916)
<0.500 mg/l
Chromium,Tot
(01034).
<0.005 mg/1
.Cadmium,Tot
(01027)
<0.002 mg/1
Nickel,Tot
(01067)
0.009 mg/1
Sodium,Tot
(00929)
49.6 mg/1
Selenium,Tot
(01147)
<0.005 mg/1
Barium,Tot
(01007)
0.013 mg/l
Arsenic,Tot
(01002)
<0.005 mg/l
--------------------
Clients Sample Source COATS AMERICAN MW10
Number
Time Collected (Hrs) 0756
P.O. Box 473. 106 Short Street,• Kernersville, North Carolina 27284.336-996-2841 • Fax [phone]
www.randalabs.com

RESEARCh & ANALyTICA1
LZORATORIES, INC.
Analytical/Process Consultations
W.
:-
ac a cc NC
r� ' ����f�Y''• 5
Water Tech Labs. Inc.
Date Sample Collected :
08/06/13
P.O. Box 1056
Date Sample Received
: 08/07/13
Granite_ Falls,
NC 28630
Date Sample Analyzed
: 08/07/13
Attn: Joe Gragg
Date of Report
: 08/14/13
Analyses Performed by
: AP -KL -JC
Lab Sample Number
--------------------
764568
Parameter
Storet #
Results
TOC
(00680)
<1.0 mg/l
Sulfate
(00945)
38.6 mg/l
Magnesium,Tot
(00927)
21.9 mg/l
Lead,Tot
(01051)
<0.005 mg/l
Ma.nganese,Tot
(01055)
<0.005 mg/l
Aluminum,Tot
(01105)
0.125 mg/l
Calcium,Tot
(00916)
68.4 m4/1
Chromium,Tot
(01034)
<0.005 mg/1
Cadmium,Tot
(01027,)
<0.002 mg/l
Nickel,Tot
(01067)
0.024 mg/l
Sodium,Tot
(00929)
17.2 mg/l
Selenium,Tot
(01147)
<0.005 mg/l
Barium,Tot
(01007)
0,046 mg/l
Arsenic,Tot
(01002)
<0.005 mg/l
--------------------
Clients Sample -Source COATS AMERICAN MW11R
Number
Time Collected (Hrs) 0802
P.O. Box 473. 106 Short Street - Kernersville, North Carolina 27284.336-996-2841 - Fax [phone]
www.randalabs.com

Aft
RESEARch & ANA[yTICA1 `
LABORATORIES, INC.
M �:y Zt PZ
,•. = NO
�i34 _
-p, Analytical/Process Consultations
Water Tech Labs. Inc. Date Sample Collected : 08/06/13
P.O. Box 1056 Date Sample Received : 08/07/13
Granite Falls, NC 28630 Date Sample Analyzed : 08/07/13
Attn: Joe Gragg. Date of Report : 08/14/13
Analyses Performed by : AP -KL -JC
Lab Sample Number
--------------------
764569 x
Parameter Storet # Results
TOC 2.28 mg/l
Sulfate (00945) 58.0 mg/l
Magnesium,Tot (00927) 13.9 mg/l
Lead,Tot (01051) <0.005 mg/l
Manganese,Tot (01055) 4.06 mg/l
Aluminum,Tot (01105) 0.114 mg/l
Calcium,Tot (00916) 92.1 mg/l
Chromium,Tot (01034) <0..005 mg/l
Cadmium,Tot (01027) <0.002 mg/l
Nickel,Tot (01067) 0.048 mg/l
Sodium,Tot (0'0929) 114 mg/l
Selenium,Tot (01147) <0.005 mg/1
Barium,Tot (01007) 0.150 mg/1
Arsenic,Tot (01002) <0.005 mg/l
--------------------
Clients Sample Source COATS AMERICAN MW12
Number
Time Collected (Hrs) 0813
P.O. Box 473. 106 Short Street • Kernersville. North Carolina 27284.336-996-2841 • Fax [phone]
www.randalabs.com

RESEARCLI & ANALYTICAL �ION
•••• r .•••4 C•••. ++
-_ LkO-RATORIES, INC. 0 a •
NOWz•
#34 _
Analytical/Process Consultations J-
��i � •'•• �REGKb4' �5 •�•�
Water Tech Labs. Inc.
Date Sample Collected
08/06/13
P.O. Box 1056
Date Sample Received
08/07/13
Granite Falls,
NC 28630
Date Sample Analyzed
08/07/13
Attn: Joe Gragg
Date of Report
08/14/13
- Analyses Performed by
AP -KL -JC
Lab Sample Number
--------------------
764570
Parameter
Storet #
Results
TOC
(00680)
1.31 mg/1
Sulfate
(00945)
26.0 mg/l
Magnesium,Tot
(00927)
7.20 mg/l
Lead,Tot
(01051)
<0.005 mg/1
Manganese,Tot
(01055)
0.182 mg/l
Aluminum,Tot
(01105)
0.029 mg/l
Calcium,Tot
(00916)
11.4 mg/l
Chromium,Tot
(01034)
<0.005 mg/l
Cadmium,Tot
(01027)
<0.002 mg/1
Nickel,Tot
(01067)
0..012 mg/l
Sodium,Tot
(00929)
62.1 mg/l
Selenium,Tot
(01147)
<0.005 mg/l
Barium,Tot
(01007)
0.030 mg/l
Arsenic,Tot
(01002)
<0.005 mg/1
--------------------
Clients Sample Source COATS AMERICAN MW13
Number
Time Collected (Hrs) 0819
P. 0. Box 473. 106 Short Street • Kernersville, North Carolina 27284.336-996-2841 • Fax [phone]
www.randalabs.com

RESEARch & ANA[yTICA1
LAhORATORIES, INC.
Analytical/Process Consultations
v
Water Tech Labs. Inc. Date Sample Collected 08/06/13
P.O. Box 1056 Date Sample Received 08/07/13
Granite Falls, NC 28630 Date Sample Analyzed 08/07/13
Attn: Joe Gragg. Date of Report 08/14/13
Analyses Performed by AP -KL -JC
Lab Sample Number .
--------------------
764571
Parameter Storet # Results
TOC
(00680)
4.96 mg/l
Sulfate
(00945)
61.1 mg/1
Magnesium,Tot
(00927)
35.2 mg/l
Lead,Tot
(01051)
<0.005 mg/1
Manganese,Tot
(01055)
0.570 mg/l
Aluminum,Tot
(01105)
0.196 mg/l
Calcium,Tot
(00916)
55.9 mg/1
Chromium,Tot
(01034)
<0.005 mg/l
Cadmium,Tot
(01027)
<0.002 mg/l
Nickel,Tot
(01067)
0.030 mg/l
Sodium,Tot
(00929)
92.4 mg/1
Selenium,Tot
(01147)
<0.005 mg/l
Barium,Tot
(01007)
0.144 mg/1
Arsenic,Tot
(01002)
<0.005 mg/l
--------------------
Clients Sample Source COATS AMERICAN MW14
Number
Time Collected (Hrs) 0824
P. 0. Box 473. 106 Short Street - Kernersville, North Carolina 27284.336-996-2841 - Fax [phone]
uwwv.randalabs.com

RESEARch & ANA[yTICA[
LAbORATORIE- , INC.
Analytical/Process Consultations
,�1�iir r rU��i
¢ � NC Z! cn Z.
#34
� b
Water Tech Labs. Inc. Date Sample Collected : 08/06/13
P.O. Box 1056 Date Sample Received : 08/07/13
Granite Falls, NC 28630 Date Sample Analyzed : 08/07/13
Attn: Joe Gragg Date of Report : 08/14/13
Analyses Performed by : AP -KL -JC
`Lab Sample Number
-----------------
764572
Parameter Storet # Results
TOC
3.30 mg/1
Sulfate
(00945)
65.6 mg/l
Magnesium,Tot
(00927)
26.1 mg/l
Lead,Tot
(01051)
0.013 mg/l
Manganese,Tot
(01055)
1.23 mg/l
Aluminum,Tot
(01105)
0.794 mg/l
Calcium,Tot
(00916)
79.4 mg/l
Chromium,Tot
(01034)
<0.005 mg/l
Cadmium,Tot
(01027)
<0.002 mg/1
Nickel,Tot
(01067)
0.045 mg/l
Sodium,Tot
(00929)
22.2 mg/l
Selenium,Tot
(01147)
<0.002 mg/l
Barium,Tot
(01007)
0.132 mg/1
Arsenic,Tot
(01002)
<0.005 mg/1
--------------------
Clients Sample Source COATS AMERICAN MW15
Number
Time Collected (Hrs) 0833
P.O. Box 473. 106 Short Street • Kernersville, North Carolina 27284.336-996-2841 • Fax [phone]
www.randalabs.com

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:J.
Permit Name (if
Facilitv Address:
Contact Person:- 3:311 11 1
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County 11'Lr1l(iW+t-1 t
Telephone #: Rai -r 'f --'
No. of Wells to be Sampled:
Well Identification Number (from Permit): T11 W " cat
Well Depth: it. Well Diameter: _
Screened Interval: ft. to } Pf ft.
Depth to Water Level: Left. below measuring point.
Measuring Point (M.P.) is: ft. above land surface.
Gallons of water pumped/bailed before sampling:
Field analysis: pH_ 1 , Specific Conductance
Temp. °C, Odor A
PARAMETERS (Samples for metals were collected i
COD
mg/I
Coliform: MF Fecal /100ml
Coliform: MF Total 1100ml
(Note: Use MPH method for high) turbid samples)
Dissolved Solids: Total t4-12- 90
mg/I
PH (when analyzed) `� -9 �+ 1
units
TOC_ -1N Z'1 . r�
mg/I
Chloride LI-12 (n::3
mg/I
Arsenic Ll -1 1 L 01 CQS
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate y +11 �- I©_
mg/l
Specific Conductance uMhos
Total Ammonia
mg/I
TKN as N
mg/I
For Groundwater Treatment Systems
in. Check One: ❑ Influent (98)
❑ Effluent (99)
DEPARTMENT OF ENVIRONMENT & NATURAL RESC
WATER QUALITY DIVISION, GROUNDWATER SECTIO
1636 MAIL SERVICE CENTER
PERMIT #: W QW05(.00 EXPIRATION DATE: _
Non -Discharge UIC -,* O
NPDES
TYPE PERMITTED OPERATION BEING MONITORED 0 Q
Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation: (D
Rotary Distributor Land Applic U I Sludge
Other:
NOTE: Values should reflect dissolved and MAY 2 12013
colloidal concentrations.
Relative M.P. Elevation in ft: WATER QUALITY SECTION`
_(� Date sample collected: Date sample analyzed: (it' &, rC) f'I�RMATION PROCESSING UNIT
uMhos Laboratory Name: _ �APC 'TPQb
ppearance Certification No.
ered/NYES NO and field acidified
Nitrite (NO2) as N
mg/l
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P C/ fZyLIR
mg/I
Orthophosphate.
mg/I
Al - Aluminum H rl1 o, R 3
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd -Cadmium '� -11 o. on a-
mg/l
Chromium: Total -i 1 6,WS
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium -I Irk
mg/I
Mn - Manganese_C-I-11 6.316
mg/I
/\ YES NO)
Ni - Nickel y -11 <a �5 mg/1
Pb -Lead-0 I mg/I
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
M;
M
l
ElIPOiJrn L)-11 LCi= OS f �tj sz
Sr)cl i L) 14- l l
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No, (0)
VOC method # =
method # _
method # =
Rev. 03/2000

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: C-ap American
Permit Name (if different :
Facility Address: T O
Contact Person: ram=(
Well Location/ Site Name:
County f 11' L)O let 1
Telephone #: 2as -15(o - Ll
No. of Wells to be Sampled:.
Well Identification Number (from Permit): ML-0- 16 For Groundwater Treatment Systems
Well Depth: 1 %_ it. Well Qiameter.. a in. Check One: ❑ Influent (98)
Scr11 eened lnlerval: n3 Pt ft. to iJ I A �ft. ElEffluent (99)
Depth to Water Level: to .1 ft. below measuring point.
Measuring Point (M.P.) is: a,3 it. above land surface. Relative M.P. Elevation in
Gallons of water pumped/bailed before sampling: "— Date sample collected:
Field analysis: pH tD , Specific Conductance uMhos
Temp._°C, Odor Appearance
PARAMETERS (Samples for metals were collected unfilte
COD mg/I
Coliform: MF Fecal /100m1
Coliform: MF Total /100m1
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total LI - IZ
1N Lk mg/I
pH (when analyzed)'-1 -R
units
TOC f-1- 2G
1.0 mg/I
Chloride 41 1
to . 3 mg/I
Arsenic y -11
4 a.0O5 mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate !A -IN
ZR.L1 mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/l
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC 27699-1636 Phone: [phone]:
PERMIT #: W O C' WS (o 03 EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
-9 -/ Date sample analyzed: OS& t? Ip t.')
LaboratoryName: 16�cffi,1 -Tec-h
Certification No. qn
red_ /\ YES -NO and. field acidified
Nitrite (NO2) as N mg/I
Nitrate (NO3) as N mg/I
Phosphorus: Total as P 9-1Q Lo,18 mg/I
Orthophosphate mg/I
AI - Aluminum 14-11 40.C)RS mg/I
Ba - Barium _N -11 O .00(0 mg/I
Ca - Calcium LI-11 LD s5oo mg/I
Cd - Cadmium 4-11 4 0 009 mg/I
Chromium: Total W -11 4, 0 , 005 mg/I
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potassium mg/I
Mg - Magnesium �1-11 Lo �oomg/I
Mn - Manganese 4-11 40.005 mg/l
—A YES NO)
Ni - Nickel_ _`I-11 4.0. L05 mg/I
Pb - Leader -11 O f 00's mg/I
Zn - Zinc mg/l
Ammonia Nitrogen mg/l
Other (SpecifyCompoundsand Concentration Units)
10.0
0 • f0 Ma I .Q
Se.lPYli LJm y -11
0.66 5 MA
a
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
method # =
method # =

'SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: cpalb American
Permit Name (if different
Facilitv Address: FAD C)X `6te$
Contact Person: rf
Well Location/ Site Name:
County
Telephone #: ' 11510 -L
No. of Wells to be Sampled:
Well Identification Number (from Permit): 1 I 1(; For Groundwater Treatment Systems
Well Depth: '6� ft. Well Diameter- cZ in. Check0ne: ❑ Influent (98)
Screened Interval: —N- ft. to 1 ft. ❑ Effluent (99)
Depth to Water Level: ff. below measuring point.
Measuring Point (M.P.) is: a it. above land surface. Relative M.P. Elevation in #t.:
Gallons of water pumped/bailed before sampling: 9 Date sample collected: ^
Field analysis: pH S - O , Specific Conductance uMhos
Temp. Z0 °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC 27699-1636 Phone: [phone]
PERMIT #: LA)& (M()S(D03 'EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 5 P %ln c
Laboratory Name: 1 Pr Teoun
Certification No. 50
PARAMETERS (Samples for metals were -collected unfiltered A YES
NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as
P y -29 LO•l to
mg/I
(Note: Use MPN method for highly turbid
samples)
Orthbphosphate
mg/I
Dissolved Solids: Total L>-12 ZZ2 mg/I
Al - Aluminum LI-11
46. 025
mg/I
pH (when analyzed) L1-051
units
Ba - Barium Ll -1k
01038
mg/I
TOC y-I1
mg/I
Ca - Calcium Ll-I1
36. to
mg/I
Chloride tJ- -1'Z
to 5 mg/I
Cd -Cadmium U-11
10-00--L
mg/I
Arsenic LA-1)
40.005 mg/I
Chromium: Total L4-I1
40IM5
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate
AWA mg/I
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg -Magnesium 14-11
1'71-9
mg/I
TKN as N
mg/I
Mn -Manganese LA -11
1,01005
mg/I
_,EYES NO)
Ni - Nickel y -11 4 0 -008 mg/1
Pb - Lean `^I-1 1_ 4o cm,5, mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
method # =
method # =

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:s
Permit Name (if
Facility Address:
Contact Person:3:ff 1% "'
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County f f 'V tJUWC t 1
Telephone #:
No. of Wells to be Sampled:
Well Identification Number (from Permit): M W - I Z- For Groundwater Treatment Systems
Well Depth: I r_� ft. Well Diameter. Q in. Check One: ❑ Influent (98)
Screened Interval: ft. to it.
ElEffluent (99)
Depth to Water Level: 8 ft. below measuring point.
Measuring Point (M.P.) is: ISO ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: I & 5 Date sample collected: LA -13
Field analysis: pH S Specific Conductance uMhos
Temp. °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH. NC 27699-1636 Phnno- M M 777-17-
PERMIT #: LO Q 0oa 5(c03 EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
_ Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: S,ee 5fl e-m-z
Laboratory Name: (A--) T-e to
Certification No. O
PARAMETERS (Samples for metals were collected unfiltered )k YES NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P L-1-29 �O.l b
mg/I
(Note: Use MPN method for highly turbid samples)
LHZ tDSLI
Orthophosphate
mg/I
Dissolved Solids: Total
mg/I
Al -Aluminum 4-11 4 b. oZS
mg/I
pH (when analyzed) CI
units.
Ba - Barium L1 -11 0, 101
mg/I
TOC -11
mg/i
Ca - Calcium 14 -11 r12. 3
a
mg/I
Chloride 4-12
(o.o mg/I
Cd - Cadmium -11 L.p100Z
mg/I
Arsenic L1-11
40-U05 mg/I
Chromium: Total LI-11 4.0�UUS
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate y-I 1
ti b• O mg/I
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium 14-11 13.6
mg/I
TKN as N
mg/I
Mn - Manganese L1 -11 21 $5
mg/I
x YES NO)
Ni - Nickel. L� 11 mg/1
Pb - Lead-9 -1 1 4 O• DOS mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
iL4 -I I R'g Mall
14 -1 t O Lc� 4I,9,
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
method # _
method #

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:
Permit Name (if
FAddress:
M ('I br.,
Contact P
Well Location/ Site Name:
n
SUBMIT FORM ON YELLOW PAPER ONLY
Please Pr/nt Clearly or Type
County 9 f 11 ' kJU t
Telephone #:
No. of Wells to be Sampled:
Well Identification Number (from Permit): VY)W -13 For Groundwater Treatment Systems
Well Depth: 151 ft. Well Diameter: Z in. Check One: ❑ Influent (98)
Screened Interval: �F ft. to &jI A ft.
El Effluent (99)
Depth to Water Level:__Q'!_g below measuring point.
Measuring Point (M.P.) is: I -AD ft. above land surface. Relative M.P. Elevation In ft.:
Gallons of water pumped/bailed before sampling: 1 5 Date sample collected: y.'4-1.3
Field analysis: pH 3 , Specific Conductance uMhos
Temp. __U0_ °C, Odor Appearance
PARAMETERS (Samples for metals were collected unfilte
-COD mg/l
Coliform: MF Fecal /100m1
Coliform: MF Total /100m1
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total a-12
Zl0 mg/I
pH (when analyzed) 4-01
65 units
TOC 4-It
1 it-15 mg/I
Chloride W-1Z
45to mg/I
Arsenic y -1l
/,0 -005 mgll
Grease and Oils
mg/I
Phenol
mg/I
Sulfate -11
43 mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
DEPARTMENT OF ENVIRONMENT $ NATURAL RESOURCES
WATER OUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC 27699-1636 phnnP* 1a7 41 7'41-111,
PERMIT#:t#-)c?Ocx36(o03 EXPIRATION DATE:
Non -Discharge U IC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
— Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other: _
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed:
LaboratoryName: -_ WQ} P r T
Certification No. SO
red_ A YES NO and field acidified
Nitrite (NO2) as N mg/I
Nitrate (NO3) as N mg/I
Phosphorus: Total as PL4-Z9 40,16 mg/I
Orthophosphate mg/I
Al - Aluminum LI-11 D1024 mg/I
Ba - Barium LA - I I �9.5 mg/I
Ca - Calcium-11 0l (00 mg/I
Cd -Cadmium �� -1 1 c� .002 mg/I
Chromium: Total LI -11 t o.006 mg/I
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potassium mg/I
Mg - Magnesium -y-11 (D.50 mg/I
Mn - Manganese_U -11 b.Od2 mg/I
YES NO) .
Ni -Nickel. �I-11 4,6,t0S mg/1
Pb - Lead LA -1 1 0 005 mg/I
Zn - Zinc mg/1
Ammonia Nitrogen mg/1
Other (Specify Compounds and Concentration Units)
t M —t
Ven*Om 14-
rn
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
method # =
method # =

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:S
Permit Name (if i
Facility Address:
Contact Person:r' I 1!i"
Well Location/ Site Name:.
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County I I I' I
Telephone #: 0%1 (o.
No. of Wells to be Sampled:
Well Identification Number (from Permit): - I For Groundwater Treatment Systems
Well Depth: Is ft. Well Diameter- 2 in. Check One: ❑ Influent (98)
Screened Interval: AAA ft. to J ft.
❑ Effluent (99)
Depth to Water Level: lot I to ft. below measuring point.
Measuring Point (M.P.) is: a 1 to ft. above land surface. Relative M.P. Elevation In ft.:
Gallons of water pumped/bailed before sampling: 2.aS Date sample collected: y -4
Field analysis: pH0 , Specific Conductance _ uMhos
Temp. 1 °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #:'lam Q00C) %(a03 EXPIRATION DATE:
Non -Discharge
NPDES
UIC
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: _
Laboratory Name: W er T� h0�—
Certification No. _ IC-10
PARAMETERS (Samples for metals were collected unfiltered)� YES NO and field acidified
COD mg/I Nitrite (NO2) as N mg/I
Coliform: MF Fecal /100m1 Nitrate (NO3) as N mg/I
Coliform: MF Total. /100ml Phosphorus: Total as P U-Zq L�,tlo mnLl
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total y -I 'Z 39 (o
mg/I
pH (when analyzed) 11-4 6-0
units
TOC q-11 , 5$
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate LA -►1 t-Ib I 55
mg/I
Specific Conductance uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Orthophosphate
mg/I
Al - Aluminum 1�_ F.
So,n25 mg/I
Ba -Barium y -11
D, o$ 1 mg/I
Ca - Calcium 14 -11
(PLA i to mg/I
Cd - Cadmium 9 -11
4 o , oo—r- mg/I
Chromium: Total A-lj
40-(�5 mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium Ll-11
140.9 mg/I
Mn - Manganese y--11
h,?0'1 ma/I
YES NO)
Ni - Nickell I C b, c S mg/I
Pb - Lead Ll -11 4.o . 005 mg/1
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
� i ot,r%
Delfni om y -11
4.0,OOS nna ,Q
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes(1) No (0)
VOC . : method # =
method # =
method # =

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: L
Permit Name (if
Facility Address:
Contact Person: V It I►I
Well Location/ Site Name:
Al
'SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County I I ►- lu 3 ue 11
Telephone #: (D
No. of Wells to be Sampled:
Well Identification Number (from Permit): M LA) -15
Well Depth: 1 to it. Well DiameterZ
Screened Interval: A -)I f ft. to X- ft.
Depth to Water Level: 3 ft. below measuring point.
Measuring Point (M.P.) is:_La It. above land surface.
Gallons of water pumped/bailed before sampling: �
Field analysis: pH (oI 4 _ , Specific Conductance
. Temp. 1q QC, Odor A
PARAMETERS (Samples for metals were collected un
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPH method for high) turbid samples)
Dissolved Solids: Total -12 0 m9 /I
pH (when analyzed) L1-G (o%Ll units
TOC L` -11 I , c50 mg/I
Chloride 'A-12
45, O g
m /I
Arsenic W-11
mg/I
Grease and Oils
Phenol
Sulfate -11
mg/1
mg/I
22, to mg/I
Specific Conductance
- uMhos
Total Ammonia
TKN as N
mg/I
mg/1
For Groundwater Treatment Systems
in. Check one: ❑ Influent (98)
El Effluent (99)
Relative M.P. Elevation In ft.:
Date sample collected:
uMhos
DDearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: W Q 0WSkc03 EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 5 FolA%_0
Laboratory Name: kPr Tech
Certification No. 50
tared A YES
NO and field acidified
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as Py-29 1,0,I b
mg/I
Orthophosphate
mg/I
Al - Aluminum A-11
4.b.cx5
mg/1
Ba - Barium 4-11
6,pgI
mg/I
Ca - Calcium _ 4 -11
"7 2 1
mg/I
Cd -Cadmium 14-1 I
mg/I
Chromium: Total 4-11
4.O,yo5
m9 /I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium A-1 I
2S,q
mg/I
Mn -Manganese -11
1,35
mg/I
RYES NO) -
Ni - Nickel L1-11 4,0,005 g/
m I
Pb - Lead L1-11 0 1005 mg/I
-Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
- 1
16A
_Se 1-ent orv-N L1-11
�o.t�S m4
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
method #
m 011-4 4 _

RTER4T CH L178-5.Inc.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#02) COLLECTIONDATE:
4/9/2013
PERMITA- COLLECTION TIME:
09:13
ADDRESS: Coats America (Wells) RECEIVED DATE:
4/9/2013
P.O. Box 368 RECEIVED TIME:
15:00
Marion, NC 28752
REPORTED:
5/10/2013
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST' .
TDS
90
mg/L
4/12/13
lag
Chloride
6.3
mg/L
4/12/13
lag
T. Phosphorus
0.18
mg/L
4/29/13
)dg
TOC
<1,0
mg/L
4/11/13
Sulfate
<10.0
mg/L
4/11/13
metals
see attached
pH
7.9
su's
4/9/13
lag
LOG ID: 1304-199 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

I
1d r , 4mcm murs.Inc.
4
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28530
[phone]
SAMPLE: Coats America (MW#10) COLLECTION DATE:
4/9/2013
PERMIT #. COLLECTION TIME:
09:23.
ADDRESS: Coats America (Wells) RECEIVED DATE.,
4/9/2013
P.O. Box 368 RECEIVED TIME:
15:00
Marion, NC 28752
REPORTED:
5/10/2013
ANALYSIS
ANALYSIS
'RESULTS
UNITS
DATE
ANALYST
TDS
144
mg/L
4112113
lag
Chloride
6.3
mg/L
4112/13
lag
T. Phosphorus
<0.16
mg/L
4/29/13
ldg
TOC
<1.0
mg/L
4111/13
Sulfate
38.4
mg/L
4/11/13
metals
see attached
pH
6.6
su's
4/9/13
lag
' LOG ID: 1304-200 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

IdOrER ECH LITIPSInc.
POST OFFICE BOX 1056 • 46 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#11 B) COLLECTION DATE:
4/9/2013
PERMIT #: COLLECTION TIME:
09:35
ADDRESS: RECEIVED DATE:
4/9/2013
RECEIVED TIME:
15:00
REPORTED:
5/10/2013
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TDS
222
mg/L
4/12/13
lag
Chloride
6.5
mg/L
4/12/13
lag
T. Phosphorus
<0.16
mg/L
4129/13
ldg
TOC
<1.0
mg/L
4/11/13
Sulfate
51.4
mg/L
4/11/13
metals
see attached
pH
8.5
su's
4/9113
lag
,a
LOG ID: 1304-201 REPORTED BY: NC CERTIFIED LAB # 50
fl�
Tony Gragg, Lab Supervisor

M
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#12) COLLECTION DATE:
4/9/2013
PERMITA- COLLECTION TIME:
09:48
ADDRESS: Coats America (Wells) RECEIVED DATE:
4/9/2013
P.O. Box 368
RECEIVED TIME:
15:00
Marion, NC 28752
REPORTED:
5/10/2013
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TDS
.654
mg/L
4/12/13
lag
Chloride
6.0
mg/L
4/12113
lag
T. Phosphorus
<0.16
mg/L
4/29/13
Jdg
TOC
1.96
mg/L
4/11/13
Sulfate
<10.0
mg/L
4/11/13
metals
see attached
pH
6.8
su's
4/9/13
lag
LOG ID: 1304-202 REPORTED BY: NC CERTIFIED LAB # 50
fo� *
Tony Gragg, Lab Supervisor

"RiTECH LRE•ICiC.
f
POST OFFICE BOX 1056 • 45 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#13) COLLECTION DATE:
4/9/2013
PERMIT #: COLLECTION TIME:
10:01
ADDRESS: Coats America (Wells) RECEIVED DATE.
4/9/2013
P.O. Box 368 RECEIVED TIME:
15:00
Marion, NC 28752
REPORTED:
5/10/2013
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TDS
210
mg/L
4112/13
lag
Chloride
<5.0
mg/L
4/12/13
lag
T. Phosphorus
<0.16
mg/L
4/29113
jdg
TOC
1.45
mg/L
4/11113
Sulfate
43.9
mg/L
4111/13
metals
see attached
pH
6.3
su's
4/9113
lag
LOG ID: 1304-203 REPORTED BY: NBC, CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

miumirrCH LIT11.5-inc,
i
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#14) COLLECTION DATE:
4/9/2013
PERMIT #: COLLECTION TIME:
10:08
ADDRESS: Coats America (Wells) RECEIVED DATE
4/9/2013
P.O. Box 368
RECEIVED TIME:
15:00
Marion, NC 28752
REPORTED:
5/10/2013
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TDS
396
mg/L
4/12113
lag
Chloride
<5.0
mg/L
4/12/13
lag
T. Phosphorus
<0.16
mg/L
4/29/13
jdg
TOC
2.38
mg/L
4/11/13
Sulfate
40.5
mg/L
4/11/13
metals
see attached
pH
6.7
su's
419113
lag
LOG ID: 1304-204 REPORTED BY: NC CERTIFIED LAB # 50
ff� *
Tony Gragg, Lab Supervisor

ldfirEriv
e
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS. NORTH CAROLINA 28630
(828) 39&4444
SAMPLE: Coats America (MW#15) COLLECTION DATE: 4/9/2013
PERMIT #: COLLECTION TIME: 10:18
ADDRESS: Coats America (Wells) RECEIVED DATE.- 4/9/2013
P.O. Box 368 RECEIVED TIME: 15.00
Marion, NC 28752
REPORTED: 5/10/2013
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
TDS
330
mg/L
4/12113
lag
Chloride
<5.0
mg/L
4/12/13
lag
T. Phosphorus
<0.16
mg/L
4/29/13
Jdg
TOC
1.50
mg/L
4/11113
Sulfate
22.6
mg/L
4/11/13
metals
see attached
pH
6.6
su's
- 419/13
lag
LOG ID: 1304-205 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

RESEARCh & ANA1yTICA1
LAbORATWES, INC.
Analytical/Process Consultations
♦iit��►I Iltfl�tl
ly
Z
w . . V.
14; 416) ANw `ii`
�40ti11'311106
Water Tech Labs. Inc.
Date
Sample Collected
04/09/13
P.O. Box 1056
Date
Sample Received
04/11/13
Granite Falls, NC 28630
Date
Sample Analyzed
04/11/13
Attn: Joe Gragg
Date
of Report
05/01/13
Analyses Performed by
JC -SK
Lab Sample Number
-----------------
755496
Parameter Storet # - Results
Magnesium,Tot
(00927)
7.32 mg/l
Lead,Tot
(01051)
0.012 mg/l
Manganese,Tot
(01055)
0.316 mg/1
Aluminum,Tot
(01105)
0.823 mg/1
Calcium,Tot
(00916)
13.7 mg/1
Chromium,Tot
(01034)
<0.005 mg/1
Cadmium,Tot
(01027)
<0.002 mg/1
Nickel,Tot
(01067)
<0.005 mg/l
Sodium,Tot
(00929)
9.30 mg/1
Selenium,Tot
(01147)
<0.005 mg/1
Barium,Tot
(01007)
0.055 mg/1
Arsenic,Tot
(01002)
<0.005 mg/1
TOC
<1.0 mg/1
Sulfate
(00945)
<10.0 mg/1
--------------------
Clients Sample Source MW2
Number COATS AMERICAN.
Time Collected Mrs) 0913
P.O, Box 473 • 108 Short Street • Kernersville, North Carolina 27284.336-996-2841 • Fax [phone]
www.randalabs.com

onx
ANAL yp
to
LAbORATORiES, INC.
rc
f flow
Analytical/ rocess Consultations `
Water Tech Lab
a. Inc.zoo. o��o Sample Collected ' o�/o�/�y
P.O. Box 1056 Date Sample Received 04/11/13
Granite Falls, mc 28630 Date Sample Analyzed . 04/11/13
Attn: doe oragg ' Date of Report 05/01/13
Analyses Performed by ; JC -SK
_ Lab Sample Number
-----^---'----------
' 7ss4y7
Parameter Storet # Results .
Magneainm,rot (00927) ^o,sno mg/l
Lead'Tot (01051) <o'oos mg/l
Mazgna000c'rpt (01055) ^o'oos.mg/l
Alomioum,zpt (01105) ^n'nas mg/l
Calcium,Tot (VOyzs) *n.soo mg/l
zhromium,Tot (01034) <o.00s mg/1 '
oadmiom,rot (010e7) ^u.ouz mg/l
miokal,Tot <01067> <0.005 mg/1
Godium,Tot (00929) *6.8 mg/l
Seleoiom,rot (01147) <n.00s mg/l
aazinm'Tot (01007) 0.006 mg/l
Aroenlo,Tot (0I002) <u'oos mg/l '
ToC <z.o mg/l
Sulfate (00945) 38.4 mg/l
`
-------------
Clienta.aamgIo Source Mw10
Number ' COATS JmxERICaN
Time Collected (ors) oecs
P,c\Box 473^106 Short Street ^Ko,nerovme,North Carolina a7o84^336-goo'e841-Fax o3G'9aa-0oeO
`

ttti►�l Ir11UO,?,d
RESEARCh & ANA[.YTICA[ ``'���+& +cry, Oi*`�
LAbORATWES, INC.
NC #34' c+q
Analytical/Process Consultations t
C► '
��i�, it► , ..........
A ......
Water Tech. Labs. Inc. Date Sample Collected 64/09/13
P.O- Box 1056 Date Sample Received 04/11/13
Granite Falls, NC 28630 Date Sample Analyzed 04/11/13
Attn: Joe Gragg Date of Report 05/01/13
Analyses Performed by JC -SK
Lab Sample Number
--------------------
755498
Parameter Storet # Results
Magnesium,Tot (00927) 17.9 mg/1
Lead,Tot (01051) <0.005 mg/1
Manganese,Tot (01055) <0.005 mg/1
Aluminum,Tot (01105) <0.025 mg/1
Calcium,Tot (00916) 36.6 mg/1
Chromium,Tot (01034) <0.005 mg/1
Cadmium,Tot (01027) <0.002 mg/1
Nickel,Tot (01067) <0.005 mg/1
Sodium,Tot (00929) 17.3 mg/1
Selenium,Tot (01147) <0.005 mg/1
Barium,Tot (01007) 0.038 mg/1
Arsenic,Tot (01002) <0.005 mg/1
TOC <1.0 mg/l
Sulfate (00945) 51.4 mg/l
--------------------
Clients Sample Source MW11
Number COATS AMERICAN
Time Collected (Hrs) 0935
P 0. Box 473 • 106 Short Street • Kernersville, North Carolina 272B4 • 336-996-2841 • Fax [phone]
www,randelahs.com

1"r4F
RESEARCh & A NALyTiCAL
LAbORATWES, INC. .'1�
_ # e
Analytical/Process Consultations S J
�lllrrayU,1��
Water Tech Labs. Inc. Date Sample Collected 04/09/13
P.O. Box 1056 Date Sample Received : 04/11/13
Granite Falls, NC 28630 Date Sample Analyzed 04/11/13
Attn: Joe Gragg Date of Report 05/01/13
Analyses Performed by : LTC -SK
Lab Sample Number
---------------------
755499
Parameter Storet #k Results
Magnesium,Tot (00927) 13.6 mg/1
Lead,Tot (01051) <0.005 mg/l
Manganese,Tot (01055) 2.85 mg/l
Aluminum,Tot (01105) <0.025 mg/1
Calcium,Tot (00916) 72.3 mg/l
Chromium,Tot (010#34) <0.005 mg/l
Cadmium,Tot (01027) <0.002 mg/1
Nickel,Tot (0167) 0.007 mg/1
Sodium,Tot (00929) 128 mg/1
Selenium,Tot (01147) <0.005 mg/1
Barium,Tot (01007). 0.101 mg/1
Arsenic,Tot (01002) <0.005 mg/1
TOC 1.96 mg/1
Sulfate (00945) <10.0 mg/l
Clients Sample Source
Number
Time Collected (Hrs)
--------------------
MW12
COATS AMERICAN
0948
P.O. Box 473 • 10B Short Street • Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone]
www.randelabs.com

14161111 %
RESEARchANALyTicAL &.!rT/'rr�r
- LABORATORIES, INC.
wt1c;�- 0.Nw
No #34 x, ' ..
Analytical/Process Consultations {
S +.
4b
`r� f��13 AN',V0 �'►t�
Water Tech Labs. Inc. Date Sample Collected 04/09/13
Q.O. Box 1056 Date Sample Received : 04/11/13
Granite Falls, NC 28630 Date Sample Analyzed 04/11/13
Attn: Joe Gragg Date of Report : 05/01/13
Analyses Performed by JC -SK
Lab Sample Number
--------------------
755500
---------------
Parameter Storet # Results
Magnesium,Tot (00927) 6.50 mg/l
Lead,Tot (01051) <0.005 mg/1
Manganese,Tot (01055) 0.042 mg/l
Aluminum,Tot (01105) 0.032 mg/1
Calcium,Tot (00916) 9.60 mg/l
Chromium,Tot (01034) <0.005'mg/1
Cadmium,Tot (01027) <0.002 mg/l
Nickel,Tot (01067) <0.005 mg/l
Sodium,Tot (00929) 65.2 mg/l
Selen.ium,Tot (01147) <0.005 mg/1
Barium,Tot (01007) 0.025 mg/l
Arsenic,Tot (01002) <0.005 mg/1
TOC - 1.45 mg/1
}
Sulfate (00945) 43.9 mg/l
--------------------
Clients Sample Source MW13
Number COATS AMERICAN
Time Collected (Hrs) 1001
P.O. Box 473 • 106 Short Street • Kernersville. North Carolina 27284 • 336-996-2841 • Fax [phone]
www.randalabs.com

�,,�j�111111►►tt
RESEARCh & ANA[yTlCA[
�'o .`ZL AN +°
�yr, Clio
yi
L.Ab®RAT®RlES, INC.
i(
V f�
`;4'±4.
D . va
-
to IVC #3� +
Analytical/Process Consultations
ta►aY��s
Water Tech Labs, Inc.
Date Sample Collected
: 04/09/13
P.O. Sox 1056
Date Sample Received
04/11/13
Granite Falls, NC 28630
Date Sample Analyzed
04/11/13
Attn: Joe Gragg
Date of Report
: 05/01/13
Analyses Performed by ;
J'C -SK
Lab Sample Number
--------------------
755501
Parameter Storet #
Results
Magnesium,Tot (00927)
40.7 mg/l
Lead,Tot (01051)
<0.005 mg/l
Manganese,Tot (01055)
0.307 mg/l
Aluminum,Tot (01105)
<0.025 mg/l
Calcium,Tot (00916)
64,6 mg/l
Chromium,Tot (01034)
<0.005 mg/l
Cadmium,Tot (01027)
<0.002 mg/l
Nickel,Tot (01067)
<0.005 mg/l
Sodium,Tot (00929)
20.2 mg/l
Selenium,Tot (01147)
<0.005 mg/l
Barium,Tot (01007)
0,081 mg/l
Arsenic,Tot (01002)
<0.005 mg/1
TOC
2.38 mg/l
Sulfate (00945)
40.5 mg/l
--------------------
Clients Sample Source MW14
Number COATS AMERICAN
Time Collected (Hrs) 1008
P.O. Box 473 • 106 Short Street - Kernersville, North Carolina 27284 - 336-996-2e41 - Fax [phone]
www,randalabs.com

tttttlrlpb�!
RESEARCH & ANALyTICAI
LABORATORIES INC.
-' 1q0,#34
Analytical/Process Consultations
i
Water Tech Labs. Inc. Date Sample Collected 04/09/13
P.O. Box 1056 Date Sample Received 04/11/13
Granite Falls, NC 26630 Date Sample Analyzed 04/11/13
Attn: Joe Gragg Date of Report 05/01/13
Analyses Performed by JC -SK
Lab Sample Number
----------------
755502
Parameter Storet # Results
Magnesium,Tot (00927) 25.8 mg/1
Lead,Tot (01051) <0.005 mg/1
Manganese,Tot (01055) 1.35 mg/l
Aluminum,Tot (01105) <0.025 mg/1
Calcium,Tot (00916) 72.1 mg/1
Chromium,Tot (01034) <0.005 mg/l
Cadmium,Tot (01027) <0.002 mg/l
Nickel,Tot (01067) <0.005 mg/l
Sodium,Tot (00929) 10.9 mg/1
Selenium,Tot (01147) <0.005 mg/l
Barium,Tot (01007) 0.097 mg/l
Arsenic,Tot (01602) <0.005 mg/l
TOC 1.50 mg/l
Sulfate (00945) 22.6 mg/l
--------------------
Clients Sample Source MW15
- Number COATS AMERICAN
Time Collected (Hr5) 1018
P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone]
www.randelabs,aom

G W-59A COMPLIANCE REPORT FORM Permit
(Submit one each monitoring period with 0T 59 forms.)
] Enter date monitoring results were due: - - Will this monitoring report (GW-59 and GW-59A) DES NO
be submitted after the established due date? '
I Was any required information missing on the GW-59 report forms? v
YES NO
IF the answer to question I or 2 is "YES', list in the space provided below the weli identification number(s) and
explain the problems encountered in obtaining the required information.
3 Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked oFconcentration(s)
ing YES NO
identification plate, area overgrown, etc.)? If the answer is "Yes ", contact the Regional Office
4 Are any monitored constituents equal to or above the established standards?
YES NO
if the answer to question 4 is `NO ;skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with conslituent
exceeding standards in the space provided below:
rnw i�
to LA3 2
DS �5�1 Iz mgn�a�iese►3 rn
al, I mQr'l these . Z,g 5 rn�I1,l�
5 For the constituents identified in question 4 above, have standards been exceeded previously for the
same constituent(s) in the same well(s) in the last two years? YES NO
If the answeL
ion 5 is NO, skip to section 8.
If the answstion 5 is "YES'; list in the space provided below, each wellwith constituents) exceedingstandards, cion(s) reported, and sample collection date for each occurrence (for the fast two years).iC� e
, Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES NO
If the answer is "YES'; a groundwater quality problem maybe occurring. CONTACT THE REGIONAL Ale
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO" monitoring wells may be improperly
located; contact the Regional Office.
7 Is the permittee implementing previously approved actions required by the Division involving this, groundwater quality problem? YES NO
If the answer to question 7 is "YES", describe those actions in the space provided below.
If the answer to question 7 is "NO" contact the Regional Office within 90 days; an evaluation may be
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surroundin this fac r1ity, Failure to do so maV sub ect the Permittee to a Notice of Violation fines, and/or penalties
8
The person completing this portion (GW-59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
GW-59A 12/8/2003

C l V oats North America
Coats
North America
�uiie'r';urojuteflctiori To Whom It May Concern:
Due to some structural damage to the casing around MW 11, we had to
630 American Thread Road
Post OfFice Box 368
FEg12����Marion, North Carolina 28752
Telephone: [phone]
FAX: [phone]
eville l Office
abandon this well. We have had a replacement well drilled to replace it. It has
been pumped several times by Brett Laverty with the State Office in
Swannanoa, but has not been fully developed. We are in hopes that we will
have this well developed and ready to sample by our next sampling date which
is in April. If you have any questions, feel free to call Sara Hudgins or Phillip
Pittman at Coats North America. Our phone number is [phone]
extensions 3291 or 3368.
Thank You,
Sara Hudgins

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: (' ( S A Cr e it CQr`.
Permit Name (if diffe(ent):
Facility Address: ©X- r _
Contact Person: ` INI ►lk.
Well Location/ Site Name:
County Mc f] t., ce I
Telephone #: RN -1
No. of Wells to be Sampled:
—j—
Well Identification Number (from Permit): MW-Z For Groundwater Treatment Systems
Well Depth: IS it. Well Diameter: 6 in. Check One: ❑ Influent (98)
Screened Interval: ft. to ft. 11 Effluent (99)
Depth to Water Level: � � k� ft. below measuring point.
Measuring Point (M.P.) is: a 1 3 ft. above land surface. Relative M.P. Elevation in ft.:—
Gallons of water pumped/bailed before sampling: inb— Date sample collected: IS-J
Field analysis: pH ° , Specific Conductance ' uMhos
Temp. QC, Odor Appearance
PARAMETERS (Samples for metals were collected unft
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total IZ -Ii
mg/I
pH (when analyzed) Z- :
'090 units
TOC I Z--1'A
41 mg/I
Chloride I Z-�Uo
S.,(,) mg/I
Arsenic t Z--Zko
40,005 mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate 1 _I
t� mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
FED 12 2013
-- I Z
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: WCX
Non -Discharge_
NPDES
EXPIRATION DATE: S -2011
UIC
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and . —
colloidal concentrations. HB 04 20;11
Date sample analyzed: 5e ( P jet 0
Laboratory Name: LU to l "iCU,,
Certification No.
:ered&_YE5 NO
and field acidified
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P./-243
L,o mg/I
Orthophosphate
mg/I
Al - Aluminum/Z-7-b
mg/I
Ba - Barium 1Z-Z.i.o
C). it 1 mg/I
Ca - Calcium 12 &
I'-i ; Z mg/I
Cd - Cadmium IZ-16
40.00Z. mg/I
Chromium: Total 12 -Z.Io
L 0,5 mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/1
Mg - Magnesium It-Zlo
c.CP1 mg/I
Mn - Manganese_ )'Z--Z(,o '
o' 23 ' mg/I
YES NO)
Ni - Nickel iZ-ZL O-W l mg/I
Pb - Learl 17--Z(o h (-3 3 mg/I
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units) ((ll
f)deQlt\1Cn 17- -3
1 :5dYl0x
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. ach lab report.)
Report Attached? Yesi ) No (0)
VOC method # _ .3
method # =
method # =
GW-59
Rev. 0312000
Asheville Regional Office

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:,
Permit Name (it
Facility Address
Contact Person:r1J114
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County I I" LA )L X 0, t t
Telephone # 2S - -t
No. of Wells to be Sampled:
Well Identification Number (from Permit): MI __O-I For Groundwater Treatment Systems
Well Depth: I 11R it. Well Diameter: �- in. Check One: ❑ Influent (98)
Screened Interval: •�3 '"'J it. to ft.
❑ Effluent (99)
Depth to Water Level:16, 9_ft. below measuring point.
Measuring Point (M.P.) isZ, 2-1 it. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/b�iled'before sampling: 3 Date sample collected:
Field analysis: pH '�-11 ` Specific Conductance ' uMhos
Temp. lk °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #:UL '310C Ck5 C'C73 EXPIRATION DATE: I i
Non -Discharge U IC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
_ Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: _ , 5EN E;b"
Laboratory Name: i- ('r T h
Certification No. En
PARAMETERS (Samples for metals were collected unfiltered1% YES NO • and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
1100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total.
/100m1
Phosphorus: Total as P-] -Z-) b,'Z�k
mg/I
(Note: Use MPN method for highly turbid
samples)
1 Zq
Orthophosphate
mg/1
Dissolved Solids: Total 1 Z-1 q mg/I
Al - Aluminum IZ-Zb O;
mg/I
pH (when analyzed) )'Z-I'3
I � 1 units
Ba - Barium I'Z-ZId b'(n
mg/I
TOC IZ-
41 mg/I
Ca - Calcium - L . `
mg/I
Chloride 12-L6
1 1 ' mg/I
Cd - Cadmium 12-- Z
mg/I
Arsenic iZ-Z(o
40, 065 mg/l
Chromium: Total 12 -DO' b, On
mg/i
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/1
Fe - Iron
mg/I
Sulfate
mg/I
Hg - Mercury
mg/l
Specific Conductance
uMhos
K - Potassium
mg/1
Total Ammonia
mg/I
Mg -Magnesium i2 -Z o 4 06*
mg/I
TKN as N
mg/I
Mn - Manganese [Z-Zk' 4b. <
mg/I
Rev. 0312000
YES NO)
Ni - Nickel 2-Z , mg/I
Pb - Lean )Z-ZL to1,toS mg/,I
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units) ii
-,r�
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes__\,/_(1) No (0)
VOC : method # = rs2,(Dy A
method #
method #

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: i
Permit Name (if
Fac,`ility ,address:
Contact Person:WD1111
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County If►�411 t�f�It
Telephone M
No. of Wells to be Sampled:
Well Identification NuLnber (from Permit): r0Q 1 L For Groundwater Treatment Systems
Well Depth: 1 J It. Well Diameter: in. Check One: ❑ Influent (98)
Screened Interval: k: ft. to _ it. ❑ Effluent (99)
Depth to Water Level: I + ft. below measuring point.
Measuring Point (M.P.) is:? ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/b filed before sampling: L_ Date sample collected: If:3
Field analysis: pH 1 Specific Conductance * Umhos
Temp. ___L]—°C, Odor Appearance
PARAMETERS (Samples for metals were collected un
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total IZ -1 4 (,oqZ mg/I
pH (when analyzed) 12-I
3 units
TOC 17--IL1
mg/I
Chloride 1'Z-� In
4.c;; G mg/I
Arsenic 1I2..-Z;to
L, d r 00S mgll
Grease and Oils
mg/I
Phenol.
rng/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER OUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT#:Lk) QEXPIRATION DAT7`70Non-Discharge UIC
NPDES
TYPEDF PERMITTED OPERATION BEING MONITO
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: S50e
Laboratory Name: _% ate iILP
Certification No.i`�
tered)S,_YE5 NO
and field acidified
Nitrite (NO2) as N
mg/I
Nitrate (Nog) as N
mg/I
Phosphorus: Total as P mg/I
Orthophosphate
mg/I
Al - Aluminum M-Z+6
mg/I
Ba - Barium
mg/I
Ca - Calcium V,-- to
Ct mg/I
Cd -(
�Z_0 ,002 mg/I
Chromium: Total M-_Z(a'
L,0.00S mg/I
Cu.- Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium _1' -t(o
G mg/I
ZiC�S'C
Mn - Manganese IZ-be;
mg/I
YES NO)
Ni - Nickel 7_ Z (Y'n
-2(o
mg/1
Pb - Lear9_ I' c�� (-�c��
rpg/I
Zn - Zinc
mg/1
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
=1 LZ -,i.i Mo M-P,
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. A tach lab report.)
ROC Rep6rt Attached? Yes(1)- No (0)
method # _ LVr O `
method # _
method #

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: ( t l t I J
Permit Name (if dif rent):
Facility Address:
Contact Person:
Well Location/ Site Name:
"SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County I ► )L- X
Telephone M
No. of Wells to be Sampled:
Well Identification Number (from Permit): M t_k. - 1 -S For Groundwater Treatment Systems
Well Depth: I _'C" ft. Well Diameter..- in. Check One: ❑ Influent (98)
Screened Interval:_ ft. to AA A ft. ❑ Effluent (99)
Depth to Water Level: -L ft. below measuring point.
Measuring Point (M.P.) fs:Z- tO ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pump'e_d/ba'led before sampling: �_ Date sample collected: Zi ) 2
Field analysis: pH� , Specific Conductance uMhos
Temp. 1 QC, Odor Appearance
PARAMETERS (Samples for metals were collected unfiltered
COD mg/I Nitri
Coliform: MF Fecal /100ml Nitr
Coiiform: MF Total /100ml Pho
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total IZ-14 c;c,)9 mg/I
pH (when analyzed) Z-1
o 13 units
TOC 12_-1 _
y C> mg/I
Chloride Z- 2Z o
Z' O mg/I
Arsenic 12-ZG�
46'C0- mg/I
Grease and Oils
mg/I
Phenol
mg/I
.
Sulfate
mg/I
Specific Conductance
- uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Rev. 0312000
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: ( ty� bb05(063 EXPIRATION DATE:
Non -Discharge U IC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Rerhedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: '�'yP 'Pce-
Laboratory Name: _LQOO V of TOCt"
Certification No. 8 D
_;AYES NO and field acidified
to (NO2) as N mg/I
ate (NO3) as N mg/1
sphorus: Total as P mg/I
Orthophosphate mg/I
Al - Aluminum J7_-'' ► c1Ci( mg/I
Ba - Barium - c) o b4 S mg/I
Ca - Cal ciu' rn - I I I S. mg/I
Cd - Cadmium I'Z-Zug Z'01OOC-mg/I
Chromium: Total _GL?to LO.Cismg/I
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potassium mg/I
Mg -Magnesium 'Z' (o mg/I
Mn - Manganese � �?.(o n. 00mg/I
/� YES NO)
Ni - Nickel- (') � (~C`� mg/I
Pb - Lead` . -? (P L r')(•_ C s mg/I
Zn - Zinc mg/1
Ammonia Nitrogen mgll
Other (Specify Compounds and Concentration Units)
I
0 �
ORGANICS: (GC,GC/MS,HPLG)
(Specify -test and method #. Attach lab report.)
Report Attached? Yes_�,_/_(1) NO—� ((000)
VOC method #
method # =

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:_
Permit Name (if
Facility Address
Coritact Person: i'l It I t I
Well Location/ Site Name:
r\.
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County I o P- L A r' I
Telephone M z J
No. of Wells to be Sampled:
Well Identification Nu ber (from Permit): Pn W -1'1 For Groundwater Treatment Systems
Well Depth. - ft. Well iameter•: z in. Check One: ❑ Influent (98)
Screened Interval: A.) -p► ft. to _ ft. El Effluent (99)
Depth -to Water Level. 9%", V ft. below measuring point.
Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: Z t -S Date sample collected: L-73
Field analysis: pH LO -` , Specific Conductance uMhos
Temp. °C, Odor. Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: [,C.C�� �in(�j EXPIRATION DATE:
Non -Discharge UIC
NPDES
TY E F PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: ' e f OLD j
Laboratory Name: P
Certification No. _ 15 )
PARAMETERS (Samples for metals were collected unfiltered---'A-YES -NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100m1
Nitrate (NO3) as N
rng/I
Coliform: MF Total
/1 OOmI
Phosphorus: Total as P�-2-/ E6,1(6mg/I
(Note: Use MPN method for
Dissolved '�
�' OrthOphOSphate
mg/l
Solids: To�g,h�lyr,bldsamples)
mgll
Al - Aluminum 12-2i<� 0,`L"
mg/I
pH (when analyzed)
TOC)
C� units
2
Ba - BariumL- ZZI,5 �, I i
'�'
mg/I
-1u1
Chloride 1 Z-Z(O
,"1'Z mg/I
�S O mg/I
Ca - Calcium )'Z- 2 a
Cd - Cadmlum.!'L-Zip 21C_). t:Zmg/I
mg/I
Arsenic i 2.,-Z t.,
4,U 0OS mg/l
Chromium: Total j'Z-Z(o' 40, M'S
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
Sulfate I` -I
mg/1
f 6 O mg/I
Fe - Iron
Hg - Mercury
mg/I
mg/I.
Specific Conductance
uMhos
K - Potassium
g
Total Ammonia
TKN as N
mg/I
Mg - Magnesium i Li
-2 '`"1�
m /1
g
mg/I
Mn -Manganese (o �
mg/I
Permittee (or *uthartzed A am d Tit - Please
GW-59 c
Signature of Permilte (o
Rev. 03/2000 r Authorized enl)
_YES NO)
Ni - Nickel- 0— 4D,C mg/I
Pb - Lead_IZ?sI Q LD's mg/1
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes __,_( ­I) No (0)
VOC method # 6
method #. =
method # _
_N_

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility Name:
Permit Name (if
Facility Address:
I t r r1 laueeq Jl,� C: t 2 Count
ICnY) 5) le (rQ) y
Contact Person: ' t i Telephone #:'I (n'q
Well Location/ Site Name. t e r No. of Wells to be Sampled: __ (0
(IremPermit)
Well Identification Number (from Permit): For Groundwater Treatment Systems
Well Depth: ft. Well Di meter: in. Check One: ❑ Influent (98)
Screened Interval: ft. to ft. p Effluent (99)
Depth to Water Level: _'111i'3 ft. below measuring point.
Measuring Point (M.P.) is: t la ft. above land surf) ce. Relative M.P. Elevation in ft.:
Gallons of water pumped/bpiled before sampling: Date sample collected:
Field analysis: pH_J.P_ -_ , Specific Conductance uMhos
. Temp._°C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: Lk)(a CYCO&O03 EXPIRATION DATE:
Non -Discharge U IC
NPDES
TYPE F PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed:
Laboratory Name: t a pc-
Certification No. —Ell)
PARAMETERS (Samples for metals were collected unfiltered--A—YES NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P_I -Z-I < -ft
mg/I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total 12 L1 4lo-L mg/l
Orthophosphate
Al - Aluminum -Z(o
mg/I
mg/I
pH (when analyzed)
'
t units
Ba - Barium K a
mg/I
TOC
mg/I
_0 mg%I
Ca. - Calcium -
Cd - Cadmium - iJ
mg/I
mg/I
Chloride IZ
Arsenic j2 - Z coIg/I
Chromium: Total I2-2(o' 1).00S
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/l
Phenol
` 1Z-1
mg/I
Fe - Iron
mg/I
Sulfate
mg/l
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium
Z �r
mg/I
TKN as N
mg/I
Mn - Manganese 2- 2 Q '
mg/I
Rev. D3/2000
A YES _ . NO)
Ni - Nickel-Jz"
,('4S Mg/1
Pb - Lead— fZ-7C�
0 mg/1
Zn -Zinc
mg/1
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. A)tach lab report.)
Report Attached? Yes(1) No (0)
VOC : method # =
method it =
method # =

GW-59A COMPLIANCE REPORT FORM Permit # -wa"' (pL,�j
(Submit one each monitoring period with Gil-59 forms.)
1
Enter date monitoring results were due. p - be submitted after the established due date? Will this monitoring report (GW-59 and GW-59A) YES NO
2
Was any required information missing on the GW-59 report forms?
YES
NO
IF the answer to question 9 or 2'is 'YES", list in the space provided below the weh' identification number(s) and
explain the problems encountered in obtaining the required information.
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or'missing cap, missing
identification plate; area overgrown, etc.)? If the answer is ••Yes ", contact the Regional Officefor guidance.
YES
NO
4,
Are any monitored constituents equal to or above the established standards?
YES
O
If the answer to question 4 is `NO", skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below.
mLQ 1Z T 05 (00'Z IM ),Z fy) w? L&- 1 c��3 mr I ivy w IZ MGoc n esC
Z;U
me
m w i3 i fl5 50q me j,Q mt,�� rY1Gn anPsc o-fi33 s lx m 15 (Ylan%nn
sz
1 �3
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
same constituent(s) in the same well(s) in the last two years?
YES
NO
'
If the answer to question 5 is `NO", skip to section 8.
If the answer to question 5 is "YES", list in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
L`iZ, M(18 :nP, - Z�r-13 rr �.J Q �S-�l"l� T1�5 5C3 8M, jj �S Q-1 tti'1W 7
frac�gne ; lrI rn1.1 I2. 1
I DS 51 t) mC&I"o 12 -h -i 1
f�a�oni'sz 3 .i17E�m �,R y '3 - .Z TDS Sir o rn �,Q �1=1� - I I ��
nes
I
. nes
n
-Ic,- 1
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
If the answer is "YES'; a groundwater quality problem maybe occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells maybe improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
groundwater quality problem?
YES
NO
If the answer to question 7 is 'YES", describe those actions in the space provided below.
If the answer to question 7 is "NO" contact the Regional Office within 90 days; an evaluation may be
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surrounding this facility Failure to do so may subject the permittee to a Notice of Violation
fines, and/or penalties.
g
The person completing this portion (GW-59A) of the monitoring' report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
`.�, M w^_'Gi:'.T't...m: .w.'-i3' wM, .vr �Y;ST+.......r )rv.:Jx A+-r^aF.•.an
i herefiyacknowle`dgeihat,�the,�bove`.;iriformatlon wasze�aluat�d andhthe In�oc�matiph submltiedTntiilsy'��'
report (Complta eport'GW59A) is and complete to the ti®st of my kn wledge K: w ;t.',.
-ZJS -)3
Signature of Permitte or Authorized Agent) Date
r
I1Q
,rjF%
GW-59A 12/8/2003

A WRTEROTECH
POST OFFICE BOX 1056 • n5 PINEWOOD PLAZA DR
GRANITE FALLS. NORTH CAROL INA 28630
[phone]
SAMPLE. Coats America (MW#02) COLLECTION DATE: 12/1.3/2012
PERMIT #. COLLECTION TIME: 07:30
ADDRESS: Coats America (Wells) RECEIVED DATE:. 12/13/2012
P.O. Box 368 RECEIVED TIME. 13:45
Marion, NC 28752
REPORTED: 1 /18/2013
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
�-ZuIfate
<10.0
mg/L
12/14/12
\,efiloride
5.0
mg/L
12/26/12
lag
T. Phosphorus
0.38
mg/L
1/2/13
jdg
toc
<1
mg/L
12/14/12
\.XS
118
mg/L
12/14/12
metals
see attached
PH * >holding time
6.9
su's
12/13/12
lag
voc
see attached
LOG ID: 1212-239 REPORTED BY: NC CERTIFIED LAB # 50
fee'. ( `' t
Tony Gragg, Lab Supervisor

a
A
wjqrER&.rEcm __
POST OFFICEE BOY: 1056 • #5 PINEI OOD PLAZZA D.R.
GRANITE FALLS, NORTH CAROLINA 28633
[phone]
SAMPLE: Coats America (MW#10) COLLECTION DATE 12/13/2012
PERMIT #: COLLECTION TIME., 07:45
ADDRESS: Coats America (Wells) RECEIVED DATE: 12/13/2012
P.O. Box 368 RECEIVED TIME: 13:45
Marion, NC 28752
REPORTED: 1 /18/2013
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
'VSulfate
26.5
mg/L
12/14/12
hloride
7.8
mg/L
12/26/12
lag
T. Phosphorus
0.24
mg/L
1/2/13
jdg
toc
<1
mg/L
12/14/12
S
124
mg/L
12/14/12
lag
metals
see attached
pH * >holding time
7.1
su's
12/13/12
lag
voc
see attached
f
LOG ID: 1212-240 REPORTED BY: NC CERTIFIED LAB # 50

i
.111C.
POST OFFICE BOX 1056 • I'S PINEWOOD PLAZA DR
GRANITE FALLS. NORTH CAROLINA. 28630
[phone]
SAMPLE: Coats America (MW#12) COLLECTION DATE:
12/13/2012
PERMIT #: COLLECTION TIME.
08:00
ADDRESS: Coats America (Wells) RECEIVED DATE:
12/13/2012
P.O. Box 368
RECEIVED TIME:
13:45
Marion, NC 28752
REPORTED:
1 /18/2013
ANAL YSI S
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
,,/Sulfate
11.2
mg/L
12/14/12
,,Chloride
<5.0
mg/L
12/26/12
lag
T. Phosphorus
<0.16
mg/L
112/13
jdg
toc
2.62
mg/L
12/14/12
TDS
642
mg/L
12/14/12
lag
metals
see attached
pH ' >holding time
6.7
su's
12/13/12
lag
voc
see attached
LOG 1D: 1212-241 REPORTED BY: NC CERTIFIED LAB # 50
Trmv OraacT T.ah Cnnervicnr

i
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANIT; FALLS. NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#13)
COLLECTION DATE:
12/13/2012
PERMIT #:
COLLECTION TIME:
08:15
ADDRESS: Coats America (Wells)
RECEIVED DATE:
12/13/2012
P.O. Box 368
RECEIVED TIME.'
13:45
Marion, NC 28752
REPORTED:
1 /18/2013
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
�,,.,iSulfate
68.1
mg/L
12/14/12
,,6hloride
<5.0
mg/L
12/26/12
lag
T. Phosphorus
0.20
mg/L
1/2/13
jdg
toc
4.30
mg/L
12/14/12
TDS
509
mg/L
12/14/12
lag
metals
see attached
PH ' >holding time
6.6
su's
12/13/12
lag
voc
see attached
LOG ID: 1212-242 REPORTED BY: NC CERTIFIED LAB # 50

POS T OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS. NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#14) COLLECTION DATE: 12/13/2012
PERMIT #: COLLECTION TIME: 08:30
ADDRESS: Coats America (Wells) RECEIVED DATE. 12/13/2012
P.O. Box 368
Marion, NC 28752 RECEIVED TIME: 13:45
REPORTED: 1 M R/1)ni q
ANAL YSI S
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
sulfate
<10.0
mg/L
12/14/12
VC5hloride
<5.0
mg/L
12/26/12
lag
T. Phosphorus
<0.16
mg/L
1/2/13
jdg
toc
2.72
mg/L
12/14/12
J;p6S
497
mg/L
12/14/12
lag
metals
see attached
PH ' >holding time
6.7
su's
12/13/12
lag
voc
see attached
LOG ID: 1212-243 REPORTED BY: NC CERTIFIED LAB # 50
fkt

A
MR TER I
_-cm ffss
Inc. .
?OAT OFFICE BOX 1056 • n5 PINEWOOD PLAZA DR.
GRANITE FALLS. NORTH CAROLINA 28630
[phone]
SAMPLE. Coats America (MW#15) COLLECTION DATE: 12/13/2012
PERMIT #: COLLECTION TIME: 08:45
ADDRESS: Coats America (Wells) RECEIVED DATE: 12/13/2012
P.O. Box 368
Marion, NC 28752 RECEIVED TIME: 13:45
RFPnRTFn'
-- -"'--•
/ Iv/GV IJ
ANALYSIS
NALYSIS
EF,,Xulfate
RESULTS
UNITS
DATE
ANALYST
99.6
mg/L
12/14/12
\Aloride
<5.0
mg/L
12/26/12
lag
T. Phosphorus
<0.16
mg/L
1/2/13
jdg
tooc
2.79
mg/L
12/14/12
'V/,I DS
462
mg/L
12/14/12
lag
metals
see attached
PH " >holding time
6.9
su's
12/13/12
lag
voc
see attached
LOG ID: 1212-244 REPORTED BY: NC CERTIFIED LAB # 50

CHAIN OF CUSTODY - Analytical Request
Client Name: Q �ML'f (C?�r1..
Address:
Report to:
Phone:
PO Number:
Preservatives
o
Sample Identification
U
b
�'
7
O
+
x
-
UD
� S
q
N
_
U
OCd
Z
"Q
!243-1 L
9 3C)
I
� :oo
3
$ :30
emperature (°C)
j
eceived on Ice:
Y / N
waled Cooler:
Y / N
amples Intact
Y / N
Mitional Comments:
WATER TECH LABS, INC.
PO BOX 1056
GRANITE FALLS, NC 28630
PHONE: [phone]
Project Name:
Project Number:
Requested Analyses
M
MWENNNO
ME
owmamem
0NOM00N
ffimOI►11IIDlm
Printed Name of Sampler: sm-a
Signature of Samplek
pH Checked Upon Receipt
C12 < 0.2 mg/1 Upon Receipt
Field Temp. (C°) I Comments
ins
1 Z-1,3-1

RESEARCh & ANAI}rrial
LAb4RATORIES, INC.
Analyflcd/Process ConsuftWons
January 8, 2013
Water Tech Labs
P.O. Box 1056
Granite falls, NC 28630
Attention: Joe Gragg .
Project Name: Coats American
H.Miscellaneous
MW2
MW10
MW12
MW13
MW14
MW15
Date
Parameters
unit
Results
Resuftff
Results
Results
watts
Results
Anal=d
Aluminum, Total
mg/L
3.11
0.044
0.080
0.399
0.267
0.034
12/26/12
Arsenic, Total
mg/L
<0.005
<0.005
<0.005
<0.005
<0.005
<0.005
12/26/12
Barium, Total
mg/L
0.111
0.009
0.112
0.045
0.113
0.133
I2/26/12
Cadmium, Total
mg/L
<0.002
<0.002
<0.002
<0.002
<0.002
<0.002
12/26/12
Chromium, Total
mg/L
<0.005
<0.005
<0.005
<0.005
<0.005
<0.005
12/26/12
Calcium, Total
mg/L
17.2
<0.500
53.9
11.5
88.0
74.1
12/26/12
Lead, Total
mg/L
0.030
<0.005
<0.005
<0.005
0.005
<0.005
12/26/12
Magnesium, Total
mg/L
9.09
<0.500
9.44
8.68
56.4
24.6
12/26/12
Manganese, Total
mg/L
0.835
<0.005
2.08
0.402
0.760
1.38
12/26/12
Nickel, Total
mg/L
0.007
<0.005
0.009
0.008
<0.005
<0.005
12/26/12
Selenium, Total
mg/L
<0.005
<0.005
<0.005
<0.005
<0.005
<0.005
12/31/12
Sodium, Total
mg/L
12.1
39.2
186
207
44.1
563
12/31/12
Sulfate
mg/L
<10.0
26.5
11.2
68.1
<10.0
99.6
01/07/13
TOC
mg/L
<1
<l
2.62
4.30
2.72
2.79
12/27/12
Sample Number
747193
747194
747195
747196
747197
747198.
Sample Date
12/13/12
12/13/12
12/13/12
12/13/12
12/13/12
12/13/12
Sample Time
0730
0745
0800
0815
0830
0845
ml L = milligrams per Liter = parts per million (ppm) < = Less than or below detection limit

,s
RESEARck & ANA(yT16At
Ub( mmitks, INC.
Arelyticcl/Process C0r=MC dons
Chemical Analyslsfor Selected Parameters and Water Sample Identified as Coats American
(A Water Tech Labs, Inc Proiec4 collected 13 December 2012)
I. Volatile Organics
Quantitetlon
EPA Method 8260 B
Umlt
Mw2
Mw10
Mw12
Mw13
Parameter
fa ►-ba
l>2Rhi
lot
imw
LM
Mw14
Mwls
Aedone
Loll
18>IX
Aaakm
25
too
BQL
SOL
BQl
SOL
BQL
ROL
BOL
QL
Aayloaflr0a
Benzene
10o
SOL
QL
BQL
BQL
BQL
Bmmobernme
D's
SOLDs SQL
BQL
QL
BQL
SQL
BQL
BQL
g4
Bmmacblaamdhatto
BnomodkhI mmahme
OS
0A
SOL
QL
SOL
L
BQL
SOL
SOL
Bromo(orm
SOL
SOL
13�QjL
13QL
BQQL
SOL
BQL
BQL
eBroxw3dil
to
25
BQL
DQL
BQL
BQL
SOL
SOL
SOL
BQL
BQL
CarbonDkUW*
05
BQL
BQL
SOL
SOL
BQL
BQL
BQL
BQL
BQL
BQL
CaboaTdraebiwide
as
BQL
BQL
BQL
SQL
BQL
SQL
SQL
l�mlee
IA
SOL
SOL
SOL
SOL
SOL
BQL
2-Qkao
2 Cb{omtbyl ether
ChIMIAM
5.0
BQL
BQLSOL
SOL
Cblomnmhmm
�A
78
BQL
SOL
SQL
SQL
BQL
SQL
BQL
BQL
2 Chlorototadta
4•Cldorotalutue
OS
05
Q L
SQL
SQL
SQL
BQL
SQL
SQL
BQL
tit-1,2-DiebloroMpc
0.5
SOL
BQL
BQL
SQL
BQL
BRQL
!Is i3•DieLlpraptppeoe
l KD> )
OS
5.0
BQL
QQLL
BQL
RO
QL
SQL
SOL
J-DhVMDdlCfa(EDB)
1,2.Dr�romodltaae(EDS)
05
SQL
BQL
SOL
BOLL
SOL
D3mmoahb modhane
D16mmomahrae
p
SO
QL
BQL
SQL
SQL
BQL
1.2-DkUotobczeae
as
BQL
SQL
BQL
SOL
SQQL
SOL
SOL
BQL
1.3•Dirblombmrme
lA-Dkhlombemme
OS
BQL
BQL
SOL
SOL
ROLSOL
SOL
BQL
t.l-Dichtoroahaaa
OS
OS
SQL
BQL
SOL
SQL
BQSOL
L
QL
BQL
12•Dkbloroahaao
(Diehbro
OS
0.5
SQL
BQL
BQL
SOL
SQL
SQL
SQL
BQL
SQL
SOL
omometbanaa
I Z Dichlaropmpsne
as
OS
SQL
SOL
SQL
QL
SO
SQL
BQL
SQL
SQL
SQL
1.3•Dkhlaropmpaac
W-Dichlompropmte
0.5BQQL
OS
SOL
SOLL
QL
SOL
BQL
SQL
SQL
BQL
SQL
l.l-Dkhbmpmpme
05
BQL
QL
SOL
BQL
SOL
SQL
SQL
SQL
amwne
S 0
BQL
SOL
SQL
BQL
SOL
BQL
BQL
SQL
BQL
SQL
IPE
I-PromaccZew
0.5
BQL
BQL
QL
BQ
SOL
SQL
BQL
SQL
SQL
SOL
.4•Mahyl-2-Pemmoae
0.5
5.0
BQL
BQL
SOL
QL
SOL
QL
SOL
Mettry4lodidt
�� LlorRe
1.0
3.0
BQL
SQL
BQL
BQL
BQQL
MTBE
Neplalutlate
as
0.5
06L
VOL
Z6
#
Q
a .
•Suyfbm:me
�P3
05
OS
QL
SOL
BQL
BQL
SOL
SQL
SQL
BQL
BQL
pyhducae
SNYThename
OS
_SQL
BQL
SQL
BQL
SQL
BQL
BQL
Q L
SIYfdte
as
05
SOL
SOL
SOL
BQQL
SOL
QL
Tat-Bulylhcradte
QS
BQL
BQL
BQL
SQL
SOL
SOL
1.1.1.2 Tamehlorodhaoe
1.1.2I-Tdrachlomettme
OS
OS
SOL
BQL
SQL
SQL
SQL
BQL
SQL
am
BQL
Tetrurldorwhene
OS
BQL
SQL
SOL
Q
SQL
SQL
SQL
SOL
SQL
Tofu=
Trons•1.2-Dkldoroetlrae
OS
BQL
BQQL
SOL
BQL
SOL
BQL
SOL
SOL
QQL
Tr®s-13-Meblampmpene
0,5
SOL
BQL
BQL
BQL
SQL
Trans l 4 Dkhloro 2-bateae
I.23•Trkh%Tobw=
3.0
0.5
BQL
BQL
SOL
�
BQL
SOL
BQL
as
RQL
SOL
SQL
SOL12.4-TrWorobemeaa
SOL
BQL
SOL
SOL
1.1.1-Tridaomahane
1.1.2-Trialdomahaae
0.5
05
SOLgQL
SQL
SOL
SOL
SOL
13QL
SOLL
Tvkhbmahme
TrkNomllamoatelhm
Os
SQL
BQL
Q
SQL
SQL
BQL
SQL
SQL
QL
SQL
o
,a-T6chl—Pmp-prop
OS
0.5
BQL
BQL
BQL
BQL
BQL
DQL
BQL
BQL
t.2.4-Tmrtethyllsmme
1.35-Trimethyibmzam
as
0.5
BQL
SQL
SQL
gQQL
BQL
SQL
BQL
v'tt
1.0
SQL
BQL
QL
QL.
BQL
BQL
SQL
BQL
SQL
SQL
SQL
chbfAcetae
Vhryl Chloride
ToW Xyk=
0.5
1.0
BQL
SQL
BQL
BQL
SQL
SQL
BQL
BQL
BQL
BQL
BQL -
BQL
MUM Factor
r
,
I,
Sample Number
747193
747194
747195
747196
747197
747198
Sample Date
Samplemme(hra)
12/13/12
12/J13112
12J13/12
12113112
12/13/12
12/13/ 12
Analyst
Ono,
0745
0800
0815
0930
0840
NM
NM
NM
NM
NM
NM
Date Analyzed
122V12
12/27/12
1227112
12/27/12
32/27/12
1227112
TimeAualynd
2051
2124
2157
241
2304
2334
Surrogate Recovery
Rauge
DBFM
(70-1300/a)
102%
1050/0
104%
102%
103%
103%
Toluent3•d8
(70-130%)
97%
990%
95%
99%
101%
119%
4-BFB
(70-1309/6)
98%
1030%
99%
99%
102%
101%

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: 1, X[=�
Permit Name (if different):
EacilitV Address: 'Po
Contact Person:111111119,
Well Location/ Site Name:
SUBMIT FORM -ON -YELLOW PAPER ONLY j
Please Print Clearly or Type
County - mu _I)C G'� l I
Telephone #: 312 -Is6 -4I
No. of Wells to be Sampled:
Well Identification Number (from Permit): M W - Z. For Groundwater Treatment Systems
Well Depth: is ft. Well lameter_10 in. Check One: ❑ Influent (98)
Screened Interval: V A ft. to—m A ft_ ❑ Effluent (99)
Depth to Water Level: -Sq-Ln ft. below measuring point.
Measuring Point (M:P.) ts: Z.3 ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: _(aa Date sample collected:
Field analysis: pH '7. o , Specific Conductance ' uMhos
. Temp. 1$' °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER OUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC 27699-1636 ph—.. rot of -Yaa-no-
PERMIT #:LJ&0M54003 EXPIRATION DATE:
Non -Discharge UIC
NPDES I
TYPE QE PERMITTED OPERATION BEING MONITORED'
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion: t\D `
Rotary Distributor Land Application of Sludge N
Other:
L
NOTE, Values should reflect dissolved andRE IV
.
colloidal concentrations. �` °ED
Date sample analyzed: 5 C- L C3 L=Lo 1 ® C �'J'�
Laboratory Name: WNICIE T€
Certification No. So DWQ/BOG Unit
PARAMETERS (Samples for metals were collected unfiltered_XYES NO
and field acidified
COD
Coliform: MF Fecal
mg/I
/100ml
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/I
mg/I
Coliform: MF Total
/100ml
.9hosphorus: Total as P.5-?9--1Z 0.14
mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/l
Dissolved Solids: Total 9' - \`�
-m Ioz mg/l
Al - Aluminum l -Zo -I2
H '1b
mg/I
pH (when analyzed) 9 - ly-1z
,�?&C
'I .cam units
Ba - Barium 2 - Zo -1Z
0- 4-01
mg/I
Q--L0-17-
\•o mg/I
(a S
Ca - Calcium. 2-Zo -IZ
31• to
mg/I
*hloride a -U - m
Arsenic �3 -to -m
I mg/I
<0.005 mg/I
Cd - Cadmium k -20 - 12
Chromium: Total 9-2047-
z o.00z-
mg/I
mg/I
I
o- 00-S
Grease and Oils
mg/I
Cu - Copper
mg/l..
Phenol
�t�Ifate q-2U -12
mg/I
14y
Fe - Iron
m /I
Specific Conductance
mg/I
uMhos
Hg - Mercury
K - Potassium
mg/I
mg /I
Total Ammonia
mg/I
Mg - Magnesium-Zo-12
1'1. 1
me6/1
TKN as N
MCA
Mn - Manganese 9-20-1?
I .'13
/
/\ YES NO)
Ni- Nickel__-Zo -IZ o.otto mg/I
Pb - Lean k -20 - I Z o •0to'7 mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/l
Other (Specify Compounds and Concentration Units)
�sl�nior►-. �-2o-IZ Co OOSrY+s(Q
S�Ccl�unn Fs-Zo-l? 10 q r,+at •R
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.
Report Attached? Yes (1) No (0)
VOID : method # =
mg I method # =
method # =
- �_ .- a ..., ..- _... .- - •- -- - --- -

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM '
Facility Name: —
Permit Name (if
Facility Address:
Contact Person:tJliiQJ
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County —III' It` 1�]ot )Q 1l
Telephone #: 172 151, -L
No. of Wells to be ,Sampled:
Well Identification Number (from Permit): M. LO - 10 Screened For Groundwater Treatment Systems
Well Depth:. i�_ii. Well Diameter•:�� in. Check One: ❑ Influent (98)
Interval: �t' `-- ft. to —tiT_ it. ❑ Effluent (99)
Depth to Water Level: ►Z ft. below measuring point.
Measuring Point (M.P.) is:-Z-3 It. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 3_ Date sample collected:
Field analysis: pH (o • Specific Conductance umhos
Temp. �� °C, Odor Appearance
-1 2
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC 27699-1636 Phone: [phone]:
PERMIT #: W Q d0C3� loth EXPIRATION DATE: 5 -
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
�— Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: S L'L Cut= n 1 RECEIVE)
Laboratory Name: t 0 RI C F_ 1 f e t4 n�T it h
Certification No. 5o
PARAMETERS (Samples for metals were collected unfiltered A YES NO
and field acidified
COD
Mg/jr
/100ml
Nitrite (NO2) as N
Nitrate (NO3) as N
mg /I
Coliform: MF Fecal
Coliform: MF Total
/100m1
Phosphorus: Total as P-2-2&-1z 40.1e
m/I
g
mg /I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
m/I
Dissolved Solids: Total-1'7-12 I M mg/I
Al - Aluminum. -Zo-17-
o.18�{
mg/I
pH (when analyzed)9-14-tz
TOC 5 -7®-12
-113 units
�.1•o
Ba - Barium T-Zo-12
o.of3
mg/I
Chloride G-7-1'-t2-
mg/1-
< S.0 mg/I
Ca - Calcium 8-2o-t2
Cd - Cadmium-i�-Zo -t2
<0.50o
mg/I
mg/I
< o.00z.
Arsenic _9 -2o - L2
40.005 mg/I
Chromium: Total -26-li
4.o.00s
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
Sulfate 8-2e-tz
mg/I
`� mg/I
Fe -Iron
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
m /I
g
Total Ammonia
mg/I
o
Mg - Magnesium Z-IZ
<0050o
TKN as N
mg/I
Mn - Manganese E-20-12
'4o•o0S
mg/I
X YES NO)
DWQ/BOG
Ni - Nickel _�-2o-1z Co oos mg/I
Pb - Lead 4 -Zo -tmg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
e enion., -7a-12 <o.005m .SZ
^� ir�rtr. -20-1Z 446W mall
ORGANICS: (GC,GC/MS,HPLC)
(Specify -test and method #. Attach lab report )
Report Attached? Yes (1) No :�40)
VOC : method # =
: method # =
: method #

'00/
`SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility Name: L�QM 17i11Ni I LUI I
Permit Name (if different):
Facility Address: tab Ribs. �IDR
mar
•.b (Street) Z8 C
O •IZip County - lit gowe
Icay) i � r f"
Contact Person: Telephone M
Well Location/ Site Name: C No. of Wells to be Sampled:
Well Identification Number (from Permit): M, W - 10 For Groundwater Treatment Systems
Well Depth: 19 ft. Well Diameter: Z in. Check One: ❑ Influent (98)
Screened Interval: N_ ft. tom_ ft. ❑ Effluent (99)
Depth to Water Level: . Z ft. below measuring point.
Measuring Point (M.P.) is:'Z9 ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: _ 3 Date sample collected: '
Field analysis: pH (o • , Specific Conductance ' uMhos
Temp. 23 °C, Odor Appearance
-12
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER OUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: W q 000E� 1c03 EXPIRATION DATE: 5'
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
—A Lagoon Remedialion• Infiltration Galle
Spray Field
Rolary Distributor
Other:
ry
Remedialion: _
Land Application of Sludge
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: S L1_ (� =1 n _1 RECEIVE,
Laboratory Name: f .J RT £ tZ 1 £C t4 nC T;I_
Certification No. 5o
PARAMETERS (Samples for metals were collected unfiltered X YES NO and field acidified
COD mg/I Nitrite (NO2) as N mg /I
Coliform: MF Fecal /100ml Nitrate (NO3) as N m/I
Coliform: MF Total /i 00MI Phnsnhnri ic- Tntnl ne ID Q� -7-►� n .�.�. j* Ir- 9n
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total _9 -1'?-12 1 M mg/I
pH (when analyzed)_2-IS-Iz 'I13 units
TOC `a -20-12 /,1. 0 mg/1
Chloride S,-2C-t2.
< So mg/I
Arsenic -4 -zo -
Grease and Oils
Phenol
mg/I
mg/I
mg/1
Sulfate g-Zo-IZ
Zb.'l mg/I
Specific Conductance
Total Ammonia
TKN as N
uMhos
mg/I
mg/I
Orthophosphate
m /I
Al - Aluminum 2-Zo-12-
0.1814 mg/I
Ba - Barium B - Zo -12
0.013 mg/I
Ca - Calcium.?�20-12
<o.5oO mg/I
Cd - Cadmium--2o -t2
c o.00z_ mg/I
Chromium: Total -20-12.
4 o ,005 mg/1
Cu - Copper
mg/l
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium.? -70 J Z
e- 11,500 mg/I
�40.00S
Mn - Manganese 8-20-12
mall
X YES NO) DWQ/BOG
Ni - Nickel_ -2o-1Z Ld dos mg/I
_i� Pb - Lead-Zo -1 Z Go . oo S mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
eflipM Ap.00srn
5b1ic�fY�-20-t-Z
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report )
Report Attached? Yes 0) No (0)
VOC method # =
method # =
method # =

A ,�e�Ae-& &)w - �<) 1 0ra—t�ugus�-
SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility Name: kJ
Well Identification Number (from Permit): Ali �1 I A For Groundwater Treatment Systems
Well Depth: ) it. Well Diameter: 7- in. Check One: ❑ Influent (98)
Screened Interval: it. to it. ❑ Effluent (99)
Depth to Water Level: H,9 ft. below measuring point.
Measuring Point (M.P.) is:ALI-_ it. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: ?% Date sample collected:
Field analysis: pH (0. S , Specific Conductance Umhos
Temp. 2-1 °C, Odor Appearance
-12
DEPARTMENT OF ENVIRONMENT & NATURAL RESOU
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER I
PERMIT #: W 0000d5w03 EXPIRATION DATE: -
Non -Discharge U IC
NPDES
TYPE F PERMITTED OPERATION BEING MONITOR
Lagoon Remedialion: Infiltration Gi
Spray Field
Rotary Distributor
Other:
Remedialion:
Land Application of Sludge .
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: 5de fSelatA)
Laboratory Name: wer T _eln
Certification No. So
PARAMETERS (Samples for metals were collected unfiltered--2_YE5 NO
and field acidified
COD
Coliform: MF Fecal
mg/I
/100ml
Nitrite (NO2) as N
Nitrate (NO3) as N
m /I
Coliform: MF Total
/100m1
mg/I
g
Phosphorus: Total as P ���'�-lZ �0l'7 m /I
(Note: Use MPH method for highly turbid samples) ,
. Orthophosphate
mg/I
Dissolved Solids: Total 9-17 -) Z 190 mg/I
Al - Aluminum J -ZoA 2
o.1 Og mg/I
pH (when analyzed) 12-14m1Z
(-.`? units
Ba- Barium_ -Zo-IT
oblo(c, mg/I
TOC'9 -Zo -1 Z.
f.95' mg/I
45eo
Ca - Calcium _S-2®-1 Z
11.1 mg/I
Chloride V-Z1*01&
Arsenic _'P- Zo-- Z
mg/I
40- 009 mg/I
Cd - Cadmium_fi-Z®-I-
Chromium: Total'i-Zo-Vt _
0.007- mg/I
<o, cog mg/I
Grease and Oils
mg/I,
Cu - Copper
mg/I
Phenol
Sulfate -2_0 --1Z
mg/I,
mg/I
Fe - Iron
Hg -Mercury
mg/I
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium 9 -10-I Z
S Z3 mg/I
TKN as N
mg/I
Mn - Manganese 9-ZoJV
6.149 mg/I
__ -YES NO)
Ni- Nickel_ 2-2o-1 z 40.005 mg/I
Pb - Leads -Z®- IZ /_o .00S mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
_ —ele tor, % -20 -rt 40.66S tM4).k
S,drl . 0 rn '6 - Zo - t7_ 11-12.® , p
ORGANICS: (GC,GC/Ms,HPLC).
(Specify test and method #. Attach lab report.)
Report Attached? Yes—(1). No Le"(0)
VOC : method # =
method #
method 4 =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
'FACILITY INFORMATION ' A Please Print Clearly or Type
Facility Name: CDQkS� A V\ r j CaA
Permit Name (if different):
Facility Address:'20 501, BUS
CQC3.t Inn Istreeq JU C_ 74krt SZ
lCey) 1e lZZ County ths- pow e l t
Contact Person: i li r Telephone #: ?Zd `?*t ,
Well Location/ Site Name: f C' No. of Wells to be Sampled: _
(Iron Permll)
Well Identification Number (from•Permit): rALO- 11
Depth: t For Groundwater Treatment Systems
Well De
P 3 Jt. Well Diameter: Z in. Check0ne: ❑ Influent 98
Screened Interval: /V IT ft. to ft.
P —1]� 11 ti. below measuring point. Effluent 99 Depth 10 Water-Leve{: � • ( )
Measuring Point (M.P.) is: .lo "iL:above land surface. Relative M.P. Elevation in ft::
Gallons of water pumped/bailed before sampling: 3W Date sample collected: 9 l 1-IZ
Field analysis: pH Lo r , Specific Conductance ' uMhos
Temp. 21 °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: WQpt :j 1p03 EXPIRATION DATE: 5
Non -Discharge UIC
NPDES
TYPE F P RMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor
Other:
Land Application of Sludge
NOTE: Values should reflect dissolved and .
colloidal concentrations. (�
Date sample analyzed: - - eww RECEIVED
Laboratory Name:.LA-)A-TLle -rr-C (lf� ( 7n12
Certification No. So
PARAMETERS (Samples for metals were collected unfiftered_:�__YES NO
COD
and field acidified
mg/I
/100ml _
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/I
Coliform: MF Fecal
Coliform: MF Total
/100ml
m /I
Phosphorus: Total as P -28-12 O.1'7 mgg/I
(Note: Use MPH method for highly turbid
Dissolved Solids: Total _$'-17-12
samples)
t%b mg/I
Orthophosphate
AI - Aluminum 8 -Zo-12
mg/I
pH (when analyzed) $-J%A 11L
k..q units
Ba - Barium V-2t]-1?
mg/I
mg/1
TOC -20-12
7-1 mg/I
<S;o mg/I
Ca - Calcium_ 2-?o-12
Cd -Cadmium S =20-17•
<o.Sop mg/I
Z-o -00z.
Chloride . 4i •2:1- Iz
Arsenic Ss •Zo-tz
40.005 mg/I
Chromium: Total V-Zo-12
mg/I
4 o.coS mg/I
Grease and Oils
mg/I
'Cu - Copper
m g /I
Phenol
Sulfate -20-1Z.
mg/I
mg/I
Fe -Iron
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
g/I
Total Ammonia
TKN as N
mg/I
Mg - Magnesium 9-2o-1Z
mg/I
mg/I
Mn - Manganese -20-12
999r�g/l
X YES NO) D —
Ni - Nickel 8 -•ZC) -12 G o Co mg/I
Pb - Lean S -?o -12 <o. C�S mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
U�i1it� �•�:�
Sele.iliun'i 8-7A-1-4 Lb�OoSrr I,Q
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report )
Report Attached? Yes (1) No (0)
VOC method # =
method # =
method #

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name S AlMeCiMft
Permit Name (if different):
Facility Address:eTd
(Street) We Well
ll
( �iY);vl . County.—
Contact Person: ) t+nan Telephone #: $2� ''1S(o -q 1k X
Well Location/ Site Name: SP ;e C U t1 No. of Wells to be Sampled: _
- (Irom ermll)
Well Identification Number (from Permit):._ M U-) - 11, For Groundwater Treatment Systems
Well Depth: 13 ­ft. Well Diameter �_ in. -Check One: ❑ Influent .(98)
Screened Interval: �I— ft. to —_ it,
Depth to Water Level: 10 It. below measuring point. ❑ Effluent (99)
Measuring Point (M.P.) is: Z , 6 it. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: —�— Date sample collected: - tA-1Z-
Field analysis: pH rl, Z , Specific Conductance uMhos
Temp. Z1 °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #:WG. MC%;o03
Non -Discharge
EXPIRATION DATE: S -ZO 1l
UIC
NPDES
TYPE F PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations. RECEIVED
Date sample analyzed: 5 Er
Laboratory Name: _W BTC CZ T£ 4t ACT ),; o
Certification No. _ 50
PARAMETERS (Samples for metals were collected unfiltered A YES NO
and field acidified
COD
mg/I
/100ml
Nitrite (NO2) as N
_ Nitrate (NO3) as N
m /I
Coliform: MF Fecal
Coliform: MF Total
/100m1
mg/I.
g
•Phosphorus: Total as P_�-Zq-1Z D•m9 /I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: ;T'otal!j l2 nFr) mg/I
Al - Aluminum -20-12.
0. 10k mg/I
pH (when analyzed) S_-1q-I2 1 -
TOC %- Z O -17- '1,39
l units
Ba - Barium 9-Zo - Iz
0.139 mg/I
-- mg/I
Chloride � �Z1 -1'L 5:d mg/I
"w-Zo
Ca : Calcium S- Zo -Iz
Cd - Cadmium_ 'Ps -Zo-12
54 . I mg/I
4-a.007-mg/I
Arsenic -1Z. 40,005
mg/I
Chromium: Total �r -ZO=►2
40 •ooSmg/I
Grease and Oils
mg/I
Cu - Copper.
mg/I
Phenol
Sulfate—-Zo-IZ Z2r
mg/I
mg/I
Fe - Iron
Hg - Mercury
/I
mg/l
Specific Conductance
uMhos
K - Potassium
mg
mg/I
Total Ammonia
mg/I
Mg - Magnesium Q -Zo -12
11 S mg/I
TKN as N
mg/I
%Mn - Manganese -ZO =tZ
z, Scl mg/I
.�uvn rr nit
X YES NO)
Ni - Nickel �-Za -12
L g/
Pb-Lead _ W-20-1
a tbmg/1
Zn - Zinc
mg/1
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
Pleniem '20-1
L.D.I�U�/�
-o-
D9ma
0
ORGANICS: (GC,GC/MS,HPLC)
(Specify test arid method #. Attach lab report.)
Report Attached? Yes (1) No � (0)
VOC : method # -
mall -my
method#=
Certify that, to the best of my knowledge and belief_ ihp infnrmafiAn

i✓
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:
Permit Name (it d
Facility Address:_
Contact Person:
Well Location/ Site Na e.
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County I f t'�11—
7elephone #: LS -75fo
No. of Wells to be Sampled:
Well Identification Number (from Permit): (Y) U) -13 For Groundwater Treatment Systems
Well Depth: 15 it. Well Diameter: 2 in. Check One: ❑ influent (98)
Screened Interval: . ft_ to �_ ft. El Effluent (99)
Depth to Water Level: 12•"l ft. below measuring point.
Measuring Point (M.P.) is: Z- to ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 3%y Date sample collected: 9 - W- jZ
Field analysis: pH b "1 Specific Conductance uMhos
Temp. Z-*Z °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT $ NATURAL RESOURCES
WATER OUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: LA-_> QCKD0,S(o63
Non -Discharge
NPDES
EXPIRATION DATE: -2011
UIC
TYPE OF PERMITTED OPERATION BEING MONITORED
—�� Lagoon Aemedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .RECEI'VED
colloidal concentrations.
Date sample analyzed: _ 5 C r- oW QC I (. o Z 0 ;Z
Laboratory Name: w NT£ t2 Te, vM information Proce sins t fnit
Certification No. Sb DWQ/BOG
PARAMETERS (Samples for metals were collected unfiltered__,)(_�YES NO
and field acidified
COD
Coliform: MF Fecal
mg/I
/100ml
Nitrite (NO2) as .N
Nitrate (NO3) as N
m /I
Coliform: MF Totaf
/100m1
mgg/I
g
Phosphorus: Total as P �-ZFr-)Z <o.�tq-n /I
(Note: Use MPN method for hlghl turbid Samples)
P
Dissolved Solids: '-
Orthophosphate
mg/I
Total - Z 31 mg/I.
pH (when analyzed)_�'r-14-12 7-0 units
Al - Aluminum i-n-l?
Ba - Barium 9-7O-IZ
D. 1tcA mg/I
TOC 19-20 -1`-
1 q "1 mg/I
Ca - Calcibm_ h' -1Z.
0. u4y mg/I
)to .6 mg/I
Chloride _2 -Z1- IZ
4 S.O mg/I
Cd - Cadmium 16 - 7 0 -IZ
< b -OOZ mg/I
Arsenic 2 -Zo -17-
a.00s mg/I
Chromium: Total l Z0-12
4.0,o05 mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
Sulfate Ss =Zo -12
2 mg/I
g
He - IMercu ron
g �'
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
mg/I
Total Ammonia
mg/I
Mg - Magnesium B-ZO-IZ-
10.71 mg/I
TKN as N
mg/I
Mn - Manganese _'-Zo-17
U-415.E mg/I
(or Author( Agent) Name and
__X__YES NO)
Ni - Nickel_F-Z0-1Z /10.00
mg/l
Pb -LearL mg/1
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
ReportAttached? Yes (1) No �i (0)
VOC method # =
method # _
method # =
print or type
GW-59
Rev. 03/2000
lee
EWAWo

V
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: l�(X
Permit Name (if di e
Facility Address:
Contact Person .A �
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County 1tt` L �11)J)� I 1
Telephone #: ��IQ -`
No. of Wells to be Sampled:
Well Identification Number (from Permit): _m t_AJ- 1Li For Groundwater Treatment Systems
Well Depth: 5 it. Well lameter Z in. Check One: ❑ Influent (98)
Screened Interval: ft. to it- El Effluent (99)
Depth to Water Level: 1 it. below measuring point.
Measuring Point (M.P.) is: Z• b ft. above land surface. Relative M.P. Elevation in ft.-
Gallons of water pumped/bailed before sampling: .Z Date sample collected:
Field analysis: pH__Us'3_ Specific Conductance uMhos
. Temp. U °C, Odor Appearance
PARAMETERS (Samples for metals were collected unfilte
COD mg/I
Coliform: MF Fecal /100m1
Coliform: MF Total /100m1
(Note: Use MPN method for highly turbid sample``s�
Dissolved Solids: Total 2-11-12 �1L12 mg/I
pW(when analyzed) V-1a-VZ -q units
TOC %-2o-1 3.Z5 mg/I
Chloride 2-7-1-1'Z 4$. > mg/I
Arsenic $ - Zo -1-1 oo S mg/I
Grease and Oils mg/I
Phenol mg/I
Sulfate 1i -Zo -12 11. mg/I
Specific Conductance uMhos
Total Ammonia mg/I
TKN as N mg/I - -
method #
method #
�= a .. , -..- _.. . .. .
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: WCCJOc5cQp3 EXPIRATION DATE: Zbl
Non -Discharge U IC
NPDES
TYPE F PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations. %CVJ
Date sample analyzed: �[r �F_lft�
Laboratory Name: �)C0 r 'T _ (` � ACT 1 6 2012.
Certification No. _ 5c) Information Processing Unit
red /� YES NO and field acidified
Nitrite (NO2) as N m /I
Nitrate (NO3) as N mg/I
Phosphorus: Total as P� -2� - I Z e-o.)(,m9/I
Orthophosphate mg/I
9
Al - Aluminum''-Zo-12 o.(.,sko mg/I
Ba - Barium -20 - l2 0. 1 8 mg/I
Ca - Calcium _ S 'Zo -1Z q1.2 g
Cd - Cadmium -Zo -17 <a.00Z mg/I
Chromium: Total 9 -Zo -l2 40, OoS mg/I
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
k - Potassium mg/I
Mg - Magnesium S-70-IZ S3.8 mg/I
Mn - Manganese_V-20 Al o• 4o� mg/I
_YES NO)
Ni - Nickel 9 - ZD -M L O.00 S mg/I
Pb - Lear: -Zo -1 O ppq mg/I
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
SelQnion,-20-1'L Lo 005 I.SZ
4 i von - - IZ QtA Z �'+19t1 J-
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No _X (0)
VOC : method # =
i,�n.�co ��� t+uuiunze gents Name and. Title -Please print or type
GW-59 -Z'-) -
Rev. 03/2000 Stgnalure of Permillee or prized Agent)

V
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:' k: ,1.
Permit Name (if d jjere
Facilitv Address O
Contact Person:Yt1J11ll_
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County t l Ke llrit g e l 1.
Telephone #:.R?S- 790 -u
No. of Wells to be Sampled:
Well Identification Number (from Permit): M -1 For Groundwater Treatment Systems
Well Depth: 10 it. Well D'ameter•: Z "1- Check One: ❑ Influent (98)
0 Screened Interval. _ ft. to A_ ft.
Depth to Water Level-.. 12- 1 it. below measuring point' El Effluent (99)
Measuring Point (M.P.) is: Z.le ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/b iled before sampling: _,� Date sample collected: IR _)L4 -I IL
Field analysis: pH�9 , Specific Conductance ' uMhos
. Temp. Z0 °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGHNC 27699-1636 Phone: [phone]:
PERMIT #: Flo Q 000
Non -Discharge
NPDES
EXPIRATION DATE:
UIC
TYPE PF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and . ®�
colloidal concentrations.
Date sample analyzed: �j[L t�Dtti) OCT f �
LaboratoryName: _W ft t Qe T£ to 'in
Certification No. SO recessing Unit
DWQ/BOG
PARAMETERS (Samples for metals were collected unfiltered A YES NO
and field acidified
COD
Coliform: MF Fecal
mg/I
/100m1
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/I
Coliform.: MF Total
/100ml
Phosphorus: Total as PI-ZSr-IZ 4-,W
mg/I
mg/l
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Totals-0-12 -,,A? mg/I
Al -Aluminum. 2-ZO-12
0 OV9
mg/1
pH (when analyzed) 1,�-ltA -1Z
Vs
'°l Z units
Ba - Barium -9 -20 - Z
0 . 11 R
mg/I
TOC -Z® 1-L
3 11 mg/I
mg/1
Ca - Calcium -Za-1Z
Cd-Cadmium S-Zo-1Z
126.0
mg/I
mg/I
Chloride
4o.007-
Arsenic 9-Zo-ft
40.Op5 mg/I
Chromium: Total S-2a-12
4o.c�b5
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
Sulfate-io-1Z
mg/l
113 mg/I
Fe -Iron
Hg - Mercury
mg/I
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium ' zo-1Z.
- Z.4i
mg/I
TKN as N
m ga
Uang.,
n. YES NO)
Ni - Nickel '�-Zo-1Z 46.00S mg/I
Pb - LeadB-Zo-tZ o,nos mg/I
Zn -'Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
Ix1iu� -20-12
Z0�T,Q.
ORGANICS: (GC,GC/MS,HPLC).
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No X_ (0)
VOC : method # =
method
1 certify that, to the best of my knowledge nnri hatie f oin infnnimnfin.. tit, :_ .L
GW-59
Rev. 0312000
re of Nerfnillee (or
or type

�• vv---)yFi UU10' PLIANCE REPORT FORM Permit (Suhmit one each monitoring period with GFV forms.)
I 1 Enter date monitoring results were due. - Will this monitoring report (GW-59 and GW-59A)
be submitted after the established due date?
YES
NO
2 Was any required information missing on the GW-59 report forms?
`
IF the answer to question 1 or 2 is "YES", list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the
YES
NO.
required information.
3 Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
identification plate, area overgrown, etc.)? If the answer is "?es ",
YES
NO
contact the Regional Office for giiidance.
4 Are any monitored constituents equal to or above the established standards?
If the answer to question 4 is "NO", skip to section 8. -
YES
NO
If the.answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s) exceeding standards in the space provided below:
MLC41 L.*ctd 0-0l99 �.Q rn w e--
Z.
_ ► 05 150 nncalJL
(AGAta4esc d . 93,�k AlargQne6,e z,sq nQj�
5 For the constituents identified in quescri
same constituent(s) in the same well(s) in the last two years?
tion 4 above, have standards been exceeded previouslJ�ng
YES
NO
If the answer to question 5 is `NO'; skip to section 8.
If the answer to question 5 is "YES", list in the space provided below, each well with constituent(sstandards, concentration(s) reported, and sample collection date
for each occurrence (for the last tw
rY1 t•v Z' fYi4rnPs 1,1� �+�3L i2 -lam -11 -� 1'L (ylgc�gnes e Z,`;;3'&nP5
_
C
Mein �'onese- 1- tot rA814 `i -3-17- 7DS ;5 56—�JQ. � -9 -
��
- l iI
t_raa 6.05G M2,IJL 4 -3> 1'� i PS Sao m�Z
3,�6
DS �� ®�, �t-tql
Are the monitoring wells listed inlocated at or beyond the review boundary?YE
0if
the answeris "YES', a groundwater quality problem maybe occurring. CONTACT THE REGOFFICE IMMEDIATELY FOR GUIDANCE. If the
"NO',
answer is monitoring wells maybe improperly
located, contact the Regional Office.
7 Is the permittee implementing previously approved actions required by the Division involving this
groundwater quality problem?
YES
NO
If the answer to question 7 is "YES", describe those actions in the space provided below.
If the answer to question 7 is "NO", contact the Regional
Office within 90 days; an evaluation may be
re wired to determine the im act the was osal s stem ► s havtn co
boundaries at the review and m liance
surroundingthis facili Fai ma sub'ect the permittee to a Notice of Violation
fines, and/or penalties
It7fpr
tloQ
O1VQ/eOGsig9
Ij
g The person completing this portion (GW-59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the
address provided at the top of the current GW-59 form.
1 here6yacknowledge that;thR, ove Information was eValuatc d and the Information submltted�nthis
report (Compliance Report GW 59A} is true and complete to the best of my knowledgeA
_...,
�P,,-e
ignature of (or Authorized Agent) Date
GW-59A 12/8/2003

rm tl lire LITYS,Inc.
POST OFFICE BOX 1056 4 #15 PINEWOOD PLAZA DR,
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#02) COLLECTION DATE:
8/14/2012
PERMIT #: COLLECTION TIME:
09:05
ADDRESS: Coats America (Wells) RECEIVED DATE:
8/14/2012
P.O. Box 368
RECEIVED TIME:
14:50
Marion, NO 28752
REPORTED:
9/21 /2012
.ANALYST
ANALYSIS
RESULT'S
UNITS
dATE
ANALYST
Sulfate
144
mg/L
8/20/12
Chloride
6.5
mg/L
8/21/12
lag
T. Phosphorus
0.46
mg1L
8/28/12
jdg
too
<1.0
mg/L
8/20/12
TDS
102
mg/1-
8/17/12
lag
metals
see attached
pH ` >holding time
7.0
su's
8/14112
lag
LOG ID: 1208-202 REPORTED BY: NC CERTIFIED LAB # 5
Tony Gragg, Lab Supervisor

. rivi
POST OFFICE BOX 1056 • #5 PINEWOOO PLAZA DR.
GRANITE FALLS, NORTH CAROLlNA 28630
[phone]
SAMPLE: Coats America (MW#10) COLLECTION DATE: 8/14/2012
PERMIT #: COLLECTION TIME. 09:15
ADDRESS: Coats America (Wells) RECEIVED DATE: 8/14/2012
P.O. Box 368 RECEIVED TIME: 14:50
Marion, NC 28752
REPORTED: 9/21 /2012
AN,
ANALYSIS
RESULTS
{WITS
DATE
ANALYST
Sulfate
26.7
mg/L
8/20/12
Chloride
<5.0
mg/L
8121/12
lag
T. Phosphorus
<0.16
mg/L
8/28/12
Jdg
toc
<1.0
mg/L
8/20/12.
TDS
108
mg/L
8/17/12
lag
metals
see attached
PH ' >holding time
7.3
su's
8114/12
lag
LOG ID: 1208-203, REPORTED BY: NC,CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

WrtivnrcH LRES,ll,..
A
POST OFFICE 8OX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#11) COLLECTION DATE: 8/14/2012
PERMIT #: COLLECTION TIME: 09:20
ADDRESS: Coats America (Wells) RECEIVED DATE: 8/14/2012
P,O. Box 368 RECEIVED TIME: 14:50
Marion, NC `28752
REPORTED: 9/2112012
ANALYSIS
,4NA ysi$
RESULTS
L/NITS
DAATE
ANALYST
Sulfate
40.2
mg/L
8/20/12
Chloride
<5.0
mg/L
8/21/12
lag
T. Phosphorus
0.17
mg/L
8/28/12
jdg
toc
2.78
mg/L
8120112
TDS
180
mg/L
8/17/12
lag
metals
see attached
pH ">holding time
6.7
su's
8114/12
lag
i
LOG ID:, 1208-204 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

idivrERiTECH ITIF.S.Inc.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#12) COLLECTION DATE:
8/14/2012
PERMIT #: COLLECTION TIME.,
09:25
ADDRESS: Coats America (Wells) RECEIVED DATE:
8/14/2012
P.O, Box 368 RECEIVED TIME:
14:50
Marion, NC 28752
REPORTED:
9/21 /2012
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
Sulfate
22.8
mg/L
8/20/12
Chloride
<5.0
mg/L
8/21/12
lag
T. Phosphorus
0.24
mg/L
8/28112
jdg
toc
3.39
mg/L
8/20112
TDS
750
mg/L
8/17/12
lag
metals
see attached
pH ` >holding time
7.1
su's
8/14/12
lag
LOG ID: 1208-205 REPORTED BY: NC CERTIFIED LAB #f 50
fl�6"
Tony Gragg, Lab Supervisor

pwrEnirEcH Livas,c.
a
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28830
[phone]
SAMPLE., Coats America (MW#13) COLLECTION DATE: 8/1412012
PERMIT #: COLLECTION TIME: 09:30
ADDRESS: Coats America (Wells) RECEIVED DATE: 8/14/2012
P.O. Box 368 RECEIVED TIME: 14:50
Marion, NC 28752
REPORTED: 9/21 /2012
ANAL.YSI S
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
Sulfate
24.4
mg/L
8/20/12
Chlorlde
<5.0
mg/L
8/21112
lag
T. Phosphorus
<0.16
mg/L
8/28112
jdg
toc
1.97
mg/L
8/20/12
TDS
331
mg/L
8/17112
lag
metals
see attached
pH >holding time
7.0
su's
8/14/12
lag
LOG ID: 1208-206 REPORTED BY: NBC` CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

rriv4 mcH LRES.Inc,
POST OFFICE BOX 1056 - #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#14) COLLECTION DATE., 8/14l2012
PERMIT #: COLLECTION TIME: 09:35
ADDRESS: Coats America (Wells) RECEIVED DATE: 8/14/2012
P.O. Box 368 RECEIVED TIME: 14:50
Marion, NC 28752
REPORTED: 9/21 /2012
ANAL YSIS
ANALYSIS.
RESULTS
UNITS
DATE
ANALYST
Sulfate
11.5
mg/L
8/20/12
Chloride
<5.0
mg/L
8121112
lag
T. Phosphorus
<0.16
mg/L
8/28/12
Idg
too
3.25
mg/L
8/20112
TDS
442
mg/L
8/17/12
lag
metals
see attached
pH >holding time
6.9
su's
8/14/12
lag
E
LOG ID: 1208-207 REPORTED BY: N�Ce CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

idivrEpwirEcHLES. In c.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 26630
[phone]
SAMPLE: Coats America (MW#15) COLLECTION DATE: 8/14/2012
PERMIT #: COLLECTION TIME: 09:40
ADDRESS: Coats America (Wells) RECEIVED DATE, 8/14/2012
P.O. Box 368 RECEIVED TIME; 14:50
Marion, NC 28752
REPORTED. 9/21 /2012
ANALYSIS. .
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
Sulfate
113
mg1L
8/20112
Chloride
<5.0
mg/L
8121/12
lag
T. Phosphorus
0.78
mg/L
8/28/12
jdg
too
3.1.1
mg/L
8/20112
TDS
398
mg/L
8/17/12
metals
see attached
pH">holdingtime
7.2
su's
8/14112
lag
LOG ID: 1208-208 REPORTED BY: NC, CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

Ys: �0` G��& Ah1ACYTj �P i�
RESEARCh & ANAiyTICA1 ��. .... ,..• •
LAbORATWES INC.
NC #34
Analytical/Process Consultations
Water Tech Labs, Inc. Date Sample Collected 08/14/12
P,O. Box 1056 Date Sample Received 08/20/12
Granite Falls, NC 28630 Date Sample Analyzed 08/20/12
Attn: Joe Gragg Date of Report 08/30/12
Analyses Performed by AD -JC -KL
Lab Sample Number
738428
Parameter Storet ## Results
TOC,
(00680)
<1.0 mg/l
Magnesium,Tot
(00927)
17.1 mg/l
Lead,Tot
(01051)
0.067 mg/l
Manganese,Tot
(01055)
1.73 mg/l
Aluminum,Tot
(01105)
4.76 mg/1
Calcium,Tot
(00916)
32.6 mg/l
Chromium,Tot
(01034)
0.005 mg/1
Cadmium,Tot
(01027)
<0.002 mg/l
Nickel,Tot
(01067)
0.016 mg/l
Sodi.um, Tot
(00929)
1.0.9 mg/1.
Selenium,Tot
(01147)
<0.005 mg/1
Barium,Tot
(01007)
0,201 mg/1
Arsenic, Tot
•(01002)
<0.005 mg/l
Sulfate
(00945)
144 mg/l
--------------------
Clients Sample Source COATS AMERICAN
Number MONITORING WELLS MW2
Time Collected (Hrs) 0905
P.O. Box 473 • 106 Short Street - Karnersville, North Carolina 272B4 •336-996-2841 ^ Fax [phone]
www,randalabs.com

4®,etvISRIIil1'r ,
RESEARCh & ANA1yTICAL
LABORATORIES, INC No #34
Analytical/Process Consultations ; t
+�ll�f7ff1�j1�
Water Tech Labs. Inc. Date Sample Collected : 08/14/12
P.O. Box 1056 Date Sample Received 08/20/12
Granite Falls, NC 28630 Date Sample Analyzed 08/20/12
Attn: Joe Gragg Date of Report 08/30/12
Analyses Performed by JC -AP -KL
.Lab Sample Number
---------------------
738429
Parameter Storet # Results
TOC (00680) <1.0 mg/1
Magnesium,Tot (00927) <0.500 mg/1
Lead, Tot (01051) <0.005 mg/l
Mariganese,Tot (01055) <0.005 mg/l
Aluminum,Tot (01105) 0.184 mg/l
Calcium,Tot (00916) <0.500 mg/1
Chromium,Tot (01034) <0,005 mg/l
Cadmium,Tot (01027), <0.002 mg/1
Nickel,Tot (01067) <0.005 mg/1
Sodium,`Zot (00929) 44,8 mg/1 1
Selenium,Tot (01147) <0.005 mg/1
Barium,Tot (01007) 0.013 mg/l
Arsenic,Tot (01002) <0.005 mg/1
Sulfate (00945) 26.7 mg/l
--------------------
Clients Sample Source COATS AMERICAN
Number MONITORING WELLS MW1(Z'
Time Collected (Hrs) 0915
P, 0, Box 473 ^ 106 Short Street • Kernersville, North Carolina 27284 ^ 336.996-2841 • Fax [phone]
www.randalabs.com

- RESEARCh & ANA1YT9CAL
LAbOIRATWES, INC.
Analytical/Process Consultations
U)
NC#34
Q 4v
r,G � • rqEC'tdQ' �� �•
'PIED AN�'���
14111Idf111o1�4
Water Tech Labs. Inc.
Date Sample Collected
08/14/12
P.O. Box 1056
Date Sample Received
08/20/12
Granite Falls,
NC 28630
Date Sample Analyzed
08/20/12
Attn: Joe Gragg
Date of Report
08/30/12
Analyses Performed by
AP -JC -KL
Lab Sample Number
-------------------
738430
Parameter
Storet #
Results
TOC
(00680)
2.78 mg/l
Magnesium,Tot
(00927)
5.28 mg/1
Lead,Tot
(01051)
<0.005 mg/l
Manganese,Tot
(01055)
0.748 mg/l
Aluminum,Tot
(01105)
0.108 mg/l
Calcium,Tot
(00916)
17.7 mg/l
Chromium,Tot
(01034)
<0.005 mg/l
Cadmium,Tot
(01027)
<0.002 mg/1
Nickel,Tot
(01067)
<0.005 mg/l
Sodium,Tot
(00929)
42.0 mg/1
Selenium,Tot
(01147)
<0.005 mg/1
Barium,Tot
(01007)
0.106 mg/l
Arsenic,Tot
(01002)
<0.005 mg/1
Sulfate
(00945)
40.2 mg/1
--------------------
Clients Sample Source COATS AMERICAN
Number MONITORING WELLS MW1k
Time Collected (Hrs) 0920 _
P.O. Box 473 > 106 Short Straot • Kernersvilla, North Carolina 27284 • 336-996-2841 • Fax [phone]
www,randalabs.com

RESEARCh ANA1yTICAi
LAbORATORlES, INC.
NC1f.T1'
IjOyA � r
Analytical/Process Consultations Od`
Water Tech Labs, Inc. Date Sample Collected 08/14/12
P.O. Box 1056 Date Sample Received 08/20/12
Granite Falls, NC 26630 Date Sample Analyzed 08/20/12
Attn: Joe Gragg Date of Report 08/30/12
Analyses Performed by : AD -KL -JC,
Lab Sample Number
--------------------
738431
Parameter Storet # Results
TOC (00680) 3.39.mg/l
1
Sulfate (00945) 22.8 mg/l
Magnesium,Tot (00927) 11.5 mg/l
Lead,Tot (01051) <0.005 mg/l
Manganese,Tot (01055) 2.59 mg/1
Aluminum,Tot (01105) 0.106 mg/l
Calcium,Tot (00916) 59.1 mg/1
Chromium,Tot (01034) <0.005 mg/l
Cadmium,Tot (01027) <0.002 mg/l
Nickel,Tot (01067) 0.010 mg/l
Sodium,Tot (00929) 209 mg/1
Selenium,Tot (01147) <0.005 mg/l
Barium, -Tot (01007) 0.139 mg/1
Arsenic,Tot (01002) <0.005 mg/l
--------------------
Clients Sample Source COATS AMERICAN
Number MONITORING WELLS MW1',\
Time Collected (Hrs) 0925
P.O. Box 473 • 106 Short Street • Kernersville. North Carolina 27284 •336-996-2841 - Fax [phone]
www.randalebs.com 4

`,,1�`�Tlrirlpjttt
• 11,E �``� r��,,jt�
RESEARCh & ANALyTICA1 �,• • ,,. ;...H,.. ,,.
LAb®RATWES INC.
Analytical/Process Consultations
4
Water Tech Labs. Inc. Date Sample Collected 08/14/12
P.O. Box 1056 Date Sample Received 08/20/12
Granite Falls, NC 28630 Date,Sample Analyzed : 08/20/12
Attn: Joe Gragg Date of Report 08/30/12
Analyses Performed by AD -KL -JC
Lab Sample Number
-----------------
738432
Parameter Storet # Results
TOC
(00680)
Sulfate
(00945)
Magnesium,Tot'
(00927)
Lead,Tot
(01051)
Manganese,Tot
(010.55)
Aluminum,Tot
(01105)
Calcium,Tot
(00916)
Chromium,Tot
(01034)
Cadmium,Tot
(0102.7)
Nickel,Tot
(01067)
Sodium,Tot
(00929)
Selenium,Tot
(01147)
Barium,Tot
(01007)
Arsenic,Tot
(01002)
Clients Sample Source
Number
Time Collected (Hrs)'
1.97 mg/l
i
24.4 mg/l
10.7 mg/1
<0.005 mg/l
0.403 mg/1
0,169 mg/l
16.0 mg/l
<0.005 mg/1"
<0.002 mg/1
<0.005 mg/l
108 mg/1
�0.005 mg/1
0.044 mg/1
<0.005 mg/l
--------------------
COATS AMERICAN
MONITORING WELLS MW13
0930
r
P.O. Box 473 - 106 Short Street • Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone]
www.randalabs.com

�'®�0147lii9,r'e
RESEARCh&ANA��/T�CA�
........
LABORATORIES, INC.
#34
- Analytical/Process Consultations
Water Tech Labs, Inc. Date Sample Collected 08/14/12
P.O. Box 1056 Date Sample Received 06/20/12
Granite Falls, NC 28630 Date Sample Analyzed 08/20/12
Attn: Joe Gragg Date of Report 08/30/12
Analyses Performed by ; AD -KL -JC
Lab Sample Number
--------------------
738433
- -----------------------------------------------------------------------------
Parameter Storet # Results
TOC (00680) 3.25 mg/l
Sulfate (00945) 11.5 mg/l
Magnesium,Tot (00927) 53.8 mg/l
Lead,Tot (01051) 0.009 mg/l
Manganese,Tot (01055) 0.906 mg/l
Aluminum,Tot (01105) 0:656 mg/1
Calcium,Tot (00916) 87.2 mg/l
Chromium,Tot (01034) <0.005 mg/1
Cadmium,Tot (01027) <0.002 mg/l
Nickel,Tot (01067) <0.005 mg/l
Sodium,Tot (00929) 44.2 mg/l
Selenium,Tot (01147) <0.005 mg/l
Barium,Tot (01007) 0.120 mg/1
Arsenic,Tot (01002) <0.005 mg/l
--------------------
Clients Sample Source COATS AMERICAN
Number MONITORING WELLS MWly
Time Collected (Hrs) 0935
P.O, Box 473 . 106 Short Street, Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone]
www.randslabs,com

RESEARCh & ANALyT9CAL
LAbORATORiES,.INC.
Analytical/Process Consultations
,,`���►►tll►d�trr,
� ANAL p +r
+Sr
NC #34 x:
N �
g � v
Water Tech Labs. Inc. Date Sample Collected : 08/14,/12
P.O. Box 1056 Date Sample Received 08/20/12
Granite Falls, NC 28630 Date Sample Analyzed ; 08/20/12.
Attn: Joe Gragg Date of Report 08/30/12
Analyses Performed by : AD -KL -JC
Lab Sample Number
-----------------
738434
Parameter Storet # Results
TOC
(00680)
3.11 mg/l
Sulfate
(00945)
113 mg/l
Magnesium,Tot
(00927.)
32.8 mg/l
Lead,Tot
(01051)
<0.005 mg/1
Manganese,Tot
(01055)
0.849 mg/l
Aluminum,Tot
(01105)
0.029 mg/1
Calcium,Tot
(00916)
86.0 mg/1
Chrcmium,Tot
(01034)
<0.005 mg/l
Cadmium,Tot
(01027)
<0.002 mg/1
Nickel,Tot
(01067)
<0.005 mg./l
Sodium,Tot
(00929)
37.9 mg/1
Selenium,Tot
(01147)
<0.005 mg/l
Barium,Tot
(01007)
0.118 mg/l
Arsenic,Tot
(01002)
<0.005 mg/1
--------------------
Clients Sample Source COATS AMERICAN
Number. MONITORING WELLS MW1 5-
Time Collected (Hrs) 0940
P.O. Box 473 • 106 Short Street • Kernersville, North Caroline 27284. 336-996-2841 • Fax [phone]
www.randelabs.com

CHAIN OF CUSTODY - Analytical Request
Client Name: %n �n J�%/!�✓
Address: C u
Report to:
Phone:
PO Number:
WATER TECH LABS, INC.
PO BOX 1056 -
GRANITE FALLS, NC 28630
PHONE: [phone]
Project Name:
Project Number:
Reauested Analvses
pH Checked Upon Receipt
Preservatives
Cl2 < 0.2 mg/I Upon Receipt
U
Sample Identification
Q
N
o
O
J
Q'
�'
N
U `�
"`
rn
F x
Field Temp. (C") Comments
w
t,.
Ltd
I Stan
Temperature (`C)
Received on lee:
Y / N
i
(7
Sealed Cooler
Y / N
Samples Intact
Y / N
Additional Comments.
Sampler
_ and
_ Date
Printed of Samp1er.
JtR
b
gnature
WLJg,,CV
d - .V
M

CHAIN OF CUSTODY - Analytical Request
Client Name: Cffk (Yl f i(I yL
Address:
Report to:
Phone:
PO Number:
Preservatives
Sample Identification
U
OR
0
z
z
x
�q
+
o
¢,
, �.,
N
�
U
m
z
cc5
z
Mm
41
• • • • • • •
• 'D
• •
)1�
'
Temperature (°G) a�
Received on Ice:
y /
Sealed Cooler.
y / N
Samples Intact Y / N
Additional Comments:
WATER TECH LABS, INC_
PO BOX 1056
GRANITE FALLS, NC 28630
PHONE: [phone]
Project Name:
Project Number

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:
Permit Name (if d)
Facility Address:_
Contact Person: V111 III
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
Z County —Mc 010LL)C--LL
P'!57elephone #: _ _?U- 7% - 4 )1)
No. of Wells to be Sampied: „__1_
Well Identification Number (from Permit): M le) - Z For Groundwater Treatment Systems
Well Depth: �5 it. Well lameter:.�_ in. Check One: ❑ Influent (98)
Screened Interval: /ifT it. to ft. El Effluent (99)
Depth to Water Level: 7+ ft. below measuring point.
Measuring Point (M.P.) is: a,3 ft. above land surface. Relative M.P. Elevation inft,:
Gallons of water pumped/bailed before sampling: _Up Date sample collected:
Field analysis: pH I , Specific Conductance uMhos
. Temp. -AQ 'C, Odor Appearance
Z
DEPARTMENT OF ENVIRONMENT $ NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: WQWIJb(003 EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
✓ Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of SI
Other: dge _- ,a
NOTE: Values should reflect dissolved and .
D
colloidal concentrations.
C:
CD
_
Date sample analyzed: C- 13 G I-6 W
M
Laboratory Name: W AT 171- 1Z 7-C-
Certification No.
c�
E2
PARAMETERS (Samples for metals were collected unfiltered,_ —YES NO and field acidified
COD mg/1 Nitrite (NO2) as N mg /1
Coliform: MF Fecal /100ml Nitrate (NO3) as N m/I
Coliform: MF Total /100ml Phnsnhnri ic• Tntal 9e 0 U-zfi_'1 A.L.+Q'.� �11
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total + ?-/ Z 01
pH (when analyzed) _9-3-/Z
TOC N-JO -Iz <I.o
mg/l
units
mg/1
Chloride 41-10-12 -7%o
mg/I
Arsenic y-5-17- b•oog
mg/I
Grease and Oils
Phenol
mg/1
mg/I
Sulfate 17 ,-7-
mg/1
Specific Conductance uMhos
Total Ammonia mg/I
TKN as N mg/I
GW-59
Rev. 03/2000
Orthophosphate
mg/I
Al - Aluminum' -5-17-
y,09
mg/I
Ba -Barium H -5- t z
a-1%,2
mg/I
Ca - Calcium. 14-5-1z
3'7,o
mg/I
Cd - Cadmium 14-5-17-
<o.goZ mg/I
Chromium: Total y -5-1 i
a ,0c>n
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I.
Mg - Magnesium q-S-IZ
)9,11
mg/I
Mn - Manganesey-5-1i
/- (-/
m❑/I
YES NO)
Ni - Nickel -s-1Z
&Ptc. mg/I
Pb - Lea y - - I?-
a ,059 mg/I
Zn - Zinc
mg
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
�eleninm �1-5-12
<o,00s ,,,ilk
SodiuM / -5-1Z
/0•'7 malt
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes-I(l) No ✓(0)
VOC ; method # =
method # =
method # =
Name and Title - Please print or type
.O MAY 212012
Agent)
Information Processing Unit
DWO/BOG
5 - )'7 V Z-

V/
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: 1 I)(i"I
Permit Name (if di ere
Facility Address:
Contact Person:='rullip
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY -
Please Print Clearly or Type
Countv.
iTelephone #: �,n-%Sfo - U I I)
No. of Wells to be Sampled:_
Well Identification Number (from Permit): _M W An
Well Depth: For Groundwater Treatment Systems
P it. Well iameter: Z in. Check One: ❑ Influent (98)
Screened Interval: It. to ft.
Depth to Water Level: ]lot 1 ft. below measuring point. 0 Effluent (99)
Measuring Point (M.P.) is: ` a ft. above land surface. Relative M.P. Elevation in )ft.:
Gallons of water pumped/bailed before sampling:.. 3— Date sample collected:
Field analysis: pH 71,0 Specific Conductance uMhos
Temp. —-°C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #:W&000 15W3 EXPIRATION DATE: S -Zoi 1
Non -Discharge U IC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: Z. E ZELDLAD
Laboratory Name: Ik) I C rZ -T- _ 0 H
Certification No. �5h
PARAMETERS (Samples for metals were collected unfiltered-3—kYES NO
and field acidified
COD
mg/I
/100ml
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/I
Coliform: MF Fecal
Coliform: MF Total
/100ml
mg/I
Phosphorus: Total as P 9-2to-)z <o.ttgng/I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total 4-4-)Z 13-1
Orthophosphate
mg/I
mg/I
pH (when analyzed) 4-3 -1 Z '7.0 units
Al - Aluminum _y-S-lz
Ba - Barium 9 - s - i 2
0.0c06 mg/I
TOC_
x-J.0 mg/I
8,5
Ca - Calcium z1-5- I2.
0 . nz0 t-ng/I
Lo,Soo mg/I
Chloride'-/-ltc-)z
Arsenic 14-5-1Z
mg/I
40•oo5 mg/I
Cd-Cadmium q-5-17-
Chromium:Totaly-5-1z'
L.0.007- mg/I
co.00s mg /I
Grease and Oils
mg/I
Cu - Copper
m/i
Phenoron
Sulfa el q - 5 -) z
'Z � 7 mg/l
mg/1
Hg - (Mercury
m9/I
Specific Conductance
K - Potassium
mg/1
mg/I
otal Ammonia N
TKN
mg/I
Mg - Magnesium y - 5 -1Z
4o.t500 mg/I
mg/I
Mn - Manganese N -5-1'7-
4.0.o05 mg/I
YES NO)
Ni -Nickel. y-S-Iz
40.005 mg/I
Pb - Leant y -5 -12
4 o 00 S mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and
Concentration Units)
5elenio—M 44-5-I z
�o oos r►,,i,�
O t m 7-
Ai /. M
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No V` (0)
VOC method # =
method # =
method #._
r.....+r .,u�J111-�n•l3�lll�)�► ��� 1l�uf �l�rr�i .�Ti ..

.0/
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:
Permit Name (it d
Facilitv Address: -
Contact Person:�VWllj1.
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
2 S County rbO W O 1
3relephone'#:_r`�l�-7S(o -L/1) j
1.1 No. of Wells to be Sampled:..—�
Well Identification Number (from Permit): POW--11 For Groundwater Treatment Systems
Well Depth: 13,0 it. Well Diameter: z in. Check One: ❑ Influent (98)
Screened Interval: n1IT_ ft. to. NII� f(. [] Effluent (99)
Depth to Water Level: 103G ft, below measuring point.
Measuring Point (M.P.) is:3. b ft. above land surface. Relative M.P. Elevation in ff.:
Gallons of water pumped/bailed before sampling: J5 Date sample collected:
Field analysis: pH Ln• y Specific Conductance ' uMhos
. Temp. 12 QC, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION; GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC 27699-1636 Phone: (919) 713_1r.
PERMIT #: W 61,O005(oo,3 EXPIRATION DATE: S -Zo II
Non -Discharge U IC
NPDES_
TYPE OF PERMITTED OPERATION BEING MONITORED
— Lagoon Remedtalion: Infiltration, Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
-1 Z Date sample analyzed: 5eI77: 13t-Lnt,,,)
Laboratory Name: W B 7 r= 2
Certification No. - 5n
PARAMETERS (Samples for metals were collected unfilteredYES NO and field acidified
COD mg/1 Nitrite (NO2) as N mg /I
Coliform: MF Fecal /100ml Nitrate (NO3) as N m/I
Coliform: MF Total /100ml Phncnhnn ic• Tntal ne ID 4_7 r. _/� 9n
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total `i-Q-12 17(2
mg/I
pH (when analyzed) 41-3-t 2 69
units
TOC q-Ib-lz z .IZ
mg/I
Chloride y - I to-- 17- ter,
mg/I
Arsenic q-5-I-z '40.00$
mg/I
Grease and Oils
mg/I
Phenol
rng/I
Sulfate y - 5 -1 2- 33. b
mg/I
Specific Conductance uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Orthophosphate
mg/I
Al - Aluminum y-.5-it
6.377,
mg/I
ea : 13arium 14-5 -12.
O. c744
mg/I
Ca - Calcium 4 -5- ► z
18.7-
mg/I
Cd - Cadmium 4-5-IZ.
40.00z
mg/I
Chromium: Total q-5-1 i
Lo, oos
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/1
K - Potassium
mg/I
Mg - Magnesium y -5-12-
5.8tA
mg/I
Mn - Manganese
ma/I
A YES NO)
Ni -Nickel y-5-17_ 40.Obs mg/I
Pb - Lean'4 - 5 -1 2 Lo, 005 mg/I
Zn - Zinc rng/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
Selen;oa, y-t -17- . /,o .0 0S
Bunn 4^5-t2 314.Z MAI 0
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No ✓ (0)
VOC : method # =
method #
method # _

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: —
Permit Name (if
F-Wility Address:
Contact Person'.�1111144
Well Location/ Site Nar e.
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County I f IL: t X )L.c_ )'I ( _
Telephone #: `l8 ' -
No. of Wells to be Sampled:
dram rermnt
Well Identification Number (from Permit): j 1,A1 `) Z
Well Depth: it. Well Diameter: 7- in. For Groundwater Treatment Systems
Screened Interval: ft. to _�_ ft. Check One: ❑ Influent (98)
Depth to Water Level: 989 ft. below measuring point. ❑ Effluent (99)
Measuring Point (M.P.) is: 2. io ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling:/ d5 Date sample collected:
Field analysis: pH -7' 2 , Specific Conductance ' uMhos
Temp. 89°C; Odor Appearance
-)Z
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT#: W& OW5003 EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE F PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: ',) E = Q) r 1 CW
Laboratory Name: _mil) A'rF_i EC_"
Certification No. 50
PARAMETERS (Samples for metals were collected unfiltered NO
and field acidified
COD OD
mg/I
/100m1
Nitrite (NO2) as N
Nitrate (NO3) as N
/I
Coliform: MF Fecal
Coliform: MF Total
Use
/100ml
mg/I
Phosphorus: Total as P N Zb-) z a.19 mg/I
(Note: MPN method for highly turbid samples)
Dissolved Solids: Total4-9-/Z (Pol
OrthOphosphate
mg/I
mg/I
pH (when analyzed) 4)-3-) Z. 7# Z. units
Al - Aluminum q-5-12
Ba - Barium y-5 -I2
A. /og/ mg/1
D. /y/
TOC _H-/ 0 -1 Z z
o mg/1
Ca - Calcium. Q -5 -12
mg/I
mg/I
Chloride y-1 fo'-12
I Z .
Arsenic 41-5 -) Z
mg/1
Cd - Cadmium_ y-5 -1 Z
<0,007- mg/I
Grease and Oils
mg/1
Chromium: Total 14s-1 z'
i <o,OOS mg/I
Phenol
mg/I
Cu - Copper
mg/I
•Sulfate q-5-I Z A>
mg/I
'7 m /I
Fe : Iron
H Mercury
g ry
mg/1
Specific Conductance
uMhos
K -Potassium
mg/1
mg/I
Total Ammonia
TKN as N
mg/I
Mg - Magnesium q-S-12
/y. 3 mg/I
mg/I
Mn - Manganese 1-5-It
3-IoSr mg/I
(or
GW-59
Rev. 03/2000
—A YES NO)
Ni - Nickel y-s•-IZ 0,069 mg/I
Pb - Lead -Al -5 -1 Z- o o Iq mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
vele(li onn -S - I z 40,OOS avil
—�odiym `I-S-Iz _zoonzq..11
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes 0) No _ / (0)
VOC method # =
or type
method # =
method # =
-1.7 -/ Z

a
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:_,
Permit Name (if d
Facility Address:_
Contact Person: UII111f)
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY.
Please Print Clearly or Type
County f I iL IXI!rl-2Y-/ f
�elephone M - 80rps- 2iS( -
No. of Wells to be Sampled:
Well Identification Number (from Permit): MLA) -13 For Groundwater Treatment Systems
Well Depth: . is it. Well Diameter. z- in. Check One: ❑ Influent (98)
Screened Interval: JO ft. to - A ft. El Effluent (99)
Depth to Water Level: �,'ft. below measuring point.
Measuring Point (M.P.) is:_a-( ft. above land surface. Relative M.P. Elevation in ft.:.
Gallons of water pumped/bailed before sampling: ? Date sample collected: 14-3-1Z.
Field analysis: pH— to1 3 , Specific Conductance ' uMhos
. Temp. _I LS °C, Odor Appearance
DEPARTMENT OF ENVIRONMiENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #:'IA}4 OW
Non -Discharge
EXPIRATION DATE:
U
NPDES.
TYPE OF PERMITTED OPERATION BEING MONITORED
—N Lagoon Reinedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of SIu d
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: EL .13t WLA3
Laboratory Name: 1A3 RT9_Q T r^
Certification No. 56
PARAMETERS (Samples for metals were collected unfiltered__ p_YES NO
and field,acidified
COD
mg/I
/100ml
Nitrite (NO2) as N
Nitrate (NO3) as N
mg /I
m/I
Coliform: MF Fecal
Coliform: MF Total
/100m1
Phosphorus: Total as Py-2(--)Z 0,19
mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total q-Q-)Z
'L76 m9/1
Al : Aluminum L/-5-fZ.
0.4.19
mg/I
pH (when analyzed) L4 - 3-12
16,3 units
Ba - Barium Lit- 5 -1 2
6.0316
mg/I
TOC y -I b -12
Z's"I mg/I
Ca - Calcium `i -5 - I z
ll, z
mg/I
Chloride y -1 b -1 Z
/4, S' mg/I
Cd - Cadmium 14-5 -12
Lo-oo z-
mg/I
Arsenic All- 5 - I z ►moo . oos a mg/I
Chromium: Total y- s -12
4a • ooS
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
m g /I
Sulfate _q-S -I Z
Specific Conductance
y'�,$ mg/I
uMhos
Hg -Mercury
K -Potassium
mg/I
mg/I
Total Ammonia
mg/I
Mg - Magnesium y-5-IZ
7,72-
mg/I
TKN as N
mg/I
Mn -Manganese y-5 -t2
0.z)3
mg/I
(or
GW-59
-Rev. 0312000
ge
—YES NO)
Ni -Nickel y-s -12, O• DOR mg/I
Pb - Lead T76 _ri 0,009mg/l
Zn - Zinc , mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
fnionn ��s-►z
<o,00s r►al,k
ORGANICS: (GC-,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No ✓ (0)
VOC : method # =
method # =
method # _
- mease print or type
S 47-4- / Z

-6/
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:_
Permit Name (if
Contact Person: I�J
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Prinf Clearly or Type
County I I IQ: VUtA-YiU_-
Telephone #: S 20o - 750 - y I I I
No: of Wells to be Sampled:.. r7
Well Identification Number (from Permit): mw- N For Groundwater Treatment Systems
Well Depth: IS ft. Well Djameter: - Z. in. Check One: ❑ Influent (98)
Screened Interval: ---NIA ft. to /V A it. El Effluent (99)
Depth to Water Level: 9-3 ft. below measuring point.
Measuring Point (M.P.) is: Z, io ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: ZoS Date sample collected: 4-3-1'L
Field analysis: pH 401E , Specific Conductance ' uMhos
. Temp. /9 °C, Odor Appearance
PARAMETERS (Samples for metals were collected unfilte
COD mg/I
Coliform: MF Fecal /100m1
Coliform: MF Total /100m1
(Note: Use MPN method for highly turbid samples)
Dissolved 'Solids: Total ?-I Z , B3
mg/I
pH (when analyzed) 14-3-17- (o,grr
units
TOC (I-10 -17- 2, 51
mg/I
Chloride 4- lip-: I z < s. o
mg/I
Arsenic _y-
mg/I
Grease and Oils
mg/I
Phenol
mg/l
Sulfate '1-5 -1 Z 1v. o
mg/I
Specific Conductance uMhos
Total Ammonia
mg/I
TKN as N
mg/I
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMITfl:WSLOooir(oo3 EXPIRATION DATE: 5 -Zoll
Non -Discharge U1C
NPDES
TYPE QF PERMITTED OPERATION BEING MONITORED
Lagoon - Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other: -
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: _5 C- L 5 E 1 OW
Laboratory Name: W R !E0 TECH
Certification No. 50
YYES NO)
Ni - Nickel -4-5 -►z
<0,00s mg/I
Pb - Lead y-S -112-
o -o(oS mg/1
Zn - Zinc
mg/1
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
- 5eleAium
y-5 -1Z
40, M�
f,k
Soliur,
q-5-12
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No ✓ (0)
VOID method # =
method # =
method #
. . . �w�wwee�se�.�
red A YES NO_ and field acidified
Nitrite (NO2) as N mg/I
Nitrate (NO3) as N mg/I
Phosphorus: Total as P 9-zb-iz to if
Orthophosphate mg/I
Al - Aluminum y=5-12 Z,Fry mg/I
Ba -Barium LI-5 -12 0,1 Zq mg/I
Ca - Calcium 4-5-t2 73.3 mg/I
Cd - Cadmium 4-S -11- 4o.00z mg/I
Chromium: Total y-5-12 40.005 mg/I
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potassium mg/[
Mg - Magnesium �1-s-Iz y9.7 mg/I
Mn - Manganese Al-6 -1 z O, 135 mg/I

40/
SUBMIT FORM ON YELLOW PAPER ONLY -
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: Coa}S Anner t on
Permit Name (if different):
Faciliitty` Address: ``}}�' o io s' '3&i'
pireeqA) Q $`%S 2
lChy) 1e) lZt t County MCivOWr1_L
Contact Person: Ili Qi �n Telephone #:-249-2-%-'1///
Well Location/ Site Name: Jler' No. of Wells to be Sampled:
Well Identification Number (from Permit): M W -15 For Groundwater Treatment Systems
Well Depth: � to it, ! Well Diameter- Z in. Check One: ❑ Influent (98)
Screened Interval: �IJ�A ft. to N A ft. El Effluent (99)
Depth to Water Level: ft. below measuring point.
Measuring Point (M.P.) is: Z, to It. above land surface. Relative M.P. Elevation in fit.:
Gallons of water pumped/bailed before sampling: _1 25 Date sample collected:
Field analysis: pH t�� , Specific Conductance uMhos
Temp. 19 °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC 27699-1636 Phone: [phone]:
PERMIT#: wd10005to03
Non -Discharge
EXPIRATION DATE: S -2011
UIC
NPDES
TYPE F PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 51_ C- 15ELDW
Laboratory Name: Wo:.ker-rcClej
Certification No. 5o
PARAMETERS (Samples for metals were collected unfiltered___�_YE5 NO and field acidified
COD mg/I Nitrite (NO2) as N mg/I
Coliform: MF Fecal /100ml Nitrate (NO3) as N mg/I
Coliform: MF Total /100ml Phnsnhnn ts- Tnfnl ne PLJ-21e -12 46.1(o. _n
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total q-9-12
353
mg/I
pH (when analyzed) 14-3-12
Lo, k-
units.
TOC N-10 -1 Z
21 IS
mg/I
Chloride y-JL=1 Z
LS:o
mg/I
Arsenic 4 -5 -12
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate 4-5 -IZ
y3.o
mg/1
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Orthophosphate
mg/I
Al - Aluminum _y-s-i L
40.0- s
rng/I
Ba - Barium 4 -5 -1 z
0.1) 5
mg/I
Ca - Calcium 14-5 -12
172, 3
mg/I
Cd - Cadmium N-5 -1 z
4o ooz mg/I
Chromium: Total4-5-Iz
4o. 0o5
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/1
K - Potassium
mg/I
Mg - Magnesium 1-4-5-17-
3 3.Io
mg/I
Mn - Manganese 'q-5 - I Z
/ • / 3
ma/I
X YES NO)
Ni - Nickel 9-5 -► z 40100 s
mg/I
Pb - Lead y-5-12 1-0,bo S
mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
5elen►um 14-5 -) z o,ods
Mal,lZ
Soa i o rv, LI -S- 12. Z 1 14
M p
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.
Report Attached? Yes (1) No
(0)
VOC : method # =
method#=
nerl�t�� fhel In Otis hec• i .., L � .a � � � �

GW-59A C0IVIPLIANCE REPORT FORM Permit
(Submit one each monitoring period wish GiV-59 forms.)
1 Enter date monitoring results were due. -)7 - Will this monitoring report (GW-59 and GW-59A) YES NO
be submitted after the established due date?
2 Was any required information missing on the GW-59 report forms? v
YES NO
iF the answer to question 1 or 2 is 'YES , list in the space provided below the well identification numbers))and
explain the problems encountered in obtaining the required information.
3 Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing YES NO
identification plate, area overgrown, etc.)? If the answer is "?'es", contact the Regional Office for guidance.
4 Are any monitored constituents equal to or above the established standards? V
YES NO
if the answer to question 4 is 'NO", skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below.
MW Z LiNd n-OSa Mil Q• mw Z -rps (pot rn91.z MW 1Ll
nnQ5Qnes(: I•lo1 "'Q Maganese mead
o. o�oS �-�
5 For the constituents identified in question 4 above, have standards been exceeded previously for the YES NO
same constituent(s) in ,the same well(s) in the last two years?
If the answer to question 5 is "NO", skip to section 8. v
If the answer to question 5 is "YES" list in the space provided below, each well with constituents) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
rnW.Iz Mo. oW)Me 2.q3 nM,3l,• S q-II maaof) 0sa ow Z. I - Id M61a iz -to - II
TOO 575r-aj.A 4-It mu�anesr mW iZ z•lomg�,,l? Iz-Io-II
-r os S t 0 me l.k
'Tos Sworn y -14 - l l
6 Are the monitoring wells li ed in section 5 located at or beyond the review boundary? YE5 NO
if the answer is "YES", a groundwater quality problem may be occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If.the answer is "NO") monitoring wells may be improperly
located; contact the Regional Office.
7 is the permittee implementing previously approved actions required by the Division involving this YES NO
groundwater quality problem?
If the answer to,question 7 is "YES", describe those actions in the space provided below.
If the answer to question 7 is "NO", contact the Regional Office within 90 days• an evaluation maybe
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surrounding this_ facility. Failure to do so may subject the permittee to a Notice of Violation
fines, and/or penalties.
g The person completing this portion (GW-59A) of the monitoring report should sign below and submit this
form with GW-59 forms for requiredwells to the address provided at the top of the current GW-59 form.
1 herebyacknowledge tfiat theabove Informatlon`was evaltiaEea and the information submitted In th s
report (Compliance Report GW59A) fs true and complete o the best of my kn owiedgeAAA
t
- -12
Signature of Pe ittee (or Authorized Agent) Date
rr VV en. ,1�O

RECEWE®
- T 17 TECH _..... .._.. _....Inc.
POST OFFICE BOX 1056 • ##5 PINEWOOD PLAZA DR. P AY 2 g 2612
GRANITE FALLS, NORTH A CAAAAROLINA 28630(828)396
Asheville Regional office
SAMPLE. Coats America (MW#02) COLLECTION DATE: 4/3/2x 12 Aq IfE?l hr otection '
PERMITA* COLLECTION TIME: 09:15
ADDRESS. Coats America (Wells) RECEIVED DATE: 4/3/2012
P.O. Box 368 RECEIVED TIME., 14:50
Marion, NC 28752
REPORTED: 5/11/2012
ANALYSIS
� ..
ANALYSIS'` :
RESULTS
(!NITS
DATE
_ :ANALYST
Sulfate
12.2
mg/L
4/5/12
vi`hlodde
7.0
mg/L
4/16/12
lag
T. Phosphorus
0.48
mg/L
4/26/12
jdg
toc
<1.0
mg/L
4/10/12
"^S
101
mg/L
4/9/12
lag
metals
see attached
pH >holding time
7.1
su's
4/3/12
lag
9
LOG ID: 1204-040 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

w#wTER6rv-cHLjqv-s.1nc
POST OFFICE BOX 1056 n5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
(828) 3964444
SAMPLE: Coats America (MW#10) COLLECTION DATE: 4/3/2012
PERMITA- COLLECTION TIME. 09:20
ADDRESS: Coats America (Wells) RECEIVED DATE., 4/3/2012
P.O. Box 368 RECEIVED TIME., 14:50
Marion, NC 28752
REPORTED: '5/11/2012
ANALYSIS
=` ANALYSIS ;
:RESULTS
UN1TS
DATE
:ANALYST ->
Sulfate
32.7
mg/L
4/5/12
Chloride
8.5
mg/L .
4/16/12
lag
T. Phosphorus
<0.16
mg/L
4/26112
jdg
toc
<1.0
mg/L
4/10/12
JfDS
127
mg/L
4/9/12
lag
metals
see attached
pH ' >holding time
7.0
su's
4/3112
lag
LOG ID., 1204-041 REPORTED BY: NC CERTIFIED LAB # 50
fp�
Tony Gragg, Lab Supervisor

POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTHCAAAAROLINA 28630
A
(828) 396`f` 44
SAMPLE. , Coats America (MW#11) COLLECTION DATE: 4/3/2012 '
PERMIT* COLLECTION TIME: 09:40
ADDRESS., Coats America (Wells) RECEIVED DATE: 4/3/2012
P.O. Box 368
RECEIVED TIME: 14:50
Marion, NC 28T52
REPORTED. 5/11/2012
ANALYSIS _
-
ANALYSIS =
RESULTS
UN1TS
©ATE
`ANALYST =
Sulfate
33.6
mg/L
4/5/12
chloride
9.3
mg/L
4/16/12
lag
T. Phosphorus
<0.16
mg/L
4/26/12
jdg
toc
2.12
mg/L
4/10/12
%,At$
176
mg1L
4/911,2
Iag
metals
see attached
pH ' >holding time
6.3
su's
413/12
lag
LOG ID: 1204-042 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#12)
PERMIT &
ADDRESS: Coats America (Wells)
P.O. Box 368
Marion, NC 28752
COLLECTION DATE: 4/3/2012
COLLECTION TIME.- 09:47
RECEIVED DATE: 4/3/2012
RECEIVED TIME: 14:50
REPORTED: 5/11/2012
10.7
mg/L
4/5/12
Sulfate
%Aoride 12.3
mg/L
4116112
tag
T. Phosphorus 0.19
mg/L
4/26112
jdg
toc 2.30
mg/L
4110112
419/2...
metals see attached
pH ' >holding time 7.0
su's
4/3/12
lag
LOG ID: 1204-043 REPORTED BY: NC CERTIFIED LAB # 50
fk�'. 60"
Tony Gragg, Lab Supervisor

R6 KCH LROSinc.
POST OFFICE BOX 1056 - #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#13) COLLECTION DATE:
4/3/2012
PERMIT A COLLECTION TIME.
09:57
ADDRESS: Coats America (Wells) RECEIVED DATE.
4/3/2012
P.O. Box 368 RECEIVED TIME.,
14:50
Marion, NC 28752
REPORTED:
'5/11/2012
,�nrAc.Yses
ANALYSIS
:-RESULTS
Ul1(tTS 'DATE
�
ANALYST
Sulfate
47.8
mg/L
4/5/12
%iloride
19.8
mg/L
4116/12
lag
T. Phosphorus
0.19
mg/L
4126112
jdg
toc
2.57
mg/L
4/10/12
S
276
mg/L
419/12
lag
metals
see attached
PH'>holdingtime
6.3
su's
4/3112
lag
LOG ID: 1204-044 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab 3upervisor

LBO
.w F4i, rvCH
I Inc.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#14) COLLECTION DATE: 4/3/2012
PERMIT A COLLECTION TIME: 10:04
ADDRESS: Coats America (Wells) RECEIVED DATE: 4/3/2012
P.O. Box 368 RECEIVED TIME: 14:50
Marion, NC 28752
REPORTED: -5/11/2012
ANALYSIS
ANALYSIS.`
RESULTS
UNITS
DAZE
'ANALYST
Sulfate
<10.0
mg/L
4/5112
%.Zhloride
<5.0
mg/L
4/16/12
lag
T. Phosphorus
0.22
mg/L
4/26112
jdg
toc
2.51
mg/L
4/10/12
%,4'DS
383
mg/L
419/12
lag
metals
see attached
pH ' >holding time
6.7
su's
413/12
lag
LOG ID: 1204-045 REPORTED BY: -NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR -
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#15) COLLECTION DATE. 4/3/2012
PERMIT A COLLECTION TIME. 10:16
ADDRESS: Coats America (Wells) RECEIVED DATE: 4/3/2012
P.O. Box 368 RECEIVED TIME: 14:50
Marion, NC 28752
REPORTED: 5/1.1 /2012
ANALYSIS
RESCLLTS
UNITS
©ATE
ANALYST
Sulfate
43.0
mg/L
4/5112
-,_Aloride
<5.0
mg/L
4/16/12
lag
T. Phosphorus
<0.16
mg/L
4/26/12
jdg
toc
2.18
mg/L
4/10/12
''Y S
353
mg/L
4/9/12
lag
metals
see attached
pH ">holding time
7.0
su's
4/3/12
lag
LOG ID: 1204-046 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

i'���ttlilll�lr'
��. RESEARCh St ANAL TICAI.
C
r
NC. = o�
LAboRATORIES , I�
z;ca
NC#34
Analytical/Process Consultations
NecidirFj9-•.....••' �5 '0i
���ir�ED ANP �`~
Water Tech Labs. Inc.
Date Sample Collected
04/03/12
P.O. Box 1056
Date Sample Received
04/05/12
Granite Falls,
NC 28630
Date Sample Analyzed
04/05/12
Attn: Joe Gragg
Date of Report
04/13/12
Analyses Performed by
JC -MS
Lab Sample Number
---------------------
728516
---------------------
Parameter
Storet #
Results
Magnesium,Tot
(00927)
19.8 mg/l
Calcium,Tot
(00916)
37.0 mg/l
Sodium,Tot
(00929)
10.7 mg/l
vLhromium,Tot
(01034)
0.007 mg/l
veadmium,Tot
(01027)
<0.002 mg/1
vilickel,Tot
(01067)
0.016 mg/l
%Zelenium,Tot
(01147)
<0.005 mg/l
%Aarium,Tot
(01007)
0.182 mg/1
%oKrsenic,Tot
(01002)
0.008 mg/1
Manganes�,Tot
(01455)
1;61..mg/l.;
Aluminum,Tot
(01105)
4.09 mg/1
vgulfate
(00945)
12.2 mg/l
--------------------
Clients Sample Source COATS AMERICAN MW 2
Number
Time Collected (Hrs) 0915
P.O. Box 473. 106 Short Street • Kernersville, North Carolina 27284 + 336-996-2841 • Fax [phone]
www.randelabs.com

10
RESEARCIi & ANAI TICA1 ,•••,�=�..C.,rTi .
- UbORATORIES, INC.ca
NC #34 Z.
Analytical/Process Consultations . 't�..O'� �. • ,,'
Water Tech Labs. Inc. Date Sample Collected : 04/03/12
P.O. Box 1056 Date Sample Received : 04/05/12
Granite Falls, NC 28630 Date Sample Analyzed : 04/05:/12
Attn: Joe Gragg Date of Report : 04/13/12
Analyses Performed by : JC -MS
Lab Sample Number
--------------------
728517
Parameter Storet # Results
Magnesium,Tot
(00927)
Calcium,Tot
(00916)
Sodium,Tot
(00929)
vehromium, Tot
(01034)
%,,dadmium,Tot
(01027)
�ickel,Tot
(01067)
%,delenium,Tot
(01147)
%Aarium,Tot
(01007)
�Xrsenic,Tot
(01002)
:. VZead,Tot
(01051)
VAanganese,Tot (01055)
Aluminum,Tot (01105)
sulfate (00945)
Clients Sample Source
Number
Time Collected (Hrs)
<0.500 mg/l
<0:500 mg/l
47.3 mg/1
<0.005 mg/l
<0.002 mg/l
<0.005 mg/l
<0.005 mg/l
0.020 mg/l
<0.005 mg/1
<0.005 tng/l
<0.005 mg/l
0.066 mg/l
32.7 mg/l
--------------------
COATS AMERICAN MW 10
0920
P.O. Box 473. 106 Short Street • Kernersville, North Carolina 27284. 336-996-2841 • Fax [phone]
www.randalabs.com

RESEARCh & ANAIyTICA1
LABORATORIES, INC.
Analytical/Process Consultations
Water Tech Labs. Inc.
Date Sample Collected
: 04/03/12
P.O. Box 1056
Date Sample Received
: 04/05/12
Granite Falls,
NC 28630
Date Sample Analyzed
: 04/05/12
Attn: Joe Gragg
Date of Report
: 04/13/12 .
Analyses Performed by
: JC -MS
Lab Sample Number
--------------------
728518
Parameter
Storet #
Results
Magnesium,Tot
(00927)
5.86 mg/1
Calcium,Tot
(00916)
18.2 mg/l
Sodium,Tot
(00929)
34.2 mg/l
t/hromium,Tot
(01034)
<0.005 mg/l
X/admium,Tot
(01027)
<0.002 mg/l
%4ickel,Tot
(01067)
<0.005 mg/l
%4elenium,Tot
(01147)
c0.005 mg/l
%Xarium,Tot
(01007)
0.099 mg/l
%,ersenic,Tot
(01002)
<0.005 mg/l
%,eead,Tot
(01051)
<0.005 mg/1
Aluminum,Tot,
(01105)
0.372 mg/l
%ulfate
(00945)
33.6 mg/l
--------------------
Clients Sample Source COATS AMERICAN MW 11
Number
Time Collected (Hrs) 0940
P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27284. 336-996-2841 • Fax [phone]
www.randalabs.com -

RESEARch & ANA[yTICA1
LAboR* ATWE!�INC.
Analytical/Process Consultations
Water Tech Labs. Inc.
P.O. Box 1056
Granite Falls, NC 28630
Attn: Joe Gragg
♦♦`��►Fi cly
�YTj fti
=�. O: N
NC#34 z:
RED
Date Sample Collected 04/03/12
Date Sample Received 04/05/1.2
Date Sample Analyzed 04/05/12
Date of Report 04/13/12
Analyses Performed by JC -MS
Lab Sample Number
--------------------
728519
---------------------------
Parameter Storet # Results
Magnesium,Tot (00927) 14.3 mg/1
Calcium,Tot
(00.916)
79.8 mg/l
Sodium,Tot
(00929)
201 mg/l
�hromium,Tot
(01034)
<0.005 mg/i
%Zadmium,Tot
(01027)
<0.002 mg/l
dickel,Tot
(01067)
0.008 mg/1
`4elenium,Tot
(01147)
<0.005 mg/l
%Xarium,Tot
(01007)
0.141 mg/1
Al.<rsenic,Tot
(01002)
<0.005 mg/1
Lead, Tot
(0.1051} _
0 _019 `mg/1-
Manganes,Tot COlb55).68
mg/1
Aluminum,Tot
(01105)-
0.104 mg/l
Veulfate
(00945)
10.7 mg/l
--------------------
Clients Sample Source COATS AMERICAN MW 12
Number
Time Collected (Hrs) 0947
P.O. Box 473. 106 Short Street • Kernersville, North Carolina 27284 •336-996-2841 • Fax [phone]
www.randalabs.com

RESEARCh & ANA[YTICA[ ` gjN A..... •��'•
LAhORATORIES, INC. CO- ;
M • '
Analytical/Process Consultations Zw
Water Tech Labs. Inc. Date Sample Collected 04/03/12
P.O. Box 1056 Date Sample Received 04/05/12
Granite Falls, NC 28630 Date Sample Analyzed 04/05/12
Attn: Joe Gragg Date of Report 04/13/12
Analyses Performed by JC -MS
Lab Sample Number
728520
Parameter Storet # Results
Magnesium,Tot
(00927)
7.72 mg/l
Calcium,Tot
(00916)
11.2 mg/1
Sodium,Tot
(00929)
79.0 mg/l
t,,dhromium,Tot
(01034)
<0.005 mg/l
%Xadmium,Tot
(01027)
<0.002 mg/l
vNrickel,Tot
(01067)
0.008 mg/l
%Xelenium,Tot
(01147)
<0.005 mg/l
1/garium,Tot
(01007)
0.036 mg/l
VKXsenic,Tot
(01002)
<0.005 mg/l
%,Zead,Tot,
(01051)
0.009 mg/l
vl�tariganee, Tot:; . (01055).. -=
0 213 'mg/1
Aluminum,Tot
(01105)
0.619 mg/1
-vXulfate
(00945)
47.8 mg/l
--------------------
Clients Sample Source COATS AMERICAN MW 13
Number
Time Collected (Hrs) 0957
P.O. Box 473. 106 Short Street • Kernersville, North Carolina 27264.336-996-2841 • Fax [phone]
www.randalabs.com

VIS��,uui,���i
RESEARCh & ANALyTICA1 '`�� cYr *�y
UbORATOI&S INC. te
v =¢cwo NC �:cn
Analytical/Process Consultations
qp
ED AK
Water Tech Labs. Inc. Date Sample Collected : 04/03/12
P.O. Box 1056 Date Sample Received : 04/05/12
Granite Falls, NC 28630 Date Sample Analyzed : 04/05/12
Attn: Joe Gragg Date of Report : 04/13/12
Analyses Performed by : JC -MS
Lab Sample Number
--------------------
728521
Parameter Storet # Results
Magnesium,Tot
(00927)
48.7 mg/l
Calcium,Tot
(00916)
73.3 mg/l
Sodium,Tot
(00929)
24.8 mg/1
.-Aromium,Tot
(01034)
<0.005 mg/1
%Xadmium,Tot
(01027)
<0.002 mg/l
%,4ickel,Tot
(01067)
<0.005 mg/l
%Zelenium,Tot
(01147)
<0.005 mg/l
%,4arium,Tot
(01007)
0.129 mg/1
v&rsenic,Tot
(01002)
<0.005 mg/l
Lead,Tot�
(O1d51)
OV 065 mgJl
�ian..ganese,Tot
C01455) =
r� 135 mg/�...'
Aluminum,Tot
(01105)
2.84 mg/l
,,,g'ulfate
(00945)
<10.0 mg/l
--------------------
Clients Sample Source COATS AMERICAN MW 14
Number
Time Collected (Hrs) 1004
P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27284.336-996-2841 • Fax [phone]
www.randalebs.com

'twives I1100re.
+ rr Ij
RESEARCh & ANA1yTICAL er`'Q v+�' •••n••••..'? '�..
UbORATWES, INC.A daI--.
H A'
; c" NO �i34 z' cn
Analytical/Process Consultations
trllil/y�
Water Tech Labs. Inc. Date Sample Collected : 04/03/12
P.O. Box 1056 Date Sample Received : 04/05/12
Granite Falls, NC 28630 Date Sample Analyzed 04/05/12
Attn: Joe Gragg Date of Report : 04/13/12
Analyses Performed by : JC -MS
Lab Sample Number
--------------------
728522
Parameter Storet # Results
Magnesium,Tot
(00927)
33.6 mg/1
Calcium,Tot
(00916)
72.3 mg/l
Sodium,Tot
(00929)
21.4.mg/1
vCeromium,Tot
(01034)
<0.005 mg/l
�admium,Tot
(01027)
<0.002 mg/l
%Xickel,Tot
(01067)
<0.005 mg/l
V relenium,Tot
(01147)
<0.005 mg/1
%Afarium,Tot
(01007)
0.115 mg/l
%'4rXsenic,Tot
(01002)
<0.005 mg/l
a/Lead,Tot
(01051)
<0.005 mg/1
Aluminum,Tot
(01105)
<0.025 mg/1
%-S'Oulfate
(00945)
43.0 mg/1
--------------------
Clients Sample Source COATS AMERICAN MW 15
Number
Time Collected (Hrs) 1016
P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27284.336-99&2841 • Fax [phone]
www.randalabs.com

Page 1 of 2
VROOTEST
Laboratory Report
Lab Location X' Lab Location 'C'
NC/UVW Cent* 067 NC1DW Cert# 37731 NC/W W CerL* 103 NC/DW Cert#. 37733
6701 Conference Dr, Raleigh, NC 27607 6300 Ramada Dr, Suite C2, Clemmons,'NC 27012
Ph: [phone] Fax [phone] Ph: [phone] Fax [phone]
Project No.: 01
Project ID: COATS AMERICA MW
— Prepared for —
Jon Gragg
Water Tech Labs
PO Box 1056
Granite Falls, NC 28630
Report -Date: 4111 /2012
Date Received: 4/4/2012
Work Order #: 1204-00325
Cust. Code: WATERT
Cust. P.O.#: INCL TOC RESULTS
No. Sample ID
Date Sampled
Time Sampled Matrix
Sample Type Condition
001 MONITORING WELL #2
4/3/2012
9:15 GW .
Grab 4 +1- 2 deg C
Test Performed
Method
Results
Lab Loc DatYed Time Qualifier
Total Organic Carbon
5310C
<1.0 mglL
R 4110112 14.58
No. Sample ID
Date Sampled
Time Sampled Matrix
Sample Type. Condition
002 MONITORING WELL #10
413/2012
9:20 GW
Grab 4 +1- 2 deg C
Test Performed Method Results Lab Loc Daatyzed Time Qualifier
Total Organic Carbon 6310C <1.0 mglL R 4110/12 14.58
No. Sample ID Date Sampled Time Sampled Matrix Sample Type Condition
003 MONITORING WELL #11 4/3/2012 9:40 GW Grab 4 +1- 2 deg C '
Test Performed
Method
Results Lab Loc DateyZed
Time Qualifier
Total Organic Carbon
5310C '
2.12 mglL R 4110112
14.68
No. Sample ID
Date Sampled
Time Sampled Matrix Sample Type
Condition
004 MONITORING WELL #12
4/312012
9:47 GW Grab
4 +1- 2 deg C
Test Performed Method Results fib Loc Dated Time Qualifier
Total Organic Carbon 5310C 2.30 mg/L R 4110112 14:68
No. Sample ID Date Sampled Time Sampled Matrix Sample Type Condition
006 MONITORING WELL #13 4/3/2012 9:57 GW Grab 4 +/- 2 deg C
Test Performed Method Results lab-Loc Da W� Time Qualifier
Total Organic Carbon 6310C 2.67 mg1L R 4110112 14:68

9
Telephone: [phone]
Fax: [phone]
1TRJTEST
6701 Conference Drive
Raleigh, NC 27607
Telephone: [phone]
Fax. [phone]
Laboratory Report
Work Order # 1204-00325
Page 2 of 2
NClWW Cart #: 067
NC/DW Cart #: 37731
No. Sample ID
006 MONITORING WELL #14
Date Sampled
413/2012
Time Sampled Matrix
10:04 GW
Sample Type Condition
Grab 4 +1- 2 deg C
Test Performed
Method
Results
Lab Loc Dared Time Qualifier
Total Organic Carbon
5310C
2.61 mg1L
R 4110112 14:58
No. Sample ID
007 MONITORING WELL #15
Date Sampled
413/2012
Time Sampled Matrix
10:16 GW
Sample Type Condition
Grab 4 +1- 2 deg C
Test Performed
Method
Results
l�nal zed
Lab Loc at Time Qualifier
Total Organic Carbon
5310C
2.18 mg1L
R 4110112 14:58
Reviewed by:
/ E'tG�z�-L:c ter-...e�.��,,��►Lc1/
for Tritest, Inc.

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:— ( ILQ�t
Permit Name (if different):
Facility Address:C>
Contact Person.'�WJlj) P
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County I P► MY.t 1 a t �_
Telephone #:'633 - 9 b -L
No. of Wells to be Sampled:
Well Identification Number
ber (from Permit): t} to -- Z For Groundwater Treatment Systems
Well Depth: '7 � it. `Well Diameter: � in.. Check One: ❑ Influent (98)
Screened Interval: ) it. to it.
Depth to Water Level: r ft. below measuring point. ❑ Effluent (99)
p J .
Measuring Point (M.P.) is: 9: -3 It. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 352 Date sample collected:
Field analysis: pH (0,G_17 ,Specific Conductance uMhos
Temp. %a °C, Odor Appearance
' • _ DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES--
AR QUALITY DIVISION, GROUNDWATER SECTION
NOW163T6',MAILS
ERVICE CENTERALIGH NC 27699-1636 Phone: 919 I733-fi21
—
PERMIT #: t t)CZCCbSkz,03 EXPIRATION DATE:
t;}
L
Non -Discharge UIC
1" -
ri
NPDES
O o
1
-
e'
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
2, CC
r
Spray Field Remediation:
�0 r�
Rotary Distributor Land Application of Sludge
Other: I
�?
NOTE: Values should reflect dissolved and . ��
colloidal concentrations. 'f "� Fs1V
Date sample analyzed: a_e JAN 1 2 2012
Laboratory Name:
Certification No, vrrnation i'rucggs►r�g nit
PARAMETERS (Samples for metals were collected unfiltered X YES NO '
and field acidified
COD
mg/I
Nitrite (NO2) as N
mg /I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MFTotal
/100ml
Phosphorus: Total as P_Iz-la-il <c•Iton.t/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total Ia-)a-I1
�
IC,� mg/1
Al -Aluminum
,-5,39
mg/I
pH (when analyzed)
la-h• 11 6 zs units
Ba - Barium 12-Lo - 1 \
Ca. t 3ta
m
TOC _1,a -�? - \
Chloride la -1 rj
4 1, l mg/I
mg/I
Ca - Calcium l z--(o -I t
Cd - Cadmium_. i z. -6.-� t
z�,
mg/I
mg/I
v . o©
Arsenic i a (yi\
(I (D5 mg/l
Chromium: Total /2 -�-it
Go, 1 -S
m lI
g
Grease and Oils
mg/I
Cu -Copper
mg/1
Phenol
Sulfate _ �a-1r,-1\
mg/I
1y. \ mg/I
Fe - Iron
Hg -Mercury
m /I
g
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg - Magnesium /Z-L-//
► �,o
m /I
g
TKN as N
m /I
Mn - 1'z-� - l'
_ YES NO)
- --
Ni - Nickel )z -(, -I 1 0 of z mg/I
Pb- Lean iZ -& -1/ o-O"fz- mg/1
Zn - Zinc mg/I
'Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes ✓(1) No (0)
VOC D -'I : method # = & 2i o 0
method#=
ceft(fy that, to the best of tmtf knotrtltedne nnri hafiaf fho infmmofinn :-A I-:- ____ .._ .___
ame
lie - Please print or
r G W-59
Re; , 03/2000
of

0
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:_
Permit Name (if
Facility Address:
Corilact Person:.�1S
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County t
4`111ephone #: .X , V -1
No. of Wells to be Sampled:
prom rermn)
Well Identification Number (from Permit): MW --1
Well Depth: �g For Groundwater Treatment systems
P t ft.- Well Diameter.: _ in. Check One: ❑ Influent 98
Screened Interval: :+J � ( )
�_ ft. to �,�1 f-- ft.
Depth to Water Level: lh. e[p Effluent99ft. below measuring point. (
Measuring Point (M.P.) is: 2 ; ft. above land surface. Relative M.P. Elevation in #t.: 2
Gallons of water pumped/bailed before sampling: 3 Date sample collected:
Field analysis: pH 1 •Q , Specific Conductance '
Temp. . 1`1 °C, Odor
Appearance _
PARAMETERS (Samples for metals were collected unfit
COD mg/I
Coliform: MF Fecal /100ml
Coliform: MF Total 1100m1
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total Iz-Iz-)t qln
mg/I
pH (when analyzed) Iz. o -t\ -7, o
units
TOC_1­7 -Ci -1\ 1-\,0
mg/I
Chloride i\,D
mg/I
Arsenic IZ-t✓ t\ 4',c)•OoS
mg/I
Grease and Oils
mg/I
Phenol
mg/I
IZ
Sulfate -k-t\
mg/I
Specific Conductance uMhos
Total. Ammonia
mg/I
TKN as N
mg/I
umhos
' • a -DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH NC 27fi99-1636 Phone: [phone]
PERMIT #: UO C_:kW05 (063 EXPIRATION DATE: " ' 61
Non -Discharge UIC
NPDES__
TYPE OF PERMITTED OPERATION BEING MONITORED
�— Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: �F�t�t'Ic`st,y
Laboratory Name:--1_�7rd+,er-
Certification No.
tered A YES NO
and field acidified
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg /I
Phosphorus: Total as P IZ-1Z-1k 4o.iiamg/I
Orthophosphate
m9/I
Al - Aluminum I Ao-I
mg/I
Ba - Barium I� -(>-1\
C,. ��� mg/I
Ca - Calcium _12-(o-
mg/I
Cd- Cadmium 1Z-(,)-I1
CQ&OOz. mg/I
Chromium: Total_iz-to-i1
4C.005 mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I,
Hg - Mercury _
mg/I
K - Potassium
mg/I
Mg - Magnesium i z -6 - i 1
2, 0.5Cc) mg/I
Mn - Manganese iZ-to-0
4p:ut5 mg/I
X YES NO)
Ni - Nickel i Z-L,-1 1 mg/I
Pb - Lead I Z -b- t I G G t ; mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units),
ORGANICS: ('GC,GC/MS,HPLC)
(Specify test and method #. Atjach lab report.)
Report Attached? Yes V (1) No (0)
VOC method # = eZ 1 b p _
method # =
method #
r rmittee (or Aulharizert�4geO Name and Title - Please print or type
`GW-59
ReV. 03/2000 Signature of Permaleei raurnnd7ad n­rn

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name: 1 i A•1"
Permit Name (if different):
Facility Address: 7•C)•
Contact Person. nk\t
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY -
Please Print Clearly or Type
County t I +,- `, AsC 1 \
Telephone
No. of Wells to be Sampled:.
Well Identification Number (from Permit): T�'ttij - } For Groundwater Treatment Systems
Well Depth: %'2' Cam, it. Well Diameter: -Z- in. Check One: ❑ Influent (98)
Screened Interval: u It. to A..' ft. Effluent (.99)
Depth to Water Level: 1L�•C! ft. below measuring point.
Measuring Point (M.P.) is: 3, Ic ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: Date sample collected: 21 b -1 )
Field analysis: pHSpecific Conductance uMhos
. Temp. t `l °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC 27699-1636 Phone: [phone]:
PERMIT#:WC'�L_)00 063, EXPIRATION DATE: "201 1
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
— Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NQ—Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: _ Sep ph(Aiy,lk)
Laboratory Name: 04 ko x 1 e n h
Certification No. _ 56
PARAMETERS (Samples for metals were collected unfiltered x YES NO
and field acidified
COD
Coliform: MF Fecal
mg/I
/100m1
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/I
Coliform: MFTotal
/100ml
Phosphorus: Total as P-12--1:3--11
mg/I
40•16mg /I
(Note: Use MPN method for highly turbid samples)
" Orthophosphate
m/I
Dissolved Solids: Total IZ-)2 -11 L < mg/I
Al - Aluminum-) z -6-1A
0'9')D m9/I
pH'(when analyzed)iz -(c -1
1 (o.0 ; units
Ba - Barium � L -h - t 1
0, 0`1 b mg/I
TOC _tz -r-r - j\
u. � mg/I
Ca - Calcium 'z -�o
'3 mg/I
Chloride -1 S-�
_I'� �
Arsenic t
mg/I
mg/I
Cd - Cadmium 17.4-1 - t
Chromium: Total 1a-IV i.1
4 o. 00'a mg/I
/'d.c'5 mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
Sulfate _i'Z -lo-
mg/I
mg/I
Fe - Iron
Hg - Mercury
mg/I
mg/I
Specific Conductance
uMhos
K - Potassium
mg /1
Total Ammonia
�
mg/I
Mg - Magnesium a (�-1►3
m /I
' ` g
TKN as N
mg/I
Mn - Manganese
mg/I
t cettity that to the best of my knnwianna nnri honof itio .s., ► .,
X YES NO)
Ni - Nickel IZ-G-t1 mg/I
Pb - Lead LZ 40Dos mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
'15F'�en10nn
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes ✓ (1) No (0)
VOC method # _ (a y1O O
method # =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility Name: l (,t i"r') 1-tf Ytl'f itC4t�
Permit Name (if different):
Facility Address: 17 b pp '?') obi
• ri (Sveeq
tcays �C County ?�r (9:.�
Contact Person: k• ` Isar to°I
` �., 2 i{ n Telephone #: -
Well Location/ Site Name: .7t is i Ni i'��`IuL COP No. of Wells to be Sam
Well Identification Number (from Permit): M W - 1y For Groundwater
Well Depth: )"'7) it. Well Diameter 7� in. Check One: ElScreened Interval: %ice ) IA ft. to � ft. ❑ I
Depth to Water Level: _eft, below measuring point.
Measuring Point (M.P.) is:kc) ft. above land surface. Relative M.P. Elevati
Gallons of water pumped/bailed before sampling: -�— Date sample collet
Field analysis: pH k to Specific Conductance uMh
Temp. 1 tO °C, Odor Appearance
l\ —
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC 27699-1636 Phone: (919)
PERMIT #: L,JU 00C%Sio
Non -Discharge
EXPIRATION DATE: S -'Z0 t
M1
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
--—_.Lagoon
Remedi o1 r
V
RaQn�J:L;�
i rjuT�"
n,
n i tration Gallery
Remediation: _
Land Application of Sludge
should reflect dissolved and .
I concentrations.
lialyzed:
Certification No. _ S0
PARAMETERS (Samples for metals were collected unfiltered A YES NO and field acidified
COD mg/I Nitrite (NO2) as N m /I
Coliform: MF Fecal /100ml Nitrate (NO3) as N mg/I
Coliform: MF Total /100m1 Phnsnhnnic• Tntal ac P 12-1*"� t Z6.ti.,Y, /I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total _I
z°-I �-/ 1 Sib m9 /I
pH (when analyzed) ZZ-G-1I f .to"3 units
TOC _ f Z--Cl -11
"? 1v mg/I
Chloride 1 G--1 S- I I
m /l
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate _1z.-try -
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
` GW-59
Rev. 03/2000
Orthophosphate
mg/I
Al - Aluminum J'Z-(, - t 1
0. o'73
mg/I
Ba - Barium _1 z - to - � i
6. 017U
mg/I
Ca - Calcium /'z-1,-, - (1
y1?,3
mg/I
Cd - Cadmium/Z -to - i►
4o-00 Z
mg/I
Chromium: Total 7"7-_1r•1;
4'0•e,c�
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium i'2 -4,-11
mg/I
Mn - Manganese
7-1/ c
me/I
_YES NO)
Ni -Nickel. 0, 007 mg/I
Pb - Leads /�2 -U -/ / <o d7la S m9/1
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
SeiPni U.,-� !:� '% ••1 I
Ld UL� .�iti�C;��
Socki or-,, 12_-G - I 1
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes ✓ (1) No (0)
VOC( : method # L-) ID'
method # =
method # =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: (__ lL-i Ary-P(►CCI►'"
Permit Name (if different):
Facility Address: __ Pb. 'N ay
Contact Person:.
Well Location/ Site Name:
county me Qnwe t
Telephone #: `'a' • 1 I 1
No. of Wells to be Sampled:
Well Identification Number (from Permit):_ fnW -)* For Groundwater Treatment Systems
Well Depth: LS ft. Well Diameter: 19 in. Check One: ❑ Influent (98)
Screened Interval: "N ft. to �% it. El Effluent ('99)
Depth to Water Level: _ft. below measuring point.
Measuring Point (M.P_) is::a l ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling:_ Date sample collected: I:a -6
Field analysis: pH fo+ a 1e , Specific Conductance uMhos
. Temp. I ka °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT N: IA3 0, t)oo "-1 O 3 EXPIRATION DATE: _ �" ZO I j
Non -Discharge UIC_
NPDES
TYPE 9F PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of.Sludge
Other:
NOTE; Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: See 6c`pu;
Laboratory Name: o t
Certification No. SiJ
PARAMETERS (Samples for metals were collected unfiltered YES NO
and field acidified
COD
Coliform: MF Fecal
mg/I
/100ml
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/I
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P1z-/3ii 1-0,)& mg/I
(Note: Use MPH method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total l
� -1 � -/► 43 mg/I
AlAI -Aluminum _%z-tom-rl
� O•bds mg/I
pH (when analyzed) 1Z-L
�'
- I \ (o- a -_ units
Ba -Barium /Z-t- -)
mg/I
TOC I`�- I J
Chloride _/Z-11-0
z.
L! b '- mg/I
mg/1
Ca - Calcium 12--c,� - i I
Cd - Cadmium _%2-c,, •-I I
1 �{ c� tng/I
c.e .00 �� mg/I
g
Arsenic _j z - e� �-/ !
z c7• ��c>s
. mg/I
Chromium: Total i���lo•-61
C
��,ar�� mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
Sulfate r z- to -i f
mg/I
4/0- c mg/I
Fe - Iron
Hg -Mercury
m /I
9
mg/I
Specific Conductance
LlMhos
K - Potassium
mg/I
Total Ammonia
mg/I
Mg- Magnesium _) Z!L-ll
mg/I
TKN as N
mg/I
Mn - Manganese_iz-(o-0
mg/I
il
✓ YES NO)
Ni - Nickel_ f a -f, --a n 00(o mg/I
Pb - LeacL/z--10--/I L ary )J mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
('iP(1►t�f1.1 !. -fr -') D Z n c�t�x� �ti-•ca,` �.
5QL�io 12- (11 -1 1 L3 4
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. ttach lab report.)
Report Attached? Yes (1) No (0)
VOC 0 DL method # - _ (o; 11G p
method # _

�i
SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING -
COMPLIANCE REPORT FORM
FACILITY INFORMATION - Please Print Clearly or Type
Facility Name: LCl-va
Permit Name (if different):
-
Facility Address: Pvita
Y,� r. , - - - -
Contact Person:
Well Location/ Site Name:
County 1 ham V-b06 \
Telephone #: LA I \
No. of Wells to be Sampled:
Well Identification Number (from Permit): DoU.a For Groundwater Treatment Systems
Well Depth: 1 1,5 ft. Well Diameter: _ in. Check One: ❑ Influent (98)
Screened Interval: ) _
Depth to Water Level: Gi . _ ft. below measuring point. 0 Effluent (99)
Measuring Point.(M.P.) is: It. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling:_ Date sample collected:
Field analysis: pH [,2A 5 Specific Conductance ' uMhos
Temp. ►b 'C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT-#: •WaCX-)C)SO0 j EXPIRATION DATE:
Non -Discharge U IC
NPDES
TYPE OF'PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed:
Laboratory Name: u--1cxke f t PC1^L
Certification No. t
PARAMETERS (Samples for metals were collected unfiltered _YES NO
and field acidified
COD
mg/I
/100ml
Nitrite (NO2) as N
Nitrate (NO3) as N
m /I
Coliform: MF Fecal
Coliform: MF Total
1100m1
Phosphorus: Total as P lz %:III
mg/I
zp 9
+gym /I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/l
Dissolved Solids: Total/ZIZ-I)
Z14/ mg/1
Al -Aluminum &- -11
�?.qy mg/I
pH (when analyzed) W-0- -Ca-11
Wq units
Ba - Barium _j7�--(- -1)
0.•f mg/I
TOC _j'z-
° , 22 ? - mg/I
4-?; 5 mg/I
Ca - Calcium 1'z; &, -!/
Cd - Cadmium
-7 L,3 mg/I
Lo• W4- mg/I
Chloride Jz_/ -l7
Arsenic /Z-&-/)
4c) -y2S mgll
Chromium: Total l2-fv-0'
40•0o.5 mg/I
Grease and Oils
mg/I
Cu - Copper
mg/l
Phenol
Sulfate L2 -do -f f
mg/I
�I� mg/I
Fe - Iron
Hg - Mercury
mg/I
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
TKN as N
mg/I
Mg -. Magnesium 12-t�-1)
55: g
m /I
mg/1
Mn - Manganese_ E -k' -I I
f~ c t� 1 m9/I.
e (or
73
x YES NO)
Ni-Nickel
mg/I
Pb - Lead I' -6 i t
-03LI_ mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
5'yF>I/y}PcI�1�nJn-�
Cc 05���.
1)'�
ORGANICS: (GC,GCIMS,HPLC)
(Specify test and method #. Altach lab report.)
Report Attached? Yes V (1) No (0)
VOC (? 1L : method # _ jig 10 0
method # =
method # _
or type
GW-59
Rev. 03/2000
Agent)

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: (, '0A! A rVl
Permit Name (if different):
Facility Address: ` c-, Q} hl 0-1 —_
01 ( tt 3 "�' tscat t �� o/ County fC
Icnr) _
Contact Person^ t `i ' �� Q D4elephone #:
Well Location/ Site Name: a�'u' e9 ShTJd
No. of Wells to be Sampled: "_
Well Identification Number (from Permit): L') -
Well Depth: �(p For Groundwater Treatment Systems
P �� ft. Well Diameter-- in. Check One: ❑ Influent (98)
Screened Interval: �_ ft. to
Wit,} 1 � ft_
Depth to Water Level: it. below measuring point. ❑ Effluent (99)
Measuring Point (M.P.) is: ft. above land surfa e. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: ja Date sample collected: %-j
Field analysis: pH Iv r 17 , Specific Conductance ' uMhos
Temp. J_O°C, Odor Aonearanr.P
DEPARTMENT OF ENVIRONMENT $ NATURAL RESOURCES
WATER'OUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: L J GLC-005 Ca6,3 EXPIRATION DATE: S �d
Non -Discharge t Itf
NPDES
TYPE F PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other.
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed:
Laboratory Name: 1A IXIL 1Jl t ( Ln
Certification No. 60
PARAMETERS (Samples for metals were collected unfilteredk_YE5 NO
and field acidified
COD
Coliform: MF Fecal
mg/I
/100ml
Nitrite (NOZ) as N
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P-1a 1;3•il Go./U
mg/1
m /I
(Note: Use MPH method for highly
Dissolved Solids: Total l
turbid samples)
/��61 3kQ
Orthophosphate
mg/I
g
mg/I
pH (w en analyzed) /'7 units
Al - Aluminum./62-6-//
Ba -Barium l-Lo-/I
400- ��
mg/1
(7• `c��
TOC�
Chloride t"- /
L mg/I
�� S mg/I
Ca - Calcium )�_(„ /f
Cd - Cadmium /-2 j/
'�
mg/I
m /I
4 Q.OGQ
-
Arsenic 1�-� -l%
Grease and Oils
�o ©c75 mg/I
Chromium: Total fa -to-ft
" cO..y(:-S
mg/I
mg/1
Phenol
mg/I
Cu - Copper
mg/I
Sulfate i-19-i/
Specific
mg/I
r`�i n mg/I
Fe - Iron
Hg - Mercury
mg/I
m /I
Conductance
Total Ammonia
uMhos
K - Potassium
9
mg/l
TKN as N
mg/I
Mg - Magnesium
mg/I
mg/l
Mn - Manganese L -(a-1
mg/I
_( YES NO)
Ni -Nickel /,'2--<9 // -0 «� mg/I
Pb - Lead/-L-2 / .0 Cf')-mg/I
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify.test and method #. Attach lab report.)
Report Attached? Yes t%(1) No (0)
VOC AL method # = (ajD a
method #
method # =
Ml
• � aria Y�nl��� i�ycct
Permittee (or Authonzeci iigenl) a —me and Title Please print or type r /
G1N 59 t Ad g <✓�!
Rev. 03/2000 Signature of Perm ittee (o Aulhorized Agent) ,�-,

v �• -�yti %.v1v1r1,L'11N UE REPORT FORM Permit #
(Submit one each monitoring period with GFV-59 forms.)
1 Enter date monitoring results were due. ( —(d -j �) Will this monitoring report (GW-59 and GW-59A)
be submitted after the established due date?
YES
NO
2 Was any required information missing on the GW-59 report forms?
IF the answer to question 1 or 2 is "YES", list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the required information.
YES
NO
3 Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
identification plate, area overgrown, etc.)? If the answer is "Yes ", conlact the Regional Office for guidance.
YES
NO
4 Are any monitored constituents equal to or above the established standards?
Fthenswer to question 4is 'NO" skip to section 8.
nswer to question 4 is "YES" list the affected wells individually with constituents) and concentration(s)
ing standards in the space provided below:
c (VI wz [U.7� rnwtiZ �Z.lc�
YES
NO
5 For the constituents identified in question 4 above, have standards been exceeded previously for the
same constituent(s) in the same well(s) in the last two years?
YES
NO
If the answer to question 5 is 'NO'; skip to section 8.
if the answer to question 5 is "YES" list in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence'(for the last two years).
i D S. frn w I Z L S coo> L( -1 C( - 11
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
If the answer is "YES'; a groundwater quality problem maybe occurring, CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO'; monitoring wells maybe improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
groundwater quality problem?
YES
NO
if the answer to question 7 is 'YES", describe those actions in the space provided below.
If the answer to question 7 is "NO", contact the Regional Office within 90 days: an evaluation may be
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surrounding this facility. Failure to do so may subject the permittee to a Notice of Violation
fines, and/or penalties.
g
The person completing this portion (GW-59A) of the monitoring report shoulaf sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
1 herebyacknowlec)ge that thQ; Bove information was evaluat6d4,bnd the information subinitted-Tithis s",
report_(Compliance ReportGW59A) Is true and complete to the`6 st of my knowi@a9e v �z �- ,;
Signature of Perm' ee (or Authorized Agent) Date
GNV-59A 12/8/2003

Lfiffi
_ -ins..
P08T OFFICE EOX Iar55 EfNEir(I6615 ELAZA biq.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#02)
PERMIT #:
ADDRESS: Coats America (Wells)
P.O. Box 368
Marion, NC 28752
COLLECTIONDATE. 12/6/2011
COLLECTION TIME. • 07:00
RECEIVED DATE: 12/6/2011
RECEIVED TIME.- 13:45
RFPOPTFn•
LOG ID: 1112-176 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

6T.V H
Inc.
. r
POST OFFICE BOX 1056 -4 #5 PINEWOOD PLAZA DR.,
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#10) COLLECTION DATE:
12/6/2011 _
PERMIT A COLLECTION TIME
07:30
ADDRESS: Coats America (Wells) RECEIVED DATE:
12/6/2011
P.O. Box 368
Marion, NC 28752 RECEIVED TIME.,
13:45
REPORTED:
12/29/2011
:.
ANALYSIS
ANALYS/S
RESULTS
U/VITS
DATE
ANgLYST
✓Sulfate
14A
mg/L
12/8/11
✓Chloride
11.0
mg/L
12/15/11
lag
T. Phosphorus
<0.16
mg/L
12/13/11
jdg.
toc
<1.0
mg/L
12/9/11
`/FDS
96
mg/L
12/12111
lag
metals
see attached
voc
see attached
LOG ID: 1112-177 REPORTED.BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor -

MRTER'�- XCH
.Inc.
POST OFFICE BOX 1056 • n5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE., Coats America (MW#11)
PERMIT #:
ADDRESS: Coats America (Wells)
P.O. Box 368
Marion, NC 28752
COLLECTION DATE.,
12/6/2011
COLLECTION TIME:
08:00
RECEIVED DATE:
12/6/2011
RECEIVED TIME.,
13:45
REPORTED:
12/29/2011
LOG ID: 1112-178 REPORTED BY: NC CERTIFIED LAB # 50
ff�*
Tony Gragg, Lab Supervisor

POST OFFICE BOX 1056 • 95 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROL►NA 28630
(828) 39&4444
SAMPLE., Coats America (MW#12) COLLECTION DATE: 12/6/2011
PERMIT A COLLECTION TIME. • 08:30
ADDRESS: Coats America (Wells) RECEIVED DATE., 12/6/2011
P.O. Box 368 RECEIVED TIME., 13:45
Marion, NC 28752
REPORTED: 12/29/2011
�4NALYSIS
ANALYSIS :
RESULTS
.........
,DATE
ANALYST
✓Sulfate
<10.0
mg/L
12/8111
✓Chloride
11.5
mg/L
IW5/11
lag
T. Phosphorus
<0.16
mg/L
12/13/11
jdg
toc
2.76
mg/L _
12/9111
TDS
.510
mg/L
12/12/11
lag
metals
see attached
voc
see attached
LOG ID: 1112-179 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

:i LfiJ .Inc.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE. Coats America (MW#13) COLLECTION DATE: 12/6/2011
PERMIT #: COLLECTION TIME: 09:00
ADDRESS: Coats America (Wells) RECEIVED DATE: 12/6/2011
P.O. Box 368
Marion, NC 28752 RECEIVED TIME: 13:45
REPORTED. 12/29/2011
LOG ID., 1112-180 REPORTED BY: NBC. CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

rm6rrcH Lass. -Inc
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS. NORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#14) COLLECTION DATE: 12/6/2011 _
PERMIT #. COLLECTION TIME: 10:00
ADDRESS., Coats America (Wells) RECEIVED DATE: 12/6/2011
P.O. Box 368 RECEIVED TIME: 13:45
Marion, NC 28752
REPORTED: 12/29/2011
- ANALYSIS
ANALYSIS -
_:RESULTS
UNITS ;DATE
�4NALYST
--'Sulfate
<10.0
mg/L
12/8/11 -
.%Chlodde
<2.5
mg/L
12/15/11
lag
T. Phosphorus
<0.16
mg/L
12/13/11
jdg
toc
2.82
mg/L
1219111
`/`IDS
441
mg/L
12/12/11
lag
metals
see attached
voc
see attached
LOG 1D: 1112-182 REPORTED BY: NBC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

mqrER6rjrcHL1fAfi.1nc.
POST OFFICE BOX 1056 • 45 PINEWOOD PLAZA DR.
GRANITE FALLS, NORTH CAROLINA 28830
[phone]
SAMPLE. Coats America (MW#15) COLLECTION DATE: 12/6/2011
PERMIT A COLLECTION TIME: 10:30
ADDRESS., Coats America (Wells) RECEIVED DATE: 12/6/2011
P.O. Box 368 RECEIVED TIME., 13:45
Marion, NC 28752
REPORTED., 12/29/2011
ANALYSIS
ANAtYS/S
RESULTS
UIyITS DATE ANALYST
✓Sulfate
29.0
mg/L
12/8111
✓Chloride
<2.5
mg/L
12/15/11 lag
T. Phosphorus
<0.16
mg/L
12/13/11 jdg-
toc
2.56
mg/L
1219/11
,4DS
382
mg/L
12/12/11
metals
see attached
voc
see attached
LOG ID: 1112-183 REPORTED 3Y: Nff�
CCERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

RF-SEARCh- & ANALYTICAL
•
LA ORATORIES/ INC.
Analytical/Process Consultations
December 21, 2011
Water Tech Labs
P.O. Box 1056
Granite Falls, NC 28630
Attention: Joe Gragg,
Project Name: Coats American
II. Miscellaneous
MW2
MW10
MW11
MW12
MW13
MW14
MW15
Parameters
Unit
Results
Results
Results
Results
Results
Results
Results.
Aluminum, Total
mg/L
3.39
0.073
0.272
0.093
<0.025
2.44
<0.025
✓Arsenic, Total
mg/L
0.005
<0.005
<0.005
<0.005
<0.005
<0.005
<0.005
✓�arium, Total
mg/L
0.136
0.018
0.076
0.096
0.046
0.140
0.123
Vtadmium, Total
mg/L
<0.002
<0.002
<0.002
<0.002
<0.002
<0.002
<0.002
.,chromium; Total
mg/L
<0.005
<0.005
<0.005
<0.005
<0.005
<0.005
<0.005
Calcium, Total
mg/L
27.7
0.221
13.3
483
14.0
76.3
73.7
Lead, Total
mg/L
0.04D yvt
<0.005
<0.005
<0.005
<0.005
OA3
<0.005
Magnesium, Total
mg/L
= ;��u,l 1�' 0
<0.500
:. 4 >
~.10y
10. ]
,
.iJj
X Manganese, Total
mg/L
1. 4
<0.005
0. 62 0
2. 0
Q:V:
. 94
Nickel, Total
mg/L
0.012
<0.005
<0.005
0.007
0.006
<0.005
<0.005
-,Selenium, Total
mg/L
<0.005
<0.005
<0.005
<0.005
<0.005
<0.005
<0.005
Sodium, Total
mg/L
11.5
34.2
23.0
143
134
26.3
16.2
,-91fate
mg/L
10.1
14A
23.9
<10.0
<10.0
<10.0
29.0
,Sample Number
719754
719755
719756
719757
719758
719759
719760
Sample Date
12/06/11
12/06/11
12/06/11
12/06/11
12/06/11
12/06/11
12/06/11
Sample Time
0700
0730
0800
0830
0900
0930
1000
mg/L = milligrams per Liter = parts per million (ppm)
< = Less than or below detection limit

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Page 1 of 2
V H, c5iEST
Laboratory Report
Lab Location R' Lab Location 'C' Lab Location 'W
NC/NW Cert# 067 NC/DW Cert#: 37731 NC/WW CerL#: 103 NC/DW Cert.#: 37733 NC/VVW Cert#: 075 NC/DW CerL#: 37721
6701 Conference Dr, Raleigh, NC 27607 6300 Ramada Dr, Suite C2, Clemmons, NC 27012 6624 Gordon Rd, Unit G, Wilmington, NC 28411
Ph: [phone] Fax: [phone] Ph: [phone] Fax: [phone] Ph: [phone] Fax: [phone]
Project No.: 01 Report Date: 12/14/2011
Project ID: COATS AMERICA MONITORING WELLS Date Received: 12/7/2011
Prepared for —
Jon Gragg
Water Tech Labs Work Order #: 1112-00431
PO Box 1056 Cust. Code: WATERT
Granite Falls, NC 28630 Cust. P.O.#i INCL TOC RESULTS
No. Sample ID
001 MONITORING WELL #2
Date Sampled
12/6/2011
Time Sampled Matrix
7:00 GW
Sample Type
Grab
Condition
4 +/- 2 deg C
Test Performed
Method
Results
— Anal zed
Lab Loc atey
Time Qualifier
Total Organic Carbon
5310C
<1.0 mg/L
R 1219111
9.10
No. Sample ID
002 MONITORING WELL #10
Date Sampled
12/6/2011
Time Sampled Matrix
7:30 GW
Sample Type
Grab
Condition
4 +/- 2 deg C
Test Performed
Method
Results
Lab Loc DnaVzedTime
Qualifier
Total Organic Carbon
5310C
<1.0 mg/L
R 12/9/11
9:10
No. Sample ID
003 MONITORING WELL #11
Date Sampled
12/612011
Time Sampled Matrix
8:00 GW
Sample Type
Grab
Condition
4 +/- 2 deg C
Test Performed
Method
Results
lyzed
Lab Loc Date
Time Qualifier
Total Organic Carbon
5310C
4.08 mg/L
R 1219111
9:10
No. Sample ID
004 MONITORING WELL #12
Date Sampled
12/612011
Time Sampled Matrix
8:30 GW
Sample Type
Grab
Condition
4 +1- 2 deg C
Test Performed
Method
Results
Lab Loc DaTyzed
Time Qualifier
Total Organic Carbon
5310C
2.76 mg/L
R 1219/11
9:10
No. Sample ID
005 MONITORING WELL #13
Date Sampled
1216/2011
Time Sampled Matrix
9:00 GW
Sample Type
Grab
Condition
4 +1- 2 deg C
Test Performed
Method
Results
nal ed
Lab Loc Date'
Time Qualifier
Total Organic Carbon
5310C
4.02 mg/L
R 1219/11
9:10

"TROYEST
6701 Conference Drive Page 2 of 2
Raleigh, NC 27607
Telephone: [phone]
Telephone: [phone] Fax: [phone] NCIWW Cert. #: 067
Fax: [phone] NCIDW Cert. M 37731
Laboratory Report
Work Order m 1112-00431
No. Sample ID
006 MONITORING WELL #14
Date Sampled
12/6/2011
Time Sampled Matrix
9:30. GW
Sample Type
Grab
Condition
4 +/- 2 deg C
Test Performed
Method
Results
zed
Lab Loc D,Ty
Time Qualifier
Total Organic Carbon
5310C
2.82 mg/L
R 12/9111
9:10
No. Sample ID
007 MONITORING WELL #15
Date Sampled
12/612011
Time Sampled Matrix
10:00 GW
Sample Type
Grab
Condition
4 +1- 2 deg C
Test Performed
Method
Results
Lab Loc Date ed
Time Qualifier
Total Organic Carbon
5310C
2.56 mg/L
R 12/9111
9:10
Reviewed by:
i
for Tritest, Inc.

'SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility Name: L O H t_5 1-1 in t r ! r f}yj
Permit Name (if different):
Facility Address: 6 (1 0 3
Yh I4 r • o V (St(eet) 2 $,tz
(City) Stale) (zip) County � G --.Wet C
Contact Person: 1 ll t �►� ►`) r` Telephone #: SZg-9d-G - 4// 1
Well Location/ Site Name:.5elail- I;C EX Grdury No. of Wells to be Sampled: �_
[tram Permit)
Well Identification Number (from Permit): M&I- 2-- For GroundwaterTreatment Systems
Well Depth: 76' it. Well Diameter /2 in. Check One: ❑ Influent (98)
Screened Interval: '"A+ it. to .11/4 ft. ❑ Effluent (99)
Depth to Water Level: 39.6 It. below measuring point. .
Measuring Point (M.P.) is: 2,3 It. above land surface. Relative M.P. Elevation MR.:
Gallons of water pumped/bailed before sampling: 7/•2.f Date sample collected:
Field analysis: pH , Specific Conductance ' uMhos
Temp. I6 °C, Odor Appearance
9-11
DEPARTMENT OF ENVIRONMENT & NATURAL RE40URCES
WATER QUALITY DIVISION, GROUNDWATER SECT ON-
1636 MAIL SERVICE CENTER
PERMIT #: 418 o005G q5EXPIRATION DATE: CV' ?2`80
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED 13 ID
Lagoon Remedialion: Infiltration Galle 0`
Spray Field Remediation:
I �_ CM
Rotary Distributor Land Application of
Other:
Sludge
NOTE: Values should reflect dissolved and .
E-
E f V E
D
colloidal concentrations.
Date sample analyzed: t-=E /Vc I/d k/
Laboratory Name: W14 '7-Pc/,
Certification No. 6-0
ation
Processing nt
/BOG
PARAMETERS (Samples for metals were collected unfiltered_Y YES NO and field acidified
COD mg/I Nitrite (NO2) as N mg/I
Coliform: MF Fecal /100ml Nitrate (NO3) as N mg/I
Coliform: MF Total /100ml Phosphorus: Total as P_V'16-11 0.21 mn/I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total 8•io-ii
/aZ mg/I
pH (when analyzed) 919 //
•b units
TOC
mg/I
Chloride 8-2-1-11
Zs'o mg/I
Arsenic S-f2-li
50.004;' mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate 8-12-11
X-C) mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/1
GW-59
R Vj. 03/2000
Orthophosphate
mg/I
Al - Aluminum
mg/I
Ba - Barium V- l2-t t
0, 127
mg/I
Ca - Calcium _ Y- I?-
2S• y
mg/I .
Cd-Cadmium V-12"
Zb.00t
mg/I
Chromium: Total 41-t2- I1
4 6.00C
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg ,- Mercury
mg/I
K - Potassium
mg/I
Mg -Magnesium fI-12-11
13.7
mg/I
Mn-Manganese t3-t 2-li
0432-
mQ/1
X_ YES
Ni -Nickel 13-►2-
Pb - Leart
Zn - Zinc
Ammonia Nitroge
Other (Specify Com
NO)
n
pounds and Concert
-0-1 J
-lz-
n9 mg/1
mg/I
— mg/1
mg/I
ation Units)
O, o�G•
O,G n,oii
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #.'Attach la report.)
ReportAttached? Yes (1) o (0)
VOC method # =
method # =
method # =
11ti,"t.L1 KT'1'an q w O f G
Permittee (orpArthbfized Agent) name and I e - PI ase print or type
-��W
Signature of ermittee (or A ho(zed Agent) (Dale)
0
G
CJ

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: Co (,4+- s Vn l: r "G A ry
Permit Name (if differe t):
Facility Address: �U �O 3fo
Yh in C AJ (slreeq tv` 7-V MS ljowel't
(Cil ) ( ale) Rip) County
Contact Person:�+,tt 4 P'i4Vh A- A i+l� �✓ Telephone #:
Well Location/ Site Name: 540it,111456 °"' No. of Wells to be Sampled: T_
(Irani Permll)
Well Identification Number (from Permit): 0741- /d For Groundwater Treatment Systems
Well Depth: 1 it. Well Diameter. 2- in. Check one: ❑ Influent (98)
Screened Interval: it. to wA" ft: ❑ Effluent (99)
Depit� to Water Level: fib•/ fl. below measuring point.
Measuring Point (M.P.) is: Z,3 ft. above land surface. Relative M.P. Elevation In ft.:
Gallons of water pumped/bailed before sampling: 3 Date sample collected: _
Field analysis: pH '�/S Specific Conductance uMhos
Temp. 2 / °C, Odor Appearance
PERMIT #: w
Non -Discharge
DEPARTMENT OF ENVIRONMENT & NATURAL RE OURCES
WATER QUALITY DIVISION, GROUNDWATER SEC ION
1636 MAIL SERVICE CENTER
b+ooB5Goc3 EXPIRATION DATE: RAJ/
UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITOR[
_ Lagoon Remedialion: Infiltration Ga
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations. EI`v ED
REC
Date sample analyzed: Sew /3•t%/o rr/
Laboratory Name: W d y"e r TPc n
Certification No. S"a
Information Processing Unit
PARAMETERS (Samples for metals were collected unfiltered X YES NO 'and field acidified
COD mg/I Nitrite (NO2) as N - mg/I
Coliform: MF Fecal /100ml Nitrate (NO3) as N mg/I
Coliform: MF Total /100ml Phnsnhnrus- Tntal as P SI-Id-1l LO,/6 mn/1
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total 5-16-11
116' mg/I
pH (when analyzed) (?-?-It
G.y3" units
TOC $-14-t /
t ►.D mg/I
Chloride 9- 21-11
mg/I
Arsenic 9-12- 11
Co.00S mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate g-12-11
32. mg/I
Specific Conductance -
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Orthophosphate
mg/I
Al - Aluminum
mg/I
Ba - Barium S- ►2- If
a.oZb
mg/I
Ca - Calcium_9-12-11
40.saa
mg/I
Cd - Cadmium 9-12-11
40.1001
mg/I
Chromium: Total
o,00s
mg/I
Cu - Copper
trig/l
Fe - Iron
rng/I
Hg - Mercury
mg/I
K -- Potassium
g
Mg - Magnesium 9,12'1 I
o •s a0
mg/I
Mn - Manqanese_ 5-12-rf'
40,00s'
m❑/I
X -YES NO) l wunsvu
Ni - Nickel-1z-1► 46oaf mg/I
Pb - Lea 5'•/Z- 11 .00Smg/I
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Conce tration Units)
o iu - 2-i ,
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
ReportAttached? Yes (1) o (0)
VOC : method # =
method # =
method # =
(or Aul ari ed AV
gent) Name and T411a 7 Prase print or tvoe
L
GW-59 �� O./e-�/
Rev. 03/2000 Signature of Fwfmillee (or „ulWrized Agent) (Dale)

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: %o AfS on, c r i c 4&
Permit Name (if differ nt):
Facility Address: t, 6 3 £�
dr ON (Streeq
Icily) stale) 2$%!iot County l�/ Our el G
Contact Person: 'ji Pli,nro,c rI+ 1�u �.Y5 Telephone
Well Location/ Site Name: SkvitF / 195h No. of Wells to be Sampled: 7
(Irom P.—II)Well Identification Number (from Permit): Mlr! For Groundwater Treatment Systems
Well Depth: ft. Well Diameter: 2--in- Check One: ❑ Influent (98)
Screened Interval:/j4 ft. to ^'/A ft. 11 Effluent 99
Depth to Water Level: 14,9 ft. below measuring point.
Measuring Point (M.P.) ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: _ Date sample collected: ?-q-//
Field analysis: pH , Specific Conductance ' uMhos
. Temp. %9 -C, Odor Appearance
PERMIT #: U,
Non -Discharge
NPDES
DEPARTMENT OF ENVIRONMENT & NATURAL RE 3OURCES
WATER QUALITY DIVISION, GROUNDWATER SECI ION
1636 MAIL SERVICE CENTER
RALEIG'H, NC 27699-1636 Phone: [phone]:
EXPIRATION DATE:
UIC
TYPE F PERMITTED OPERATION BEING MONITOREI
Lagoon - Remedialion: Infiltration Galli
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
RE
Date sample analyzed: S 4-oOF &rrl e W
Laboratory Name: W W7 it ?;mac _h Sj
Certification No. SS 6
PARAMETERS (Samples for metals were collected unfiltered_X YES NO
and field acidified
COD
mg/I
Nitrite (NO2) as N
m /I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P lb-lf
-10.14 mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
m /I
Dissolved Solids: Total 51-to-jr
244 mg/I
AlAI -Aluminum
mg/I
pH (when analyzed) F-?-//
G•/y units
Ba -Barium 2-11
6.107
mg/I
TOC
mg/I
Ca - Calcium E t2.-a
237, 3
mg/I
Chloride g`21-t1
Arsenic 53-f2-rl
/[o mg/I
Co•oo5 mg/I
Cd - Cadmium 8-12 -►1
Chromium: Total.8-a-•r► '
'Zn,00 1
mg/I
m /I
g
Zo.00s
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
Sulfate 8- IZ--ft
mg/I
1Z9 mg/f
Fe - Iron
Hg -Mercury
mg/I
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
TKN as N
mg/I
Mg - Magnesium 9"12-11
W-82
mg/I
mg/I
Mn-Manganese 9-12-it
O,1,3%
mg/I
;`
l'ermittee (or A thor' ed Agent)
GW-59
Rev. 03/2000 Signature o ermit ee (orA 1
A YES NO)
Ni -Nickel S-12-11 46
Pb- Lead SLIL-11 to
Zn - Zinc
Ammonia Nitrogen
Other (Specify Compounds and Concen
-2611
EI V ED
Oil
os mg/I
os mg/I
mg/I
.— mg/I
ition Units)
ORGANICS: (GC,GC/MS,HPLC,)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) NO (0)
VOC : method #
and TiI!l." Pleaseprini or Woe
method #
method #
A //
Unit.:

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
' - • DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
. WATER QUALITY DIVISION, GROUNDWATER SECTION
COMPLIANCE REPORT FORM
1636.MAIL SERVICE CENTER
FACILITY INFORMATION
Please Print Clearly or Type
RALEIGH NC 27699-1636 Phone: 91
733-3221
PERMIT #: 600 S G d EXPIRATION DATE: cS
Non -Discharge UIC
FacilityName: �b 14 �S /� N1 >= ►^ C{ /�-
-241
Permit Name (if differept):
Facility Address: i' �0 �e G
NPDES
M $4 r 1 O rV (Street)
_ N C Stale) 297'Z,c) County INN po w e t l ..
Contact Person �'h l,1 ?74'Imo- / 9APk Nud�_ - 14
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon
Well Location/ SF / fF/
Telephone #: R241-7S6 )11
—X Remediation: Infiltration Galle
Site Name: v r'� ,f vE,.i
No. of Wells to be Sampled: �_
Spray Field Remediation:
(from pemll)
Rotary Distributor Land Application of Sludge
Other:
Well Identification Number (from Permit): In&)-12 For Groundwater Treatment Systems
13
Well Depth: ft. Well Diameter•: 1
Screened Interval; 1 ft. to `V00— it.
in. Check One: ❑ Influent (98)
Effluent 99
Depth to Water Level: /D•I ft. below measuring point.
TE
NOTE,
�� Values should reflect dissolved and .
colloidal FOE�/
���a'�
Measuring Point (M.P.) is: ?•b ft. above land surface.
Relative M.P. Elevation in ft.:
concentrations.
Gallons of water pumped/bailed before sampling: _�_ Date sample collected: - 9-//
640
Date sample analyzed: .5 ,F ,BAe /d kr SF
P 29 7 2011
Field analysis: pH , Specific Conductance
uMhos
Laboratory. Name taAfAr 'c
Temp. 1C 'C, Odor
Appearance
Certification No. Sl1 nor
hV Unit
tD
woeo� /Boo
PARAMETERS (Samples for metals were collected unfiltered_ X _YES NO
and field acidified _YES NO)
COD mg/I
Coliform: MF Fecal /100mf
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/I Ni - Nickel P/2-11
/I �-
mg/I
Coliform: MF Total /100m1
m I?b -Lea z-ll
g ee-
. Phosphorus: Total as P. S Z0,16 mg/I Zn - Zinc
oS mg/I
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total `/0-/1 s 9,f mg/I
Orthbphosphate
Al - Aluminum
mg/I Ammonia Nitrogen
mg/I
mg/I
pH (when analyzed) - -// .G units
Ba - Barium R-IZ-U
mg/I Other (Specify Compounds and. Concen
01126 mg/I S /4" - 2-11
ration Units)
-
TOC _ $- lb `1( 3.19 mg/I
Ca -Calcium 9112-1)
An
e• fl rn 9 /I d;0 M
ZOO
Chloride _S -2EI f 2 mg/I
Cd -Cadmium 9-12- If
-.54
Z n, 1101 mg/I
Arsenic _ 9-12-u 6.00! mg/I
Chromium: Total S-lz-)I
46,005 mg/I
Grease and Oils. mg/I
Cu - Copper
mg/I
Phenol mg/I
Sulfate -12-II /1.1 mg/I
Fe - Iron
Hg - Mercury
mg/I ORGANICS: GC,GC/MS,HPLC
( )
Specific Conductance
P uMhos
K - Potassium
mg/I
9 (Specify test and method #, Attach la
mg/I Report Attached? Yes
report.)
Total Ammonia mg/I
Mg - Magnesium gl-12-1=i
1
/0.3 mg/I VOC
0 0
( )
TKN as N mg/I
Mn-Manganese V-12-j1
method #)=
2.13 mg/I
:method #
method # =
Au
or type
C.,
GW-59
Rev. 0312000
Agen

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
• DEPARTMENT OF ENVIRONMENT $ NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
COMPLIANCE REPORT FORM
1636 MAIL SERVICE CENTER
FACILITY INFORMATION Please Print Clearly or Type
RALEIGH NC 27699-1636 Phone:[phone]
n
Facility Name: 1.oA'(5 A0%EriC_Aw
2a�/
PERMIT #:W906OSG03 EXPIRATIONDATE:
Non -Discharge UIC
Permit Name (if different):
Facility Address: P O X 2 6 t3.
NPDES
it A C I D n- vU c 2 � Z c
ICnY) (Sireeq Y r1i c- 6o to e t l
(rP) Count
TYPE OF PERMITTED OPERATION BEING MONITORED
Conta& Person?h;tt; ? f vn,4 r$(A ria i - Telephone #: �a8-7S6 ' N// %
— Lagoon Remediation: Infiltration Galley
Well Location/ Site Name: 51V • N /v,t Kf No. of Wells to be Sampled: 7
--mil)
Spray Field Remediation:
(Uom
Rotary Distributor Land Application of Sludge
Other:
Well Identification Number (from Permit): YYl W ` 13 For Groundwater Treatment Systems
Well Depth: 1.5 it. Well Diameter. 2 in. Check One: ❑ Influent (98)
�—. Values should reflect dissolved and .
Screened Interval: ""/A ft. to r`/A El ft.
�Effluent (99)
Depth io Water Level: 13•7 ft, below
a
measuring point.
Measuring Point (M.P.) is: 21ft. above land surface. Relative M.P. Elevation in ft.:
colloidal concentrations.
'(�' 'VE®
Gallons of water pumped/bailed before sampling: - Date sample collected: -4 '/I
Date sample analyzed: ,$,EE a ie&r k)
s
a
P
Field analysis: pH 6.3.5 , Specific Conductance uMhos
Laboratory Name: W.4�Er P0A '
Temp. Z n °C, Odor Appearance
Certification No. 6' Information
Processing t1nR
PARAMETERS (Samples for metals were collected unfiltered YES NO and field acidified
COD mg/I Nitrite (NO2) as N m /1
Coliform: MF Fecal /100ml Nitrate (NO3) as N mg/I
Coliform: MF Total _ /I00Ml Phnsnhnrnic• Tntal ac 17 II
(Note: Use MPN method for highly turbid samples
Dissolved Solids: Total
8-40•-it X7l •mg/l
pH (when analyzed)
9-11 L.3S units
TOC __ g-lb-fl
3 .a$ mg/I
Chloride 8 -Z 1- 11
j 23 mg/I
Arsenic 9-1Z~11
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate 1?-12-1f
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Orthophosphate
mg/I
Al - Aluminum -
mg/I
Ba - Barium 9-1 Z-1
0.01.1
mg/I
Ca - Calcilam -1I
2
239 .
mg/I
Cd - Cadmium `) L-1
'44001
mg/I
Chromium: Total 9-)Z-/r-
40,006-
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
m g/I
Mg - Magnesium -12 �J/
/d•z
mg/I
Mn - Manganese.
01757
mn/I
I2A
K YES NO)
Ni - Nickel
Pb-- Lea
Zn - Zinc
Ammonia Nitrogen_
Other (Specify Compound
S,E/EwiG�► 8�1Z`
LO• o g/
Go, OS mg/I
mg/1
mg/I
and Conce tration Units)
1 o d,57-
I .,ac—
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach I b report.)
Report Attached? Yes (1) o (0)
VOC : method # =
C
method # =
method # =
GW-59
Rev. 0312000

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
t-AUILI I Y trot-unmH I [UN Please Print Clearly or Type
Facility Name: CO' -AS 4 yh•Er-1CAA—
Permit Name (if diffe�g nt):
Facility Address: NO f3a X' 36 8
(Street)
1ti, t4 ni >7rl/ ,t� c 2��SZ County ^ /0.010A 6G
tac -i.: l: .% , -now �a�e rA //4 .Nz'°' Telephone #: _�Li�'7,s6
Contact Person:
Well Location/ Site Name: r 1,66 / ti No. of Wells to be Sampled:_
(from ermlt)
Well Identification Number (from Permit): For Groundwater Treatment Systems
Well Depth: IS S it. Well Diameter-2 in. Check One: ❑ Influent (98)
Screened Interval: '1/'F ft. to � it. I-] Effluent (99)
Depth io'Waler Level: 9.1 It. below measuring point.
Measuring Point (M.P.) is:-2.12_ ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 'Z Date sample collected:
Field analysis: pH li ./ Specific Conductance uMhos
Temp. /7 °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RE OURCES
WATER QUALITY DIVISION, GROUNDWATER SEC ION
1636 MAIL SERVICE CENTER
PERMIT #: w EXPIRATION DATE
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITOREC
A Lagoon Remediation: Infiltration Galle
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: SEE` QE/
Laboratory Name: —,4 -1,CP 7"
Certification No. . S- D
PARAMETERS (Samples for metals were collected unfiltered-_A_YE5 NO
and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P- A'// . CG•/G m9 /I
(Note: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total Jo-J/ W mg/I
Al - Aluminum
mg/I
pH (when analyzed) f4- /1
"1& `/1
4-7/ units
Ba - Barium 6-12 t f
D•/2Z mg/I
TOC _
y 2y mg/I
Ca - CaIcItim f2,-11
7q 2- rng/I
Chloride
4n mg/I
Cd - Cadmium " 2-11
m /I
Arsenic 9`12-1 f
�d.6o5 mg/I
Chromium: Total `/2`►t
Lb�oaS mg/I
Grease and Oils
mg/I
Cu - Copper
mg/l
Phenol
Sulfate S3-2t'II
mg/I
<B.t7
/ mg/I
Fe - Iron
Hg -Mercury
m /I
g
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
rrlg/I
Mg -Magnesium _ 8-12` //
y/•3 mg/I
TKN as N
mg/I
Mn - Manganese_ 2'1/'
/.a>' m9 /I
_YES NO)
Ni - Nickel k-/2-11
Pb - Lead 8-/4-/1
Zn - Zinc
Ammonia Nitrogen -
Other
�-'���(Specify Compounds and
���N:Gzn V-/2-/I
=Z6/
SFP T, 7 `1011
mation Processing Uni
Z o•e1os-
<o
mg/I
mg/I
mg/I
mg/I
Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach IE b report.)
Report Attached? Yes (1) o (0)
VOC : method # _
method #
method # =
e, Pe/_ O!`C
• GW-59 '
Rev. 0312000 Signature of Per ttee (or Aulhorized ent) (Date)

SUBMIT FORM ON YELLOW PAPER ONLY
r DEPARTMENT OF ENVIRONMENT & NATURAL RE 3OURCES
GROUNDWATER QUALITY MONITORING: WATER QUALITY DIVISION, GROUNDWATER SEC1 ION
COMPLIANCE REPORT FORM 1636MAIL SERVICE CENTER
RALEIGH NC 27699-1636 Phone: [phone],
ACILITY INFORMATION n Please Print Clearly or Type
Facility Name: l , o (1tzT.5 IV /// E' r' r' C q. In,
Permit Name, (if differe t :
Facility Address: IF
M04 n 1 a 4 ) (streeq/�"� 0
(City) s at IZip) County
Contact Person: l: • a• NN ti Telephone #: 929- 76
Well Location/ Site Name: S-!G. " r % WSA No. of Wells to be Sampled:
Well Identification Number (from Permit): W- / For Groundwater Treatment Systems
Well Depth: % ft. Well Diameter•: in. Check One: ❑ Influent (98)
Screened Interval: / lo/ it_ to '-/'N ft. ❑ Effluent (99)
Depth to Water Level: _/A3 ftbelow measuring point.
Measuring Point (M.P.) is:_5 It. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: Y2 Date sample collected:
Field analysis: pH •L/ Specific Conductance . uMhos
Temp. 19! °C, Odor Appearance
PERMIT #: m EXPIRATION DATE:
Non -Discharge U IC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
_K_ Lagoon - Remedialion: Infiltration Galle
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .���
colloidal concentrations.RECoE
Date sample analyied: S Sr '2?.F16 •J 1w '1011
Laboratory Name:. wid-1 ✓ Te
Certification No. st7 tntforma +on pe�nessing Unit
PARAMETERS (Samples for metals were collected unfiltered_ X YES NO and field acidified
COD mg/I Nitrite (NO2) as N mg/I
Coliform: MF Fecal /100ml Nitrate (NO3) as N mg/I
Coliform: MF Total /100m1 Phnsnhnri is• Tntal ac P f-lb-11 Z-A./6 rr -/l
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total
.0 mg/I
pH (when analyzed)
6•,2 units
TOC 9-16 -1/
IV-mg/I
Chloride _ R-W - Il
-'' .0 mg/I
Arsenic 0-12-)1
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate -12-11
mg/I
_/�G
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Orthophosphate
mg/I
Al - Aluminum
mg/1
Ba - Barium Vf Z - f 1
O./y a
mg/I
Ca - Calcium 91-U-lf
b-y
mg/I
admium i?• ►Z�-I/
Cd - Cadmium—
Ld•oo f
mg/I
Chromium: Total 9-12-11 '
� � •o os
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
g
Mg : Magnesium I2-4/
31• 2,
mg/I
Mn - Manqanese "f2-(1
/49
rrin/I
Permittee r A 1 orize n
GW-s9
Rev. 03/2000 Signature of er inee orAull
—L_YES NO)
Ni - Nickel •iz_r < mg/I
Pb -'Lead t'12-/l co-605 mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/1
Other (Specify Compounds and Cancer tration Units)
SELEoit,m V-r2,-11 6.0t7�i
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) NO (0)
VOC method # =
method # =
method # =
i //
rl

GW-49A COMPLIANCE REPORT FORM Permit # 1�&66OS 4c 3
(Submit one each monitoring period with GiV-59 forms.)
1
Enter date monitoring results were due. ( t/ - `3. o- tt) Will this monitoring report (GW-59 and GW-59A)
be. submitted after the established due date?
YES
NO
X
2
Was any required information missing on the GW-59 report forms?
YES
NO
iF the answer to question 1 or 2 is "YES', list in the space provided below the welt identification numbers) and
explain the problems encountered in obtaining the required information.
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
Identification plate, area overgrown, etc.)? If the answer is "1'es ", contact the Regional Office for guidance.
YES
NO
4
Are any monitored constituents equal to or above the established standards?
YE
NO
if the answer to question 4 is "NO", skip to section B.
If the answer to question 4 is "YES" list the affected wells individually with constituents) and concentration(s)
exceeding standards in the space provided below.
-% jo s W 1 'L :fin ;.tu5 t-'
ffipxygns e a i•.13ar�°%i 5> zl � �' i�'�'�%�
5
For the constituents identified in question'4 above, have standards e-en exceeded previously for the
same constituent(s) in the same well(s) in the last two years?
If the answer to question 5 is 'NO" skip to section 8.
If the answer to question 5 is "YES'; fist in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
YES
NO
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
If the answer is "YES", a groundwater quality problem maybe occurring, CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO', monitoring wells maybe improperly
located; contact the Regional Office.
X
7
is the permittee implementing previously approved actions required by the Division involving this
groundwater quality problem?
YES
NO
if the answer to question 7 is 'YES", describe those actions in the space provided below.
If the answer to question 7 is "NO", contact the Regional Office within 90 days; an evaluation may be
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surrounding this facility Failure to do so may subject the permittee to a Notice of Violation
fines, and/or penalties.
RECEWPD
SEA 2 7 2013
'nfoi7n8tion Pmce 9 Unit
8
The person completing this portion (GW-59A) o t itoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
1 hereliyackrio a that;the}above information was evaluated and the inforanationsubniltfed_Tnfhis
Sign re of Permittee Authorized Agent) Date
GW-59A 12/8/2003

A
r;
WRTER
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE F.=%L.LS. NORTH CA,ROLiNA 28630
[phone]
SAMPLE: Coats America (MW#02) COLLECTION DATE: 8/9/2011
PERMIT #: COLLECTION TIME: 09:00
ADDRESS:
RECEIVED DATE: 8/9/2011
RECEIVED TIME: 13:25
REPORTED: 8/30/2011
ANALYSIS
ANALYSIS RESULTS UNITS DATE ANALYST
`
Sulfate <10.0 mg/L 8112/11
Chloride <5.0 mg/L 8/21/11 jmf
T. Phosphorus 0.28 mg/L 8/16/11 jdg
toc <1.0 mg/L 8/16/11
TDS 102 mg/L 8/10/11 lag
metals see attached
MCCENE
SEP
Wo aWn processing unit
DWQ150
LOG ID: 1108-135 REPORTED BY: NC CERTIFIED LAB # 50
fm * I
Tony Gragg, Lab Supervisor

k
_ ._ ._ ._ :___ --. ./nc.
POST CI :iCE SOX 1056 • #5 PINEWOOD PLAZA DR.
t RAI IITE FALLS, NORTH CAROLINA 28630
[phone]
SAMPLE.
Coats America (MW#1-0) COLLECTION DATE:
8/9/2011
PERMIT #:
COLLECTION TIME.,
09:15
ADDRESS:
RECEIVED DATE:
8/9/2011
RECEIVED TIME.,
13:25
REPORTED:
8/30/2011
ANALYSIS
ANALYSIS
RESULTS UNITS DATE
ANALYST'
Sulfate
32.6 mg/L 8/12/11
Chloride
7 mg/L 8/21/11
jmf
T. Phosphorus
<0.16 mg/L 8/16/11
jdg
toc
<1.0 mg/L 8/16/11
TDS
115 mg/L 8/10/11
lag
metals
see attached
LOG ID: 1108-136 REPORTED BY: NC CERTIFIED LAB # 50
l i
Tony Gragg, Lab Supervisor

94
8-inc,
05
POST OFFICE BOX 1056 5 PINEWOOD PLAZA DR.
GRANITE FALLS. iti1ORTH CAROLINA 28630
[phone]
SAMPLE: Coats America (MW#11) COLLECTION DATE: 8/9/2011
PERMIT # COLLECTION TIME: 09:30
ADDRESS: RECEIVED DATE., 8/9/2011
RECEIVED TIME: 13:25
REPORTED: 8/30/2011
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
Sulfate
128
mg/L
8/12/11
Chloride
16
mg/L
8121/11
jmf
T. Phosphorus
<0.16
mg/L
8/16/11
jdg
toc
2.35
mg/L
8/16/11
TDS
299
mg/L
8/10/11
lag
metals
see attached
LOG ID: 1108-137 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

t
POST OFFICE BOX. ': 56 • 115 PINEWOOD PLAZA DR.
GRAM T = FALLS. NORTH CAROLINA 28630
[phone]
SAMPLE. Coats America (MW#12) COLLECTION DATE: 8/9/2011
PERMIT #: COLLECTION TIME: 09:45
ADDRESS: RECEIVED DATE: 8/9/2011
RECEIVED TIME: 13:25
REPORTED: 8/30/2011.
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
Sulfate
11.1
mg/L
8/12/11
Chloride
8
mg/L
8121/11
jmf
T. Phosphorus
<0.16
mg/L
8/16/11
jdg
toc
3.19
mg/L
8/16/11
TDS
595
mg/L
8/10/11
lag
metals
see attached
LOG ID: 1108-138 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

;4
_ - _ _ . __ __ .inc.
TECH
POST OFFICE BOX 1056 ° #5 PINEWOOD PLAZA DR,
GRANITE FALLS. NORTH CAROLINA 28630
[phone]
SAMPLE.
Coats America (MW#13) COLLECTION DATE:
8/9/2011
PERMIT*
COLLECTION TIME:
10:00
ADDRESS:
RECEIVED DATE.,
8/9/2011
RECEIVED TIME:
13:25
REPORTED:
8/30/2011
ANALYSIS
ANALYSIS
RESULTS UNITS DATE
ANALYST
Sulfate
<10.0 mg/L 8/12/11
Chloride
123 mg/L 8/21/11
jmf
T. Phosphorus .
<0.16 mg/L 8/16/11
jdg
toc
3.08 mg/L 8/16/11
TDS
471 mg/L 8/10/11
lag
metals
see attached
LOG ID: 1108-139 REPORTED BY: NC CERTIFIED LAB # 50
Tony Gragg, Lab Supervisor

Y,
,COST OF=ICE BOX -L55 a #5 PINEWOOD PLAZA DR.
GRANITE: FALLS. NORTH CAR UNA 29630
[phone]
SAMPLE: Coats America (MW#14) COLLECTION DATE: 8/9/2011
PERMIT #: COLLECTION TIME: 10:15
ADDRESS: RECEIVED DATE: 8/9/2011
RECEIVED TIME: 13:25
REPORTED: 8/30/2011
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
Sulfate
<10.0
mg/L
8/12/11
Chloride
<5.0
mg/L
8/21/11
jmf
T. Phosphorus
<0.16
mg/L
8/16/11
jdg
toc
4.24
mg/L
8/16/11
TDS
457
mg/L
8/10/11
lag
metals
see attached
LOG ID: 1108-140 REPORTED BY: NC CERTIFIED LAB # 50
fo
Tony Gragg, Lab Supervisor

4
WHTER°:.
ECH ln,`.
POST OFFICE BOX 1056 • #5 PINEWOOD PLAZA DR.
GRANITE FALLS, NORT! i CAROLINA 2863E
[phone]
SAMPLE: Coats America (MW#15)
PERMIT #.
ADDRESS:
COLLECTION DATE:
8/9/2011
COLLECTION TIME:
10:30
RECEIVED DATE:
8/9/2011
RECEIVED TIME.
13:25
REPORTED:
8/30/2011
ANALYSIS
ANALYSIS
RESULTS
UNITS
DATE
ANALYST
-Sulfate
156
mg/L
8/12/11
Chloride
<5.0
mg/L
8/21/11
jmf
T. Phosphorus
<0.16
mg/L
8/16/11
jdg
toc
3.52
mg/L
8/16/11
TDS
460
mg/L
8/10/11
lag
metals
see attached
LOG 1D: 1108-141
REPORTED BY: NC CERTIFIED LAB # 50
foot 3
Tony Gragg, Lab Supervisor

Method SM 20Ed 4500-H
PH WORKSHEET
Analysis
Date Time
Sample ID
Collection
Date Time
Results SU's
Analyst
-4— /
,3o
Buffer4.00
****
*****
2,
Buffer 10.00
*****
*****
Of Ch
63
Buffer 7.00 QC
*****
*****
f0o
*****
Slope Efficiency
*****
*****
6 3
Am A J-2
l
q Ga
S, 6
3X
�`�
7.v-
-( I
t9930
0. 3
W-
106b
(0.3
6 Eb
Z630
,
LSZ
,01
BUFFERS: Fisher
4.00 LOT # 1,05314 EXP 08/2012
7.00 LOT # 104056 EXP 06/2012
NON REPORTABLE
FOR NPDES
!` - -T T A 1 - A - T TT /1 Tl T\ T !1
10.00 LOT 9 104216 EXP 07/2012
—T TT T T! A TT In i n 1 CST T]n

a
O
Page 1 of 2
UROUTEST
Laboratory Report
Lab Location R' -
Lab,Location 'C'
Lab Location 'W
NC/WV Cert.#: 067 NC/DW Cert.#: 37731
NC/WV Cert.#: 103 NC/DW Cert.#: 37733
NCM/W Cert.#: 075 NC/DW Cert.#: 37721
6701 Conference Dr, Raleigh, NC 27607
8300 Ramada Dr, Suite C2, Clemmons, NC 27012
6624 Gordon Rd, Unit G, Wilmington, NC28411
Ph: (919) 8344984 Fax: [phone]
Ph: [phone] Fax: [phone]
Ph: [phone] Fax: [phone]
3
Project No.: 01
Project ID: COATS AMERICA MONITORING WELLS
--- Prepared for ---
Jon Gragg
Water Tech Labs
PO Box 1056
Granite Falls, NC 28630
Report Date: 8/19/2011
Date Received: 8/10/2011
Work Order #:
1108-00759
Cust. Code:
WATERT
Cust. P.O.#:
INCL TOC RESULTS
No. Sample ID Date Sampled Time Sampled Matrix Sample Type Condition
001 MONITORING WELL #2 8/9/2011 9:00 GW Grab 4 +1- 2 deg C
Test Performed
Method
Results
------------ Analyzed T-----
Lab Loc Date Time Qualifier
Total Organic Carbon
5310C
<1.0 mg/L
R 8/16111
10:43
No. Sample ID
002 MONITORING WELL #10
Date Sampled
819/2011
Time Sampled Matrix
9:15 GW
Sample Type
Grab
Condition
4 +1- 2 deg C
Test Performed
Method
Results
------------ Analyzed
Lab Loc Date
--------
Time Qualifier
Total Organic Carbon
5310C
<1.0 mg1L
R 8/16111
10:43
No. Sample ID
003 MONITORING WELL #11
Date Sampled
8/9/2011
Time Sampled Matrix
9:30 GW
Sample Type
Grab
Condition
4 +/- 2 deg C
- - - - --- Analyzed
--------
Test Performed
Method
Results Lab Loc Date
Time Qualifier
Total Organic Carbon
5310C
2.35 mg/L R 8116/11
10:43
No. Sample ID
Date Sampled
Time Sampled Matrix Sample Type
Condition
004 MONITORING WELL #12
8/9/2011
9:45 GW Grab
4 +1- 2 deg C
- - - - --- Analyzed --------
Test Performed Method Results Lab Loc Date Time Qualifier
Total Organic Carbon 5310C 3.19 mg/L R 8116111 10:43
No. Sample ID Date Sampled Time Sampled Matrix Sample Type Condition
nns MONITORING WFI 1 #13 819/9011 10.00 rW Grab 4 +l- 2 deg C
- - - --- Analyzed --------
Test Performed Method Results Lab Loc Date Time Qualifier
Total Organic Carbon 5310C 3.08 mg1L R 8116/11 10:43

0
0
Telephone: [phone]
Fax: [phone]
iIG`'TEST
6701 Conference Drive
Raleigh, NC 27607
Telephone: [phone]
Fax: [phone]
Laboratory Report
Page 2 of 2
NC/WW Cert. #: 067
NC/DW Cert. #: 37731
Work Order #: 1108-00759
No. Sample ID Date Sampled Time Sampled Matrix Sample Type Condition
006 MONITORING WELL #14 8/9/2011 10:15 GW Grab 4 +/- 2 deg C
Test Performed
Method
- - --- Analyzed
Results Lab Loc Date
--------
Time Qualifier
Total Organic Carbon
5310C
4.24 mg/L R 8/16/11
10:43
No. Sample ID
Date Sampled
Time Sampled Matrix Sample Type
Condition
007 MONITORING WELL #15
8/9/2011
10:30 GW Grab
4 +/- 2 deg C
- - - --- Analyzed --- ----
Test Performed Method Results Lab Loc Date Time Qualifier
Total Organic Carbon 5310C 3.52 mg/L R 8116/11 10:43
Reviewed by:
r
for Tritest, Inc.

e+���eoa®atttP�i
RESEARCH ArNAlyTICAI ,,,`�`G��'
z. UbORAT®RiES INC.
rNC
Analytical/Process Consultations •
Water Tech Labs. Inc. Date Sample Collected 08/09/11
P.O. Box 1056 Date Sample Received 08/12/11
Granite Falls, NC 28630 Date Sample Analyzed 08/12/11
Attn: Joe Gragg Date of Report 08/26/11
Analyses Performed by SK -JC
Lab Sample Number
---------------------
710003
Parameter Storet # Results
Sulfate (00945) <10.0 mg/l
Arsenic,Tot (01002) <0.005 mg/1
Barium,Tot (01007) 0.107 mg/l
Cadmium,Tot (01027) <0.001 mg/1
Chromium, Tot (01034) <0.005 mg/1
Calcium,Tot (00916) 25.4 mg/l
Lead,Tot (01051) 0.029 mg/1
Magnesium, Tot (00927) 13.7 mg/l
Manganese,Tot (01055) 0.832 mg/l
Nickel,Tot (01067) 0.009 mg/l
Selenium,Tot (01147) <0.005 mg/1
Sodium,Tot (00929) 10.6 mg,/l
Clients Sample Source Coats American MW2
Number
Time Collected (Hrs) 0900
P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone]
www.randalabs.com

®'t�mesa'�e�etee
aw RESEARCh 6&ANA1YTiCA[..eG`�F`.....�,rr�.
I-AbORATO&S, INC. cc
NC #34 z -
Analytical/Process Consultations s
CTO
!PIE0 AN�4�
Water Tech Labs. Inc. Date Sample Collected 08/09/11
P.O. Box 1056 Date Sample Received 08/12/11
Granite Falls, NC 28630 Date Sample Analyzed 08/12/11
Attn: Joe Gragg Date of Report 08/26/11
Analyses Performed by SK -JC
Lab Sample Number
--------------------
710004
Parameter Storet # Results
Sulfate (00945) 32.6 mg/l
Arsenic,Tot (01002) <0.005 mg/1
Barium,Tot (01007) 0.026 mg/l
Cadmium,Tot (01027) <0.001 mg/1
Chromium,Tot (01034) <0.005 mg/1-
Calcium,Tot (00916) <0.500 mg/1
Lead,Tot (01051) <0.005 mg/l
Magnesium,Tot (00927) <0.500 mg/1
Manganese,Tot (01055) <0.005 mg/1
Nickel,Tot (01067) <0.005 mg/1
Sel.enium,Tot (01147) <0.005 mg/l
Sodium,Tot (00929) 43.6 mg/1
Clients Sample Source
Number
Time Collected (Hrs)
Coats American MW10
0915
P.O. Box 473 • 106 Short Street ^ Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone]
www.randalabs.com-

,�+s0e m, uo�awi
F RESEARCH LANA1YTiCA1 .�``c,� trT���♦
LAb®RA►TORIES INC.0.
NC #34 Zs '
Analytical/Process Consultations
Water Tech Labs. Inc. Date Sample Collected 08/09/11
P.O. Box 1056 Date Sample Received 08/12/11
Granite Falls, NC 28630 Date Sample Analyzed 08/12/11
Attn: Joe Gragg Date of Report 08/26/11
Analyses Performed by
Lab Sample Number
-----------------
710005
Parameter Storet # Results
Sulfate (00945) 128 mg/1
Arsenic,Tot (01002)
Barium,Tot (01007)
Cadmium,Tot
(01027)
=T Chromium, Tot
(01034)
Calcium,Tot
(00916)
Lead,Tot
(01051)
Magnesium,Tot
(00927)
Manganese,Tot (01055)
Nickel,To.t (01067)
Selenium; Tot (011.47)
Sodium,Tot (00929)
<0.005 mg/1
0.107 mg/l
<0.001 mg/l
<0.005 mg/l
• 25.3 mg/l
Number
Time Collected (Hrs) 0930
<0.005 mg/l
8.82 mg/l
0.639 mg/1
<0.005 mg/1
<0.005 mg/l
69.1 mg/l
0
P.O. Box 473 • 1.06 Short Street • Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone] .
www.randalabs.com

RESEARCh & ANA1YTiCA1 �e�G�............
cly
Atyp����i�
LAbORATOMESO INC. = C'2
-fie •— o:CA
NO
Analytical/Process Consultations
+, i� rFD AJANo-`�
Water Tech Labs. Inc. Date Sample Collected 08/09/11
P.O. Box 1056 Date Sample Received 08/12/11
Granite Falls, NC 28630 Date Sample Analyzed 08/12/11
Attn: Joe Gragg Date of Report 08/26/11
Analyses Performed by SK -JC
Lab Sample Number
--------------------
71000G
Parameter Storet # Results
Sulfate (00945) 11.1 mg/1
Arsenic,Tot (01002) <0.005 mg/1
Barium,Tot (01007) 0.120 mg/1
Cadmium,Tot (01027) <0.001 mg/l
Chromium,Tot (01034) <0:0'05`,mg/1
Calcium,'Tot (00916) 50.8 mg/l ,
Lead,Tot (01051) <0.005 mg/1
-Magnesium,Tot (00927) 10.3 mg/1
Manganese,Tot (01055) 2.43 mg/l
Nickel,Tot (01067) 0.010 mg/1
Selenium,Tot (01147) <0.005 mg/1
Sodium,Tot (00929) 184 mg/1
--------------------
Clients Sample Source Coats American MW12
NUMber
Time Collected (Hrs) 0945
P.D. Box 473 • 106 Short Street , Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone]
www.rand.alabs.com

' �e44�asaeaUaP�i
RESEARCh ANA[yTiCA UbORATORiES, INC.
NC
�'`bc��' •• �T��,°`a
JY �a � • O M
Analytical/Process Consultations e
V
Water Tech Labs. Inc. Date Sample Collected 08/09/11
P.O. Box 1056 Date Sample Received 08/12/11
Granite Falls, NC 28630 Date Sample Analyzed 08/12/11
Attn: Joe Gragg Date of Report 08/26/11
Analyses Performed by SK -JC
Lab Sample Number
--------------------
710007
Parameter Storet # Results
Sulfate (00945) <10.0 mg/1
Arsenic,Tot (01002) <0.005 mg/1
Barium,Tot (01007) 0.073 mg/l
Cadmium,Tot (01027) <0.001 mg/1
Chromium,Tot (01034) <0.005 mg/l
•
Calcium,Tot (00916) 23.9 mg/1
Lead,Tot (01051) <0.005 mg/l
Magnesium,Tot (00927) 16.2 mg/1
Manganese,Tot (01055•) 0.757 mg/l
Nickel,Tot (01067) <0.005 mg/1
Selenium,Tot .(01147) <0.005 mg/1
Sodium,Tot (00929) 105 mg/1
Clients Sample Source
u e
Time Collected (Hrs)
--------------------
Coats American MW13
1000
P.O. Box 473 • 106 Short Street . Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone]
www.randalabs.com

RESEARCh 8L ANA1YTiCA[
I-AbORATORVS, INC.
Analytical/Process Consultations
.sv1111811"4
Ojai
co
®✓� �{�y4 .U) rys
r i 4
���',9;o PEED ANP`, •`9
Water Tech Labs. Inc.
Date Sample Collected
08/09/11
P.O. Box 1056,
Date Sample Received
08/12/11
Granite Falls,
NC 28630
Date Sample Analyzed
08/12/11
Attn: Joe Gragg
Date of Report
08/26/11
Analyses Performed by
SK -JC
Lab Sample Number
--------------------
710008
Parameter
Storet #
Results
Sulfate
(00'945)
<10.0 mg/1
Arsenic,Tot
(01002)
<0.005 mg/l
Barium,Tot
(01007)
0.122 mg/l
Cadmium,Tot
(01027)
<0.001 mg/l
Chromium,Tot
(01034)
<0.005 — /1 -_-'
Calcium,Tot
(00916)
74.2 mg/1
Lead,Tot
(01051)
<0.005 mg/l
Magnesium,Tot
(00927)
41.5 mg/l
Manganese,Tot
(01055)
1.05 mg/l
Nickel,Tot
(01067)
<0.005 mg/l
Selenium,Tot
(0.1147)
<0.005 mg/l
Sodium,Tot
(00929)
57.7 mg/1'
Clients Sample Source
Nuffiber
Time Collected (Hrs)
--------------------
Coats American MW14
1015
P.O. Box 473 ® 106 Short Street . Kernersville, North Carolina 27284 • 336-996-2841 • Fax [phone]
www.randalabs.com

6
RESEARC & ANAlyTICAI
LkORATWEs, INC.
Analytical/Process Consultations
;%`rv431112,f14,
♦�,,�6 . �.chlto
sue._ :cam.
NC
Qooi
Water Tech Labs. Inc. Date Sample Collected 08/09/11
P.O. Box 1056 Date Sample Received 08/12/11
Granite Falls, NC 28630 Date Sample Analyzed 08/12/11
Attn: Joe Gragg Date of Report 08/26./11
Analyses Performed by SK -JC
Lab Sample Number
-----------------
710009
Parameter
Storet #
Results
Sulfate
(00945)
156 mg/l
Arsenic,Tot
(01002)
<0.005 mg/l
Barium,Tot
(01007)
0.140 mg/l
Cadmium,Tot
(01027)
<0.001 mg/l
�CYiromium,�Tot
(01034)
<0.005 mg/1
Calcium,Tot
(00916)
73.4 mg/l
Lead,Tot
(01051)
<0.005 mg/1
Magnesium,Tot
(00927)
31.2 mg/l
Manganese,Tot
(01055)
1.49 mg/l.
Nickel,Tot
(01067)
<0.005 mg/l
ScicniUM, Tot
(011=7i
<0.00S mg/1
Sodium,Tot
(00929)
61.7 mg/1
--------------------
ien s Sample Source
Number
Time Collected (Hrs) 1030
P.O. Box 473 • 106 Short Street • Kernersville, North Carolina 27284 • 336-996-2841• Fax [phone]
www.rsndalabs.com

G
CLIENT
rr
a
5 Pinewood Plaza Drive • P.O. Ix 1056
Granite Falls, NC 28630
Phone [phone] • Fax [phone]
PHONE:
A� o,6 tj C IS7S 2 TYPE SAMPLE:
No. LOCATIONS:
$2S'766-V/)1 6 X 3 3 f g SAMPLER NAME:
OtA PLE LOCATION
FACILITY NAME
SAMPLE
COLLECTION
SAMPLE TYPE
CONTAINERS
ANALYSIS REQUIRED
DATE
TIME
TEMP °C
GRAB /
COMPOSITE
NO.
PLASTIC I
GLASS
G
7
• -,PG-
I%
Zd ► �(
�"1 �f
/�3a
G-
L
P4' V _
e/
G-
7
P4- G.
AA) , 13
16;oD
C%-
7
P-4
RELINQUISHED BY:
DATE:
TIME:
RECEIVED BY:
u �� �a �rv��i`l
DATE:
� i l
TIME:
2 00
RELINQUISHED BMY:
DATE:
TIME:
REC ED BY:
.o,�-��
DATE:
TIME:
PRESERVATION:
[ ] Cool 4°C - BOD, TSS
[ ] Cool 40C - pH<2 w/ H2SO4- NH3
1 2
[ ] Cool 40C - Na2S203 - Coliform Bacteria, NH3
Sample Temperature at Lab (°C)
1 - Chlorine Residual mg/I
2 - Chlorine Residual mg/I
NC CERTIFIED LAB # 50

GROUNDWATER QUALITY MONI
COMPLIANCE REPORT FORM
Facility Name: k
�s fH>�E
r?'SEU JFgOlfR °
SUBM T FOFTM �ON YELL W PAPER ONLY
RING: 2,L Q 5 21
Well Identification Number (from Permit): M 60" z- For Groundwater Treatment Systems
Well -Depth: "l�7 it. Well Diameter-: in. Check One: ❑ Influent (+a8)
Screened Interval: �/ft it. to //n' l�3 it. ❑ Effluent {J9)
Depth to Water Level: 2 fr % ft. below measuring point.
Measuring Point (M.P.) It. above land surface.
� Relative M.P. Elevation in fit.:
('
Gallons of water pumped/bailed before sampling: Date sample collected:
Field analysis: pH— _ , Specific Conductance- ' umhos
. Temp. C, Odor Appearance
DEPARTMENT OF ENVIRONMENT $ NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC27699-1636 Phone: [phone]:
PERMIT#: W 060©-S(-O' EXPIRATION )ATE: J_-2 61/
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
< Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:'
NOTE: Values should reflect dissolved and .
colloidal concentrations.
-// Dale sample analyzed: . 5C A= 13 ct n t j
Laboratory Name:—Zd,4+e,- —T c A
Certification No. 1; "d
PARAMETERS (Samples for metals were collected unfiltered _X_YES ta0 and field acidified
COD mg/I Nitrite (NOZ) as N m /I
Coliform: MF Fecal g
/100m1 Nitrate (NO3) as N _mg/I
Coliform: MF Total /100ml Phnsnhnri,s• Tntal ac / 7/ . _/l
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total q-2o- /1 hb
mg/I
pH (when analyzed)
units
TOC y-25-- /1 1-6
mg/1
Chloride L4-2o-11 S-, ce?
mg/I
Arsenic •1•-Ig•- I-J 0.©/
mg/I
a Grease nd Oils
mg/l
Phenol
mg/I
Sulfate
mg/I
C�/-L2-/1 ,L3c/
Specific onductance uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Orthophosphate
mg/I
Al - Aluminum
— mg/I
Ba - Barium y-19
0.397 mg/I
Ca - Calcium -1 •-f /
mg/I
Cd - Cadmium'_-( `1={I
4 6.662- mg/I
Chromium: Total-T.-
0.012- mg/I
Cu - Copper
m9 /I
Fe - Iron ,� _•__
.1:.:W. mg/I
Hg - Mercury
?U1f mg/I
K - Potassium!F->,,-.--
-
mg/I
Mg -Magnesium �� _�/:.�. ;,F. {lrCj, / mg/I
Mn - Manganese -1/ 11, 35' ma/I
X YES NO)
Ni - Nickel /9 -T/ 0.0 / mg/I
Pb - Lead-z!-/9J/ a i5+% mg/I
Zn - Zinc mg/1
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
T F"v, uon �/_1 G-// G U, Od ` !h5/Z
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
method # =
method # =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
r—iA% r j j , nir r,mA i t�ry n s Please. Print Clearly or Type
Facility Name o >=6&)
Permit Name (if differ t):
Facility Address: 1O & 3
fi7 City)
(Street) 2 Y �SZ (t r � ,v Count fYi
1 ! l 1 , _((State) tZip) y
Contact Person: ' \ �! w' `' Telephone #: 2 S6 ­ 9 /i I _
Well Location/ Site Name: 5 +� 64 _,,, No. of Wells to be Sampled;__. _
Well Identification Number (from Permit): For Groundwater Treatment Systems
to
Well Depth: / II. Wel�Diameter•: 2 in. Check One: ❑ Influent- (013)
Screened Interval: ' / ft. U�f} it. I] Effluent (g9)
Depth to Water Level: L% ft. below measuring point.
Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: S Date sample collected:
Field analysis: pH ?, 2- Specific Conductance uMhos
Temp. °C, Odor Appearance
DEPARTMENT of ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: WC9CsQCS�y �,0 EXPIRATION DATE: 15
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
_ Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: + (= 6 to
Laboratory Name: 4 E r^ Tee h
Certification No.
PARAMETERS (Samples for metals were collected unfiltered_ A YES _f <O
and field acidified
COD
Coliform: MF Fecal
mg/I
/100ml
Nitrite (NO2) as N.
Nitrate (NO3) as N �
mg%I
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P.1-5 l 1 r 0, lf` mg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate _
m /I
9
Dissolved Solids: Total
4l 20 // I(�S mg/I
Al -Alum
Aluminum �
mg/C
pH (when analyzed)
TOC �j-2S-ll
units
Z- to 0
Ba - Barium q::-L 'I - f i
`- ct-il
LD-e2(3mg/I
Chloride L1-26-11
mg/I
I 53 mg
Ca - Calcitam' _
Cd - Cadmium.'-►9-(_.L_,
0,500 m /I
40,002mg/I
g
Arsenic q-1 •- f 1
,—�',
<10, aos mg/l
Ll
Chromium: Tota11�_i 1_'
L�, 00,E mg/1
Grease and Oils
mg/I
Cu.- Copper___
mg/I
Phenol
Sulfate 22-1l
�`
mg/I
% 3,(� mg/I
Fe - Iron __.
Hg -Mercury
m /I
g
m /I
Specific Conductance
uMhos
K - Potassium----mg/I
Total Ammonia
mg/I
Mg - Magnesium �._1`j._Il
0,221 mg/I
TKN as N
mg/I
Mn - Manganese --- I```f'l
�<0'005' mg/1
A YES NO)
Ni - Nickel!cJ-1/ 4.6,66 mg/I
Pb - Lead_y'1mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units
,jLc E'I7ii 'I9? �/-1��// L C?
�r� iv,y� ��-r-i9•-r� �2, y
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
method # =
method#
certifv that. t0 the hest of MW knnwlarfna and hatiof it,o :nf,..... ,►a.,....,,�. «:.a .� :_ .�:_ __
p ►" C
rermittee (or Authorized Ag t) N me and Title - Please print ar
Rev. 0312000
Signature of Peutriiles (o ulhorized Agen (Date)

0
GROUNDWATER
COMPLIANCE RI
Facility Name: t 0
Permit Name (if diff _ ent):
Facility_Adoress:�
Contact Person: 114
Well Location/ Site Name: -
�jh.e N
JO,
"SUBMIT FORM ON YELLOW PAPER ONLY -
Print Clearly or Type
r. Telephone #: IE2 W-- `7,, `'b :l i j J
=A No. of Wells to be Sampled: ,—_'Z:,
Well Identification Number (from_ Permit): -/ For Groundwater Treatment Systems
Well Depth: ft. Well Diameter: 2 in. ,t
r, Check One: ❑ Influel (98)
Screened Interval: / ft. to _ ft. ❑ Effluent i99)
Depth to Water Level: __L5-6 ft. below measuring point. _
Measuring Point (M.P_) is: 3y1_ ft. above land surface. Relative M.P. Elevation in ft.:'y
Gallons of water pumped/bailed before sampling: �_ Date sample collected:
Field analysis: pH --�<`7—, Specific Conductance uMhas
,[�
Temp. °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATERSECTION
1636 MAIL SERVICE CENTER
PERMIT #: 0 0660S 6
Non -Discharge
NPDES
EXPIRATION DATE: --,5
La
TYPE OF PERMITTED OPERATION BEING MONITORED
— Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: 1 p iLJ
Laboratory Name: GJ r T-c h
_ Certification No. S 6
PARAMETERS (Samples for metals were collected unfiltered--X_YE5 __._8t0' and field acidified
COD mg/I Nitrite (NO2) as N m /I
Coliform: MF Fecal g
/100m1 Nitrate (NO3) as N m /I
Coliform: MF Total _ /100m1 Phnsnhnnrc• TnfnI /' ,76--/l
(Note: Use MPH method for highly turbid samples)
Dissolved Solids:
Total 1-715`//
mg/I
pH (when analyzed)
units
TOC I-f ` 2.5-11
'm 9 /I
Chloride �,1` 2 0 -1 f
�J. 3 mg/I
Arsenic ��-19- 11
. mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate !1-22-- I I
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Orthophosphate _
mg/I
Al -Aluminum
mg/I
Ba - Barium ` ` 1 /
Ca - Calcium )9'-%/ /1, Z
mg/I
_
Cd - Cadmium_ CD •OOZ
mg/I
Chromium: Total `-I�%_:_'.! ��:oos
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium-­mg/I
Mg - Magnesiumf•�
mg/I
Mn - Manganese J_/ - 6,05t/ _
ma/I
Signalure of Pem-Iitiee
,A —YES NO)
Ni - Nickel' -/9`1/
c .moo mg/I
Pb - Lead 19 2'-//
mg/I
Zn - Zinc
mg/l
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
l iviy,7 c. /)
-9e)
,Sep r .`[� v✓L
% � � Z.
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC method # =
method # =
method # =

GROUNDWj
< j I Fa-,4<. 15
COMPLIANT
FACILITY INFORf�
Facility Name:
Permit Name.(if difl
Facility Address:
'
ConIcnr)tact Person:
Well Location/ Site Name: S -4'v 1,61 r FF l ,1,ol�,
SUBMIT FORM ON YELLOW PAPER ONLY
)RING:
Please Print CIE
C I%.- ry
pZ County ?
Telephone #:
No. of Wells to be
A)
Co�t`✓t,t�w-
Well Identification Number (from Permit): a 40 - / 2-
_
Well Depth: {=.2 ft. Well Diameter: '� in. For Ground,_ Check One: ❑ IntlUetzt_�
Screened Interval: "'f4- It.
to---=-fL—fL [] Effluent (39)
`
Depth to Water Level: 1., ft. below measuring point.
Measuring Point (M.P.) is: 2- Cw It. above land surface. Relative M.P. Elevation in fit.:
Gallons of water pumped/bailed before sampling: l n1 Date sample collected:
Field analysis: pH 6 '69 , Specific Conductance ' uMhos
. Temp. >'7 °C, Odor Appearance
'Vf Cb. 4
1eaa
rge
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
EXPIRATION DATE: +ZO
UIC
OPERATION BEING MONITORED
n Remedialion: Infiltration Gallery
Field Remedialion:
Distributor Land Application of Sludge
NOTE: Values should reflect dissolved and
colloidal concentrations.
y 1 Date sample analyzed:
Laboratory Name: LJ' 4+c'r 7F,
Certification No.
PARAMETERS (Samples for metals were collected Unfiltered YES.
: fC) and field acidified
COD
mg/I
Nitrite (NO2) as N _.
_._ mg/I
Coliform: MF Fecal
/100ml
Nitrate N as N _.
mg/I
Coliform: MF Total
/100m1
(01 Total as i
5-.h'lI f}��fmg/I
(Note: Use MPN method for highly turbid samples)
Orthophosphate _-_
_ mg/I
Dissolved Solids: Total
yt-2bfil LO mg/I
Al - Aluminum
m /I
pH (when analyzed)
`t �-2-S-
units
Ba - Barium 4 -/9--1
O, r�i mg/I
TO t I
2 4E) mg/I
Ca - Calcidm 19-•1 J
_ S3 mg/I
Chloride
mg/I
Cd - rtltri �,/- I�-! �-
_ �a "e2-mg/I
Arsenic y-J�r -I !
.� -Oc mg/I
�C far,r ifa ,: Total 9
: L en, ob6- mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Ph
_.-
-_.
—YES. NO)
Ni - t t?a'''l`) li d►,��, tv mg/I
Pb
Zn - ZIn mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
��� iy:yi �/ •19 J/ / 7 �
eno
Sulfate 'L1�"22: ►i
%"- mg/I
Fe - Iron --
m9/I
ORGANICS: (GC,GC/MS,HPLC)
Specific Conductance
g/I
uMhos
Hg - Mercury
K - Potassium
mg/I
mg/I
(Specify test and method #. Attach lab report.)
Report
Total Ammonia
mg/I
Mg- Magnesium r{�t` �i
l%-T mg/I
Attached? Yes1 No (0)
VOC
TKN as N
mg/I
Mn -
mg/I
:method #)_
method # =
method # =
r ► . _ .
... -.._ _.. ..21-

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
rsAi,lu r T rrvr r+mfa i iUry Please Print Clearly or Type
Facility Name: l• �s Z mIrr/tC4
Permit Name (if different
Facility Address: 6 BOX 34 Se 4/, iO-L (Street) � ---
(City) ai) ZL Z--Rip) County 9 )
Contact Person: ` - _ 1''L • Telephone #:' Z%'
Well Location/ Site Name: 2.A—P161 No. of Wells to be Sampled: —
Well Identification Number (from Permit): filzc) / For Groundwater Treatment ::yslems
Well Depth: 1 ft. Well Diameter 2 in. Check One: E] lnfluen; (98)
Screened Intel: ft. to ft. E] Effluent 99
Depth rva
th to Water Level: `�' �/ ff. below measuring point.
Measuring Point (M.P.) is: 4J_4 it. above land surface. Relative M.P. Elevation in ft.:'_
Gallons of water pumped/bailed before sampling: 2. r7, Date sample collected:
Field analysis: pH A y Specific Conductance uMhos
Temp. °C, Odor Appearance
DEPARTMENT OF ENVIRONMENT $ NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC 27699-1636 Phone: [phone]:
PERMIT #: j��EXPIRATION DATE: Jam` L'6 i
Non -Discharge UJC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
V Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: - -5A
Laboratory Name: WA 01,
Certification No. -
PARAMETERS (Samples for metals were collected unfiltered_A YES
?•f0 and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as i,_
mg/I
(Note: Use MPH method for highly turbid samples)
Orthophosphate
mg/I
Dissolved Solids: Total L/­?&-J1
D1 mg/I
Al - Aluminum -
mg/I
pH (when analyzed)
TOC y' 1 /
units
Z.3C► mg/I
Ba - Barium 4/ -1 -1 %
Ca - Calcium ` `/ ` i/_...__
c�•a'3 smg/I
/�L
Chloride
it mg/I
Cd - Cadmium -1/ ._._.:
mg/I
&,a2-mg/I
Arsenic _ V -19 -1 1
-e66- C6 r I
Chromium: Total �I -/`i_
!_ t6,c}�"mg/l
Grease and Oils
mg/I
Cu - Copper __
_ • mg/I
Phenol
Sulfate '�j.• 2 2-
g
- Z-mg/I
__..__
Hg = (Mercury
mg/I
mg/I
Specific Conductance
uMhos
K - Potassium--,mg/I
Total Ammonia
mg/I
Mg - Magnesium [ j :_. 1 _ /b, Jr mg/I
TKN as N
mg/I
Mn - Manganese LT;-_.
0 �. oz>f� mg/I
GW-59
Rev. 03/2000
Signature of
r Authsrize
1K YES NO)
Ni -Nickel. mg/I
Pb - Lead �1-19-1-/ �L r�cS mg/I
Zn -Zinc • mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration �Units)
far
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
or
C
method # =
method # _

'SUBMIT FORM ON YELLOW PAPER ONLY -
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION j Please Print Clearly or Type
Facility Name: C (1 K _
Permit Name (if differe
Facility Address:
(Street) —�--
9 County
(city) r /. ` i 7 to e) aim (Zip)
Contact Person: Telephone #: P2V' f
Well Location/ Site Name: S�µt'rl+�t�rd /t+ No. of Wells to be Sampled:,.✓�
({ruin Pump)__
Well Identification Number (from Permit): Mk)-) i For Groundwater Treatment Systems
Well Depth: it. Well Diameter: in. Check One: ❑ lnfluetat (98)
Screened Interval: y'��f ft. Co 'rfr9- ft. ❑ Effluent (09)
Depth to Water Level: `��� ft. below measuring point.
Measuring Point (M.P.) is: ?4 ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling:_ Date sample collected:.l'
Field analysis: pH— , Specific Conductance umhos
Temp. -°C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER OUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT#: &)600EXPIRATION DATE: S- :E)ll
Non -Discharge U IC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
— Lagoon Remedialfon: Infiltration Gallery
Spray Field Remediation:
Rolary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: - LSC,r Air/ 4 uJ
Laboratory Name: 011 e `TEc
Certification No. .Sr
PARAMETERS (Samples for metals were collected unfiltered_OYES -._?':O
and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N _
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as i'_ =S`/' 0.2mg/I
(Note: Use MPN method for highly turbid
samples)
Orthophosphate
mg/I
Dissolved Solids: Total y-25-tI 33 2 mg/I
Al - Aluminum __
mg/I
pH (when analyzed)
units
Ba - Barium -1 -1 /
mg/I
TOC `�`2;5=//
Z.r'12- mg/I
Ca - Calcium �r­ /y-ll
mg/I
Chloride q-2D--11
mg/I
Cd - Cadmium �_1 6 `!�
�r°�� mg/I
Arsenic -1!3 -1%
mg/I
Chromium: Total `_�=__
�•�o mg/1
Grease and Oils
mg/I
Cu - Copper ____.
mg/I
Phenol
Sulfate tf '- �2� 1
mg/I
-K16 mg/I
Fe - Iron
Hg - Mercury
rhg/I
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
m h
9
M Magnesium ;�ti
9 - 9
Y3r 2 mg/I
TKN as N
mg/I
Mn - Manganese -,Uf-rr'
Ga% 63 mg/I
GW-59
Rev. 0312000
Permittee (or t
Signature of Peuailic;e
lie -
—YES NO)
Ni- Nickel V -1
mg/I
Pb-Lead
mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
S'(-' ,"Vff7 Iv i
460&-1f'%jL
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC : 'method # =
*/(-- U t"
method # _
method # _
~9f/

n
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:
Permit Name (if diff
Facility Address:-
01;4rt6A,
Contact Person: Yh, I
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY -
Please Print Clearly or Type
r iCt+
%Sz County -
(zip)
Telephone #:
No. of Wells to be Sampled:�;�
Well Identification Number (from Permit): /ram/rl `/r7 For Groundwater Treatment Syslems
Well Depth: l it. Well Diameter. '2- in. Check One: ❑ Influen'i (98)
Screened Interval. ✓`bf- it. to ✓"0 it. p Effluent (99)
Depth to Water Level: 3 fi. below measuring point.
Measuring Point (M.P.) is: A✓6'^ft. above land surface. Relative M.P. Elevation in ft.: _
Gallons of water pumped/bailed before sampling: d7iDate sample collected:
Field analysis: pH , Specific Conductance ' uMhos
. Temp. __1__1C, Odor Appearance
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH, NC 27699-1636 Phnna• 14101 719_'lo-
PERMIT#:Gc��OO�rS/r'� EXPIRATION DATE:
Non -Discharge UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
X_ Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
J Date sample analyzed: 5 Ak s- 6 -/ 0
Laboratory Name: - Ll rw,F1 v TecA
Certification No. !i
PARAMETERS (Samples for metals were collected unfiltered_X YES ;:() and field acidified
COD mg/I Nitrite (NO2) as N mg/I
Coliform: MF Fecal /100ml Nitrate (NO3) as N mg/1
Coliform: MF Total /100ml Phosphorus: Total as r. ->-SIl L6,11, mnn
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total �1-26=11 36b
mg/I
pH (when analyzed)
units
TOC _4` 2,5 -1 i /• 83
mg/I
Chloride it`20-)l /,<-,6
mg/I
Arsenic -f5"`II Ze.156s,
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific onductance LiMhos
Total Ammonia
mg/I
TKN as N
mg/I
Orthophosphate
_ mg/I
Al - Aluminum
mg/I
Ba - Barium L? �5�-I•/
6.123 mg/I
Ca - Calcium "� /✓ __.•_
_ gY, i mg/1
Cd - Cadmium t ` 9-Il____
_ �6•�o a mg/I
Chromium: Total_t;
�d•oa5 mg/1
Cu - Copper _.__
: mg/I
Fe - Iron
- mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium Ir
_ 444C4s mg1l
_
Mn - Manganese�.
_. .:7S -'1 ma/I
Signature of PeIiisiltee
YES NO)
Ni - Nickel_ `l �� ✓/
�- ycf� mg/I
Pb -Lead
ze.,-e — mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and
Concentration Units)
- �zry ►rr -� - /�
�d1 ��� of>: L
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.)
Report Attached? Yes (1) No (0)
VOC method # =
method # =
method # =

Li W-:t0A [ O MPLL&NCE REPORT FORM
Permit # W& OL051
(Submit one each monitoring period with GW-59 forms)
1
Enter date monitoring results were due. Will this monitoring report (GW-59 and GW-59A)
YES
NO
be. submitted after the established due date?
2
Was any required information missing on the GW-59 report forms?
YES
NO
IF the answer to question 9 or 2 is "YES", list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the required information.
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
YES
NO
identification plate, area overgrown, etc.)? Ifthe answer is -Yes'; contact the Regional Ofce forguidance.
/
4
Are any monitored constituents equal to or above the established standards?
YE>
NO
If the answer to question 4 is NO; skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituents) and concentrations)
exceeding standards in the space provided below:
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
YES
NO
same constituent(s) in the same well(s) in the last two years?
If the answer to question 5 is "NO" skip to section B.
If the answer to question 5 is "YES", list in the space provided below, each well with constituent(s) exceeding
j
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
If the answer is "YES". a groundwater quality problem may be occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE If the answer is "NO", monitoring wells may be improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
YES
NO
groundwater quality problem?
If the answer to question 7 is 'YES", describe those actions in the space provided below.
If the answer to question 7 is "NO", contact the Regional Office within 90 days; an evaluation may be
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surrounding this facility- Failure to do -so may subject the pennittee to a Notice of Violation
fines, and/or penalties.
g
The person completing this portion (GW-59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
i hereby acknowledge that a above irifoFrr�iatlon yvas,evalWAR- Ind nfo—dWon-5ubmitted
.the.
report (Gompi , Report GUY 59A,,,�f-' '. s and.:.complete�o�Fie�est of my kriowlec}ge ;�. .�
Signat of Permittee r AutHorrized Agent) Date
G«'-59A 12/8/2003