WQ0035049_Monitoring - 04-2024_20240524

Monitoring Report Submittal
..................................................
Permit Number#* WQ0035049
Name of Facility:* Maple Hill WWTF-Wastewater Irrigation System
Month: * April Year: * 2024
Report Information
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address: *
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Upload Document*
Maple Hill April 2024 NDMR, NDAR reports.pdf 1.22MB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Anthony Colon
6VWI M 44'f 6011W
Reviewer: Wanda.Gerald
5/24/2024
This will be filled in automatically

Is the project number correct?* WQ0035049
Is the monitoring report accepted?* Yes No
Regional Office* Wilmington
Reviewer: _anonymous
Review Date: 6/6/2024

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _1_of-4_
Permit No.: WQ0035049
Facility Name: Maple Hill WWTF
County: Pender
Month: April
Year: 2024
Field NaM01
1
Field Name:
2
Field Name:
3
Field Name:
4
Did irrigation occur
Area (acres).
1,72
Area (acres):
1.72
Area (acres):
1.72
Area (acres):
1.72
at this facility?
Cover Crop;
B6rmoda
Cover Crop:
Bermuda
Cover Crop:
Bermuda
Cover Crop:
Bermuda
e YES ❑ NO
Hourly, late (iny
0.41
Hourly Rate (in):
0.41
Hourly Rate (iny:
0.41
Hourly Rate (in):
0.41
58
Annual Rate (in):
29.71
Annual Rate (in):
29.71
Annual Rate (in);
29.71
Annual Rate (in):
29.71
Weather
Freeboard
Field Irrigated?
I] YES ❑ NO
Field Irrigated?
❑ YES ❑ NO
Field Irrigated?
❑ YES Cl NO
Field Irrigated?
O YES F No
a
M
O
a�i
:3°
p
0
CL
a
5)
d °'
0 75
0
jt
❑ R
LO
7Q
Da
I
E
(�y33fY
co
A
❑
m-0
U
E
CD
J
r7
O
C
E 7 a
o R
2L
C
E
J
A
❑
E
o
v a
co
mL
aUJ £R =' n
xo 0U
❑
(D
°F
in
ft
ft
gal
min
in,
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
C
72
0
3.2
2
PC
64
0
3.2
3
R
68
0.2
3.2
4
C
48
0.4
3.2
10,650
0
0.23
0.23
10,590
30
0.23
0.23
9,930
30
0.21
0.21
10,590
30
023
023
5
CL
44
0
3.2
6
7
8
C
42
C
3.2
7,120
210
0.15
0.15
7,300
20
0.16
0.16
6.660
20
0.14
0.14
10,740
20
0.23
0.23
9
CL
65
0
3.2
10
CL
61
0
3.2
11
R
68
0
3.2
12
C
63
0.4
3.2
13
14
15
C
60
0
3.2
13.400
40
0.29
029
14,040
40
0.30
0.30
12,800
40
0.27
0.27
13,480
40
0-29
0.29
16
C
62
0
3.2
17
PC
57
0
3.2
18
C
68
0
3.2
10,800
30
023
0.23
10,920
30
0.23
0.23
10,!050
30
0.22
0.22
10,710
30
0.23
0.23
19
CL
63
0
3.2
20
--
21
22
CL
48
1.5
3.2
23
C
36
0
3.2
24
C
51
0
3.2
10,320
30
0.22
0.22
10,260
30
0,22
0.22
9,510.
3D
0.20
0.20
10,140
30
0.22
0.22
25
C
66
0
3.2
26
CL
53
0
3.2
27
28
29
C
58
0
32
10,860
30
0.23
0.23
10.950
30
0,23
0.23
10.080
30
0.22
0.22
10,830
30
0,23
0.23
30
C
65
0
3.2
31
Monthly Loading:
63,150
1.35
64.060
1.37
59,030
1.26
_ .�,=
66,490
1.42
12 Month Floating Total (in):
9.98
_
9,74
-

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _2_ ot_4_
Permit No.: W00035049
Facility Name: Maple Hill WWTF
County: Pender
Month: April
Year: 2024
Field Name:
5
Field Name:
6
Field Name,
7
Field Name:
8
Did irrigation occur
Area (acres);
1,72
Area (acres):
1.72
Area (acres):
1.74
Area (acres):
1.71
at this facility?
Cover Crop:
Bermuda
Cover Crop:
Bermuda
Cover Crop:
Bermuda
Cover Crop:
Bermuda
El YES ❑ NO
Hourly Rare (in):
0.41
Hourly Rate (in):
0.41
Hourly Rate ('in):
0,41
Hourly Rate (in):
0.41
Annual fate (Inn
29.71
Annual Rate (in):
29.71
Annual Rate (in):
29,71
Annual Rate (in):
29.71
Weather
Freeboard
Field Irrigated?
Q YES ❑ NO
Field Irrigated?
171 YES ❑ NO
Field Irrigated?
Q YES C7 NO
Field irrigated?
d YES ❑ NO
a
W
a,
M
CL
°
V
a
'a
L6
o
in
3
a
E
O a
0
5V '
N O
.
10
O
0
-Z
M S
E d
op CL
a
0:
vJ aO aCi130s
La
En
ta x7 'pa
0
°F
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
C
72
0
3.2
2
PC
64
0
3.2
3
R
68
0.2
3.2
4
C
48
0.4
3.2
9,990
00
01.21
0,21
10,920
30
0.23
0.23
10,950
30
0.23
0.23
10,740
30
0.23
0.23
5
CL
44
0
3.2
6
7
8
C
42
0
3.2
6,540
20
0,14
0,14
7,380
20
0.16
0.16
7,440
20
0.16
0.16
7,260
20
0.16
0.16
9
CL
65
0
3.2
10
CL
61
0
3.2
11
R
68
0
3.2
12
C
63
0.4
3.2
13
14
15
C
60
0
3.2
12,480
40
0.27
017
13,600
40
0.29
0.29
13,8.00
40
0,29
0,29
13,800
40
0.30
0,30
16
C
62
0
3.2
17
PC
57
0
3.2
18
C
68
0
3.2
10,080
30
022
0.22
11,160
30
0.24
0.24
11,220
30
0.24
0.24
10,860
30
0.23
0.23
19
CL
63
0
3.2
20
21
22
CL
48
1.5
3.2
23
C
38
0
3.2
24
C
51
0
3.2
9,450
30
0.20
0.20
10.530
30
0.23
0,23
10,830
30
013
0.23
10,350
30
0.22
0.22
25
C
66
0
3.2
26
CL
53
0
3.2
27
28
29
C
58
0
3.2
9,180
30
0.20
0.20
11,160
30
0,24
0.24
11,340
30
0.240.24
11,010
30
0.24
0.24
30
C
65
0
3.2
31
Monthly Loading:
57,720
1.24
64,750
1.39
35,580
1.39
64,020
1.38
F72 Month Floating Total (in):
9.78

FORM: NDAR-1 10-13 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page _3_of_4_
Permit No.: W00035049
Facility Name: MAPLE HILLWWTF
County: Pender
Month: April
Year: 2024
Did irrigation
Field Name,
9
Field Name:
10
Field Name:
11
Field Name:
occur
Area (adios),
1 7
Area (acres):
1.77
Area (aorea):
1.72
Area (acres):
at this facility?
Cover Crop:
p:
Bermuda
Cover p:
Bermuda
Cover p.:
Bermuda
CoverCro p:
El YES C NO
14.ourlyHate (ink
0.41
Hourly Rate (in):
0.41
Hourly Rate (in):
0.41
Hourly Rate (in):
0
Annual Rate (in);
29,71
Annual Rate (in):
29.71
Annual Rate (in):
29,71
Annual Rate (in):
Weather
Freeboard
Fieldfrrigated?
2 YES ❑ NO
Field Irrigated?
C YES o NO
Field Irrigated?
❑ YES ❑ r:.a
Field Irrigated?
❑ YES ❑ NO
a14,
H
,+_
a`
O
�
O 0
LO
oO
r �
41 +
E
pv
R
0
E
C
~E
r
=
E.0
r
E
E
X
OCL
�
=
J
C
E� TO tA)
v
E .2V
?
C
wC
E
O E4
7 i00_m
E
O
3:
°F
in
ft
ft
gal
min
in
in
gal
min
in
in
go
min
in
in
gal
min
in
in
1
C
72
0
3.2
2
PC
64
0
3.2
3
R
68
0.2
3.2
4
C
48
0.4
3.2
10,920
30
0.23
0.23
10,680
30
0.22
0.22
9,780
30
0.21
0.21
5
CL
44
0
3.2
6
7
8
C
42
0
3.2
7,400
20
0.16
0,16 1
7,240
20
0.15
0.15
6,580
20
0.14
0.14
9
CL
65
0
3.2
10
CL
61
0
3.2
11
R
68
0
3.2
12
C
63
0.4
3.2
13
14
15
C
60
0
3.2 j
13,960
40
0.29
0,29
14,160
40
0.29
0.29
12,080
40
0.26
0,26
16
C
62
0
3.2
17
PC
57
0
3.2
181
C 1
58
0
3.2
10,920 '
30
0,23
0,23
10,590
30
0.22
0,22
9,450
30
0.20
0.20
19
CL 1
63
0
3.2
20
21
22
CL
48
1.5
3.2
23
C
38
0
3.2
24
C
51
0
3.2
10,470
30
0.22
0,22
10,260
30
021
021
9,450
30
0.20
0-20
251
C 1
66
0
3.2
26
CL
53
0
3.2
27
28
29
C
58
0 1
3.2
11.160
30
0,23
C.23
10,980 1
30
0,23
0.23
9,990
30
021
0.21
30
C
65
0
3.2
31
Monthly Loading:
64,830
'` `-.
1.36
63,910
1,33
57.330
121,
D
0.00
12 Month Floating Total (in):
9.90
9.67
9 00

10] 11rj0i•Ita7GC6Eto] d1t
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Page _4_ of _4_
Did the application rates exceed the limits in Attachment B of your permit?
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
Was a suitable vegetative cover maintained on all sites as specified in your permit?
Were all setbacks listed in your permit maintained for every application to each permitted site?
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
O Compliant rJ Non -Compliant
171 Compliant 11 Non -Compliant
t7 Compliant © Non Compliant
O Compliant ❑ Nan -Compliant
fJ Compliant ❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Christopher Pickett
Permittee:
Pender County Utilities
Certification No.: 1010919
Signing Official: Anthony Colon
Grade: WW-SI Phone Number: 910-259-1570
Signing Official's Title: Director
Has the ORC changed since the previous NDAR-1? E: res F1 No
Phone Number: 910-259-1570 Permit Exp.: 8/31/26
06
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance
with a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted Based on my
inquiryof the person or persons who manage the system, or those persons directly responsible for gathering the information, the
information submitted is, to the best of my knowledge and belieftrue, accurate. and complete I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page _1_ of -2_
Permit No.: W00035049
Facility Name: Maple Hill WWTF
county: Pender
Month: April
Year: 2024
PPI: 001
Flow Measuring Point: 0 Influent ❑ Effluent ❑ No flow generated
Parameter Monitoring Point: ❑ lnfluent O Effluent O Groundwater Lowering ❑ Surface Water
Parameter Code ►
80050
00400
.00310
00530
00.610
00620
00626
31616
00600
00665
00940
70300
O
4v
C
O
6
c a
°
C`
N
L
0
CE
°
c
t
U
r.
W
F
°
ui
aO
d
; py
aN
J°mQ
t-
NL
m
24-hr
hrs
G'PD
su
mg1L
mg/L
mglL
mg/L
mg1L
#/100 mL
mg/L
mg/L
mglL
mg/L
1
07:30
6
11,807
7.3
2
07:30
5
11,626
7.2
3
07:30
5
14,052
7.3
4
07:30
7
13,449
7.3
5
07:30
6
11,564
7.3
6
10,804
7
10,547
8
07:30
7
10,571
7.3
9
09:30
6
9,731
7.4
10
07:30
4
8,663
7.4
11
07:30
6
9,240
7.5
12
07:30
6
9,835
7.4
13
8,513
14
10,315
15
07:30
7
9,597
7A
16
07:30
7
7,9"69
7.5
171
07:30
6
8,923
7.3
8
11.6
0.6
28.1
.40.5
32
28.4
6.96
181
07:30
7
8,317
7.5
191
07:30
5
9,570
7.6
20
9,073
21
17,925
22
07:30
6
11,292
7.6
23
07:30
6
9,753
7.6
24
07:30
7
11,302
7.4
251
10:00
5
9,879
7.2
26
07:30
7
8,975
7.6
27
10,573
28
9,452
29
07:30
7
8,222
7.7
30
07:30
7
7,157
T7
31
Average:
10,290
8.00
11.60
0.60
28.10
0.00
32 00
2840
6.96
Daily Maximum:
17,925
7 70
6.00
11.60
0.60
28 10
0.50
3200
2840
6.96
Daily Minimum:
7,157
7.20
800
1160
0.60
28 10
0.50
32 00
28.40
6.96
Sampling Type:
Recorder
Grab
Composite
Composite
Composite
Composite
Composite
Grab
Composite
Grab
Composite
Composite
Monthly Avg. Limit:
42,000
n/a
3.0
30
15
n/a
n/a
200
n/a
n/a
We
n/a
Daily Limit:
n%
6 to 9
nfa
nla
n/a
nla
n/a
n/a
n/a
n/a
n/a
nla
Sample Frequency:
Continvus
5XWK
Weekly
Weekly
Weekly
Weekly
Weekly
Nlee'kly
Monthly
Mostly
3XYR
3XYR

i=oRlUl NDMR 10-13 NON -DISCHARGE MONITORING REPORT (NDMR) Page _2_of_2_
Sampling Person(s)
Name: Samples were collected by the Certified Laboratory
Name:
Certified Laboratories
Name: Environmental Chemists, Inc.
Name: Jay Baker
Does all monitoring data and sampling frequencies meet the requirements in Attachment of your permit? a Compliant ❑ Noncnmplant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s)
taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Christopher Pickett
Permittee: Pender County Utilities
Certification No.: 995432
Signing Official: Anthony Colon
Grade: WW2 Phone Number: 910-259-1570
Signing Official's Title: Director
Has the ORC changed since the previous Ni ❑ Yes ❑ No
Phone Number: 910-259-1570 Permit Expiration: 8/3112026
K
-zr� z� z
Signature Date
Signature Date
By this signature. I certify that this report is accurrata and complete to the best of my knowledge
I certfy. under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the in!ormabon
t—itir;d_ Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the informaton submitted a. to the best of my knowledge and belief, true, accurate, and complete I am
aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

e
nvirochem
ANALYTICAL & CONSULTING CHEMISTS
Pender County Utility Operations
Post Office Box 995
Burgaw NC 28425
Attention:
Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 . 910.392.0223 Lab o 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 * 252.4735702 Lab/Fax
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
infoia enk ironmentalchemists.com
Date of Report: Apr 26, 2024
Customer PO M
Customer ID: 08100095
Report M 2024-08921
Project ID: Maple Hili WWTP
Lab ID Sample ID:
24-21747 Site: Effluent - Composite
Test
Collect Daterrime
4/17f2024 10:00 AM
Method
Matrix Sampled by
Water JCB/Envirochem
Results Date Analyzed
Ammonia Nitrogen
EPA 350 1, Rev. 2.0,1903
0.6 mg/L 04/23/2024
Total Kjeldahl Nitrogen (TKN)
EPA 351 2, Rev. 2.0,1993
< Q.5 mg/L 04/25/2024
Residue Suspended (TSS)
5M 2540 D-2015
11.6 mg/L 04/18/2024
BOD
SM 5210 B-2016
8 m /L 04/17/2024
Sample estimated. Did not meet quality
control requirements, Blank result 0.24 mg1L, above acceptable limit of 0.2 mglL
Nitrate Nitrogen (Cale)
Nitrite Nitrogen
EPA 353.2. Rev, 2.0. 1293
0.27 mg& 04/17/2024
Nitrate+Nitrite-Nitrogen
EPA 353.2 Rev. 2.0, 1993
28.4 mg/L 04/19/2024
Nitrate Nitrogen
Subtraction Method
28.1 mg/L 04/19/2024
Lab ID Sample ID:
Collect DatelTime
Matrix Sampled by
24-21748 Site. Effluent - Grab
4/1712024 10:35 AM
Water JCB/Envirochem
Test
Method
Results Date Analyzed
Fecal Coliform IdexxColitert-18 32 MPN1100ml 04/17/2024
Temperature SM 2550 B-2010 23.8 C 04/17/2024
pH SM 4500 H B-2011 7.2 units 04/17/2024
Total Phosphorus SM 4500 P (F-H)-2011 6.98 mg/L 04/2512024
Comment:
Reviewed by:
Report #:: 2024-06921 Page 1 of 1

-4M.
Facility Name:
_f2cjc=2� L
Analyst: __jay agker
Permit(#:
�)�J t- l L.0
PH
Calibration Time
Cal Butter 4 0 s U.
Reference Method
Cal Buffer 10 0 s u
SM4500 H+B -2011
Check Buffer 7.0
Instrument ID STARA221 : K06795
s-u
Comments
�iDo
4-oo '
IVAD ('
>
*pH check buffer must read within ±0,1 pH units ofthe buffer's true value
4 so buffer Lot#/: Rieca 1304N61 F2W 04r25,
7 su buffer lot#:= Rai
g ')l OC 40 Ex t012d
10 so puffer LoW RLCCA 1304P74 Exo I O/24
Sample location
Sample Collection
Try+
Sample Analysis
Timek
pH Result
s.0
►Past -analysis Buffer
Check value s u
Commcnts/Dala Qualifiers
- j
► Post analvs+s finfrer rh-k
.
+s rrA ..•i,.. r—.-
- 77-7-
-
-.1— VI 111e Vnlier 5 true value
All pH values in pH units (re , s.u.). Record all data to the nearest 001 s u and report to the nearest 0 I s.0
Total Residual Chlorine (TRQ
Reference M+°thnd .rM 41,Wri_Mnl 1 m—k sr>e-juv ,-+__-- ------ _-_,-
Post -analysis
--
.._---"-
•••-..•�
ulal,u curl,
n�ai.n�umrrm 131Ltlx.L
Dail Check
y
Standard Result
Check Std
Time check
Standard
Sample
Sample
Collecton
Sample
Analysis
7RC Result
ag/L or mgfL
( when Y 8 anal zm
Analyzed
Location
Time
Time
pP,n- or mg/I.
Commeats/Data Qualifiers
at multi Ic sites
---,-.--_.. •••••••'••••• ••••" •m"" -_ -yam+a. ai Di�I �. mxupkettux range •Ag/L Or mg/L GEL Sf D3 HACH A0038
Check standards must recover within :,.-10%of the check standard's true value
Annual Calibration Curve Verification Date 11/25/73 IDEXX (Free) 230901 F,xp. Date 1031124 IDEXX (Total) Ex 4
Reagent Blank Value -(When applicable Analyze and document a reagent blank when standards, sample dilutions or IrT Samples are prepared)
Dissolved Oxygen (DO)
Reference Method SM 4500 0 G •2016 Instrument ID. YSI PRO 20 22DI00065
Calibration variable ♦ Post-analys:s calibration
Calibration/ Meter reading verification (when nccessai})
Verification or ° 0 efficiency Comments
Tithe Barometric after calibration
Temp pressure Salinity, Theoretical Calculated
oC MM112 I PP1 Value mg/L I Value rng/L
Use this row when performing it verification Instead of
Sample Location
Sampte Collection
Time
*Sample Analysis
Time
DO reading
—411L.
CommentsiDataQuallfiers
�• r� �� env miler MUSE oe MMIUMIec at eacti site belOre analysis or a post -analysis calibraron verification must be performed
* If sample is measured directly in the stream and/or onsae, only time analyzed xould be recorded with a note that the} are measured -n situ or immediately
Temperature
Sample Location
Sample
Collection
Time
*Sample
Analysis
Time
Temperature
C
'- - � +11V FYI AfMtiiGJ � RVV lad
Comments/DataQualifiers
- �i-
b35
Z3.5
_-- .- -- _..__......-..-....,,,,, .W ..,„ ,,,,,j . „— al .1— ♦1—. l"V+cca:ucu, ,Nitna noic mat uiey are measures in suuorinuneuiateh
Annual Verification Date 11-25-23
Field Personnel Note:
QA.Oot 12MI/22
Rev I-2022

Environmental Chemist, Inc., Wilmington, NC Lab #94
Sample Receipt Checklist
6602 Windmill Way
Wilmington, NC 28405
910.392,0223
Client: _ Date: Report Number: _ 2024- (}��
1 At x k� kAf aC
Receipt of sample: 4EMMM70kupQ Client Delivery El UPS ❑ FedEx ❑ Other ❑
❑ YES 113 NO © N/A 1. Were custody seals present on the cooler?
❑ YES
❑ NO 0 N/A
12. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt 'C Corrected temperature upon receipt °C
How temperature taken: ❑ Temperature Blank © Against Bottles
IR Gun ID: Thomas Traceable S/N 210886869 IR Gun Correction Factor'C: 0.0
© YES
❑ NO
3. If temperature of cooler exceeded 6'C, was Project Mgr./QA notified?
0 YES
❑ NO
4. Were proper custody procedures (relinquished/received) followed?
21 YES
❑ NO
S. Were sample ID's listed on the COC?
.C7x. YES
❑ NO
6. Were samples ID's listed on sample containers?
IO YES
❑ NO
7. Were collection date and time listed on the CDC?
21 YES
❑ NO
8. Were tests to be performed listed on the COC?
O YES
❑ NO
9. Did samples arrive in proper containers for each test?
0 YES
❑ NO
10. Did samples arrive in good condition for each test?
YES
❑ NO
11. Was adequate sample volume available?'
9 YES
❑ NO
12. Were samples received within proper holding time for requested tests?
YES
a NO
13. Were acid preserved samples received at a pH of <2?
❑ YES
❑ NO
14. Were cyanide samples received at a pH >12?
❑ YES
❑ NO
15. Were sulfide samples received at a pH >9?
YES
C] NO
16. Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L? **
YES
❑ NO
17. Were Sulfide/Cyanide received at a chlorine residual of <0.5 m/L?
❑ YES
❑ NO
118. Were orthophosphate samples filtered in the field within 15 minutes?
" TOC/volatiies are pH checked at time of analysis and recorded on the benchsheet.
** Bacteria samples are checked for Chlorine at time of analysis and recorded on the bench -sheet.
Sample Preservation: (Must be completed for any sample(s) incorrectly preserved or with headspace)
Sample(s) were received incorrectly preserved and were adjusted accordingly
by adding (circle one): HZSO4 HNO3 HCI NaOH
Time of preservation: If more than one preservative is needed, notate in comments below
Note: Notify customer service immediately for incorrectly preserved samples. Obtain a new sample or
notify the state lab if directed to analyzed by the customer. Who was notified, date and time:
Volatiles Sample(s) were received with headspace
COMMENTS:
DOC. QA.002 Rev 1

ndmill Way
ENVIRONMENTAL CHEMISTS, INC OF C : 1N392-07231FAX 9'10-392�24$
Analytical & Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 info(&nvironmentalchemists.com
COLLECTION AND CHAIN OF CUSTODY
Client: Pender County Utilities (Wastewater)
PROJECT NAME: Maple Hill WWTP (PPI 001)
REPORT NO: LJ L`r' P 9L/
ADDRESS:
CONTACT NAME: Chris Pickett, ORC
PO NO:
REPORT TO: ORC
PHONEIFAX:
COPY TO:
email:
Sampled By:
SAMPLE TYPE: I = Influent. E = Effluent. W = Well. ST = Stream- SO = Soil. SL = Sludne_ Other -
Sample Identification
Collection
m m
F
e
m a
o `o 0
U
m
c C7
o;
U-
c`
E
U
a LLl
Z
PRESERVATION
_ -
ANALYSIS REQUESTER
Date
Time
Temp
z
2
-j
=
0
0
?
0
o
~
w
O
WWTP PPI 001 (composit
)/��
X
BOD, TSS, NO2
,
C
P
X
NO3, NH3, TKN
WWTP PPI 001
(composite) Triannuals
C
P
X
Chloride, TDS (March, July, Nov)
C
P
G
G
WWTP Effluent (grab)
L'}
X
Total Phos
G
pH (field):`
C
P
X
Fecal Coliform
G
G
C
P
G
71G
Samples due 11month
C
P
G
G
C
P
G
G
limits: BOD 30 mglL, TSS 30 m91L, NH3 15 mgl1, Fecal 200 colonies/100 ml
Transfer Relinquished By:
DaterTime
Received By
DatelTime
1.
2.
I emperature when Received: Accepted: Rej�cr Resample R u sted:
Delivered By: �/L Received By: „ Date: �' - Time:,T
Comments: A ROUND: