WQ0010528_Residual Annual Report 2018_20190218

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ANNUAL SLUDGE DISPOSAL REPORT
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SUMMARY OF THE
LAND APPLICATION PROGRAM
FOR THE
TOWN OF RAMSEUR
RFC`t=i1�F�
FEB 1 8 2019
prepared by DWR SECTION
INFORMATION PROCESSING UNIT
SUEZ
Clemmons, North Carolina
[phone]

CLASS
WQ PERMIT #:
NNUAL DISTRIBUTION AND MARKETING/ SUK., ,%ZE DISPOSAL CERTIFICATION AND SUMMARY FORM
WQ0010528
PHONE: [phone]
FACILITY TYPE (please check one):
FACILITY NAME:
COUNTY:
Randolph
OPERATOR:
Town of Ramseur
Town of Ramseur
i l Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
J Distribution and Marketing (complete Parts A, B, and C)
Was the facility in operation during the past calendar year? Yes !d No J —► If No skip parts A, B, C and certify form below
Part A*:
Part B*:
Month
Sources(s) (include NPDES # if
applicable)
Volume (dry tons)
Recipient Information
Amendment/
Bulking Agent
Residual In
Product Out
Name(s)
Volume (dry tons)
Intended use(s)
January
February
March
WWTP - NCO026565
0.03
0.05
0.08
April
May
WTP
27.55
27.55
June
July
August
September
October
November
December
Total from FORM DMSDF (sup)
Totals:
Annual (dry tons):
0.03
27.6
1 27.63
0
Amendment(s) used: Lime Bulking Agent(s) used:
* If more space is required, attach additional information sheets (FORM DMSDF (supp)): Total Number of Form DMSDF (Supp)
Part C:
Facility was compliant during the past calendar year with all conditions of the land application permit 0 Yes
(including but not limited to items 1-3 below) issued by the Division of Water Resources: IJ No ► If No, Explain in Narritive
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water Resources.
No contravention of Ground Water Quality Standards occurred at a monitoring well.
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Per ittee Date Signature df Preparer**
(if different from Permittee)
**Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
Date
DENR FORM DMSDF (12/2006)

ANNUAL RESIDUAL Si-xiviPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - B
WQ Permit Number:
Facility Name:
Residual Source WQ # or
NPDES #:
WWTP Name:
Residual Analysis Data
WQ0010528
Town of Ramseur
�CKIZI . •1.�T.�
Ramseur WWTP
Laboratory: 1) Environment 1
2) SGS Accutest
3)
4)
5)
Parameter
• I- -
,' 1
-------
Molybdenum
Total Phosphorus
' For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
r
Signature of Pr9lparer
1-T ( -11
Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM RSSF (12/2006)

0
OAKMONT DRIVE
EENVILLE, N.C. 27858
SUEZ WATER (RAMSEUR WWTP-SLUDGE)
NADINE BLACKWELL
P.O. BOX 1279
CLEMMONS ,NC 27012
Sludge
Analysis
Method
PARAMETERS
Sample
Date Analyst
Code
PH, Units
6.9
12/07/18
HMM
4500HB-11
Arsenic (dry wt. basis), mg/kg
<2.5
12/19/18
MTM
311313-04
Chromium, T.(dry wt. basis),mg/kg
58
12/12/18
LFJ
EPA200.7
Nickel (dry wt. basis), mg/kg
8
12/12/18
LFJ
EPA200.7
Total Solids, %
0.38
12/05/18
KDS
2540G-11
Wastewater IV: 10
PHONE [phone]
FAX [phone]
ID#: 965
DATE COLLECTED: 12/04/18
DATE REPORTED : 12/26/18
REVIEWED BY:

Environment 1, Inc. CHAIN OF C i T`'TODY RECORD
P.O. Box 7( 14 Oakmont Dr. Page 1
Greenville, 7858
environment 1 inc.com
DISINFECTION
Phone [phone] • Fax [phone]
CHLORINE NEUTRALIZED AT COLLECTION
Fi CHLORINE
pH CHECK (LAB)
CLIENT:965 Week: 7
Fi UV
p
p
p
p
p
p
G
G
G
G
G
I
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CONTAINER TYPE, P/G
UEZ WATER (RAMSEUR WWTP-SLUDGE)
❑ NONE
fADINE BLACKWELL
.O. BOX 1279
CHEMICAL PRESERVATION
'LEMMONS NC 27012
A
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A
A
A
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A
A
A
A
A
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A -NONE D-NAOH
536)766-0270
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SAMPLE LOCATION
DATE
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Sl udge Sample
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CLASSIFICATION:
WASTEWATER (NPDES)
DRINKING WATER
DWQ/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
N
SAMPI FS'Cl7TECTED BY:
(Please Print)
1
SAMPLES 4CEIVED IN LAB AT�°C
RE INQUI ED BY (SIG.) (SAMPLER)
II)ATUTIME
RECEIVED B G.) I
A`T,ETIME ,
COMMENTS:
(
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D I1
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RELINQUISHED BY (SIG.)
DATE/TIME
RECEIVED BY (SIG.
DATE/TIME
RELINQUISHED BY (SIG.)
DATE/TIME
I
RECEIVED BY (SIG.)
DATE/TIME
I I
i
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for
FORM #s Grab sample in the blocks above for each parameter requested. N 2 3 4 2 A 01

SGS
Orlando, FL
The results set forth herein are provided by SGS North America Inc. eHardcopy 2.0
Automated Report
Technical Report for
Environment 1, Inc
Suez Water, Ramseur WWTP; Clemmons, NC
965
SGS Job Number: FA60021
Sampling Date: 12/04/18
Report to:
Environment 1, Inc
PO Box 7085
Greenville, NC 27835
[e-mail]
ATTN: Deedee Woolard
Total number of pages in report: 14
Test results contained within this data package meet the requirements Caitlin Brice, M.S.
of the National Environmental Laboratory Accreditation Program General Manager
and/or state specific certification programs as applicable.
Client Service contact: Jean Dent -Smith 407-425-6700
Certifications: FL(E83510), LA(03051), KS(E-10327), IL(200063), NC(573), NJ(FL002), NY(12022), SC(96038001)
DoD ELAP(ANAB L2229), AZ(AZ0806), CA(2937), TX(T104704404), PA(68-03573), VA(460177),
AK, AR, IA, KY, MA, MS, ND, NH, NV, OK, OR, UT, WA, WV
This report shall not be reproduced, except in its entirety, without the written approval of SGS.
Test results relate only to samples analyzed.
SGS North America Inc. • 4405 Vineland Road • Suite C-15 • Orlando, FL 32811 • tel: [phone] • fax: [phone]
SGS is the sole authority for authorizing edits or modifications to this document. Please share your ideas about ��
Unauthorized modification of this report is strictly prohibited. how we can serve you better at:
Review standard terms at: http://wwtiv.sgs.cotii/en/terms-and-conditions EHS.US.CustomerCare Casgs.com
1 of 14
FA60021

Table of Contents
-1-
Section1: Sample Summary...................................................................................................
Section2: Summary of Hits....................................................................................................
Section3: Sample Results........................................................................................................
3.1: FA60021-1: SLUDGE SAMPLE..................................................................................
Section4: Misc. Forms............................................................................................................
4.1: Chain of Custody...........................................................................................................
Sections:
3
4
5
6
12
13
2of14
FA60021

SGS North America Inc.
Sample Summary
Environment 1, Inc
Job No: FA60021
Suez Water, Ramseur WWTP; Clemmons, NC
Project No: 965
Sample
; Collecfed-
': - _
Matrix
Client
Number
Date
Time By
Received Code Type
Sample ID
FA60021=1- ; 12/04/18 09:50 TL 12/08/18 SO Sludge SLi1DGE;SEIMPLE ;
Soil samples reported on a dry weight basis unless otherwise indicated on result page.
3of14
��� FA60021

Summary of Hits
Job Number:
FA60021
Account:
Environment 1, Inc
Project:
Suez Water, Ramseur WWTP; Clemmons, NC
Collected:
12/04/18
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FA60021-1 SLUDGE SAMPLE
Corrosivity as pH
su
Ignitability (Flashpoint) a ">200:`';W Deg. F
(a) Not ignitable.
Page 1 of 1
,
SW846 CHAP7
SW846 1010A MOD
4 at 14
FA60021

I- I
-9•}
x
Orlando, FL *"'
Sample Results''
Report of Analysis
Section 3
rA
5of14
FA60021

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA60021-1 Date Sampled: 12/04/18
Matrix: SO - Sludge Date Received: 12/08/18
Method: SW846 8260B SW846 1311 Percent Solids: 0.5
Project: Suez Water, Ramseur WWTP; Clemmons, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 C0129136.1) 10 12/13/18 02:26 SO 12/11/18 14:45 OP72982 VC5125
Run #2
Purge Volume
Run #1 5.0 ml
Run #2
VOA TCLP List
CAS No.
Compound
Result
HW#
MCL RL
71-43-2
Benzene
ND
D018
0.50 0.010
78-93-3
2-Butanone (MEK)
ND
D035
200 0.050
56-23-5
Carbon Tetrachloride
ND
D019
0.50 0.010
108-90-7
Chlorobenzene
ND
D021
100 0.010
67-66-3
Chloroform
ND
D022
6.0 0.010
106-46-7
1,4-Dichlorobenzene
ND
D027
7.5 0.010
107-06-2
1,2-Dichloroethane
ND
D028
0.50 0.010
75-35-4
1,1-Dichloroethylene
ND
D029
0.70 0.010
127-18-4
Tetrachloroethylene
ND
D039
0.70 0.010
79-01-6
Trichloroethylene
ND
D040
0.50 0.010
75-01-4
Vinyl Chloride
ND
D043
0.20 0.010
CAS No.
Surrogate Recoveries
Run# 1
Run# 2
Limits
1868-53-7
Dibromofluoromethane
100%
83-118%
17060-07-0
1,2-Dichloroethane-D4
101%
79-125%
2037-26-5
Toluene-D8
97%
85-112%
460-00-4
4-Bromofluorobenzene
98%
83-118%
TCLP Leachate method SW846 1311
MDL
Units Q
0.0031
mg/1
0.020
mg/1
0.0036
mg/1
0.0020
mg/1
0.0030
mg/1
0.0026
mg/1
0.0031
mg/1
0.0032
mg/1
0.0022
mg/1
0.0035
mg/1
0.0041
mg/1
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
_SGS_ 6of14
FA60021

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA60021-1 Date Sampled: 12/04/18
Matrix: SO - Sludge Date Received: 12/08/18
Method: SW846 8270D SW846 3510C Percent Solids: 0.5
Project: Suez Water, Ramseur WWTP; Clemmons, NC
Page 1 of 1
-7 M
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 X064217.1) 1 12/13/18 21:19 MV 12/13/18 08:45 OP73016 SX2650
Run #2
Initial Volume Final Volume
Run #1 100 ml 1.0 ml
Run #2
ABN TCLP List
CAS No.
Compound
Result
HW#
MCL
RL
95-48-7
2-Methylphenol
ND
D023
200
0.050
3&4-Methylphenol
ND
D024
200
0.050
87-86-5
Pentachlorophenol
ND
D037
100
0.25
95-95-4
2,4,5-Trichlorophenol
ND
D041
400
0.050
88-06-2
2,4,6-Trichlorophenol
ND
D042
2.0
0.050
106-46-7
1,4-Dichlorobenzene
ND
D027
7.5
0.050
121-14-2
2,4-Dinitrotoluene
ND
D030
0.13 0.050
118-74-1
Hexachlorobenzene
ND
D032
0.13 0.050
87-68-3
Hexachlorobutadiene
ND
D033
0.50 0.050
67-72-1
Hexachloroethane
ND
D034
3.0
0.050
98-95-3
Nitrobenzene
ND
D036
2.0
0.050
110-86-1
Pyridine
ND
D038
5.0
0.10
CAS No.
Surrogate Recoveries
Run# 1
Run# 2
Limits
367-12-4
2-Fluorophenol
37%
14-67%
4165-62-2
Phenol-d5
25%
10-50%
118-79-6
2,4,6-Tribromophenol
81%
33-118%
4165-60-0
Nitrobenzene-d5
68%
42-108%
321-60-8
2-Fluorobiphenyl
69%
40-106%
1718-51-0
Terphenyl-dl4
77%
39-121%
TCLP Leachate method SW846 1311
MDL
Units Q
0.0056
mg/l
0.0098
mg/1
0.050
mg/1
0.0074
mg/1
0.0075
mg/1
0.0050
mg/I
0.0081
mg/1
0.0069
mg/1
0.0050
mg/I
0.016
mg/1
0.0093
mg/1
0.020
mg/1
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
-SGS1 7 of 14
FA60021

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA60021-1 Date Sampled: 12/04/18
Matrix: SO - Sludge Date Received: 12/08/18
Method: SW846 8151A SW846 3510C Percent Solids: 0.5
Project: Suez Water, Ramseur WWTP; Clemmons, NC
Page 1 of 1wa
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 CC060463.1) 1 12/14/18 16:50 RS 12/13/18 13:40 OP73025 GCC1386
Run #2
Initial Volume Final Volume
Run #1 10.0 ml 5.0 ml
Run #2
Herbicide TCLP Leachate
TCLP Leachate method SW846 1311
CAS No.
Compound
Result HW#
MCL RL
MDL Units Q
94-75-7
2,4-D
:AND,;;; D016
10 0.050
0.017 mg/1
93-72-1
2,4,5-TP (Silvex)
ND :; _ `, D017
1.0 0.0050
0.0013 mg/1
CAS No.
Surrogate Recoveries
Run# 1 Run# 2
Limits
19719-28-9
2,4-DCAA
;;;1l04%'s:;:y^'
39-135%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
8of14
FA60021

SGS North America Inc.
Client Sample ID: SLUDGE SAMPLE
Report of Analysis
Lab Sample ID: FA60021-1 Date Sampled: 12/04/18
Matrix: SO - Sludge Date Received: 12/08/18
Method: SW846 8081B SW846 3510C Percent Solids: 0.5
Project: Suez Water, Ramseur WWTP; Clemmons, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 KK92415.D 1 12/13/18 18:16 WH 12/13/18 08:30 OP73018 GKK2939
Run #2
Initial Volume Final Volume
Run # 1 100 ml 5.0 ml
Run #2
Pesticide TCLP Leachate
TCLP Leachate method SW846 1311
CAS No.
Compound
Result
HW#
MCL RL
MDL
Units Q
58-89-9
gamma-BHC (Lindane) a
ND
D013
0.40 0.00010
0.000022
mg/I
12789-03-6
Chlordane
ND
D020
0.030 0.0010
0.00038
mg/1
72-20-8
Endrin
ND
D012
0.020 0.00020
0.000021
mg/1
76-44-8
Heptachlor
ND
D031
0.0080 0.00010
0.000026
mg/1
1024-57-3
Heptachlor epoxide a
ND
D031
0.0080 0.00010
0.000020
mg/1
72-43-5
Methoxychlor
ND
D014
10 0.00020
0.000050
mg/I
8001-35-2
Toxaphene
ND
D015
0.50 0.0050
0.0021
mg/I
CAS No.
Surrogate Recoveries
Run# 1
Run# 2
Limits
877-09-8
Tetrachloro-m-xylene
101%
42-127%
2051-24-3
Decachlorobiphenyl
122%
27-127%
(a) Associated ICV outside control limits high, however sample ND.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
CGS9of14
FA60021

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA60021-1 Date Sampled: 12/04/18
Matrix: SO - Sludge Date Received: 12/08/18
Percent Solids: 0.5
Project: Suez Water, Ramseur WWTP; Clemmons, NC
Page 1 of 1
Metals Analysis, TCLP Leachate SW846 1311
Analyte Result HW#
MCL
RL
Units
DF
Prep
Analyzed
By
Method
Prep Method
Arsenic < 0.10 D004
5.0
0.10
mg/1
1
12/11/18
12/12/18
LM
SW846 6010C 2
SW846 3010A 4
Barium < 2.0 D005
100
2.0
mg/1
1
12/11/18
12/12/18
LM
SW846 6010C 2
SW846 3010A 4
Cadmium < 0.050 D006
1.0
0.050
mg/1
1
12/11/18
12/12/18
LM
SW846 6010C 2
SW846 3010A 4
Chromium < 0.10 D007
5.0
0.10
mg/1
1
12/11/18
12/12/18
LM
SW846 6010C 2
SW846 3010A 4
Lead < 0.050 D008
5.0
0.050
mg/1
1
12/11/18
12/12/18
LM
SW846 6010C 2
SW846 3010A 4
Mercury < 0.0050 D009
0.20
0.0050
mg/I
1
12/11/18
12/11/18
JC
SW846 7470A 1
SW846 7470A 3
Selenium < 0.10 D010
1.0
0.10
mg/1
1
12/11/18
12/12/18
LM
SW846 6010C 2
SW846 3010A 4
Silver < 0.10 D011
5.0
0.10
mg/1
1
12/11/18
12/12/18
LM
SW846 6010C 2
SW846 3010A 4
(1) Instrument QC Batch: MA15458
(2) Instrument QC Batch: MA15465
(3) Prep QC Batch: MP34790
(4) Prep QC Batch: MP34791
RL = Reporting Limit
MCL = Maximum Contamination Level (40 CFR 261 7/1/11)
SGS_ 10 of 14
FA60021

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA60021-1 Date Sampled: 12/04/18
Matrix: SO - Sludge Date Received: 12/08/18
Percent Solids: 0.5
Project: Suez Water, Ramseur WWTP; Clemmons, NC
General Chemistry
Analyte
Corrosivity as pH
Cyanide Reactivity
Ignitability (Flashpoint) a
Solids, Percent
Sulfide Reactivity
(a) Not ignitable.
RL = Reporting Limit
Result RL
Units
DF
Analyzed
By
Method
su
1
12/17/18 12:51
BW
SW846 CHAP7
z_280"; '-': : ` 280
mg/kg
1
12/14/18 14:00
JK
SW846 CHAP7
>,200Y '." ".
Deg. F
1
12/11/18 10:23
BW
SW846 1010A MOD
%
1
12/13/18 11:55
AC
SM19 254OG
9300
mg/kg
1
12/14/18 15:30
LR
SW846 CHAP7
S11 of 14
FA60021

SGS,---
Orlan
Misc. FormsTW
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
Section 4
SGS12 of 14
FA60021

P.OBox°7085, 114 Oakmont Dr.
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Page 1 of 1
Greenville, NC 27858
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DISINFECTION
CHLORINE NEUTRALIZEDATCOLLECiON
environmentlinc.com
Phone [phone] • Fax [phone]
CHLORINE
pHCHECK (LAB)
LIENT;965 Week:7
uv
P
P
P
P
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P
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G
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CONTAINER TYPE,P/G
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NONE
IADINE BLACKWELL
-.O. BOX 1279
❑
CHEMICAL PRESERVATION
'LEMMONS NC 27012
A
A
A
A
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A
A
A
A
A
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336) 766-0270
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WASTEWATER(NPDES)
DRINKINGWATER
DWO/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
N
SAMPLES CTED BY
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NOUISHED BY (SIG.)
DATE/RME
RECEIVED BY (SIG.) ;
tiE
17ATE/DME-
kI9I1� I 9)
111ld'i61w0
PLEASE READ Instructions for completing this form on the reverse side. �v'Q zGrab sample in the blocks ampler must place ck for composite sample or a "G" for
f�aM a.5 � ° � s above for each naramnter rnnuasrad. No q A ,) d n i
FA60021: Chain of Custody
Page 1 of 2
13 of 14
SG _
FA60021

SGS Sample Receipt Summary
Job Number: FA60021 Client: ENV. 1 Project: 965
Date / Time Received: 12/8/2018 10:00:00 AM Delivery Method: FX Airbill Ws: 1001693371060003281100461155066267
Therm ID: IR 1; Therm CF: -0.2; # of Coolers: 1
Cooler Temps (Raw Measured) eC: Cooler 1: (2.0);
Cooler Temps (Corrected) eC: Cooler 1: (1.8);
Cooler Information
Y or
N
Sample Information
Y or
N
N/A
1. Custody Seals Present
®
❑
1. Sample labels present on bottles
®
❑
2. Custody Seals Intact
®
❑
2. Samples preserved property
®
❑
3. Temp criteria achieved
®
❑
3. Sufficient vokrme/containers recvd for analysis:
®
❑
4. Cooler temp verification
IR Gun
4. Condition of sample
law
5. Cooler media
Ice (Bao)
5. Sample recvd within HT
®
❑
6. Datesfrimea/lDs on CDC match Sample Label
®
❑
Trio Blank Information
Y or
N NIA
VOCs have headspace
❑
❑
1. Trip Blank present / cooler
❑
❑ ®
8. Bottles received for unspecified teats
❑
2. Trip Blank listed on CDC
❑
❑ ®
9. Compositlnp Instructions dear
❑
❑
W
or S N/A
10. Voa Soil Kits/Jars received past 48hrs?
❑
❑
11. % Solids Jar received?
❑
❑
Ea
3. Type Of TB Received
❑
❑ ®
12. Residual Chlorine Present?
❑
❑
Misc. Information
Number of Encores: 25-Gram 5-Gram Number of 5035 Field Kits: Number of Lab Filtered Metals:
Test Strip Lot #a: pH 0-3 230315 pH 10-12 219813A Other. (Specify)
Residual Chlorine Test Strip Lot #:
Comments
SNGRw. Mla 052N77
Technician: PETERH Date: 12/6/2018 10:00:00 A Reviewer. Date:
Rev.
FA60021: Chain of Custody
Page 2 of 2
14 of 14
�— FA60021

ANNUAL RESIDUAL Si 'LING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - B
WQ Permit Number: WQ0010528 Laboratory:
Facility Name: Town of Ramseur
Residual Source WQ # or
NPDES #:
NCG590019
WWTP Name: Ramseur Water Treatment Plant
Residual Analysis Data
1) Environment 1
2) SGS Accutest
3)
4)
5)
Parameter
- -
Conc.•
Limit
or • .• Date
1
----------
Molybdenum
e For surface disposal facilities the ceiling concentration limits listed in this form are not applicable. Reference the individual permit for metals limits.
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature 6f Preparer *
Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26) DENR FORM RSSF (12/2006)

SUEZ WATER (RAMSEUR WTP-SLUDGE)
NADINE BLACKWELL
P.O. BOX 1279
CLEMMONS ,NC 27012
Sludge
Analysis
Method
PARAMETERS
Sample
Date
Analyst
Code
PH, Units
3.4
05/25/18
HMM
4500HB-11
Arsenic (dry wt. basis), mg/kg
<2.5
05/30/18
MTM
311313-04
Chromium, T.(dry wt. basis),mg/kg
8
06/04/18
LFJ
EPA200.7
Nickel (dry wt. basis), mg/kg
26
06/04/18
LFJ
EPA200.7
Total Solids, %
6.44
05/23/18
JMT
2540G-11
ID#: 950
DATE COLLECTED: 05/22/18
DATE REPORTED : 06/15/18
REVIEWED BY:

Environment 1. Inc. CHAIN OF C7 T"TODY RECORD
P.O. Box,70: 4 Oakmont Dr.
Greenville,) 858 Page 1
environment 1 inc .com
DISINFECTION
Phone [phone] • Fax [phone]
CHLORINE NEUTRALIZED AT COLLECTION
Ij CHLORINE
pH CHECK (LAB)
CLIENT:950 Week: 7
UV
p
p
p
IP
p
p
G
G
G
G
G
I
I
CONTAINER TYPE, P/G
UEZ WATER (RAMSEUR WTP-SLUDGE)
❑ NONE
TADINE BLACKWELL
'.O. BOX 1279
FA
CHEMICAL PRESERVATION
'LEMMONS NC 27012
A
A
A
A
A
A
A
A
A
A
A
m o
ECl)
C/) A -NONE D-NAOH
336) 766-0270
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COL_ECTION
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°
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Q
SAMPLE LOCATION
DATE
TIME
Sludge Sample'
_r
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8
,;
CLASSIFICATION:
FA WASTEWATER(NPDES)
Ij DRINKING WATER
DWO/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
cD N
SAMPLES COLLECTED BY:
(Please Print)
SAMPLES RECEIVED IN LAB AT °C
RELI O ISHED BY SIG.)
DATE/TIME
VED BY SIG.)
DATE/TIME
COMMENTS:
Aw .S
_Z2-, P �3o Z�
�� —t S
—2 -2-, P I /2 o o
INOUISHED BY (SIG.)
DATE TIME
RECEIV D Y (SIG.)
DATE/TIME
f
sir
iy
RELINO ISHED BY (SIG.)
DATE/TIME
RECEIVED BY (SIG.)
DATE/TIME
Sampler must place a "C" for composite sample or a "G" for
PLEASE READ Instructions for completing this form on the reverse side.
FORM us Grab sample in the blocks above for each parameter requested. N _0
3 4 2 ,4 1 %

Orlando, FL
The results set forth herein are provided by SGS North America Inc. eHardcopy 2.0
Automated Report
Technical Report for
Environment 1, Inc
Suez Water, Ramseur WWTP; Clemmons, NC
965
SGS Job Number: FA54556
Sampling Date: 05/22/18
Report to:
Environment 1, Inc
PO Box 7085
Greenville, NC 27835
dwoolard@environment 1 inc. corn
TTN: Deedee Woolard
Total number of pages in report: 15
e
Test results contained within this data package meet the requirements Caitlin Brice, M.S.
of the National Environmental Laboratory Accreditation Program General Manager
and/or state specific certification programs as applicable.
Client Service contact: Jean Dent -Smith 407-425-6700
Certifications: FL(E83510), LA(03051), KS(E-10327), IL(200063), NC(573), NJ(FL002), NY(12022), SC(96038001)
DoD ELAP(ANAB L2229), AZ(AZ0806), CA(2937), TX(T104704404), PA(68-03573), VA(460177),
AK, AR, IA, KY, MA, MS, ND, NH, NV, OK, OR, UT, WA, WV
This report shall not be reproduced, except in its entirety, without the written approval of SGS.
Test results relate only to samples analyzed.
SGS North America Inc. • 4405 Vineland Road • Suite C-15 • Orlando, FL 32811 • tel: [phone] • fax: [phone]
SGS is the sole authority for authorizing edits or modifications to this document. Please share your ideas about �
Unauthorized mG
modification of this report is stricth, prohibited. how we can serve you better at:
Review standard terms at: http://wxvN%.sgs.coni-en/terms-and-conditions EHS.US.Customert:are t7sgs.com
i of 15
FA54556

Sections:
Table of Contents
-1-
Section1: Sample Summary................................................................................................... 3
Section2: Summary of Hits.................................................................................................... 4
Section3: Sample Results........................................................................................................ 5
It: FA54556-1: SLUDGE SAMPLE.................................................................................. 6
3.2: FA54556-IA: SLUDGE SAMPLE............................................................................... 7
3.3: FA54556-IL: SLUDGE SAMPLE............................................................................... 8
Section4: Misc. Forms............................................................................................................ 13
4.1: Chain of Custody........................................................................................................... 14
2of15
_ SGS. _
FA54556

SGS North America Inc.
Sample Summary
Environment 1, Inc
Job No: FA54556
Suez Water, Ramseur WWTP; Clem coons, NC
Project No: 965
Sample
Collected
Matrix
Client
Number
Date Time By
Received Code Type
Sample ID
FA54556-1 05/22/18 10:20 MJ 05/29/18 SO Sludge SLUDGE SAMPLE
FA54556-IA
05/22/18
10:20 MJ
05/29/18
AQ
Water
SLUDGE SAMPLE
FA54556-IL
05/22/18
10:20 MJ
05/29/18
SO
Sludge
SLUDGE SAMPLE
Soil samples reported on a dry weight basis unless otherwise indicated on result page.
1�
3of15
__SGS
FA54556

Summary of Hits
Job Number: FA54556
Account: Environment 1, Inc
Project: Suez Water, Ramseur WWTP; Clemmons, NC
Collected: 05/22/18
Page 1 of 1
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FA54556-1 SLUDGE SAMPLE
Ignitability (Flashpoint) a > 200
FA54556-IA SLUDGE SAMPLE
Corrosivity as pH 6.8
FA54556-IL SLUDGE SAMPLE
No hits reported in this sample.
(a) Not ignitable.
Deg. F SW846 1010
su SW846 CHAP?
4of15
SGS'
FA54556

CGS
Orla
Sample Results
Report of Analysis
Section 3
cc 5of15
FA54556

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA54556-1 Date Sampled: 05/22/18
Matrix: SO - Sludge Date Received: 05/29/18
Percent Solids: 6.8
Project: Suez Water, Ramseur WWTP; Clemmons, NC
General Chemistry
Analyte
Result
Cyanide Reactivity a
< 21
Ignitability (Flashpoint) b
> 200
Solids, Percent
6.8
Sulfide Reactivity a
< 710
(a) Sample analyzed beyond
hold time.
(b) Not ignitable.
RL = Reporting Limit
Page 1 of 1
RL Units
DF
Analyzed
By
Method
21 mg/kg
1
06/09/18 12:19
KH
SW846 CHAP?
Deg. F
1
06/14/18 13:49
BW
SW846 1010
%
1
06/07/18 13:51
JC
SM19 2540G
710 mg/kg
1
06/09/18 14:15
BW
SW846 CHAP7
SGS_
6of15
FA54556

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA54556-1A Date Sampled: 05/22/18
Matrix: AQ - Water Date Received: 05/29/18
Percent Solids: 6.8
Project: Suez Water, Ramseur WWTP; Clemmons, NC
General Chemistry
Analyte Result RL Units DF
Corrosivity as pH 6.8. su 1
RL = Reporting Limit
Page 1 of 1
Analyzed By Method
06/11/18 BR SW846 CHAP?
7
—SGot15_
FA54556

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA54556-IL Date Sampled: 05/22/18
Matrix: SO - Sludge Date Received: 05/29/18
Method: SW846 8260B SW846 1311 Percent Solids: 6.8
Project: Suez Water, Ramseur WWTP; Clemmons, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 M0103337.1) 10 06/05/18 14:18 AB 06/04/18 12:45 OP70327 VM4454
Run #2
Purge Volume
Run #1 5.0 ml
Run #2
VOA TCLP List
CAS No.
Compound
Result
HW#
MCL RL
71-43-2
Benzene
ND
D018
0.50 0.010
78-93-3
2-Butanone (MEK)
ND
D035
200 0.050
56-23-5
Carbon Tetrachloride
ND
D019
0.50 0.010
108-90-7
Chlorobenzene
ND
D021
100 0.010
67-66-3
Chloroform
ND
D022
6.0 0.010
106-46-7
IA-Dichlorobenzene
ND
D027
7.5 0.010
107-06-2
1,2-Dichloroethane
ND
D028
0.50 0.010
75-35-4
1,1-Dichloroethylene
ND
D029
0.70 0.010
127-18-4
Tetrachloroethylene
ND
D039
0.70 0.010
79-01-6
Trichloroethylene
ND
D040
0.50 0.010
75-01-4
Vinyl Chloride
ND
D043
0.20 0.010
CAS No.
Surrogate Recoveries
Run# 1
Run# 2
Limits
1868-53-7
Dibromofluoromethane
102%
83-118%
17060-07-0
1,2-Dichloroethane-D4
103%
79-125%
2037-26-5
Toluene-D8
101%
85-112%
460-00-4
4-Bromofluorobenzene
94%
83-118%
TCLP Leachate method SW846 1311
MDL
Units Q
0.0031
mg/1
0.020
mg/1
0.0036
mg/I
0.0020
mg/1
0.0030
mg/1
0.0026
mg/1
0.0031
mg/I
0.0032
mg/i
0.0022
mg/1
0.0035
mg/I
0.0041
mg/I
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
_SGS 8 of 15
FA54556

SGS North America Inc.
Report of Analysis
:lient Sample ID: SLUDGE SAMPLE
,ab Sample ID: FA54556-1L Date Sampled: 05/22/18
Ratrix: SO - Sludge Date Received: 05/29/18
Rthod: SW846 8270D SW846 3510C Percent Solids: 6.8
roject: Suez Water, Ramseur WWTP; Clemmons, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 61701197.1) 1 06/04/18 18:11 NJ 06/02/18 08:45 OP70324 S6F45
Run #2
Initial Volume Final Volume
'.un #1 100 ml 1.0 ml
'.un #2
ABN TCLP List
CAS No. Compound
95-48-7 2-Methylphenol
3&4-Methylphenol
87-86-5
Pentachlorophenol
95-95-4
2,4,5-Trichlorophenol
88-06-2
2,4,6-Trichlorophenol
106-46-7
1,4-Dichlorobenzene
121-14-2
2,4-Dinitrotoluene
118-74-1
Hexachlorobenzene
87-68-3
Hexachlorobutadiene
67-72-1
Hexachloroethane
98-95-3
Nitrobenzene
110-86-1
Pyridine
CAS No. Surrogate Recoveries
367-12-4
2-Fluorophenol
4165-62-2
Phenol-d5
118-79-6
2,4,6-Tribromophenol
4165-60-0
Nitrobenzene-d5
321-60-8
2-Fluorobiphenyl
1718-51-0
Terphenyl-d14
Result HW# MCL RL
ND, . '-, .
D023
200
0.050
D024
200
0.050
D037
100
0.25
D041
400
0.050
D042
2.0
0.050
D027
7.5
0.050
D030
0.13 0.050
ND-; `; ; , '
D032
0.13 0.050
D033
0.50 0.050
D034
3.0
0.050
2.0
0.050
:ND',': 4'r-`-:°
D038
5.0
0.10
Run# 1 Run# 2
Limits
'27% -.:,' .
t"
14-67%
,16%'
10-50%
33-118%
42-108%
40-106%
39-121%
TCLP Leachate method SW846 1311
MDL
0.0056
0.0098
0.050
0.0074
0.0075
0.0050
0.0081
0.0069
0.0050
0.016
0.0093
0.020
Units Q
mg/l
mg/1
mg/l
mg/1
mg/1
mg/1
mg/I
mg/1
mg/1
mg/1
mg/1
mg/1
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
9of15
FA54556

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA54556-11 Date Sampled: 05/22/18
Matrix: SO - Sludge Date Received: 05/29/18
Method: SW846 8151A SW846 3510C Percent Solids: 6.8
Project: Suez Water, Ramseur WWTP; Clemmons, NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 CC058449.D 1 06/04/18 21:43 NJ 06/02/18 11:45 OP70326 GCC1299
Run #2
Initial Volume Final Volume
Run #1 10.0 nil 5.0 ml
Run #2
Herbicide TCLP Leachate
CAS No.
Compound
94-75-7
2,4-D
93-72-1
2,4,5-TP (Silvex)
CAS No.
Surrogate Recoveries
19719-28-9
2,4-DCAA
TCLP Leachate method SW846 1311
Result HW# MCL RL MDL Units Q
D016 10 0.050 0.017 mg/1
ND D017 1.0 0.0050 0.0013 mg/1
Run# 1 Run# 2 Limits
73% 39-135%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
—S-Gtflofl5
FA54556

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA54556-11 Date Sampled: 05/22/18
Matrix: SO - Sludge Date Received: 05/29/18
Method: SW846 8081B SW846 3510C Percent Solids: 6.8
Project: Suez Water, Ramseur WWTP; Clemmons, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 KK89515.D 1 06/04/18 11:16 KL 06/02/18 10:30 OP70325 GKK2858
Run #2
Initial Volume Final Volume
Run #1 100 ml 5.0 ml
Run #2
Pesticide TCLP Leachate
TCLP Leachate method SW846 1311
CAS No.
Compound
Result
RW#
MCL RL
MDL
Units Q
58-89-9
gamma-BHC (Lindane)
ND
D013
0.40 0.00010
0.000022
mg/I
12789-03-6
Chlordane
ND
D020
0.030 0.0010
0.00038
mg/1
72-20-8
Endrin
ND
D012
0.020 0.00020
0.000021
mg/1
76-44-8
Heptachlor
ND
D031
0.0080 0.00010
0.000026
mg/1
1024-57-3
Heptachlor epoxide
ND
D031
0.0080 0.00010
0.000020
mg/1
72-43-5
Methoxychlor
ND
D014
10 0.00020
0.000050
mg/I
8001-35-2
Toxaphene
ND
D015
0.50 0.0050
0.0021
mg/1
CAS No.
Surrogate Recoveries
Run# 1
Run# 2
Limits
877-09-8
Tetrachloro-m-xylene
105%
42-127%
2051-24-3
Decachlorobiphenyl
76%
27-127%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
__SGS' 11 of 15
FA54556

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA54556-11 Date Sampled: 05/22/18
Matrix: SO - Sludge Date Received: 05/29/18
Percent Solids: 6.8
Project: Suez Water, Ramseur WWTP; Clemmons, NC
Page 1 of 1
Metals Analysis, TCLP Leachate SW8461311
Analyte Result HW#
MCL
RL
Units
DF
Prep
Analyzed By
Method
Prep Method
Arsenic < 010:. .' D004
5.0
0.10
mg/1
1 '
06/07/18
06/07/18
LM
SW846 6010D Z
SW846 3010A 4
Barium <;2:0 D005
100
2.0
mg/1
1
06/07/18
06/07/18
LM
SW846 6010D 2
SW846 3010A 4
Cadmium - 0,QmX,: ', D006
1.0.
0.050
mg/I
1
06/07/18
06/07/18
LM
SW846 6010D Z
SW846 3010A 4
Chromium a ;01'Q=. - D007
5.0
0.10
mg/1
1
06/07/18
06/07/18
LM
SW846 6010D Z
SW846 3010A 4
Lead ;< 0050s _;` D008
5.0
0.050
mg/1
1
06/07/18
06/07/18
LM
SW846 6010D Z
SW846 3010A 4
Mercury ' <'0' 0050: �:, D009
0.20
0'.0050
mg/1
1
06/04/18
06/04/18
Jc
SW846 7470A 1
SW846 7470A 3
Selenium c;O`a'O'`;,, ` ; DO10
1.0
0.10
mg/1
1
06/07/18
06/07/18
LM
SW846 6010D 2
SW846 3010A 4
,��..
Silver:,. D011
5.0
0.10
mg/1
1
06/01/18
06/07/18
LM
SW846 6010D Z
SW846 3010A 4
(1) Instrument QC Batch: MA14944
(2) Instrument QC Batch: MA14956
(3) Prep QC Batch: MP33830
(4) Prep QC Batch: MP33852
RL = Reporting Limit
MCL = Maximum Contamination Level (40 CFR 261 711/11)
12of16
FA54556

SGS
Orlar
Section 4
Misc. Forms
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
SG� 13 of 15
a FA54656

P.O. Box 7085, 114 Oakmont Dr.
Greenville, NC 27858
environment I inc.com
Phone [phone] • Fax [phone]
FECTION
HLORINE
FLI
CLIENT950 Week. 7 .
V
I IUEZ WATER (RAMSEM WTP-SLUDGE)
❑ NONE
°lAD1NE BLACHWELL
Y.O. BOX 1279
CLEMMONS NC 27012
❑
�z
Eo
[phone]
z
COLLECTION
a Weo8 4�
U 6
� ul
SAMPLELOCA110N
DATE TIME
o¢
as-ru 1W0
0
r
BY(SIG.) DATERIME
v PLEASE READ Instruct
-
FOR 125 ions for completin
� 18 l0'30
r.
CHAIN OF CUSTODY RECORDS44 5 `6
I�ro
CLASSIFICATION:
lm 12110
WASTEWATER(NPDES)
DRINIONGWATER
❑
❑
❑ DWO/GW
SOLIDWASTESECTION
❑,
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
C9 N
SAMPLES COLLECTED BY.(Please Prim)
CHLO,
pHCHECI
�O °tenet
P
P
P P
P
P
G
G
G
G
G
OONTAINER',
A A A
A
A
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A
A
A
A
CHEMICALPflE�
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D-NAOH
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a
w
8-HNO,
E-HCL
C-HzSO,
F-ZINCACETATEMAOH
NATHIOSULFATE
F
a
I on the reverse side.
ezwAep
SAMPLES RECEIVED INLA13AT V ' Y -C
" ""� COMMENTS:
1300 0
DATEMME
lie sq
Sampler must place a "C" for composite sample or a "G" for
Grab sample in the blocks above for each parameter requested. N2 342417
FA54556: Chain ®f Custody
Page 1 ®f 2
rkf%ot1 14 of 15
_buk
FA54556

SGS Sample Receipt Summary
Job Number: FA54556 Client: ENV 1 INC Project: 950
Date / Time Received: 5/29/2018 9:00:00 AM Delivery Method: FX Airbill 99: 1001891783790003281100439402209589
Therm ID: IR 1; Therm CF: 0.4; # of Coolers: 1
Cooler Temps (Raw Measured)'C: Cooler 1: (20.4);
Cooler Temps (Corrected) IC: Cooler 1: (20.8);
Cooler Information
Y or
N
Samole Information
Y or
N
NIA
1. Custody Seals Present
®
❑
1. Sample labels present on bottles
®
❑
2. Custody Seals Intact
®
❑
2. Samples preserved property
®
❑
3. Temp criteria achieved
❑
®
3. Sufficient volume/containers recvd for analysis:
®
❑
4. Cooler temp verification
IR Gun
4. Condition of sample
IOtasd
5. Cooler media
Ice (Bao)
5. Sample recvd within HT
®
❑
S. Dates/fimes/IDs on CDC match Sample Label
®
❑
Trio Blank Information
Y or
N N/A
7. VOCs have headspace
❑
❑
1. Trip Blank present / cooler
❑
❑ ®
S. Bottles received for unspecified tests
❑
10
2. Trip Blank listed on CDC
❑
❑ ®
9. Compositing instructions dear
❑
❑
W
or S N/A
10. Voa Soil Kits/Jars received past 48hrs?
❑
❑
11. % Solids Jar received?
❑
❑
12
3. Type Of TB Received
❑
❑ ®
12. Residual Chlorine Present?
❑
❑
Misc. information
Number of Encores: 25-Gram 5-Gram Number of 5035 Field Kits: Number of Lab Filtered Metals:
Test Strip Lot #s: pH 0-3 230315 pH 10-12 219813A Other. (Specty)
Residual Chlorine Test Strip Lot #:
Comments RECEIVED 5 BOTTLES CDC READS 5,TEMPERATURE CRITERIA NOT MET
snout Ray. Date 05R//17 Technician: JORGEC Date: 529/2018 9:00:00 AM Reviewer. Date:
FA54556: Chain of Custody
Page 2 of 2
15 Of 15
FA54556

CHAIN OF CUSTODY
Sample Location: (W a I Z f C
Sample Collection Date: S -A P, - )
Sample Collection Time: t D• Z D n
Person Collecting Sample Name/Signature M WlS C fOs ,,
Parameter
Analysis Time
Result I Analyst Name
Analyst Sig ature
pH
/a O
7 ►V-Osr
Temperature
Samples Sent to Laboratory for additional analyses? OYES NO
Comments:
Attach copy of commercial lalmratory Chain of Custody to this form

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Facility Name: Town of Ramseur
WWTP Name: Ramseur WWTP
WQ Permit Number:
NPDES Number:
WQ0010528
NCO026565
Monitoring Period: From 1/1/2018 To 12/31/2018
Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed:
Class A:
Alt. A (time/temp) ❑
I Alt B (Alk Treatment)❑
Alt. C (Prior Testing)..
A1t.D (No Prior Test) J
Process to Further Reduce Pathogengs ❑
If applicable to alternative
performed (Class A only indicate "Process to Further Reduce Pathogens":
Compost ❑
Heat Drying ❑
Heat Treatment L1
Therrnophilic
Beta Ray ❑
Gamma Ray ❑
Pasteurization r]
Class B:
jAlt. (1) Fecal Density ❑
Alt. (2) Process to Significantly Reduce Pathogens ' 1
If applicable to alternative
performed (Class
B only) indicate "Process to Significantly_ Reduce Pathogens":
Lime Stabilization R)
Air Drying ❑
Composting ❑
Aerobic Digestion ❑
Anaerobic Digestion ❑
If applicable to alternative performed (Class A or Class B) complete the following
monitoring data:
Parameter
Allowable Level
in Sludge
Pathogen Density
Number ot
Excee-
n
Frequency
of Analysis
Sample
Type
Analytical
Tech -
nia
Minim
Geo. Mean
MaximumUnits
Fecal Coliform
2 x 10 to the
6th power
per gram of
total solids
MPN
CFU
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria
(in lieu of fecal
coliform)
3 MPN per 4 grams
total solid (dry
weight)
'ector Attraction Reduction (15A NCAC 02T .1107) - Please indicate alternative performed:
Alt.1 (VS reduction) ❑
Alt. 2 (40-day bench) F1
Alt. 3 (30-day bench) ❑
Alt. 4 (Spec. 02 uptake) ❑
Alt. 5 (14-Day Aerobic) ❑
Alt. 6 (Alk. Stabilization P-1
Alt 7 (Drying - Stable) ❑
Alt. 8 (Drying - Unstable)
Alt. 9 (Injection) ; l
Alt. 10 (Incorporation) ❑
No vector attraction reduction alternatives were performed [.3
CERTIFICATION STATEMENT (please check the appropriate statement)
C! "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have been met."
"I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
err �tw o•� lM ��.
Preparer ame and Title (type or print)
gnatu of Preparer*
Land Applier Name and Title (if applicable)(type or print)
1-3/-tq
Date Signature of Land Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM PVRF 02T (12/2006)

Jan.24.2019 05:59 PM Ramseur WWTP
3368243939
PAGE.
4/ 13
a
�t (_ LIMB LOS SHEET'
Month 11 � o-V-(' � year
z r8
DATE
GAL. WAgYkb
Initial TEMP ■C
imit'1111 pN, SU
6.5
18S OF LIME o
b Q
TIME
PH, 5U
MP
� 5
Temp Correctod PH, 5U
p aftvr2M
TEMP "C; wfter 2 ARS
amp Mrocted p ,
, t .ass
PH elFtar 94 HR9
?j
MP'C after 24 HRS
Temp Corra ted ph, su
H Correction
Trim C
Correction
4
P Ys 0.4 5
39
Pus 0,42
515
rlus 13.19
37
Plus 0,36
36
Plus 0,33
35
Plus 0.30
1210.0 0.27
Yri 0.2h
32
Plus 0.21
31
us .
3
u1, 8.15
29
t, 3, 7 Z
Plus 0.09
28
27
Plus 0.05
26
�d25 .�
Plus 0,03
U
A-4
Minue 0.03
38
Minus 0106
22
Minus 0,09
3).
Minus 0.1.2
_ ZG
Mh1Y5 0,15
'" ip
Minur+ o,ao
18
Minus 0.21
17
Minus 0.24
16
Minus 0.27
1S
Minut; 0,
14
Inur0.33
13
Minus 0.36
32
Minus 0.39
11
Mlnut 0.42
10
Mlnua 0.45
"I certify, tinder peneity of low, that the Cis6s 9 pathogen requlrements in 4n (,rn, part sna,a7.th1 hmm hen 1nuL arid tale vector attraction raduetlon requirement in 40
CVIL part 503,33113)14) Raft (f,) 11eu11. I,cn111,,,ot. Tltly detvrminiMon hlit bias mad& unt lar My direatien and nupervixton In accarderic4 with thw bv&Lvm desig►red to eitsure.
that aualified pomonnal propedy gather and 1evalwao. u,M IrI ftq�Iptlon vied to dearmina pt3r tho pothuren and vector attraction roductlan trqulre►mnts pawn lisom nut.
I vie+ swore thn there era alAnlficont penalties tof frlA& aeltifleetiein Irtrl"1Nny (lufp, earl lotptlNU 111 11t. "
PrinwU Name & Title
311sn,Itut e
rz� KM