0601_ROSCANS_1988

OPERATION/CONSTRUCTION MANAGERS
Municipal
P.O. Box 97. Garner, North Carolina 27529 [phone]
January 19, 1988
Ms. Kathryn G. Hemphill
Attorney
Post Office Box 758
Newland, North Carolina 28057
Re: Site INspection (January 5, 1988)
Construction Project at Landfill
Dear Ms. Hemphill:
CIVIL/SANITARY ENGINEERS
En ineerin
P.O. Box 349, Boone, North Carolina 28607 [phone]
Following this inspection, 1 veririeo to my sazisraczion znaz no compacz1on
had been performed on the entire roadway subgrade or the stone surface of
the roadway and that the subgrade stabilization material was not "an equal"
of the specified Dupont-Typar 3601 Nonwoven Geotextile material (Sample and
Specifications are attached.)
The subgrade was to have been compacted to 95% (Standard Proctor, Maximum
Density) and the stone base .was to have been 8'.' compacted S. A. B. C. My
investigation determined that no.r.ollers were utilized on either the sub -
grade or the stone and that the average depth of the stone was no more than
6" of non -compacted stone.
The only item on the previous inspection report.(December 2, 1987) that had
been attended to was the placement of some hay bales in the severely eroded
sections of the Diversion Ditch on the east side of the existing landfill.
I feel that the County of Avery .should institute a civil suit against the
Contractor (Cuthbertson) to obtain a satisfactory settlement of the total
damages caused the County by his total.lack of regard for the original plans
and specifications and his non-performance of corrective measures as
delineated at the meeting on December 2, 1987.
If we can be of further service to -the County of Avery concerning a civil
suit against the contractor, please let me know.
Very truly yours,
Ralph F. Owens
RFO:cw

N.C. DEPARTMENT OF HUMAN RESOURCES
WEATHER CONDITIONS DIVISION OF HEALTH SERVICES PERMIT NUMBf9
INSPECTION FOR SANITARY LANDFILLS
NAME Of SITE CY
OUNT
LOCATION ( SI-GNATU-R_E-O-_F_PERSON(S) RECEIVING REPORT__
y
SiRTAN-INSPE-CTION-OF YOUR -LAND DISPOSAL SITE HAS BEEN MADE THIS DATE AND -YOU ARE NOTIFIED OF THE -VIOLATIONS, -IF -ANY,, MARKED BELOW
WITH A CROSS (X).
(].) PI AN AN PERMIT REQI IIRPM ENTS (A) SIGN —REQUIREMENTS
(a) Construction plans shall be approved and followed. (a) Signs providing information on dumping procedures, the hours
(b) Specified monitoring and reporting requirements shall be met. during which the site is open for public use, the permit number
(2) SPREADING AND COMPACTING REQUIREMENTS and other pertinent information shall be posted at the site
entrance.
— (a) Solid waste shall be restricted into the smallest area feasible. _ (b) Signs shall be posted stating that no hazardous or liquid waste
_(b) Solid waste shall be compacted as densely as practical into cells. can be received without written permission from the division.
(3) COVER REQUIREMENTS if: k h I d d
(a) Solid waste shall be covered after each day of operation, with a
compacted layer of at least six inches of suitable cover or as
specified by the division.
(b) Areas which will not have additional wastes placed on them for
12 months or more shall be covered with a minimum of one foot
of intermediate cover.
(c) After final termination of disposal operations at the site or a
major part thereof or upon revocation of a permit, the area shall
be covered with at least two feet of suitable compacted earth.
(4) EROSION CONTROL REQUIREMENTS
— (a) Adequate erosion control measures shall be practiced to pre-
vent silt from leaving the site.
- -- (b) Adequateerosioncontrol measures shall be practiced to pre-
vent excessive on -site erosion.
(5) DRAINAGE CONTROL REQUIREMENTS
(a) Surface water shall be diverted from the operational area.
(b) Surface water shall not be impounded over or in waste.
— (c) Completed areas shall be adequately sloped to allow surface
water runoff in a controlled manner.
(6) VEGETATION REQUIREMENTS
(a) Within six months after final termination of disposal operations
at the site on a major part thereof or upon revocation of a
permit, the area shall be stabilized with native grasses.
(b) Temporary seeding will be utilized as necessary to stabilize the
site.
(7) WATER PROTECTION REQUIREMENTS
(a) The separation distance of four (4) feet between waste and
water table shall be maintained unless otherwise specified by
the division in the permit.
(b) Solid waste shall not be disposed of in water.
(c) Leachate shall be contained on site or properly treated prior to
discharge. An NPDES permit may be required prior to the dis-
charge of leachate to surface waters.
(8) ACCESS AND SECURITY REQUIREMENTS
(a) The site shall be adequately secured by means of gates, chains,
berms, fences, and other security measures approved by the
division, to prevent unauthorized entry.
— (b) An attendant shall be on duty at the site at all times while it is
open for public use to ensure compliance with operational
requirements.
(c) The access road to the site shall be of all-weather construction
and maintained in good condition.
(d) Dust control measures shall be implemented where necessary.
REMARKS
DATE
NAME:
-(c, Tra Ic signs or mar ers s a I be prove a as necessary to pro-
mote an orderly traffic pattern to and from the discharge area
and to maintain efficient operating conditions.
(10) SAFETY REQUIREMENTS
— (a) Open burning of solid waste is prohibited.
(b) Equipment shall be provided to control accidental fires or
arrangements shall be made with the local fire protection
agency to immediately provide fire -fighting services when
needed.
— (c) Fires that occur at a sanitary landfill shall be reported to the
division within 24 hours and a written notification shall be
submitted within 15 days.
(d) The removal of solid waste from a sanitary landfill is prohibited
unless the owner/operator approves and the removal is not
performed on the working face.
(e) Baelsand drums shall -not beclispoised ofunless the at
Y
and perforated sufficiently to ensure that no liquid or hazard-
ous waste is contained therein.
(11) WASTE ACCEPTANCE AND DISPOSAL REQUIREMENTS
— (a) A site shall only accept those solid wastes which it is permitted to
receive.
(b) No hazardous, liquid, or infectious waste shall be accepted or
disposed of in a sanitary landfill except as may be approved by
the division.
(c) Spoiled foods, animal carcasses, abattoir waste, hatchery waste,
and other animal waste delivered to the disposal site shall be
covered immediately.
(d) Asbestos waste that is packaged in accordance with 40 CFR 61, as
amended through January 1,1985, may be disposed of separate
and apart from other solid wastes at the bottom of the working
face or in an area not contiguous with other disposal areas, in
either case, in virgin soil. Separate areas shall be clearly marked
so that asbestos is not exposed by future land -disturbing activi-
ties. The waste shall be covered immediately with soil in a
manner that will not cause airborne conditions. Copies of 40
CFR 61 may be obtained and inspected at the Solid and Hazard-
ous Waste Management Branch, Division of Health Services,
P. O. Box 2091, Raleigh, NC, 27602.
(12) MISCELLANEOUS REQUIREMENTS
(a) Effective vector control measures shall be applied to control
flies, rodents, and other insects or vermin when necessary.
(b) Appropriate methods such as fencing and diking shall be pro-
vided within the area to confine solid waste subject to be blown
by the wind. At the conclusion of each day of operation, all
windblown material resulting from the operation shall be col-
lected and returned to the area by the owner or operator.
Solid and Hazardous Waste Management Branch
DHS 1709 (Revised 4/85)
Solid & Hazardous Waste Management Branch (Review 4/86) (white — Raleigh Office yellow — Facility green — Preparer)

N.C. DEPARTMENT OF HUMAN RESOURCES
WEATHER CONDITIONS DIVISION OF HEALTH SERVICES PERMIT NUMBR
INSPECTION FOR SANITARY LANDFILLS
NAME OF SITE
CK619►ri7
LOCATION �'J- _, SIGNATURE OF PERSON(S) RECEIVING_ REPORT
- -
—SIR: AN-fNSP-EC-TIOiNbfYOUR-LAND-DISPOSAL SITE HAS BEEN -MADE THIS DATE AND -YOU ARE -NOTIFIED OF THE VIOLATIONS, IF ANY, MARKED BELOW-
WITH A CROSS (X).
— (a) Construction plans shall be approved and followed.
(b) Specified monitoring and reporting requirements shall be met.
(2) SPREADING AND COMPACTING REQUIREMENTS
(a) Solid waste shall be restricted into the smallest area feasible.
— (b) Solid waste shall be compacted as densely as practical into cells.
(3) COVER REQUIREMENTS
— (a) Solid waste shall be covered after each day of operation, with a
compacted layer of at least six inches of suitable cover or as
specified by the division.
(b) Areas which will not have additional wastes placed on them for
12 months or more shall be covered with a minimum of one foot
of intermediate cover.
(c) After final termination of disposal operations at the site or a
major part thereof or upon revocation of a permit, the area shall
be covered with at least two feet of suitable compacted earth.
(4) EROSION CONTROL REQUIREMENTS
— (a) Adequate erosion control measures shall be practiced to pre-
vent silt from leaving the site.
- - — (b) Adequate erosion control measures shall be practiced to pre-
vent excessive on -site erosion.
(10)
(5) DRAINAGE CONTROL REQUIREMENTS
— (a) Surface water shall be diverted from the operational area.
— (b) Surface water shall not be impounded over or in waste. (11)
(c) Completed areas shall be adequately sloped to allow surface
water runoff in a controlled manner.
(6) VEGETATION REQUIREMENTS
(a) Within six months after final termination of disposal operations
at the site on a major part thereof or upon revocation of a
permit, the area shall be stabilized with native grasses.
(b) Temporary seeding will be utilized as necessary to stabilize the
site.
(7) WATER PROTECTION REQUIREMENTS
—(a) The separation distance of four (4) feet between waste and
water table shall be maintained unless otherwise specified by
the division in the permit.
(b) Solid waste shall not be disposed of in water.
(c) Leachate shall be contained on site or properly treated prior to
discharge. An NPDES permit may be required prior to the dis-
charge of leachate to surface waters.
(a) Signs providing information on dumping procedures, the hours
during which the site is open for public use, the permit number
and other pertinent information shall be posted at the site
entrance.
— (b) Signs shall be posted stating that no hazardous or liquid waste
can be received without written permission from the division.
— (c) Traffic signs or markers shall be provided as necessary to pro-
mote an orderly traffic pattern to and from the discharge area
and to maintain efficient operating conditions.
SAFETY REQUIREMENTS
(a) Open burning of solid waste is prohibited.
(b) Equipment shall be provided to control accidental fires or
arrangements shall be made with the local fire protection
agency to immediately provide fire -fighting services when
needed.
— (c) Fires that occur at a sanitary landfill shall be reported to the
division within 24 hours and a written notification shall be
submitted within 15 days.
(d) The removal of solid waste from a sanitary landfill is prohibited
unless the owner/operator approves and the removal is not
performed on the working face.
(e)-Barrels and drums sha►► not bedisposeclof unless they are empty -
and perforated sufficiently to ensure that no liquid or hazard-
ous waste is contained therein.
WASTE ACCEPTANCE AND DISPOSAL REQUIREMENTS
— (a) A site shall only accept those solid wastes which it is permitted to
receive.
(b) No hazardous, liquid, or infectious waste shall be accepted or
disposed of in a sanitary landfill except as may be approved by
the division.
(c) Spoiled foods, animal carcasses, abattoir waste, hatchery waste,
and other animal waste delivered to the disposal site shall be
covered immediately.
(d) Asbestos waste that is packaged in accordance with 40 CFR 61, as
amended through January 1,1985, may be disposed of separate
and apart from other solid wastes at the bottom of the working
face or in an area not contiguous with other disposal areas, in
either case, in virgin soil. Separate areas shall be clearly marked
so that asbestos is not exposed by future land -disturbing activi-
ties. The waste shall be covered immediately with soil in a
manner that will not cause airborne conditions. Copies of 40
CFR 61 may be obtained and inspected at the Solid and Hazard-
(8) ACCESS AND SECURITY REQUIREMENTS ous Waste Management Branch, Division of Health Services,
(a) The site shall be adequately secured by means of gates, chains, P. O. Box 2091, Raleigh, NC, 27602.
berms, fences, and other security measures approved by the (12) MISCELLANEOUS REQUIREMENTS
division, to prevent unauthorized entry. (a) Effective vector control measures shall be applied to control
(b) An attendant shall be on duty at the site at all times while it is flies, rodents, and other insects or vermin when necessary.
open for public use to ensure compliance with operational (b) Appropriate methods such as fencing and diking shall be pro -
requirements. vided within the area to confine solid waste subject to be blown
(c) The access road to the site shall be of all-weather construction by the wind. At the conclusion of each day of operation, all
and maintained in good condition. windblown material resulting from the operation shall be col-
- (d) Dust control measures shall be implemented where necessary. lected and returned to the area by the owner or operator.
REMARKS:/
DATE: ( NAME:
Solid and Hazardous Waste Management Branch (� A
DHS 1709 (Revised 4/85)- - ; ` ;. , � ! 0
Solid & Hazardous Waste Management Branch (Review 4/86) (white — Raleigh Office yellow — Facility green — Preparer)

N.C. DEPARTMENT OF HUMAN RESOURCES
WEATHER CONDITIONS DIVISION OF HEALTH SERVICES PERMIT NUMkA
INSPECTION FOR SANITARY LANDFILLS
NAME OF SITE COUNTY
LOCATION_ SIGNATURE OF PERSON(S) RECEIVING REPORT ----- —
ANIFfSPFC ION OF YOUR LAND DISPOSAL SITE HAS El_N ADETHISDATEANDYOUARE NOTIFIED OFTHE VIOLATIONS, IFANY, MARKED BELOW
WITH A CROSS (X).
9}-SiGN-REQUIREME_N T-S
(a) Construction plans shall be approved and followed. — (a) Signs providing information on dumping procedures, the hours
(b) Specified monitoring and reporting requirements shall be met. during which the site is open for public use, the permit number
and other pertinent information shall be posted at the site
(2) SPREADING AND COMPACTING REQUIREMENTS entrance.
(a) Solid waste shall be restricted into the smallest area feasible. _ (b) Signs shall be posted stating that no hazardous or liquid waste
(b) Solid waste shall be compacted as densely as practical into cells. can be received without written permission from the division.
(3) COVER REQUIREMENTS
(a) Solid waste shall be covered after each day of operation, with a
compacted layer of at least six inches of suitable cover or as
specified by the division.
— (b) Areas which will not have additional wastes placed on them for
12 months or more shall be covered with a minimum of one foot
of intermediate cover.
(c) After final termination of disposal operations at the site or a
major part thereof or upon revocation of a permit, the area shall
be covered with at least two feet of suitable compacted earth.
(10)
(4) EROSION CONTROL REQUIREMENTS
(a) Adequate erosion control measures shall be practiced to pre-
vent silt from leaving the site.
(b) Adequate erosion control measures shall be practiced to pre-
vent excessive -on -site erosion. - - - - - -
(5) DRAINAGE CONTROL REQUIREMENTS
— (a) Surface water shall be diverted from the operational area.
(b) Surface water shall not be impounded over or in waste.
(c) Completed areas shall be adequately sloped to allow surface
water runoff in a controlled manner.
(6) VEGETATION REQUIREMENTS
(a) Within six months after final termination of disposal operations
at the site on a major part thereof or upon revocation of a
permit, the area shall be stabilized with native grasses.
(b) Temporary seeding will be utilized as necessary to stabilize the
site.
(7) WATER PROTECTION REQUIREMENTS
(a) The separation distance of four (4) feet between waste and
water table shall be maintained unless otherwise specified by
the division in the permit.
(b) Solid waste shall not be disposed of in water.
(c) Leachate shall be contained on site or properly treated prior to
discharge. An NPDES permit may be required prior to the dis-
charge of leachate to surface waters.
(8) ACCESS AND SECURITY REQUIREMENTS
(a) The site shall be adequately secured by means of gates, chains,
berms, fences, and other security measures approved by the
division, to prevent unauthorized entry.
(b) An attendant shall be on duty at the site at all times while it is
open for public use to ensure compliance with operational
requirements.
(c) The access road to the site shall be of all-weather construction
and maintained in good condition.
(d) Dust control measures shall be implemented where necessary.
REMARKS
DATE
NAME:
(c) Traffic signs or markers shall be provided as necessary to pro-
mote an orderly traffic pattern to and from the discharge area
and to maintain efficient operating conditions.
SAFETY REQUIREMENTS
— (a) Open burning of solid waste is prohibited.
— (b) Equipment shall be provided to control accidental fires or
arrangements shall be made with the local fire protection
agency to immediately provide fire -fighting services when
needed.
(c) Fires that occur at a sanitary landfill shall be reported to the
division within 24 hours and a written notification shall be
submitted within 15 days.
(d) The removal of solid waste from a sanitary landfill is prohibited
unless the owner/operator approves and the removal is not
performed on the working face.
- (e) Barrels and drums shall not be disposed of unless they are empty
and perforated sufficiently to ensure that no liquid or hazard-
ous waste is contained therein.
(11) WASTE ACCEPTANCE AND DISPOSAL REQUIREMENTS
— (a) A site shall only accept those solid wastes which it is permitted to
receive.
(b) No hazardous, liquid, or infectious waste shall be accepted or
disposed of in a sanitary landfill except as may be approved by
the division.
— (c) Spoiled foods, animal carcasses, abattoir waste, hatchery waste,
and other animal waste delivered to the disposal site shall be
covered immediately.
— (d) Asbestos waste that is packaged in accordance with 40 CFR 61, as
amended through January 1,1985, may be disposed of separate
and apart from other solid wastes at the bottom of the working
face or in an area not contiguous with other disposal areas, in
either case, in virgin soil. Separate areas shall be clearly marked
so that asbestos is not exposed by future land -disturbing activi-
ties. The waste shall be covered immediately with soil in a
manner that will not cause airborne conditions. Copies of 40
CFR 61 may be obtained and inspected at the Solid and Hazard-
ous Waste Management Branch, Division of Health Services,
P. O. Box 2091, Raleigh, NC, 27602.
(12) MISCELLANEOUS REQUIREMENTS
(a) Effective vector control measures shall be applied to control
flies, rodents, and other insects or vermin when necessary.
(b) Appropriate methods such as fencing and diking shall be pro-
vided within the area to confine solid waste subject to be blown
by the wind. At the conclusion of each day of operation, all
windblown material resulting from the operation shall be col-
lected and returned to the area by the owner or operator.
Solid and Hazardous Waste Management Branch
DHS 1709 (Revised 4/85)
Solid & Hazardous Waste Management Branch (Review 4/86) (white.— Raleigh Office yellow — Facility green — Preparer)

N.C. DEPARTMENT OF HUMAN RESOURCES
WEATHER CONDITIONS DIVISION OF HEALTH SERVICES PERMIT NUMBER
INSPECTION FOR SANITARY LANDFILLS
NAME OF SITE
COUNTY
LOCATION SIGNATURE _ - — _- —__ _ I SIGNATURE OF PERSON(S) RECEIVING REPORT
Tf A INSPECTION OF -YOUR LAND DISPOSAL SITE HAS BEEN MADE THIS DATE AND YOU ARE NOTIFIED OF THE VIOLATIONS, IF ANY, MARKED BELOW
WITH A CROSS (X).
"GN-REQUIREMENTS
— (a) Construction plans shall be approved and followed. — (a) Signs providing information on dumping procedures, the hours
(b) Specified monitoring and reporting requirements shall be met. during which the site is open for public use, the permit number
(2) SPREADING AND COMPACTING REQUIREMENTS and other pertinent information shall be posted at the site
entrance.
(a) Solid waste shall be restricted into the smallest area feasible. _ (b) Signs shall be posted stating that no hazardous or liquid waste
(b) Solid waste shall be compacted as densely as practical into cells. can be received without written permission from the division.
(3) COVER REQUIREMENTS
(a) Solid waste shall be covered after each day of operation, with a
compacted layer of at least six inches of suitable cover or as
specified by the division.
— (b) Areas which will not have additional wastes placed on them for
12 monthsor more shall be covered with a minimum of one foot
of intermediate cover.
(c) After final termination of disposal operations at the site or a
major part thereof or upon revocation of a permit, the area shall
be covered with at least two feet of suitable compacted earth.
(4) EROSION CONTROL REQUIREMENTS
(a) Adequate erosion control measures shall be practiced to pre-
vent silt from leaving the site.
— (b) Adequate erosion control measures shall be practiced to pre-
vent -excessive on -site erosion.-- -- --- - - -
(5) DRAINAGE CONTROL REQUIREMENTS
(a) Surface water shall be diverted from the operational area.
(b) Surface water shall not be impounded over or in waste.
(c) Completed areas shall be adequately sloped to allow surface
water runoff in a controlled manner.
(6) VEGETATION REQUIREMENTS
(a) Within six months after final termination of disposal operations
at the site on a major part thereof or upon revocation of a
permit, the area shall be stabilized with native grasses.
(b) Temporary seeding will be utilized as necessary to stabilize the
site.
(7) WATER PROTECTION REQUIREMENTS
(a) The separation distance of four (4) feet between waste and
water table shall be maintained unless otherwise specified by
the division in the permit.
(b) Solid waste shall not be disposed of in water.
(c) Leachate shall be contained on site or properly treated prior to
discharge. An NPDES permit may be required prior to the dis-
charge of leachate to surface waters.
(8) ACCESS AND SECURITY REQUIREMENTS
(a) The site shall be adequately secured by means of gates, chains,
berms, fences, and other security measures approved by the
division, to prevent unauthorized entry.
(b) An attendant shall be on duty at the site at all times while it is
open for public use to ensure compliance with operational
requirements.
(c) The access road to the site shall be of all-weather construction
and maintained in good condition.
(d) Dust control measures shall be implemented where necessary.
REMARKS
DATE
NAME:
(c) Traffic signs or markers shall be provided as necessary to pro-
mote an orderly traffic pattern to and from the discharge area
and to maintain efficient operating conditions.
(10) SAFETY REQUIREMENTS
— (a) Open burning of solid waste is prohibited.
— (b) Equipment shall be provided to control accidental fires or
arrangements shall be made with the local fire protection
agency to immediately provide fire -fighting services when
needed.
(c) Fires that occur at a sanitary landfill shall be reported to the
division within 24 hours and a written notification shall be
submitted within 15 days.
(d) The removal of solid waste from a sanitary landfill is prohibited
unless the owner/operator approves and the removal is not
performed on the working face.
—(e) Barrels and dru ms shall not be disposed of unless they are empty
and perforated sufficiently to ensure that no liquid or hazard-
ous waste is contained therein.
(11) WASTE ACCEPTANCE AND DISPOSAL REQUIREMENTS
(a) A site shal I only accept those solid wastes which it is permitted to
receive.
(b) No hazardous, liquid, or infectious waste shall be accepted or
disposed of in a sanitary landfill except as may be approved by
the division.
(c) Spoiled foods, animal carcasses, abattoir waste, hatchery waste,
and other animal waste delivered to the disposal site shall be
covered immediately.
(d) Asbestos waste that is packaged in accordance with 40 CFR 61, as
amended through January 1,1985, may be disposed of separate
and apart from other solid wastes at the bottom of the working
face or in an area not contiguous with other disposal areas, in
either case, in virgin soil. Separate areas shall be clearly marked
so that asbestos is not exposed by future land -disturbing activi-
ties. The waste shall be covered immediately with soil in a
manner that will not cause airborne conditions. Copies of 40
CFR 61 may be obtained and inspected at the Solid and Hazard-
ous Waste Management Branch, Division of Health Services,
P. O. Box 2091, Raleigh, NC, 27602.
(12) MISCELLANEOUS REQUIREMENTS
— (a) Effective vector control measures shall be applied to control
flies, rodents, and other insects or vermin when necessary.
— (b) Appropriate methods such as fencing and diking shall be pro-
vided within the area to confine solid waste subject to be blown
by the wind. At the conclusion of each day of operation, all
windblown material resulting from the operation shall be col-
lected and returned to the area by the owner or operator.
Solid and Hazardous Waste Management Branch
DHS 1709 (Revised 4/85)
Solid & Hazardous Waste Management Branch (Review 4/86) (white — Raleigh Office yellow — Facility green — Preparer)

• N.C. DEPARTMENT OF HUMAN RESOURCES
DIVISION OF HEALTH SERVICES
r LABORATORY SECTION
P . 0. BOX 28 04 7
RALEIGH, N.C. 27611
—kNtY
A
E
REPORT TO:
ADDRESS k�� I��/ , �?/ . C • �� 7 /
SOURCE COUNTY Al--=� `�
COLLECTED BY DATE %.Z// ��� TIME
PLEASE DO NOT WRITE BELOW THIS LINE
PLEASE SEE DIRECTIONS AND EXPLANATIONS ON REVERSE
COLIFORM GROUP Ph'SENT
FIVE
FIVE
FIVE
FIVE
FIVE
FIVE
FIVE
FIVE
EANTED
-
10 ml
1 ml
.1 ml
. 01 ml
. 001 ml
.0001 ml
. 00001 m
. 000001m1
NUMBER
PRESUMPTIVE
NUMBER
CGNi o"I IRMED
POS1fIVE
(J
lJ
'!UMBER
I Er,nL
O
O
TOTAL
MPN
FECAL
MPN :/.0
g A 3 2 7 8
DEC
LAB. NO. AND DATE REC'D.
DATE REPORTED - 5 198a
DNS FORM 1532 (Rev. 7/78)
LABORATOP':'

STATE LABORATORY OF PUBLIC HEALTH
DIVISION OF.HEALTH SERVICES
N.C. DEPARTMENT OF HUMAN RESOURCES
P.O. BOX 2BO47 — 306 N. WILMINGTON ST., RALEIGH 27611
— INIORGANIC-=CHEMICAGANALYSES PUBLIC WATER
1-
Complete All Items Above Heavy Line
See InsttuctidRs on Reverse -Side)
/stem :
ddress:
ZIP
aunty:
eport To:
( ► Community
( ► Non -Community
Source of Water:
( ) Ground ( ) Both
(,) Surface ( 1 Purchased
Source of Sample:
( ► Distribution Tap ( 1 House Tap
( ) Well Tap
"2_' / T,,na of Samnlp•
ddress:
O Raw
( ) Treated
Type of Treatment:
ZIP
( None
( 1 Lime
elephone-Number- ---- -�-
( Chlorinated
_(_ ) Soda Ash
Fluoridateb _
( ) Filtered
( ) Polyphosphate
( ) Water Softener
,.a ' t
ollected By:
/
AM
PM
Alum
1 1 Other
ate Collected:
Time:
Type of Sample:
ocation of Sampling Point:
Regular
( ) Private
( 4l--Tpecial
>ddress where sample was collected)
( ► Check
WATER SYSTEM I.D. NUMBER (COPY FROM MAILING LABEL)
emarks:
��_❑❑_❑❑❑
tate Drinking Water Parameters (Required)
Optional Parameters (List as needed)
Results
Results
lrsenic
' 0
mg/I
2
3arium
O.
mg/I
I
:admium
< a• ter
mg/I
'hromium
c)
mg/I
2
=luoride
(j, le
mg/I
_ead
< O• 03
mg/1
2
Mercury
D. DOO 2.
mg/I
Vitrate (as N)
/, Oo
mg/I .
Selenium
U C) U
mg/I
Silver
•C. 'U
mg I
2
)H
units
1
ron
4. /
mg/I
Manganese
�� O
mg/I
2
Date Received
Date Analyzed __
OHS Form 2887 7/79
'._aboratory
Date Reported / �" _ / �`f ' Reported By
Laboratory Number UG041�b ILL 2 Be
OWNER
Mildred A. Kerbauyh
Director

STATE LABORATORY OF PUBLIC HEALTH
DIVISION OF HEALTH SERVICES
N.C. DEPARTMENTI)F HUMAN RESOURCES
P.O. BOX 28047 — 306 N. WILMINGTON ST., RALEIGH 27611
INORGANIC CHEMICAL ANA4SES - PUBLIC WATER
Complete All Items Above Heavy Line
(See Instructions on Reverse Side)
Type of System:
a e o C� 2 ( ) Community
,/stem: ( ) Non -Community
ddress: Source of Water:
( ) Ground
ZIP ( ,k) Surface
ounty: _
eport To
-- �REC+-
vY?io �
Hcelth a�
L
(In
( ) Both
( ► Purchased
Source of Sample:
( ) Distribution Tap ( ) House Tap
( ► Well Tap
7
Type of Sample:
() Raw
( ) Treated
ddress:
ZIP
-
T pe of Treatment:
O None
( 1 Chlorinated
p Fluoridated '
( ► Filtered---
( ► Alum
( ) Lime
( ) Soda Ash
( 1 Polyphosphate
(—)—Water Softener
( 1 Other
E lephone Number:
otiected-By-: —
_
ate Collected: � / / Time- / r r
_-
Al
ocation of Sampling Point: - /
\ddress where sample was collected)
,�.'
emarks: /4'
p`
1
AM
PM
Type of Sample:
( 1 Regular
( ) Check
( ) Private
Special
WATER SYSTEM I.D. NUMBER (COPY FROM MAILING LABEL)
o❑ a❑ aa❑
Late Drinking Water Parameters (Required)
Results
Optional Parameters (List as needed)
Results
\rsenic
0
mg/I
2
_
3arium
-G O, /
mg/I
,admium
.0 O, oD�
mg/I
;hromium
U
mg/I
2;
1,,
=luoride
` G, /(
mg/I
_ead
< O,
mg/I
2
r
Aercury
Q , O
mg/I
Jitrate (as N)
< /, o O
mg/1
2
selenium
< O U Sr
mg/I
3
silver
• U S
mg I
2
iH
units
1
ron
O. / '7
mg/I
2
Aanganese
D, U
mg/I
2
)ate Received
date Analyzed _
DHS Form 2887 7/79
_aboratory
Date Reported / Reported By
ULL-
Laboratory Number
OWNER
Mildred A. Kerbaugh
Director

STATE LABORATORY OF PUBLIC HEALTH
DIVISION OF HEALTH SERVICES
N.C. DEPARTMENT OF HUMAN RESOURCES
P.O. BOX 28047 — 306 N. WILMINGTON ST., RALEIGH 27611
MIC=CHEMICAL ANALYSES — PUBLIC -
WATER -Complete All Items Above Heavy Line
-(See Instructions on Reverse Side
A.
-- -
—
,•
1t6
O ns1p° o Gos
geN
L
Health
ame of J'"1/ ,
I 1 _LZ"�
YPe-v T_. Ysmrn
1 1 Community
(stem:
( 1 Non -Community
Source of Water:
ddress:
( ) Ground
( 1 Both
ZIP
Surface
( 1 Purchased
Source of Sa le:
7 . - ,t /
Runty:
1 ► Distri ution Tap
( 1 House Tap
�/
C,
( ► Well Tap
eport To:
Type of Sample:
/
(X) Raw
( ) Treated
ddress:
Typ of Treatment:
ZIP
w (7 None
( 1 Lime
elephone-Number: (
-_
"`' ( 1 _ - Chlorinated
( ) Soda Ash
-
( ► Fluoridated _
}
( 1 Polyphosphate
allected By: '
( 1 Filtered
( 1 Water Softener
AM
PM
( ) Alum
( ) Other
ate Collected: /' .�'
Time:
Type of Sample:
ocation of Sampling Point:
t r/
Regular
( ) Private
( .1%.-
cial
\ddress where sample was collected)
( 1 Check
C_I
WATER SYSTEM I.D. NUMBER (COPY FROM MAILING LABEL)
emarks: I
. [1[1-F1n4
tate Drinking Water Parameters (Required)
Optional Parameters (List as needed)
Results
Results
>rsenic
A< 0 •
mg/I
2
3arium
G O, /
mg/I
'admium
< p. 00
mg/I
3
:hromium
U
mg/I
2
-luoride
<U , ,
mg/I
_ead
< d, 03
mg/l
2
Mercury
<D. O
mg/I
Jitrate (as N)
/ !,O
mg/I
2
selenium
D • D7)
mg/I
3
ver
O
mg I
2
,H
units
1
ron
O,
mg/I
,Ianganese
'!5'•
mg/I
2
)ate Received
Date Analyzed
DHS Form 2887 7/79
_aboratory
Date Reported _ Reported By
Laboratory Number
OWNER
Mildred A. Kerbauyh
Director