WQ0001048_Residual Annual Report 2019_20200227

an&n&ma off&w�oo&zw g'ewe&z .0G9tZ,rc>t
CMSD
POST OFFICE BOX 477
GRIFTON, NORTH CAROLINA 28530
CHARLES M. SMITHWICK, JR.
DISTRICT MANAGER
Mr. Daryl Merritt
DENR/DWR/Water Quality Section
Non -Discharge Compliance/Enforcement Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Contentnea MSD
Land Application Permit #WQ0001048
2019 Annual Report
Dear Mr. Merritt,
February 20, 2020
,tg •" � %020
Pe�i�tin9 Unit
Please find enclosed three (3) copies of the above referenced annual sludge land application program
report for the Contentnea Metropolitan Sewerage District (CMSD), Permit Number WQ0001048, for
your review.
If you should need any additional information please contact me at [phone].
Sincerely,
(�4 '/ 'e--"
Charles M. Smithwick, Jr.
Land Application ORC
Enclosure

ANNUAL LAND APPLICATION CERTIFICATION FORM K�v
WQ Permit#: 0JjpLJ<9 County: '.j7i+-;- Year: 70) C
Facility Name (as shown on permit): Onnfen4noE )- (Y%d-D
Land Application Operator: i-yxf rf). `JJ7 g-y)ui kj ( Phone:
,and application of residuals as allowed by the permit occurred during toe past calendar year?
0 Yes ❑ No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled. I-`_,3 ;, 7 2020
-
Total number of application fields in thepermit:
Za
Total number of fields utilized for land application during the year:
3
Total amount of dry tons applied during the year for all application sites:
y-Z: 30
Total number of acres utilizes for land application during the year:
Part B - Annual Compiance Statement: �n
Facility was compliant during calendar year ZG>I i with all conditions of the land a�plicC� }gr'�tt"
(including but not limited to items 1-13 below) issued by the Division of Water Resources. ❑ `Y'es ;U No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T. I 105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .1105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T .1111 were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
11) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"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."
Yermitt Name and Title (type or print) Signature f�Permittee Date
Signature of Preparer* Date Signature of Land Applier Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T .1102 (26) DENR FORM ACF (12/2006)

EXPLANATIONS FOR DEVIATIONS FOR THE 2019 ANNUAL
SLUDGE LAND APPLICATION REPORT
2-19-19 Monitoring Well #9 Total Organic Carbon 10.10 mg/L
Monitoring Well #10 Chromium 16 ug/L
Monitoring Well #14 Chromium 26 ug/L
Copper 0.077 mg/L
10-14-19 Monitoring Well #9
Fecal Coliform
16/100 ml
Monitoring Well #10
Fecal Coliform
35/100 ml
Monitoring Well #14
Fecal Coliform
7/100 ml
Monitoring Well #15
Fecal Coliform
12/100 ml
Monitoring Well #18
Fecal Coliform
200/100 ml
On June 11, 2019 Groundwater Management Associates, Inc. (GMA) performed a groundwater
evaluation at the Contentnea Metropolitan Sewerage District (CMSD) residuals land application
sites. GMA concluded "that historical reports of chromium concentrations exceeding the
groundwater standards in the monitoring wells at the facility were most likely associated with
excessive turbidity. As such, these chromium detections would be naturally occurring in the
aquifer materials. The June 11, 2019 sampling results do not indicate the presence of
groundwater contaminations by metals (such as chromium) associated with residuals land
application areas. The CMSD implemented a redevelopment program for their monitoring well
network that entailed repeated bailing of the wells to remove sediment and to reduce turbidity.
The Fecal Coliform hits in the monitoring wells during the October 14, 2019 sampling event are
believed to have been caused by contamination of the well casings due to continued exposure
during the bailing and purging of the wells prior to the sampling event. The CMSD has had all
wells disinfected in January 2020 to eliminate any contamination.

CLASS A Ai... JAL DISTRIBUTION AND MARKETING/ SURFA, DISPOSAL CERTIFICATION AND SUMMARY FOnivi
WQ PERMIT #: ;,,,jQOC O [C)4;S FACILITY NAME: CL�lliC�l�1l �. m,,�D
PHONE: 'e,52--JZU-5Sg 4 COUNTY: Pj.}+ OPERATOR: CY)af j 2-) M, 6Mj01)( i CL)Tf -
FACILITY TYPE (please check one): 13 Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
❑ Distribution and Marketing (complete Parts A, B, and C)
Was the facility in operation during the past calendar year? Yes 09 No ❑ ---► If No skip parts A, B, C and certify form below
Part A*:
Part B*:
Month
Sources(s) s) ( include NPDES # if
applicable)
Volume
(dry tons)
Recipient Information
Amendment/
Bullring Agent
Residual In
Product Out
Name(s)
Volume (dry tons)
Intended use(s)
January
February
March
April
May
June.!
July
t,WTP t 400032o77
August
September
October
November
December
Total from FORM DMSDF (sup)
Totals:
Annual (dry tons):
Amendment(s) used:
Bulking Agent(s) used:
* If more space is required, attach additional information sheets (FORM DMSDF (supp)):
Part C:
Total Number of Form DMSDF (Supp)I
Facility was compliant during the past calendar year with all conditions of the land application permit ❑ Yes
(including but not limited to items 1-3 below) issued by the Division of Water Resources: ❑ No P It 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."
.x-19.?ci?a
Signature of Permittee Date Signature of Preparer** Date
(if different from Permittee)
**Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM DMSDF (12/2006)

RESIDUAL SAMPLING SUMMARY
LAB REPORTS

ANNUAL RESIDUAL SAMri,ING 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: L)QCAc�ol04� Laboratory: 1) �/1�ffC�I�me/�% Z�l✓1C
Facility Name: L`�n}, rf,6`D 2)
Residual Source WQ # or 3)
NPDES #: 4)
WWTP Name: Conken�-n eg-fr6D 5)
Residual Anal sis Data
Parameter
(mg/kg)
Conc.
Limit
m /k a
Sample or Composite Date
�l z�
Percent Solids (%)
NA
Arsenic
75
< 2,5
Cadmium
85
Copper
4,300
Z�?
Chromium
NA
Z3
Lead
840
vD,
Mercury
57
l) .Z,5
Molybdenum
75
<6,CS
Nickel
420
t 15
Selenium
100
Zinc
7,500
�� )
Total Phosphorus
NA
313 jgp
TKN
NA
��,o
Ammonia -Nitrogen
NA
r)5,5
Nitrate and Nitrite
NA
a 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
pe7r��
bmitting false information, including the possibility of fines and imprisonment for knowing violations."
-?-I9-awc
Signature of Preparer *
Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26) DENR FORM RSSF (12/2006)

�n1Ml� T o,n qp (@n� � �n�(�,no o oTmm (� 4
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
PH (not to be used for reporting)
Aluminum, (dry wt. basis), mg/kg
Arsenic (dry wt. basis), mg/kg
t-alcium (dry wt. basis), mg/kg
admium (dry wt. basis), mg/kg
topper (dry wt. basis), mg/kg
Chromium, T.(dry wt. basis),mg/kg
Lead (dry weight basis), mg/kg
Magnesium (dry wt. basis), mg/kg
Mercury (dry wt. basis), mg/kg
Nickel (dry wt. basis), mg/kg
Potassium (dry wt. basis), mg/kg
Selenium (dry wt. basis), mg/kg
Sodium (dry wt. basis), mg/kg
Zinc (dry wt, basis), mg/kg
Total Nitrogen, mg/kg (calc)
Total Solids, %
TKN (dry wt.), mg/kg
Ammonia Nitrogen (dry wt.),mg/kg
Nitrate Nitrogen(dry wt.), mg/kg
Nitrite Nitrogen(dry wt.), mg/kg
Phosphorus, T. (dry wt.), mg/kg
Molybdenum (dry wt. basis), mg/kg
Sludge
Analysis
Method
Sample
Date Analyst
Code
3.6
04/29/19
JMS
4500HB-11
19636
05/02/19
LFJ
EPA200.7
<2.5
05/07/19
MTM
3113B-04
15246
05/02/19
LFJ
EPA200.7
1.0
05/02/19
MTM
3113B-04
271
05/02/19
LFJ
EPA200.7
23
05/02/19
LFJ
EPA200.7
25
05/08/19
MTM
3113B-04
4394
05/02/19
LFJ
EPA200.7
0.25
05/10/19
MTM
EPA7471B
15
05/02/19
LFJ
EPA200.7
6957
05/02/19
LFJ
EPA200.7
< 5.0
05/09/19
MTM
3113B-04
3081
05/15/19
LFJ
EPA200.7
721
05/02/19
LFJ
EPA200.7
47426
05/06/19
SEJ
1.57
04/29/19
JTH
254OG-11
c 40560
05/03/19
TLH
351.2 R2-93
c 1755
05/01/19
KPG
350.1 R2-93
c 6858
05/01/19
DTL
353.2 R2-93
c 7.96
05/01/19
TLH
353.2 R2-93
c 33180
05/03/19
BLD
365.4-74
< 5.0
05/02/19
LFJ
EPA200.7
Drinking Water ID: 3771-
Wastewater IDi 10
PHONE [phone]
FAX [phone]
ID#: 416
DATE COLLECTED: 04/29/19
DATE REPORTEI) : 05/15/19
A D y 1
REVIEWED BY: ✓/(
c Uncertified data. DWR does not offer non -aqueous certification for this analytical procedure.

TCLP LAB REPORTS

Orlando, FL
The results set forth herein are provided by SGS North America Inc.
Technical Report for
Environment 1, Inc
Contentnea Metro Sewage District; Grifton, NC
416
SGS Job Number: FA62888
Sampling Date: 03/26/19
Report to:
Environment 1, Inc
PO Box 7085
Greenville, NC 27835
dwoolard@environmentlinc. com
ATTN: Deedee Woolard
Total number of pages in report: 14
e Hardeopy 2.0
Automated Report
Test results contained within this data package meet the requirements General
Manrice, 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), N1(FLO02), NY(12022), SC(96038001)
DoD ELAP(ANAB L2229), AZ(AZO806), 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 $�V
Unauthorized modification of this report is strictly prohibited. how we can serve you better at:
Review standard terms at: http:/hvww.sgs.com/en/temis-and-conditions Eli S.US.CustomerCare(ii se; com
1 of 14
FA62888

Table of Contents Sections:
_1_
Section1: Sample Summary................................................................................................... 3
Section2: Summary of Hits.................................................................................................... 4
Section3: Sample Results........................................................................................................
3.1: FA62888-1: SLUDGE SAMPLE ............................................................................... 6
Section4: Misc. Forms .......................................................................................................... 12
4.1: Chain of Custody........................................................................................................... 13
2of14
VG _
FA62888

SGS North America Inc.
Sample Summary
Environment 1, Inc
Job No: FA62888
Contentnea Metro Sewage District; Grifton, NC
Project No: 416
Sample
Collected`
Matrix
Client
Number
Date Time By
Received Code Type
Sample ID
FA62888-1 03/26/19 09:05 KH 03/30/19 SO Sludge SLUDGE SAMPLE
Soil samples reported on a dry weight basis unless otherwise indicated on result page.
3of14
FA62888

Summary of Hits Page 1 of 1
Job Number: FA62888
Account: Environment 1, Inc
Project: Contentnea Metro Sewage District; Grifton, NC
Collected: 03/26/19
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FA62888-1 SLUDGE SAMPLE
Corrosivity as pH 6.3 su SW846 CHAP?
Ignitability (Flashpoint) a > 200 Deg. F SW846 1010A MOD
(a) Not ignitable.
SGw 4 of 14
FA62888

SGS'
Orlando, FL
Sample Results
Report of Analysis
Section 3
1�
SGS5of14
FA62888

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE.
Lab Sample ID: FA62888-1 Date Sampled: 03/26/19
Matrix: SO - Sludge Date Received: 03/30/19
Method: SW846 8260B SW846 3510C Percent Solids: 2.1
Project: Contentnea Metro Sewage District; Grifton, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 B132660.D 10 04/04/19 19:23 CV 04/02/19 15:00 OP74421 VB5355
Run #2
Purge Volume
Run #1 5.0 nd
Run #2
VOA TCLP List
CAS No.
Compound
Result
I-IW#
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
0.10 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
106%
83-118%
17060-07-0
1, 2-Dichloroethane-D4
115%
79-125%
2037-26-5
Toluene-D8
99%
85-112%
460-00-4
4-Bromofluorobenzene
90%
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/I
0.0026
mg/1
0.0031
mg/1
0.0032
mg/I
0.0022
mg/I
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
c� 6of14
FA62888

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA62888-1 Date Sampled: 03/26/19
Matrix: SO - Sludge Date Received: 03/30/19
Method: SW846 8270D SW846 3510C Percent Solids: 2.1
Project: Contentnea Metro Sewage District; Grifton, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 9I004720.1) 1 04/08/19 22:01 MV 04/06/19 08:30 OP74496 S9I171
Run #2
Initial Volume Final Volume
Run #1 100 ml 1.01111
Run #2
ABN TCLP List TCLP Leachate method SW846 1311
CAS No. Compound Result HW# MCL RL MDL Units Q
95-48-7
2-Methylphenol
ND
D023
200
0.050
0.0056
mg/1
3&4-Methylphenol
ND
D024
200
0.050
0.0098
mg/I
87-86-5
Pentachlorophenol
ND
D037
100
0.25
0.050
mg/1
95-95-4
2,4,5-Trichlorophenol
ND
D041
400
0.050
0.0074
mg/1
88-06-2
2,4,6-Trichlorophenol
ND
D042
2.0
0.050
0.0075
mg/1
106-46-7
1,4-Dichlorobenzene
ND
D027
7.5
0.050
0.0050
mg/1
121-14-2
2,4-Dinitrotoluene
ND
D030
0.13 0.050
0.0081
mg/1
118-74-1
Hexachlorobenzene
ND
D032
0.13 0.050
0.0069
mg/1
87-68-3
Hexachlorobutadiene
ND
D033
0.50 0.050
0.0050
mg/1
67-72-1
Hexachloroethane
ND
D034
3.0
0.050
0.016
mg/1
98-95-3
Nitrobenzene
ND
D036
2.0
0.050
0.0093
mg/I
110-86-1
Pyridine
ND
D038
5.0
0.10
0.020
mg/1
CAS No.
Surrogate Recoveries
Run# 1
Run# 2
Limits
367-12-4
2-Fluorophenol
29%
14-67%
4165-62-2
Phenol-d5
24%
10-50%
118-79-6
2,4,6-Tribromophenol
79%
33-118%
4165-60-0
Nitrobenzene-d5
56%
42-108%
321-60-8
2-Fluorobiphenyl
56%
40-106%
1718-51-0
Terphenyl-dl4
74%
39-121%
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
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FA62888

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA62888-1 Date Sampled: 03/26/19
Matrix: SO - Sludge Date Received: 03/30/19
Method: SW846 8151A SW846 3510C Percent Solids: 2.1
Project: Contentnea Metro Sewage District; Grifton, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 CC061615.D 1 04/09/19 05:49 RS 04/06/19 11:00 01174497 GCC1434
Run #2
Run #1
Run #2
Initial Volume Final Volume
10.0 ml 5.0 nil
Herbicide TCLP Leachate
TCLP Leachate method SW846 1311
CAS No.
Compound
Result
HW#
MCL RL
MDL Units Q
94-75-7
2,4-D
ND
D016
10 0.050
0.017 mg/I
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
93%
39-135%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1A1) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
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FA62888

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA62888-1 Date Sampled: 03/26/19
Matrix: SO - Sludge Date Received: 03/30/19
Method: SW846 8081B SW846 3510C Percent Solids: 2.1
Project: Contentnea Metro Sewage District; Grifton, NC
Page 1 of 1
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 KK93509.D 1 04/08/19 16:25 WH 04/06/19 08:00 OP74495 GKK2971
Run #2
Initial Volume Final Volume
Run #1 100 ml 5.01111
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)
ND
D013
0.40 0.00010
0.000022
mg/1
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/1
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
71%
42-127%
2051-24-3
Decachlorobiphenyl
75%
27-127%
ND = Not detected MDL = Method Detection Limit j = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/l/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
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FA62888

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA62888-1 Date Sampled: 03/26/19
Matrix: SO -Sludge Date Received: 03/30/19
Percent Solids: 2.1
(Project: Contentnea Metro Sewage District; Grifton, 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/l
1
04/11/19
04/12/19
LM
SW846 6010D 2
2
SW846 3010A 4
SW846 3010A 4
Barium < 2.0 D005
D006
100
1.0
2.0
0.050
mg/1
mg/l
1
1
04/11/19
04/11/19
04/12/19
04/12/19
LM
LM
SW846 6010D
SW846 6010D 2
SW846 3010A 4
Cadmium < 0.050
Chromium < 0.10 D007
5.0
0.10
mgA
1
04/11/19
04/12/19
LM
SW846 6010D 2
SW846 3010A 4
Lead < 0.050 D008
5.0
0.050
mg/1
1
04/11/19
04/12/19
LM
SW846 6010D 2
1
SW846 3010A 4
SW846 7470A 3
Mercury < 0.0050 D009
0.20
1.0
0.0050
0.10
mg/1
mg/1
1
1
04/04/19
04/11/19
04/04/19
64/12/19
Jc
LM
SW846 7470A
SW846 6010D 2
SW846 3010A 4
Selenium < 0.10 DO10
Silver < 0.10 D011
5.0
0.10
mg/1
1
04/11/19
04/12/19
LM
SW846 6010D 2
SW846 3010A 4
(1) Instrument QC Batch: MA15750
(2) Instrument QC Batch: MA15773
(3) Prep QC Batch: MP35316
(4) Prep QC Batch: MP35352
RL = Reporting Limit
MCL = Maximum Contamination Level (40 CFR 261 7/l/11)
er%s 10 of 14
__au
FA62888

SGS North America Inc.
Report of Analysis
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA62888-1 Date Sampled: 03/26/19
Matrix: SO -Sludge Date Received: 03/30/19
Percent Solids: 2.1
Project: Contentnea Metro Sewage District; Grifton, NC
General Chemistry
Analyte
Result
RL Units
DF
Corrosivity as pH
6.3
so
1
Cyanide Reactivity
< 72
72 mg/kg
1
Ignitability (Flashpoint) a
> 200
Deg. F
1
Solids, Percent
2.1
%
1
Sulfide Reactivity
< 2400
2400 mg/kg
1
(a) Not ignitable.
RL = Reporting Limit
Page 1 of 1
Analyzed By Method
04/11/19 15:15
BW
SW846 CHAP7
04/09/19
GW
SW846 CHAP7
04/02/19 11:15
BW
SW846 1010A MOD
04/11/19 15:22
AC
SM19 254OG
04/09/19 11:55
AC
SW846 CHAP7
_SGS 11 of 14
FA62888

SGS
Orlando, FL
Misc. Forms
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
Section 4
C
(� 12of14
_VLIc
FA62888

Environment 1, Inc.
P.O. Box 7085, 114 Oakmont Dr.
Greenville, NC 27858
nvironment I inc.com
hone [phone] • Fax [phone]
CLIENT: 416 Week:9
CMSD (SLUDGE & WELLS ACCT)
CONTEN7NEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRTFCON NC 28530
[phone]
CHAIN OF CUSTODY RECORD
FA�ZOEof I
DISINFECTION
CHLORINE NEUTRNJZED AT COLLECTION
CHLORINE
pH CHECK (LAB)
UV
NONE
P
P
P
G
G
G
G
G
CONTAINER TYPE, PIG
CHEMICALPRESERVATION
A
A
A
A
A
A
A
A
N A -NONE D-NAOH
Z
w o
¢
o
b
B-tea E-HCL
o¢
Z
z
y.
rn
a
a
C-HLS0 F-ZINCACETATEINAOH
o
g
8
.o
a¢ G-NATHIOSIAFATE
0 0
�" ¢
�
u
s
a
�
U
u
F
,a
rr��
F
U
F
f-
F
a
a
ib
5
CLASSIFICATION:
WASTEWATER(NPOES)
DRNKINGWATER
DWR(GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURINPMENT/DELIVERY
Y N
SAMPLES COLLECTED BY:
(Please P it LL''
71 �Q `emu .r7S
SAMPLES RECEIVED IN LAB AT °C
RECEI BY(SIG.)
>F/I1ME
COMMENTS:
•
RECEN (SIG.)
E
w
T P.
aw C. rU
y7-0DATFJtM�v1EA.
RECEIVED BY (SIG.
q IQ - a
Sampler must place a V for composite sample or a "G° for
f 3� j /fGrab sample in the blocks above for each parameter requested. N2 365257
FA62888: Chain of Custody
Page 1 of 2
bu __
13of14
FA62888

SGS Sample Receipt Summary
Job Number: FA62888 Client: ENVIROMENT 1, INC. Project: SLUDGE AND WELLS ACCT
pate / Time Received: 3/30/2019 9:15:00 AM Delivery Method: FED EX Airbill Vs: 1001893324360003281100486845038270
Therm ID: IR 1; Therm CF: 0.4; # of Coolers: 2
Cooler Temps (Raw Measured) "C: Cooler 1: (1.8); Cooler 2: (2.2);
Cooler Temps (Corrected) °C: Cooler 1: (2.2); Cooler 2: (2.6);
Cooler Information
1. Custody Seals Present
2. Custody Seals Intact
3. Temp criteria achieved
4. Cooler temp verification
5. Cooler media
Trio Blank Information
1. Trip Blank present / cooler
2. Trip Blank listed on COC
Y or N
® ❑
© ❑
0 ❑
IR Gun
Ice a
Y or N N/A
❑ 0 ❑
❑ 0 ❑
W or S NIA
3. Type Of TB Received ❑ ❑
Misc. Information
Number of Encores: 25-Gram 5-Gram
Test Strip Lot #s: pH 0-3 230315
Residual Chlorine Test Strip Lot #:
sample mrormaoon
1. Sample labels present on bottles
2. Samples preserved properly
3. Sufficient volume/containers recvd for analysis:
4. Condition of sample
5. Sample recvd within HT
6. Dates/rimes/IDs on COC match Sample Label
7. VOCs have headspace
8. Bottles received for unspecified tests
9. Compositing instructions clear
10. Voa Soil Kits/Jars received past 48hrs?
11. % Solids Jar received?
12. Residual Chlorine Present?
L.
©
❑
nta
❑
❑
❑�
❑
❑
❑
❑
❑
❑
66
❑
❑
Number of 5035 Field Kits: Number of Lab Filtered Metals:
pH 10A2 219813A Other. (Specify)
shoot Technician: TRINITYM Date: 3/30/2019 9:15:00 AM
Rev. Dale 0524117
Reviewer: Date:
FA62888: Chain of Custody
Page 2 of 2
14 of 14
__ SGS7
FA62888

LAND APPLICATION FIELD
SUMMARY FORMS

ANNUAL LAND APPLICATION F —,D SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: �,�� WQ Permit #: tCIC�t I� Field #:
Land Owner: (� ����-jam Annual Dry Tons Applied: Site #:
Operator: Chorl e5rf)6t -T1- Predominant Soil Series:
Crop 1 Name: &-01- -C(baCrop 1 Max. PAN: I")(v Crop 2 Name:
Acres Utilized: Z,,gL/
Acres Permitted: Z, q4
Cation Exchange Capacity (non 503): 1-4.6
Crop 2 Max. PAN:
�, �
°
°
c °
Q
Volume applied
Pp �
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
A lied er
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
�rY.
Wet
Moist
Precip.
Past 24
Hrs.
inches
>
b
oo w,
o
�
C
o
7y w
P
w�.
w ,
w.
N
w..
0
TKN
mg/kg
Z��
o
°C,°
C, w•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
P YP
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
71
....
. ....
Residuals Applications totals on FORM FSF supp (attach FORM
FSF supp to this form):
..................
TOTALS:
2C
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
SePZn
P
3-1.52�
Lime A lied
lbs/acre
O,Annual ,5
5
5O-Col?
0. U
.OIO
G `
0► O
Z3 G
:.: ...........
Date
lbs/ac
Prior Years Cumulative lbs/ac
,5a5
.5� I
q-CQ� ,
Z2,&QS
,P'P
.3b4
.4�3
'2. Z4
3
Current Cumulative lbs/ac
CU 5l0
.5o(o
I
•h�f3
Ici
0,3b�3...Permitted
C. P. L. R.****
(
3U
1338
—
z(P)
t 5
—
4
Zu
Permit PAN Limit 1st/2nd Crop
P
i Co
"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
informati9p, including the possibility of fines and imprisonment for knowing violations."
Al
Signature of Ladd Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5. Iniection/Incornoration - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: %n-i�n6a..-IYM6f� Total Dry Tons Applied (Annual): Z, 75L5
P— nit #• LoQW01C .I.td Cation Exchange Capacity (non 503 only): U. 5
rator: (' pi l9LCIL�Tr• Owner: ('Cn+M1 nta.N)6Dj Predominant Soil Series:
Acres Used: Z• S(4 Acres Permitted: Z. S(-y Site #: 13 Field #: �
pacifl„nl Analveic Data (Aeavv Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent ft
Sample or
Com-
posite
Date
1
,Zq,/q
2
3
4
5
6
7
8
9j
LOJ
11
12
% Solids
1.515v
Arsenic
G 2 , 5
Cadmium
I • D
Copper
Z71
Chromium Z3
Lead
v5
Mercury
p • Z5
Molyb-
denum
e 6.0
Nickel
1 r7
Selenium
< 5. D
Zinc
02I
Total
Phos-
us
13,31 c6O
nol FTeaw Metal Field Loadings (Calculated in lbs/acre):
Total
1
2
3
4
5
6_
L7J
L8J
9
10,1
11
12
DT/Ac./
6_�5,ia
c
App.
Event
mq&g
Arsenic
p Cn5
Cadmium
6.03Z
OZ
Copper
D. 52 5
6z,5
Chromium.
D14 5
c, 0415
Lead
, C)LI4
O.OUS
Mercury
C) ,
D coo
Molyb-
0)0
o CA 0
Nickel
, &Zq
O
Selenium
C-), D 10
C' 01 O
Zinc
Total
Phos-
phorus
Z
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accoruance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I ^— aware that there are significant penalties for submitting false information, including the possibility of fines and
it sonment for knowing violations".
&.4 ,,/ o�-�9ycye
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: lxt�ax CYl�2) WQ Permit #: 04q Field #: Z Acres Utilized: Z• (�, Z
Land Owner: con+a--t Annual Dry Tons Applied: 13(4 0 Site #: Acres Permitted: L7,
(p2
Operator: &)al Ienm, brn,A4.0Ct,1-Sr Predominant Soil Series: 16c+al U 5 Cation Exchange Capacity (non 503):
Crop 1 Name: I ZOO 5iL-dSMIM Crop 1 Max. PAN: i SO Crop 2 Name: Crop 2 Max. PAN:
° +�
° °
Q
Volume applied
enter one Solids/
( )
Liquid
Cu. Yds Gallons
o
/o
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc )
Soil
Cond.
(D
Wet
Moist
Precip.
Past 24
Hrs.
inches
>
4.0
, R3
E'
a w
* O
�J
C
o
�
* N
w .,
w
* w
* �•
TKN
mg/kg
z ��
q
o �
CO 5.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
24-�-1
za�O
1.,5
1. ZG Q
WCC03 Zo-p
Ar,4
10
0, 5
0.30
465bo
1-)55
gkoqe,
z
(. Cjq
Residuals Applications totals on FORM FSF supp (attach FORM FSF supp to this form):
TOTALS]
�Z�
::
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
6, z
Lime Applied
Annual lbs/acre
Prior Years Cumulative lbs/ac
Current Cumulativelbs/ac
Permitted C. P. L. R.****
Permit PAN Limit lst/2nd Cro
Cp(n O,C©3 d, py ,0I3 . ,0L
Z 5.065 a.IGU 34, w O 3 s.gg5' -) i
d. &V9 5•v�Q W-$GQ,31•1.3o► 1-06 0.35L1 Z 9��3 .G3L4 6 R o3 :::::::::::`>.':::::::::::
_ ...........................
U '2 Z 7 15 - 37L1 �3ci Z4r1 ::::::::::::::::::::: : : : ::::: : : : : : ::: ::::::
............. .... .......................
Date
lbs/ac
G-25A
lb�
1 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, ,0cluding the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5. Iniection/Incornoration - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Cpnt"P14m,-fY 6D Total Dry Tons Applied (Annual): JQC4
Permit #: Of!�0 o(C49 Cation Exchange Capacity (non 503 only): (4-
rator: Owner: 0nf-)1-C����r� G� IYl,?� Predominant Soil Series: P[ajc))(P h
txvl es Used: Z. (p Acres Permitted: z 2 Site #: Field #: `z
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
L-11
21
3
4
5
6
7
8
9
10
11
12
% Solids
1v
Arsenic
< Z.,5
Cadmiuml
1.0
Copper
I r) I
Chromium Z3
Lead
Zcj
Mercury
Molyb-
deninn
Nickel
15
Selenium
<5.0
Zinc
I 721
Total
Phos-
^T A us
3319 C;
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1
2
3
L4J
L5
6
7
8
9
1 o
11
12
y
DT/Ac./
{�Zy_loi
o
App •
LA
Event
.;Wig.
Arsenic
p
,
Cadmium
0 , Op3
0, oc;3
Copper
p, L)4
,-)a4
Chromium
O ; p(„ p
O
Lead
c).6105
M.6106
Mercury
p _ 1
O.
Molyb-
cionum
, 13
0,013
Nickel
p 03Cj1_3
SeleniumZinc
1.Q73
7
Total
Phos-
phorus
Z
2
"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
in onment for knowing violations".
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: C0nAQ-4nf0-rn6D WQ Permit C�(I Field #: 3 Acres Utilized: z.iz
Land Owner: cliff`} (1�0�-fY1217 Annual Dry Tons Applied: Z , I G, 3 Site #: Acres Permitted: t�, 7 Z
Operator: C�Gflfr�..5mi`Iuy.�iCYL7� Predominant Soil Series: ���� Cation Exchange Capacity (non 503): (4, 5
Crop 1 Name: -bffn-L1n0- Crop 1 Max. PAN: I -)L� Crop 2 Name: Cron 2 Max. PAN:
o G
+'
a o
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
oho
Solids
Volume
A lied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist
Precip.
Past 24
firs.
inches
>
b
o
a
C
o
w
w �
* N'
* N
o
0
7y
w .,
� w
* w
f
TKN
mg/kg
Z
o El
°R 0
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
Mb
r.�,
o. oco-1c�3Zo7�
r
p
o.5
o3a
D
5
�b
31.7Ji
C°
Q. sCCp
Residuals Applications totals on FORM FSF supp (attach FORM
FSF supp to this form):
TOTALS:
Annual lbs/acre
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit Ist/2nd —Crop
As Cd Cu Cr Pb H Mo Ni Se Zn P L
G, U O,COZ p; -) O.
53S'
p, j 7 c (�.gS1 g,� 3 0- Z-P141 10.t418 c,Poo I 3 :..... . .::
-i5 1.23ci 54, 4 4a,ci ig 4 .423 , ZG3 ZG Ltd ....................
3C� `�....1.3 S - Zto7 15 3)4 S° ZUGg — .. .....
ti i0
Lime Applied..
Date lbs/ac
,i's -Fi
61W/h5
- �- -__„ ..u..— F, 11"=L.,y vi law, LL1216 LUIS uucument was prepares 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 of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5. Iniection/Incoruoration -1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
(r` +tr,4nr`C--m6D
Total Dry Tons Applied (Annual):
Z. q 3
Permit #:
(^ )nfb-4n�l��
Cation Exchange Capacity (non 503 only):
C/,5
•ator:
Cl-pf �e6in. brn l l iU,77 Owner:
r(j)+pn+n6DL m6Dt Predominant Soil Series:
Acres Used:
Z:7Z Acres Permitted:
Z.-)z Site #: 6 Field #:
3
Residual
Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use
Raw Percent #):
Sample or
Com-
posite
Date
1
Cl
2
3
4
5
6
7
8
91
10
11
12
% Solids
i. -fi
Arsenic
<7.1j
Cadmium
(• O
Copper
7­2 1
Chromium Z 3
Lead
ZC
Mercury
C) , ZS
Molyb-
< 5.p
Nickel
16
Selenium
I <�j.©
Zinc
o Z I
Total
Phos-
�' ial Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1 11
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
� z5-1 G
y
o
App.
Event
b.g6(.o
Arsenic
D.
O•CL i
Cadmium
0, WZ-
Copper
T
O.43-)
Chromi
, 3--)
. 637
Lead
6, p4D
O, 040
Mercury
p . ©
4, COCA
Molyb-
Nickel
, OZW
U
Selenium
Zinc
Total
Phos-
phorus
53•14
53� 4S�
"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
im cnment for knowing violations".
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION _LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Cbn+er4n.egL m6D WQ permit #: lO i 04,q Field #: y Acres Utilized:
Land Owner: C0n+ff e0 m�tD Annual Dry Tons Applied: 0,-�ZC� Site #: 3 Acres Permitted: & 3u
Operator: CLQl11e5M-6640 I• Predominant Soil Series: _} IU_j Cation Exchange Capacity (non 503): y• 5
Crop 1 Name: C a_ -A r r.cj&_ Crop 1 Max. PAN: I g© Crop 2 Name: Crop 2 Max. PAN:
Y
a�
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc )
Soil
Cond.
(Dry,
Wet,
Moist
Precip.
Past 24
Hrs.
inches
y
a b
F" �"
o� w
* o
C
o
;n w
�, �
o —
7y
w, Q
°�
N
*
o
TKN
mg/kg
Z��
�
o
Q° o
g w'
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
I�
510CX�
1.5
I • CCA
NCCC337lS�
1, 000
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALs:
5►CCO
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
3S,�7o
Lime Applied
Annual lbs/acre
Prior Years Cumulative lbs/ac
a. OO O COZ ` (aZ ,. jp(o 310 ' ::::..::.::::
(b � O . 016 OU3 d 0, 013 `I I.Z
©,`)} 1 4 G5U k(I-49 24 614 -)q 0-lid .-)SG ci.tZ3 0.43 0 Zqr
...
7(i to U.�iS U•i 472.`� , t�� Z •7GG (o j3 6 �+ 4 C ZC4,125
36 y 13 5 "7 15 — "X4 Qq
1.
Date
lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R.
Permit PAN Limit 1st/2nd Cro P
•'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
:7M
luding the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
JIF ova!r�/ 7 .t�'� **Volatilization Rate: Surface - 0.5. Iniection/Incornoration - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: C6n+e-)4f)feci_-WOD Total Dry Tons Applied (Annual): 3. 33c)
Permit #: Cation Exchange Capacity (non 503 only): U , 5
•ator: CitlfD�J1 Y�iCIL�S� Owner: CpI--)}en44-)� i� Predominant Soil Series:
Acres Used: 3, 3 4 Acres Permitted: S.3Q Site #: 3 Field #: 4
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
2
3
4
5
6
7
8
9
10
11
12
% Solids
Arsenic
<2.5
Cadmium
) . p
Copper
Z-) I
Chromium Z3
Lead
Z5
Mercury
p, Z-j
Molyb-
denum
<5•0
Nickel
15
Selenium
<!5.0
Zinc
I
Total
Phos-
-'---us
"31�sv
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1 1
2
3
4
5
6
7
8
9
10
11
12
App.
Event
I - CCD
1. O
Arsenic
C)Cj,5
Cadmium
6, CC;&
D, Z
Copper
6, 5tjZ
Z
Chromium
0,04(o
Lead
0.0,50
. 050
Mercury
In, p
p,
Molyb-
denilm
O
<OIO
Nickel
0,C 3C>01
Selenium
0,C>tO
61010
Zinc
I. ULl1
I.LIUZ
Total
Phos-
phorus
.' (co
(ol0 3bD
"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
in onment for knowing violations".
dIZ4 V
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION"- —LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Co-y l+n,@g- m `d
Land Owner: Cn,-Fer�ne« f')517
Operator: 0—)006nn.6niwU 0-Jr
Crop 1 Name: 'rv,, err
WQ Permit #: tx_)=1041 Field #:
Annual Dry Tons Applied: . �37 Site #•
Predominant Soil Series: u(15
Crop 1 Max. PAN: IV( Crop 2 Name:
5
Acres Utilized: 3 7 (4
3 Acres Permitted: 3,--)L4
Cation Exchange Capacity (non 503)
Crop 2 Max. PAN:
u•5
o +'
a; o
at
Q
tQ
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
00
%
Solids
t.M
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
' O S `
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
9C 03 ')�
Soil
Cond.
(Dry,
Wet,
Moist
Precip.
Past 24
Hrs.
inches
O
a
b
5 o'
o w
p
C
o
�y
w
;
* N•
* w
o
p.5
;�
w,
co ?=
* �•
*
* c.
0
o.3Z)
TKN
mg/kg
Stud
Z
o B
o0 0
o w•
mg/kg
1-)56
Nitrate
and
Nitrite
mg/kg
64b59rc
PAN Applied
lbs/acre
( )
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
Q • (1
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
.
ToT' s. LU
Annual lbs/acre
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
etmitted C. P. L. R. ****
Permit PAN Limit lst/2nd Crop P
LLT _
As Cd Cu Cr Pb Hg I Mo Ni I Se Zn P
v Z O, Co) , 7 01 O . ZZ D. o b. 0. 013 , Z4 �(o :
0. 1Z t}, 17 ci37 3�, p33 p�, 3• I4 i G.�72 I -
..... .... .
l y L-1.1 '�u 7 .174 3lv•� U 055 Z� (L 5 5 0 .G85 i •u3b :::.:::::::::::......... .....
....................
(o I — Z )37y g9 4cg ::
....................................................
Lime A lied
Date lbs/ac
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
informatin30ncluding the possibility of fines and imprisonment for knowing violations."
_ *Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5. Iniection/Incornoration - 1.0
JOV
Signature of Land Applier Datex* Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Conien,�)co_ Cn67 Total Dry Tons Applied (Annual):
Permit #: Cation Exchange Capacity (non 503 only):
•ator: Cl�t(1>° �5rs�l ltt Cl j, f• Owner: CC�()4er4f)6DL rf-&-pj Predominant Soil Series: _Rcc+ob)
Acres Used: 3,-?L4 Acres Permitted: i,')L4 Site #: -13 Field #: 5
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
a-L _Iq
21
3
4
5
6
7
8
9
10
1j
12
% Solids
i . 57 0
Arsenic
C 7,5
Cadmium
I ,D
Copper
z71
Chromium Z3
Lead
Z l5
Mercwy
0 ,25
Molyb-
denum
<5, o
Nickel
I lj
Selenium
<6, p
Zinc
/)Z I
Total
Phos-
_'--.:s
331S01
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
App.
Event
6,(4343
Arsenic
0,002
10, UO-z
Cadmium
O . Col
Copper
p
D, Z,32
ChromiumO
OZD
GZ
Lead
Mercury
Cp,Cjpp
Molyb-
Coo
4
Nickel
O 13
3
Selenium
4
Zinc
Z
D lo32
Total
Phos-
phorus
ZCf,OL4o I
I
I
I
I
Zq•CX�
"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
im onment for knowing violations".
card vtl
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: COnier4r q— n()dp WQ Permit #: G�_)Q�* jC)QR Field M 49 Acres Utilized:
Land Owner: OC�nfEr)4n eC� fYi�-D Annual Dry Tons Applied: 3 (,) BCD Site #: c -ram II Acres Permitted:
Operator: %t ittwo, 6ln4-ocqr— Predominant Soil Series: Cation Exchange Capacity (non 503):
Crop 1 Name: }gl L�fr)(,iCl+C3.. Crop 1 Max. PAN: 17Z Crop 2 Name: Crop 2 Max. PAN:
-2•-)3
4.5
° + °
° >~
°
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist
Precip.
Past 24
Hrs.
inches
Y
a w
C
o
,y w
w �•
� -
N
o
o
7y
m w
*
TKN
mg/kg
Z
q
o 0
°�°, o
o P.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
lbs/acre
( )
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
Z2
::
C) • �l4 (.v
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
5Z7LXJ .:<-:::
»:
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
n.-n I
Lime Applied
Annual lbs/acre
-Z I Zug OZ ► (D,015 CO .0014 p.lotil 5� :::...
D, I I.')")Z 41-11 5O -ZLID.�I`.
(v I (v 'p3 . 53 Z� b� 5 5. 34 (� 13�(2 IUS 5. 3Z I o • 14:1�5 ,3
15
7
I Z
Date
lbs/ac
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R. * * * *
Permit PAN Limit 1st/2nd Crop
"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
informati, inNluding the possibility of fines and imprisonment for knowing violations."
Signature of Land
*Application Method: S - Surface, IN - Injection, INC - Incorporation
I ,A .2 U **Volatilization Rate: Surface - 0.5. Iniection/Incornoration - 1.0
Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Cpnten�ne_&_rnbT Total Dry Tons Applied (Annual): i3.45o
Permit #: ,,per I GUI Cation Exchange Capacity (non 503 only): 4.'5
rator: Cj 1� �,n, 6MtWj 0g Owner: �Pf)jen4ne� (��;�� Predominant Soil Series:
Acres Used: -),-)3 Acres Permitted: 7_--23 Site #: C_TjaC } Field #:
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
U ZG- IGl
21
3
4
5
6
7
8
9
10
11
12
% Solids
j .57`Jv
Arsenic
< Z, 5
Cadmium
I.O
Copper
Z-)
Chromium Z5
Lead
Z15
Mercury
C) , Z5
Molyb-
deninn
Nickel
15
Selenium
<6.C)
Zinc
7Z1
Total
Phos-
-'--Us
3►:6o
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
DT/Ac./
App.
Event
p, L1 fc
121
L3J4]
L5J
6
7
8
9
10
11
12
� (p
Arsenic
Z
Oc�Z
Cadmium
0, 00
Copper
O, ZL4Z
Z42
Chromim
Lead
0
0 1 0V
Mercury
p, C)
D • p00
Molyb-
demum
oou
Nickel
13
Selenium
0, OCqO
004
Zinc
p. (ot. -5
`
u3
Total
Phos-
horus
Zq, J�F)
"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
im onment for knowing violations".
Signature of Land Applier 01 Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION -__LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: C©Her I)*-CL [y)6 J7 WQ Permit #: 1x.)Q0W tC)44,g Field #:
Land Owner: Ccn+eFQ m6t) Annual Dry Tons Applied: 0 • P0 Site #:
Operator: C11ak-,) li)• bm'14-u i(ui. Predominant Soil Series: A l aao.
Crop 1 Name: CQ=l�lri Klg= Crop 1 Max. PAN: 02 Crop 2 Name:
C4
Acres Utilized:
c `n- f Acres Permitted:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
5.i5
6.15
4.5
o
a�
Q
Volume applied
(enter one) Solids/
Li Liquid
4
Cu. Yds Gallons
%
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc )
Soil
Cond.
D
( rY�
We t
Moist
Precip.
Past 24
Hrs.
inches
y
b
o� w
* o
o
C
o
�y w
�.
c� .r
po �
,
�,
* N
� �•
0
TKN
mg/kg
Z
�o o
g
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
-1q
4m6
i 574b
©,SfU
U3 -)
rndi&
n
0,5
0,30
Q
1-66161-:5.124,31-551
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
.
TOTALS: . :::::::::::::::
Annual lbs/acre
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PA N Limit lst/2nd Crop
As Cd Cu Cr Pb H Mo Ni Se Zn P J1.5�
G. ooci O, WZ O, 4U I U• CZn D, py I • `p:�3 ©,p.4 O.OU3 , ao 1 ' ::
1. g-) U ,54. Zb.$19 5 :5 Z 1 0 ,141 10t, 6,W3(o 07):::::::::::::::::::::::::::::::::::::::::
55 (F, �tG 5. IG3 Z(:�5% 5.5 b"L iUl Z• ��I 5,1o37 O • iy G51::.....:.:.`:.:.:...:.:.::.:.:.:...
_
.3u i Z(or) 15 ,3-)L4 U g ::::::::::::::::::::::::::»:< :: :
-17 Z'
Lime
Date
A lied
lbs/ac
2j
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 in�ding the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
^'! �-'ai4,7D **Volatilization Rate: Surface - 0.5. Iniection/Incornoration - 1.0
Signature of Land Applier Date Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: CC r)i �eCk. M &D Total Dry Tons Applied (Annual): 44, IQC)
Permit Cation Exchange Capacity (non 503 only): y 5
•ator: Cbpf� f(�.5rfi �viC�iY Owner: CCU}en �a YYI Predominant Soil Series: A �
Acres Used: 5.15 Acres Permitted: 5,15 Site #: C TQCj z1 Field #: Cr
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
21
3
L 4
5
6
7
8
9
10
11
12
% Solids
Arsenic
2, 5
Cadmium
i .O
Copper
Z-21
Chromium Z3
Lead
Z5
Mercury
C5, ZS
Molyb-
denlim
Nickel
f �j
Selenium
< Cj
Zinc
721
Total
Phos-
,,--is
33 i
tal Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1
2
3
4
5
6
7
8
9
10
11
12
DT/Ac./
c
App.
a
Event
©. y
zj
Arsenic
6,0014©.L
1
Cadmium
.CX>Z
002
Copper
j
Chromiiu
C) 37
7
Lead
O 4
Mercury
0.ODCO
O
Molyb-
deflilm
Nickel
0, 62Z j
.OZ(4
Selenium
C) • COfd
Zinc
L 174
1 1 C
Total
Phos-
phorus
54-QF1
"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
irr onment for knowing violations".
A
Signature of Land Applier Jr Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION '&....,LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: �' cfillleL�. WQ Permit #: Field #: 13 Acres Utilized: 3• 20
Land Owner: Cef)+en�nlEg_ 1•f):51D Annual Dry Tons Applied: Site #: C ('Z-Q&Z Acres Permitted: 3,30
Operator: 11P1,►t1iJfCkl�r Predominant Soil Series: On �� Cation Exchange Capacity (non 503):
Crop 1 Name: %ZL 2fmuei OL Crop 1 Max. PAN: Ito I Crop 2 Name: Crop 2 Max. PAN:
o
a)
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc )
Soil
Cond.
(Dry'
Wet'
Moist
Precip.
Past 24
Hrs.
inches
>
5 �
A w
*
o
�J
C
o
�,
� —
* N
F)
4
7y
w
CD RL
*
0
TKN
mg/kg
Z �
q
o �
M 0
0 R.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
O
0-3L1
4c6&0
1755
Ug A(,i
.
(U . Lf-)(c
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
ZcFpv
As
Cd
Cu
Cr
Pb
H
Mo
Ni
Se
Zn
P
i . , �I
Lime Applied
Annual lbs/acre
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit l st/2nd Crop
t� 1 1 D-Ol1
Z . L). , 0,04 0 ); 7 ..: >::::::::. ...
0, 3 ZO 0,229 t 7 7, i U Z• 33 3 0.013 1 • C?5 .4")� r q u Clf2 ..........
L 3 ............... .. ... . .
32 v;3s�35 2.33 Z,357 :G� 1,06 2•GCti c, 4 Gu, .......................
-��....... Z Q ::: ..............
�'' `'
Date
lbs/ac
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
informati "luding the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5. Iniection/Incorporation - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: m� Total Dry Tons Applied (Annual): j , 5-) )
Permit #: k C t.`O�IC�I� Cation Exchange Capacity (non 503 only): y. j
rator: ( r0 {�. i f161� eCkj7�. Owner: (_pf) f e _n-0 Predominant Soil Series: j11 G�
Acres Used: 13-bb Acres Permitted: 3.3C�. Site #: j _�> Field #: CMC(Cf-11
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
11
oq
21
3
L 41
L-51
L 61
7
8
9[io-I
11
12
% Solids
-)
Arsenic
, 5
Cadmium
1 -0
Copper
Z7 i
Chromium Z-3
Lead
Z5
Mercury
L), Z)
Molyb-
denum
<5Q
Nickel
1,5
Selenium
C5O
Zinc
'7Z
Total
Phos-
us
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
Total©
©
©
0
0
0
•.
Event
•
b •
• rr
®®®®®®®®®®®♦
••
MEMO, MI
•
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• -• u
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owl
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EEEEEEEEEEEN�
__ahorus__M-,
"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
im anment for knowing violations".
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION I. .,,D SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: LnieNner -m-,p WQ Permit #: 1JQ=1()49 Field #:
Land Owner: i��FY1 Annual Dry Tons Applied: Z,CC4-1-S Site #•
Operator: ��i�,.y7r Predominant Soil Series:
Crop 1 Name: CCD&x1 ter Crop 1 Max. PAN: 17(p Crop 2 Name:
Acres Utilized: 3. 0D
Acres Permitted: 3-on
Cation Exchange Capacity (non 503): (4- 5
Crop 2 Max. PAN:
JtJ
° a-
N s~
°
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
a/o
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
We t,
Moist
Precip.
Past 24
Hrs.
inches
y
5 o'
o w
�,
C
o
7y �.
�, �-
* N'
o
4
;v �
w •,
� �
*
'-
TKN
mg/kg
Z y
q
o a
ao o
o
w•
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(Ibs/acre)
Name of Crop Type
Receiving Residual
Application
Crop I
Crop 2
Crop 1
Crop 2
-1 pe
I
[xx
1.5
©• (
1-�Cc�3ZU��
d
C� : S
o 3U
c/ . o
t
�5.4io
Z') • of 1
b • Lq q
Residuals Applications totals on FOkM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
Lime Applied
Annual lbs/acre
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit 1 st/2nd -Crop
- 0 , CCU' L ool , , 0. Z O. 5 v O�OZ) . ' 7`1-Cb!'4&31q >:: >:
0,710 0•405 q • Q-'4 0- }k ) -�40 O,C210 Ca- '-n Z w) ic�l,•
o, Zi 3 0,4cCCq-C,9-) 4.(, i •4si b ,
_ �SSS �.3ZZ (� 333....:...::.:.::::.:.:..........
u I ^8 L�� i 5 a3�u g�a Z4�i
(o
Date
lbs/ac
�"-,
h
1 certuy, unaer 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
informati n�ncluding the possibility of fines and imprisonment for knowing violations."
Al
Signature of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5. Iniection/Incornoration - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: C cnit7-An>?c ff k2 Total Dry Tons Applied (Annual): -K 025
p-r*nit th 104 Cation Exchange Capacity (non 503 only): 4.5
rator: OyAt le-0. SrYl'a')OckATi Owner: C(� -- P11�1 0 m,`J 1� Predominant Soil Series: �+j�
Acres Used: 6,00 Acres Permitted: & W Site #: Field #: IL..}
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
_Ic
121
3
4
5
6
7
8
9
10
11
12
% Solids
Arsenic
Z, cj
Cadmium
Copper
1
Chromium Z 3
Lead
Z�
Mercury
& 7,5
Molyb-
denum
rj,D
Nickel
i
Selenium
<,j.O
Zinc
/)Z I
Total
Phos-
us
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1
121
3
L4 j5
6
7
8
9
10
11 J
12
DT/Ac./
App.
Event
0.
0::eR
Arsenic
0.O03
00 3
Cadmium
p Co I
,Gb
Copper
Chromium
D, 32
_
,032
Lead
O , 35
0 035
Mercury
000
DODO
Molyb-
denum
p.a(?7
7
Nickel
0, t72l
Selenium
7
.1X77
Zinc
j pp7
I.007
Total
Phos-
horus
4h, la I4h,31q
"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 a— -ware that there are significant penalties for submitting false information, including the possibility of fines and
im �)nment for knowing violations".
CA" W a1W;6�16
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION-' - --.LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: C��c �� WQ Permit #: LJQCWfWgg Field #:y 5 Acres Utilized: Z.31
Land Owner: ' ('fo Annual Dry Tons Apphed z, rj Site #: Acres Permitted: 2•39'
Operator: Chakl ) (l.&n4-uli S• Predominant Soil Series:
(� �;(-4-�r-(��►.y'1 Cation Exchange Capacity (non 503): f../. 5
Crop 1 Name: CQ ,, .faJ 13ermL Crop 1 Max. PAN: i") (0 Crop 2 Name: Crop 2 Max. PAN:
°
°
d °
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
Pp P
Acre
(Dry TonslAc)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist
Precip.
Past 24
Hrs.
inches
y
4 �
coo
E
o A
a
*
C
o
7� w
w
i --
* N'
?_
o
�
�
P.
o w
*
w
* o'
TKN
mg/kg
Z y
El
o 0
ac o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
i
31WO
1.
4�80
i��CC�3Z0"�
rnoia+
5
C� 5
a�30
4as�v
I755
�5
U.11 S
........
.........
..... ..
.
.......
.......
.......
45`d
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):..................
....................
TOTA1s:ZCcv
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
34.11$
Lime Applied
Annual lbs/acre
Prior Years Cumulative lbs/ac
5, COLI (3,DaZ p;11-)7 0, 61
0- 742 0,u-I0 22510 q,102 Z.IL,,2 0 035 0, 0D 2.4Zg 6,346 i i5 Iw :. :::
,Zino p L112 Z)•��a 1U�- Z.ZUIo d35 e7 • bU5 Cj01 4U� 1 .U1 `::`::"::::::::>::::: >::'::::
...........
t-{ 133� — ZI�� I ' j -- 374 q Z 8 ..........:.......:.:.:.:.:.:.:.:.:.:.:.:.
.........................
7 1 �
Date
lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R. * * * *
Permit PAN Limit lst/2 nd Cro p
'•1 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
informat* ncluding the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5. Iniection/Incornoration - 1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2, Signature of Land Applier Date
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Dame: Co fYl6�1 Total Dry Tons Applied (Annual): Z, UG,
Permit #: ,LJQC)W I OL4 Cation Exchange Capacity (non 503 only): Lt, 6
rator: dt. ,m, jr ; iq— - Owner: (�C��}��}r� m � Predominant Soil Series: Pal6ffg_6�h
Acres Used: Z,?�Cd Acres Permitted: -Z-34 Site #: �6 D Field #: 1
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1 1
U-
121
3
L4
5
6
7
8
9
10
11
12
% Solids
1.
Arsenic
<' Z. -6
Cadmium
1.0
Copper
I zi1
Chromium Z 3
Lead
25
Mercury
,25
Molyb-
dcniirn
�5.0
Nickel
i 5
Selenium
<5,()
Zinc
r?z 1
Total
Phos-
is
I T�
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
..
D
-
pp
Event
w �s a
®®®®®®®®®®•
i • •
Phos-
__Rhorus
"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
im cnment for knowing violations".
Cam" Al 07W ;wro
Signature of Land Applier Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION'- .. "LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: cb- f& )lea- rfa
Land Owner: CCnferkeo�- g15D
Operator: t�ejiil.6rn,10)ujgZ[.
Crop 1 Name: `a IZ&KX&Z
WQ Permit #: V3gC,pi(2%4 5 Field #: HIP Acres Utilized:
Annual Dry Tons Applied: Z. 357 Site #: D Acres Permitted:
Predominant Soil Series: A ICL6 C� Cation Exchange Capacity (non 503):
Crop 1 Max. PAN: 72 Crop 2 Name:
Crop 2 Max. PAN:
2�4�8
4.5
°
a) r.
°
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
oho
Solids
Volume
A lred er
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet,
Moist)inches
Precip.
Past 24
Hrs.
y
410
o
0 0'
a '•
0
C
o
7y -
w ..
; =
* �
o
0
po r
P, .,
�
* �•
TKN
mg/kg
Z
o El
o
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
( lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
-I Nei
3eobb
16A
,) I
►-1 W--)
Afu
0
S
3' 5
0.30
PCs
b 5.cro
7
::':
.'Y1
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:F
Annual lbs/acre0,004
Prior Years Cumulative lbs/ac
Current Cumulative lbs/ac
Permitted C. P. L. R. * * * *
Permit PAN Limit lst/2 nd Crop
LLT
As Cd Cu Cr Pb I Hg Mo Ni Se Zn P 7
0,CO2 , Qq 0.0y p CUg I , I U 2 l lql;
o,v5s O�2 .45,0E Z-I1B 0.033 0.1,14 IZ O.L100 'l '>
Z(oZ tl 71 �5, 53 Z2 33 O • IaZZ- 53� 64D`d i S130 :....:`. `'........ . .
...............:::.::::::: :
3 (v U 1 ' 7 15 ..:
i
Lime
Date
A lied
lbs/ac
KfCS-Gi
Z/G2`�Jhn
1 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
informat!A iNluding the possibility of fines and imprisonment for knowing violations."
,W6 ,/ �7��Q•b *Application Method: S - Surface, IN - Injection, INC - Incorporation
100, ��9� ^f **Volatilization Rate: Surface - 0.5. Iniection/Incornoration - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant LoadinLy Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Ccn fen. n-eam67 Total Dry Tons Applied (Annual):
Permit #: Cation Exchange Capacity (non 503 only):
rator: Owner: ��[{ ' (� Predominant So
Acres Used: �, Cry Acres Permitted: 7,C
�eg Site #:
Z 357
W5
it Series: /-}�QCpQ
Field #: 1(0
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
4X
2
3
4
5
6
7
8
9
10
11
12
% Solids
1. A
Arsenic
<Z,,5
Cadmium
1 - Q
Copper
�71
Chromium Z3
Lead
,Z,5
Mercury
0, L,5
Molyb-
demim
Nickel
15
Selenium
C5.0
Zinc
7z 1
Total
Phos-
zs
IUL
ial Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
IN
a
E
NEINEE
App.
Event
R! MOO
r •
__®_®®__®_®®_®_®®•
M0
RIM
®®®®®®®®
Ir •.'
r ITT
®
Y
®®®®®®®®®®®•
, '
®
®®®®®®®®®®®®
P,
"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
im mment for knowing violations".
(�;A7 4 �(/ 4; � -4 w 11
Signature of Land Applier
79 Baas
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION I ...,,,D SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: &f) I.er�he -map WQ permit #: "COOINq Field #: I-) Acres Utilized: 3-(,02
Land Owner: (rJ- 491vre)-K-& Annual Dry Tons Applied: S C� Z43 Site #: V Acres Permitted: 3, 4"z
Operator: n�" I,l'Nfl. 6rilW1Jialy , Predominant Soil Series: A lgaQ, Cation Exchange Capacity (non 503): 4-15
Crop 1 Name: CnQ6iQ1-t30n- _dCL Crop 1 Max. PAN: 1'72 Crop 2 Name: Crop 2 Max. PAN:
°
a� >~
°
Q
Volume applied
(enter one) Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
Applied per
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist
Precip.
Past 24
Hrs.
inches
>
K b
�'
o� w
C
o
�;
-
*
4
7y
CD ?j
* w
* o'
TKN
mg/kg
Z ��
iX
o
°� 0
�.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
g
Application
Crop 1
Crop 2
Crop 1
Crop 2
00Dv
1.5A
1.0�65
Ha-WWT)
mcii�+
O
S
0-5
0.30
40SPv
Q55
6AC5.q(-
J • O ' 5
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
6000O .::::::.:.:.:.::
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
tU2.c5
Lime Applied
Annual lbs/acre
025
0,062
,
0056 5
P
Date
lbs/ac
Years Cumulative lbs/ac
'' '' ''''Prior
iD I ZC3 0.64U O* Z l 3_ Zu5
' . 3Z2 , LQ(, 7.G i5 i . cio Z A 4-) p . Q45 , S32 3. 2-2q 0.5 u ► r q ::::?:::::: `::.:.:.>:.:.:. »:
ZIv7 i -
,3 U i $ 3
............................................................................................. Z
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit Ist/2nd Crop
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."
w A
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Iniection/Incornoration - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Cn'l+ff4neCL m5p Total Dry Tons Applied (Annual): 13,CjZg
Permit #: ;� pool CA; Cation Exchange Capacity (non 503 only): 4 5
rator: (y b{� �j((). �nj� J� i. Owner: Predominant Soil Series:
Acres Used: �. (o"Z Acres Permitted: _toz Site #: Field #: 1 j
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
DateZr
I 1
2
3
4
5
6
7
8
9
10
Li12
% Solids
Arsenic
< 2,6
Cadmium
1.Q
Copper
--) I
Chromium 3
Lead
2 J
Mercury
Molyb-
Nickel I
Selenium
Zinc
11) Z J
Total
Phos-
zs
3 j
A [al Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
I 1 I
L2]3
4
5
6
7
8
9
10
11
12
DT/Ac./
rt
App.
n
Event
o,5 7
Arsenic
, 5
I
I
16.006
Cadmium
p , COZ
Copper
-d
13. ka
Chromium
, 05 D
Lead
, CGSu
6, C6LJ
Mercury
• bO {
1
Molyb-
-
C>,Oil
O.Ot 1
Nickel
©• 3
1
1
0.633
Selenium
p, b { I
O+OI J
Zincly�
Total
Phos-
horus
�Z.GYj
"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
im mment for knowing violations".
Signature of Land Applier 40, Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION i —LD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: ©n lF to lYl WQ Permit #: wq (50C t0(48 Field #: I q Acres Utilized:
Land Owner: U'n ii°ll l /Yi(Z✓ Annual Dry Tons Applied: Cj, Zc, (, Site #: C-r�q�411 Acres Permitted:
Operator: O)DA e5m, 6MiW-%,-kCL T. Predominant Soil Series: A hAa— Cation Exchange Capacity (non 503): C.�.
Crop 1 Name: CCCZQl-jf- Crop 1 Max. PAN: jI 2 Crop 2 Name: Crop 2 Max. PAN:
°
N
Q
Volume applied
(enter on Solids/
Liquid
Cu. Yds Gallons
%
Solids
Volume
A hed er
PP P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry,
Wet
Moist
Precip.
Past 24
Hrs.
inches
>
b
�'
o� w
C
o
iz
w �.
*
4
7d R
w •,
='
w
R
TKN
mg/kg
Z
�F
o El
aq 0
w.
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
,
- i
51-1-)c9
1.5A
Q, (Z
14 5
rnO15+
0
5
C) ,'5
p , 5
>-6D
v
4 bD
I
Rio
5q4
3
rz.bg (.o
Cj., 7C
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
114=1.......:
As
Cd
Cu
Cr
Pb
Hiz
Mo
Ni
Se
Zn
P
so X
Lime Applied
Annual lbs/acre
6, DO I
p , pU Z
. 4Zct
O. L3 4
0 ,1�4�
Old
v CX
O. 023
O: UU$
1.14 2";
3 55
;>:::.:::.:.
Date
lbs/ac
Prior Years Cumulative lbs/ac
5 2 Q , coi p, n 4 D . C� C� -60 3 b ©v ®..GYM . abb 4 0.:::::::::: ::::::::::::: :
, oo U (D • d)3 .603 , ok5 o . Cf3 6 -Y oo p , p 12 - , O3 Z . U1-L 1. a Z :: :::::: :::: »>:: »::::: ::.:..................
:::::::::.
LA 1 Z 7 ► � — ..................
7U G yq
Current Cumulative lbs/ac
Permitted C. P. L. R.****
Permit PAN Limit lst/2nd Crop
--f 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
informationAc!0ing the possibility of fines and imprisonment for knowing violations."
A a � *Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Iniection/Incornoration - 1.0
Signature of Land Applier Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: C(y)ttj-)4offi_ (Y),-17 Total Dry Tons Applied (Annual): ry.7!i, v
Permit #: e�Cool 04'? Cation Exchange Capacity (non 503 only): Lt. 5
rator: Lf�l��m �p�y# � 7i t. Owner: Predominant Soil Series: (Qaa�
Acres Used: 1.75 Acres Permitted: Site #: C=TiaC+j. Field #: IGj
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
1
42q-1G
121
jf- cae,
3
• Zc,_/Q
4
5
6
7
8
9
10
11
12
% Solids
�_ 7`IO
1,611)
1.67b
Arsenic
, 5
< Z . 5
< Z.,5
Cadmium
1.0
1.0
i , 6)
Copper
Z7 I
Z? 1
271
Chromium
Z 3
Z 3
Lead
2-3 Z5
Z 5
Z`j
Mercury
C}•Z5
C),ZS
Molyb-
denum
C60
<�5,b
<6,o
Nickel
1,5
15
151
Selenium
<!�. o
< 6. D
< 6.0
Zinc
7 Z J
'i 21
'
Total
Phos-
as
331�&
331lO
331Ib
tal Heavy Metal Field Loadings (Calculated in lbs/acre):
App.
Event
r
r
...
®..
..
• 1
• •
L 1
______®®_
• r
W6 ma,
"66
6
An _
. • .
• � r
r6W
Mom
• ►
®®___®®®®
Total
Phos-
_phorusIMMMENEEMENEEN.1
"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
im mment for knowing violations".
��4 i6�_
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

PATHOGEN AND VECTOR
ATTRACTION REDUCTION FORM

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Facility Name: C(Y)4er)4irlf;P- WQ Permit Number: L)2�aao104S
WWTP Name: ObniNPDES Number: M_M-&W-0
Monitoring Period: From -bounty i,?. P To TpeCPM% 31,Zolgi
'athogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed:
Class A:
Alt. A (time/temp) ❑
Alt B (Alk Treatment) [I
Alt. C (Prior Testing)❑
A1t.D (No Prior Test) ❑
Process to Further Reduce Pathogengs ❑
If applicable to alternative
performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost ❑
Heat Drying ❑
Heat Treatment ❑
Thermophilic ❑
Beta Ray ❑
Gamma Ray ❑
Pasteurization ❑
Class B:
Alt. (1) Fecal Density
Alt. (2) Process to Significantly Reduce Pathogens ❑
............
If applicable to alternative
performed (Class
B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization ❑
Air Drying ❑
Composting ❑
Aerobic Digestion (�
Anaerobic Di estion
g
..................................................
If applicable to alternative performed (Class A or Class B) complete the following
monitoring
data:
Parameter
Allowable Level
in Sludge
Pathogen Density
Number of
Excee-
Frequency
of Analysis
Sample
'type
Analytical
Tech-
Minim
Geo. Mean
axim
Units
Fecal Coliform
2 x 10 to the
6th power
per gram of
total solids
MPN
< 11-j
1 1-7
< 1 Z1
C P� Clf
b(3u�5
Q
-7
C f�
g2Z1 E-�
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)
Vector Attraction Reduction (15A NCAC 02T .1107) - Please indicate alternative performed:
Alt.1 (VS reduction) ❑
Alt. 2 (40-day bench) ❑
Alt. 3 (30-day bench) ❑
Alt. 4 (Spec. 02 uptake)
Alt. 5 (14-Day Aerobic) ❑
Alt. 6 (Alk. Stabilization ❑
Alt 7 (Drying - Stable) ❑ 1
Alt. 8 (Drying - Unstable) ❑
Alt. 9 (Injection) ❑
Alt. 10 (Incorporation) ❑
No vector attraction reduction alternatives were performed ❑
CERTIFICATION STATEMENT (please check the appropriate statement)
"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."
rto l e�ftl.,St"Ia—Ti . / c r rI. 401 CCACAdr—
Prep r ame and Title (type or print)
u.r,aature of Preparer* Date
Cl�, i��• �mi�i�ic��%/nnd � a+rro6l.cXZG
Land Applier Name and Title (i applicable)(type or print)
6" / .-;2-A-Ahad
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)

Enw,un[ME&M Flo himpumbd
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
Sample Analysis Method
PARAMETERS #1 Date Analyst Code
Total Residue, mg/1 14940 04/23/19 JTH 2540E-11
Fecal Coliform (MPN), /gram Solids < 121 04/22/19 JTH 9221E-06
PHONE [phone]
FAX [phone]
ID#: 416 A
DATE COLLECTED: 04/22/19
DATE REPORTED : 04/25/19
REVIEWED BY:

EAUT&MBM Flo MoTpumho
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
Total Residue, mg/l
Fecal Coliform (MPN), /gram Solids
Sample Analysis Method
#2 Date Analyst Code
15360 04/23/19 KDS 2540B-11
< 117 04/23/19 KDS 9221E-06
Drinking Water ID: 37715
Wastewater ID: 10
PHONE [phone]
FAX [phone]
ID#: 416 A
DATE COLLECTED: 04/23/19
DATE REPORTED : 04/25/19
REVIEWED BY:

EIMAnNE&M % hwPuMNA
■
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
Sample Analysis Method
PARAMETERS #3 Date Analyst Code
Total Residue, mg/l 15940 04/24/19 JTH 2540B-11
Fecal Coliform (MPH /gram Solids < 113 04/24/19 JTH 9221E-06
PHONE [phone]
FAX [phone]
ID#: 416 A
DATE COLLECTED: 04/24/19
DATE REPORTED : 04/26/19
REVIEWED BY:

Enwkwn[d % hwTP@T@%4
114 OAKMONT DRIVE PHONE [phone]
FAX [phone]
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
Total Residue, mg/l
Fecal Coliform (MPH /gram Solids
Sample Analysis Method
#4 Date Analyst Code
16020 04/29/19 JTH 2540B-11
<113 04/29/19 JTH 9221E-06
ID#: 416 A
DATE COLLECTED: 04/29/19
DATE REPORTED : 04/30/19
REVIEWED BY:

oo oflnbM % hwPoTOW
114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27858 FAX [phone]
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
Total Residue, mg/I
Fecal Coliform (MPH /gram Solids
Sample Analysis Method
##5 Date Analyst Code
15420 04/30/19 KDS 254OB-11
<117 04/30/19 JTH 9221E-06
ID#: 416 A
DATE COLLECTED: 04/30/19
DATE REPORTED : 05/02/19
REVIEWED BY:

Mwkwn(M Flo hmpumW
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
Total Residue, mg/l
Fecal Coliform (MPH /gram Solids
Sample Analysis Method
#6 Date Analyst Code
15500 05/02/19 JTH 2540B-11
<116 05/01/19 KDS 9221E-06
PHONE [phone]
FAX [phone]
ID#: 416 A
DATE COLLECTED: 05/01/19
DATE REPORTED : 05/06/19
REVIEWED BY:

Eflw'unflmid Flo hmpumW
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
Total Residue, mg/1
Fecal Coliform (MP1), /gram Solids
Sample Analysis Method
#7 Date Analyst Code
14980 05/06/19 JMH 2540B-11
<120 05/06/19 JMH 9221E-06
FAX [phone]
ID#: 416 A
DATE COLLECTED: 05/06/19
DATE REPORTED : 05/08/19
REVIEWED BY:

Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Specific Oxygen Uptake Rate
SOUR
Facility Name:
Biosolids Permit Number:
Date:
Digester Temperature:
Sampling Date/Time:
Sampled By:
Analysis Date/Time:
Analyzed By:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
7.
7.
7
7.
22
14-22-19/1310 1
7.54
7.49
7.43
7.2
7.1
70
6_9
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
4-22-19/1315
Windy Sammond
1.58
23
0.07
8.1
0.98
Dry Solids
grees Celsius
arees Celsius
4.37 mg Oxygen/hr
0.28 mg Oxygen/hr/g
23 degrees Celsius
0.86
Temperature Corrected Specific Oxygen Uptake Rate: 0.24 mg Oxygen/hr/g
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.
Updated 10/23/2013

8.4
8.2
8
7.8
a�
7.6
m
7.4
m
N 7.2
_N
In
7
6.8
6.6
6.4
Oxygen Uptake Rate Chart
y ==0.0729 + 8.196
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 11
Time (minutes)

Specific Oxygen Uptake Rate
SOUR
Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facility Name:
Biosolids Permit Number:
Date:
Digester Temperature:
Sampling Date/Time.-
Sampled By:
Analysis Date/Time:
Analyzed By:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
8.23
8.19
8.14
8.09
8.03
7.97
7.96
7.87
7.84
7.75
7.71
7.64
7.57
7.49
7.42
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
CMSD
W00001048
4/24/2019
22
4-24-19/1245
Andrew Edwards
4-24-19/1258
Windy Sammond
1.62 %
22 dE
22 dE
0.06
8.3
0.99
Dry Solids
agrees Celsius.
agrees Celsius
3.32 mg Oxygen/hr
0.20 mg Oxygen/hr/g
22 degrees Celsius
0.91
Temperature Corrected Specific Oxygen Uptake Rate: 0.19 mg Oxygen/hr/g
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.
Updated 10/23/2013

FW
Oxygen Uptake Rate Chart
8.4
8.2
8
7.8
7.2
7
I y =-0.0553� + 8.353
I�
6.8 ' !
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1E
Time (minutes)

Specific Oxygen Uptake Rate
SOUR
Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facility Name. C
Biosolids Permit Number: V
Date:
Digester Temperature:
Sampling Date/Time: 4
Sampled By: A
Analysis Date/Time: 4
Analyzed By: V
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
8.08
8.08
7.97
7.94
7.91
7.9
7.84
7.81
7.77
7.71
7.63
7.4
7.
73
72
Slope:
I ntercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
3D
0001048
-25-19/1350
ndrew Edwards
indy Sammond
1.63 % Dry Solids
24 degrees Celsius
24 dearees Celsius
0.05
8.1
0.99
3.24 mg Oxygen/hr
0.20 mg Oxygen/hr/g
24 degrees Celsius
0.82
Temperature Corrected Specific Oxygen Uptake Ratej 0.16 mg Oxygen/hr/g
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.
Updated 10/23/2013

E: A
8
7.8
0
E
7.6
x
O
7.4
0
N
N
0
7.2
7
Oxygen Uptake Rate Chart
,
-0.05 x+8.18
I
i
I
I I
j
i
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time (minutes)

Specific Oxygen Uptake Rate
SOUR
Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facility Name:
Biosolids Permit Number:
Date:
Digester Temperature:
Sampling Date/Time:
Sampled By:
Analysis Date/Time:
Analyzed By:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
8.86
8.75
8.74
8.7
8.61
8.52
8.46
8.37
8.31
8.26
8.2
d02
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
CMSD
WQ0001048
5/1/2019
24
5-1-19/1350
Andrew Edwards
5-1-19/1400
Windy Sammond
1.6
23
22
% Dry Solids
degrees Celsius
degrees Celsius
3.50 mg Oxygen/hr
0.22 mg Oxygen/hr/g
23 degrees Celsius
0.86
Temperature Corrected Specific Oxygen Uptake Rate: 0.19 mg Oxygen/hr/g
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.
Updated 10/23/2013

9
8.8
8.6
8.4
0
7.8
7.6
7.4
Oxygen Uptake Rate Chart
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1E
Time (minutes)

Specific Oxygen Uptake Rate
SOUR
Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facility Name. CMSD
Biosolids Permit Number: WQ0001048
Date: 5/2/2019
Digester Temperature: 25
Sampling Date/Time: 5-2-19/1325
Sampled By: Andrew Edwards
Analysis Date/Time: 5-2-19/1333
Analyzed By: Windy Sammond
Total Solids: 1.58 % Dry Solids
Beginning Temperature: 23 degrees Celsius
End Temperature: 22 degrees Celsius
Dissolved Oxygen Level
8.42
8.42
8.41
8.41
8.37
8.35
8.32
8.29
8.28
8.25
8.23
8.22
8.2
8.19
8.18
8.16
Slope:
I ntercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
0.02
8.4
0.99
1.16 mg Oxygen/hr
0.07 mg Oxygen/hr/g
23 degrees Celsius
0.86
Temperature Corrected Specific Oxygen Uptake Rate:1 0.06 mg Oxygen/hr/g
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.
Updated 10/23/2013

8.5
8.45
8.4
8.35
8.3
a�
a�
a
"'8.25
o
N 8.2
N_
8.15
8.1
8.05
8
Oxygen Uptake Rate Chart
t
y =-0.0194 + 8.458
J � I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1E
Time (minutes)

Specific Oxygen Uptake Rate
SOUR
Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facility Name:
Biosolids Permit Number:
Date:
Digester Temperature:
Sampling Date/Time:
Sampled By:
Analysis Date/Time:
Analyzed By:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
8.2
8.2
8.2
8.2
8.2
8.22
8.22
8.21
8.19
8.17
8.16
8. 33
8.11
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
5/8/2019
25
5-8-19/1405
Andrew Edwards
Sammond
1.54 % Dry Solids
24 degrees Celsius
23 dearees Celsius
0.01
8.3
0.89
0.58 mg Oxygen/hr
0.04 mg Oxygen/hr/g
24 degrees Celsius
0.82
Temperature Corrected Specific Oxygen Uptake Rate: 0.03 mg Oxygen/hr/g
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.
Updated 10/23/2013

8.25
-- 8.2
E
08.15
0 8.1
8.05
8
Oxygen Uptake Rate Chart
_-0.0097 + 8.282
I
i
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 1E
Time (minutes)

Specific Oxygen Uptake Rate
SOUR
Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facility Name:
Biosolids Permit Number:
Date:
Digester Temperature:
Sampling Date/Time:
Sampled By:
Analysis Date/Time:
Analyzed By:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
8.
8.
8.3
8.3
C:7
8.32
8.31
8.29
8.27
8.24
8.22
8.19
8.16
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
Andrew Edwards
5-9-19/1325
Windv Sammond
53 % Dry Solids
25 degrees Celsius
24 degrees Celsius
0.02
8.4
0.99
0.96 mg Oxygen/hr
0.06 mg Oxygen/hr/g
25 degrees Celsius
0.78
Temperature Corrected Specific Oxygen Uptake Ratel mg Oxygen/hr/g
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.
Updated 10/23/2013

8.35
M:lC3
a)
E
,m8.25
a
x
O
(D 8.2
0
U)
�8.15
:M
8
Oxygen Uptake Rate Chart
I
i
y
-0.016
+ 8.435
I
i
j
1
I
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time (minutes)

GROUNDWATER MONITORING
LAB REPORTS

GW-59A COMPLIANCE REPORT FORM Permit # U-)q0 0
(Submit one each monitoring period with GW-59 forms.)
1
Enter date monitoring results were due. Will this monitoring report (GIN-59 and GW-59A)
YES
NO
be submitted after the established due date?
2
Was any required information missing on the GW-59 report forms?
YES
N,ItQ
IF the answer to question 1 or 2 is "YES", list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the required information.
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
YES
NO
identification plate, area overgrown, etc.)? If the answer is "Yes", contact the Regional Office for guidance.
Y
4
Are any monitored constituents equal to or above the established standards?
YV
NO
If the answer to question 4 is "NO'; skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below:
( I #c) -T i O, i CJrrLj 1 �- t vPJ I �ILA
(�1 I * 16 �rc�mi urn I to Lq) CCPP o
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
in the last two
YES.
NO
same constituent(s) in the same well(s) years?
If the answer to question 5 is "NO", skip to section 8.
If the answer to question 5 is "YES", list in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reported; and sample collection date for each occurrence (for the last two years)..
loe)I+ Z 7,2-1; -To.(, IZ•Iur -q>' l tJ21I #tO Z2Z-.Q Clirtxf)fL'M iL4Uq/� l I4CinfC1T)%L M
65 1 "� I tvuq 1 t
-rp C (' z , ru4-'q,� i, le--r--��r) C.11tOrniU 2-7R-I
Ib-lt-I� i lt�gl�
1�.Drom �L Z-ZO-1 Ct-NVCM �M I ,Q,
18 Ztht4 TC1C F7 b(, ZD-l4 Cn(CM° I(Qct l
i L
-L �I � (r)(pni4m 9UU
6
Are the monitoring wells listed in section 5 located at or beyond. the review boundary?
YES
1
If the answer is "YES" a groundwater quality problem maybe occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO'; monitoring wells maybe improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
YES
NO
groundwater quality problem?
If the answer to question 7 is "YES", describe those actions in the space provided below.
If the answer to question 7 is "NO", contact the Regional Office within 90 days: an evaluation may be
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surrounding this facility Failure to do so may subject the permittee to a Notice of Violation,
fines, and/or penalties.
1�ttrif) Vtt era rnP i�-I`or c api '
ampGn a ,l:xxile!(I,�+�dhav r i r
t (y 4-0d e
f feel � et tat pr a^�
a Qa�al u�cri as �;u:o� S �nc1.�2ar c�rktnS i�iJ h
eme
g
The person completing this portion (GW-59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided of the top of the current GW-59 form.
eg Wa_5bo9Avejalisr�tfro�.mationsear aiedand�e�nyfoFtitatc�n`b"mei tttl�thi
a andcomp to o: hebest o mk�r owteoge�
rehb(yconotlea
pCrtkphoatrtytGeh_
oE
Lnpj
Slgndiure of Permittee (or Authorized Agent) Gate
GW-59A 12/8/2003

SUBMIT FORM ON DW PAPER ONLY
GROU�­ATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or Type
Facility Name: L0
Permit Name (if different):
Facility Address: qM
County
l' yl (Sla le) j2ip)
Contact Person: Telephone#:
�PP�t's1
Well Location/Site Name :\ 715� No, of wells to be sampled: Cp
PERMIT Number: Expiration Date: 6I W'�X_
Non -Discharge UIC
NPDESOther
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑,/Remediation:
El Rotary Distributor S Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): Date sample collected:
Well Depth: ft. Well Diameter: Z in.
Depth to Water Level B2546: ft. below measuring point Screened Interval: _aft. to Q ft.
Measuring Point is ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling: gallons
Samples for metals were collected unfiltered: r.YES ❑ NO and field acidified: X YES ❑ NO
FIELD ANALYSES:
pH 00400:units Temp. 000lo: 13 °C
Spec. Cond. 00094: C/�i 3 µ
Odor 00085: nc
Appearance (� 1r
If WELL
WAS
DRY at
time ofMhos sampling,
check
here: ❑
LABORATORY INFORMATION
Date sample analyzed: Z-1 IC9
Laboratory Name: EVj COEW)EATl
If-f-, Certification No.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD oo335 mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 /100mL
Nitrate (NO3) as N 00620 C),C)(_o
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665
mg/L
(Note: Use MPN method for highly turbid samples)
OrthophoSphate 70507 D t C)�)
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 "7 LP mg/L
AI - Aluminum 01105
mg/L
pH (Lab) 00403 4rj units
Ba - Barium 01007
ug/L
TOC 00680 ) Q, 10 mg/L
Ca - Calcium oog16
mg/L
Chloride 00940 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034 5
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042 <D. OI()
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 G(C`, �j ELMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia omio O. (p 1 mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH,as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
_ ug/L
, method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): IInfluent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
Permittee (or Authorized Agent) Name and Title'- Please print or type
GW-59 Rev.3-1-2016
for Nuulonzeu Agent)
luaw)

SUBMIT FORM ON AMOW PAPER ONLY
GROUNMATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFOR
Facility Name:
Permit Name (if di
Facility Address:
(aiaiel
Please Print Clearly or Type
Contact Person: � fy r ' Telephone#: .Z6Z-62(4_515gU
Well Location/Site Name: 6 cW ri eld" No. of wells to be sampled: (D
PERMIT Number: Expiration Date: J-� ZQZQ
Non -Discharge U40W- 104,0 UIC
NPDES IUCCX`�37,n) Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
WELL ID NUMBER (from Permit): d
Date sample collected: 7-JC/-%c/
FIELD ANALYSES:
If WELL
WAS
Well Depth: ft.
Well Diameter: --in.
pH 00400: 5 J units Temp. 000lo: R_ °C
DRY at
Depth to Water Level ersas: & Z ft. below measuring point
Screened Interval: Z ft. to 9 ft.
Spec. Cond. 000sa: Cf.CD µMhos
time of
Measuring Point is _0 ft. above land surface
_
Relative M.P. Elevation: ft.
Odor 00085: nwt
sampling,
Volume of water pumped/bailed before sampling: gallons
Appearance OC 069
check
here:
❑
Samples for metals were collected unfiltered: � YES El NO
and field acidified: [A YES El NO
late sample analyzed: Z 19-19
Laboratory Name: -f
nyitCflr`Yle-)4 Zj 1M_Certification No. %d
ARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead o1o5i ug/L
Coliform: MF Fecal 31616
/100mL
Nitrate (NO3) as N 00620
C ,' D
rng/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
Q.ICj
mg/L
Other (Specify Compounds and Concentration Units):
ssolved Solids:Total 70300 L�j
mg/L
Al -Aluminum 01105
mg/L
PH (Lab) 00403 6 1
units
Ba - Barium 01007
ug/L
TOC 00680 � 4 -qj
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940
mg/L
Cd - Cadmium 01027
ug/L .
Arsenic 01002
ug/L
Chromium: Total 01034
J iv
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
<O, 0 i Q
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate oosas_
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
pecific Conductance 00095 �A - (
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia 00610 1 (
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn -Manganese o1o55
ug/L
,method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
UVr rcrtrreurauUrr aysterns umy (.viracn Lao rceports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
Permittee(or
GW-59
Rev. 3-1-2016

SUBMIT FORM ON JW PAPER ONLY
GROU1_.ATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please
Facility Name:
Permit Name (if di
Facility Address:
A , n,
(zip,
or
Contact Person:Telephone#:
Well Location/Site Name: 16 No. of wells to be sampled:
PERMIT Number: Expiration Date: /-� [WZ6J
Non -Discharge LQtC0I0C4 cS UIC
NPDES N4cpmlun Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): f C)
Date sample collected:
FIELD ANALYSES:
WAS,
Well Depth: ��j ft.
Well Diameter: in.
pH ooa00:� units Temp. 000lo: )L4 °C
DRY at
Depth to Water Level 825a6: 5ft. below measuring point
�= g p
Screened Interval: (P ft. to j3 ft.
Spec. Cond. 000sa: �j� . CJ µ Mhos
time of
Measuring Point is Z ft. above land surface
Relative M.P. Elevation: ft.
Odor 00085: n (X)s
sampling,
check
Volume of water pumped/bailed before sampling: 5
gallons
Appearance CIW 69
here: ❑
Samples for metals were collected unfiltered: YES El
�/
NO and field acidified: L]9 YES ❑ NO
Date sample analyzed: n q— q
Laboratory Name:
Z IlV 1 (( ff—a)
' J:
( r - Certification No. j
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 Z
/100mL
Nitrate (NO3) as N 00620 0, 'Z_
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 315o4
/100mL
Phosphorus: Total as P 00665
mg/L
(Note: Use MPN method for highly turbid samples)
hoS Ortho p phate 70507
mg/L
Other (Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 4b
mg/L
AI - Aluminum oil o5
mg/L
pH (Lab) 00403 j . "j
units
Ba - Barium 01007
ug/L
TOC 000sa L� • %T�
mg/L
Ca - Calcium oog16
mg/L
Chloride 00940
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
Z�
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
Q. O"T7
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 Si .
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia 00610 Q ,O LP
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3asN; Ammonia Nitrogen, Total)
Mn. - Manganese o1o55
ug/L
method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
rermmee for Autnonzea Agent) Name and I Itle - Please print or type
GW-59 Rev.3-1-2016
of Permittee (or Authorized Agent)

SUBMIT FORM ON )W PAPER ONLY
GROUImuvvATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
NFORMATION
Facility Name:
Permit Name (if di
Facility Address:
Crime
(City)
Please Print Clearly or
(Slate) (Zip)
act Person: �(�f�'Q,�(�]y D l Telephone#: -M-Z_5zq--!5 qC4
Location/Site Name: j n+&act 0(2 IgP 'f',6P,_IG j O No. of wells to be sampled: Cv
ERMIT Number: Expiration Date: f-Ll_/oZID
on -Discharge i,_Qc C0D1OQ'5? UIC
PDES jQ_ t'_03715)-) Other
YPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
EJ Rotary Distributor NrLand Application of Sludge
❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): j 'rj Date sample collected: Z Iq-I Cj
Well Depth: 19 ft. Well Diameter: Z in.
Depth to Water Level 825a6:
p �, 5 ft. below measuring point Screened Interval: ?eft. to ft.
Measuring Point is 2.above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling: 5 gallons
Samples for metals were collected unfiltered: EYES ❑ NO and field acidified: [2(YES ❑ NO
FIELD ANALYSES:
pH 00400:11�._L units Temp. 000lo: I °C
Spec. Cond. 000sa: S; µMhos
Odor 00085: f7 On
Appearance eal(
If WELL
WAS
DRY at
time of
sampling,
check
here:❑
LABORATORY INFORMATION
Date sample analyzed: Z--Igp jqI
Laboratory Name: uj (On g �)
f`G Certification No.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead o1051 ug/L
Coliform: MF Fecal 31616 21 /100mL
Nitrate (NO3) as N 00620
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P o0665
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507 n , o3
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 mg/L
AI -Aluminum 01105
mg/L
pH (Lab) 00403 5,?, units
Ba - Barium 01007
ug/L
TOC omm Cj.ZU mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 uglL
Chromium: Total 01034
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042 <&C)10
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia 00610 0 . mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L
, method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): I Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
�l %` )m W) LQ(-d &P 1 0:�4, a1 C12�
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.3-1-2016
of Permittee (or Authorized Agent)
(Date)

SUBMIT FORM ON OW PAPER ONLY
GROUlimuvv'ATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
ACILITY
Facility Name:
Permit Name (if different):
Facility Address: oc
- C,V �-4tr
Print Clearly or Type
County
(City) (Slate) (Zip)
Contact Person: Telephone#:z ��t i-�J ✓�u
Well Location/Site Name: L'Q(ne sie(o n No. of wells to be sampled:
PERMIT Number: Expiration Date: 1_31_ZpZC)
Non -Discharge lccm UIC
NPDES HGDO376-) ) Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor ® Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): )1-] Date sample collected: _19 /n
Well Depth: 15? ft. Well Diameter: Z. in.
Depth to Water Level 825a6:
P 4 5 ft. below measuring point Screened Interval: z ft. to ft.
Measuring Point is Z.33 ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling: gallons
Samples for metals were collected. unfiltered: [?YES ❑ NO and field acidified: N YES ❑ NO
FIELD ANALYSES:
pH ooaoo: 5.0 units Temp. 000lo: 13 °C
Spec. Cond. 000sa: Co / I j µ Mhos
Odor 00085: nC.-J-)
Appearance L'�(
If WELL
WAS
DRY. at
time of
sampling,
check
here:❑
LABORATORY INFORMATION
Date sample analyzed: Z / �'{—) �j
Laboratory Name:
n\ji (-Cn ffl�� S�� (�• Certification No. J
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 /100mL
Nitrate (NO3) as N 00620
1) mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507 ©.)0 mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 (,4
mg/L
Al - Aluminum oil o5
mg/L
pH (Lab) 004o3 5. (�
units
Ba - Barium 01007
ug/L
TOC 00680 �.Z�
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
1 D ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 (9 I. C4
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia 00610 �:
mg/L
Mg - Magnesium o0927
mg/L
method #
(Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L
, method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
GW-59
Rev. 3-1-2016
nt or type
of Permiftee (or Authorized Agent)
(Date)

SUBMIT FORM O
PAPER ONLY
GROUNT"if1/ATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: },
Permit Name (if different): �_ mJ_ I
Facility Address: QU) (,L)1 1'Pn (r).V! j��1
County
(Slate) (zip)
Contact Person::T)enef &—gtq-n Telephone#: z6Z sZy1
Well Location/Site Name: uj &.� R (16 4r I_--5 No. of wells to be sampled:
PERMIT Number: Expiration Date: / —LJ W Z0
_ Non -Discharge UIC
_ NPDES Other
_ TYPE OF PERMITTED OPERATION BEING MONITORED
_ ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor Land Application of Sludge
P ❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): 119
Date sample collected:
FIELD ANALYSES:
WAS
Well Depth: ! ft.
Well Diameter: Z. in.
pH 00000: 4. (D units Temp. 000lo: 13 °C
DRY at
Depth to Water Level 62646: ft. below measuring point
Screened Interval eft. to / b ft.
Spec. Cond. 000sa- µMhos
time of
Measuring Point is Z_ft. above land surface
Relative M.P. Elevation: ft.
Odor oo085:
sampling,
check
Volume of water pumped/bailed before sampling: gallons
Appearance Gear
here: ❑
Samples for metals were collected unfiltered: ® YES ❑ NO
and field acidified: [V YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: z �� ��
Laboratory Name: Env) rOn1y)&)+'S)
I Certification No. 10
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD oo335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 i /100mL Nitrate (NO3) as N 00620 �U_�jC ` mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 1100mL Phosphorus: Total as P 00665 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 < C).C)mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 12C) mg/L
AI -Aluminum oilo5
mg/L
pH (Lab) 00403 4. Ce units
Ba - Barium 01007
ug/L
TOC 00660 15. mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034 5 Lj
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
C®= O10 mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg -Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
pecific Conductance 00095 j (��
µMhos
K - Potassium 00937
mg/L
VOC 7873 , method #
Total Ammonia oo6lo (-j, 10 mg/L Mg - Magnesium 00927 mg/L method #
(Ammonia Nitrogen; NH,as N: Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L , method #
TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method #
t-or rtemeatation systems Unly (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
�e �n� Lar)1 Ate) t � i crm G2L
Permittee (or Authorized Agent) Name and Title - Plea a print or type Sign
GW-59 Rev.3-1-2016
Agent)
(Date)
9

E1Mw'UT@1Efl&10 alp howp(mbd
wa�tewat�r xarTio
� OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27858 FAX [phone]
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
ID#: 416
DATE COLLECTED: 02/19/19
DATE REPORTED : 03/04/19
REVIEWED BY:
Well #9 Well #10 Well #14 Well #15 Well #17
Analysis Method
Date Analyst Code
Fecal Coliform (MF), /100 Mls
< 1
< 1
2
2
1
02/19/19
JMH
9222D-06
Ammonia Nitrogen as N, mg/l
0.61
0.08
0.06
0.19
0.07
02/20/19
TLH
350.1 R2-93
Nitrate Nitrogen as N, mg/1
0.06
0.80
0.82
0.82
0.11
02/20/19
BLD
353.2 R2-93
Total Organic Carbon, mg/l
10.10
4.93
4.03
9.24
5.21
02/28/19
SEJ
531OC-11
T-fal Dissolved Residue, mg/l
76
43
40
72
64
02/21/19
TBG
2540C-11
iI Chromium, ug/l
<5.0
16
26
7
10
02/21/19
LFJ
EPA200.7
i,opper, ug/l
< 10
< 10
77
< 10
< 10
02/21/19
LFJ
EPA200.7
Conductivity (at 25c), uMhos/cm
94.3
69.0
57.9
86.2
61.4
02/25/19
JMH
251OB-11
Total Ortho-Phosphate as P, mg/l
0.09
0.19
0.26
0.03
0.18
02/20/19
KDS
450OPE-11

EMIAnIMEW % hCOTPOTEW
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
Fecal Coliform (M[F), /100 Mls
Ammonia Nitrogen as N, mg/l
Nitrate Nitrogen as N, mg/l
Total Organic Carbon, mg/l
" ' it Dissolved Residue, mg/l
it Chromium, ug/l
Copper, ug/l
Conductivity (at 25c), uMhos/cm
Total Ortho-Phosphate as P, mg/l
Well ##18 Analysis Method
Date Analyst Code
< 1
02/19/19
JMH
9222D-06
0.10
02/20/19
TLH
350.1 R2-93
< 0.04
02/20/19
BLD
353.2 R2-93
5.53
02/28/19
SEJ
531OC-11
120
02/21/19
TBG
2540C-11
<5.0
02/21/19
LFJ
EPA200.7
<10
02/21/19
LFJ
EPA200.7
163
02/25/19
JMH
251OB-11
< 0.01
02/20/19
KDS
450OPE-11
PHONE [phone]
FAX [phone]
ID#: 416
DATE COLLECTED: 02/19/19
DATE REPORTED : 03/04/19
REVIEWED BY:

GW-59A COMPLIANCE REPORT FORM Permit # ic(4s
(Submit one each monitoring period with GW-59 forms.)
1 Enter date monitoring results were due. ( - -I ) Will this monitoring report (GW-59 and GW-59A) YES NO
be submitted after the established. due date?
2 Was any required information missing on the GW-59 report forms? YES
IF the answer to question .1 or 2 is "YES", list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the required information.
3 Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing YES NO
identification plate, area overgrown, etc.)? If the answer is "Yes", contact the Regional Of ce for guidance. X
4 Are any monitored constituents equal to or above the established standards? YES
If the answer to question 4 is 'NO", skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below:
5 For the constituents identified in question 4 above, have standards been exceeded previously for the I YES I NO
ii
same constituent(s) the same well(s) in the last two years?
If the answer to question 5 is "NO", skip to section 8.
If the answer to question 5 is "YES", list in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary? YES NO
If the answer is "YES", a groundwater quality problem may be occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells may be improperly
located, contact the Regional Office.
7 Is the permittee implementing previously approved actions. required by the Division involving this YES NO
groundwater quality problem? '
If the answer to question 7 is "YES, describe those actions in the space provided below.
If the answer to question 7 is "NO', contact the Regional Office within 90 days; an evaluation may be
—4 rmmnliAnt
fines and/or penalties.
8 The person completing this portion (GW-59A) of the monitoring report should sign below and submit d
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
Pwr
a� e�e�' ac°k owle�d' et at the above mfo matoii}w s'eVal�uate ndtt-eoatiorisubm�tted �n thin
_-- Ven�nr>_G`oe�.tc.+ , p�anrl.:co"�mn1 {e to he es Qftm s�k11Q Ied9e.
Signature of Permittee (or Authorized Agent)
,7- 31
Date
GW-59A 12/8/2003

SUBMIT FORM ONAMLOW PAPER ONLY
IGROURMATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
ILI I Y INFORMATION Please Print Clearly or Type
lity Name: ©nib­f�lf _ t^(i"-z
nit Name (if different); ` en1 nda_ n_),)AD
litynAddress: GHQb_)i 01�jO4LL -7
1�I-l�.l r,� IStreetf �C_ Z(
TlJ t D53U County
(Cilyf f5�ale1 i7-ii>,
Contact Person: Telephone#: z5Z-5ZL4-Fj5<&L4
Well Location/Site Name:. &�tjj CD� p(prr� No. of wells to be sampled:
PERMIT Number: Expiration Date: )-3j-ZDZU
Non -Discharge jj =D1047, UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
...I ­_ 1—r Mwlj, I tury
WELL ID NUMBER (from Permit): G
Date sample collected: (,-)-►�j
FIELD ANALYSES:
If WELL
WAS
Well Depth: g ft.
Well Diameter: Z in.
pH 00400:4_q units Temp. 000lo: z °C
DRY at
Depth to Water Level 82546: 3`�► ft. below measuring point
Screened Interval: 3 ft. to g ft.
Spec. Cond. 000sa: (a 5 C.� µMhos
time ofsampling,
Measuring Point is %. �j ft. above land surface
Relative M.P. Elevation: ft.
Odor 000ss:
check
Volume of water pumped/bailed before sampling: ,j gallons
Samples
Appearance
here:❑
for metals were collected unfiltered: U YES ❑ NO
and field acidified: M YES ❑ NO
Date sample analyzed: 1_'-I I -ICI
Laboratory Name: E.ny l (Qf-)ma*
Z,
f Certification No. 10_
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
_
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 '
/100mL
Nitrate (NO3) as N 00620 C). 6
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507 0.
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 t4 Lo
mg/L
AI - Aluminum oil o5
mg/L
pH (Lab) 00403 L) .Cj
units
Ba - Barium 01007
ug/L
TOC 00680 �•� Z
mg/L
Ca - Calcium oo91s
mg/L
Chloride 00940
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034 < 5. O
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042 jQ
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 000ss l�.
(tMhos
K - Potassium 00937
mg/L
VOC 7673 method #
Total Ammonia ooslo C.CC
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3 as N: Ammonia Nitrogen, Total)
Mn -Manganese 01055
lJg/L
,method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
r•or mememation systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
ittee (or Authorized Agent) kiame and Title - PI a e print or type
GW-59 Rev.3-1-2016
of Permiftee (or
%-t3)4:�
(Date)

SUBMIT FORM ON' W PAPER ONLY
all'i W
GROUNuvvATER QUALITY MONITORING: SUN=an-
COMPLIANCE REPORT FORM 1 sa
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: j-�►- /�7_(
Facility Name: 7() c4 Jtp_ 1 7 ,e )Di Non -Discharge OCC-3t )(JI's UIC
Permit Name (if different): n i en �_ rii�l NPDES PtM5_Z(5_P Other
Facility Address: qca U-),) � Qovjn�) (-j) TYPE OF PERMITTED OPERATION BEING MONITORED
Catr-IWCn istreelj t4l_ i(( 1D 530 Count
y _:�10--}- ❑Lagoon ❑Remediation: Infiltration Gallery
(Cilyj - (SI.I.) (zip) / I ❑ Spray Field ❑ Remediation:
Contact Person: 2Pnep-6 1`iy) Telephone#: ❑ Rotary Distributor 9 Land Application of Sludge
Well Location/Site Name: 6 (-,� Fi P_1 d # U No. of wells to be sampled:- ❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER from Permit):
( ) �(� Date sample collected: (0-1 I�I
Well Depth:
P � ft. Well Diameter: Z in.
Depth to Water Level s2sas: z- ft- below measuring point Screened Interval: Z ft. to ft.
Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft.
Volume of water before sampling:
pumped/bailed p g: gallons
Samples for metals were collected unfiltered: ® YES ❑ NO and field acidified: N YES ❑ NO
FIELD ANALYSES:
pH ooaoo:�� units Temp. o0010: � �C
Spec. Cond. 00094: 5 .0 µMhos
-Odor 000e5: none-
Appearance CI.�Q'�
If WELL
WAS
DRY at
time of
sampling,
check
here:❑
LABORATORY INFORMATION
Date sample analyzed:
Laboratory Name: nyi fQnrnb-)-( ZI
rc Certification No.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead o1051 ug/L
Coliform: MF Fecal 31616 /100mL
Nitrate (NO3) as N 00620
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00565
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507 Q. Quo
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 mg/L
Al -Aluminum 01105
mg/L
pH (Lab) 00403 4. q units
Ba - Barium 01007
ug/L
TOC omm mg/L
Ca - Calcium oo916
mg/L
Chloride 00940 mg/L
Cd - Cadmium 01027
uglL
Arsenic 01002 ug/L
Chromium: Total 01034 C)
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042 <Q, QIO
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 5,5 .c) )LMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia omio <C)-c-)4 mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen: NH3 as N; Ammonia Nitrogen. Total)
Mn - Manganese o1o55
ug/L
, method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
�jgn� m ) Lanq Dvp1-I (t�- W ay_(_
Pemmittee (or Authorized Agent) Name and Title -. Ple se print or type
GW-59 Rev.3-1-2016

SUBMIT FORM ON )W PAPER ONLY
GROW ATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
T�
Facility Name:
Permit Name (if di
Facility Address:
(Jt.M)
Please Print Clearly or Type
act Person: r It fib '(�-h Telephone#: Z5Z-570- S 4
Location/Site Name: S� O_� No. of wells to be sampled: (o
PERMIT Number: Expiration Date:
Non -Discharge L)Q oca OL I-3 UIC
NPDESOther
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor Land Application of Sludge
❑ water Source Heat Pump ❑ Other:
o�rvrrr_umu trNrUKMA I IUN
If WELL
WELL ID NUMBER (from Permit):
Date sample collected: (0-1
FIELD ANALYSES:
WAS
Well Depth: 13 ft.
Well Diameter: Z in.
pH oosao: q - 6 units Temp. 000io: IC( °C
DRY at
Depth to Water Level 82546:J.-T5 ft. below measuring point
Screened Interval:ft. to 13 ft.
Spec. Cond. 000sa: �j, Cj µMhos
time of
Measuring Point is Z ft. above land surface
Relative M.P. Elevation: ft.
Odor 000ss: r)QfL
sampling,
check
Volume of water pumped/bailed before sampling: gallons
Appearance cjto`(
here:❑
Samples for metals were collected unfiltered: M YES ❑ NO
and field acidified: D� YES ❑ NO
Date sample analyzed: (p—I I-1 GI Laboratory Name: env+ FCn rn01A- _T_) Inc.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NOZ) as N 00615 mg/L Pb - Lead olosi
Coliform: MF Fecal 31616 / I /100mL Nitrate (NO.) as N oosao ZCI rng/L Zn - Zinc 01092
Coliform: MF Total 31504 `t /100mL Phosphorus: Total as P 00665 mg/L
(Note: Use MPN method for highly turbid samples)
Certification No. K!)
ug/L
mg/L
Orthophosphate 70507 3. alp mg/L Other (Specify Compounds and Concentration Units):
)issolved Solids:Total 70300
mg/L
Al -Aluminum oiios
mg/L
pH (Lab) 00403 Lt, �j
units
Ba - Barium 01007
ug/L
TOC oosao Z.L}Z
mg/L
Ca - Calcium oosls
mg/L
Chloride oosao
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034 '� ug/L
G
,ease and OIIS ooss2 mg/L
Cu - Copper 01042 <0.01Q
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 �36.q-I µMhos
K - Potassium 00937
mg/L
VOC 71373 , method #
Total Ammonia oosao <(j.Q�} mg/L Mg - Magnesium 00927 mg/L
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total) ug/L
Mn - Manganese oioss
TKN as N 00625 mg/L Ni - Nickel 01067 ug/L
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
D­)a_-Q'�l0-)I (gf IiC ItCt�
ittee (or Authorized Agent)Name and THIe -'Please print or type
GW-59 Rev.3-1-2016
and that the lat--ratory analytical data
lllty of fines and imprisonment for Knc
I
method #
method #
method #
mg/L VOC Removal%
(Date)

SUBMIT FORM ON' iW PAPER ONLY
GROUNuvvATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please Print Clearly or
Facility Name:
Permit Name (if di
Facility Address:
Contact Person: l} e nee-i`)mJ V-h Telephone#: Z,67-,5Z(45!%4
Well Location/Site Name: i nit�oec i-dZIGIu 1 G 1 O No. of wells to be sampled: (.
PERMIT Number: Expiration Date: 1-31-2670
Non -Discharge U-)QWOtb4 UIC
NPDES HC,0 737L5-7 Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor ® Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
If WELL
WELL ID NUMBER (from Permit): Date sample collected: (,—I)—I c j FIELD ANALYSES:
Well Depth: , ft. Well Diameter: Z in. pH 00400::5, ) units Temp. 000lo: Zo 'C
Depth to Water Level 62546: ZZ-1 ft. below measuring point Screened Interval: 3 ft. to ft. Spec. Cond. 00094: µMhos
Measuring Point is Z-j ft. above land surface Relative M.P. Elevation: ft: Odor 00085:
Volume of water pumped/bailed before sampling: 5 gallons Appearance CITY
Samples for metals were collected unfiltered: N YES ❑ NO and field acidified: M YES ❑ NO
DRY at I
time of
sampling,
here: ❑
ate sample analyzed: to 1)-)G
I Laboratory Name: Envl (cn(Ye?I-:r
nC• Certification No. IQ
kRAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD oo3a5
mg/L
Nitrite (NO2) as N oo615
mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 1 C>
/100ml-
Nitrate (NO3) as N 00620 ©,
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507 0.C�(-k
mg/L
Other (Specify Compounds and Concentration Units):
;solved Solids:Total 70300 �? o
mg/L
Al - Aluminum o11 os
mg/L
pH (Lab) 00403 ,�. `
units
Ba - Barium oloo7
ug/L
TOC o0660 Q.
mg/L
Ca - Calcium 00916
mg/L
-
Chloride 00940
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034 �j
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042 <Q, Q jo
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
>ecific Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 7873 , method #
Total Ammonia 00610 0 319 1mg/L Mg - Magnesium 00927 mg/L
(Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total)
Mn -Manganese oloss ug/L
TKN as N 00625 mg/L Ni - Nickel 01067 ug/L
method #
method #
method #
For. Remediation Systems Only. (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
� nm, Q-) pr-QADD -04C Cn etc_,
Permittee (or Authorized Agen Name and Title'- Please print or type
GW-59 Rev.3-1-2016
of Permittee (or Authorized Agent)

SUBMIT FORM ON )dMDW PAPER ONLY
GROUK_ATER QUALITY MONITORING:
Iq mum
COMPLIANCE REPORT FORM
n 9-8 30
FACILITY INFORMATION Please Print Clearly or Type
PERMIT Number: Expiration Date:
Facility Name: -P_(�_ m6c
Non -Discharge UxPW=4-9 UIC
NPDES Other
Permit Name (if different): (,Z m�o
Facility Address: G l l I e l­V5
—6cv, Lim
TYPE
OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
� (Street]
ri m 1-a� �'j-5p County j
(city) (Stale) (zip,
❑ Spray Field ❑ Remediation:
Contact Person: �Q� �l^[ll
Telephone#: Z-�J�-J�U
❑ Rotary Distributor M Land Application of Sludge
Well Location/Site Name:
No. of wells to be sampled:
❑ Water Source Heat Pump ❑ Other:
(from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): I �)
Date sample collected:
FIELD ANALYSES:
WAS
Well Depth: ft.
Well Diameter: 2 in.
pH 00400: 4t (o units Temp. 000lo: Zh °C
DRY at
Depth to Water Level szsas: 4;� ft. below measuring point
Screened Interval: ft. to ft.
Spec. Cond. 0009a: 3g• G µMhos
time ofsampling,
Measuring Point is Z 33 ft. above land surface
Relative M.P. Elevation: ft.
Odor 00085: ncnt,
check
Volume of water sampling: before pumped/bailed um
P P p g:
gallons
Appearance cJ�l( _
here:
❑
Samples for metals were collected unfiltered: ® YES ❑
NO and field acidified: [X YES El NO
LABORATORY INFORMATION
Date sample analyzed: (o—I �-I�
Laboratory Name: e[yror)rner )+_T,
I Irc• Certification No.�_
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615 mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 /100mL
Nitrate (NO3) as N 00620 mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 mg/L
(Note: Use MPN method for highly.turbid samples)
Orthophosphate 70507 mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 Q-) mg/L
Al -Aluminum o11os mg/L
pH (Lab) 00403 4 • w units
Ba - Barium 01007 ug/L
TOC D0680 mg/L
Ca - Calcium oo916 mg/L
Chloride 00940 mg/L
Cd - Cadmium 01027 ug/L
Arsenic 01002 ug/L
Chromium: Total 01034 ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
< ).C)o mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
pecific Conductance 00095 'S.q
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia 00610 CQ -CA
mg/L
Mg - Magnesium oo927
mg/L
method #
(Ammonia Nitrogen: NH3 as N; Ammonla Nitrogen, Total)
Mn - Manganese oloss
ug/L
, method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
of Permittee (or Authorized Agent)
GW-59 Rev.3-1-2016

SUBMIT FORM ON �W PAPER ONLY
GROUNLjvvATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:
Permit Name (if di
Facility Address:
(Stale) (zip)
or
Contact Person: Telephone#: Z6Z-'5ZCJ-6%
Well Location/Site Name: No. of wells to be sampled:
PERMIT Number: Expiration Date: I-I—LDII`
Non -Discharge I,_x,` WID049 UIC
NPDES N( 3,2LM Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor ® Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): g
Date sample collected: (Q) I-1�I
FIELD ANALYSES:
WAS
Well Depth: lC) ft.
Well Diameter: z in.
pH ooaoo:$.rj units Temp. 00010: 19 'C
DRY attime of
Depth to Water Level 82546: ft. below measuringpoint
P
Screened Interval: ft. to 1 ft.
5 Q
Sec. Cond. o009a:
P
9� µMhos
sampling,.
Measuring Point is Z ft. above land surface
Relative M.P. Elevation: ft.
Odor 00065:
norm'
check
Volume of water pumped/bailed before sampling: 5 gallons
Appearance
0 ffA Ilr
here:❑
Samples for metals were collected unfiltered: 09 YES ❑ NO
and field acidified: N YES ❑ NO
-------------
Date sample analyzed: L-) F-IG
Laboratory Name: t--nxJI i-cy-v ul
T t
I OC Certification No. 16
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead most ug/L
Coliform: MF Fecal 31616 ? (]�
/100mL
Nitrate. (NO.) as N 00620 O �j
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665
mg/L
(Note: Use WIN method for highly turbid samples)
Orthophosphate 70507 Q. QZ
mg/L
Other (Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 Igs
mg/L
Al -Aluminum o1105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC oo660 G2.
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034 �rj .Q
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042 �O,Q
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 1�j
µMhos
K - Potassium 00937
mg/L
VOC 7673 method #
Total Ammonia 00610 �j.(
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen: NH3as N: Arnmonla Nitrogen, Total)
Mn - Manganese o1os5
ug/L
- , method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
ittee (or Authorized Agent) Name and Title -'Please print or type
GW-59 Rev.3-1-2016
of Permittee (or Authorized Agent)

MRATmEqW Flo hmpumho
OAKMONT DRIVE
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
Fecal Coliform (MF), /100 Ms
Ammonia Nitrogen as N, mg/l
Nitrate Nitrogen as N, mg/1
Total Organic Carbon, mg/l
Total Dissolved Residue, mg/1
ital Chromium, ug/1
copper, ug/l
Conductivity (at 25c), uMhos/cm
Total Ortho-Phosphate as P, mg/1
PHONE [phone]
FAX [phone]
ID#: 416
DATE COLLECTED: 06/11/19
DATE REPORTED : 07/08/19
REVIEWED BY:
Well #9
Well #10
Well #14
Well #15
Well #17
Analysis
Method
Date
Analyst
Code
< 1
1
4
10
< 1
06/11/19
MAR
9222D-06
0.99
<0.04
<0.04
0.38
<0.04
06/13/19
DTL
350.1 R2-93
0.15
0.55
0.29
0.19
0.48
06/12/19
AKS
353.2 112-93
7.82
3.89
2.42
9.22
1.73
06/13/19
SEJ
531OC-11
46
30
35
126
47
06/13/19
KDS
2540C-11
<5.0
<5.0
7
5
5
06/13/19
LFJ
EPA200.7
< 10
< 10
< 10
< 10
< 10
06/13/19
LFJ
EPA200.7
65.0
55.0
35.9
137
38.9
06/17/19
JMS
251OB-11
0.07
0.06
0.06
0.04
0.16
06/12/19
KDS
450OPE-11

�ooQ0000� % hCoTpumbd
I I-t'1jMr\IVIV IV I VI U V L
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
Well #18
Analysis
Method
PARAMETERS
Date
Analyst
Code
Fecal Coliform (W), /100 Mls
>600
06/11/19
MAR
9222D-06
Ammonia Nitrogen as N, mg/l
<0.04
06/13/19
DTL
350.1 R2-93
Nitrate Nitrogen as N, mg/1
0.05
06/12/19
AKS
353.2 R2-93
Total Organic Carbon, mg/1
7.92
06/13/19
SEJ
531OC-11
"Dtal Dissolved Residue, mg/l
108
06/13/19
KDS
2540C-11
otal Chromium, ug/l
<5.0
06/13/19
LFJ
EPA200.7
Copper, ug/1
<10
06/13/19
LFJ
EPA200.7
Conductivity (at 25c), uMhos/cm
151
06/17/19
JMS
251OB-11
Total Ortho-Phosphate as P, mg/l
0.02
06/12/19
KDS
450OPE-11
FAX [phone]
ID#: 416
DATE COLLECTED: 06/11/19
]GATE REPORTED : 07/08/19
REVIEWED BY: 'A -

EmbbimmW % hCoTpumbd
GREENVILLE, N.C. 27858
ID#: 416 Y
FAX [phone]
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN DATE COLLECTED: 06/11/19
P.O. BOX 477 DATE REPORTED : 07/08/19
GRIFTON ,NC 28530
REVIEWED BY: .�
Well #10 Well #14 Analysis Method
PARAMETERS Date Analyst Code
Total Chromium, ug/1 <5.0 <5.0 06/13/19 LFJ EPA200.7
Copper, ug/1 < 10 < 10 06/13/19 LFJ EPA200.7

GW-59A COMPLIANCE REPORT FORM Permit k d
(Submit one each monitoring period with GW-59 forms.)
1
Enter date monitoring results were due. ( i)I ) Will this monitoring report (GW-59 and GW-59A)
YES
NO
be submitted after the established due date?
x
2
Was any required information missing on the GW-59 report forms?
YES
IF the answer to question 1 or 2 is "YES", list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the required information.
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
is "Yes", the Regional Office
YES
NO
identification plate, area overgrown, etc.)? If the answer contact for guidance.
4
Are any monitored constituents equal to or above the established standards?
YTS
NO
If the answer to question 4 is "NO", skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below.
u-)204q �Coli �• ) I �/)cowl wel►#►5 �=eca cbo izfm l ►corY• )
�^ well # i� (ec (Cc�Li m
Cbl �' adVlocrn
�211 #Io a ecal
tL>,2 l�(t_.I �(DalCot fM �I
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
YES
'1l4/
NO
same constituent(s) in the same well(s) in the last two years?
If the answer to question 5 is "NO", skip to section 8.
If the answer to question 5 is "YES", list in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
;fcQ I Col i M
7 (�rni fGZLI g oel) 1� SjlGOri
(� (l-I�l Iv811#K3 l/iCGm1 well*(4
� bi�i1�/ic-1 ZI�a iiZwp�5 i/) 11
Je) Io*Lj
�� e 11 15 [al)OCm I I)ei) 4-0 l/icom I
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
tVQ
X
If the answer is "YES"' a groundwater quality problem maybe occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO". monitoring wells maybe improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
YES
NO
groundwater quality problem?
X
If the answer to question 7 is 'YES", describe those actions in the.space provided below.
If the answer to question 7 is "NO" contact the Regional Office within 90 days: an evaluation may be
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surrounding this facility. Failure to do so may subject the permittee to a Notice of Violation.
fines, and/or penalties. 4000vig�-�eChfcmiuml �j
ue i�ve been oldlt C C60-191,J4h ���
rr. p,j a reoult
Y��M i alcttecl 4•h-e cN�e.rl CCk4.)n�j 5• [�e c�r� �rIC11�� do
txl i eve J-h e-pPcalcc(icbrm
elidif)-% ifvht LLe,(I� b� ,P- tt--,1a pl e l�c�etini r�F bfc �r� 2vzv
g
The person completing this portion (GW-59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
hlfereQj bZockno lw edge tha Vi ove i fo motion was luated'antl theAnfo r dMidnLsub`rF tied i "th s
w��,� 4._
9A)_is� e�and cotnPt�obes my Howled e
irep�Compliange.ReportW p
Signature of Permittee (or Authorized Agent) Date
GW-59A 12/8/2003

SUBMIT FORM ON )W PAPER ONLY
711AeM O OENFA1kWA__ i 1 0.-.O_... E
GROUNDWATER QUALITY MONITORING: o I
COMPLIANCE REPORT FORM s c s9 t: a s; B 6n s3o,
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date:
Facility Name: C(nlenlr_e_CL ft_�f17 Non -Discharge UIC
Permit Name (if different): q NPDES NCC©�71j7� Other
Facility A/d�dre/s�s/:ICJ j L° n -P 'v U-)-) TYPE OF PERMITTED OPERATION BEING MONITORED
(�(11�Ty I E" QC Z�530 County A -1* ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City' (siaie' (Zip)
❑ Spray Field ❑ Remediation:
Contact Person: Telephone#: 76 5_2q-� V-1 ❑ Rotary Distributor 56 Land Application of Sludge
Well Location/Site Name: ,,.)Ljedq=0P,Q()6j_rC No. of wells to be sampled: F ❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): G Date sample collected: jQ-jC..j --jq
Well Depth: g ft. Well Diameter: Z in.
De
Depth to Water Level 825a6:
p 5, � ft. below measuring point Screened Interval: 3 ft. to � ft.
Measuring Point is Z . 5 ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling: Jr gallons
Samples for metals were collected unfiltered: IX] YES ❑ NO and field acidified: YES ❑ NO
FIELD ANALYSES:
pH 00400:q.--7 units Temp. 000lo: Z3 °C
Spec. Cond. 000sa: �(� µ Mhos
Odor 000B5: ()Cj-) 'e-
Appearance CjeQ r
If WELL
WAS
DRY at
time of
sampling,
check
here:❑
LABORATORY INFORMATION
Date sample analyzed: to-10-ej
Laboratory Name: F. n!j 000mcni
Z)
Certification No.)0
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N o0615
mg/L
Pb - Lead olo51 ug/L
Coliform: MF Fecal 31616 i
/100mL
Nitrate (NO3) as N 00620 GG (2)Q
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 315o4
/100mL
Phosphorus: Total as P 00665
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300
mg/L
Al - Aluminum oil o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC oo68o
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940
mg/L
Cd - Cadmium olo27
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034 ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042 CO C)
mg/L
ORGANICS: (by GC, GCIMS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? lLidid Yes (1) ❑ No (0)
Specific Conductance 00095 Z30
FtMhos
K - Potassium 00937
mg/L
VOC 7873 method # (ozoo c -
Total Ammonia oo610 j . ­6y
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen: NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L
method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
u� rcn uuicc tui nuuiuuccu nyci u�
GW-59 Rev.3-1-2016
IL:L:IL71

SUBMIT FORM ON' W PAPER ONLY
GROUNDWATER QUALITY MONITORING: and I copy to:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: bn+tT)4')e-a ff),0
Permit Name (if different): n+cn 'eL— (nLiD
Facility Address: Qoo ()J`I i f r'6 Q j 2PA
County W-
(Cay) (Statel (ZiP) ! '
Contact Person: J�jo_��j()jl� Telephone#: Z62-,2�-j�S�t
Well Location/Site Name: ,-/) o-r P dd *4 No. of wells to be sampled: (o
PERMIT Number:
Expiration Date:
Non -Discharge
UIC
NPDES
Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon
❑ Remediation: Infiltration Gallery
❑ Spray Field
El Remediation:
❑ Rotary Distributor
di -and Application of Sludge
❑ Water Source Heat Pump
ElOther:
If WELL
WELL ID NUMBER (from Permit): IQ Date sample collected: Id-Iq-ICf
Well Depth: ft. Well Diameter: in.
Depth to Water Level 8254e: C�) (o ft. below measuring point Screened Interval: ft. to 9 ft.
Measuring Point is _3 ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling: gallons
Samples for metals were collected unfiltered: [[] YES ❑ NO and field acidified: [A YES ❑ NO
FIELD ANALYSES:
pH 00400: U • 8 units Temp. 00010: Z3 °C
Spec. Cond. oossa: 4,0. 3 µMhos
Odor 000as: 000-e..
Appearance r )oo f— d fajr
late sample analyzed: IO- 14-jCj Laboratory Name: FnO f on m ent TIt Ity
'ARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead oio51
Coliform: MF Fecal 31616 135 /100mL Nitrate (NO3) as N 00620 O G 5 mg/L Zn - Zinc 01092,
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 mg/L
Certification No. ) 3
ug/L
mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 0,1(.0 mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 6tZ
mg/L
Al -Aluminum o11os
mg/L
pH (Lab) 004o3 q• 9
units
Ba - Barium 01007
ug/L
TOC oosao Z •4 Co
mg/L
Ca - Calcium oos1B
mg/L
Chloride oosao
mg/L
Cd - Cadmium olo27
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034 <-,
ug/L
DRY at
time of
sampling,
here: ❑
Grease and Oils 00552 mg/L
Cu - Copper 01042 Co,Q►0
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? �d Yes (1) ❑ No (0)
Specific Conductance 00095 µMhos
K - Potassium 00937
mg/L
VOC 7873 , method # A WOC, --I
Total Ammonia ooelo C>. I (p mg/L Mg - Magnesium 00927 mg/L
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen. Total)
Mn -Manganese oloss ug/L
TKN as N 00625 mg/L Ni - Nickel 010e7 ug/L
method #
method #
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
V V V-D'd mev. J- I-ZU 10

SUBMIT FORM ON) W PAPER ONLY
GROUNDWATER QUALITY MONITORING: oR o ocEssl
COMPLIANCE REPORT FORM S C _ENTER G 19BO -G306
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: I-a)-ZO QZ
Facility Name: f-en4-nf0'^-- [Y)L- (, Non -Discharge ,��ry
Cw(��5 UIC
Permit Name (if different): fl 0-Win-ea- Q Mb- NPDES Other
Facility Address: _9QQ LL) j I �u �,�YA m , Po -Eck ED-) TYPE OF PERMITTED OPERATION BEING MONITORED
r 1 4� estreeq �4C ZA!53( County �g Gallery � ❑ Lagoon El Infiltration
(04y) tstaie, ,zlw ❑ Spray Field ❑ Remediation:
Contact Person: I��nec `d 1 11 4_� Telephone#: Z-L52(.4-' %4 ❑ Rotary Distributor M Land Application of Sludge
Well Location/Site Name: Cs }(yy g No. of wells to be sampled: ❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): % Ll Date sample collected:
Well Depth: 1 ft. Well Diameter: Z in.
Depth to Water Level 82546: 10. d� ft. below measuring point Screened Interval: &ft. to 1 ✓ ft.
—
Measuring Point is ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling: 5 gallons
Samples for metals were collected unfiltered: )] YES ❑ NO and field acidified: YES ❑ NO
FIELD ANALYSES:
pH 00400:4,'5 units Temp. 000m: ZJ C
Spec. Cond. 0009a: i � µMhos
Odor 000s5: nCy-)e_
Appearance cir
If WELL
WAS
DRY at
time of
sampling,
check
here:❑
LABORATORY INFORMATION
Date sample analyzed: to- I( _K_ff
Laboratory Name: F- nyI fcnmeo+
�1
lry--- Certification No. 1
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N oo615
mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 /100mL
Nitrate (NO3) as N 00620
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507 o .b
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 g-% mg/L
Al -Aluminum o11o5
mg/L
pH (Lab) 00403 46 units
Ba - Barium 01007
ug/L
TOC omm mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 mg/L
Cd - Cadmium 01027
ug/L
Arsenic01002 ug/L
Chromium: Total01034
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042 <G, QIO
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? 9 Yes (1) ❑ No (0)
Specific Conductance 00095 f 5 tlMhos
K - Potassium 00937
mg/L
VOC 7873 method # 6Z�QCJ L
Total Ammonia oo610 Q.W mg/L
Mg - Magnesium oo927
mg/L
method #
(Ammonia Nitrogen; NH3asN; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L
, method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mglL VOC Removal%
_Pharlt1fl. d A-W imkm 06c
Penmttee (or Authorized Agent) Name and Title - PI ase print or type
GW-59 Rev.3-1-2016

SUBMIT FORM ON
PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
GAr`n ITV tntCnDRNATtnnt Please
Facility Name:
Permit Name (if different):
Facility Address: qCC
or
County
(city) fstatel (zip)
ontact Person: J�e(� eP l Telephone#: Z,fZ-!5Z4-�
fell Location/Site Name:I E*60eCf' JaP141-6091 O No. of wells to be sampled
PERMIT Number: Expiration Date: I-,N-ZGZn
Non -Discharge t,�[Q42 UIC
NPDES NCCC)aZQ_n Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): 1,5 Date sample collected:
Well Depth: ft. Well Diameter: c7_in,
Depth to Water Level s254s:
De p �• 5 ft. below measuring point Screened Interval: 3 ft. to �ft_
Measuring Point is Z.6 ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling: 5 gallons
Samples for metals were collected unfiltered: [%YES ❑ NO and field acidified: YES ❑ NO
FIELD ANALYSES:
pH 00aoo:4• C0 units Temp. 000lo: z� °C
Spec. Cond. oo0s4: '� � • �-i µ Mhos
Odor 00085: r-)or)t_
Appearance G(r—L F
If WELL
WAS
DRY at
time of
sampling,
check
here:❑
LABORATORY INFORMATION
Date sample analyzed: ��}-iC }�
I jp
Laboratory Name: Envifo')n)c +-Tj Certification No.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N oo615 mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 /100mL
Nitrate (NO3) as N 00620 d•©(� mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100ml-
Phosphorus: Total as P 00665 mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507 (}.(x% mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 mg/L
Al -Aluminum o11os mg/L
pH (Lab) 00403 •(� units
Ba - Barium 01007 ug/L
TOC oosso Cj.� mg/L
Ca - Calcium oosss mg/L
Chloride 00940 mg/L
Cd - Cadmium 01027 ug/L
Arsenic 01002 ug/L
Chromium: Total 01034 (n ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042 CQ •Q JQ mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045 ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 719oo ug/L
Lab Report Attached? 1� Yes (1) ❑ No (0)
Specific Conductance 00095 0-4 µMhos
K - Potassium 00937 mg/L
VOC 7873 method # %WOC_4 I
Total Ammonia oosso ©, L4 90 mg/L
Mg - Magnesium 00927 mg/L
method #
(Ammonia Nitrogen; NH, as N; Ammonia Nitrogen. Total)
Mn - Manganese o1o55 ug/L
, method #
TKN as N 00625 mg/L
Ni - Nickel 01067 ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
C)af1 m �; ��czSc lCand l� lirnc c.
Permittee (or Authorized Agent) Name and Title - P ease print or type
GW-59 Rev.3-1-2016

SUBMIT FORM ON
PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
CAf-ll ITV IAlCr)DI111ATIrlA1 Please
Facility Name: (_a
Permit Name (if different):
Facility Address: C/CQ
or Type
County
ntact Person: I�)trle. "-rnII vv-) Telephone#: 762-'5Z4- 5%4
'll Location/Site Name:. C(�nff P PJC[ #(Qi No. of wells to be sampled: (p
PERMIT Number: Expiration Date:
Non -Discharge 1,000IDOIC>< I d UIC
NPDESOther
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor CvLand Application of Sludge
❑ Water Source Heat Pump ❑ Other:
WELL ID NUMBER (from Permit):
Date sample collected: I C--14-jG
FIELD ANALYSES:
Well Depth: q ft.
Well Diameter: in.
pH 00400:4-9 units Temp. 000lo:
Depth to Water Level 62546: I (p ft. below measuring point
Screened Interval: Z ft. to ft.
Spec. Cond. 00094: �5 I g µMhos
Measuring Point is �.�j�j ft. above land surface
Relative M.P. Elevation: ft.
Odor 000e5: �C�l
Volume of water pumped/bailed before sampling:
gallons
Appearance ld'e(
Samples for metals were collected unfiltered: OYES
❑ NO and field acidified: [A YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: IC15-(4--�Cj
L
LaboratoryName: F fN) f(n jY 15_) 1 .T�
�%1C Certification No.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615 mg/L
Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 ' /100mL
Nitrate (NO3) as N 00620 0 • (p mg/L
Zn - Zinc D1092 mg/L
Coliform: MF Total 31504 /100ml-
Phosphorus: Total as P 00665 mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507 1�•.O� mg/L
Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 5(� mg/L
Al - Aluminum 01105 mg/L
pH (Lab) 00403 la . units
Ba - Barium 01007 ug/L
TOC 006eo Z- I �0 mg/L
Ca - Calcium 00916 mg/L
Chloride 00940 mg/L
Cd - Cadmium 01027 ug/L
Arsenic 01002 ug/L
Chromium: Total 01034 C �J. (� ug/L
If WELL
DRY at
time of
sampling,
here: ❑
Grease and Oils o0552
mg/L
Cu - Copper 01042 C O • SIC)
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? 1� Yes (1) ❑ No (0)
Specific Conductance 00095 mj •�
ELMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia o0610 �. I
mg/L
Mg - Magnesium oo927
mg/L
method #
(Ammonia Nitrogen; NH, as N; Ammonia Nitrogen. Total)
Mn - Manganese olos5
ug/L
, method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
Permittee (or Authorized Agent) Na
GW-59 Rev.3-1-2016
- Please pnnt or type
ica' W ou-

SUBMIT FORM ON Y4111111111V/ PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:
Permit Name (if different):
Facility Address: C(c):!
,� LPlease Print Clearly or
1 t h b
(Slate) lzlp)
County P1 +-f-
act Person: enee 5-m� Telephone#: Z57 5ZLi- 55�_`4
Location/Site Name: I,k)C�D r I ei 6 4hj No. of wells to be sampled:—( _
PERMIT Number: Expiration Date: )-A,�►-L000
Non -Discharge k_QCCOI04q UIC
NPDES I-IC�03ZC�7�i Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): 1,9 Date sample collected:
Well Depth: �� ft. Well Diameter: Z in.
Depth to Water Level 82546: -�, 1 (c ft. below measuring point Screened Interval: S ft. to la ft.
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling:�:!! gallons
Samples for metals were collected unfiltered: YES ❑ NO and field acidified: YES ❑ NO
FIELD ANALYSES:
pH 0oaoo: -0 units Temp. 000lo: ZZ °C
Spec. Cond. 00094: 13Gi µMhos
Odor 00085:
Appearance G Q Y
If WELL
WAS
DRY at
time of sampling,
check
here:❑
LABORATORY INFORMATION
Date sample analyzed: I � I L4-1,:
Laboratory Name:
_
F_rw i ra) (�eit _.-L
j nc - Certification No. C—
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N oo815
mg/L
Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 _E00 /100mL
Nitrate (NO3) as N 00820
�� , QL mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00885
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
O . �J mg/L
Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 1 mg/L
Al - Aluminum o11os
mg/L
pH (Lab) 00403 5.0 units
Ba - Barium 01007
ug/L
TOC 0068D Q -L O mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 mg/L
Cd - Cadmium olo27
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
C)LC) mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? rLq_- Yes (1) ❑ No (0)
Specific Conductance 00095 µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia oo810 mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen: NH3 as N: Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L
, method #
TKN as N 00825 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
_VV II-J -I-GU IV

Efiw'w0)flmM % hC0TV@TMW
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
z �. -----Wastewater TD: 10
PHONE [phone]
FAX [phone]
ID#: 416
DATE COLLECTED: 10/14/19
DATE REPORTED : 11/18/19
REVIEWED BY: --
Well #9
Well #10
Well #14
Well #15
Well #17
Analysis
Method
Date
Analyst
Code
PARAMETERS
Fecal Coliform (N1F), /100 Mls
16
35
7
12
< 1
10/14/19
HJO
9222D-06
Ammonia Nitrogen as N, mg/l
1.34
0.16
0.20
0.48
0.13
10/16/19
BLD
350.1 R2-93
Nitrate Nitrogen as N, mg/l
<0.04
0.95
1.45
0.04
0,61
10/15/19
BLD
353.2 R2-93
Total Organic Carbon, mg/l
6.78
2.46
2.09
9.83
2.16
10/16/19
SEJ
531OC-11
tal Dissolved Residue, mg/I
53
42
87
119
50
10/15/19
MAR
2540C-11
tal Chromium, ug/1
<5.0
<5.0
<5.0
6
<5.0
10/25/19
LFJ
EPA200.7
Copper, ug/l
< 10
< 10
< 10
< 10
< 10
10/17/19
LFJ
EPA200.7
Conductivity (at 25c), uMhos/cm
230
47.3
158
81.4
51.8
10/21/19
TMR
251OB-11
Total Ortho-Phosphate as P, mg/I
0.12
0.16
0.03
0.08
0.07
10/15/19
KDS
450OPE-11

RMUmNEW Flo hCupTOW
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
Well #18
Analysis
Method
PARAMETERS
Date
Analyst
Code
Fecal Coliform (MF), /100 MIS
200
10/14/19
HJO
9222D-06
Ammonia Nitrogen as N, mg/l
0.28
10/16/19
BLD
350.1 R2-93
Nitrate Nitrogen as N, mg/l
<0.04
10/15/19
BLD
353.2 R2-93
Total Organic Carbon, mg/l
8.47
10/16/19
SEJ
531OC-11
otal Dissolved Residue, mg/1
133
10/15/19
MAR
2540C-11
otal Chromium, ug/l
<5.0
10/25/19
LFJ
EPA200.7
Copper, ug/l
< 10
10/17/19
LFJ
EPA200.7
Conductivity (at 25c), uMhos/cm
139
10/21/19
TMR
251OB-11
Total Ortho-Phosphate as P, mg/1
0.05
10/15/19
KDS
450OPE-11
Wastewater iD -0
PHONE [phone]
FAX [phone]
ID#: 416
DATE COLLECTED: 10/14/19
DATE REPORTED : 11/18/19
REVIEWED BY:

% howpud(d
114 OAKMONT UHIVE
GREENVILLE, N.C. 27858
CLIENT: CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. $OX 477
GRIFTON, NC 28530
REVIEWED BY:
VOLATILE ORGANICS
m„ i, vmvnna g'7nno-1 i
jNE [phone]
FAX [phone]
CLIENT ID: 416
ANALYST: KPG
DATE COLLECTED: 10/14/19
DATE ANALYZED: 10/23/19
DATE REPORTED: 11/18/19
Page: 1
PARAMETERS, ug/1
Well #9
Well #10
Well #14
Well #1S
Well #17
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
1. Benzene
<0.50
<0.50
<0.50
<0.50
<0.50
2. Bromobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
3. Bromochloromethane
<0.50
<0.50
<0.50
<0.50
<0.50
4. Bromodichloromethane
<0.50
< 0.50
< 0.50
< 0.50
< 0.50
5. Bromoform
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
6. Bromomethane
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
7. N-Butylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
S. Sec-Butylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
9. Tert-Butylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
10. Carbon Tetrachloride
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
11. Chlorobenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
12. Chloroethane
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
13. Chloroform
1.022
< 0.50
< 0.50
< 0.50
< 0.50
14. Chloromethane
<0.50
<0.50
<0.50
<0.50
<0.50
15. 2-Chlorotoluene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
16. 4-Chlorotoluene
<0.50
<0.50
<0.50
<0.50
<0.50
17. Dibromochloromethane
<0.50
<0.50
<0.50
<0.50
<0.50
18. 1,2-Dibromo-3-Chloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
19. 1,2-Dibromoethane
<0.50
<0.50
<0,50
<0.50
<0.50
20. Dibromomethane
<0.50
<0.50
<0.50
<0.50
<0.50
21. 1,2-Dichlorobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
22. 1,3-Dichlorobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
23. 1,4-Dichlorobenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
24. Dichlorodifluoromethane
<0.50
<0.50
<0.50
<0.50
<0.50
25. 1,1-Dichloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
. 1,2-Dichloroethane
26.
<0.50
<0.50
<0.50
<0.50
<0.50
1,1-Dichloroeth
2ane
<0.50
<0.50
<0.50
<0.50
<0.50
28. Cis-1,2-Diroeth ethane
<0.50
<0.50
<0.50
<0,50
<0.50
29. trans-1,2-Dichloroethene
<0.50
<0.50
<0.50
<0.50
<0.50
30. 1,2-Dichloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
31. 1,3-Dichloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
32. 2,2-Dichloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
33. 1,1-Dichloropropene
<0.50
<0.50
<0.50
<0.50
<0.50
34. Cis-1,3-Dichloropropene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
35. trans-1,3-Dichloropropene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
3 6. Ethylbenzene
EthylbHexac
<0.50
<0.50
<0.50
<0.50
<0.50
3. lorobutadiene
<0.50
<0.50
<0.50
<0.50
<O.SO
38. Isopropylbenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
39. 4-Isopropyltoluene
< 0.50
< 0.50
<0.50
< 0.50
< 0.50
40. Methylene Chloride
< 0.50
<0.50
< 0.50
< 0.50
< 0.50
41. Naphthalene
<0.50
< 0.50
< 0.50
< 0.50
< 0.50
42. Propylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
43. Styrene
44. 1,1,1,2-Tetrachloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
<6.50
45. 1,1,2,2-Tetrachloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
4 6. Tetrachloroethene
<0.50
<0.50
<0.50
<0.50
<0.50
4. Toluene
<0.50
<0.50
<0.50
<0.50
<0.50
48. 1,2,3-Tricblorobenzene

ElMnNEW Flo hcupumbo
wastewater ID; 19
1_10
__,<wPHONE [phone]
114 OAKMONT DRIVE FAX [phone]
GREENVILLE, N.C. 27858
CLIENT: CMSD (SLUDGE & WELLS ACCT) CLIENT ID: 416
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN ANALYST: KPG
7 DATE COLLECTED: 10/14/19 Page: 2
P.O. BOX 47BOX
47 28530 DATE ANALYZED: 10/23/19
GRIFTONDATE REPORTED: 11/18/19
REVIEWED BY:
VOLATILE ORGANICS
emn mRTunnS 92.0OC-11
PARAMETERS, ug/l
Well #9
Well #10
Well #14
Well #15
Well #17
49. 1,2,4-Trichlorobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
50. 1,1,1-Trichloroethane
<0.50
<.0.50
<0.50
<0.50
<0.50
51, 1,1,2-Trichloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
52. Trichloroethene
53. Trichlorofluoromethane
<0.50
<0.50
<0.50
<0.50
<0.50
54. 1,2,3-Trichloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<0,50
<0.50
<0.50
55. 1,2,4-Triinethylbenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
56. 1,3,5-Trirnethylbenzene
<0.50
< 0.50
< 0.50
< 0.50
< 0.50
57, Vinyl Chloride
< 1.00
< 1.00
< 1.00
< 1.00
< 1.00
58. Total Xylenes
59. Methyl Tert Butyl Ether
< 1.00
< 1.00
< 1.00
< 1.00
< 1.00

EMMUTORHM Flo hCupumho
114 O l"MONT DRIVE
GREENVILLE, N.C. 27858
CLIENT: CMSD (SLUDGE & WELDS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON, NC 28530
REVIEWED BY:
- r !4', wastewater ID: �0
PHONE [phone]
FAX [phone]
CLIENT ID: 416
VOLATILE ORGANICS
STD. METHODS 620OC-11
ANALYST: KPG
DATE COLLECTED: 10/14/19 Page: 3
DATE ANALYZED: 10/23/19
DATE REPORTED: 11/18/19
PARAMETERS, ug/l
Well #18
1.
Benzene
< 0.50
2.
Bromobenzene
< 0.50
3.
Bromochloromethane
<0.50
4.
Bromodichloromethane
<0.50
5.
Bromoform
< 0.50
6.
Bromomethane
< 0.50
7.
N-Butylbenzene
<0.50
8.
Sec-Butylbenzene
<0.50
9.
Tert-Butylbenzene
<0.50
10.
Carbon Tetrachloride
<0.50
11.
Chlorobenzene
<0.50
12.
Chloroethane
< 0.50
13.
Chloroform
<0.50
14.
Chloromethane
< 0.50
15.
2-Chlorotoluene
< 0.50
16.
4-Chlorotoluene
< 0.50
17.
Dibromochloromethane
< 0.50
18.
1,2-Dibromo-3-Chloropropane
< 0.50
19.
1,2-Dibromoethane
< 0.50
20.
Dibromomethane
<0.50
21.
1,2-Dichlorobenzene
< 0.50
22.
1,3-Dichlorobenzene
< 0.50
23.
1,4-Dichlorobenzene
< 0.50
24.
Dichlorodifluoromethane
<0.50
25.
1,1-Dichloroethane
< 0.50
26,
1,2-Dichloroethane
<0.50
27,
1,1-Dichloroethene
< 0.50
28.
Cis-1,2-Dichloroethene
< 0.50
29.
trans-1,2-Dichloroethene
< 0.50
30.
1,2-Dichloropropane
< 0.50
31.
1,3-Dichloropropane
< 0.50
32.
2,2-Dichloropropane
< 0.50
33.
1,1-Dichloropropene
< 0.50
34.
Cis-1,3-Dichloropropene
<0.50
35.
trans- 1,3-Dichloropropene
< 0.50
36.
Ethylbenzene
< 0.50
37.
Hexachlorobutadiene
< 0.50
38.
Isopropylbenzene
< 0.50
39.
4-Isopropyltoluene
< 0.50
40.
Methylene Chloride
<0.50
41.
Naphthalene
< 0.50
42.
Propylbenzene
< 0.50
< 0.50
43.
44.
Styrene
1,1,1,2-Tetrachloroethane
< 0.50
45.
1,1,2,2-Tetrachloroethane
< 0.50
46.
Tetrachloroethene
< 0.50
47.
Toluene
<0.50
< 0.50
48.
1,2,3-Trichlorobenzene

r 7- '
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
CLIENT: CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON, C 28530
REVIEWED BY:
VOLATILE ORGANICS
STD. METHODS 620OC-11
PARAMETERS, ug/l
WaatewaC®r TDt 10
PHONE [phone]
FAX [phone]
CLIENT ID: 416
ANALYST: KPG
DATE COLLECTED: 10/14/19
DATE ANALYZED: 10/23/19
DATE REPORTED: 11/18/19
Well ##18
49.
1,2,4-Trichlorobenzene
< 0.50
50.
1,1,1-Trichloroethane
< 0.50
51.
1,1,2-Trichloroethane
< 0.50
52.
Trichloroethene
<0.50
53.
Trichlorofluoromethane
<0.50
54.
1,2,3-Trichloropropane
< 0.50
55.
1,2,4-Trimethylbenzene
< 0.50
56.
1,3,5-Trimethylbenzene
< 0.50
57.
Vinyl Chloride
<0.50
58.
Total Xylenes
< 1.00
59.
Methyl Tert Butyl Ether
< 1.00
Page: 4

SOILS ANALYSIS LAB REPORTS
LIME APPLICATION

NCDA&CS Agro c Division Phone: [phone] Website: www.nc lov/agronomi/ Report No. F' L006679
Client: CMSD Advisor: Chris Whitehurst
Predictive PO Box 477 Ayden Nitrogen
Grifton, NC 28530 PO Box 7
Soil Report Mehlich-3 Extraction Ayden, NC 28513
Sampled County: Pitt
"•'"t•5`� �Links to Helpful Information
Client ID: 147385 Advisor ID: 490477
Sampled:09/19/2019 Received: 09/27/2019 Completed: 10/04/2019 Farm:
Agronomist's Comments:
ATTENTION: This report was flagged with a "C" and/or " Z" to alert you that copper and/or zinc have accumulated in the soil and are approaching a level that could be
detrimental to crop production. The C and Z symbols are printed on your report for soil test Zn and Cu index levels of 2000 or more for agronomic crops; for peanuts with
zinc, the level is 250. This note is designed to be a "trigger" that allows enough time to either reduce the rate of application or find another field for application of biosolids
and/or waste water. The CTL (critical toxic level) for Cu and Zn is set at a 3000 index; for peanuts with zinc, the level is 500. Maintaining a pH of 6.0 or higher may reduce
potential for toxicity, especially for Zn. These levels are used by DENR as a benchmark to determine when application of waste products should be stopped. The CTL for
copper and zinc was set to Rrevent levels from accumulating to the point where they become toxic to crops grown on a field.
Sample ID: 1
Recommendations: Lime Nutrients (lb/acre)
More
Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0 180-220 0 130 0 0 0 Z 0 0
Note: 12 Note:
2- 0.0
Test Results [units - WN in g/cm3; CEC and Na in meg1100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral
HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-I Mn-All Mn-Al2 Zn-I Zn-AI Cu-1 Na ESP SS-1 NO3-N
0.56 1.02 16.2 86 2.2 6.2 996 42 66 19 49 75 59 3558 3558 1265 0.2 1
Sample ID: 2
Recommendations: Lime Nutrients (lb/acre)
More
Crop (tons/acre) N P2O5 K2O Mg S Mn Zn Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0 180-220 0 170 0 0 0 Z 0 0
Note: 12 Note:
2- 0.0
Test Results [units - WN in g/cm3; CEC and Na in meg1100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral
HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg% S-1 Mn-1 Mn-All Mn-AI2 Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N
0.51 0.94 17.4 89 1.8 6.4 1021 28 69 19 58 72 55 4450 4450 1505 0.3 2
Forth Carolina
Tobakto ltkm 1 uwwd Ccwnmisslon
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler. Commissioner of Aaricu/ture

NCDA&CS Agro--
c Division Phone: [phone]
Website: www.nc
lov/agronomi/
Report No.
F` ;L006679
Page 2 of 10
Sample ID: 3
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 - Bermuda hay/past., M 0.0
180-220 0
190
0
0
pH$
Z
0 0
Note: 12 Note:
2- 0.0
Test Results [units - W/V in g/crT?; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% W/V
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-I Na ESP
SS-1 NO3-N
0.51 1.12
16.8 96 0.6 7.0 991 20
74 22
55
67
42
3022
3022
844 0.3
2
Sample ID: 4
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.7
180-220 0
170
0
0
0
Z
0 0
Note: 12 Note:
2- 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% W/V
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-I Na ESP
SS-1 NO3-N
0.71 0.92
15.0 81 2.8 5.8 1002 28
63 17
142
71
60
2532
2532
1176 0.3
2
Sample ID: 5
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1-Bermuda hay/past., M 0.8
180-220 0
80
0
0
0
Z
0 0
Note: 12 Note:
2- 0.0
Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dM3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
0.46 0.81
19.6 84 3.2 5.8 1013 66
60 22
84
80
65
4192
4192
1842 0.3
2
Sample ID: 6
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
140
0
0
0
Z
0 0
Note: 12 Note:
2- 0.0
Test Results [units
- WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/drn3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-1
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
0.60 1.04
17.6 89 1.9 6.4 991 39
67 22
52
78
58
3997
3997
1224 0.2
1

NCDA&CS Agroi
Division Phone: [phone]
Website: www.nc
lov/agronomi/
Report No.
F` L006679
Page 3 of 10
Sample ID: 7
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
130
0
0
pH$
Z
0 0
Note: 12 Note: 3
2 - 0.0
Test Results [units - WN in g/cd; CEC and Na in meq/100 cm3; NO3-N in mg/drri3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-1
Mn-All
Mn-Al2
Zn-I
Zn-AI
Cu-I Na ESP
SS-1 NO3-N
0.51 1.09
14.7 94 0.9 6.8 845 44
70 22
47
83
54
2066
2066
579 0.2
1
Sample ID: 8
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
160
0
0
0
Z
0 0
Note: 12 Note:
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-Al2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
0.97 1.02
17.4 89 1.9 6.4 886 29
68 21
56
76
57
2882
2882
1251 0.3
2
Sample ID: 9
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
110
0
0
pH$
Z
0 0
Note: 12 Note:
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn4
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
0.41 1.13
17.6 95 0.9 6.9 884 49
71 23
35
100
63
3658
3658
959 0.1
1
Sample ID: 10
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
140
0
0
pH$
Z
0 0
Note: 12 Note:
2 - 0.0
Test Results [units
- WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-Al2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
0.27 1.07
19.6 95 1.0 6.9 978 37
71 23
36
80
51
5042
5042
1480 0.1
1

NCDA&CS Agro
r Division Phone: [phone]
Website: www.nc
lov/agronomi/
Report No.
F 'L006679
Page 4 of 10
Sample ID: 11
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
150
0
0
0
Z
0 0
Note: 12 Note:
2 - 0.0
Test Results [units
- W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/drrt3]:
Soil Class:
Mineral
HM% W/V
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-Al2
Zn-I
Zn-AI
Cu-1 Na ESP SS-1 NO3-N
0.41 1.15
12.6 88 1.5 6.4 846 36
66 21
35
100
71
2779
2779
815 0.1
1
Sample ID: 12
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
130
0
0
0
Z
0 0
Note: 12 Note:
2 - 0.0
Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-I Na ESP
SS-1 NO3-N
0.41 1.04
16.9 90 1.7 6.5 871 41
69 20
42
84
60
4232
4232
1254 0.2
1
Sample ID: 13
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1- Bermuda hay/past., M 0.6
180-220 0
140
0
0
0
0
0 0
Note: 12
2 - 0.0
Test Results [units - W/V in g/cm3; CEC and Na in meg1100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-Al
Cu-I Na ESP SS-1 NO3-N
0.92 1.02
11.3 81 2.2 5.8 843 40
61 19
52
85
68
1753
1753
580 0.2
2
Sample ID: 14
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1- Bermuda hay/past., M 0.0
180-220 0
150
0
0
0
0
0 0
Note: 12
2 - 0.0
Test Results [units
- WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% W/V
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-1
Mn-All
Mn-Al2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
0.71 1.14
9.9 87 1.2 6.4 527 35
64 22
37
78
58
1034
1034
293 0.1
1

NCDA&CS Agror--' : Division Phone: [phone]
Website: www.nc
ov/agronomil
Report No.
F) L006679
Page 5 of 10
Sample ID: 15
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1- Bermuda hay/past., M 1.4
180-220 0
170
0
0
0
0
0 0
Note: 12
2- 0.0
Test Results [units - WN in
g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-I
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-Al2
Zn-1
Zn-AI
Cu-I Na ESP
SS -I NO3-N
1.19 1.19 4.4
50 2.2 5.0 134 27
34 13
27
32
36
256
256
66 0.1
2
Sample ID: 16
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 2.4
180-220 0
160
0
20
0
0
0 0
Note: 12
2- 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-I
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-I Na ESP SS -I NO3-N
1.94 1.13 5.3
36 3.4 4.5 116 31
23 10
23
31
36
230
230
55 0.1
2
Sample ID: 17
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1-Bermuda hay/past., M 0.0
180-220 0
160
0
0
0
0
0 0
Note: 12
2- 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dM3]:
Soil Class:
Mineral
HM% W/V CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-Al2
Zn-I
Zn-AI
Cu-1 Na ESP SS -I NO3-N
0.60 1.14 8.5
80 1.7 5.9 601 30
57 21
44
73
61
940
940
357 0.1
1
Sample ID: 18
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.3
180-220 0
140
0
0
0
Z
0 0
Note: 12 Note:
2- 0.0
Test Results [units - WN in g/cd; CEC and Na in meg1100 cm3; NO3-N in mg/drrt3]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-I Na ESP SS -I NO3-N
0.51 1.01 14.4
85 2.2 5.9 1139 38
62 21
52
78
64
3350
3350
1119 0.1
1

NCDA&CS Agror--' : Division Phone: [phone]
Website: www.nc
ov/agronomi/
Report No.
Fly L006679
Page 6 of 10
Sample ID: 19
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
140
0
0
0
Z
0 0
Note: 12 Note: $
2 - 0.0
Test Results [units - WN in
g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dM3]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-Al2
Zn-I
Zn-AI
Cu-I Na ESP
SS-1 NO3-N
0.81 1.00 15.9
90 1.5 6.4 1027 37
67 22
45
77
57
2826
2826
822 0.1
1
Sample ID: 20
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
120
0
0
pH$
0
0 0
Note: 12 Note:
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-1 Na ESP
SS-1 NO3-N
1.14 1.11 10.2
93 0.7 6.7 294 46
68 23
33
100
67
662
662
175 0.1
1
Sample ID: 21
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
130
0
0
pH$
0
0 0
Note: 12 Note:
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dd]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-1 Na ESP SS-1 NO3-N
0.71 1.10 10.4
93 0.7 6.7 550 43
70 22
35
115
75
1197
1197
308 0.1
1
Sample ID: 22
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1- Bermuda hay/past., M 2.4
180-220 0
130
0
0
0
0
0 0
Note: 12
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
0.66 0.94 11.7
66 4.0 5.1 1116 44
48 17
89
81
66
1923
1923
1300 0.1
1

NCDA&CS Agror--'
; Division Phone: [phone]
Website: www.nc
ov/agronomi/
Report No.
Fly L006679
Page 7 of 10
Sample ID: 23
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.6
180-220 0
160
0
0
0
Z
0 0
Note: 12 Note:
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-Al2
Zn-I
Zn-AI
Cu-I Na ESP
SS -I NO3-N
0.60 1.00
12.9 80 2.5 5.8 1035 32
59 21
58
67
57
2794
2794
1023 0.1
1
Sample ID: 24
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
160
0
0
pH$
0
0 0
Note: 12 Note:
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-I Na ESP
SS-1 NO3-N
0.71 1.10
11.9 90 1.2 6.6 712 30
65 25
48
92
64
1823
1823
550 0.1
1
Sample ID: 25
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
150
0
0
pH$
Z
0 0
Note: 12 Note:
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-Al2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
0.81 1.08
13.9 93 1.0 6.7 832 34
71 21
38
58
42
2885
2885
617 0.1
1
Sample ID: 26
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tonslacre)
N P2O5
K2O
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1-Bermuda hay/past., M 0.0
180-220 0
170
0
0
0
Z
0 0
Note: 12 Note:
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
1.87 1.03
13.3 86 1.9 6.1 854 28
70 14
43
61
53
3385
3385
1010 0.2
2

NCDA&CS Agror----0 ; Division Phone: [phone]
Website: www.nc
ov/agronomi/
Report No.
F) L006679
Page 8 of 10
Sample ID: 27
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1-Bermuda hay/past., M 0.0
180-220 0
150
0
0
0
Z
0 0
Note: 12 Note:
2 - 0.0
Test Results [units - WN in
g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dM3]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-Al2
Zn-I
Zn-AI
Cu-I Na ESP
SS-1 NO3-N
2.08 0.98 13.7
87 1.8 6.2 824 35
69 17
37
48
43
2653
2653
812 0.1
1
Sample ID: 28
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1- Bermuda hay/past., M 0.0
180-220 0
160
0
0
0
0
0 0
Note: 12
2 - 0.0
Test Results [units - WN in
g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
1.80 1.10 10.3
83 1.8 6.0 666 30
65 17
33
75
62
1416
1416
409 0.1
1
Sample ID: 29
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1-Bermuda hay/past., M 0.0
180-220 0
160
0
0
0
Z
0 0
Note: 12 Note:
2 - 0.0
Test Results [units - W/V in
g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-I Na ESP SS-1 NO3-N
1.08 1.08 12.2
88 1.5 6.3 872 31
66 21
38
61
49
2180
2180
648 0.1
1
Sample ID: 30
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1-Bermuda hay/past., M 0.0
180-220 0
170
0
0
0
Z
0 0
Note: 12 Note:
2 - 0.0
Test Results [units - WN in
g/cd; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% W/V CEC BS% Ac pH P-1 K-I
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-1 Na ESP SS -I NO3-N
2.52 1.04 13.9
88 1.7 6.2 784 26
67 20
35
62
51
2131
2131
653 0.1
1

NCDA&CS Agroi
; Division Phone: [phone]
Website: www.nc
ov/agronomil
Report No.
F) L006679
Page 9 of 10
Sample ID: 31
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1- Bermuda hay/past., M 0.0
180-220 0
170
0
0
0
0
0 0
Note: 12
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/drr?]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-Al2
Zn-I
Zn-AI
Cu-1 Na ESP
SS-1 NO3-N
1.37 1.16
10.0 90 1.0 6.4 491 27
67 21
34
63
49
1266
1266
296 0.1
1
Sample ID: 32
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1- Bermuda hay/past., M 1.0
180-220 0
150
0
0
0
0
0 0
Note: 12
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-1 Na ESP SS-1 NO3-N
0.60 1.15
9.4 75 2.4 5.6 895 33
55 18
44
74
61
1508
1508
513 0.1
1
Sample ID: 33
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P205
K20
Mg
S
Mn
Zn
Cu B
Information
Lime History:
1- Bermuda hay/past., M 0.0
180-220 0
150
0
0
0
0
0 0
Note: 12
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% W/V
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I
Mn-All
Mn-AI2
Zn-I
Zn-AI
Cu-1 Na ESP SS-1 NO3-N
0.56 1.13
9.9 83 1.7 6.1 795 33
60 21
39
68
57
1565
1565
477 0.1
1

NCDA&CS Agror
Division
Phone: [phone]
Website: www.nc
ov/agronomi/ Report No. F) L006679
Page 10 of 10
Understanding the Soil Report: explanation of measurements, abbreviations and units
Recommendations I Report Abbreviations
Lime
Ac
exchangeable acidity
If testing finds that soil pH is too low for the crop(s) indicated, a time recommendation will be given in units of either
B
boron
ton/acre or Ib/1000 sq ft. For best results, mix the lime into the top 6 to 8 inches of soil several months before planting.
BS%
% CEC occupied by basic cations
For no -till or established plantings where this is not possible, apply no more than 1 to 1.5 ton/acre (50 Ib/1000 sq ft) at on
Ca%
% CEC occupied by calcium
time, even if the report recommends more. You can apply the rest in similar increments every six months until the full rate
CEC
cation exchange capacity
is applied. If MG is recommended and lime is needed, use dolomitric lime.
Cu-I
copper index
ESP
exchangeable sodium percent
Fertilizer
HM%
percent humic matter
Recommendations for field crops or other large areas are listed separately for each nutrient to be added (in units of
K-I
potassium index
lb/acre unless otherwise specified). Recommendations for N (and sometimes for B) are based on research/field studies
K20
potash
for the crop being grown, not on soil test results. K-1 and P-1 values are based on test results and should be > 50. If they
Mg%
% CEC occupied by magnesium
are not, follow the fertilizer recommendations given. If Mg is needed and no lime is recommended, 0-0-22 (11.5% Mg) is
MIN
mineral soil class
an excellent source; 175 to 250 lb per acre alone or in a fertilizer blend will usually satisfy crop needs, SS -I levels appear
Mn
Mn-All
manganese
Mn-availability index for crop 1
only on reports for greenhouse soil or problem samples.
Mn-AI2
Mn-availability index for crop 2
Mn-I
manganese index
Farmers and other commercial producers should pay special attention to micronutrient levels. If $, pH$, $pH, C or Z
M-0
mineral -organic soil class
notations appear on the soil report, refer to $Note: Secondary Nutrients and Micronutrients. In general, homeowners do not
N
nitrogen
need to be concerned about micronutrients. Various crop notes also address lime fertilizer needs; visit
Na
sodium
ncagr.gov/agronomi/pubs.htm.
NO3-N
nitrate nitrogen
ORG
organic soil class
Recommendations for small areas, such as home lawns/gardens, are listed in units of Ib/1000 sq ft. If you cannot find
pH
current soil pH
the exact fertilizer grade recommended on the report, visit www.ncagr.gov/agronomi/obpart4.htmi#sfind information that
P-1
phosphorus index
may help you choose a comparable alternate. For more information, read A Homeowner's Guide to Fertilizer.
P205
phosphate
S-1
sulfur index
Test Results
SS-1
soluble salt index
WIV
weight per volume
Zn-AI
zinc availability index
The first seven values [soil class, HM%, W/V, CEC, BS%, Ac and pH] describe the soil and its degree of acidity. The
Zn-I
zinc index
remaining 16 [P-I, K-1, Ca%, Mg%, Mn-I, Mn-All, Mn-Al2, Zn-I, Zn-AI, Cu-I, S-1, SS-1, Na, ESP, SS -I, NO3-N (not routinel
available)] indicate levels of plant nutrients or other fertility measurement. Visit www•ncagr.gov/agronomi1uyrst.htm

Payment 1005633
Ayden Nitrogen
4728 Old NC 11 / P.O. Box 7
Ayden, NC 28513
252-746-2152
Fax [phone]
Ayden Golf & Country Club
4343 Ayden Golf Club Road
Ayden, NC 28513
Description
Payment Received
Discount Allowed
Total Credit to Account
Invoice # Amount
1017230 87.48
Date 02/18/2020
Customer ID 011256
Check 20444 87.48
Amount
87.48
0.00
87.48
Ayden Golf & Country Club - Balance after this payment 0.00
Payment 1005633
File 2 Copy

Payment 1005633
Ayden Nitrogen
4728 Old NC 11 / P.O. Box 7
Ayden, NC 28513
252-746-2152
Fax [phone]
Ayden Golf & Country Club
4343 Ayden Golf Club Road
Ayden, NC 28513
Description
Payment Received
Discount Allowed
Total Credit to Account
Invoice # Amount
1017230 87.48
Date 02/18/2020
Customer ID 011256
Check 20444 87.48
Amount
87.48
0.00
87.48
Ayden Golf & Country Club - Balance after this payment 0.00
Payment 1005633
File Copy

Payment 1005633
Ayden Nitrogen
4728 Old NC 11 / P.O. Box 7
Ayden, NC 28513
252-746-2152
Fax [phone]
Ayden Golf & Country Club
4343 Ayden Golf Club Road
Ayden, NC 28513
Description
Payment Received
Discount Allowed
Total Credit to Account
Invoice # Amount
1017230 87.48
Date 02/18/2020
Customer ID 011256
Check 20444 87.48
Amount
87.48
0.00
87.48
Ayden Golf & Country Club - Balance after this payment 0.00
Payment 1005633
Customer Copy

NC,DA&CS.Agror
Division Phone: [phone]
Website: www.nc,
)v/agronomi/
Report No. FY _008558
Client:
CMSD
Advisor:
Chris Whitehurst
Y � �%Y'
Predictive
PO Box 477
Ayden Nitrogen
T
Grifton, NC 28530
PO Box 7
}
Soil Report Mehlich-3 Extraction
Ayden, NC28513
Sampled County: Pitt
Links to Helpful Information
Client ID: 147385
Advisor
ID: 490477
Sampled:09/19/2019
Received: 10/08/2019 Completed: 10/16/2019
Farm:
Sample ID: 37
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O Mg S
Mn
Zn
Cu
B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
160 0 0
pH$
0
0
0
Note: 12 Note:
2 - 0.0
Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-I Mn-All Mn-Al2
Zn-I
Zn-AI
Cu-I
Na ESP SS-1 NO3-N
0.60 1.12
12.6 94 0.7 6.9 541 31
67 26
41
89 57
836
836
300
0.1 1
Sample ID: 38
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O Mg S
Mn
Zn
Cu
B
Information
Lime History:
1 -Bermuda hay/past., M 0.0
180-220 0
180 0 0
pH$
0
0
0
Note: 12 Note:
2 - 0.0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dn13]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-I
Ca% Mg%
S-1
Mn-I Mn-All Mn-AI2
Zn-I
Zn-AI
Cu-I
Na ESP SS-1 NO3-N
1.14 1.19
10.9 94 0.7 6.8 142 22
69 24
31
61 42
451
451
116
0.1 1
Sample ID: 39
Recommendations: Lime
Nutrients (lb/acre)
More
Crop (tons/acre)
N P2O5
K2O Mg S
Mn
Zn
Cu
B
Information
Lime History:
1- Bermuda hay/past., M 0.6
180-220 0
170 0 0
0
0
0
0
Note: 12
2 - 0.0
Test Results [units - W/V in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dtrr3]:
Soil Class:
Mineral
HM% WN
CEC BS% Ac pH P-1 K-1
Ca% Mg%
S-1
Mn-1 Mn-All Mn-Al2
Zn-I
Zn-AI
Cu-I
Na ESP SS-1 NO3-N
1.43 1.12
8.6 78 1.9 5.7 437 26
60 16
34
53 49
919
919
265
0.1 1
North Carolina
Ii+Ma<ci� crust Furw,J C'i�nvni+.lcaro
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler. Commissioner of Agriculture

NCDA&CS.Agron Division Phone: [phone] Website: www.nce w/agronomil Report No. FY: 008558
Page 2 of 3
Sample ID: 40
Recommendations:
Lime
Nutrients (ID/acre)
More
Crop
(tons/acre)
N P2O5
K2O
Mg- S
Mn Zn Cu B
Information
Lime History:
1- Bermuda hay/past.,
M 0.0
180-220 0
160
0 0
0 0 0 0
Note: 12
2 -
0.0
Test Results [units - WN in g/cm3; CEC and Na in
meq/100 cm3; NO3-N in mg/dm3]:
Soil Class:
Mineral
HM% WN CEC
BS% Ac pH
P-1 K-1
Ca% Mg% S-1
Mn-I
Mn-All Mn-Al2
Zn-I Zn-AI Cu-I Na ESP SS-1 NO3-N
1.19 1.11 9.4
87 1.2 6.3
269 32
65 21 39
66
52
597 597 217 0.1 1

NCDA&CS,Agron Division Phone: [phone] Website: www.nci w/agronomi/
Report No. FY: .008558
Page 3 of 3
Understanding the Soil Report: explanation of measurements, abbreviations and units
Recommendations
Report Abbreviations
Lime
Ac
exchangeable acidity
If testing finds that soil pH is too low for the crop(s) indicated, a lime recommendation will be given in units of either
B
boron
ton/acre or Ib/1000 sq ft. For best results, mix the lime into the top 6 to 8 inches of soil several months before planting.
BS%
% CEC occupied by basic cations
For no -till or established plantings where this is not possible, apply no more than 1 to 1.5 ton/acre (50 Ib/1000 sq ft) at on
Ca%
% CEC occupied by calcium
time, even if the report recommends more. You can apply the rest in similar increments every six months until the full rate
CEC
cation exchange capacity
is applied. If MG is recommended and lime is needed, use dolomitric lime.
Cu-I
copper index
ESP
exchangeable sodium percent
Fertilizer
HM%
percent humic matter
Recommendations for field crops or other large areas are listed separately for each nutrient to be added (in units of
K-I
potassium index
lb/acre unless otherwise specified). Recommendations for N (and sometimes for B) are based on research/field studies
K20
potash
for the crop being grown, not on soil test results. K-1 and P-1 values are based on test results and should be > 50. If they
Mg%
% CEC occupied by magnesium
are not, follow the fertilizer recommendations given. If Mg is needed and no lime is recommended, 0-0-22 (11.5% Mg) is
MIN
mineral soil class
an excellent source; 175 to 250 lb per acre alone or in a fertilizer blend will usually satisfy crop needs, SS-1 levels appear
Mn
Mn-All
manganese
Mn-availability index for crop 1
only on reports for greenhouse soil or problem samples.
Mn-AI2
Mn-availability index for crop 2
Mn-I
manganese index
Farmers and other commercial producers should pay special attention to micronutrient levels. If $, pH$, $pH, C or Z
M-O
mineral -organic soil class
notations appear on the soil report, refer to $Note: Secondary Nutrients and Micronutrients. In general, homeowners do not
N
nitrogen
need to be concerned about micronutrients. Various crop notes also address lime fertilizer needs; visit
Na
sodium
ncagr.gov/agronomi/pubs.htm.
NO3-N
nitrate nitrogen
ORG
organic soil class
Recommendations for small areas, such as home lawns/gardens, are listed in units of Ib/1000 sq ft. If you cannot find
pH
current soil pH
the exact fertilizer grade recommended on the report, visit www.ncagr.gov/agronomi/obpart4.htm1#sfind information that
P-1
phosphorus index
may help you choose a comparable alternate. For more information, read A Homeowner's Guide to Fertilizer.
P205
phosphate
S-1
sulfur index
Test Results
SS-1
soluble salt index
W/V
weight per volume
Zn-AI
zinc availability index
The first seven values [soil class, HM%, WN, CEC, BS%, Ac and pH] describe the soil and its degree of acidity. The
Zn-I
zinc index
remaining 16 [P-I, K-I, Ca%, Mg%, Mn-I, Mn-All, Mn-Al2, Zn-I, Zn-Al, Cu-I, S-1, SS -I, Na, ESP, SS -I, NO3-N (not routinel
available)] indicate levels of plant nutrients or other fertility measurement. Visit www•ncagr.gov/agronomi/uyrst.htm

SavedRx: LIME 2019-2020
ge-m-e- Soil Fertility
Poweca Hy
grower: CMSD Farm: WILEY GASKINS RD Field(s): Multiple Fields
Tenn Lime - Fertilizer Application (Ibs/ac)
F, 5.5
17. -
0
400 1578 2756 3934 5112
Lab: NCDA Equation: Lab - NCDA Commodity: Bermuda Grass Sample Dates: 2019-09-19 - 2018-10-12
Constraints:
Target pH: 6 Crop Type: Pick Type Max Rate: N/A Multiplier: N/A
Min Rate: 400.0 Ibs/ac Subtract: N/A
Switch Rate: 400.0 Ibs/ac
Minimum Application Rate:
400.0 Ibs/ac
Total Product:
44471.15 Ibs
Maximum Application Rate:
5112.1 Ibs/ac
Total Product Bulk:
22.24 ton
Average Application Rate:
1650.79 Ibs/ac
Product Cost / Bulk:
$0.0/ton
Application Area:
26.94 ac
Total Product Price:
$0.0
Average Field Rate:
586.32 Ibs/ac
Application Cost / Area:
$0.0/ac
Total Area:
75.85 ac
Total Application Cost:
$0.0
Total Cost:
$0.0
Ayden Nitrogen
4728 Old NC 11 10/23/19 08:20 AM
Ayden, NC 28513 1/2
252-746-2152

PlA1T61i11
h
r-ertilizer Application Summary
SavedRx: LIME 2019-2020
Soil Fertility
Grower: CMSD Commodity: Bermuda Grass
Farm: WILEY GASKINS RD Labs: NCDA
Field(s): Multiple Fields
Field Summary
Field PLS ID .. County Area Centroid
Pitt 2.06 ac 35.365487,-77.414558
1
Pitt
16.18 ac
35.360361,-77.418702
F
Pitt
2.21 ac
35.358556,-77,418100
Pitt
2.35 ac
35.358478,-77.421019
4
Pitt
13.83 ac
35.367513,-77.419061
F-05
Pitt
14.34 ac
35.366959,-77.415219
F-06
Pitt
4.40 ac
35.365362,-77.416477
F-07
Pitt
15.91 ac
35.360321,-77.410402
F-08
I Pitt
14.40 ac
35.362013,-77.410097
Ayden Nitrogen
4728 Old NC 11 10/23/19 08:20 AM
Ayden, NC 28513 2/2
252-746-2152

Statement
Ayden Nitrogen Statement Date: 10/31/2019
4728 Old NC 11 / P.O. Box 7 ID: 010202
Ayden, NC 28513 Total Balance: $1,690.65
Phone [phone]
Page: 1
Contentnea Metro Sewage Dist
__-
_
I
Amount Remitted:
Po Box 477
_...
Griffon, NC 28530 J -
Terms:
Unless otherwise agreed in wrifing by Harvey Fertilizer &
0 " "
Gas Co, interest will accrue at a periodic rate of 1.5% per
j
month. To avoid additional finance charges, payments must
G
be in office by last day of month.
-- -- - -
- - -
- _ 1�-_-.,-Your Share ----I
Date Number Description / Detail
Quantity
Price 1 Unit Extension / Prepaid
Regular
Balance Forward
0.00
0.00
10/25/2019 1017044 Charge Invoice - Due 11/24/2019
Dolomitic Lime - Bulk
9.150 Tons
51.000 [Tons 466.65
466.65
App Fees Materials
9.150 Each
14.000 /Each 128.10
128.10
Invoice Total 594.75 0.00
594.75
10/25/2019 1017045 Charge Invoice - Due 11/24/2019
Dolomitic Lime - Bulk
7.920 Tons
51.000 !Tons 403.92
403.92
App Fees Materials
7.920 Each
14.000 /Each 110.88
110.88
Invoice Total 514.80 0.00
514.80
10/25/2019 1017046 Charge Invoice- Due 11/24/2019
Dolomitic Lime - Bulk
8.940 Tons
51.000 [Tons 455.94
455.94
App Fees Materials
8,940 Each
14.000 ]Each 125.16
125.16
Invoice Total 581.10 0.00
581.10
Ending Total Balances 0.00
1,690.65
Current 1 - 30 31 - 60 61 - 90
Over 90
Unapplied Budget Billing Prepay
Overall
1,690.65 0.00 0.00 0.00 0.00 0.00 0.00 0.00 -i,690.c
Ayden Nitrogen Date: 10/31/2019 Contentnea Metro Sewage Dist