WQ0020793_Monitoring - 03-2020_20200409

("TI-1)
Tyson
April 3, 2020
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER,
RALEIGH, NC 27699-1617 Phone: [phone]
Subject: Ground Water Quality Monitoring
Tyson Farms, Inc. Hays Hatchery
Compliance Report — March. 2020
To whom it may concern:
Enclosed is the quarterly Groundwater Compliance report for Hays Hatchery.
Please contact me at 3 36- 651-2871, should you have any questions.
Sincerely,
James Brown
Complex Environmental Manager
Tyson Farms Inc. Fresh Retail Division 704 Factory Wilkesboro, N.C. 28697
336-651-3836 336-838.2171 Fax:[phone] www.tysonfoods.com
L

SUBMIT FORM ON YELLOW PAPER ONLY
UNDWATER QUALITY MONITORING.
PLIANCE REPORT FORM
Facility Name: Tyson Farms, Inc.
Permit Name (if different):
Facility Address: P.O. Box 936/3649 Airport Road
NORTH WILKESBORO (street) NC
Print Cloarly or Type
28659
County Wilkes
act Person: James Brown Telephone#: [phone]
Location/Site Name: Hays Hatchery No. of wells to be sampled: 4
PERMIT Number: WQ0020793 Expiration Date: 07/31/2026
Non -Discharge WQ0020793 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: Evaporation/Infiltration Pond
WELL ID NUMBER (from Permit): MW - 1 Date sample collected: 3/26/2020
Well Depth: 40 ft. Well Diameter: 2 in.
Depth to Water Level 82546: 25 ft. below measuring point Screened Interval: 23 ft. to 40 ft.
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: 1347.53 ft.
Volume of water pumped/bailed before sampling: 7.33 gallons
Samples for metals were collected unfiltered: ❑ YES 0 NO and field acidified: ❑ YES ❑■ NO
FIELD ANALYSES:
pH 00400: 5.9 units Temp. 000lo: 15.4 eC
Spec. Cond. 00094: µMhos
Odor 00085: none
Appearance clear
WAS
DRY at
time of
sampling,
check
here:❑
LABORATORY INFORMATION
Date sample analyzed: 31261202E
Laboratory Name: Statesville Analyitical
Certification No. 440/3775
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
rng/L
Nitrite (NO2) as N 00615
rng/L
Pb - Lead D1051 ug/L
Coliform: MF Fecal 31616 a1
1100mL
Nitrate (NO3) as N 00620 7.07
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
1100mL
Phosphorus: Total as P 00665 0.6
mg/L
(Note: Use MPN method for hlgWy turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 161
mg/L
Al -Aluminum 01105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC oo6m
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 10.6
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
ug1L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug1L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate OG945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑■ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 78732: method #
Total Ammonia o0610 <0.5
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese o1055
ug/L
method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
PAr'll 1Tv f hIrrIDUATinu Please Print Cleadv or
:acility Name: Tyson Farms, Inc.
'ermit Name (if different):
:acility Address: P.O. Box 936/3649 Airport Road
NORTH WILKESBORO INC
28659 County Wilkes
(Zinn
Contact Person: James Brown Telephone#: [phone]
Well Location/Site Name: Hays Hatchery No. of wells to be sampled: 4
WELL ID NUMBER (from Permit): MW - 2 Date sample collected: 3/26/2020
Well Depth: 36 ft. Well Diameter: 2 in.
Depth to Water Level 82546: 26 ft. below measuring point Screened Interval: 21 ft.
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: 1331.83
Volume of water pumped/bailed before sampling: 4.89 gallons
Samples for metals were collected unfiltered: ❑ YES M NO and field acidified: ❑ YES
PERMIT Number: WQ0020793 Expiration Date: 07/31/2026
Non -Discharge WQDD20793 UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Romediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump X Other: Evaporation/Infiltration Pond
to 36 ft.
ft.
FIELD ANALYSES:
pH 00400: 6.5 units
Spec. Cond. 00094:
Odor 00085: none
Appearance clear
Temp.00010: 15.9 °C
µMhos
Date sample analyzed: 3/26/2020
Laboratory Name: Statesville Analyitical
Certification No. 440/3775
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
rng/L
Pb - Lead 01051 uglL
Coliform: MF Fecal 31616 <1
1100mL
Nitrate (NO3) as N 00620 1,19
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
1100mL
Phosphorus: Total as P oo665 0.3
mg1L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
)issolved Solids:Total 7030o 69
mglL
Al - Aluminum o11o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
uglL
TOC oo6so
mg/L
Ca - Calcium 00916
mglL
Chloride 0094o 20.4
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
ugfL
Grease and Oils oo552
mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01U45
ug1L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
uglL
Lab Report Attached? ❑ Yes (1) A No (0)
ipecific Conductance 00095
µMhos
K - Potassium 00937
mglL
VOC 78732: method #
Total Ammonia 00610 4.90
mg1L
Mg - Magnesium 00927
mglL
method #
(Ammonia Nitrogen; NH,asN; Ammonia Nitmgan, Total)
Mn - Manganese 01055 -
u"g/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%
James Brown Complex Environmental Manager
Permittee (or Authorized Agent) Name and Titlo - Please print or type signatu of Perm itlee (or Authorized Agent) (Date)
GW-59 Rev.212010 '
WAS
DRY at
time of
sampling,
check
here: ❑
I

SUBMIT FORM ON YELLOW PAPER ONLY
UNDWATER QUALITY MONITORING:
PLIANCE REPORT FORM
=acility Name: Tyson Farms, Inc.
'ermit Name (if different):
=acility Address: P.O. Box 936/3649 Airport Road
NORTH WILKESBORO (sva '; NC
28659
0-"'
or
County Wilkes
Contact Person: James Brown Telephone#: [phone]
Well LocationlSite Name: Hays Hatchery No. of wells to be sampled: 4
WELL ID NUMBER (from Permit): MW - 3 Date sample collected: 3/26/2020
Well Depth: 36 ft_ Well Diameter: 2 in.
Depth to Water Level 82546: 11.0 ft. below measuring point Screened Interval: 21 ft.
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: 1326.34
Volume of water pumped/bailed before sampling: 12.22 gallons
Samples for metals were collected unfiltered: ❑ YES 0 NO and field acidified: ❑ YES
PERMIT Number: WQ0020793 Expiration Date: 07/31/2026
Non -Discharge WQ0020793 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 Mother: Evaporation/Infiltration Pond
to 36 ft.
ft. —
NO
FIELD ANALYSES:
pH 00400: 5.1 units
Spec. Cond. 0009c
Odor 000m: none
Appearance clear
If WELL
Temp. 000to: 14.4 °C Itime
DRY at
uMhos of
Date sample analyzed: 312612020
Laboratory Name: Statesville Analyitical
Certification No. 440/3775
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD oo335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead w051 uglL
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 6
mg/L
Zn - Zinc 01092 mg1L
Coliform: MF Total 31504
1100mL
Phosphorus: Total as P oosss 0-5
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg1L
Other (Specify Compounds and Concentration Units):
)issolved Solids:Total 70300 92
mg/L
Al - Aluminum a11o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug1L
TOC ooss0
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 <10
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
ug1L
Grease and Oils 00552
mg1L
Cu - Copper o1o42
mg/L
ORGANICS: (by GC, GCIMS, HPLC)
Phenol 32730
ug1L
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) M No (0)
ipecific Conductance 00095
pMhos
K - Potassium 00937
mg/L
VOC 73732: method #
Total Ammonia oo610 <0.5
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Wrogen; NH3as N; Ammonia Nitrogen, Total)
Mn - Manganese olo55
9
uglL
,method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs
James Brown
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.2/2010
mg/L Effluent Total VOCs:
mg1L VOC Removal%

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: Tyson Farms, Inc.
Permit Name (if different):
Facility Address: P.O. Box 936/3649 Airport Road
NORTH WILKESBORO NC 28659
`CrY) (Stale) ':CIF)
Contact Person: James Brown
Well Location/Site Name: Hays Hatchery
County Wilkes
Telephone#: [phone]
No. of wells to be sampled: 4
ERMIT Number: WQ0020793 Expiration Date: 07/31/2026
on -Discharge WQ0020793 UIC
PDES Other
1fPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑■ Other: Evaporation/Infiltration Pond
WELL ID NUMBER (from Permit): MW - 4
Date sample collected: 3/26/2020
FIELD ANALYSES:
WAS
Well Depth: 27 ft.
Well Diameter: 2 in.
pH 00400: 5.7 units Temp. ocolo: 12.7 °C
DRY at
Depth to Water Level 82546: 7.4 ft. below measuring point Screened Interval: 12 ft. to
27 ft.
Spec. Cond. 000s4: µMhos
time of
sampling,
Measuring Point is 2 eft. above land surface
Relative M.P. Elevation: 1299.0 ft.
Odor 00085: none
check
Volume of water pumped/balled before sampling:
9.58
gallons
Appearance clear
here:
❑
Samples for metals were collected unfiltered: El YES
® NO and field acidified: ❑ YES ❑■ NO
LABORATORY INFORMATION
Date sample analyzed: 3/26/20
Laboratory Name: Statesville Analyitical
Certification No. 440/3775
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg1L
Pb - Lead o1o51 ug1L
Coliform: MF Fecal 31616 <1
1100mL
Nitrate (NO3) as N 0062o 2.83
mglL
Zn - Zinc 01092 mglL
Coliform: MF Total 31504
1100mL
Phosphorus: Total as P 00665 0.5
mg/L
(Nate: Use MPN method for highly turbid samples}
Orthophosphate 10507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total'70300 170
mglL
Al -Aluminum o11o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC oo6w
mg/L
Ca - Calcium ooei6
mglL
Chloride oo94o 18.6
mg/L
Cd - Cadmium 01027
ug1L
Arsenic 01002
ug/L
Chromium: Total 01034
ug1L
Grease and Oils oo552
mg/L
Cu - Copper 01042
mglL
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
it
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug1L
Lab Report Attached? ❑ Yes (1) ■❑ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 76732: method #
Total Ammonia oomo <0.5
mglL
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug1L
, method #
TKN as N oo625
mg/L
Ni - Nickel o1067
uglL
method #
I -or Kemeaiatlon Systems Only (Attach Lab Reports):
James Brown
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.2/2010
Influent total voGs:
lii�iillC7'itiC�3Fi\►LeI�i
plete, and that the laboratory analytical data
possibility of fines and.imprison mant for icnc
I
mg1L VOC Removal%

C -59A COMPLIANCE REPORT FORM Tyson Farms, Inc. Permit # 02 793
(Saabn dt one each monitoringperiod with GW-59 form.)
1
Enter date monitoring results were due. ( ) Will this monitoring report (GW-59 and GW-59A)
YES
N
be submitted after the established due date?
2
Was any required information missing on the GW-59 report forms?
YES
NO
IF the answer to question 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
identification plate, area overgrown, etc.)? If the answer is "Yes", contact the Regional Office for guidance.
4
Are any monitored constituents equal to or above the established standards?
ES'
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
3/26/20 PH 6.5- 8.5 Ammonia 1.5 Nitrate 10
MW - i PH - 5.9
MW- 2 4.9 mg/l
MW-3 PH-5.1
MW-4 PH -5. 6
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
YE
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).
G IN Standards Nitrate 10 GW Standards ammonia 1.5
MW 1- 07-10-18 11.6 mg17 MW-2 3-26-20 4.90 mgR MW-2
MW-2 11-7-19 5.04 mg/1 MW-2
MW-2 07-11-19 4,14 mg/1 MW-2
MW-2 03-7-19 4.82mg/7 MW-2
MW-2 11-19-18 6.16 mgh MW-2
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YE
NO
If the answer is "YES". a groundwater quality problem may be occurring. CONTACT THE REGIONAL
OFFICE 1MMEDIATELYFOR 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
E
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 max be
reauired to determine the impact the waste disposal system is having at the review and compliance
boundaries surrounding this facili(V, FailUra to do so may subiect the permittee to a Notice of Violation,
fines.. and/or penalties.
�� �,vjI a- rUV,ci- C
S
The person completing this portion (G W-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.
l hereby agknowledge-thatAhe ab ye information was evaluated and the information
is.frue and complete to the best of my knowledg
Signature of Perm ittee (or Au horized Agent) Date
r-1W-1;;QA 11?1QIIAW%

Works heet # 0
Tyson Farms, Inc.
Completed by:
Max Byers
Title :
WWT Operator
Date :
7-A r-20
No. of Wells to be Sampled 4
Has Hatchery
Groundi Water sampling data Hays Hatchery Compliance Data
Constituents equal to or above the eslablished Standards
Has
1 per 100ML
500 mg/1
250 m 1
1.5 m II
10 Mg/1
NA
6.5-8.5
Date
Wells ID:
Fecal
TDS
Chloride
Total NH3
Nitrate
Phos hours
PH
Mar-8-2018
MW - 1
<1
331
10.6
<0.5
8.00
1.3
6.4
MW-2
<1
213
37.5
6.27
4
0.9
6.0
MW-3
<1
53
<10
<0.5
5
1.8
5.5
July-10-2018
MW - 1
<1
208
11.5
<0.5
11.6
<0.1
5.7
MW-2
<1
210
34.6
6.16
2.91
<0.1
6.0
MW - 3
<1
62
11.0
<0.5
4.59
<0.1
5.3
Nov-19-2018
MW - 1
<1
206
<10
<0.5
6.74
0.4
5.9
MW-2
<1
193
29.2
6.16
1.4
0.9
6.2
MW - 3
<1
67
<10
1 <0.5
4.93
0.6
4.9
Mar-7-2019
MW - 1
<1
206
<10
<0.5
7.70
0.7
6.0
MW-2
<1
180
24.8
4.82
2.06
0.9
6.2
MW-3
<1
78
<10
<0.5
7.14
0.7
4.9
July-11-2019
MW - 1
<1
179
<10
<0.5
7.90
0.5
6.0
MW-2
<1
71
<10
4.14
1.72
1 0.7
6.5
MW-3
<1
176
19
1 <0.5
5.70
0.9
5.4
Nov-7-2019
MW - 1
<1
178
<10
<0.5
4.30
<0.1
6.2
MW-2
<1
182
<10
5.04
0.68
<0.1
6.4
MW-3
<1
73
<10
<0.5
4.14
<0.1
5.0
Mar-26-2020
MW - 1
<1
161
10.6
<0.5
7.07
0.6
5.9
MW-2
<1
69
20.4
4.90
1.19
1 0.3
6.5
MW-3
<1
92
<10
<0.5
6.00
0.5
6.1
MW-4
<1
170
18.6
<0.5
2.83
0.5
5.7
Maximum
0
435
43
6
12
7
7
Minimum
I
I <1
53
11
4
1
0
5

Analytical Results
Tyson Foods -Wilkesboro
704 Factory Street
Wilkesboro, NC 28697
Receive Date: 03/26/2020
Reported: 04/02/2020
For: Hays Hatchery
Comments:
Sample Number Parameter Sample ID Result
Unit Method Analyzed Analyst
200326-14-01
Ammonia Nitrogen
MW1
<0.5
mg/L
SM450ONH3C-2011
03/30/2020
CJE
200326-14-01
Chloride
MW1
10.6
mg/L
SM4500CIC-2011
03/27/2020
MD
200326-14-01
Fecal Coliforms
VIM
<1
CFU100 ML
SM9222D-2006
03/26/2020
WC
200326-14-01
Nitrate
MW1
7.07
mg/L
SM45❑❑NO3F-2011
03/31/2020
CL
200326-14-01
T. Phosphorous
MW1
0.6
mgfL
SM450OPE-2011
03/30/2020
CL
200326-14-01
Total Dissolved
MW1
161
mg/L
sM 2540 C lath Edtion
03/27/2020
MD
Solids
200326-14-02
Ammonia Nitrogen
MW2
4.90
mg/L
SM4500NH3C-2011
03/30/2020
CJE
200326-14-02
Chloride
MW2
20.4
mgfL
SM4500CIC-2011
03/27/2020
MD
200326-14-02
Fecal Coliforms
MW2
<1
CFU100 ML
sM8222o-2005
03/26/2020
WC
200326-14-02
Nitrate
MW2
1.19
mg/L
SM450❑NO3F-2011
03/31/2020
CL
200326-14-02
T. Phosphorous
MW2
0.3
mg/L
SM4500PE-2011
03/30/2020
CL
200326-14-02
Total Dissolved
MW2
69
mg/L
SM 2540 C 18th Edition
03/27/2020
MD
Solids
200326-14-03
Ammonia Nitrogen
MW3
<0.5
mg/L
sM450ONH3C-2011
03/30/2020
CJE
200326-14-03
Chloride
MW3
<10
mg/L
SM45❑CCIO-2011
03/27/2020
MD
200326-14-03
Fecal Coliforms
MW3
<1
CFU100 ML
SM9222D-2006
03/26/2020
WC
200326-14-03
Nitrate
MW3
6
mg/L
SM450ONO3F-2011
03/31/2020
CL
200326-14-03
T. Phosphorous
MW3
0.5
mg/L
SM450❑PF-2011
03/30/2020
CL
200326-14-03
Total Dissolved
MW3
92
mg/L
sM 2540 C 18th Editon
03/27/2020
MD
Solids
200326-14-04
Ammonia Nitrogen
MW4
<0.5
mg/L
SM450ONHZC-2011
03/30/2020
CJE
200326-14-04
Chloride
MW4
18.6
mg/L
SM4 00CIC-2011
03/27/2020
MD
200326-14-04
T. Phosphorous
MW4
0.5
mg/L
SM450OPF-2011
03/30/2020
CL
200326-14-04
Total Dissolved
MW4
170
mg/L
sM 2540 C 18th Edition
03/27/2020
MD
Solids
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 1 of 5
A

Sample !Number Parameter Sample ID Result
200326-14-04 Fecal Coliforms MW4 <1
200326-14-04 Nitrate MW4 2.83
Respectfully submitted,
Dena Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NC00909
Unit Method Analyzed Analyst
CFU100 ML sM9222n-20o6 03/26/2020 WC
mg/L SM45ODN03F-2011 03/31/2020 CL
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 2 of 5

Condition of Receipt
Sample Number 200326-14-01 Temp on Arrival: 3.2
Parameter Schedule: Total Dissolved Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Parameter Schedule:
Sulfuric Acid Received on Ice
Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Parameter Schedule: T. Phosphorous
Sulfuric Acid Received on Ice
Parameter Schedule: Chloride
Received on Ice
Sample Number 200326-14-02 Temp on Arrival: 3.2
Parameter Schedule: Total Dissolved Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Parameter Schedule: T. Phosphorous
Sulfuric Acid Received on Ice
Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Parameter Schedule:
Sulfuric Acid Received on Ice
Parameter Schedule: Chloride
Received on Ice
Sample Number 200326-14-03 Temp on Arrival: 3.2
PO Box 228 • Statesville, NC 28687 • 704/872/4697
Page 3 of 5
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Parameter Schedule: Total Dissolved Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Parameter Schedule:
Sulfuric Acid Received on Ice
Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Parameter Schedule: T. Phosphorous
Sulfuric Acid Received on Ice
Parameter Schedule: Chloride
Received on Ice
Sample Number 200326-14-04 Temp on Arrival: 3.2
Parameter Schedule: Total Dissolved Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received on Ice
Parameter Schedule: T. Phosphorous
Sulfuric Acid Received on Ice
Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Parameter Schedule:
Sulfuric Acid Received on Ice
Parameter Schedule: Chloride
Received on Ice
PO Box 228 * Statesville, NC 28687 * 704/872/4697
Page 4 of 5
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Client:
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122 Coat So set • P.O. Box 228
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(704) 8724
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