WQ0007283_Monitoring - 06-2020_20200731

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of 1
Permit No.: WQ0007283
Facility Name: TOWN of POLLOCKSVILLE
County: Jones
Month: June
Year: 2020
PPI: 002
Flow Measuring Point: 0 Influent ❑ Effluent ❑ No flow generated
Parameter Monitoring Point: ❑ Influent 0 Effluent ❑ Groundwater Lowering ❑ Surface water
Parameter Code -0
50050
00940
00353
00353
00600
d jp
O ..
Q
O O
O E
P
O
of
O
O
LL
U
z
a
22
z z
z
m
Z O
Z
m
E
C U
p R
F O
Z
24-hr
hrs
'Y/N/B/H
GPD
#N/A
mg/I
mg/I
mg/1
1
08:00
2.0
Y
71,000
2
7:30
3.0
Y
63,000
3
7:25
3.0
Y
51,000
4
07:45
4.0
Y
47,000
5
10:00
2.0
Y
57,000
6
10:30
2.0
Y
45,000
7
08:45
1.0
Y
39,000
8
08:15
3.0
Y
45,000
9
06:20
2.0
Y
47,000
10
09:30
2.0
Y
51,000
0.07
0,07
11.68
11
09:15
3.0
Y
91,000
12
08:30
2.0
Y
47,000
13
08:50
4.0
Y
370,000
14
07:00
1.0
Y
87,000
15
07:15
4.0
Y
62,000
16
10:00
4.0
Y
200,000
17
06:30
3.0
Y
221,000
18
06:25
3.0
Y
168,000
19
08:50
5.0
Y
130,000
20
10:30
2.0
Y
287,000
21
08:30
1.0
Y
126,000
22
07:00
5.0
Y
86,000
231
09:30
2.0
Y
92,000
24
06:15
3.0
Y
70,000
25
08:15
3.0
Y
74,000
26
06:15
1.0
Y
72,000
27
08:00
1.0
BORC
82,000
28
09:00
1.0
BORC
78,000
2911
1.0
BORC
81,000
301
0550 1
1.0
BORC
80,000
31
Average:
100,667
22
0.81
<1
0.29
<0.04
1
33
2.00
58618
0.0
60730
Daily Maximum:
370,000
22
0.81
<1
0.29
<0.04
-33.0
2.00
58618
0.0
60730
Daily Minimum:
39,000
22
0.81
<1
0,29
<0.04
33.0
2.00
58618
0.0
60730
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Avg. Limit:
102,000
Daily Limit: 1
N/A
Sample Frequency:
Continuous
Mar,Jul,Nov
per Event
-(Y)ES, (N)O, (B)ACK UP ORC, (H)OLIDAY

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s) Certified Laboratories
Name: Operator on Duty Name: Environment 1
Name: Johnnie J. Chadwick/ORC Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑ Compliant ❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: JOHNNIE J. CHADWICK
Permittee: Town of Pollocksville
Certification No.: SS-11861/WW2-9579
Signing Official: James Bender Jr.
Grade: SS/WW-2 Phone Number: 252-617-1692
Signing Official's Title: Mayor
Has the ORC changed since the previous NDMR? ❑ Yes El No
Phone mber: 252-224- Permit Expiration: JULY 31,2021
JULY 26,2020
/
�!�✓
gnature Date
Signature Date
By this signatuertify t r I cthat this report is accurrate and complete to the best of my knowledge.
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment
for knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDMR 03-12 NON -DISCHARGE MONITORING REPORT (NDMR) Page 1 of
Permit No.: WQ0007283
Facility Name: TOWN of POLLOCKSVILLE
County: Jones
Month: June
Year: 2020
PPI: 002
Flow Measuring Point: D Influent ❑ Effluent ❑ No now generated
Parameter Monitoring Point: ❑ Influent Effluent ❑ Groundwater Lowering ❑ Surface water
Parameter Code ->
50050
00310
00665
31616
00610
00620
00400
70300
00530
00931
00916
00625
00927
50060
Q
d
;
O
Q
.O+
O
CL
O E
F
V
O
O
LL
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[a
y
_ O
~
a
LL O
U
C
£
d
.
d y
y U)
o
C
'O y
I— y rAO
N
C
E°
U)
Q
E
U
2
Y
3
- o
a)U
La
U
E
t0
24-hr
hrs
*Y/N/B/H
GPD
mg/L
#NIA
#/100 mL
mg/L
mg/L
su
mg/L
mg/L
mg/L
#NIA
j mg/L
mg/L
j mg/L
ug/L
1
08:00
2.0
Y
71,000
2
7:30
3.0
Y
63,000
3
7:25
3.0
Y
51,000
4
07:45
4.0
Y
47,000
5
10:00
2.0
Y
57,000
6
10:30
2.0
Y
45,000
7
08:45
1.0
Y
39,000
8
08:15
3.0
Y
45,000
9
06:20
2.0
Y
47,000
10
09:30
2.0
Y
51,000
25
1.85
24000
2.42
<0.04
39
1.60
77843
11.61
9360
56290
Ill
09:15
3.0
Y
91,000
12
08:30
2.0
Y
47,000
13
08:50
4.0
Y
370,000
14
07:00
1.0
Y
87,000
15
0715
4.0
Y
62,000
16
10:00
4.0
Y
200,000
17
06:30
3.0
Y
221,000
18
06:25
3.0
Y
168,000
19
08:50
5.0
Y
130,000
20
10:30
2.0
Y
287,000
21
08:30
1.0
Y
126,000
221
07:00
5.0
Y
86,000
23
09:30
2.0
Y
92,000
24
06:15
3.0
Y
70,000
25
08:15
3.0
Y
74,000
26
06:15
1.0 1
Y
72,000
27
08:00
1.0
B/H
82,000
28
09:00
1.0
B/H
78,000
29
05:30
1.0
B/H
81,000
30
05:50
1.0
B/H
80,000
31
Average:
100,667
22
0.81 1
<1
0.29
<0.04
33
2.00
58618
11.61
9360
0.0
60730
Daily Maximum:
370,000
22
0.81
<1
0.29
<0.04
'33.0
2.00
58618
11.61
9360
0.0
60730
Daily Minimum:
39,000
22
0.81
<1
0.29
<0.04
33.0
2.00
58618
11.61
9360
0.0
60730
Sampling Type:
Recorder
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Grab
Monthly Avg. Limit:
102,000
Daily Limit:
N/A
Sample Frequency:l
Continuous
Mar,Jul,Nov
per Event
-(Y)ES, (N)O, (B)ACK UP ORC, (H)OLIDAY

FORM: NDMR 03-12
NON -DISCHARGE MONITORING REPORT (NDMR)
Sampling Person(s) Certified Laboratories
Name: Operator on Duty Name: Environment 1
Name: Johnnie J. Chadwick/ORC Name:
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑ Compliant ❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: JOHNNIE J. CHADWICK
Permittee: Town of Pollocksville
Certification No.: SS-11861/WW2-9579
Signing Official: James Bender Jr.
Grade: SS/WW-2 Phone Number: 252-617-1692
Signing Official's Title: Mayor
Has the ORC changed since the previous NDMR? ❑ Yes 0 No
ber: 2 -2 4-9831 Permit Expiration: JULY 31,2021
qem
A/
JULY 26,2020
Signature Date
Znmum,
Signature Date
By this I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment
for knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 08-11 NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Permit No.: W00007283
Facility Name: TOWN of POLLOCKSVILLE
County: Jones
Month: June
Year: 2020
Did irrigation occur
Field Name:
ONE
Field Name:
TWO
Field Name:
THREE
Field Name:
FOUR
at this facility?
Area (acres):
3.5
Area (acres):
3.5
Area (acres):
4
Area (acres):
4
Cover Crop:Bermuda/Rye
Y a
Cover Crop:
p:
Bermuda/Rye a
Y
Cover Crop:
p:
Bermuda/Rye
Cover Crop:
Bermuda/Rye
❑ YES No
Hourly Rate (in):
0.7
Hourly Rate (in):
0.7
Hourly Rate (in):
0.7
Hourly Rate (in):
0.7
Annual Rate (in):
92.56
Annual Rate (in):
92.56
Annual Rate (in):
92.56
Annual Rate (in):
92.56
Weather
Freeboard
Field Irrigated?
❑ YES 0 No
Field Irrigated?
❑ YES NO
Field Irrigated?
❑ YES [2] NO
Field Irrigated?
❑ YES E NO
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°F
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
C
61
0.0
2.4
2
C
60
0.0
2.4
3
C
70
0.0
2.5
4
CL
69
0.0
2.5
5
PC
74
0.0
2.5
6
CL
82
0.0
2.6
7
PC
76
0.0
2.6
8
C
71
0.0
2.6
9
CL
68
0.0
2.6
10
CL
80
0.0
2.6
11
PC
79
0.0
2.7
12
R
73
1.0
2.6
13
CL
66
3.3
2.5
14
CL
61
0.0
2.5
15
CL
63
0.0
2.5
16
R
71
1.8 1
2.5
17
R
61
1.0
2.4
18
PC
63
0.0
2.4
19
PC
72
0.0
2.4
20
PC
75
0.9
2.3
21
R
69
0.3
2.3
22
C
75
0.0
2.3
23
C
80
0.0
2.3
24
CL
73
0.0
2A
25
C L 1
73
0.0
2.4
26
PC 1
70
0.0
2.4
27
C
69
0.0
2.4
28
PC
73
0.0
2.5
29
C
70
0.0
2.5
30
CL
72
0.0
2.5
31
0 0.00 0 0.00
12 Month Floating Total (in):Ikm 33.61 28.12 21.74 13.30

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
❑ Compliant
❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
❑ Compliant
❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
❑ Compliant
❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
❑ Compliant
❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑ Compliant
❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
12-13,2020 received 3.25 inches of rain during 24 hrs./heavy flow infiltration at lift station #4 /ring seal leaking ground water into lift station
16-17,2020 received 2.75 inches of rain during 48 hrs/ heavy flow infiltration at lift station #4/ ring seal leaking ground water into lift station
20,2020 received 9/10 inches of rain during 24 hrs/ heavy flow infiltration at lift station #4/ring seal leaking/ due to ground water levels into lift station
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: JOHNNIE J. CHADWICK
Permittee:
Town of Pollocksville
Certification No.: SS-11861/WW2-9579
Signing Official: James Bender Jr.
Grade: SS/WW2 Phone Number: [phone]
Signing Official's Title: Mayor
Has the ORC changed since the previous NDAR-1? ❑ Yes [21 No
Phone Numb : (2 2) 224-9831 Permit Exp.: JULY 31,2021
.
Jul 26,2020
- - 7/Q ��
j �nature Date
Signature Date
By this signature, cethis report is accurrate and complete to the best of my knowledge.
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Permit No.: WQ0007283
Facility Name: TOWN of POLLOCKSVILLE
County: Jones
Month: June
Year: 2020
Did irrigation
Field Name:
FIVE
Field Name:
SIX
Field Name:
Field Name:
occur
Area (acres):
4
Area (acres):
4.2
Area (acres):
Area (acres):
at this facility?
Cover Crop:Bermuda/Rye
y a
Cover Crop:
p:
Bermuda/Rye
Cover Crop:
p:
Cover Crop:
p:
❑ YES [] NO
Hourly Rate (in):
0.7
Hourly Rate (in):
0.7
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
92.56
Annual Rate (in):
92.56
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
❑ YES C NO
Field Irrigated?
❑ YES 0 NO
Field Irrigated?
❑ YES ❑ NO
Field Irrigated?
❑ YES ❑ NO
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°F
in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
C
61
0.0
2.4
2
C
60
0.0
2.4
3
C
70
0.0
2.5
4
CL
69
0.0
2.5
5
PC
74
&0
2.5
6
CL
82
0.0
1 2.6
7
PC
76
0.0
2.6
8
C
71
0.0
2.6
9
CL
68
0.0
2.6
10
CL
80
0.0
2.6
11
PC
79
0.0
2.7
12
R
73
1.0
2.6
13
CL
66
3.3
2.5
14
CL
61
0.0
2.5
15
CL
63
0.0
2.5
16
R
71
1.8
2.5
17
R
61
1.0
2.4
18
PC
63
0.0
2.4
19
PC
72
0.0
2.4
20
PC
75
0.9
2.3
21
R
69
0.3
2.3
22
C
75
0.0
2.3
23
C
80
0.0
2.3
24
CL
73
0.0
2.4
25
CL
73
0.0
2.4
26
PC
70
0.0
2.4
27
C
69
0.0
2.4
28
PC
73
0.0
2.5
29
C
70
0.0
2.5
30
CL
72
0.0
2.5
31
0
0.00
35.42
Monthly Loading:
12 Month Floating Total (in):
0.00
34.70
0.00
0.00
0
0
0.00
0.00

FORM: NDAR-1 08-11
NON -DISCHARGE APPLICATION REPORT (NDAR-1)
Did the application rates exceed the limits in Attachment B of your permit?
❑ Compliant
❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites?
❑ Compliant
❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit?
❑ Compliant
❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site?
Q Compliant
❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit?
❑ Compliant
❑ Non -Compliant
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance. Provide in your explanation the date(s) of the non-compliance and describe the corrective
action(s) taken. Attach additional sheets if necessary.
12-13,2020 received 3.25 inches of rain during 24 hrs./heavy flow infiltration at lift station #4 /ring seal leaking ground water into lift station
16-17,2020 received 2.75 inches of rain during 48 hrs/ heavy flow infiltration at lift station #4/ ring seal leaking ground water into lift station
20,2020 received 9/10 inches of rain during 24 hrs/ heavy flow infiltration at lift station #4/ring seal leaking/ due to ground water levels into lift station
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: JOHNNIE J. CHADWICK
Permittee:
Town of Pollocksville
Certification No.: SS-11861/WW2-9579
Signing Official: James Bender Jr.
Grade: SS/WW2 Phone Number: [phone]
Signing Official's Title: Mayor
Has the ORC changed since the previous NDAR-1? ❑ Yes 0 No
Phone Num r: 52) 224-9831 Permit Exp.: JULY 31,2021
Jul 26,2020
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations.
Mail Original and Two Copies to:
Division of Water Quality
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617

114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
TOWN OF POLLOCKSVILLE (EFFLUENT)
ATTN: JAMES BENDER, JR.
P.O. BOX 97
POLLOCKSVILLE ,NC 28573
PARAMETERS
BOD, mg/l
. Fecal Coliform (MF), /100 Mls
• Total Suspended Residue, mg/l
. Ammonia Nitrogen as N, mg/l
. Total K,jeldahl Nitrogen as N,mg/l
Nitrate -Nitrite as N, mg/I (calc)
i Nitrate Nitrogen as N, mg/1
o Nitrite Nitrogen as N, mg/1
Total Phosphorus as P, mg/l
• Calcium, ug/l
Magnesium, ug/I
Sodium, ug/l
. Sodium Adsorption Ratio (calc)
Total Nitrogen, mg/l (calc)
Effluent
Analysis
Method
Date
Analyst
Code
25
06/10/20
GNB
521OB-11
24000
06/10/20
JMS
9222D-06
39
06/11/20
JMS
254OD-11
2.42
06/15/20
TCW
350.1 112-93
11.61
06/16/20
TLH
351.2 112-93
0.07
353.2 R2-93
<0.04
06/10/20
DTL
353.2 112-93
0.07
06/10/20
DTL
353.2 112-93
1.85
06/16/20
DTL
365.4-74
77843
06/15/20
LET
EPA200.7
9360
06/15/20
LFJ
EPA200.7
56290
07/08/20
NAB
3111B-11
1.6
11.68
Wastewater IDi 10.'.
PHONE [phone]
FAX [phone]
ID#: 319
DATE COLLECTED: 06/10/20
DATE REPORTED : 07/09/20
REVIEWED BY:
JUL 1 3 1010

"Q`�X 7 O 85 , 114 Oakmont Dr.
reenville NC 27858
ivironrne t l i nc.com
hone [phone] 9 Fax [phone]
'LIENIC— 31' Week:26
AWN OF POLLOCKSVILLE (EFFLUENT)
MN: JAN¢S BENDER, JR.
O. BOX 9 V
�LLOCIKS ILLE NC 28573
52) 224-9S31
SAMPLE LOCATION
Effluent
BY (SIG.)
COLLECTION
DATE TIME
2D
MUN- 9
DISIN CTION
CHLORINE
Ij UV
Ij NONE
Fi
0)o
E�
w w Cl)
Cr
00 ¢LO Z
V H U Q
_ ~ w
Q� CL w0 0
F- 0 LL
00 �� 0
6
RECEIVE Y SIG.)
Y
RECEIV D 8 SIG.)
RECEIVED BY (SIG.)
...A"'N yr %-. U,-3 1 V10 Y XCEUUKD
COMMENTS:
Page I of i
CHLORINE NEUTRALIZED AT COLLECTION
pH CHECK (LAB)
CONTAINER TYPE, P/G
CHEMICAL PRESERVATION
A -NONE D-NAOH
Uj
B-HNO3 E-HCL
Cn
cr
w C- H2SO, F - ZINC ACETATE/NAOH
a G - NATHIOSULFATE
C SIRCATION:
UX'WASTEWATER (NPDES)
LjDRINKING WATER
DWR/GW
SOLID WASTE SECTION
------------
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING 'PM
Y N
SAMPLES CO ECTED BY:
SAMPLES RECEIVED IN LAB AT Z-Co -C
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for
FORM #5 Grab sample in the blocks above for each parameter requested.
K10 777A7'7

ER,wu [MUM % hwPuMd
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
TOWN OF POLLOCKSVILLE (EFFLUENT)
ATTN: JAMES BENDER, JR.
P.O. BOX 97
POLLOCKSVILLE ,NC 28573
Wastewater iDi 16
PHONE [phone]
FAX [phone]
ID#: 319
DATE COLLECTED: 06/10/20
DATE REPORTED : 07/09/20
REVIEWED BY:
Effluent
Analysis
Method
PARAMETERS
Date
Analyst
Code
• SOD, mg/l
25
06/10/20
GNB
521OB-11 -
. Fecal Coliform (MF), /100 Mls
24000
06/10/20
JMS
9222D-06
• Total Suspended Residue, mg/1
39
06/11/20
JMS
2540D-11
• Ammonia Nitrogen as N, mg/1
2.42
06/15/20
TCW
350.1 R2-93
• Total Neldahl Nitrogen as N,mg/1
11.61
06/16/20
TLH
351.2 R2-93
0L5
• Nitrate -Nitrite as N, mg/1 (calc)
0.07
353.2 R2-93
i Nitrate Nitrogen as N, mg/1
<0.04
06/10/20
DTL
353.2 R2-93
JUL 1 3 2020
Nitrite Nitrogen as N, mg/1
0.07
06/10/20
DTL
353.2 R2-93
Total Phosphorus as P, mg/1
1.85
06/16/20
DTL
365.4-74
BY.
• Calcium a /1
� l;
77843
06/15/20
LF.i
EPA200.7
• ......••-'••••••••••
• Magnesium, ug/I
9360
06/15/20
LFJ
EPA200.7
Sodium, ug/I
56290
07/08/20
NAB
3111B-11
. Sodium Adsorption Ratio (calc)
1.6
Total Nitrogen, mg/1 (calc)
11.68

.Uo -
0_10 85 114 Oakmont Dr.
reeennvville NC 27858
Ivironme nt 1 inc.com
hone (25 :7 ) 756-6208 • Fax [phone]
'LIENIC� 311 Week:26
)WN OF VOLLOCKSVILLE (EFFLUENT)
CI'N: J
S BENDER, JR.
O. BOX 9 "
:)LLOCI"-:s IEEE NC 28573
52) 224-9S31
SAMPLE LOCATION
liflluen
t
BY (SIG.)
COLLECTION
DATE TIME
D-
a
2 Ian
D
vilt lil \ "X,
\_U01
VL x
K��■ ■{d � ■
\J1\L
Page I of 1
DISIN CTION
CHLORINE
CHLORINE NEUTRALIZED AT COLLECTION
UV
pH CHECK (LAB)
NONE
P
P
P
P
P
P P
P P
P
CONTAINER TYPE, P/G
A
G
A
C C
C A
A C
A A
CHEMICAL PRESERVATION
_z
0
LLL,- W
c
A -NONE D-NAOH
Cr -' ¢ zo
0 0 U
w
w
.�.
z
Y
y
=
c
c
w
� B HNO3 E HCL
¢
wLU
_j
o
c�
=
o
j ::
C
0cc
�- C H SO
,,, z a F ZINC ACETATE/NAOH
rn
~ c J.U��
v
o
o
v
?
w
:3
y a
=
�:
0
Q G - NA THIOSULFATE
a
6
i
C SIFlCATION:
WASTEWATER (NPDES)
DRINKING WATER
DWR/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING IPMENT/DELIVERY
Y N
SAMPLES CO ECTED BY:
(Pie s
:CEIVE Y SIG.)
SAMPLES RECEIVED IN LAB AT 2- (o °C
DATEInME
(C11A07i-
COMMENTS:
RECEIVED BY (SIG.)
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for
FORM S5 Grab sample in the blocks above for each parameter requested.
PJ 0 '177A77

Nlm'wuhlmEffil % DIMNTPWMNO
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
TOWN OF POLLOCKSVILLE (EFFLUENT)
ATTN: JAMES BENDER, JR.
P.O. BOX 97
POLLOCKSVILLE ,NC 28573
wastewater ID) 10
PHONE [phone]
FAX [phone]
ID#: 319
DATE COLLECTED: 06/10/20
DATE REPORTED : 07/09/20
REVIEWED BY:
Effluent
Analysis
Method
PARAMETERS
Date
Analyst
Code
• BOD, mg/l
25
06/10/20
GNB
5210B-11 ,
. Fecal Coliform (MF), /100 Mls
24000
06/10/20
JMS
9222D-06
• Total Suspended Residue, mg/I
39
06/11/20
JMS
254013-11
Ammonia Nitrogen as N, mg/l
2.42
06/15/20
TCW
350.1 112-93
. Total Neldahl Nitrogen as N,mg/1
11.61
06/16/20
TLH
351.2 R2-93
0 ( 8
• Nitrate -Nitrite as N, mg/1 (calc)
0.07
353.2 R2-93
i Nitrate Nitrogen as N, mg/1
Nitrite
<0.04
06/10/20
DTL
353.2 R2-93
JUL 1 3 2020
Nitrogen as N, mg/l
0.07
06/10/20
DTL
353.2 112-93
Total Phosphorus as P, mg/1
1.85
06/16/20
DTL
365.4-74
:............
• Calcium a /1
g
77843
06/15/20
LET
EPA200.7
..••••.•...
Magnesium, 11g/1
9360
06/15/20
LFJ
EPA200.7
• Sodium, ug/l
56290
07/08/20
NAB
3111B-11
. Sodium Adsorption Ratio (calc)
1.6
Total Nitrogen, mg/l (calc)
11.68

85, 114 Oakmont Dr.
reenv� C 27858
won yic i t 1 inc.com
hone
756-6208 • Fax [phone]
hone (25 �� �- �
;LIENT' 319 Week:26
)WIN OF VOLLOCKSVILLE (EFFLUENT)
Cl'N: J�
S BENDER, JR.
O. BOX 9 V
JLLOCIKS ILLE NC 28573
52) 224-9S31
SAMPLE LOCATION
Effluent
RELINQUISHED BY (SIG.)
COLLECTION
DATE TIME
D 2a l o�
NIME
DISCTION
IZCHLORINE
UV
NONE
Fi z
Eo
w W C) �
z
J cUj
c
0 p e O z
U U
U Q �
� wOap 0¢�OOo / 6
RECEIVE Y SIG.)
RECEIV 08 SIG.)
RECEIVED BY (SIG.)
t.t1C111\ "r 1t—u31 "1J Y KL+ UORD
Page I of 1
CHLORINE NEUTRALIZED AT COLLECTION
pH CHECK (LAB)
CONTAINER TYPE, P/G
CHEMICAL PRESERVATION
f2 A -NONE D-NAOH
LU
B HNO3 E-HCL
0z
w C HZSO, F - ZINC ACETATE/NAOH
G - NA THIOSULFATE
aa.
C S'RCATION:
WASTEWATER (NPDES)
LjDRINKING WATER
Ij DWR/GW
Ij SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING IPMENT/DELIVERY
Y N
SAMPLES CO ECTED BY
SAMPLES RECEIVED IN LAB AT 2-(0 �
DATEIfIME COMMENTS:
DATEMME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for
FORM #5 Grab sample in the blocks above for each parameter requested.
M 0 777A77