NC0026271_Regional Office Historical File Pre 2018 (7)

-A�
SOC Priority Project: No
To: Permits and Engineering Unit
Water Quality Section
Attention: Charles Weaver
Date: November 25, 2009
NPDES STAFF REPORT AND RECOMMENDATION
County: Alexander
Permit No. NCO026271
PART I - GENERAL INFORMATION
1. Facility and address: Town of Taylorsville
344 Minnagan Lane
Taylorsville, North Carolina 28681
2. Date of investigation: November 5, 2009
3. Report prepared by: B. Dee Browder, Environmental Engineer I
4. Persons contacted and telephone number: Mr. Brian Eades, [phone].
5. Directions to site: From the junction of NC Hwy 64 and NC HWY 16 in Taylorsville, travel
west on Hwy 64 and take the first left onto Happy Plains Road. Travel approximately 0.1
mile and turn left onto Minnigan Lane. The WWTP is located at the end of Minnigan Lane.
6. Discharge point(s), list for all discharge points:
Latitude: 35' 53' 02" Longitude: 8V 11' 44"
U.S.G.S: Quad No.: D 14 NW U.S.G.S. Quad Name: Taylorsville, NC
7. Site size and expansion area consistent with application? Yes. There is limited area available
for expansion, if necessary.
8. Topography (relationship to flood plain included): Moderately sloping; the WWTP is not
located within the 100 year flood plain.
9. Receiving stream or affected surface waters: Lower Little Creek
a. Classification: C
b. River Basin and subbasin no.: Catawba 030832
C. Describe receiving stream features and pertinent downstream uses: The facility
discharges into an outfall a significant distance from the WWTP. The receiving
stream was approximately 60 feet wide and 5-8 feet deep.

PART II - DESCRIPTION OF DISCHARGE AND TREATMENT WORKS
1. a. Volume of wastewater to be permitted: 0.83 MGD
b. Current permitted capacity of the wastewater treatment facility: 0.83 MGD
C. Actual treatment capacity of the current facility (current design capacity): 0.83 MGD
d. Date(s) and construction activities allowed by previous Authorizations to Construct
issued in the previous two years: There have been no ATCs issued to this facility in
the past two years (see (f) below).
e. Please provide a description of existing or substantially constructed wastewater
treatment facilities: The WWTP facility consists of a bar screen, a grit chamber,
flow splitter box, dual aeration basins, dual secondary clarifiers, chlorine contact
chamber and dechlorination chamber, and four aerobic digesters.
f. Please provide a description of proposed wastewater treatment facilities: There are
no proposed WWT facilities at this time.
g. Possible toxic impacts to surface waters: Chlorine is added to the waste stream.
Dechlorination is not presently provided.
h. Pretreatment Program (POTWs only): Not required.
2. Residuals handling and utilization/disposal scheme: Precision Land Application. (PLA)
removes residuals as needed.
3. Treatment plant classification: Class II (no change from pervious rating).
PART III - OTHER PERTINENT INFORMATION
1. Is this facility being constructed with Construction Grant Funds or are any public monies
involved? N/A
2. Special monitoring or limitations (including toxicity) requests: None.
3. Important SOC, JOC or Compliance Schedule dates (Please indicate): N/A
4. Alternative Analysis Evaluation: N/A

PART IV - EVALUATION AND RECOI'IMENDATIONS
The permittee, has requested reissuance of the subject permit. The WWTP will be
submitting application for expansion in 2010 if funding allows. Expansion design is for 1.2 MGD.
Currently the facility has a temporary on -site lime slurry tank. Lime is added to the
headworks of the facility. Central office needs to evaluate the time frame and use of this system to
determine if a permit modification needs to include this system.
It is recommended that the permit be rem d, pending a final review and concurrence of the
draft permit when it becomes available.
•� �� r
Signature of Report Preparer ate
it 3009
Water Quality Regional Supervisor Date

{
Town of -Taylors ville
"The Brushy Mountain Gateway"
67 Main Avenue Drive
Taylorsville, North Carolina 28681
828.632.2218 (Phone)' 828.632.7964 (Fax)
www.taylorsvillenc.cocn
September 29, 2009
A7TN: Mrs. Dina Sprinkle
NC DENR/DWQ/Point Source Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
SUBJECT: NPDES Permit Renewal
Permit #NC0026271
Taylorsville WWTP
Mrs. Sprinkle,
The Town of Taylorsville is requesting a renewal of sewer discharge Permlit
NC002671. There have been no changes to our facility since the issuance of the last
permit. Since the Town of Taylorsville received the advanced notice for permit renewal
requirements from your office in late January of this year, we decided right away to submit the
earliest data we had available, and to begin the PPA analyses immediately. There was not
enough time between the notification from your office and the due date to get all of the proper
testing in. We have always been aware of the 180 day limitation, but never have had this much
information to gather in this timeframe. As of today we have not received results from a fourth
PPA that we ran in conjunction with our quarterly toxicity; and are waiting to send the October
flathead minnow toxicity with our regular quarterly toxicity. Once we receive final lab data
in late October we will forward it to you to complete the uermit auulication
requirements.
Permitting in the past has not seemed this complicated. It seems that more stringent
regulations have been adopted since our last application. I realize that we are under 1 MGD,
but felt that since we were at or near 1 MGD that we should follow that criteria. We hope in
the future to go to 1.2 MGD, but have no funding to proceed as yet. I have done my best to
provide the information you requested. Some of the maps are difficult to read. We are
currently having all of our piping and headworks put on GIS, but as of now this is not complete.
If you need these maps more visible, I can email them to you in pdf so you can zoom in on pipe
sizes, etc. If you need more information, call me at 828-6 n
Core
Sincerely,
OCT - 5 2009
Mr. Brian Eades, DENR - WATER OUALITY
ORC Taylorsville WWTP- POINT SOURCE BRANCH
'ILe Town of Taylorsville Jots not diteriminate on the basis of race, color, natiotrd origin,
sex, religion, age or disability in a npinytnent or the pmeiaion of services.

r�
TOWN OF TA YLORSVILLE WWTP SCHEMATIC
FORCEMAIN
PLANT COMPONENTS
A.
FLOW SPLITTER BOX
I.
AEROBIC DIGESTER NO. 4
B.
AERATION NO. 1
J.
CHLORINE CONTACT CHAMBER
C.
AERATION BASIN NO.2
K.
DECHLORINATION CHAMBER
D.
CLARIFIER NO. 1
L.
RECYCLE PUMPING STATION NO. 1
E.
CLARIFIER NO. 2
M.
RECYCLE PUMPING STATION NO. 2
F.
AEROBIC DIGESTER NO. 1
N.
SCUM PUMPING STATION NO. 1
G.
AEROBIC DIGESTER NO. 2
0.
SCUM PUMPING STATION NO. 2
H.
AEROBIC DIGESTER NO. 3
P.
SLUDGE DECANT PUMPING STATION

11
FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
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NPDES Y,f, ,tirj.,�- '1
s rio.. Ild,ra5 . it .ht t.d
APPLICATION OVERVIEW
Form 2A has been developed in a modular format and consists of a "Basic Application Information" packet
and a "Supplemental Application Information" packet. The Basic Application Information packet is divided
into two parts. All applicants must complete Parts A and C. Applicants with a design flow greater than or
equal to 0.1 MGD must also complete Part B. Some applicants must also complete the Supplemental
Application Information packet. The following items explain which parts of Form 2A you must complete.
BASIC APPLICATION INFORMATION:
A. Basic Application Information for all Applicants. All applicants must complete questions A.1 through A.8. A treatment works
that discharges effluent to surface waters of the United States must also answer questions A.9 through A.12,
B. Additional Application Information for Applicants with a Design Flow >_ 0.1 MGD. All treatment works that have design flows
greater than or equal to 0.1 million gallons per day must complete questions B.1 through 13.6.
C. Certification. All applicants must complete Part C (Certification).
SUPPLEMENTAL APPLICATION INFORMATION:
D. Expanded Effluent Testing Data. A treatment works that discharges effluent to surface waters of the United States and meets
one or more of the following criteria must complete Part D (Expanded Effluent Testing Data):
1. Has a design flow rate greater than or equal to 1 MGD,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to provide the Information.
E. Toxicity Testing Data. A treatment works that meets one or more of the following criteria must complete Part E (Toxicity Testing
Data):
1. Has a design flow rate greater than or equal to 1 MGD,
2. Is required to have a pretreatment program (or has one in place), or
3. Is otherwise required by the permitting authority to submit results of toxicity testing.
F. Industrial User Discharges and RCRA/CERCLA Wastes. A treatment works that accepts process wastewater from any
significant industrial users (SIUs) or receives RCRA or CERCLA wastes must complete Part F (Industrial User Discharges
and RCRA/CERCLA Wastes). SIUs are defined as:
1. All industrial users subject to Categorical Pretreatment Standards under 40 Code of Federal Regulations (CFR) 403.6 and
40 CFR Chapter I, Subchapter N (see instructions); and
2. Any other industrial user that:
a. Discharges an average of 25.000 gallons per day or more of process wastewater to the treatment works (with certain
exclusions); or
b. Contributes a process wastestream that makes LIP 5 percent or more of the average dry weather hydraulic or organic
capacity of the treatment plant; or
c. Is designated as an SIU by the control authority.
G. Combined Sewer Systems. A treatment works that has a combined sewer system must complete Part G (Combined Sewer
Systems).
APPLICANTS MUST;COMPLETE;PART_C (CERTIFICATION)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 1 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
yl��/GS ►,)r Y /a,fivT�' ✓VGc�'l �� I l�I.r,�� i��l L �l �lG✓
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PA T�A,iBASIOI,A LIGA'�IOI 41NFORMPT OR�FtO+Ri' 'L �1 ; ,1 ICAN, St It �� hl �n +!lr...4t ('k<: Mtt 1
All treatment works must complete questions AA. through A.B of this Basic Application Information Packet.
A.1. Facility Information.
Facility Name / n
Mailing Address r') / ��!� �, I�f' �✓� of
Contact Person�✓��
Title
Telephone Number 'Crl x) ' 3 2-
Facility Address%Lr �i�j����r!/1,J i•f�N �— ��' ��
(not P.O. Box)
A.2. Applicant Information. If the applicant is different from the above, provide the following:
Applicant Name
Mailing Address
Contact Person
Title
Telephone Number ( )
Is the applicant the owner or operator (or both) of the treatment works?
[owner operator
Indicate whether correspondence regarding this permit should be directed to the facility or the applicant.
❑ facility © applicant
A.3. Existing Environmental Permits. Provide the permit number of any existing environmental permits that have been issued to the treatment works
(include state -issued permits).
NPDES Al C.' o 0 -L% PSD
UIC Other
RCRA Other
A.4. Collection System Information. Provide information on municipalities and areas served by the facility. Provide the name and population of each
entity and, if known, provide information on the type of collection system (combined vs. separate) and its ownership (municipal, private, etc.).
Name Population Served Type of Collection System Ownership
vlLr.�-
�j�
r
Total population served
EPA Form 3510.2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 2 of 22
r

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVEP BASIN:
l_OQ 1 (, .a-� �e��
A.S. Indian Country.
a. Is the treatment works located in In i'an Country?
❑ Yes [#} No
b. Does the treatment works discharge to a receiving water that is either in Indian Country or that is upstream from (and eventually flows
through) Indian Country?
❑ Yes (D/No
A.6. Flow. Indicate the design flow rate of the treatment plant (i.e., the wastewater flow rate that the plant was built to handle). Also provide the
average daily flow rate and rnaxinwm daily flow rate for each of the last three years. Each year's data must be based on a 12-month time period
with the 12"' month of "this year" occurring no more than three months prior to this application submittal.
a. Design flow rate c� 0MGD
Two Years Aoo
Last Year
This Year
b. Annual average daily flow rate
ti //J-C) C�
- C`r
, Z �r
C. Maximum daily flow rate
`7
�(, J v
� vf�/
A.7. Collection System. Indicate the type(s) of collection system(s) used by the treatment plant.
contribution (by miles) of each.
Check all [hat apply.
Also estimate the percent
9--geparate sanitary sewer
/n CS
❑ Combined storm and sanitary sewer
%
A.B. Discharges and Other Disposal Methods
a. Does the treatment works discharge effluent to waters of the U.S.? M Yes
❑ No
If yes, list how many of each of the following types of discharge points the treatment works uses:
1. Discharges of treated effluent
ii. Discharges of untreated or partially trebled effluent
iii. Combined sewer overflow points
iv. Constructed emergency overflows (prior to the headworks)
V. Other 11!11q
--
b. Does the treatment works discharge effluent to basins, ponds, or other surface impoundments
that do not have outlets for discharge to waters of the U.S.? ❑ Yes
D�No
If yes, provide the following for each surface inlooundmenL
Location:
Annual average daily volume discharge to surface impoundments)
MGD
Is discharge ❑ continuous or ❑ intermittent. ?
C. Does the treatment works land -apply treated wastewater?
❑ Yes No
If yes, provide the following for each land application site:
Location:
Number of acres:
Annual average daily volume applied to site:
MGD
Is land application ❑ continuous or ❑ intermittent?
d. Does the treatment works discharge or transport treated or untreated wastewater to another
treatment works?
❑ Yes MIN,
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 3 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
it/CUU •? E 2i i
�`r..N�,�n (_
(/J�l i(iLir•1
�fr� � �✓z'� Lilll.-� L,t.JI�,'r►�'
If yes, describe the mean(s) by which the wastewater from the treatment works is discharged or transported to the other treatment works
(e.g., tank truck, pipe).
A,J ''i
If transport is by a party other than the applicant, provide:
Transporter Name
Mailing Address
Contact Person
Title
Telephone Number ( )
For each treatment works that receives this discharge, provide the following:
Name
Mailing Address
Contact Person
Title
Telephone Number ( )
If known, provide the NPDES permit number of the treatment works that receives this discharge
Provide the average daily flow rate from the treatment works into the receiving facility.
MGD
e. Does the treatment works discharge or dispose of its wastewater in a manner not included
in A.B. through A.B.d above (e.g., underground percolation, well injection): ❑ Yes
No
If yes, provide the following for each disposal method:
Description of method (including location and size of sites) If applicable):
,AJ / ti
Annual daily volume disposed by this method:
Is disposal through this method ❑ continuous or ❑ intermittent?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 4 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
WASTEWATER DISCHARGES:
If you answered "Yes" to question A B.a, complete questions A 9 through A 12 once for each outfall (including bypass points) through
which effluent is discharged. Do not include Information on combined sower overflows In this section. If you answered "No" to question
A.B.a, go to Part B, "Additional Application Information for Applicants with a Design Flow Greater than or Equal to 0.1 MGD."
A.9. Description of Outfall.
a. Oulfall number r U
b. Location //7 "/ 6:,/4 1.•7L_% e�- �� • � 5;
(City or town, if applicable) (Zip Code)
(County)
(Slate)
• J o ,,
(Latitude)
(Longitude)
C. Distance from shore (if applicable) ft.
d. Depth below surface (if applicable) ft.
e. Average daily flow rate 2/�'' MGD
f. Does [his outfall have either an intermittent or a periodic discharge? ❑ Yes No (go to A.9.g.)
If yes, provide the following information:
Number f times per year discharge occurs:
Average duration of each discharge:
Average flow per discharge: MGD
Months in which discharge occurs:
g. Is outfall equipped with a diffuser?
❑ Yes m-No
A.10. Description of Receiving Waters.
a. Name of receiving water
b. Name of watershed (if known)
United Stales Soil Conservation Service 14-digit watershed code (if known):
C. Name of Slate Management/River Basin (if known):
United Stales Geological Survey 8-digil hydrologic cataloging unit code (if known):
d. Critical low flow of receiving stream (if applicable)
acute cis chronic
e. Total hardness of receiving stream at critical low flow (if applicable):
cis
mg/l of CaCO3
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550.6 & 7550-22. Page 5 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
A.11. Description of Treatment
a. What level of treatment are provided? Check all that apply.
❑ Primary Secondary
❑ Advanced ❑ Other. Describe:
b. Indicate the following removal rates (as applicable):
U
Design BOD5 removal or Design CBOD5 removal
r)
Design SS removal
Design P removal
Design N removal —
Other
C. What type of disinfection is used for the effluent from this outfall? If disinfection varies by season, please describe:
�2
If disinfection is by chlorination is dechlorinalion used for this outfall? W Yes ❑ No
Does the treatment plant have post aeration? ❑ Yes ©"No
A.12. Effluent Testing Information. All Applicants that discharge to waters of the US must provide effluent testing data for the following
parameters. Provide the Indicated effluent testing required by the permitting authority for each outfall through which effluent Is
discharged. Do not include Information on combined sewer overflows In this section. All Information reported must be based on data
collected through analysis conducted using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of
40 CFR Part 136 and other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a
minimum, effluent testing data must be based on at least three samples and must be no more than four and one-half years apart.
Outfall number: o U %
MAXIMUM DAILY VALUE
AVERAGE DAILY VALUE
PARAMETER
Value,
Units
Value
Units
Number.of Samples
pH (Minimum)
S.U.
�� •
a a
i .
pH (Maximum)
, )
s.u.
�.
? � t f..�•.:-
Flow Rate
�% / /
; "� (�" D
L/-7----
Temperature (Winter)
Temperature (Summer)
For pH please report a minimum and a maximum daily value
MAXIMUM DAILY'-
AVERAGE DAILY. DISCHARGE
`
DISCHARGE..
ANALYTICAL-
ML/MDL
POLLUTANT
,METHOD:
' Number of
Conc.
Units.:
Conc
Units ;
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
BIOCHEMICAL OXYGEN
BOD5
1), (r�
✓h G L
0 t;
N� �, IL
-5
j /'i S 2 /0
DEMAND (Report one)
CBOD5
—
—_
FECAL COLIFORM
Z i))
fug nl
% 5
jirl ? L LZ' U
TOTAL SUSPENDED SOLIDS (TSS)
3 6
j+• /!✓
L2 Ari F,
+^ 6 /r
THE APPLICATION OVERVIEW, (PAGE 1 TO DETERMINE WHICH OTHER PARTS
REFER
, '
OF FORM 2A YOU MUSTI COMPLETE`', , +
+' ,:,,..,.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 6 of 22

e
FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
rtuz:(
BASIC;APPLICATION.INFORMATION 1,J.
PART M ADDITIONAUAPPLICATION INFORMATION.FOR.APPLICANTS WITH :A DESIGN FLOW GREATER THAN OR
EQUgL'.TO;0I.MOD' (100,000 gallojts;per.day):',
n.
All applicants with a design flow rate z 0.1 MGD must answer questions BA through B.6. All others go to Part C (Certification). 1
B.1. Inflow and Infiltration. Estimate the average number of gallons per day that flow into the trealrnent works from inflow and/or infiltration.
J O ."lc) i? gpd
Briefly explain any steps underway or planned to minimize inflow and infiltration.
/' /,; rf A) r �%%�/t��/i! S C � ,V, )!r1' LiN/,
J
I
ill N lJL'_ h r ;='r T , i ? r:,f f / �r•? / id„ / i(%�.< �� jr r t/ % r _Z 6
B.2. Topographic Map. Attach to this application a topographic map of the area extending at least one mile beyond facility property boundaries. This
map must show the outline of the facility and the following information. (You may submit more than one map if one map does not show the entire
area.)
a. The area surrounding the treatment plant, including all unit processes.
b. The major pipes or other structures through which wastewater enters the treatment works and the pipes or other structures through which
treated wastewater is discharged from the treatment plant. Include oulfalls front bypass piping, if applicable.
c. Each well where wastewater frorn the treatment plant is injected underground.
d. Wells, springs, other surface water bodies, and drinking water wells that are: 1) within '/. mile of the property boundaries of the treatment
works, and 2) listed in public record or otherwise known to the applicant.
e. Any areas where the sewage sludge produced by the treatment works is stored, treated, or disposed.
I. If the treatment works receives waste that is classified as hazardous under the Resource Conservation and Recovery Act (RCRA) by truck, rail,
or special pipe, show on the map where the hazardous waste enters the treatment works and where it is treated, stored, and/or disposed.
B.3. Process Flow Diagram or Schematic. Provide a diagram showing the processes of the treatment plant, including all bypass piping and all
backup power sources or redunancy in the syslern. Also provide a water balance showing all treatment units, including disinfection (e.g.,
chlorination and dechlorination). The water balance must show daily average flow rates at influent and discharge points and approximate daily flow
rates between treatment units. Include a brief narrative description of the diagram.
BA. Operation/Maintenance Performed by Contractor(s).
Are any operational or maintenance aspects (related-tto wastewater treatment and effluent quality) of the treatment works the responsibility of a
❑
contractor? Yes
If yes, list the name, address, telephone number, and status of each contractor and describe the contractor's responsibilities (attach additional
pages if necessary).
Name: ,/i/
Mailing Address:
Telephone Number: 1
Responsibilities of Contractor:
B.5. Scheduled Improvements and Schedules of Implementation. Provide information on any uncompleted implementation schedule or
uncompleted plans for improvements that will affect the wastewater treatment. effluent quality, or design capacity of the treatment works. If the
treatment works has several different implementation schedules or is planning several improvements, submit separate responses to question B.5
for each. (If none, go to question B.6.)
a. List the outfall number (assigned in question A.9) for each o IWI that is covered by this implementation schedule.
C1 /
b. Indicate whether the planned improvements or implementation schedule are required by local, State, or Federal agencies.
❑ Yes 0`"N0
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 7 0l 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
If the answer to B.5.b is "Yes," briefly describe, including new maximum daily inflow rate (if applicable).
C.
/1
d. Provide dates imposed by any compliance schedule or any actual dales of completion for the implementation steps listed below, as
applicable. For improvements planned independently of local, State, or Federal agencies, indicate planned or actual completion dales, as
applicable. Indicate dates as accurately as possible.
Schedule Actual Completion
Implementation Stage MM/DD/YYYY MM/DD/YYYY
Begin Construction
End Construction
Begin Discharge
Attain Operational Level / / / /
e. Have appropriate permits/clearances concerning other Federal/Stale requirements been obtained? El b�No
- //.' �f L.L, l l 1'¢r C_ cJ�C./•r /C /t. � �C4=1� J' 1`7�„ �'Y,-o
Describe briefly:
�J
�'�/ X/.l1 r2UJC1 • /��t,_,S /p%%nrl �t2� '
B.6. EFFLUENT TESTING DATA (GREATER THAN 0.1 MGD ONLY).
Applicants that discharge to waters of the US must provide effluent testing data for the following parameters. Provide the Indicated
effluent testing required by the permitting authority for each outfall through which effluent Is discharged. Do not Include Information
on combine sewer overflows In this section. All Information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements of 40 CFR Part 136 and other appropriate
QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. At a minimum effluent testing data must be
based on at least three pollutant scans and must be no more than four and on -half years old.
CJG
Oulfall Number:
MAXIMUM DAILY.`AVERAGE;DAILY
DISCHARGE
;
DISCHARGE:ANALYTICAL
MLIMDL
POLLUTANT
METHOD
-METHOD
Number of
Conc.
Units
Conc.
Units
.;
Samples
CONVENTIONAL AND NON CONVENTIONAL COMPOUNDS
AMMONIA (as N)
A 0 U
►�,j U
r`"�
�7
CHLORINE (TOTAL
1v
d�
Uc / 1L
1I
< Q
rJ-
L,.. L
RESIDUAL, TRC)
.7
DISSOLVED OXYGEN
TOTAL KJELDAHL
7
rN 1[
n ,U L
NITROGEN (TKN)
NITRATE PLUS NITRITE
i'. S U
~ `J ��'
�J
Z• U
/
r•-f� / f'
NITROGEN
OIL and GREASE
PHOSPHORUS (Total)
//, t,
w• j 2
TOTAL DISSOLVED SOLIDS
(TDS)
OTHER
r
WHICH
REFER, 0- :HEiAPP�ICATION'OVERVIEW(PAGE11)4'TOtQ.ETERMINE OTHER PARTS'
,:.
�u OFFF0RMI2A'YOU MUST COIVIPLETE r
I :1
I, r
EPA Form 3510-2A (Rev. 1.99). Replaces EPA forms 7550-6 & 7550-22. Page 8 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMI T ACTION REQUESTED:
RIVER BASIN:
I' LCJ%/'5 �' � �. (.-...�L �'�/lam ���i , / ✓ �lJ U 1 � �. � �
'�' � � �
��
BASIC APPLICATION INFORMATION
:,
PART C'.CERTIFICATION
All applicants must complete the Certification Section. Refer to Instructions to determine who Is an officer for the purposes of this
certification. All applicants must complete all applicable sections of Form 2A, as explained In the Application Overview. Indicate below which
parts of Form 2A you have completed and are submitting. By signing this certification statement, applicants confirm that they have
reviewed
Form 2A and Have completed all sections that apply to the facility for which this application Is submitted.
In ate which parts of Form 2A you have completed and are submitting:
7-
Basic Application Information packet Supplemental Application Information packet:
19 Part D (Expanded EfllUenl Testing Data)
Part E (Toxicity Testing: Biomoniloring Data)
❑ Part F (Industrial User Discharges and RCRA/CERCLA Wastes)
❑ Part G (Combined Sewer Systems)
ALL APPLICANTS MUST, COMPLETE THE FOLLOWING'CERTIFICATION.� '
I certify under penally of law that this document and all attachments were prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel property gather and evaluate 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 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 fine and imprisonment
for knowing violations.
Name and official title
Signature
Telephone number
Date signed (� /? '' �o 7
Upon request of the permitting authority, you must submit any other information necessary to assure wastewater treatment practices at the treatment
works or identify appropriate permitting requirements.
SEND COMPLETED FORMS TO:
NCDENR/ DWQ
Attn: NPDES Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 9 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
SU�61W
TIONNF�0
tAP,, IWENTALNAPRUCA II
A
E P T E*XPANDED-1; JTES� N Gi D
dF ; 1.
4:1;.1i
0.1 4 kt' lix ;,J"
1. 1 ,
Refer to the directions on the cover page to determine whether this section applies to the treatment works.
Effluent Testing: 1.0 MGD and Pretreatment Works. If the treatment works has a design flow.greater than or equal to 1.0 MGD or it has (or is required
to have) a pretreatment program, or is otherwise required by the permitting authority to provide the data, then provide effluent testing data for the following
pollutants. Provide the indicated effluent testing information and any other information required by the permitting authority for each outfall through which
effluent is discharged. Do not include information on combined sewer overflows in this section. All information reported must be based on data collected
through analyses conducted using 40 CFR Part 136 methods. In addition, these data must comply with QA/QC requirements of 40 CFR Part 136 and
other appropriate QA/QC requirements for standard methods for analytes not addressed by 40 CFR Part 136. Indicate in the blank rows provided below
any data you may have on pollutants not specifically listed in this form. At a minimum, effluent testing data must be based on at least three pollutant
scans and must be no more than four and one-half years old.
Outfall number: (Complete once for each outfall discharging effluent to waters of the United States.)
POLLUTANT
MAXIMUM DAILY:DISCHARGE
j AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD':.-:
ML/MDL .
Com,
Units...
Mass!
,Units!-
..Conc;
units".i"
Mass,..-`
Units
-Nu inbeir
o f -
METALS (TOTAL RECOVERABLE), CYANIDE, PHENOLS, AND HARDNESS. -
ANTIMONY
ARSENIC
BERYLLIUM
CADMIUM
CHROMIUM
COPPER
LEAD
MERCURY
NICKEL.
SELENIUM
SILVER
THALLIUM
ZINC
CYANIDE
TOTAL PHENOLIC
COMPOUNDS
HARDNESS (as CaCO3)
F
Use this space (or a separate sheet) to provide information on other metals requested by the permit writer
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 10 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
Outfall number: (Complete once for each oulfall discharging effluent to waters of the United Slates.)
POLLUTANT
MAXIMUM DAILY DISCHARGE.
AVERAGE DAILY DISCHARGE':.;.•
ANALYTICAL,
METHOD.
ML/MDL
Conc.
Units
Mass;
' Units
Conc.
Units
Mass
Units-
Number
of
Samples
VOLATILE ORGANIC COMPOUNDS
ACROLEIN
ACRYLONITRILE
BENZENE
BROMOFORM
CARBON
TETRACHLORIDE
—
CHLOROBENZENE
CHLORODIBROMO-
METHANE
CHLOROETHANE
2-CHLOROETHYLVINYL
ETHER
CHLOROFORM
DICHLOROBROMO-
METHANE
1,1-DICHLOROETHANE
1,2-DICHLOROETHANE
TRANS-I.2-DICHLORO-
ETHYLENE
1,1-DICHLORO-
ETHYLENE
1,2-DICHLOROPROPANE
1,3-DICHLORO-
PROPYLENE
ETHYLBENZENE
METHYL BROMIDE
METHYL CHLORIDE
METHYLENE CHLORIDE
1.1,2.2-TETRA-
CHLOROETHANE
TETRACHLORO-
ETHYLENE
TOLUENE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 11 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Outfall number: (Complete once for each oulfall discharging effluent to waters of the United Stales.)
POLLUTANT ; °
MAXIMUM DAILY DISCHARGE')
t:'AVERAGE DAILY DISCHARGE
ANALYTICAL,
METHOD
.:. MUMDL.
i
Cone;
i'
l}nits r,
. Massl
i Units
Co�c ,`
UnIWI
,:Mass':,
Units
Number
:of
Samples
TRICHLOROETHANE
1,1,2-
TRICHLOROETHANE
TRICHLOROETHYLENE
VINYL CHLORIDE
Use this space (or a separate sheet) to provide information on other volatile organic compounds requested by the permit writer
177
1
1
1
T
ACID -EXTRACTABLE COMPOUNDS
P-CHLORO-M-CRESOL
2-CHLOROPHENOL
2,4-DICHLOROPHENOL
2,4-DIMETHYLPHENOL
4,6-DINITRO-0-CRESOL
2,4-DINITROPHENOL
2-NITROPHENOL
4-NITROPHENOL
PE14TACHLOROPHENOL
PHENOL
2,4,6-
TRICHLOROPHENOL
Use this space (or a separate sheet) to provide information on other acid -extractable compounds requested by the permit writer
BASE -NEUTRAL COMPOUNDS
ACENAPHTHENE
ACENAPHTHYLENE
ANTHRACENE
BENZIDINE
BENZO(A)ANTHRACENE
BENZO(A)PYRENE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 12 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Outfall number: (Complele once for each outfall discharging effluent to waters of the United Stales.)
POLLUTANT.
MAXIMUM DAILY DISCHARGE'
AVERAGE DAILY DISCHARGE
ANALYTICAL
METHOD
ML/MDL
Conc.
Units
Mass
Units
Conc.
Units
Mass
Units
Number
of
Samples
3.4 BENZO-
FLUORANTHENE
BENZO(GHI)PERYLENE
BENZO(K)
FLUORANTHENE
BIS (2-CHLOROETHOXY)
METHANE
BIS (2-CHLOROETHYL)-
ETHER
BIS (2-CHLOROISO-
PROPYL)ETHER
BIS (2-ETHYLHEXYL)
PHTHALATE
4-13ROMOPHENYL
PHENYLETHER
BUTYL BENZYL
PHTHALATE
2-CHLORO-
NAPHTHALENE
4-CHLORPHENYL
PHENYLETHER
CHRYSENE
DI-N-BUTYL PHTHALATE
DI-N-OCTYL PHTHALATE
DIBENZO(A,H)
ANTHRACENE
1,2-DICHLOROBENZENE
1.3-DICHLOROBENZENE
1,4-DICHLOROBENZENE
3,3-DICHLORO-
BENZIDINE
DIETHYL PHTHALATE.
DIMETHYL PHTHALATE
2.4-DINITROTOLUENE
2,6-DINITROTOLUENE
1.2-DIPHENYL-
HYDRAZINE
--
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22 Page 13 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Oulfall number: (Complete once for each oulfall discharging effluent to waters of the United States.)
W.
MAXIMUM bAILY.DISCHARGE'
•,;AVERAGE DAII, DISCHARGE . ','
ANALYTICAL.'„ML%MDL
:, ,
t
Number
POLLUTANT :
I
Con
l�nits
Mass
Units
Conc
Units `
Mass%
Units
"of ,
'METHOD
i
.Samples-
FLUORANTHENE
FLUORENE
HEXACHLOROBENZENE
HEXACHLORO-
BUTADIENE
HEXACHLOROCYCLO-
PENTADIENE
HEXACHLOROETHANE
INDENO(1,2,3-CD)
PYRENE
ISOPHORONE
NAPHTHALENE
NITROBENZENE
N-NITROSODI-N-
PROPYLAMINE
N-NITROSODI-
METHYLAMINE
N-NITROSODI-
PHENYLAMINE
PHENANTHRENE
PYRENE
1,2,4-
TRICHLOROBENZENE
Use this space (or a separate sheet) to provide information on other base -neutral compounds requested by the permit writer
Use this space (or a separate sheet) to provide information on other pollutants (e.g., pesticides) requested by the permit writer
I. -: i, i� i it �, r. :il f tit , , ,i) �-' , {, J.y ,
f; i' "
7 END'OF PART;D' ' ?+;'; +[' r
+ ,I ,1;4,
REFER TO THE'APPLICATION',OVERVIEW(RAGE1) TO;DETEF�MIIJE;WHICH OTHER PARTS,
OF FORM 2A'Y0U MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550.6 & 7550-22. Page 14 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
SUPPLEMENTAL APPLICATION .INFORMATION
PART E.: TOXICITY. TESTING DATA..
POTWs meeting one or more of the following criteria must provide the results of whole effluent toxicity tests for acute or chronic toxicity for each of the
facility's discharge points: 1) POTWs with a design flow rate greater than or equal to 1.0 MGD; 2) POTVVs
with a pretreatment program (or those that are
required to have one under 40 CFR Part 403); or 3) POTWs required by the permitting authority to submit data for these parameters.
• A( a mininwnl, these results must include quarterly testing for a 12-month period within the past 1 year using multiple species (minimum of two
species), or the results from four tests performed at least in
annually the four and one-half years prior to the application, provided the results
show no appreciable toxicity, and testing for acute and/or chronic toxicity, depending on the range of receiving water dilution. Do not include
information on combined sewer overflows in this section. All information reported must be based on data collected through analysis conducted
using 40 CFR Part 136 methods. In addition, this data must comply with QA/QC requirements
of 40 CFR Part 136 and other appropriate QA/OC
requirements for standard methods for analyles not addressed by 40 CFR Part 136.
• In addition, submit the results of any other whole effluent toxicity tests from the past lour and one-half years. If a whole effluent toxicity test
conducted during the past four and one-half years revealed toxicity,
provide any information on the cause of the toxicity or any results of a
toxicity reduction evaluation, if one was conducted.
• If you have already submitted any of the information requested in Part E, you need not submit it again. Rather, provide the information
requested in question EA for previously submitted information. If EPA methods were not used, report the reasons for using alternate
methods.
It lest summaries are available that contain all of the information requested below, they may be submitted in place of Part E.
If no biomoniloring data is required, do not complete Part E. Refer to the Application Overview for directions on which other sections of the form to
complete.
E.I. Required Tests.
Indicate the number
ber of whole effluent toxicity tests conducted in the past four and one-half years.
® chronic ❑ acute
E.2. Individual Test Data. Complete the following chart for each whole effluent toxicity lest conducted in the Iasi four and one-half years. Allow one
column per test (where each species constitutes a test). Copy this page if more than three tests are being reported.
Test number: Test number: Test number:
a. Test information.
Test Species & lest method number
Age at initiation of lest
Outfall number
Dates sample collected
Date lest started
Duration
b. Give toxicity test methods followed.
Manual title
Edition number and year of publication
Page number(s)
c. Give the sample collection method(s) used. For multiple grab samples, indicate the number of grab samples used.
24-Hour composite
Grab
d. Indicate where the sample was taken in relation to disinfection. (Check all Ihal apply for each.
Before disinfection
After disinfection
After dechlorinalion
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550.6 & 7550-22. Page 15 of 22

FACILITY NAME AND PERMIT NUMBER:
'
PERMIT ACTION REQUESTED:
RIVER BASIN:
Test number: Test number: Test number:
e. Describe the point in the treatment process at which the sample was collected.
Sample was collected:
I. For each lest, include whether the test was intended to assess chronic toxicity, acute toxicity, or both
Chronic toxicity
Acute toxicity
g. Provide the type of test performed.
Static
Static -renewal
Flow -through
h. Source of dilution water. If laboratory water, specify type; if receiving water, specify source.
Laboratory water
Receiving water
I. Type of dilution water. If salt water, specify "natural' or type of artificial sea salls or brine used.
Fresh water
Salt water
j. Give the percentage effluent used for all concentrations in the lest series.
k. Parameters measured during the test. (Stale whether parameter meets test method specifications)
pH
Salinity
Temperature
Ammonia
Dissolved oxygen
I. Test Results.
Acute:
Percent survival in 100%
effluent
%
%
%
LCso
95% C.I.
%
o� o
°�
°
Control percent survival
%
%
%
Other (describe)
EPA Form 3510.2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 16 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
Chronic:
NOEC
%
o/
o
° /o
IC25
_
%
%
°
/o
Control percent survival
%
/o
Other (describe)
rn. Quality Control/Quality Assurance.
Is reference toxicant data available?
Was reference toxicant test within
acceptable bounds?
What date was reference toxicant lest
run (MM/DD/YYYY)?
Other (describe)
E.3. Toxicity Reduction Evaluation. is the treatment works involved in a Toxicity Reduction Evaluation?
❑ Yes [[]'No If yes, describe:
E.4. Summary of Submitted Biomonitoring Test Information. If you have submitted biomollitoring lest information. or information regarding the
cause of toxicity, within the past four and one-half years, provide the dates the information was submitted to the permitting authority and a summary
of the results.
Date submitted: / / (MM/DD/YYYY)
Summary of results:: (see instructions)
`END OF PART.E
REFER`;TO THE APPLICATION OVERVIEW°(PAGE 1)•;TO DETERMINE' WHICH OTHER.PARTS
OF: FORM'2A YOU. MUST COMPLETE.
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-ti & 7550-22. Page 17 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
SUPPLEMENTAL APPL'ICAI. ON;IN., RMATION 'y , +, I ;
s ; .j
.. ... 7. ,
PART F INDUSTRIAL USERtibISCHARGES AND RCRp10ERCLArWA$TES '
-
All treatment works receiving discharges from significant Industrial users or which receive RCRA,CERCLA, or other remedial wastes must
complete part F.
GENERAL INFORMATION:
F.I. Pretreatment program. Does the treatment works have, or is subject ol, an approved pretreatment program?
❑ Yes ❑ No
F.2. Number of Significant Industrial Users (SIUs) and Categorical Industrial Users (CIUs). Provide the number of each of the following types of
industrial users that discharge to the treatment works.
a. Number of non -categorical SIUs.
b. Number of CIUs.
SIGNIFICANT INDUSTRIAL USER INFORMATION:
Supply the following information for each SIU. If more than one SIU discharges to the treatment works, copy questions F.3 through F.8 and
provide the Information requested for each SIU.
F.3. Significant Industrial User Information. Provide the name and address of each SIU discharging to the treatment works. Submit additional pages
as necessary.
Name:
Mailing Address:
FA. Industrial Processes. Describe all the industrial processes that affect or contribute to the SIU's discharge.
F.5. Principal Product(s) and Raw Material(s). Describe all of the principal processes and raw materials that affect or contribute to the SIU's
discharge.
Principal product(s):
Raw material(s):
F.6. Flow Rate.
a. Process wastewater flow rate. Indicate the average daily volume of process wastewater discharge into the collection system in gallons per
day (gpd) and whether the discharge is continuous or intermittent.
gpd ( continuous or intermittent)
b. Non -process wastewater flow rate. Indicate the average daily volume of non -process wastewater flow discharged into the collection system
in gallons per day (gpd) and whether the discharge is continuous or intermittent.
gpd ( continuous or intermittent)
F.7. Pretreatment Standards. Indicate whether the SIU is subject to the following:
a. Local limits ❑ Yes ❑ No
b. Categorical pretreatment standards ❑ Yes ❑ No
If subject to categorical pretreatment standards, which category and subcategory?
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 18 of 22

FACILITY NAME AND PERMIT NUMBER:
PERMIT ACTION REQUESTED:
RIVER BASIN:
F.B. Problems at the Treatment Works Attributed to Waste Discharge by the SIU. Has file SIU caused or contributed to any problems (e.g., upsets, interference) at the treatment works in the past three years?
❑ Yes ❑ No If yes, describe each episode.
RCRA HAZARDOUS WASTE RECEIVED BY TRUCK, RAIL, OR DEDICATED PIPELINE:
F.9. RCRA Waste. Does the treatment works receive or has it in the past Ihree years received RCRA hazardous waste by truck, rail or dedicated pipe?
❑ Yes ❑ No (go to F.12)
F.10. Waste transport. Melhod by which RCRA waste is received (check all that apply):
❑ Truck ❑ Rail ❑ Dedicated Pipe
F.11. Waste Description. Give EPA hazardous waste number and amount (volume or mass, specify units).
EPA Hazardous Waste Number Amount Units
CERCLA (SUPERFUND) WASTEWATER, RCRA REMEDIATION/CORRECTIVE ACTION
WASTEWATER, AND OTHER REMEDIAL ACTIVITY WASTEWATER:
FA 2. Remediation Waste. Does the treatment works currently (or has it been notified that if will) receive waste from remedial activities?
❑ Yes (complete F.13 through F.15.) ❑ No
F.13. Waste Origin. Describe the site and type of facility at which the CERCLA/RCRA/or other remedial waste originates (or is excepted to origniate in
the next five years).
F.14. Pollutants. List the hazardous constituents that are received (or are expected to be received). Include data on volume and concentration, if
known. (Attach additional sheets if necessary.)
F.15. Waste Treatment.
a. Is this waste treated (or will be treated) prior to entering the treatment works?
❑ Yes ❑ No
If yes, describe the treatment (provide information about the removal efficiency):
b. Is the discharge (or will the discharge be) continuous or intermittent?
❑ Continuous ❑ Intermittent If inlerrnitlent, describe discharge schedule.
;..:.;. -:END OF- PART:>F.,,,
REFER TO THE APPLICATION OVERVIEW JPAGE 1) TO:DETERMINE.WHICH OTHER PARTS
OF.FORM 2A.'YOU MUST COMPLETE,:
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 & 7550-22. Page 19 of 22

FACILITY NAME AND PERMIT NUMBER:
1
PERMIT ACTION REQUESTED:
RIVER BASIN:
1 1 1
I,'1:. 1
INFORMQ�ION,I, ll,r ;} It7 } I rl l 1 ty ,;
SUPPLEMENTALfAPPL'ICATION ,, �f,,,,r ,1� , 1,1 I ,
r I,
d I, '
�...,. it 1.-11,{ -!• ,'.. � :, .>:. , I,L
,
1
' `Ij'
�PARTrG ::COMBINED SEWER"SYSTEMS. �I /1,1 I
If the treatment works has a combined sewer system, complete Part G.
G.1. System Map. Provide a map Indicating the following: (may be included with Basic Application Information)
a. All CSO discharge points.
b. Sensitive use areas potentially affected by CSOs (e.g., beaches, drinking water supplies, shellfish beds, sensitive aquatic ecosystems, and
outstanding natural resource waters).
C. Waters that support threatened and endangered species potentially affected by CSOs.
G.2. System Diagram. Provide a diagram, either in the map provided in G.1 or on a separate drawing, of the combined sewer collection system that
includes the following information.
a. Location of major sewer trunk lines, both combined and separate sanitary.
b. Locations of points where separate sanitary sewers feed into the combined sewer system.
C. Locations of in -line and off-line storage structures.
d. Locations of flow -regulating devices.
e. Locations of pump stations.
CSO OUTFACES:
Complete questions G.3 through.G.6 once for each CSO discharge point.
G.3. Description of Outfall.
a. Outfall number
b. Location
(City or town, if applicable) (Zip Code)
(County) (Stale)
(Latitude) (Longitude)
C. Distance from shore (if applicable) ff•
d. Depth below surface (if applicable) ft.
e. Which of the following were monitored during the last year for this CSO?
❑ Rainfall ❑ CSO pollutant concentrations ❑ CSO frequency
❑ CSO flow volume ❑ Receiving water quality
f. How many storm events were monitored during the last year?
GA. CSO Events.
a. Give the number of CSO events in the last year.
events (❑ actual or ❑ approx.)
b. Give the average duration per CSO event.
hours (❑ actual or ❑ approx.)
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550.6 & 7550-22. Page 20 of 22

FACILITY NAME AND PERMIT NUMBER: PERMIT ACTION REQUESTED: RIVER BASIN:
C. Give the average volume per CSO event.
million gallons (❑ actual or ❑ approx.)
d. Give the minimum rainfall that caused a CSO event in the last year
Inches of rainfall
G.5. Description of Receiving Waters.
a. Name o1 receiving water:
b. Name of watershed/river/stream system:
United State Soil Conservation Service 14-digit watershed code (if known):
C. Name of Slate Managernent/River Basin:
United Slates Geological Survey 8-digit hydrologic cataloging unit code (if known):
G.6. CSO Operations.
Describe any known water quality impacts on the receiving water caused by this CSO (e.g.. permanent or intermittent beach closings, permanent or
intermittent shell fish bed closings, fish kills, fish advisories, other recreational loss, or violation of any applicable Slate wafer quality standard).
REFER TO THE APPLICATION OVERVIEW (PAGE'-1) TO DETERMINE WHICH OTHER PARTS
'OF;FORM;2A YOU,MUST COMPLETE
EPA Form 3510-2A (Rev. 1-99). Replaces EPA forms 7550-6 8 7550-22. Page 21 of 22

Additional information, if provided, will appear on the following pages.
NPDES FORM 2A Additional Information

Effluent Toxicity Report Form - Chronic Pass/Fail and Acute LC50 ,+z,,,,-,.,,Da t0
Facilit-.-: OF TAYLORSVIL-S NPDES)): NC0026271 Pipe#k: 001 County: ALEXANDER
Labora_,f _erforming Test: __ A LABORATORIES, INC.
Comments: Final Effluent
Si c_�F _-are gq,?-rator i_1=_esponsi e Charge Water Tech Project
* PASSED: 0.74% Reduction *
A
Work Order: 635854/636%c- Environmental Sciences Branch
MAIL ORIGINAL TO: Div. of Environmental Management
N.C. Dept. of EHNR
1621 Mail Service Ctr
Raleigh, North Carolina 27699-1621
r - -
VLU11 Ld101.111d LCL1ti Uct �J 11111d
Chronic Pass/Fa--'1 Reproduction Toxicity Test
'ONTROL ORGANISIVIS 1 2 3 4 5 6 7 8 9 10 11 12
# Young Produced 22124121 23 21 23 22 25 22 21 23 23
Adult Wive (D) ead IL IL IL IL IL IL IL IL IL IL L L
I
ffluent l8.2%
CREATMENT2 ORGANISMS 1 2 3 4 5 6 7 8 9 10 11 12 Control CV
5.525%
it Young Produced 21 25 23 22 24 23 19 21 24 23 21 22 % control orgs
producing 3rd
brood
Adult (L) ive (D) ead L L L L L L L L L L L L 100 %
Chronic Test Results
Calculated t = 0.277
Tabular t = 2.508
Reduction = 0.74
Mortality
Avg.Reprod.
0.00
22.50
Control
Control.
0.00
22.33
Treatment 2
Treatment 2
PASS FAIL
X
Check One
1st sample 1st- sample 2nd sample Complete This For Either Test
PH Test Start Date: 01/07/09
Control 6.93 6.99 6.94 7.02 6.94 7.02 Collection (Start) Date
Sample 1: 01/05/09 Sample 2: 01/08/09
Treatment 2 6.88 6.95 6.89 6.97 6.90 6.98 Sample Type/Duration 2nd
1st P/F
s s s Grab Comp. Duration D
t e t e t e I S S
a n a n a n Sample 1 X 24 hrs L A A
r d r d r d U M M
t t t Sample 2 X 24 hrs T P P
1st sample 1st sample 2nd sample
D.O. Hardness (mg/1) 48
Control 8.6 8.4 8.6 8.4 8.6 8.4
Spec. Cond.(µmhos) 182. 416 295
Treatment 2 8.4 8.3 8.5 8.3 8.6 8.4
Chlorine (mg/1) ,,,,.... 0.05 O. US'
LC50/Acute Toxicity Test Sample temp. at receipt(°C) ,,,,,,.. 3.2 3.4
(Mortality expressed as %, combining replicates)
Note: Please
Concentration Complete This
Section Also
Mortality
start/end start/end
LC50 = - Method of Determination
95% Con i ence Limits Moving Average _ Probit
-- - Spearman Karber _ Other
Organism Tested: Ceriodaphnia dubia Duration(hrs):
Control
High
rnnr
lE
Copied from DEM form AT-1 (3/87) rev. 11/95 (DUBIA ver. 4.32)
PH

.ent Toxicity Report Form - Chronic Pass/Fail and Acute LC50
ity: TOWN' OP TA`1LORSVILLE NPDES:HX
: NC0026271 Pipers: 001 County: ALEANDER
,oratpq Performing Test: R L A LABORATORIES, INC. Comments: Final Effluent A
erator inin Responsible
water Tech Project
IX w Laboratory Supervisor I * PASSED: 3.99% Reduction
ignaturA
.: , :1 L .,l ''`rf.11..7L " !�,',_ i ,� . .,a 1. ,y3t. ldTi'. '• - a12+ws4 '�.1.2 ,P> ,tr. , r.. } .�, :!i ...fyiy a. :. ....} n L_l7-. t
Work Order: 643349/64366 Environmental Sciences Branch
D'iAIL ORIGINAL TO: Div. of Environmental Management
N.C. Dept. of EHNR
1621 Mail Service Ctr
Raleigh, North Carolina 27699-1621
North Carolina Ceriodaphnia
Chronic Pass/FaiChronic Test Results
.l Reproduction Toxicity Test Calculated t = 1.5
Tabular t = 2.508
CONTROL ORGANISMS 1 2 3 4 5 6 7 8 9 10 11 12 % Reduction = 3.99
% Mortality Avg_Reprod.
#F Young Produced 23 21 25I22 24 23 22 21 25 23 26 21 0.00 23.00
Control Control
Adult (Wive (D)ead IL L L L L L L L L �L]L L 0.00 22•08
Treatment 2 Treatment 2
Effluent %: 8.2%
TREATMENT 2 ORGANISMS 1 2 3 4 5 6 7 8- 9 10 11 12 Conatrool CV PASS FAIL
## Young Produced 22 21 20 23 22 24 21 22 24 21 22 23 -, control producing 3rds X
brood Check One
Adult (L) ive (D) ead L L L L L L L IL L L L L 100%
1st sample 1st sample 2nd sample Test StCotplete:te T0is ForEitherTest
pH
Control F
7.00 6.94 7.03 6.91 6.99 Collection (Start) Date
Sample 1: 04/13/09 Sample 2: 04/16/09
2nd
Treatment 2 7.01 6.93 7.02 6.93 7.00 Sample Type/Duration 1st P/F
s s s Grab Comp. Duration D
t e t e t e I S S
a n a n a n Sample 1 X 24 hrs U M M
r d r d r d
t t t Sample 2 X 24 hrs T P P
1st sample 1st sample 2nd sample Hardness (mg/1) 4E
.........
D.O.
Control 8.6 8.5 8.6 8.4 8.6 8.5 Spec. Cond.(µmhos) 18342
Treatment 2 8.6 8.4 8.6 8.4 8.6 8.5 Chlorine(mg/1) 0.09
' ;: -.d.1 ds:s ifiL�i;F. _.�. " 3•:S_ i.. �`i.. tiv,,' 'dig' a ::..s. ' ._ �...
/
Sample temp. at receipt(OC) 1.7 1.0
..........
LC50 Acute ToxicityTest
(mortality expressed as %, combining replicates) Note: Please
Concentration Complete This
Section Also
Mortality
start/end start/end
LC50 = % Method of Determination Control
95% Con i ence Limits Moving Average Probit - High
Sp
Other
Conc.
pH D.O.
Organism Tested: Ceriodaphnia dubia Duration(hrs): _
Copied from DEM form AT-1 (3/87) rev. 11/95 (DUBIA ver. 4.32)

0
gn
0
Town of Taylorsville WWTP
Countv- Alexander Stream Class: C
Receiving Stream: Lower Little River. Sub -Basin: 030832
Latitude- 35' 53' 02" Grid/Quad: D14NW
Longitude: 8 19 1 V 44"
J
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iaa
F;
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N
116P
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r
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LOCATION
(not to scale)
North FPDES. Permit No. NCOMW1
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o
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I, N'n1:1111 t'1)I't;;lll il•, 011ailtilatioll
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II
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I ll.lI
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lu 11.
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lit )I
I-ISmauuuc
14(11
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ill (1
IS()1
( :,,lion I )wdlid'.
i U
lit II
1 -1 6- 1 millomphewd
I U a
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( am I Irtwcillund,
ISO(
Ar cuaplu6,a`'
1(I.II
11OI
(idol ab,uh•nr
it.i
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t\i cllapin llylrlll•
1(1 I I
It( )I
( Illaloollillic
I.it
M11
e\llllllitcelll'
10I,
Ill)1.
2-(•hlm oethyl vill.yl cliw:
i.(1
h(Il.
l6•lizallll,'
ill 0
IS( )I.
( llhilwom,
Il.l
11.14
lull/.alill:lllllm.evi"
it) 1)
Is( )I
l'hlnl ulurlhiulc
1 U
ItOI.
Itell/ma ipylenc
IO.(1
ISOI.
2 d.'hlurmoturur
(Li
ISO(
1lruzu(Inlhunaulhrllr
IU.0
It(A
44'Idomloillou
U.i
M.A.
Itcnz,rl Ehihurylcln"
I11 (!
IS(II
(.I.1-I ) IC I III I" leIIIt'lli
(1.5
ISO 1.
14cluot k Illumanllic'„r
I I) (1
I4l II.
(.Is- I..i -I hrhlnrop.opcm'
0.5
1YA
Heitz I'myl pllthidal<'
II111
Ii1') 1.
1,2-1)Iill unul-i-Cillulupnrpaue(UIIC'I'I
5.0
Itit.
li,s11-cldunirlhusylulcl(I:IIIo
Illu
It(IL
I•1-UiUnnuorltrutc I HIM
0.5
MA
Him_1-chlomethylmliel
Ill 11
Itl)II.
I)i llmllochlol aulelh3lic
(I.j
IIl)I
ISIS(2-cld(Il nlsuplopyhel icr
IQ.(I
ISUL
I)ihmillo l l le( low-
U.)
It01.
111s12-Caryl-hr.\ygpinhala(r
111.0
HOI.
1.2-I)Ichlumbc•uzc'uc
Il.i
1101
4-I it Implicit yl phcoyl till,,
10.0
14(il.
I,l-1)'Chlal ollL'Ilz. nr
{l-5
lit 1.
2 C.11l(rrnllaillllllillrllr
10.1,
I1(II.
I J-1)Ichlur(mhenzenc
(l..i
11()I
•1-(:llh,rnllhellylIIII'llylcillel
IU."
it(11.
I•I- I Achim oc•dlnllr
0.5
11()I.
('llry\CII,
10.(,
Hot.
1.2-1)Ic'11l(illi,111:IIIt'
u.i
It()1.
lhheIl%(1Ia,IIlaIIIIiflc'c'11,-
10.I-
IS()I.
I .I -I Iic'I11,11ocIIic1r
0.5
110L
1 ,1-I )icId"ruIle IIzeII,
I II.11
1161.
Uic'Idan,IlrnuoIIteth;tic
U i
II(11.
1.4-I)i('hlit rrllienz,n,
10.0
Ito I.
1.2- I) ICI dur(Ipn l In ur
u.5
ISO(
1,4- I )ICIIIt, fnlie IizeI,,-
10.0
ISO_ I.
1 .5-1 hchloropropallr
(I.5
It01.
1.4-1
)o U
IIf )I.
' /-DwIllnloplopaur
0.5
1SO1.
1hel6vlphlh:da('
10.0
lit 11-
I.I-Uichlanq)rupruc
0.5
1101.
I)iutelhylpluhtdatc
IOm
I1(11.
fld,vl Henzrnr
Il.i
IIO1.
UaN-kulyl pharilale
1u.6
I;OI.
'-I l,salruur
5.11
1101.
'�,-I-I)iuurnlu lucuc
Ili 0
Ill )I
II'I'
US
IS(,)I.
!.64)ill itImo luclle
1(l.0
44(11
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U 5
14(11
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III (r
14O1
4 N1rdp'I-_'-I'rnuuumc
i.0
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I.2-Ihphenylllydr;szlln'
5011
lit )I
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I.0
H(11.
pluunmlhCll''
IUU
It( 1.
NIclhyicnr (:Illoildl•
i 11
14OI.
I'luulcol'
I11.11
IIUI.
NIT141:
I).'
I4OI
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10.0
If01
NaplullaWliv
(15
1i0l.
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IOm
I4()1
N.Ifulylhenzcuc
Ui
lilt,.
Ilcxilihlunu'vilupcm:t(11rui
IUU
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It
HOI
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o
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RESEARCh& ANA[yTiCA[
LAbORATORiES INC.
NC #34 wS
Analyl!C(IUROCOSS CO1`1SLJltG lions
()9,
AO�
D Al I
Chemical Anal
si.fiw Selecred PaIWIlleters and Water Samples Identified
(I.V Tavlorsville
(A Water Tech Lahs Project, colit—,efed 27 Fehrially 2009)
[N,11 iscellaileolis
011.111titation Taylorsville
Limit
Parameters
Antimony
0.02
Arsenic
D.00( 110i
hervIlium
0.001
Cadmium
0.00')
Chromium
0.0(h HOL
Copper
OMOS 0.022
Lead
0.005 nol.
NI ercm-N
0.0004 11Q1.,
Nickel
0.005 HQL
`3elenilim
0.00.5 lu)l-
silvcr
0.005 1101-
'HWIlit.1111
0.00 13QI..
Zinc
0.020 0.107
Cyanide
0.00 nQl-
Phentils
0.005 11()[.
Hardlies
1.0 S.()
Sample Number 039860
Sample Dale 02/27/0()
SampleTillie I ()()()
1101. = BCIOW OLIM111MIM11 L111111S
mu,/ L = milli"ralm, lici- Lim— parts per million (pj-.
t,

04/06/2009 12:26 3369923976 R AND A LAAS
ctrluent IOXICfty Report Form -Chronic Fathaad Minnow Multi-Cunrontration Toss
Facility: TAY( ()R VILLI="�- N0002B271--
Laboralo)y: Research $ Analytical Laboratones -�
Signattuie of Operator In Responsible Chnrgo
x T
Signature of L ora(ory�Supervisor'
Pipe *: 0U1
PAGE 02/02
o�to:3>'ivaoosa
County; ALEXANDER
Final Effluent
N WAT I TECH C1.IpNT
MAIL l)RI(:rNAL'1'O; Lnvhonmeutol3cio—��n °ca Branch
Divislnn of Wester Quallly
NC nENlt
1611 N-14;1 $crvicc Ccnter
Ralrlgh, NC 27699-1621
Teat Initiation Date/Time FEB 25,2009_/ 1340pm
% Eft. Repl.
Il j eurvivind 4
Or{ylnal #
W1/orlglnal (mg)
i] Surviving ax
Original #
Wt/original (mg)
Surviving 0
Original #
vv0onglnal (mg)
639889
Avg WVSurv. Control �O g4 to I Test Organisms
iT33
(>--
J
—O.gJ07'
--U,d
T
-
Surviving # ---ir
Original0 TJ
Wt/originel (mg)-O'93Dii
Surviving #
Original M
WVoriginal (mg)--
�... 16- Surviving #
Original 0
WVoriginal (mg)
V.
Water Quality Data
Control
pH (SU) Init/Fin
DO (mg/I.) Init/Fln
Temp (C) IniVFln
HIE Concentradon
phi (SU) InIVFIn
DO (mg/L) InlVfin
I emp (c) Inwin
Sample
C:ollaalon Start Dale
Grab
Composite (Duration)
Hardness (mg/t.)
Alkalinity (mg/L)
Conductift (umhos/cm)
Chlodne(mg/L)
Temp. at %cek)t (IC)
Dilution H2O
Flprdneas (ing/l.)
Alkeunity (rng/L)
Conductivity (umtio5/txn)
% Survival
Avg Wt (mg)
% Survivelr—TriU —
Avg Wt(mg)
% SUrvtvalI^t51�
Avg Wtl (nig)=
% Survival
Avg Wt (mg)
W. Currhrol� f11
Avg Wt (mg)r___:nTW__7
% Survival
Avg Wt (mp)Ei7'
I_. Cultured In -House
17 Outside Supplier
Flatch Date: 2/7.3/2009
Hatch Tune: After 1600
o
T.r
J
O
Ia
1.14
lI)
FGB 23,2000
Va. "vd6,20 9
MAR 01,2000
24 HRS
24HRS;
i 24 MRS
36
42
46
28
31
28
475
47R
1,. 248
_<0.01
<0.01
<0.01
�3.1
DVVQ Fonn AT-5 (1104)
48
its
Survival
Growth
Overall Result
Normal
P"I.
30'
ChV ;16.4%
Horn. Var.
NOEC
16.4OW
1A.An%
LOEC
16.40°l.
I. 16.40%
ChV
a16.4°%
Yr>18,4%�
Method
STEEL'S
D NN T6
Stats
Survlva/
Growth
Cvnu.
Grltloal
-Calculated
Crttrcal
Calcul¢ted
4.1
10
16
2.41
0.3105
6.15
10
- 16
2.41
- 17.6329
_
16
2.41
_
0.6946
12.3
10 _
16
2,41
0.4791 -
1 F.4
10
16
_ _
2.41
0.7455

00/06/2009 12:26 3369923976 R AND A LAAS PAGE 02/02
unuent 1 OXICIt 1 Repott Fonn-Chronic Fathead Unnovv Multi -CO11contreltiowi Teed Date:3/31/2009
rnnuty: r Sri t ncBVILL.E — NC0026211I
Laboialo)y: Research & Analytical laboratories
Signature of Operator In Responsible Charge
Signature of L�oralory Supervisor
I'Ipd #: U111 Counly, ALEXANDER
Comm al Effluent
A WATER TECH CLIENT
RAUi639588.639852.839889
NIA11. 0R1r:rNA1.'('0, En.d.onmenml Seienc°a Branch
Wylsion of Water Quality
NC 1)ENR
1631 Alail Se - -icc Ccntcr
Raleigh, NC 27699-1621
Test Initsation Date/Time FE13-25.2009 / 1340pm
% Eff. Repl.
onto Surviving #
Original #
WVoriginal (mg)
Surviving #
Original #
Wt/original (mg)
r� Surviving #
Original #
WVonginal (rng)
Surviving #
Original a
WVorlginel (mg)
liZ•3) Surviving #
Original #
WVodglnal (mg)
1] Surviving #
Original #
Wt/original (mg)
water uuaitty uata
Control
PH (SU) IniVFin
DO (mg/I,) Init/Fin
Ternp (C) InIVFIn
HIE Concentration
pH (61j) Invin
DO (mg/L) Init/Fln
I amp (C) lnrVFln
Sample
Collectlon Start pale
Grab
Composite (Duration)
Hardness (mg/L)
Alkalinity (mg/L)
iducdvitr (umhos/an)
Chlorine(mg/L)
Ternp. at F3acelpt (IC)
Dilution H2O
Haitness (mg/L)
Alkalinity (my1L)
Conductivity (umhos/an)
rt••r
FEB 23,2009
R 6 2009
AR 01,200E
24 HR
24HRS;
24 HRS
36_
42
46
26
31
28
475
A7it
248
<D.01
<0.01
<0.01
3,177_
1.rJ
1.4
DKU For») A7-5 (1104)
48
its
182 --
Uay
Avg WUSurv. Control 6,9415 Test Organisms
% Survival
Avg Wt (mg)(�i�--'�
% SurvtvaliUtS
Avg Wt (mg)
% Survtval -,.—TM=
Avg Wr. (n')g)[ __"�3038��
% $IIIVtVaI,�,
Avg Wt (mg)CiI SII
% Survivalr--�10
Avg Wt (mg)�$()�,
% Survival
Avg Wt (Mg)
--
r' Cultured In -House
Outside Supplier
Hatch Date: 2/23/2009
Hatch Time: After 1600
Survival
Growth
Overall Result
Normal
U"I.
1Ribli
ChV M16.4%
Horn. Var.
D I:
NOEC
18.40%
! 1a.4no/
LOEC
16.409/6
16.40%
ChV
'; >18.4%
Method
_>16.4%°
STEkL'S
I. D NN- ET6
State
Sumval
Growth
COnu,
Gntlaw
Calculated
r:rtdoal
Calculatod
_4.1 _
10
16
2.41
0.3105
6.15
10
_
18^
2.41
0.6329_
8.2 ,
v 10
16
2.41
0.6946
12.3
10
_ a
2.41
0.4791
16.4
10
_16
16
2.41
0.7465

s
GEL LABORATORIES LLC
20,10 Savage Road Charleston SC 29407 - [phone] - www.gel.com
Certificate OI' Analysis
C0111pa11\' :
w:ul'r'f CC11 1.ahll-morics
Alldre„ .
P.U. Iiox 106
Granite kills, Worth Carohii:i 28(13t1
l•onlilcl:
NII•. I (Illy (.11'i'. L'I!
ProJecr
Low Level llg
Clicnt tialllplc II): "town of Titylorsville
Sample I[):
Malri.x: \V\V
Collect I):Ite: 27-11:ffi-(III 08:40
Receive [)ale• I()-I\1IAR-09
C:ollrclr'r: Clirnl
Parameter Oualilicr RV.Stilt l;ncerl:lutty D1.
Mercury ,knalysis-I:VAA
EPA MJ l Low Leve/ Morcur , Analysis "As Received"
3 0.2100
The following Analytical \•lethods were pel•fornud
Alelhod Description
1 FPA 10311: -
krlinn Ualr: ;;\larih 10.
Ilmlect: \VA•l'R00IIll
Clicnl l[): \V;\'fkOOI
Units
1) V AllalystUote
Time Batch Method
0.5011
a /L
1 G'I'L 03/12/09
1236 9-1942-1 1
Analyst Comments
Page -� (11 O

1 49
GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 - [phone] -- www.gel.com
CN-tificlite ol'Anall'sis
A(1(11'c,,,s
P.O. li(lx 10--)h
2,m.io
Colitact
N'll..Toll), Cirri'.,
Project:
Low Level I Ig
Client Stllll)IC 11):
Town ol-kaylor"vi lie 1"(1. filillik
.alllplc Ili:
22 5 8 () 5 () () 2
N'lainx:
13 LA N K
Culled Date:
27-1:1:13-0t) 08:Ll()
\L!Cei\,e D'ac:
10-11VIAR-01)
collcclol.:
Client
P
Qualifier Result
Uncertainly Rl
Mercury Analysis-01AA
/-'PA /().)/ Low Level Alercio-YAnaNsis "m Received"
IMercury
1 0.27
0.50
TIle following Analytical
Methods were-pelforilled
N''Ictilod
I)escriptioll
HPA I 631F
I\Cl)ol.l I )a1c: N'larch 10. -1001)
PMICCI: \Vi\,I,I\,()O 10 1
Clicill ID: \V ATR (10 1
Units DF AnalysiDitte Tillie Batch Method
I ETI 03/12/09 1215 540424 1
Analyst Conilliellis
Page 0 ()1, 9

GEL Laboratnrics, LLC
Page: — of-- --
GEL Chain of Custody and Analytical Request=o40SaiagcRoad
Charleston. SC 29407
GEL Quote t,:
Phone. (84) 71
Number—
COC Number _ —GEL Work Order Number:
lrax:(R4_)7(6-117175
�
Ls 1
PU?�'umher: u V�
sis Requested (s) (ill in the number of containers for each test)
Client Name: '1<e, I u r t� ' 1 (� Phone N: Sample Analysis m
1 L Qr �P
Fax #'
F'rcject/Site Name: uf- Jn' [-u,(-�(•1./C/._�
'
Should this
sample be
'~'
❑
•R
1}P1
---PreSCrvelrvC Tt•�c (f�)
Address: L -7 /F n , r > /t t' % /_e�.e_JV) e�� Gv L LiS i ?3
considered:
c
Cammcnts
Collected by: �; j,,Q,J Send Results To:
,
Note: extra sample is
p�!�-f
Y
A
i
x
E
`
—
recuired for sampie
speci f ie QC
•hate a,urr,ed
•Tina
collected
Oc Cndr
Field
$an, l_
r •
Sample I L�
T
(Military)
nl
Fiitrmd'/'
Matrix "
c
-v
U
't
• For C(n:/k/-,�ifi5 - i,:diCule' S1G'I nn:/ illlJ% G:llflfin,C
(mm-dd-Y�•)
(hhmm)
c"•
F••
\ /
• a l -, I(
r l
I t
I Y%F FQ
R
E
VED
Ti#I
,: l
-�
An
lys�:
1'A Requested: Normal: Rush: Spccifv: ISuhirct to Surchar17e) Fax Results Yes / No Circic Deliverable: C of A / QC Summan i Let cl I ! Level 2 i Level 3 / Level
brown ha=arils applicable ro ;hese samples? Ifso, please list the hazard~. Saninlc Co!Icction Timc Znne
Rer»arks: Are there am Esiern Pacific
Central Other
Mountain
Chain of Custody Signatures
Sample Shipping and Delircn• Dc:ails
Relinquished 11y(Signc•dl Date Time
Received by (signed) Date Time
GEL PM:
Method of Shipment.
Data Shipped:
1 J.7 J4 �� yU
I 1[j
Airhill p:
F1-1
AH,ill p:
3
1.1 Chain o:':,wnd, Number = Client Dcwnnintd
Ulank Mg = Matrix Spike Sample, MSD , Malria Spikc Duplica:c Sample, G - Grah, C = Composite
For Lob Receiving Use Ontr
2.) QC Coics: N Cnm,al Sample. I - Trip Blank. FD = Field Duplicaw. Ea = Equipment
3.) Field Fii:c-d Fn: liquid matrices. ind,catc �':th a - Y - for ya the sample was held fil:emd or - N - tot sample was or field fihemd.
w=Wa¢r. S0=toll, SD'-SCdinicn SS=Solid Wr mc. O-Oil, F=Filler. P° N'ipc. U=ii:in:. F= Fcc�.. N=Nevi
)'f.S .A'O Pr
r - N'N'=H'astc N'a:cr. .~t-=Sludge,
4.1 Slatrix Coda. Uw'=Drirkin(; t\'n:cr. GW GmunAw'alcr. SW=Sur,e.c N'atn,
8'.608. 6010rtr/i70A)and numkc: o.`eontaircrs prorldrd fa rash (i.c. 6?6Otr 3. 60/OB17476A I I
C. UUIc•r l em./,.
-) Samplc Aoalysis Rcquestcd' Arulyticul method requested (i.<.
_ ._ .. .. _ '---�_ .:.. .... ++........ rr. c•,.G,,,,, 'n,b.�„ntu.If nn nrrservarive is nailed = Icavc field bb,n'.
C
L) Pmscn-ativc T�, c H A = Hydmchlnric Acid. NI - Noric Acid. = Sodium mm y .
..-_.. _.• .._._..... ...
WHITE = LABORATORI' 1'ELLOH' = FILE PINK = CLIENT �.

Laboratories LLC SAMPLE RECEIPT & REVIEW FORM
Client:kla
SDC/ARCOC1%Vork Order: (�
5 'b 5
Received By: Le ws,,
Date Received:
_
fu
Suspected Hazard Inforn]ation
,,
o
'lf Counts > x2 area background on samples not marked "radioactive", contact
the Radiation Safety Croup
of further investigation.
COC/Samples marked as radioactive'?
—
Ivlaxirnun] Counts Observed-:
xj
Classified Radioactive lI or III by IZSO'?
COC/Samples narked containing PCBs?
Shipped as a DOT Hazardous?
/
Hazard Class Shipped: UNk:
Saniples identified as Foreign Soil?
/
Sample Receipt Criteria
r
Culnn]ents/Qualifiers (Required for Nin]•Confuruung Items)
Shipping containers received intact and
CircleAllpilcable: scats btuken
1
sealed?
da111mUl container leaking collt:llnef other (describc)
Samples requiring cold preservation
PIC]efYilllo(1 bledlUd:
ICt hagjbIUC
within 0 S 6 deg. C'?
/
011c other (describe)
ICC dry ICC (SD
t
3
Chain of custody documents included
with shipment'?
�
Circle Applicable: seats broken
a
Sample containers Intact and sealed?
dalluged container leaking con Winer other (describe)
Samples requiring chemical
Sample lD's, containers affected and observed pH:
preservation at proper pfl?
If Preservation added, t.nla:
VOA vials free of headspace (defined as
Sample Ill's and containers affected:
6
< 6mm bubble)?
(If yes, InmiLedlalely deliver to VUimi ICs laboratory)
7
Are Encore containers present?
Id's and tests affected:
8
Samples received within holding time?
Sample Us and containers affected:
Sample ill's on COC match ID's on
9
bottles?
Date &time on COC match date &time
Swulllc ID's alfecled:
10
oft bottles'?
Number of containers received match
sample ID's affcc(ed:
11
number indicated on COC?
COC forin is properly signed in
12
relinquished/received sections'?
Comments:
h�(�Ijjvi)(pp'R)vIA) review: Initials_ --,J Date 0-
� ter'

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 - [phone] -- www.gel.com
Certificate of Analysis Report
for
\\�A"hRUU I Witter "I'ecll L,thnratc,ric�
Clicni SDG: 225M5 GLa. \York Ordcr: 22. S ,
The Quillilicrs in this report are defined as l'ollows:
A quMhy control analyze recove'Y Is outs;de Wspecified acceplance cruena
Analyte is it surrogate compound
.I Value iS rstinrucd
U Analyze was analyzed fur, huz not detected above the ,NII)I., ,,]VIDA, or 1,01).
\Vhere the analytical nlelhoel IMS heen performed under NI:I.AI' certification, the analysis ha, stet all of the
requiren,eats of zhc NLiI..AC standard unless qualified nn the Cerlif;cale ol' Analysis.
The designation ND, it' present, appe:u-s in the result column when the :tit: ow umcemnalm is nut detected above
the detection limit.
This data repurt has been prepared and reviewed in accordance with (.;I:a.. Laburalorics I.LC
standard operating procedures. Please direct any questions to your Pl'( ject Manager, Amanda Rawl.
4m,.,,L -sue
Reviewed by
INpe 4 4 9

GEL LABORATORIES LLC
2040 Savage Road Charleston, SC 29407 - [phone] - www.gel.com
QC Summary\Paler
Tech I.ahoralorics
Relm"I Dulc:
\larch 10, 2001)
11.0. [lox 1050
Page I of 2
(;ranilc Falls, North C arolhut
Contact: \Ir. Tolly Gregg
Workordcr: 225865
Parliuwnu' NU;\I
~ample Qual (1C
Units IWD%
RFC'7p
Range Aalst
Dille Time
Mut:ds ,\u:dvsis-\Icrcurl'
QC12(1179614:1 I.Cs
\•Icrcury i.00
.31
uglL.
100
(77"/„-12)31%,I Ii'Il.
03/12/0()12:01
( )( -' 12017961 1.1 \•Ili
1%9ercury
I1 N11
ngh.
03/121/01) 11:i4
(1C1211179(,I-18 225MS'008 \•IS
(Mercury 40.0
12.7 i.Io
n"/t_
102
171(,-Ili'%(.)
03/12/01) 14:10
QC1201796149 22588S(1(IS \ISD
Mercury 40.0
12.7 53.7
1101_ U
102
(0'?n-24'G,)
113/12/II1)14:42
Notes:
The Qualifiers in this report are delined its follows
Analyte is it surrogate compound
< Result is less Ihan value reported
> Result is greater than value reported
A 'I'hc TIC is it suspected aldol-colidensmion product
Ii For General Chemistry and Organic analysis the target ;tlalyte was detected in the associated blank.
C Anllyte has been confirmed by GC/NIS analysis
D Results ;u'c rcPorlcd fi-ranl it diluled aliquot of uhc Sample
li \4etals—`/(;cliflerelice ol'sample ;lnd SD is >10(r.. Sample concentration must loM fl;tggulg crteria
F Cisliol;ued Valuc
11 Analytical holding tittle was exc•ceded
J Value Is csunlated
\-I N4ttrix Related Failure
N/A RPD or 44,Rccovery limns do not apply.
ND Analyse concenu'atinn is not eletecle(I above the (Ietc•cuon linul
NJ Consull Case Narrative, Data Summary package, or pritlecl \gan;lpc•r CMICCIl11Ilg Illls gtalifi LT
R Saulplc results are rejected
U Anllylc wits analyzed for. hill not detected ahove the \41:)I.. \4DA, ur LOD
S Consull Casc Narrative, Data Summary pac•kituc, or Project \Manager C't,IlCcr11111V. 1111s (I at ilt 11 li11'
Y QC Sample; werc nol spike(( walla this c•onlpnund
RI'D of sample and duplicatc evaluated usuag +/-RI.. Conccnlration, are <i\ the RI_. Qualifier iNol Applicahlc Ior Raditwhcmisiry.
It I'leparatiorl nr preservation 1101(ling (tine wits exceeded

GEL LABORATORIES LLC
20,10 Savage Road Charleston. SC 29407 - (843) 55G-8171 - www.(el.coni
QC S11111111ary
\Vurl:order: 22i}i65
Parliwall)e :\'(1!\I tian)plc C)u:d I)C Units kl'll'%, klil.''y. Range :\ IIst I);Ile •I'inle
NIA mdicates tll:ff splkc recover\ linlil; Ill- nnl alll>IY when ,:uol)IC (UneellII';loll rscccdti slake cone. by it (Herat o(4 or nulrc
'I hr kelauve IYI Celli DIITCrence (I:I'l.)) ollai ned Ironl the Nanyllu uuplica(e (I AJl') Is cv:!lo:ued acaiost [lie ;Iccrin;n!ee crnrna wh. a the ,:nnllle a p.rr;ffcr 111:111
Iivc Ilnlcs (.5X ) ill,- eono'act rryu!re(t drlecuun till"' 11<I.). lu CIISr] whcrc rnhcr the ,anydr of duplic:lle v;due Is Its, Il;nl iX the kl., ;� control Inns l-1 11- the
ICI. is ox•d Ili cvalua(e the I)(11' retiull.
" Indic;nrs fluff it Quality C'oulrol pura(netcr was no( wnhlll spvclIic;it lons.
I -or PS. PSI). and SDILT results, Ihr values lisled are I'll` ule:lsn rrd anunnffs. not Iinfil COIICelllr;ltl(nl,.
\there Ihr analytical melhn(I has hrc•II Inrlornlrrl under NFLA(' certificaliun, Ihr ;uedysls has firer Al of the
(c(yun-entents of Ile \II•.LAC: standard unless yualificd on life QC luulnlarl'.
P111128(Ift)

1 t-�)I,)
IIItI��11111SCr\\
I 100
I! 1111'.1 ! A
c,� i Lti.LA
tuluu.nn
ull1111m.13V II, -Id.)(] S-(1
X,L-flLO-SE_MI0,01 .
d\'"I 1N
t,- hOE I N.I.
I
C,000CIDI/I MOT 101
mllll),ICjtill 1Us
C\t_00-89 _
<1 V•li]N — I!Ill l'.,\I�cSlI 11 �,.1
hOr,b ,--
!nuuyelYQ
hOLSb.. f. _
_
A\G N
LtiL
r.ulic,.mJ t{LwN
9� I LY::I (V"IIN "l:a
ANON..
i )RDS
d\%'I INI— I',,,aIN
Z I O00.)S
r.1m., ON
%II17S—bV �
sllsnll.nusla,� .
91_0 0
dVT_IN — I!urlsnur 1
6u 100
(y.�ntuay
I O—: )S—J
r.Irrynll
n�OOn�
dV .-IN-'I1,11!111
t,111110;)S
I,y°I'I
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YIN
i
LQO
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16 I LX-1
cIVTIIN - 1:1,1.111:1
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dVTJN - "•!u.lnlill!.)
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rsur.y.l\;
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'I"rl;) 1ln.Lm•� Jn 1SI'l

Effluent
c T-y Report Form - Chronic Pas s/Fai I and Acute 1,(15 0
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1-.F,ncl Pipefl: owl
I'a bo
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Lalwalnr.; Research /;. Anamical I_auormone•,
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amrnenh � Final Elhuenl
!/,. VVATER TF';H UIEW
�F<Al :r Fi�1:3:;=14).6r1:3670.(;4:377(i
MA11. (tltlt;l\:\l.'f(u Llivurnnrlicntal Sciences Branch
I tl OS111n III' \1 ;ilel" (,n B111Y
NU DENk
1621 \tail Scrvicc (.rnu•r
I(;rlei.-di. N( 276411-1621
es( Initiation DamMme April 15.2009 t:31`.iunt Avg %Wbur;. Control (1.8t6U l Test Organisms
Ef(. Repl. 2 3 4 1 Cullulr:cl lu-Huusr:
ontro Surviving to "1• `survival U (• f` Uutsule Su > >hel
1 I
Ongutal 11 j? _
Wl/ori(linal ung) U. cir U. a U.. �., s AVg Wl (Irly)l 0.816,0 1Hatcat Dal(: 411312001)
Surv,vuu) tt h Survival .0 Hatch Time Alter 1600
Ong,nal ti :;
Wl/ongutal (ntg) I Q.. J..ti ().Wuo l . .,.;: U,; .;o Avy W1 mig)l 0.927,
TJ Sul VIVIng fl
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'Original li
Wllonginal (my)
AVC VVt (nlg} t .
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t, Survival ) .()
Ungmal i,
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Avy Wl (mg) 61
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°r„ Survival )
Original f:
WUonginal (mg)
Avg Wl (Frig)l U.95 r
u. Surviving it
% Survlvall 100.0l —�
Original 4
Wllongina( (mg)
Avg Wl (111g) U..I , Z 1
water uuality uata
uay
Control
Iu
pH (SU) Inil/Fin
DO (mg/L) in,t/Fin
Sample
Collection Start Date
Grab
Composite (DurationI
Harmless mialLI
Alkalinity img/L)
iduclivity wrnnos/cnlI
Chlonnetmg/LI
Ienl:) at Receipt Cl
■ice
Temp (C) Init/Fin
Hic Concentration _ _i
pF1 (SU) Inil/Fin
DU (mg/Li Init/Fin !.nu ti, , i,r ,.:1U
.s B.1)(1 8.30 ,,.1) ! ..; 1 ; ,3 � ci.., I
2 s
April 13.09 April 16.05, Apn11gAS1
'2 A, HP,S 2 4 H R S 1=1 FIRS
30 2'; .31
a(i 41 37
1`Z 342 317
0.03 u.N o.r.,7
I
Dilution H2O
Harmless ung!L, 4t;
Altcahruty Und/l_i :3li
uu,cuvuyiumhosrrni-
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177I
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lvonnal
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PI Oc C
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Cone
4 1
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6FF1
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>1(i 41­
DUIVNET':�
Overall Result
vrotvrJ i
Calculated Critical Calculated
2.4 2 41-7.0097
2 s
April 13.09 April 16.05, Apn11gAS1
'2 A, HP,S 2 4 H R S 1=1 FIRS
30 2'; .31
a(i 41 37
1`Z 342 317
0.03 u.N o.r.,7
I
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Altcahruty Und/l_i :3li
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177I
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l_OEC
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Stats
Cone
4 1
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6FF1
16.ao',
>1(i 41­
DUIVNET':�
Overall Result
vrotvrJ i
Calculated Critical Calculated
2.4 2 41-7.0097
Dilution H2O
Harmless ung!L, 4t;
Altcahruty Und/l_i :3li
uu,cuvuyiumhosrrni-
Survival
177I
CI
I6 AU°
STEEL'S
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Cone
4 1
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>1(i 41­
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Overall Result
vrotvrJ i
Calculated Critical Calculated
2.4 2 41-7.0097

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GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 - [phone] - www.gel.com
Certificate of Analysis
(:ongtany \V;rtcrTccIII.;iImInI m ICs
Address P.O. lies I1156
Cr:utitc Falls. North Cnrulinn 2X0 i 1
Contact_ IMI.. Tony Grcgy
Projrcr I.00' Level IIg
Client sample ID: 'I'aylorsville tiff
Sample ID: 22828a001
Millrix: \V
Collect Date: 14-AIT-09 08:30
Receive Date: 20-APR-09
Collector: Client
------- ------------------ ----------------------------
Paranteler tloalifier Result Uncertainly DI
Mercury Analysis-CVAA ---- —
/-J'A 16.0 Lott, Level Alert uyAnulvsis "As Received"
NgcrcurY 18.4 0.200
_I - he follott,ing r\nalylical I\Iclluxls tvc---- t'urntcd -- ----- ----
\•lelhod --Description
I F'I A I ()31 G
Rclum D;lic: April _18. 2001)
I'roiccl: \VATR00101
Client ID: \VATR001
IZ1. Units DI Analystl)nte Tinte Batch Method
0.500 ng/l- I F I'I_ 04/28/09 1135 8600It) I
Analyst Comments
Page 6 of I U

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 — [phone] — www.gel.com
Certificate of/analysis
Company
Lahuraunics
Address :
P.O. Box 10O
Granite falls, North C;irolina 28630
Contact'
Mr. gamy Gregg
Prolucl:
Low Level 119
Client sample ID:
Blank
Smilple 11):
228293002
Matrix:
BLANK
Collect Date:
14—APR-09 0;;:3(
Receive Date:
20—APR-09
Collector:
Client
Parameter Qualifier Result Uncertainty 1)1. RI
1%4ercury Analysis—CVAA -- —
F_P.•t 1031 Low Level hlercurY Analysis "As Received"
ivlcrcury (i <0.2
The following, Analytical Methods werei)erformed
Nlethod Description
EPA 1631E
0.200 0.500
Report Datc April 28, 2009
Protect: WA"I R00101
Client ID: WA 1 Rflo I
Units DF AnalyslUate Time Batch Method
ng/L I E"I'L 04/28/09 1046 860019 1
Analyst Comments
Page 7 of* 10

p 0]

LaboratorioS LLc
SAMPLE RECEIPT & ItEVII-W roultil
Client:
Received By:
SI)G/:11ZCOC/NVm-k Order:
[);Ile Received: .LV&V/V 9 13
'Il
Suspected hazard Inrormalion
L o CottnlS > .x2 area background on saluplcs nut marked "radivacuvc', t unlat l
the Radiation Safety Group of further
COC'/S:urylles rn;lrked as radivactive'?;inxllll
ulvestlgarlon.
Counts Ohsrrvrd*:
Classified Radioactive 11 or III by RSO?
tjy
r
(--OC/SaIII(llt.'S marked comailling I)C BS?
Shipped as a DOT Hazardous?
Hazard Class Shipped: UN11:
S;itnpleS identified as I-oreign Soil:'
Sample Receipt C.rl(eria
� 'r C
j. Clllllllll'llt-0)ualitiel-s (IZetll,ireJ t'ur Non -Confirming Iteuttil
Shipping containers received intact and
l-II'Cle AI1plllahle:
1
seals broken
d:unlgeJanuaulcr Ica king container othcr(uescnhc)
Samples requiring cold preservation
within o s 6 (leg. C)
3 Chain of cusiody documents included
wllli Shipment'! /
4 ISample containers intact and sealed? I /
Samples requiring chenlical
preservation at proper plT.1
6 VOA vials free of headspace (defined as
< 6mm bubble)'?
— ----M
7 rreI ricore conla ,,jers present?
8 ISamples received within holding time?
g Sample ID's on COC match LD's on
bottles?
111 D:tie �L time nn COC match date & nine
on bottles?
I 1 Number of containers received ma[ch
nurnher indicated on Co(-,,?
12 COC form is properly signed in
relinquished/received Sections?
Cuninlents:
.-� p o Co C. .
Preservation NIclhod:
blue ice Ice bass
d(yice (
rune nherdescnbe)
Circle Applicable:
seats hm,ken
damaged contalner leaking conlamer other (d�:scrit)ej
'ian)ple IU's, Ct)nlalllers affected and observed pI I:
If Preservation added, t_otx:
`;angllc IU's :old containers affected:
(it yes, I111111edwely deliver tU VUIallles IahUlal(jiy)
Id's :aid tests altected:
Sample IIYs and cunta,ller5 anecied:
Sample IIYs affecled: —
?0- k 1
sample IU's affected:
`/9S-9f7 0 z
Wi
f'NI (or PNIA) review: Initials _ c __ _Date i r' (?('` i

Subject: Re: Samples received today
IF•I'om: "Misly" <\Nal�i'l1<��tICllarlCi'.IICI>
Uutc: TLIC., 21 Apr 2009 09:32:5 3 -0-100
To: "/Amanda Rnsw" <amancla.rilsco(��L cl.cc�m>
The collection date and time IS 4/14/09 at 8:30 AM.
Thanks,
'bony Gragg
-- Or.iginal. Message ----- From: "Amanda Rasc•o" anl:ulr!<a.r.asca!<4�e.! .com%
To: 1C@r CiC ilChartef II('l:
Sant: P4onday, April 201 2009 5:00 Ki
Subject: Samples received today
Tony,
Par the Taylorsv.ill.e samples received today, there are no collection date/tames
referenced on the COC or containers. Can you provide me this information? Let me
know if you have any questions.
Thanks,
Amanda
Amanda J . Rasco
Project Manager
GEL Laboratories, LLC
2040 Savage Road
Charleston, SC (USA) 29407
Direct: 843.169.7313
Main: 843.556.8171 x4297
Fax: [phone]
E-mail: A.manda . Rascohgel . c_om
Web:
I (W 1 40112MW 914 Af\4

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 - [phone] - www.gel.com
Certificate of Analysis Report
for
\VATROM Water Tech Laho ratories
Client SDG: 22-9283 G[=:L Work Order: 2?-X?-83
The Quidifiers in this report are defined its follows:
A duality control analyte recovery is outside ol, specified acceptance critena
Anttlyte is it surro-ate Compound
J Value is estimated
lJ Anafyte was :unalyred for, but not detected above the MDL, IMDA, or LOI).
Where the analytical method has heen performed under Nlil_AP certification, the analysis has met all of the
requirements of the NE -LAC standard unless dttalified on the Certificate of Analysts.
The designation ND, if present, appears in the result column when the analyte concentration is not detected shove
the detection limit.
This data report has been prepared and reviewed in accordance with G1 1. Laboratories LI.0
standard operating procedures. Please direct any questions to your Project Manager, Anuutda Basco
Reviewed by
Pace 5 t)( 10

GEL LABORATORIES LLC
2040 Savage Road Charleston, SC 29407 - (843) 556-81 71 - www.gel.conl
Water Tech Laboratories
V.O. Box 1050
Granite Falls, North Carolina
Contact: NIr.Tony(:regg
Workorder: 228283
['arun na1ue NONI
�i\Iclals .1na11•sis•�\icrcurl•
Batch 86I111111
QC:12II1821 id? L(: S
NiercurY 5.00
OC1201821541 NIli
Mercury
(I(.:1$11823111-128'_S3nl)1 MS
N•Icrcury 40.0
UC120I823112 '29'8300I NISI)
N•lercury 40.0
Notes:
File Olga fliers in this report are defined as follows
`C Summary
Reuorl Date: April 28, 20111)
I'age I of 2
Sample Dual ()( Units RI'D17" ICI{( % Rallge Aulst Date 'lilac
4.Xx
m-YI.
97.7 (771.!-12314,) FTI.
0412 9101) 10: 11
Il NI:)
042R/09 10:04
I ti.4 =18.5
ng/I .
70.1 (711/-125"/„)
0.1/28/09 12:27
18.4 :15.9
11.0L 0.2S2
70A (01%,-24%)
04/2,4/01) 12:3-1
'* Analyte Is a surrogate Compound
< Resell is less than value reported
> Result is greater than value reported
A The TIC is it suspected ;ddol-condcnSal [oil product
13 For General Chemistry and Organic analysis the ulrget analylc was dete(je(I ul the associated blank.
C Analyse has been Confirmed by GC/MS ;urllysls
D Results are reported from a diluted :di(luot of the s;ullplu
I; Memis--'%dil'Icrence of sample ;uld SD is > 10%. Sample concentration must oluel 11;Igglllg criteria
I. Istimaled Value
I I AlMlyliCid holding tittle was CXCCCdCd
1 VALIC is Cstinl:ucd
M Matrix Related Failure
N/A RI'D (it— %,Rccovery linens do not apply.
ND Altalyte concentrailllll is not dclectcd ahovu the rICIUM011 limit
NI Consult Case N;urnive. Dam Summary packaee. or I'ro1CCt iIMilnagcr Concerolog (Ills (1u;llifier
R Sample resells are rcjccled
1) Amilylc %vas ❑o:11)'-d for, hul not detwed above the iIMDL, MI.)A• or I-(ll).
X C.r111s1111 C:;IS(- Narr;oivc, Daly Summary packai_,c, or Project Nlan:li-cr conccroing this qualifier
Y OC• Samples %acre not spiked with this Compound
c
RI'I:) of sample and (1111111C11(C L•%';IIl1;t(C(I 115111L (-/-I<I_ C:o"C1•Illr111111"S arc <5\ the RL. Ou;lllller Not Applicable for kadioChenllstry.
Il I'r( parauun or Ire SCrvauon holdul" tillIC was CXCCCdcd
Page 8 of 10

GEL LABORATORIES LLC
2040 Savage Road Charleston, SC 29,107 - (E343) 556-8171 - www.gel.com
QC .111111111an,
\\'orkorder: 228283
Page 2 of 2
I';m-nuctme NO\I Sarnple Oual OC Units IZIII)`%, 1th:('`%r, llaufc :\nlsl Dale Time
N/A indicates Ili:lt spike recovery limits du nut :apply when stunplc cnnccntr:uiun exceeds spike cone. by ❑ lactor of i ur nuxc.
^ The Relative Percent Ulllerence IRNA ubuoned Irum the sample duplicae (UUI') Is evaluated attamst the acceptance crrtena when the s;unplc is grrucr than
five limes (i\) the contract rr(Iutrcd detection limit WI.). In C;mSCS %s•here ether the s;unple nr dmPlic;tc value Is less than iX the RI.. a Control linmit nl +/- III(:
RI. Is used to evaluate the DUP result.
' Indicates that a Quality Control parameter was not within specifications.
I:or PN, PSI), and SIAL'I results, the values listed arc the measured atuuunts, not linal couccntratious.
Where the analytical method has been perl'Ormcd miler NFA AP certification, the analysis has mcl all of the
reclumements of the NI I..AC SMIRI;lyd unless (Jmalilied on the QC timinm)ary.
Page 1) of, 10

I Ast OF CUITC111 GEI, Cel-lifications as of 28 April 2009
m- - -- - - - --.. -,
r i zo I I;
o
1 15 1 CA
Columdo
FP'A Regimi
\VG- 1 5) 1
I H(li-ida NTLAP
1 -115 6
-;c oi -, 1;1
1:811)(, (FIAWLAP)
GetirLia IM
1)07
....... ...
I lawaii
N/A
17025
- --------- ---------- ---------
5 (,7. 0 1
Idallo
SCOM) I
1 1111fhlois - INLLAP :
-
c -S C - () I
Kansas - NFLAP
F-10.132
- ---------
Kentucky
- -
90 1 N
. ................
mmsiana - Nl:.I,i\ll
030-10
aryl MILI
70
N'lassitchuselts
-.s C 12
Ncvad a
wo I
SCO02
New kluxict)
INFLAP E87 150
New York - NFLAP
11501
North Carolina
23 3
North Carolina DW
45709
Oklahoma
990-1
NELAP
08-00485
I small Carolina
11112000 1 / 10 120002
Telilicssee
'I-N 02934
------------ -
Temis - NELAP
TI11-4704215-0711-TX
U.S. Dcpt. o1 Ag.liculuire
S-i-2567-
Verniont
VTX71 iO
vir�illla
— - - -------
10 of M

problem .volved
P.O. 11o.r.10712-Charleston, S.C. 29417-2040 Savage Ihmd-29407
f8a.i).i,ib-N17/-Fa.r(44.1)7hh- /! I,S
Invoice l'or Analytictll Services
Mr. Tony Gregg
hater Tech Laboratories
P.O. Box 10.56
Granite lulls, North Carolina 28630
PO:200901
lovoice It:
183274
Invoice Datc:
8-AIT-09
'l'ernls:
Net .10
Client:
Walel''l'uch I'll horatorics
Descril)tioll ((hider): Low Level Ilg
Workorder/SDC:
228?8.1
Project:
\V A, I' I ( 0 1110 1
Project \tanager:
Amanda Itasca
GFl.1D:2?g283Un1 \'Ialris:W,\"I'lilt (lieulln: hyl"Isville1:11
'Pest Description \Iclhols
\1FIc1631_1- ITA 1631 Low 1-cvcl M1rc1.1y Analysis lit':\ 16311i
(:1{LID:??828U111? Malris:\VATHR Clientll): lil:ul:
'Pest Description Methods
NWR1631_1. Ii1'A 1631 Low Level Mercury Analysis lilt\ 1631F..
.Miscellaneous Charge Dexription
Paec I nl I
Collected: I4-AVR-04 Received: 20-A1'I(-I1)
Turn Daps (711111.gc
IJ (Receive) S69.(11)
Sample TotaL S68.1111
Cnllecled: IJ-Al'R-lry Received: N-Ailk 0-)
Turn (lays Charge
I.1 (Receive I $M.011
sample Total: V.K.1111
Charge
Invoice Total: $1.36.00

Effluent Toxicity Report Form Chronic Pass/Fail and Acute LC50 V.)a U. rk) 4 0 9
TOWN OF' IjPI*)F:S'fl: Pl.peli: 001.
L,AP0PATOPI*F:!,, 1'11c.
Com] Ile I'l t-s FInca ] F .1 f: f:.I I I e 1.1 v
Pelwa _0 L I I e C1 la r(j WaLe!. Tech P I
a A 1.a S S I--, I P ed 1.1 1- 1 ol'l
CjI p �.i I
Wock Or(jel. 0 11 3 4 9 64 16 1."Ilv 1. I' ol 111- a 1 0. 1 1(:.i- I* al-w I I
1, OR IGI [.1,41. T(.) 1) 1. V . of 1-:11V L E*0I'IIII(-AIL.,I.I 1'11M)aCjelllelll
H 11: . Deihl.. (--11: H., 1-1 [.-1 P
1. 1 MaJ I S' e I-"/ I C: e C, v. I-
kci le i.C111, Hc)rt-h Ch i.11'.1
I'lart'.11 ' 'eriodapt-II.I.I.r.1
C'11vollic P:'Iss/Fail Resulv-!.;
1.0 11 1.:_1 C( I L1 C. V- U I 1 9
-ITPOL, ORGANISMS i 2 -'1
Av(I Pepl:()d . ll
it Youriq Produced 21. 2 2 24 :13 22 1. 2 2 1.
I -I.-- - -- --- -- -- t - ) . 01) 2 3 . 00
COI*It: 1-0.1 Control
Adul-L ( IA i ve D) ead 11 11 1 -1-, I� L, 11 11 1., 1., L' I-,
-1 --- 0. 00 22.OH
reat-mei'iL Treatment 2
TREATNIL1,11' 2 ORGAN TS314S 1. 11. 1 4 6 "1 9 10 1.1
- 416 PASS FATL
it Young Produced 22 21 20 23�22 2)4 21 22 24 22 23 coilu1:01 q s (21- -.- producil-vj .111-d F-21i EI
-,"Clul-t W i v e . D) e-ad 1, 1, 1., I. 1 1, 1, 1-, 1, 1., L 1-. 11' h rood L 0 () % I I cl-lecl On d
I.sL sample. IsL sampl& 2rid sample Complete This Por Lit:her Test
pl-I Test Starr Date: 011/1-5/09
Col'itrol 6.92 03 6.911(".99 C0l1.eCti0f1 (Starr) DW7.E�
1: 04/13/09 Sample 2: 0Zj/lCj/0L)
Treatment 2 02 G . 9 7.00 Sample Type/Durat:iori '. 11 d
13 TTI,,/ lsu p p
S s s Grab Comp. Durauioi-i D
a 11 a [I a I-1 Samp'le 1. X 21 lirs L, A A
I: d r. CI r CI U h l M
e '�a1111D.le 2 X1 24 h rs
Sample 1st sample. grid sample
D.O. Ila rdriess (mcl /1 l9
F .......... ... ......
("ol'It 1. o.1 II.6 B. i 8 6 8 .4 a 6) B S
r ROG I pc �C.. CoIld . L B 2 3,12
Treatment 8 6 Fe .4 13 6 ei -I
1.1 e (III(j
1 0
'I'0Xi(:i.t%'7 Tesl: Sample, temp. it. : 1. "1 L'C: 5 0 ..........
(Hort:alil'y expressed as combiliillcl I- e. p I I- c a I.. s I
NOU E' : P1eCISE7.
Complet--e This
Sectiol'l Also
a r I: I I (.I s U. a r V. / e 1.1 d
mei:hod of
(:()I*l I: rol
F-
AvAverage111-ai:)iv-
P
Karher Oc.hel:
Iliql-I
I
PH
0E-(j'1II1.SIII Tested: ocer.l.odaphl-licl dubia DUCEIL30IIH-117S)
coj.-)ied from DEM form AT. -I ('.1118'7) rev. 1.1!91� vel:. '1.2'2)

• t
I-AbORn-rcrrr USr lrva.;.
ar�w.uuuwt ''•nniVllC:nlll'cur:F�S�t�Olt51 d1016:}n';
,,,t�l....1f 11/•
iN Nc #34 Z; y
•s
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C•h('11)1(-111:Illit/ P.\•is joI. Srlrlred I'uruuit, Iv)-; ulld II'utrr.S(Iul/)It, I(/(-IIIijif' d cu ]'ilplue\pille /'/':I .Tr(Ill
(A IVcrler Trrh Luhs. hic•. Project, collrc•ied ' i ,/ulte ?009)
I. \ul Hilt t)rg; It I)tlanlil:uiun Ia\Im \Ills' III. "cmi-r..latilr lh„Dunn Iltlalll al ilnl 'I :1\lun\il6'
I.I':\ >IvIl 1 h!d lAillil 1'I':\ ."ctul \Icllu..l hL' I.iulil I'I',\ "caul
VAntuirlcr (ilr-I.I Lnu11,1 I'aryirlcr ur,�l_I Iln•'tl.I
a 1c111•, lv.( hltnuh
11111❑
It(it
nrhlunr l l ul
I
I I�I iu'llhullclhrIIc
�I IIIn
III 11
I .I�Uuillnt urlhallr
II IIib
15111
t hlul nunw
nnlu
UUI
I al It In I t ll:n'lll I 11 l,'
II IIIII
III II
I: II It' I IIIIII UIGlllt'
II II III
IIIII
111lhl,nni lllr Ol'
'I IIIU
I{I 11
I hl I n ull nh Intl nurlhail 11
'1 uUl
Iitp
I .1,2-1 uch lunn'I I,; t-
II II III
141 )I
Ic'l l;wll lnl nrlllrnr
1i 11141
l{111
I IIIy IInhcllirll..
Il uln
I1t 11
I I;IIi.�- I.1 -I III II I, II�rrI III:II�
ll ll 11,1
141.11
I._' light ...... llnlllr
1111111
II111
I.I. I -In,' h lnu. tlllulc
ll it 11)
m)I
It,.. Inh: hlnnwu'Ih;ull'
is 0111
WA
( h-Il1.11hrhlol upnlpcuc
n.fiill
h0l.
Itch trot
11 sills
it, 11
I t:ulti 1, 4'I)Irhlnngn open"
0.u1u
Ill
Inrnnnl�t III
II IIIII
Ill )I
1,I.'. Ic'll 011nlnrlluuiv
11010
Ill ll
fulurnr
nuln
It it
I'.Ihyl llcn�ruc
nnln
HIh
t ld nr,......hr
uulu
IV4 II.
itl,nuun." ll.st,
'1 nl❑
Ill d
\lull,"hlunJr
40I11
Ill q.
1'him-- uaur
n ulo
It, A
lotal \vivlw,
nl)lu
14111
1.'1'IdrIII
II IIIII
it()I
At., lon't Iv
n Inn
lit 11
!-t'h Inn fit IM vur\•I rill,-,
II uln
HQI.
I hhluuu I'acrn
I
(,)if a IIIII at 111ll
I`;I\III i',\'I Ill•
A I iscel I a it I.(1111
I.I I1111
I'1':\ Scall
II. I'hl;�lgglgrs
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{mb�l_l
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11.u'S
It, 11
41tirIIrt. Im:u
uun'
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licl\'11uu 1. 1ouli
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h0i
l alllluu111. I .,I ;It
n fill!
lit 11
I I ........ um. ItnaI
oft li
iilh
t lgqu'I, I Ilal
(IOW.
Il.11hll
i.r:LLl, Inlal
n 011,
14f li
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"II— I. I mai
it Iln'.
lit )I
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tl Oil"
14111
/m . II•Ial
11 it 10
(1.25N
t 1';IIIId�'
11 kill
It, 11
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7N
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t.1hylphcno
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I'hcwli
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I it'sI IInc
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Ilruu.. h 11LInI:uuhcnr
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141s11-r1dnl uVi hu.\v1. 11,:u u'
I I I,1 t -cl I Iw oI'I II yl irl hol
lit's chln..... qr;llydlct
I Nst _-rlhabhr.\1'11lllnhal:nr
4 Ihnuuglhru\'I phru•;I rlhrl
!'Is ln..... lhlh:druc
J-1 lllnnglhru\•I phru\'I ot71n
I ) i'vw..nt u,ll till's hl:l: rin
I I hchl. n I Ov's-uo
I.; -I )ielllnluhruirur
i .4.1 h: hlnnlhrntruv
5.1.1 hrhlnnlhratulwr
111-N-limy" phth.daw
'.�I-I huunUulucuc
`.b-I bolo uudurn\
Ur�.r)r1}•I phlhahur
Plwnaull-w
I lr_\achlnlnhcutrur
I It'wcIIlotofIuladl
I lr.curhlon n'•;elupcnullhrur
I II—willnlnetIl;
Inucuul l,!.4 .d) IM—,
lanphnlnn,'
��aph111;11rin'
\ II III I,.I I, v 11v
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i` N IIu\nd II the n rl:m IIIII
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I'\n'lll
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it o..' alwlI I II I
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a�
"amply INmulwi
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NI II Itrlm. I slaw unl l,m I uuu\
IIIF'I wllhi9:IIII, In'I I.ucl Il.ln, prl wllhnn llrpwl
Vulillllc fir,_';II11 \'.: allll1y/4'tl IIiN llnitl1111t IMIC (lilt' Ill hills II :11UY\' ithllhlllt'lll I:11I ll l'\'
unlll Ihli
lI nII• Iit It
11 olo ISt II
II 111n III 11
n n,li IV 11
I1 1 41 lit )I
unlu it II
d Bill It, 11
Il llllr Ill )I
I l.11 111 41 h
,uIit; II(,11
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n Il,ll I it 11
u Ilin It. )I
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It Il10 lit 11
Ill n ll lit I
it nin it,)I
umII, lit 11.
nnlu lilll
u is Its ISt)I
it uln IIUI
II IIIII Hill
4 Ilill lit 11
u uln Itul
It( It
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U nitl 14f)I
n lit III rl
nulu It(it
nnin IIIII
Il,nln HI11.
t l.11ln 1l1 II
ul)Iu Iitit
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0.u1n tun
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uuln it(it
II IIIII lit II
fl Ili ll 111 11
n(IIit IIIII
0 Ultl Is( )I
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II I)111 It( )1
II II III lit 11
11 t1111 III A
t11110 it(A
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u tlln It, It
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11 I I"11 I5, 1

Plpu II 011I-- (;uunly ALII_X/0lDPlt
. r
I alluratrny Re Si,arcll 6 Analytical L�iboi doll,
SuJnaunr�ril (�
J211 oj( III
161 y'
IIIsIIIIe (: Iar(Ja:
(;ununoills I-In:111 111ur:nl
------ -- ----------------
AINAIL:Il 11:U1 U.11--NI
RA1.11( 5o'lO'.I I.i`.i1142.(i'. 1 2..Z
I- II\ II'U1111MIII;11 �wicuccs Iiraurll
Ilici.unl .I \\ah, l)u;llilt
N( DI - NI(
It,21 I\hail ti1r\wi. ( cider
kalci,-ll, \'( .'76'M-1621
I ill Initiaaoll Wile/ Iunr. JulyI1).l(1(1J I')5UpII1 Avg VVI/Sory ConUol lJ.ti`.i`.j7---- Test organlslrls ------
Eff. Re1)1.
2 3
4
C-ont�ul Sur'nviny rr
1',-
l-r------lT—
_ir
)-r--
//uongu,al—o-flS)F1C�-,-b-f?517--rf;7T3-
FF
I/Vnnc)Inalllrlc))
0�J 87 ---I].5'11�--
-('i5i)----T-0-A27--
( h'lyulal „
VVI/orlyulal (111g)
L�? Survlvutg rt
Uru:)u)al ri
VVIloliquial (111g)
fi 31 Survlvuty rr
---1 Uncpnallt
VVUorlyulal (rny)
'-WIVIVIny H
J OUy1n:d it
VVI/orlyinal (Ing)
water duality Jima
Control
pfi (SU) In11l1 uI
DU 11ny/I_) In11/1 In
Imnll) (C) Irnl/f n)
l
Tr
r-- 1
T�-
5-
T
°hI SUIVIVal==1=---1
Avy VVt (nly)E -�'rr'n--
Avy w1 (111(;))F �f3�2='�- J
"A. S(IIVIwII ICI-l)
Avy VVI In,y) 17.)
"!I, SUrvlval��6��—�
Avy VVt unyl �F?�fi7(5--
Sulvlval
Avy +NI (111(j)�_O f7—J
SUIVlvalr
-T-r-- - fir— )-r— ----) r--- 1----------�
Avg Wt
Uay
r Cullule(i In-11out,
( Uutsicle Suppllta
f ialch Dale ?1 I3/200.1
Hawn IIIIIB AfWl MOO
Hic Concentration
JAI (5U) 11uu1 u) /-tlr-, 7
U(1 (U1yll. J hull/f'lll(ti -f� }1-3�(f-1 -75�6 �73 Ti) -T- -I—T�t��- '-':I
_ 8
65�- 71�1
7b1,
;f -TA-7I-d- jT ('.
Sample
Collr:cuon Slalt Dale
Gras)
(.UIIII)USIIE: (I)111'a11011)
I lalllnmss (nlgil_)
Alkallmol lin(l/l )
Conr)ucllvlly (11n111n:;,cill)
(:Illonnml lnclil- i
k-mll, 1114!culOI (I(:)
2 3
Ally I'iOO
.IIIyIG.UU
July19,09 -
10
- —cJ- -
I.)II1111011 1120
itlk:lhnllylnul/l_1 ---ifi ---
Conouchvllylunlhuslclni---ifi7----
Normal
Hurl ''/al
NUF(.
LUL (.
Chv
nneuloo
Stilts
Gone
Survival
VI
UI
I 4U"4.
- I
I (; d
5tuvival
Critical
1O
— 10 —10
Growth
:klt I
III I I
Overall Result
;l1\ -
i;ru�:)'tlr
calcul;iwo
Critical C�dr.ulatnd
[(i
1 d 1
3 7SJ:i7
--------------
-----------
2—I I
01N(1 ! of n A V h ('IR)q)
r

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 - (843)`556-8171 - www.gel.com
Certificate of All-AN'sis
l nnlxutp \\'tort tech I.ahorawlICN
Itn..x IUi6
( irannc Fall,. North Carolina 'X0.10
Conracr Mr. Tolly (;rct,r
Prolcct: Low Ilg
(.•licnl Saotple IU:
la\'lorsvtlle I:I,Iluvnt
Sample ll)
?.4300-40ull
IMaurty
\Vatcr
( ,c)IIccl Date;
I4---JUL 01) 09:1>
Receive Date:
17-.IUI.--O()
Collector:
Client
Parameter Qualifier Result
Uncertainty I)I
\icrcury Analysis-C'V:\:\
/031 Low Level dlerc•tirt,llunit-.Q' "AsRcccived"
Mercury 1.72
The following Analytical :Nicthods were performed
Method Description
I I.:PA I6311:
Page 5 of 11
kClxfln I)aI .hill -'N. 'UI)'t
Protect: \VATR0O101
Client 11): \VA I k001
RI. Units
0.2(I(I 0.50)0 lw!l.
Analyst Comments
1)1, AnalN°stl):uc "Time Bauch Method
I FT[ I 07/73/t)'I 1416 `1,6677 I

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 - (843) 55(i-8171 -- www.gel.corn
Certificate of II-AN'sis
( tmymnv . 1\';urr I'cch I.ahnrauulcs
\rltlre;ti I'.(1 Itt�� Illin
( ii-ami Fall,. Montt ( : mima 'M.;(1
( nnlacl\ir Tum (,rcce
Prolc-cl: L(I1v Level 1114
Clicnl Sample II)'
'1 nvlorsvdlc lilanl.
tilimpic II):
? 33664002
\•Ia(rtx.
t i LA N:K
(,ollect Date:
Ill .IUL 09 09: I i
RCCClvr DlI[C:
17 JUL W)
( oliCCIM':
(.Ilc'lll
I'll 1-:1meter 011aliller IZCSIIII
lII1CC1'Iallll\' DI
\Icrcory Analysis—(:\':\,\
la':1 10.0 1 Lrn,' l.r•re1 ,l-Icrcur l'-luull'srr "As Ret-1,11-ed"
Mercury 0.569
The following :\11:11)'ticni 1\lcth(ids trerc performed
Method Description
I FI"A 16311.
Page G of 11
Rcp,wl I):or .11111' _';'. 'U(Il)
Prolcct: WATROU 101
(11cnt 11): \1'A•I,RIIO I
R1. Units
Anak'st Comments
Ill \nalystD:rtc Time Batch 1\Ic111(itl
I FIT 117!23/(11) 1348 h1(1(177 I

NEC: -, nf—
GEL Chain of Custody and Analytieal Request
/ /
Work Order \umber: '2,5
GEL Utbomfories. I LC
=040Sac::gel<c,:,d
Charleston, SC'•9407
Phone: (Ftii) S_lf,-8j % 1
fax: IFa; l 766• 117F
,Prgicci9- __ _.
GEL Quote 9: ------
COC Number' t' _ __._.- _
-GEL
P �'u:ahrr: I
Cl,,-�Ilnt Name: / � G� �jl �Grs l4 Ld e Phone P/: �B �'3z ��
Sample Analysis Requested "! iFill in the number of containers for each test)
Prdaect/Site Name: 1!�)A —1 Fax
Should this
sample he
CL•n.l'1/rCr4d:
C
°
c
_
7
-- Prescrvative Type (6)
•,--1 n r✓ ///� /p�
�.QyrL'$$. /( / V G f/ 1 Z L� ll /
q
J
✓�
Ctrtnmcnts
Nntc: extra sample is
required for sample
specific QC
Collected bN: blr/,rJ A�/'D I• S Send Results To: �k i ` e
y.
_
1
¢
r
Sample ID
' rot compo,ite., - in,iiCatr starl -d slop o we"trm<'
• P.m, C.11-1. d
fmmrlJ-rv)
rim,
col!eacd
MIMI r.)
(hhmnQ
QCe&
_
Field
Filtcrcd�s'
Snaptc
N1�uu''�
So
P
E
BERVED
i
I
atq:
na first:
I
TAT Kcaucsled: Normal: Kash: Sr rCifL: IS,:hiw to Surch:,rFcl
Fix Kesulls. Yes No
I
Circic Dcliverfble: C o(^. OC Sut:mlaoA .c,cl I Lc -.el _ Lcvel 3 Lc%el 4
Remarks: ,9ru there ant' kwoivl) hazards applicahle to these sarn.vics? If so. please list fire hazards Sample Collce!ion Time Zonc
Laste:n Pacific
Central 011ie,
' Mountain
Chain of Custody Signatures
Sample Shipping and Dc'lit erti, Details
Rcl!nquishve Bv (Sipud! Date Time
1 ��i U� O //r
)tel'CI,Cd b) (C,Er1Cd) Dale 7'llile
I '% ��
GEL P.M:r
Aicihod a! Shminen : Detc Shi ,;led:
2
Airhill
i
-
Airhill p.
1.1 0 ;,, ni C,nrN) Numhcr . Clicnl D,i mtincJ
') QC Codes. �' ` Noma! Sa.mpte, TB 11 it nienA, PD - Fmld I!u;d�. u:r. Cif Gyuipmem nl:vb., AK = N1111r1\ Soi4 Sac•ple. NiStl , Mmri. Spi., Ouplictdr SamPlc. G ' 61 1'. C' CuuiPosi:c
1 ! Field Fiitued For liquid r.:atriees. inJirs!r ,• Ji, a - Y lur yes tin' .—.P!, , 3 r:eld fiharcd or - !C - .ro: sa-11Plc , - nm li,ld lihcrcd
1 N1::rir. C-ws, D%V-p;inAin): Water. C.N%' tt;;;ndH'aler. CN1'=S,`-,c, 11'WO W"'= Waslr W icr; W- Walcr, SO=Soil. Sn=Scd:mcnl. SS•Soi:d N•us:c. O-(fit r•'t�iher. r w:nr 11 l•�inc. f-ircnl. N .�v..
?.) Snmp!c Ar._I. si: Kcqucslcd Ana1)-,i-I —:hod rrqucs;ca i,r N:(OU. GU I0Ifn4111A ) u d numbs: n: cuntainc•r> pm,•idcd h,r curb li.c. b'26OU 3, 601011,7: %!)A
h Trrc nn • I Is,in,cnlnrir Acid NI = Nitri, .Acid. Nil = iaJnnn FI)um,.iJc. SA = Sulluri; A,;J AA r Ascurhir Arid. IIX - FL sane, S7 ' $ndiurn lhlowlietc, li nr• pre:: n-a:i.r i> oJJ,1 l—, tied h1-1
W111.1'E= LABORATORY YGLLON'= FlIT PINK=C1_IENT
rut' Luh Rcceiving U c r7rJy:
Cuclu:: 1'.Sea/ rRln'
)'F_ c 0/V
Couier Tcmp:
2-2 C

Laboratories LLc SANIPLE RECI:IP'T & REVIEW FORM
Client -
WATA
SDG/ARCOCIWork Order: 3 3 (Q
Received
By:
Date Received: 7
Suspected Hazard lnforniatiott
W
e
'1f Counts > x2 area background on samples not tnarkcii "radioactive", contact
the Radiation Safety Group of further investigation.
COC/Samples marked as radioactive?
'vlaximum Counts Observed*: 16
Classified Radioactive fI or III by RSO?
COC/Samples marked containing PCBs?
Shipped as a DOT Hazardous?
hazard Class Shipped: UN#:
Samples Identified as Foreign Soil?
^
Sample Receipt Criteria.
Couullents/Qualifiers (Required for Non-Coufornting lteuu)
1
Shipping containers received intact and
Circle Applicable:
seats blVkCfl
dantaged
sealed'?
container leaking container other (describe)
Samples requiring cold preservation
Preservation Method: Ice bags
�
(I 5 6 deg. C'?
blue ICC dry ICC=-.11V
her (describe)within
3
Chain of custody documents included
with shipment?
Circle Applicable: seals broken
A
Sample containers intact and sealed?
darnrged container leaking container ollu:r(describe)
Samples requiring cherrtical
Sanyded e It's, LUntalnCl] allecled and obserypll:
5
preservation at proper pI-I'?
If Preservation added, LoW
6
JVOA vials free of heacispace (defined as
Sart4)Ic ID's and containers affected:
< 6mrn bubble)?
(If yes, inurcdiately deliver to Volatiles laboratory)
%
Are Encore CUR(aInCCS present?
Id's and tests affected:
8
Samples received within holding time'?
Sample ID's on COC snatch ID's on
Sample ID's and containers affected:
r
bottles?
Date &time on COC match bate & time
Sample ID's affected:
10
on bottles?
t ` {1 k,
1�—L YtA�t I'w
Number of containers received match
Sample li)'s affected:
11
number indicated on COC?
/
1.
COC form is properly signed in
/
relinquished1received sections?
Conuncnls:
-A atk4
PM (or PIv1A) review: initials _ Date

GEL LABORATORIES LLC
2040 Savage Road Charleston sc. 29407 - [phone] - www.geL.corn
Certificate of Analysis Report
for
\V;\TROOI 11%atcr I_ccl1 I_.ahtu'alorlr;
(.11c lll SDG: 23.100=1 (il:l.. Work OI'(lcr: ".13 04
The ( )ualiliers in this report ary dcllned as Follows:
r\ quality control analytc recovery is outsrcic ol'sliecilicd acccl-flance crilcrr,t
** :\nalytc is it surroU,ale comhuuncl
I Value is cstinuuecl
Where the ❑nalyllcal nteihud has heell herlornted under I\'I'.LAP ccrtilicatioo, the analysts has nlct all ol'thc•
requirements ofthc standard unless qualiliccl on the (.'ertilicatc of /\nalysis.
The desttnalion ND, it present.. appears in tllc result colunut when the analyie concenunation is not detected ahov(.
the detection limit.
"his data report has i)een prepcn'ed and revicwrd Ill accordance with CiI L Lahol-mories Ll.('
suuiclard operating. procedures. Please• direct alit' questions Io your Project \Qanager...liilic IZohinson.
Reviewed by
Page 4 of 11

GEL LABORATORIES LI_C
2040 Savage Road Charleston. SC 29407 - [phone] - www.gel.com
OC' Sul>>niary
N�':Ilel• r[!•I, I.:Illlll':111II'll•S
l(('IIUI'I D:IIL':.1111v 27. 111114
1'.(,. Itns Intl
I':
(;I'71I11I1' I':Ills, �'ll1'lh (:11'llll
lla
( nlll{I l'I: INII•. Igill), (;I'c""
\\'url:nrder: 233664
I':1I'1IIllallil'
N'O:\I
1:Illlllly (,11:t1
(�(
I)n114
Itl'1,'4, 14V "h 1611;C AIII,I
Dale Ihill.
\IcI:II. ,\nalv,i,-.\lemur,
I t;uc i,
(.t(.1 !II I KX.If,.VI I.( -S
\Irrcury
iO(I
i.l l
ne,:l
I11' 177",-I'4"„I 1 11
n7%,Vul) I l i-I
1)(-I_'UI".110N NIII
\Ierc(I
II,'ll
(A *1 _'II I NK-ifoll ! i ih1,:111111 \'I ``
NIcrrurY
i (h)
1.7'
i.7S
Ile/
\I..' 111"--1_1i`l;,)
n7,_?
Q('I'Ill IX"'.lnil _S;oo4udl NISI)
\irt'r,lr1'
i.IH)
1 7_'
i.i t
lit/I
1.4U 7h.]
r
Nolcs.
•I he 011:11iliet-, III llu, report arc delincd a. Callow,
Almlyle Is :I M111,012NOC Compound
kesulll Is Ic.s than value reposed
Resuh Is 91-r:uel' lhnn value reporu•d
A fhe VIL: IS :t suspecicd aldol-condrns:ltlon pri(hlcl
it I-ur ( iclicral Clicnusily and ( )rptuuc analysis the lar.ucl im,l)'tc ,,;I> dclecicd nl the associated blank.
( :\nalylc has been confirmed by ( i(VIMS analyst.
I) Rcsulls are rcporic(I h'om ;t diluted .lhduut ol'lhe ,:unple
I. NI Cut Is--"S JI lfercuc•e ilSit ny)le and SI) Is ,10%'. Sanlp le cosecs ll'al Ion 11111sI IIIL-Cl 1a11u II I cl'11 el ;I
P 1-.,ulnaled Value
11 MIk.'I cal hil(11IIL 11111e WNS cseeeded
1 \'aloe I, estimated
\I Milin.s Rclawd kilitile
NIA Rill) oil' %.RcciverY linuts do nit apply.
NO :\milvic conccnu'anoo I, nil detected above Ilse drlrcuon lint
N I ('onsull ( a,r Nanauvc- Data Sumlmu'y paikapc. ,-r I'rolccl \lanacrr eonrernnlc I111, yu;lllhcr
k Sllnlple 1'elllll, are rc ccled
l! ;\nal�'lc ,v:u :uta1)wd (nr. hul nol IICIeCIC(l ahov,! Ihr Nil )I., \II ):\. ur L( 11 )
('gym.till ( :1.e N;IMlll4e, l MA Slnllll1M)' I)iWkacc. of I'I'Ulecl \ganaLer eolh'crt II11! 1111, (joilh Ilc I'
1' (X 1;impIvs were ling spiked with ibis compound
kill) of vunplc and ditl,h,ale vvahlaled uslne -1-kl.. ( onertu'auons:nY i\ the RI.. Oualihei Not :\pphrahlc for ludm,licnluu'
II Prepanulon or prCwl,vauou holdlnp tnlc' ,ails e>.csrdcd
Page 7 of 11

GEL LABORATORIES LLC
2040 Savage Roan Charleston, SC 29407 - [phone] - :•rvnv.geL.com
QC S11111111111' ,
\1'urlcul-tler: 233604
1'3tiC 2 nl2
Pao-ntname \O:\I 1:Inilllc Dual OU Units I(I'11",5 I(I?( I%. Ramp. 1):ur l'iule
NIA Indic:ucs Ihnt sIIIke I-cutwel y IStiff Is do nul allllly when ,:un11IC Wilk cnlruloll C..\cccd, ,l)tkc couc. III it liiClor of -1 or nuu'C.
1 he I(elaove I'crccnl I WICI'cnec I1(111 )I ohtauted Ironl the ,auylle dnlillc:ue (I Will I, cvaloatrd cllsun,t IIIC accClwulCC crurrla %.IIcn the ,aoq)IC I, Lrr:ui•r Ihan
hvv umcs I i.\ 1 Ihr C0IIII'!IC1 rcywrcd (ICICL-IIoll linut I kl.l. lu c-:I'Cs whCrc- Cnhcr the vunl)IC nr dul)licatr value is Ics, thou iS Iltr k I., .I cnnlnll lams of Ihr
Itl. N usca uI cva(lilt C I h C I)IJP IC,IIII.
IndIcllICs III:II if Ulm IiIY (-of ItIoI pilI:IIIICIcr \Ya, IIIII w I I I I I I I ,I)CCIII cilIItIIIs.
Por I'S, PSU. and SI )II.'I I.C,IIIIS- the value, II,ICd :SIC IhC Inr:I,urrd anu,tlnls, not Iln:tl concenlraoun,
\VhCI-C Ihr analyuc-al method has brCII IICrIornlCd antler \I.I.AI' CCrulictllion, the analyses has ntct ;III of the
rrcluircnlCnls ol'(hC Nl:[-.\(. stiuulard unlCss (loalilWki on Illy (?(' tion,n,:uy.
Page 8 of 11

No non conformance reports were generated for this work order
Page 9 of 11

^ °
..fflueut roxioity uapoz� Form ' Chronic Pass/Fail and Aoute ccSu ua��. oi/z]/ov
� ---_'___--'---__----_----_---_-_'-__-__-__-_-__-'__-------_-_'
Work ocder. 6so705/6szzj onvir^nmpncuI sciences acaucu
mxl/. oRz&zoAu. TO: Div. of su"iconmeucal wanagcmeuL
H.C.oept:o1 oxwn
mzz mail sec"ice ccr
ualci9h' n"/U/ catnliu* 276991oz1.
morrb Carolina Ceriodaphuia
Chronic paxo/raJA r'`xici�y Test Chronic 'rcut: Results
c�lculaced c ~ z.xox
Tabular c ~ 2.506
cow'rno|. oxoxnzswu 1 2 ] it s 6 7 u y u> 11 zz | x neUucl:ioo ~ 3.82 |
U xouug erouuccU 11z21z31zz1zz1z11z111zo1zz1n»1zn1zz1z3
Adult (L)ivc (o)ead 111, \L 11, 11, 11, IL IL, 11, IL 11, IL 1,1,
Effluent u: o zx
znt sample zot sample '-:)rid sample
pH
Control
Treatment z | K�p� |6'94|7'02|
s o u
t e I: n c �
a n a n a o
z d c U r d
�oV. sample znc aax,ple Znd sample
oo
concrnl
T'ceac/oent z
Lcso/xoutc nnxicicy 'rest �
Control
Control
conLool cv
5 xoux
p%no FAIL
* control orgu
producing xcd
brund |
100%
Complete This For Either zeat- |
TeuL Start Dace. 07/15/09
Collection (Start) Date
Sample z. 07/1.3/09 Sample z07/1.6/09
sample Type/Duration aou
I Sr p/r
Sample z
Sample z|
� }------|-----
|oamplc �cmp n� crreipc<"c)|.........�| x z | 4.0
Section Also
—
yx o.o
copird from orm form AT-1 (3/87) rev zz/os (ouo\x vcr . i .12)