NC0086941_Renewal (Application)_20201102

���.ROY COOPER �GovernorMICHAEL S. REGAN {4'11
,^,, .•* K¢
Secretary �Q "` �•``
�:�mcca.�t"•"
S. DANIEL SMITH NORTH CAROLINA
D+rector Environmental Quality
November 02, 2020
Southeastern Wayne Sanitary District
Attn: Stephen C. Hamilton, District Manager
PO Box 1583
Goldsboro, NC 27533-1583
Subject: Permit Renewal
Application No. NC0086941
Devil's Woodyard WTP
Wayne County
Dear Applicant:
The Water Quality Permitting Section acknowledges the October 30, 2020 receipt of your permit renewal application and
supporting documentation. Your application will be assigned to a permit writer within the Section's NPDES WW permitting
branch. Per G.S. 150B-3 your current permit does not expire until permit decision on the application is made.
Continuation of the current permit is contingent on timely and sufficient application for renewal of the current permit. The
permit writer will contact you if additional information is required to complete your permit renewal. Please respond in a
timely manner to requests for additional information necessary to allow a complete review of the application and renewal
of the permit.
Information regarding the status of your renewal application can be found online using the Department of Environmental
Quality's Environmental Application Tracker at:
https://deq.nc.gov/permits-regulations/permit-guidance/environmental-application-tracker
If you have any additional questions about the permit, please contact the primary reviewer of the application using the
links available within the Application Tracker.
Sin�c�errel ���8
Wren Thedford
Administrative Assistant
Water Quality Permitting Section
ec: WQPS Laserfiche File w/application
`t North Caro Pa Department of Env.ronmental Qustty I D.vsan of Water Resources
L.�111.1E Q) Wash ngtor Reg ona Offae 1943 Wash noon Square Mari I Washington,North Carolina 27889
252-94S-84S1

W ayne SanityA rtfitaste .z. •
is%
SO I' 0 Box 1583
grI6°Iv. NC 2 7533-1583
919 731-231 O (Office)
(919) 734-5994 (ia,J
October 27, 2020
Ms. Wren Thedford RECEIVED
NC DENR/DWR/NPDES Unit OCT : 2020
1617 Mail Service Center
Raleigh,NC 27699-1617 NODEQ/D\NR/NPDES
Subject: NPDES Permit Renewal
NPDES Permit No.NC0086941
Southeastern Wayne Sanitary District
Wayne County,NC
Dear Ms. Thedford:
This letter will serve as Southeastern Wayne Sanitary District's request for renewal of our NPDES
Permit NC0086941. There has been no discharge from this facility since August 2005. In lieu of
discharge, the water is being blended with raw water coming into the plant. However, the District must
maintain the ability to discharge. Please find attached the following items:
1. Completed Application Form(one original and 2 copies)
2. Map Showing Discharge Location
3. Flow Schematic
4. Residuals Management Plan
On or about October 22, 2008, this office requested to be decertified, since we were not discharging.
There is an agreement with the City of Goldsboro to analyze any samples until we are recertified, in the
event we need to resume discharging.
Should you have questions regarding our request for renewal you may contact Cecil G. Madden, Jr.,
P.E.with McDavid Associates,Inc. at(919) 736-7630 or call me.
Sincerely,
d 4i 0t
Stephen C. Hamilton
District Manager
Attachments
cc: McDavid Associates,Inc.
Quality
On Tap!
Our Commitment a Our Profession � North orth Carolina R,uralWater Association
W:\D1(_GEN\DI OOX_MSW\D1005_CORRES_MSW\CGM\2020\SEWSD\REQUEST FOR RENEWAL.DOC

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
Mail the complete application to:
N. C. Department of Environment and Natural Resources
Division of Water Quality / NPDES Unit
1617 Mail Service Center, Raleigh, NC 27699-1617
NPDES Permit Number NC0086914
If you are completing this form in computer use the TAB key or the up - down arrows to move from one
field to the next. To check the boxes, click your mouse on top of the box. Otherwise,please print or type.
1. Contact Information:
Owner Name Southeastern Wayne Sanitary District
Facility Name SEWSD WTP No. 1 or Devils Woodyard WTP P r-r I i I E D
Mailing Address Post Office Box 1583
City Goldsboro
State / Zip Code North Carolina 27533
Telephone Number [phone]
Fax Number [phone]
e-mail Address [e-mail]
2. Location of facility producing discharge:
Check here if same as above ❑
Street Address or State Road 4820 Arrington Bridge Road
City Mount Olive
State / Zip Code North Carolina 28365
County Wayne
3. Operator Information:
Name of the firm, consultant or other entity that operates the facility. (Note that this is not referring to the
Operator in Responsible Charge or ORC)
Name
Mailing Address
City
State / Zip Code
Telephone Number ( )
Fax Number ( )
4. Ownership Status:
Federal ❑ State ❑ Private ❑ Public El
Page 1 of 4 Version 5/2012

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
5. Type of treatment plant:
❑ Conventional (Includes coagulation, flocculation, and sedimentation, usually followed by
filtration and disinfection)
❑ Ion Exchange (Sodium Cycle Cationic ion exchange)
® Green Sand Filter (No sodium recharge)
❑ Membrane Technology (RO, nanofiltration)
Check here if the treatment process also uses a water softener ❑
6. Description of source water(s) (i.e. groundwater, surface water)
Groundwater
7. Describe the treatment process(es) for the raw water:
Aeration, potable water plant filtration, potassium permanganate solution to maintain the
greensand filters, chlorination, or chloramination, and fluoridation
8. Describe the wastewater and the treatment process(es) for wastewater generated by the
facility:
Backwash from the potable water filters is settled to remove solids and calcium thiosulfate
is added to remove the chlorine residual.
9. Number of separate discharge points: One
Outfall Identification number(s) 001
10. Frequency of discharge: Continuous ❑ Intermittent El
If intermittent:
Days per week discharge occurs: No Discharge has occurred since August 2005; however, we
must retain the capability. Once solids are settled the water is recycled into the raw water intake
and blended with the raw water for treatment and consumption. Duration: Not Apply
11. Plant designflowrate a t despotable g 1.620 MGD
Backwash or reject flow 0.066 avg. & 0.132 peak MGD
12. Name of receiving stream(s) (Provide a map showing the exact location of each outfall, including
latitude and longitude):
Horsepen Branch, Class C-Sw, 35 deg 13' 02" N and 77 deg 57' 27" W
Page 2 of 4 Version 5/2012

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
13. Please list all water treatment additives, including cleaning chemicals or disinfection
treatments, that have the potential to be discharged.
Alum / aluminum sulfate Yes X No
Iron sulfate / ferrous sulfate Yes No X
Fluoride Yes X No
Ammonia nitrogen / Chloramines Yes X No
Zinc-orthophosphate or sweetwater CP1236 Yes No X
List any other additives below:
Potassium Permanganate Solution
Carus 8100 (Blended Polyphosphate Solution)
Calcium Thiosulfate Solution
14. Is this facility located on Indian country? (check one)
Yes El No
15. Additional Information:
• Provide a schematic of flow through the facility, include flow volumes at all points in
the water treatment process. The plan should show the point[s] of addition for
chemicals and all discharges routed to an outfall [including stormwater].
• Solids Handling Plan
16. NEW Applicants
Information needed in addition to items 1-15:
• New applicants are highly encouraged to contact a permit coordinator with the
NCDENR Customer Service Center.
Was the Customer Service Center contacted? ❑ Yes ❑ No
• Analyses of source water collected
• Engineering Alternative Analysis
• Discharges from Ion Exchange and Reverse Osmosis plants shall be evaluated using a
water quality model.
17. Applicant Certification
I certify that I am familiar with the information contained in the application and that to the
best of my knowledge and belief such information is true, complete, and accurate.
Stephen C. Hamilton District Manager
Printed nam f er o i ping Title
10 - 21 - Zo2-O
Signature o pplica Date
Page 3 of 4 Version 5/2012

NPDES PERMIT APPLICATION - SHORT FORM C - WTP
For discharges associated with water treatment plants
North Carolina General Statute 143-215.6(b)(2) provides that:Any person who knowingly makes any false statement representation,or certification in any application,
record,report,plan,or other document files or required to be maintained under Article 21 or regulations of the Environmental Management Commission implementing that
Article,or who falsifies,tampers with,or knowingly renders inaccurate any recording or monitoring device or method required to be operated or maintained under Article 21 or
regulations of the Environmental Management Commission implementing that Article,shall be guilty of a misdemeanor punishable by a fine not to exceed$25,000,or by
imprisonment not to exceed six months,or by both. (18 U.S.C.Section 1001 provides a punishment by a fine of not more than$25,000 or imprisonment not more than 5
years,or both,for a similar offense.)
Page 4 of 4 Version 5/2012

Southeastern Wayne Sanitary District
P. O. Box 1583
GoldNC27533
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W:\D1 OXX_GEN\D100X_MSW\D1005_CORRES_MSW\CGM\2020\SEWSD\REQUEST FOR RENEWAL.DOC
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Residuals Management Plan
Quantity Generated
Residuals to be handled come from the backwashing of iron filters. It is anticipated that approximately
that 1 mg/1 of iron will be removed.
Annual Iron Removal = 365 days x 0.9 MGD x 8.43 x 1 mg/I
2,740 lbs.
2,740 lbs. / 140 lbs/ft3
• 19.6 ft3 per year
Residuals Handling and Storage
Backwash from the iron filters is distributed to two 40' by 20' waste settling tanks where the solids
precipitate out.
Depth of Residuals = Annual Residuals/Tank Area
Within Tanks
• 19.6ft3/(2x40' x20')
• 0.01225' deep
• 0.147"deep
Adequate storage is available.
Ultimate Disposal or Reuse
Residuals do not have to be removed frequently. They are being handled under contract with Granville
Farms,Inc,Post Office Box 1396,Oxford,NC 27565.
Stephe C.Hamilton,District Manager
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=2:ct• SEAL r :Cecil G.Madden,Jr.,P.E. _ :a- 6359 : _
McDavid Associates,Inc. ��•'����' ` /( Zi
919 736-7630 �NGIN�.•..a•�
(919) //5 .G••MPip\\\
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W:\D 1 OXX_GEN\D 100X_MS W\D 1005_CORRES_MS W\CGM\2020\SE W SD\REQUEST FOR RENEWAL.DOC

(4 MICROBAC* Merano Laboratories,Inc.-Wilson Division
3309 Airport Drive NW
Wilson,NC 27808
Tel: (25* 237-4175
CERTIFICATE OF ANALYSIS
Report'laic 2016105/20
%n'5;''W-T';.Z. ;:Wt;a4T-:.;:eZ,''I'lWt,, ASIVM17;f5gMa4.
',04,,,„,:„',21.4f,,,,,.,,.:.,s,„...x4",,,,..:;, -,,,,,,,,,., ,,, quota; 23.15-39-1
SCOTT CARPENTER Work Order: 2016-05-04-017
SOIL PLUS
x:
208 WILLIAMS ST Matri WW
GREENVILLE NO 27858 Collection Dates 2016105/94
Sample Submission Date: 2016105/04
al.M Client MadO Analysis Name Method Result
A6098,17 Wayne County Water WC 050418 Flash Point-Liquids SW848 1010 See comments
AB09837 Wayne County Water WC 050418 pH{Corrosivity) SW846 9045D See comments
A1309837 Wayne County Water WC 050416 Reactive Cyanide Chapter 7/9014 See comment
AB09837 Wayne County Water WC 050416 Reactive Suifole Chapter 7/9014 See comments
AB09837 Wayne County Water WC 050418 TCLP Full Metals Subcontract See comments
Comments: See attached report. Sample analyzed by Microbac Laboratories, Inc.-Ohio Valley Division.
Wilson Division.EPA Codification I 11C00120 taG Milking Water CeitificatiOrt V was
The Follosiing methods are IS01-7026 curged:
Yaw/Mold Parr Pali and Smart Plato Method Art01-627
Aerottio Plate taunt Pour Pieta Method MCE3-02a
Esorreinthia cob 0 f5TH7 Microbial Screed Testing+,4th Revasai That Ai Method MCB-0t2
Taut COWINITI Eschstriarbabok EnernerafiolvPettrifft TM Method FM t04
Defecibe of tWorie L,Mows/oven's Fri Foods;RklRed Rapid I romp Method MCS-037
AVIA*pwe wore Pritafrow FM103
Resutts relate only do items tested
A by
"....40 .
el
Tanya idgen
Client Services Manager
For any feedback concerting our sundaes please contact Mark Hathaway al rasnostisawayemicrotsmeau
of assert Crook:sum at preslisentoulcmbaci.ovin
Environmental •Agrochemical • road • Pharmaceuticals Page I at'I
W:\D10XX_GEN\D100X_MSW\D1005_CORRES_MSW\CGM\2020\SEWSD\REQUEST FOR RENEWAL.DOC

•
Microbac <,
Laboratory Report Number t L16050244
Jeff Taylor
Microbac Laboratories
3909 Airport Drive
Wilson,NC 27896
please find enclosed the analytical results for the samples you submitted to Microbac
Laboratories.Review and compilation of your report was completed by Microbac's Ohio
Valley Division(DVD).It you have any questions,comments,or require further assistance
regarding this report,please contact your service representative listed below.
Laboratory Contact:
Emily Yoak—Client Services Specialist
[phone]
ernityypakairnictobac.com
I certify that ail lest results most at!of the ret7uirarrieniS of the ace.reifitioR authority&WO below At'results 6st sot'
sarepies ate reported on a terweigirif basis nkiss specified othetwise,Anaryticat ruts far water and mares are
reported on a as received'basis untess specified otherwise A statemerst of Un talotyforeath analysis is
sterol upon request This istraeatoiy report shag not be reArookrced,except in furl,without the written it,parovai of
teicrobac Laboratories The reported resorts are aciated orriy to the samples analyzed as received
This report was certified on May 16 2016
e)„,,,,v
David Vandenberg—Managing Director
State ot Orign:IL
Amediting Authority:Environmentat Protection Agency ID:200019
• QAPP Microbac OVO,
,
0 vs ACCp#4,
• 's‘'
Metortee Laharaltarker *Olao valley Divolon
ma Sterile Drtio,Marato,OH 45750*T![phone] F:(MO)a72-4835*ve.w.untcr~.earn
P G 1
L16050244 Revision;0 15 total aortas Genemted:05;16/2016 16:19
W:\D1OXX_GEN\D100X_MSW\D1005_CORRES_MSW\CGM\2020\SEWSD\REQUEST FOR RENEWAL.DOC

Lab Report#: L16060244
52
Lab Protect ft: 2941.4)16
)ect Name: Wilson NC
Lab Contact Ltrlily Yoak
Record of Sample Receipt and Inspection
Cetiltrientagriserepaneies
This is the rue rrd et the st ipnaettt crsndiiians and the inspection records for the samples received and reported as a sample delivery
Tulip(SDG). All of the samples were inspected and observed to conform to our receipt palates,except as noted below.
The following discrepancies were noted:
Dlscrepeocy Restitution
No time on Labels Wit lag per grformed n en CCC.t RG Pler ie fog per rh iraforrrialion on the CCC and proceext.-eny
Cooler# Temperature Temperature ure COC I AYbiF U
nun
r]}i3415 H 1.tt t77,0S01sct19O19t1235 i
QttestiOn ReSUlt
1 Were shMping coolers seated? Yea
2 Wore custody seals attach NA
9 Were cooler temperatures ill range or 0,6? Yes
4 Was ice present? Yea
5 Were COCS received tr tormation complete!signed and dated? Yes
6 Were sample containers inter and match CCC? Yes
7 Were sample labels intact and match COC? No
6 were Cite correct carttalr ers and volumes received? Yes
9 Were samples received within EPA hold tortes? Yes
10 All samples were checked for pH and mei the standard,Exceptions are noted above under discrepancy. tdR
(water only)
11 Were pH ranges acceptable?(voas excluded) NA
12 were VOA samples free of headspace(less than 6mm)? NA
Mi cks cc Laboratories•Ohio Valley Division
15S s train Dive,Monaca,OH 45750•T(740)3734071 F:(4Op373x48?5
u wnritrabec-Carer
Page 2
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•
Lab Report N: L160b0244
Lab Project#. 2941.016
m1L1 1 € Project Elate: Wilson NC
Lab Contact Ernr7y Yoak
.''
Sat-rip-lee Received
client I[) Laboratory ID Date Collected Data Received
ABOS183Z tioostv44.01 (ti3 "icri OS.30 05 f741B 0033
fiat:mbar,Laboratories+abio valley Division
158 StatrOte Drive.Mariana:,OM 45750+T.(7 373-4O71 F;{74I)373-45;s5
valowanicrabac.econ
Page
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,..
It,f,v,',,,':7 Lab Apart . L16(60044
I ok,P,.1.,1 A; Mt}tete
NI icr()1);tc
t.a>C..6.* titily'Ma,
II
Certificate of Analysis
Sample if: Llt,O5G244-01 Pref'tcp Method; titA Main:natal: OURET
Ghent ID: A1300631 Prep Mettintl: SW7.34 Prep Date: NIA
Matrix:, Solideraste Atialytical Method: SW7.34 CaI Maim
Warkgreuip a: 114656712S Analyst: TD Niiti Date: 0541362t136 17,45
Collect Date: 05AR4t2016 09:30 ElikitIcne I Fite ID: E1.ift36061746 06
Sample Tag: LInIts: milikg
Analyte CAS 4 Result Quail RL MDL
Rear:dye/A Salida , 144190.26.4 U 100 100
D I Not detected at or above acksted sample detection limit
Sample P. L16050244-03 PrePrep Method: NM Insertirrietit: ORION,i4STAR
Client ID: A5OS031 Prep Method: SO4.5D Prep Date: N/A
matrix: Sogiivitaste A,iaktica)Metlparl: PO4t...4.3 Car Date'
orl,gnaup it: 'iliCi5577:i'S Analyst; Dt P Run Date: 05,0517010 iiiiTiS
Collect Date: 0ND412016 09 30 Dilution: 3 File ID: DS161150016752701
Sample Tag: Units; UNITS
Metre CAS# 1 Result i qua! RI. tiADL
..._.....
COITOS/Vity pH I 10-24-7 t `r',bi) 0000 '. 0.000
Temperature At Deliermirtation(C) I . 14.2 I 0 000 0.000
Sample it: L150g,0244-01 PrePrep Method: NM Instrument PRECISION
chent tat ABErS337 Prep Method: 1010 Prep Date: NIA
Matrix: Snliciamati, Analytical Method: 1010 Cal Data:
Woe kgianp di: ING566216 Analyst: CPO Run Date: 0bt1112016 09 30
Collect Dale: 05,04t2016 DP SO Dilution: 1 Ede tat P1116061116353901
Sample Tag: Unita; Degrees C
Aitaltite I CitS 4 Result 1 goal 1 Rt. MDL
ion -listility aka I , I 0000 01:00
...
IReSuif ie ereater ems die 4. 0rtrateri ruarierleal value.
.. .
Sample et 1.16050244.01 Prep Method: NIA Instretrierati ITV-260
Client ID: Ad800827 Prep Method: SIA17,32 Prep Date: NA
Matti : Soldwasir Analytical Ntethoct SW7.33 Cal Date: 02,C9./2010 10.20
Workgroup F; W0N07931 Analyst: TN Rim Dale: 050112010 18.30
Collect Date: 05A)442016 0010 Dilation: 1 Fitt ID: ocisosostaao,OS
Sample Toe: Unita; ilirierD
: Queered al Way ie.Ztte icri5
Page 4
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DOG VM3N.3ZI 1I03.LS3f oall\QSM3S\OZOZ\NIDOUT1SIN SH211I0D SOOICRMSNI X00IQ\NHD XXO!Q\M
swot wax Inkw 134111M6 L408gand
-_- punt uvlpa]aP eidures RaVerifre anoge io Ie paiMaiap oN k Ei
OWL COIL f7 9-rt-LS aplu o'fiiAnneeti
117111 fEi font. 4nsati HMO €0Iau'V
SIS*LrV#Q aleagluaO
'mi./ova =Pintaman
riGC Rla.?wdgri -
>P23Ix:3i3 y'ei

�� LaL Rttwtt M'. L1�NXt}#id
rTh Ttztaal MIA1 29t16'{
i an r sen.it: Emtf Al*
Cenlficate of Analysis
Sarnptt ta: L16050244-01 Pr&nep Method: Inatraatn t; HP1 511
CUM itt ID: AB093?7 Prep Method: +ti030fPfl.130C.+r,j15A Prep Dale; Pd*A
Matfixt TCLP Leach Analytical Method: HMOS. Cal Dalin 05fi3 715 2117
Viroitig I oil41 kJ: VWQ580444 Analyst: 3D9 Rtrn Data; 05112f2015 0°1:40
Collect Date: D5/0442016 09:30 Dilution: 1.0 File ID: 11M11789
sample Tag: 0101 Unlit tilt
Analyte Result Q RL MDL EPA HWO Reg,Limit
Benzene L' 50A 1.25 00113 600
Carbon temadifotide U 50.0 250 D019 500
Cldorabenzene U 50.0 1.25 [ D021 100000
Chloroform U i $0.0 1.25 t?022 6000
i 1.2- ddmo fftwie U 50.0 2.50 a025 500
1.1.- ichi nettlea,te U 50,0 SAO C071 TOO
Methyl Ethyl(Ketone U 100 25.0. 0035 200300
Tetr&ohloroelhane U 500 2.50 D039 700
Trlohlorot:theatt Uf. I WA) I 2,60 D040 .500
SARA tri0rldc U 100 2.50 D049 2C10 ...
Surrogate Recovery Lower Limit 1 Upper Limit Q
bibrcmoflumorneihane 92 2 85 11$
1,2- 84,4 j 80 Up
Toluene-d6 37.3 j 58
a-roue ,ornberrzene , 102 1 96 115
U Plot detected at air above adjusted sample detection limit
Sample ii: L10050244-01 PrePrep Method: Instrument HPMS4
Client ID: A503437 Prep Method: 3.510C Prep Dele: 0!:;1it2014i 14400
Matrix: TCLP Leath Analytical Method. 5270r CAI Date; /131201013:4P
Vtrrkgroup e: WG5E5502 Analyst: SCO Run Dais. 05/12 2010 1054
Collect Date: 051040116 09:50 Dilution: 1 rile ID: 4 1`78113
Satnple Tag: 01 Under: u4tt.
Analyte Result Qua' RL Mt3L EPA HMI Rey.Link
.w. _ _.. .. - t xu3 I 200200
trcYes01 U fhb zs.0 !
rtl.,p.Gre&a'. U 50.0 25.0 0025 20L'000
1,4-Dichlort benzene Li .5040 25.0 0027 7600
22.4 :+sratrotoIttcne U 5f'.0 25.0 D030 130
Heocachloroben2ene g U 50.0 25.0 ( D032 130
Hexedloraburadicno U 50.0 ( 2S.0 ( D033 500 I
Herachicroolhane U 50.0 I 25.0 It034 1 3000 1,
awe 1,14 easravad at may 16,2tt16 t6:35
WADI OXX_GEN\D 1 OOX MS W\D 1005_CORRES_MS W\CGM\2020\SEWSD\REQUEST FOR RENEWAL.DOC

',7 / irM Npartft L`fi: 3714
.NIicrobd4 9f Project-Wow YtwnrqC
Lab Carms�r: Emily Vt.k
Certificate Of Anahtsis
Analyze___, Retook.
...,. QUv 1 RL MDL ( EPA HW i Rey.Limit
Mtrohatnzena U ,. __50.0 25.0 tk188 1 2cco
Pontachlorophennl __ ,. U �. 250 I 125 0037 i fDOgttp
� U. 250 125 0038 5080
2,4,5-Trichl nal U 50.0 251 0041 400000
2,4,5-TrichIcctlptanal U 50,0 25.0 0042' z 2000
Swage's Recovery i Lower Limit inter Limit Q
2-cltaaropherw 22.0 1 2'1 i X.t
_
Pnol d5 211 , 1=hes
_
Nitoberuerce,d5 50.4 35 11
2.FtiorotitOrierlyi 61.1 43 no
24.64ft>rt> aPeentil 94,4 10 123 1
t
Tetrihta`.yI4114 lab 33 141 s
U No(datddind at or obtrvc bdjus16d sample detetliam kilt __.._
Stctsple#: t.10050244.0t PrtPrep Method: lrislrutment: HP15
C0cnt ID: AB09937 Prep Method: 3510C Prep Date: 05110d2016 14:00
Matrix, TCLP Leath :Analytical ltkthad. 90816 Cal Date. 051030016 20:21
Wbrlcgrouw4: 03508465 Analyst; AED Run Date: 05?121201602:56
Cuiteei Data: 05104,2016 08:30 l2ilutioe: 1 Fite ID: 15G56035A.P
S*tttple Teg: 01 Units: t41/L
Artety10 Result i Qual Pt MDL EPA HWd Req.Litblt
4
Etldile { U 0.5t10 0_1a1 0012 _ 20
lindens U 0.500 0.10 0013 400
Ue4sostydf ar U 0,500 01.L0 001410030
1 nphene U 10,0 3,0U D01:5 500
Chlordane' u mu :.00 Di120 30
11eptechklr ..I U mum 0100 rs031 8
l eptaztierEpoxide U 0:x5100 0.100 1 0031 8
alpha Ct tiane U 0,500 0,100
gammacreerdane I U 0500 0.100
Slitttrighie Recovery Lower Limit 1UpperUnit Q
2,4,5,8• rn xylrne 34,8 20 180
Dearchloeciolphenyi 49.9 2S 140
U 1401 detected at or above adjusetd sample detection Wit
esg02u14 coromiall ar Ater A,?MI tare
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t✓ ; Lib srcs M: 211r1.014
Microbac y Project name: V, n EC
; ,
Certificate of Alitalysis
Sample N: 11133 502 4 4-0 1 PrePrr1 Melhod: Instrument; HP1.7
Chant t0: Al O 3t Prep Meihceti: 1.MFTkO) Pus p Oats:: tttr11/701 is 16 trl
Matrix.: -TCLP Leach Analytical Method: 11151A Cal Date: 0`A74Y20101t1:ai
Warkgroup a: WG568b1 Analyst: AEO RuP Oats; 05,12f201118;01
Collect Date: 05?0412016 05:30 Dilution: I File 1D: 17G21592,R
Semple Tag: 01 ,; :^" Units: ugde
Areaiyte »aeon~ ' Quin Fa. MDL. EPA MVO . Reg.Limit
2A-13 U 20.0 SAO 1)010, 10000
2,4,5-TP(Snvex) U 2400 0,500 D017 1000
Surrogate Recovery Lower Limit Uppertilnit I Q
2,4-01chlarapEtettyLaceticacid 78.0 20 J 144
U i Not detected at cc above adjusted sample deteC.2&P Iffit
Sa nple II: L16 0 502 4 4-0 1 PrePrep Method:. NMn Instrument: iCP-THERM33
Client to: ABO9837 Prep Mather!: 1315 Prep Date: OS.'.10,263612:31
Matrix: TCLP Leah Analytical Matha6: 5010E Cal Date: 06111l2016<11:40
Week0rttup A: WGS69231. Analyst: 10(8 Run Date. 051112241616:44
Collect Date; 05k14t2O16 09:30 Dilution: 1 File to: 73sb1116_'14415
Sample Tag: 01 Units: malt
Anelytte Result Qteal RL MIDI_ # EPA HIM! Reg.Limit
Araerge,TCLP U i.til 0__00 D004 5
Bat ten,rcLP O.11/9 0.100 0.050.1 D0005 100
Ctlusrliear4►,TC11.13 U 0.100 0.0500 0006 1
Chromium,TCtP i U 0_200 O1D0 15007 5
Lead,Tc1.11* U 1.00 0.500 n008 j 5
,Sek.nittm,TCPP T tl f19C0 0.400 i 13010 I
i _ _
$ve,TC. P U O 5SSQ0 D011 it 5
'U Nat detected at or abuse atnusie i sample detection Gerrit
Sate ate O: 1.1605 24d-01 PrePrep method: Instrument: GVA41
Client 1M ABD95 7 Prep Method: 7470A Prop Data. Oht10a201611:20
tMtatrix: TCLP Leach Analytical Method: 74l0A Cal Date: 05f117f201614,50
Workryreup s; WG568225 Analyst: Pars Run Date: 05J10t201013;22
collect Date: 05J 41015 09:30 tuition: 1 File ID: M7.051.015,152212
Sample Tag: 02 Units: mgJt
Anatyte ? Result Qual I RL i 1413L EPA HWd peg.Limit
Mercury ? i U l 0.60232 0=00 I D005 0.2
ti Rot detected st or above**rated same detection Irma
P.tpt 1,tt 4 r,,. alk+t e:Me"15 2M6 16:15
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Ld l ptll1/: L W44
4..N9 PmJett p[ 244L4SG
MIGrodltt : err
Ltf4 Gmtnct Ertlybhxla
74.!/;,,
Certificate of Analysis
Ph,�r 4❑t 1 E ibw+pwcf ac YAay 1A,20361an
Page 9
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Mi.crobac Laboratories Inc.
Ohio valley Division Analyst List
May 16, 2016
001 - BID-CHEM TESTING WVDEI 220 002 - REIC Consultants, Inc. W D P ffi0
003 - Sturm Environmental 004 - MICROBAC PITTSBURGH
005 - ES LABORATORIES 006 - ALCOSAN LABORATORIES
007 - ALS LABORATORIES 008 - BENCHMARK LABORATORIES
010 - MICROHAC CH*CAGOLAND AC - AIR R. CARMICHAEL
ADC - ANTHONY D. CANTER ADG - APRIL D. GREENE
AED - ALLEN B. DAVIS ALS - ADRIANE L. STEED
AMA - ALEXANDRA M. ALFRED AWE - ANDREW W. ESSIG
AEU - AFTER HOURS BJO - BRIAN J. OGDEN
BET - BRENDAN TORRENCE BLG - BRENDA L. GREENWALT
ERG - BRENDA R. GREGORY CAA - CASSIE A. AUGENSTEIN
CAP - CHERYL A. FLOWERS CEB CHAD E, BARNES
CJR - COURTNEY J. REXROAD CLC - CHRYS L. CRAWFORD
CLS - CARA L. STRICKLER CLW - CHARISM L. WINTERS
CFO - CHAD P. DAVIS CSH -- CHRIS S. HILL
DAK - DEAN A. KETELSEN DCM - DAVID C. MERCKLE
DEV - DAVID E. VANDENBERG DI} - DEANNA I. HESSON
DLB - DAVID L. BUMGARNER DLP - DOROTHY L. PAYNE
DLW - DIANA L. WRIGHT DSM - DAVID S. MOSSOR
ECL - ERIC C. LAWSON EMW - ERIC M. WILKEN
ENT - EMILY N. YOAK ERP - ERIN R. PORTER
E'JB -- FRANCES J. BOLDEN JBK - JEREMY B. KINNEY
JDK - JUSTIN D. HESSON JDS - JARED D. SMITH
JJS - JOHN J. STE MARIE JKP - JACQUELINE K. PARSONS
JLD - JRSSICA L. DELONG JLL -- JOHN L. LENT
JMW - JEANA M. WHITE JTP - JOSHUA T. PEMBERTON
JWR - JOHN W. RICHARDS JWS - JACK W. SHEAVES
JYR - JI Y. HU KAJ - KELLIE A. JOHNSON
KAT - KATHY A. TUCKER K0W - KATHRYN D. WELCH
KEB - KATIE E. BARNES ERR - KIM H. RHODES
KKB - KERRI K. BUCK KRA - KATHY R. ALBERTSON
KRB - KAELY R, BECKER KRP - KATHY R. PARSONS
LEC - LAURA E. CARPENTER LKN - LINDA K. NEDEFF
LLS - LARRY L. STEPHENS LSE - LESLIE S. BUCINA
NAP - MAARLA A. PORTER MILK - MORGAN B. KNOWLTON
MDA - MIKE D. ALBERTSON MDC - MIKE D. COCHRAN
MRS MARY E. SCHILLING MLB - MEGAN L. BACHE
MMB - MARRN M. BEERY MRT - MICHELLE R. TAYLOR
MSW - MATT S. NII.SON PUN - PIERCE D. MORRIS
PIT = MICROBAC WARRFNDALE PAL PAIGE R. LAMB
PSW - PEGGY S. WEBB OX - QIN XU
RAH - ROY A. HALSTEAD REK - BOB E. KYER
RLB BOB BUCHANAN RM - RAYMOND MALE.KE
RNP - RICK N. PETTY RST - ROBIN S. TURNER
5AV - SARAH A. VANDENBERG SCB - SARAH C. DOGOLIN
SDC - SHALYN D. CONLEY SLM - STEPHANIE L. MOSSBURO
SLP - SHERI L. PFALZGRAF TB - TODD BOYLE
TGF - TIM G. FELTON TMB - TIFFANY M. BAILEY
TMM - TAMMY M. MORRIS VC - VICKI COLLIER
VFJB WILL J. BE;ASLEY WRR - WESLEY R. RICHARDS
WTD WADE T. OBLONG XXX - UNAVAILABLE OR SUBCONTRACT
Pagel()
W:\D10XX_GEN\D100X_MSW\D1005_CORRES_MSW\CGM\2020\SEWSD\REQUEST FOR RENEWAL.DOC

•
M lttabac Laboratories Inc-
Lisl of Valid Qualifiers
May 16,2016
Quiikey: STD NOeU
Qualifier Description
• Surrogate or spike compound out of range
f Correlation coefolenf for the MSA is kiss than 0.995
Resull ks le than the orsodaled numerical vatic„
Reuel is greater than the associated numerical value..
A Sae the report narrative
B Anatyle present in method blank
81 Target arcatyte detected in method tiler*at or above the method reporting limit
139 Target ar snide detected in cabibrafon blank at or above the method mooring lime
C ConIYfned try GCl1 tS
Ca Confluent growth
DL Surrogate or spike compound was dieted out
E Estimated concentration duo to sample matrix Interference
EDL Elevsloti dangle rtgxerltrad*nits,presence of non impel rtnalytcs
EMPC Estimated Maximum Poaelbte Concentration
F,S Estimated result below quaniltafion lint method of standard additlons(MSA)
FL Free Liquid
FP1 Did not ignite,
H1 Ste- analysts performed pant trOkling time.
Serniyuanti*alivre result(out of instrument cat3,ration range)
J The anatyte was positively Idenrtfled,but the quanteallon was below the RL
J,41 Altafyte detected in both the method blank arid sample above the MDL.
J,H1 Th.acolyte was positively He:mifted,but the gvantibalion was below the RL. Sample analysis performed past holding tine
J,P Estirnabe;columns dent agree to within A0%
J,S Estimated oricentreion;analyzed by method of standard addition(NASA)
L Sample reporting mats elevated due to matrix interference
L1 The associated blank spike(LCS)recovery was above tare Laboratory acceptance limits.
L2 The associated blank sprite(LGS)recovery was below the laboratory acceptance gnats,
M Matrix effect;the concentration is en estimate due to rnalrix effect.
N Tentatively Identified otxnpound(TIC)
NA Not appieabte
ND,S trot deterred;analyzed by method of standard ridditaxt(MSA)
ND,I_ Not detected;sisrnple reporting limit(RL)elevated due 1a Interference
NF Nat found by library searuw
NFL No tree liquid
NI Non-ignitable
NR Anelylu is not required to be analyzed
HS Not spiked
P Concentrations>d,D%deference tsetween the two GC columns
One or more quality control criteria failed.See narrative-
ONS Quantity of sample not sufficient to perform analysis
RA Reanalysis confirm napaled results
RE Raarsitytri:confirms sarnple maids Intarfororx'o
S Analyzed by method of standard addition(MSA)
SMf Sample matrix Interference on aerrogate
SP Reported results are for spike compounds tarty
TIC Library Search Compound
TNTC Too nurnreorrs kr count
U Not detected at or alxrve adjusted sample deloctlfaxt Arrll
U,H1 Not detected;sample analysis performed past nokring time.
UJ undeteraec:the htDL and RL are estimated due to quality control discrepancies.
W Post-digestion spike for furnace AA out of control emits
Exceeds rrr•,rurakwry ferret
X,S Exc.-ads rugtkrlwry Merit;method of standard u44akrw(USA)
Z Coral-LA Le resolved from'Isomer-see below
IX
Page 11
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- lificrobac Laboratories/Wilson Division
11rI crobac 3809 Airport Drive, Wilson, MC. 27896
252-237-4175 Phone [phone] Fax.
x'ww.znicrob2 gyp,
Analysis Request Form—lntraL aboratory Chain of Custody
P.O.iWorlk Order# 2-0! a y-tit 7 Date Ordered: Y',1 6
Stfbcontracted Company: MIcRQBkc I OVD
Contact at Sub Company: gMLLY YQAK
Address: ; rricr o OVD
Amostved. as/mara010 ag:aa
158 STARLITE DR a ay. oP GRUM 22101:4445 5t
MARIE:0:A OH 4578r
Phone: [phone] AteCharti
STRL Datefiirne
Sample# SampledartlDle Description is Re ed
A8afir? J / 3L Hlayt,c (awr>it Ake 'C L f
_ Vvc OSOyI6 15y1:40+;131/41
Check if RUSli service is requested: Tracking#:
Check if data is to be used for regulatory compliance if yes,which agency:
Special Instructions: Please reference our Sample#on report. Report each
Sample#Maly. Also, include entire sample description.
Send Reports to:tommoridgenernkrrbac.cant, &fax [phone]
Invoices should be sent to Jeff Taylor: leff.taylo[ti2miceobac,weri
Number of Containers Shipped: g Page t of 1_
Subcontracted ted by: !kV KO Date: St-
Sample Split by: . Date:
Shipped by: tt g Ko Date: r
Received by: Date:
Chemical and Micr chialogical Analysis:
Environmental*Agrochemical Foods*Pharmaceutieala
Pane 12
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•
Micrabac Laboratot es Inc.
Internal Chain of Custody Report
Login: L16090244
Account: 2941
Project: 2941.0/6
Samples: I
Due Date: 12-MAY-2016
Simplon= Container ID Products
L16050244-01 739546 TC-ZHE
Bottle: 1
Semi Purpose Inter To Date/Time Accept IRe1 inqui.sl`i _.
1 ,IN .., L8R W1 05-MAY-2016 13:41 CLS
2 ALY2 IW1 TCL 09-MAY-2016 09:31 ERG CLS
3 TORE TCL A2 09-MAY-2016 15:44 (lb" BRG
Samplenum Container ID Products
1.16050244-01 739547 TC-EX
R4tt1e: 1
Seq. Purpose From To Date/Time Accept Relinquish) pH
a.,, LOGIN OGLER W1 45-MAY-2016 13:41 CIS
2 ANALYS W1 TCL 09-MAY-2016 09:31 SRG OT fi
3 STORE TCL A2 09-MA.Y-2016 15:44 CLS BRO
Bottle: 2
Seq. Purpose I From I To ( Date/Time J Ac cept I'Re1 i.nrtu i 3hl pH
1 LOGIN IOOLVR W1 05-MAY-2016 11:41 CLS
2 ANALYS WI TCL 09-MAY-2016 09:31 ERG— CLS
Sm np•lenust Container ID Products
L16050244-01 739548 REACTC REACTS
Bottle: 1
ISeq.I Purpose From To - D ate Tams Accept Relinquish pH
1 'LOGIN COOLER WI 05-r4AY-2016 13:41 CLE
2 ANALY2 W1 WET b5-MAY-2016 16406 DLP CLS
3 -STORE WET A2 10-MAY-2016 17:32 CLS TB
Seapiecsum Container ID Products
I4.6050244-01 739 S49 PLASH
Bottle: 1
seq.) Purpose From L To Date/Time lAcceptIRelinqu EN pH f
(1 LOGIN CO01FF Al 65-MAY-2016 13 41 CI4
2 PREP Al TCL 11-MAY-2016 09:+8 CPS, �..SRO w�
3--STORE TCL A2 134IRY-2016 10:04 BRG AMA
Al -Sample Archive(COLD)
A2-Sample Archive(AMBIENT)
Fl=Volatiles Freezer in Login
VI -Votatiles Refrigerator In Login
W1-Welkin Cooler in Login
Page 13
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