WQ0005910_Monitoring - 11-2020_20201221

GW-59A COMPLIANCE REPORT FORM Permit #-WQ 0005gtiQ
(Submit one each tit oniloring period with GW-59 forms.)
i
Enter date monitoring results were due. (12-30-20) Will this monitoring report (GW-59 and GW-59A)
YES
NO
be submitted after the established due date?
,//
2
Was any required information missing on the GW-59 report forms?
YES
NO
iF the answer to question 1 or 2 is "YES", list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the required information.
/
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
YES
NO
identification plate, area overgrown, etc.)" If the answer is "Yes", cortlacl the Regional Once for guidance.
4
Are any monitored constituents equal to or above the established standards?
YES
NO
if the answer to question 4 is 'NO", skip to section 8.
if the answer to question 4 is "YES" list the affected wells individually with constituents) and concentrations)
/
exceeding standards in the space provided below:
"t'okal O.wAVV\Q w - -Yvlw 100
5
For the constituents identified In question 4 abovq, have standards been exceeded previously for the
YES
NO
same constituent(s) in the same well(s) in the last two years?
If the answer to question '5 is NO", skip to section 8.
If the answer to question 5 is "YES", list in the space provided below, each welt with constituents) exceeding
standards, concentrations) reported, and sample collection date for each occurrence (for the last two years).
`711���0— tt•32, z1��i�0- $12 -11ai110 — SSI-111311q,- toti
3130110 — G 1 `I 511\o Wt - tcLt$
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
If the answer is "YES", a groundwater quality problem may be occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells may be improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
YES
NO
groundwater quality problem?
If the answer to question 7 is 'YES", describe those actions in the space provided below.
If the answer to question 7 is "NO", contact the Regional Office within 90 days, • an evaluation may be
required to determine the impact the waste disposal system Is having at the review and compliance
boundaries surrounding this facility, Failure to do so maV subiect the permittee to a Notice of Violation,
fines and/or penalties.
r,r
ry
8
The person completing this poi n (GW-59A) of the monitoring report should sign below and submit this
y
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
I'hereby1acknowledge.that the above lnfofmation was dVal'u�ated a"nd the Iriformatfbn �subm ttekd` n thyi�s,
report (Compliaric e ort .. ,-59 Js true and complete to,the best of my Knowladget ;;�;, ,, i¢+. ••s.i M�
Signature of PeWe ( Authorized Agent) Date

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: N4,0cu LLC
Permit Name (if different):
Facility Address: F
evv ",III (Sueel) 7-14S-7 County-- 1
(cuy) lsieie) (zip) p 2S2-4
t Person: hone #: �2-� 133
Contact Telephone
Well Location/ Site Name:
No. of Wells to be Sampled:
Well Identification Number (from Permit): MW-S
Well Depth: Zt-1 .—ft. Well Diameter: 2- in
Screened Interval: IS ft. to 2.2 ft.
Depth to Water Level: _�ft. below measuring point.
Measuring Point (M.P.) is:ft. above land surface. Re
Gallons of water pumped/bailed before sampling: 5_
Field analysis: pHL+--IL , Specific Conductance
Temp. 23 5 °C, Odor W O one. Ap
For Groundwater Treatment Systems
Check 0ne: ❑ Influent (98)
❑ Effluent (99)
lative M.P. Elevation in ft.:
Date sample collected: %\-\\-?-
uMhos
pearance
PARAMETERS (Samples for metals were collected unfiltered
COD mg/I Nitri
Coliform: MF Fecal /100ml Nitr
Coliform: MF Total /100ml Pho
(Note: Use MPN method for highly turbid samples)
S(vs
Dissolved Solids: Total
mg/I
pH (when analyzed)
units
TOC 3.05
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia o-N
mg/I
TKN as N
mg/I
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH. NC 27699-1636 Phone: [phone],
PERMIT #: • EXPIRATION DATE: 10 31 20
Non Discharge " 000541 D UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: 11I ICI;p - 1� 1 I -�'0
Laboratory Name: Lnu iicOMCAA
Certification No. V)
v YES NO and field acidified
to (NO2) as N mg/I
ate (NO3) as N <-0. mg/I
sphorus: Total as P z- 0 - mg/I
Orthophosphate mg/I
Al - Aluminum mg/I
Ba - Barium mg/I
Ca - Calcium 3S S mg/I
Cd - Cadmium mg/I
Chromium: Total mg/I
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potassium mg/I
Mg - Magnesium mg/I
Mn - Manganese mg/I
YES NO)
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. ach lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
method # =
method if =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: Awo(u LLC_
Permit Name (if different):
Facility Address: F f,
VV !d'll (Streeq WC 2-14S-7 County 1
(Ciry) (Stale) (zip)
Contact Person: +cif► Gow'cr Telephone #: 2S2 4�2-2133
Well Location/ Site Name: No. of Wells to be Sampled: (from Pe Wit)
Well Identification Number (from Permit): MQ3- For Groundwater Treatment Systems
Well Depth: � ft. Well Diameter: Z in. Check One: ❑ Influent (98)
Screened Interval: 3 ft. to I P)_ ft. ❑ Effluent (99)
Depth to Water Level: 4.7 ft. below measuring point.
Measuring Point (M.P.) is: 2 ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: SJ Date sample collected: \\2(
Field analysis: pHSpecific Conductance uMhos
Temp. 9- 4 °C, Odor ate- Appearance (aecc.f
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
RALEIGH. NC 27699-1636 Phone: [phone]:
PERMIT #: , EXPIRATION DATE: 10 -M 2 y
Non -Discharge WQ 000591 O UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: — \,;" ) \ a�
Laboratory Name: Env ►xc0nm
Certification No. ko
PARAMETERS (Samples for metals were collected unfiltered y_YES NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/1
Coliform: MF Total
/100ml
Phosphorus: Total as P O. 0
mg/I
(Note: Use MPN method for highly turbid sa pies)
Orthophosphate
mg/I
Dissolved Solids: Total
2. mg/I
Al - Aluminum
mg/I
pH (when analyzed)
units
Ba - Barium
mg/I
TOC
LA. 0,5 mg/I
Ca - Calcium 5.933
mg/I
Chloride
1—I mg/I
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate
mg/I
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia
O.O-1 mg/I
Mg - Magnesium
mg/I
TKN as N
mg/I
Mn - Manganese
mg/I
YES NO)
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. ach lab report.)
Report Attached? Yes (1) No (0)
VOC method # =
method # =
method ff =
01

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: Aj)(a L.LC,
Permit Name (if different):
Facility Address: 9)y I IgvOca V60--In Rocca
cvv i-t'll (Street) N(-. Z-14S-7 J Qar�;e-
("'n � �! ) (z°) County Telephone #:2SZ'4 -�1
Co
ntactac t Person:
Well Location/ Site Name: No. of Wells to be Sampled: 11-5
(from Permit)
Well Identification Number (from Permit): N\WFor Groundwater Treatment Systems
Well Depth: ft. Well Di meter: Z in. Check One: ❑ Influent (98)
Screened Interval: 3 ft. to Vb ft. ❑ Effluent (99)
Depth to Water Level: (o•1 it. below measuring point.
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: • EXPIRATION DATE:
Non -Discharge W Q 000591 c) UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
V Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Measuring Point (M.P.) is: 2- ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: S Date sample collected: 1—11-2rJ Date sample analyzed:
Field analysis: pH (0- S 1 , Specific Conductance uMhos Laboratory Name: An
Temp. Zy•(n °C, Odor Q ov.A, Appearance C.lepuy, Certification No. V)
PARAMETERS (Samples for metals were collected unfiltered
COD mg/I Nitri
Coliform: MF Fecal /100ml Nitr
Coliform: MF Total /100ml Pho
(Note: Use MPN method for highly turbid mpies)
TIT
Dissolved Solids: Total
mg/I
pH (when analyzed
units
TOC 21 - 00
mg/I
Chloride Z3
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia O.9(_n
mg/I
TKN as N
mg/I
YES NO and field acidified
to (NO2) as N mg/I
ate (NO3) as N _ < n . oL4 mg/I
sphorus: Total as P 4.4;1'l mg/I
Orthophosphate mg/I
AI - Aluminum mg/I
Ba - Barium mg/I
Ca - Calcium l(„•"l mg/I
Cd - Cadmium mg/I
Chromium: Total mg/I
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potassium mg/I
Mg - Magnesium mg/I
Mn - Manganese mg/I
YES NO)
4
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Oach lab report.)
Report Attached? Yes V (1) No (0)
VOC : method # =
method # =
method if =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: Awo(u PLC
Permit Name (if different):
Facility Address: 1r '
(street) PI(Z"1
. Q5-7 County
(city), (state) (zip) 252 4
Contact Person: Telephone #:
Well Location/ Site Name:
No. of Wells to be Sampled:
Well Identification Number (from Permit): ski -9 For Groundwater Treatment Systems
Well Depth: ZZ.90 .—ft. Well Diameter: 2- in. Checkone: ❑ Influent (98)
Screened Interval: 10 ft. to ft. ❑ Effluent (99)
Depth to Water Level: it. below measuring point.
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: • EXPIRATION DATE: 10 31 20 4
Non -Discharger Q 000591 UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Measuring Point (M.P.) is: ft. above land surface. Relative M.P. Elevation in ft.: 11
Gallons of water pum ed/biz(fed before sampling: �J Date sample collected: \ �— 1'20 Date sample analyzed:
Field analysis: pH � •1` , Specific Conductance uMhos Laboratory Name: �1riv �Yptnw�e,n'�
Temp. 23.4 *C, Odor 11, 0-4L Appearance Lleax✓ Certification No.
PARAMETERS (Samples for metals were collected unfiltered
COD mg/1 Nitri
Coliform: MF Fecal /1 ooml Nitr
Coliform: MF Total /100m1 Pho
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total 2-(o9 mg/I
pH (when analyzed)
units
TOC
mg/I
Chloride 2-
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia 0
. mg/I
TKN as N
mg/I
YES NO and field acidified
to (NO2) as N mg/I
ate (NO3) as N mg/I
sphorus: Total as P 0.2-H mg/I
Orthophosphate mg/1
Al - Aluminum mg/I
Ba - Barium mg/I
Ca - Calcium t-1 16, O LA I mg/I
Cd - Cadmium mg/I
Chromium: Total mg/I
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potassium mg/I
Mg - Magnesium mg/I
Mn - Manganese mg/I
YES NO)
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. At h lab report.)
Report Attached? Yes (1) No (0)
VOC : method # =
method # =
method # =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: No(cL PLC•
Permit Name (if different):
Facility Address:A1JQCx'1ravvn Road
C.VV µ•it, (Sheep N(.. 2.14S7 County
(city) (state) (tip)
Contact Person: ,ei,n �+�� Telephone #: 2S2 4�2-� 133
Well Location/ Site Name:
No. of Wells to be Sampled:
Well Identification Number (from Permit): KW - 1 O For Groundwater Treatment Systems
Well Depth: Z.P __ft. Well Diameter: 2- in. Check One: ❑ Influent (98)
Screened Interval: s ft. to '2..0 ft. ❑ Effluent (99)
Depth to Water Level: S-L4 ft. below measuring point.
Measuring Point (M.P.) is: 2- ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pum ed/bailed before sampling: _; Date sample collected:
Field analysis: pH 935 , Specific Conductance uMhos
Temp. 24 • Co °C, Odor Lj o Appearance L\-? '
PARAMETERS (Samples for metals were collected unfiltered
COD mg/I Nitri
Coliform: MF Fecal /100ml Nitr
Coliform: MF Total /100ml Pho
(Note: Use MPN method for highly turbid sam les)
Dissolved Solids: Total 3Q)`I
mg/I
pH (when analyzed)
units
TOC I • 5L4
mg/I
Chloride LAq
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia < O C)4
mg/I
TKN as N
mg/I
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: • EXPIRATION DATE
Non -Discharge w Q 00054 i O UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other: -
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed:
Laboratory Name: �1RV ►YnY�w+¢
Certification No. io
YES NO and field acidified
to (NO2) as N mg/I
ate (NO3) as N co23 mg/I
sphorus: Total as P u mg/I
Orthophosphate mg/I
AI - Aluminum mg/I
Ba - Barium mg/I
Ca - Calcium 3S .1 mg/I
Cd - Cadmium mg/I
Chromium: Total mg/I
Cu - Copper mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potassium mg/I
Mg - Magnesium mg/I
Mn - Manganese mg/I
YES NO)
q
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. P ach lab report.)
Report Attached? Yes (1) No (0)
VOC method # =
method # =
method # =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: Awt)(a LLC,
Permit Name (if different):
Facility Address:-9)y 1 P+vacc. Fa.-Yn Roacl
tvv 4-l'll (St,eet) 1N(. 7--14S-7 County
(City) (state) (zip) +ZSZ y
Contact Person: Telephone #: 162-�;t1S3
Well Location/ Site Name:
No. of Wells to be Sampled:
Well Identification Number (from Permit): - k I For Groundwater Treatment Systems
Well Depth: 2-2- _ft. Well Diameter: in. Check One: ElInfluent (98)
Screened Interval:. 7 ft. to 2-2- ft. ❑ Effluent (99)
Depth to Water Level: 13,i ft. below measuring point.
Measuring Point (M.P.) is: 2- ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pum ed/ iled before sampling: 9 Date sample collected:
Field analysis: pH , Specific Conductance uMhos
Temp. y OC, Odor WOw2� Appearance 0.1�V
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: • EXPIRATION DATE:
Non -Discharge UOQ 000541 O UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: �21 Z.rJ
Laboratory Name: -Etf1v ►Yco nme ni
Certification No. ko
PARAMETERS (Samples for metals were collected unfiltered V YES NO and field acidified
COD mg/I
Coliform: MF Fecal /100mi
Coliform: MF Total /100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total (o92-
mg/I
pH (when analyzed)
units
TOC C� • —tCo
mg/I
Chloride 2.L9
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia \2., lb O
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N e_a o4
mg/I
Phosphorus: Total as P
mg/I
Orthophosphate
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium 0 • U1
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
YES NO)
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Mach lab report.)
Report Attached? Yes/ (1) No (0)
VOC : method # =
method # =
method # =

11 0)
GREE
AVOCA, LLC (WASTEWATER)
MR. BRIAN CONNER
ID#: 3.32
Drinking Water ID: 37725
P.O. BOX 129
DATE
COLLECTED: 11/11/20
MERRY HILL ,NC 27957
DATE
REPORTED
: 12/02/20
REVIEWED BY:
Effluent
Well #4
Well #5
Well N7
Well //8
Analysis
Method
PARAMETERS
Date Analyst
Code
BOD, mg/I
3290
11/12/20
KDS
521OB-11
Total Suspended Residue, mg/i
367
11/13/20
HJO
2540D-11
Ammonia Nitrogen as N, mg/I
0.51
Nlissing
0.14
0.07
0.96
1 t/13/20
KES
350.1 112-93
Total Kjeldahl Nitrogen as N,mg/I
51.24
11/17/20
ICES
351.2 R2-93
Nitrate -Nitrite as N, mg/t (talc)
0.81
353.2 R2-93
Nitrate Nitrogen as N, mg/l
0.23
Missing
<0.04
0.64
<0.04
11/12/20
DTL
353.2 R2-93
Nitrite Nitrogen as N, ing/I
0.58
11/12/20
TLH
353.2 I12-93
Total Phosphorus as P, mg/l
23.32
Nlissing
11/17/20
TLH
365.4-74
Total Phosphorus as P, mg/I
<0.04
0.08
4.87
11/20/20
KES
365.4-74
Total Organic Carbon, mg/I
Missing
3.05
4.03
25.00
11/12/20
SEJ
531OC-11
Bromide, mg/I
Missing
Chloride, mg/1
82
Nlissing
32
17
23
11/16/20
KDS
45000LB-1I
Total Dissolved Residue, mg/I
920
Missing
565
218
378
11/17/20
HJO
2540C-11
Calcium, ug/l
26615
Nlissing
35250
5933
16735
11/13/20
LFJ
EPA200.7
Magnesium, ug/l
3976
11/13/20
LI+J
EPA200.7
Sodium, ug/I
142850
12/01/20
NAB
3111B-11
Sodium Adsorption Ratio (talc)
0.6
Total Nitrogen, mg/l (talc)
52.05

Environment 1 Incorporate)
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
AVOCA, LLC (WASTEWATER)
MR. BRIAN CONNER
P.O. BOX 129
MERRY HILL ,NC 27957
Drinking Water ID: 37715
FAX [phone]
ID#: 132
DATE COLLECTED: 11/11/20
DATE REPORTED : 12/02/20
REVIEWED BY: ;e-�—
N9
Well #10
Well #11
Analysis
Method
PARAMETERS
Date Analyst
Code
Ammonia Nitrogen as N, mg/I
0.07
<0.04
12.80
11/13/20
KES
350.1 112-93
Nitrate Nitrogen as N, mg/I
2.16
6.23
<0.04
11/12/20
DTL
353.2 R2-93
Total Phosphorus as P, mg/l
0.24
<0.04
1.62
11/20/20
KES
365.4-74
Total Organic Carbon, mg/l
1.07
1.34
6.76
11/12/20
SEJ
531OC-11
Chloride, mg/I
28
44
26
11/16/20
l(DS
4500C1.13-11
Total Dissolved Residue, mg/I
269
387
692
11/17/20
HJO
2540C-11
Calcium, ug/1
48042
35100
17671
11/13/20
LFJ
EPA200.7

Environment 1, in arporated
Drinking Water ID: 37715
GREENVILLE, N.C. 27858 FAX
CLIENT: AVOCA, LLC (WASTEWATER) CLIENT ID: 132
MR. BRIAN CONNER
P.O. BOX 129 ANALYST: DTL
MERRY HILL, NC 27957 DATE COLLECTED: 11/11/20
DATE ANALYZED: 11/24/20
DATE REPORTED: 12/02/20
REVIEWED BY:
VOLATILE ORGANICS
STD. METHODS 620OC-11
Page: 1
PARAMETERS, ug/l
Well #7
Well k8
Well N9
Well #10
Well #11
1. Benzene
<0.50
<0.50
<0.50
<0.50
<0.50
2. Bromobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
3. Bromochloromethane
<0.50
<0.50
<0.50
<0.50
<0.50
4. Bromodichloromethane
<0.50
<0.50
<0.50
<0.50
<0.50
5. Bromoform
<0.50
<0.50
<0.50
<0.50
<0.50
6. Bromomethane
<0.50
<0.50
<0.50
<0.50
<0.50
7. N-Butylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
8. Sec-Butylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
9. Tert-Butylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
10. Carbon Tetrachloride
<0.50
<0.50
<0.50
<0.50
<0.50
11. Chlorobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
12. Chloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
13. Chloroform
<0.50
<0.50
<0.50
<0.50
<0.50
14. Chloromethane
<0.50
<0.50
<0.50
<0.50
<0.50
15. 2-Chlorotoluenc
< 0.50
< 0.50
<0.50
< 0.50
< 0.50
16. 4-Chlorotolaene
<0.50
<0.50
<0.50
<0.50
<0.50
17. Dibromochloromethane
<0.50
<0.50
<0.50
<0.50
<0.50
18. 1,2-Dibromo-3-Chloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
19. 1,2-Dibromocthane
<0.50
<0.50
<0.50
<0.50
<0.50
20. Dibromomethane
<0.50
<0.50
<0.50
<0.50
<0.50
21. 1,2-Dichlorobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
22. 1,3-Dichlorobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
23. 1,4-Dichlorobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
24. Dichlorodifluoromethane
<0.50
<0.50
<0.50
<0.50
<0.50
25, 1,1-Dichloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
26. 1,2-Dichloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
27. 1,1-Dichloroethene
<0.50
<0.50
<0.50
<0.50
<0.50
28. Cis-1,2-Dichloroethene
<0.50
<0.50
<0.50
<0.50
<0.50
29. trans-1,2-Dichloroethene
<0.50
<0.50
<0.50
<0.50
<0.50
30. 1,2-Dichloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
31. 1,3-Dichloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
32. 2,2-Dichloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
33. 1,1-Dichloropropene
<0.50
<0.50
<0.50
<0.50
<0.50
34. Cis-1,3-Dichloropropene
<0.50
<0.50
<0.50
<0.50
<0.50
35. trans-1,3-Dichloropropene
<0.50
<0.50
<0.50
<0.50
<0.50
36. Ethylbenrene
<0.50
<0.50
<0.50
<0.50
<0.50
37, Hexachlorobutadiene
<0.50
<0.50
<0.50
<0.50
<0.50
38. Isopropylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
39. 4-1sopropyltoluene
<0.50
<0.50
<0.50
<0.50
<0.50
40. Methylene Chloride
<0.50
<0.50
<0.50
<0.50
<0.50
41. Naphthalene
<0.50
<0.50
<0.50
<0.50
<0.50
42. Propyibenzene
<0.50
<0.50
<0.50
<0.50
<0.50
43. Styrene
<0.50
<0.50
<0.50
<0.50
<0.50
44. 1,1,1,2-Tetrachloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
45. 1,1,2,2-Tetrachloroe thane
<0.50
<0.50
<0.50
<0.50
<0.50
46. Tetrachloroethene
<0.50
<0.50
<0.50
<0.50
<0.50
47. Toluene
<0.50
<0.50
<0.50
<0.50
<0.50
48. 1,2,3-Trichlorobenzene
<0.50
<0.50
<0.50
<0.50
<0.50

Environment 1f Incorporated!
GREENVILLE, N.C. 27858
CLIENT: AVOCA, LLC (WASTEWATER)
MR. BRIAN CONNER
P.O. BOX 129
MERRY HILL, NC 27957
REVIEWED BY:
VOLATILE ORGANICS
emn MFinannG r9toor-ll
Drinking Water ID: 37715
FAX [phone]
CLIENT ID: 132
ANALYST: DTL
DATE COLLECTED: 11/11/20 Page: 2
DATE ANALYZED: 11/24/20
DATE REPORTED: 12/02/20
PARAMETERS, ug/1
Well #7
Well N8
Well N9
Well #10
Well #11
49. 1,2,4-Trichlorobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
50. 1,1,1-Trichloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
51. 1,1,2-Trichloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
52. Trichloroethene
<0.50
<0.50
<0.50
<0.50
<0.50
53. Trichlorofluoromethane
<0.50
<0.50
<0.50
<0.50
<0.50
54. 1,2,3-Trichloropropaue
<0.50
<0.50
<0.50
<0.50
<0.50
55, 1,2,4-Trimethylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
56. 1,3,5-Trimethylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
57. Vinyl Chloride
<0.50
<0.50
<0.50
<0.50
<0.50
58. Total Xylenes
< 1.00
< 1.00
< 1.00
< 1.00
< 1.00
59, Methyl Tert Butyl Ether
< 1.00
< 1.00
< 1.00
< 1.00
< 1.00

Environment 1,1ne.
CHAIN OF CUSTODY
RECORD
P.O. Box 7085, 114 Oakmont
Dr.
Page I of 2
Greenville, NC 27858
environment] iiac.com
DISINFECTION
CHLORINE NEUTRALIZED AT COLLECTION
Phone [phone]'• Fax [phone]
❑ CHLORINE
CLIENT: 132 Week: 50
UV
G
'� L
Z
pH CHECK (LAB)
AVOCA, LLC (WASTEWATER)
❑ NONE
P P
P
P P P P
P P P
P P P
G
CONTAINER TYPE,NG
MR. BRIAN CONNER
P.O. BOX 129
❑
A A
C
C C A A
C C A
A A A
A
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CHEMICAL PRESERVATION
MERRY FULL NC 27957
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SAMPLES RECEIVED IN LAB AT V °C
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DATEMME
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(SIG.)
1 ! DATE/11ME
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REUWUISHED BY (SIG.)
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RECEIVED BY (SIG.)
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PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for FORM #5 Grab sample in the blocks above for each parameter requested. N0 s 385405

Environment 1, Inc. CHAIN OF CUSTODY RECORD
P.O. Box 7085. 114 Oakmont Dr. Page 2 of 2
UleenVt11G. 1141- LIOJ0
-nvironment 1 inc.com
DISINFECTION
CHLORINE NEUTRALIZED AT COLLECTION
Phone [phone] •Fax [phone]
CHLORINE
CLIENT: 132 Week: 50
UV
Z
j,"L
L2
pH CHECK(UaB)
G
G
G
G
CONTAINER TYPE,P/G
VOCA, LLC (WASTEWATER)
❑ NONE
[R. BRIAN CONNER
.O. BOX 129
[ERRY HILL NC 27957
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CHEMICAL PRESERVATION
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LU
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a
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SAMPLE LOCATION
DATE
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SAMPLES D BY:
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RELINQUISHED BY (SIG.) (SAMPLER)
DATEJTIME
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Sampler must place a "C" for composite sample or a "T for
PLEASE READ Instructions for completing this form on the reverse side.
FORM #5 Grab sample in the blocks above for each parameter requested. N ® 385404

... ..... . ... SG__$__
yF'
Orl
The results set forth. herein are provided by SGS North America Inc.
Technical Report for
Environment 1, Inc
AVOCA LLC; Merry Hill, NC
132
SGS Job Number: FA79941
Sampling Date: 10/14/20
Report to:
Environment 1, Inc
PO Box 7085
Greenville, NC 27835
[e-mail]
ATTN: Ann Brown
Total number of pages in report: 1.3
a
s
Test results contained within this data package meet the requirements
of the National Environmental Laboratory Accreditation Program
and/or state specific certification programs as applicable.
e Hardcopy 2.0
Arrtornnted Report
Norm Farmer
Technical Director
Client Service contact: Jean Dent -Smith 407-425-6700
Certifications: FL(E83510), LA(03051), KS(E-10327), IL(200063), NC(573), NJ(FL002), NY(I2022), SC(96038001)
DoD ELAP(ANAB L2229), AZ(AZ0806), CA(2937), TX(T104704404), PA(68-03573), VA(460177),
AK, AR, IA, KY, MA, MS, ND, NH, NV, OK, OR, UT, WA, WV
This report shall not be reproduced, except in its entirety, without the written approval of SOS.
Test results relate only to samples analyzed.
SOS North America Inc. • 4405 Vineland Road - Suite C-15 • Orlando, FL 32911 • tel: [phone] • t'ax� 407-425-0707
SUS is the sole aullwrity Ivr authorizing edits or modifications to this document. Please share your ideas about
Unauthorized modification of this repoit is strictly prohibited. how we can sorvc you letter at: �_
Review standard terms at: hlryt:'iwww.sgs.cont/eiVterms-and-conditions Eli S.t1S,Custumertare(u!sgs.cont
i of 13
FA79941

.E
Table of Contents Sections:
r
-1-
Section1: Sample Summary................................................................................................... 3
Section2: Summary of Hits.................................................................................................... 4
VNI
Section3: Sample Results........................................................................................................ S
3.1: FA79941-1: DIGESTER SLUDGE.............................................................................. b
Section4: Misc. Forms............................................................................................................ 11
4.1: Chain of Custody........................................................................................................... 12
2of13
-
FA79941

SGS North America Inc.
Sample Summary
Environment 1, Inc
AVOCA LLC; Merzy Hill, NC
Project No: 132
Job No: FA79941
Sample Collected Matrix Client
Number Date Time By Received Code Type Sample ID
T.report ntae followngap"pltej
Organics ND = Not detected above the MDL
FA79941-1 10/14/20 18:0013C 10/17/20 AQ Water DIGESTER SLUDGE
3 of 13
FA79941

Summary of Hits
Job Number:
FA79941
Account:
Environment 1, Inc
Project:
AVOCA LLC; Merry Hill, NC
Collected:
10/ 14/20
Lab Sample ID Client Sample ID Result/
Analyte Qua1 RL MDL Units Method
FA79941-1 DIGESTER SLUDGE
. .......... ...
2-Butanone (MEK) 1.67 0.050 0.020 mg/1 SW846 8260B
Page 1 of I
._.S_LiS_
ff°° 4of13
_
FA79941

m
i
Orlando FL r
°So� Results
Report of Analysis
Section 3
5of13
SMS, _
FA79941

SGS North America Inc.
Report of Analysis
it Sample ID:
DIGESTER SLUDGE
Sample ID:
FA79941-1
rix:
AQ - Water
hod:
SW846 8260B SW846 1311
ect:
AVOCA LLC; Merry Hill, NC
File ID
DF Analyzed By
#1 C0144547.1)
10 10/29/2014:37 SO
#2
Purge Volume
Run # 1 5.0 ml
Run #2
VOA TCLP List
CAS No.
Compound
71-43-2
Benzene
78-93-3
2-Butanone (MEK)
56-23-5
Carbon Tetrachloride
108-90-7
Chlorobenzene
67-66-3
Chloroform
106-46-7
1,4-Dichlorobenzene
107-06-2
1,2-Dichloroethane
75-35-4
1,1-Dichloroethylene
127-18-4
Tetrachloroethylene
79-01-6
Trichloroethylene
75-01-4
Vinyl Chloride
CAS No.
Surrogate Recoveries
1868-53-7
Dibromofluoromethane
17060-07-0
1,2-Dichloroethane-D4
2037-26-5
"Toluene-D8
460-00-4
4-Bromofluorobenzene
Page 1 of 1 s
Date Sampled: 10/14/20
Date Received: 10/17/20
Percent Solids: n/a
Prep Date Prep Batch Analytical Batch
10/20/20 09:15 OP82562 VC5800
Result HW# MCL RL
ND
DO18
0.50 0.010
L67
D035
200 0.050
ND
D019
0.50 0.010
ND
D021
100 0.010
ND !
D022
6.0 0.010
ND `.
D027
7.5 0,010
ND
D028
0.50 0,010
ND
D029
0.70 0.010
ND
D039
0.70 0.010
ND
D040
0.50 0.010
ND
D043
0.20 0.010
Run# 1
Run# 2
Limits
102%-
83-118%
103%
79-125%
97%
85-112%
99%
83-118%
TCLP Leachate method SW846 1311
MDL
Units Q
0.0031
mg/I
0.020
mg/1
0.0036
mg/1
0.0020
mg/i
0.0030
mg/1
0.0026
mg/I
0.0031
mg/I
0.0032
mg/I
0.0022
mg/I
0.0035
mg/I
0.0041
mg/1
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
Sid_, 6 of 13
FA79941

SGS North America Inc.
Report of Analysis Page I of I a
Client Sample ID: DIGESTER SLUDGE
Lab Sample ID: FA79941-1 Date Sampled: 10/14/20
Matrix: AQ - Water Date Received: 10/17/20
Method: SW846 8270D SW846 3510C Percent Solids: n/a
Project: AVOCA LLC; Merry Hill, NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 a 6F06952.D 2 10/29/20 15:11 MV 10/28/20 08:45 OP82710 S617269
Run #2
Initial Volume Final Volume
un #1 100 ml 1.0 ml
un #2
ABN TCLP List
TCLP Leachate method SW846 1311
CAS No.
Compound
Result
HW#
MCL RL
MDL
Units Q
95-48-7
2-Methylphenol
ND
D023
200
0.10
0.011
mg/1
3&4-Methylphenol
ND
D024
200
0.10
0.020
mg/l
87-86-5
Pentachlorophenol b
ND
D037
100
0.50
0.10
mg/1
95-95-4
2,4,5-Trichlorophenol
ND
D041
400
0.10
0.015
mg/1
88-06-2
2,4,6-Trichlorophenol
NTH '.
D042
2.0
0.10
0.015
mg/l
106-46-7
1,4-Dichlorobenzene
ND.
D027
7.5
0.10
0.010
mg/1
121-14-2
2,4-Dinitrotoluene
ND
D030
0.13
0.10
0,016
mg/l
118-74-1
Hexachlorobenzene
ND
D032
0.13
0.10
0.014
mg/1
87-68-3
Hexachlorobutadiene
ND_ :
D033
0.50
0.10
0.010
mg/1
67-72-1
Hexachloroethane
ND,
D034
3.0
0.10
0.033
mg/1
98-95-3
Nitrobenzene
ND:,
D036
2.0
0.10
0.019
mg/l
110-86-1
Pyridine
ND s
D038
5.0
0.20
0.040
mg/1
CAS No.
Surrogate Recoveries
Run# 1
Run# 2
Limits
367-12-4
2-Fluorophenol
15% `
14-67%
4165-62-2
Phenol-M
10%
10-50%
118-79-6
2,4,6-Tribromophenol
530/4
33-118%
4165-60-0
Nitrobenzene-d5
39% °
42-108%
321-60-8
2-Fluorobiphenyl
41% :
40-106%
1718-51-0
Terphenyl-dl4
440//o
39-121%
(a) Dilution
required due to matrix interference.
(b) Associated
CCV outside of control limits high, sample was ND.
(c) Outside
control limits due to matrix interference. Confirmed by batch DUP.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
c�%%��' 7 of 13
SGS....
FA79941

SGS North America Inc.
Report of Analysis Page 1 of I 1
Client Sample ID: DIGESTER SLUDGE
Lab Sample ID: FA79941-1 Date Sampled: 10/14/20
Matrix: AQ - Water Date Received: 10/17/20
Method: SW846 8151A SW846 3510C Percent Solids: n/a
Project: AVOCA LLC; Merry Hill, NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run #1 CC071386.1) 1 10/29/20 19:43 JA 10/28/20 10:00 OP82711 GCC1750
Run #2
Initial Volume Final Volume
Run #1 10.0 ml 5.0 ml
Run #2
Herbicide TCLP List
TCLP Leachate method SW846 1311
CAS No.
Compound
Result
IIW#
MCL RL
MDI, Units Q
94-75-7
2,4-D
ND
D016
10 0.050
0.017 mg/1
93-72-1
2,4,5-TP (Silvex)
ND
D017
L0 0.0050
0.0013 mg/1
CAS No.
Surrogate Recoveries
Run# 1
Run# 2
Limits
19719-28-9
2,4-DCAA
85% '
39-135%
ND = Not detected MDL _ Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N Indicates presumptive evidence of a compound
jj�!�! 8 of 13
_SGS,
FA79941

SGS North America Inc.
Report of Analysis
Client Sample ID:
DIGESTER SLUDGE
Lab Sample ID:
FA79941-1
Matrix:
AQ - Water
Method:
SW846 8081B SW846 3510C
Project:
AVOCA LLC; Merry Hill, NC
File ID
DF Analyzed By
Run #1 KK99321.D 1 10/27/20 21:08 WH
Run #2
Initial Volume Final Volume
Run #1 100 ml 5.0 ml
Run #2
Page 1 of 1
Date Sampled: 10/14/20
Date Received: 10/17/20
Percent Solids: n/a
Prep Date Prep Batch Analytical Batch
10/23/20 09:07 OP82630 GKK3176
Pesticide TCLP List
TCLP Leachate method SW846 1311
CAS No.
Compound
Result
HW#
MCL RL
MDL
Units Q
58-89-9
gamma-BHC (Lindane) a
ND
D013
0.40 0.00010
0.000022
mg/1
12789-03-6
Chlordane
ND
D020
0.030 0.0010
0.00038
mg/1
72-20-8
Endrin
ND
D012
0.020 0.00020
0.000021
mg/l
76-44-8
Heptachlor a
ND
D031
0.0080 0.00010
0.000026
mg/1
1024-57-3
Heptachlor epoxide
ND `.
D031
0.0080 0.00010
0.000020
mg/l
72-43-5
Methoxychlor a
ND
D014
10 0,00020
0.000050
mg/I
8001-35-2
Toxaphene
ND
D015
0.50 0.0050
0.0021
mg/1
CAS No.
Surrogate Recoveries
Run# 1
Run# 2
Limits
877-09-8
Tetrachloro-m-xylene
54%.
42-127%
2051-24-3
Decachlorobiphenyl
30%`
27-127%
(a) Associated CCV outside of control limits high, sample was ND.
ND = Not detected MDL Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
9of13
MS.-
FA79944

SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID: DIGESTER SLUDGE
Lab Sample 1D: FA79941-1 Date Sampled: 10/14/20
Matrix: AQ - Water Date Received: 10/17/20
Percent Solids: n/a
Project: AVOCA LLC; Merry Hill, NC
Metals Analysis, TCLP Leachate SW846 1311
Analyte Result HW#
MCL
RL
Units
DF Prep
Analyzed
By
Method
Prep Method
...................... .
Arsenic <0.10 D004
5.0
0.10
mg/l
1 10/29/20
10/29/20
LM
SW8466010D2
SW8463010A4
Barium <2.0 D005
100
2.0
mg/1
1 10/29/20
10/29/20
LM
SW846 6010D 2
SW846 3010A 4
Cadmium < 0.050 D006
1.0
0.050
mg/1
1 10/29/20
10/29/20
LM
SW846 6010D 2
SW846 301OA 4
Chromium < 0.10 D007
5.0
0.10
mg/1
1 10/29/20
10/29/20
LM
SW846 6010D 2
SW846 3010A 4
Lead < 0.050 D008
5.0
0.050
mg/I
1 10/29/20
10/29/20
LM
SW846 6010D 2
SW846 3010A 4
Mercury < 0.0050 D009
0.20
0.0050
mg/1
1 10/22/20
10/22/20
is
SW846 7470A 1
SW846 7470A 3
Selenium <0.10 DO W
1.0
0.10
mg/l
1 10/29/20
10/29/20
LM
SW846 6010D 2
SW846 3010A 4
Silver <0.10 DO11
5.0
0.10
mg/1
1 10/29/20
10/29/20
LM
SW846 601OD 2
SW846 3010A 4
(1) Instrument QC Batch: MA17159
(2) Instrument QC Batch: MA17189
(3) Prep QC Batch: MP38012
(4) Prep QC Batch: MP38054
RL = Reporting Limit
MCL = Maximum Contamination Level (40 CFR 261 7/1/11)
SGS' 10 of 13
FAM41

S-Gg--
Orlando FL by r3 ^ y=s
Misc. ;Forms
Custody Documents and Other Forms
Includes the following where applicable;
• Chain of Custody
Section 4
0
11 of 13
FA79941

Environment 1, Inc.
P.O. Box 7095, 114 Oakmont DT.
CHAIN OF CUS+ODY RECORD W ` IA1
Page I_ of l
J�CL'n VI11�, ,�V. c.u✓,.
:nvicanmant I inacom
DISINI LCIIO N
CHLORINE NEUTAALI2E0ATC0LLECTION
Phone [phone] • Fax [phone]
❑ CHLORINE
pH CHECKIIAB)
CLIENT: 132 A Week-. 45
I y
UV
(❑�
CONTAINERTYPE,P/G
VOCA, ),LC (WASTFWATRR)
NONE
G
G
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G
it. BRIAN CONNBR
R BOX 129
CHEMICALPRES9iVATION
IRRRY IBLT, NC 21957
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3
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'H
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❑ DRINKINGWATER
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❑ SOUOWASTESECTLON
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
0 N
SAMPLES COLLECTED BY:
(Please Print)
v�
SAMPLES RECEIVED IN IAEt AT o `C
RE NOUISIiEDBY (SIG.)(SAMPLER)
DATFlRM£
RE, CES1Ef�Y(S1G:)
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FORM MS
PLEASE READ Instructions for completinginls torm on loe reverse slue.
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e. Grab sample In the blocks above for each parameter requested. N ° 385751
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FA79941: Chain of Custody
Page 1 of 2
01
12 of 13
FA79941

SGS Sample Receipt Summary
Job Number: FA79941 Client: ENVIROMENTAL 1 Project: AVOCA WASTEWATER
Date / Time Received: 10117/202012:D5:00 PM Delivery Method: FEDEX Alrbill #'s: 90043372674
Therm ID; IR 1; Therm CF: -0.2; 11of Coolers: 1
Cooler Temps (Raw Measured) 'C: Cooler 1: (3.8);
Cooler Temps (Corrected) °C: Cooler 1: (3.6);
1. Custody Seale Present
6d
❑
1. Sample labels present on bottles
®
❑
2. Custody Seals Intact
®
❑
2. Samples preserved properly
®
❑
3. Temp criteria achieved
®
❑
3. Sufficient volume/containers recvd for analysis:
®
❑
4. Cooler tamp vergicatlon
IR Gun
4. Condition of sample
leieci
5. Cooler media
lea (Baal
5. Sample recvd within HT
®
❑
6. Dates/TimeSADs on COC match Sample Label
®
❑
Trip Blank Information
Y or
N
N/A
7. VOCa have headspace
❑
❑
Ed
1. Trip Blank present / molar
❑
❑
®
8. Bottles received for unspecified tests
❑
2. Trip Blank listed on CDC
❑
❑
®
9. Compositing Instructions clear
❑
0
W
or S
NlA
10. Voe Soll Klls/Jars received pest 48hre?
❑
❑
11. % Solids Jar received?
❑
❑
3. Type Of TB Received
❑
❑
8
12. Residual Chlorine Present?
❑
❑
SE
Misc. Information
Number of Encores: 25-Gram 5-Gram Number of 5035 Field Kits: Number of Lab Filtered Metals:
Teat Strip Lot lis: pH 0-3 230315 pH 10.12 219813A Other: (Specify)
Resldual Chlorine Teat Strip Lot M.
Comments
scoot
Rw. Dab OSrlV 17 Technician: MAGALEAK Date: 10/17/202012:05:00
Reviewer. Date:
FA79941: Chain of Custody
Page 2 of 2
A
La
13 of 13
FA79941

Environment 1, Inc.
PO. Box 7085, 114 Oakmont Dr.
(;reenville NC 27RSR
CHAIN OF CUSTODY RECORD
Page I of _ I
environnientl ine.com
DISINFECTION
CHLORINE NEUTRALIZED ATCOLLECTION
Phone [phone] • Fax [phone]
CHLORINE
CLIENT: 132 A Week: 45
pH CHECK (LAB)
UV
G
G
G
G
CONTAINER TYPE,P/G
VOCA, LLC (WASTEWATER)
❑ NONE
iR. BRIAN CONNER
.O. BOX 129
CHEMICAL PRESERVATION
TERRY HILL NC 27957
A
A
A
A
c o
A -NONE D-NAOH
:52) 482-2133
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COLLECTION
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G - NA THIOSULFATE
SAMPLE LOCATION
DATE
TIME
Digester Sludge
:O-1�F 20
1w• 00
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3
a
CLASSIFICATION:
WASTEWATER (NPDES)
DRINKING WATER
DWR,KGW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
0 N
SAMPLES COLLECTED BY:
(Please Print)
��1d✓v
SAMPLES RECEIVED IN LAB AT o °C
RELINQUI�FIED BY (SIG.) (SAMPLER)
DATFITIME
RECEIVED BY (SIG.)
j� j� DATEM E
COMMENTS:
RELINQUISHED BY (SIG.)
DATErnME
RECEIVED BY (SIG.)
DATErnME
100wzf, 1 7;oc.
RELINQUISHED BY (SIG.)
DATE/TIME
RECEIVED BY (SIG.)
DATE/TIME
PLEASE READ Instructions for completing this form on the reverse side.
FORM #5
Sampler must place a "C" for composite sample or a "G" for
Grab sample in the blocks above for each parameter requested. N 0 385751