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Home My WebLink AboutWQ0001664_Monitoring - 11-2020_20210113SUBMIT FORM ON YELLOW PAPER ONLY ROUNDWATER QUALITY MONITORING: OMPLIANCE REPORT FORM Print Clearly or Type Facility Name: Belvedere Plantation Permit Name (if different): Facility Address: 130 Fairway Dr Hampstead N.C. 28443 County Pender Contact Person: Greg Spillman Telephone#: 252-241-0661 Well Location/Site Name # 3 Green No. of wells to be sampled: PERMIT Number: Expiration Date: 1/31/2020 Non -Discharge WQ0001664 UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other: INFILTRATION BASIN SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW7 Date sample collected: 11/2/2020 FIELD ANALYSES: WAS Well Depth: 17 ft. Well Diameter: 2 in. pH 00400: 6.3 units Temp. 0001c 21 6 °C DRY at Depth to Water Level 82546: 4 Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µMhos time of sampling, Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: None check Volume of water pumped/bailed before sampling: 5 gallons Appearance Tan here:❑ Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO LABORATORY INFORMATION Date sample analyzed. 11/2/2020 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 0.02 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 0.13 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.37 mg/L (Note. Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 87 mg/L Al -Aluminum ol1o5 mg/L pH (Lab) 00403 6.3 units Ba - Barium 01007 ug/L . P TOC 00680 mg/L Ca - Calcium 00916 mg/L Chloride 00940 12 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) pecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 <0.2 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen, NH3asN; Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # InfluentFor Remediation Systems Only (Attach Lab Reports): .. • 1 certify that, to the best of my knowledge and belief, the information submitted in this report is true, accurai DWR-certified laboratory. I am aware that there are significant penalties for submitting false information, it GW-59 Rev. Permittee (or Authorized Aqent) Name and Title - Please print or tvpe mg/L Effluent Total VOCs: Signature of Permittee (or Authorized Aqent) mg/L VOC Removal% 1?-.3 -si (Date) SUBMIT FORM ON YELLOW PAPER ONLY GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM FACILITY INFORMATION Please Print Clearly or Type Facility Name: Belvedere Plantation Permit Name (if different): Facility Address: 130 Fairway Dr Hampstead N.C. 28443 County Pender IContact Person. Greg Spillman Telephone#: 252-241-0661 Well Location/Site Name # 7 Green No. of wells to be sampled: I ERMIT Number: Expiration Date: 1/31/2020 on -Discharge WQ0001664 UIC PDES Other YPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other: INFILTRATION BASINS SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW8 Date sample collected: 11/2/2020 FIELD ANALYSES: WAS Well Depth: 18 ft. Well Diameter: 2 in. pH 00400: 6.4 units Temp. 0001r 22.9 °C DRY at Depth to Water Level 82546: 8 Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µMhos time of Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: None sampling, check Volume of water pumped/bailed before sampling: 5 gallons Appearance Tan here: ❑ Samples for metals were collected unfiltered: ❑ YES El NO and field acidified: El YES ❑ NO Date sample analyzed: 11/2/2020 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 <0.02 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 0.6 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 3.04 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids -.Total 70300 239 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 6.4 units Ba - Barium 01007 ug/L TOC 00680 mg/L Ca - Calcium 00916 mg/L Chloride 00940 8 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method M ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) pecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 <0.2 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen, NH3as N, Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% Permittee (or Authorized Aqent) Name and Title - Please print or type GW-59 Rev.8/2013 Siqnature of Permittee (or Authorized Agent) (Date) SUBMIT FORM ON YELLOW PAPER ONLY GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM FACILITY INFORMATION Please Print Clearly or Type Facility Name: Belvedere Plantation Permit Name (if different): Facility Address: 130 Fairway Dr Hampstead N.C. 28443 County Pender act Person: Greg Spillman Telephone#: 252-241-0661 Location/Site Name # 3 Green near woods No. of wells to be sampled: 0 PERMIT Number: Expiration Date: 1/31/2020 Non -Discharge WQ0001664 UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other: INFILTRATION BASINS SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW9 Date sample collected: 11/2/2020 FIELD ANALYSES: WAS Well Depth: 23 ft. Well Diameter: 2 in. pH 00400: 6.2 units Temp. 0001c 209 °C DRY at Depth to Water Level 82546: 15 Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µMhos time of Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: None sampling, check Volume of water pumped/bailed before sampling: 5 gallons Appearance Tan here: ❑ Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: El YES El NO LABORATORY INFORMATION Date sample analyzed: 11/2/2020 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 <0.02 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 0.3 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 1.45 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 160 mg/L Al - Aluminum of 105 mg/L pH (Lab) 00403 6.2 units Ba - Barium 01007 ug/L TOC 00680 mg/L Ca - Calcium 00916 mg/L Chloride 00940 54 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) pecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 <0.2 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3as N; Ammonia Nitrogen, Total) Mn -Manganese 01055 ug/L ,method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% IZ.31-2o Permittee (or Authorized Aqent) Name and Title - Please print or tvpe GW-59 Rev.8/2013 Siqnature of Permittee (or Authorized Aqent) !L• 3 t • z� (Date) SUBMIT FORM ON YELLOW PAPER ONLY GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM and I cop) FACILITY INFORMATION Please Print Clearly or Type Facility Name: Belvedere Plantation Permit Name (if different): Facility Address: 130 Fairway Dr Hampstead N.C. 28443 County Pender Contact Person: Greg Spillman Telephone#: 252-241-0661 iWell Location/Site Name # 3 green near tee box No. of wells to be sampled: 9 WELL ID NUMBER (from Permit): MW10 Date sample collected: Well Depth: 18 ft. Well Diameter: Depth to Water Level 82546: 4 ft. below measuring point Screened Interval: Measuring Point is 3 ft. above land surface Relative M.P. Elevation: Volume of water pumped/bailed before sampling: 5 gallons 11 /2/2020 PERMIT Number: Expiration Date: 1/31/2020 Non -Discharge WQ0001664 UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other: INFILTRATION BASINS 2 in. 5 ft. to 15 ft. ft. Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO FIELD ANALYSES: pH 00400: 6.1 units Spec. Cond. 00094: Odor 00085: Appearance WAS Temp. 000lc 25 °C DRY at µMhos time of None sampling, check Tan here: ❑ Date sample analyzed: 11/2/2020 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 <0.02 mg/L Pb - Lead o1o51 ug/L Coliform: MF Fecal 31616 4 /100mL Nitrate (NO3) as N 00620 3.64 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 2.76 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 98 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 6.1 units Ba - Barium 01007 ug/L TOC 00680 mg/L Ca - Calcium 00916 mg/L Chloride 00940 10 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) pecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 <0.2 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% Permittee (or Authorized Aqent) Name and Title - Please print or type Siqnature of Permittee (or Authorized Agent) (Date) GW-59 Rev.8/2013 SUBMIT FORM ON YELLOW PAPER ONLY GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM FACILITY INFORMATION Please Print Clearly or Type Facility Name: Belvedere Plantation Permit Name (if different): Facility Address: 130 Fairway Dr Hampstead N.C. 28443 County Pender Contact Person: Greg Spillman Telephone#: 252-241-0661 Well Location/Site Name Basin A right corner No. of wells to be sampled: WELL ID NUMBER (from Permit): MW11 Date sample collected: Well Depth: 15 ft. Well Diameter: Depth to Water Level 82546: 14 ft. below measuring point Screened Interval: Measuring Point is 3 ft. above land surface Relative M.P. Elevation: Volume of water pumped/bailed before sampling: 5 gallons I 11 /2/2020 PERMIT Number: Expiration Date: 1/31/2020 Non -Discharge WQ0001664 UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other: INFLITRATION BASINS 2 in. 5 ft. to 15 ft. ft. Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO FIELD ANALYSES: pH 00400: 4.5 units Spec. Cond. 00094: Odor 00085: Appearance Temp. 0001( 212 °C uMhos None Tan Date sample analyzed: 11/2/2020 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 <0.02 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 0.05 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.29 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids.Total 70300 26 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 4.5 units Ba - Barium 01007 ug/L TOC 00680 mg/L Ca - Calcium 00916 mg/L Chloride 00940 14 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) pecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 <0.2 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen, NH3as N, Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% Via_ - �-\k -_,�>,-.L, Permittee (or Authorized Agent) Name and Title - Please print or type GW-59 Rev.8/2013 12-3 t • 2- Signature of Permittee (or Authorized Agent) (Date) If WELL DRY at time of sampling, check here: El JUt51Vll I rVKIVI VIV TCLLVVV F'Hr'CK VIVLT GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM FACILITY INFORMATION Please Print Clearly or Type Facility Name: Permit Name (if different): Facility Address: 130 Fairway Dr Hampstead N.C. 28443 County Pender Belvedere Plantation ontact Person: Greg Spillman Telephone#: 252-241-0661 tell Location/Site Name Back of Basin B No. of wells to be sampled: 9 If— P PERMIT Number: Expiration Date: 1/31/2020 Non -Discharge WQ0001664 UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other: INFILTRATION BASINS SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW12 Date sample collected: 11/2/2020 FIELD ANALYSES: WAS Well Depth: 15 ft. Well Diameter: 2 in. pH 00400: 5.4 units Temp. 0001C 21.5 °C DRY at Depth to Water Level 82546: 11 Screened Interval. 5 ft. to 15 ft. Spec. Cond. 00094: µMhos time of Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: Slight sampling, check Volume of water pumped/bailed before sampling: 5 gallons Appearance tan here: ❑ Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: El YES ❑ NO Date sample analyzed: 11/2/2020 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 <0.02 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 0.07 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.93 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 118 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 5.4 units Ba - Barium 01007 ug/L TOC 00680 mg/L Ca - Calcium oo916 mg/L M Chloride 00940 42 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) pecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 0.3 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; N113as N; Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% Permittee (or Authorized Aqent) Name and Title - Please print or type Siqnature of Permittee (or Authorized Aqent) (Date) GW-59 Rev.8/2013 SUBMIT FORM ON YELLOW PAPER ONLY log• • DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES GROUNDWATER QUALITY MONITORING: DIVISION OF WATER RESOURCES -INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM • • • • 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699A617 Phone: 919.807-6306 FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 1/31/2020 Facility Name: Belvedere Plantation Non -Discharge WQ0001664 UIC NPDES Other Permit Name (if different): Facility Address: 130 Fairway Dr Hampstead N.C. 28443 TYPE OF PERMITTED OPERATION BEING MONITORED County Pender ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: Contact Person: Greg Spillman Telephone#: 252-241-0661 ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name 1st Basin C near front right corner No. of wells to be sampled: 9 ❑ Water Source Heat Pump ❑ Other: INFILTRATION BASINS from Permit SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW13 Date sample collected: 11/2/2020 FIELD ANALYSES: WAS Well Depth: 15 ft. Well Diameter: 2 in. pH 00400: 4.7 units Temp. 0001c 21.1 °C DRY at Depth to Water Level 82546: 14 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µMhos time of sampling, Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: None check Volume of water pumped/bailed before sampling: 5 gallons Appearance light brown here:❑ Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO LABORATORY INFORMATION Date sample analyzed: 11/2/2020 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 <0.02 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 0.02 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 1.13 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 25 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 4.7 units Ba - Barium 01007 ug/L TOC 00680 mg/L Ca - Calcium 00916 mg/L Chloride 00940 5 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) pecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 <0.2 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3as N; Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% I certify that, to the best of my knowledge and belief, the information submitted in this report is true. accurate, and complete, and that the laboratory analytical data was produced using approved methods of analysis by a DWR-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations. Permittee (or Authorized Aqent) Name and Title - Please print or tvpe Siqnature of Permittee (or Authorized Agent) (Date) GW-59 Rev.8/2013 SUBMIT FORM ON YELLOW PAPER ONLY • • DEPARTMENT OF ENVIRONMENT 8, NATURAL RESOURCES GROUNDWATER QUALITY MONITORING: DfVISION OF WATER RESOURCES - INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM • • • • ¢17 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: 919.807-6306 FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 1/31/2020 Facility Name: Belvedere Plantation Non -Discharge WQ0001664 UIC NPDES Other Permit Name (if different): Facility Address: 130 Fairway Dr Hampstead N.C. 28443 TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery County Pender ❑ Spray Field ❑ Remediation: Contact Person: Greg Spillman Telephone#: 252-241-0661 ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name Basin left corner. No. of wells to be sampled: 9 ❑ Water Source Heat Pump ❑ Other: INFILTRATION BASINS from Permit SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW14 Date sample collected: 11/2/2020 FIELD ANALYSES: WAS Well Depth: 15 ft. Well Diameter: 2 in. pH 00400: 5.4 units Temp. 0001c 23.1 °C DRY at Depth to Water Level 82546: 13 ft. below measuring point Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µMhos time of sampling, Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft. Slight Odor 000m: Sli g check Volume of water pumped/bailed before sampling: 5 gallons Appearance tan here:❑ Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO LABORATORY INFORMATION Date sample analyzed: 11/2/2020 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 <0.02 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 <1 /100ml- Nitrate (NO3) as N 00620 0.04 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.58 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 110 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 5.4 units Ba - Barium 01007 ug/L TOC 00680 mg/L Ca - Calcium oo916 mg/L Chloride 00940 20 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) pecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 0.3 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs. mg/L VOG-Removal% I certify that, to the best of my knowledge and belief, the information submitted in this report is true, accurate. and complete, and that the laboratory analytical data was produced using approved methods of analysis by a DWR-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations. �.- Permittee (or Authorized Agent) Name and Title - Please print or type to -a Siqnature of Permittee (or Authorized Agent) (Date) GW-59 Rev.8/2013 JUbMi I rUKM UN YLLLUVV F'AF'LK UNLY GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM FACILITY INFORMATION Please Print Clearly or Type Facility Name: Belvedere Plantation Permit Name (if different): Facility Address: 130 Fairway Dr Hampstead N.C. 28443 County Pender itact Person: Greg Spillman Telephone#: 252-241-0661 II Location/Site Name Between Basin B & C No. of wells to be sampled: I PERMIT Number: Expiration Date: 1/31/2020 Non -Discharge WQ0001664 UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump ❑ Other: INFILTRATION BASINS from Permit SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW15 Date sample collected: 11/2/2020 FIELD ANALYSES: WAS Well Depth: 18 ft. Well Diameter: 2 in. pH 00400: 4.5 units Temp. 000lr 21.6 °C DRY at Depth to Water Level 82546: 13 Screened Interval: 5 ft. to 15 ft. Spec. Cond. 00094: µMhos time of Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: None sampling, check Volume of water pumped/bailed before sampling: 5 gallons Appearance light brown here: El Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO Date sample analyzed: 11/2/2020 Laboratory Name: Environmental Chemists, Inc. Certification No. 94 PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 <0.02 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 0.02 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.86 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 42 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 4.5 units Ba - Barium 01007 ug/L TOC oomo mg/L Ca - Calcium 00916 mg/L Chloride 00940 12 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) pecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 <0.2 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH3as N; Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:. I certify that. to the best of my knowledge and belief, the information submitted in this report is true, accura DWR-certified laboratory. I am aware that there are significant penalties for submitting false information, it GW-59 Rev. Permittee (or Authorized Acient) Name and Title - Please print or twe mg/L Effluent Total VOCs: mg/L VOC Removal% — — 12-- ; if - 2 . Siqnature of Permittee (or Authorized Agent) (Date) Environmental Chemists, Inc. envirochem6602 Windmill Way, Wilmington, NC 28405 s 910.392.0223 Lab + 910-392.4424 Fax 710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax `S', 255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax ANALYTICAL & CONSULTING CHEMISTS infot'e environmentalchemists.cam CWS - Hampstead Date of Report: Nov 13, 2020 130 Fairway Dr Customer PO #: Hampstead NC 28443 Customer ID: 08100029 Attention: Report #: 2020-18581 Project ID: Belvedere Monitoring Wells Lab ID Sample ID: Collect Date/Time Matrix Sampled by 20-47303 Site: MW-7 11/2/2020 10:37 AM Water Mike Miracle Test Method Results Date Analyzed Color Color Tan 11/02/2020 Depth to water, ft. Depth to water, Ft. 4.3 feet 11/02/2020 Ammonia Nitrogen EPA350,1 < 0.2 mg/L 11/05/2020 Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 11/02/2020 Odor Qualitative None 11/02/2020 Total Dissolved Solids (TDS) SM 2540 C 87 mg/L 11/03/2020 Temperature SM 2550 B 21.6 C 11/02/2020 Chloride SM 4500 Cl E 12 mg/L 11/09/2020 pH SM 4500 H B 6.3 units 11/02/2020 Total Phosphorus SM 4500 P F 0.37 mg/L 11/11/2020 Fecal Coliform SM 9222D MF <1 Colonies/100mL 11/02/2020 Nitrate Nitrogen (Calc) Nitrite Nitrogen EPA 3532 0.02 mg/L 11/02/2020 Nitrate+Nitrite-Nitrogen EPA353.2 0.13mg/L 11/03/2020 Nitrate Nitrogen Subtraction Method 0.11 mg/L 11/09/2020 Report #:: 2020-18581 Page 1 of 9 F"I'07 —. -"47 LL • i isri ANALYTICAL & CONSULTING CHEMISTS Environmental Chemists, Inc. 6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax 710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax 255-A Wilmington Highway, Jacksonville, NC 28540 + 910.347.5843 Lab/Fax info@a environmentalchemists. com CWS - Hampstead 130 Fairway Dr Hampstead NC 28443 Attention: Date of Report: Nov 13, 2020 Customer PO #: Customer ID: 08100029 Report #: 2020-18581 Project ID: Belvedere Monitoring Wells Lab ID Sample ID: Collect Date/Time Matrix Sampled by 20-47304 Site: MW-8 11/2/2020 11:00 AM Water Mike Miracle Test Method Results Date Analyzed Color Color Tan 11/02/2020 Depth to water, ft. Depth to water, Ft. 8.0 feet 11/02/2020 Ammonia Nitrogen EPA350.1 <0.2mg/L 11/05/2020 Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 11/02/2020 Odor Qualitative None 11/02/2020 Total Dissolved Solids (TDS) SM 2540 C 239 mg/L 11/03/2020 Temperature SM 2550 B 22.9 C 11/02/2020 Chloride SM 4500 Cl E 8 mg/L 11/09/2020 pH SM 4500 H B 6.4 units 11/02/2020 Total Phosphorus SM 4500 P F 3.04 mg/L 11 /11 /2020 Fecal Coliform SM 92220 MF <1 Colonies/100mL 11/02/2020 Nitrate Nitrogen (Calc) Nitrite Nitrogen EPA 353.2 < 0.02 mg/L 11/02/2020 Nitrate+Nitrite-Nitrogen EPA353.2 0.60mg/L 11/03/2020 Nitrate Nitrogen Subtraction Method 0.60 mg/L 11/09/2020 Report #. 2020-18581 Page 2 of 9 Environmental Chemists, Inc. envirochem6602 Windmill Way, Wilmington, NC 28405 + 910.392.0223 Lab • 910.392.4424 Fax 710 Bowsertown Road, Manteo, NC 27954 + 252.473.5702 Lab/Fax 255-A Wilmington Highway, Jacksonville, NC 28540 t 910.347.5843 Lab/Fax ANALYTICAL & CONSULTING CHEMISTS infoiilenvironmentalchemists.com CWS - Hampstead Date of Report: Nov 13, 2020 130 Fairway Dr Customer PO #: Hampstead NC 28443 Customer ID: 08100029 Attention: Report #: 2020-18581 Project ID: Belvedere Monitoring Wells Lab ID Sample ID: Collect Date/Time Matrix Sampled by 20-47305 Site: MW-9 11/2/2020 10:20 AM Water Mike Miracle Test Method Results Date Analyzed Color Color Tan 11/02/2020 Depth to water, ft. Depth to water, Ft. 15.3 feet 11/02/2020 Ammonia Nitrogen EPA350.1 <0.2mg/L 11/05/2020 Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 11/02/2020 Odor Qualitative Norte 11/02/2020 Total Dissolved Solids (TDS) SM 2540 C 160 mg/L 11/03/2020 Temperature SM 2550 B 20.9 C 11/02/2020 Chloride SM 4500 Cl E 54 mg/L 11/09/2020 pH SM 4500 H B 6.2 units 11/02/2020 Total Phosphorus SM 4500 P F 1.45 mg/L 11 /06/2020 Fecal Coliform SM 9222D MF <1 Colonies/100ml- 11/02/2020 Nitrate Nitrogen (Calc) Nitrite Nitrogen EPA 353.2 < 0.02 mg/L 11/02/2020 Nitrate+Nitrite-Nitrogen EPA353.2 0.30mg/L 11/03/2020 Nitrate Nitrogen Subtraction Method 0.30 mg/L 11/09/2020 Report #:: 2020-18581 Page 3 of 9 ,envirochem ANALYTICAL & CONSULTING CHEMISTS Environmental Chemists, Inc. 6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax 710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax 255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax info(aenviro nmen talchemists.com CWS - Hampstead Date of Report: Nov 13, 2020 130 Fairway Dr Customer PO #: Hampstead NC 28443 Customer ID: 08100029 Attention: Report #: 2020-18581 Project ID: Belvedere Monitoring Wells Lab ID Sample ID: Collect Date/Time Matrix Sampled by 20-47306 Site: MW-10 11/2/2020 10:00 AM Water Mike Miracle Test Method Results Date Analyzed Color color Tan 11/02/2020 Depth to water, ft. Depth to water, Ft. 4.0 feet 11/02/2020 Ammonia Nitrogen EPA350.1 < 0.2 mg/L 11/05/2020 Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 11/02/2020 Odor Qualitative None 11/02/2020 Total Dissolved Solids (TDS) SM 2540 C 98 mg/L 11 /03/2020 Temperature SM 2550 B 25.0 C 11/02/2020 Chloride SM 4500 Cl E 10 mg/L 11 /09/2020 pH SM 4500 H B 6.1 units 11/02/2020 Total Phosphorus SM 4500 P F 2.76 mg/L 11 /06/2020 Fecal Coliform SM 9222D MF 4 Colonies/100mL 11/02/2020 Nitrate Nitrogen (Calc) Nitrite Nitrogen EPA353.2 < 0.02 mg/L 11/02/2020 Nitrate+ N itrite-N itrogen EPA 353.2 3.64 mg/L 11/04/2020 Nitrate Nitrogen Subtraction Method 3.64 mg/L 11/09/2020 Report #. 2020-18581 Page 4 of 9 SM ANALYTICAL & CONSULTING CHEMISTS r- - - 7 -, -,"7 Environmental Chemists, Inc. 6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax 710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax 255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347,5943 Lab/Fax info@environmentalchemists.com CWS - Hampstead 130 Fairway Dr Hampstead NC 28443 Attention: Date of Report: Nov 13, 2020 Customer PO #: Customer ID: 08100029 Report #: 2020-18581 Project ID: Belvedere Monitoring Wells Lab ID Sample ID: Collect Date/Time Matrix Sampled by 20-47309 Site: MW-11 11/2/2020 12:05 PM Water Mike Miracle Test Method Results Date Analyzed Color Color Tan 11/02/2020 Depth to water, ft. Depth to Water, Ft. 13.8 feet 11/02/2020 Ammonia Nitrogen EPA 350.1 < 0.2 mg/L 11/05/2020 Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 11/02/2020 Odor Qualitative None 11/02/2020 Total Dissolved Solids (TDS) SM 2540 C 26 mg1L 11/03/2020 Temperature SM 2550 B 21.2 C 11/02/2020 Chloride SM 4500 Cl E 14 mg/L 11/09/2020 pH SM 4500 H B 4.5 units 11/02/2020 Total Phosphorus SM 4500 P F 0.29 mg/L 11/06/2020 Fecal Coliform SM 9222D MF <1 Colonies/100mL 11/02/2020 Nitrate Nitrogen (Cale) Nitrite Nitrogen EPA 353.2 < 0.02 mg/L 11/02/2020 Nitrate+Nitrite-Nitrogen EPA 353.2 0.05 mg/L 11/03/2020 Nitrate Nitrogen Subtraction Method 0.05 mg/L 11/09/2020 Report #:: 2020-18581 Page 5 of 9 [envirochem ANALYTICAL & CONSULTING CHEMISTS Environmental Chemists, Inc. 6602 Windmill Way, Wilmington, NC 28405 * 910.392.0223 Lab * 910.392.4424 Fax 710 Bowsertown Road, Manteo, NC 27954 * 252.473,5702 Lab/Fax 255-A Wilmington Highway, Jacksonville, NC 28540 * 910.347.5843 Lab/Fax infaa environmentalchemists.com CWS - Hampstead Date of Report: Nov 13, 2020 130 Fairway Dr Customer PO #: Hampstead NC 28443 Customer ID: 08100029 Attention: Report #: 2020-18581 Project ID: Belvedere Monitoring Wells Lab ID Sample ID: Collect Date/Time Matrix Sampled by 20-47310 Site: MW-12 11/2/2020 11:28 AM Water Mike Miracle Test Method Results Date Analyzed Color Color Tan 11/02/2020 Depth to water, ft. Depth to water, Ft, 10.7 feet 11/02/2020 Ammonia Nitrogen EPA350.1 0.3mg/L 11/05/2020 Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 11/02/2020 Odor Qualitative Slight 11/02/2020 Total Dissolved Solids (TDS) SM 2540 C 118 mg/L 11/03/2020 Temperature SM 2550 B 21.5 C 11/02/2020 Chloride SM 4500 Cl E 42 mg/L 11/09/2020 pH SM 4500 H 8 5.4 units 11/02/2020 Total Phosphorus SM 4500 P F 0.93 mg/L 11/06/2020 Fecal Coliform 5M 9222D MF <1 Colonies/100mL 11/02/2020 Nitrate Nitrogen (Caic) Nitrite Nitrogen EPA 353.2 < 0.02 mg/L 11/02/2020 Nitrate+Nitrite-Nitrogen EPA353.2 0.07mg/L 11/03/2020 Nitrate Nitrogen Subtraction Method 0.07 mg/L 11/09/2020 Report #:: 2020-18581 Page 6 of 9 ANALYTICAL & CONSULTING CHEMISTS row"' -- -77 Environmental Chemists, Inc. 6602 Windmill Way, Wilmington, NC 28405 * 910.392.0223 Lab • 910.392.4424 Fax 710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax 255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax info(aenvironmentalchemists.com CWS - Hampstead 130 Fairway Dr Hampstead NC 28443 Attention: Date of Report: Nov 13, 2020 Customer PO #: Customer ID: 08100029 Report #: 2020-18581 Project ID: Belvedere Monitoring Wells Lab ID Sample ID: Collect Date/Time Matrix Sampled by 20-47311 Site: MW-13 11/2/2020 12:38 PM Water Mike Miracle Test Method Results Date Analyzed Color color Lt. Brown 11/02/2020 Depth to water, ft. Depth to water, Ft. 14.4 feet 11/02/2020 Ammonia Nitrogen EPA 350.1 < 0.2 mg/L 11 /05/2020 Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 11/02/2020 Odor Qualitative None 11/02/2020 Total Dissolved Solids (TDS) SM 2540 C 25 mg/L 11 /03/2020 Temperature SM 2550 B 21.6 C 11/02/2020 Chloride SM 4500 Cl E 5 mg/L 11 /09/2020 pH SM 4500 H B 4.7 units 11/02/2020 Total Phosphorus SM 4500 P F 1.13 mg/L 11/06/2020 Fecal Coliform SM 9222D MF <1 Colonies/100ml- 11/02/2020 Nitrate Nitrogen (Calc) Nitrite Nitrogen EPA353.2 < 0.02mg/L 11/02/2020 Nitrate+Nitrite-Nitrogen EPA353.2 0.02mg/L 11/03/2020 Nitrate Nitrogen Subtraction Method 0.02 mg/L 11/09/2020 Report #: 2020-18581 Page 7 of 9 enviroehem ANALYTICAL & CONSULTING CHEMISTS Environmental Chemists, Inc. 6602 Windmill Way, Wilmington, NC 28405 a 910.392.0223 Lab • 910.392.4424 Fax 710 Bowsertown Road, Manteo, NC 27954 + 252.473,5702 L,ab/Pax 255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax info(i�environmentalchemists.com CWS - Hampstead Date of Report: Nov 13, 2020 130 Fairway Dr Customer PO #: Hampstead NC 28443 Customer ID: 08100029 Attention: Report #: 2020-18581 Project ID: Belvedere Monitoring Wells Lab ID Sample ID: Collect Date/Time Matrix Sampled by 20-47312 Site: MW-14 11/2/2020 11:48 AM Water Mike Miracle Test Method Results Date Analyzed Color Color Tan 11/02/2020 Depth to water, ft. Depth to water, Ft. 12.8 feet 11/02/2020 Ammonia Nitrogen EPA 350.1 0.3 mg/L 11/05/2020 Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 11/02/2020 Odor Qualitative Slight 11/02/2020 Total Dissolved Solids (TDS) SM 2540 C 110 mg/L 11/03/2020 Temperature SM 2550 B 23.1 C 11/02/2020 Chloride SM4500CIE 20mg/L 11/09/2020 pH SM 4500 H B 5.4 units 11/02/2020 Total Phosphorus SM 4500 P F 0.58 mg/L 11/06/2020 Fecal Coliform SM 9222D MF <1 Colonies/100mL 11/02/2020 Nitrate Nitrogen (Calc) Nitrite Nitrogen EPA353.2 < 0.02 mg/L 11/02/2020 Nitrate+Nitrite-Nitrogen EPA 353.2 0.04 mg/L 11/03/2020 Nitrate Nitrogen Subtraction Method 0.04mg/L 11/09/2020 Report #, 2020-18581 Page B of 9 :envirochem ANALYTICAL & CONSULTING CHEMISTS Environmental Chemists, Inc. 6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax 710 Bowsertown Road, Manteo, NC 27954 * 252.473.5702 Lab/Fax 255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax infotaenvironmentalchemists.com CWS - Hampstead 130 Fairway Dr Hampstead NC 28443 Attention: Date of Report: Nov 13, 2020 Customer PO #: Customer ID: 08100029 Report #: 2020-18581 Project ID: Belvedere Monitoring Wells Lab ID Sample ID: Collect Date/Time Matrix Sampled by 20-47313 Site: mw-15 11/2/2020 12:22 PM Water Mike Miracle Test Method Results Date Analyzed Color Color Lt. Brown 11/02/2020 Depth to water, ft. Depth to water, Ft. 12.7 feet 11/02/2020 Ammonia Nitrogen EPA 350.1 < 0.2 mg/L 11/05/2020 Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 11/02/2020 Odor Qualitative None 11/02/2020 Total Dissolved Solids (TDS) SM 2540 c 42 mg/L 11 /03/2020 Temperature SM 2550 8 21.8 C 11/02/2020 Chloride SM 4500 Cl E 12 mg/L 11 /09/2020 pH SM 4500 H B 4.5 units 11/02/2020 Total Phosphorus SM 4500 P F 0.86 mg/L 11/06/2020 Fecal Coliform SM 9222D MF <1 Colonies/100mL 11/02/2020 Nitrate Nitrogen (Calc) Nitrite Nitrogen EPA 353.2 < 0.02 mg/L 11/02/2020 Nitrate+Nitrite-Nitrogen EPA353.2 0.02mg/L 11/03/2020 Nitrate Nitrogen Subtraction Method 0.02 mg/L 11/09/2020 Comment: ��L Reviewed by: Report #:. 2020-18581 Page 9 of 9 Date: / /--0 a Analyst: l� lilt ��` Facility lame: rim i('/f Permit #: PH Reference Method. S104500 11+8 -2011 Instrument ID Calibration Time Cal Buffer 4,0 s.u. Cal Buffer 10,0 s u Check Buffer 7 0 s.u. Comments 'pH check buffer must read within t 0 1 pH units of the buffer's true value 4 su buffer Lot#/: Ricca 2001520 Exo 1/2022 7 su buffer Lodt?: Ricca 2008993 Exp, 7/2022 10 su buffer Lodi: Ricca 1001791 7/2021 Sample location Sample Collection Ttme• Sample Analysis Time* pH Result s u ► Post -analysis Buffer J Check value s.u. CommentslData Qualifiers //le/ .5" y !✓t / 1 5 y IZ12 Z I Zz.- /Oyo/3 ► Post analysis buffer check is required when performing analyses at multiple sampling locations and must be within f 0.1 units of the buffer's true value All pH values in pH units (ix, s u ) Record all data to the nearest 0 01 s u and report to the nearest 0.1 s.u. Total Residual Chlorine (TRC) Reference Method, SM 4500 CI-G2011. Hach 8167 HR ( Please circle applicable Method Instrument.ID Daily Check Post -analysis Time check Sample Sample Standard Result Check Sid Standard Sample Collection Analysis TRC Result Comments/Data Qualifiers µg'L, o: mgrl hen analyzing Analyzed Location Time Time µgo or mg L at multiple at multi le sites) TRC Daily Check Standard true value µg/L or mg/L acceptance range `__,...,..-,......_.__µg/L or mgfL Check standards must recover -.cithin = 10%of the check standard's true value Annual Calibration Curve Verification Date: LOT !t _ Exp. Date: Reagent Blank Value: (When applicable. Analyze and document a reagent blank when standards, sample dilutions or PT Samples are prepared) Dissolved Oxygen (DO) Reference Method SM 4500 O G,-201 1 Instrument ID. Calibration/ Verification Time Calibration vanable Meter reading or % efficiency after calibration • Post -analysis calibration verification (when necessary) Comments Temperature Barometric pressure Theoretical Value m rL Calculated Value m L Use this row when performing a verification instead of 'n Sample Location Sample Collection Time *Sample Analysis Time DO reading m Comments Data Qualifiers • When performing analyses at multiple locations, the meter must be recalibrated at each site before analysis or a post -analysis calibration verification must be performed ' If sample is measured directly in the stream andr'or onsite, only time analyzed would be recorded with a note that they are measured in situ or immediately Temperature 1 Reference Method SM 2550 B-2010 Instrument ID.f l (- �js/ iJ 'r(/V Sample Location Sample Collection Time 'Sample Analysis Time Temperature °C Comments/Data Qualifiers %L- Zf/ /417 //yY 2 2— " i ZZtd ZLL Z/. *"Ifsample is measured directly in the stream and/or on site, only time analyzed would be recorded, with a note that they are measured in situ or immediately Annual Verification Date 1- 202 ;t Field Personnel Note: QA.001 Rev 9-2020 Date:—Z'L Facility Name: Ce ifrcation ��._,..._ ' i �.�/ 71.� 1 1 Analyst: w Permit #: q jj Reference Method. �S 14500 H+B -201 I Instrument to �� Calibration Time Cal Buffer 4.0 s.u. Cal Buffer 10.0 s.0 Check Buffer 7.0 s.u. Comments 'pH check buffer must read within ± 0,1 pH units of the buffer's true value. 4 su buffer Lot#/: Ricca 2001820 Exo 1/2022 7 su buffer Lot#/: Ricca 2008993 Exp. 72022 10 su buffer Lot#: Ricca 1001791 7/2021 Sample location P Sample Collection Time♦ Sample Analysis Ti me• pH Result s,u ► Post -analysis Buffer Check value s.u. ,-mments/Data Qualifiers It�J L Q ► Post analysis buffer check is required when performing analyses at multiple sampling locations and must be within t 0.1 units of the buffer's true value All pH values in pH units (i.e , s.u.) Record all data to the nearest 0.01 s.u. and report to the nearest 0.1 s.u. Total Residual Chlorine (TRC) Reference Method: SM 4500 CI-G2011: Hach 8167 HR ( Please circle am ilicable Method Instrument II) Daily Check Post -analysis Check Std. Time check Sample Sample Sample TRC Result s Standard Result (when analyzing Standard Location Collection Analysis µgm or mgrL r Comments/Data Qualifiers µ g.'L or mg/L at multiple sites) Analyzed Time Time TRC Daily Check Standard true value µg/L or mg/L acceptance range_ µg/L or mgll., Check standards must recover within * 10% of the check standard's true value Annual Calibration Curve Verification Date: LOT # Exp. Date: Reagent Blank Value: (When applicable. Analyze and document a reagent blank when standards, sample dilutions or PT Samples are prepared) Dissolved Oxygen (DO) Referenre Methnd•RM 41nn n r. -mi i incrniment 1171• Calibration/ Verification Time Calibration variable Meer reading or %efficiency after calibration • Post -analysis calibration verification (when necessary) Comments Temperature Barometric ressure Theoretical Value m /L Calculated Value ma/L Use this row when performing a verification instead of calibration Sample Location Sample Collection Time 'Sample Anal}sis Time DO reading m Comments/Data Qualifiers ♦ When performing analyses at multiple locations, the meter must be recalibrated at each site before analysis or a post -analysis calibration verification must be performed ' if sample is measured directly in the stream and/or onsite, only time analyzed would be recorded with a note that they are measured in situ or immediately Temperature � �� 0 10 Referenre Methnd SM 255n R.?(11 n m Instment trS• Aittt Y/fl` Sample -Sample Temperature i 5amplc Location Collection Analysis C Comments/Data Qualifiers Time Time i�tw aY' dl d ' If sample is measured directly in the stream and/or on site, only time analyzed would be recorded, with a note that they are measured in situ or immediately Annual Verification Date 1—Zo20 Field Personnel Vote: QA.001 Rev 9-2020 Environmental Chemist, Inc., Wilmington, NC Lab #94 6602 Windmill Way Wilmington, NC 28405 910.392.0223 Sample Receipt Checklist Client: N.A),5 _ Date: 1 l Z 1/Report Number: Receipt ofsamole: ECHEM Pickup Client ftplivpry ❑ fliPs ❑ FPr y r-1 Atha' n ❑ YES 10 NO N/A 11. Were custody seals present on the cooler? ❑ YES ❑ NO I tq N/A 12. if custody seals were present, were they intact/unbroken? Original temperature upon receipt �_°C Corrected temperature upon receipt °C How temperature taken: ❑ Temperature Blank Against Bottles IR Gun ID: Thomas Traceable S/N 192511657 iR Gun Correction Factor °C: 0.0 ❑ YES ID NO 3. If temperature of cooler exceeded 6°C, was Project Mgr./QA notified? YES 113 NO 4. Were proper custody procedures (relinquished/received) followed? y� Tr.3 u iuv I n. were sampie lu-s iisteo on the COC? YES ❑ NO 6. Were samples ID's listed on sample containers? YES ❑ NO 7. Were collection date and time listed on the COC? YES ❑ NO 8. Were tests to be performed listed on the COC? YES ❑ NO 9. Did samples arrive in proper containers for each test? I5i( YES 10 NO 10. Did samples arrive in good condition for each test? YES 10 NO 11. Was adequate sample volume available?' LW YES I ❑ NO 12. Were samples received within proper holding time for requested tests? YES 10 NO 113, Were acid preserved samples received at a pH of <2? ❑ YES I0 NO 114. Were cyanide samples received at a pH >12? YES 10 NO 115. Were sulfide samples received at a pH >9? YES ❑ NO 16. Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L? ** YES ❑ NO 17. Were Sulfide/Cyanide received at a chlorine residual of <0.5 m/L? 13 YES ❑ NO 118. Were orthophosphate samples filtered in the field within 15 minutes? * TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet. ** Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet. Sample Preservation: Sample(s) by adding (circle one): Time of preservation: (Must be completed for any sample(s) incorrectly preserved or with headspace) were received incorrectly preserved and were adjusted accordingly H2SO4 HNO3 HCl NaOH If more than one preservative is needed, notate in comments below kNote: Notify customer service immediately for incorrectly preserved samples. Obtain a new sample or fy the state lab if directed to analyzed by the customer, Who was notified, date and time: atiles Sample(s) were received with headspace COMMENTS: DOC, QA.002 Rev 1 6602 Windmill Way Wilmington, NC 28406 ENVIRONMENTAL CHEMISTS, INC OFFICE: 910-392-0223 FAX 910-392-4424 Analytical & Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: OLS CERTIFICATION # 37729 lnfo@environmentalchomists.com COLLECTION AND CHAIN OF PU Y DTQ4 CLIENT: CWS-Hampstead PROJECT NAME: Belvedere REPORT NO: "?, dZ0 — ADDRESS: CONTACT NAME: Greg Spillman PO NO: REPORT TO: PHONEIFAX: ICOPY TO: lemail: Sampled By:___ 7;f, SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other: Sample Identification Collection CL E CL '0 1! *a - 9 0 0 M 421 E z PRESERVATION ANALYSIS REQUESTED Date Time Temp z Wi3 0 z a o o j.- w 0 Well:, C P x Chloride, TDS, NO2 G Depth to water: C -G P x NO3, NH3, Total P G --j G G pH (Field )7 -7 Cl X Fecal G G Gallons Bailed: P G G Odor: C P G G Color: -74-rli G P G G C I P G G C P G G C P G G Total of 9 wells (7,8,9,10,11,12,13,14,15) Due March, July, November Transfer Relinquished By: Date/Time Received By: Date/Time 1. 2. Temperature when Received *C: —Accepted: I-' Rejected: Remarrift 5equested: Delivered By:_,-" Received BY: Date: 1 12,12-0 Time: Comments- TURNAROUND: 6602 WindilWay Wilmington, NC ENVIRONMENTAL CHEMISTS, INC OFFICE: 91m0-1 392-0223 FAX 910-392-442428406 Analytical & Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS., DLS CERTIFICATION # 37729 lnfo@environmentalchomists.com COLLECTION AND CHAIN OF CUSTODY CLIENT: CWS-Hampstead 111W -11 PROJECT NAME: Belvedere AAACM44gb S REPORT NO: 0 -91 ADDRESS: CONTACT NAME: Greg Spillman PO NO: REPORT TO:PHONE/FAX: COPY TO: lemail: bampiec 406e t -T SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other: Sample Identification Collection E vi E 0 0 t; 6 E z PRESERVATION ANALYSIS REQUESTED Date Time Temp z x 0 Uj 0 Well: -?9' A C P 1,3(JY x 4 x Chloride, TDS, NO2 NO3, NH3, Total P /Z z - w -/7,! g-0 G I C G G P G Depth to water: pH (Field): Gallons Bailed: Odor: zf-c111 Color: C P x Fecal G C G P G C G P G C G P G G C P G G C P G C P IG G G Total of 9 wells (7,8,9,10,11,12,13,14,16) Due March, July, November Transfer Relinquished By: Date/Time Received By: Date/Time 1. 2. Temperature when Received *C: I - I Accepted: k-1 Delivered By: F, ex Received By: Time: Comments: t TURNAROUND: 4=P ENVIRONMENTAL CHEMISTS, INC Analytical & Consulting Chemists NCDENR: DWO CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 COLLECTION AND CHAIN OF CUSTODY ,-z, 6602 Windmill Way Wilmington, NC 28405 OFFICE: 910-392-0223 FAX 910-392-4424 lnfo@environmentalchomists.com CLIENT: CWS-Hampstead _ PROJECT NAME: Belvedere REPORT NO: ADDRESS: CONTACT NAME: Greg Spillman PO NO: REPORT TO: PHONE/FAX: COPY TO: email: Sarnoled Bv: Alike SAMPLE TYPE: I = Influent E = Efftuont W a Wall AT = Ctrn2m cn = Cnil C! a QIvarl..a nth— Sample Identification P Collecti-o-nr m E, ®� r o P e c o a _ 0 E " w m g? Z PRESERVATION ANALYSIS REQUESTED Date i Time Temp o Z $ _= a a Z o W o Well: De th to water: j� C P '� 4 X L X Z, Chloride, TDS, NO2 i NM NFi3, Total P z- l Z G C G P G G N (Field): X Fecal G G Gallons Bailed: !j C P G G Odor: do C P G G Color: 4 C P G G G G C P - i i G G C P^....' i I G G Total of 9 welts (7,8,9,10,11,12,13,14,15) Due March, July, November Transfer Relinquished By: Date/Time Received By: Date/Time 1. 2. Temperature when Received °C: Accepted: Rejected: Resan Delivered By: C Received By: &27 Date:. Comments Time: 4=w ngton ENVIRONMENTAL CHEMISTS, INC 6602 I E:910-3 2-02231FiAX910-392-4424 5 Analytical & Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 info@environmenhalchemista.com COLLECTION AND CHAIN OFrelLIU01DY CLIENT: CWS-Hampstead PROJECT NAME: Belvedere REPORT NO. - f ADDRESS: CONTACT NAME: Greg Spillman PO NO: REPORT TO: PHONE/FAX: COPY TO: email: Sampled By: --_--/4e SAMPLE TYPE: I = Influent E = Effluent W = Wall. ST = Stream_ SC) = Snii SI = Sh idge nthpr• Sample Identification Collection A o a c a s U `" a " E o m 5'z PRESERVATION ANALYSIS REQUESTED �— Date Time Temp _ i = = o i c Q 5 c 3 Well: .9 /Q Dept to water: l .ZS , l/ ° C I P •� 1 U ' X le X w I Chloride, TDS, NO2 I NO3, NH3, Total P, I - �la G C G P G G H (Field): . /L�44— C P X Fecal G G Gallons Bailed: �a� C P G G Odor: -/ G G Color: C P G G C P I f G G G G G G Total of 9 wells (7,8,9,10,11,12,13,14,15) Due March, July, November Transfer Relinquished By: Date/Time Received By: Date/Time 12. i erhperature when rceceivea -c::1 Accepted: k' Rejected: Resam�;1 R guested: Delivered By: C.a' Received By: Date: " Z. 2-0 Time: Comments: TURNAROUND: ENVIRONMENTAL CHEMISTS, I N C OFFICE: 910'392 23 F'AX ngton910-3 2-44248 Analytical &Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 info@environmentalchemists.com COLLECTION AND CHAIN OF CUSTODY CLIENT: CWS-Ham stead PROJECT NAME: Belvedere WWTF-Hi h Rate Wells REPORT N04v -• 8 1 ADDRESS: CONTACT NAME: Greg Spillman PO NO: REPORT TO: PHONEIFAX: COPY TO: email: Sampled By: j rC SAMPLE TYPE: i = Influent. E = Effluent. W = Well. ST = Stream_ SO = Sail- St_ = Siudap_ Other - Sample Identification Collection m E ~ w a o e e 0 ��^ a g c o � o m " E pW m i PRESERVATION T ANALYSIS REQUESTED Date Time Temp _ z + «, p x p a w Well: ��// G/•Z C P �� X Chloride, TDS, NO2 - �ZG G G Depth to water: C P 'S � X N.03, NH3, Total P G G H (Field): `7 Li % C P X Fecal G G Gallons Bailed: Odor: py4f' i C P G G G G Color: m� C P G G C P G G C P G G C I P m�mmmm G G Total of 9 wells (7,8,9,10,11,12,13,14,16) Due March, July, November Transfer Relinquished By: Date/Time Received By: DatelTime 1. 12. i emperature wnen meceivea -t.: I . # RCcepted:�-- rejected: Resampl Requested: Delivered By: Received By: Date: _ Date: l Titi Time: Comments: TURNAROUND: 4=w ENVIRONMENTAL CHEMISTS, INC Analytical & Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 COLLECTION AND CHAIN OF CUSTODY 6602 Windmill Way Wilmington, NC 28406 OFFICE: 910-392-0223 FAX 910-392-4424 info@environmentatchemists.com CLIENT: CWS-Hampstead PROJECT NAME: Belvedere WWTF-Hi h Rate Wells REPORT NO: 620 -1 — I ADDRESS: CONTACT NAME: Greg Spillman PO NO: REPORT TO: PHONEIFAX: COPY TO: email: sam lea t3 : +' Zr SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other: --- Collection = I � a PRESERVATION z g c o w Sample Identification E$ o $ a c E g'z ANALYSIS REQUESTED i Date Time Tem " $ _ x $ o C P Well: 15)o X Chloride, TDS, NO2 G G Depth to Water: ZZZ" Z./, 5 C P 'S X NO3, NH3, Total P G I C G P G H (Field): x Fecal C P G C G P Gallons Bailed: I I Odor: G G Color: G G ' G G G G G G Total of 9 wells (7,8,9,10,11,12,13,14,15) Due March, July, November Transfer Relinquished By: Date/Time Received By: _ Date/Tim12. Temperature when Received °C: I Accepted: Rejected: Resample Requested: Delivered By: Received By: ,Date: Il Time: Comments: I TURNAROUND: • Analytical & Consulting Chemists ENVIRONMENTAL. CHEMISTS, INC NCDENR: DWO CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 COLLECTION AND CHAIN OF CUSTODY 6602 Windmill Way Wilmington, NC 28405 OFFICE: 910-392-0223 FAX 910-392-4424 info@environmentalchemists.com CLIENT: CWS-Hampstead PROJECT NAME: Belvedere WWTF-Hi h Rate Wells REPORT NO: ADDRESS: CONTACT NAME: Greg Spillman PO NO: REPORT TO: PHONEIFAX: COPY TO: email: Sampled Bv: / /�"4G SAMPLE TYPE: I = Influent_ E = Effluent_ W = Well_ ST = Stream_ SO = Snit SI = ,gInd a other - Sample Identification Collection .. .,,,.__.. m � o m _ o C J .2£ a w z PRESERVATION ANALYSIS REQUESTED Date Time Tempa z 3 o o Welt%.3 C P X Chloride, TDS, NO2 -Z d L� G G1 Depth to water: / 7 C P X a- NO3, NH3, Total P G G H (Field): L�IV C P 9 X Fecal G G r. Gallons Bailed: S C P� G I G Odor: yrl t° C P I G O Color: i G G G G G C G P G G Total of 9 wells (7,8,9,10,11,12,13,14,15) Duo March, July, November Transfer Relinquished By: Date/Time Received By: Date/Time 1. 2. i emperature wnen rceceiveo '%-;: l • i Acceptea:I,-_ , Rejected: Resa le equested: Delivered B �C.� Received By:,�� Y� Date: Time: Comments: TURNAROUND: ENVIRONMENTAL CHEMISTS, INC Analytical & Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 COLLECTION AND CHAIN OF CUSTODY 6602 Windmill Way Wilmington, NC 28405 OFFICE: 910-392-0223 FAX 910-392.4424 lnfo@environmentaichemists.com CLIENT: CWS_Hampstead� PROJECT NAME: Belvedere WWTF-High Rate Wells REPORT NO: U-- ADDRESS- CONTACT NAME: Greg Spillman PO NO: REPORT TO: PHONE/FAX: COPY TO: email: l Sam iett ti` l rtr is r - -�v SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other: Sample Identification Collection E g.£ o _ =c� a i; = a ` o L E " c m g= = PRESERVATION ANALYSIS REQUESTED Date Time Temp' a Z "_ o 0 _ o a w c Well: ;01-1 ZZI C P I X Chloride, TDS, NO2 G G Depth to water: C P X NO3, NH3, Total P G G H (Field): Gailons Bailed: .-� X Fecal = G C G P G G Odor: �// C P w_ G G Color: cr G G C P G G_ C P G G C P _ G G Total of 9 wells (7,8,9,10,11,12,13,14,15) Due March, July, November Transfer Relinquished By: DateiTime Received B : DatefTime . 2. Temperature when Received -C: I • I Accepted:y Delivered By: ez Received By: Comments: Time: TURNAROUND: 4=P ENVIRONMENTAL CHEMISTS, INC OFFICE: 910-3 2-023FIAX910-392-4424 Analytical &Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 info@environmentalchemists.com COLLECTION AND CHAIN OF CUSTODY CLIENT: CWS-Ham stead PROJECT NAME: Belvedere WWTF-Hi h Rate Wells REPORT NO: 0 — S ADDRESS: CONTACT NAME: Greg Spillman PO NO: REPORT TO: PHONE/FAX: COPY TO: email: . SarnDled Bv: / 1 `t1 SAMPLE TYPE: I = Influent. E = Effluent, W = Well. ST = Stream. SO = Soil. SL = Sludoe. Other: Sample Identification Collection M a I `o m _ cU' `o U a m c t " a 2w m g g Z PRESERVATION ANALYSIS REQUESTED Date Time r Temp i $ _ $ _ o _ 0 _ 0 o Well: / Zr C P 41 X Chloride, TDS, NO2 - Q y G Get. Depth to water: /S �� C P •, X NO3, NH3, Total P G G H (Field): 5l% C P X Fecal G G Gallons Bailed: C P G G Odor: aN C P G G l Color: % �/ C P G G C P G G C P G G C P G G Total of 9 wells (7,8,9,10,11,12,13,14,15) Due March, July, November Transfer Relinquished By: Date/Time Received By: Datefrime 1. 2. Temperature when Received °C: (• I Accepted:' Rejected: Resamj4e equested: Delivered By: 2—, 8 P— Received By: Date:l Time: Comments: TURNAROUND: