WQ0000795_Monitoring - 07-2021_20210816 (2)

DWR - NonDischarge Monitoring Report Submittal y
NORTH CAROLINA
Ertrlranmerttat Qieaffty
Monitoring Report Submittal
..............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Permit Number#* WQ0000795
Name of Facility:* Surf City WWTF
Month:* July Year:* 2021
Report Information
Type* Upload Document*
GW-59 July 2021 GW-59 pdf.pdf 6.36MB
FDF Only
NDMR, NDAR-1, NDAR-2, NDMLR July 2021 NDMR pdf.pdf 2.58MB
FDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR,GW-59).
Confirmation Email Address:* [e-mail]
Name of Submitter:* Zachary C Butler
Signature:
y 6) e
Date of submittal: 8/16/2021
This will be filled in autorratically
Initial Review

Reviewer: Mokashi, Poorva
Is the project number correct?* WQ0000795
Is the monitoring report ( Yes r No
accepted?*
Regional Office* Wilmington
Accepted Date: 8/30/2021

SUBMIT FORM ON YELLOW PAPER ONLY
i at orlgina DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
t0: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
and 1 copy 1617 MAIL SERVICE CENTER,RALEIGH,NC 27899-1617 Phone:[phone]
COMPLIANCE REPORT FORM Please Print Clearly or Type PERMIT Number: Expiration Date: 2/28/22
FACILITY INFORMATION Non-Discharge wQ0000795 UIC
Facility Name: Surf City W.W.T.P. NPDES Other
Permit Name(if different): TYPE OF PERMITTED OPERATION BEING MONITORED
Facility Address: P.O.BOx 2475 ❑ Lagoon ❑Remediation: Infiltration Gallery
Surf City NC 28445 County Onslow 0 Spray Field 0 Remediation:
Zachary Butler Telephone#:
910-329-1011 ❑ Rotary Distributor El Land Application of Sludge
Contact Person: 1 ❑ Water Source Heat Pump ❑Other: _
No.of wells to be sampled:
Well Location/Site Name:30 Acre Storage Pond from Permit) If WELL
SAMPLING INFORMATION WAS
WELL ID NUMBER(from Permit): PZ-16 Date sample collected: 7/15/21 FIELD ANALYSES: °C DRY at
Well Diameter: 2 in. pH 00400: units Temp.00010: time a
Well Depth: 25 ft. 25 ft. Spec.Cond. 0oosa: µMhos sampling,
of
Screened Interval: 10 ft. to check
Depth to Water Level 82546:12.1 ft.below measuring point Relative M.P.Elevation: ft. Odor 000s5:
Measuring Point is 2 ft. above land surface here:❑
Volume of water pumped/bailed before sampling: gallons Appearance
Samples for metals were collected unfiltered: ❑YES 0 NO and field acidified: ❑YES 0 NO
LABORATORY INFORMATION Certification No. 94
Date sample analyzed:7/15/21 Laboratory Name: Envirochem
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations. Pb Lead o1051 ug/L
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L
Coliform: MF Fecal 31616 /100mL
Nitrate(NO3)as N 00620 mg/L Zn-Zinc o10s2 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00655 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Al-Aluminum 01105 mg/L
Dissolved Solids:Total 70300 mg/L Ba_Barium 01007 ug/L
pH(Lab)00403 units
TOC 00680 mg/L Ca-Calcium 00916 mg/L
Chloride oos40 mg/L Cd-Cadmium 01027 ug/L
Arsenic 01002 uglL Chromium:Total 01034 ug/L
Grease and nol 00552 mg/L
Cu-Copper 01042 mg/L ORGANICS:(by GC,GC/MS,HPLC)
uglt Fe-Iron 01045 uglL (Specify test and method#.ATTACH LAB REPORT.
)
Sulfate 00945 mg/L Hg-Mercury 71900 u
Phenol 32730 /L Report Attached? CI Yes(1) 0 No(0)
g Lab�
Specific Conductance mossµMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia moo m L Mg-Magnesium 00927 mg/L ,method#
,method#
(Ammonia Nitrogen;NH3es N;Ammonia Nitrogen,Total) Mn-Manganese 01055 ug/L ,method#
Ni-Nickel 01067 uglL
TKN as N 00625 mg/L m w
g/ VOC Removal%
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs:
L Effluent Total VOCs: mg/L
approved methods of analysis by a
S certify that.to the best cf my knowledge and boliel.the information submitted in!his report is true,accura'e,end complete,and that the laboratory analytical da.n was prrduced using
DWQ•cedified iabcraiory. I acre aware that there are significant penalties foi submitting false information,including the possibility of fin ^nd imprisc me.-it fr:mowing.!olatbons. 7/20/21
19 . _v
Zachary Butler ORC (Date)
Permittee(or Authorized Agent)Name and Title-Please print or type
Signett -of Per mitt:-
or Autho'zed Agent)
GW-59 Rev.2/2010 If

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 2/28/22
Facility Name: Surf City W.W.T.P. Non-Discharge WQ0000795 UIC
NPDES Other
Permit Name(if different):
Facility Address: P.O.BOx 2475 TYPE OF PERMITTED OPERATION BEING MONITORED
,-eet} NC 28445 County Onslow ❑ Lagoon CI Remediation: Infiltration Gallery
Surf City ❑Remediation:
,:,. © Spray Field
Contact Person: Zachary Butler
Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:30 Acre Storage Pond No.of wells to be sampled: a r°m Permit) ❑ Water Source Heat Pump 0 Other:
If WELL
SAMPLING INFORMATION WAS
WELL ID NUMBER(from Permit): PZ-15 Date sample collected: 7/15/21 FIELD ANALYSES: DRY at
o0400: units Temp.0o010: °C
Well Depth: 25 ft. Well Diameter: 2 in. pHµMhos time of
Depth to Water Level 8254s:16.2 ft.below measuring point Screened Interval: 10 ft. to 25 ft. Spec.Cond. 00094: sampling,
Measuring Point is
2 ft. above land surface Relative M.P.Elevation: ft. Odor 00085: check
here:❑
Volume of water pumped/bailed before sampling: gallons Appearance
Samples for metals were collected unfiltered: El YES El NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION Envirochem Certification No. 94
Date sample analyzed:7/15/21 Laboratory Name:
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations. Pb Lead 01051 ug/L
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L
)(
Coliform:MF Fecal 31616 /100mL Nitrate NO3 as N 00620 mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 mg/L
(Note Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium oo91s mg/L
Chloride 00940 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 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)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732: ,method#
mg/L Mg-Magnesium 00927 mg/L , method#
Total Ammonia ooslo g , method#
(Ammonia Nitrogen;NH3as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 ug/L
TKN as N 00625 mg/L
Ni-Nickel 01067 ug/L ,method#
/L Effluent Total VOCs: mglL VOC Removal%
For Remediation Systems Only(Attach Lab Reports): Influent Total VOCs: mg/L
I certify that,to the best of my knowledge and bet+el the information submitted in this report is true,accurate and complete.and that the laboratory analytical data was produced using approved methods of analysis eye
Dv1Q•certiEed laboratory. I am aware that there are significant Pena?ties for submitting false information includ€ng the possibility of finesand imwr,sonr*entt,?TL! Kno•w;.g sio!at�r.
j li 7/20/21
Zachary Butler ORC T l (Dat0}
Permittee(or Authorized Agent)Name and Title-Please print or type
Sign-ire of Perml or Authorized Agent)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 2/28/22
Facility Name: Surf City W.W.T.P. Non-Discharge WQ0000795 UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.BOx 2475 TYPE OF PERMITTED OPERATION BEING MONITORED
Surf City NC 28445 County Onslow ❑ Lagoon ❑Remediation: Infiltration Gallery
;c;zy, ❑■ Spray Field ❑Remediation:
Contact Person: Zachary Butler Telephone#: [phone] ❑ Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name:30 Acre Storage Pond No.of wells to be sampled: 1 0 Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): PZ-14 Date sample collected: 7/15/21 FIELD ANALYSES: WAS
25 f. Well Diameter: 2 in. pH 00400: units Temp.00010: °C DRY at
Well Depth: time of
Depth to Water Level 92546: 15.3 ft.below measuring point Screened Interval: 10 ft. to 25 ft. Spec. Cond.00094: µMhos
sampling,
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: gallons Appearance here:❑
Samples for metals were collected unfiltered: ❑YES 0 NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:7/15/21 Laboratory Name: Envirochem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N o0615 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616 /100mL Nitrate(NO3)as N ooszo mg/L Zn-Zinc o1os2 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
3issolved Solids:Total 70300 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 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 o1045 ug/L (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? 0 Yes(1) 0 No(0)
Specific Conductance 00095 Athos K-Potassium o0937 mg/L VOC 78732: ,method#
Total Ammonia 00610 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 ray 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
MO-certified laboratory. I am aware that there are significant penalties for submitting false.nformation.including the possibility of fines ar.d imprisonment for knoomg vin'.:itions.
Zachary Butler ORC /Jr wir 7/20/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signatur-r Permittee( uthorized Age ) (Date)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original:'EPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
'GROUNDWATER QUALITY MONITORING: and 1 copy to• 'VISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 2/28/22
Facility Name: Surf City W.W.T.P. Non-Discharge W00000795 UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.BOx 2475 TYPE OF PERMITTED OPERATION BEING MONITORED
Surf City Street' NC 28445 County Onslow ❑ Lagoon ❑Remediation: Infiltration Gallery
y (zip) II Spray Field ❑Remediation:
Contact Person: Zachary Butler Telephone#: [phone] ❑ Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name:30 Acre Storage Pond No.of wells to be sampled: 1 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): PZ-13 Date sample collected: 7/15/21 FIELD ANALYSES: WAS
Well Depth: 25 ft. Welt Diameter: 2 in. pH 00400: units Temp.00010: °C DRY at
Mhos time of
Depth to Water Level s25as:15.9 ft.below measuring point Screened Interval: 10 ft. to 25 ft. Spec.Cond.00094: µ sampling,
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: check
Volume of water pumped/bailed before sampling: gallons Appearance here:❑
Samples for metals were collected unfiltered: ❑YES 0 NO and field acidified: 0 YES ❑NO _
LABORATORY INFORMATION
Date sample analyzed:7/15/21 Laboratory Name: Envirochem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616 /100mL Nitrate(NO3)as N 00620 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 mg/L Ca-Calcium o0916 mg/L
Chloride 00940 mg/L Cd-Cadmium 01027 ug/L
Arsenic otooz 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 oto45 uglL (Specify test and method#.ATTACH LAB REPORT.)
Sulfate 00945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? 0 Yes(1) 0 No(0)
Ibpecific Conductance 000ss µMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia 00610 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%
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
DWQ•ceriilied laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Zachary Butler ORC - r IA< 7/20/21
Permittee(or Authorized Agent)Name and Title-Please print or type Sign e of Pe I, ee(or Authorized Agent) (Date)
GW-59 Rev.2/2010 .

Environmental Chemists, Inc.
envirochem 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
iSM
255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS infordenvironmentalchemists.com
Town of Surf City Date of Report: Jul 19, 2021
Post Office Box 2475 Customer PO#:
Surf City NC 28445 Customer ID: 08110024
Attention: Report#: 2021-11850
Project ID: Juniper Site Piezometer
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-29480 Site: PZ-13 7/15/2021 1:25 PM Water Eric McHorney
Test Method Results Date Analyzed
Depth to water, ft. Depth to Water,Ft. 15.9 feet 07/15/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-29481 Site: PZ-14 7/15/2021 1:20 PM Water Eric McHorney
Test Method Results Date Analyzed
Depth to water, ft. Depth to Water,Ft. 15.3 feet 07/15/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-29482 Site: PZ-15 7/15/2021 1:15 PM Water Eric McHorney
Test Method Results Date Analyzed
Depth to water, ft. Depth to Water,Ft. 16.2 feet 07/15/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-29483 Site: PZ-16 7/15/2021 1:10 PM Water Eric McHorney
Test Method Results Date Analyzed
Depth to water, ft. Depth to Water,Ft. 12.1 feet 07/15/2021
Comment:
LilLi
Reviewed by: `' kJ ,--
Report#:: 2021-11850 Page 1 of 1

8602 Windmill Way Wilmington,NC
2840
(JI1Z'3rQc 1em ENVIRONMENTAL CHEMISTS, INC OFFICE:910392-0223FAX[phone]
Analytical&Consulting Chemists NCDENR:DWQ CERTIFICATION#94 NCDHHS:DLS CERTIFICATION#37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY t ' 5 G
Client:Town of Surf City PROJECT NAME:Juniper Site-Piezometer REPORT NO: 2. 1 " t I 0
ADDRESS: CONTACT NAME: PO NO:
REPORT TO: PHONE/FAX:
COPY TO: email:
Sampled By:cLA 4I SAMPLE TYPE:I=Influent,E=Effluent,W=Well,ST=Stream,SO=Soil,SL=Sludge,Other:
' Coil ction m.._ PRESERVATION
ar ffi ,p c(7 c 0 W
Sample Identification AFT E o `o r E mg i 0 0 0 5 ANALYSIS REQUESTED
Date Time Temp " o a " Z _ _ = z o
C P -
PZ-13 '1ttS1yl V.Y Zg�D 1
S-^ G G Depth to Water: !q( II
C P
PZ-14 1:}o�+ G G 2g49 1 Depth to Water:_ (83 L'
C P
PZ-15 1'-1 S'.� G G 2 8 2 Depth to Water: 'Q r'
C P �j
PZ-16 I:ta A+ G G 2q "' Depth to Water: I' -3 r�
C P
G G
C P
G G
C P
G G
C P
G G
- - -C P
G G
Transfer Relinquished By: Date/Time Received By: Date/Time
1.
2. �j
Temperature when Received: N C Accepted: ejected: Resample tell:
Delivered By: Received By: Date:7 �—.. Time:
Comments: T RN OUND:

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and copy to DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
1
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 2/28/22
Facility Name: Surf City W.W.T.P Non-Discharge wq0000795 UIC
Permit Name(if different): NPDES Other
Facility Address: PO Box 2475 TYPE OF PERMITTED OPERATION BEING MONITORED
Surf City NC 28445 County Onslow ❑ Lagoon ❑Remediation: Infiltration Gallery
(City State. t Zip• ® Spray Field 0 Remediation:
Contact Person: Zachary Butler Telephone#: [phone] 0 Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name:Zone 4 No. of wells to be sampled: 1 0 Water Source Heat Pump 0 Other:
(from Permit)
SAMPLING INFORMATION 'If WELL
WELL ID NUMBER(from Permit): Well 3 Date sample collected: 7/15/21 FIELD ANALYSES: WAS
Well Depth: 18.2 ft. Well Diameter: 2 in. pH 00400: 6.3 units Temp.000lo: 22.9 °C DRY at
Depth to Water Level 82546:6.3 ft. below measuring point Screened Interval: 17 ft. to 18.2 ft. Spec.Cond.00094: µMhos time of
sampling,
Measuring Point is 3.4 ft. above land surface Relative M.P.Elevation: ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 5.0 gallons Appearance It brown/clear here:0
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: 0 YES 0 NO
LABORATORY INFORMATION
Date sample analyzed:see Report Laboratory Name: Envirochem Certification No, 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 .02 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616 1 /100mL Nitrate(NO3)as N 00620 .19 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 .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 415 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC oosao 19.5 mg/L Ca-Calcium 00916 mg/L
Chloride oosao 175 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 oo945 mg/L Hg-Mercury 71900 ug/L Lab Report Attached? 0 Yes(1) 0 No(0)
Specific Conductance(moss µMhos K-Potassium 00937 mg/L VOC 78732: ,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 tha:.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 arlalys:s by a
DiANO-certified laboratory. t ant aware that there are significant perm:tres for submitting false information.Including the rossibiiity of fines ane imnpriso^.-rer:for knr wina violations
Zachary Butler ORCr — ' 8/3/21
Permittee(or Authorized Agent)Name and Title-Please print or type Sign- r ete r Authorized Agen) (Date)
GW-59 Rev.2/2010 /

SUBMIT FORM ON YELLOW PAPER ONLY
Mail Original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 9 copy to DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH.NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 2/28/22
Facility Name: Surf City W.W.T.P Non-Discharge wq0000795 UIC
Permit Name(if different): NPDES Other
Facility Address: PO Box 2475 TYPE OF PERMITTED OPERATION BEING MONITORED
Surf City NC 28445 County Onslow ❑ Lagoon ❑Remediation: Infiltration Gallery
0 Spray Field ❑Remediation:
Contact Person: Zachary Butler Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Zone 1 No.of wells to be sampled: 1 ❑ Water Source Heat Pump Cl Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): Well 4 Date sample collected: 7/15/21 FIELD ANALYSES: WAS
Well Depth: 18.4 ft. Well Diameter: 2 in. pH 00400: 6-4 units Temp.Nolo: 24 °C DRY at
Depth to Water Level 82546:3.9 ft.below measuringft. to 18.4 ft. Spec.Cond.00094: µ time of
p point Screened Interval: 16.4 Mhos
MeasuringPoint is 2.2sampling,
ft. above land surface Relative M.P.Elevation: ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 5.0 gallons Appearance clear here:rj
Samples for metals were collected unfiltered: ❑YES ❑NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:see report Laboratory Name: Envirochem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 <.02 mg/L Pb-Lead o1os1 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 <0.04 mg/L
(Note. Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 297 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC o0680 6.7 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 486 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1o02 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)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia o0610 <0.2 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen;NFt3as 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:s true.accurate,and complete,and that the laboratory ara!yticel data mas aroduced using approved methods of analysis by a
DING-cer ified laboratory. I am avtisre that there are significant penalties for submitt:rg false information Moulding the pess;b::ty o'fines and imprisonment fcr knew,g violations
Zachary Butler ORC 7 Iry__ 8/3/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signatu -of Permi' e(or•uthorized Agent) (Date)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 'I copy t0: VISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 2/28/22
Facility Name: Surf City W.W.T.P Non-Discharge wq0000795 UIC
Permit Name(if different): NPDES Other
Facility Address: PO Box 2475 TYPE OF PERMITTED OPERATION BEING MONITORED
Surf City street) NC 28445 County
Onslow CI Lagoon ❑Remediation: Infiltration Gallery
lty °ate, ❑■ Spray Field ❑Remediation:
Contact Person: Zachary Butler Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Zone 15 No.of wells to be sampled: 1 ❑ Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): Well 7 Date sample collected: 7/15/21 FIELD ANALYSES: WAS
Well Depth: 28.2 ft. Well Diameter: 2 in. pH o0400: 7.4 units Temp.00010: 23.1 °C DRY at
Depth to Water Level 82546:0.0 ft. below measuringpoint Screened Interval: 26.2Mhos time of
ft. to 28.2 ft. Spec.Cond.00094: µ sampling,
Measuring Point is 1.7 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 0.5 gallons Appearance very clear here:
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:see report Laboratory Name: Envirochem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N oasis <.02 mg/L Pb-Lead 01051 uglL
Coliform:MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 <.02 mg/L Zn-Zinc 01os2 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <.04 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 262 mg/L Al-Aluminum et105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 1.8 mg/L Ca-Calcium costs mg/L
Chloride 0o940 10 mg/L Cd-Cadmium 01027 ug/L
Arsenic oieoz 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)
Specific Conductance 000s5 Athos K-Potassium 00937 mg/L VOC 78732: ,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 oos25 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%
l certify that tr,the best of my knnmiedge and belief,the information submitted in this report is true accurate.and camptete,and that the laboratory analytical data was produced using approved methods of analysts by a
MVO-certified laboratory. I am aware that there ace significant penalties for submitting false information.including the aossibiltty of fines and impnsonmc„t it I.kno.y:ng violations
Zachary Butler ORC / i 8/3/21
Permittee(or Authorized Agent)Name and Title-Please print or type Sign re of Per ee(or Authorized Agent) '6.....----' (Date)
GW-59 Rev.2/2010 /

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING: Mail original DEPARTMENT QUALITY-INFORMATION
RESOURCES
and 1 C O py to: DIVISION OF WATER QUALITY INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 2/28/22
Facility Name: Surf City W.W.T.P Non-Discharge wq0000795 UIC
Permit Name(if different): NPDES Other
Facility Address: PO Box 2475 TYPE OF PERMITTED OPERATION BEING MONITORED
Surf City NC 28445 County Onslow ❑ Lagoon 0 Remediation: Infiltration Gallery
"IPI 0 Spray Field ❑Remediation:
Contact Person: Zachary Butler Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Zone 6 No.of wells to be sampled: 1 ❑ Water Source Heat Pump 0 Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): Well 8 Date sample collected: 7/15/21 FIELD ANALYSES: WAS
Well Depth: 5.2 ft. Well Diameter: 2 in. pH 00400: 5.4 units Temp.00010: 23.7 °C DRY at
Mhos time of
Depth to Water Level 82546:6.8 ft.below measuring point Screened Interval: 4.99 ft. to 9.99 ft. Spec.Cond.00094: µ sampling,
Measuring Point is 3.0 ft. above land surface Relative M.P.Elevation: ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 5 gallons Appearance clear here:❑
Samples for metals were collected unfiltered: ❑YES 0 NO and field acidified: ❑YES 0 NO
LABORATORY INFORMATION
Date sample analyzed:see report Laboratory Name: Envirochem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 .02 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 .02 mg/L Zn-Zinc oyez mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P o0665 <0.04 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
)issolved Solids:Total 70300 48 mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC 00680 3.7 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 17 mg/L Cd-Cadmium 01027 ug/L
Arsenic o1002 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? 0 Yes(1) 0 No(0)
Specific Conductance 0oos5 µMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia 00610 <0.2 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen;NH3as N;Ammonia Nitrogen,Total) Mn-Manganese o1055 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%
l certify that.to the best of my knowledge and belief,the information submitted in this report. i:ue,accurate and complete,and that the laboratory analytical data was produced using approved methods of analysis by a
0WL1-certified laboratory. I am aware that there are significant penalties for submlttmg false information,including the possibility of tines and imprisonme for know ng violations.
Zachary Butler ORC . •� y
8/3/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signat '-of Perm -e(or Authori -d Agen) (Date)
GW-59 Rev.2/2010

Environmental Chemists, Inc.
envirochem 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
sM. 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS info!a,environmentalchemists.com
Town of Surf City Date of Report: Aug 02, 2021
Post Office Box 2475 Customer PO#:
Surf City NC 28445 Customer ID: 08110024
Attention: Report#: 2021-11844
Project ID: Sarge Martin Site MW's
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-29460 Site:MW-3 7/15/2021 10:15 AM Water Eric McHorney
Test Method Results Date Analyzed
Color Color Lt Brown/Clear 07/15/2021
Depth to water, ft. Depth to Water,Ft. 6.3 feet 07/15/2021
Ammonia Nitrogen EPA 350.1,Rev.2.0,1993 < 0.2 mg/L 08/01/2021
Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 07/15/2021
Odor Qualitative None 07/15/2021
Total Dissolved Solids(TDS) SM 2540 C-2015 415 mg/L 07/16/2021
Temperature SM 2550 B-2010 22.9 C 07/15/2021
pH SM 4500 H B-2011 6.3 units 07/15/2021
Total Phosphorus SM 4500 P(F-H)-2011 0.13 mg/L 07/25/2021
Total Organic Carbon (TOC) SM 5310 B-2014 19.5 mg/L 07/19/2021
Fecal Coliform SM 9222 D-2015 MF 1 Colonies/100mL 07/15/2021
Chloride SM4500 CI E-2011 175 mg/L 07/22/2021
Nitrate Nitrogen(Cale)
Nitrite Nitrogen EPA 353.2,Rev.2.0,1993 0.02 mg/L 07/16/2021
Nitrate+Nitrite-Nitrogen EPA 353.2,Rev.2,0,1993 0.21 mg/L 07/22/2021
Nitrate Nitrogen Subtraction Method 0.19 mg/L 07/26/2021
Report#:: 2021-11844 Page 1 of 4

x
b �= ENVIRONMENTAL CHEMISTS, INC 6602 Windmill Way Wilmington,NC 28405OFFICE:910-392-0223FAX[phone]
Analytical&Consulting Chemists NCDENR:DWQ CERTIFICATION#94 NCDHHS:DLS CERTIFICATION#37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY
CLIENT: Town of Surf City PROJECT NAME: Sarge Martin MW's REPORT NO: -2 ( - I I'3 TA
ADDRESS: CONTACT NAME: PO NO:
REPORT TO: ,PHONE/FAX:
COPY TO: email:
Sampled By:c„yre.,lA,n 41."'1 SAMPLE TYPE:I=Influent,E=Effluent,W=Well,ST=Stream,SO=Soil,SL=Sludge,Other:
Collection
O 0` o W PRESERVATION
Sample Identification a W U 6 5 m m m w p A E° z 3 0 0 o w ANALYSIS REQUESTED
E a
Date Time Temp w v v a v -' i 0 = _ = z ~
0
2�
C P y�
:t'a
MW# 3 7614., l, ,-- •4 G G X _ Chloride,TDS
C P f 44 «-
Gallons Bailed: S. G G X NO3,TP, NH3
, C P�
Depth to Water: -SW G G X TOC
Color:M ec4i1 ct.t,..r I G G X Fecal
C P
Odor: N G G X
VOC (November)
C P
pH (field) a-UP V G G
C P
G G
C P
G G
C P
G G
Transfer Relinquished By: Date/Time Received By: Date/Time
1.
2.
Temperature when Received° : -,, S' Accepted: Rejected: Resample,Revested:
Delivered By: Zi"e--4"`' Received By: '" Date: -7/r471 / Time: Z:Tel'""-
Comments: TURNAROUND:

Environmental Chemists, Inc.
envirochem 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
sM 710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Town of Surf City Date of Report: Aug 02, 2021
Post Office Box 2475 Customer PO#:
Surf City NC 28445 Customer ID: 08110024
Attention: Report#: 2021-1 1 844
Project ID: Sarge Martin Site MW's
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-29463 Site:MW-4 7/15/2021 10:30 AM Water Eric McHorney
Test Method Results Date Analyzed
Color Color Clear 07/15/2021
Depth to water, ft. Depth to Water,Ft 3.9 feet 07/15/2021
Ammonia Nitrogen EPA 350.1,Rev.2.0,1993 < 0.2 mg/L 08/01/2021
Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 07/15/2021
Odor Qualitative None 07/15/2021
Total Dissolved Solids(TDS) SM 2540 C-2015 297 mg/L 07/16/2021
Temperature SM 2550 B-2010 24.0 C 07/15/2021
pH SM 4500 H B-2011 6.4 units 07/15/2021
Total Phosphorus SM 4500 P(F-H)-2011 < 0.04 mg/L 07/25/2021
Total Organic Carbon (TOC) SM 5310 8-2014 6.7 mg/L 07/19/2021
Fecal Coliform SM 9222 D-2015 MF <1 Colonies/100mL 07/15/2021
Chloride SMa500 Cl E-2011 486 mg/L 07/22/2021
Nitrate Nitrogen (Calc)
Nitrite Nitrogen EPA 353.2,Rev.2.0,1993 < 0.02 mg/L 07/16/2021
Nitrate+Nitrite-Nitrogen EPA 353.2,Rev.2.0,1993 0.07 mg/L 07/22/2021
Nitrate Nitrogen Subtraction Method 0.07 mg/L 07/26/2021
Report#:: 2021-11844
Page 2 of 4

` ENVIRONMENTAL CHEMISTS t
Cli,.: ' " '' :_ 6602 Windmill Way Wilmington,NC 28406
y N w OFFICE:910-392-0223 FAX [phone]
Analytical&Consulting Chemists NCDENR:DWQ CERTIFICATION#94 NCDHHS:DLS CERTIFICATION#37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY
CLIENT: Town of Surf City PROJECT NAME: Sarge Martin MW's REPORT NO: 2 1 , I g 44 L4
ADDRESS: CONTACT NAME: PO NO:
REPORT TO: PHONE/FAX:
�p COPY TO: email:
ter
Sampled By: c' , /L , - SAMPLE TYPE:I=Influent,E=Effluent,W=Well,ST=Stream,SO=Soil,SL=Sludge,Other:
ollection m 2 d _ PRESERVATION
Sample Identification E S. a race
TA g C -' o W
.o r E t� e ° r E 00 g `,A; u o $ oz o I, ANALYSIS REQUESTED
Date Time Temp 8 a o g z z I = s z I-- c
C P �2
MW# 4 1/ /,.i tQ4... �`
: $ 4-6 G G '�14ti4J x Chloride, TDS
C Pjiri‘c* 1
Gallons Bailed: c G G X 1403,TP, NH3
,� C P
Depth to Water: 47 G G
X TOC
C P
Color: L .aq/ G G ` X Fecal
Odor: �3•r,+t C P �.'J
G G X VOC (November)
pH (field) to.1 V 4,1 / G P
�J G G
- C P
G G
C P
G G
C P
G G
Transfer Relinquished By: Date/Time Received By: Date/Time
1.
2. /
Temperature when Received °C: ?.S Accepted: t� Re' cted: Resample a ested:
Delivered By: � _ Received By: GAG Date: Will.) Time: a'%7o/°—
Comments: TURNAROUND:

Environmental Chemists, Inc.
enviroehem 6602 Windmill Way,Wilmington,NC 28405 . 910.392.0223 Lab • 910.392.4424 Fax
M, 710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Town of Surf City Date of Report: Aug 02, 2021
Post Office Box 2475 Customer PO#:
Surf City NC 28445 Customer ID: 08110024
Attention: Report#: 2021-11844
Project ID: Sarge Martin Site MW's
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-29464 Site: MW-7 7/15/2021 10:50 AM Water Eric McHorney
Test Method Results Date Analyzed
Color Color Clear 07/15/2021
Depth to water, ft. Depth to Water,Ft. 0.0 feet 07/15/2021
Ammonia Nitrogen EPA 350.1,Rev.2.0,1993 <0.2 mg/L 08/01/2021
Gallons bailed before sampling Gallons Bailed before sampling 0.50 gallons 07/15/2021
Odor Qualitative None 07/15/2021
Total Dissolved Solids(TDS) SM 2540 C-2015 262 mg/L 07/16/2021
Temperature SM 2550 8-2010 23.1 C 07/15/2021
pH sM 4500 H B-2011 7.4 units 07/15/2021
Total Phosphorus SM 4500 P(F-H)-2011 <0.04 mg/L 07/25/2021
Total Organic Carbon (TOC) SM 5310 B-2014 1.8 mg/L 07/19/2021
Fecal CQliform SM 9222 D-2015 MF <1 Colonies/100mL 07/15/2021
Chloride SM4500 CI E-2011 10 mg/L 07/22/2021
Nitrate Nitrogen (Calc)
Nitrite Nitrogen EPA 353.2,Rev.2.0,1993 <0.02 mg/L 07/16/2021
Nitrate+Nitrite-Nitrogen EPA 353.2,Rev.2 0,1993 < 0.02 mg/L 07/22/2021
Nitrate Nitrogen Subtraction Method <0.02 mg/L 07/26/2021
Report#:: 2021-11844
Page 3 of 4

602
C- ` _ '= ENVIRONMENTAL CHEMISTS, INC OFFICE:910' a3920223 FAX [phone]
�'_ NCDENR:DWQ CERTIFICATION#94 NCDHHS:DLS CERTIFICATION#37729 info [e-mail]
Analytical&Consulting Chemists
COLLECTION AND CHAIN OF CUSTODY CLIENT: Town of Surf City PROJECT NAME: Sarge Martin MW s REPORT NO: 2.1 —1 17441
ADDRESS: CONTACT NAME: PO NO:
REPORT TO: PHONE/FAX:
COPY TO: email:
Sampled By: 'r.R,, v- SAMPLE TYPE: I=Influent,E=Effluent,W=Well,ST=Stream,SO=Soil,SL=Sludge,Other:
'IC:Lotion a N a J o PRESERVATION
Sample Identification e 0 ," o 0
y ~ c g c a L E a I z . 'o 0 0 o w ANALYSIS REQUESTED
Date Time Temp 0 — '' zz z = 2 = z 1- o
1C P
MW# 'it s//I 14:sod.;- 27- ( G G ��(D X Chloride, TDS
C P Gallons Bailed: f9•S— G G ( . X NOpp
3TP, NH3
it C P
Depth to Water: 0 G G X TOC
C P
Color: C�. / G G X Fecal
C P
Odor: e... G G X VOC (November)
pH (field) r'[31 C P
4/ G G
C P
G G
C P
G G
C P
G G
Transfer Relinquished By: Date/Time Received By: Date/Time
1.
2.
Temperature when Received °C: 'S:S Accepted: Z.-- Rejected: Resample eqsted:
Delivered By: /_�, . ..i
Received By: G--u-f Date: '7 , / Time: = ��
Comments: � .1. .� /f"'
TU NAROUND:
I

Environmental Chemists, Inc.
envirochem 6602 Windmill Way,Wilmington,NC 28405 . 910.392.0223 Lab • 910.392.4424 Fax
snn 710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Town of Surf City Date of Report: Aug 02, 2021
Post Office Box 2475
Surf Ci Customer PO#:
ty NC 28445 Customer ID: 08110024
Attention: Report#: 2021-11844
Project ID: Sarge Martin Site MW's
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-29465 Site:MW-8 7/15/2021 9:50 AM Water Eric McHorney
Test Method Results
Date Analyzed
Color Color
Clear 07/15/2021
Depth to water, ft. Depth to Water,Ft. 6.8 feet
07/15/2021
Ammonia Nitrogen EPA350.1,Rev.2.0,1993
< 0.2 mg/L 08/01/2021
Gallons bailed before sampling Gallons Bailed before sampling
5.0 gallons 07/15/2021
Odor Qualitative None
07/15/2021
Total Dissolved Solids(TDS) SM 2540 C-2015 48 mg/L 9 07/16/2021
Temperature SM 2550 B-2010 23.7C
07/15/2021
PH SM 4500 H B-2011 5.4 units 07/15/2021
Total Phosphorus SM 4500 P(F-H)-2011 <0.04 mg/L 9 07/25/2021
Total Organic Carbon (TOC) SM 5310 B-2014
3.7 mg/L 07/19/2021
Fecal Coliform SM 9222 D-2015 MF <1 Colonies/100mL 07/15/2021
Chloride SM4500 CI E-2011 17 mg/L
Nitrate Nitrogen (Calc) g 07/22/2021
Nitrite Nitrogen EPA 353.2,Rev.2.0,1993 0.02 m /L
9 07/16/2021
Nitrate+Nitrite-Nitrogen EPA 353.2,Rev.2.0,1993 0.04 mg/L 9 07/22/2021
Nitrate Nitrogen Subtraction Method 0.02 mg/L 9 07/26/2021
Comment:
Reviewed by: 040111j
Report*: 2021-11844
Page 4 of 4

7
f _ ENVIRONMENTAL CHEMISTS INC 6602 Windmill Way Wilmington,NC 28405
OFFICE:910-392-0223 FAX [phone]
Analytical&Consulting Chemists NCDENR:DWQ CERTIFICATION#94 NCDHHS:DLS CERTIFICATION#37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY
CLIENT: Town of Surf City PROJECT NAME: Sarge Martin MW's REPORT NO: 2 I-( l-y-i-4
ADDRESS: CONTACT NAME:
PO NO:
REPORT TO: PHONE/FAX:
COPY TO: email:
Sampled By: �t,/•a I - SAMPLE TYPE:I=Influent,E=Effluent,W=Well,ST=Stream,SO=Soil,SL=Sludge,Other:
Collection d - d _ m rc PRESERVATION
Sample Identification E a 0 o q ` o < -a e w
t0 F- o 8 c a° t E ¢; z u H o 0 o w ANALYSIS REQUESTED
Date Time Temp `� u 8 " u -' zz 2 = _ z 2 o
C P
7/Sil1 q:C' 4., Xi-1 G G 465 X
Chloride, IDS
C P
Gallons Bailed: G G X
, ) _ . NO3, TP, NH3
C P
Depth to Water: $ l G G X
C P TOC
Color: CAL...- G G
X Fecal
C P
Odor: u,r,..,.i. G G X
VOC (November)
C P
pH (field) C.Y 3 G G
C P -
G G
C P
G G
C P
G G
Transfer Relinquished By: Date/Time Received By:
1. Date/Time
2. /
Temperature when Received°C: 3.S Accepted: f/ Rejected: Resample Re ue ted:
Delivered By: �rGC-74-a_ Received By: G��iG./` "
Date: 'T S- i
Comments: '- Time: % p�/°~-
TURNAROUND: 1

Date._ S!
—`+ _` Facility\ame: � .., �' rr1 n a ga —
Anal)st:__et a•`
Permit F:
pH
Ca'bra:c Trn: 1erer _e Me:hod SM;90u Fi-B 2)!I I CoCa'B.;rfer 4 Os u Cal B `er 100 s u l s:,--."-n:IJ
1 Con ren's
Check s,r�er7.o 5
c, b_ r� read l h'i:{G.IFHu`.�)art Br't�� (" f ".0( Cy) _ {� o
ss b_.;.Lc_ Ricca 2GO1B20 E. 1/2022 s L^�_la':1e f1 `e 6 ,.r
7 s: buffer Lots'-',-":__Ricca 25G6 S43 Fen 7 im2
10 s,b_ff r Lo:=: Ricca 1001731 7 2071
1 Sa-p,.e -aacr / Sample ColiecCor. j Sample Ana- - -
Tire♦ I Time.
f+ priRe:_.. f 1 ►Pes:-z.:z,}sis9_`t-:; )
- '� s u Check ca'ue f Co,-.men_Ua:_
I •���- I�h /70 .... tG2G I 5.� '
1 J_KW - �{ i /d:,;a Af••- I td:7•14-. I --_ __
I
/fit - g 1s�d A� '!� j? $'�
IZ% a4..- l C•43 11
Post ana:}s;s buffer eF ,4 I I I check is required Il hen
p p'rcrrr:ng ana,'y
I1 =l I a' s r-pH uri•s(i e,s u 1 Re:o 'st 0 a: a aid report to location and must
.d all data to the r._ere,'0.01 s a and report to ice nearest C'!;c b.ut.�., _0 i units e;the b::rfer's t=-:la'1:
Reverence Method'5t.45)0 ,. Total Residual Chlorine(TRC)
r C!-G_ul{ Hach 6157 HR
Da; Checl.
Post-anal} C Please curie a ,i;caS,c i\(:;:nd s,r
Standard R Check Std Time check
Sample Result StandardSample ale Sample
s I.or Rc Cllhen a.a'}un_ Co'lec[in; 'FRC R [
i a:r.,ulti Analyzed Lo:aaon Anz)s,; esclt
le Time Tints j 1.=1 orrrz1 Cc' _Da'aQ ,'`:.-s
I I
TRC Dail}Check Standard true/a! 1 I — ! -- _ !
TR -,,,.r- _ _ 0e itgq.or mgn. a:cep:ance range r
Call r:_s:r::..,.: .:: -_ _ t:.:, st,I.:dr ' a',..;
_ n 1 or n-4
Anr;73 r°' Verification ••to _ n i�vtC 1
�.t,?n Curve� inn I)1• d';. .
F::a'en;Wank l'a1'c._ _—_ ___(When appIrca4ie.:�natc7e and document a reagent blankIt hen staaLO.-d,;;ample drluii, b.xp Date _ --_
WankDissolved Oxygen (DO)
nsnr f'TSantplesare preparcdt
Reference.Method 5ti.145000 G.-231 I
ICalibration
1 Iti'r _ ;[7
C'aLS:a;ran C'ai!;r :,o-Ian:Sle ! ♦Pos:-ara'y,is":..:-,Via.- 1
\'_ Met:;reading
trcaS�r c 1 lerffica:roa!µhenre cssanj
- r I r- ra: 1 E331.0a-t.,-:eisurc,c i after ea!ibra:io- t C-- _
i I Theoretica.r i Ca'cufa±ed
L*H ' 1
I Value rn 1.. I Value ma",
i ,
___. .
I [se this roe. hen performing a 4erirrcalion imtcad of
all tin ;
Tie, p e Ar I sin DO readfn?
Ttm. maL Cen,-z Ua'j Q,i f
♦ i,':`.:pe moo.-i^z a^�:y ses a:r u' ,ie�ztor
• -.:e measure.: , tipl- s.to me:er r::us:be re:abb3:ed a:each site before;ct.:2,i::the stream a., o: , o-.} t:T:a al.zed ao.ad be recorded µ._a of o:a Fan'.-era s•s ca:sj tr a 1e�5:med. rr: :be pr.is^=?
.. rote that t:e a-_.reasa-ed;••s. _i-.._2'ate.'!.
Temperature
Re.er_..,e Method SNI255-B-:LiIC ID
I S mp:. . *Samp'e. 1 TemperatureI
Instrument
S_ Lc:_._ I CTtr..ec i }Tun. I Coe-:,'sDs_ s
w' 7 c
I t o'-is I eo:f-,.4.,14„ ..q
IW - q 1 is?e,L%. !tW: ' 144. 0 I
Miv- 7 i v:SOr —i to:6-4A 3,? 1
6�^ q.rbA••/ �;S• ,,' 2.Y_'1 I
• I S:.T.pi: 5 mC3;.r:,'-d'�cl:' in t"C stream ardor l
Anrua:\'en::c3::o Date��Z rd or or,sic orl t..^a ana'y zed µ..'d be recorded,µ:: a e:e b r ^^ed•a•e
a: ,a.are itea:_.c rn situ or; 'I
Field Personnel sore.
Rev 9-20mi Q k.oGI

Environmental Chemist, Inc., Wilmington, NC Lab#94 6602 Windmill Way
Wilmington, NC 28405
910.392.0223
Sample Receipt Checklist
Clients( Uri j TOWN Date: t SAP > —/ Report Number: QI ! 8 1/44
Receipt of sample: ECHEM Pickup Client Delivery 0 UPS 0 FedEx 0 Other 0
❑ YES ❑ NO _ielciN/A 1. Were custody seals present on the cooler?
❑ YES ❑ NO R N/A 2. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt 3.% °C Corrected temperature upon receipt °C
How temperature taken: 0 Temperature Blank ;d Against Bottles
IR Gun ID:Thomas Traceable S/N 192511657 IR Gun Correction Factor°C: 0.0
❑ YES 0 NO 3. If temperature of cooler exceeded 6°C, was Project Mgr./QA notified?
=+ YES 0 NO 4. Were proper custody procedures(relinquished/received) followed?
II YES 0 NO 5. Were sample ID's listed on the COC?
in YES 0 NO 6. Were samples ID's listed on sample containers?
U YES 0 NO 7. Were collection date and time listed on the COC?
'■ YES 0 NO 8. Were tests to be performed listed on the COC?
11 YES 0 NO 9. Did samples arrive in proper containers for each test?
II YES 0 NO 10. Did samples arrive in good condition for each test?
ai YES 0 NO 11. Was adequate sample volume available?'
►- YES 0 NO 12. Were samples received within proper holding time for requested tests?
I YES 0 NO 13. Were acid preserved samples received at a pH of<2? *
J YES 0 NO 14. Were cyanide samples received at a pH>12?
■ YES 0 NO 15. Were sulfide samples received at a pH >9?
r YES 0 NO 16. Were NH3/TKN/Phenol received at a chlorine residual of<0.5 m/L? **
❑ YES 0 NO 17. Were Sulfide/Cyanide received at a chlorine residual of<0.5 m/L?
❑ YES 0 NO 18. 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: (Must be completed for any sample(s) incorrectly preserved or with headspace)
Sample(s) were received incorrectly preserved and were adjusted accordingly
by adding (circle one): H2SO4 HNO3 HO NaOH
Time of preservation: If more than one preservative is needed, notate in comments below
Note:Notify customer service immediately for incorrectly preserved samples.Obtain a new sample or
notify the state lab if directed to analyzed by the customer.Who was notified,date and time:
Volatiles Sample(s) _were received with headspace
COMMENTS:
DOC.QA.002 Rev 1

SUBMIT FORM ON YELLOW PAPER ONLY
Mail o r i g i n a l DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0000795 Expiration Date: 2-28-22
Facility Name: Surf City W.W.T.P: Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.Box 2475 TYPE OF PERMITTED OPERATION BEING MONITORED
Surf City 'streell NC 28445
County Onslow ❑ Lagoon El Remediation: Infiltration Gallery
D Spray Field 0 Remediation:
Contact Person: Zachary Butler Telephone#: [phone] ❑ Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Zone H No. of wells to be sampled: 1 0 Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-9 Date sample collected: 7/15/21 FIELD ANALYSES: WAS
Well Depth: 12 ft. Well Diameter: 2 in. pH o0400: 4.4 units Temp.00010: 25.1 °C DRY at
Depth to Water Level 82546:2 ft.below measuring point Screened Interval: 2 ft. to 12 ft. Spec.Cond.00094: µMhos time of
sampling,
Measuring Point is 2.5 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none check
Volume of water pumped/bailed before sampling: 5 gallons Appearance clear here:❑
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: 0 YES 0 NO
LABORATORY INFORMATION
Date sample analyzed:see report Laboratory Name: Envirochem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 <.02 mg/L Pb-Lead 01051 ug/L
Coliform: MF Fecal 31616 <1 /100mL Nitrate(NO3)as N 00620 .12 mg/L Zn-Zinc o1o02 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <.04 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 448 mg/L Al-Aluminum o11os mg/L
pH(Lab)00403 units Ba-Barium 01007 ugiL
TOC 00680 11.8 mg/L Ca-Calcium o0s16 mg/L
Chloride 00940 303 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) 0 No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732: , method#
Total Ammonia 00610 .3 mg/L Mg-Magnesium 00927 mg/L , method#
(Ammonia Nitrogen;NH,asN;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 cerli€ythat.to the best of my knowledge and belief,the information submitted in this report is True.accurate,and complete,end that the laboratory analytical data was produced using approved methods of analysis bya
©WO-certified laboratory. I am aware that there are significant penalties for submitting false information.including the.possibility of fines and imprisonment for'::,.,wi.rg vir,at'ans.
4 ,pprYZachary Butler ORG �� 8/3/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signature• •ermitte .'zed Agent) (Date)
GW-59 Rev.2/2010
/ d

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and Copy to: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
I
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: WQ0000795 Expiration Date: 2/28/22
Facility Name: Surf City W.W.T.P. Non-Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.Box 2475 TYPE OF PERMITTED OPERATION BEING MONITORED
Surf City 'Street. NC 28445 County
Onslow ❑ Lagoon ❑Remediation: Infiltration Gallery
'City ...State) © Spray Field ❑Remediation:
Contact Person: Zachary Butler Telephone#: [phone] 0 Rotary Distributor CI Land Application of Sludge
Well Location/Site Name:Zone D No.of wells to be sampled: 1 0 Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-10 Date sample collected: 7/15/21 FIELD ANALYSES: WAS
Well Depth: 12 ft. Well Diameter: 2 in. pH 00400:4.9 units Temp.00o10: 24.1 °C DRY at
Depth to Water Level 82546:5.2 ft. below measuring point Screened Interval: 2 ft. to 12 ft. Spec.Cond.00094: µMhos time of
sampling,
Measuring Point is 2.5 ft. above land surface Relative M.P.Elevation: ft. Odor o0085: none check
Volume of water pumped/bailed before sampling: 5 gallons Appearance Lt tan/turbid here:❑
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: ❑YES ❑NO
LABORATORY INFORMATION
Date sample analyzed:see report Laboratory Name: Envirochem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 .04 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616<1 /100mL Nitrate(NO3)as N 00620 <.02 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 <.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 88 mg/L Al-Aluminum o1105 mg/L
pH(Lab)man units Ba-Barium 01007 ug/L
TOC 00680 1.1 mg/L Ca-Calcium o0s16 mg/L
Chloride oosao 39 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? 0 Yes(1) ❑ No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia 0os10<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 heiief•the information submitted in this report is true,accurate and coc'iipieta,and that the laboratory analyticai data was produced using approved methods of analysts by a
L'DrjQ-certified laroratory lam aware that there are significant penalties tor submitting raise information,including the possibility of nines afar imprisonmer:t for tin:.vit:g v'jbSion5. _ _
Zachary Butler ORC irf 8/3/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signature ermittee uthorized Agent) (Date)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING: Mail original IEPARTNIENTOF ENVIRONMENT&NATURAL RESOURCES
and 1 copy to; DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1817 Phone:[phone]
FACILITY INFORMATION Please Print Clearly or Type
PERMIT Number: Expiration Date: 2/28/22
Facility Name: Surf City W.W.T.P.
Non-Discharge WQ000795 UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.Box 2475 TYPE OF PERMITTED OPERATION BEING MONITORED
Surf City cet' NC 28445 County Onslow ❑ Lagoon ❑Remediation: Infiltration Gallery
i Statei ,,Zip, a Spray Field 0 Remediation:
Contact Person: Zachary Butler Telephone#: [phone]
p ID Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name:Zone C No.of wells to be sampled: 1 ❑ Water Source Heat Pump 0 Other:
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER(from Permit): MW-11 Date sample collected: 7/15/21 FIELD ANALYSES: WAS
Well Depth: 12 ft. Well Diameter: 2 in. pH 00400: 4.9 units Temp.00010: 26.6 °C DRY at
Depth to Water Level 62546:5.8 ft.below measuring point Screened Interval: 2 ft. to 12 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 Lt yellow/turbid here:❑
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: 0 YES 0 NO
LABORATORY INFORMATION
Date sample analyzed:see report Laboratory Name: Envirochem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 .09 mg/L Pb-Lead 01051 ug/L
Coliform:MF Fecal 31616 14 /100mL Nitrate(NO3)as N 00620 <.02 mg/L Zn-Zinc 01092 mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 0.06 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
dissolved Solids:Total 70300 254 mg/L Al-Aluminum o11os mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L
TOC oosso 3.7 mg/L Ca-Calcium 0091s mg/L
Chloride 00940 37 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) 0 No(0)
Specific Conductance 0009s µMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia ooslo <0.2 mg/L MgMagnesium 00927
9 9 mg/L method#
(Ammonia Nitrogen;NH3as N;Ammonia Nitrogen,Total) Mn-Manganese 01055 U /L
9 ,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-betief,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
❑WQ-certified laboratory. I am aware that there are significant penalties for submitting false inforrhation.including the possibility of fines and impe
rissonment f.,;'rnon ing violations.
Zachary Butler ORC I' 8/3/21
Permittee(or Authorized Agent)Name and Title-Please print or type Signet/of Permit-(or Authorized Agent) (Date)
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING: Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
COMPLIANCE REPORT FORM and 1 copy to: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER,RALEIGH,NC 27699-1617 Phone:[phone]
FACILITY INFORMATION Please Pflnt C/early or Type PERMIT Number: WQ0000795 Expiration Date: 2/28/22
Facility Name: Surf City W.W.T.P. Non Discharge UIC
Permit Name(if different): NPDES Other
Facility Address: P.O.Box 2475 TYPE OF PERMITTED OPERATION BEING MONITORED
Surf City ,streef. NC 28445
County Onslow 0 Lagoon 9 CI Remediation: Infiltration Gallery
* Spray Field 0 Remediation:
Contact Person: Zachary Butler Telephone#: [phone] 0 Rotary Distributor 0 Land Application of Sludge
Well Location/Site Name:Zone A No.of wells to be sampled: 1
P 0 Water Source Heat Pump ❑Other:
(from Permit)
SAMPLING INFORMATION
WELL ID NUMBER(from Permit): MW-12 If WELL
) Date sample collected: 7/15/21 FIELD ANALYSES: WAS
Well Depth: 12 ft, Well Diameter: 2 in. pH 00400: 6 units Temp.00o10: 25.4 °C DRY at
Depth to Water Level 82546:3.1 ft.below measuring point Screened Interval: 2 ft. to 12 ft. Spec.Cond.00094: µMhos time of
Measuring Point is 2.5 ft.above land surface Relative M.P. Elevation: ft. Odor 00085: none sampling,
Volume of water pumped/bailed before sampling: 5.0 gallons check
Appearance Lt brown/turbid here:
Samples for metals were collected unfiltered: ❑YES ❑ NO and field acidified: 0 YES 0 NO
LABORATORY INFORMATION
Date sample analyzed:see report Laboratory Name: Envirochem Certification No. 94
PARAMETERS NOTE:Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 .05 mg/L Pb-Lead o1051 ug/L
Coliform:MF Fecal 31616 4 /100mL Nitrate(NO3)as N 00620 <.02 mg/L Zn-Zinc 01092 9/
g mg/L
Coliform:MF Total 31504 /100mL Phosphorus:Total as P 00665 .06 mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
)issolved Solids:Total 70300 507 mg/L Al-Aluminum 401105 mg/L
pH(Lab)00403 units Ba-Barium 01007
ug/L
TOC 0oss0 29.6 mg/L Ca-Calcium 00916 mg/L
Chloride 00940 256 mg/L Cd-Cadmium o1027 ug/L
Arsenic 01002 uglL 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) 0 No(0)
Specific Conductance 00095 µMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia met 0.4 mg/L Mg-Magnesium 00927
(Ammonia Nitrogen;NH3as N;Ammonia Nitrogen,Total) mg/L ,method#
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 tndE,to the best of my knowledge and belief the information submitted in this report is true,accurate,and complete,and that the saboratcry analytical data was produced using approved methods of analysis by a
D.WQ-certified laboratory. f am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment tcr:,,r ..ing violations.
Zachary Butler ORC r
Permittee(or Authorized Agent)Name and Title-Please print or type 1117
Signatur of Permute r Aut orized Agent) (Date)
GW-59 Rev.2/2010

Environmental Chemists, Inc.
envirochem 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
sm 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Town of Surf City Date of Report: Jul 28,2021
Post Office Box 2475 Customer PO#:
Surf City NC 28445 Customer ID: 08110024
Attention: Report#: 2021-11846
Project ID: Juniper Site MWs
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-29469 Site:MW-9 7/15/2021 12:10 PM Water Eric McHorney
Test Method Results Date Analyzed
Color Color Clear 07/15/2021
Depth to water, ft. Depth to Water,Ft. 2.0 feet 07/15/2021
Ammonia Nitrogen EPA 350.1,Rev.2.0,1993 0.3 mg/L 07/22/2021
Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 07/15/2021
Fecal Coliform Idexx Colilert-18 <1 MPN/100m1 07/15/2021
Odor Qualitative None 07/15/2021
Total Dissolved Solids(TDS) SM 2540 C-2011 448 mg/L 07/16/2021
Temperature SM 2550 B-2010 25.1 C 07/15/2021
pH SM 4500 H B-2011 4.4 units 07/15/2021
Total Phosphorus SM 4500 P F-2011 < 0.04 mg/L 07/25/2021
Total Organic Carbon (TOC) SM 5310 B-2011 11.8 mg/L 07/19/2021
Chloride SM4500 CI E-2011 303 mg/L 07/22/2021
Nitrate Nitrogen(Calc)
Nitrite Nitrogen EPA 353.2,Rev.2.0,1993 <0.02 mg/L 07/16/2021
Nitrate+Nitrite-Nitrogen EPA 353.2,Rev.2.0,1993 0.12 mg/L 07/22/2021
Nitrate Nitrogen Subtraction Method 0.12 mg/L 07/26/2021
Report#:: 2021-11846 Page 1 of 4

-.: , .r ENVIRONMENTAL CHEMISTS, INC 6602windmill Way Wilmington,NC 28405
OFFICE:910-392-0223 FAX [phone]
Analytical&Consulting Chemists NCDENR:DWQ CERTIFICATION#94 NCDHHS:DLS CERTIFICATION#37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY
CLIENT: Town of Surf City PROJECT NAME: Juniper MW's REPORT NO: 2 d — t t S (0
ADDRESS: CONTACT NAME: PO NO:
REPORT TO: PHONE/FAX:
COPY TO: email:
Sampled By: 4€. .?At.1.49`nAii SAMPLE TYPE:I=Influent,E=Effluent,W=Well,ST=Stream,SO=Soil,SL=Sludge, Other:
Collection d N m _ d PRESERVATION
Sample Identification E a o. o R " -- o m
m l- E 0 c ° r E g g z a' 'o 0 0 o w ANALYSIS REQUESTED
Date Time Temp `� 0 0 a 0 z Z = _ = Z i= o
C P
MW# a ?(tr/fit W SS', 1 G G 2 L4(9 X Chloride, TDS, NO2
r 1 IC P
Gallons Bailed: 5...
G G X NO3, TP, NH3
C P
Depth to Water: G G X TOC
C P
Color: {, t G G X Fecal
C P
Odor: Mi....., G G X VOC (November)
y _ _ J C P
pH (field) , .'fir-{s t s G G
1't C P
G G
C P
G G
C P
G G
Transfer Relinquished By: Date/Time Received By: Date/Time
1.
2. /
Temperature when Received°C: 7.K- Accepted: ./ Rejected: Resample Re uested:
Delivered By: Lief-- Received By: ‘2_,G4.4.1 Date: 747. r Time: a%2,. o—
Comments: TURNAROUND:

Environmental Chemists, Inc.
envirochem 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
'SM
255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Town of Surf City Date of Report: Jul 28, 2021
Post Office Box 2475 Customer PO#:
Surf City NC 28445 Customer ID: 08110024
Attention: Report#: 2021-11846
Project ID: Juniper Site MWs
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-29470 Site:MW-10 7/15/2021 12:25 PM Water Eric McHorney
Test Method Results Date Analyzed
Color Color Lt Tan/Turbid 07/15/2021
Depth to water, ft. Depth to Water,Ft. 4.7 feet 07/15/2021
Ammonia Nitrogen EPA 350.1,Rev.2.0,1993 <0.2 mg/L 07/22/2021
Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 07/15/2021
Odor Qualitative None 07/15/2021
Total Dissolved Solids(TDS) SM 2540 C-2011 88 mg/L 07/16/2021
Temperature SM 2550 8-2010 24.1 C 07/15/2021
pH SM 4500 H B-2011 4.9 units 07/15/2021
Total Phosphorus SM 4500 P F-2011 <0.04 mg/L 07/25/2021
Total Organic Carbon (TOC) SM 5310 B-2011 1.1 mg/L 07/19/2021
Fecal Coliform SM 9222 D-2015 MF <1 Colonies/100mL 07/15/2021
Chloride SM4500 CI E-2011 39 mg/L 07/22/2021
Nitrate Nitrogen (Calc)
Nitrite Nitrogen EPA 353.2,Rev,2.0,1993 0.04 mg/L 07/16/2021
Nitrate+Nitrite-Nitrogen EPA 353.2,Rev.2.0,1993 <0.02 mg/L 07/22/2021
Nitrate Nitrogen Subtraction Method <0.02 mg/L 07/26/2021
Report#:: 2021-11846
Page 2 of 4

Way
envirochem ENVIRONMENTAL CHEMISTS, I N C 6602
OFFICE:Windmill 910-392-0223 F'AX 910-392-4424
Analytical&Consulting Chemists NCDENR:DWQ CERTIFICATION#94 NCDHHS:DLS CERTIFICATION#37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY
CLIENT: Town of Surf City PROJECT NAME: Juniper MWs REPORT NO: I —< < g4(47
ADDRESS: CONTACT NAME: PO NO:
REPORT TO: PHONE/FAX:
COPY TO: email:
Sampled By: _Ct•c �``� yt,■.,,, SAMPLE TYPE: I=Influent,E=Effluent,W=Well,ST=Stream,SO=Soil,SL=Sludge,Other:
Collection w
N a) _ a) PRESERVATION
Q, . re
Sample Identification o. CCD = o m
Aa E ° c7 c ° r E Q 0 z ca' m o =p o ni ANALYSIS REQUESTED
in
Date Time Temp 0a -' Z = _ _ = Z o
� C P ay 7°
'U t f (�.:, i '>4. G G Z X
MW# 1 O Chloride, TDS, NO2
C P ppAtc
Gallons Bailed: c G G X IQ03, TP, NH3
. \ ,
<< C P
Depth to Water:
. G G X TOC
LA•-raw, C P
Color: el--0..r641 G G X Fecal
C P
Odor: No---I✓ G G X VOC (November)
C P
pH(field) •S‘k ,. V G G
C P
G G
C P
G G
C P
G G
Transfer Relinquished By: Date/Time Received By: Date/Time
1.
2.
Temperature when Received°C: ?, S" Accepted: / ReJy ed: Resample qu ted:
Delivered By: !�-�GC� _ Received By:i 7 Date: 7/S i Time: .2%?4),—
Comments: TURNAROUND:

Environmental Chemists, Inc.
envirochem 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
sm
710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Town of Surf City Date of Report: Jul 28, 2021
Post Office Box 2475 Customer PO#:
Surf City NC 28445 Customer ID: 08110024
Attention: Report#: 2021-11846
Project ID: Juniper Site MWs
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-29471 Site:MW-11 7/15/2021 12:45 PM Water Eric McHorney
Test Method Results Date Analyzed
Color color Lt Yellow/Turbid 07/15/2021
Depth to water, ft. Depth to Water,Ft. 3.3 feet 07/15/2021
Ammonia Nitrogen EPA 350.1,Rev.2.0,1993 <0.2 mg/L 07/22/2021
Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 07/15/2021
Odor Qualitative None 07/15/2021
Total Dissolved Solids(TDS) SM 2540 C-2011 254 mg/L 07/16/2021
Temperature SM 2550 B-2010 26.6 C 07/15/2021
pH SM 4500 H 8-2011 4.9 units 07/15/2021
Total Phosphorus SM 4500 P F-2011 0.06 mg/L 07/25/2021
Total Organic Carbon (TOC) SM 5310 6-2011 3.7 mg/L 07/19/2021
Fecal Coliform SM 9222 D-2015 MF 14 Colonies/100mL 07/15/2021
Chloride SM4500 CI E-2011 37 mg/L 07/22/2021
Nitrate Nitrogen (Calc)
Nitrite Nitrogen EPA 353.2,Rev.2.0,1993 0.09 mg/L 07/16/2021
Nitrate+Nitrite-Nitrogen EPA 353.2,Rev.2.0,1993 <0.02 mg/L 07/22/2021
Nitrate Nitrogen Subtraction Method <0.02 mg/L 07/26/2021
Report#:: 2021-11846
Page 3 of 4

_, :" ENVIRONMENTAL CHEMISTS, INC 6602
indmi910l Way
Wilmington,
NC28392-0223 FAX 05
OFF4
Analytical&Consulting Chemists NCDENR:DWQ CERTIFICATION#94 NCDHHS:DLS CERTIFICATION#37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY
CLIENT: Town of Surf City PROJECT NAME: Juniper MW's REPORT NO: Z I — I 1$"I'4'
ADDRESS: CONTACT NAME: PO NO:
REPORT TO: PHONE/FAX:
COPY TO: email:
Sampled By: €n L'AA a( ' v• SAMPLE TYPE:I=Influent,E=Effluent,W=Well,ST=Stream,SO=Soil,SL=Sludge,Other:
r ollection
PRESERVATION
y _
a s o c
Sample Identification G -' o m
E °6 c ° ° E m ; z d o § = o w ANALYSIS REQUESTED
Date Time Temp Cl, 8 v g z z = _ _ `_ 1- o
1 C P q�}11
MW#
'►jr54 t (.I SP— U..c. G _ G 2 X Chloride, TDS, NO2
C P iote•4 ..1
-
Gallons Bailed: G G X NO3, TP, NH3
--}
o%% C P
Depth to Water: "t G G X TOC
L1-44U.. C P
Color: "t'l.rLeit G G X Fecal
C P
Odor: IQ.,''.4. G G X VOC (November)
L �to C P
pH (field) G G
C P
G G
C P
G G
C P
G G
Transfer Relinquished By: Date/Time Received By: Date/Time
1.
2.
l
Temperature when Received°C: ?, 5- Accepted: J Rejected: Resample eq9ested:
Delivered By: �s,.GG�/1'�- Received By: G.Cd- fea--
Date: '7 /CAAI Time: 2 %f).100--
Comments: // C(�J TURNAROUND:

Environmental Chemists, Inc.
envirochem 6602 Windmill Way,Wilmington,NC 28405 . 910.392.0223 Lab a 910.392.4424 Fax
710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
rn, 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Town of Surf City Date of Report: Jul 28,2021
Post Office Box 2475 Customer PO#:
Surf City NC 28445 Customer ID: 08110024
Attention: Report#: 2021-11846
Project ID: Juniper Site MWs
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-29472 Site: MW-12 7/15/2021 1:00 PM Water Eric McHorney
Test Method Results Date Analyzed
Color Color Lt Brown/Turbid 07/15/2021
Depth to water, ft. Depth to Water,Ft. 2.7 feet 07/15/2021
Ammonia Nitrogen EPA 350.1,Rev.2.0,1993 0.4 mg/L 07/22/2021
Gallons bailed before sampling Gallons Bailed before sampling 5.0 gallons 07/15/2021
Odor Qualitative None 07/15/2021
Total Dissolved Solids(TDS) SM 2540 C-2011 507 mg/L 07/16/2021
Temperature SM 2550 B-2010 25.4 C 07/15/2021
PH SM 4500 H B-2011 6.0 units 07/15/2021
Total Phosphorus SM 4500 P F-2011 0.06 mg/L 07/25/2021
Total Organic Carbon (TOC) SM 5310 B-2011 29.6 mg/L 07/19/2021
Fecal Coliform SM 9222 D-2015 MF 4 Colonies/100mL 07/15/2021
Chloride SM4500 CI E-2011 256 mg/L 07/22/2021
Nitrate Nitrogen (Cale)
Nitrite Nitrogen EPA 353.2,Rev.2.0,1993 0.05 mg/L 07/16/2021
Nitrate+Nitrite-Nitrogen EPA 353.2,Rev,2.0,1993 0.02 mg/L 07/22/2021
Nitrate Nitrogen Subtraction Method <0.02 mg/L 07/26/2021
Comment:
Reviewed by: Mcu kd SIQ
, 9i4 j\ctko.„
Report#:: 2021-11846
Page 4 of 4

__-- ---�
L_ f ENVIRONMENTAL CHEMISTS INC OFFICE:910'392-0223 FLAX ngton 970,NC
-392-44245
Analytical&Consulting Chemists NCDENR:DWQ CERTIFICATION#94 NCDMMS:DLS CERTIFICATION#37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY ' +
CLIENT: Town of Surf City PROJECT NAME: Juniper MW's REPORT NO: 2 1 --1 1 1 `
t'(P
ADDRESS: CONTACT NAME: PO NO:
REPORT TO: PHONE/FAX:
COPY TO: email:
Sampled By: '-et 14.,,r^+-i SAMPLE TYPE:I=Influent,E=Effluent,W=Well,ST=Stream,SO=Soil,SL=Sludge,Other:
gollection m r m ^ d PRESERVATION
as c a e s °� - O W
Sample Identification
- E °0 c ° r E °° ; o al o 0 0 o E. ANALYSIS REQUESTED
Date Time Temp `� u c 5 z z = _ = z .- o
C P
MW# I 1 4S/�-1 f., g,. 2„g. / G G -701
411#X Chloride, TDS, NO2
C P .I-
Gallons Bailed: c G G X I(O3, TP, NH3
P 3��c C P
Depth to Water: G G X TOC
L.,,' bd.," C P
Color: ova G G X Fecal
C P
Odor: b.-M G G
X VOC(November)
C P
pH (field) (p. a'�' G G
C P
G G
C P
G G
C P
G G
Transfer Relinquished By: Date/Time Received By: Date/Time
7.
2. /
Temperature when Received°C: 1. 5- Accepted: L. Rejected: Resample equ ted:
Delivered By: fib (-D._ Received By: L�1-46- Date: ? 4' / Time: :Z:S,i°—
Comments: TURNAROUND:

Date —r1(Sl Y r Cer(iticc`a.ipn# g--4 —,_
� — Facility Name: y. i .4
Analyst: �['
Permit ft: on T'i ie
Ca'bra:en Time Reference Method
S 74500 H-B-2011
CalBuif_r40so Cal Buffr100suInstrumentelp
Check Buffer 7.0 a u Comments
flommil , . . 0,- ,,, ....i.o,
,,, <,
_ , - g.s--e/
'pH check buffer must read within=0 1 pH u nets of the buff is true taus _4 an buffer Lot-4.': Ricca 20011320 Ex,1/2022 7 so buffer Lot.-:!: Ricca 2408993 Exo 7'2022
tO an 6u;.K
erLo=; RiccalM1771 72001
52. P'e I I Semple Collector.oca::on + Sample Aral ais ! {Result
Time, I I p' Post-analysis Time• s u Check value Co-,-er.�D
/-•�^ } s.L' a:a Qoaliriers
I l i:t o p.�`' I/at: ei w 4.4(7 I
I
W- ke I /.1:.1S Il04'7A-.
w— � t K•��! I
I it uerl /s w7I4-- IY v. 1
w i1 I /:#0 e-.. II:, IA— 16.. 1
I I I J
► Post analysis buff r check is required a hen '
All p perforr ng analyses at multiple sampling locat,ons and mustwithin±
Fi values in pH units(i e,s u) Record all data to the nearest 0.Cl s a and report to the nearest 0 1 s u be tci.m 0.t tin: of the buffer's true ta;ur
Total Residual Chlorine(7 RC)
Reference titethod 5tt 4500 CI-G2011: Hach81G7 HR
Please Clfe!e 2fli: ,�t2b!eC±had Instrumnt iD
p7! J!! r-
TRCe checSam Indard P CollectialczadTine__ t I I 9
TRC Daily C{e k Standard true t slue i
h;:': •, , P�7 or me!. acceptance range poZ.or mg I t
::5!,__•. _: ;01.eftC:ci;ec et.:iiJuilj a true t ahue —
Annual Calibra'tort Curve Verification Date:
Reagent Blank Value. ,(When applicable.Analyze and document a reagent blank tthen standards.sample dilutions or PT Samples are prepared)
Dissolved Oxygen (DO)
Reference Method Sllf 45000 G.-201 I t
IIv.,water.:[D
II
Cal:bretio.n j Cah�rulie n t ♦POs nand'}sis ca6bra'ian a'i"' Sitter read!n2 i
\'eriticanon 1 terification(when recessapj
T:—e or°a efficiency
Baromet„c after calibration Co-Tear:
Tempera.u._ Theoretical Calculated
rusting Value mei. f Value mei, + !
I I 1
I I
Use this port»hen performing a verification instead of I
l
Ia ' tin
Sample Loca•en Sample Collection *Sample Analysis
Time - DO read!re
Tima moL Comments Da:a QL:3:1 ens
• \\'h_,pt far^^g analyses
* _ s at rru tiple locators,the meter must be reeahbra:ed a:each site before analysis or a pas•:analtsis calibration t eri0cation rr u_be perfar-•zd
t samp'e is measured d ractly in the stream and or onslte only time analyzed µ0uld be recorded lath a rote that they are measured in ate or im,-rzd•a:_'t
Temperature
Reference Sfethod 5Sf 2550 B-2010 Instrument ID
Szr-,^':Location � Sample !Sample + Temperature
Col:ecter Aia,ysis 1 =C !
Car Time Trine I i uner.'s Data Qualifier;
Mw'- °r I/, colt.,. I 1;`Ill I1,,.I • - .
fir- I a 11j:I rte.- I iL:4.1 p..I . . ( I
Lv.1( !I1uir# I/d .Y7p--I A•G
' w• 14, levee*--I l:a 1ro-. ! .1r.
• I 1
Ifsampie is measured d•rect' it t e smear.:and or on site only time analyzed Aauld be recorded,u th a note that they are measu ed in situ or immediately
Annual Verification Date
Field Personnel Note:
Q t.001
Rev 9-2020

Environmental Chemist, Inc., Wilmington, NC Lab#94 6602 Windmill Way
Wilmington, NC 28405
910.392.0223
Sample Receipt Checklist
Clientca$L-F 0.4 �i (JON Date: 1 J �) Report Number: O�) — 118 ti P
Receipt of sample: ECHEM PickuppJ Client Delivery 0 UPS 0 FedEx 0 Other 0
❑ YES 0 NO N/A 1. Were custody seals present on the cooler?
❑ YES 0 NO r
N/A 2. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt 3. °C Corrected temperature upon receipt °C
How temperature taken: 0 Temperature Blank Against Bottles
IR Gun ID: Thomas Traceable S/N 192511657 IR Gun Correction Factor°C: 0.0
❑ YES 0 NO 3. If temperature of cooler exceeded 6°C, was Project Mgr./QA notified?
YES 0 NO 4. Were proper custody procedures(relinquished/received)followed?
YES 0 NO 5. Were sample ID's listed on the COC?
YES 0 NO 6. Were samples ID's listed on sample containers?
m YES 0 NO 7. Were collection date and time listed on the COC?
gYES 0 NO 8. Were tests to be performed listed on the COC?
YES 0 NO 9. Did samples arrive in proper containers for each test?
1 YES ❑ NO 10. Did samples arrive in good condition for each test?
YES 0 NO 11. Was adequate sample volume available?'
YES 0 NO 12. Were samples received within proper holding time for requested tests?
YES 0 NO 13. Were acid preserved samples received at a pH of<2? *
YES 0 NO 14. Were cyanide samples received at a pH>12?
❑ YES 0 NO 15. Were sulfide samples received at a pH >9?
YES 0 NO 16. Were NH3/TKN/Phenol received at a chlorine residual of<0.5 m/L? **
YES 0 NO 17. Were Sulfide/Cyanide received at a chlorine residual of<0.5 m/L?
❑ YES 0 NO 18. 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: (Must be completed for any sample(s) incorrectly preserved or with headspace)
Sample(s) were received incorrectly preserved and were adjusted accordingly
by adding (circle one): H2SO4 HNO3 NCI NaOH
Time of preservation: If more than one preservative is needed, notate in comments below
Note:Notify customer service immediately for incorrectly preserved samples.Obtain a new sample or
notify the state lab if directed to analyzed by the customer.Who was notified,date and time:
Volatiles Sample(s) were received with headspace
COMMENTS:
DOC.QA.002 Rev 1

GW-59A COMPLIANCE REPORT FORM Permit# 4
(Submit one each monitoring period with GW-59 forms.)
1 Enter date monitoring results were due.( V 1/fi Will this monitoring report(GW-59 and GW-59A) YES NO
be submitted after the established due date? l
2 Was any required information missing on the GW-59 report forms? YES
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",contact the Regional Office for guidance.
4 Are any monitored constituents equal to or above the established standards? X 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 constituent(s)and concentration(s)
exceeding standards in the space provided below:
Pk* 3ZI "' IC) l< (2
Wocill5 For the constituents identified in question 4 above,have standards been exceeded previously for the YE) 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 well with constituent(s)exceeding
standards, concentration(s)reported, and sample collection date for each occurrence(for the last two years).
See eXCe
6 Are the monitoring wells listed in section 5 located at or beyond the review boundary? YES
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 maybe 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? ` 7
/1\
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 may subject the permittee to a Notice of Violation,
fines,and/or penalties.
8 The person completing this portion(GW-59A)of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
I hereby acknowledge that the above information was evaluated and the information submitted in this
report(Compliance Report G )is t and complete to the best of my knowledge,
Sig ture of P itt r Authorized gent) , (3/D
ate
GW-59A 12/8/2003

total
Fecal dissolved Chloride
Parameters Date mpn/100 solids 500 Ph 6.5-8.5 250 Nitrate 10
Well 4 3/1/2013 <1 593 5.52 329 <.02
7/22/2013 <1 614 5.88 280 0.02
11/14/2013 <1 581 5.39
zone 1 3/14/2014 <1 769 5.92 373 <.02
7/18/2014 <1 779 5.26 331 <.02
11/3/2014 <1 738 5.3 272 <.02
3/9/2015 <1 758 5.44 287 <.02
7/22/2015 <1 602 5.08 326 <.02
11/16/2015 <1 596 6.12 233 <.02
3/17/2016 <1 559 5.34 241 <.02
7/19/2016 <1 519 5.18 232 <.02
11/10/2016 <1 474 6.02 192 <.02
3/10/2017 <1 452 5.17 206 0.031
7/14/2017 <1 504 5.97 191 <.02
11/2/2017 <1 515 6.73 210 <.02
3/26/2018 <1 514 5.51 214 0.05
7/30/2018 4 565 5.76 191 0.1
11/14/2018 <1 582 5.78 248 <.02
3/19/2019 <1 578 5.85 248 <.02
7/18/2019 <1 576 5.87 218 <.02
11/21/2019 <1 582 6.27 240 <.02
3/17/2020 <1 629 6 281 0.08
7/23/2020 <1 604 6.2 271 0.1
11/5/2020 <1 621 6.9 230 0.17
3/11/2021 <1 754 6.2 199 0.12
7/15/2021 <1 297 6.4 486 0.07

total
Fecal dissolved Chloride
Parameters Date mpn/100 solids 500 Ph 6.5-8.5 250 Nitrate 10
Well 3 3/1/2013 <1 471 5.98 251 <.02
7/22/2013 <1 540 6.41 211 0.08
11/14/2013 <1 436 5.83 198 0.05
zone 4 3/14/2014 <1 490 6.34 242 0.05
7/18/2014 9 560 5.67 198 0.04
11/3/2014 <1 485 5.88 169 0.04
3/9/2015 2 554 5.92 239 <.02
7/22/2015 <1 134 6.5 15 0.44
11/16/2015 9 221 6.73 132 <.02
3/17/2016 <1 622 5.66 283 <.02
7/19/2016 5 141 6.46 23 0.09
11/10/2016 4 138 6.67 19 <.02
3/10/2017 1 431 5.8 181 0.1
7/14/2017 10 208 6.92 24 <.02
11/2/2017 3 255 6.46 34 <.02
3/26/2018 <1 575 5.95 229 0.32
7/30/2018 1400 142 6.13 17 0.05
11/14/2018 <1 549 6.06 245 <.02
3/19/2019 2 547 6.02 209 <.02
7/18/2019 <1 552 5.34 228 0.08
11/21/2017 <1 536 6.11 194 0.13
3/17/2020 <1 530 6 217 0.11
7/23/2020 3 350 6.4 132 0.15
11/5/2020 1 357 6.6 130 0.09
3/11/2021 4 763 6.1 182 0.16
7/15/2021 1 415 6.3 175 0.19

total
Fecal dissolved Chloride
Parameters Date mpn/100 solids 500 Ph 6.5-8.5 250 Nitrate 10
Well 7 3/1/2013 <1 255 7.4 17 <.02
7/22/2013 <1 261 7.31 8 <.02
11/14/2013 <1 243 7.35 5 <.02
zone 15 3/14/2014 <1 249 7.08 9 0.03
7/18/2014 <1 253 6.64 7 <.02
11/3/2014 <1 256 6.91 8 <.02
3/9/2015 <1 247 7.17 10 <.02
7/22/2015 <1 35 6.85 6 <.02
11/16/2015 <1 230 7.38 7 <.02
3/17/2016 <1 239 7.07 8 <.02
7/19/2016 <1 239 7.35 7 <.02
11/10/2016 <1 254 7.36 7 <.02
3/10/2017 <1 233 7.28 8 <.02
7/14/2017 <1 249 7.21 8 <.02
11/2/2017 <1 244 6.98 6 <.02
3/26/2018 <1 250 6.8 7 0.07
7/30/2018 <1 251 6.9 7 0.03
11/14/2018 <1 241 7.04 8 <.02
3/19/2019 <1 247 7.31 7 <.02
7/18/2019 4 241 7.87 7 0.08
11/21/2019 <1 248 7.42 7 <.02
3/7/2020 <1 248 7.3 8 <.02
7/24/2020 <1 234 7.4 8 <.02
11/5/2020 <1 234 7.4 7 <.02
3/11/2021 <1 258 7.4 9 0.04
7/15/2021 <1 262 7.4 10 <.02

total
Fecal dissolved Chloride
Parameters Date mpn/100 solids 500 Ph 6.5-8.5 250 Nitrate 10
Well 8 3/1/2013 <1 55 5.55 11 <.02
7/22/2013 <1 49 5.93 <5 <.02
11/14/2013 <1 33 5.73 <5 <.02
zone 6 3/1/2014 <1 28 6.43 <5 <.02
7/18/2014 <1 32 5.88 <5 <.02
11/3/2014 <1 39 5.35 8 <.02
3/9/2015 <1 37 5.62 8 <.02
7/22/2015 <1 239 6.08 9 <.02
11/16/2015 <1 46 5.83 17 <.02
3/17/2016 <1 59 5.61 14 <.02
7/19/2016 <1 60 5.48 <5 <.02
11/10/2016 <1 49 5.15 14 <.02
3/10/2017 <1 51 4.9 8 <.02
7/14/2017 <1 39 5.88 <5 <.02
11/2/2017 <1 46 5.16 <5 <.02
3/26/2018 <1 37 5.81 <5 0.05
7/30/2018 <1 42 5.7 <5 0.02
11/14/2018 <1 44 5.17 9 <.02
3/19/2019 <1 38 5.28 10 <.02
7/18/2019 <1 53 4.99 16 <.02
11/21/2019 <1 112 5.09 12 <.02
3/17/2020 <1 62 5.4 14 <.02
7/23/2020 <1 37 5.5 8 <.02
11/5/2020 <1 44 5.3 11 0.03
3/11/2021 <1 57 5.4 11 0.02
7/15/2021 <1 48 5.4 17 0.02

total
Fecal dissolved Chloride
Parameters Date mpn/100 solids 500 Ph 6.5-8.5 250 Nitrate 10
Well 9 3/7/2013 <1 85 5.43 22 <.02
7/22/2013 4 97 6.14 15 0.08
11/14/2013 <1 84 5.48 12 0.04
zone H 3/14/2014 <1 74 5.51 24 <.02
7/18/2014 <1 218 4.64 106 0.04
11/3/2014 <1 167 4.47 87 0.09
3/9/2015 <1 219 4.31 130 <.02
7/22/2015 1000 187 4.72 197 <.02
11/16/2015 <1 292 4.23 154 <.02
3/17/2016 <1 259 4.87 136 <.02
7/19/2016 1 350 4.86 170 <.02
11/10/2016 <1 300 4.66 133 <.02
3/10/2017 <1 _ 353 3.94 173 0.1
7/14/2017 <1 342 5.19 170 <.02
11/2/2017 220 316 4.01 177 <.02
3/26/2018 <1 351 3.76 171 0.1
7/30/2018 1 325 5.19 152 0.19
11/14/2018 <1 328 4.67 165 <.02
3/19/2019 <1 275 4.71 142 <.02
7/18/2019 <1 240 4.13 120 0.03
11/21/2019 2 306 4.23 167 0.54
3/17/2020 <1 335 4.2 176 0.12
7/23/2020 <1 351 4.5 214 0.06
11/5/2020 <1 416 4.5 190 0.11
3/11/2021 <1 354 4.8 165 0.12
7/15/2021 <1 448 4.4 303 0.12

total
Fecal dissolved Chloride
Parameters Date mpn/100 solids 500 Ph 6.5-8.5 250 Nitrate 10
Well 10 3/7/2013 <1 72 5.2 18 <.02
7/22/2013 3 130 5.81 43 0.04
11/14/2013 <1 103 5.28 38 0.03
zone D 3/14/2014 <1 55 5.82 29 0.06
7/18/2014 <1 123 5.99 42 0.03
11/3/2014 <1 112 4.84 47 0.04
3/9/2015 <1 95 4.58 45 <.02
7/22/2015 <1 112 4.83 56 <.02
11/16/2015 <1 121 4.83 50 <.02
3/17/2016 <1 100 5.16 43 <.02
7/19/216 <1 124 4.93 55 <.02
11/10/2016 <1 127 4.76 54 <.02
3/10/2017 <1 95 3.72 47 <.02
7/14/2017 <1 101 5.32 39 <.02
11/2/2017 5 99 4.08 43 <.02
3/26/2018 <1 108 3.9 36 0.06
7/30/2018 <1 80 5.35 16 0.1
11/14/2018 <1 44 4.93 16 0.03
3/19/2019 <1 110 4.37 46 <.02
7/18/2019 <1 132 4.98 52 0.04
11/21/2019 <1 114 4.92 30 <.02
3/17/2020 <1 123 4.3 46 <.02
7/23/2020 <1 108 5.3 56 0.04
11/5/2020 <1 130 4.4 43 0.03
3/11/2021 <1 115 4.8 53 0.02
7/15/2021 <1 88 4.9 39 <.02

total
Fecal dissolved Chloride
Parameters Date mpn/100 solids 500 Ph 6.5-8.5 250 Nitrate 10
Well 11 3/7/2013 <1 206 5.23 9 <.02
7/22/2013 2100 853 5.61 109 <.02
11/14/2013 <100 595 5.62 9 <.02
zone C 3/14/2014 <1 1450 6.43 93 <.02
7/18/2014 93, 520 5.73 37 <.02
11/3/2014 <1 640 5.12 16 0.05
3/9/2015 <1 157 5.26 20 <.02
7/22/2015 1100 145 5.25 42 <.02
11/16/2015 17 143 5.17 26 <.02
3/17/2016 <1 644 5.69 19 <.02
7/19/2016 123 517 4.86 18 0.03
11/10/2016 <1 391 4.8 21 <.02
3/10/2017 91 257 4.75 20 <.02
7/14/2017 <1 214 5.43 20 <.02
11/2/2017 3100 123 5.31 14 <.02
3/26/2018 4 192 4.94 17 <.02
7/30/2018 >6000 202 5.67 18 <.02
11/14/2018 410 355 5 28 <.02
3/19/2019 <1 179 5.22 22 0.11
7/18/2019 <1 735 5.01 35 <.02
11/21/2019 5 192 4.75 38 <.02
3/17/2020 5 179 4.8 34 <.02
7/23/2020 <1 129 4.8 40 <.02
11/5/2020 1 113 4.7 133 <.02
3/11/2021 <1 110 4.9 37 0.02
7/15/2021 14 254 4.9 37 <.02

total
Fecal dissolved Chloride
Parameters Date mpn/100 solids 500 Ph 6.5-8.5 250 Nitrate 10
Well 12 3/7/2013 <1 76 5.58 20 0.04
7/22/2013 <1 224 5.05 120 0.03
11/14/2013 <1 227 4.33 100 0.04
zone A 3/14/2014 <1 160 5.4 66 0.09
7/18/2014 1 148 4.79 26 0.03
11/3/2014 91 282 4.66 126 0.03
3/9/2015 <1 217 5.26 107 <.02
7/22/2015 1300 332 5.37 172 <.02
11/16/2015 19 241 5.55 8 <.02
3/17/2016 <1 329 5.3 157 <.02
7/19/2016 800 456 5.3 193 0.08
11/10/2016 7 318 5.07 165 <.02
3/10/2017 3 431 5.36 208 0.08
7/14/2017 8 287 5.87 140 <.02
11/2/2017 41 224 5.03 114 <.02
3/26/2018 3 386 4.76 178 0.12
7/30/2018 290 409 6 168 0.05
11/14/2018 48 280 5.29 141 <.02
3/19/2019 <1 387 5.19 183 <.02
7/18/2019 <1 473 4.62 205 0.05
11/21/2019 7 455 5.02 194 0.11
3/17/2020 1 380 5.8 177 <.02
7/23/2020 290 564 6.1 297 0.11
11/5/2020 7 439 5.6 199 0.03
3/11/2021 <1 461 6 202 0.03
7/15/2021 4 507 6 256 <.02