NC0072877_Compliance Evaluation Inspection_20211222

ROY COOPER
Governor
ELIZABETH S. BISER
Secretary
S. DANIEL SMITH
Director
Stephen Jackson
Town of Newton Grove
PO Box 4
Newton Grove, NC 28366-0004
NORTH CAROLINA
Environmental Quality
December 22, 2021
SUBJECT: Compliance Inspection Report
Newton Grove WWTP
NPDES WW Permit No. NC0072877
Sampson County
Dear Permittee:
The North Carolina Division of Water Resources conducted an inspection of the Newton Grove WWTP
on 11/18/2021. This inspection was conducted by Stephane Zorio to verify that the facility is operating in
compliance with the conditions and limitations specified in NPDES WW Permit No. NC0072877. The
findings and comments noted during this inspection are provided in the enclosed copy of the inspection
report entitled "Compliance Inspection Report".
Please respond in writing to this office within 30 days of your receipt of this letter regarding your plans
or measures to be taken to address the following issues:
• The broken pallet under the bleach barrel must be replaced in order to prevent a potential spill. Please
consider using a secondary containment device to store the bleach barrel. This would prevent the damage
caused by a spill, and it would allow the bleach to be recovered and used for its intended purpose
therefore saving money.
• Please dispose of the plastic tote adjacent to the barrel. While disposal is scheduled, please cover the
opening of the tote to prevent more rain water or animals from accidentally falling in.
• The unfinished condition of the building on the facility grounds prevents proper storage of required
records, equipment, and does not provide a proper setting for a field laboratory via 40 CFR 122.41(e) and
number 2 in Section C of the facility's NPDES permit:
2. Proper operation and maintenance. The permittee shall at all times properly operate and maintain all
facilities and systems of treatment and control (and related appurtenances) which are installed or used by
the permittee to achieve compliance with the conditions of this permit. Proper operation and maintenance
also includes adequate laboratory controls and appropriate quality assurance procedures. This provision
D_EQ-?)
nape/vs/of Envimmenhl
North Carolina Department of Environmental Quality I Division of Water Resources
Fayetteville Regional Office 1225 Green Street, Suite 714 I Fayetteville. North Carolina 28301
910.4333300

requires the operation of back-up or auxiliary facilities or similar systems which are installed by a permittee
only when the operation is necessary to achieve compliance with the conditions of the permit.
Inspection Summary
Most files are stored at Town Hall or at the ORC's private residence while the office and storage building at
the WWTP is undergoing stalled renovation. The current ORC is Glen Holland. The backup ORC is Vernon
Freeman. A permit renewal application was submitted in June 2020. Process control parameters include
settleable solids, pH, DO, and sludge judge. All records, including an ORC log, were available at the time of
the review and complete. The facility grounds were largely well -maintained and orderly. The two exceptions
were a barrel of bleach and a large plastic tote. Please replace the broken pallet under the bleach barrel to
prevent a potential spill. The plastic tote was scheduled to be disposed of but was reported to be forgotten
by the contracted company that had previously disposed of another tote. Please cover the opening of the
tote to prevent more rainwater or animals from accidentally falling in while disposal is scheduled.
Influent and effluent samples are collected once per week as specified in the NPDES permit. Aliquots are
collected every 15 minutes for 24 hours into an ice -cooled portable composite sampler. There is no grit
chamber associated with the headworks of the facility. The debris bin is emptied every other week.
There is one pump in the equalization basin. A sufficient amount of air is introduced to keep DO high enough
to prevent the wastewater from turning septic overnight. No audio-visual alarms were operable and may
never have been. Additionally, there are no audio-visual alarms or autodialer/SCADA systems in use at the
facility although there appears to be infrastructure in place for implementation. The plant does not receive a
high amount of flow but in an emergency the lack of alarms and/or remote notification could lead to a
permit violation. Solids and debris should be removed around high water floats.
The aeration basin is the primary source of repeat violations for the facility, particularly for DO and BOD. In
order to maintain a consistent DO amount, the water level is raised. As a result, more water contacts the
paddles of the mixer leading to increased friction and burnout of motors. The mixer motor has been replaced
three times in the last 1-2 years at significant cost. DO is measured every Friday and Saturday. The skimmer
arm of the clarifier has been broken for approximately one year. Staff regularly clean out the accumulated
debris and solids; however, the clarifier arm should be repaired so that equipment performs as described in
the NPDES permit. The Division encourages the Town to seriously consider the long-term cost -saving effects
of replacing the mixer system with another approved technology.
The UV disinfection system was operating normally. Extra UV bulbs are available on site. Bulbs are generally
changed once per year. A true automated back-up system is not in place, but the facility keeps a stock of
chemical disinfectants and dechlorinators for use in the event of an emergency. Covering the UV array would
prevent leaves from accumulating in the channel.
The ORC does a commendable job running the plant, but the overall smooth function of the facility is
hampered by the lack of a finished and permanent office, laboratory, and storage space at the site of the
WWTP. A visit by the laboratory certification program was recommended because of the condition of the
field laboratory. The ORC performs sampling, calibration, and reporting properly but is constrained by
working out of an unfinished building with no proper work surfaces, running water, or storage areas. All
parameters are sampled in the field with a multiprobe. The ORC has compiled a notebook of SOPs for
sampling. It is strongly recommended that the town finish the installation and construction of the new
building to assist in avoiding potential future NPDES permit violations.
D_E
North Carolina Department of Environmental Quality I Division of Water Resources
Fayetteville Regional Office 1 225 Green Street, Suite 714 I Fayetteville. North Carolina 28301
910.4333300

If you should have any questions, please do not hesitate to contact Stephanie Zorio with the Water
Quality Regional Operations Section in the Fayetteville Regional Office at 910-433-3300 or via email at
[e-mail].
ATTACHMENTS
Cc: Laserirche
Sincerely,
—DocuSigned by:
=A99704FAED5D494,..
Dr. Stephanie D. Zorio, Environmental Specialist
Water Quality Regional Operations Section
Fayetteville Regional Office
Division of Water Resources, NCDEQ
DE
paw/vent Ernennenhi
North Carolina Department of Environmental Quality I Division of Water Resources
Fayetteville Regional Office 1225 Green Street, Suite 714 I Fayetteville. North Carolina 28301
910.4333300

United States Environmental Protection Agency
EPA Washington, D.C. 20460
Water Compliance Inspection Report
Form Approved.
OMB No. 2040-0057
Approval expires 8-31-98
Section A: National Data System Coding (i.e., PCS)
Transaction Code
1 IN I 2 L 3
21IIIIII IIIIIIIIIIIIIIIIII
NPDES yr/mo/day Inspection
I NC0072877 111 121 21/11/18 117
Type
1810I
IIIIIIIIIII
Inspector Fac Type
191S I 2011
I IIIIII
P6
Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA Reserved
671I 70 I3 I 71 INI 72 I N I 731 1 74 71
I I
I I I I I I 180
Section B: Facility Data
Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include
POTW name and NPDES permit Number)
Newton Grove WWTP
Pork Chop Hill Rd
Newton Grove NC 28366
Entry Time/Date
10:OOAM 21/11/18
Permit Effective Date
17/02/01
Exit Time/Date
01:30PM 21/11/18
Permit Expiration Date
22/01/31
Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s)
///
Ervin Glenn Holland/ORC/919-252-9025/
Other Facility Data
Name, Address of Responsible Official/Title/Phone and Fax Number
Contacted
Stephen Jackson,PO Box 4 Newton Grove NC 283660004/Mayor/910-594-0827/
No
Section C: Areas Evaluated During Inspection (Check only those areas evaluated)
Permit Flow Measurement Operations & Maintenar Records/Reports
Self -Monitoring Progran Sludge Handling DispoFacility Site Review Effluent/Receiving Wate
Laboratory
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
(See attachment summary)
Name(s) and Signature(s) of
Stephanie Zorio
Inspector(s) Agency/Office/Phone and Fax Numbers Date
-D iyned by: DWR/FRO WQ/910-433-3322/
12/22/2021
'-A99704FAED5D494...
Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date
Mark Brantley DWR/FRO WQ/910-433-3300 Ext.727/
EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete.
Page# 1

sI
NPDES yr/mo/day
NC0072877 111 121 21 /11 /18
117
Inspection Type
18 [j
(Cont.)
1
Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary)
Comments
• The broken pallet under the bleach barrel must be replaced in order to prevent a potential spill.
Please consider using a secondary containment device to store the bleach barrel. This would prevent
the damage caused by a spill, and it would allow the bleach to be recovered and used for its intended
purpose therefore saving money.
• Please dispose of the plastic tote adjacent to the barrel. While disposal is scheduled, please
cover the opening of the tote to prevent more rain water or animals from accidentally falling in.
• The unfinished condition of the building on the facility grounds prevents proper storage of
required records, equipment, and does not provide a proper setting for a field laboratory via 40 CFR
122.41(e) and number 2 in Section C of the facility's NPDES permit:
2. Proper operation and maintenance. The permittee shall at all times properly operate and maintain
all facilities and systems of treatment and control (and related appurtenances) which are installed or
used by the permittee to achieve compliance with the conditions of this permit. Proper operation and
maintenance also includes adequate laboratory controls and appropriate quality assurance
procedures. This provision requires the operation of back-up or auxiliary facilities or similar systems
which are installed by a permittee only when the operation is necessary to achieve compliance with
the conditions of the permit.
Inspection Summary
Most files are stored at Town Hall or at the ORC's private residence while the office and storage
building at the WWTP is undergoing stalled renovation. The current ORC is Glen Holland. The
backup ORC is Vernon Freeman. A permit renewal application was submitted in June 2020. Process
control parameters include settleable solids, pH, DO, and sludge judge. All records, including an ORC
log, were available at the time of the review and complete. The facility grounds were largely
well -maintained and orderly. The two exceptions were a barrel of bleach and a large plastic tote.
Please replace the broken pallet under the bleach barrel to prevent a potential spill. The plastic tote
was scheduled to be disposed of but was reported to be forgotten by the contracted company that
had previously disposed of another tote. Please cover the opening of the tote to prevent more
rainwater or animals from accidentally falling in while disposal is scheduled.
Influent and effluent samples are collected once per week as specified in the NPDES permit. Aliquots
are collected every 15 minutes for 24 hours into an ice -cooled portable composite sampler. There is
no grit chamber associated with the headworks of the facility. The debris bin is emptied every other
week.
There is one pump in the equalization basin. A sufficient amount of air is introduced to keep DO high
enough to prevent the wastewater from turning septic overnight. No audio-visual alarms were
operable and may never have been. Additionally, there are no audio-visual alarms or
autodialer/SCADA systems in use at the facility although there appears to be infrastructure in place
for implementation. The plant does not receive a high amount of flow but in an emergency the lack of
alarms and/or remote notification could lead to a permit violation. Solids and debris should be
removed around high water floats.
The aeration basin is the primary source of repeat violations for the facility, particularly for DO and
BOD. In order to maintain a consistent DO amount, the water level is raised. As a result, more water
contacts the paddles of the mixer leading to increased friction and burnout of motors. The mixer
motor has been replaced three times in the last 1-2 years at significant cost. DO is measured every
Page# 2

Permit: NC0072877
Inspection Date: 11/18/2021
Owner - Facility: Newton Grove WWTP
Inspection Type: Compliance Evaluation
Friday and Saturday. The skimmer arm of the clarifier has been broken for approximately one year.
Staff regularly clean out the accumulated debris and solids; however, the clarifier arm should be
repaired so that equipment performs as described in the NPDES permit. The Division encourages the
Town to seriously consider the long-term cost -saving effects of replacing the mixer system with
another approved technology.
The UV disinfection system was operating normally. Extra UV bulbs are available on site. Bulbs are
generally changed once per year. A true automated back-up system is not in place, but the facility
keeps a stock of chemical disinfectants and dechlorinators for use in the event of an emergency.
Covering the UV array would prevent leaves from accumulating in the channel.
The ORC does a commendable job running the plant, but the overall smooth function of the facility is
hampered by the lack of a finished and permanent office, laboratory, and storage space at the site of
the WWTP. A visit by the laboratory certification program was recommended because of the condition
of the field laboratory. The ORC performs sampling, calibration, and reporting properly but is
constrained by working out of an unfinished building with no proper work surfaces, running water, or
storage areas. All parameters are sampled in the field with a multiprobe. The ORC has compiled a
notebook of SOPs for sampling. It is strongly recommended that the town finish the installation and
construction of the new building to assist in avoiding potential future NPDES permit violations.
Page# 3

Permit: NC0072877
Inspection Date: 11/18/2021
Owner - Facility: Newton Grove WWTP
Inspection Type: Compliance Evaluation
Laboratory
Are field parameters performed by certified personnel or laboratory?
Are all other parameters(excluding field parameters) performed by a certified lab?
# Is the facility using a contract lab?
# Is proper temperature set for sample storage (kept at less than or equal to 6.0
degrees Celsius)?
Incubator (Fecal Coliform) set to 44.5 degrees Celsius+/- 0.2 degrees?
Incubator (BOD) set to 20.0 degrees Celsius +/- 1.0 degrees?
Comment:
Yes No NA NE
• ❑ ❑ ❑
▪ ❑ ❑ ❑
❑ ❑ • ❑
Operations & Maintenance Yes No NA NE
Is the plant generally clean with acceptable housekeeping? • ❑ ❑ ❑
Does the facility analyze process control parameters, for ex: MLSS, MCRT, Settleable MODE
Solids, pH, DO, Sludge Judge, and other that are applicable?
Comment: Process controls include settleable solids, PH, DO, and sludge judge.
Permit Yes No NA NE
(If the present permit expires in 6 months or less). Has the permittee submitted a new IN ❑ El El
application?
Is the facility as described in the permit? • El El El
# Are there any special conditions for the permit? • El El El
Is access to the plant site restricted to the general public? • ❑ ❑ ❑
Is the inspector granted access to all areas for inspection? • El El El
Comment: A permit renewal application wzas submitted in June 2020.
Record Keeping Yes No NA NE
Are records kept and maintained as required by the permit? • El El El
Is all required information readily available, complete and current? • El El El
Are all records maintained for 3 years (lab. reg. required 5 years)? • El El El
Are analytical results consistent with data reported on DMRs? • El El El
Is the chain -of -custody complete? • El El El
Dates, times and location of sampling ■
Name of individual performing the sampling •
Results of analysis and calibration •
Dates of analysis •
Page# 4

Permit: NC0072877
Inspection Date: 11/18/2021
Owner - Facility: Newton Grove WWTP
Inspection Type: Compliance Evaluation
Record Keeping Yes No NA NE
Name of person performing analyses •
Transported COCs ■
Are DMRs complete: do they include all permit parameters? • ❑ ❑ ❑
Has the facility submitted its annual compliance report to users and DWQ? ❑ ❑ • ❑
(If the facility is = or > 5 MGD permitted flow) Do they operate 24/7 with a certified ❑ El • El
operator on each shift?
Is the ORC visitation log available and current? • ❑ ❑ ❑
Is the ORC certified at grade equal to or higher than the facility classification? • ❑ El El
Is the backup operator certified at one grade less or greater than the facility • El El El
classification?
Is a copy of the current NPDES permit available on site? • ❑ ❑ ❑
Facility has copy of previous year's Annual Report on file for review? El El • El
Comment: Most files are stored at Town Hall or at the ORC's private residence while the office and
storage building at the WWTP is in stalled renovation. The current ORC is Glen
Holland. The backup ORC is Vernon Freeman.
Influent Sampling
# Is composite sampling flow proportional?
Is sample collected above side streams?
Is proper volume collected?
Is the tubing clean?
# Is proper temperature set for sample storage (kept at less than or equal to 6.0
degrees Celsius)?
Is sampling performed according to the permit?
Yes No NA NE
• ❑ ❑ ❑
• ❑ ❑ ❑
• ❑ ❑ ❑
Comment: An influent sample is collected once per week as specified in the NPDES permit.
Aliquots are collected every 15 minutes for 24 hours into an ice -cooled portable
composite sampler.
Bar Screens Yes No NA NE
Type of bar screen
a.Manual •
b.Mechanical El
Are the bars adequately screening debris? • El El El
Is the screen free of excessive debris? • El El El
Is disposal of screening in compliance? • El El El
Is the unit in good condition? • ❑ ❑ El
Page# 5

Permit: NC0072877
Inspection Date: 11/18/2021
Owner - Facility: Newton Grove WWTP
Inspection Type: Compliance Evaluation
Bar Screens Yes No NA NE
Comment: No grit chamber. The debris bin is emptied every other week.
Equalization Basins Yes No NA NE
Is the basin aerated? • ❑ ❑ ❑
Is the basin free of bypass lines or structures to the natural environment? • ❑ ❑ ❑
Is the basin free of excessive grease? ■ ❑ ❑ ❑
Are all pumps present? • ❑ El El
Are all pumps operable? • El El El
Are float controls operable? • El ❑ ❑
Are audible and visual alarms operable? El • El El
# Is basin size/volume adequate? • El El El
Comment: There is one pump in the equalization basin. A sufficient amount of air is introduced to
keep DO high enough to prevent the wastewater from turning septic overnight. No
audio-visual alarms were operable and may never have been. Additionally, there are
no audio-visual alarms or autodialer/SCADA systems in use at the facility although
there appears to be infrastructure in place for implementation. The plant does not
receive a high amount of flow but in an emergency the lack of alarms and/or remote
notification could lead to a permit violation. Refuse and debris should be removed
around high water floats.
Aeration Basins Yes No NA NE
Mode of operation Ext. Air
Type of aeration system Surface
Is the basin free of dead spots? ■ El El El
Are surface aerators and mixers operational? • El ❑ ❑
Are the diffusers operational? El El • El
Is the foam the proper color for the treatment process? • ❑ ❑ ❑
Does the foam cover less than 25% of the basin's surface? • El El El
Is the DO level acceptable? • El ❑ ❑
Is the DO level acceptable?(1.0 to 3.0 mg/I) • El El El
Comment: The aeration basin is the primary source of repeat violations for the facility, particularly
for DO and BOD. In order to maintain a consistent DO amount, the water level is
raised. As a result, more water contacts the paddles of the mixer leading to increased
friction and burnout of motors. The mixer motor has been replaced three times in the
last 1-2 years at significant cost. DO is measured every Friday and Saturday,
Flow Measurement - Effluent Yes No NA NE
Page# 6

Permit: NC0072877
Inspection Date: 11/18/2021
Owner - Facility: Newton Grove WWTP
Inspection Type: Compliance Evaluation
Flow Measurement - Effluent
# Is flow meter used for reporting?
Is flow meter calibrated annually?
Is the flow meter operational?
(If units are separated) Does the chart recorder match the flow meter?
Yes No NA NE
• ❑ ❑ ❑
❑ ❑ • ❑
Comment: Chadwick Instruments services the flow meter annually. The last calibration occured on
11 /19/2020.
Secondary Clarifier Yes No NA NE
Is the clarifier free of black and odorous wastewater? • ❑ ❑ ❑
Is the site free of excessive buildup of solids in center well of circular clarifier? El • El El
Are weirs level? • ❑ ❑ ❑
Is the site free of weir blockage? • ❑ ❑ ❑
Is the site free of evidence of short-circuiting? • ❑ ❑ ❑
Is scum removal adequate? • ❑ ❑ ❑
Is the site free of excessive floating sludge? ■ ❑ ❑ ❑
Is the drive unit operational? • ❑ ❑ ❑
Is the return rate acceptable (low turbulence)? • ❑ ❑ ❑
Is the overflow clear of excessive solids/pin floc? • ❑ ❑ ❑
Is the sludge blanket level acceptable? (Approximately'/4 of the sidewall depth) ■ ❑ ❑ ❑
Comment: buildup
Filtration (High Rate Tertiary) Yes No NA NE
Type of operation: Cross flow
Is the filter media present? • ❑ ❑ El
Is the filter surface free of clogging? • El El El
Is the filter free of growth? • El ❑ ❑
Is the air scour operational? El El • El
Is the scouring acceptable? El El • El
Is the clear well free of excessive solids and filter media? • El El El
Comment:
Disinfection - UV
Are extra UV bulbs available on site?
Are UV bulbs clean?
Yes No NA NE
❑ ❑ ❑
Page# 7

Permit: NC0072877
Inspection Date: 11/18/2021
Owner - Facility: Newton Grove WWTP
Inspection Type: Compliance Evaluation
Disinfection - UV Yes No NA NE
Is UV intensity adequate?
Is transmittance at or above designed level?
Is there a backup system on site?
Is effluent clear and free of solids?
•
❑ • ❑ ❑
❑ ❑ ❑
Comment: Back-up system of a sort. Manual application of bleach disinectant and declorination is
available if needed.
Effluent Sampling Yes No NA NE
Is composite sampling flow proportional? ❑ • ❑ ❑
Is sample collected below all treatment units? • ❑ ❑ ❑
Is proper volume collected? • ❑ ❑ ❑
Is the tubing clean? • ❑ ❑ ❑
# Is proper temperature set for sample storage (kept at less than or equal to 6.0 ■ ❑ ❑ ❑
degrees Celsius)?
Is the facility sampling performed as required by the permit (frequency, sampling type • ❑ ❑ ❑
representative)?
Comment: An effluent sample is collected once per week as specified in the NPDES permit.
Aliquots are collected every 15 minutes for 24 hours into an ice -cooled portable
composite sampler.
Standby Power
Is automatically activated standby power available?
Is the generator tested by interrupting primary power source?
Is the generator tested under load?
Was generator tested & operational during the inspection?
Do the generator(s) have adequate capacity to operate the entire wastewater site?
Is there an emergency agreement with a fuel vendor for extended run on back-up
power?
Is the generator fuel level monitored?
Comment:
Yes No NA NE
• ❑ ❑ ❑
Page# 8

Regional Inspectors' Checklist for Field Parameters
[This checklist is to be completed during regional plant inspections for Field Laboratories, denoted by certification numbers in the 5000s.]
Facility Name: Newton Grove WWTP
Regional Plant Inspector: Stephanie Zorio
Permit #: NC0072877
Regional Inspector Contact #: 919-368-6077
Field Lab Certification #: 5571
Region:FRO
Lab Contact: Glen Holland
Date: 11/18/21
I. Check the parameter(s) performed at this site for reporting purposes.
❑ Total Residual Chlorine (TRC) ® Temperature (TEMP) ❑ Specific Conductance (SC)
❑ pH ® Dissolved Oxygen (DO) ❑ Settleable Residue (SETT)
II. General Laboratory (note any exceptions in section XI
Are instruments, meters, probes, photometric cells, etc. maintained in good condition?
0 Yes ❑ No
Are standards, reagents and consumables used within manufacturer expiration dates?
[TRC gel standard is exempt.]
L Yes
❑ No
Are the following items documented (-\I where applicable):
Item
TRC
pH
TEMP
DO
SC
SETT
Date of sample collection*
N/A
X
X
X
N/A
N/A
Time of sample collection*
N/A
X
X
X
N/A
N/A
Sample collector's initials or signature
N/A
X
X
X
N/A
N/A
Date of sample analysis*
N/A
X
X
X
N/A
N/A
Time of sample analysis*
N/A
X
X
X
N/A
N/A
Analyst initials or signature
N/A
X
X
X
N/A
N/A
Sample site (i.e., facility name, location, ID, etc.)
N/A
X
X
X
N/A
N/A
Instrument ID
N/A
X
X
X
N/A
N/A
Parameter
N/A
X
X
X
N/A
N/A
Data qualifiers, when required
N/A
N/A
N/A
N/A
N/A
N/A
*Date and time of sample collection and analysis may be the same for in situ or on -site measurements.
III. Total Residual Chlorine — reference method:
Total Residual Chlorine meter make and model:
N/A
Is a check standard analyzed each day of use? (Circle one: gel or liquid standard)
❑ Yes ❑ No
Does the check standard recover within ±10% of the known value?
❑ Yes ❑ No
What is the assigned/observed value of the daily check standard?
Is a 5-standard calibration verification performed? Note date of last verification:
❑ Yes [l No
Alternatively, does the lab construct a linear regression, using 5 standards, to calculate
results? Note date of last calibration curve constructed:
Yes ❑ No
True values: ❑ pg/L ❑ mg/L
Obtained values: ❑ pg/L ❑ mg/L
What program are samples analyzed on?
Are results reported in proper units? Check one: ❑ pg/L ❑ mg/L
❑ Yes ❑ No
Are results reported between the facility's permit limit and the compliance limit of 50 pg/L?
❑ Yes ❑ No
Are results less than the low standard reported as "<x", where x=low standard conc.?
❑ Yes ❑ No
Is DPD/buffer added within 15 minutes of collection?
❑ Yes ❑ No
Is a post -analysis check standard analyzed if samples are analyzed at multiple sites?
❑ Yes ❑ No
IV. pH — reference method:
pH meter manufacturer and model:
YSI 556
Multiprobe
Is the pH meter calibrated with at least 2 buffers per mfg's instructions each day of use?
Note buffers used: 4, 7, 10
y Yes ❑ No
Is the pH meter calibration checked with an additional buffer prior to sample analysis?
Note check buffer used: 7
y Yes ❑ No
Does the check buffer read within ±0.1 S.U. of the known value?
A Yes ❑ No
Are the following items documented:
Meter calibration?
i1 Yes ❑ No
Check buffer reading(s)?
I1 Yes ❑ No
Are samples analyzed within 15 minutes of collection? Instant in field
Al Yes ❑ No

Are sample results reported to 0.1 pH units on the eDMR?
1/ Yes
❑ No
Is a post -analysis check buffer analyzed if samples are analyzed at multiple sites? N/A
❑ Yes
❑ No
V. Temperature — reference method:
What instrument(s) is used to measure temperature? Check all that apply:
❑ DO meter ❑ Conductivity meter ❑ Digital thermometer ❑ Glass thermometer
L
pH meter
YSI 556
Multiprobe
Is the instrument/thermometer calibration checked at least annually against a NIST
traceable thermometer?
►1 Yes ❑ No
Is NIST traceability documentation maintained on site? In storage
❑ Yes /1 No
Are samples measured within 15 minutes? Instant in field
0
Yes ❑ No
Are sample results reported in degrees C?
L
Yes ❑ No
VI. Dissolved Oxygen — reference method: _
DO meter make and model:
YSI 556
Multiprobe
Is the air calibration of the DO meter performed each day of use?
a Yes ❑ No
Is meter calibration documented?
a/ Yes
No
Are samples analyzed within 15 minutes of collection?
A Yes
No
Are results reported in mg/L?
r Yes ❑ No
If samples are analyzed at multiple sites, is the meter recalibrated at each site or a post -
analysis calibration verification performed? N/A
Yes No
Does the post -analysis verification theoretical value agree within 0.5 mg/L of the meter
calibration reading? N/A
Yes No
VII. Conductivity — reference method:
Conductivity meter make and model:
N/A
Is the meter calibrated daily according to the manufacturer's instructions? Note standard
used (this is generally a one -point calibration):
Yes No
Is a daily check standard analyzed? Note value:
❑ Yes
No
Is meter calibration documented?
❑ Yes
No
Are samples analyzed within 28 days of collection?
❑ Yes
No
Is a post -analysis check standard analyzed if multiple samples are analyzed?
Are results reported in pmhos/cm (some meters display equivalent pS/cm units)?
❑ Yes ❑ No
VIII. Settleable Residue — reference method:
N/A
Does the laboratory have an Imhoff Cone in good condition?
❑ Yes No
Is the sample settled for 1 hour?
❑ Yes ❑ No
Is the sample agitated after 45 minutes?
❑ Yes ❑ No
Are the following items documented:
Volume of sample analyzed? Note volume analyzed (must use 1 L):
❑ Yes ❑ No
Date and time of sample analysis (settling start time)?
❑ Yes ❑ No
Time of agitation after 45 minutes of settling?
❑ Yes ❑ No
Sample analysis completion (settling end time)?
❑ Yes ❑ No
Are samples analyzed within 48 hours of collection?
❑ Yes ❑ No
Are results reported in ml/L?
❑ Yes ❑ No
IX. Was a paper trail (comparing contract lab and on -site data to DMRs)
performed? If so, list months reviewed:
Yes ❑ No
X. Is follow-up by the Laboratory Certification program recommended?
Yes ❑ No
XI. Additional comments: A visit is recommended because of the condition of the field laboratory. The
ORC performs sampling, calibration, and reporting properly but is constrained by working out of an unfinished
building with no proper work surfaces, running water, or storage areas. All parameters are sampled in the field
with a multiprobe. The ORC has compiled a notebook of SOPs for sampling.
Please submit a copy of this completed form to the Laboratory Certification program at:
DWR Lab Certification, Water Sciences Section, 1623 Mail Service Center, Raleigh NC, 27699-1623
Electronic copies may be emailed to [e-mail].
Revision 3/2021