WQ0001048_Residual Annual Report 2021_20220216

Non -Discharge Branch Upload/Submittal Form
NORTH CAROLINA
EnvironmentalQuul1ty
Version 2 - Revised June 23, 2020
Initial Review
Reviewer
Thornburg, Nathaniel D
Is this submittal an application? (Excluding additional information.) *
Yes No
If not an application what is the submittal type?*
Annual Report Year*
Permit Number (IR) *
Applicant/Permittee
Email Notifications
Does this need review by the hydrogeologist? *
Regional Office
CO Reviewer
Admin Reviewer
Annual Report
Residual Annual Report
Additional Information
Other
2021
WQ0001048
Contentnea Metropolitan Sewerage District
Yes No
Washington

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
Name* Charles M. Smithwick, Jr.
Email Address*
[e-mail]
Project Information
Application/Document Type *
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Phone Number*
2525245584
O Modification - Minor
O Renewal
O GW-59, NDMR, NDMLR, NDAR-1,
NDAR-2
Residual Annual Report
Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
https://edocs.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Permit Type: *
Permit Number:*
Wastewater Irrigation
Other Wastewater
Closed -Loop Recycle
Single -Family Residence Wastewater
Irrigation
WQ0001048
Has Current Existing permit number
Applicant/Permittee Address* P.O. Box 477 Grifton, NC 28590
Facility Name*
Contentnea MSD Class B Residuals Program
Please provide comments/notes on your current submittal below.
2021 Sludge Land Application Report for the Contentnea MSD Permit No. WQ0001048
High -Rate Infiltration
Reclaimed Water
Residuals
Other
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here. *
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
20220216122854772.pdf 7.92MB
Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
By checking this box, I acknowledge that I understand the application will not be
accepted for pre -review until the fee (if required) has been received by the Non -
Discharge Branch. Application fees must be submitted by check or money order and
made payable to the North Carolina Department of Environmental Quality (NCDEQ).
I also confirm that the uploaded document is a single PDF with all parts of the
application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature
C...f.�tlaF
Submission Date 2/16/2022

ANNUAL LAND APPLIIjCATION CERTIFICATION FORM
WQPermit#: tijQCCOOE. County: YI4'TLYear: 607.-)
Facility Name (as shown on permit): COnie '1R.ifY
Land Application Operator:
Chaff -orn&Oc a -
Phone: Z S.Z4; V--
Land application of residuals as allowed by the permit occurred during the past calendar year?
❑ Yes ❑ No - If No, skip Part A, and Part B and proceed to Part C. Also, If residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Part A - Residuals Application Summary:
Total number of application fields in the permit:
76
Total number of fields utilized for land application during the year:
d j
Total amount of dry tons applied during the year for all application sites:
fa 11 I)
Total number of acres utilizes for land application during the year: 1.jq. (p 5
Part B - Annual Compiance Statement:
Facility was compliant during calendar year ZbZj with all conditions of the land application permit
(including but not limited to items 1-I3 below) issued by the Division of Water Resources. ❑ Yes El No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or
the limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies
of laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1105(a) or the Pollutant
Loading Rates in 15A NCAC 02T .1105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T .1111 were complied with (applicable to 40 CFR Part
503 regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and renrediations.
11) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as
specified in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fines and imprisonment for knowhig violations."
(fin 11,f5M .5^41-hld etick AYbPAW
Pennittee me and Title (type or pr t)
Signature of Pernittee ' Date
ild.J.1 d .2 yL Ycr.7a
Signature of Preparer* Date Signature of Land Applier Date
(if different from Pennittee) (if different from Pennittee and Preparer)
* Preparer is defined in 40 CFR Part 503,9 (r) and 15A NCAC 02T .1102 (26) DENR FORM ACF (12/2006)

EXPLANATIONS FOR DEVIATIONS FOR THE 2021 ANNUAL
SLUDGE LAND APPLICATION REPORT
10-20-21 Monitoring Well #15 Total Organic Carbon
Total Chromium
10-20-21 Monitoring Well #18 Total OrganicCarbon
11.22 mg/L
20 ug/L
11.42 mg/L
The TOC in this area naturally runs higher. The water table was very low at the time samples
were taken, and there was quite a bit of sediment in the wells. This contributed to the higher
Total Organic Carbon and the elevated Chromium in Monitoring Well #15. The monitoring wells
were bailed extensively and Monitoring Well #15 was resampled for Chromium. The results
were well within established limits.

CLASS A ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIUICATION AND SUMMARY FORM
WQ PERMIT #: L)Q0001,01.44 FACILITY NAME:Clef)-} y1 P
PHONE: z5-57.4%,4 COUNTY: 4 OPERATOR: e [le6 ). }( ;Tf -
FACILITY TYPE (please check one): rzi Surface Disposal (complete Part A (Source(s) and "Residual In" Volume only) and Part C)
❑ Distribution and Marketing (complete Parts A, B, and C)
Was the facility in operation during the past calendar year? Yes $ No ❑ --+ If No skip parts A, B, C and certify form below
Part A*:
Part B*:
Month
Sources(s) (include NPDES # if
applicable)
Volume (dry tons)
Recipient Information
Amendment)
Bulking Agent
Residual In
Product Out w
Names
()
(dry tons)
VolumeIntended
use(s)
( )
January
February
March
April
May
June
C.i11 7j k)( t--LCzi-P
1z• 4
July
CYDO 114.VP CfD3 ))
Z') -44 )
August
C1Tla7 tt)iu t`✓37‘5))
7L .u,55
September
October
November
December
Total from FORM DMSDF (sup)
Totals:
Annual (dry tons):
{o j .1 fri
Amendment(s) used:
Bulking Agent(s) used:
DMSDF (Supp)
* If more space is required, attach additiolvi information sheets (FORM DMSDF (supp)): Total Number of Form
art C:
Facility was compliant during the past calendar year with all conditions of the land application permit ❑ Yes
(including but not limited to items 1-3 below) issued by the Division of Water Resources: it No ► If No, Explain in Narrative
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, prior authorization was received from the Division of Water Resources.
3. No contravention of Ground Water Quality Standards occurred at a monitoring well.
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
daA
Signature ofPeranittee
Date
**Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
a3'4
Signature of Preparer* *
(if different from Pennittee)
27L:42_2_
Date
DENR FORM DMSDF (1212006)

RESIDUAL SAMPLING SUMMARY
AND
LAB REPORTS

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Please note that your permit may contain additional parameters to be analyzed. The parameters can be reported in FORM RSSF - B
WQ Permit Number: 04)e0C3 1046
Facility Name: (yen- .0-4,n6a m6,7)
Residual Source WQ # or
NPDES 1#:
WWTP Name:
Residual Analysis Data
Crreneo rf )
Laboratory: I) Err I rOr -..Z1 frc .
2)
3)
4)
5)
Parameter
(mg/kg)
Ceiling
Conc.
Limit
Sample or Composite Date
.-fl-Z.J
v
Percent Solids (%)
NA
1. (4,Zi
Arsenic
75
< 2.5
Cadmium
85
l.5
Copper
4,300
Z(A`Z,
Chromium
NA
t 43
Lead
840
2_1
Mercury
57
0.31p
Molybdenum
75
G,'Z-
Nickel
420
11
Selenium
100
S6._0
Zinc
7,500
53P1
Total Phosphorus
NA
&Ja)
TKN
NA
tlicotab
Ammonia -Nitrogen
NA
MI
! 1
Nitrate and Nitrite
NA
1)32,1 g
posai racuxues the telling concentration Iiz .its listed in this form are not applicable Reference the individual permit for metals limits.
"Y certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed
to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant
penaltie or submittincr false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Preparer
*Preparer is defned in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
.27g:24S.2-
Date
DENR FORM RSSF (12/2006)

�.. ' `'52 7:56-620
GRE ENVIL,LE. I\I.G. 2 Th8 FAX (252) f 56-06 3
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON, NC 26530
PARAMETERS
Sludge Analysis Method
Sample Date Analyst Code
PH (not to be used for reporting) 3,6 05/27/21 DIJ 4500HB-11
Aluminum, (dry wt. basis), mg/kg 15981 06/04/21 LFJ EPA200.7
Arsenic (dry wt. basis), mg/kg <2.5 06/04/21 MTM 3113E-04
Calcium (dry wt. basis), mg/kg 16143 06/04/21 LFJ EPA200.7
Cadmium (dry wt. basis), mg/kg 1.5 06/07/21 MTM 3113B-04
Copper (dry wt. basis), mg/kg 262 06/04/21 LFJ EPA200.7
Chromium, T.(dry wt. basis),mglkg 18 06/04/21 LFJ EPA200.7
Lead (dry weight basis), mg/kg 21 06/04/21 MTM 3113B-04
Magnesium (dry wt. basis), mg/kg 6364 06/04/21 LFJ EPA200;7
Mercury (dry wt. basis), mg/kg 0.36 06/21/21 MTM EPA7471B
Nickel (dry wt. basis), mg/kg 17 06/04/21 LFJ EPA200.7
Potassium (dry wt. basis), mg/kg 8137 06/11/21 LFJ EPA200.7
Selenium (dry wt. basis), mg/kg <5.0 06/07/21 MTM 3113B-04
Sodium (dry wt. basis), mg/kg 3279 06/14/21 NAB 3111B-11
Zinc (dry wt. basis), mg/kg 839 06/04/21 LFJ EPA200.7
Sodium Adsorption Ratio (calc) 5.5
Total Nitrogen, mg/kg (calc) 46792 06/22/21
Total Solids, % 2.04 06/02/21 CAW 2540G-11
TKN (dry wt.), mg/kg c 46060 06/02/21 TLH 351.2 R2-93
Ammonia Nitrogen (dry wt.),mg/kg c 1111 06/04/21 KES 350.1 R2-93
Nitrate Nitrogen(dry wt.), mg/kg c 730.2 06/03/21 KES 353.2 R2-93
Nitrite Nitrogen(dry wt.), mg/kg c 1.98 06/02/21 TLH 353.2 R2-93
Phosphorus, T. (dry wt.), mg/kg c 24900 06/02/21 KES 365.4-74
Molybdenum (dry wt, basis), mg/kg 9.2 06/09/21 MTM EPA200.7
ID#: 416
DATE COLLECTED: 05/27/21
DATE REPORTED : 06/23/21
REVIEWED HX:
c Uncertified data. DWR does not offer non -aqueous certification for this analytical procedure.

% SOLIDS, TOTAL SOLIDS, and TOTAL VOLATILE SOLIDS
ANALYSIS BY:
SAMPLE IDENTIFICATION
DISH NUMBER
A. WEIGHT OF DISH,gm .53 f
Be WEIGHT OF DISH
AND SAMPLE,gm 38',4- -k
C. WEIGHT OF DISH
DRY SOLIDS,gm *3_1(-;
Do WEIGHT OF DISH
AND ASH,gm
E. VOLUME OF SAMPLE,m1
% SOLIDS, % t ,Loa-
.* TOTAL SOLIDS,g/1
*** TOTAL
VOLATILE SOLIDS
9,S Lc
* % SOLIDS}% = C-A X 100
DATE:L-16'C) TIME: 15 Pi
COI C ec.-1-f C 1€ end o-f dry ryt h
a 1 l -he( a nc 1()6 i 3 iJc cel l
Deb Z �DT3
ikkalr(6 -,:)1(Adce_
acyclrn a 4 j no!
((Waif i(-- c cL elf b- [c )
`)L)
Z�

TCLP LAB REPORTS

The results set forth herein are provided by SGS North America Inc.
Technical Report for
Environment 1, Inc
Contentnea Metro Sewage District; Grifton, NC
416
SGS Job Number: FA86015
Sampling Date: 05/27/21
Report to:
Environment 1, Inc
PO Box 7085
Greenville, NC 27835
[e-mail]
ATTN: Ann Brown
Total number of pages in report: 14
Test results contained within this data package meet the requirements
of the National Environmental Laboratory Accreditation Program
and/or state specific certification programs as applicable.
e-Hardeopy 2.0
Automated .Report
Norm Farmer
Technical Director
Client Service contact: Jean Dent -Smith 407-425-6700
Certifications: FL(E83510), LA(03051), KS(E-10327), NC(573), Nd(FLO02), NY(12022), SC(96038001)
DoD ELAP(ANAB L2229), AZ(AZ0806), CA(2937), TX(TI04704404), PA(68-03573), VA(480177),
AL, AK, AR, CT, IA, KY, MA, MI. MS, ND, NH, NV, OK, OR, UT, VT, WA, WV
This report shall not be reproduced, except in its entirety, without the written approval of SGS.
Test results relate only to samples analyzed.
SGS North America Inc. • 4405 Vineland Road • Suite C-15 • Orlando, FL 32811 • tel: [phone] • fax: [phone]
SOS is the sole authority for authorizing edits or modifications to this document.
Unauthorized rmidif cation ,sr this report is strictly prohibited,
Review standard terms at: http:t!ww re.sgs.comferifte.rnts-and-co€tditions
Please share your ideas about
how we can serve you butter at:
E-llS.US,CtistouterCare!a sgs.eoni
1 of 14
FAa8a15

Sections:
Table of Contents
-1-
Section 1: Sample Summary 3
Section 2: Summary of Hits 4
Section 3: Sample Results 5
3.1: FA86015-1: SLUDGE SAMPLE 6
Section 4: Misc. Forms 12
4.1: Chain of Custody 13
SGS
2 of 14
EAa6ni5

SGS North America Inc.
Sample Summary
Environment 1, Inc
Contentnea Metro Sewage District; Clifton, NC
Project No: 416
Job No: FA86015
Sample Collected Matrix
Number Date Time By Received Code Type
Client
Sample ID
This report contains results reported as ND = Not detected The following ail)
Organics ND = Not detected above the MDI.
es:
FA86015-1 05/27/21 11:25 AE 05/29/21 SO Sludge
SLUDGE SAMPLE
Soil samples reported on a dry weight basis unless otherwise indicated on result page.
3 of 14
FA88815

Summary of Hits
Job Number: FA86015
Account: Environment 1, Inc
Project: Contentnea Metro Sewage District: Grifton, NC
Collected: 05/27/21
Page 1 of 1
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FA86015-1
SLUDGE SAMPLE
Corrosivity as pH
Ignilability (Flashpoint) a
(a) Not ignitable.
5.3
> 200
su SW846 CHAP7
Deg. F SW846 1010A MOD
ill
4 of 14
FA86015

Sample Results
Report of Analysis
.;1111:1
5 of 14
FA86(115

SGS North America Inc.
Report of Analysis
Page 1 of 1
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA86015-1
Matrix: SO - Sludge
Method: SW846 8260E SW846 1311
Project: Contentnea Metro Sewage District; Grifton, NC
Date Sampled: 05/27/21
Date Received: 05/29/21
Percent Solids: 2.0
Run #1
Run #2
File ID
DF Analyzed By
C0149319.D 10 06/10/21 18:58 SO 06/02/21 14:00 OP85689 VC6019
Prep Date Prep Batch Analytical Batch
Run #1
Run #2
Purge Volume
5.0 m1
VOA TCLP List
CAS No. Compound
TCLP Leachate method SW8461311
Result IOW# MCL RL MDL Units Q
71-43-2 Benzene ND D018 0.50 0.010 0.0031 mg/I
78-93-3 2-Butanone (MEK) a ND D035 200 0.050 0.020 mg/I
56-23-5 Carbon Tetrachloride t' ND D019 0.50 0.010 0.0036 mg/1
108-90-7 Chlorobenzene ND D021 100 0,010 0.0020 mg/I
67-66-3 Chloroform ND D022 6.0 0.010 0.0030 mg/1
106-46-7 1,4-Dichlorobenzene ND D027 7.5 0.010 0.0026 mg/1
107-06-2 1,2-Dichloroethane ND D028 0.50 0.010 0.0031 mg/1
75-35-4 1, I-Dichloroethylene ND D029 0.70 0.010 0.0032 mg/I
127-18-4 Tetrachloroethylene b ND D039 0.70 0.010 0.0022 mg/I
79-01-6 Trichloroethylene ND D040 0.50 0.010 0.0035 mg/1
75-01-4 Vinyl Chloride ND D043 0.20 0.010 0.0041 mg/I
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
1868-53-7 Dibromofluoromethane 101% 83-118%
17060-07-0 1, 2-Dichloroethane-D4 107% 79-125%
2037-26-5 Toluene-D8 99% 85-112%
460-00-4 4-Bromofluorobenzene 99% 83-118%
(a) Associated CCV outside of control limits low.
(b) Associated CCV outside of control limits high, sample was ND.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
sus
6 of 14
FABGUi 5

Matrix:
Method:
Project:
SGS North America Inc.
Report of Analysis
Page 1 of 1
Client Sample .(D: SLUDGE SAMPLE
Lab Sample ID: FA86015-1
SO - Sludge
SW846 8270D SW846 3510C
Contentnea Metro Sewage District; Grifton, NC
Date Sampled: 05/27/21
Date Received: 05/29/21
Percent Solids: 2.0
Run #1
Run #2
File ID DF
91013141.D 1
Analyzed By Prep Date Prep Batch Analytical Batch
06/04/21 21:36 WH 06/04/21 08:20 OP85734 S91471
Run #1
Run #2
Initial Volume Final Volume
100 xnl 1.0 ml
ABN TCLP List
TCLP Leachate method SW846 1311
CAS No. Compound Result HW# MCL RL MDL Units Q
95-48-7 2-Melhylphenol ND D023 200 0.050 0.0056 mg/l
3&4-Methylphenol ND D024 200 0.050 0.0098 mg/l
87-86-5 Pentachlorophenol ND D037 100 0.25 0.050 mg/I
95-95-4 2,4,5-Trichlorophenol ND D041 400 0.050 0.0074 mg/l
88-06-2 2,4,6-Trichlorophenol ND D042 2.0 0.050 0.0075 mg/I
106-46-7 1,4-Dichlorobenzene ND D027 7.5 0.050 0.0050 mgll
121-14-2 2,4-Dinitrotoluene ND D030 0.13 0.050 0.0081 mg/I
118-74-1 Hexachlorobenzene ND D032 0.13 0.050 0.0069 mg/I
87-68-3 Hexachlorobutadiene ND D033 0.50 0.050 0.0050 mg/I
67-72-1 Hexachloroethane ND D034 3.0 0.050 0.016 mg/I
98-95-3 Nitrobenzene ND D036 2.0 0.050 0.0093 mg/l
110-86-1 Pyridine ND D038 5.0 0.10 0.020 mg/l
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
367-12-4 2-Fluorophenol 25% 14-67%
4165-62-2 Phenol-d5 19% 10-50%
118-79-6 2,4,6-Tribromophenol 69% 33-118%
4165-60-0 Nitrobenzene-d5 56% 42-108%
321-60-8 2-Fluorobiphenyl 57% 40-106%
1718-51-0 Terphenyl-d14 58% 39-121%
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
7 of 14
FA86015

SGS North America Inc.
Report of Analysis
Page 1 of 1
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA86015-1
SO - Sludge
SW846 8151A SW846 3510C
Contentnea Metro Sewage District; Grifton, NC
Matrix:
Method:
Project:
Date Sampled: 05/27/21
Date Received: 05/29/21
Percent Solids: 2.0
Run #1
Run #2
File ID DF
CC074606.D 1
Analyzed By Prep Date Prep Batch Analytical Batch
06/07/2113:59 SH 06/04/2108:14 OP85733 GCC1856
Run #1
Run #2
Initial Volume Final Volume
10.0 ml 5.0 ml
Herbicide TCLP List
CAS No. Compound
94-75-7
93-72-1
2,4-D a
2,4,5-TP (Silvex)
TCLP Leachate method SW846 1311
Result IIW# MCL RL MDL Units Q
ND D016 10 0.050 0.017 mg/I
ND D017 1.0 0.0050 0.0013 mg/I
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
19719-28-9 2,4-DCAA
69% 39-135%
(a) Associated CCV outside of control limits high, sample was ND.
ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
8of14
FA861115

SGS North America Inc.
Report of Analysis
Page 1 of 1
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA86015-1
Matrix: SO - Sludge
Method: SW846 8081B SW846 3510C
Project: Contentnea Metro Sewage District; Grifton, NC
Date Sampled: 05/27/21
Date Received: 05/29/21
Percent Solids: 2.0
File ID DF
Run #1 ST152719.D 1
Run #2
Analyzed By Prep Date Prep Batch Analytical Batch
06/04/21 20:28 WH 06/04/21 08:09 OP85732 GST3704
Run #1
Run #2
Initial Volume Final Volume
100 mI 5.0 ml
Pesticide TCLP List
CAS No. Compound
TCLP Leachate method SW846 1311
Result HW# MCL RL MDL Units Q
58-89-9 gamma-BHC (Lindane) ND D013 0.40 0.00010 0.000022 mg/I
12789-03-6 Chlordane ND D020 0.030 0.0010 0.00038 mg/I
72-20-8 Endrin ND D012 0.020 0.00020 0.000021 mg/1
76-44-8 Heptachlor ND D031 0.0080 0.00010 0.000026 mg/1
1024-57-3 Heptachlor epoxide ND D031 0.0080 0.00010 0.000020 mg/I
72-43-5 Methoxychlor ND D014 10 0.00020 0.000050 mgll
8001-35-2 Toxaphene ND D015 0.50 0.0050 0.0021 mg/I
CAS No. Surrogate Recoveries Run# 1 Run# 2 Limits
877-09-8 Tetrachloro-m-xylene 77% 42-127%
2051-24-3 Decachlorobiphenyl 73% 27-127%
ND = Not detected MDL = Method Detection Limit d = Indicates an estimated value
MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank
E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound
9 of 14
FAB3D15

SGS North America Inc.
Report of Analysis
Page 1 of 1
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA86015-1 Date Sampled: 05/27/21
Matrix: SO - Sludge Date Received: 05/29/21
Percent Solids: 2.0
Project: Contentnea Metro Sewage District; Grifton, NC
Metals Analysis, TCLP Leachate SW846 1311
Analyte Result HW# MCL RL Units DF Prep Analyzed By Method Prep Method
Arsenic < 0.10 D004 5.0 0.10 mg/1 1 06/11/21 06/11/21 LM SW846 6010D 2 SW846 3010A 4
Barium < 2.0 D005 100 2.0 mg/1 1 06/11/21 06/11/21 LM SW846 6010D 2 SW846 3010A 4
Cadmium < 0.050 D006 1.0 0.050 mg/1 1 06/11/21 06/11/21 LM SW846 6016D 2 SW846 3010A 4
Chromium < 0.10 D007 5.0 0.10 mg/I 1 06/11/21 06/11/21 LM SW846 8010D 2 SW846 3010A 4
Lead < 0.050 D008 5.0 0.050 mg/1 1 06/11/21 06/11/21 LM SW848 6010D 2 SW846 3010A 4
Mercury < 0.0050 D009 0.20 0.0050 mg/1 1 06/04/21 06/04/21 Jc SW846 7470A 1 SW846 7470A 3
Selenium < 0.10 D010 1.0 0.10 mg/1 1 06/11/21 06/11/21 LM SW846 6010D 2 SW846 3010A 4
Silver < 0.10 D011 5.0 0.10 mg/1 1 06/11/21 06/11/21 LM SW846 6010D 2 SW846 3010A 4
(1) Instrument QC Batch: MA17754
(2) Instrument QC Batch: MA17777
(3) Prep QC Batch: MP39052
(4) Prep QC Batch: MP39083
RL = Reporting Limit
MCL = Maximum Contamination Level (40 CFR 261 7/1/11)
10 of 14
FA86O1 s

SGS North America Inc.
Report of Analysis
Page 1of1
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA86015-1
Matrix: SO - Sludge
Project: Contentnea Metro Sewage District; Griffon, NC
Date Sampled: 05/27/21
Date Received: 05/29/21
Percent Solids: 2.0
General Chemistry
Analyte
Corrosivity as pH
Cyanide Reactivity
Ignitability (Flashpoint) a
Solids, Percent
Sulfide Reactivity
(a) Not ignitable.
Result
RL Units DF Analyzed By Method
5.3 su 1 06/09/21 10:38 JB
< 7.5 7.5 mg/kg 1 06/09/21 09:58 AC
> 200 Deg. F 1 06/04/21 09:36 KSA
2 % 1 06/07/21 13:38 KSA
< 250 250 mg/kg 1 06/08/21 17:00 JC
SW846 CHAP7
SW846 CHAP7
SW846 1010A MOD
SM19 2540G
SW846 CHAP7
RL — Reporting Limit
11 of 14
FA86018

Misc. Forms
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
Section 4
12 of 14
FA36015

P
Environment 1, Ine.
P.O. Box 7085, 114 Oakmont Dr.
Greenville., NC 27858
CHAIN OF CUSTODY RECORD F
Page 1 or 1
env ironmn et I inc.cont
Phone [phone] Fax
CLIENT: 416
MSD (SLUDGE & WELLS ACC')
ONTENTNEA METRO. SEWAGE
IS. RENEE PRrDGEN
.0. BOX 477
•RIFTON NC 28530
i52) 524-5584
(252) 75G-D631
Week; 10
DIST%
DISINFECTION
rjCHLORINE
' UV
I NONE
t,
❑
—
CHLORINE NEUIRAUZEOATCOLLECTION
pICHECK (t14B)
P
PP
GGGGG
CONTA:NEHTYPE, PG
A
A
A
A
A
A
A
A
CHEMICALPRESEBVATION
A•NONE LI-NAOH
B. HNO E-HCL
a
• H,SO, F - ZINC ACETAT£INAOH
G • NATHIOSUFATE
TOTAL CHLORINE, mgA
OR ugi AT COLLECTOR
9
O
V'
;
8
o
f
F4
A'
$
•$
k
c'
TCLP VoUSvol
I"
w
U
F
•�
a
°gym
;
E.
`
U
E.
W0
E�i
E
y
P
..
COLLECTION
SAMPLE LOCATION
DATE
TIME
Sludge Sample
5 tea\
1 0-.S
\
5
$i
'.. -..s
LOTS
5
CLASSIFICATION:
Ij WAST€, IATER(NPDES)
OHINKINGWATER
tj CWRIGW
❑ SOLIDWASTESECTION
it
-1
L.,\.k
ToAL74Saa....
rsftu,7ltx
a..
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING �SHIPMENT/DELIVERY
(' N
SAMPLES COLLECTED BY.
(Feast P64q
A•N d rA S
SAMPLES
RECEIVED INLABAT •'.6 'C
SHED .DY Sip ISNAP fR)
,an
DATE/TIME
SlaM
RECEI
BY (Se)
DATEIDME
Slz7I f z7
COMMENTS: file* -L.k1frog) 2' 2\
ISHED flY(SIG.)
�---
DATE01ME
5•/z31z1 I $`--cr3
AEI; a/ED Y IG
'_ 4 ,(
6i rf�'
ATEJDME
g
1 eG al- : e .
.".'
HUMMED By (SI }
J2e ,
DATE/RME RE , DBY(51G.)
5aelalliteA• '� o --t
DATEIRME
4 I it `)
J A ; 72/74/4-1,,.f sAr--) 11..t,•.-•-•
FORM
eat t' vu s!?A17.( t i`
1 PLEASE EA° Instructions for cosnpledng this form op the reverse side.
t5 \V
Sampler must place a "C' for composite sample or a "G° tar
Grab sample in the blocks above for each parameter requested. N9 389323
PA86015: Chain of Custody
Page 1 of 2
43of14
FA88415

SGS Sample Receipt Summary
Job Number: FA86015 Client: ENVIROMENT 1
Date l Time Received: 5/29/2021 10:15:00 AM Delivery Method; FEDEX
Project: 416
Airblll #'s: 954628460857
Therm ID: IR 1;
Therm CF: -1.8;
Cooler Temps (Raw Measured) °C: Cooler 1: (2.8);
Cooler Temps (Corrected) °C: Cooler 1: (1.0);
# of Coolers: 1
Cooler Information
1. Custody Seals Present
2. Custody Seals Intact
3. Temp criteria achieved
4. Cooler temp verification
5. Cooler media
Trip Blank information
1. Tip Blank present 1 cooler
2. Trip Blank listed on COC
3. Type Of TB Received
Y or N
tVi
IR Gun
ice (Ban)
Y or N
I ❑
0
W or S
u
Sample Information
1. Sampte Labels present on bottles
2. Samples preserved properly
3. Sufficient volume/containers recvd for analysis;
4. Condition of sample
5. Sample recvd within HT
6. Dates(fimes/IDs on COC match Sampte Label
7. VOCs have headspace
8. Bottles received for unspecified Tests
9. Composlting instructions clear
10. Voa Soil Kits/Jars received past 48hrs?
11. % Solids Jar received?
12. Residual Chlorine Present?
Y or N_
�I n
Intac
El
Li
El El '�i
El ❑ . :r
❑ ❑ ,WI
❑ Ri
Misc. Information
Number of Encores: 25-Gram
Test Strip Lot #s: pH 0-3
Residual Chlorine Test Strip Lot #:
5-Gram Number of 5035 Field Kits: Number of Lab Filtered Metals:
230315
pH 10-12 219813A
01her. (Specify)
Comments
sM001
Rev. Dale 05/24/17
Technician: BRYANG
Date: 5/29/2021 10:15:00 A Reviewer:
Date:
FA86015: Chain of Custody
Page 2 of 2
14 of 14
FA88015

LAND APPLICATION FIELD
SUMMARY FORMS

ANNUAL LAND APPLICATION F IELD SUMMARY FORM
PLEASE MAKE A COPY OF 1111S BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WFfFN NOT APPLICABLE.
Facility Name: C�ngt, WQ Permit #: u31C4 Field #:
Land Owner: C'fa_ Annual Dry Tons Applied: 5 (4--) 4053 Site #:
Operator: £{ , 14-r)ky -.
Crop 1 Name: rinl gry"LriCt.
Predominant Soil Series:' *4JL
13
Crop 1 Max. PAN: 1 t) Crop 2 Name:
2.
Acres Utilized:
Acres Permitted:
Cation Exchange Capacity (non 503):
Croi3 2 Max. PAN:
C-�z
'If .5
41
'� 4
R
Volume
(enter one)
Liquid
Cu. Yds
applied
Solids/
Gallons
%
Solids
Volume
ACond.p
Applied P
Acre
(Dry Tons/Ac)
Residual Sources
(NPDES #, WQ#,Past
Fort, Animal
Waste, etc}
Soil
(Dr'
Wet,
Preci
24
Hrs.
inches
ti
0 1
6 "
0`
/
1
0 �"r
h
"
H .
r �
P Q
�;
p
TKN
mg/kg
u ,
t
,
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
pp
(lbslacxe)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
&r1 Z1
( )
L. 4,Z?O
i •' 4�
CciO3Z0 )
Jc\it
p
5
e.5
o .3o
1 o
i 1 t l
i3Z.l5;
yS
,a.
1 ,6 i..}—]
Residuals Applications totals on FORIVI FSF supp ( attach FORM FSF supp to this form):
TOTALS:
k6
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
145:7C(4
Lime
Applied
Annual
lbs/acre
O= (X74g
A, CO5
O. S t (._
0 • bSLo
a.01c,.
0 -m l
0
0.6Zg
0.053
0 ..DI.
. i1,
to .641
:
Date
lbs/ac
Prior Years Cj niulative lbs/ac
0 • (05U
6.D?b
Si.45-l•
34.35) 7
4.053
0,
Z. r4'-t t
4f Geo 1
0.4:g i
,z>
2.3O6TL
"
ii -1 Z1
woo
Current Cumulativelbs/ac ..Q•(oLoZ
6-05g2.244
30,.. 3
`5 .w
0.351,3•Dlq
l5
--
.plu
,37t-E-
0.4b°(oj C
G Zc'rg
Permitted C. P. L. R.****
3Cp
34 i3'
—
Pernik PAN Limit l st/2nd Crop
rLF
i C5(j
I certify, under penalty 0f law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
info on, including the possibility of fines and imprisonment for knowing violations."
Signature oand Applier
rz-6 726,22
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORA'
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Operator:
Acres Used:
Lon .- .y)ea_, jam,`) Total Dry Tons Applied (Annual): 4 6bt- L o5'3
i 2Qt oO IOL.(-4 Cation Exchange Capacity (non 503 only): 4,5
C1-•ra.fl 'fil 6rn1 high, )1Ct`r!�• Owner: CMl yl@:-A _A-6D Predominant Soil Series: --f .Jdu j
L &, Z Acres Permitted: Z. /pZ Site #: Field #:
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
5-f-2._1
4 1
i
±I
7
81
1 S 1
101
'1;
12
% Solids
1. t,Z`)0
Arsenic
e Z, 5
Cadmium
1.'
Copper
zi, Z
Chromium 1 c
Lead
Z1
Mercury
0,3,,
Molyb-
denum
q • Z
Nickel
1 1
Selenium
<5 , D
Zinc
1?,„,,'
Total
Phos-
phorus
?114bd
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
DT/Ac./
App.
Event
?J
g f
_ j
10 I
11 j
12
1, f‘,47
0,4g
0,(15
(„I-1=221
1.66Ll1
Arsenic
c,C
Cadmiwn
0,a,5
Copper
D ,Sit 1
C"3 I I
0,-C.V.
Chrornitur
0 , 09,,
Lead
6.065
0,665
p ,CC> 1
Ci • 62g
Mercury
0 , cc> I
Molyb-
denum
0. dl-
Nickel
-j, 063
©.-05�
0,0/5
Selenium
i:), of
Zinc
z. j (,0
Total
Phos-
phorus
/n( )
rr},Ofl!
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
&411-4
Signature of Land Applier
0,72 ate.
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION _ ELD SUMMARY FORM
PLEASE MAKE A COPY OF I'HIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "NIA" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: C.01- . lnieow �l) WQ Permit #: tA jlcco f eLa Field #:
Land Owner: cill_eatntn<m6) Annual Dry Tons Applied: Z.'70Z Site#:
Operator: ChAde5ro_ 1 ro-r. Predominant Soil Series:7�C u.,3
Crop 1 Name: Cce&larBeirrucia Crop 1 Max. PAN:
( )
Crop 2 Name:
3
Acres Utilized:
Acres Permitted:
Cation Exchange Capacity (non 503):
Cro 2 Max. PAN:
3-34
3.3(4
4.5
Volume
(enter one)
Liquid
Cu. Yds
applied
Solids/
Gallons
o/,
Solids
Volume
Applied per
Acre
© Tans/Ac
( �Y }
Residual Sources
(NPDES #, WQ#,
Q ,
Pert, Animal
waste, etc)
Soil
Cond.
Ws '
Moist)
Preci P
24 Past
Hrs.
inches
4 1
b
�,
n Q
M q
rt
@ x
i N
fl H
x 0
TKN
mg/kg
n H
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
_{o-azi
Liocoo
i-(Z15
©-c6(i
1 3ZD`))
dry
©
5
6. J
G.a)
tii,o&O
i [! I
'Bill
Z,3.GoZ
r s° mom`
c, sc
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
I
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
a 4bZ1
Lime
Applied
Annual lbs/acre
Q . ajU
o •C)2
(>. .7(4.2".Ol
eD .63(4
Q, pb1
0,615
0, 6Z7?
G ./xA
j. 5 7
b Z' SJ
Date
lbs/ac
Prior Years emulative lbs/ae
p ,`) 4 La
4_45161
•-
;i4 'r314_2_6'
0.1-1)
7.' —r
cf.4,53
6.Gel
Z .ice
1 l-(2 7
-560
Current Cumulative lbs/ac
�, f5 (:
L1. C{
P :-
3 (..p.(2
,7-t4-t,z
. h c�
7, c� t L1
c(- v� U
[.tr6Z
to • CIa.
Z�1
Permitted C. P. L. R.****
3 (.,
3'(-I
),-?)g
---
2-(;7
15
—
3--)4
Z
Permit PAN Limit lst/2nd Crop
may, under penal y os law, tnat tn►s document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
informa . ' including the possibility of fines and imprisonment for knowing violations."
AA/
Signature of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
* ** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM``
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Operator:
Acres Used:
Chink14 a:- m3P
L \Qc x OUP
4 k i lorf). omf<1D1;uicr)Tf. Owner:
`3Ll Acres Permitted:
Total Dry Tons Applied (Annual): Z,'Z
Cation Exchange Capacity (non 503 only): 14.'5
Cary[ervin o_ fi5D Predominant Soil Series: Taco�j
'�. Zif Site #: Field ##: 4
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
3 I
1
9 1
10
1111
1121
6 n_2f
_§_l
% Solids
l-<iz%
Arsenic
< x, 5
Cadmium
1 , 5
Copper
ZIp-
Chromiurn 1l'
Lead
Z1
Mercury
D ,'L(n
Molyb-
denum
0,2
Nickel
1
Selenium
<6, Q
Zinc
4 2A
Total
Phos-
phorus
' q 5
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
DT/Ac./
App.
Event
.J
_J
3
4 f
, 5J
6 r
81
9J
ito
111
12
6,45
p. jL.j
(.-11Zi
6.4(,
.J
Arsenic
0,0DLi
Cadmium
0.001,
_i.d)2
d , u-Z
Copper
6.02.,(.1
Chr'omi€ur
f*j, Gj
0.D -
a,63ci
Lead
0,D3i-1
Mercury
tj , pO 1
0 .} 1
Molyb-
denum
0 015
O. U 15
Nickel
0 , nl
p_(1Z�
0,
Selenium
O-664
Zinc
1, 35 )
Total
Phos-
phorus
to.nq
Llano
"I certify, under penalty of law, that this document was prepared under my direction or supei vision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
,2—)
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUNIlVIARY FORM
PLEASE MAKE A COPY OF TBIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WREN NOT APPLICABLE.
Facility Name: Cor,4f M5 WQ Permit #: 6,�0.CC` f0(4 Field #:
Land Owner: Ccik ra- F'ndr) Annual Dry Tons Applied: 2,437 Site #:
Operator: ('P{�_ tl '1ui Cif Predominant Soil Series: TQrjoi{t�
Crop 1 Name: 113a Crop 1 Max. PAN: j j') Crop 2 Name:
15
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
Acres Utilized:
Acres Permitted:
374
3[4
4.5
41 0
Jj
Volume
(enter one)
Liquid
Cu. Yds
applied
Solids/
Gallons
%
Solids
Volume
Applied per
Acre
(Dry TansfAc)
Residual Sources
DES #, VJ #
Q,1
Fert, Animal
Waste, etc)
Soil
Cond.
(DM
wet
Moist)
Precip.T
Past 24
Hrs.
inches
0 I
N w
p
0
p
"'
i t
HH w
C N
G
,1
TKN
mg/kg
y
mg/kg
Nitrate:
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
weL,
Crop 2
6-1q--2-1
31o1CL
Pin
©• (65c)
r-i-Co3Z(57)
cry
O
5
3.5
0.36
4‘ob4
i li f
•ig
R.71)4
T
0. {o
Residutils Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
3 to COO:'
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
"lg. zcf-1j
Lime
Applied
Annual lbs/acre
Q.PO3
0 -COZ
0-"3-4 4
C .L`I3
©,G7.7
cpU
r)-olz
O.622
p-(1)lo
f-C i
Z,-az
Date
lbs/ac
Prior Years G'mulative lbs/ae
0 .4g l-7
4. Koq
)0-8/p
,o. 50
$_G) Ca
0.2_7
a.IG.Z
et.IoO6
C*Aci 1
, Z.Z68
1)-1-Z1
0
Current Cumulative lbs/ac
O' 662L)
C4. ici 1
'1Cc.5f
66,iac)
° 4-103
©-2 O
.3-747L
c1 •iaZ�-f`
AQ.--)
a. 1`
z
Permitted C. P. L. R.****
alp
3 4
132y
--
24j)
15
—
374
q
Permit PAN Limit 1 stl2nd Crop
1 ceruiy, under penalty o#-law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
informatio 'ncIuding the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: con-i-er,iryea.m5D Total Dry Tons Applied (Annual): Z,43Z
Permit #: Cation Exchange Capacity (non 503 only): 4, 6
Operator: Chatle3rn•6mi itiCtja• Owner: ('C`.(-t (inertM Predominant Soil Series: `ioClehi�
Acres Permitted: 3.7La Site #: fJ Field #: '5
Acres Used:
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
_LI
31
41
J
J
J
J
10
1 t
12
5,n-L1
% Solids
14%1.'6
Arsenic
<2, 5
Cadrniunn
j .6
Copper
Z14,Z
Chromium 1 g
Lead
Z 1
Mercury
a, 3 to
Molyb-
denum
0 2
Nickel
$ —1
Selenium
< 6. p
Zinc
q-ag
Total
Phos-
phorus
L4c()o
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
DT/Aci
App.
Event
J
4.-J
C,7,(150
_i
J
±
U
Jji
__9i
:ILI
itu
12
0
0,141,5h
p ,4j3
0 , 6t5Z
�y i
Arsenic
U ,w3
Cadmium
0 , 00Z
Copper
el ,ail j
Chromiurr
p , a3
CG .623
D ,67-17
6.W6
Q.L!Z
0 7-7
0.06(..,
Lead
p , )7,"7
Mercury
p •W0
Molyb-
denum
C.),DiZ
Nickel
0, b22.
Selenium
0 ,(t)(p
Zinc
`t.aci 1
1,CA, l
Total
Phos-
phorus
3Z, 3-7)D
32.37a
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
/`%
Signature of Land Applier
-
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF 'I'IIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WFiFN NOT APPLICABLE.
Facility Name: }eNnea D WQ Permit #: Laccol oqg Field #:
Land Owner: rc,n4a0,1n -D Annual Dry Tons Applied: i, )C (p Site #: G-Tictc4 5
Operator:( e5rsi). ornikihttii ITC
I Name:Irracfa,
Predominant Soil Series: (4a
Crop 1 Max. PAN:
Cro 2 Name:
Acres Utilized:
Acres Permitted:
Cation Exchange Capacity (non 503):
Cro
-273
q• 5
la
Volume
(enter one)
Liquid
Cu. Yds
applied
Solids/
Gallons
%
Solids
Volume
Applied per
Acre
D Ac
(Dry Tons/ )
Residual Sources
(NPDES #, WQ#
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
Hrs.
Inches
v
G
w
a
p
P
;1'
f t,
7
Fl
x
TKN
mg/kg
y
4
N,
H
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acze)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
1 7-1.
(A
1-621
a •5 G4
44GCGZZol--)
r try
()
3
o, 5
Q ?oo
U►
i 1 1
'23.z.J 1
ri.65G
1-1411
677.DO
1•2, ?c
4.544 4
1,40-1)3245)-)
milJ►-
C)
5
0. 5
n•�)
•i of
1 it i
' 32
i( 01
_
i .1-5q
Residulls Applications totals on FORM FSF supp ( attach FORM FSF supp
to this form):
TOTALS:
I
i' .2OO
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
33.
j
Lime
Applied
Annual lbs/acre
D ,Off(P
C3.( 4Q.
LP
G•Dt-F 1
0.04g
©-ri p
p,071
a.D3g
c.at i
i-Rt a
.67Z
`.
Date
lbs/ac
Prior Years Cumulative lbs/ac
Current Cumulative
©- (02L
7)5
54CRD
25,-)
5-433
CU•135
7 • IZ!
5 3LP
0.10()
7t_91. 3
E !-I2J
land
Ibs/ac
0 • (a7/
i -"f q
55.5(6U
Z j -t
6 - [,ig 4
p =r65
2,• 1-
�_34s5
-).1,-)
ZDL )3
._
Permitted C. P. L. R.****
Permit
a (0
3�
133
—
7_io)
4 FJ
—
3-i4.1
4
2(-1C[ d
PAN Limit l st/2nd Crop
cc
__Ti Z
I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalises for submitting false
informati'including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Operator:
Acres Used:
Cxi-er e-ri 7
tJQ U001 Otg
Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
Owner: ecryt--en4-nert-rn5D Predominant Soil Series:
')3 Acres Permitted: )3 Site #: C to Field #:
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
SampleorJ
Com-
posite
Date
5-EN-1
J
&-Z? Z1
J
J
J
6J
7
J
J
101
11
12
% Solids
1 • 6/15
1-1o7...50
Arsenic
42,6
<2.5
Cadmium
1 .6
1 .6
Copper
•1422..
7.102,
Chromium 1 6
t 1
Lead
Z 1
1
Mercury
p.-y
(.).3(a
Molyb-
denum
G .2.
G •2-
Nickel
11
("?
Selenium
<5, (j
<5. (�
Zinc
4d 3c-1
g3-G7
Total
Phos-
phorus
Z4 CO
21-1CiO(j
•
Annual Heavy Metal Field Loadings (Calculated in lbslacre):
Total
DT/Ac./
App.
Event
J
J
0-10-7-1
G.54t-1
31
J
J
?
$ 1
9 j
itcli
11
12
li
0
t,) Q
30-2-4
0.5 LJ
Arsenic
0. DO
0.6( 5
0 • ( (.
Cadinitun
p • Ct,j
p , 002
Copper
0,-6.1 t
0.Z.Se5
a.�c�
C> . 6q 1
Chrornhur
p • (7Z 1
0 . bt.0
Lead
6, (77,_'5
c • bl-
Merctny
O bbO
0•CO0
0,.QO0
0.011
Molyb-
denum
c c t
0.0(0
Nickel
0,07_0
0, d l q
(L), (-3
Selenium
0.wL
0,o.
D.61 i
1.G 10
Zinc
2.ic1)
0,q 13
Total
Phos-
phorus
1.-Ct• 31
2.,17C j 1
ic.,•6.7Z
certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
AFL-Aa62a
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION HELD SUNLVIARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: COntizirea_1-) WQ Permit #: \C Qf,(a Field #: Q
Acres Utilized:
Land Owner:.-1-0-144rEa.1y),6,D Annual Dry Tons Applied: I. " ) (4 2_ Site #: fC( TE Acres Permitted:
Operator: l n.afy)1 lc91_ Predominant Soil Series: 4
Crop 1 Name: C4.tiaragrlytia- Crop 1 Max. PAN: 1 ") 7 Crop 2 Name:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
;5 )5'
5./5
p
H 4
Volume
(enter one)
Liquid
Cu.. Yds
applied
Solids/
Gallons
%
Solids
Volume
Applied per
Acre
p Tons/Ac
Residual Sources
(NPDESQ
#, W #
Pert,
Waste, etc)
Soil
Cond.
(DrY
We
Precip•
Past 24
Hrs.
inches
d
P'
is 0
0
p µ
p
0 O•
N
"'
W
h i
p '
r y
T N
mg/kg
1
mg/kg
Nitrate
and
Nitrite
PAN Applied
(lbs/acre)
Name of Crop Type
ReceivingResidual
Application
mg/kg
Crop 1
Crop 2
1
Crop 2
r;-1 4.-1
'.L-Ia21
Q 70
1. 2b
1.102-
l-C.CU3.7_C5) idf•i
0
5
C3.5
o.30
Li6I6U
lit 1
i)3Z)
Z4 ?
1/4„Crop
RA' 4
4-5100
l.(r)
a -kilo
aCCO3ZoT)
mo f
o, I
5
0.5
0.50
i-)
1 1 1 1
/E, I
`f•(,cq
n-"=('',
1. (pq g
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
1 9I4C)1
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
'50ll?S
Lime Applied
Annual lbs/acre
o-6(;e
O-CO5
C?.gc'q-1
o,a01
O.W!
6.cO1
O•Q31
0) 7a61-7
z�
%f
Date
lbs/ac
Prior Years Cumulative lbs/ac
O.5 (-5
J- c"?e!
. 5.grcRi
zi4,, O4
6.1d1
.1113
Z-70q
6.05
0 ;-?i ()
7 t 153
.
1.11 Z 4
loon
Current Cumulative lbs/ac
0 T 7 (-1
i .(64S4
56 TA
Zlc cii
6. lds')
,0.1 LAA
Z.735
6.7L2
D iZ)
Z.11. 2]
Permitted C. P. L. R.****
3t
3 Li
1334g
—
ZO
15
—
374
.g
wed
Permit PAN Limit 1 stl2nd Crop
l Z
I certify, under penalty of law, that thus document was prepared under my direction or supervision in accordance with. a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information l ding the po hility of fines and imprisonment for knowing violations."
Signature of Land Applier
*Application Method: S - Surface, IN - Injection, INC - Incorporation
1-1Z A5.2./ **Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM'
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: CAh.11-1eGt..14\6,D Total Dry Tons Applied (Annual): g.Z%Z
Permit #: L.V0000(4.ta Cation Exchange Capacity (non 503 only):
Operator: hadebto, dniLtihol 7. Owner: icrl`[el)ipe�1' Predominant Soil Series: Maya.
Acres Used: 5• I Fj Acres Permitted: 5 j',j Site #: CT' ad--[T Field #: (;)
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample orb
Com-
posite
Date
7
8
9
10
111
12
5:Li-21
6-Z7•ZI
% Solids
I- Z`?o
1.6290
Arsenic
(2.r
<7,rJ
Cadmium
1,6
I ,6
Copper
Z, Z.
Z102
Chromium ) 4
1 g
Lead
L !
Z I
Mercury
p . 3- i,
a 3
Molyb-
denum
q1 • Z
r-! - Z
Nickel
I /
17
Selenium
<6,0
<rj D
Zine
1 q1
g,3q
Total
Phos-
phorus
v-ig00
2_1-44(Y,
Annual Heavy Metal Field Loadings (Calculated in Ibs/acre):
Total
DT/Ac./
App
Event
1 1 I
J
±
__5_1
JJ
LB]
9
10
,1
[ 2
1.447/
0.19
(5,dt15
O.
(3.0W
0.671
ii
Nq
`1-I-21
I -(©Z
1-13-2i
0iS('
Arsenic
p ,p(j(,,
0.003
Cadmium
0,(bU3
c»6(7Z
Copper
0,51)
O.312
Chromium
a, 014, 0
0,O2.1
Lead
cs,4LI'6
el, Dv,
Mercury
o , Cot
o .Do0
. (Y)1
Molyb-
denum
©• 02.0
0.01 I
..0
O. C31
Nickel
p .037)
0.621)
©.15 J
0•oil
Selenium
O,GiI
O•Coto
Zinc
1. extq
1,GDO
Z•(ZUe
4i1 .901
Total
Phos-
phorus
6(1.w)24.14d
I
_
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
.--46E:9/-
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION I+'LELD SUMMARY FORM
PLEASE MAKE A COPY OF MIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WREN NOT APPLICABLE.
Facility Name: ( -ferlihea., i f
WQ Permit #: tijQCC))Q(d-K
Land Owner: CrfAerahecL i j Annual Dry Tons Applied: 3. 243
Operator: Ckya1lei•Jin 'Y,)1[ 9i'.
Crop 1 Name: Cr9a rBeirf G1iJ L
Predominant Soil Series: t -3 i 0 Gt .
Field #: 1 3
Site #: C Tf ar.A. T
Crop 1 Max. PAN: 1 jF Crop 2 Name:
Acres Utilized:
Acres Permitted:
Cation Exchange Capacity (non 503):
Cro 2 Max. PAN:
a�
3.32
L5
;�
li 0
Volume
(enter one)
Liquid
Cu_ Yds
applied
Solids/
Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual
(NPDESQ
Pert.,
Waste,
Sources
#, wT #,
Animal
Soil
Cond.
(DrY'
Wet
Moist)
Preoi p•
Past 24
Hrs.
inches
1
(f
li N
n 0
G
0 ri w
1 "
H
,,
?
o-'
r p
TKN
mg/kg
y
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(1%s/acre)
Name of Crop Type
Receiving Residual
Application
etc)
Crop 1
Crop 2
Crop 1
Crop 2
-7.0'-21
4-KsoDo
!-a
(). ciq 3
H-C Z15l f
is rvai
(
3
a. 5
0.
646
01 I
/23z.1g
zR.c 3
WM.
(i) C -3
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
Lai
As
Cd
Cu
Cr
Pb
Ig
Mo
Ni
Se
Zn
P
ZQ.C1 3 (
Lime Applied
Annual lbs/acre
6, C`US
O .C123
0.56
o. € 5
0,041
0 . c 1
0. b1 0
0 , 33
0.0o
\ .6C.e
€4,6353
..
Date
lbs/ac
Prior Years
Cumulative lbslac
0 , 37J
-6-3-1
C3.4 b 1
14.1:
Z). )
Z• b' 1
0. D74
I - Otpg
3. Ct
0. 4D1
0-.7 Z!
�1,37p
l l-c-7J
)
dry)
Current Cumulative lbslac
p .
p .col -I
1 . i00
Z,7.V2
Z. -2-
0 , b"7 5
[ • 0cs 6
3. p(•1.1
�'} . t-i 11
Permitted C. P. L. R****
3.�
3u
i33o
--
-)
15
—
3 -)Lj.
� ?
Zw&
Permit PAN Limit l st/2nd Crop
l (a 1
I certz£y, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Date
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Cis -enea_rn6D
Total Dry Tons Applied (Annual): ,3, ZC�3
Permit #: 14/Pjj( C.K) Cation Exchange Capacity (non 503 only):
Operator: ('Licale,fil,► mf lC�' f - Owner: Con-1-enjnect,1110 Predominant Soil Series: CO ((a.
i3 �Lj Site #: CTi-ad-ff Field #: 13
Acres Used: Z(j Acres Permitted:
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or?
Com-
posite
Date
5-Z7-i i
6T
7
s
9
i o
1
12
—
% Solids
1, t,t
Arsenic
(2.6
Cadmium
1.6
Copper
Zk,Z
Chromiuin 1 g
Lead
Z 1
Mercury
t) .
Molyb-
denum
Nickel
11
Selenium
< 4: O
Zinc
3,4-.
Total
Phos-
phorus
7...4G00
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
DAT/p e./
Event
,0�
0, eN 3
_II
_i
U
jj U
._9j
-111
11
12
Q
e 43
15.D `�
Arsenic
0 , C05
Cadmium
6,W3
0 .00c3
Copper
D, €.,15
p,515
6.635
00.Ott l
Chromium°
, 0535
Lead
0, 1
Mercury
6,00 1
0.C)0 i
�,Ui'3
O 03"3
Molyb-
denum
0.01
Nickel
0 ,033
Selenium
0,r)IO
,DID
Zinc
1, 14,4q
1- ttKi
q, , ci63
Total
Phos-
phorus
LW q53
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

Facility Name: ( 45-31ne F j
Land Owner: or,y., fj.I1&. mg)
Operator: Ckv to - ct5J
Crop 1 Name: 113 rnricia..
ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF TFIIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
WQ Permit #: L f 0 ( Field #: 1 l4.
Site #:
Annual Dry Tons Applied: z .4 ig
Acres Utilized:
Acres Permitted:
3,✓D
Predominant Soil Series: -kr-i-opti..h Cation Exchange Capacity (non 503): 4,5
Crop 1 Max. PAN: 1i to Crop 2 Name:
Croa 2 Max. PAN:
�t
l)
liip
Volume
(enter one)
Liquid
Cu. Yds
applied
Solids/
Gallons(DryTons/Ac
%
Solids
Volume
Applied per
Acre
)
Residual Sources
(NPDES #, W #,
Pert., Animal
Waste,
Soil
Cond.
wry=
Wet,
Moist)
Preci
Past 24
Hrs.
r
r
N
nV "
p
N
I N
w
'
-0 ,
y
mg/kg
Nitrate
and
Nitrite
+
PAN
lb Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
1
Crop 2
Crop 1
Crop 2
r
.5-0 2)
�
3 5 0
I- IA
/'�/�
l_/, ��G7.:>
yetc)
�
o52 !7
roi
/innches
bar
e 5
as')
/ �m/g�/kg/�
4h/, 1 b
1 (t
/��m'g7/kg
Zlig
yC�jroop
7 f3
�f1 .
0 ,460 (p
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
00
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
1,3,C131
Lime
Applied
Annuallbs/acre
0.004
O,D02
0.472
nLpZ�i
r.0 Li
o.ex;i
(),015
_
C.PZ'7
6-an
1.- 52
LI.D.F
Date
lbs/ac
Prior Years Cumulative lbs/ae
6,2.1r)
3,467
iUi35i
2,1.44a0g
i,Q0Li
O.D2.72
o," J
7.33ci
6,343
i0 ...
1
i!-S71
b
Current Cumulative lbs/ac
3.2.7-1
5.0071
Iori)3
7.1-1.�3 �
t.G"Q
r).bZ9_r3• bDg
?_•3.,6
0•35k
tc.1,5g:'
Permitted C. P. L. R.****
&
6 L-f
133g
—
Ztc?
i 5 —
3-) U
qGT
-I'?
Permit PAN Limit 1st/2nd Crop
rx,
I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information eluding the possibility of fines and imprisonment for knowing violations."
,a,hd
Signature of Land Applie
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Operator:
Acres Used:
u e ccolo44
( td i-6mi - Owner:
d DU Acres Permitted:
Total Dry Tons Applied (Annual):
Cation Exchange Capacity (non 503 only):
i3,0n Site #:
4.5
Predominant Soil Series:ThJo nth
Field #:
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #)•
Sample or
Com-
posite
Date
±
?J
`t
_i
_LI
8
9i
10 1
11
12
6 fl-Zj
% Solids
I.6p2%
Arsenic
< 2.6
Cadmium
1.6
Copper
z1,2
Chromium I
Lead
2-1
Mercury
p,36
Molyb-
denum
Cl • Z
Nickel
11
Selenium
<5.6
Zinc
g,j
Total
Phos-
phorus
Z ! ?b0
Annual Heavy Metal Field Loadings (Calculated in Ibs/acre):
Total
DTIAc.J
App.
Event
Al
12 r
3J
_i
_i
±I
7
1 8 1
9 I
10
'I 1
12
G
0.4)a.
d .
$-II ZI
t.ifp(o
Arsenic
p, DO{ -I
Cadmium
6,062,
a,tbZ
Copper
O •L 77
a.472
63.029
6,G?,e-t
Chromimr.
0,6n
Lead
0,p3U
Mercury
6 , Lif l
.Q
• CO !
Molyb-
denum
0.0i5
6,66
6.623
6 •GM3
I. Z
Nickel
D , b2..)
Selenium
c ti Y
Zinc
1, i:j2
Total
Phos-
phorus
4A943q
4 •!'.'J
"I certify, under penalty of law, that this document was prepared under my direction or supei vision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION II IELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH 1LELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Cbcl+ rer_mg) WQ Permit #: 0.4 Field #: i
Land Owner: rr lam' Annual Dry Tons Applied: �702. Site #: D
Operator: ctNctiit` 1. 114,,j . -t- Predominant Soil Series: /}.)Q50..,
Crop 1 Name: Ccoofaer Crop p Cr
1 Max. PAN: l`) 7 Cro2 Name: o 2 Max PAN
Acres Utilized: Z,5
Acres Permitted: Z,��
Cation Exchange Capacity (non 503):
4. 5
iJ
F -iF-2i
Volume
(cuter one)
Liquid
Cu. Yds
applied
Solids/
Gallons
o/a
Solids
Volume
Applied per
Acre
(Dry TonslAe
Residual Sources
DES #, WQ#,
Q
Fert., Animal
Waste, etc)
Soil
Cond.
iDrY
We
Moist)
Precip.
Past 24
Hrs.
inches
�(
^
i
rt
N,
ri 0
G
rt
m N,
i µ
w
U 0
(E
6 1
i P
TKN
mg/kg
"f
1
n
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
4
_i -6Th
a .4(5
4c� ooa2b-i)
rnNai-
O
5
0.6
p.
()r6
111 I
r Z-vv
7
gtRAL.^
r
_
-
.
, g- --)
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS:
L yy
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
Zh 1
Lime
Applied
Annual
lbs/acre
0.005
c . cx)3
0.4-)5
0.033
0 , D3S
a. L)1
Q . 017
0 , c +,-p-ce.
VS ZZ
46. 1 (..R
Date
lbs/ac
Prior Years Cumulative lbslac
6,71/15
!'�. 4,
Zrd
�.�5
2.214.4
O.0aq
p_
Z5'Z
9.4tiq
i2i.Zle5
. .
j 24
56O
Current Cumulative lbslac
ci , 2...13
D.?fa'q
2.G4L
.q lc
7-36Z
0 =C3'S
O. 0
Z.543
0.1-4Zg
IZ2, '}
Permitted C. P. L. R.****
61
,3Li.•
1338
—
Dir)
16
—
37O'
'1
Z 1.g
Permit PAN Limit 1 st/2nd Crop
44T
nz
certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
informati : , eluding the possibility of fines and imprisonment for knowing violations."
Signature of Land Applier
A�j *Application Method: S - Surface, IN - Injection, INC - Incorporation
g.a **Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM'
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Operator:
Acres Used:
4-. 5
CivileA,601huicicgt, Owner: 00-1-1- nm0 Predominant Soil Series:
Acres Permitted: • CIS Z. q$ Site #: Field #: t LC/
C 4eNne -r0 Total Dry Tons Applied (Annual): z,-»z,
LOQCOOKYR Cation Exchange Capacity (non 503 only):
Residual Analysis Data (Heavy Metals and Total Phosphorus use zng/kg, % Solids use Raw Percent #1:
Sample or
Com-
posite
Date
.�
_
3
4
11
±
7
v
8
9
ILI
11
1.
6'Z7 Z1
% Solids
„ton
Arsenic
< , 5
Cadmium
) .6
Copper
Z(Z
-
Chromium )1;
Lead
ZJ
Mercury
b, 3 (0
Molyb-
denum
G.Z
Nickel
l —1
Selenium
<5, 6
Zinc
/3q?~
Total
Phos-
phorus
MOO
nnual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
D 11Apc./
Event
11
c -11-Zi
0,467
±I
_
4J
_ j
6 J
8 J
t jj
irod
i 1
12
0 .O
D
Arsenic
p . co 5
Cadmium
0.17)3
6 .tj3
c.(fJ5
Copper
Ca,475
Chrorniurr.0,0
3
c3.)33
Lead
0,6N
©. ate
p. CO 1
Mercury
0 . w !
Molyb-
denum
0,011
0,017
o , 63-1
o, Glhcr
I. 6Z2
46.10
Nickel
0,031
Selenium
0,Cpq
Zinc
I , ; 22 -
Total
Phos-
phorus
�15! loq
_
"i certrxy, under penalty of law, that this document was prepared under my direction or super vision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: 1 iiD WQ Permit #: I c( Oj1O( Field #:
Land Owner: C 4 ffial Annual Dry Tons Applied: (p,( q Site #:
Operator: ( L'i( -56occji. Predominant Soil Series: Ma
Crop 1 Name:(4. Crop 1 Max. PAN: 11 Crop 2 Name:
1l
Acres Utilized:
Acres Permitted:
Cation Exchange Capacity (non 503):
Crop 2 Max. PAN:
Vim- a'aL.
d
Volume
(enter one)
Liquid
Cu.. Yds
applied
Solids/
Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/Ac)
Residual Sources
DES #, W #
{Q ,
Fert., Animal
Waste, etc)
Soil
Cond.
��'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
ti
{i
r r�
0 "
rt r+
14 k
N
li
d !
TKN
mg/kg
yy
M
r
n
mg/kg
Nitrate
and
Nitrite
mg/kg
PAN Applied
(lbs/acre)
Name of Crop Type
ReceivingResidual
Application
Crop 1
Crop 2
Crop 1
Crop 2
7-20
45206
1 into
D •(3
-207)
dfi
(3,6
0.3 b
y(aD
1 I I 1
1 Zig
Z4 Bch
ctvtaivck
$47,21
51 C )
I -fir)
I'),g4l
14Ci^� 51-)
mai -.i-
0
5
.5
D )
4
114 I
1.32.1q
Z4.1fl
t .1q ,5
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp
to this form):
TOTALS:
4 (02D6
As
Cd
Cu
Cr
Pb
Hg
Mo 1
Ni
Se
Zn
P
63.b331
Lime
Applied
Annual lbs/acre
fig, CCP
p ,
p,gict,1
©.©L-L4
C.0-75
0-X2
6,0344
.•G(ol
0.01`8
3.6I2-
Ssq. l
Date
lbs/ac
Prior Years C:,z„ulative lbs/ac
0.3fl
6.47
as.306
II •q55'
3.60-7
O,
C) . 53
3_321
I3,
t Eg7Lg
i (.;).2 r
11-t Z
tC o()
Current Cumulative lbs/ac
C) • .35 to
c ,1LiC553C.7q 1
f2., 6222
3- Lx61-
o , CArto.
)
3.3ca
Cl .511
Permitted C. P. L. R.****
,3(p
.4. I3g
—
!fp`)
15
—
5,
Gq
Z4ci�
Permit PAN Limit lst/2nd Crop
112
I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
/I w
Sigture of Land App ier
*Application Method: S - Surface, IN - Injection, INC - Incorporation
01/6 -Ago" **Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
Date *** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (1212006)

ANNUAL METALS FIELD LOADING SUMMARY FORA?
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:ef-('{} Total Dry Tons Applied (Annual):
Permit #: tJQCCOIC Cation Exchange Capacity (non 503 only):
Operator: (mil# ,o'lir ljCtp . Owner: (Mi-en-inel m Predominant Soil Series: F4 G .
Acres Used: 13. 102 Acres Permitted: 3 62 Site #: D Field #:
U. s
17
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
_J
5n2I
41
51
6i
7
J
9I
10 I
11
''
5.Z7Z1
_A
%Solids
I.jpZLr.
1.Iono
Arsenic
C Z. 5
< 7, ,5
Cadtniuin
I.5j
1..
Copper
zi02
42
Chromium )
1
Lead
7 I
2,1
Mercury
d . -6_Iv
0 ,3-10
Molyb-
denum
q .2
q.2
Nickel
1 "j
11
Selenium
<5, jj
<54)
Zinc
3qi
cs3q
Total
Phos-
phorus
24g00
&QC°
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
DT/Ac./
App.
Event
1 I
2 f
' -12 2-1
0.q51.,
4J
5 f
_i
J
81
9 I
Ai
1.
12
0
I. Y 1
'R-21, zI
0.4 3
Arsenic
0. bOti
0, 065
O. L
Cadmitun
0. 55
p,U)3
0,00(.
Copper
0 . itta.
to,i_igci
c041
(1),N0(-i
Chromitur
®, 03
O, 21.1
Lead
0,03
O,OLIO
e),675
O . Coz
0.U3i-I
Mercury
D. CO 1
(, 001
Molyb-
dentun
C3 . C i 1'
0.018
Nickel
(1, (-2 1
6.b32,
0.061
©.01Q
3. 012
Selenium
0,()(4
0.01D
Zinc
1. (--1 16
1. 5G')
Total
Phos-
phorus
/Ala 1
e-n•/A '
qc1- 1
"I certify, under penalty of law, that this document was prepared under my direction or super vision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: ieNi u) WQ Permit #: u_DocoField #: 1 cg
Land Owner: �4j r Annual Dry Tons Applied: «. � "� Site #:
�•� *^ Predominant Soil Series: C- -01U 3 Cation Exchange Capacity (non 503):
Operator
• rim-bnkik-ocgi--
Crop 1 Name: Cccktj{ira.ICfz.•
Crop 1 Max. PAN:
Cron 2 Name:
Acres Utilized:
Acres Permitted:
•
Z-4Z
y •5
4 0
pCI
Volume
(enter one)
Liquid
q
Cu. Yds
applied
PP
Solids/
Gallons
%
Solids
Volume
Applied per
Acre
(0ry Tons/Ac)
Residual Sources
DES #, W #
Pert., Animal
Waste, etc
Soil
Cond.
(DrY'
Wet,
Moist)
Precip.
Past 24
Hrs.
inches
6 r
r
w
n 0
p
Q w
l"
w
P
0 Y
x p
TKN
mg/kg
y
r
N
i
mg/kg
Nitrate
and
Nitrite
mglkg
PAN Applied
(lbs/acre)
Name of Crop Type
Receiving Residual
Application
Crop 1
Crop 2
Crop 1
Crop 2
Pg.-Li
toLletz
t-6
Z-403
14C37O7)
r
d.2.
5
a.5
0.3O
`moo
t)l1
1.51tg
15-xR
7
miAL.
i-2b-21
ZWDO
14„2"6
ci • lo-?U
!4Cc3767)
mai --
C)
.5
t9 ,5
(.&)
4fr,.l,(c)
f t I i
/2,3LA
p.-
rl
3.57 -3
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
-
TOTALS:
I
E2(60l
As
Cd
Cu
Cr
Pb
Hg
Mo
Ni
Se
Zn
P
C5:544
Lime
Applied
Annual.lbs/acre
0.01
6•01 i
1402
0-1Zg
C3456
0.00Z
0.06.5
0.172
0.03(a
6_GG.5
mR-7
Date
lbs/ac
Prior Years Cumulative lbslac
O.
D .1L` d
5-56(„3
crnz
p
p ,o-z3
c).;$i4
i-cam 1
c..).1b
D. d
'.
11-td--2.1
t00,ID
Current Cumulative lbslac
C. I Z`)
0 • t 1 g
1M5
i7. c►00
1- IQ q
p . 625
Q. LI6'°/
j - 71.j3
p 12-(-1
eli,. 3
Permitted C. P. L. R.****
3
3 P
/-33
—
2_a)
1 5
—
3 )4
.gq
z. 8
Permit PAN Limit lst/2nd Crop
190
«I ti
cer fy, under penalty of law, chat this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, ,eluding the possibility of fines and imprisonment for knowing violations"
Signature of Land Applier
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FOR1Ve
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: rcryl-e e0.-Kbp Total Dry Tons Applied (Annual): g, 6,L/ )
Permit #: 00 C5C0i OW Cation Exchange Capacity (non 503 only): Lk- `5
Operator: CIiQtIeill fLth Owner: ecni-eAtirlea, in D Predominant Soil Series: dok
Acres Used: 7, qZ Acres Permitted: Z C/Z Site #: D Field #: j449
Residual Analysis Data (Heavy Metals and Total Phosphorus use nag/kg, % Solids use Raw Percent #):
Sample or
Com-
posite
Date
FJ -Tiz1
A
±i
U
jj
A
jj
' :
11
12
Zl
% Solids
.„6:n
1•(o71)
140l2o
Arsenic
C2, 5
C 2, 5
Cadaniunn
1.6
1
Copper
Z('2
7 t,Z
Chroznimn 1 e
1 q
Lead
ji
Z1
Mercury
p, a
0 4 ate
Molyb-
denum
C[- Z
0
Nickel
17
17
Selenium
<6.0
C5.0
Zinc
.434
q0 3ej
Total
Phos-
phorus
t4 ?OC)
z.q o0
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
DT/Ac./
App.
Event
/ lr 71
Z.V?L73
i-Z4-Z1
to•Ip-)U
U
6
±
. s j Lpj
-:i,
11
111
k'z.5
Ili
Q
73
Arsenic
0. DI Fj
0 ,UO'a
O. e1Q
Cadmium
0,CX1ci
0,002
04'i 1
Copper
1, 6-Li
0, 1
1.T) z
Chroiniuir
©. oil
0 . 0Zu
t) • 124g
Lead
0.1 7,2
0.bi.d
0.6(.)
Mercury
4•052,
O.CD0
p•DOZ
Molyb-
denum
4.D53
C..01Z
p.b(6
Nickel
p,bgG
0,b 3
o•1Z2
nt 66. U
Selenium
a , olq
0.057
Zinc
c. i.4t))
1,1 7....1-4
5, S
Total
Phos-
phorus
itIti.50
3343fp&
171.G31)
"I certify, under penalty of law, that this document was prepared under my direction or super vision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
4f4 i
Signature of Land Applier
Date
DENR FORM MFLSF (12/2006)

ANNUAL LAND APPLICATION t th,LD SUMMARY FORM
PLEASE MAKE A COPY OF TUTS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH FIELD APPLIED ON
PLACE A "NIA" IN A BLANK OR BOX WHIN NOT APPLICABLE.
Facility Name: C©rkninect-- D WQ Permit #: n=)/0( .4 Field #: 1 C j Acres Utilized: Er/5
Land Owner: Ccn* i e . 1o7 Annual Dry Tons Applied: 1 1, LK i..14 Site #: C` iaCA ir Acres Permitted:
Predominant Soil Series: 4
Crop1 Name: .
(�`�(��i)��. Crop 1 Max. PAN: i`�1 Z Crop 2 Name: p
Operator:( (l4nc��?r,
Cation Exchange Capacity (non 503):
Cro 2 Max. PAN:
11:15
e�_ 5
1] 0
Q
Volume
(enter one)
Liquid
Cu. Yds
applied
Solids/
Gallons
%
Solids
Volume
Applied per
Acre
(Dry Tons/AG)
Residual Sources
(NPDES #, WQ#,
Fert., Animal
Waste, etc)
Soil
Cond.
(Dry'
Wet,
Moist)
Precip.
Past 24
Hrs.fi
inches
�
'd
r r
i 0
0
G "
r rt
,"
7
a
r w
P
i p
TKN
mg/kg
N;
N
mg/kg
Nitrate
and
Nitrite
mg/kg
p AN Applied
(lbs/acne)
Name of Crop Type
ReceivingResidual
Application
Crop 1
Crop 2
Crop 1
Crop 2
1 11
r/ocLZ7
1-laz`7( <
6 .G-1")
A Ci .2)7.(5-P
From
0
s
©r 5
a.
0
111 1
q3lig
2
.‘;10
Q 4 7)
Residuals Applications totals on FORM FSF supp ( attach FORM FSF supp to this form):
TOTALS.
nDcco
As
Cdd
Cu
Cr
Pb
Hg
Mo
Ni
Se
.Zn
P
ZI.cip5
Lime
Applied
Annual lbs/acre
0.005
o -cD3
0.512
C..o
.041
C3 CU i
, () i b
o.1$3
0.145O.0I--?
6.Of 0
i .13ci
ZZrt
44.415
`
'
Date
lbs/ac
Prior Years Cumulativelbs/ae
Q. Cbq
6.co4
C-(o2
6.0{01
0,CD1
0.CO66.01g
lid-2.1
.dc)c
Current Cumulative Ibs/ac
Cs.. )(U
D.007
t.3`7U
O.09(e
0,11-L
0 1
o-LZ3(00
•6g
O.62---)
3.Q33
Pen fitted C. P. L. R.****
y- to
all
133g
—
zit, i
—
37)L4
S'q
ZCPC'
Permit PAN Limit 1st/2nd Crop
1 17
i< certYfy, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that
qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false
information, including the possibility of fines and imprisonment for knowing violations."
Signature of Land Appli.er
Date
*Application Method: S - Surface, IN - Injection, INC - Incorporation
**Volatilization Rate: Surface - 0.5, Injection/Incorporation -1.0
*** Mineralization Rates: Compost -0.1, anaerobially digested -0.2,
aerobically digested -0.3, raw sludge -0.4
****C.P.L.R.: Cumulative Pollutant Loading Rate
DENR FORM FSF (12/2006)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Operator:
Acres Used:
Jc4eni-r-)€0„.m6-7
Qor0 EO(
Char tebli),6Miliegi- Owner:
11.7) Acres Permitted:
Total Dry Tons Applied (Annual): J 1 , L L/
Cation Exchange Capacity (non 503 only): 1t. rj
CCni941@a inn Predominant Soil Series: ,L} J �,
1 I.7 5 Site #: G-1i id-fl Field #: fC1J
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sample ors[
Com-
posite
Date
$
±1
jj
a
9 1
10
11
12
5-1) 2 j
% Solids
1,1,2 44)
Arsenic
< 2. 6
Cadmium
1.6
Copper
Z.lo Z
Chromium J g
Lead
Z }
Mercury
rj, 3
Molyb-
denum
R . 2_
Nickel
1 ']
Selenium
< 5 O
Zinc
«3
Total
Phos-
phorus
114400
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
DT/Ac./
App.
Event
1
4 f
±
f
7 J
j 11
10
11 j
12
0
4 `,Y-
0 -Cb3
16-1
Q.ci^)
._0,6419-2
Arsenic
•S , fir
Cadmium
6 ,603
Copper
0.5 iz
o. i2
Chromium
0,036
Lead
0 , f LJ 1
a.DY--t-1
D •Ce)1
Mercury
p,C 1
Molyb-
denum
0-614
0.D1d
Nickel
0 , 6,33
0• 633
0.016
-g
Selenium
p . 010
Zinc
1. (03ci
Total
Phos-
phorus
64,1F5'5
t jg.4T5
certi y, un er pena ty o law, that t is document was prepared under my direction or supervision in accordance
with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted.
I am aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
4.14/t/ '107a A,
1:11°:?1'
Signature of Land Applier
Date
DENR FORM MFLSF (1212006)

PATHOGEN AND VECTOR
ATTRACTION REDUCTION FORM

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Facility Name:
WWTP Name:
eA1511-frYta -D WQ Permit Number: {,owoof,
fl`1-$rt iy)5 NPDES Number: j— .0:YjZ6D
Monitoring Period: From ,ic�nt.lc;t1 t wit To))e_c, 3) 7
Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed:
Class A:
Alt. A (time/temp) ❑
Alt B (Alk Treatment) ❑
Alt. C (Prior Testing) ❑
Alt.D (No Prior Test) •
Process to Further Reduce Pathogengs •
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost ❑
Heat Drying ❑
Heat Treatment ❑
Therrnophilic ❑
Beta Ray 0
Gamma Ray 0
Pasteurization Cl
:`
Class B:
Alt. (1) Fecal Density IYI
Alt. (2) Process to Significantly Reduce Pathogens ❑
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization ❑
Aix Drying •
[ Composting ❑
Aerobic Digestion f '
Anaerobic Di estion
S
If applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Parameter
Allowable Level
in Sludge
Pathogen DensityNumber
gExcee-
of
deuces
Frequency
of Analysis
Sample
Type
Analytical
Tech
mane
Minimum
Geo. MeanMaximurr
Units
Fecal Coliform
2x10tothe P
6th power
per gram of
total solids
MPN
'f�)©
1 1
3ICJQ
pow"
oU'Da
0
G Q.h
4ZUE-CX0
CFU
1000 rnpn pe gram
of total solid (dry
weight)
Salmonella bacteria
(in lieu of fecal
conform)
3 MPN per 4 grams
total solid (dry
weight)
Vector Attraction Reduction (15A NCAC 02T .1107) - Please indicate alternative performed:
Alt.1 (VS reduction)
0
Alt. 2 (40-day bench) ■
Alt, 3 (30-day bench) ❑
Alt. 4 (Spec, 02 uptake)
IA
Alt. 5 (14-Day Aerobic)
0
Alt. 6 (Alk, Stabilization 0
Alt 7 (Drying - Stable) ❑
Alt. 8 (Drying - Unstable)
❑
Alt. 9 (Injection)
❑
Alt, 10 (Incorporation) •
No vector attraction reduction alternatives were performed
❑
CERTIFICATION STATEMENT (please check the appropriate statement)
d "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have been met."
❑ "I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you cheek this statement attach an explanation why you have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
f �i�l�t°�b'l. nt {C j�i1Lal A{ irr a ZG C L .oroitildlc -y7/ •
Prepare � ame and Title (type or print) gg Land Applier Name and �
itle (if applicable)(type or print)
Signature of Preparer* Date Signature of Land Applier (if plicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 1SA NCAC 2T .1102 (26)
DENR FORM PVRF 02T (12/2006)

OTOZ
GREE VILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
G_
PHONE [phone]
FAX'(252) 756E-0633.
ID#: 416 A
DATE COLLECTED: 05/03/21
DATE REPORTED : 05/07/21
REVIEWED BY:
Sample Sample Sample Sample Sample Analysis Method
#1 #2 #3 #4 #5 Date Analyst Code
Total Residue, mg/I 17540 Missing Missing Missing Missing 05/04/21 JMS 2540B-11
Fecal Coliform (MPN), /gram Solids 1300 Missing Missing Missing Missing 05/03/21 JMS 9221E-06

114 OAKMONT DR1V
GREENVILLE, N.0 27858',;
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P,O, BOX 477
GRIFTON ,NC 28530
PARAMETERS
Sample Analysis Method
lit Date Analyst Code
Total Residue, mg/1 17220 05/04/21 JMS 2540B-11
Fecal Coliform (MPN), /gram Solids 460 05/04/21 KDS 9221E-06
PHONE [phone]
FAX [phone]
ID#: 416 A
DATE COLLECTED: 05/04/21
DATE REPORTED : 05/07/21
REVIEWED BY:

14 OAKMONT DFUVE PHONE '( a2) 756-620
GR ILLEM c 27858 FAX [phone].
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
Sample Analysis Method
M3 Date Analyst Code
Total Residue, mg/1 16620 05/06/21 CAW 2540E-11
Fecal Coliform (MPN), /gram Solids 200 05/05/21 JMS 9221E-06
ID#: 416 A
DATE COLLECTED: 05/05/21
DATE REPORTED : 05/12/21
REVIEWED BY: ��✓L/J

114 OAKM©NT DF UVE PHONE',(252) 7 6-620€3
GC EENVILLE,''N.C. 27858 FAX [phone]`:'
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
Sample Analysis Method
14 Date Analyst Code
Total Residue, mg/1 18640 05/11/21 BLV 2540B-11
Fecal Coliform (MPN), /gram Solids 560 05/10/21 BLV 9221E-06
ID#: 416 A
DATE COLLECTED: 05/10/21
DATE REPORTED 05/18/21
REVIEWED BY: ���

141 OAKMONT'DRIVE PHONE [phone]'
GREENVILLE N.C. 27858 FAX [phone]'
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
Sample Analysis Method
#5 Date Analyst Code
Total Residue, mg/1 18200 05/11/21 BLV 2540B-11
Fecal Coliform (MPN), /gram Solids 820 05/11/21 BLV 9221E-06
ID#: 416 A
DATE COLLECTED: 05/11/21
DATE REPORTED : 05/18/21
REVIEWED BY:

1M-AEIg L
[Pr
.4 OAKMONT`DRIVE PHONE '(252)'756-6208
GREENVILLE,'N.C. 2 856 FAX (252) 756`-0633
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIP'TON, NC 28530
PARAMETERS
Sample Analysis Method
116 Date Analyst Code
Total Residue, mg/l 17640 05/19/21 JMS 2540B-11
Fecal Coliform (MPN), /gram Solids 3100 05/12/21 BLV 9221E-06
ID#: 416 A
DATE COLLECTED: 05/12/21
DATE REPORTED : 05/25/21
REVIEWED BY:

4 OAKMONT DRIVE PHONE [phone] .:
GREENVILLE,`'N.C. 27858 FAX [phone]
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON, NC 28530
PARAMETERS
Total Residue, mg/I
Fecal Coliform (MPN), /gram Solids
Sample Analysis Method
#7 Date Analyst Code
18720 05/19/21 JMS 2540B-11
560 05/17/21 BLV 9221E-06
ID#: 416 A
DATE COLLECTED: 05/17/21
DATE REPORTED : 05/25/21
REVIEWED BY:

Specific Oxygen Uptake Rate
SOUR
4\
Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facility Name:
Biosolids Permit Number:
Date:
Digester Temperature:
Sampling Date/Time:
Sampled By:
Analysis Date/Time:
Analyzed By:
Sample Volume:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
(mgli)
Slope: 0.0
Intercept: 8.8
Correlation Coefficient: 1.0
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
milliliters
% Dry Solids
degrees Celsius
degrees Celsius
2.28 mg Oxygen/hr
0.13 mg Oxygen/g/hr
20 degrees Celsius
1
Temperature Corrected Specific Oxygen Uptake Rate:
mg Oxygen/g/hr
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.

8.9
8.8
8.7
8.6
a)
E 8.5
c
m
a
x 8.4
0
8.1
8
7.9
Oxygen Uptake Rate Chart
y =-0.038x + 8.8755
1
2 3 4 5 6 7 8 9
Time (minutes)
10
11
12
13
14
15
16

Specific Oxygen Uptake Rate
SOUR
4i
Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facility Name:
Biosolids Permit Number:
Date:
Digester Temperature:
Sampling Date/Time:
Sampled By:
Analysis Date/Time:
Analyzed By:
Sample Volume:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
(mg/I)
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
milliliters
% Dry Solids
degrees Celsius
degrees Celsius
0.0
8.6
1.0
2.37 mg Oxygen/hr
0.13 mg Oxygenlglhr
22 degrees Celsius
0.907029478
Temperature Corrected Specific Oxygen Uptake Rate:
mg Oxygen/g/hr
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.

8.8
8.6
8.4
1713
E
a 8.2
T
0
a) 8
0
N
7.8
7.6
7.4
Oxygen Uptake Rate Chart
y =-0.0395x + 8.609
1
2 3 4 5 6 7 8 9
Time (minutes)
10
11
12
13
14
15
16

Specific Oxygen Uptake Rate
SOUR
Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facility Name:
Biosolids Permit Number:
Date:
Digester Temperature:
Sampling Date/Time:
Sampled By:
Analysis Date/Time:
Analyzed By:
Sample Volume:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
(mg/I)
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
milliliters
% Dry Solids
degrees Celsius
degrees Celsius
0.1
8.1
1.0
4.19 mg Oxygen/hr
0.23 mg Oxygenlglhr
22 degrees Celsius
0.907029478
Temperature Corrected Specific Oxygen Uptake Rate:
mg Oxygen/g/hr
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.

8.4
8.2
7.8
ass
E 7.6
a
a
x 7.4
0
m
Z. 7.2
0
6.8
6.6
6.4
y =-0.0699x + 8.211
Oxygen Uptake Rate Chart
1
2 3 4 5 6 7 8 9
Time (minutes)
10
11
12
13
14
15
16

Specific Oxygen Uptake Rate
SOUR
Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facility Name:
Biosolids Permit Number:
Date:
Digester Temperature:
Sampling Date/Time:
Sampled By:
Analysis Date/Time:
Analyzed By:
Sample Volume:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
(mgll)
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
milliliters
% Dry Solids
degrees Celsius
degrees Celsius
0.0
8.8
1.0
2.91 mg Oxygen/hr
0.16 mg Oxygen/g/hr
21 degrees Celsius
0.952380952
Temperature Corrected Specific Oxygen Uptake Rate:
mg Oxygen/g/hr
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.

9
8.8
8.6
E
= 8.4
0
8.2
0
w
cn
8
7.8
7.6
1
Oxygen Uptake Rate Chart
2 3 4 5 6 7 8 9
Time (minutes)
10
11 12
13
y =-0.0485x + 8.8213
14
15
16

Specific Oxygen Uptake Rate
SOUR
Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facility Name:
Biosolids Permit Number:
Date:
Digester Temperature:
Sampling Date/Time:
Sampled By:
Analysis Date/Time:
Analyzed By:
Sample Volume:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
(mg/I)
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
CMSD
Andrew Edwards
5-10-21/1350
Windy Sammond
milliliters
Dry Solids
degrees Celsius
degrees Celsius
0.1
8.6
1.0
5,78 mg Oxygen/hr
0.31 mg Oxygen/glhr
22 degrees Celsius
0.907029478
Temperature Corrected Specific Oxygen Uptake Rate:
mg Oxygenlglhr
Instructions: Enter Data in the Blue Boxes, The Calculation and the Spreadsheet execute automatically.

Dissolved Oxygen (mg/I)
10
9
8
7
6
5
4
3
2
1
0 -1
y =-0.0963x + 8.71
Oxygen Uptake Rate Chart
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
Time (minutes)

Specific Oxygen Uptake Rate
SOUR
Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facility Name:
Biosolids Permit Number:
Date:
Digester Temperature:
Sampling Date/Time:
Sampled By:
Analysis Date/Time:
Analyzed By:
Sample Volume:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
(mg/I)
Scope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
CMSD
WQ0001048
5/11/2021
5-11-21/1340
Andrew Edwards
5-11-21/1345
Windy Sammond
1000
1.89
0.1
9.0
1.0
milliliters
Dry Solids
degrees Celsius
degrees Celsius
4.58 mg Oxygen/hr
0.24 mg Oxygen/g/hr
22 degrees Celsius
0.907029478
Temperature Corrected Specific Oxygen Uptake Rate:
0.22f
mg Oxygen/g/hr
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.

9.2
9
8.8
8.6
0
-a 8
m
a
Q
N 7.8
b
7.6
7.4
7.2
7
y =-0.0763x + 9.0458
Oxygen Uptake Rate Chart
1
2 3 4 5 6 7 8 9
Time (minutes)
10
11
12
13
14
15
16

Specific Oxygen Uptake Rate
SOUR
Time
(minutes)
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Facility Name:
Biosolids Permit Number:
Date:
Digester Temperature:
Sampling Date/Time:
Sampled By:
Analysis Date/Time:
Analyzed By:
Sample Volume:
Total Solids:
Beginning Temperature:
End Temperature:
Dissolved Oxygen Level
(mg/I)
Slope:
Intercept:
Correlation Coefficient:
Oxygen Uptake Rate:
Ambient Specific Oxygen Uptake Rate:
Average Temperature:
Temperature Correction Factor:
milliliters
% Dry Solids
degrees Celsius
degrees Celsius
0.1
8.6
1.0
3.80 mg Oxygenlhr
0.20 mg Oxygenlglhr
18 degrees Celsius
1.1449
Temperature Corrected Specific Oxygen Uptake Rate:
mg Oxygenlglhr
Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically.

8.8
8.6
8.4
8.2
73)
5
c 8
a)
x
0
7.8
0
W
Vl
0 7.6
7.4
7.2
7
Oxygen Uptake Rate Chart
y = -0.0634x + 8.6703
1
2 3 4 5 6 7 8 9
Time (minutes)
10
11
12
13
14
15
16

GROUNDWATER MONITORING
LAB REPORTS

GW-59A COMPLIANCE REPORT FORM Permit # tom
(Submit one each monitoring period with GW 59 forms.)
1
Enter date monitoring results were due. ( 11- 2i.) Will this monitoring report (GW-59 and GW-59A)
YES
`x/
NO
be submitted after the established due date?
2
Was any required information missing on the GW-59 report forms?
'YO
NO
IF the answer to question 1 or 2 is "YES;', list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the requirqd information. ue_did(i % rptexc -1-4"Ve—
f tOtsdt5 Pcm e eat rnakrda( tab un` 12,-k-2L ' "Tht.'YOC. 06,6 rtic-(- Min kJW)
4-hi anal\f6(5 b-eCauoe c)-P pc•.6ervaQ) 15 tik514-P4_,2b-ilE> r Ur
h-e6€Ll+5 (61 I l bezeibrni t i
Nen�. � Th0(0 t O nP f -1l Z 1, t.l-
ton vio.rePttem.1-4L-002. boo i s caicde©-CN-hi 5 i 6hue•
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
identification plate, area overgrown, etc.)? If the answer is "Yes", contact the Regional Once for guidance.
YES
NQ
�!(
4
Are any monitored constituents equal to or above the established standards?
IS
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:
Qe1I-4V16 -TeX- 11..ZLt 1L ChfomiUr() Zi) qkL
o€.11 1g -MC 11.-LvLmcfL
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
same constituent(s) in the same well(s) in the last two years?
'YE$
�/
NO
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).
t0 tJ Zc3 Ottt 4-1 -IOC tO,Z-?rn9Ib
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YESjq'
J�
If the answer is "YES", a groundwater quality problem may be occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells may be improperly
located; contact the Regional Office.
7
is the permittee implementing previously approved actions required by the Division involving this
groundwater quality problem?
YE$
NO
If the answer to question 7 is "YES", doscribe those actions in the space provided below.
If the answer to question 7 is "NO'; contact the Regjonal 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. -rh e -roc 1Neb nC }" ict I N [-on 170Py(3 n �.p�ij L`r'2GL. Lacar
e- Pr -Wart t ere p1'C coe 14J1:5-C-c�r c(rn i -rht, i yet' taid,e, i 5
fiery Gt) r4 -r.JPoo anaOrre_'o 1 cc bIt4V a lrne`'t i(1 lcfi��, M
et4ed�in (e+morn a tounLit t r �fi ft$S oGr I r• ,nit i4,l I
e h1` el errors um lra�-ran5 are m Wej a pe rl�t owl hl',c
'Ear i r� • u►1- . (DR- totZo io c6k:0.teo�i5 i sue .
g
The perso 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 G W-59 form.
raTIVie6 a !not �. hat=lF�eFa o�`ve nto RI a e SSW as l o f io, 4 itIifi rAJA `
re o Y�" ` hee�,�or�GWrb9A�31s�fruekantl cornpleta�t�fii'i,e,;best� f�y�kno�vle�geAMV-"-�y`'l;
Signature of permittee (or Authors d Agent) Date
GW-59A 12/8/2003

GW-59A COMPLIANCE REPORT FORM Permit #oOcoiO4q
(Submit one each monitoring period with GYY--59 forms)
I
Enter date monitoring results were due. ( ) I-3b;M) Will this monitoring report (GW-59 and GW-59A)
YES
)J
NO
be submitted after the established due date?
2
Was any required information missing on the GW-59 report forms?
Y-ees
J�
NO
IF the answer to question 1 or 2 is "YES", list in the space provided below the well identification number(s) and
explain tho problems encountered in obtaining the required information.
-Thky, f Ii.5 i nc'.it de.. lc,VOC,---1- i- tab ietrap) ed cn t i-l=2-)d Litio
-ile era -ken I tiOC1L.iI(nl4he 0.Zc}Z1&rnPri 11Sevrr-r
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
identification plate, area overgrown, etc.)? If the answer is "Yes", contact the Regional Office for guidance.
YES
NO
4
Are any monitored constituents equal to or above the established standards?
YES
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 tho space provided below:
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
same constituent(s) in the same well(s) in the last two years?
YES
NO
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 iwo years).
6
Are the monitoring wells listed in section S located at or beyond the review boundary?
YES
NO
!f the answer is "YES", a groundwater quality problem may be occurring. CONTACT THE REGIONAL.
OFFICE IMMEDIATELY FOR GUIDANCE If the answer is "NO", monitoring wells may be improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
groundwater quality problem?
YES
NO
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.
'ti e y ae owl e b above it for o s ev a d liM;[loOVI sy iltd`d »t [ _
_r'epott (C,o • itaace Re oatkli9AjRfs' fi�u hdre tiOT tetto the bes gfkjacwledge -. { l
Signature of Fermittee (or Author ••d Agent) Date
GW-59A 12/8/2003

JIMI2d
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON, NC 28530
PARAMETERS
Dxinking Water ID; 37715
Waste,W.ater__IP_1.0.
PRONE [phone]
FAX [phone]
ID#: 416
DATE COLLECTED: 10/20/21
DATE REPORTED : 11/29/21
REVIEWED BY: ,Z�y
Well #9 Well #10 Well ff14 Well 1115 Well #17 Analysis Method
Date Analyst Code
Fecal Coliform (MF), /100 MI5 <1 <1 <1 <1 10/20/21 CAW 9222D-15
Ammonia Nitrogen as N, mg/1 1.01 0.04 0.06 0.45 3.26 10/25/21 KES 350.1 R2-93
Nitrate Nitrogen as N, mg/I 0.14 0.33 <0.04 <0.04 0.14 10/20/21 KES 353.2 R2-93
Total Organic Carbon, mg/1 6.80 2.15 1.89 11.22 2.94 11/05/21 I-IMM 5310C-14
Chloride, mg/1 4 2 3 3 4 10/25/21 RLV 4500CLB-11
Total Dissolved Residue, mg/I 43 24 13 120 35 10/21/21 CAW D5907-13
Total Chromium, ug/I <5.0 <5.0 10 20 5 10/21/21 LFJ EPA200.7
Copper, ug/I <10 <10 <10 <10 <10 10/21/21 LEI EPA200.7
Conductivity (at 25c), uMhos/cm 66 35 34 139 43 10/25/21 HMV 2510E-11
Total Ortho-Phosphate as P, mg/I 0.03 0.04 0.02 0.07 0.07 10/21/21 KES 4500PE-11

114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. 8OX 477
GRIFTON, NC 28530
PARAMETERS
Fecal Coliform (MF), /100 Mls
Ammonia Nitrogen as N, mg/I
Nitrate Nitrogen as N, mg/I
Total Organic Carbon, mg/I
Chloride, mgll
Total Dissolved Residue, mg/1
Total Chromium, ug/1
Copper, ug/1
Conductivity (at 25c), uMhos/cm
Total Ortho-Phosphate as P, mg/I
Well #18 Analysis Method
Date Analyst Code
2 10/20/21 CAW 9222D-15
0.10 10/25/21 KES 350.1 R2-93
<0.04 10/20/21 ICES 353,2 R2-93
11.42 11/05/21 HMM 5310C-14
3 10/25/21 BLV 4500CLB-11
100 10/21/21 CAW D5907-13
<5.0 10/21/21 LFJ EPA200.7
<10 10/21/21 LFJ EPA200.7
135 10/25/21 HMV 2510E-11
0.03 10/21/21 KES 4500PE-11
PHONE [phone]
FAX [phone]
ID*: 416
DATE COLLECTED: 10/20/21
DATE REPORTED : 11/29/21
REVIEWED BY:

Environment 1, Incorporated
SEA Ord tom t� <i it 2€t j%i�'ii�1�5W txlk�,r�,�E
CLIENT: CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BO 477
GRIRTO
REVIEWED BY
VOLATILE ORGANICS
METHODS 6200C-11
CLIENT ID:
416
ANALYST: JAP
DATE COLLECTED: 11/17/21
DATE ANALYZED: 11/25/21
DATE REPORTED: 12/17/21
S52),17WWW02
7S 252) 7 6;0
Page: 1.
PARAMETERS, ug/1
Well #9
Well #10
Well #14
Well #15
Well #17
1. Benzene
<0.50
<0.50
<0.50
<0.50
<0.50
2. Bromobenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
3. Bromochloromethane
< 0.50
< 0.50
< 0.50
< 0.50
< 0,50
4. Bromodichlo:•ornethane
< 0.50
< 0.50
< 0.50
< 0,50
< 0.50
5, Bromoform
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
6. Bromomethane
<0.50
<0.50
<0.50
<0.50
<0.50
7. N-Butylbenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
8. Sec Butylbenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
9. Tert-Butylbenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
10. Carbon Tetrachloride
< 0.50
< 0.50
< 0.50
< 0,50
< 0.50
11. Chlorobenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
12. Chloroethane
< 0.50
< 0.50
< 0.50
<0.50
< 0.50
13. Chloroform
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
14. Chloromethane
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
15. 2-Chlorotoluene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
16. 4-Chlorotoluene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
17. Dibromochloromethane
< 0.50
< 0.50
<0.50
< 0,50
< 0.50
18. 1,2-Dibromo-3-Chtoropropane
< 0.50
< 0.50
<0.50
< 0.50
< 0.50
19. 1,2-Dibromoethane
< 0.50
< 0.50
<0.50
< 0.50
< 0.50
20. Dibromomethane
< 0.50
< 0.50
<0.50
< 0.50
< 0.50
21. 1,2-Dichlorobenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
22. 1,3-Dieliorobenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
23. 1,4-Dichlorobenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
24, Dichlorodifiuoromethane
< 0.50
< 0,50
< 0.50
< 0.50
< 0.50
25. 1,1-Diehloroetl:ane
< 0.50
< 0,50
< 0.50
< 0.50
< 0.50
26. 1,2-Dichloroethane
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
27. 1,1-Dichloroethene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
28. Cis-1,2-Dtchloroethene
< 0.50
< 0.50
< 0.50
<0.50
< 0.50
29. trans-1,2-DichIoroethene
< 0.50
< 0.50
< 0.50
<0.50
< 0.50
30. 1,2-Diehloropropane
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
31. 1,3-Dichloropropanc
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
32. 2,2-Diehloropropane
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
33. 1,1-Dichloropropene
< 0.50
< 0.50
< 0.50
<0.50
< 0.50
34. Cis-1,3-Dichloropropene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
35. trans-1,3-Dichloropropene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
36. Eutylbenzene
< 0.50
< 0.50
< 0.50
< 0.50
<0.50
37. Hexachlorobutadiene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
38. lsapropylbenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
39. 4-lsopropyltoluene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
40. Methylene Chloride
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
41. Naphthalene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
42. Propylbenzene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
43. Styrene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
44. 1,1,1,2 TetrachIoroethane
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
45. 1,1,2,2-Tetrachloroethane
< 0.50
< 0.50
< 0.50
< 0.50
<0.50
46. Tetrachloroethene
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
47. Toluene
< 0,50
< 0,50
< 0.50
< 0.50
<0.50
48. 1,2,3-Tricblorobenzene
< 0,50
< 0.50
< 0.50
< 0.50
< 0.50

Environment 1, Incorporated
'T' n 14;wivaitr q,[4 - 'Y : ill MW i tIO2 7VIZ ti e .trig ", r r A 9t,.€4,S iY t 41E0 35i1
CLIENT: CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. 1 OX 477 f'1 1 1
GRIP, �j7s NC/f 2853
REVIEWED BY:
VOLATILE ORGANICS
STD. METHODS 6200C-11
CLIENT ID:
ANALYST:
DATE COLLECTED
DATE ANALYZED:
DATE REPORTED:
J°JEP r(JJf la�'J f rJ��ll Ali �laJilJJs�jf`l!€:},'�,.�J��!;J�lii�l
f:�,�cs:•ti13Pi�ei�: �i3;�=;.�;= ypas( �:i+' ;A
416
TAP
: 11/17/21
11/25/21
12/17/21
Pages 2
PARAMETERS, ug/l
Well #9
Well #10
Well #14
Well #15
Well #17
49.
1,2,4-Trichlorobenzene
<
0.50
<
0.50
<
0.50
<
0.50
<
0.50
50.
1,1,1-Trlehloroethane
<
0.50
<
0.50
<
0.50
<
0.50
<
0.50
51.
1,1,2-Trichloroethane
<
0.50
<
0.50
<
0.50
<
0.50
<
0.50
52.
Trichloroethene
<
0.50
<
0.50
<
0.50
<
0.50
<
0.50
53.
Triehlorofluoromethane
<
0.50
<
0.50
<
0.50
<
0.50
<
0.50
54.
1,2,3-Trichloropropane
<
0.50
<
0.50
<
0.50
<
0.50
<
0,50
55.
1,2,4-Trimethylbenzene
<
0.50
<
0.50
<
0.50
<
0.50
<
0.50
56.
1,3,5-Trlmethylbenzene
<
0.50
<
0.50
<
0.50
<
0.50
<
0.50
57.
Vinyl Chloride
<
0.50
<
0.50
<
0.50
<
0.50
<
0.50
58,
Total Xylenes
<
1.00
<
1.00
<
1.00
<
1.00
<
1.00
59.
Methyl Tert Butyl Ether
<
1.00
<
1.00
<
1.00
<
1.00
<
1.00

Environment 1, incorporated
.4a
? Qa_i34�C 7p 5� 1 iE Mi$109
"iGR>:�NV1Ll,�.�1C x,27Q�5z.7,Qej
gfix-y'I
CLIENT: CMSD (SLUDGE & WELLS ACCT)
CONTZNTNEA METRO. SEWAGE DIST.
MS. REIM PRTD iEN
P.O. BOX 477
ORTFT. , NC 28530
REVIEWED BY:
\s
CLIENT ID:
.33
4 16
ANALYST: OAP
DATE COLLECTED: 11/17/21
DATE ANALYZED: 11/25/21
DATE REPORTED: 12/17/21
VOLATILE ORGANICS
STD. METHODS 6200C-11•
Well #18
PARAMETERS, ug/i
1, Benzene
2. Bromohenzene
3. Bromochloromethane
4, Bromodichloromethane
5. Bromoform
6. Bromomethane
7. N-Butylbenzene
8. Sec-Butylhenzene
9. Tert-Butylbenzene
10. Carbon Tetrachloride
11, Chlorobenzene
12. Chloroethane
13. Chloroform
14. Chloromethane
15. 2-Chlorotoluene
16, 4-Chlorotoluene
17. Dibromochloromethane
18. 1,2-Dihromo-3-Ch ioropropane
19. 1,2-Dibroroethane
20. Dibromonkethane
21. 1,2-Dichlorohenzene
22. 1,3-Dichiorohenzene
23. 1,4-Dichlorobenzene
24. Dichlorodifluoramethaue
25. 1,1-Dichloroethane
26, 1,2-Dichloroethane
27. 1,1-Dichloroethene
28. Cis-1,2-Dichloroethene
29. trans-1,2-Dichloroethene
30. 1,2-Dichloropropane
31. 1,3-Dichloropropane
32, 2,2-Dichloropropane
33. 1,1 Dichloropropene
34. Cis-1,3-Dichloropropene
35. trans-1,3-Dichloropropene
36. Etliylbenzene
37. Hexachlorobutadiene
38. Isopropylbenzene
39. 4-Isopropyltoluene
40. Methylene Chloride
41. Naphthalene
42. Propylbenzene
43. Styrene
44. 1,1,1,2-Tetrachloroethane
45. 1,1,2,2-Tetrachloroethane
46. Tetrachloroethene
47. Toluene
48. 1,2,3 Trichlorobenzene
<0.50
<0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0,50
< 0,50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
<0.50
<0.50
<0.50
<0.50
< 0.50
< 0.50
< 0.50
< 0.50
<0.50
< 0.50
<0.50
< 0.50
<0.50
< 0.50
<0.50
< 0.50
< 0.50
< 0.50
< 0.50
X-( klt 6.47'0334
Page: 3

Environment 1, Incorporated
'ha S9 �f.[1r+3�t'-E;{�" _ �s �z�R sss_,�r �3€%_ " k4 `�}�t; �ii.,� �"c- ix•r �'�4 {Lx� y''�����xiS`7 �.�'Y�} c �ry °-i- _��.4 �i f,'T C'
•
j'L.S t� s4F '�`�It! pit i�l' J FI ' :f1it[.fi . 7i l E 6' r
CLIENT: CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. B X 477
C,RxrTO, ,, NC 2f8530
REVIEWED B
VOLATILE ORGANICS
STD. METHODS 6200C-11
CLIENT ID:
T;5tr,Dlv�hl�aI�i4liti�5`83,xb0 �3371�RI6'i
416
ANALYST: d'AP
DATE COLLECTED: 11/17/21
DATE ANALYZED: 11/25/21
DATE REPORTED: 12/17/21
PARAMETERS, ug/i
Welt #18
49.
1,2,4-Trichtorobenzene
< 0.50
50.
1,1,1-Trichloroethane
< 0.50
51.
1,1,2-Trichloroethane
< 0.50
52.
Trichloroethene
<0.50
53.
Trichlorofluoromethane
<0.50
54.
1,2,3-Trichtoropropane
< 0.50
55.
1,2,4-Trimethylbenzene
< 0.50
56.
1,3,5-Trimethylbenzene
< 0.50
57.
Vinyl Chloride
< 0.50
58.
Total Xylenes
< 1.00
59.
Methyl Tert Butyl Ether
< 1.00
Page: 4

EHATORNIg
1 U
114 OAKMONT DRIVE
GREENVILLE, N.C. 27858
CMSD (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. SOX 477
GRIFTON, NC 28530
Well #9 Analysis Method
PARAMETERS Date Analyst Code
Fecal Coliform (MF), /100 Nils <1 10/28/21 BL.V 9222D-15
Arinking Wetter'
Waatewater.
PHONE [phone]
FAX [phone]
ID#: 416
DATE COLLECTED: 10/28/21
DATE REPORTED : 11/01/21
REVIEWED BY:

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name:
Mail original
and 1 copy to:
Permit Name (if different): %if ea---- 1n>��
Facility Address: ?YY h_,) I . n5 -7O}" j( Lin
GrlZ IStreei �(�5 County rj 44--
ICioyl [Statel 12ip7
Contact Person: eiIltll}€[k
Well Location/Site Name:..1)(4 CCU_ plor t6(+ C.
Telephone#: r7 5%i-j6j0.
No. of wells to be sampled: Co
(from Permit)
'OW .• ! OF a- RoMIAE ii3ATIKQW: a MOO
NFO D PROGESalN`�
WV .._.. aOURCES u
pig 14SERIIIe CENIER G N a 769916 m- on?49t5 80�-s3D,E
PERMIT Number: Expiration Date: 47-3.J-zoz
Non -Discharge It C 104-S' UIC
NPDES L j3 tip Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
D Spray Field ❑ Remediation:
❑ Rotary Distributors Land Application of Sludge
El Water Source Heat Pump El Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit):
Well Depth: ft.
Depth to Water Level 82546: to ft- below measuring point
Measuring Point is % 5 ft. above land surface
Date sample collected: )0--Z--21
Well Diameter:
Screened Interval: 3 ft. to ' ft.
RelativeM.P. Elevation: ft
Volume of water pumped/bailed before sampling: 5 gallons
Samples for metals were collected unfiltered: [']YES ❑ NO and field acidified:
IA YES ❑ NO
FIELD ANALYSES:
pH 00400: 4:q units Temp. won: °C
Spec. Cond. 00094: tocfo µMhos
Odor 00085: 1)00t
Appearance C-Ve l`
If WELL
WAS
DRY at
time of
sampling,
check
here:
LABORATORY INFORMATION
Date sample analyzed: lid-70-Z.geral IQ-ZQ-l(
PARAMETERS NOTE: Values should reflect dissolved
COD 00335
Coliform: MF Fecal 31515
Coliform: MF Total 31504
(Nate: Use MPN method for highly turbid samples)
mg/L
I100mL
/100mL
Dissolved Solids:Total 70300 L1-5 mglL
pH (Lab) 00403 4 .Cr units
TOC 00680 (o _S.O mg/L
Chloride 0c94o g mg/L
Arsenic 01002 uglL
Grease and Oils 00552 mglL
Phenol 32730 ug/L
Sulfate 00945 mg/L
Specific Conductance 00095 (!, p.Mhos
Total Ammonia 00s10 I , o j mglL
(Ammonia Nitrogen: NH3 as N; Ammonia Nitrogen, Total)
TKN as N 00625
mg/L
Laboratory Name:
and colloidal concentrations
Nitrite (NO2) as N 00616
Nitrate (NO3) as N 00520
Phosphorus: Total as P 00665
Orthophosphate 70507
Ai - Aluminum o11as
Ba - Barium 01007
Ca - Calcium 00916
Cd - Cadmium 01027
Chromium: Total 01034
grN f (an pnern+ I1 I nc
•
0.14-
p,p3
<5•U
Cu - Copper 61042 <G 010,
Fe - Iron o1 oas
Hg - Mercury 71900
K - Potassium D0937
Mg - Magnesium 00927
Mn - Manganese 01055
Ni - Nickel 01067
mg/L
mg/L
mglL
mg/L Other (Specify Compounds and Concentration Units):
mg/L
Certification No. dG
ug/L
mg/L
uglL
Pb - Lead 01051
Zn -Zinc Dio92
uglL
mg/L
ug/L
mg/L ORGANICS: (by GC, GC/MS, HPLC)
ug/L (Specify test and method #. ATTACH LAB REPORT.)
uglL Lab Report Attached? ❑ Yes (1) ❑ No (0)
mg/L VOC 7873 , method #
mglL
ug/L
ug/L
, method #
, method #
, method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs:
mg/L
Effluent Total VOCs:
mglL VOC Removal%
1 certify that, to the best of my knowledge and belief, the information submilted in this report is true, accurate, and complete: and that the laboratory analytic-aat data taus produced using approved methods of analysis by a
15WR-certified laboratory. 1 am aware that there are significant penalties for submitting false information, including the possibility ai tiri s and imprisonment for knowing violations.
cnctrl3 rn om ; a.-h lei ck.)�r . i � G manCf 1Z- -2A
Permittee (or Authorized Agent) Name and Title - Please int or type gy Sign ure of Permittee (or Authorized Agent) (Date)
GW-59 Rev. 3-1-2016

SUBMIT FORM ON YELLOW PAPER ON
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Cc +e- eC�- MO-0
Mail original
and 1 copy to:
Facility Name:
Permit Name (if different): fc °f4€le0-. j-7 61)
Facility Address:
i c�ss qc l }1 aori17� e-"Pcra, [Fr)
G4' eet) str14G (.g53c
{City) [Stale} IZip}
Contact Person: (' ec)-,(1'l1-hk.L 1 CC,
Well Location/Site Name: 0 Q r-i \ u
County
( of iNENTOPENV1RDNMENT QUA lY D O WAFERIRESDORCEsr
64 .SERVICE•CEN7Ef2; ' G "taZgy ` ane el• 30
1 DRINA O PROCESS
Telephone#: ZoZ 5 z
No. of wells to be sampled:
(from Permit)
PERMIT Number: Expiration Date:
Non -Discharge s I oL UIC
NPDES MCC ,32(j7}) Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor CZ Land Application of Sludge
El Water Source Heat Pump ❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit):
Well Depth: S' ft.
E 0 Date sample collected: 13--Zi >-Z)
Depth to Water Level 82546: C_. . 3 ft. below measuring point
Measuring Point is 3 ft. above land surface
Volume of water pumped/bailed before sampling:
Samples for metals were collected unfiltered: ® YES
Well Diameter. 7 in.
Screened Interval: a ft. to g ft_
Relative M.P. Elevation: ft.
gallons
❑ NO and field acidified:
I YES ❑ NO
FIELD ANALYSES:
pH oo400:5• d units Temp. 00o10: ZZ DC
Spec. Cond. 00094: 05 )Mhos
Odor 00085: n cot
Appearance
car
If WELL
WAS
DRY at
time of
sampling,
check
here:
LABORATORY INFORMATION
Date sample analyzed: ) D--JQ-�
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD ooss5
Coliforrn: MF Fecal 31616
<1
Col€form: MF Total 31504
(Note: Use MPN method for highly turbid samples)
Dissolved Solids:Total 7oso0
pH (Lab) 00403
TOC 00680
Chloride 0o9a0
Arsenic 01002
Grease and Oils 00552
Phenol 32730
Sulfate 00945
•Specif€c Conductance 00095
ZL4
6.0
Z. t5
Total Ammonia cosio
(Ammonia Nitrogen; Nli3as N: Ammonia Nitrogen, Total)
TKN as N 00625
mg/L
/100mL
/100mL
mg/L
units
mg/L
mg/L
ug1L
mgfL
ug/L
rng/L
ttMhos
mg/L
mg/L
Nitrite (NO2) as N 00615
Nitrate (NO3) as N 00620
Phosphorus: Total as P 00665
Orthophosphate 70507
Al - Aluminum 01105
Ba - Barium o1007
Ca - Calcium 00916
Cd - Cadmium 01027
Chromium: Total 01034
Cu - Copper 01042
Fe - Iron o1045
Hg - Mercury 71900
K - Potassium 00937
Mg - Magnesium 00927
Mn - Manganese 01055
Ni - Nickel 01067
Laboratory Name: b)1 f - I) I(�.
0-33
0,oy
<0,0)O
mg/L
mg/L
mg/L
mg/L
mg/L
ugfL
mg/L
ug!L
ug1L
mg/L
ug/L
ug1L
mg/L
mg/L
ug!L
ug1L
Pb - Lead 01051
Zn - Zinc 01092
Certification No. IQ
ug!L
mg/L
Other (Specify Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) 0 No (0)
VOC 7873 , method #
method #
, method #
, method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs:
mg/L
Effluent Total VOCs:
mg/L VOC Removal%
certifylhat, to the best of my knowledge and belief, the information submitted in this report is true. accurate, and complete, and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of (cries and imprisonment for knowing violations.
Caile3in,brni i eLF�-. �i i6-mar ev
Permittee (or Authorized Agent) Name and`ritfe- Please print or type
Signature of Permittee (or Authorize
�i
Agent)
lZ 2)
(Date)
GW-59 Rev. 3-1-2016

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: C(_)(7-*P --PrVa.- rnaD
Permit Name (if different): C OIl-}- rre[t-M'O,j7
Facility Address: qc I,JS 1 (-rn6V 5 TO J LF"7 )
C, ac53D County PH-
l�l i :?foTh
latreett
(City) Muriel
Contact Person: rttIC11, I h.,JiC.r
Well Location/Site Name: ( I-k.\\I L1 g
z p)
Mail original
and 1 copy to:
Telephone#: [phone]' I -
No. of wells to be sampled: (p
(from Permit)
CEPARi 7 0 r�TlVliiONMENTAL QIJ D OFiWATE y OURCES
INFORMA� OCESSI U
IVIAWSERVICeCEMER.t�uR pn, i 599c 6 i P one. 9 9 -6306
PERMIT Number: Expiration Date: ,-3.1-Z'35
Non -Discharge ,°�Q/,Q4-g UIC
NPDES 'I.ficO3Z $ f Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon
❑ Spray Field
❑ Rotary Distributor Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
❑ Remediation: Infiltration Gallery
❑ Remediation:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit):
Weil Depth: 13 ft
14
Depth to Water Level a2546: 10.1 7 ft. below measuring point
Measuring Point is z, ft above land surface
Date sample collected: 13-6Z.f
Well Diameter: Z. in.
Screened Interval: ft_
Relative M.P. Elevation:
to 13 ft.
ft_
Volume of water pumped/bailed before sampling: 5 gallons I�
Samples for metals were collected unfiltered: El YES ❑ NO and field acidified: YES ❑ NO
FIELD ANALYSES:
pH c04o0: S. 1 units
Spec. Cond. 00094: 3-11' µMhos
Odor moss: n ( t
Appearance dear
If WELL
WAS
DRY at
time of
sampling,
check
here:
LABORATORY INFORMATION
Date sample analyzed: j{ Z 7r7„� Laboratory Name: EMI feri[ r) j- ).11-c.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Coliform: MF Fecal s1s1s
< 1 /100mL
Coliform: ME Total 31504 /100mL
{Note: Use MPN method far highly turbid samples)
Dissolved Solids:Total 70300 13 mg/L
pH (Lab) 00403 5. units
TOC cosao )-�1 mg/L
Chloride 00940 3 mg/L
Arsenic 0-1002 uglL
Grease and Oils 00552 mg/L
Phenol 32730 uglL
Sulfate oos45 mg/L
Specific Conductance moss µMhos
Total Ammonia oos10 0 _ 0Lp mg/L
mg/L
t34
(Ammonia Nitrogen: NI-13as N; Ammonia Nitrogen, Total)
TKN as N 00625
Nitrite (NO3) as N 00615
Nitrate (NO3) as N 00620
Phosphorus: Total as P o066s
Orthophosphate 70507
Al - Aluminum oi105
Ba - Barium 01007
Ca - Calcium Duals
Cd - Cadmium 01027
Chromium: Total 01034
Cu - Copper o1042
Fe - Iron 01045
Hg - Mercury 71900
K - Potassium 00937
Mg - Magnesium 09927
Mn - Manganese 01055
Ni - Nickel 01067
<0.04
10
<ps010
mg/L
mg/L
mg/L
mg/L
mgJL
ug!L
mg/L
ug(L
uglL
mg/L
ug/L
ug/L
mg/L
mg/L
ugfL
ug!L
Pb - Lead 01051
Zn - Zinc 010s2
Temp. 000le: zj °C
Certification No. Jti
ug/L
mg/L
Other (Specify Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (I) ❑ No (0)
VOC 7673 , method #
, method #
, method #
, method #
For Remediation Systems Only (Attach Lab Reports):
influent Total VOCs:
mg/L
Effluent Total VOCs:
mg/L VOC Removal%
I certify that, to the best of my knowledge and belief, the information Submitted in this report is true, accurate, and complete, and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of f: ie_ and imprisonment for knowing violations.
C `ai 1e) rn- & ONoi C �C DI d- r v . f
Permittee (or Authorized Agent) Name and Ti e - Please print or type
Signature of Pennittee (or Authonzed Agent)
(Date)
GW-59 Rev.3-1-2016

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
C af\-+e fa. m
Facility Name:
Permit Name (if different): Con-1 -info- mop
Facility L����� (_,�' t (sweet]
Address: (�0 �C]'f lL�� (�CtbY 1(�C� � f'Lin
(City]
Contact Person:
(Slate) (Zip)
ChuCirn\aLinw[ d.C,
Well Location/Site Name: iN-(2(.6 -1 ,..i2,4CUL °d-, .2(Ci lQ
County Nl'
Telephone#: Z5Z 5zq 560-1
No. of wells to be sampled: (9
(from Permit)
DEp aRTNiENROFr PIVIROI w! 4[i11I 17.1r l
NFORMATIOIC RocESSIN
aF,VILIETF,RTESOURCESZkg
PERMIT Number: Expiration Date:
Non -Discharge tt,,er6r)04412 U1C
NPDES }-.cco j7 ('s-r) Other
R-31 - ZoZS
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon
❑ Spray Field
❑ Rotary Distributor
❑ Water Source Heat Pump
❑ Remediation: Infiltration Gallery
❑ Remediation:
fg Land Application of Sludge
❑ Other.
SAMPLING INFORMATION
WELL ID NUMBER (from Permit):
Well Depth: g ft.
Depth to Water Level 62546: � ft. below measuring point
Measuring Point is Z. 5 ft. above [and surface
Volume of water pumped/bailed before sampling: 5
Samples for metals were collected unfiltered: 1 J YES
Date sample collected: —7.0'2.-[
Well Diameter: Z in.
Screened Interval: 3 ft.
Relative M.P. Elevation:
gallons
❑ NO and field acidified: 'YES ❑ NO
FIELD ANALYSES:
pH 0040051 3 units Temp. aoolo: ZJ °C
to p ft. Spec. Cond_ 00094: 1-aq µMhos
ft_ Odor 00085: non-e-
Appearance
Cloudy
If WELL
WAS
DRY at
time of
sampling,
check
here:
LABORATORY INFORMATION
Date sample analyzed: 10 2 -2-1, Laboratory Name: -fi N1 hiN Z) y(c. -
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
Coliform: MF Fecal 31616
Coliform: MFTotal 31504
<
(Note: Use MPN method for highly turbid samples)
Dissolved Solids:Total 70300
pH (Lab) 00403
TOC 00680 1 i .zZ mg/L
Chloride 00940
Arsenic 010oz
Grease and Oils 00552
Phenol 32730
Sulfate 00945
Specific Conductance 00095
Total Ammonia 00610 3,. Li'S mg/l..
mg/L
/100mL
/100mL
Zb mg/L
5 3 units
.3
!q
(Ammonia Nitrogen: NH,as N; Ammonia Nitrogen. Total)
TKN as N 00625
mg/L
ug/L
mg/L
ug!L
mg/L
µMhos
mg/L
Nitrite (NO2) as N 00615
Nitrate (NO3) as N 00620
Phosphorus: Total as P 00665
Orthophosphate 70507
Al -Aluminum o1105
Ba - Barium o1007
Ca - Calcium 00916
Cd - Cadmium 01027
Chromium: Total 01034
Cu - Copper 01042
Fe - Iron 01045
Hg - Mercury 71900
K - Potassium 00937
Mg - Magnesium 00927
Mn - Manganese moss
Ni - Nickel 01067
Gc o-i-
©, 07
mg/L
mg/L
mg/L
mg/L
mglL
ug/L
mg/L
ug/L
ug!L
Pb - Lead o1051
Zn - Zinc 01092
Certification No. f{J
uglL
mg/L
Other (Specify Compounds and Concentration Units):
CD,O10 mg/L ORGANICS: (by GC, GC/MS, HPLC)
ug/L (Specify test and method #. ATTACH LAB REPORT.)
uglL Lab Report Attached?
mg/L VOC 7873
mg/L
uglL
uglL
❑ Yes (1) ❑ No (0)
, method #
, method #
, method*
, method #
For Remediation Systems Only (Attach Lab Reports):
influent Total VOCs:
mg/L
Effluent Total VOCs:
mglL VOC Removal%
I certify that, to the best of my knowledge and belief. the information submitted in this report is true, accurate, and complete. and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for k^awing violations.
Chat] `)m-am•ik-D11,Jif ia_ 'trill] eel
Permittee (orAuthorized Agent) Name and Title- Ple e print or type v
Signature of Permittee (or Authorized Agent)
(Date)
GW-5g Rev.3-12016

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: Cknn .
Permit Name (if different): i -r\eQ.. }poi
Mail original
and 1 copy to:
Facility Address: co lit I el, ('-�toluti6 46L (477-)
14G ZA53o
4tG+a,
tStre6tj
(City) (Stalel (Zip)
Contact Person: Chtglbarn4123
Well Location/Site Name: 6, corner C p(ei6 IG? No. of wells to be sampled: Co
County
Telephone#: Z 6Z-LFG SLi
{from Permit)
as-DEPARTMENVOF ENA1ROMNRiiii
NFORMknoP acEss1M
iscr 141 sE1 vicEE RAL G„, NC Z699
►k OtIRG
1
?hone. 996 -630
PERMIT Number: Expiration Date: g-3(-ZOZ5
Non -Discharge ,WOC)I 53 U€C
NPDES j-4(_c 3%j5)) Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon
❑ Remediation: Infiltration Gallery
O Spray Field El Remediation:
O Rotary Distributor NI Land Application of Sludge
❑ Water Source Heat Pump ❑ Other.
SAMPLING INFORMATION
WELL ID NUMBER (from Permit):
Well Depth: ft.
1-7
Date sample collected:
;o zo zi
Well Diameter: L in,
Depth to Water Level 62546: (p•Z ft. below measuring point Screened Interval: Z ft. to q ft.
Measuring Point is z. 35 ft above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling: 5 gallons
Samples for metals were collected unfiltered: (] YES 0 NO and field acidified: Egi YES ❑ NO
FIELD ANALYSES:
pH 00400:4 g units Temp. cool 0: ZZ °C
Spec. Cond. 00094: 43 ',Mhos
Odor across: I ib7)t
Appearance
cs
If WELL
WAS
DRY at
time of
sampling,
check
here.
LABORATORY INFORMATION
Date sample analyzed: 1(-2 j-Z1 Laboratory Name:
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO2) as N oos15
Cal-rform: MF Fecal 31616
Coliform: MF Total 31504
{Note; Use MPN method for highly turbid samples)
C /100mL
]issolved Solids:Total70300
pH (Lab) 00403
TOC 00680
Chloride 00940
Arsenic o1002
Grease and Oils 00552
Phenol 32730
Sulfate 00945
Specific Conductance 00095
Z•G4
(-13
Total Ammonia 00610 %3.2 2
(Ammonia Nitrogen; NHS as N; Ammonia Nitrogen. Total)
TKN as N 00625
/100mL
mg/L
units
mg/L
mglL
ug/L
mg/L
uglL
mg/L
(.(Mhos
mg/L
mg/L
Nitrate (NO3) as N 00620
Phosphorus: Total as P 00665
Orthophosphate 70507
Al -Aluminum o11os
Ba - Barium o1007
Ca - Calcium 00916
Cd - Cadmium o1027
Chromium: Total 01034
3.14-
mg/L
mg/L
mg/L
mg/L
Cu - Copper 01042 <.r,p l(
Fe - Iron 01045
Hg - Mercury 71900
K - Potassium 00937
Mg - Magnesium 00927
Mn - Manganese 01055
Ni - Nickel 01067
mg/L
uglL
mg/L
uglL
ug/L
mg/L
uglL
ugfL
mg/L
mg/L
ug/L
ug/L
Pb - Lead 01051
Zn - Zinc 01092
Certification No.
uglL
mg/L
Other (Specify Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VOC 7873 , method #
, method #
, method #
, method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs:
mg/L
Effluent Total VOCs:
mglL
VOC Removal%
I certify that, to the best of my knowledge and belief. the information submitted in this report ie true. accurate, and complete, and that the laboratory analytical data was produced using approved methods of analysis by a
DWR-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of f res and imprisonment for knowing violations.
ChouIre,S 1. l Lvt(Y l r7l. icVsfQre'
Perrnittee (or Authorized Agent) Name and tie - ease print or type Sign
(aLoermittee (or Authorized Agent)
I C✓-(0 Z!
(Date)
GW-59 Rev. 3-1-2016

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or Type
Facility Name: CaYFtLT r)sea-. 3/
Permit Name (if different): Con+r)"_(naD
Facility Address: �()(�j P,k.)11 C-0,56r) kd �O i
ISlreetj t 4 C 7C55 3'
(Cilyl
(Slate) (Zip)
Contact Person: ChUCt,a-niC1/10 CL—
Well Location/Site Name: to •P i.1+13
County
Mail original
and 1 copy to:
Telephone#: 75Z-5Z S'L/
No. of wells to be sampled: (,
{from Permit)
DEPARTMENTA0 a D ENT 011A1_'I1Y UIV,'.O
{ INF•OR D PROCESSI
6 t7111A1L SERVIC�CEENIER, RALEIGW,
ate m..�:� ..�,-_,...�..�-.k.�..
27,69, 1B11 P one. 91 e63.
PERMIT Number: Expiration Date:
Non -Discharge 1N OW LAC
NPDES C}ZZi) Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Remediation: Infiltration Gallery
0 Lagoon
0 Spray Field ❑ Remediation:
0 Rotary Distributor giLand Application of Sludge
0 Water Source Heat Pump 0 Other.
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): (c2
Well Depth: r fit_
Depth to Water Level 82546: 1,3 ft. below measuring point
Measuring Point is Z ft above land surface
Volume of water pumped/bailed before sampling: 5 gallons
Samples for metals were collected unfiltered: al YES 0 NO and field acidified: YES ❑ NO
Date sample collected: 6- -'ZI
Well Diameter
Screened Interval: 5 it
Relative M.P. Elevation:
LABORATORY INFORMATION
Date sample analyzed: _ZO-u Laboratory Name:
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
CORfOrm: MF Fecal 31616
7-
mgfL Nitrite (NO2) as N 00615
f100mL Nitrate (NO3) as N 00620
Coliform: MF Total s15o4 1100mL
(Note: Use MPN method for highly turgid samples)
Dissolved Solids:Total 70300 fW
pH (Lab) 004o3 5. 5
TOC 00680
Chloride o0940
Arsenic o1002
Grease and Oils 00552
Phenol 32730
Sulfate 00945
Specific Conductance 00095
IL•47_
3
t1)�
Total Ammonia ooslo ©• 1 Q
(Ammonia Nitrogen: NH, as N: Ammonia Nitrogen, Total)
TKN as N 00625
mg/L
units
mg/L
mg/L
uglL
mglL
ug!L
mg/L
})Mhos
mg/L
mg/L
to LC ft.
ft.
FIELD ANALYSES:
pH 00400: 6.5 units
Spec. Cond. 00094:
Temp. oo0lo: 1
U5 (.Mhos
Odoroaos5: nc(Y°L
Appearance C ear
EnvCrc ) me.fyl
Phosphorus: Total as P 0066s
Orthophosphate 70507
Al - Aluminum o11os
Ba - Barium 01007
Ca - Calcium Dom
Cd - Cadmium o1027
Chromium: Total 01034
Cu - Copper 01042
Fe - Iron 01045
Hg - Mercury 71900
K - Potassium 0as37
Mg - Magnesium 00027
Mn - Manganese 010s5
Ni - Nickel 01067
<G.D4
o. 5-
Certification No. I
mglL Pb - Lead oi051 ugtL
mg/L Zn - Zinc 01092 mg/L
mg/L
mg/L Other (Specify Compounds and Concentration Units):
mg/L
uglL
mg/L
uglL
5.p ug!L
if WELL
WAS
DRY at
time of
sampling,
check
here:
<0.010 mglL ORGANICS: (by GC, GC/MS, HPLC)
uglL (Specify test and method #. ATTACH LAB REPORT.)
uglL Lab Report Attached? ❑ Yes (1) ❑ No (0)
mg/L VOC 7873 , method #
mg/L
ug/L
uglL
, method #
method##
, method #
L
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs:
mg/L Effluent Total VOCs:
mg/L VOC Removal%
I certify that, to the best of my knowledge and belief, the information submitted in this report is true, accurate, and complete, and that the laboratory analytical data was produced using approved methods of analysis by a
DWRcertified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of !lies p.;Id imprisonment for knowing violations.
ChoF'O- ` ithiGiC -DrT " r 07
Permittee (or Authorized Agent) Name and die - lease print or type
Signature of Pennittee (or Authorized Agent)
(Date)
GW-59 Rev. 3-1-2016

UXink3ng Water in$ 37714
durramoinlig ig Elgllcupervad
����N171t
CMSD (SLUDGE & Wi us ACCT)
CQNTENTNEA METRO. SEWAGE DXST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON, NC 28530
PARAMETERS
Total Chromium, t:gll
Copper, ttg/I
Well #15 Analysis Method
Date Analyst Code
5 12/23/21 LF<.J EPA200.7
<10 12/23/21 LFJ EPA2.00.7
252),756.108i
ID# : 416
DATE COLLECTED: 12 /2 L/21.
DATE REPORTED : .01/07/22
REVIEWED BY:

SOILS ANALYSIS LAB REPORTS
LIME APPLICATION

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.govlagronomi/ Report No. FY22-SL009409
Client: CMSD Advisor: Ayden Nitrogen-
PO Box 477 Ayden Nitrogen
Grifton, NC 28530 P.O. Box
Mehlich-3 Extraction Ayden, NC
Report
Sampled County :Pitt
to Helpful Information
Primary
7
28513
F0 `s,k
Predictive
'' E' r
r. Soil
Links
Sampled: 10/01/2021 Received:
Client ID: 147385 Advisor ID: 503187
10/14/2021 Completed: 10/29/2021 Farm: Wiley Gaskins
Agronomist's Comments:
ATTENTION: This report was flagged with a "C" and/or "Z" to alert you that copper and/or zinc have accumulated in the soil and are approaching a level that could be
detrimental to crop production. The C and Z symbols are printed on your report for soil test Zn and Cu index levels of 2000 or more for agronomic crops; for peanuts with
zinc, the level is 250. This note is designed to be a "trigger" that allows enough time to either reduce the rate of application or find another field for application of biosolids
and/or waste water. The CTL (critical toxic level) for Cu and Zn is set at a 3000 index; for peanuts with zinc, the level is 500. Maintaining a pH of 6.0 or higher may reduce
potential for toxicity, especially for Zn. These levels are used by DENR as a benchmark to determine when application of waste products should be stopped. The CTL for
copper and zinc was set to Prevent levels from accumulating to the point where they become toxic to crops grown on a field.
Sample ID: 1
Lime History:
Recommendations: Lime . Nutrients (lb/acre)
..............
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Information
Note: 12 Note: $
Crop (tons/acre) N P2O5 K20 Mg S Mn Zn Cu B
1 -Bermuda hay/past., E 0.0 60-80 0 90 0 0 0 Z 0 0
2 - 0.0
Test Results [units - WN in glcm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg% S-I Mn-I Mn All Mn-Al2 Zn-I Zn-AI Cu-I Na ESP SS -I NO3-N
0.56 1.07 13.0 90 1.3 6.4 853 22 69 20 36 56 44 2208 2208 1195 0.1 1
Sample ID: 2
Lime History:
Recommendations: Lime Nutrients (lb/acre)
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Information
Note: 12 Note: $
Crop (tonslacre) N P205 K2O Mg S Mn Zn Cu B
1 - Bermuda hay/past., E 0.0 60-80 0 70 0 0 pH$ Z 0 0
2 - 0.0
Test Results [units - WN in glcm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]: Soil Class: Mineral
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg% S-1 Mn-I Mn-AI1 Mn-Al2 Zn-1. Zn-Al Cu-I Na ESP SS -I NO3-N
0.56 1.07 13.4 91 1.2 6.6 836 33 69 21 35 56 42 2267 2267 888 0.1 1
North Carolina
Reprogramming of the laboratory -information -management system that makes this report possible is being funded
through a grant from the North Carolina Tobacco Trust Fund Commission.
Thank you for using agronomic services to manage nutrients and safeguard environmental quality.
- Steve Troxler, Commissioner of Agriculture
Tobacco Trust Furad Commist+io s

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.govlagronomil
Report No. FY22-SL009409
Page 2 of 11
Sample ID: 3
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12 Note: 3
Crop (tonslacre) N P205
1 -Bermuda hay/past., E 0.6 60-80 0
2 - 0.0
K20
80
Mg S Mn Zn
0 0 0 Z
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meg1100 cm3; NO3-N in mg/dm31:
HM% WN CEC BS% Ac pH P-1 K-I Ca% Mg%
0.60 1.01 13.0 81 2.4 5.8 881 29 61 19
S-I
52
Mn-I
54
Soil Class: Mineral
Mn All Mn-Al2 Zn-I Zn-AI
49 2429 2429
Cu-I
1271
Na
0.2
ESP
2
SS-1 NO3-N
Sample ID: 4
Lime History:
Recommendations: Lime
Nutrients (Iblacre)
More
Information
Note: 12 Note: $
Crop (tonslacre) N P205
1 -Bermuda hay/past., E 0.3 60-80 0
2- 0.0
K20
80
Mg S Mn Zn
0 0 0 Z
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in megl100 cm3; NO3-N in mgldm3]:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.46 1.00 13.8 83 2.3 5.9 928 30 63 19
S-I
47
Mn-I
62
Soil Class: Mineral
Mn-AI1 Mn-Al2 Zn-1 Zn-AI
54 3863 3863
Cu-1
1377
Na
0.2
ESP
1
SS -I NO3-N
Sample ID: 5
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12 Note: $
Crop (tonslacre) N P205
1 -Bermuda hay/past., E 0.0 60-80 0
2 - 0.0
K20
110
Mg S Mn Zn
0 0 0 Z
Cu
0
B
0
Test Results [units - WN in g/cm3; CEC and Na in meg1100 cm3; NO3-N in mg/dm3]:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.66 1.10 10.4 88 1.2 6.3 784 17 70 17
S-I
41
Mn-1
51
Soil Class: Mineral
Mn-All Mn-Al2 Zn-I Zn-AI
43 2246 2246
Cu-I
793
Na
0.1
ESP
1
SS-1 NO3-N

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.govlagronomil
Report No. FY22-SL009409
Page 3of11
Sample ID: 6
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tons/acre) N P205
1 -Bermuda hay/past., E 0.9 60-80 0
2 - 0.0
K20
100
Mg S Mn Zn
0 0 0 0
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meq/100 ma; NO3-N in mg/dm31:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.71 1.04 9.4 75 2.3 5.6 795 21 60 15
S-I
48
Mn-I
59
Soil Class: Mineral
Mn-All Mn-Al2 Zn-I Zn-AI
52 1463 1463
Cu-I
943
Na
0.1
ESP
1
SS -I NO3-N
Sample ID: 7
Lime History:
Recommendations: Lime
Nutrients (Ib/acre)
More
Information
Note: 12 Note: $
Crop (tons/acre) N P205
1 -Bermuda hay/past., E 0.0 60-80 0
2 - 0.0
K20
60
Mg S Mn Zn
0 0 pH$ Z
Cu
0
B
0
Test Results [units - WN in g1cm3; CEC and Na in meq/100 cm3; NO341 in mg/dm3]:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.18 1.20 11.8 95 0.6 6.9 779 37 72 22
S-I
28
Mn-I
64
Soil Class: Mineral
Mn-All Mn-Al2 Zn-I Zn-Al
42 2368 2368
Cu-I
778
Na
0.1
ESP
1
SS -I NO3-N
Sample ID: 8
Lime History:
Recommendations: Lime
Nutrients (Ib/acre)
More
Information
Note: 12 Note: $
Crop (tons/acre) N Pz0s
1 -Bermuda hay/past., E 0.0 60-80 0
2 - 0.0
K20
90
Mg S Mn Zn
0 20 pH$ Z
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meg1100 cm3; NO3-N in mgldm3]:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.22 1.17 9.8 91 0.9 6.7 772 25 69 20
S-I
18
Mn-I
50
Soil Class: Mineral
Mn-AI1 Mn-Al2 Zn-I Zn-AI
37 2092 2092
Cu-I
798
Na
0.1
ESP
1
SS -I NO3-N

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomcl
Report No. FY22-SL009409
Page 4 of 11
Sample ID: 9
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tons/acre) N P205
1 -Bermuda hay/past., E 0.0 60-80 0
2 - 0.0
K20
100
Mg S
0 0
Mn Zn
0 0
Cu
0
B
0
Test Results [units - WN in g/cm3; CEC and Na in meg1100 cm3; NO3-N in mgldm31:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
1.25 1.16 7.5 89 0.8 6.5 145 20 66 21
S-I
28
Mn-I
43
Soil Class:
Mn-All Mn-Al2
35
Mineral
Zn-I Zn-AI
293 293
Cu-I
101
Na
0.1
ESP
1
SS -I NO3-N
Sample ID: 10
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
information
Note: 12
Crop (tonslacre) N P205
1 -Bermuda hay/past., E 0.6 60-80 0
2 - 0.0
K20
110
Mg S
0 0
Mn Zn
0 0
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3]:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
1.08 1.19 5.5 71 1.6 5.6 295 14 55 15
S-I
31
Mn-1
34
Soil Class:
Mn-All Mn-Al2
37
Mineral
Zn-I Zn-AI
432 432
Cu-I
177
Na
0.1
ESP
2
SS-1 NO3-N
Sample ID: 11
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tonslacre) N P205
1 -Bermuda hay/past., E 0.5 60-80 0
2 - 0.0
K20
110
Mg S
0 0
Mn Zn
0 0
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meg1100 cm3; NO3-N in mgldm3]:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.97 1.15 6.2 74 1.6 5.7 420 17 57 16
S-I
35
Mn-I
37
Soil Class:
Mn-AI1 Mn-Al2
39
Mineral
Zn-1 Zn-AI
590 590
Cu-1
309
Na
0.1
ESP
2
SS -I NO3-N

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.govlagronomil
Report No. FY22-SL009409
Page 5 of 11
Sample ID: 12
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tonslacre) N P2O5
1 -Bermuda hay/past., E 0.0 60-80 0
2 - 0.0
KzO
100
Mg S Mn Zn
0 0 0 0
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meg/100 cm3; NO3-N in mgldm3]:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.41 1.21 6.9 79 1.4 6.0 615 21 58 19
S-I
36
Mn-I
66
Soil Class: Mineral
Mn-All Mn-Al2 Zn-I Zn-AI
57 1005 1005
Cu-I
369
Na
0.1
ESP
1
SS -I NO3-N
Sample ID: 13
Lime History:
Recommendations: Lime
Nutrients (Iblacre)
More
Information
Note: 12 Note: $
Crop (tonslacre) N P205
1 -Bermuda hay/past., E 0.0 60-80 0
2 - 0.0
K2O
110
Mg S Mn Zn
0 0 pH$ 0
Cu
0
B
0
Test Results [units - WN in g1cm3; CEC and Na in meg1100 cm3; NO3-N in mg/dm3]:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.76 1.07 9.3 91 0.9 6.6 526 16 67 23
S-I
45
Mn-I
57
Soil Class: Mineral
Mn-AI1 Mn-Al2 Zn-I Zn-AI
42 923 923
Cu-I
344
Na
0.1
ESP
1
SS -I NO3-N
Sample ID: 14
Lime History:
Recommendations: Lime
Nutrients (Iblacre)
More
Information
Note: 12
Crop (tonslacre) N P2Os
1 -Bermuda hay/past., E 0.0 60-80 0
2 - 0.0
K20
100
Mg S Mn Zn
0 0 0 0
Cu
0
B
0
Test Results [units - WN in g1cm3; CEC and Na in meg/100 cm3; NO3-N in mgldm3]:
HM% WN CEC BS% Ac pH P-I K-1 Ca% Mg%
1.37 1.08 10.1 87 1.3 6.3 573 20 64 22
S-1
41
Mn-I
51
Soil Class: Mineral
Mn-All Mn-Al2 Zn-1 Zn-Al
43 996 996
Cu-I
334
Na
0.1
ESP
1
SS -I NOa-N

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.govlagronomil
Report No. FY22-SL009409
Page 6of11
Sample ID: 15
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tonslacre) N P205
1 -Bermuda hay/past., E 1.1 60-80 0
2 - 0.0
K20
100
Mg S Mn Zn
0 0 0 0
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meq/100 cm3; NO3-N in mgldm3]:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.66 1.14 7.5 70 2.2 5.4 805 19 51 18
S-I
57
Mn-I
73
Soil Class: Mineral
Mn-All Mn-AI2 Zn-I Zn-AI
61 731 731
Cu-i
530
Na
0.1
ESP
1
SS -I NO3-N
Sample ID: 16
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12 Note: $
Crop (tons/acre) N P205
1 -Bermuda hay/past., E 0.0 60-80 0
2 - 0.0
K20
110
Mg S Mn Zn
0 0 pH$ 0
Cu
0
B
0
Test Results [units -WN in glcm3; CEC and Na in meg1100 cm3; NO3-N in mgldm3]:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.46 1.17 8.2 91 0.8 6.7 476 15 67 23
S-I
30
Mn-I
62
Soil Class: Mineral
Mn-AI1 Mn-Al2 Zn-i Zn-AI
44 979 979
Cu-I
356
Na
0.0
ESP
SS -I NO3-N
Sample ID: 17
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tons/acre) N P205
1 -Bermuda hay/past., E 0.0 60-80 0
2 - 0.0
K20
90
Mg S Mn Zn
0 0 0 0
Cu
0
B
0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mgldm31:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.27 1.18 9.1 86 1.3 6.3 759 24 64 21
5-I
39
Mn-I
56
Soil Class: Mineral
Mn-All Mn-Al2 Zn-I Zn-AI
46 1648 1648
Cu-I
654
Na
0.1
ESP
1
SS -I NO3-N

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.govlagronomi/
Report No. FY22-SL009409
Page 7of11
Sample ID: 18
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tonslacre) N P2Os
1 -Bermuda hay/past., E 0.8 60-80 0
2 - 0.0
K20
60
Mg S
0 0
Mn Zn
0 0
Cu
0
B
0
Test Results [units - WN in g1cm3; GEC and Na in meq/100 cm3; NO3-N in mgldm3]:
HM% WN CEC BS% Ac pH P-1 K-1 Ca% Mg%
0.46 1.18 7.0 72 2.0 5.6 670 37 55 15
S-I
46
Mn-I
78
Soil Class:
Mn All Mn-Al2
64
Mineral
Zn-I Zn-AI
521 521
Cu-I
497
Na
0.1
ESP
1
SS-1 NO3-N
Sample ID: 19
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tonslacre) N P205
1 -Bermuda hay/past., E 0.5 60-80 0
2 - 0.0
K20
90
Mg S
0 0
Mn Zn
0 0
Cu
0
B
0
Test Results [units - WN in glcrrt3; CEC and Na in megl100 cm3; NO3-N in mg/dm3]:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.41 1.16 8.3 78 1.8 5.8 719 26 59 17
S-I
39
Mn-1
85
Soil Class:
Mn All Mn-Al2
68
Mineral
Zn-I Zn-AI
1469 1469
Cu-I
588
Na
0.1
ESP
1
SS -I NO3-N
Sample ID: 20
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tonslacre) N P205
1 -Bermuda hay/past., E 0.9 60-80 0
2 - 0.0
K20
60
Mg S
0 0
Mn Zn
0 0
Cu
0
B
0
Test Results [units -WN in glcm3; CEC and Na in meg1100 cm3; NO3-N in mg/dm3]:
HM% WN CEC BS% Ac pH P-I K-1 Ca% Mg%
0.27 1.10 9.3 76 2.2 5.6 944 39 55 18
S-1
47
Mn-I
80
Soil Class:
Mn-AI1 Mn-Al2
65
Mineral
Zn-I Zn-AI
1586 1586
Cu-I
864
Na
0.1
ESP
1
SS -I NO3-N

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
Report No. FY22-SL009409
Page 8 of 11
Sample ID: 21
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tons/acre) N P2O5
1-Bermuda hay/past., E 0.4 60-80 0
2 - 0.0
K2O
70
Mg S Mn Zn
0 0 0 0
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3):
HM% WN CEC BS% Ac pH P-I K-1 Ca% Mg%
0.41 1.18 7.7 78 1.7 5.8 703 35 57 18
S-I
38
Mn-I
74
Soil Class: Mineral
Mn-All Mn-Al2 Zn-I Zn-AI
61 1242 1242
Cu-I
546
Na
0.1
ESP
1
SS-1 NO3-N
Sample ID: 22
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12 Note: $
Crop (tons/acre) N P2O5
1 -Bermuda hay/past., E 0.0 60-80 0
2- 0.0
K2O
90
Mg S Mn Zn
0 20 pH$ 0
Cu
0
B
0
Test Results [units - WN in g/cm3; CEC and Na in meq/100 cm3; NO3-N in mg/dm3l:
HM% WN CEC BS% Ac pH P-i K-I Ca% Mg%
0.46 1.18 9.2 95 0.5 7.0 524 23 73 21
S-I
12
Mn-I
48
Soil Class: Mineral
Mn All Mn-Al2 Zn-I Zn-AI
31 1292 1292
Cu-I
413
Na
0.1
ESP
1
SS -I NO3-N
Sample ID: 23
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tons/acre) N P2O5
1 -Bermuda hay/past., E 0.0 60-80 0
2 - 0.0
1(20
100
Mg S Mn Zn
0 0 0 0
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meg1100 cm3; NO3-N in mgldm3l:
HM% WN CEC BS% Ac pH P-1 K-I Ca% Mg%
1.80 1.06 11.6 87 1.5 6.2 659 19 71 15
S-I
31
Mn-I
48
Soil Class: Mineral
Mn All Mn-Al2 Zn-I Zn-AI
43 1790 1790
Cu-I
630
Na
0.1
ESP
1
SS -I NO3-N

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi!
Report No. FY22-SL009409
Page 9 of 11
Sample ID: 24
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tons/acre) N P2O5
1 -Bermuda hay/past., E 0.5 60-80 0
2 - 0.0
K2O
100
Mg S Mn Zn
0 0 0 0
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meg1100 cm3; NO3-N in mgldm31:
HM% WN CEC BS% Ac pH P-I K-1 Ca% Mg%
1.87 1.12 9.8 80 2.0 5.8 629 19 66 13
S-1
31
Mn-I
71
Soil Class: Mineral
Mn-All Mn-Al2 Zn-I Zn-AI
60 1371 1371
Cu-I
530
Na
0.1
ESP
1
SS -I NO3-N
Sample ID: 25
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tonslacre) N P205
1 -Bermuda hay/past., E 0.0 60-80 0
2 - 0.0
K20
80
Mg S Mn Zn
0 0 0 0
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meg1100 cm3; NO3-N in mg/dm3]:
HM% WN CEC BS% Ac pH P-1 K-I Ca% Mg%
0.71 1.11 10.5 86 1.4 6.2 754 27 67 18
S-1
38
Mn-I
52
Soil Class: Mineral
Mn-A11 Mn-Al2 Zn-1 Zn-AI
45 1690 1690
Cu-1
606
Na
0.1
ESP
1
SS -I NO3-N
Sample ID: 26
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tons/acre) N P2O5
1 -Bermuda hay/past., E 0.0 60-80 0
2 - 0.0
K2O
90
Mg S Mn Zn
0 0 0 0
Cu
0
B
0
Test Results [units -WN in glcm3; CEC and Na in megl100 cm3; NO3-N in mgldm31:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
2.22 1.13 8.9 81 1.7 5.9 524 25 65 15
S-1
29
Mn-I
47
Soil Class: Mineral
Mn-AI1 Mn-Al2 Zn-I Zn-AI
45 1202 1202
Cu-I
455
Na
0.1
ESP
1
SS -I NO3-N

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.govlagronomi/
Report No. FY22-SL009409
Page 10 of 11
Sample ID: 27
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tonslacre) N P2O5
1 -Bermuda hay/past., E 0.7 60-80 0
2 - 0.0
K2O
70
Mg S
0 0
Mn Zn
0 0
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meg/100 cm3; NO3-N in mg/dm3]:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.76 1.14 6.4 73 1.7 5.6 504 32 55 16
S-I
40
Mn-I
62
Soil Class:
Mn-All Mn-Al2
54
Mineral
Zn-I Zn-AI
881 881
Cu-1
336
Na
0.1
ESP
2
SS -I NO3-N
Sample ID: 28
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tons/acre) N P2O5
1 -Bermuda hay/past., E 0.0 60-80 0
2 - 0.0
K2O
90
Mg S
0 0
Mn Zn
0 0
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meg1100 cm3; NO3-N in mg/dm3]:
HM% WN CEC BS% Ac pH P-I K-I Ca% Mg%
0.97 1.18 8.4 84 1.4 6.1 514 26 65 18
S-I
41
Mn-I
72
Soli Class:
Mn-AI1 Mn-AI2
59
Mineral
Zn-I Zn-AI
914 914
Cu-I
343
Na
0.1
ESP
1
SS -I NO3-N
Sample ID: 29
Lime History:
Recommendations: Lime
Nutrients (lb/acre)
More
Information
Note: 12
Crop (tons/acre) N P2O5
1 -Bermuda hay/past., E 0.8 60-80 0
2 - 0.0
K2O
120
Mg S
0 20
Mn Zn
0 0
Cu
0
B
0
Test Results [units - WN in glcm3; CEC and Na in meg/100 cm3; NO3-N in mgldm3]:
HM% WN GEC BS% Ac pH P-I K-I Ca% Mg%
1.25 1.15 4.7 62 1.8 5.5 116 11 40 21
S-I
13
Mn-1
15
Soil Class:
Mn-All Mn-AI2
26
Mineral
Zn-I Zn-AI
188 188
Cu-I
60
Na
0.0
ESP
SS-1 NO3-N

NCDA&CS Agronomic Division Phone: [phone] Website: www.ncagr.gov/agronomi/
Report No. FY22-SL009409
Page 11 of 11
Understanding the Soil Report: explanation of measurements, abbreviations and units
Recommendations
Lime
If testing finds that soil pH is too low for the crop(s) indicated, a lime recommendation will be given in units of either
ton/acre or Ib/1000 sq ft. For best results, mix the lime into the top 6 to 8 inches of soil several months before planting.
For no -till or established plantings where this is not possible, apply no more than 1 to 1.5 ton/acre (50 lb/1000 sq ft) at one
time, even if the report recommends more. You can apply the rest in similar increments every six months until the full rate
is applied. If MG is recommended and lime is needed, use dolomitric lime.
Fertilizer
Report Abbreviations
Ac exchangeable acidity
B boron
BS% % CEC occupied by basic cations
Ca% % CEC occupied by calcium
CEC cation exchange capacity
Cu-I copper index
ESP exchangeable sodium percent
HM% percent humic matter
K-1 potassium index
K20 potash
Mg% % CEC occupied by magnesium
MIN mineral soil class
Mn manganese
Mn-All Mn-availability index for crop 1
Mn-Al2 Mn-availability index for crop 2
Mn-I manganese index
M-0 mineral -organic soil class
N nitrogen
Na sodium
NO3-N nitrate nitrogen
ORG organic soil class
pH current soil pH
P-1 phosphorus index
P205 phosphate
S-I sulfur index
SS -I soluble salt index
WN weight per volume
Zn-Al zinc availability index
Zn-I zinc index
Recommendations for field crops or other Large areas are listed separately for each nutrient to be added (in units of
Ib/acre unless otherwise specified). Recommendations for N (and sometimes for B) are based on research/field studies
for the crop being grown, not on soil test results. K-1 and P-I values are based on test results and should be > 50. If they
are not, follow the fertilizer recommendations given. If Mg is needed and no lime is recommended, 0-0-22 (11.5% Mg) is
an excellent source; 175 to 250 lb per acre alone or in a fertilizer blend will usually satisfy crop needs, SS -I levels appear
only on reports for greenhouse soil or problem samples.
Farmers and other commercial producers should pay special attention to micronutrient levels. If $, pH$, $pH, C or Z
notations appear on the soil report, refer to $Note: Secondary Nutrients and Micronutrients. In general, homeowners do not
need to be concerned about micronutrients. Various crop notes also address lime fertilizer needs; visit
ncagr.gov/agronomi/pubs.htm.
Recommendations forsmall areas, such as home lawns/gardens, are listed in units of Ib/1000 sq ft . If you cannot find
the exact fertilizer grade recommended on the report, visit www.ncaqr.cloviacironorni/obpart4.htmtgsfind information that
may help you choose a comparable alternate. For more information, read A Homeowner's Guide to Fertilizer.
Test Results
The first seven values [soil class, HM%, WN, CEC, BS%, Ac and pH] describe the soil and its degree of acidity. The
remaining 16 [P-1, K-I, Ca%, Mg%, Mn-I, Mn-A11, Mn-Al2, Zn-1, Zn-AI, Cu-I, S-I, SS -I, Na, ESP, SS -I, NO3-N (not routinely
indicate levels fertility Visit www.ncagr.gov/agronomi/uyrst.htm
available)] of plant nutrients or other measurement.

Pow'siN Dy
Grower:
CMSD
Farm:
WILEY GASKINS RD
Ayden Nitrogen
4728 Old NC 11 Ayden, NC 28513
252-746-2152
Farm Sample ID

pnxete4 By
SavedRX: ALL
Soil Fertility
Grower: CMSD
Farm: WILEY GASKINS RD
Field(s): Multiple Fields
Tenn Lime - Fertilizer Application (Ibs/ac)
Equation Variables
Target pH: 6
Lab:
Custom Eq:
Commodity:
Sample Date:
Max Rate:
Min Rate:
Switch Rate:
NCDA
NCDA Recs
Corn
2021-10-01
N/A
400.0 Ibslac
400.0 Ibslac
Multiplier:
Subtract:
Min Application Rate:
Max Application Rate:
Avg Application Rate:
Application Area:
Average Field Rate:
N/A
N/A
400.0Ibslac
2300.0 Ibslac
1191.14 lbs/ac
41.03 ac
642.81 Ibslac
Total Area:
Total Product:
Total Product Bulk:
Product Cost / Bulk:
Total Product Price:
Application Cost/Area:
Total Application Cost:
Total Cost:
76.03 ac
48872.69 Ibs
24.44 ton
$52.0/ton
$1270.69
$0.0/ac
$0.0
$1270.69
Ayden Nitrogen
4728 Old NC 11
Ayden, NC 28513
9J,7_74A..71 c.7
10/29/21 01:46 PM
1/2

Statement Page: 1
Ayden Nitrogen
4728 Old NC 11 / P.O. Box 7
Ayden, NC 28513
Phone [phone]
Contentnea Metro Sewage Dist
Po Box 477
Griifton, NC 28530
Date Number Description 1 Detail
Statement Date: 11/30/2021
ID: 010202
Total Balance: $1,701.85
Amount Remitted:
Terms:
Unless otherwise agreed in writing by Harvey Fertilizer &
Gas Co, interest will accrue at a periodic rate of 1.5% per
month. To avoid additional finance charges, payments must
be in office by last day of month.
Quantity Price / Unit
Extension
I ---Your Share----1
Prepaid Regular
Balance Forward
11/08/2021 1021928 Charge Invoice - Due 12/08/2021
Dolomitic Lime - Bulk
App Fees - Lime
11/09/2021 1021933 Charge Invoice -Due 12/09/2021
GPS Soil Sampling
20.360 Tons
20.360 Each
75.690 Acre
0.00 0.00
51.000 /Tons 1,038,36 1,038,36
14.000 /Each 285.04 285.04
Invoice Total 1,323.40 0.00 1,323.40
5.000 /Acre 378,45 378.45
Invoice Total 378.45 0.00 378.45
Ending Total Balances 0.00 1,701.86
Current 1 - 30 31 - 60 61 - 90 Over 90 Unapplied Budget Billing Prepay Overall
1,701.85 0.00
0.00 0.00 0.00 0.00 0.00 0.00 1,701.85
Ayden Nitrogen
Date: 11/30/2021 Contentnea Metro Sewage Dist