WQ0000455_Residual Annual Report 2021_20220218

Non-Discharge Branch Upload/Submittal Form �.
NORTH CAROLINA
EnWrvnmenfol Quoity
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
Residual Annual Report
Additional Information
Other
Annual Report Year* 2021
Permit Number(IR)* WQ0000455
Applicant/Permittee Lewis Farms and Liquid Waste,Inc.
Email Notifications
Does this need review by the hydrogeologist?* Yes • No
Regional Office Wilmington
CO Reviewer
Admin Reviewer

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* Martin Mabe
Email Address* Phone Number*
[e-mail] 3363121396
Project Information
Application/Document Type* New(Fee Required) Modification-Minor
Modification-Major(Fee Required) Renewal
Renewal with Major Modification(Fee GW-59, NDMR,NDMLR, NDAR-1,
Required) NDAR-2
Annual Report Residual Annual Report
Additional Information Change of Ownership
Other
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:* Wastewater Irrigation High-Rate Infiltration
Other Wastewater Reclaimed Water
Closed-Loop Recycle Residuals
Single-Family Residence Wastewater Other
Irrigation
Permit Number:* WQ0000455
Has Current Existing permit number
Applicant/Permittee Address* 8155 Malpass Corner Road,Currie,NC 28435
Facility Name* Lewis Farms and Liquid Waste Class B Residuals Program
Please provide comments/notes on your current submittal below.
Lewis Farms and Liquid Waste,Inc.-2021 Class B Annual Report WQ0000455
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.)
Lewis Farms-2021 Annual Report W00000455.pdf 25.15MB
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
CP rz W
Submission Date 2/18/2022

2021 ANNUAL REPORT
LAND APPLICATION PROGRAM
LEWIS FARMS AND LIQUID WASTE, INC.
PERMIT #WQ0000455
Prepared For:
Lewis Farms and Liquid Waste, Inc.
8155 Malpass Corner Road
Currie,North Carolina 28435
Compiled By:
Willcox&Mabe Soil Solutions,PLLC
7231B Summerfield Road
Summerfield,North Carolina 27358
February 2022

# t
willcox&rnabe
SOIL SOLUTIONS
February 18,2022
NCDEQ-DWR Non-Discharge Compliance Unit
512 North Salisbury Street
9th Floor, Office 942X
Raleigh,North Carolina 27604
Attention: Non-Discharge Compliance Unit
Reference: 2021 LAND APPLICATION ANNUAL REPORT
Lewis Farms and Liquid Waste,Inc.
Permit No. WQ0000455
WMSS Project No. 15-20 Ph: 01
Non-Discharge Compliance Unit:
Willcox&Mabe Soil Solutions,PLLC(WMSS)is submitting all monitoring and reporting
requirements as specified in the above referenced permit on behalf of Lewis Farms and
Liquid Waste, Inc. (Lewis Farms). WMSS compiled this report using data gathered during
the compliance year by Lewis Farms. This data includes: 1)certification form,2)residuals
analyses and pathogen/vector data, 3)application summaries and field loading rate reports,
and 4) soil analyses.
If there is any further information required or questions regarding this annual report please
do not hesitate to contact Lewis Farms or WMSS for further assistance.
Sincerely,
Willcox&Mabe Soil Solutions,PLLC
/46. Lie
Martin Mabe
NC Land Application/Residuals Operator
#22753
Enclosures
SharedlWMSS Projects12015115-20 Lewis Farms12021 Annual Report12021 ANNUAL REPORT.cfoc
Willcox&Mabe Soil Solutions,PLLC 17231 B Summerfield Road I Summerfteld,NC 273581 Rob 336.339.9128 or Martin
336.312.1396/www.willcoxmabesoil.com

TABLE OF CONTENTS
SECTION NO. TITLE
I Certification Form
II Residuals Analyses&Pathogen/Vector Attraction Data
III 2021 Application Summary and Field Loading Rate Reports
IV Soil Analysis

CERTIFICATION FORM

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#: WQ0000455 County: Fender Year: 2021
Facility Name(as shown on permit): Lewis Farms and Liquid Waste, Inc.
Land Application Operator: Mr. Wesley Wooten Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year?
0 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: 19
Total number of fields utilized for land application during the year: 8 _
Total amount of dry tons applied during the year for all application sites: 486.08
Total number of acres utilizes for land application during the year: 228.63
Part B-Annual Compiance Statement:
Facility was compliant during calendar year 2021 with all conditions of the land application permit
(including but not limited to items 1-13 below)issued by the Division of Water Quality. 0 Yes ❑ 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 I5A 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 Quality.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and remediations.
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 knowing violations."
Mr. Wesley Wooten, President �w 1/20/2021
Permittee Name and Title(type or print) Signature of yermittee Date
Signature of Preparer* Date Signature of Land Applier Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 503.9(r)and 15A NCAC 02T.1102(26) DENR FORM ACE (12/2006)

RESIDUAL ANALYSES
TCLP ANALYSES IF REQUIRED
AND PATHOGEN AND VECTOR ATTRACTION REDUCTION

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Attach this form to the corresponding laboratory analysis.
Please note that your permit may contain additional parameters to be analyzed than those required to be summarized on this form.
Permit Number W00000455 Laboratory 1)Envirochem
Facility Name Lewis Farms and Liquid Waste, Inc. 2)Environment 1
NPDES# See Below 3)
WWTP Name See Below 2021 DATA
RESIDUAL ANALYSIS DATA
NPDES# W000130193 ' NC0065480 W00033770 VI-30-08 ' NC0021253 NC0021253 NC0003344 NC0062539 NC0030406 NC0021342
W'NfP Name Bald Head Island Beau Rivage Carolina Plant. Grand Villas Havelock Havelock House of Raeford Horse Creek Riverbend Trenton
Composited l Grab 12/15/21 12121/21 12/27/21 12/27/21 07/15/21 10/12/21 02/15/21 12/27/21 11/16/21 02/11/21
Percent Solids 2.30 4.13 2.53 3.30 3.58 3.76 2.05 3.30 3.88 3.02
PARAMETERS(mg/kg dry weight)
Arsenic 41.80 23.30 30.80 27.80 2.70 2.50 16.00 27.80 30.67 I 2.50
Cadmium 41.80 23.30 30.80 27.80 1.80 1.50 16.00 27.80 15.30 0.50
Copper 376.00 219.00 87.70 367.00 721.00 670.00 292.00 367.00 1,070.00 32.00
Lead 41.80 23.30 30.80 27.80 15.00 26.00 16.00 27.80 17.30 3.90
Mercury 0.74 0.41 0.64 1.80 0.48 0.33 0.82 1.80 2.31 0.04
Molybdenum 41.80 23.30 30.80 27.80 6.00 6.00 16.00 27.80 15.30 5.00
Nickel 41.80 23.30 30.80 27.80 12.00 10.00 16.00 27.80 17.80 5.00
Selenium 41.80 23.30 30.80 27.80 _ 5.00 5.00 16.00 27.80 15.30 5.00
Zinc 3,360.00 2,260.00 2,070.00 4,610.00 2,201.00 1,971.00 231.00 4,610.00 1,150.00 121.00
TKN 47,000.00 52,100.00 77,100.00 56,800.00 47,830.00 25,640.00 75,900.00 56,800.00 39,600.00 5,803.00
Ammonia-Nitrogen 2,350.00 4,790.00 7,340.00 4,220.00 2,994.00 2,254.00 3,410.00 4,220.00 2.58 39.86
Nitrate-Nitrogen 2.78 4.40 4.63 6.53 3.98 2.98 6.86 6.53 14.20 49.83
Total Phosphorus 26,500.00 22,000.00 30,900.00 22,100.00 12,520.00 42,600.00 20,100.00 22,100.00 27,500.00 3,343.00
RESIDUAL ANALYSIS DATA
NPDES# NC0062642
WWTP Name Webb Creek
Composited 1 Grab 11/17/21
Percent Solids 2.31
PARAMETERS(mg/kg dry weight)
Arsenic 21.00
Cadmium 21.00 _
Copper 278.00 _
Lead 21.00
Mercury 0.72
_ Molybdenum 21.00 _
Nickel 21.00
Selenium 21.00
Zinc 273.00
TKN 70,900.00
Ammonia-Nitrogen 3,840.00
Nitrate-Nitrogen 1.32
Total Phosphorus 41,800.00
X N/A due to number of sources Page 1 of 1
(SIGNATURE OF PREPARER) DATE
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.

LEWIS FARMS
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater Treatment Plant
Date Sampled: December 15,2021
Bald Head Island Permit No.WQ0000455
Mineralization Rate 0.30 2.30 %Solids
7.02 pH
Parameter % Mg/Kg Dry Weight Pounds/Dry Ton
(%x 10,000) (Mg/Kg x 0.002)
Nitrogen(TKN) 4.700 47,000.000 94.000
Phosphorus 2.650 26,500.000 53.000
Potassium 0.392 3,920.000 7.840
PAN(injected)* 1.575 15,747.780 31.496
PAN(surface)* 1.457 14,572.780 29.146
Ammonia Nitrogen 0.235 2,350.000 4.700
Calcium 3.860 38,600.000 77.200
Calcium Carbonate Eq. --- --- ---
Magnesium --- 3,350.000 6.700
Sodium --- 8,300.000 _ 16.600
Sulfur --- --- ---
Nitrate N/Nitrite N --- 2.780 0.006 _
Barium --- --- --- SAR
Chloride --- --- --- 1.65
Iron --- --- --- _ Ceiling Concen.
Aluminum --- 3,530.00 7.060 (Mg/Kg)
Arsenic --- 41.80 0.084 75
Cadmium --- 41.80 0.084_ 85
Chromium --- 41.800 ---
Copper --- 376.00 0.752 _ 4,300
Lead _ --- 41.80 0.084_ 840
Mercury -- 0.735 0.001 _ 57
Molybdenum _ --- 41.80 0.084_ 75
Nickel --- 41.80 0.084 _ 420
Selenium --- 41.80 0.084__ 100
Zinc --- 3,360.00 6.720 7,500
Environmental Chemists,Inc.# 2021-22185
*Determination of Plant Available Nitrogen(PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia N)+Ammonia N+Nitrate N+Nitrite N=%PAN
Surface Application:
(Mineralization Rate)(TKN-Ammonia N)+(0.5)(Ammonia N)+Nitrate N+Nitrite N=%PAN
Note: Constituents N.D.(Not Detected)or<detection limits are listed as detection limits
for calculation purposes.

LEWIS FARMS
WQ0000455
Bald Head Island
fiRis040iM
MIPN per gram
12/15/21 558 2.7466
12/15/21 1,077 3.0322
12/15/21 1,636 3.2138
12/15/21 1,112 3.0461
12/15/21 1,058 3.0245
12/15/21 1,613 3.2076
12/15/21 1,154 3.0622
Total 21.3331
Average 3.0476
Geometric Mean jiMilinfilrfiqyilil Fecal Coliform MPN/gram
Geometric Mean of Less than 2,000,000 meets Class B -Alternative 1 Pathogen for Reduction
requirement.

;,
~ „ Environmental
�, � v:;���":�. Chemists, Inc.
r.� B 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
' • . y'. ... M1• -, 710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
'` °:41 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Lewis Farms & Liquid Waste, INC. Date of Report: Jan 07, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Wesley Wooten Report#: 202 1-22 1 85
Project ID: sludge
Lab ID Sample ID: 64,0 i-je,.J Collect Date/Time Matrix Sampled by
21-55584 Site: Sludge 12/15/2021 7:30 AM Solid/Sludge Client
Test f-7_aa. Method Results Date Analyzed
Sludge Residuals
Aluminum EPA 200.7,Rev.4.4,1994 3530 mg/kg 12/23/2021
Arsenic EPA 200.7,Rev.4.4,1994 <41.8 mg/kg 12/23/2021
Cadmium EPA 200,7,Rev.4.4,1994 <41.8 mg/kg 12/23/2021
Calcium EPA 200.7,Rev.4.4,1994 38600 mg/kg 12/23/2021
Chromium EPA 200.7,Rev.4.4,1994 <41.8 mg/kg 12/23/2021
Copper EPA 200.7.Rev.4.4,1994 376 mg/kg 12/23/2021
Lead EPA 200.7,Rev,4.4,1994 <41,8 mg/kg 12/23/2021
Magnesium EPA 200.7,Rev.4.4,1994 3350 mg/kg 12/23/2021
Molybdenum EPA 200,7.Rev.4.4,1994 <41.8 mg/kg 12/23/2021
Nickel EPA 200.7.Rev.4.4,1994 <41.8 mg/kg 12/23/2021
Potassium EPA 200.7,Rev.4.4,1994 3920 mg/kg 12/23/2021
Selenium EPA 200.7,Rev.4.4,1994 <41.8 mg/kg 12/23/2021
Sodium EPA 200.7,Rev.4.4,1994 8300 mg/kg 12/23/2021
Zinc EPA 200.7,Rev.4.4,1994 3360 mg/kg 12/23/2021
Nitrate+Nitrite-Nitrogen EPA 353-2 2.78 mg/kg 12/16/2021
Total Solids (%) SM 2540 a 2.30% 12/16/2021
Ammonia Nitrogen SM 4500 NHH3 C-2011 2350 mg/kg 12/17/2021
Total Kjeldahl Nitrogen (TKN) SM 4500 Norg B-2011 47000 mg/kg 12/17/2021
Total Phosphorus SM 4500 P F-2011 26500 mg/kg 12/20/2021
pH SW 846 Method 9045D 7.02 units 12/22/2021
Mercury 5W-846 7471 s <0.735 mg/kg 12/21/2021
Report#:: 2021-22185
Page 1 of 3

4 ,'7 r , �- r, Environmental Chemists, Inc.k
AC„ 9 +! 1y?O + e p 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab P 910.392.4424 Fax
"~`''� i j` ` ' _':r '�r';c"°Y. 710 Bowsertown Road,Manteo NC 27954 • 252.473.5702 Lab/Fax
- .AI 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Lewis Farms & Liquid Waste, INC. Date of Report: Jan 07, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Wesley Wooten Report#: 2021-22185
Project ID: sludge
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-55585 Site: 1 12/15/2021 7:31 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 a 2.33% 1211612021
Fecal Density SM 9221C E-2014 558 MPN/g 12/15/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-55587 Site:2 12/15/2021 7:32 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.23% 1211612021
Fecal Density SM 9221C E-2014 1077 MPN/g 12/15/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-55588 Site: 3 12/15/2021 7:33 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 9 2,14% 1211612021
Fecal Density SM 9221C E-2014 1636 MPN/g 12/15/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-55589 Site: 4 12/15/2021 7:34 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 9 2.16% 12/16/2021
Fecal Density SM 9221C E-2014 1112 MPN/g 12/15/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-55590 Site:5 12/15/2021 7:35 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.27% 12/16/2021
Fecal Density SM 9221C E•2014 1058 MPN/g 12115/2021
Report A';! 2021.22195
Page 2 of 3

� �pp-,, °.• Environmental Chemists, Inc.
h4r ,�'L2l
el ' `°]C IeP' 6602 Windmill Way,Wilmington,NC 28405 0 910.392.0223 Labe 910.392.4424 Fax
4' ;'' s, 4. . �- '" , 710 Bowsertown Road,Manteo,NC 27954 . 252.473.5702 Lab/Fax
T .:K:,{' ,Y,r1.:„ 255-A Wilmington Highway,Jacksonville,NC 28540 . 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS info [e-mail]
Lewis Farms & Liquid Waste, INC. Date of Report: Jan 07, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Wesley Wooten Report#: 2021-22185
Project ID: sludge
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-55591 Site: 6 12/15/2021 7:36 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids(%) SM 2540 8 2.17% 12116/2021
Fecal Density SM 9221C E-2014 1613 MPN/g 12/15/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-55592 Site: 7 12/15/2021 7:37 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 a 2.08% 1 211 612 0 2 1
Fecal Density 5M 9221C E-2014 1154 MPN/g 12/15/2021
Comment: Sludge residuals, except pH, reported on a dry weight basis. pH reported on an as received basis.
Reviewed by: Kalut, 4iEJ
Report#:; 2021-22185
Page 3 of 3

Environmental Chemist, Inc., Wilmington, NC Lab #94
6602 Windmill Way
Wilmington, NC 28405
910.392.0223
Sample Receipt Checklist
ClientL V)I5 S Date/Z i, 1 Report Number: 02 I --c1,�I 8
Receipt of sample: ECHEM Pickup 0 Client DeliveryYES0 !UPS 0 FedEx 0 Other 0
N/A 1. Were custody seals present on the cooler?
❑ YES 0 NO N/A 2. If custody seals were present, were
Original temperature upon receipt 5--- oC they intact/unbroken?
How temperature taken: 0 Temperature Blank k Against Bottles
Corrected temperature upon receipt °C
IR Gun ID:Thomas Traceable S/N 192511657 IR Gun Correction Factor C:0.0
0 YES 0 NO 3. If temperature of cooler exceeded 6°C,was Project Mgr./QA notified?
k` YES ❑ NO 4. Were proper custody procedures (relinquished/received) followed?
YES 0 NO 5. Were sample ID's listed on the COC?
YES 0 NO 6. Were samples ID's listed on sample containers?YES 0 NO 7. Were collection date and time listed on the COC?
id-- YES 0 NO 8. Were tests to be performed listed on the COC?
YES 0 NO 9. Did samples arrive in proper containers for each test?
YES 0 NO 10, Did samples arrive in good condition for each test?
YES 0 NO 11. Was adequate sample volume available?'
1,c1I YES 0 NO 12. Were samples received within proper holding time for requested tests?
❑ YES 0 NO 13. Were acid preserved samples received at a pH of<2? *
❑ YES 0 NO 14. Were cyanide samples received at a pH>12?
❑ YES ❑ NO 15. Were sulfide samples received at a pH>9?
❑ YES 0 NO 16. Were NH3/TKN/Phenol received at a chlorine residual of<0.5 m/L? **
❑ YES 0 NO 17. Were Sulfide/Cyanide received at a chlorine residual of<0.5 m/L?
❑ YES 0 NO 18. Were orthophosphate samples filtered in the field within 15 minutes?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
** Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet.
Sample Preservation: (Must be completed for any sample(s) incorrectly preserved or with headspace)
Sample(s) _ were received incorrectly preserved and were adjusted accordingly
by adding(circle one): HZSO4 HNO3 HCI NaOH
Time of preservation: If more than one preservative is needed, notate in comments below
Note:Notify customer service immediately for Incorrectly preserved samples.Obtain a new sample or
notify the state lab if directed to analyzed by the customer.Who was notified,date and time:
Volatiles Sample(s) were received with headspace
COMMENTS:
DOC. QA.002 Rev 1

aA ENVIRONMENTAL CHEMISTS, INC OFFlCEI 6602 ndmill 2-2 3ilmingtton,FAX [phone]
Way NC 28405
Analytical&Consulting Chemists NCDENR:DWQ CERTIFICATION#94 NCDHHS:DLS CERTIFICATION#37729 info&nvironmentalchemists.com
COLLECTION AND CHAIN OF CUSTODY
Client: Lewis Farms &Liquid Waste PROJECT NAME: REPORT NO: t.o L-f - L.L/?lc-
ADDRESS: CONTACT NAME: Wesley Wooten PO NO:
REPORT TO: Martin Mabe/Mahe-Wilcox PHONE/FAX:
COPY TO: email:
Sampled By: Gn.c.,74--- SAMPLE TYPE: I=Influent, E=Effluent,W=Well,ST=Stream,SO=Soil,SL=Sludge, Other:
Collection 0 PRESERVATION
12, a, a m IC7 c _r ow
Sample Identification m c9 r i= E `o d r g g z EI N o 0 o w ANALYSIS REQUESTED
Oat Time Temp tov " " z z = = x F a
Aft ti 4'r— C P
Sludge 111 G G 5552(f X Fy> t" Nutrients/Metals
1 G G 555 o
_ X Fecal Density//oT5
kVI C P
2 G G -555S 7 X Fecal Density/%TS
3.
4./ C P
3 G G 555 g X Fecal Density/%TS
�:: C P
`5
4 _ G G 52g X Fecal Density/%TS
4- -'-- C P
5 G G S qO X Fecal Density/%TS
C P
6 G Gq'/ X Fecal Density/%TS
}t C P
7 4 G G 2 -- X Fecal Density/%TS
Transfer Relinquished By: DatelTime Received By. Date/Time
1.
2. .----
Temperature when Received: ( V Accepted: - Rejected: _Resample Re ue ted:
Delivered By: a l/ -- Received By: J _ / Date: -, Time: e aI 4_
Comments: TU N ROUND:

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM(02T Rules)
Facility Name; Lewis Farms&Liquid Waste,Inc_ WQ Permit Number: WQ0000455 _
WWTP Name: Bald Head Island NPDES Number: WQ0000193
Monitoring Period: From 1/1/202I To 12/31/2021
Pathogen Reduction(15A NCAC 02T.1106)-Please indicate level achieved and alternative performed:
Class A: Alt. A(time/temp) 0 1 Alt B(A1kTreatment)0 Alt. C(Prior Testing)❑
AIt.D(No Prior Test) ❑ Process to Further Reduce Pathogengs 0
If applicable to alternative performed(Class A only)indicate"Process to Further Reduce Pathogens":
Corn ost ❑ Heat Drying ❑ Heat Treatment 0 Thermophilic ❑
Beta Ray ❑ Gamma Ray ❑ Pasteurization ❑ , , .......... . < . '
Class 13: Alt.(1)Fecal Density p Alt.(2)Process to Significantly Reduce Pathogens p
If applicable to alternative performed(Class B only)indicate'Process to Significantly Reduce Pathogens":
Lime Stabilization ❑ Air Drying ❑ Composting 0 'Aerobic Digestion 0
Anaerobic Digestion t : .
a
fM
If a plicable to alternative performed (Class A or Class B)complete the following monitoring data:
t�fumberot Anal teal
Allowable Level Pathogen.Density Frequency Sample
ParameterExeee- Tech-
in Sludge Minimum Geo.Mean Maximum Units dances of Analysis Type !Acne
2 x 10 to the MPN 558 1,116 1,636 MPN/g 0 Annual Grab sM 9221 CE
6th power
per gram of CPU
Fecal Colifonn total solids
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria 3 MPN per 4 grams
(in lieu of fecal total solid(dry
conform) weight)
Vector Attraction Reduction (15A NCAC 02T.1107)-Please indicate alternative performed:
Alt.l (VS reduction) ❑ Alt.2(40-day bench) ❑ Alt.3(30-day bench) ❑ Alt.4(Spec.03 uptake) ❑
Alt.5(14-Day Aerobic) © _Alt.6(Alk.Stabilization ❑ Alt 7(Drying-Stable) 0 Alt.8(Drying-Unstable) ❑
Alt.9(Injection) E3 Alt. 10(Incorporation) p No vector attraction reduction alternatives were performed ❑
CERTIFICATION STATEMENT(please check the appropriate statement)
C) "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."
Cl "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 check 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."
David Sucher,ORC Wesley Wooten,President
PreparerN���(typ�r print) Land Applier Name and Title(if applieable)(type or print)`per 2-1-22 , 1/27/22
Signature of Preparer* Date Signature of d Applier(if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r)and 15A NCAC 2T.1102(26)
OENR FORM PVRF 02T(12/2006)

LEWIS FARMS
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater Treatment Plant
Date Sampled: December 21,2021
Beau Rivage Permit No.WQ0000455
4.13 %Solids
7.05 pH
Parameter % Mg/Kg Dry Weight Pounds/Dry Ton
(%x 10,000) (Mg/Kg x 0.002)
Nitrogen(TKN) 5.210 _ 52,100.000 104.200
Phosphorus 2.200 _ 22,000.000 44.000
Potassium 0.373 3,730.000 7.460
PAN(injected)* 1.899 18,987.400 37.975
PAN(surface)* 1.659 16,592.400_ 33.185
Ammonia Nitrogen 0,479 4,790.000 9.580
Calcium 2.190 2I,900.000 43.800
Calcium Carbonate Eq. --- _- ___
Magnesium --- 2,330.000 4.660
Sodium --- 2,330.000 4.660
Sulfur ___ ---
Nitrate N/Nitrite N --- 4.400 0.009
Barium -- _ --- --- SAR
Chloride --- --- --- 0.81
Iron --- --- --- Ceiling Concen.
Aluminum --- 15,300.00 30.600 (Mg/Kg)
Arsenic --- 23.30 _ 0.047 75
Cadmium --- 23.30 0.047 85
Chromium --- 23.300 --- ---
Copper --- 219.00 0.438 4,300
Lead --- 23.30 0.047 840
Mercury --- 0.414 0.001 57
Molybdenum --- _ 23.30 0.047 75
Nickel --- 23.30 0.047 420
Selenium --- 23.30 0.047 100
Zinc --- 2,260.00 4.520 7,500
Environmental Chemists,Inc.# 2021-22510
*Determination of Plant Available Nitrogen(PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia N)+Ammonia N+Nitrate N+Nitrite N=%PAN
Surface Application:
(Mineralization Rate)(TKN-Ammonia N)+(0.5)(Ammonia N)+Nitrate N+Nitrite N=%PAN
Note: Constituents R.D.(Not Detected)or a detection limits arc listed as detection limits
for calculation purposes.

LEWIS FARMS AND LIQUID WASTE, INC.
WQ0000455
Beau Rivage WWTP
o
12/21/21 186,225 5.2700
12/21/21 129,808 5.1133 _
12/21/21 231,156 _ 5.3639
12/21/21 _ 213,954 5.3303
12/21/21 395,062 5.5967
12/21/21 394,089 5.5956
12/21/21 133,005 5.1239
Total 37.3937
Average 5.3420
Geometric Mean :iiii!ii!Mia:04,ME Fecal Coliform MPN/gram
Geometric Mean of Less than 2,000,000 meets Class B -Alternative 1 Pathogen Reduction
requirement.

Environmental Chemists, Inc.
Qt,8r.1 rant � ; ' 6602 Windmill Way,Wilmington,NC 28405 b 910,392.0223 Lab V 910.392.4424 Fax
1 `,� g " 4 ` 710 Bowsertown Road,Manteo,NC 27954 • 2
-mot,,, ,�.,�, � �sMi 52.473.5702 Lab/Fax
=: l_; ,-,t-r,'/: '- 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Lewis Farms & Liquid Waste, INC. Date of Report: Jan 07, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Report#: 2021-22510
Project ID: AquaNC-Beau Rivage
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56335 Site: Sludge 12/21/2021 7:00 AM Solid/Sludge Lewis Farms
Test Method Results Date Analyzed
Sludge Residuals
Aluminum EPA 200.7,Rev.4.4,1994 15300 mg/kg 12/30/2021
Arsenic EPA 200.7,Rev.4,4,1994 <23.3 mg/kg 12/23/2021
Cadmium EPA 200.7,Rev.4.4,1994 <23.3 mg/kg 12/23/2021
Calcium EPA 200.7,Rev.4.4,1994 21900 mg/kg 12/23/2021
Chromium EPA 200.7,Rev.4.4,1994 <23.3 mg/kg 12/23/2021
Copper EPA 200.7,Rev.4.4,1994 219 mg/kg 12/23/2021
Lead EPA 200.7,Rev.4.4.1994 <23.3 mg/kg 12/23/2021
Magnesium EPA 200.7.Rev.4.4,1994 2330 mg/kg 12/23/2021
Molybdenum EPA 200.7,Rev.4.4,1994 <23.3 mg/kg 12/23/2021
Nickel EPA 200.7,Rev.4.4,1994 <23.3 mg/kg 12/23/2021
Potassium EPA 200.7,Rev,4.4,1994 3730 mg/kg 12/23/2021
Selenium EPA 200.7,Rev 4.4,1994 <23.3 mg/kg 12/23/2021
Sodium EPA 200.7,Rev.4.4,1994 2330 mg/kg 12/23/2021
Zinc EPA 200.7,Rev.4.4,1994 2260 mg/kg 12/23/2021
Nitrate-I-Nitrite-Nitrogen EPA 353.2 4.40 mg/kg 12/22/2021
Total Solids (%) SM2540B 4.13% 12/27/2021
Ammonia Nitrogen SM 4500 NH3 C-2011 4790 mg/kg 12/21/2021
Total Kjeldahl Nitrogen(TKN) SM 4500 Norg B-2011 52100 mg/kg 12/17/2021
Total Phosphorus SM 4500 P F-2011 22000 mg/kg 12/28/2021
pH SW 646 Method 90450 7.05 units 12/22/2021
Mercury SW-846 7471 B <0.414 mg/kg 01/05/2022
Report rt:: 2021-22510
. Page 1 of 3

' v Environmental Chemists, Inca
`-l'i v l Qt(x _env' 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
'y a 710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
��.�'�, -� sM
.:fir''-- r : '' 255-A Wilmington Highway,Jacksonville,NC 28540 . 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Lewis Farms & Liquid Waste, INC. Date of Report: Jan 07, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Report#: 2021-22510
Project ID: AquaNC-Beau Rivage
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56336 Site: 1 12/21/2021 7:05 AM Solid/Sludge Lewis Farms
Test Method Results Date Analyzed
Total Solids(%) SM 2540 s 3.92 a/° 12/27/2021
Fecal Density SM 9221C E-2014 186225 MPN/g 12/21/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56337 Site: 2 12/21/2021 7:06 AM Solid/Sludge Lewis Farms
Test Method Results Date Analyzed
Total Solids (%) SM 2540 a 4.16°/, 12/27/2021
Fecal Density SM 9221c E-2014 129808 MPN/g 12/21/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56338 Site: 3 12/21/2021 7:07 AM Solid/Sludge Lewis Farms
Test Method Results Date Analyzed
Total Solids(%) SM 2540 s 3.9$% 12/27/2021
Fecal Density SM 9221C E-2014 231156 MPN/g 12/21/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56339 Site:4 12/21/2021 7:08 AM Solid/Sludge Lewis Farms
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 4.30% 12/27/2021
Fecal Density SM 9221C E-2014 213954 MPN/g 12/21/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56340 Site: 5 12/21/2021 7:09 AM Solid/Sludge Lewis Farms
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 4,05% 12/27/2021
Fecal Density SM 9221C E-2014 395062 MPN/g 12/21/2021
Report#:: 2021-22510
Page 2of3

. Environmental Chemists,
;1L.+r ,' Noehe " f r.
r
'' 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
" `�- 710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
$' 7,4"'4 " . 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Lewis Farms & Liquid Waste, INC. Date of Report: Jan 07, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Report*: 2021-22510
Project ID: AquaNC-Beau Rivage
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56341 Site: 6 12/21/2021 7:10 AM Solid/Sludge Lewis Farms
Test Method Results Date Analyzed
Total Solids (%) SM 2540 e 4 06% 1 212 712 0 2 1
Fecal Density SM 9221C E-2014 394089 MPN/g 12/21/2021
Lab ID Sample rD: Collect Date/Time Matrix Sampled by
21-56342 Site:7 12/21/2021 7:11 AM Solid/Sludge Lewis Farms
Test Method Results Date Analyzed
Total Solids (%) SM 2540 8 4.06% 12/27/2021
Fecal Density SM 9221C E-21714 133005 MPN/g 12/21/2021
Comment: Sludge residuals, except pH, reported on a dry weight basis. pH reported on an as received basis.
Reviewed by: Balid3 j, O 4
Report#:: 2021-22510
Page3of3

Environmental Chemist, Inc., Wilmington, NC Lab #94
6602 Windmill Way
Wilmington, NC 28405
910.392.0223
Sample Recei t Checklist
ClientLEW* DatiP\ i
Report Number: p21 --o 5 ru
Receipt of sample: ECHEM Pickup 0 Client Delivery ]UPS 0 FedEx ❑ Other 0
❑ YES ❑ NO pki N/A 1. Were custody seals present on the cooler?
❑ YES 0 NO K. N/A 2. if custody seals were present,,were they intact/unbroken?
Original temperature upon receipt °C Corrected temperature upon receipt C
How temperature taken: 0 Temperature Blank Against Bottles °
IR Gun iD:Thomas Traceable 5/N 192511657 IR Gun Correction Factor°C:0.0
❑ YES CI NO 3. If temperature of cooler exceeded 6°C,was Project Mgr./QA notified?
ve YES 0 NO _4. Were proper custody procedures (relinquished/received)followed?
YES 0 NO 5. Were sample ID's listed on the COC? -
E YES CI NO 6. Were samples ID's listed on sample containers?
YES ❑ NO 7. Were collection date and time listed on the COC?
YES C7 NO 8. Were tests to be performed listed on the COC?
YES 0 NO 9. Did samples arrive in proper containers for each test?
YES 0 NO 10. Did samples arrive in good condition for each test? -
Li YES ❑ NO 11. Was adequate sample volume available?'
] YES 0 NO 12. Were samples received within proper holding time for requested tests?
❑ YES 0 NO 13. Were acid preserved samples received at a pH of<2?*
❑ YES 0 NO 14. Were cyanide samples received at a pH >12?
❑ YES 0 NO 15. Were sulfide samples received at a pH>9?
❑ YES ❑ NO 16. Were NH3/TKN/Phenol received at a chlorine residual of<0.5 m/L? '"
© YES 0 NO 17. Were Sulfide/Cyanide received at a chlorine residual of<0.5 m/L?
❑ YES 0 NO 18. Were orthophosphate samples filtered in the field within 15 minutes?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
** Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet.
Sample Preservation: (Must be completed for any sample(s) incorrectly preserved or with headspace)
Sample(s) were received incorrectly and were adjusted accordingly
by adding(circle one): H2SO4 HNO3 HCi N
Time of preservation: If more than one preservative is needed,notate in comments below
Note:Notify customer service immediately for incorrectly preserved samples.Obtain a new sample or
notify the state lab if directed to analyzed by the customer.Who was notified,date and time:
,Volatiles Sample(s) were received with headspace
COMMENTS:
DOC. QA.002 Rev 1

- --- ENVIRONMENTAL CHEMISTS, INC OFFICE!9 Oi13l Way9202231FAX9ton,NC 2840 0392 245
Analytical&Consulting Chemists NCDENR:DWQ CERTIFICATION#94 NCDHHS:DLS CERTIFICATION#37729 Info@ envlronmentalchemists.corn
COLLECTION AND CHAIN OF CUSTODY
Client: Lewis Farms &Liquid Waste PROJECT NAME: /ram. / •� REPORT NO: L r - LLs'r c_
ADDRESS: CONTACT NAME: Wesley Wooten PO NO:
REPORT TO: Martin Mahe/Mahe-Wilcox PHONE/FAX:
COPY TO: email:
Sampled By: �(.t Jr- SAMPLE TYPE: I=Influent, E=Effluent,W=Well,ST=Stream,SO=Soil,SL=Sludge,Other:
Collection
y d _. m PRESERVATION
Sample Identification E a ., y" o m
y f- E° ° ii a 8 E mg z o o o ❑ w ANALYSIS REQUESTED
Date Time Temp z s = z o
Min r C P
G G 5�33 X
Sludge Full TCLP, RCI, Nutrients/Metals _
1 *'_ C P SC33‘P
G G�� C P
X Fecal Density/%TS
- : _ -
2 G G 5 X Fecal Density/%TS
4.4 C P .
3 G G 510338 X Fecal Density/%TS
.?
4 G P '5b339 X Fecal Density/%TS
17_d9
5 G G .563 X Fecal Density/%TS
P; C P '
6 G G 56391 X Fecal Density/%TS
4"•r C P
7 , G G ki3 ,;" X Fecal Density/%TS
Transfer Relinquished By: Date/Time Received By: Date/Time
1.
2.
Temperature when Received: cf-i- Accepted: Rejected: Resample R u ted:
Delivered By: Received By: t.F 5 Date: IL L1 Time: "?7j
Comments: TU N ROUND:

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Facility Name: Lewis Farms and Liquid Waste, Inc. WQ Permit Number: WQ0000455
WWTP Name: Beau Rivage YI'DES Number: NC0065480
Monitoring Period: From 1/1/2021 To 12/31/2021
Pathogen Reduction (1SA 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 0 I-lent Drying CI Heat Treatment ❑ Thennophilic ❑
Beta Ray ❑ , Gamma Ray CI Pasteurization ❑
Class B: Alt. (1) Fecal Den,si p Process to Significantly Reduce Pathogens 0
if applicable to alternative performed Class indicate"Process to Sifnlficnntly Reduce Pathogens":
Lime Stabilization 0 Air Drving ❑ Composting ❑ Aerobic Digestion ❑
Anaerobic Digestion ❑
If applicable to alternative performed (Class A or Class B)complete the following monitoring data:
Allowable Level Pathogen DensityNumOerof Anatyta
Parameter g Exccc- Frequency Sample Tech
in Sludge Minimum Geo. Mean Maximum Units Y T aces of Analysis Type
nrorre
x 10 to the MPN 129,808 219,764 395,062 MPN/g 0
6th power Annual Grab SM9221C
per grain of
Fecal Coliform total solids Cl-tJ
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria 3 MPN per 4 grams
(in lieu of fecal total solid(dry
coliform) weight)
Vector Attraction Reduction (15A NCAC 02T.1107)-Please indicate alternative performed:
Alt.! (VS reduction) ❑ Alt_ 2(40-day bench) ❑ Alt.3 (30-day bench) 0 Alt. 4(Spec. 0.uptake) O.
Alt.5(14-Day Aerobic) ❑ Alt.6(Alk. Stabilization ❑ Alt 7(Drying-Stable) 0 Alt. 8(Drying-Unstable) ❑
Alt.9(Injection) [J Alt. 10(Incorporation) El No vector attraction reduction alternatives were performed 0
CERTIFICATION STATEMENT(please check the appropriate statement)
El "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 I5A NCAC 02T.1107 have not been met." (Please note if
you check 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 tine and imprisonment."
Cole Price, ORC Wesley Wooten, President
Preparer Nam 'and 'tie(type or print) Land Applier/Naame and Title(if applicable)(type or print)
�(, , 1/17/21
Signature of Prcparer* Date Signature of Lan Applier(if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r)and I SA NCAC 2T 1102(26)
DENR FORM PVRF 02T(1212006)

LEWIS FARMS
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater Treatment Plant
Date Sampled: December 27,2021
Carolina Plantation Permit No.WQ0000455
2.53 %Solids
6.6 pH
Parameter % Mg/Kg Dry Weight Pounds/Dry. Ton
(%x 10,000) (Mg/Kg x 0.002) ,
Nitrogen(TKN) 7.710 77,100.000 1 154.200
Phosphorus 3.090 30,900.000 61.800
Potassium 0.644 6,440.000 12.880
PAN(injected)* 2.827 28,272.630 56.545
PAN(surface)* 2.460 24,602.630 49.205
Ammonia Nitrogen 0.734 7,340.000 14.680
Calcium 1.890 18,900.000 _ 37.800
-
Calcium Carbonate Eq. --- --- ---
Magnesium --- 3,420.000 6.840
Sodium --- 4,310.000 8.620_
Sulfur --- -_
A
Nitrate N/Nitrite N --- 4.630 0.009
Barium --- --- --- SAR
Chloride --- --- --- 1.20
Iron --- --- --- Ceiling Concen.
Aluminum --- 8,850.00 17.700 (Mg/Kg)
Arsenic --- 30.80 0.062_ 75
Cadmium --- 30.80 0.062 85
Chromium --- 30.800 --- --
Copper --- 87.70 0.175 4,300
Lead --- 30.80 0.062 840
Mercury --- 0.640 0.001 57
Molybdenum --- 30.80 0.062 75
Nickel --- 30.80 0.062 420
Selenium --- 30.80 0.062 100
Zinc --- 2,070.00 4.140 7,500
Environmental Chemists,Inc.# 2021-22770
''Determination of Plant Available Nitrogen(PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia N)+Ammonia N+Nitrate N+Nitrite N=%PAN
Surface Application:
(Mineralization Rate)(TKN-Ammonia N)+(0.5)(Ammonia N)+Nitrate N+Nitrite N=%PAN
Note: Constituents N.D.(Not Detected)or<detection limits are listed as detection limits
for calculation purposes.

LEWIS FARMS
WQ0000455
Carolina Plantation
12/27/21 74,075 4.8697
12/27/21 68,670 4.8368
12/27/21 66,946 4.8257
12/27/21 101,266 5.0055
12/27/21 106,195 5.0261
12/27/21 75,118 4.8757
12/27/21 68,966 4.8386
Total 34.2781
Average 4.8969
Geometric Mean liii!Illi17040111illi11111 Fecal Coliform MPN/gram
Geometric Mean of Less than 2,000,000 meets Class B - Alternative 1 Pathogen for Reduction
requirement.

Environmental Chemists, Inc.
°'J J1 O " s 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 910,392.4424 Fax
.<{, .;% w s .. 710 Bowser town Road,ManEeo,NC 27954 • 252.473.5702 LaU/Fax
,, _ 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Lewis Farms & Liquid Waste, INC. Date of Report: Jan 24, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Wesley Wooten Report#: 2021-22770
Project ID: alimpiejow Coda
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56937 Site: 1 12/27/2021 7:32 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.16% 12/27/2021
Fecal Density SM 9221C E-2014 74075 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56938 Site:2 12/27/2021 7:33 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.33% 12/27/2021
Fecal Density SM 9221C E-2014 68670 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56939 Site: 3 12/27/2021 7:34 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2 39% 12/27/2021
Fecal Density SM 9221C E-2014 66946 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56940 Site:4 12/27/2021 7:35 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.37% 12/27/2021
Fecal Density SM 9221C E-2014 101266 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56941 Site: 5 12/27/2021 7:36 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.26% 12/27/2021
Fecal Density 5M 9221C E-2014 106195 MPN/g 12/27/2021
Report#_ 2021-22770 —
Page 1 of 3

wf:�4 N, of ant ram Environmental Chemists, Inca
' a ,' 0.t 6602 Windmill Way,Wilmington,NC 28405 • 910.392,0223 Lab • 910.392,4424 Fax
-r ,- ,w o.6 } . . .. 710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL 8 CONSULTING CHEMISTS [e-mail]
Lewis Farms &Liquid Waste, INC. Date of Report: Jan 24, 2022
8155 Mafpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Wesley Wooten Report#: 2021-22770
Project ID: 41110aSaiiip SrpI._L:41.
Lab ID Sample 1D: Collect Date/Time Matrix Sampled by
21-56942 Site: 6 12/27/2021 7:37 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.13% 12/27/2021
Fecal Density SM 9221C E-2014 7511 B MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56943 Site: 7 12/27/2021 7:36 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.32% 12/27/2021
Fecal Density SM 9221C a-2014 68966 MPN/g 12/27/2021
Report#:. 2021.22770
Page 2 of 3

y Ask. w Environmental Chemists, Inc.
' n •t, _ (e � 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
" k4...:",'`y r..,.7 ;�, :. 710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS info C!environrnentalchemists.corn
Lewis Farms& Liquid Waste, INC. Date of Report: Jan 24, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Wesley Wooten Report#: 2021-22770
Project ID: 1-
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56944 Site: Sludge 12/27/2021 7:30 AM Solid/Sludge Client
Test Method Results Date Analyzed
Sludge Residuals Aluminum EPA200,7,Rev.4.4,1994 8850 mg/kg 01/04/2022
Arsenic EPA 200.7,Rev.4.4,1994 <30.8 mg/kg 01/04/2022
Cadmium EPA 200.7,Rev 4.4,1994 <30,8 mg/kg 01/04/2022
Calcium EPA 200.7,Rev.4,4,1994 18900 mg/kg 01/04/2022
Chromium EPA 200.7,Rev,4.4,1994 <30.8 mg/kg 01/04/2022
Copper EPA 200.7,Rev.4,4,1994 87.7 mg/kg 01/04/2022
Lead EPA 200.7,Rev.4.4,1994 <30.8 mg/kg 01/04/2022
Magnesium EPA 200 7,Rev.4.4,1994 3420 mg/kg 01/04/2022
Molybdenum EPA 200.7,Rev.4.4,1994 <30.8 mg/kg 01/04/2022
Nickel EPA 200.7,Rev.4.4,1994 <30,8 mg/kg 01/04/2022
Potassium EPA 200.7,Rev.4.4,1994 6440 mg/kg 01/04/2022
Selenium EPA 200.7,Rev.4.4,1994 <30.8 mg/kg 01/04/2022
Sodium EPA 200.7,Rev.4.4,1994 4310 mg/kg 01/04/2022
Zinc EPA 200.7,Rev_4.4,1994 2070 mg/kg 01/04/2022
Nitrate+Nitrite-Nitrogen EPA 353.2 4.63 mg/kg 12/28/2021
Total Solids (%) SM 2540 B 2.53% 12/27/2021
Ammonia Nitrogen SM 4500 NH3 C.2011 7340 mg/kg 12/28/2021
Total Kjeldahl Nitrogen (TKN) SM4500 Norg 6-2011 77100 mg/kg 12/28/2021
Total Phosphorous SM 4500 P(F-H)-2011 30900 mg/kg 12/30/2021
pH SW 846 Method 9045D 6.60 units 01/14/2022
Result estimated. Analyzed out of 15 minutes hold time.
Mercury SW-846 7471 B <0.640 mg/kg 01/05/2022
Comment: Results, except pH, reported on a dry weight basis. pH reported on an as received basis.
Reviewed by:
Report#.' 2021-22770
Page 3 of 3

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM(02T Rules)
Facility Name: Lewis Farms&Liquid Waste,Inc. WQ Permit Number: WQ0000455
WWTP Name: Carolina Plantation NPDES Number: WQ0033770
Monitoring Period: From 1/1/202I To 12/31/2021
Pathogen Reduction (15A NCAC 02T.1106)-Please indicate level achieved and alternative performed:
Class A: Alt. A(time/temp) ❑ I Alt B (Alk Treatment)❑ I Alt.C (Prior Testing)❑
A1t.D(No Prior Test) 0 I Process to Further Reduce Pathogengs ❑ _
If applicable to alternative performed(Class A only)indicate"Process to Further Reduce Pathogens":
Compost ❑ Heat Drying ❑ Heat Treatment 0 Thennophilic ❑
Beta Ray 0 Gamma Ray ❑ Pasteurization ❑ ............. . .... .......... .... .
Class B: 'Alt_(1)Fecal Density El Alt. (2)Process to Significantly Reduce Pathogens ❑ I
If applicable to alternative performed(Class B only)indicate"Process to Significantly Reduce Pathogens":
Lime Stabilization ❑ I Air Drying ❑ I Composting ❑ Aerobic Digestion ❑
Anaerobic DigestionE _
If applicable to alternativeperformed (Class A or Class B)� completethe g monitor
PP following ing data:
Number of Analytical
Parameter Allowable Level Pathogen Density Frequency SampleExce N
Tech-
in Sludge Minimum Geo.Mean Maximum Units Bence- of Analysis Type
nirmedeuces yP nin��e _
2 x 10 to the MPN 66,946 78,863 106,195 MPNIg 0 Annual Grab SM922ICE
6th power
per gram of
Fecal Coliform total solids CFU
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria 3 MPN per 4 grams
(in lieu of fecal total solid(dry
coliform) weight)
Vector Attraction Reduction (15A NCAC 02T.1107)-Please indicate alternative performed:
Alt.1 (VS reduction) ❑ 'Alt.2(40-day bench) ❑ Alt.3(30-day bench) ❑ Alt.4(Spec.O,uptake) ❑
Alt. 5(14-Day Aerobic) 0 •Alt.6(Alk.Stabilization ❑ Alt 7(Drying-Stable) ❑ Alt. 8(Drying-Unstable) ❑
Alt.9(Injection) 0 Alt. 10(Incorporation) p No vector attraction reduction alternatives were performed ❑
CERTIFICATION STATEMENT(please check the appropriate statement)
El "I certify,under penalty of law,that the pathogen requirements in 15A NCAC 02T.1106 and the
vector attraction reduction requirement in ISA 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 check 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."
Jeff Jarmon,ORC Wesley Wooten,President
Preparer e an ' le(type or print) Land Applier Name and Title(if applicable)(type or print)
1/31/2022 1/27/22
Signature of Preparer* Date Signature of Land Ap ier(if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r)and 15A NCAC 2T.1102(26)
DENR FORM PVRF 02T(12/2006)

LEWIS FARMS
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater Treatment Plant
Date Sampled: December 27,2021
Grand Villas Permit No.
3.30 %Solids
7.19 pH
Parameter % Mg/Kg Dry Weight Pounds/Dry Ton
(%x 10,000) (Mg/Kg x 0.002)
Nitrogen(TKN) 5.680 56,800.000 113.600
Phosphorus 2.210 22,100.000 44.200
Potassium 0.298 2,980.000 5.960_
PAN(injected)* 2.000 20,000.530 40.001
PAN(surface)* 1.789 17,890.530 35.781
Ammonia Nitrogen 0.422 4,220.000 8.440
Calcium 0.211 2,110.000 4.220
Calcium Carbonate Eq. ___ --- ---
Magnesium _ 2,110.000 4.220
Sodium _ 3,790.000 7.580
Sulfur --- --- ---
Nitrate N/Nitrite N 6.530 0.013
Barium - --- --- --- SAR
Chloride --- --- --- 2.52
Iron --- --- --- Ceiling Concen.
Aluminum --- 226.00 0.452 (Mg/Kg)
Arsenic --- 27.80 0.056 _ 75
Cadmium --- - 27.80 0.056 85
Chromium --- 27.800 —
_
Copper --- 367.00 0.734 4,300
Lead --- 27.80 0.056 840
Mercury --- 1.800 0.004 57
Molybdenum --- 27.80 0.056 75
Nickel --- 27.80 0.056 420
Selenium --- 27.80 0.056 100
Zinc --- 4,610.00 9.220 7,500
Environmental Chemists,Inc.II 2021-22769
*Determination of Plant Available Nitrogen(PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia N)+Ammonia N+Nitrate N+Nitrite N=%PAN
Surface Application:
(Mineralization Rate)(TKN-Ammonia N)+(0.5)(Ammonia N)+Nitrate N+Nitrite N=%PAN
Note: Constituents N.D.(Not Detected)or<detection limits arc listed as detection limits
for calculation purposes.

LEWIS FARMS AND LIQUID WASTE,INC.
WQ0000455
Grand Villas WWTP
'` a€ € lea Colima
12/27/21 34,628 4.5394
12/27/21 46,921 4.6714 _
12/27/21 18,621 4.2700
12/27/21 11,076 4.0444
12/27/21 7,718 18875
12/27/21 _ 79,208 4.8988
12/27/21 30,464 4.4838
Total 30.7952
Average 4.3993
Geometric Mean O8 Fecal Coliform MPN/gram
Geometric Mean of Less than 2,000,000 meets Class B -AIternative 1 Pathogen Reduction
requirement.

.0 ; « may-r ,,_ EnvironmentalChemists, Inca
;�x.�*' Ysa
, o-r� r+'Ffi' ASK'
l 1 i~u i , ': 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab e 910.392.4424 Fax
. �x:; ; '-`MI 710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
1:' 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Lewis Farms& Liquid Wastes INC. Date of Report: Jan 17, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Wesley Wooten Report#: 2021-22769
Project ID: Annual Sludge (or. . Ll 1ld5
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56929 Site:Sludge 12/27/2021 7:50 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 3,09% 12/27/2021
Fecal Density SM 9221C E-2014 34628 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56930 Site: 1 12/27/2021 7:51 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) sM 2540 B 3.41 % 12/27/2021
Fecal Density SM9221C E-2014 46921 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56931 Site:2 12/27/2021 7:52 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) 5M 2540 B 2.90% 12/27/2021
Fecal Density SM 922tC E-2014 18621 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56932 Site: 3 12/27/2021 7:53 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) 5M 2540 B 3.16% 12/27/2021
Fecal Density SM 9221C E•2014 11076 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56933 Site:4 12/27/2021 7:54 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 3.11 % 12/27/2021
Fecal Density SM 9221C E-2014 7718 MPN/g 12/27/2021
Report#:: 2021-2276s Page 1 of 3

,, V r 14:. ',Y- Environmental Chemists, Inc.
.ire viroche .F�.r,'.' 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Labe 910.392 4424 Fax
r �"h j s ti;.x� ' 'Y'q�� 710 Bowsertown Road,Man teo,NC 27954 • 252.473.5702 Lab/Fax
r swr.cam :4 �'
5 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
environmentalchemists.com
Lewis Farms & Liquid Waste, INC. Date of Report: Jan 17, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Wesley Wooten Report#: 2021-22769
Project ID: Annual Sludge&r U 11 S
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56934 Site: 5 12/27/2021 7:55 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 a 3.03% 12/27/2021
Fecal Density SM 9221C E-2014 79208 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56935 Site: 6 12/27/2021 7:56 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 H 3.02% 12/27/2021
Fecal Density SM 9221C E-2014 30464 MPN/g 12/27/2021
Report#'. 2021-22789
Page 2 of 3

=ti ' 4 Environmental Chemists, Inc.
Y„l ?'s` `ram , ,.
'�1�riit0 r• ,�, 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
M ,.V-;turr4�N " rk,s , 710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
'�• 5r 1'1 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Lewis Farms &Liquid Waste, INC. Date of Report: Jan 24, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Wesley Wooten Report#: 2021-22769
Project ID: Annual Sludge Ge.I. 1,1 L1._5
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56936 Site: Sludge 12/27/2021 7:45 AM Solid/Sludge Client
Test Method Results Date Analyzed
Sludge Residuals
Aluminum EPA200,7,Rev,4.4,1994 226 mg/kg 01/04/2022
Arsenic EPA 200.7,Rev.4.4,1994 <27.8 mg/kg 01/04/2022
Cadmium EPA 200.7,Rev.4.4,1994 <27.8 mg/kg 01/04/2022
Calcium EPA 200.7,Rev.4.4,1994 2110 mg/kg 01/04/2022
Chromium EPA 200.7,Rev.4.4,1994 <27.8 mg/kg 01/04/2022
Copper EPA 200.7,Rev.4,4,1999 367 mg/kg 01/04/2022
Lead EPA 200.7,Rev.4.4,1994 <27.8 mg/kg 01/04/2022
Magnesium EPA 200.7,Rev.4.4,1994 2110mg/kg 01/04/2022
Molybdenum EPA 200.7,Rev,4.4,1994 <27.8 mg/kg 01/04/2022
Nickel EPA 200.7,Rev.4,4,1994 <27.8 mg/kg 01/04/2022
Potassium EPA 200.7,Rev.4.4,1994 2980 mg/kg 01/04/2022
Selenium EPA 200.7,Rev.4,4,1994 <27.8 mg/kg 01/04/2022
Sodium EPA 200.7,Rev.4.4,1994 3790 mg/kg 01/07/2022
Zinc EPA 200.7,Rev.4.4,1994 4610 mg/kg 01/04/2022
Nitrate+Nitrite-Nitrogen EPA 353.2 6.53 mg/kg 12/28/2021
Total Solids (%) SM 2540 a 3.30% 12/27/2021
Ammonia Nitrogen SM 4500 NH3 C-2011 4220 mg/kg 12/28/2021
Total Kjeldahl Nitrogen (TKN) SM 4500 Norg B-2011 56800 mg/kg 12/28/2021
Total Phosphorous SM 4500 P(F-H0-2011 22100 mg/kg 12/30/2021
pH SW 846 Method 9045D 7.19 units 01/14/2022
Result estimated. Analyzed out of 15 minutes hold time.
Mercury SW-846 7471 B 1.80 mg/kg 9 9 01105/2022
Comment: Results, except pH, reported on a dry weight basis. pH reported on an as received basis.
Reviewed by:
Report# 2021-22769
Page 3 of 3

`" rim '3 INC8602 Windmill Way Wilmington,NC 28405
f=t.� 01 ENVIRONMENTAL CHEMISTS, I OFFICE:910-392-0223 FAX [phone]
Analytical Consulting Chemists NCDENR:DWQ CERTIFICATION#94 NCDHHS:DLS CERTIFICATION#37729 info@environmentalchemists_com
COLLECTION AND CHAIN OF CUSTODY
Client: Lewis Farms&Liquid Waste PROJECT NAME: 54 REPORT NO: 2 , 2Z:7 6,7 Qj
ADDRESS: CONTACT NAME: Wesley Wooten PO NO:
REPORT TO: Martin Mahe/Mahe-Wilcox PHONE/FAX:
COPY TO: email:
Sampled By: "+`r "4"'�f SAMPLE TYPE: I=Influent, E=Effluent,W=Well,ST=Stream,SO=Soli,SL=Sludge,Other:
Collection PRESERVATION
Sample Identification ii t Es ` J n m
Sam
P E r it, C a a` m g z _ ❑ w ANALYSIS REQUESTED
y C L J 0 ° = O U m 2 Q E =
Date Time Tern p " z 2 = 2 = z is
ILA 4/Lr }ia. C P
Sludge G G _5(idX Full TCLP, utrients/Metals
1 G G 5q X Fecal Density/%TS
-
i' C P
2 G G 5C2C1130
X Fecal Density/%TS
}CL
3 G G 5 o 3[ X Fecal Density/%TS
3.<3, C P
4 G G actS2 X Fecal Density/%TS
.- _ C J P —
5 _ G G 10q 33 X Fecal Density/%TS
_ C P
6 G G 54 Ct314 X Fecal Density/%TS
4- C P
7 G G , 61P935 X Fecal Density/%TS
Transfer Relinquished By: Date/Time Received By: Date/Time
1.
2.
Temperature when Received: Accepted: Rejected: Resample Re ested:
Delivered By: Received By: l/1i{r--r Date: iii-�t, Time: j^
Comments: TURNAROUND:

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM(02T Rules)
Facility Name: Lewis Farms&Liquid Waste, Inc. WQ Permit Number: WQ0000455
WWII'Name: Grand Villas NPDES Number: VI-30-08
Monitoring Period: From I/1/2021 To 12/31/2021
Pathogen_Reduction (i5A NCAC 02T.1106)-Please indicate level achieved and alternative performed:
Class A: Alt.A(time/temp) ❑ Alt B (Alk Treatment)❑ I Alt.C(Prior Testing)❑
A1t.D(No Prior Test) ❑ Process to Further Reduce Path,ogengs ❑ _
If applicable to alternative.performed(Class A only)indicate"Process to Further Reduce Pathogens":
Compost ❑ Heat Drying ❑ Heat Treatment ❑ Thermoplulic ❑
Beta Ray ❑ Gatnuia Ray ❑ Pasteurization ❑
Class B: _Alt.(1)Fecal Density 0 Alt.(2)Process to Significantly Reduce Pathogens ❑
If applicable to alternative performed(Class B only)indicate"Process to Significantly Reduce Pathogens":
Lime Stabilization ❑ Air Drying 0 Composting 0 !Aerobic Digestion Cl
aer is An obr Digestion 0
If'applicable to alternative performed(Class A or Class B)complete the following monitoring data:
Number of Analytical
Allowable Level Pathogen Density Frequency Sample
Parameter - Tech-
in Sludge Minimum Geo.Mean Maximum Units des of Analysis Type ±�e
2 x 10 to the MPN
6th power
per gram of• _ T
Fecal Coliform total solids CF'U
I000 mpn per gram
of total solid (dry
►weight)
'-Salmonella bacteria 3 MPN per 4 grams
(in lieu of fecal total solid(dry
conform) weight)
Vector Attraction Reduction (15A NCAC 02T.1107)-Please indicate alternative performed:
AIt.1 (VS reduction) ❑ Alt.2(40-day bench) ❑ Alt.3(30-day bench) ❑ Alt.4(Spec.02 uptake) ❑
Alt.5 (14-Day Aerobic) ❑ Alt.6(Alk.Stabilization ❑ .Alt 7(Drying-Stable) 0 Alt.8(Drying-Unstable) ❑
Alt.4(Injection) 0 Alt. 10(Incorporation) 0_ No vector attraction reduction alternatives were performed ❑
CERTIFICATION STATEMENT(please check the appropriate statement)
CI "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 check 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."
Raymond Braxton, ORC Wesley Wooten,President
Preparer Name and Title(type or print) Land Applier Name and Title(if a plicable)(type or print)
4-�'7 1-2W 2L- 1/24/22
Signature of Preparer* Date Signature of Land Ap er(if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r)and 15A NCAC 2T.1102(26)
DENR FORM PVRF 02T(1212006)

CITY OF HAVELOCK
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater Treatment Plant
Date Sampled: July 15,2021
Havelock Permit No.NC0021253
Mineralization Rate 0.30 3.58 %Solids
6.6 pH
Parameter 1 % I Mg/Kg Dry Weight Pounds/Dry Ton
(%x 10,000) + (Mg/Kg x 0.002) f
Nitrogen(TKN) 4.783 47,830.000 _ 95.660
Phosphorus 1.252 12,520.000 _ 25.040
Potassium 0.475 4,748.000
9.496
PAN(injected)* 1.645 16,448.780 32.898
PAN(surface)* _ 1.495 14,951.780 29.904
Ammonia Nitrogen 0.299 2,994.000 5.988
Calcium 3.902 39,015.000 78.030
Calcium Carbonate Eq. ___ ___
---
Magnesium _ --- 2,791.000
5.582
Sodium --- 3,159.000 6.318
Sulfur --- ___
Nitrate N I Nitrite N _ --- 3.980 0.008
Barium ___
__ -- SAR
Chloride ---
Iron --- --- --- Ceiling Concen.
Aluminum 24,593.00 49.186 (Mg/Kg)
Arsenic --- 2.70 0.005 _ 75
Cadmium --- 1.80_ 0.004 85
Chromium --- 16.00 0.032_ _-
Copper --- _ 721.00 1.442 4,300
Lead --- 15.00 0.030_ 840
Mercury --- 0.48 0.001 57
Molybdenum 6.00 0.012 75
Nickel --- 12.00 0.024 420
Selenium --- 5.00 0.010 100
Zinc --- 2,201.00 4.402 7,500 _
Jl
Environment 1,Inc.# 414
*Determination of Plant Available Nitrogen(PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia N)+Ammonia N+Nitrate N+Nitrite N=%PAN
Surface Application:
(Mineralization Rate)(TKN-Ammonia N)+(0.5)(Ammonia N)+Nitrate N+Nitrite N=%PAN
Note: Constituents N.D.(Not Detected)or<detection limits arc listed as detection limits
for calculation purposes.

¶u [IM@©r"p®gng
Drinking Hater ID' 37715
Wastewater ID, 10
114 OAKMON`f DRIVE PRONE(252) 756-6208
GREENVILLE, N.C. 27858 FAX[phone]
ID#: 414
CITY OP HAVELOCK(SLUDGE)
SUE SAYGER
WASTEWATER TREATMENT PLANT DATE COLLECTED: 07/15/21
304 N. JACKSON DRIVE DATE REPORTED : 08/05/21
HAVELOCK, NC 28532
REVIEWED BY: V
Sludge Analysis Method
PARAMETERS Sample Date Analyst Code
PH, Units 6.6 07/19/21 Ji44S 450011E-I1
Aluminum, (dry tint. basis), mg/kg 24593 08/04/21 MTM EPA200.7
Arsenic (dry wt. basis), mg/kg 2.7 08/04/21 MTM 3113E-04
Calcium (dry wt. basis), mg/kg 39015 08/04/21 MTM EPA200.7 •
•
Cadmium (dry wt. basis), mg/kg 1.8 08/03/21 MTM 3113B-04
Copper (dry wt. basis), mg/kg 721 08/04/21 MTM EPA200.7
Chromium, T.(dry wt. basis),mg/kg 16 08/04/21 MTM EPA200.7
Lead (dry weight basis), mg/kg 15 08/03/21 MTM 3113E-04
Magnesium (dry %nt. basis), mg/kg 2791 08/04/21 MTM EPA200.7
Mercury (dry wt. basis), mg/kg 0.48 08/02/21 MTM EPA7471B
Nickel (dry wt. basis), mg/kg 12 08/04/21 MTI11 EPA200.7
Potassium (dry wt. basis), mg/kg 4748 08/04/2I MTi41 EPA200.7
Selenium (dry wt. basis), mg/kg <5.0 08/04/21 MTM 31.13B-04
Sodium (dry wt. basis), mg/kg 3159 08/04/21 MTM EPA200.7
Zinc (dry wt. basis), mg/kg 2201 08/04/21 MTM EI'A200.7
Sodium Adsorption Ratio (calc) 4.2
Total Solids, % 3.58 07/15/21 1CDS 2540C-11
TKN (dry wt.), mg/kg c 47830 07/20/21 1-1141M 351.2 R2-93
Ammonia Nitrogen (dry wt.),mg/kg c 2994 07/22/21 KES 350.I R2-93
Phosphorus, T. (dry ►vt.), mg/kg c 12520 07/20/21 ICES 365.4-74
Nitrate-Nitrite (dry wt.), mg/kg c 3.98 07/21/21 DTL 353.2 R2-93
Plant Available Nitrogen, mg/kg 14952 07/30/21 MAO
Molybdenum (dry wt. basis), mg/kg 6.0 08/04/21 MTM EPA200.7
•
e Uncertified data. AWn doca not offer non-aqueous certification for this analytical procedure.

Environment 1,lint. CHAIN OF CUSTODY RECORD
P.O.Box 7085. 114 Oakmont Dr. I I
Greenvil?1.NC 27858 Pale of
environnientl inc.com DISINFECTION '
•
Phone[phone] •Fax[phone] CHLORINE NEUTRALIZEDA€COLLECTION
CHLORINE
CLIENT: 4I4 Week:33
lIV _ pH CHECK pp
CITY OF HAVELOCK(SL,UDGE) [J NONE P P PPPPP CONTAINER TYPE,PIG
SUE SAYGER
WASTEWATER TREATMENT PLANT —
304 N.JACKSON DRIVE lj A A A A AA A A CHEMICALPRESI=FIVA€ION
HAVELOCK NC 28532 `z - `
r A-NONE D•NAOH
[phone] z o _� w
cc cc
o cc o z ' E 8 HNO3 E HCL
0¢ u J z s - M C HZSO F-ZINC ACEfATFJNAOH
COLLECTION - uw� o o L+ o z - rLij
�- E" = z cc G-NA THIOSULFATE
SAMPLE LOCATION DATE TIME :o o a o - z m o E-� - a
�: cm E�, _
Sludge Sample 7 f 21 10.750 \ 1.11 5 • -... `' .' Y' v;~ i
' CLASSIFICATION:
- — _ - LI WASTEWATER(NPDES)
rj DRINKING WATER
r . .. ..
LI DWR1GW
f
Ul SOLID WASTE SECTION
CHAIN OF CUSTODY(SEAL)MAINTAINED
DURING SHIPMENT/DELIVERY
_ 8 N
SAMPLES COLLECTED BY:
(Please Print)
:IL-Cce a7 Qennr
_ I_ SAMPLES RECEIVED IN LAB AT 2-....5 IC
R I I ISH BY(SIG.)(SAMPLER) DATEII1ME RECEIVED BY(SIG,),_ DATE/TIME COMMENTS: ! -
R aSHE BY(SIG.) DATE/TIME RECEIVED BY(SIG.) DATE1fIME •
RELINQUISHED BY(SIG.) DATE111ME RECEIVED BY(SIG.) DATER-NE
1 i
PLEASE READ instructions for completing this form on the reverse side. Sampler must place a"C"for composite sample or a"G"For �r
1�� 39SOQ6
FORM#5 Grab sample in the blocks above for each parameter requested.

CITY OF HAVELOCK
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater Treatment Plant
Date Sampled: October 12,2021
Havelock Permit No.NC0021253
Mineralization Rate 0.30 3.76 %Solids
6.6 pH
Parameter % Mg/Kg Dry Weight Pounds/Dry Ton
(%x 10,000) (Mg/Kg x 0.002)
Nitrogen(TKN) 2.564 25,640.000 51.280
Phosphorus 4.260 42,600.000 85.200J
Potassium 0.412 4,124.000 8.248
PAN(injected)* 0.927 9,272.780 18.546
PAN(surface)* 0.815 8,145.780 16.292
Ammonia Nitrogen 0.225 2,254.000 4.508
Calcium 3.969 39,691.000 79.382
Calcium Carbonate Eq. ___ ___ ___
Magnesium -- 2,764.000 5.528
Sodium --- 3,226.000 6.452
Sulfur ___ _-- -_-
Nitrate N/Nitrite N --- _ 2.980 0.006
Barium -__ -
Chloride ___ � --- --- SAR
--- --- 0.82
Iron -- --- --- Ceiling Concen.-
Aluminum --- 26,649.00 53.298 (Mg/Kg)
Arsenic --- 2,500 0.005 1 75
Cadmium --- 1.500 0.003 85
Chromium --- 21.000 0.042__
Copper --- 670.00 1.340 4,300
Lead --- 26.000 0.052 840
Mercury --- 0.330 0.001 57
Molybdenum --- 6.000 0.012 75
Nickel --- 10.00 0.020 420
Selenium --- _ 5.000 _ 0.010 100
Zinc --- 1,971.00 3.942 7,500
Environment I,Inc.#414
*Determination of Plant Available Nitrogen(PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia N)+Ammonia N+Nitrate N+Nitrite N=%PAN
Surface Application:
(Mineralization Rate)(TKN-Ammonia N)+(0.5)(Ammonia N)+Nitrate N+Nitrite N=%PAN
Note: Constituents N.D.(Not Detected)or<detection limits arc listed as detection limits
for calculation purposes.

EEmi[r©ffic ai Off.g - rpo N i nrinking Water IQ1 37715
Wastewater 1De 10
'I 14. OAKMONT DRIVE PHONE [phone]
GREENVILLE, KC. 2785E FAX [phone]
ID#: 414
CITY OP HAVELOCK(SLUDGE)
SUE SAYGER
WASTEWATER TREATMENT PLANT DATE COLLECTED: 10/12/21
304 N. JACKSON DRIVE DATE REPORTED : 11/11/21
HAVELOCK, NC 28532
REVIEWED BY:
Sludge Analysis Method
PARAMETERS Sample Date Analyst Code
PH, Units 6.6 10/13/21 DNS 45001=IB-11 •
Aluminum, (dry wt. basis), mg/kg 26649 10/21/21 LFJ EPA200.7
Arsenic (dry wt. basis), mg/kg <2.5 10/27/21 MTM 3113E-04
Calcium (dry wt. basis), mg/kg 39691 10/21/21 LFJ EPA200.7
Cadmium (dry wt. basis), mg/kg 1.5 11/03/21 MTM 3113B-04
Copper (dry wt. basis), mg/kg 670 10/21/21 LFJ EPA200.7
Chromium, T.(dry wt. basis),mg/kg 21 10/2I/21 LFJ EPA200.7
Lead (dry weight basis), mg/kg 26 11/09/21 MTM 3113B-04
Magnesium (dry wt. basis), mg/kg 2764 10/21/21 LFJ EPA200.7
Mercury (dry wt. basis), mg/kg 0.33 10/27/21 MTM EPA7471B
Nickel (dry wt, basis), mg/kg 10 10/21/21 LFJ EPA200.7
Potassium (dry wt. basis), mg/kg 4124 10/21/21 LFJ EPA200.7
Selenium (dry wt. basis), mg/kg <5.0 11/10/21 MTM 3113E-04
Sodium (dry wt. basis), mg/kg 3226 10/21/21 LFJ EPA200.7
Zinc (dry wt. basis), mg/kg 1971 10/21/21 LFJ EPA200.7
Sodium Adsorption Ratio (talc) 4.2
Total Solids, % 3.76 10/14/21 JMS 2540G-15
TICN (dry wt.), mg/kg c 25640 10/19/21 BMD 351.2 R2-93
Ammonia Nitrogen (dry wt.),mg/Icg c 2254 10/18/21 ICES 350.1 R2-93
Phosphorus, T. (dry wt.), mg/kg c 42600 10/19/21 TRJ 365.4-74
Nitrate+Nitrite (dry wt.), mg/kg c 2.98 10/19/21 ICES 353.2 R2-93
Plant Available Nitrogen, mg/kg 9273 10/25/21 MAO
Molybdenum (dry wt. basis), mg/kg 6 10/21/21 LFJ EPA200.7
c Uncertified data. DWR does not offer non-aqueous certification for this analytical procedure,

Environment 1,Inc. CHAIN OF CUSTODY RECORD
P.O.Box 7085. 114 Oakmont Dr. Page 1 of 1
Greenville,NC 27358
environment I inc-com DISINFECTION
Phone[phone] a Fax[phone] � CHLORINE NEUTRALIZED AT COLLECTION
Ei CI-ILORINE
CLIENT: �
414 Week:46 �� pH CHECK(LAB)
LL�.i uv
CITY OF HAVELOCK(SLUDGE) NONE1. P I P P P P P P CONTAINER TYPE,PIG
SUE SAYGER
WASTEWATER TREATMENT PLANT CHEMICAL PRESERVATION
304 N.JACKSON DRIVE Li A A A A A A A A
HAVELOCK NC 28532 _ A NONE D-NAOH
•
(232) 67I-6373 ¢ al w co E C B-HNC), E-HCL
o 0 n o ¢ 'o z
i t— u R Z w C-H,SO; F-ZINC ACETATE/NAOH I
COLLECTION a L a 7.
g _ % c8 Q Q Z .5 O L z G NATHIOSULFATE
SAMPLE LOCATION DATE TIME Io a F- ¢ o g r,, r, a c, z c. _
a_
gi
Sludge Sample l0tla(2-( t �:CO V 5 ' � i _ W CLASSIFICATION:
-
,, i WASTEWATER(NPDES)
DRINKING WATER
0 DWRIGW
SOLID WASTE SECTION
CHAIN OF CUSTODY(SEAL)MAINTAINED
- DURING SHIPMENT/DELIVERY
N
1 SAMPLES COLLECTED BY:
- I (Please Print)
i Sr' f)lo, V,,,o
fSAMPLES RECEIVED IN LAB AT U 4,e
RELINQUISHED BY(SIG-)(SAMPLER) DATE/TIME RI.CEIU Y(SIG.) D ATEIIME - COMMENTS:
RELINQUISHED BY(SIG.) 4?JME R;CEIUE BY(SIG.) ATE!nME
RELINQUISHED BY(SIG.) DATEME RECEIVED BY(SIG.) DATE/TIME
I
PLEASE READ Instructions for completing this form On the reverse side- Sampler must place a"C"for composite sample or a"G'for N0 392203 -
FORM as Grab sample in the blocks above for each parameter requested.

1.
.K a 4 .do- rt`' .vy s,.� .51-7 M * �..-�- r^
Orlando, Fl.. §" L£ -0 4
1,F .� } r. f .. ii. _
The results set forth herein are provided by SGS North America Inc. e-Hardcopy Z Q
Autohrater!Report
.`::
gar �(tom �
�r<��.�r�y_oa, aL
e-M
iW
k ;� `. : e,,,l Environment 1, Inc
City of Havelock WVVTP; 304 N Jackson Dr, Havelock, NC
- - `-'� - 414
. - �. SGS Job Number: FA82594
am,e, ,* Sampling Date: 01/19/21
b�
r •
•,'*•• •,t_il, .te
^��-ir
Report to:
Environment 1, Inc
PO Box 7085
Greenville, NC 27835
abrown@environmentl inc.com
ATTN: Ann Brown
Total number of pages in report: r7
4- ,�, °ems
,
Test results contained within this data package meet the requirements Norm Farmer
of the National Environmental Laboratory Accreditation Program Technical Director
and/or state specific certification programs as applicable.
Client Service contact: Jean Dent-Smith 407-425-6700
Certifications:FL(E83510),LA(03051),KS(E-10327),IL(200003),NC(573),N7(FL002),NY(12022),SC(99038001)
DoD ELAP(ANAB L.2229),AZ(AZ0606),CA(2937),TX(1104704404),PA(68.03573),VA(460177),
AK,AR,IA,KY,MA,MS,ND,NIA,NV,OK,OR,UT,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-i 5 • Orlando,FL 32811 • tel:[phone] • fax:[phone]
SOS is the sole authority for authorizing edits or mu tifications to this document. ' Please share your ideas about end

Sections:
Table of Contents
Section 1: Sample Summary.. 3
Section 2: Summary of Hits 4
Section 3: Sample Results 5
3.1: FA82594-1: SLUDGE SAMPLE 6
3.2: FA82594-1L: SLUDGE SAMPLE 7
Section 4: Misc. Forms 12
4.1: Chain of Custody 13
4.2: Chain of Custody(SGS Dayton,NJ) 15
chranI 2

SGS North America Inc.
Sample Summary
•
Environment 1, Inc
Job No: FA82594
City of Havelock WWTP; 304 N Jackson Dr, Havelock, NC
Project No: 414
Sample Collectea Matrix Client
Number Date Time By Received Code Type Sample ID
riiiMIW-fagatigGPEMErie
Organics ND = Not detected above the MDL
01/19/21 11:00 DA 01/23/21 SO Sludge SLUDGE SAM
vA504,11.; 01/19/21 11:00 DA 01/23/21 SO Sludge
Soil samples reported on a dry weight basis unless otherwise indicated on result page.
• c="111 •

Summary of Hits Page 1 of I
Job Number: FA82504
Account: Environment 1, Inc
Project: City of Havelock WWTP;304 N Jackson Dr, Havelock, NC
Collected: 01/19/21
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
TA82594-I SLUDGE SAMPLE
Corrosivity as pH T3 :_':: ; ':; su SW846 CHAP7
Ignitability(Flashpolnt)a >;W0:::'::`:`; .; Deg.17 SW840 1010A MOD
FA82594-1L SLUDGE SAMPLE
No hits reported in this sample.
(a) Not Ignitable.

ate?£r'•5+."' "VI. -- ;kr—
• Lt 3 l �n 4 1 "w'''@"
•
Ortancio `FL r _ • �` n
...`_, � � nix
Section 3
•
•
Report of Analysis
•
• raaroat 5

SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA82594-1 Date Sampled: 01/19/21
Matrix: SO-Sludge Date Received: 01/23/21
Percent Solids: 3.4
Project: City of Havelock WWTP; 304 N Jackson Dr, Havelock,NC
General Chemistry
Analyte Result RL Units DI? Analyzed By Method
Corrosivity as pH 7;7.-3:` ' '. ? su 1 01/26/21 13:30 1$ SW846 CHAP?
Cyanide Reactivity a :;<'2 O i= ::r;. 290 mg/kg 1 02/11/21 12:14 ANI SW846 CHAP1/9012 B
Ignilability(Flashpoint)b °5` 00=;'','i':;:' ', Deg. F 1 01/28/2108:35 CS SW846 3014A MOD
Solids,Percent :3;!1. �;; .,:: :`': % 1 02/02/21 11.58 KSA SM19 2540G
Sulfide Reactivity <:1400 ? -:; 1400 mg/kg 1 01/28/21 13:30 Ic SW840 CHAP?
(a)Analyzed outside the 14 day holding lime applied by laboratory SOP. No regulatory holding lime published for
this method. Analysis performed at SGS Dayton,NI.
(b)Not ignitable.
•
RL= Reporting Limit
euribral • 6

SGS North America Inc.
Report of Analysis Page I of 1
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA82594-1L Date Sampled: 01/19/21
Matrix: SO-Sludge Date Received: 01/23/21 '
Method: SW846 8260B SW846 1311 Percent Solids: 3.4
Project: City of Havelock WWTP;304 N Jackson Dr, Havelock, NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run#I P77711.D 10 02/05/21 13:01 SO 01/28/21 14:20 OP83884 VP3132
Run#2
Purge Volume
Run#1 5.0 ml
Run#2
VOA TCLP List TCLP Leachate method SW84613I1
CAS No. Compound Result HW# MCL RL MDL Units Q
71-43-2 Benzene ND`.; =:: .`:` ; D018 0.50 0.010 0.0031 mg/1
78-93-3 2-Butanone(MEIC) 'ND.;' ; .';;':::. D035 200 0.050 0.020 mg/I
56-23-5 Carbon Tetrachloride �rl�l,��"�' �:::' �D018 0.50 0.010 0.0036 mg/1
108-90-7 Chlorobenzene ND_' °k D021 100 0.010 0.0020 mg/1
67-66-3 Chloroform ND.;; °;< ';;:`D022 6.0 0.010 0.0030 mg/1
106-46-7 1,4-Dichlorobenzene <-�D027 7.5 0.010 0.0026 mg/I
107-06-2 1,2-Dichloroethane :N3 - D028 0.50 0.010 0.0031 mg/I
75-35-4 1,1-Dichloroethylene ND :;;`';: = D029 0.70 0.010 0.0032 mg/1
127-18-4 Tetrachloroethylene ND• . - 'D039 0.70 0.010 0.0022 mg/1
79-01-6 Trichloroethylene :ND ::;` ;`:; `.D040 0.50 0.010 0.0035 mg/1
75-01-4 Vinyl Chloride {D ,_ D043 0.20 0.010 0.0041 mg/1
CAS No. Surrogate Recoveries Run#1 Run#2 Limits
1868-53-7 Dihromofluoromethane 101%': .=;;' 83-118%
17000-07-0 1,2-Dicldoroethane-D4 11,$%? : .':; 79-125%
2037-26-5 Toluene-D8 =104gb 85-112%
460-00-4 4-Bromofluorobenzene 101% '= 83-118%
ND = Not detected MDL= Method Detection Limit 3= 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
• etnei! 7

SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA82594-1L Date Sampled: 01/19/21
Matrix: SO-Sludge Date Received: 01/23/21
Method: SW846 8270D SW846 3510C Percent Solids: 3.4
Project: City of Havelock WIT;304 N Jackson Dr,Havelock,NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run#1 X074305.D 1 02/02/21 18:03 WH 01/30/21 09:45 OP83924 SX3029
Run#2
Initial Volume Final Volume
Run#1 100 nil 1.0 ml
Run#2
ABN TCLP List TCLP Leecbnte method SW846 1311
CAS No. Compound Result HW# MCL RL MDL Units Q
95-48-7 2-Methylphenol ND ;`• :!.-.c;!;:<D023 200 0.050 0.0050 mg/1
3&4-Methylphenol ND.=:':'_, ;`: D024 200 0.050 0.0098 mg/1
87-86-5 Pentachlorophenol _ND '",is •: D037 100 0.25 0.050 mg/I
95-95-4 2,4,5-Tiricliloraphenol ND :::::4:D041 400 0.050 0.0074 mg/1
88-06-2 2,4,6-Trichlorophenol Nkrgi,g t :'''D042 2.0 0.050 0.0075 mg/1
106-46-7 1,4-Dicblorobenzene :ND. ::>` ;` ' D027 7.5 0.050 0.0050 mg/1
121-14-2 2,4-Dinitrotolnene ND: '::L' D030 0.13 0.050 0.0081 mg/1
118-74-1 Hexachlorohenzenc Np.:: .:`;_ : D032 0.13 0.050 0.0069 mg/1
87-68-3 Hexachlorobutadiene ID,`' ':' :,,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/1
110-86-1 Pyridine :. ' :
yri 1VD�:�:';`'�:�;�;:::;D038 5.0 0.10 0.020 mg/1
CAS No. Surrogate Recoveries Run#I Run#2 Limits
367-12-9 2-Fluorophenol 20%, ??':;;'i 14-67%
4165-62-2 Phenol-d5 13,%`•;';. __`- 10-50%
118-79-6 2,4,6-Tribromophenol =70° `>;;` ;= > 33-118%
4165-60-0 Nitrobenzene-d5 : $%:':`: '.;<< 42-108%
321-60-8 2-Fluorohiphenyl 08%`.: ..`'.`' 40-106%
1718-51-0 Terphenyl-d14 :76% '; ;:;g 39-121%
..
ND= Not detected MDL= Method Detection Limit 3= 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

SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA82594-1L Date Sampled: 01/19/21
Matrix: SO-Sludge Date Received: 01/23/21
Method: SW846 8151A SW846 3510C Percent Solids: 3.4 •
Project: City of Havelock WWTP; 304 N Jackson Dr,Havelock, NC
File ID DF Analyzed By Prep Date Prep Batch Analytical Batch
Run#1 CC072902.D I 02/02/21 15:28 JA 02/01/21 10:00 OP83926 GCC1794
Run#2
Initial Volume Final Volume
Run#1 10.0 ml 5.0 ml
Run#2
Herbicide TCLP List TCLP Leachate method SW846 1311
CAS No. Compound Result HW# MCL RL MDL Units Q
94-75-7 2,4-D :ND :'::= i;'D016 10 0.050 0.017 mg/I
93-72-1 2,4,5-TP (Silvex) LVD:' ;°; ' D017 1.0 0.0050 0.0013 mg/I
• CAS No. Surrogate Recoveries Rung 1 Run#2 Limits
19719-28-9 2,4-DCAA :301%0 ;; >: 39-135%
ND= Not detected MDL= Method Detection Limit J= Indicates an estimated value
MCL= Maximum Contamination Level(40 CFR 261 7/1/11) B= Indicates analyse found in associated method blank
E= Indicates value exceeds calibration range N= Indicates presumptive evidence of a compound
ras�.r.� 9

SGS North America Inc.
Report of Analysis Page 1 of 1
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID; FA82594-1L Date Sampled: 01/19/21
Matrix: SO-Sludge Date Received: 01/23/21
Method; SW846 8081B SW846 3510C Percent Solids: 3.4
Project: City of Havelock WWTP;304 N Jackson Dr, Havelock, NC
File ID DF Analyzed •By Prep Date Prep Batch Analytical Batch
Run#1 5T151250.3 1 02/01/21 19:28 WH 01/30/21 09:45 0P83925 GST3646
Run#2
Initial Volume Final Volume
Run#1 100 ml 5.0 ml
Run#2
Pesticide TCLP List TCLP Leachate method SW846 I3I1
CAS No. Compound 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
" 'D020 0.030 0.0010 0.00038 mg/I
NI).�:�,�::�'t;iii
72-20-8 Endrin a 1VA,.: ;; D012 0.020 0.00020 0.000021 mg/I
76-44-8 Heptachlor `ND>;;:=:t:; "D031 0.0080 0.00010 0.000026 mg/1
1024-57-3 Heptachlor epoxide ND ;::'.?'; : i D031 0.0080 0.00010 0.000020 mg/I
72-43-5 Methoxychlor b .:1:;D014 10 0.00020 0.000050 mg/1
8001-35-2 Toxaphene 141 ::; _: JD015 0.50 0.0050 0.0021 mg/1
CAS No. Surrogate Recoveries Run#1 Run#2 Limits
877-09-8 Tetrachloro-m-xyiene $3°fo?..`. ;'`: 42-127%
2051-24-3 Decachloroblphenyi '76%.-;'``''a 27-127%
(a)Associated CCV outside of control limits high, sample was ND.
(b)Associated ES outside of control limits high, sample was ND. 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
i .11%6 10.

SGS North Ametica Inc.
Report of Analysis Page 1 of 1
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA82594-1L Date Sampled: 01/I9/21
Matrix: SO-Sludge Date Received: 01/23/21
Percent Solids: 3.4
Project: City of Havelock WWTP;304 N Jackson Dr, Havelock,NC
Metals Analysis, TCLP Leachate SW846 1311
AnaIyte Result HW# MCL RL Units OF Prep Analyzed By Method Prep Method
Arsenic 4 0, 0. .; D004 5.0 0.10 mg/1 1 01/29/21 01/29/21 LM SW846 6010D 1 SW846 3610A 3
Barium :< 2::0.:'_ : D005 100 2.0 mg/I 1 01/29/21 01/29/21 LM SW846 6010D 1 SW81638t0A 3
Cadmium <0;050`;:; DOOII 1.0 0.050 mg/1 1 01/29/21 01/29/21 LM SW840 6010D 1 SW846 S010A 3
Chromium '010 : '+;D007 5.0 0.10 mg/1 1 01/29/21 01/29/21 LM Sw840 6010D 1 SW846 3010A 3
Lead <`0 0511. ;D008 5.0 0.050 mg/I 1 01/29/21 01/29/21 LM SW846 6010D 1 SW846 3010A 3
Mercury k:'D 005Q;--;' D009 0.20 0.0050 mg/I 1 02/01/21 02/01/21 .1C SW846 7470A 2 SW846 7470A 4
Selenium .0 10 D010 1.0 0.10 mg/1 1 01/29/21 01/29/2] LM SW84G 6010D 1 5W846 3010A 3
Silver :` 0.10 _ D011 5.0 0.10 mg/i 1 01/29/21 01/29/21 LM SW846 6010D 1 SW846 MIA 3
(1)Instrument QC Batch:MA17423
(2)Instrument QC Batch:MA17425
(3)Prep QC Batch:MP38492
(4)Prep QC Batch; MP38502
RL= Reporting Limit
MCL; Maximum Contamination Level(40 CFR 261 7/I/11)
• r %ra1 • 11

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''l'',l4,47.,,r,,E,-g,,,:6,,,'..:.-''*':.•4 I.4,4-C,-.=.,...,„7 4.,:1,_..1.
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Section 4
,:,,,, :':':`�''oim':.. _ ..,E:':...:.:..:::_:,
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
• • Chain of Custody(SGS Dayton, NJ)
rani ' 12

fc.avironracur 1,Inc. CHAIN OF CUSTODY RECORD FAIS. 59 4
P.O.Dox 7085,114 Oakmont Dr,
Greenville.NC 2785a Page of t
cnvimnmcnlline.cam DISINFECTION I - I
Phanc(252)756-620H•Fax(252)756•1633 0 CtILORV.E NEUTRALIZED ATDC[LECf1OH
CHLORINE 1 -• -
CLIENT: 414 Week:8 .
a 4V pHCHECKpJ4B)
CITY O1'11AVELOCK(S7,CJDCE) CI NONE ; P P P G G G G CCNTA{NERTYPE P!O
MR.RODNEYGE+ORGLr `
WAS YATEIE TREATMENTENT PLANT
304 N.JACKSON DRIVE I I ^`� ` I A A A A A A A CHEMICAL PRESERVATION
HAVELOCK NC29532 _ --
.
D ' A-NONE D-NAOH
(252)671 K373 d w 5 9 a B.EWOs E•MCI
y a C•H,50 R-ZNCACETATEAIAOH .
fAllECTK)N _ ,.a „ n E a y� pa
r- S H 1 o u U' U G-NATTa05(LFATE
SAMPLE:LOCADON (LATE f TIIMEEn R o 2 r4 ��O F'ro �k-, t- F-, 2
1 Sludge Sample I-11 a( II,tOO>C J Ji 9 _ ) r t . . : @W .lam eat i
CLASSIFICATION:
1 _ El WASTEWATER{NPDe'S)
- ❑ DniaKINGWATER
ElDWRH W
in SC.KIWASTESECTIGN
• CHAIN OF CLISTOAY(SEAL)MAINTAINEO
- - DURINGIIPMENTNELIVERY
CO N
SAM P LES CO LL ECTELI aY:
- - _ {Please Pail DekAA Nei.m.r
SAMPLESRECENEDIN(ABM Fo .3_ 'C
HEli I5HED IG.}(SA,�FlER) DATFJfIIl,E BYI6IG.) gATF1Ri�1E COMME:NCS a `rg
-Iq1 �:5 �CENED Cam I/ar 3`33 + 2]
REUNQLH5HEDSY(SlG,] DAT'EWIE RECEIVEDDY{SICi) - OA1EfTIME O `j7 ((} ��1L D:� 1-1 .y� •-
II P.i
ED {SIG) A1ElfIkE �c15�53G DAT r fliL4EE ....
' �`r �/ :1I f� A t123/7-4I R45 ---lla w.inMir ill iZ '
I PLEASE READ Inslruclians for completing this form an tea reverse side. Sampler must place a'C'fared) osil@ sample ore"G'To;
FORM AS Grab sump(e In the blocks above for oath parameter iequesled. Nu 38887 f
FA82594: Chain of Custody
Page 1 of 2
t
•
n6 13

SGS Sample Receipt Summary
Job Number: FA82594 Mont: ENVIRONMENT 1 _ Project; 414
Date J Time Received: 1/23/2021 9:45:00 AM Delivery Method: FEDEX Alrblll#'a: 954628454130
Therm ID: IR 1; Therm CF: 0.2;
#of Coolers: 1
Cooler Temps(Raw Measured)°C: Cooler 1:(1.6);
Cooler Temps(Corrected)°C: Cooler 1;(1.8);
Cooler information Y or N Sample inforrnallo
n • Y or N NIA -
1.CustodySears Present g 0 1.Sample labels presenton bottles g 0
2.Custody Seals Intact ❑' 0 2.Samples preserved properly ® 0
3.Temp criteria achieved 2 ❑ 3.Sufficient vofumeloonlatners recvd for analysis: lJ ❑
4.Cooler temp verification IR Gun 4.Condition of sampleWag(
5.Cooler media Jce fBag). 5.Sample recvd within HT CJ ❑
6.Oaths/Times/Ds on COC match Sample Label ' 2 ❑
Trip Blank informatfoit Y or N NIA. 7.VOCs have headspace 0 0 I
1.Trip Blank present 1 cooler 0 ❑ 2 6.Bottles received for unspecified tests ❑ 2
2.Trip Blank listed on COC ❑ ❑ n]i 9.Camposiling instructions dear ❑ 0 Q
W or S N1A• le.Voa Soil Kits/Jars received past 49hrs7 ❑ 0 2
3.Type Of TB Received 0 0 11.%9 Solids Jar received? 00 0
Pi 12.Residual Chlorine Present? ❑ ❑ 2
Misc.lnformaltorf
Number of Encores: 25-Gram 5-Gram Number or6035 Field Klls: Number of Lab Filtered Metals:
Test Strip Lot#s: pH 0-3 230315 pH 10-12 219813A _ Other: (Specify) _ _
Residual Chlorine Test Strip Lot#:
Comments
RhS001 Technician: BRYANG Dale: 1/23/2021 9A5:00 AM Reviewer. Dale; •
Rev.Oats eSr2W17 _ '
FA82594: Chain of Custody
Page 2 of 2
p 14 •

S//''''�� CHAIN OF CUSTODY Page I of 2
�,,,•5 SOS North Rnmd.9licu(na-Orlando e1P..ino..9• or.ewr
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0 Iw,.a.ewo.i(ua»..l D V.m4.4.04.09.L.o.l4 Q P.O.14........11 Thank y.u.
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FA82594: Chain of Custody
Page 1 of 3
SGS Dayton,NJ
end` 1s .

i i.* • J. ' ., Y y r. . ,—`.' -,,A7 ..kit 1.3:V• "4' - .c • i
, lSi,T R.
Reactive Cyanide and Reactive Sulfide Preparation Log •
Method:SW846 Chapter 7,revision 3,1996 •
CN Batch#:GP D 2( Balance 1D AI])Q(1tf
Date; 01+271ZI
(mmdd-yy) S Batch#:GP 3592.1 Flowmeter ID Jr.:,411ou Leto
Seraph!'10.8ot11o# Inlllal Sample N2 Start N2 End N2 Final Olatll.
Vol(ml)/Wt(g) Time Time Gommenls
now Vol{ml}
(24:00) (24:00) (mltmin)
GP -MB1(Ma 3-),a 14.32 I$:07- ( I- Gob
GP 61SBSP CN) ry n 1 (p+ — STANDARDS Lot IF
GP 81(BSP 5) Om 1 ZIZl21 Sulfide AI�r UL]
GP D1(DUPy 10.1�� �� Cyanide G'•1.Jitoi`{
1D4.1
ocFAtz.0-3.1 _ iaa; 1 S.o
2 1, -4 . l I0.z3 lb•f 3 ltc:`•1:3 1,x. 7 —
DZ� i
REAGENTS
a\ii1'�� -a ir�.z3qq (OS.to MFF1�8Zc 3-I.2_ 31IOl.I2.5NNaOHGnl3AZS
� 1 �q.2 ,/ F1j259 1.1. i 0.25NNaOH 6n730ylY
6 _ 0.1N Sulfuric acid Wt1�N7
7 0.01N Sulfuric acid 6,u3io3)`
6 4 fr 131
9
10 —
11
12 ',IC •
13 p/
14 1�1
15
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1 J 6
17
18 :'......"'''''''\
19
�' -
20
Analyst Stgnaruro: r —s•--- Date: 0%1 L7121 .
a or 50
FA82594: Chain of Custody
Page 2 of 3
ram 16

SGS Sample Receipt Summary
Job Number: FA82594 Client: Project:
Date f Time Recelved: 2/10/2021 10:30:00 AM Delivery Method: _ Alrblfl#s:
Cooler Temps(Raw Measured)°C: Cooler 1:(2.3);
Cooler Tampa(Corrected)°C: Cooler 1:(1.0);
Cooler$Recurity Y or N Y or N Samrllelntegrity-Documenlatlon Y or N
1_Custody Seats Present: 2 ❑ 3.COC Present: y] Q
2 Custody Seals bead: ® ❑ 4.Smpl DateslTrme OK CO Q 1.Sample labels present on bottles: GO ❑
2.Container labeling complete: ❑
Cooler Temperature Y or N 3.Sample conLairier label!CCC agree: El 0
1.Temp cdterle achieved; ® ❑ Sample integrity-Condition Y or N
2.Cooler temp verification: IR Gun _
3.Cooler meda: Ice(Bag) 1.Sample recvd within HT:
4.No.Coolers 1 2.All conlalnere accounted far: Q
3.Condition of sample: Intact
Quality Control Preservation Y or N NIA
1.Tdp Blank present/cooler.. ❑ 0 rg
Sample Integrity-Instructions Y or N NIA
2 Tdp Blank listed on COC: 0 ❑ 1.Analysts requested fs clear, © 0
2.Bellies received for unspecified tests 0
3.Samples preserved properly: [v] Q 3.Sufficient volume recvd for analysis:
4.VOCs headspace free: ❑ ❑ 2 4.Camposlling instructions clear. Q 0
5.Fllterfng lnsirucllans dear. Q
Test StrIp Lot ifs: pH 1-12: 212820 pH 12+; 203117A _ Other: (Specify)
Comments
SM1tea9-0J
Rev.Date 12r7r17
FA82594: Chain of Custody
Page 3 of 3
erk6 17

•
(-''''''7,,=!:4; 1.Z.Itl''-i-,..;:'
I
Orlando, FL tci+ itYPP
The results set forth herein are provided by SGS North America Inc. 8-- �d3'c e1� �y "0
Automated Report
Technical Report for
Environment 1, Inc
City of Havelock WWTP; 304 N Jackson Dr, Havelock, NC
414
SGS Job Number: FA84061
ram'
Sampling Date: 03/15/21
'7,7-.-.. • . ;4
Report to:
Environment 1, Inc
PO Box 7085
Greenville, NC 27835
[e-mail]
ATTN: Ann Brown
Total number of pages in report: 9
��,e pccR0
VNI ,
/ /
`�e�RAti4 ,µ.me
Test results contained within this data package meet the requirements Norm Farmer
of the National environmental Laboratory Accreditation Program Technical Director
and/or state specific certification programs as applicable.
Client Service contact:Jean Dent-Smith 407-425-6700
Certifications:FL(E83510),LA(0305I).KS(E-10327),IL(200063),NC(573),NJ(FL002),NY(12022),SC(96038001)
DoD ELAP(ANAB L2229),AZ(AZ080G),CA(2937),TX(T104704404),PA(68-03573),VA(460177),
AK,AR,IA,KY,MA,MS,ND.NH,NV,OK,OR,UT,WA,WV
This report shall not be reproduced,except in its entirety,without the written approval of SGS.
Test results relate only to samples analyzed.
SCS North America Inc. • 4405 Vineland Road • Suite C-15 • Orlando,FL 32811 • tel_407-425-6700 • fax:[phone]
StiS is ill,:soic aulhuri:\for aulhori/.in,�diis i i 111:1ditiCtui,L1 ID Ilu.Jucuna:ui. I'k .r:i. slum:your ikas:bout q1 I of 9
i,,,,,,,t1c ri,:2'd im..lif it;itii,ll,il ilii..i :urn iti siri2llp prohibited, you toiler ul:
I I how�r�eau.�r,.•c
l-t•vi4u'st:ii I:uti i i'i n- tit. 414,:t/www.-:...,:s.00mivilii‘Nws-aui.1..L..onklitioril.: lit-I.l-,:S.['Ii 1OI1hhrf.:awil?i1 iiIil - FA84061

T j� Sections:
Re of Contents
Section 1: Sample Summary 3 F'
.
Section 2: Summary of Hits 4
Section .3: Sample R$::5u s .....,.., e
..1: FA84061-1: SLUDGE SAMPLE 6
Section 4: Misc. Forms ;R
4.1: Chain of Custody 8
R ql 9 of 9
[ �'
. Faanos1

SGS North America Inc.
Sample Summary
Environment 1, Inc
City of Havelock WWTP; 304 N Jackson Dr, Havelock, NC Job No: FA$9061
Project No: 414
Sample Collected Matrix Client
Number Date Time By Received Code Type Sample ID
FA84061-1 03/15/21 10:25 JP 03/20/21 SO SIudge SLUDGE SAMPLE
Soil samples reported on a dry weight basis unless otherwise indicated on result page.
'lf_
FAuo6F

Summary of Hits Page 1 of 1
Job Number: FA840610 +
Account: Environment 1, Inc
Project: City of Havelock WWTP; 304 N Jackson Dr, Havelock, NC
Collected: 03/15/21
Lab Sample ID Client Sample ID Result/
Analyte Qual RL MDL Units Method
FA8406I-1 SLUDGE SAMPLE
No hits reported in this sample.
SCC
F.R8,1061

•
Jg
Oftrido, FL
'Ter1,1i
Seci:lon 3
•
Sample Results
Report of Analysis
5 of 9
• • FA8061

SGS North America Inc.
Report of Analysis Page 1 of 1 ''
Client Sample ID: SLUDGE SAMPLE
Lab Sample ID: FA84061-1 Date Sampled: 03/15/21
Matrix: SO-Sludge Date Received: 03/20/21
Percent Solids: 3.7
Project: City of Havelock WWTP; 304 N Jackson Dr, Havelock,NC
General Chemistry
Analyte Result RL Units DF Analyzed By Method
Cyanide Reactivity <4.1 4.1 mg/kg 1 03/29/21 12:29 AC SW846 CHAP7
Solids, Percent 3.7 % I 03/23/21 12:05 AC SMI9 2540G
Sulfide Reactivity <130 130 mg/kg 1 03/26/21 14:30 JC SW84G CHAP7
RL = Reporting Limit
6of9
•
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Orlando, FL
Section 4
Misc. Forms
Custody Documents and Other Forms
Includes the following where applicable:
• Chain of Custody
/Pi, 7of9
FA8d8Gi

Environment I,inc. •3 ej s CHAIN OF CUSTODY RECORD vatio61
P.O.Box 7085,114 Onlcmmnt Dr.
Greenville,NC 27858 r Page 2.of 1
environment Iinc.com DISINECGTION I Ij
• Phone[phone]•FAK(252)756-0633IL I CHLORINE NEUTRvL�DATCDLLEC110N
414 Week:S ❑CHLORINE CLIENT * pHCHECK(IA8'❑( 1UVCITY OF HAVELOCK(SLUDGE) P t 1—j-. MR.RODNEY GEORGE ❑ NONE CONTAINER7YPE PJG
WASTEWATER TREATMENT PLANT -
304 N.JACKSON DRIVE '_— ——
HAVELOCK NC 28532 ❑ A t L r A A n t CHEMICALPRESERVATiCN -P.
x 1
—t
(252)ri71-6373 —— — e w A•NONE D•NAOH
E 115 I i = - _ •, 3 a B HNO• E•HCL
i
- F = i C SO F-ENGACETATEINAOH =�:'.�'�,
COLLECTION ¢i 4 P F S• - - ra ►a• F. ` Ht
r r f 3 �$+ 5 G.NATHIOSIILFATE
SAMPLELOCADON DATE ME o o P a o I. r.. r4 F, odr
SluJgcSomple W t. �" `, 7
3.Isxl Ia;z� l631 °l - 1gi tr• T s< , r-"1• CLASSIFICATION: —
I • _,___.
❑ WASIEWATER(NPOES)
- - ❑ DRINIGNGWAWA
_ ❑ DWROGw
❑ sauownsi>t sEcnGN
CHAIN OF CUSTODY(SEAL)MAINTAINED
DURING SHIPMEN7IGELIVERY
SAMPLES fr I FCTEDBY:
- . (PleaserryRini)
SAMPLES RECEIVED NLABATo2.2 sC
aims r 1 DATE/TIME CENEDBY(SIDI DAAERWiE
COMMENTS.
3.n.lr f =3s � yI 13:3q PO t Qt-4k'(V3 lC{zJ+
EEL•, r BY ICE DATFJT1ME m reAn.,,-
RAC. -t •w R 0�,,,D a� DATEMIE
Lorno.A�— I a:AO r' .� ,tJ 3//� d P:19.;.0 LABEL
VSSESSM{
I$tfEDBYIS - DATE/NE RECEIVED BY(SiGI RA DATEIIME
3 • Il,ie r in.2'c.3i 21 I WA%
wr-rA Lam
PLEASE READ Instructions forcomple(in this form on Ike reverse side. Sampler must place a"C'for composite sample ara'G'kw Is 396515
r OAIJ rs 1 L � Grab sample in the blocks above for each parameler requested,
FF'1 W 6is Chains of Custody
Page 1 of 2
et Te: 8ot9
StUrt
FAB'Iflei

SGS Sample Receipt Summary
Job Number: FA84061 Client: ENVIRONMENT 1 Protect: 414
Date/Time Received: 3/20/2021 10:45:00 AM Delivery Method: FEDEX Afrblll#'s: 954628457221
Therm ID: IR 1; Therm CF: -1.8; #of Coolers: 1
Cooler Temps(Raw Measured)°C: Cooler 1:(2.6);
Cooler Temps(Corrected)°C: Cooler 1:(0.8);
A
cooler Info►matIoq Y or N Sample Information Y or N N/A .i
1.Custody Seals Present 8 0 s,1d?„
1.Sample labels present on bottles 0 0 �tr
2.Custody Seals Intact 0 ❑ 2.Samples preserved properly 2 ❑
3.Temp criteria achievedf y ;
0 0 3.Sufficient volume/containers recvd for analysis: 0 0
4.Cooler temp verification JR Gila 4.Condition of sample intact
5.Cooler media Jce(Baal 5.Sample recvd within HT RI 0
6.Dates/l imes/1Ds on COC match Sample Label 0 0
Trip Blank Information ._or N- f1JA 7.VOCs have headspace 0 0
1.Trip Blank present!cooler 0 ❑ 0 8.Bottles received for unspecified tests 0 0
2.Trip Blank listed on COC 0 0 0 9.Composiling instructions clear ❑ ❑ 0
W or S N/A_ 10.Voa Soil Kits/Jars received past 48hrs? 0 0
3.Type Of TB Received 0 0 0 11.%Solids Jar received? 0 0 e
12.Residual Chlorine Present? 0 0 0
Miss.Informatloq
Number of Encores: 25-Gram 5-Gram Number of 5035 Field Kits: Number of Lab Filtered Metals: _
Test Strip Lot#s: pH 0-3 230315 pH 10-12 2191313A Other. (Specify)
Residual Chlorine Test Strip Lot#:
Comments
RMp61 Technician: BRYANG Date: 3l2D12021 10:45:00 A Reviewer: Date:
Rev.Date 05124177
FA84061: Chain of Custody
Page 2 of 2
^g. l 9 of 9
FABJ061

} E Environmental Chemists, Inca
' i":� 1 0 P 91 s {W V -, 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road,Manteo,NC 27954 ° 252.473.5702 Lab/Fax
255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Environment-I Date of Report: Mar 31, 2021
Post Office Box 7085 Customer PO#:
Greenville NC 27858 Customer ID: 08100051
Attention: Report#: 2021-04623
Project ID: Sludge
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-11385 Site: Havelock 3/15/2021 10:25 AM Solid/Sludge Client
Test Method Results Date Analyzed
Cyanide SM 4500 CM1!D 15.3 mg/kg 03/26/2021
Sulfide SM45o0 S D 5.26 mg/kg 03/30/2021
Comment:
Reviewed by: _71 � �
jz)
F7nnw.1.V- nnn4 nAc.,

Environmental Chemist, Inc., Wilmington, NC Lab#94
6602 windmill Way
Wilmington, NC 28405
910.392.0223
Sample Receipt Checklist
Client:FM\U? .0 ! i\A- m-r , Date:3 A 9 70Ri Report Number: 02/ -v 4:Q
Receipt of sample: ECHEM Pickup Client Delivery 0 iUPS 0 FedEx❑ Other ❑
0 YES ❑ NO fXr N/A 1. Were custody seals present on the cooler?
❑ YE5 0 NO ! N/A 2. If custody seals were present,were the ?
Original temperature upon receipt Qi °C y intact/unbroken?
Corrected temperature upon receipt oC
How temperature taken: 0 Temperature Blank 4 Against Bottles
IR Gun ID:Thomas Traceable S/N 192511657 IR Gun Correction Factor°C: 0.0
❑ YES 0 NO 3. If temperature of cooler exceeded 6°C, was Project Mgr./QA notified?
FIN YES 0 NO 4. Were proper custody procedures (relinquished/received) followed?
ur YES 0 NO 5. Were sample ID's listed on the COC?
YES 0 NO 6. Were samples ID's listed on sample containers?
u YES 0 NO 7. Were collection date and time listed on the COC?
i■ YES 0 NO 8. Were tests to be performed listed on the COC?
II YES 0 NO 9. Did samples arrive in proper containers for each test?
II YES 0 NO 10. Did samples arrive in good condition for each test?
■l YES 0 NO 11. Was adequate sample volume available?'
►' YES ❑ NO 12. Were samples received within proper holding time for requested tests?
❑ YES ❑ NO 13. Were acid preserved samples received at a pH of<2? *
❑ YES ❑ NO 14. Were cyanide samples received at a pH >12?
❑ YES 0 NO 15. Were sulfide samples received at a pH >9? •
❑ YES 0 NO 16. Were NH3/TKN/Phenol received at a chlorine residual of<0.5 m/L? **
❑ YES 0 NO 17. Were Sulfide/Cyanide received at a chlorine residual of<0.5 m/L?
❑ YES 0 NO 18. Were orthophosphate samples filtered in the field within 15 minutes?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
** Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet.
Sample Preservation: (Must be completed for any sample(s) incorrectly preserved or with headspace)
Sample(s) were received incorrectly preserved and were adjusted accordingly
by adding (circle one): H2504 HNO3 HCl NaOH
Time of preservation: If more than one preservative is needed, notate in comments below
Note:Notify customer service immediately for incorrectly preserved samples.Obtain a new sample or
notify the state lab if directed to analyzed by the customer.Who was notified,date and time:
Volatiles Sample(s) were received with headspace —
COMMENTS:
DOC. QA.002 Rev 1

ri
Environment I Inc. 4'`' *-447: 1' "�0�' .� .., CHAIN OF CUS"O Y RECORD � `f��
P.O. Box 7085, I 1 l Oakmont Dr. �•4.
Greenville,NC 27858 = '`;' r ."Al; ° Page 1 - or 1
environment I inc.com DISINFECTION I A r I e
i
Phone[phone] • Fax [phone] I CHLORINE NEUTRALIZED AT COLLECTION Ljj
414 A Week: 8 CHLORINE
CLIENT:
U U V pH CHECK(LAB)
CITY OF HAVELOCK(SLUDGE) - Irr
AR.RODNEY GEORGE f NONE P R I p P ii Gr CONTAINER TYPE,PIG
WASTEWATER TREATMENT PLANT ! t.
304 N.JACKSON DRIVE ° f --
IIAVELOCK NC 28532 '� A A f A �. • j Ai CHEMlCALPRESERVATION
0,0
(( I
252) 671-6373 u.iE i ( ± A NONE D-NAOH
ao =Q _cc A r B HNO3 E HCL
COLLECTION o ° ' '.- Pr., i .o s: C H,SOa I -ZINC ACETATEINAOH
- a o v ¢ o " G-NATHIOSULFATE
SAMPLE LOCATION DATE TIME o o �" a o �' '� U E ci-a
Sludge Sample ( 5 •9 v .i F a •;,,=,: ,�.,, :� �,:� . 'i. ", ,"' CLASSIFICATION:
' x � :9 �w,: r�i_ 4
t
WASTEWATER(NPDES)
L3DRINKING WATER
_r______ Lj DWR/GW
tiSOLID WASTE SECTION .
- CHAIN OF CUSTODY(SEAL)MAINTAINED
DURING SHIPMENT/DELIVERY
",) N
-
SAMPLES COLLECTED BY:
- - - (Please Print)
SAMPLES RECEIVED IN LAB AT a,'a. °C
REØ7y)7(SAMPLEA) DATE1TIME RECEIVEDBY( G.) DATE/TIME COMMENTS: Q(�. — 7�L y t 4 C (ci 2- 1 V1 /2 3R HED BY DATE/TIME R El E Y(SIG.) DATE/TIME J
WTI BY(51G.) DATE/TIME RE Y(SIG.) _...)(7- D Tl=!TIME
7 Y 7-9-R I 1 0-5.4/1/
PLEASE READ Instructions for completing this form on the reverse side. C Sampler must place a"C"for corcposile sample or a"G"for •
FORM 115 - Grab sample in the blocks above for each parameter renuested. N 396516

CITY OF HAVELOCK
WQ0000702
City of Havelock WWTP
07/15/21 43,000 _ 4.6335
07/15/21 120,000 5.0792
07/15/21 45,000 4.6532
07/15/21 11,000 4.0414
07/15/21 27,000 4.4314
07/15/21 44,000 4.6435
07/15/21 82,000 4.9138
Total 32.3959
Average 4.6280
Geometric Mean .VEP:;,40kliigii Fecal Coliform MPN/gram
Geometric Mean of Less than 2,000,000 meets Class B -Alternative 1 Pathogen Reduction
requirement.

d
Drinking Water ID! 37715
Wastewater 1DI 10
114 OAKMONT DRIVE PHONE [phone]
GREENVILL.E, N.C. 27858 FAX [phone]
ID#: 41.4 B
CITY OF HAVELOCK(SLUDGE)
SUE SAYGER
WASTEWATER TREATMENT PLANT DATE COLLECTED: 07/15/21
304 N. JACKSON DRIVE DATE REPORTED : 07/23/21
HAVELOCK, NC 28532
REVIEWED BY:
Sample Sample Sample Sample Sample Analysis Method
PARAMETERS #1 #2 #3 #4 #5 Date Analyst Code
Total Residue, mg/I 30233 30433 29000 30200 29467 07/15/21 KDS 2540B-11
Fecal Coliform (MPN), /gram Solids 43000 120000 45000 11000 27000 07/15/21 KDS 9221E-06

EEM1T©H in ¶ia 11Ecorprroiftgi
Drinking Water ID' 37715
Wastewater ID' 10
114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27858 FAX [phone]
ID#: 414 B
CITY OF HAVELOCK(SLUDGE)
SUE SAYGER
WASTEWATER TREATMENT PLANT DATE COLLECTED: 07/15/21
304 N. JACKSON DRIVE DATE REPORTED :. 07/23/21
HAVELOCK, NC 28532
REVIEWED BY: J --r—
— -
Sample Sample Analysis Method
PARAMETERS #6 #7 Date Analyst Code
Total Residue, mg/I 29533 29267 07/15/21 ICDS 2540B-11
Fecal Coliform (MPN), /gram Solids 44000 82000 07/15/2I KDS 9221E-06

Environment 1,Inc. CHAIN OF CUSTODY RECORD
P.O-Box 7085- f I Oakmont Dr. Page 1 of
Greenville,NC 27858
anvironrnentl inc-cam DISINFECTION
CHLORINE NEUTRALIZED AT COLLECTION
Phone[phone] •Fax [phone]
CHLORINE - _ -
CLIENT: 414 B Week:33
pH CHECK(LAB)
aUV
CITY OF HAVELOCK(SLUDGE) NONE p p CONTAINER TYPE,PIG
SUE SAYGER - —
WASTEWATER TREATMENT PLANT
304 N.JACKSON DRIVE � A,. A CHEMICAL PRESERVATION
HAVELOCK NC 28532 =z
A NONE D-NAOH
[phone] z J . a = C B-HNO3 E-HCL
ccS o lio z o
z r'- ¢ w z 7, E r"J- C-H2SO, F-ZINC ACETATE/NAOH
COLLECTION _, ¢ J o - "'
1- _ 0 IA 0 ��—y cc
G-NATHIOSULFATE
1 SAMPLE LOCATION DATE TIME o a ¢ o F a
_ — av{^;:4;:
Sample#1 1-151 X( (a 5-< 37,i1 2 b } CLASSIFICATION:
P ( fi.00 32.3 2 _
Sample#2 �, ! 2 _ t WASTEWATER(NPDES)
Sample#3 .7.15. ZL /is a- 31:7 2 —
I y �Y DRINKING WATER
Sample#4 �.15_v it i' d 3i-�' 2 ,, ,N
Sample#5 7.f 35. i f[;r) 1 5.LD 2 z Imo,; [ DWR/GW
Sample#6 '7-1 Z( (('2D ,5r,� 2 - 7` SOLID WASTE SECTION
-
# CHAIN OF CUSTODY(SEAL)MAINTAINED
3�� 2 �.;Sample#7 7(�Zt I{�vS �s
- DURING SHIPMENT/DELIVERY
_ a N
SAMPLES COLLECTED BY:
. (Please Print)
.. r _ _
-1-egCrzr an A.7
SAMPLES RECEIVED IN LAB AT .- 3 `C
RELI ' H BY IG,)(SAMPLER) DATFJTlME RECE 1 BY(SIG.) DATE/TIME COMMENTS:
RELI • UIS , D BY(SIG.) DATFJfIME RECEIVED BY(SIG.) DATE/TIME
I
REUNQUISHED BY(SIG.) DATE/TIME RECEIVED BY(SIG) DATE/fiME _
1
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a"C"for composite sample or a"G"for
FORM 45 Grab sample in the blocks above for each parameter requested. N� 398005 •

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM(02T Rules)
Facility Name: Lewis Farms and Liquid Waste,Inc.
WWTP Name: Havelock WWTP WQ Permit Number: WQ0000455
m NPDES Number: NC0021253
Monitoring Period: Fro
711/202I To 4130/2021
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
Alt.D(Na Prior Test) ❑ (Prior Testing)❑
Process to Further Reduce Pathogengs El
Co applieable to alternative performed(Class A
Cone oct I only)indicate"Process to Further Reduce Pathogens":
p ❑ f
Heat g ❑ I Heat Treatment ElThermophilic ❑ J
Beta RayRay 0
Pasteurization ❑ {::^:; ; :u,.,.r,; ,; :;a>r;{= ::i :
Class B: 'Alt. (l)Fecal Density .. :;.�.�:::.,: .�;•:..:;s�:::��r:4:; ::�`=�?<:::;
o I Alt. (2)Process to Significantly Reduce Pathogens 0 1 If applicable to alternative performed(Class B only)indicate'Process to Significantly Reduce Pathogens":
Lime Stabilization 0 1 f
Anaerobic Digestion 0 : Air;Drying ©:.. Composting ❑ !Aerobic Digestion ❑
If applicable . .,....:
to alternative -� •••-.data:
performed(Class A or Class B)complete the following monitoring'data:
Parameter Allowable Level - Pathogen Density TAumber o-r Analytical
Frequency
in Sludge Excee- Sample
Minimum Geo.Mean Maximum Units of Analysis Type Tech-
in niaue
2 x l0 to the
6th power MPN 27,000 42,460 120,000 MPN/g 0 Quarterly Grab 5M42210E
per gram of - -
Fecal Coliform total solids CFD
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria 3 MPN per 4 grams -
(in lieu of fecal total solid(dry
coliform) 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
Alt.5(14-DayAerobic) bench) ❑ Alt.4(Spec.0•,uptake) ❑
❑ Alt.6(Alk.Stabilization ❑ Alt 7(Drying-Stable) 0'Alt.
8
Alt.9(Injection) 0_ Alt. 10(Incorporatireon) (Drying-Unstable) ❑
CERTIFICATION STATEMENT(please check the❑appropriate attraction alternatives were performed El
0 "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 1SA NCAC 02T.1106 and the
vector attraction reduction requirement in 15A NCAC 02T.1107 have not been met." (Please note if
you check 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."
Ray Burgos,ORC Wesley Wooten,President
P nd 1' le e or print) Land Applier Name and Title(if applicable)(type or print)
I . --ia- !l g 1/I4/22
Signature of Preparer* Date Signature of Lan Applier(if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r)and 15A NCAC 2T.1102(26)
DENR FORM PVRF 02T(12/2006)

CITY OF HAVELOCK
WQ0000702
City of Havelock WWTP
°per €
10/12/21 15,000 4.1761
10/12/21 11,000 4.0414
10/12/21 24,000 4.3802
10/12/21 14,000 4.1461
10/12/21 7,000 3.8451
10/12/21 15,000 4.1761
10/12/21 15,000 4.1761
Total 28.9411
Average 4.1344
Geometric Mean 6 Fecal Coliform MPN/gram
Geometric Mean of Less than 2,000,000 meets Class B - Alternative 1 Pathogen Reduction
requirement.

nvoroi�fc �t'( [Itcommg&
Drinking Water ID3 37715
Waenewater ID$ 10
114 OAKMONT DRIVE PHONE [phone]u1
GREENVILLE. N . 2788513 FAX (252) 75C-063;3
ID$: 414 B
CITY OF HAVELOCK(SLUDGE)
SUE SAYGER
WASTEWATER TREATMENT PLANT DATE COLLECTED: 10/12/21
304 N. JACKSON DRIVE DATE REPORTED : 10/18/21
HAVELOCK, NC 28532
REVIEWED BY: `�/G� L✓ {�v
Sample Sample Sample Sample Sample Analysis Method
PARAMETERS #1 #2 #3 #4 1/5 Date Analyst Code
Total Residue, mg/I 33467 30367 33300 34800 32800 10/14/21 MIS 254013-15
Fecal Coliform (MPN), /gram Solids 15000 11000 24000 14000 7000 10/12/21 JMS 9221614

� r rn --r,��l ( -r � ,f
[EUIIJU. 1Irl I. Lnno��®g�
Drinking Water IDi 37715
Waakewater ID' 10
114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27858 FAX [phone](N.i,
ID#: 414 B
CITY OF HAVELOCK(SLUDGE}
SUE SAYGER
WASTEWATER TREATMENT PLANT DATE COLLECTED: 10/12/21
304 N. a7ACKSON DRIVE DATE REPORTED : 10/18/21
HAVELOCK, NC 28532
REVIEWED BY:
Sample Sample Analysis Method
PARAMETERS #6 1/7 Date Analyst Code
Total Residue, mg/1 33333 31967 10/14/21 JMS 2540B-15
Fecal Coliform (MPN), /gram Solids 15000 15000 10/12/21 JMS 9221E-14

Environment 1.Inc. CHAIN OF CUSTODY RECORD
P.O.Box 70S5. 114 Oakmont Dr. Page_i___of_j____
Greenville.NC 27858 ,
environment l inc_corn DISINFECTION
CHLORINE NEUTRALIZED AT COLLECTION
Phone[phone] a Fax[phone]
... . CHLORINE I - ,
CLTEN T: 414 B Week:46 pH CHECK(LAB)
UV
CONTfAINER TYPE,PIG
CITY OF HAVELOCK(SLUDGE) L NONE P P
SUE SAYGER
WASTEWATER TREATMENT PLANT CHEMICAL PRESERVATION
304 N.JACKSON DRIVE A A
HAVELOCK NC 23532 E a A-NONE D-NAOH
LU 9 ` B-HNO_ E-1-#CL
[phone] z o o z m -
z o p w �z y C-H,SO, F-ZINC ACETATE/NAOH
COLLECTION a, LI o o0 C L G-NATHIOSULFATE
1- = m c3 u U
SAMPLE LOCATION DATE TIME o o w ¢ o E 2 c
r
S }r.
Samvlein \OI�i)-t r�.i �Q;�i ?�fiN. 2 ".{ j CLASSIFICATION:
l y�r c� j f, � WASTEWATER(NPDES)
Sample #2 ��D�I`��[ �'� r1� �}+1, 2 ;:: ;=
k3 to(pJ ( 101 dlS° 2 `." s I r
. r
Sample t !
r DRINKING WATER
o
Samples#4 10(1 -L-( \1•` 1 ._ g,c\ 2 ; ,.' a
DWRIGW
_ample#5 10 La W 1. '.53 , a;�t 2 � ; > _ _
I 1
SOLIDWASTESECTION
Sample#6 �6 j� t :C 1J a5r 2 aK ,
7R r, f
Sample#7 o E an( .J'57 2 CHAIN OF CUSTODY(SEAL)MAINTAINED
I DURING SHIPMENT/DELIVERY
0 N
SAMPLES COLLECTED BY:
_ (Please Print)
5 .ph on VaPI i
SAMPLES RECEIVED IN LAB AT r � =C
R NOUI HED BY(S� . (SAMPLER) DATE/TIME REC VED kV ..G,) DATE/TIME COMMENTS:
\.01 \\�( .� 10///),1:If
RELI UISHED BY(SIG.) DATE/TIME RECEIVED BY(51G,) DATE/TIME
RELINQUISHED BY(SIG.) DATEIflME RECEIVED BY(SIG.) DATE/TIME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a'C"for compose sample or a"G"for N2 392202
FORM gs Grab sample in the blocks above for each parameter requested.

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM(02T Rules)
Facility Name: Lewis Farms and Liquid Waste,Inc.
WWT1'Name: Havelock WVYTp WQ Permit Number: WQ0000455
Monitoring Period: From 10/Il2021 NPDES Number: NC0021253
Pathogen Reduction(ISA NCAC 02T.1106)-Please indicateTo 12l31l2021
Class A: level achieved and alternative performed:
Alt.A(time/temp) ❑ Alt B(Alk Treatment)❑ Alt.C
AIt.D(No Prior Test) ❑ (Prior Testing)El
Process to Further Reduce Pathogengs 0
If applicable to alternative performed(Class A only)indicate"Process to Further Reduce Pathogens":
P ❑ Heat Drying ❑ Heat Treatment ❑ Thermo htlic
Beta Ray ❑ Gamma Ra 0 Pasteurization ❑ �«�:� <:<:>:; : :;s:« P ' ❑
Class B: Alt.(1)FecaI Densi .� � �"'�• ' ���
If applicable to alternative erformed(Class B only)nl ind sate"Pi"Process to Significantly Reduss to Si In ificand Reduce ce Pathogens":
Lime Stabilization ❑ � i •I ❑ g
Anaerobic Di;estion ❑ ; <: {: :i_n Com.ostin_ 0 Aerobic Di:estion ❑
........,...........C.-�...::S:r::$X... ':hi:;:??:. :{SAY. yi:;.:•ry:Y43yI:C`: ':?r?>.:{:
gn
If applicable to alternative performed(Class A or Class B)complete the following monitoring data:
Parameter Allowable Level Pathogen Density Number of Analyucat
Fin Sludge Minimum Geo.Mean Maximu Units Exeee- frAnalys s equency Sample
Tech-
2 x I0 to the MPN •
6thpower 7,000 13,628 24,000 MPN/g 0 Qllarterly drab sM922ICE
per gram of
Fecal Coliform total solids CFU
1000 mpn per gram
of total solid (dry
wei ht)
salmonella bacteria 3 mpi:i per 4 grams
(in lieu offecal total solid(dry
conform) weight)
Vector Attraction Reduction(15A NCAC 02T.1107)-Please indicate alternative performed:
AIt.I (VS reduction) ❑ Alt.2(40-day bench) ❑ Alt.3d 30- a( y bench) 0 'Alt.4(Spec.0,uptake) DIA(Y. 5(I4-Day Aerobic)
0 Alt.6(Alk.Stabilization El 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)
0 "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 ISA NCAC 02T.1106 and the
vector attraction reduction requirement in 15A NCAC 02T.1107 have not been met," (Please note if
you check 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."
Ray Burgos,ORC Wesley Wooten,President
r •tle e or print) Land Applier Name and Title(if a licable
�!Ni a� PP )(type or print)
Signature of Preparer* Date Signature of Lan Applier(if applicable) llIate2
Pp PP ) Date
*Preparer is defined in 40 CFR Part 503.9(r)and 15A NCAC 2T.1102(26)
DENR FORM PVRF 02T(1212006)

COASTAL FARMS
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater Treatment Plant
Date Sampled: February 15,2021
House of Raeford Permit No.WQ0034806
Wallace Plant 2.05 %Solids
7.16 pH
Parameter % Mg/Kg Dry Weight Pounds/Dry Ton
(%x 10,000) (Mg/Kg x 0.002)
Nitrogen(TKN) 7.590 75,900.000 151.800
Phosphorus 2.010 20,100.000 40.200
Potassium 0.473 4,730.000 9.460
PAN(injected)* 3.241 32,412.860 64.826
PAN(surface)* 3.071 30,707.860 61.416
Ammonia Nitrogen 0.341 3,410.000 6.820
Calcium 1.330 13,300.000 26.600
Calcium Carbonate Eq. _ --- -_
Magnesium -- 4,540.000 9.080
Sodium --- 6,000.000 12,000
Sulfur
Nitrate N I Nitrite N --- 6.860 0.014
Barium
Chloride _--
Iron
Aluminum --- 22,900.00 _ 45,800
Arsenic --- 16.00 0.032
Cadmium --- 16.00 0.032
Chromium --- 16.000
Copper --- 292.00 _ 0.584
Lead --- 16.00 0.032
Mercury --- 0.815 0.002
Molybdenum --- 16.00 0.032
Nickel --- 16.00 0.032
Selenium --- 16.00 0.032
Zinc --- 231.00 0.462
Environmental Chemists# 2021-02570
*Determination of Plant Available Nitrogen(PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia N)+Ammonia N+Nitrate N+Nitrite N=%PAN
Surface Application:
(Mineralization Rate)(TKN-Ammonia N)+(0.5)(Ammonia N)+Nitrate N+Nitrite N=%PAN
Note: Constituents N.D.(Not Detected)or<detection limits are listed as detection limits
for calculation purposes.

LEWIS FARMS
WQ0000455
House of Raeford - Wallace Plant
1111111i110001101CP1411000401: ,::;:; '
02/15/21 10,000 4.0000
02/15/21 42,923 4.6327
02/15/21 14,286 4.1549
02/15/21 33,019 4.5188
02/15/21 20,445 4.3106
02/15/21 10,748 4.0313
02/15/21 21,801 4.3385
Total 29.9868
Average 4.2838
Geometric Mean !Ilgii1.9401ilia Fecal Coliform MPN/gram
Geometric Mean of Less than 2,000,000 meets Class B - Alternative 1 Pathogen for Reduction
requirement.

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et r Irr1 r.',_ '....��I 1 ✓ 1-:1:�'t131.. .Ja
tf$2,47.s:
"Prl.�Y roche�m� 6602 vVindniiil Way,Wilmington,NC 28405 • 910.392.0223 Lab • 9'10.392.4424 Fax
f wt , T,1 t v rM 7101iowsertown Road,Manteo,NC 27954 • 252 473.5702 Lab/Fax
'-:=:f� ift--1 255-A VVilmin tan Highway,Jacksonville, 28540 /g ig gay, l IC • 910.3a7.5843 Lab rax
ANALYTICAL n CONSULTING CHEMISTS [e-mail]
House of Raeford-Wallace Facility Date of Report: Mar 09, 2021
Post Office box 40 Customer P®#:
Rose Hill NC 28458 Customer ID: 13030026
Attention: Chris Murray Report#: 2021-02570
Project ID: Annual Sludge
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-06206 site: Sludge 2/15/2021 11:25 AM Solid/Sludge jcb/envirochem
Test Method Results Date Analyzed
Chlordane (TCLP) SW 846 Method 8081B/3510 <0.02 mg/L 03/01/2021
Endrin (TCLP) SW 646 Method B001B/3510 <0.0005 mg/L 03/01/2021
Heptachlor(TCLP) SW 846 Method 8081B/3510 <0.0005 mg/L 03/01/2021
Heptachlor epoxide (TCLP) SW B46 Method 8081B/3510 <0.0005 mg/L 03/01/2021
Lindane (TCLP) SW 846 Method 80816/3510 <0.0005 mg/L 03/01/2021
Methoxychlor(TCLP) SW 846 Method 8081B/3510 <0.0005 mg/L 03/01/2021
Toxaphene (TCLP) SW 846 Method 8081 B/3510 <0.05 mg/L 03/01/2021
'I,4-Dichlorobenzene (TCLP) SW 846 method 8270/3510 <0.050 mg/L 03/01/2021
2,4,5-Trichlorophenol (TCLP) SW 846 method 8270/3510 <0.050 mg/L 03/01/2021
2,4,6-Trichlorophenol (TCLP) SW 846 method 8270/3510 <0.050 mg/L 03/01/2021
2,4-Dinitrotoluene (TCLP) SW 846 method 8270/3510 <0.050 mg/L 03/01/2021
Cresol (TCLP) SW 846 method 0270/3510 0.196 mg/L 03/01/2021
Hexachloro-1,3-butadiene (TCLP) SW896 method 8270/3510 <0.050 mg/L 03/01/2021
Hexachlorobenzene (TCLP) SW 846 method 8270/3510 <0.050 mg/L 03/01/2021
Hexachloroethane (TCLP) SW 846 method 8270/3510 <0.050 mg/L 03/01/2021
m -t- p-Cresol (TCLP) SW 846 method 8270/3510 0.196 mg/L 03/01/2021
Nitrobenzene (TCLP) SW 846 method 8270/3510 <0.050 mg/L 03/01/2021
o-Cresol (TCLP) SW 846 method 8270/3510 <0.050 mg/L 03/01/2021
Pentachlorophenol (TCLP) SW 846 method 8270/3510 <0.250 mg/L 03/01/202'1
Pyridine (TCLP) SW 846 method 8270/3510 <0.050 mg/L 03/01/2021
2,4,5-TP (TCLP) SW846 Method 8151A <0.003 mg/L 02/26/2021
2,4-D (TCLP) SW846 Method 8151A <0.003 mg/L 02/26/2021
1,1-Dichloroethylene (TCLP) SW846 Method 8260/5030 <0.01 mg/L 02/26/2021
1,2-Dichloroethane (TCLP) SW846 Method 8280/5030 <0.01 mg/L 02/26/2021
Benzene (TCLP) SW846 Method 8260/5030 <0.01 rng/L 02/26/2021
Carbon Tetrachloride (TCLP) SW846 Method 8260/5030 <0.01 mg/L 02/26/2021
Report/i'• 2021-02570

, ter ..... TiI�l o
E }hit�� ";f t�_'i � � 7 t l 1 F 'l } ''
e virtu a :=." 6602 Windrnill Way,VlfihningLon,NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax1 1.,E
� , ,7 "� 710 liotivsertoWn Road,Manta), NC 27954 + 252.473.5702 Lab/Fax
� fsM
, 255-A 4Vilmington Highway,Jacksonville,NC 28540 • 910.347 5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS in FVh men talchernists.com
House of Raeford-Wallace Faculty Date of Report: Mar 09, 2021
Post Office box 40 Customer PO#:
Rose Hill NC 28458 Customer ID: 13030026
Attention: Chris Murray Report#: 2021-02570
Project ID: Annual Sludge
Chlorobenzene (TCLP) SW646 Method 8260/5030 <0.01 mg/L 02/26/2021
Chloroform (TCLP) SW846 Method 8260/5030 <0.01 mg/L 02/26/2021
Methyl ethyl ketone (TCLP) SW846 Method 8260/5030 0.07 mg/L 02/26/2021
Tetrachloroethylene (TCLP) SW846 Method 8260/5030 <0.01 mg/L 02/26/2021
Trichloroethylene (TCLP) SW646 Method 8260/5030 <0.01 mg/L 02/26/2021
Vinyl Chloride (TCLP) SW646 Method 8260/5030 <0.01 mg/L 02/26/2021
RCI
Cyanide SM 4500 CN D <1 mg/kg 02/16/2021
Sulfide SM 9500 S D 2.52 mg/kg 02/22/2021
Ignitabifity SW 846 method 1010 >180°F 03/04/2021
pH SW 846 Method 9045D 7.16 units 02/16/2021
Sludge Residuals
Aluminum EPA 200.7 22900 mg/kg 02/18/2021
Arsenic EPA 200.7 <16.0 mg/kg 02/18/2021
Cadmium EPA200.7 <16.0 mg/kg 02/18/2021
Calcium EPA200.7 13300mg/kg 02/18/2021
Chromium EPA 200.7 <16.0 mg/kg 02/18/2021
Copper EPA 200,7
292 mg/kg 02/18/2021
Lead EPA 2007 <16.0 mg/1<g 02/18/2021
Magnesium EPA 200.7 4540 mg/kg 02/18/2021
Molybdenum EPA 200.7 <16 0 mg/kg 02/18/2021
Nickel EPA 200.7 <16.0 mg/kg 02/18/2021
Potassium EPA 200.7 4730 mg/1<g 02/18/2021
Selenium EPA 200.7 <16.0 mg/kg 02/18/2021
Sodium EPA 200.7 6000 mg/kg 02/18/2021
Zinc EPA 200.7 231 mg/kg 02/18/2021
N itrate+Nitrite-Nitrogen EPA 353.2 6.86 mg/kg 02/19/2021
Total Solids (%) SM 2540 B 2.05% 02/15/2021
Ammonia Nitrogen SM 4500 NH3 C 3410 mg/kg 02/16/2021
Total Kjeldahl Nitrogen (TKN) SM 4500 Org B 75900 mg/kg 02/16/2021
Reports:; 2021.02570

# ��, , mow :I _.._ ./ Y :� _�
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. ' P I71Z Oe1 'a 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 910.392.s4.24 Fax
1 �`g m�s• 710 Bowsertawn Road,N1anteo,NC 27954 • 252.t7 y.5702 Lab/Fax
•'._ ',;' g;;n.=. : 255-A Wilmington highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS info rr environmentaichemists.coin
House of Raeford-Wallace Facility Date of Report: Mar 09, 2021
Post Office box 40 Customer PO#:
Rose HID NC 28458 Customer ID: 13030026
Attention: Chris Murray Report#: 2021-02570
Project ID: Annual Sludge
Total Phosphorus SM 4500 P F 20100 mglhg 02/17/2021
Mercury SW846 74718 <0.815mglkg 02/24/2021
TCLP Metals
Arsenic EPA 200.7 <1.0 mg/L 02/24/2021
Barium EPA 200.7 <1.0 mg/L 02/24/2021
Cadmium EPA 200.7 <1,0 mg/L 02/24/2021
Chromium EPA 200.7 <1.0 mg/L 02/24/2021
Lead EPA 200.7 <1.0 mg/L 02/24/2021
Selenium EPA 200.7 <1.0 mg/L 02/24/2021
Silver EPA 200.7 <1.0 mg/L 02/24/2021
Mercury EPA 245.1 0,0003 mg/L 02/24/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-06207 Site: 1 2/15/2021 11:28 AM Solid/Sludge jcb/envirochem
Test Method Results Date Analyzed
Total Solids (%) SM 2540 e 2.30% 02/15/2021
Fecal Density SM 9221C E MPN 24 hr 503 10000 MPN/g 02/15/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-06208 Site: 2 2/15/2021 11:29 AM Solid/Sludge jcb/envirochem
Test Method Results Date Analyzed
Total Solids (%) SM 2540 2.19%% 02/15/2021
Fecal Density SM 9221C E MPN 24 hr 503 42923 MPN/g 02/15/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-06209 Site: 3 2/15/2021 11:30 AM Solid/Sludge jcb/envirochem
Test Method Results Date Analyzed
Total Solids (%) SM 2540 a 2.31 % 02/1512021
Fecal Density SM 9221C E MPN 24 hr 503 14286 iV1PN/g 02/15/2021
Reportf.`:: 2021-02570 "-. ___.. �.._. .»._..t-n....=.e�� �.

Yam, s _
x s 4, '*h. 11 i.:.i J. .2?, if"l�.+i'�1L2. '9.1 f �'� re' _ (, 1 r}
;�: eJ1vJro1 1I ' ' , 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 9I0,392.4424 Fax
�'E"�': I ` ` 1 j . 'M 710 6osysertown Road, Manteo,NC 27954 • 254 _r�,47
3 5702 Lab/Fax
' .>' 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5643 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS infb@envi m nmentalchem isis.com
House of Raeford-liVallace Facility Date of Report: Mar 09, 2021
Post Office box 40 Customer PO #:
Rose Hill NC 28458 Customer ID: 13030026
Attention: Chris Murray Report#: 2021-02570
Project ID: Annual Sludge
Lab ID Sample ID: Collect DatelTime Matrix Sampled by
21-06210 Site: 4 2/15/2021 11:31 AM Solid/Sludge jcb/envirochem
Test Method Results Date Analyzed
Total Solids (%) SM 2540 8 2,12% 02/15/2021
Fecal Density SM 9221C E MPN 24 hr 503 33019 MPN/g 02/15/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-06211 Site: 5 2/15/2021 11:32 AM Solid/Sludge jcb/envirochem
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.25% 02/15/2421
Fecal Density SM 9221 C E MPN 24 hr 503 20445 MPN/g 02/15/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-06212 Site: 6 2/15/2021 11:33 AM Solid/Sludge jcb/envirochem
Test Method Results Date Analyzed
Total Solids (%) 5M 2540 8 2.14 a/o 02/15/2021
Fecal Density 5M 9221C E MPN 24 hr 503 10748 MPN/g 02/15/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-06213 Site: 7 2/15/2021 11:34 AM Solid/Sludge jcb/envirochem
Test Method Results Date Analyzed
Total Solids (%) SM 2540 6 2.11 % 02/15/2021
Fecal Density SM 9221C E MPN 24 hr 503 21801 MPN/g 02/15/2021
Comment: Results reported on a dry weight basis.
Reviewed by: liknAh,(3LO/ 1/10Pi1
ki
Report 4:: 2021-02570 `e rv_'ss ._� ma .'_�", " •
Pena A nid

Environmental Chemist, inc., Wilmington, NC Lab #94 6602 Windmill Way
Wilmington, NC 28405
910.392.0223
Sample Receipt Checklist
Client: 1-1/CAA ® F I--Pe Date:ak 1,J c..J Report Number:(24 — C)QO 7 0
Receipt of sample: ECHEM Piclwp)6 Client Delivery 0 UPS 0 Fed Ex El Other El
El YES 0 NO N/A 1. Were custody seals present on the cooler?
❑ YES 0 NO N/A 2. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt Jt— °C Corrected temperature upon receipt °C
How temperature taken: 0 Temperature Blank Against Bottles
IR Gun ID: Thomas Traceable 5/N 192511657 IR Gun Correction Factor°C: 0.0
El YES 0 NO 3. If temperature of cooler exceeded 6°C, was Project Mgr./QA notified?
+km YES 0 NO 4. Were proper custody procedures (relinquished/received) followed?
it YES 0 NO 5. Were sample ID's listed on the COC?
N YES 0 NO 6. Were samples flits listed on sample containers?
YES 0 NO 7, Were collection date and time listed on the COC?
4 YES ❑ NO 8. Were tests to be performed listed on the COC?
' YES ❑ NO 9. Did samples arrive in proper containers for each test?
YES ❑ NO 10, Did samples arrive in good condition for each test?
l ' YES 0 NO 11. Was adequate sample volume available?'
YES 0 NO '12. Were samples received within proper holding time for requested tests?
El YES ❑ NO 13. Were acid preserved samples received at a pH of<2?
❑ YES ❑ NO 14. Were cyanide samples received at a pH >12?
El YES ❑ NO 15. Were sulfide samples received at a pH >9?
❑ YES El NO 16. Were NH3/TKN/Phenol received at a chlorine residual of<0,5 m/L? **
❑ YES 0 NO 17. Were Sulfide/Cyanide received at a chlorine residual of<0.5 m/f_?
❑ YES 0 NO 18. Were orthophosphate samples filtered in the field within 15 minutes?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
** Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet.
Sample Preservation: (Must be completed for any sample(s) incorrectly preserved or with headspace)
!Sample(s) were received incorrectly preserved and were adjusted accordingly
Jby adding (circle one): H2504 HNO3 HO NaOH a
"Time of preservation: If more than one preservative is needed, notate in comments below
Note: Notify customer service immediately for incorrectly preserved samples.Obtain a new sample or
!notify the state lab if directed to analyzed by the customer.Who was notified,date and time:
Volatiles Sample(s)
were received with headspace
COMMENTS:
DOC. QA,002 Rev 1

5602
cr,y Ai)e':iiriCi: ENVIRONMENTAL CHEMISTS! INC OFFI indmillWa2 ilminFAX ton, 924d24 NC 5
Analytical&Consulting Chemists NCDENR: DWQ CERTIFICATION#94 NCDHHS: DLS CERTIFICATION#37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY
Client: House of Raeford-Wallace PROJECT NAME: Wallace Plant-sludge (annual) REPORT NO: 2.- f -2-5— v
ADDRESS: CONTACT NAME: PO NO:
REPORT TO: Chris Murray PHONE/FAX:
COPY TO: email:
Sampled By: 7-,/j - r �_____. SAMPLE TYPE: I =Influent, E= Effluent,W=Well, ST=Stream, SO=Soil, SL=Sludge, Other:
III/ Collection A, PRESERVATION
1 a ,I, Q a := ( c _, olifJ
Sample Identification m ti l o F o` `o E rn m m z d o = o w ANALYSIS REQUESTED
at Time Temp m ID cD U Time
C Pa c) z z = r = � P. E,
L�� G, -
Sludge _ G G 4PG X_ Full TCLP, RCI,Nutrient/metals
//L C P _
1 G G �L� X fecal density/%TS
1/L ' C P _
2 G G _ �� X fecal density/% TS
/0' C P C1
3 G G X fecal density/%TS
//51 C P
4 G G (DIA'�
X fecal density/% TS
/151- C P
5 G G Gz/I X fecal density/%TS
r►3 j C P b�it-
6 - —
G G X fecal density)% TS
1i �11 C P -
7 _ G G _ C LA X fecal density/% TS
C P
G G
Relinquished By: —
Transfer Relin
q1]atelTime Received By: DakelTime
1.
2.
Temperature when Received: 5�
Accepted: >,---' ejec d: Resample Req ested:
Delivered By: Received B Date Time: fG
Comments: Y TURNA OU D:

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM(02T Rules)
Facility Name: Lewis Farms and Liquid Waste,Inc. WQ Permit Number: WQ0000455
WWTP Name: Wallace Chicken Processing Plant NPDES Number: NC0003344
Monitoring Period: From 1h/202I To 12/31/2021
Pathogen Reduction(15A NCAC 02T.1106)-Please indicate level achieved and alternative performed:
Class A: I Alt. A(time/temp) ❑ I Alt B(Alk Treatment)tit t)❑ Alt.C(Prior Testing)❑
lAIt.D(No Prior Test) ❑ 1 Process to Further Reduce Pathogengs ❑
Ifapplicabie to alternative performed(Class A only)indicate"Process to Further Reduce Pathogens":
Compost ❑ Heat Drying ❑ Heat Treatment ❑ Thermophilic ❑ I
Beta Ray 0 Gamma Ray ❑ Pasteurization D .
Class B: Alt.(1)Fecal Density p Alt_ (2)Process to Significantly Reduce Pathogens ❑ I
If applicable to alternative performed(Class B only)indicate"Process to Significantly Reduce Pathogens":
Lime Stabilization ❑ I Air Drying 0 I Composting ❑ 'Aerobic Digestion 0
Anaerobic Digestion ❑
If applicable to alternative performed(Class A or Class B)complete the following monitoring data:
Allowable Level Pathogen Density Number of Analytical
Parameter Excee- Frequency Sample
in Sludge Minimum Geo. Mean Maximum Units denrps of Analysis Type nin n
, 2 x 10 to the MPN 10,000 19,223 42,923 MPN/g 0 Annual Grab SM922 IC
bth power
per gram of
Fecal Coliform total solids CFU
1000 mpn per gram
of total solid (dry
weight)
[Salmonella bacteria 3 MPN per 4 grams ,
(in lieu of fecal total solid(dry
coliform) weight)
Vector Attraction Reduction (15A NCAC 02T.1107)-Please indicate alternative performed:
Alt.! (VS reduction) 0 Alt.2 (40-clay bench) ❑ Alt. 3(30-day bench) ❑ Alt.4(Spec.02 uptake) ❑
Alt. 5(14-Day Aerobic) ❑ Alt. 6(Alk.Stabilization ❑ Alt 7(Drying-Stable) 0 Alt.8 D( tying-Unstable) D.
Alt. 9(Injection) El Alt. 10(Incorporation) El No vector attraction reduction alternatives were performed ❑
CERTIFICATION STATEMENT(please check the appropriate statement)
0 "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 check 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."
Bradley Vann,ORC Wesley Wooten,President
Preparer Name and Title(type or pri ) Land Applier Name and Title(if applicable)(type or print)
1/26/22 ! /
Gi 3/18/21
Signature of Preparer* Date Signature of LAW Applier(if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r)and 15A NCAC 2T.1102(26)
.. nr� n rr�r.a nti rr�� nnr rsnr.»tii.n.

LEWIS FARMS
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater Treatment Plant
Date Sampled: December 27,2021
Horse Creek Farms Permit No.WQ0000455
3.30 %Solids
7.19 pH
Parameter % Mg/Kg Dry Weight Pounds/Dry Ton
(%x 10,000) (Mg/Kg x 0.002)
Nitrogen(TKN) 5.680 56,800.000 113.600
Phosphorus 2.210 22,100.000 _ 44.200
Potassium 0.298 2,980.000 5.960
PAN(injected)* 2.000 20,000.530 40.001
PAN(surface)* 1.789 17,890.530 35.781
Ammonia Nitrogen 0.422 4,220.000 8.440
Calcium 0.211 2,110.000 4.220
Calcium Carbonate Eq. -- --- ___
Magnesium --- 2,110.000 4.220
Sodium --- 3,790.000 7.580
Sulfur --- --- --
Nitrate N/Nitrite N --- _ 6.530 0.013
Barium --- --- --- _ SAR
Chloride --- --- --- 2.52
Iron --- --- --- Ceiling Concen.
Aluminum --- 226.00 0.452 (Mg/Kg)
Arsenic --- 27.80 0.056 _ 75
Cadmium --- 27.80 0.056 85
Chromium --- 27.800 --- —
Copper --- 367.00 0.734 4,300
Lead --- 27.80 0.056 840
Mercury --- 1,80 0.004 57
Molybdenum --- 27.80 0.056_ 75
Nickel --- 27.80 0.056 420
Selenium --- 27.80 0.056 100
Zinc --- 4,610.00 9.220 7,500
Environmetal Chemists,Inc. 2021-22769
*Determination of Plant Available Nitrogen(PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia N)+Ammonia N+Nitrate N+Nitrite N=%PAN
Surface Application:
(Mineralization Rate)(TKN-Ammonia N)+(0.5)(Ammonia N)+Nitrate N+Nitrite N=%PAN
Note: Constituents N.D.(Not Detected)or<detection limits arc listed as detection limits
for calculation purposes.

LEWIS FARMS
WQ0000455
Horse Creek
:::,et
��?xxn. Lo
12/27/21 34,628 _ 4.5394
12/27/21 46,921 4.6714
12/27/21 18,621 4.2700
12/27/21 11,076 4.0444
12/27/21 7,718 3.8875
12/27/21 _ 79,208 4.8988
, 12/27/21 30,464 4.4838
Total 30.7952
Average 4.3993
Geometric Mean 5O$p € Fecal Coliform MPN/gram
Geometric Mean of Less than 2,000,000 meets Class B -Alternative 1 Pathogen for Reduction
requirement.

r4. t Environmental Chemists, Inc.
t:vat, '° -) 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
. . _;R � ., 710 Bowsertown Road,Manteca,NC 27954 • 252.473.5702 Lab/Fax
�-`� ,Ai 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS info c@r environmentalchemists.com
Lewis Farms & Liquid Waste, INC. Date of Report: Jan 24, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Wesley Wooten Report#: 2021-22769
Project ID: Annual Sludge 1-torieLen eJC
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56929 Site: 1 12/27/2021 7:50 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 3.09% 12/27/2021
Fecal Density SM 9221C E-2014 34628 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56930 Site:2 12/27/2021 7:51 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 3.41 % 12/27/2021
Fecal Density SM 9221C E-2014 46921 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56931 Site:3 12/27/2021 7:52 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.90% 12/27/2021
Fecal Density SM 9221C E-2014 18621 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56932 Site:4 12/27/2021 7:53 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 8 3.16% 12/27/2021
Fecal Density SM 9221C E-2014 11076 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56933 Site:5 12/27/2021 7:54 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 3.11 % 12/27/2021
Fecal Density SM 9221C E-2014 7718 MPN/g 12/27/2021
Report 4: 2021-22769 Page 1 of 3

, i Environmental Chemists Inc.
k „fjL a C^' 6 is 6602 Windmill Way,Wilmington,NC 28405 a 910.392.0223 Lab Y 910.392.4424 Fax
' } "'i,:fd ry� Tti F ; , M) 71.0 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
7 - -- 255-A Wilmington Highway,Jacksonville,NC 28540 •
'`L~`F �' g910.347.5643 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Lewis Farms & Liquid Waste, INC. Date of Report: Jan 24, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Wesley Wooten Report#: 2021-22769
Project ID: Annual Sludge )-foist.Crcc-.k.
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56934 Site: 6 12/27/2021 7:55 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) sM 2540 a 3.03% 12/27/2021
Fecal Density SM 9221C E-2014 79208 MPN/g 12/27/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56935 Site: 7 12/27/2021 7:56 AM Solid/Sludge Client
Test Method Results Date Analyzed
Total Solids (%) 5M 2540 B 3.02% 12/27/2021
Fecal Density SM 9221C E-2014 30464 MPN/g 12/27/2021
Report# 2021-22769
Page 2 of 3

. �., av_ Environmental Chemists, Inc.
.n 1 4 'LLTo1 �I e 9. 6602 Windmill Way,Wilmington,NC 28405 910.392.0223 Lab • 910.392�1424 Fax
rf a.' .; . '' . 710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
=:,;.'w.w=. - ;.": 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Lewis Farms & Liquid Waste, INC. Date of Report: Jan 24, 2022
8155 Malpass Corner Road Customer PO#:
Currie NC 28435 Customer ID: 14020008
Attention: Wesley Wooten Report#: 2021-22769
Project ID: Annual Sludge J-10,6e _r-e-a,_
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-56936 Site: Sludge 12/27/2021 7:45 AM Solid/Sludge Client
Test Method Results Date Analyzed
Sludge Residuals
Aluminum EPA 200.7,Rev,4,4.1994 226 mg/kg 01/04/2022
Arsenic EPA 200.7,Rev.4.4,1994 <27.8 mg/kg 01/04/2022
Cadmium EPA 200.7,Rev.4.4,1994 <27.8 mg/kg 01/04/2022
Calcium EPA 200.7,Rev.4.4,1994 2110 mg/kg 01/04/2022
Chromium EPA 200.7,Rev.4.4,1994 <27.8 mg/kg 01/04/2022
Copper EPA200.7,Rev.4.4,1994 367mg/kg 01/04/2022
Lead EPA 200.7,Rev.4.4,1994 <27.8 mg/kg 01/04/2022
Magnesium EPA 200.7,Rev.4.4,1994 2110 mg/kg 01/04/2022
Molybdenum EPA 200.7,Rev.4.4,1994 <27.8 mg/kg 01/04/2022
Nickel EPA 200.7,Rev.4 4,1994 <27.8 mg/kg 01/04/2022
Potassium EPA 200.7,Rev.4.4,1994 2980 mg/kg 01/04/2022
Selenium EPA 200.7,Rev.4.4,1994 <27.8 mg/kg 01/04/2022
Sodium EPA 200.7,Rev.4.4,1994 3790 mg/kg 01/07/2022
Zinc EPA 200.7,Rev.4.4,1994 4610 mg/kg 01/04/2022
Nitrate+Nitrite-Nitrogen EPA 353.2 6.53 mg/kg 12/28/2021
Total Solids (%) SM 2540 B 3.30% 12/27/2021
Ammonia Nitrogen SM 4500 NH3 C-2011 4220 mg/kg 12/28/2021
Total Kjeldahl Nitrogen (TKN) SM 4500 Norg B-2011 56800 mg/kg 12/28/2021
Total Phosphorous SM 4500 P(F-H)-2011 22100 mg/kg 12/30/2021
pH SW 046 Method 9045D 7.19 units 01/14/2022
Result estimated. Analyzed out of 15 minutes hold time.
Mercury SW-B46 7471 B 1.80 mg/kg 01/05/2022
Comment: Results, except pH, reported on a dry weight basis. pH reported on an as received basis.
Reviewed by:
Report#'. 2021-22769
Page 3 of 3

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM(02T Rules)
Facility Name: Lewis Farms and Liquid Waste,Inc. WQ Permit Number: WQ0000455
WWTP Name: Horse Creek WWTP NPDES Number: NC0062359
Monitoring Period: From 1/1/2021 To 12/31/2021
Pathogen Reduction (15A NCAC 02T.1106)-Please indicate level achieved and alternative performed:
Class A: Alt. A(time/teAnp) ❑ Alt B (Alk Treatment)❑ I Alt.C(Prior Testing)❑
AIt.D(No Prior Test) 0 Process to Further Reduce Pathogengs ❑
If applicable to alternative performed(Class A only)indicate"Process to Further Reduce Pathogens":
Compost ❑ Heat Drying ❑ Heat Treatment ❑ Thermophilic 0
Beta Ray 0 Gamma Ray ❑ Pasteurization ❑
Class B: JAlt.(1)Fecal Density El Alt. (2)Process to Significantly Reduce Pathogens ❑
If applicable to alternative performed(Class B only)indicate"Process to Significantly Reduce Pathogens":
Lime Stabilization 0 AirDrying ❑ Composting Aerobic Digestion p g ❑ I 0
Anaer
obic Digestion ❑ WMMMRMMMMWVMOWMMMUMWPMNWWM
If applicable to alternative performed(Class A or Class B)complete the following monitoring data:
Number of Anal Kcal
Parameter Allowable Level Pathogen Density Frequency Sample
Tech-
in Sludge Excee- of Anal T e Teeh
g Minimum Geo.Mean Maximum Units deuces ysis yp niotie
2 x 10 to the MPN 7,718 25,080 79,208 MPN/g 0 Annual Grab SM9221C
6th power
per gram of CFU
Fecal Coliform total solids
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria 3 MPN per 4 grams
(in lieu of fecal total solid(dry
coliform) weight)
Vector Attraction Reduction(15A NCAC 02T.1107)-Please indicate alternative performed:
Alt.1 (VS reduction) ❑ Alt.2(40-day bench) ❑ Alt.3 (30-day bench) ❑ Alt.4(Spec.0,uptake) ❑
Alt.5 (14-Day Aerobic) ❑ Alt.6(Alk.Stabilization 0 Alt 7(Drying-Stable) ❑ Alt. 8(Drying-Unstable) 0
Alt.9(Injection) p Alt. 10(Incorporation) [J No vector attraction reduction alternatives were performed ❑
CERTIFICATION STATEMENT(please check the appropriate statement)
El "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 check 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."
Jeff Jarmon,ORC Wesley Wooten,President
Preparer Name and Title(type or print) Land Applier Name and Title(if applicable)(type or print)
1/31/2022 /
.t/ 1/27/22
Signature f epa r* Date Signature of Land pplier(if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r)and 15A NCAC 2T.1102(26)
DENR FORM PVRF 02T(12/2006)

LEWIS FARMS
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater Treatment Plant
Date Sampled: November 16,2021
River Bend Permit No.WQ0000455
3.88 %Solids
7.04 pH
Parameter % Mg/Kg Dry Weight Pounds/Dry Ton
(%x 10,000) (Mg/Kg x 0.002)
Nitrogen(TKN) 3.960 39,600.000 79.200
Phosphorus 2.750 27,500.000 55.000
Potassium 0.257 _ 2,570,000 5.140
PAN(injected)* _ 1.190 11,896.006 23.792
PAN(surface)* 1.189 11,894.716 23.789
Ammonia Nitrogen _ 0.000 2.580 0.005
Calcium 7.730 77,300.000 154.600
Calcium Carbonate Eq. --- --- ___
Magnesium --- 2,940.000 5.880
Sodium --- 3,350.000 6.700
Sulfur --- --- ---
Nitrate N/Nitrite N --- 14.200 0.028
Barium --- --- --- SAR
Chloride --- --- --- 0.63 i
Iron --- ---
--- Ceiling Concen.
Aluminum _ --- 9,870.00 19.740 (Mg/Kg)
Arsenic --- 30.67 0.06! 75
Cadmium --- 15.30 0.031 _ 85
Chromium --- 22.900 --- —
Copper --- 1,070.00 2.140 4,300
Lead --- 17.30 0.035 840
Mercury --- 2.3I 0.005 57
Molybdenum --- 15.30 _ 0.031 75
Nickel --- _ 17.80 0.036 420
Selenium --- _ 15.30 0.031 100
Zinc --- 1,150.00 2.300 7,500
Environmental Chemists,Inc: 202 1-203 1 9
*Determination of Plant Available Nitrogen(PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia N)+Ammonia N+Nitrate N+Nitrite N=%PAN
Surface Application:
(Mineralization Rate)(TKN-Ammonia N)+(0.5)(Ammonia N)+Nitrate N+Nitrite N=%PAN
Note: Constituents N.D.(Not Detected)or<detection limits arc listed as detection limits
for calculation purposes.

LEWIS FARMS
WQ0000455
River Bend WWTP
::: : ]:ate Fecal:° :: `° Q
11/16/21 _ 118 2..0719
11/16/21 51 1.7076
_ 11/16/21 44 1.6435
11/16/21 113 2.0531
11/16/21 52 1.7160
11/16/21 112 2.0492
11/16/21 44 1.6435
Total I 12.8847
Average 1.8407
Geometric Mean Fecal Coliform MPN/gram
Geometric Mean of Less than 2,000,000 meets Class B -Alternative 1 Pathogen Reduction
requirement.

,, - V ;; ^yyy� yyEE , Environmental Chemists, Inc.
.k �,a y i deli a �:' 6602 Windmill Way,Wilmington,NC 28405 • 910,392.0223 Lab • 910.392.4424 Fax
` ` 4" '4 7r -•4: ''',SM. 710 Bowsertown Road,Maraca,NC 27954 • 252.473.5702 Lab/Fax
7 _.'„ t 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Town of River Bend Date of Report: Dec 20, 2021
45 Shoreline Drive Customer PO#:
New Bern NC 28562 Customer ID: 12110004
Attention: Brandon Mills Report#: 2021-20319
Project ID: Annual Sludge
Lab ID Sample ID: Collect DatelTime Matrix Sampled by
21-50930 Site: Sludge 11/16/2021 8:35 AM Solid/Sludge Brandon Mills
Test Method Results Date Analyzed
Chlordane (TCLP) SW-846 8081 B <0.02 mg/L 11/29/2021
Endrin (TCLP) SW-846 8081 B <0.0005 mg/L 11/29/2021
Heptachlor(TCLP) SW-848 6081 B <0.0005 mg/L 11/29/2021
Heptachlor epoxide (TCLP) SW-846 6081 B <0.0005 mg/L 11/29/2021
Lindane (TCLP) SW-646 8081 B <0.0005 mg/L 11/29/2021
Methoxychlor(TCLP) SW-846 8081 s <0.0005 mg/L 11/29/2021
Toxaphene (TCLP) SW-846 8081 B <0,05 mg/L 11/29/2021
2,4,5-TP (TCLP) SW-846 8151 A <0,003 mg/L 11/23/2021
2,4-D (TCLP) SW-846 8151 A <0.003 mg/L 11/23/2021
1,4-Dichlorobenzene (TCLP) SW-846 8270 E <0.050 mg/L 11/24/2021
2,4,5-Trichlorophenol (TCLP) SW-846 8270 E <0.050 mg/L 11/24/2021
2,4,6-Trichlorophenol (TCLP) SW-846 8270 E <0.050 mg/L 11/24/2021
2,4-Dinitrotoluene (TCLP) SW-8468270E <0.050 mg/L 11/24/2021
Cresol(TCLP) SW846 8270 E <0.050 mg/L 11/24/2021
Hexachloro-1,3-butadiene (TCLP) SW-846 8270 E <0.050 mg/L 11/24/2021
Hexachiorobenzene (TCLP) SW-846 8270 E <0.050 mg/L 11/24/2021
Hexachloroethane (TCLP) SW-846 8270 E <0.050 mg/L 11/24/2021
m + p-Cresol (TCLP) SW-846 8270E <0.050 mg/L 11/24/2021
Nitrobenzene (TCLP) SW-846 8270 E <0,050 mg/L 11/24/2021
o-Cresol (TCLP) sW-646 8270 E <0.050 mg/L 11/24/2021
Pentachlorophenol (TCLP) SW-846 8270 E <0.250 mg/L 11/24/2021
Pyridine (TCLP) SW-846 8270 E <0.050 mg/L 11/24/2021
1,1-Dichloroethyiene (TCLP) SW-846 Method 8260D <0.01 mg/L 11/24/2021
1,2-Dichloroethane (TCLP) SW-846 Method 8260D <0.01 mg/L 11/24/2021
Benzene (TCLP) SW-846 Method 8260D <0.01 mg/L 11/24/2021
Carbon Tetrachloride (TCLP) SW-846 Method 82600 <0.01 mg/L 11/24/2021
Report#:: 2021-20319 Page 1 014

,F�,riA' n � ` Environmental Chemists, Inc.
F
4,,, • a! r L N y I
s; 1YXrC� 11e 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 91.0.392.4424 Fax
�.' -''` `-att 3; '. �M 710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
C ~" 255-A Wilmington Highway,Jacksonville,NC 28540 •
-" - r`-��� �� � 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Town of River Bend Date of Report: Dec 20, 2021
45 Shoreline Drive Customer PO#:
New Bern NC 28562 Customer ID: 12110004
Attention: Brandon Mills Report#: 2021-203 1 9
Project ID: Annual Sludge
Chlorobenzene (TCLP) SW-846 Method 8260D <0.01 mg/L 11/24/2021
Chloroform (TCLP) SW-846 Method 8260D <0,01 mg/L 11/24/2021
Methyl ethyl ketone (TCLP) SW-846 Method 82800 <0.05 mg/L 11/24/2021
Tetrachloroethylene (TCLP) SW-846 Method 8260D <0,01 mg/L 11/24/2021
Trichloroethylene (TCLP) SW-846 Method 8260D <0.01 mg/L 11/24/2021
Vinyl Chloride (TCLP) SW-846 Method 8260D <0.01 mg/L 11/24/2021
Sludge Residuals
Aluminum EPA 200.7,Rev.4.4,1994 9870 mg/kg 11/18/2021
Arsenic EPA 200.7,Rev.4 4,1994 <30.67 mg/kg 11/30/2021
Cadmium EPA 200.7,Rev.4.4,1994 <15.3 mg/kg 11/18/2021
Calcium EPA 200.7,Rev.4.4.1994 77300 mg/kg 11/18/2021
Chromium EPA 200.7.Rev.4 4.1994 22.9 mg/kg 11/18/2021
Copper EPA 200 7,Rev.4.4,1994 1070 mg/kg 11/18/2021
Lead EPA 200.7,Rev.4.4,1994 17.3 mg/kg 11/18/2021
Magnesium EPA 200.7,Rev.4.4,1994 2940 mg/kg 11/18/2021
Molybdenum EPA 200,7,Rev.4.4.1994 <15,3 mg/kg 11/18/2021
Nickel EPA 200.7,Rev.4 4,1994 17.8 mg/kg 11/18/2021
Potassium EPA 200.7,Rev.4.4,1994 2570 mg/kg 11/18/2021
Selenium EPA 200.7,Rev.4.4,1994 <15.3 mg/kg 11/18/2021
Sodium EPA 200.7,Rev 4.4,1994 3350 mg/kg 11/18/2021
Zinc EPA 200.7,Rev.4.4,1994 1150 mg/kg 11/18/2021
Nitrate+Nitrite-Nitrogen EPA 353.2 14.2 mg/kg 11/18/2021
Total Solids (%) SM 2540 B 3.88% 11/18/2021
Ammonia Nitrogen SM 4500 NH3 C-2011 <2.58 mg/kg 11/17/2021
Total Kjeldahl Nitrogen (TKN) SM 4500 Norg B-2011 39600 mg/kg 11/17/2021
Total Phosphorus SM 4500 P F-2011 27500 mg/kg 11/29/2021
pH SW 846 Method 9045D 7.04 units 11/23/2021
Result estimated, Analyzed out of 15 minutes hold time.
Mercury SW-8467471 B 2.31 mg/kg 11/18/2021
TCLP Metals
Report#: 2021-20319
Page 2 of 4

. 4 �%e .� Environmental Chemists, Inc.
ny �envLJ oc o ' 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
�.r 't, ' ` 710 Bowsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
:` .., '" 255-A Wilmington Highway,Jacksonville,NC 28540 • 910,347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS info@environmen talchemists.com
Town of River Bend Date of Report: Dec 20, 2021
45 Shoreline Drive Customer PO#:
New Bern NC 28562 Customer ID: 12110004
Attention: Brandon Mills Report#: 2 02 1-203 1 9
Project ID: Annual Sludge
Arsenic EPA 200.7,Rev.4.4,1994 <1.0 mg/L 12/06/2021
Barium EPA 200,7,Rev.4.4.1994 <1.0 mg/L 12/06/2021
Cadmium EPA 200.7,Rev.4.4,1994 <1.0 rng/L 12/06/2021
Chromium EPA 200,7,Rev.4.4,1994 <1.0 mg/L 12/06/2021
Lead EPA 200.7,Rev.4.4,1994 <1.0 mg/L 12/06/2021
Selenium EPA 200.7,Rev.4.4,1994 <1.0 mg/L 12/06/2021
Silver EPA 200.7,Rev.4.4,1994 <1.0 mg/L 12/06/2021
Mercury EPA 245.1 <0.0002 mg/L 11/30/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-50931 Site: Sludge#1 11/16/2021 8:37 AM Solid/Sludge Brandon Mills
Test Method Results Date Analyzed
Total Solids (%) 5M 2540 B 3.83% 11/18/2021
Fecal Density SM 9221C E-2014 118 MPN/g 11/16/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-50932 Site: Sludge#2 11/16/2021 8:39 AM Solid/Sludge Brandon Mills
Test Method Results Date Analyzed
Total Solids (%) 5M 2540 B 3.98% 11/18/2021
Fecal Density SM 9221C E-2014 51 MPN/g 11/16/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-50933 Site: Sludge#3 11/16/2021 8:40 AM Solid/Sludge Brandon Mills
Test Method Results Date Analyzed
Total Solids(%) 5M 2540 B 4.10 o/a 11/18/2021
Fecal Density SM 9221C E-2014 <44 MPNIg 11/16/2021
Report#:' 2021-20319
Page 3 of 4

=x- �, '' _.-s- Environmental Chemists, Inc.
6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab ' 910.392.4424 Fax
r,,• ' .;if :,*e 710 Bowsertown Road,Manteo,NC 27954 " 252.473.5702 Lab/Fax
• .„,f,,t' #' rM` 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS [e-mail]
Town of River Bend Date of Report: Dec 20, 2021
45 Shoreline Drive Customer PO#:
New Bern NC 28562 Customer ID: 12110004
Attention: Brandon Mills Report#: 2021-20319
Project ID: Annual Sludge
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-50934 Site: Sludge#4 11/16/2021 8:42 AM Solid/Sludge Brandon Mills
Test Method Results Date Analyzed
Total Solids (%) SM 2540 8 3.99% 11/18/2021
Fecal Density SM 9221C E-2014 113 MPN/g 11/16/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-50935 Site: Sludge#5 11/16/2021 8:43 AM Solid/Sludge Brandon Mills
Test Method Results Date Analyzed
Total Solids (%) 5M 2540 8 3.91 % 11/18/2021
Fecal Density SM 9221C E-2014 52 MPNIg 11/16/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-50936 Site: Sludge#6 11/16/2021 8:45 AM Solid/Sludge Brandon Mills
Test Method Results Date Analyzed
Total Solids (%) SM 254013 4,04% 11118I2021
Fecal Density SM 9221C E-2014 112 MPN/g 11/16/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-50937 Site: Sludge#7 11/16/2021 8:47 AM Solid/Sludge Brandon Mills
Test Method Results Date Analyzed
Total Solids (%) SM 2540 8 4,12% 11/18/2021
Fecal Density SM 9221C E-2014 <44 MPN/g 11/16/2021
Comment: Sludge residuals, except pH, reported on a dry weight basis. pH reported on an as received basis.
Reviewed by: & 1x1D., O)i OAj
Report#_: 2021-20319 � ••••••-
Page 4 of 4

Environmental Chemist, Inc., Wilmington, NC Lab#94
6602 Windmill Way
Wilmington, NC 28405
910.392.0223
Sample Receipt Checklist
Client \LI> .. ?) b) ro[AN Date! 1 l f ozi Report Number:_ 02,l—a 1)3/ 9
Receipt of sample: ECHEM Pickup Client Delivery 0 1UPS 0 FedEx 0 Other 0
❑ YES [❑ NO lki
N/A 1. Were custody seals present on the cooler?
❑ YES ❑ NO k N/A 2. If custody seals were present were they
y intact/unbroken?ntact/unbroken.
Original temperature upon receipt o(r r -°C Corrected temperature upon receipt °C
How temperature taken: 0 Temperature Blank T Against Bottles
IR Gun ID:Thomas Traceable 5/N 192511657 IR Gun Correction Factor°C: 0.0
❑ YES 0 NO 3. If temperature of cooler exceeded 6°C,was Project Mgr./QA notified?
Ra YES 0 NO 4. Were proper custody procedures(relinquished/received)followed?
y_ YES CI NO 5. Were sample ID's listed on the COC?
YES D NO 6. Were samples ID's listed on sample containers?
'i YES El NO 7. Were collection date and time listed on the COC?
►+ YES 0 NO 8. Were tests to be performed listed on the COC?
4+ YES ❑ NO 9. Did samples arrive in proper containers for each test?
►i YES 0 NO 10. Did samples arrive in good condition for each test?
YES ❑ NO 11. Was adequate sample volume available?'
Vd YES 0 NO 12. Were samples received within proper holding time for requested tests?
0 YES 0 NO 13. Were acid preserved samples received at a pH of<2? *
0 YES ❑ NO 14. Were cyanide samples received at a pH>12?
0 YES ❑ NO 15. Were sulfide samples received at a pH >9?
❑ YES 0 NO 16. Were NH3/TKN/Phenol received at a chlorine residual of<0.5 rn/L? **
❑ YES ❑ NO 17. Were Sulfide/Cyanide received at a chlorine residual of<0.5 m/L?
0 YES 0 NO 18. Were orthophosphate samples filtered in the field within 15 minutes?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
** Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet.
Sample Preservation: (Must be completed for any sample(s)incorrectly preserved or with headspace)
Sample(s) were received incorrectly preserved and were adjusted accordingly
by adding(circle one): H2504 HNO3 HCI NaOH
Time of preservation: If more than one preservative is needed, notate in comments below
Note:Notify customer service immediately for incorrectly preserved samples.Obtain a new sample or
notify the state lab If directed to analyzed by the customer.Who was notified,date and time:
Volatiles Sample(s) were received with headspace
COMMENTS:
DOC.QA.002 Rev 1

no 4_h.• u.lo9_to,51 ENVIRONMENTAL CHEMISTS, INC OFFIWindmill
i`"g o`_3 281FAX[phone]
Analytical&Consulting Chemists NCDENR:DWQ CERTIFICATION#94 NCDHHS: DLS CERTIFICATION#37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY
Client: Town of Riverbend WWTP PROJECT NAME: Annual Sludge REPORT NO: /_ £03f 9
ADDRESS: 45 Shoreline Drive CONTACT NAME: Brandon Mills, ORC PO NO:
New Bern, NC 28562 REPORT TO: PHONEIFAX: 252.229.2813
COPY TO: Email:
Sampled By: z i/��Ll( /e74_, /4r,2.?r/ s SAMPLE TYPE: I =Influent, E=Effluent,W=Well, ST=Stream, SO=Soil, SL=Sludge, Other:
Collection 0 PRESERVATION
Sample Identification Q a a l5 b `� 15` g m
F E ° 8 e ° -z E m g w d N o 0 o w ANALYSIS REQUESTED
Date Time Temp CO0
z z = = I Z o
Sludge _ G 5°9.30 X utrient/metals (sludge anay,
/I/6 V/ , ' 3 `': C
SI ea G X i �uII TCLP
J Ji/ r ‘Z-.'5? C � �s�
SI ) G ®ql X Fecal density/%TS
f r// -4 gf r C 33
/, f � � SI G az X Fecal density/%T5
SI G 33 X Fecal densi !%TS
L( ICI i K�-2 C CIP
SI G 57 X C Fecal densi °
f*t 5<rILT C V ,,
/ SI 0 , G , 357 X Fecal density/%TS
1p / C
!!! SI G X Fecal density/%T
, SI7—P-LC G 37 X Fecal density/%TS
Transfer Relinquished By: Date/Time eceived By: DatelTime
1. - ' 111)// 6 00 i 9W if Ph 4i a 0-3.-
Temperature a e' d °C: iT Accepted: Rejected: Resam I Re uested:
Delivered By Received By: Date: � Time:
Comments: TURNA OUND:

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM(02T Rules)
Facility Name: Lewis Farms&Liquid Waste,Inc. WQ Permit Number: WQ0000455
WWTP Name: River Bend NPDES Number: NC0030406
Monitoring Period: From 1/1/2021 To 12/31/2021
Pathogen Reduction (15A NCAC 02T.1106)-Please indicate level achieved and alternative performed:
Class A: Alt.A(time/temp) D. Alt B (Alk Treatment)❑ Alt.C(Prior Testing}❑
A1t.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 0 Thennophilic ❑
Beta Ray p 'Gamma Ray ❑ Pasteurization D ......................,. } ...
....-......-.....-....
Class B: Alt. (1).Fecal Density p I Alt. (2)Process to Significantly Reduce Pathogens 0 , I
If applicable to alternative performed(Class B only)indicate"Process to Significantly Reduce Pathogens":
Lime Stabilization ❑ Air Drying ❑ Composting ❑ 'Aerobic Digestion ❑
Anaerobic Digestion _ _
g
r stian
g ❑
If applicable to alternative performed (Class A or Class B) complete the following"monitoring data:
Parameter Allowable Level Pathogen Density Numberot Analytical
Frequency Sample
in Sludge Excee-• of AnalysisTypeTech-
Minimum Geo.Mean Maximum Units ctence4 nine
2 x 10 to the
6th Doer MPN 44 69 118 MPN/g 0 Annual Grab SM922106
P
per gram of '
Fecal Colifortn total solids CFU
1000 mpn per gram -
of-total solid (dry
weight)
Salmonella bacteria 3 MPN per 4 grams
(in lieu of fecal total solid(dry
coliform) weight)
Vector. Attraction Reduction (15A NCAC 02T.1107)-Please indicate alternative performed:
Alt.1 (VS reduction) ❑ Alt.2(40-day bennch) 0 Alt.3(30-day bench) ❑_Alt.4(Spec.02 uptake) ❑
Alt.5(14-Day Aerobic) ❑ Alt.6(Alk.Stabilization 0 Alt 7(Drying-Stable) ❑ Alt..8 (Drying-Unstable) ❑
Alt.9(Injection) p Alt. 10(Incorporation) Q No vector attraction reduction alternatives were performed ❑
CERTIFICATION STATEMENT(please check the appropriate statement)
ID "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 havebeen met"
• El "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 check 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."
Brandon Mills,ORC Wesley Wooten,President
Preparer Name and Title(type or print) Land Applier Name and Title(if applicable)(type or print)
a �, 1 � f/�j / 1/3/21
S gnature of Preparer* Date Signature of Land Applier(if applicable)P ) Date
*Preparer is defined in 40 CFR Part 503.-9(r)and 15A NCAC 2T.1102(26)

LEWIS FARMS
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater Treatment Plant
Date Sampled: February 11,2021
Trenton Permit No.WQ0000455
3.02 %Solids
11.98 pH(taken from Lime Stab.)
Parameter % Mg/Kg Dry Weight Pounds/Dry Ton
(%x 10,000) (Mg/Kg x 0.002) i
'Nitrogen(TKN) - 0.580 5,803.000 11.606
Phosphorus 0.334 _ 3,343.000 6.686
Potassium 0.072 721.000 1.442_
PAN(injected)* 0.182 1,818.632 3.637
PAN(surface)* 0.180 1,798.702 3.597
Ammonia Nitrogen 0.004 39.860 _ 0.080
Calcium 39.048 390,483.000 _ 780.966
Calcium Carbonate Eq. --- ---
Magnesium --- 2,232.000 4.464
Sodium --- 1,427.000 2.854
Sulfur --- ___ -_
Nitrate N/Nitrite N --- 49.830 0.100
Barium --- --
_ _ - SAR
Chloride --- --- --- 0.11
Iron --- --- --- Ceiling Concen.
Aluminum --- 4,052.00 8.104 (Mg/Kg)
Arsenic --- 2.50 _ 0.005 75
Cadmium --- 0.50 0.001 _ 85
Chromium --- —
Copper --- 32.00 0.064 4,300
Lead --- 3.90 0.008 840
Mercury --- 0.04 0.000 57
Molybdenum --- _ 5.00 0.010 75
Nickel --- 5.00 0.010 420
Selenium --- _ 5.00 0.010 100
Zinc _ --- 121.00 0.242 7,500
Environment 1,Inc.# 268 B
*Determination of Plant Available Nitrogen(PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia N)+Ammonia N+Nitrate N+Nitrite N=%PAN
Surface Application:
(Mineralization Rate)(TKN-Ammonia N)+(0.5)(Ammonia N)+Nitrate N+Nitrite N=%PAN
Note: Constituents N.D.(Not Detected)or<detection limits are listed as detection limits
for calculation purposes.

Evrir[iQ©imaicgER fig [lEcoucsmiNd
Drinking water 1Di 37715
wastewater 'Dm to
114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27858 FAX[phone]
IDS: 268 13
TOWN OF TRENTON WWTP
ATTN: TONY HAWKINS
HAWKINS WASTEWATER DATE COLLECTED: 02/11/21
202 HWY. 41 W. DATE REPORTED : 03/25/21
TRENTON ,NC 28585
1z>JvzzaWzan BY:
Digester Analysis Method
PARAMETERS Date Analyst Code
Aluminum, (dry wt. basis), mg/kg 4052 03/05/21 LFJ EPA200.7
Arsenic (dry wt. basis), ing/kg <2.5 03/02/21 MTM 3113B-04
Calcium (dry wt. basis), mg/kg 390483 03/05/21 LFJ EPA200.7
Cadmium (dry wt. basis), mg/kg <0.5 03/01/21 MTM 3113B-04
Copper (dry wt. basis), mg/kg 32 03/23/21 LFJ EPA200.7
Lead (dry weight basis), mg/kg 3.9 03/03/21 MTM 3113B-04
Magnesium (dry wt. basis), mg/kg 2232 03/05/21 LFJ EPA200.7
Mercury (dry wt. basis), mg/kg <0.04 02/23/21 MTM EPA7471B
Nickel (dry wt. basis), mg/kg <5.0 03/05/21 LF.T EPA200.7
Potassium (dry wt. basis), nig/kg 721 03/05/21 LFJ EPA200.7
Selenium (dry wt. basis), mg/kg <5.0 03/03/21 MTM 3113B-04
Sodium (dry wt. basis), mg/kg 1427 03/05/21 LFJ EPA200.7
Zinc (dry wt. basis), mg/kg 121 03/06/21 LFJ EPA200.7
Sodium Adsorption Ratio (calc) 0.6
Total Solids, % 3.02 02/1I/21 JMS 2540G-11
TKN (dry wt.), mg/kg c 5803 02/16/21 ICES 351.2 R2-93
Ammonia Nitrogen (dry wt.),mg/kg c 39.86 02/18/21 KES 350.1 R2-93
Phosphorus, T. (dry wt.), mg/kg c 3343 02/16/21 TLH 365.4-74
Nitrate-Nitrite (dry wt.), mg/kg c 49,83 02/17/21 ICES 353.2 R2-93
Plant Available Nitrogen, mg/kg 1799 02/20/21 MAO
Molybdenum (dry wt. basis), mg/kg <5.0 03/05/21 LFJ EPA200.7
c Uncertified data, DWR does not offer non-aqueous certification for this analytical procedure.

Environment I,Inc. CHAIN OF CUSTODY RECORD
P.O.Box 7085, I[4 Oakmont Dr. Page 1 of I
Greenville,NC 27858 _
en vironme ntl Inc.co n DISINFECTION CHLORINE NEUTRALIZED AT COLLECTION
Phone[phone] a Fax[phone]
CHLORINE - -
C .IENT: 268 B Week: 12 pH CHECK(LAB)
!iv
'OWN OF TRENTON WWTP [J NONE P PPPPP CONTAINER TYPE,P/G
.TTN:TONY HAWKINS
[AWHINS WASTEWATER L' � CHEMICAL PRESERVATION
02 HWY.41 W. A A A A A A A
'REN'TON NC 28585
7330 Cji A-NONE Q NAOH
"' a
C S-HNO3L52)521-7687 ¢ -g us z w .. :: E-HCL
T . E- w Z w C-H2SO, F-ZINC ACEfATEINAOH
COLLECTION _, ,_ w -1 O = a :- -
o E; z = G-NATHIOSULFATE
f SAMPLE LOCATION DATE TIME ° o L ¢ o r m s F O� Z a., CL
PAN Digester 2-I)_2} S to," 17,a - f.c` 4 :' ,.'.,t .- CLASSIFICATION:
- WASTEWATER(NPDES)
- - - ,„ DRINKING WATER
DWRIGW
LISOLID WASTE SECTION
CHAIN OF CUSTODY(SEAL)MAINTAINED
' L _ DURING SHIPMENT/DELIVERY
rep
_ N
SAMPLES COLLECTED BY:
. _ (Please Print)
- - - y 14 .,. ;-,/�s`-
SAMPLES RECEIVED IN LAB AT( 5 cc
REI.IN9.UISHED BY(Sr .) MPLER) DATEFIME RECEIVED BY(SIG.) DATE/TIME COMMENTS:
—<l / 1-/i-2 / ksz64-&-, #6 L,C.C2 ` Zit//2i 12
RELINQUISHED BY(SIG. DATEiiME DATE/TIME
l` °`� f 1 G
- I RECEIVED BY(SIG.) /
RELINQUISHED BY(SIG.) DATE/l1ME RECEIVED BY(SIG.) DATE/TIME
PLEASE READ Instructions for completing this form on the reverse side, Sampler must place a"C"for composite sample or a"G"for
FORM y5 Grab sample in the blocks above for each parameter requested. No 38 7 57 9

LEWIS FARMS AND LIQUID WASTE, INC.
WQ 0000455 ALKALINE STABILIZATION OF WASTEWATER BIOSOLIDS
Facility Name: Trenton P.0.#k h.r
Batch Size(gallons): 3 - '7".-„ k !osr)5 Lbs.or Gallons Used: Material Used For Stabilization: Lime -
Initial pH >12 pH 2 Hour pH 24 Hour pH Operator
Date pH Temp C Temp C Con-. Corrected Time pH Corr. Corrected llmt3 Corr, Corrected COM Corrected Initials
Factor+ pH Factor+ pH pH Temp C Time pH Temp C Time
Factor+ pH Factor+ pH
11.7z 12 ^.3 9 -i -3 3 l0:.r-) l2.E,`7� 7 Z -„. lt.Zr 11:03 )7,6) it -. 3 0a.22 c>J.'o.r 12.YO H -.42. jj.gt? 12:5'T rr
r
o L 4 N A rh CO) g; rn 0 rO r CO N CD N in
) 0 0 l r N N M p) C 7
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o_ 0. a 4. R. d 0. [L a a a a R 0. 2 2 g g g g g
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E ..,zr co co co) co CO Co co co Co) Cr) N N N N cV N N N N ci
F

LEWIS FARMS AND LIQUID WASTE, INC.
WQ 0000455 ALKALINE STABILIZATION OF WASTEWATER BIOSOLIDS
Facility Name: Trenton P.O.#
Batch Size(gallons): / 3, }CJ . Lbs.or Gallons Used: Material Used For Stabilization: Lime
Initial pH >12 pl-I 2 Hour pH 24 Hour pH Operator
Date pH Temp C Corr. Corroded Time pH Temp C Corr, Corrected Corr. Corrected Tim_ . Corrected Initials
Factor+ pH p Factor+ pH Time pH Temp C Factor+ pH Time pH Temp C Factor pH Time
''h' !--ICJ )'U: r'M1 .J9 11,l1. lZ;cil.r, l.,t" 2
«) N 0 CO In o Ih a CO C1-1 CV 0) CO CO 0) LC) Cr? 01 u) CO 'C n C cn CO 0) Cm 0)
O �' -- CO COP7 Cc) CV CO N r .- r 0 O O CI 0 g - n? c.r N CO CC) rC m v q
o (.? O O 0 O C7 Q 0 0 O o 0 ci O q p o q d d C o p 0 0 o O O o o d
N N N N N N N N N N U) U) N N N 0 J CO C i7 S C C C C 2 2 C = J
7 7 7 7 7 7 D 7 a c c c
ci " a. a a o- o- a. � a. o- a. a a o_ a. a 2 C S ; a
C)
CI O 0) 0) ti (D IC) 'c) (C) N d o7 00 N- (D t.0 - t*) N Y 6) CO N (.0tO
(7. • (C) co (0) t") rc) P') co M ce) M N N N N N N N N N N r c- Y— ,- , -- r �
F-

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM(02T Rules)
Facility Name: Lewis Farms&Liquid Waste,Inc. WQ Permit Number: WQ0000455
WWTP Name: Trenton NPDES Number: N00021342
Monitoring Period: From 1/1/2021 To 12/31/2021
Pathogen Reduction (15A NCAC 02T.1106)-Please indicate level achieved and alternative performed:
Class A: Alt. A(time/temp) ❑ I Alt B (Alk Treatment)(5-1 Alt.C(Prior Testing)❑
AIt.D(No Prior Test) ❑ I Process to Further Reduce Pathogengs 0
If applicable to alternative performed(Class A only)indicate"Process to Further Reduce Pathogens":
Compost ❑ Heat Drying ❑ Heat Treatment ❑ Thennophilic ❑
Beta Ray ❑ Gamma Ray ❑ Pasteurization ❑
Class B: Alt.(I)Fecal Density Q I Alt. (2)Process to Significantly Reduce Pathogens ❑
If applicable to alternative performed(Class B only)indicate"Process to Significantly Reduce Pathogens":
Lime Stabilization El L Air Drying 0 Composting ❑ Aerobic Digestion ❑
Anaerobic
If applicable to alternative performed(Class A or Class B) complete the following monitoring data:
Allowable Level Pathogen Density Number of Analytical
Parameter Excee- Frequency Sample
in Sludge Minimum Geo. Mean Maximum Units dencgs afAnalysis Type Tech-
2xI0tothe MPN
moue
6th power
per gram of
Fecal Coliform total solids CFU
I000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria 3 MPN per 4 grams
(in lieu of fecal total solid(dry
conform) weight)
Vector Attraction Reduction (15A NCAC 02T.1107)-PIease indicate alternative performed:
Alt.' (VS reduction) ❑ Alt 2(40-day bench) 0 Alt. 3 (30-day bench) ❑ Alt.4(Spec.p,uptake) ❑
Alt.5(14-Day Aerobic) ❑ Alt. 6(Alk. Stabilization p Alt 7(Drying-Stable) ❑ Alt. 8 (Drying-Unstable) 0
Alt.9(Injection) ❑ Alt. 1.0(incorporation) 0 No vector attraction reduction alternatives were performed ❑
CERTIFICATION STATEMENT(please check the appropriate statement)
<] "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.1.106 and the
vector attraction reduction requirement in 15A NCAC 02T.1107 have not been met." (Please note if
you check 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."
Tony Hawki s, ORC
Prepay r Name a d Tit' type or print) Land Applier Name and Title(if applicable)(type or print)
gignature of'?reparer* Date Signature of Land Applier(if applicable) Date
"Preparer is defined in 40 CFR Part 503.9(r)and 15A NCAC 2T.1102 (26)
DENR FORM PVRF 02T(12/2006)

LEWIS FARMS
LAND APPLICATION PROGRAM
RESIDUALS ANALYSIS
Residual Type: Wastewater Treatment Plant
Date Sampled: November 17,2021
Pluris-Webb Creek Permit No.WQ0000455
2.31 %Solids
6.96 pH
Parameter % Mg/Kg Dry Weight Pounds/Dry Ton
(%x 10,000) (Mg/Kg x 0.002)
Nitrogen(TKN) 7.090 70,900.000 141.800
Phosphorus 4.180 41,800.000 83.600
Potassium 0.606 6,060.000 12.120
PAN(injected)* 2.396 23,959.320 47.919
PAN(surface)* 2.204 22,039.320 44.079
Ammonia Nitrogen 0.384 3,840.000 7.680
Calcium _ 2.520 25,200.000 50.400
Calcium Carbonate Eq. _ --- --- ---
Magnesium --- 3,220.000 _ 6.440
Sodium --- 4,180.000 8.360
Sulfur --- --- ---
Nitrate N/Nitrite N --- 1.320 0.003 _
Barium --- --- --- SAR
Chloride --- --- --- _ 1.00
Iron --- --- --- Ceiling Concen.
Aluminum --- 18,100.00 36.200 (Mg/Kg)
Arsenic --- _ 21.00 0.042 75
Cadmium --- 21.00 0.042 85
Chromium --- 22.800 --- _-
Copper --- 278.00 0.556 _ 4,300
Lead --- _ 21.00 0.042 840
Mercury --- 0.723 0.001 57
Molybdenum --- 21.00 0.042 75
Nickel --- 21.00 0.042 _ 420
Selenium --- 21.00 0.042 _ 100
Zinc --- _ 273.00 0.546 7,500
Environmental Chemists 2021-20494
*Determination of Plant Available Nitrogen(PAN):
Injected Application:
(Mineralization Rate)(TKN-Ammonia N)+Ammonia N+Nitrate N+Nitrite N=%PAN
Surface Application:
(Mineralization Rate)(TKN-Ammonia N)+(0.5)(Ammonia N)+Nitrate N+Nitrite N=%PAN
Note: Constituents N.D.(Not Detected)or<detection limits arc fisted as detection limits
for calculation purposes.

LEWIS FARMS
WQ0000455
Pluris Webb Creek WWTP
11/17/21 37,552 4.57.46
11/17/21 74,075 4.8697
11/17/21 44,661 4.6499
11/17/21 73,733 4.8677
11/17/21 74,767 4.8737
11/17/21 40,000 _ 4.6021
11/17/21 41,256 4.6155
Total 33.0532
Average 4.7219
Geometric Mean I€€€ 52 ' 0 !€ ?i Fecal Coliform MPN/gram
Geometric Mean of Less than 2,000,000 meets Class B -Alternative 1 Pathogen for Reduction
requirement.

K Rµ � V �, Environmental Chemists, Inc.
41 9 n}.`- : 6602 Windmill Way,Wilmington,NC 28405 ° 910.392.0223 Lab ° 910.392.4424 Fax
- v 710 8owsertown Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
WAEMOW sr., 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS info a environmentatchemists.com
Pluris LLC. Date of Report: Dec 03, 2021
P. O. Box 856 Customer PO#:
Sneads Ferry NC 28460 Customer ID: 09110001
Attention: Randy Hoffer Report#: 2021-20494
Project ID: Webb Creek Sludge
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-51363 Site: Sludge 11/17/2021 9:30 AM Solid/Sludge Gary Covington
Test Method Results Date Analyzed
Sludge Residuals
Aluminum EPA200.7,Rev.4.4,1994 18100mg/kg 11/18/2021
Arsenic EPA 200.7.Rev.4.4,1994 <21,0 mg/kg 11/18/2021
Cadmium EPA 200.7,Rev.4.4,1994 <21.0mg/kg 11/18/2021
Calcium EPA 200.7,Rev.4.4,1994 26200 mg/kg 11/18/2021
Chromium EPA 200.7,Rev.4.4,1994 22.8 mg/kg 11/18/2021
Copper EPA 200.7,Rev.4.4,1994 278 mg/kg 11/18/2021
Lead EPA 200.7,Rev.4.4,1994 <21.0 mg/kg 11/18/2021
Magnesium EPA 200.7.Rev.4.4,1994 3220 mg/kg 11/18/2021
Molybdenum EPA 200.7,Rev.4.4.1994 <21.0 mg/kg 11/18/2021
Nickel EPA 200.7,Rev.4.4,1994 <21.0 mg/kg 11/18/2021
Potassium EPA 200.7,Rev.4.4,1994 6060 mg/kg 11/18/2021
Selenium EPA 200.7,Rev.4.4,1994 <21.0 mg/kg 11/1 B/2021
Sodium EPA 200.7,Rev.4.4,1994 4180 mg/kg 11/18/2021
Zinc EPA 200.7,Rev.4.4,1894 273 mg/kg 11/18/2021
Nitrate+Nitrite-Nitrogen EPA 353.2 1.32 mg/kg 11/22/2021
Total Solids (%) SM 254013 2.31% 11/18/2021
Ammonia Nitrogen SM 4500 NH3 C-2011 3840 mg/kg 11/22/2021
Total Kjeldahl Nitrogen (TKN) SM 4500 Norg a-2011 70900 mg/kg 11/22/2021
Total Phosphorus SM 4500 P F-2011 41800 mg/kg 12/01/2021
pH SW 845 Method 90450 6.96 units 11/23/2021
Result estimated. Analyzed out of 15 minutes hold time.
Mercury SW 845 7471 8 <0.723 mg/kg 11/18/2021
•
. : . .
nepert d.: 20E1-1:04114
•
Pam 4 of n

•11 ,` 1MAtat Environmental Chemists, Inc.
.e #`� i il. _,$ .:;4 • 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab • 910.392.1424 Fax
.i--" E`i `' • . 710 Bowsertown Road,Marko,NC 27954 • 252.473.570_Lab/Fax
'�''L4 t.?f,��J``_'�� 7�„r'LKia.° tilt 7 �
255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS inrofa:environmentalchcmists.com
Pluris LLC. Date of Report: Dec 03,2021
P. O. Box 656 Customer PO#:
Sneads Ferry NC 28460 Customer ID: 09110001
Attention: Randy Hoffer Report#: 2021-20494
Project ID: Webb Creek Sludge
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-51364 Site:001 11/17/2021 9:30 AM Solid/Sludge Gary Covington
Test Method Results Date Analyzed
Total Solids (%) 5M 2540 B 2.45% 11/18/2021
Fecal Density SM 9221C E MPN 24 hr 503 37552 MPN/g 11/1712021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-51365 Site:002 11/17/2021 9:30 AM Solid/Sludge Gary Covington
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.16% 11/18/2021
Fecal Density 5M 9221C E MPN 24 hr 503 74075 MPNIg 11/17/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-51366 Site:003 11/17/2021 9:30 AM Solid/Sludge Gary Covington
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.06% 11/18/2021
Fecal Density SM 9221C EMPN 24 hr503 44661 MPN/g 11/17/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-51367 Site:004 11/17/2021 9:30 AM Solid/Sludge Gary Covington
Test Method Results Date Analyzed
Total Solids (%) SM 2540 B 2.17% 11118/2021
Fecal Density SM 9221C E MPN 24 hr 603 73733 MPN/g 11/17/2021
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-51368 Site;005 11/17/2021 9:30 AM Solid/Sludge Gary Covington
Test Method Results Date Analyzed
Total Solids (%) SM 254o C 2.14% 11I1312021
Food Density SM 9221C E MPN 24 hr 503 74767 MPN/g 11/11/2021
•
Rupurl a: 2021-2049d A.,—
Page 2 of

L; -, � Environmental lChemists, Inca
Y ang I o he n°t 6602 Windmill Way,Wilmington,NC 28405 • 910.392.0223 Lab ' 910,392.4424 Fax
VI,4�• .r s - 710 Bnwsertnwn Road,Manteo,NC 27954 • 252.473.5702 Lab/Fax
�,Rw 255-A Wilmington Highway,Jacksonville,NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL&CONSULTING CHEMISTS infofil environmentalchemists.corn
Plurls LLC. Date of Report; Dec 03, 2021
P. 0. Box 856 Customer PO#:
Sneads Ferry NC 28460 Customer ID: 09110001
Attention: Randy Hoffer Report#: 2021-20494
Project ID: Webb Creek Sludge
Lab ID Sample ID: Collect Date/Time Matrix Sampled by
21-51369 Site:006 11/17/2021 9:30 AM Solid/Sludge Gary Covington
Test Method Results Date Analyzed
Total Solids (%) SM 2540 9 2.30% 11/18/2021
Fecal Density SM 9221C E MPN 24 hr 503 40000 MPN/g 11/17/2021
Lab ID Sample ID: Collect Date/Tlme Matrix Sampled by
21-51370 Site: 007 11/17/2021 9:30 AM Solid/Sludge Gary Covington
Test Method Results Date Analyzed
Total Solids(%) SM 254a$ 2.23% 1 111 8/202 1
Fecal Density SM 922IC EMPN 24 hr 503 41256 MPN/g 11/17/2021
Comment: Sludge residual results, except pH, reported on a dry weight basis. pH reported on an as received
basis.
Reviewed by: R �
Rcpa,t N.. 3031-20404 -
Page 3 or 3 .

ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM(O2T Rules)
Facility Name: Lewis Farms&Liquid Waste,Inc. WQ Permit Number: WQ0000455
WWTP Name: Pluris-Webb Creek NPDES Number: NC0062642
Monitoring Period: From 1/1/202I To 12/31/2021
Pathogen Reduction (15A NCAC 02T .1106)-Please indicate level achieved and alternative performed:
Class A: Alt.A(time/temp) El Alt B (Alk Treatment)❑ Alt. C(Prior Testing)❑
A1t.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 ❑ Thermophilic ❑
Beta Ray 0 Gamma Ray ❑ Pasteurization ❑ ' :_.. :..
.......................... ..... .........
Class B: Alt. (1)FecaI Density El Alt. (2)Process to Significantly Reduce Pathogens ❑'
If applicable to alternative performed(Class B only)indicate"Process to Significantly Reduce Pathogens":
Lime Stabilization ❑ Air Drying ❑ Composting ❑ Aerobic Digestion ❑
Anaerobic
b Die :• •:
g
If stion �:�<:�:
applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Number of Anat
Parameter Allowable Level Pathogen Density Frequency Sample yticaC
in Sludge Minimum Geo.Mean Maximum Units Pxcee- of Analysis Tecli-
denccs Type Winne
2 10
tothe MPN 37,552 52,708 74,767 MPN/g 0 Annual Grab SM922ICE
6th
power
per gram of CFU
Fecal Coliform total solids
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria 3 MPN per 4 grams —
(in lieu of fecal total solid(dry
coliform) weight)
Vector Attraction Reduction (15A NCAC 02T.1.107)-Please indicate alternative performed:
Alt.1 (VS reduction) ❑ Alt.2 (40-day bench) ❑ Alt.3 (30-day bench) ❑ Alt.4(Spec,02 uptake) ❑
AIt. 5 (14-Day Aerobic) ❑ Alt. 6(Alk. Stabilization ❑ Alt 7 (Drying-Stable) ❑ Alt. 8(Drying-Unstable) 0
Alt.9(Injection) p Alt. 10(Incorporation) p No vector attraction reduction alternatives were performed ❑
CERTIFICATION STATEMENT(please check the appropriate statement)
El "I certify, under penalty of law,that the pathogen requirements in 15A NCAC 02T.1106 and the
vector attraction reduction requirement in I5A 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 check 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."
William Andrews, ORC Wesley Wooten,President
Prepa Name a Titer (type or print) Land Applier Name and Title (if applicable)(type or print)
0 t/V'
, 0-1`)-( , ollK/ 12/6/21
Signature of Preparer* Date Signature of Land iplier(if applicable) Date
"Preparer is defined in 40 CF[l Part 503.9(r)and 15A NCAC 2T.1102(26)

2021 APPLICATION SUMMARY

LEWIS FARMS
Permit#WQ 0000455
2021
RESIDUALS APPLICATIONS
APPLICATION SUMMARY
FIELD ACRES TOTAL TOTAL TOTAL TOTAL PAN
NO. USED , GALLONS WET TONS DRY TONS Crop 1 Crop 2
L3 18.60 550,000 57.09 _ 113.01 47.95
L4 24.50 707,000 90.89 101.89 47.48
L5 23.03 153,500 24.07 16.83 0.00
L8 _ 31.20 335,000 57.69 45.69 24.53
L9 36.70 1,105,000 94.46 _ 117.78 49.07
W1 33.70 214,500 18.34 35.27 0.00
W2 36.70 855,000 90.95 87.09 31.25
W3 24.20 546,000 52.59 55.79 48.35
Totals + 228.63 4,466,000 0 0 486.08
Metric Tons 440.87

FIELD LOADING RATE REPORTS

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
Facility Name:Lewis Farms Permit#:W00000455 Annual Dry Tons Applied: 57.09
Owner: Lewis Farms Operator: Lewis Farms
Site#: 1 Field#: L3 Acres Utilized: 18.6 Acres Permitted: 18.6 Predominant Soil Goldsboro-GoA
Application Method*: S/INC Volatilization Rate**: 0.5/1.0 Mineralization Rate: 30 % House of Raeford 40%
gr..:ki.
7! 1!11 1"0,.}, s€@I'€i€i: Cio'.: ":: "::' a:::...... , ....
Ltalrl licad
2021 _ 97,500 5,242 2.30 0.50 'm ina G/D 0.042 0.042 0.378 0.042 0.001 0.042 0.042 0.042 3.379 15.83 26.65 Corn 47.26 2.36 0.00
L.a
2021 452,500 24,328 2.53 2.57 G/D 0.158 0.158 0.450 0.158 0.003 0.158 0.158 0.158 10.626 97.18 47.95 158.62 corn wheat 395.77 37.68 0.02
I - ,
Total 550,000
/ Annual Ibs/acre 0.200 0.200 0.828 0.200 0.004 0.200 0.200 0.200 14.004 113.01 47.95 185.26 Lime App.
Current Cumulative tbs./acre 1.12 0.69 85.36 4.68 0.05 1.02 2.64 1.00 146.60 147 50 Permit PAN Limt lst/2nd Crop Date Lbs/Ac
Prior Years Cumulative 16s/acre 0.92 0.49 84.53 4.48 0.04 0.82 2.44 0.80 I32.60
Permitt C.P.L.IL*** 36 34 1,338 267 15 n/a 374 89 2,498
"1 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 lines and imprisonment for knowing violations."
X l/I/ ' 1/28/22 *Application Method:S-Surface,IN-Injection,INC-Incorporation
(Signature of nd Applier) Date **Volatilization Rate:Surface-0.5,Injection/Incorporation-1.0
***C.P,L.R.:Cumulative Pollutant Loading Rate
Bold denotes Incorporation and Volatilization Rate of 1.0
DENR FORM FSF(7/2002)Mod.
WMMS,PLLC

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
Facility Name:Lewis Farms Permit#:W00000455 Annual Dry Tons Applied: 90.89
Owner: Lewis Farms Operator: Lewis Farms
Site if: 1 Field#: L4 Acres Utilized: 24.50 Acres Permitted: 24.50 Predominant Soil Goldsboro-CoA _
Application Method*: S/1NC Volatilization Rate**: 0.5/1.0 Mineralization Rate: 30 % House of Raeford 40%
fiS�..�::i :E:?g. i:'io.. r��tsiifs"': i�'�-f�`�'•i����c`•�?is��'����:a::=::::;:;-':::::
i€N ro`.rtt�. Ili'�ai�''�iiiil�':::
i']�.. .... A .. ^.,�.:`•rker S'vurc?k`-i's •ykbti f; is .g:;:'_'• y'r}
•:I►'Co:i i`'Ni'?i �ii'2'_;�`..,t#ei is
, - ... .1rt•.•. .. .._.- a}A�� -I=il�2g •_i:iihefEd ..
i ..........
--• Carolina � ...".. ...- .. ..
2021 330,500 13,490 2.53 1.42 Ptantatinn G/D 0_088 0.088 0.250 -0.088 0.002 0.088 0.088 0.088 5.892 32.99 47.48 v 87.95 Corn Wheat 219.46 20.89 0.01
2021 16,000 6S3 330 0.09 Grand Villas C/11 0.005 0.005 0.066 0.005 0.000 0.005 0.005 0.005 0.829 3.22 3.97 Corn 10.21 0.76 0.00
202I 360,500 14,714 3.58 2.20 Havelock G/D 0.012 0.008 3.168 0.066 0.002 0.026 0.053 0.022 9.670 65.69 55.00 Corn 210.13 13.15 0.02
Total 707,000
Annual lbs/acre 0.105 0.101 3.483 0.159 0.004 0.I19 0.145 0.115 16.390 101.89 47.48 146.93 Lime App.
Current Cumulative lbs/acre 1.03 0.74 65.68 1.20 0.32 57.45 4.39 0.63 70.19 147 50 Permit PAN Limt lst/2nd Crop Date Lbs/Ac
Prior Years Cumulative lbs/acre 0.93 0.64 62.20 1.04 0.32 57.33 4.25 0.52 _53.79
Permitt C.P.L.R.*** 36 34 1,338 267 15 n/a 374 89 2,498
"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."
X .. 1/28/22 *Application Method:S-Surface,IN-Injection,INC-Incorporation
(Signature of L d Applier) Date **Volatilization Rate:Surface-0.5,Injection/Incorporation- 1.0
***C.P.L.R.:Cumulative Pollutant Loading Rate
Bold denotes Incorporation and Volatilization Rate of 1.0
DENR FORM FSF(7/2002)Mod.
WMMS, PLLC

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
Facility Name:Lewis Farms Permit#:W00000455 Annual Dry Tons Applied: 24.07
Owner: Lewis Farms Operator: Lewis Farms
Site#: I Field#: L5 Acres Utilized: 23.30 Acres Permitted: 23.30 Predominant Soil Goldsboro-GoA
Application Method*: S/INC Volatilization Rate**: 0.5/1.0 Mineralization Rate: 30 % House of Raeford 40%
-�'Iit ...0..• �1.. 1K��#'��'sIli•` ''•'��=�`=== =r :;:::E: i :::�:�i:�:� °_
.e `: Gis ' ':i4icc ='a: 'o'
�.
.....n.•.;. :Ih�j�€x Algal '<_' bra"`� ��r�'� `-€:'I'I{NS€:
2021 153,500 • 6,588 3.76 1.03 Havelock G/D 0.005,0.003 1.384 0.054 0.001 0.012 0.021 0.010 4.072 16.83 88.01 wheat 52.97 4.66 0.01
- 1
Total 153,500
Annual lbslacre 0.005 0.003 I.384 0.054 0.001 0.012 0.021 0.010 4.072 16.83 0.00 88.01
Lime AEp.
Current Cumulative Ibs/acre 0.63 0.42 32.77 2.51 0.12 0.47 2.40 0.59 72.80 135 50 Permit PAN Limt Istl2nd Crop Date Lbs/Ac
Prior Years Cumulative lbs/acre 0.62 0.41 31.39 2.46 0.12 0.45 2.38 ,1 0.58 68.72
Permitt C.P.L.R.*** 36 34 , 1,338 267 15 n/a 374 89 2,498
"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."
X / �/ 1/28/22 *Application Method:S-Surface,IN-injection,INC-Incorporation
(Signature of Land Applier Date **Volatilization Rate:Surface-0.5,Injection/Incorporation-1.0
***C.P.L.R.:Cumulative Pollutant Loading Rate
Bold denotes Incorporation and Volatilization Rate of 1.0
DENR FORM FSF(7/2002) Mod.
WMMS, PLLC

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
Facility Name:Lewis Farms Permit#:W00000455 Annual Dry Tons Applied: 57.69
Owner: Lewis Farms Operator: Lewis Farms
Site#: 1 Field#: LS Acres Utilized: 31.20 Acres Permitted: 31.20 Predominant Soil Grantham-Gr
Application Method*: SfINC Volatilization Rate**: 0.5/1.0 Mineralization Rate: 30 % House of Raeford 40%
:.a:i'i Ij7 '. �esiii'tiiiti :: Si" •:�:::
u€r�6 t tc. F�:'€ idri s iEibtilCiti`: EE 6C �s
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... �...... .... Intl:;; ¢1S`iE:� •-tli=i< �o`::` _
.=i€r�............""-.".....� • �1'ic�'� �`#'.d1k"s� Na'3
2021 335,000 10,737 4.13 1.85 Bcau Rivagc G/D 0.086 0.086 0.8I0 0.086 0.002 0.086 0.086 0.086 8.358 45.69 24.53 81.36 Corn Wheat 192.68 17.72 0.02
Total 335,000,
Annual Ibs/acre 0.086_0.086 0.810 0.086, 0.002 0.086 0.086 0.086 8.358 45.69 24.53 81.36 Lime App.
Current Cumulative lbslacre 0.44 0.31 14.76 1.36 0.04 0.42 1.23 0.43 64.03 136 50 Permit PAN Limt lst/2nd Crop a Date Lbs/Ac
Prior Years Cumulative lbs/acre 0.35 0.22 13.95 1.27 0.04 0.33 1.15 0.34 55.67
PermittC.P.L.R.*** 36 34 1,338 267 I5 n/a 374 89 2,498
"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."
Y 1/28/22 *Application Method:S-Surface,IN-Injection,MC-Incorporation
(Signature of Land pplier) Date **Volatilization Rate:Surface-0.5,Injection/Incorporation- 1.0
***C.P.L.R.:Cumulative Pollutant Loading Rate
Doh]denotes Incorporation and Volatilization Rate of 1.0
DENR FORM FSF(7/2002)Mod.
WMMS, PLLC

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
Facility Name:Lewis Farms Permit#:W00000455 Annual Dry Tons Applied: 94.46
Owner: Lewis Farms Operator: Lewis Farms
Site#: 1 Field#: L9 Acres Utilized: 36.70 Acres Permitted: 36.70 Predominant Soil Grantham-Gr
Application Method*: S/1NC Volatilization Rate**: 0.5/1.0 Mineralization Rate: 30 % House of Raeford 40%
_: D�':E i'Resfilialii _• • _
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R ? i!#S S` S ;iCcf`Li` ` `�'.: i :�? #' '"i J �r i'?`6 E ;c c: Eii�i Y "?i'-?i': - •
... ......... .......... Y4e i€.......4�re....... CDri11< :.:�s.:..:.;��.:..:.:Cq.:::....P1t::: _;��:::::::IS'Y�:::::::N�:s` ��:'kasi��.►!::::`:C��,I!i;)� .;1'r�NI::::::::Ix.:.:.:::fro : .:.•r : :::: :. . .::::. .:;:.:
.40
2021 1,105,000 30,109 2.05 2.57 Iiouse of Raeford G/D 0.082 0.082 1.503 0.082 0.004 0.082 0.082 0.082 1.189_117.78 49.07 103.47 Corn Wheat 390.71 17.55 0.04
Total 1,105,000
Annual lbs/acre 0.082 0.082 1.503 0.082 0.004 0.082 0.082 0.082 1.189 117.78 49,07 103.47 _ Lime App.
Current Cumulative lbs/acre 0.60 0.39 57.91 3.46 0.06 0.73 1.87 0.69 93.82 136 50 Permit PAN Limt Ist/2nd Crop _ Date Lbs/Ac
Prior Years Cumulative lbs/acre 0.52 0.31 56.41 3.37 0.06 0.65 1.79 0.60 92.63
Permitt C.P.L.R.*** 36 34 1,338 267 15 n/a 374 89 2,498
"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."
X � 1/28/22 *Application Method:S-Surface,IN-Injection,INC-Incorporation
(Signature of Land Appli& Date **Volatilization Rate:Surface-0.5 Inaection/Incorporation- 1.0
***C.P.L.R.:Cumulative Pollutant Loading Rate
Bold denotes Incorporation and Volatilization Rate of 1.0
DENR FORM FSF(7/2002)Mod.
WMMS,PL.LC

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
Facility Name: Lewis Farms Permit#:W00000455 Annual Dry Tons Applied: 18.34
Owner: Lewis Farms Operator: Lewis Farms
Site#: W Field#: 1 Acres Utilized: 33.70 Acres Permitted: 33.70 Predominant Soil Grantham-Cr
Application Method*: S/INC Volatilization Rate**: 0.5/1.0 Mineralization Rate: 30 % House of Raeford 40%
: ?�..s,. ..�'�'•.f Res. .. _
i>Ga 2 Y
... ............... ..... �.. G.nth ': .s.. ' �' �°� 'ii° ��-I'�'@s= 3
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.. .. _...•......•....3CriiRX G�;�n� ']K�f ,: �Il�#3t1��N�
2021 214,500 6,365 2.05 0.54 House of Raeford G/D 0.017 0.017 0.318 0.017 0.001 0.017J 0.017 0.017 0.251 35.27 21.87 wheat 82.60 3.71 0.01
Total 214,500
Annual lbslacrc 0.017 0.017 0.318 0.017 0.001 0.017 0.017 0.017 0.251 35.27 0.00 21.87 Lime App.
Current Cumulative lbs/acre 0.31 0.28 74.24 3.96 0.04 0.44 2.07 0.41 117.53 Ill 50 Permit PAN Limt 1st12nd Crop _Date Lbs/Ac
Prior Years Cumulative lbs/acre 0.29 0.26 73.93 3.94 0.04 0.42 2.05 0.39 117.28
Permitt C.P.L.R.*i* 36 34 , 1,338 267 15 n/a 374 89 2,498
"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."
X 4/ 1/28/22 *Application Method:S-Surface,IN-Injection,INC-Incorporation
(Signature of Land pplier) Date **Volatilization Rate:Surface-0.5,Injection/Incorporation-1.0
***C.P,L.R.:Cumulative Pollutant Loading Rate
Bold denotes Incorporation and Volatilization Rate of 1.0
DENR FORM FSF(7/2002)Mod.
WMMS, PLLC

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
Facility Name:Lewis Farms Permit#:WO0000455 Annual Dry Tons Applied: 90.95
Owner: Lewis Farms Operator: Lewis Farms
Site#: W Field#: 2 Acres Utilized: 36.70 Acres Permitted: 36.70 Predominant Soil Grantham-Gr
Application Method*: S/INC Volatilization Rate**: 0.511.0 Mineralization Rate: 30 % House of Raeford 40%
Mils;€�li's1a'c
2021 585,000 15,940 2.05 1.36 Honse of Raeford G/D 0.044 0.044 0.796 0.044 0.002 0.044 0.044 0.044 0.630 63.80 24.54 54.78 Corn Wheat 206.85 9.29 0.02
Horse Creek
2021 95,500 2,602 3.30 0.36 Forms G/D 0.020 0.020 0.263 0.020 0.001 0.020 0.020 0.020 3.302 6.10 6.71 15.83 Corn Wheat 40.68 3.02 0.00
2021 162,500 4,428 3.88 0.72 River Bend G/D 0.044 0.022 1.533 0.025 0.003 0.022 0.026 0.022 1.648 17.04 _ 39.40 Corn 56.74 0.00 0.02
2021 12,000 327 3.02 0.04 -Trenton G/D 0.000 0.000 0.003 _0.000 0.000 0.000 0.000 0.000 0,010 0.15 0.28 Corn 0.48 0.00 0.00
Total 855,000
Annual lbs/acre 0.108 0.085 2.594 0.089 0.007 0.086 0.089 0.086 5.589 87.09 31.25 110.28 Lime App.
Current Cumulative lbs/acre 0.48 0.37 17.75 1.96 0.04 75.37 0.83 0.52 L 32.83 136 50 Permit PAN Limt 1st/2nd Crop Date Lbs/Ac
Prior Years Cumulative lbs/acre 0.37 0,29 15.16 1.87 0.03 75.28 0.74 _ 0.43 27.24
Pcrmitt C.P.L.R.*** 36 34 1,338 267 15 n/a 374 89 2,498
"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."
X tt/e1/28/22 *Application Method:S-Surface,IN-Injection,INC-Incorporation
(Signature of Land Applier) Date **Volatilization _
Rate:Surface 0.5,Injection/incorporation- 1.0
***C.P.L.R.:Cumulative Pollutant Loading Rate
Bold denotes Incorporation and Volatilization Rate of 1.0
DENR FORM FSF(7/2002)Mod.
WMMS, PLLC

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
Facility Name:Lewis Farms Permit#:W00000455 Annual Dry Tons Applied: 52.59
Owner: Lewis Farms Operator: Lewis Farms
Site#: W Field#: 3 Acres Utilized: 24.20 Acres Permitted: 24.20 Predominant Soil Woodington-Wo
Application Method*: S/INC Volatilization Rate**: 0.5/1.0 Mineralization Rate: 30 % House of Raeford 40%
s. Ib3�ii'
s.. `€A. e` € 'I"Si ��re ' ��iiir�'� '--:.
........ ....... ... e:.. IWisid_Ei�1Aif���-�ii't.'•`iho:�:
INf2413
Muria-Web b
2021 546,000 22,562 2.31 2.17 c„reAg G/D 0.091 0.091 1.208 0.091 0.003 0.091 0.091 0.091 1.187 55.79 48.35 181.69 Corn Wheat 308.18 16.69 0.01
Total 546,000
Annual Ibs/acre 0.091 0.091 1.208 0.09I 0,003 0.091 0.091 0.091 1.187 55.79 48.35 181.69 Lime App.
Current Cumulative Ibs/acre 0.49 0.30 77.74 4.11 0.06 0.41 1.89 0.44 99.19 118 50 Permit PAN Limt 1st/2nd Crop Date Lbs/Ac
Prior Years Cumulative lbs/acre 0.40 0.21 76.53 4.02 0.06 0.32 I.79 0.35 98.01
Permitt C.P.L.R.*** 36 34 1,338 267 15 n/a 374 89 2,498
"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."
X 1/28/22 *Application Method:S-Surface,IN-Injection,INC-Incorporation
(Signature of Land Applie Date **Volatilization Rate:Surface-0.5,Injection/Incorporation-1.0
***C.P.L.R.:Cumulative Pollutant Loading Rate
Bold denotes Incorporation and Volatilization Rate of 1.0
DENR FORM FSF(7/2002)Mod.
WMMS,PLLC

SOIL ANALYSIS REPORTS

Page 1 of 1 1j A y0
Report No: 22-046-1054 yY
Account No: 08361
/%yp 0lflt 7621 Whitepine Road,Richmond,VA23237
Main 804-743-9401°Fax [phone]
ANALYTICAL www.waypointanalytical.com
Advisor: Willcox&Mabe Soil Solutions,PLLC Client:Lewis Farms Farm:
7231 B.Summerfield Rd
Summerfield NC 27358
Date Received:02/15/2022
Date of Report:02/17/2022
)Lab No Field ID Sample ID Soil Class HM% W/V pH Ac P-I K-1 S-1 Mn-I Mn All Mn-Al2 Zn-I Zn-Al Cu-I CEC BS% Ca% Mg% ESP Na I
15689 L06 MIN 5.7 0.6 153 31 29 31 0 0 85 85 270 2.8 77 60 10 1.2 0
15690 L07 MIN 5.8 1,6 77 38 19 31 0 0 90 90 100 8.2 81 71 7 0.5 0
15691 L08 MIN 6.4 0.3 114 50 35 25 0 0 115 115 220 3.8 92 73 12 1.3 0
15692 L09 MIN 5.8 1.5 76 49 25 25 0 0 95 95 105 8.0 81 70 7 0.5 0
15693 L10 MIN 6.0 0.8 87 50 29 25 0 0 115 115 165 5.2 85 69 10 1.0 0.1
15695 WO1 MIN 5.9 0.8 109 44 29 38 0 0 113 113 230 4.4 83 66 11 1.1 0
15696 W02 MIN 6.0 0.7 115 34 27 31 0 0 160 160 235 4.6 84 72 8 0.8 0
15697 W03 MIN 5.7 0.7 136 32 31 25 0 0 85 85 270 3.3 80 63 11 1.4 0
15698 W04 MIN 5.9 0.9 79 58 27 25 0 0 125 125 120 5.3 84 67 10 1.0 0.1
15699 AW-F1 MIN 6.4 0.6 88 58 25 25 0 0 123 123 120 7.1 92 77 10 0.9 0.1
15700 CFC-11 MIN 5.7 0.6 166 32 29 25 0 0 78 78 245 2.8 79 62 10 1.2 0
15701 CFC-12 MIN 6.5 0.5 76 43 19 25 0 0 93 93 105 7.2 94 80 10 0.8 0.1
15702 JJ-01 MIN 5.8 1.0 98 71 27 25 0 0 150 150 145 5.1 81 62 11 1.0 0.1
15703 JJ-02 MIN 5.9 0.7 131 42 35 25 0 0 93 93 210 4.2 84 66 12 1.2 0.1
15704 JR-F MIN 7.0 0.0 77 37 25 31 0 0 83 83 115 7.7 100 86 11 0.7 0.1
15706 L02 MIN 5.7 1.1 96 68 27 31 0 0 148 148 135 5.1 79 62 10 0.9 0
15707 L03 MIN 5.2 0.7 159 23 23 38 0 0 80 80 290 2.0 66 44 15 2.2 0
15708 L04 MIN 6.6 0.4 82 43 23 25 0 0 95 95 110 6.9 94 82 8 0.6 0
15709 L05 MIN 5.5 0.6 170 29 29 31 0 0 78 78 305 2.2 73 51 13 2.2 0
Comment:
Test result units=CEC and Na in meq/100cm3;NO3 N in mgldm3;WN in glcm3
North Carolina Division of Water Quality Certification#257,Analysis and fertility recommendations shown on this report are performed in accordance within NCDA guidelines,Analysis prepared by:Waypoint Analytical Virginia,Inc.