WQ0020793_Monitoring - 03-2022_20220321

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * March
Report Information
Type *
GW-59
WQ0020793
Tyson Farms, Inc. Hays Hatchery
Confirmation Email Address: *
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2022
Upload Document*
Monitoring Wells Water DMR 4.15MB
3-3-22.pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
James Brown
Reviewer: Gerald, Wanda
3/21 /2022
This will be filled in automatically

Is the project number correct?* WQ0020793
Is the monitoring report accepted?* YeS No
Regional Office* Winston-Salem
Accepted Date: 4/11/2022

March 21, 2022
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER,
RALEIGH, NC 27699-1617 Phone: [phone]
Subject: Ground Water Quality Monitoring
Tyson Farms, Inc. Hays Hatchery
Compliance Report — March, 2022
To whom it may concern:
Enclosed is the quarterly Groundwater Compliance report for Hays Hatchery.
Please contact me at 336- 6,51-3836, should you have any questions.
Sincerely,
James Brown
Complex Environmental Manager
Tyson Farms Inc. Fresh, Retail Division 704 Factory Wilkesboro, N.C. 28697
336-651-3836 336-838.2171 Fax: 33.65t.3867 wwwAysonfoods.corri

SUBMIT FORM ON YELLOW PAPER ONLY
® .
nEPARTM19EN, 917 ENY.IRORi EidT-&NATURAL ItESOURCEs .
�
GROUNDWATER QUALITY MONITORING:
�� > �
� otvls16r4'C)F�wATER'�QUAttTY�INF6xMATi6N'PROCESSINOlukIT
COMPLIANCE REPORT FORM
izzi1L 4tEc�v�t R, Rti, izzsss-,z `Qn�_ {ty xszxt
FACILITY INFORMATION
€Meese Print ClearlyarType
PERMIT Number: WQ0020793 Expiration Date: 0713112026
Facility Name: Tyson Farms, Inc.
Non -Discharge WQ0020793 UIC
Permit Name (if different):
NPDES Other
Facility Address P.O. Box 936/3649 Airport Road
TYPE OF PERMITTED OPERATION BEING MONITORED
NORTH WILKESBORO NC
28659 County Wilkes
❑ Lagoon ❑ Remediation: infiltration Gallery
Spray Field ❑ Remediation:
Contact Person: James Brawn
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well LocationlSite Name: Hays Hatchery
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other: Evaporation/Infiltration Pond
(from Perm3tl
-
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW -1
Date sample collected: 3/312022
FIELD ANALYSES. WAS
Well Depth: 40 ft.
Well Diameter: 2 in,
pH 00400: 6.0 units Temp. o0010: 15.9 °C DRY at
Depth to Water Level 82546: 28 ft. below measuring point Screened Interval: 23 ft. to
40 ft. Spec. Cone. 00094_ µ time ofMhos sampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: 1344.85 ft.
Odor 00085 none check
Volume of water pumped/bailed before sampling:
5-87
gallons
Appearance clear here:
Samples for metals were collected unfiltered: ❑ YFS
® NO and field acidified: ❑ YES ff NO
LABORATORY INFORMATION
Date sample analyzed:31312022
Laboratory Name: Statesville Analyitical
Certification No. 44013775
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
rang/L
Nitrite (NO.) as N oo615
mg1L Pb - Lead cios1 ug/L
Coliform: ME Fecal 31616 <1
/100mL
Nitrate (NO.) as N 00620 2.54
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 <0.1
mg1L
(No1euse MPN roeth.d far highly I.,bid 5 r€Ipies(
Orthophosphate 70507
mg1L Other (Specify Compounds and Concentration Units):
)issolved Solids_Total 703oo 243
mg/L
Al - Aluminum 011o5
mg1L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC Ciomo
mg/L
Ca - Calcium oo916
mg/L
Chloride 00940 <10
mg1L
Cd - Cadmium 01027
ug/L
Arsenic 01002
uglL
Chromium: Total 01034
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L ORGANICS: (by GC: GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L Lab Report Attached? ❑ Yes (1) ❑■ No (0)
apecific Conductance 00095
µMhos
K - Potassium 00937
mgCL VOC 78732_ method #
Total Ammonia riwio <0 1
mg/L
Mg - Magnesium 00927
mg/L method #
(Arnmania Wrogen;. NHas N. Ammonia Nitrogen. Total?
Mn -Manganese 01 055
ug/L .method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ucg/L method
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs. mgiL VOC Removala/o
James Brown Complex Environmental Manager
Permittee (or Authorized Agent) Narne and Title - Please print or type
GW-59 Rev.212010

SUBMIT FORM ON YELLOW PAPER ONLY
tmtfir ;9 Mitt € NMEhf r B NAiRFRA3 F ES4tiiRG S
R U ATER QUALITY MONITORING:
� 8 �
� t?ti�t�fot�o�: �T���uaLtT� trio sib �T16 k6C sst44�urIT
COMPLIANCE REPORT FORM
46 �'S�g y€ 2 tEEl�t�,ri���s�s=�st�
FACILITY INFORMATION
Please Print clearly or Type
PERMIT Number: WQ0020793 Expiration Date: 0713112026
Facility Name: Tyson Farms, .Ehc
Non -Discharge W00020793 UIC
Permit Name (If different):
-
NPDES Other
Facility Address: P.O, Box 936/3649 Airport Road
TYPE OF PERMITTED OPERATION BEING MONITORED
NORTH WILKESBORO NC
26659 C6unty Wilkes
El Lagoon ❑ Remediation: Infiltration Gallery
D Spray Field El Remediation:
Contact Person: ,lames Brown
Telephone* [phone]
El Rotary Distributor ® Land Application of Sludge
Well Location/Site Name: Hays Hatchery
No. of wells to be sampled: 4
® Water Source Heat Pump ❑ Other: Evaporation/Infiltration Pond
Perini)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW - 2
Date sample collected: 313/2022
FIELD ANALYSES:
WAS
Well Depth: 36 ft.
Well Diameter: 2 in.
pH 00400: 6.3 units Temp. 000lo: 16.3 °c
DRY at
Depth to Water Level 32546: 32 ft. below measuring point
Screened Interval: 21 ft. to 36 ft. Spec. Cond. 00094 uMhos
Time ofsampling,
Measuring Point is 2 ft. above land surface
Relative M.P. Elevation: 1329.59 ft.
Odor 00085: none
check
Volume of water pumped/bailed before sampling:
1-96
gallons
Appearance clear
here:
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: ® YES N NO
EABORATORY INFORMATION
Date sample analyzed:313/2022
Laboratory Name' Statesville Analyitical
Certification No. 440J3775
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg1L
Nitrite (NO3) as N oo613
mg/L Pb - Lead o1051 ug/L
Coliform: MF Fecal 31616 <1
/10®mL
Nitrate (NO3) as N 00620 .84
mg/L Zn -Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P ooses <0-1
mg/L
(mote: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
Dissolved Soiids:Total 70300 160
mg/L
Al - Aluminum 011o5
mg/L
pH (Lail) 00403
-
units
Ba - Barium 01007
ug/L ..;
TOO 00680
rng1L
Ca - Calcium 00916
mgiL
Chloride otJ940 13.3
mgiL
Cd - Cadmium 01027
tag/L
Arsenic 01002
ug/L
Chromium: Total 01034
ug/L
Grease and Oils 0G552
mgiL
Cu - Copper 01042 _ -
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
a /L
Fe - Iron 01045
ug/L (Specify test and method 9. ATTACH LAB REPORT.)
Sulfate 0OP45
mg/L
Fig - Mercury 71900
ug/L Lab Report Attached? El Yes (1) FE-1 No (0)
Specific Conductance oo09s
uMhas
K - Potassium 00937
mg/L VOC 78732 method #
Total Ammonia o0610 4.03
mgiL
Mg - Magnesium 00927
mgiL method #
- -
(Ammonia Nitrogen'. NH3 as N: Ammonia Nitrogen, Total)
Mn - Manganese 01 o55
leg/L method #
TKN as N 04625
mgiL
Ni - Nickel 01os7
ug/L method A
For Remediation Systems Only (Attach Lab Reports)
GW-59 . Rev.212010
Influent Total VOCs
Effluent Total VOCs.
mg/L V'OC Retnaval°lo

SUBMIT FORM ON YELLOW RAPER ONLY
A
=acility Name: Tyson Farms, Inc.
:1errnit Name (if different):
=acility Address: p.O. Box 93613649 Airport Road
NORTH WILKESBORO NO
act Person: James Brown
LocationlSite Name. Hays Hatchery
Please Print Clearly or Type
28659 County Wilkes
Telephone#: [phone]
No. of wells to be sampled. 4
PERMIT Number: W00020793 Expiration Date: 07131/2026
Non -Discharge WQ0020793 UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
El Water Source Heat Pump LK Other: Evaporation/Infiltration Pond
AMPLING INFORMATION
If WELL
TELL ID NUMBER (from Permit): MW - 3
Date sample collected: 3/3(2022
FIELD ANALYSES:
WAS
dell Depth: 36 ft.
Well Diameter: 2 in.
pH oo400: 5.0 units Temp. oriolo: 15.0 "C
DRY at
lepth to Water Level 82546: 17 ft. below measuring point Screened Interval: 21 ft. to 36 ft.
Spec. Cond. 00094:
µMhos
time of
sampling,
leasuring Point is 2 ft. above land surface
Relative M,P, Elevation: 1306,40 ft.
Odor 00085. none
check
plume of water pumped/bailed before sampling: 9.29
gallons
Appearance clear
here:
amples for metals were collected unfiltered: ❑ YES
IN NO and field acidified: ❑ YES X NO
ABORATORY INFORMATION
pate sample analyzed:3/312022
Laboratory Name: Statesville Analyitical
Certification No. 440/3775
ARAETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD oo335 mg/L
Nitrite (NO2) as N 00615 mg/L
Pb - Lead o1os1
ug/L
Coiiform: MF Fecal 31616 s1 /100mL
Nitrate (NO,,) as N 00620 6.1 mgiL
Zn - Zinc 01092
mgfL
Coliform: MF Total 31504 1100mL
rN I ' U MPN - th d f r h' W • bid I
Phosphorus: Total as P 00%s <0.1 mg/L
oe. se me 6 0. _,gy.ur sampes)
Orthophosphate 70507
ril
Other (Specify Compounds and Concentration Units):
ssolved Sol ds:Total 703oo 75
mg/L
Al -Aluminum ol105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC omw
mg/L
Ca - Calcium oos16
mg/L
Chloride 00940 11.5
mgfL
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
ug/L
Grease and Oita 00552
mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method ft. ATTACH LAB REPORT.)
Sulfate 00945
mgiL
Hg = Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑■ No (0)
peclflc Conductance 00095
CtMlhos
K - POtasSI Urn 00937
mg/L
VOC 78732: method #
Total Ammonia 00610 f0A
mgfL
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3as N; Ammonia Nitrogen, Total)
Mn - Manganese gloss
ug/L
.method #
TKN as N D0625
mglL
Ni - Nickel o1o67
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mgfL VOC Removal%
,lames Brown Complex Environmental Manager
Per€ ittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev, 2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY V
REPORT FORM
i3)t=iE�t AT�O"iNtVitEFN't:.OAtFE'ENyr`lrRA�Ltdl4l�- l+(To�idAT�tJrRoAN Sf�EtsdRc�utrVIT�RI� 1617AdECNTE'RAEN, 33OMPLIA1✓E
,'Ci322t -.
FACILITY INFORMATION f'iease Pnnt Cieariy or Type
PERMIT Number: WQ0020793 Expiration Date: 07/31/2026
Facility Name: Tyson Farms, Inc.
Non -Discharge WQ0020793 UIC
Permit Name (if different):
NPDES Other
Facility Address: P.O. Box 936/3649 Airport Road
TYPE OF PERMITTED OPERATION BEING MONITORED
NORTH WILKESBORO NC 28659 County Wilkes
❑ Lagoon ❑ Remediation: Infiltration Gallery
EI Spray Field ❑ Remediation:
Contact Person: Jaynes Brown Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Hays Hatchery No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other: Evaporation/Infiltration Pond
WELL ID NUMBER (from Permit): MW - 4 Date sample collected: 3/3122
Well Depth: 27 ft. Weil Diameter: 2 in,
Depth to Water Level 82546: 10 ft. below measuring point Screened Interval: 12 ft.
Measuring Point is 2 ft. above land surface Relative M.P. Elevation: 1324.13
Volume of water pumped/bailed before sampling: 8.31 gallons
Samples for metals were collected unfiltered: ❑ YES N NO and field acidified: ❑ YES
to 27 ft.
ft_
IN NO
FIELD ANALYSES:
pH 00400: 6.7 units Temp. oo01o: 13.9 °C
Spec. Coed. 00094 pMhos
Odor 00005: none
Appearance clear
WAS
DRY at
time ofsampling,
check
here: Lj
LABORATORY INFORMATION
Date sample analyzed:3/3/2022
Laboratory Name: Statesville Analyitical
Certification No. 440/3775
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
rng/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead 01051 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 3,13
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P ooe65 <0.'I
mg/L
(Nate: Use MPN method for highly t.,bid sarnPtes)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
3issolved Solids:Total 7030o 115
mg/L
Al - Aluminum o1105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
E
TOG oo68o
mg/L
Ca - Calcium oos15
mg/L
Chloride 00940 18.6
mg/L
Gd - Cadmium 01027
ug1L
Arsenic 01002
ugiL
Chromium: Total U1034
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GO GC/MS, HPLC)
Phenol 32730
ugiL
Fe - Iron 01045
ug1L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) X No (0)
Specific Conductance 00095
uMhos
K - Potassium oo937
mg/L
VOC 78732: method #
Total Ammonia ooslo <0.1
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese 01 o55
ug/L
method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ugiL
method #
For Remediation Systems Only (Attach Lab Reports)
GW-59 Rev.2/2010
Influent Total VOCs
Effluent Total VOCs:
mg/L VOC Removal%o

GW-59A COMPLIANCE REPORT FORM Tyson Farms, Inc. Permit 9_' Y�20�793
(Submit one each monitoring period with GW-59.forms.)
Enter date monitoring results were due. ( _) Will this monitoring report (GW-59 and GW 59A)
S
-VF—,
NO
be submitted after the established due date?
Was any required information missing on the Gird-59 report forms?
YES
VQ
IF the answer to question I or 2 is "YES", list in the space provided below the, well identification number(s) and
explain the problems encountered in obtaining the required information.
Are any ofthe monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
identification plate, area overgrown, etc.)? Ifthe answer is "Yes", contact the Regional 0 fficefbrg-Wdance.
Are any monitored constituents equal to or above the established standards? ------ ----j:!Y:E§
N—O
If the answer to question 4 is "NO", skip to section 8.
if the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentrations)
exceeding standards in the space provided below
1 313/22 PH 6.5- 8.5 Ammonia 1.5 Nitrate 10 Fecal
Mw- I PH - 60
Mw- 2 PH - 6.3 4.03 mg11
MW- 3 PH - 5.0
MW-4 PH - 5.7
For the constituents identified in question 4 above, have standards been exceeded previously for the
YES
NO
same constituent(s) in the same well(s) in the last two years?
If the answer to question 5 is "NO", skip to section 8-
If the answer to question 5 is "YES" list in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
GIN Standards Nitrate 10 GIN Standards ammonia 1.5
MW-2 3-3-22 4.03 mg)l
MW-2 11-11-21 4.62 rng)7
MW-2 7-1-21 5.60 mgA
MW-2 3-4-21 4.82 mg17
MW-2 11-5-20 4.14 mg17
MW-2 7-16-20 4.7 mg17
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
if the answer is "YES", a groundwater quality problem may be occurring. CONTACT fWt—R7E—GiO—AWA—L
OFFICE IMMEDIA TEL Y FOR GUIDANCE. If the answer is "NO", monitoring wells may be improperly
located; contact the Regional Office.
Is the pen-nittee implementing previously approved actions —required by the Division involving this
5 ES
NO
groundwater quality problem?
If the answer to question 7 is "YES", describe those actions in the space provided below.
If the answer to question 7 is "NO", cgataat (bg i3agigaill QtaCa WItbia 20 dayg; 211 eyAjLjRtj2L3 Ma &a
ujmd t2 date6mine the imi2act the, waste UjAgosal satam ig hal4ing at the reyiew aud aQMj21jaarg
boundariagurmundiag this far.0z
LUiaa.
The person completing this portion (GW-59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
in'th"
k rt ,fo eato, my 06W e,
T epo is, ruean complete the
Signature 01permittee for Authorized Agent) Date
elill CA A I I 10fli nil I

Worksheet * 4b
Tyson Farms, Inc.
Completed by.:
Max Byers
Title:
WWT Operator
Date :
21-Mar-22
No. of Wells to be Sampled 4
toys iatchery
GroundWnte Water sampling data Hays Hatchery Complier- Oatla
Has
1 er 1QQML
500 m ll
250 m /
1.5 m /I
10 m !I
NA
6.5-8.5
Date
Wells ID:
Fecal
TOS
Chloride
Total NH3
Nitrate
Fihos hours
PH
July-16-2020
MW -1
<1
188
<10
<Q.5
6.21
0.2
6.9
MW-2
<1
176
16.2
4.70
1.83
0.1
7A
MW-3
<1
79
<10
<0.5
5.76
0.5
5.6
MW-4
<1 1
112
19.6
<0.5
3.8
0.1
6.0
Nov-5-2020
MW - 1
<1
206
<10
<0.5
6,43
0.1
6.2
MW-2
<1
181
17,9
4.14
1.35
0.1
6.3
MW-3
<1
63
11.0
<0.5
6.10
0.1
5.3
MW - 4
<1
106
20.4
<0.5
2,17
0.1
5.7
Mar-4-202.1
MW - 1
<1
212
<10
<0.5
7.05
<0.1
6,3
MW-2
<1
187
14.5
4.82
2.00
<0.1
6.4
MW-3
<1
69
<10
<0.5
6.19
<0.1
5.0
MW-4
<1
118
19.6
<0.5
6,17
0.1
5.3
July-1-2021
MW - 1
<1
265
<10
<0.5
5.45
<0.1
6.0
MW-2
8
162
19.6
5.60
1.78
<0.1
6.3
MW-3
<1
64
<10
<0.5
6.06
<0,1
4.9
MW - 4
<1
134
19.6
<0.5
7.17
<0' 1
5.4
Nov-11-2021
MW-1
<1
204
<10
<0.1
4.61
<0.1
6.3
MW-2
<1
143
14.0
4.82
1.03
<0.1
6.4
MW-3
<1
53
14.8
<0.1
5.93
<0A
5.0
MW-4
<1
96
21.1
<0.1
6.49
<Q.1
5.5
Mar-3-2022
MW - 1
<1
243
<10
<0.1
2.54
<0.1
&0
MW-2
<1
160
13.3
4.03
0.84
<0.1
6.3
MW - 3
<1
75
11.5
<0.1
6,10
<0.1
5.0
MW-4
e1
115
1 18.6
<0.1
3.13
<0.1
5.7
Maximum
8
435
43
6
8
2
7
Mindmum
<1
53
11
4
1
Q
5

'Tyson Foods -Wilkesboro � u'
704 Factory Street
Wilkesboro, NC 28697
Receive Date: 03/03/2022
Reported: 03/ 1512022
For:
Sample Number
Parameter
Sample ID
Result
Unit
Method
Analyzed
Analyst
220303-30-01
Ammonia Nitrogen
MW1
<0.1
mg/L
SM45ClONH3C-2011
0310712022
LE/C[
220303-30-01
Chloride
MW1
<10
mg/L
SM4500CIC-2011
03109/2022
MD
220303-30-01
Fecal Coliforms
MW1
<1
CFU100 ML SM9222D-2006
03/03/2022
WC
220303-30-01
Nitrate
MW1
2.54
m,g1L
5M460ONO3F•2011
03/14/2022
CL
220303-30-01
T. Phosphorous
MW1
<0.1
mg/L
SM4500PE-2011
03/04/2022
CL
220303-30-01
Total Dissolved
MW1
243
mg/L
sM 254a c 13th EdtVon
03/07/2022
MD
Solids
220303-30-02
Ammonia Nitrogen
MW2
4.03
mg/L
SM450ONH3C-2011
03/07/2022
LEICE
220303-30-02
Chloride
MW2
13.3
mg/L
SM4500GIC-2041
03/09/2022
MD
220303-30-02
Fecal Coliforms
MW2
<1
CFU100 ML
sM922213-2006
03/03/2022
WC
220303-30-02
Nitrate
MW2
0.84
mg/L
SM450ONO3F-2011
03/1412022
CL
220303-30-02
T, Phosphorous
MW2
<0.1
mg/L
SM450OPE-2011
03/0412022
CI_
220303-30-02
Total Dissolved
MW2
160
mg/L
SM 2540 C 15th Edstworo
03/07/2022
IVID
Solids
220303-30-03
Ammonia Nitrogen
MW3
<0.1
mg/L
SM450ONH3C-2011
03/07/2022
LE/CE.
220303-30-03
Chloride
MW3
11.5
mg/L
SM4500CIC-2011
03109/2022
MD
220303-30-03
Fecal Coliforms
MW3
<1
CFU1'00 ML SM9222D-2006
03103/2022
WC
220303-30-03
Nitrate
MW3
6.1
mglL
SM4500No3F-2o11
03/14/2022
CL
220303-30-03
T. Phosphorous
MW3
<0.1
mg/L
SM460OPE-2011
03/0412022
CL
220303-30-03
Total Dissolved
MW3
75
mg/L
SM 2540 C lath Edition
03/07/2022
MD
Solids
220303-30-04
Chloride
MW4
18.6
mg/L
SM4500CIC-2011
03109/2022
MD
220303-30-04
Nitrate
MW4
3.13
mg/L
SM450QN03r-2011
03/14/2022
CL
220303-30-04
T. Phosphorous
MW4
<0.1
mg/L
SM450OPE-2011
03/04/2022
CL
220303-30-04
Total Dissolved
MW4
115
mg/L
sM 2540 c lath Edition
03/0712022
MD
Solids
PO Box 228 - Statesville, NC 28687 e 704/872/4697
Page 1 of 5

Sample Number Parameter
220303-30-04 Ammonia Nitrogen
220303-30-04 Fecal Coliforms
Respectfully submitted,
Melissa Myers
NC Cert #440,
NCDW Cert #37755,
EPA #NCO0909
Sample ID
MW4
MW4
Result
<0.1
<1
Unit Method
mg/L SM45©GNH3C�2011
CFU100 ML SM92221)-2006
Analyzed
Analyst
03/07/2022,
LE/CE
03/03/2022
WC
PC) Box 228 a Statesville, NC 28687 @ 704/872/4697
Page 2 of 5

Condition of Receipt
Sample Number 220303-30-01 Temp on Arrival: 3.0
Parameter Schedule: Total Dissolved Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thiosulfate Received an Ice
Parameter Schedule: T. Phosphorous
Sulfuric Acid Received on Ice
Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Parameter Schedule: Nitrate
Sulfuric Acid Received on Ice
Parameter Schedule: Chloride
Received on Ice
Sample Number 220303-30-02 Temp on Arrival: 3.0
Parameter Schedule: Total Dissolved Solids
Received on Ice
Parameter Schedule: Fecal Coliforms
Sodium Thlosulfate Received on Ice
Parameter Schedule: Nitrate
Sulfuric Acid Received on Ice
Parameter Schedule: T. Phosphorous
Sulfuric Acid Received or Ice
Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Parameter Schedule: Chloride
Received on Ice
Sample Number 220303-30-03 Temp vn Arrival: 3.0 Box 228 e Statesville, NC 28687 * 704/872/4697
Page 3 of 5

Parameter Schedule: Total Dissolved Solids
I 040M 0 Met M
Parameter Schedule-, Fecal Coliforms
Sodium Thlosulfate Received on Ice
Parameter Schedule: Nitrate
Sulfuric Acid Received on Ice
Parameter Schedule: T. Phosphorous
Sulfuric Acid Received on Ice
Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Parameter Schedule: Chloride
Received on Ice
Sample Number 220303-30-04 Temp on Arrival: 3.0
Parameter Schedule: Total Dissolved Solids
Received on Ice
Parameter Schedule- Fecal Coliforms
Sodium Thiosulfate Received on Ice
Parameter Schedule: Nitrate
Sulfuric Acid Received on Ice
Parameter Schedule: T. Phosphorous
Sulfuric Acid Received on Ice
Parameter Schedule: Ammonia Nitrogen
Sulfuric Acid Received on Ice
Parameter Schedule: Chloride
Received on Ice
PO Box 228 ® Statesville, NC 28687 * 704/872/4697
Page 4 of 5

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