WQ0000484_Monitoring - 04-2022_20220524

GW-59A COMPLIANCE REPORT FORM Permit
(Submit one each monitoring period with GW-59 forms.)
1
Enter date monitoring results were due. -1) Will this monitoring report (GW-59 and GW-59A)
YES
O
be submitted after the established due date?
2
Was any required information missing on the GW-59 report forms?
YES
NO
IF the answer to question 1 or 2 is "YES", list in the space provided below the well identification numbers) and
explain the problems encountered in obtaining the required information.
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
YES
identification plate, area overgrown, etc.)? ffthe answer is "Yes", contact the Regional Office for guidance.
4
Are any monitored constituents equal to or above the established standards?
ES
NO
If the answer to question 4 is "NO", skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below:
MW *-I 'No3 :A 1
s;L- a-_;•3
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
YES
O
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 occurreU (,for the last two years).
MAY 2 6 2022
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
O
If the answer is "YES", a groundwater quality problem maybe occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells maybe improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
YES
NO
groundwater quality problem?
If the answer to question 7 is "YES", describe those actions in the space provide below.
If the answer to question 7 is "NO", contact the Regional Office within 90 days; an evaluation may be
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surrounding this facilit . Failure to do so maV subject the permittee to a Notice of Violation
fines, and/or penalties. a
z,
8
The person completing this portion (G W-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.
hereby acknowledge that the above information was evaluated and the information submitted in this
report (Compliance Report GW-59A) is true and complete to the best of my knowledge.
Signature of P r ittee (or Authorized Agent) Date
GW-59A 12/8/2003

SUBMIT FORM ON YELL OW PAPFR ONl Y
GROUNDWATER QUALITY MONITORING:
•
•
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
• • .
•
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION Please Print
CleariyorType
PERMIT Number: WQ0000484 Expiration Date: 02/28/2023
Facility Name: Mountaire Farms of North Carolina
Non -Discharge X UIC
NPDES Other
Permit Name (if different):
Facility Address: 17269 NC Hwy 71 N
TYPE OF PERMITTED OPERATION BEING MONITORED
El Lagoon ❑Remediation: Infiltration gallery
Lumber Bridge (street) NC 28357-0339 County Robeson
(City) (State) (zip)
N Spray Field ❑ Remediation:
Contact Person Robert Jackson
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Mountaire Inner and Outer Perimeter Spray Fields No. of wells to be sampled: 12
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-14
Date sample collected: 04/26/2022
FIELD ANALYSES:
WAS
Well Depth: 20.3 ft.
Well Diameter: 2 in.
H 00400: 6.00
p units Temp. 00010: 17.8 °C
DRY at
Depth to Water Level 82546: 122 ft. below measuring point Screened Interval: ft. to
ft. Spec. Cond. 00094: µMhos
time of
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation: ft.
Odor 00085:
sampling,
check
Volume of water pumped/bailed before sampling: 5.0
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered ❑ YES
■❑ NO and field acidified: ❑ YES ■❑ NO
LABORATORY INFORMATION
Date sample analyzed: 04/26-5/16/2022
Laboratory Name: Cameron Testing Services
Certification No. 654
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead o1o51 u9 /L
Coliform: MF Fecal 31616 <1 /100mL
Nitrate (NO3) as N 00620 4.99
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665 <0.050
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 83.0 mg/L
AI - Aluminum o11o5
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L
Di
TOC 00680 <1.00 mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 6.28 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total olo34
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑■ No (0)
Specific Conductance 00095 µMhos
K - Potassium 00937
mg/L
VOC 78732: method # EPA 8260B
Total Ammonia 00610 0.114 mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3as N. Ammonia Nitrogen, Total)
Mn - Manganese o1055
ug/L
method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
ror memealarion zystems unly (Attacn Lab Keports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
David White, Dir. of Processing
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.212010

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
• •
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
• • •
•
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION Please Print
Clearly orType
PERMIT Number: W00000484 Expiration Date: 02/28/2023
Facility Name: Mountaire Farms of North Carolina
Non -Discharge X UIC
NPDES Other
Permit Name (if different):
Facility Address: 17269 NC Hwy 71 N
TYPE OF PERMITTED OPERATION BEING MONITORED
❑Lagoon ❑Remediation: Infiltration Gallery
Lumber Bridge (street) NC 28357-0339 Count Robeson
y
(city) (state) (zip)
❑■ Spray Field ❑ Remediation:
Contact Person: Robert Jackson
Telephone#: [phone]
❑ Rotary Distributor ElLand Application of Sludge
Well Location/Site Name: Mountaire Inner and Outer Perimeter Spray Fields No. of wells to be sampled: 12
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-15
Date sample collected: 04/26/2022
FIELD ANALYSES:
WAS
Well Depth: 15.5 ft.
Well Diameter: 2 in.
pH 00400: 6.83 units Temp. 000lo: 20.0 °C
DRY at
Depth to Water Level 82546: 11.3 ft. below measuring point Screened Interval: ft. to
Spec. Cond. 00094: µMhos
time ofsampling,
Measuring Point is 4.5 ft. above land surface
Relative M.P. Elevation: ft.
_ft.
Odor 00085:
check
Volume of water pumped/bailed before sampling: 2.0
gallons
Appearance
here:
Samples for metals were collected unfiltered: ❑ YES
ANO and field acidified: El YES ■❑ NO
❑
LABORATORY INFORMATION
Date sample analyzed: 04/26-5/16/2022
Laboratory Name: Cameron Testing Services Certification No. #654
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615
rng/L Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 <1 /100mL
Nitrate (NO3) as N 00620 3.96
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665 0.089
mg/L
(Note Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 93.0 mg/L
Al - Aluminum ol1os
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L f1 1
TOC oo68o 4.03 mg/L
Ca - Calcium 00916
mg/L d
Chloride o0940 16.3 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L Lab Report Attached? ❑ Yes (1) ❑■ No (0)
pecific Conductance o0095 µMhos
K - Potassium 00937
mg/L VOC 78732: method # EPA 8260E
Total Ammonia 00610 <0.100 mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen: NFi as N: Ammonia Nitrogen, Total)
Mn - Manganese otoss
ug/L ,method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
David White, Dir. of Processing
Permittee (or Authorized Agent) Name and Title - Please print or type
G W-59 Rev. 2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
• •
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION Please Print
Clearly or Type
PERMIT Number: W00000484 Expiration Date: 02/28/2023
Facility Name: Mountaire Farms of North Carolina
Non -Discharge X UIC
NPDES Other
Permit Name (if different):
Facility Address: 17269 NC Hwy 71 N
TYPE OF PERMITTED OPERATION BEING MONITORED
El Lagoon ❑Remediation: Infiltration Gallery
Lumber Bridge (Stfeet) NC 28357-0339 CountyRobeson
(city) (state) (zip)
X Spray Field ❑ Remediation:
Contact Person: Robert Jackson
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Mountaire Inner and Outer Perimeter Spray Fields No. of wells to be sampled: 12
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-37
Date sample collected: 04/26/2022
FIELD ANALYSES:
WAS
Well Depth 22.5 ft.
Well Diameter: 2 in.
pH 00400. 5.73 units Temp. 000to: 19.9 °C
DRY at
Depth to Water Level 82546: 10.5 ft. below measuring point Screened Interval: ft. to
ft. Spec. Cond. 00094: µMhos
time of
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation: ft.
Odor 000m:
sampling,
check
Volume of water pumped/bailed before sampling: 6.0
gallons
Appearance clear
here: ❑
Samples for metals were collected unfiltered: ❑ YES
❑■ NO and field acidified: ❑ YES ■❑ NO
LABORATORY INFORMATION
Date sample analyzed: 04/26-5/16/2022
Laboratory Name: Cameron Testing Services Certification No. #654
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615
mg/L Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 <1 /100mL
Nitrate (NO3) as N 00620 30.0
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665 <0.050
mg/L
(Note. Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 446 mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L
TOC oosm 1.27 mg/L
Ca - Calcium oo916
mg/L
Chloride 00940 31.7 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total o1o34
ug/L Ay L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate oo945 mg/L
Hg - Mercury 71900
ug/L Lab Report Attached? ❑ Yes (1) ❑■ No (0)
Specific Conductance 00095 µMhos
K - Potassium 00937
mg/L VOC 78732: method # EPA 8260B
Total Ammonia oo6lo <0.100 mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen, NH3as N, Ammonia Nitrogen, Total)
Mn -Manganese oloss
ug/L ,method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
David White, Dir. of Processing
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev. 212010

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
• • -
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
COMPLIANCE REPORT FORM
• • •
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION Please Print
Clearly or Type
PERMIT Number: WQ0000484 Expiration Date: 02/28/2023
Facility Name: Mountaire Farms of North Carolina
Non -Discharge X UIC
NPDES Other
Permit Name (if different):
Facility Address: 17269 NC Hwy 71 N
TYPE OF PERMITTED OPERATION BEING MONITORED
❑Lagoon ❑Remediation: Infiltration Gallery
Lumber Bridge (Street) NC 28357-0339 Count Robeson eson
(city) (State) (Z,P)
❑■ Spray Field ❑ Remediation:
Contact Person: Robert Jackson
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Mountaire Inner and Outer Perimeter Spray Fields No. of wells to be sampled:
12
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-47
Date sample collected: 04/26/2022
FIELD ANALYSES:
WAS
Well Depth: 17.3 ft.
Well Diameter: 2 in.
pH 00400 5.69 units Temp. 000lo 17.4 °C
DRY at
Depth to Water Level 82546: 4.7 ft. below measuring point Screened Interval: ft.
to
ft. Spec. Cond. 00094: µMhos
time of
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation:
ft.
Odor 00085:
sampling,
Volume of water pumped/bailed before sampling: 6.25
gallons
Appearance
check
here:❑
Samples for metals were collected unfiltered: ❑ YES
❑■ NO and field acidified: ❑ YES
NO
LABORATORY INFORMATION
Date sample analyzed: 04/26-5/16/2022
Laboratory Name: Cameron Testing
Services Certification No. #654
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 <1 /100ml-
Nitrate (NO3) as N 00620 29.7
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665 <0.050
mg/L
(Note. Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 399 mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L
TOC oo68o 2.16 mg/L
Ca - Calcium oo916
mg/L
Chloride oos4o 96.0 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑■ No (0)
Specific Conductance 00095 µMhos
K - Potassium 00937
mg/L
VOC 78732 method # 8260
Total Ammonia 00610 0.225 mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen, NH3 as N. Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L
method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
r �r r�C�rrCV,pL'Vrr Qyarrtrta vrny trludcn L-ar) Kepor[s/: Influent Iota) vuus: mg/L Effluent Total VOCs: mg/L VOC Removal%
David White, Dir. of Processing
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.2/2010
Signature of Permittee (or Auth
(Date)

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
• • -
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
•
COMPLIANCE REPORT FORM
• • •
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, INC 27699-1617 Phone: [phone]
FACILITY INFORMATION Please Print Clearly or Type
PERMIT Number: WQ0000484 Expiration Date: 02/28/2023
Facility Name: Mountaire Farms of North Carolina
Non -Discharge X UIC
Permit Name (if different):
NPDES Other
Facility Address: 17269 NC Hwy 71 N
TYPE OF PERMITTED OPERATION BEING MONITORED
Lumber Bridge (street) NC 28357-0339 CountyRobeson
❑Lagoon ❑Remediation: Infiltration Gallery
(city) (State) (zip)
❑■ Spray Field ❑ Remediation:
Contact Person: Robert Jackson Telephone#: [phone]
❑ Rotary Distributor El Land Application of Sludge
Well Location/Site Name: Mountaire Inner and Outer Perimeter Spray Fields No. of wells to be sampled:
12
El Water Source Heat Pump El Other:
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-48
Date sample collected: 04/26/2022
FIELD ANALYSES:
WAS
Well Depth: 18 ft.
Well Diameter: 2 in.
pH 0040o: 5.35 units Temp. 000lo 21.5 °C
DRY at
Depth to Water Level 82546: 8.9 ft. below measuring point
Screened Interval: ft. to ft.
Spec. Cond. 00094: µMhos
time of
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation: ft.
Odor 000as:
sampling,check
Volume of water pumped/bailed before sampling: 4.5 gallons
Appearance
here: ❑
Samples for metals were collected unfiltered: ❑ YES ❑� NO
and field acidified: ❑ YES ■❑ NO
LABORATORY INFORMATION
Date sample analyzed: 04/26-511612022
Laboratory Name: Cameron Testing Services
Certification No. #654
\RAMETERS NOTE: Values should reflect dissolved and colloidal concentrations
COD 00335
mg/L
Nitrite (NO2) as N 00615
Coliform: MF Fecal 31616
<1
/100mL
Nitrate (NO3) as N 00620 12.2
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 <0.050
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
solved Solids:Total 70300
316
mg/L
Al - Aluminum 01105
pH (Lab) 00403
units
Ba - Barium 01007
TOC oo68o
1.80
mg/L
Ca - Calcium 00916
Chloride oo94o
95.5
mg/L
Cd - Cadmium 01027
Arsenic 01002
ug/L
Chromium: Total 01034
Grease and Oils 00552
mg/L
Cu - Copper 01042
Phenol 32730
ug/L
Fe - Iron 01045
Sulfate 00945
ni
Hg - Mercury 71900
�cific Conductance 00095
µMhos
K - Potassium 00937
Total Ammonia 00610
0.137
mg/L
Mg - Magnesium 00927
(Ammonia Nitrogen. NH3 as N, Ammonia
Nitrogen, Total)
Mn - Manganese 01055
TKN as N 00625
mg/L
Ni - Nickel 01067
mg/L
mg/L
mg/L
mg/L
mg/L
ug/L
ni
ug/L
ug/L
mg/L
ug/L
ug/L
mg/L
mg/L
ug/L
ug/L
Pb - Lead o1o51 ug/L
Zn - Zinc 01092 mg/L
Other (Specify Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑■ No (0)
VOC 78732: method # 8260
method #
method #
method #
ror Ircememation systems only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: ni VOC Removal%
David White, Dir, of Processing �&) 4 _ /J -C , ?
Permdtee (or Authorized Agent) Name and Title - Please print or type Signature of Permittee (or Authorized Agent)+(' ly/ ✓�� ✓ G (Date)
GW-59 Rev.212010

SUBMIT FORM ON YELLOW PAPFR ONI Y
GROUNDWATER QUALITY MONITORING:
• •
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
COMPLIANCE REPORT FORM
•
• •
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
PERMIT Number: W00000484 Expiration Date: 02/28/2023
FACILITY INFORMATION Please Print C/eadyorType
Facility Name: Mountaire Farms of North Carolina
Non -Discharge X UIC
NPDES Other
Permit Name (if different):
Facility Address: 17269 NC Hwy 71 N
TYPE OF PERMITTED OPERATION BEING MONITORED
El ❑Remediation: Infiltration gallery
G
Lumber Bridge (street) NC 28357-0339 Count Robeson
Y
(City) (State) (tip)
❑■ Spray Field ❑ Remediation:
Contact Person: Robert Jackson
Telephone#: [phone]
ElRotary Distributor ElLand Application of Sludge
Well Location/Site Name: Mountaire Inner and Outer Perimeter Spray Fields No. of wells to be sampled:
12
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): MW-49
Date sample collected: 04/26/2022
FIELD ANALYSES:
If WELL
WAS
Well Depth: 17.6 ft.
Well Diameter: 2 in.
pH 0040o: 5.62 units Temp. 000lo 19.2 °C
DRY at
Depth to Water Level 82546: 7.5 ft. below measuring
point Screened Interval: ft.
to
ft. Spec. Cond. 00094: µMhos
time of
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation:
ft.
Odor 00085:
sampling,
Volume of water pumped/bailed before sampling: 5.0
gallons
Appearance
check
here:
Samples for metals were collected unfiltered: ❑ YES
❑� NO and field acidified: [I YES
■❑ NO
❑
LABORATORY INFORMATION
Date sample analyzed: 04/26-5/16/2022
Laboratory Name: Cameron Testing
Services Certification No. #654
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 <1 /100mL
Nitrate (NO3) as N 00620 2.40
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665 <0.050
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 128 mg/L
AI -Aluminum ol1o5
mg/L
DJ
pH (Lab) 00403 units
Ba - Barium 01007
ug/L
TOC 00680 <1.00 mg/L
Ca - Calcium 00916
mg/L
Chloride oo94o 27.1 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ElYes (1) Al No (0)
pecific Conductance 00095 µMhos
K - Potassium 00937
mg/L
VOC 78732: method # 8260
Total Ammonia coslo 0.111 mg/L
Mg - Magnesium o0927
mg/L
method #
(Ammonia Nitrogen. NH, as N, Ammonia Nitrogen, Total)
Mn -Manganese oloss
ug/L
,method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
— mullivurauvn aysiems unity IiAtiacn LaD Keports): Intluent Iota] VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
David White, Dir. of Processing
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.2/2010
Agent)
(Date)

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or
Facility Name: Mountaire Farms of North Carolina
Permit Name (if different):
Facility Address: 17269 NC
Lumber Bridge (street)
(city)
71N
NC
(State)
28357-0339 County Robeson
act Person: Robert Jackson Telephone#: [phone]
Location/Site Name: Mountaire Inner and Outer Perimeter Spray Fields No. of wells to be sampled: 12
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER QUALITY -INFORMATION
PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
PERMIT Number: W00000484
Expiration Date: 02/28/2023
Non -Discharge X
UIC
NPDES
Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon
❑ Remediation: Infiltration Gallery
❑■ Spray Field
❑ Remediation:
❑ Rotary Distributor
❑ Land Application of Sludge
❑ Water Source Heat Pump
❑ Other:
WELL ID NUMBER (from Permit): MVV-50 Date sample collected: 04/26/2022
Well Depth: 17.5 ft. Well Diameter: 2 in.
Depth to Water Level 82546: 5A ft. below measuring point Screened Interval: ft. to ft.
Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling: 160 gallons
Samples for metals were collected unfiltered: ❑ YES ■❑ NO and field acidified: ❑ YES ■❑ NO
LABORATORY INFORMATION
Date sample analyzed: 04126-05116/22 Laboratory Name: Cameron Testing Services
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N oo615
Coliform: MF Fecal 31616 < 1
/100mL
Nitrate (NO.) as N 00620 4.23
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 <0.050
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
issolved Solids:Total 70300 427
mg/L
Al - Aluminum 01105
pH (Lab) 00403
units
Ea - Barium 01007
TOC 00680 4.69
mg/L
Ca - Calcium oo916
Chloride 00940 172
mg/L
Cd - Cadmium 01027
Arsenic 01002
ug/L
Chromium: Total 01034
Grease and Oils 00552
mg/L
Cu - Copper 01042
Phenol 32730
ug/L
Fe - Iron 01045
Sulfate 00945
mg/L
Hg - Mercury 71900
Specific Conductance 00095
µMhos
K - Potassium 00937
Total Ammonia 00610 < 0.100
mg/L
Mg - Magnesium 00927
(Ammonia Nitrogen, NH,as N, Ammonia Nitrogen, Total)
Mn - Manganese 01055
TKN as N 00625
mg/L
Ni - Nickel 01067
mg/L
mg/L
mg/L
mg/L
mg/L
ug/L
mg/L
ug/L
ug/L
mg/L
ug/L
ug/L
mg/L
mg/L
ug/L
ug/L
FIELD ANALYSES:
pH 00400: 5.75 units
Spec. Cond. 00094:
Odor 00085:
Appearance
Temp. 000lo: 17.8 °C
uMhos
Certification No. #654
Pb - Lead 01051 ug/L
Zn - Zinc 01092 mg/L
Other (Specify Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑■ No (0)
VOC 78732: method # 8260
method #
method #
method #
t-or ttemeatatton Systems only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
David White, Dir. of Processing
Permittee (or Authorized Agent) Nat
GW-59 Rev.2/2010
and Title - Please print or type
Signature of
WELL
DRY at
time of
sampling,
check
here: ❑

SUBMIT FORM ON YELLOW PAPFR nNI Y
GROUNDWATER QUALITY MONITORING:
• •
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
COMPLIANCE REPORT FORM
•
• • •
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION Please Print Clearly or Type
PERMIT Number: WQ0000484 Expiration Date: 02/28/2023
Facility Name: Mountaire Farms of North Carolina
Non -Discharge x UIC
NPDES Other
Permit Name (if different):
Facility Address: 17269 NC Hwy 71 N
TYPE OF PERMITTED OPERATION BEING MONITORED
❑Lagoon ❑Remediation: Infiltration Gallery
Lumber Bridge (Street) NC 28357-0339 County Robeson
(City) (sae) (Z.P)
❑■ Spray Field ❑ Remediation:
Contact Person: Robert Jackson
Telephone#: [phone]
ElRotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Mountaire Inner and Outer Perimeter Spray Fields No. of wells to be sampled:
12
❑ Water Source Heat Pump ❑ Other:
(from Pertnit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-51
Date sample collected: 04/26/2022
FIELD ANALYSES:
WAS
Well Depth: 17.5 ft.
Well Diameter: 2 in.
pH 00400: 6.26 units Temp. 000lo: 16.2 °C
DRY at
Depth to Water Level 82546: 5.8 ft. below measuring
point Screened Interval: ft.
to
ft. Spec. Cond. 00094: µMhos
time of
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation:
ft.
Odor 000as:
sampling,check
Volume of water pumped/bailed before sampling: 5.75
gallons
Appearance
here:
Samples for metals were collected unfiltered: ❑ YES
❑■ NO and field acidified: ❑ YES
NO
❑
LABORATORY INFORMATION
Date sample analyzed: 04/26-5/1612022
Laboratory NameCameron Testing
Services Certification No. #654
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead 01051 u9 /L
Coliform: MF Fecal 31616 <1 /100mL
Nitrate (NO3) as N 00620 19.4
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665 <0.050
mg/L
(Note. Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 128 mg/L
At - Aluminum oil o5
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L
TOC oo68o 3.47 mg/L
Ca - Calcium 00916
mg1L
Chloride oo94o 70.9 mg/L
Cd - Cadmium 01027
u9 /L
Arsenic 01002 ug/L
Chromium: Total 01034
u9 /L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑■ No (0)
Specific Conductance coo95 µMhos
K - Potassium 00937
mg/L
VOC 78732: method # 8260
Total Ammonia 00610 1.07 mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen: NH3as N: Ammonia Nitrogen, Total)
Mn -Manganese Sloss
ug/L
,method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
ror Kemeolauon Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCS: mg/L VOC Removal%
David White, Dir. of Processing
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev_ 2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING:
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
• •
•
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617 Phone: [phone]
FACILITY INFORMATION
Please Print
Clearly or Type
PERMIT Number: WQ0000484 Expiration Date: 02/28/2023
Facility Name: Mountaire Farms of North Carolina
Non -Discharge X UIC
NPDES Other
Permit Name (if different):
Facility Address: 17269 NC Hwy 71 N
TYPE
OF PERMITTED OPERATION BEING MONITORED
❑Lagoon ❑Remediation: Infiltration Gallery
Lumber Bridge (Street) NC 28357-0339 CountyRobeson
(city) (State)
(zip)
❑■ Spray Field ❑ Remediation:
Contact Person: Robert Jackson
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Mountaire Inner and Outer Perimeter Spray Fields No. of wells to be sampled: 12
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-52
Date sample collected: 04/26/2022
FIELD ANALYSES:
WAS
Well Depth: 17.3 ft.
Well Diameter: 2 in.
pH 00400 6.06 units Temp. 000lo 16.5 °C
DRY at
Depth to Water Level szsas: 7.9 ft. below measuring
point Screened Interval: ft. to
ft.
Spec. Cond- 00094: µMhos
time ofsampling,
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation: ft.
Odor 00085
check
Volume of water pumped/bailed before sampling
4.50
gallons
Appearance
here:
Samples for metals were collected unfiltered: ElYES
❑■ NO and field acidified: ❑ YES ❑■ NO
LABORATORY INFORMATION
Date sample analyzed: 04/26-5/16/2022
Laboratory Name: Cameron Testing Services
Certification No. #654
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO,) as N 00615
mg/L
Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 25.E
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 <0.050
mg/L
(Note. Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 531
mg/L
AI - Aluminum ol1o5
mg/L
pH (Lab) 00403
units
Ba - Barium 01D07
ug/L
Di
TOC 00680 11.8
mg/L
Ca - Calcium 00916
mg/L
Chloride oo94o 135
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total o1o34
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 =45
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate oo945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑■ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 78732: method # 8260
Total Ammonia o0610 0.165
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen. NH, as N, Armmnia Nitrogen, Total)
Mn - Manganese 01055
ug/L
, method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%a
David White, Dir. of Processing
Permittee (or Authorized Agent) Name and Title - Please print or type
Signature of Permittee (or
-2c-
GW-59 Rev.2/2010

SUBMIT FORM ON YELLOW PAPER ON[ Y
GROUNDWATER QUALITY MONITORING:
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION Please Print Clearly or Type
PERMIT Number: WQ0000484 Expiration Date: 02/28/2023
Facility Name: Mountaire Farms of North Carolina
Non -Discharge X UIC
NPDES Other
Permit Name (if different):
Facility Address: 17269 NC Hwy 71 N
TYPE OF PERMITTED OPERATION BEING MONITORED
❑Lagoon ❑Remediation: Infiltration Gallery
Lumber Bridge (Street) NC 28357-0339 Count Robeson
y
(city) (State) (Zip)
❑■ Spray Field ❑ Remediation:
Contact Person: Robert Jackson
Telephone#: [phone]
❑ Rotary Distributor ElLand Application of Sludge
Well Location/Site Name: Mountaire Inner and Outer Perimeter Spray Fields No. of wells to be sampled:
12
❑ Water Source Heat Pump ❑ Other:
(from Permii)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-53
Date sample collected: 04/26/2022 FIELD ANALYSES:
WAS
Well Depth: 17.5 ft.
Well Diameter: 2 in.
pH 00400: 6.60 units Temp. 000lo 18.6 °C
DRY at
Depth to Water Level 82546: 3.9 ft. below measuring point Screened Interval: ft.
to ft. Spec. Cond. 00094: µMhos
time of
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation:
ft. Odor 000ss:
sampling,
check
Volume of water pumped/bailed before sampling: 6.75
gallons
Appearance
here -
Samples for metals were collected unfiltered: ❑ YES
NO and field acidified: ❑ YES
0 NO
LABORATORY INFORMATION
Date sample analyzed: 04/26-5/16/2022
Laboratory Name: Cameron Testing
Services Certification No. #654
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO.) as N 00615
mg/L Pb - Lead 01051 ug/L
Coliform: ME Fecal 31616 <1 /100mL
Nitrate (NO3) as N 00620 5.26
mg/L Zn -Zinc 01092 m9 /L
Coliform: ME Total 31504 /100mL
Phosphorus: Total as P 00665 <0.050
mg/L
(Note Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issolved Solids -Total 70300 344 mg/L
AI -Aluminum o11o5
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L D
TOC oo68o 1.26 mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 44.2 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron olo45
ug/L (Specify test and method #. ATTACH LAB REPORT-)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L Lab Report Attached? ❑ Yes (1) ❑■ No (0)
Specific Conductance 00095 µMhos
K - Potassium G0937
mg/L VOC 78732: method # 8260
Total Ammonia 00610 0.120 mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen, NH3asN. Ammonia Nitrogen, Total)
Mn - Manganese o1o55
ug/L , method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L method #
t-or t<emealation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
David White, Dir. of Processing
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev 2/2010

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or
Facility Name: Mountaire Farms of North Carolina
Permit Name (if different):
Facility Address: 17269 NC Hwy 71 N
Lumber Bridge ($1feet) NC
(city) (State)
28357-0339 County Robeson
(Contact Person: Robert Jackson Telephone#: [phone]
Well Location/Site Name Mountaire Inner and Outer Perimeter Spray Fields No. of wells to be sampled: 12
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER QUALITY -INFORMATION
PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
PERMIT Number: W00000484
Expiration Date: 02/28/2023
Non -Discharge X
UIC
NPDES
Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon
❑ Remediation: Infiltration Gallery
0 Spray Field
❑ Remediation:
❑ Rotary Distributor
❑ Land Application of Sludge
❑ Water Source Heat Pump
❑ Other:
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): MW-54 Date sample collected: 04/26/2022
Well Depth: 17.5 ft. Well Diameter: 2 in.
Depth to Water Level 82546: 10.6 ft. below measuring point Screened Interval: ft. to ft.
Measuring Point is 3 ft. above land surface Relative M.P. Elevation: ft.
Volume of water pumped/bailed before sampling: 3.5 gallons
Samples for metals were collected unfiltered: ❑ YES ❑■ NO and field acidified: ❑ YES ■❑ NO
FIELD ANALYSES:
pH 00400: 5.95 units Temp. 000lo 18.4 °C
Spec. Cond. 00094: µMhos
Odor 000as:
Appearance
If WELL
WAS
DRY at
time of
sampling,check
here:❑
LABORATORY INFORMATION
Date sample analyzed: 04126-5/16/2022
Laboratory Name: Cameron
Testing Services
Certification No. #654
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
rng/L
Pb - Lead o1o51 u9 /L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 29.9
rng/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 <0.050
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 99.0
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC 00680 3.36
mg/L
Ca - Calcium 00916
mg/L
Chloride 00940 75.4
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) 0 No (0)
Specific Conductance 000s5
µMhos
K - Potassium 00937
mg/L
VOC 78732: method # 8260
Total Ammonia 00610 <0.100
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen, NH,as N, Ammonia Nitrogen, Total)
Mn - Manganese o1o55
ug/L
, method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
ror memeuiation aysiems unly (Attacn Lab Keports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
David White, Dir. of Processing
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.212010

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
• •
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
DIVISION OF WATER QUALITY -INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
•
• • •
1617 MAIL SERVICE CENTER, RALEIGH, INC 27699-1617 Phone: [phone]
FACILITY INFORMATION Please Print
Clearly or Type
PERMIT Number: W00000484 Expiration Date: 02/28/2023
Facility Name Mountaire Farms of North Carolina
Non -Discharge X UIC
NPDES Other
Permit Name (if different):
Facility Address 17269 NC Hwy 71 N
TYPE OF PERMITTED OPERATION BEING MONITORED
El Lagoon ❑Remediation: Infiltration Gallery
Lumber Bridge (street) NC 28357-0339 Count Robeson
y
(cay) (state) (zip)
X Spray Field ❑ Remediation:
Contact Person: Robert Jackson
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Mountaire Inner and Outer Perimeter Spray Fields No. of wells to be sampled:
12
❑ Water Source Heat Pump ❑ Other:
(from Permit)
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW-55
Date sample collected: 04/26/2022 FIELD ANALYSES:
WAS
Well Depth: 17 ft,
Well Diameter: 2 in.
pH 00400 6.51 units Temp. 000lo: 17.9 °C
DRY at
Depth to Water Level 82546: 9.2 ft. below measuring point Screened Interval: ft.
to ft. Spec. Cond. 00094: µMhos
time of
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation:
ft. Odor 00085,
sampling,
check
Volume of water pumped/bailed before sampling: 4.0
gallons
Appearance
❑❑Samples for metals were collected unfiltered: YES
❑■ NO and field acidified: ❑ YES❑
(here:
NO
LABORATORY INFORMATION
Date sample analyzed: 04/26-5/16/2022
Laboratory Name: Cameron Testing
Services Certification No. #654
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO2) as N 00615
mg/L Pb - Lead 01051 u9 /L
Coliform: MF Fecal 31616 <1 /100mL
Nitrate (NO3) as N 00620 1.81
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665 <0.050
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compo9Ind Concentration Units):
Dissolved Solids:Total 70300 86.0 mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L
TOC 00680 1.13 mg/L
Ca - Calcium 00916
mg/L
Chloride oog4o 31.2 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01o02 ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L Lab Report Attached? ❑ Yes (1) ❑■ No (0)
Specific Conductance 00095 µMhos
K - Potassium 00937
mg/L VOC 78732: method # 8260
Total Ammonia 00610 <0.100 mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen, NH, as N. Ammonia Nitrogen, Total)
.
Mn - Manganese oloss
ug/L ,method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
David White, Dir. of Processing
Perm ittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.212010

Cameron Testing Services, Inc. Laboratory Report
Client: Mountaire Farms CTS Proj.
Project: April 2022 Monitoring Wells Regulatory
Sample Information
Sampled C. Cameron Date 04/26/22 Received
Analyses and Results
NC DENR #654
NC PHHS #37799
US EPA #NC01918
2204-0224
Yes Page 1 of 5
J Cameron Date 04/26/22
Lab ID
Sample ID
o 2
Analyte
Result
E
m E
N
? '=
Std. Methods
c o
Reference
d
2204-0224 01
MW-14
TDS
83.0
25
05/02/22
2540 C -TDS
N-NH3
0.114
mgiL
01
05/03/22
4500 NH3 - D
N-NO3
4.99
mg/L
005
05/10/22
4500 NO3 - E
Fec. Coliform-W
<1
CFU
1
04/26/22
9222 D - MF
/100mL
TOC
0.725
mg/L
1
05/16/22
5310 B2000
Chloride
6.28
mg/L
0.01
05/09/22
4500 Cl - D
Tot P
<0.050
m/gL
005
05/03/22
4500 P - B/E
02
MW-15
Gw
Gr
TDS
93.0
mg/L
25
05/02/22
2540 C -TDS
N-NH3
<0.100
mg/L
01
05/03/22
4500 NH3 - D
N-NO3
3.96
0.05
05/10/22
4500 NO3 - E
Fec. Coliform-W
<1
CFU
1
04/26/22
9222 D - MF
/100mL
TOC
4.03
mg/L
1
05/16/22
5310 B2000
Chloride
16.3
mg/L
0.01
05/09/22
4500 Cl - D
Tot. P
0.089
m/gL
0.05
05/03/22
4500 P - B/E
03
MW-37
Gw
G,
TDS
446
mg/L
25
05/02/22
2540 C - TDS
N-NH3
<0.100
mg/L
01
05/03/22
4500 NH3 - D
N-NO3
30.0
mg/L
005
05/10/22
4500 NO3 - E
Fec. Coliform-W
<1
FU
1
04/26/22
9222 D - MF
t
TOC
1.27
mg/L
1
05/16/22
5310 B2000
Chloride
31.7
mg/L
001
05/09/22
4500 Cl - D
Tot. P
<0.050
m/gL
005
05/03/22
4500 P - B/E
219 S. Steele Str. 919-208-4240
Sanford NC 27330 chrislFi:canlerontesting.com

Cameron Testing Services, Inc. Laboratory Report
Client: Mountaire Farms CTS Proj.
Project: April 2022 Monitoring Wells Regulatory
Sample Information
Sampled C. Cameron Date 04/26/22 Received
Analyses and Results
NC DENR #654
NC PHHS #37799
US EPA 4NC01918
2204-0224
Yes Page 2 of 5
J.Cameron Date 04/26/22
Lab ID
Sample ID
Analyte
Result
6
N
m
:Std. Methods
o
U
D
c o
:3 Reference
O
2204-0224 04
MW-47
GW
TDS
399
mg/L
25
05/02/22
2540 C - TDS
N-NH3
0.225
mg/L
01
05/03/22
4500 NH3 - D
N-NO3
29.7
mg/L
005
05/10/22
4500 NO3 - E
Fec. Coliform-W
<1
CFU
1
04/26/22
9222 D - MF
/100ml.
TOC
2.16
mg/L
1
05/16/22
5310 B2000
Chloride
96.0
mg/L
0.01
05/09/22
4500 Cl - D
Tot P
<0.050
mlgL
005
05/03/22
4500 P - B/E
05
MW-48
GV1
Gr
TDS
316
mg/L
25
05/02/22
2540 C - TDS
N-NH3
0.137
mg/L
01
05/03/22
4500 NH3 - D
N-NO3
12.2
mg/L
005
05/10/22
4500 NO3 - E
Fec. Coliform-W
<1
CFU
04/26/22
9222 D - MF
/100mL
TOG
1.80
mg/L
1
05/16/22
5310 B2000
Chloride
95.5
mg/L
001
05/09/22
4500 Cl - D
Tot. P
<0.050
m/gL
0 05
05/03/22
4500 P - B/E
06
MW-49
GW
Gr
TDS
128
mg/L
25
05/02/22
2540 C - TDS
N-NH3
0.111
mg/L
01
05/03/22
4500 NH3 - D
N-NO3
2.40
mg/L
0 C5
05/10/22
4500 NO3 - E
Fec. Coliform-W
<1
CFU
1
04/26/22
9222 D - MF
1100ML
TOG
0.681
mg/L
05/16/22
5310 B2000
Chloride
27.1
mg/L
001
05/09/22
4500 Cl - D
Tot. P
<0.050
m/gl-
0.05
05/03/22
4500 P - B/E
219 S. Steele Str. 919-208-4240
Sanford NC 27330 chris!a,camerontesting.com

Cameron Testing Services, Inc. Laboratory Report
Client: Mountaire Farms CTS Proj.
Project: April 2022 Monitoring Wells Regulatory
Sample Information
Sampled C. Cameron Date 04/26/22 Received
Analyses and Results
NC DENR #654
NC PHHS #37799
US EPA #NCO1918
2204-0224
Yes Page 3 of 5
J.Cameron Date 04/26/22
Lab ID
Sample ID
X
a
o
Analyte
Result
d .�
N
`= Std. Methods
v
c o
3 Reference
a
C7
2204-0224 07
MW-50
GW
Gr
TDS
427
mg/L
25
05/02/22
2540 C - TDS
N-NH3
<0.100
mg/L
0.1
05/03/22
4500 NH3 - D
N-NO3
4.23
mg/L
0.05
05/10/22
4500 NO3 - E
Fec. Coliform-W
<1
CFU
1
04/26/22
9222 D - MF
1100mL
TOC
4.69
mg/L
1
05/16/22
5310 62000
Chloride
172
mg/L
001
05/09/22
4500 Cl - D
Tot. P
<0.050
m/gL
0.05
05/03/22
4500 P - B/E
08
MW-51
GW
Gr
TDS
128
mg/L
25
05/02/22
2540 C - TDS
N-NH3
1.07
mg/L
01
05/03/22
4500 NH3 - D
N-NO3
19.4
mg/L
0.05
05/10/22
4500 NO3 - E
Fec. Coliform-W
<1
CFU
/100mL
1
04/26/22
9222 D - MF
TOC
3.47
mg/L
1
05/16/22
5310 82000
Chloride
70.9
mg/L
oc1
05/09/22
4500 Cl - D
Tot. P
<0.050
m/gL
005
05/03/22
4500 P - B/E
09
MW-52
GW
Gr
TDS
531
mg/L
25
05/02/22
2540 C - TDS
N-NH3
0.165
mg'L
0 1
05/03/22
4500 NH3 - D
N-NO3
25.3
rrm9/L
005
05/10/22
4500 NO3 - E
Fec. Coliform-W
<1
CFU
04/26/22
9222 D - MF
/100ml-
TOC
11.8
mg/L
1
05/16/22
5310 62000
Chloride
135
mg/L
001
05/09/22
4500 Cl - D
Tot. P
<0.050
mrgL
005
05/03/22
4500 P - B/E
219 S. Steele Str. 919-208-4240
Sanford NC 27330 chrisCacamerontesting.com

Cameron Testing Services, Inc. Laboratory Report
Client: Mountaire Farms CTS Proj.
Project: April 2022 Monitoring Wells Regulatory
Sample Information
Sampled C. Cameron Date 04/26/22 Received
Analyses and Results
NC DENR #654
NC PHHS #37799
US EPA #NC01918
2204-0224
Yes Page 4 of 5
J.Cameron Date 04/26/22
Lab ID Sample ID
b
E
Analyte
Result
m E
Std. Methods
U
J
C o
:3 Reference
a
C7
2204-0224 10 MW-53
Gw
Gr
TDS
344
mg/L
25
05/02/22
2540 C - TDS
N-NH3
0.120
mg/L
01
05/03/22
4500 NH3 - D
N-NO3
5.26
mg/L
005
05/10/22
4500 NO3 - E
Fec. Coliform-W
<1
1 FU
1
04/26/22
9222 D - MF
TOC
1.26
mg/L
1
05/16/22
5310 62000
Chloride
44.2
mg/L
0.01
05/09/22
4500 Cl - D
Tot. P
<0.050
m/gL
0.05
05/03/22
4500 P - B/E
M W-54
GVV
Gr
TDS
99.0
mg/L
25
05/02/22
2540 C - TDS
N-NH3
<0.100
mg/L
01
05/03/22
4500 NH3 - D
N-NO3
29.9
mg/L
005
05/10/22
4500 NO3 - E
Fec. Coliform-W
<1
CFU
1
04/26/22
9222 D - MF
/100mL
TOC
3.36
mg/L
1
05/16/22
5310 B2000
Chloride
75.4
mg/L
001
05/09/22
4500 Cl - D
Tot. P
<0.050
mlgl-
0.05
05/03/22
4500 P - B/E
12 MW-55 Gw Gr TDS
86.0
mg/L
25
05/02/22
2540 C - TDS
N-NH3
<0.100
mg/L
01
05/03/22
4500 NH3 - D
N-NO3
1 81
mg/L
005
05/10/22
4500 NO3 - E
Fec. Coliform-W
<1
cFu
04/26/22
9222 D - MF
1100ML
TOC
1.13
mg/L
/
05/16/22
5310 B2000
Chloride
31.2
mg/L
001
05/09/22
4500 Cl - D
Tot P
<0.050
m/gL
0.05
05/03/22
4500 P - B/E
219 S. Stecle Str. 919-208-4240
Sanford NC 27330 chrisii camerontesting.com

Cameron Testing Services, Inc. Laboratory Report
Client: Mountaire Farms CTS Proj.
Project: April 2022 Monitoring Wells Regulatory
Sample Information
Sampled C. Cameron Date 04/26/22 Received
Analyses and Results
NC DENR #654
NC PHHS #37799
US EPA #NC01918
2204-0224
Yes Page 5 of 5
J.Cameron Date 04/26/22
CL
N
Lab ID Sample ID @ o 2 Analyte Result v E m = Sid. Methods
v c 0 Reference
a ct
Report
Review
Project Manager Date
219 S. Steele Str. 919-2084240
Sanford NC 27330 [e-mail]

219 S Steele Str.
Sanford, NC 27330
Phone [phone]
Cameron Testing Services, Inc.
NC WW/GW Cerl #654 NC PHHS Cert # 37799 US EPA NC01918
Chain of Custody
Page / of I
Company:
Mountaire Lumber Bridge
Email:
Rjackson(aMountaire.com
CTS lab use
Contact:
Robert Jackson
Ph910-350-5275
SampleTempLab ID
Address (City,
17269 NC Hwy 71 N
Fax:
Ice (YIN)
State, zip)
Lumber Bridge, NC
28357
Notes:
Permit (YIN)
Project:
22-
Rush (YIN) Due.
Collected:
Name
Signature
Sample Information
Number of bottles
Requested Analysis
a '—`
?
m a 0. f0 N
Preservatives (U)npreserved, H(C)I,
CTS Lab
Sample
ID
o
o @
}
N N o �, <
0j
a`
r
O
H2(S)04. H(N)03, (Na)Thiosulfate. Na(0)H,
ID
U
0
" u' m
Other (X), Indicate
MW 14
``'z�L �s(�
`
1 U
TDS, Cl-, N-NO2
/
MW-15
114i5
15
N-NO3, N-NH3, P-TP
MW-37
14 z6
Na
Fec-W
r3�
MW-47
IZ3&
1 P
TOC
MW-48
12nU
Bottle set for all samples
Field pH/Temp
t,
MW-49
131s
1C
VOC (Dec only)
MW-50
j 3Sb
Analyses for all samples,
MW-51
162.9
M W-52
t S 15
O�
MW-53
/C
Rel' ui :h
Received:
Date/Time
Rush work will require prior approval. Additional charges will apply
a

219 S Steele Str
Sanford, NC 27330
Phnne 919-208-4240
Cameron Testing Services, Inc.
NC WW/GW Cert #654 NC PHHS Cert # 37799 US EPA NC01918
Chain of Custody
Page of
Company:
Mountaire Lumber Bridge
Email: Riacksol-I Mountaire.com
CTS lab use
Contact:
Robert Jackson
Phone:
910-350-5275
Sample Temp
(c)
Lab ID / L
�, /-r�
Address (City,
17269 NC Hwy 71 N
Fax:
Ice (Y/N)
State, zip)
Lumber Bridge, NC
28357
Notes:
Permit (Y/N)
Project:
Rush (YIN)
Due
Collected:
Name:
Signature
Sample Information
Number of bottles
Requested -Analysis
aD
(a. .Q
x
Z
M n- a
W
Preservatives: (U)npreserved, H(C)I,
CTS Lab
Sample ID
`L°
m
}
O o u -
a
Q t
H2(S)O4,
H(N)03, (Na)Thiosulfate, Na(0)H,
ID
~
Cj
U
N °' ' m
O O
Other (X), Indicate
MW-54
`4 j1.ISv
(j ioi
Y
1U
TDS, Cl-, N-NO2
�l
MW-55
tW
W
.�
,�
1S
N-NO3, N-NH3, P-TP
1 Na
Fec-W
1 P
TOC
Bottle set for all samples J
Field pH/Temp
1C
VOC (Dec only)
Analyses for all samples
Relin uishe
Received:
Date/Time
Rush work will require prior approval. Additional charges will apply