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HomeMy WebLinkAboutWQ0001048_2022 Residual Annual Report_20230216 (2)Initial Review Reviewer Nathaniel.Thornburg 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* 2022 Permit Number (IR) * WQ0001048 Applicant/Permittee Contentnea Metropolitan Sewerage District Email Notifications Does this need review by the hydrogeologist? * Yes No Regional Office Washington 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* Charles M. Smithwick, Jr. Email Address* cmsdlOO@embarqmail.com Project Information ......................... Application/Document Type* New (Fee Required) Modification - Major (Fee Required) Renewal with Major Modification (Fee Required) Annual Report Additional Information Other Phone Number* 2525245584 Modification - Minor Renewal GW-59, NDMR, NDMLR, NDAR-1, N DAR-2 Residual Annual Report Change of Ownership We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form. https://edoes.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:* WQ0001048 Has Current Existing permit number Applicant/Permittee Address* P. O. Box 477 Griffon, NC 28530 Facility Name* Contentnea MSD Class B Residuals Program Please provide comments/notes on your current submittal below. 2022 Sludge Land Application Report for the Contentnea MSD Permit No. WQ0001048 At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg at nathaniel.thornburg@ncdenr.gov. Please attach all information required or requested for this submittal to be reviewed here. (Application Form, Engineering Plans, Specifications, Calculations, Etc.) 20230216104351360.pdf 8.35MB 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 Submission Date 2/16/2023 ANNUAL LAND APPLICATION CERTIFICATION FORM WQ Permit#:yrijj(j County: Year: �OzZ Facility Nance (as shown on permit): Cf� � Land Application Operator: f�—R`�-�1�1�� ( Phone: Land application of residuals as allowed by the permit occurred during the past calendar year? 14 Yes ❑ No - If No, ship 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. Total number of a Total number of fields utilized for land Total amount of dry tons fields in the the vear for all the year: ion sites: Total number of acres utilizes for land application during the year: W Part B - Annual Com iance Statement: ZOZ _ with all conditions of the land application permit Facility was compliant during calendar year (including but not limited to items 1-13 below) issued by the Division of Water Resources. 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 fart 503 regulated facilities). 8) All monitoring and reporting requirements in 15A NCAC 02T .1111 were complied with (applicable to 40 CFR Part 503 regulated facilities). 9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior authorization was received from the Division of Water Resources. 10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are attached to include appropriate actions and 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 ]nrowledge 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." Ld 4- Pea,mittee Name and Title (type or print) Signature of Permittee Date exA W4,1-19 Date Signature of Preparer* Date Signature of Land Applier (if different from Permittee) (if different from Permittee and Preparer) * Preparer is defined in 40 CFR Part 5039 (r) and 15A NCAC 02T .1102 (26) l7ENR FORM ACF (1212000) EXPLANATIONS FOR DEVIATIONS FOR THE 2022 ANNUAL SLUDGE LAND APPLICATION REPORT 10-18-22 Monitoring Well #14 Fecal Coliform 1/100 ml Total Chromium 10 ug/L 10-18-22 Monitoring Well 415 Total Chromium 14 ug/L All of the monitoring wells have been flooded several times. We have had them all sanitized in an effort to reduce the Fecal Coliform in the wells. As cited in the report from Groundwater Management Association in 2019, the elevated Chromium levels in the wells are most likely associated with high turbidity levels in the wells. The lime recommendations from the Solis Analysis for 2022 was applied January 3, 2023. The invoice for the lime is included in the report, but not on the Field Summary Forms because it wasn't applied during the calendar year 2022. N 'Cf N �-i O v 1-i N D Q O 0 �1 N 4-t O d5-4 z z y a3 o Q � O � DA N ^� O ro Ell u a k t! ? a R c.) �OZA H 14- 4 i v O F-; (�E U U M O kn a d' 7j N a�i REST DI JAL SAMPLING SUMMARY AND LAB REPORTS E R= 1=rd I A M b r f 4 v Q O O U b 4 cn I ZY 0 Nb L! 1 O m v� t� O CD O � F-r F-� o U' A U0 U JP �uF 1 r� j I(jI}k[ i ((I J 3 [6 � € 3 E(� E_+ o�:) } I 6 ! L �.�.7 !.!:J�.-d�1._3 i.- P_E E.3L 1Li'1f ].J L. �J e.��� i�1 u �.� CMSD (SLUDGE & WELLS ACCT) CONTENTNEA METRO. SEWAGE DIST. MS. RENEE PRIDGEN P.O. BOX 477 GRIFTON, NC 28530 PARAMETERS PH (not to be used for reporting) Aluminum, (dry wt. basis), mg/kg Arsenic (dry wt. basis), mg/kg Calcium (dry wt. basis), mg/kg Cadmium (dry wt, basis), mg/kg Copper (dry wt. basis), mg/kg Chromium, T.(dry wt. basis),mg/kg Lead (dry weight basis), mg/kg Magnesium (dry wt. basis), mg/kg Mercury (dry wt, basis), mg/kg Nickel (dry wt. basis), mglkg Potassium (dry wt. basis), mg/kg Selenium (dry wt. basis), mg/kg Sodium (dry wt, basis), mg/kg Zinc (dry wt. basis), mg/kg Sodium Adsorption Ratio (calc) Total Nitrogen, mg/kg (calc) Total Solids, % TKN (dry wt.), mg/kg Ammonia Nitrogen (dry wt.),mg/kg Nitrate Nitrogen(dry wt.), mg/kg Nitrite Nitrogen(dry wt.), mg/kg Phosphorus, T. (dry wt.), mg/kg Molybdenum (dry wt. basis), mg/kg Sludge Analysis Method Sample Date Analyst Code 5.0 03/17/22 DNS 4500HB-11 17618 03/30/22 LFJ EPA200.7 G2.5 03/30/22 MTM 3113B-04 16086 03/30/22 LFJ EPA200.7 1,5 03/31/22 MTM 3113B-04 236 03/30/22 LFJ EPA200.7 22 03/30/22 LEJ EPA200.7 19 03/29/22 MTM 3113E-04 6292 03/30/22 LFJ EPA200.7 0.30 03/30/22 MTM EPA7471B 17 03/30/22 LFJ EPA200.7 9779 03/30/22 LFJ EPA200.7 C 5.0 03/31/22 MTM 3113B-04 2890 03/30/22 LFJ EPA200.7 786 03/30/22 LFJ EPA200.7 4.9 48438 1.80. 03i22i22 DNS 2540G45 c 48420 03/22/22 BMD 351.2 R2-93 c 44.21 03/26/22 KES 350.1 R2-93 c 10.90 04/11/22 KES 353.2 R2-93 c 6.94 04/11/22 TRJ 353.2 R2-93 c 29430 03/22/22 TRJ 365.4-74 8 03/30/22 LFJ EPA200.7 REVIEWED BY: a Uncertified data. DWR does not offer non -aqueous certification for this analytical procedure, in TCLP LAB REPORTS y, i Tile results set forth herein are provided by SGS North. America Inc. Automated Report Technical Report for Environment 1, Inc Contentnea Metro Sewage District; Grifton, NC 416 SGS Job Number: FA94115 Sampling Date: 03/17/22 Report to: Environment 1, Inc PO Box 7085 Greenville, NC 27835 abrown@environment l ine - com TTN: Ann Brown Total number of pages in report: 14 f r arm F Norm e Test results contained within this data package meet the requirements Technical al Director of the National Environmental laboratory Accreditation Program 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), NC(573), NJ(FL002), NY(12022), SC(96038001) DoD ELAP(ANAB L2229), AZ(AZ0806), CA(2937), TX(T104704404), PA(68-03573), VA(460177), AL, AK, AR, CT, rA, KY, MA, Mi. MS, ND, NH, NV, OK, OR, IL, UT, VT, WA, WI, WV This report shall not be reproduced, except in its entirety, without the written approval of SOS. Test results relate only to samples analyzed, SGS North America Inc. • 4405 Vineland Road • Suite C-15 • Orlando, FL 32811 • tel: 407-425-6700 • fax: 407-425-0707 SGS is the sole authority for :1110101-izing edits or modlficatlt€ns (1) this d0curuent. P1e350 6111n'e your ideas about Unauthorized moditica6on of this report is Strictly lrrcihillitcrl. liq�v we can serve.you bet€c€' at: ltevi(;w standard terms at; http:I,hvtvlu.sl s.coinlenitertrts-and conditions 1 I tS.l1S.CustunterCarc(�i sgs.com 1 of 14 FAJ4115 Sections: -I - Section1: Sample Summary................................................................................................... 3 Section2: Summary of Hits.................................................................................................... 4 Section3: Simple Results ....... ................. .............. a............................................................ 3.1: FA94115-1: SLUDGE SAMPLE.................................................................................. ..... 6 Section4: Misc. Forms............................................................................................................ .12 4.1: Chain of Custody........................................................................................................... 13 SGS North America Inc, Sample Summary Environment 1, Inc Contentnea Metro Sewage District; Griffon, NC Project No: 416 Job No: FA94115 Sample CoUceted Matrix Client Number Date Time By Received Code Type Sample ID This report eorfam� res. uNot defected, The folloryzng applies Organics ND = Not detected above the MDL FA94115-1 03/17/22 10:40 AE 03/19/22 SO Sludge SLUDGE SAMPLE Soil samples reported on a dry weight basis unless otherwise indicated on result page. 3of14 PA94115 Summary of Hits ,lob Number: FA94115 Account: Environment 1, Inc Project: Contentnea Metro Sewage District; Grifton, NC Collected: 03/17/22 Lab Sample ID Client Sample ID Result/ Analyte Qual RL F'A94115-1 SLUDGE SAMPLE Corrosivity as pH 5.1 Ignitability (Flashpoint) e > 200 (a) Not ignitable. Page 1 of 1 0 MDL Units Method su SW846 CHAP7 Deg, F SW846 1020C MOD 4of14 PAS4115 f Sample Results. Report of Analysis 5 of '14 FAWI S SGS North America Inc. Report of Analysis Page I of I Client Sample ID: SLUDGE SAMPLE Date Sampled: 03/17/22 Lab Sample ID: FA94115-1 Date Received: 03/19/22 Matrix: SO - Sludge Method: SW846 8260D SW846 1311 Percent Solids: 1.8 Project: Contentnea Metro Sewage District; Grifton, NC File ID Dp Analyzed By Prep Date Prep batch Analytical Batch F4Run1 5E31695.D 10 03/29/22 22:19 LR 03/23/22 10:00OP90361 VSE1457 #2 Purge Volume #1 5.0 ml #2 VOA "TCLP List CAS No. Compound 71-43-2 Benzene 78-93-3 2-Butanone (MEK) 56-23-5 Carbon' Tetrachloride 108-90-7 Chlorobenzene 67-66-3 Chloroform 106-46-7 1,4-D ichlorobejnzene 107-06-2 1,2-Dichloroethane 75-35-4 l,l-Dichloroethylene 127-18-4 Tetrachloroethylene 79-01-6 Trichloroethylene 75-01-4 Vinyl Chloride CAS No. Surrogate Recoveries 1868-53-7 Dibromofluoromethane 17060-07-0 1,2-Dichloroethane-D4 2037-26-5 Toluene-138 460-00-4 4-13romofluorobenzene Result HW# MCL RL ND. ; ',`' : ::: D018 0.50 0.010 ND.`:' `. D035 200 0,050 ND D019 0.50 0.010 ND `. D021 100 0.010 ND D022 6.0 0.010 ND D027 7.5 0.010 ND. ': ,: D029 0.50 0.010 ND D029 0.70 0.010 ND D039 0.70 0.010 ND D040 0.50 0.010 ND D043 0.20 0.010 Run# 1 Run# 2 Limits 100% 83-118% 93% 79-125% 107% 85-112% 106%' .. 83-118% TCLP Leachate method SW846 1311 MDL Units Q 0.0031 mg/1 0.020 mg/l 0.0036 mg/I 0.0020 mg/l 0.0030 mgll 0.0026 mg/l 0.0031 mg/l 0.0032 mg/l 0.0022 mgll 0.0035 mg/l 0.0041 mg/l ND = Not detected MDL = Method Detection. Limit J = indicates an estimated value MCL = Maximum Contamination Level (40 CFR 261 7/l/l 1) B = Indicates analyte found in associated method blank E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound 6 of '14 FAR4115 SGS North America Inc. Report of Analysis Client Sample ID: SLUDGE SAMPLE Lab Sample ID: FA94115-1 Date Sampled: 03/17/22 Matrix: SO - Sludge Date Received: 03/19/22 Method: SW846 8270E SW846 3510C Percent Solids: 1.8 Project: Contentnea Metro Sewage District; Grifton, NC Page 1 of 1, File ID DF Analyzed By Prep Date Prep Batch Analytical Batch #1 X080437.1) 1 03/31/22 21:09 WH 03/28/22 11:00 OP90447 SX3231 #2 Initial Volume Final Volume Run # 1 100 m1 1.0 ml Run #2 ABN TCLP List TCLP Leachate method SW846 1311 CAS No. Compound Result HW# MCL RL MDL Units Q 95-48-7 2-Methylphenol ND D023 200 0.050 0.0056 mg/1 3&4-Methylphenol ND D024 200 0.050 0.0098 mg/1 87-86-5 Pentachlorophenol ND: D037 100 0.25 0.050 mgll 95-95-4 2,4,5-Trichlorophenol ND D041 400 0.050 0.0074 mg/I 88-06-2 2,4,6-Trichlorophenol ND D042 2.0 0.050 0.0075 mg/1 106-46-7 1,4-Dichlorobenzene ND D027 7.5 0.050 0.0050 mg/l 121-14-2 2,4-Dinitrotoluene ND D030 0.13 0.050 0.0081 mg/l 118-74-1 Hexachlorobenzene ND D032 0.13 0.050 0.0069 mg/l 87-68-3 Hexachlorobutadiene ND.. D033 0.50 0.050 0.0050 mg/l 67-72-1 Hexachloroethane ND D034 3.0 0.050 0.016 mg/1 98-95-3 Nitrobenzene ND D036 2.0 0.050 0.0093 mg/1 110-86-1 Pyridine ND D038 5.0 0.10 0.020 mg/I CAS No. Surrogate Recoveries Run# 1 Run## 2 Limits 367-12-4 2-l;luorophenol 30% 14-67% 4165-62-2 Phenol-6 20%: 10-50% 118-79-6 2,4,6-Tribromophenol 66% 33-118% 4165-60-0 Nitrobenzene-d5 67% 42-108% 321-60-8 2-Fluorobiphenyl 62% 40-106% 1718-51-0 Terphcnyl-dl4 75% 39-121% ND = Not detected MDL = Method Detection Limit 7 = Indicates an estimated value MCL = Maximum Contamination Level (40 CFR 261 7/l/11) B = Indicates analyte found in associated method blank E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound 7oti4 FA94116 SGS North America Inc. Report of Analysis Page 1 of 1 Client Sample ID: SLUDGE SAMPLE Lab Sample ID: FA94115-1 Date Sampled: 03/17/22 Matrix: SO -Sludge Date Received: 03/19/22 Method: SW846 8151A SW846 3510C Percent Solids: 1.8 Project: Contentnea Metro Sewage District; Grifton, NC File ID DF Analyzed By Prep Date Prep Batch Analytical Batch Run #1 CC081 t90.D 1 03/29/22 15:35 AF 03/28/22 13:30 OP90449 GCC2055 Run #2 Initial Volume Final Volume 81 10.0 ml 5.0 ml #2 Herbicide TCLP List CAS No. Compound 94-75-7 2,4-D 93-72-1 2,4,5-TP (Silvex) CAS No, Surrogate Recoveries 19719-28-9 2,4-DCAA Result HW# MCL RL ND D016 10 0.050 ND D017 1.0 0.0050 Run# 1 Run# 2 Limits 1150/4 39-135% TCLP Leachate method SW846 1311 MDL Units Q 0,017 mg/1 0.0013 mg/1 ND = Not detected MDL = Method Detection Limit J = Indicates an estimated value MCL = Maximum Contamination Level (40 CFR 261 7/1/11) S = Indicates analyte found in associated method blank E = Indicates value exceeds calibration range N = Indicates presumptive evidence of a compound 8of14 FA84118 SGS North America Inc. Report of Analysis Page 1 of 1' Client Sample ID: SLUDGE SAMPLE Lab Sample ID: FA94115-1 Date Sampled: 03/17/22 Matrix: SO -Sludge Date Received: 03/19/22 Method: SW846 8081E SW846 3510C Percent Solids: 1.8 Project: Contentnea Metro Sewage District; Grifton, NC File ID DF Analyzed ByPrep Date Prep Batch Analytical Batch Run #1 ST160579.D 1 04/01/22 07:28 WH 03/28/22 12:30 OP90448 GST3908 Run #2 Initial Volume Final Volume Run #1 100 ml 5.0 ml Run #2 TCLP Leachate method SW846 1311 Pesticide TCLP List CAS No. Compound Result HW# MCL RL MDL Units Q 58-89-9 gamma-BHC (Lindane) ND D013 0.40 0.00010 0.000022 mgll 12789-03-6 Chlordane ND D020 0.030 0.0010 0.00038 rngll 72-20-8 Endrin a ND D012 0.020 0.00020 0.000021 mg/l 76-44-8 Heptachlor a ND D031 0.0080 0.00010 0.000026 mg/1 1024-57-3 Heptachlor epoxide a ND D031 0.0080 0,00010 0.000020 mg/1 72-43-5 Methoxychlor a ND „ .: D014 10 0.00020 0,000050 mg/1 8001-35-2 Toxapheae ND D015 0.50 0.0050 0.0021 mgll CAS No. Surrogate Recoveries Run# I Run# 2 Limits 877-09-8 Tetrachlora-m-xylene 98%. `: 42-127% 2051-24-3 Decachlorobiphenyl 94% 27-1271/6 (a) Associated CCV outside of control limits high, sample was ND. ND = Not detected MDL = Method Detection Limit J = indicates an estimated value MCL = Maximum Contamination Level (40 CFR 261 7/1/11) B = Indicates analyte found in associated method blank E = Indicates value exceeds calibration range N = indicates presumptive evidence of a compound .. -SGSTL 9 of 'f 4 FM4115 SGS North America Inc. Report of Analysis page I of I Client Sample ID: SLUDGE SAMPLE Date Sampled: 03/17/22 Lab Sample ID: FA94115-1 Date Received: 03/19/22 Matrix: SO -Sludge Percent Solids: 1.8 Project: Contentnea Metro Sewage District; Grifton, NC Metals Analysis, TCLP Leachate SW8461311 Analyte Result HW# MCL RL Units DF Prep Analyzed By Method Prep Method Arsenic < 0.10 D004 5.0 0.10 mg/1 1 03/29/22 03/30/22 LM SW846 6010D 2 60101) 2 SW846 301 OA 4 SW846 3010A 4 Barium; <2.0 D005 100 2.0 0.050 mg/1 mg/l 1 1 03/29/22 03/29/22 03/30/22 LM 03/30/22 LM SW846 SW846 6010D 2 SW846 3010A 4 Cadmium < 0.050. D00fi < D007 1.0 5.0 0.10 mg/1 1 03/29/22 03/30/22 LM SW846 6010D 2 SW846 3010A 4 Chromium 0.10 Lead < 0.050 D008 5.0 0.050 mg/1 1 03/29/22 03/30/22 LM SW846 6010D 2 1 SW846 3010A 4 SW846 7470A 3 Mercury < 0.0050 D009 0.20 0.0050 0.10 mg/l mg/I 1 1 03/28/22 03/29/22 03/28/22 JC 03/30/22 LM SW846 7470A SW846 6010D z SW846 3010A 4 Selenium <0.10 :: DOW < 0.10 , DO11 1.0 5.0 0.10 mg/l 1 03/29/22 03/30/22 LM SW846 6010D 2 SW846 3010A 4 Silver (1) Instrument QC Batch: MA18552 (2) Instrument QC Batch: MA18561 (3) Prep QC Batch: MP40471 (4) Prep QC Batch: MP40481 RL = Reporting Limit MCI, = Maximum Contamination Level (40 CFR 261 7/1/11) 14 of 14 I FA34115 SGS North America Inc. Report of Analysis Page I of 1 Client Sample I➢: SLUDGE SAMPLE Date Sampled: 03/17122 Lab Sample ID: FA94115-1 Date Received: 03/19/22 Matrix: SO - Sludge Percent Solids: 1.8 Project: Contentnea Metro Sewage District; Griffon, NC General Chemistry Analyte Result RL Units DF Analyzed By Method Corrosivity as pH 5.1 su 1 03/23/22 13:23 rB Sw846 CHAP? Cyanide Reactivity < 8.2 ` 8.2 mg/kg 1 03/25/22 10:14 AC SW846 CHAP7 Ignitability (Flashpoint) a > 200 Deg, F 1 03/23/22 11:13 RA SW846 1020C MOD Solids, Percent 1.8 % 1 03/24/22 11:56 RA SM19 25400 Sulfide Reactivity 270 270 mg/kg 1 03/24/22 14:47 7C SW846 CttAr7 (a) Not ignitable. RL = Reporting Limit 11 of 14 FA9411B ection Misc. Forms Custody Documents and Other Forms Includes the following where applicable; • Chain of Custody 12 of 14 FA94115 `Etiv13'usiment 1, Inc. PO Rnx 7OR5. 114 Oakmont Dr. CT4 Cc M: p.l GI (2! CHAIN OF CUSTODY RE, CORD P1A +) 1'5 Pugc i or I ,ecenvil€e, NC 27858 nviron WentSinc.com DISIN€'DCLION COLLECTION'hone (252) 756-6208 Pax (252) 756-0633 CHLORINLILIENT: FCHL(nN[NEUITRALIZEOAT CK{LAB} 416 Week-. 10 uvNER TYPE, PIG ISD (SLUDGE & WELLS ACCT) NONE Y P p G G G G G ..._^ CHEWCALPRESERVATION VNTTrNTNEA METRO. SEWAGE DLST. i. TLENEy PRIDGEIY p A A A A A A A X BOX 4W LIFTON NC 28530 1� A •NONE D- NAOH Vl �, o E 524-5584 = . ui Z ur w o 3 B-MNO, E-HCL i2) . C -Hz50, F , ZINC ACETATEJNAOH a r. �: �. g u- i -a �� `c G- NATHIOSLIVATE pc E5AMPtECATI�*1 Y PTIME ye 5 �� CL4SSIFlCATiON: mple WASTEWATER (NPDES) DRINtiNGWATER DW€JGW SOLID WASTESEOTION USTODY (SEAL) MAINTAINED NG MENTIDELIVERY �Y N FSA 1N111 L M OLLECTED BY: 4 SAMPLES RECEIVED INLA13AT --'C UATF�TIAkC SiE cNED BY I - B ME M GOh MEN75: R€1JN)UISRED BY I� ) I.SA AI LEA# rraall3Y HCL tEDt3Y{SIG.)' S -oo DATEIME RBS VC-R Y(SKi,) DATF�i•1l/lflCy (` DATFAME CEIEQmSIG.) L` SG$ 3tlg iF1[IiJE ' �{ M .q l 1f'.( a✓ 15 � ; t O. Sampler must place a'V iot composite sample or a V for ° 5151778 tt pLL4iSE REAC)irL3lruCliolls Iot COnL[11pI€llg INIs rarrn 0n 111 rf:vB ��1FG. Crab sample In the blocks above (or each naramates rennastan. cnwra a��Jre'i /_ p 7l`�-�Zy �1;�jD FA94115: Cilain of Custody Page I of 2 13 of 14 ma4115 SGS Sample Receipt Summary Job Number: FA941115 Client: ENVIRONMENT 1, INC. Project: CMSD (SLUDGE & WELLS Date ! Time Received: 3119/2022 9:30:00 AM Delivery Method: FEDEX Alrblll Vs: Therm ID: IR 1; Therm CF: 0,4; Cooler Temps (Raw Measured) °C: Cooler 1: (4.0); Cooler 2: (3.2); Cooler Temps (Corrected) °C: Cooler 1: (4.4); Cooler 2: (3.6); tf of Coolers: 2 �� Y or N _ a e of 1. Custody Seals Present ® ❑ 1. Sample labels present an bottles 2. Custody Seals Intact ® © 2. Samples preserved properly 3. Temp criteria achieved 0 ❑ 3. Sufficient voiumelcontainers recvd for analysis: 4. Cooler temp verifcaftrt IR Gun 4. Condition of sample 5. Cooler media Ica 5. Sample recvd within HT 6. Dates/TimesllDs on COC match Sample Label N/A 7. VOCs have headspace 1. Trip Blank present 1 cooler ❑ ❑ © 8. Bottles received for unspecified tests 2. Trip Blank listed on COC ❑ ❑ © 9. Composiling Instructions clear 1a. Voa Sail KitsMars received past 48hrs? NIA 11. % So€ids Jar received? 3. Type Of TB Received ❑ ❑ © 12. Residual Chlorine Present? Y or N NIA © ❑ ® ❑ ® ❑ n[a ® ❑ ❑ ❑ 9 ❑ ❑ B ❑ ❑ ❑ ❑ Sd Number of Encores: 25-Gram 5-Gram Number of 5035 Field Kits: Number of Lab Filtered Meiais: Tort Strip Lot *s: pH 0-3 230315 pH 10-12 219813A Other: (Specify) Residual Chlorine Test Strip Lot 9: Comments Smoot Technician: SAMLIELM Date: 311912022 9:30:00 AM Reviewer: Date: Rev, Date M241 it FA94115: Chaim of Custody Page 2 of 2 14 of 14 FA94115 N 0 v, O nO rn W . C > ul OO t~ .� l o7� �% 0 d. " m 4Y ri Z !�3 X_ m TOTAL CHLORINE, rr?q"':LlLt u 0 �� - � OR ugli AT COLLECTION � n� m rr =MP URE, °Ga rrCTOV cr cr trs . � #CAP CWAINERS' �t :. Reactivity > t Ig►zitability { Corrosivity ro 7-f TCLP VollSvol C7 ` TCLP Pesticides = TCLP Herbicides > 0 TCLP Metals Y 0 TCLP Extra `a �i i? a r cn r PARAMETERS/TESTS C L_1 �i Ci Ei7 Ci Z Ci 3 Qi 0 -n DD m t O c> J v L G. Per 0 � M f LAND APPLICATION FIELD SUMMARY FORMS U z ry y H Ammonia Y U Nitrogen E H E4k a Mineralization Rate***kZ, Volatilization ° 1 Rate** N rn t5' Application to 0 Method* ^Q CO41 Pk-e o uP-�-E>:' U w O v y -d O ¢ d (77 Q o V O U � -k N tj N t� qjuo G .to a��Q 4.1 C3 S� d bA C O s d U C t Q� O ws cd PC r-f m CO R cv o CO aw bfi U . rs P. w �' 0 n u U o P4 > '0: O A O t2t O � G. c a�i ai 4.. O� 4-1 3 O <u O k. bA U � ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: cm-tmdLen--CD6D _Total Dry Tons Applied (Annual): i5. () 0 Permit #: Cation Exchange Capacity (non 503 only): q. 5 Operator: Owner' - Cyr l) -D Predominant Soil Se►'ies: 4] Acres Used: Z-1�644 Acres�Permitted: jX6Q- Site #: -j Field #: 1 Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #): Sample or 1 2 3 4 5 6 7 8 9 10 11 12 Com- posite Date _22 % Solids ! .�6UF3ca Arsenic < Z .6 Cadmium Copper I Chromium ZZ Lead I lG Molyb- denu g Nickel 1-7 Selenium <5. e) Zinc `] (a Total Phos- Cnnual Heavy Metal Field Loadings (Calculated in lbs/acre): Total 1 2 3 4 5 6 7 8 9 10 11 12 H 0 DT/Ac./ `-App. 1✓ t ven Arsenic 5 Cadmium C) Copper p i LlZ Z —hron iuin p , (�q d Lead Mercury Molyb- C' bZ�i f Nickel p p(r,1 Selenium 041. Z Zinc Total Phos- i horus "I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations'". Signature of Land ApplieDate s' DENR FORM MFLSF (12/2006) U bo .�4 ` 4) A z� b � � a o U z�z wa�: M Ammonia Y c Nitrogen m E " Mineralization Z }late*** Volatilization �D C, f 4 Rate** c� L Application PP b Method* -h.-•• ..... C • � m .9 } rm If 0 y 1.. U o O b0 .�Q 01t7.a .'. O ^ U nn F� ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this forin to the corresponding Field Loading Summary Form to be submitted in Annual Report Data (Heavy Metals and Total 2Z3b IT a.3D g E) < 5j D % MOW fetal Field Loa b Facility Name: Cr-)FA Total Dry Tons Applied (Annual): 41, 604-1 Permit #: Cation Exchange Capacity (iron 503 only): C !j Operator: (� {j fll.� I � Owner: rmfer" I cc, W Predominant Soil Series: �a(� _ Acres Used: �(p Z _Acres Permitted: Site #: �j _Field #: Residual sample or Com- posite Date % Solids J. )c Arsenic C Z•5J Cadmium E ,5 Lead l " Mercury •3 Molyb- denum Nickel Selenium < 5. Zinc IN , Total Phos- Annual Total DT/Ac./ `. App Event Arsenic Cadmium Lead Mercury 0 Molyb- in lbslacre): use mgllig, % Solids use Raw Percent H Signature of Land Applier Date DENR FORM MFLSF (12/2006) 'd F4 z U c�E . ........... .......... P p U JL P+ U � M 4V 40. Ammonia Y o � N c3 rZ Nitrogen Mineralization Rate*** Volatilization 1[� 7 + Rate** ' Application Method x U IC a yL •" C ."O.` GC Q '� N •.�. p U.. '••:•: � U N Q c Cd U) U U O C, > N �a c U v p U v o b Ri U P� G Q 0 N LL O LL z w Q ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Dame:. 1�.+,r.a �r�lr� L`l1�17 Total Dry Tons Applied (Annual): �3 •�U3 Permit #: IP-nomio 4q' Cation Exchange Capacity (non 503 only): �( . Operator: �Y j �1�}, 6.1'sli�iiY�( vjJ Ownet, : �� A- YY1 Predominant Soil Series; L�l� Acres Used: 2 "2 Acres Permitted: Z, iZ Site #: Z Field H. _ Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #): iampie or Com- posite Date % Solids Arsenic e 7 rj (� Cadmium l 1.5 Copper I Z-3(.,> -2,3(f;. hromium 2z Lead IQ I G Mercury Cj , t) D Q Molyb- Nickel I-] Selenium <5,C . Z Zinc6 Total Phos- �n—nu aI Heavy Metal Field Loadings (Calculated in lbs/acre): Total 1 2 3 4 5 6 7 8 9 10 11 12 y DT/Ac./ App. Event Arsenic Cadmium o i Copper. Chromium 0 Lead id.UZ Mercury Molyb- denurn Nickel 0, 04 Selenium p . I 0 3 a; �• Zinc ) .. Total Phos- horus 4 i ici. 3 4. "I certify, under penalty of lava, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations". Signature of Land Applier Date DFNR FORM MFLSF (1212006) �J C) U r �-t a�i � o N U A z z E 4° Ammonia 4'E Nitrogen v� ... Y rn � O Cn T eD Mineralization Rate*** S Volatilization kOo Rate** Application Method* U F a a. - 42 o Q o Cu q m qjuOw xoa}uQ t ° wUwPL� a 0 0 N CV LL 0) LL 2E 0-1 LL i.L Z w 0 ANNUAL METALS FIELD LOADING SUMMARY FORM` Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: ��,�� g ty(�G:1`115D Total Dry Tons Applied (Annual): Permit #: OQCODj (� Cation Exchange Capacity (non 503 only): 4-.6-_ __ Operator: (� '4. Owner: Predominant Soil Series: lam, ydK321 -� Ll Acres Used: �,'bq Acres Permitted: Site #: Field #: Residual Analysis Data Sample or 1 Cozx1- posite Date -77 % Solids 1, $ 7 Arsenic CZ� 5 Cadmium 1. 6 Copper 7_-2,6 Lead Molyb- Nickel 1 r Selenium ,p Zinc 1h (a Total Phos- 1 Heavy Metal Field Total 1 DTIAc.I "—V App. (,j G vy Metals and Total Phosphorus use inglkg, % Solids use Raw Percent Calculated in lbslacre Event Q, o w7- Arsenic . QOZ Cadmium Copper `- ,j'L o' IZ -hromium Lead Mercury p a: Molyb- domilm 7 Nickel Seleniumn , Zinc a7L�1v � Total Phos- "ent I certify, under penalty of law, that this documwas prepared under any 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 fincs and imprisonment for knowing violations". Signature of Land Applier Date DENR FORM MFLSF (12/2006) N - o N d N R tj m Ammonia N N Nitrogen E Mineralization rto NO Rate*** Volatilization o 0 l -: Rate** CO -r' Application w x cs Method* �� O U N Ia a 0 CY C D N � ��„rqI t�1 Q tc� 40 CCd U o U O C] o y - N a NUU �Q 10 a L>I-iLL R� R a 0 0 N LL U) L O t�. Z W Q ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: CCSn �p k lYl Total Dry Tons Applied (Annual): 0.&03 E Permit #; t��l'Y7�C�� g Capacity Predominant Soil Series: ^ 5 Cation Exchange Ca acr non 503 only): L ( Operator: (`iygrl 'Ill �m� l�-tC�L �C. Owner: CCX>�-e� �( Acres Used: Old Acres Permitted: ._T4 Site #: `i3 Field #: S Residual Analvsis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #): ;ample or Com- posite Date % Solids Arsenic Cadmium. i . F Lead I l Gj Molyb- Nickel Selenium Zinc Total Phos- Cd c� Z 'd N P, Lk A Q or}o f ice. Y U7 � _ l", 1 ,�.'.'.'.'.'.'.'.'.'..,. •. ?� :.:::.:.:.:.:.:.:.:.::: Ammonia N N Nitrogen E � U) i^ V '::•: E 0 Q Mineralization Rate*** 0 Volatilization <1 Q, q _ Rate" [y v N Application 5 4 Method* o o :•:_: u o d 3 U N 'Y 0 4� U o 'a O Cj�iIo�j�[ N a [-4 Pi U P-I U u � p � O O G C? "'; ` N Im L J= 'O ceS 4) y� y d' cd A., T^•i o �� yy, •�Qoa t4 ) O o i. v, va U m Ki > o bbU p sa u 'G p � P• o.oAu � � � � •k ice.. '.E o � m � p c p t� 0 F1 a (0) © ayi w 04 p d? o a o pD t N in, •b 1. P 0 R7 � 40, y. U lK 1-d 0 ANNUAL METALS FIELD LOADING SUMMARY FORM' Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: 4 m6D Total Dry Tons Applied (Annual): 1 y -Wrl Permit #: 1,4(1f pi(4q Cation Exchange Capacity (non 503 only): Operator: i`�Yli� lit �tY1[ '�i� )ICC r Owner : Aer" r D(1b1� Predominant Soil Series. Acres Used • Acres Permitted: Site #: � IT Field #: g — Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #): Sample or 1 2 3 4 5 6 7 8 9 10 11 12 Com- posite Date &n ZZ %Solids 1 • . Cad►niu�n i _ Fj • j • � _ ',hromium ZZ Z Lead 1 1 Gl Mercury Molyb- denu e g Nickel Selenium Z ) �� Zinc 7 (v 7 (o Total Phos- Wnual Heavy Metal Field Loadings (Calculated in lbs/acre): Total 1 2 3 4 5 6 7 F 8 9 10 11 12 y 0 DT/Ac-/ -App. Event Arsenic o, W3.. C04 Cadmium p , `, 'Z Copper e� Chromiur �� 03 [� `I e Lead? '7 Mercury oiw OtGO-0 '' C Molyb- ! , C7Z. U23: Nickel U ,: ' 64 Selenium pj'i , Zinc Total Phos- horus Ll I I t43, "I certify, under u penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations". Signature of Land Applier• Date DENR FORM MF1_SF (12/2006) n Uaq bA p O O Z v c� O b •o :: cy ,p � bn yam, zs rA v. v, U o �, "N w P, r s N] li' m � :p p � bi A U 0 U v Z Z E �. b �E W Ammonia y f� N a o U o 0 W ar N :: > "C3 p Nitrogen PW f� .:.: G w sue. m U Mineralization �en0, b••U� *n] � Zn Rate*** ZxUo ► — ! , " ' ,t q rd�fCc+1 rp Volatilization � U Rate* � bf Application w Method* WN C. o m aa zz PA w 8wa�� P.( r G4O 043 01 45 Gn ,1 .a--- -j 1-4 P;,TO OTUCI w co 0 0 N CV LL Q) LL LL z LLI 0 ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: - C'(-y)+e-nonea-cc6D Total Dry Tons Applied (Annual): j Z .610 Permit #: LkocoioL4 Cation Exchange Capacity (non 503 only): 45 Operator: (itbiy)• 'S- )'Aj n lck� Owner: Predominant Soil Series: Acres Used: 5 l Acres Permitted: I rj Site ft.0 T(oCJT Field #: Residual Analysis Data (Heavy Metals and Total Phosphorus use rng/l"g, % Solids use Raw Percent #): Sample or 1 2 3 4 5 E 7 8 9 10 11 12 Com- posite Date 641V '] zz ) 7Z °10 Solids j • ! Arsenic < .5 < Z 5 < 26 Cadmium ro Copper zz 69 Chromium Z Z ZZ Z Lead 1 Mercury o.30 0,3D Molyb- Nickel f I yj I l Selenium Zinc �6Zp Total Phos- horus Zit �LOv jCjZ4 Annual Heavy Metal Field Loadings (Calculated in lbs/acre): Total 1 2 3 5 6 7 8 9 i o 11 12 H DT/Ac./ 0 -App. U� 13velzt I i O , Arsenic O COS Cadmium 3 O -002 2 Copper p . t : , 2-)'5 IOq Chromiumd l , Lead b, 4tl 04 7 Z : 3 Mercury Moly6- 0., I Niciccl y e 1 !Sl lJt Selenium 00 Zine I . I , U' I t3.44 Total Phos- 1 phorus 141,ZDZ "I certify, under l penalty of law, that this document was prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations". Signature of Land Applier Date DENR FORM MFLSF (12/2006) u v N : 'd • U yr o V T7 N ¢ P ° ... U C� Z E C` a° Ammonia Nitrogen E d c`. " >: o �. � Mineralization � Rate*** O O n Volatilization c Rate O o G��s Application bf Method*� � pp rLn N b DO 0 8 �Cn qjuoW R, Y H ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: ('{�! �{ �� �LYI'�f7 Total Dry Toes Applied (Annual); Permit #: I �[�t Q�n( � Cation Exchange Capacity (non 503 only): Operator: Owner: Predominant Soil Series: Acres Used: Acres Permitted: Site #: Field #: Residual Analysis Data Com- posite Date in, % Solids 5 Arsenic < 5 Cadmiuml 1. 15 Copper z Chromium -ZZ. Lead Ict Mercury 0, 3 D Molyb- Nickel 1-7 Selenitun 4 Zinc Total Phos- Annual Heavy Metal Field Total 13 DT/Ac./ Z ZZ App• Rvent n_ -1 L1- l Metals and Total Phosphorus use in lbs/acre): % Solids use Raw Percent #): y� -1 1/ 6+` Signature of Land Applier Date i' i DENR FORM MFLSF (12/2006) U o UPL an . N v R rM 40. r Ammonia N r Nitrogen F o a Mineralization Z € �` <•:': [Late*� * Volatilization ko Rate" w HApplication Method*� �i P� P� Q o � 0C � — a(,0Cd o ¢ � � � �• O U N p � OR q ..e 0 y ✓' LIJUON -ea , 0 ao a} U w: CL� ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: (� MWD Total Dry Tons Applied (Annual): 3, a)l Permit #: 04( ; Cation Exchange Capacity (non 503 only): 4.6 Operator: j �IG� i . Owner: Predominant Soil Series: Acres Used: 300 Acres Permitted: , 0� Site #: T T Field #: 14 ,onrM-1 A —I—vir Mafa fuPwvv MPtalc and 'T`atai Phosnhnrus use mg/kg. % Solids use Raw Percent ft Sample or Com- posite Date _-iz 5 6 7 8 9 10 11 12 % Solids 1.5 Arsenic < • 5 Cadmium I -'5 Copper &3 b Chromium ZZ Lead I Mercury Molyb- denii Nickel Selenium <, 0 Zinc (o Total Phos- horas 430 Annuai heavy rvictui r ium joaur,xgN k—j-1—rou — i"a, a , j. Total 1 2 3 4 5 6 7 S 9 10 11 12 H DT/Ac,/ 0 App. �,cv{ Event l•(Y�t Arsenic C).005 Cadmium 7j O •'GY73 Copper 7 Z o Z Chromiur C)U4 0.044 Lead C33`� 3g Mercury O . .. ` 1 o cD6 Molyb- demira 0,01 � Nickel 34 y Selenium p 0 o :.OI Zinc -6-)Li {•' Li:` Total Phos- hoaus 51 Jq lq 5�a�il? "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". nl Signature of Land Applier L� Date DFNR FORM MFLSF (12/2006) P ~ U C4.V '_' '• p pR', N Z N �P� U R U :........:........ rn Z Z o _ Ammonia N Nitrogen E 0. Mineralization c� FTw z Rate*** Q � Volatilization O Rate** Gn + Application r � Method's � O x 0 ::.:.: • N vi 4% � � 5 PK O -- _ U) C j yr a U U 1) �C d) 0 O o � U y +•fl t N >v�a fl .('��,w U 'd ITIUOIN ao eILQ ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name:. C'Cf)Ci l7 Total Dry Tons Applied (Annual): z 7DZ Permit #: 0(, c` C01pLI4 Cation Exchange Capacity (non 503 only): 4 - 5 Operator: �y i l 1�1..`�r�i j4� �L.Owner: k 1��� Predominant Soil Series: Acres Used: Acres Permitted: •Z.,3 Site #: .Field #: ) Rncirlv,a1 Ana1v6Q Tiara (Nenvv Metals and Total Phosphorus use mfflkg. % Solids use Raw Percent 4): Sample or Com- posite Date 1 V 3-nrzz 2 3 4 5 fi 7 8 9 10 11 12 % Solids 1, Arsenic Cadmium Copper Z3 L" Chromium Z Lead CI Mercury C),30 Molyb- denum Nickel Selenium <6, Zinc Lq Total Phos- phorus 2P43D 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". .24 Signature of Land Applier Date DE=NR FORM MFLSF (12/2006) a C,7 I �. U o' z� cv U a ro bZO tj , zz40. Ammonia Q Nitrogen 0. 1-�O Q Mineralization Z f :•'` Rate*** U Volatilization I � 0 Q -S ` Rate** a � Application Method* OO il a IS G � p tJ N r G / Q u � o. Q � 9 (S' .•.•, N Q O v � V Ed x- H U o O MO d Al pC n ry Cd U U CjjitO� �R•) :�:: � PL' .O q 0 O o q� u o a�i r -4 w) R O � � O C SO.s vi v, "C7 v © Aa 0 rj U Pam. m GO m 42, M nnU o o � � ,'m ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: �,,� t0_ I"i,_t7 Total Dry Tons Applied (Annual): 3[v(55 Permit #: V)Qocpl CLK� Cation Exchange Capacity (non 503 only): 14, f Operator: chcLtie3rfl,brfiitv�id f, Owlier: -}-ep44)eo_1Y)&D Predominant Soil Series: /� r Acres Used: z , cied Acres Permitted: Z.q q Site #: T) Field #: t �, Residual Sample or Com- posite Date Analysis Data i 2 Z2 (Heavy Metals and Total 4 5 Phosphorus 6 use tnglkg, % Solids use 7 8 9 10 Raw Vereent #): 11 12 % Solids PL Arsenic Cadmium 1.15 Copper Chromium Lead Ci Mercury p Molyb- Nickel -j Selenium < Zinc ' j to Total Phos- horu Q3 D Anneal Heavv Metal Ftelq LoaclanLs (Uateulamea in IDS/acre). "I certify, under penalty of law, that this document was prepared under my direction or supervision in accor ance 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". f �r� Sigiiature of Date DENR FORM MFLSF (12/2006) N r d a N in fJ � U U o x (V o H o jjrc� r .:.:.:.:•:•:•:•:.:.:...tj .d �- 0. i 0 .:Q ............. ::•: Ammonia N N Nitrogen E -0 N T (A Mineralization, Z CQ Rate*** O d Volatilization V) Rate**kP r� rJ Application xbL *� Method* V)� �N -0 _r 0 0 wP. to o r .� U 49 u _ a � ' U 9� g .9 — o b - p U P � U � •� 43 p a U JO OIBC[ E P-� U P-i Re 4 q ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: . Total Dry Tons Applied (Annual): L/. ZD3 Permit #: _�jCj�t;Lt _ Cation Exchange Capacity (non 503 only): t{ j Operator: Chal IOwner: Predominant Soil Series: f Acres Used: 3- (o Z Acres Permitted: 31to Z Site #: Field #: QPuM,val Analveic Data (FIPaw Metals and Total Phosphorus use mu/ka, % Solids use Raw Percent #): Sample or Com- posite Date 1 y 2 3 4 5 6 7 8 9 Tr_11 12 % Solids �. Arsenic Cadmium { . copper Z3lo Cluorxriurn 22 Lead Gj Mercury Molyb- denurn Nickel Selenium Zinc Total Phos- phorus, ru3D Annual Heavy tvtetai rxeKa j,oactings <<,aic:uiatcu ►u iuwaviv); Total 1 3 4 5 6 7 8 9 10 11 12 H DTIAc.I App. 7 Event ifol iW► Arsenic , pOty O.GY>b Cadmium110. Copper G.SLIS a;' A cht-orniurn n, a5) Lead p�p(lj o;vu4 Mercury O j . • LY71 Molyb- baDl Nickel , G� Selenium p, Zinc Total Phos- horus 4 ,33W "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 luiowing violations". r� Signature of Land Applier a2 L.1 Date DENR FORM MFI..SF (12/2006) � U R w oL ,A C> cn .� C; r� N O n U Q� H U ........:.:...:.::.. a � td �- w Ammonia N Nitrogen E E � Mineralization Rate*** � u Volatilization ;n 0 .; Rate" w un 4 , Application+ M cys Method* aN� a) n P, w � 0 L 40 °yam Awl a U�: O 15 G o , o v �O U Cd ct U N u LIJUOYj IO �)W(I '; P P-i U P, P, a b US ANNUAL METALS FIELD LOADING SUMMARY FORM' Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: Total Dry Tons Applied (Annual): - , ZZ)& Permit #: Cation Exchange Capacity (non 503 only): 14. 5 Operator: t� � E�4'1 (. Owner: pjm I Predominant Soil Series:?o0{-d(6 Acres Used: Acres Permitted: Z.Lr Site #: Field #:119 Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #): Sample or 1 2 3 4 5 6 7 8 9 10 11 12 Corn- posite Date �-,-,-77 2,n 2Z 3-n-n % Solids Arsenic Cadmium . 5 'I. '�D 1,5 Copper Z5 Z3 (� Chromium ZZ GZ ZZ Lead 10 1 Q1 i Cl Mercury p.,3 U Molyb- denum— g Nickel 1 1-7 11 Selenium <6. 0 . D < 5 D Zinc Total Phos- horus Annual Heavy Metal Field Loadings (Calculated in lbs/acre): Total 1 2 3 4 5 6 7 DT/Ac,l App. Event . Gci ^,W3 G.QQ3 Arsenic , ©i�J Cadmium p, CG3, D.CQ3 o, 3 Z Copper- 61 '. C G•L(oc7 QD Chromium Lead D;i ILA Mercury 0, CO I CO O'co I C5, 0©1. Molyb- C�. (9l (p I la. O,QI w 0,' (l� Nickel Selenium otolo -.010 C),ol0 3l� Zinc I Total Phos- phorus .UGC SS+�Iti�. 4u3 �j. "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". Signattu•e of Land Applier Date DENR FORM MFLSF (12/2006) n3 CG U - ro o N a V z 20 Ammonia rc� Nitrogen E ❑, m Cn �z Mineralization 6 Rate"* � Q �3• -y Volatilization l(� Rate** w W Application C�1 Method*� xbf a CIqo 0 . U�Q} ,�3 Ow CY � (- - 0 F•1 am 4 V .y 0 o w 9C © �3 p U O, �v U 0 v,U o sw t1luow Y Q ANNUAL METALS FIELD LOADING SUMMARY FORM* Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report Facility Name: CIl' Total Dry Tons Applied (Annual): �}. ZeDGo Permit #: i,Jf�CC�C`31pU� Cation Exchange Capacity (non 503 only): ". 55 Operator: Owner: Predominant Soil Series: G`, Acres Used: Acres Permitted: Site #: C_jVC_-Jr_ Field #: Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #): Sample or Com- posite Date 1 2 % Solids `! Arsenic Cadmium Copper (� b Chromium LZ Z2 Lead I Iq 1 C1 Molyb- Nickel 1-7 1-1 Selenium /� , Q C . d Zinc (0 `74 (a Total phos- A><tnual Heavy Metal Field Loadings (Calculated in lbslacre): Total 1 3:�r 6 7 8 9 90 11 12 H DVAc./ 4-Z6-Zz App. hvent 0 0 0,30,03 .• 1 'p . Z �3 GDt Cl O,I {1: 0� C71"1 Inpp Gj,1:5pDoc) U , "" -j Z 1 Selenium , CEO , ` L} LZ,6 q 97 "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 supmyttea. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations". Signature of Land Applier Date ©ENR FORM MFLSF (12/2006) ,, ,� � , �; A � 1; �' � P � � � � ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules) Facility Name: C�(�lriJ� WQ Permit Number: WWTPName: �(�, P_(ljflPlt f`i4 NPDESNumber: CC03 OT) _ Monitoring Period: From 'VY Z To e ' i•f` Dora„r+;r,,, (11;A NCAC AIT .1106) -Please indicate level achieved and alternative performed: 1 "RAxv,4AA Class A: Alt. A (tune/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 El Heat Drying ❑ heat Treatment El Thermo l- lic ❑ P >:.... . Beta Ray ❑ Gamma Ray ❑ Pasteurizatioml Class B: Alt. (1) Fecal Density 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 Digestion Di Elg If applicable to alternative performed (Class A or Class B) complete the following monitoring data: Allowable Level Pathogen Density Number of Frequency Sample Analytical Parameter in Sludge Minimum Geo. Mean Maximurr, Units Excee- of Analysis Type Tech- 2 x 10 to the,NZO Z� Zv 70 m414fo -�a�� ClG� 6th power per gram of Fecal Coliform total solids CFU 1000 mpn per gram of total solid (dry weight) Salmonella bacteria 3 MPN per grams (in lieu of fecal total solid (dry coliform) weight A ff,..,..f—, U arlL,rl;A" (1 qA NUA[ ' FUT . 1 ill"/ I- rlease ln(llcate aiternallve t)er-lui-it,uu: V UA tIJA XRtLL sL,.Lly as iwv�+vv.... Alt, l (VS reduction) ❑ a� ,J...-,.- - . ---- --- --I Alt. 2 (40-day bench) ❑ - Alt. 3 (30-day bench) ® jAlt. 4 (Spec. 02 uptake) 123 Alt. 5 (14-Day Aerobic) ❑ Alt. 6 (Alk. Stabilization ❑ Alt 7 (Drying - Stable) ❑ 1 Alt. 8 (Drying - Unstable) ❑ Alt. 9 (Injection) ❑ Alt. 10 (Incorporation) ❑ No vector attraction reduction alternatives were performed ❑ CERTIFICATION STATEMENT (please check the appropriate statement) 10 "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 imprisolllnent." i C1Aa `m CQ-( Cbo c I •6r6 O W`EC T( (C W Preparer Name and Title (t pe or print) Land Applier Name and Title (if applicable){type or print) '_L-- Signature of Preparer` Date Signature of Land App ier (if applicable) Date *Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26) DE=NR FORM PVRF 02T (12/2006) 114 0�-.Kr 10N T DRNE GR EENV'L11_ E , in.`s, 27858 CMSD (SLUDGE & WELLS ACCT) CONTENTNEA METRO. SEWAGE DIST. MS. RENEE PRIDGEN P.O. BOX 477 GRIFTON, NC 28530 PARAMETERS Total Residue, mg/t Fecal Coliform (MPH /gram Solids Sample Analysis Method #1 Date Analyst Code 16160 03/17/22 DIJ 2540B-15 2500 03/17/22 DIJ 9221E-14 `fTaa�:e.riater.::�?ni 10 PHONE / 56-6208... _. ID#: 416 A DATE COLLECTED: 03/17/22 DATE REPORTED : 03/23/22 �V REVIEWED BY: pN, u 1] Fu F��, D F! i al 114 DRIVE CMSD (SLUDGE & WELLS ACCT) CONTENTNEA METRO. SEWAGE DIST. MS. RENEE PRIDGEN P.O. BOX 477 GRIFTON, NC 28530 PARAMETERS Total Residue, mg/l Fecal Coliform (MPN), /gram Solids Sample Analysis Method #2 Date Analyst Code 17780 03/24/22 BLV 2540B-15 5250 03/21/22 DNS 9221E-14 :Waat: evtat6r In-s 10 FAX �252f ID#: 416 A DATE COLLECTED: 03/21/22 DATE REPORTED : 03/30/22 REVIEWED BY: ✓ vV I-,= M j [ e r( r ;LS�i.7J�llI��iE�`ii^� �17 �1�fl.l:,JLt:�j����.J����..1 CMSD (SLUDGE & WELLS ACCT) CONTENTNEA METRO. SEWAGE DIST. MS. RENEE PRIDGEN P.O. BOX 477 GRIFTON, NC 28530 PARAMETERS Total Residue, mg/1 Fecal Coliform WN), /gram Solids Sample Analysis Method #3 Date Analyst Code 17920 03/24/22 BLV 2540B-15 7300 03/22/22 BLV 9221E-14 Drinking Water IDs 37715 ID##: 416 A DATE COLLECTED: 03/22/22 DATE REPORTED : 03/28/22 REVIEWED BY: ��. Drinking Water IAt 37715 REVIEWED BY: = .a _ Sample Analysis Method PARAMETERS #4 bate Analyst Code Total Residue, mg/l 18080 03/24/22 BLV 2544E-15 Fecal Coliform (MPH /gram Solids 1800 03/23/22 JMS 9221E-14 J"r' TEE E i CMSD (SLUDGE & WELLS ACCT) CONTEN'TNEA METRO. SEWAGE DIST. MS. RENEE PRIDGEN P.O. BOX 477 GRIPTON, NC 28530 PARAMETERS Total Residue, mg/1 Fecal Coliform (MPH /gram Solids Sample Analysis Method #5 Date Analyst Code 17500 03/24/22 BLV 254OB-15 2800 03/24/22 HCE 9221E-14 IDA 416 A DATE COLLECTED: 03/24/22 DATE REPORTED : 03/29/22 REVIEWED BY: r r�:�,� � �� ���.�r• -ram c: �Ti �i i� ��E;� �� f� "�� 1 � Cz` Drinking Water IDs 37715 C" FREE NV€.1_L E, € ,G. 27858 CMSD (SLUDGE & WELLS ACCT) CONTENTNEA METRO. SEWAGE DIST. MS. RENEE PRIDGEN P.O. BOX 477 GRIFTON, NC 28530 PARAME, TERS Total Residue, mg/1 Fecal Coliform (MPH /gram Solids Sample Analysis Method #5 Date Analyst Code 18540 03/29/22 HCE 2540E-15 950 03/28/22 DIJ 9221E-14 ID#: 416 A DATE COLLECTED: 03/28/22 DATE REPORTED : 03/31/22 REVIEWED BY: Drinking Water ZDz 37715 GIREFINVILLS, N C, 2_7858 CMSD (SLUDGE & WELLS ACCT) CONTENTNEA METRO. SEWAGE DIST. MS. RENEE PRIDGEN P.O. Box 477 GRIFTON, NC 28530 PARAMETERS Total Residue, mg/l Fecal Coliform (MPH /gram Solids Sample Analysis Method #7 Date Analyst Code 18820 03/29/22 HCE 2540B-15 420 03/29/22 HCE 9221E-14 IDHOiNI E (2r2) '756-6208 ID#: 416 A DATE COLLECTED: 03/29/22 DATE REPORTED : 03/31/22 REVIEWED BY: �� J Time (minutes) 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Specific Oxygen Uptake Rate SOUR Facility Name: Biosolids Permit Number: Date: Digester Temperature: Sampling Date/Time: Sampled By: Analysis Date/Time: Analyzed By: Sample Volume: Total Solids: Beginning Temperature: End Temperature: Dissolved Oxygen Level Slope: Intercept: Correlation Coefficient: Oxygen Uptake Rate: Ambient Specific Oxygen Uptake Rate: Average Temperature: Temperature Correction Factor: D001048 3/17/202 1 "-2211440 rew Edwards '-22/1445 dv Sammond illiliters Dry Solids ,grees Celsius ;grees Celsius 0.1 9.0 1.0 3.02 mg Oxygenlhr 0.16 mg Oxygenlglhr 19 degrees Celsius 1.07 Temperature Corrected Specific Oxygen Uptake Rate: o.18 mg Oxygenlglhr Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically. LO a Ct 0 x 0 LO 0 0 F 02 i~ �� OD CO IT N oo00 CD o6 c6 c6 c (IJOW) U@GAXp panlossia Time (minutes) 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Specific Oxygen Uptake Rate SOUR Facility Name:M3-21-22/1400 Biosolids Permit Number: Date:11 Digester Temperature: Sampling Date/Time:0Sampled By.eAnalysis DatelTime:7Analyzed Bym Sample Volume: Total Solids: Beginning Temperature: End Temperature: Dissolved Oxygen Level Slope: Intercept: Correlation Coefficient: and 000 milliliters 1.87 % Dry Solids 16 degrees Celsius 17 degrees Celsius 0.0 9.9 1.0 Oxygen Uptake Rate: 2,66 mg Oxygenlhr Ambient Specific Oxygen Uptake Rate: 0.14 mg Oxygenlglhr Average Temperature: 17 degrees Celsius Temperature Correction Factor: 1.225043 Temperature Corrected Specific Oxygen Uptake Rate: 0.17 mg Oxygenlglhr Instructions: Enter Data in the Blue Boxes, The Calculation and the Spreadsheet execute automatically. LO C3 (14 CD f X 0 F-0 AU p co CO It Cli m OD (D ai 6 (7) o6 06 (IIBW) UOBAXp panlossip 3 Time (minutes) 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Specific Oxygen Uptake Rate SOUR Facility Name: Biosolids Permit Number: Date: Digester Temperature: Sampling Date/Time: Sampled By: Analysis Date/Time: Analyzed By: Sample Volume: Total Solids: Beginning Temperature: End Temperature: Dissolved Oxygen Level Slope: Intercept: Correlation Coefficient: M rew Edwards !-2211315 dy Sammonc aup 10C 1 1 0.1 9.9 1.0 illiliters Dry Solids :grees Celsius ;grees Celsius Oxygen Uptake Rate: 3.51 mg Oxygenlhr Ambient Specific Oxygen Uptake Rate: 0.18 mg Oxygenlglhr Average Temperature: 18 degrees Celsius Temperature Correction Factor: 1.1449 Temperature Corrected Specific Oxygen Uptake Rate: E o i mg Oxygenlglhr Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically. M O) f X LO M LO O O R 0') CO CD CO CD r (I/BW) UeBAXO panlOsslp r D 7 Y) r :N r Time (minutes) 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Specific Oxygen Uptake Rate SOUR Facility Name: Biosolids Permit Number: Date: Digester Temperature: Sampling Date/Time: Sampled By: Analysis Date/Time: Analyzed By: Sample Volume: Total Solids: Beginning Temperature: End Temperature: Dissolved Oxygen Level Slope: Intercept: Correlation Coefficient: M001045 3/23/202 1 3-22/1405 Irew Edwards 3-22/1410 3dy Sammond 100 1.9 1 0.1 9.3 1.0 illiliters Dry Solids ;green Celsius mrees Celsius Oxygen Uptake Rate: 3.51 mg Oxygenlhr Ambient Specific Oxygen Uptake Rate: 0.18 mg Oxygenlglhr Average Temperature: 19 degrees Celsius Temperature Correction Factor: 1.07 Temperature Corrected Specific Oxygen Uptake Rate: 0.2© mg Oxygenlglhr Instructions: Enter Data in the Blue Boxes, The Calculation and the Spreadsheet execute automatically. (+) ti It m x 00 a 1-M 101 u �y N Cn co co d Co od ai (l1BW) UOBAXp PBAJOSsia CV co co o6 ti n N CU rn E 0 00 E ti uv� IT lffp� N T Time (minutes) 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Specific Oxygen Uptake Rate SOUR Facility Name:rAndrew Biosolids Permit Number: Date: Digester Temperature: Sampling Date/Time: Sampled By:Analysis DatelTime:Analyzed By: Sample Volume: Total Solids: Beginning Temperature: End Temperature: Dissolved Oxygen Level Slope: Intercept: Correlation Coefficient: 1048 s 1441 ammond 1000 milliliters 1.83 % Dry Solids 21 degrees Celsius 20 dearees Celsius 0.1 8.9 1.0 Oxygen Uptake Rate: 3.23 mg Oxygenlhr Ambient Specific Oxygen Uptake Rate: 0.18 mg Oxygenlgihr Average Temperature: 21 degrees Celsius Temperature Correction Factor: 0.952380952 Temperature Corrected Specific Oxygen Uptake Rate: 0.17 mg Oxygen lglhr Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically. J OD x OD 0 0 F P 00 00 CD d N co 00 06 c6 (IJBW) UOBAXp panlosslq Time (minutes) 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Specific Oxygen Uptake Rate SOUR Facility Name: CM Biosolids Permit Number: WC Date: Digester Temperature: Sampling Date/Time: 3-2 Sampled By: An Analysis Date/Time: 3-2 Analyzed By: Wii Sample Volume: Total Solids: Beginning Temperature: End Temperature: Dissolved Oxygen Level Slope: Intercept: Correlation Coefficient: Oxygen Uptake Rate: Ambient Specific Oxygen Uptake Rate: Average Temperature: Temperature Correction Factor: 048 1-22/1405 rew Edwards 1-22/1410 dv Sammond 11000 milliliters 1.89 % Dry Solids 15 degrees Celsius 16 degrees Celsius 0.0 9.9 1.0 2,63 mg Oxygenlhr 0.14 mg Oxygenlglhr 16 degrees Celsius 1.31079601 Temperature Corrected Specific Oxygen Uptake Rate: 0.18 mg Oxygenlglhr instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically, 6 LO ca rn x 00 m O O R i U c� Q. M C 4) Im p ao c4 I: N T pj 6) 6) 6) (I/OW) UGBAXp panlosslQ I co T LO T T :.. , . T N T T T O T N w � LO N T CW 00 06 Time (minutes) 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Specific Oxygen Uptake Rate SOUR Facility Name: CMSD Biosolids Permit Number: WQ000 Date: Digester Temperature: Sampling Date/Time: 3-29-22 Sampled By: Andrew Analysis Date/Time: 3-29-22 Analyzed By: Wind Sample Volume: Total Solids: Beginning Temperature: End Temperature: Dissolved Oxygen Level Slope: Intercept: Correlation Coefficient: Oxygen Uptake Rate: Ambient Specific Oxygen Uptake Rate: Average Temperature: Temperature Correction Factor: 1048 356 mmond )00 milliliters ,96 % Dry Solids 15 degrees Celsius 16 degrees Celsius 0.0 9.9 1.0 2.79 mg Oxygenlhr 0.14 mg Oxygenlglhr 16 degrees Celsius 1.31079601 Temperature Corrected Specific Oxygen Uptake Rate: 0.19 mg Oxygenlglhr Instructions: Enter Data in the Blue Boxes. The Calculation and the Spreadsheet execute automatically. r� x O iLw G1 .F+ d lie m 4a CL C d M X ru p co (0 I r o) 07 (I/BW) UGBAXp panlossl© m cV O 15 1! � I Al il"12 DO: GW-59A COMPLIANCE REPORT FORM Permit H Wa �� ✓l (Submit one each Monitoring period IvUh G6Y 59 forms.) Enter date monitoring results were due. ( fl- ) Will this monitoring report (GW-59 and OW-59A) YES i� 1 be submitted after the established due date? Was any required information missing on tlae GW-59 report forms? YES ir3p' !F the answer to question 1 ar 2 is "YF'S , list in the space provided below the well identification numbers) and explain the problems encountered in obtaining the required information. Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing ICES Nfl/ identification plate; area o vergroivn, etc.)? If the answer is "Yes", contact the Regional Office for guidance, J/ Are any monitored constituents equal to or above the established standards? X NO if the answer to question 4 is "NO", skip to section 8, If the answer to question 4 is "YES" fist the affected welts individually with constituent(s) and concentrations) exceeding standards in the space provided below: W 41� 5 ('i� t OMi unc 1 51 i Wtl17R14 cn� MIwMForml�I j1DOm15 For the constituents identified in question 4 above, have standards been exceeded previously for the 7 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'; fist in the space provided below, each well with constituent(s) exceeding standards, concentrations)�p��e��and a4 �orMle lection �fldat�yt,iSeach ������lSccurrence foCthe last lir��� o��r�� fl wt 11 1� 101 fib -A 4 k tarn � r~ m 16 u-9Il - 6 Are the monitoring wells listed in section 5 located at or beyond the review boundary? YES 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 may be improperly located; contact the Regional Office. 7Is the permittee implementing previously approved actions required by the Division involving this 7-- groundwater quality problem? If the answer to question 7 is "YES", describe those actions in the space provided below. contact the Re on maj�b If the answer to question 7 is "NO"I rntrinri at wn a0the review and codays, an 1mA ancee boundaries surrouncnn in 7w[:iui u,. 11 .- - -- ii h� Maw, d„A flues and/or onalties. rl� try S one FG�c 1 CGl W �11 }�i! I<1C1�5 hCt,V-L lz,-e-e„ f io�L�� n�arz .�ltie-n once b&t4 ACCVs � h��� s'�fiec�c Wk+e,_ -1aht6 t`5 10to r:5t-� or.� a-Ab ��r� � � 01 Pr�S'e^C� 0f Serg���n� / &kflS, � S C�ftd �`� PL1'Ot waw� l ,i FS r°I�t k - �tvs�i4 ,:n kM^ eA/(�Atn_- M57' 1YS0C 4�4 2.o1-9 i,?�h �G hl�h� 4i4rbdSn�lMc NDwk-14/ka aV&P- - of 4hAr ,J'S�44 The person completing this portion (GW--SSA) of the monitoring report should sign below and submit this form with G W-59 forms for required wells to the address provided at the top of the current GW-59 form. 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'-' m m N ' p A z r o a m 0 rn °; p L © ¢ U x u z to t7 0 m a E E J J -j -� - is - J N E o a E E E E a E x E E O N V m £ 0 1'^ [y 1 ) 1a 1 l[I p m O ma © 0 o O N M o P O 2 0 © O zmar d E .o m P P pk Uo O U U1 O C p1 41 [� c o z r oo F r as m p E z LL CL O m a ro Eo U o'0 p 4 QZ � U r� U in 0 O E U 0 m d EIMANNHINER % bwPumb do -Wast�ewaEer.:.i.P'.� 10 114 O/�ICN�ON I DRIVE PHONE (252) 756-6208 GREENVILLE, N.C. 27B5I3 FAX (252) 756-0633 CMSD (SLUDGE & WELLS ACCT) CONTENTNEA METRO. SEWAGE DIST.. MS. RENEE PRIDGEN P.O. BOX 477 GRIFTON, NC 28530 ID#: 416 DATE COLLECTED: 10/18/22 DATE REPORTED : 11/14/22 REVIEWED BY: �✓ s Well #9 Well #10 Well #14 Well #15 Well #17 Analysis Method Date Analyst Code PARAMETERS <1 <1 1 <1 <1 10/18/22 JDJ 9222D-15 Fecal Coliform (MT), /100 Mls 0,07 0.04 0.12 0.05 10/19/22 KES 350.1 R2-93 Ammonia Nitrogen as N, mg/l 0.91 0.37 0.18 <0.04 0.61 10/19/22 KES 353.2 R2-93 Nitrate Nitrogen as N, mg/I <0.04 1.17 2.31 8.73 2.21 10/26/22 HMM 531OC-14 Total Organic Carbon, mg/l 5.74 6 7 10/19/22 EMV 4500CLB-11 Chloride, mg/1 5 3 41 5 41 72 43 10/20/22 BNC D5907-13 Total Dissolved Residue, mg/1 37 10 14 <5.0 10/24/22 MTM EPA200.7 TotaI Chromium, ug/l <5.0 <5.0 10 < 10 < 10 < 10 10/24/22 MTM EPA200.7 Copper, ug/l < 10 < 39 72 49 59 10/24/22 ADR 251OB-11 Conductivity (at 250, uMhos/cm 50 0.06 0.11 0.06 10/19/22 TRJ 450OPE-11 Total Ortho-Phosphate as P, mg/l 0.06 0.05 n0d . .... .. ... . W0.etBWdteY IA: 1V PHONE (252) 756-6208 114 OAKMONT DRIVE FAX (252) 756-0633 GREENVILLE, N.C. 27858 CMSD (SLUDGE & WELLS ACCT) CON'.TENTNEA METRO. SEWAGE DIST. MS. RENEE PRIDGEN p.0. BOX 477 GRIFTON, NC 28530 Well #18 Analysis Method PARAMETERS Date Analyst Code Fecal Coliform (MIS), 1100 Mls <1 10/18/22 JDJ 9222D-15 Ammonia Nitrogen as N, mgll 0.09 10/19/22 KES 350.1 R2-93 Nitrate Nitrogen as N, mg/1 <0.04 10/19/22 I ES 353.2 R2-93 Total Organic Carbon, mgll 9.06 10/26/22 I1IV M 531OC-14 6 10/19/22 HMV 4500CLB41 Chloride, mg/1 Total Dissolved Residue, mgll 87 10/20/22 BNC D5907-13 Total Chromium, 0911 <5.0 10/24/22 MTM EPA200.7 < 10 10/24/22 MTM EPA200.7 Copper, ug/l Conductivity (at 25c), uMhoslcM 112 10/24/22 ADR 251OB-11 Total Ortho-Phosphate as P, mg/l 0.03 10/19/22 TRJ 450OPE-11 ID#I:: 41.6 DATE COLLECTED: 10/18/22 DATE REPORTED : 1.1/1.4/22 REVIEWED BY: W Em'ONNEW1 % NcNpmno�gcl wastewater PHONE (252) 756 6208 114. OA. MONT DRIVE FAX (252) 756-0633 GREENVILLE, N,C, 27858 CLIENT: CMSD (SLUDGE & WELLS ACCT) CLIENT ID: 416 CONTENTNEA METRO. SEWAGE DIST. ANALYST: .7AP MS. RENEE PRIDGEN DATE COLLECTED: 10/1$/22 Page: 1 47 P.O. SOX 477 DATE ANALYZED: 10/30/22 GRIFTON, 25530 DATE REPORTED: 11/14/22 REVIEWED BY: VOLATILE ORGANICS STD. METHODS 620OC-11 Wen #9 Well #10 Well #14 Well #154.50l #17 pARAA4ETERS, ug/L <0.50 <0.50 <0.50 <0.50 <0.50 0 <0.50 1. Benzene Z. Bromobenzene <0.50 <0.50 <0.50 <0.50 <0,50 <0.50 <0,50 <0.50 3. Bromochioromethane <0 50 <0 50 <0.50 <0.50 <0.50 <0.50 4, Bromodichlorometbane <0 50 <0.50 <0.50 <0.50 <0.50 5. Bromoform <0.50 <0.50 <0.50 <0.50 <0.50 6. Bromomethane <0.50 <0.50 <0.50 <0.50 < 0.50 < 0.50 7. N-Butylbenzene 8. Sec-Butylbenzene < 0.50 < 0.50 <0,50 < 0.50 <0.50 <0.50 <0.50 9. Tert-Butylbenzene <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 10, Carbon Tetraebloride <0 50 <0.50 <0.50 <0.50 <0.50 11, Chlorobenzene <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 12. Chloroethane <0.50 <0.50 <0.50 <0.50 <0.50 13. Chloroform 14. Chloromethane <0.50 <0.50 <0.50 <0,50 <0.50 <0.50 <0.50 <0.50 15, 2-Chlorotoluene <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 16. 4-Chlorotoluene 17. Dibromochloromethane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 18. 1,2-Dibromo-3-Chloropropane <0.50 <U 50 <0.50 <0.50 <0.50 <0.50 19. 1,2-Dibromoethaue <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 20. Dibromomethane <0 50 <0.50 <0.50 <0.50 <0.50 21, 1,2-Dichlorobenzene <0.50 <0.50 <0.50 <0.50 <0.50 22. 1,3-Dichlorobenzene 23. 1,4-Dichlorobenzene <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 24. Dichlorodifiuoromethane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 25. 1,1-Dichloroethane < 0,50 < 0.50 <0,50 <0.50 <0.50 26. 1,2-Dichloroethane 27. 1,1-Dichloroethene <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 28, Cis-1,2-Dichloroethene <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 < 0.50 29. trans-1,2-Dichloroethene < 0.50 < 0.50 < 0.50 < 0.50 30, 1,2-Dichloropropane <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 31. 1,3-Dichloropropane <0.50 <0.50 <0.50 <0.50 <0.50 32. 2,2-Dichloropropane <0 50 <0.50 <0.50 <0,50 <0.50 33. 1,1-Dichloropropeiie <© 50 <0.50 <0.50 <0.50 <0.50 34. Cis-1,3-Dichloropropene <0.50 <0.50 <0.50 <0.50 <0,50 35. trans-1,3-Diebloropropene <0 50 <0.50 <0.50 <0.50 <0.50 36, Ethylbenzene 37. Hexachlorobutadiene <0.50 <0.50 <0.50 <0.50 < 0.50 <0.50 < 0.50 < 0.50 38. isopropylbenzene < 0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 39. 4-Isopropyttoluene <0.50 <0.50 <0.50 <0.50 <0.50 40. Methylene Chloride <0 50 <0 50 <0.50 <0.50 <0.50 41. Naphthalene <0.50 <0.50 <0.50 <0,50 <0.50 <0.50 42. Propylbenzene <0.50 <0.50 <0.50 <0.50 <0.50 43, Styrene 44. 1,1,1,2-Tetrachloroethatie <0,50 <0.50 < 0.50 <0.50 < 0.50 < 0.50 < 0.50 45. 1,1,2,2-Tetrachloroetbane < 0.50 <0.50 <0.50 <0.50 <0,50 <0,50 46, Tetrachloroethene <0.50 <0.50 <0.50 <0.50 <0.50 47. Toluene <0.50 <0.50 <0.50 <0.50 <0.50 48. 1,2,3-Trichlorobenzene �nl"dr`dnf) rn-) nnlr]fnlVn� r@nn��nnn`I�A 114 OAKMONT DRIVE GREENVILLE, N.C. 27853 I�HUivL-- rn0-0--u0 FAX (252) 756-0633 CLIENT: CMSD (SLUDGE & WELLS ACCT) CLIENT ID: 416 CONTENTNEA METRO. SEWAGE DIST. JAP ANALYST: MS, RENEE PRIDGEN DATE COLLECTED: 10/18/22 Page: 2 47 7 P.O. BOX 47BOX DATE ANALYZED: 10/30/22 28530 DATE REPORTED: 1.1/14/22 REVIEWED BY: VOLATILE ORGANICS STD. METHODS 6200C-11 Weil #9 Well #10 Well #14 Well #15 Well #17 PARAMETERS, u911 49. 1,2,4-Trichlorobenzene Cd.SO <0 50 [0.50 <0.50 <0.50 [0.50 <0.50 <0.50 <0.50 <0.50 50. 1,1,1-Trichloroethane <0.50 [0.5d <0.50 <0.50 <0.5d <O.SO 51, 1,1,2-Trichloroetbaue <0.50 <O.SO <0.50 <0.50 52. 53. TrichIoroethene Trichlorofluoromethane <0.50 <0.5d <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 54. 1,2,3-Trichloropropane <© 50 <0.50 <0.50 <0.50 <0.50 <0.50 <0.50 55. 1,2,4-Trimethylbenzene <0 50 <0.50 <0.50 <0.50 <0.50 56. 1,3,5-Triniethylbenzene- <0 50 <0.50 <0.50 <0.50 <1.00 57. Vinyl Chloride <1.00 <1.00 <1.00 <1.00 < 1.00 < 1.00 58. Total Xylenes < 1.00 < 1.00 < 1.00 59, Methyl Tert Butyl Ether d �1��®i�I�C�1 �W Vraseewater cup iv PHONE (252) 756-6208 114 OAI<MONT DR[VE FAX {252} 756-0633 GREENVILLE, NL. 27858 CLIENT: CMSD (SLUDGE & WELLS ACCT) CLIENT TD: 416 CONTENTNEA METRO. SEWAGE DIST. aAP MS. RENEE PRIDGEN ANALYST: DATE COLLECTED: 10/1$/22 47 P.O.BOX 477 P.O. BOX BATE ANALYZED: 10/30/22 28530 DATE REPORTED: 11/14/22 REVIEWED BY: VOLATILE ORGANICS STD. METHODS 6200C-11 2WEell18 PARAMETERS, ugll <0.50 1. Benzene <0.50 2. Bromobenzene <0.50 3. Bromochloromethane <0.50 4, Bromodichloromethane <0.50 5. Bromoform . <0.50 6. Bromomethane < 0.50 7. N-Butylbenzene <0.50 8. Sec-Butylbenzene <0.50 9, Tert-Butylbenzene < 0.50 10, Carbon Tetrachloride <0.50 11. Chlorobenzene < 0.50 12. Chloroethane <0.50 13. Chloroform <0.50 14. Chloromethane <0.50 15, 2-Chlorotoluene <0.50 16, 4-Chlorotoluene <0.50 17. Dibromochloromethane < 0.50 18. 1,2-Dibromo-3-Chloropropane < 0.50 19. 1,2-Dibromoethane <0.50 20. Dibroniomethane < 0,50 21. 1,2-Dichlorobenzene <0. 50 22. 1,3-Dichlorobenzene <0.50 23. 1,4-Dichlorobenzene <0.50 24. Dichloroditluoromethane < 0.50 25. 1,1-Dichloroethane < 0.50 26. 1,2-Dichloroethane < 0.50 27. 1,1-Dichloroethene < D.50 28. Cis-1,2-Dichloroethene <0.50 29. trans-1 2-Dichloroethene , <0.50 30. 1,2-Dichloropropane < 0.50 31. 1,3-Dichloropropane 50 < 0.50 32. 2,2-Dichloropropan < 0.e 33. 1,1-Dichloropropene <0.50 34. Cis-1,3-Dichl0ropropene < 0.50 35. trans-1,3-Dichloropropene < 0.50 36. Euhylbenzene <0.50 37. Hexachlorobutadiene < 0.50 38. Isopropylbenzene < 0.50 39. 4-1sopropyltoluene <0.50 40. Methylene Chloride <0.50 41. Naphthalene < 0.50 42. Propylbenzene < 0.50 43. Styrene 44. 1,1,1,2-Tetrachloroethane <0.50 45. 1,1,2,2-Tetrachloroethane <0.50 <0.50 46. Tetrachloroetbene <0.50 47. Toluene G 0.50 48. 1,2,3-Trichiorobenzene Page: 3 E[duh1mm(pM Ila Wwpmmtdo PHONE (252) 756-6208 114 OAKMO1'\11' DRIVE FAX (252) 756-0633 GRE-ENVILLE, N.C. 27858 CLIENT: CMSD (SLUDGE & WELLS ACCT) CONTENTNEA METRO. SEWAGE DIST. MS. RENEE PRSDGEN P.O. BOX 477 GRIFTON, NC 28530 REVIEWED BY: �✓ �� `• VOLATILE ORGANICS STD. METHODS 620OC-11 PARAMETERS, u9/1 49. 1,2,4-Trichlorobenzene 50, 1,1,1-Trichloroethane 51. 1,1,2-Trichloroethane 52, Trichloroethene. 53. Trichloroiluoromethane 54. 1,2,3-Trichloropropane 55. 1,2,4-Trinnethylbenzene 56. 1,3,5-Trimethylbenzene 57. Vinyl Chloride 58. Total Wenes 59. Methyl Tert Butyl Ether CLIENT ID: 416 ANALYST: JAP DATE COLLECTED: 10/18/22 DATE ANALYZED: 10/30/22 DATE REPORTED: 11/14/22 Well #18 <0.50 < 0.50 <0.50 <0.50 < 0.50 <0.50 <0.50 < 0.50 <0.50 < 1.00 <1.00 Page: 4 SOILS ANALYSIS LAB REPORTS LIME APPLICATION- 9 1 f.pa� Grower: CMSD Farm: WILEY GASKINS RD Farm Sample ID * Ayden Nitrogen F F C+ SYS T E M S' 4728 Old NO 11 Ayden, NO 28513 252-746-2152 p c C 2 (� T E� a a0 00 W a? a? w a o u I m � n m v a so V T D. 0 r N •�i w 1 nW d C> C'4 N r L � N cm � sin h g J to N cv CD ;n N LO z 2LO t� N W 3i to LQ m _ V� ca ca , r T f I i �, G. I On'•tO1v N CO r - yy 7 4 M Q I LU Ln i to to g � �s. Z ah Go�D }' N I &:II dd N Z K (� uj co a 11�I: a. 8 .o m a 0 a� 0� C a x c � U � O � �z c � m tU w m U m c � m m N qii C 0) C14 mV' i �i �e eta o CS T Ci o a I. pLLI O (0 .4G c6 00 O T•- J3 N N, N '`"• N r T=1 {w N fy o o c� ci Lo m cq M ao o C7 0© o g N N N M CO O O c C9 o.F r - i N N N i INI�IN �I� N r Cn ' 7 3: v w a Os } } 7 x 0.0QOOQ Qj z W m, U, DD tD cD •ODD CDt�7p7 OD co w 00 O�d 7 to so r~ co u) 0 X y� z in 9 LL W tl i 3_aaan- 0 0 0 00 0' (Y w,ly U U U U U C7 0 a Q 0 z z z z z I v Lo (D r, CO w [y) co N h Z og in °a ate) _ m cn U ca C � N Z U E d =1 to Q L) (n aT X M � U 'O Y G T r- P c m ,r �• V o � N •p U In D G � CL o 0 z a0)► N N� e .Q N a v E a 0 O d A. L� z r J� O i 1- N m N y E E o U � w �y U UJ cr �S Q n� a L U m v � ro In 0 0 N CD c X — e U o � pN A Q ) C � o m 0.. 0 U 0 z 1- 6 M N u �g O � 41 r y E i 1J. a z= J Q a:a EL 0. O OHO O O U U U U U 0 0 0 0 0 z z z z z F' T N of Ir v �R x IJ! N�y mil__ _ cp 7 ci} CL. 0 R , o 6 O d ti of 00 0� cl (,1 . (10 N cQ W n its so oa N N i� Cl N Z o ci ci c v ci y('t-'�TI- LYv v N ch v o c � p o -. a I C71 E ° aNncicir' a)s e et `- LIJ IL c�+7 �l O • N i � Y T N r � •�, Ofcq (07 W T C,MC!a to +e7 ti to ti c a ! n CD n� (0to(D mrn w c) m +r : a) (D F N L1 r T F•' N .y: M 'R fi . lAp rn N CL 1 N r 0 dN' %Wc 111 C � F o ,- N r) a v— r Ccr�p Ul m V' Lu lu,; "�' m ao no ao so ao U �w w t• , pp cn C O � L w 12 M tiz 0, CO 0. 4 N w N a Z ui w f% en N m :z -0 6 F.7 1- a7 w -- I to CD t� to M • 0 r N,N N N N'm c7 D_ EL! IL & a.. M [x o 0 0 0 0 0 0 uu aaac�aaac U U U U U U U U z z z z z z z d t i � c a. to ll'i <Q t r`• � � N N N N N Q M M 4 C O •lV � SavedRx: LIME22-23 Soil Fertility Fertilizer Application Summary Grower: CMSD Commodity: Bermuda Grass Farm: WILEY GASKINS RD Labs: Waters NC Kipidkl• UjitinlP Fields FC«SYSTEMS" Ayden Nitrogen 4728 Old NC 11 Ayden, NC 28513 252-746-2152 12/13/22 08:50 AM 2/2 Grower: CMSD Farm: WILEY GA5KIN5 RD Fleld: Multiple Fields Label Area White 75.69 Notes: Done, Ayden Nitrogen f E F C° S Y S T E M S` 4726 Old NC 11 10/19122 10:25 AM Ayden, NC 28513 1/1 252-746-2152 SavedRx: LIME22-23 Soil Fertility Grower. CMSD Farm: WILEY GASKINS RD Tenn Lime - Fertilizer Application (Ibslac) Field(s): Multiple Fields 35.0 17.5_................................................. _._............_ 0.0 ..� 4 - -- e750 1425 2fOO 2775 Crop Type: Pick Type Equation Variables Target p: 6 Lab: Waters NC Switch Rate: 600 lbslac Total Area: 75.85 ac Equation: Lab - Default Rate Multiplier: NIA Total Product: 27540.64 Ibs Commodity: Bermuda Grass Rate Subtract: NIA Total Product Bulk: 13.77 ton Sample Date: 2022-11-28 Min Application Rate: 600.0 lbslac Product Cost / Bulk: $0.0/ton Rec Multiplier: NIA Max Application Rate: 3626.52 lbslac Total Product Price: $0.0 Rec Subtract: NIA Avg Application Rate: 1537.29 lbslac Application Cost / Area: $0.0/ac Max Rate: NIA Application Area: 17.92 ac Total Application Cost: $0.0 Min Rate: 600 lbslac Average Field Rate: 363.10 Ibslac Total Cost: $0.0 Ayden Nitrogen 12/13/22 08:50 AM E F C- S Y S T E All S y 4728 Old NO 11 Ayden, NO 28513 252-746-2152 1 /2 Ayden Nitrogen Invoice 1024331 4728 Old NC 11 / P.O. Box 7 Ayden NC 28513 Invoice Date 01103/2023 252-746-2152 Fax: 252-746-8472 Due Date 02/02/2023 Customer ID 010202 Contentnes Metro Sewage Dist Snipping Loc. 01 Po Box 477 Grlfton, NC 28530 Quantity Description Unit Price Total $ 13.750 Tons Dolomitic time - Bulk 72.50 /Tons 996.88 13.750 Each App Fees Dry Fertz 15.00 /Each 206.25 Terms: Unless otherwise agreed in writing by Harvey Fertilizer & Gas Co, interest will Sub Total 1,203.13 accrue at a periodic rate of 1.5% per month. To avoid additional finance charges, payments must be In office by last day of month. Amount Due 1,203.13 Remit To: Harveys PA. Box 189 Kinston NC 26502 Phone #: 252-523-9090 Invoice 10243 Contentnea Metro Sewage Dist copy