WQ0007798_GW Monitoring_19981013

�I1VDIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY' MONITORING: forms P.O.GNO 7626-
For additional fo[ms RALEIGH, NO 27fi26.0578.
COMPLIANCE REPORT FORM please write or call: [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED)
Facility Name Non -Discharge U 1(�i 6607299
Address tAAJT k1cl, NPDES
Z u�G/ 4 LI ee. A). C. County S .6%�A/ D TYPE OF DISPOSAL OPERATION BEING MONITORED
�1 (REQUIRED)
Well Location LET ��/� c/s r 0�. 7 onA,• /� 7-7 I Lagoon Septic Tank/Drain Field
Well Identification Number M tJ -) Well Depth O Ft. spray Field Subsurface Low -Pressure
Well Diameters 0 " Sample (Screened) Interval Ft. To a'C 0 Ft. Piping (LPP)
Depth to Water Level /9. y.S ft. below measuring point (before sampling) Land Application of Sludge
�
Measuring point is Z 157 _
ft. above land surface D Rotary Distributor 74
Other
Gallons of water pumped/bailed before sampling
Field Analysis: pH tp. O fn Specific Conductance uMhos Temp. C Odor Appearance
Date Sample Collect d 9• 3 • 98 N Date Lab Sample Analyzed 9 • Z• �_
Laboratory Name WAZ,QAhr! M Certification No. LIS
SAMPLES FOR METALS WERE COLLEC ED UNFILTERED AND FIELD ACIDIFIED LV4_YES NO
COD
Coliform:
Coliform:
MF Fecal
MF Total
(Note: Use MPN method for highly turbid samples)
_ mg/I
/100ml
/100ml
Dissolved Solids: Total
mg/I
pH (when analyzed) i .
'9 units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/1
Na - Sodium
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
.iS - 9g
Sign ture f Permi ee (or Aut orize gent*) Date
GW-59 REV. 8/96
kn
co
O
S=n�
Ni - Nickel
Pb - Lead
I�Ig/I
— u mg/I
Zn - Zinc
Pesticides/Herbicides
(Specify Compounds)
", mg/I
CO_
ug/I
ug/I
ug/I
Other (Specify Compounds and
Concentration units)
�-.
Qf
Note: Values should reflec('dissolved and
colloidal Ed1YG Qptrz (see #3 on back)
FSee back for instructions.
mit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED. `
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours. `
Sample preparation in the laboratory (extraction and filtration) must be completed w6in72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOTTJHOSE THAT ARE A PART PFF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director,.Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Spepifio Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected. '
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY • GROUNDWATER SECTION
29578
GROUNDWATER QUALITY' MONITORING: P.O.Box
For additional forms RALEIGH, NC 27626626-
-A578
COMPLIANCE REPORT FORM please write or call: [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED
Facility Name l /AR,S7wJb_�STic_g IA/c Non -Discharge Iw1 O/�n779A
Address % .AjT Rd NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
G County —sae : t4.�l,D (REQUIRED)
Well Location Ri. Az/° Lem Lagoon Septic Tank/Drain Field
Well Identification Number M W - Z Well Depth 30 . 0 Ft. Spray Field Subsurface Low -Pressure
Well Diameter l�LSample (Screened)Interval Ft. To;36•O Ft. Piping(LPP)
Depth to Water Level /7.3 '9 ft. below measuring point (before sampling) Land Application of Sludge
Measuring point is I. goft. above land surface other
Gallons of water pumped/bailed before sampling /•S Rotary Distributor
Field Analysis: pH Specific Conductance — uMhos Temp. C Odor Appearance
Date Sample Collected 1.7 • 4g Date Lab Sample Analyzed_/D • ,S • 99 - w o
ca -
Laboratory Name c E Certification No$J 2i:
SAMPLES FOR METALS WERE COLLEC ED UNFILTERED AND FIELD ACIDIFIED YES NO
COD
Coliform:
Coliform:
MF Fecal
MF Total
(Note: Use MPN method for highly turbid samples)
mg/I
OOml
00ml
Dissolved Solids: Total
mg/I
pH (when analyzed) 1.. f3
units
TOC
mg/1
Chloride
mg/1
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN s NM
/I
Nitrite (NO2) as N
Nitrate (NO3) as N
Phosphorus: Total
Al - Aluminum_
Ba - Barium
Ca - Calcium_
Cd - Cadmium_
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury_
K - Potassium
Mg - Magnesium
Mn - Manganese
Na - Sodium
as P
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/1
mg/l
mg/I
mg/I
mg/I
Ni - Nickel
Pb - Lead
Zn - Zinc
Pesticides/Herbicides
(Specify Compounds)
.c- : !
CO c
Other (Specify Compounds and
Concentration units)
r%r-.,I, o - /ND��
RIQ
s
a g
ftrnt,
CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
9�
Sig at re of P rmit ee (or Authorized Agent*) Date
GW-59 REV. 8196
Note: Values s
colloidal
ug/I
ug/I
ug/I
;d and
#3 on back)
* See back for instructions.
** Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standatd Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours. • -
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection. -
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION -QR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1970, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific -Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be.calibrated fn accordance with recommendations by the manufacturer.
9. Samples must be filtered �grough w0 45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
1 O.The sample container' should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11. "Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATEROUALITY- GROUNDWATERSECTION I
GROUNDWATER QUALITY' MONITORING: P.O. BOX 7626-
For additional forms RALEIGH, NO 2626.0578
COMPLIANCE REPORT FORM please write or call: [phone]
or
Facility Name
Address
pen ana press
PERMIT NUMBER: (REQUIRED)
Non -Discharge onn 7'79z
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Well Location I-A-r- Sy' Y7' ]L ` LnA)G i7- Z-1 y i• s
Well Identification Number M W - 2 Well Depth 30, O Ft.
Well Diameter //, Zs t l Sample (Screened) Interval Ft. To .30. 0 Ft.
Depth to Water Level 4'�.7N ft. below measuring point (before sampling)
Measuring point is S• Z ft. above land surface
Gallons of water pumped/bailed before sampling /•S
Field Analysis: pH to Specific Conductance — uMhos Temp. °C Odor
Date Sample Collected • Z3 • 9$ Date Lab Sample Analyzed 110.1..99
Certification No. !Viz
YES NO
Laboratory Name t:2 2 rc,
SAMPLES FOR METALS WERE
COD _
Coliform:
Coliform:
MF Fecal
MF Total
(Note: Use MPN method for highly turbid samples)
UNFILTERED AND FIELD ACIDIFIED
mg/I
OOml
OOml
Dissolved Solids: Total
mg/I
pH (when analyzed)
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mq/I
Nitrite (NO2) as N _
Nitrate (NO3) as N_
Phosphorus: Total as P
Al - Aluminum
Ba - Barium
Ca - Calcium
Cd - Cadmium
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese
Na - Sodium
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
Sig ate of P mitt a (or Authorized Agent') Date
GW-59 REV. 8/96
Lagoon
Septic Tank/Drain Field
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of Sludge r
_..�< Other LO
Rotary Distributor Co
Appearance
N
:•u
mg/I
Ni - Nickel
Vmg/I
mg/I
Pb - Lead
mg/I
mg/I
Zn - Zinc
mg/I
mg/I
Pesticides/Herbicides
mg/I
(Specify Compounds)
mg/I
ug/I
mg/I
ug/I
mg/I
ug/I
mg/I
Other (Specify Compounds and
mg/I
Concentration units)
mg/I
lL
us
mg/I
rGt(orneiGm.ne_ - 413
y�//
mg/I
mg/I
mg/I
o I I;
Note: Values s
colloidal
solved and
(see #3 on back)
* See back for instructions.
•' Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED. I
2. Metals Analyses: Use "Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD III
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated_ nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.'
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental, "
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific.Conduotance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected. • J, -
8. Field equipment must be calibrated ih accordance with recommendations by the manufacturer.
9. Samples must be filtered.1hro.ug.h;a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY- GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: P.O.GNC276 6-
For additional forms RALEIGH, NC.27626.0578 '.
COMPLIANCE REPORT FORM please write or call; [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED)
Facility Name Non-Discharge1A)a 7
99
(REQUIRED)
Address �,t4L NPDES
/ aun, SJ G y A)C� County �tn L 4N1� TYPE OF DISPOSAL OPERATION BEING MONITORED
Well Location Lagoon Septic Tank/Drain Field
Well Identification Number MIAI=`-/ Well Depth 7 /. n Ft.
,r Spray Field Subsurface Low -Pressure
Well Diameter ��Sample(Screened)Interval Ft. To_0L90 Ft. Piping(LPP)
Depth to Water Level eft. below measuring point (before sampling) Land Application or sludge
Measuring point is ft. above land surface Rotary Distributor X Other
Gallons of water pumped/bailed before sampling S
Field Analysis: pH 79 Specific Conductance uMhos Temp. 7-3. y o C Odor Appearance
Date Sample Collected Date Lab Sample Analyzed /D • 7. 95 ? ,
Laboratory Name OLLECTE17b Certification No. z/g� c
SAMPLES FOR METALS WERE CUNFILTERED AND FIELD ACIDIFIED YES NO — -
o
COD
mg/I
Nitrite (NO2) as N
mg/1
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
(Note: Use MPN method for highly turbid samples)
Al - Aluminum
mg/I
Dissolved Solids: Total
mg/I
Ba - Barium
mg/I
pH (when analyzed) t•sJ
units
Ca - Calcium
mg/1
TOC
mg/I
Cd - Cadmium
mg/I
Chloride
mg/1
Chromium: Total
mg/I
Arsenic
mg/I
Cu - Copper
mg/I
Grease and Oils
mg/I
Fe - Iron
mg/I
Hardness: Total
mg/I
Hg - Mercury
mg/I
Phenol
mg/I
K - Potassium
mg/I
Sulfate
mg/I
Mg - Magnesium
mg/I
Specific Conductance
uMhos
Mn - Manganese
mg/I
Total Ammonia
mg/I
Na - Sodium
mg/I
TKN as N
mg/I
Ni - Nickel =mg/I
Pb - Lead = N mg/I
Zn - Zinc mg/I
Pesticides/Herbicides O7
(Specify Compounds)
ug/I
ug/I
ug/I
Other (Specify Compounds and
Concentration units)
7�.ft/nrr e f%onQ 790v�/i
�r;ek(aro e•FD.L2�p - ?30D tr��i
Inv
1 CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values shjpMA_r.e&ct dissolved and
Sig fur of Pek itt e (or Authorized Agent*)
GW-59 REV. 8/96
colloidal
(see #3 on back)
�G ' 3 / g * See back for instructions.
Date I ** Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES'IN THE FIELD III
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, Q THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION -AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984; -
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least volumes of water in the well.should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, -Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered thrgugh:a ff'.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11. "Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY GROUNDWATER SECTION
GROUNDWATER QUALITY' MONITORING: P.O. NG 2 626-
For additional forms RALEIGH, NC 27626.0578
COMPLIANCE REPORT FORM please write or call. [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED)
Facility Name 11P
'— Non -Discharge 1nJ61^nQp '>'z9
Address„- ofT NPDES
/ A, ,e1A)LiU2C Al. P.. CDUnty �,r�%L/}AI a PE OF REQUIRED DISPOSAL OPERATION BEING MONITORED
Well Location t-f}T' qq" VX r Di;. gib A2 *79* Z% ' go. g (REQUIRED)
) Lagoon Septic Tank/Drain Field
Well Identification Number M/Aj —S Well Depth ZN. O Ft.
Well Diameter /.25"' Sample (Screened) Interval Ft. To ZN D Ft. —Spray Field Subsurface Low -Pressure
p ( Piping (LPP)
Depth to Water Level /0 , Sfo ft. below measuring point (before sampling) Land Application of Sludge
Measuring point is 3 - ZO ft. above land surface other
Rotary Distributor ,
Gallons of water pumped/bailed before sampling S
Field Analysis: pH Specific Conductance - uMhos Temp. ZC• °C Odor — Appearance — co T
Date Sample Collected C/ — $ —Date Lab Sample Analyzed //� • ] 9R `o m
Laboratory Name �ile 4a r� �4 IUA -)IT-t o- 4L / ,4Ro e_-4raavFs Certification No. `191 c
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED t4l_YES NO V Tri
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/I
pH (when analyzed) -Sr 78
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/1
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
ma/I
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
Signatul of Pe lee (or Authorized Agent*) Date
GW-59 REV. 8/96
Ni - Nickel
Pb - Lead
Zn -Zinc
Pesticides/Herbicides
(Specify Compounds)
Other (Specify Compounds and
Concentration units)
Note: Values
mg/I
mg/I
ug/I
ug/I
ug/I
and
(see #3 on back)
* See back for instructions.
** Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Siandard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD m
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION _QR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION. -
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director,. Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49,.No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH,.Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in•accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY- GROUNDWATER SECTION
GROUNDWATER QUALITY' MONITORING:For P.O., NO 7626-
COMPLIANCE 'REPORT FORM please rite additional forms RALE`GH'N027626 0578
pleasewrlteorcalL• 9i9 733-3221
or
Facility
pen and press
PERMIT NUMBER: (REQUIRED)
Non -Discharge MQ OQp 7795
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
rRF:nl IlArnl
Well Location LA-i -<LID
N/ SS.y""
�jAX a' Z1 YG.7-'
Lagoon
Septic Tank/Drain Field
Well Identification Number & W— G
Sample Screened Interval
Well Diameter Sam p (Screened)
Well Depth 36" o Ft.
Ft. To - Ft.
—spray Field
Subsurface Low -Pressure
Piping (LPP)
Depth to Water Level 1(c• /t•1 ft.
below measuring point
(before sampling)
Land Application of Sludge
Measuring point is 4y, 20 ft.
above land surface
Z—
Rotary Distributor
Other
Gallons of water pumped/bailed before sampling
/O. O
Field Analysis: pH y.9 ( Specific Conductance
— uMhos Temp. Zo. to C
Odor Appearance
—
LO
Date Sample Collec�t yd % Z `
Y4a1FO
%q R�� Date Lab Sample Analyzed /v • 7' 9$
MAI_ /a9An Pao TaQi ES
Certification No.
//8/
co
o
c,n
Laboratory Name IC
nPAL
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED
YES NO
COD
mg/I
Nitrite (NO2) as N
mg/I
Ni - Nickel
='
�'rlg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Pb - Lead
=
rlg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
Zn - Zinc
mg/I
(Note: Use MPN method for highly turbid samples)
Al - Aluminum
mg/I
Pesticides/Herbicides
o
Dissolved Solids: Total
mg/I
Ba - Barium
mg/1
(Specify Compounds)
pH (when analyzed) 1/. 9
/o units
Ca - Calcium
mg/1
ug/1
TOC
mg/I
Cd - Cadmium
mg/I
ug/I
Chloride
mg/I
Chromium: Total
mg/I
ug/I
Arsenic
mg/I
Cu - Copper
mg/l
Other (Specify Compounds and
Grease and Oils
mg/I
Fe - Iron
mg/1
concentration units)
Hardness: Total
mg/I
Hg - Mercury
mg/1
s- / 2-�; �{� (ora a
na - 336
09/.
Phenol
mg/I
K - Potassium
mg/1
%�,'e_h(cro r4,e .-e_e.
- /s ,o ,,
/ j
Sulfate
mg/I
Mg - Magnesium
mg/I
Specific Conductance
uMhos
Mn - Manganese
mg/I
Total Ammonia
mg/I
Na - Sodium
mg/I��
TKN as N
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values sh uld rAMOdissolved and
colloidaFAc a t�lions. (see #3 on back)
tLr-�
,y/��, _ 3 o rs.
�'1 `� `- � �Q / 9g See back for instructions.
Si !t�e of er ittee (or Authorized Agent`) Date •* Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD W
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT -THOSE THAT RE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental.
Management:
(a) Standard Methods for the Examination of Waterand Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition,1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific•;Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0:45,micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11. "Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY -GROUNDWATER SECTION
P.O.BOX 27628
GROUNDWATER QUALITY MONITORING:
For additional forms RALEIGH, NC 27626-0578
COMPLIANCE REPORT FORM please write or call: [phone]
Type or Use a ball-point pen ana press firmly.
PERMIT NUMBER: (REQUIRED)
Facility Namev�
4p•FS
Non -Discharge— _ 1A) A Gad •77 99
Address F/arf
NPDES
TYPE OF DISPOSAL
OPERATION BEING MONITORED
RoR1tA)1Z )eG A&r
Well Location AT &y0 W rf LO/Lf6
Count .Srn2- -AA)
y
(REQUIRED)
Lagoon
Septic Tank/Drain
Field
, ��
W0 Z7 N7• Z
Well Identification Number /YI(j - 7
Well Depth 45'. b Ft.
Spray Field
Subsurface Low
-Pressure
Well Diameter •Do Sample (Screened) Interval �
Ft. To 3S0 Ft.
Piping (LPP)
Depth to Water Level /5• ID ft. below measuring point
(before sampling)
Land Application of Sludge
Measuring point is �/_- ZO ft. above land surface
K
Rotary Distributor
Other
is
r�
Gallons of water pumped/bailed before sampling
� 3• �--
Field Analysis: PH ,S 37 Specific Conductance
- uMhos Temp. 70 • Z-oC
Odor — Appearance
o
�
Mn
Date Sample Collected Date Lab Sample Analyzed /D • 7 •
Laboratory Name aa...m AA; A•G
/ nA.47-6RdeF5
Certification No.
`t8/
ND
SAMPLES FOR METALS WERE COLLECT D UNFILTERED AND FIELD ACIDIFIED �W_YES NO
COD mg/I
Nitrite (NO2) as N
mg/I
Ni - Nickeling/I
Coliform: MF Fecal /100ml
Nitrate (NO3) as N
mg/I
Pb - Lead
mg/I
Coliform: MF Total /100ml
Phosphorus: Total as P
mg/I
Zn - Zinc
= mg/I
(Note: Use MPN method for highly turbid samples)
Al -Aluminum
mg/I
Pesticides/Herbicides
Dissolved Solids: Total mg/I
Ba - Barium
mg/I
(Specify Compounds)
pH (when analyzed) S.a
H units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
mnll
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
/0 • l3 " 9�
Sign ur of Perm•tte (or uthori ed Agent*) Date
GW-59 REV. 8/96
ug/I
ug/I
ug/I
Other (Specify Compounds and
Concentration units)
c� Ip., 2 ne - IaBD c J/
' E
Note: Values 2 f issolved and
colloid-00 '� - s. (see #3 on back)
Fee back for instructions.
ubmit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!r
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours. -
Sample preparation in the laboratory (extraction and filtration) must be completed within72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART 9F SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION 2 SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical. procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition,1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for,PH Sped!f C Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered throug!r=a.0.45'rnicron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: P.O. sox zs57a
For additional farms RALEIGH, NC 27626-0578
COMPLIANCE REPORT FORM please write or call; [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED)
Facility Name S'r Non -Discharge L.cJQ Ooa 7798
AddressN NPDES
I�-r/Q1A)39AG Ale, County Srn>t.an/D TYPEDISPOSAL OPERATION BEING MONITORED
rr / (REQUIRED)
Well Location G/FT i� e NS f Q'�!. `/ �n/t)L %0o Z % Ste. /o Lagoon Septic Tank/Drain Field
Well Identification Number M W ` q Well Depth' Z-S-• O Ft. Spray Field Subsurface Low -Pressure
Well Diameter �Sample (Screened) Interval Ft. To 7-S OO Ft. Piping (LPP)
Depth to Water Level It—ft. below measuring point (before sampling) Land Application of Sludge -
—i.p
Measuring point is—ft. above land surface o Other
Distributor co r
Gallons of water pumped/bailed before sampling S
Field Analysis: pH 5'-0 7 Specific Conductance — uMhos Temp.1$_i °C Odor — Appearance —
Date Sample Collect e Z3 • 9 Date Lab Sample Analyzed /0 • 7 • i 1?
Laboratory Name A r n 14WAIL1-r.r.m!- Z,&L?7A.4 7d _:5 Certification No. ye6 N "'
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED AVq—YES NO
COD
mg/I
Nitrite (NO2) as N
mg/I
—
Ni - Nickel s-
t
mg/I
Coliform: MF Fecal
/100m1
Nitrate (NO3) as N
mg/I
Pb - Lead `a
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
Zn - Zinc
mg/I
(Note: Use MPN method for highly turbid samples)
Al - Aluminum
mg/I
Pesticides/Herbicides
Dissolved Solids: Total
mg/I
Ba - Barium
mg/I
(Specify Compounds)
pH (when analyzed) S . z 3
units
Ca - Calcium
mg/I
ug/I
TOC
mg/I
Cd - Cadmium
mg/I
ug/I
Chloride
mg/I
Chromium: Total
mg/I
ug/I
Arsenic
mg/I
Cu - Copper
mg/I
Other (Specify Compounds and
Grease and Oils
mg/I
Fe - Iron
mg/I
Concentration units)
Hardness: Total
mg/I
Hg - Mercury
mg/1
C.j]5- 4 Z - 71tome-t4v y2e - 4/
A
Phenol
mg/I
K - Potassium
mg/I
Sulfate
mg/I
Mg - Magnesium
mg/I
T,
Specific Conductance
uMhos
Mn - Manganese
mg/I
P a r." ME `
Total Ammonia
mg/I
Na - Sodium
mg/I
TKN as N mg/I — W,
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values shotlicl"01Wi�[Welved and
0, d colloidal corfa9W QFcFd&1 see #3 on back)
/ram � /' 9g See back for instructions.
Sign .tut a of Pe(mitt e (o/ r Authorized Agent") Da a� F Submit blue and yellow copies only to address above.
GW-59 FfEV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD Ilt
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 Hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION .QR SAMPLING
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management: `
(a) Standard Methods for the Examination of Water, and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing, any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific`Coriddctance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected. �-
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered,throuyh a.0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container shddid be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY- GROUNDWATER SECTION: '
P.O. BOX 29578
GROUNDWATER QUALITY MONITORING: 6-
For additional forms RALEIGH, NC.27626-.U578
COMPLIANCE REPORT FORM. please write or call: [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED)
Facility Name <Q 17-M#STe.2 /J,/C Non -Discharge r-J+&-Ono 774g
/71r'/- �• NPDES
Address
TYPE OF DISPOSAL OPERATION BEING MONITORED
/.�ur:e aura N.G. County—Sf�T�-� /a (REQUIRED)
Well Location Lagoon Septic Tank/Drain Field
Well Identification Number M W - /O Well Depth ZS. 6 Ft.
Well Diameter Lt. oc"Sam le Screened Interval Ft. Tob52Ft. Spray Field SubsurfaceLow-Pressure
p (Screened) Piping (LPP)
Depth to Water Level _//. 1.2 ft. below measuring point (before sampling) Land Application of Sludge
Measuring point is a. ZS it. above land surface _ Other
!3 S t \ Rotary Distributor
Gallons of water pumped/bailed before sampling drJTJ1 _
Field Analysis: pH S• $S Specific Conductance - uMhos Temp. 8-7 oC Odor Appearance
Date Sample Collected 9 • Z R • �g Date Lab Sample Analyzed /n • 7. 98
Laboratory Name 2426b eC.M �}/Uw77eAt Z_4,Q6,eq-m e.f c5 Certification No. 4/5r/
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED YES NO
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/I
pH (when analyzed) 5'• oZ
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
Nitrate (NO3) as N_
Phosphorus: Total as
AI - Aluminum
Ba - Barium
Ca - Calcium
Cd - Cadmium
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese
Na - Sodium
0
<
V r. r-,
mg/I
Ni - Nickel
mg/I
mg/I
Pb - Lead
mg/I
Zn - Zinc
mg/I
mg/I
Pesticides/Herbicides
mg/I
(Specify Compounds)
mg/I
ug/I
mg/I
ug/I
mg/I
ug/I
mg/I
Other (Specify Compounds and
mg/I
Concentration units)
'
$
mg/I
• - - -
v5 /
mg/I
% '?- pme44-nm. -IW
ug/b
mg/I
if
mg/I
mg/I
7- J1
%
1 CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
colloidal eFAY&t d$6hstE{see #3 on back)
I ,.
See back for instructions.
Signature of Pe mitt e or Authorized Agent*) Date ** Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours. `
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental ,
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes. of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY • GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: P.O. eox For additional forms RALEIGH, NO 276267626-
�0678
COMPLIANCE REPORT FORM please write or call: [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED)
Facility Name 0�%M •rF� /�/� Non -Discharge Ma 41667229
Address P%,r'f- �U NPDES
/A+JQrAI ,rr2G /t/� County SceTGSFu D TYPE OF DISPOSAL OPERATION BEING MONITORED
Well Locations 3'f ° YS' 00• L' �Nb 72' 7- 7' Y.Y. Z (REQUIRED) Lagoon Septic Tank Drain Field
Well Identification Number A114 - // Well Depth ZS. D Ft.
Well Diameter •oo '� Sample (Screened) Interval Ft. TO Ft.
Depth to Water Level / 7,116 K ft. below measuring point (before sampling)
Measuring point is : f S ft. above land surface
Gallons of water pumped/bailed before sampling 3 7 . O
Field Analysis: pH .t. Z6 Specific Conductance — uMhos Temp.C Odor
Date Sample Collected 9 • Z3. 91 Date Lab Sample Analyzed /D • 7. 99
Laboratory Name F" 4.01,,m Z4rVA4kr1e1 V' LARA Pw rn2iE5 Certification No.
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIEDg#D,,—YES
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of Sludge
_ - Other
Rotary Distributor VD
Appearance —
NO
COD
mg/I
Nitrite (NO2) as N
mg/I
Ni - Nickel
�mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Pb - Lead
mg/l
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
Zn - Zinc
_mg/I
(Note: Use MPN method for highly turbid samples)
Al - Aluminum
mg/I
Pesticides/Herbicides
Dissolved Solids: Total
mg/I
Ba - Barium
mg/I
(Specify Compounds)
pH (when analyzed) S. S 1
units
Ca - Calcium
mg/I
ug/I
TOC
mg/I
Cd - Cadmium
mg/I
ug/I
Chloride
mg/I
Chromium: Total
mg/I
ug/I
Arsenic
mg/I
Cu - Copper
mg/I
Other (Specify Compounds and
Grease and Oils
mg/I
Fe - Iron
mg/I
Concentration units)
Hardness: Total
mg/I
Hg - Mercury
mg/I
C 'S - 1, z - ; nhl rn e inP
Phenol
mg/I
K - Potassium
mg/I
Sulfate
mg/I
Mg - Magnesium
mg/I
Specific Conductance
uMhos
Mn - Manganese
mg/I
Total Ammonia
mg/I
Na - Sodium
mg/I
r-j lff7Qz: jj� =
TKN as N
mg/I
"-
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
Si na re ofVerittee(or Au orized Agent*) Date
GW- REV.8/
Note: Values should reflect dissolved and
colloidal QOpRVWTaWW IIsee #3 on back)
See back for instructions.
•` Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OFF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 161h Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through,a, 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY`- GROUNDWATER SECTION
GROUNDWATER QUALITY' MONITORING: PO 29578-
For additional Corms RALEIGH, NO :27626;0575
COMPLIANCE REPORT FORM please write or call: [phone]
Type or Use a ball-point pen and press
Facility Name
Address
County Gf a TL AAJ/-.)
Well
PERMIT NUMBER: (REQUIRED)
Non -Discharge & 0d0 7 719
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Lagoon
Well Identification Number lou) - /Z Well Depth?S. 0 Ft.
Well Diameter " Sample (Screened) Interval Ft. To %S.O Ft. spray Field
Septic Tank/Drain Field
Subsurface Low -Pressure
Piping (LPP)
Depth to Water Level /l. fo3 ft. below measuring point (before sampling) Land Application of Sludge
Measuring point is Z . S ft. above land surface other
Gallons of water pumped/bailed before sampling g !� Rotary Distributor
Field Analysis: pH .5--. / 0 Specific Conductance — uMhos Temp.`/ C Odor � Appearance
Date Sample Collected 9. 2 3 • Date Lab Sample Analyzed-16 • 7 • 98
Laboratory Name LsFGro.2 Rrr=s Certification No. h 9/
SAMPLES FOR METALS WERE COLLECTED'UNFILTERED AND FIELD ACIDIFIED 4 YES NO
COD
Coliform:
Coliform:
MF Fecal
MF Total
mg/I
00ml
OOml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total mg/I
pH (when analyzed) o .. )'� units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
Nitrate (NO3) as N_
Phosphorus: Total as P
Al - Aluminum
Ba - Barium. -
Ca - Calcium
Cd - Cadmium
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese
Na - Sodium
CJ
�0
0
O o
mg/I
Ni - Nickel T
;= mg/I
mg/I
Pb - Lead
mg/1
mg/I
Zn - Zinc —
r'lmg/I
mg/I
Pesticides/Herbicides t-O
mg/I
(Specify Compounds)
o
mg/I
ug/I
mg/I
ug/I
mg/I
ug/I
mg/I
Other (Specify Compounds and
mg/I
Concentration units)
mg/I
T_, rh in, 6 eWik" e?
mg/I
mg/I
mg/I
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
. .R
#3 on back)
45_ �
�/ lb • 1-3 9 * See back for instructions.
S na re of er ittee (or Authorized Agent*) Date ** Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1: Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED As WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT.THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION DR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title'15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must fie calibrated in accordance with recommendations by the manufacturer.
9. Samples must be f!Itered.through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11. "Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: P.O. sox For additional forms RALEIGH, NO 27626-
7626.0578
COMPLIANCE 'REPORT FORM please write or call: [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED)
Facility Name I c Non -Discharge bL Gnp�?'726
Address Pn.,a AodNPDES
/ �rrst3! 1t.�lU �. CountOy y c.eT�.onje TYPE OF DISPOSAL OPERATION BEING MONITORED
9(REQUIRED)
Well Location Ll1T RV0 %g n OY. 9 rr 40ALI[. 70 27 r -/9• 3 rr Lagoon Septic Tank/Drain Field
Well Identification Number Al AJ - 13 Well Depth •!0. O Ft.
Well Diameter -06" Sample (Screened) Interval Ft. ToSQ-0 Ft.
Depth to Water Level Z_Z _L6 ft. below measuring point (before sampling)
Measuring point is 3 Z ft. above land surface
Gallons of water pumped/bailed before sampling /D. �t=
Field Analysis: pH C. Hho O Specific Conductance uMs Temp./$-5C Odor
Date Sample Collected 9 - 2 2 - 95? Date Lab Sample Analyzed AQ- 3 - 99
Laboratory Name Z:cCertification No.
SAMPLES FOR METALS WERE COLLECT UNFILTERED AND FIELD ACIDIFIED zZZ YES
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/I
pH (when analyzed) .S.NIo
units
TOC
mg/I
Chloride
mg/1
Arsenic
mg/1
Grease and Oils
mg/1
Hardness: Total
mg/l
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/1
TKN as N
mg/I
Spray Field
Subsurface Low -Pressure
Piping (LPP)
Land Application of Sludge
_ c Other
c
Rotary Distributor
Appearance —
n
NO
v
Nitrite (NO2) as N
mg/I
Ni - Nickel
= R mg/I
Nitrate (NO3) as N
mg/I
Pb - Lead
rn mg/I
Phosphorus: Total as P
mg/I
Zn - Zinc
o " mg/I
Al - Aluminum
mg/I
Pesticides/Herbicides
Ba - Barium
mg/I
(Specify Compounds)
Ca - Calcium
mg/I
ug/I
Cd - Cadmium
mg/I
ug/I
Chromium: Total
mg/I
ug/I
Cu - Copper
mg/I
Other (Specify Compounds and
Fe - Iron
mg/I
Concentration units)//
Hg - Mercury
mg/I
els
K - Potassium
mg/I
Tr-, cA(a1-o e4Ae_*Le
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na -Sodium
mg/I
- �
KiaR�
A S rF 4
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
lb - L :R - 15! 6
igna ure of erm'ttee (or Authorized Agent*) Date
GW-59 REV. 8/96
Note: Values shodRefUtV&olved and
colloidal copgq(ZtI I F_M4see #3 on back)
ni_u. ur-i" Rai_
* See back for instructions.
** Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES'IN THE FIELD !11
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within.72`hours of'collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE,
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION t R SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director,.Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be lahel2d'at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

IGROUNDWATER QUALITY MONITORING: For additional forms
COMPLIANCE REPORT FORM please write or pap,
Type or Use a ball-point pen and press firmly.
Facility Name .�6 7-M4-,TTrW_, //VC.
Address/r+ ✓t •F 2�) .
DIVISION OF WATER QUALITY• GROUNDWATER SECTION.>
P.O.. BOX.29578
RALEIGH, NC 27626.0578
(919) 7333221.
PERMIT NUMBER: (REQUIRED)
Non -Discharge tJd eOo 7749
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Well Location /_A-T &Y° '78 O%. ,S - /_ON.- /7- [ / -17.(= Lagoon Septic Tank/Drain Field
Well Identification Number /YAW - /'-/ Well Depth. 30.60 Ft.
Well Diameter !V.0 " Sample (Screened) Interval Ft. To Jin .eo Ft.
Depth to Water Level 13 - G57 ft. below measuring point (before sampling)
Measuring point is i4. 7_0 ft. above land surface
Gallons of water pumped/bailed before sampling 33
Spray Field
Subsurface Low -Pressure
Piping (LPP)
Land Application of Sludge
Other
Rotary Distributor
Field Analysis: pH �i.7 i Specific Conductance — uMhos Temp. /RTi oC Odor Appearance
Date Sample Collected ?A Date Lab Sample Analyzed /0 7 9il
Laboratory Name A•-2i-yrc " AIVALV7 ceAC Laao/l aTr /y c 5 Certification No. Z-/
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED
COD mg/1
Coliform: MF Fecal /100ml
Coliform: MF Total /100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/I
pH (when analyzed) S. wo
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Prel
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
- /S . (3• 911K
Si re of r ittee (or Authorized Agent*) Date
GW-59 REV. 8/96
Ni - Nickel
t mg/I
Pb - Lead
= «}Ig/1
Zn - Zinc
's -img/I
Pesticides/Herbicides
(Specify Compounds)
ug/I
ug/I
ug/I
Other (Specify Compounds and
Concentration units)
/
Z - .r li Gi/) era P'ti1Ch�
' trc/I
Note: Values shd(00 rofje"ossolved and
colloidal concentrations. (see #3 on back)
v_ if,
* See back for insPnFMQ0a' _;L"° _
** Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN -THE FIELD err
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection:
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION _R SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209,, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
1 O.The sample container should be labeled at the time of collection with, the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING:
P.O. BOX 29578
For additional forms
RALEIGH, INC 27626-0578
COMPLIANCE REPORT FORM please write or call:
[phone]
J Type or Use a ball-point pen and press firmly.
PERMIT NUMBER: (REQUIRED)
Facility Name D /V
Non -Discharge WQndo77c%R
Address W �v + )ZP
NPDES
Lrrl2! U�j C� Sc
TYPE OF DISPOSAL OPERATION BEING MONITORED
Ni3 G ^! County oTtAa
(REQUIRED)
Well Location
Lagoon Septic Tank/Drain Field
Well Identification Number gLL3 — I Well Depth ,!d.06 Ft.
Well Diameter Sample (Screened) Interval Ft. To 5a dyFt.
spray Field Subsurface Low -Pressure
Piping (LPP)
Depth to Water Level 26', 64.ft. below measuring point (before sampling)
Land Application of Sludge
Measuring point is1,0 ft. above land surface
)C other
Gallons of water pumped/bailed before sampling
Rotary Distributor
Field Analysis: pH O Specific Conductance _ uMhos Temp. 11 4 oC
Odor Appearance
Date Sample Collected 9 Z A • I Date Lab Sample Analyzed c0 - 7 -
W
Laboratory Name FA" D l�, A n, A l �.TlP #6 L nn1z,& S
Certification No. `j R J `CD
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED A.0 YES NO
COD
mg/I
Coliform: MF Fecal
/loom)
Coliform: MFTotal
/loom[
(Note: Use MPN method for highly turbid Samples)
Dissolved Solids: Total
mg/I
pH (when analyzed) 47, yit,
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NOp) as N
mg/I
Ni -Nickel
(1
Nitrate (NO3) as N
mg/I
Pb - Lead
^mg/I
Phosphorus: Total as P
mg/I
Zn - Zinc
C� mg/I
AI -Aluminum
mg/I
Pesticides/Herbicides
o
Ba - Barium
mg/I
(Specify Compounds)
Ca - Calcium
mg/I
ug/I
Cd - Cadmium
mg/I
ug/I
Chromium: Total
mg/I
ug/I
Cu - Copper
mg/I
Other (Specify Compounds and
Fe - Iron
mg/I
Concentration units)
Hg - Mercury
mg/I
—880
vaI t
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na -Sodium
mg/I
'P
a
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
O rl
Signat reo.f Permit (or Authorized Agent*) Date
GW-59 R 8/96
Note: Values should reflbct'dYssolved and
colloidal cprjperAr8k�ft!Ls.(see #3 on back)
• See back for instructions.
** Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours. - . .
Sample preparation in the laboratory (extraction and filtration) must be completed within 72,hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE 9 PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the method§ described in one of
the following publications, or by other methods approved beforehand by the Director, Division c.tEnvironmental
Management: "
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample containef'should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

IGROUNDWATER QUALITY MONITORING: For additional forms
COMPLIANCE REPORT FORM please write or call:
Type or Use a ball-point pen and press firmly.
Facility Name 1 nftt i Nt14STr-2_ //U O
Address pT1"T
(A-ug�iAr13u/LG A1L county SccTe_4AJb
Well Location
Well Identification Number gj'W — Z Well Depth a- 60 Ft.
Well Diameter i140 Sample (Screened) Interval Ft. To_SZ_&�t.
Depth to Water Level _IS . Zq ft. below measuring point (before sampling)
Measuring point is 2, 10 ft. above land surface
Gallons of water pumped/bailed before sampling
Field Analysis: pH 5. 10 Specific Conductance — uMhos Temp. L9 `� C
Date Sample Collected 9 • 7_ 3 ' 9A Date Lab Sample ADalyzed /h • 7 • 2
Laboratory Name <&A Arne
SAMPLES FOR METALS WERE
AND FIELD ACIDIFIED
DIVISION OF WATER QUALITY - GROUNDWATER SECTION
P.O. BOX 29578
RALEIGH, NC 27626.0578
[phone]
PERMIT NUMBER: (REQUIRED
Non -Discharge W 666 '> 7 4f
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Lagoon Septic Tank/Drain Field
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of Sludge
)C Other
Rotary Distributor
Odor x Appearances— co
O di
Certification No. !�4 ;71
YES NO —
COD
mg/I
Nitrite (NO2) as N
mg/I
Ni - Nickel
i^ rri;,
^ r•mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Pb - Lead
_ �= -mg/I
Coliform: MF Total
/100mI
Phosphorus: Total as P
mg/I
Zn - Zinc
"' mg/I
(Note: Use MPN method for highly turbid samples)
Al - Aluminum
mg/I
Pesticides/Herbicides
--
Dissolved Solids: Total
mg/I
Ba - Barium
mg/I
(Specify Compounds)
pH (when analyzed) Z�I units
Ca - Calcium
mg/I
ug/I
TOC
mg/I
Cd - Cadmium
mg/I
ug/1
Chloride
mg/I
Chromium: Total
mg/I
ug/I
Arsenic
mg/I
Cu - Copper
mg/I
Other (Specify Compounds and
Grease and Oils
mg/I
Fe - Iron
mg/I
con ntrafi units)
Hardness: Total
mg/I
Hg -Mercury
mg/I
c klom >z+EtevtlL —
/loy
Phenol
mg/I
K - Potassium
mg/I
Sulfate
mg/I
Mg - Magnesium
mg/I
Specific Conductance
uMhos
Mn - Manganese
mg/I
Total Ammonia
mg/I
Na - Sodium
mg/I
TKN as N
mg/I
Ki
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
colloidal coifie n'fiatlohtsCAPQ OFFICE (see #3 on back)
See back for instructions.
Signat re f Permitt e ( r Authorized Agent") Date •• Submit blue and yellow copies only to address above.
GW-59 RE . 8196

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD tII
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
r
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION QR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical, procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition,1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be cali6ratdd'in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0,45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should. 30%labeledat the time of collection with the facility name, well identification number and date and time collected.
11. "Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY • GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: IG NG2626-
For additional forms RALEIGH, NC 27628�0578
COMPLIANCE REPORT FORM please write or call: [phone]
or Use a
Facility Name
Well Location K W —
pen and press
County Sri dan
Well Identificati n Number 4!,A) _3 Well Depth NA.O0 Ft.
Well Diameter . u Sample (Screened) Interval Ft. ToL16 -00Ft.
Depth to Water Level ZZ 5 9ft. below measuring point (before sampling)
Measuring point ism 60 ft. above land surface
Gallons of water pumped/bailed before sampling L—
Field Analysis: pH _Specific Conductance — uMhos Temp.ZO. 7, oC Odor
Date Sample Collecte Z Date Lab Sample Analyzed 99
Laboratory Name filar i '4211 �r—t�A-li Certification No. yg�
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AJ�YES NO
PERMIT NUMBER: (REQUIRE 7 7 }$
Non -Discharge
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Lagoon Septic Tank/Drain Field
AND FIELD ACIDIFIED
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of Sludge
Other
Rotary Distributor
Appearance
cr
t-0
COD
mg/I
Nitrite (NOp) as N
mgll
Ni -Nickel "'
= =,Jngll
Coliform: MF Fecal
/100m1
Nitrate (NO3) as N
mg/I
Pb -Lead —
ri-7ng/I
Coliform: MF Total
/100m1
Phosphorus: Total as P
mg/I
Zn -Zinc =
='�mg/I
(Note: Use MPN method for highly turbid samples)
Al -Aluminum
mg/I
Pesticides/Herbicides
Dissolved Solids: Total
mg/I
Ba -Barium
mg/I
(Specify Compounds) o
�
pH (when analyzed) _t�. S3
units
Ca - Calcium
mg/I
- ug/1
TOC
mg/I
Cd -Cadmium
mg/I
ug/I
Chloride
mg/I
Chromium: Total
mg/I
ug/I
Arsenic
mg/I
Cu -Copper
mg/I
Other (Specify Compounds and
Grease and Oils
mg/I
Fe -Iran
mg/I
co9�ntratioP units)
Hardness: Total
mg/I
Hg -Mercury
mg/I
1 n2.ti lcrb ern inn
Phenol
mg/I
K -Potassium
mg/I
Sulfate
mg/I
Mg -Magnesium
mg/I
Specific Conductance
uMhos
Mn -Manganese
mg/I
Total Ammonia
mg/I
Na -Sodium
mg/I
TKN as N
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
Note:
Values shlovvuld relldiftissolved and
cQlloidal;�'p�cegltC�tlons. (see #3 on back)
I f PI_R
/D • /3 • 8
9
See back for instructions.
Sig at re of Per it ee (or Authorized
Agent')
Date
•* Submit
blue and yellow copies only to address
above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD III
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental,_
Management: '
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984; -
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION'
GROUNDWATER QUALITY MONITORING: P.O.GNO 7626-
:For additional forms RALEIGH, NO 27626.0575 ,
COMPLIANCE REPORT FORM please write or call: [phone]
or
Facility
Well
pen and press
PERMIT NUMBER: (REQUIRED)
Non -Discharge j_)Q Gbo 2-7TS
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED) _
Lagoon Septic Tank/Drain Field
Well Identification Number 1A)rLu—c'l 7— Well Depth Ft.
Well Diameter —Sample Screened Interval Ft. To Ft. Spray Field Subsurface Low -Pressure
(Screened) Piping (LPP)
Depth to Water Level ft. below measuring point (before sampling) Land Application of Sludge
Measuringpoint is ft. above land surface _7 Other of
Rotary Distributor co
Gallons of water pumped/bailed before sampling
Field Analysis: pH y Specific Conductance — uMhos Temp./9-0 C Odor — Appearance
Date Sample Collect Date Lab Sample Analyzed 612 • *7 93 _
Laboratory Name, A70 rGM as!rr,nAt /-A3oeRira,eLFs Certification No. yev
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED AVA YES NO
COD _
Coliform:
Coliform:
MF Fecal
MF Total
(Note: Use MPN method for highly turbid samples)
_ mg/I
/100ml
/100ml
Dissolved Solids: Total
mg/I
pH (when analyzed) f. z 8
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N _
Nitrate (NO3) as N_
Phosphorus: Total as
Al - Aluminum
Ba - Barium
Ca - Calcium
Cd - Cadmium
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese
Na - Sodium
0
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
0- 13 9�
na ure of Pe m ttee (of=uthorize_cT_Agent*) Date
GW-59 REV. 8/96
mg/I
Ni - Nickel
.. n
cn = mg/I
mg/I
Pb - Lead
" =' mg/I
mg/I
Zn - Zinc
mg/I
mg/I
Pesticides/Herbicides
mg/I
(Specify Compounds)
mg/I
ug/I
mg/I
ug/I
mg/I
ug/I
mg/I
Other (Specify Compounds and
mg/I
Concentration units)
mg/I
'%r; rh torne_4-" -
/ /Onya,/
mg/I
mg/I
mg/I
mg/I
Note: Values should reflect dissolved and
colloidal condeh r-s I OVii(ke #3 on back)
nos= u=
* See back for instructions.
** Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED. 1.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD Ilt
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated'in accordance with recommendations by the manufacturer.
9. Samples must be filtered through'a`D:45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should,be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY'= GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING:
P.O. BOX 29578
For. additional forms
RALEIGH,.NO 27626.0578
COMPLIANCE REPORT FORM
please wrlteorcall;
[phone]
Type or Use a ball-point pen and press firmly.
PERMIT NUMBER: (REQUIRED)
Facility Name /Ylf}STc� ��t1�
Non -Discharge uJ/� nl5c) :> 7
Address a/ -A'- kd-
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
k'�(Zf aQs.QG nrC�
COUnty���T/-h'A��
(REQUIRED)
Well Location
Lagoon Septic Tank/Drain Field
Well Identification Number 12Enlc-N &;tLuenJi
Well Depth Ft.
Spray Field Subsurface Low -Pressure
(Screened)
Well Diameter —Sample Screened Interval
Ft. To Ft.
Piping (LPP)
Depth to Water Level ft. below measuring point
(before sampling)
Land Application of sludge
Measuring point is—ft. above land surface
_-e Other
Rotary Distributor
Gallons of water pumped/bailed before sampling
Field Analysis: pH Specific Conductance
uMhos Temp. /9. Z/ DC
Odor — Appearance _ co
7 y • 98
Date Sample Collect Date Lab Sample Analyzed /O • 7. 98
T
0
Laboratory Name rr/Zybvt AnrAa�,nu90
//dam/L47a2 ors
Certification No. e/A/
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED
YES NO GJ ra ,
COD mg/I
Nitrite (NO2) as N
�= me
mg/I Ni - Nickel =_ '- mg/I
Coliform: MF Fecal /100m1
Nitrate (NO3) as N
rr
mg/I Pb -Lead mg/I
Coliform: MF Total /100ml
Phosphorus: Total as P
mg/I Zn - Zinc = mg/I
(Note: Use MPN method for highly turbid samples)
AI - Aluminum
mg/I Pesticides/Herbicides =-
Dissolved Solids: Total mg/I
Ba - Barium
mg/I (Specify Compounds)
pH (when analyzed) 6, • R R units
Ca - Calcium
mg/I ug/I
TOC mg/I
Cd - Cadmium
mg/I ug/I
Chloride mg/I
Chromium: Total
mg/I Ug/I
Arsenic mg/I
Cu - Copper
mg/I Other (Specify Compounds and
Grease and Oils mg/I
Fe - Iron
mg/I Concentration units)
Hardness: Total mg/I
Hg - Mercury
mg/I
Phenol mg/I
K - Potassium
mg/I
Sulfate mg/I
Mg - Magnesium
mg/I
Specific Conductance uMhos
Mn - Manganese
mg/I
Total Ammonia mg/I
Na -Sodium
mg/I
TKN as N mg/I
s
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
Note: Values fh'W, I1c dissolved and
colloidaR l0s. (see #3 on back)
i
/D - /3
See back for instructions.
Slgnatuof P mitt e r Authorized Agent*)
Date
** Submit blue and yellow copies only to address above.
GW-59-REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1: Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION "_R SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the, Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition,1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846; `
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No.209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volum "are°removed; samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45, micron -filler immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection_with the.facility-name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

I DIVISION OF WATER QUALITY • GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: P.O. Box 29578
For additional forms RALEIGH, NO 27626.0578
COMPLIANCE REPORT FORM please write or call: [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED)
Facility Name nAa_Si Qe Non -Discharge V 16 6_08 : C�k
Address'P\4,.' V NPDES
County Sr_ ni tr<.n. & TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Well Location Lagoon Septic Tank/Drain Field
Well Identification Number r--t F 10n-..,,TT Well Depth Ft.
Well Diameter -Sample Screened Interval Ft. To Ft. Spray Field Subsurface Low -Pressure
(Screened) Piping (LPP)
Depth to Water Level ft. below measuring point (before sampling) Land Application of Sludge
Measuring point is ft. above land surface Other
Gallons of water pumped/bailed before sampling Rotary Distributor
Field Analysis: pH E,`'15? Specific Conductance uMhosTemp?\,O °C Odor Appearance
Date Sample Collected 'n ,20 cI 9 Date Lab Sample Analyzed 6 1119
Laboratory Name �nen c� inn. A..,'�-1 , �, r,n l L"en. �a2 cS _ Certification No. �� I
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED ti11)r_YES NO
COD
mg/I
Nitrite (NO2) as N
mg/I
Ni - Nickel
o -
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Pb - Lead
co n—,mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
Zn - Zinc
C= 89;mg/I
(Note: Use MPN method for highly turbid samples)
AI - Aluminum
mg/I
Pesticides/Herbicides
o<
Dissolved Solids: Total
mg/I
Ba - Barium
mg/I
(Specify Compounds)
cn no
pH (when analyzed) 5, 119
units
Ca - Calcium
mg/I
oug/I
ug/I
TOC
mg/I
Cd - Cadmium
mg/I
�'
Chloride
mg/I
Chromium: Total
mg/I
— 2-1 g/I
Arsenic
mg/I
Cu - Copper
mg/I
Other (Specify Compounds and
Grease and Oils
mg/1
Fe - Iron
mg/I
Concentration units)
z
Hardness: Total
mg/I
Hg - Mercury
mg/I
iz: c l \cDzc�p. 4.� �, - —
'tcC L7 0311­
Phenol
mg/I
K - Potassium
mg/I
Sulfate
mg/I
Mg - Magnesium
mg/I
Specific Conductance
uMhos
Mn - Manganese
mg/I
Total Ammonia
mg/I
Na - Sodium
mg/I
TKN as N
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
colloidal concentrations. (see #3 on back)
Y' tty See back for instructions.
Signat a Of rm t e (or uthorized Agent`) tom,_ Date _.,�'' " Submit blue and yellow copies only to address above.
GW-59 REV. 8/96 w

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART QF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure -and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: 1
P.O. BOX 29578
For additional forms
RALEIGH, NC 27626.0578
COMPLIANCE REPORT FORM please write or call:
[phone]
Type or Use a ball-point pen and press firmly.
PERMIT NUMBER: (REQUIRED)
Facility Name�flRSTM ns i e0 k ntC
Non -Discharge c'`c9c3't'i CA 4
Address ti •
NPDES
Lk r ns \nt�P wC County cn'�\IN
TYPE OF DISPOSAL OPERATION BEING MONITORED
Well Location %Q r t lr\.. — S tl�1 octi 1
(REQUIRED)
Lagoon Septic Tank/Drain Field
Well Identification Number Well Depth Ft.
Well Diameter —Sample Screened Interval Ft. To Ft.
(Screened)
spray Field Subsurface Low -Pressure
Piping (LPP)
Depth to Water Level ft. below measuring point (before sampling)
Land Application of Sludge
/
Measuring point is—ft. above land surface
— other
Gallons of water pumped/bailed before sampling
Rotary Distributor
Field Analysis: pH — Specific Conductance uMhos Temp. — oC
Odor — Appearance
Date Sample Collected `�_ `a9 `5 y Date Lab Sample Analyzed r 1 9 '1
Laboratory Name A�.t?\�`r'.ckl I- .A\,c,-TIP,%`L:rt
Certification No. u
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED LL YES NO
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/I
pH (when analyzed)
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
Ni - Nickel
Pb - Lead
mg/I
mg/I
Zn - Zinc
Pesticides/Herbicides
(Specify Compounds)
—a rqC3
N sug/I
C-) ug/1
ug/I
Other (Specify Compounds and
Concentration units)
`
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
_ I colloidal concentrations. (see #3 on back)
L�t c©t �� See back for instructions.
Sign ure o Per Ittee Authorized Agent') Date *` Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

1�`
COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

GROUNDWATER QUALITY MONITORING: For additional forms
COMPLIANCE REPORT FORM please write or call:
or
Facility Name
pen and press
Well Location _LJ4T 34 ° 449 ' 67r3'r L b C, '79`
Well Identification Number 0" LJ -%XA Well Depth 30,6i
Well Diameter Lk. O" Sample (Screened) Interval Ft. To3oC
Depth to Water Level 10. %0 ft. below measuring point (before sampling)
Measuring point is 3N rAC> ft. above land surface
Gallons of water pumped/bailed before sampling 4C). n
Field Analysis: pH ti. S 61 Specific Conductance — uMhos Temp.
Date Sample Collec ed ��
'AO,�! Date Lab Sample Analyzed_
DIVISION OF WATER QUALITY -,GROUNDWATER SECTION
P.O. BOX 29578.
RALEIGH, NC 27626.0578
[phone].
PERMIT NUMBER: (REQUIRED) WWQ ���,�
Non -Discharge
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Lagoon Septic Tank/Drain Field
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of Slue
Other
Rotary Distributor
°C Odor — Appearance
Laboratory Name �f <ILRC� ��r.1 Avr \ ��� r. Al 9 Asa rL�i � -, P r _ Certification No. LA 82
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED ,NLA-`YES NO
COD _
Coliform
Coliform
MF Fecal
MF Total
(Note: Use MPN method for highly turbid samples)
mg/I
OOml
OOml
Dissolved Solids: Total
mg/I
pH (when analyzed)h , S t
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
Nitrate (NO3) as N
Phosphorus: Total
AI - Aluminum
Ba - Barium
Ca - Calcium_
Cd - Cadmium_
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury_
K - Potassium
Mg - Magnesium
Mn - Manganese _
Na - Sodium
as P.
mg/I
Ni - Nickel
mg/I
mg/I
Pb - Lead
mg/I
mg/I
Zn - Zinc
mg/I
mg/I
Pesticides/Herbicides
°D
C'=
mg/I
(Specify Compounds)
C
�n
mg/I
?r= ug/I
mg/I
%n
-ug/I
mg/I
-*+
r:'ioug/I
mg/I
Other (Specify Compounds and
mg/I
Concentration units)
mg/I",,�`�a``dto�.``4i
cG,(�d���
mg/I
J�ir.fi ,-�GN VnGJQ. Ct
— t� ��L
mg/I
l e
L
mg/I
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
� 9 colloidal concentrations. (see #3 on back)
L `0 See back for instructions.
Signa ure o er ttee Authorized Agent*) Date ** Submit blue and yellow copies only to address above.
GW-59 REV. 8/96 r

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, Q THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
r
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At leastavolumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
S. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: P.O. BOX 29578
For additional forms RALEIGH, NO 27626.0578
COMPLIANCE REPORT FORM please Write or oath [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED)
Facility Name I Oti<TO-^ �z�9— r 1:'.'C_ Non -Discharge i�.S c` L '2�06-7 -?CA
Address •Q(R^�t `Q�-�- NPDES
( 11JP. J .Nl1�}4 �.1C - County _<C ) I1' ., f TYPE OF DISPOSAL OPERATION BEING MONITORED
Well Location / f1 T .3 4° \� r c? < 1.3 ` Lt 7nl �iq ° `vlo -1 f L-(�(, Z �' (REQUIRED) Lagoon Septic Tank/Drain Field
Well Identification Number M\.s —lZ Well Depth '76.0 Ft.
Well Diameter "1 Oc�' Sample Screened Interval Ft. To D O Ft. Spray Field Subsurface Low -Pressure
p (Screened) :�+-�— Piping (LPP)
Depth to Water Level ft. below measuring point (before sampling) Land Application of Sle
Measuring point is 's, 1 ft. above land surface Other
Gallons of water pumped/bailed before sampling h L�d�rtdl Rotary Distributor
Field Analysis: pH 5. 6LA Specific Conductance uMhos Temp. 2a DC Odor Appearance
Date Sample Collected aJ.q�' Date Lab Sample Analyzed
Laboratory Name PPr2rL� �r_ ns }\ �:cA \ � ��r»pr�t�t i r 5 Certification No. LA 2
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED A/t /} YES NO
COD _
Coliform
Coliform
MF Fecal
MF Total
(Note: Use MPN method for highly turbid samples)
mg/I
/1 ooml
/1 ooml
Dissolved Solids: Total
mg/I
pH (when analyzed)
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
Nitrate (NO3) as N_
Phosphorus: Total as
AI - Aluminum
Ba - Barium
Ca - Calcium
Cd - Cadmium
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese
Na - Sodium
0
mg/I
Ni - Nickel
g/I
mg/I
Pb - Lead-uig/I
mg/I
Zn - Zinc
Cn :;7_
mg/I
Pesticides/Herbicides
,ig/I
-0 z m
mg/I
(Specify Compounds)
cn 2
mg/I
ug/I
mg/I
t �l Ig/I
mg/I
'Dg/I
mg/I
Other (Specify Compounds and
mg/I
Concentration units)
mg/I
C:s- t,a-- eT-'eiat
mg/I
TtT , c.V1 r,%e, e1-1• r_ — 'All
y c I. L
mg/I
mg/I
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
colloidal concentrations. (see #3 on back)
\ t� See back for instructions.
Signature o er • tee ( r Authorized Agent*) Date ** Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE 94. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART QF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
t EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
S. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to'sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: P.O. BOX 29578
For additional forms RALEIGH, NC 27626-0578
COMPLIANCE REPORT FORM please write or call: [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED)
Facility Name 1 HRG7nMl`G�l l TT"[e Non -Discharge- __ l/'Ja 000 iiG�
Address NPDES
( r),l9;�1\nJ2a. nsf_ County Sr'n-�-\na` TYPE OF DISPOSAL OPERATION BEING MONITORED
- (REQUIRED)
Well Location Lagoon Septic Tank/Drain Field
Well Identification Number Mkt - trl- Well Depth Ft.
Well Diameter's r`_ Sample Screened Interval Ft. To �S�� Ft. spray Field PipingSubsulace Low -Pressure
P (Screened) Piping (LPP)
Depth to Water Level 10, Oq ft. below measuring point (before sampling) Land Application of Sludge
Measuring point is '1,9 ft. above land surface other
Gallons of water pumped/bailed before sampling Z�g Rotary Distributor
Field Analysis: pH _Specific Conductance r uMhos Temp. C Odor — Appearance
Date Sample Collected a Date Lab Sample Analyzed F •2 'et8
Laboratory Name Prst rA et Z. . R U �l-k:c.w1 Certification No. y gt
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED niI�YES NO
COD mg/I
Nitrite (NO2) as N
mg/I
Ni - Nickel mg/1
Coliform: MF Fecal /100ml
Nitrate (NO3) as N
mg/I
Pb - LeadCo �n mg/I
Coliform: MF Total /100ml
Phosphorus: Total as P
mg/I
Zn - Zinc mg/I
(Note: Use MPN method for highly turbid samples)
Al - Aluminum
mg/I
Pesticides/Herbicides cm
Dissolved Solids: Total mg/I
Ba - Barium
mg/I
(Specify Compounds) _ o<
pH (when analyzed) A7. I units
Ca - Calcium
mg/I
ug/I
TOC mg/I
Cd - Cadmium
mg/I
-'� ug/I
Chloride mg/I
Chromium: Total
mg/I
> ug/I
Arsenic mg/I
Cu - Copper
mg/1
Other (Specify Compounds and - c,
Grease and Oils mg/I
Fe - Iron
mg/I
Concentration units) r o
Hardness: Total mg/I
Hg - Mercury
mg/I
Mp+l .. \.� N� cQ \�n_'�\p - � .)6% li-
Phenol mg/I
K- Potassium
mg/I
Sulfate mg/I
Mg - Magnesium
mg/I
Specific Conductance uMhos
Mn - Manganese
mg/I
Total Ammonia mg/I
Na - Sodium
mg/I
TKN as N mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
Note:
Values should reflect dissolved and
colloidal concentrations. (see #3 on back)
EDS
(O t
*
See
back for instructions.
Sign re of Per i ee (bf uthorized Agent*)
Date
** Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION QR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
r, (b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW 846;
r (d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
r October 26, 1984;
5. Measure*and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumpedibailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

GROUNDWATER QUALITY MONITORING: for additional forms
COMPLIANCE REPORT FORM please write or call:
Type or Use a ball-point pen and press firmly.
Facility Name
Address
Well Location &Ar 3 LI 0 C1-g ` coo 3 " 1 ntj o '?q o '7 ' t t3
Well Identification Number /�?W -I I Well Depth 'IS, b Ft.
Well DiameterLk,W"Sample (Screened) Interval Ft. To kq.0 Ft.
Depth to Water Level 1�`Zft. below measuring point (before sampling)
Measuring point is I tC ft. above land surface
Gallons of water pumped/bailed before sampling -0
Field Analysis: pH 5 � 412 Specific Conductance "' uMhos Temp. k �1'
Date Sample Collected '; ,ab —Date Lab Sae Analyzed 6 •a'`t
Laboratory Name 2f\P-A01',, . ANr4\�},Glt-t mpplAL1 ,-)o-tk�njIc4
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED
COD _
Coliform:
Coliform:
MF Fecal
MF Total
(Note: Use MPN method for highly turbid samples)
mg/I
00ml
00ml
Dissolved Solids: Total
mg/I
pH (when analyzed)
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
Nitrate (NO3) as N
Phosphorus: Total
Al - Aluminum_
Ba - Barium
Ca - Calcium_
Cd - Cadmium_
Chromium: Total _
Cu - Copper
Fe - Iron
Hg - Mercury_
K - Potassium
Mg - Magnesium _
Mn - Manganese _
Na - Sodium
as P.
I
DIVISION OF WATER QUALITY - GROUNDWATER SECTION
P.O. BOX 29578
RALEIGH, NO 27626.0578
[phone]
PERMIT NUMBER: (REQUIRED)b
Non -Discharge �. 000-'11111(I>
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Lagoon Septic Tank/Drain Field
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of SI e
Other
Rotary Distributor
Odor Appearance
Certification No. bD
NIA' YES NO
mg/I
Ni - Nickel
mg/1
mg/1
Pb - Lead
c mg/1
mg/1
Zn - Zinc ca
mg/I
mg/I
Pesticides/Herbicides
o
mg/I
(Specify Compounds)
sr
mg/I
om ug/I
mg/I
va ug/I
mg/I
ug/I
mg/I
Other (Specify Compounds and -
m�
mg/I
Concentration units)
—"
mg/I
i?:C\'\t�0.�� eHir_ v� C1UT-
L
mg/I
mg/I
mg/I
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
%r 9 colloidal concentrations. (see #3 on back)
See back for instructions.
Signat2o`fperrrfit e (or uthorized Agent*) Date ** Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART QF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
- (c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
r (d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure -and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least TVolumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

GROUNDWATER QUALITY MONITORING: For additional forms
COMPLIANCE REPORT FORM please write or call:
Type or Use a ball-point pen and press firmly.
Facility Name T�v,s�mnsir3 t T ice.
Address (-'1Art� `c.
GA, o,,-3ta�,Pr,.)C County GGc�tlnnc�
Well Location
Well Identification Number /14LJ -10 Well Depth Ft.
Well Diameters "r Sample (Screened) Interval Ft. Tor`�c-D' Ft.
Depth to Water Level Vt5t72 ft. below measuring point (before sampling)
Measuring point is III; ft. above land surface
Gallons of water pumped/bailed before sampling 3C
Field Analysis: pH !n r t Specific Conductance — uMhos Temp. II t,r+-1 00C
DIVISION OF WATER QUALITY - GROUNDWATER SECTION
P.O. BOX29578
RALEIGH, NC 27626-0578
[phone]
PERMIT NUMBER: (REQUIRED)
Non -Discharge W bZ
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Lagoon Septic Tank/Drain Field
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of Sludge
Other
Rotary Distributor
Odor '- Appearance
Date Sample Collected 10 ' afa K b Date Lab Sample Anzed In ` t °WS'
Laboratory Name ?PsgMNZ�t.. A,,)k ;�s�t ZA.,,alyC—qe (\Q, i c< Certification No. �( �
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED AJ�L_YES NO
COD
Coliform:
Coliform:
MF Fecal
MF Total
(Note: Use MPN method for highly turbid samples)
_ mg/I
/100ml
/100ml
Dissolved Solids: Total
mg/I
pH (when analyzed) LA,q
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/1
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
Signa re o Per rD
r Authorized Agent`)
GW-59 REV. 8/96
Ni - Nickel
mg/1
Pb - Lead
o mg/I
Zn - Zinc
o
o mg/I
Pesticides/Herbicides
`
A�
(Specify Compounds)
m
ug/I
ug/I
v
m` ug/I
Other (Specify Compounds and
cn�
Concentration units)
_
Crn
c;s-1 t�-
A ,Jy1L-
11A.,2,%t� t Y.Ai� �.LJiI � aY
�
5y e k)_
Note: Values should reflect dissolved and
colloidal concentrations. (see #3 on back)
Sto, (V See back for instructions.
Date •` Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART -OFF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION 911 SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
r . EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3.volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING:
P.O. BOX 29578
For additional forms
RALEIGH, NO 27626.0578
COMPLIANCE REPORT FORM
please write or call:
[phone]
Type or Use a ball-point pen and press firmly.
PERMIT NUMBER: (REQUIRED)
Facility Name 1STmnspr, 0!aSTe_. -,,4C
Non -Discharge Z"C1 (Doc)-1 S
Address G\A-3QI
(_n.�n:y��_ QL_
County Sr.ni•1fvs�
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
Well Location �-l�i 2�' �-1S ` l3 U 4 r� f-O•.1G
Zd`'' 'air 4� t. �'r
(REQUIRED)
Lagoon Septic Tank/Drain Field
Well Identification Number Ml z-q
Well Depth aErL2 Ft.
Well Diameter s"Sam le Screened Interval
P (Screened)
Ft. To 36�_Ft.
spray Field Subsurface Low -Pressure
Piping (LPP)
Depth to Water Level ft. below measuring point
(before sampling)
Land Application of Sludge
Measuring point is—ft. above land surface
1
other
Rotary Distributor
Gallons of water pumped/bailed before sampling
rL7
Field Analysis: pH h • W? Specific Conductance
_ uMhos Temp. t 6,ct °C
Odor Appearance —
Date Sample Collected (n ao c� S? Date Lab
Sample Analyzed 6, �L `A q
Laboratory Name Phhq A fs r� A FZck.
t /t- p, y n-Fnn.; •e c
_ Certification No.
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED A!3-YES NO
COD mg/I
Nitrite (NO2) as N
mg/I Ni - Nickel mg/I
Coliform: MF Fecal /100ml
Nitrate (NO3) as N
mg/I Pb - Lead o mg/I
Coliform: MF Total /100ml
Phosphorus: Total as P
mg/I Zn - Zinc o mg/I
(Note: Use MPN method for highly turbid samples)
Al - Aluminum
mg/I Pesticides/Herbicides ��
Dissolved Solids: Total mg/I
Ba - Barium
mg/I (Specify Compounds) _ om
pH (when analyzed) h , a3 units
Ca - Calcium
mg/I u — g/I
TOC mg/I
Cd - Cadmium
mg/I n ug/I
Chloride mg/I
Chromium: Total
mg/I
Arsenic mg/I
Cu - Copper
mg/I Other (Specify Compounds and ,nz
Grease and Oils mg/I
Fe - Iron
mg/I Concentration units)
Hardness: Total mg/I
Hg - Mercury
mg/I r Cs - Ilk - �:<.l �otgc�ih� - uS1L
Phenol mg/I
K- Potassium
mg/I
Sulfate mg/I
Mg - Magnesium
mg/I
Specific Conductance uMhos
Mn - Manganese
mg/I
Total Ammonia mg/I
Na - Sodium
mg/I
TKN as N mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
Note: Values should reflect dissolved and
colloidal concentrations. (see #3 on back)
eq * See back for instructions.
Sig atur f P ittee or Authorized Agent*) Date ** Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW 846;
(d) Test Procedures for the Analysis of Po!luants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
r' October 26, 1984;
r
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
voluines are removed; samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: P.O. eox 29578
For additional forms RALEIGH, NC 27626-0578
COMPLIANCE REPORT FORM please write or call: [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED)
Facility Name t 04c \ r nhe.Ae2- ; PJ C. Non -Discharge IN Cc c,30 c1
Address Pta,-,T 2 ,. NPDES
Lt - t )nos r )C - County <c-i \ a << TYPE
ODISPOSAL OPERATION BEING MONITORED
Well Location i by Zy� t-tq� Lv.aG -7c)o �i td`I.aii (REQUIRED) Lagoon Septic Tank/Drain Field
Well Identification Number Well Depth Ft. s Field subsurface Low -Pressure
Well Diameter 21.00" Sample (Screened) Interval Ft. To Ft. Spray
Piping (LPP)
Depth to Water Level 12,2A� ft. below measuring point (before sampling) Land Application of Slue
Measuring point is L-A1i ft. above land surface Other
Gallons of water pumped/bailed before sampling Rotary Distributor
Field Analysis: pH h . M o Specific Conductance - uMhos Temp. 00,4 °C Odor Appearance
Date Sample Collected ti Date Lab Sam le Analyzed 6t3ltt4?
s
Laboratory Name Patz(��;� ti Ak\ k-,aN\ I.rt� 2rrtoe:Ls _CertificationNo. L; l
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED A-L _YES NO
COD
Coliform
Coliform
MF Fecal
MF Total
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/I
pH (when analyzed)
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/1
Sulfate
mg/l
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
Nitrate (NO3) as N_
Phosphorus: Total as P
Al -Aluminum
Ba - Barium
Ca - Calcium
Cd - Cadmium
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese
Na - Sodium
mg/I
mg/I
mg/1
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
Ni - Nickel mg/I
Pb - Lead mg/1
Zn - Zinc mg/I
Pesticides/Herbicides co CD
(Specify Compounds) C_ om
— �;�Jg/I
glg/I
Other (Specify Compounds and =9 70,�n
Concentration units) N�
LDS - i, a - �:c1, Q6IL
I eT2t3G\n1no,jtL
7z:c1 \.>:Lcearl.aaG - 11ODo L
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
q colloidal concentrations. (see #3 on back)
See back for instructions.
Si� f Plirittee Dr Authorized Agent*) Date ** Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At Ieasf 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
vo(uim6s'are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

GROUNDWATER QUALITY MONITORING: For additional forms
COMPLIANCE REPORT FORM please write or call:
Type or
Facility
pen ana press
Well Location LA-C 2LO A_? ' \ 40 , b" `?C(o 'dl l U4
Well Identification Number AA w -(6 Well Depth .; F.O Ft.
Well Diameter IND " Sample (Screened) Interval Ft. To 3b ,J Ft.
Depth to Water Level 14 5.0 ft. below measuring point (before sampling)
Measuring point is G.AO ft. above land surface
Gallons of water pumped/bailed before sampling I O. (1)
Field Analysis: pH b N6 Specific Conductance r uMhos Temp. C
DIVISION OF WATER QUALITY • GROUNDWATER SECTION
P.O. BOX 29578.
RALEIGH, NC 27626.0578
[phone].
PERMIT NUMBER: (REQUIRED
Non -Discharge
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Lagoon Septic Tank/Drain Field
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of Sludge
`^'— Other
Rotary Distributor
Odor — Appearance -
Date Sample Collected F ?; ,u Q Date Lab Sample Analyzed f_. 3 Ufi
Laboratory Name 4ntua;l.�a�,nnl�4nr��c< _ Certification No.
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED '�12YES NO
COD _
Coliform:
Coliform:
MF Fecal
MF Total
(Note: Use MPN method for highly turbid samples)
_ mg/I
/loom[
/loom[
Dissolved Solids: Total
mg/I
pH (when analyzed) h �3
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
a
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/[
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
A,
Signat re of er i ee (ol Authorized Agent')
GW-59 REV. 8/96
Ni - Nickel
mg/I
Pb - Lead
mg/I
Zn - Zinc
r o 7; mg/I
Pesticides/Herbicides
CIO
(Specify Compounds)
z om
- = ug/I
Ln = rn ug/I
.+ m� ug/I
Other (Specify Compounds and t( r"
Concentration units) -
CiS-\*1-_")'CN'N\SK)c'-eh-e_ -gip vs\L
1n 0"\kNna r' N.at _ \hok1 Zc\L
Note: Values should reflect dissolved and
colloidal concentrations. (see #3 on back)
`_ w .% * See back for instructions.
Date ** Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART 2F SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION _R SAMPLING PROCEDURES,
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
r October 26, 1984;
C
5. Measurorand record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least a volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
S. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
or
Facility Name I nasl'mft�l�n_ �L, c,
Address o%o.--Nk �•
DIVISION OF WATER QUALITY - GROUNDWATER SECTION
P.O. BOX.29578
For additional forms RALEIGH, NC 27626.0578
please write or call: [phone]Y
PERMIT NUMBER: (REQUIRED)
Non -Discharge W Q Q W''1'7gY
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
Well Location ! AT _3 (I' L)9(?4 t9" C.O 1C3 G° a"fr LAO. "' (REQUIRED)
Lagoon Septic Tank/Drain Field
Well Identification Number /" w h Well Depth riLt.0 Ft.
Well Diameter1. 16 " Sample (Screened) Interval Ft. To 1�k. L) Ft. spray Field SubsuurfaccePiping P' ow -Pressure
Depth to Water Level ft. below measuring point (before sampling) Land Application of Slud ie
Measuring point is 3 , o ft. above land surface !� other
Gallons of water pumped/bailed before sampling
t cl7 Rotary Distributor
Field Analysis: pH & v 3 3 Specific Conductance — uMhos Temp. C Odor — Appearance —
Date Sample Collected G 'AO •4c2 Date Lab Sample Analyzed CkQ
Laboratory Name LNzAc -rn �"r0s�1-;c.nl �n�rzasoR��s Certification No. L02(
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED .v YES NO
pen and press
COD
mg/1
Nitrite (NO2) as N
mg/I
Ni - Nickel
mg/1
Coliform: MF Fecal
/100ml
Nitrate (Nog) as N
mg/I
Pb - Lead
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
Zn - Zinc , o
mg/I
(Note: Use MPN method for highly turbid samples)
Al - Aluminum
mg/I
Pesticides/Herbicides
Dissolved Solids: Total
mg/I
Ba - Barium
mg/I
(Specify Compounds)
rn
pH (when analyzed)
C. to units
Ca - Calcium
mg/I
g
1Ug/l
TOC
mg/I
Cd - Cadmium
mg/1
cn
F r ug/I
Chloride
mg/I
Chromium: Total
mg/l
,a
g/l
Arsenic
mg/I
Cu - Copper
mg/I
Other (Specify Compounds and �=
��
Grease and Oils
mg/I
Fe - Iron
mg/I
Concentration units)
Hardness: Total
mg/I
Hg - Mercury
mg/I
-&o aS(L
Phenol
mg/I
K- Potassium
mg/I
vrz:Cvlrar�efil.e�e — 4Zhc
lL
Sulfate
mg/I
Mg - Magnesium
mg/I
Specific Conductance
uMhos
Mn - Manganese
mg/I
Total Ammonia
mg/I
Na - Sodium
mg/I
TKN as N
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND
ACCURATE.
Note:
Values should reflect dissolved and
colloidal concentrations. (see #3 on back)
�1�
S- P.,
See back for instructions.
Sig ture o Pelfiittee
Authorized Agent`)
Date
** Submit
blue and yellow copies only to address
above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION QR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
_ (d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
r October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
,;
6. At lbasP volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

GROUNDWATER QUALITY MONITORING: For additional forms
COMPLIANCE REPORT FORM please write or call:
or
Facility Name nAcTrwhcif- e.V y i Nc .
Address Q,"•
t NO2. mtt ",k, P6 C_ County
Well Location
Well Identification Number Anw-H Well Depth I . 0 Ft.
Well Diameter1,15 " Sample (Screened) Interval Ft. To'N 1, ZFt.
Depth to Water Level 13 %5 5 ft. below measuring point (before sampling)
Measuring point is ft. above land surface
Gallons of water pumped/bailed before sampling i , O
Field Analysis: pH IN %' 3 Specific Conductance — uMhos Temp.
Date Sample Collected a .au •r\q Date Lab Sample Analyzed `3
Laboratory Name_ 9A.n-A&a rn A"�r\!:g F: r r'l jinn.:-_
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIE
pen and press
COD _
Coliform:
Coliform:
mn/I
MF Fecal /loom[
MF Total /loom[
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total mg/I
pH (when analyzed) tnunits
TOC mg/I
Chloride mg/I
Arsenic mg/I
Grease and Oils mg/I
Hardness: Total _ mg/I
Phenol mg/I
Sulfate mg/I
Specific Conductance uMhos
Total Ammonia mg/I
TKN as N mg/I
DIVISION OF WATER QUALITY- GROUNDWATER SECTION
P.O. BOX 29578
RALEIGH, NO 27626-0578
[phone]
PERMIT NUMBER: (REQUIRED)
Non -Discharge \w1Q C'QO%ZCA.
{�
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Lagoon Septic Tank/Drain Field
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of Sludge
Other
Rotary Distributor
D
°C Odor — Appearance
G8
Certification No. L1(21
n:iJi YES NO
Nitrite (NO2) as N
DIVISION OF WATER QUALITY- GROUNDWATER SECTION
P.O. BOX 29578
RALEIGH, NO 27626-0578
[phone]
PERMIT NUMBER: (REQUIRED)
Non -Discharge \w1Q C'QO%ZCA.
{�
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Lagoon Septic Tank/Drain Field
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of Sludge
Other
Rotary Distributor
D
°C Odor — Appearance
G8
Certification No. L1(21
n:iJi YES NO
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
Ni - Nickel
= mg/I
Pb - Lead
rr, mg/I
Zn - Zinc
mg/I
Pesticides/Herbicides
zm
(Specify Compounds)cil
:r:m
Other (Specify Compounds and ,� �
Concentration units) o 0
C lS - l t a - a % r_kn1020 e tk7e.a ` 970 QtIL
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
c� Q colloidal concentrations. (see #3 on back)
See back for instructions.
Sign ture o Permi ee (or uthorized Agent*) Date ** Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
r; (b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measurs'and record the depth of water in the well prior to pumping or bailing any water from the well.
c•
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

GROUNDWATER QUALITY MONITORING:
For additional forms
COMPLIANCE REPORT FORM please write or call:
Type or Use a ball-point pen and press firmly.
Facility Name Ton4�n�rtSTeD_ kiN�.
Address P\nNT R2
DIVISION OF WATER QUALITY - GROUNDWATER SECTION
P.O. BOX,29578
RALEIGH, INC 27626-0578
(919)'733-3221
PERMIT NUMBER: (REQUIRED))
Non -Discharge. vJ a ewf 0ii c1'�
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
REQUIRED
Well Location Lrit �Lic q-y .�6.(�r` 1_n�,,(, �1" ;ry 4�­I.3tr ( ) Lagoon Septic Tank/Drain Field
Well Identification Number I'A W -3 Well Depth 30.o Ft.
Well Diameter!,. Sample (Screened) Interval Ft. To 3c7,O Ft. spray Field Piping
P 9( Subsurface LPPLow-Pressure
)
Depth to Water Level \ ] .3O ft. below measuring point (before sampling) Land Application or Sludge
Measuring point is ft. above land surface other
Gallons of water pumped/bailed before sampling I ro Rotary Distributor
Field Analysis: pH r. , (� L4 Specific Conductance — uMhos Temp. C Odor — Appearance _
Date Sample Collected Date Lab Sample Analyzed 6 ` \ r\,g t t Q
Laboratory Name Pnnac�'.$m A %r r, 1 � tzco-,\ La-1�,o2wton_;r— Certification No.
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED N 1 A YES NO
COD _
Coliform:
Coliform:
mn/I
MF Fecal /100ml
MF Total /100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/I
pH (when analyzed) 6.'t 3
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
_ mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/1
Nitrite (NO2) as N
mg/1
Nitrate (Nog) as N
mg/1
Phosphorus: Total as P
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/1
K - Potassium
mg/1
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
Si ature f Per ittee or Authorized Agent`)
GW-59 REV. 8/96
Ni - Nickel mg/I
Pb - Lead mg/1
Zn - Zinc m mg/1
Pesticides/Herbicides �=
(Specify Compounds) cc'
rn ..
Other (Specify Compounds and rn
to �
Concentration units)
cis - l,l - J:c�loear.fhr Icy CTao IL
61'e11-
i-aZo.a.c P+I.eNc - au u,I,L
Note: Values should reflect dissolved and
colloidal concentrations. (see #3 on back)
See back for instructions.
Date •* Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At leasf 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4, above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING:
P.O. 2
For additional Corms
NC 626-
RALEIGH, NC 27626.0578
COMPLIANCE REPORT FORM please write or caul
[phone]
Type or Use a ball-point pen and press firmly.
PERMIT NUMBER: (REQUIRED)
Facility Name 1n`js Mlle I eV_
Non -Discharge 060
Address
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
"III 1+' �C.C1'tf}Jc�
o County
Well Location LAT 340 �F�r ] ,3 LDraG �(�� ai yf,(��rr
(REQUIRED)
Lagoon Septic Tank Drain Field
Well Identification Number M(N- a Well Depth —Ft.
rr
Well Diameter k � 3 5 Sample (Screened) Interval Ft. To 30, 0 Ft.
Spray Field Subsurface Low -Pressure
Piping
Depth to Water Level 1 S, 6`� ft. below measuring point (before sampling)
(LPP)
Land Application of Stud
Measuring point is i . 10 ft. above land surface
Other
Distributor
Gallons of water pum ed/bailed before sampling IC)Rotary
Field Analysis: pH 64 Specific Conductance uMhos Temp. °C
Odor — Appearance
Date Sample Colle led 1E'aO' q Date Lab Sample Analyzed l •qq
ANPr�.;�N:Gfx(
uy�
Laboratory Name �R�*� �n1 (cS
Certification No.
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED N14
YES NO o
COD
Coliform:
Coliform:
ma/I
MF Fecal /100ml
MF Total /100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/I
pH (when analyzed) 4 '38
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
mg/I
Ni - Nickel
tng/I
Nitrate (NO3) as N
mg/I
Pb - Lead
r#ig/I
Phosphorus: Total as P
mg/1
Zn - Zinc
— ". g/I
Al - Aluminum
mg/I
Pesticides/Herbicides
Ba - Barium
mg/I
(Specify Compounds)
y 11-1 C:3.
Ca -Calcium
mg/I
g/I
Cd - Cadmium
mg/I
` l Ig/I
Chromium: Total
mg/I
o dug/I
Cu - Copper
mg/I
Other (Specify Compounds and
Fe - Iron
Hg - Mercury
mg/I
mg/I
Concentration units)
M�t\..P. ' r. C\
— IO1 ug)L
K - Potassium
mg/I
``e
ia;
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
colloidal concentrations. (see #3 on back)
See back for instructions.
Sign to f ermitte (or Authorized Agent*) Date ** Submit blue and yellow copies only to address above.
GW-59 REV. 8196

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours. -
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of -Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition,1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be.collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official docurnents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
P.O. BOX 29578
GROUNDWATER QUALITY MONITORING: 626-
For additional forms RALEIGR, NC 27fi28.0578
COMPLIANCE REPORT FORM please write or call: [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED
Facility Name T',A,S q<TrQ T 0C Non -Discharge �
Address AtoRA,.tr QNPDES
(_n.,2:,ati.,9 � 1�C County SCttlRad TYPEDISPOSAL OPERATION BEING MONITORED
n�e� (REQUIRED)
Well Location i r cx2"7 ' f-c7N& 79.O 7�Zf Lagoon Septic Tank/Drain Field
Well Identification Number m W" I Well Depth ab ,0 Ft.
Well Diameter ')-,0" Sample (Screened) Interval Ft. To ah ,b Ft.
Depth to Water Level 1 a • 1 `I ft. below measuring point (before sampling)
Measuring point is 0 ,b ft. above land surface
Gallons of water pumped/bailed before sampling '1 •0
Field Analysis: pH (,%L tLt Specific Conductance uMhos Temp.:O• °C
Date Sample Collected a • OO ^1 Date Lab Sample Analyzed 6 • A "kS
Laboratory Name QAcb- iprn A. aLg+;rAi
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land. Application of Sludge
7� Other
Rotary Distributor
Odor r Appearance —
Certification No. NS
SAMPLES FOR METALS WERE COLLECTED UNFILTERED AND FIELD ACIDIFIED NIA YES NO
COD
Coliform:
Coliform:
MF Fecal /10om[
MF Total /100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/I
pH (when analyzed) r,.S'?
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
Nitrate (NO3) as N
Phosphorus: Total
AI - Aluminum_
Ba - Barium
Ca - Calcium_
Cd - Cadmium_
Chromium: Total _
Cu - Copper
Fe - Iron
Hg - Mercury_
K - Potassium
Mg - Magnesium _
Mn - Manganese _
Na - Sodium
as P
mg/I
Ni - Nickel
r
7
mg/I
Pb - Lead
w
`
mg/I
Zn - Zinc
�—
mg/I
Pesticides/Herbicides
==
5
mg/I
(Specify Compounds)
cs1
mg/I
1
mg/I
-
mg/I
mg/I
Other (Specify Compounds and
-
F
`
mg/I
Concentration units)
mg/I
T2\try\D L 7 Qt\1C Nt" - CC
Z
mg/I
mg/I
mg/I
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
colloidal concentrations. (see #3 on back)
� qS
c - Io - See back for instructions.
Signs ure q PPe?n­tee r Authorized Agent*) Date ** Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE 94. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD III
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED A5 WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT AREA PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION QR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Directors Division of Environmental _ .
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
c.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign off icial'documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
29578
GROUNDWATER QUALITY MONITORING: �RO P.Q. NC
For additional forms RALEIGH,.NC 27626.7626-
0578
COMPLIANCE REPORT FORM please write or call: [phone]
_ Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIR e
Facility Name Non -Discharge
Address NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
Uri Ur C CDUnty (REQUIRED)
Well Location
Well Identification Number Well Depth Ft.
Well Diameter Sample (Screened) Interval Ft. To Ft.
Depth to Water Level ft. below measuring point (before sampling)
Measuring point is-ft. above land surface
Gallons of water pumped/baailed before sampling Field Analysis: . Co .7_ Specd'fic Conductance — uMhos Temp. °
Date Sample Collected ' a D Date Lab Sample Analyzed I • P 1 ' g
Laboratory Na t rh CAI k ruiSntS
SAMPLES FOR METALS WERE COLLEdTED UNFILTERED AND FIELD ACIDIFIED h
COD
Coliform: MF Fecal
Coliform: MF Total
_ mg/I
/100ml
/100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total mg/I
pH (when analyzed) 5. units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
Nitrate (NO3) as N_
Phosphorus: Total as P
Al - Aluminum
Ba - Barium
Ca - Calcium
Cd - Cadmium
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese
Na - Sodium
Lagoon
Septic TanWDrain Field
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of Slud e
Other
Rotary Distributor
Odor — Appearance
Certification No. 491 `0 �' YES NO
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
Ni - Nickel
Pb - Lead
Zn - Zinc
Pesticides/Herbicides
(Specify Compounds)
mg/I
—c m9 /I
—r mg/I
ug/I
ug/I
ug/I
Other (Specify Compounds and
Concentration units L
Cam�C) IIa-b"1arD2 end-q�,9
fri D 2n� IL
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values shREi6&lk1Fl®d and
, (� colloidal concentrations. (see #3 on back)
/ 77 l�2 / "t FSee back for instructions.
Signat re Permittee (or ut rized Agent*) Date ubmit blue and ye#AcyV_1gLw address above.
GW-59 REV. 8/96 nr_%j. OFFICE

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 30300 for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES-IN"THE FIELD !!t
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
." ":... . _ "_.. .
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, N T THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title ) 5„ North Carolina Administrative Code, Subchapter 2L, analytical -procedures shall be in accordance with the methods described in one of
the following publications, or by other methods', approved beforehand by the Director, Division of Environmental.
Management:_ `.:. _ .. " . " 1 ........
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
Y; (b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition,1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3-volumes of" Water,!n the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes_are:re_mQved, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH?SeCiffc6r�ituctanGe, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrai2din accordance with recommendations by the manufacturer.
9. Samples must be #filtered; tfirougll~at, 0:95 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample containef should be labeidd a#rt;(1e time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent"is_aay�Cp erase* officer or public official authorized by the company, corporation, or governmental body to sign official'documents.

,.., .
GROUNDWATER QUALITY MONITORING: For atlditional forms
COMPLIANCE REPORT FORM please write or call:
DIVISION OF WATER QUALITY • GROUNDWATER SECTION
P.O.Box
626-
RALEIGH, NC 27626-0678
[phone]
Type or sea ball-point pen and press firmly.
PERMIT NUMBER: (REQUIR
-�ir h
Facility Name
Non -Discharge �%%9$
Address
Gf,d
NPDES
TYPE OF DISPOSAL
OPERATION BEING MONITORED
,1AY r n
Well Location LAT ?i4D `iA 0o'% LONG
^Cniinty�l5�4
! 1 a% r
(REQUIRED)
Lagoon Septic Tank Drain Field
Well Identification Number M LA-) — I
Well Diameters ,D Sam le (Screened) Interval
Well Depth , D Ft.
Ft. To 45, 0 Ft.
Spray Field Subsurface Low -Pressure
Piping (LPP)
Depth to Water Level 7,91 ft. below measuring point
(before sampling)
Land Application of Sludgg
�_ Other
T7:
Measuring point is a r ft. above land surface
12,0
�O
Rotary Distributor CO
_?
Gallons of water pumped/ ailed before sampling
Field Analysis: pH 9 Specific Conductance
LiMhos Temp. °C
Odor — Appearance Co
r„
r
Date Sample Coll ted 1 a7 98 Date Lap Sample Analyzed I' ' 9%
Analu+i eL+ort
No.
N
70
C—
cam
Laboratory Name RY7X�;!Ipn al ahoy- .S
SAMPLES FOR METALS IERE CO f __TEA UNFILTERED AND FIELD ACIDIFIED R
Certification
YES —NO `�"
COD mg/I
Nitrite (NO2) as N
mg/I
Ni - Nickel w"mg/I
Coliform: MF Fecal /100ml
Nitrate (NO3) as N
mg/1
Pb - Lead
== mg/I
Coliform: MF Total /100ml
Phosphorus: Total as P
mg/I
Zn - Zinc
mg/I
(Note: Use MPN method for highly turbid samples)
Al - Aluminum
mg/I
Pesticides/Herbicides
Dissolved Solids: Total mg/I
Ba - Barium
mg/I
(Specify Compounds)
pH (when analyzed) •a�units
Ca - Calcium
mg/I
ug/I
TOC mg/1
Cd - Cadmium
mg/I
ug/I
Chloride mg/I
Chromium: Total
mg/I
ug/I
Arsenic mg/I
Cu - Copper
mg/I
Other (Specify Compounds and
Grease and Oils mg/I
Fe - Iron
mg/1
Concentration units)
Hardness: Total mg/I
Hg - Mercury
mg/1
Phenol mg/I
K - Potassium
mg/I
Sulfate mg/I
Mg - Magnesium
mg/I
Specific Conductance uMhos
Mn - Manganese
mg/I
Total Ammonia mg/I
Na - Sodium
mg/I
TKN as N mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values shoL&KQ1{" Ived and
Colloidal cor796kr4)Aft9ee #3 on back)
See back for instructions.
Si atur of ermittee or thorized Agent*) Date •* Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

" COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection:
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS� WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART gFF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION QR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION. 11
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division,of Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition,1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for PH Pecif Cori ictartct't�"r.dtu[e;jodor and appearance must be made in the field on unfiltered samples when the sample is
collected. "... 7:4 3�
8. Field equipment must be calibrated in accordance with.recommendations by the manufacturer.
.,r
9. Samples must be filtered _fltJd6d 0.45 micron filtq; imFti'Mately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the:time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

-
DIVISION OF WATER QUALITY- GROUNDWATER SECTION
QUALITY MONITORING:
P.OGROUNDWATER 7626-
For additional forms
IG NO
RALEIGH, NC27626�0578
COMPLIANCE REPORT FORM please write orcallr
[phone] -
Type or usea ball-point pen and press firmly.
I
PERMIT NUMBER: (REQU`R•�D],
6 MQ % %�
Facility Name 'r•u 1►7C •
Non -Discharge W
NPDES
Address�lan} (Z
TYPE OF DISPOSAL OPERATION BEING MONITORED
C-
County
n a r q
Well Location) ATAT r S$' 3 NG 79 01 -� LI�(0'IO(O
(REQUIRED)
Lagoon Septic Tank/Drain Field
Well Identification Number MIA) Well Depth -0 Ft.
Spray Field Subsurface Low
-Pressure
11
Well Diameter�i9 (Screened) Interval Ft. To,��Ft.
Piping (LPPA
gSample
Depth to Water Level ft. below measuring point (before sampling)
Land Application of Sludge co
�C
_C:;
V
Measuring point is 1,30 ft. above land surface
Other
Rotary Distributor �
, _
Qt—
Gallons of water pum ed/bailed before sampling c71.O
— II oC
— _
of
Field Analysis: pH �4Specific Conductance uMhos Temp. -D
Odor Appearance ro
M,
Date Sample Colle ted 1 ' a'1 9 `6 Date Lab Sampl�1 Anal zed I' Al- `)1A
Laboratory Name rad�ar.r. flrA%A� i I styiri tt n vs
Certification No. T$I
SAMPLES FOR METALS WdRE COLLE&ED UNFILTERED AND FIELD ACIDIFIED
YES NO
COD
mg/I
Nitrite (NO2) as N
mg/I
Ni - Nickel
P, mg/1
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Pb - Lead
mg/1
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
Zn -Zinc
mg/I
(Note: Use MPN method for highly turbid samples)
Al - Aluminum
mg/I
Pesticides/Herbicides
Dissolved Solids: Total
mg/I
Ba - Barium
mg/I
(Specify Compounds)
pH (when analyzed) , oR
units
Ca - Calcium
mg/I
ug/1
TOC
mg/I
Cd - Cadmium
mg/I
ug/I
Chloride
mg/I
Chromium: Total
mg/I
ug/1
Arsenic
mg/I
Cu - Copper
mg/I
Other (Specify Compounds and
Grease and Oils
mg/I
Fe - Iron
mg/I
Concentration nits)
TrtGhjoro
-13 u9I
Hardness: Total
mg/I
Hg - Mercury
mg/I
aAena-
L
Phenol
mg/I
K - Potassium
mg/I
Sulfate
mg/I
Mg - Magnesium
mg/I
Specific Conductance uMhos Mn - Manganese mg/I
Total Ammonia mg/I Na - Sodium mg/IRECEn-,,;=n
TKN as N mg/I 7'
9
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
Z- Z ,Q@
Sig at f Permittee (o Aut orized Agent*) Date
GW-59 REV. 8/96
Note: Values s
colloidal
solved and
(see #3 on back)
* See back for instructions.
** Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDINGTIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPL•ESJN"THE FIELD 111
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT -THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION PR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative. Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Diviston of Environmental
Management: -
(a) Standard Methods for the Examination of Water'and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR' Part 136,
October 26, 1984; • -
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water_ in the well shouldpe pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
Volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
y
dwz._
7. Determination for pH, Specify QQnductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected. �' % , • ' '' S
8. Field equipment must be calibrated in accordance with recom pidations by the manufacturer.
9. Samples must be filtered. throagh.q 045 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container�"hould`b'e labeled at the time of collection with -the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

GROUNDWATER QUALITY MONITORING- For additional forms
COMPLIANCE REPORT FORM please write or call:
or
Facility
pen and press
Well Location I RI 6!t- 9 / ` ,-AP t9 IJIr`L-e /- a r. `t r- Z
Well Identification Number fK1W 3 Well Depth 30.4 Ft.
It
Well Diameter I101Sam,(�le (Screened) interval Ft. To 30, 0 Ft.
Depth to Water Level �3 ft. below measuring point (before sampling)
Measuring point is 5, ft. above land surface
Gallons of water pumped/b iled before sampling of r D
Field Analysis: pHSpecific Conductance — uMhos Temp. I�^
Date Sample Collected
Laboratory Name C-Ir
SAMPLES FOR METALS
DIVISION OF WATER QUALITY- GROUNDWATER SECTION
P.O. BOX29578
RALEIGH, NC 27626-0578
[phone]
PERMIT NUMBER:(REQUlgyb OOD,77`l8,
Non -Discharge WW
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Lagoon Septic Tank/Drain Field
Spray Field Subsurface Low -Pressure
Piping (LP�
Land Application of Slud
Other f-1 f^
Rotary Distributor t7J _Jc�
y oC Odor Appearance—
ca I LAWr'CA_T*Vr% Certification No.
UNFILTERED AND FIELD ACIDIFIED A YES
COD mg/I
Coliform: MF Fecal /100ml
Coliform: MF Total /100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total mg/I
pH (when analyzed)units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
NO
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
2 -2co -9R
'/ — C' LALL�� — Sig ture f Permittee (or A thorized Agent*) Date
GW-59 REV. 8/96
L4 8 I
Ni - Nickel
mg/I
Pb - Lead
mg/I
Zn - Zinc
mg/I
Pesticides/Herbicides
(Specify Compounds)
ug/I
ug/I
ug/I
Other (Specify Compounds and
Co centration units) /
ct-1,g-DichloV-Qe ter Suy L
TrT� orpe ens 5fn� u4 /►.
Note: Values s
colloidal
�d and
#3 on back)
* See back for instructions.
** Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE ##4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES'INTHE FIELD !i!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours. �-
Sample preparation in the laboratory (extraction and filtration) must be completed within- 727hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION_QR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, pivision of Environmental_ ,
Management: F -
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes. of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes.aee.Yemoved, samples,can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered through a f 45•micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
pu
•„e ;`�. a i;.':>t
1 O.The sample containe iafioiil&bapow at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: P.O. 13Ox 29s7$
For additional forms RALEIGH, NO 27626.0578
COMPLIANCE REPORT FORM please write or call: [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIR
Facility Name lT_t_ G• Non -Discharge M 007-29W
Address NPDES
N C— County f� (REQUIRED) TYPE OF DISPOSAL OPERATION BEING MONITORED
Well Location Lagoon Septic Tank/Drain Field
Well Identification Nun)0er MLV- 4 Well Depth d1-U
Well Diameters. as Sample (Screened) Interval Ft. To�211
Depth to Water Level 940 ft. below measuring point (before sampling)
Measuring point is—ft. above land surface
Gallons of water pumped/b@iled before sampling a•O
Field Analysis: pH �7' 3 1 —Specific Conductance — uMhos Temp.
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of SI e
Other
Rotary Distributor
Odor Appearance —
Date Sample Collected I • of 1 "I�5 Date Lab Sample Analyzed 1' ac f • r a
Laboratory Name �Arp�Igwl ono Iujlt'CAI Laboro�iyri e5 Certification No.
SAMPLES FOR METALS WY=RE COLLE. .IED UNFILTERED TERED AND FIELD ACIDIFIED �Y YES NO try ^'
co _.
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/1
pH (when analyzed) 5.(o3
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/1
TKN as N
mg/I
Nitrite (NO2) as N
mg/I
Ni - Nickel
mg/l
Nitrate (NO3) as N
mg/1
Pb - Lead
--ing/I
Phosphorus: Total as P
mg/1
Zn -Zinc
Al - Aluminum
mg/I
Pesticides/Herbicides
Ba - Barium
mg/I
(Specify Compounds) -
�=
Ca - Calcium
mg/I
w
ug/I
Cd - Cadmium
mg/I
ug/I
Chromium: Total
mg/1
ug/I
Cu - Copper
mg/1
Other (Specify Compounds and
Fe - Iron
Hg - Mercury
mg/I
mg/I
Concentration units)
dT, a Dic1 dorDtlklOu_- Sao
uy L
K- Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/1
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
Sign ure)f Permittee (r Au orized Agent*)
GW-59 REV. 8/96
colloidal
(see #3 on back)
r r"%a. t
See back for instructions.
Date ** Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES -
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be'submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION _QR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the, methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental ,
Management: _ ..
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition,1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984; =
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least,3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes. are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected. i
8. Field equipment must be calibratgd in accordance with recommendations by the manufacturer.
9. Samples must be filtered through.,; Q.J5 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
1 O.The sample container slsdiNEel •Iape#I'ed &t;the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY GROUNDWATER SECTION
P.O. BOX2
GROUNDWATER QUALITY MONITORING: 26-
For additional forms RALEIGH, NO 27626-0678
COMPLIANCE REPORT FORM please write or call: [phone]
or
Facility Name
Address
pen ano press
PERMIT NUMBER: (REQUIRtUb )0779 d
Non -Discharge ((��GGII u.[! 0
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Well Location G f 0 q
u r ' g ,r
Lagoon
Septic Tan1-0Drair{_ield
Well Identification Nugiber M W -S
)'a7
Well Depth oZ - 0 Ft.
To�SLFt.
Spray Field
�=
Subsurfaces ow -Pressure
E-j
Well Diameter Sample (Screened) Interval
Ft.
Piping (LAP.}t
F:7
Depth to Water Level (e05 ft. below measuring point (before sampling)
Land Application of Sludy�
�
other
c r,'.
Measuring point is 3, DO ft. above land surface
!-
Rotary Distributor
�
Gallons of water pumped/bailed before sampling ark
_1
Field Analysis: pH oZ Specific Conductance
uMhos Temp. 15• °C Odor
Appearance
Date Sample Collected Date Lap
Sample
Analyzed I ' oth' 78
Laboratory Name ?try i M
ftc
born
i Certification No.
SAMPLES FOR METALS WERE COLLb",TED
UNFILTERED AND FIELD ACIDIFIED n AYES
NO
vI
'"
COD mg/I
Coliform: MF Fecal /loom[
Coliform: MFTotal /loom)
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total mg/1
pH (when analyzed) units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
Hardness: Total
Phenol
mg/I
mg/I
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Nitrite (NO2) as N
Nitrate (NO3) as N
Phosphorus: Total
Al - Aluminum_
Ba - Barium
Ca - Calcium_
Cd - Cadmium_
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury_
K - Potassium
Mg - Magnesium _
Mn - Manganese _
as P.
mg/I Ni - Nickel
mg/I
mg/I Pb
- Lead
mg/I
mg/I Zn
- Zinc
mg/I
mg/I Pesticides/Herbicides
mg/I (Specify Compounds)
mg/I
ug/I
mg/I
ug/I
mg/I
ug/I
mg/I Other (Specify Compounds and
mg/I Concentration units
mg/I C-111 o1- D; c� o ro i e-
qCD
mg/I
TrloroeA_- (P=
J%L.
I_
mg/1
mg/I
Total Ammonia mg/I Na - Sodium mg/I
TKN as N mg/1 t yea
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values sh6Uld refle dissolved and
(�Q colloidal=9?"iid . (see #3 on back)
2 2 CD "lC FTSeeb ack for InstructionsVV1)Sig of Permittee or thorized Agent`) Date Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.. ,,
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be'subrrlitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.'
3. ANALYSES ARE TO BE MADEOF THE MOBILE.CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT AREA PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION,QR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods cJescribed in one of
the following publications, or by other methods approved beforehand by the Director, Division of EnvironmentalC.
_... "
Management:
(a) Standard Methods for the Examination of Water,and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition,1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least.3youlumes of water in_ the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes ,are1..removed, samp1.lQsc1.an.be.coll@cted as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance,,temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered tlirou 'h a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container shoyldb,,glaf3elo;1 of the time of collection with the facility name, well identification number and date and time collected.
11. "Authorized agent" is any corpolte,:officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: P.O. BOX NIC 29673
:For additional forms RALEIGH, NC 2762&0578
COMPLIANCE REPORT FORM please write or call: [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIggEEpp gyp
Facility Name ^ Q T.C. • Non -Discharge W� 00775M
Address NPDES
Y U G Count a n TYPE OF DISPOSAL OPERATION BEING MONITORED
LOJAc f v , (REQUIRED)
Well Location T 5. � G Lagoon Septic Tank//Drairf Field
Well Identification Nur ber f.U" Well Depth70'ti, Ft.
rSpray Field Subsurfacx w-Pressure
Well Diameter�Sample (Screened) Interval Ft. To�Ft. Piping (LgR)I j :;
Depth to Water Level lb Qq ft. below measuring point (before sampling) Land Application of sludg ua - M
Measuring point is q, Ro ft. above land surface^ other ry `v,;
id O Rotary Distributor �.
Gallons of water pum ed/b sled before sampling
Field Analysis: pH �' $ S ecific Conductance " uMhos Temp. °C Odor Appearance
Date Sample Collected Date La Simple Analyzed /p I = Ti=`:
f� LIE
Laboratory Name �a 'IiM �R u artt rl e. Certification No. W u,
SAMPLES FOR METALS WIRE GOLLEC. dD UNFILTERED TERED AND FIELD ACIDIFIED r? LX YES NO cn c-!
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/I
pH (when analyzed) lam I
units
TOC
mg/I
Chloride
mg/1
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P
mg/I
Al -Aluminum
mg/1
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/1
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
)UM %> � -2& 'fie
Sign ure f Pe mittee (o(Au orized Agent') Date
GW-59 REV. 8/96
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Pesticides/Herbicides
(Specify Compounds)
ug/I
ug/I
Ug/I
Other (Specify Compounds and
Concentration units
CA I , a- D�cl,ioroe. Fl,Pr--I qo fcg)L
-19-cW Drop 2nL - ! -DDT
0� IFa
G�
Note: Values shQjujd reflect dissolved and
colloidal N(N ► EE(see #3 on back)
' See back for instructions.
" Submit blue and yellow copies only to address above.

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1.. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use StandardMethod 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD if'
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and shb fd lie submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection:
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT _ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per TitI6.15, North Carolina Administrative Code, Subchapter 2L, analytical -procedures shall be in accordance with the methods. described in one of
the following publications, or by other methods approved beforehand by the Director, _Division of Environmental __ r
Management: -
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can.b.e collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conduc%ance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
'r
8. Field equipment must be eali6rated in accordance with recommendations by the manufacturer.
9. Samples must be filtered throe jh 3,0,�15 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
::1✓.. t .ti .�
10.The sample containersfiould' be9aksered'at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official•documents.

GROUNDWATER QUALITY MONITORING: For additional forms
COMPLIANCE REPORT FORM please Write or oaM
DIVISION OF WATER QUALITY - GROUNDWATER SECTION.
P.O. BOX 29578
RALEIGH, NO 27626-0578
[phone]
Type or Use a ball-point pen and press firmly.
PERMIT NUMBER: (REQUIF}Ep �M r�r
Non -Discharge W & OX77 % a
Facility Name r
NPDES
Address A
C-
TYPE OF DISPOSAL OPERATION BEING MONITORED
n Y Count n
I not Y r f
Well Location 4 UrV� 0 7'
(REQUIRED)
Lagoon Septic Tank/Drain
Field
Well Identification Number W --7 Well Depth 35•0 Ft.
Interval Ft. To �Ft.
spray Field Subsurface Low -Pressure
Well Diameter0� Sample (Screened)
Piping (LPP)
Depth to Water Level S•43 ft. below measuring point (before sampling)
Land Application of Slu
Other
Measuring point is • aD ft. above land surfac
g p
w
Fotary Distributor
M
Gallons of water pumped/bailed before sampling
a(o ' ivr °�
- _
ri
=M1
Field Analysis: pH Specific Conductance uMhos Temp.
I' g
Odor Appearance
,ni
Date Sample Colle ed of - 98 pate L b S mple A alyzed .
✓
yg I J
�'
Laboratory Name AY I
Certification No.
SAMPLES FOR METALS RE COLLE ED UNFILTERED AND FIELD ACIDIFIED
a'�YES NO
COD mg/I
Coliform: MF Fecal /100ml
Coliform: MF Total /100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total mg/I
pH (when analyzed) S�units
TOC mg/1
Chloride mg/I
Arsenic mg/I
Grease and Oils mg/I
Hardness: Total mg/1
Phenol mg/1
Sulfate mg/I
Specific Conductance uMhos
Total Ammonia mg/I
TKN as N mg/I '!A; i
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/1
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/1
K - Potassium
mg/1
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
ri
Ni - Nickel =
Pb - Lead E—�
Zn - Zinc
Pesticides/Herbicides
(Specify Compounds)
Other (Specify Compounds and
,in ntration un t,$)
IIrir�lorD��f\4-nf?�— MD aAIL
mg/I
mg/I
ug/I
ug/1
ug/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Nate: Values s NN�`��k#ssolved and
Colloidal FMA3. (see #3 on back)
98 See back for instructions.
Sig(ature f Permittee horized Agent') Date *• Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD 11,
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Diyision.of Environmental _
Management:
(a) Standard Methods for the Examination of Water'and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
` EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984; _
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of -water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for M,.'.SpeCi ie bndu�Gtaripe, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrtited iii accordance with recommendations by the manufacturer.
9. Samples must be filte,74
hrc}{ghaLf,5.micron lifter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11. "Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

GROUNDWATER QUALITY MONITORING: For additional forms
COMPLIANCE REPORT FORM please write or call:
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
PX 29578 26-
RALEIGH, N NC 27628.0578
[phone]
1 Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRE
Non -Discharge I0h 00077c?d
Facility Name 1'P" 0 2c
NPDES
Address Ar
•� r N
Co t cb a TYPE
OF DISPOSAL
OPERATION BEING MONITORED
n
Well Location � � 0L• -r M
(REQUIRED)
7f 55,
_ Lagoon Septic Tank/Drain Field
Well Identification Nupber MLA) — 9
Well Diameters Sample (Screened) Interval
Well Depth 5' a Ft.
0
Ft. To 5 Ft.
Spray Field Subsurfacece Low-P `ensure
Piping (LPPCO
Depth to Water Level 10 r� ft. below measuring point
(before sampling)
Land Application of SI d e co
Other
Measuring point is—ft. above land surface
7r aField
f_q
Rotary Distributor Tl
Gallons of water pu�mped/b iled before sampling
Temp.15, S oC Odor
— AppearanceDate
Analysis: pH Specific Conductance
q Date Lap
uMhos
Sample Analyzedgg
Sample Colle�
Laboratory Name ckr-aol;wr+rn Ana, N' l
f pt�rct�DricS Certification No.
' /
L19 1
SAMPLES FOR METALS V:IoC w1LLCC• tD UNFILTERED 11 TFPFfI AND FIELD ACIDIFIED yES
NO
COD mg/I
Nitrite (NO2) as N
mg/I
Ni - Nickel
ci mg/I
Coliform: MF Fecal /100ml
Nitrate (NO3) as N
mg/I
Pb - Lead
mg/I
Coliform: MF Total /100ml
Phosphorus: Total as P
mg/I
Zn - Zinc
mg/I
(Note: Use MPN method for highly turbid samples)
Al - Aluminum
mg/I
Pesticides/Herbicides
Dissolved Solids: Total mg/1
Ba - Barium
mg/I
(Specify Compounds)
pH (when analyzed) r 1 units
Ca - Calcium
mg/I
ug/I
TOC mg/I
Cd - Cadmium
mg/I
ug/I
Chloride mg/I
Chromium: Total
mg/I
ug/I
Arsenic mg/I
Cu - Copper
mg/I
Other (Specify Compounds and
Grease and Oils mg/I
Fe - Iron
mg/I
Concentration units)
Hardness: Total mg/I
Hg - Mercury
mg/I
Phenol mg/I
K - Potassium
mg/I
_-
Sulfate mg/I
Mg - Magnesium
mg/I
Specific Conductance uMhos
Mn - Manganese
mg/I,Tlgr��
Total Ammonia mg/I
Na - Sodium
mg/I
TKN as N mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
colloidal concentrations. (see#3 on back)
See back for instructions.
Sign ture f Per ittee (oK&utbAbrized Agent*) Date ** Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD III
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours. '
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours ofcollection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NDT..•THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods.approved beforehand by the Director,"Division of Environmental-
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removbd S—W� s''ca'R&c lfected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH„Specifictbrlductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected. ••
s a! E �r 't
8. Field equipment must ba lera&t ?(rn,pyccordancetyith recommendations by the manufacturer
9. Samples must be filtered:1hr6bh 3 g-4t r icron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents:

DIVISION OF WATER QUALITY - GROUNDWATERSECTION
GROUNDWATER QUALITY MONITORING: P.O. BOX 29578
For additional forms RALEIGH, NC 27626.0578
COMPLIANCE REPORT FORM please write or call; [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED ,�/
Facility Name Non -Discharge I'�77�25
Address �'�I NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
r-U/' C CDUnty Q (REQUIRED)
Well Location Lagoon Septic Tank/Drain Field
Well Identification Number f•Yt W' f U Well Depth a5 • D Ft.
r Well Diameter Q a'mj�le (Screened) Interval Ft. To �O —Ft.
Depth to Water Level eft. below measuring point (before sampling)
Measuring point is Ioff 5 ft. above land surfaco
Gallons of water pumped/bailed before sampling
Field Analysis: pH � Spgoific Conductance r uMhos Temp..
Date Sample CoIlec yd f a I Date Lab sample Analyzed f r
Laboratory Name Ta✓txL ��t * 1 r1o� U ' 1 L9 b0KtfDn �S
SAMPLES FOR METALS VV91RE COLLEC D UNFILTERED AND FIELD ACIDIFIED
COD
mg/I
Coliform: MF Fecal
/100m1
Coliform: MF Total
/100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/I
pH (when analyzed) rJT R
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of Sludge,
X. Other
Rotary Distributor r
Odor Appearance
Certification No. 4901
�YES NO
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/1
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
co
co
n
rV
v
Ni - Nickel
e mg/I
Pb - Lead
mg/I
Zn - Zinc
' mg/I
Pesticides/Herbicides
s
(Specify Compounds)
ug/I
ug/I
ug/I
Other (Specify Compounds and
Concentration units)
/lic-1 - is r I en -0 ] aS�L
Tp:j�2 joroe.,tkpbj. - 77
ul' L
M1')�
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values s Alsolved and
Colloidal co d arts. (see #3 on back)
Z,2(,.q UQ See back for instructions.
Signa re Permittee (oLAOorized Agent') Date •' Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use`Stan der d Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD III
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours. - -
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION ,OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental.-,
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the well should' be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are_ removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for H,'Sp c'i a pnd t`c32ni;e, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected. °` F
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filteedd-thpg6 4� 5 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
1 O.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY • GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: P.O. sox29578
For additional forms ,RALEIGH, NC 27626-
7626.0578
COMPLIANCEREPORT FORM please write or call: [phone]
Type or Use a ball-point pen and press firmly. PERMIT NUMBER: (REQUIRED
Facility Name l Q )-tf"' Non -Discharge WU W01-7gK
Address NPDES
tLrt of Count c-0 0.n TYPE OF DISPOSAL OPERATION BEING MONITORED
Well Location T e r 00, 2 n LD E 9 y 7 r 3.0 n (REQUIRED) Lagoon Septic Tank/Drain Field
Well Identification Number iY)W— II Well Depth ,0 Ft.
Ir Spray Field Subsurface Low -Pressure
Well Diameter Sample (Screened) Interval Ft. To a5Ft. Piping (LPP)
Depth to Water Level 61 - ft. below measuring point (before sampling) Land Application of Sludge
Measuring point is 3_3,1-5 ft. above land surface other
Gallons of water pumped/bailed before samplinq 37.0 Rotary Distributor
Field Analysis: pH J *1
Appearance
Date Sample CoIle ted �
Ck a a>r
uate Lao asr le Hn I zea r � 6 , m� ��Y�
u 1 �i borQ tOn e 5
o
No. o
c.:
Laboratory Name
t a
Certification
SAMPLES FOR METAL�OLLEC
D UNFILTERED AND FIELD ACIDIFIED 9Lr
YES NO
c
COD
mg/I
Nitrite (NO2) as N
mg/I
Ni - Nickel
;
_=mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as N
mg/I
Pb - Lead
'Mmg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
Zn - Zinc
-;mg/I
(Note: Use MPN method for highly turbid samples)
AI - Aluminum
mg/1
Pesticides/Herbicides
_
n?
Dissolved Solids: Total
mg/I
Ba - Barium
mg/I
(Specify Compounds)
w
pH (when analyzed)
units
Ca - Calcium
mg/I
47,
ug/I
TOC
mg/I
Cd - Cadmium
mg/1
ug/I
Chloride
mg/I
Chromium: Total
mg/1
ug/I
Arsenic
mg/I
Cu - Copper
mg/1
Other (Specify Compounds and
Grease and Oils
mg/I
Fe - Iron
mg/1
�oAnc ntration unit )
Hardness: Total
mg/I
Hg - Mercury
mg/I
Jri� oro v end — I t'i
D
Phenol
mg/I
K - Potassium
mg/I
Sulfate
mg/I
Mg - Magnesium
mg/I
11 Ir-ems,
Specific Conductance
uMhos
Mn - Manganese
mg/I
Total Ammonia
mg/1
Na - Sodium
mg/I
1�141998
TKN as N
mg/1
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values s11351j,.q§ solved and
Q ff
colloidal concentratio s. (see #3 on back)
See back for instructions.
Sighatuib of Permittee(&thorized Agent') Date Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES'IN THE'FIELD II!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT -THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical.procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, -Division of_ Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984; _
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least3 volumes of water in the well should. be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination fo[ pH; .Spe�feGgfidu`dtahce, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must tie callbrated in accordance with recommendations by the manufacturer.
9. Samples must be filter t 10` hdb% micron filter immediately after collection when a dissolved analysis is required. See #4. above
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

IGROUNDWATER QUALITY MONITORING: For additional forms
COMPLIANCE REPORT FORM please write or call:
Type or Use a ball-point pen and press firmly.
Facility Name . asIm =rG•
Well Location
Well Identification Number MUJ— Id, Well Depth 615. O'U Ft.
Well Diameter a,pi! Sample (Screened) Interval Ft. To •07 Ft.
Depth to Water Level 7• 4 ft. below measuring point (before sampling)
Measuring point isc�r L_ft. above land surface,
Gallons of water pumped/bailed before sampling /
DIVISION OF WATER QUALITY • GROUNDWATER SECTION
P.O. BOX29578
RALEIGH, NC 27626-0578
[phone]
PERMIT NUMBE aUIWh OW7798�
Non -Discharge
rge ((�,((JJ
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
(REQUIRED)
Lagoon Septic Tank/Drain Field
Spray Field Subsurfacg Low Piessure
Piping ( ) -
Land Application of Sludge :,
Other• M rr;
D Rotary Distributor CCr
Field Analysis: pH r a S ec'fic Conductance uMhos Temp.y15. 7 0 Odor Appearance c�
Date Sample Coll '� Date a Sample A )alyzed�► � t � =_
Laboratory Name I I n Certification No. 9 =
SAMPLES FOR METALS WERE COLLE ED UNFILTERED AND FIELD ACIDIFIED n !X YES NO �!
COD
Coliform:
Coliform:
mn/I
MF Fecal /100ml
MF Total /100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total mg/I
pH (when analyzed) 5 0 units
TOC
mg/I
Chloride
mg/1
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
Nitrate (NO3) as N_
Phosphorus: Total as P
Al -Aluminum
Ba - Barium
Ca - Calcium
Cd - Cadmium
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese
Na - Sodium
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE.
Signa ure Permittee ( r Aut orized Agent*) Date
GW-59 REV. 8196
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/1
mg/1
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
mg/I
Ni - Nickel
mg/1
Pb - Lead
mg/I
Zn - Zinc
mg/I
Pesticides/Herbicides
(Specify Compounds)
Other (Specify Compounds and
ug/I
ug/I
ug/I
L
Note: Values shoulil reflect dissolved and
colloid=f&s. (see #3 on back)
* See back for instructions.
** Submit blue and yellow copies only to address above.

11 -''\\
COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN'THE FIELD 111
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours. ' . - •
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division, of Environmental
Management:.
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984; -
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of water in the. well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are rer idved,.sample's can fie collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be calibrated in'accbrdance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 ri1(oron filter immediately after collection when a dissolved analysis is required. (See #4. above)
IV
10.The sample container slioyc,Ii&Nb&Q& the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING: P.O.t30X29576
For additional forms RALEIGH, NC27626-0578
COMPLIANCE REPORT FORK please write or call: [phone]
Type or Use as ball-point pen and press firmly. PERMIT NUMBER: (REQUIR D d
Facility Name r rr7C. Non -Discharge JAM W�7%9n
Address NPDES
Ur'if1 r' County TYPE OF DISPOSAL OPERATION BEING MONITORED
Well Location 3 0 % I (REQUIRED) Lagoon Septic Tank/Drain Field
Well Identification Number YY)W '! S Well Depth .712.60 Ft.
Well Diameters -0 to Sam le (Screened) Interval Ft. To 50. OO Ft.
Depth to Water Level ft. below measuring point (before sampling)
Measuring point is 3 ft. above land surface
Gallons of water pumpedI�/bailed before sampling 17.0
Field Analysis: ' �.L Specific Conductance — uMhos Temp. '
Date Sample Colle.QWd -LAS 9Z. Date Lal) Sample Analyzed l c
Laboratory Name
SAMPLES FOR METALS
COD
Coliform: MF Fecal
Coliform: MF Total
UNFILTERED AND FIELD ACIDIFIED
mg/I
/1 ooml
/1 ooml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total mg/I
pH (when analyzed) S. units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
Hardness: Total
Phenol
mg/I
mg/I
mg/I
Sulfate
mg/I
Specific Conductance
Total Ammonia
uMhos
mg/I
Spray Field Subsurface Low -Pressure
Piping (LPP)
Land Application of Sludge
_lli� Other
Rotary Distributor
Odor Appearance
r-�
_ m
Certification No.
YES NO rn n
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
Ni - Nickel —' Gam' mg/I
Pb - Lead- `- mg/I
Zn - Zinc — mg/I
Pesticides/Herbicide
(Specify Compounds) Y
ug/I
ug/I
ug/I
Other (Specify Compounds and
Concentration units
r - - D ick DY'Qe n[,-5 IA /L
o C —Vj IL
o� e
TKN as N mg/I
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values s6�d�l /l±�r/��fl�Z�slt,r'�iCfisolved and
FMB Colloidal FIdr;rf Offf1Q&. (see #3 on back)
2� v * See back for instructions.
Signat re o er ittee or uthor ed Agent*) Date ** Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be "submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within_72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THO E THAT ARE OF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION � AMPLIN PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. Asper Title 15, North Carolina Administrative Code, Subchapter 2L, analytical- procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of Environmental ... -
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition,1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3-volumes of water in the.well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, samples can be collected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pHJ S ec$ dncjudf e, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected. " "x `
8. Field equipment must be calibrated in accordance with recommendations by the manufacturer.
9. Samples must be filtered tW
&hh-
V-4_t micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent" is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY -GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING:
P.O.ox
For additional forms
RALEIGH, NO 2762fi,0578
626-
COMPLIANCE REPORT FORM please write or call:
(919)733-32211
Ty a or Use a ball-point pen and press firmly.
PERMIT NUMBER: (REQUIR�E�
Facility Name
me .
Non -Discharge OR CX77RK
Address '�'
NPDES
• C- County C _t h
TYPE OF DISPOSAL OPERATION BEING MONITORED
l7 t O p f r
Well Location '3 Ltrn a
(REQUIRED)
Lagoon
Septic Tank/Drain
Field
Well Identification Number Well Depth • OD Ft.
n
Well Diameter �i 0 S pie (Screened) Interval Ft. To 0• W Ft.
Spray Field
Subsurface Low -Pressure
Piping (LPG '
ft. below measuring point before
Depth to Water Level rJ g p (sampling)
Land Application of Slud e
c)o
Other
r
Measuring point is 3•a0 ft. above land surfacp5
-'rt
,^
Gallons of water pumped /b^
fled before sampling ``tt
Rotary Distributor
Field Analysis: pH
)'
S e ifto Conductance uMhos Temp. 15 I oC
g'�� )'o •F8
Odor Appearance
t
t
Date Sample Collected Date Lab Sample Analyzed
� 1/
Laboratory Name Yrn LR Q
Certification No. " t g I
m
SAMPLES FOR METALS RE COLLEC ED UNFILTERED AND FIELD ACIDIFIED 1-ILL-YES
NO
—
r•i�
COD
Coliform
Coliform
mn/I
MF Fecal /100ml
MF Total /100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total mg/I
pH (when analyzed)units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
Hardness: Total
Phenol
mg/I
mg/I
mg/I
Sulfate
mg/I
Specific Conductance
Total Ammonia
uMhos
mg/I
Nitrite (NO2) as N _
Nitrate (NO3) as N_
Phosphorus: Total as
AI - Aluminum
Ba - Barium
Ca - Calcium
Cd - Cadmium
Chromium: Total
Cu - Copper
Fe - Iron
Hg - Mercury
K - Potassium
Mg - Magnesium
Mn - Manganese
Na - Sodium
0
mg/I
Ni - Nickel
mg/I
mg/I
Pb - Lead
mg/I
mg/I
Zn - Zinc
mg/I
mg/I
Pesticides/Herbicides
mg/I
(Specify Compounds)
mg/I
ug/I
mg/I
ug/I
mg/I
ug/I
mg/I
Other (Specify Compounds and
mg/I
mg/I
Concentration unitg)
Gi 1-I, a-DIXlorneRene--
a u91L
mg/I
fir; DrDe here. -
13 !2q L
mg/I
mg/I
M-r.FINIFM,
mg/I
TKN as N mg/I
1 CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values sFrp��&�ssolved and
Q
colloidal COff9el* egs. (see #3 on back)
l * See back for instructions.
Sig Lure f ermittee or A horized Agent*) Date ** Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES IN THE FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample, and should be submitted to the
lab within 24 hours.
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 Hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NOT THOSE THAT ARE A PART (QF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION OR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical, procedures shall be in accordance with the methods described in one of
the following publications, or by other methods approved beforehand by the Director, Division of_ Environmental
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least-3 volumes of water in the, well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are'removed; samples can, be cQflected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pHt Secf'ndO'Y e, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be'cafibrdted in accordance with recommendations by the manufacturer.
9. Samples must be filtered-tlii a4�5 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents.

DIVISION OF WATER QUALITY - GROUNDWATER SECTION
GROUNDWATER QUALITY MONITORING:
9578
P.O.GNC2626-
For additional forms
RALEIGH, NC 27626�0578
COMPLIANCE REPORT FORM please write or call;
[phone]
Type or Use a ball-point pen and press firmly.
PERMIT NUMBER: (REQUIRED)
Wa ccn7-%Address
Facility Name
Non -Discharge
tvri
NPDES
TYPE OF DISPOSAL OPERATION BEING MONITORED
CDUnfy
(REQUIRED)
Well Location
Lagoon
Septic Tank/Drain
Field
_
Well Identification Number Well Depth Ft.
Spray Field
Subsurface Low
-Pressure
Well Diameter Sample (Screened) Interval Ft. To Ft.
Piping (LPP2
Depth to Water Level ft. below measuring point (before sampling)
Land Application of Slu
"^
Measuring point is-ft. above land surface
Rotary Distributor
(M Omer n
c,
C-�
Gallons of water pumped/bailed before sampling
,
Field Analysis: Ic Conductance uMhos Temp. C
a ' 9 9
Odor Appearance
n er
Date Sample Coll ted Date Lab S m le/jrtal ed 1 '
p )pt'1
�r$�
Laboratory Name d '� COL
Certification No.
_
T
SAMPLES FOR METALS VI) RE COLLE D UNFILTERED AND FIELD ACIDIFIED
A. YES NO
: _
rq
:;;-
COD mg/I
Coliform: MF Fecal /100ml
Coliform: MF Total /100ml
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total
mg/I
pH (when analyzed)
units
TOC
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Hardness: Total
mg/I
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N
mg/I
Phosphorus: Total as P
mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
Na - Sodium
mg/I
Ni - Nickel " mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Pesticides/Herbicides
(Specify Compounds)
ug/I
ug/I
ug/I
Other (Specify Compounds and
Concentration units)
RPrTIVED
yA.4' 7 1099
I CERTIFY THAT THIS REPORT IS TRUE AND ACCURATE. Note: Values should reflect dissolved and
colloidal concentrations. (see #3 on back)
Z . 2tD A v See back for instructions.
Signekure,bf Permitte (or Authorized Agent*) Date •* Submit blue and yellow copies only to address above.
GW-59 REV. 8/96

•• 1
COLLECTION AND ANALYSIS OF GROUNDWATER SAMPLES
1. Samples should be analyzed as soon as possible after collection. SAMPLES WHICH ARE NOT ANALYSED WITHIN THE HOLDING TIME SPECI-
FIED FOR THE METHOD USED (SEE #4. BELOW) MUST BE DISCARDED AND NEW SAMPLES COLLECTED.
2. Metals Analyses: Use Standard Method 3030C for sample preparation (mercury excluded). DO NOT FILTER METALS SAMPLES'IN T14E FIELD !!!
Unfiltered samples must be collected for metals, then field acidified with 5 ml concentrated nitric acid per liter of sample,;and should be s�bfnitted to the
lab within 24 hours. ' .. - . � -
Sample preparation in the laboratory (extraction and filtration) must be completed within 72 hours of collection.
3. ANALYSES ARE TO BE MADE OF THE MOBILE CONSTITUENTS (DISSOLVED AS WELL AS COLLOIDAL) IN THE
GROUNDWATER, NQTNTHO E THAT ARE A PART QF SEDIMENT ASSOCIATED WITH WELL CONSTRUCTION 9RR SAMPLING PROCEDURES.
CHECK WITH YOUR LABORATORY ON PROPER PROCEDURES FOR SAMPLE COLLECTION AND PRESERVATION.
4. As per Title 15, North Carolina Administrative Code, Subchapter 2L, analytical procedures shall be in accordance with the, methods od_ s described in one of
the following publications, or by other methods approved beforehand by the Director_, Division of Environmental.
Management:
(a) Standard Methods for the Examination of Water and Wastewater, 16th Edition, 1985 and 17th Edition, 1989, published jointly by
` American Public Health Association, American Water Works Association and Water Pollution Control Federation;
(b) Methods for Chemical Analysis of Water and Waste, 1979, U.S. Environmental Protection Agency publication number
EPA-600/4-79-020, as revised March 1983;
(c) Test Methods for Evaluating Solid Wastes: Physical/Chemical Methods, 3rd Edition, 1986, U.S. Environmental Protection Agency
publication number SW-846;
(d) Test Procedures for the Analysis of Polluants Under the Clean Water Act, Federal Register Vol. 49, No. 209, 40 CFR Part 136,
October 26, 1984;
5. Measure and record the depth of water in the well prior to pumping or bailing any water from the well.
6. At least 3 volumes of.Wgter.in the well should be pumped or bailed prior to collecting a sample for analysis. If the well is pumped/bailed dry before 3 well
volumes are removed, sa6nptp ea IJ6 * of(lected as soon as the well recovers to the point where enough water is available to collect your sample.
7. Determination for pH, Specific Conductance, temperature, odor and appearance must be made in the field on unfiltered samples when the sample is
collected.
8. Field equipment must be ili6r4�Ltedn£1lccordance with recommendations by the manufacturer.
9. Samples must be filtered through a 0.45 micron filter immediately after collection when a dissolved analysis is required. (See #4. above)
10.The sample container should be labeled at the time of collection with the facility name, well identification number and date and time collected.
11."Authorized agent' is any corporate officer or public official authorized by the company, corporation, or governmental body to sign official documents: