NC0090239_Modification_20240201

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Certified Mail Return Receipt
7022 2410 0001 4110 4405
January 30, 2024
Mr. Sergei Chernikov RECEIVED
Division of Water Resources
Water Quality Permitting Section - NPDES FEB 01 2024
1617 Mail Service Center
Raleigh, NC 27699-1617 NCDEQ/DWR/NPDES
Subject: NPDES Permit NC0090239- Modification
Eli Lilly and Company- Concord
1420 Concord Parkway South, Concord, North Carolina 28027
Dear Mr. Chernikov:
Eli Lilly and Company (Lilly) is submitting this NPDES major permit modification to its
existing NPDES Permit NC0090239 to incorporate the groundwater discharge from
dewatering activities. The proposed groundwater discharge to the existing stormwater
management system will be comingled with HVAC condensate and stormwater will continue
to meet the no exposure certification requirements from Lilly's Concord facility located at
1420 Concord Parkway South, Concord, NC, in Cabarrus County. Manufacturing operations
are not expected to begin until the fourth quarter of 2024.
Based on our previous email correspondence, Lilly is providing the following information in
this NPDES Permit Modification Package:
• EPA Form 2C
• Groundwater laboratory results as required by EPA Form 2C
Mailed separately by our procurement department:
• A check in the amount of$340 for Major Permit Modification to an Individual NPDES
permit.

Page 2 of 2
NPDES Permit Application
Thank you in advance for your assistance in processing this permit modification. If you have
any questions regarding the information provided, please contact Jamie Hunter, Eli Lilly and
Company Concord Site HSE Director at 980-356-0790 or by email at [e-mail].
Very truly yours,
Eli Lilly and Company
Rosa Manso
Site Head, Eli Lilly and Company Concord
cc: Jamie Hunter- HSE Director, Eli Lilly- Concord
Erin Wylie - Senior Engineer, Eli Lilly- Concord
Brian Griesemer, PE - HSE Senior Principal Associate, Eli Lilly- Indianapolis

United States Office of Water EPA Form 3510-2C
Environmental Protection Agency Washington,D.C. Revised March 2019
Water Permits Division
.,EPA Application Form 2C
Existing Manufacturing ,
Commercial , Mining , and
Silvicultural Operations
NPDES Permitting Program
Note: Complete this form and Form 1 if your facility is an existing manufacturing, commercial, mining,
or silvicultural facility that currently discharges process wastewater.

Paperwork Reduction Act Notice
The U.S. Environmental Protection Agency estimates the average burden to collect information and
complete Form 2C to be 32.5 hours. This estimate includes time for reviewing instructions, searching
existing data sources, gathering and maintaining the needed data, and completing and reviewing the
collection of information. Send comments about the burden estimate or any other aspect of this
collection of information to the Chief, Information Policy Branch(PM-223), U.S. Environmental
Protection Agency, 1200 Pennsylvania Avenue, NW, Washington, DC 20460, and to the Office of
Information and Regulatory Affairs, Office of Management and Budget, 725 17th Street,NW,
Washington, DC 20503, marked"Attention: Desk Officer for EPA."

FORM 2C—INSTRUCTIONS
General Instructions Definitions
Who Must Complete Form 2C? The legal definitions of all key terms used in these instructions and
Form 2C are in the"Glossary"at the end of the"General
You must complete Form 2C if you answered"Yes"to Item 1.2.2 on Instructions"in Form 1.
Form 1—that is,if you are an existing manufacturing,commercial,
mining,or silvicultural facility that currently discharges process Line-by-Line Instructions
wastewater. Section 1.Outfall Location
Where to File Your Completed Form Item 1.1. Identify each of the facility's outfall structures by number.
For each outfall,specify the latitude and longitude to the nearest
Submit your completed application package(Forms 1 and 2C)to 15 seconds and name of the receiving water.The application form
your National Pollutant Discharge Elimination System(NPDES) provides reporting space for three outfalls. If your facility has more
permitting authority. Consult Exhibit 1-1 of Form 1's"General than this number, attach additional sheets as necessary.The
Instructions"to identify your NPDES permitting authority. location of each outfall(i.e.,where the coordinates are collected)
Public Availability of Submitted Information shall be the point where the discharge is released into a water of
the United States. Latitude and longitude coordinates may be
The U.S.Environmental Protection Agency(EPA)will make obtained in a variety of ways, including use of hand held devices
information from NPDES permit application forms available to the (e.g.,a GPS enabled smartphone),internet mapping tools(e.g.,
public for inspection and copying upon request.You may not claim https://mvnasadata.larc.nasa.gov/latitudelongitude-finder/),
any information on Form 2C(or related attachments)as geographic information systems(e.g.,ArcView),or paper maps
confidential. from trusted sources(e.g., U.S. Geological Survey or USGS).For
You may make a claim of confidentiality for any information that you further guidance,refer to
submit to EPA that goes beyond the information required by Form
http:l/www.eoa.qov/geospatial/latitudelongitude-data-standard.
2C. Note that NPDES authorities will deny claims for treating any Section 2.Line Drawing
effluent data as confidential. If you do not assert a claim of Item 2.1.Attach a line drawing showing water flow through your
confidentiality at the time you submit your information to the facility,from intake to discharge. Indicate the sources of intake
NPDES permitting authority, EPA may make the information water(e.g.,city,well,stream,other);operations contributing
available to the public without further notice to you. EPA will handle wastewater to the effluent including process and production areas,
claims of confidentiality in accordance with the Agency's business sanitary flows,cooling water, and stormwater runoff;and treatment
confidentiality regulations at Part 2 of Title 40 of the Code of units labeled to correspond to the more detailed descriptions under
Federal Regulations(CFR). Section 3.You may group similar operations into a single unit.
Completion of Forms Construct a water balance on the line drawing by showing average
Print or type in the specified areas only. If you do not have enough flows(specify units)between intakes,operations,treatment units,
space on the form to answer a question,you may continue on and outfalls.Show all significant losses of water to products,the
additional sheets, as necessary, using a format consistent with the atmosphere,and discharge.You should use actual measurements
form. wherever available;otherwise use your best estimate. If you cannot
determine a water balance for your activities(such as mining
Provide your EPA Identification Number from the Federal Registry activities),provide a pictorial description of the nature and amount
Service, NPDES permit number,and facility name at the top of of any sources of water and any collection and treatment measures.
each page of Form 2C and any attachments. If you do not know An example of an acceptable line drawing is provided in Exhibit
your EPA Identification Number,contact your NPDES permitting 2C-1 at the end of these instructions.
authority. See Exhibit 1-1 of Form 1's"General Instructions"for
contact information.Additionally,for Tables A through E,provide Section 3.Average Flows and Treatment
the applicable outfall number at the top of each page. Item 3.1.For each outfall identified under Item 1.1,provide the
Do not leave any response areas blank unless the form directs you following information: (1)all processes,operations,or production
to skip them. If the form directs you to respond to an item that does areas that contribute wastewater to the effluent for the outfall,
not apply to your facility or activity,enter"NA"for"not applicable"to including process wastewater, sanitary wastewater,cooling water,
show that you considered the item and determined a response was and stormwater runoff;(2)average flow of wastewater contributed
not necessary for your facility. by each operation in million gallons per day(mgd);(3)a description
of the treatment unit(including size of each treatment unit,flow rate
The NPDES permitting authority will consider your application through each treatment unit,retention time,etc.); (4)the applicable
complete when it and any supplementary material are received and treatment code(s)from Exhibit 2C-2(see end of instructions);and
completed according to the authority's satisfaction.The NPDES (5)the ultimate disposal of any solid or fluid wastes that are not
permitting authority will judge the completeness of any application discharged to the receiving water.You may describe processes,
independently of the status of any other permit application or permit operations,or production areas in general terms(e.g., "dye-making
for the same facility or activity. reactor"or"distillation tower").You may estimate the average flow
of point sources composed of stormwater; however, you must
2C-1

FORM 2C—INSTRUCTIONS CONTINUED
indicate the basis of the rainfall event and the method of estimation. Item 5.3. Indicate if the limitations in the applicable ELGs are
Add additional sheets as necessary. expressed in terms of production or other measure of operation. For
Item 3.2.Answer whether you are applying for an NPDES permit to operational parameter, it is expressed in terms of production (e.g.,
operate a privately owned treatment works. If yes,continue to Item "pounds of biological oxygen demand per cubic foot of logs from
3.3. If no, skip to Section 4. which bark is removed,"or"pounds of total suspended solids per
megawatt hour of electrical energy consumed by smelting
Item 3.3.Attach a list to your application that includes the identity of furnace").An example of an ELG not expressed in terms of a
each user of the treatment works,then answer"Yes"to Item 3.3. measure of operation is one that limits the concentration of
Section 4.Intermittent Flows pollutants. If yes,continue to Item 5.4. If no,skip to Section 6.
Item 4.1.Answer"Yes"or"No"to indicate whether any of the Item 5.4. Indicate the operations,products,or materials produced
discharges you described in Sections 1 and 3 of Form 2C are at the facility for each outfall. For each operation, product,or
intermittent or seasonal,except for stormwater runoff,spillage,or material produced,denote the quantity produced per day using the
leaks.An intermittent discharge is one that is not continuous.A measurement units specified in the applicable ELG.The NPDES
continuous discharge is one that occurs without interruption during permitting authority will use the production information to apply
the operating hours of the facility,except for infrequent shutdowns ELGs to your facility.You may not claim that the production
for maintenance,process changes,or other similar activities.A information you submit is confidential.You do not need to indicate
discharge is seasonal if it occurs only during certain parts of the how you calculated the reported information.The production figures
year. If yes,continue to Item 4.2. If no,skip to Section 5. provided must be based on a reasonable measure of actual daily
Item 4.2.By relevant outfall number, identify each operation that production,not on design capacity or on predictions of future
has intermittent or seasonal discharges. Indicate the average operations.To obtain alternate limits under 40 CFR 122.45(b)(2)(ii),
frequency(days per week and months per year),the long-term you must define your maximum production capability and
demonstrate to the NPDES permitting authority that your actual
average and maximum daily flow rates in mgd,and the duration of production is substantially below maximum production capability
the intermittent or seasonal discharges. Base your answers on and that there is a reasonable potential for an increase above
actual data if available. Otherwise, provide your best estimate. actual production during the duration of the permit.
Report the average of all daily values measured during days when
the discharge occurred for"Long-Term Average,"and report the Section 6.Improvements
highest daily value for"Maximum Daily." Item 6.1.Indicate if you are required by any federal,state,or local
Section 5.Production authority to meet an implementation schedule for constructing,
Item 5.1. Indicate whether any effluent limitation guidelines(ELGs) upgrading,or operating wastewater treatment equipment or
promulgated under Section 304 of the Clean Water Act(CWA) practices or any other environmental programs that could affect the
apply to your facility. If yes,continue to Item 5.2. If no,skip to discharges described in your application.The requirements include,
Section 6.All ELGs promulgated by EPA appear in the Federal but are not limited to, permit conditions,administrative enforcement
Register and are published annually in 40 CFR Subchapter N.An orders,enforcement compliance schedule letters,stipulations,court
orders, and emnt3r loan conditions. If yes,continue to Item 6.2. If
ELG applies if you have any operations contributing process no,skip to
wastewater in any subcategory covered by a Best Practicable Item 6.3.
Control Technology Currently Available(BPT), Best Conventional Item 6.2. Briefly identify and describe each applicable project(e.g.,
Pollutant Control Technology(BCT),or Best Available Technology consent decree,enforcement order,or permit condition). For each
Economically Achievable(BAT)guideline. If you are unsure condition,specify the affected outfall number(s),the source(s)of
whether you are covered by a promulgated ELG,consult your the discharge,the projected final compliance date,and the
NPDES permitting authority(see Exhibit 1-1 of the"General required final compliance date.
Instructions"of Form 1).You must check"Yes"if an applicable ELG Item 6.3.OPTIONAL ITEM. If desired, attach descriptions of any
has been promulgated,even if the ELG is being contested in court. additional water pollution control programs(or other environmental
If you believe that a promulgated ELG has been remanded for projects that could affect your discharges)that are now underway
reconsideration by a court and does not apply to your operations, or planned. Indicate in your attachments whether each program is
you may answer"No"to Item 5.1 and skip to Section 6. actually underway or is planned, and indicate your actual or
Item 5.2.Complete Item 5.2 by indicating the applicable ELG planned schedule for construction.
category, ELG subcategory,and corresponding regulatory citation. Section 7.Effluent and Intake Characteristics
See the example below.
Items 7.1 to 7.17.These items require you to collect and report
5.2 ELG Category ELG Regulatory data for the parameters and pollutants listed in Tables A through E,
W Subcategory Citation located at the end of Form 2C. The instructions for completing the
Pulp,Paper, Secondary Fiber 40 CFR 430, tables are table-specific in addition to the criteria for determining
and Non-Deink Subpart J who should complete them. In general,the following conditions
Paperboard Subcategory
Point Source apply:
Category
2C-2

FORM 2C—INSTRUCTIONS CONTINUED
Table Pollutants/Parameters Who Completes? Item 7.5. Because you indicated in Item 7.4 that the facility's
A Conventional and non- All applicants from all outfalls unless a processes contribute wastewater that falls into one or more of the
conventional pollutants waiver is obtained from the NPDES primary industry categories,check"Testing Required"for all toxic
permitting authority. metals,cyanide,and total phenols in Section 1 of Table B.Answer
B Toxic metals,cyanide,total Applicants in the primary industry y
phenols,and organic toxic categories listed in Exhibit 2C-3 at the "Yes"to Item 7.5 once you have completed this task.
pollutants end of these instructions.
C Certain conventional and - Applicants subject to ELGs that limit Item 7.6.Because you indicated in Item 7.4 that the facility's
non-conventional pollutants pollutants directly or indirectly and processes contribute wastewater that falls into one or more of the
applicants who believe pollutants may primary industry categories, list the primary industry categories
be present in their facility's discharge. applicable to your facility. Next, review Exhibit 2C-3 to determine
D Certain hazardous Applicants who believe pollutants may
substances and asbestos be resent in their facili 's discha e. whether testing is required and for which GC/MS fraction(s):volatile
E 2,3,7,8-tetrachlorodibenzo- Applicants that use or manufacture the compounds,acid compounds,base/neutral compounds, and
p-dioxin(2,3,7,8-TCDD) pollutant pollutant y pesticides.Check the applicable boxes for each GC/MS fraction
be present in the facility's ' '
requiring testing.
Important note: Read the"General Instructions for Reporting,
Sampling,and Analysis"on pages 2C-5 and 2C-6 before Item 7.7.For each of the required GC/MS fractions, check"Testing
completing Section 7 and Tables A through E. Required"for each of the pollutants in the required fraction in
Sections 2 through 5 of Table B.Answer"Yes"to Item 7.7 once you
Item 7.1 and Table A.All applicants must report at least one have completed this task.
analysis for each conventional and non-conventional pollutant listed
in Table A for each outfall(one table per outfall).This includes Item 7.8 and Sections 1 through 5 of Table B. For all other cases
outfalls discharging only noncontact cooling water or stormwater (secondary industries,nonprocess wastewater outfalls,and
runoff. However, at your request,the NPDES permitting authority nonrequired GC/MS fractions)and remaining pollutants,check
may waive the requirement to test for one or more of the listed "Believed Present"or"Believed Absent"in Sections 1 through 5 of
pollutants for specific outfalls, upon a determination that available Table B to indicate whether you have reason to believe that any of
information is adequate to support issuance of your NPDES permit the pollutants listed are discharged from your outfalls.Answer"Yes"
with less stringent reporting requirements.You may also request a to Item 7.8 after you have completed this step.
waiver from your NPDES permitting authority for one or more of the Item 7.9 and Section 1 of Table B.For each pollutant you know or
Table A pollutants for your industry category or subcategory. have reason to believe is present in your discharge from each
Indicate whether you are requesting a waiver in response to Item applicable outfall in concentrations of 10 parts per billion(ppb)or
7.1. If yes,continue to Item 7.2. If no, skip to Item 7.3. greater,you must report quantitative data. For every pollutant
Item 7.2.Specify the outfalls for which you are requesting a waiver. expected to be discharged in concentrations less than 10 ppb,you
Next, indicate on Table A for the applicable outfalls the pollutants must submit quantitative data or briefly describe the reasons the
for which the waiver is being requested.Attach your waiver request pollutant is expected to be discharged. For pollutants in intake
and supporting information to your completed Form 2C. water,see the discussion under"General Instructions for Reporting,
Sampling,and Analysis"below.Answer"Yes"to Item 7.9 once you
Item 7.3.Test your effluent from each outfall for each pollutant have completed Section 1 of Table B.
listed in Table A for which you have not requested a waiver.You
may also conduct optional tests of your intake water for the Table A Item 7.10.This item asks if you qualify as a"small business."If so,
pollutants.See the"General Instructions for Reporting, Sampling, you are exempt from submitting quantitative data for the organic
and Analysis"on pages 2C-5 and 2C-6 for further information. toxic pollutants on Table B(Sections 2 through 5).You still must
indicate,though,whether you believe any of the pollutants listed in
Item 7.4 and Table B.This item asks whether any of the facility's Sections 1 through 5 are present in your discharge per the
processes that contribute wastewater fall into one or more of the Instructions at Item 7.8 above.
primary industry categories listed in Exhibit 2C-3. If you are
applying for a permit for a privately owned treatment works, You can qualify as a small business in two ways:(1) If your facility
determine your testing requirements based on the industrial is a coal mine and if your probable total annual production is less
categories of your contributors.This exercise is simply to determine than 100,000 tons per year,you may submit past production data
your testing requirements only.You are not giving up your right to or estimated future production(such as a schedule of estimated
challenge your inclusion in the category determined for testing(e.g., total production under 30 CFR 795.14(c))instead of conducting
for deciding whether an ELG is applicable)before your permit is analyses for the organic toxic pollutants.(2) If your facility is not a
issued. If yes,continue to Item 7.5. If no,skip to Item 7.8. coal mine and if your gross total annual sales for the most recent
three years average less than$100,000 per year(in second
Complete a separate Table B for each outfall. Section 1 of Table B quarter 1980 dollars),you may submit sales data for those years
lists toxic metals,cyanide, and total phenols. Sections 2 through 5 instead of conducting analyses for the organic toxic pollutants.
of Table B list the pollutants in each of the gas
chromatography/mass spectrometry(GC/MS)fractions. Note that The production or sales data must be for the facility that is the
inclusion of total phenols in Section 1 of Table B does not mean source of the discharge.The data should not be limited to
that EPA is classifying the group as toxic pollutants. production or sales for the process or processes that contribute to
the discharge, unless those are the only processes at your facility.
2C-3

FORM 2C—INSTRUCTIONS CONTINUED
For sales data, in situations involving intra-corporate transfer of Item 7.14 and Table D.For each outfall,indicate if you believe that
goods and services,the transfer price per unit should approximate any pollutant listed in Table D is"Believed Present"or"Believed
market prices for those goods and services as closely as possible. Absent"in your facility's effluent. Check the boxes in the applicable
Sales figures for years after 1980 should be indexed to the second columns on Table D next to each pollutant. For every pollutant
quarter of 1980 by using the gross national product price deflator believed present,you must briefly describe the reasons the
(second quarter of 1980= 100).This index is available online from pollutant is expected to be discharged and report any quantitative
the U.S. Department of Commerce, Bureau of Economic Analysis data you have for that pollutant. Note that you are not required to
at http://bea.gov/national/pdf/SNTables.pdf. perform analytical tests for any of the Table D pollutants at this time.
If you qualify as a small business according to the criteria above, However, if you have prior test results, you must report them.
answer"Yes"to Item 7.10. Check the box at the top of Table B to Item 7.15.Answer"Yes"to this Item when you have completed
show that you are not required to submit quantitative data for the Table D.
organic toxic pollutants(Sections 2 through 5 of Table B),then
skip to Item 7.12. Otherwise,answer"No"and continue to Item Under40 CFR 117.12(a)(2),certain discharges of hazardous substances
7.11. (listed in Exhibit 2C-4 at the end of these instructions)may be exempted from
the requirements of Section 311 of the CWA,which establishes reporting
Item 7.11 and Sections 2 through 5 of Table B.Unless you requirements,civil penalties,and liability for cleanup costs for spills of oil and
qualify as a small business(see Item 7.10),you must provide hazardous substances.A discharge of a particular substance can be exempted
quantitative data for all pollutants for which you marked"Testing if the origin,source,and amount of the discharged substances are identified in
Required"in Sections 2 through 5 of Table B.You must also the NPDES permit application or in the permit,if the permit contains a
requirement for treatment of the discharge,and if the treatment is in place.
provide quantitative data for all pollutants you marked as"Believed
Present"in Sections 2 through 5 of Table B if you discharge those Exemptions are allowed from the requirements of CWA Section 311.
pollutants in concentrations of 10 ppb or greater,except for Applications for exemptions must set forth the following information:
acrolein,acrylonitrile, 2,4-dinitrophenol,and 2-methyl-4,6- 1. The substance and the amount of each substance that may be discharged.
dinitrophenol. If you discharge any of the four latter pollutants in 2. The origin and source of the discharge of the substance.
concentrations of 100 ppb or greater, you must report quantitative 3. The treatment to be provided for the discharge by:
data. If you discharge the pollutants in Sections 2 through 5 of a. An onsite treatment system separate from any treatment system
Table B less than these thresholds(i.e., <100 ppb for acrolein, treating your normal discharge;
acrylonitrile,2,4-dinitrophenol,and 2 methyl 4,6 dinitrophenol and b. A treatment system designed to treat your normal discharge and that is
additionally capable of treating the amount of the substance identified
<10 ppb for all others),you must submit quantitative data or briefly under paragraph 1 above;or
describe the reasons the pollutant is in your discharge, c. Any combination of the above.
For pollutants in intake water,see the discussion under"General See 40 CFR 117.12(a)(2)and(c)or contact your NPDES permitting authority
Instructions for Reporting, Sampling, and Analysis"on pages for further information on exclusions from CWA Section 311.
2C-5 and 2C-6 for further information.
Once you have completed these tasks, answer"Yes"to Item 7.11. Item 7.16. Indicate whether:
Item 7.12 and Table C. For each outfall(including outfalls • Your facility uses or manufactures 2,4,5-trichlorophenoxy
containing only noncontact cooling water or stormwater runoff), acetic acid(2,4,5-T); 2 (2,4,5 trichlorophenoxy)propanoic acid
indicate whether you know or have reason to believe that any of (Silvex,2,4,5-TP);2-(2,4,5-trichlorophenoxy)ethyl 2,2-dichloro-
the pollutants listed on Table C are present in your discharge. If propionate(Erbon);0,0-dimethyl 0-(2,4,5-trichlorophenyl)
so, mark the box in the"Believed Present"column for each phosphorothioate(Ronnel);2,4,5,-trichlorophenol(TCP);or
applicable pollutant. If not, mark the box in the"Believed Absent" hexachlorophene(HCP).
column for each applicable pollutant.Answer"Yes"to Item 7.12 • You know or have reason to believe that 2.3.7,8-
once you have completed the required task for each outfall. tetrachlorodibenzo-p-dioxin(TCDD)is or may be present in an
Item 7.13 and Table C.You are required to report quantitative effluent.
data for any Table C pollutants that are directly limited in an If yes,continue to Item 7.17. If no,skip to Section 8.
applicable ELG or are indirectly limited in an applicable ELG
through an expressed limitation on an indicator(e.g.,use of total Item 7.17 and Table E. If you answered"Yes"to Item 7.16,you
suspended solids(TSS)as an indicator to control the discharge must report qualitative data,generated using a screening procedure
of iron and aluminum). For all other pollutants that you marked as not calibrated with analytical standards,for TCDD.Your screening
"Believed Present,"you must either report quantitative data or analyses must be performed using gas chromatography with an
briefly describe the reasons the pollutant is expected to be electron capture detector.A TCDD standard for quantitation is not
discharged. required. Describe the results of your screening analysis(e.g.,"no
measurable baseline deflection at the retention time of TCDD"or"a
For pollutants in intake water,see the discussion under"General measurable peak within the tolerances of the retention time of
Instructions for Reporting, Sampling, and Analysis"on pages TCDD.")on Table E.The NPDES permitting authority may require
2C-5 and 2C-6 for further information. you to perform a quantitative analysis if you report a positive result.
Answer"Yes"to Item 7.13 when you have fully completed the Answer"Yes"to Item 7.17 when you have completed Table E.
tasks associated with Table C and Items 7.12 and 7.13 above.
2C-4

General Instructions for Reporting,Sampling,and Analysis
Important note: Read these instructions before completing Tables All reporting of values for metals must be in terms of"total
A through E and Section 7 of Form 2C. recoverable metal,"unless:
General Items • An applicable, promulgated ELG specifies the limitation for
Complete the applicable tables for each outfall at your facility. Be the metal in dissolved,valent,or total form;
sure to note the EPA Identification Number, NPDES permit number, • All approved analytical methods for the metal inherently
facility name,and applicable outfall number at the top of each page measure only its dissolved form(e.g., hexavalent chromium);
of the tables and any associated attachments. or
You may report some or all of the required data by attaching • The permitting authority has determined that in establishing
separate sheets of paper instead of completing Tables A through E case-by-case limitations it is necessary to express the
for each of your outfalls so long as the sheets contain all of the limitations of the metal in dissolved,valent,or total form to
required information and are similar in format to Tables A through carry out the provisions of the CWA.
E. For example,you may be able to print a report in a compatible Note that you are not required to complete the"Maximum Monthly
format from the data system used in your GC/MS analysis Discharge"and the"Long-Term Average Daily Discharge"columns
completed under Table B. of Tables A through C;however,these fields should be completed
Table A requires you to report at least one analysis for each if data are available.
pollutant listed.Tables B through D require you to report analytical If you measure only one daily value,complete the"Maximum Daily
data in two ways. For some pollutants,you may be required to Discharge"columns of the tables and enter"1"in the"Number of
check the box in the"Testing Required"column and test and report Analyses"columns.The NPDES permitting authority may require
the levels of the pollutants in your discharge whether or not you additional analyses to further characterize your discharges.
expect them to be present in your discharge. For all other For composite samples,the daily value is the total mass or
pollutants,you must check the box in either the"Believed Present" average concentration found in a composite sample taken over the
or"Believed Absent"columns based on your best estimate and test operating hours of the facility during a 24-hour period. For grab
for those you believe to be present(with some exceptions). Base samples,the daily value is the arithmetic or flow weighted total
your determination that a pollutant is present in or absent from your mass or average concentration found in a series of at least four
discharge on your knowledge of your raw materials,maintenance grab samples taken over the operating hours of the facility during a
chemicals,intermediate and final products and byproducts,and any 24-hour period.
previous analyses known to you of your effluent or similar effluent.
For example,if you manufacture pesticides,you should expect If you measure more than one daily value for a pollutant and those
those pesticides to be present in contaminated stormwater runoff. values are representative of your wastestream,you must report
If you would expect a pollutant to be present solely because of its them.You must describe your method of testing and data analysis.
presence in your intake water,you must mark"Believed Present" When an applicant has two or more outfalls with substantially
but you are not required to analyze for that pollutant. Instead, mark identical effluents,the NPDES permitting authority may allow the
an"X"in the long-term average value of the"Intake"column; applicant to test only one outfall and report those quantitative data
optionally,you may instead provide intake data. as applying to the substantially identical outfall. If the permitting
Reporting of Effluent Data authority grants your request,attach a separate sheet to the
application form identifying the outfall tested and describing why the
Report sampling results for all pollutants in Tables A through C as other outfall(s)are substantially identical.
concentration and total mass,except for flow,temperature,pH, Reporting of Intake Data
color,and fecal coliform organisms. If you are reporting
quantitative data under Table D,report concentration only. You are not required to report data under the"Intake"columns of
Flow,temperature,pH,color,and fecal coliform organisms must be Tables A through C unless you wish to demonstrate your eligibility
reported as mgd,degrees Celsius(°C),standard units,color units, for a"net"effluent limitation for one or more pollutants in Tables A
and most probable number per 100 milliliters(MPN/100 mL), through C(i.e.,an effluent limitation adjusted by subtracting the
respectively. Use the following abbreviations in the columns average level of the pollutant(s)present in your intake water).
requiring"units"in Tables A through D. NPDES regulations allow net limitations only in certain
circumstances.To demonstrate your eligibility,under the"Intake"
Concentration Mass columns report the average of the results of analyses of your intake
ppm=parts per million lbs=pounds water and discuss the requirements for a net limitation with your
mg/L=milligrams per liter ton=tons(English tons) NPDES permitting authority. If your water is treated before use,test
the water after it has been treated.
ppb=parts per billion mg=milligrams
pg/L=micrograms per liter g=grams
MPN=most probable number per kg=kilograms
100 milliliters T=tonnes(metric tons)
2C-5

General Instructions for Reporting,Sampling,and Analysis Continued
Sampling Aliquots may be collected manually or automatically. For"GC/MS
The collection of samples for the reported analyses should be Fraction—Volatile Compounds"in Table B,aliquots must be
supervised by a person experienced in performing sampling of combined in the laboratory immediately before analysis. Four
industrial wastewater.You may contact your NPDES permitting (rather than eight)aliquots or grab samples should be collected for
authority for detailed guidance on sampling techniques and for this fraction.These four samples should be collected during actual
answers to specific questions. See Exhibit 1-1 of Form 1 for hours of discharge over a 24 hour period and need not be flow
contact information.Any specific requirements in the applicable proportioned. Only one analysis is required.
analytical methods—for example, sample containers, sample Use of Historical Data
preservation, holding times,and the collection of duplicate
samples—must be followed. Existing data may be used, if available, in lieu of sampling
conducted solely for the purposes of this application, provided that:
The time when you sample should be representative of your normal all data requirements are met;sampling was performed,collected,
operation,to the extent feasible, with all processes that contribute and analyzed no more than 4.5 years prior to submission;all data
wastewater in normal operation, and with your treatment system are representative of the discharge;and all available representative
operating properly with no system upsets. Collect samples from the data are considered in the values reported.
center of the flow channel,where turbulence is at a maximum,at a
site specified in your present NPDES permit,or at any site Analysis
adequate for the collection of a representative sample. Except as specified below,all required quantitative data shall be
Grab samples must be used for pH,temperature,cyanide,total collected in accordance with sufficiently sensitive analytical
phenols,residual chlorine,oil and grease,fecal coliform(including methods approved under 40 CFR 136 or required under 40 CFR
E. coli),and enterococci(previously known as fecal streptococcus chapter I,subchapter N or 0.A method is"sufficiently sensitive"
at 40 CFR 122.26(d)(2)(iii)(A)(3)),and volatile organic compounds. when:
For all other pollutants, a 24 hour composite sample, using a • The method minimum level(ML)is at or below the level of the
minimum of four grab samples, must be used unless specified applicable water quality criterion for the measured pollutant or
otherwise at 40 CFR 136. However,a minimum of one grab pollutant parameter.
sample may be taken for effluents from holding ponds or other • The method ML is above the water quality criterion, but the
impoundments with a retention period greater than 24 hours. amount of the pollutant or pollutant parameter in the facility's
For stormwater discharges, a minimum of one to four grab discharge is high enough that the method detects and
samples must be taken,depending on the duration of the quantifies the level of the pollutant or pollutant parameter in
discharge. One grab sample must be taken in the first hour(or the discharge.
less)of discharge,with one more grab sample(up to a minimum of • The method has the lowest ML of the analytical methods
four)taken in each succeeding hour of discharge for discharges approved under 40 CFR 136 or required under 40 CFR
lasting four hours or more. chapter I, subchapter N or 0 for the measured pollutant or
pollutant parameter.
Except for stormwater discharges,the NPDES permitting authority
may waive composite sampling requirements for any outfall for Consistent with 40 CFR 136, you may provide matrix-or sample-
which you demonstrate that use of an automatic sampler is specific MLs rather than the published levels. Further,where you
infeasible and that the minimum of four grab samples will be can demonstrate that,despite a good faith effort to use a method
representative of your discharge. Results of analyses of individual that would otherwise meet the definition of"sufficiently sensitive,"
grab samples for any parameter may be averaged to obtain the the analytical results are not consistent with the quality assurance
daily average. Grab samples that are not required to be analyzed (QA)/quality control(QC)specifications for that method,then the
immediately may be composited in the laboratory,if the container, NPDES permitting authority may determine that the method is not
preservation,and holding time requirements are met and if sample performing adequately and the NPDES permitting authority should
integrity is not compromised during compositing.See Table II at 40 select a different method from the remaining EPA-approved
CFR 136.3 for further information. methods that is sufficiently sensitive consistent with 40 CFR
122.21(e)(3)(i). Where no other EPA-approved methods exist,you
A grab sample is an individual sample of at least 100 milliliters must select a method consistent with 40 CFR 122.21(e)(3)(ii).
collected at a randomly chosen time over a period not exceeding
15 minutes. When there is no analytical method that has been approved under
40 CFR 136;required under 40 CFR chapter I,subchapter N or 0,
A composite sample is a combination of at least eight sample and is not otherwise required by the NPDES permitting authority,
aliquots of at least 100 milliliters, collected at periodic intervals you may use any suitable method but shall provide a description of
during the operating hours of a facility over a 24-hour period.The the method. When selecting a suitable method,other factors such
composite must be flow proportional;either the time interval as a method's precision,accuracy,or resolution,may be
between each aliquot or the volume of each aliquot must be considered when assessing the performance of the method.
proportional to either the stream flow at the time of sampling or the
total stream flow since the collection of the previous aliquot.
2C-6

FORM 2C—INSTRUCTIONS CONTINUED
Section 8.Used or Manufactured Toxics Section 12.Checklist and Certification Statement
Item 8.1. Indicate if any pollutant listed in Table B is used or Item 12.1.Review the checklist provided. In Column 1,mark the
manufactured in your facility as an intermediate or final product or sections of Form 2C that you have completed and are submitting
byproduct. If yes,continue to Item 8.2. If no,skip to Section 9. with your application. In Column 2, indicate for each section
Item 8.2.List the applicable toxic pollutants. Note that the NPDES whether you are submitting attachments.
permitting authority may waive or modify the requirement if you Item 12.2.The CWA provides for severe penalties for submitting
demonstrate that it would be unduly burdensome to identify each false information on this application form. Section 309(c)(2)of the
toxic pollutant and the permitting authority has adequate CWA provides that"Any person who knowingly makes any false
information to issue you a permit.You may not claim this statement,representation,or certification in any application, ...shall
information as confidential. Note that you do not need to distinguish upon conviction, be punished by a fine of no more than$10,000 or
between use or production of the pollutants or list amounts. by imprisonment for not more than six months or both."
Section 9.Biological Toxicity Tests FEDERAL REGULATIONS AT 40 CFR 122.22 REQUIRE THIS
Item 9.1. Indicate if you have any knowledge or reason to believe APPLICATION TO BE SIGNED AS FOLLOWS:
that any biological test for acute or chronic toxicity has been made A. For a corporation, by a responsible corporate officer. For the
on any of your discharges or on a receiving water in relation to your purpose of this section,a responsible corporate officer means:
discharge within the last three years. If yes,continue to Item 9.2. If (1)a president,secretary,treasurer,or vice-president of the
no,skip to Section 10. corporation in charge of a principal business function,or any
Item 9.2. Identify the tests known to have been performed and the other person who performs similar policy or decision making
purposes of each. For each test,check"Yes"or"No"to indicate if functions for the corporation,or(2)the manager of one or
you have submitted the test results to the NPDES permitting more manufacturing, production,or operating facilities,
authority and the date the results were submitted.The NPDES provided the manager is authorized to make management
permitting authority may ask you to provide additional details after decisions which govern the operation of the regulated facility
reviewing your application. including having the explicit or implicit duty of making major
capital investment recommendations,and initiating and
Section 10.Contract Analyses directing other comprehensive measures to assure long term
environmental compliance with environmental laws and
Item 10.1.Indicate if any of the analyses reported in Section 7 were
regulations;the manager can ensure that the necessary
performed by a contract laboratory or consulting firm. If yes, systems are established or actions taken to gather complete
continue to Item 10.2. If no,skip to Section 11. and accurate information for permit application requirements;
Item 10.2. Identify each laboratory or firm used in the table and where authority to sign documents has been assigned or
provided. For each,provide the name, address, and phone number delegated to the manager in accordance with corporate
of the laboratory or firm and the pollutants analyzed. procedures.
Section 11.Additional Information B. For a partnership or sole proprietorship, by a general partner
or the proprietor, respectively.
Item 11.1. In addition to the information reported on the application C. For a municipality, state,federal,or other public facility,by
form,the NPDES permitting authority may request additional either a principal executive officer or ranking elected official.
information reasonably required to assess the discharges of the For purposes of this section,a principal executive officer of a
facility and to determine whether to issue an NPDES permit.The federal agency includes: (1)The chief executive officer of the
additional information may include additional quantitative data and agency,or(2)a senior executive officer having responsibility
bioassays to assess the relative toxicity of discharges to aquatic life for the overall operations of a principal geographic unit of the
and requirements to determine the cause of the toxicity. Indicate agency(e.g., Regional Administrators of EPA).
under Item 11.1 whether the NPDES permitting authority has
requested additional information from you. If yes,continue to Item END
11.2. If no,skip to Section 12. Submit your completed Form 1,Form 2C,and
Item 11.2.List the items requested and attach the required all associated attachments
information to the application. (and any other required NPDES application forms)
to your NPDES permitting authority.
2C-7

Exhibit 2C-1.Example Line Drawing
Blue River Municipal
I
190,000 GPD Water Supply Blue River
10,000 GPD
145,000 GPD 45,000 GPD 30,000 GPD Cooling Water
Raw Materials Fiber 15 000 20,000 10,000 5,000 GPD
10,000 GPD
► Preparation GPO ► Dyeing GPD ► Washing GPD ► Drying To Atmosphere►
40,000 GPD 40,000 GPD 40,000 10,000 To Product
GPD GPD 5,000 GPD
Solid Waste Grit Neutralization Loss Waste
4---- P. 0- Treatment 1
4,000 GPD Separator Tank 6,000 GPD
Plant tf2
36,000 GPD 34,000 GPD Outfall 002
• 1 50,000 GPD
Waste
► OutfaII001
Stomnvater Treatment 70,000 GPD+Stormwat'er
Max:20,000 GPD Plant#1
Schematic of Water Flow
Brown Mills,Inc.
City,County, State
2C-8

Exhibit 2C-2.Codes for Treatment Units and Disposal of Wastes Not Discharged
1. PHYSICAL TREATMENT PROCESSES
1—A Ammonia stripping 1—M Grit removal
1—B Dialysis 1—N Microstraining
1—C Diatomaceous earth filtration 1-0 Mixing
1—D Distillation 1—P Moving bed filters
1—E Electrodialysis 1—Q Multimedia filtration
1—F Evaporation 1—R Rapid sand filtration
1—G Flocculation 1—S Reverse osmosis(hyperfiltration)
1—H Flotation 1—T Screening
1—I Foam fractionation 1—U Sedimentation(settling)
1—J Freezing 1—V Slow sand filtration
1—K Gas—phase separation 1—W Solvent extraction
1—L Grinding(comminutors) 1—X Sorption
2. CHEMICAL TREATMENT PROCESSES
2—A Carbon adsorption 2—G Disinfection(ozone)
2—B Chemical oxidation 2—H Disinfection(other)
2—C Chemical precipitation 2—I Electrochemical treatment
2—D Coagulation 2—J Ion exchange
2—E Dechlorination 2—K Neutralization
2—F Disinfection(chlorine) 2—L Reduction
3. BIOLOGICAL TREATMENT PROCESSES
3—A Activated sludge 3—E Pre-aeration
3—B Aerated lagoons 3—F Spray irrigation/land application
3—C Anaerobic treatment 3—G Stabilization ponds
3—D Nitrification—denitrification 3—H Trickling filtration
4. WASTEWATER DISPOSAL PROCESSES
4—A Discharge to surface water 4—C Reuse/recycle of treated effluent
4—B Ocean discharge to outfall 4—D Underground injection
5. SLUDGE TREATMENT AND DISPOSAL PROCESSES
5—A Aerobic digestion 5—M Heat drying
5—B Anaerobic digestion 5—N Heat treatment
5—C Belt filtration 5-0 Incineration
5—D Centrifugation 5—P Land application
5—E Chemical conditioning 5—Q Landfill
5—F Chlorine treatment 5—R Pressure filtration
5—G Composting 5—S Pyrolysis
5—H Drying beds 5—T Sludge lagoons
5—I Elutriation 5—U Vacuum filtration
5—J Flotation thickening 5—V Vibration
5—K Freezing 5—W Wet oxidation
5—L Gravity thickening
2C-9

Exhibit 2C-3.Testing Requirements for Organic Toxic Pollutants Industry Categories*
INDUSTRY CATEGORY GC/MS FRACTION'
Volatile Acid Base/Neutral Pesticide
Adhesives and sealants X X X ❑
Aluminum forming X X X ❑
Auto and other laundries X X X X
Battery manufacturing X ❑ X ❑
Coal mining ❑ ❑ ❑ ❑
Coil coating X X X ❑
Copper forming X X X ❑
Electric and electronic compounds X X X X
Electroplating X X X ❑
Explosives manufacturing ❑ X X LI
Foundries X X X ❑
Gum and wood chemicals(all subparts except D and F) X X ❑ ❑
Gum and wood chemicals, Subpart D(tall oil rosin) X X X ❑
Gum and wood chemicals, Subpart F(rosin-based X X X ❑
derivatives)
Inorganic chemicals manufacturing X X X ❑
Iron and steel manufacturing X X X ❑
Leather tanning and finishing X X X ❑
Mechanical products manufacturing X X X ❑
Nonferrous metals manufacturing X X X X
Ore mining, Subpart B(base and precious metals) ❑ X ❑ ❑
Organic chemicals manufacturing X X X X
Paint and ink formulation X X X ❑
Pesticides X X X X
Petroleum refining X ❑ LI ❑
Pharmaceutical preparations X X X ❑
Photographic equipment and supplies X X X ❑
Plastic and synthetic materials manufacturing X X X X
Plastic processing X I 1 ❑ ❑
Printing and publishing X X X X
Pulp and paperboard mills X X X X
Rubber processing X X X ❑
Soap and detergent manufacturing X X X ❑
Steam electric power plants X X
Textile mills(except Subpart C, Greige Mills) X X X ❑
Timber products processing X X X X
* See note at conclusion of 40 CFR 122,Appendix D(1983)for explanation of effect of suspensions on testing requirements for primary
industry categories.
t The pollutants in each fraction are listed in Table B.
X=Testing is required.
=Testing is not required.
2C-10

I
Exhibit 2C-4.Hazardous Substances
1.Acetaldehyde 73.Captan 144.Ferrous sulfate
2.Acetic acid 74.Carbaryl 145.Formaldehyde
3.Acetic anhydride 75.Carbofuran 146.Formic acid
4.Acetone cyanohydrin 76.Carbon disulfide 147.Fumaric acid
5.Acetyl bromide 77.Carbon tetrachloride 148.Furfural
6.Acetyl chloride 78.Chlordane 149.Guthion
7.Acrolein 79.Chlorine 150.Heptachlor
8.Acrylonitrile 80.Chlorobenzene 151.Hexachlorocyclopentadiene
9.Adipic acid 81.Chloroform 152.Hydrochloric acid
10.Aldrin 82.Chloropyrifos 153.Hydrofluoric acid
11.Allyl alcohol 83.Chlorosulfonic acid 154.Hydrogen cyanide
12.Allyl chloride 84.Chromic acetate 155.Hydrogen sulfide
13.Aluminum sulfate 85.Chromic acid 156.Isoprene
14.Ammonia 86.Chromic sulfate 157.Isopropanolamine dodecylbenzenesulfonate
15.Ammonium acetate 87.Chromous chloride 158.Kelthane
16.Ammonium benzoate 88.Cobaltous bromide 159.Kepone
17.Ammonium bicarbonate 89.Cobaltous formate 160.Lead acetate
18.Ammonium bichromate 90.Cobaltous sulfamate 161.Lead arsenate
19.Ammonium bifluoride 91.Coumaphos 162.Lead chloride
20.Ammonium bisulfite 92.Cresol 163.Lead fluoborate
21.Ammonium carbamate 93.Crotonaldehyde 164.Lead fluorite
22.Ammonium carbonate 94.Cupric acetate 165.Lead iodide
23.Ammonium chloride 95.Cupric acetoarsenite 166.Lead nitrate
24.Ammonium chromate 96.Cupric chloride 167.Lead stearate
25.Ammonium citrate 97.Cupric nitrate 168.Lead sulfate
26.Ammonium fluoroborate 98.Cupric oxalate 169.Lead sulfide
27.Ammonium fluoride 99.Cupric sulfate 170.Lead thiocyanate
28.Ammonium hydroxide 100.Cupric sulfate ammoniated 171.Lindane
29.Ammonium oxalate 101.Cupric tartrate 172.Lithium chromate
30.Ammonium silicofluoride 102.Cyanogen chloride 173.Malathion
31.Ammonium sulfamate 103.Cyclohexane 174.Maleic acid
32.Ammonium sulfide 104.2,4-D acid(2,4-dichlorophenoxyacetic acid) 175.Maleic anhydride
33.Ammonium sulfite 105.2,4-D esters(2,4-dichlorophenoxyacetic acid esters) 176.Mercaptodimethur
34.Ammonium tartrate 106.DDT 177.Mercuric cyanide
35.Ammonium thiocyanate 107.Diazinon 178.Mercuric nitrate
36.Ammonium thiosulfate 108.Dicamba 179.Mercuric sulfate
37.Amyl acetate 109.Dichlobenil 180.Mercuric thiocyanate
38.Aniline 110.Dichlone 181.Mercurous nitrate
39.Antimony pentachloricle 111.Dichlorobenzene 182.Methoxychlor
40.Antimony potassium tartrate 112.Dichloropropane 183.Methyl mercaptan
41.Antimony tribromide 113.Dichloropropene 184.Methyl methacrylate
42.Antimony trichloride 114.Dichloropropene-dichloproropane mix 185.Methyl parathion
43.Antimony trifluoride 115.2,2-dichloropropionic acid 186.Mevinphos
44.Antimony trioxide 116.Dichlorvos 187.Mexacarbate
45.Arsenic disulfide 117.Dieldrin 188.Monoethylamine
46.Arsenic pentoxide 118.Diethylamine 189.Monomethylamine
47.Arsenic trichloride 119.Dimethylamine 190.Naled
48.Arsenic trioxide 120.Dinitrobenzene 191.Naphthalene
49.Arsenic trisulfide 121.Dinitrophenol 192.Naphthenic acid
50.Barium cyanide 122.Dinitrotoluene 193.Nickel ammonium sulfate
51.Benzene 123.Diquat 194.Nickel chloride
52.Benzoic acid 124.Disulfoton 195.Nickel hydroxide
53.Benzonitrile 125.Diuron 196.Nickel nitrate
54.Benzoyl chloride 126.Dodecylbenzesulfonic acid 197.Nickel sulfate
55.Benzyl chloride 127.Endosulfan 198.Nitric acid
56.Beryllium chloride 128.Endrin 199.Nitrobenzene
57.Beryllium fluoride 129.Epichlorohydrin 200.Nitrogen dioxide
58.Beryllium nitrate 130.Ethion 201.Nitrophenol
59.Butylacetate 131.Ethylbenzene 202.Nitrotoluene
60.n-butylphthalate 132.Ethylenediamine 203.Paraformaldehyde
61.Butylamine 133.Ethylene dibromide 204.Parathion
62.Butyric acid 134.Ethylene dichloride 205.Pentachlorophenol
63.Cadmium acetate 135.Ethylene diaminetetracetic acid(EDTA) 206.Phenol
64.Cadmium bromide 136.Ferric ammonium citrate 207.Phosgene
65.Cadmium chloride 137.Ferric ammonium oxalate 208.Phosphoric acid
66.Calcium arsenate 138.Ferric chloride 209.Phosphorus
67.Calcium arsenite 139.Ferric fluoride 210.Phosphorus oxychloride
68.Calcium carbide 140.Fenic nitrate 211.Phosphorus pentasulfide
69.Calcium chromate 141.Ferric sulfate 212.Phosphorus trichloride
70.Calcium cyanide 142.Ferrous ammonium sulfate 213.Polychlorinated biphenyls(PCB)
71.Calcium dodecylbenzenesulfonate 143.Ferrous chloride 214.Potassium arsenate
72.Calcium hypochlorite 215.Potassium arsenite
2C-11

Exhibit 2C-4. Hazardous Substances
216.Potassium bichromate 245.Sodium phosphate(dibasic) 271.Uranyl acetate
217.Potassium chromate 246.Sodium phosphate(tribasic) 272.Uranyl nitrate
218.Potassium cyanide 247.Sodium selenite 273.Vanadium penoxide
219.Potassium hydroxide 248.Strontium chromate 274.Vanadyl sulfate
220.Potassium permanganate 249.Strychnine 275.Vinyl acetate
221.Propargite 250.Styrene 276.Vinylidene chloride
222.Propionic acid 251.Sulfuric acid 277.Xylene
223.Propionic anhydride 252.Sulfur monochloride 278.Xylenol
224.Propylene oxide 253.2,4,5-T acid(2,4,5-trichlorophenoxyacetic acid) 279.Zinc acetate
225.Pyrethrins 254.2,4,5-T amines(2,4,5-trichlorophenoxy acetic acid 280.Zinc ammonium chloride
226.Quinoline amines) 281.Zinc borate
227.Resorcinol 255.2,4,5-T esters(2,4,5-trichlorophenoxy acetic acid 282.Zinc bromide
228.Selenium oxide esters) 283.Zinc carbonate
229.Silver nitrate 256.2,4,5-T salts(2,4,5-trichlorophenoxy acetic acid salts) 284.Zinc chloride
230.Sodium 257.2,4,5-TP acid(2,4,5-trichlorophenoxy propanoic acid) 285.Zinc cyanide
231.Sodium arsenate 258.2,4,5-TP acid esters(2,4,5-trichlorophenoxy propanoic 286.Zinc fluoride
232.Sodium arsenite acid esters) 287.Zinc formate
233.Sodium bichromate 259.TDE(tetrachlorodiphenyl ethane) 288.Zinc hydrosulfite
234.Sodium bifluoride 260.Tetraethyl lead 289.Zinc nitrate
235.Sodium bisulfite 261.Tetraethyl pyrophosphate 290.Zinc phenolsulfonate
236.Sodium chromate 262.Thallium sulfate 291.Zinc phosphide
237.Sodium cyanide 263.Toluene 292.Zinc silicofluoride
238.Sodium dodecylbenzenesulfonate 264.Toxaphene 293.Zinc sulfate
239.Sodium fluoride 265.Trichlorofon 294.Zirconium nitrate
240.Sodium hydrosulfide 266.Trichloroethylene 295.Zirconium potassium fluoride
241.Sodium hydroxide 267.Trichlorophenol 296.Zirconium sulfate
242.Sodium hypochlorite 268.Triethanolamine dodecylbenzenesulfonate 297.Zirconium tetrachloride
243.Sodium methylate 269.Triethylamine
244.Sodium nitrite 270.Trimethylamine
2C-12

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
OMB No.2040-0004
Form U.S.Environmental Protection Agency
2C VY/EPA Application for NPDES Permit to Discharge Wastewater
NPDES EXISTING MANUFACTURING, COMMERCIAL, MINING,AND SILVICULTURE OPERATIONS
SECTION 1.OUTFALL LOCATION(40 CFR 122.21(g)(1))
1.1 Provide information on each of the facility's outfalls in the table below.
o Numbelr Receiving Water Name Latitude Longitude
0 2 Wetlands to Coddle Creek 35° 23' 29.1" N -80° 37' 40.7" W
J
m
0
SECTION 2. LINE DRAWING(40 CFR 122.21(g)(2))
co 2.1 Have you attached a line drawing to this application that shows the water flow through your facility with a water
c . balance?(See instructions for drawing requirements.See Exhibit 2C-1 at end of instructions for example.)
J al
o ❑✓ Yes ❑ No
SECTION 3.AVERAGE FLOWS AND TREATMENT(40 CFR 122.21(g)(3))
3.1 For each outfall identified under Item 1.1, provide average flow and treatment information.Add additional sheets if
necessary.
*'`Outfall Number** 2
Operations Contributing to Flow
Operation Average Flow
Dewatering 0.56 mgd
mgd
mgd
-a
mgd
LL Treatment Units
cuDescription Code from Final Disposal of Solid or
(include size,flow rate through each treatment unit. Table 2C-1 Liquid Wastes Other Than
retention time,etc.) by Discharge
Stormwater Retention Basin 1-U NA
EPA Form 3510-2C(Revised 3-19) Page 1

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
OMB No.2040-0004
3.1 **Outfall Number**
cont. Operations Contributing to Flow
Operation Average Flow
mgd
mgd
mgd
mgd
Treatment Units
Description Code from Final Disposal of Solid or
(include size,flow rate through each treatment unit, Table 2C 1 Liquid Wastes Other Than
retention time,etc.) by Discharge
-0
d
c
c
0
U
c
a>
E:
m
I-
**Outfall Number**
Operations Contributing to Flow
Operation Average Flow
LL
mgd
d
a mgd
mgd
mgd
Description Code from Final Disposal of Solid or
(include size,flow rate through each treatment unit, Table 2C 1 Liquid Wastes Other Than
retention time,etc.) by Discharge
3.2 Are you applying for an NPDES permit to operate a privately owned treatment works?
❑ Yes ❑✓ No .4 SKIP to Section 4.
y3.3 Have you attached a list that identifies each user of the treatment works?
❑ Yes ❑ No
EPA Form 3510-2C(Revised 3-19) Page 2

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
OMB No.2040-0004
SECTION 4. INTERMITTENT FLOWS(40 CFR 122.21(g)(4))
4.1 Except for storm runoff. leaks. or spills. are any discharges described in Sections 1 and 3 intermittent or seasonal?
❑ Yes ❑✓ No 4 SKIP to Section 5.
4.2 Provide information on intermittent or seasonal flows for each applicable outfall.Attach additional pages, if necessary.
Outfall Operation Free uency Flow Rate
Number (list) Average Average Long-Term Maximum Duration
Days/Week Months/Year Average Daily
days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
days/week months/year mgd mgd days
SECTION 5. PRODUCTION(40 CFR 122.21(g)(5))
5.1 Do any effluent limitation guidelines(ELGs)promulgated by EPA under Section 304 of the CWA apply to your facility?
❑ Yes ❑✓ No 4 SKIP to Section 6.
5.2 Provide the following information on applicable ELGs.
w ELG Category ELG Subcategory Regulatory Citation
6,3
a
a
5.3 Are any of the applicable ELGs expressed in terms of production(or other measure of operation)?
❑ Yes ❑ No 4 SKIP to Section 6.
0
Y 5.4 Provide an actual measure of daily production expressed in terms and units of applicable ELGs.
Outfall Operation,Product,or Material Quantity per Day Unit of
Number Measure
co
0
O
d
EPA Form 3510-2C(Revised 3-19) Page 3

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
OMB No.2040-0004
SECTION 6.IMPROVEMENTS(40 CFR 122.21(g)(6))
6.1 Are you presently required by any federal, state,or local authority to meet an implementation schedule for constructing,
upgrading,or operating wastewater treatment equipment or practices or any other environmental programs that could
affect the discharges described in this application?
❑ Yes ❑✓ No 4 SKIP to Item 6.3.
6.2 Briefly identify each applicable project in the table below.
en
Affected Final Compliance Dates
Brief Identification and Description of Outfalls Source(s)of
Project (list outfall Discharge Required Projected
n number)
E
v
c
N
0_
C. _
6.3 Have you attached sheets describing any additional water pollution control programs(or other environmental projects
that may affect your discharges)that you now have underway or planned?(optional item)
❑ Yes ❑ No ✓❑ Not applicable
SECTION 7.EFFLUENT AND INTAKE CHARACTERISTICS(40 CFR 122.21(g)(7))
See the instructions to determine the pollutants and parameters you are required to monitor and, in turn,the tables you must
complete. Not all applicants need to complete each table.
Table A.Conventional and Non-Conventional Pollutants
7.1 Are you requesting a waiver from your NPDES permitting authority for one or more of the Table A pollutants for any of
your outfalls?
❑✓ Yes ❑ No 4 SKIP to Item 7.3.
7.2 If yes, indicate the applicable outfalls below.Attach waiver request and other required information to the application.
Outfall Number 2 Outfall Number Outfall Number
ce
7.3 Have you completed monitoring for all Table A pollutants at each of your outfalls for which a waiver has not been
co requested and attached the results to this application package?
✓❑ Yes ❑ No;a waiver has been requested from my NPDES
permitting authority for all pollutants at all outfalls.
5 Table B.Toxic Metals,Cyanide,Total Phenols,and Organic Toxic Pollutants
R 7.4 Do any of the facility's processes that contribute wastewater fall into one or more of the primary industry categories
listed in Exhibit 2C-3?(See end of instructions for exhibit.)
❑ Yes ✓❑ No 4 SKIP to Item 7.8.
co
7.5 Have you checked"Testing Required"for all toxic metals,cyanide,and total phenols in Section 1 of Table B?
❑ Yes ❑ No
7.6 List the applicable primary industry categories and check the boxes indicating the required GC/MS fraction(s)identified
in Exhibit 2C-3.
Primary Industry Category Required GCIMS Fraction(s)
(Check applicable boxes.)
❑ Volatile ❑Acid ❑ Base/Neutral 0 Pesticide
❑ Volatile 0 Acid 0 Base/Neutral 0 Pesticide
❑Volatile ❑Acid 0 Base/Neutral 0 Pesticide
EPA Form 3510-2C(Revised 3-19) Page 4

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
OMB No.2040-0004
7.7 Have you checked"Testing Required"for all required pollutants in Sections 2 through 5 of Table B for each of the
GC/MS fractions checked in Item 7.6?
❑ Yes ❑ No
7.8 Have you checked"Believed Present"or"Believed Absent"for all pollutants listed in Sections 1 through 5 of Table B
where testing is not required?
❑✓ Yes ❑ No
7.9 Have you provided(1)quantitative data for those Section 1,Table B,pollutants for which you have indicated testing is
required or(2)quantitative data or other required information for those Section 1,Table B,pollutants that you have
indicated are"Believed Present"in your discharge?
p Yes ❑ No
7.10 Does the applicant qualify for a small business exemption under the criteria specified in the instructions?
❑ Yes 4 Note that you qualify at the top of Table B, ❑✓ No
d then SKIP to Item 7.12.
7.11 Have you provided(1)quantitative data for those Sections 2 through 5,Table B,pollutants for which you have
o determined testing is required or(2)quantitative data or an explanation for those Sections 2 through 5,Table B,
N pollutants you have indicated are"Believed Present"in your discharge?
`—' ✓❑ Yes ❑ No
;, Table C.Certain Conventional and Non-Conventional Pollutants
Es 7.12 Have you indicated whether pollutants are"Believed Present"or"Believed Absent"for all pollutants listed on Table C
co
for all outfalls?
a) ❑
a) yes ❑✓ No
• 7.13 Have you completed Table C by providing(1)quantitative data for those pollutants that are limited either directly or
indirectly in an ELG and/or(2)quantitative data or an explanation for those pollutants for which you have indicated
"Believed Present"?
❑ Yes ❑✓ No
E Table D.Certain Hazardous Substances and Asbestos
7.14 Have you indicated whether pollutants are"Believed Present"or"Believed Absent"for all pollutants listed in Table D for
all outfalls?
❑ Yes ❑✓ No
7.15 Have you completed Table D by(1)describing the reasons the applicable pollutants are expected to be discharged
and(2)by providing quantitative data, if available?
❑ Yes ElNo
Table E.2,3,7,8-Tetrachlorodibenzo-p-Dioxin(2,3,7,8-TCDD)
7.16 Does the facility use or manufacture one or more of the 2,3,7,8-TCDD congeners listed in the instructions,or do you
know or have reason to believe that TCDD is or may be present in the effluent?
❑ Yes 4 Complete Table E. ❑✓ No 4 SKIP to Section 8.
7.17 Have you completed Table E by reporting qualitative data for TCDD?
❑ Yes ❑ No
SECTION 8. USED OR MANUFACTURED TOXICS(40 CFR 122.21(g)(9))
8.1 Is any pollutant listed in Table B a substance or a component of a substance used or manufactured at your facility as
an intermediate or final product or byproduct?
CD
❑ Yes ElNo 4 SKIP to Section 9.
8.2 List the pollutants below.
1. 4. 7.
- 2. 5. 8.
tll
3. 6. 9.
EPA Form 3510-2C(Revised 3-19) Page 5

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
OMB No.2040-0004
• CTION 9.BIOLOGICAL TOXICITY TESTS(40 CFR 122.21(g)(11))
9.1 Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made
within the last three years on (1)any of your discharges or(2)on a receiving water in relation to your discharge?
❑ Yes ❑✓ No -* SKIP to Section 10.
9.2 Identify the tests and their ourposes below.
Test(s) Purpose of Test(s) Submitted to NPDES Date Submitted
o Permitting Authority?
❑ Yes ❑ No
0
0
'm ❑ Yes ❑ No
❑ Yes ❑ No
•ECTION 10.CONTRACT ANALYSES(40 CFR 122.21(g)(12))
10.1 Were any of the analyses reported in Section 7 performed by a contract laboratory or consulting firm?
❑✓ Yes ❑ No 4 SKIP to Section 11.
10.2 Provide information for each contract laboratory or consulting firm below.
Laboratory Number 1 Laboratory Number 2 Laboratory Number 3
Name of laboratory/firm PACE Analytical Services
Laboratory address 7726 Moller Road
Tcs
Indianapolis,IN 46268
U
fC
0 Phone number
[phone]
Pollutant(s)analyzed Table land Table 2
pollutants
SECTION 11.ADDITIONAL INFORMATION(40 CFR 122.21(g)(13))
11.1 Has the NPDES permitting authority requested additional information?
o ❑ Yes 12No 4 SKIP to Section 12.
E 11.2 List the information requested and attach it to this application.
1. 4.
o
2. 5.
3. 6.
EPA Form 3510-20(Revised 3-19) Page 6

EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19
OMB No.2040-0004
SECTION 12.CHECKLIST AND CERTIFICATION STATEMENT(40 CFR 122.22(a)and(d))
12.1 In Column 1 below, mark the sections of Form 2C that you have completed and are submitting with your application.
For each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority. Note
that not all applicants are required to complete all sections or provide attachments.
Column 1 Column 2
✓❑ Section 1: Outfall Location ❑ w/attachments
❑✓ Section 2: Line Drawing ❑ w/line drawing ❑ w/additional attachments
171 Section 3:Average Flows and w/list of each user of
Treatment ❑ w/attachments ❑ privately owned treatment
works
❑✓ Section 4: Intermittent Flows ❑ w/attachments
❑✓ Section 5: Production ❑ w/attachments
w/optional additional
❑✓ Section 6: Improvements ❑ w/attachments ❑ sheets describing any
additional pollution control
plans
❑ w/request for a waiver and ❑ w/explanation for identical
supporting information outfalls
d w/small business exemption w/other attachments
d ❑ request ❑
❑ Section 7: Effluent and Intake ❑✓ w/Table A Q w/Table B
Characteristics
0
❑ w/Table C ❑ w/Table D
❑ w/Table E ❑ w/analytical results as an
attachment
❑✓ Section 8: Used or Manufactured ❑ wl attachments
Toxics
❑ Section 9: Biological Toxicity ❑ w/attachments
Tests
U
✓❑ Section 10:Contract Analyses ❑ w/attachments
❑✓ Section 11:Additional Information ❑ w/attachments
❑ Section 12: Checklist and ❑ w/attachments
Certification Statement
12.2 Certification Statement
I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly
responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true,
accurate,and complete. I am aware that there are significant penalties for submitting false information, including the
possibility of fine and imprisonment for knowing violations.
Name(print or type first and last name) Official title
Rosa Manso Site Head-Eli Lilly-Concord
Signature Date signed
�.41-
�--� _ o—k) - 2-0 2-
EPA Form 3510-2C(Revised 3-19) Page 7

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE A.CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(iii))1
Effluent Intake
Waiver (Optional)
Pollutant Requested Units Maximum Maximum Long-Term
(if applicable) (specify) Daily Monthly Average Daily Number of Long-Term Number of
Discharge Discharge Discharge Analyses Average Value Analyses
(required) (if available) (if available)
0 Check here if you have applied to your NPDES permitting authority for a waiver for all of the pollutants listed on this table for the noted outfall.
Biochemical oxygen demand Concentration mg/L 2 1
1. El(BOD5)
Mass
Chemical oxygen demand Concentration mg/L 25 1
2. El(COD) Mass
Concentration mg/L 5
3. Total organic carbon(TOC) ❑
Mass i
Concentration mg/L 3.2
4. Total suspended solids(TSS) ❑
Mass i
Concentration mg/L 0.1
5. Ammonia(as N) ❑
Mass i
6. Flow 0 Rate
Temperature(winter) ❑✓ °C °C
1 7
Temperature(summer) ❑✓ °C °C
pH(minimum) ❑ Standard units s.u. 8.6 1
8.
pH(maximum) ❑ Standard units s.u. 8.6 1
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C(Revised 3-19) Page 9

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))l
Presence or Absence
(check one) Effluent Intake
(optional)
PollutantlParameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
Discharge Discharge Average
(required) (if available) Discharge Analyses Value Analyses
(if available)
❑ Check here if you qualify as a small business per the instructions to Form 2C and, therefore,do not need to submit quantitative data for any of the organic toxic pollutants in Sections
2 through 5 of this table. Note. however, that you must still indicate in the appropriate column of this table if you believe any of the pollutants listed are present in your discharge.
Section 1.Toxic Metals,Cyanide,and Total Phenols
Antimony, total Concentration ug/L 50 1
1.1 (7440-36-0) Mass
Arsenic,, total ❑ ❑ ❑ Concentration ug/L 30 1
1.2 (7440-38-2) Mass
Beryllium, total Concentration ug/L 10 1
1.3 (7440 41 7) Mass
Cadmium, total Concentration ug/L 10 1
1.4 (7440-43-9) ❑ 0 El Mass
Chromium,total Concentration ug/L 84.7 1
1.5 .
(7440-47-3) Mass
Copper,total Concentration ug/L 20 1
1.6 (7440-50-8) Mass
Lead, total ID ❑ ❑ Concentration ug/L 25 1
1.7 (7439-92-1) Mass
Mercury, total Concentration ug/L 0.2 1
1.8 El CI El
(7439-97-6) Mass
Nickel, total Concentration ug/L 20 1
1.9 (7440-02-0) Mass
1.10 Selenium,total Concentration ug/L 40 1
(7782-49-2) Mass
Silver,total Concentration ug/L 10 1
1.11 (7440-22-4) ❑ ❑ ❑ Mass
EPA Form 3510-2C(Revised 3-19) Page 11

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
Discharge
(required)Ch ge Discharge)f available) Discharge Analyses AverageValue Analyses
( (if available)
Thallium,total Concentration ug/L 200 1
1.12 (7440 28 0) ❑ ❑ ❑
Mass
Zinc,total Concentration ug/L 136 1
1.13 (7440-66-6) El El ElMass
•
1.14 Cyanide,total ❑ ❑ a Concentration mg/L 0.008 1
(57-12-5) Mass
Concentration mg/L 0.02 1
1.15 Phenols,total ❑ ❑ ❑✓
Mass
Section 2.Organic Toxic Pollutants(GC/MS Fraction—Volatile Compounds)
21 Acrolein ❑ ❑ ❑ Concentration ug/L 5 1
(107-02-8) Mass
2.2 Acrylonitrile ❑ ❑ ❑ Concentration ug/L 5 1
(107-13-1) Mass
2.3 Benzene ❑ ❑ ❑ Concentration ug/L 1 1
(71-43-2) Mass
2.4 Bromoform ❑ ❑ ❑ Concentration ug/L 2 1
(75-25-2) Mass
2.5 Carbon tetrachloride ❑ ❑ ❑✓ Concentration ug/L 2 1
(56-23-5) Mass
2.6 Chlorobenzene 1:: 0
❑ Concentration ug/L 2 1
108-90-7
( ) Mass
Chlorodibromomethane 0 0 ❑ Concentration ug/L 2 1
2.7 (124-48-1) Mass
2.8 Chloroethane Concentration i ug/L 2 1
El ❑ ❑
(75-00-3) Mass
EPA Form 3510-2C(Revised 3-19) Page 12

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Dail of Term of
D requi edge Discharge(if available) Discharge Analyses AValuee Analyses
( )
2-chloroethylvinyl ether ❑ ❑ ❑ Concentration ug/L 5
2.9 (110-75-8) Mass
2.10 Chloroform(67-66-3) CI CI
❑✓ Concentration ug/L 2
Mass
Dichlorobromomethane ❑ Concentration ug/L 2
2.11 (75-27-4) Mass
1,1-dichloroethane Concentration ug/L 2
2.12 CI CI
(75-34-3) Mass
1,2-dichloroethane ❑ Concentration ug/L 2
2.13 CI CI
(107-06-2) Mass
1.1-dichloroethylene CICI ❑ Concentration ug/L 2
2.14 (75-35-4) Mass
1,2-dichloropropane CI , CI ❑ Concentration ug/L 2
2.15 (78 87 5) Mass
2.16 1,3-dichloropropylene Concentration ug/L 2 cis and trans isomers analyzed analyzed
El El CI
(542-75-6) Mass CAS# 10061-01-5 10061-02-6
Ethylbenzene CI ❑ Concentration ug/L 1
2.17 (100-41-4) Mass
Methyl bromide CI CIConcentration ug/L 2
2.18 (74-83-9) Mass
Methyl chloride Concentration ug/L 2
1 2.19 CI CI 0
(74-87-3) Mass
2 20 Methylene chloride Concentration ug/L 2
CI CI CI
(75-09-2) Mass
221 1,1,2,2-tetrachloroethane CI CI Concentration ug/L 2
CI
(79-34-5) Mass
EPA Form 3510-2C(Revised 3-19) Page 13

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))l
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
Discharge Discharge Average
(required) (if available) Dischar(ifavailable)ge Analyses Value Analyses
2.22 Tetrachloroethylene ❑✓ Concentration ug/L 2
El LI
(127-18-4) Mass
Toluene Concentration ug/L 1
2.23 (108-88-3) 0 El _
2.24 1,2-trans-dichloroethylene 12
Concentration ug/L 2
(156-60-5) Mass
2.25 1,1,1-trichloroethane 12
Concentration ug/L 2
(71-55-6) Mass
2.26 1,1,2-trichloroethane 0Concentration ug/L 2
(79-00-5) Mass
2.27 Trichloroethylene ❑✓ Concentration ug/L 2
El El
(79-01-6) Mass
2 28 Vinyl chloride Concentration ug/L 2
II I=1 El
(75-01-4) Mass
Section 3.Organic Toxic Pollutants(GC/MS Fraction—Acid Compounds)
3.1 2-chlorophenol ✓❑ Concentration ug/L 4.2
ID 0(95-57-8) Mass
2 4-dichlorophenol ci Concentration ug/L 4.2
3.2 El
(120-83-2) El Mass - —
2,4-dimethylphenol El Concentration ug/L 8.3
3.3 (105-67-9) Mass
3.4 4,6-dinitro-o-cresol ✓❑ Concentration ug/L 8.3
(534-52-1) Mass
3.5 2,4-dinitrophenol El Concentration ug/L 41.7
0 0(51-28-5) Mass
EPA Form 3510-2C(Revised 3-19) Page 14

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE B.TOXIC METALS, CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))l
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long Number
Present Absent Daily Monthly Daily of Term of
Discharge Discharge Discharge Analyses Average Analyses
(required) (if available) Value
(if available)
2-nitrophenol 0 Concentration ug/L 4.2
3.6 CI CI
(88-75-5) Mass
4-nitrophenol 0 Concentration ug/L 8.3
3.7 CI CI
(100-02-7) Mass
p-chloro-m-cresol ❑ Concentration ug/L 4.2
3.8 1:1 El(59-50-7) Mass
Pentachlorophenol Concentration ug/L 8.3
3.9 El El El
(87-86-5) Mass
Phenol Concentration ug/L 4.2
3.10 (108-95-2) Mass
3.11 2,4,6-trichlorophenol Concentration ug/L 8.3
(88-05-2) Mass
Section 4.Organic Toxic Pollutants(GCIMS Fraction—Base/Neutral Compounds) _
Acenaphthene ❑ Concentration ug/L 4.2
4.1 CI CI(83-32-9) Mass
4.2 Acenaphthylene Concentration ug/L 4.2
(208-96-8) Mass
4.3 Anthracene Concentration ug/L 4.2
CI CI 0
(120-12-7) Mass
4.4 Benzidine Concentration ug/L 41.7
(92-87-5) Mass
4.5 Benzo(a)anthracene ❑✓ Concentration ug/L 4.2
CI CI(56-55-3) Mass
4.6 Benzo(a)pyrene 0Concentration ug/L 4.2
CI CI
(50-32-8) Mass
EPA Form 3510-2C(Revised 3-19) Page 15

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number.if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Term
Discharge Discharge Daily of Average of
(required) (if available) Dischar(ifavailable)ge Analyses Value Analyses
3,4-benzofluoranthene 0 Concentration ug/L 4.2
4.7 0 El
(205-99-2) Mass
Benzo(ghi)perylene Concentration ug/L 4.2
4.8 (191-24-2) 0 El Mass
Benzo(k)fluoranthene ci Concentration ug/L 4.2
4.9 (207-08-9) Mass
4.10 Bis(2-chloroethoxy)methane 0 0 0 Concentration ug/L 8.3
(111-91-1) Mass
4.11 Bis(2-chloroethyl)ether ❑ 0 Concentration ug/L 4.2
(111-44-4) Mass
4.12 Bis(2-chloroisopropyl)ether 0 0 Concentration ug/L 4.2
(102-80-1) Mass
4.13 Bis(2-ethylhexyl)phthalate 0 0 12 Concentration ug/L 4.2
(117-81-7) Mass
4.14 4-bromophenyl phenyl ether Li Concentration ug/L 4.2
(101-55-3) Mass
4.15 Butyl benzyl phthalate Concentration ug/L 4.2
0 0
(85-68-7) Mass
2-chloronaphthalene Concentration ug/L 4.2
4.16 (91-58-7) Mass
4.17 4-chlorophenyl phenyl ether 0 0 0 Concentration ug/L 4.2
(7005-72-3) Mass
Chrysene Concentration ug/L 4.2
4.18 (218019) ❑ �
Mass
Dibenzo(a,h)anthracene 0 ElConcentration ug/L 4.2
4.1E (53-70-3) Mass
EPA Form 3510-2C(Revised 3-19) Page 16

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent (optional)
PollutantlParameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Dailyof Term of
Discharge Discharge Dischar a Analyses Average Analyses
(required) (if available) g Value
(if available)
1,2-dichlorobenzene ❑ Concentration ug/L 2
4.20 (95-50-1) Mass
1,3-dichlorobenzene 0 Concentration ug/L 2
4.21 (541-73-1) Mass
1,4-dichlorobenzene Li Concentration ug/L 2
4.22 (106-46-7) Mass
3,3-dichlorobenzidine 0 Concentration ug/L 8.3
4.23 (91-94-1) Mass _
Diethyl phthalate Concentration ug/L 4.2
4.24 (84-66-2) Mass
4.25 Dimethyl phthalate Concentration ug/L 4.2
(131-11-3) Mass
4.26 Di-n-butyl phthalate Concentration ug/L 4.2
(84-74-2) Mass
2,4-dinitrotoluene Concentration ug/L 4.2
4.27 (121-14-2) Mass
4.28 2,6 dinitrotoluene ❑ ❑ ❑✓ Concentration ug/L 4.2
(606-20-2) Mass
4.29 Di-n-octyl phthalate ❑ ❑ D✓ Concentration ug/L 4.2
(117-84-0) Mass
1,2-Diphenylhydrazine ✓ Concentration ug/L 4.2
4.30 (as azobenzene)(122-66-7) Mass
4.31 Fluoranthene ❑✓ Concentration ug/L 4.2
(206-44-0) Mass
4.32 Fluorene Concentration ug/L 4.2
(86-73-7) Mass
EPA Form 3510-2C(Revised 3-19) Page 17

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Term
of
Discharge Discharge DisDchar a aily Analyses Average Analyses
(required) (if available) g Value
(if available)
4.33 Hexachlorobenzene Concentration ug/L 4.2
(118-74-1) Mass
4.34 Hexachlorobutadiene Concentration ug/L 4.2
(87-68-3) Mass
4.35 Hexachlorocyclopentadiene 0 0 0Concentration ug/L 8.3
(77-47-4) Mass
4.36 Hexachloroethane Concentration ug/L 4.2
(67-72-1) Mass
4.37 Indeno(1,2,3-cd)pyrene 0 Concentration ug/L 4.2
(193-39-5) Mass
4.38 Isophorone Concentration ug/L 8.3
(78-59-1) Mass
4.39 Naphthalene Concentration ug/L 4.2
(91-20-3) Mass
4.40 Nitrobenzene 0Concentration ug/L 4.2
0 0(98-95-3) Mass
4.41 N-nitrosodimethylamine ❑ ElConcentration ug/L 4.2
(62-75-9) Mass
4.42 N-nitrosodi-n-propylamine ❑ ElConcentration ug/L 4.2
El
(621-64-7) Mass
4.43 N-nitrosodiphenylamine ❑ 0 Concentration ug/L 8.3
(86-30-6) Mass
4.44 Phenanthrene Concentration ug/L 4.2
(85-01-8) Mass
-
Pyrene Concentration ug/L 4.2
4.45 0 El El
(129-00-0) Mass
EPA Form 3510-2C(Revised 3-19) Page 18

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Dail of Term of
D`eqh edui ) Discharge
(if available) Discharge Analyses AValuee Analyses
(if available)
1,2,4-trichlorobenzene 0El I=1 Concentration ug/L 4.2
4.46 (120-82-1) Mass
Section 5.Organic Toxic Pollutants(GC/MS Fraction—Pesticides)
Aldrin 0 Concentration ug/L 0.042
5.1 (309-00-2) Mass
a-BHC 0 Concentration ug/L 0.042
5.2 (319-84-6) Mass
5.3 R-BHC 0Concentration ug/L 0.042
(319-85-7) Mass
y-BHC Concentration ug/L 0.042
5.4 (58 89 9) Mass
b-BHC 0 Concentration ug/L 0.042
5.5 El El
(319-86-8) Mass
Chlordane Concentration ug/L 0.42
5.6 (57-74-9) Mass
4,4'-DDT Concentration ug/L 0.042
5.7 El I=1 El
(50-29-3) Mass
4,4'-DDE Concentration ug/L 0.042
5.8 (72-55-9) Mass
5.9 4,4'-DDD Concentration ug/L 0.042
El El El
(72-54-8) Mass
Dieldrin Concentration ug/L 0.042
5.10 (60-57-1) El ❑ Li Mass
a endosulfan 0 ❑ 0 Concentration ug/L 0.042 See Endosulfan 1&2
5.11 (115-29-7) Mass
EPA Form 3510-2C(Revised 3-19) Page 19

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence
(check one) Effluent Intake
(optional)
Pollutant'Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Term
Discharge Discharge Di Daily harge Analyses Average Analyses
(required) (if available) Value
(if available)
5.12 R-endosulfan Concentration ug/L 0.042 See Endosulfan 1&2
(115-29-7) Mass
Endosulfan sulfate Concentration ug/L 0.042
5.13 El 0(1031 07 8) � _
Mass
Endrin Concentration ug/L 0.042
5.14 (72 20 8)
Mass
Endrin aldehyde Concentration ug/L 0.042
5.15 0 0(7421 93 4) 0
Mass
5.16 Heptachlor Concentration ug/L 0.042
El 0 CI
(76-44-8) Mass
Heptachlor epoxide Concentration ug/L 0.042
5.17 (1024-57-3) 0 0 0 Mass
PCB-1242 Concentration ug/L 0.42
5.18 (53469-21-9) 0 El 0 Mass
PCB-1254 Concentration ug/L 0.42
5.19 (11097-69-1) 0 0 C Mass
PCB-1221 Concentration ug/L 0.42
5.20 (11104-28-2) 0 0 0 Mass
PCB-1232 Concentration ug/L 0.42
5.21 (11141-16-5) 0 0 CI Mass
PCB-1248 Concentration ug/L 0.42
5.22 (12672-29-6) 0 0 C Mass
PCB-1260 Concentration ug/L 0.42
5.23 (11096-82-5) 0 0 C
Mass
PCB-1016 Concentration ug/L 0.42
5.24 (12674-11-2) 0 0 C Mass
EPA Form 3510-2C(Revised 3-19) Page 20

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE B.TOXIC METALS,CYANIDE,TOTAL PHENOLS,AND ORGANIC TOXIC POLLUTANTS(40 CFR 122.21(g)(7)(v))1
Presence or Absence Intake
(check one) Effluent (optional)
Pollutant/Parameter Testing Units Long-Term
(and CAS Number,if available) Required Believed Believed (specify) Maximum Maximum Average Number Long- Number
Present Absent Daily Monthly Daily of Term of
Discharge Discharge Discharge Analyses Average Analyses
(required) (if available)
(if available)
Toxaphene Concentration ug/L 0.42
5.25 (8001-35-2) ❑ 0 0 Mass -
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C(Revised 3-19) Page 21

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))1
Presence or Absence Intake
(check one) Effluent (Optional)
•
Pollutant Units Maximum Long-Term
Believed Believed (specify) Maximum Daily Long-Term
Present Absent Discharge Monthly Average Daily Number of Average Number of
Discharge Discharge Analyses • Analyses
(required) Value
(if available) (if available)
El❑ Check here if you believe all pollutants on Table C to be present in your discharge from the noted outfall. You need not complete the"Presence or Absence"column of Table C for
each pollutant.
El❑ Check here if you believe all pollutants on Table C to be absent in your discharge from the noted outfall.You need not complete the"Presence or Absence"column of Table C for
each pollutant.
1 Bromide ❑ 0 Concentration
(24959-67-9) Mass
2 Chlorine, total ❑ ❑ Concentration
residual Mass
3. Color El ❑ Concentration
Mass
0 ❑ Concentration
4. Fecal coliform
Mass
Fluoride ❑ ❑ Concentration
5 (16984-48-8)
Mass
• Concentration
6 Nitrate-nitrite ❑ ❑ Mass
Nitrogen,total El ❑ Concentration
7. organic(as N) Mass
Concentration
8. Oil and grease ❑ ❑ Mass
9 Phosphorus(as ❑ ❑ Concentration
P), total(7723-14-0) Mass
10.
Sulfate(as SO4) ❑ ❑ Concentration
(14808-79-8) Mass
•
Concentration
11. Sulfide(as S) ❑ ❑ Mass
EPA Form 3510-2C(Revised 3-19) Page 23

EPA Identification Number NPDES Permit Number Facility Name Outlall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))1
Presence or Absence Intake
(check one) Effluent (Optional)
Pollutant Units Maximum Long-Term
Believed Believed (specify) Maximum Daily Long-Term
Present Absent Discharge Monthly Average Daily Number of Average Number of
Discharge Discharge Analyses Analyses
(required) Value
(if available) (if available)
12. Sulfite(as S03) ❑ ❑ Concentration
(14265-45-3) Mass
13. Surfactants 0 0
Concentration
Mass
14. Aluminum,total 0 0 Concentration
(7429-90-5) Mass
15. Barium,total 0 ❑ Concentration
(7440-39-3) Mass
16. Boron,total 0 ❑ Concentration
(744042-8) Mass
17 Cobalt,total Concentration
0 0
(744048-4) Mass
18 Iron,totalCI 1:1 Concentration
(7439-89-6) Mass
19 Magnesium,total ❑ ❑ Concentration
(7439-95-4) Mass
Molybdenum, Concentration
20. total ❑ ❑ Mass
(7439-98-7)
21. Manganese,total ❑ 0 Concentration
(7439-96-5) Mass
22 Tin,total 0 0 Concentration
(7440-31-5) Mass
Titanium,total ❑ 0 Concentration
23. (7440-32-6)
Mass
EPA Form 3510-2C(Revised 3-19) Page 24

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE C.CERTAIN CONVENTIONAL AND NON CONVENTIONAL POLLUTANTS(40 CFR 122.21(g)(7)(vi))1
Presence or Absence Intake
(check one) Effluent (Optional)
Pollutant Units Maximum Long-Term
Believed Believed (specify) Maximum Daily Long-Term
Present Absent Discharge Monthly Average Daily Number of Average Number of
Discharge Discharge Analyses Analyses
(required) Value
(if available) (if available)
24. Radioactivity
Concentration
Alpha,total ❑ ❑ Mass
Concentration
Beta,total ❑ 0 Mass
Concentration
Radium,total ❑ ❑ Mass
Concentration
Radium 226,total 0 ❑ Mass
1 Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C(Revised 3-19) Page 25

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 122.21(g)(7)(vii))1
Presence or Absence
Pollutant (check one) Available Quantitative Data
Believed Believed Reason Pollutant Believed Present in Discharge (specify units)
Present Absent
1. Asbestos ❑ ❑
2. Acetaldehyde ❑ ❑
3. Ally!alcohol ❑ ❑
4. Ally!chloride ❑ ❑
5. Amyl acetate ❑ ❑
6. Aniline ❑ ❑
7. Benzonitrile ❑ ❑
8. Benzyl chloride ❑ ❑
9. Butyl acetate ❑ 0
10. Butylamine ❑ ❑
11. Captan ❑ ❑
12. Carbaryl ❑ ❑
13. Carbofuran ❑ ❑
14. Carbon disulfide ❑ ❑
15. Chlorpyrifos ❑ ❑
16. Coumaphos 0 ❑
17. Cresol ❑ ❑
18. Crotonaldehyde ❑ ❑
19. Cyclohexane ❑ ❑
EPA Form 3510-2C(Revised 3-19) Page 27

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE D. CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 12221(g)(7)(vii))1
Presence or Absence
Pollutant (check one) Available Quantitative Data
Believed Believed Reason Pollutant Believed Present in Discharge
(specify units)
Present Absent
20. 2,4-D(2,4-dichlorophenoxyacetic acid) ❑ 0
21. Diazinon ❑ 0
22. Dicamba ❑ ❑
23. Dichlobenil 0 ❑
24. Dichlone ❑ 0
25. 2,2-dichloropropionic acid ❑ ❑
26. Dichlorvos ❑ ❑
27. Diethyl amine ❑ ❑
28. Dimethyl amine ❑ 0
29. Dintrobenzene 0 ❑
30. Diquat ❑ 0
31. Disulfoton ❑ ❑
32. Diuron ❑ ❑
33. Epichlorohydrin ❑ ❑
34. Ethion ❑ ❑
35. Ethylene diamine 0 ❑
36. Ethylene dibromide ❑ 0
37. Formaldehyde ❑ ❑
38. Furfural ❑ 0
EPA Form 3510-2C(Revised 3-19) Page 28

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 12221(g)(7)(vii))1
Presence or Absence
Pollutant (check one) Available Quantitative Data
Believed Believed Reason Pollutant Believed Present in Discharge
(specify units)
Present Absent
39. Guthion 0 ❑
40. Isoprene ❑ ❑
41. Isopropanolamine ❑ ❑
42. Kelthane ❑ ❑
43. Kepone ❑ ❑
44. Malathion ❑ ❑
45. Mercaptodimethur ❑ ❑
46. Methoxychlor ❑ ❑
47. Methyl mercaptan ❑ ❑
48. Methyl methacrylate ❑ ❑
49. Methyl parathion ❑ ❑
50. Mevinphos ❑ ❑
51. Mexacarbate ❑ ❑
52. Monoethyl amine ❑ ❑
53. Monomethyl amine ❑ ❑
54. Naled ❑ ❑
55. Naphthenic acid ❑ ❑
56. Nitrotoluene ❑ ❑
57. Parathion ❑ ❑
EPA Form 3510-2C(Revised 3-19) Page 29

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 122.21(g)(7)(vii))1
Presence or Absence
Pollutant (check one) Available Quantitative Data
Believed Believed Reason Pollutant Believed Present in Discharge
(specify units)
Present Absent
58. Phenolsulfonate 0 ❑
59. Phosgene 0 ❑
60. Propargite 0 ❑
61. Propylene oxide ❑ ❑
62. Pyrethrins ❑ 0
63. Quinoline 0 ❑
64. Resorcinol 0 ❑
65. Strontium ❑ 0
66. Strychnine 0 0
67. Styrene 0 0
68. 2,4,5-T(2,4,5-trichlorophenoxyacetic ❑ 0
acid)
69. TDE(tetrachlorodiphenyl ethane) 0 0
70. 2,4,5-TP[2-(2,4,5-trichlorophenoxy) ❑ 0
propanoic acid]
71. Trichlorofon 0 0
72. Triethanolamine 0 0
73. Triethylamine 0
y0
74. Trimethylamine 0 0
75. Uranium 0 0
76. Vanadium 0 0
EPA Form 3510-2C(Revised 3-19) Page 30

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE D.CERTAIN HAZARDOUS SUBSTANCES AND ASBESTOS(40 CFR 122.21(g)(7)(vii))l
Presence or Absence
Pollutant (check one) Available Quantitative Data
Believed Believed Reason Pollutant Believed Present in Discharge (specify units)
Present Absent
77. Vinyl acetate ❑ 0
78. Xylene ❑ 0
79. Xylenol ❑ 0
80. Zirconium ❑ ❑
' Sampling shall be conducted according to sufficiently sensitive test procedures(i.e., methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or
required under 40 CFR chapter I,subchapter N or 0. See instructions and 40 CFR 122.21(e)(3).
EPA Form 3510-2C(Revised 3-19) Page 31

This page intentionally left blank.

EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03/05/19
OMB No.2040-0004
TABLE E.2,3,7,8 TETRACHLORODIBENZO P DIOXIN(2,3,7,8 TCDD)(40 CFR 122.21(g)(7)(viii))
TCDD Presence or
Congeners Absence
Pollutant Used or (check one) Results of Screening Procedure
Manufactured Believed Believed
Present Absent
2.3.7.8-TCDD ❑ ❑
EPA Form 3510-2C(Revised 3-19) Page 33

Line Drawing of Dewatering Wells and
Basement Pumps Discharging to BMP #2
Well 1- Well 2-
18gpm 18gpn,
Max Max
Dewatering from
Building 3 Basement-
300gpm Well 3-
18gpm
Max
Well4- Well 5-
18 gpm 18 gpm -------
Max Max

Pace Analytical Services,LLC
7726 Moller Road
A/ f+ Indianapolis,IN 46268
[phone]
October 11, 2023
Brian Griesemer
Eli Lilly & Company
Corporate Center
Building 147 - LTC South
Indianapolis, IN 46285
RE: Project: NC-Concord Groundwater
Pace Project No.: 50351209
Dear Brian Griesemer:
Enclosed are the analytical results for sample(s) received by the laboratory on August 08, 2023. The results relate only to
the samples included in this report. Results reported herein conform to the applicable TNI/NELAC Standards and the
laboratory's Quality Manual,where applicable, unless otherwise noted in the body of the report.
The test results provided in this final report were generated by each of the following laboratories within the Pace Network:
• Pace Analytical Services-Asheville
•Pace Analytical Services-Charlotte
• Pace Analytical Services-Peachtree Corners, GA
Revised report replaces report dated 09/06/23. Revised to add 624 compounds per client request. 101123hmp
Revised report replaces report dated 08/14/23. Revised to add TOC and Hg. 082223hmp
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Heather Patterson
[e-mail]
[phone]
Project Manager
Enclosures
cc: TC Garrod, Eli Lilly&Company
A REPORT OF LABORATORY ANALYSIS
0 This report shall not be reproduced,except in full,
without the written consent of Pace Analytical Services,LLC. Page 1 of 36

Pace Analytical Services,LLC
ace- 7726 Moller Road
Indianapolis,IN 46268
[phone]
CERTIFICATIONS
Project: NC-Concord Groundwater
Pace Project No.: 50351209
Pace Analytical Services Charlotte
South Carolina Laboratory ID:99006 South Carolina Certification#:99006001
9800 Kincey Ave.Ste 100, Huntersville,NC 28078 South Carolina Drinking Water Cert.#:99006003
North Carolina Drinking Water Certification#: 37706 Florida/NELAP Certification#: E87627
North Carolina Field Services Certification#:5342 Kentucky UST Certification#:84
North Carolina Wastewater Certification#: 12 Louisiana DoH Drinking Water#: LA029
South Carolina Laboratory ID:99006 VirginiaNELAP Certification#:460221
Pace Analytical Services Asheville
2225 Riverside Drive,Asheville,NC 28804 South Carolina Laboratory ID:99030
Florida/NELAP Certification#: E87648 South Carolina Certification#:99030001
North Carolina Drinking Water Certification#:37712 VirginiaNELAP Certification#:460222
North Carolina Wastewater Certification#:40
Pace Analytical Services Peachtree Corners
110 Technology Pkwy,Peachtree Corners, GA 30092 North Carolina Certification#:381
Florida DOH Certification#: E87315 South Carolina Certification#:98011001
Georgia DW Inorganics Certification#:812 Virginia Certification#:460204
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
without the written consent of Pace Analytical Services,LLC. Page 2 of 36

Pace Analytical Services,LLC
Pace- 7726 Moller Road
Indianapolis,IN 46268
[phone]
SAMPLE SUMMARY
Project: NC-Concord Groundwater
Pace Project No.: 50351209
Lab ID Sample ID Matrix Date Collected Date Received
50351209001 Sample 1 Water 08/07/23 15:00 08/08/23 08:00
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
without the written consent of Pace Analytical Services,LLC. Page 3 of 36

Pace Analytical Services,LLC
7726 Moller Road
Indianapolis,IN 46268
[phone]
SAMPLE ANALYTE COUNT
Project: NC-Concord Groundwater
Pace Project No.: 50351209
Analytes
Lab ID Sample ID Method Analysts Reported Laboratory
50351209001 Sample 1 EPA 608.3 SEM 30 PASI-C
EPA 200.7 MS 13 PASI-GA
EPA 245.1 VB 1 PASI-GA
EPA 625.1 PKS 60 PASI-C
EPA 624.1 SAS 35 PASI-C
SM 2540D-2015 MAB2 1 PASI-A
SM 5210B-2011 KO 1 PASI-A
EPA 9040C SMS 1 PASI-A
EPA 350.1 Rev 2.0 1993 ARJ 1 PASI-A
EPA420.4 Rev 1.0 1993 ARJ 1 PASI-A
SM 4500-CN-E-2011 KDF1 1 PASI-A
SM 5220D-2011 JMH1 1 PASI-A
SM 5310B-2014 MDW 1 PASI-A
PASI-A=Pace Analytical Services-Asheville
PASI-C=Pace Analytical Services-Charlotte
PASI-GA=Pace Analytical Services-Peachtree Corners,GA
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
without the written consent of Pace Analytical Services,LLC. Page 4 of 36

Pace Analytical Services,LLC
/ ace Indianapolis,IN 46268
[phone]
ANALYTICAL RESULTS
Project: NC-Concord Groundwater
Pace Project No.: 50351209
Sample: Sample 1 Lab ID: 50351209001 Collected: 08/07/23 15:00 Received: 08/08/23 08:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
608 PCB Pest RVE Analytical Method: EPA 608.3 Preparation Method:EPA 608.3
Pace Analytical Services-Charlotte
Aldrin ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 309-00-2
alpha-BHC ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 319-84-6
beta-BHC ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 319-85-7
delta-BHC ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 319-86-8
gamma-BHC(Lindane) ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 58-89-9
Chlordane(Technical) ND ug/L 0.42 1 08/09/23 09:31 08/11/23 17:22 57-74-9
alpha-Chlordane ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 5103-71-9
gamma-Chlordane ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 5103-74-2
4,4'-DDD ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 72-54-8 L1
4,4'-DDE ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 72-55-9
4,4'-DDT ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 50-29-3
Dieldrin ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 60-57-1
Endosulfan I ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 959-98-8
Endosulfan II ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 33213-65-9
Endosulfan sulfate ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 1031-07-8
Endrin ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 72-20-8
Endrin aldehyde ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 7421-93-4
Heptachlor ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 76-44-8
Heptachlor epoxide ND ug/L 0.042 1 08/09/23 09:31 08/11/23 17:22 1024-57-3
PCB-1016(Aroclor 1016) ND ug/L 0.42 1 08/09/23 09:31 08/11/23 17:22 12674-11-2
PCB-1221 (Aroclor 1221) ND ug/L 0.42 1 08/09/23 09:31 08/11/23 17:22 11104-28-2
PCB-1232(Aroclor 1232) ND ug/L 0.42 1 08/09/23 09:31 08/11/23 17:22 11141-16-5
PCB-1242(Aroclor 1242) ND ug/L 0.42 1 08/09/23 09:31 08/11/23 17:22 53469-21-9
PCB-1248(Aroclor 1248) ND ug/L 0.42 1 08/09/23 09:31 08/11/23 17:22 12672-29-6
PCB-1254(Aroclor 1254) ND ug/L 0.42 1 08/09/23 09:31 08/11/23 17:22 11097-69-1
PCB-1260(Aroclor 1260) ND ug/L 0.42 1 08/09/23 09:31 08/11/23 17:22 11096-82-5
PCB,Total ND ug/L 0.42 1 08/09/23 09:31 08/11/23 17:22 1336-36-3
Toxaphene ND ug/L 0.42 1 08/09/23 09:31 08/11/23 17:22 8001-35-2
Surrogates
Tetrachloro-m-xylene(S) 72 % 10-137 1 08/09/23 09:31 08/11/23 17:22 877-09-8
Decachlorobiphenyl(S) 88 % 19-200 1 08/09/23 09:31 08/11/23 17:22 2051-24-3
200.7 MET ICP Analytical Method: EPA 200.7 Preparation Method: EPA 200.7
Pace Analytical Services-Peachtree Corners,GA
Antimony ND ug/L 50.0 1 08/09/23 10:55 08/09/23 23:36 7440-36-0
Arsenic ND ug/L 30.0 1 08/09/23 10:55 08/09/23 23:36 7440-38-2
Beryllium ND ug/L 10.0 1 08/09/23 10:55 08/09/23 23:36 7440-41-7
Cadmium ND ug/L 10.0 1 08/09/23 10:55 08/09/23 23:36 7440-43-9
Chromium 84.7 ug/L 10.0 1 08/09/23 10:55 08/09/23 23:36 7440-47-3
Copper ND ug/L 20.0 1 08/09/23 10:55 08/09/23 23:36 7440-50-8
Lead ND ug/L 25.0 1 08/09/23 10:55 08/09/23 23:36 7439-92-1
Nickel ND ug/L 20.0 1 08/09/23 10:55 08/09/23 23:36 7440-02-0
Selenium ND ug/L 40.0 1 08/09/23 10:55 08/09/23 23:36 7782-49-2
Silver ND ug/L 10.0 1 08/09/23 10:55 08/09/23 23:36 7440-22-4
Thallium ND ug/L 200 1 08/09/23 10:55 08/09/23 23:36 7440-28-0
Tin ND ug/L 40.0 1 08/09/23 10:55 08/09/23 23:36 7440-31-5
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 5 of 36

Pace Analytical Services,LLC
ace///►►► 7726 Moller Road
�// /�+ Indianapolis,IN 46268
(,(�,/v [phone]
ANALYTICAL RESULTS
Project: NC-Concord Groundwater
Pace Project No.: 50351209
Sample: Sample 1 Lab ID: 50351209001 Collected: 08/07/23 15:00 Received: 08/08/23 08:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
200.7 MET ICP Analytical Method: EPA 200.7 Preparation Method: EPA 200.7
Pace Analytical Services-Peachtree Corners,GA
Zinc 136 ug/L 20.0 1 08/09/23 10:55 08/09/23 23:36 7440-66-6
245.1 Mercury Analytical Method: EPA 245.1 Preparation Method: EPA 245.1
Pace Analytical Services-Peachtree Corners,GA
Mercury ND ug/L 0.20 1 08/25/23 11:00 08/25/23 13:34 7439-97-6
625 RVE Analytical Method: EPA 625.1 Preparation Method:EPA 625.1
Pace Analytical Services-Charlotte
Acenaphthene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 83-32-9
Acenaphthylene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 208-96-8
Anthracene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 120-12-7
Benzidine ND ug/L 41.7 1 08/09/23 11:52 08/10/23 18:25 92-87-5 L2
Benzo(a)anthracene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 56-55-3
Benzo(a)pyrene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 50-32-8
Benzo(b)fluoranthene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 205-99-2
Benzo(g,h,i)perylene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 191-24-2
Benzo(k)fluoranthene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 207-08-9
4-Bromophenylphenyl ether ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 101-55-3
Butylbenzylphthalate ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 85-68-7
4-Chloro-3-methylphenol ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 59-50-7
bis(2-Chloroethoxy)methane ND ug/L 8.3 1 08/09/23 11:52 08/10/23 18:25 111-91-1
bis(2-Chloroethyl)ether ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 111-44-4
2-Chloronaphthalene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 91-58-7
2-Chlorophenol ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 95-57-8
4-Chlorophenylphenyl ether ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 7005-72-3
Chrysene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 218-01-9
Dibenz(a,h)anthracene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 53-70-3
3,3'-Dichlorobenzidine ND ug/L 8.3 1 08/09/23 11:52 08/10/23 18:25 91-94-1
2,4-Dichlorophenol ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 120-83-2
Diethylphthalate ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 84-66-2
2,4-Dimethylphenol ND ug/L 8.3 1 08/09/23 11:52 08/10/23 18:25 105-67-9
Dimethylphthalate ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 131-11-3
Di-n-butylphthalate ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 84-74-2
4,6-Dinitro-2-methylphenol ND ug/L 8.3 1 08/09/23 11:52 08/10/23 18:25 534-52-1
2,4-Dinitrophenol ND ug/L 41.7 1 08/09/23 11:52 08/10/23 18:25 51-28-5
2,4-Dinitrotoluene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 121-14-2
2,6-Dinitrotoluene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 606-20-2
Di-n-octylphthalate ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 117-84-0
1,2-Diphenylhydrazine ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 122-66-7
bis(2-Ethylhexyl)phthalate ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 117-81-7
Fluoranthene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 206-44-0
Fluorene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 86-73-7
Hexachloro-1,3-butadiene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 87-68-3
Hexachlorobenzene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 118-74-1
Hexachlorocyclopentadiene ND ug/L 8.3 1 08/09/23 11:52 08/10/23 18:25 77-47-4
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 6 of 36

Pace Analytical Services,LLC
/�/�//�� 7726 Moller Road
j// P Indianapolis,IN 46268
(�(�/v [phone]
ANALYTICAL RESULTS
Project: NC-Concord Groundwater
Pace Project No.: 50351209
Sample: Sample 1 Lab ID: 50351209001 Collected: 08/07/23 15:00 Received: 08/08/23 08:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
625 RVE Analytical Method:EPA 625.1 Preparation Method: EPA 625.1
Pace Analytical Services-Charlotte
Hexachloroethane ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 67-72-1
Indeno(1,2,3-cd)pyrene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 193-39-5
Isophorone ND ug/L 8.3 1 08/09/23 11:52 08/10/23 18:25 78-59-1
Naphthalene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 91-20-3
Nitrobenzene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 98-95-3
2-Nitrophenol ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 88-75-5
4-Nitrophenol ND ug/L 8.3 1 08/09/23 11:52 08/10/23 18:25 100-02-7
N-Nitrosodimethylamine ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 62-75-9
N-Nitroso-di-n-propylamine ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 621-64-7
N-Nitrosodiphenylamine ND ug/L 8.3 1 08/09/23 11:52 08/10/23 18:25 86-30-6
2,2'-Oxybis(1-chloropropane) ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 108-60-1
Pentachlorophenol ND ug/L 8.3 1 08/09/23 11:52 08/10/23 18:25 87-86-5
Phenanthrene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 85-01-8
Phenol ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 108-95-2
Pyrene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 129-00-0
1,2,4-Trichlorobenzene ND ug/L 4.2 1 08/09/23 11:52 08/10/23 18:25 120-82-1
2,4,6-Trichlorophenol ND ug/L 8.3 1 08/09/23 11:52 08/10/23 18:25 88-06-2
Surrogates
Nitrobenzene-d5(S) 71 % 10-120 1 08/09/23 11:52 08/10/23 18:25 4165-60-0
2-Fluorobiphenyl(S) 46 % 15-120 1 08/09/23 11:52 08/10/23 18:25 321-60-8
Terphenyl-d14(S) 136 % 11-131 1 08/09/23 11:52 08/10/23 18:25 1718-51-0 S3
Phenol-d6(S) 38 % 10-120 1 08/09/23 11:52 08/10/23 18:25 13127-88-3
2-Fluorophenol(S) 47 % 10-120 1 08/09/23 11:52 08/10/23 18:25 367-12-4
2,4,6-Tribromophenol(S) 95 % 10-137 1 08/09/23 11:52 08/10/23 18:25 118-79-6
624 Volatile Organics Analytical Method: EPA 624.1
Pace Analytical Services-Charlotte
Acrolein ND ug/L 5.0 1 08/09/23 20:56 107-02-8 AC
Acrylonitrile ND ug/L 5.0 1 08/09/23 20:56 107-13-1 AC
Benzene ND ug/L 1.0 1 08/09/23 20:56 71-43-2
Bromodichloromethane ND ug/L 2.0 1 08/09/23 20:56 75-27-4
Bromoform ND ug/L 2.0 1 08/09/23 20:56 75-25-2
Bromomethane ND ug/L 2.0 1 08/09/23 20:56 74-83-9
Carbon tetrachloride ND ug/L 2.0 1 08/09/23 20:56 56-23-5
Chlorobenzene ND ug/L 2.0 1 08/09/23 20:56 108-90-7
Chloroethane ND ug/L 2.0 1 08/09/23 20:56 75-00-3
2-Chloroethylvinyl ether ND ug/L 5.0 1 08/09/23 20:56 110-75-8 I
Chloroform ND ug/L 2.0 1 08/09/23 20:56 67-66-3
Chloromethane ND ug/L 2.0 1 08/09/23 20:56 74-87-3
Dibromochloromethane ND ug/L 2.0 1 08/09/23 20:56 124-48-1
1,2-Dichlorobenzene ND ug/L 2.0 1 08/09/23 20:56 95-50-1
1,3-Dichlorobenzene ND ug/L 2.0 1 08/09/23 20:56 541-73-1
1,4-Dichlorobenzene ND ug/L 2.0 1 08/09/23 20:56 106-46-7
1,1-Dichloroethane ND ug/L 2.0 1 08/09/2320:56 75-34-3
1,2-Dichloroethane ND ug/L 2.0 1 08/09/23 20:56 107-06-2
1,1-Dichloroethene ND ug/L 2.0 1 08/09/23 20:56 75-35-4
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 7 of 36

Pace Analytical Services,LLC
Pace'''/'-e�' 7726 Moller Road
/�/ Indianapolis,IN 46268
(�(v�J [phone]
ANALYTICAL RESULTS
Project: NC-Concord Groundwater
Pace Project No.: 50351209
Sample: Sample 1 Lab ID: 50351209001 Collected: 08/07/23 15:00 Received: 08/08/23 08:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
624 Volatile Organics Analytical Method:EPA 624.1
Pace Analytical Services-Charlotte
trans-1,2-Dichloroethene ND ug/L 2.0 1 08/09/23 20:56 156-60-5
1,2-Dichloropropane ND ug/L 2.0 1 08/09/23 20:56 78-87-5
cis-1,3-Dichloropropene ND ug/L 2.0 1 08/09/23 20:56 10061-01-5
trans-1,3-Dichloropropene ND ug/L 2.0 1 08/09/23 20:56 10061-02-6
Ethylbenzene ND ug/L 1.0 1 08/09/23 20:56 100-41-4
Methylene Chloride ND ug/L 2.0 1 08/09/23 20:56 75-09-2
1,1,2,2-Tetrachloroethane ND ug/L 2.0 1 08/09/23 20:56 79-34-5
Tetrachloroethene ND ug/L 2.0 1 08/09/23 20:56 127-18-4
Toluene ND ug/L 1.0 1 08/09/23 20:56 108-88-3
1,1,1-Trichloroethane ND ug/L 2.0 1 08/09/23 20:56 71-55-6
1,1,2-Trichloroethane ND ug/L 2.0 1 08/09/23 20:56 79-00-5
Trichloroethene ND ug/L 2.0 1 08/09/23 20:56 79-01-6
Vinyl chloride ND ug/L 2.0 1 08/09/23 20:56 75-01-4
Surrogates
4-Bromofluorobenzene(S) 98 % 70-130 1 08/09/23 20:56 460-00-4
Toluene-d8(S) 101 % 70-130 1 08/09/23 20:56 2037-26-5
1,2-Dichloroethane-d4(S) 105 % 70-130 1 08/09/23 20:56 17060-07-0
2540D Total Suspended Solids Analytical Method:SM 2540D-2015
Pace Analytical Services-Asheville
Total Suspended Solids 3.2 mg/L 2.5 1 08/10/23 12:15
5210B BOD,5 day Analytical Method: SM 5210B-2011
Pace Analytical Services-Asheville
BOD,5 day ND mg/L 2.0 1 08/09/23 07:02 08/14/23 09:44 B3
9040 pH Analytical Method: EPA 9040C
Pace Analytical Services-Asheville
pH at 25 Degrees C 8.6 Std. Units 0.10 1 08/12/23 10:34 H3
350.1 Ammonia Analytical Method: EPA 350.1 Rev 2.0 1993
Pace Analytical Services-Asheville
Nitrogen,Ammonia ND mg/L 0.10 1 08/11/23 14:41 7664-41-7
420.4 Phenolics,Total Analytical Method:EPA420.4 Rev 1.0 1993 Preparation Method: EPA420.4 Rev 1.0 1993
Pace Analytical Services-Asheville
Phenolics,Total Recoverable ND mg/L 0.020 1 08/09/23 09:02 08/09/23 11:54 64743-03-9
4500CNE Cyanide,Total Analytical Method:SM 4500-CN-E-2011 Preparation Method: SM 4500-CN-E-2011
Pace Analytical Services-Asheville
Cyanide ND mg/L 0.0080 1 08/10/23 10:00 08/10/23 12:20 57-12-5
5220D COD Analytical Method:SM 5220D-2011 Preparation Method:SM 5220D-2011
Pace Analytical Services-Asheville
Chemical Oxygen Demand ND mg/L 25.0 1 08/10/23 11:36 08/10/23 16:46
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 8 of 36

Pace Analytical Services,LLC
ace.
7726 Moller Road
Indianapolis,IN 46268
[phone]
ANALYTICAL RESULTS
Project: NC-Concord Groundwater
Pace Project No.: 50351209
Sample: Sample 1 Lab ID: 50351209001 Collected: 08/07/23 15:00 Received: 08/08/23 08:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
5310E TOC Analytical Method:SM 5310B-2014
Pace Analytical Services-Asheville
Total Organic Carbon 5.0 mg/L 1.0 1 08/24/23 01:29 7440-44-0
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 9 of 36

Pace Analytical Services,LLC
ace'-e///��� 7726 Moller Road
j// Indianapolis,IN 46268
(�(v�J [phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
QC Batch: 792369 Analysis Method: EPA 200.7
QC Batch Method: EPA 200.7 Analysis Description: 200.7 Metals Total
Laboratory: Pace Analytical Services-Peachtree Corners,GA
Associated Lab Samples: 50351209001
METHOD BLANK: 4105939 Matrix: Water
Associated Lab Samples: 50351209001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Antimony ug/L ND 50.0 08/09/23 21:11
Arsenic ug/L ND 30.0 08/09/23 21:11
Beryllium ug/L ND 10.0 08/09/23 21:11
Cadmium ug/L ND 10.0 08/09/23 21:11
Chromium ug/L ND 10.0 08/09/23 21:11
Copper ug/L ND 20.0 08/09/23 21:11
Lead ug/L ND 25.0 08/09/23 21:11
Nickel ug/L ND 20.0 08/09/23 21:11
Selenium ug/L ND 40.0 08/09/23 21:11
Silver ug/L ND 10.0 08/09/23 21:11
Thallium ug/L ND 200 08/09/23 21:11
Tin ug/L ND 40.0 08/09/23 21:11
Zinc ug/L ND 20.0 08/09/23 21:11
LABORATORY CONTROL SAMPLE: 4105940
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Antimony ug/L 1000 1030 103 85-115
Arsenic ug/L 1000 1040 104 85-115
Beryllium ug/L 1000 1010 101 85-115
Cadmium ug/L 1000 1030 103 85-115
Chromium ug/L 1000 1020 102 85-115
Copper ug/L 1000 1040 104 85-115
Lead ug/L 1000 1020 102 85-115
Nickel ug/L 1000 1030 103 85-115
Selenium ug/L 1000 1000 100 85-115
Silver ug/L 1000 999 100 85-115
Thallium ug/L 1000 1010 101 85-115
Tin ug/L 1000 1010 101 85-115
Zinc ug/L 1000 1030 103 85-115
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4105941 4105942
MS MSD
92681230001 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
Antimony ug/L ND 1000 1000 1070 1130 107 113 70-130 5 20
Arsenic ug/L ND 1000 1000 1110 1190 109 117 70-130 7 20
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 10 of 36

Pace Analytical Services,LLC
Pace' 7726 Moller Road
Indianapolis,IN 46268
[phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4105941 4105942
MS MSD
92681230001 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
Beryllium ug/L ND 1000 1000 1030 1030 103 103 70-130 0 20
Cadmium ug/L ND 1000 1000 1070 1080 107 108 70-130 1 20
Chromium ug/L ND 1000 1000 1030 1020 103 102 70-130 1 20
Copper ug/L ND 1000 1000 1070 1070 107 107 70-130 0 20
Lead ug/L ND 1000 1000 1030 1060 103 106 70-130 3 20
Nickel ug/L ND 1000 1000 1030 1090 103 108 70-130 5 20
Selenium ug/L 66.0 1000 1000 1120 924 105 86 70-130 19 20
Silver ug/L ND 1000 1000 1020 1020 102 102 70-130 1 20
Thallium ug/L ND 1000 1000 1040 1110 104 111 70-130 7 20
Tin ug/L ND 1000 1000 1030 1030 103 103 70-130 0 20
Zinc ug/L ND 1000 1000 1010 1430 101 143 70-130 34 20 M1,R1
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4105943 4105944
MS MSD
92681462002 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
Antimony ug/L ND 1000 1000 1050 1080 105 108 70-130 3 20
Arsenic ug/L ND 1000 1000 1060 1090 106 109 70-130 2 20
Beryllium ug/L ND 1000 1000 1010 1050 101 105 70-130 3 20
Cadmium ug/L ND 1000 1000 1030 1060 103 106 70-130 3 20
Chromium ug/L ND 1000 1000 1020 1060 101 105 70-130 3 20
Copper ug/L ND 1000 1000 1060 1090 104 108 70-130 3 20
Lead ug/L ND 1000 1000 1030 1060 103 106 70-130 3 20
Nickel ug/L ND 1000 1000 1050 1080 105 108 70-130 3 20
Selenium ug/L ND 1000 1000 1000 1050 100 105 70-130 4 20
Silver ug/L ND 1000 1000 983 1010 98 101 70-130 3 20
Thallium ug/L ND 1000 1000 927 1030 93 103 70-130 10 20
Tin ug/L ND 1000 1000 1000 1040 100 104 70-130 4 20
Zinc ug/L 0.029 1000 1000 1080 1100 105 107 70-130 2 20
mg/L
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 11 of 36

Pace Analytical Services,LLC
Pace-''///��� 7726 Moller Road
j// a Indianapolis,IN 46268
(�(v v [phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
QC Batch: 795988 Analysis Method: EPA 245.1
QC Batch Method: EPA 245.1 Analysis Description: 245.1 Mercury
Laboratory: Pace Analytical Services-Peachtree Corners,GA
Associated Lab Samples: 50351209001
METHOD BLANK: 4124552 Matrix: Water
Associated Lab Samples: 50351209001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Mercury ug/L ND 0.20 08/25/23 13:28
LABORATORY CONTROL SAMPLE: 4124553
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Mercury ug/L 2.5 2.6 103 85-115
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4124554 4124555
MS MSD
92683801001 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
Mercury ug/L ND 2.5 2.5 2.4 2.0 95 80 70-130 16 20
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 12 of 36

Pace Analytical Services,LLC
Pace 7726 Moller Road
Indianapolis,IN 46268
[phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
QC Batch: 792436 Analysis Method: EPA 624.1
QC Batch Method: EPA 624.1 Analysis Description: 624 MSV
Laboratory: Pace Analytical Services-Charlotte
Associated Lab Samples: 50351209001
METHOD BLANK: 4106479 Matrix: Water
Associated Lab Samples: 50351209001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
1,1,1-Trichloroethane ug/L ND 2.0 08/09/23 12:24
1,1,2,2-Tetrachloroethane ug/L ND 2.0 08/09/23 12:24
1,1,2-Trichloroethane ug/L ND 2.0 08/09/23 12:24
1,1-Dichloroethane ug/L ND 2.0 08/09/23 12:24
1,1-Dichloroethene ug/L ND 2.0 08/09/23 12:24
1,2-Dichlorobenzene ug/L ND 2.0 08/09/23 12:24
1,2-Dichloroethane ug/L ND 2.0 08/09/23 12:24
1,2-Dichloropropane ug/L ND 2.0 08/09/23 12:24
1,3-Dichlorobenzene ug/L ND 2.0 08/09/23 12:24
1,4-Dichlorobenzene ug/L ND 2.0 08/09/23 12:24
2-Chloroethylvinyl ether ug/L ND 5.0 08/09/23 12:24
Acrolein ug/L ND 5.0 08/09/23 12:24
Acrylonitrile ug/L ND 5.0 08/09/23 12:24
Benzene ug/L ND 1.0 08/09/23 12:24
Bromodichloromethane ug/L ND 2.0 08/09/23 12:24
Bromoform ug/L ND 2.0 08/09/23 12:24
Bromomethane ug/L ND 2.0 08/09/23 12:24
Carbon tetrachloride ug/L ND 2.0 08/09/23 12:24
Chlorobenzene ug/L ND 2.0 08/09/23 12:24
Chloroethane ug/L ND 2.0 08/09/23 12:24
Chloroform ug/L ND 2.0 08/09/23 12:24
Chloromethane ug/L ND 2.0 08/09/23 12:24
cis-1,3-Dichloropropene ug/L ND 2.0 08/09/23 12:24
Dibromochloromethane ug/L ND 2.0 08/09/23 12:24
Ethylbenzene ug/L ND 1.0 08/09/23 12:24
Methylene Chloride ug/L ND 2.0 08/09/23 12:24
Tetrachloroethene ug/L ND 2.0 08/09/23 12:24
Toluene ug/L ND 1.0 08/09/23 12:24
trans-1,2-Dichloroethene ug/L ND 2.0 08/09/23 12:24
trans-1,3-Dichloropropene ug/L ND 2.0 08/09/23 12:24
Trichloroethene ug/L ND 2.0 08/09/23 12:24
Vinyl chloride ug/L ND 2.0 08/09/23 12:24
1,2-Dichloroethane-d4(S) % 105 70-130 08/09/23 12:24
4-Bromofluorobenzene(S) % 101 70-130 08/09/23 12:24
Toluene-d8(S) % 102 70-130 08/09/23 12:24
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 13 of 36

Pace Analytical Services,LLC
7726 Moller Road
ace' Indianapolis,IN 46268
[phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
LABORATORY CONTROL SAMPLE: 4106480
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
1,1,1-Trichloroethane ug/L 20 19.4 97 70-130
1,1,2,2-Tetrachloroethane ug/L 20 19.6 98 70-130
1,1,2-Trichloroethane ug/L 20 19.1 96 70-130
1,1-Dichloroethane ug/L 20 19.2 96 70-130
1,1-Dichloroethene ug/L 20 19.3 97 70-130
1,2-Dichlorobenzene ug/L 20 19.3 96 70-130
1,2-Dichloroethane ug/L 20 19.0 95 70-130
1,2-Dichloropropane ug/L 20 19.0 95 70-130
1,3-Dichlorobenzene ug/L 20 19.0 95 70-130
1,4-Dichlorobenzene ug/L 20 19.0 95 70-130
2-Chloroethylvinyl ether ug/L 40 34.6 87 63-130
Acrolein ug/L 100 104 104 60-140
Acrylonitrile ug/L 100 97.4 97 70-130
Benzene ug/L 20 18.6 93 70-130
Bromodichloromethane ug/L 20 17.9 89 70-130
Bromoform ug/L 20 17.5 88 70-130
Bromomethane ug/L 20 15.9 80 45-151
Carbon tetrachloride ug/L 20 18.7 93 70-130
Chlorobenzene ug/L 20 18.9 95 70-130
Chloroethane ug/L 20 20.8 104 40-152
Chloroform ug/L 20 19.6 98 70-130
Chloromethane ug/L 20 17.0 85 58-130
cis-1,3-Dichloropropene ug/L 20 18.4 92 70-130
Dibromochloromethane ug/L 20 17.9 89 70-130
Ethylbenzene ug/L 20 18.6 93 70-130
Methylene Chloride ug/L 20 18.6 93 66-130
Tetrachloroethene ug/L 20 18.4 92 70-130
Toluene ug/L 20 18.1 91 70-130
trans-1,2-Dichloroethene ug/L 20 20.1 101 70-130
trans-1,3-Dichloropropene ug/L 20 17.7 89 70-130
Trichloroethene ug/L 20 18.9 94 70-130
Vinyl chloride ug/L 20 15.6 78 62-130
1,2-Dichloroethane-d4(S) % 105 70-130
4-Bromofluorobenzene(S) % 102 70-130
Toluene-d8(S) % 99 70-130
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4106481 4106482
MS MSD
92681126001 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
1,1,1-Trichloroethane ug/L ND 20 20 25.1 24.0 125 120 70-150 4 21
1,1,2,2-Tetrachloroethane ug/L ND 20 20 22.6 22.1 113 110 69-142 2 30
1,1,2-Trichloroethane ug/L ND 20 20 24.0 23.2 120 116 70-138 3 27
1,1-Dichloroethane ug/L ND 20 20 25.0 24.0 125 120 70-150 4 24
1 1,1-Dichloroethene ug/L ND 20 20 25.7 24.7 129 124 70-156 4 30
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 14 of 36

Pace Analytical Services,LLC
ace. 7726 Moller Road
[phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4106481 4106482
MS MSD
92681126001 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
1,2-Dichlorobenzene ug/L ND 20 20 22.4 21.8 112 109 70-141 2 30
1,2-Dichloroethane ug/L ND 20 20 24.7 23.3 124 116 69-143 6 29
1,2-Dichloropropane ug/L ND 20 20 24.2 23.4 121 117 70-156 3 30
1,3-Dichlorobenzene ug/L ND 20 20 22.2 22.0 111 110 70-143 1 24
1,4-Dichlorobenzene ug/L ND 20 20 22.4 22.1 112 111 70-142 1 30
2-Chloroethylvinyl ether ug/L ND 40 40 ND ND 0 0 10-200 34 P5
Acrolein ug/L ND 100 100 108 98.4 108 98 40-160 10 30
Acrylonitrile ug/L ND 100 100 123 116 123 116 69-147 6 30
Benzene ug/L ND 20 20 24.3 23.3 122 117 70-142 4 30
Bromodichloromethane ug/L 6.3 20 20 30.5 29.7 121 117 70-139 3 30
Bromoform ug/L ND 20 20 19.0 18.4 95 92 64-140 3 25
Bromomethane ug/L ND 20 20 25.2 23.6 124 116 28-192 7 34
Carbon tetrachloride ug/L ND 20 20 23.4 22.9 117 115 70-140 2 26
Chlorobenzene ug/L ND 20 20 22.5 22.2 113 111 70-141 1 29
Chloroethane ug/L ND 20 20 27.5 24.4 137 122 58-191 12 30
Chloroform ug/L 46.9 20 20 76.4 75.2 148 142 70-138 2 30 M1
Chloromethane ug/L ND 20 20 22.0 15.7 109 77 43-162 34 30 R1
9
cis-1,3-Dichloro ro ene u /L ND 20 20 22.9 22.1 114 110 68-151 4 30
P P
Dibromochloromethane ug/L ND 20 20 22.2 21.2 109 104 70-144 5 30
Ethylbenzene ug/L ND 20 20 22.1 21.7 110 109 70-143 2 30
Methylene Chloride ug/L ND 20 20 24.3 23.3 122 117 70-144 4 30
Tetrachloroethene ug/L ND 20 20 21.4 21.4 107 107 70-143 0 23
Toluene ug/L ND 20 20 22.6 22.1 113 111 69-144 2 22
trans-1,2-Dichloroethene ug/L ND 20 20 24.2 24.3 121 121 70-151 0 27
trans-1,3-Dichloropropene ug/L ND 20 20 22.0 21.5 110 107 70-139 3 30
Trichloroethene ug/L ND 20 20 23.9 23.2 119 116 70-142 3 29
Vinyl chloride ug/L ND 20 20 20.6 19.7 103 99 61-162 5 30
1,2-Dichloroethane-d4(S) % 104 100 70-130
4-Bromofluorobenzene(S) % 101 100 70-130
Toluene-d8(S) % 99 99 70-130
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39AM without the written consent of Pace Analytical Services,LLC. Page 15 of 36

Pace Analytical Services,LLC
^/'� 7726 Moller Road
�// a Indianapolis,IN 46268
(�(�,/ [phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No,: 50351209
QC Batch: 792101 Analysis Method: EPA 608.3
QC Batch Method: EPA 608.3 Analysis Description: 608 PCB Pest Red Vol
Laboratory: Pace Analytical Services-Charlotte
Associated Lab Samples: 50351209001
METHOD BLANK: 4104402 Matrix: Water
Associated Lab Samples: 50351209001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
4,4'-DDD ug/L ND 0.050 08/11/23 18:13
4,4'-DDE ug/L ND 0.050 08/11/23 18:13
4,4'-DDT ug/L ND 0.050 08/11/23 18:13
Aldrin ug/L ND 0.050 08/11/23 18:13
alpha-BHC ug/L ND 0.050 08/11/23 18:13
alpha-Chlordane ug/L ND 0.050 08/11/23 18:13
beta-BHC ug/L ND 0.050 08/11/23 18:13
Chlordane(Technical) ug/L ND 0.50 08/11/23 18:13
delta-BHC ug/L ND 0.050 08/11/23 18:13
Dieldrin ug/L ND 0.050 08/11/23 18:13
Endosulfan I ug/L ND 0.050 08/11/23 18:13
Endosulfan II ug/L ND 0.050 08/11/23 18:13
Endosulfan sulfate ug/L ND 0.050 08/11/23 18:13
Endrin ug/L ND 0.050 08/11/23 18:13
Endrin aldehyde ug/L ND 0.050 08/11/23 18:13
gamma-BHC(Lindane) ug/L ND 0.050 08/11/23 18:13
gamma-Chlordane ug/L ND 0.050 08/11/23 18:13
Heptachlor ug/L ND 0.050 08/11/23 18:13
Heptachlor epoxide ug/L ND 0.050 08/11/23 18:13
PCB-1016(Aroclor 1016) ug/L ND 0.50 08/11/23 18:13
PCB-1221 (Aroclor 1221) ug/L ND 0.50 08/11/23 18:13
PCB-1232(Aroclor 1232) ug/L ND 0.50 08/11/23 18:13
PCB-1242(Aroclor 1242) ug/L ND 0.50 08/11/23 18:13
PCB-1248(Aroclor 1248) ug/L ND 0.50 08/11/23 18:13
PCB-1254(Aroclor 1254) ug/L ND 0.50 08/11/23 18:13
PCB-1260(Aroclor 1260) ug/L ND 0.50 08/11/23 18:13
Toxaphene ug/L ND 0.50 08/11/23 18:13
Decachlorobiphenyl(S) % 129 19-200 08/11/23 18:13
Tetrachloro-m-xylene(S) % 49 10-137 08/11/23 18:13
LABORATORY CONTROL SAMPLE: 4104403
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
4,4'-DDD ug/L 0.25 0.41 163 31-141 L1
4,4'-DDE ug/L 0.25 0.34 136 30-145
4,4'-DDT ug/L 0.25 0.35 139 25-160
Aldrin ug/L 0.25 0.18 71 42-135
alpha-BHC ug/L 0.25 0.29 117 37-140
alpha-Chlordane ug/L 0.25 0.31 122 45-140
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39AM without the written consent of Pace Analytical Services,LLC. Page 16 of 36

Pace Analytical Services,LLC
Pace'' 7726 Moller Road
Indianapolis,IN 46268
[phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
LABORATORY CONTROL SAMPLE: 4104403
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
beta-BHC ug/L 0.25 0.30 120 38-147
delta-BHC ug/L 0.25 0.26 104 19-140
Dieldrin ug/L 0.25 0.33 131 36-146
Endosulfan I ug/L 0.25 0.29 117 45-153
Endosulfan II ug/L 0.25 0.29 115 38-155
Endosulfan sulfate ug/L 0.25 0.30 119 42-144
Endrin ug/L 0.25 0.35 140 33-147
Endrin aldehyde ug/L 0.25 0.28 113 33-153
gamma-BHC(Lindane) ug/L 0.25 0.28 113 32-140
gamma-Chlordane ug/L 0.25 0.30 121 45-140
Heptachlor ug/L 0.25 0.26 103 34-140
Heptachlor epoxide ug/L 0.25 0.27 109 37-142
Decachlorobiphenyl(S) % 104 19-200
Tetrachloro-m-xylene(S) % 109 10-137
LABORATORY CONTROL SAMPLE: 4104411
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
PCB-1016(Aroclor 1016) ug/L 5 5.7 114 50-140
PCB-1260(Aroclor 1260) ug/L 5 6.0 119 42-140
Decachlorobiphenyl(S) % 94 19-200
Tetrachloro-m-xylene(S) % 100 10-137
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4104404 4104405
MS MSD
92680331004 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
PCB-1016(Aroclor 1016) ug/L ND 8.3 8.3 10.0 6.4 120 77 50-140 44 36 R1
PCB-1260(Aroclor 1260) ug/L ND 8.3 8.3 7.1 4.2 86 50 42-140 53 38 R1
Decachlorobiphenyl(S) % 75 45 19-200
Tetrachloro-m-xylene(S) % 114 88 10-137
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4104406 4104407
MS MSD
92680825001 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
4,4'-DDD ug/L ND 0.42 0.42 0.48 0.49 115 117 31-141 1 39
4,4'-DDE ug/L ND 0.42 0.42 0.42 0.42 100 100 30-145 0 35
4,4'-DDT ug/L ND 0.42 0.42 0.43 0.41 103 99 25-160 5 42
Aldrin ug/L ND 0.42 0.42 0.27 0.25 64 61 42-140 4 35
alpha-BHC ug/L ND 0.42 0.42 0.39 0.39 93 94 37-140 0 36
alpha-Chlordane ug/L ND 0.42 0.42 0.34 0.35 83 84 45-140 1 35
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 17 of 36

Pace Analytical Services,LLC
ace
'./1 7726 Moller Road
a/ a Indianapolis,IN 46268
,� �/ [phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4104406 4104407
MS MSD
92680825001 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
beta-BHC ug/L ND 0.42 0.42 0.39 0.42 93 100 21-147 7 44
delta-BHC ug/L ND 0.42 0.42 0.35 0.35 83 84 19-140 1 52
Dieldrin ug/L ND 0.42 0.42 0.36 0.36 86 87 36-146 1 49
Endosulfan I ug/L ND 0.42 0.42 0.39 0.40 94 95 45-153 1 28
Endosulfan II ug/L ND 0.42 0.42 0.37 0.36 89 86 13-174 4 53
Endosulfan sulfate ug/L ND 0.42 0.42 0.40 0.40 96 96 26-144 1 38
Endrin ug/L ND 0.42 0.42 0.40 0.40 96 97 30-147 1 48
Endrin aldehyde ug/L ND 0.42 0.42 0.31 0.31 75 75 10-167 0 30
gamma-BHC(Lindane) ug/L ND 0.42 0.42 0.38 0.39 92 93 32-140 2 39
gamma-Chlordane ug/L ND 0.42 0.42 0.35 0.35 83 84 45-140 1 35
Heptachlor ug/L ND 0.42 0.42 0.32 0.33 78 79 34-140 2 43
Heptachlor epoxide ug/L ND 0.42 0.42 0.33 0.33 79 79 37-142 1 26
Decachlorobiphenyl(S) % 41 42 19-200
Tetrachloro-m-xylene(S) % 82 85 10-137
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 18 of 36

Pace Analytical Services,LLC
ace' 7726 Moller Road
/// a Indianapolis,IN 46268
(�(�,/�J [phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
QC Batch: 792337 Analysis Method: EPA 625.1
QC Batch Method: EPA 625.1 Analysis Description: 625 MSS
Laboratory: Pace Analytical Services-Charlotte
Associated Lab Samples: 50351209001
METHOD BLANK: 4105871 Matrix: Water
Associated Lab Samples: 50351209001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
1,2,4-Trichlorobenzene ug/L ND 5.0 08/10/23 11:12
1,2-Diphenylhydrazine ug/L ND 5.0 08/10/23 11:12
2,2'-Oxybis(1-chloropropane) ug/L ND 5.0 08/10/23 11:12
2,4,6-Trichlorophenol ug/L ND 10.0 08/10/23 11:12
2,4-Dichlorophenol ug/L ND 5.0 08/10/23 11:12
2,4-Dimethylphenol ug/L ND 10.0 08/10/23 11:12
2,4-Dinitrophenol ug/L ND 50.0 08/10/23 11:12
2,4-Dinitrotoluene ug/L ND 5.0 08/10/23 11:12
2,6-Dinitrotoluene ug/L ND 5.0 08/10/23 11:12
2-Chloronaphthalene ug/L ND 5.0 08/10/23 11:12
2-Chlorophenol ug/L ND 5.0 08/10/23 11:12
2-Nitrophenol ug/L ND 5.0 08/10/23 11:12
3,3'-Dichlorobenzidine ug/L ND 10.0 08/10/23 11:12
4,6-Dinitro-2-methylphenol ug/L ND 10.0 08/10/23 11:12
4-Bromophenylphenyl ether ug/L ND 5.0 08/10/23 11:12
4-Chloro-3-methylphenol ug/L ND 5.0 08/10/23 11:12
4-Chlorophenylphenyl ether ug/L ND 5.0 08/10/23 11:12
4-Nitrophenol ug/L ND 10.0 08/10/23 11:12
Acenaphthene ug/L ND 5.0 08/10/23 11:12
Acenaphthylene ug/L ND 5.0 08/10/23 11:12
Anthracene ug/L ND 5.0 08/10/23 11:12
Benzidine ug/L ND 50.0 08/10/23 11:12
Benzo(a)anthracene ug/L ND 5.0 08/10/23 11:12
Benzo(a)pyrene ug/L ND 5.0 08/10/23 11:12
Benzo(b)fluoranthene ug/L ND 5.0 08/10/23 11:12
Benzo(g,h,i)perylene ug/L ND 5.0 08/10/23 11:12
Benzo(k)fluoranthene ug/L ND 5.0 08/10/23 11:12
bis(2-Chloroethoxy)methane ug/L ND 10.0 08/10/23 11:12
bis(2-Chloroethyl)ether ug/L ND 5.0 08/10/23 11:12
bis(2-Ethylhexyl)phthalate ug/L ND 5.0 08/10/23 11:12
Butylbenzylphthalate ug/L ND 5.0 08/10/23 11:12
Chrysene ug/L ND 5.0 08/10/23 11:12
Di-n-butylphthalate ug/L ND 5.0 08/10/23 11:12
Di-n-octylphthalate ug/L ND 5.0 08/10/23 11:12
Dibenz(a,h)anthracene ug/L ND 5.0 08/10/23 11:12
Diethylphthalate ug/L ND 5.0 08/10/23 11:12
Dimethylphthalate ug/L ND 5.0 08/10/23 11:12
Fluoranthene ug/L ND 5.0 08/10/23 11:12
Fluorene ug/L ND 5.0 08/10/23 11:12
Hexachloro-1,3-butadiene ug/L ND 5.0 08/10/23 11:12
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39AM without the written consent of Pace Analytical Services,LLC. Page 19 of 36

Pace Analytical Services,LLC
Pace'/� 7726 Moller Road
/J/ /�+ Indianapolis,IN 46268
(,�(�,/�J [phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
METHOD BLANK: 4105871 Matrix: Water
Associated Lab Samples: 50351209001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Hexachlorobenzene ug/L ND 5.0 08/10/23 11:12
Hexachlorocyclopentadiene ug/L ND 10.0 08/10/23 11:12
Hexachloroethane ug/L ND 5.0 08/10/23 11:12
Indeno(1,2,3-cd)pyrene ug/L ND 5.0 08/10/23 11:12
Isophorone ug/L ND 10.0 08/10/23 11:12
N-Nitroso-di-n-propylamine ug/L ND 5.0 08/10/23 11:12
N-Nitrosodimethylamine ug/L ND 5.0 08/10/23 11:12
N-Nitrosodiphenylamine ug/L ND 10.0 08/10/23 11:12
Naphthalene ug/L ND 5.0 08/10/23 11:12
Nitrobenzene ug/L ND 5.0 08/10/23 11:12
Pentachlorophenol ug/L ND 10.0 08/10/23 11:12
Phenanthrene ug/L ND 5.0 08/10/23 11:12
Phenol ug/L ND 5.0 08/10/23 11:12
Pyrene ug/L ND 5.0 08/10/23 11:12
2,4,6-Tribromophenol(S) % 107 10-137 08/10/23 11:12
2-Fluorobiphenyl(S) % 67 15-120 08/10/23 11:12
2-Fluorophenol(S) % 61 10-120 08/10/23 11:12
Nitrobenzene-d5(S) % 84 10-120 08/10/23 11:12
Phenol-d6(S) % 46 10-120 08/10/23 11:12
Terphenyl-d14(S) % 134 11-131 08/10/23 11:12 S3
LABORATORY CONTROL SAMPLE: 4105872
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
1,2,4-Trichlorobenzene ug/L 100 48.2 48 44-142
1,2-Diphenylhydrazine ug/L 100 78.0 78 25-150
2,2'-Oxybis(1-chloropropane) ug/L 100 57.9 58 36-166
2,4,6-Trichlorophenol ug/L 100 78.3 78 37-144
2,4-Dichlorophenol ug/L 100 61.9 62 1-191
2,4-Dimethylphenol ug/L 100 64.2 64 32-119
2,4-Dinitrophenol ug/L 500 388 78 1-181
1 2,4-Dinitrotoluene ug/L 100 67.6 68 39-139
2,6-Dinitrotoluene ug/L 100 71.6 72 50-158
2-Chloronaphthalene ug/L 100 62.7 63 60-118
2-Chlorophenol ug/L 100 62.8 63 23-134
2-Nitrophenol ug/L 100 70.9 71 29-182
3,3'-Dichlorobenzidine ug/L 200 114 57 1-262
4,6-Dinitro-2-methylphenol ug/L 200 178 89 1-181
4-Bromophenylphenyl ether ug/L 100 68.1 68 53-127
4-Chloro-3-methylphenol ug/L 200 123 61 22-147
4-Chlorophenylphenyl ether ug/L 100 66.3 66 25-158
4-Nitrophenol ug/L 500 179 36 1-132
Acenaphthene ug/L 100 65.5 66 47-145
Acenaphthylene ug/L 100 66.4 66 33-145
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39AM without the written consent of Pace Analytical Services,LLC. Page 20 of 36

Pace Analytical Services,LLC
ace'/� 7726 Moller Road
%// a Indianapolis,IN 46268
�(v�J [phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
LABORATORY CONTROL SAMPLE: 4105872
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Anthracene ug/L 100 62.2 62 1-166
Benzidine ug/L 200 ND 2 10-130 L2
Benzo(a)anthracene ug/L 100 68.6 69 33-143
Benzo(a)pyrene ug/L 100 70.1 70 17-163
Benzo(b)fluoranthene ug/L 100 69.7 70 24-159
Benzo(g,h,i)perylene ug/L 100 73.6 74 1-219
Benzo(k)fluoranthene ug/L 100 72.8 73 11-162
bis(2-Chloroethoxy)methane ug/L 100 62.8 63 33-184
bis(2-Chloroethyl)ether ug/L 100 63.2 63 12-158
bis(2-Ethylhexyl)phthalate ug/L 100 75.5 75 8-158
Butylbenzylphthalate ug/L 100 80.1 80 1-152
Chrysene ug/L 100 68.0 68 17-168
Di-n-butylphthalate ug/L 100 65.7 66 1-118
Di-n-octylphthalate ug/L 100 69.3 69 4-146
Dibenz(a,h)anthracene ug/L 100 70.2 70 1-227
Diethylphthalate ug/L 100 60.9 61 1-114
Dimethylphthalate ug/L 100 61.9 62 1-112
Fluoranthene ug/L 100 61.4 61 26-137
Fluorene ug/L 100 66.0 66 59-121
Hexachloro-1,3-butadiene ug/L 100 45.2 45 24-116
Hexachlorobenzene ug/L 100 69.1 69 1-152
Hexachlorocyclopentadiene ug/L 100 52.0 52 25-150
Hexachloroethane ug/L 100 42.6 43 40-113
Indeno(1,2,3-cd)pyrene ug/L 100 69.3 69 1-171
Isophorone ug/L 100 64.2 64 21-196
N-Nitroso-di-n-propylamine ug/L 100 69.0 69 1-230
N-Nitrosodimethylamine ug/L 100 51.6 52 25-150
N-Nitrosodiphenylamine ug/L 100 71.7 72 25-150
Naphthalene ug/L 100 52.3 52 21-133
Nitrobenzene ug/L 100 63.9 64 35-180
Pentachlorophenol ug/L 200 142 71 14-176
Phenanthrene ug/L 100 68.8 69 54-120
Phenol ug/L 100 41.2 41 5-112
Pyrene ug/L 100 84.6 85 52-115
2,4,6-Tribromophenol(S) % 74 10-137
2-Fluorobiphenyl(S) % 60 15-120
2-Fluorophenol(S) % 44 10-120
Nitrobenzene-d5(S) % 63 10-120
Phenol-d6(S) % 35 10-120
Terphenyl-d14(S) % 74 11-131
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 21 of 36 i

Pace Analytical Services,LLC
7726 Moller Road
Pace Indianapolis,IN 46268
[phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4105873 4105874
MS MSD
92680892004 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
1,2,4-Trichlorobenzene ug/L ND 100 100 25.6 26.6 26 27 44-142 4 30 M1
2,2'-Oxybis(1- ug/L ND 100 100 29.3 37.6 29 38 36-166 25 30 M1
chloropropane)
2,4,6-Trichlorophenol ug/L ND 100 100 39.7 15.3J 40 15 37-144 30 M1
2,4-Dichlorophenol ug/L ND 100 100 33.9 25.4 34 25 1-191 29 30
2,4-Dimethylphenol ug/L ND 100 100 35.9 41.6 36 42 32-119 15 30
2,4-Dinitrophenol ug/L ND 500 500 345 ND 69 0 1-181 30 M1
2,4-Dinitrotoluene ug/L ND 100 100 62.1 70.8 62 71 39-139 13 30
2,6-Dinitrotoluene ug/L ND 100 100 41.5 49.2 41 49 50-158 17 30 M1
2-Chloronaphthalene ug/L ND 100 100 31.6 36.3 32 36 60-118 14 30 M1
2-Chlorophenol ug/L ND 100 100 33.1 30.8 33 31 23-134 7 30
2-Nitrophenol ug/L ND 100 100 37.3 30.8 37 31 29-182 19 30
3,3'-Dichlorobenzidine ug/L ND 200 200 124 178 62 89 1-262 36 30 R1
4,6-Dinitro-2-methylphenol ug/L ND 200 200 201 ND 101 7 1-181 30
4-Bromophenylphenyl ether ug/L ND 100 100 40.9 47.5 41 47 53-127 15 30 M1
4-Chloro-3-methylphenol ug/L ND 200 200 68.7 80.3 34 40 22-147 16 30
4-Chlorophenylphenyl ether ug/L ND 100 100 32.8 39.8 33 40 25-158 19 30
4-Nitrophenol ug/L ND 500 500 212 ND 42 0 1-132 30 M1
Acenaphthene ug/L ND 100 100 32.5 39.1 32 39 47-145 18 30 M1
Acenaphthylene ug/L ND 100 100 32.5 39.4 33 39 33-145 19 30
Anthracene ug/L ND 100 100 57.3 62.8 57 63 1-166 9 30
Benzidine ug/L ND 200 200 ND ND 0 10 10-130 30 MO
Benzo(a)anthracene ug/L ND 100 100 92.5 105 92 105 33-143 12 30
Benzo(a)pyrene ug/L ND 100 100 93.4 105 93 105 17-163 12 30
Benzo(b)fluoranthene ug/L ND 100 100 95.7 110 96 110 24-159 14 30
Benzo(g,h,i)perylene ug/L ND 100 100 102 122 102 122 1-219 18 30
Benzo(k)fluoranthene ug/L ND 100 100 93.1 106 93 106 11-162 13 30
bis(2- ug/L ND 100 100 32.9 39.4 33 39 33-184 18 30
Chloroethoxy)methane
bis(2-Chloroethyl)ether ug/L ND 100 100 32.3 44.8 32 45 12-158 33 30 R1
bis(2-Ethylhexyl)phthalate ug/L ND 100 100 92.8 105 93 105 8-158 12 30
Butylbenzylphthalate ug/L ND 100 100 105 111 105 111 1-152 5 30
Chrysene ug/L ND 100 100 91.5 105 92 105 17-168 14 30
Di-n-butylphthalate ug/L ND 100 100 83.6 96.5 84 97 1-118 14 30
Di-n-octylphthalate ug/L ND 100 100 95.3 113 95 113 4-146 17 30
Dibenz(a,h)anthracene ug/L ND 100 100 99.9 119 100 119 1-227 17 30
Diethylphthalate ug/L ND 100 100 54.8 57.7 55 58 1-114 5 30
Dimethylphthalate ug/L ND 100 100 38.2 43.8 38 44 1-112 14 30
Fluoranthene ug/L ND 100 100 79.6 95.8 80 96 26-137 19 30
Fluorene ug/L ND 100 100 33.5 42.8 33 43 59-121 24 30 M1
Hexachloro-1,3-butadiene ug/L ND 100 100 24.4 23.9 24 24 24-116 2 30
Hexachlorobenzene ug/L ND 100 100 49.1 58.0 49 58 1-152 17 30
Hexachlorocyclopentadiene ug/L ND 100 100 19.2J 17.4J 19 17 25-150 30 M1
Hexachloroethane ug/L ND 100 100 22.5 23.6 22 24 40-113 5 30 M1
Indeno(1,2,3-cd)pyrene ug/L ND 100 100 98.8 118 99 118 1-171 18 30
Isophorone ug/L ND 100 100 34.9 43.0 35 43 21-196 21 30
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 22 of 36

Pace Analytical Services,LLC
^///'''���///'''��� 7726 Moller Road
/// �+ Indianapolis,IN 46268
(�(v�J [phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4105873 4105874
MS MSD
92680892004 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
N-Nitroso-di-n-propylamine ug/L ND 100 100 36.1 45.8 36 46 1-230 24 30
N-Nitrosodimethylamine ug/L ND 100 100 28.4 35.4 28 35 25-150 22 30
N-Nitrosodiphenylamine ug/L ND 100 100 46.6 52.6 47 53 25-150 12 30
Naphthalene ug/L ND 100 100 28.4 31.5 28 31 21-133 10 30
Nitrobenzene ug/L ND 100 100 35.7 42.6 36 43 35-180 18 30
Pentachlorophenol ug/L ND 200 200 161 29.9 81 15 14-176 137 30 R1
Phenanthrene ug/L ND 100 100 61.6 63.4 62 63 54-120 3 30
Phenol ug/L ND 100 100 24.2 24.4 24 24 5-112 1 30
Pyrene ug/L ND 100 100 102 102 102 102 52-115 0 30
2,4,6-Tribromophenol(S) % 71 39 10-137
2-Fluorobiphenyl(S) % 38 38 15-120
2-Fluorophenol(S) % 29 16 10-120
Nitrobenzene-d5(S) % 41 45 10-120
Phenol-d6(S) % 26 22 10-120
Terphenyl-d14(S) % 119 105 11-131
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39AM without the written consent of Pace Analytical Services,LLC. Page 23 of 36

Pace Analytical Services,LLC
ace-/� 7726 Moller Road
/// e Indianapolis,IN 46268
(,�(v�J [phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
QC Batch: 792642 Analysis Method: SM 2540D-2015
QC Batch Method: SM 2540D-2015 Analysis Description: 2540D Total Suspended Solids
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 50351209001
I METHOD BLANK: 4107466 Matrix: Water
Associated Lab Samples: 50351209001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Suspended Solids mg/L ND 2.5 08/10/23 12:14
LABORATORY CONTROL SAMPLE: 4107467
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Total Suspended Solids mg/L 250 236 94 90-110
SAMPLE DUPLICATE: 4107818
92681221001 Dup Max
Parameter Units Result Result RPD RPD Qualifiers
Total Suspended Solids mg/L ND ND 25
SAMPLE DUPLICATE: 4107819
92681293003 Dup Max
Parameter Units Result Result RPD RPD Qualifiers
Total Suspended Solids mg/L 188 230 20 25
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 24 of 36

Pace Analytical Services,LLC
/ ace Indianapolis,IN 46268
[phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
QC Batch: 792285 Analysis Method: SM 5210B-2011
QC Batch Method: SM 5210B-2011 Analysis Description: 5210B BOD,5 day
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 50351209001
METHOD BLANK: 4105761 Matrix: Water
Associated Lab Samples: 50351209001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
BOD,5 day mg/L ND 2.0 08/14/23 09:15 B3
LABORATORY CONTROL SAMPLE: 4105763
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
BOD,5 day mg/L 198 196 99 84.6-115 B3
SAMPLE DUPLICATE: 4105764
92681418001 Dup Max
Parameter Units Result Result RPD RPD Qualifiers
BOD,5 day mg/L 437 460 5 25 B3
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 25 of 36

Pace Analytical Services,LLC
n/�//'��_ 7726 Moller Road
Pace'r+ Indianapolis,IN 46268
{.�V VV [phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
QC Batch: 793145 Analysis Method: EPA 9040C
QC Batch Method: EPA 9040C Analysis Description: 9040 pH
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 50351209001
SAMPLE DUPLICATE: 4110161
92682097006 Dup Max
Parameter Units Result Result RPD RPD Qualifiers
pH at 25 Degrees C Std. Units 9.5 9.5 0 10 H3
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 26 of 36

Pace Analytical Services,LLC
ace-'
///111 7726 Moller Road
iI/ F+p Indianapolis,IN 46268
(�(�/ / [phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
QC Batch: 792925 Analysis Method: EPA 350.1 Rev 2.0 1993
QC Batch Method: EPA 350.1 Rev 2.0 1993 Analysis Description: 350.1 Ammonia
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 50351209001
METHOD BLANK: 4109128 Matrix: Water
Associated Lab Samples: 50351209001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Nitrogen,Ammonia mg/L ND 0.10 08/11/23 14:17
LABORATORY CONTROL SAMPLE: 4109129
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Nitrogen,Ammonia mg/L 5 5.0 99 90-110
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4109130 4109131
MS MSD
92680667001 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
Nitrogen,Ammonia mg/L 1.1 5 5 6.0 6.0 98 98 90-110 0 10
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4109132 4109133
MS MSD
92680684002 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
Nitrogen,Ammonia mg/L 50.8 5 5 54.9 55.1 82 86 90-110 0 10 M1
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 27 of 36

Pace Analytical Services,LLC
7726 Moller Road
ace Indianapolis,IN 46268
[phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
QC Batch: 792315 Analysis Method: EPA 420.4 Rev 1.0 1993
QC Batch Method: EPA 420.4 Rev 1.0 1993 Analysis Description: 420.4 Phenolics
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 50351209001
METHOD BLANK: 4105826 Matrix: Water
Associated Lab Samples: 50351209001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Phenolics,Total Recoverable mg/L ND 0.020 08/09/23 10:57
LABORATORY CONTROL SAMPLE: 4105827
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Phenolics,Total Recoverable mg/L 0.05 0.053 106 90-110
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4105828 4105829
MS MSD
92680834002 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
Phenolics,Total mg/L 0.13 0.05 0.05 0.19 0.22 108 168 90-110 15 10 M1,R1
Recoverable
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 28 of 36

Pace Analytical Services,LLC
7726 Moller Road
aceIndianapolis,IN 46268
[phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
QC Batch: 792306 Analysis Method: SM 4500-CN-E-2011 j
QC Batch Method: SM 4500-CN-E-2011 Analysis Description: 4500CNE Cyanide,Total
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 50351209001
METHOD BLANK: 4105788 Matrix: Water
Associated Lab Samples: 50351209001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Cyanide mg/L ND 0.0080 08/10/23 12:02
LABORATORY CONTROL SAMPLE: 4105789
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Cyanide mg/L 0.1 0.082 82 80-120
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4105790 4105791
MS MSD
92681415001 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
Cyanide mg/L ND 0.1 0.1 0.097 0.082 93 78 80-120 17 10 M1,R1
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4105792 4105793
MS MSD
92681417001 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
Cyanide mg/L ND 0.1 0.1 0.091 0.096 86 91 80-120 5 10
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
P P P
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 29 of 36

Pace Analytical Services,LLC
a/ace' 7726 Moller Road
a Indianapolis,IN 46268
v�J [phone]
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
QC Batch: 792687 Analysis Method: SM 5220D-2011
QC Batch Method: SM 5220D-2011 Analysis Description: 5220D COD
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 50351209001
METHOD BLANK: 4107635 Matrix: Water
Associated Lab Samples: 50351209001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Chemical Oxygen Demand mg/L ND 25.0 08/10/23 16:43
LABORATORY CONTROL SAMPLE: 4107636
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Chemical Oxygen Demand mg/L 750 766 102 90-110
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4107637 4107638
MS MSD
92680914002 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
Chemical Oxygen Demand mg/L 36.2 100 100 145 145 109 109 90-110 0 3
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4107639 4107640
MS MSD
92681178001 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
Chemical Oxygen Demand mg/L 84.9 100 100 187 187 102 102 90-110 0 3
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 30 of 36

T
Pace Analytical Services,LLC
Pace' 7726 Moller Road
Indianapolis,IN 46268
[phone] 1
QUALITY CONTROL DATA
Project: NC-Concord Groundwater
Pace Project No.: 50351209
QC Batch: 795532 Analysis Method: SM 5310B-2014
QC Batch Method: SM 5310B-2014 Analysis Description: 5310E TOC
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 50351209001
METHOD BLANK: 4122182 Matrix: Water
Associated Lab Samples: 50351209001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Organic Carbon mg/L ND 1.0 08/24/23 00:57
LABORATORY CONTROL SAMPLE: 4122183
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Total Organic Carbon mg/L 25 24.0 96 90-110
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4120115 4120116
MS MSD
92681405001 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
Total Organic Carbon mg/L ND 25 25 23.7 24.0 94 95 90-110 1 10
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4122184 4122185
MS MSD
92682803003 Spike Spike MS MSD MS MSD %Rec Max
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual
Total Organic Carbon mg/L ND 25 25 25.0 25.0 99 99 90-110 0 10
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 31 of 36

Pace Analytical Services,LLC
ace„/1 7726 Moller Road
%// /�+ Indianapolis,IN 46268
(,(�/�,/ [phone]
QUALIFIERS
Project: NC-Concord Groundwater
Pace Project No.: 50351209
DEFINITIONS
DF-Dilution Factor, if reported,represents the factor applied to the reported data due to dilution of the sample aliquot.
ND-Not Detected at or above adjusted reporting limit.
TNTC-Too Numerous To Count
J-Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL-Adjusted Method Detection Limit.
PQL-Practical Quantitation Limit.
RL-Reporting Limit-The lowest concentration value that meets project requirements for quantitative data with known precision and
bias for a specific analyte in a specific matrix.
S-Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270.The result for each analyte is
a combined concentration.
Consistent with EPA guidelines,unrounded data are displayed and have been used to calculate%recovery and RPD values.
LCS(D)-Laboratory Control Sample(Duplicate)
MS(D)-Matrix Spike(Duplicate)
DUP-Sample Duplicate
RPD-Relative Percent Difference
NC-Not Calculable.
SG-Silica Gel-Clean-Up
U-Indicates the compound was analyzed for,but not detected.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Reported results are not rounded until the final step prior to reporting.Therefore,calculated parameters that are typically reported as
"Total"may vary slightly from the sum of the reported component parameters.
Pace Analytical is TNI accredited.Contact your Pace PM for the current list of accredited analytes.
TNI-The NELAC Institute.
ANALYTE QUALIFIERS
AC Analysis of acrolein and/or acrylonitrile was performed from a sample that was field preserved to pH<2,which is less
than the pH range of 4-5 specified in the test method and required for NPDES compliance per 40CFR Part 136.
B3 The dissolved oxygen depletion of the dilution water blank exceeded 0.2 mg/L.
H3 Sample was received or analysis requested beyond the recognized method holding time.
L1 Analyte recovery in the laboratory control sample(LCS)was above QC limits. Results for this analyte in associated
samples may be biased high.
L2 Analyte recovery in the laboratory control sample(LCS)was below QC limits. Results for this analyte in associated
samples may be biased low.
MO Matrix spike recovery and/or matrix spike duplicate recovery was outside laboratory control limits.
M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample(LCS)recovery.
P5 The EPA or method required sample preservation degrades this compound,therefore acceptable recoveries may not be
achieved in sample matrix spikes.
R1 RPD value was outside control limits.
S3 Surrogate recovery exceeded laboratory control limits.Analyte presence below reporting limits in associated sample.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC. Page 32 of 36

Pace Analytical Services,LLC
ace 7726 Moller Road
Indianapolis,IN 46268
[phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: NC-Concord Groundwater
Pace Project No.: 50351209
Analytical
Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch i
50351209001 Sample 1 EPA 608.3 792101 EPA 608.3 792595
50351209001 Sample 1 EPA 200.7 792369 EPA 200.7 792461
50351209001 Sample 1 EPA 245.1 795988 EPA 245.1 796016
50351209001 Sample 1 EPA 625.1 792337 EPA 625.1 792694
50351209001 Sample 1 EPA 624.1 792436
50351209001 Sample 1 SM 2540D-2015 792642
50351209001 Sample 1 SM 5210B-2011 792285 SM 5210B-2011 792304
50351209001 Sample 1 EPA 9040C 793145
50351209001 Sample 1 EPA 350.1 Rev 2.0 1993 792925
50351209001 Sample 1 EPA 420.4 Rev 1.0 1993 792315 EPA 420.4 Rev 1.0 1993 792344
50351209001 Sample 1 SM 4500-CN-E-2011 792306 SM 4500-CN-E-2011 792688
50351209001 Sample 1 SM 5220D-2011 792687 SM 5220D-2011 792816
50351209001 Sample 1 SM 5310B-2014 795532
REPORT OF LABORATORY ANALYSIS
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Date: 10/11/2023 11:39 AM without the written consent of Pace Analytical Services,LLC, Page 33 of 36

//('�� CHAIN-OF-CUSTODY / Analytical Request Document
T ace The Chain-of-Custody is a LEGAL DOCUMENT.All relevant fields must be completed ac
Submitting a sample via this chain of custody constitutes acknowledgment and acceptance of the Pace Terms and Conditions found at https://info.pacelabs.com/hubfs/pas-1
Section A Section B Section C
Required Client Information: Required Project Information: Invoice Information:
Company. Eli Lilly 8 Company Report To. Griesemer,Bran Attention.
Address Corporate Center Copy To: Company Name:
Building 147-LTC South,Indianapolis,IN 46285 Address.
Email: [e-mail] Purchase Order#: Pace Quote:
Phone. [phone] IFax Project Name: Diesel Pace Project Manager: erick.hanna@pacelabscom,
Requested Due Date: Project#: Pace Profile#: 14584
Requested Analysts Filtered(VI
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SIGNATURE of SAMPLER: DATE Signed:

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Saaed
DC#—Title: ENV-FRM-HUN1-0083 v02—Sample Condition Upon Receipt
Effective Date: 11/14/2022
Laboratory receiving samples:
Asheville ❑ Eden❑ Greenwood ❑ Huntersville Raleigh❑ Mechanicsville❑ Atlantan Kernersville❑
Sample Condition Client Name:
Upon Receipt Project U:
/f) 6,2te.i
Courier: ❑Fed Ex CUPS ( ❑LISPS 1®Cl ent
0 Commercial ❑Pace ❑Other: Y
Custody Seal Present? Oyes 613,No Seals Intact? Oyes .No t (/I /�
Date/Initials Person Examining Contents: PJ A 4J
Packing Material: ❑Bubble Wrap [Bubble Bags ❑None ❑ Other Biological Tissue Frozen?
Thermometer:
Dyes ❑No .N/A
IR Gun ID: 2(0 c Type of Ice: Wet OBlue ['None
`7 Correction Factor:
Cooler Temp: �` Add/Subtract('C) `� Temp should be above freezing to 6°C
Cooler Temp Corrected(°C): —7, 3 ❑Samples Out of temp criteria.Samples on ice,cooling process
has begun
USDA Regulated Soil(®N/A,water sample)
Did samples originate in a quarantine zone within the United States:CA,NY,or SC Did samples originate from a foreign source(internationally,
(check maps)?Oyes WNo including Hawaii and Puerto Rico)o Oyes JEINo
Comments/Discrepancy: 7
Chain of Custody Present? glYes ONo ON/A 1.
Samples Arrived within Hold Time? (Oyes ONo ON/A 2.
Short Hold Time Analysis(<72 hr.)? glYes ONo ON/A 3.
Rush Turn Around Time Requested? ❑Yes ONo RN/A 4.
Sufficient Volume? QJYes ❑No ON/A S. _
Correct Containers Used? Yes ❑No ON/A 6.
-Pace Containers Used? RlYes ONo ON/A
Containers Intact? Yes ONo ON/A 7.
CDissolved analysis:Samples Field Filtered? ❑Yes ONo gIN/A 8.
Sample labels Match COC? Oyes ONo rmN/A 9.
-Includes Date/Time/ID/Analysis Matrix: 11✓1
Headspace in VOA Vials(>5-6mm)? ❑Yes 53No ON/A 10. _
Trip Blank Present? Oyes ONo RN/A 11.
Trip Blank Custody Seals Present? ❑Yes ONo giN/A
COMMENTS/SAMPLE DISCREPANCY Field Data Required? Ores ONo
rl
///V) S Lr�c_- 4--7•L
W(l& 1' 'i ei'f‘i,_/ /;, .. ' 773 6 ! 00
lot ID of split containers:
CLIENT NOTIFICATION/RESOLUTION
Person contacted: Date/Time:
Project Manager SCURF Review: Date:
Project Manager SRF Review: Date:
Qualtrax ID: 69614 Page 1 of 2