WQ0031725_2023 Residual Annual Report_20240228 (2)

Initial Review
Reviewer
nathaniel.thorn burg
Is this submittal an application? (Excluding additional information.) *
Yes No
If not an application what is the submittal type?* Annual Report
Residual Annual Report
Additional Information
Other
Annual Report Year* 2023
Permit Number (IR) * WQ0031725
Applicant/Permittee Baxter Healthcare Corporation
Email Notifications
Does this need review by the hydrogeologist? * Yes U No
Regional Office Asheville
CO Reviewer
Admin Reviewer Wanda Gerald

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
Name* Derek Bouchard
Email Address*
derek—[e-mail]
Project Information
.........................
Application/Document Type*
New (Fee Required)
Modification - Major (Fee Required)
Renewal with Major Modification (Fee
Required)
Annual Report
Additional Information
Other
Phone Number*
8287566644
Modification - Minor
Renewal
GW-59, NDMR, NDMLR, NDAR-1,
N DAR-2
Residual Annual Report
Change of Ownership
We no longer accept these monitoring reports through this portal. Please click on the link below and it will take you to the correct form.
https://edoes.deq.nc.gov/Forms/NonDischarge_Monitoring_Report
Permit Type:*
Wastewater Irrigation
High -Rate Infiltration
Other Wastewater
Reclaimed Water
Closed -Loop Recycle
Residuals
Single -Family Residence Wastewater
Other
Irrigation
Permit Number:*
WQ0031725
Has Current Existing permit number
Applicant/Permittee Address*
65 Pitts Station Rd. Marion, NC 28752
Facility Name*
Baxter Healthcare Corporation Class B Residuals Program
Please provide comments/notes on your current submittal below.
At this time, paper copies are no longer required. If you have any questions about what is required, please contact Nathaniel Thornburg
at [e-mail].
Please attach all information required or requested for this submittal to be reviewed here.
(Application Form, Engineering Plans, Specifications, Calculations, Etc.)
2023 Annual Land Application Report WQ0031725.pdf 1.35MB
Upload only 1 PDF document (less than 250 MB). Multiple documents must be combined into one PDF file unless file is larger
than upload limit.
* By checking this box, I acknowledge that I understand the application will not be accepted for pre -review until the fee (if required) has
been received by the Non -Discharge Branch. Application fees must be submitted by check or money order and made payable to the
North Carolina Department of Environmental Quality (NCDEQ). I also confirm that the uploaded document is a single PDF with all parts
of the application in correct order (as specified by the application).
Mail payment to:
NCDEQ — Division of Water Resources
Attn: Non -Discharge Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Signature
01-mo fflowA�il".11
Submission Date 2/28/2024

a
February 27, 2024
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, NC27699-1617
RE: 2023 Annual Land Application Report
Permit No. WQ0031725
Baxter Healthcare Corporation
McDowell County
Please find the enclosed annual land application report for calendar year 2023. No non-
compliance or other irregular events occurred in 2023.
If you have any questions or require additional information, please contact me at 828-756-6644
or via email at derek—[e-mail].
Sincerely,
Derek Bouchard
Environmental Manager
Attachment: 2023 Land Application Report

ANNUAL LAND APPLICATION CERTIFICATION FORM
WQ Permit#: WQ0031725 County: McDowell Year: 2023
Facility Name (as shown on permit): Baxter Healthcare Corporation
Land Application Operator: U.S. Biosolids, Inc. Phone: [phone]
Land application of residuals as allowed by the permit occurred during the past calendar year?
0 Yes ® No - If No, skip Part A, and Part B and proceed to Part C. Also, if residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
Part _A_- Residuals Application Summary:
Total number of a22lication fields in thepermit:
10
Total number of fields utilized for land application during the year:
7
Total amount of dry tons applied during the year for all application sites:
134.63
Total number of acres utilizes for land application during the year:
55.87
Part _B_- Annual Compiance Statement:
Facilitycompliant during
was p g calendar year 2023 with all conditions of the land application permit
(including but not limited to items 1-13 below) issued by the Division of Water Resources. 2 Yes 0 No
If no please, provide a written description why the facility was not compliant, the dates, and explain corrective action
taken.
1) Only residuals approved for this permit were applied to the permitted sites.
2) Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at least 6.0 or the
limit specified in the permit.
3) Annual soils analysis were performed on each site receiving residuals during the past calendar year and three (3) copies of
laboratory results are attached.
4) Annual TCLP analysis (if required) was performed and three (3) copies of certified laboratory results are attached.
5) All other monitoring was performed in accordance with the permit and reported during the year as required and three (3)
copies of certified laboratory results are attached.
6) The facility did not exceed any of the Pollutant Concentration Limits in 15A NCAC 02T .1105(a) or the Pollutant Loading
Rates in 15A NCAC 02T .1105(b) (applicable to 40 CFR Part 503 regulated facilities).
7) All general requirements in as specified in the Land Application Permit were complied with (applicable to 40 CFR Part
503 regulated facilities).
8) All monitoring and reporting requirements in 15A NCAC 02T. 1111 were complied with (applicable to 40 CFR Part 503
regulated facilities).
9) All operations and maintenance requirements in the permit were complied with or, in the case of a deviation, prior
authorization was received from the Division of Water Resources.
10) No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of violations are
attached to include appropriate actions and rernediations.
11) Vegetative cover was maintained and proper crop management was performed on each site receing residuals, as specified
in the permit.
12) No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
13) All buffer requirements as specified on the permit were maintained during each application of residuals.
Part C - Certification:
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate,
and complete. I am aware that there are significant penalties for submitting false information, including the possibility
of fines and imprisonment for knowing violations."
Permittee Name and Ti type or print) Signature of ermittee Date
CLC.IL /1
Signature of Preparcr* Date
(if different from Permittee)
* Preparer is defined in 40 CFR Part 503.9 (r) and 15A NCAC 02T
Date
(if different from Permittee and Preparer)
1102 (26) DENR FORM ACF (12/2006)

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ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 11.94
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator:
Acres Used:
Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
5.5 Acres Permitted: 5.5 Site #: DP Field #: lA
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sa
or
posite
Date
Total
Phos-
phorusIMENEEMENEENE.
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
J]
3
4-
?_i
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1{3_
19
12
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--
_�.i
..6._;
,8
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DT/Ac./
App-
Event
2.17
•.
Arsenic
0.043
0.000
0.000
0.000
F 0�000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.043
Cadmium
0.003
0.000
0.000
0..000
0.000
0.000
0.000
0:0.00
0.000
0A00
0.000
0.000
0.003
Copper
0..764
0.000
0.000
0.000
0,000
0.000:
0.000
0,000
0.000
0.000
0.000
0.000..
0.764
hromiu
0.192
0.000
0.000
0.000
0.000
0.000
0.0.00
0.000
0,000
0.000
0.000
0.000
0.192
Lead
0.:033
0.000
0.000
0.000
0,000
0,000
0.000
0.000
..0.000
0.000
0.000
0.000
0.033
Mercury
0.005
0.000
0.0.00
0.000
F 0.000
0.000
uool
0,000
"0:,000
0.000.
0000
0.000
0:005
Molyb-
0.02.4
0.000 .,
0.000
0.000
0.000
0.000
0A00
0.000
0.000
0.000
0.000
0,000
0.024
denum
denum
Nickel
0.095
:0A00
0.000
0.000
0.000
0,000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.098
Selenium
0.015
0.000
0.000
0:0.00
0:000
0.000
0.000
0.000
0.000
0.000:
0.000
0.000..0,015
Zinc
0.699
0.000
0.000
0.000
6.000
0.000
0.00.0
0A0
0.000
0.000 1
0.000
0.000
0.;699
Total
Phos-
83.325
0.000
0.000
0.000
0::000
0.000
0.000
0A00
0.000.
0.060
0.000
0.000
83.328
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
L 1-31-2024
Signature of La Applier Date
DENR FORM MFLSF (12/2006)

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ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 6.05
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 3 Acres Permitted: 3 Site #: DP Field #: IC
Recidun] Analvcic Data (Heavy Metals and Total Phosphorus use mPAR. % Solids use Raw Percent #):
Total
Phos-
p4lor-us
annuai
heavy avtezai rmiu i.uaujngs
tuaicutaceu xis juatawrcj.
Total
1 %
...2Z .
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App.
Event
2.02
Arsenic
0..040 1
0.000:
0..000
0.000
1 0,000
0.000
0.000
0.000
0.000
0.000' :
0..000
0.000 ;1
0.040
Cadmium
0.003
0.000
0.000
0.000
0,0.00
0.000
0.000
f1.000
0.000
0.000
0,000
0.000
0.003
Copper
0.709
0.000
" 0.000 .
0.000
0.000
0.00.0
0.000
0.006
0;000
0.000
0.000
0.000
0..709
Cbromiurr
0.179
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.006
0.000
0.000
0.000
0...179
Lead
0.031
0.000
0.000
0.000
0A00
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
.0.031
Mercury
0.005
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.005
Molyb-
0.022
0,000 '
0.000
0.000
0.00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.022
denum
Nickel
0.0.91
0000.
0.000
0.000
0.000 :
0.000
0.00.0
0.000
.0.000. ;
0.000 '
0.000
0.0.00
0.0.91
Selenium
0,014
.0.000
0.000.
0.000
0.000
0.000
01000
0.000
,000
0.000
0.000.
0,000
0.014
Zinc
0.649
0.000
0.000
0,000
0.000
0.000.
0.000
0,000
0.00.0
0.000 '
0.000
0.000
0..649
Total
Phos-
77.376
0.000
0.000
0.000
0.000
0.000
0.000
0.060
0.000
.0.000
0.000
0,000
.77,376
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.. .............................
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
1-31-2024
Signatrl're of Land. lierYYY VVV - T mmm� Date
DENR FORM MFLSF (1212006)

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ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name:
Permit #:
Operator:
Acres Used:
Baxter Healthcare Corporation Total Dry Tons Applied (Annual):
WQ0031725 Cation Exchange Capacity (non 503 only):
Douglas Poplin Owner: Douglas Poplin Predominant Soil Series:
7.617 Acres Permitted: 14.6 Site #: DP Field #: 3-Corn
16.79
FcB2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent ft
Total
P hos-
..
Annual Heavv Metal Field Loadings (Calculated in lbs/acre):
Total
? -
?_ €
4.'
5 EE
6
71
8�
9
101
1i7
121
DT/Ac./
App.
y
Event
2.20
Arsenic
0.044
" 0.000
0.000
0.00.0
0.000
0,000
0.000
0.000
0.000
0.0.00 1.
0„000
0,0.00.
0.044
Cadmium
0.003 ''
0.000
0.000
0..000
0,.000 .
0.000
0.000
0,000
0.000
0.000
0.000
0..000
0.003
Copper
0.776
0.000
0A00.
0.000
0:000
0.000
0.000
0.000
0.00.0
0.000
0.000
0:000
0.776
Chromiurr
0.495
0.000
0.000
0:.000
0.000
0.000
01000
0.000
0,000
0.000
0,000
0.000
0..195
Lead
0.033
0,000 :
0.000
. 0,000
0.000
0.000 .
0.000
t 0.000
0.000
0.000
0.000
. 0.000
0.033
Mercury
0.005
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000:
0.000
0.0.00 ..
'0.005
Molyb-
0.024
0.000
0,000
0.000
0.000
0.000
0.0.00
0.000
0.000
0.000:
0,000
0,000
0.024
n m
Nickel
0.100
1 0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000>
0.000:
0.000
0.000
0.100
Selenium
0.015
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,000
0.000
0.000
:0,000
U15.
Zinc
0.710
0.000
0.000
0,000 :
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 .
0.710
Total
Phos-
84,634
0.000
0.000.
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
84,634
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
1-31-2024
Date
DENR FORM MFLSF (12/2006)

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ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 21.62
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcB2
Acres Used: 6.983 Acres Permitted: 14.6 Site #: DP Field #: 3-Grass
Rocillnal Analvcic Data (Heave Metals and Total Phosphorus use intylkir. % Solids use Raw Percent #i:
Sample
or
posite
D.
.
Total
Phos-
phorus
.annual
heavy lvlelal rlelu LUAU11%3
k%-A11;U1A1e11 111 111114*;1C).
Total
2
3
4 i
5
5
7'
8
9;
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11
12
DT/Ac./
App.
Event
3.10
Arsenic
0.061
0.000
1 0.000
0.000 1
0.000
0.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.061
Cadmium
0.004
0.000
0.000
0.000
0.000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.1004
Copper
1.090
0.000.
0.000
0.000
0,000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
1,090
Chromiurr
0.274
0.000
0..000
0:000
0.000
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.274
Lead
0.047
0.000 :
0.000
0;000
.0.000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.047
Mercury
0.007
0.000
0.000
0::000
. 0.000
0.000
0.000
0,000.
0.000
0.000
0.000
0.000
0,007
Mo1yb-
0.034
0.000.
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,034
n m
Nickel
0.140
0.000:
0.000
0.000
0.000
0.000:
0..000
0,000
0.000
0.000
0.000
0.000
0..140.
Selenium.
0.021
0:00.0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.00:0
0.000
0.021
Zinc
0.997
0.00.0
0.000
i 0.000
0.000
0.000
0,000.
0.000
0.000
0.000
0.000
0:.000
0.997
Total
Phos-
118.886'
0.000
0.000
0.:000
0,000.'.
0.000
0.000 .
0.000
0,000
0.000
0.000
0.000
# ####
nhorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
1-31-2024
Signature of Land 4pplier Date
DENR FORM MFLSF (12/2006)

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ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 23.37
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: Fe82
Acres Used: 8.7 Acres Permitted: 8.7 Site #: DP Field #: 4
Residual Analvsis Data (Heavv Metals and Total Phosphorus use mrJkP, % Solids use Raw Percent #):
Sample
Com-
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Date
Total
P
phorusENNEENEEMEN
M
Annual
Heavy Metal Held Loadings
(calculated to lbs/acre):
Total
'E_,
2'
�..�
61
7
8 i
9
10
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12
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Event
2.69
..
Arsenic
1. 0.053
0.000
0.000
0:000 .'
. 0.000
0.:000
0.000
0.000 .
0.000
0,000
0.000
0.000
0.053
Cadmium'
0:004
O,000
0.000.
0.000
0.000 :
0.000
0.00.0
0.000
0.000 :
0.0.00
0.000
0.000
0.004
Copper
0,945
0.000
0.000
0.0000
0.000
0.000
0.000
0:000
0.000
0.000
0.000
0.000
0.945
Chromium
0,238
0.000
0..000
0.000
0.000
0.000
0.0.00
0.000
0.000
0.000
0.000
0.000
0.238
Lead
0.041
0.000
0.000
0.000
0.000:
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,041
Mercury
0,006..
0.000
0.000
0::000
0.000
0.000
0.000
0.000
0.000.
0.000.
0.000
0.000
0.006
Molyb-
0.030 '
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.00.0
0.000
0.000
0.000
0.030
denum
Nickel
0A21
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000'
0.000
0.000
0.000
: 0.121
Selenium
0.019
0.000
0.000
0.000
0.000
0,000
0.000
0..000
0.000
0.000.
0.000
0.000
0.019
Zinc
0.865
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.865
Total
Phos-
103.142
0.000'
0.000
0 000
0.000
0.000
01000
0.000
0.000
0.000
..6.000
0,000
'
nhorus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for lmowing violations".
Signature of Land, pplier Date
DENR FORM MFLSF (12/2006)

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ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 33.93
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 15.9 Acres Permitted: 15.9 Site #: DP Meld #: 5
Residual Analvsis Data (Heave Metals and Total Phosphorus use me/ke. % Solids use Raw Percent #):
Total
Phos-
!1
Annual
Heavy metal neia Loaaings
tualcuiatea in iDslacre):
Total
DT/Ac./
App.
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? l
2.13
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0.042
0.000
0.000
0.000
0.000
0.000
0.00.0 :
0.0.00
.0.000
0.000
0.000
0.000 :
0.042 .
Cadmium
0.:003
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
: 0.000
0.000
0.000
0,003
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0.751
0.000
0.000
0.000.
0A00
0.000
0.0.00
0,000' :
0.000
0.000
0.000
0.000
0..751
Chromiurr
0..189
0.000
0.000
0.000
0.000
0.000
1 0.000
0.000
0.000
0.000
0.000 '
0.000
0.189
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0.032 .'.
0.000
0.000
0.000
0.000 .'
0.000
0.000
0.000
0.000
0.000
0.000 :
0.000
0 032
Mercury
: 0..005
0.000
0.000
0.000
0.000
0..000
0.000
0A00
0.000
0.000
0.000
0.000
0.005
Molyb-
denum
0.023
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000 ''
0.000
0.000
0.000
0.023
Nickel
0.09E
0.000
0.00.0
0.060
0.000
0 000
0.006
0.000
0.000
1 0.000
0.000 .
0.000
0.096
Selenium
0.0.15
0.000 '
0.000
0.000
..0.000
0.000 '
0.0.00
00.00
0.000
1 0.000
0.000
0:000
.0.015
Zinc
0.687
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.697
otal
os-81.94d
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0.000
0.000
0.000
0.000 .
0.000
0.000
.0.000
0.000
0.000
0.000
0.000:
8L946
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"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
1-31-2024
Signature of La Applier Date
DENR FORM MFLSF (12/2006)

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ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual):
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series:
Acres Used: 5.5 Acres Permitted: 5.5 Site #: DP Field #:
11.14
FcC2
6
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent ft
Total
Phos-
.......
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
_?._l
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4 II
S i
s :
7
81
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DT/Ac./
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Event
2.03
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Arsenic
0.04.0
0.000
0.000
0.000
0.000
0.000.
0.0.00
0.000
0_000
0.000
0.000
0.000
0.040
Cadmium
0.003
0.000
0.000
0.000
0.000
0.000
0.000:
0.000
0,000
0.000
0.000
0.000
0.00.3
Copper
0.713
0.000
0.000
0.000
0.000
0.000
0.000 .
0.000
0.000
0..000
0.000
0.000
0.713
Chromium
0..180
0.00.0
0.000
0.000
0.000
0.000
0:000
0000
0.000
0.000
0.000
0.000
0.180
Lead
0.031
0.000
0.000
0.000
0.000
0.000.
0.000 1
0.000
0.000.1
0.000
0.000
0.000
U31
Mercury
0.005
0.000
0.000
0.000
0A00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.005
Molyb-
0..022
0.000
0..000
0<000
0.000
0 000
0.000
0:.000
0.000
0..000
0.0000
000
0.022
d num
Nickel
0.092
0.000
0.000
0..:000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,092.
Selenium
0.014
0.000
0.000
0.000
0.000
0,000:
0.000
0.000
0.000
0.000
0.000
0.000
0.014
Zinc
0..652
0.000....
&000
0.000
.0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.652
Total
Phos-
77.798
0.000
0.000
GM0
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
77.798
horus
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
1-31-2024
Si ature of LaJApplier_. Date_.
DENR FORM MFLSF (12/2006)

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ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: Baxter Healthcare Corporation Total Dry Tons Applied (Annual): 9.79
Permit #: WQ0031725 Cation Exchange Capacity (non 503 only):
Operator: Douglas Poplin Owner: Douglas Poplin Predominant Soil Series: FcC2
Acres Used: 4.4 Acres Permitted: 4.4 Site #: DP Field #: 7
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/4, % Solids use Raw Percent #):
Total
P .
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
Total
1
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2.22
..
Arsenic
0.044
0.000
0.000
0.000
0;000
0.000
0;000
0,000
0.000
0.000
01000
0.000
0,044
Cadmium.
0.003
0,000
0.000
0,000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000.
0.003
Copper
0.783
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000.
0.000
0.0.00
0.000
0.783
Chrorniurr
0.197
0.000
0.0.00
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0.000
0,197
Lead
0.034
0.000
0.000
0.000
0.000
0.000
0..000
0.000
.U..U00
0.000
1 0.000
0.000
0.034
Mercury
0 005..
0.000:0.000
0.000
0,000
0.000
0.000
0.000
1 0.000
0.000
0,000
0.000
0.005
Molyb-
0:024
0.000
0.000
0:000
0.000
0.000:
0.000
0 000
0.000
0.000
0.000
0.000
0.024
denum
Nickel
0,101
0.000
0.000
0.000
0.000
0,0.00
0.000 '
0.0.00
0.000'
0.000
0.000
0.000
04101
Selenium
0.015
0.000
0.000
0.000
0.000'
0.00.0
0.000
0.:000
0.000'
0.000
0.00.0
0.000
0.015
Zinc
0..716
0.000
0.000
0.000
0.000
0.000
0,0.00
. 0..000
0.000
0..000
0.000
0.000
0.716
Total
1'hos-
85..402
' 0.000
0.000
0.000
0.000
' 0.000
0.000
0.0.00
0.00.0
' 0.000
0.000
0..000
: 85.4.02
horns
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and
imprisonment for knowing violations".
Signature of Land Applier
1-31-2024
Date
DENR FORM MFLSF (12/2006)

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ANNUAL PATHOGEN AND VECTOR ATTRACTION REDUCTION FORM (02T Rules)
Facility Name: Baxter Healthcare Corporation WQ Permit Number: WQ0031725
WWTP Name: Baxter Healthcare Corporation NPDES Number: NCO006564
Monitoring Period: From l/l/2023 To 12/31/2023
Pathogen Reduction (15A NCAC 02T .1106) - Please indicate level achieved and alternative performed:
Class A:
Alt. A (time/temp) ®
Alt B (Alk Treatment)0
Alt. C (Prior Testing)[]
Alt.D (No Prior Test) 0
Process to Further Reduce Pathogengs 0
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost 01
Heat Drying ®
Heat Treatment ®
Thermophilic
Beta Ray 01
Gamma Ray 0
Pasteurization [
Class B:
Alt. (1) Fecal Density R
Alt. (2) Process to Significantly Reduce Pathogens 0
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization 0
1 Air Drying 0 1 Composting 0
jAerobic Digestion IJ
Anaerobic Digestion 11
If applicable to alternative performed (Class A or Class B) complete the following monitorin data:
Parameter
Allowable Level
in Sludge
Pathogen Density
Number ot
Excee-
denrl&q
Frequency
of Analysis
Sample
Type
Ana yhca
Tech -
woue
Minimum
Geo. Mean
Maximu
Units
Fecal Coliform
2 x 10 to the
6th power
per gram of
total solids
MPN
143420
147184
152111
MPN/g
0
7
grab
sm9221
CFU
1000 mpn per gram
of total solid (dry
weight)
Salmonella bacteria
(in lieu of fecal
coliform)
3 MPN per 4 grams
total solid (dry
weight)
Vector Attraction Reduction (15A NCAC 02T .1107) - Please indicate alternative performed:
Alt.l (VS reduction)
Alt. 2 (40-day bench) 0
Alt. 3 (30-day bench)
JAIL 4 (Spec. 02 uptake) 11
Alt. 5 (14-Day Aerobic)
Alt. 6 {Alk. Stabilization El
Alt 7 (Drying -Stable)
1Alt. $ (Drying -Unstable) 0
Alt. 9 (Injection) 0
Alt. 10 (Incorporation) 0No
vector attraction reduction alternatives
were performed
CERTIFICATION STATEMENT (please check the appropriate statement)
"I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have been met."
"I certify, under penalty of law, that the pathogen requirements in 15A NCAC 02T .1106 and the
vector attraction reduction requirement in 15A NCAC 02T .1107 have not been met." (Please note
if you check this statement attach an explanation why you have not met one or both of the
requirements.)
"This determination has been made under my direction and supervision in accordance with the system
designed to ensure that qualified personnel properly gather and evaluate the information used to determine
that the pathogen and vector attraction reduction requirements have been met. I am aware that there are
significant penalties for false certification including fine and imprisonment."
Preparer Name and Title (type or print)
Signature of Preparer*
Zach ley U.S. Biosolids, Inc.
Land Applier Name and Title (if applicable)(type or print)
L� X� 1-31-2024
Date Signature of Land Applier (if applicable) Date
*Preparer is defined in 40 CFR Part 503.9(r) and 15A NCAC 2T .1102 (26)
DENR FORM PVRF 02T (12/2006)

p AM
PROMPT-AMMIRAT
LABORAT40RIESY INC
AN NNTARL %RS.CONI
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RCRDA.Ni,, - 2 ai
DATE
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P FiOMAT•AG C:U hATC•R6LIABL6
PAF;Z
I..A.BORA';C'C]iiI�S� INC
WWW.RARL_ASS.C©M
30 Day Bench Scale Extended Aeration Test
Percent Volatile Solids Reduction
A U.S. BIOSOLIDS,
y O
Start: End:
TS
0,1306
0.1620
TS%
1.34%
1,33%
vs
0.1087
0,1263
VS%
83,23%
77.96%
Mass Fraction of Volatile Solids in Liquid SIUd e
0.0111464
0.0103719
x Mass Fraction of Fixed Solids in Liquid Sludge
0.0022457
0.0029317
FSVR Mass Balance
6-96%
FSVR Van Kleeck
6.94%
FSVR Mass Balance<15%
YES
FSVR (Van Kleeck) <15%
YES
1'�-, Hox,41148', 0 Charlottr, NC 2KI1.14S3
Phone: (1-04) CSS-83330Fax ('01) 588-8�35

PAR
PROM PT -AC CU RATE, RCLIASLE
LABORATORIES, INC
W W W.PARLARS.COM
Collected
D.O.
Crucible
Tare Wt (9)
Sample Wt +
Tare Wt(g)
Liquid Sludge Wt
(9)
Oven Temp °C
Date(Tme In
Date/Time Out
Dried Sample Wt
+ Tare Wt (g)
Dried Sludge Wt (g:
Fixed Solids Wt (9
Furnace Tamp °C
Date/Time In
DateMme Out
Burned Sample
Wt + Tare Wt (9)
Volatile Solids Wt (p)
TS%
VS%
30 Day Bench Scale Extended Aeration Test
v�,+K vpuon �. rerceni volatile >onas rceaucnon
U.S. SIOSOLIDS, INC.
02/16/23
03/16123
As Receives! Day 0 Day 7 Day 14 Day 21 Day 28
0211FJ9.1 n2/19123 02123123 03/02/23 03109123 03JIG123
1.65
2,18
3.90
4.33
5.30
X11
X11
X13
X15
X22
X29
21,0398
21.0398
21.8740
23,1875
17.1742
20.1090
30.7918
30.7918
31.6194
33.0012
27.6179
32.2861
9.7520
9.7520
9.7454
9.8137
10,4437
12.1771
107
106
106
1D5
105
106
02/16/23 15:30
02/16/23 15:30
02/23/23 09:50
03/02/23 10:05
0310923 10:10
03/16123 09:45
02I17123 1U0
02/17/23 1520
02/24/23 10:00
03/03/23 10:00
03110/23 10:30
03/1723 MD0
21.1704
21.1704
22.0028
23,3153
17.3110
20.2710
0.1306
0,1306
0,1288
0.1278
0.1368
0.1620
0.0219
0.0221
0.0228
0,0292
0.0357
550
550
550
550
550
02/17/23 16:00
02/24/23 15:40
03iO3C23 14:55
0311023 15:20
03/17/23 14:50
02/17/23 17:05
02/24/23 1 T00
03l03/23 16:00
03/10/23 16:30
03/17/23 15:55
21,0617
21.8961
23.2103
17.2034
20.1447
0,1087
0.1067
0,1050
0.1076
0.1263
1.34%
1.34%
1.32%
1.30%
1.31 %
1.33%
t ,
83.23°%
82,94%
82.16%
78.65%
-7.96e/a
yr Ma" FMti= 01 vom" SSVr" in aqua iFaejl
yr, kla" Frdob o1 Vwe i o SCW5 it Lrf�d �Bcrr -
Swdge at Start or Tm
0.0111464
at Erd or Tem
0.0103719
xt V.M FrdGGQn of KvLd Solids it LKMd+FOadi Slunge
xQ rNie Frmnm of Fm-d `wr9 �r Lq�d �80tWMm
at StareQrTest
0,0022457S*x*o„Er
of 7*at
0,0029317
Ts
0.13D6
Ts
0.162
VS
0,1087
vs-wi
0.1263
Volatile Fraction In: 0521121
P 0. Sox 411483 r (:hy lunu, NC: 2r1241-148;
Phone: � -04) 5,145 K33i 4 Fox l7(14) ]S8-8i}j
Volatile Fraction _0ut: 0.58617

PA FZ
PRO MP T-ACCURAT6.RELbft8LE
LABORATORIES, INC
Shipping & Mailing:
2217 Graham Park drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
R s essentia; that all information Ce vrdaf on this Ct�am of Custody document fo, ameatjnoe by PAR Laboratonas. Inc. aml the Nowt
UarcHinH uepamnenz of tnvironmentai am Nawral Kesmmes
Company Name (billing) Comments/ Special Instructions
V S Oa.s
Address
City, State ft zip code
ROJO
Point of Contact $ Telephone Number
�c �-• e � ,�.� y.G'i -,ASS Ci �
Sample
Taken By: SIGNATURE PRINTED NAME
ARE SAMPLES FOR STATIE or EPA REPORTING? YES NO
'Sample Type: DW w. ww _ , GvuMw _. HVw _._ s4tt Other _
Sample Temp at time of sampling: _ _ ° C Sample Temp upon receipt: ° C
„field Preserved: Yes No _Teflon Liner2ero Fleadspace: Yes No nla
Residual Chlorine checked at time of sampling (YIN): Dechlorination Necessary (Y/N):
" C=Composite G=Grab DW=Drinking Water MmWastewater GWWV=Grocndvaater Monitoring Well FNIi=Hazardous Waste

PLI
)w4P I -A Cf----L)RAAT - RFL ;A Fi F
LABORATORIES, INC
kN U W.P.NRLA RS.CONI
Attn: 7ACH' Ky
B,.)X 146
P,uN,,}A" N1"1 2 I,'I"
SAMIII�� NIL, R,
2'�
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Pag�? 1 of 11
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BY 7
YIP'F S A M
A N A I
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M2110�`7
Gi ahai n Park [.)rive harlotte, N(. -'S273
Fax: (1704) 2;SS-8335

ARQMPT•AC UiQA •RCl1ABL.E
LABORA'IC7RIES� INC
2217 Graham Park Drive
PO Sox 411483
Charlotte, NC 28241-1483
NC Cert # 20, SC Cert # 99003001
U.S. BIOSOLIDS,
�3ATl i
4TTWOOMMME
146487
1
56,968
39,71%
143,456.68
2
55,938
39.00%
143,420.64
3
56,713
37.35%
151 835.22
4
55,688
38.71 %
143 859.85
5
57,172
39.16%
145, 994.67
6
56,883
37.94%
149,928.36
7
58.943
38.75%
152,111.20
t�L�=
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R AOL
PROMPT•UF;?
•
LABORATOR.TES, 1wc
Shipping & Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
It is essential VW all information be recorded on this Chair, of Custody aacurnent for acceptance try PAR LaWfatones, Inc. and Me North
oT tnvironmenTai ano r iawrai mesources,
Company Name (billing)
J S
Address
Po at), i
City, State Etzip code j Q
R'nFJA jVC rfCS
Pain of Contact rm Telephone Number
Samoie
Taken By:
SIGNATURE
Comments/ Soecial Instructions
PRINTED NAME La`s
ARE SAMPLES FOR STATE or EPA REPORTING? YES X NO
"Sample Type, DW ww+ ?� cwMw _..__ Hw _ soft other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
"Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No n/a
Residual Chlorine checked at time of sampling (YIN): Dechlorination Necessary (WN):
C=Cornposite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well HW=Hazardous Waste

WayPA nt,(D
NALYTICAL
2/28/2023
US Biosolids Inc
Dennis Key
958 Hoots Road
Roaring River, NC, 28669
Ref: Analytical Testing
Report Number: 23-048-0002
Project Description: Baxter
7621 White pine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Dear Dennis Key:
Waypoint Analytical Virginia, Inc, received sample(s) on 2/17/2023 for the analyses presented in the following
report.
The above referenced project has been analyzed per your instructions. The analyses were performed in
accordance with the applicable analytical method. Sub -contracted testing is noted on the Sample Summary Table
if applicable.
The analytical data has been validated using standard quality control measures performed as required by the
analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all
parameters (NELAP and non-NELAP) were performed in accordance with guidelines established by the USEPA
(including 40 CFR 136 Method Update Rule May 2012) and NELAC unless otherwise indicated.
Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of
sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time.
Refer to sample analysis time for confirmation of holding time compliance.
The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as -
received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to
the samples included in this report.
Please do not hesitate to contact me or client services if you have any questions or need additional information.
Sincerely,
Brandi Watson
Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the
analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis.
Page 3 of 8

Waypoint.(2)
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]"6
www.waypointanalytical.com
Sample summary Table
Report Number: 23-048-0002
Client Project Description: Baxter
Lab No Client Sample ID Matrix Date Collected Date Received Method Lab ID
60926
46381
Solids
02/16/2023
09:00
02/17/2023
60926
46381
Solids
02/16/2023
09:00
02/17/2023
SM-4500-NH3C
WP
MTN
60926
46381
Solids
02/16/2023
09:00
02/17/2023
9045D
WP
MTN
60926
46381
Solids
02/16/2023
09:00
02/17/2023
4500NO3F-2011
WP
MTN
60926
46381
Solids
02/16/2023
09:00
02/17/2023
6010D
WP
MTN
60926
46381
Solids
02/16/2023
09:00
02/17/2023
SW-7471B
WP
MTN
60926
46381
Solids
02/16/2023
09:00
02/17/2023
SM-4500-NH3C-TKN
WP
MTN
60926
46381
Solids
02/16/2023
09:00
02/17/2023
SM-254OG
WP
MTN
WP MTN - Memphis, TN: Waypoint Analytical - TN, Memphis, TN
Page 2 of 8

7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Report Date : 02/28/2023
Received : 02/17/2023
Brandi Watson
Report Number : 23-048-0002 REPORT OFANALYNS
Lab No : 60926 Matrix: Solids
Sample ID : 46381 Sampled: 2/16/2023 9:00
Test Results Units MQL OF Date I Time By Analytical
Analyzed Method
Moisture
85.5
%
0.010
1
02/23/2315.45
FMM
SM-254OG
Sulfur
12300
mg/Kg - dry
69.0
1
02/22/23 23:38
BKN
6010D
Calcium
9860
mg/Kg - dry
345
1
02/22/23 23:38
BKN
6010D
Aluminum
1490
mg/Kg - dry
34.5
1
02/22/23 23:38
BKN
6010D
Manganese
75.2
mg/Kg - dry
3.45
1
02/22/23 23:38
BKN
6010D
Organic N
81170
mg/Kg - dry
1724
1
02/27/23 14:00
CALCULATION
Nickel
22.6
mg/Kg - dry
1.72
1
02/22/23 23:38
BKN
6010D
Lead
7.59
mg/Kg - dry
2.07
1
02/22/23 23:38
BKN
6010D
Arsenic
9.93
mg/Kg - dry
3.45
1
02/22/23 23:38
BKN
6010D
Selenium
<3.45
mg/Kg - dry
3.45
1
02/22/23 23:38
BKN
6010D
Test
Results
Units
MOL
OF
Date 1 Time
By
Analytical
Analyzed
Method
Total Solids
14.5
%
0.010
1
02/23/23 15:45
FMM
SM-254OG
Phosphorus
19200
mg/Kg - dry
34.5
1
02/22/23 23:38
BKN
6010D
Copper
176
mg/Kg - dry
3.45
1
02/22/23 23:38
BKN
6010D
Total Kjeldahl Nitrogen
Qualifiers/ DF Dilution Factor
Definitions
83400 mg/Kg - dry 1720 1 02/27/23 14:00 JP3 iM-4500-NH3C-TKF
MQL Method Quantitation Limit
Page 3 of 8

Report Number:23-048-0002
7621 Whitepine Road, Richmond, VA 23237
Main $04-743-9401 ° Fax [phone]
www.waypointanalytical.com
REPORT Or
Report Date: 02/28/2023
Received : 02/17/2023
Brandi Watson
Lab No : 60926
Sample ID : 46381
Matrix: Solids
Sampled: 2/16/2023 9:00
Potassium
10800
mg/Kg - dry
345
5
02/24/23 04:23
TJS
6010D
Magnesium
4830
mg/Kg - dry
34.5
1
02/22/23 23.38
BKN
6010D
Sodium
3900
mg/Kg - dry
172
1
02/22/23 23:38
BKN
6010D
Iron
5900
mg/Kg - dry
69.0
1
02/22/23 23:38
BKN
6010D
Zinc
161
mg/Kg - dry
8.62
1
02/22/23 23:38
BKN
6010D
Ammonia Nitrogen
2260
m91Kg - dry
690
1
02/28/23 11:00
JPJ
SM-4500-NH3C
Nitrate+Nitrite-N
3816
mg/Kg - dry
34.5
1
02/23/23 13:38
ZBD
4500NO3F-2011
Cadmium
<0.690
mg/Kg - dry
0.690
1
02/22/23 23:38
BKN
6010D
Chromium
44.3
mg/Kg - dry
1.72
1
02/22/23 23:38
BKN
6010D
Mercury
<1.12
mg/K9 - dry
1.12
1
02/22/23 15:14
FDS
SW-7471B
pH
7.0
S.U.
1
02/23/2315:30
SAR
9045D
Molybdenum
5.50
mg/Kg - dry
1.72
1
02/22/23 23:38
BKN
6010D
Qualifiers/ DF Dilution Factor MQL Method Quantitation Limit
Definitions
Page 4 of B

way 0 nt,(2)
pol
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Client: US Biosolids Inc CASE NARRATIVE
Project: Baxter
Lab Report Number: 23-048-0002
Date: 2/28/2023
Metals Analysis Method 6010D
Sample 88165
Analyte: Aluminum
QC Batch No: 1-666345/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 88165
Analyte: Arsenic
QC Batch No: 1-665778/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Sample 88165
Analyte: Chromium
QC Batch No: 1-665778/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 88165
Analyte: Iron
QC Batch No: 1-666047/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 88165
Analyte: Potassium
QC Batch No: 1-665778/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A dilution test
was performed and passed quality control acceptance ranges. No matrix interference is suspected.
Sample 88165
Analyte: Lead
QC Batch No: L6660471L665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Sample 88165
Analyte: Selenium
QC Batch No: 1-665778/1-665368
The matrix spike and/or the matrix spike duplicate was outside quality control acceptance ranges. A post
digestion spike was performed and passed quality control acceptance ranges. No matrix interference is
suspected.
Page 5 of 8

Waypointo
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main 804-743-9401 ° Fax [phone]
www.waypointanalytical.com
Solids Total Mercury Analysis - CVAA Method 7471A
Sample 88961 (JR-1-1)
Analyte: Mercury
QC Batch No: 1-665626/1.665268
The matrix spike, matrix spike duplicate and the post digestion spike were all outside of the quality control
acceptance ranges. Matrix interference is suspected.
Page 6 of 8

Waypointo
ANALYTICAL
7621 Whitepine Road, Richmond, VA 23237
Main $04-743-9401 ° Fax [phone]
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 46381
Customer Name: US Biosolids Inc
Report Number: 23-048.0002
Shipping Method
0 Fed Ex 0 US Postal 0 Lab
UPS 0 Client 0 Courier
0 Other:
Thermometer ID:
Shipping container/cooler uncompromised?
Yes
0 No
Number of coolers/boxes received
; 1
Custody seals intact on shipping container/cooler?
0 Yes
0 No
Not Present
Custody seals intact on sample bottles?
0 Yes
0 No
0 Not Present
Chain of Custody (COC) present?
# Yes
0 No
COC agrees with sample label(s)?
0 Yes
0 No
COC properly completed
* Yes
0 No
Samples in proper containers?
0 Yes
0 No
Sample containers intact?
Yes
0 No
Sufficient sample volume for indicated test(s)?
0 Yes
0 No
All samples received within holding time?
Yes
0 No
Cooler temperature in compliance?
Yes
0 No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
Yes
0 No
Water - Sample containers properly preserved
0 Yes
0 No
N/A
Water - VOA vials free of headspace
0 Yes
0 No
N/A
Trip Blanks received with VOAs
0 Yes
0 No
0 N/A
Soil VOA method 5035 — compliance criteria met
0 Yes
0 No
N/A
( High concentration container (48 hr)
High concentration pre -weighed (methanol -14 d)
Low concentration EnCore samplers (48 hr)
Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included?
Comments: I.. _...... .... _ ... ......... ..... ... ....
0 Yes
... ........
# No
......... ........ ..........
........ i
.....
Signature David Lennon Date & Time 02/1712023 12:39:16
...
Page 7 of 8

-7-
Page 8 of 8

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PROMPT -ACCURATE• RELiAMLE
LADORATORIESi INC
Shipping Et Mailing:
2217 Graham Park Drive
Charlotte, NC 28273
CHAIN OF CUSTODY
Phone [phone]
Fax [phone]
ft is essential that all information be recorded on this Ct)ain of Custody document for acceptance by PAR Laboratories, Inc. and the North
Carolina Department of Environmental and Natural Resources.
CGmpany Name (bitting) p i Commentsi Special Instructions
Address
to
box - - - -_ _ .___ _ .....__.. _ ._._ _ ......._ _...._
City, State
Pi'tAYI� i3 Zt{} code �__�,___.._.._._,__...__._.._._....__.__........_..............._....,- ..-.r_.........._......__�
Point of Contact €s Tetephone Number
SarnDle
Taken By: SIGNATURE
PRINTED NAME < at A
ARE SAMPLES FOR STATE or EPA REPORTING? YES NO
*Sample Type. Dw _ ww _ GWMW _ HW Soil __ Other
Sample Temp at time of sampling: C Sample Temp upon receipt: ° C
**Field Preserved: Yes No Teflon Liner/Zero Headspace: Yes No nfa
Residual Chlorine checked at time of sampling (YIN): Dechlonnation Necessary (YIN):
` C-Composite G=Grab DW=Drinking Water WW=Wastewater GWMW=Groundwater Monitoring Well t 1W=Hazardous Waste

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