WQ0018708_GW Monitoring_20071212

_Bay Tree Utility Company REG�IM
r a
_.- 33 West Bay Ridge Road AN
Harrells.- NorthCarolina 28444
t [phone] DENR—FALEREGONALD�7C�.
December 12, 2007
Mr. Joel Shields
NC Dept. of Natural Resources
Division of Water Quality
225 Green St., Suite 714
Fayetteville, NC 28301
Dear Joel Shields:
Please be advised that Mr. Brooks. Barwick.Will serve as,•signer for all pertinent business
transactions for Bay Tree Utilities in the absence of ]Vlr: D.'.Stephen-Jones. IVIr. Jones is
expected to be absent for an.extended period of time due to health reasons.
Sincerely:
D. Step . e nes .
President, Lake Creek rporation
d.b.a. Bay Tree Utility Company.

• ACILArpWIN179171MATION Please Print Clearly or Type
Bay Tree Lakes
FacilityAddr6bs.
-33-1W-.*Bay,Rid &e Road
Harrelsl'sk2846 laden
ounty
Ste hen Jones (ZIP)
--588-4432-, -
ont erson:;_�� Telephone #9 10,
11 .- -,. - Z. - " � ` 4
aW ft/' Ite',Namei :Well #3 No. of Wells to be Sample&
Ifff om7frm
ilcall6n: Number (from. Permit):. For Groundwalbr Treatment Systems
WellAdWl -Wel]L. #3
Wel(�De'70 Jt',_'Well Diameter: - 2 in. Check One:
s(c"e6fi4d"Q`ritdrvaI::,, ft. ft.
�" - ; , O'Influent. (98)
— iM&fiir Depftfb� ,Ljq4eI:_Z, UP -ft. 'below measuring point. A ­­ El Effluent (99)
Me I' as �6161 s —ft.; above land surface.
,2`
Gall6iiiii'df�gWiitdr,,pumpecVb ed before sampling: Aja5
plecific'Coriclubtance uMhos
%
`Od TPr9p., or Appearance
pW(�
TOP
Chlol
Greas4
Phenol
'`',
sbifite
SOCHI
Tof a-.
TKN`
PERMIT 4: 'EXPIRATION DATE: _-2 L-01
Non:Dlscharge 1WQ00 18708 UIC
NPDES
TYPE OF PERMITTED, OPERATION BEING MONITORED".;,` -
Lagoon —Rerhediallon: Infiltration Gallery 'I'.T.".
w/ Spray Field Remediallon:
Rotary Distributor, Land Application of Sludge".
Other.
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample collected: 11"26-07 Date sample ana yze
I Vann Laboratories. Oxford Llioxatory Ir
Laboratory'Name: 4AS
Certification -No.' 22, 75 .1 3,
(SamplesE6
for metals ward'ccilected unfillered;..—Y
NO and field acidified
— YES NO).
mg/I
Nitrite (NO2) "as N
moll
NI - Nickel moll
AFFebal
&7ota
<-1—Mooml.
/I 00ml
Nitrate (NO3):6s N moll
Phosphorus: Total as P moll
Pb - Lead
Zn 'Zinc
11j,m6thbd for highly turbid camp
3).
Orthophosphatd
mg/l
Ammonia Nitrogen mg/I,
PIldsk. Total
moll.
Al - Aluminum
moll
Other (Specify Compounds and Ccincefitration units).
analvzed),
units
Ba ma Barium
/I
moll
Ca -Calcium
I
o moll'
Cd - Cadmium
V
. .....
moll.
Chromium: Total
id;011s:
moll
Cu- Copper,
t tolflg/l
mg/l
moll
Fe - Iron
gAntt
ORGANICS: (GC,Gb/MS,HPLC),:"4.;:.
mg/I
-uMhos
Hg .- Mercury.
"n
rMati g/l
(Specify test and method'#. 41tach' Y':
h d6 'dtgnce,
b
K - Potassium
mg /I
Report Attached? Yes_V(1)�:-, 0
a-
moll
Mg-'- Magnesium
moll
VOC method
moll
Mn- Manganese
mg/l
7
methodkt,-,
method ffwz",
JC_.1 A-,
11101 #%gone name ana 1 ilia - I -lease print or type
-----------

Pen
FacHa :
rr cor
Screei
Depth
me azi"st
Gall6t
Fie ,5
' PARR
COD;
Co 60,fi
'
co"Ific,
R
Ea
opecli
T K INCie"
Elm
•
)BIVIATION Please Print Cleady or Type
ay. Tree Likes -
'different):
':33.,'W-l;l* Bay Ridixe, Road
2840county -
W&) BlAden
...,Stephen Jones (zip) 910=588-4432
3on. Telephone #
6il 6'Name:— Well 15: No. of Wells to be,'Pampled: 4
ift16n Number (from Permit): -Well 15 For Groundwater treatment Systems
18- 11 ff %A/ If Ill Mare 2 In
PERMIT 4: EXPIRATION DATE: UtO
Non'-Discharge-WQ0018708 _UIC
NPDES
aPE OF PERMITTED OPERATION BEING MONITORED,`
Lagoon —Rerhediallon: Infiltration GallerySpray Field Remedlationi:
Rotary Distributor Land Application of Slul dge"
Other:
ft. to
0neCK one:
D InflLtent (98)
tAOTE: Values should reflect dissolved and
tdr:Lev­eh'
ft.,beloW measuring point.
0 EffIdent, (99)
colloidal concentrations.
lbIht:Is_,ft. ,above land surface.
Mbr�,pumpedlballed before sampling:
led: /L**'_67 Date sample a�nalyi�ld'&-
Date sample collected: V
Laboratory Name: Vana Labaratmcies, OKfimd laborabmT.,7r4��jp
TempOCi'Odot-
Specific, Qionduclance uMhos
:,.'Appearance
Cerilficallon-No.
22, 75 1. 7
­N,
,MOaimpl�es for metalls-were,601lected unflItered,.—YiES.'
NO
and field acidified
YES NO).
—
6"g
mg1I
Nitrite (NO2)� as,N
m 11
NI - Nickel
AF:fecal:
-e'] /100ml
Nitrate (NO�) as, N'
<0,16 mg/l
Pb - Lead g/l
AFF-Total—
J1 00ml
Phosphorus: Total'as'P_
ld- 0. 05 mg/I
Zn - Zinc
N ffib - I . hod for hIghly.lurbld
samples)!,
Orthophosph'ate'.
mg/l
Ammonia Nitrogen
��§611ds-,"Total mg1l
Al - Aluminum
mg/l
Qther (Specify Compounds and, Cnn6eh6aII6'6`0nl6)
analyzed)
units.
Ba - Barium.'—
MCI
mg/I
Ca - Calcium ,
SIR
tff
11,1 mg/I
Cd - Cadmium
L_ mg/l
mg/I
Chromium: Total
a anmg/l
mg/I
Cu- Copper mg/l
mg/I
Te -Iron,
PrOce *nbWlt
ORGANICS: (GC,GC/MS,HPL
mg/I
Hg - Mercury to or
pwQlgpc_g/I
(Sp6cIfy test and method'#. Astach 1,
ohdUctanice
.
kbos
K - Potassium
mg/l
Report Attached?' Yes✓ (11) No" 0
@�m g/I
Mg:& Magnesium
mg/l
bod
VOC met #
mg/I
Mn -Manganese
mg/l
method-�.11
*
17;`-,�
meth y 'W 7, 7;
violations.
I Z.) w
print or type

Perfnit
Fibillt
77-,iWy
Cohtaiy(
t " -:- "S'.
We
V61fild
,Screen
Nleasui
�• Gallons
-.17161dj'al
v 9
(Nola :,U
PH;Jcgi
TOC
Chloral
ArsE01
Tots
TKt
)HMA1IQN Please Print Clearly, or 77
Type
Bay Tree Lakes
W:, Bay Ridize, Road
28466C;ounty_Bladen
Stephen Jones, 04. 8) (4)
Telephone #[phone].
No. of Wells to b6 Sa
4
(IromParm
in Number (from Permit): Well # I
For Groundvlater'Treatment Systems
2
Check One::,
al ft. 0
Influ'ent.,'(98)
below measuring point.
f Is ft.-a*bove*:1drid surface.- Effluent .'(99)--
r,;pumped/bailed before sampling: 2.93
pH -S136-cific'Conductance
5
_, - ---
. dM;, hos
�mp 4C Odor Appearance ,.
,
,
PERMIT M EXPIRATION DATE: f
Non=Dlscharge WQ0018708 _UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED r
Lagoon —Rernecriatlon: Infiltratio
n . da' 118� `
y' Spray Field Remedlallon:
;Itg�
Land Application Sludge'
Rotary Distributor ,'4 of
Other:
NOTE: Values should r"e"flect dissolved and
colloidal concentrations.
Date sample collected- Date s -a
Laboratory Name: Vam Mbomtorjes, QKEDrd
Certification No.' 22, 75 jz6 7
ile:arial , v z e i
FM,!(Sbm0Ies for;metals,wer6'collected unfiltered,.' YES�,.':_,: NO and field acidified
YES NO).
mg/I
Nitrite, (NO2Ya
mg/I
Ni -Nickel
K4 F Fd 6 a I
1100MI
Nitrate (NO3) as N lb
mg/I
L
Pb - ead
MF Total'`
J100ml
Phosphorus: Tot8lbs P A 0,!r
mg/I
Zn - 'Zinc
Wi'6'e.l.h.od for. highly turbid
�Pbllft Total mg1I
Orthophosphate
Al - Aluminum
mg/I
Ammonia Nitro en
9
alfted)
—Units
Ba - Barium 10
mg/I
MnIl
Other (Specify Compounds and Conde
a
mg/I
Ca - Calcium,
mg/l
mg/I
Cd-- Cadmium n
mg/1
mg/I
Chromium: Total unite
mg/I
--77
id-,1011s
mg/I
Cu - Copper- ,j,xrn4%onvr1
mg/I
mg/I
Fe - Iron
mg/I
ORGANICS: (GC,GC/MS,HPI_C)''
mg/I
uMhos
Hg - Mercury
K - Potassium
Mg/I
-mg/I
(Specify test and method #. Attach lab report.)
Report Attached?, ✓YeS�(1)
'6hdu ctance
or '
mg/l
Mg'- Magnesium
mg/I
V00:method #=
mg/I
Mn - Manganese
mg/I
-, ., �,': ,
method#=
method#.
. 1111"llu
'Ale
=a.nd5Tl'1'
se (or I ze A 1) N a and Tille - Please print or type 77
CJ
Signature of Pdrnli (Date):
9r

or eii
Ns.SON
pH,-'(Wh
Td&_
Chl6h—d
Arserilcl
GPhre"e'.
1 -6 1 n sulfat"d
S'P6,601i
Total
�'-
s
I cerlifj
tielnri -
7`
G
Please Print Clearly or Type
4`33.'W-.', Bay, Ridge -,Road
jjjr) 7, 28466county Bladen
�_­Stephen Jones- (ZIP)
Telephone #[phone],
36;Na"me: W61142 No. of Wells to be Sampled.'"' 4
_dt16n`,Nu mber (frohn Permit): Well #2
For Grotmdwal�r, Treatment Systems
Well Diameter: 2 In. Check One:
ft. to ft. ❑ Influent ('98)
te� e� , Level. 61240 M. below measuring point. 11 Effluent (99)
16AAHS , ft.-abo've land surface.
af&i.,'ptjmpedlbailed before'sampling:
i-;-­pH' 1 4, 5_ .,"Specl"fic;'Conductance uMh os
_-,,mj,,,Odot, ..'Appearance
'PERMIT M EXPIRATION DATE:-
Non:Dlscharge WQ0018708 UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED;.&.['
Lagoon Rerbecliation: lnfiltrallbn Gallery
spray Field RemedIallon:
Rotary Distrlbulori, Land Application of Sludge',;;
Other:
NOTE* Values should reflect dissolved and
colloidal concentrations.
Date sample collected: Date Sam le'a'na"lyze
Laboratory, Name: Van[iLibamtories, QQK&fiord rr,T r
Certlflcallon.No: 22. 75,67
ff(Sdrriples for 'metals, wero'collected unfiltered ,,._-YES; '
NO and field acidified
-YES NO).
mg/I
Nitrite (NO2) as, N
mg/I
Ni - Nickel jngk
F 6 q a 1:
<I 1I 00ml,
Nitrate (NO3) as-N
mg /I
Pb - Lead
/1 00ml
Phosphorus: Total as. P
< A, mg/I
Zn 'Zinc
.,Method for highly turbid
sarnpljw.
Orthophosphate
mg/I
Ammonia. Nitrogen
,bllds'Tbtal :��o m g/I
Al - Aluminum
ther (Specify Compounds and bo6c6nIraIlon":UnIt6.
nalvzed)
units
'Ba - Barium
11-no, mg/I
Ca - Calcium
:mg/
mg/I
Cd - Cadmium.,
mg/I
Chromium: Total
mg/I
mg/I
Cu -Copper
Gemou"11
mg/I
Fe - Iron"
tntorma E)walaorng/l
ORGANICS: (GC,GC/MS,HPLC),,
mg/I
Hg - Mercury
mg/I
(Specify test and method'#. 6flach,
iductance
uMhos
K - Potassium.
mg/I
Report Attached?, Yes V (1);,.,'Nd'
mg1l
Mg'- Magnesium
mg/I
77.;-(0),
VOO method
mg/I
Mn - Manganese
mg/I
methodJt7,w
methiv 9.m ........... r
alluf 15.
FWP,
.d J0 '40
, 10% F . Mrld MOSAi
a7Zq,4_-.S
and T111a - Plan,
or type

S 4
e- ,.,3 � vs. i � ...a— i x� ,.� `',.,� -> r s4,t.�� m vr%S -.� �• v .'tt�l� r rr-„•-a� 4 .'zif- t .s. -
-
1_.- . -P.O. Box 668 Y �;, ... �-•T _� - .. _.
--------------------
... • •Wallace NC,• 28466 • -
Phone: (919)28"966
- Fax: [phone]
Well Samples
Client. .�� pH Meter
Model: 50
Date Sampled: - Serial # C000822Z
Calibrated: Date: Time: S�dR .
Sampled By: a � . Buffer 4.00 Al.�o
Buffer 10.00
Buff, r•7.00%' 1,. D � -
Analyst:
Location
Well 1. D. J,
Depth of Well (ft) .
: D 40
Depth to Water Level (ft) .• .
Water Depth (ft)
Well Vol. * 3• (Gals)
Time Sampled.;
14/1
Temperature, °C �. �, s• • s•'
Color
Sampler's Signature: iE
Q Daie:o
t ^� 7

Phone: [phone]
Bay Tree -Lakes:
Vann. Labor a o' ries
P. O. Box:668.
Wallace; NC 28466 , rt
WaslewaterlD # ,t
_ -- -- s Collected
November 26,2007
PA44METER -
UNITS
DATE
ANALYZED
Well # 1
Well #2
Well f3
Well 15
PH -
BOD5
mg%L
COD
mg1L
Fecal Coliform
co1.1100 ml
11-26 -07
< 1
< 1
< 1
< 1
Total Kjeldahl Nitrogen
mg;X
Total Residue (Dissolved]
m91L
11-26-07
<40
<40
56
62
Total Suspended Residue
mglL_ .
Detergents MBAS
mg1L
Oil & Grease
mglL
Total Phosphorous
mg1L •
12-6-07
<0..05
<0.05
0.26
<0. 05
Sulfides
mgX
Phenols
uglL
Total Chromium
ug/L
Total Copper
ug/L
Total Magnesium
mglL
Total Zinc
ug/L
Ammonia Nitrogen
mg1L
11-26- 07
<0.20
<0.20
<0.20 .
2.38
Nitrate
mg/L
1-28- 07.
<0.10
<0:10
<040
<0.10 `
Chloride
mg/L
1-29-07
8.2
4.7
6.5
11.1.
TOC ..
mg/L ,
1-30-07 "
—2.10
;.:.;. 8:2 -
11.4 .;
9.15
*Analysis performed by Oxford Laboratory
w.
Signed: 77

•{ Tritest, Inc.
6624
F }
w 3 u Page 1 of 3fi{
_
�' `•,
' ^`'- r ��,; k, �e a . i+ :-x. Su ite
.` ..
i ...
Telephone [phone] •
WI�til7lriCjtOf1,::NC. - 28411 NC/WW ert. #. 075
Fax: [phone]
-
NC/DW Cert #t 37721
www.tntestmc.com
Labo"ra-tory
Pop 6rt, o
— . Prepared for —
Wayne Vann
Vann Laboratories
Report Date:
12/17/2007
PO Box 668
_ ,>_.
_ Date Received: 11/27/2007
Wallace, NC 28466
Work Order#:
0711-56675
Project No.: Bay Tree Lakes
Cust.'Code:
VANN79.,.
Project ID::, VL' 112607103-7 :TPHOS/NOX/6230D
'Gust.-P.O.#
Vo. Sample ID
Date -Sampled
Time Sampled. Matrix
Sample Type Condition
0.01 VL112607103
11/2,612007'
3:45 WW
Grab 4 +/- 2 deg C
Analyzed
Test Performed
Method
Results
Date Time Qualifier .. .
Nitrate+Nitrite '
Attached
*:6.48 mg/L
12/7/07. 16:21
No. Sample ID
Date Sampled
Tme Sampled Matrix
Sample -Type Condition.
002 VL112607104
11/26/2007 -
3:10 GW
Grab : 4 t/- 2 deg C
Analyzed
- Test Performed
Method
Results
Dates Time Qualifier
Phosphorus, Total
EPA 365.4
*'<0'.05 mg/L
-1216107 14:24 '.
Nitrate
EPA 353.2.
*•<0.10.mg/L
11/28/07 11'-.00
�o. Sample ID
Date Sampled ..
Time.Sampled Matrix-
Sample.Typ6 Condition .
003. VL112607105
1.1/26/2007
3:35 GW
Grab .. 4 +l -2 deg C
Analyzed
Test Performed
Method
Results
Date. •Time . Qualifier
- Phosphorus, Total .
EPA 365.4
* <0.05:mg/L
12/6/07 14:24
Nitrate
EPA'.353.2
<0.10 mg/L
11/28/07 11:00
40. Sample ID
Date Sampled '
Time Sampled Matrix
Sample Type Condition'
004 VL1160 27106
11/26/2007
4:00 GW
Grab 4 +/- 2 deg C'
Analyzed
Test Performed .
Method
Results
Date .Time Qualifier
Phosphorus, Total,._
:EPA _365.4
* 0.26 mg/L :.12/6/07: = 14:24
- .Nitrate :'_
-EPA.353.2
<0.1Qmg/L
'11/28/07-.,11:00:
-m

z
a �
Telephone ,.910 768-9793f
Fax [phone] `" WiIM
www.tritestinc.com
Wit- j
NC/WW Bert..#: 075 l
�C+ 28411 s NC/DW Cert.V; 37721
Laboratory Report
Work Order #: 0711-56675
;o. Sample ID Date Sampled Time Sampled Matrix Sample Type Condition
)05 VL112607107 _ 11126/2001 4:20 GW Grab 4 +/- 2 deg C
Analyzed
Test Performed Method Results Date Time Qualifier
Phosphorus, Total EPA 365.4 * <0.05 mg/L 1216/07 14:24
Nitrate EPA 353.2 <0.10 mg/L 11/28/07 11:00
lo. Sample ID Date Sampled Time Sampled Matrix Sample Type Condition
)06 WELL #1 11/26/2007 4:20 GW Grab 4 +/- 2 deg C
- Analyzed
Test Performed Method Results " Date Time Qualifier
M-6230D M-6230D ATTACHED 1215/07 6:32
lo. Sample ID Date Sampled Time Sampled • Matrix Sample Type. Condition
)07 WELL #2 11/26/2007 4:20 GW Grab 4 +/- 2 deg C
Analyzed
Test Performed Method Results Date 4. Time Qualifier
M-6230D ' M-6230D ATTACHED 1215/07 6:32
Io. Sample ID Date Sampled. Time Sampled Matrix Sample Type Condition
)08 WELL #3 11126/2007 4:20 GW Grab 4 +1- 2'deg C
Analyzed
Test Performed Method Results Date Time Qualifier
M-6230D' M-6230D ATTACHED 12/5/07 6:32

Tritest, Inc.
z > yro- '�s 7 y.. _`"r'. j-ri•- r i {s
9
?- ,`: Yelephone • 910 763-9793 � ` w ``t`, ' , $Ulte G '� � �
NC a
Fax: [phone] M. s 1WW 075,
Wilmington; NC 28411 NCIDW cent#; 37721 .. . www.fritestinc.com ..
Laboratory Report
Work Order #: 0711-5667.5
Reviewed by:,
est, Inc = r

Dec.14 2007`1T.45AM "''Tr.i-te'st.`f�az " o
Telephone:",Will) 834
Fax: [phone]
vok
N_o 8567 P, 28
7
<•��� i=RPagel of 7 f
1
y1CIVVW pert. #: 067 4
NC/DW Cert. #: 3.7131
La. bo.ratory' Report
_. --Prepared for-
MARY GODLEY
Report -Date.:
Report
211112007
TRITEST / WILMINGTON
Date Received:
11/28/2007
6624 GORDON ROAD
UNIT G
Work Order#:
011.1-01514
WILMINGTON, NC 28411
Project No.:
Cust: Co:
OX9793 -
Project ID: -0711-56675 ..
Cust. P.O.M ,
No, Sample ID
Date Sampled
Time Sampled Matrix
Sample Type,
Condition
001 0711-56675=001
0:00 W1W
Unknown
4 +1- 2 deg C
Analyzed
Test Performed
Method
Results
Date '.-Time
- Qualifier
Nitrate -Nitrite
EPA-363.2 ..
6.48 mg/L as N. 4 -.
12I7107 16:21
No.',' Sample ID,
Date Sampled
Time Sampled ' Matriz
Sample Type -
Condition
002 •. 0711-56675-002
0:00 WW'
Unknown
4+1.2 deg C
Analyzed
TestPerformedMethod
Results
Date. ' Time
Qualifier
Total Phosphonis
EPA 365.4 •'
<0.05 rng1L
12/6107 14:24
No. Sample ID
Date Sampled
Time Sampled ' Matrix
Sample. Type
Condition
003 0711-56675-003
0.00 WW
Unknown
4 +1. 2 deg C ,.
Analyzed
Test Performed ..
Method.
Results.
Date Time
Qualifier, ,
- Total Phosphorus
EPA 365.4 •
<0.05 mglL
12/6107 ,14:24
No. Sample ID
Date Sampled'
- . Time Sampled Matrix
Sample Type
Condition
004 . 0711-56675.004
.0:00 • WW.
Unknown
4 +172 deg C
Analyzed .
.
Test Performed
Method
Results
Date Time
Qualifier
Total Phosphorus
EPA 365A
0.26. mg1L
1216107 14:24
No. Sample ID "
Date Sampled ";,
` Time Sampled Matrix ' :
Sample -Type
Condition.
005 ` 0711-56875-005 f>
0:00 _' .- WW • ,:
Unknown .:
4 +/. 2 deg C
_ Analyzed-.
Test Performed Method.
Results - Date Time
Qualifier
Total Phosphorus' ", - ;: -
EPA 36SA :
, _ <0.05 mg1L:-'
12/6107 14:24

-14. 200'7 10::45Am
Tritest faz: o
No 8567 P. 29."
s r a e2of7
Y•.r, ` r 6701gConference Dr1've A
Y'{ ,-+5�y .k' s i -.r r S.. r ..-.- ^^ r i ryiA* . E" c ' .a,s
f r3 Raleigh, NO 2760T,4
=Telephone := (91r9) 834984
3
y
�NCIWWCerL #' 067 V
Fax: (919)V4-6497
_.
_ .
NCIDW Cert: #: 37731
La•b0' fa#ory R-ep�ort
Bay Tree, Lakes
Work Order* 0711.01.614 .
No. Sample ID cell '� # 1,
Date; Sampled Time, Sampled Matrix
Sample Type Condition
006 . 0711-56675-DOB . -.
"� 0:00
WW
Unknown 4 +/- 2 deg-C
Analyzed
Test -Performed....''
Method
Results'
Date Time Qualifier
VOCs in GW by 6230D '
62300
1215107 6:32
Benzene
6230D
<0;5 ug/L
1215107 6:32
Bromobenzene
6230D
<0.5 ug/L „
1215107_ 6:32
Bromochloromethane
6230D
<0.5-ugfL
12/5107 6:32
Bromodichloromethane
6230D
<0.5 ug/L
1215107 6:32
Bromoform
'6230D
<0.5 ugfL
1215101 6 32
Carbonite'trachloride
�6230D
<0.5 ug/L
1215107 6:32
Chlorobenzene
6230D
<0.5 ugfL,
1215107 6:32
Chloroethane. -
62300
<0.5 ugfL . ►
1215107 6:32
'Chloroform
6230D
`<0.5 ug/L
1215107' 6:32
Chloromethans . ; -
8230D ..
<0.5 ugfL
1215107 6:32
. 2-Chlorotoluene
6230D
<0.5 ugfL
1214107 6:3Z ,
4-Chlorotoluene . -
6230D
<0.5 ug/L
12007 6:32.
Dibromochloromethane
6230D .
<0:5 ug1L
1215107 6:32
7,2-Dibromo-3-chloropropane -
62300
<0.5.ug/i
12/5107 6:32
1,2-Dibromoethane .
6230D,
<0:5 ug/L
1215107, 6:32
Dibromomethane .
-62306 -
<0.5 ug/L
1216/07' 6:32
' Dichlorodifluoromethane ; •_
6230D
<0.5 ug/L
1215107 6:32
. 1,1-Dichloroethane
6230D
c0.5 ug/L
12l5107 6:32
" . 1,2-Dichloroethane ;
6230D
�<0.5. ug/L
.1215107 6:32
1,1-131chloroethene
62300
<0,5 ugfL .
1215107- 6:32
cis-1,2-Dlchloroethene.
6230D
<0.5 ugfL
1215/07 6:32 •
trans-1,2-Di4hlor6ethene
6230D
<ax ugfL ,
1215107 6:32
1,2-Dichloropropans
; 6236D
<0.5 ug/L _
1215/07 6:32
-1,3-Dichloropropane
6230D .
<0.5 ugfL
1215107 6:32-
- 2,2-Dichloropropane
6236
<0.5 ugfL
1215107 6:32
1,1-Dichloropropene, .
6230D
<0.5 ug/L
1215107 6,32
'cis-1,3-Dichloropr6pene
.6230D
<0.5 ug/L
1215/07 6.32
trans-1,34D16hloropropene' .
623013
- <0.5 ugfL,
1215/07. 6:32,
Ethylbenzene :
6230D
.<0.5 ug/L
1215/07 6:32
kexachlorobutadiene
6230D
<0.5 u91L
A215I07 :, 6:32
lsopropylbenzene
6230D
<0.5 ug/L
12W07 ' 6:32
4-Isopr6pyltoluene- .
6230D
c0.5 ug/L
1215107 6:32
Methylene chlorld.a
1230D
<0,5 ug/L
1215107 6:32
jVaphthafene
6230D
<0 5 ug/L
1215107. 6:32
n-Propylbenzene '
6230D
<0.5 ugfL
1215107 6.32
Styrene'
6230D-
<0.5 ugfL
1215/07 6:32
1.1,1;2-Tetrachloroethene :
623CD
Q.5:ug/L
12/5/07.:.6:32.
1;1,2,2 Tetrachloroetfiane
6230D"
c0.5 ugfL. ',`
12/5/07 532-
Tetrachloroethenet 6230D
,
<0. 5 ug1L
'.171510T .6:32'
Toluene
_ 6Z30D <0 6 ugfL
,� -1215107. 6:32
1,2,3 Trichlorobenzene" 62300
<0.5ug1L
1215/07 -"6:32 .
�,2,4-Trlchl6r666zene`"
" ` 6230D
<0.5 ug/L
1215107 . 6:32

T 10:45AM` °ritest' faz o
w . o. E5:67`'' 'P 3'
670:1 Conference Drivew 5 Page 3 of 7
# s '_� .. ¢ '-n t. 7 •rr .r?':. z, a y'--sv t-i=E, n 'jx y,..
r¢ Y;'Raleigh� NC127607�� fiT: ti
'a r �' �. { ` . r.. t, � �.
Telephone (919)_8344984 t ' NCIWIN Cart. #c o6T
Fax: ; [phone] • - : _Y NC/DW pert # 37731
R
Labo•ra:#ory.Repo:rf
Bay"'Tree Lakes Work Order #: - 0711-01514 „
No. Sample, ID Pell # 1- � Date Sampled ' Time Sampled _ Matrix-,~' Sample Type Condition
006 ` 0711,56675.006 0:00 WW Unknown : 4 +1- 2 deg C
y Analyzed -
Test Performed' Method' Results „„ Date Time - Qualifier
1,1,1 TrlchlorokK4n' e, 6230D .' . ` <0.5ugrL , '' 1215107 ,6:32
1;1.,2.Trichloroethano 6230D " <0.5ugIL. 12/5l07 '6:32, -
Trichloroethene ,6230D' <0:5ug/L 1215107 6:32
Trichlorofluoromethane 62301) <O.S uglL 1215107 ,6:32:
12,3 Trichloropropane . '6230D <0.5 uglL 1215107 .6:32
1,2,4-Trlmethylbenzene .6230D " �O:S,ugIL 1215107 6:32
1,3,54rimethylbenzene- 6236D 4.5 uglL : 1215i67 6:32
Vinyl chloride:, 6230D 0.5 ug/L 12/5107 6:32
o-Xylene 6230D ' <0.5 uglL. 12/5107 0:32
m,p-Xylene 6230D V0.5 u91L _1215107. 6.32
1,2-Dichlorobanrsno ' 6230D <1 uglL °, ` 1215107 6:3254-
"
1,3-131chlorobenzene, 6230D <1' uglL 12J5/07 6:32
1,44Dichlorobenzene 623013 e1 uglL° 12/5/07 ", 6:32
No., Sample ID Well #2 ;Date Sampled Time Sampled ,Matrix Sample Type Condition
007 . , 071:1-56675-007 0:00 WW . . Unknown 4 +/-'2 deg C .
Analyzed"
Test Performed Method -. Results Date Time - Qualifier
VOCs In.GW by 6230D 6230D 1215107 6:32
Benz®no 6230D <0:5 uglL 12I5107 6;32, .
Bromobenzene ' .' ,_ 623013. <0.5 ug/L 1215107 6:32'
'13romochloromethane = . 6230D <0.5 ug/L 1215107 6:32,-
13romodichloromethane ` _ 6230D ' '<0:5 uglL - = . 1215107 6:32
Bromoforni 6230D ` zp.5 ug/L 1215107 6:32
carbon tetrachloride 6230D:_ . <0.5 ug/L 1215107 6:32
Chlorobenzene 62306 <0.5 ug/L - 1215107 6:32
. '-Chloroethane' 62301) <0 5 ug/L 1215107 6:32
Chloroform ' " 6230D <0.5 uglL" 1215107: 6:32
Chloromethane 6230D . <0,5 uglL 1215107 6:32
2 Chlorotoluene 6230D <0.5 uglL 1215/07 6:32
" 4=Chlorotoluene' 6230D' e0,5 ug/L 1215/07 6:32
Dibroniochloromethane 62301) <0.5 ug/L 12I5/07 , 6:32
1,20bromo-3-chloropropane 62300, <0.5_u9lL 1215107 6:32"
1,2-Dlbromoethane:.. 6230D' <0.5 ug►L . 1215107• 6-31
Dibromomethane 8230D <0:5 u014 1214107 %6:32
Dichlorodifluoromethane 6230D <0:5.ug1L ' 121,5107`. 6:32
.'1,7-Dicfiloroethene 6230D <: <0.5 uglL 7215/07 6:32
1.2 D�chloroethane 6230D <0.5 ug1L 1215/07„ 6:32
7,1-Dlchl oethenA 6230D f <0 5 uglL 12/5!07 6,32
cis 1.2 D�chloroathene f' 6230D cO.S uglL 1216I07 _6.32
trans 1.2-Dlchloroethena 6230D <0 5 ug/L :1215/07 6:32 '

856.7 I P. 31
.
Dec,1.4,­-20,07 10,` 45 AM Tritest" -fax . 0`U�TST
;a
re.epj
hoine:
Fak,:._ (91 S
Bay. Tree Lakes'
No.� 7-Sample ID
007 07,11-56875-007. Well 12,
N
NCIDW Cert. 73
L'a b 6,ra to ry R. e p o. H
Work drd'er#':' 071,11-011614
Date Sampled Time Sampled Matrix
0:00 WW
Test Performed Method Results
Sample Type
Unknown
deg
Analyzed
rIftle, -ri e
ger
1,2-Oichloropropah.e.
6230D
<0.5 ug/L
1216107
6:32
1,3 -Djchl&o'prop;;ne
62300
<0.5 ug/L.,
6:32
42-DIchloropropane
6230D
<0.5 uqIL
.12/510T
1215107
6:32
1.1-Dichloropropenii
6230D
<0.5 ug/L
1215107
6:32
cis-11,3-Dichloropropeno,
6230D
<0Z ugfL
1215107
6:32
trans-1,3-Dichlor,opropene-
6130D
<0.5 ug/L
UAW
6:32
Et_
._ ylbenzene
6230D
ug/L
.1215107,
6:32
Hiaxachlorobutadjen a,
6230D,
<0.6 ug/L
1215107
6:32
I� opropylbenzene'.
6230P
0.5 ug/L.
1215/07
6:32
4.1sop, ropylloluehe
:
.6230D
4045 ug/L
1215joi..
6:32
Methylene chloride'
6230D
<0.5 ug/L
1215107
6:32
Naphthalene
6230D
<0.5 ug/L
11215107
6:32
n -Propylbenzen�'.
6230D
40.5 u9IL
12/5107
6:32
Styrehe
6230D
<0.5 ug/L
1215107
6:32
j,%I,2-Tetrachloro&thahq
6230D
40-5 ug/L
1215107
6:32
1i1,2,2-Tetraichlaroethane
6230D
<0.6 ug/L
1215107
6:32
Tetrach! Aiethene
6230D
=503 ug/L
_1215107
6:32
Toluand
6230D'
<0.5 ug/L
12/5107,
6:32
1,23-Trichlorobenzene
= .6230D
<0.5 ug/L
12/5107
6:32
1,2,4-TrIchloroben,z9he
6230D
<04 ugIL
1215107
6,32
-1,1,1-Trichloroothane
6230D-
40.5 ug/L
1215107
6.32
11,11,24fichloroethane
6230D
<0.5 ug/L
1215107'
6:32
Tkchloroethene:;
6230D
<0.5 ugIL
1215107
6:32
.Trichlorofludroenethane
6230D
.<0.5,ugfL
1215107
6.32
62301)
<0.5 ug/L
1215107
6:32,
1 -T
.,2,4 firnethy1benzene
6230D
<0.5 ug/L
12ISM7
6:32
1,35-Trilmethylbenzefie
.62306.
<oz ugiL
12f5107
6:32
Vinyl chloride
6230D
<0.5 ug/L
12/5/07
6:32
o-Xylone
6230D'
<0.5 ug/L
1215/07
6:32
.m,p7XYIene:
"62.30D
<0.5 ug/L
1215W
-6:32
1,2-Dichicrobenzene,
6230D
�I ug/L
6:32
i.36DichWbbenzene'
<1 ug/L
1215107,
-6:32
1,4-01chlorobenzie'ne
<1 601L
12/5107
6:32
Sample ID Well 13-
Date Sampled
Time Sampled Matrix
Sample Type Condition
008 .07111-56675-068
0:00 WW
Unknown 4 +1- 2 dog C
.Analyzed
-Ana
Test P erformedMethod"Time
'
Results
:-Da
Date;
Qualifier
VOCs in VW by 6230D -
'a
6230D
12f5/07
6:32 -
623013'
ug L
112rSIOT.,
6:32.-
irotobe
6230D
<0.5 ug/L
1215107
6.32

J'Dec. 14.--2007: 10 45AM7`I
r i`t`e`st` fax". ' o = -_
No 85,67 K: 32:
` l aT 05
z
1
h 6701=Conference Drove, Page 5 of 7
Ra I® K. NCB 27607
Telephone r(919) 834=498a N rt # OW
[phone]
v
NC ert #: 37731
.:
3
L-a..b.orat-ory Reporf
Bay Tree Lakes
Work Order #: 0111-01514
No.. Sample ID Well #3
Date Sampled Time Sampled Matrix
Sample Type Condition
008 0711.56675-008 -
0:60
WW
Unknown' 4 +1- 2 deg C
Analyzed
Test Performed
Method
Results
Date . Time Qualifier
Bromochloromethane
6236D
<0.5 ug/L
1215107 6:32 _
Bromodlchloromethane
62300
<0.5 ug/L
1215/07 6:32
aromoform
.62300
<0.5 ug/L
1215107,, 6:32
Carbon tetrachloWe
6230D
<O.d ug/L .
1215107. 6:32
Chlorobenzene
6230D'
<0.5 ug/L
12/5107 6:32
'Chloroethane
6230D
<0;5 uglL
1215107 6:32
Chloroform
6230D '
<0:5 ug/L-'
1215107, 6:32
Chloromethane-
6236D
<0.5 uglL
1215107 6:32
2-Chlorototuene
6230D `
<6.5 ug/L
1216107 6:32
4-Chlorotoluene
6230D
<01 ug/L +
12/5107 6:32
- Dibromochloromethane
62300
<0.5 uglL .
• 1215107 6:82
1,2-Dibromo-3-chioropropane.
6230D -
<0.5-uglL
• 12I5107 6:32
1,2-Dlbromoethane
6230D
<0.5 ug1L
1215107 6:32
Dibromomethane
6230D-
<0.5 ug1L'
12/5/07 ' 6:32
Dichlorodifluoromethane
.62300.
<6.5.ugIL '
1215107 6:32
1,1-Dichl6roethene
d230D
<0.5 ug/L -
1215107 6:32
1.2-Dichloroethane
6230D
<0,5 ug/L
1215107 6:32
1,1-Dichloroethene
6230D
<0.5 ug/L.
1215107 6:32
cis-1,2-Dichloroethene
'62300
<0.5 ug/L
1215107 6:32
trans-1,2-Dichloroethene
6230D
<0.5 ug/L
1215107 :6:32
1,2-Dichicropropane ,
6230D '
<0.5 ug/L
1215107 6:32
1,3-Dichloropropane
6230D
<0.5 ug/L,
1215107 6:32
2,2-Dichloropropane
62300
<0.5 ug/L
_
12/5/07 6:32
'1,1-Dichloropropene
6230D
; <0.5 ug/L
1215107 6:32
cls-4,3-Dichloropropene
623013 .
<0.5uglL
1215/07 6:32
trans-1,3-Dichloropropene
6230D
<0.5 uglL
1215107 6:32
Ethylbenzens "
6230D
<0.5 ug/L
1215107, 6:32
-- 14exachlorobutadiene
62300
<0.6,ug/L
.1215107 - 6:32
lsopropylbenzone
6230D
<0:5 ug1L
1215107 6:32
'44sopropyltolu6ne
6230D
<0.5 uglL
1215107 6:32
Methylene chlorlde ,
6230D
<0,5 ug/L
1215167 6:3.2
Naphthalene..
6230D
<0.5 ug/L
12/5/07 6:32
n-Propylbenzene
6230D
-0.5 ug/L
1215107 6:32
Styrene '
6230D .
<0,5 uglL
12/5107 . 6:32
1,1,1,2 Tetrachloroethane
6230D
<0.5'ug/L
1215107 6:32
- 1,1;2,24e"chloroethane
62301)
<0,5 uglL . ,'
1215107 6:32
Tetrachloroethene '
} 62300
<0.5"uglL
12/5/07 6:32 _
Toluene . _
62300'
<0.5 ug/L
1215107, 1:32
-1,2,3-Trichlorobeimne
6230D "
<0.5 ug/L ;
12/5107-_ ' 6:32
1,2,4 Trichlorobenzene .
6230D_
<0.5,ug/L
9215J07: 6:32
TrlcttloroetFiane
6230D "
<0.5 ug/L
1215/07 -- 6:3Z.
1,1,2 Tnctiloroethane
, 6230D.
1215107: 6:32 .
- = Trlchloroethane,�
5 62300
c0.5 ug/L"
1215/07 6.32
_' _
Trlchlorofluoromethane
6230D
<06 use/L
1215107 ' 6:32

+. `200T 10.:45AM=`
'TrJt i "fax o
NO'.' P;' 33
- }
aT�ST
�
..
6701 Conference
Page 6
1 iI Y 'r • L 4-, .yA {ttl
Raleigh; NC r27607
Telephone [phone]NClvvvuCentc os7
.
Fax:[phone]
.
NC/Dw cart. : 37731:.
Laborafor.y „Report
Bay Tree Lakes
Work.Order #: 0711-01614
No.'Sample-ID Well. #3 `.
Date Sampled Time Sampled , Matrix
= Sample Type. Condition
008 071146675-008'
' . 0:00
WWI
Unknown 4 +/- 2 deg C
Analyzed
Test Performed
Method
.Results :
Date Time Qualifier
1,2,3-Trichloropr6pane
6230D
'<0.5 uglL
IW5107 -6:32
1,2,4-Trimethylbenzene
62300 .
<0.5 ug/L
1215107 6:32
1,3,5-Trimethylbenzene
.'6230D
<0.5, ug/L
12/5L07 _6:32
Vinyl chloride
6230D
<0.5 ug/L
1215/07 6:32
o Xylene
62301)
<0.5' ug/L
1215107 6:32
m.p Xylene
6230D
'<0.5 ug1L
1215107 6:32
.1,2-Dichlorobenzene
6230D .
<1 uglL
1215107 6,32
1,3-Dichlorobenzene
6230D.
<7 ug/L.
12/5/07 6:32
1,4-Dichlorobenzene
: 6230D
<1 u'91L
1215107 6:32 .
0.
Noy Sample ID Well 15
:Date Sampled Time Sampled Matrix
_ Sample Type Condition .
009 0711-56676-009,
0:00
WW
Unknown 4_t/. 2 deg C
Analyzed
Test Performed
Method
Results
Date Time Qualifier
VOCs in. GW by 6230D
6230D
121W07 6:32
Benzene
6230D
<04 ug►L
1215107 6:32
Bromobanzeno `
6230D
<0:5 ug/L
1215107, -6:32
Bromuchloromethane
6230D
<0.6 ug/L '
12/5/07 - 6:32
Bromodlchloro`-methane
6230D
<0.5 ug/L.12/5/07
6:32
Bromoform,
6230D
<0.5 ug/L
1215107 6:32
Carbon tetrachloride -
6230D
c0.5 uglL
1215/07 ", 6:32
Qhlorobenzene
6230D
<0.5 ug/L
12/5/07 6:32
Chtoroethane
6230D
<0.6 uglL
1215107 : 6:32 "
Chloroform
6230D
<0.5 ug►L
1215107 6:32'
Chloro methane
.6230D
<0.5 ug/L
12/5107 6.32 ,
2-Chlorotoluerie
6230D
<0.5 ug/L
1215107 6:32
4-Chlorotaluene
<0.5 uglL'
1216/07 6:32
Dibromochlorome#iane
_6230D
6230D
<0.5 ug/L
1215/07 6:32
�1,2-Dibromo-3-chloropropane
6230D
<0.5 uglL
12/5107 6:32
1,2=Dlbromoethane
6230D
<0.5 ug/L
12/5107 6:32
Dibromomethane
62300
<0.5 uglL:
1215/07 6:32
Dichlorodifluoromethane
6230D
<0.5 ugIL
1215107 6:32
1,1-01chlcroethnne
6230D
COX u41L
12/5/07.: 6:32
1,2-Dichloroethane
62300
<05 uglL
12/5107: 6:32
1,14Dlchloroethene
623OD
<0.5 ug/L
12/5/07 6:32
cls-1,2-1011chloroethene''
- 6230D
.40:5 ug/L
12/5107, 6:32 -
imns-a 2-Dichl6roethene . '
_ 62300. :
, ; <0.5, ug/L
- 12/5107, 6,32 `
1,2-Dichloropropane
6230D
<OA uglL
_
1216/07 : 6:32
�1,3 D1ch16�ropropane
6230D
<0.5 ug1L = "
' ' 1215107, 6c32 - -
Q,24, ichloropropane
6230D_ ' -
<0.5 ug►L `
1215/07 _'6:32:
'1,7-01chloropropene
' f 6230D
= < <0.5 uglL
1215107 6:32

Dec. 14:- 2-001" 10` 46AM-
Tr'i'tesr `fix o' .:
-
No 8561 K 34
F r 6701 Conference�Drive f f �� PageTc�f 7- 4
t
z , L Raleigh NC 276Q7e
Telephone (919)
834-4984 ; ° r t ' NCIWW�Cert 067
' Fax: (919) 834-�6497
ek
`NcIDW Cert_. #: 37731
Labo'rato'-ry Rep.ort
Bay Tree Lakes
Work Order#P 67111.01514
No_� . Sample ID Well 15
Date Sampled Time Sampled Matrix
Sample Type 'Condition
008 0711-56675-009
0:00
,VWII :
Unknown. 4 +/- 2 deg C
Analyzed
Test Performed
Method "
Results
Date 'Time Qualifier
cis-1.3-Dichloropropene
6230D
<0:5 ug/L
`' S215/O7-• 6:32
trans-1,3�0Ichloropropona
'6230D
<0.5 uglL
1215107 6:32
Ethylbenzene
6230D
<0.5 ug/L
121510T 6:32
Hexachlorobutadlene
6230D
<0.5 ugIL
-
12/5/07 6:32
lsopropyl6enzene
6230D
<0:5 uglL
1215/07 6:32
4-Isopropyltoluene
6230D
<0.5 ug/L
.1215107 6:32
Methylene chloride
6230D _
<0;5 u9IL ''.'
12/5/07 6:32
' Naphthalene
6230D
<0.5 091E
1215107' 6:32
n-Propyibenzene
6230D -
<0.5 ug/L _
1215107 ' 6:32
Styrene .
6230D
<0:5 ug1L r:
1215/07- 6:32
1,1,1,2 Tetrachloroethane '
6230D_ .4
4.5 uglL
1215/07 6:32
1.1.2.2-Tetrachloroethans
6230D
<0.5 uglL
-1215107 6.32
Tetrachloroethone;
6230D
<0.5 ug/L -
12/5- . 6:32
Toluene
6230D
<05 uglL
12J5/07 6:32
1,2,3 Trichlorobenzene
6230D
<0.5 ug1L
12/5/07 6:39
1,2,4-Trichlorobenzone
6230D
<0.5 ug/L
1215107 6:32
1,1,1-Tricyloroethane
6230D
:;.<O.S 091E
12/5/07� 6:32
1,1,2-Trichloroethane .
6230D "
<0.5 uglL
1215107, 6:32
Trlchloroethene
-623013 -
<0.5 uglL
1215107 6:32
TrichlorcNoromethane
6230D
'<0.5 ug/L
1215/07 -6:32
11,2,3-Trlchloropropane '
8230D.-
<O.S 091E
12/5/07 6:32
1,2,4=Trimethylbenzene
6230D
<0.5 091E
1215107 6:32
`1,3,5-Trimethylbenzene
6230D
<0.5 ug/L '
1215107 6:32
Vinyl chloride
6230D . '
<0:5 uglL
1215107 6:32
o-Xyleno
6230D
<0:5 ug/L
12/5107 6:32 •-
.m.p Xylene
6230D .
<0.5 ug/L
1215/07 6:32
1,2-Dichlorobenzene
•6230D
<1.091E
1vsw 6:32
1,3-Dichlorobenzene
6230D
<1091E
1215/07, 6:32
IA-Dichlorobenzene
6230D .
<1 ug/L
1215107 6:32

M� ' ;&
Please Print Clearly or Type
.Facility Game: ;r Ba4 Ti
Permit Name (If`di f f erent):
:... Ate.,_:--. 33 W.' l
E;4lls 28466County $laden
�y ( Ids) (ZIP) Stephen Jones Telephone #[phone]
Con act Person: P 4
Well Location/ Site Name: Well # 1 No. of Wells to be Sampled:
rom um
Well Identification Number (from Permit): Well I i For Groundwater Treatment Systems
Weil Depth: ,Zg&D ft. Well Diameter: 2 in. Check One;
Screened Interval: _____—ft. to It. . . ❑ Influent (98)
Depth to Water Level: ___.Z2ft. below measuring point. O Effluent (99)
Measuring Point is—ft. above land surface.
Gallons of water pumped/balled before sampling: 04
Field analysis: pH.-._._ 4�'.�� , Specific Conductance uMhos
Temp. .—..1703 OC, Odor Appearance
PERMIT #: EXPIRATION DATE: -
Non -Discharge, W00018708 UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Rernedlation: Infillral - a
✓ Spray Field Remediallon: 140=2 `" �..�
Rotary Distributor Land Appilcallon �o©f Sludge
Other: HAll It q1 2 n P
NOTE: - Values should reflect dissolved and
colloidal concentrations.
Date sample collected: llzo.f Date rsample ,Nozed: 27
Laboratory Name: Ua°°
Certificatlon.No: 22, 75
PARAMETEg (Samples for metals were collected unfiltered. YES NO
and field acidified
COD
mg/I
Nitrite (NO2) as N
mgll
Coliform: MF Fecal < /
Coliform: MF Total
/100ml
/i 00ml
Nitrate (NOs) as N
Phosphorus: Total as P
mg/l
cw02 mg/l
(Not®: Use MPN method for highly turbid samples)
Orthophosphate
mg/I
mg/I
Dissolved Solids: Total
mgll
Al - Aluminum
pH (when analyzed)
units-
Ba - Barium
mg/I
�./�
TOC iry0�0
mg/l
Ca - Calcium
mg/I
Chloride hs,
mg/I
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
mg/I
Grease and.0iis
mg/I
Cu - Copper
mg/I
Phenol
mg/1
Fe - Iron,
mg/I
Sulfate -
mg/l
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia •<d'?D mg/l
Mg - Magnesium
mg/l
TKN as td
mg/I
Mn - Manganese
mg/l -
YES ' NO)
Ni - Nickel mg/
Pb - Leap mg/
Zn - Zinc mg/
Ammonia Nitrogen mg/
Other (Specify Compounds and Concentration Unit.
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach tab report.)
Report Attached? Yes (1) No ._.
VOC method #
method,#/_____.__
method #
Permlttee (or Aulhorked Agenl) Name and Tiller Please print or type
GWI-59 Rev.:4198
na ura qI Perm Iloe (or Auihorirrc genli

4 &
ouwrvn i rvmm vlV r c&6vry nmr-cm uNLY
Please Print Clearly or Type
.Facility Name: Bay Tree Lakes
Permit NaMS (if d33 W.t)Ba Ridge Road
Facility Address:
Harrel.ls W1 28466County - Biaden
Contact Person: Stephen Jones Telephone #[phone]
Well Location/ Site Name: Well #2 No. of Wells to be Sampled,4
rom arm
Well Identification Number (froin Permit):' Well 12 For Groundwater Treatment Systems
Well Depth:ft. Well Diameter: 2 in. Check One:
Screened Interval: ft. to ft. ❑ Influent (98)
Depth to Water Level:ft. below measuring point. ❑ Effluent (99)
Measuring Point is ft. above land surface.
Gallons of water pumpedlbailed before sampling: Azey
Field analysis: pH— 3 , Specific Conductance - uMbos
Temp. °C, Odor I Appearance
PERMIT M EXPIRATION DATE: !j'-o
Non:Discharge W00018708 UlC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Rerhedlatlon: Infiltration Gallery'
_Spray Field Remediatton:
Rotary Distributor Land Applica���O
Other.�I1 I
DOTE: Values should reflect dissolved and 04-AY 0 9 2007
colloidal concentrations.
Date sample collected:' Date sample analyzed:.
Laboratory' Name: Qacni�=ies, 0�d � '
Certification No. 22, 75
PARAMETER$ (Samples for metals were collected unfiltered YES NO
and field acidified
COD
mgA
Nitrite (NO2) as N
mgA
Coliform: MF Fecal < I
/100ml
Nitrate (NO3) as N
<0-10 mgA
Coliform: MF Total
/100ml
Phosphorus: Total as P
<0 62 mg/I
(Note: llse MPN method for highly turbid samples)
Orthophosphate
mg/l
Dissolved Solids: Total J-9 mgA
At - Aluminum
_ mg/l
pH (when analyzed)
units
Ba - Barium
mg/i
TOO Y-44
mg/i
Ca - Calcium
mg/I
Chloride Z"o
mg/l
Cd - Cadmium
mg/1
Arsenic
mg/I
Chromium: Total
mg/I
Grease and.0ils
mgA
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate
mg/l
Hg - Mercury
mg/1
Specific Conductance
uMhos
K - Potassium
mg/I
Total Ammonia <62(?
mgA
Mg'- Magnesium
mg/I
TKN as td
- mg/I
Mn - Manganese
mg/l
- YES ' NO)
N1- Nickel
mg/I
Pb - Lead
mg/i
Zn - Zinc
mg/1
Ammonia Nitrogen
mg/I
Other (Specify Compounds and. Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method '#. Attach lab report.)
Report Attach.edT Yes (1) No (0)
VOC method #
method.
methol # s
Permlttee (or Authorized Agont) Name and 7111e -Please printor type
J 8l0
©Vh59 Rev. A/98 nature o • erm flee tar ut Nrrc gent)

A,
Facility Name: pay free LaKeu
permit Name (if, dgferen))II„� u Boa R��a
i Stephen .tones - - Telepnone -- - -
Conttaot Person: We11 #3 No. of Wells to be Sampled: 4
erm
Well Location/ site Name: r°m
Well Identification rvumoer tirom 5„, ...„_.._.._._...__.. -- .
Well Depth: ' Z0ft• Well Diameter:2 in. Check One:
Screened Interval: ft. to _�. ft. . 0 Influent (98)
Depth to Water Level: B4O ft. below measuring point. [I Effluent (99)
Measuring Point is ft- above land surface.
Gallons of water pumpedi al ad before sampling: /Z 0
S ecifio Conductance uMhos
Field analysis: •pH MI ec. Ya Odor Appearance -
Values should reflect dissolved and
colloidal concentrations. •
Date sample collected: T,d°
Laboratory' Name: Vasa 'A"" __ '
Cerllticatton.No: 22, 75
EARAMMBA (Samples for metals were collected -unfiltered _._.YES _____NO and field acidified
mg/l Nitrite (NO2) as N mg/I
COD
Coliform: MF Fecal �' I
/ 1OOml
Nitrate (NO3) as N
Phosphorus: Total as P - o�zk42!g/l
m m
Coliform: MF Total
/100m1
Orthophosphate
mgll
ll
(Note: Use MPN method for highly turbid Samples)
Dissolved Solids: Total q mg/i
Al - Aluminum
mgll
mg/I
pH (when analyzed)
3 015`r--
units
mg/ I
Ba - Barium
Ca - Calcium
mg/I
TOO
Chloride 7,
L mg/I
mg/i
Cd - Cadmium
Chromium: Total
mg/1
mg/l
Arsenic
Grease and.0ils
mg/l
Cu - Copper
mg/1
mg/l
Phenol
mg/I
mg/I
Fe - Iron
Hg - Mercury _ -
melt
Sulfate
Specific Conductance hos
�"
K - Potassium
Mg =Magnesium
mg/l
melt
Total Ammonia ____—�`
TKN as N
mgn
mg/I
Mn - Manganese
mg/i
YES • . NU) ,
NI - Nickel mg/l
Pb - Lead mg/1
Zn - Zinc mg/l
.Ammonia Nitrogen mg/1
Other (specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. Attach lab report.).
Report AttachedT Yes (1) No. (0
V0�_ : melbod #
method.,
meth+ #
r
permittee (or Authorized Agont) Name and Title -please t ar type
GWI-59 Rev.: 4/98

a,
ouorvu r r%jmivr vry r er-rwvv r^rcrs ut%. r
�ec;iLITY i FORMATION Please Print Clearly or Type
.Facility 14ame: Bay Tree Lakes
Permit Name (if diferenl):
Facility Address: 3 W. Ba Ridge Road
flarrells t 28466County Bladen
Contaco
t Persn: Stephen Jones tZIP) Telephone #[phone] -
Well Location/ Site Name: Well #5 No. of Wells to be Sampled: 4
rom arm
Well Identification Number (from Permit): Well iF- For Groundwater Treatment Systems
Well Depth: , ft. Well Dlameter: 2 in, Check One:
Screened Interval: ft. to It. . ❑ Influent (98)
Depth to Water Level: Z ft. below measuring point, ❑ Effluent (99)
Measurlrig Point Is ft. above land surface.
Gallons of water pumped/bailed before sampling: X73
Field analysis: -pH A..o r Specific Conductance uMhos
Temp, /bd °C, Odor Appearance
PERMIT #: - EXPIRATION DATE: _ S•Zy94—
Non=Discharge,_WQ0018708 UIC
NPDES
JyPE OF PERMITTED OPERATION BEING MONIOf it DR ECF— 9l-lx
Lagoon Reihediatlon: tnliltratl a $�9��i
Spray Field Remedfallon:
Rotary Distributor Land Application of SludgePlAy 0 9, 20[
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample collected: -T.�'�0 67 Date sample analyzed:'
Laboratory Name: Vaoa labarayries, Offmd Laboratory
Certification.No; 22, 75
PARAMETERS (Samples for metals were collected unfiltered YES NO
and field acidified
COD mg/I
Nitrite (NO2) as N
mgll
Coliform: MF Fecal < 1_/100ml
Nitrate (NO3) as N
Ate mg/l
Coliform: MF Total /100ml
Phosphorus: Total' as P
b mg/l
(Note: Use MPN method for highly turbld samples)
Dissolved Solids: Total , 00 mg/l
Orthophosphate
Al - Aluminum
mg/I
mg/i
pH (when analyzed) units
Ba - Barium
mg/1
TOG 7'45 mgli
Ca - Calcium
mgll
Chloride ls.Z mg/I
Cd - Cadmium
mg/1
Arsenic mg/I
Chromium: Total
mg/l.
Grease and•Oils mg/I
Cu - Copper
mg/1
Phenol mg/I
Fe - Iron
mg/l
Sulfate mg/1
Hg - Mercury
mg/1
Specific Conductance
Potassium
mg/i
Z, lol�Mmos
Total Ammonia g
M-
g = Magnesium
mg/I
TKN as N mg/I
Mn - Manganese
mg/i
YES —NO).
Ni - Nickel mg/I
Pb - Lead .T mg/1
Zn - Zinc mg/l
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration knits)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method#. Attach lab report.)
Report Attached?' Yes(1) No ____..(0)
VOC : metbod #
method m
Permittee (or Authorized Agont) Name and 7RIe - Please print or type
f3Vir-59 R®Y: d19tf • ' , nalur8 0 , erm i ae (or Aui r md• gnnq •
( ate)

v. -1-6__1 -
W QO-O/87O�i
- GPS Field Sheet
Project/ Location
Date
Time
GPS File No.
Field
Latitude
Field '
Longitude
'Corrected
Latitude
Corrected
Longitude
Comments
TArZPeEe. T&V MW - (p
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$1 ZO y/5.4.
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78 8305(0 I
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78. 8 , 93J•'�PM-
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351. (OYo 5'0 /
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GROUNDWATER SECTION Page
1 of I
Report to: FRO
CHAIN OF CUSTODY (COC) RECORD
i
(check one): [®j CENTRAL j❑ 1 ARO [❑ 1 WaRO
NC DENR/DWQ LABORATORY
For Investigation of: Lake Creek-- Bay Tree Lake
Incident No.WQ 0018708
Sample collector (print name) i .
and GW-54 forms completed by: Bill Todd Sample collector's signature:
Field storage conditions and location (when applicable):
NUMBER
Lab Use Only
I DATE
; SAMPLED
TIME
SAMPLED
OF
CONTAINERS
LAB NO.
SAMPLE ID
QUAD. NO.
LOCATION
Bay Tree Lake
Y
5
IvIW-1
Bay Tree Lake
`ai6A�
5
MW-2
Bay Tree Lake
MW-3
Bay Tree Lake
5
MW-5
I.
Time
I
DateTTime
yceived by (signature):,
Date
Relin uished by
(s' nature):
Dateeceived
by (signature):
Date
Time
Relinquished by (signature):
by (signature):, ;
I,
Date
Time
Relinquished by (signature):DateReceived
I I
Method of Shipment (check one): State Courier® Hand -delivered[] Federal Express[] UPS[] Other:
Sealed by:
Broken by:
Security Type and Conditions:
INTRALABORATORY
LAB NUMBERS
FROM
CHAIN
THROUGH
OF CUSTODY
NUMBER
BOTTLES
- Lab use vni
ANALYSES
REQUESTED
RELINQUISHED
BY:
RECEIVED
gY
DATE
TIME
I
i�
�I.
I
1'

port to: FRO GROUNDWATER SECTION
CHAIN OF CUSTODY (COC) RECORD
NC DENRIDWQ LABORATORY (check one): I® I CENTRAL I❑ I ARO I❑ I WaRO
Page 1 of 1
For Investigation of: Lake Creek— Bay Tree Lake
Incident No.W 0018708
JUL
Sample collector (print name) ��
and GW-54 forms completed by: Bill Todd Sample collector's signature:
t R-- FAYR - LE REGIONAL
OFFICE
Field storage conditions and location (when applicable):
-
Lab Use Only
LAB NO.
SAMPLE ID
QUAD. NO.
LOCATION
j
DATE,
SAMPLED
TIME
SAMPLED
NUMBER
OF
CONTAINERS
�C(2
ll
MW-1
Bay Tree Lake
—lG-o?
, R
D,�n
5
j(;j4 99
�� 11
MW-2
Bay Tree Lake
! ?
1(,11116 i9
5
MW-3
Bay Tree Lake
l �C
5 .
MW-5
Bay Tree Lake
_
`
5
I
f
'
I
f 1
Relinquished by (s' nature):
Date
Time
M We by (signatur
to
Time
Relinquished by (signature):
Date
Time
Rec ived by (signature): 1
Date
Time,
Relinquished by (signature):
Date
Time
Received by (signature):
Date
Time
Method of Shipment (check one): State Courier® Hand -delivered❑ Federal Express[] UPSO, Other:
Security Type and Conditions:
Sealed by:
P
�
en by:
INTRALABORATORY CHAIN OF CUSTODY - Lab Use Onlv
LAB NUMBERS
FROM THROUGH
.
ANALYSESA
• •
•
®®'I

® MEMBER Pagel of'1
Microbac Laboratories, Inc.
FAYETTEVILLE DIVISION INVOICE
2592 HOPE MILLS ROAD
FAYETTEVILLE. NC 28306 NO. 53410
[phone] FAX [phone]
R. W. SANDERS, SR. - V.P. & MANAGING DIRECTOR
http://www.microbac.corh E-Maii'l: [e-mail]
NC DENW - DWQ (Aquifer Prot)
Mr. Art Barnhardt .
225 Green Street, #714 .
Fayetteville, NC 28301
Sampling done on 071161107, Sample received at lab or': 07176107
LAS REPORT NO.-
CLIENT ACCOUNT NO '
TERMS :
`DATE I
CLIENT PURCHASE ORDER NO.
0707-00619
N022
NET 30 DAYS
' 07/31/07
Description ;._ '.
' Rate i
Date.
Quantity
` :Extended
COLIFORM, FECAL
$27.00 I
4
$ 108.00
i
Y ki.: y
Total Amount
$ 108.00
F a� z ��
1$0.00
Prepaid Amount
CHEMISTRY MICROBIOLOGY • FOOD SAFETY CONSUMER PRODUCTS : Amount
.
WATER . AIR WASTES • FOOD PHARMACEUTICALS NUTRACEUTICALS Due .
$ 108.00
``LAB REPORT`NO
CLIENT ACCOUNT NO"
TERMS
DATE
Invoice' Number
0707-00619
N022
NET 30 DAYS
07/31/07
53410
M/W Samples - Lake Creek - Bay Tree Lake
Please include this Invoice Stub with all remittances
•
CHEMISTRY MICROBIOLOGY • FOOD SAFETY • CONSUMER PRODUCTS Amourit°
108.00
WATER - AIR WASTES • FOOD • PHARMACEUTICALS` NUTRACEUTICALS Due

®. Microbac: Laboratories, Inc.
Page 1 of 1
FAYETTEVILLE DIVISION
2592 HOPE MILLS ROAD
STATE CERT ID.
FAYETTEVILLE, NC 28306
NC #11
[phone] FAX [phone]
NC437714
R. W. SANDERS, VICE PRESIDENT
USDA #3787
http://www.tnicrobac.cotn E=Mail: [e-mail]
CHEMISTRY MICROBIOLOGY • FOOD SAFETY • CONSUMER PRODUCTS
WATER • AIR WASTES • FOOD • PHARMACEUTICALS • NUTRACEUTICALS.
NC DENW - DWQ (Aquifer Prot)
Mr. Todd
225 Green Street, #714
Fayetteville, NC 28301
Permit No.
Sampler: Todd
CERTIFICATE OF ANALYSIS
Date Reported:
Date Received:
Subject: M/W Samples - Lake Creek _.Bay Tree Lake
SMP Test Method
COLIFORM, FECAL
COLIFORM, FECAL
SM18 9222D
SM18 9222D
Result
<1 cfu%100 ml
<1 cfu/100 ml
Order Number.
Invoice No.:
Customer #:
Sample Date:
Sample Time:
I ,
I
7/31 /2007
7/16/2007
0707-00619
53410
N022
7/16/2007
0:00
Date , . Time Tech
7/16/2007 15:07
f
7/16/2007 15:07
MAI
MAI
Tr'z �27 5 '' � ,-
COLIFORM, FECAL SM18 9222D <2 cfu/100 ml 7/16/2007 15:07 MAI
COLIFORM, FECAL SM18 9222D <2 cfu/100 mi." 7/16/2007 15:07 MAI
i
1
RESPECTFULLY SUBMITTED:
MICROBAC LABORATORIES, INC.
Thank you for your business. We invite your feedback on our level of service to you. Please contact the Laboratory Director, Ron Sanders at 910-864-1920 , Robert Morgan,
COO, at [e-mail] or Trevor Boyce, CEO, at [e-mail] with any comments or suggestions.
I
I
LAB CODES -NID = None Detected NIF = None Found < =.Less than > = Greater than Est. = Estimated
The data and other information contained on this, and other accom an in documents, represent only the sam le s analyzed and is rendered u MEMBER
P Y 9 P Y P �) Y upon the condition that it is not to be reproduced wholly or in part for advertising or other purposes without written approval from the laboratory. -
USDA-EPA-NIOSH Testing Food Sanitation Consulting Chemical and Microbiological Analyses and Research W9

DWO LaboratorySection Wesufts
Sample ID: AB19430
Loc. Descr.: LAKE CREEK - BAY TRACE LAKE
• PO Number# 7G0582
Location ID: WQ0018708 VisitlD
County: BLADEN - `adF W AT�QG
Collect Date: 07/1612007
River Basin
Report To FROAP q Collect Time:: 12:13
_ r
Region: FRO � a e� _ ✓ ; 'I Date Received: 67/17/2007
'
Collector: B TODD E Nil r08:20
Time Received:
Sample Matrix: GROUNDWATER AUGO 7 2W7 1
MONITORING WELL F1 /I Late es rte is MMA
Loc. Type: `—[\'1J
Sample Depth Date Reported: 08/02/2007
DENR—FAYETTEVILLEREGIONALCIFFICE Emergency Yes/No
COC Yes/No YES
Sample Qualifiers and Comments
Routine Qualifiers
For a,more detailed description of these qualifier codes refer to www.dwglab.org under Staff Access
A-Value'reported is the average of two or more determinations
N3-Estimated concentration is < PQL and >MDL
B1-Countable membranes with <20 colonies; Estimated
NE -No established - ---- -- � ---- --� -- -
B2- Counts from all'filfers were zero.
P-Elevated PQL due to matrix interference and/or sample dilution
133- Countable membranes with more than 60 or 80 colonies; Estimated - — - -
Q1-Holding time exceeded prior to receipt at lab.
B4-Filters have counts of both >60 or 80 and < 20; Estimated
Q2- Holding time exceeded fallowing receipt by lab
135-Too many colonies were present; too numerous to count (TNTC) PQL- Practical Quantitation Limit -subject to change due to instrument sensitivity
J2- Reported value failed to meet QC criteria for either precision or accuracy; Estimated
U-Samples analyzed for this compound but not detected
J3-The sample matrix interfered with the ability to make any accurate determination; Estimated
X1-Sample not analyzed for this.compound
J6-The lab analysis was from an unpreserved or improperly chemically preserved sample; Estimated -
N1-The component has been tentatively identified based on mass spectral library search and has an estimated value
LAB
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 2

NC 1n2VQ La6oxatory Section 1�esuCts Sample ID AB19430
07/16/2007
Ls tyti0 ID: W00018708
Collect Date:
�.
°Loc. Descr.: LAKE CREEK - BAY TRACE LAKE
C Collect Time::, 12:13
i�\,
Visit ID
CAS # Analyte Name PQL Result Qualttier units Anatysuuate Approvea toy ►uate
Method Reference
7/17107
7/17/07
MIC
TOC In liquid
2.0
7.0
mg/L
ADEXTER
CGREEN
Method Reference
APHA5310B-20th
7/26/07
8/1107
WET
Total Dissolved Solids In liquid
12
62
mg/L
AWILLIAMS
CGREEN
Method Reference
APHA254OC-18TH
7/19/07
7/27/07
Chloride
1.0
8.7
mg/L
MIBRAHIM
MOVERMAN
Method Reference
EPA 300.0
.7/17/07
7/20/07
Fluoride
0.4
0.4
U
mg/L
MIBRAHIM
MOVERMAN
Method Reference
EPA 300.0
7/17/07
7/20/07
Ion Chromatography
TITLE
mg/L
MIBRAHIM
MOVERMAN
Method Reference
EPA.300.0
7/17/07
7/20/07 .
Sulfate
2.0
4.6
mg/L
MIBRAHIM
MOVERMAN
Method Reference
EPA300.0
7117107
7/20107
NUT
NH3 as N In liquid
0.02
2.8
mg/L as N
MAJAYI
CGREEN
Method Reference
LaclO-107-06-1-J
7/191,07
7/23/07
NO2+NO3 as N In liquid
0.02
0.02
U
mg/L as N
MAJAYI
CGREEN
Method Reference
LaC10-107-04-1-c
7/19/07
7/25/07
Nitrate as N In liquid
0.02
0.02
U
mg/L as N
MOVERMAN
CGREEN
Method Reference
Lachatl07-04-1-c,
7/23/07
7/23/07
Nitrite as N In liquid
0.01
0.01
U
mg/L as N
GBELK
CGREEN
Method Reference
Lachatl07-04-1-c
7/18/07
7/23/07
Laboratory Section>> 1623 Mail,Service Center, Raleigh, NC 27699-1623 [phone] Page 2 of 2

GROUNDWATER FIELD/LAB FORM
Location code WQ 0018
County_Bladen,
Quad No Serial No.
Lat. Long.
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
SAMPLE TYPE SAMPLE PRIORITY G Z
� Water ZI Routine Lab Numbermtq r
❑ Soil ❑ Emergency Date Recei ed d ( Time314
❑ Other Redd By: rom:Bus ours r, and Del.,
IL ® Chain of Custody Other:
Report To: AR CFFed.
MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston Trust, Central Off., Other: Date Reported:
Shipped by: Bus, oune , Hand Del., Other: Purpo
Collector(s):_BillTodd Date �T lr' �T�me eZ ' 3 B seline, Complaint, ompliance (LUST, Pesticide Study; Federal Trust, Other:
FIELD ANALYSES Owner �4.�Ce Cl�c'_c� iC r 04q ��� e -� Aid
pH 400 44 i Spec. Cond.94 at 25°C
Temp.lo PT. °C Odor /'llzO 'C'_
Annearance A4 a"-8
Field Analysis
By: _BillTodd
LABORATORY ANALYSES
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /loom[
Coliform: MF Total 31504 /100ml
X
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410- --- mg/L
Alkalinity to pH 8.3 415_ mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
X
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 CU
Cyanide 720 mg/L
Lab
Location or Site
Description of samplin oint E ! I e_s d
/ Sampling Method Ai j a Sample Interval
Remarks um°. bailer. etc.)
(Pumping time, air.temp., etc.)
X
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/1
Specific Cond. 95
uMhos/cm
X
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
X
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L
P:.Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
Ag-Silver 46566 u /L
AI -Aluminum 46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 46558 u /L
Ca -Calcium 46552 m /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u /L
Cu-Copper46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 m /L
Mg-Magnesium.46554-- - --- m /L-
Mn-Manganese 46565 u /L
Na-Sodium 46556 m /L
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn-Zinc 46567 u /L
Or anochlorine Pesticides
Or ano hos horns Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Range
Volatile Organics(VOA bottle
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival (°C):

LOW
r
Sample ID: AB19429
Loc. Descr.: LAKE CREEK - BAY TRACE LAKE
PO Number# 7G0581
Location ID: WQ0018708 VisitiD
County: BLADEN Q W AT�Q Collect Date: 0711612007
River Basin `�j QG
Report To FROAP RECEIVED y U \ Collect Time:: 11:40
t
Region: FRO .. ;, *ti..,:,/;y � Date Received: 07/17/2007
Collector: B,TODD AUG ,o 2W7 g- Time Received: 08:20
Sample Matrix: 'GROUNDWATER \
Late Rep Logrted: D MMA
Loc. Type: MONITORING WELL ,
Date Reported: 08/02/2007
Sample Depth DENR — FAYE i UiLE REGIONAL OFFICE
Emergency Yes/No
COC Yes/No YES
Sample Qualifiers and Comments
Routine Qualifiers
For a more detailed description of these qualifier codes refer to www.dwqlab.org under Staff Access
A -Value reported is the average of two or more determinations
N3-Estimated concentration is < PQL and >MDL
Bl-Countable membranes with <20 colonies; Estimated
_ _ ___ _ - _ _ ______, __ NE=No established PQL _
B2-Counts from all filters were zero: - - - -
P-Elevated PQL due to matrix interference and/or sample dilution
133- Countable membranes with -more than-60 or 80 colonies;' Estimated - -- - - -' - - - — - _
Q1-Holding time exceeded prior to receipt at lab.
B4-Filters have counts of both >60 or 80 and < 20; Estimated
Q2- Holding time exceeded following receipt by lab
135-Too many colonies were present; too numerous to count (TNTC) PQL- Practical Quantitation Limit -subject to change due to instrument sensitivity
J2- Reported value failed to meet QC criteria for either precision or accuracy; Estimated
U- Samples analyzed for this compound but not detected
J3-The sample matrix interfered with the ability to make any accurate determination; Estimated
X1-Sample not analyzed for this compound
J6-The lab analysis was from an unpreserved or improperly chemically preserved sample; Estimated
N1-The component has been tentatively identified based on mass spectral library search and has an estimated value
LAB'
Laboratory Section» 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 2

s� �C DWQ .Laboratory Section 1�esufts Sample ID aB1s42s
•location ID: WQ00187d8 Collect Date: 07/16/2007
Loc. Descr.; e, ` x Time:: 11:40 "
LAKE CREEK -BAY TRACE LAKE Collect Visit ID
ICAS # Analyte Name, PQL Result Qualifier Units Analyst/Date Approved By /Date
Method Reference
7/17/07
7/17/07
m1c .
TOC In liquid
2.0
9.6
mgfL
ADEXTER
CGREEN
Method Reference
APHA5310B-20th
7/26/07
8/1/07'
WET
Total Dissolved Solids In
liquid
12
41
mgfL "
AWILLIAMS - `
.CGREEN
Method Reference
APHA2540G18TH ' `
7/19i07
7/27/07
Chloride
1.0
12'
mgfL
MIBRAHIM
MOVERMAN
Method Reference
EPA 300.0
7117/07
7/20/07
Fluoride
0.4-
0.4 U
mgfL
MIBRAHIM
MOVERMAN
Method Reference
EPA 300.0
7/17/07
7120107
Ion Chromatography
TITLE_
mg/L
MIBRAHIM'
MOVERMAN
Method Reference
EPA 300.0
7117/07
7/20/07
Sulfate
2.0
11
mg1L
MIBRAHIM
MOVERMAN
Method Reference
EPA300.0
7/17/07
7/20/07
NUT
NH3 as N In liquid
0.02
-- 0.04
mg/L as N '
MAJAYI
CGREEN
Method Reference
LaclO-107-06-1-J
7/19/07
7/23/07
NO2+NO3 as N In liquid
0.02
0.56
mg/L as N
MAJAYI
CGREEN
Method Reference
1.600-107-04-1-c
7/19/07
7/25/07
Nitrate as N In liquid .
0A2
-0.56 "
mg1L as N
MOVERMAN
CGREEN
Method Reference
Lachat107-04-1-c
7/23/67
7/23/07,
Nitrite as N In liquid_
0.01
0.01 U
mgfL as N
GBELK
CGREEN
Method Reference
Lachat107-04-1-c
7/18/07
7123107
Laboratory Section>> 1623 Mali Service Center, Raleigh, NC 27699-1623 [phone] Page 2 of 2

fl.
North Carolina
GROUNDWATER FIELD/LAB FORM
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Location code_WQ 0018708 SAMPLE TYPE SAMPLE PRIORITY n
County_Bladen )4 Water 0 Routine D
qaboNrumber rVT_
Quad No Serial No. Soil El EmergencyDate Receive91
Time:
9•
Lat. Lon ❑Other 3 Rec'd By: From:Bus oude
3 Hand Del.,
Chain of Custody Other:
Report To: ARO FRO MRO, RRO, WaRO, WiRO,. I Data Entry By: Ck:
WSRO, Kinston FO Fed. Trust, Central Off., Other: Date -Reported:
Shipped by: Bus, ourier Hand Del., Other: Purpos
Collector(s):_BillTodd ?���o-c5 Time )Baseline, Complaint, Complianc LUST, Pesticide Study, Federal Trust, Other:
Date r% (circle one) /
FIFI n ANA -1 YgPR Owner L AiZe. C reP ek 7-Ife-P_
pH 400 A-t . Y -Spec. Cond
Temp.to • 9, fl 1 °C Odor A 4
Appearance qk[>'. f e cz U
Field Analysis
By:_BillTodd
LABORATORY ANALYSES
BOD 310 mg/L
COD High,340 mg/L
COD Low 335 mg/L ,
Coliform: MF Fecal 31616 /100ml .
Coliform: MF Total 31504 /100ml
X
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403units
_
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L '
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
X
Chloride 940 mg/L
Chromium: Hex 1032 uglL
Color: True 80 Cu
Cyanide 720mg/L
Lab
25°C Location or Site
Description of sampling
Sampling Method
X
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/1
Specific Cond. 95
uMhos/cm
X
Sulfate 945
mg/L
Sulfide 745 -
mg/L
Oil and Grease
mg/L
X
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L.
P: Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
Sample Interval
(Pumping time, air temp.; etc,)
Ag-Silver 46566 u /L
AI -Aluminum 46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 46558 a /L
Ca-Calcium'46552 m /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u /L
Cu-Copper 46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 m /L
-
My-K4a4n_esium46554- -- --m /L-
-
Mn-Manganese 46565 u /L
Na-Sodium 46556 m /L
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn-Zinc 46567 u /L
Acid Herbicides
TPH-Diesel
TPH-Gasoline
ITemperature on arrival (°C): I

DB Laboratoty Section Wesults
Loc. Descr.: LAKE CREEK - BAY TRACE LAKE
Location ID: W00018708
County: BLADEN " t� WArr4
River Basin
,Report To FROAP ��
V\
Region: FRO .A1�a�. �I _
Collector: B TODD A 7 \�
Sample Matrix: GROUNDWATER- -AUG 01 2Ml
Loc. Type: MONITORING WELL
Sample Depth DEhR-FA1'ErfE11iLLEREGIONALOMCE
Sample ID:
AB19428
PO Number#
7GO580
VisitlD
Collect Date:
07/16/2007
Collect Time::
11:10
Date Received:
07/17/2007
Time Received:
08:20
Labworks LoginlD
MMA
Date, Reported:
08/02/2001
Emergency Yes/No
COC Yes/No
YES
Sample Qualifiers and -Comments
Routine Qualifiers
For a more detailed description of these qualifier codes refer to www.dwqlab.org under Staff Access
A -Value reported is the average of two or more determinations
N3-Estimated concentration is < PQL and >MDL
�B1-Countable membranes�with­20•colonies; Estimated
132- Counts from all filters were zero.
P-Elevated PQL due
_to,matr'ix interference and/or sample dilution.. _
63- Countable membranes with more than 60 or 80 colonies; Estimated
Q1-Holding time exceeded prior to receipt at lab.
134-Filters have counts of both >60, or 80 and < 20; Estimated
Q2- Holding time exceeded following receipt by lab
B5-Too many colonies were present; too numerous to count (TNTC)
PQL-,Practical Quantitation Limit -subject to change due to instrument sensitivity
J2- Reported value failed to meet QC criteria for either precision or accuracy; Estimated
U- Samples analyzed for this compound but not detected
J3-The sample matrix interfered with the ability to make any accurate determination; Estimated
X1-Sample not analyzed for this compound ,
J6-The lab analysis was from an unpreserved or improperly chemically preserved sample; Estimated
NI -The component has been tentatively identified based on mass spectral library search and has an estimated value
LAB
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Pagel of 2

jr: XC (D Q Laboratory Section ResuftS Sample ID AB19428
Location ID: W00018708 Collect Date: 07/1612007
Loc. Descr.: LAKE CREEK - BAY TRACE LAKE Collect Time:: 11:10
Visit ID r fop i?
CAS # Analyte Name P61L Result tdualttler - units Anatysvuale • Approvea tsy /uate,
Method Reference
7/17/07
7/17/07
MIC
TOC In liquid
2.0
7.7
mgfL
ADEXTER
CGREEN
Method Reference
APHA5310B-20th
7126/07
8/1107
WET
Total Dissolved Solids In liquid
12
29
M91L
AWILLIAMS
CGREEN
Method Reference
APHA2540C-18TH
7/19107
7/27/07
Chloride
1.0
4.0
mg/L
MIBRAHIM
MOVERMAN
Method Reference
EPA 300.0
7/17/07
7120/07
Fluoride
0.4
OA
U
mgfL
MIBRAHIM
MOVERMAN
Method Reference
EPA 300.0
7/17/07
7120/07
Ion Chromatography
TITLE_
mgfL
MIBRAHIM
MOVERMAN
Method Reference
EPA 300.6
7/17/07
7/20/07
Sulfate
2.0
2.0
U
mgfL
MIBRAHIM
MOVERMAN
Method Reference
EPA 300.0
7117/07
7/20/07
NUT
NIi3 as N In liquid
0.02
0.10
mg/L as N
MAJAYI
CGREEN
Method Reference
Lac10-107-06-W
7/19/07
7123/07
NO2+NO3 as N In liquid
0.02
0.02
U
mgfL as N
MAJAYI
CGREEN
Method Reference
LaclO-107-04-1-c
7/19/07
7/25/07
Nitrate as N In liquid
0.02
0.02
U
mgfL as N
MOVERMAN
CGREEN
Method Reference
Lachat107-04-1-c
7/23/07
7/23./07
Nitrite as N In liquid
0.01
0.01
U
mglL as N
GBELK
CGREEN
—----------- -
-- ---——MethodReference - _--__Lachal10Z04-1-c___—_
7/18107
7/23/07
.Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 2 of 2

GROUNDWATER FIELD/LAB FORM r�-- D) C' p North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Location code_WQ 0018708 SAMPLE TYPE SAMPLE PRIORITY 0 �j�%1
County_Bladen C1 Water 0 Routine 0 Lab Number VA0M4 �, `�
Quad No Serial No. El soil El Emergency' �Date Received Time ' Cam✓
Lat. Long. ❑ Other Rec'd By: frorn7Bus, uri Hand Del.,
® Chain of Custody Othef:
Report To: ARO, RO MRO, RRO, WaRO, WiRO, Data EntryBy: Ck:
WSRO, Kinston FO Fed. Trust, Central Off., Other: Date Reported:
Shipped by: Bus, ourler Hand Del., Other: Purpose: .
Collector(s):_BilITO Date Time + /0 Baseline; Co mplaint,< ompliance LUST, Pesticide Study, Federal Trust, Other:
(circle one) _
FIELD ANALYSES Owner />< A 6?1' Z 'eclkl t-Ake
pH 400 Spec. Cond.94 at 250C
Temp.lo LT,-, °C Odor e � .� uxl
Appearance /1
Field Analysis
By:_BiIITodd
LABORATORY ANALYSES
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /100ml
Coliform: MF Total 31504 /100ml
X
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
X
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 CU
Cyanide 720 mg/L
Lab Com
Location or Site 1-n,4 A.4,o
Description of samplin oint Uj e 'C
Sampling Method r'tr e:2 Sample Interval
Remarks umo. ai er. a c.
X
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/I
Specific Cond. 95
uMhos/cm
X
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L ,
X
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (NO3as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
(Pumping time, air temp., etc.)
Ag-Silver 46566 u /L
AI -Aluminum 46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 46558 u /L
Ca -Calcium 46552 m /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u /L
Cu-Copper 46562 u /L
Fe -Iron 46563- u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 m /L
Mg -Magnesium 46554 ^m /L
Mn-Manganese 46565 u /L-
Na-Sodium 46556 m /L
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn-Zinc 46567 u /L
Or anochlorine Pesticides
Or ano hos horus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Range
Volatile Organics (VOAbottle)
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival (04

WC—DWO Laborato ection Wesults
AB19427
LAKE CREEK - BAY TRACE LAKE Sample ID:
Loc. Descr.: PO Number# 7G0579
Location ID: W60018708 VisitlD
County: BLADEN �Q� WA Collect Date: 07/16/2007
River Basin
Collect Time:: 10:40
Report To FROAP
Region: FRO
EEIVE1) r
t , ; .ram:, � Date Received: 07/17/2007
Collector. TODD B tom* a "u
�"�^� Time,Received: 08:20
Sample Matrix: GROUNDWATER .AUGy Q 7 2007
Loc. Type: MONITORING WELL / I\ Late Reporks rted: D MMA
y� Date Reported: - "08/02/2007
Sample Depth DENR—FAYTfEViLLE REGIONAL OFFICE U
Emergency Yes/No
COC Yes/No YES
Sample Qualifiers and Comments
Routine Qualifiers
For a more detailed description of these qualifier•codes refer to WWW-dwglab.brg under Staff Access
A -Value reported is the average of two or more determinations
N3-Estimated concentration is < PQL and >MDL
—`- - B1--CCountablemembranes'with <20,colonies; Estimated-
- - �-- ----------- ---- - - -----
NE -No established PQL -- — - — _
_B2- Counts from all filters were zero.__
- - - - - - - P-Elevated PQL due to matrix interference and/or sample dilution
133- Countable membranes with more than 60 or 80 colonies; Estimated
Q1-Holding time exceeded prior to receipt at lab.
84-Filters have counts of both>60 or 80 and < 20; Estimated
Q2- Holding time exceeded following receipt by lab
B5-Too many colonies were present; too numerous to count (TNTC)
PQL- Practical Quantitation Limit -subject to change due to instrument sensitivity .
J2- Reported value failed to meet QC criteria for either precision or accuracy; Estimated
U-Samples analyzed for this compound but not detected
J3-The sample matrix interfered with the ability to make any accurate determination; Estimated
X1-Sample not analyzed for this compound .
J6-The lab analysis was from an unpreserved or improperly chemically preserved sample; Estimated
NI -The component has been tentatively identified based on mass spectral library search and has an estimated value
LAB
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 1 of 2

�� �C 1�ZVQ La6oyatory Section 1�esuCts Sample ID AB19427
Location 0711612007
ID? WQ0018708 � Collect Date:
Loc. Descr.: LAKE CREEK - BAY TRACE LAKE ( Collect Time:: 10:40
Visit ID
CAS # Analyte Name
PQL
Result
Qualifier
Units
Analyst/Date
Approved By /Date
-
Sample temperature at receipt by lab
1.2
°C
DSAUNDERS
MMATHIS
Method Reference
7/17/07
7/17/07
mic
TOG In liquid
2.0
2.1
mg1L
ADEXTER
CGREEN
Method Reference APHA53108-20th
7/26/07
8/1107
WET
Total Dissolved Solids In liquid
12
22
J2
mg/L
AWILLIAMS
CGREEN
Method Reference APHA2540C-18TH
7119107
7127107
Chloride
1.0
3.8
mg/L
MIBRAHIM
MOVERMAN
Method Reference EPA 300.0
7/17/07
7/20/07
Fluoride
0.4
OA
U
mg1L
MIBRAHIM
MOVERMAN.
Method Reference EPA300.0
7/17/07
7/20/07
Ion Chromatography
TITLE_
mg/L
MIBRAHIM
MOVERMAN -
Method Reference EPA 306.0
7/17/07
7/20107
Sulfate
2.0
7.3
mg1L
MIBRAHIM
MOVERMAN
Method Reference EPA300.0
7/17/07
7/20/07
NUT
NH3 as N In liquid
0.02
0.02
mg1L as N
MAJAYI
"CGREEN
Method Reference LaclO-107-06-1-J
7/19/07
7/23/07
NO2+NO3 as N In liquid
0.02
0.02
U
mg1L as N
MAJAYI
CGREEN
Method Reference Lac10-107-04-1-c
7/19107
7/25107
Nitrate as N In liquid
0.02':
0.02
U
mg/L as N
MOVERMAN.
CGREEN
Method Reference Lachat107-04-1-c
7/23/07
7/23/07
Nitrite as N In liquid
0.01
0.01
U
mg/L as N
GBELK
CGREEN
- - — - --
- Method Reference - - Lachat107-04-1-c_- _
7/18107
7/23/07
Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 [phone] Page 2 of 2

OUNDWATER FIELD/LAB FORM
Location code_WQ 0018708,
County_Bladen
Quad No
North Carolina
Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
SAMPLE PRIORITY !n � V�
® Routine Q Lab Number
El Emergency Date Received Tim :
�- Rec'd By: From. -Bus, ouri , Hand Del.,
III aln o us o y Other'.
Report To: ARO, FRO MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston FO Fed. Trust, Central Off., Other: Date Reported:
Shipped by: Bus, oune Hand Del., Other: Purpose:
Collector(s):_BillTodd / y Time /r� : y ts_q.�Baseline, Complaint, Compliance LUST, Pesticide Study, Federal Trust, Other:
Date — /(6-f�/ (circle one)
FIELD ANALYSES Owner /_'4je_v- LA
pH 400 Spec. Con .94 at 250C Location or Site 7T6 M jo w
Temp.lo °C Odor -yiW, e. Description of sampling point GJ e-i t jve4
Appearance 818 A& _ Sampling Method .4, fi!=2 Sample Interval
Field Analysis Remarks umD. naileF. a c.
By:_BillTodd (Pumping time, air temp., etc.)
LABORATORY ANALYSES
Serial No.
Long. _
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /loom]
Coliform: MFTotal 31504 /loom[
X
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 _ units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH 8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
X
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color. True 80 Cu
Cyanide 720 mg/L
Lab
SAMPLE TYPE
M Water
❑ Soil
❑ Other
VCh' fC td
X
Diss. Solids 70300
mg/L
Fluoride 951
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ugh
Specific Cond. 95
uMhos/cm
X -
Sulfate.945
mg/L
Sulfide 745
mg/L
Oil and Grease
mg/L
X
NH3 as N 610
mg/L -
TkN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (NO3as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
REV. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
Ag-Silyer46566 u /L
AI -Aluminum 46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 46558 u /L
Ca -Calcium 46552 m /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u /L
Cu-Copper46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury 71900 u /L
K-Potassium 46555 m /L
Mg -Magnesium 46554 m /L
Mn-Manganese 46565- u /L
Na-Sodium 46556 m /L
Ni-Nickel u /L
Pb-Lead 46564 u /L•
Se -Selenium u /L
Zn-Zinc46567 u /L
Or anochlorine Pesticides
Or ano hos phorus Pesticides
Nitrogen Pesticides
Acid Herbicides
PCBs
Semivolatile Organics
TPH-Diesel Range
Volatile Or- anics OA bottle
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival (°C): y.

4
NC DENR/DWQ Laboratory
Report to: FRO - Sample Anomaly Report (SAR) `�
Lab Number: AB19427 Sample ID: MW 1 U,
Station Location: Lake Creek , County: Bladen Region: FRO
Bay Tree Lake
ample Type: Groundwater - ; Priority: Routine Collector: Bill Todd
Water
Date collected: 7/16/2007 Date received: 7/17/2007 Date analyzed: 7/19/2007
Affected Parameter(s): Total Dissolved Solids .
Analytical Area (check one):
NWCH ❑METALS ❑VOA ❑SVOA
❑NUT ❑MICRO ❑PEST
' I
The following anomalies occurred (check all that apply):
❑Samples
❑Improper container used
❑VOA vials with headspace
❑Sulfide samples with headspace i
❑Samples not received, but listed on fieldsheet
❑Samples received, but not listed on fieldsheet
❑Mislabeled as to tests, preservatives, etc.
❑Holding time expired
❑Prior to receipt in lab
❑After receipt in lab
❑Insufficient quantity for analysis
❑Sample exhibits gross non -homogeneity
❑Sample not chemically preserved properly
❑pH out of range (record pH):<2 i
❑Improper chemical
i
❑Residual chlorine present in sample
❑Color interference
❑Heavy emulsion formed during extraction
❑Sample bottle broken in lab - no reportable results
❑Other (specify):
NQuality Control
❑Instrument failure -no reportable results
❑Analyst error - no reportable results
❑ Surrogates
❑None added
❑Recovery outside acceptance limits
❑Spike recovery
❑None added
❑Recovery outside acceptance limits
NFailed to meet criteria for precision
❑Internal standards
❑Blank contamination
❑QC data reported outside of controls (e.g., QCS, LCS)
❑Incorrect procedure used
❑SOP intentionally modified with QA and Branch Head
approval
❑Invalid instrument calibration
❑Elevated detection limits due to:
❑Insufficient sample volume _
Comments: Sample was run at 100 mis. 18ing/L (1.8 mg/100m1) of TDS were found within the second duplicate, below the 2:5mg of
residue stated by the SOP for an accurate sample. Duplicates of the sample were also not within 56/o of the duplicate average.
The first duplicate that was run produced a 25mg/L result. If this sample had not been duplicated, the sample would have passed
precision criteria for a minimum of 2.5mg of residue.
Corrective Action:
1
❑Samples were rejected by DWQ Lab. Authorized by: Date:
❑Accepted and analyzed after notifying the collector or contact person and determining that another sample could not be secured.
❑Sample(s) on hold until: i
®Sample reported with qualification. Data! qualification code used:J2
❑Other (explain):
Notification Required? ❑ Yes ❑ No
Person Contacted: Date:
Form completed by:
r i
Lead Chemist evyi�� initial):
❑BIOCHEM�[Tf.'7 ❑PEST
[-]METALS ❑VOA,
Branch Head Review (in
QA/QC Review ( itial)
Date: 7/25/2007
❑SVOA
Logged into database by (initial):
QA\Forms\Laboratory\SAR 10/23/Oldbs

Microbac�,
r
T NAME & ADDRESS:
�,n 74d 0)
Fayetteville Division 2592 Hope Mills Road - Fayetteville, NG 1t33uti (ylu) 004- 1 WZU I oo-+-of I" IGA
CHAIN OF CUSTODY RECORD
PAGE 1 OF 1
PRaECTrLacATION: TYPE OF ANALYSIS PRESERVATION (CODE)
La/!e
N ,
..,s,
L �
?,uzej ee�
o�
Sample Type
Sample SampleCHLORINE
Start Date Start Time Date Tlme
COMP GRAB
�
pH
D.O.D O
TEMP
CHLORINE
LAB ID #
w - 3
she -- -=--
Date Time Received by:�
nme Comments or Special Hazards:
-
Date
y
1 7 G o? 1 1�
2-Relinquished
`J
Time
Temp:
Received b
Date Time Y
Dat
Relinquished by:.
4
3
Date Time Recelved by:
Date
Time
pH:
Relinquished by:
B
Date Time Received by:
Date
Time
Flow:
Relinquished by:
B
7
Additional Sample Comments:

North Carolina
GROUNDWATER FIELD/LAB FORM Department of Environment and Natural Resources
DIVISION OF WATER QUALITY -GROUNDWATER SECTION
Location code_WQ 0018708 SAMPLE TYPE SAMPLE PRIORITY
Couhty_Bladen Water ® Routine LQ Lab Number
Quad No Serial No. ❑ Soil ❑ Emergency Date Received Time:
Lat. Long. ❑ Other ,- Rec'd By.- From:Bus, Courier, Hand Del.,
X Chain of Custody Other:
Report To: ARO, FRO MRO, RRO, WaRO, WiRO, Data Entry By: Ck:
WSRO, Kinston FO. Fed. Trust, Central Off—Cither: Date Reported:
Shipped by: Bus, oune Hand Del., Other: Purpose:
Collector(s):_BillTodd Date / Baseline, Complaint, Compliance LUST, Pesticide Study, Federal Trust,.Other:
y (d �I (circle one)
FIELD ANALYSES Owner 4,4,4a C :2e e__ , ft '%e ` Z_4 e
pH 400- l Spec. Con 4 at 250C Location or Site e, M 1A (A} '
Temp.10 Sr'J °C Odor lr�,w a Description of sampling point bJ z 11 Ne.a .
Appearance_ C' .9 A) Sampling Method a�� f�q2 Sample Interval
Field -Analysis Remarks umo. bailer. etc.]
By:_BIIITodd (Pumping time, air temp., etc.)
LABORATORY ANAI YSFS
BOD 310 mg/L
COD High 340 mg/L
COD Low 335 mg/L
Coliform: MF Fecal 31616 /loom]
Coliform: MF Total 31504 " /100ml
X
TOC 680 mg/L
Turbidity 76 NTU
Residue, Suspended 530 mg/L
pH 403 units
Alkalinity to pH 4.5 410 mg/L
Alkalinity to pH-8.3 415 mg/L
Carbonate 445 mg/L
Bicarbonate 440 mg/L
Carbon dioxide 405 mg/L
X
Chloride 940 mg/L
Chromium: Hex 1032 ug/L
Color: True 80 CU
Cyanide 720 mg/L
Lab
X
Diss. Solids 70300
mg/L
Fluoride 951 .
mg/L
Hardness: Total 900
mg/L
Hardness (non-carb) 902
mg/L
Phenols 32730
ug/1
Specific Cond. 95
uMhos/cm
X
Sulfate 945
mg/L
Sulfide 745
mg/L
Oil and -Grease
mg/L
X
NH3 as N 610
mg/L
TKN as N 625
mg/L
X
NO2 + NO3 as N 630
mg/L
P: Total as P 665
mg/L
X
Nitrate (NO3 as N) 620
mg/L
X
Nitrite (NO2 as N) 615
mg/L
GW-54 REV. 7/03 For Dissolved Analysis -submit filtered sample and write "DIS" in block.
Ag-Silver 46566 u /L
AI -Aluminum 46557 u /L
As -Arsenic 46551 u /L
Ba-Barium 46558 u /L
Ca -Calcium 46552 m /L
Cd-Cadmium 46559 u /L
Cr-Chromium 46559 u /L
Cu-Copper46562 u /L
Fe -Iron 46563 u /L
Hg-Mercury71900 u /L
K-Potassium 46555 m /L
Mg -Magnesium 46554
Mn-Manganese 46565 -- - - u /L
Na-Sodium 46556 m /L
Ni-Nickel u /L
Pb-Lead 46564 u /L
Se -Selenium u /L
Zn-Zinc 46567 u /L
Or ano hos horus Pesticides
Nitro en Pesticides
Acid Herbicides
PCBs
Semivolatile Or anics
TPH-Diesel Ran e
Volatile Organics(VOA bottle
TPH-Gasoline Range
TPH-BTEX Gasoline Range
LAB USE ONLY
Temperature on arrival (°C):

yr'
vq
99a
Compliance Inspection Report
Permit: WQ0018708 Effective: 08/22/01 Expiration: 08/31/06 Owner: Lake Creek Corporation
I
SOC: Effective: Expiration: Facility: Lake Creek Corp-Baytree Lakes
i
County: Bladen
` r
Region: Fayetteville
Contact Person: Steve Jones Title: Phone: [phone]
Directions to Facility:
System Classifications:
I
Primary ORC: William E Stafford Certification: 989284 Phone: [phone]
Secondary ORC(s): F
On -Site Representative(s):
Related Permits:
Inspection Date: 07/16/2007 Entry Time:,10:00 AM
Primary Inspector: Bill Todd
Secondary Inspector(s):
Reason for Inspection: Routine
Permit Inspection Type: Surface Irrigation
Facility Status: Q Compliant Q Not Compliant
Question Areas:
Miscellaneous Questions NWells
(See attachment summary)
Exit Time: 01:00 PM1
Phone:[phone]
Inspection Type: Compliance Sampling
Page: 1
7

A
Permit: WO0018708 Owner - Facility: Lake Creek Corporation
Inspection Date: 07/16/2007 Inspection Type: Compliance Sampling Reason for Visit: Routine
Inspection Summary:
I, Bill Todd traveled to Bay Tree Lakes to meet with Wayne Vann of Vann Labs to conduct or to split -sample with Van
Labs the wells at Bay Tree Lakes. We sampled MW-1, MW-2, Mw-3 and MW-5 for all the paramters that are required in
the permit. All of My samples wer sent to the DWQ lab in Raleigh with the exception of the Coliform sample which were
delivered to Micr-Bac in Fayetteville. The sample results showed that The wells at Bay Tree were completely in
compliance.
Page: 2
I

North Carolina Department of Environment, Health, and Natural Resources j
Division of Environmental Health, Public Water Supply Section
SOURCE INFORMATION Date Form Completed
GROUND WATER
Owner Assigned
Source Code Well Name purchase, name of seller
i WOl WD � �1�,
If purchase, seller ID# Source Begin Date Direct Influence Date
MM - YY
Location of well within the system (If purchase
MM - DD - YY
location of master meter)
IACROSS ROAD FROM OFFICE, BEHIND FIRE DEPT
L
!: 05/30/08
b
Code G=Ground
❑
W=Purchase/G
G Y=G w/direct influence
Z=W w/direct influence
Availability
P=Permanent
E=Emergency
I=Interim
S=Seasonal
i O=Other
Latitude (N) Longitude (W)
Deg. Min Sec Deg Min Sec
34 41 18.77 78 24 58.67
Ifpurchase, use sell is primary source lfat/longg�)II r
3 �. 3 g sy %� .— . / $ . ' � (p �� %
Vulnerable VOC'sl Y N
How Determined
G=GPS
❑ M=Map GPS File Name
S=Surveyed
D=Differential GPS
MM - DID - YY
Assessment Date 01-01-90
ENTRY POINT INFORMATION
Owner Assigned
,
Entry Point Code Entry Point Name
L-- E01 TANK SITE
Use Code Availability
Entry Point Begin Date Entry Point End Date
=Ground/Permanent 1E P=Year-round S=Seasonal D�1
=Ground/non-Permanent E=Emergency u
I=Interim
O=Other
MM/YY MM/YY
Location: AT WELL #1
Well Site: Owned or controlled? Y (Y,N) Control Area (100' radius?) Y (Y,N) If no, explain: —_
Sources of pollution/distance: STORAGE BUILDINGS NEAR WELL HEAD
Y ---
Surface water within 200'? FN In N If yes, actual distance If yes, bact. samples collected? tl (YIN)
Adequate slope? Y (Y,N) Flooding? N
(Y,N) Maintenance: OK
Well House: Free of stored materials? N (Y,N)
Properly drained? Y (Y,N) Locked? Y . (Y,N)
Condition of house: OK
Type of freeze protection: HOUSED
,�V` ell biameter �10'-'" Type: DRILLED
Yield (gpm): _ UNK Properly sealed? Y (Y,IN) ;
(If unknown,
Properly vented? Y (Y,N) Casing Depth UNKK�ft put'UNK') Well depth: UNK
Concrete slab adequate? Y (Y,N) If no, explain:
Size of blow -off: 2"
Sample tap?: Before treatment? Y (Y,N)
Meter available? Y (Y,N)
i
Size: >3'
After Treatment? Y (Y,N)
Pumps: Capacity: GPM:
SUB HP' 7 1/,'2 Pump intake depth: UNK
Auxiliary Power? N
(Y,N)
Type pump: SUB
_
C G_5_ O 6-Po C�/�ptClTt'J,- Height above floor;(pump/casing): SUB
6
/ 20"+-
Storage at well site: Elev:
r Hydro: 6,000—
Ground: f
If hydro,"air volume control? N (Y,N) Safety valves: Y (Y,N)
Coded?. UNK (Y,N)
High service pumps: 1.
_ gpm. hp 2. gpm hp 3. gpm
`
hp 'Auxiliary power?
(Y,N)
Is water treated?
F (Y,N) If yes, complete back of form.
If other wells are treated here, which ones? W02 If treated elsewhere, where?
If purchase, retreat?
[—](Y/N) If yes, complete back of form.
DENR 3803 (Revised 9-97)
Public Water Supply Section (Review 9-00)

P North Carolina Department of Environment, Health, and Natural Resources
Division of Environmental Health, Public Water Supply Section
SOURCE INFORMATION Date Form Completed
GROUND WATER 05/30/08
Owner Assigned
Source Code Well Name (If purchase, name of seller) Code G=Ground
" - - -- W=Purchase/G
j W02 WELL ,2P � � Y=G w/direct influence
Z=W w/direct influence
If purchase, seller ID# Source Begin Date Direct Influence Date Availability
MM - ` YY MM - DID - YY
r� P=Permanent �
I N E=Emergency I -Interim
r — S=Seasonal i O=Other
Location of well within the system (If purchase, location of master meter) —
APPX. 200' SE OF WELL #1
Latitude (N) Longitude (W)
rDeg. Min Sec Deg Min Sec
If purchase, use seller's primary source lat/lotig)
Vulnerable VOC'slYl N
How Determined
G=GPS
a =Map
B=Surveyed y PPS File Name
D=Differential GPS
MM - DD - YY
Assessment Date 01-01-90
ENTRY POINT INFORMATION
Owner Assigned
Entry Point Code Entry Point Name
E01 WELL' #1
Use Code Availability Entry Point Begin Date Entry Point End Date
C=Ground/Pennanent P P=Year-round S=Seasonal
L_d D=Ground/non-Permanent ❑ E=Emergency I=Interim O=Other
MM/YY MM/YY
Location: AT WELL SITE
Well Site: Owned or controlled? Y ; (Y,N) Control Area (100' radius?) _Y (Y,N) If no, explain:
Sources of pollution/distance: NONE NOTED AT TIME OF INSPECTION WITHIN 100'
Y
Surface water within 200'? �N N If yes, actual distance If yes, bact. samples collected? �' (Y/N)
Adequate slope? Y (Y,N) Flooding? N (Y,N) Maintenance: OK M�
Well House: Free of stored materials? N/A (Y,N) Properly drained? N/A (Y,N) Locke'd? N (Y,N)
Condition of house: FIBERGLASS COVER Type of freeze protection: ;
lk Dtamete _4 Type: DRILLED Yield (gpm): UNK Properly sealed? Y (Y,N)
a, (If unknown,„ e
Properly vented? Y (Y,N) `C�astng�Depth' 275- t..ft put'uNlc') WeI depth 3:OS``' Meter available? Y (Y,N)
Concrete slab adequate? Y (Y,N) If no, explain: Size: >3'
Size of blow -off: 2" Sample tap?: Before treatment? Y (Y,N) After Treatment? Y (Y,N)
Pumps: Capacity: GPM: UNK IJP-IX259Pump intake depth: UNK_ :Auxiliary Power? N (Y,N)
Type pump: SUB _ _ Height above floor (pump/casing): SUB / 12"
Storage at well site: Elev: I I Hydro: Ground: L
If hydro, air volume control? (Y,N) Safety valves: _ (Y,N) Coded?(Y,N)
High service pumps: 1. gpm' hp 2. gpm hp 3. gpm hp Auxiliary power? (Y,N)
Is water treated? �Y (Y,N) If yes, complete back of form.
If other wells are treated here, which ones? If treated. elsewhere, where? WELL #1 _
If purchase, retreat? (Y/N) If yes, complete back of form.
I
DENR 3803 (Revised 9-97)
Public Water Supply Section (Review 9-00)

DESIGN T. R.OBrRT LYONS AND ASSOCIATES SHEET
CONSULTING ENGINEERS I I
c"AnLOTTr, 'NORTH CAROLINA Ei�
FOR JOB. NO.
CHECK JOB .,I, - -, =--i
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t R O� North Carolina
Department of Environment,& Natural Resources
Division of Water Quality
Aquifer Protection Section
MONITORING WELL INSPECTION REPORT
Well Location: AV -14% - � -;rofrs,9_A1ib C• -- `DateF»
Owner: 1,41,1e C e C ��4- Gr �� iCe � WELL.TYPE a /11b Q,
Address: 3 Pal i A RA e / s f7iC 9 } County 7& a-04`
Road/StreetJlw� j/ f4,s-E-:
Quad No.
BMW#=
(Serial No. ims 0.0 41�� dl7
•Z 'J !Lat to / Long.? , d. /7
We1T onstruction
Well Contractor e e e_ %h ja'
N e
ddress
Contractor -Certification# cX G 2 Check Items Meets
Min.
Standards, ' Remarks
Measured
Permit Reg uired ? (Y/N) L . , :.
Yes
No !
i (Permit No.%(!( bog 2b
Location - Distance From:...........
f
I
Water Tight Sewage/waste collection
15P A F4
Waste Disposal (septic tank drain field) _
:✓
Other Poll: Source( ) }
Other -Poll. Source(
1 . last' Cazbon Galy. St. Other
Casing
Type ................. .... t
yp .. is
5 }
s
Depth.. ..................:
Weight/thickness ..... . ..........e
i
Height(A.L.S.).................
$ h
Other ( )
Grout
S
9
;
S
Type
s
.......................
f
Thickness .....:.............
#
Depth .......................
r
E
Other( )
3
Screens",.
Screened interval 15 — ).a
Other( �) a
Well Contractor ............
Abandonment g '
Temporary .. s
Permanent .......:.......... 4 ? s

Cuttinl4s
Reports
Construction (GW-1) ...... .
Abandonment (GW-30) .....
Well Head Completion ........
Access port
Water tight pipe entry ... , .. .
Well entry :..........'.... .
Date Well Constructed ,_ - f A a o t
Cheek Items Meets Min. Standards Remarks
Measured Yes No.
i f
INSPECTOR^v
Name Office
Witness(es)
(If Available) Name Address Type
Name Address Type

r
Al,' p15Vy s�
'
North Carolina
Department of Environment &,Natural Resources
Poly Division of Water Quality
Aquifer Protection Section,
MONITORING WELL INSPECTION REPORT
Well Location: w /;�. - /11A/, - • Date JIAJ_ - /�
t Owner: e o Q e e ! WELL TYPE /' o fry
Address: a' Bry ��� el 2 e / s C ' j County %�}
Road/Street Yzv 9 yj
Quad No.
Serial No —;M y
,y! .� r ,3� • . _ �` Lat Long.
e1T , oonstruction
4 ..
Well Contractor / e- eZ
e Address
Contractor Certification# Check Items Meets Min. Standards Remarks
Measured Yes No j
Permit Required (Y/N) L .... (Permit No. 001?2
Location - Distance From:......... / d
Water Tight Sewage/waste collection
Waste Disposal (septic tank drain field) i
Other Poll. Source( ) i
s 8i
Other Poll. Source(
t �
Casing GDCarbon Galy. St: Other
Type................... E:
Depth..
Weight/thickness ................ / 1
Height A.L.S. ✓ i '
i
Other ( ) f s
Grout
Type.............
Thickness .....:....... ...
4
Depth ...............: ..
Other( )
Screens
i
Screened interval ...........
x � N
C
Other(.
Well Contractor ............
Abandonment
Temporary .................
Permanent ................. s.
Z S

Cuttings
Reports
Construction (GW-1) .......
Abandonment (GW-30) .....
Well Head Completion .......
Access port .. ...... ...... .
Water tight pipe entry ... , .. .
Well entry . ................ .
� # �pMeets
r �n
Check Items Min. Standards
� Remarks
Measured Yes
NoIt
yjn'
Y
}
Date Well Constructed 9L— /,4- .16 IN
r
INSPECTOR-
D
Ile
Name
Office
e
Witness(es�
(If Available) Name
Address Type
Name
Address Type
9

North Carolina
Department of Environment &,Natural Resources
Division of Water Quality 1
Aquifer Protection Section
MONITORING- WELL INSPECTION REPORT
Nell Location: � us.e / d -� C ;Date
Owner° j�e C aaA �b f 4ez-11 1. ROE- ' . ;WELL —PE1a6rdL2(�c,
Address: &J ,�,� 'Rs(/ i�d, e/%� �%� o?a' jCounty
jRoad/Street 411 "i .
:Quad No.
1W #_
,Serial No.)6, i _s ob 4a�
Long.
Well" onstructlon 1
Well Contractor /r �-�
Na e Address
Contractor Certification# f Check Items Meets Min. Standards Remarks
Measured Yes No
Permit Required ? (Y/N) L .... t (PermitNoW4 Cc/,(70)$
Location - Distance From:...........
Water Tight Sewage/waste collection
Waste Disposal (septic tank drain field)
Other -Poll. Source( ) ► '/-
Other Poll. Source( ) F[
F.' ✓ R 1
Casing Plastic Carbon Galy. St. Other
Type.......................
Depth . ..............
Weight/thickness .................
4
Height (A.L.S.) .. .:........ ,
Other ( ) #
Grout /
Type............. ...... V
Thickness .....:............. i� 3
a
Depth.......................
s
Other(
Screens
Screened interval ........... t �s ✓ `
Other(
Well Contractor ......... r u.
-
Abandonment i
Temporary .. r
Permanent .................. i F

Cuttings
Reports
Construction (GW-1) ........
Abandonment (GW-30) .... .
Well Head Completion .......
Access port .................
Water tight pipe entry ... ,
Well entry .................
Date Well Constructed D D
Check Items Meets Min. Standards Remarks
Measured Yes No,
� Y 4 �•
6
.`t
INSPECTOR
Name Office
(If Available) Name
Address Type
Name Address Type

�,v�. North Carolina
fffiii p� Department of Environment &.Natural Resources
�,iy Division of Water Quality
Aquifer Protection Section
MONITORING WELL INSPECTION REPORT
._ Mns.+a.a+wmn.4iw�'.'aif"i+wT�c.+3iaavn•.owm�
Well Location: #10 �= % MA-kVQWK% Ale-, Date-TA.-J. 11, Pa/ 0
Owner: 2 I WELL TYPE /t7anlao2 r
Address: J,3 ,Q C . ai County e-,-1
j Road/Street h l s
Quad No.
MW .#='
Serial-5a
z / f %. �. % /- 3 0 j Lat.3!5L lo9q lj Long.
Well Contractor Cj'ryll,�Y/�C� y�2'.7"h 6'i2d'
Name
Contractor Certification# oZ /,.I to
Permit Required ? (Y/N) I.... .
Location - Distance From:.......... .
Water Tight Sewage/waste collection
Waste Disposal (septic tank drain field)
Other,Poll. Source( )
Other Poll. Source( )
Casing ,
Type.......................
Depth. ..................
Weight/thickness ................
Height (A.L.S.) .................
Other ( )
Grout
Type .............
Thickness .....:.............
Depth.......................
Other( )
Screens
Screened interval ...........
Other( )
Well Contractor ............
Abandonment
Temporary .................
Permanent ...............
Address
Check Items Meets Min. Standards Remarks
Measured Yes No
w I"
� (Permit NoW
Plastic Carbon Galy. St. Other
6 � c. 1. , zl t� '✓ i

CuttinLs
Reports
Construction (GW-1) .......
Abandonment (GW-30) ... .
Well Head Completion .......
Access port ..................
Water tight pipe entry :.......
Well entry........ ...... .
Date Well Constructed
Check Items Meets Min. Standards' Remarks
Measured Yes No
r-' A
INSPECTOR e, 0-
Name Office
Witness(es)
(If Available) Name Address Type
Name Address Type