WQ0035809_More Information (Received)_20240805

Initial Review
Reviewer
nathaniel.thornburg
Is this submittal an application? (Excluding additional information.) *
Yes No
If not an application what is the submittal type?* Annual Report
Residual Annual Report
Additional Information
Other
Permit Number (IR) * W00035809
Applicant/Permittee Old North State Water Company, LLC
Email Notifications
Does this need review by the hydrogeologist? * Yes No
Regional Office
CO Reviewer
Admin Reviewer

Submittal Form
Project Contact Information
Please provide information on the person to be contacted by NDB Staff regarding electronic submittal, confirmation of receipt, and other correspondence.
......................................................................................................................................................................................................................................................................................... ... ... ... ... ... .. ... ... ... ... ..
Name* John Phillips
Email Address*
[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*
919-467-9972
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:*
WQ0035809
Has Current Existing permit number
Applicant/Permittee Address*
PO Box 10127, Birmingham AL 35202
Facility Name*
Stateside WWTP
Please provide comments/notes on your current submittal below.
This submittal provides responses to Mr. Mega's Additional Information Request letter of July 5, 2024.
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.)
Response Letter to Additional Information Request -
14.23MB
Stateside WQ0035809.pdf
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
0%aia ej;. 017 �1 _
Submission Date 8/5/2024

DIEHL & PHILLIPS, P.A.
CONSULTING ENGINEERS
1500 Piney Plains Rd., Suite 200
Cary, North Carolina 27518
Telephone [phone] — Fax [phone]
August 5, 2024
Mr. Zachary J. Mega, Engineer III
Non -Discharge Permitting Section
Division of Water Resources, DEQ
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Application No. WQ0035809
Additional Information Request #1
Stateside WWTP
High Rate Infiltration System
Onslow County
Dear Mr. Mega:
WILLIAM C. DIEHL, P.E.
JOHN F. PHILLIPS, P.E.
ALAN R. KEITH, P.E.
On behalf of Old North State Water Company, Inc., we offer the following responses
and information in reply to your Additional Information Request #1 letter of July 5,
2024. The responses follow the order of the comments in your letter, with your
comments presented in italics.
A. Overall:
1. Mr. Tyler G. Benson and Mr. Geoffrey G. Kegley from the Wilmington Regional Office
(W%RO) reviewed the submitted application package and provided the following
comments:
a. The Operator in Responsible Charge (ORC) for the facility has stated that high -rate
infiltration Basins 3, 4, and 5 may not be assimilating waste at the permitted loading
rates. Condition 11115 of the Final Permit issued on January 30, 2023, requires the
Permittee to clean the infiltration areas at least once per permit cycle to remove
deposited materials that may impede the infiltration process. Please provide the
cleaning records for these highrateinfiltration basins pursuant to 15A NCAC 02T
.0707(h).
Response: The basins were cleaned by ONSWC, using a rented long reach excavator
to remove the surface layer of the basin bottoms. This was done during the second
week of April 2024. Attached are the equipment rental invoice and photos of the
excavated materials, which were spread onsite. The regional manager for ONSWC did

Mr. Zachary J. Mega
August 5, 2024
Page 2 of 5
notify Ms. Helen Perez of the Division when the work was completed and that it
appeared the work did allow the ponds to drain as intended.
b. The Division has only received two months (February 2023 and June 2023) of
monitoring well sampling data since the Permittee constructed monitoring wells MW-
4, MW-5, and MW-6 on December 5, 2018. Condition IV,13 and A ttachment C of
the Final Permit issued on January 30, 2023, require the Permittee to submit a
Compliance Monitoring Form (GW-59) with attached copies of laboratory analyses
every February, June, and October. Please provide all sampling data for these
monitoring wells pursuant to 15A NCAC 02T . 0105(m).
Response: The Groundwater Compliance Monitoring Form (GW-59) and laboratory
analyses for monitoring wells MW-4, MW-5, and MW-6 for the period October 2020
to February 2024 are attached. The records prior to October 2020 were maintained
by Envirolink, a contract operator for ONSWC. The records were not provided to
ONSWC when Envirolink's contract was terminated. ONSWC will try to retrieve the
2018 to 2020 records, and will submit them to the Division if successful.
B. Cover Letter: 1. No comment
C. Auulication Fee: 1. No comment
D. Auulication (Form: HRIS 06-16):
1. Item IV.9 — Pursuant to Instruction P of Form: HRIS 06-16 and 15A NCAC 02T
.0105(c)(10), please provide documentation from the Department's Natural Heritage
Program demonstrating the presence or absence of threatened or endangered species
within the boundary of the wastewater treatment, storage, and infiltration facilities.
The Division requires this documentation for all new projects and modifications
regardless of scope.
Response: A copy of the NC Natural Heritage Report for the Stateside WWTP site is
enclosed.
2. Item V 11.e — Please add the proposed flow equalization pumps to the table.
Response: The proposed flow equalization pumps have been added to the table, and a
copy of the revised application page is enclosed.
E. Prouerty Ownershiu Documentation:
1. Pursuant to Instruction D of Form: HRIS 06-16 and 15A NCAC 02T . 0704(t), please
provide property ownership documentation. See Comment E.2.

Mr. Zachary J. Mega
August 5, 2024
Page 3 of 5
Response: Copies of the deed and exhibit map are attached. These documents confirm
the Stateside treatment plant, constructed infiltration basins, and monitoring wells are
on property now owned by Old North State Water Company, Inc.
2. Condition II.10 of the Final Permit issued on January 30, 2023, requires the
Permittee to execute and file with the Onslow County Register of Deeds (RoD) an
easement running with the land for any land within the compliance boundary of the
high -rate infiltration basins that the Permittee does not own (%e., Basins 1 and 2). The
Agreement included with the Final Permit issued on March 1, 2017, which discusses the
terms between the A. Sydes Construction, Inc, and Old North State Water Company,
Inc, was not filed with the Brunswick County RoD nor does it meet the requirements of
15A NCAC 02L .0107(k).
Please either. -
a. Provide an executed easement document filed with the Onslow County RoD that
meets the requirements of 15A NCAC 02L . 0107(k) and, if necessary, revise the
previous Agreement
b. Revise the previous Agreement to meet the requirements of 15A NCAC 02L
. 0107(k) and act as an easement running with the land, and file the Agreement with
the Onslow County RoD.
Response: Old North State Water Company, Inc. does not foresee a need for Infiltration
Basins 1 and 2 and therefore does not intend to construct or operate them in the
future. ONSWC requests the Division remove Infiltration Basins 1 and 2 from the
Permit.
ONSWC has acquired the property on which the treatment plant, Infiltration Basins 3, 4,
and 5, and monitoring wells 4, 5, and 6 are located. Due to this land acquisition,
Attachment B of the Permit should be modified to reflect Old North State Water
Company, Inc. is the Owner of Infiltration Sites 3, 4, and 5 now, rather than A. Sydes
Construction, Inc.
Two small portions of the area within the groundwater Compliance Boundary, as
located in the current permit, fall outside of the boundary of the property acquired by
ONSWC. Therefore, it is proposed to move the Compliance Boundary in these areas to
be 50 feet inside of the ONSWC property line, and to move the Review Boundary to be
halfway between the basins and revised Compliance Boundary. A revised site map is
attached for your review and for inclusion in the modified permit.
With these requested permit modifications, the Compliance Boundary will be located
entirely within property owned by ONSWC, and no easements will be required.
F. Setback Waivers: 1. No comment

Mr. Zachary J. Mega
August 5, 2024
Page 4of5
G. Soil Evaluation: 1. N/A
H. Aaronomist Evaluation: 1. N/A
I. Hydroaeoloaic Reuort: 1. N/A
I Water Balance: 1. N/A
K. Enaineerina Plans: 1. No comment
L. Suecifications:
1. The replacement Dosatron pump (supplying sodium hydroxide [NaOHJ to the
membranes) that the Engineering Plans depict is not included in Section 11 A of the
Specifications. If this is not alike- for -like replacement, ,please include the relevant
specifications for the Dosatron pump and any other related components of the
membrane clean -In -place (CIP) system pursuant to Instruction J of Form: HRIS 06-16
and 15A NCAC 02T . 0704(c)(2).
Response: The replacement Dosatron is similar to the existing unit, but not identical.
Specification Section 11-A has been modified to include the replacement unit. A copy of
the revised Section 11-A is attached.
M. Enaineerina Calculations: 1. No comment
N. Site Mau:
1. Please include the names of each monitoring well (% e., MW-4, MW-5, and MW-6) on
each page of the Site Map.
Response: The names of the monitoring wells have been added to each page of the
Site Map. As described in the response to E. Property Ownership Documentation, the
site maps have also been updated to reflect the modified Compliance Boundary.
O. Power Reliability Plan: 1. No comment
P. Oueration & Maintenance Plan: 1. No comment
O. Residuals Manaaement Plan: 1. No comment
R. Additional Documentation:
➢ Certificate of Public Convenience and Necessity.• 1. No comment.
➢ Existing Permit- 1. No comment
➢ Final Environmental Document, 1. N/A
➢ Floodway Regulation Compliance: 1. N/A

Mr. Zachary J. Mega
August 5, 2024
Page 5 of 5
➢ Operational Agreement.- 1. N/A
➢ Threatened or Endangered Aquatic Species Documentation: 1. See Comment
D.I.
➢ Wastewater Chemical Analysis: 1. N/A
S. Recommendations (Resuonse not reauired):
1. Engineering Plans —
a. Sheet 2 — Recommend removing the stray Anework under "Phase I —
Installation of New Membranes in Existing Membrane Tank'
Response: Stray linework has been removed.
Please advise if you have any questions regarding the responses above or the attached
information, or if you require any further information to process the requested Permit
modification. Thank you for your continued assistance with this matter.
Yours very truly,
Diehl & Phillips-, P.A.
I-IA-W
John F. Phillips, P.E.
Cc: Mr. John McDonald, ONSWC
Mr. Sean McMillan, ONSWC
Mr. Dale Boyette, ONSWC

INFORMATION DOCUMENTING THE CLEANING OF
THE STATESIDE WWTP INFILTRATION BASIN
BOTTOMS

Office Address: Remit Payments to:
555 Wise Road , PO Box 736976
Clayton, NC 27520 Dallas, TX 75373 6976
t919) 773-1424 [phone]
NATIONAL EQUIPMENT DEALERS Nei-;0
IAccount# Order # Brc S1S R E N T A L R E T U R N Date Invoice #Page
3266860 k064908 I03 fMA.R� I N V O I C E 104-15-24� 03049762 I 1
Sold To: 000 Ship To:
OLD NORTH STATE WATER COMPANY INC OLD NORTH STATE WATER COMPANY INC
3212 6TH AVE SOUTH QUAKER BRIDGE RD
BIRMINGHAM AL 35202
Entered By Customer Purchase Order
bbass
Ord Ship B/O Part Number
JACKSONVILLE NC 28546
Ship Via MARCUS
(Customer Contact Ord Date
CHIP WHITE 336--549-8990 04-08-24
Equip ID (Customer Job #�205-326-6860
Customer Phone #
Description Unit Price UM Extended
1 Id# 2813 FROM: 04-08-24 THRU: 04-15-24
Model-HX300LR Serial#-HHKHK801V'KO001849
73,000 LB LONG REACH EXC
mtr in: 3428 mtr out: 3398 mtr used: 30
1 Id# RS595 Included with 2813
Model-HX140 Serial#-59600
60" DITCH BUCKET
mtr in: ❑ mtr out: 0 mtr used: 0
1 FREIGHT - RENTAL DELIVERY
1 FREIGHT - RENTAL PICK UP
Sub Total
NC North Carolina Sales Tax
5 Days
4,500.00
600.00 600.00
600.00 600.00
5,700.00
399.00
ALL RETURNS SUBJECT TO A 25 PERCENT RESTOCKING FEE Total Invoice
RETURN MUST BE WITHIN 30 CALENDAR DAYS OF PURCHASE Due By: I 6,099.00
PARTS MUST BE IN ORIGINAL, UNDAMAGED PACKAGING 05/15/24
ELECTRICAL PARTS, SPECIAL ORDER PARTS, HOSES,
RUBBER ITEMS, ORINGS OR GASKETS ARE NON -RETURNABLE
NO CREDITS WILL BE ISSUED FOR FREIGHT

ii1ii11iiiil`
MAIN PUMP
Type Variable displacement tandem axis piston pumps
Max. flow 2 x 273 Urnin (72.1 gpm)
Sub -pump for pilot circuit Gear pump
HYDRAULIC MOTORS
Travel
Variable -displacement axial piston motor
Swing
Axial piston motor
RELIEF VALVE SETTING
Implement circuits
350 kgf/cmz(4,980
psi)
Travel
350 kgf/cmz(4,980
psi)
Boom
400 kgf/cmz(5,690
psi)
Arm
250 kgf/cmz(3,560
psi)
Bucket
270 kgf/cmz(3,840
psi)
Swing circuit
300 kgf/cmz(4,270
psi)
Pilot circuit
40 kgf/cmz(570 psi)
Service valve
Installed
HYDRAULIC CYLINDERS
Boom: 140 x 1,465 mm (5.5" x 57.7")
No. of cylinders bore X stroke Arm: 150 x 1,765 mm (5.9" x 69.5")
Bucket: 135 x 1,185 mm (5.3" x 46.7")
Drive method
Fully hydrostatic type
Drive motor
Axial piston motor, in -shoe design
Reduction system
Planetary reduction gear
Max. drawbar pull
26,500 kgf (58,420 Ibf)
Max. travel speed (high / low)
5.9 km/hr (3.67 mph) / 3.3 km/hr (2.05 mph)
Gradeability
35° (70%)
Parking brake
Multi wet disc brake
Pilot pressure operated joysticks and pedals provide very -low -effort operation.
Two joysticks with one safety lever
Pilot control (LH): Swing and arm
(RH): Boom and bucket (ISO)
Traveling and steering Two levers with pedals
Engine throttle Electric, dial type
Operating weight, including 10.2 m (33' 6") boom, 7.85 m (25' 9") arm,
SAE heaped 0.52 m3 (0.68 yd3) bucket, lubricant, coolant, full fuel tank, full
hydraulic tank, 7,000 kg (15,450 lb) counterweight and all standard equipment.
OPERATING WEIGHT
Shoes Operating weight Ground pressure
Width
Type mm (in)
Triple 800 (32")
grouser
Swing motor
Swing reduction
Swing bearing lubrication
Swing brake
Swing speed
kg (lb) I kgf/cmz (psi)
HX30OLR 1 33,070 (72,910) 1 0.48 (6.83)
Fixed displacement axial piston motor
Planetary gear reduction
Grease -bathed
Multi wet disc brake
10.2 rpm
Refilling
liters
US gal
Fuel tank
500
132
Engine coolant
40
10.6
Engine oil
23
6.1
Swing device
11
2.9
Final drive (each)
7.8
2.06
Hydraulic system (including tank)
330
87
Hydraulic tank
190
50
DEF/AdBlue®
42.5
11.2
The X-leg type center frame is integrally welded with reinforced box -section track
frames. The undercarriage includes lubricated rollers, idlers, track adjusters with
shock -absorbing springs and sprockets, and a track chain with double or triple
grouser shoes.
Center frame X-leg type
Track frame Pentagonal box type
No. of shoes on each side 48 EA
No. of carrier rollers on each side 2 EA
No. of track rollers on each side 9 EA
No. of rail guards on each side 2 EA

10.2 m (33' 6") boom and 7.85 m (25' 9") arm
A Overall length
14,560 (47' 9")
B Overall width, with 800 mm shoe
3,400 (11' 2")
C Overall height of boom
3,560 (11' 8")
D Superstructure width
2,980 (9' 9")
E Overall height of cab
3,030 (9' 11 ")
F Ground clearance of counterweight
1,190 (3' 11 ")
G Overall height of engine hood
2,600 (8' 6")
G' Overall height of handrail
3,340 (10' 11 ")
H Minimum ground clearance
500 (1' 8")
HX30OLR WORKING RANGE
A Max. digging reach 18,510 (60' 9")
A' Max. digging reach on ground 18,400 (60' 4")
D
® A C7 w
j M
K N
A B�L)
-F28Po
I Rear -end distance
3,120 (10' 3")
I' Rear -end swing radius
3,200 (10' 6")
J Distance between tumblers
4,030 (13' 3")
K Undercarriage length
4,885 (16' 8")
L Undercarriage width
3,400 (11' 2")
M Track gauge
2,600 (8' 6")
N Track shoe width, standard
800 (31' 5")
B Max. digging depth 14,820 (48' 7") Q
w
B' Max. digging depth (8' level) 14,690 (48' 2")
C Max. vertical wall digging depth 12,020 (39' 5")
D Max. digging height 14,500 (47' 7")
E Max. dumping height 12,190 (40' 0")
C)
Co E0
F Min. swing radius 6,250 (20' 6")
_ A
_ A'
F
Length mm (ft-in)
10,200 (33' 5")
Boom
Weight kg (lb)
2,980 (6,570)
Length mm (ft-in)
7,850 (25' 9")
Arm
Weight kg (lb)
1,340 (2,960)
kN
70
SAE kgf
7,100
Bucket
Ibf
15,650
digging
force
kN
80
ISO kgf
8,200
Ibf
18,080
kN
47.1
SAE kgf
4,800
Arm
Ibf
10,580
crowd force
kN
48.1
ISO kgf
4,900
Ibf
10,800
Note:
Boom weight includes arm cylinder, piping, and pin
Arm weight includes bucket cylinder, linkage, and pin
02

Boom: 10.2 m (33' 6")
Arm: 7.85 m (25' 9")
Bucket: 0.52 m3 (0.68 yd3) SAE heaped
Shoe 800 mm (32") triple grouser, CWT 5,600 kg (12,350 lb)
Lift -point radius
Load point
height 1.0 m (3.3 ft)
(m/ft) 6
4.0 m (13.1 ft) 7.0 m (23.0 ft)
6 � 6 �
Lift -point radius
L
O1
.a
L
C
.Q
a )�\ \
J o
Capacities based on North American Standard
Configuration in accordance with ISO condition 2 standard.
Rating over -front
Rating over side or 360 degree
At max. reach
10.0 m (32.8 ft) 13.0 m (42.7 ft) 16.0 m (52.5 ft)
6 [�=K 6 ig-=K 6 [�=K
12.0 m
kg
39.4 ft
Ib
10.5 m
kg
34.4 ft
Ib
9.0 m
kg
29.5 ft
Ib
7.5 m
kg
24.6 ft
Ib
6.0 m
kg
19.7 ft
Ib
4.5 m
kg
14.8 ft
Ib
3.0 m
kg
*9,450
*9,450
*4,950
*4,950
*3,640
*3,640
9.8 ft
Ib
*20,830
*20,830
*10,910
*10,910
*8,020
*8,020
1.5 m
kg
*4,140
*4,140
*6,000
*6,000
*4,120
3,900
4.9ft
Ib
*9,130
*9,130
*13,230
*13,230
*9,080
8,600
0.0 m
kg
*3,500
*3,500
*6,900
5,860
*4,570
3,640
0.0 ft
Ib
*7,720
*7,720
*15,210
12,920
*10,080
8,020
-1.5 m
kg
*2,140
*2,140
*3,890
*3,890
*7,580
5,470
*4,970
3,430
-4.9 ft
Ib
*4,720
*4,720
*8,580
*8,580
*16,710
12,060
*10,960
7,560
-3.0 m
kg
*2,960
*2,960
*4,630
*4,630
*8,050
5,240
*5,280
3,270
-9.8 ft
Ib
*6,530
*6,530
*10,210
*10,210
*17,750
11,550
*11,640
7,210
-4.5 m
kg
*3,830
*3,830
*5,570
*5,570
*8,320
5,110
5,240
3,170
-14.8 ft
Ib
*8,440
*8,440
*12,280
*12,280
*18,340
11,270
11,550
6,990
-6.0 m
kg
*4,750
*4,750
*6,670
*6,670
*8,400
5,080
5,190
3,120
-19.7 ft
Ib
*10,470
*10,470
*14,700
*14,700
*18,520
11,200
11,440
6,880
-7.5 m
kg
*5,750
*5,750
*7,970
*7,970
*8,290
5,120
5,190
3,120
-24.6ft
Ib
*12,680
*12,680
*17,570
*17,570
*18,280
11,290
11,440
6,880
-9.0 m
kg
*6,850
*6,850
*9,520
*9,520
*7,980
5,220
5,250
3,180
-29.5ft
Ib
*15,100
*15,100
*20,990
*20,990
*17,590
11,510
11,570
7,010
-10.5 m
kg
*8,080
*8,080
*11,460
*11,460
*7,410
5,400
*5,040
3,300
-34.4ft
Ib
*17,810
*17,810
*25,260
*25,260
*16,340
11,900
*11,110
7,280
-12.0 m
kg
*10,540
*10,540
*6,430
5,670
-39.4ft
Ib
*23,240
*23,240
*14,180
12,500
*2,410
*2,410
*1,630
*1,630
*5,310
*5,310
*3,590
*3,590
*2,590
*2,590
*2,000
1,970
*5,710
*5,710
*4,410
4,340
*2,810
*2,810
*2,290
1,920
*6,190
*6,190
*5,050
4,230
*3,050
2,730
*2,540
1,850
*6,720
6,020
*5600
4,080
*3,300
2,590
*2,740
1,780
*7,280
5,710
*6,040
3,920
*3,550
2,460
2,840
1,720
*7,830
5,420
6,260
3,790
*3,780
2,340
2,790
1,670
*8,330
5,160
6,150
3,680
3,710
2,250
*2,610
1,630
8,180
4,960
*5,750
3,590
3,650
2,200
8,050
4,850
3,620
2,170
7,980
4,780
3,640
2,190
8,020
4,830
3,720
2,260
8,200
4,980
Y
Capaci Reach
m (ft)
*1,320
*2,910
*1,280
*2,820
*1,260
*2,780
*1,260
*2,780
*1,270
*2,800
*1,300
*2,870
*1,350
*2,980
*1,410
*3,110
*1,500
*3,310
*1,620
*3,570
*1,770
*3,900
*1,970
*4,340
*2,250
*4,960
*2,660
*5,860
*3,320
*7,320
*4,020
*8,860
*4,270
*9,410
NOTES:
1. Lifting capacities are based on ISO 10567. 3. The Lift -point is bucket pivot mounting pin on the arm (without bucket mass).
2. Lifting capacity of the HX Series does not exceed 75% of tipping load with 4. (*) indicates load limited by hydraulic capacity.
the machine on firm, level ground or 87% of full hydraulic capacity.
*1,320 14.10
*2,910 (46.2)
* 1, 280 15.05
*2,820 (49.4)
*1,260 15.81
*2,780 (51.9)
*1,260 16.39
*2,780 (53.8)
*1,270 16.82
*2,800 (55.2)
*1,300 17.10
*2,870 (56.1)
*1,350 17.25
*2,980 (56.6)
*1,410 17.27
*3,110 (56.7)
*1,500 17.15
*3,310 (56.3)
1,510 16.90
3,330 (55.4)
1,550 16.51
3,420 (54.2)
1,620 15.96
3,570 (52.4)
1,740 15.25
3,840 (50.0)
1,930 14.34
4,250 (47.1)
2,220 13.20
4,890 (43.3)
2,690 11.76
5,930 (38.6)
3,580 9.88
7,890 (32.4)
03

ENGINE STD OPT
Cummins QSB 6.7 engine
HYDRAULIC
Intelligent Power Control (IPC)
3-power mode, 2-work mode, user mode
Variable power control
Pump flow control
Attachment mode flow control
Engine auto idle
Engine auto shutdown control
Electronic fan control
ISO standard cabin
Rise -up type windshield wiper
Radio / USB player
Bluetooth / hands -free mobile phone system with USB
Miracast
12-volt power outlet (24 V DC to 12 V DC converter)
Electric horn
All-weather steel cab with 360' visibility
Safety glass windows
Sliding fold -in front window
Sliding side window (LH)
Lockable door
Hot and cool box
Storage compartment and ashtray
Transparent cabin roof -cover
Sun visor
Door and cab locks, one key
Mechanical suspension seat with heater
Pilot -operated adjustable joystick
Console box height adjust system
Cabin lights
Cabin front window rain guard
Cabin roof -steel cover
Automatic climate control
Air conditioner and heater
Defroster
Starting aid (air grid heater) for cold weather
Centralized monitoring
8" LCD display
Engine speed or trip meter / accel.
Engine coolant temperature gauge
Max. power
Low speed / high speed
Auto idle
Overload
Check engine
Air cleaner clogging
Indicators
ECO gauges
Fuel level gauge
Hydraulic oil temperature gauge
Fuel warmer
Warnings
Communication error
Low battery
Clock
ALHYUNDAI
CONSTRUCTION EQUIPMENT
www.hceamericas.com
6100 Atlantic Blvd., Norcross, GA 30071
TEL [phone] FAX [phone]
Seat
Adjustable air suspension seat with heater
Cabin FOPS/FOG
FOG ISO 10262 Level 2 Front and top guard
(FOPS ISO 3449 Level 2) Top guard
Cabin ROPS
ROPS ISO 12117-2
Battery master switch
Rearview camera
AAVM (All -Around View Monitoring)
Six front working lights (4 boom mounted, 2 front frame mounted)
Dual boom working lights
Travel alarm
Rear work lamp
Beacon lamp - LED
Automatic swing brake
Boom holding system
Arm holding system
Safety lock valve for boom cylinder with overload warning device
Safety lock valve for arm cylinder
Swing lock system
Three outside rearview mirrors
Booms
10.2 m, 33' 6" Long reach
Arms
7.85 m, 25' 9" Long reach
Removable clean -out dust net for cooler
Removable reservoir tank
Fuel pre -filter
Duel fuel warmer
Self -diagnostics system
Hi -mate remote management system Mobile
Satellite
Batteries (2 x 12 V x 160 Ah)
Fuel -filler pump (50 Urnin / 13 qpm)
One -pedal straight travel system
Pilot accumulator
Pattern -change valve (SAE and ISO)
UNDERCARRIAGE D OPT
Lower frame under cover (normal)
Track shoes
Triple grouser shoes (800 mm, 32")
Triple grouser shoes (900 mm, 36")
Track rail guard
NOTE: Standard and optional equipment may vary. Materials and specifications are subject to change without
advance notice. Contact your Hyundai dealer for more information.
PLEASE CONTACT
Made in the U.S.A. 1072-EX-SP_2/2018v11

Soil from the bottom of the basins being pulled up onto the banks of the basins, and
then spread onsite to dry.

GROUNDWATER SAMPLING DATA AND FORM GW59
FOR MONITORING WELLS MW-4, MW-5, AND MW-6
FOR THE PERIOD OCTOBER 2020 TO FEBRUARY
2024

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM, AL 35222
Drinking Water ID, 37715
Wastewater IDe 10
PHONE [phone]
FAX [phone]
ID#: 359 W
DATE COLLECTED: 02/01/24
DATE REPORTED : 02/27/24
REVIEWED BY:
MW-4
MW-5
MW-6
Analysis
Method
PARAMETERS
Date
Analyst
Code
PH (field measurement), Units
4.8
7.9
8.3
02/01/24
PJC
4500HB-11
Fecal Coliform (MF),cfu/100 mLs
1
< 1
< 1
02/01/24
HMV
9222D-15
Ammonia Nitrogen as N, mg/1
0.09
1.44
0.06
02/07/24
BMD
350.1 R2-93
Nitrate Nitrogen as N, mg/l
0.41
< 0.04
< 0.04
02/01/24
AMC
353.2 R2-93
Total Phosphorus as P, mg/l
0.09
0.24
1.19
02/07/24
AMC
365.4-74
Total Organic Carbon, mg/l
8.25
16.01
02/08/24
BLV
531OC-14
Total Organic Carbon, mg/l
14.36
02/15/24
BLV
531OC-14
Chloride, mg/1
L 6
L 61
02/05/24
HMV
4500CLB-11
Chloride, mg/l
19
02/12/24
HMV
4500CLB-11
Total Dissolved Residue, mg/l
88
M 510
M 91
02/06/24
HMV
D5907-13
Static Water Level, feet
9.15
11.30
5.50
02/01/24
PJC
Water Bailed, Gals.
2.0
2.0
3.6
02/01/24
PJC
All QC requirements were not met, L Laboratory Control Sample exceeded control limits.
M Blank result exceeded method constant weight criteria.

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please P;hn (,early or Typo
Facility Name: ) k S , C (► 1 JJ_ 1 tP_
Permit Name (if different):
Facility Address i-.~�YZ L�! {�j rL I C� t �L+✓�
`So�L��Y1 ri-tF I.11 C d t -� L-Fo
Contact Person. 4,, tJ-
Well Location/Site Name ► L L 5 ` 1
County D ns f 0(�",
Telephone# S. �lG z] y C _ Vol
No of wells to he sampled:
SIPm r'.nnnu
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): v1/1 W e-t Date sample collected: Z — + — Z4
Well Depth: jl¢s fl Well DiarnelerIn.
Depth to Water Level 82546. C1 - 1 It below measuring point Screened Interval. fl. to
Measuring Point is - ft above land surface Relative M P. Elevation: It
Volume of water pumped/bailed before sampling:
.9\ , U
gallons
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified:
LABORATORY INFORMATION
Date sample analyzed:
Laboratory Nanle:
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD00335
mg/L
Nihite (NO;) as N uowt5
Coliforrn: MF Fecal 3ieir; I
/100nit.
Nitrate (NO,) as N 00620
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P uu(iu5
-N. ie uee Mi'N melnotl la highly a,rt,nt ,, miueri)
Orthophosphate 70507
)issolved Solids Total 7u3oo
mg/L
At - Aluminum of lo,
pH (Lab) 00403
units
Ba - Barium 01007
TUC 0000 , ,2 s
mg/L
Ca - Calcium otom
Chloride 0094U L,
mg/L
Cd - Cadmium mop
Arsenic wow
ug1L
Chromium. Total u1o34
Grease and Oils 00552
mg/L
Cu - Copper 01042
Phenol 32730
ug/L
Fe - Iron 01045
Sulfate 00945
mg/L
Hg - Mercury 71900
Specific Conductance oou95
hMhos
K - Potassium 00937
Total Ammonia uooIo . ej
mg/L
Mg - Magnesium 00927
IAmnxmma Ndroyrn NN,ds N Ammonia Nitrogen lulal)
Mn - Manganese 01055
TKN as N 00625
mg/L
Ni - Nickel 01067
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
YES
❑ NO
rng/L Pb - Lead 01051
r\p mg/L Zn - Zinc olog
V 2
, 0q
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
PERMIT Number:
Expiration Dale IV
Non -Discharge
UIC
NPDES
Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon
❑ Remediation: InfiIW4tion Gallery
❑ Spray Field
❑ Remediation:
❑ Rotary Distributor
❑ Land Application of Sludge
❑ Water Source Hcat Pump
❑ Other irLC.iL�CGi'
If WELL
FIELD ANALYSES:
WAS
pH owou I - 19 units
Temp uuuin C DRY at
fl Spec Cond nno94
hMhos time of
samplwy,
Odor 000m _ _ _
_ uhi3ck
Appearance
here:F
mg/L
mg/L
mg/L
ug/L
mg/L
uglL
ug/L
mg/L
ug/L
ug/L
mg/L
mg/L
ug/L
uglL
Certification No ( C?
ug/L
mg/L.
Other (Specify Compounds and COnCeulralion Units)
ORGANICS: (by GC, GC1MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VOC 7B/3 method #
method #
rnethod #
method #
mg/L Effluent Total VOCs.
mg/L VOC Removal%
S-Mr V i C.1�11 11 q/� C C� �� d r -- I 9 2--
PFmrillee for AuthrHiaed en11 Name and TAte - Please prini or tape matre 1w A,nf,w,rrd i iai i rtni
GW-59 Rev 3-1-2016

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Pnrii CCllodrty or 1 ype
Facility Name: �{r, �- Sr (te is L ( f
Permit Name (if different):
Facility Address: 1[[-iQ_ h:Ll al[`,fl 12J
County 0 /1 40._v
Contact Person C. Ei�i..f' ..uh t VE Telephone#: � � IG ---S K Q —ts ` f� U
Well Location/Site Name: 1 ry\ t..) S No. of wells to be sampled.
-- dtnm I uu•NI
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27599-1617 Phone: [phone]
PERMIT Number: Expiration Date 1 -8
Non -Discharge UIC
NPDES Other J,.,r_jf_
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediatlon:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heal Pump ❑ Other Lwt d_'4
SAMPLING INFORMATION
WELL ID NUMBER (trorn Permit): ►..: S Dale samplecoller:tFd ' -2-q
Weil Depth 1 � ft Well Diameter L ul
Depth to Water Level sw!wlo 1 j,AQ (l beluw pleasuring point Screened Interval- _ 5 ft to ^ft
Measuring Point is 2— ft. above land surface Re$ative M.P Elevation: It
Volume of writer pumpedlhalled before sarnpling 12.0 gallons
Samples for metals welt: collected unflltered. ❑ YES ❑ NO and fiend acidified- OYES ❑ NI)
LABORATORY INFORMATION
Date sample analyzed: Laboratory Name.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD o0335
mg/L
Nitrite (NO;) as N oo615
Coliform: MF Fecal muiti 41
/100mL
Nilrate (NO,) as N 00620
Coliform: MF Total 31504
1100mL
Phosphorus: Total as P oot,65
Wdte Use %*'N melh,xl lox higniy Iwbm san'.plrsi
Orthophosphate 70.507
dissolved Solids.Tolal ru3ou M S to
mg/L
Al - Aluminum or r3s
PH (Lab) (xw03
units
Ba - Barium 01007
TOC oo6tlo . , C)
mg/L
Ca - Calcium 00416
Chloride uoswo L L. 1
mg/L
Cd - Cadmium 01027
Arsenic 01002
ug/L
Chromium. Total u1034
Grease and Oils l 5u
mg/L
Cu - Copper 01042
Phenol 32730
ug/L
Fe - Iron oluas
Sulfate 00945
mg/L
Hg - Mercury 711400
Specific Conductance 000,rs
pMhus
K - Potassium 00937
Total Ammonia uowo E /I HLA
mg/L
My - Magnesium txj927
(Anunonxa Nitrogen NH, as N Anmxonxd Nxirogen Toxdl)
Mn - Manganese o1o55
TKN as N 00625
mg/L
Ni - Nickel 01067
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs.
FIELD ANALYSES:
PH I]fi4W 12- units
Spec. Grind i1 "A
Odor lu] jm
Appearartte
J
mg/L Pb - Lead uio:1
`J m IL Zn - Zinc oviv1"
9
mglL
mg/L
mg/L
ug/L
mg/L
ug/L
ug/L
ing/L
ug/L
ug/L
mg/L
mg/L
ug/L
ug/L
If WELL.
WAS
Tenip. + fnllla. [ : DRY al
}(MTiras lime of
- S,:impling,
chr:cls
Here ❑
Certification No v
ug/L
mg/L
Other (Specify Compounds and Concentration Units)
ORGANICS: (by GC. GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VOC 787-A method #
method #
method ll
method #
mg/L Effluent Total VOCs:
rng/L VOC Removal%
ML MI \\Rv\ c o v "X/' AL, F 1212 �
Pervnktee lur Aulhorl[eid Aqeni) Name and Tille • Pkrasu Winn or type SK)AMMEXI cnnateaae. Aulhonzed Apent) (Patti
GW-59 Rev 3-1-2016

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION , reaso r rinr Gruddy or TYPO
Facility Name 5�- ,t-e
Permit Name (if different)
Facility Address: hex IL
Contact Person:
Well Location/Site Name ((� ( '.: b
SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
� INFORMATION PROCESSING UNIT
1617 MAiL Si:RVICE CENTER, RALEIGH. NC 27699-1617 Phone: [phone]
PERMIT Number: Expiration Date IV L -
Non -Discharge UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
County Del �� to L'7 ❑ Lagoon ❑ Remediation Infiltration Gallery
❑ Spray Field ❑ Remedlalion
Telephone#: -5 3t.--SLf,, -VeK,o ❑ Rotary Distributor ❑ Land Application of Sludge
No of wells to be sampled: ^ 5 ❑ W ate:r Source Heat Pump ❑ Other [.S.>71 oGft CjQ[ r I
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): ry) l ,V Date sample collected — I ~ Z
Well Depth Lfl Well Diameter .2 in
Depth to Water Level 82!,ati: S, S ft. below measuring point Screened Interval i5 It to It
Measuring Point is ,- It above land surface Relative M P Elevation: it
Volume of water pumped/bailed before sampling: 'i . �'_gallons
FIELD ANALYSES:
pH 00400 `3, j units
Spec Cond.00094
Odor outlnr,
Appearance
Samples for metals were collected unfiltered. ❑ YES ❑ NO and field acidified: Q YES ❑ NO
LABORATORY INFORMATION
Dale sample analyzed Laboratory Name: AOCL'i PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. +
COD ocls35 mg/L Nilrile (NO.) as N no6is mg/L Pb - Lead 4)w5i
Colifonn: MF Fecal 31616 G /100mL Nitrate NO,) as N 0062o
( ( 4 U ^Li my/L Zn Zinc u1u.11
Coliform: MF Total 315(A
/100mL
Phosphorus: Total as P 00665
, t Cj mg/L
(Noce rse nmN meu„xf w, h,yhly lu,e,o s mple,j
Orlhophosphate mwz
mg/L
)Issolved Solids: Total 7U30U YYl Ct
mg/L
AI - Aluminum m icis
mg/L
pH (Lab) 00403
units
Ba - Barium o1oo7
ug/L
TOC onsnn (4{ , _�
ing/L
Ca - Calcium oovtr,_
mg/L
Chloride U0940 Gj
mg/L
Cd - Cadmium ov)27
ug/L
Arsenic 01002 ,
uglL
Chromium: Total 01034
uglL
Grease and Oils 00552
mg/L
Cu - Copper 010-12
mglL
Phenol 32730
ug/L
Fe - lion 01045
ug/L
Sulfate u0945 .
mg/L
Hq - Mercury 71900
ug/L
Specific Conductance 000g5
pMhos
K - Potassium OU937
mg/L
Total Ammonia ou61o_—V, U (J
mg/L
Mg - Magnesium 0o927
rny/L
Ammuma Nd,oyen NH.asN Ammon,d Niliuueu 1-01a1)
Mn - Manganese moss
ug/L
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
For Remedlation Systems Only (Attach Lab Reports): Influent Total VOCs.
Sea In A& ;11" C 0 U
Pennillee (or AwliwkilA AUent) Name did Thle Please print or (Vpe
GW-59 Rev 3-1-2016
Ternp ooulo c,
µMhos
Certification No. I'D
ug/L
mq/L
Other (Specify Compounds and Concentration Units)
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VOC 787'� method #
molhod #
method #
rnelhod #
mg/L Effluent Total VOC&
L'4---
(of Aulirt„v,!.: Aq,.it,
mg/L VOC Removal%
�ri
icatt-i
It WELL
WAS
DRY at
time ut
sampling,
check
here !_--_I
7�

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM, AL 35222
Drinking Water ID: 37715
Wastewater ID. 10
PHONE [phone]
FAX [phone]
ID#: 359 W
DATE COLLECTED: 10/02/23
DATE REPORTED : 10/17/23
REVIEWED BY:
MW-4
MW-5
MW-6
Analysis
Method
PARAMETERS
Date
Analyst
Code
PH (field measurement), Units
5.2
7.3
7.1
10/02/23
PJC
4500HB-11
Fecal Coliform (MF), /100 Mls
24
< 1
230
10/02/23
MCY
9222D-15
Ammonia Nitrogen as N, mg/l
0.25
1.80
0.08
10/03/23
AMC
350.1 R2-93
Nitrate Nitrogen as N, mg/l
0.06
< 0.04
< 0.04
10/03/23
BNC
353.2 R2-93
Total Phosphorus as P, mg/1
0.05
0.37
0.13
10/06/23
AMC
365.4-74
Total Organic Carbon, mg/l
6.75
25.38
6.04
10/03/23
BLV
531OC-14
Chloride, mg/l
7
66
7
10/09/23
BNC
4500CLB-11
Total Dissolved Residue, mg/l
M 99
M 650
M 98
10/03/23
HMV
D5907-13
Static Water Level, feet
9.49
11.33
4.08
10/02/23
PJC
Water Bailed, Gals.
2.0
2.0
1.5
10/02/23
PJC
All QC requirements were not met: M Blank result exceeded method constant weight criteria.

Could Not find data records in RAWDATAL.
Batch Number is Equal to 0.
For: Test
= 620C
Client =
359 W
Cooler =
0
Week# =
44
Received =
10/02/23

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY I N FORMATION +'+"arse Pam L;Iewjy or type
Facility Name: ! 'J'-e Sr J"o l.vl-J 7Y-
Permit Name (if different):
F:,+.alll Address: ULjx,k---L O,t r [7'sv P-ex
]�r_1a nU 1i� m r P1 4"AG
Contact Person: Cr A-r�� 1
Well LocationlSite Name: ( _vv\ W Ll
SUBMI I FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
and I copy to: INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH. INC 27699-1617 Phone: [phone]
PERMIT Number: Expiration Date
Non -Discharge UIC
NPDES OtherLL"L1 �r'1
TYPE OF PERMITTED OPERATION BEING MONITORED
county�❑ Lagoon ❑ Remediahoii Infiltration Gallery
/� /' ❑ Spray Field ElRemediation
Telephone#: � �1G' - SqY -ar,`P/Y IO ❑ Rotary Distributor ❑ Land Application of Sludge
No of wells to be sampled 3 ❑ Water Source Heat Pump ❑ Olhei Uri t[,p,{ C{ an' n
d,,.n I'm n.,i
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): VV\ U.)
Date sample collected: l U 2
- 2
FIELD ANALYSES:
WAS
Well Depth: LLft.
Well Diameter 1Lin
pH oo400 5 . Z units Temp. o0wo 'C
DRY al
Depth to Water Level 82cAli: C1 It below measuring paint Screened Inlerval: _it
to _ft
Spec. Cond 00094 I,Mhos
time of
sampling,
Measuring Point is 2- ft above land surface
Relative M P Elevation:
ft
Odor 000m
check
Volume of water pumped/bailed before sampling:
, V
gallons
Appearance
here
Samples for metals were collected unfiltered ❑ YES
❑ NO and field acidified I..T YF_S
NO
�.
LABORATORY INFORMATION
Dale sample analyzed
Laboratory Name
%--0CX4j pp
L
C-, ✓► r Certification No rj 0
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD uo:+35
mg/L
Nitrite (NO;) as N oo615
ing/L
Pb - Lead mu51 ug/L
Coliform: MF Fecal iun; y
/100ml-
Nitrate (NO,) as N uo62U�r �,C,
mg/L
Zn - Zinc oIo92 mg/L
Coliform: MF Total 31504
/100ml-
Phosphorus: Total as P uo66:, r), 05
mg/L
jNole U,e MNN m,-m„d lot rilghl,11,1bid 11,I,uir,i
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units)
Nssvlved Solids:Total 70300 t Y1 Cj
rng/L
Al - Aluminum u i ins
mg/L
pH (Lab) 00403
units
Ba - Barium 01007
ug1L
TOC oust+o tD S
mg/L
Ca - Calcium ou�r16
nig/L
Chloride 00940
mg/L
Cd - Cadmium U1U27
ug/L
Arsenic uwo2
ug/L
Chromium. Total Ultua
uglL
Grease and Oils 00552
mg/L
Cu - Copper 01ua2
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 .
ug/L
Fe -Iron Ui(A5
uglL
(Specify test and method ft. ATTACH LAB REPORT.)
Sulfate 00445
mg/L
Hg - Mercury /lgno
uglL
Lab Report Attached? ❑ Yes (t l ❑ No (0)
Specific Conductance uoo95
tiMhos
K - Potassium 001137
mg/L
VOC 7873 method #
Total Ammonia uowo !fir', a.
mg/L
Mg - Magnesium 00927
rng/L
method #
i A,nmoma Niur,gen NH.as N Aunnr,,,,a ZKMfk awl,
Mn - Manganese oloss
ug/L
. method #
TKN as N uor;25
mg/L
Ni - Nickel oio67
uglL
method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs ing/L
Effluent Total VOCs mg/L VOC Removal%
GW 59 Rev 3-1-2016

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY JINFORMATION 17r:ase t'nnl Clearly of Type
Facility Name: -�,
Pnnnil Name (if different):
Fcici�.AddrPss
W-cziV l
Contact Person: C
Wr;ll Location/Site Name
SAMPLING INFORMATION
SUBMIT FORM ON YELLOW PAPER ONLY
__Aliail original DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
and I copy to: I INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
PERMIT Number: Expiration Date: 10 -- -3 }, — L ft
Non -Discharge UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
County Jr'1"1��L�.3 ❑ Lagoon ❑ Remedialion: Infiltration Gallery
❑ Spray Field ❑ Remediation:
Telephone#. S3tc - SLfQ - $ f Cj L) ❑ Rotary Distributor ❑ Land Application of Sludge
No of wells to be sampled.. ❑Water Source Heal Pun1p ❑Other Ljrr �1.� CT �tCi r1
iGrar PurnW}
WELL ID NUMBER (from Permit): ImoDate sample collected: 1 (�
Well Depth: 1'9 ft Well Diameter_it)
Depth to Water Level 82s46 iL,'33 ft below measuring point Scieened Inteival:it
Measuring Point is 'Z ft above land surface Relative M,P. Elevation:
Volume of water pumped/bailed before sampling:
�C , C)
gallons
Samples for metals were collected unfiltered ❑ YES
❑ NO and field acidified.
LABORATORY INFORMATION
Dale sample analyzed:
Laboratory Name.
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD W335
mg/L
Nitrite (NO;) as N uoto5
Coliform- MF Fecal mooti 1
/100ml-
Nitrate (NO,) as N oorizo
Coli(orm: MF Total :o5o4
/100ml-
Phosphorus: Total as P 00665
lNole
Orlhophosphate 70507
)issolved Solids:Tolal in uo 6 Si]
rnq/L
AI - Aluminum ut io5
pH (Lab) 00403
units
Ba - Barium 01007
TOC uu6tio 1�51 sp_mg/L
Ca - Calcium oo9i6
Chloride 00940 h
mg/L
Cd - Cadmium ui(iz7
Arsenic 01002
ug1L
Chromium: Total 010M
Grease and Oils 00552
mglL
Cu - Copper 01042
Phenol 32.7:11)
ug/L
Fe - Iron 011045
Sulfate no945
mg/L
Hg - Mercury 719uu
`specific Conductance oou95
µMhos
K - Potassium 00937
Total Ammonia oo6io (J
mg/L
Mg - Magnesium ut1927
(Ammonia Nilrugen NH, as N r4aa)gnn Totall
Mn - Manganese oio55
TKN as N u0625
mg/L
Ni - Nickel oiu67
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs:
S'Oav7 1kcM, I(" (foC)
Permiitee (or Authrxiziefd &p1tl Nance and Title - Pledse I:innl or type
GW-59 Rev 3-1-2016
0 YES
M
If WELL
FIELD ANALYSES:
WAS
pH uuaou• -7. 3 units Temp uou o C
DRY ,i(
to
ft. Spec Cond 00094- itmhos
III)le of
sampling,
ft
Odor uuoes
check
Appearance
ftert? El©
NO
1. OLIAE
OV0lV'),tCertification No f ti
mg/L
Pb - Lead om5,i ug/L
L 0,(D I
rng/L
Zn - Zinc uur91 mg/L
b , 1
rng/L
mg/L
Other (Specify Compounds and Concentration Units).
mg/L
ug/L
mg/L
uglL
ug/L
mglL
ORGANICS: (by GC, GC/MS, HPLC)
uglL
(Specify test and method #. ATTACH LAB REPORT.)
ug/L
Lab Report Attached? ❑ Yes tl) ❑ No (o)
mg/L
VOC 780 method #
rng/L
method #
ug/L
method #
ug/L
method #
mg/L
Effluent Total VOCs mg/L VOC Removal%
rle allitybro Uy C.
o! fines
and
Imprisonmentr=4jb9I',y
of .
{
�ur
urrarrf
rv;�nr RUlhu rrr:d riIt Wah l >!

SUBMIT FURM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION p prease Prillr ch'drfy or type
Facility Name.
Permit Name (if different):
Facility Address: ti rl { 7+Lt i+l
County (Dn4�,k e-,{
Contact Person: (�4L ti \--1 l V n Y£ Telephone#. S y C11 _c q C1 G
Well Location/Site Name No of wells to be sampled-
Ito—, I'a,+.t
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV• OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1817 MAIL SERVICE CENTER, RALEIGH, NC 27099-1517 Phone: [phone]
PERMIT Number: Expiration Date
Non -Discharge UIC
NPDJES Other Jr'l��i-+zzt►f-cti �-!� 1
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Rernediation-
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heal Pump ❑ Other
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): b Date sample collected I C) -
Wool Depth: 119 ft Well Diameter "Z in
Depth to Water Level 82546: Lt, C>q, ft below measuring point Screened Interval. ft to —ft
Measuring Point is •Z ft. above land surface Relative M.P Elevation. ft
Volume of water purnped/balled before sampling: l r 5 gallons �
Samples for metals were collected unfiltered: ❑ E YES ❑ NO and field acidified. YES ❑ NO
LABORATORY INFORMATION
Dale sample analyzed. Laboratory Narne:
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations
COD 00335
mg/L
Nitrite (NO,) as N onm;,
Coliform. MF Fecal iwiti 0
/100mL
Nitrate (NO-,) as N 00e20
Culiform: MF Total 31504
/10omL
Phosphorus: Total as P ooees
Noie lke MPN metn(Yd lui rugliiy (wind oaniple>
Orthophosphate 70507
)tssotvi;d Solids Total 7050p__y)(-' �j S
mg/L
Al - Aluminum uI to!,
pH (Lab) 00403
units
Ba - Banunt U1007
TOC oowio�r)Lf
mg/L
Ca - Calcium oogifi
Chloride 00940 `7
mg/L
Cd - Gadrnturn 01027
Arsenic nioo2-
ug/L
Chromium: Total 010:14
Grease and Oils out;52
mg/L
Cu - Copper 0 104 2
Phenol t2730
ug/L
Fe - Iron un.45
Sulfate o0445
mg/L
Hg - Mercury 71900
Speclric Conductance 00095
µMhos
K - Potassium 00937
Total Ammonia (10610
rng1L
Mg - Magnesium ow)27
;Ammonia Nitk W,. NH,as N Amim,nia Nioaten otal)
Mn - Manganese o1o55
TKN as N 00625
mg/L
Ni - Nickel 010637
For Remediation Systems Only (Attach Lab Reports)
Putmillet• (or Atilluaved Agenl) Name and Tilt[ Pkaye print or type
GW-59 Rev 3-1-201b
Influent Total VOCs
L C), G c(
0, l 77
spin Aire [it
If WELL
FIELD ANALYSES: WAS
pH 00400 _T. I units Temp noon, C DRY at
Mhos limta of
Spec- Cond. 00044 I sampling,
Odor oo0e5 check
Appearance here-1-1
mgiL Pb - Lead Most
mgiL Zn - Zinc oung;
n1g/L
mg/L
rng/L
ug/L
mg/L
ug/L
ug/L
mg/L
ug/L
ug/L
mgiL
mg/L
ug/L
ug/L
Certification No l
ug/L
mg/L
Other (Specify Compounds and ConcentiaUun Units)
ORGANICS: (by GC GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1 ) ❑ No (0)
method #
method #
method #
method #
Effluent Total VOCs:
Aut1iifived AmPit1
mg/L VOC Removal%

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM, AL 35222
PARAMETERS
PH (field measurement), Units
Fecal Coliform (MF), /100 Mls
Ammonia Nitrogen as N, mg/l
Ammonia Nitrogen as N, mg/1
Nitrate Nitrogen as N, mg/l
Total Phosphorus as P, mg/l
Total Organic Carbon, mg/l
Chloride, mg/1
Total Dissolved Residue, mg/l
Static Water Level, feet
Water Bailed, Gals.
MW-4
MW-5
MW-6
4.8
7.2
5.7
<1
<1
<1
0.14
1.74
0.16
< 0.04
< 0.04
< 0.04
0.20
0.27
0.15
6.75
23.28
3.23
6
54
26
99
660
115
10.00
11.46
5.21
2.0
2.0
1.5
Drinking W: ter ID: 37715
Wastewater ID: 10
PHONE [phone]
FAX [phone]
ID#: 359 W
DATE COLLECTED: 06/20/23
DATE REPORTED : 06/30/23
REVIEWED BY:
Analysis Method
Date Analyst Code
06/20/23
NNK
4500HB-11
06/20/23
JMS
9222D-15
06/22/23
TRJ
350.1 R2-93
06/27/23
TRJ
350.1 R2-93
06/21/23
TRJ
353.2 R2-93
06/27/23
TRJ
365.4-74
06/27/23
HMV
531OC-14
06/26/23
HMV
4500CLB-11
06/22/23
HMV
D5907-13
06/20/23
NNK
06/20/23
NNK

SUBMIT FORM ON YELLOW PAPFR ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION nI Cloarry or type
Facility Name J,&-4-e C4, I >J L"—) 1 t"
Permit Name (if different) Facility Address: r. 4 V-) & i lA0-- 1-1
-ct Ulkl-e NL 0-
County D ja SI O
1�! 4,�S C�CC�Contact Persone Telephone#
Well Location/Site Name. w `k No, of wells to be sampled:
(Own n, r,ua:
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH.
NC 27699.1617 Phone: [phone]
PERMIT Number.
Expiration Date: I ct
Non -Discharge
UIC
NPDES
Other -� A 411 A-fla TLI C ; }
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon
❑ Remedialion: Infiltration GaIlr.,ry
❑ Spray Field
❑ Remediatlon:
❑ Rotary Distributor
❑ Land Application of Sludge.
❑ Water Source Heat Pump
❑ Other U M Ltl'LC�flGtir h
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): _ Y� iA) y Date sample collected ZC' - 7 3 FIELD ANALYSES:
Well Depth: Is Well Diameter Z in pH 00400 vo units
Depth to Water Level 82s4c: jp,0 ft below measuring point Screened Interval Zft to ft Spec. Cond 00094
Measuring Point is 2 ft. above land surface Relative M P Elevation: ft. Odor uuons
Volume of water pumped/bailed before sampling: -�2 . O gallons - Appearance
Sanlules for metals were collected unfiltered ElYES ❑ NO and field acidified: E JYES ❑ NO
LAB6RATORY INFORMA 110N t
I )�Ilr- sample analyzed Laboratory Name:
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO:.) as N noels
/ L�--; &110 Vjvl) t-
Coldorm: MF Fecal 3161e
L `
1100mL
Nitrate (NO,) as N om2o L 0i0 ►t
Coliform: MF Total 31504
1100mL
Phosphorus. Total as P oo6ec• Fj ► 20
iNote Usc MPN me1n,A inr
I•.,nly luihn,l,:unrdre)
Orthophosphate 70507
r'
]issolved,Solids: Total 703410
mg/L
Al - Aluminum o11os
pH (Lab) 00403
units
Ba - Barium 01007
TOC uue8o
1p -1 S
nig/L
Ca - Calcium 00916
Chloride 00940
mg/L
Cd - Cadmium 01027
Arsenic olou2
ug/L
Chromium: Total 01034
Grease and Oils W!iQ
mg/L
Cu - Copper aIW2
Phenol 327.10
ug/L
Fe - Iron onus
Sulfate 00945
mg/L
Hg - Mercury 7lyoti
Specific Conductance 000y�,
pMhos
K - Potassium 00937
Total Ammonia uualo
1!-I
mg/L
Mg - Magnesium 00921
Ammonia Niliogen NH, as N Ammonia Ndiujen Tniai)
Mn - Manganese otoss
TKN as N m6ze
mg/L
Ni - Nickel owii/
For Remediation Systems Only (Attach Lab Reports):
Sean
I+i-riiiMee (or 11uthutvtiri Aqent) Na
GW-59 Rev 3-1-2016
Influent Total VOCs:
rng/L
mg/L
mg/L
mg/L
mg/L
ug/L
mg/L
ug/L
ug/L
mg/L
ug/L
ug/L
mg/L
mg/L
ug/L
ug/L
Pb - Lead urosl
Zn - Zinc uiue2
If WELL
WAS
Temp- oonlu ''C DRY at
uMhos time Of
sampling.
check
here.
Certification No 10
ug/L
mg/L
Other (Specify Compounds and Concentration Units)
ORGANICS: (by GC, GC/MS, HPI C)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VOC 787 , method #
method #
method #
method #
mg/L Effluent Total VOCs
ifnirled (or A4111oi'i:ed Atwol1
VOC Removal%
1"Z � 2
l Io)

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION I'100Srl Pfgtl Cloai)y or Type
Facility Name: `�) �P,�d.Q LA__>L'U_T1P
Permit Name (if drffero 11 :
Facility Address.
Contact Person. C_
Well Location/Site Name: )T/j t A 1 C�
SUBMIT FORM ON YELLOW PAPER ONLY
t • DEPARTMENT OF ENVIRONMENTAL ouALfTY - DIV. OF WATER RESOURCES
and I copy to: INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
PERMIT Number: Expiration Dale,
Non -Discharge UIC
NPDES Other )rt
C( TYPE OF PERMITTED OPERATION BEING MONITORED
County {) f� s� (] C� ❑ Lagoon ❑ Remediation: Infiltration Gallery
�y ❑ Spray Field ❑ Remediation
Telephone# �}� .� �tS O ❑ Rotary Distributor ❑ Land Application of Sludge
No, of wells to be sampled-. ❑ Water Source Heal Pump ❑ Other L ,t d 4 1' ti
luau r'ea,ro
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): ry, t_J S Date sample collected (D -
Well Depth. I � ft. Well Diameter: 2Gir
Depth to Water Level 82546: j I ,Lj(p ft below measuring point Screened Interval _L.�_f
Measuring Point is ft. above land surface Relative M P. Elevation:
Volume of water pumped/bailed before sampling: ,9 , o gallons
Sam Iles for metals were collected unfiltered El YES ❑ NO and field acidified: YES
LABORATORY INFORMATION
Date sample analyzed Laboratory Name. J i
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD Uu335 Ing/L Nitrite (NO,) as N ooa15
ZU • Z_j FIELD ANALYSES:
l pH 00400 %. , units Ternp uuuui
t. to ^ft Spec. Cond 00094
ft. Odor oonlls
Appearance
❑ NO
1
Coliform. MF Fecal i1616 /100mL Nitrate (NO,) as N ou62o Gr C,`r
Coliform: MF Total 31504
NoW lisro MPN mel—d for highly uab'd semp'esl
]lssolved Solids -Total 7ueuU_�� U L
pH (Lab) 00403
TOC uubso
Chloride 00440
Arsenic oino2
Grease and Oils U0552
Phenol 12730
/100n1L Phosphorus Total as P ou66s
Orthophosphate 70507
mg1L Al - Alunnnum 01105
units
a 7 i ,A &_ mg/L
S mg/L
ug/L
mg/L
ug/L
Sulfate 00945 mg/L
?pectfic Conductance uuo95 iiMhos
Total Ammonia 0u610 f 7 mg/L
(Aimrwia Nillogen NH,ns N AgTrxigi i Nilrogen Total)
TKN as N uo625
mg/L
For Remediation Systems Only (Attach Lab Reports):
S ctV1 A& Vvt 114r 1
Perrndlee (or Aidhunzed Agent) Name and Tille PfeaBC Drinl or type
GW-59 Rev 31-2016
Ba - Barium owu7
Ca - Calcium (10916
Cd - Cadmium 01027
Chromium Total01ua4
Cu - Coppel 01(A2
Fe - Iron 01045
Hg - Mercury 71goo
K - Potassium 00937
Mg - Magnesium U0927
Mn - Manganese o1o55
Ni - Nickel 01067
Influent Total VOCs.
C00
[-U)jj (201n1-
mg/L Pb - Lead o1u51
mg/L Zn - Zinc if lwr'
rng1L
mg/L
mg/L
ug/L
mg/L
ug/L
ug/L
mg1L
uglL
ug/L
mg/L
mg/L
uglL
ug/L
If WELL
WAS
DRY at
µMhos lime of
sampling,
check
here:�
Certification No- t D
ug/L
mg/L
Other (Specify Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VOC 7B7? method #
method #
method # .
method #
rng/L Effluent Total VOCs:
SNitAtt o.ol'Perinrllee (or Authorized Aqent)
mg/L VOC Removal%
F12 �Zy
(Date

GROUNDWATER DUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Wease Prinr Cleary or typo
Farmlity Name: S f'J-e. ej t
Psrrnit Name (if differWt)
Facility Address: I r. [il
:kk a fJ C
Contact Persun ( `,L.A c
Well Location/Site Name. VY) LA_.) lfr
SUBMff FORM ON YELLOW PAPER ONLY
Mail original I DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
and 1 copy to: 11 INFORMATION PROCESSING UNrr
1517 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
PERMIT Number: Expiration Dale tj '31 - Zj';�,
Non-Di,,'charge UIC
NPDES Other in'I1�.1c�Pfv.'l
TYPE OF PERMITTED OPERATION BEING MONITORED
County V 1S (r.L A] ❑ Lagoon ❑ Rernedialron Infiltration Gallery
p ❑ Spray Field ❑ Remedlatlon
Telephone#. :2 J7(rj ' S `{ -0 �C�(� El Rotary Distributor ❑Land Apf]Itlpatr[an of Sludge
of wells to be sampled: ❑ Water Source Heat Pump ❑ Other L r) 4 --4? 11 C44 44 /1
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): V171 lD Date sample collected: Lp - 2-_?> FIELD ANALYSES:
WE-11 Depth: ft Well Diameter � in pH orwoo 5 units Temp ouui ,
Depth to Water Level 82546. 45, L-k It below measuring point Screened Interval: It to _ ft Spec Cond 00094
Measuring Point is �Z, ft above land surface Relative M.P Elevation: It Odor 000m
Volume of water pumped/bailed before sampling: I , 5j gallons Appearance
Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified; YES ❑ NO
LABORATORY INFORMATION
L),lle sample analyzed: Laboratory Name:
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations
rng/L
Nitrite (NO,) as N uu615
Cuh(arm MF Fecal 31616
L 'I
1100mL
Nitrate (NO,,) as N 0062U
Colifonn MF Total :n5o4
11OOmL
Phosphorus: Total as P 00665
(tore Use MPN mvih: f rur highy rur6nl
aaniUles)
Orthophosphate lo%7
)Issulved Solyds:Tolal 70300
5
mg/L
Al - Aluminum 01105
pH (Lab) rxmo:l
units
Ba - Barium uim-(
TOC 00680
; 'l 3
mg/L
Ca - Calcium o091(i
Chloride a)94o
Z
mg/L
Cd - Cadmium 01027
Arsenic 01002
ug/L
Chromium Total ot034
Grease and Oils uoh52
mg/L
Cu - Copper 01042
Phenol 32730
ug/L
Fe - Iron ow4s
Sulfate 00945
mg/L
Hg - Mercury 71900
Spwilic Conductance 0009,,
pMhos
K - Potassium 00937
Total Ammonia u0610
n , i Le
mg/L
Mg - Magnesium 00927
,Aminunia Nitrogen NH, as N Arrx"IfiTN+trupnn retlrii
Mn - Manganese 01o55
TKN as N 00625
mg/L
Ni - Nickel 01067
For Remediation Systems Only (Attach Lab Reports):
1•,!rlrrglHY- Nr Auluu,rr.uu �w,vny ,.ou,a. .., ,.. ...... ....-........_. _.. ..�-.
GW-59 Rev. 3-1 2016
Influent Total VOCs:
mg/L
OiLf mg/L
mg/L
mg/L
nlg/L
ug/L
mg/L
ug/L
ug/L
rng/L
ug/L
ug/L
mgiL
mg/L
ug/L
ug/L
Certification No
Pb - Lead most
Zn - Zinc 01092
If WELL
WAS
,1C
DRY at
pmhos
time of
sampling,
check
here ❑
ug/L
nlg/L
Other (Specify Compounds and Concentration Units)
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes(l) ❑ No(o)
VOC 7872 method #
method #
method #
method #
mg/L Effluent Total VOCs:
'Agurrtl
mg/L VOC Removal% ~ j""
e)

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM, AL 35222
Drinking Water ID: 37715
Wantevater ID. 10
PHONE [phone]
FAX [phone]
ID#: 359 W
DATE COLLECTED: 02/09/23
DATE REPORTED : 02/22/23
REVIEWED BY:
MW-4
MW-5
MW-6
Analysis
Method
PARAMETERS
Date Analyst
Code
PH (field measurement), Units
5.6
7.8
9.2
02/09/23
PJC
4500HB-11
Fecal Coliform IMF), /100 Mls
< 1
< 1
< 1
02/09/23
ADR
9222D-15
Ammonia Nitrogen as N, mg/l
< 0.04
5.03
0.14
02/15/23
TRJ
350.1 112-93
Nitrate Nitrogen as N, mg/l
0.50
< 0.04
< 0.04
02/09/23
BMD
353.2 112-93
Total Phosphorus as P, mg/l
0.05
0.19
1.74
02/16/23
BMD
365.4-74
Total Organic Carbon, mg/l
9.43
19.60
7.70
02/2U23
HMM
531OC-14
Chloride, mg/l
8
55
11
02/13/23
HMV
4500CLB-11
Total Dissolved Residue, mg/l
130
490
110
02/14/23
JDJ
D5907-13
Static Water Level, feet
9.23
12.11
6.31
02/09/23
PJC
Water Bailed, Gals.
2.0
1.5
3.0
02/09/23
PJC

Wayp�nt_
ANALYTICAL
114 QAKMC)NT DRIVE
GREENVILLE, N.C. 27858
STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVMME S
STE 200
BIRMINGHAM, AL 35222
Drinking Water 101 31115
]NE {252) 75-6-6208
FAX [phone]
ID#: 359 W
DATE COLLECTED: 02/09/23
DATE REPORTED : 02/22/23
REVIEWED 4B /w - X' N.,
1
MW-4
MW-$
MW-6
Analysis
Method
PARAMETERS
Date Analyst
Code
PH (field measurement), Units
5.6
7.8
9.2
02/09/23
PJC
4500FIB-11
Fecal Coliform (A>F), /100 Mls
< 1
< 1
< 1
02/09/23
ADR
9222D-15
Ammonia Nitrogen as N, mg/1
<0.04
5.03
0.14
02/15/23
TRJ
350.1 112-93
Nitrate Nitrogen as N, mg/1
0.50
<0.04
<0.04
02/09/23
BMD
353.2 R2-93
Total Phosphorus as P, mg/l
0.05
0.19
1.74
02/16/23
BMD
365.4-74
Total Organic Carbon, mg/l
9.43
19.60
7.70
02/21/23
HMM
531OC-14
Chloride, mg/l
8
55
11
02/13/23
HMV
4500CLB-11
Total Dissolved Residue, mg/l
130
490
110
02/14/23
JDJ
D5907-13
Static Water Level, feet
9.23
12.11
6.31
02/09/23
PJC
Water Bailed, Gals.
2.0
1.5
3.0
02/09/23
PJC

SUBMIT FORM ON YELLOHf PAPER ONLY
GROUNDWATER QUALITY MONITORING:
s : MPARTM@R OP [NIAPMMBRAL a1ALrrY - M. DF WATER RESOURCES
UrtOrlgtATM � UWT
COMPLIANCE REPORT FORM-op
tFs� wuL ae�tytclt t, otl� uc sfaaFt�tT tam m114074 soa
FACILITY INFORMATION PIee+e Pmf Crawfy or TM@ --
PERMIT Number: W 4 o02S8'opE*ra0= Date: / D /'5//Zy
Facility Name: .S-'il' a4F5 IJi`. W lAJ T P
Non-ftcharge UIC
Permit Name (if different):
_
NPDES OlfherT7f, T-;, y
Fw0llty Address:A a-,4F-- e,-,i u,ti � ; ly f1
TYPE OF PERMITTED OPERATION BEING MONITORED
ckSa.,Li Ile Al) C --l-WSYD
CountyO n/ S 0,1-•)
❑ Lagoon ❑ Rernedlabon. Inflll scan Gallery
_�T,p
` -
❑ Spray Field ❑ Renlediatlon.
Contact Person: TP
Telephones: c) /D ^ 310 ^YA %
❑ Rotary Distributor ❑ Land AppkaWn of Sludge
Well Location/Site Name: -S a {w S �`r�� A)zj 7 70
No. 01 welts to be sampled: j
❑ Water Source Heat Pump W crew. r� R►�d�a . n1s
SAMPLING INFORMATION
1
if tiiEu
WELL ID NUMBER (from Permit): %� W �
Date sample collected: q -1,
,5 FIELD ANALYSES: WAS
Well Depth: L(t
Well Diameter sin.
pH ooroo�(_ units Temp. 00010 •C DRY at
time of
Depth to Water Level ers46: , Z tl below measuring point
Screened Interval: -15_fl. to
ft. Spec• Land scow' �� sampling.
Measuring Point is _1__ ft. above land surface
Relative M.P. Elevation: fl.
Odor o0085 dwic k
Volume of water pumped/balled before sampling: 2
gallons
Appeaww hone:
❑
Samples for metals were collected unfiltered: ❑ YES ❑
NO arai f•,eid ac d,fieu. )j"YES ❑ NO
LABORATORY iNFORMATPON _ '
Date sampleanaWxed. 3
Laboratory Name. AY PO.rI
r� Certification No /0
PARAMETERS NOTE Values should ►affect dkssolved and
colloidal concentrations.
COD e033s mg/L
Nitrite (NO2) as N ooe+s
mg/L Pb -lead wosi ugrL
Coliform: IMF Fecal 31918 L _L 11O00ml-
NiUalle (NO3) as N ooam a -S
mg/L Zn - Zinc 01092 FrVIL
Collfonn: MF Total mum 11OOmL Phosphorus: Total as P oo66s
mg/L
(NM kbe MpR meewd nor rq+r rrua.aryeai
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Unrts)-
]rssohm,dSolids:Total707001-10 my/L
Al - Aluminumoiios
not
pH (Lab) 00403 units
Be - Barium o1007
uglL
TOC 00e60 Cf. 43 mg/1.
Ce - Calcium oo91B
mall
Chloride 00940 mall
Cd - Cadmium o1027
ug/L
_�'
Arsenic otooz ug1L
Chromium- Total oto34
uglL
Grease and Oils 00a52 mg/L
Cu - Copper olWz
mg1L ORGANICS: (by GC, GCIMS, HPLC)
Phenol 32730 ugfL
Fe - Iron otats
uglL (SpW4 test and method S. ATTACH LAB REPORT.)
Sulfate 00945 M91L
Hg - Mercury 7190o
ug1L Lab Report Attached? ❑ Yea (1) ❑ No (0)
Specific Conductance 00095 µMho°
K - Potassium oow7
mg/L VOC 7e73 method S
Total Ammonia oosio r 0 mg/L
Mg - MeglledUM a119Y7
mg1L method 0
Wvmwm t&np k fm,aa N. Awmr►s f&WOW TOW
Mn - Manganese 01055
ug1L method M
TKN as N 00625 . mg/L
NI - Nickel oroe7
ug/L method 9
For Remedladon Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs:
Spa
Pem4w (a Authmaed AD i
GW-59 Rev 3-1-2015
Vbsre print or Ime
not VOC Removal%

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFOR T) IN Pn•.aa Prrd t: 0my 0r t'ym
Facility Name: ,-/r, S dit
Permit Name (it different):
Fadllty Addreea: AJ JE0*— 0 0 A k90— 1%L.` d;,r 2 d
.ate Al
SUBMIT FORM ON YELLOW, PAPER ONLY
DEPARTMENT OF EW W101A1 ENTAL QUALITY - ENV. OF WATM IIENOUftrES
and ..
INFORMATION .. r , " a UNT
ts17 MAIL aernncE tENTF14 RAI.E701l. NC stew -tat? Ptw.r: e19407-6306
- - PERMIT Number:► '0 0* 4" cY Expiration Date:
Non-Dischstge UIC --
- - NPDES Olher:r;.f•jfn. /-W S15'frr'1
TYPE OF PERMfTTED OPERATION BEING MONITORED
County C __F(DW ❑ Lagoon ❑ Remediatfon: Infiltration Gallery
❑ Spray Fwld ❑ Remediatlon: —
Contact Person: `I Zuz- Jntiv►,a'i Telephoneli: �/P_ 530-B/br ❑ Rotary Distributor ❑ LandAWkat)anr of Sludge
Well LocaUOnlSlle Neme• -C-lt Ir 5 'Of Cr-1t+' T' No of wells to be sampled! 3 ❑ Water Source Heat Pump ❑ Dlher�t;'ti.dky) ; a/3
r
SAMPLING IHFOPJAATION
J
WELL ID NUMBER (from Permit):
Date eample collected: 21
Well Depth: S- ft.
Well Diameter. 'I- In.
Depth to Water Level a25ae: 12 . // ft, below measuring point
Screened Interval:15 ft to
ft.
Measuring Point is 7- IL above land surface
Relative M.P Elevation: ft.
Volume of water pumpedballed before sampling: /, S gallons
Samples For metals were colleateci unfiltered: n YFR ❑
NO and field_acidifia0 VYES 11 NO
LABORATORY INFORMATI )N
Date sample analyzed: / �},?3 �'
f
Z-I2112_
V _
Laboratory Name: IJA �/ f S)r ;
PARANIETERS NOTE: alues should reflect dissolved and colloldal concentrations. r
COD o0335
mg&
Nitrite (NO2) as N ooals
m911-
Colifonn: MF Fecal 316m
/100mL
Nitrato (NO3) as N W620 <Q, OY
ng/L
Coliforn: MF Total stso.~
1100ml- Phospheruw: Total as P cows • �9
mg/L
;nw V_ UPN+,-vrc na �p++r r.sa wool+s)
Orthophosphate low
"NA
JiSSUiYC� Sotids:Total 7o3o0 y 9D
m91L
AI -Aluminum o11o5
m91L
pH (Lab) 00403
units
Ba - Barium o1oo7
ugfL
TOC oosao 1;
mg/L
Ca - Calcium W916
mglL
Chloride oewo _5 S
mg1L
Cd - Cadmium oio27
uglL
Arsenic 01002
uglL.
Chromium: Total o1o3c
ugfL
Grease and Offs M52
mg1L
Cu - Copper o1 W2
m911_
Phenol 3273e
uplL
Fe - Iron oloas
ug/L
Suffate 0011,65
mg/L
Hg - Mercury 71900
ugfL
Specific Conductonce o00gs
PMhos
K - Potassium oowT
mg1L
Total Ammonia am 'a j r
mofL
Mg - Magnesium oom
ng/L
p,, NXM ftV0VM ie+,a.>r +m.=I a P4*WM T04n
Mn - Manganese 01055
ugIL
TKN as N 0062s
mg/L
NI - Nickel otoe7
uglL
If WELL
FIELD ANALYSES:
WAS
PH oo.00 2A units Temp. coo10.
°C
DRY at
Spec. Coed. crow.
i�nx� of
sampling.
Odor owns
U rs
Appearance
I>ere r
`
Certification No
O
Pb - Lead most
u91L
Zn - Zinc oto92
ng/L
Other (Specify Compounds and Conowiration Units)
ORGANICS: (by GC, GC1MS, HPLC)
(Specify test and method a. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VAC 7e73 method Lt
method p
method is
method S
For Remedlauon Systems Only (Attach Lab RapoAa): Total Vtxs: mg1L Effluent Total VOCs:
.. Influent Total... ,., ,......: \, ._ -
--_ -_--...-_,... '..... _\Il!•. -• .._. ...�. �..:.'..,-..Ili_.... ...I....d-.. _.
P.amUee la A1eWRLed)q10erM) fJfm° and Td'a PSip/s pool of IYD.
GW-59 Rev 3-1-201e
ng/L VOC RemovaM

SUIDMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER DUALITY MONITORING:�gl
COMPLIANCE REPORT FORM
FACILtrY INFOIRMATIO" emu■ F%inl csowh' w Type
Fac&VName: S4-p-A2s-dr-
Perms! Name (it dlller n()-
FacilityAddress: E
�p C j[ f v. / L2 ' /K /vC 2 fR 7 vo County law-S
DEPAR M19fT OF a/MRa7NMENTAL GLWUJTY -f7Y. OF WA -MR P"OfJIFACES
WADFURATEW a7tiOf:Essaho uqT
1617 MAIL SEMWE CENM% P-MMISK NC 276911ta17 F11M : a10-a07iaea
PI=RMIT Humb*r:w06a as0•o y Expiration oats: f0/3//Zs-
Non-DUCharge UIC j
NPDES Other �e� r+ 7 o T'-6 +j Sys,
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remedisdom Infiltration Gallery
❑ Spray Field ❑ Remedistlon:
❑ Rotary Distributor ❑ Land Apo � boll Of Sludge
dd►;,. 77 '..1
❑ Water Source Heat Pump ❑ allaorGJS 7r o
Contact Person: 1� r �]pr� �rL "o)
Telephonep: 914- 330 —QI67
Well LocationfSite Name.-5!Y-r+ f rLs,'c )e Yoo L1 i"
No. of wells to be sampled: 'S
sus►,
SAMPLING INFORMATION
WELL ID NUMBER (from Permlt): /" Lj t,p
Date sample collected: Z 3
Well Depth: Jk fL
Well Diameter.._In.
Depth to Water Level s254s:6,j 1 R below measuring point
Screened Interval:15ft. to _fL
Measuring Point Is Z FL above land surface
Relative M.P Elevation: tL
Volume of water pumpedlbafled before sampling: n_gallons
rr��
Samwere cog for metals weco Rrf urn �hsmd- I-1 YES ❑ NO and field acidified: (AYES El NO _
LABORATORY INf-0R1rFATIQI �., /
Daft sample analyzed:` �19 z — JAI2 3
Laboratory blame: 1/��y po .-
PARAMEfFRS NOTE: Volumes should reflect �sso verf and
Colloidal cortcentratlons
COD oosss mg -
Nitrite (NOj) as N ooeis mg/L
Colilorm: MF Fecal »era f 1100ML
`�•4
Nitrate (NOS) as N ooan mg/L
Coliform: MF Total 315M /100ml. Phosphorus: Total as P oo5as f r 7yt ng/L
I,mr Ua-r,vr,n.ww.OWN".,wur.d.ar
Orthophosphale70507 nWL
JL,Ssaweo Sofrds:TOtal T03oo ii o mg/L
AI -Aluminum 91 ms mg/L
pH (Lab) oo403 units
Ba - Barium otoo7 ug/L
TOC owao %i 7 mg/L
Ce - Calcium 00216 mg/L
Chloride oo94o / / mg/L
Cd - Cadmium oio27 ug/L
Arsenic 01002 ug/L
Chromium: Total oi=4 u9fL
Grease and Oils oo55z mg/L
Cu - Copper o1M2 mg/L
Phenol 32M ugfL
Fe - Iron alas ug/L
Suffice 00945 mg1L
Hg - Mercury71a00 ug/L
Specific Conductance 000as liMhos
K - Potassium 00237 mg/L
Total Ammonta omen • y my/L
Mg - Magnesium oo927 rng/l
f/rr� Ntagan rinser N, Anma" Tiseq
Mn - Manganese moss u91L
TKN as N Oo62s mg/L
NI - Nickel oio67 UWL
For Remedlatlon Systems Only (Attach Lab Report): Influent Total VOCs:
GW-69 Rev, 3-1-2016
M911-
T
If WELL
FIELD ANALYSES:
WAS
pH , 2 units
Temp 000to 'C
ORY at
Spec. Card. 0009r
yMFros
brrra of
sampnng.
Odor 000as
chock
Appearanim
here, ❑
CeRification No.
Pb - Lead oiosr
usrL
Zn - Z1nt oiosz
n19r1L
Other (Specify Compounds and Concentration Unrts)
ORGANICS: (by GC, GCJMS, HPLC)
(9peelfy fast and r .tholy. ATTACH LAB REPORT.)
Lab Report Attached? gir Yes (1) ❑ No (0)
VOC Ten method 9
method Y
method 0
method
Effluent Total VOCs:
mg/L VOC Removals

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM, AL 35222
MW-4 MW-5 MW-6
PARAMETERS
PH (field measurement), Units
6.1
6.6
6.7
Fecal Coliform (MF), /100 Mls
220
< 1
25
Ammonia Nitrogen as N, mg/l
0.09
0.36
0.08
Nitrate Nitrogen as N, mg/l
1.07
< 0.04
< 0.04
Total Phosphorus as P, mg/l
< 0.04
0.32
0.66
Total Organic Carbon, mg/l
TESTED
TESTED
TESTED
Chloride, mg/1
10
54
9
Total Dissolved Residue, mg/l
200
590
73
Static Water Level, feet
9.26
11.67
4.20
Water Bailed, Gals.
2.0
2.0
1.5
Drinking Water IDs 37715
Wastewater ID: 10
PHONE [phone]
FAX [phone]
ID#: 359 W
DATE COLLECTED: 10/03/22
DATE REPORTED : 10/24/22
REVIEWED BY:
Analysis Method
Date Analyst Code
10/03/22
PJC
4500HB-11
10/03/22
JDJ
9222D-15
10/07/22
BMD
350.1 R2-93
10/04/22
TRJ
353.2 R2-93
10/06/22
BMD
365.4-74
10/10/22
BNC 4500CLB-11
10/04/22
BNC D5907-13
10/03/22
PJC
10/03/22
PJC

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
Drinking Water ID. 37715
Wastewater IDg 10
PHONE [phone]
FAX [phone]
CLIENT: STATESIDE WWTP (ONSWC) CLIENT ID: 359 W
OLD NORTH STATE WATER
3212 6TH AVENUE S ANALYST: JAP
STE 200 DATE COLLECTED: 10/03/22
BIRMINGHAM, AL 35222 DATE ANALYZED: 10/10/22
DATE REPORTED: 10/24/22
REVIEWED BY:
VOLATILE ORGANICS
STD. METHODS 620OC-11
MW-4
MW-5
MW-6
PARAMETERS, ug/I
1.
Benzene
< 0.50
< 0.50
< 0.50
2.
Bromobenzene
< 0.50
< 0.50
< 0.50
3.
Bromochloromethane
< 0.50
< 0.50
< 0.50
4.
Bromodichloromethane
< 0.50
< 0.50
< 0.50
5.
Bromoform
< 0.50
< 0.50
< 0.50
6.
Bromomethane
< 0.50
< 0.50
< 0.50
7.
N-Butylbenzene
< 0.50
< 0.50
< 0.50
8.
Sec-Butylbenzene
< 0.50
< 0.50
< 0.50
9.
Tert-Butylbenzene
< 0.50
< 0.50
< 0.50
10.
Carbon Tetrachloride
< 0.50
< 0.50
< 0.50
11.
C hlorobenzene
< 0.50
< 0.50
< 0.50
12.
Chloroethane
< 0.50
< 0.50
< 0.50
13.
Chloroform
< 0.50
< 0.50
< 0.50
14.
Chloromethane
< 0.50
< 0.50
< 0.50
15.
2-Chlorotoluene
< 0.50
< 0.50
< 0.50
16.
4-Chlorotoluene
< 0.50
< 0.50
< 0.50
17.
Dibromochloromethane
< 0.50
< 0.50
< 0.50
18.
1,2-Dibromo-3-Chloropropane
< 0.50
< 0.50
< 0.50
19.
1,2-Dibromoethane
< 0.50
< 0.50
< 0.50
20.
Dibromomethane
< 0.50
< 0.50
< 0.50
21.
1,2-Dichlorobenzene
< 0.50
< 0.50
< 0.50
22.
1,3-Dichlorobenzene
< 0.50
< 0.50
< 0.50
23.
1,4-Dichlorobenzene
< 0.50
< 0.50
< 0.50
24.
Dichlorodifluoromethane
< 0.50
< 0.50
< 0.50
25.
1,1-Dichloroethane
< 0.50
< 0.50
< 0.50
26.
1,2-Dichloroethane
< 0.50
< 0.50
< 0.50
27.
1,1-Dichloroethene
< 0.50
< 0.50
< 0.50
28.
Cis-1,2-Dichloroethene
< 0.50
< 0.50
< 0.50
29.
trans-1,2-Dichloroethene
< 0.50
< 0.50
< 0.50
30.
1,2-Dichloropropane
< 0.50
< 0.50
< 0.50
31.
1,3-Dichloropropane
< 0.50
< 0.50
< 0.50
32.
2,2-Dichloropropane
< 0.50
< 0.50
< 0.50
33.
1,1-Dichloropropene
< 0.50
< 0.50
< 0.50
34.
Cis-1,3-Dichloropropene
< 0.50
< 0.50
< 0.50
35.
trans-1,3-Dichloropropene
< 0.50
< 0.50
< 0.50
36.
Ethylbenzene
< 0.50
< 0.50
< 0.50
37.
Hexachlorobutadiene
< 0.50
< 0.50
< 0.50
38.
Isopropylbenzene
< 0.50
< 0.50
< 0.50
39.
4-Isopropyltoluene
< 0.50
< 0.50
< 0.50
40.
Methylene Chloride
< 0.50
< 0.50
< 0.50
41.
Naphthalene
< 0.50
< 0.50
< 0.50
42.
Propylbenzene
< 0.50
< 0.50
< 0.50
43.
Styrene
< 0.50
< 0.50
< 0.50
44.
1,1,1,2-Tetrachloroethane
< 0.50
< 0.50
< 0.50
45.
1,1,2,2-Tetrachloroethane
< 0.50
< 0.50
< 0.50
46.
Tetrachloroethene
< 0.50
< 0.50
< 0.50
47.
Toluene
< 0.50
< 0.50
< 0.50
48.
1,2,3-Trichlorobenzene
< 0.50
< 0.50
< 0.50
Page: 1

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
CLIENT: STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM, AL 35222
REVIEWED BY:
VOLATILE ORGANICS
STD. METHODS 620OC-11
PARAMETERS, ug/l
49.
1,2,4-Trichlorobenzene
50.
1,1,1-Trichloroethane
51.
1,1,2-Trichloroethane
52.
Trichloroethene
53.
Trichlorofluoromethane
54.
1,2,3-Trichloropropane
55.
1,2,4-Trimethylbenzene
56.
1,3,5-Trimethylbenzene
57.
Vinyl Chloride
58.
Total Xylenes
59.
Methyl Tert Butyl Ether
Drinking Water ID: 37715
Wastewater ID: 10
PHONE [phone]
FAX [phone]
CLIENT ID: 359 W
ANALYST: JAP
DATE COLLECTED: 10/03/22 Page: 2
DATE ANALYZED: 10/10/22
DATE REPORTED: 10/24/22
MW-5 MW-6
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 1.00
< 1.00
< 1.00
< 1.00
< 1.00
< 1.00

GROUNDWATER QUALITY MONITORING.
COMPLIANCE REPORT FORM
FACILITY INFORMATION "•rr y or Tyyv
Facility Name: 6-V" . &t uoQJ-T`o
Permit Name (if different). r,
Facility Address: y "0."L' E' P Y ►-�!
t-A F'L`l aLl L
Contact Person. A () Y }
Well Location/Site Name: WI1—)
SUBMIT FORM ON YELLOW PAPEK UNLY
Mail original DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617 Phone: [phone]
PERMIT Number: Expiration Date 1 D~-3 Z V
Non -Discharge UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
County�Lagoon ❑ Remedlation. Infiltration Gallery
❑ Spray Field ❑ Remedialion:
Telephone# 33(054G —9 Iq-p f D ❑ Rotary Distributor ❑ Land Application of Sludge
No of wells to be sampled: _� ❑ Water Source Heat Pump ❑ Other: LL d_jrL
SAMPLING INFORMATION
WELL li) NUMBER (from Permit): V" ILA �
Date sample collected. 2
FIELD ANALYSES:
If WELL
WAS
Well Depth: �ft
Well Diameter. 2 in
pH 00400 ti'Q, I units Temp ouulu C
DRY at
Depth to Water Level 82546 q , 2 It below measuring point Screened Interval-, It 10
ft.
Spec Cond 00094- 1 rMhos
trine of
sampling,
Measuring Point is It, above land surface
Relative M.P Elevation ft
Odor 000e5
check
Volume of water pumped/bailed before sampling:
gallons
Appearance
here ❑
Samples for metals were collected unfiltered: ❑ YES
,�,��i
❑ NO and field acidified_ LTYES ❑ NO
LABORATORY INFORMATION
— I
Date sample analyzed:
Laboratory Name: __•
Certification No.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO.) as N oo615
mglL
Pb - Lead oinsl ug/L
Cotiform: MF Fecal .1t61u 7 v 1100mL
Nitrate (NO3) as N 00620 I , p-7
mg/L
7n - Zinc ou1y2 mg/L
Coliform: MF Total 315(A /100ml-
Phosphorus Total as P 00665_ L- .17Lf
mg/L
iNoie Use WN melh,ai lui highly iwbid s lilplee
Orthophosphate 70507
n1g/L
Other (Specify Compounds and Concentration Units) -
)issolved Solids:Total 70300 C9, oo mg/L
Al - Aluminum ul iu5
ing,'L
pH (Lab) 00403 units
Ba - Banum 01007
ug/L
TOC oo6Ho -e 4j)� mg/L
Ca - Calcium 00916
mg/L
Chloride oomo mg/L
Cd - Cadmium 01027
ug/L
Arsenic unx12 ug/L
Chromium: Total 01134
ug/L
Grease and Oils 00552 n1g/L
Cu - Copper 01042
rng/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 3273o ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate ooy45 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance ouoy5 µMhos
K - Potassium U0937
ing/L
VOC 767? method #
Total Ammonia 00610 J mg/L
Mg - Magnesium 00921
mg/L
method #
(Ammonw Nihogen Nr1,as N AmmoniaNdruyen orjll
Mn - Manganese o1o55
ug/L
method #
TKN as N o0625 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs: mg/L
Effluent Total VOCs: mg/L VOC Removal%
GW-59 Rev 3-1-2016

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY I NFO R MAT1O� Piewoo ►'Vint Civarly a Type
FaciMy Name. S Si I -Le V-) Lo
Permit Naine (if different):
Facility Address . 12- �(} rL v[
` C.Lc-a . tin � 1 U N c
Contact Person: L 1A .,- „ , , I�
Well Location/Sile`Namey — YNl W
SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENTAL DUALITY - DIV. OF WATER RESOURCES
and I copy to:. INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH. NC 27699-1617 Phone: [phone]
PERMIT Number: Expiration Date
Nc:n-Dtschargi, U I C
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
County 0V1S❑ Lagoon ❑Remediation Infiltration Gallery
Vim+ ❑ Spray Field ❑ Remediation•
Telephone#: 1 3 (o —S 'If q —p 17o ❑ Rotary Distributor ❑ Land ,ApFfrkc:alion of Sludge
No of wells to be sampled. 7 ❑ Water Source Heal Purnp ❑ Other andt4a 4.1
S'rWultinruli .
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): VVX. W �j
Date sample collected:
) 0 -3-2 2
FIELD ANALYSES:
If WELL
WAS
Well Depth: ft
Well Diameter:
2in
pH awwu (0,10 units Temp oouiu "C
DRY al
Depth to Water Level 82546: 1v7 ft below measuring point Screened Interval:
S it to
It
Spec. Cond..10osa tµMhos
time of
sampling
Measuring Point is 2 ft above land surface
Relative M P Elevation:
It
Odor o(x)e5
check
VOILime of water pumped/bailed before sampling: 2
gallons
Appearance
here
Samples for metals were collected unfiltered: ❑ YES
�'YE
El NO and field acidified E YES ❑ NO
LABORATORY INFORMATION
S
I
Date sample analyzed:
Laboratory Name:
1
Certification No C
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO.,) as N uo015
mg/L
Pb - Lead 01051 ug/L
Culiform IMF Fecal mbiti L ( /100m1.
Nitrate (NOi) as N oo0z0
L U OLf
111g/L
Zn - Zinc 01042 nig/L
Coliform. MF Total 31504 /100rrd
Phosphorus: Total as P 00665--L-). "�2
mg/L
�Nc a rst A1F'N nialnw la iupnlf rut UiJgdinpies�
Orthophosphate 70507
nig/L
Other (Specify Compounds and Concentiation Units)
)issolved Solids Total 7ii-inu lj 1 -D mg/L
At - Aluminum o11u5
rng/L
pH (Lab) ff(Awi units
Ba - BariLlIn 01007
ug/L
TOC oo6H0 j -ry %�C� mg/L
Ca - Calcium ou01a
mg/L
Chloride uuvae_ 4�1_ `-F rng/L
Cd - Cadmium 01027
ug/L
Arsenic o1oo2 ug/L
Chromium: Total o1o:w
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L
ORGANICS. (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71goo
ug/L
Lab Report Attached? ❑ Yes(l) ❑ No (0)
3peclfic Conductance ouoss µMhos
K - Potassium 00937
mg/L
VOC 1872 method #
Total Ammonia 0o61u Q (P mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammunia Nrirugen. Nrl, m N, Amrnuma Nitrogen Tulai;
Mn - Manganese o1os5
ug/L
method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs
mg/L
Effluent Total VOCs mg/L VOC Removal%
GW-59 Rev 31-2016

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION "� M4-'rsu }Yu,r 00ady or type
Facility Name: S [ S. fi _C W jj �
Permit Name (if different). y
Facility Address: 0L&"4 k-�LR- f `�
t`C,r-i',ojjj,.)d (rC AlC- County��
Contact Person: { p j�.J�l Telephone#:33 (O — 6q -[ __5 99
Well Location/Site Name: VMA- No of wells to be sampled 3
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH,
NC 27699-1617 Phone: [phone]
PERMIT Number:
Expiration Date f 0 --3 t — 2
Non -Discharge
UIC
NPDES
Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon
❑ Remediation Infiltration Gallery
❑ Spray Field
❑ Remediation
❑ Rotary Distributor
❑ Land Application of Sludge
El Water Source Heal Pump
❑tither U►1a--'—c4Cvv1
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): VA/t- W tp
Date sample collected ( O —
Well Depth: ) S ft
Well Diameter: Z in
Depth to Water Level 82546: '-(• VOft. below measuring point Screened Interval:it to
_ft
Measuring Point is 2 ft. above land surface
Relative M.P Elevation: ft
Volwne of water pumped/bailed before sampling:
. ( . 5
gallons
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: �FS ❑ NO
LABORATORY INFORMATION
Date sample analyzed
Laboratory Name \=r I
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD W335
mg/L
Nitrite (NO ) as N uoets
mg/L
Colifornl MF Fecal .nuts Z S
/100ml-
Nitrate (NO,) as N 00G20 L C),Dq
mg/L.
Coliform: MF Total 11504
/100n1L
Phosphorus: Total as P ou665 O , to 10
mg/L
(Nme Use MPN ,ne1W0 !o! 11,91111 Iwb!d ...... r-At"
Orthophosphate ioso'i-
rng/L
].rssolved Solids Total 70300 -
mg/L
Al - Aluminum tit to:,
niq/L
pH (Lab) 00403
units
Ba - Banum 01007
ug/L
TOC uo6so ; -Prj
mg/L
Ca - Calcium uu916
rng1L
Chloride 00940 q
mg/L
Cd - CadnliLinl o lu l
ug/L
Arsenic, 01lw2
ug/L
Chromium. Total 01034
ug/L
Grease and Oils (10552
rng/L
Cu - Copper 010-12 .
rng/L
Phenol 32730
ug1L
Fe - Iron 01045
ug/L
Sulfate 00945
rng/L
Hq - Mercury /loon
ug/L
3per:ific Conductance uou,)5
IiMhos
K - Potassium 00937
rng/L
Total Ammonia oo61u
mg/L
Mg - Magnesium 00922
mg/L
Ammonia N-uogen NH, as N Ammoni., NdrDgen iul:nj
Mn -Manganese otoss
uglL
TKN as N o0625
mg/L
Ni - Nickel 01067
ug/L
If WELL
FIELD ANALYSES: WAS
pH 004006, 7 units Tramp, rra,Iaii C DRY at
Spec. Cand 00094 1
Mhos time? of
sampling.
Odor uuua5 Check
Appearance here,
Certification No. n
Pb - Lead otosl ug1L
Zn - Zinc moue mgrL
Other (Specify Compounds and Concenlration Units),
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VOC Ten method #
method #
method #
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs rng/L Effluent Total VOCs: mg/L VOC Removal%
Perinill,dc iur AutrW,iPliO Agent) Name and Tdle Pfeas,r V,Mt or type
GW 59 Rev 3-1-2016

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM, AL 35222
Drinking Natar ID: 37715
Naatewater ID: 10
PHONE [phone]
FAX [phone]
ID#: 359 W
DATE COLLECTED: 06/09/22
DATE REPORTED : 06/29/22
REVIEWED BY:
MW-4
MW-5
MW-6
Analysis
Method
PARAMETERS
Date
Analyst
Code
PH (field measurement), Units
4.2
6.9
6.8
06/09/22
PJC
4500HB-11
Fecal Coliform (MF), /100 Mls
< 1
< I
< 1
06/09/22
DIJ
9222D-15
Ammonia Nitrogen as N, mg/l
0.05
0.23
0.31
06/16/22
HMM
350.1 R2-93
Nitrate Nitrogen as N, mg/1
0.16
< 0.04
< 0.04
06/09/22
KES
353.2 R2-93
Total Phosphorus as P, mg/1
< 0.04
0.26
0.66
06/28/22
BMD
365.4-74
Total Organic Carbon, mg/l
4.92
26.72
4.88
06/09/22
HMM
531OC-14
Chloride, mg/l
13
38
8
06/13/22
HCE
4500CLB-11
Total Dissolved Residue, mg/l
89
720
88
06/14/22
DIJ
D5907-13
Static Water Level, feet
9.61
11.75
6.00
06/09/22
PJC
Water Bailed, Gals.
2.0
2.0
1.5
06/09/22
PJC

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATIO FYUasu Prrnr C "Ily of Type
Facility Name: IL 1)') WTP
Permit Name (if ddlgti,Lril):
Fa lity Ajd�drreess ` (1 ri,1k� �'1 iR f1 �Cj
L JQc,k5 �.�� Il1
SUBMIT FORM ON YELLOW PAPER ONLY
Mail original
DEPARTMENT OF ENVIRONMENTAL QUALITY- DIV. OF WATER RESOURCES
and 1 copy INFORMATION PROCESSING UNIT
11W MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
PERMIT Number: Expiration Date:
Non -Discharge UIC
NPDES Other1rl�'.��`f-f(G'!?
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remedialion: Infiltration Gallery
❑ Spray Field ❑ Renlediation
Contact Person: relephone#: 33(0 � — 97gV ❑ Rotary Distributor ❑ Land Applici-illun Sludge
Well Location/Site Name: A t )� No. of wells to be sampled ❑ Water Sour H Pump p _� Source eat u np ❑ Other 0 I�L>Vr �ra.e !] 9�
I1rL.,. ,
SAMPLING INFORMAI ION WELL ID NUMBER (from Permit): Y it
A W y Date sample collected (p
Well Depth: fft Well Diameter 2 in
Depth to Water Level ea5•16 Cj , lia ( ft. below measuring point Screened Interval eft to _ft.
Measuring Point is 2 ft. above land surface Relative M P Elevation ft
Volume of water pumped/baled before sampling-
'I. V gdllons
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified:
LABORATORY INFORMATION
Dale sample analyzed:
Laboratory Name.
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD uue3s
mg/L
Nitrite (NO;,) as N uurus
Colifurni MF Fecal 3wit> /
�^
/100mL
Nitrate (NO,) as N u0620
Coliform• MF Total '051w
/100mL
Phosphorus Total as P ooers
(Noll, U-H MPN nicOwd lo• 7tut Ind s,,n,:nes,
Orthophosphate 70507 .
)issolved Solids:Total /u3(m -
mg/L
Al - Aluminum ul fur,
pH (Lab) 00403
units
Ba - Barium orour
TOC o06au L4 , C j '2.
mg/L
Ca - Calcium onrilc
Chloride 00940
mg/L
Cd - Cadmium lunar
Arsenic o1uue
ug/L
Chromium Total 01014
Grease and Oils 00552
mg/L
Cu - Copper 010.12
Phenol 32730_
uglL
Fe - Iron urtlaa
Sulfate W945 .
mg/L
Hg - Mercury 71900
Specific Conductance 0ony5
IiMhos
K - Potassium 00937
Total Ammonia oo6lo o. Q
mg/L
Mg - Magnesium O0927
I Ammoma Nil,uyen_ NH as N Ammun,a Ndloger- TntaO
Mn - Manganese ou155
TKN as N W625
mg/L
Ni - Nickel o1o67
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs
YES ❑ NO
1�1'-_ - (
mg/L
0. %P mg/L
L U•Juj mg/L
mg/L
mg/L
ug/L
mg/L
ug/L
ug/L
_ mg/L
ug/L
ug/L
mg/L
mg/L
ug/L
ug/L
If WELL
FIELD ANALYSES:
WAS
pH o(Aoo 4, Zunils Temp unpin
C
DRY at
Spec. Cond Ouuua
liMhos
time of
sampling,
Odor oon"'
- -
chc=ck
Appearance
here ❑
Certification No
rn
Pb - Lead uio;,1
ug/L
Z-n - Zinc uio�w
rng/L
Other (Specify Compounds and Concentration Unils)
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VOC 7872 method #
method #
method #
method #
mg/L Effluent Total VOCs:
rng/L VOC Removal%
Pennittee (or Aul opted Aye il) Name and Title - t'lease print or type 7 n Purinlitee rr uiru ri: • AIJ,:ni i Lla
GW-59 Rev 3-1 2016

SUBMIT FORM ON YELLOW PAPER ONLY
Mail original:
DEPARTMENT OF ENVIRONMENTAL QUALRY - DIV. OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
INFORMAnON PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: 919-e -63116
Pleas,+ Piml Clearly u, Type
FACILITY INFORMATIONrr --
/
PERMIT Number. Expiration Date 6
Facility Name_'t'05���� (�JW L
Non -Discharge UIC
Permit Name (if d1ffN Hr1t).
Fainfly Adtlress: a iS r,►r n (`*
"""T��"`
NPDES OlherbdJtfo4lGo,J_)���m
TYPE OF PERMITTED OPERATION BEING MONITORED
� r.N � � f ��
+
County (�r)�1 (���)
❑ Lagoon ❑ Reinediatwn. Infiltration Gallery
❑ Spray Field ❑ Rernedialion:
j, JJ �
Contact Person: (� [ i C
/ �)�Q p�
Telephone#: 33(0 � 7 O
❑Rotary Distributor ❑ Land A ry lication o Sludge
Well Location/Site Name j�/j, [� }
No of wells to be sampled
❑ Water Source Heat Pump ❑ Other
SAMPLING INFORMATION
- C�
If WELL
WAS
WELL ID NUMBER (frorn Permit): w
Dale sample collected:
FIELD ANALYSES,,.
Well Depth: L ft.
Well Diameter: in
pH 00400 units Temp :)(jinn. C DRY at
Depth to Water Level 732CA6: Il .1'j ft below measuring point
Screened Interval: ft to
tune of
ft Spec. Cond. ouuya r'Mhos sonlpling
Measuring Point is a ft- above land surface
Relative M.P. Elevation: ft
Odor 0006s check
Volume of water pumped/bailed before sampling: ,� ,'iJ
gallons
Appearance liefe
❑
Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: ❑ YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed:
Laboratory Name
Certification Nu.
PARAMETERS NOTE: Values should reflect dissolved and
colloidal concentrations.
COD oo:i.f:, mg/L
Nitrite (NO;) as N riow5
mg/L
Pb - Lead u1os1 ug)L
Coliform: MF Fecal 316iG L /100mL
Nitrate (NO,) as N oor,2u tit L}L
mq/L
Zn - Zinc a1u92 mq/1
Coliform: MF Total 31504 /100mL Phosphorus: Total as P ofitiw, E] , 24P
rng/L
v, e use MF N memnn tn, gniy w n d ,.nnu �sr
Orthophosphate 70507
mg/L
Othei (Specify Compounds and Concentration Units)
dissolved Solids.Total ru3o0 rng/L
At - Aluminum of los
mg/L
pH (Lab) 00403 units
Ba - Barium 01001
ug/L
TUC ooseo , to rng/L
Ca - Calcium uo416
mg/L
Chloride 00e40 mg/L
Cd - Cadmium oio21
ug/L
Arsenir, 01002 ug/L
Chromium Total oiwo
ug/L
Grease and Oils 00552 mg/L
Cu - Copper u1os2.
mg/L
ORGANICS: (by GC, GC/MS. HPLC)
Phenol 32730 ug/L
Fe - Iron o104s
ug/L
(Speclfy test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance oous5 liMhos
K - Potassium 00437
mg/L
VOC 7873 method #
Total Ammonia ouwu mg/L
Mg - Magnesium 00927
mg/L
method #
iAmmoroa Nmogen NH, as N Ammun,a Nd,cjen oiA
Mn - Manganese orr155
ug/L
method #
TKN as N 0062.9 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs mg/L
Effluent Total VOCs: rng/L VOC Removal%
GW-59 Rev 3-1-2016

SUBMIT FORM ON YELLOW PAPER ONLY
Mah original DEPARTMENT OF ENVIRONMENTAL QUALITY - I71V" OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING: and I copy INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1917 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617 Phone: [phone]
FACILITY INFORMATION ; se Pont Cleany ur I yNe PERMIT Number: Expu alion Date:
Facility Name: Q_ _ Non -Discharge UIC ff rr I1
Permit Name (if diff rmn�Q t) NPDES Other It,
t y]
F c:Iltty Address.�� �i1"' I JtT]11 d TYPE OF PERMITTED OPERATION BEING MONITORED
gC.kSc/Y] �r� 1 �-e., r . Countyr}�^�� �.( ❑ Lagoon ❑ Remedlation. Infiltration Gallery
❑ Spray Field ❑ Remediallon
Contact Person V] •�Q 1 Telephone# �-I ✓ Z �_'Z q6 ❑ Rotary Distributor ❑ Land Ala ficatwn f Sludge
Well Location/Site Name: j l� No. of wells to be sampled: ❑Water Source Heal Pump ❑Other. d jin I
h,+n �',-n mi I
SAMPLING INFORMATION '' FF C., If WELL
WELL ID NUMBER (from Permit): rn L�� (O Date sample collected: (G; - I — Z FIELD ANALYSES: WAS
Well Depth: IS It Well Diameter: in pH ooaoo: units Teinp. 000lo "C DRY,,it
tinle of
Depth to Water Level H2:,at;: rQQ It. below measuring point Screened Interval ft to _ft Spec Consampling
d. 0000,t tImhos
samplling
Measuring Point is 'Z ft above land surface Relative M.P Elevation: ft Odor uooe5 check
Volume of water pumped/bailed before sampling: { , Cj gallons Appearance herein
Samples for metals were collected unfiltered: ❑ YES El NO and field acidified: ❑ YES El NO "--�—'
LABORATORY INFORMATION
Dale sample analyzed Laboratory Name
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO,) as N oo615
Coliform MF Fecal 3161C
(
/100mL
Nitrate (NO,) as N oo62o
Coliform: MF Total 31504
11OOmL
Phosphorus: Total as P ou(i65
(Note Use MPN methW for mgh,p ;wind s.mrylre)
Orlhophosphate 70507
Dissolved Solids Total 71300
D pi
mg/L
Al - Aluniinuln 011os
pH (Lab) 00403
units
Ba - Barium 01007
TOC oomo
L {
rng/L
Ca - Calcium ooL)ie`
Chloride oUS14o�
mg/L
Cd - Cadmiurn om27
Arsenic 01002
ug/L
Chromium- Total 01034
Grease and 0115 00552
mg/L
Cu - Copper 01042.
Phenol 32730
ug/L
Fe - Iron owas
Sulfate oovaF
mg/L
Hg - Mercury 71900
Specific Conductance nnovs
pMhos
K - Potassium n0937
Total Ammonia oo6lo
?j,
mg/L
Mg - Magnesium 00927
(Ammonia Nilugen NH,asN Anuounia
Nitrogen Tolal)
Mn - Manganese oloss
TKN as N 00625
Ni - Nickel 01067
For Remediation Systems Only (Attach Lab Reports):
PePijWkto p,r Authixrre(l AtIenl) ante and Title Please print or type
GW 59 Rev. 3-1-2016
Influent Total VOCs:
Certification No 4 1
mg/L
Pb - Lead otosi ug/L
L 0, 0q
mg/L
Zn - Zinc 01092 mg/L
r (p (p
mg/L
my/L
Other (Specify Compounds and Concentration Units)'
mg/L
ug/L
mg/L
_
ug/L
uglL
mg/L
ORGANICS: (by GC, GCiMS, HPLC)
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
mg/L
VOC 7873 method #
mg/L
method #
ug/L
method #
ug/L
method #
ing/L Effluent Total VOCs: rng/L VOC Removal%
ffie pos2;j1j-hty ef fines
and imprisonment
for knowing violations.
Srpp, F:rrtNl cr IUr
-trim---Pq iratrnll

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM, AL 35222
Drinking Water ID: 37715
Wastewater ID: 10
PHONE [phone]
FAX [phone]
ID#: 359 W
DATE COLLECTED: 02/14/22
DATE REPORTED : 03/02/22
REVIEWED BY:
MW-4
MW-5
MW-6
Analysis
Method
PARAMETERS
Date
Analyst
Code
PH (field measurement), Units
5.4
6.4
6.6
02/14/22
PJC
4500HB-11
Fecal Coliform (MF), /100 Mls
< 1
< 1
< 1
02/14/22
BLV
9222D-15
Ammonia Nitrogen as N, mg/l
0.19
0.51
0.12
02/17/22
TRJ
350.1 R2-93
Nitrate Nitrogen as N, mg/l
0.43
0.05
< 0.04
02/16/22
KES
353.2 112-93
Total Phosphorus as P, mg/l
0.10
0.21
0.16
02/22/22
TRJ
365.4-74
Total Organic Carbon, mg/l
9.57
22.52
6.13
03/02/22
HMM
531OC-14
Chloride, mg/l
12
52
8
02/21/22
DNS
4500CLB-11
Total Dissolved Residue, mg/1
82
350
99
02/15/22
BLV
D5907-13
Static Water Level, feet
9.14
11.62
4.68
02/14/22
PJC
Water Bailed, Gals.
2.0
2.0
3.9
02/14/22
PJC

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Piea5e Print Givarry or type
Facility Name: S{8,{=S1 [y `-_'�[�
Permit Name (if different)-
Fars�Address: LJ, •.akaf
Contact Person (V1 ' /' L�1r %--�
Well Location/Site Name Vj f V) (A ) 4
SUBMIT FORM ON YELLOW PAPER ONLY
11ail original DEPARTMENT OF ENVIRONMENTAL DUALITY - OIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
PERMIT Number: Expiration Date -;1 - 2�
Non -Discharge UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
CountyrtDL ❑ Lagoon ❑ Remediauon: Infiltration Gallery
2 f �) ❑ Spray Field ElRemediation:_
Telephone# ^]3k �`t � d "6, ❑Rotary Distributor Lai AFliyltcalion of Sludge
No of wells to be sampled- '?;� ❑ Water Source Heal Pump ❑ Other L&,ti4!2
luMm l .,. 101
SAMPLING INFORMATION
1 t
WELL ID NUMBER (from Permit):
Dale sample collected:
Well Depth. Ig ft
Well Diameter: Z in -
Depth to Walei Level nz5ot; GZ , ►y ft. below measuring point Screened Interval: ft to _ ft
Measuring Point is �It above land surface
Relative M.P. Elevation: ft
Volume of water pumped/bailed before sampling -7 , L7
gallons
Samples for metals were collected unfiltered ❑ YES
❑ NO and field acidified- E3rYES ❑ NO
LABORATORY INFORMATION
L� —
Date sample analyzed.
Laboratory Name:
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO;) as N oo615 mg/L
Coliform: MF Fecal 31616 L 1 /100ml-
Nitrate (NO I) as N 00e20 Lt.>mg/L
Coliform• MF Total :{15o4 /100ml-
Phosphorus Total as P uoc65 (� , 0 mg/L
[Note lbe MPN ntelMxl fot huihlr tin ln] semples)
Orthophosphate 70507 mglL
dissolved Solids:Total 7n,ioo� mglL
AI - Aluminum 01105 rmy/L
pH (Lah) 00403 units
Ba - Barium 01007 uglL
TOC 000eu Ct , s "j mg/L
Ca - Calcium oo,)m mg/L
Chloride 00440
12-
my/L
Cd - Cadmium 01027
Arsenic 01002
ug/L
Chromium Total n1n34
Grease and Oils oo552
mg/L
Cu - Copper o1n42
Phenol 32730
ug/L
Fe - Iron 01045
Sulfate oo945
mg/L
Hg - Mercury 71400
Specific Conductance onu9.,
µMhos
K - Potassium 004:17
Total Ammonia uo610
p, 1 1
mg/L
Mg - Magnesium 00927
,Ammonia Ndwgen NH, as N Am—
• r:,li ,- Zulu')
Mn - Manganese om55
TKN as N 00625
mg/L
Ni - Nickel 01067
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs
ug/L
ug/L
mg/L
ug/L
ug/L
rng/L
mglL
ug/L
ug/L
If WELL
FIELD ANALYSES: WAS
pH 00400 5 M units Temp oon iu: C DRY at
Spec. Cond 00094 t[Mhos time ofsampling,
Odor uoutts check
Appearance here
Certification No I
Pb - Lead oto51 ug/L
Zn - Zinc o1142 mg!L
Other (Specify Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VOC 7873 method #
method #
method #
method #
mg/L Effluent Total VOCs:
mg/L VOC Removal%
teu for Rswrire, AtjenW111Jarna: and Tille Pleas it of type Sigrla lot AJt W�Aqent) fi.7xtr.i
GW-59 Rev 3-1 2016

SUBMIT FORM ON YELLOW PAPER ONLY
--Mail original
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF wAT Lit RESOURCES
GROUNDWATER QUALITY MONITORING:
and 1 copy to:
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH. NC 27699-9617 Phone: 919-B07-6306
FACILITY INFORMATION Please Pnnl Cleallyof
Type
PERMIT
Number: Expiration Date j f, - ?i l
Facility Name: z A_P' � -"t 14
Non
-Discharge UIC
PermrlName (if different)
NPDES
Other ;t1.f-7 1 •7
.Tf
j1r.�-�[
Facilit ddress `f ►oel_ I C %2 Cti
TYPE
OF PERMITTED OPERATION BEING MONITORED
J� c W��Li�IJ ]1L�r /jL
`
County (�,� \S�( i JJ
❑ Lagoon ❑ Remediatron: Infiltration Gallery
Field ❑ Remediatron
rElSpray
Contact Person l� �� j.-s�
Telephone# �j�b
S t CJ `�� IC
❑ Rotary Distributor ❑ Land Application of Sludge
VV,-u Location/Site Name: m (
No. of wells to be sampled:
❑ Water Source Heat Pump ❑ Other 1,.j, _aef (Ytf_ V__1
Nruir I crn+u}
If WELL
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): 4`Y] U-) Z
Dale sample collected'
FIELD ANALYSES: WAS
Wail Depth I It, it
Well Diameter-
Z In
pH o0400 W. , units Temp 00010: C DRY at
Urne of
Depth to Water Level e25a6fl. below measuring point
Screened Interval:
irk It. to _ ft
+ Mhos
Spec. Cond. uuuvq t sampling,
Measuring Point is y ft above land surface
Relative M P Elevation:
ft
Odor 000wi ChPck
Voltlme of water pumped/bailed before sampling: 'A D gallons
/
Appearance here ❑
Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified: n-YES
❑ NO
LABORATORY INFORMATION_
� f
1
Certification No l7
Date sample analyzed:
Laboratory Name:.�J
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L
Nitrite (NO,) as N 00015
mg/L
Pb - Lead otosi ug/L
Coliform MF Fecal sn;tb � � /100mL Nitrate (NO,) as N ooc,2a
05 mg1L
Zn - 71nr.. oros2 mg/L
Coliform: MF Total :11.514 /100mL Phosphorus:
Total as P oors5
0. 2 mg/L
!Note Use N1PN melhxr I,r Iuyl ly Wrbid Sampled
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units)
15501ved Solids:Total 70300 .3 SJ mg/L
At - Aluminum onus
Ing/L
pH (Lab) 00403 units
Ba - Barium 1)1007
ug/L
TOC oo6e0 2 mg/L
Ca - Calcium 000u;
mg/L
Chloride 00940 +, mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total o1134
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mq/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 0I(A5
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg1L
Hg - Mercury 71900
uglL
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 µMhos
K - Potassium U0937
mg/L
VOC 7873 method #
Total Ammonia 0o6to mg/L
Mg - Magnesium 00027
mg/L
method #
Ammonia Nitrogen NH, as Ammnnra Nitrogen tolai)
Mn -Manganese utn55
ug/L
method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
mg/L Effluent Total VOCs- mg/L VOC Removal%
-e C'
(r • eF 12
Perrndlee (or Autliurr,rud Aitr•+1ly Name and Title -Please print or ty11
Sot1n�1�{IirLPransdles (or
AulArH+te+I AgHn1)
GW-59 Rev.3-1-2016

SUBMI I FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Pnnl Clearly or Type
Facility Name: �)k-Ev-"k :) 1 1 f k
Pignut Name (if different)
FacIlr�Ad>krass. �j �I?�1iZC�G2 IL (L d
County . �rl.Slni�
Contact Person C— V Llv Telephone# ' j 3cq - 5 9 -�01Cl D
Well Location/Site Name: 01 No. of wells to be sampled: ?
DEPARTMENT OF ENVFRONMENIAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
PERMIT Number: Expiration Date. % U •- -3 I - Z $
Non -Discharge UIC
NPDES Other jfii"t`�MrC-4,1110-A
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Inflllrolion Gallery
❑ Spray Field ❑ Remedialion
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Purnp ❑ Other 11 A twt VId CI"+'L
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): OA LA-)
Date sample collected: 4
�2
FIELD ANALYSES:
WAS
Well Depth. I q ft
Well Diameter: Z in
pH ooauo (0 (i units Temp uooiu, C
DRY at
,i Q
Depth to Water Level 82546 �[,�fs 4 It below measuring point Screened Interval S ft to
It
Spec. Cond. uoo�t. I'Mh°s
lime of
I11-ne sampling -
Measuring Point is ft above land surface
Relative M.P. Elevation: It
Odor 00085
check
Volume of water pumped/bailed before sampling:
--�> i Cj
gallons
Appearance
here:
❑
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: FfYES ❑ NO
_
LABORATORY INFORMATION
i
Date sample analyzed:
Laboratory Name: /
Certification No. l G
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO,) as N 000es
rng/L
Pb - Lead o1051 ug/L
Coliform: MF Fecal 316w L 1
/100mL
Nitrate (NO,) as N 00b2u L p,OL(
mg/L
Zn - Zinc 01092 Intg/L
Coliform: MF Total 31s114
/100mL
Phosphorus: Total as P oob6s I Lo
mg/L
(Nule Use MPN melhod tot higtdy turb;d sdmples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units).
Nssolved Solids Total 70300
mg/L
Al - Aluminum 01105
n1g/L
pH (Lab) 00403
units
Ba - Barium 01007
ug/L
TOC oobm i �]
mg/L
Ca - Calcium oo91b
mglL
Chloride 00940 Q
my/L
Cd - Cadmium u1u27
ug/L
Arsenic u1ou2
ug/L
Chromium: Total ulom
ug1L
Grease and Oils 00552
rng/L
Cu - Copper 01(W2
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol -12730
ug/L
Fe - Iron o1o45
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate nns45
mg/L
Hg - Mercury 719uu
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 000es
I,Mhos
K - Potassium W937
mg/L
VOC 7873 method P
Total Ammonia ooslo �. 1 Z
mg/L
Mg - Magnesium 00927
mg/L
methud It .
rAnnnonia Nitrogen NH , as N l mmoma Ndragen Tnt.1h
Mn - Manganese owss
ug/L
method # _
TKN as N 00625
mg/L.
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs mg/L
Effluent Total VOCs: mg/L VOC Removal%
GW-59 Rev 3-1-2016

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM, AL 35222
Drinking W:ter ID: 37715
Wastewater ID: 10
PHONE [phone]
FAX [phone]
ID#: 359 W
DATE COLLECTED: 10/06/21
DATE REPORTED : 10/28/21
REVIEWED BY:
MW-4
MW-5
MW-6
Analysis
Method
PARAMETERS
Date
Analyst
Code
PH (field measurement), Units
5.4
6.6
6.5
10/06/21
PJC
4500HB-11
Fecal Coliform (MF), /100 Mls
< 1
< 1
< 1
10/06/21
DU
9222D-15
Ammonia Nitrogen as N, mg/l
0.17
0.06
0.10
10/07/21
TRJ
350.1 R2-93
Nitrate Nitrogen as N, mg/l
< 0.04
< 0.04
< 0.04
10/07/21
KES
353.2 R2-93
Total Phosphorus as P, mg/l
0.74
10/14/21
BMD
365.4-74
Total Phosphorus as P, mg/l
0.50
1.46
10/19/21
TRJ
365.4-74
Total Organic Carbon, mg/l
6.12
36.62
2.40
10/07/21
HMM
531OC-14
Chloride, mg/1
5
52
8
10/18/21
DNS
4500CLB-11
Total Dissolved Residue, mg/l
67
590
110
10/12/21
DIJ
D5907-13
Static Water Level, feet
9.75
12.15
5.00
10/06/21
PJC
Water Bailed, Gals.
4.8
4.5
3.9
10/06/21
PJC

Environment 1, Incorporated
Drinking Water IDt 37715
Wastewater ID= 10
P.O. BOX 7085, 114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
CLIENT: STATESIDE WWTP (ONSWC) CLIENT ID: 359 W
OLD NORTH STATE WATER
3212 6TH AVENUE S ANALYST: JAP
STE 200 DATE COLLECTED: 10/06/21 Page: 1
BIRMINGHAM, AL 35222 DATE REPORTED: 10/28/21
REVIEWED BY:
VOLATILE ORGANICS
STD. METHODS 620OC-11
Date Analyzed:
10/18/21
10/19/21
10/19/21
MW-4
MW-5
MW-6
PARAMETERS, ug/l
1.
Benzene
< 0.50
< 0.50
< 0.50
2.
Bromobenzene
< 0.50
< 0.50
< 0.50
3.
Bromochloromethane
< 0.50
< 0.50
< 0.50
4.
Bromodichloromethane
< 0.50
< 0.50
< 0.50
5.
Bromoform
< 0.50
< 0.50
< 0.50
6.
Bromomethane
< 0.50
< 0.50
< 0.50
7.
N-Butylbenzene
< 0.50
< 0.50
< 0.50
8.
Sec-Butylbenzene
< 0.50
< 0.50
< 0.50
9.
Tert-Butylbenzene
< 0.50
< 0.50
< 0.50
10.
Carbon Tetrachloride
< 0.50
< 0.50
< 0.50
11.
Chlorobenzene
< 0.50
< 0.50
< 0.50
12.
Chloroethane
< 0.50
< 0.50
< 0.50
13.
Chloroform
< 0.50
< 0.50
< 0.50
14.
Chloromethane
< 0.50
< 0.50
< 0.50
15.
2-Chlorotoluene
< 0.50
< 0.50
< 0.50
16.
4-Chlorotoluene
< 0.50
< 0.50
< 0.50
17.
Dibromochloromethane
< 0.50
< 0.50
< 0.50
18.
1,2-Dibromo-3-Chloropropane
< 0.50
< 0.50
< 0.50
19.
1,2-Dibromoethane
< 0.50
< 0.50
< 0.50
20.
Dibromomethane
< 0.50
< 0.50
< 0.50
21.
1,2-Dichlorobenzene
< 0.50
< 0.50
< 0.50
22.
1,3-Dichlorobenzene
< 0.50
< 0.50
< 0.50
23.
1,4-Dichlorobenzene
< 0.50
< 0.50
< 0.50
24.
Dichlorodifluoromethane
< 0.50
< 0.50
< 0.50
25.
1,1-Dichloroethane
< 0.50
< 0.50
< 0.50
26.
1,2-Dichloroethane
< 0.50
< 0.50
< 0.50
27.
1,1-Dichloroethene
< 0.50
< 0.50
< 0.50
28.
Cis-1,2-Dichloroethene
< 0.50
< 0.50
< 0.50
29.
trans-1,2-Dichloroethene
< 0.50
< 0.50
< 0.50
30.
1,2-Dichloropropane
< 0.50
< 0.50
< 0.50
31.
1,3-Dichloropropane
< 0.50
< 0.50
< 0.50
32.
2,2-Dichloropropane
< 0.50
< 0.50
< 0.50
33.
1,1-Dichloropropene
< 0.50
< 0.50
< 0.50
34.
Cis-1,3-Dichloropropene
< 0.50
< 0.50
< 0.50
35.
trans-1,3-Dichloropropene
< 0.50
< 0.50
< 0.50
36.
Ettylbenzene
< 0.50
< 0.50
< 0.50
37.
Hexachlorobutadiene
< 0.50
< 0.50
< 0.50
38.
Isopropylbenzene
< 0.50
< 0.50
< 0.50
39.
4-Isopropyltoluene
< 0.50
< 0.50
< 0.50
40.
Methylene Chloride
< 0.50
< 0.50
< 0.50
41.
Naphthalene
< 0.50
< 0.50
< 0.50
42.
Propylbenzene
< 0.50
< 0.50
< 0.50
43.
Styrene
< 0.50
< 0.50
< 0.50
44.
1,1,1,2-Tetrachloroethane
< 0.50
< 0.50
< 0.50
45.
1,1,2,2-Tetrachloroethane
< 0.50
< 0.50
< 0.50
46.
Tetrachloroethene
< 0.50
< 0.50
< 0.50
47.
Toluene
< 0.50
< 0.50
< 0.50

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
CLIENT: STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM, AL 35222
REVIEWED BY:
VOLATILE ORGANICS
STD. METHODS 6200C-11
Date Analyzed: 10/18/21
MW-4
PARAMETERS, ug/1
48.
1,2,3-Trichlorobenzene
49.
1,2,4-Trichlorobenzene
50.
1,1,1-Trichloroethane
51.
1,1,2-Trichloroetbane
52.
Trichloroethene
53.
Trichlorofluoromethane
54.
1,2,3-Trichloropropane
55.
1,2,4-Trimethylbenzene
56.
1,3,5-Trimethylbenzene
57.
Vinyl Chloride
58.
Total Xylenes
59.
Methyl Tert Butyl Ether
Drinking Water ID: 37715
Wastewater IDe 10
PHONE [phone]
FAX [phone]
CLIENT ID: 359 W
ANALYST: JAP
DATE COLLECTED: 10/06/21 Page: 2
DATE REPORTED: 10/28/21
10/19/21 10/19/21
MW-5 MW-6
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 1.00
< 1.00
< 1.00
< 1.00
< 1.00
< 1.00

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Pled4e Pont clearrr or ► ypo
Facility Nanle:
Permit Name (if different)
Facility Address: aL' \ I�Ct,
Contact Person: L—\,& Q s,,I'll-
Well Location/Site Nalrie: kVI LA--' `f
SUBMIT FORM ON YELLOW PAPER ONLY
lah original OEPARFMENT OF ENVIRONMENTAL QUALITY - OIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
PERMIT Number:
Expiration Date- in --
Non -Discharge
UIC
NPDES
Other ��,� l]C �,,•_�
TYPE OF PERMITTED
OPERATION BEING MONITORED
County�ti�jr���e� ❑ Lagoon
❑ Rernedlalrun. Infiltration Gallery
❑ Spray Field
❑ Remedlatlon:
Telephone#:—>-5k& - .� y4 - q�r► ❑ Rotary Distributor ❑ Land Application Sludge
No. of wells to be sampled: -j ❑ Water Source Heat Pump ❑ Other
It14111 !r,!, I, nl,
SAMPLING INFORMATION -2 'nn ' ` (� —(p 1
WELL ID NUMBER (from Permit): /'r w -1 Date sample collected:
Well Depth- �ft. Well Diameter: 2 In
Depth to Water Level 112546 Ct ,-l5 R below measuring point Screened Interval. L ft to _ft
Measuring Point Is Z ft. above land surface Relative M.P Elevation ft
Volume of water pumped/bailed before sampling: q, $ gallons
Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified. ffYES �❑ NO
LABORATORY INFORMATION , _ I
Date sample analyzed_ Laboratory Name: �-
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO;) as N u0G1r,
Coliform: MF Fecal �oGif,
L '
/100ml-
Nitrate (NO,) as N n(Hi2o G O.o
Coliform: MF Total :WAA
/100mL
Phosphorus: Total as P omfis _ r
tNuie Use MPN me111u1 la n,yhlr Iwr
d>,implusl
Orthophosphate to507
)Issolved Solids:Total 703o11
(n %
ing/L
Al - Aluminum ui nis
pH (Lab) 00403
units
Ba - Barium 01007
TOC noes0
(p , 12
mg/L
Ca - Calcium uos16 _
Chloride uogao
s
mg/L
Cd - Cadmium ulm7
Arsenic u1oo2
ug/L
Chromium Total oU;34
Grease and Ods 00552
mg/L
Cu - Copper 01042
Phenol 12730
ug/L
Fe - Iron 01045
Sulfate 00945
mg/L
Hg - Mercury 71900
3peclfic Conductance uoom
µMhos
K - Potassium 00937
Total Ammonia 00610
(9 , J 7
mg/L
Mg - Magnesium 011927
(Ammunm Nitrogen NH,as N Ammonia Ndlugen Tow)
Mn - Manganese o1o55
TKN as N ooi,25
mg/L
Ni - Nickel oro67
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs:
mg/L
mg/L
mg/L
mg/L
mg/L
ug/L
inq/L
ug/L
ug/L
mg/L
ug/L
ug/L
!ng/L
mg/L
ug/L
ug/L
FIELD ANALYSES:
pH 00400: 5,'-1 units Temp, oomo C
Spec. Cond. WON IlMhos
Odor txroas
Appearance
Certification No IV
Pb - Lead oloro ug/L
Zn - Zinc oroW nlg/L_
Other (Specify Compounds and Concentratiun Units)
ORGANICS: (by GC. GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1 ) ❑ No (0)
VOC 7873 method #
nlelhud #
method #
method #
mg/L Effluent Total VOCs:
mglL VOC Removal%
Sea ►��� l C' 00 Sri ■ �1`' �� 1-7
Pennrtlee for ulhotizedAticlnl)NFllrltf.,ntiTitirr P!uasr_ nru or typo +lrr
GW-59 Rev 3-1-2016
If WELL
WAS
DRY at
Urne of
sampling,
check
here: ❑
J

SUBMIi FORM ON YELLOW PAPER ONLY
Mail onglinal.
DEPARTMENT OF ENVIRONMENTAL OUAUTY - DIV. OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
1
to:
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
and copy
lei?
MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION Ph?asr!PonrCfeafiyorType
PERMIT Number: Expiration Date. JC
Facility Name: -�' ;F i`
Non -Discharge UIC
Permit Narne (if different):
NPDES Other It Itr;r"
Facility Address. (.,�,�
TYPE OF PERMITTED OPERATION BEING MONITORED
TYPE
County 2 , `Ln
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation.
Contact Person
Telephone# �n
El Rotary Distributor ❑Land Application of Sludge
Well Location/Site Name: L' I?
No. of wells to be sampled: }
❑ Water Source Heat Purmp ❑ Other. (/u�f r��%�.)
SAMPLING INFORMATION
I,um i'r n neli
-
f
24
1_ 0--1 If WELL
E+ WAS
WELL ID NUMBER (from Permit): �� _�
Date sample collected lo— 6
FIELD AIVALYrrEs
Well Depth ft
Well Diameter. m
pH r,ua0a6r (9,ills Ternp uoo10 "C DRY at
time of
Depth to Water Level Hzsae:� Z 1S ft below measuring point Screened Interval: /, ft. to
_ ft.
rMhos
Spec Con . uunna. L sampling.
Measuring Point is ft above land surface
Relative M P Elevation: It
Odor D.1085 check
Volume of water pumped/bailed before sampling %4 . S
gallons
Appearance here❑
Samples for metals were collected unfiltered: ElYES
❑ NO and field acidified: YE El NO
LABORATORY INFORMATION
Date sample analyzed:
Laboratory Name-
Certification No.
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335 mg/L
Nitrite INC.,) as N oow-,
mg/L
Pb - Lead motel ug/L
Coliforrn: MF Fecal muic, L f I100mL
Nitrate (NO,) as N 00620 GUr , pe.(
mg/L
Zn - Zinc owy2 nigh
Coliform: MF Total 31%4 /100mL
Phosphorus: Total as P 00665 5 C>
mg/L
(Nor, Use MPN melhwl fu Nghly (urhui sanga„'
Oithophosphate 71,1507
mg/L
Other (Specify Compounds and ConcentratiUri Units)
)issolved Solids Total 70300 �j ( V mg/L
Al - Aluminum uilm
mg/L
pH (Lab) oonW units
Ba - Barium 010117
ug/L
TOC uomu �j (o (� Z_mg/L
Ca - Calcium uocot;
mg/L
Chloride 00940 'G mg/L
Cd - Cadmium uio2r
ug/L
Arsenic 01002 ug/L
Chromium. Total 010e4
ug/L
Grease and Oils 00552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate riu445 mg/L
Hg - Mercury 71400
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 0009s µMhos
K - Polasswrn rxw37
mg/L
VOC 787 � method #
Total Ammonia ou6io (G mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen NH,as N Arnmunia Ndrugen Toial)
Mn - Manganese oluss
uglL
,method #
TKN as N nub25 mg/L
Ni - Nickel 01067
ug/L
rnethod #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs: mg/L
Effluent
Total VOCs. mg/L VOC Removal%
GW 59 Rev 3-1-2016

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION i "JN jo )'your i +ea +y ur Iyr+u
Facility Name: a - 7? _":l, i (, L 1 L -, )l .v 1
Permit Name (if different).
Facility Address: tJkC..r .Y—C � �-+ v►.4� Y
Contact Person
Well Location/Site Name: W�
SUBMIT FORM ON YELLOW PAPI
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1117 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
PERMIT Number: Expiration Date
Non -Discharge U IC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
County n�pw ❑ Lagoon ❑ Remediatwn. Infiltration Gallery
❑ Spray Field ❑ Rernediation:
Telephone#: r— S �(� — f�7L ❑ Rotary Distributor ❑ Land Applicalinn of Sludgf.
No. of wells to be sampled: ❑ Water Source Heat Pump ❑ Other t< 4tatteda w n
SAMPLING INFORMATION '/1/,' � 1
WELL ID NUMBER (from Permit): lb
Date sample collected-
Well Depth: /ft.
Well Diameter: "Z in -
Depth to Water Level 82,'Ab. 5 ft. below measuring point Screened Interval: L_ft to
_ft.
Measuring Point is Z ft above land surface
Relative M.P Elevation: ft
Volume of water pumped/bailed before sampling:
� gallons —-
Samples for metals were collected unfiltered: ❑ YES
El NO and field acidified: LJ YES ❑ NO
LABORATORY INFORMATION
_r
Dale sample analyzed:
Laboratory Name (�
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD rw,r3s
mg/L
Nitrite (NO,) as N 0owF,
mg/L
Coliform: MF Fecal 31n16 L
/100mL
Nitrate (NO,) as N 00e20 O p f
mg/L
Coliform: MF Total 3 i3Oa
/100mL
Phosphorus. Total as P oosis
mg(L
INoie Use MPN melhud roi highly twbid Sampled
Orthophosphate 10507 _
my/L
Jrssolved Solids:I otal 70300 ' r< IQ
mg/L
At - Altarnmum 0 i lot,
mg/L
pH (Lab) O(AO3
units
Ba - Barium 01007
ug/L
TOC 00680 {
mg/L
Ca - Calcium 0ogus .
mg/L
Chloride uureao 4i
mg/L
Cd - Cadrnlurn 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 010.14
ug/L
Grease and Oils ou95.,
mg/L
Cu - Copper 01042
mg/L
Phenol 32730
ug/L
Fe - Iron u1i)4s
ug1L
Sulfate 00945
mg/L
Hg - Mercury 71s00
ug/L
Specific Conductance onot+s
liMhos
K - Potassium oo437 _
mg/L
Total Ammonia 0o6to 0.10
mg/L
Mg - Magnesium 00927
mg/L
IArnnionia Ndrogen Nrl.as N Ammonia Ndrogen Total)
Mn - Manganese o1O55
uglL
TKN as N oos2s
mg/L
Ni - Nickel 01087
ug/L
For Remediation Systems Only (Attach Lab Reports)
PAnnrttea (or Authorized Agent) Narne and Titre Pteiisr-; print hi type
GW-59 Rev.3-1-2016
Influent Total VOCs:
006-
FIELD ANALYSES:
pH ooaoo.{pry units I-emp enure C
Spec, Cond. 000941 IiMhos
Odor doom,
Appearance
Certification No
Pb - Lead oiosi ug/L
Zn - Zinc oto�): mg/L
Other (Specify Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method N. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes(l) ❑ No(0)
VOC 7873 method #
method #
method #
method #
rng/L Effluent Total VOCs.
r e 0 PerrNliler (or Arilhnrired An"111
mg/L VOC Removal%
If WELL
WAS
DRY at
time of
sampling,
check
hP.re: ❑

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM, AL 35222
Drinking Watar ID: 37715
Westavater ID: 10
PHONE [phone]
FAX [phone]
ID#: 359 W
DATE COLLECTED: 06/02/21
DATE REPORTED : 06/11/21
REVIEWED BY:
MW-4
MW-5
MW-6
Analysis
Method
PARAMETERS
Date
Analyst
Code
PH (field measurement), Units
4.3
6.7
6.2
06/02/21
PJC
4500HB-11
Fecal Coliform (MF), /100 Mls
< 1
< 1
< 1
06/02/21
KDS
9222D-06
Ammonia Nitrogen as N, mg/l
0.26
0.16
0.08
06/04/21
KES
350.1 112-93
Nitrate Nitrogen as N, mg/l
< 0.04
< 0.04
06/03/21
KES
353.2 R2-93
Nitrate Nitrogen as N, mg/l
0.10
06/04/21
TLH
353.2 R2-93
Total Phosphorus as P, mg/l
0.08
1.18
06/08/21
DTL
365.4-74
Total Phosphorus as P, mg/l
2.70
06/10/21
DTL
365.4-74
Total Organic Carbon, mg/l
10.84
31.40
10.88
06/08/21
KDS
531OC-11
Chloride, mg/l
15
57
8
06/04/21
BLV
4500CLB-11
Total Dissolved Residue, mg/l
130
06/03/21
CAW
D5907-13
Total Dissolved Residue, mg/l
M 760
M 98
06/08/21
DNS
D5907-13
Static Water Level, feet
10.24
11.73
4.95
06/02/21
PJC
Water Bailed, Gals.
2.0
2.0
1.5
06/02/21
PJC
All QC requirements were not mats M Blank result exceeded method constant weight criteria.

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please 0MI C'leal+y ur 1 yrh
Facilely Name
Pannit Name (if different)
Facility Address
Conlcx2 Person:
Well Location/Site Name: lint w
SUBMIT FORM ON YELLOW PAPER ONLY
lalforiginal
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
i617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: [phone]
PERMIT Number: Expiration Dale: J_r -- 1
Nop i-Dischargtr UIC �
NPDES Other' ,�'k}{ 41&-j
TYPE OF PERMITTED OPERATION BEING MONITORED
County Qti�,1.�'l�,-j ❑ Lagoon ❑ Remedlatlon Infiltration Gallery
❑ Spray Field ❑ Remedlation: _ ____
Telephone#. _11;, -3 414 — 5'lko ❑ Rotary Distributur ❑ Land Application of Sludge
No. of wells to be sampled, ❑ Water Source Heat Pump U Other
I tlwtt rimmlI -
if WELL
SAMPLING INFORMATION
WELL ID NUMBER (from P. h`j Lr'�i
le collected
Date sample
(p — 2 2
FIELD ANALYSES:
WAS
/ermit)-
Wdl Depth: f S ft.
Well Diameter.
—I- in.
pH oonoo Lf•3 units Temp. oomo "C
DRY at
lone of
l7t;lrth to Water Level a2:Aui. 0. ft. below measuringpoint Screened Interval:
P
s fl. to
L_
_fl
Spec. Cond. uo0ea: ilMhc.ls
s3nlpllny,
Measuring Point is 2 ft, above land surface
Relative M.P. Elevation
ft.
Odor 000es
check
Volume of water pumped/bailed before sampling:. 2
gallons
Appearance
here ❑
Samples for metals were collected unfiltered. ❑ YES
❑ NO and field acidified- EfYES ❑ NO
LABORATORY INFORMATION
- —
65/
No lD
Cate sample analyzed
Laboratory Name:
!
Certification
PARAMETERS NOTE: Values should reflect dissolved
and colloidal concentrations.
COD 00335 rng/L
Nitrite (NO: J as N ou615
mg/L
Pb - Lead wo51 ug/L
Coliform: MF Fecal 31616 1/-- ( /100mL
Nitrate (N01) as N 00620
p ,v� f
fng/L
Zn - Zinc 010v2 my/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P oo66s
O , OS
mg/L
(Noie Use MPN melood lot 1•yh1V lurhrl aanl0esl
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units)
)issolved Solids:Total lo30o v mg/L
At - Aluminum o1105
mg/L
pH (Lab) 00403 units
Ba - Barium umo7
ug/L
TOC oo6eo j Q , do(4 mg/L
Ca - Calceunl 00916
mg/L
Chloride 0oy4o j �j mg/L
Cd - Cadmium 011027
uglL
Arsenic 01002 ug/L
Chromium Total 01034,
ug/L
Grease and Oils 00552 mg/L
Cu - Copper olo42
mg/L
ORGANICS: (by GC, GC/MS. HPLC)
Phenol 32730 uglL
Fe - Iron o1o45
uglL
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate nnsas mg/L
Hg - Mercury -,idol
uglL
Lab Report Attached? ❑ Yes (1) ❑ No (0)
3peclfic Conductance 00095 µMhos
K - Polasslum 00937
mglL
VOC 1873 method #
Total Ammonia 00610 ©t?i(p mg1L
Mg - Magnesium 00927
mg/L
method #
iAmmome Nilrogen NH, as N A immma Nanyen Toaq
Mn - Manganese 01055
ug/L
, method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs:
mg/L
Effluent
Total VOCs: mg/L VOC Removal%
GW-59 Rev 3-1-2016

SUBMIT FORM ON YELLOW PAPER ONLY
originalMail
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
1
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
and
o p
16t7 MAIL SERVICE CENTER RALEIGH, NC 27699-1617 Phone: [phone]
FACILITY INFORMATION please Pried Marty w rype
PERMIT Number: Expiration Date V
Facility Namey„19
Non -Discharge UIC
Permit Name (if different)
NPDES Other , ai 11,fk
�(�
Facility Address: yCksl r 1ffCA �" LlF.
TYPE OF PERMITTED OPERATION BEING MONITORED
{
]4.1", L4 to Courtly fit.�>`,
❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation
Contact Person [ �; I�
Telephone#
❑Rotary Distributor El Land Application of Sludge
Well Location/Site Name. jrvt "
No of wells to be sampled-_
U Water Source Heal Pump ❑ Others) Ar( %CAA. ,
-
,n.rn
r,mroll
-
SAMPLING INFORMATION
It WELL
WELL ID NUMBER (from Permit): ii'i (1l]
Date sample collected.
2'
FIELD ANALYSES: WAS
Well Depth: 19ft
Well Diameter In.
pH 00400 units Temp 0oolo "C DRY at
Depth to Water Level 62546
p f (,73f1. below rneasunng point Screened Interval �tt
to _ft
Inne of
Spec. Cond. oo0srl )IMhos Sampling.
Measuring Point is ft. above land surface
Relative M.P Elevation
ft
Odor 0006s check
Volume of water pumped/bailed before sampling:
gallons
Appearance here.❑
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified: YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed:
Laboratory Name. (i
Certification No 10
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 nig/L
Nitrite (NO,) as N 00615
mg/L
Pb - Lead otr151 ug/L
Coliform: MF Fecal 31616 � / /100mL
Nitrate (NO,) as N 00620 D . 1'0
ntg/L
Zn - Zinc ointr2 mg/L
Cohform MF Total 31504 /100mL
Phosphorus. Total as P OU665 f ,
mg/L
(N,Ne use nWN method 1. hgn1j i,A,ld samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units).
)issolved Solids Total 10300 ✓Vj `� ip 0 mg/L
Al - Aluminum o1los
mg/L
pH (Lab) 00403 units
Ba - Barium 01007
ug/L
TOC o069o. S I .1-(o mg/L
Ca - Calcium omis
mg/L
Chloride 00440 -7 ing/L
Cd - Cadmium 01027
ug/L
Arsenic 61002 ug/L
Chromium' Total olo34
ug/L
Grease and Oils 00552_ mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32130 ug/L
Fe - Iron olo45
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095 IiMhos
K - Potassium 00931
mg/L
VOC 767e method #
Total Ammonia oo610 Q , Ike mg/L
Mg - Magnesium 00927
mg/L
method #
Ammonia Nitrogen NH, as N Ammonia Nitrogen Toiel)
Mn -Manganese o1o55
ug/L
,method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs: mg/L Effluent Total VOCs mg/L VOC Removal%
!� 1r�.�►` ��, f_ ��C� .� .ilk-+�..�� � r � � � `�
Pernntlee (or Push, n, a Agent) Name and TINT - P]tase Punt or type 7igr a Wr Adlhonzed Ayrnlj lh•14F
GW-59 Rev 3-1-2016

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION PleasePrullClearlyor Type
Facility Name. 5 Vales �,t. {
Permit Name (if different):
Facility Address "Llia�Ldr `11 C'Vx1r" la.,r .
� r � .C' CK ,.f l ll r +.t� C ;Z) ef'L-'q it
Contact Person: +•�� �1�,�?
Well Location/Site Name:
SUBMI f FORM ON YELLOW PAPER ONLY
Mail original . DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
and I copy to:: INFORMATION PROCESSING UNIT
JSIT PAIL SERVICE CENTER. RALEIGH. NC 27699-1617 Phone: [phone]
PERMIT Number: Expiration Date.
Ikon -Discharge UIC - J
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
County � ❑ Lagoon ❑ Remedialion Infiltration Gallery
�t1 (� ❑ Spray Field ElRemediation:
Telephone#: � �� - 74� - 3q ❑Rotary Distributor El Land Application of Sludge
No. of wells to be sampled: ❑ Water Source Heat Pump ❑ Olhet ; �Czt
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): J/{/] (,1�� Date sample collected:-2/
Well Depth- /1, ft Well Diameter: 2 in
Depth to Water Level 82546: L?t Q S ft below measuring point Screened Interval 1.5 ft. to �ft
Measuring Point is % ft. above land surface Relative M.P Elevation ft
mI
Volum
e of water pumped/bailed before sampling: r S gallons
Samples for metals were collected unfiltered: ❑ YES ❑ NO and field acidified Lj YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: Laboratory Name.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335)
mg/L
Nitrite (NO;) as N 00615
Coliform: MF Fecal :mils
2
/100mL
Nitrate (NO i) as N 00620
Coliform: MF Total 315o4
/100mL
Phosphorus Total as P 00665
(Note Ike MPN method for rghly
MU,J samtA:ti)
Orthophosphate 70501
)issolved Solids:Total 10300
rnglL
Al - Aluminum m105
PH (Lab) 00403
units
Ba - Barium 01007
TOC oo6ou
mg/L
Ca - Calcium 00916
Chloride 00940
mg/L
Cd - Cadmium o1o21
Arsenic oloo2
ug/L
Chromium. Total 0104
Grease and Oils OU552
mg/L
Cu - Copper 01042
Phenol 32730
ug/L
Fe - Iron urtws
Sulfate oo94s
mg/L
Hg - Mercury 71900
apeeific Conductance oo095
ItMhos
K - Potassium 00937
Total Ammonia ooslo
Q, V5
mg/L
Mg - Magnesium 00927
(Ammonia Nitrugert NH,as N Amnwnte Nnta]en Total)
Mn - Manganese 01o55
TKN as N 00625
mg/L
Ni - Nickel 01067
L-�
mg/L
L O .O y mg/L
7, -7p mg/L
mg/L
mg/L
ug/L
mg/L
ug/L
ug/L
mg/L
ug/L
ug/L
mg/L
mg/L
ug/L
ug/L
FIELD ANALYSES:
PH 004rx1 k-A Z units Temp onow C
Spec. Cond 00094 pmhos
Odor tNx)8!)
Appearance
Certification No J 0
Ph - Lead o1o51 ug/L
Zr1 - Zinc 01092 rng/L
Other (Specify Compounds and Concentration Units)
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1 ) ❑ No (0)
VOC 7e72 method #
method #
method #
method #
For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
eonPernlittee (or uthor d AW, N.
GW 59 Rev 3-1-2016
If WELL
WAS
DRY at
time of
sampling,
check
an —

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM ,AL 35222
Drinking Water ID: 3771S
Wastewater ID: 10
PHONE [phone]
FAX [phone]
ID#: 359 W
DATE COLLECTED: 02/18/21
DATE REPORTED : 03/08/21
REVIEWED BY:
MW-4
MW-5
MW-6
Analysis
Method
PARAMETERS
Date
Analyst
Code
PH (field measurement), Units
6.0
6.6
6.3
02/18/21
SEB
4500HB-11
Fecal Coliform (MF), /100 Mls
< 1
< 1
< 1
02/18/21
KDS
9222D-06
Ammonia Nitrogen as N, mg/l
< 0.04
0.05
< 0.04
02/19/21
KES
350.1 R2-93
Nitrate Nitrogen as N, mg/1
0.26
0.07
< 0.04
02/18/21
DTL
353.2 R2-93
Total Phosphorus as P, mg/l
0.06
1.59
0.72
03/02/21
DTL
365.4-74
Total Organic Carbon, mg/l
7.90
23.80
10.28
02/18/21
KDS
531OC-11
Chloride, mg/l
7
51
5
03/01/21
KDS
4500CLB-11
Total Dissolved Residue, mg/l
L 150
L 490
L 100
02/23/21
BLV
D5907-13
Static Water Level, feet
8.60
11.28
3.53
02/18/21
SEB
Water Bailed, Gals.
2.0
2.0
2.0
02/18/21
SEB
All QC requirements were not met: L Laboratory Control Sample exceeded control limits.

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Rease Phnf Gluaffr or Type
Facility Name: n��j j WJ
Permit Name (if differ-r�i)�
Facility Address: jLI�.j
r.
Contact Persor, _
Weil Location/Site Name: T Yyl [A-> L-{
SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENTAL QUALITY -DIV. OF WATER RESOURCES
and I copy to: INFORMATION PROCESSING UNIT
1817 MAIL SERVICE CENTER, RALEIGN, NC 27699-1517 Phone: [phone]kma
PERMIT Number: Expiration Dale: _ t' O - _J — Zl—
Non- Disr. harge U I C
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
County (r), ❑ Lagoon ❑ Remediation Infiltration Gallery
❑ Spray Field ❑ Remediatiow
Telephone# _ ❑ Rotary Distributor ❑ Land Application of Sludge
No, of wells to be sampled 3 ❑ Water Source Heat Pump ❑ Other.
�er..nt I'nm�J
SAMPLING INFORMATION
11 WELL
WELL ID NUMBER (from Permit): V1/Lu)
Dale saniple collected:
�7
FIELD ANALYSES:
WAS
Well Depth: fl
P
Well Diameter: in
�
H Liii
p S� units Temp uun�ci
DRY at
f'
Depth to Water Level H2546: '3,tp0 It. below measuring pain[ Screened Interval: 1 S ft
to
Spec. Cond. 00094
((Mhos Umeolsampling,
Measuring Point is 7 R above land surface
Relative M P Elevation.
_ft
ft.
Odor 00085
check
Volume of water purnpedlbailed lxefore sampling: 2
gallons
Appearance
here ❑
Samples tar metals were collected unfiltered: ❑ YES
❑ NO and field acidified: YES ❑
NO
LABORATORY INFORMATION
Date sample analyzed.
Laboratory Name. ,
Certification No
((�
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 rng/L
Nitrite (NO,,) as N oo615
mg/L
Pb - Lead oimi
ug/L
Coldorm: MF Fecal 31616 ( /100mL
Nitrate (NO;) as N 00620 O, -ZA-P
mg/L
Zn -Zinc uvlet2
mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P 00665 O r o W
rng/L
(Note• lJse. niPN tnemod la highly wft m ,aninles)
Orthophosphate 70501
mg/L
Other (Specify Compounds and Concentration Units)
)issolved Solids:Total 70300 Lr) so mg/L
At - Aluminum u1 to.,,
nig/L
pH (Lab) uo4o3 units
Ba - Barium 01007
ug/L
TOC 00680 -7, clD mg/L
Ca - Calcium uo916
mg/L
Chloride 00940 —7 mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002 ug/L
Chromium: Total 01034
ug/L
Grease and Oils U0552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC. GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1)
❑ No (0)
Specific Conductance oo095 liMhos
K - Potassium 00931
mg/L
VOC 787-1 method #
Total Ammonia 00610 mg1L
Mg - Magnesium 00927
rng/L
method #
(Anunoma Nitrogen NH, as N Ammonia Ndrugen o[atl
Mn -Manganese 01055
ug/L
,method #
TKN as N 00625 mg/L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs: mg/L
Effluent Total VOCs mg/L
VOC Removal%
_borat"- I arn aware that there aro sTgnificam penallies forinformation,-
..
�)6
�.e
�.
Peitiullee (or Auilwruad Agrnrin ll Name d Titre Please pint nF type
Styr
(Trifler• (o
lO3t�
GW-59 Rev 3-1-2016

SUBMIT FORM ON YELLOW PAPER ONLY
111al, I ori , I n al
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
GROUNDWATER QUALITY MONITORING:
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
and I ` `
` 1617 MAIL SERVICE CENTER. RALEIGH, NC 27699-1617 Phony: 919.607.63DS
FACILITY INFORMATION Awase Prim Cluny or ryr,e
PERMIT Number: Expiration Date: J O
Facility Name: A-D4{ r10fi V),) kh
Non -Discharge UIC
Period Name (if different
NPDES Other j ,A F1' r�(LG l b Zj
Facility Address: �1l�lL.e_Q» �j� , GC
t
TYPE OF PERMITTED OPERATION BEING MONITORED
y
County
❑ Lagoon ❑ Remediation. Infiltration Gallery
11 It
❑ Spray Field ❑ Remediation:
Contact Person
Telephonef#•_
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: (A) S
No. of wells to be sampled: 'S)
❑ Water Source Heat Pump ❑ Other V-a lilI 't
,ill—we1B.0
SAMPLING INFORMATION
iN(w
Z
If WELL
WAS
WELL ID NUMBER (from Permit):
Date sample collected 2 — 18 -
I
FIELD ANALYSES
Well Depth: 1% ft
Well Diameter 2 in
pH 00400 (p. 6 units Temp. uouto. C DRY at
Depth to Water Level 82546' [/,Zell. below measuring point Screened Interval.Ft to
_ft
Spec. Cond. ouoga t(Mhos time ofsampling,
Measuring Point is Z ft. above land surface
Relative M.P. Elevation: ft
Odof 000m cheek
Volume of water pumped/bailed before sampling: Z
gallons
Appearance here
❑
Samples for metals were collected unfiltered: ❑ YES
❑ NO and field acidified YES n NO
LABORATORY INFORMATION
�1
1,0
Date sample analyzed:
Laboratory Name: r
Certification No.
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 ing/L
Nitrite (NO,) as N bows
mg/L
Ph - Lead olmo ug/L
COVOME MF Fecal 31616 L ( /100mL
Nitrate (NO,) as N 00620 p, p%
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL
Phosphorus: Total as P ouc,6,5 I , -j Cj
mg/L
INuie Use MPN meihoa foi highfy turbo ad?nules?
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units)
)issolved Solids:Total 7(j300 L Y-f Z) mg/L
At - Aluminum o f toy
mg/L
pH (Lab) O(AO3 units
Ba - Barium oioo7
ug/L
TOC ootiao 3, �D mg/L
Ca - Calcium oo91G
mg/L
Chloride oog4o J mg/L
Cd - Cadinwm mo27
ug/L
Arsenic moue ug/L
Chromium: Total ulo i4
ug/L
Grease and Oils OU552 mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L
Fe - Iron UUA!,
ug1L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate oo945 mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1 ) ❑ No (0)
Specific Conductance o0095 pMhos
K - Potassium 00937
mg/L
VOC 787' method I/
Total Ammonia oo610 'OS mg/L
Mg - Magnesium ou92i
mg/L
method 14
?Ammonia Nihogen NH. ds N Ammonia Nilrmjen Tool)
Mn - Manganese 01055
ug/L
,method q
TKN as N 00625 mg1L
Ni - Nickel 01067
ug/L
method #
For Remediation Systems Only (Attach Lab Reports):
Influent Total VOCs: mg/L
Effluent
Total VOCs: mg/L VOC Removal%
GW-59 Rev 3-1-2016

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Pleaso Print COvatlyor 1yr„d
Facility Name
Permit Name (if dlftererr). I
Faclltl ddress.
�r^C 4C.�r1✓ +1 Lt I�.i C
Contact Person,
Well Location/Site Name- i �j
SUBMl I FORM ON YELLOW PAPER ONLY
DEPARTMENT OF ENVIRONMENTAL QUALrrY - DIV. OF WATER RESOURCES
aind I copy to: INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phono: 919-807.6306
PERMIT Number: Expiration Date } 0
Non -Discharge UIC
NPDES Other %(I) �+I✓'t+efE �Ib it
TYPE OF PERMITTED OPERATION BEING MONITORED
County IO/\5�p k� Q` ❑ Lagoon ❑ Remediation Infiltration Gallery
❑ Spray Field ❑ Remediatiun:
Telephone# _qN -33o — E047 ❑ Rotary Distributor El Land Applicalran of Sludge
No of wells to be sampled- 7 ❑ Water Source Heat Pump ❑ Other L•t A
SAMPLING INFORMATION
WELL ID NUMBER (from Permit): to (10 Date sample cullected.
Well Depth: /12 ft Well Diameter -2- in
Depth to Water Level 82546 3. 53ft. below measuring point Screened Interval 1-5 ft.
Measuring Point is Z ft. above land surface Relative M.P. Elevation.
Volume of water pumped/bailed before sampling: Z gallons
Samples for metals were collected unfiltered: ❑ YES ❑ NO and held acidified:
LABORATORY INFORMATION
Dale sample analyzed Laboratory Name:
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO;) as N uutar,
Coldornl MF Fecal 1u,n; ( /100rnL Nitrate (NO,) as N 00620
Colitorm: MF Total 31504
/100mL
I N�nr. i h� MPN melmrJ li,r ngldy li,�bm s;unplr.�)
)issolved Solids'Total 7u3nu____Z- /C)Q
mg/L
pH (Lab) 00403
units
TOC oo68o
mg/L
Chloride ons4o S
rng/L
Arsenic olao2
ug/L
Grease and Ods 00!,52
mg/L
Phenol 32730
ug/L
Sulfate 00946
mg/L
Specific Conductance oouss
liMhos
Total Ammonia uusiu L. rJt
mg/L
�,Arnm n Nilr ugen Nil Anmx nia Nitl Utjen lb"')
TKN as N 00625 mg/L
Phosphorus Total as P oo665
Orthophosphate 70507
Al - Aluminum u11n5
Ba - Barium uux17
Ca - Calcium oci916
Cd - Cadmium 01027
Chromium Total 010s4
Cu - Copper onu2
Fe - Iron 01045
Hg - Mercury 71900
K - Potassium 00937
Mg - Magneslum 00927
Mn - Manganese olo55
Ni - Nickel u1067
to �ft.
ft
YI �f ES I —I NO
rng/L
L p, p L f rng/L
O, 7 Z mg/L
- mg/L
mg/L
ug/L
mg/L
ug/L
ug/L
mg/L
ug/L
ug/L
mg/L
mg/L
ug/L
ug/L
If WELL
FIELD ANALYSES:
WAS
pH 00400.(03 units Temp. uuulrl C
DRY al
Spec Cond. uuu94_ LlMhOS
Ume of
sampling
Odor 00085
check
Appearance
here: ❑
Certification No I br
Pb - Lead uiu:, i ug/L
Zn - Zinc olo92 mg/L
Other (Specify Compounds and Concentration Units)
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VOC 7973 method #
method #
method #
method #
ll�or Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
Permine& (or Autnun:, J Agenl) Name and Tdie Ploas, ,nni ur type
GW-59 Rev 3-1-2016
Ida lit, Ai Aiice.�riTjer,l
9%2 f _,
iMte)

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM ,AL 35222
Drinking Water IDg 37715
Waetevater ID: 10
PHONE [phone]
FAX [phone]
ID#: 359 W
DATE COLLECTED: 10/28/20
DATE REPORTED : 11/06/20
REVIEWED BY:
MW-1
MW-2
MW-3
MW-4
MW-5
Analysis
Method
PARAMETERS
Date
Analyst
Code
PH (field measurement), Units
Missing
Missing
Missing
4.8
5.0
10/28/20
SEB
4500HB-11
Fecal Coliform (MF), /100 Mls
Missing
Missing
Missing
< 1
< 1
10/28/20
HJO
9222D-06
Ammonia Nitrogen as N, mg/l
Missing
Missing
Missing
<0.04
0.07
10/29/20
TCW
350.1 R2-93
Nitrate Nitrogen as N, mg/1
Missing
Missing
Missing
< 0.04
< 0.04
10/29/20
DTL
353.2 R2-93
Total Phosphorus as P, mg/l
Missing
Missing
Missing
0.08
1.00
11/05/20
TLH
365.4-74
Total Organic Carbon, mg/l
Missing
Missing
Missing
4.98
38.02
10/29/20
SEJ
531OC-11
Chloride, mg/l
Missing
Missing
Missing
8
64
11/02/20
JMS
4500CLB-11
Total Dissolved Residue, mg/l
Missing
Missing
Missing
41
301
10/29/20
JMS
2540C-11
Static Water Level, feet
Missing
Missing
Missing
9.25
11.53
10/28/20
SEB
Water Bailed, Gals.
Missing
Missing
Missing
2.0
2.0
10/28/20
SEB

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM ,AL 35222
MW-6
Analysis
Method
PARAMETERS
Date
Analyst
Code
PH (field measurement), Units
6.4
10/28/20
SEB
4500HB-11
Fecal Coliform (MF), /100 Mls
< 1
10/28/20
HJO
9222D-06
Ammonia Nitrogen as N, mg/l
0.04
10/29/20
TCW
350.1 R2-93
Nitrate Nitrogen as N, mg/l
< 0.04
10/29/20
DTL
353.2 R2-93
Total Phosphorus as P, mg/l
0.68
11/05/20
TLH
365.4-74
Total Organic Carbon, mg/l
3.32
10/29/20
SEJ
531OC-11
Chloride, mg/1
6
11/02/20
JMS
4500CLB-11
Total Dissolved Residue, mg/l
98
10/29/20
JMS
2540C-11
Static Water Level, feet
4.55
10/28/20
SEB
Water Bailed, Gals.
1.5
10/28/20
SEB
Drinking Watar ID: 37715
Wastewater IDs 10
PHONE [phone]
FAX [phone]
ID#: 359 W
DATE COLLECTED: 10/28/20
DATE REPORTED : 11/06/20
REVIEWED BY:

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
Drinking Water IDt 37715
Wastewater ID: 10
PHONE [phone]
FAX [phone]
CLIENT: STATESIDE WWTP
(ONSWC)
CLIENT ID:
359 W
OLD NORTH STATE
WATER
3212 6TH AVENUE
S
ANALYST:
DTL
STE 200
DATE COLLECTED:
10/28/20
BIRMINGHAM, AL
35222
DATE ANALYZED:
11/02/20
DATE REPORTED:
11/06/20
REVIEWED BY:
VOLATILE ORGANICS
STD. METHODS 620OC-11
MW-4
MW-5
MW-6
PARAMETERS, ug/l
1.
Benzene
< 0.50
< 0.50
< 0.50
2.
Bromobenzene
< 0.50
< 0.50
< 0.50
3.
Bromochloromethane
< 0.50
< 0.50
< 0.50
4.
Bromodichloromethane
< 0.50
< 0.50
< 0.50
5.
Bromoform
< 0.50
< 0.50
< 0.50
6.
Bromomethane
< 0.50
< 0.50
< 0.50
7.
N-Butylbenzene
< 0.50
< 0.50
< 0.50
8.
Sec-Butylbenzene
< 0.50
< 0.50
< 0.50
9.
Tert-Butylbenzene
< 0.50
< 0.50
< 0.50
10.
Carbon Tetrachloride
< 0.50
< 0.50
< 0.50
11.
Chlorobenzene
< 0.50
< 0.50
< 0.50
12.
Chloroethane
< 0.50
< 0.50
< 0.50
13.
Chloroform
< 0.50
< 0.50
< 0.50
14.
Chloromethane
< 0.50
< 0.50
< 0.50
15.
2-Chlorotoluene
< 0.50
< 0.50
< 0.50
16.
4-Chlorotoluene
< 0.50
< 0.50
< 0.50
17.
Dibromochloromethane
< 0.50
< 0.50
< 0.50
18.
1,2-Dibromo-3-Chloropropane
< 0.50
< 0.50
< 0.50
19.
1,2-Dibromoethane
< 0.50
< 0.50
< 0.50
20.
Dibromomethane
< 0.50
< 0.50
< 0.50
21.
1,2-Dichlorobenzene
< 0.50
< 0.50
< 0.50
22.
1,3-Dichlorobenzene
< 0.50
< 0.50
< 0.50
23.
1,4-Dichlorobenzene
< 0.50
< 0.50
< 0.50
24.
Dichlorodifluoromethane
< 0.50
< 0.50
< 0.50
25.
1,1-Dichloroethane
< 0.50
< 0.50
< 0.50
26.
1,2-Dichloroethane
< 0.50
< 0.50
< 0.50
27.
1,1-Dichloroethene
< 0.50
< 0.50
< 0.50
28.
Cis-1,2-Dichloroethene
< 0.50
< 0.50
< 0.50
29.
trans-1,2-Dichloroethene
< 0.50
< 0.50
< 0.50
30.
1,2-Dichloropropane
< 0.50
< 0.50
< 0.50
31.
1,3-Dichloropropane
< 0.50
< 0.50
< 0.50
32.
2,2-Dichloropropane
< 0.50
< 0.50
< 0.50
33.
1,1-Dichloropropene
< 0.50
< 0.50
< 0.50
34.
Cis-1,3-Dichloropropene
< 0.50
< 0.50
< 0.50
35.
trans-1,3-Dichloropropene
< 0.50
< 0.50
< 0.50
36.
Ethylbenzene
< 0.50
< 0.50
< 0.50
37.
Hexachlorobutadiene
< 0.50
< 0.50
< 0.50
38.
Isopropylbenzene
< 0.50
< 0.50
< 0.50
39.
4-Isopropyltoluene
< 0.50
< 0.50
< 0.50
40.
Methylene Chloride
< 0.50
< 0.50
< 0.50
41.
Naphthalene
< 0.50
< 0.50
< 0.50
42.
Propylbenzene
< 0.50
< 0.50
< 0.50
43.
Styrene
< 0.50
< 0.50
< 0.50
44.
1,1,1,2-Tetrachloroethane
< 0.50
< 0.50
< 0.50
45.
1,1,2,2-Tetrachloroethane
< 0.50
< 0.50
< 0.50
46.
Tetrachloroethene
< 0.50
< 0.50
< 0.50
47.
Toluene
< 0.50
32.60
< 0.50
48.
1,2,3-Trichlorobenzene
< 0.50
< 0.50
< 0.50
Page: 1

Environment 1, Incorporated
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
CLIENT: STATESIDE WWTP (ONSWC)
OLD NORTH STATE WATER
3212 6TH AVENUE S
STE 200
BIRMINGHAM, AL 35222
REVIEWED BY:
VOLATILE ORGANICS
STD. METHODS 620OC-11
MW-4
PARAMETERS, ug/1
49.
1,2,4-Trichlorobenzene
50.
1,1,1-Trichloroethane
51.
1,1,2-Trichloroethane
52.
Trichloroethene
53.
Trichlorofluoromethane
54.
1,2,3-Trichloropropane
55.
1, 2, 4-Trimethylbenzene
56.
1,3, 5-Trimethylbenzene
57.
Vinyl Chloride
58.
Total Xylenes
59.
Methyl Tert Butyl Ether
Drinking Rater ID: 37715
Wastewater ID: 10
PHONE [phone]
FAX [phone]
CLIENT ID: 359 W
ANALYST: DTL
DATE COLLECTED: 10/28/20 Page: 2
DATE ANALYZED: 11/02/20
DATE REPORTED: 11/06/20
MW-5 MW-6
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
<0.50
<0.50
<0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
<1.00
<1.00
<1.00
< 1.00
< 1.00
< 1.00

NORTH CAROLINA NATURAL HERITAGE REPORT

Roy Cooper, Governor
■ ■■■
■■ ■ INC DEPARTMENT OF
■ ■
Bosom NATURAL AND CULTURAL RESOURCES
■ ■■■
July 19, 2024
John Phillips
Diehl & Phillips, P.A.
1500 Piney Plains Road
Cary, NC 27518
RE. Stateside WWTP Site
Dear John Phillips:
D_ Reid Wilson, Secretary
Misty Buchanan
Deputy Director, Natural Heritage Program
NCNHDE-26783
The North Carolina Natural Heritage Program (NCNHP) appreciates the opportunity to provide
information about natural heritage resources for the project referenced above.
A query of the NCNHP database indicates that there are records for rare species, important natural
communities, natural areas, and/or conservation/managed areas within the proposed project
boundary. These results are presented in the attached `Documented Occurrences' tables and map.
The attached `Potential Occurrences' table summarizes rare species and natural communities that
have been documented within a one -mile radius of the property boundary. The proximity of these
records suggests that these natural heritage elements may potentially be present in the project area
if suitable habitat exists. Tables of natural areas and conservation/managed areas within a one -mile
radius of the project area, if any, are also included in this report.
If a Federally -listed species is documented within the project area or indicated within a one -mile
radius of the project area, the NCNHP recommends contacting the US Fish and Wildlife Service
(USFWS) for guidance. Contact information for USFWS offices in North Carolina is found here:
httios://www.fws.aov/offices/Directorv/ListOffices.cfm?statecode=37.
Please note that natural heritage element data are maintained for the purposes of conservation
planning, project review, and scientific research, and are not intended for use as the primary criteria
for regulatory decisions. Information provided by the NCNHP database may not be published
without prior written notification to the NCNHP, and the NCNHP must be credited as an information
source in these publications. Maps of NCNHP data may not be redistributed without permission.
Also please note that the NC Natural Heritage Program may follow this letter with additional
correspondence if a Dedicated Nature Preserve, Registered Heritage Area, Land and Water Fund
easement, or an occurrence of a Federally -listed species is documented near the project area.
If you have questions regarding the information provided in this letter or need additional assistance,
please contact the NCNHP at natural.heritaaeWdncr.nc.aov.
Sincerely,
NC Natural Heritage Program
DEPARTMENT OF NATURAL AND CULTURAL RESOURCES
Q 121 W. JONES STREET. RALEIGH. NC 27603 • 1651 MAIL SERVICE CENTER. RALEIGH. NC 276"
OFC 919.707.91120 • FAX [phone]

Natural Heritage Element Occurrences, Natural Areas, and Managed Areas Intersecting the Project Area
Stateside WWTP Site
July 19, 2024
NCNHDE-26783
No Element Occurrences are Documented within the Project Area
There are no documented element occurrences (of medium to very high accuracy) that intersect with the project area. Please note, however, that although the
NCNHP database does not show records for rare species within the project area, it does not necessarily mean that they are not present, it may simply mean that
the area has not been surveyed. The use of Natural Heritage Program data should not be substituted for actual field surveys if needed, particularly if the project
area contains suitable habitat for rare species. If rare species are found, the NCNHP would appreciate receiving this information so that we may update our
database.
No Natural Areas are Documented within the Project Area
Managed Areas Documented Within Project Area
fvTanaged Area 1171-771 Wwner Owner Type
Hofmann Forest NC State Natural Resources Foundation, Private
I Inc.
NOTE: If the proposed project intersects with a conservation/managed area, please contact the landowner directly for additional information. If the project intersects with a Dedicated Nature Preserve
(DNP), Registered Natural Heritage Area (RHA), or Federally -listed species, NCNHP staff may provide additional correspondence regarding the project.
Definitions and an explanation of status designations and codes can be found at httr)s //ncnhde natureserve ora/help. Data query generated on July 19, 2024; source: NCNHP, Summer (July) 2024. Please
resubmit your information request if more than one year elapses before project initiation as new information is continually added to the NCNHP database.
Page 2 of 4

Natural Heritage Element Occurrences, Natural Areas, and Managed Areas Within a One -mile Radius of the Project Area
Stateside WWTP Site
July 19, 2024
NCNHDE-26783
No Element Occurrences are Documented Within a One -mile Radius of the Project Area
No Natural Areas are Documented Within a One -mile Radius of the Project Area
Managed Areas Documented Within a One -mile Radius of the Project Area
Managed Area Nam wner Owner Type
Hofmann Forest NC State Natural Resources Foundation, Private
I nc.
Definitions and an explanation of status designations and codes can be found at httr)s //ncnhde natureserve ora/help. Data query generated on July 19, 2024; source: NCNHP, Summer (July) 2024. Please
resubmit your information request if more than one year elapses before project initiation as new information is continually added to the NCNHP database.
Page 3 of 4

NCNHDE-26783: Stateside WWTP Site
4/' A
O�
9
C
0
2
0 a
';a
a�
�J
51 ft
Gum Br ch o
W� er�a9
N �55 ft
W + E+ 0.55
S
July 19, 2024
Managed Area (MAREA)
Q Buffered Project Boundary
Q Project Boundary
Esri, NASA, NGA, USGS, FEMA
Duke University., State of North Carolina DOT, Esri, TomTom, Garmin. SafeGraph,
GeoTechnologies, Inc, METI/NASA, USGS, EPA, NIPS, US Census Bureau,
USDA, USFWS
Page 4 of 4

TABLE V.11.E FROM FORM HRIS 06-16, UPDATED
TO INCLUDE PUMPS IN ADDED FLOW
EQUALIZATION TANK

V. WASTEWATER TREATMENT FACILITY DESIGN CRITERIA —15A NCAC 02T .0705 (continued):
e. PUMPS
Location
No. of
purpose
Manufacturer /
Capacity
Plan Sheet
Specification
Pumps
Type
GPM TDH
Reference
Reference
Building next to
Membrane Permeate
Vogelsang Rotary
118 48
4-7
11-A
treatment plant
Pumps
Lobe
Added Flow Eq.
2
Transfer flow to
Sulzer
250 29
9 & 10
11-A
Tank
primary FE tank
f. BLOWERS
Location
Building next to
treatment plant
Building next to
treatment plant
g. MIXERS
Location
No. of
Units Served
Manufacturer /
Capacity
Plan Sheet
Specification
Blowers
Type
(CFM)
Reference
Reference
Kaeser rotary lobe-
3 Aeration &
existing blowers -
180
1,10
11-A
membrane tank
speed to be increased
by changin sheaves
Kaeser rotary lobe -
Sludge and
existing blower -
147
1,10
11-A
Equalization tanks
speed to be increased
by changin sheaves
No. of Manufacturer / Power Plan Sheet Specification
Mixers Units Served Tape (hp) Reference Reference
h. RECORDING DEVICES & RELIABILITY
Device No. of Location
Units
Effluent Flow Measuring Device 1 Building
Select
Select
Select
i. EFFLUENT PUMP / DOSING TANK (IF APPLICABLE):
Manufacturer Maximum Plan Sheet Specification
Capacity Reference Reference
Endress-Hauser NA 4 11-A
FORM: HRIS 06-16 Page 6 of 13

PROPERTY OWNERSHIP DOCUMENTATION

Type: CONSOLIDATED REAL PROPERTY
Recorded: 4/15/2024 3:58:20 PM
Fee Amt: $26.00 Page 1 of 4
Revenue Tax: $0.00
Onslow County, NC
Omega K. Jarman Reg. of Deeds
BK 6132 PG 84 - 87
Delinquent taxes, if any, to be paid by the closing attorney
to the Onslow County Tax Collector upon disbursement of
closing proceeds
Prepared by: Lanier Fountain & Ceruzzi/dd
114 Old Bridge Street
Jacksonville, NC 28540
Parcel No: vortion of 052265
Excise Stamps: -0-
STATE OF NORTH CAROLINA
COUNTY OF ONSLOW
NORTH CAROLINA WARRANTY DEED OF CORRECTION
THIS DEED, made and entered into this the dday of April 2024, by and between
A SYDES CONSTRUCTION, INC., a North Carolina Corporation with its principal office located
at 100 Carolina Plantations Boulevard, Jacksonville, NC, hereinafter referred to as "Grantor", and
OLD NORTH STATE WATER COMPANY, INC., a North Carolina Corporation, with its
principal office located 1620 Chalk Road, Wake Forest, NC 27587, hereinafter referred to as
"Grantee."
WITNESSETH:
That the Grantor, for a valuable consideration paid by the Grantee, the receipt of which is
hereby acknowledged, has and by these presents does grant, bargain, sell and convey unto the
Grantee, its successors and assigns in fee simple, all those certain lots or parcels of land situated
in Richlands Township, Onslow County, North Carolina and more particularly described as
follows:
BEING all of Tract I, containing 22.27 acres, as shown on survey plat entitled, "Division
Map, Stateside Wastewater Treatment Facilities" dated 06/12/17, prepared by Parker &
Associates, Inc. recorded in Map Book 73 Page 138, Onslow County Registry.
submitted electronically by "Lanier Fountain & Ceruzzi"
in compliance with North Carolina statutes governing recordable documents
and the terms of the submitter agreement with the onslow county Register of Deeds.
Book: 6132 Page: 84 Page 1 of 4

TOGETHER WITH a non-exclusive easement for vehicular ingress, egress and regress from
Quaker Bridge Road to the property over existing roadways as may from time to time exist
on the property. Grantor reserves the right to relocate said roadways in its sole discretion
provided reasonable access is granted to Grantee for the installation, operation,
maintenance, repair and replacement of the waste water utility system to be constructed on
the property.
The property does not include the primary residence of Grantor.
This conveyance is made subject to all matters appearing of record, all state and federal
regulations applicable to the development of the property and matters which may be
disclosed by an accurate survey of the property.
*The purpose of this deed is to correct the name of the Grantee in that certain Deed recorded
in Deed Book 6129, Page 888, because the limited liability company was converted into a
corporation prior to its recording.
TO HAVE AND TO HOLD the aforesaid lots or parcels of land and all privileges and
appurtenances thereto belonging to the Grantee in fee simple.
And the Grantor covenants with the Grantee, that Grantor is seized of the premises in fee
simple, has the right to convey the same in fee simple, that title is marketable and free and clear
of all encumbrances, and that Grantor will warrant and defend the title against the lawful claims
of all persons whomsoever, except as above noted.
[Signature Page to Follow]
Book: 6132 Page: 84 Page 2 of 4

IN WITNESS WHEREOF, the Grantor has hereunto set its hand and seal the day and
year first above written.
A. SYDES CONSTRUCTION, INC.,
A Nort Carolina Corporation
BY:
thony W. Sy , P isident
STATE OF NORTH CAROLINA
COUNTY OF ONSLOW
I, hereby certify that the following person personally came before me this day and
acknowledged that he signed the foregoing document in the capacity indicated thereon:
Anthonv W. Svdes.
Date: April\5 2024.
' y Notary Public _
My Commission Expires: 1
DONNA L- DAVIS
Notary Public
Borth Carolina
onslow County
1111
Book: 6132 Page: 84 Page 3 of 4

DEPARTMENT OF TAX ADMINISTRATION
Tax Certification Form
(Check One Box)
0 This certifies that there are no delinquent ad valorem taxes, or other
taxes which the Onslow County Tax Collector is charged with
collecting, that are a lien on:
Parcel Identification Number:
Portion of 052265 GRANTEE (S): OLD NORTH STATE WATER
COMPANY, INC.
This is not a certification that this Onslow County Parcel
Identification Number matches the deed description.
No certification required, as attorney statement that any delinquent
taxes will be paid from closing proceeds is included on first page of
deed, and the assessor has obtained the desired information from the
conveyance (G.S. 105-303).
Balance due on account. It must be paid to Onslow County Tax Collector.
Please make payment within 5 days of closing.
Kimberly M Campbeil Dee l202404. 5Y12:3 33-M'00' ell 4/15/2024
Tax Collections Staff Signature Date
This parcel may have deferred taxes which become due upon transfer of the
property. Call the Tax Office, Land Records Division at 910-989-2204 for
more information.
234 NW Corridor Blvd - Jacksonville, North Carolina - 28540 - Phone: [phone] - Fax: [phone] - OnslowCountyNC.gov/tax
Book: 6132 Page: 84 Page 4 of 4

1. Edwin N. Foley, Professional Land Sori L-2884,
certify in one of the fallowing as indicated:
❑ A, That the survey creates nsubdidnon of lard
with. the area of a county or mummpality that
has an ordinance that regulate pwcels of Imd;
❑ B That the survey is located in a portion of a county
inpahty that is unregulated as to an ordnance
that regulates parcels of land:
❑ C. Any are of the fallowing.
1. Thai the survey N of an. sating parcel or
parcels of land and does not create a riew street
or Kong. an existing street.
2. That the survey is of an existing bailding or
ether structure, or natural feature, such as a
watercourse or
3. That the survey is. enahr.l survey.
X D. Thai In.s-ey is of awther category, such as ih...... bwatmn
If a ising parcels,. court -ordered -ey, or other exceptl-to
This map is not subject to the 0,51" County Suhdwisian
Regulaii.rw, end ie an EXEMPTION per Section 301(B).Oi
County 5ubifirenn Ord -nee, 10-17-05
d.d . 8/l4/1-7
One -County 5ubdi nono Idlamentrot. Dote
the definition of subdivision: 571°32'0� Humphrey Minerals, LLC
❑ E. That the information available to the surveyor is such that the 116.47' D,8. 1545, Pg. 369
surveyor is unable to make a deierminahon to the best of stir
... veyor's professional ability w to pravisions c,nt,[,.d in Flood Za-X Mm'8aret Brandt
(A) through(b) obave. / 585°08'gg E598.85' (RUn0, Bt4ncft 8 (Operty)
585°tl8'50"E ]75T00' 1 the P1'Dpexty L,Ine)
Edwin N. Foley, PL 5, L-8 UUU - .-3 .50897'"��•"�°g4 N4°16'30'E
Wetlands Line "A" - 11B"
SEARING
LENGTH
36"07'36"E
514°24'20"E
56.53'
s20°20'40 a
2a ".
sctv38'47W
64.00'
II``ff56°39'46"E
8.96'
f�28°36'18"E
55.67'
585°36'3WE
24.B5'
534°01'11"E
46.90'
1512°34'24"E
2292' 1
N71°39'25`E
4CJ7'
N16°39'OB"E
13.14'
I NO2°04'01"W
6615'
1 N29°02'35"E
44.21' 1
N69°18108"E
152.73' 1
i565°44'WE
143.26' 1
525°41'02"E
162.26'
11W11'41E
15986'
546°10'12°E
12B 19,
1562°30'25`E
13866'
1569155'5YE
49,82'
N8
138.1"
''02`E
526°59WE
115.fi0'
Sl1.33'WE
I21.86
514°33'02'E
127.92'
519°40'51°W
1968'
1581°46'51"E
124.42' I
N70°26'44°E
130.41' 1
509°46'49"W
11772- 1
Nl2°54'32°E
14186' 1
N69°59'43`E
27,04' 1
IN43.05'15"W
11958' 1
INt754'23"E
132.49' 1
1 NO3°0"3'W
129,19'
N60°53'12"E
MAT 1
I N80°05'37'E
142.82' 1
IN64°17'49'E
149.37'
N54°06'05"E
12632'
1555°25'54"E
44.34' 1
N63-27'04"E
139.67'
N35"24'57"E
15175' 1
N14°C0'20"E
14B.oe' 1
1N85°11'40"E
13555' 1
587°23'38"E
12936' 1
N28°52'05"E
126.80' 1
I N08°59'10"E
4540' 1
I N26°49'54"E
3124'
I N5W56'29"E
41.96' 1
N31°34'09"E
45.47' 1
IN43°27'52"E
6529,
IN43°1]'4T'E
46.54'
IN38°49'44"E
1.16'
N39°49'06"E
45.37'
1572°00'14"E
4104,
501°31'36"W
5919,
IS7e48'58'W
3508'
Is21°25'19°E
38.82' 1
155542'49"E
64,60' 1
/ Flood Zorw aE v3 59.47
..546°37'37"E4-r
Wetlands Lim N83°4
°1 + + + ♦`" �-Fload Lfre° "555°02'53"E�7
Exists ° 1° „742"E�
"� I. + "1 34.49'
Cemetery / Flood Zone •�
• Remaining Trail III 0plyadA '1. ° �' • 1. ° Z ''�1-
A. Sydes c--ruction, Inc. ry .na - / • �r°
D.B. 2995, Pg 76
m .B. 54, Pg. 188
Re Irg fParnon 2 a l-� +� ``�• +�£�/�-
f Onslow l9 Tract
270.05 A,.
i�
a£
Wetlands Line "C" - I'D"
BEa LNG
LENGTH I
N37�6'32"E
19.21,
N10°42'33"E
4322'
11,132°4716"W
1N23°4•t'3o"W
12811,
141W I
IN45°31'50'E
61.91' 1
1 N14°31'49"E
115.35' 1
NO2°48'22"W
L4802'
N00°55'5t"W
872'
1 N2T33'291-W
I52.17' 1
N10`37'38"W
141.60'
IN06°56'23"W
I23.09'
N21°04'22"W
120,90'
Ni
19162' I
1519°23'15"E
2211'
548°43'35"E
71"
1524°06'59"E
34.45'
13379' I
I536°43'56"E
505°05'54"E
150.93' I
I SO4°05'36"W
140.54' 1
1511°49TW W
34,98' I
1s40'41'09"E
128.40' 1
I S46°42'04"E
15,3fi' I
1S09°26'05"W
369M I
1588°31'43"W
15121' 1
566°04'37"W
161.63' 1
531°24'34"W
16845' 1
I Sl9°20'53"E
156.16' I
1S43°02.30"W
35.63' I
I N86°44'38"W
13229' I
1 N32°47'16`W
12A5' I
1510°42'33"W
138.31, 1
1537°16'32"W
119.371
NOTES
Legend:
%
- aerie
• H.�F�.y.-d",y�
lompA Computed Point
CP - Contra) Pond
b.B. - Dead Book
E - Ged.,
&L - wound Level
I55-111, Stoke Set
M.8, - Map Book
N- Northing
p
ar ap�u
NC5.R- North Carolina 5..Iohy Road
Pg. - Page
?p
RI55 -Reference Iran stake Set
R/W- Right-of-way
A
`rP
.] - Wetlands Hatch
( ) - Distance to Riii Iron
t°vr"i owa"`c�is
43' 2VE
Vicinity Sketch
985 ! 552°36'42"E
N. to sc.le
18.65'
541°30'58"E
I, Edwin N.Foley, certify that
ihanrroon,
supern,tr
from. actual survey(Deed and Plat
✓j///
5334
Idrawn hasoony
re{eren shown"no,or ), witmonrNial
c shown, mode enter my supervision,
a
'
cacplet.ol on 7/31/17, that
N59°5Z53"E
the r of precision poor to I,lIotmertrs
that the boundar.s not
81.04
su0.l',
rveyed are shown as broken lines drawn
❑_Wetlands Lire
from sources nated, that thin map caw
prepared in accordance with s.5. 47-30 as
mnended, this map was prepared far -rding
°54.44'E tiBii
18.66' /-YM.xs ,(NoEiNp v
Purposes.
.
E5,91 L
wd-o ray arignal signature license
)ass Tract II s =as Tract I
16.65 Ac. L� 2227 Ai,
• �+�.�Wetlands Line
s2g3 ,C °
y�sss y • /..• a Wetlands Lim
w63gOB _ /:
IlCli 2J g , 42.11' 05•
11DII J 2 574°5�59,.,N 526
�Wetlaiids Line was 1•tss / /
is=tp553hazasP ,/.
1. Flood tines drawn from an electronic overlay of the digital flood map FIRM
ON 370340 4451J (Orslow County), effective Nov. 3, 20)5.
2 All distances are horimrdnl ground, US survey feet
3 All acreage calcutend by coordinates
4. There are w Areas of Environmental Concern (AEC) as, defined by Coastal
A- Monagement Act (CAMA) on this site.
5. No Register of Deed search do,m by or furnished to survayor regarding deed
or rant restridians.
6. Wetlands line token from mops entitled "TRACT 2 ONSLOW
19 4 PORTION OF ONSLOW 19 TRACT° doted September 23, 2013
by Parker 6 Associates, Inc, Delineated by Land Management Graup, Inc.
and signed by the U.5.A.C.O.E, on I-Ity, 2, R014 and.spines Jeniary 2, 2019,
unless there Is o ¢hang¢ in the law or pubbshed r,g latlaas.
7. The RE pardon of the baundary7mnirol work was performed to third order,
Class x, F&CC specifications, the coordinates were obtained by Real Time Kinematic
Differential GPS Obser-nee using Trimble Survey &rode 5800 GPS Unit, W65
RTK Network Ad iastmerns to NC Grid MAb'83, (2011)_
Field Book: N/A
Disk Name: ACAD #2414
Filename: WWTP-Division.dwg 33L
Jab N., C341126-]91n
_ f ¢ BEAL d -�
number and seal this�Z_day at
- L-2884
%�cl4usi AD 2017.
Q
A
-. r,
rry ivv
Edwin N. Foly4
- 30
m oN
❑ E
NORTHCAROLINA.... ON5LOW COUNTY
8
U u.l i aD ee T. X
1
The Board of Trustees NCSU
D.B. 516, Pg. 408
I, eker ,
Review Officer of all County, certify that
the map or plat to which this certification
s affixed meets all statutory reaumemenrs
for recording.
N
3 Lots
.d R Ac.
D
Deed Ref: 7ortion of D B. 2995, Pg. 76
M.B. 54, Pg. 188
R-8M Zone
DIVISION MAP
JR ie -).&A $ - //Y//7
IIIIIIIIIIII�IIIIIIIIIIIIIIIIIIIIIII3IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIu Y
736000f T02: CBP
Recorded: 09/]4/201] at 02:42.91 PH
Fee Amt: $21.00 Page 1 If 1
Rebeca.DL."Poll.rd Rea..f Deeds
BKH Pe138
VV
Regi ter of Deeds Orel. tty
I�2h�C�Gt ���c>t,�6Q
STATESIDE WASTEWATER
TREATMENT FACILITIES
Richlands Twp., Onslow Co., Norlh Carolina
Owner: Developer:
A. sydes construction, Inc. Old North State Water Company, LLC
1620 Chalk Road
Wakes Fomal, NC 2]5e7
(262)235i900
GRAPHIC SCAT F: t"=90N'
DATE:06112/17 0 100 200 400 600
SCALE: 1"=200'
FEET
PARKER & ASSOCIATES, INC.
Consulting Engineers - Land Surveyors - Land Planners
Jacksonville, North Carolina
P.O. Box 976 - 28541-0976 306 New Bridge Street - 28540
Sheet 1 of 1 Phone [phone] - Fax [phone]
Firm License Number: F-0108
Book. 73 Page. 138 Page 1 of 1 _ _ HDDk,_...73„ Pa 1977 C t
-;,,.,--.4�•anmm�e.w�.-...•. _ _ _ .. 9

SITE MAPS - REVISED TO SHOW PROPERTY
OWNED BY OLD NORTH STATE WATER COMPANY,
REVISED COMPLIANCE BOUNDARY, AND
MONITORING WELL NAMES

DOWNGRADIENT 1 ��� � ' \
MONITORING WELL VW-6
LAT.: 34°5252.12"N
LONG.: 77°28'47.67"W INFILTRAT-
1
1
1 / /
I � �
` I
r
1 '
I
\ 1 I
\
� 1
I /r
1
UPGRADIENT 1
MONITORING WELL VW-4
LAT.: 34°52'45.78 "N 1
LONG.: 77"28'49.58 "W '
l
I
J
� I
TREATMENT
PLANT
\\ BASIN #5
I �
/
I,
�J
COMPLIANCE BOUNDARY
I�.,. REVIEW BOUNDARY r
I ..
j
50'
DOWNGRADIENT
MONITORING WELL MW-5
LAT.: 34°52'47.51'N
LONG.: 7728'44.90 "W
PROPERTY LINE
LEGEND
— c — c — c — COMPLIANCE BOUNDARY
REVIEW BOUNDARY
O MONITORING WELL
li
SITE SOILS WERE
EVALUATED AND MAPPED
AS ONSLOW LOAMY FINE
SAND.
15A NCAC 02T .0704(d)
SITE MAP 1 OF 2
FOR
STATESIDE WWTP
OLD NORTH STATE WATER
COMPANY, LLC
GRAPHIC SCALE
200 0 100 200 400
( IN FEET)

LEGEND
_500_500_500_ 500 FOOT SETBACK LINE
_400_400_400_
i� '� 1\ 400 FOOT SETBACK LINE
1
Zoo —Zoo —Zoo— 200 FOOT SETBACK LINE
,00 100 FOOT SETBACK LINE
I
—50-50-50— 50 FOOT SETBACK LINE
Jib �� OO MONITORING WELL
GRADIENT
SETBACKS PER
MONITONG WELL L MW-6 WE
LL
� I , / , �
LAL: 34'52'52.12"N 15A NCAC 02T .0706
LONG.:7728'47.67w ;� �- I INFILTRATION
BASIN #5 l 50' FROM INFILTRATION SITES TO:
0 SURFACE WATER DIVERSIONS
• PUBLIC RIGHTS OF WAY
0 SURFACE WATERS
•
' kr` G.W. LOWERING DITCHES
i —0 SUBSURFACE G.W. LOWERING
DRAINAGE SYSTEMS
> � Alp!
% `�_j ' J I�� --- ' ; 100' FROM INFILTRATION SITES TO:
--,-� _�' I I - • WELLS (EXCLUDING MONITORING WELLS)
• SWIMMING POOLS
a `� 9SI�9T • WATER SUPPLY SOURCE
IOC
200' FROM INFILTRATION SITES TO.-
0 PROPERTY LINES
% _-_--0 HABITABLE RESIDENCE/PUBLIC
ASSEMBLY PLACE THAT IS
PART OF PROJECT SITE
400' FROM INFILTRATION SITES TO:
AIM�i L I HABITABLE RESIDENCE/PUBLIC
ASSEMBLY PLACE THAT IS NOT
UPGRADIENT DOWNGRADIENT PART OF PROJECT SITE
MONITORING WELL MW-4 1 I MONITORING WELL MW-5
LAT: 34'52'45.78"N , , LAT: 34'52'47.51 "N
500' FROM INFILTRATION SITES T0:
LONG.: 77'28'49.58"W LONG.: 77'28'44.90"W • IMPOUNDED OR SHALLOW G.W.
PUBLIC WATER SUPPLIES
15A NCAC 02T .0704 d
TREATMENT SITE MAP 2 OF 2
( PLANT
FOR
STATESIDE WWTP
OLD NORTH STATE WATER
COMPANY, LLC
PROPERTY LINE - "
r GRAPHIC SCALE
(TYP
J i > .)
\� 7 13d - - 200 0 100 200 400
r�J 1 L J r
IN FEET)

SPECIFICATION SECTION 11-A, REVISED TO
INCLUDE REPLACEMENT DOSATRON UNIT (SEE
PARAGRAPH I.)

DIVISION 11 - EQUIPMENT
11-A: EXPANSION OF THE STATESIDE WASTEWATER TREATMENT PLANT FROM 100,000
GPD TO 150,000 GPD CAPACITY
A. General:
The Contractor shall furnish all labor, materials, tools, equipment, and perform all work and
services necessary for or incidental to the expansion of the Stateside WWTP to a rated
capacity of 150,000 gallons per day average daily flow, as shown on drawings and as
specified in accordance with provisions of the contract documents.
Although such work is not specifically shown or specified, all supplementary or
miscellaneous items, appurtenances, and devices incidental to or necessary for a sound,
secure, complete, and compatible installation shall be furnished and installed as part of this
work.
B. General Description of the Scope of Work and Eauipment Reauired:
The modifications to the Stateside WWTP necessary to expand the treatment plant to a
capacity of 150,000 gpd include, but are not limited to, the following work and equipment
installations:
Membranes: The existing system is permitted to have 16 A3-USA U70 membrane modules
stacked 4 high in a total of 4 stacks. There are currently four membrane air boxes and
guide rail systems installed, with three of them populated with membrane modules for a
total of 12 membrane modules installed. This project will add two new membrane air boxes,
each with a stack of 4 membrane modules, and will also install the 4 previously permitted
membrane modules in the existing (empty) air box/guide rail system.
Permeate PumDincl Svstem: The two existing permeate pumps are to be replaced with two
new permeate pumps with greater flow capacities. The permeate piping system will also
be modified. There is currently one permeate pipe the carry permeate from the four
permitted permeate stacks to the permeate pumps. The proposed project will install
additional piping to have two permeate pipes with each carrying permeate from three
membrane stacks to one of the permeate pumps.
Ultra -violet Disinfection Svstems: The two existing UV disinfection systems are to be
replaced with two new UV disinfection systems with greater flow capacities.
Waste Sludae PumDina Svstem: The existing waste sludge pump will be replaced with a
pump of equal capacity. This is a like -for -like replacement for maintenance reasons, and is
not part of the requested permit modification for this project.
Aeration Svstem for Bioloaical Process: There are three existing 15 horsepower rotary lobe
positive displacement blowers that provide air aeration in the Oxic Zone and the Membrane
Tank. Two blowers are normally in operation, with the third blower providing redundancy.
11-A-1

In order to provide the aeration requirements for the expanded wastewater treatment
capacity, the sheaves for the blower and blower motor will be replaced to increase the
blower speed and air discharge rates. The modified blowers will each be capable of
discharging 180 CFM against 9.0 psig discharge pressure.
Aeration for Flow Eaualization Svstem: There is one existing 10 HP rotary lobe positive
displacement blower that provides aeration to the flow equalization basin. There is also an
interconnection valve that will allow the process blowers to provide air for the equalization
basin if required. In order to provide additional aeration capacity for the flow equalization
volume added by this project, the sheaves for the blower and blower motor will be replaced
to increase the blower speed and air discharge rates. The modified blower will be capable
of discharging 147 CFM against 9.0 psig discharge pressure.
Flow Eaualization Svstem: The existing flow equalization basin has a permitted volume of
28,951 gallons. The minimum equalization volume required to support a 150,000 gpd
wastewater treatment capacity is 37,500 gallons. A steel tank with a working volume of
18,000 gallons will be added by this project, creating a total flow equalization volume of
46,951 gallons. This project will also include two submersible pumps in the steel tank, to
return flow into the existing flow equalization tank, as well as a pump control panel and a
motor actuated plug valve.
Internal Recirculation Pumas and Submersible Mixers: The existing facility has existing
internal recirculation pumps and mixers permitted that are adequate for the increased
flowrate. No new recirculation pumps or mixers are included in this requested permit
modification.
C. Submittals:
Shop Drawings: The Contractor shall submit drawings and data for approval by the
Engineer before proceeding with work. The Contractor shall be responsible for proper fitting
and construction of the work, and the furnishing of materials and work required by the
Contract that may not be specifically indicated on the drawings but required for a complete
installation. Submittals shall generally include information on equipment materials,
dimensions, performance, detailed material specifications, dimensions of proposed
equipment, membrane modules data, performance curves for modified blowers, pump
performance curves, valve data, and other information as may be requested by the
Engineer.
The submittals shall include of a bill of material listing all components the system
manufacturer will deliver; component Manufacturer's catalog cut sheets listing materials of
construction, performance curves/charts, standards of design, and warranty statements.
Shop drawings of assembled systems stating what items will be shipped to the job site
assembled and those shipped loose for field assembly shall be provided. Submittal shall
also include a list of all exceptions and an explanation of each non-compliance with the
specifications.
11-A-2

All electrical and controls information shall be provided. Submittals shall present
information on all panel components, layout of panel face and components, and all
related information as requested by the Engineer.
0&M Manuals: Two paper sets of Operations & Maintenance Manuals and one digital file
(as a PDF) shall be submitted before the construction is 90% completed. The 0&M manual
shall include the equipment manufacturer's directions and guidance regarding the proper
maintenance of each equipment item. The manual shall include lubrication materials and
schedules, parts lists, and service contact information.
D. Additional Membrane Modules:
The new membrane modules shall be identical to the existing modules, which are model
No. U70-H-004 plate membrane modules (pore size 0.038 microns). There shall be four
membrane modules stacked in each guide rail system. There shall be two new 304 stainless
steel guide rail systems installed. Each guide rail system shall include a membrane aeration
box with five fine bubble aeration diffusers that will supply diffused air at the base of the
membrane stack. In addition to the two new guide rail systems and membrane modules
stacks, there shall be four new membrane modules installed in one existing guide rail
system. Each new membrane stack shall be furnished with permeate and air hoses with
shutoff valves and quick connection hardware.
The additional membrane stacks will require the existing air and permeate piping to be
modified, as detailed in the construction plans. The permeate piping will be modified to
create two permeate headers, with each header serving three membrane stacks. One new
Transmembrane Pressure sensor will be added to the piping and connected to the existing
PLC controller. The new exterior permeate piping will be schedule 10 stainless steel (304)
welded pipe and fittings, while the permeate piping within the existing building will be
schedule 80 PVC pipe and fittings. These modifications are to be made in accordance with
the approved construction sequence as the treatment plant will continue to receive flow
during the construction of the modifications.
E. Permeate PumDina Svstems:
The existing permeate pumps shall be replaced with two new Vogelsang rotary lobe pumps,
model IQ112-81. Each pump shall be capable of pumping up to 118 gpm against a
discharge pressure of 17.4 psig (40.2 feet). Each pump shall have a 4 HP motor, rated for
inverter duty on a 460V, 3 phase, 60 Hz power supply.
The modified permeate piping system will normally have each permeate pump pulling
permeate from three membrane stacks, with crossover valving provided. The forward flow
discharge of each permeate pump will have a magnetic flow meter that will be connected
to the existing PLC system controller. There is one existing flow meter that will be relocated
and continue in service. The new flow meter will be a 4-inch Endress-Hauser Proline
Promag D 10 electromagnetic flowmeter.
11-A-3

F. Ultra -Violet Liaht Disinfection Svstems:
The two existing UV light disinfection systems shall be replaced with two new S.I.T.A. UV
disinfection systems, model No. UV AM 96 (one in use, one redundant). Each closed pipe
UV system shall be rated for a dose of 40,000 pwatt-secs/cm2 for a maximum flow rate of
423 gpm of clean water with a UV transmittance of 98%, derated to a maximum flow of
280 gpm for treated wastewater effluent with a UVT of 65%. Each UV system shall have a
power consumption of 666 watts and shall be rated for a 115 V, 60 Hz, single phase power
supply.
The new UV units shall be installed in the same general location as the existing UV units.
The Contractor shall follow the approved construction sequence that will have the existing
UV units temporarily relocated and remain in service while the new units are installed and
made ready to operate.
G. Blower Modifications:
The three existing aeration blowers are Kaeser model BB 69C — 5435, with 15 HP motors
and variable frequency drives. The existing blowers currently have sheaves sized to deliver
an air flow of 163 CFM when operating at maximum speed. The sheaves of these three
blowers will be changed under this project to deliver an air flow of 180 CFM when operating
at maximum speed. There will normally be two blowers operating at one time to deliver
the required 360 cfm to the Oxic and Membrane tanks for the expanded treatment plant
flow.
The existing flow equalization/sludge tank blower is a Kaeser model BB 52C — 5820, with
a 10 HP motor and variable frequency drive. This blower currently has sheaves sized to
deliver an air flow of 125 CFM when operating at maximum speed. The sheaves of this
blower will be changed under this project to deliver an air flow of 147 CFM when operating
at maximum speed. This increase in blower capacity will allow the added flow equalization
steel tank to be aerated when it is in use. The existing emergency interconnection valve
between the aeration blower piping and the flow equalization/sludge blower piping will
remain in place.
H. Added Steel Flow Eaualization Tank, Pumas, Motor Actuated Valve, and Control Panel:
The existing flow equalization tank volume of 28,951 gallons is to be supplemented by the
addition of a steel tank with a usable volume of 18,000 gallons. The added tank will be a
side -stream" equalization tank that will only be used when the capacity of the existing
tank is inadequate to equalize the influent peak flow periods. An overflow pipe will be added
to the existing flow equalization (FE) tank, and will convey the excess flow to the steel tank
when the existing FE tank is filled. The steel tank will have aeration system piping and
diffusers, and will accumulate the excess flow. When the level in the existing FE tank
declines, as sensed by float switches, the transfer pumps in the steel tank will begin to
return the accumulated wastewater to the existing FE tank, and from that tank into the
treatment plant. The transfer pumps will continue to operate until the steel tank has been
emptied. Should the steel tank be filled to a point that it can no longer accept overflow
from the existing FE tank, a motor actuated valve in the overflow piping will close. This will
11-A-4

cause the existing FE tank to fill to a level where a second overflow pipe will convey
wastewater directly to Anoxic Zone No.1, the first stage of the treatment process.
The duplex transfer pumps shall be Sulzer model XFP 80C C131 (oil filled), rated for 250
gpm at 28.9 feet total dynamic head. The pumps shall each have a 3.75 HP motor operating
at 1,750 rpm and rated for a 460V, three phase power supply.
The motor actuated 4-inch eccentric plug valve shall utilize a Dezurik or equal eccentric
plug valve for this application. The motor actuator noted for the plug valve shall be as
manufactured by EIM, Auma, or approved equal. Actuator shall be mounted on the valve
bonnet, and shall have a NEMA 4 rating for exterior installation in direct sunlight. The
actuator shall be rated for 120V, single phase power supply, and shall provide Open -
Close operation of the valve. Actuator shall be sized to overcome the required operating
torque of the valve in the indicated application. Speed from Open to Close shall be 30
seconds. Actuator shall have a Local -Off -Remote selector switch, Open -Close pilot lights,
Open -Close -Stop pushbuttons, space heater, visual position indicator, terminals for
remote indication of Open -Closed status, and a manual override handwheel. Valve,
actuator, and all related components shall be provided from a single source for unit
responsibility.
The Transfer Pump Control Panel shall have a NEMA 4X stainless steel enclosure, and shall
be mounted on the steel tank FE basin as noted on the plans. The Contractor shall construct
a rack for mounting the panel on the handrail of the tank.
The control panel shall be powered by a 30 amp, 3 pole, 480 VAC, 3-phase circuit breaker
added in the existing 277V/480V panelboard. The control panel shall have a main
breaker, with operating handle extending through the panel inner door. All disconnect
switches, control switches, reset buttons, indicating lights, and other control features
shall be located through the panel inner door and be operable with the inner door closed.
Each pump shall have thermal switches in the windings of each pump. The panel shall
be designed to interrupt the control power to the pump starter to stop the pump when
one of the thermal switches opens. The panel shall also have pilot lights in the panel
door to indicate the high motor temperature conditions. If a thermal switch opens, the
relay that causes that pump to stop shall maintain power to its coil until it is manually
reset through an "Overtemp Reset" pushbutton in the panel door.
The float switches shall be powered through intrinsically safe relays. These relays shall
provide contact closures as required to start and stop the pumps.
The electrical probe sensor in the moisture sensing chamber in each pump shall detect
seal leakage. When moisture is detected, relays shall illuminate a warning light in the
inner door of the panel and close a set of dry contacts.
Elapsed time meters shall be provided in the inner door to record pump run times.
11-A-5

Elapsed time meters shall be six -digit, non-resettable type mounted through the hinged
inner door. A relay (or auxiliary contacts) shall be provided for each pump that will be
energized when the starter is closed. These contacts shall be used for the elapsed time
meters and the pump run lights in the panel door. A set of dry contacts shall also be
provided for each pump run condition.
A flashing High Water Level Alarm light and buzzer horn shall be installed on the panel.
The light and buzzer shall be activated when the steel tank has reached its maximum
operating level and has closed the motor actuated plug valve.
The control panel shall have control logic as described in the following paragraphs
when the pumps are switched to the ""Auto" operating mode. There shall be a total of
six float switches provided with the control panel. Two float switches shall be installed
in the existing FE tank, and four shall be installed in the steel tank. The two switches in
the existing FE tank shall be used by the control logic to cause the pumps to operate in
a "pump up" mode (in conjunction with the level switches in the steel FE tank). As the
water level in the existing FE tank rises, it will activate both float switches but will not
cause a transfer pump to operate. If the water level continues to rise in the existing FE
tank, water will enter the overflow pipe and begin to fill the steel FE tank. The rising
water level in the steel tank will first close the ""Pump Off" level switch, and then the
""Pump Start Allowed" level switch. With the water level in the existing FE tank above
both float switches in that tank, a transfer pump will not operate. As the peak flow
subsides, the water level in the existing FE tank will fall as its pump delivers flow into
the treatment process. When the level falls to the activation elevation of the "Pump
Start" switch, a transfer pump in the steel FE tank will be started and will continue until
the water level in the existing FE basin reaches the activation elevation of the "Pump
Stop" switch. This cycle will be repeated until the water level in the steel FE tank falls
to a level that opens the ""Pump Off" float switch, and the operating transfer pump is
stopped.
Should the existing FE tank continue to overflow into the steel tank until the rising
water level closes both the "Open Valve" and the "High Water Alarm/Close Valve" float
switches, the following will occur: (1) the high water alarm buzzer will sound, (2), the
flashing red high water alarm light will be energized, and (3) the motor actuated valve
in the overflow pipe will close. If the influent flow rate into the existing FE basin
continues to outpace the FE pump that supplies the treatment plant, the level in the
existing FE basin will rise. With the motor actuated valve in the overflow pipe to the
steel tank closed, the water level in the existing FE tank will rise to the elevation of a
second overflow pipe installed as a part of this Project. Flow entering the second
overflow pipe will flow directly into Anoxic Zone No. 1.
The closed motor actuated valve will re -open when the water level in the steel FE tank
falls below the ""Open Valve" level switch.
The Transfer Pump Control Panel shall include, but not be limited to, the following
11-A-6

features:
1
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20
21
A Phase and Voltage Monitor that monitors incoming power for phase failure,
phase reversal, and under voltage conditions. A control switch shall be
provided in the panel to allow the PVM to be switched to ""Active" (will interrupt
control power to TPCP if three phase power supply quality is outside of PVM
settings) or to ""Bypassed" (will allow control power to TPCP regardless of three
phase power quality).
Control voltage transformer to provide 120VAC, single phase power for the
operation of the TPCP
Condensation strip heater with thermostat.
Seal leakage relays and indicating lights (one per pump).
Duplex alternating relay, switchable to allow alternation or selection of a
specific lead pump
NEMA type non -reversing motor starters sized for the furnished pump motors,
with overload relays
A three pole circuit breaker on the line side of each motor starter
Terminal block with properly sized lugs to accept all required line and load side
wiring requirements, with shielding of exposed, energized components
Industrial grade oil -tight switches with transparent polycarbonate contact
blocks
Hand -Off -Automatic switches for each pump
Open — Automatic — Close switch for motor actuated valve
Industrial grade oil -tight pilot lights with insulated sockets and lexan lens
Control relays with sockets by the same manufacturer
External red flashing light for the high water alarm indication
A continuous sounding alarm buzzer for the high water alarm indication
Pushbutton to silence audible alarm.
Terminal blocks for connection of all external wiring and cables to the panel
Plastic wiring troughs (Panduit or equal) for neat and orderly containment of
panel wiring
Engraved phenolic plastic nameplates for the TPCP and all indicator lights,
alarms, switches, pushbuttons, circuit breakers, and other major control
components.
A laminated wiring/control diagram (panel as -built drawing).
Dry contacts (and terminals for connection of field wiring) for:
a) Pump Over Temperature for each pump
b) Pump starter engaged for each pump (one contact for each)
c) Seal Leakage for each Pump
d) High Level Alarm
e) Motor Actuated Valve Open
f) Motor Actuated Valve Closed
11-A-7

Wire gauge shall be determined according to the ampacity tables in the National Electric
Code applicable to the appropriate conditions of use and type of insulation. Wire bundles
shall be secured in slotted wiring duct and be filled to a maximum of 60% capacity.
Properly fitting wire duct covers shall be provided. Circuits requiring shielded wires shall be
routed away from conductors carrying large or noisy currents. When routing in the same
wire way is required, proper electromagnetic shielding shall be provided. Shielded cable
shall be grounded according to the requirements of the electrical devices or instruments
connected. Signal and power wiring shall not be run in the same conduit, tray, or junction
box. Labels shall be applied to identify all panel -mounted components. Identifying labels
shall correspond to the device labels on the supplied control panel schematics. Identifying
labels shall be of embossed metal, engraved plastic or plastic labels and either fastened
mechanically or with adhesive. Terminals shall be of modular type, DIN rail mountable and
of adequate capacity for current and wire size as required. Terminals shall be marked with
factory molded snap in markers. When terminals must have jumper connections, jumpers
shall be center screw type with jumper bars. Spare terminal blocks of no less than 10%
shall be provided. Grounding lugs shall be provided for bonding the panel to the enclosures
and enclosure doors when the enclosures and doors are made of conductive material.
I. Dosatron Replacement:
The existing Dosatron (water powered eductor for the chemical feed used for the
membrane Clean in Place operations) shall be replaced with a new, larger capacity unit.
The replacement Dosatron shall be a model D40MZ5, with a water flow range of 2.2 to 40
gallons per minute and a dilution range of 1:100 to 1:20 (1% to 5%). The unit shall have
1.5-inch male NPT connections. A 200 mesh filter and check valve shall be installed with
the unit, per the manufacturer's recommended installation. The unit shall be manufactured
by Dosatron International, Inc.
J. Service:
Furnish the services of a manufacturer's authorized representative for the following
services:
Provide and install the new blower sheaves, verify proper operation of the modified
blowers, verify acceptable current draws, refresh all lubricants, and provide field report of
activities and findings (Kaeser certified technician)
Inspect the installation of the new permeate pumps and their operation, provide a startup
report (Vogelsang certified technician)
Inspect the installation of the new ultra -violet light disinfection systems and their operation,
provide a startup report (SITA certified technician)
Inspect the installation of the new transfer pumps, motor actuated valve, and transfer
pump control panel (by technicians certified by the various manufacturers/suppliers)
A3 USA shall provide a programmer that shall modify the programming of the existing PLC
to reflect the changed operation of the permeate pumping system, the addition of the steel
FE tank, the transfer pumps, and the motor actuated valves. The graphic screens for the
HMI shall be modified and supplemented as required by the system changes and additions
created by this project. I/O modules shall be added in the existing control enclosure if
11-A-8

needed.
A3 USA shall also provide operator training for the new equipment and changed permeate
flow scheme.
K. Warranty:
The manufacturers of the equipment specified herein and/or the equipment vendors shall
provide warranties to the Owner, stating that the provided equipment is warranted to be
in accordance with the product specifications mutually agreed upon and to be free from
defects in workmanship and materials. The manufacturers' product warranties will extend
to all products supplied by them, whether or not manufactured by them. The warranty
period shall be the manufacturer's standard period, but at minimum it shall extend to twelve
(12) months in service with the original user or eighteen (18) months from the date of
shipment, whichever occurs first.
The Contractor shall guarantee that all items furnished and installed by Contractor will be
warranted against defects in material and workmanship for a period of 12 months after
start-up and acceptance, unless a longer warranty period is specified for certain equipment
items.
End Division 11-A
11-A-9