WQ0005910_Monitoring - 11-2016_20170104 (2)

GW -59A COMPLIANCE REPORT FORM Permit # W O 000 Sq 10
(Submit one each monitoring periad with GFF59 jarmr.)
I IEnter date monitoring results were duo
be submitted after the established due
2 1 Was any required
3
4
5
6
7
on the GW -59 report forms?
IF the answer to question t or 2 is "YES" list to the space provided below the
explain the problems encountered in obtaining the required information.
Are any of the monitor wells in need
identification plate, area overgrown,
Are any
air or maintenance (damaged casing, unlocked or missing cap,
Ijthe answer is "Yes ", contact the Regional Ofce jorguidance.
T
It the answer to question 4 is NO" skip to section a
If the answer to question 4 Is "YES"fist the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below.,
mw-6-SDS-tob4«�y1L
same constituent(s) in the same well(s) in the last two years?
it me answer to question 5 is NO" skip to section B.
If the answer to question 5 is "YES", list in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
Muf-N ko.%-Le_ Man-4-ZOS
10111.11$-17,4 t111aIW-1V,t,0
-Ilaal�- I1,4 '11141H-\-1,la
31015-1�,3t, Zlaaltb-14,8
If the answer is "YES", a groundwatl
OFFICE IMMEDIATELY FOR GUIDAA
located; contact the Regional Office.
groundwater quality problem?
if the answer to question 7 is "YES' d
If the answer to question 71s 'NO",
-tlaoht,-Inks 'Itrsm.-'16s
31a1W-lo4'1 .31101IS--11s
l0l2L41hr-1t4
I�nanti- �l.<
Dn 5 located at or bevond the n
orob/em may be
answer Is NO".
in the space
wells may be Improperly
S
�� Z :7
i m
.o CO N
Z _O
g The person completing this portion (GW -59A f the m n ng report should sign below and submit d
form w/th GW -59 forms for required wells to address plffvidedat the top of the current GW -59 form.
I hereby'ac wlatlge that the above' nfort twat on'was ava7uatetl t t}'e'ln o a a uti t"3e is
repojt (C lance.yyA G @9. s.,t nd �grJp�etgjofo[tnyQwle„ gs,.,, s°
Signature of Pennines (or Authorized Agent) Date
GW -59A 12/8/2003
YES NO
V
YES NO
YES NO
YES NO
YES
YES I NO
lzul

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
^M° I furl Please Print Clearly or Type
Facility Name:_ IA✓ o ca) Im C
Permit Name (if different):
Well Location/ Site Name:
County _E9r't%c
Telephone #:ZR2-482—
No. of Wells to be Sampled:
Well Identification Number (from Permit): Yr1lw)—� For Groundwater Treatment Systems
Well Depth: 21.4] ft. Well Diameter: Z in. Check One: ❑ Influent (98)
Screened Interval: IS It. to '22 ft. ❑ Effluent (9
9) to Water Level: 10.0 fl. below measuring point. (9)
Measuring Point (M.P.) i� ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: IS Date sample collected: 11 1 1
Field analysis: pH [s.22 , Specific Conductance uMhos
Temp. 7.0 °C, Odor WDv%4- Appearance 0fdLu-
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: • EXPIRATION DATE: 5 1311201
Non -Discharge 00005` r) UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon _Remediation: Infiltration Gallery
Spray Field Remediation:
Rotary Distributor _ Land Application of Sludge
Other:
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed:\1f4��1b— 1ZISI1f
Laboratory Name: �rtyt.ov.++ bn•F 1
Certification No. 10
PARAMETERS (Samples for metals were collected unfiltered ✓ YES _NO and field acidified
COD mg/1
Coliform: MF Fecal /100ml
Coliform: MF Total /100ml
(Nate: Use MPN method for highly turbid samples)
mg/I
Dissolved Solids: Total 31►1
mg/I
hen analyzed )
units
TpH OC �8
mg/I
Chloride 41
mg/1
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/1
Sulfate
mg/I
Cu - Copper
mg/I
Specific Conductance
uMhos
Total Ammonia G 0.0`1
mg/I
TKN as N
mg/I
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N \ 1 • `I
mg/I
Phosphorus: Total as P
mg/I
Orthophosphate
mg/I
Al - Aluminum
mg/I
Ba - Barium 1).049
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
YES _ NO)
Ni - Nickel
mg/I
PID - Lean
mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (SpeciCompounds and Concentration Units)
�•S
kSS ena )L
JAN 16 2017
ORGANICS: (GC,GC/MS, E
(Specify test and method#. tach lab report.)
Report Attached? Yes(1) No_(0)
VOC : method # =
method # _
melhnrl /k _

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:_
Permit Name (if
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County M"S rL
Telephone #:1S2-402-2
No. of Wells to be Sampled:
Well Identification Number (from Permit): MO- S For Groundwater Treatment Systems
Well Depth: 21.-j _ft. Well Diameter:'L in. Check One: ❑ Influent (98)
Screened Interval: IS ft. to 2'Z ft. ❑ Effluent (99)
Depth to Water Level: 65 ft. below measuring point.
Measuring Point (M.P.) is: Z ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: IS Date sample collected: 11%Nel Ib
Field analysis: pH '4-71LA , Specific Conductance uMhos
Temp. 2_°C, Odor IJ 0'10- Appearance ckfav-
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT#: • EXPIRATION DATE: 01'
Non -Discharge kaocp591f) UIC
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon
Spray Field
Rotary Distributor
Other:
Remediation: Infiltration Gallery
Remediation:
Land Application of Sludge
N TE7 Values should reflect dissolved and
colloidal concentrations.
Date sample analyzed: 11 10 Ito- %;q S It to
Laboratory Name: Env sroo Vy ev f
Certification No. t0
(Samples for metals were collected unfiltered V YES _NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal
/100ml
Nitrate (NO3) as IN < Dom—
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
(Note: Use MPN method for highly turbidsamples)
Dissolved
Orthophosphate
mg/I
Solids: Total WA
mg/I
Al - Aluminum
mg/I
TOC hen an2yl4d)
units
Ba - Barium 0.029
mg/I
mg/I
Ca - Calcium
mg/I
Chloride (o l
mg/I
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
mg/I
Grease and Oils
mg/I
Cu - Copper
mg/I
Phenol
mg/I
Fe - Iron
mg/I
Sulfate
mg/I
Hg - Mercury
mg/I
Specific Conductance —uMhos
K - Potassium
mg/I
Total Ammonia _ Or 09
mg/I
Mg - Magnesium
mg/I
TKN as N
mg/I
Mn - Manganese
mg/I
YES _ NO)
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
iS5 - S.S L
M�
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #, attach lab report.)
Report Attached? Yes (1) NO—(0)
VOC : method # =
method # =
method # =
Rev. 03/2000

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:_
Permit Name (if
Contact Person: Jaian
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or Type
County txrT(�-
Telephone #:2_S2 41bZ—
No. of Wells to be Sampled:
Well Identification Number (from Permit):M14�(p For Groundwater Treatment Systems
Well Depth: 21.9 _ft. Well Diameter: Z in.
15 Check One: ❑ Influent (9)
Screened Interval: ft. to 22 ft. El Effluent (99)
Depth to Water Level:�_�ft' below measuring point.
Measuring Point (M.P.) is:_? ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumnped/bailed before sampling: IS Date sample collected: 011tf lltp
Field analysis: pH •bS , Specific Conductance uMhos
Temp. to •S °C, Odor 00"e, Appearance S1Cav
PARAMETERS (Samples for metals were collected unfi
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPN method for highly turbidsamples)
Orthophosphate
Dissolved Solids: Total 2115
mg/I
pH (when analyzed)
units
mg/I
mg/I
Chloride 2
mg/I
Arsenic
mg/I
Grease and Oils
mg/1
Phenol
mg/I
Sulfate
mg/I
mg/I
K - Potassium
Specific Conductance
uMhos
Total Ammonia 4 2. to
mg/I
TKN as N
mg/I
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT #: • EXPIRATION DATE -
Non -Discharge (4&000 S91C) UIC
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon _Remediation: Infiltration. Gallery
Spray Field _ Remedialion:
Rotary Distributor _ Land Application of Sludge
Other.
NOTE: Values should reflect dissolved and
colloidal concentrations.
Date sample analyzgd: 111121110— %711010
Laboratory Name:
Certification No. _ t0
JA`lIl 10 Z017
eredy YES _NO
and field acidified
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N 25 -LA
mg/I
Phosphorus: Total as P
mg/I
Orthophosphate
mg/I
Al - Aluminum
mg/I
Ba -Barium 0.032)
mg/I
Ca - Calcium
mg/1
Cd - Cadmium
mg/1
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
YES _ NO)
Ni - Nickel mg/1
PID - Lead mg/1
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specify Compounds and Concentration Units)
ISS- c �,to ry $ I L
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. /attach lab report.)
ReportAttached? YeS_✓ (1) No _ (0)
VOC : method # =
method #
m2thnri It -

GROUNDWATER QUALITY MONITORING:
CO
REPORT FORM
SUBMIT FORM ON YELLOW PAPER ONLY
�`IVJW t 7 mlrynlwAI JUN Please Print Clearly or Type
Facility Name: 06f`40C[a3'3nL-
Permit Name (if difftrent):
Well Location/ Site Name:
County._X'-rt'C
Telephone fi:Z•S2�Z.t33
No. of Wells to be Sampled:., _
Well Identification Number (from Permit): 'MW- For Groundwater Treatment Systems
Well Depth: fCO' _f(. Well Diameter:z- in. Check One: ❑ Influent (98)
Screened Interval: S— ft. to 1'6 ft. ❑ Effluent (99)
Depth to Water Level: -1,0 ft. below measuring point.
Measuring Point (M.P.) is: Z ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: IS Date sample collected: 111 [1i LLo
Field analysis: pH _Y-40 , Specific Conductance uMhos
Temp. 22- 'C, Odor tJ 0 tAppearance Cig4 r
PARAMETERS (Samples for metals were collected unfiltered 'V' YES
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPN method for highly turbid samples)
mg/1
Dissolved Solids: Total 7-/0"1 mg/I
pH (when analyzed)
units
TOC u1'1'zmg/I
Ca - Calcium
Chloride 3N
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
mg/I
mg/I
K - Potassium
Specific Conductance
uMhos
Total Ammonia • 12
mg/I
TKN as N
mg/I
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1676 MAIL SERVICE CENTER
PERMIT 0: • EXPIRATION DATE: �
Non-Dischargewa D00S910 UIC
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon
Spray Field
Rotary Distributor
Other: _
_Remediation: Infiltration Gallery
Remediation:
Land Application of Sludge
NOTE; Values should reflect dissolved and
colloidal concentrations. ✓4*
Date sample analyzed: 1�I\OILIo� 11ISIILo i`r o2Qj�
Laboratory Name: a V12nr+u, 1 ��
Certification No. it)
_NO and field acidified
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N 1.O
mg/I
Phosphorus: Total as P
mg/I
Orthophosphate
mg/1
AI - Aluminum
mg/I
Ba - Barium 0.042
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
YES _ NO)
Ni - Nickel
mg/I
Pb - Lead
mg/I
Zn - Zinc
mg/I
Ammonia Nitrogen
mg/I
Other (Specify Compounds and Concentration Units)
%SS- If_71X mf0L..
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method If. 5ttach lab report.)
Report Attached? Yes_/ (1) No _(0)
VOC : method fl =
method H =
methnd it =

GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Facility Name:_
Permit Name (if
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Print Clearly or
County 1SC_V`*(C-
Telephone #:2S7_ ­A
No. of Wells to be Sampled:
Well Identification Number (from Permit): MW- For Groundwater Treatment Systems
Well Depth: IZ ft. Well Diameter: Z in. Check One: ❑ Influent (98)
Screened Interval: _3 ft. to IS ft. ❑ Effluent (99)
Depth to Water Level: —1 it. below measuring point.
Measuring Point (M.P.) is: 2- ft. above land surface. Relative M.P. Elevation in It.:
Gallons of water pumped/bailed before sampling: I S Date sample collected: k% ItitoKka
Field analysis: pH r-1 , Specific Conductance uMhos
Temp. 2l °C, Odor 0 O„e Appearance C-kdw
PARAMETERS (Samples for metals were collected
COD
mg/I
Coliform: MF Fecal
/100ml
Coliform: MF Total
/100ml
(Note: Use MPN method for highly turbid samples)
mg/I
Dissolved Solids: Total 302 mg/I
pH (when anal zed)
units
TOC 3,�0
mg/I
Chloride 41
mg/I
Arsenic
mg/1
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
mg/I
mg/I
K - Potassium
Specific Conductance
uMhos
Total Ammonia _ 0.102
mg/I
TKN as N
mg/I
DEPARTMENT OF ENVIRONMENT 8 NATURAL RESOURCES
WATER DUALITY DIVISION, GROUNDWATER SECTION
1676 MAIL SERVICE CENTER
PERMIT k: • EXPIRATION DATE: 10 1_
Non -Discharge (S) 000 S91 D UIC
NPDES
TYPE OF PERMITTED OPERATION BEING MONITORED
—r Lagoon _Remediation: Infiltration Gallery
y Spray Field _ Remediation:
Rotary Distributor _ Land Application of Sludge
Other.
NOTE' Values should reflect dissolved and
colloidal concentrations
tn j�O
Date sample analyzed: tm(Ialshto
Laboratory Name: EmVkravZ
Of,
1
Certification No. 10
%red v YES _NO and field acidified
Nitrite (NO2) as N
mg/I
Nitrate (NO3) as N 0-`1
mg/I
Phosphorus: Total as P
mg/I
Orthophosphate
mg/I
Al - Aluminum
mg/I
Ba - Barium • IDS
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
mg/I
Cu - Copper
mg/I
Fe - Iron
mg/I
Hg - Mercury
mg/I
K - Potassium
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mg/I
YES _ NO)
Ni - Nickel mg/I
Pb - Learf mg/I
Zn - Zinc mg/I
Ammonia Nitrogen mg/I
Other (Specittyy"�Compounds and Concentration Units)
TSrw�IL
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method If. Ottach lab report.)
Report Attached? YesL�(1) No (0)
VOC : method # =
method N =
method If =
Rev. 03/2000

Ewhnn(W alp hmpormUd
--
..1 i":a T•IR..! i £ S-f� .3,°Y31N _ Y {F V'��' •' j t:
.Dnng Water ID, 37715;
,.sikiN
.. 1.
' e , �''• wastewater ID: 10
P.O. BOX 7085, 114 OAKMONT DRIVE PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
ID#: 132
AVOCA, INC. (WASTEWATER)
MR. BRIAN CONNER
P.O. BOX 129 DATE COLLECTED: 11/16/16
MERRY BILL ,NC 27957 DATE REPORTED : 12/16/16
REVIEWED BY:
Effluent
Well
Well
Well
Well
Analysis
Method
PARAMETERS
N4
#5
#6
#7
Date
Analyst
Code
BOD, mg/l
5450
11/17/16
KKM
521OB-01
Total Suspended Residue, mg/1
70
<2.5
5.5
<2.6
<2.5
11/18/16
KMH
254OD-97
Ammonia Nitrogen as N, mgA
0.06
12/05/16
MF
350.1 R2-93
Ammonia Nitrogen as N, mg/1
<0.04
0.09
11/30/16
RAJ
350.1 R2-93
Ammonia Nitrogen as N, mg/1
0.11
0.12
12/07/16
MF
350.1 R2-93
Total Kjeldahl Nitrogen as N,mg/I
22.52
11/21/16
RAJ
351.2 112-93
Nitrate -Nitrite as N, mgA
0.19
11/18/16
RAJ
353.2 R2-93
Nitrate Nitrogen as N, mg/1
11.70
<0.04
3.49
1.05
11/18/16
RAJ
353.2 R2-93
Total Phosphorus as P, mg/1
57.60
11/22/16
MF
365.4-74
Total Organic Carbon, mgA
<1.00
2.18
<1.00
4.73
11/18/16
SEJ
531OC-00
Chloride, mg/l
41
61
28
34
11/21/16
MAR
4500CLB-97
Total Dissolved Residue, mg/I
314
664
245
267
11/17/16
KDS
254OC-97
Barium, ug/1
49
29
38
42
11/28/16
LFJ
EPA200.7
Calcium, ugA
18635
11/28/16
LFJ
EPA200.7
Magnesium, ug/l
5604
11/28/16
LFJ
EPA200.7
Sodium, ug/1
73620
12/15/16
JMN
3111B-99
Sodium Adsorption Ratio (talc)
3.8

environment 1, Incor
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
AVOCA, INC. (WASTEWATER)
MR. BRIAN CONNER
P.O. BOX 129
MERRY HILL ,NC 27957
PARAMETERS
Total Suspended Residue, mg/I
Ammonia Nitrogen as N, mg/I
Nitrate Nitrogen as N, mg/I
Total Organic Carbon, mg/l
Chloride, mg/1
Total Dissolved Residue, mg/l
Barium, ug/l
d
Well
Analysis
Method
#8
Date
Analyst
Code
5.4
11/18/16
KMH
254OD-97
0.62
12/05/16
MF
350.1 R2-93
0.44
11/18/16
RAJ
353.2 R2-93
3.88
11/18/16
SEJ
531OC-00
41
11/21/16
MAR
4500CLB-97
382
11/17/16
KDS
254OC-97
105
11/28/16
LFJ
EPA200.7
EW1Dsinkiag MatZD, 37Y
.. I Wastewater ID, 10 '
PHONE [phone]
FAX [phone]
ID#: 132
DATE COLLECTED: 11/16/16
DATE REPORTED : 12/16/16
REVIEWED BY: za

Environment 1, Inorp 0I - I
,g " cstf
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835.7085
CLIENT: AVOCA, INC. (WASTEWATER)
MR. BRIAN CONNER
P.O. BOX 129
MERRY HILL, NC 27957
REVIEWED BY:
VOLATILE ORGANICS
STD. METHODS 62000 (971
Drinking Water ID: 37715
Wastewater ID: 10
PHONE [phone]
FAX [phone]
CLIENT ID: 132
ANALYST: MAO
DATE COLLECTED: 11/16/16 Page: 1
DATE REPORTED: 12/16/16
Date Analyzed:
PARAMETERS, ug/1
11/29/16
Well
#4
11/29/16
Well
#5
11/29/16
Well
#6
11/29/16
Well
#7
11/30/16
Well
#8
1. Benzene
<0.50
<0.50
<0.50
<0.50
<0.50
2. Bromobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
3. Bromochloromethane
<0.50
<0.50
<0.50
<0.50
<0.50
4. Bromodichloromethane
<0.50
<0.50
<0.50
<0.50
<0.50
5. Bromoform
<0.50
<0.50
<0.50
<0.50
<0.50
6. Bromomethane
<0.50
<0.50
<0.50
<0.50
<0.50
7. N-Butylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
S. Sec-Butylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
9. Tert-Butylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
10. Carbon Tetrachloride
<0.50
<0.50
<0.50
<0.50
<0.50
11. Chlorobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
12. Chloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
13. Chloroform
<0.50
<0.50
<0.50
<0.50
<0.50
14. Chloromethane
<0.50
<0.50
<0.50
<0.50
<0.50
15. 2-Chlorotoluene
<0.50
<0.50
<0.50
<0.50
<0.50
16. 4-Chlorotoluene
<0.50
<0.50
<0.50
<0.50
<0.50
17. Dibromochloromethane
<0.50
<0.50
<0.50
<0.50
<0.50
18. 1,2-Dibromo-3-Chloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
19. 1,2-Dibromoethane
<0.50
<0.50
<0.50
<0.50
<0.50
20. Dibromomethane
<0.50
<0.50
<0.50
<0.50
<0.50
21. 1,2 -Dichlorobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
22. 1,3 -Dichlorobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
23. 1,4 -Dichlorobenzene
<0.50
<0.50
<0.50
<0.50
<0.50
24. Dichlorodifluoromethane
<0.50
<0.50
<0.50
<0.50
<0.50
25. 1,1-Dichloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
26. 1,2-Dichloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
27. 1,1-Dichloroethene
<0.50
<0.50
<0.50
<0.50
<0.50
28. Cis-1,2-Dichloroethene
<0.50
<0.50
<0.50
<0.50
<0.50
29. trans-1,2-Dichloroethene
<0.50
<0.50
<0.50
<0.50
<0.50
30. 1,2-Dichloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
31. 1,3-Dichloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
32. 2,2-Dichloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
33. 1,1-Dichloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
34. Cis-1,3-Dichloropropene
<0.50
<0.50
<0.50
<0.50
<0.50
35. trans-1,3-Dichloropropene
<0.50
<0.50
<0.50
<0.50
<0.50
36. Ethylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
37. Hexachlorobutadiene
<0.50
<0.50
<0.50
<0.50
<0.50
38. Isopropylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
39. 4-Isopropyltoluene
<0.50
<0.50
<0.50
<0.50
<0.50
40. Methylene Chloride
<0.50
<0.50
<0.50
<0.50
<0.50
41. Naphthalene
<0.50
<0.50
<0.50
<0.50
<0.50
42. Propylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
43. Styrene
<0.50
<0.50
<0.50
<0.50
<0.50
44. 1,1,1,2 -Tetrachloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
45. 1,1,2,2 -Tetrachloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
46. Tetrachloroethene
<0.50
<0.50
<0.50
<0.50
<0.50
47. Toluene
<0.50
<0.50
<0.50
<0.50
<0.50

Environment 1, Inco
P.O. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
CLIENT: AVOCA, INC. (WASTEWATER)
MR. BRIAN CONNER
P.O. BOX 129
MERRY HILL, NC 27957
REVIEWED BY:
skt lkL Driaking Water IDI 7977
Wastewater ID: 10"
PHONE [phone]
FAX [phone]
CLIENT ID: 132
VOLATILE ORGANICS
STD. METHODS 6200C (97)
ANALYST: MAO
DATE COLLECTED: 11/16/16 Page: 2
DATE REPORTED: 12/16/16
Date Analyzed:
PARAMETERS, ug/1
11/29/16
Well
#4
11/29/16
Well
k5
11/29/16
Well
k6
11/29/16
Well
k7
11/30/16
Well
N8
48. 1,2,3-Trichlorobenzene
<0.50
<0.50
< 0.50
<0.50
<0.50
49. 1,2,4-Trichlorobenzene
< 0.50
<0.50
< 0.50
<0.50
<0.50
50. 1,1,1 -Trichloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
51. 1,1,2 -Trichloroethane
<0.50
<0.50
<0.50
<0.50
<0.50
52. Trichloroethene
<0.50
< 0.50
<0.50
< 0.50
< 0.50
53. Trichlorofluoromethane
<0.50
<0.50
<0.50
<0.50
<0.50
54. 1,2,3-Trichloropropane
<0.50
<0.50
<0.50
<0.50
<0.50
55. 1,2,4-Trimethylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
56. 1,3,5-Trimethylbenzene
<0.50
<0.50
<0.50
<0.50
<0.50
57. Vinyl Chloride
<0.50
<0.50
<0.50
<0.50
<0.50
58. Total Xylenes
<.1.00
<1.00
<1.00
<1.00
<1.00
59. Methyl Tert Butyl Ether
<1.00
<1.00
<1.00
<1.00
<1.00

MLaboratories -c
a member of The GEL Group INC
December 04, 2016
Ms. Deedee Woolard
Environment One, Inc.
114 Oakmont Drive
Greenville, North Carolina 27858
Re: Routine Analysis - Woolard
Work Order: 411096
SDG: 132
Dear Ms. Woolard:
:;4712 GTIMmm,SC 24,TY
D4 ry., Baa cnanescnSE, s4or
P ;9s.LSti 31:1
F
GEL Laboratories, LLC (GEL) appreciates the opportunity to provide the enclosed analytical results for the
sample(s) we received on November 21, 2016. This original data report has been prepared and reviewed in
accordance with GEL's standard operating procedures.
Our policy is to provide high quality, personalized analytical services to enable you to meet your analytical needs
on time every time. We trust that you will find everything in order and to your satisfaction. If you have any
questions, please do not hesitate to call me at [phone], ext. 4778.
Sincerely,
Hope Taylor
Project Manager
Purchase Order: 132 -BR -071713
Enclosures
Page 1 of 14
problem solved

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 — [phone] — www.gel.com
Certificate of Analysis Report
for
ENV0001 Environment One, Inc.
Client SDG: 132 GEL Work Order: 411096
The Qualifiers in this report are defined as follows:
* A quality control analyte recovery is outside of specified acceptance criteria
** Analyte is a Tracer compound
** Analyte is a surrogate compound
H Analytical holding time was exceeded
J Value is estimated
U Analyte was analyzed for, but not detected above the MDL, MDA, MDC or LOD,
Where the analytical method has been performed under NELAP certification, the analysis has met all of the
requirements of the NELAC standard unless qualified on the Certificate of Analysis.
The designation NO, if present, appears in the result column when the analyte concentration is not detected above
the limit as defined in the 'U' qualifier above.
This data report has been prepared and reviewed in accordance with GEL Laboratories LLC
standard operating procedures. Please direct any questions to your Project Manager, Hope Taylor.
Reviewed by Q a
Page 2 of 14

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 - [phone] - www.gel.com
Certificate of Analysis
Report Date: December 4, 2016
Company: Environment One, Inc.
Address : 114 Oakmont Drive
Greenville, North Carolina 27858
Contact:
Project:
Ms. Deedee Woolard
Routine Analysis - Woolard
Client Sample ID:
Well #4
Sample ID:
411096002
Matrix:
Ground Water
Collect Date:
16-NOV-16 10:26
Receive Date:
21-NOV-16
Collector:
Client
Project: ENV000113
Client ID: ENV0001
Parameter Qualifier Result DL RL Units PF DF Analyst Date Time Batch Method
Ion Chromatography
EPA300.0 Bromide Liquid "As Received"
Bromide 1 0.112 0.067 0.200 mg/L I MXL2 1129116 1545 1619620 1
The following Analytical Methods were performed:
Method Description Analyst Comments
1 EPA 300.0
Notes:
Column headers are defined as follows
DF: Dilution Factor Lc/LC: Critical Level
DL: Detection Limit PF: Prep Factor
MDA: Minimum Detectable Activity RL: Reporting Limit
MDC: Minimum Detectable Concentration SQL: Sample Quantitation Limit
Page 3 of 14

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 - [phone] - www.gel.com
Certificate of Analysis
Report Date: December 4, 2016
Company : Environment One, Inc.
Address : 114 Oakmont Drive
Greenville, North Carolina 27858
Contact:
Ms. Deedee Woolard
Project:
Routine Analysis - Woolard
Client Sample ID:
Well #5
Sample ID:
411096003
Matrix:
Ground Water
Collect Date:
16-NOV-16 11:07
Receive Date:
21-NOV-16
Collector:
Client
Project: ENV000113
Client ID: ENV0001
Parameter Qualifier Result DL RL Units PF DF Analyst Date Time Batch Method
[on Chromatography
EPA300.0 Bromide Liquid "As Received"
Bromide 9.31 0.335 1.00 mg/L 5 MM2 1129/16 1819 1619620 1
The following Analytical Methods were performed:
1 EPA 300.0
Notes:
Column headers are defined as follows
DF: Dilution Factor Lc/LC: Critical Level
DL: Detection Limit PF: Prep Factor
MDA: Minimum Detectable Activity RL: Reporting Limit
MDC: Minimum Detectable Concentration SQL: Sample Quantitation Limit
Page 4 of 14

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 - [phone] - www.gel.com
Certificate of Analysis
Report Date: December 4, 2016
Company: Environment One, Inc.
Address : 114 Oakmont Drive
Greenville, North Carolina 27858
Contact:
Ms. Deedee Woolard
Project:
Routine Analysis - Woolard
Client Sample ID:
Well #6
Sample ID:
411096004
Matrix:
Ground Water
Collect Date:
16-NOV-16 11:45
Receive Date:
21-NOV-16
Collector:
Client
Project: ENV000113
Client ID: ENV0001
Parameter Qualifier Result DL RL Units PF DF Analyst Date Time Batch Method
Ion Chromatography
EPA300.0 Bromide Liquid "As Received"
Bromide 0.247 0.067 0.200 mg/L 1 MXL2 11/28/16 1643 1619620 l
The following Analytical Methods were uerformed:
I
Notes:
EPA 300.0
Column headers are defined as follows
DF: Dilution Factor Lc/LC: Critical Level
DL: Detection Limit PF: Prep Factor
MDA: Minimum Detectable Activity RL: Reporting Limit
MDC: Minimum Detectable Concentration SQL: Sample Quantitation Limit
Page 5 of 14

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 - [phone] - www.gel.com
Certificate of Analysis
Company: Environment One, Inc.
Address : 114 Oakmont Drive
Greenville, North Carolina 27858
Contact:
Ms. Deedee Woolard
Project:
Routine Analysis - Woolard
Client Sample ID:
Well #7
Sample ID:
411096005
Matrix:
Ground Water
Collect Date:
16-NOV-16 01:30
Receive Date:
21-NOV-16
Collector:
Client
Report Date: December 4, 2016
Project: ENV000113
Client ID: ENV0001
Parameter Qualifier Result DL RL Units PF DF Analyst Date Time Batch Method
Ion Chromatography
EPA300.0 Bromide Liquid "As Received"
Bromide 9.85 0.335 1.00 mg/L 5 MXL2 11/29/16 1848 1619620 1
The following Analytical Methods were performed:
I EPA
Notes:
Column headers are defined as follows
DF: Dilution Factor Lc/LC: Critical Level
DL: Detection Limit PF: Prep Factor
MDA: Minimum Detectable Activity RL: Reporting Limit
MDC: Minimum Detectable Concentration SQL: Sample Quantitation Limit
Page 6 of 14

GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 - [phone] - www.gel.com
Certificate of Analvsis
Company: Environment One, Inc.
Address: 114 Oakmont Drive
Greenville, North Carolina 27858
Contact:
Ms. Deedee Woolard
Project:
Routine Analysis - Woolard
Client Sample ID:
Well #8
Sample ID:
411096006
Matrix:
Ground Water
Collect Date:
16-NOV-16 12:32
Receive Date:
21-NOV-16
Collector:
Client
Report Date: December 4, 2016
Project: ENV000113
Client ID: ENVOOOI
Parameter Qualifier Result DL RL Units PF DF Analyst Date Time Batch Method
Ion Chromatography
EPA300.0 Bromide Liquid "As Received"
Bromide 10.2 0.335 1.00 m1/L 5 MM 11/29/16 1917 1619620 1
The following Analytical Methods were performed:
Method Description Analvst Comments
1 EPA 300.0
Notes:
Column headers are defined as follows:
DF: Dilution Factor Lc/LC: Critical Level
DL: Detection Limit PF: Prep Factor
MDA: Minimum Detectable Activity RL: Reporting Limit
MDC: Minimum Detectable Concentration SQL: Sample Quantitation Limit
Page 7 of 14

GEL LABORATORIES LLC
2040 Savage Road Charleston, SC 29407 - [phone] - www.gel.com
QC Summary Report Date: December 4, 2016
Environment One, Inc. Page 1 of 2
114 Oakmont Drive
Greenville, North Carolina
Contact: Ms. Deedee Woolard
Workorder: 411096
Parmname NOM Sample Quad QC Units RPD% REC% Range Anlst Date Time
hon Chromatography
Batch 1619620
QC1203678648 411096006 DUP
Bromide 10.2 10.1 mg/L 0.814 (0%-20°/6) MXL2 11/29/1619:46
QC1203678647 LCS
Bromide 1.25
QC1203678646 MB
Bromide U
QC1203678649 411096006 PS
Bromide 1.25 2.05
Notes:
1.25
mg(L
100 (90'Y 110%)
1128/16 15:16
ND
mg/L
1128/1614:47
3.27
mg/L
98.2 (90%-110%)
1129/16 20:15
The Qualifiers in this report are defined as follows:
< Result is less than value reported
> Result is greater than value reported
B The target analyte was detected in the associated blank.
E General Chemistry --Concentration of the target analyte exceeds the instrument calibration range
H Analytical holding time was exceeded
J Value is estimated
N/A RPD or%Recovery limits do not apply.
N I See case narrative
ND Analyte concentration is not detected above the detection limit
NJ Consult Case Narrative, Data Summary package, or Project Manager concerning this qualifier
Q One or more quality control criteria have not been met. Refer to the applicable narrative or DER.
R Per section 9.3.4.1 of Method 1664 Revision B, due to matrix spike recovery issues, this result may not be reported or used for regulatory compliance
purposes.
R Sample results are rejected
U Analyte was analyzed for, but not detected above the MDL, MDA, MDC or LOD.
X Consult Case Narrative, Data Summary package, or Project Manager concerning this qualifier
Z Paint Filter Test --Particulates passed through the filter, however no free liquids were observed.
^ RPD of sample and duplicate evaluated using +/-RL. Concentrations are <5X the R.L. Qualifier Not Applicable for Radiochemistry.
it 5 -day BOD --The 2:1 depletion requirement was not met for this sample
e 5 -day BOD --Test replicates show more than 30% difference between high and low values. The data is qualified per the method and can be used for
reporting purposes
Page 8 of 14

GEL LABORATORIES LLC
2040 Savage Road Charleston, SC 29407 - [phone] - www.gel.com
QC Summary
Workorder: 411096 Page 2 o 2
Parmname NOM Sample Qual QC Unita RPD% REC% Ranee Anlst Date Time
Preparation or preservation holding time was exceeded
N/A indicates that spike recovery limits do not apply when sample concentration exceeds spike conc. by a factor of 4 or more or %RPD not applicable.
A The Relative Percent Difference (RPD) obtained from the sample duplicate (DUP) is evaluated against the acceptance criteria when the sample is greater than
five times (5X) the contract required detection limit (RL). In cases where either the sample or duplicate value is less than 5X the RL, a control limit of+/- the
RL is used to evaluate the DUP result.
• Indicates that a Quality Control parameter was not within specifications.
For PS, PSD, and SD1LT results, the values listed are the measured amounts, not final concentrations.
Where the analytical method has been performed under NELAP certification, the analysis has metall of the
requirements of the NELAC standard unless qualified on the QC Summary.
Page 9 of 14

General Chemistry
Technical Case Narrative
Environment One, Inc. (ENVO)
SDG #: 132
Work Order #: 411096
Product: Ion Chromatography
Analytical Method: EPA 300.0
Analytical Procedure: GL -GC -E-086 REV# 25
Analytical Batch: 1619620
The following samples were analyzed using the above methods and analytical procedure(s).
GEL Sample ID#
Client Sample Identification
411096002
Well #4
411096003
Well #5
411096004
Well #6
411096005
Well #7
411096006
Well #8
1203678646
Method Blank (MB)
1203678647
Laboratory Control Sample (LCS)
1203678648
411096006(Well #8) Sample Duplicate (DUP)
1203678649
411096006(Well #8) Post Spike (PS)
The samples in this SDG were analyzed on an "as received" basis.
Data Summary
All sample data provided in this report met the acceptance criteria specified in the analytical methods and
procedures for initial calibration, continuing calibration, instrument controls and process controls where
applicable, with the following exceptions.
Technical Information
Sample Dilutions
The following samples 1203678648 (Well #SDUP), 1203678649 (Well #8PS), 411096003 (Well #5),411096005
(Well #7) and 411096006 (Well 98) were diluted because target analyte concentrations exceeded the calibration
range. Dilutions may be required for many reasons, including to minimize matrix interferences or to bring over
range target analyte concentrations into the linear calibration range.
411096
Analyte
Oar 005 006
Bromide I 5X I 5X I 5X
Miscellaneous Information
Manual Integrations
Sample 411096002 (Well #4) were manually integrated to correctly position the baseline as set in the calibration
standards.
Page 10 of 14

Certification Statement
Where the analytical method has been performed under NELAP certification, the analysis has met all of the
requirements of the NELAC standard unless otherwise noted in the analytical case narrative.
Page 11 of 14

w i
z
�Ivirotttuent'A, Ltc.
r
1;9 -Box 7085, 114 Oakmont Dr.
CCddeenville, NC 27858
c1tvironmentline.com
DISINFPCFfON
Phone [phone] • 1--14'[phone]
COLLECTION
Ij CHLORINE
CLIENT: 132 Week; 46
o
SAMPLE LOCATION
Ij UV
AVOCA, INC. (WASTEWATER)
MR. BRIAN CONNER
NONE
P.O. BOX 129
MERRY HILL NC 27957
[phone]
z
y
r
z�
COLLECTION
<
o
a
o
SAMPLE LOCATION
DATE
TIME
Fp
Effluent�m
lI l(, lL
s
Well p4
/l l(, r6
M.'Jb
D.D
13
Well bS
1 (6
11 of
II�
Well #6
//4A&
5
/25
11
Well //7
1"3z)
'.2 D
11
Well s8
////b�rd'V:
"01
39
al,D
11
EY (S G) ( PIER) ` D TE/RME R VE BY
l /f l'lDAT IME
BY(SIG.) hu DATE/f1ME RS
BY (SIG.)
CHAIN OF CUSTODY RECORD
Page�o(_
CHLORINE NEUTRALIZED AT COLLECTION
pH CHECI( (LAB)
P r r P P r r G G G CONTAINER TYPE, PIG _
A C C A A A A A E E E CHEMICALPRESERVATION
------------
A-NONE D -NADH
tz w
B-HNOa E -HCL
C-HiSO, F-71NCACETATE/NAOH
aG-NATHIOSULFATE
1/7f//v 1 81 -yr
COMMENTS:
S
CLASSIFICATION:
WASTEWATER(NPDES)
ILI DRINKINGWATER
DWQGW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURIN HIP ENT/DELIVERY
Y N
SAMPLES COLLECTED BY.
(Please Print)
SAMPLES RECEIVED IN LAB AT 6 °C
- 4`c h- ror�
PLEASE READ Instructions for completing Ihis form on the reverse side Sampler must place a "C" for composite sample or a "G" for
Fonts as Grab sample in Ilia blocks above lot each parameter requested. NO 322194'

® LaboratOrleS u.c
SAMPLE RECEIPT & REV IEW FORM
Client: F—�d�l� SDG/ARICOC(Work Order: I (o) a
Received By: Date Received: ) 21
-If Net Counts IOOcpm on samples am marked -radioactive', contact the Radiation Safety Croup for Further
Suspected Bazerd Information Z investigation.
COC/Somples marked as radioactive? Maximum Net Counts Observed- (Observed Counts - Arra Background Conten):
goryl
Classified Radioactive 11 or M by RSO? If yes. Were swipes Laken of sample containers < action levels?
COC/Samples marked containing PCBs?
Package, COC, and/or Samples marked as
segregated as Safety Controlled Samples, and opened by the GEL Safely oup.
beryllium cr asbealos eunLainioq? If yes, samples are to be se C
Shippd $aDOT Hazmdousi H.zmd Class Shipped: UNN:
Sam les identified as Foreign Soil?
Sample Receipt Criteria
Z •�°
Cormnents/QualiBors(Required for Non-Confunnine Items)
Shipping containesreeeived intact and
Circle Amd
pplkable: 5ea,litoken Daagedr.rudiier lyalngeamwiner Odmr(describe)
1
sealed?
2
Samples requiring cold preservation
Preervminn Mdhod! lmbsgoner Blueirs Dryim Other(descvibe)
•all in Celsius
within (0 <6 deg. C)?a
semperamres are recorded
s -r
2a
Daily check performed and passed on Ra
Tem aaaaae Device Sedad 0:
Sccoadwy Temperature Device Smal r(If Applicable): )_�3^PtiIp��? \
temperature gun?
L
Chain of custody documents included
3
with shipment?
Circle Applicable Seelshroken Damaged container Irakingronctiner Other(doesibe)
4
Sample containers intact and sealed?
Samples requiringchemical preservation
_
Sampl,10',containers affectedind observed pit:
S
at proper pH?
Do Low Level Perchlorate samples have
Sample IV, ..it n comaineeffmvd:
6
hcadspace as required?
7
VOA vials wnroin acid preservation?
(If unlmown, sden No)
VOA vials free of hcadspace (defined as
Sample rat anal comaioen affected:
S
<6man, bubble)?
9
Are Encore containers present?
(try., Immediately deliverm Voleiilest&ormory)
ID's end teas affected:
10
Samples received within holding bun?
Sample ID's on COC match UYS on
Sample ID's and containers affected:
11
bottles?
12
Date & time im COC match date & 6nm
Sample ID's affected:
I f
on bottles?
I,I fq , pr7 I65- /IW ` i5 1 7
Number of containers received match
SamplelD'saffceed: '
13
number indicated on COC?
Are sample containers identifiable as
14
GEL rovided?
Is
COC form is propaiy signed in
relict uished/teeeived sections?
C' 4 nlirable,
FedEx Air FedEx Ground UPS Field Services Courier Other
16
Carriera al tracking number.
i zoos D3 cgs* 93��
Comments (Use Comi... tion Form if needed):
PM (or PMA) review: Initials _:S7 L page -of
GL -CHL -SR -001 Rev 3
Page 13 of 14

List of current GEL Certifications as of 04 December 2016
State
Certification
Alaska
UST
-0110
Arkansas
88-0651
CLIA
42DO904046
California
2940
Colorado
SC00012
Connecticut
PH -0169
Delaware
SC00012
DoD ELAP/ IS017025 A2LA
2567.01
Florida NELAP
E87156
Foreign Soils Permit
P330 -15-00283,P330-15-00253
Georgia
SC00012
Georgia SDWA
967
Hawaii
SC00012
Idaho Chemistry
SC00012
Idaho Radiochemistry
SC00012
Illinois NEI AP
200029
Indiana
C—SC-01
Kansas NELAP
E-10332
Kentucky SDWA
90129
Kentucky Wastewater
90129
Louisiana NELAP
03046 (A133904)
Louisiana SDWA
LA170010
Maryland
270
Massachusetts
M—SCO12
Michigan
9976
Mississippi
SC00012
Nebraska
NE—OS-26-13
Nevada
SC000122016-1
New Hampshire NELAP
205415
New Jersey NELAP
SCO02
New Mexico
SC00012
New York NELAP
11501
North Carolina
233
North Carolina SDWA
45709
North Dakota
R-158
Oklahoma
9904
Pennsylvania NELAP
68-00485
S.Carolina Radchem
10120002
South Carolina Chemistry
10120001
Tennessee
TN 02934
Texas NELAP
T104704235-16-11
Utah NELAP
SC000122016-21
Vermont
VT87156
V irginia NELAP
460202
Washington
C780
West Virginia
997404
Page 14 of 14

Envin n cent 1, Inc. CHAIN OF CUSTODY RECORD
P.Q. Bos 71195. U Oakmont Dr.
Greenville, NC 27855 Page 1 of 2
environment 1 inc.com
DISINFECTION
Phone 1'_52) 756-6208 • Fax [phone]
CHLORINE NEUTRALIZEDATCOLLECTION
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MR. BRIAN CONNER
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CHEMICALPRESERVATION
P.O. BOX 129
MERRY HILL NC 27957
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CHAIN OF CUSTODY (SEAL) MAINTAINED
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SAMPLES COLLECT ED BY.
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WAW-7��2 6 PZ -'9i
SAMPLES RECEIVED IN LAB AT & LL c
RELINUISHED BY (SIG.) (SAMPLER)
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PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for
FORM 05 Grab sample in the blocks above for each parameter requested. N4 322184

Environment I, Inc.
P.O. Box 7085. I1-1 Oakmont Dr.
Greenville. NC 27858
CHAIN Or CUS'T'ODY RECORD
Page 2 of 2
env iron menti ntC-Com
DISINFECTION
Phone [phone] • Fax (ISI-) 756-063,3
CHLORINE NEUTRALIZED AT COLLECTION
CHLORINE
CHECK
CLIENT: 132 Week: 46
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pH (LAB)
AVOCA, INC. (WASTEWATER)
MR. BRIAN CONNER
NONE
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CONTAINER TYPE, P/G
P.O. BOX 129
MERRY FALL NC 27957
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CHEMICAL PRESERVATION
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CLASSIFICATION:
WASTEWATER(NPOES)
Well N4
13
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Well #5
11
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DRINKINGWATER
Well N6
11
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SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING S IPMENT/DELIVERY
V N
SAMPLES COL CTEDBY.
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SAMPLES RECEIVED IN LAB AT
RELIN UISH�E"D BY�I(SIG.)(SAMPLER)
DATE/11ME fL}�
RECEIV BY IG.)
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COMMENTS:
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RELINQUISHED BY(SIG.) a
DATE/FIME
RECEIVED BY(SI .)
E/TIME
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RELINQUISHED BY (SIG.)
DATE/TIME
RECEIVED BY (SIG.)
DATEITIA
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for
FORM "`' Grab sample in the blocks above for each parameter requested. N?

Environment 1, Inco
P.O. BOX 7085, 114 OAKMONT DRIVE .0
GREENVILLE, N.C. 27835-7085
Md
EVERETT MARINE@ CYPRESS COVE MARINA
P.O. BOX 390
COLUMBIA ,NC 27925
Total Suspended Residue, mg/l
Oil & Grease (ITEM), mg/1
Aluminum, ugfl
Copper, ug/l
Lead, ug/1
Zinc, ug/1
Stormwater
Analysis
Method
(#I, Grab)
Date
Analyst
Code
67
12/05/16
KMH
2540D-97
48
12/02/16
SEJ
1664B
3743
12/07/16
LFJ
EPA200.7
2244
12/07/16
LFJ
EPA200.7
15
12/16/16
MTM
31136-04
520
12/07/16
LFJ
EPA200.7
pr�,¢k aq Nalar IDx 317 5.
Ka•lewater ID: 10
PHONE [phone]
FAX [phone]
ID#: 403
DATE COLLECTED: 12/01/16
DATE REPORTED : 12/16/16
REVIEWED 6Y:

Cnvironment 1, Inc. CHAIN OF CUSTODY RECORD
P.O. Box 7085, 114 Oakmont Dr.
Greenville, NC -27858 Page of
1 1
environment I inc.com
DISINFECTION
Phone [phone] • Fax [phone]
CHLORINE NEUTRALIZED AT COLLECTION
Ij CHLORINE
L
pHCHECK (LAB)
CLIENT: 403 Week: 44
uv
P
G
P
P
CONTAINER TYPE, P/G
EVERETT MARINE@ CYPRESS COVE MARI
NONE
P.O. BOX 390
A
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CHEMICAL PRESERVATION
COLUMBIA NC 27925
❑
A -NONE D-NAOH
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[phone]
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( 114
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CLASSIFICATION:
WASTEWATER(NPDES)
DRINKINGWATER
DWQ/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY (SEAL) MAINTAINED
DURING SHIPMENT/DELIVERY
N
SAMPLES COLLECTED BY:
(Please Print)
7__'C
SAMPLES RECEIVED IN LAB AT .
RELINQUISHED BY
TIME
RECEI BY
TETIME
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W
%
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RELINQUISH BY (SIG.)
ATFJRME
CEIVEDBY(SIG.)
ATETIME
ELINQUISHED BY (SIG.)
DATE/TIME
RECEIVED BY (SIG.)
DATETIME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a °C" for composite sample or a "G" for
FORM ns Grab sample in the blocks above for each parameter requested. N9 323890'