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HomeMy WebLinkAboutWQ0014785_Monitoring - 12-2016_20170120SUBMIT FORM ON YELLOW PAPER ONLY GROUNDWATER QUALITY MONITORING: COMPLIANCE REPORT FORM =ACILITY INFORMATION measePrintcieanyorType =acility Name: Midway Middle School 3ermit Name (if different): =acility Address: -9"n H1 S o(2e,L 24= Dunn (street( NC 28334 County Sampson (city) (stale) (Zip) act Person: Robert Carroll Telephone#: 910-385-6116 Location/Site Name: Spray Field Surface Drip No. of wells to be sampled: 2 PERMIT Number: Expiration Date: /iQ &I - o2b /'b Non -Discharge WQ0014785 UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery 0 Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump Other: Surface Drip /100mL If WELL L ID NUMBER (from Permit): MWi Date sample collected: 12-08-2016 Depth: 25 ft. Well Diameter: 2 in. 1 to Water Level 82546:5.7 ft. below measuring point Screened Interval: 5 ft. to 25 ft. luring Point is 3.0 ft. above land surface Relative M.P. Elevation: ft. ne of water pumped/bailed before sampling: 5 gallons )les for metals were collected unfiltered: 9 YES ❑ NO t YES LI NO FIELD ANALYSES: pH 00400: 4.8 units Spec. Cond. 00094: Odor 00085: none Appearance cloudy Temp. 000lo: /to- j_C µMhos DRY at time of sampling, check here: ❑ Date sample analyzed: 12-15-2016 Laboratory Name: Microbac Certification No. PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead o1051 ug/L Coliform: MF Fecal 31616 <1.0 /100mL Nitrate (NO3) as N 00620 0.290 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 <0.050 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Speci Compounds and Concentration Units): issolved Solids Total 703oo 38.0 mg/L Al - Alumir n.o11o5 mg/L � � "?—tn (Lab) 00403 5.0 units Ba - Barium 01007 ug/L r " TOC 00680 mg/L Ca - Calcium 00916 mg/L 2 ?n 17 Chloride 0094o 2.29 Arsenic 01002 mg/L uglL - Cd - Cadmium 01027 ug/L Chromium: Total 0103 i] uglL A _ (" Jlrt�! ftT ijel treat.. Grease and Oils 00552 mg/L Cu - Copper 01042 -{fn il r mg/L ORGANICS; (by GC, GCiM s-," 'i 11 Phenol 32730 o ug/L Fe - Iron 01045 ® I 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) pecific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 , method # 8260B Total Ammonia 00610 <0.10 mg/L Mg - Magnesium oo927 mg/L method # (Ammonia Nitrogen; Mass N; Ammonia Nitrogen, Total) Mn - Manganese 01066 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% ZA,,2- z,ge /Z14111 L Permittee (or Authorized Agent) Name an Title - Please print or type Signature of Permittee (or GW -59 Rev. 3-1-2016 ° (Date) Fayetteville Division Certificate of Analysis Sampson Co. Schools Date Reported: 12/29/16 Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Date Received: 12/08/16 Post Office Box 439 Date Sampled: 12/08/16 Clinton NC, 28328 Sampled By: Carroll M/Well #1, grab K6L0361-01 Analyte Result Units Analyzed Analyzed By Method Qualifier Analyzed by: Microbac Laboratories, Inc. - Ohio Valley 1,3-Dichloropropane <0.200 ug/L 12/20/16 17:14 TMB SW8260B 1,4 -Dichlorobenzene <0.125 ug/L 12/20/16 17:14 TMB SW8260B 2,2-Dichloropropane <0.250 ug/L 12/20/16 17:14 TMB SW8260B 2-Butanone <2.50 ug/L 12/20/16 17:14 TMB SW8260B 2-Chloroethyl vinyl ether <2.00 ug/L 12/20/16 17:14 TMB SW8260B 2-Chlorotoluene <0.125 ug/L 12/20/16 17:14 TMB SW8260B 2-Hexanone <2.50 ug/L 12/20/16 17:14 TMB SW8260B 4-Chlorotoluene <0.250 ug/L 12/20/16 17:14 TMB SW8260B 4-Methyl-2-pentanone <2.50 ug/L 12/20/16 17:14 TMB SW8260B Acetone <2.50 ug/L 12/20/16 17:14 TMB SW8260B Benzene <0.125 ug/L. 12/20/16 17:14 TMB SW8260B Bromobenzene <0.125 ug/L 12/20/16 17:14 TMB SW8260B Bromochloromethane <0.200 ug/L 12/20/16 17:14 TMB SW8260B Bromodichloromethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B Bromoform <0.500 ug/L 12/20/16 17:14 TMB SW8260B Bromomethane <0.500 ug/L 12/20/16 17:14 TMB SW8260B Carbon disulfide <0.500 ug/L 12/20/16 17:14 TMB SW8260B Carbon tetrachloride <0.250 ug/L 12/20/16 17:14 TMB SW8260B Chlorobenzene <0.125 ug/L 12/20/16 17:14 TMB SW8260B Chlorodibromomethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B Chloroethane <0.500 ug/L 12/20/1617:14 TMB SW8260B Chloroform <0.125 ug/L 12/20/16 17:14 TMB SW8260B Chloromethane <0.500 ug/L 12/20/16 17:14 TMB SW8260B cis-1,2-Dichloroethene <0.250 ug/L 12/20/16 17:14 TMB SW8260B cis-1,3-Dichloropropene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Dibromomethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B Dichlorodifluoromethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B Ethylbenzene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Hexachlorobutadiene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Isopropylbenzene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Microbac Laboratories, Inc. Page 2 of 8 2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com Fayetteville Division Certificate of Analysis Sampson Co. Schools Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Post Office Box 439 Clinton NC, 28328 Date Reported: 12/29/16 Date Received: 12/08/16 Date Sampled: 12/08/16 Sampled By: Carroll M/Well #1, grab K6L0361-01 Analyte Result Units Analyzed Analyzed By Method Qualifier Analyzed by: Microbac Laboratories, Inc. - Ohio Valley m -,p -Xylene <0.500 ug/L 12/20/16 17:14 TMB SW8260B Methylene chloride <0.250 ug/L 12/20/16 17:14 TMB SW8260B Naphthalene - <0.200 ug/L 12/20/16 17:14 TMB SW8260B n-Butylbenzene <0.250 ug/L 12/20/16 17:14 TMB SW8260B n-Propylbenzene <0.125 ug/L 12/20/16 17:14 TMB SW8260B o -Xylene <0.250 ug/L 12/20/16 17:14 TMB SW8260B p-Isopropyltoluene <0.250 ug/L, 12/20/16 17:14 TMB SW8260B sec-Butylbenzene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Styrene <0.125 ug/L 12/20/16 17:14 TMB SW8260B tert-Butylbenzene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Tetrachloroethene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Toluene <0.250 ug/L 12/20/16 17:14 TMB SW8260B trans-1,2-Dichloroethene <0.250 ug/L 12/20/16 17:14 TMB SW8260B trans-1,3-Dichloropropene <0.500 ug/L 12/20/16 17:14 TMB SW8260B Trichloroethene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Trichlorofluoromethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B Vinyl acetate <2.50 ug/L 12/20/16 17:14 TMB SW8260B Vinyl chloride <0.250 ug/L 12/20/16 17:14 TMB SW8260B Surrogate: 1,2-Dichloroethane-d4 88.3% 80%-120% 12120116 17:14 TMB SW8260B Surrogate: 4-BromoJluorobenzene 91.4% 86% - 115% 12120116 17:14 TMB SW8260B Surrogate: Dibromo luoromethane 89.7% 86%-118% 12120116 17:14 TMB SW8260B Surrogate: Toluene -d8 93.9% 88%-110% 12120116 17.14 TMB SW8260B Total Organic Carbon 4.63 mg/L 12/19/16 21:15 DIH E415.1 M/W #2, grab K6L0361-02 Analyte Result Units Analyzed Analyzed By Method Qualifier Field Data pH 4.8 pH Units 12/08/16 11:15 Carroll pH Microbac Laboratories, Inc. Page 3 of 8 2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com M I C R O B A C .n. Fayetteville Division Certificate of Analysis Sampson Co. Schools Date Reported: 12/29/16 Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Date Received: 12/08/16 Post Office Box 439 Date Sampled: 12/08/16 Clinton NC, 28328 Sampled By: Carroll M/W #2, grab K6L0361-02 Analyte Result Units Analyzed Analyzed By Method Qualifier Temperature 16.1 °C 12/08/16 11:15 Carroll Field Analyzed by: Microbac Laboratories, Inc. - Fayetteville Ammonia as N <0.100 mg/L 12/09/16 11:40 DSK SM 4500 NH3 C-1997 Chloride 25.2 mg/L 12/15/16 13:42 AC EPA 300.0, Rev. 2.1(1993) Coliform, Fecal <1.0 per 100 mL 12/08/16 16:27 JR SM 9222 D-1997 Nitrate as N 2.05 mg/L 12/15/16 13:42 AC EPA 300.0, Rev. 2.1 (1993) pH 4.7 pH Units 12/13/16 17:02 AC SM 4500 H+13-2000 H (Aqueous) Phosphorus, Total <0.050 mg/L 12/19/16 12:23 DSK SM 4500-P F-1999 Total Dissolved Solids 80.0 mg/L 12/09/16 15:38 JR SM 2540 C-1997 Analyzed by: Microbac Laboratories, Inc. - Ohio Valley 1,1,1,2 -Tetrachloroethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,1,1 -Trichloroethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,1,2,2 -Tetrachloroethane <0.200 ug/L, 12/20/16 23:36 ADC SW8260B 1,1,2 -Trichloroethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,1-Dichloroethane <0.125 ug/L 12/20/16 23:36 ADC SW8260B 1,1-Dichloroethene <0.500 ug/L 12/20/16 23:36 ADC SW8260B 1,1-Dichloropropene <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,2,3-Trichlorobenzene <0.150 ug/L 12/20/16 23:36 ADC SW8260B 1,2,3-Trichloropropane <0.500 ug/L 12/20/16 23:36 ADC SW8260B 1,2,4-Trichlorobenzene <0.200 ug/L 12/20/16 23:36 ADC SW8260B 1,2,4-Trimethylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,2-Dibromo-3-chloropropane <1.00 ug/L 12/20/16 23:36 ADC, SW8260B 1,2-Dibromoethane <0.250 ug/L, 12/20/16 23:36 ADC SW8260B 1,2 -Dichlorobenzene <0.125 ug/L 12/20/16 23:36 ADC SW8260B 1,2-Dichloroethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,2-Dichloropropane <0.200 ug/L 12/20/16 23:36 ADC SW8260B 1,3,5-Trimethylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,3 -Dichlorobenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,3-Dichloropropane <0.200 ug/L 12/20/16 23:36 ADC SW8260B 1,4 -Dichlorobenzene <0.125 ug/L 12/20/16 23:36 ADC SW8260B Microbac Laboratories, Inc. Page 4 of 8 2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com Fayetteville Division Certificate of Analysis Sampson Co. Schools Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Post Office Box 439 Clinton NC, 28328 Date Reported: 12/29/16 Date Received: 12/08/16 Date Sampled: 12/08/16 Sampled By: Carroll M/W #2, grab K6L0361-02 Analyte Result Units Analyzed Analyzed By Method Qualifier Analyzed by: Microbac Laboratories, Inc. - Ohio Valley 2,2-Dichloropropane <0.250 ug/L 12/20/16 23:36 ADC SW8260B 2-Butanone <2.50 ug/L 12/20/16 23:36 ADC SW8260B 2-Chloroethyl vinyl ether <2.00 ug/L 12/20/16 23:36 ADC SW8260B 2-Chlorotoluene <0.125 ug/L 12/20/16 23:36 ADC SW8260B 2-Hexanone <2.50 ug/L 12/20/16 23:36 ADC SW8260B 4-Chlorotoluene <0.250 ug/L, 12/20/16 23:36 ADC SW8260B 4-Methyl-2-pentanone <2.50 ug/L 12/20/16 23:36 ADC SW8260B Acetone <2.50 ug/L 12/20/16 23:36 ADC SW8260B Benzene <0.125 ug/L 12/20/16 23:36 ADC SW8260B Bromobenzene <0.125 ug/L 12/20/16 23:36 ADC SW8260B Bromochloromethane <0.200 ug/L 12/20/16 23:36 ADC SW8260B Bromodichloromethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B Bromoform <0.500 ug/L 12/20/16 23:36 ADC SW8260B Bromomethane <0.500 ug/L 12/20/16 23:36 ADC SW8260B Carbon disulfide <0.500 ug/L _ 12/20/16 23:36 ADC SW8260B Carbon tetrachloride <0.250 ug/L 12/20/16 23:36 ADC SW8260B Chlorobenzene <0.125 ug/L 12/20/16 23:36 ADC SW8260B Chlorodibromomethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B Chloroethane <0.500 ug/L 12/20/16 23:36 ADC SW8260B Chloroform <0.125 ug/L 12/20/16 23:36 ADC SW8260B Chloromethane <0.500 ug/L 12/20/16 23:36 ADC SW8260B cis-1,2-Dichloroethene <0.250 ug/L 12/20/16 23:36 ADC SW8260B cis-1,3-Dichloropropene <0.250 ug/L 12/20/16 23:36 ADC SW8260B Dibromomethane <0.250 ug/L. 12/20/16 23:36 ADC SW8260B Dichlorodifluoromethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B Ethylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B Hexachlorobutadiene <0.250 ug/L 12/20/16 23:36 ADC SW8260B Isopropylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B m -,p -Xylene <0.500 ug/L 12/20/16 23:36 ADC SW8260B Methylene chloride <0.250 ug/L 12/20/16 23:36 ADC SW8260B Microbac Laboratories, Inc. Page 5 of 8 2692 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com Fayetteville Division Certificate of Analysis Sampson Co. Schools Date Reported: 12/29/16 Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Date Received: 12/08/16 Post Office Box 439 Date Sampled: 12/08/16 Clinton NC, 28328 Sampled By: Carroll M/W #2, grab K6L0361-02 Analyte Result Units Analyzed Analyzed By Method Qualifier Analyzed by: Microbac Laboratories, Inc. - Ohio Valley Naphthalene <0.200 ug/L, 12/20/16 23:36 ADC SW8260B n-Butylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B n-Propylbenzene <0.125 ug/L 12/20/16 23:36 ADC SW8260B o -Xylene <0.250 ug/L 12/20/16 23:36 ADC SW8260B p-Isopropyltoluene <0.250 ug/L 12/20/16 23:36 ADC SW8260B sec-Butylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B Styrene <0.125 ug/L 12/20/16 23:36 ADC SW8260B tert-Butylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B Tetrachloroethene <0.250 ug/L 12/20/16 23:36 ADC SW8260B Toluene <0.250 ug/L 12/20/16 23:36 ADC SW8260B trans-l,2-Dichloroethene <0.250 ug/L 12/20/16 23:36 ADC SW8260B trans-l,3-Dichloropropene <0.500 ug/L 12/20/16 23:36 ADC SW8260B Trichloroethene <0.250 ug/L 12/20/16 23:36 ADC SW8260B Trichlorofluoromethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B Vinyl acetate <2.50 ug/L 12/20/16 23:36 ADC SW8260B Vinyl chloride <0.250 ug/L 12/20/16 23:36 ADC SW8260B Surrogate: 1,2-Dichloroethane-d4 89.5% 80%-120% 12/20/16 23:36 ADC SW8260B Surrogate: 4-Bromofluorobenzene 92.0% 86%-115% 12/20/16 23:36 ADC SW8260B Surrogate: Dibromofluoromethane 90.0% 86a/o - 118% 12120/16 23:36 ADC SW8260B Surrogate: Toluene -d8 91.8% 88%-110% 12120/16 23:36 ADC SW8260B Total Organic Carbon 3.19 mg/L 12/19/16 21:27 DIH E415.1 QC Batch Run - (Microbac Laboratories, lac. - Fayetteville) Analyte Result Units Source RPD Limit Phosphorus, Total 0.34 mg/L K61,0365 127 10 pH 7.5 pH Units K6L0422 0.1 200 pH 4.7 pH Units K61,0328 0.2 200 Phosphorus, Total 3.2 mg/L K6L0554 1 10 Phosphorus, Total 1.8 mg/L K61,0520 5 10 Phosphorus, Total 2.4 mg/L K61,0700 1 10 Microbac Laboratories, Inc. Page 6 of 8 2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com ICROBAc` Fayetteville Division Certificate of Analysis Sampson Co. Schools Date Reported: 12/29/16 Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Date Received: 12/08/16 Post Office Box 439 Date Sampled: 12/08/16 Clinton NC, 28328 Sampled By: Carroll QC Batch Run - (Microbac Laboratories, Inc. - Fayetteville) Analyte Result Units Source RPD Limit pH 8.2 pH Units K6L0223 0 200 Ammonia as N ND mg/L K6L0236 20 Chloride 9.21 mg/L K6L0065 118 10 Chloride 4.01 mg/L K6L0325 110 10 Nitrate as N 8.90 mg/L K6L0065 116 200 Total Dissolved Solids 3710 mg/L l K6L0304 0.5 5 Nitrate as N 3.58 mg/L K6L0325 117 200 QC Batch Run - (Microbac Laboratories, Inc. - Ohio !Valley) Analyte Result Units Source RPD Limit Notes and Definitions U Not detected at or above adjusted sample detection limit H Analyte was prepared and/or analyzed outside of the analytical method holding time * [Undefined] State Certifications: Respectfully Submitted NCDNR #11 NCDOH #37714- vvv Jeanne Overstreet, Project Manager Thank you for your business. We invite yourjeedback on our level of service to you. Please contact the Division Manager, Rob Dernier at 910-861-1910 H•irh any questions. You may also contact J. Trevor Boyce, President at president@microbac.com Microbac Laboratories, Inc. Page 7 of 8 2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com SUBMIT FORM ON YELLOW PAPER ONLY UNDWATER QUALITY MONITORING: PLIANCE REPORT FORM ILITY INFORMATION Please Print Clearly or Type ity Name: Midway Middle School tit Name (if different): ityAddress: //(s / csbc� _S—,tea✓� /�c G a% 33 County Sampson (city) (5tale) (zip) Contact Person: Robert Carroll Telephone#: 910-385-6116 Well Location/Site Name: Spray Field Surface Drip No. of wells to be sampled: 2 ce WELL ID NUMBER (from Permit): MW2 Date sample collected: 12-08-2016 Well Depth: 25 ft. Well Diameter: 2 in. Depth to Water Level 82546:6.2 ft. below measuring point. Screened Interval: 5 ft. Measuring Point is 3.0 ft. above land surface Relative M.P. Elevation: Volume of water pumped/bailed before sampling: 5 gallons Samples for metals were collected unfiltered: N YES ❑ NO and field acidified: ❑ YES ❑ PERMIT Number: Expiration Date: Non -Discharge WQ0014785 UIC NPDES Other TYPE OF PERMITTED OPERATION BEING MONITORED ❑ Lagoon ❑ Remediation: Infiltration Gallery ❑■ Spray Field ❑ Remediation: ❑ Rotary Distributor ❑ Land Application of Sludge ❑ Water Source Heat Pump 0 Other: Surface Drip to 25 ft. ft. FIELD ANALYSES: pH 00400: 4.7 units Spec. Cond. 00094: Odor 000s5: none Appearance cloudy Temp. 000lo:Aa . °C µMhos DRY at time of sampling, check here: ❑ )ate sample analyzed: 12-15-2016 Laboratory Name: Microbac Certification No. PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead o1o51 ug/L Coliform: MF Fecal 31616 <1.0 /100mL Nitrate (NO3) as N 00620 2.05 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 <0.050 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): )issolved Solids:Total 703oo 80.0 mg/L Al -Aluminum o11os _ mg/L pH (Lab) 00403 4.7 units Be - Barium 01007 ug/L TOC 00680 mg/L Ca - Calcium 00916 mg/L AN 2`3 2017 Chloride oo94o 25.2 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 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 71900 ug/L Lab Report Attached? 0 Yes (1) ❑ No (0) Specific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # 8260B Total Ammonia 00610 <0.10 mg/L Mg - Magnesium oo927 mg/L method # (Ammonia Nitrogen: N% as N: Ammonia Nitrogen. Total) Mn - Manganese,o1055 ug/L method # TKN as N 00625 mg/L Ni - Nickel o1067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% - �nm aKawni.�r-ra•tr-iutc��rfwr-or-uaur-i�uw.:r-uai4inmT _Permittee (or Authorized Agent) Name and Title - Please print or type GW -59 Rev. 3-1-2016 (Date) ,)MICROBAG`N' Fayetteville Division Certificate of Analysis Sampson Co. Schools Date Reported: 12/29/16 Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Date Received: 12/08/16 Post Office Box 439 Date Sampled: 12/08/16 Clinton NC, 28328 Sampled By: Carroll M/Well #1, grab K6L0361-01 Analyte Result Units Analyzed Analyzed By Method Qualifter Field Data pH Temperature 4.8 pH Units 15.9 °C Analyzed by: Microbac Laboratories, Inc. - Fayetteville Ammonia as N <0.100 Chloride 2.29 Coliform, Fecal <1.0 Nitrate as N 0.290 pH 5.0 mg/L mg/L per 100 mL mg/L pH Units Phosphorus, Total <0.050 mg/L Total Dissolved Solids 38.0 mg/L 12/08/16 11:15 12/08/16 11:15 12/09/16 11:40 12/15/16 13:42 12/08/16 16:27 12/15/16 13:42 12/13/16 17:02 12/19/16 12:23 12/09/16 15:38 Carroll, pH Carroll Field DSK SM 4500 NH3 C-1997 AC EPA 300.0, Rev. 2.1 (1993) JR SM 9222 D-1997 AC EPA 300.0, Rev. 2.1 (1993) AC SM 4500 H+13-2000 H SW8260B (Aqueous) DSK SM 4500-P F-1999 JR SM 2540 C-1997 Analyzed by: Microbac Laboratories, Inc. - Ohio Valley 1,1,1,2 -Tetrachloroethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B 1,1,1 -Trichloroethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B 1,1,2,2 -Tetrachloroethane <0.200 ug/L 12/20/16 17:14 TMB SW8260B 1,1,2 -Trichloroethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B 1,1-Dichloroethane <0.125 ug/L 12/20/16 17:14 TMB SW8260B 1,1-Dichloroethene <0.500 ug/L 12/20/16 17:14 TMB SW8260B 1,1-Dichloropropene <0.250 ug/L 12/20/16 17:14 TMB SW8260B 1,2,3-Trichlorobenzene <0.150 ug/L 12/20/16 17:14 TMB SW8260B 1,2,3-Trichloropropane <0.500 ug/L 12/20/16 17:14 TMB SW8260B 1,2,4-Trichlorobenzene <0.200 ug/L 12/20/16 17:14 TMB SW8260B 1,2,4-Trimethylbenzene <0.250 ug/L 12/20/16 17:14 TMB SW8260B 1,2-Dibromo-3-chloropropane <1.00 ug/L 12/20/16 17:14 TMB SW8260B 1,2-Dibromoethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B 1,2 -Dichlorobenzene <0.125 ug/L 12/20/16 17:14 TMB SW8260B 1,2-Dichloroethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B 1,2-Dichloropropane <0.200 ug/L 12/20/16 17:14 TMB SW8260B 1,3,5-Trimethylbenzene <0.250 ug/L 12/20/16 17:14 TMB SW8260B 1,3 -Dichlorobenzene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Microbac Laboratories; Inc. Page lo 8 2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com Fayetteville Division Certificate of Analysis Sampson Co. Schools Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Post Office Box 439 Clinton NC, 28328 Date Reported: 12/29/16 Date Received: 12/08/16 Date Sampled: 12/08/16 Sampled By: Carroll M/Well #1, grab K6L0361-01 Analyte Result Units Analyzed Analyzed By Method Qualifier Analyzed by: Microbac Laboratories, Inc. - Ohio Valley 1,3-Dichloropropane <0.200 ug/L 12/20/16 17:14 TMB SW8260B 1,4 -Dichlorobenzene <0.125 ug/L 12/20/16 17:14 TMB SW8260B 2,2-Dichloropropane <0.250 ug/L 12/20/16 17:14 TMB SW8260B 2-Butanone <2.50 ug/L 12/20/16 17:14 TMB SW8260B 2-Chloroethyl vinyl ether <2.00 ug/L 12/20/16 17:14 TMB SW8260B 2-Chlorotoluene <0.125 ug/L 12/20/16 17:14 TMB SW8260B 2-Hexanone <2.50 ug/L 12/20/16 17:14 TMB SW8260B 4-Chlorotoluene <0.250 ug/L 12/20/16 17:14 TMB SW8260B 4-Methyl-2-pentanone <2.50 ug/L 12/20/16 17:14 TMB SW8260B Acetone <2.50 ug/L 12/20/16 17:14 TMB SW8260B Benzene <0.125 ug/L 12/20/16 17:14 TMB SW8260B Bromobenzene <0.125 ug/L 12/20/16 17:14 TMB SW8260B Bromochloromethane <0.200 ug/L 12/20/16 17:14 TMB SW8260B Bromodichloromethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B Bromoform <0.500 ug/L 12/20/16 17:14 TMB SW8260B Bromomethane <0.500 ug/L 12/20/16 17:14 TMB SW8260B Carbon disulfide <0.500 ug/L 12/20/16 17:14 TMB SW8260B Carbon tetrachloride <0.250 ug/L 12/20/16 17:14 TMB SW8260B Chlorobenzene <0.125 ug/L 12/20/16 17:14 TMB SW8260B Chlorodibromomethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B Chloroethane <0.500 ug/L 12/20/16 17:14 TMB SW8260B Chloroform <0.125 ug/L 12/20/16 17:14 TMB SW8260B Chloromethane <0.500 ug/L 12/20/16 17:14 TMB SW8260B cis-1,2-Dichloroethene <0.250 ug/L 12/20/16 17:14 TMB SW8260B cis-1,3-Dichloropropene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Dibromomethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B Dichlorodifluoromethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B Ethylbenzene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Hexachlorobutadiene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Isopropylbenzene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Microbac Laboratories, Inc. Page 2 of 8 2692 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com MICR®BAC Fayetteville Division Certificate of Analysis Sampson Co. Schools Date Reported: 12/29/16 Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Date Received: 12/08/16 Post Office Box 439 Date Sampled: 12/08/16 Clinton NC, 28328 Sampled By: Carroll M/Well #1, grab K6L0361-01 Analyte r Result Units Analyzed Analyzed By Method Qualifier Analyzed by: Microbac Laboratories, Inc. - Ohio Valley m -,p -Xylene <0.500 ug/L 12/20/16 17:14 TMB SW8260B Methylene chloride <0.250 ug/L 12/20/16 17:14 TMB SW8260B Naphthalene <0.200 ug/L 12/20/16 17:14 TMB SW8260B n-Butylbenzene <0.250 ug/L 12/20/16 17:14 TMB SW8260B n-Propylbenzene <0.125 ug/L 12/20/16 17:14 TMB SW8260B o -Xylene <0.250 ug/L 12/20/16 17:14 TMB SW8260B p-Isopropyltoluene <0.250 ug/L 12/20/16 17:14 TMB SW8260B sec-Butylbenzene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Styrene <0.125 ug/L 12/20/16 17:14 TMB SW8260B tert-Butylbenzene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Tetrachloroethene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Toluene <0.250 ug/L 12/20/16 17:14 TMB SW8260B trans-1,2-Dichloroethene <0.250 ug/L 12/20/16 17:14 TMB SW8260B trans-1,3-Dichloropropene <0.500 ug/L 12/20/16 17:14 TMB SW8260B Trichloroethene <0.250 ug/L 12/20/16 17:14 TMB SW8260B Trichlorofluoromethane <0.250 ug/L 12/20/16 17:14 TMB SW8260B Vinyl acetate <2.50 ug/L 12/20/16 17:14 TMB SW8260B Vinyl chloride <0.250 ug/L 12/20/16 17:14 TMB SW8260B Surrogate: 1,2-Dichloroethane-d4 88.3% 80%-120% 12/20/16 17:14 TMB SW8260B Surrogate: 4-Bromofluorobenzene 91.4% 86%-115% 12/20/16 17:14 TMB SW8260B Surrogate: Dibromofluoromethane 89.7% 86%-118% 12/20/16 17:14 TMB SW8260B Surrogate: Toluene -d8 93.9% 88%-110% 12/20/16 17:14 TMB SW8260B Total Organic Carbon 4.63 mg/L 12/19/16 21:15 DIH E415.1 M/W #2, grab K6L0361-02 Analyte Result Units Analyzed Analyzed By Method Qualifier Field Data pH 4.8 pH Units 12/08/16 11:15 Carroll pH Microbac Laboratories, Inc. Page 3 of 8 2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com Fayetteville Division Certificate of Analysis Sampson Co. Schools i Date Reported: 12/29/16 Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Date Received: 12/08/16 Post Office Box 439 Date Sampled: 12/08/16 Clinton NC, 28328 Sampled By: Carroll 12/09/16 11:40 DSK M/W #2, grab K6L0361-02 Analyte Result Units Analyzed Analyzed By Method Qualifier Temperature 16.1 °C 12/08/16 11:15 Carroll Field Analyzed by: Microbac Laboratories, Inc. - Fayetteville Ammonia as N <0.100 mg/L 12/09/16 11:40 DSK SM 4500 NH3 C-1997 Chloride 25.2 mg/L 12/15/16 13:42 AC EPA 300.0, Rev. 2.1(1993) Coliform, Fecal <1.0 per 100 mL 12/08/16 16:27 JR SM 9222 D-1997 Nitrate as N 2.05 mg/L 12/15/16 13:42 AC EPA 300.0, Rev. 2.1 (1993) pH 4.7 pH Units 12/13/16 17:02 AC SM 4500 H+B-2000 H (Aqueous) Phosphorus, Total <0.050 mg/L 12/19/16 12:23 DSK SM 4500-P F-1999 Total Dissolved Solids 80.0 mg/L 12/09/16 15:38 JR SM 2540 C-1997 Analyzed by: Microbac Laboratories, Inc. - Ohio Valley 1,1,1,2 -Tetrachloroethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,1,1 -Trichloroethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,1,2,2 -Tetrachloroethane <0.200 ug/L 12/20/16 23:36 ADC SW8260B 1,1,2 -Trichloroethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,1-Dichloroethane <0.125 ug/L 12/20/16 23:36 ADC SW8260B 1,1-Dichloroethene <0.500 ug/L 12/20/16 23:36 ADC SW8260B 1,1-Dichloropropene <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,2,3-Trichlorobenzene <0.150 ug/L 12/20/16 23:36 ADC SW8260B 1,2,3-Trichloropropane <0.500 ug/L 12/20/16 23:36 ADC SW8260B 1,2,4-Trichlorobenzene <0.200 ug/L 12/20/16 23:36 ADC SW8260B 1,2,4-Trimethylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,2-Dibromo-3-chloropropane <1.00 ug/L 12/20/16 23:36 ADC , SW8260B 1,2-Dibromoethane <0.250 ug/L, 12/20/16 23:36 ADC SW8260B 1,2 -Dichlorobenzene <0.125 ug/L 12/20/16 23:36 ADC SW8260B 1,2-Dichloroethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,2-Dichloropropane <0.200 ug/L 12/20/16 23:36 ADC SW8260B 1,3,5-Trimethylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,3 -Dichlorobenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B 1,3-Dichloropropane <0.200 ug/L 12/20/16 23:36 ADC SW8260B 1,4 -Dichlorobenzene <0.125 ug/L 12/20/16 23:36 ADC SW8260B Microbac Laboratories, Inc. Page 4 of 8 2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920_p 1910.864.8774 f I www.microbac.com Fayetteville Division Certificate of Analysis Sampson Co. Schools Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Post Office Box 439 Clinton NC, 28328 Date Reported: 12/29/16 Date Received: 12/08/16 Date Sampled: 12/08/16 Sampled By: Carroll M/W #2, grab K6L0361-02 Analyte Result Units Analyzed Analyzed By Method Qualifier Analyzed by: Microbac Laboratories, Inc. - Ohio Valley 2,2-Dichloropropane <0.250 ug/L 12/20/16 23:36 ADC SW8260B 2-Butanone <2.50 ug/L 12/20/16 23:36 ADC SW8260B 2-Chloroethyl vinyl ether <2.00 ug/L 12/20/16 23:36 ADC SW8260B 2-Chlorotoluene <0.125 ug/L 12/20/16 23:36 ADC SW8260B 2-Hexanone <2.50 ug/L 12/20/16 23:36 ADC SW8260B 4-Chlorotoluene <0.250 ug/L 12/20/16 23:36 ADC SW8260B 4-Methyl-2-pentanone <2.50 ug/L 12/20/16 23:36 ADC SW8260B Acetone <2.50 ug/L 12/20/16 23:36 ADC SW8260B Benzene <0.125 ug/L 12/20/16 23:36 ADC SW8260B Bromobenzene <0.125 ug/L, 12/20/16 23:36 ADC SW8260B Bromochloromethane <0.200 ug/L 12/20/16 23:36 ADC SW8260B Bromodichloromethane <0.250 ug/L, 12/20/16 23:36 ADC SW8260B Bromoform <0.500 ug/L 12/20/16 23:36 ADC SW8260B Bromomethane <0.500 ug/L 12/20/16 23:36 ADC SW8260B Carbon disulfide <0.500 ug/L 12/20/16 23:36 ADC SW826013, Carbon tetrachloride <0.250 ug/L 12/20/16 23:36 ADC SW8260B Chlorobenzene <0.125 ug/L 12/20/16 23:36 ADC SW8260B Chlorodibromomethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B Chloroethane <0.500 ug/L. 12/20/16 23:36 ADC SW8260B Chloroform <0.125 ug/L 12/20/16 23:36 ADC SW8260B Chloromethane <0.500 ug/L 12/20/16 23:36 ADC SW8260B cis-1,2-Dichloroethene <0.250 ug/L 12/20/16 23:36 ADC SW8260B ` cis-1,3-Dichloropropene <0.250 ug/L 12/20/16 23:36 ADC SW8260B Dibromomethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B Dichlorodifluoromethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B Ethylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B Hexachlorobutadiene <0.250 ug/L 12/20/16 23:36 ADC SW8260B Isopropylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B m -,p -Xylene <0.500 ug/L 12/20/16 23:36 ADC SW8260B Methylene chloride <0.250 ug/L 12/20/16 23:36 ADC SW8260B Microbac Laboratories, Inc. Page 5 of 8 2692 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com Fayetteville Division Certificate of Analysis Sampson Co. Schools Date Reported: 12/29/16 Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Date Received: 12/08/16 Post Office Box 439 Date Sampled: 12/08/16 Clinton NC, 28328 Sampled By: Carroll M/W #2, grab K6L0361-02 Analyte Result Units Analyzed Analyzed By Method Qualifier Analyzed by: Microbac Laboratories, Inc. - Ohio Valley Naphthalene <0.200 ug/L 12/20/16 23:36 ADC SW8260B n-Butylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B n-Propylbenzene <0.125 ug/L 12/20/16 23:36 ADC SW8260B o -Xylene <0.250 ug/L 12/20/16 23:36 ADC SW8260B p-Isopropyltoluene <0.250 ug/L 12/20/16 23:36 ADC SW8260B sec-Butylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B Styrene <0.125 ug/L, 12/20/16 23:36 ADC SW8260B tert-Butylbenzene <0.250 ug/L 12/20/16 23:36 ADC SW8260B Tetrachloroethene <0.250 ug/L 12/20/16 23:36 ADC SW8260B Toluene <0.250 ug/L 12/20/16 23:36 ADC SW8260B trans-l,2-Dichloroethene <0.250 ug/L 12/20/16 23:36 ADC SW8260B trans-1,3-Dichloropropene <0.500 ug/L 12/20/16 23:36 ADC SW8260B Trichloroethene <0.250 ug/L 12/20/16 23:36, ADC SW8260B Trichlorofluoromethane <0.250 ug/L 12/20/16 23:36 ADC SW8260B Vinyl acetate <2.50 ug/L. 12/20/16 23:36 ADC SW8260B Vinyl chloride <0.250 ug/L 12/20/16 23:36 ADC SW8260B Surrogate: 1,2-Dichloroethane-d4 89.5% 80%-120% 12120116 23:36 ADC SW8260B Surrogate: 4-Bromo luorobenzene '92.0% 86%-115% 12120116 23:36 ADC SW8260B Surrogate: Dibromo luoromethane 90.0% 86%-118% 12120116 23:36 ADC SW8260B Surrogate: Toluene -d8 91.8% 88%-110% 12120116 23:36 ADC SW8260B Total Organic Carbon 3.19 mg/L 12/19/16 21:27 DIH E415.1 QC Batch Run - (Microbac Laboratories, Inc. - Fayetteville) Analyte Result Units Source RPD Limit Phosphorus, Total 0.34 mg/L K6L0365 127 10 pH 7.5 pH Units K61,0422 0.1 200 pH 4.7 pH Units K6L0328 0.2 200 Phosphorus, Total 3.2 mg/L K6L0554 1 10 Phosphorus, Total 1.8 mg/L K61,0520 5 10 Phosphorus, Total 2.4 mg/L K61,0700 1 10 Microbac Laboratories, Inc. Page 6 of 8 2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com MACROBAC Fayetteville Division Certificate of Analysis Sampson Co. Schools Date Reported: 12/29/16 Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Date Received: 12/08/16 Post Office Box 439 Date Sampled: 12/08/16 Clinton NC, 28328 Sampled By: Carroll QC Batch Run - (Microbac Laboratories, Inc. - Fayetteville) Analyte Result Units Source RPD Limit pH 8.2 pH Units K6L0223 0 200 Ammonia as N ND mg/L K6L0236 20 Chloride 9.21 mg/L K6L0065 118 10 Chloride 4.01 mg/L K6L0325 110 10 Nitrate as N 8.90 mg/L K6L0065 116 200 Total Dissolved Solids 3710 mg/L K6L0304 0.5 5 Nitrate as N 3.58 mg/L K6L0325 117 200 QC Batch Run - (Microbac Laboratories, Inc. - 01do Valley) Analyte Result Units Source RPD Limit Notes and Definitions U Not detected at or above adjusted sample detection limit H Analyte was prepared and/or analyzed outside of the analytical method holding time ' [Undefined] State Certifications: NCDNR #I I NCDOH #37714 Respectfully Submitted �.LlLJ[11� t�i.�LLQ.�c� Jeanne Overstreet, Project Manager Thank you for your business. We invite yourfeedback on our level ofservice to you. Please contact the Division Manager, Roh Dernier at 910-864-1920 with any questions. You may also contact J. Trevor Boyce, President at president@nticrobac.com Microbac Laboratories, Inc. Page 7 of 8 2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com e n Fayetteville Division Certificate of Analysis Sampson Co. Schools Date Reported: 12/29/16 Mr. Robert Carroll Project: M/W Samples - Midway Middle - Dec Date Received: 12/08/16 Post Office Box 439 Date Sampled: 12/08/16 Clinton NC, 28328 Sampled By: Carroll 0.290 pH M/Well #1, grab K6L0361-01 Analyte Result Units Analyzed Analyzed By Method Qualifier Field Data pH 4.8 Temperature 15.9 Analyzed by: Microbac Laboratories, Inc. - Fayetteville Ammonia as N <0.100 Chloride 2.29 Coliform, Fecal <1.0 Nitrate as N 0.290 pH 5.0 Phosphorus, Total <0.050 Total Dissolved Solids 38.0 Analyzed by: Microbac Laboratories, Inc.- Ohio Valley 1,1,1,2 -Tetrachloroethane <0.250 1,1,1 -Trichloroethane <0.250 1,1,2,2 -Tetrachloroethane <0.200 1,1,2 -Trichloroethane <0.250 1,1-Dichloroethane <0.125 1,1-Dichloroethene <0.500 1,1-Dichloropropene <0.250 1,2,3-Trichlorobenzene <0.150 1,2,3-Trichloropropane <0.500 1,2,4-Trichlorobenzene <0.200 1,2,4-Trimethylbenzene <0.250 1,2-Dibromo-3-chloropropane <1.00 1,2-Dibromoethane <0.250 1,2 -Dichlorobenzene <0.125 1,2-Dichloroethane <0.250 1,2-Dichloropropane <0.200 1,3,5-Trimethylbenzene <0.250 1,3 -Dichlorobenzene <0.250 pH Units 12/08/16 11:15 Carroll pH °C 12/08/16 11:15 Carroll Field mg/L 12/09/16 11:40 mg/L 12/15/16 13:42 per 100 mL 12/08/16 16:27 mg/L 12/15/16 13:42 pH Units 12/13/16 17:02 mg/L 12/19/16 12:23 mg/L 12/09/16 15:38 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 ug/L 12/20/16 17:14 DSK SM 4500 NH3 C-1997 AC EPA 300.0, Rev. 2.1 (1993) JR SM 9222 D-1997 AC EPA 300.0, Rev. 2.1 (1993) AC SM 4500 H+13-2000 H (Aqueous) DSK SM 4500-P F-1999 JR SM 2540 C-1997 TMB TMB TMB TMB TMB TMB TMB TMB TMB TMB TMB TMB TMB TMB TMB TMB TMB TMB SW8260B SW8260B SW8260B SW8260B SW8260B SW8260B SW8260B SW8260B SW8260B SW8260B SW8260B SW8260B SW8260B SW8260B SW8260B SW8260B SW8260B SW8260B Microbac Laboratories, Inc. Page 1 of 8 2592 Hope Mills Road I Fayetteville, NC 28306 1910.864.1920 p 1910.864.8774 f I www.microbac.com ` NON -DISCHARGE APPLICATION REPORT Page of SPRAY IRRIGATION SITE(S) THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED. PERMIT NUMBER: WQ0014785 MONTH: YEAR: Zo/L r FACILITY NAME: Midway Middle School COUNTY: _ Sampson Formulas: Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feel/gallon) x 12 (inches/foot)] / [Area Sprayed (acres) x 43,560 (square feellacre)) OR = Volume Acplied (gallons); [Area Sprayed (acres) x 27,152 (gallcnslacre-inch)] Monthly Hourly Loading (inches) = maximum inches applied over a one hourperiod forthat day Monthly Loading (inches) = Sum of Daily Loadings (inches) 12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings Cinches) Average Weekly Loading (inches) = [Monthly Loading (inches/month) / Number of days in the month (days/month)] x 7 (dayslweek) Did Irrigation Occur At This Facility: Did Irrigation Occur On This Field: Yes: ❑ No: 2r Yes: ❑ No: a Did Irrigation Occur On This Field: Yes: ❑ No: ❑ ...................................... FIELD NUMBER: 1 AREA SPRAYED (acres): 3.47 COVERCROP:1 R e PERMITTED HOURLY RATE (inches): 0.16 FIELD NUMBER: AREA SPRAYED (acres): COVER CROP: PERMITTED HOURLY RATE (inches): WEATHER CONDITIONS PERMITTED YEARLY RATE (inches): 39 PERMITTED YEARLY RATE (inches): D A T E Storage Temper- Lagoon Weather � ature at Preeipita- Fr a. Code application tion board Volume Time Dail Y Applied Irrigated Loading_Loading Maximum Hourly Y Volume Time Applied Irrigated Dail Y Loading Maximum Hourly Y Loading IT) inches feet gallons minutes inches inches gallons minutes inches inches 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 p 23 �? 4 24 25 D 26 27 D - 28it TION FRU /f , ,). 29 30 31 d Total Gallons/Monthly Loading (inches) C2 ll 0 0.00 12 Month Floating Total (inches) :::::::; ; ::;:; ; ; ; ; :::; :=; ; ::::: Average Weekly Loading (inches),:: 0 Weather Codes: C -clear, PC -partly cloudy, CI -cloudy, R -rain, Sn-snow, SI -sleet Spray Irrigation Operator in Responsible Charge (ORC): ORC Certification Number: Mail ORIGINAL and TWO COPIES to: DENR Division of Water Quality ATTN: Information Processing Unit 1617 Mail Service Center RALEIGH, NC 27699-1617 Robert Carroll 26341 Check Box if ORC Has Changed C Phone: (910)385-6116 (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE) BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. DENR FORM NOAR-1 (11/2005) NON -DISCHARGE APPLICATION REPORT Page_,of SPRAY IRRIGATION SITE(S) Facility Status: Please indicate ( by inserting Y(es) or,N(o) in the appropriate box ) whether the facility has been compliant with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the compliant box. - ) Compliant Y,N) 1. The application rate(s) did not exceed the limit(s) specified in the permit. 2. Adequate measures were taken to prevent wastewater runoff from the site(s). 3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit. 4. All buffer zones as specified in the permit were maintained during each application. 5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s) specified in the permit. If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance with its permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." WW? 0 (Signature of Permittee)* 47 Date (Permittee -Please print or type) PO Box 439 Clinton, NC 28329 (Permittee Address) (Name of Signing Official -Please print or type) (Position or Title) (910)592 -4111 - (Phone Number) - (Permit Exp. Date) If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (b)(2)(D). DENR FORM NDAR-1 (11/2005) NON DISCHARGE WASTEWATER MONITORING REPORT Page of PERMIT NUMBER: WQ0014785 MONTH: blzo-- YEAR: 2,0/4 FACILITY NAME: Midway Middle School COUNTY: Sampson Operator in Responsible Charge (ORC): Robert Carroll Grade: S Phone: (910)385-6116 Check Box if ORC Has Changed: ❑ ORC Certification Number: Certified Laboratories (1): Person(s) Collecting Samples Mail ORIGINAL and TWO COPIES to: DENR Division of Water Quality ATTN: Information Processing Unit 1617 Mail Service Center RALEIGH, NC 27699-1617 EHC Rober Carroll (2): ���� e� (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE) BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. nein 7- lM.A nine en � 144 lnnn C% .-. .. 'Was There Effluent Flow For This Month Generated At ■ ... . Daily Rate (Flow) into .....Coll Treatment System . . :.. Fecal Daily ������is����� Daily Minimum Composite (C) Grab (G� Operator in Responsible Charge (ORC): Robert Carroll Grade: S Phone: (910)385-6116 Check Box if ORC Has Changed: ❑ ORC Certification Number: Certified Laboratories (1): Person(s) Collecting Samples Mail ORIGINAL and TWO COPIES to: DENR Division of Water Quality ATTN: Information Processing Unit 1617 Mail Service Center RALEIGH, NC 27699-1617 EHC Rober Carroll (2): ���� e� (SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE) BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE TO THE BEST OF MY KNOWLEDGE. nein 7- lM.A nine en � 144 lnnn C% NON DISCHARGE WASTEWATER MONITORING REPORT Facility Status: Please answer the following question: 1. Does all monitoring data and sampling frequencies meet permit requirements? Page of Compliant (Y,N) 4 If the facility is non-compliant, please explain in the space below the reason(s) the facility was not in compliance with its permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." A"Zdua&ri5v� 4 6- 6 6"-14, �� (Signature of Permittee)* Cl Date (Permittee -Please print or type PO Box 439 Clinton, NC 28329 (Permittee Address) Paramafar Cnfips' (Name of Signing Official-Please`print or type) (Position or Title) (910)592-4111 (Phone Number) (Permit Exp. Date) 01002 Arsenic 31504 Coliform, Total 00600 Nitrogen, Total 00929 Sodium 01022 Baron 00094 Conductivity 00630 NO2&NO3 00931 SAR 00310 BODS 01042 Copper 00620 NO3 00745 Sulfide 01027 Cadmium 00300 Dissolved Oxygen 00556 Oil -Grease 70295 TDS 00916 Calcium 31616 Fecal Coliform WQ09 PAN (Plant Available) 00010 Temperature 00940 Chloride 01051 Lead 00400 pH o 00625 TKN 50060 Chlorine, Total Residual 00927 Magnesium 71900 Mercury 32730 Phenols 00665 Phosphorus, Total 00680 TOC 00530 TSS/TSR 01034 Chromium 00610 NH3asN 00937 Potassium 00076 Turbidity 00340 COD 01067 Nickel 00545 Settleable Matter 01092 Zinc Parameter Code assistance may be obtained by calling the Water Quality Land Application Unit at (919) 715-6189. The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only the units designated in the reporting facility's permit for reporting data. If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (b)(2)(D). DENR FORM NDMR-1 (1112005)