WQ0001048_Residual Annual Report 2014_20150223

COW&IM"a cf6ezo�vo1 taiz Smez ye .0htuW
CMSD
POST OFFICE BOX 477'
GRIFTON, NORTH CAROLINA 28530
CHARLES M. SMITHWICK, JR.
DISTRICT MANAGER
February 16, 2015
Mr. Daryl Merritt
DENR/DWR/Water Quality Section
Non -Discharge Compliance/Enforcement Unit
1617 Mail Service Center
Raleigh, NC 27699-1617
Re: Contentnea MSD
Land Application Permit #WQ0001048
2014 Annual Report
Dear Mr. Merritt,
Please find enclosed three (3) copies of the above referenced annual sludge land application program
report for the Contentnea Metropolitan Sewerage District (CMSD), Permit Number WQ0001048, for
your review.
If you should need any additional information please contact me at [phone].
Sincerely,
Renee Smith
Land Application ORC
Enclosure
RECEIVEDIDENRIDWR
FL.6 a ;i a015
WgtorQualit _
pefW tung gen

EXPLANATIONS FOR DEVIATIONS FOR THE 2014 ANNUAL
SLUDGE LAND APPLICATION REPORT
2-25-14 Monitoring Well #9
Total Organic Carbon
12.74 mg/L
Monitoring Well #9
Chromium
16 ug/L
Monitoring Well #10
Chromium
15 ug/L
Monitoring Well #14
Chromium
21 ug/L
Monitoring Well #18
Chromium
12 ug/L
6-18-14 Monitoring Well #9
Total Organic Carbon
14.86 mg/L
Monitoring Well #10
Chromium
11 ug/L
Monitoring Well #14
Chromium
10 ug/L
10-29-14 Monitoring Well #9
Total Organic Carbon
15.62 mg/L
Monitoring Well #9
. Chromium
19 ug/L
Monitoring Well #14
Chromium
11 ug/L
All of the above violations were reported to NC Department of Environment and Natural
Resources -Washington Regional Office. The TOC is typically higher in this area. The VOC analysis
on 10-29-14 revealed no compounds over the detection limit. We are working with a
representative from NCDENR-WRO in an effort to address the Chromium issues.
RECEIVED1DENPJDWR
FC62.3�d15

ANNUAL LAND APPLICATION CERTIFICATION FORM
Permit#: 10(>Cc oloo � County: �{ i l i� Li°flol ( Year: Z�1 Ll
Facility Name (as shown on permit): ('WJepn- r-t2C� rn6-
.Land Application Operator: I�,py)pe (gym 0­1 Phone: ZSZf! �Z�I-55R�
'Land application of residual solids as allowed by the permit occurred during the past calendar year?
Yes [3 No If No, skip Part A; .and Part B and proceed to the certification. Also, if residuals were
generated but not land applied, please attach an explanation on how the residuals were handled.
P rt A'
a
Total number of application fields in permit:
Z Cj
Total number of fields land application occurred during the year:
12
Total amount of dry tons applied during the year for all application sites:
3 5Q 5
Total number of acres land application occurred during the year:
aa- • ocl
Part B:
Facility was compliant during calendar year Z01 l4 with all conditions of the land application permit
(including but not limited to items 1-12 below) issued by the Division of Water Resources.(] Yes ED No
If no please, provide a written description why the facility was -not compliant, the dates, and explain
corrective action taken.
1.Only residuals approved for this permit were applied to the permitted'sites. ,
2. Soil pH was adjusted as specified in the permit and lime was applied (if needed) to achieve a soil pH of at
least 6.0 or the limit specified .in the permit.
3. Annual soils analysis were performed on each site receiving residuals during the past calendar year and three
(3) copies of laboratory results are attached.
;'4. Annual TCLP analysis was performed and three (3) copies of certified laboratory results are attached.
5: All other monitoring was performed in accordance with the permit and reported during the year as required
y and three (3) copies of certified laboratory results are attached.
6. The facility did not exceed any of the Pollutant Concentration Limits in Table 1 of 40 CFR Part 503.13 or the
Pollutant Loading Rates in Table 2 of 40 CFR part 503.13 (applicable to 40 CFR Part 503 regulated facilities).
7. All general requirements in 40 CPR Part 503.12 and management practices in 40 CFR Part 503.14 were
complied with (applicable to 40 CFR Part 503 regulated facilities).
8. All operations and maintenance requirements in the permit were complied with or, in the case of a deviation,
prior authorization was received from the Division of Water Resources.
9. No contravention of Ground Water Quality Standards occurred at a monitoring well or explanations of
violations are attached to include appropriate actions and remediations.
10. Vegetative cover as specified in the permit was maintained on this site and the crops grown were removed
in accordance with the crop management plan.
11. No runoff of residuals from the application sites onto adjacent property or nearby surface waters has occurred.
12. All buffer requirements as specified on the permit were maintained during each application of residuals. ,
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true,,
Accurate, and complete. I am aware that there'are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
ChW1,bm,6m,1, ht6jCk.;,V J manw&
Permittee Name and Title (type or print) Signature of Permittee 0.V Date
2--13-i 5
Signature of Preparer* Date Signature of Land Applier Date
(if different from Permittee) (if different from Permittee and Preparer)
* Preparer is defined in 40 CFR Part 50.3.9 (r)
DENR FORM ACF (5/2003)

ANNUAL DISTRIBUTION AND MARKETING/ SURFACE DISPOSAL CERTIFICATION AND SUMMARY FORM
'ERMIT #: �JQoCOICW� FACILITY NAME:
PHONE: Z5Z-5ZLI-55�d �� COUNTY:. �j l q-�- OPERATOR: � j�2n� Jr�"1 I a-I'�
FACILITY TYPE (please check one): [3 Surface Disposal (complete Part A (Source
(s) and "Residual In" Volume only) and Part �)
❑ Distribution and Marketing (complete Parts A, B, and C)
Vas the facility in operation during the past calendar year? Yes ONO No If No skip parts A, B, C and certify form below
Part -A*: Part B*:
Volume (dry tons) Recipient Information
Month Sources(s) (include NPDES # if Amendment/ Residual In Product Out Name(s) Volume (dry Intended use(s)
applicable) tons)
RiiMnv AuPnt
+ebrua
March
,7 tool i1
511
ZI
Dctober
vovember
December
Totals: Annual (dry tons): 3 1-,,. 5
Amendments used: I Bulking Agent(s) used:
* If more space than given is required, please attach additional information sheet(s). ❑ Check box if additional sheet(s) are attached
Part C:
Facility was compliant during calendar year ZD ICI with all conditions of the permit (including but not limited to items 1-3 below) issued by the
�1 No If No, please provide a written description why the facility was not compliant.
Division of Water Resources. ❑Yes
1. All monitoring was done in accordance with the permit and reported for the year as required and three (3) copies of certified laboratory results are attached.
ior authorization was received from the Division of Water
2. All operation and maintenance requirements were compiled with or, in the case of a deviation, pr
Resources.
3. No contravention of Ground Water Quality Standards occurred at a monitoring well.,
"I certify, under penalty of law, that the above information is, to the best of my knowledge and belief, true, accurate and complete. I am aware
th a are signjficapenalties for submitting false information, including the possibility of fines and imprisonment for knowing violations!"
Signature of Permittee Date Signature of Preparer** - Date
(if different from Permttee) **Preparer is defined in 40 CFR Part 503.9(r)
..—.. ran nr+nr /.1.1 ~%nrn

RESHDUAL . SAMFILHNG jcgUMMARY
AND
.."al
li� sl
MIAMI Moll Moll, IrDE-11,
.is

ANNUAL RESIDUAL SAMPLING SUMMARY FORM
Attach this form to the corresponding Annual Report to be summarized on this form.
Please note that your permit may contain additional parameters to be analyzed than those required
PermitNumber• U-Q DC 1, 049 Laboratory: 1) F- i i f onr ne- -) }-T; 1 cc -
2)
Facility Name:
3)
NPDES # or
WQ#: f _I CC03ZG`�� 4)
WWTP Name:
Residual Anal si
Sample or
Com osite Date
Percent Solids
Arsenic
cadmium
Chromium
Data
�
ad
[yMercury
denum
Nickel
Selenium
Zinc
Total Phosphorus
TKN
Ammonia-Nitrog
d N'tr't
i-2z�-1U
U 2l-lu
q—l1!1ILI
i2 q IU
t • (oD90
90
l • fie
Z , 01 �o
<2.5
<Z,S
3
2.6
l,u
Z
Z
7-9
`�
ZZ
30
3 L13
Z3Z
30
O.tic
�,C�3
0, 6q
D•U�
�5c�
<5•®
<5 ®
<60
q50
Ci U 1
Zb 11i
3a Ol O
35Z6 L)
3q 2Z
uI��IG 1
3 &-7q
--2A34q
u 6q
�215D
1
Nitrate an i i eI
"I certify, under penalty of law, that this document was prepared under my direction or rvision in submittedccordance with a I am aware that there asystemre
designed to assure that qualified personnel properly gathered and -evaluated the information
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.79
Date
Signature of Preparer

hw
GREEWILLE, N.C. 27835-7085
�mggd
C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
Aluminum, (dry wt. basis), mg/kg
Arsenic (dry wt. basis), mg/kg
Calcium (dry wt. basis), mg/kg
Cadmium (dry wt. basis), mg/kg
Copper (dry wt. basis), mg/kg
Chromium, T.(dry wt. basis),mg/kg
Lead (dry weight basis), mg/kg
Magnesium (dry wt. basis), mg/kg
Mercury (dry wt. basis), mg/kg
Nickel (dry wt. basis), mg/kg
Potassium (dry wt. basis), mg/kg
Selenium (dry wt. basis), mg/kg
Sodium (dry wt. basis), mg/kg
Zinc (dry vt. basis), mg/kg
Total Nitrogen, mg/kg
Total Solids, %
TKN (dry wt.), mg/kg
Ammonia Nitrogen (dry wt.),mg/kg
Nitrate Nitrogen(dry wt.), mg/kg
Nitrite Nitrogen(dry wt.), mg/kg
Phosphorus, T. (dry wt.), mg/kg
Molybdenum (dry wt. basis), mg/kg
Sludge Analysis Method
Sample Date Analyst Code
18399
02/07/14 LFJ
EPA200.7
<2.5
03/04/14 MEL
311313-04
18542
02/07/14 LFJ
EPA200.7
2.5
03/09/14 MEL
311313-04
343
02/07/14 LFJ
EPA200.7
28
02/07/14 LFJ
EPA200.7
21
03/03/14 MEL
311313-04
4172
02/07/14 LFJ
EPA200.7
0.49
02/11/14 ADD
245.1 R3-94
16
02/07/14 LFJ
EPA200.7
6514
02/07/14 LFJ
EPA200.7
< 5.0
03/10/14 MEL
311313-04
7334
02/07/14 ADD
311113-99
920
02/07/14 ADD
311113-99
39746
02/06/14 SEJ
1.6
01/30/14 CMC
2540G-97
39422
02/03/14 ANO
351.2 R2-93
4696
01/30/14 ANO
350.1 R2-93
317
01/31/14 ANO
353.2 R2-93
6.50
01/31/14 ANO
353.2 R2-93
9461
02/03/14 ALB
365.4 -74
<5.0
02/07/14 LFJ
EPA200.7
Wastewater ID 10.".
DNE [phone]
FAX [phone]
ID#: 416
DATE COLLECTED: 01/28/14
DATE REPORTED : 03/11/14
REVIEWED BY: "

iwnfln&M % hwrf
GREENVILLE, N.C. 27835-7085
�d0do
C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
Sludge Analysis Method
PARAMETERS Sample Date Analyst Code
PH (not to be used for reporting)
4.2
04/21/14 TRB
4500HB-00
Aluminum, (dry wt. basis), mg/kg
16592
04/29/14 LFJ
EPA200.7
Arsenic (dry wt. basis), mg/kg
<2.5
04/29/14 MEL
311313-04
Calcium (dry wt. basis), mg/kg
14056
04/29/14 LFJ
EPA200.7
Cadmium (dry wt. basis), mg/kg
1.4
05/15/14 MEL
311313-04
Copper (dry wt. basis), mg/kg
232
04/29/14 LFJ
EPA200.7
Chromium, T.(dry wt. basis),mg/kg
27
04/29/14 LFJ
EPA200.7
Lead (dry weight basis), mg/kg
16
04/30/14 MEL
311311-04
Magnesium (dry wt. basis), mg/kg
4013
04/29/14 LFJ
EPA200.7
Mercury (dry wt. basis), mg/kg
0.43
04/24/14 MTM
245.1 R3-94
Nickel (dry wt. basis), mg/kg
12
04/29/14 LFJ
EPA200.7
Potassium (dry wt. basis), mg/kg
7272
04/29/14 LFJ
EPA200.7
Selenium (dry wt. basis), mg/kg
<5.0
05/14/14 MEL
311313-04
Sodium (dry wt. basis), mg/kg
6142
05/02/14 MTM
3111B-99
Zinc (dry wt. basis), mg/kg
682
05/02/14 MTM
311113-99
Total Nitrogen, mg/kg
65410
05/02/14 SEJ
Total Solids, %
1.08
04/21/14 CMC
2540G-97
TKN (dry wt.), mg/kg
46491
04/28/14 ANO
351.2 R2-93
Ammonia Nitrogen (dry wt.),mg/kg
4375
04/24/14 ANO
350.1 112-93
Nitrate Nitrogen(dry wt.), mg/kg
18915
04/25/14 ANO
353.2 R2-93
Nitrite Nitrogen(dry wt.), mg/kg
3.81
04/30/14 ANO
353.2 R2-93
Phosphorus, T. (dry wt.), mg/kg
26177
04/28/14 ALB
365.4 -74
Molybdenum (dry wt. basis), mg/kg
5
04/29/14 LFJ
EPA200.7
Wastewater ID; 101:'I;
HONE [phone]
FAX [phone]
ID#: 416
DATE COLLECTED: 04/21/14
DATE REPORTED : 05/19/14
REVIEWED BY:
v

c.M]� `� u
Wastewater ID: 1
.r,...." ,...r.`� � �` •
7085, 114 OAWOINT DRIVE PHONE [phone]
GREENVILLE, N.C. 27835-7085 FAX [phone]
C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
Aluminum, (dry wt. basis), mg/kg
Arsenic (dry wt. basis), mg/kg
Calcium (dry wt. basis), mg/kg
Cadmium (dry wt. basis), mg/kg
Copper (dry wt. basis), mg/kg
Chromium, T.(dry wt. basis),mg/kg
Lead (dry weight basis), mg/kg
Magnesium (dry wt. basis), mg/kg
Mercury (dry wt. basis), mg/kg
Nickel (dry wt. basis), mg/kg
Potassium (dry wt. basis), mg/kg
Selenium (dry wt. basis), mg/kg
Sodium (dry wt. basis), mg/kg
Zinc (dry wt. basis), mg/kg
Total Nitrogen, mg/kg
Total Solids, %
TKN (dry wt.), mg/kg
Ammonia Nitrogen (dry wt.),mg/kg
Nitrate Nitrogen(dry wt.), mg/kg
Nitrite Nitrogen(dry wt.), mg/kg
Phosphorus, T. (dry wt.), mg/kg
Molybdenum (dry wt. basis), mg/kg
Sludge Analysis Method
Sample Date Analyst Code
19499
09/30/14
LFJ
EPA200.7
< 2.5
10/06/14
MEL
311313-04
19458
09/30/14
LFJ
EPA200.7
2
10/16/14
MEL
311313-04
306
09/30/14
LFJ
EPA200.7
22
09/30/14
LFJ
EPA200.7
28
10/21/14
MEL
311313-04
5349
09/30/14
LFJ
EPA200.7
0.34
10/09/14
MTM
245.1 R3-94
15
09/30/14
LFJ
EPA200.7
6351
09/30/14
LFJ
EPA200.7
<5.0
10/23/14
MEL
311313-04
4860
10/02/14
MTM
311113-99
851
10/07/14
MTM
3111B-99
46136
09/23/14
SEJ
1.03
09/16/14
KKF
2540G-97
36679
09/22/14
AKS
351.2 112-93
2150
09/18/14
ANO
350.1 R2-93
9453
09/19/14
AKS
353.2 R2-93
3.61
09/19/14
AKS
353.2 R2-93
39010
09/22/14
ALB
365.4-74
6
09/30/14
LFJ
EPA200.7
ID#: 416
DATE COLLECTED: 09/16/14
DATE REPORTED : 10/28/14
REVIEWED BY:

a
fifflnfin& % hwonabd
RO. BOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085
C.M.S.D. (SLUDGE
CONTENTNEA METRO.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
PH (not to be used for reporting)
Aluminum, (dry wt. basis), mg/kg
Arsenic (dry wt. basis), mg/kg
Calcium (dry wt. basis), mg/kg
�admium (dry wt. basis), mg/kg
�opper (dry wt. basis), mg/kg
Chromium, T.(dry wt. basis),mg/kg
Lead (dry weight basis), mg/kg
Magnesium (dry wt. basis), mg/kg
Mercury (dry wt. basis), mg/kg
Nickel (dry wt. basis), mg/kg
Potassium (dry wt. basis), mg/kg
Selenium (dry wt. basis), mg/kg
Sodium (dry wt. basis), mg/kg
Zinc (dry wt. basis), mg/kg
Total Nitrogen, mg/kg
Total Solids,
TKN (dry wt.), mg/kg
Ammonia Nitrogen (dry wt.),mg/kg
Nitrate Nitrogen(dry wt.), mg/kg
Nitrite Nitrogen(dry wt.), mg/kg
Phosphorus, T. (dry wt.), mg/kg
Molybdenum (dry wt. basis), mg/kg
& WELLS ACCT)
SEWAGE DIST.
Sludge Analysis Method
Sample Date Analyst Code
4.3
12/09/14
TRB
4500HB-00
22340
12/18/14
LFJ
EPA200.7
3
12/18/14
MTM
311313-04
16321
12/18/14
LFJ
EPA200.7
2
12/19/14
MTM
311313-04
304
12/18/14
LFJ
EPA200.7
30
12/18/14
LFJ
EPA200.7
31
12/15/14
MTM
311313-04
2323
12/18/14
LFJ
EPA200.7
0.48
12/19/14
MTM
245.1 113-94
13
12/18/14
LFJ
EPA200.7
2868
12/18/14
LFJ
EPA200.7
<5.0
12/15/14
MTM
311313-04
4075
12/16/14
MTM
3111B-99
950
12/18/14
MTM
3111B-99
46114
12/18/14
SEJ
2.01
12/09/14
KKF
2540G-97
39344
12/15/14
BJC
351.2 R2-93
2518
12/11/14
BJC
350.1 R2-93
6767
12/12/14
KDB
353.2 R2-93
2.88
12/12/14
KDB
353.2 112-93
35254
12/15/14
AKS
365.4-74
5
12/18/14
LFJ
EPA200.7
Wastewater ID: 10,,.
A
ONE [phone]
FAX [phone]
ID#: 416
DATE COLLECTED: 12/09/14
DATE REPORTED : 12/23/14
REVIEWED BY:

f,
FW: fRp Fl lrt E:diB.l.
May 06, 2014
Deedee Woolard
Environment 1, Inc.
114 Oakmont Dr
P.O. Box 7085
Greenville, NC 27858
TEL: [phone]
FAX: [phone]
RE: C.M.S.D.4/21
Dear Deedee Woolard:
Summit Environmental Technologies, Inc.
3310 Win St.
Cuyahoga Falls, Ohio 44223
TEL: [phone] FAX.- [phone]
Website: http•//www.settekcom
Order No.: 14042081
Summit Environmental Technologies, Inc. received 1 sample(s) on 4/22/2014 for the analyses
presented in the following report.
There were no problems with the analytical events associated with this report unless noted in the
Case Narrative.
Quality control data is within laboratory defined or method specified acceptance limits except
where noted.
If you have any questions regarding these tests results, please feel free to call the laboratory.
Sincerely,
Dr. Mo Osman
Project Manager
3310 Win St.
Cuyahoga Falls, Ohio 44223
A2LA 0724.01, Alabama 41600, Arkansas 88-0735, California 07256CA, Colorado, Connecticut PH-0105, Delaware, Florida NELAC E87688, Georgia
E87688 and 943, Idaho OH00923, Illinois 200061 and Reg.5, Indiana C-OH-13, Kansas E-10347, Kentucky (underground Storage Tank) 3, Kentucky
90146, Louisiana 04061 and LAI2004, Maine 2012015, Maryland 339, Massachusetts M-OPH923, Minnesota 409711, Montana CERT0099, New
Hampshire 2996, New Jersey OH006, New York 11777, North Carolina 39705 and 631, Ohio 4170, Ohio VAP CL0052, Oklahoma 9940, Oregon
OH2O0001, Pennsylvania 68-01335, Rhode Island LA000317, South Carolina 92016001, Tennessee TN04018, Texas T104704466-11-5, Region 8 8TMS-
L, USDA/APHIS P330-11-00244, Utah OH009232011-1, Vermont VT-87688, Virginia 00440 and 1581, Washington C891, West Virginia 248 and 9957C
and E87688, Wisconsin 399013010
Page 1 of 5

Summit Environmental Technologies, Inc. Workorder
2riq 3310 Win St.
Cuya ry
il
r.wVJRoM1,1EHTAL IFGIV40LOG)ES, tNr- hoga Falls, Ohio 44223 Sample Summa
TEL: [phone] FAX.• [phone] WO#: 14042081
Website: hW.1APww.settekcom 06-May-14
CLIENT: Environment 1, Inc.
Project: C.M.S.D. 4/21
Lab SamplelD Client Sample ID Tag No Date Collected Date Received Matrix
14042081-001 Sludge Sample 4/21/2014 8:50:00 AM 4/22/2014 9:45:00 AM Sludge
N
Page 2 of 5

Summit Environmental Technologies, Inc. Case Narrative
1��21$dillA
a
3310 Win St.
XLGiES� WC Falls, Ohio 44223 WO#• 14042081
6Fittai4hiiali:Ed1'dL _
�aratyt:cst i. barror� �; TEL: [phone] FAX. [phone] Date: 5/6/2014
Website: htta•/hvww.settek.com
CLIENT: Environment 1, Inc.
Project: C.M.S.D.4/21
This report in its entirety consists of the documents listed below. All documents contain the Summit
Environmental Technologies, Inca Work Order Number assigned to this report.
Paginated Report including: Cover Letter, Case Narrative, Analytical Results, Applicable Quality
Control �Sumniary Reports and copies of the Chain of Custody Documents supplied with this sariple
set.
Concentrations reported with a J flag in the Qual field are values below the Limit of Quantitation
(LOQ) but greater than the established Limit of Detection (LOD). There is greater uncertainty
associated with these results and data should be considered as estimated.
Method numbers, unless specified. as SM (Standard Methods) or ASTM, are EPA methods.
Estimated uncertainty values are available upon request.
Any comments or problems with the analytical events associated with this report are noted below.
Original
Page 3 of 5

fRu61
Summit Environmental Technologies, Inc.
3310Win St.
WO#:
14042081
4�3
Date Reported:
5/6/2014
.s
� IVIRt3NMENTAL TECHUOLOCI-ES,INC
Cuyahoga Falls, Ohio 44223
TEL: [phone] FAX. [phone]
Company:
Environment 1, Inc.
Anzly(ical
Website: hitp://www.settek.com
Address:
114 Oakmont Dr
Greenville NC 27858
Received: 4/22/2014
Project#: C.M.S.D.4/21
TCLP Metals Analysis (6010)
Client ID#
Lab ID# Collected Analyte
Rep Lmt Result Units
Matrix
Method
DF
RegLvl
Run
Analyst
Sludge Sample
001
4/21/2014 TCLP Arsenic(As)
0.50
ND mg/L
Sludge
EPA 6010 C
1
5.0
4/24/2014
WK
Sludge Sample
001
4/21/2014 TCLP Barium(Ba)
5.0
ND mg/L
Sludge
EPA 6010 C
1
100
4/24/2014
WK
Sludge Sample
001
4/21/2014 TCLP Cadmium(Cd)
0.10
ND mg/L
Sludge
EPA 6010 C
1
1.0
4/24/2014
WK
Sludge Sample
001
4/21/2014 TCLP Chromium(Cr)
0.20
ND mg/L
Sludge
EPA 6010 C
1
5.0
4/24/2014
WK
Sludge Sample
001
4/21/2014 TCLP Lead(Pb)
0.50
ND mg/L
Sludge
EPA 6010 C
1
5.0
4/24/2014
WK
Sludge Sample
001
4/21/2014 TCLP Selenium(Se)
0.50
ND mg/L
Sludge
EPA 6010 C
1
1.0
4/24/2014
WK
Sludge Sample
001
4/21/2014 TCLP Silver(Ag)
0.50
ND mg/L
Sludge
EPA 6010 C
1
5.0
4/24/2014
WK
TCLP Mercury Analysis (1311/7470)
Client ID#
Lab ID# Collected Analyte
Rep Lmt Result Units
Matrix
Method
DF
RegLvl
Run Analyst
Sludge Sample
001 4/21/2014 TCLP Mercury
0.0020 ND mg/L
Sludge
EPA 7470 A
1 -
0.20
4/24/2014 ALJ
SVOC SW-846: 8081-TCLP Pesticides
Client ID#
Lab ID# Collected Analyte
Rep Lmt Result Units
Matrix
Method
DF
RegLvl
Run
Analyst
Sludge Sample
001
4/21/2014 Chlordane, total
0.010
ND mg/L
Sludge
EPA 8081 B
1
0.030
4/25/2014
JBN
Sludge Sample
001
4/21/2014 Toxaphene
0.10
ND mg/L
Sludge
EPA 8081 B
1
0.50
4/25/2014
JBN
Sludge Sample
001
4/21/2014 Endrin
0.0020
ND mg/L
Sludge
EPA 8081 B
1
0.020
4/25/2014
JBN
Sludge Sample
001
4/21/2014 gamma-BHC
0.0020
ND mg/L
Sludge
EPA 8081 B
1
0.40
4/25/2014
JBN
Sludge Sample
001
4/21/2014 Heptachlor
0.0020
ND mg/L
Sludge
EPA 8081 B
1
0.0080
4/25/2014
JBN
Sludge Sample
001
4/21/2014 Heptachlor epoxide
0.0020
ND mg/L
Sludge
EPA 8081 B
1
0.0080
4/25/2014
JBN
Sludge Sample
001
4/21/2014 Methoxychlor
0.0020
ND mg/L
Sludge
EPA 8081 B
1
10
4/25/2014
JBN
VOC by GC/MS (8260)-TCLP
Client ID#
Lab ID# Collected Analyte
Rep Lmt Result Units
Matrix
Method
DF
RegLvl
Run
Analyst
Sludge Sample
001
4/21/2014 1,1-Dichloroethene
0.10
ND mg/L
Sludge ,
EPA 8260 B
1
0.70
5/5/2014
MES
Sludge Sample
001
4/21/2014 1,2-Dichloroethane
0.10
ND mg/L
Sludge
EPA 8260 B
1
0.50
5/5/2014
MES
Sludge Sample
001
4/21/2014 Benzene
0.10
ND mg/L
Sludge
EPA 8260 B
1
0.50
5/5/2014
MES
Sludge Sample
001
4/21/2014 Carbon tetrachloride
0.10
ND mg/L
Sludge
EPA 8260 B
1
0.50
5/5/2014
MES
Sludge Sample
' 001
4/21/2014 Chlorobenzene
0.10
ND mg/L
Sludge
EPA 8260 B
1
100
5/5/2014
MES
Sludge Sample
001
4/21/2014 Chloroform
0.10
ND mg/L
Sludge
EPA 8260 B
1
6.0
5/5/2014
MES
Sludge Sample
001
4/21/2014 Tetrachloroethene
0.10
ND mg/L
Sludge
EPA 8260 B
1
0.70
515/2014
MES
Sludge Sample
001
4/21/2014 Trichloroethene
0.10
ND mg/L
Sludge
EPA 8260 B
1
0.50
5/5/2014
MES
Sludge Sample
001
4/21/2014 Vinyl chloride
0.20
ND mg/L
Sludge
EPA 8260 B
1
0.26
5/5/2014
MES ,
'Sludge Sample
001
4/21/2014 MEK
2.0
ND mg/L
Sludge
EPA 8260 B
1
200
5/5/2014
MES
Page 4 of 5

�` i rl
r
Summit Environmental Technologies, Inc.
3310 Win St.
W0#:
14042081
1flr�'
L
Cuyahoga Falls, Ohio44223
Date Reported:
5/6/2014
t'rtvint�k�l;s[r1T,�.L tEGl:1<QLrU,cs, AC,
TEL: [phone] FAX. • [phone]
Company:
Environment 1, Inc.
Website: htto:/hvww.settekcon?
Address:
114 Oakmont Dr
Greenville NC 27858
Received:
4/22/2014
Project#:
C.M.S.D.4/21
SVOC 8270 TCLP BNA List
Client ID#
Lab ID# Collected Analyte
Rep Lmt Result Units
Matrix
Method
DF
RegLvl
Run
Analyst
Sludge Sample
001
4/21/2014 1,4-Dichlorobenzene
0.10
ND mg/L
Sludge
EPA 8270 C
1
7.5
4/24/2014
AKE
Sludge Sample
001
4/21/2014 2,4,5-Trichlorophenol
0.25
ND mg/L
Sludge
EPA 8270 C
1
400
4/24/2014
AKE
Sludge Sample
001
4/21/2014 2,4,6-Trichlorophenol
0.25
ND mg/L
Sludge
EPA 8270, C
1
2.0
4/24/2014
AKE
Sludge Sample
001
4/21/2014 2,4-Dinitrotoluene
0.10
ND mg/L
Sludge
EPA 8270 C
1
0.13
4/24/2014
AKE
Sludge Sample
001
4/21/2014 Cresols, Total
5.0
ND mg/L
Sludge
EPA 8270 C
1
200
4/24/2014
AKE
Sludge Sample
001
4/21/2014 Hexachloro-1,3-
0.10
ND mg/L
Sludge
EPA 8270 C
1
0.50
4/24/2014
AKE
butadiene
Sludge Sample
001
4/21/2014 Hexachlorobenzene
0.10
ND mg/L
Sludge
EPA 8270 C
1
0.13
4/24/2014
AKE
Sludge Sample
001
4/21/2014 Hexachloroethane
0.10
ND mg/L
Sludge
EPA 8270 C
1
3.0
4/24/2014
AKE
Sludge Sample
001
4/21/2014 Nitrobenzene
0.10
ND mg/L
Sludge
EPA 8270 C
1
2.0
4/24/2014
AKE
Sludge Sample
001
4/21/2014 Pentachlorophenol
0.25
ND mg/L
Sludge
EPA 8270 C
1
100
4/24/2014
AKE
Sludge Sample
001
4/21/2014 Pyridine
0.25
ND mg/L
Sludge
EPA 8270 C
1
5.0
4/24/2014
AKE
SVOC SW-846: 8321 Herbicides-TCLP
Client ID#
Lab ID# Collected Analyte
Rep Lmt Result Units
Matrix
Method DF
RegLvl
Run
Analyst
Sludge Sample
001 4/21/2014 2,4-D
5.0 ND mg/L
Sludge
EPA 8321 A 1
10
4/25/2014
AMZ
Sludge Sample
001 4/21/2014 2,4,5-TP
0.50 ND mg/L
Sludge
EPA 8321 A 1
1.0
4/25/2014
AMZ
Page 5 of 5

11TV. CHAIN (_jj-
F717, -NF,--C 11"IC'N
416 NV(:ck: 11
E I I
C..M.S.D. (SLUDGE S., WE'll's r�,C(71') G C G
CONTUNTNEIA MI,,TR 0. SMAGE DIST.
NIS. RrNUT PRIDGEN'
77 11.0. BOX 4'
GRIVI'WN NC 28510
(2521
Uj
DIATE
S�'A`ILEP,
"W-EMME
A
I J-: :N;�15 - L--r,

ull� t I
;V4 0—
14
i� JZ;,: ", lir�ll E is rI, T. kv, , . 7r.6 1,3"Co- I.- —.d I*M, D%v I ; 07-;' .13 ccc t-R. , 0 2
Page 2 of 2

;nvironment 1,• Inc,
'.O. Box 7085, 114 C__�:_ont Dr.
:raamii�IP N(' 77R5R
CHAIN OF OUST( ( RECORD
Page 1 of 1
'hone [phone] • Fax [phone]
DISINFECTION
CHLORINE NEUTRALIZED AT COLLECTION
CHLORINE
MENT: 416 Week: 11
pH CHECK (LAB)
UV
C.M.S.D. (SLUDGE & WELLS ACCT)
� NONE
G
G
G
G
G
CONTAINER TYPE,P/G
CONTENTNEA METRO. SEWAGE DIST.
A
A
A
A
A
CHEMICAL PRESERVATION
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON NC 28530
A -NONE D-NAOH
a,o
E~�
b
524-5584
z
Ic
d
- 3
E HCL(252)
oJo
f 0
w
:D
w
co
°',
C�
W
µ� C - H,SO, F - ZINC ACETATE/NAOH
COLLECTION
a
~_
oP S
LU o
0
W ¢
o
o
H
a
F
a
EU-F
a
EU+
a
EU�
G NATHIOSULFATE
a
SAMPLE LOCATION
DATE
TIME
Sludge Sample
`
l�
5.
`'`•'`
CLASSIFICATION:
jWASTEWATER (NPDES)
DRINKING WATER
DWQ/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY MAINTAINED
DURING SHIPMENT/DELIVERY
O N
SAMPLES COLLECTED BY:
(Please Print)
T arne,5 Ooo&rd
SAMPLES RECEIVED IN LAB ATy • '� °C
RELINQUISHED BY (SIG.) (SAMPLER)
RECEIU BY (SIG.)
DATE/TIlM,\Eyv"ri
�7
COMMENTS:
poDATFJTIME
/p
l f
f N�
✓/ Jj
RELI ISHED�Y (SI
] DA ETIME
REC VED BY (SIG.
DA EMME
RELINQUISHED Y (S .)
DATFjTIME
RECEIVED BY (SIG.)
DATElTIME
PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for T
pg (_roh comnio in fho hlnniec ohn— fnr oonh norm —tor roni iocforf v 8

f:-p � �dy Summit Environmental Technologies, Inc.
3310 Win St.
;,<-, Cuyahoga Falls, Ohio 44223
TEL: [phone] FAX: [phone]
Websile: ham.11m w.setteLcom
September 11, 2014
Deedee Woolard
Environment 1, Inc.
114 Oakmont Dr
P.O. Box 7085
Greenville, NC 27858
TEL: [phone]
FAX: [phone]
RE: Sludge Sample
Dear Deedee Woolard:
Order No.: 14090399
Summit Environmental Technologies, Inc. received 1 sample(s) on 9/3/2014 for the analyses
presented in the following report.
There were no problems with the analytical events associated with this report unless noted in the
Case Narrative.
Quality control data is within laboratory defined or method specified acceptance limits except
where noted.
If you have any questions regarding these tests results, please feel free to call the laboratory.
Sincerely,
Dr. Mo Osman
Project Manager
3310 Win St.
Cuyahoga Falls, Ohio 44223
A2LA 0724.01, Alabama 41600, Arizona AZ0788, Arkansas 88-0735, California 07256CA, Colorado, Connecticut PH-0105, Delaware, Florida NELAC
E87688, Georgia E87688 and 943, Idaho OH00923, Illinois 200061 and Reg.5, Indiana C-OH-13, Kansas E-10347, Kentucky (Underground Storage Tank)
3, Kentucky 90146, Louisiana 04061 and LA12004, Maine 2012015, Maryland 339, Massachusetts M-OPH923, Minnesota 409711, Montana CERT0099,
New Hampshire 2996, New Jersey OH006, New York 11777, North Carolina 39705 and 631, Ohio Drinking Water 4170, Ohio VAP CL0052, Oklahoma
9940, Oregon OH2O0001, Pennsylvania 68-01335, Rhode Island LA000317, South Carolina 92016001, Tennessee TN04018, Texas T104704466-11-5,
Region 8 8TMS-L, USDA/APHIS P330-11-00244, Utah OH009232011-1, Vennont VT-87688, Virginia 00440 and 1581, Washington C891, West
Virginia 248 and 9957C and E87688, Wisconsin 399013010
Page l of 4
Page 1 of 6

MR. 0?l
q ny
0 '71 f, 7, f�- �
"•, V , ' " -
i" 2,
Summit Environmental Technologies, Inc.
3310 Win St.
Workorder
ju
Ohio 44223
Sample Summary
Li
AC,
Cuyahoga Falls,
TEL: [phone] FAX. [phone]
WO#: 14090399
Website: hity.-Ilivww.settek.com
11-Sep-14
CLIENT:
Environment 1, Inc.
Project:
Sludge Sample
Lab SamplelD Client Sample ID
14090399-001 Sludge Sample
Tag No Date Collected Date Received
9/2/2014 9:00:00 AM 9/3/2014 10:00:00 AM
Matrix
Sludge
(I
Page 2 of 4
Page 2 of 6

t rDAi�: Summit Environmental Technologies, Inc. Case Narrative
',; 33/0 Win St.
rs
0Li,t;;r,_;�,;_ Cuyahoga Falls, Ohio44223 WO#: 14090399
TEL: (330)"253-8211 FAX: [phone] Date: 9/11/2014
Website: htW1APww.settek.com
CLIENT: Environment 1, Inc.
Project: Sludge Sample
This report in its entirety consists of the documents listed below. All.documents contain the Summit
Environmental Technologies, Inc. Work Order Number assigned to this report.
Paginated Report including: Cover Letter, Case Narrative, Analytical Results, Applicable Quality
Control Summary Reports and copies of the Chain of Custody Documents supplied with this sample
set.
Concentrations reported with a J flag in the Qual field are values below the Limit of Quantitation
(LOQ) but greater than the established Limit of Detection (LOD). There is greater uncertainty
associated with these results and data should be considered as estimated.
Method numbers, unless specified as SM (Standard Methods) or ASTM, are EPA methods.
Estimated uncertainty values are available upon request.
Any comments or problems with the analytical events associated with this report are noted below.
Original
Page 3 of 4
Page 3 of 6

Summit Environmental Technologies, Inc.
3310 Win St.
WO#:
14090399
'�dr
Cuyahoga Falls, Ohio 44223
Date Reported:
9/11/2014
rR�
,rr; ,;,,
I'u�,;`�$dOLO°;I,�S;
,,, , . ?,,,,•,xr4, ,a
TEL: [phone] FAX. • [phone]
Company:
Environment 1, Inc.
Website: httn:/hvwiv.settek.com
Address:
114 Oakmont Dr
Greenville NC 27858
Received:
9/3/2014
Project#:
Sludge Sample
Client ID#
Lab ID# Collected Analyte Result Units
Matrix
Method DF RL Run Analyst
Sludge Sample
001
9/2/2014
Flashpoint (140°F)
>140 °F
Sludge
EPA 1010 1
9/9/2014
TAH
Sludge Sample
001
9/2/2014
Cyanide, Reactive
ND pom
Sludge
EPA 9014 ' 1
0.50 9/5/2014
TIR
Sludge Sample
001
9/2/2014
pH
4.7 s.u.
Sludge
EPA 9045 D 1
9/5/2014
AYS
Sludge Sample
001
9/2/2014
Sulfide, Reactive
ND ppm
Sludge
EPA 9034 1
25 9/5/2014
TIR
•
•
Pajee4 aM

CHAIN Cfgi CUSTODY'
RECORD
l:Rvirunrtt4'tit I, tnr,
-
Pagt:.-.
RCI, jWx 70R5, 114 Clak,nasst Dr.
('frcQuc(Ile. NC T.1955
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C.NIS.D. {SI,IIDt:E $c WELLS Al_C:TI
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CONTYN-l',tF.A NMrRO. SEWAGE DIS .
C}iE-ALPR@SEr.L'ARON
Mg. RF.NEE PRIDGEN
A
h A
P-U- Box 477
— - — --
j
p NONE t•51�4!
GRM'Oy NC 2,8550
v
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1
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[phone]
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CRAIN OF CUSIOOY VmvTAtNED
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Sampler must o12ce a `C• for composite sample ar a'G"tar fl
_,- f3cal sample in ft �IC
RE,!AnIn51tunjiaY5torCarnplellaGthiSfDrm the (WrSe SidR, Lk5 a17a'i@ for F'i.Ch oamme€e, retue5l0

910 9 9612d
DC-7
Rev. f3
OWW 14
Summit Erwironmental Technologies, Inc.
Cooler Receipt Form
`• Inluais of person insetting cooler and samples..., ^,
� �^� � r'
Client: _,aVj(0n�d� �4`�'►"`�- Order Number:/f /Y�
Date. Received: d f 3 i Time Rocalved:-f '"" DatPlrime coolaa(s) opened and sampz s mspatl_ Y edlI-212 ' J
Number of CoolorslBoxor�.-.,. ! NIA
Shipper. FED EX PS ) OHL Asrbnme US Pestal WaIK•in Pickup Mr__
adtaging: C�'� Peanuts BubbteWtaapp Paper Foam None Other:
Tape on eoolertbox 0— N NIA
Custody Seats intact �Y WA
GO-c in %sk ( Y 1 N NIA
ice 7Blus ice _ �sen ahsani I mailed WA
Sample Temperature tR Gun 01§929459 CF °C 2 + �3 `C WA
Radiological Testing Instrumentsoriaifi35t27 Y N NIA
(situ page 2 for scan results)
"Use 1 shoat per sample for Radiological Testing. If sample Is NOT, tha Radfologtcal Safety Officer must be noOffed
immedtatefy.
C-O-C fired out property Y N NIA
Samples fnseparale bags Y N NIA
Sample confaiienS intact' f N NIA
'If no, fst broken sompie(s):
Sample tabet(s) complete, {ID. date, etFJ Y'j
N
MA
Sabel{S},gree with C-O-C LY l
N
WA
Correct containers used
µ
NIA
Sufficient sample received
N
NIA
Bobb.es absent from 40 mL vials" Y
N
N A
"Samples with bubbles <Bmm are acceptable, Irdicale txlbble slzo if >8mm.
Was client contaded about samples Y N
'
Will client send new samples Y N
Client contact;,,,,,,,,,
Dolortirriw­
Logged in by,
GAOCSNAREDt[7ocumentConlclTemplates -Tracking%Coolerraceipt form Rev. f308.28-14.doc Page Iof2
0

CHAIN OF CUSTG., j(RECORD
a
;nvlrornnent 1, Inc.
Page �of �
_ _
'.O. Box 7085; 114 Oakmont Dr.
3reenville, NC 27858
CHLORINE NEUTRALIZED AT COLLECTION
mvironmentl inc.com
DISINFECTION
?hone [phone] • Fax [phone]
Ij CHLORINE
pH CHECK (LAB)
CLIENT: 416 B Week: 2
Ij UV
CONTAINER TYPE, P/G
..M.S.D. (SLUDGE & WELLS ACCT)
� NONE
P
P
P
,ONTENTNEA METRO. SEWAGE DIST.
CHEMICALPRESERVATION
4S. RENEE PRIDGEN
A
A
A
,.O. BOX 477
A NONE D NAOH
;RIFTON NC 28530
w u,
C B - HNO3 E - HCL
252) 524-5584
Cc J z o z
f=
�,
LU C - H2SOG F -ZINC ACETATE/NAOH
j a
LU
o
,
>
u3
¢ G - NATHIOSULFATE
COLLECTION
6 o 8
0 "
;
�
w
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SAMPLE LOCATION DATE TIME
o L¢ o
a
9D
U
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/ A� 1
.:.
cn.•
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CLASSIFICATION:
Sludge Sample Cj _Z )�
WASTEWATER(NPDES)
DRINKINGWATER
DWQ/GW
SOLID WASTE SECTION
CHAIN OF CUSTODY MAINTAINED
DURING,! ENT/DELIVERY
N
SAMPLES COLLECTED BY:
Please Print)
c� ((0-0
SAMPLES RECEIVED IN LAB AT O -2 °C
R INQUISHED B (SIG.) (SAMPLER) q ATEMME
RECEI Y (SIG.
1 ATEMME COMMENTS:
y
& /
DATEMME
REL ED B )
��
RECEIVED BY (
)
DATEJI-IME
RELINQUISHE ( .)' DATEITIME
RECEIVED BY (SIG.)
DATEMME
Sampler must place
a "C" for composite sample or a "G' for 0 2 8 319 3
mmnln#inn this fnrrn nn fhP

j
ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A N/A IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Permit #: u.�QDCDI C f10 Annual Dry Tons Applied: 2" 3Z-)Z
pwner: Operator: ,-r, Cation Exchange Capacity (non 503): y".5
Cps-I-p�-�.�.n.C� m �7 p 'Renee �< <� Acres Permitted:
A Acres Utilized: Z• �g iG.q I
')ite #: 1'-) Field #.
o"Report
Totals
D Tons
d Per SolidAcre
Acre s
As
Site
Inches
Appli-
Vola-
Miner-
Ammo
Ni-
Residual
Sources
(Summarize)
Cond.
Dry,
Wet, I
Precip.
Past 24
Hrs.
cation
Meth-
od*
tili-
zation
Rate**
ali-
zation
Rate
TKN
nia-
Ni-
trogen
irate
and
Nitrite
rf,6-1)t�)OT?
Al
rMidr
®
S
©.5
o:�vLICI1
PAN 11 PAN 2
C
Must Select
Crop 1 or Crop
2
Crop 1 I Crop 21 *
Cd Cr Cu Pb H Mo Ni Se Zn P PAN 1 PAN 2 Lune
. _I I _ . 117 1 ^. C, A �� 1 I n i,i,arI i In Z 1U�.�S� Sg.GOC Date
knnual lbs/acre 0 , 0 (4 ().cub C).UL4 -
Current Cumulative lbs/ac t,1a (o, ,� �•��� 3lvLl .Z 4Z G,IaI� ZSSGZ
Prior Years Cumulative lbs/ac 4 4,L4go UG3 (o,DI Q31p G• 3 -LD
ZL-101 g
Permitted C. P. L. R.***
............
2D
Permit PAN Limit lst/2ndCrop
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
si nificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
g
*Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Vnlatili�atinn Rate: �nrface - (1_S_ Tniectinn/Tncnrnnratinn - 1 _f9
***C_P_T,_R_: Cumulative PnlbAnnt T,nadinu Rate
* * * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into'
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.
r. r.m r�nnn r_o� /G /Y 11l14\

ANNUAL METALS FIELD LOADHgG SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Total Dry Tons Applied (Annual):
eility I�Tarne• rC�(1+Pfl� Z.34•Z
�rmit #• u)QW0I OUP Cation Exchange Capacity (non 503 only):
Operator: 'lfn e6rntl.h Owner: CGflk n�nff MOO
Acres Used: Z . Acres Permitted: I cf-cii Site #: Field #:
MiPnw metnlc and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Elm
IRM
..
7 TT..v.<�ai Mpt�l FiPlr(i .nariinac f('nlCulate[i m (nsiacre�:
IIIIiIIII16
I'
Tot 1.
h
"I certify, under penalty of law, that this document was preparea unaer my uirecuun ui- 5upwil V.aiuu .n
�cordance with a system designed to assure that qualified personnel properly gathered and evaluated the
—information submitted. I am aware that there are significant penalties for submitting false information,
including the ossibility of fines and imprisonment for knowing violations"
Signature of Land Applier Date
Y See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form
DENR FORM MFLSF (5/2003)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD,
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Can 4ec4fV_a- rl)6D Permit #: ICCI�, Annual Dry Tons Applied: 3.01-1
owner: �'D�}�n p� n1�1� Operator: —P)-)en 6n- 1 4h Cation Exchange Capacity (non 503): tf:6
4te #: Field #: Z, Acres Utilized: A, tP4 Acres Permitted: )G.C! I
Site
Inches
Appli-
Vola-
Miner-
Ammo
Ni-
Must Select
Totals
%
Dry Tons Per
Residual
Cond.
Precip.
cation
tili-
ali-
TKN
nia-
trateoPer
PAN 1
PAN 2
Crop 1 or Crop
FReport
Solid
Acre
Sources
(Summarize)
D'Past
24
Meth-
zation
zation
Ni-
and
2
Acre
s
Wet,
Hrs.
od *
**
Rate
Rate
trogen
Nitrite
Crop 1
Crop 2
l U
1-?000
Z53F/
,DIGq
1.l 3
�� P
moi�.t'
S
0.15
0.30
Q�ugl
QZ-)5
i4sRV2
32
c
2
2
3
4
5
6
7
8.
10
11
12
TOTALS:
As
Cd Cr
Cu
Pb
Ha
Mo
Ni
Se
Zn
P
PAN 1
I PAN 2
Lime A
lied
knnual lbs/acre
• .00w
W d.� ).D(oL
0.66 a
o• I
o•DI I
0•vZ�
C3.UI
1• .
5a III
�•13Z
Date
lbs/ac
Cumulative lbs/ac
p.5gg 6X4f 3�G4� !�. 1). ,lo 0.34Z4CAI :_ . '90 p Z .qZI :::::::::::: :::::::::::::::::::
©• 5q"Z 5•(�UZ 3'�•45�5 %(v.uP(o 1. IG D.3 Z• 5 �C D, `7 7_'�•21�2 .::::....:....:.:.:..: .....::....:
a 3 I Z(o� 3'•a g Z(o� 15 — -� U LI 7- G L
z
Durrent
?rior Years Cumulative lbs/ac
?ermitted C. P. L. R.***
ermit PAN Limit 1 st/2n d Crop
`I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
3esigned to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
dgnifi'cant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
`'� d �m ►3-� 5 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Vnlatili7.atinn Rate: 9nrfaee - 0_5_ Tniectinn/Tnenrnnratinn - 1.0
rumnlative Pollntnnt T.nndinu Rate
P * * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF. are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.
nGklp Pnann T=cP 1tii1)nn1Z%

ANNUAL METALS FIELD L®A HNG SUMMARY FORM*
,h this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
ne: (`mdit -N)fo M6D Total Dry Tons Applied (Annual):
WOMO IC)LA Cation Exchange Capacity (non 503 only):
I�t'f P � 4 Owner: PnniP�"l-� m-P D
;ed: Z hu Acres Permitted: PIP I Site #• Field #• ?
MENNEN
No
ME.
0
0
0
0
0
0
0
0
o
m
m
m
.,7f .......,= -_ --9 -"at L11101 uU%;uuieuL WUN preparea under my direction or supervision in .
nce 'h a system designed to assure that qualified personnel properly gathered and evaluated the
tion submitted. I am aware that there are significant penalties for submitting false information,
g the possibility of fines and imprisonment for knowing violations"
�� L Z-13-15
of Land Applier Date
tom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form

1
ANNUAL LAND APPLICATION FILL D SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: CGr7) en44-eCA- fy-)&7 Permit #: ,,,4C60j0e4,g Annual Dry Tons Applied:
z- 34Z.
)wner: C r4f) )eC`r%-D Operator: -_ ca'e-&milh _ Cation Exchange Capacity (non 503): Q.,S
ite #: Field #: Acres Utilized: �, C�C1 Acres Permitted: I C.G I
oTotals
,2 oPer
Acre
%
Solid
s
D Tons Per
Dry
Acre
Residual
Sources
(Summarize)
Site
Cond.
Dry'
Wet,
Inches
Preci P
Past 24
Hrs.
Appli-
cation
Meth-
od*
Vola-
tili-
zation
Rate**
Miner-
ali-
zation
Rate
TKN
Ammo
nia-
Ni-
trogen
Ni-
trate
and
Nitrite
PAN 1
LiC
PAN 2
Must Select
Crop 1 or Crop
2
rRe
Crop 1
Crop 2
,Zo-jt-
62Oo
36
biog
5 ., I
m �k)wTi�
6,14
5
n-,5
0.30
UriI
4J?,
Bq .SI
t55,-n-)
r
1
2
3
--
4
5
6
7
8
9
10
11
12
'OTALS:
lct
::
As
Cd
Cr
Cu
Pb
Hg
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime Applied
Lnnual lbs/acre
US.�
5'8TI`�
Date
lbs/ac
'urrent Cumulative lbs/ac
o.�4© ice► tIU.S�� D.� Z a3 O:Z - Z �7Z 10. 4Z D.,23 3 I :....:.:.:::::::::::::::::::::::::::::::::::::::::::
0,1&o .ZQ (..lU.� Z) .Q5 �_ (,o Z. ( 3 lD.2ZI a. v 31:1 3.:::::::::::::::;::::::::::::::::::::::::::::
3tI Z �� 1�Z9 Z �j — �u e ZU:::::::::::::............ ::
Prior Years Cumulative lbs/ac
Permitted C. P. L. R.***
ermt i PAN Limit 1 st/2n d Crop
I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
lesigned to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
ignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Z 13-15 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Vnlatilizntinn Rate! gnrface - 0_5_ Tniectinn/Tncnrnoratinn - 9.0
C urnnlative Pnllntnnt T,naclinu Rate
* * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.
DENR FORM FSF (5/2003)

ANNUAL METALS FIELD LOADING SUMMARY FORD[*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Deport
,cility Name: ("nH er4neOL ( 7 Total Dry Tons Applied (Annual): Z. 34Z
_:Xmit #• LJQ000- LOU e Cation Exchange Capacity (non 503 only): 4. 5
Operator: i�•En%e.&fl5�Lh Owner: CGnJenoea-
Acres Used: Z, (oCj Acres Permitted: IQ,Cj I Site #: -jj Field #: 3
h h m /ka. % Solids use Raw Percent #):
Annual
Heavy 1v1Gi41
1
r1v1u
2
3
4
5
6
7
8
9
10
11
12
0
9) I
xoQ
O.DUZ
©•(xZ
Arsenic
Cadmium
--hromiun
Copper
Lead
Mercury
Molyb-
.GCO20C�q
1
Z� I
Nickel
K
j
Total
Phos-
U�•��
horus
U�•�ob
_a _
_a
ennavvicinn
in
-"I certify, under penalty of law, that this document was prepareu uuue

ANNUAL LAND APPLICATION FIL_,- SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Con -I er-4nfo_ W&-D Permit #: VXCC,0l OL•I,,g Annual Dry Tons Applied: Z_ /Il Z
owner: - Cc ntenl-neo_ (fXf7 Operator: 6f'Sl4h Cation Exchange Capacity (non 503): 4,,5
lite #: -6 Field #: q Acres Utilized: Acres Permitted: l,?" )
o
0
o
SpedSped&
Totals
Per
Acre
%
Solid
s
Dry Tons Per
Acre
Sources
(Summarize)
Site
Cond.
Dry,
Wet,
A If
Inches
Precip.
Past•24
Hrs.
Appli-
cation
Meth-
od*
Vola-
tili-
zation
Rate**
Miner-
ali-
zation
Rate
r
Ammo
nia-
Ni-
trogen
Ni
trate
and
Nitrite
PAN 1
I ct�
PAN 2
Must Select
Must
Crop 1 or Crop
p p
2
Gal.
Cu.Yd.
::
Report
Totals
in Gal.
Crop 1
Crop 2
�231u
6QOOD
Z C►8l
.DICE
C�.�(pf3
ClnWti3TF�
Ilol.�-1"
O
©•5
ozD
�F(��{ci I
U375
! og. I
6.Zs5
r`rc
1
2
3'
4
5
-
-
6
8
9
10
11
12
'OTALS:
As
Cd
Cr
Cu
Pb
HR
Mo
Ni
Se
Zn
P
PAN 11
PAN 2
Lime A
lied
annual lbs/acre
a,CpS
3
b,(�
o, oa
D .L4LIq
D, 1
o.Cb I
:010
o,bz3
o��i0
t��(G
�.......
�S...
Date
lbs/ac
.:.:
;urrent Cumulative lbs/ac
.
©. CI t-1 •G'5(o 64,LR0 ' : TLU /2, 5C9 0.01 Z.7Z5 :.4(�� C). I zt�. lo:::::.......:.:.:.:.:.:.:.:::.:.:.:.:.:.:.:.:.:.:.. .
3 ai.og La. �5 �:��� O-no Z.-715 U3 �� � �. I : ::: :::::::::::::::::::
3 (� f 3 Z 0� i � �d Z(P7 t 5 — 3� a ICI Uqg ::: :: :::::::::::::::::;:;:;::::::
ZU
'rior Years Cumulative lbs/ac
'ermitted C. P. L. R. * * *
ermit PAN Limit 1 st/2nd Crop
I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
esigned to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
ignificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
713-15 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Valatilizatinn Rate_ Snrfaee - 0_5_ Tnieetion/Tnearnnrntinn - 1.0
***C_P_T._R_: f mmulative Pnllutnnt T.nndinu Rate
* * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.
DENR FORM FSF (5/2003)

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
;ility Name: Con { or lneL (1`�1� Total Dry Tons Applied (Annual): Z, eo1 z
•mit #• Cation Exchange Capacity (non 503 only): L.E. 5
Operator: --,;,)t?nee 6mi Wrl Owner: 00n+ef-4nea- r�)&-
Acres Used: Acres Permitted: C, Ci I Site #: 13 Field #: 4
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
VAM
EIRM
Total
Annual Heaw Metal Field Loadings (Calculated in lbs/acre):
Total
Phos-
Pbo—ru—S
"i _certify, under penalty of law, that this document was prepared under my direction or supervision in
rdance with a system designed to assure that qualified personnel properly gathered and evaluated the
information submitted. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations"
Signature of Land Applier Date
* See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form
MEAM rnonn RAM cr 1rP)MON

r
ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE
MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name:
Conl Ens n)c� k_ nfp Permit #: tk_Q(,\WIAnnual Dry Tons Applied:
Owner:
CON
eNDep-Operator: en 6M1V-) Cation Exchange Capacity (non 503): 61. S
Site #:
Field #: (�, Acres Utilized: 1 .G� Acres Permitted: PR
I
Specify
Site
Inches
Appli-
Vola-
Miner-
Ammo
Ni-
Must Select
�.
Totals
%
Dry Tons Per
Residual
Cond.
Precip.
cation
tili-
ali-
TKN
nia-
trate
PAN 1
PAN 2
Crop I or Crop
o
rReport
Per
Solid
Acre
Sources
(Summarize)
D'�
Past 24
Meth-
zation
zation
Ni-
andAcre
2
s
Wet
Hrs.
od
**
Rate
Rate
trogen
Nitrite,C,
Crop 1
Crop 2
®W
TOTALS: As Cd Cr Cu Pb H Mo Ni Se Zn P PAN I PAN 2 Lime A lied
Annual lbs/acre .GCS p,Cl��-1 O.WG, 0,1r O (),D6q ©.001 O,D13 0 ba 1 (,b10 i -W t.(d� C1 �7b3 Date lbs/ac
Current Cumulative lbs/ac 0, U47U I. G 12 t ' . I�G(o 31o• +Z G.��3 b.l 5 1,UG3 1-063 ©.t6_5 IU�c 3 ::::::::::::::::::::::::
Prior Years Cumulative lbs/ac a.0 g 1 eGg 19'Ac> 310.Z62 U•�u D.)L 1.3gi © Ll•UZZ ,<u�F3 it10-1'3:'::::::: ::::::::.:.::.:::::::
Permitted C. P. L. R.*** Z � �3�i _(n�7 33G _ZU-) 1 '5 17_qq d ::::::::::::::::::
2 '
Permi
t PAN Limit 1st/ 2nd Cr
op Z
p
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Vnlntilizatinn Rate: Surface - 0.5_ Tniectinn/ineornorntinn - 9.0
***C'._P_T,_R_: rurnijlative Pnllntant T,nadinu Rate
**** The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.
n=nio Cnonn C:cr irIiOnn IN

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Deport
_-- wility Name: pC)Nb (116 Total Dry Tons Applied (Annual): , '. Z
:rmit #• 6oY C)Ot Cation Exchange Capacity Ct I� (non 503 only): . 5
�,� Owner: Can-� �-n�e� rn��
Operator: �P'(% Field #:
Acres Used: I .�[-�
Acres Permitted: [C{ . C[ I Site #:
72ow Percent 0).
1
tesidual Analysis
Data (Heavy
Metals and
4
'totai rnospnorus use u,g,nr's �� ��=10
5 6 7 8
Sample
)r Com-
posite
Date
Yo Solids I . (OTC
Arsenic <Z.5
-admium "Z
Chromium
Copper 130 (11
Lead 2_�11
Mercury C) • -514
Molyb- 6
Nickel ) 1j
Pnim<�.Dnctal
Phos-
ohorus
2 3
_
Annual Heavy 1Vletal rieia Loauiug� �� a=a u=K.... =u-��•,---i _,_
U
n, DUB
Lead 0.OU l
vlercury (�
Molyb-
.0
Nickel (�. COZ
o
Zinc 1. 16V
Total
Phos- I.l
horus [
rh
"I certify, under penalty of law, that this document was prepared under my direction or supervision in
jficcordance with a system designed to assure that qualified personnel properly gathered and evaluated the
information submitted. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations"
Date
Signature of Land Applier
Y See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematicalDENR FORM MFLSF (5/2003)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: �Cn-} �1 f'f 17 Permit #: �5c)aDI OUS Annual Dry Tons Applied: I .5410
Owner: cD�i��rnb� Operator: '������-�c�)�(-� Cation Exchange Capacity (non 503): �,.!j
Site #:
Field #: � Acres Utilized: Z , pp Acres Permitted: IR' •Gl I
Must Select
oTotals
o
per
Acre
%
Solid
s
Dry Tons Per
Acre
Residual
Sources
(Summarize)
Site
Cond.
D,�p
Wet,
Inches
Preci
Past24
Appli-
cation
Meth-
od*
Vola-
tili-
zation
Rate**
Miner-
ali-
zation
Rate
TKN
Ammo
nia-
Ni-
trogen
Ni-
trate
and
Nitrite
PAN 1
PAN 2
Crop 1 or Crop
2
rReport
Crop 1
Crop 2
u
H
©•(X�I
d•ZD(�
G•Z(f
Mo
D�f�i
I.1gly
Ni
�° Z-3
u. I
Se
C5'CX�$
C
Zn
13}
?u
P PAN 1 PAN 2
°' .` ZG�
::::::::::::::
:;.:.:•:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:.:
Lime A
Date.
lien
lbs/ac ..:
;.
TOTALS:
Annuallbs/acre
Current Cumulativelbs/ac
As
O.0 U
O,4 5
Cd
bv3
Z,G�iZ
Z.G�c
�U
Cr
t,( U
O. 3
1�•62G
Z���
Cu
O•�'�
35.4533•(pt��
n;�l•�tS50
i3�d
Pb
O.C�►�
3-IoZU
Z(p7
Prior Years Cumulative lbs/ac
p.� 11
Permitted C. P. L. R.***
r_. Flo
Permit PAN Limit 1st/2nd Crop ::::' ::;:::::`:::.;;.:.:: >;;:;:;:<:::::::::::::::::::::::::::::::.:.:.:.:.:.:..:.:.:.:.:.:...::: ;; .:...........• • .... .........
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and. imprisonment for knowing violations."
Laul��J z-)3-15 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Vnlatilizatinn Rate: Surface- 0.5_ Tniectinn/inenrnnrntinn - 1.0
***r...P.T,.R_: rilmnlative Pnllntant Londinu Rate
F Form. The FSF and MFLSF are
linked so this
nformation needs to be entered
nto
* * * * The same
Data and the Dry Tons MFLSF as isAcre are o be enteredon the identd on the ically numbered umbered FSF row to properly complete he metals equations. ie. FSF row # 1 to MFLSF column 1.
the same numbered column on the

ANNUAL METALS FIELD LOADING SUMA AKy rvtcivl
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
acility Name: CCU' -f ef)L'eo -- MD Total Dry Tons Applied (Annual):
ermit #• "Wol 0(3s Cation Exchange Capacity (non 503 only): U 5
1p )r: �-j as ee 6 Y)1 c1 f) Owner: 0[)n+J- -4n)PQ(Yi 17
.cres Used • L? U Acres Permitted: I C , Q i Site #: 15 Field #:
:esidu h h rs use moke, % Solids use Raw Percent #):
;ample
r Com-
posite
Date
to Solids
Arsenic
,admiuff
!hromiu
Copper
Lead
Vlercu
Molyb-
Nickel
>eleniu
Zinc
Total
Phos-
PA
1 Iieavv inetat rlela Loauings �%.aicUIULVU lu iu�,n�=.�•
�
S R o �-3
.r
Arsenic 3LI O
Cadmium n> L3 �: D
u
"I certify, under penalty of law, that this document was prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gathered and evaluated the
inl, " ration submitted. I am aware that there are significant penalties for submitting false information,
in( ng the possibility of fines and imprisonment for knowing violations"
_ IY140 �at�. Z-5
Signature of Land Applier Date
x See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form
DENR FORM MFLSF (5/2003)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE,
Facility Name: CCnier)4nea_ ry,)6-j Permit #: , 1Cjj�B Annual Dry Tons Applied: 6,
Owner: Can }�.� m,�� Operator: &64n Cation Exchange Capacity (non 503): Lt. 5
Site #: CT(caC-I Field #: C Acres Utilized:, Z3 Acres Permitted:,33
o
.0 - o
� o
Q
:::
Specify
Totals
Per
Acre_
%
Solid
s
y Tons Per.
Acre'
Residual
Sources
(Summarize)
Siteust
Cond.
D
Wet'
Inches
Preci p
Past 24
Hrs.
Appli-
cation
Meth-
od*
Vola-
tili-
zation
Rate**
Miner-
ali-
zation
Rate
TKN
Ammo
nia-
Ni-
trogen
Ni-NiDr
trate
and
Nitrite
PAN 1
PAN 2
Select
Crop 1 or Crop
2
Gal.
CuNd.
:::
"
Report
in Gal.
Crop 1
Crop 2
La:L
614=
twi5
.c d
©. o,5
,r'Slo tom
'S.i'
c.-L
J
a: 5
O. O
G I
3-)5
1PP O
I. q
r
1
I -IL
a CCX7
(�qO
.=19
o.t4i20
CI)6C)uJL,-rF_P
rn -16i
05
5'
:3C
410 CI J
G,3:-)5
JJc!1q.19I
&3•l 4
0PUM- t.
2
K -lu
33000
610
CGS
0 ZgU
`n-0-D k-DJ -tom
mol ait
n
Q
D �7
0,30
44GLA I
u37>
11SE611
l i(o5
r ��
3
4
5
6
7
-
8
9
10
11
12
TOTALS:
T7Z5
:::<:::::::`::,
As
Cd
Cr
Cu
Pb
Hg
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime Applied
Nnnuallbs/acre
©. 5
0.00-3
0,D0
0.6160
o.04b
c-,. D
.00
o=(Uo
D•U13
1,-)0Z
6•a-lf�
f��.ZlQ
Current Cumulative lbs/ac
��7 75� 5. U 51, 3 u , IZ (� .13c� Z • D4 5 . I h� O. I iG'Z. .
©.5)z t. 5u Z iO o,�7D �•l G.13D Z C 1 J laq C�>(cCXI iG1.zs3Z > ':: :::::: :..........:.:>::
•3 U 77 ) 7( `) i --- 37L{ 9G up
:: ZZO
Prior Years Cumulative lbs/ac
tDate5lbs/ac
Permitted C. P. L. R.* * *
Perm it PAN Limit 1st/ 2nd Cro P
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
dgn�i—ficant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
1"l , nUU /Yn1 Z iZ-if *Application Method: S - Surface, IN -Injection, INC - Incorporation
Signature of Land Applier Date **Vnlatilizatinn Rate: .19nrfaee - 0.5. Tniection/Inearnoration - 1.0
***C_P.T._R.: Cumnlative Pnllntant T.narlinsr Rate
* * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and NIFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
"cility Name: COn i('alnea-RJ2 Total Dry Tons Applied (Annual):
rmit #- L UD©l Cation Exchange Capacity (non 503 only):
Operator: Owner: Confer4nfa-1-ndD
Acres Used: 5. Z3 Acres Permitted: b3©,33 Site #: ('-j ` + LT Field #:
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
F-7,/1-71-10
2 3 4 5 6 7 8 9 10 /1.71-iU U71-IU
% Solids q ,CjSS'Jo � (�
Arsenic �Z.67 <Z
Cadmium 1 • U l
Copper 7 3`6
Lead I G,
Mercury G . 4-3
Molyb-
Nickel 1 Z 1
Selenium 5 � G
Zinc ' e3 2 b
Total .
Phos-
5 <Z.'t)
1.0
1 Z-7
Z Z3Z
> Ilo
3 C),u3
'L
v Metal
Ifs
Lo;
�¢ O
I
G
-
d
o
o ,, 40
o,409
d: C)OZ
(5 , O I
.0. bZ
.13-
O.ZV-f
C).00 I
o. ()OI
o - 015
0• 13-L
Arsenic
C,, 0oz
Cadmium
p, 60 1
Chromiun
©, Z6
Copper
C3 , 1
Lead
Q15
G.©1 Lo
1) , cm
r��,C�S
-).COG
0, OCO
DaDa3
Mercury
D . MD
Molyb-
©.CGS
Nickel
Q I I
0.01 Z
(5, cc)-?
Selenium
(�3 , , 05
om,5
D • W3
Zinc
d ,(�3� I
D• leg
Total
Phos-
O
R.
5.q0
MO
,,D13
5�n13
horns Zti, 3 4,5 Z(a. f Z7 jjq.q6,j -
"I certify, under penalty of law, that this document was prepared under my direction or supervision in
ecordance with a system designed to assure that qualified personnel properly gathered and evaluated the
:.iformation submitted. I am aware that there are significant penalties for submitting false information,
including the ossibility of fines and imprisonment for knowing violations"
Signature of Land Applier _ Date
r See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form
DENR FORM MFLSF (5/2003)
NA

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLEASE MAKE A COPY OF THIS
PLACE A "NIA"
IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Con -}en- n (Y);�j7
Permit #: �, � �Qy� Annual Dry Tons Applied: 3, &n-3
Owner: Con48- -he(Lff)6D Operator:
Cation Exchange Capacity (non 503): ram, j
Site #: C T(O& -tr Field #: q
Acres Utilized: G c, (� Acres Permitted: W , 3-3
::: S eci
Site
Inches
Appli-
Vola-
Miner-
Ammo
Ni-
Must Select
$.
o
Gal.
Totals
%
Dry Tons Per
Residual
Cond.
Precip.
cation
tili-
ali-
TKN
nia-
trate
PAN 1
PAN 2
Crop 1 or Crop
d.
� o
F:::Report
Per
Solid
Acre
Sources
(Summarize)ls,
Dry,
Past 24
Meth-
zation
zation
Ni-
and
2
Acre
s
Wet,
Hrs.
od*
Rate**
Rate
trogen
Nitrite
iilalcic
Crop 1
Crop 2
r 11 1LI
al.
Q(Y1�',!i
rl 17.c1
,iS1Den'
b.%ZCn
C tY16171t�G� I�
fY�31�E
d
5
O, 5
©Q0
° l C I
�1375
1U) I
09-qQZ
Cal
1
TOTALS: , Z� As Cd Cr Cu Pb H Mo Ni Se Zn P PAN 1 PAN 2 Lime A lied
Annual lbs/acre O • DOLl C>, Db� L3 • c ar c�• 3�7 G. bE3 C). w 1 C), DO! 0. ol-' o. CX�� 6• b 38• eC� �18• Z Date lbs/ac
Current Cumulative lbs/ac O. L iQ3 1, g52- Z/ .5v2 6D,5 6,10-5 s,13(-1 2. 69G) �• 01 1 L&0, 9 '45. �' .? .............:
Prior Years Cumulative lbs/ac 0.41QGl 11. 5n 1 V,.0 3 5©,-L'5Z 5.170 G.133 L'29Z L_;y"LI L(not IC .::::..
Permitted C. P. L. R.*** 3� 3�I Uol� 1�3� L�� i5 — 3�{ ............::::::::.
�c C�l�
Z
2 dC Crop
Z D
' n N Limit 1st/
Permi
t PA
P
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
Sig ificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
LL Z (3--15 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Volatilization Rate- Snrface - 0.5_ Tniection/inenrnorntinn - 1.0
***C'..P_T,_R_: Cumulative Pollutant T,nadinu Rate
* * * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # I.

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Waa�ility Name:
mit #:
Operator:
Acres Used:
Residual Ana13
Sample 1
or Com-
posite
Date O ZI•-I Ll
% Solids 1 • p(�I_
Arsenic
Cadmium , LI
Chromium Z7
Copper Z32
Lead j(o
Mercury ().Li3
Molyb- 5
denlim
Nickel j Z
Selenium 1,5.0
Zinc (� 2
Total
Los -
Cans l Erl 7 Total Dry Tons Applied (Annual): -.
tA. ,C0C)1C1-t•1-1 Cation Exchange Capacity (non 503 only):
f� nef- Owner: C}Of1�PY`�lf1L°C�fYi�`I�
(4, Of (o Acres Permitted: 30,33 Site #: CTrGC�IL Field
sis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Annual
heavy IVICLU1
v 1Giu
juv"%RA.
F.
9
10
11
12
2
3
4
5j
6
7
8
H
a
to rs t7
�.
G - bUU
Arsenic
a , GpLl
Cadmium
0, (r2
0, G-�
hromi
©. G3C)
3
Copper
C'.3y)
3
p, �
-3
3.0z3
Lead
Mercury
0,
•
O 1
0. UU7
Molyb-
denlim
d,GO�
0, G j-)
p,W-)
(0.ci t�
O.QIi
0
Nickel
Selenium
Zinc
Total
Phos-
3Q,C 3
phorus
awcq
"I certify, under penalty of law, tuat 11115 uUcu111cuL vrnO tyxati"A■ -
")rdance with a system designed to assure that qualified personnel properly gathered and evaluated the
=__jrmation submitted. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations"
Signature of Land Applier Date
X See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematicalDENR FORM Form
(5/2003)

t
ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Cc)n4er)4n-ea_ M65) Permit #: L �ccpicqs Annual Dry Tons Applied: Z.q?-j
Dwner: C3n+er)_�i1fD_ (Y &_D Operator: --�tnec 6m`,4k-) Cation Exchange Capacity (non 503):
Site #• C:T(cLC_-Field #: l_3 Acres Utilized: 3.35 Acres Permitted: 30--3
o
0 Pi
Q
Gal.
Cu.Yd.-
Totals
PerSosid
%
Dry Tons
Acre
Report
Totals
Acre
in Gal.
lwGDC)
7nZC
:bID3
0. g7Z
i-n IU
Site I Inches I Appli- I Vola- I Miner -
Residual
Cond.
Precip.
cation
tili-
ali-
Sources
Dry,
Past 24
Meth-
zation
zation
(Summarize)
Wet,
Hrs.
od*
Rate**
Rate
r n a��'� , i ►�
,-rnibl-
0
5
0.5
O Z D
Ammo Ni- Must Select
nia- trate Crop 1 or Crop
TKN Ni- and PAN 1 PAN 2 2
trogen Nitrite Il o(_ Crop 1 Crop 2
W]
I —_ i 1I TOTALS: C? As Cd Cr Cu Pb H Mo Ni Se Zn P PAN 1 PAN 2 Lime A lied
aZ
Annuallbs/acre D u o. 3 D,h360 063(j G.DQqG.W, �.010 0:07'(s, n0oq I.Laq 3 Date lbs/ac
:::::::::::::::::
Current. Cumulativelbs/ac D. Z -z- �.7g5 1Z•ZgL Zl�:Z3c� Z. 0•D1"Ci 1 1 9 Z.S(�U .65c� ��•�Zs�
Prior Years Cumulative lbs/ac Q-Z-7q 5 D.b(OG D.GGq Z•g3c1 0.3(A) g�•i�6u .................. ::;:<:::::::::.:.:.>
Permitted C. P. L. R.*** 3U ; iO_? 1-a3q ZO. 15 37u gcl 1s 1G 5� ::::::::::::::...
roP
ZZ 0
rtl st/2n dC
Perm it PA
N Lim
:�
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
6"a ,�� Z-13-15 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Vnlatilizatinn Rate: Vinrface - 0.5_ Tnieetion/Tnenrnnratinn - 1.0
rurni lotive Prillntnnt T'andinu Rate
* * * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.
nr_nin cr%onn rolf ic1nnn'3\

ANNUAL METALS FIELD LOADING SUMMARY FORM`
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Deport
�� cility Name•t�/� e�,;>t°� YYI�� Total Dry Tons Applied (Annual): Z.GZ J
)rmit #• QgrpoICcf� Cation Exchange Capacity (non 503 only):
Operator: P) re, J` rsll� Owner: �0n�en4ne0--ff)61)
Acres Used: 3,3rj Acres Permitted: �3o.33 Site #: C,T(GC+r Field
Residual Analysis Data
Sample r
or Com-
posite
% Solids I.
Arsenic C
Lead
Eq
Mercury
0 ..3 U
Molyb-
denum
LP
Nickel
15
Selenium
<60
Zinc
s5 J
Total
1hos-
oorus
1,-fC)10
Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent
1 uo., Mr +Qt Fig -la T.narlinac WnIculated in lbs/acre):
h
. .
"I certify, under penalty of law, that this document was preparea under my Wrecuun ur bupvl viaauu lu
r .ordance with a system designed to assure that qualified personnel properly gathered and evaluated the
_ormation submitted. I am aware that there are significant penalties for submitting false information,
including the possibility of fines ��and imprisonment for knowing violations"
Signature of Land Applier Date
Y See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form
DENR FORM MFLSF (5/2003)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: `Conn en4neo- W&&) Permit #: 00-0cD ICLIc2 Annual Dry Tons Applied: Q. Z 33
Owner: CGn 4 ff-� nfc,; K) D Operator: 6m) (i-) Cation Exchange Capacity (non 503): L4, 5
Site #: Field #: , Acres Utilized: A3.CC� Acres Permitted: I Q. 00
o
o
A
:::I Suecify
Totals
Per
Acre
%
Solid
s
Dry Tons Per
Acre
Residual
Sources
(Summarize)
Site
Cond.
D�'�
wet,
Inches
Precip.
Past 24
Hrs.
Appli-
cation
Meth-
od *
Vola-
tili-
zation
Rate **
Miner-
ali-
zation
Rate
TKN
Ammo
nia-
Ni-
trogen
Ni-
trate
and
Nitrite
PAN 1
I
PAN 2
Must Select
Crop 1 or Crop
2
'
Gal.
Cu.Yd.
Report
Totals
in Gal.
Crop 1
Crop 2
523-/-I
&IU
(0ZC00
320oo
W60
lc o i
,Olo
>CUIC
..LI U
Cn-,6nD
: OtLYT
,rL
\
C9
L-)
0.5
5
0.30
4,cp I
L13�)5
Kqjg.91
tvK's, 167
(,Z.,
zp�l,
�K�-
2
3
4
-
5
6
7
8
9
10
11
12
TOTALS: 3133LI :::::::::::::::
Annuallbs/acre
As
001
Cd
O.L�CI
Cr
0.U1
Cu
C�. 5
Pb
O. u5
H
D.CC)I
Mo
C).l>IU
Ni
©.(-J3LI
Se
D.nILi
Zn
I.�iZ5
P
3. 2
PAN 1
�15•Z17
PAN 2
Lime A
Date
lied
lbs/ac
Current Cumulative lbs/ac
D• i�7 D� 5� LI LJ ZU. I 1. 3 lv D. DVI' tZ. 3i2 0. 3Z(-I ;� .(04Z ; ::::::::: >: >:::::« ........
0.1 r C) 0. Z55 . GOB Z3. U i .-)Ci 1 O or? D I Z. Z- � G.3 ► o is � 17...:.........:..:..:.:.:.:.:.:.:
Flo y Zh�� 133`� Z(cr] i �......`�� I `3ci Z�iG� ::::::.:.:...:...:. . .
ZZ
Prior Years Cumulative lbs/ac
Permitted C. P. L. R.***
2 d Crop
Perm it PA Limit 1 s n N Lun t/ P
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
L'inw �rr_U� *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Vnlatilizatian Rate: Surface - 0.5. Tniectionflfneornaration - 1.0
***C_P_T,_R_: Cumulative Pnllutant T.nadinu Rate
* * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the,identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.

ANNUAL METALS FIELD LOADING SUMMARY FORM'
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: W6D Total Dry Tons Applied (Annual): 14,Z33
?ermit #: w�vQCp; QUA Cation Exchange Capacity (non 503 only): 46
gyp. )r: i�EnE� `Jm Owner: CDn%eNf� 9 rf16l7.
tcres-Used: ,gyp Acres Permitted: 1 Lk. CO Site #: iD Field #: I (o
lesidu XLtals and Total Phosphorus use mgLkg, % Solids use Raw Percent #):
Sample
:)r Com-
posite
Date
% Solids
Arsenic
�admiurn
Mrorniurn
Copper
Lead
Mercury
Molyb-
denum
Nickel
Seleniumr
Zinc
Total
Phos-
P11-1@
NNIIIIIIIIII
Am I
Am I
Heavy Metal Field Loadings
(Ualculated in ins/acre):
0
1
2
3
4
5
6
7
8
9
10
11
12
H
CD
L4
o
Cj.Ct�l
(.Ll, C7
I.0 1 I
Arsenic
0 C(>5
0, 'i,
0.666
Cadmium
C, Co-3
0, CO 1
G. 00c)
Mromi
C,.65 U
CG . C2�
Copper
0. LI-42
Q .ZZ3
Lead
Cj,O-6U
D,p15
ECJ'S-�Mercury
r,'
C),C=o I
Q,w©
Molyb-
denum
C22
LOD -
C�,OIi1
Nickel
, , ) LZ
0, 01'L
o'G-6 y
Selenium
CpG7
p, OQ 7
G. G 6 W
Zinc
; . Z--) 0
r) .155
I c 15
Total
Phos-
phorus
Z5, F60
Z
"I certify, under penalty of law, that this document was prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gathered and evaluated the
inf(.,-- - [tion submitted. I am aware that there are significant penalties for submitting false information,
inc] . -i[g the possibility of fines and imprisonment for knowing violations"
" I nyLL& Z-1 l5
Signature of Land Applier Date
x See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form
I DENR FORM MFLSF (5/2003 )

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE. -
Permit #: I,- Ip4C�
FacilityName: Cbn 4 eri�ec� Annual Dry Tons Applied: Z.CI'7Z
n��
Owner: C'p;�}����..1"fl.� Operator: �j�� rril�lan _Cation Exchange Capacity (non 503): 4. �
Site #: -D Field #: Acres Utilized: Z. 37 Acres Permitted: P U• lib
D Tons Per
Residual
Sources
(Summarize)
Site
Cond.
Dry,
Wets
Inches
Precip.
past 24
Appli-
cation
Meth-
od*
Vola-
tili-
zation
Rate**
Miner-
ali-
zation
Rate
TKN
Ammo
nia-
Ni-
trogen
Ni-
trate
and
Nitrite
PAN 1
cal.
PAN 2
Must Select
Crop 1 or Crop
2
�.
oV
Q
::: s eci
Totals
per
Acre
%
Solid
s
Gal.
d.
ReportAcre
ls
Crop 1
Crop 2
1.ZS
rs w �
c1k
C
Oe5
0,3c�
I
375
/4R/I.�I
C: 3
.
rn
1
2
4o
voICS
3
4
5
6
7
8
9
10
11
12
Cd
0b0c1
C). L450
C% (lu(A
3u
Cr
p.b(o3
11. §ZPJ
i l • W11
ZI�7�
Cu
©.582
31 -'Q5
3��
Pb
o.CLIC�
Z • UZ=0
H
o.co i
03LI
b33
I
Mo
C�•Qi3
G, ZU
a
—
Ni
D•GZD
3•0-110
ZGc�
U
Se
p.Gl3
0,1A3q
C��I(•
'9c)
Zn
i.�IC9
log.04C5
P PAN 1 PAN 2
f�lvSZ- u4. �3
...:.....:..:...:..........................
...........?..........
.... ..................
Z2 0
with a system
Lime A
Date
lied
lbs/ac
TOTALS:
As
Annual lbs/acre
C0 �0�
Current Cumulative lbs/ac
Prior Years Cumulative lbs/ac
Permitted C. P. L. R. * * *
Permit PANLimit rt 1st/2nd Crop
Z7 Z
p. ZIAD
_3
nr w,,.,Prv;cinn
in accordance
"I certify, under penalty_ of law, that this document was preparCu uuuv■ uay uJLJL ..&­_- — "--M--- •---_..__ ___ __ _ _ _ _______
designed to assure that qualified personnel ,properly gathered and evaluated the information submitted. I am aware that there are
significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
*Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Vnlatilization Rate: Surface - 0_5_ Tniectinnftnenrnoratinn - 1.0
***( P_T._R_: cumulative Pollutant T,nadinu Rate
* * * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # I to MFLSF column # 1.

ANNUAL METALS FIELD LOADING SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: 0()n� Ply ae GL 0�6-j) Total Dry Tons Applied (Annual): Z •�`f7Z
mit #; oo ceo i ow? Cation Exchange Capacity (non 503 only): 14 i 15
Operator: J'hP-n2f- 6rm Lv) Owner: CDO& r4neCL md-b.
Acres Used: Z.Z177 Acres Permitted: I Li, p D Site #: I Field #:
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
��iiiiiiiiiii
Annual Heavy -Metal Field Loadings Calculated in lbs/acre):
Elm
Total
Phos-
.ho
"I certify, under penalty of law, that this document was prepared under my direction or supervision in
rdance with a system designed to assure that qualified personnel properly gathered and evaluated the
.u--rmation submitted. I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations"
&Jx� AmtiL-k - Z-13-6
Signature of Land Applier Date
X See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form
DENR FORM MFLSF (512003)

ANNUAL LAND APPLICATION FIELD SUMMARY FORM
PLEASE MAKE A COPY OF THIS BLANK FORM TO BE COMPLETED AND SUBMITTED FOR EACH APPLICATION FIELD.
PLACE A "N/A" IN A BLANK OR BOX WHEN NOT APPLICABLE.
Facility Name: Ca-)-f >°c(jybi� Permit #: w -)aoC�Io(I43 Annual Dry Tons Applied:
Owner:
Site #:
Con4ef-- nt-o_ i J7 Operator: ktM14_r)
1D Field #: 1,2 Acres Utilized: I : Cio
Cation Exchange Capacity (non 503): L1, S
Acres Permitted: I Lt. CCU
o
y oPer
Specify
Totals
Acre
%
Solid
s
D Tons Per
Dry
Acre
Residual
Sources
(Summarize)ls
Siteust
Cond.
D ry,
Wet,
Inches
Preci p
Past24
Hrs.
Appli-
cation
Meth-
od*
Vola-
tili-
zation
Rate**
Miner-
ali-
zation
Rate
TKN
Ammo
nia-
Ni-
trogen
Ni-Ni-
trate
and
Nitrite
PAN 1
CCrop
PAN 2
Select
Crop 1 or Crop
2
Gal.
d.
F:::Report
al.
1
Crop 2
-�-1�
5bbb©
G(G7�I
,=vio3
1.Zl�iv
C7�'i
rroi5,-
CU
�,
0.5
o.3lJ
P!
Z►5o
c14•(�I
�Z.I
rerr( '
1
2
3
4
5
6
7
8
9
10
11
12
TOTALS:
2�iuOU
::::::::
As
Cd
Cr
Cu
Pb
Ha
Mo
Ni
Se
Zn
P
PAN 1
PAN 2
Lime A
lied
Annual lbs/acre
ri = C>G
v . W5
o, o5l,
o•-)-)5.
0' , b- 1
0,C01
0 • v 15
v. Q 2
O. C513
Z. 515
57.(�Ol y
Date
lbs/ac
Current Cumulativelbs/ac
0, -7 0.103 Q-I3SQ i2.­�1Z C,4S6 c)-at 0,3(,q w3� 0.1tg 0
D, oG I O.�S Ll-.��Z I ,�3� 0,(3I u G=UZl C5.3�U G= � 0 15� 5 3 :::: ::::.... `...... `.......
� 3 4 ao-) 1-83 q ZOO-) 74ci R : :
Prior Years Cumulative lbs/ac
Permitted C. P. L. R. * * *
Permit PAN Limit 1st2nd Crop
"I certify, under penalty of law, that this document was prepared under my direction or supervision in accordance with a system
designed to assure that qualified personnel properly gathered and evaluated the information submitted. I am aware that there are
'significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Il( 41 p/Ylt( _=- 13 15 *Application Method: S - Surface, IN - Injection, INC - Incorporation
Signature of Land Applier Date **Vnlatilizatinn Rate: ;lnrface - 0_5_ Tniectinn/Inearnnrntinn - 1.0
rmmilative Pnllntant T,nndinu Rate
* * * * The RSSF Data and the Dry Tons Per Acre are to be entered on the MFLSF Form. The FSF and MFLSF are mathematically linked so this information needs to be entered into
the same numbered column on the MFLSF as is entered on the identically numbered FSF row to properly complete the metals equations. ie. FSF row # 1 to MFLSF column # 1.
DENR FORM FSF (5/2003)

ANNUAL METALS FIELD LOADEgG SUMMARY FORM*
Attach this form to the corresponding Field Loading Summary Form to be submitted in Annual Report
Facility Name: (2i2f) 8-)4n6a-l'l'� Total Dry Tons Applied (Annual): Z-40S"
emit #; V�QW)DIC 1q Cation Exchange Capacity (non 503 only): t4. 5
Operator: 'P 61�e2 6-04n Owner: CO M ec4n ea - m 6D
Acres Used: Acres Permitted: I L4. 00 Site #: Field #: 1,2
Residual Analysis Data (Heavy Metals and Total Phosphorus use mg/kg, % Solids use Raw Percent #):
Sam
��iiii�ii�ii
Total
■■■■■■■�■tee■
Annual Heavy Metal Field Loadings (Calculated in lbs/acre):
1011111101i
logo
• .
Phos-
phorusEENEENEENEEN
t
"I certify, under penalty of law, that this document was prepared under my direction or supervision in
rdance with a system designed to assure that qualified personnel properly gathered and evaluated the
i____-mation submitted. I am aware that there are significant penalties for submitting false information,
including the po sibility of fines and imprisonment for knowing violations"
Z-13-15
Signature of Land Applier Date
x See bottom of FSF Form for helpful instructions for this MFLSF Form and the mathematically linked FSF Form
DENR FORM MFLSF (5/2003)

ANNUAL PATHOGEN AND VECTOR ATTRACTION REIDUCTION.FORM
Facility Name: ` . n+g)4 -eo_ ( 6-D Permit Number: UCq o_,a0104,q
WWrP Name: C'oNen4neo_ NPDES Number: f�CC03ZL��
Monitoring Period: From AGO Locq I12010 To D2(:2mbe( ai,-za4
Pathogen Reduction (40 CFR 503.32) - Please indicate level achieved and alternative performed:
Class A:
Alternative 1 ❑
Alternative 2 ❑
Alternative 3 [3
Alternative 40
Alternative 5 ❑
Alternative 6 ❑
If applicable to alternative performed (Class A only) indicate "Process to Further Reduce Pathogens":
Compost ❑
Heat Drying ❑
Heat Treatment ❑
Thermophilic ❑
Beta day ❑
Gamma Ray ❑
Pasteurization ❑
Class B:
Alternative 1
Alternative 2 ❑
Alternative 3 ❑
If applicable to alternative performed (Class B only) indicate "Process to Significantly Reduce Pathogens":
Lime Stabilization . ❑
Air Drying ❑
Composting ❑
Aerobic Digestion ❑
Anaerobic onDig esti❑
.......................................................................................
If applicable to alternative performed (Class A or Class B) complete the following monitoring data:
Parameter
Allowable Level
in Sludge
Pathogen Density
Number of
Excee-
Frequency
of
Sample
Type
Analytical
Tech-
Minimum'Geo.
Mean
Maximurr
Units
Fecal Coliform
2 x 10 to the 6th
power MPN per
gram of total
solids or 2 x 10 to
the 6th power
38v
<' �O
JOW)
<nLj
3451
< I Q
MPPIW-PPI
i
0
0
`7
g la0
-2Z) L-00
gzzjc--G(o
1nP►j6f?PP
O
glap
yfclm
9ZZIE6(o
gzzlr -o
1000 mph per
gram of total solid
weight)
Salmonella bacteria
(in lieu of fecal
coliform) I
3 MPN per 4
grams total solid
(dry weight)
Vector Attraction Reduction (40 CFR 503.33) - Please indicate option performed:
Option 1 ❑ Option 2 ❑ Option 3 ❑ I Option 4 I(M I Option 5 ❑
Option 6 ❑ Option 7 ❑ Option 8 ❑ Option 9 ❑ Option 10 ❑
No vector attraction reduction
were options performed ❑
p
CERTIFICATION STATEMENT (please check the appropriate statement)
l "I certify, under penalty of law, that the pathogen requirements in 40 CFR 503:32 and the vector
attraction reduction requirement in 40 CFR 503.33 have been met."
❑ "I certify, under penalty of law, that the pathogen requirements in 40 CFR 503.32 and the vector
attraction reduction requirement in 40 CFR 503.33 have not been met." (Please note if you check
this statement attach an explanation why you have not met one or both of the requirements.)
"This determination has been made under my direction and supervision in accordance with the
system designed to ensure that qualified personnel properly gather and evaluate the information
used to determine that the pathogen and vector attraction reduction requirements have been met. I
am aware that there are significant penalties for false certification including fine and imprisonment."
I �`1� Cc�.h o� Pn�2 �m►� � to ryj aQ2 oV_L
Preparer Name and Title (type or print) Land Applier Name and Title (if applicable)(type or print)
Signature of Preparer Date Signature of Land Applier (if applicable) Date.
DENR FORM RF (5/2003)

�o�� 00000 �hcupown. uLod
GREEN1 IEEE, N.C. 27835-7085
C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
PARAMETERS
Sample Sample Sample
#1 #2 #3
Wastewater ID 10%
ONE (252) 756#-6208
FAX [phone]
ID#: 416 A
DATE COLLECTED: 01/28/14
DATE REPORTED : 01/30/14
I/ °/
REVIEWED BY:
Sample Sample Analysis Method
#4 #5 Date Analyst Code
Total &-sidue, mg/l 13960 15920 16360 11840 14200 01/28/14 MDD 2540B-97
Fecal Coliform (MPN), /gram Solids 2364 879 1039 380 3451 01/28/14 MDD 9221E-06

0[�cm"R & do'
{'.O. 'I tCX 7085, 114 OAKMON I L
GREENVILLE, N.C. 27835-7085
C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
Wast
FAX [phone]
ID#: 416 A
DATE COLLECTED: 01/28/14
DATE REPORTED : 01/30/14
a
i�
REVIEWED BY:
L
Sample Sample Analysis Method
PARAMETERS #6 #7 Date Analyst Code
Total Residue, mg/1 13440 15480 01/28/14 MDD 2540B-97
Fecal Coliform (MPH /gram Solids 967 504 01/28/14 MDD 9221E-06

GREENVILLE, N.C. 27835-7085
C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
ID#: 416 A
DATE COLLECTED: 04/21/14
DATE REPORTED : 04/25/14
REVIEWED BY:
Sample Sample Sample Sample
PARAMETERS #1 #2 #3 #4
Total Residue, mg/1 10400 10160 10320 10420
Fecal Coliform (M N), /gram Solids < 173 < 177 < 174 < 173
Sample Analysis Method
#5 Date Analyst Code
10460 04/21/14 CMC 2540B-97
< 172 04/21/14 CMC 9221E-06

m 'wummiN % bw
P.O. BGX 7085, 114 OAKMONT DR
GREEWILLE, N.C. 27835-7085
mhd
C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
tewate
FAX [phone]
ID#: 416 A
DATE COLLECTED: 04/21/14
DATE REPORTED : 04/25/14
REVIEWED BY:
Sample
Sample
Analysis
Method
PARAMETERS
#6
#7
Date Analyst
Code
Total Residue, mg/l
10000
10620
04/21/14 CMC
2540B-97
Fecal Coliform (M N), /gram Solids
<180
<170
04/21/14 CMC
9221E-06

n o e t ,
InG►
�C Wo
C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
iatewater.
ID#: 416 A
DATE COLLECTED: 09/16/14
DATE REPORTED : 09/19/14
REVIEWED BY:
Sample Sample
Sample Sample
Sample Analysis
Method
PARAMETERS #1 #2
#3 #4
#5 Date Analyst
Code
Total Residue, mg/1 10580 10440
11000 11000
11020 09/16/14 KKF
2540B-97
Fecal Coliform (MP1S), /gram Solids < 170 < 172
< 164 < 164
181 09/16/14 CMC
9221E-06

��do�oUHM % hcooQ
wmq d
C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
Sample
PARAMETERS #6
ID#: 416 A
DATE COLLECTED: 09/16/14
DATE REPORTED : 09/19/14
REVIEWED BY:
Sample Analysis Method
#7 Date Analyst Code
Total Residue, mg/l 10520 10720 09/16/14 KKF 2540B-97
Fecal Coliform (MPH /gram Solids <171 <168 09/16/14 CMC 9221E-06

Em"Infimid % honowdod
WastewaterII
NONE (252) 756e
P.O. SOX 7085, 114 OAKMONT DRIVE
GREENVILLE, N.C. 27835-7085 FAX (252) 756-
ID#: 416 A
C.M.S.D. (SLUDGE
& WELLS
ACCT)
CONTENTNEA METRO.
SEWAGE
DIST.
MS. RENEE PRIDGEN
DATE
COLLECTED: 12/09/14
P.O. BOX 477
DATE
REPORTED
: 12/12/14
GRIFTON ,NC 28530
REVIEWED BY:
Sample
Sample
Sample Sample
Sample
Analysis
Method
PARAMETERS
#1
#2
#3 #4
#5
Date Analyst
Code
Total Residue, mg/1
19120
19120
19220 18300
18740
12/09/14 KKF
2540B-97
Fecal Coliform (MTN), /gram Solids
24
24
57 25
<10
12/09/14 KKF
9221E-06

a
do
EEhWILLE, N.C. 27835-7085
C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
Wastewat
PHONE (252)
FAX (252)
ID#: 416 A
DATE COLLECTED: 12/09/14
DATE REPORTED : 12/12/14
REVIEWED BY: /
Sample Sample Analysis Method
PARAMETERS #6 #7 Date Analyst Code
Total Residue, mg/l 20100 19580 12/09/14 KKF 2540B-97
Fecal Coliform (MPH /gram Solids 39 49 12/09/14 KKF 9221E-06

�,eOu �)44aC4�cn
1&4 Q uO,(-lf-(
SPECIFIC OXYGEN! UPTAKE RATE (SOUR)
FOR
AEROBICALLY STABILIZED SLUDGE
Analysis By: enff6-nA-h Date•.
Sample Point: IC�, eb{_ _
Sample Time:__- 3' I6�/�"� _
Air Temp (Ta).- ° Sample Temp (T,): Q 0 _ Sample Site Do:_.___,
Time Dissolved 02
I (Minutes) I _ mg/L I
i I 66 I
(See Attached Graph)
Oxygen Consumption Rate (Slope), mg0 /L/min
_I-- ZZ� i �7 4 I =(DO, mq/L) Time% - (D02mg/L) Time7-
Zl I� Timed - Time %
I I I Zb-5—
LijJ0[0`7 mg O&/L/min
J I I
I I �
Total Solids: 1 I •-i _g/L
� I I
I I i
Specific Oxygen Uptake Rate, mg0Z/g/hr at 20® C
(20-TO
p, u�lta��I __ mg0�/L/min 60 min (1.06)
I� -( Total Solids, g/L hr
60 min (1.06) (D �3c000�
X hr
= D.ZI30--? mg0a/g/hr at 200C

t SOLIDS, TOTAL SOLIDS, and 'TOTAL VOLATILE SOLIDS
Abr�L4fSgS Ova ` "'� 1 DATEYIKEs L)'-W fn
_ SAWPLE IDEWTZ FILAYION . L[6t-DA
DISH NUMBER �—
A o WESBHY OF OKSH, gm
®o wEgrHT-OF DISH �.IGY�%
Amo sAWPL(E o gay! .
Co WE88Hi OF DISH
DRY SO LIDS o gin i® � � •4�v� ®:
0. ' WEIBHT OF ®ISH .
AND ASH o gm ,
Eo VGLUWE OF SAC77PLE,mi. ZD
t SOLIDS, Rs' l Ig��_ I•I(o�
T07AL SOLIDS,g/g
��.
TOTAL
VOLATILE SOLIDS*
-D-f•-7t
SOLIDSe 5�, a C—A X ISO
B®A
'LOYAL SOLXDS,g/l ®.-C—A X 1006
E
TOTAL VOLATILE SOLIDS,g/I C—D X 1688
E

V,6 la 44roa�cn
Znd C ua(4 e(
SPECIFIC OXYGEN UPTAKE RATE (SOUR)
FOR
AEROBICALLY STABILIZED SLUDGE
Analysis By: _.. j�l���' �I �'i�-i1 _ Date:
Sample Point: jl 2�} ( _ Sample Time: rn
Air Temp (Te ) : ISample Temp (T.,) : Z5°C _ Sample Site DO:_...____.
Time Dissolved 02
I (Minutes) I mg/L I
(See Attached Graph)
Oxygen Consumption Rate (Slope), mgO /L/min
= DO _mq/L) Timers — (D0, mq/L) 7ime�
Times — Time%
C�.Old�75 mg O&/L/min
I I Total Solids: g/L
I
J I I
Specific Oxygen Uptake Rate, mg0Z/g/hr at 200 C
(20—TO
6,o(,q-6 = mgOm/L/min 60 min , (1.06)
Total Solids, g/L hr
(20—T2) ( 5�
60 min (1.06)
0, C'C 6C)q X hr
o ZZ�g2) mg0$/g/hr at 200'C

SAL.PSo TOTAL SOLIDS, and TOTAL VOLATILE SOLIDS
ANALVSZS HV8 �i4 h- DATE TXH'E
SA14PLE XDENTXFXCATXO
DISH NUMBER.
A. WEZGHT OF DZSHogm
0. WE XrmHT OF DISH
AND SAWPLE"gm
C. WEXaHT OF DISH
DRY. SOLZASogm
OF ®ASH
AND ASHDOM
E. VOLUME OF S AMPLE,,mi
t; SOLIDS, Z6' '2D
TOTAL SOLRDS,,'gil 131LANJL
TOTAL
VOLATILE SOLIDS"
SOLXDSo5 n C—A X ISO
B—A
TOTAL SOLXDtDg/i --C-A X 1068
E
'C-T TOTAL !VOLATILE SOL'OSD9/1 C-0 X 1809.
E

4-edu 44rac=,Drn
6rd Qua(+eV
SPECIFIC OXYGEN! UPTAKE RATE (SOUR)
FOR
AEROBICALLY STABILIZED SLUDGE
Analysis By: _ Date:
Sample Point:a` -k2( _ Sample Time:
Air Temp (To) : Sample Temp (T�) : �� _ Sample Site DO: _.____..
Time I Dissolved 02 1
(See Attached Graph)
Oxygen Consumption Rate (Slope), mgO /L/min
=_(DO, mg/L) Time, - (D0, mg/L) Time -
Times - Time%
—.55'
=__0--cfa3Z mg 0�/L/min
J I I
I � I
Total Solids: g/L
Specific Oxygen Uptake Rate, mg0Z/g/hr at 20® C
(20-Ta)
60 min , (1.06)
10,E Total Solids, g/L hr Z4
( 20-T2 (- L}�
60 min (1.06)
O, 00140l X hr
mg0&/g/hr at 200C

t SAL%9S, TOTAL SOLXDS, and TOTAL VOLATZLE SOLIDS
AMALVSZS OV s 1 •6m.i(-Ll DATE YXWE s l400
SAIAP6E XDE6 TXFXCAYX®id
OXSH NUMBER
Aa WEXSITY OF DBSHDgm
0. W87GHY OF DXSH
AND SAMPLE o gm l0 D'2�✓ v
C o WEYSHT AID DXSH
DRY SOLZDS,gm ®.
®o WEXBHY OF DXSH .
AND ASHogm
E. VOLUME OF SAWPLE,ml 7,1�
t SOLZOS, t
TOTAL SOLXDS,g/b 10• (, L
TOTAL
VOLATILE SOLIDS'
i� SOLXDSe a C—A X 1S@
B-A
"a TOTAL SOLXDS,g/l o .C—A .X 1098
E
TOTAL VdLAYXLE SOLXDS,g/I C—D X 1869
E

Nr-ec+94 /-)4(C6V(C )
SPECIFIC OXYGEN! UPTAKE RATE (SOUR)
FOR
AEROBICALLY STABILIZED SLUDGE
Analysis By:-6o)-lah _ Date: izZc-1�
Sample. Point: �l l �( _ Sample Time: lL! I S
Air Temp (To) : 2.30 Sample Temp (T-) Sample Site DO:w_ _T
Time Dissolved 02
I (Minutes) I ma h
(See Attached Graph)
Oxygen Consumption Rate (Slope), mgO /L/min
Timet - (DO. mgfL) -rimeS
Times - Time
I is
I I I =...... r", 2A mg 0?/L/min
Total Solids: QA __9/L
I I I
Specific Oxygen Uptake Rate, mgOZ/g/hr at 2e C
(20-TO
mgQi- L/min X 60 min (1.06)
)� Total Solids, g/L hr ZZ
60 min � (1.06)
C)-C) X hr
mgOg/g/hr at 200'C

tc ,SOLIDS, TOTAL SOLIDS,, and TOTAL VOLATILE SOLIDS
ANALVS%S BV s- DATE a 122 =�� TIWE s
SAMPLE IDENTIFICATION 4,�h_��
DISH NUMBER. .
WEIGHT OF DISH,gm -- ®'—
®, WEIGHT OF DISH
AMD SAMPLE,gm
C o WEIGHT OF DISH �� ���
DRY SOLIAS,gm
0. WEIGHT OF DISH
AND ASH o gm ,
E. VOLUME Off SAMPLE,,ml L--
t SOLIDS, L.®Z-7v
TOTAL SOLIDS,.9/1 � `6•L
TOTAL
VOLATILE SOLIDS*
SOLXDSj i n C—A X 199
B—A
TOTAL SOLIDS,g/1 — -C—A X 1000
E
TOTAL VOLATILE SOLIO,S,9/1 — C—D X 1906
E

pl�

u� av =y: tip (L,UIVA!i !,,LIAll(t fa' IL'%IF OCU-F(DIU1I FOB-M, r #, ' � f? i)
(�aslissuis' one each rsa,saifpcisae g�ea•B©d rviv, gFp,, 59 forin.T.)
A Enter date monitoring results t'vere dine. (''1 :.�1-1J 1 Will this Mcnit®ring 6 PGrt (G4ll/.59 and GVV-59A)
be submitted after the established due date?
YES
Wo
r.
2 Was any required Information missing on the Get/-59 report forms?
��8
�®
IF the answer to I 2 is "YES",
question or list in the space provided below the well identification numbers) and
explain the problems encountered in obtaining the required information.
o
3 Are an of the monitor welis in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
Identification plate, area overgrown, etc.)? If the answer is "Yes '; confacl the Regional Ofce jorguidanee.
YES
110
V
Are any monitored constituents equal to or above the established standards?
If the answer to question 4 is "!NO , skip to section B.
YS
1�10
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentratlon(s)
exceeding standards in the space provided below:
the 11 G; ►CG t Z �t Is�r�' iL tk t'.I i -i-( Iu C fnml(j-rli Zl OL
CU-)(crnlLtrn 1Lf1L
t
DUI I -(;✓ 1� ChcCmlurn F�ti�•1C�•
For the constituents Identified in question 4 above, have standards been exceeded previously for the
same constituent(s) in the same wall(s) In the last two
YES
No
years?
X
If the answer to question 5 is "NO", skip to section 8.
If the answer to question 5Is "YES" list in the space provided below, each well with constituents) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
G EI h#! �1 Z-Zp-I'5 rt gic- t';ue n * M ChrDrn m tZ t y1L , o-Zi4-i Z
a-)fOf))iUU»�r�!�/(, U7fCfllrUn� Liotf%, 4v-7 I3
Itj�il rr 1(j (� LLB (? ��CClYltikml� ' IL Ghtoniun�
..[
�rZ(r 13 C1lYL3Y11 LQ'T l LJtt�(C-
Aare the monitoring wells listed in section 5 located at or beyond the review boundary?
"YES",
HIES
if the answer Is aj groundwater quality problem maybe occurring. CONTACT THE AEG/OiVA P
�✓
OFFICE IiliMEOIATELYFOR GUiDANCE If the answer is "NO", monitoring we/is maybe Improperly
located; contact the Regional Office.
i Is the permittee implementing previously approved actions required by the ®ivision involving this YES NO
groundwater quality problem? V
If the answer to question 7 is "YES", describe those actions in the space provided below. v
If the answer to question 7Is "NO", contact the Re_alonal Office within an rnt L-- m.,
t�3<-) a v 11). 0-u [ -r419 w0j, 6! i n ; �,; ,Lh -D (AQ- it h Q3 -0 LVec I t.U+P- rcvy) i u rn i n
44)e .iron l4cy i (-,\� i,.ei15 . Ail var)S h6tw bon f�ep-Oeci � r � 12-u�4�?L•
g The mperson completing this portion (GIN-59A) of the monitoring report should sign below and submit this
forwith GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
, ireiipeo�ertb.(yCaocmlcpriloi�eirilecd®gRo®_fphat.f.hizoy®Inorma• fne�aset,:fato g r. fp':teuae
dn
o;5�s:u®and�eom�pf5 Signature of Permittee (or Authorized Agent) r.�•o
GVV-59A 12/8/2003

J SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MOMTORING-
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Prinf Clearly or Type
Facility Name: CLY- _yc�n�l �'ec� ti D
Permit Name (if different):
FacilityAodress: q' -I JI If �C,�Ci n5
Well Location/ Site Name:
County - i"++
Telephone fl: ZCrZQ 5F
No. of Wells to be Sampled:
Well Identification Number (from Permit): __G? .um,.,
Well Depth: For Groundwater Treatment Systems
P it. Well Diameter: Z in. Check One: ® Influent (98)
Screened Interval: � It. to � � ft.
Depth to Water Level: ft. below measuring point. 0 Effluent (99)
Measuring Point (M.P.) is:7, 5 ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 5 Date sample collected: L 2644
Field analysis: pH-1-I - C46 - , Specific Conductance _ ' 261-. I. uMhos
Temp. f °C, Odor non-6 Appearance. (.-J0U0\/
DEPARTMENT OF ENVIRONMENT & NATURAL RFSOURCFS
WATER OUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT fl: EXPIRATION DATE: La):._ (;/
Non -Discharge tOO— nQ iC l4 UIC
NPDES i4CCG3707)
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
-Spray Field Remedlaflon:
Rotary Distributor = Land Applicalion of Sludge
Other.
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 7-26 10
Laboratory Name: E s , I
Certification No.
PARAMETERS (Samples for metals were collected unfilteredYES
NO and field acidified
CO®
Coliform: MF Fecal I
mg/I
/1 OOmI
Nitrite (NO2) as N
Nitrate (NO3) as N
mg/I
mg/I
Z G�
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/l
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total L2
mg/I
Orthophosphate
Al Aluminum
r7 , 0 is
mg/I
ply (when analyzed) Li" 0(P
units
-
Ida - Barium
mg/I
mg/I
TOC Q.--) L1-
Chloride
mg/I
Ca - Calcium
mg/I
Arsenic
mg/I
mg/I
Col- Cadmium
Chromium: Total
mg/I
mg/I
0. 01 (�
Grease and Oils
Phenol
mg/I
Cu - Coppe
2<0 I Q I
mg/I
Sulfate
c7
mg/I
mg/I
Fe - Iron
I-Ig - Mercury
mgn
mg/I
Specific Conductance__ L 1 • I
uMhos
K - P®tasslurrt
mg/I
Total Ammonia
TKN as N
mg/I
Mg - Magnesium
9 /1
YES NO)
Ni - Nickel mg/I
Pb -Lead mg/l
Zn - Zinc mg/I
Ammonia Nitrogen M-0/1
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method 1). Attach la'brepot.)
Repolt Attached?. Yes —(I) No (®)
VOC . method 0 =
method
method
I•certlfv that. to the best of my knowipena nnri holier rho

GROUNDWATER QUA►L. THY MMTORING:
COMPLIANCE REPORT( FORM
Facility Name:_
Permit Name (if
Well Location/ Site Name:
SUBMIT FORM ON Y LL W PAPER ONLY
Please print Clearly or 'hype
County `YID
Telephone id: Z5Z
No. of Wells to be Sampled:
�.n rn.mur
Well Identification Number (from Permit): ►C>
Well Depth: Q For Groundwater Treatment Systems
p is t Well Diameter-: Z in. Ghechone: ® Influent '(98)
Screened Interval: Z ft
Depth to Water Level: ft. below measuring point. ® Effluent (99)
Measuring Point (M.P.) is: -3 ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: �5 Date sample collected: 7�I�
Field analysis: pH-- *1h- (o , Specific Conductance — P I . 0 - uMhos
Ji
Temp. 13 °C, Odor tr_ )Cnl -' Appearance
PARAMETERS (Samples for metals were collected un
COD mg/I
Coliform: MF Fecal 1 /100ml
Coliform: MF Total /100ml
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total (If) mg/I
pH (when analyzed) Q• �� units
TOC mg/I
Chloride mg/I
Arsenic mg/1
Grease and Oils mg/I
Phenol mg/I
Sulfate mg/I
Specific Conductance __ G I. C� uMhos
Total Ammonia mg/I
TKN as N mg/I —
: method €G =
: method a =
- M .::.=iK-rauttv[tll • i : :: ::: : .. S 'n c+ S3l�ss -
DEPARTMENT OF ENVIRONMENT $ NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT 0: EXPIRATION DATE: I-31=LOd>
Non -Discharge _i )Qi ',CY)I 0-e UIC
NPDES WC00370-n
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon FRemedialion: infiltration Gallery
Spray Feld Remedialion:
Notary Distributor = Land Applicatiori of Sludge
Other.
HQUE,• Values should reflect dissolved and .
colloidal concentrations.
Dale sample analyzed: Z Z5-1 Lf
Laboratory Name: E lryinr) ,,Inc.
Certification No.
X YES NO)
tered A YES NO and field acidified
Nitrite (NO2) as N mg/I
Nitrate (NO3) as N � .�'�! mg/I
Phosphorus: Total as P mg/I
Orthophosphate !? .C�1S mg/I
Al - Aluminum mg/I
Ba - Barium mg/I
Ca - Calcium mg/I
Cd - Cadmium mg/I
Chromium: Total _ C-)-0)5 mg/I
Cu - Copper c n. C310 mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potassiut* mg/I
Mg - Magnesium mg/I
Mn - Manganese mg/1
Ni - Nickel mg/I
Pb - Lean M0/1
Zn - Zinc mg/1
Ammonia Nitrogen 0 C map
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specliy test and method 0. Attach Itch repart.)
Report Attached? Yes (I) No Q®)
1/OC ' . method ll =
r� I -u� u ` 1 nG to m : me - nease print or type
GW y
-59 7( 1
Rev. 03/2000 Signature of Penrnllla (or Authorized a,rionii r��

SUBMIT FORM ON YE_ LLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING -
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Pr/nf Clearly or Type
Facility Name:
Permit Name (It different):
Well Location/ Site Name:
County
Telephone it: L5 5Zq6
No. of Wells to be Sampled:
Well Identification Number (from Permit): I L"1 For Groundwater Treatment Systems
Well Depth: 13 ff. Well Diameter: in. Checic One: ® Irtfluent (98)
Screened Interval: it. to 1­5— ft. ® Effluent (99)
Depth to Water Level: FJ ft. below measuring point.
Measuring Point (M.P.) is: Z It. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumpediballed before sampling: Date sample collected: 7-75-1L1
Field analysis: pH L1 - S;(9 , Specific Conductance- 5 uMhos
Temp.. I (P °C, Odor one - Appearance rI CUCF\,l
DEPARTMENT OF ENVIRONMENT 8, NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT tt: EXPIRATION DATE: 1-3i mi5
Non -Discharge_ IuCCOD I 34q UIC
NPDES_ I'-LCO_�0320_n
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray -Meld Remediatiion:
Rotary Distributor Y_Land Application of Sludge
Other
NOTE- Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: L-7.6-ILl•
Laboratory Name: F1111 f -)I ) f`( )C-L') J;, I OC,
Certification No.
PARAMETERS (Samples for metals were collected unfiltered X YES
NO and field acidified
COI]
Coliform: MF Fecal < I
mg/I
/100ml
Nitrite (NO2) as N
Nitrate (NO3) as N
m /1
01 mg/l
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/l
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total 3 i-I
Orthophosphate
r • 04 mg/l
PH (when analyzed) U.u'3
mg/l
units
Al - Aluminum
Ba - Barium
mg/l
mg/I
TOC _ 1.
Chloride
mg/I
Ca - Calcium
mg/I
Arsenic
mg/I
mg/l
Cd - Cadmium
Chromium: Total
mg/I
O.C7,1 mg/l
Grease and Oils
mg/I
Cu - Copper
<r G I mg/I
Sulfate
mg/l
mg/I
Fe - Iron
I-Ig - Mercury
mg/I
mg/1
Specific Conductance __ (0(� -3
uMhos
K - Potassium
mg/I
Total Ammonia
mg/f
Mg - Magnesium
mg/l
TKN'as N
mg/I
Mn - Manganese
mg/I
YES NO)
Ni - Nickel mg/I
Pb - Lead mil
Zn - Zinc mg/l
Ammonia Nitrogen_
Other (Specify Compounds and Concentration Units)
®ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method 0. Attach lab repart.)
Report Attached? Yes (I) No Q®)
VOC method it =
method 0 =
method #9 =
ra E
I�IIUII�1 11116llil 1�tilIlTT119"T1TiITrTTTrETfIT17T
(or
GW-59
Rev. 03/2000
or type
'3-Zq-1C/

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
Please priraf Clearly or Type
Facility Name:_
Permit Name (if
01 1 -ii v r - - LI County iil�l"1"
Contact Person: f� C� 1C'e. ` i '�I-i�r R► Telephone fi: 06- 2C
Well Location/ Site Name: -1TI)ef6dY—c212111�I-4(Z141G No. of Wells to be Sampled:
Well Identification Number (from Permit): I For Groundwater Treatment Systems
Well Depth: ft. Well Diameter L in. ChecicOne: ® Ihfluent (08)
Screened Interval: It. to 0 ft. ® Effluent (gg)
Depth to Water Level:, ft. below measuring point.
Measuring Point (M.P.) is:7_ 5 ft. above land surface. Relative M.P. Elevation in ft.:
(gallons of water prlmped/bafled before sampling: 5 Dale sample collected: C Z5 1C►
Field analysis: pH GL q f , Specific Conductance aZ• SS uMhos
Temp. _1_°C, Odor ncnf Appearance CIOLPCJV
/ .
DEPARTMENT OF EMVIRGMMCMT A NATU11AL Ar-DOMOrs
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL. SERVICE CENTER
PERMIT ff: EXPIRATION DATE: [-3- ZO 5
Non -Discharge �ICCO l C UIC
NPDES I-�C.:W)326�)
TYPE OF PERMITTED OPERATION BEING MONITORED �
Lagoon Remedialion: Infillralfon Gallery
Spray Field Remediation:
Rotary Distributor Land Applical(on of Sludge
Other. _ I
NOTE, Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: Z75-ILI
Laboratory Name: E LI) 12-)LQ r + T.
Certification No.
PARAMETERS (Samples for metals were collected unfiltered )' YES
NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal 7_
/100ml
Nitrate (NO3) as N
13 I mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
(Note: Use MPH method for highly turbid samples)
Orthophosphate;
0 •C%Ll mg/I
Dissolved Solids: Total so mg/I
Al - Aluminum
mg/I
pH (when analyzed) 1-11, 5 !
units
B3a - Barium
mg/I
TOG `� "� I
mg/I
Ca - Calcium
mg/I.
Chloride
mg/I
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
C) C-0 9 mg/I
Crease and Oils
mgA
Cu - Copper
<0.0mg/I
Phenol
mg/I
Fe - Iron
mgh
Sulfate
ET
mg/I
Hg - Mercury
mg/I
Specific Conductance
uMhos
K - Potassiurrl
mg/I
Total Ammonia
mg/I
Mg - Magnesium
mg/1
TIN as N
mg/I
Mn - Manganese
mg/i
YES NO)
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Ammonia Nitrogen_ <C).CU mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method V. Attach lib report.)
Repoft Attached? Yes —(I) No (0)
vOG : method 43 =
method 0 =
: method 8 =

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please Print Clearly or TYPO
Facility Name: ( --,nJ-NnQL- M67
Permit Name (if different: . , _ , ,. , .. 1
Well Location/ Site Name:
County 411-i l-
Telephone if: ZSZ, SZL-
No, of Wells to be Sampled:
Well Identification Number (from Permit): I u For Groundwater Treatment Systems
Well Depth: 10 ft. Well Diameter: in. Cheetbrie: ® Influent (98)
Screened Interval: 5 ft. to 10 it. ® Effluent (99)
Depth to Water Level: S ft. below measuring point.
Measuring Point (M.P.) is: Z it. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: S Date sample collected: 47:-7.5 M
Field analysis: pH % 1 f 2 , Specific Conductance . n l umhos
Temp. 13 °C, Odor Appearance C=ICL'4)
PARAMETERS (Samples for metals were collected unfilte
COD mg/I
Coliform: MF Fecal 1 /100ml
Coliform: MF Total /100m1
(Note: Use MPH method for highly turbid samples)
Dissolved Solids: Total 17.5
mg/I
_
ply (when analyzed) 3- c6q
units
TOC 4.57.
mg/I
Chloride
mg/I
Arsenic
mg/I
Grease and Oils
mg/I
Phenol
mg/I
Sulfate
Specific Conductance 1'-)c)
mg/l
uMhos
Total Ammonia
mg/I
TKN as N
mg/I
DEPARTMENT OF ENVIRONMENT 1h NATURAL RSSOURCE9
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT 0: EXPIRATION DATE: LINE 1/1
Non -Discharge i,L)QC)r—'0i0 q, - UIC
NPDES hLOO IM)
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Meld Remediafion:
Rotary Distributor Land Applicalforo of Sludge
Other.
®T • Values should reflect dissolved and .
colloidal caricentradtions.
Date sample analyzed: 7-7-6_1y'
Laboratory Name: . rt r 7-
Certification No.
red­l—�YES NO and field acidified
Nitrite (NO2) as N mg/I
Nitrate (NO3) as N <0.05' mg/I
Phosphorus: Total as P mg/I
Orthophosphate ( .oil mg/I
Al - Aluminum mg/I
Ba - Barium mg/I
Ca - Calcium mg/I
Cd - Cadmium mg/I
Chromium: Total C). 3I Z. mall
Cu - Copper <0. GI O mg/I
Fe - Iron mg/I
Hg -Mercury mg/I
K - Potassium mg/I
Mg - Magnesium mg/l
Mn - Manganese mg/1
YES NO)
Ni - Nickel mg/I
Pb - Lead mall
Zn - Zinc mast
Ammonia Nitrogen mgll
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,FIPLC)
(Specify test and method 0. Attach lib report.)
ReporlritAttached? Yes —(I) No (0)
VOC : method 0
method 0 _
method 0 =

Eflw'W@flHW % kcapumbd1
Wastewat
P.O. BOX 7085, 114 OAKMUN I UHIVt F (252)
FAX [phone]
252)
GREENVILLE, N.C. 27835-7085 F
ID#: 416
C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN DATE COLLECTED: 02/25/14
P.O. BOX 477 DATE REPORTED : 03/11/14
GRIFTON ,NC 28530
REVIEWED BY:
Well Well Well Well Well Analysis Method
PARAMETERS #9 #10 #14 #15 #18 Date Analyst Code
Fecal Coliform (MF), /100 Mls <1 1 <1 2 <1 02/25/14 MDD 9222D-97
Ammonia Nitrogen as N, mg/l 0.77 0.04 <0.04 <0.04 <0.04 02/27/14 ANO 350.1 112-9
Nitrate Nitrogen as N, mg/1 0.26 0.84 0.76 1.31 <0.08 02/26/14 ANO 353.2 112-9
Total Organic Carbon, mg/1 12.74 8.09 1.58 8.71 4.52 02/28/14 SEJ 531OC-00
Total Dissolved Residue, mg/1 66 67 34 80 125 02/26/14 CMC 2540C-97
Copper, ug/1 < 10 < 10 < 10 < 10 < 10 03/03/14 LFJ EPA200.7
Total Chromium, ug/1 16 15 21 8 12 03/03/14 LFJ EPA200.7
Ortho-Phosphate as P, mg/l 0.08 0.08 0.04 0.04 0.04 02/25/14 SEJ 450OPE-99

OW-9A CL MPMAr\\1(CEORrM,92\41 Per mL, iL `r.�26�CrC?10.4,2
(Subeealsone each uaasdearhagpas-lad r+1do
Enter date monitoring results were due.( Will this monitoring report (GVV-59 and GW-59A)
S128
No
be submitted after the established due date?
Was any required Information missing on the GW-59 report forms?
YES
�O
IF the answer to ,question I or 2 is "YES", list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the required information.
Are any of the monitor Dwells in need of repair or maintenance (damaged casing, unlocked ®r missing cap, missing
YES
NO
Identification plate, area overgrown, etc.)? If the answer is "Yes". conlacl the Regional Of ce forguidance.
Are any monitored constituents equal to or above the established standards?
Yip
NO
If the answer to question 4 is "iNO", skip to section B.
if the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below.
well-4q fcG i4•q(og1L
G)�II`'�I(7 GhrC�itun �3=©►l�l� .
wcIl -*Iu Ch�C+`�iturm 0- 0I0I7cIIL
For the constituents Identified In question 4 above, have standards been exceeded previously for the
YES
NO
same constituent(s) in the same well(s) In the last two years?
If the answer to question 5 is "NO" skip to •section 8.
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).
Gtill-#qiGC.1q.3zrrglL ��-iZ E11 16Chrcrn�wno.on+rglLbz��3
IOG nc.015nx1LZ-zS-W
3 joel'�)ymI,ZG4
Lil�6•5Z/'1I,nr''jIyL IZr�432i+u(Anr�
74
IC-13 0uv�a1,i0LU,romsum 3
OC6.D3�rs+clf lerzi
nr»iir�
�a Z5p,OZI n�j'1L Z-Z5�u
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
}p
v
If the answer Is "YES", a groundwater quality problem maybe occurring. CO NTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells maybe Improperly
located; contact the Regional Office.
5
Bs the permittee implementing previously approved actions required by the Division Involving this
YES
NO
groundwater quality problem?
If the answer to question 7 is "YES", describe those actions in the space provided below.
If the answer to question 7 Is "NO", contact the Regional Office within 90 days: an evaluation may be
required to determine the Impact the waste disposal system Is haying at the review and compliance
boundaries surrounding this facility, Failure to do so may subject the permittee to a Notice of Violation.
Vines. and/or penalties.
IX (% e CU�rf V- q VV' b l-S -Dwe- �-,Qeo 4o ecuctte n
Qll PolvilGia' OF6 havD%- bQ-en ��{x +zd�ac� �'� tea •
_ n
8
The person completing this portion (GW-59A) of the monitoring report should sign below and submit this
form with GiW-59 forms for required wells to the address provided at the top of the current GW--59 form.
1 ` ie�eby cltrioti�l®eg-nc`oym_asp;yb.isV
�®t�a.4:®Xa
r!�'4Wig�i
.ropor(Compliaric® '
4f�hogm�
�@o®-tphoar4t�Gg. iI*shurM®saen.tkdo
l iiliFt®d®n�tfv
i�cg®
Signature of Petmittee (or Authorized Agent) Date
Q"7\\ AG AL 1712117n IX

SUBMIT FORM ON Y LLQW PAPER ONLY
GROUNDWATER QUALFY MCMTORIh :
COMPLIANCE REPORT FORM
FACILITY INFORMATION IIDleaSe Prine Clearly or Type
Facility Name: -
Permit Name (if different):
Well Location/ Site Name:
County-VI-11-
Telephone 0: Z5z15Z4 -
No. of Wells to be Sampled:
Well Identification Number (from Permit): G F®r Groundwater Treatment Systems
Well Depth: � ft. Well Diameter-: Z in. CitecicQne: ® Irt$Ia�Ieaatt Qgl�)
Screened Interval: 3 it. to � ft. ®E$$9�tertt Qgg)
Depth to Water Level: 5 it. below measuring point.
Measuring Point (M.P.) is: Z: 5 ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: : Oate sample collected:
Field analysis: pH _ P • i l , Specific Conductance r7C) uMhos
Temp. 3 - °C, Odor nonC .Appearance GI CC c'),/
DEPARTMENT OF ENVIRONMENT 8! NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION -
1636 MAIL SERVICE CENTER
PERMIT 0: EXPIRATION DATE: i-31-Z6I,5
Non -Discharge 1, :QCCnl0L1(0 UIC
NPDES PCC�33Z(_M
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Rernedialion: Infiltration Gallery
Spray Field " _T Remedialion:
Rotary Distributor Land Applicaliori of Sludge
Other:
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 6_ )19-/U
Laboratory Name:
Certification No.
PARAMETERS (Samples for metals were collected unfiltered YES
NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/l
Coliform: MF Fecal < I
/100ml
Nitrate (NO3) as N
O. mg/l
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
(Note: Use MPh method for highly turbid samples)
Dissolved Solids:
Orthophosphate
o - (-"5- rng/l
Total .55
mg/I
Al - Aluminum
mg/I
pH (when analyzed) G .-) I
units
Ba - Barium
mg/I
TOC i G • 8L
mg/l
Ca - Calcium
mg/l
Chloride
mg/l
Cd - Cadmium
mg/l
Arsenic
mg/I
Chromium: Total
o • CCg mg/I
Grease and Oils
moll
Cu - Copper
<O,olo - mg/I
Phenol
mg/l
Fe - Iron
rngA
Sulfate
mg/I
Hg - Mercury
mg/I
Specific Conductance q0
uMhos
K - Potasslum
mg/I
Total Ammonia
mg/I
Mg - Magnesium
mg/I
TKN as N
mg/I
Mn - Manganese
mg/I
i YES NO)
Ni - Nickel
mg/l
Pb - Lead
MOJI
Zn - Zinc
mg/I
Ammonia Nitrogen 0,57
mg/B
Other (Specify Compounds and Concentration Units)
(ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method fl. Attach la ..b report.)
ReporR Attached? Yes (I) No (0)
a/OC method It =
. method €€ =

GROUNDWATER QUAL6TY MOMTOMNG:
COMPLIANCE REPORT (FORM
Facility Name:_
Permit Name (if
Well Location/ Site Name:
SUBMIT FORM ON YELLOW PAPER ONLY
Please Priest Clearly or Type
County I -r
Telephone Il: 7 Z 6ZII-54-
No. of Wells to be Sampled:
Well Identification Number (from Permit): ILA For Groundwater Treatment Systems
Well Depth: ft. Well Diameter; 7- in. ChecltOne: ® Influent (98)
Screened Interval: Z it. to � ft. ® Effluent (99)
Depth to Water Level: L4 0. below measuring point.
Measuring Point (M.P.) is: 3 ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: J Date sample collected: (n,-/1q,- !4
Field analysis: pH ,.Specific Conductance uMhos
Temp. _l a=OC, Odor 00e Appearance C-182.( -
OEIiARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT 0: 1 EXPIRATION DATE: 131-7,01 f
Non -Discharge rCOD IC) � UIC
NPDES P.('�)37C"n
T YPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Meld Remediation:
Rotary Distributor 7Land Application of Sludge
Other.
OT • Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed:
Laboratory Name: r.l V r0- nLY- ri-f :T� /77-
Certification No.
PARAMETERS (Samples for metals were collected unfiltered X YES NO and field acidified
COD mg/1 Nitrite (NO2) as N mg/I
Coliform: MF Fecal 1 /100ml Nitrate (NO3) as N 2. IS mg/I
Coliform: MF Total /100ml Phosphorus: Total as P mo/I
(Note: Use MPN method for highly turbid samples)
Dissolved -Solids: Total 5q
mg/l
pH (when analyzed) LI, lo4
units
TOC Z CPO
mg/I
Chloride
mg/l
Arsenic
mg/I
Crease and Oils
mg/l
Phenol
mg/I
Sulfate
mg/I
Specific Conductance /)(0 uMhos
Total Ammonia
mg/I
MINI N
Orthophosphate C), C11
mg/l
Al - Aluminum
mg/l,
Ba - Barium
mg/I
Ca - Calcium
mg/l
Cd -.Cadmium
mg/1
Chromium: Total 0,01 1
mg/l
Cu - Copper C D,6 10
mg/I
Fe - Iron
mg/l
Hg - Mercury
mg/I
K - Potassium
rng/I
Mg - Magnesium
mg/I
X YES NO)
Ni - Nickel
mol
Pb - Lead
mg/I
Zn - Zinc
rng/I
Ammonia Nitrogen <'p• DPI
mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,OC/MS,HPLC)
(Specify test and method 1). Att6ch Iab repart.)
Report Attached? Yes (1) No (0)
vOC : method U = `
a8 mg/I Mn - Manganese mg/I method 0 =
method D =

i 1 i
SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
COMPLIANCE REPORT FORM
FACILITY INFORMATION Please PrIng Clearly or Type
Facility Name:- Can-I-C'fl4nea- nntD
Permit Name (if different):
Contact Person: r .irl
Well Location/ Site Name:
County L I -P-1-
Telephone fi: %�6Z/-m-55t1
No. of Wells to be Sampled:
Well Identification Number (from Permit): J - For Groundwater Treatment Systems
Well Depth: I -a it. Well Diameter: Z in. CheckOne: ® IrtflLtertt (9f�)
Screened Interval:ft. to �_ it.
®EftlLtet�t Q99)
Depth to Water Level: I ft. below measuring point.
Measuring Point (M.P.) is: Z It. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/balled before sampling: 5 Date _sample collected: 6-fS-)(4
Field analysis: pH c1 lo5 , Specific Conductance '? Z- • uMhos .
Temp. LZ °C, Odor none Appearance C16ar
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER DUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT 0: EXPIRATION DATE: La-70I5
Non-Discharge-.LLi-C)CCIC`,44 UIC
NPDES�Id:CC� W_T)
TYPE OF PFPIMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
=Rotary Distributor Land Application of Sludge
Other
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: (s1 Q,-)(-j
Laboratory Name: E nvi Fnen-i -T, I t-c.
Certification No.
PARAMETERS (Samples for metals were collected unfiltered x YES
NO and field acidified
COD
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal < I
/100ml
Nitrate (NO3) as N
2 �'
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/l
(Note: Use MPH method for highly turbid samples)
Orthophosphate
<C3.01
mg/l
Dissolved Solids: Total pG
mg/I
Al - Aluminum
mg/I
pH (When analyzed) LI. (n�
units
Ba - Barium
mg/1
TOC
mg/I
Ca - Calcium
mg/1
Chloride
mg/I
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
0. n 10
mg/1
Crease and Oils
mg/I
Cu --Copper
<0'010
mg/I
Phenol
mg/I
Fe - Iron
mgA
Sulfate
mg/I
I-lg - Mercury
mg/1
Specific Conductance `� Z
uMhos
K - Potassium
_
mg/1
Total Ammonia
mg/1
Mg - Magnesium
mg/1
TKN as N
mg/1
Mn - Manganese
mg/1
YES NO)
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/I
Ammonia Nitrogenmg/1
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and m'arthod V. Attach 1�b repeat.)
Reportt Attached? lies (I) N® (0)
vOC : method if =
method 01=
method ft =
- Please print or type
GW-59 ^= 9 ���L� Y l� lk - '7 Z 1-1c1

SUBMIT FORM ON Y LLOW PAPER ONLY
GROUNDWATER QUALffY MONITORM-
COMI PLIANCE REPORT FORM
FACILITY INFORMATION Please Prdne Clearly or Type
Facility Name:-- el?�G'�LC� Fn6j)
Permit Name (if different):
`l oYl , ' LD J JV County
Contact Person:ilen 671UTI I�1 Telephone it:.lF7 67-0-j
Well Location! Site Name:i��F�t�+el,I�t�1AILI�t�51Zlq(G No. of Wells to be Sampled:
Well Identification Number (from Permit): 155
For Groundwater Treatment Systems
Well Depth: � ft. Well Dj-ameter--: �- in. Clleclt one: ® It=tfltatdn� Q9�)
Screened Interval: 3 ft. to � n. ®Eftilaset�� Q��)
Depth to Water Level: � ft. below measuring point.
Measuring Point (M.P.) is: 7 �� ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 5 Date sample collected:-,l-11-1
Field analysis: pH. l-1 • /oZ , Specific Conductance � ((-uMhos
Temp. 2.5 °C, Odor G'L2 ne Appearance r1C11.6-1,
DEPARTMENT OLD ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT Pe: EXPIRATION DATE: 1-f-5i1- -Znl 2J
Non -Discharge wWCQ1C_49 UIC
NPDES RC0C 5Z-0"T-)
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remediation: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor X Land Application of Sludge
Other
OT • Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 6,Ia-14
Laboratory Name: -- F fl\ll rQQfYlC1'-1-! . -iInc-..
Certification No.
PARAMETERS (Samples for metals were collected unfiltered X YES
NO and field acidified
CO®
mg/I
Nitrite (NO2) as N
mg/I
Coliform: MF Fecal <
/100ml
Nitrate (Nos) as N
i • 60
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/l
(Note: Use MPN method for highly turbid samples)
Orthophosphate
D • 01
mg/l
Dissolved Solids: Total (06
mg/I
Al - Aluminum
mg/l
pH (when analyzed) - Q- 62
units
Ba - Barium
mg/I
TOC G U
mg/I
Ca - Calcium
mg/I
Chloride
mg/I
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total -
<0.C()5
mg/1
Grease and Oils
mg/I
Cu - Copper
<0'00
mg/I
Phenol
mg/l
Fe - Iron
mg/I
Sulfate
Specific Conductance V�2
mg/I
uMhos
1-Ig - Mercury
K - Potassium
mg/l
mg/I
Total Ammonia
mg/I
Mg - Magnesium
mgll
TKN as N
/1
M M
YE. NO)
Ni - Nickel mgll
Pb - Lead mg/I
Zn - Zinc m9/1
Ammonia Nitrogen_ D• iC� mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS.HPLC)
(Specify test and method 0. Attach la.b report.)
Report Attached? Yes —(I) No (0)
VOC : method if =
mg n - anganes� mg/I : method €I =
: method 0 =

SUBMIT FORM ON Y LLOW PAPER ONLY
GROUNDWATER QUALITY MONITORS NGo
COMPLIANCE REPORT [FORM
FACILITY INFORMATION Please Pring Clearly or Type
Facility Name:_ (bn4eNn mdo
Permit Name (if different): , _t.-.
Well Location/ Site Name:
County f' 'Fl—
Telephone fb: Z5Z SZtll�
No. of Wells to bd Sampled:
Well Identification Number (from Permit): 1113 11 For Groundwater Treatment Systems
Well Depth: ICE —ft. Well Diametee: Z in. Cheep ®ne: ® Influent (98)
Screened Interval: it. to ► 0 ft. ® Effluent (99)
Depth to Water Level: ft. below measuring point.
Measuring Point (M.P.) is: Z It. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bailed before sampling: 5 Date sample collected:
Field analysis: pH 0.CQ , Specific Conductance 1 L2 - uMho.
Temp. Z� °C, Odor nCit Appearance c1C'uC U
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT 0: EXPIRATION DATE:
Non -Discharge (00CCI) 1CW5 U1C
NPDES Ll CCCZZD") )
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Meld Remediation:
Rotary Distributor - Land Application of sludge
Other
NOTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: -I —II I
Laboratory Name:
Certification No.
PARAMETERS (Samples for metals were collected unfiltered X YES
NO and field acidified
X YES NO)
COD
mg/I
Nitrite (NO2) as N
mg/1
Ni - Nickel `
n" m
Coliform: MF Fecal < 1
/100ml
Nitrate (NO3) as N
cc"', mg/I
Pb - Learl
rrig/I
Coliform: MF Total
/100m1
Phosphorus: Total as P
mg/l
Zn - Zinc
mg/1
(Note: Use MPH method for highly turbid samples)
Orthophosphate
C?� C)7. mg/I
Ammonia Nitrogen
mg/l
Dissolved Solids: Total C (q mg/1
Al - Aluminum
mg/I,
Other (Specify Compounds and Concentration Units)
pH (when analyzed) 13-c_]
units
Sa - Barium
mg/1
TOC f) - cc
mg/I
Ca - Calcium
mg/1
Chloride
mg/I
Cd -- Cadmium
mg/I
Arsenic
mg/1
Chromium: Total
0. ccI mg/I
Grease and Oils
mg/l
Cu - Copper
; G .O► 0 mg/I
Phenol
mg/I
Fe - Iron
mg/I
ORGANICS: (GC,GC/MS,HPLC)
Sulfate
mg/1
Hg - Mercury
mg/I
(Specify test and method 0. Attach 16 repom)
Specific Conductance uMhos
IL - Potasslu
mg/I
Report Attached? Yes (1) No
Q0�
Total Ammonia
mg/I
Mg - Magnesium
mg/1
VOC method If =
TKN as N
mg/I
Mn - Manganese
mgh
: method 0 =
method 0
1 en 5r-n o

kour000To do
P.O. BOX 70851 114 OAKMONT
GREENVILLE, N.C. 27835-7085
C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
FAX [phone]
ID#: 416
DATE COLLECTED: 06/18/14
DATE REPORTED : 07/07/14
REVIEWED BY: 411,
171,
Well
Well
Well
Well
Well
Analysis
Method
PARAMETERS
#9
#10
#14
#15
#18
Date Analyst
Code
Fecal Coliform (NIF), /100 Mls
< 1
< 1
< 1
< 1
< 1
06/18/14 LW
9222D-97
Ammonia Nitrogen as N, mg/l
0.52
<0.04
<0.04
0.16
<0.04
06/19/14 ANO
350.1 112-93
Nitrate Nitrogen as N, mg/1
0.30
2.18
2.78
1.50
<0.08
06/20/14 ANO
353.2 R2-93
Total Organic Carbon, mg/1
14.86
2.97
1.53
6.94
7.00
06/23/14 SEJ
531OC-00
Total Dissolved Residue, mg/1
55
57
49
60
96
06/19/14 CMC
2540C-97
Copper, ug/l
< 10
< 10
< 10
< 10
< 10
06/24/14 LFJ
EPA200.7
Total Chromium, ug/l
9
11
10
<5.0
6
06/24/14 LFJ
EPA200.7
Ortho-Phosphate as P, mg/1
0.07
0.04
<0.01
0.01
0.02
06/19/14 SEJ
450OPE-99

(Submit om each awa tca•iaag period r,*h GW-59 fosaaas.)
J,
[inter date monitoring results were due. Will this rnonit®ring report (GIN-59 and GW=597)
YES
No
be submitted after the established due date?
was any required Information missing on the GW-59 report forms?
YES
IF the answer to question I or 2 is 'YES", list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the required information.
3�
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
YES
NO
identification plate, area overgrown, etc.)? If the answer is "Yes". contact the Regional Of ce for guidance.
4
sire any monitored constituents equal to or above the established standards?
1
NO
'if the answer to question 4 is "NO", skip to section B.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards In the space provided below:
i)21► #fit -7CC I'5•1oZMW-
ci1rodurn O, 01C(rrq-1L I
Wei l -#+lU ChrGmi UM G, C,1 l a�jlC.
iFor the constituents identified in question 4 above, have standards been exceeded previously for.the.
YES
NO
same constituents) in the same wells) in the last two years?
1f the answer to question 5 is "NO", skip to section a.
If the answer to question 5Is "YES°; list in the space provided below, each well with constituents) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
j�Bl l I CC i l • 5U,)_q1( EG-Zu 3 rtF• bl > 1 C `,a a�� kX211,#1t, ei'1rCrrii tin'' o � wDW-li� G Z 3
7 ZD-1 �i)#gC_l)fory' jL.in0.Ci(>gjLZ-71r13
Zq.ZUnq/ 0-cairr;dLiGU-1-3
iG �✓o rncl/ 1, j- v, 13 ©L2r6 nag 4 c�. DZI mq1L Z Zrl
C
i3 •fit roWC IaZ!-13 0.01 to a.
6
Are the Monitoring wells listed In section 5 located at or beyond the review boundary?
YES
I�
If the answer is "YES", a groundwater quality problem maybe occurring. CONTACT THE REGIONAL
OFFICE IiN MEDIATE► Y FOR GUIDANCE. If the answer is "NO", monitoring wells maybe Improperly
located; contact the Regional Office.
9
Is the permittee implementing previously approved actions required by the Division Involving this
YfIE
NO
groundwater quality problem?
if the answer to question 7 is "YES" describe those actions in the space provided below.
If the answer to question 71s "NO", contact the Regional Office within 90 dads: an evaluation may be
required to determine the Impact the waste disposal system Is having at the review and compliance
boundaries surrounding this faclllty. Failure to do so may sublect the permittee to a Notice of Violation
fines, and/or penalties.
Ue CAf e CLtfj_ —j-fly D—Ob`I7� wl�h7olZ- �2C3 � 2i1��LQGt� Cl��re;�,nlc�n�
iSwec) ir) aiI man)+Ui 5iutIIs. All \aiob4lcr�� have been r4PD[fej
q-0
The person completing this portion (G W-59A) of the monitoring report should sign below and submit this
form with GW--59 forms for required wells to the address provided at the top of the current GW--59 form.
:®tieb '�cltngirtitleii ,� ._.. ._ _ - „M }.,,.. •..tr.
b... _ !a®tip=4fiB�oy® Ingorritivr vasaluated;and gha:dnfo�mation-ubm[tted, nthl��
Peport.(Compli�ric® F�ppoe4, ? fi59A) 14ru®and cm�mpl®4e, o rt{ii� boat of lny f wie�c�g y � : ?,
@}-ZQ-I q
Signature of Pe rmittee (or Authorized Agent) Date
OW-59A 12/8/2003

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALOTi Y MOWORING:
CO.MPUANCE REPORT FORM
I=ACILITY INFORMATION Please Print Clearly or Type
Facility Name: (hn')PlAnece _ i�f7
Permit Name (if dlyprent):, — -
(_=,t _I-+(-T) wuccly M C 7263U County ­21-I-+
iM - ��•IVnisww) (zip) p -Z 52L1-jr
Contact Person: P�f'n�`=i Telephone 0: �
Well Location/ Site Name:ylC Cd . 01"DCtn-1&d C- No. of Wells to be Sampled:
Well Identification Number (from Permit): v For Groundwater Treatment Systems
Well [depth: ft. Well D•iameter-. G in. Chech One: ® (98)
Screened Interval: 3 ft. to 1% If. ® 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 pumped/bailed before sampling: 5 Date sample collected: tU-Z' I-ILI
Field analysis: pH , Specific Conductance 7 = uMhos
Temp. _La_°C, Odor _ C� Appearance GIml. y
DEPARTMENT OR ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT 0: EXPIRATION DATE: 1-31-6012
Non -Discharge kQQCOIC4 UIC
NPDES LICCC3261)
TYPE OF -PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Applicaltori of Sludge
Other.
OT • Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: )C6--(Z�-ILI
Laboratory Name: r 17y11CS�h` n 1 `I I nG
Certification No.
PARAMETERS (Sample's for metals were collected unfiltered X YES'
NO and field acidified
COO
mg/I
Nitrite (NO2) as N
mg/l
Coliform: MF Fecal
< i
/100ml
Nitrate (NO3) as N
n-ZZ
mg/I
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
(Note: Use MPN method for highly
turbid samples)
Orthophosphate
0, CT)
mg/I
Dissolved Solids: 'total
l i D
mg/I
Al - Aluminum
mg/I
pH (when analyzed)
5•Dt)
units
Ba - Barium
mg/I
TOO
mg/I
Ca - Calcium
mg/I
Chloride
mg/I
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total
G • 010i
mg/1
Crease and Oils
mg/1
Cu - Copper
40,010
mg/I
Phenol
mg/I
Fe - Iron -
mg/I
Sulfate
mg/I
I-lg - Mercury
mg/I
Specific Conductance
uMhos
K - Potasslu
mg/1-
Total Ammonia
mg/I
Mg - Magnesium
mgll
T GIN as N
mg/1
Mn - Manganese
mg/1
Rev: ®3•'^^��
i YES NO)
Ni - Nickel mg/I
Pb - Lead mg/I
Zn Zinc mg/1
Ammonia Nitrogen 1,15 mg/1
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method 8. Attach lab report.)
Report Attached? Yes (I) No (0
VOC method 9 = C 1
method # =
method # =

SUBMIT FORM ON YELLOW PAPER ONLY
GPROUJ NDWATi ER QUAD Y MONK I>I'ORING.-
COMPUAMCE REPORT FORM
Facili4l Name: C nr- i' , c'_'C -- (Y I
Permit Name (if different):
Contact Person: n-rJ sC
Well Location/ Site Name:
Please PPInr Clearly or Type
County I147F
Telephone 0: n'7_ 67J1-�
No. of Wells to be Sampled:
Vtfell Identification Number (from Permit): I 0 For Groundwater Treatment Systems
Well Depth: 5.1, it. Well Diameter- 7, in. Check One: ® 1rtfflt.tent (98)
Screened Interval: Z ft. to `s ft. ®Eff�9tlet�tt Qgg)
Depth to Water Level: it. below measuring point.
Measuring Point (M.P.) is: -2 ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/balled before sampling: 5 Dale sample collected: 10r 44
Field analysis: pH •.S 14 , Specific Conductance ' _5 uMhos
Temp. 1_ 2 °C, Odor no-C Appearance C ew—'\l
DEPARTMENT OF ENVIRONMENT A NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT 0: EXPIRATION DATE: ICI-ZCU15
Non -Discharge 2;QQCQ 104 UIC
NPDES M ; 57 C5-
TYPF OF PERMITTED OPERATION BEING MONITORED
Lagoan Remediation: Infiltration Gallery
Spray Field Remedialion:
Rola►y Distributor Land Application of Sludge.
Other:
}VOTE: Values should reflect dissolved and .
colloidal concentiations.
Date sample analyzed: ICr7 f4
Laboratory Name: �Fi�ilCi DIY , a
Certification No.
PARAMETERS (Samples for metals were collected unfiltered )S YES NO and field acidif led
COIF
mg/I
Nitrite (NO2) as N
mg/l
C®liforrll: M1= Fecal C I
/100m1
Nitrate (NO3) as N 13�
mg/l
Coliform: MF Total
/100ml
Phosphorus: Total as P
mg/I
(Note: Use MPN method for highly turbid samples)
Dissolved Solids: Total < I C)
mg/I
Orthophosphate 0 • b— ?
Al - Aluminum
mg/l
pH (when analyzed) 5 .6q
units
Ba - Barium
mg/I
mg/l
t OC I
mg/l
Ca - Calcium
mg/I
Chloride
mg/I
Cd - Cadmium
mg/I
Arsenic
mg/l
Chromium: Total C.COko
mg/I
Grease and Oils
mg/l
Cu - Copper 010
mg/l
Phenol
mg/I
1=e - Iron
mg/I
Sulfate
Specific Conductance
mg/I
uMhos
Hg - Mercury
K - Potassium
mg/I
mg/I
T otaI Ammonia
mg/1
Mg - Magnesium
mg/I
T i< NP as N
mg/I
Mn - Manganese
mg/1
YES NO)
Ni - Nickel mg/I
Pb - Learl mg/1
Zn - Zinc mg/1
Ammonia Nitrogen -'O, O4 mg/1.
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method 9. Attach lab report.)
Repad AUachedl? Yes-Y—(I) No (0)
VOC : method 0 = (Z (3G(G7
: method # =
method # =

SUBMIT FORM ON YELLOW PAPER ONLY
GRROU iNDWA ER QUALRTY MOMTOMNGo
COMB 1[_IaNICE REPORT FORM
Facility Name: —
Permit Name (if
Well Location/ Site Name:
Please PrinB Clearly or Type
County �i-+T
Telephone if: _6Zf 6Ztf'.5�
No. of Wells to be Sampled:
Well Identification Number (from Permit.): I LI For Groundwater Treatment Systems
Well Depth: 1--5 ft. Well Diameter: in. Checlt One: ® ihfluent (98)
Screened Interval: Co it. to f 'D ft.
Depth to Water Level• Ulf-5 ft. below measuring point. ® Effluent (99)
[Measuring Point (M.P.} is: Z ft. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pure d/bailed before sampling: S Date sample collected: 1� �
Field analysis: pH �5C , Specific Conductance _�'3 - uMhos
Temp. Z3 °C, Odor nonf Appearance ci pN r
DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT 0: EXPIRATION DATE: 1-31-Z012
Non -Discharge U0000104(0 UIC
NPDES W-60-3ZQ2-2
TYPE QE PERMITTED OPERATION BEING MONITORED
Lagoon Remedialion: Infiltration Gallery
Spray Field Remedialion:
Rotary Distributor Land Applicaliori of Sludge
Other:
GTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: I0-ZqM_1LP
Laboratory Name: L II (On MTJ.i Jryl
Certification No.
PARAMETERS (Samples for metals were collected unfiltered__�L_1(ES NO and field acidified
COD mg/I Nitrite (NO2) as N mg/I
Coliform: MF Fecal < 1 /100ml Nitrate (NO3) as N 3.190 mg/I
Coliform: MF Total /100ml Phosohorus: Total as P MnIl
(Note: Use MPH method for highly turbid samples)
�
Dissolved Solids: Total ,-to mg/I
pH (when analyzed) 50
units
T OC i . Z3
mg/I
Chloride
mg/I
Arsenic
mg/I
Crease and Oils
mg/i
Phenol
mg/I
Sulfate
mg/I
Specific Conductance
uMhos
Total Ammonia
mg/I
T K6v as N
mg/1
G W-59
Rev. ®S- "Z�7
i J
Orthophosphate
D.DZI mg/I
Al - Aluminum
mg/I
Ba - Barium
mg/I
Ca - Calcium
mg/I
Cd - Cadmium
mg/I
Chromium: Total
0 1011 mg/l
Cu - Copper
40- 10 mg/I
Fe - Iron
mg/I
I-lg - Mercury
mg/I
K - Fotassiurm
mg/I
Mg - Magnesium
mg/I
Mn - Manganese
mq/l
YES NO)
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc m9/1
Ammonia Nitrogen <a • oU mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,NPLC)
(Specify test and method q. ttach lab report.)
Repot Afteched? Yes(1) No • (0)
V/OC method ll = a
method 0 =
method # =

SUBMIT FORM ON YELLOW PAPER ONLY
CARO IUJ INS DWATER QUAD Y MONFORIMG:
OOMPUAMCE REPORT FORM
Please Pring Clearly or 'Type
Facility Name: -
Permit Name (if
c s -Krt-r t County
El` -r
t�avk I� k 1�v1
Cantaet Person: �I"lam t�� n 14rTelephone 9:
Well Location/ Site Name: +602G10 No. of Wells to be Sampled:
Well Identification Number (from Permit):, 115 For Groundwater Treatment Systems
Well Depth: � ft. Well iameter: �� in. Cheat[ One: ® Influent (9�)
Screened Interval: it. to � n. 0E$$9tsent (gg)
Depth to Water Level: Loft. below measuring point.
Measuring Point (M.P.) is: Z -5 It, above land surface. Relative M.P. Elevation in'R.:
Gallons of water pumped/bailed before sampling: Date sample collected: I3-1L1
Field analysis: pilJ. I I , �`Specific Conductance of uMhos
�
Temp. Z°C, Odor _nCO�' Appearance - GIEG1.0
DEPARTMENT OF ENVIRONMENT Fh NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT 0: EXPIRATION DATE:
Non -Discharge ►.fit C0,31,0LI UIC
NPDES hIX(M-0—n
TYPE OF PERMITTED OPERATION BEING MONITORED
Lagoon Remedial(on: Infillral(on Gallery
Spray Feld Remedial➢on:
Rotary Distributor = Land Application of Sludge
Other.
}COTE: Values should reflect dissolved and .
colloidal concentrations.
Date sample analyzed: 1 r J-P-IC4
Laboratory Name: r✓ 1(C'n rnen 1 J z I .
Certification No.
PARAMETERS (Samples for metals were collected unfilteredX_YES NO and field acidified
COD'
mgll
Nitrite (NO2) as N
mg/1
Coliform: MF Fecal _
/I00ml
Nitrate (NO3) as N 0•02
mg/l
C©liform: MF Total
/100ml
Phosphorus: Total as P
mg/I
(Hole: Use MPH method for highly turbid sa plea)
Orthophosphate 0. 03
mg/I
Dissolved Solids: Total
mg/I
Al - Aluminum
mg/l
H (when analyzed)
units
Ba - Barium
mg/I
p
mg/I
Ca - Calcium
mg/I
Chloride
mg/I
Cd - Cadmium
mg/I
Arsenic
mg/I
Chromium: Total O , M)
m 1
Crease and Oils
mg/I
Cu - Copper <n.010
mg/I
Phenol
mg/I
Fe - Iron
mgn
Sulfate
Specific Conductance I
mg/I
uMhos
Hg.- Mercury
K - Potasslum
mg/I
mg/l
Total Ammonia
mg/I
Mg - Magnesium
mg/1
VNP,asN
YES NO)
Ni - Nickel mg/I
Pb - Lead mg/I
Zn - Zinc mg/1
Ammonia Nitrogen 0-30 mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,HPLC)
(Specify test and method #. ttach lab report.)
Report Attached? Yes ()) No (0.
�!®C : method # = /'OOC
mg/1 Mn - Manganese - mgll : method #
: method # =
�. %I rbun►r wame ena l In® - rlease print or type I
CVV-59 I N D Q (� k- , / 1 Zq -1 cf
Rely. 031POOQ Signature uthanzed Agent) l' (Date)
} t

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUAUTY MO FORING-
CO6i P 1UANCE REPORT FORM
I-ACIt_0 T Y INFORMATION Please PrIng Clearly or Type
Gracility Name: 0C7mP_f1+nl'_Ct. mo-i)
Permit Name (if different):
Contabi person:
Well Location/ Site Name:
County -�i
Telephone fl: 62 -1
No. of Wells to be Sampled:
Well Identification Number (from Permit): _ I
Well Depth: 10) For Groundwater Treatment Systems
p ft. Well Diameter: Z in. Checlt0ne: ® Influent 98
Screened Interval: it. to 'I 0 t,
�_ft. below measuring point. ®�ffffle�ent 99
Depth to Water Level: � (
Measuring Point (M.P.) is: It. above land surface. Relative M.P. Elevation in ft.:
Gallons of water pumped/bgiled before sampling: r Date sample collected: r C=lq
Field analysis: pH ,SpecificConductance It4 •1 uMhos
Temp. ZL �C. Odor 01MC Appearance
EIJI RAAMETERS (Samples for metals were collected unfi
COIF
mg/I
Coliform: MF Fecal I
/100ml
Coliform: MF Total
/100ml
Note: Use MPN method For highly turbid samples)
Dissolved Solids: Total _ G, ( mg/I
pH (vvhen analyzed) <--i Q6
units
T OC _ - C. [
mg/I
Chloride
mg/I
Pkrsenic
mg/l
Cheese and Oils
mg/l
Phenol
mg/I
sulfate
mg/I
Specific Conductance—_ I (I I
uMhos
Total Ammonia
mg/I
T KNF as N
mg/l
CW-59
Rev. I731�,,.,�
DEPARTMENT OP ENVIRONMENT & NATURAL RESOURCES
WATER QUALITY DIVISION, GROUNDWATER SECTION
1636 MAIL SERVICE CENTER
PERMIT 0: EXPIRATION DATE:
Non -Discharge tLocmloUIC
NPDES HCEC�C)�7_t��7
PE OF PEFIMITTED OPERATION BEING MONITORED
Lagoon Remedalion: Infiltration Gallery
Spray Field �T Remediation:
Rotary Distributor ,_,�C Land Applicaliori of Sludge
Other.
NOTE: Values should reflect; dissolved and .
colloidal concentrations.
Date sample analyzed: JOZq_)(4
Laboratory Name: ' en li f cflmpt-j-F s, inc
Certification No.
tered6YES NO . and field acidified
Nitrite (NO2) as N mg/l
Nitrate (NO3) as N C��.02 mg/I
Phosphorus: Total as P mg/I
Orthophosphate 0.0 V mg/l
Al - Aluminum mg/I
Ba - Barium mg/I
Ca - Calcium mg/I
Cd - Cadmium mg/I
Chromium: Total <C mg/I
Cu - Copper_ ���.nI0 mg/I
Fe - Iron mg/I
Hg - Mercury mg/I
K - Potassium mg/I
Mg - Magnesium mg/I
Mn - Manganese mg/l
method # =
•• 1 1 1 1 A
for
or type
YES NO)
`
Ni - Nickel
mg/I
Pb - Lead
mg/I
Zn - Zinc
mg/l
Ammonia Nitrogen 0.IZ
mg/I
Other (Specify Compounds and Concentration Units)
ORGANICS: (GC,GC/MS,I-IPLC)
(Specify test and method q. ttach lab report.)
Report Attached? Yes(1) No &
®C method 9 = & ZCDC
(p
method #
(Date)

ID n- a % hCupumb ad
-
Wastewater ID: 10
77777777
� � �_�
PHONE [phone]
FAX [phone]
C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON ,NC 28530
ID#: 416
DATE COLLECTED: 10/29/14
DATE REPORTED : 11/10/14
REVIEWED BY: f
Well
Well
Well
Well
PARAMETERS
#9
#10
#14
#15
Fecal Coliform (NIF), /100 Mls
< 1
< 1
< 1
3
0.30
Ammonia Nitrogen as N, mg/l
1.15
<0.04
<0.04
Nitrate Nitrogen as N, mg/1
0.22
1.36
3.84
0.08
Total Organic Carbon, mg/I
15.62
3.61
1.23
8.32
Total Dissolved Residue, mg/l
110
<10
< 10
86
<10
Copper, ug/1
<10
<10
<10
7
Total Chromium, ug/1
19
6
0.07
11
0.02
0.03
Total Ortho-Phosphate as P, mg/l
0.07
Well
Analysis
Method
#18
Date Analyst
Code
< 1
10/29/14
LW
9222D-97
0.12
10/30/14
ANO
350.1 R2-S
<0.08
10/31/14
AKS
353.2 R2 c
9.06
11/04/14
SEJ
531OC-00
90
10/30/14
KKF
2540C-97
<10
11/05/14
LFJ
EPA200.7
<5.0
11/05/14
LFJ
EPA200.7
0.01
10/29/14
SEJ
450OPE-99

�aw wUun(@M dd humpoMgdo'
P.C). 13CX 7085, 114'OA1{iitONT DRIVE
GREENVILLE, N.C. 27835-7085
CLIENT: C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON, NC 28530
REVIEWED BY: s -�--
VOLATILE ORGANICS
STD. METHODS 6200C (97)
''4'vDr eking Water ID:=377i
Wastewater ID: 10
PHONE [phone]
FAX (252) 7 a6-0633
CLIENT ID: 416
ANALYST: CHS
DATE COLLECTED: 10/29/14 Page: 1
DATE REPORTED: 11/10/14
Date Analyzed:
PARAMETERS, ug/1
11/02/14
Well
#9
11/02/14
Well
#10
11/04/14
Well
#14
11/04/14
Well
#15
11/04/14
Well
#18
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
8. 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-Dichloropropene
<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. Tetrachloroethee
< 0.50
< 0.50
< 0.50
< 0.50
< 0.50
47. Toluene
< 0.50
< 0.50
<0.50
< 0.50
< 0.50

[ oflum � rho kcapumbdu
CLIENT: C.M.S.D. (SLUDGE & WELLS ACCT)
CONTENTNEA METRO. SEWAGE DIST.
MS. RENEE PRIDGEN
P.O. BOX 477
GRIFTON, NC 28530
REVIEWED BY:
VOLATILE ORGANICS
omn mvmunnC F7nnr (971
CLIENT ID: 416
ANALYST: CHS
DATE COLLECTED: 10/29/14 Page: 2
DATE REPORTED: 11/10/14
Date Analyzed:
PARAMETERS, ug/l
11/02/14
Well
#9
11/02/14
Well
#10
11/04/14
Well
#14
11/04/14
Well
#15
11/04/14
Well
#18
48. 1,2,3-Trichlorobenzene
< 0.50
< 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
<0.50
<0.50
<0.50
<0.50
50. 1,1,1-Trichloroethane
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
<0.50
<0.50
53. Trichlorofluoromethane
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
<0.50
54. 1,2,3-Trichloropropane
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
<0.50
<0.50
<0.50
57. Vinyl Chloride
58. Total Xylenes
<0.50
< 1.00
<0.50
< 1.00
< 1.00
< 1.00
< 1.00
59. Methyl Tert Butyl Ether
< 1.00
< 1.00
< 1.00
< 1.00
< 1.00

'cl(GHLS ANALYSHS
MAP AND LAI3 REPORTS

Simply connected.
!rtilizer Application Summary
Grower: CMSD Commodity: Bermuda Grass
Farm: WILEY GASKINS RD Labs: NCDA
Field(s): Multiple Fields
selected Parameters
�� ■- . - . -
Tenn Lime 100 N/A 400 Ibs/ac 0.00 400 Ibs/ac
enn Lime 44662.9 (Ibs) 22.3 ton
,pplication
otals
Fertility Analysis
$0.0/ton $0.0 $0.0/ac
$0.0 /ac $0.0 $0.0/ac
$0.0 $0.0/ac
Field Summary
13.83 ac
35.367513,-77.419061
-
F-04
-
16.18 ac
35.360361;-77.418702
F Ol
2.35 ac
35.358478,-77.421019
F-03
2.21 ac
35.358556,-77.418100
F-02
5.91 ac
35.360321,-77.410402
F-07
14.40ac
35.362013,-77.410097
F-08
--
4.40 ac
35.365362,-77.416477
F-06
14.34ac
35.366959,-77.415219
F-05
Ayden Nitrogen 12-9-2014 4:16 PIN
4728 Old NC 11 2/2
Ayden, NC 28513
252-746-2152

� uncd
i� simply connected. Fertility Analysis
-ower: CMSD Farm: WILEY GASKINS RD Field(s): Multiple Fields
Tenn Lime - Fertilizer Application (Ibs/ac)
400
1594 2788 3982
5175
Lab: NCDA Equation: Lab - NCDA
Commodity: Bermuda Grass
Sample Date: 2013-09-05
Constrai nts:
Target pH: 6.0 Crop Type: Maintenance
Max Rate: N/A
Multiplier: N/A
Min Rate: 400 Ibs/ac
Subtract: N/A
Switch Rate: 400 Ibs/ac
Minimum Application Rate:
400.3 Ibs/ac
Total Product:
44662.9 Ibs
Maximum Application Rate:
5175.4 Ibs/ac
Total Product Bulk:
22.3314 ton
Average Application Rate:
1703.3 Ibs/ac
Product Cost / Bulk:
$0.0/ton
Application Area:
26.2 ac
Total Product Price:
$0.0
Average Field Rate:
605.4 Ibs/ac
Application Cost / Area: $0.0/ac
Total Area:
73.8 ac
Total Application Cost:
$0.0
Total Cost:
$0.0
Ayden Nitrogen
4728 Old NC 11 12-9-2014 4:16 PM
Ayden, NC 28513 1/2
252-746-2152

Statement Page:1
Ryden, NOtTogen
4728 Old NC 111 P.O. Box 7
Ayden, NC 28513
Phone [phone]
Contentnea Metro Sewage Dist
Po Box 477
Grifton, NC 28530
Date:
03/31 /2014
ID:
010202
Total Balance:
$2,112.06
Amount Remitted:
Terms:
Unless otherwise agreed in writing by Harvey Fertilizer &
Gas Co, interest will accrue at a periodic rate of 1.5% per
month. To avoid additional finance charges, payments must
be in office by last day of month.
1----Your Share ----I
Quantity Price / Unit Extension �/ Prepaid Regular
Date Number Description / Detail ti)I
0.00 0.00
Balance Forward
03/03/2014 1004108 Charge Invoice'- Due 04/02/2014
Dolomitic Lime- Bulk 34.910 Tons 45.50 Irons 1,588.41 1,588.41
App Fees Materials 34.910 Each 15.00 /Each 523.65 523.65
Current 1 - 30 31 - 60
2,112.06 0.00 0.00
Sales Recap
Total Fertilizer
Total Services
Invoice Total 2,112.06 0.00 2,112.06
Ending Total Balances 0.00 2,112.06
61 790 Over 90 Unapplied Budget Billing Prepay Overall
0.00 0.00 0.00 0.00 0.00 2,112.06
Quantity Dollars
34.91 1,588.41
34.91 523:65
Total 69.82 2,112.06
Total Sales Tax 0.00
Sales Recap Total 2,112.06
Ayden Nitrogen Date: 03/31/2014 Contentnea Metro Sewage Dist

71
Waters Agricultural Laboratories, Inc.
RS Ic WAT L RAL WAT RS Ic L PAL;;
LA o IE , Nc.p 2101 Calhoun Rd. Hwy 81 Owensboro, KY 42301 Lao IE , _Nc, .r•
[phone] FAX [phone]
AYDEN NITROGEN
Soil Analysis Report
Grower: CMSD
Account#:
60218
PO BOX 7
NCDA Index
Field ID:
Received:
Processed:
12/05/2014
12/09/2014
AYDEN, NC 28513
P-I
Water
S-I
❑
Zn-I
Zn-AI
Mn-I
Mn-AI
Cu-I
CEC
BS /o HM /° Soil Class
K-I Mg%
Ca% pH Ac
❑
Lab Number Sample ID
19498700 1
575
55
18.4
59.2
6.9 1.8
53
2012
2012
46
31
789
17.3
79.2
2.54 MIN
Recommendations - Ibs./A
Lime-Tons/AM
P205
K20
Mg
❑S
Cu
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
40
0
0
0
0
0
12
19498800 : 2
1 630
45
18.3
57.7 j
6.6 1.8
53
2645
2645
34
28
994
16.0
77.4
3.10 MIN
Recommendations - Ibs./A
Lime Tons/A
0
P205
K20
Mg
❑S
Cu
lzn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
50
0
0
0
0
0
12
19498900 : 3
629
36
17.1
58.5 1
6.5 1.6
50
2230
2230
34
30
749
13.9
76.9
2.52 MIN
Recommendations - lbs./A
Lime-Tons/A
[N]
P205
K20
Mg
❑S
Cu
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
70
0
0
0
0
0
12
19499000 4
684
39
17.1
58.3
6.2 1.6
61
2998
2998
37
36
854
13.8
76.8
2.69 MIN
Recommendations - Ibs./A
Lime-Tons/A
P205
K20
Mg
OS
Cu
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
60
0
0
0
0
0
12
19499100 5
672
56
17.0
46.7
5.6 2.6 1
58
3772
4715
28
40
1342
15.1
65.6
4.67 M-0
Recommendations - lbs./A
Lime Tons/A
0
P205
K20
Mg
0
Cu
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
40
0
0
0
0
0
12
19499200 : 6
627
50
17.2
51.5
6.2 2.4
41
2908
2908
28
31
882
16.2
70.3
2.51 MIN
Recommendations - lbs./A
Lime Tons/A
P205
K20
Mg
❑S
Cu
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
40
0
0
0
0
0
12
19499300 17
562
51
19.1
61.5
7.1 1, 1.2
32
1 1857
1857
31
19
550
13.7
82.5
2.18 MIN
Recommendations - Ibs./A
Lime-Tons/A
P205
K20
Mg
0
Cu
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
40
0
0
0
0
$pH
12
19499400 :8
572
42
18.3
54.0
6.5 2.0
36
2442
2442
28
26
709
1
15.2
73.7 1
2.56 MIN
Recommendations - Ibs./A
Lime-Tons/AR
P205
K20
Mg
0
Cu
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
60
0
0
0
0
0
12
Fertilizer recommendations are based on the philosophy and recommendations of the NCDA Agronomic Division
DWQ Laboratory Certification Number 635

Waters Agricultural Lau®ratories, tic.
WAT R1,RWAT RS IC L RAL
°S IC 'ENCAL 2101 Calhoun Rd. Hwy 81 Owensboro, KY 42301 LA ° IE , N.0
(970) RRF-40?a FAY (971)) 696-2099
AYDEN NITROGEN Soil Analysis Report Grower: CMSD Account#: 60218
Received: 12/0512014
PO BOX 7 NCDA Index Field ID: Processed: 12/09/2014
AYDEN, NC 28513
Water
Lab Number Sample ID P-I K-I Mg% Ca% pH Ac S-I Zn-I Zn-AI Mn-I Mn-AI Cu-I CEC BS% HM% Soil Class
19499500:9 536 41 16.7 57.8 6.5 1.8 40 1781 j 1781 31 28 778 14.9 75.9 2.24 MIN
Recommendations - Ibs./A Lime-Tons/A P205 K20 Mg 0 Cu Zn © Mn See Note
Crop BERMUDA PASTURE E 0.0 80 0 60 0 0 0 0 0 12
19499600 110 613 62 18.3 55.4 i 6.5 1.6 33 2350 2350 37 32 704 13.3 76.0 2.12 MIN
Recommendations - Ibs./A Lime-Tons/A Q P205 K20 Mg ❑S Cu Zn © Mn See Note
Crop BERMUDA PASTURE E 0.0 80 0 30 0 0 0 0 0 12
19499700 ; 11 625 79 18.9 58.8 6.7 1.6 35 3573 3573 25 21 1055 16.1 80.1 2.71 MIN
Recommendations - Ibs./A Lime-Tons/A 0 P205 K20 Mg 0 Cu Zn © Mn See Note
Crop BERMUDA PASTURE E 0.0 80 0 20 0 0 0 0 $pH 12
19499800 :12 1 450 49 19.2 60.1 6.8 1 0.8 27 1024 1024 40 29 288 8.9 82.1 1.47 MIN
Recommendations - Ibs./A Lime-Tons/A P205 K20 M® ❑S Cu Zn © Mn
u See Note
Crop BERMUDA PASTURE E 0.0 80 0 40 0 0 0 0 0 12
19499900 13 673 63 17.8 1 54.1 6.4 1.6 33 2520 2520 31 30 724 12.6 74.5 1.91 MIN
Recommendations - Ibs./A P7205 K20 Mg ❑S Cu Zn © Mn See Note
Crop BERMUDA PASTURE E 0.0 80 0 30 0 0 0 0 0 12
19500000 : 14 648 73 18.2 54.2 6.5 1.8 35 2685 2685 28 26 797 14.3 74.9 1.92 MIN
Recommendations - Ibs./A Lime-Tons/A N❑ 2205 K20 Mg ❑S Cu Zn © Mn See Note
Crop BERMUDA PASTURE E 0.0 80 0 20 0 0 0 0 0 12
19500100 15 472 39 19.2 57.9 6.8 1.0 37 1174 1174 46 32 324 9.6 79.2 1.71 MIN
Recommendations - Ibs./A Lime-Tons/A U P205 K20 Mg ❑S Cu Zn © Mn See Note
Crop BERMUDA PASTURE E 0.0 80 0 60 0 0 0 0 0 12
19500200 : 16 702 36 17.5 53.7 6 1.4 1 52 1881 1881 31 36, 623 10.4 73.0 2.02 M I N
Recommendations - Ibs./A Lime-Tons/A 2205 K20 Mg Cu Zn © Mn See Note
Crop BERMUDA PASTURE E 0.0 80 0 70 0 0 0 0 0 12
Fertilizer recommendations are based on the philosophy and recommendations of the NCDA Agronomic Division
DWQ Laboratory Certification Number 635

Waters Agricultural Laboratories, Inc. WAT Rs IC L RAL
WAT RS Ic L RAL LA 0 IE NC.
LA o IE NC. 2101 Calhoun Rd. Hwy 81 Owensboro, KY 42301
[phone] FAX [phone]
AYDEN NITROGEN Grower: CN1SD Account#: 60218
Soil Analysis Report Received: 12/05/2014
PO BOX 7 NCDA Index Field ID: Processed: 12/09/2014
AYDEN, NC 28513
Water n ��---� 0 � far 1 �I Zn-I Zn-AI Mn-I � Mn-AI Cu-I CEC BS /o HM /o Soil Class
Lab Number FSample ID� U LJ l y I u 1 p I u u
19500300 17 627 38 18.2 57.0 6.4 1.4 46 2276 2276 31 30 614 12.1 76.8 2.39 MIN
Recommendations - Ibs./A Lime-Tons/A ❑N P2051 K20 t Mg ❑S Cu Zn © Mn See Note
Crop BERMUDA PASTURE E 0.0 80 0 60 0 0 0 0 0 12
19500400 118 346 43 17.7 54.2 1 6.5 1.4 i 37 842 842 43 35 249 10.8 74.0 1.74 MIN
Recommendations - IbS./A Lime-Tons/A ❑N P205 K20 Mg OS Cu Zn © Mn See Note
Crop BERMUDA PASTURE E
0.0 80 0 50 0 0 0 0 0 12
19500500 : 19 188 39 1 21.3 60.9 7.1 0.4 20 289 289 50 30 91 5.6 85.7 1.20 MIN
Recommendations -Ibs./A Lime-Tons/A N❑ P2051 K20 Mg ❑S Cu Zn © Mn See Note
Crop BERMUDA PASTURE E
0.0 80 0 60 0 20 0 0 0 12
19500600 20 1 722 42 14.7 41.5 5.2 2.2 73 1527 1527 50 39 735 10.5 58.3 2.20 j MIN
Recommendations -Ibs./A Lime-Tons/A ❑N P205 K20 Mg ❑S Cu Zn © Mn See Note
Crop BERMUDA PASTURE E
1.3 80 0 60 0 0 0 D 0 12
19500700 j 21 568 36 18.4 54.8 6.4 1.4 50 1528 1528 40 35 496 11.1 74.8 1.96 MIN
Recommendations -Ibs./A Lime-Tons/A ❑N P205 K20 ' Mg 0 Cu Zn © Mn See Note
Crop BERMUDA PASTURE E
0.0 80 0 70 0 0 0 0 0 12
19500800 22 316 34 19A 61.2 68 0.8 32 871 871 46 32 219 9.0 82.1 1.73 MIN
Recommendations -Ibs./A Lime Tons/A �N P205 K261 Mg 0 Cu Zn © Mn See Note
Crop BERMUDA PASTURE E
0.0 80 0 70 0 0 0 0 0 12
19500900 23 257 40 20.9 65.8 7.3 0.6 30 660 660 53 29 170 10:5, 88.6 1i75 MIN
Recommendations - Ibs./A Lime-Tons/A N❑ P2051 K20 Mg ❑S Cu Zn © Mn See Note
Crop BERMUDA PASTURE E
0.0 80 0 60 0 0 0 0 0 12
19501000 i 24 496 54 20.5 62.3 7.4 0:8 30 1660 1660 31 14 409 10.9 85.3 1.61 MIN
Recommendations - Ibs./A Lime-Tons/A ❑N P2051 K20 ' M� 0 Cu Zn © Mn See Note
Crop BERMUDA PASTURE E 0.0 80 0 40 0 0 0 0 $pH 12
Fertilizer recommendations are based on the philosophy and recommendations of the NCDA Agronomic Division
DWQ Laboratory Certification Number 635

Waters Agricultural Laboratories, Inc.
' WAT RS IC L RAL`-, WAT RS IC L RAL
`A ° 'E 2101 Calhoun Rd. Hwy 81 Owensboro, KY 42301 "r ° '� ' r" '
[phone] FAX [phone]
AYDEN NITROGEN
Soil Analysis Report
Grower: CMSD
Account#:
60218
PO BOX 7
NCDA Index
Field ID:
Received:
12/05/2014
AYDEN, NC 28513
Processed:
12/09/2014
P-I
K-I
0
Mg /o
o Water
Ca /o
Ac
❑�
S-I
❑
Zn-I
❑
Zn-AI
❑
Mn-I
❑
Mn-AI
Cu-I
❑
CEC
❑
BS /o HM /o Soil Class
❑ ❑
Lab Number Sample ID
pH
19501100 : 25
588
38
16.7
59.8
6.7
1.2
36
2000
2000
18
17
586
11.0
78.3
1.96 MIN
Recommendations - Ibs./A
Lime-Tons/A
�N
P205
K20
Mg
❑S
Cu
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
60
0
0
0
0
$pH
12
19501200 : 26
566
51
14.0
55.8 j
6.4
1 1.6 1
36
2153
2153
21
24
659
11.5
72.1
2.25 MIN
Recommendations - Ibs./A
Lime-Tons/A
�N
P205
K20
Mg
❑S
Cu
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
40
0
0
0
0
$pH
12
19501300 ; 27
155
30
20.5
63.9
7.2
0.6
28
334
334
50
29
70
8.6
86.1
1.42 MIN
Recommendations - Ibs./A
P205
K20
Mg
S❑
Cu
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
80
0
0
0
0
0
12
19501400 : 28
394
38
18.5
59.5
6.8
1.0
31
876
876
40
29
250
10.0
79.9
1.71 MIN
Recommendations - Ibs./A
P205
K20
Mg
S❑
Cu
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
60
0
0
0
0
0
12
19501500 : 29
355
42
16.9
55.6
6.6
1.4
35
949
949
37
30
282
11.0
74.5
1.83 MIN
Recommendations - Ibs./A
P2205
K20
Mg
S❑
Cu
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
60
0
0
0
0
0
12
19501600 :30
340
51
14.1
58.2
6.6
1.2
37
876
876
40
32
229
9.6
75.0
1.67 MIN
Recommendations - Ibs./A
FP 2-0 51
K20
Mg
lqn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
40
0
0
0
0
0
12
19501700 ; 31
373
42
13.1
61.5
6.3
1.2
43
954
954
40
36
260
10.3
76.6
1.68 MIN
Recommendations - Ibs./A
P205
K20
Mg
❑S
Cu
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
60
0
0
0
0
0
12
19501800 :32
314
35
16.6
64.7
6.8
0.6
30
703
703
46
32
204
7.4
83.7
1.40 MIN
Recommendations - Ibs./A
P205
K20
Mg
❑S
19
Zn
©
Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
70
0
0
0
0
0
12
Fertilizer recommendations are based on the philosophy and recommendations of the NCDA Agronomic Division
DWQ Laboratory Certification Number 635

Waters Agricultural Laboratories, Inc. WAT RS Ic L RAL
WAT RS IC L RAL LA OR IE NC. ,
LA O IE NC. 2101 Calhoun Rd. Hwy 81 Owensboro, KY 42301
- [phone] FAX [phone]
Grower: CMSD Account#: 60218
AYDEN NITROGEN Soil Analysis Report
Received: 12/05/2014
PO BOX 7 NCDA Index Field ID: Processed: 12/09/2014
AYDEN, NC 28513
Water Soil Class
Lab Number Sample ID P I K I Mg% Ca% pH Ac S-I Zn-I Zn-AI Mn-I Mn-AI Cu-I CEC BS /o HM /°
19501900 33 147 35 14.3 50.9 6.3 1.2 28 388 388 31 31 104 7.4 67 6 1 60 MIN
Lime-Tons/A 0 P2051 K20 1 Mg 0 Cu Zn © Mn See Note
Recommendations - lbs./A 0 12
Crop BERMUDA PASTURE E 0.0 80 0 70 0 0 0 0
19502000 34 170 34 15.6 57.6 6.5 0.827
309 309 18 2p 96 6.6 75.8 1.26 MIN
Recommendations - IbS./A Lime Tons/A ❑N 1 K20 Mg 0 Cu Zn © Mn
P205See Note
Crop BERMUDA PASTURE E
0.0 80 0 70 0 0 0 0 $PH 12
28 20.4 61.4 6.9 0.8 31 508 508 31 22 108 9.5 83.2 1.55 MIN
19502100 : 35 i 156 i
Recommendations - lbs./A Lime-Tons/A �N P205 K20 1 Mg Cu Zn © Mn See Note
Crop BERMUDA PASTURE E
0.0 80 0 80 0 0 0 0 $pH 12
134 38 18.9 55.8 6.9 0.8 30 268 268 25 18 77 7.1 77.4 1.35 MIN
19502200 :36 i i
Recommendations - Ibs./A Lime-Tons/A ND P2051 K20 ' Mg 0 Cu Zn © $pFM See Note
Crop BERMUDA PASTURE E
0.0 80 0 60 0 0 0 0 $PH 12
434 50 17.6 46.4 6.1 1.4 50 894 894 34 36 308 8.5 67.0 1.53 MIN
19502300 37 i
Recommendations - lbs./A Lime-Tons/A ❑N P2051 K20 ' Mg SD Cu Zn © Mn See Note
Crop BERMUDA PASTURE E
0.0 80 0 40 0 0 0 0 0 12
19502400 38 462 36 18.3 58.0 MIN
6.3 0.8 40 1209 1209 34 33 290 7.5 78.7 1.47
Recommendations - lbs./A Lime-Tons/A �N P205 K20 Mg Cu Zn © Mn See Note
Crop BERMUDA PASTURE E
0.0 80 0 70 0 0 0 0 0 12
19502500 39 467 23 17.7 54.4 6.3 1.2 50 1 1323 1323 34 33 362 9.0 73.4 1.68 MIN
Recommendations -lbs./A Lime-Tons/A ❑N P205 K20 Mg 0 Cu Zn © Mn See Note
Crop BERMUDA PASTURE E
0.0 80 0 90 0 0 0 0 0 12
19502600 40 294 32 20.3 58.5 6.7 1.0 43 773 773 40 30 195 10.2 80.4 1.78 MIN
Recommendations - lbs./A Lime-Tons/A ❑N P205 K20 M® 0 Cu Zn © Mn See Note
Crop BERMUDA PASTURE E
0.0 80 0 80 0 0 0 0 0 12
Fertilizer recommendations are based on the philosophy and recommendations of the NCDA Agronomic Division
DWQ Laboratory Certification Number 635

Waters Agricultural Laboratories, Inc. wAT RS IC L RAL
WAT RS IC L RAL�
LA ° 'E "C2101 Calhoun Rd. Hwy 81 Owensboro, KY 42301 o IE 'Hc'�
[phone] FAX [phone]
AYDEN NITROGEN
Soil Analysis Report
Grower: CMSD
Account#:
60218
Received:
12/05/2014
PO BOX 7
NCDA Index
Field ID:
Processed:
12/09/2014
AYDEN, NC 28513
P-I K-I
Water
S-I Zn-I
Zn-AI
Mn-I
Mn-AI
Cu-I CEC BS% HM% Soil Class
Mg%
Ca% pH Ac
Lab Number Sample ID
19502700 : 41
436 32
14.2
51.1
6 1.4
46 1170
1170
46
45
286 8.5 67.1
1.59 MIN
Recommendations - Ibs./A
Lime-Tons/A
�N
P205
K20
Mg
0
Cu
Zn
© Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
80
0
0
0
0
0
12
19502800 : 42
263 1 38
19.9
55.0
6.7 0.8 1
37 511
511
46
34
163 7.1 77.6
1.51 MIN
Recommendations - Ibs./A
Lime Tons/A
�N
P205
K20
Mg
S❑
Cu
Zn
© Mn
See Note
Crop BERMUDA PASTURE E
0.0
80
0
60
0
0
0
0
0
12
Fertilizer recommendations are based on the philosophy and recommendations of the NCDA Agronomic Division
DWQ Laboratory Certification Number 635