WQ0010689_Application_20190520

State of North Carolina
DWR Department Environmental Quality
Division of Water Resources
WATER QUALITY REGIONAL OPERATIONS SECTION
Division of Water Resources NON -DISCHARGE APPLICATION REVIEW REQUEST FORM
May 20, 2019
To: ARO-WQROS: Landon Davidson / Zan Price
From: Troy Doby, Water Quality Permitting Section - Non -Discharge Branch
Permit Number: WQ0010689
Applicant: Baxter Healthcare Corporation
Owner Type: Organization
Facility Name: Baxter Healthcare DCAR
Signature Authority: Jon Rushford
Address: 65 Pitts Station Rd., Marion, NC 28752
Fee Category: Non -Discharge Major
Comments/Other Information:
Permit Type: Distribution of Residual Solids (503 Exempt)
Project Type: Renewal
Owner in BIMS? Yes
Facility in BIMS? Yes
Title: Plant Manager
County: McDowell
Fee Amount: $0 -Renewal
Attached, you will find all information submitted in support of the above -referenced application for your review,
comment, and/or action. Within 45 calendar days, please take the following actions:
® Return this form completed. ® Return a completed staff report.
❑ Attach an Attachment B for Certification. ❑ Issue an Attachment B Certification.
When you receive this request form, please write your name and dates in the spaces below, make a copy of this sheet, and
return it to the appropriate Central Office Water Quality Permitting Section contact person listed above.
RO-WQROS Reviewer: &J, � Date: M 7 W
DIA=n
MAY 2 2 2019
Water Ou,'Ily Ran10nal Opero+Ions
FORM: WQROSNDARR 09-15 Page 1 of 1

ROY COOPER
Governor
MICHAEL S. REGAN
Secretary
LINDA CULPEPPER
Director
JON RUSHFORD — PLANT MANAGER
BAXTER HEALTHCARE CORPORATION
65 PITTS STATION RD.
MARION, NORTH CAROLINA 28752
Dear Mr. Rushford:
NORTH CAROLINA
Environmental Quality
May 21, 2019
MAY 2 2 2019
Water (Juar6, ��^'^^'I ngaratlons
Ash^ _�._•-r'r. ___
Subject: Acknowledgement of
Application No. W00010689
Baxter Healthcare DCAR
Residuals Management System
McDowell County
The Water Quality Permitting Section acknowledges receipt of your permit application and
supporting documentation received on May 17, 2019. Your application package has been assigned the
number listed above, and the primary reviewer is Troy Doby.
Central and Regional Office staff will perform a detailed review of the provided application, and
may contact you with a request for additional information. To ensure maximum efficiency in processing
permit applications, the Division of Water Resources requests your assistance in providing a timely and
complete response to any additional information requests.
Please note that processing standard review permit applications may take as long as 60 to 90 days
after receipt of a complete application. If you have any questions, please contact
Troy Doby at [phone] or [e-mail].
Sincerely,
Nathaniel D. Thornburg, Supervisor
Division of Water Resources
cc: Asheville Regional Office, Water Quality Regional Operations Section
Permit File W00010689
D_E QJ� North Carolina Department of Environmental Quality I Division of Water Resources
512 North Salisbury Street 1 1617 Mail Service Center I Raleigh, North Carolina 27699-1617
NO11 Tr.(MJLIY4
aed+..,nae,m.l�.mea.lnr 919.707.9000

May 10, 2019
NCDEQ Division of Water Resources
Water Quality Permitting Section
Non -Discharge Permitting Unit
1636 Mail Service Center
Raleigh, NC 27699-1636
RECEIVEDINCDEOIDWR
MAY 1 7 2019
Baxter
Non -Discharge
RE: Permit No.WQ0010689 Permit Renewal Application for Noft raantikm Generation Plant Ash
Distribution Program
Baxter Healthcare Corporation requests renewal of Permit No. WQ0010689. There have been no major
process changes or physical changes to equipment covered by this permit since our current permit was
issued. Please find the enclosed:
1. Form DCAR 06-16
2. Supplemental Information for DCAR 06-16
a. Program Information
b. Ash Distribution Utilization Agreement (label)
c. Ash Distribution O & M Plan
3. Form RSC 06-16
4. Supplemental Information for RSC 06-16
a. Generator Facility Information
b. Compliance Inspection Reports (2)
c. Analytical Report
If you have any questions regarding this application, please contact me at 828-756-6636.
Sincerely, '
Corey`Cara/rppeent
Sr. Environmental Engineer
MAY 2 2 2019 '
Water QOeiitv n^..,'^.." J nP^rations
Baxter Healthcare Corporation
PO Box 1390, Marion, NC 28752
T 828.756A151

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Alt.
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
15A NCAC 02T .1100 — DISTRIBUTION OF CLASS A RESIDUALS
INSTRUCTIONS FOR FORM: DCAR 06-16 & SUPPORTING DOCUMENTATION
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted. the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit website
General —This application is for treatment, storage, transport, distribution, land application, and/or marketing of Class A (or Equivalent)
residuals under 15A NCAC 02T .1100.
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Distribution of Class A Residuals (FORM: DCAR 06-16):
Submit the completed and appropriately executed Distribution of Class A Residuals (FORM: DCAR 06-16) form. Please do
not make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to
the application may be made, as long as the attachments are numbered to correspond to the section and item to which they
refer.
The project name should be consistent on the plans, specifications, etc.
® The Applicant's Certification on Page 3 of this form shall be signed in accordance with 15A NCAC 02T .0106(b). An alternate
person may be designated as the signing official if a delegation letter is provided from a person who meets the criteria in 15A
NCAC 02T .0106(b).
Q If this project is for a modification of an existing permit, submit one copy of the existing permit.
Please submit this application form at least 180 days prior to the expiration date on the existing permit, or 90 days prior to
operation of proposed facility(ies) for application packages involving new or changes to treatment and storage units.
B. Application Fee (New and Major Modification Application Packages)
r] Submit a check, money order or electronic funds transfer made payable to: North Carolina Department of Environmental
Quality (NCDEQ).
Facility Classification
New Permit
Major Modification'
Major (residuals permitted for distribution > 3,000 dry tons/year)
$1,310
$395
Minor (residuals permitted for distribution < 3,000 dry tons/year)
$810
$245
' - A major modification shall be defined as any permit modification that: increases the generating facility's residuals dry tonnage;
adds additional residuals sources; or includes the addition of new treatment or storage units/processes not previously permitted.
There is no fee for minor permit modifications.
C. Cover Letter (All Application Packages)
1Z List all items included in the application package, as well as a brief description of the requested permitting action.
Division cf icair Rsource9
MAY 2 2 2019
Water otmrr„ q„_'.,­, r,,,.,,.,ons
Ash-.,...
RECEIVEDINCDEQIDWR
MAY 1 7 2019
Non -Discharge
PermitUng Unit
INSTRUCTIONS FOR FORM: DCAR 06-16 Page 1 of 3

D. Program Information (All Application Packages)
® Provide a narrative explaining the following:
How the materials will be handled and transported from where the residuals were produced to where it will be treated.
How the residuals will be processed/treated (attach process flow diagram).
® How leachate collection will be handled.
Where the residuals will be stored until processed.
® How the final product will be distributed (packaging, bulk, etc.)
What nutrients or other constituents (i.e. nitrogen, phosphorous, aluminum, calcium, etc.) are used or recommended as the
limiting parameter for determination of residuals loading rate to ensure that it does not overload the soil and cause
contravention of surface water or groundwater standards, limit crop growth, or adversely impact soil quality.
Attach a marketability statement detailing destinations and approximate amounts of the final product to be distributed.
Provide either a label that shall be affixed to the bagged processed residual or an information sheet that shall be provided to the
person who receives the processed residual. The label or information sheet shall contain, at a minimum, the following
information:
Name and address of the person who prepared the residual that is sold or given away.
A statement that application of the residuals to the land shall be in accordance with the instructions on the label or
information sheet.
A statement that the residuals shall not be applied to any site that is flooded, frozen or snow-covered.
A statement that adequate procedures shall be provided to prevent surface runoff from carrying any disposed or stored
residuals into any surface waters.
Information on all applicable setbacks in accordance with 15A NCAC 02T .1108(b).
A statement that the residuals shall be applied at agronomic or recommended rates for intended uses.
E. Detailed Plans and Specifications (Application Involving New or Changes to Treatment or Storage Units)
E] Submit detailed plans and specifications that have been signed, sealed, and dated by a NC Professional Engineer per 15A
NCAC 02T .1104(a). Specifications for standard equipment may only be omitted for municipalities with approved standard
specifications, but use of the standard specifications must be noted on each sheet of the plans.
Q Plans must include the following minimum items: a general location map, a topographic map, plan and profile view of the
residuals treatment and storage units as well as the proximity of the residuals treatment and storage units to other utilities and
natural features within 500 feet of all treatment and storage facilities, and detail drawings of all items pertinent to the residuals
treatment and storage units. Depict minimum separations required in 15A NCAC 02T .I 108(a) on the plans.
C] Specifications must include, at a minimum, the following for all items pertinent to residuals treatment and storage units:
description of materials to be used, methods of construction, quality of construction testing procedures to ensure the integrity
of the final product in accordance with 15A NCAC 02T . I 104(a)(2)(B), including leakage and pressure testing as appropriate.
Q Plans and specifications must not be labeled with preliminary phrases (e.g., FOR REVIEW ONLY, NOT FOR
CONSTRUCTION, etc.) that indicate that they are anything other than final plans and specifications. However, the plans and
specifications may be labeled with the phrase: FINAL DESIGN —NOT RELEASED FOR CONSTRUCTION.
F. Engineering Calculations (Application Involving New or Changes to Treatment or Storage Units)
d Submit all design calculations that have been signed, sealed, and dated by a NC Professional Engineer per 15A NCAC 02T
.1104(a).
G. Environmental Assessments (Maybe Required —See 15A NCAC IC .0300)
El Submit a copy of the Findings of No Significant Impact (FONSI) or Environmental Impact Statement (EIS). Also, include
information on any mitigating factor(s) from the Environmental Assessment (EA) that impact the construction of the residuals
treatment and storage facilities. An EA may also be required for private systems if any public funds and/or lands are used for
the construction of the subject facilities.
INSTRUCTIONS FOR FORM: DCAR 06-16 Page 2 of 3

H. Operation and Maintenance Plan (New and Renewal Application Packages)
❑ For Modification Application, if there are any changes to the existing plan, submit an updated O&M plan.
® Submit the O&M Plan in accordance with 15A NCAC 02T .1110 and include at a minimum:
Operational functions; describe the operation of the program to show what operations are necessary for the program to function
and by whom the functions are to be conducted.
Maintenance schedules; may include equipments calibration, maintenance of signs, etc.
Safety measures; may include safety training program, manuals, signs, etc.
® Spill response plan; including control, containment, remediation, emergency contact information, etc.
Inspection plan including the following information;
Names and titles of personnel responsible for conducting the inspections.
Frequency and location of inspections, including those to be conducted by the ORC, and procedures to assure that the selected
location(s) and inspection frequency are representative of the residuals management program.
® Detailed description of inspection procedures including record keeping and actions to be taken by the inspector in the event
that noncompliance is observed.
Sampling and monitoring plan including the following information;
Names and titles of personnel responsible for conducting the sampling and monitoring.
Detailed description of monitoring procedures including parameters to be monitored.
Sampling frequency and procedures to assure that representative samples are being collected. Fluctuation in temperature, flow,
and other operating conditions can affect the quality of the residuals gathered during a particular sampling event. The sampling
plan shall account for any foreseen fluctuations in residuals quality and indicate the most limiting times for residuals to meet
pathogen and vector attraction reduction requirements (e.g. facilities that land apply multiple times per year but have an annual
sampling frequency, may need to sample during winter months when pathogen reduction is most likely to be negatively affected
by cold temperatures.
ONE ORIGINAL AND TWO COPIES OF THE COMPLETED APPLICATION PACKAGE, INCLUDING ALL
SUPPORTING INFORMATION AND MATERIALS, SHALL BE SENT TO THE FOLLOWING ADDRESS:
NORTH CAROLINA DEPARTMENT OF ENVIRONMENTAL QUALITY
DIVISION OF WATER RESOURCES
WATER QUALITY PERMITTING SECTION
NON -DISCHARGE PERMITTING UNIT
By U.S. Postal Service:
1617 MAIL SERVICE CENTER
RALEIGH, NORTH CAROLINA 27699-1617
TELEPHONE NUMBER: [phone]
By Courier/Special Delivery:
512 N. SALISBURY STREET
RALEIGH, NORTH CAROLINA 27604
FAX NUMBER: [phone]
INSTRUCTIONS FOR FORM: DCAR 06-16 Page 3 of 3

DWR
State of North Carolina
Department of Environmental Quality
Division of Water Resources
Division of Water Resources 15A NCAC 02T .1100 —DISTRIBUTION OF CLASS A RESIDUALS
FORM: DCAR 06-16
1. APPLICANT INFORMATION:
1. Applicant's name: Baxter Healthcare Corporation
Applicant type: ❑ Individual Corporation ❑ General Partnership ❑ Privately -Owned Public Utility
El Federal [] State " Municipal ❑ County
Signature authority's name per 15A NCAC 02T .0106: Jon Rushford Title: Plant Manager
Applicant's mailing address: 65 Pitts Station Road
City: Marion State: NC Zip: 28752
Telephone number: [phone] Email Address: [e-mail]
2. Consultant's name: NA License Number (for P.E.):
Affiliation: ❑ On Staff ❑ Retained (Firm: _)
Consultant's mailing address: I_ RECENE.DINCDE010WR
City_ State: _ Zip: _=
Telephone number: MAY 17 2019
p (_) ` _ Email Address: �_
3. Fee submitted: i-- (See Instruction B) Non -Discharge
H. PERMIT INFORMATION: permitting Unit
1. Application is for (check all that apply):(] new, ❑ modified, renewed permit
2.
If this application is being submitted to renew or modify an existing permit, provide the following:
Permit number: W00010689
Date of most -recently issued permit: September 26, 2014 N i
Date of most -recently certified Attachment A (if different than the permit): _
III. FACILITY INFORMATION:
1. Name of residuals processing facility: North Cove Steam Generation Plant
City: Marion State: NC Zip:
Coordinates: Latitude: 350 50' 5" Longitude: 810 59' 40.7"
Datum: Level of accuracy: _
Method of measurement:
MAY 2 2 2019
Water0, ri, r.._,_�_,�rl1n�r,^tI0n5
Asl......
County where facility is located: McDowell
2. Facility contact (person familiar with residuals preparation): f
Name: Corey Camentier Title: Environmental Engineer
Mailing address: 65 Pitts Station Road
City: Marion State: NC Zip: 28752
Telephone number: [phone] E-mail address: corey camentierAbaxter.com
FORM: DCAR 06-16 Page 1 of 3

3. Is the residual process facility also the generator? 0 Yes; (f' No
If No, please specify delivery frequency and quantity of residual to be processed:
4. Length of residuals storage at facility: <90 days (Note: the Division requires minimum 30 days storage in units that are separate
from treatment system, i.e. not in clarifiers, aeration basins, etc.)
IV. RESIDUALS QUALITY INFORMATION:
1. Specify how these residuals will be distributed:
❑ sold or given away in bags or other containers; ❑ lawn (bulk); ❑ home garden (bulk);
0 other (explain); Sold or given away in bulk for agricultural application
Note: Bulk residuals shall mean residuals that are transported and not sold or giving away in a bag or other receptacles with a
load capacity of one metric ton or less.
2. Complete the following if residuals are to be mixed with other materials:
Type of Materials Amounts to be added
0.1 to 0.25
3. Approximate amounts of the residuals received and processed at the facility: 2000 dry tons per year.
4. Approximate amounts of the final product (processed residuals) to be distributed: 2000 dry tons per year.
5. Provide a description of the onsite storage management plan for the treated residuals (including estimated average and
maximum storage times prior to distribution): Basins are provided for material stockpiles of approximately 500 tons within or
on the adiacent concrete apron The apron isyrotected/lined with concrete barriers to contain residuals Although dependent
on time of year and weather conditions residuals enerally are stored onsite 30-60 days until loaded onto bulk trucks for
distribution.
6. Does the facility have a stormwater management plan? 0 Yes; 0 No
Explain whether the treatment and storage areas are under roof or how stormwater runoff will be handled: Treatment and
storage is not located under roof. The holding basins absorb all stormwater flow with residuals or are dewatered and added to
the process water system
V. RESIDUALS SOURCE INFORMATION: (Required for all new, renewed, or modified residuals source)
Complete and submit the attached Residuals Source Certification and all associated documentation.
13
RSC 06-16.doc
FORM: DCAR 06-16 Page 2 of 3

Professional Engineer's Certification: (Application Involving New or Changes to Treatment or Storage Units)
attest that this application for
has been reviewed by me and is accurate and complete to the best of my knowledge. I further attest that to the best of my knowledge
the proposed design has been prepared in accordance with the applicable regulations. Although certain portions of this submittal package
may have been developed by other professionals, inclusion of these materials under my signature and seal signifies that I have reviewed
this material and have judged it to be consistent with the proposed design.
North Carolina Professional Engineer's Seal, Signature, and Date:
Applicant's Certification:
The applicant or any affiliate has not been convicted of an environmental crime, has not abandoned a wastewater facility without proper
closure, does not have an outstanding civil penalty where all appeals have been exhausted or abandoned, are compliant with any active
compliance schedule, and do not have any overdue annual fees under Rule 15A NCAC 02T .0105.
B Yes Q No, Explain L-
I, Jon Rushford Plant Manager
(Signature Authority's Name — PLEASE PRINT) (Title)
attest that this application for Baxter Healthcare North Cove Steam Generation Plant
(Facility Name)
has been reviewed by me and is accurate and complete to the best of my knowledge. I understand that the Division of Water Resources
may not conduct a technical review of this program and approval does not constitute a variance to any rules or statutes unless specifically
granted in the pem»t. Further, any discharge of residuals to surface waters or the land will result in an immediate enforcement action,
which may include civil penalties, injunctive relief, and/or criminal prosecution. I will make no claim against the Division of Water
Resources should a condition of this permit be violated. I also understand that if all required parts of this application are not completed
and that if all required supporting information and attachments are not included, this application package will be returned to me as
incomplete.
Note: In accordance with North Carolina General Statutes § 143-215.6A and § 143-215.613, any person who knowingly makes any false
statement, representation, or certification in any application shall be guilty of a Class 2 misdemeanor, which may include a fine not to
exceed $10,000 as well as civil penalties up to $25,000 per violation.
Signature: Date: 5/19119
FORM: DCAR 06-16 Page 3 of 3

Baxter Healthcare
Permit Renewal Application: WQ0010689
Form DCAR 06-16
D. Program Information
Narrative: Residual ash solids are collected and treated in the same location. Process water is pumped
into one of two settling basins where the ash and water are separated. The water is drained from the
basin and pumped back into the emissions control process. When ash sludge reaches a sufficient depth,
the basin is taken out of service and drained of free liquid to the extent practicable. All water drained
from the basin is pumped into the adjacent in service basin where it is then recirculated through the
process. The remaining residuals are further dewatered by mixing in wood flour and/or saw dust inside
the basin using a loader or similar piece of equipment. Dewatered material may be stored in the basin
or on the concrete apron at the entrance to the basin to ensure any leachate drains back into one of the
two basins and is ether dewatered or returned to the process. A representative sample of the
dewatered material is then tested for metals, pH, and nutrient concentrations. Once the material is
characterized, is bulk loaded from the basin or storage pile into trucks with a loader or similar
equipment and transported to the location of use. Both calcium and phosphorus concentrations are
provided in the analytical data. The general application rate is three to four units by weight of ash
material for every one unit of agricultural lime recommended based on soil testing.
Marketability Statement: Baxter Healthcare anticipates production of less than 3,200 dry tons of ash
per year. Ash production for RY18 was approximately 1,606 dry tons. All ash residuals were distributed
to local recipients in accordance with Permit WQ0010689 for land application with the intended use of
agricultural soil improvement. Baxter anticipates similar activities during the next permit cycle.
1of1

Baxter Healthcare, Corp.
2859 Old Linville Road
Marion, North Carolina 28752
Ash Distribution Utilization Agreement (Valid thru 11/30/19), Recipient Copy
Baxter Healthcare, Corp., is the generator of the ash provided to
(Recipient). Application of the aforementioned ash is prohibited except in accordance with the
instructions on this sheet.
Transport: Adequate provisions shall be taken to ensure that the transportation of ash does not cause
nuisances and hazards to public health and safety or otherwise cause an adverse impact (e.g., transport
wet ash in leak -proof trucks or cover dry ash). Any spill occurring while ash is in transport or on the
application fields is the responsibility of the transporter. The transporter must keep spill control
provisions on the vehicle.
Storage: The ash shall be adequately stored to prevent wind erosion or surface runoff from carrying ash
into any surface waters. Keeping the ash slightly moistened will accomplish this objective under normal
conditions. However, beans, barriers, or tarps, may be necessary under windy or rainy conditions or if
erosion or runoff cannot be controlled.
Application: When using ash, the following shall apply:
• The ash application rates shall be limited to those that can be agronomically justified (i.e., limited to
that needed to meet the liming requirements of the crops being grown on the land).
• . Ash shall not be stockpiled for more than 60 days prior to land application
• Application of bulk residuals shall not occur within 100 feet of a public or private water supply
• A copy of this Utilization Agreement shall be maintained at the land application site when bulk
residuals are being applied.
• Ash shall not be placed within one foot of the seasonal high water table.
• Ash shall not be placed within 100 feet of any water supply well or spring unless underlain and
overlain by a liner with a maximum hydraulic conductivity of 10' centimeters per second. If such a
liner/cover is provided, ash shall not be placed within 25 feet of any water supply well or spring.
• The ash shall not be applied to any site that is flooded, frozen, or snow-covered.
• Procedures shall be put in place to prevent the surface runoff from carrying any disposed or stored
residuals into any surface waters.
A summary of the ash chemical analyses is located on page 2 of the information sheet. Detailed
laboratory results are available upon request.
Title to the ash will transfer from Baxter Healthcare, Corp to Recipient upon delivery thereof. Thereafter,
Baxter Healthcare, Corp will have no responsibility and shall not be held liable by Recipient or any third
party for any spill, misuse, misapplication or other mishandling of the ash. Recipient acknowledges and
agrees that the ash is being delivered by Baxter Healthcare, Corp to Recipient as an accommodation to
Recipient. In exchange therefore, Recipient agrees to indemnify, save and hold Baxter Healthcare, Corp
harmless from and against any and all liability, damage, loss, cost, expense (including attorneys' fees),
claim, demand, suit, action, judgment or recovery asserted against Baxter Healthcare, Corp by any third
party, including any governmental authority, whether for bodily injury (including death) or damage to
property, arising from or in connection with Recipient's receipt, transportation, handling or other use of
the ash.
Page 1 of 3

Baxter Healthcare, Corp.
2859 Old Linville Road
Marion, North Carolina 28752
Ash Distribution Utilization Agreement (Valid thru 11/30/19), Baxter Copy
Baxter Healthcare, Corp., is the generator of the ash provided to (Recipient).
Application of the aforementioned ash is prohibited except in accordance with the instructions on this sheet.
Transport: Adequate provisions shall be taken to ensure that the transportation of ash does not cause nuisances and
hazards to public health and safety or otherwise cause an adverse impact (e.g., transport wet ash in leak -proof trucks
or cover dry ash). Any spill occurring while ash is in transport or on the application fields is the responsibility of the
transporter. The transporter must keep spill control provisions on the vehicle.
Storage: The ash shall be adequately stored to prevent wind erosion or surface runoff from carrying ash into any
surface waters. Keeping the ash slightly moistened will accomplish this objective under normal conditions.
However, berms, barriers, or tarps, may be necessary under windy or rainy conditions or if erosion or runoff cannot
be controlled.
Application: When using ash, the following shall apply:
• The ash application rates shall be limited to those that can be agronomically justified (i.e., limited to that needed
to meet the liming requirements of the crops being grown on the land).
• Ash shall not be stockpiled for more than 60 days prior to land application
• Application of bulk residuals shall not occur within 100 feet of a public or private water supply
• A copy of this Utilization Agreement shall be maintained at the land application site when bulk residuals are
being applied.
• Ash shall not be placed within one foot of the seasonal high water table.
• Ash shall not be placed within 100 feet of any water supply well or spring unless underlain and overlain by a
liner with a maximum hydraulic conductivity of 10-6 centimeters per second. If such a liner/cover is provided,
ash shall not be placed within 25 feet of any water supply well or spring.
• The ash shall not be applied to any site that is flooded, frozen, or snow-covered.
• Procedures shall be put in place to prevent the surface runoff from carrying any disposed or stored residuals into
any surface waters.
A summary of the ash chemical analyses is located on page 2 of the information sheet. Detailed laboratory results
are available upon request.
Title to the ash will transfer from Baxter Healthcare, Corp to Recipient upon delivery thereof Thereafter, Baxter
Healthcare, Corp will have no responsibility and shall not be held liable by Recipient or any third party for any spill,
misuse, misapplication or other mishandling of the ash. Recipient acknowledges and agrees that the ash is being
delivered by Baxter Healthcare, Corp to Recipient as an accommodation to Recipient. In exchange therefore,
Recipient agrees to indemnify, save and hold Baxter Healthcare, Corp harmless from and against any and all
liability, damage, loss, cost, expense (including attorneys' fees), claim, demand, suit, action, judgment or recovery
asserted against Baxter Healthcare, Corp by any third party, including any governmental authority, whether for
bodily injury (including death) or damage to property, arising from or in connection with Recipient's receipt,
transportation, handling or other use of the ash.
Signed (Ash Recipient):
Ash Recipient's Address:
Intended Use of Ash:
Expected Qty/Yr:
Baxter Representative Signature:
Date:
Acres of Land:
Page 2 of 3

Marion, North Carolina
Ash Distribution Program
Historical Analysis Average
Soil Amendment Properties
Parameter
Concentration
Calcium Carbonate Equivalent
42.0%
Potash (K2O)
3.6%
20-Mesh %
85.4%
100-Mesh %
44.7%
Metals (6010 MET ICP, EPA 6010)
Parameter
Concentration (me/ke)
Arsenic
5.45
Barium
1,497
Cadmium
1.23
Calcium
86,650
Chromium
22.63
Copper
83.37
Lead
37.05
Magnesium
16,750
Manganese
2,772
Mercury
0.001
Nickel
22.15
Phosphorus
2,022
Potassium
22,200
Selenium
2.60
Silver
0.26
Sodium
5,473
Zinc
215.17
TCLP RCRA Toxicity Metals (Lecahable Concentrations)
Parameter
Concentration (mg/L)
Arsenic
0.000
Barium
5.467
Cadmium
0.007
Chromium
0.007
Lead
0.006
Selenium
0.000
Silver
0.000
EPA 9045 ph 10.0 std. units
Page 3 of 3

Baxter Healthcare
Permit Number: WQ0010689
Ash Distribution Program O&M Plan
1. Operational Function
Residual ash is created by the wood fuel combustion within an industrial boiler. Dry ash comes from the grate
raking process and is transported, by loader, to the ash ponds. The dry ash is stored on the apron of the ponds
and is surrounded by a barrier. Wet ash comes from the venturi scrubber. Ash is piped into the ponds from the
scrubber. Baxter Healthcare wood boiler alternates between two basins for ash accumulation. When the active
basin is within 24" of the top of the basin wall, the basin is considered full. At this time the alternative basin is
put into service. The basin that is considered full is then dewatered and the ash is processed. Samples are taken
from each batch of ash created and analyzed prior to any ash leaving the facility. Analysis results are compared
to limits outlined in the permit. Once the ash is approved for application it is picked up by truck and transported
to the application field. The ash may be immediately applied to the land or stockpiled in the field.
2. Maintenance Schedule
The ash ponds onsite at the Baxter Healthcare wood boiler are monitored daily. The ash levels within the ponds
dictate when the designated active pond goes into service. All pumps and ash handling infrastructure and
equipment is maintained within the Baxter Healthcare preventative maintenance program (MAXIMO).
3. Safety Measures
All ash will be stored in the basins or on the apron in such a way that prevents runoff prior to distribution and
use to prevent contamination of surface waters. During dry conditions, operators will spray water on stock piles
to prevent wind erosion. Handling and loading is conducted in the basin/apron area. Operators avoid creating
nuisance dust to the extent practicable. Ash Distribution Utilization Agreement will be distributed to each
receiver of ash material outlining transport, storage, and application requirements. This agreement is valid for
the permit cycle (November 30, 2019). Baxter Healthcare Woodboiler operates 24-hours a day, 7-days a week,
with personnel onsite at all times. The wood boiler facility is surrounded by fencing and the ash storage apron is
illuminated at night to prevent any security breaches.
4. Spill Response Plan
All ash is contained within the ash ponds and the ash pond apron. Any spill onsite is immediately contained and
cleaned up. Any spill during transportation of the ash will be the responsibility of the transporter. All
transporters must keep spill control provisions on their vehicles. Baxter Healthcare will be notified of any offsite
spill immediately.
5. Inspection Plan
The Wood Boiler Superintendent, Rick Styles, is overall responsible for all inspections; however, he may delegate
inspections to operators. A visual inspection of the two basins, ash storage piles, and associated piping is
performed at least once per day as part of the standard work for the wood boiler. Mechanical malfunctions,
operator errors, and discharges which may cause or lead to the release of waste to the environment are
documented in the operator's daily log kept in the control room. A documented monthly inspection is
conducted; this inspection includes the date and time, name of inspector, observations, and any corrective
actions taken. Inspection forms are kept in the control room of the wood boiler.
1of2

Baxter Healthcare
Permit Number: WQ0010689
6. Sampling and Monitoring Plan
The Wood Boiler Superintendent, Rick Styles, is responsible for the sampling and monitoring program.
Composite samples are taken of material offered for shipment composed of representative samples at different
locations in the storage pile. The ash is analyzed to demonstrate it is non -hazardous under the Resource
Conservation and Recovery Act (RCRA). The analyses [Corrosivity, ignitability, reactivity, and toxicity
characteristic leaching procedure TCLP)] shall be performed once during the permit cycle. Additional analysis
shall be performed based on the monitoring frequency in Attachment A of the permit for the following
parameters:
Arsenic
Magnesium
Selenium
Barium
Manganese
Silver
Cadmium
Mercury
Sodium
Calcium
Molybdenum
Zinc
Chromium
Nickel
Copper
pH
Iron
Phosphorus
Lead
I Potassium
Records of all ash distribution activities and sample results are maintained in the Wood Boiler Superintendent's
office and electronically.
7. Contact Information:
Wood Boiler Superintendent: Rick Styles 828-756-6650
Environmental Engineer:
Plant Manager:
NCDEQ (within 24-hours)
Corey Carpentier
Jon Rushford
Asheville Region
828-756-6636
828-756-6530
828-296-4500
2of2

DWR
Division of Water Resources
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
INSTRUCTIONS FOR FORM: RSC 06-16
Please use the following instructions as a checklist in order to ensure all required items are submitted. Adherence to these
instructions and checking the provided boxes will help produce a quicker review time and reduce the amount of additional
information requested. Failure to submit all of the required items will lead to additional processing and review time for the
permit application. Unless otherwise noted. the Applicant shall submit one original and two copies of the application and
supporting documentation
For more information, visit the Water Quality Permitting Section's Non -Discharge Permitting Unit
General — This certification provides detailed information of residuals source generating facility and its residuals quality for land
application, distribution, or disposal in accordance with 15A NCAC 02T .1100. Do not submit this certification for review without
a corresponding application form (FORM: RLAP 11-15, FORM: DCAR 11-15, or FORM: SDR 11-15).
Unless otherwise noted, the Applicant shall submit one original and two copies of the application and supporting documentation listed
below.
A. Residuals Source Certification (FORM: RSC 11-15):
® Submit the completed and appropriately executed Residuals Source Certification (FORM: RSC 11-15) form. Please do not
make any unauthorized content changes to this form. If necessary for clarity or due to space restrictions, attachments to the
application may be made, as long as the attachments are numbered to correspond to the section and item to which they refer.
® For new or renewed permits, submit a separate certification for each source facility.
❑ For modified permits, submit a separate certification for only those facilities that are affected by the proposed modification.
N Complete the residuals source facility summary page. List all new, renewed, or modified facilities.
B. Residuals Source -Generating Facility Information:
N For each source facility, attach the following:
N Vicinity map - A vicinity map that shows the location of the facility and meets all of the criteria in the "Map Guidance for
Residuals Land Application Permits".
N Process flow diagram and/or narrative - A detailed narrative and/or process flow diagram that describes how the residuals
are to be generated, treated, processed, and stored at the facility.
N Quantitative justification for residuals production rate - A quantitative justification for the value provided in Item 1. 8.
Ensure that the amount of residuals listed is the maximum amount expected to be generated by the facility for the life of
the permit. In addition, ensure that this amount is equivalent to that which is actually to be land applied, distributed,
and/or disposed, including any chemicals, amendments, or other additives that are added to the residuals during
processing.
N Sampling plan - A detailed sampling plan for the residuals source -generating facility. Ensure that the plan identifies
sampling points, sampling frequency, sample type, as well as the Division -certified laboratory to be used. In addition,
ensure that the plan details how the facility and/or the residuals are monitored for any applicable pathogen reduction and
vector attraction reduction requirements. Note that all sampling and monitoring must be completed on the residuals as
they are to be land applied, distributed, and/or disposed.
C. Residuals Quality Information:
N For each source facility, attach the following:
N laboratory analytical reports and operational data - reports for all laboratory analyses used to complete this certification.
❑ Documentation that the facility complies and/or the residuals comply with any applicable pathogen reduction and vector
attraction reduction requirements.
❑ For new facility that may have not yet been constructed and analytical results of residuals cannot be obtained, please
attach analytical results of residuals generated from a similar facility along with the description of similarities of the two
facilities.__
MAY 2 2 2019
INSTRUCTIONS FOR FORM: RSC 06-16 I Page 1 of I
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Division of Water Resources
I.
II.
State of North Carolina
Department of Environmental Quality
Division of Water Resources
RESIDUALS SOURCE CERTIFICATION
RESIDUALS SOURCE -GENERATING FACILITY INFORMATION (See Instruction B.):
1. Facility Name: North Cove Steam Generation Plant
2. Facility permit holder is: ❑ Federal, [@ State, ❑ Local Government, or DO Private.
Facility permit issued by: JZ Div. of Water Resources, ❑ Div. of Environmental Health,
or ❑ Other (explain: I 1.
3. Facility contact person and title: Corey Carpentier
Complete mailing address: 65 Pitts Station Road
City: Marion
Telephone number: [phone]
State: NC
Zip: 28752
E-mail address: corev camentier(obaxteccom
4. Facility physical address: 2859 Old Linville Road
City: Marion State: NC Zip: 28752
Coordinates: Latitude 35' 50' 5" Longitude: 81. 59 40 7"
Datum FI-17-21,11 Level of accuracy:
Method of measurement: Gooele Earth
5. Purpose of the facility:
FORM: RSC 06-16
MAY 2 2 2019
Water C)";,' onerations
Ashe
treatment of municipal wastewater, ❑ treatment of 100% domestic wastewater,
treatment of potable water, JZ treatment of 100% industrial wastewater,
Q treatment of industrial wastewater mixed with domestic wastewater,
(approximate percentages: % industrial and % domestic)
p other (explain: ).
6. Does the facility have an approved pretreatment program: IM Yes No
7. Facility permitted/design flow: 0.72 MGD and facility average daily flow: 0.72 MGD
8. Average amount of residuals being generated at this facility 1600 dry tons per year.
9. Specify the following regarding treatment and storage volumes available at the facility:
Type and volume of residuals treatment: Ash, 1600 tons
Type and volume of residuals storage (i.e., outside of residuals treatment units): Ash. 1600 tons
RESIDUALS QUALITY INFORMATION (See Instruction C.):
Specify if residuals are regulated under:
40 CFR Part 503 or 40 CFR Part 257.
Note: Only residuals that are generated during domestic/municipal wastewater treatment processes are regulated under 40
CFR Part 503, otherwise, the residuals are regulated under 40 CFR Part 257.
2. Specify if residuals are defined under 15A NCAC 02T.1102(6) as:
Biological E] Non -Biological
Note: Biological residuals are residuals that have been generated during the treatment of domestic wastewater, animal
processing wastewater, or the biological treatment of industrial wastewater (biological treatment is a system that utilizes
biological processes including lagoons, activated sludge systems, extended aeration systems, and fixed film systems).
FORM: RSC 06-16 Page 1 of 5

3. Hazardous Waste Determination: Complete the following to demonstrate that the residuals are non -hazardous under
RCRA: (Note - this item does not have to be completed for facilities that are less than 0.5 MGD in design flow that treat
100% non -municipal, domestic wastewater only)
a. Are the residuals listed in 40 CFR §261.31-§261.33: [] yes M no.
If yes, list the number(s):
b. Specify whether or not the residuals exhibit any of the characteristics defined by 40 CFR §261.21-
261.24: [] yes 0 no.
Fill in the following tables with the results of the latest toxicity characteristic leaching procedure (TCLP) analysis as
well as those for corrosivity, ignitability, and reactivity:
Laboratory: Pace Analytical Services and Date of analysis: 3/14/19
Passed corrosivity test: yes ] no. pH: s.u. (2 < pH < 12.5)
Passed ignitability test: yes no. Flashpoinr. L_ T (> 140°F)
Passed reactivity test: Oyes [Eno. HCN: ND mg/kg (<250) & HzS: ' _ mg/kg (<500)
TCLP Parameter
Limit
NO)
Result
(Mg/1)
TCLP Parameter
Limit
NO)
Result
NO)
Arsenic
5.0
ND
Hexachlorobenzene
0.13
ND
Barium
100.0
8.3
Hexachloro-1,3-Butadiene
0.5
ND
Benzene
0.5
ND
Hexachloroethane
3.0
ND
Cadmium
1.0
0.010
Lead
5.0
ND
Carbon Tetrachloride
0.5
ND
Lindane
0.4
ND
Chlordane
0.03
ND
Mercury
0.2
ND
Chlorobenzene
100.0
ND
Methoxychlor
10.0
ND
Chloroform
6.0
ND
Methyl Ethyl Ketone
200.0
ND
Chromium
5.0
ND
Nitrobenzene
2.0
ND
m-Cresol
200.0
ND
Pentachlorophenol
100.0
ND
o-Cresol
200.0
ND
Pyridine
5.0
ND
p-Cresol
200.0
ND
Selenium
1.0
ND
Cresol
200.0
ND
Silver
5.0
ND
2,4-D
10.0
ND
Tetrachloroethylene
0.7
ND
1,4-Dichlorobenzene
7.5
ND
Toxaphene
0.5
ND
1,2-Dichloroethane
0.5
ND
Trichloroethylene
0.5
ND
1,1-Dichloroethylene
0.7
ND
2,4,5-Trichlorophenol
400.0
ND
2,4-Dinitrotoluene
0.13
ND
2,4,6-Trichlorophenol
2.0
ND
Endrin
0.02
ND
2,4,5-TP (Silvex)
1.0
ND
Heptachlor and its Hydroxide
0.008
ND
Vinyl Chloride
0.2
ND
FORM: RSC 06-16 Page 2 of 5

4. Metals Determination: Complete one of the following tables (i.e., as applicable) to demonstrate that the residuals do not
violate the ceiling concentrations for metals regulated under 15A NCAC 02T .1105.
a. For Distribution/Land Application: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: Pace Analytical Services, Asheville. NC and Date of analysis: 3-14-19
Parameter
Ceiling
Concentration Limits
(Class-4 & C1assB)
(mg/kg)
Monthly Average
Concentration Limits
(Class A Only)
(mg/kg)
Result
(mg/kg)
Arsenic
75
41
ND
Cadmium
85
39
1.4
Copper
4,300
1,500
58.8
Lead
840
300
16.3
Mercury
57
17
ND
Molybdenum
75
n/a
1.2
Nickel
420
420
18.8
Selenium
100
100
ND
Zinc
7,500
2,800
143
b. For Surface Disposal Unit (Iandfi111: Fill in the following table with the results of the latest analyses (i.e., on a dry weight
basis) for the following metal parameters:
Laboratory: t and Date of analysis: Me,
Distance from Disposal
Unit to Boundary to
Closest Property Line
(meters, check one)
Arsenic
(mg/kg)
Chromium
(mg/kg)
Nickel
(mg/kg)
> 0 but < 25
30
200
210
❑ > 25 but < 50
34
220
240
❑ > 50 but < 75
39
260
270
❑ > 75 but < 100
46
300
320
❑ >_ 100 but < 125
53
360
390
❑ > 125
62
450
420
Result (mg/kg)
FORM: RSC 06-16 Page 3 of 5

5. Nutrient/Micronutrient Determination: Complete the following:
a. Total solids: 46.2 %.
b. Fill in the following table with the results of the latest analyses (i.e., on a dry weight basis) for the following nutrient and
micronutrient parameters:
Laboratory: Pace Analytical Services, Asheville, NC and Date of analysis: 3-14-19
Parameter
Result
(mg1kg)
Aluminum
Ammonia -Nitrogen
Calcium
77,200
Magnesium
10,500
Nitrate -Nitrite Nitrogen
pH (Standard Unit)
9.0
Phosphorus
2,200
Potassium
16,000
Sodium
7,310
Total Kjeldahl Nitrogen
c. Using the results listed in Item II. 5b. above, calculate the sodium adsorption ration (SAR): 6_5
[Note: If residuals contain SAR of 10 or higher, the applicant shall obtain recommendations from the local Cooperative
Extension Office, the Department of Agriculture and Consumer Services, the Natural Resource Conservation Service, a
North Carolina Licensed Soil Scientist, or an agronomist, prior to land application of residuals. The recommendations shall
address the sodium application rate, soil amendments (e.g., gypsum, etc.), or a mechanism for maintaining site integrity
and conditions conducive to crop growth].
d. Specify the mineralization rate to be used in calculating the plant available nitrogen (PAN) of the residuals: %.
This rate is a (check one): M default value, or El actually established.
If the residuals are not generated from the treatment of municipal or domestic wastewater, explain or provide technical
justification as to why the selected default value is appropriate to be applied to these residuals: L _
e. Calculate the PAN for the residuals (i.e., on a dry weight basis) and fill the results in the following table:
Application Method
First (1'h Year PAN
Five -Year
Maximum Adjusted PAN
(mglkg)
(mglkg)
Surface
Injection/Incorporation
6. Other Pollutants Determination: Specify whether or not there are any other pollutants of concern in the residuals and provide
the results of the latest analyses: l
FORM: RSC 06-16 Page 4 of 5

7. Pathogen Reduction: Per 15A NCAC 02T.1106, specify how residuals will meet the pathogen reduction requirements:
a. For Distribution/LandApplication ofClass AorEauivalent:
❑ A fecal coliform density that is demonstrated to be less than 1,000 MPN per gram of total dry solids,
or
❑ A salmonella sp. density that is demonstration to be less than 3 MPN per 4 grams of total dry solids.
AND one of the followings (except for non -biological residuals):
❑ Alternative 1 [ 15A NCAC 02T. 1 106(b)(3)(A)] - Time/Temperature Compliance.
❑ Alternative 2 [15A NCAC 02T.I 106(b)(3)(B)] - Alkaline Treatment.
❑ Alternative 3 [15A NCAC 02T.I 106(b)(3)(C)] - Prior Testing for Enteric VimsNiable Helminth Ova.
❑ Alternative 4 [15A NCAC 02T.1106(b)(3)(D)] - No Prior Testing for Enteric VirusNiable Helminth Ova.
❑ Alternative 5 [15A NCAC 02T.I 106(b)(3)(E)-(K)] - Process to Further Reduce Pathogens (PFRP).
Specify one: ❑ composting, ❑ heat drying, heat treatment,
❑ themrophilic aerobic digestion, a beta ray irradiation,
❑ gamma ray irradiation, or pasteurization.
b. For Land Application of Class B.
Alternative 1 [15A NCAC 02T.1106(c)(1)] -Fecal Coliform Density Demonstration.
Alternative 2 [15A NCAC 02T.1106(c)(2)] -Process to Significantly Reduce Pathogens (PSRP).
Specify one: El aerobic digestion, [0 air drying, ❑ anaerobic digestion,
El composting, or lime stabilization.
c. For Surface Disposal:
❑ Select One of the Class A or Equivalent Pathogen Reduction Alternatives in Item II.7a. above.
❑ Select One of the Class B or Equivalent Pathogen Reduction Alternatives in Item II.7b. above.
❑ Exempt -If Daily Cover Alternative is chosen in Item II.8. below [15A NCAC 02T.1106(a)(2)].
Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
8. Vector Attraction Reduction (VAR): Per 15A NCAC 02T.1107, specify how residuals will meet the VAR requirements:
❑ Alternative 1 [15A NCAC 02T.1107(a)(1)] - 38% Volatile Solids Reduction (Aerobic/Anaerobic Digestion).
❑ Alternative 2 [15A NCAC 02T.1107(a)(2)] - 40-Day Bench Scale Test (Anaerobic Digestion).
❑ Alternative 3 [15A NCAC 02T.1107(a)(3)] - 30-Day Bench Scale Test (Aerobic Digestion).
❑ Alternative 4 [15A NCAC 02T.1107(a)(4)] - Specific Oxygen Uptake Rate Test (Aerobic Digestion).
❑ Alternative 5 [15A NCAC 02T.1107(a)(5)] - 14-Day Aerobic Processes.
❑ Alternative 6 [15A NCAC 02T.I 107(a)(6)] - Alkaline Stabilization.
❑ Alternative 7 [15A NCAC 02T.I 107(a)(7)] - Drying of Stabilized Residuals.
❑ Alternative 8 [15A NCAC 02T. 1 107(a)(8)] - Drying of Unstabilized Residuals.
❑ Alternative 9 [15A NCAC 02T.I 107(a)(9)] -Injection.
❑ Alternative 10 [15A NCAC 02T.1107(a)(10)] - Incorporation.
❑ Alternative for Surface Disposal Units Only - Soil/Other Material Cover [15A NCAC 02T.1107(b)(2)].
ED Not Applicable - Non -Biological Residuals with NO Domestic Wastewater Contribution.
Note: For animal processing residuals, only alternatives 9 or 10 may be chosen due to the nuisance conditions that typically
occur when these residuals are applied and left on the land surface.
FORM: RSC 06-16 Page 5 of 5

Form RSC 06-16. B. Residuals Source -Generating Facility Information
1. The vicinity map is attached following this document
2. Process Flow Narrative: Residual ash solids are collected and treated in the same location. Process
water is pumped into one of two settling basins where the ash and water are separated. The water is
drained from the basin and pumped back into the emissions control process. When ash sludge reaches
a sufficient depth, the basin is taken out of service and drained of free liquid to the extent practicable.
The remaining residuals are further dewatered by mixing in wood flour and/or saw dust inside the basin
using a loader or similar piece of equipment. Dewatered material may be stored in the basin or on the
concrete apron at the entrance to the basin to ensure any leachate drains back into one of the two
basins and is ether dewatered or returned to the process. Once sample results have been verified in
compliance with all permit parameters, the material is transported off site for land application and/or
disposal. The material is provided to end users in a manner that allows them to land apply upon
receiving, and as such no storage occurs offsite. The general application rate is three to four units by
weight of ash material for every one unit of agricultural lime recommended based on soil testing.
3. Quantitative Justification for Residuals Production Rate: The average production rate for dry tons of
ash is approximately 1,600 tons per year. This includes organic amendments to ensure the material is
sufficiently free of liquid to be suitable for storage, transport, and land application. This rate has been
determined based on review of historical ash generation rates, which have been consistent with this
value. Wood fuel burned averages approximately 105,000 tons per year to meet the steam demand for
the facility. Facility production rates have not nor are anticipated to vary considerably to significantly
alter the steam demand for the facility.
4. Sampling Plan: A representative sample of the dewatered material is tested for metals, pH, and
nutrient concentrations as specified within the permit. Samples are analyzed by Pace Analytical Services
in Asheville, NC. Pathogen and vector reduction are not required for this process based on the permit
type. All samples are taken directly from the ash pile while it is staged on the concrete containment
apron adjacent to the settling basin. Sampling occurs prior to each distribution event, which historically
has occurred three times annually. Once the material is characterized and verified in compliance with all
permit conditions, it can then be loaded for transport to its disposal destination.

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Water Resources
ewvNmeNe uuuarr
July 03, 2018
Corey Carpentier
Baxter Healthcare Corporation
65 Pitts Station Rd
Marion, NC 28752
ROY COOPER
aovfi n
A4CHAEL S. REGAN
seergioll
LINDA CULPEPPER
bCv6e Dtecor
SUBJECT: Compliance Inspection Report
Annual Report (2017) Review
North Cove Steam Generation Plant Ash Distribution Program
Non -discharge Permit No. WQ0010689
McDowell County
Dear Permittee:
The North Carolina Division of Water Resources completed a review of the 2017 Annual Report
for the North Cove Steam Generation Plant's Ash Distribution Program on 6/21/2018. This
inspection was conducted to verify that the facility is operating in compliance with the
conditions and limitations specified in Non -discharge Permit No. W00010689. The findings and
comments noted during this inspection are provided in the enclosed copy of the inspection
report entitled "Compliance Inspection Report".
There were no significant issues or findings noted during the inspection and therefore, a
response to this inspection report is not required.
If you should have any questions, please do not hesitate to contact me at 828-296-4500 or
via email at [e-mail].
Sincerely,
COocuSgned b,:
ascCD405�4
Beverly Price, Environmental Senior Specialist
Water Quality Regional Operations Section
Asheville Regional Office
Division of Water Resources, NCDEQ
ATTACHMENTS: Inspection Report
Ec WQS ARO Server
Laserfiche
20180703_ W 00010689_CE IA RR. rtf
State or Noah Carolina I Environmental Quality I Water Resources
2090 U S 70 Highway, S%annanoa, NC 28778
828-296.4500

Compliance Inspection Report
Permit: M0010689 Effective: 12101/14 Expiration: 11/30/19 Owner: Baxter Healthcare Corporation
SOC: Effective: Expiration: Facility: North Cove Steam Generation Plant Ash Distribution
County: McDowell 2859 Old Linville Rd
Region: Asheville
Marion NC 28752
Contact Person: Corey Carpenter Title: EHS Associate Phone: [phone]
Directions to Facility:
Take NC Hwy. 221 North out of Marion to NCSR 1560 ( located behind Baxter - North Cove). The facility is located on the left
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(st:
On -Site Repres intalive(s):
24 hour contact name Corey Carpentier 828-756-6636
Related Permits
WQ0001512 Baxter Healthcare Corporation - Baxter Healthcare Corporation RLAP
Inspection Date: 06/21/2018 lgrtry Time: 03:OOPM Exit Time: 04.00PM
Primary Inspector: Beverly Price �� Phone: [phone]
Secondary Inspector(s):
Reason for Inspection: Routine Inspection Type: Annual Report Review
Permit Inspection Type: Distribution of Residual Solids (503 Exempt)
Facility Status: Compliant Not Compliant
Question Areas:
Miscellaneous Questions Record Keeping Treatment
(See attachment summary)
Page 1

Permit: W00010689 Owner -Facility: Baxter Healthcare Corporation
Inspection Date: OW2112018 Inspection Type: Annual Report Review Reason for vlsR: Routine
Inspection Summary:
The 2017 Annual Report Review was conducted by Beverly Price of the Asheville Regional Office.
1589.73 dry tons of residuals were distributed in 2017; the permit limit is 3,200 dry tons.
Metals/nutrients analyses were conducted per permit requirements. Based on the volume of residuals distributed, four
sampling events were required. Samples were collected from the north & south wood ash basins. Metals results appeared
to be compliant with permit limits for ceiling concentrations and monthly average concentrations. TCLP metals were
analyzed along with Igni ability, Corrosivity & Reactivity. All results appeared to meet permit requirements.
Reminder: A full TCLP analysis is required once per permit cycle; the permit expires 11/30/19 so the TCLP should be
conducted prior to expiration.
Ash Distribution Utilization Agreements were included in the report.
The Annual Distribution and Marketing Certification and Summary Form should show the volume of residuals distributed for
each recipient.
Page: 2

permit: w00D10689 Owner - Facility: Bazler Healthcare Corporation
Inspection Date: 06/21/2018 Inspection Type: Annual Report Review
Reason ror VisR: Routine
Type
Yes No NA NE
Land Application
❑
Distribution and Marketing
Record Keeoina
Yes No NA NE
Is GW monitoring being conducted. if required?
❑ ❑ 0 ❑
Are GW samples from all MWs sampled for all required parameters?
❑ ❑ ® ❑
Are there any GW quality violations?
❑ ❑ N ❑
Is GW-59A certification form completed for facility?
❑ ❑ N ❑
Is a copy of current permit on -site?
❑ ❑ ❑ s
Are current metals and nutrient analysis available?
0 ❑ ❑ ❑
Are nutrient and metal loading calculating most limiting parameters?
E ❑ ❑ ❑
a. TCLP analysis?
0 ❑ ❑ ❑
It. SSFA (Standard Soil Fertility Analysis)?
❑ ❑ N ❑
Are PAN balances being maintained?
❑ ❑ ❑
Are PAN balances within permit limits?
❑ ❑ ❑
Has land application equipment been calibrated?
❑ ❑ N ❑
Are there pH records for alkaline stabilization?
❑ ❑ N ❑
Are there pH records for the land application site?
❑ ❑ ® ❑
Are nutrient/crop removal practices in place?
❑ ❑ ❑ M
Do lab sheets support data reported on Residual Analysis Summary?
0 ❑ ❑ ❑
Are hauling records available?
E ❑ ❑ ❑
Are hauling records maintained and up-to-date?
! ❑ ❑ ❑
0 Has perrmidee been free of public complaints in last 12 months?
❑ ❑ ❑ 0
Has application occurred during Seasonal Restriction window?
❑ ❑ E ❑
Comment:
Treatment
Yes No NA NE
Check all that apply
Aerobic Digestion
❑
Anaerobic Digestion
❑
Alkaline Pasteurization (Class A)
❑
Alkaline Stabilization (Class B)
❑
Compost
❑
Drying Beds
❑
Other
Comment: Ash ponds for dewaterin
Page. 3

DocuSign Envelope ID: 2CD65AAS-1273-45CA-BCA6-D900B8159307
fc.
WaterResourres
/NVJNO~M GINLNy
July 03, 2018
Corey Carpentier
Baxter Healthcare Corporation
65 Pitts Station Rd
Marion, NC 28752
ROY COOPER
Gocardr
NUCHAEL S. REGAN
San+tar
LINDA CULPEPPER
hft D rtw
SUBJECT: Compliance Inspection Report
North Cove Steam Generation Plant Ash Distribution Program
Non -discharge Permit No. WQ0010689
McDowell County
Dear Permittee:
The North Carolina Division of Water Resources conducted an inspection of the North Cove
Steam Generation Plant Ash Distribution Program on 6/22/2018. This inspection was
conducted to verify that the facility is operating in compliance with the conditions and
limitations specified in Non -discharge Permit No. WO0010689. The findings and comments
noted during this inspection are provided in the enclosed copy of the inspection report entitled
"Compliance Inspection Report".
There were no significant issues or findings noted during the inspection and therefore, a
response to this inspection report is not required.
If you should have any questions, please do not hesitate to contact me at 828-296-4500 or
via email at [e-mail].
Sincerely,
Fusiontot by:
Cb05
Beverly Price, Environmental Senior Specialist
Water Quality Regional Operations Section
Asheville Regional Office
Division of Water Resources, NCDEQ
ATTACHMENTS: Inspection Report
Ec: WQS ARO Server
LF
07032018 WQ0010689_CEI_cover ltr.rtf
State of Nonh Carolina I Environmental Quality I Water Resources
2090 U S. 70 Highway, Svannanoa, NC 28778
828-296-4500

DomSign Envelope ID: 2CD65AAB-127345CA-BCA6-D900B8159307
Compliance Inspection Resort
Permit: WO0010689 Effective: 12/01/14 Expiration: 11/30f19 Owner: Baxter Healthcare Corporation
SOC: Effective: Expiration: Facility: North Cove Steam Generation Plant Ash Distribution
County: McDowell 2859 Old Linville Rd
Region: Asheville
Marion NC 28752
Contact Person: Corey Carpentier Tlde: ENS Phone: [phone]
Directions to Facility:
Take NC Hwy. 221 North out of Marion to NCSR 1560 ( located behind Baxter - North Cove). The facility is located on the left.
System Classifications:
Primary ORC: Certification: Phone:
Secondary ORC(s):
On-S@e Representative(s):
24 hour contact name
Corey Carpentier
828-756-6636
On -site representative
Corey Carpentier
828-766-6636
On-slte representative
Stephen Gouge
828-756.6608
On-slte representative
Ricky Styles
828-756-6650
Related Permits:
WO0001512 Baxter Healthcare Corporation - Baxter Healthcare Corporation RLAP
Inspection Dale: 06/22/2018 Entry Time: 09:30AM Exit Time: 10:20AM
/—Da
Primary Inspector: Beverly Price I e%� Phone: [phone]
Secondary InsPBCtOr(a): IE H—f
Mikel Willmar
Reason for Inspection: Routine Inspection Type: Compliance Evaluation
Permit Inspection Type: Distribution of Residual Solids (503 Exempt)
Faculty Status: Compliant n Not Compliant
Question Areas:
0 Miscellaneous Questions Record Keeping ® Sampling
(See attachment summary)
Page1

DocuSign Envelope ID: 2CD65AAB-1273-45CA-BCA6-D900B8159307
Permit: WQ0010689 owner- Facility: Baxter Healthcare Corporation
Inspection Data: 06122J2018 Inspection Type : Compliance Evaluation Reason for Visit: Routine
Inspection Summary:
The inspection was conducted by Beverly Price and Mika] Willmar of the Asheville Regional Office. Corey Carpentier, Steve
Gouge and Ricky Styles assisted with the inspection.
The inspection included a review of the site facilities and record keeping.
Concrete barriers are in place around the concrete apron to prevent migration of ash residuals. This area should be
monitored during rain events to ensure leachate does not leave the site.
All distributions are carried out by Baxter via a local hauler, Jeff Banks.
A soils analysis is not required per the permit, however, the residuals recipient does get a soils analysis which Baxter then
uses to help determine loading rates.
The ash storage facility appears to be well maintained and operated.
Page: 2

DocuSign Envelope to: 2CD65AA8.1273-45CA-BCA6-D90088159307
Permit: Wo0010689 Owner - Facilely: Baxter Healthcare Corporation
Inspection Date: 06/22/2018 Inspection Type: Compliance Evaluation Reason for Vied:
Routine
Tvoe
Yes No NA NE
Land Application
❑
Distribution and Marketing
Record Keeping
Yes No NA NE
Is GW monitoring being conducted, g required?
❑ ❑ 0 ❑
Are GW samples from all MWs sampled for all required parameters?
❑ ❑ 0 ❑
Are there any GW quality violations?
❑ ❑ 0 ❑
es GW-59A certification form completed for facility?
❑ ❑ 0 ❑
Is a copy of current permit on -site?
0 ❑ ❑ ❑
Are current metals and nutrient analysis available?
0 ❑ ❑ ❑
Are nutrient and metal loading calculating most limiting parameters?
0 ❑ ❑ ❑
a. TCLP analysis?
❑ ❑ 0 ❑
b. SSFA (Standard Soil Fertility Analysis)?
❑ ❑ 0 ❑
Are PAN balances being maintained?
❑ ❑ 0 ❑
Are PAN balances within permit limits?
❑ ❑ 0 ❑
Has land application equipment been calibrated?
❑ ❑ ❑ 0
Are there pH records for alkaline stabilization?
Cl ❑ 0 ❑
Are there pH records for the land application ails?
❑ ❑ 0 ❑
Are nutrienticrop removal practices in place?
0 ❑ ❑ ❑
Do lab sheets support data reported on Residual Analysis Summary?
❑ ❑ ❑ 0
Are hauling records available?
0 ❑ ❑ ❑
Are hauling records maintained and up-to-date?
0 ❑ ❑ ❑
N Has permittee been free of public complaints in last 12 months?
0 ❑ ❑ ❑
Has application occurred during Seasonal Restriction window?
❑ ❑ 0 ❑
Comment: 1/26/18 sample results were reviewed and appeared to be compliant with permit limits.
The Dermit does not require calibration of the land application eauioment
Semolina
Yes No NA NE
Describe sampling:
When the basin is full, ash is removed and stored on the concrete apron adjacent to the basin. At least 12
grab samples are collected from various points in the stockpile. Grab samples am composited for analysis
at a contract lab. One composite sample is kept on site until sample results are verified.
Is sampling adequate?
0 ❑ ❑ ❑
Is sampling representative?
0 ❑ ❑ ❑
Comment
Page. 3

,�aceftljdical'
nww.pacwabacom
March 28, 2019
Mr. Ricky Styles
Baxter Healthcare
2859 Old Linville Road
Marion, NC 28752
RE: Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
Dear Mr. Styles:
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Hunlersville, NC 28078
[phone]
Enclosed are the analytical results for sample(s) received by the laboratory on March 14, 2019. The
results relate only to the samples included in this report. Results reported herein conform to the most
current, applicable TNI/NELAC standards and the laboratory's Quality Assurance Manual, where
applicable, unless otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Chris Derouen
[e-mail]
[phone]
Project Manager
Enclosures
t;-D
11-r fl6jources
MAY 2 2 2019
Water rr,rations
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 1 of 27

aceAnalytical e
a»wpacele5s.tnm
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
Pace Analytical Services, LL(
9800 Kincey Ave. Suite 10(
Huntersville, NC 28071
(704)875-909:
Atlanta Certification IDs
110 Technology Parkway Peachtree Corners, GA 30092
Florida DOH Certification M E87315
Georgia DW Inorganics Certification M 812
Georgia DW Microbiology Certification #: 812
Charlotte Certification IDs
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
Lou late na/NELAP Certification # LAI70028
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification M 5342
North Carolina Wastewater Certification M 12
Asheville Certification IDs
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP CertificationM E87648
Massachusetts Certification M M-NC030
North Carolina Drinking Water Certification #: 37712
CERTIFICATIONS
North Carolina Certification #: 381
South Carolina Certification M 98011001
Virginia Certification M 460204
South Carolina Certification M 99006001
Florida/NELAP Certification M E87627
Kentucky UST Certification M 84
VirginiaNELAP Certification M 460221
North Carolina Wastewater Certification M 40
South Carolina Certification #: 99030001
VirginiaNELAP Certification M 460222
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 2 of 27

aceAnalXical
~pecelabs.c=
SAMPLE ANALYTE COUNT
Pace Analytical Services, LL<
9800 Kincey Ave. Suite for
Huntersville, NC 2807E
(704)875-909:
Project:
Pace Project No.:
Wood Boiler Ash 3/14
92421396
Analytes
Lab ID
Sample ID
Method
Analysts
Reported
Laboratory
92421396001
NP31419A
EPA 6010D
DS, KQ
17
PASI-A
EPA 6010D
DS
7
PASI-A
EPA 7470A
RDT
1
PASI-A
EPA7471B
RDT
1
PASI-A
ASTM D2974-87
KDF
1
PASI-C
EPA9045D
ECH
1
PASI-A
EPA 365.1 Rev 2.01993
MDW
1
PASI-A
92421396002
NP31419B
EPA8081B
SEM
9
PASI-C
EPA8082A
SEM
8
PASI-C
EPA8151A
MZP
3
PASI-GA
EPA6010D
DS
7
PASI-A
EPA7470A
RDT
1
PASI-A
EPA 8270E
BPJ
18
PASI-C
EPA8260D
SAS
14
PASI-C
ASTM D2974-87
KDF
1
PASI-C
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 3 of 21

aceAnalytical a
avm.pecele6scom
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 10C
Huntersville, NC 2807E
[phone]
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
Sample: NP31419A Lab ID: 92421396001 Collected: 03/14/19 10:45 Received: 03/14/19 13:34 Matrix: Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
6010 MET ICP Analytical Method: EPA 6010D Preparation Method: EPA 3050B
Arsenic
ND
mg/kg
1.3 1
03/23/19 10:10
03/24/19 21:54
7440-38-2
Barium
1400
mg/kg
6.5 10
03/2311910:10
03/25A921:42
7440-39-3
Cadmium
1.4
mg/kg
0.13 1
03/23/19 10:10
03/24/19 21:54
744043-9
Calcium
77200
mg/kg
130 10
03123/1910:10
03125/1921:42
7440-70-2
Chromium
16.6
mg/kg
0.65 1
03/23/19 10:10
03/24/19 21:54
7440.47-3
Copper
68.8
mg/kg
0.65 1
03/23/19 10:10
03/24/19 21:54
7440-50-8
Iron
9580
mg/kg
13.0 1
03/23/19 10:10
03/24/19 21:54
7439-89.6
Lead
16.3
mg/kg
0.65 1
03/23/19 10:10
03/24/19 21:54
7439-92-1
Magnesium
10600
mg/kg
13.0 1
03/23/19 10:10
03/24/19 21:54
7439-95-4
Manganese
2720
mg/kg
6.5 10
03/23/19 10:10
03/25/19 21:42
7439-96-5 D3
Molybdenum
1.2
mg/kg
0.65 1
03/23/19 10:10
03124/1921:54
7439-98-7
Nickel
18.8
mg/kg
0.65 1
03/23/19 10:10
03/24/19 21:54
7440-02-0
Potassium
16000
mg/kg
6490 10
03/23/19 10:10
03/25/19 21:42
7440-09-7
Selenium
ND
mg/kg
1.3 1
03/23/19 10:10
03/24/19 21:54
7782.49-2
Silver
ND
mg/kg
0.65 1
03/23/19 10:10
03/24/19 21:54
7440-22.4
Sodium
7310
mg/kg
649 1
03/23/19 10:10
03/24/19 21:54
7440-23-5
Zinc
143
mg/kg
1.3 1
03/23/19 10:10
03/24/19 21:54
7440-66-6
6010 MET ICP, TCLP
Analytical Method: EPA6010D Preparation Method: EPA 3010A
Leachate Method/Dale: EPA 1311; 03/21/19 22:24 Initial pH: 9.43; Final
pH: 5
Arsenic
ND
mg/L
0.050 1
03/23/19 09:04
03/24/19 17:58
7440-38-2
Barium
8.3
mg/L
0.25 1
03/23/19 09:04
03/24/19 17:58
7440-39-3
Cadmium
0.011
mg/L
0.0050 1
03/23/19 09:04
03/24/19 17:58
744043-9
Chromium
ND
mg/L
0.050 1
03/23/19 09:04
03/24/19 17:58
744047.3
Lead
0.027
mg/L
0.025 1
03/23/19 09:04
03/24/19 17:58
7439-92-1
Selenium
ND
mg/L
0.10 1
03/23/19 09:04
03/24/19 17:58
7782-49-2
Silver
ND
mg/L
0.025 1
03/23/19 09:04
03/24/19 17:58
7440-224
7470 Mercury, TCLP
Analytical Method: EPA 7470A Preparation Method: EPA
7470A
Leachate Method/Date: EPA 1311; 03/21/19 22:24 Initial pH: 9.43; Final
pH: 5
Mercury
ND
mg/L
0.00020 1
03/23/1912:08
03/25/1913:47
7439-97.6
7471 Mercury
Analytical Method: EPA 74718 Preparation Method: EPA 7471B
Mercury
ND
mg/kg
0.0082 1
03121/1919:08
03/22/1915:43
7439-97-6
Percent Moisture
Analytical Method: ASTM D2974-87
Percent Moisture
64.1
%
0.10 1
03/15/19 15:42
9045 pH Soil
Analytical Method: EPA 9045D
pH at 25 Degrees C
9.0
Sid. Units
0.10 1
03/15/19 16:09
H1
365.1 Phosphorus, Total
Analytical Method: EPA 365.1 Rev 2.01993
Preparation Method: EPA365.1 Rev 2.0 1993
Phosphorus
2200
mg/kg
105 50
03/20/1921:14
03/20/1923:36
7723-14.0
REPORT
OF LABORATORY
ANALYSIS
This report shall not be reproduced, except in
full,
Date: 03/28/2019 04:51 PM
without
the written consent of
Pace Analytical Services, I.I.C.
Page 4 of 27

aceAnalytical
eww.pacelabs.am
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 10(
Huntersville, NC 2807E
(704)875-909:
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
Sample: NP31419B Lab ID: 92421396002 Collected: 03/14/19 10:45 Received: 03/14/19 13:34 Matrix: Solid
Results reported on a "dry weight" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qua[
8081 TCLP Pesticides RVE
gamma-BHC (Lindane)
Chlordane (Technical)
Endrin
Heptachlor
Heptachlor epoxide
Methoxychlor
Toxaphene
Surrogates
Decachlorobiphenyl (S)
Tetrachloro-m-xylene (S)
8082 GCS PCBs, Grind/TCLP
PCB-1016 (Aroclor 1016)
PCB-1221 (Aroclor 1221)
PCB-1232 (Aroclor 1232)
PCB-1242 (Aroclor 1242)
PCB-1248 (Aroclor 1248)
PCB-1254 (Aroclor 1254)
PCB-1260 (Aroclor 1260)
Surrogates
Decachlorobiphenyl (S)
8151A CI Acid Herbicides TCLP
2,4-D
2,4,5-TP (Si[vex)
Surrogates
2,4-DCAA (S)
Analytical Method: EPA 80818 Preparation Method: EPA 3510C
Leachate Method/Date: EPA 1311; 03/19/19 18:30 Initial pH: 5.94; Final pH: 4
ND
ug/L
0.50
1
03/22/19 15:32
03/25/19 09:23
58-89-9
ND
ug/L
3.0
1
03/22/19 15:32
03/25/19 09:23
57-74-9
ND
ug/L
0.50
1
03/22/19 15:32
03/25/19 09:23
72-20-8
ND
ug/L
0.50
1
03/22/19 15:32
03125A9 09:23
76-44-8
ND
ug/L
0.50
1
03/22/19 15:32
03/25/19 09:23
1024-57-3
ND
ug/L
1000
1
03/22/19 15:32
03/25/19 09:23
7243-5
ND
ug/L
3.0
1
03/22/19 15:32
03/25/19 09:23
8001-35-2
ill
%
10-138
1
03/22/19 15:32
03/25/19 09:23
2051-24-3
108
%
10.110
1
03/22/19 15:32
03/25/19 09:23
877-09-8
Analytical Method: EPA 8082A Preparation Method: EPA 3510C
Leachate Method/Date: EPA 1311; 03/19M9 18:30 Initial pH: 5.94; Final pH: 4
ND
ug/L
1000
1
03/22/19 13:48
03126/19 04:53
12674-11-2
ND
ug/L
1000
1
03/22119 13:48
03/26/19 04:53
11104.28-2
ND
ug/L
1000
1
03/22/19 13:48
03/26/19 04:53
11141-16-5
ND
ug/L
1000
1
03/22/19 13:48
03/26/19 04:53
53469-21-9
ND
ug/L
1000
1
03/22/19 13:48
03/26/19 04:53
12672-29-6
ND
ug/L
1000
1
03/22/19 13:48
03/26/19 04:53
11097-69-1
ND
ug/L
1000
1
03/22/19 13:48
03/26/19 04:53
11096-82-5
49
%
10-132
1
03/22/19 13:48
03/26/19 04:53
2051-24.3
Analytical Method: EPA 8151A Preparation Method: EPA 8151A
Leachate Method/Dale: EPA 1311; 03121/19 12:00 Initial pH: 9.49; Final pH: 4.87
ND mg/L 0.0050 1 03/25/19 09:30 03/26/19 04:23 94-75-7
ND mg/L 0.010 1 03/25/19 09:30 03/26/19 04:23 93-72-1
83 %. 10-155 1 03/25/19 09:30 03/26/19 04:23 19719.28-9
6010 MET ICP, TCLP
Analytical Method: EPA 601 OD Preparation Method: EPA 3010A
Leachate Method/Date: EPA 1311; 03/21/19 22:24 Initial pH: 9.56; Final
pH: 5.5
Arsenic
ND mg/L 0.050 1 03123/1909:04
03/24/1918:01
7440-38-2
Barium
8.5 mg/L 0.25 1 03/23/1909:04
03/24/1918:01
7440-39-3
Cadmium
0.010 mg/L 0.0050 1 03/23/1909:04
03/24/1918:01
7440A3-9
Chromium
ND mg/L 0.050 1 03/23/1909:04
03/24/1918:01
7440A7-3
Lead
ND mg/L 0.025 1 03/23/1909:04
03/24/1918:01
7439-92-1
Selenium
ND mg/L 0.10 1 03/23/19 09:04
03/24/19 18:01
7782-49-2
Silver
ND mg/L 0.025 1 03/23/1909:04
03/24/1918:01
7440-22A
7470 Mercury, TCLP
Analytical Method: EPA 7470A Preparation Method: EPA 7470A
Leachate Method/Date: EPA 1311; 03/21/19 22:24 Initial pH: 9.56; Final
pH: 5.5
Mercury
ND mg/L 0.00020 1 03/23/1912:08
03/25/1913:49
7439-97-6
REPORT OF LABORATORY ANALYSIS
Ll
This report shall not be reproduced, except in full,
Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, LLC. Page 5 of 27

aceAnalytical g
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ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 10(
Huntersville, NC 2807f
(704)875-909:
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
Sample: NP31419B Lab ID: 92421396002 Collected: 03/14/19 10:45 Received: 03/14/19 13:34 Matrix: Solid
Results reported on a "dry welght" basis and are adjusted for percent moisture, sample size and any dilutions.
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
8270E MSSV TCLP Sep Funnel
1,4-Dichlorobenzene
2,4-Dinitrotoluene
Hexachloro-1,3-butad iene
Hexachlorobenzene
Hexachloroethane
2-Methylphenol(o-Cresol)
3&4-Methylphenol(m&p Cresol)
Nitrobenzene
Pentachlorophenol
Pyridine
2,4,5-Trichlorophenol
2,4,6-Trichlorophenol
Surrogates
Nitrobenzene-d5 (8)
2-Fluorobiphenyl(S)
Terphenyl-d14 (S)
Phenol-d6 (S)
2-Fluorophenol(S)
2,4,6-Tribromophenol (S)
8260D MSV TCLP
Benzene
2-Butanone (MEK)
Carbon tetrachloride
Chlorobenzene
Chloroform
1,4-Dichlorobenzene
1,2-Dichloroethane
1,1-Dichloroethene
Tetraohloroethene
Trichloroethene
Vinyl chloride
Surrogates
1,2-Dichloroethane-d4 (S)
Toluene-d8 (S)
4-Bromofluorobenzene (S)
Percent Moisture
Percent Moisture
Analytical Method: EPA 8270E Preparation Method: EPA 3510C
ND
ug/L
50.0
1
03/22/19 08:55
03/26/19 18:47
106.46-7
ND
ug/L
50.0
1
03/22/19 08:55
03/26/19 18:47
121-14.2
ND
ug/L
50.0
1
03/22/19 08:55
03/26/19 18:47
87-68-3
ND
ug/L
50.0
1
03/22/19 08:55
03/26/19 18:47
118-74-1
ND
ug/L
50.0
1
03/22/19 08:55
03/26/19 18:47
67-72-1
ND
ug/L
50.0
1
03/22/19 08:55
03/26/19 18:47
9548-7
ND
ug/L
50.0
1
03/22/19 08:65
03/26/19 18:47
15831-104
ND
ug/L
50.0
1
03/22/19 08:55
03/26/19 18:47
98-95-3
ND
ug/L
100
1
03/22/19 08:55
03/26/19 18:47
87.86-5
ND
ug/L
50.0
1
03/22/19 08:55
03/26/19 18:47
110-86.1
ND
ug/L
50.0
1
03/22/19 08:55
03/26/19 18:47
95-95-4
ND
ug/L
50.0
1
03/22/19 08:55
03/26/19 18:47
88-06-2
83
%
12.102
1
03/22/19 08:55
03/26/19 18:47
4165-60-0
83
%
13.107
1
03/22/19 08:55
03/26/19 18:47
321-60-8
85
%
21-132
1
03/22/19 08:55
03/26/19 18:47
1718-51-0
28
%
10-110
1
03/22/19 08:55
03/26/19 18:47
13127-88-3
42
%
10-110
1
03/22/19 08:55
03/26/19 18:47
367-124
80
%
27-108
1
03/22/19 08:55
03/26/19 18:47
118-79-6
Analytical Method: EPA 8260D
ND
ug/L
100
20
03/23/1917:44
71-43-2
ND
ug/L
200
20
03/23/19 17:44
78-93-3
ND
ug/L
100
20
03/23/1917:44
56-23-5
ND
ug/L
100
20
03/23/19 17:44
108-90-7
ND
ug/L
100
20
03/23/1917:44
67-66-3
ND
ug/L
100
20
03/23/1917:44
10646-7
ND
ug/L
100
20
03/23/1917:44
107-06-2
ND
ug/L
100
20
03/23/1917:44
75-354
ND
ug/L
100
20
03/23/1917:44
127.184
ND
ug/L
100
20
03/23/1917:44
79-01-6
ND
ug/L
100
20
03/23/19 17:44
75-01.4
98
%
70.130
20
03/23/1917:44
17060-07-0
103
%
67-135
20
03/23/1917:44
2037-26-5
98
%
70-130
20
03123/1917:44
460-004
Analytical Method: ASTM D2974-87
53.8 % 0.10 1
REPORT OF LABORATORY ANALYSIS
03/15/19 15:43
This report shall not be reproduced, except in full,
Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 27

ceAnalytical a
wwwpacelabs.com
QUALITY CONTROL DATA
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
OC Batch: 465000 Analysis Method: EPA 7470A
QC Batch Method: EPA 7470A Analysis Description: 7470 Mercury TCLP
Associated Lab Samples: 92421396001, 92421396002
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 10l
Hunlersville, NC 2807E
(704)875-909:
METHOD BLANK: 2527185 Matrix: Water
Associated Lab Samples: 92421396001, 92421396002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Mercury mg/L ND 0.00020 03/2511913:09
METHOD BLANK: 2527581 Matrix: Water
Associated Lab Samples: 92421396001, 92421396002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Mercury mg/L ND 0.00020 03/25/1913:14
LABORATORY CONTROL SAMPLE: 2528972
Spike LCS LCS %Rec -
Parameter Units Conc. Result %Rec Limits Qualifiers
Mercury mg/L 0.0025 0.0029 118 80-120
LABORATORY CONTROL SAMPLE: 2528973
Spike LCS LCS % Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Mercury mg/L 0.0025 0.0028 112 80-120
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2528974 2528975
MS MSD
92421567001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Oust
Mercury mg/1- ND 0.0025 0.0025 0.0031 0.0030 124 119 75-125 5
Results presented on this page are In the units Indicated by the "Units" column except where an alternate unit Is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, L-C.
Page 7 of 27 1

aceftlXical
wnw.pacela85.com
QUALITY CONTROL DATA
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 10C
Huntersvilla, NC 2807E
[phone]
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
QC Batch: 464634
Analysis Method: EPA 7471 B
QC Batch Method: EPA 7471B
Analysis Description: 7471 Mercury
Associated Lab Samples: 92421396001
METHOD BLANK: 2526699
Matrix: Solid
Associated Lab Samples: 92421396001
Blank Reporting
Parameter Units
Result Limit
Analyzed Qualifiers
Mercury mg/kg
NO 0.0060
03/22/1915:18
LABORATORY CONTROL SAMPLE: 2526700
Spike LCS
LCS % Rec
Parameter Units
Conc. Result
%Rec Limits Qualifiers
Mercury. mg/kg
0.083 0.080
96 80-120
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2526701 2526702
MS MSD
92420834001
Spike Spike MS
MSD MS MSD %Rec
Parameter Units Result
Conc, Conic. Result
Result %Rec %Rec Limits RPD Qual
Mercury mg/kg NO
0.34 0.31 0.32
0.30 92 96 75-125 8
Results presented on this page are In the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, LLC.
Page 8 of 27 1

aceAnalytical g
wnwpacalabs.mm
QUALITY CONTROL DATA
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
QC Batch: 465018 Analysis Method: EPA 6010D
QC Batch Method: EPA 3050B Analysis Description: 6010 MET
Associated Lab Samples: 92421396001
METHOD BLANK: 2529035
Associated Lab Samples: 92421396001
Parameter
Units
Matrix:
Blank
Result
Solid
Reporting
Limit
Analyzed
Arsenic
mg/kg
ND
1.0
03/24/19 21:23
Barium
mg/kg
ND
0.50
03/2411921:23
Cadmium
mg/kg
ND
0.10
03124/1921:23
Calcium
mg/kg
ND
10.0
03/24/19 21:23
Chromium
mg/kg
ND
0.50
03/24/19 21:23
Copper
mg/kg
ND
0.50
03/24/19 21:23
Iron
mg/kg
ND
10.0
03/24/19 21:23
Lead
mg/kg
ND
0.50
03/24/19 21:23
Magnesium
mg/kg
ND
10.0
03/24/19 21:23
Manganese
mg/kg
ND
0.50
03/2411921:23
Molybdenum
mg/kg
ND
0.50
03/2411921:23
Nickel
mg/kg
ND
0.50
03/24/19 21:23
Potassium
mg/kg
ND
500
03/24/19 21:23
Selenium
mg/kg
NO
1.0
03/24/19 21:23
Silver
mg/kg
ND
0.50
03/24/19 21:23
Sodium
mg/kg
ND
500
03/2411921:23
Zinc
mg/kg
ND
1.0
03/24/19 21:23
Qualifiers
LABORATORY CONTROL SAMPLE:
Parameter
2529036
Units
Spike
Cone.
LCS
Result
LCS
%Rec
%s Rae
Limits
Arsenic
mg/kg
50
47.0
94
80-120
Barium
mg/kg
50
48.5
97
80-120
Cadmium
mg/kg
50
48.2
96
80-120
Calcium
mg/kg
500
470
94
80-120
Chromium
mg/kg
50
49.0
98
80-120
Copper
mg/kg
50
50.4
101
80-120
Iron
mg/kg
500
461
92
80-120
Lead
mg/kg
50
48.1
96
80-120
Magnesium
mg/kg
500
467
93
80-120
Manganese
mg/kg
50
47.6
95
80.120
Molybdenum
mg/kg
50
47.9
96
80-120
Nickel
mg/kg
50
48.8
98
80-120
Potassium
mg/kg
500
ND
95
80-120
Selenium
mg/kg
50
45.8
92
80-120
Silver
mg/kg
25
24.1
96
80-120
Sodium
mg/kg
500
479J
96
80.120
Zinc
mg/kg
50
48.5
97
80-120
Pace Analytical Services, LL(
9800 Kincey Ave. Suite 1Or
Huntersville, NC 28071
(704)875-9=
Qualifiers
Results presented on this page are In the unite Indicated by the" Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, LLC. Page 9 of 27

,a,eAnalXicale
ww pscefabs.com
QUALITY CONTROL DATA
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 10(
Huntersville, NC 2807f
(704)875-909:
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
MATRIX SPIKE & MATRIX SPIKE
DUPLICATE:
2529037
2529038
MS
MSD
92421002001
Spike
Spike
MS
MSD
MS
MSD
% Rao
Parameter
Units
Result
Conc.
Conc.
Result
Result
%Rec
%Rec
Limits
RPD
Qual
Arsenic
mg/kg
24.5
33.2
38.2
30.0
29.5
17
13
75-125
2
M1
Barium
mg/kg
46.5
33.2
38.2
80.6
87.0
103
106
75.125
8
Cadmium
mg/kg
0.22
33.2
38.2
30.6
35.9
92
93
75-125
16
Calcium
mg/kg
2340
332
382
3080
3200
222
224
75-125
4
M1
Chromium
mg/kg
8.6
33.2
38.2
39.0
44.8
92
95
75-125
14
Copper
mg/kg
4.3
33.2
38.2
36.3
42.5
97
100
75-125
16
Iron
mg/kg
7560
332
382
8710
9290
348
454
75-125
6
M6
Lead
mg/kg
11.7
33.2
38.2
41.7
47.4
90
93
75-125
13
Magnesium
mg/kg
208
332
382
588
656
115
117
75-125
11
Manganese
mg/kg
7.6
33.2
38.2
38.3
43.6
93
94
75-126
13
Molybdenum
mg/kg
8.7
33.2
38.2
28.3
21.4
59
33
75-125
28
M1,R1
Nickel
mg/kg
3.6
33.2
38.2
33.4
39.0
90
93
75-125
15
Potassium
mg/kg
ND
332
382
445
506
97
101
75-125
13
Selenium
mg/kg
ND
33.2
38.2
7.5
8.9
23
23
75-125
16
M7
Silver
mg/kg
16.5
19.1
14.1
16.7
85
88
75-125
17
Sodium
mg/kg
560
332
382
855
913
89
92
75-125
7
Zinc
mg/kg
2.7
33.2
38.2
33.6
38.9
93
95
75-125
15
Results presented on this page are In the units Indicated by the "Units" column except where an alternate unit Is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, I.I.C. Page 10 of 27

(�acmnalj6cala
wwwpacelebs.c»m
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
QC Batch: 464999
QC Batch Method: EPA 3010A
Associated Lab Samples: 92421396001, 92421396002
METHOD BLANK: 2527185
Associated Lab Samples: 92421396001, 92421396002
Parameter
Units
Arsenic
mg/L
Barium
mg/L
Cadmium
mg/L
Chromium
mg/L
Lead
mg/L
Selenium
mg/L
Silver
mg/L
QUALITY CONTROL DATA
Analysis Method: EPA 601 OD
Analysis Description: 6010 MET TCLP
Matrix: Water
Blank
Result
Reporting
Limit
Analyzed
ND
0.050
03/24/19 17:14
ND
0.25
03/24/19 17:14
ND
0.0050
03/24/19 17:14
ND
0.050
03/24/19 17:14
ND
0.025
03/24/19 17:14
ND
0.10
03/24/19 17:14
ND
0.025
03/24/19 17:14
METHOD BLANK: 2527581
Matrix:
Water
Associated Lab Samples:
92421396001, 92421396002
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed
Arsenic
mg/L
ND
0.050
03/24/19 17:20
Barium
mg/L
ND
0.25
0312411917:20
Cadmium
mg/L
ND
0.0050
03/2411917:20
Chromium
mg/L
ND
0.050
03/24/19 '17:20
Lead
mg/L
ND
0.025
03/24/19 17:20
Selenium
mg/L
ND
0.10
03/24/19 17:20
Silver
mg/L
ND
0.025
03/24/19 17:20
LABORATORY CONTROL SAMPLE:
2528968
Parameter
Units
Arsenic
mg/L
Barium
mg/L
Cadmium
mg/L
Chromium
mg/L
Lead
mg/L
Selenium
mg/L
Silver
mg/L
Qualifiers
Qualifiers
Spike
Conc.
LCS
Result
LCS
%Rec
% Rec
Limits
2.5
2.4
96
80-120
2.5
2.4
95
80-120
2.5
2.4
98
80-120
2.5
2.5
98
80.120
2.5
2.3
94
80.120
2.5
2.5
99
80-120
1.2
1.2
98
80-120
Pace Analytical Services, LL(
9800 Kinsey Ave. Suite 10t
Huntersville, NC 2807f
(704)875-909:
Qualifiers
LABORATORY CONTROL SAMPLE:
2528969
Spike
LCS LCS % Rec
Parameter
Units
Conc.
Result %Rec Limits Qualifiers
Arsenic
mg/L
2.5
2.3 94 80-120
Barium
mg/L
2.5
2.4 97 80-120
Results presenteel on this page are in the units Indicated by the "unite" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Dale: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, LLC,
Page 11 of 27 1

aceAnalXical e
wwwpscelabs com
QUALITY CONTROL DATA
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 10C
Huntersville, NC 28078
[phone]
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
LABORATORY CONTROL SAMPLE:
2528969
Spike
LCS
LCS
% Rae
Parameter
Units
Cone.
Result
%Rec
Limits
Qualifiers
Cadmium
mg/L
2.5
2.5
98
80.120
Chromium
mg/L
2.5
2.5
99
80-120
Lead
mg/L
2.5
2.4
96
80-120
Selenium
mg/L
2.5
2.5
99
80-120
Silver
mg/L
1.2
1.2
97
80-120
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2528970
2528971
MS
MSD
92421077001
Spike
Spike
MS
MSD
MS MSD
% Rae
Parameter
Units
Result
Cone.
Cone.
Result
Result
%Rec %Rec
Limits
RPD Qual
Arsenic
mg/L
NO
2.5
2.5
2.5
2.4
99
98
75-125
1
Barium
mg/L
ND
2.5
2.5
2.5
2.5
98
97
75-125
1
Cadmium
mg/L
NO
2.5
2.5
2.5
2.5
100
99
75.125
1
Chromium
mg/L
ND
2.5
2.5
2.5
2.5
100
99
75-125
1
Lead
mg/L
ND
2.5
2.5
2.4
2.4
96
95
75-125
1
Selenium
mg/L
ND
2.5
2.5
2.5
2.5
101
99
75-125
2
Silver
mg/L
ND
1.2
1.2
1.2
1.2
99
99
75-125
0
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, L-C. Page 12 of 27

Jor
aceAnalytical e
w pacalabs.com
QUALITY CONTROL DATA
Pace Analytical Services, LLC
98DO Kincey Ave. Suite 10C
Hunlersville, NC 28078
(/04)875-9092
Project: Wood Boiler Ash 3114
Pace Project No.: 92421396
QC Batch: 465037
Analysis Method:
EPA
8260D
QC Balch Method: EPA 8260D
Analysis Description: 8260D MSV TCLP
Associated Lab Samples: 92421396002
METHOD BLANK: 2529093
Matrix: Water
Associated Lab Samples: 92421396002
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed
Qualifiers
1,1-Dichloroethene
ug/L
NO
5.0
03/23/19 17:12
1,2-Dichloroethane
ug/L
NO
5.0
03/23/19 17:12
1,4-Dichlorobenzene
ug/L
NO
5.0
03/23/19 17:12
2-Butanone (MEK)
ug/L
NO
10.0
03/23/19 17:12
Benzene
ug/L
NO
5.0
03/2311917:12
Carbon tetrachloride
ug/L
NO
5.0
03/23/19 17:12
Chlorobenzene
ug/L
NO
5.0
03/23/19 17:12
Chloroform
ug/L
NO
5.0
03/23/19 17:12
Tetrachloroethene
ug/L
NO
5.0
03/23/19 17:12
Trichloroethene
ug/L
NO
5.0
03/23/19 17:12
Vinyl chloride
ug/L
NO
5.0
03/23/19 17:12
1,2-Dichloroethane-d4 (S)
%
96
70-130
03/23/19 17:12
4-Bromofluorobenzene (S)
%
99
70-130
03/23/19 17:12
Toluene-d8 (S)
%
101
67-135
03/23/19 17:12
LABORATORY CONTROL SAMPLE: 2529092
Spike
LCS
LCS % Rao
Parameter
Units
Conc.
Result
%Rec Limits Qualifiers
1,1-Dichloroethene
ug/L
50
45.1
90
70-130
1,2-Dichloroethane
ug/L
50
42.7
85
70-130
1,4-Dichlorobenzene
ug/L
50
46.6
93
70-130
2-Butanone (MEK)
ug/L
100
87.9
88
64-135
Benzene
ug/L
50
45.5
91
70-130
Carbon tetrachloride
ug/L
50
45.5
91
70-130
Chlorobenzene
ug/L
50
45.6
91
70-130
Chloroform
ug/L
50
42.7
85
70-130
Telrachloroethene
ug/L
50
47.1
94
69-130
Trichloroethene
ug/L
50
46.2
92
70A30
Vinyl chloride
ug/L
50
45.5
91
70-131
1,2-Dichloroethane-d4 (S)
%
92
70-130
4-Bromofluorobenzene (S)
%
100
70-130
Toluene-d8 (S)
%
97
67-135
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2529094
2529095
MS
MSD
92421239001
Spike
Spike
MS
MSD MS
MSD % Rec
Parameter Units
Result
Conc.
Conc.
Result
Result %Rec
%Rec Limits RPD Qual
1,1-Dichloroethene ug/L
NO
400
400
431
433 108 108 70.154 0
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, LLC. Page 13 of 27

aceAnalXical
w ..pscelsbs.00m
QUALITY CONTROL DATA
Project: Wood Boiler Ash 3114
Pace Project No.: 92421396
Pace Analytical Services, LLC
9800 Kinsey Ave. Suite 100
Huntersville, NC 28076
[phone]
MATRIX SPIKE & MATRIX SPIKE DUPLICATE:
2529094
2529095
MS
MSD
92421239001
Spike
Spike
MS
MSD
MS
MSD
%Res
Parameter
Units
Result
Conic.
Conc.
Result
Result
%Res
%Res
Limits
RPD Qual
1,2-Dichloroethane
ug/L
ND
400
400
370
372
93
93
70.137
0
IA-Dichlorobenzene
ug/L
ND
400
400
373
397
93
99
70-133
6
2-Butanone (MEK)
ug/L
ND
800
800
747
745
93
93
60-139
0
Benzene
ug/L
ND
400
400
392
431
98
108
70-151
10
Carbon tetrachloride
ug/L
ND
400
400
410
432
102
108
70-143
5
Chlorobenzene
ug/L
ND
400
400
399
408
100
102
70-138
2
Chloroform
ug/L
ND
400
400
395
419
92
99
70-139
6
Tetrachloroethene
ug/L
ND
400
400
420
411
105
103
59.143
2
Trichloroethene
ug/L
ND
400
400
414
426
103
106
70.147
3
Vinyl chloride
ug/L
ND
400
400
411
425
103
106
70-156
3
1,2-Dichloroelhane-d4 (S)
%
97
97
70-130
4-BromoBuorobenzene (S)
%
101
99
70-130
Toluene-d8 (S)
%
96
101
67-135
Results presented on this page ere in the units Indicated by the "Unite" column except where an alternate unit is presented to the night of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Dale: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, LLC.
Page 14 of 27 1

aceAnalXical a
waw.pecelabscam
QUALITY CONTROL DATA
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 10C
Huntersville, NC 2807E
(704)875-909<
QC Batch: 464933
Analysis
Method:
EPA 8081 B
QC Batch Method: EPA 351 OC
Analysis
Description:
8081 TCLP Pesticides RV
Associated Lab Samples: 92421396002
METHOD BLANK: 2524228
Matrix:
Water
Associated Lab Samples: 92421396002
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed Qualifiers
Chlordane (Technical)
ug/L
ND
3.0
03/25/19 10:27
Endrin
ug/L
ND
0.50
03125/1910:27
gamma-BHC (Lindane)
ug/L
ND
0.50
03/25/19 10:27
Heptachlor
ug/L
ND
0.50
03/2511910:27
Heptachlor epoxide
ug/L
NO
0.50
03/25/19 10:27
Methoxychlor
ug/L
NO
1000
03/25/19 10:27
Toxaphene
ug/L
ND
3.0
03/25/19 10:27
Decschlorobiphenyl(S)
%
122
10-138
03/25/19 10:27
Tetrachloro-m-xylene (S)
%
106
10-110
03/25/19 10:27
LABORATORY CONTROL SAMPLE:
Parameter
2528359
Units
Spike
Conc.
LCS
Result
LCS
%Rec
%Rec
Limits Qualifiers
Endrin
ug/L
1.2
1.5
120
20-134
gamma-BHC (Lindane)
ug/L
1.2
1.5
122
20.118 Ll
Heptachlor
ug/L
1.2
1.4
114
20-142
Heptachlor epoxide
ug/L
1.2
1.5
121
22-133
Methoxychlor
ug/L
3.8
4.7J
124
44-150
Decachlorobiphenyl (S)
%
136
10-138
Tetrachloro-m-xylene (8)
%
118
10-110 SO
MATRIX SPIKE SAMPLE:
Parameter
2528361
Units
92421718001
Result
Spike
Conc.
MS
Result
MS
%Rec
% Rec
Limits Qualifiers
Endrin
ug/L
ND
1.2
1.5
120
21-133
gamma-BHC (Lindane)
ug/L
NO
1.2
1.5
121
24-119 MO
Heptachlor
ug/L
ND
1.2
1.3
105
16.128
Heptachlor epoxide
ug/L
ND
1.2
1.4
115
50-150
Methoxychlor
ug/L
ND
3.8
4.8J
127
50-150
Decachlorobiphenyl (S)
%
177
10.138 SO
Tetrachloro-m-xylene (S)
%
106
10-110
SAMPLE DUPLICATE: 2528360
92421396002 Cup
Parameter Units Result Result RPD Qualifiers
Chlordane (Technical) ug/L ND NO
Endrin ug/L ND NO
Results presented on this page are In the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03128/2019 04:51 PM without the written consent of Pace Analytical Services, LLC.
Page 15 of 27 I

aceAnalXical a
mvw.pacele6s.crom
Pace Analytical S07 ' LLC
9800 Kincey Ave. Suite 10t
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: Wood Boiler Ash 3114
Pace Project No.: 92421396
SAMPLE DUPLICATE: 2528360
Parameter
Units
92421396002
Result
Dup
Result RPD Qualifiers
gamma-BHC (Lindane)
ug/L
ND
ND
Heptachlor
ug/L
ND
ND
Heptachlor epoxide
ug/L
ND
ND
Methoxychlor
ug/L
ND
ND
Toxaphene
ug/L
ND
ND
Decachlorobiphenyl (S)
%
111
99 12
Tetrachloro-m-xylene (S)
%
108
94 14
_
MAY 2 2 2019
Water CJ^I"
Results presented on this page are in the unite Indicated by the "Unite" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
Dale: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, LLC.
Page 16 of 27 1

"Analytical
ww,v.pacelebswm
QUALITY CONTROL DATA
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
QC Batch: 464915 Analysis Method: EPA 8082A
QC Batch Method: EPA 3510C Analysis Description: 8082 GCS PCB TCLP
Associated Lab Samples: 92421396002
METHOD BLANK: 2524228
Matrix:
Water
Associated Lab Samples: 92421396002
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed Qualifiers
PCB-1016 (Aroclor 1016)
ug/L
NO
1000
03/26/19 05:56
PCB-1221(Aroclor 1221)
ug/L
NO
1000
03/26/19 05:56
PCB-1232 (Aroclor 1232)
ug/L
ND
1000
03/26/19 05:56
PCB-1242 (Aroclor 1242)
ug/L
ND
1000
03/26/19 05:56
PCB-1248 (Aroclor 1248)
ug/L
ND
1000
03/26/19 05:56
PCB-1254 (Aroclor 1254)
ug/L
NO
1000
03/26/19 05:66
PCB-1260 (Aroclor 1260)
ug/L
NO
1000
03/26/19 05:56
Decachlorobiphenyl (S)
%
89
10-132
03/26/19 05:56
Pace Analytical Services, LLC
980D Kincey Ave. Suite 10C
Huntersville, NC 2807E
[phone]
LABORATORY CONTROL SAMPLE 8 LCSD:
2528253
2528254
Spike
LCS LCSD
LCS
LCSD
% Rec Max
Parameter
Units Conc.
Result Result
%Rec
%Rec
Limits RPD RPD Qualifiers
PCB-1016 (Aroclor 1016)
ug/L 25
ND NO
90
85
38-113 30
PCB-1260 (Aroclor 1260)
ug/L 25
ND NO
78
74
35-120 30
Decachlorobiphenyl (S)
%
84
79
10-132
Results presented on this page are In the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
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Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, I.I.C. Page 17 of 27

aceAnalytical
wxw.pacelabs.com
QUALITY CONTROL DATA
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
QC Batch: 25022 Analysis Method: EPA 8151A
QC Batch Method: EPA 8151A Analysis Description: 8151 GCS TCLP Herbicides
Associated Lab Samples: 92421396002
METHOD BLANK: 110905
Matrix:
Water
Associated Lab Samples: 92421396002
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed
2,4,5-TP (Silvex)
mg/L
ND
0.010
03/25/19 19:41
2,4-D
mg/L
ND
0.0050
03/25/1919:41
2,4-DCAA (S)
%.
89
10-155
03/25/19 19:41
METHOD BLANK: 111550
Matrix:
Water
Associated Lab Samples: 92421396002
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed
2,4,5-TP (Silvex)
mg/L
ND
0.010
03/25/19 20:02
2,4-D
mg/L
ND
0.0050
03/25/19 20:02
2,4-DCAA (S)
%.
80
10-155
03/25/19 20:02
Qualifiers
Qualifiers
METHOD BLANK: 112131
Matrix:
Water
Associated Lab Samples: 92421396002
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed Qualifiers
2,4,5-TP(Silvex)
mg/L
ND
0.010
03/25/1920:24
2,4-D
mg/L
ND
0.0050
0312511920:24
2,4-DCAA(S)
%.
66
10-155
03/2511920:24
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28076
[phone]
LABORATORY CONTROL SAMPLE: 112852
Spike LCS LCS % Rao
Parameter Units Conic. Result %Rec Limits Qualifiers
2,4,5-TP (Silvex) mg/L 2 1.6 80 39-138
2,4-D mg/L 2 1.4 70 29-145
2,4-DCAA (S) %. 88 10-155
MATRIX SPIKE & MATRIX SPIKE DUPLICATE:
112853
112854
MS
MSD
92420545014 Spike
Spike
MS
MSD
MS
MSD
% Rec
Parameter
Units
Result Conic.
Conc.
Result
Result
%Rec
%Rec
Limits RPD Qual
2,4,5-TP (Silvex)
mg/L
ND 2
2
1.6
1.6
80
82
10-156 2
2,4-D
mg/L
ND 2
2
1.4
1.5
72
74
10-156 3
2,4-DCAA (S)
%.
84
86
10-155
Results presented on this page are In the units Indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
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aceAna1Xica1
eww.pecelabs.corn
QUALITY CONTROL DATA
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
QC Batch: 464829 Analysis Method: EPA8270E
QC Batch Method: EPA 351 oC Analysis Description: 8270E TCLP MSSV
Associated Lab Samples: 92421396002
METHOD BLANK: 2524228
Associated Lab Samples: 92421396002
Parameter
Units
Matrix:
Blank
Result
Water
Reporting
Limit
Analyzed
1,4-Dichlorobenzene
ug/L
ND
50.0
03/25/19 14:04
2,4,5-Trichlorophenol
ug/L
ND
50.0
03/25/19 14:04
2,4,6-Trichlorophenol
ug/L
ND
50.0
03/25/19 14:04
2,4-Dinilrotoluene
ug/L
ND
50.0
03/25/19 14:04
2-Methylphenol(o-Cresol)
ug/L
NO
50.0
03/25/19 14:04
3&4-Methylphenol(m&p Cresol)
ug/L
ND
50.0
03/25/19 14:04
Hexachloro-1,3-butadiene
ug/L
ND
50.0
03/25/19 14:04
Hexachlorobenzene
ug/L
ND
50.0
03/25/19 14:04
Hexachloroethane
ug/L
ND
50.0
03/2611914:04
Nitrobenzene
ug/L
ND
50.0
03/25/19 14:04
Penlachlorophenol
ug/L
ND
100
03/25/19 14:04
Pyridine
ug/L
ND
50.0
03/25/19 14:04
2,4,6-Tribromophenol (S)
%
90
27.108
03/25/19 14:04
2-Fluorobiphenyl (S)
%
86
13-107
03/25/19 14:04
2-Fluorophenol(S)
%
47
10-110
03125/19 14:04
Nitrobenzene-d5 (S)
%
92
12-102
03/25/19 14:04
Phenol-d6 (S)
%
29
10-110
03/26/19 14:04
Terphenyl-d14 (S)
%
87
21-132
03/25/19 14:04
Qualifiers
LABORATORY CONTROL SAMPLE:
Parameter
2527807
Units
Spike
Conc.
LCS
Result
LCS
% Rec
% Rao
Limits
1,4-Dichlorobenzene
ug/L
500
396
79
10-110
2,4,5-Trichlorophenol
ug/L
500
425
85
39-108
2,4,6-Trichlorophenol
ug/L
500
449
90
40-104
2,4-Dinitrotoluene
ug/L
500
467
93
42-109
2-Methylphenol(o-Cresol)
ug/L
500
381
76
31-110
3&4-Methylphenol(m&p Cresol)
ug/L
500
302
60
30-110
Hexachloro-1,3-butadiene
ug/L
500
351
70
10-110
Hexachlorobenzene
ug/L
500
460
92
39-121
Hexachloroethane
ug/L
500
357
71
10-110
Nitrobenzene
ug/L
500
435
87
32-101
Pentachlorophenol
ug/L
1000
730
73
18-108
Pyridine
ug/L
500
188
38
10-110
2,4,6-Tribromophenol (S)
%
102
27-108
2-Fluorobiphenyl(S)
%
90
13-107
2-Fluorophenol(S)
%
48
10-110
Nitrobenzene-d5 (S)
%
95
12-102
Phenol-d6 (S)
%
31
10-110
Terphenyl-d14 (S)
%
88
21-132
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Qualifiers
Results presented on this page are In the units Indicated by the "units" column except where an alternate unit is presented to the right of the result
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, LLC. Page 19 of 27

aceAna1j4ica(
wmepacelabs.eom
QUALITY CONTROL DATA
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
QC Batch: 463625 Analysis Method: ASTM D2974-87
QC Batch Method: ASTM D2974-87 Analysis Description: Dry Weight/Percent Moisture
Associated Lab Samples: 92421396001, 92421396002
SAMPLE DUPLICATE: 2522228
92421428001 Dup
Parameter Units Result Result
Percent Moisture % 20.8 21.2
SAMPLE DUPLICATE: 2522229
92421396002 Dup
Parameter Units Result Result
Percent Moisture % 53.8 52.5
RPD Qualifiers
2
RPD Qualifiers
2
Pace Analytical Services, LLC
9800 KinceyAve. Suite 10C
Huntersville, NC 2807E
[phone]
Results presented on this page are in the units Indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, I.I.C.
Page 20 of 27 1

CeAnalytical
wwxpacelabs cnm
QUALITY CONTROL DATA
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 10C
Huntersville, NC 28078
[phone]
QG Batch: 463530
Analysis
Method:
EPA9045D
QC Batch Method: EPA 9045D
Analysis
Description:
9045 pH
Associated Lab Samples: 92421396001
SAMPLE DUPLICATE: 2521716
92420457002 Dup
Parameter Units Result Result RPD Qualifiers
pH at 25 Degrees C Std. Units 4.3 4.3 0 H1
SAMPLE DUPLICATE: 2521717
92421108002 Dup
Parameter Units Result Result RPD Qualifiers
PH at 25 Degrees C Std. Units 12.1 12.1 0 E,H1
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
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Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, L-C. Page 21 of 27

aceAnalytical
wxvpacele55.com
QUALITY CONTROL DATA
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 10C
Hunlersville, NC 28076
[phone]
Project: Wood Boiler Ash 3/14
Pace Project No.: 92421396
QC Batch: 464438 Analysis Method: EPA 365.1 Rev 2.0 1993
QC Batch Method: EPA 365.1 Rev 2.0 1993 Analysis Description: 365.1 Phosphorus, Total
Associated Lab Samples: 92421396001
METHOD BLANK: 2525762 Matrix: Solid
Associated Lab Samples: 92421396001
Blank Reporting
Parameter Units Result Limit Analyzed
Phosphorus mg/kg ND 1.0 03/20/19 23:31
LABORATORY CONTROL SAMPLE: 2525763
Parameter Units
Phosphorus mg/kg
Spike LCS
Conc. Result
50 52.0
Qualifiers
LCS % Rec
%Rec Limits Qualifiers
104 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2525764 2525765
MS MSD
92421077001 Spike Spike MS MSD MS MSD % Rao
Parameter Units Result Conic. Conc. Result Result %Rec %Rec Limits RPD Qual
Phosphorus mg/kg 2000 70.5 81 2720 1880 1020 -143 90.110 36 M6, RI
Results presented on this page are in the units indicated by the"units" column except where an alternate unit is presented to the night of the result.
REPORT OF LABORATORY ANALYSIS
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Dale: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, L-C.
Page 22 of 27 1

aceAnaljftal
eww.perelb65.Com
QUALIFIERS
Project: Wood Boiler Ash 3114
Pace Project No.: 92421396
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
TNTC - Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL -Adjusted Method Detection Limit.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
PQL - Practical Quantitalion Limit.
RL - Reporting Limit - The lowest concentration value that meets project requirements for quantitative data with known precision and
bias for a speck analyte in a specific matrix.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nilrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI -The NELAC Institute.
LABORATORIES
PASI-A
Pace Analytical Services -Asheville
PASI-C
Pace Analytical Services - Charlotte
PASI-GA
Pace Analytical Services -Atlanta, GA
ANALYTE QUALIFIERS
D3 Sample was diluted due to the presence of high levels of non -target analytes or other matrix interference.
E Analyte concentration exceeded the calibration range. The reported result is estimated.
H1 Analysis conducted outside the EPA method holding time.
L1 Analyte recovery in the laboratory control sample (LCS) was above QC limits. Results for this analyte in associated
samples may be biased high.
mo Matrix spike recovery and/or matrix spike duplicate recovery was outside laboratory control limits.
MI Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery.
M6 Matrix spike and Matrix spike duplicate recovery not evaluated against control limits due to sample dilution.
R1 RPD value was outside control limits.
SO Surrogate recovery outside laboratory control limits.
REPORT OF LABORATORY ANALYSIS
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Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, I.I.C. Page 23 of 21

(JceAna1j6ca10
aww.pscelabs.00m
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Pace Analytical Services, LLC
9800 Kinoey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project:
Pace Project No.:
Wood Boiler Ash 3/14
92421396
Analytical
Lab ID
Sample ID
QC Batch Method
QC Batch
Analytical Method
Batch
92421396002
NP31419B
EPA 3510C
464933
EPA 8081B
465120
92421396002
NP31419B
EPA 3510C
464915
EPA 8082A
465112
92421396002
NP31419B
EPA8161A
25022
EPA815lA
25081
92421396001
NP31419A
EPA 3050B
465018
EPA6010D
465056
92421396001
NP31419A
EPA 3010A
464999
EPA 6010D
465053
92421396002
NP31419B
EPA 3010A
464999
EPA 6010D
465053
92421396001
NP31419A
EPA 7470A
465000
EPA 7470A
465052
92421396002
NP31419B
EPA 7470A
465000
EPA 7470A
465052
92421396001
NP31419A
EPA 7471E
464634
EPA 7471B
464739
92421396002
NP31419B
EPA 3510C
464829
EPA 8270E
465225
92421396002
NP314198
EPA8260D
465037
92421396001
NP31419A
ASTM D2974-87
463625
92421396002
NP31419B
ASTM D2974-87
463625
92421396001
NP31419A
EPA 9045D
463530
92421396001
NP31419A
EPA 365.1 Rev 2.0 1993
464438
EPA 365.1 Rev 2.0 1993
464473
REPORT OF LABORATORY ANALYSIS
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Date: 03/28/2019 04:51 PM without the written consent of Pace Analytical Services, LLC.
Page 24 of 2-1

2cB{IIIBJJRICc1(
Document Name:
Sample Condition Upon Recelpt(SCUR)
Document Revised: February 1, 2018
Page 1 of 2
/*
,+
Document No.:
F•CAR-CS•033-Rev.06
Issuing Authority:
Pace Carolinas Quality Office
Laboratory receiving samples:
Asheville 4 Eden[] Greenwood ❑ Huntersville ❑ Raleigh❑ Mechanicsville❑
client Name: Protect q: WO# : 92421396
Courier: ❑Fed Ex ❑UPS ❑USPS ZClIent
11111111111111111111111111❑ Commercial ❑Pace ❑Other._ �
92421396
Custody Seal Present? ❑Yes PNoSeals Intact? []Yes EJ(No
Packing Material: ❑Bubble Wrap []Bubble Bags j2rNone ❑ other
7hermometein ,as it-foq Type of Ice: ❑Wet []Blue
IR Gun ID: � r� n
Cooler Temp ('C): c + 7 Correction Factor: Add/Subtract ('C) U1 U
Cooler Temp Corrected ('C): c('
Date/Initials Person Examining Contents: J 10 / I rs
Biological Tissue Frozen? 1 / �7/ r 7
❑Yes []NO RN/A None
Temp should be above freezing to 6'C
[]Samples out of temp criteria. Samples on Ice, cooling process
hasbegun
USDA Regulated Soil (❑ N/A, water sample)
Did samples ornRRlnate in a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (internationally,
1- riT., mtLidaee Hawaii and Puerto Rico)?❑Yes []NO
Yes No
.
Comments/Discrepancy:
Chain of Custody Present?
2fYes
[]No
❑N/A
1.
Samples Arrived within Hold Time?
es
Oslo
❑N/A
2.
Short Hold Time Analysis (472 hr.)?
Yes
ANo
❑N/A
3.
Rush Turn Around Time Requested?
OYes
No
N/A
4.
Sufficient Volume?
Kryes
QNo
N/A
S.
Correct Containers Used?
-Pace Containers Used?
Yes
❑Yes
❑No
o
❑N/A
N/A
6.
Containers Intact?
es
❑No
❑N/A
7.
Dissolved analysis: Samples Field Filtered?
Ores
FfNo
❑N/A
S.
Sample Labels Match COC?
-Includes Date/Time/ID/Analysis Matrix:
Ayes
5�
❑No
❑N/A
9.
Headspace In VOA Vials (>5-6mm)7
Yes
ON.
IJN/A
30.
Trip Blank Present?
Trip Blank Custody Seals Present?
❑Yes
Yes
❑No
No
N/A
/A
31.
COMMENTS/SAMPLE DISCREPANCY
Lot ID of split containers:
CLIENT NOTIFICATION/RESOLUTION
Person contacted:
Date/Time:
Field Data Required? ❑Yes rlNo
Project Manager SCURF Review: Date: r
Project Manager SRF Review: Dale: 3 I r /�

Document Name:
Document Revised: February 7, 2018
r,P
Sample Condition Upon Receipt(SCUR)
Page 1 of 2
Document No.:
Issuing Authority:
/. c7CAA178�JlllCal
F-CAR-CS-033-Rev.06
Pace Carolinas Qualin, Office
*Check mark top half of box if pH and/or dechlorination is
verified and within the acceptance range for preservation
samples.
Exceptions: VOA, Coliform, TOC, Oil and Grease, DRO/8015 (water) DOC, LLHg
"Bottom half of box Is to list number of bottle
Project # W®# : 92421396
PR: CDI Due Date: 03/28/19
CLIENT: 92—Baxter
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PH Adjustment Log for Preserved Samples
Sample ID
Type of Preservative
pH upon receipt
Date preservation adjusted
Tlme preservation
adjusted
Amount of Preservative
added
Lot 0
Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy or rms form wni be sens m me nv, 6, 4-
Out of hold, Incorrect preservative, out of temp, Incorrect containers.

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