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HomeMy WebLinkAboutNCG140128_MONITORING INFO_20180219STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. DOC TYPE ❑HISTORICAL FILE EC MONITORING REPORTS DOC DATE ❑ �DI � Oa � 7 YYYYMMDD STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM GENERAL PERMIT NO. NCGI40000 CERTIFICATE OF COVERAGE No. NCG14- FACILITY NAME: Q12- PERSON COLLECTING SAMPLES CERTIFIED LABORATORY Lab #=i-t---- Lab s* OPTIONAL INFO: Part A. Stormwater Monitoring Requirements SAMPLE COLLECTION YEAR: _ ZQI`T SAMPLING PERIOD: July -December ❑ January -June COUNTY __CTraiVa ;) -P- _ PHONE NO. ( ) ADD TO LISTSERVE? ❑YES FIND EMAIL: DISCHARGING TO CLASS: [_]SA ❑HQW ❑PNA []Trout ❑Other. Outfall No. Date Sample Collected (mo/dd/yr OR NO FLOW)' pH (Standard Units) TSS (mg/Lj Event Duration (minutes) Total 4 Rainfall (in) In Tier 2 Monthly Monitoring? (y/n) fs of Months in Tier Z Sampling' - - 6-9 2 100 Z,3- - - - Ct )l 4 RECEIVED v CEiV- -RAL FILES vvvr i 1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above. 2If a value is In excess of the benchmark, or outside the benchmark range Ifor PHI, you must implement the Tier 1 or Tier 2 responses in the General Permit, Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range. 3 TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are S0 mg/I. A For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge. Permit Date: 7/1/2011-60/30/2015 1 Last Revised 7/13/11 Page Iof2 Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year. Outfall No. Date Sample Collected (mo/dd/yr)' pH (Standard Units) TPH using method 1664A SGT-HEM (mg/L) Total Suspended Solids (mg/L) Event Duration (minutes) Total Rainfalla (In) New Motor Oil Usage (gal/month) In tier 2 Monthly Monitoring? (y/n) # of Months in Tier 2 Sampling2 6-9 15 100 - - - - I HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑ HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail Original and one copy of this DMR (Including all "No Flow" & "No Discharae" reports) within 30 days of receipt of sample for at end of monitoring period in case of "No Flow") to: Division of Water Quality Attn: OWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CER77FIC477ON FQANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." a Its — � z I I Lfl� (Sig nat4je a Permittee) ! (Date) Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 2 of 2 MCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: hap.,flnortal.ncdenr org/Acb/IrImpdes-storrnwaler/ Permit No.: Facility Name: RAA3iNl nt 1 County: _ 'ort�i: k1f Inspector: A i Date of Inspection:_ Qi_iz I #I Time of Inspection: j wZ Ap` Total Event Precipitation (inches): , 11 or Certificate of Coverage No.: W.C1 j1_Z1, /QI-i l�l$I Phone No. Was this a "Representative Storm Event" or `Measureable Storm Event" as defined by the permit? (See information below.) ETYes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or `measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. A "treasurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: oPPermittee or Designee) Page 1 of 2 5WU-242, Last modified 7/31/2013 1. Outfall Descriptfon: Outfall No. I Structure (pipe,(GDtc.) Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: Z. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: LcoWy2 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): Lbpe 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 0 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 V 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: a 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes 'U a. Is there an oil sheen in the stormwater discharge? Yes 4. is there evidence of erosion or deposition at the outfall? Yes 10. Other Obvious Indicators of Stormwater Pollution: List and describe &ILL3w— Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242, Last modified 7/31/2013 aceAnalytical 3 September 18, 2017 Jay Watkins Ready Mix Concrete 3610 Bush Street Raleigh, NC 27609 RE: Project: Plant 13 Butner Pace Project No.: 92355103 Paco Ansly11cs1 Sorvlces, LLC 9000 Kkncey Ave. Sulte 100 Huntersville, NC 28078 (704)875-9082 Dear Jay Watkins: Enclosed are the analytical results for sample(s) received by the laboratory on September 13, 2017. The results relate only to the samples included in this report. Results reported h erein 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, ` 0" 410, i Angela Baioni angela.baioni@ pacelabs.com (704)875-9092 Project Manager S Enclosures REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Semmes, LLC. Page 1 of 10 i Pace Analytical Services, LLC aceA! lj4ic el e 9800 unceyAve. Suite078 JI /`I vu HunttrsvlUe, NC 28078 WmARDOWscum (704)875-8092 CERTIFICATIONS Project: Plant 13 Butner Pace Project No.: 92355103 Eden Certification IDs 205 East Meadow Road Suite A, Eden, NC 27288 North Carolina Wastewater Certification #: 633 North Carolina Drinking V%Wer Certification #: 37738 VirginialVEIAP Certification #: 460025 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, ezcapt in full, without the written consent of Pace Analytical Services, LLC. Page 2 of 10 I aceAnalytical e r wew.pec�lebstvm r SAMPLE ANALYTE COUNT Project: Plant 13 Butner Pace Project No.: 92355103 Pace Analytical Services, LLC 9800 Kincey Ave. Serve 1100 Huntersvift, NC 2807a (704)875-9092 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92355103001 Outfall #1 Plant 13 Butner SM 2540D CTB 1 PASI-E 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 10 aceAnalytical w"..Pecehft cm i ANALYTICAL RESULTS Project; Plant 13 Butner Pace Project No.: 92355103 Pate Analytical Services, LLC 8800 Kincey Ave. Suite 100 Huntersvllle, NC 28070 (704)875-9092 Sample: Dutfall 01 Plant 13 Butner Lab ID: 92355103001 Collected: 09/12117 09:42 Received: 09/13/17 13:55 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 25400 Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 11.4 mg/L 3.2 1 99/15117 10:37 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in MI. Date: 09/18/2017 03:23 PM without the written consent of Pace Analytical Services, LLC. Page 4 of 10 aceAnalytical e www.psceleba.com QUALITY CONTROL DATA Project: Plant 13 Butner Pace Project No.: 92355103 OC Betch: 377900 Analysis Method: SM 2540D QC Batch Method: SM 2540D Analysis Descripdon: 2540D Total Suspended Solids Associated Lab Samples: 92355103001 METHOD BLANK: 2093681 Associated Lab Samples: 92355103001 Parameter Units Total Suspended Solids mg1L LABORATORY CONTROL SAMPLE: Parameter 2093662 Units Total Suspended Solids mg/L SAMPLE DUPLICATE: 2093803 Parameter Units Total Suspended Solids mglL SAMPLE DUPLICATE: 2093664 Parameter Units Total Suspended Solids mglL Pace Analytical Services, LLC S8D0 Kincey Ave. Suite 100 Huntersville, NC 28076 t704y875-DDD2 Matrix: Water Blank Reporting Result Limit Analyzed Qualtfiers ND 2.5 09A 5117 10:33 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 250 240 96 90-110 92355099001 Dup Result Result 159 273 92355087001 Dup Result Result 3.7 164 RPD Qualifiers 53 D6 RPD Qualifiers 191 06 Results presented on this page are In the unite Indicated Ey the "Units" ookartn sxceptntseee an attwnaa+ unit Is presented to the right of the raauft REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full. Date: 09T1812017 03:23 PM without the written consent of Pace Analytical Services, I.I.C. Page 5 of 10 ceAnalytical' " xmypacele6s.mm 1 QUALIFIERS Project: Plant 13 Butner Pace Project No.: 92355103 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. PQL - Practical Quantitation Limit. RL - Reporting limit. Pecs Analytical services, L.LC 9800 Kincey Ave. Suite 100 Hunteraylile, NC 28078 (704)975r9092 S - Surrogate 1,2-Olphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270, The result for each anslyte is a combined conoentratlon. Consistent with EPA guidelines, unrourided 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 riot 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 Acrylonitiile by EPA Method 8260. N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyte is a combined concentration. Pace Analytical is TNb accredited, Contact your Paoe PM for the current list of accredited analytes. TNI -The NELAC Institute. LABORATORIES PASI-E Pace Analytical Services - Eden ANALYTE QUALIFIERS D6 The precision between the sample and sample duplicate exceeded laboratory control limits. Date: 0911812017 03:23 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in Tull, wKhout the written consent of Pace Analytical Services, LLC. Page 6 of 10 aceArralytical f� www.pacsW&C0m I QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: Plant 13 Butner Pace Project No.: 92355103 Papa Analytical Services, LLC 9600 Klncey Ave. Sulte 100 Huntersvi1e, NC 28078 (704)87b9092 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92355103001 Outfall *1 Plant 13 Butner SM 2540D 377900 Date: 09/18/2017 03:23 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 7 of 10 -- Asheville ❑ Eden❑ Greenwood ❑ Hunte rsville ❑ Ralfllgh Medlenlcsville�� OlentName: , { 7` Project#* WO# : 92355103 ❑ Commercfal oP o o f1er:_ 11111111 OF 1111111111 92355103 —�ntWdySrslRMot5lalt-trrtad7... _ .Yes __. 0+m/InptahPunoeFauvdnioiCWtuuls: �`�'I; PaclArig Material: []Bubble Wrap ❑Bubble Bags Nane 0 tither 81clo61cal Tissue FXocant Tltsemomelgre� et ❑Blue ❑Npae Dyes .0go Chian of Cu3todi Presents es No N A L. Samoks Arrived wlthln held Tima? es OND . WA 1. Sfw t Held Time Anr its I[72 fir.)? Oyes 2< HA 3. Rush Turn around Time R ua ted7 OYU NIA 4. SLf"weat Volume? es No NIA 5. CarreetContainen Used? -Pace Containers Used? a ea No NNO ON1A ObljA 6 C"lainvs Imact? za No 001A ?. Olssolved ana. sls: Samples Field FUDerW? a lie A B. Sample Labels Match COC7 -lftdude3DaE/ArLabmLs Matrbr s 090 IOW► 9. Hea Race in VOA Vials a54nvnj? Yea No A 10. Ttlp Blank Present? Trip Blank Custody Seals Present? ( Yes QYR1 ❑- No NIA 101A IL C LITNTNOTIFICATIONJRESOLUTION Person Contacted: Comments/sample Discrepancy: Dato/nme: M. V .Rq r L-JrY t„ JRV 1 1 j Projea ManageF SCURF Ravlwr ;��r 1 Bate: t Prolark Manager 5RF Revtew: i'I YJ Date: Note: W haoaver there is a dhaapsw afiaelnB North [*rating colnpllama samples, a copy of thli tam wBlbIsant to the North CargBna MNR Growun Offla 0. tint of held, Inwnect PMMWtiva, Jrut Cf tamp. Im=att cootstnea} Page 8Of10 Document Name: Document Revised:3u Sam to Condition upon Recei tfSGVR Pa e 2 of 1 _ J s-c�ecsca3.iiey;a3 _ _I parvnimittvoE}iea 1 'Check marktop half of bo-x-Tp-ffan or•dechIoRnaflon - Frolez IT WO# : 92355103 Is verified and within the acceptance range for PH: IAMB Sus Date: 09/27/ 17 preservation samples. CLIENT, 92-R eady Mist e*Bottom half of baK is to list number of battles Ilk 0 MEMO Oki son �ii►�� o��u�iiii■ia°�u INS�d���i'�iiiiiii►ONES ►on MEMO N ON 0 MEN son iiLim imoiii pH Adjustment Log for Preserved Samples Sample 10 "I'll pit of iruerveftvs I pH upon reroiat asu Prli 111 an tdlisttd Ttmepnptmotm Aa+aontcl Pro adlutttd I added E age a O CHA)"F%-CUSTODY J Ana"cat Request Document Tft CNdM04kQ** IL I LEGAL GOCUVENT. AM MkWI 4US W40 b4 CWrO4*d VAMW Sptfm A 5 swtvoo c PACLdftd CFAd bdwkfieR P460= 3( ofm Al -- - - kww REWLATMY AGEMY — — G W"' (­NPDM V GXOUND�VkfEk r"' DRNMG WATER NE UST r, FmA OTHER Egad TO: owm ad xmw pn"d Suit Locagm L -TA .7 10- paga A COLLEMD W7 wxswvvalw vww I - awn"PA4 pw&.�A r amvs4d SL m - OL SAMPLE 10 i cc -0 1 AIr awoN& mh mum I* Lft" lt4o TS Wpp Dow OT U3 DAlt TIME DAVF TIME 0, PAW Lat, Pox& Prolact Hol LAb 1.0- 1*3 DU�& L -197. FF "'t, TPM WE L-- r SAMPLER KwEma smwvp ORIGNAL 1 . I., . x T RECE-NED MAY 0 4 2017 NCDENR CENTRAL FILES Stormwater Discharge Outfall (SDO) DWR SECTION Qualitative Monitoring Report Forcguidance orr filling qut this form, please visit:littp:lLpor.tal.iicdeiij-.org/weli/`li-Inpdes-stormtvaterl Permit No.: Facility Narne: R - pldrrf County: U Inspector: Date of Inspection: Time of Inspection: or Certificate of Coverage No.: N/C/G/ j/'Y/ a/ / 2/$/ Total Event Precipitation (inches): 116 Phone No. ^ q q 9-15- L13$d Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a. "representotive storm event"or "meosureoble storm event" (requirements vary, depending on the permitj. Qualitative monitoring requirements vary. Most Hermits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storril event." However, ; some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at: least 72 hours (3 days) in which no storm event pleasuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. A "measurable storm event" is a storm event that results in an actual clischar& from the permitted site outfall. The previous ineasura.ble storm event must have been at least 72 i10U1's prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signatu# of k ermittee or Designee) Page 1 of 2 SLVr1-242, Last modified 7/31/2013 1. Outfall Description: Outfall No. I Structure (pipe(ditch, c.) Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: W AA 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): AU 0Lu-0— 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1� 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: O 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes 8. Is there an oil sheen in the stormwater discharge? Yeses+' 9. Is there evidence of erosion or deposition at the outfall? Yes n 10. Other Obvious Indicators of Stormwater Pollution: List and describe W b Pse _ Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further Investigation. Page 2 of 2 SWU-242, last modified 7/31/2013 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division -of Water quality General Permit No: NCG060000 Date submitted 4 (xS 11-7 CERTIFICATE OF COVERAGE NO. NCG06 01 L FACILITY NAME t31"*r Ditty* 13 COUNTY Grwq i 114 PERSON COLLECTING 5,AMPLE5 1 LABORATORY tk(X Lab Cert. # Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR Z 01 `I FACILITY ACTIVITIES INCLUDE;(check all that apply): ❑ use/process meats ❑ use animal fats/byproducts DISCHARGING TO SALTWATERS? DYES (YNO PLEASE REMEMBER TOSIGN'ON THE. REVERSE +' Total event rainfall' • q 6 or ❑ No discharge this period} Outfall No. Sample Collected, mo/dd/yr .TSS, mg/L pH, Standard units COD; mg/L Oil and Grease, mg/L FecallColiform , Colonies per 100 ml Enterococci , Colonies per 100 ml Benchmark - 100 or SO Within 6.0-9.0 120 30 1000 S00 Only applies to facilities that use/process meats. IThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at apny outfalls. You must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Fable 3, identifying the especially sensitive receiving water, classif€cations where the more protective benchmark applies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes [Yno Part B: Vehicle Maintenance. Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS; mg/L pH, Standard units New Motor Oil usage, Annual average gal/mo Benchmark - 30 100 or 50 6.0 — 9.0 Only applies to facilities that use/process meats. 2The tota€'precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report.with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. if yes complete Part B) SWU-249 Last Revised: October 18. 2012 Page 1 of 2 *FOR PART A AND PART.B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. Y 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS: SEE PERMIT PART It SECTION B. C TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period in the case of "No Discharge" reportsTto: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 'YOU MUST SIGN THIS CERTIFICATION FOR ANYINFORMATION REPORTED: "I. certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information -submitted. Based on my inquiryof the person or persons who manage the system, or those persons directly responsible for gathering the information, the information -submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of %rniittee) 51,11,-r (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.orgLweblwci/ws/su/npde.ssw#tab-4 SWU-249 Last Revised: October 18. 2012 Page 2 of 2 ac6Analytical. wwwp=1aas.=n i ANALYTICAL RESULTS Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huniersville, NC 28078 (704)875-9092 Project: PLANT 13 BUTNER Pace Project No.: 92338348 Sample: OUTFALL #1 PLANT 13 Lab ID: 92338348001 Collected: 04/24/17 06:18 Received: 04125/17 14:55 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Oual 2540D Total Suspended Solids Total Suspended Solids Date: 04/2712017 03:04 PM Analytical Method: SM 2540D 4.9 mg1L 2.5 1 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. 04/26/17 13A0 Page 4 of 10 laboratory receiving samples: Asheville ,F I Eden[:] uonnnent Name: ESl Tech Spec Sam a Condition upon Receipt Document No.: 1 F-CAR-QA-003-Rev.02 1 Greenwood [J Huntersville Client Name: Project #: IS Courier. 40d x UPS Don lient ❑ Commercial ❑Pace ❑Other: Custody Seal Present? [(Yes N40 Seals intact? [yes 17�0Np Document Revised: Sept. 22, 2016 Pa elof2 Issuing Authority: Pace Quality Office Raleigh® Mechanicsville❑ WON_92338348 1111111111111111111111 48 pate/lnitlals Person Euamirring Contents:_94 — Packing Material: 09ubble wrap ❑Bubble Bags one QOther. Thrarmameter. ® IR Gun ID: _ 15-3452 Type a! Ice: ,wet ❑Blue ❑hone [_]Samples on Ice, tooling process has begun _ Correction Factor: Add a.6 Cooler Temp Corrected l°C). Biological Tissue Frozen? ❑Yes []NO /A Temp should be above fr eiang to 6'C USDA Regulated Soil ( N/A, water sample) Did sample originate in a uarantlne zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign sowte (lot mationatty, ❑Yes No Including Hawaii and Puerto Rico)?❑Yes VNa Comments/Dlscrtyancy: Chain of Custody present? I. amphs%tirrived'wittiiri HoidTime? --• ❑ 2 Short Hold Time Analysis (c72 hr.)? Cl 3. Rush Turn Around Time Requested? ❑T�n 4. Sufficient Volume? Correct Containers Used? -Pace Containers Used? ❑ & Containers Intact? ❑ 7. Samples Field Filtered? ❑ © S. Note if sediment is visible )n the dissolved container Sample labels Match COC? •IrxJudes Date/Tlme/lD/Analysis ,,, 9. Headspace in VOA Vials (>S-6mm)? Yes No A Ip. Trip Blank Present? Trip Blank Custody Seals Present? Yes ❑ Yes No ❑ No NIA 11. CLIENT NOT€FICATION/RESOLUT10N Person Contacted: Comments/Sample Discrepancy: Date/nme: Field Data Required? (_JYes ❑No Project Manager SCURF �,} L� Review: C W�f T I bDate-, Project Manager SRF Review: 6Y} 1 Date. {_ L •�� Note: whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form will be sent to the North Carollna DEHNR Certification Office (Le. Out of hol(A Incorrect preservative, out of temp, incorrect containers) • •.. pa�e`8 of t}0 c ra v 5L T A 2 a v rt � v_ r0 3 A O � m � a se a m CL ib w y p a 0 m n 0 •+ a, rn > w N 4 r kemi/ :j ,) SKU-125 ml Plastic Unpreserved (N/A) (CI-) BP3U•250 mL Plastic Unpreserved(NIA) BP2U-5-M rnLPoastic Unpreserved (N/Al 8P1U-1 liter Plastic Unpreserved (N/A) { BP3S-2SO mL Plastic H2SO4 tpH < 2) (Cl-) l BP3t+1-= mL plastic HNO3 (pH <2) BP3Z-2S0 mL Plastic ZN Acetate & NaOH 09) BP3C-Z50 mL Plastic N30H (p4 > 12) (CI-) ( WGFU-Wide•mnuthedGLassjar Unpreserved AGIO.1 iiterAmber Unpreserved (N/A) (Cl-) AG1H-1(lterAmber HO (pH <2) AG3U-250 MLAmber Unpreserved (N/A) (Cl-) r 11117,11111 AGIS-1 Hier Amber H2SO4 (pH < 2) AG35-2SO MAmber H2504 (pH <1) AG3A(DG3A)-2so mLAmber W14CI (N/Aj(Cl-) DGSH-40 mL VOA HCI (N/A) VG9T-40 mL VOA Na2S203 (N/Aj VG9U-40 mL VOA Unp (NIA) DG9P-4G mL VOA k3PO4 (N/A) VQAK (5 0311 per k(t}•S03S 3 it (N/A) V/GK (3 vials per kit)-VPH/Gas kit (N/A) SOSi-125 m L Sterile Plastt (NIA —lab) SP2T250-1 Sie rile Plastic (N/A —lab) 6P3A-20 mL Plastic (NH2)2504 (9.3-9.7) Culaha{ner VSGU 20 mL Sctndllation vials (N/A) GN M .'O �• �e+t C M r?D = T n 3 7 m C -� g4 a x X = C Q Cr 61 0 X T x 3 = c d {D N ¢ O is 3 1 G CD v to C � � m T a io t1 3 ap p a n O 7 C ro a x •' .. waCeAnalyfrca!' CHAIN -OF -CUSTODY 1 Analytical Request Document The Chainof-Custody is a LEGAL DOCUMENT. AY mLevgrtt fWds must tm cwWletW accwafety. pswe of Sedlon A Section 6 Section C Raquked Client infararat4n: Required Pmjcd Infortrodw: lnwwa leforMando: Company: A!, 0 Roport T4 Atantion: 2097574 d:css: I Cagy To: Company Name: - REGULATORY AGENCY Addrew 1- NPDES GROUNDWATER F DRINK€NG WATER I UST RCRA f OTHER Ema1 TO:, Purtlwae Corder No.: Osw. k i ReE.r.r.re: f'lldrle. fax: ProjW Name: Sft Ld=stjon Al-Inager: . STATE Roqu"Be4 Pus Qx%ffeT: PrajVO N.MbC t L ` 1 .e. r'r'"Na fr, Requested Analysis Floored (YIN) Secban O M4kWX Coda = R.culr.dCav+a W*r M tbn rMATRII: ! CAOE nnnlrira weLor LrLv A o COLLECTED 4S PmservoiivCB > Watef wT wam rw PW � a ro 390 WAOTSRE tAonaeea 14:. 24 w S01*0bd SL I g y w SAMPLE lD wa °� 6' M z r "i (A-z o-a r:) Nr AR A Q ►— 1- �::� �'_) 'U sample fUa MUST BE UNIQUE Triss TS p � o! Ooa:r or o N p c ` DATE TuaE oAT£ TIME _ = 2 Z Z U'J Pave Pr-JI t Nol Lab J.D. •3 4 a T 8' !i 10 11 12 ADDITIONAL_COMMENTS RELINGUNHEDBYfAFFILPATWN DATEE THE BY!AFFO ATiON DATE t1ME 6AMPLECONDfrIGNS SAMPLER MAKE AND SIGNATURE b ORIGINAL PRIYT Iterr.e Of 3AYPLpR: � 7i, � : $�i � a 510NATURE of SAXPLER: RATE $fgned ti (AIM14Q1YY): •Imfw1.0 Np By synarp d. i— ya, are .—Darip Fara'. NFT X Day P."fd w s an4 ag"nq Lu L.I. vna m at tAl, per rrmO for ant Lmevlms nor paid wZ-dn U =A -- - _F-ALL-0-02Grev.07. 1 5-Mey2DO7 A7 i` �A 94-,0/6 NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit: weblwg/ws/su/npdessw#tab-4 Permit No.: N/C/_/_/_/_/_/_/_/ or Certificate of Coverage No.: N/C/G/L Facility Name: Bu-y V-A !' I a County: 1 Parma I1'e Phone No. 'S 3 S b Inspector: IN iAl An;IV 5 Date of Inspection: 2,14 ( I L. Time of Inspection: ''1 14S A M _ Total Event Precipitation (inches): Was this a "Representative Storm Event" or "Measureable Storm Event" a�aP, A th peerrmit? (See information below.) (.r Yes ❑ No MAR 14 2016 CENTRAL FILES Please verify whether Qualitative Monitoring must be performed during a "RXresAr41Tt0wrm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has Occurred. A single storm event may contain up to 10 consecutive hours of no l precipitation. A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DW( ional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: of Permittee or Designee) Pagel of 2 5Wll-242, Last modified 10/25/2012 1. Outfall Description: Outfall No.. _ _ _ _ Structure (pip , ditch)tc.) Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: Qtar �.�V11 if-- 0 t' oad Of a loolt 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: C1-e-u " 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): Nb&Je 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: U 2 3 4 5 S. Floating Solids: Choose the number which best describes the amount of Floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with Floating solids: 1 b 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: D 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes 0 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe Nnls-e- Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242, Last modified 10/25/2012 NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit. hqp://portal.ncdenr.org/web/wq/ws/sulnpdessw#tab=4 Permit No.: N/C/_ /Y/�/_/_/,/_/ or Certificate of Coverage No.: Facility Name: B mInRje _#t 13__ County: &Ymv%ui l j- Phone No. R 1!3 - S? S - 43 Bo Inspector: k1GAT1e.lJ5 Date of Inspection: X/Y I1b Time of Inspection: '7t44f�kM Total Event Precipitation (inches): • S- Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Sigr/furc/of Permittee or Designee) Pagel of 2 SWU-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. ?— Structure (pip ditc , tc.) Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: r It&4 - 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: V 2 3 4 5 S. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 V 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1D 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes 6D B. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes V 10. Other Obvious Indicators of stormwater Pollution: List and describe tj0 Ki C- Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242, Last modified 10/25/2012 TABLE 9.1 ANALYTICAL MONITORING REQUIREMENTS-STORMWATER READY MIXED CONCRETE COMPANY — PLANT # DISCHARGE UNITS BENCHMARK SAMPLE SAMPLING CHARACTERISTIC VALUES LOCATION SCHEDULE pH Standard Within range 6.0 to 9.0 Each Outfall' Semi -Annually Total Suspended Solids (TSS) mg1L 100 mg/L2 Each Outfall' Semi -Annually Total Petroleum Hydrocarbons3 mg/L 15 mg1L Each Outfall' Semi -Annually Event Duration Minutes Not applicable Each Outfall' Semi -Annually Total Rainfall Inches Not applicable Each Outfall' Semi -Annually New Motor Oil Usage Gallons/ Month Not applicable Not applicable Semi -Annually Notes: 1. Samples shall be collected at each stormwater discharge outfall unless representative outfall status has been granted and documented by the Division of Water Quality. A copy of the letter granting representative outfall status shall be kept on site. 2. TSS benchmark for ORW, HWQ, Trout or PNA waters is 50 mg/L. 3. Only required for sites where vehicle maintenance activities occur. 4. All samples must be grab samples. Grab samples shall be collected within the first 30 minutes of discharge from a stormwater discharge outfall (SDO). 5. All samples must be collected during a measurable storm event. A measurable storm event is an event that results in an actual discharge from the permitted site outfalls. The previous measurable storm event must have been at least 72 hours prior. If no discharge occurs during a sampling period, a monitoring report indicating "No Flow" must be submitted within 30-days of the sampling period. 6. For each sampled measurable storm event the total precipitation must be recorded using an on -site rain gauge. 7. The permittee shall complete the analytical samplings in accordance with the schedule specified above, unless adverse weather conditions prevent sample collection. Inability to sample due to adverse weather conditions must be documented in the SPPP and reported on the appropriate DMR form (Appendix A). 8. A minimum of 60 days must separate each monitoring event unless monthly monitoring has been instituted under a Tier Two response 9. The permittee shall compare monitoring results to the above -referenced benchmark values for each discharge characteristic. Exceedances of benchmark values require the permittee to increase monitoring, increase management actions, increase record keeping, and/or install stormwater Best Management Practices (BMPs) in a tiered program, as specified by the general permit. 10. Failure to monitor semi-annually per permit terms immediately institutes monthly monitoring for all stormwater parameters. After six months of monthly monitoring, the permitee may make a request in writing to the Division of Water Quality to return to a semi-annual monitoring schedule. TABLE 9.2 ANALYTICAL MONITORING REQUIREMENTS -PROCESS WASTEWATER READY MIXED CONCRETE COMPANY - PLANT # DISCHARGE EFFLUENT SAMPLE SAMPLING CHARACTERISTIC UNITS LIMITATIONS LOCATION SCHEDULE pH Standard 6.0 — 9.01 Each Outfa112 Quarterly Total Suspended Solids (TSS) mg/L 30 mg/L3 Each Outfa112 Quarterly Settleable Solids mVL 5 mL/L Each Outfal12 Quarterly Total Petroleum Hydrocarbons4 mg/L 15 mg/L Each Outfal12 Quarterly Event Duration Minutes Not applicable Each Outfal12 Quarterly FIow5 Gallons/Day Not applicable Each Outfal12 Quarterly New Motor Oil Usage4 Gallons/ Month Not applicable Not applicable Quarterly Total Volume of Wastewater Discharged (HQW) Not applicable 50% of summer 7010 Flow Not Applicable Quarterly Notes: 1. pH range for saltwaters is 6.8 — 8.5. 2. Samples shall be collected at each process wastewater outfall during a discharge event. 1 TSS effluent limitation HOW is 20 mg/L and 10 mg/L for Trout or PNA waters. 4. Only required for sites where vehicle maintenance activities occur and process wastewater commingles with stormwater. 5. Flow may be measured continuously or calculated. 6. See 15A NCAC 02t3 .0224 and general permit for explanation. 7. All samples must be grab samples. Grab samples shall be collected within the first 30 minutes of discharge from a process wastewater outfall. 8. If no discharge occurs during a sampling period, record "No Flow" or "No Discharge" within 30-days of the end of the sampling period and file with SPPP. 9. Commingled discharges must be collected during a measurable storm event. A measurable storm event is an event that results in an actual discharge from the permitted site outfalls. The previous measurable storm event must have been at least 72 hours prior. 10. For each sampled measurable storm event the total precipitation must be recorded using an on -site rain gauge. 11. The permittee shall complete the analytical samplings in accordance with the schedule specified above, unless adverse weather conditions prevent sample collection. Inability to sample due to adverse weather conditions must be documented in the SPPP and reported on the appropriate DMR form (Appendix A). 12. For commingled discharges, a minimum of 60 days must separate each monitoring event unless monthly monitoring has been instituted under a Tier Two response 13. The permittee shall compare monitoring results to the above -referenced effluent limitations for each discharge characteristic. Exceedances of effluent limitations will result in a violation of permit conditions and may be subject to enforcement. 14. Failure to monitor process wastewater quarterly per permit terms immediately institutes monthly monitoring for all parameters. After six months of monthly monitoring, the permitee may make a request in writing to the Division of Water Quality to return to a quarterly monitoring schedule. PROCESS WASTEWATER —Quarterly Discharge Monitoring Report GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCG14 FACILITY NAME: PERSON COLLECTING SAMPLES: CERTIFIED LABORATORY: Lab # Lab # LIMIT VIOLATIONS? YES ❑ NO ❑ Part A: Wastewater Monitoring Requirements SAMPLE COLLECTION YEAR: i SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March ❑April -tune COUNTY: PHONE NO. [-� ADD TO LISTSERVE? DYES ❑NO EMAIL. DISCHARGING TO CLASS: [:]SA ❑HQW ❑PNA ❑Trout []Other OPTIONAL INFO: Outfall No. :al�.Sample ected (/dd/Yr) Typeaf Wastewater =Solids (VE, RM, MD) pH (standard[ Total Suspended (mg/L) SeKleable Solids (mL/L) TPH using methad16644 S (mg/L) (mg/L) Dlsiharee Duration (minutes) Total Flow v (gatlons/day) 6.91, 303's 5j (IS)s I t If wastewater systems have not discharged in this quarter— report "No Flow' or "No Discharge" here. Please make sure to mark the sample quarter above. a Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum Cleanout (MO). Report more than one type if the waste stream is commingled. 3 If an effluent limit is exceeded twice in a row, the permittee is required to institute monthly monitoring for that parameter for six months, unless DWQ RO staff notifies you to continue monitoring. pH limits are 6-9 S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. s TSS limits are 20 mg/L for wastewater discharges to HOW waters, 10 mg/L for -trout and PNA waters, and 30 mg/L for all other water classifications. Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 1 of 2 c Process wastewater discharges shall only be monitored for TPH when commingled with stormwater discharges from VMA areas. TPH does not have a Limit for wastewater, but instead is subject to benchmarks and provisions of part IV, Section A, including the Tiered Response Action. 'Flow rate can be measured continuously or calculated. Flow limits for wastewater discharges to HQW waters shall be set to 50% of the Summer 7Q1D Flow as per 15A NCAC 02B .0224. Permittces who discharge wastewater to HOW waters shall obtain a Summer 7Q10 flow and report this information to DWQ. If the permittee cannot obtain a Summer 7Q10 Flow for the receiving waters at the discharge location, the permittee shall notify DWQ, and the DWQ Regional Office may require an annual flow report on a case•by-case basis. MAIL ORIGINAL AND ONE COPY OF THIS ANNUAL SUMMARY INCLUDING ALL "NO FLOW" "NO DISCHARGE" WIT IN 30 DAYS OF RECEIPT OF SAMPLL UO AT END OF Ili ONITORING PERIOD IN CASE OF "NO FLOW-1 TO: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 (919)807-6379 M MUST S! N THIS CERTIFICATION FOR A8JY WFORMATtON REP RTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my Inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations," 3%ir �6 (Si fur Permittee) IDate) Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 2 of 7 ,�aceAna1Xical www.pacelabs. cem ANALYTICAL RESULTS Project: BUTNER #13 Pace Project No.: 92285574 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704 )875-9092 Sample: PLANT #13 OUTFALL #1 Lab ID: 92285574001 Collected: 02/04/16 07:45 Received: 02/05/16 15:10 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids ' 9.4 mg/L 2.5 1 02/10/16 10:55 Sample: PLANT #13 OUTFALL #2 Lab ID: 92285574002 Collected: 02/04/16 07:45 Received: 02/05/16 15:10 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 2540D Total,Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 11.2 mglL 2.5 1 02/10/16 10:56 Date: 02/12/2016 09:01 AM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 4 of 9 ,��aceAnalyticaI www.pacelabs.com f ' QUALITY CONTROL DATA Project: BUTNER #13 Pace Project No.: 92285574 QC Batch: EDEN121705 Analysis Method: SM 2540D QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92285574001, 92285574002 METHOD BLANK: 1663133 Matrix: Water Associated Lab Samples: 92285574001, 92285574002 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg/L ND 2.5 02/10/16 10:51 Pace Analytical Services, Inc. 9800 KinceyAve. Suite 100 Huntersville, NC 28078 (704)875-9092 LABORATORY CONTROL SAMPLE: 1663134 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Suspended Solids mg1L 250 250 100 90-110 SAMPLE DUPLICATE: 1663135 92285759001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 44.5 45.0 1 SAMPLE DUPLICATE: 1663136 92285802001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 98.0 95.0 3 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: 02/1212016 09:01 AM without the written consent of Pace Analytical Services, Inc.. Page 5 of 9 P�aceAnal ical ww.pscelabs.com Pace Analytical Services, Inc. 9800 Kincey Ave, Suite 100 Huntersville, NC 28078 (704)875-9092 QUALIFIERS Project: BUTNER #13 Pace Project No.: 92285574 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. J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit, MDL -Adjusted Method Detection Limit. PQL - Practical Quantitation Limit. RL - Reporting Limit. 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 - Sampie 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, Styrene, and Vinyl chloride. 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-Nitrosodiphenylamine 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-E Pace Analytical Services - Eden REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Oate: 0211212016 09:01 AM without the written consent of Pace Analytical Services, Inc.. Page 6 of 9 aceAnalytical www.pacelabs.com Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704 )875-9092 QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: BUTNER #13 Pace Project No.: 92285574 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92285574001 PLANT #13 OUTFALL #1 92285574002 PLANT #13 OUTFALL #2 SM 2540D SM 2540D E DE N/21705 EDENt21705 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 02/12/2016 09:01 AM without the written consent of Pace Analytical Services, Inc.. Page 7 of 9 Analytical Document Name: Sample Condition Upon ReCei Document No.: F•RAL-CS-001-rev.03 Document Revised: 26OCT2015 Page 1 of 2 Issuing Authority: Pace Huntersville Qualltv Office Emu Client Name: Project V. I� 0 fj2 �5574 Courier: _ ❑Fell Ex ❑UPS CUSPS }Clientf��f ❑CommerOal ❑Pace ❑Other: 92285574 Custody Seal on Cooler/fox Present? Dyes VNo Seals Intact? ❑Yes !"No Packing MaterWI: ❑Bubble Wrap []Bubble Bags None ❑Other: l Thermometer IRGunSN_J22065387 Used: iR Gun 5N: 121065371 Type of Ice- .- - Vwet []Blue ❑None []Samples on ice, cooling process has begun Cooler Temp Corrected ('C). y Biological Tissue Frozen? []Yes E]No �/A Tempshould be above fr ezing to 61C Correction Factor: 0.0 °C Date and Initials of Person Examining Contents: 215 1 t Q USDA Regulated Soil (X/A, water sample) Did samples a iginate in a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (International1 , [)Yes VJNo including Hawaii and Pueno Rlco)? Eyes aNa If Yes to either question, fill out a Regulated.Soll Checklist and include with SCUR/COC paperwork. COMMENTS: Chain of Custody Present? Yes QN0 ❑N/A 1. Chain of Custody Filled Out? Yes ❑No Q NIA 2. Chain of Custody Relinquished? Yes ❑Ho ❑kq/q 3. Sampler Name and/or Signature on COC? Yes QNa UNIA, 4. Samples Arrived within Hold Time? 6Yes QNo ❑N/A S. Short Hold Time Analysis (<72 hr)? ❑Yes 0190 N/A 6. Rush Tom Around Time Requested? Dyes No ❑N/A 7. Sufficient Volume? L&es ❑No NIA' 9, Correct Containers Used? Yes (3No ❑N/A 9. -Pace Contalners Used? Yes []NO ❑NIA Containers Intact? Yes No N/A 10. Flitered Volume Received for Dissolved Tests? ❑Yes No N/A Ia. Note if sedlmdnt is visible in the dissolved container Sample Labels Match COC? 0Yes C]No (]N/A 12. -Includes DatetFime/ID/Anal sis Matrix; All containers needing acid/base preservation have been checked? )Yes (]No ❑NJA 13 All containers needing preservation are found to be in compliance with EPA recommendation? (HNO3, lirSOa, HCl<2; NaOH >9 Sulfide, NaOH>12 Cyanide) Yes ❑No []N/A Exceptions: VOA, Coliform, TOC, oil and Grease, DRO/8015 (water) OOC,LLH es ❑No ❑N/A Samples checked for dechlorization Yes []No ❑NIA 14. Headspace in VOA Vials (>5-6mm)? ❑Yes ONO /A 15. Trip Blank Present? []Yes ❑No NIA 16, Trip Blank Custody Seals Present? ❑Yes 4No N/A Pace Trip Blank Lot H (if purchased): CLIENT NOTIFICATION/RESOLUTION Person Contacted: Date/Tn-ne; Comments/Resolution: Field Data Required? ❑Yes M.No, Protect Manager SCURF Review: C 4y `�� nnr• C. Note: Whenever there is a discrepancy affecting North Carolina compklance samplies, a copy of thrs form will be sent to the No hold, Incorrect preservattve, out of temp, incorrect containers), Carolina DEHNR Certliication Office (i.e. out of Page 8 of 9 �-� CHAIN -OF -CUSTODY 1 Analytical Request Document T -Pa The Chain-cf-Cuslody a LEGAL BOCUMENT. All rolevini fiRlds, mw;i by comalutod �ratt;ly'.rM v .paratab com Pa qe of Section A Section Q Section C Required Ulant Informaoon- Required Project hafwmogon: Invoice Iniercnntlon: Ctmt w": Aue (pitt ale Roporl To: Attention: 2056 301 Address: r n Copy V p To: Company Name: REGIILATOl2Y AGENCY, ' . , 4 �Z AadTBSs NPDES = GROUND WATER r- DRINKING WATER j UST i RCRA OTHER Elrall To: '' a w .�I, - rcitasa Orger No.: l r RNA" P !� tl ...} Fax; Project Name; � pmio = Location N-Tqs G6 I�����. Mnnherr, ,Site STAIF-- ReQuaated Qua DatofTAT: Prolgat Number. Pax Ridge k �{ { 1 Requested Analysis Filtered (YIN) Soction D MatTM Codes z R.q.lrod CUw t Inkm+weon fJATRLK rnnr m COLLECTED PrUServarivas >. _ ' ❑rick in3 Viakr IIW O z O Water WT Waste Wale. WW CWPO:ITE 't'r"r CUur rk EN1CRnB V W Product P Saillsdid SL =' L n (,, u SAMPLE ID W pa w, AR w Ll a Z wNr D Sampla IN MUST BE UNIQUE. Tissue TS p r L otnor oT X U W 0 � a, o 21 � It O o ti ll. O Q UZ (a C1 7S CA h DATE 1761E b:l7E TIME z Z Z `L O ,.QCD e x Pace Proj©ct NoJ Lab U )- 1 ti �J 3 6 S 8 7 8 9 10 11 ,z - ADDMONALCOMMENTS RELINQUISHED BY i AFFILIATION DATE TIME AC T B f FFIiJF It) TIME SAMPLE CONDRIONS cc. z TEb SAMPLER NAME AND SIGNATURE ORIGINAL s - PRINT Maimo15AMPLI=R: n E SIGNATURE SAMPLER: DATE Signed } ,�F. of -Imponant tJam: W :r ,nB tnh. rum v,w--ct4)ln,g Paen': n1F_7,13 day pay,mni i n+x Nnd u9too;i ] ti, LT—iwnla., t,r I r1l. 1— mono, r,r/.y v.V� not Pala VXhin JO aal;s F�ALL,O-020iov.07, 1 rblay-2007 aceAnalytical www.pacelabs.com Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704 )875-9092 Project: BUTNER #13 Pace Project No.: 92285574 Eden Certification [Ds 205 East Meadow Road Suite A. Eden, NC 27288 North Carolina Drinking Water Certification #: 37738 CERTIFICATIONS North Carolina Wastewater Certification #: 633 VirginiafVELAP Certification #: 460025 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 2 of 9 aceAnalylcal WWW'pacefab5.cw Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704 )875-9092 SAMPLE ANALYTE COUNT Project: BUTNER #13 Pace Project No.: 92285574 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92285574001 PLANT #13 OUTFALL #1 SM 2540D DWJ 1 PASI-E 92285574002 PLANT #13 OUTFALL #2 SM 2540D DWJ 1 PASI-E REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 3 of 9 STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCG14� FACILITY NAME: L71� k� _ 4-1 ri PERSON COLLECTING SAMPLES CERTIFIED LABORATORY Lab #1 CI r_ Lab It OPTIONAL INFO: Part A: Stormwater Monitoring Requirements SAMPLE COLLECTION YEAR: La I (a SAMPLING PERIOD: ❑ July -December January -June COUNTY Cyir 'i1 PHONE NO. (q 7s ` 4 3 1 i ADD TO LISTSERVE? ❑YES ❑NO EMAIL: - DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other Outfall No. Date Sample Collected (mo/dd/yrOR NO FLOW} pH (Standard Units) TSS (mg/LI Event Duration (minutes) Total Rainfall (in) In Tier 2 Monthly Monitoring? (y/n) # of Months in Tier 25ampfing r - '2 Itj !A2 r OFF .r' 1 %+ 'L l7 r'S ' If "NO FLOW" or 'NO DISCHARGE, Enter "NO FLOW" or "No DISCHARGE" for each outfall here. Please make sure to mark the sample period above. 'If a value is In excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses In the General Permit, Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range. 9 TSS benchmark values are 100 mg/I, except when discharging to ORW, HOW, Trout, and PNA waters where they are 50 mg/I. `For each sampled measurable storm event the total prec=pitation must be recorded using data from an an -site rain gauge. Permit Date: 7/112011-60/30/2015 I Last Revised 7/13/11 Page 1 of 2 Part B: Vehicle Maintenance Activrtv Monitorine Reouirements for facilities urine > 55 eat of new motor oillmanth — avera¢ed over a calendar vear Outfall No. Date Sample mo dd r' (/ Collected } PH {Standard Units) TPH vslnp method 1664A 5GT--HEM (m 1} B/ Total Solids (m L g/) Event Duration (minutes) { Total Rainfall' (in) ) New Motor Oil Usage a1 month (g / ) In Tier 2 Monthly Mo(y/n)ng? n of Months in Tier 2 Sam tin P � 6-s 15 1 I HAS YOUR FACILITY HAD c OR MORE BENCHMARK EXCEEDEN T ANY ONE OUTFALL IINCLUWNG VEHICLE MAINTENANCE)? YES [:]No 12r_ HAVE YOU CONTACTED THE REGION? YES ❑ NO REGIONAL OFFICE CONTACT NAME Mail Original and one copy ofthis DMR inclu in all "No Flow" & "No Discharge" reportsreportsl within 30 days of receipt of sample for at end of monitoring period in case of "No Flow") to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1G17 YOU MUST SIGN THIS CERTIFICATION fQft ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or Supervision in accordance with a system designed to assure that gvalified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible For gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that Cher a rig ficant pe alties for submitting false information, induding the possibility of fines and imprisonment for knowing violations." /�->- 311111j, (Signature oritiffe) (Date) Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 2 of 2 T�I r�r ; ��'�iTf Y nlSCfl,f';Gi (7lIlF,�LL (5[C?� - SrZ�l-L�1.11Z� .li Cr+, IOO f",II IGn GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO.`INCG14 D1 FACILITY NAME: P�e' PERSON COLLECTING SAMPLES `l CERTIFIED LABORATORY Lab # _ q f Lab # OPTIONAL INFO: Part A: Stormwater Monitoring Requirements SAMPLE COLLECTION-Y.EA�R: _ ZQ ) y l SAMPLING PERIOD: fy-Decernber January -tune COUNTY rjj i ) I'e PHONE NO, 575 - Lf5Sd ADD TO LISTSERVE? AYES ❑NO EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout []Other Outfall No. Date Sample Collected (mo/dd/yr OR NO FLOW)1 pH (Standard Units) yS5 (mg/L) Cvent Duration (minutes) Total Rainfa114 (in) In Tier 2 Monthly Monitoring? (V/n) # of Months in Tier 2 Sampling2 - - 6-92 100Z'3 - - - I 10115 bg P, Z_ qq,D q zo To N NOVREG 1 DWR SECT 1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above. Z if a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range. 3 TSS benchmark values are 100 mg/l, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I. For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge. 'ED 014 LES ON Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 1 of 2 Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year. Qutfall No. Date Sample Collected 1 (mo/dd/yr) PH (Standard Units) TPH using method 1664A SGT-1-fEl1R (mg/L) Total Suspended Solids (mg/L) Event Duration (minutes) Total Rainfalla (in) New Motor Oil Usage (gal/month) In InTier# 2 Tier Monthly Monitoring? Wh) of Months in Tier 2 gamplingz 6-9Z 15z 1002,3 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES []NO HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail Original and one copy of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period in case of "No Flow") to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that th re are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature ' er tee) (Date) Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 2 of 2 AQ= .� NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out thisform, please visit: httn://portal.nccienr.Qrg web/wgjwsZsLi/nodessw#tab-4 Permit No.: N/C/_/_/_/_/_/_/_/ or Certificate of Coverage No.: N/C/G///Y/O/ J / Z/$/ Facility Name: floi%t 13 lRv4gier , Wt County: GiQrtl i the Phone No. Inspector: JA4 WAINUS Date of Inspection. e/ 1 Time of Inspection: 6 14 6 )km Total Event Precipitation (inches): 0 SO Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) R'O'Y—es ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureablestorm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (SignatuA oWermittee or Designee) Page 1 of 2 SWU-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. Structure (pip , ditc! tc.) Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: ffj'l m;ierJ(odue-te Playt4 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Cl1gr 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weals chlorine odor, etc.): M60-C 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: ® 2 3 4 5 S. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: © 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 6) 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes Q S. Is there an oil sheen in the stormwater discharge? Yes V 9. Is there evidence of erosion or deposition at the outfall? Yes DN 10. Other Obvious Indicators of Stormwater Pollution: List and describe Nblt fG Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242, Last modified 10/25/2012 % 13 c6Analytical wwwpacelabs.com Laboratory Report Jay Watkins Ready Mix Concrete PO Box 27326 Raleigh, NC 27611 Project: PLANT #13 BUTNER NC Pace Project No.: 92221759 PaceAnalytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Page 1 of 1 Report Date: 10/31/2014 Date Received: 10/16/2014 Sample: OUTFALL #11PLANT 13 Lab ID: 92221759001 Collected: 10/15/14 06:45 Matrix: Water Parameters Results Units Report Limit Analyzed Qualifiers Total Suspended Solids ".0 mg/L 16.7 10/22114 09:59 Reviewed by:�— Laura J Cooper laura.cooper@pacelabs.com Raleigh Certification IDs 6701 Conference Drive, Raleigh, NC 27607 North Carolina Wastewater Certification M 67 North Carolina Bioassay Certification #: 16 North Carolina Drinking Water Certification #: 37731 Page 1 of 3 /ry �_�PdG9.4fT�i lCal+ rw,wN•pnaA.n ..�... ' Document Name:°Sample Coridltlon Upon Receipt SCU.R Document Revised: April 04', 2gl'i;` P8 e 1 of 2 ' Document No. F-RAL-CS-0014ev.02 issuing Authorities:....:,..... Pace Asheville QuallicY Oftice' Client -Name: Where Received: Huntersville Asheville Eden /*Raleigh Courier (CITCls): Fed Ex UPS LISPS le Commercial Paco . Other _ Custody Seal on CoolerfSox Present: Q Yea no Seals.intact: /yes no. - Pai kind h9ateriaf: D Btibbla Wrap' (] Bubble Stags None Other--- Circle Thermometer Used:.ifd Gun SN:11206fi7 type of Ice: Blue None [] Samples on Ice, cooling procese.has•tiegup IR Gun Bask Up SN:122066371 F Temp Correction Factor: Add ! Su r ct rq 6. C Data and Init€a1a of person cxamintng CorrQcted CoolarTemp.: C Blologleal Tissue is Frozen; yes No rA contents f Fr a ad n chectr Temp. should �o above freezing to e'C Comments: Chain of Custody Present: Yes Ma ONIA 4. Chain of Custody -Filled Out:�21qs ONo 091A 2, Chain of Custody Relln Ulshsd: es ONO OVA 3. Sampler Name & SI nature on COC: es ONo ONIA 4.. Sam pies Arrived within Hold Time: ee 'Mo UWA 5, Short Hold Time Anal als <T2h : C1Yea ©WA 6. Rush Tum Around Time Requested: ayes qk ONlA 7. Sufficient Volume: ley. ONO ONIN 8. Correet Containers Used: , j]" ONO ONix 9. ' '-'Pace Containers Used: s Oko EJNiA- Containers Intact: ee ONo ❑NfA 10, Filtered volume -received for Dissolved tests ( Yes ONo 01A 11, Sumple Labels match COC: eyes Qi o 0WA 12. -Includes dateAlmoAD/Ana1 is Matrix: All containers needing preauvatlon have been checked. es TINo ©N!A T 13. All bontalners needing pret mollan are found to be Ink. RZn ©Na ONlA oornpltarnco Wth EPA recommendation. - : exco :Ions, y2A. voilrvrm, TOG, od.G, MORO os ONO .. Samples checked for dechlorination: ❑Yes ONo wA 14. Heads ace lri VOA Vials T6mm :" OYos ❑t•:o OVA 16. Trip Blank Present: E7Ye's. CJNo r1WA 16. Trip Blank Custody Seals Present ❑ roe ON* 111r/A Face Trip Blank Lot # if purchaseft Client Notlficafford Resolution: Field Date Requited? Y ;1. : N` t i PersarrContactedr 'Date/Time., Cornmenfs/ Resolution: .:•: I; l SCURF.ISRF to: 92�22` Review.. U00119 T� 7 ,- ; g;, •tfFl�l - 5- 1 Note: W Whenever there Is a disaepancy atiodng North Carolina cornpUne ae 1]jFFF ,1!'!IgIIIII[[ff■1■■■■ lliw�l�a IjIjII]ji1ilI IlErE aemptes, a copy of this form W11 be sent to the North Carolina DFHNR Certification offics (l.e out of hold. Incorrect out of tamp, '�I -#922Z 11f[e[e1 tI7E�9a " .• s preservaWe, s x 16correrd conielners) Page 2 of 3:L • -, REGULATORYAGENCY .: RCRA DRWINGWATER OTHER w• r WON virr SAMPLE rMAhSlavic 105 MUST es UM rmulf VS ' ABM ou?w or • .' 5��'Jl:isiiX��1'JI���L•.,Wii:f:'��■■■�■■■■■■■■ !:■■■■■■■■■■■■ f► • ADDmm%iJ . Com"MENT6 RIUMCMiW Erf l XvnU nm DATE Tlm ACCEPTED BY lAFFtLLt DATE Tt1lE SARtFLE CONBRSDNS SAAWLER NAUE AND SIGNATURE u ©RIG1RlAL.. ' - bc� = PRJNT N•m• o: SAMPLEiC f s r ,�z •. d 3.8.E •`-!' '_' . _ _ ---- : DA;E5igntQi,= / ;! +` y°. 1 c I V -n- I �r_m�:"''-.;:._ r �: r• t - SIGNATUREa1SARPi`R[/ r ... - •. .. hA .{INMn3Bfr rf: 'Lnm�a`y Nr .P.v nnn.,n:ni. f�n�wv.n.a.rw�:..nP..�.N^11�w..��...................n,............w �r. w...:......1..cr -.-. n.w.,.:. .....-.�...��.. �+..�.»... ._. .. .. .... ._. _.. _._ .e ..............i __._ .. i.:l..... C.61.f�C.1�a7f+w...M.. Y,441-a.ti��fl7_. .-.. .... .-.. e DECEIVED RCDENR APR o 1 2014 Stormwater Discharge ®utfall (SDO) CENTRAL FILES Qualitative Monitoring Report DWQ/BOG Forguidance on filling out this form, please visit: htrl?: / ,1rt,I,: rct1w�I Permit No.: N/C/_/_/_/_/_/_/_/ or Certificate of Coverage No.: N%C/CG-/1/ -Y/O / i Facility Name: Pla.,j 13 13u4r,,i- �^ County: Phone No. 911?-S-75'- 14390 Inspector: Date of Inspection: 2111jm _ ,• Time of Inspection: 1:46 ow, Total Event Precipitation (inclies): • Z!� Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) [Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event." or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. i i A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. A "measurable storm event" is a storm event that results in an actual discharge from the I permitted site outfall. The previous measurable storm event Crust have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or Designee) Pagel of 2 5W U-242, Last modified 10/25/20I2 1. Ootfall Description: Outfall No. I Structure (pipe, ltc , etc.) Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint {light, medium, dark) as descriptors: 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weals chlorine odor, etc.): 06 4, Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and S is very cloudy: 0 2 3 4 5 S. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 0 2 3 4 5 G. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 3 is no solids and 5 is extremely muddy: 2 3 4- 5 7. Is there any foam in the stormwater discharge? Yes 0 8. Is there an oil sheen in the stormwater discharge? Yes to 9. Is there evidence of erosion or deposition at the outfall? Yes Vo 10. Other Obvious Indicators of Stormwater Pollution: List and describe M0-11- Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SwU-242, LaAmodified 10/25/2012 STORMWATER DISCHARGE OUTFALL (S®O) - Semi -Annual MONITORING FORM GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCG14 4 1 a+ SAMPLE COLLECTION YEAR: 2-019 FACILITY NAME la., la SAMPLING PERIOD: ❑ July -December 0 January -June PERSON COLLECTING SAMPLES IM4 �„ _ _ _ COUNTY - CERTIFIED LABORATORY Lab # q j PHONE NO. (90 )�T-7S-g3T6 Lab # ADD TO LISTSERVE? ❑YES []NO EMAIL: OPTIONAL INFO: DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other, Part A: Stormwater Monitoring Requirements Outfall No. Date Sample Collected (mo/dd/yr OR NO FLOW)1 pH (standard Units) TSS (mg/L) Event Duration (minutes) Total 4 Rainfall (in) In Tier 2 Monthly Monitoring? n (y/ ) # of Months in Tier 2 Samplingz - 6-92 1002,3 - - - - I LI Y.yv 1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above. 2 If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range. 3 TS5 benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l. 4 For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge. Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 1 of 2 Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year Outfali No. Date Sample Collected (mo/dd/yr}1 pH (Standard Units) TPH using method 1664A SGT-HEM [mg/L] Total Suspended Solids (mg/L) Event Duration (minutes) Total Rainfalla (in) New Motor Oil Usage (gal/month) In InTier# Z Tier Monthly Monitoring? Wri) of Months in Tier 2 Sampling z 6-92 152 1002'3 - - - - - HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO +� HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail Original and one copy of this DMR(including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample or at end of monitoring period in case of "No Flow") to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED. "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance With a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature s&� rmittee) ?./17 /_IV (Date) Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 2 of 2 aceAnalytical www.paculabs.com MD Capps Ready Mix Concrete PO Box 27326 Raleigh, NC 27611 Project: PLANTS #13 Pace Project No.: 92193589 Sample: OUTFALL 1 Parameters Total Suspended Solids Reviewed by: NikitRa Jones -Jackson nikitia.jones@ pacel abs. cam Laboratory Report Pace Analytical Services, Inc. 9800 KinceyAve. Suite 100 Huntersvilte, NC 28078 (704)875-9092 Page 1 of 1 Report Date: 03/25/2014 Date Received: 03/18/2014 Lab ID: 92193589001 Collected: 03/17/14 13:41 Matrix: Water Results Units Report Limit Analyzed Qualifiers 4.1 mglL 2.5 0312211411:37 Asheville Certification IDs 2225 Riverside Dr., Asheville, NC 28804 FloridalNELAP Certification #: E87648 Massachusetts Certification #: M-NCO30 North Carolina Drinking Water Certification #: 37712 North Carolina Wastewater Certification #: 40 South Carolina Certification #: 99030001 West Virginia Certification #: 356 Vrginia/VELAP Certification #: 460222 Page 1 of 3 0 aceAnalytical Report Results to: Ready Mixed Concrete P.O.Box 27326 Raleigh, NC 27611 )4fJ)C4pPS ATTN: Phone-, 919-790-1520 Chain.of CustpAi Results to: Ready Mixed Concrete P.O.Box 27326 Raleigh, NC 27611 a43 MfAk-,-5 ATTN: JQWA liakiliwn EIrstandard Report Delivery Rush Report Delivery (w/ surcharge) Requested Due Date: Project Reference: Plants #113 Purchase Order Sampled By: Relinquished Document Name; Sample Condition Upon Document Revised: April 44, 2Q13 Analytical' lr '" wr.w,nnonrpns co,n Receipt SCUR Page 1 oft Document No.: Issuing AUtllOrltles. F- l -CS- 01-rev.02 Pace Asheville Quality Office Client Name:{ Where Received: Hunters viile [j Ash Eden " Raleigh. Courier (Circle): Pad f x UPS LISPS Client Commercial Pace , Other Custody Seal on Cooler/Box Present: D yes no Seals intact: yes [] no Packing Material: Bubble Wrap }a Bags Nor Other Circle Thermometer Used: (R Gu SN:1z2485387Type of Ice: Wet Blue None Samples on Ice, cooling process has begun IR Gun B 71 Temp Correction Factor: Add I �tract r C Date anti Initials of person examining' Corrected Cooler Temp.: C Biological Tissue'is Frozen: Yes No NSA CC t s Pr o Chock. Temp should be.above freezing to,6°•C Comments: Chain of Castody Present:. _ _... es -[]No CIN1A- 1-. — :: :. . . ... ....... ... :.. Chain of Custody Filled Out: Yes ON. ❑WA 2. ' Chain of.Custody Relinquished: Yes ONO ❑NIA 3. Sampler Name & Signature on COC: Yes ❑No ❑wA 4. Samples Arrived within'Hold Time: Yes •ONo ❑WA 5'.. Short Hold Time -Analysis <72hr : Dyes VN. ONIA 6. Rush. Turn Around Time Requested: ❑Yes No 6N1A 7. Sufficient Volume: VY9. ©No ONIA 8. Correct Containers Used: -Pace Containers Used: as ONO / Yes' DNo ❑N/A C]NIA 9. ' Containers Intact: es ©No ❑NIA 10. Filtered volume -received for.' Dissolved tests ❑Yns ONO VA 11. Sample Labels match COC: -Includes date/time/ID/Analysis Matrix: l Yes A'o El NIA 12, All containers needing preservation have been checked. All containers needing preservation are found to be in compliance ► ith EPA recommendation. exceptions: yOA, rmliferm, TOG, O&G, WI-DRO (water) ONO Yes Elko Yes ONo Otd1A ❑NIA 13. Samples checked for dechlerination: oes ❑No ❑NIA 14. Headspace in VOA Vials ( >6mm : ❑Yes ❑No 116NIA 15, Trip Blank Present:. Trip Blank Custody Seals Present Pace Trip Blank Lot # (if purchased): ❑Yes ©No ©Yes ©No NrA VNIA 16. Client Notificatlonl Resolution: Field Data Required? Y I N Person Contacted: Date/Tlme: Comman{sl Resolution., SCURF 15RF^ Date: Place label here Review:: 1 1�-A- Note: whenever there is a discrepancy affecting North Carolina compli nce samples, a copy of this form will be sent to the North Carolina DUHNP Certification -office j i.e out of hold, incorrect preservative, out of temp, incorrect containers) ;[c3