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HomeMy WebLinkAboutNCG140215_MONITORING INFO_20190808STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. G aI5 DOC TYPE ❑ HISTORICAL FILE MONITORING REPORTS DOC DATE ❑ �� / 000 YYYYM M DD STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM GENERAL PERMIT NO. NCG140000 CERTIFICATE OF C 0.V,ERAGE NO. NCG14 0 A ) .S FACILITY NAME: PERSON COLLECTING SA PLES ea CERTIFIED LABORATORY e*( - 4ab k Nr;- -25LI OPTIONAL INFO: Part A: Stormwater Monitoring Requirements SAMPLE COLLECTION YEAR: SAMPLING PERIOD: D Jul� December [•January -June COUNTY C�u: I zoa PHONE NO. (It3 V) r7`�-S ADD TO LISTSERVE? ❑YES ❑NO 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/L) Event Duration - (minutes) Total i Rainfall (in) In Tier 2 Monthly Monitoring? (y/n) p of Months in Tier 2 Samplingr - - 6-92 10023- 1 - n r-ta lCi i Rtl>i�r 171% !vr.. nlf 052019 08 2019 it NO FLOW or NO uuLHARGE, 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. ' 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 precipitation must be recorded using data from an on -site rain gauge. Permit Date: 7/1/2011-60/3D/2015 Date of last pH meter calibration: E -)o'r -1 j 'Last Revised 7/13/11 Page 1 of 2 Part B: Vehicle Maintenance Activity Monitoring .,....,_:�:.:__ - Outfall No. Date Sam Sample Collected (mo/dd/yr)' -------�--•+-••-••-••�- pH (Standard Units) TPH using method 1664A SGT-HEM (mg/L) •�• •_�•::�_=•:e > Total Suspended Solids (mg/L) » ga. or new motor Event Duration (minutes) mi/month —averaged Total 4 Rainfall (in) over a calendar New Motor Oil usage g (gal/month} year. In Tier 2 Monthly Monitoring? (y/n) # in Tier 2hs Sin Tier 6-915 100 _ 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: 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 si 'ficant penaltie submitting false information, including the possibility of fines and imprisonment for knowing violations." (signature ermittee) (Date) Permit Date: 7/1/2011-60/30/201S ' Last Revised 7/13/11 Page 2 of 2 GENERAL PERMIT NO. NICG240000 CERTMCAT.E OF COVERAGE NO. NC614 D A FACILITY NAME: — PERSON COLLECTING SAMPLES: lot. +tir9� _I� CERTIFIED LADORATORY��aSaE I Lab p / - 34 Lab k LIMIT VIOLATIONS? YES ❑ NO N Part A: Wastewater Monitoring Requirements SAMPLE COLLECTION YEAR: SAMPLE QUARTER: ❑! I -Sept -]Oct -Dec ❑Jan-MareF COUNTY: Guy �o PRONE NO. (?3l. ADD TO LISTSERVE? ❑YES []NO EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQ+A( ❑PNA ❑Trout OPTIONAL INFO: gApril-June ❑Other Outfall No. Date Sample Collected' (mm/dd/yr) Type of Wastewater VE, RM, MD)' ( j pH (standard) Total Suspended Solids (ni Settleable Solids (ri TPH using method 1664A SGT-HEM' (mg/LI Discharge Duration (minutes) Total Flow (gallons/day)' - _ 6-4a. 303,5 53- nv r� $. <5 �o•t .V A yo 7 I ij wdstewa ter systems have not aiscnargeo in to is quarter - report No Plowor "No Discharge" here. Please make sure to mark the sample quarter above. ' Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material stockpiles (RNI), Mixing Drum Cleanout (MD).. Reportmore than one type if the waste -stream is commingled. ' 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 are6-9S.U. for wastewater discharges to freshwaters, and 6.8-8.5 S.U. for discharges to saltwaters. i Tss limits are 20 mg/L for wastewater discharges to HQW 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 Date of last pH meter calibration: e 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 HOW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A NCAC 02B .0224. Permittees who discharge wastewater to HQW 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") 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 (919)807-6379 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: I certify, under penaltyof late, 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." T g-ID 6-i 9 (Date) i Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 2 of 2 RIESEARCh & ANAyirkA o��LAbORAmRiIESP INCo t For: Ready Mixed Concrete Cc (ARGOS) 1491 Brookford Road Kernersville, NC Attn: Danny Rathbone Client Sample ID: 6238-2 Site: Ready Mixed Concrete -Argos Parameter Method pH SM 4500 H+B-2000 Settleable Matter SM 2540 F-1997 Total Suspended Solids JSS) SM 2540 0-1997 Report of Analysis 6/18/2019 :to NC 934 Z • NC t137701 Lab Sample ID: Collection Date: 68028-01 6/12/2019 18:30 Result Units Rea Limit Analyst Analysis Date/Time 8.1 Std. Units 6/12/2019 1830 <0.1 ml/I 0.1 AW 6/13/2019 1300 <5 mg/L 5 AW 6/17/2019 Client Sample ID: 6238-1 Lab Sample ID: 68028.02 Site: Ready Mixed Concrete -Argos Collection Date: 6/12/2019 18:30 Parameter Method Result Units Rep Limit Analyst Analysis Date/Time pH SM 4500 H+g-2000 7.6 Std. Units 6/72/2019 1830 Total Suspended Solids JSS) SM 2540 D-1997 <5 mg/L 5 AW 6/17/2019 NA = not onalyzed P.O. Box 473 106 Short Street Kernersville. North Carolina 27284 Tel: 336-99G-28a1 Fax: 336-996-0326 www,randalabs.com Page 1 rat coa_basic_v Id RFSEARCh & ANAIYACAI LA{ o i DRIES, INC. Analytical / Process Consultations Phone (336) 996-2841 CHAIN OF CUSTODY RECORD I WATER I WASTEWATER I MISC. I COMPAN ^ JOB NO. LLD m� yo` �Qm=O y0`JcdgU�mQ�mip�m,?a �� P \�ti0}moo p oo Op o aP= '� ti ti'� ro'� a �� h REQUESTED ANALYSIS STREETAD/D�RESS t �i(n PROJECT CITY, STATE, LP n D•.i.!-�S"i:Jl �:Y-IC (t( !+%/(-� / SAMPLER NAME (PLEASE .PRINT) \1 )nAItiI CONTACT PHONE ;;�� �� .I-J;iLiU\ 'Vl ,l(.-_��(���tIS'�..il� SAMPLER SIGNATU_R (' �- ,LC.�-L-�= SAWLE ISM (LAB USE OF.'LY) DATE TF'E 'GRAB C rats Cl v ma `E rcue•�o :aurae ,su vn — SAMPLE LOCATIOR I LD. OR 0 -) i 6 •ice' (,.3 :� /. ✓ .2.3 J - �� —/a_s cS RELINQUISHED BY ;" DATE' IME RECEIVED BY REMARKS: •7-G �7 SAMPLE TEMPERATURE AT RECEIPT �' i °C ��'u RELINQUISHED BY DATERIME RECEIVED BY PROCESS WASTEWATER — Quarterly Discharge Monitoring Report GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCG14 0 L -61- FACILITY NAME: I(�QahS 2.w1.I lh+X PERSON COLLECTING SAMPLES:-1�n—t/ 4 #.4 a-, CERTIFIED LABORATORY:fZenA rr.Sdc«+•..t•Iv-t'.ca4 Lab # At Nij Lab # LIMIT VIOLATIONS? YES ❑ NO SAMPLE COLLECTION YEAR: SAMPLE QUARTER: ❑Jul -Sept ❑Oct -Dec ❑Jan -March April -June COUNTY: FmL_e ` 4J, PHONE NO. (356 ) ADD TO LISTSERVE? OYES ONO EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other OPTIONAL INFO: 'artA: wastewater Outfall No. rvionnonng neq mfenicnu Date Sample Collet edl (mm/dd/yr) Type of Wastewater Y (VE, RM, MD)' H (standard) Total Suspended Solids (mg/L) Settleable Solids (mL/L) TPH using method 1664A S ,R-HEM, (mg/L) Discharge e Duration (minutes) Total Flow (gallons/day)' 6-93,4 303.5 53 (1S)s - 1 br. '7 ti GS Co.l N t¢ Lea -D 1 ' If wastewater systems have not discharged In this quarter— report "No Flowor - No uiscnarge nere. rieane ,td Re w 1.1o11 1 �or� y....• ..-•-•-•---• ' Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum Cleanout (MD). Report more than one type if the waste -stream is commingled. ' 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 HQW waters, 10 mg/L for Trout and PNA waters, and 30 mg/L for all other water classifications...c Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 1 of 2 s 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 to 50% of the Summer 7Q10 Flow as per 15A NCAC 028 .0224. Permittees who discharge wastewater to HQW 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. Division of Water Quality` Attn: DWQ Central Files t 1617 Mail Service Center - Raleigh, North Carolina 27699-1617 (919)807-6379 .i if " I certify, under penalty of la'w, 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 aresignificant penalties for submitting false information, Including the possibility of fines and imprisonment for knowing _ (Date) Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 2 of 2 PROCESS WASTEWATER — Quarterly Discharge Monitoring Report GENERAL PERMIT No. NCG140000 CERTIFICATE OF COVERAGE NO. NCG14 0 1 _6 FACILITYNAME: PERSON COLLECTING SAMPLES: CERTIFIED LABORATORYM•�l�y n+ DdcR�.ti f t'.ci 4 Lab # !J C • "',4 Lab # LIMIT VIOLATIONS? YES ❑ NO [� Part A• Wastewater Monitoring Requirements SAMPLE COLLECTION YEAR:62 O ( I - SAMPLE QUARTER: ❑J``ul11-ISIept ❑Oct -Dec ❑Jan -March - . April -June COUNTY: FcrZS 't-F�-s PHONE NO. (336 1 `7Bs`-hs 'ems ADD TO LISTSERVE? OYES ONO EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other OPTIONAL INFO: Outfall No. Date Sample Collected (mm/dd/yr) Type of Wastewater 2 (VE, RM, MD) PH (standard) Total Suspended Solids (mg/L) Settleable Solids (mL/L) TPH using method 1664A S (mg/L)4s (mg/L) Discharge Duration (minutes) Total Flow (gallons/day) - - - - 6-93< 303.s 53 (15)s - ( bt. l•y 45 co•I N r4 Ya 0-DI Oil i' If wastewater systems have not discharged in this quarter— report "No Flow" or "No Discharge' here. Please make sure to mark the sample quarter aoove. 2 Report the abbreviation for the type of Authorized Wastewater Discharges here: Vehicle and Equipment Cleaning (VE), Raw Material Stockpiles (RM), Mixing Drum Cleanout (MD). Report more than one type if the waste -stream is commingled. 3If 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 Cvastewater discharges to HQW 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 s Process wastewater discharges shall only be monitored for TPH when commingled with stormwa ter 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 HOW waters shall be set to 50% of the Summer 7Q10 Flow as per 15A NCAC 028 .0224. Permittees who discharge wastewater to HQW 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. h. Division of Water Qualit Attn: DWQ Central Files 1617 Mail Service Cente Raleigh, North Carolina (919)807-6379 "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 thaethere are significant penalties for submitting false Information, including the possibility of fines and imprisonment for knowing violations." (Signature of Permittee) (Date) V Permit Date: 7/1/2010-06/30/2015 Last Revised 07/13/11 Page 2 of 2 STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCG14 0 J_ FACILITY NAME: NZtN'S 7-,�- X)tt M. PERSON COLLECTING SAMPLES Zat/ fZcrFlbeo� CERTIFIED LABORATOR1�SeZkdl(a+nlyce»-ILab a lUL-3�1 OPTIONAL INFO: Part A: Stormwater Monitoring Requirements SAMPLE COLLECTION YEAR: O� 0 19 1 SAMPLING PERIOD: ❑ July -December January -June COUNTY FORS M PHONE NO. (134) 12S AS v'2S 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) T55 (mg/L) Even[ Duration (minutes) Total , Rainfall (in) In Tier 2 Monthly Monitoring? (y/n) q of Months in Tier 2 Samplingz - - 6-91 100 '' - - - 1 Db I= I "►•4 �S 4c I Ilk/ N 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. ' T5S benchmark values are 100 mg/I, except when discharging to ORW, HOW, Trout, and PNA waters where they are SO mg/I. 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 Date of last pH meter calibration: _%o — I a y� I Last Revised 7/13/11 Page 1 of 2 Part B: Vehicle Maintenance Activity Mnnim,ing ce—ire,......... s... Outfall No. Date Sample Collected (mo/dd/yr)' -• --�--- -- PH (Standard Units) - e ••-•,-••_ • _ •s TPH using method 1664ASGT--HEM (mg/L) �o� ,e=�e.�r, ,trig > Total Suspended Solids (rng/L) » gat m new motor Event Duration (minutes) of month - Total Rainfall° (in) averaged over a calendar New Motor Oil Usage (gal/month) year. In Tier 2 Monthly Monitoring? (y/n) a of Months in Tier 2 Sampling' - 1 HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANYONE 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 here are si�r submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signs ermittee) (Date) Permit Date: 7/l/2011-60/30/2015 Last Revised 7/13/11 Page 2 of 2 STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCG14 0 L __ je FACILITY NAME: PERSON COLLECTING SAMPLES JrWj.lt/ R�'F�b CERTIFIED LABORATORtIeYicA-ILabtt_JUL-3�J OPTIONAL INFO: Part A: Stormwater Monitoring Requirements SAMPLE COLLECTION YEAR: 01019 I SAMPLING PERIOD: ❑ July -December January -June COUNTY FORS Y I L1 PHONE NO. (3�) 7SS 7� f7S ADD TO USTSERVE? ❑YES ❑NO EMAIL: DISCHARGING TO CLASS: [:]SA ❑HQW ❑PNA ❑Trout ❑Other Ou[fall No. Date Sample Collected (mo/dd/yr OR NO FLOW)' pH (Standard Units) TSS (mg/L) Event Duration (minutes) Total Rainfall (in) In Tier 2 Monthly Monitoring? (y/n) III of Months in Tier 2Sampling = - 6-9' 1002" - - - 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. ' 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. ' 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 precipitation must be recorded using data from an on -site rain gauge. Permit Date: 7/1/2011-60/30/2015 Date of last pH meter calibration: Last Revised 7/13/11 Page 1 of 2 Part B: Vehicle Maintenance Outfall No. Date Sam Sample Collected (mo/dd/y�)' t --• ---- -- pH (Standard Units) • o ••� ,-^_ ^_^•� TPH using method 1664A SGT-HEM (mg/L) •_e�;n°�r� "'rig »> Total Suspended Solids (mg/L) gai of new motor Event Duration (minutes) oil/month—averaged Total Rainfall° (in) over a calendar New Motor Oil Usage (gal/month) year. In Tier 2 Monthly Monitoring. (y/n) # of Months in Tier2 Sam lie 2 P g 6-9 is 100, - I i HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES NO (Tg' HAVE YOU CONTACTED THE REGION? YES ONO 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 2A699-1617 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 here are si - icant a al s for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signs ermittee) ;° ! (Date) Permit Date:7/1/2011-60/30/2o1S Last Revised 7/13/11 Page 2 of 2 r RESEARCh & ANAIYTiW Report of Analysis LA ORAT®RkSr INCO 6/1812019 4�,,,, G�g AnHLyT For: Ready Mixed Concrete Cc (ARGOS) 1491 Brookford Road 11 `9 Kernersville, NC :m NC NCp3777701 i •: Attn: Danny Rathbone '•,• p� :�iq��0? Client Sample ID: 6239 W-1 Site: Ready Mixed Concrete -Argos Lab Sample ID: Collection Date: 68029-01 6/12/2019 19:00 Result 2niLs Rep Limit Analyst Analysis Date/Time Parameter Method SM 4500 H+g-2000 7.4 Sid Units 6/12/2019 1900 pH SM 2540 F-1997 40.1 mill 0.1 AW 6/.13/2019 1300 Settleable Matter Total Suspended Solids JSS) SM 2540 D-1997 <5 mg1L 5 AW 6/17/2019 Client Sample ID: 6239 S-1 Lab Sample ID: 68029-02 Site: Ready Mixed Concrete -Argos Collection Date: 6/12/2019 19:00 Parameter Method Result Units Rep Limit Analyst Analysis Daterrime pH SM 4500 H+B-2000 7.4 Std. Units 6/12/2019 1900 Total Suspended Solids JSS) SM 2540 D-1997 <5 mg/L 5 AW 6/17/2019 NA = not analyzed P.O. Box 473 106 Short Slreel Kernersville. North Carolina 27284 Tel: 336-996-2641 Fax: 336-996-0326 xnvw.randalabs.com Page 1 rat coa_basic_vld RE_SEARCN & ANA1yriCA1 LkORATORiES, INC. Analytical / Process Consultations Phone 1336) 996-2841 CHAIN OF CUSTODY RECORD WATER I WASTEWATER Il71S-c C014PAN r ,�� c I�e,?�� (�l, JOB NO. �+ o u LLo s 4 ep' o m V o�Fa� ohm pZ �F pP�\ \'��y. oby y� pW�a�O 2r0�`O}\pp pp��o'\pp�T?=per ems` O ¢ �0 ¢r o ¢. U poE of of ¢' p ¢' ¢' ¢' u `+' ry ry� ryh �� 6 REQUESTED ANALYSIS STREET ADDRESS / S-ql k 1 . ,i(,l SO I-/ � 1� ` O ` PROJECT (/_ V! %l�� CITY, STATE, ZIP (1 - Gam. }iS'i J) - �?'1-J'C 1�� /Y �`I�/L�A� SAMPLER NAME (PLEASE PRINT) � C (IN .L��\�.�•." CONTACT jj ZZ PHONE �/- J_Jd�l V \ l4 i' ' -]J` ��L1.5 ' ]-3 �� , SAMPLERSIGNATURE j \�_ /i/ ��-�✓� SAUPLE N (GBER (LAB USE ONLY) DATE TIM1�E GRAB Ei: ,C Itts eau avaar nve s.u'ti[ Rom SAMPLE LOCATION I LD. UZ�t O I !,. �� 'I fl+� X �.✓ (o.z3`� / T,1-L � �S SS RELINQUISHED BY DATEELME RECEIVED BY REMARKS: SAMPLE TEMPERATURE AT RECEIPTi S - 11 °C RELINQUISHED BY DATERIME RECEIVED BY