HomeMy WebLinkAboutNCG030659_MONITORING INFO_20191113STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
Iv L& eo 3 (i���/
DOC TYPE.
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ Ur I l 3
YYYYMMDD
- - Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030006
Date submitted 10/28/19
CERTIFICATE OF COVERAGE NO. NCG03 0 6 5 9
FACILITY NAME Matlab, Inc. -Hwy 49S Campus
COUNTY Randolph
PERSON COLLECTING SAMPLES Mitch Auman
LABORATORY Gon-test Lab Cert. # 652
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2019
SAMPLE.PERIOD ❑ Jan -June 0 July -Dec
or ❑ Monthly' (month)
RCnc�p-SCHARGINGTOCLASS ❑ORW ❑HQW ❑Trout ❑PNA
CC VED ❑Zero -flow ❑Water Supply ❑SA
NOV 13 2019 ❑other
CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 a
DWR SECTION
❑ No discharge this periodj2
Outfall No
'Date Sample
,,;Collected i'
:(mo/dd/yr).
24 hourramfall
-
amount
- In6hes3 -
- -
Total Suspended Solids -
.:
pH
.Standard units-
Total Copper
--
Total Lead
-
-
Total
-
,Non=Polar O&G/a
Total Petroleum
Hydrocarbons
,
'Total -Toxin`
:
Organics
'Benchmarks: -'
_
100mg/L or50'mg/L"
.6.0—.9.0 -
0.010 mg/L
:- 0.075. mg/L'n
0.126 mg/L_
' .15 mg/L
l mg/L
Parameter Code
:. -
46529 .
�. - C0530 .. - -
- 00400 -
01119,
01051- -
r' '01094
00552 '. - -
78141--
01
10/16/19
0.51
340
6.5
0.022
0.0069
0.061
0
N/A
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
"See General Permit, Section B, Table 1 to identify the especially sensitive receiving water classifications where the more protective benchmark applies.
5 Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 1 of 3
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
Press Brower
Name (Print name)
VP of Engineering
Title (Pri �y
\\ Signature Date _
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
n No dischome this period?2
Outfall No.
Date Sample Collected'
(mo/dd/yr). -
24 hour rainfall'amount
Inches3 -
.. New Motor Oil or
_Hydraulic OiLUsage:'Petroleum
- Non -Polar O&G/,Total;*.
Hydrocarbons
_ .Total. :Suspended,, -.
-Solids "
.Benchmarks
-
-
- - "-
i5,mg/L. _,
100 mg/L or 5o mg/0
-Parameter Code -
- - ""'
- 46529." ` ° -"
''''� - NCOIL
- 00552
C0530 - - -
Footnotes from Part A also apply to Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 2 of 3
FOR PART A AND PART B MONITORING RESULTS:
A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN AROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO 0
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original 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" reports) 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 enalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee
Permit Date: 11/1/2018-05/31/2021
Date
SWU-245, last revised 11/1/2018
Page 3 of 3
RAIN EVENT DATA
FACILITY: Matlab, Inc. — Hwy. 49 S Campus
ADDRESS: 1112 Highway 49 South
Asheboro, NC 27204
CONTACT PERSON: Press Bower TELEPHONE: 336- 629-4161
STORMIEVENT INFORMATION•'
YEAR
MONTH
DAY
DATE
2019
10
16
HOURS
MINUTES
DURATION
24
0
PRECIP.
AMOUNT (IN.)
.51"
RUNOFF
VOL. M/GAL.
0.33
HOURS
DAYS
PRECEDING
0
EVENT
3
?' :..d?'f.cFk
PRINCIPLE EXECUTIVE OFFICER OR AUTHORIZED AGENT e,
PRINT
SIGNATURE
DATE
Paul W. Spangenberg
10/16/19
43560 x 24 = 1045440 x 0.51 " = 533174.4 x 0.0833 = 44413.4 x 7.48 = 332212.4 / 100000 = 0.33
M/Gal.
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
Certification of Coverage No.:
Facility Name:
County:
Permit No: NCG03000
Matlab, Inc. — Hwy. 49S Campus
Randolph
Expires: 5/31/2021
Asheboro, North Carolina
Inspector Name:
Date of Inspection:
Jeremy Coble
10/16119
OUTFAILUDIESCRIPTION-
Outfall No.:
Structure (pipe, ditch, etc.):
Receiving Stream:
1
Pipe T
Taylor Creek
Describe the industrial activities that occur within the outfall drainage area:
Painting & Coating Manufacturing
C -
plo
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors:
Light Brown
--`—Oclor %
Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak chlorine odor, etc.):
None
Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy (circle one):
1 03 4 5 6 7 8 9 10
Floating Solds--,,
Choose the number which best describes the amount of floating solids in the stormwater discharge where 1 is no solids and 10 is
the surface is covered in floating solids (circle one):
1 3 4 5 6 7 8 9 10
�,Sus pended Solids'
Choose the number which best describes the amount of suspended solids in the stormwater discharge where 1 is no solids and 10
is extremely muddy (circle one):
1 2 4 5 6 7 8 9 10
i, Foam �',Ia:-
Is there any foam in the stormwater discharge (circle one)?: Yes
',:Oil Sheen . ... ..
Is there an oil sheen in the stormwater discharge (circle one)?: Yes No
Erosion Deposition,
Is there evidence of erosion or deposition at the outfall? (circle one): Yes No
If yes, list and describe:
Oth e r., Z
Is there other obvious indicators of stormwater pollution in the stormwater discharge (circle one): Yes No
If yes, list and describe:
Was this a Representative Storm Event? X Yes — No Total Event Precipitation (Inches h_.,5r
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.
—CertIficatIon"- 2
By this signature I certify that this report is accurate an i d complete to the best of my knowledge:
Inspector's Signature: psw—t�
STORMWATER FACILITY INSPECTION FORM
Facility Name:
Location:
Certification of Coverage No.:NCG030660
Matlab, Inc. — Hwy. 49 S campus
Asheboro, North Carolina
Expires: 5/31/2021
Number of
Inspector's Name:
Date:
Outfalls:
1
Jeremy Coble
10/16/19
:Con tin 'Areas-,'�. ,. ;......
Evidence of pollutants entering system (circle one): Yes No
If yes, describe:
Areas of potential pollutants entering system:
Describe: None
Control measures present (circle one): Yes No
If yes, describe:
Additional control measures needed (circle one): Yes No
If yes, describe:
Sediment and erosion control measures present (circle one): es No
If yes, describe:
Rip -Rap at discharge and drainages ditches
Describe any new structural stormwater management measures:
None
• ; - � ;: "..� PotentiaLPollutanYAreas- -- -• ' .:. .+ -'
Describe any loading/unloading operations:
Trucking, Tank Truck
Describe any outdoor storage activities:
Wood Pallets, Scrap Metal, Solid waste dumpsters, used equipment
Describe any outdoor manufacturing or processing activities:
None
Describe and dust or particulate generating areas:
None
Describe any onsite waste disposal activities:
None
SignificantV-ks'_or Spills,
Any reportable spills or leaks in the past year (circle one): Yes No
If yes, date: Impact on stor mwater system(s):
61' Certification ..
By this signature I certify that this report is accurate and complete to the best of my knowledge:
Inspectors Signature: lQGlt! �iQC
MATLAB, INC. — HWY. 49 S CAMPUS
ASHEBORO, NORTH CAROLINA
TIER I PERMIT COMPLIANCE INSPECTION
As required by General Stormwater Permit No. NCG030660, a compliance
evaluation was conducted on October 24, 2019 in response to the stormwater
analytical parameters exceedance. Present during the inspection were:
Paul W. Spangenberg Consultant, Director of Environmental Compliance
Jeremy Coble Plant 11 Manager
AREAS OF INSPECTIONS
1.) Areas where industrial activities are exposed to stormwater
a) Used equipment storage east of building 8. The
equipment was observed to be oil free. There was also
a closed top dumpster in this area. No evidence was
found of an impact to stormwater in this area.
b) Unloading/Loading Dock Areas: There was solid waste
dumpster at each building loading dock areas. The solid
waste was confined to the dumpsters and observed no
discharges. There were no signs of mismanagement of
regulated waste materials. The area was clean with no
staining.
c) Used wooden pallet storage east of building 8. The
pallets were observed to be oil free. There was also air
emission control equipment in this area. No evidence
was found of an impact to stormwater in this area.
Summary: With the exception of minor amounts of oil seepage from
the yard equipment, the following were not found during the
inspection:
a) leaks or spills from equipment, drums, barrels, or containers
b) off -site tracking of industrial materials
c) tracking or blowing of raw, final, or waste materials
d) evidence or, or the potential for, pollutants entering the drainage
system.
EVALUATION
2.) Analytical monitoring from Outfall 1 results from sampling
conducted on October 16, 2019 indicated the following
exceedances.
Date.
Parameters.
Copper
Parameters
TSS
3/21/19
0.0040
9.6
10/16/19
0.022
340
There is no apparent cause of the elevated copper levels. During the
inspection, the attempt to evaluate contributing factors of copper levels
were not found. No action related to the elevated copper level is
recommended at this time. The TSS exceedance were determined to
be erosion occurring in the drainage ditches between Plants 8 and 11.
However there was excavation activities accruing in close proximity
from the site. The drainage system managing the discharge is
common to the site.
3.) There are structural BMP's present at the facility. One retention
pond, and two collection basins, but no oil/water separators. Non-
structural BMP's include the minimization of outdoor storage, the
frequent disposal of accumulated wastes, and the elimination of
any oily wastes. These non-structural BMP's appear to be
adequate.
4.) The stormwater discharge outfall was inspected. There was
evidence of buildup of sediment and erosion preceding outfall was
observed. No other non-stormwater discharges were observed of
impacts at either of outfalls.
RECOMMENDATIONS
t) Schedule more frequent management of used equipment to minimize
the exposure to stormwater.
2) Implement erosion control preceding and proceeding outfall 1 discharge
point in the form of Rip -Rap to minimize erosion.
No evidence was found that the current SWPPP has any deficiencies. No
changes to the SWPPP are recommended at this time. All current initiatives
appear adequate to meet the goals of the SWPPP. Note that the SWPPP was
updated on 1 /1 /19, before the date that the inspection was conducted.
CERTIFICATION
This inspection did not reveal any violations of the permit. No areas of non-
compliance with the SWPPP were noted.
Certified by:
Name: ��ll� o'?Tprcry Date: MOOR
��� Title: �orat�re�froribrrrry.�`poc
Table of Contents
east Longmeadow, MH al UZb . hAX 41 JIo2J-04Vo -I tL. 41 Jlo2o-ZJJ2
October 24, 2019
Paul Spangenberg
Mid -Atlantic Associates, Inc. - Raleigh, NC
409 Rogers View Court
'•' Raleigh, NC 27610
Project Location: 49S Campus, Asheboro, NC
Client Job Number:
Project Number: R2943.10
Laboratory Work Order Number: 19J 1151
Enclosed are results of analyses for samples received by the laboratory on October 17, 2019. If you have any questions
concerning this report, please feel free to contact me.
Sincerely,
Kerry K. McGee
Project Manager
Page 1 of 14
Table of Contents
Table of Contents
Sample Summary
3
Case Narrative
4
Sample Results
5
'II 19J1151-01
5
Sample Preparation Infonnation
7
QC Data
8
Metals Analyses (Total)
8
B243664
8
Conventional Chemistry Parameters by EPA/APHA/SW-846 Methods (Total)
9
B243622
9
13243639
9
B243698
9
Flag/Qualifier Summary
10
Certifications
11
Chain of Custody/Sample Receipt
12
Page 2 of 14
Table of Contents
39 Spruce Street' East Longmeadow, MA 01028' FAX 413t525-6405' TEL. 4131525-2332
Mid -Atlantic Associates, Inc. - Raleigh, NC
409 Rogers View Court
Raleigh, NC 27610 PURCHASE ORDER NUMBER:
ATTN: Paul Spangcnbcrg
PROJECTNUMBER: R2943.10
ANALYTICAL SUMMARY
REPORT DATE: 10/24/2019
WORK ORDER NUMBER: 1911151
The results of analyses performed on the following samples submitted to the CON -TEST Analytical Laboratory are found in this report.
PROJECT LOCATION: 49S Campus, Asheboro, NC
I
FIELD SAMPLE k LAB ID: MATRIX SAMPLE DESCRIPTION TEST
1 19JI 151-01 Water EPA 1664E
SM21-22 2540D
SM21-22 4500 H B
S W-846 6020B
SUB LAB
Page 3 of 14
O
Table of Contents
CASE NARRATIVE SUMMARY
'All rcponed results arc within defined laboratory quality control objectives unless listed below or otherwise qualified in this repon.
Sh121-22 4500 H B
Qualifications:
11-05
4131525-2332
i Holding time was exceeded. pH analysis should be performed immediately at time of sampling. Nominal 15 minute holding time was
exceeded.
Analyze & Samples(s) Qualified:
pll
19Jll51-ol[[]
The results of analysts reported only relate to samples submitted to the Can -Test Analytical Laboratory for testing.
I certify that the analyses listed above, unless specifically listed as subcontracted, if any, were performed under my direction according to the approved methodologies listed
in this document, and that based upon my inquiry of those individuals immediately responsible for obtaining the information, the material contained in this report is, to the
best of my knowledge and belief, accurate and complete.
I 4't
Lisa A. Worthington
i' Technical Representative
Page 4 of 14
Table of Contents
it
39 Spruce Street' East Longmeadow, MA01026 *FAX 4131525-6405 * TEL. 4131525-2332
Project Location: 49S Campus, Asheboro, NC
Sample Description:
Rbrk Ordcr.
19J 1151
Dme Rcccwtd: 10/17/2019
Field Sample N: 1
Sampled: 10/16/2019 11:00
Somnlc ID: 19J1151-01
Sample Matrix: Water
Metals Analyses (Total)
Dale
Dale/Time
Acolyte
Results RI, DL Units Dilution Flag/Qual
Method
Prepared
Analyzed
Analyst
Copper
0.022 0.0010 0.00087 mg/L I
SW-8466020B
10/19/19
10/21/1913:20
QNW
Lead
0.0069 0.00050 0.000085 mg/L I
SW-8466020B
10/19/19
10/2111913:20
QNW
Zinc
0.061 0,010 0.0023 mg/L I
SW-SS466020B
10/19/19
10/21/1913:20
QNW
Page 5 of 14
Table of Contents
39 Spruce Street' East Longmeadow, MA 01028 *FAX 413/525-6405 * TEL. 4131525-2332
Project Location: 49S Campus, Asheboro, NC
Sample Description:
Work Ordev
19J1151
Dote Received: 10/17/2019
Fleld Sample N: 1
Sampled: 10/16/2019 11:00
Smnole lD: 19J 1151-01
Sample Matrix: Water
Conventional Chemistry Parameters by EPA/APHA/SW-Bab Methods (Total)
Data
Daterrime
Analyte
Results RL DL Units Dilution Flag/Qual Method
Prepared
Analyzed
Analyst
•,i PH@20.3-C
6.5 PH Units I H-05 SM21-22 45M 11 B
10/18/19
10/18/1920:35
MG2
Total Suspended Solids
340 6.2 2.6 mg/L I SM21-222540D
10/19/19
1011911917:20
LL
' Oil &Grcase(HEM)
ND 5.6 4.0 mg/L 1 EPA 1664B
10/21/19
10/21/1913:10
LL
Page 6 of 14
i
�ya+ur
�I
EPA 1664B
Lab Number [Field ID]
39 Spruce Street'
Sample Extraction Data
Batch Initial [mL] Dote
�1911151-01 [I]
B243698
250
10/21/19
it
SM21-22 2540D
Lab Number [Field IDI
Batch
Initial ImL]
Date
19J1151-01 [I]
B243639
80.0
10/19/19
SM21-22 4500 H B
Lab Number lField ID]
Batch
Initial lmLl
Dale
19J1151-01 [1]
B243622
50.0
10/19/19
Prep Moline: SSV-846 3005A-S W-846 6020B
Lab Number lField IDI
Batch
Initial[ml.l Final lmL]
Date
1911151-01 [11
B243664
50.0 50.0
10/19/19
t
Table of Contents
Page 7 of 14
Table of Contents
JU Jpruce teens - Lam 40m9meaoow, MA UI UZb - t'Ah 41J1b2b-Daub -I tL. 41 JISLb-ZJ3Z
QUALITI'CONTROL
Metals Analyses (Total) -Quality Control
Reporting Spike Source %REC RPD
Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes
Batch B243664 - SN'-846 3005A
Blank (B243664-BLKI)
Prepared:
10/19/19 Analyzed: 1021/19
Copper
ND
0.0010
mg/L
Lead
NO
0.00050
mg/L
Zinc
ND
0.010
mg/L
LCS(B243664-BSI)
Prepared:
l0/19/19 Analyzed: 10/21/19
Copper
109
OOIo
mg/L
1.00
109
80-120
Lead
0.541
00050
mg/L
0.500
108
80-120
Zinc
106
0.10
mg/L
1.00
106
80-120
LCS Dup (B243664-BSDI)
Prepared:
10119/19 Analyzed: 10/21/19
Copper
1.03
0.010
mg/L
1.00
103
80-120 5.76 20
Lead
0.513
0.0050
mg/L
0.500
103
80-120 5.40 20
Zinc
i
102
0.10
mg/L
1.00
102
80-120 4.30 20
Page 8 of 14
Table of Contents
39 Spruce Street' East Longmeadow, MA 01028' FAX 4131525-6405' TEL. 413/525-2332
QUALTI Y CONTROL
Conv cultural Chemistq Parameters by EPA/APHA/SN'-846 Methods (Total) - Qualiry Control
Reporting Spike Source %REC RPD
Analyte Result Limit Units Level Result %REC Limits RPD Limit Notes
Balch B243622 - SM21-22 4500 H B
LCS (B243622-BSI) Prepared &Analyzed: 10/21/19
PH 6,00 pH Units 6.00 100 90-110
Balch B243639 - SN121-22 2540D
Blank (B243639-BLKI) Prepared & Analyzed: 10/19/19
Total Suspended Solids ND 2.5 mg/L -
LCS (B243639-BSI) Prepared & Analyzed: 10/19/19
Total Suspended Solids 172 10 mg/L 200 86.0 57.64 18
Balch B243698- EPA 16MB
I'
Blonk(B243698-BLKI) Prepared & Analyzed: 10/21/19 ,
Oil & Grease (HEM)
ND
1.4 mg/L
Murk (R243698-RLK2)
Prepared & Analyzed: 1021/19
Oil & Grease (HEM)
NO
14 MO.
LCS (3243698-BS I)
Prepared & Analyzed: 1012 UI9
Oil &Grcasc(HEM)
20
met-
20.0 102 78-114
LCS (B243698-BS2)
Prepared & Analyzed: 10/21/19
Oil &Grc.,c(HEM)
170
mg/1-
200 85.5 78-114
Page 9 of 14
Table of Contents
39 Spruce Street' East Longmeadow, MA 01028' FAX 413/5
FLAGIQUALIFIER SU61\IARY
' QC result is outside ofestablished limits.
t Wide recovery limits established for difficult compound.
j Wide RPD limits established for difficult compound.
p Data exceeded client recommended or regulatory level
ND Not Detected
RL Reporting Limit is at the level ofquantitation (LOQ)
DL Detection Limit is the lower limit ofdoectien determined by the MDL study
MCL Maximum Contaminant Level
Percent recoveries and relative percent differences (RPDs) am determined by the software using values in the
calculation which have not been rounded.
No results have been blank subtracted unless specified in the case narrative section.
H-05 Holding time was exceeded. pit analysis should be performed immediately at time of sampling. Nominal 15
minute holding time was exceeded.
Page 10 of 14
Table of Contents
4131525-6405' TEL. 41
CERTIFICATIONS
l Certified Anal)ses included in skis Report
Analyse Certifications
EPA I664B in bitter
Oil & Grease (HEM) CT,MA,NIi,NY,RI,NC,ME,VA
SM21-222540D in 11'ater
Total Suspended Solids CT,MA,NH,NY,RI,NC,ME,VA
SV21-22 4500 H B in 11'ater
PH CT,MA,RI
S lf' 846 6020B in H'arer
Copper CT,NH,NY,ME,VA,NC
Lead CT,NH,NY,ME,VA,NC
Zinc CT,NH,NY,ME,VA,NC
The CON -TEST Environmental Laboratory Operates under the following certifications and accreditations:
I Code Description
Number
Expires
�( NHA AIHA-LAP, LLC-ISO17025:2017
100033
03/1/2020
MA Massachusetts DEP
M-MA100
06/30/2020
t CT Connecticut Department of Publilc Health
PH-0567
09/30/2021
NY New York State Department of Health
10899 NELAP
04/1/2020
NH-S New Hampshire Environmental Lab
2516 NELAP
02/5/2020
RI Rhode Island Department of Health
LAO00112
12/30/1019
,I NC North Carolina Div. of Water Quality
652
12/31/2019
n NJ New Jersey DEP
MA007 NELAP
06/30/1020
FL Florida Department of Health
E871027 NELAP
06/302020
VT Vermont Department of Health Lead Laboratory
LL015036
07/30/1020
ME State of Maine
2011028
06/9/2021
VA Commonwealth of Virginia
460217
12/14/2019
j NH-P New Hampshire Environmental Lab
2557 NELAP
09/W2020
4 VT-DW Vermont Department of Health Drinking Water
VT-255716
06/12/2020
NC-DW North Carolina Department of Health
23703
07/31/2020
PA Commonwealth of Pennsylvania DEP
68-05812
06/30/2020
Page 11 of 14
hUp:2/ wwvr. contestlabS.com
Doc A 379 Rev 1_03242017
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'41111' con -test
�,Ilulf �unwn.va.
I
Phone: 413-525-23: t C1 —� �I �'
CHAIN OF CUSTODY RECORD Worth Carofinal
39 Spruce Street
East Longmeadow, MA 01026
l'If 1111
Fax: NI-525-6405
Emil: In/o®contestlabs.com
7-Day ❑ ID -Day O
1
2
1
1
1
1 1
Address: 409 Rogers Vie,
Phone: (919) 624-0630
Project location:
Project Number.
Project Manager:
Con -Test Quote Harrell,
Mid Atlantic Associates Oue Dale: H N N N
P G P P P P
1-Day ❑ 3-Day ❑ ANALYSIS REQUESTED
Matlab, Inc. 2-Day ❑ 4-Day ❑
495 Campus, Asheboro, NC
R2943.10 Format: PDF ❑✓ EXCEL Li
Paul W. Spangenberg Other:ts
i u
CLP Like Data Pkg Required: n O F u' o- N
lgenber0(07maacinlinBcom Email To: DSDangenbergPmaaDnline.COm
Paul W. Srumiumbent . Fax To 4: 19191 250.9950
10/16/19.1C00 10116/19, 11:00 X 1 0 L X X
sui4` ArII� 1 10/16119, 11:00 10116119, 11:00 X O L X
MEp+- ..q�
I Fi, .iw 1 10/16119, 1t:00 10/16119, 11:00 X O L X X X
Please use the Following codes to Indicate possible sample concentration within the
Corte Code column above:
H - High; M - Medium; L - Low; C - Clean; U - Unknown
Relinquished by: (si"ture)
Cea /O//f//r.-11.v
Da[
I ❑ 2L
Program Information
DSCA ❑ USTfTrust Fund
SWS Landfill ❑ REC
IHSB Orphaned landfill
State Lead
Other:
Received .by (signai)ure /1'r7/61<
(,(ntL>�i�1 (
Date/Ti GWPC
SWSL j
Reli/J��uis : (sig/9n?a:tturel /G/r 7/1
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Government
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❑ Municipality
❑ Brownfield
n School
❑ Chromatogram
❑ AINA-LAP,LLC
Page-1--of
If of Containers
' Preservation Code
' Container Code
PCB ONLY rT
0
❑ Soxhlet 0
❑ Non Soxhlet C7
0
_
a
10/18/2019 Track your package or shipment with FedEx Tracking Table Of Contents
xm r
776749850662'�-,
Delivered
Friday 10/18/2019 at 9:35 am
DELIVERED
Signed for by: B.BECCA
GET STATUS UPDATES
OBTAIN PROOF OF DELIVERY
FROM
TO
Raleigh, NC US
EAST LONGMEADOW, MA US
Multiple -piece Shipment
4 Piece shipment
TRACKING NUMBER
:•SHIPPER CITY,
STATE.. '
-''.SHIP DATE STgTUS
::,-� '.�
DELIVERY DATE
-.'.'DESTINATION/RECIPIENT
'CITy STATE
..
50662
776749850662
RALEIGH, NC
10/17/2019
10/18/2019
EAST LONGMEADOW, MA ;
(master)
)
776749850581
RALEIGH, NC
10i17/2019
1D/18./2019
EAST LONGMEADOW, MA
776749850743
RALEIGH, NC '.
I I
_1J0/17/2019
10/18/2019
CAST LONGMEADOW. MA
776749850938
RALEIGH, NC
10/17/2019—+--a-�1°J
10/18/2019
EAST LONGMEADOW, MA
Shipment Facts
TRACKING NUMBER
776749850662
WEIGHT
15lbs / 6.8 kys
TOTAL PIECES
4
SERVICE
FedEx Priority Overnight
DIMENSIONS
2404x14 in.
TOTAL SHIPMENT WEIGHT
60 Ibc / 27, 22 kys
MASTER TRACKING NUMBER
776749850662.
DELIVERED TO
Shipping/Receiving
TERMS
1 hlyd Party
SHIPPER REFERENCE PACKAGING SPECIAL HANDLING SECTION
httpsl/w .fadex.com/apps/fadextrackJ?action=track&tracknumbers=776749850662&locale=en_US&cn"_wde=us Page 13 OT 14
Table of Contents
I Have Not Confirmed Sample Container
Numbers With Lab Staff Before Relinquishing
A r�lALYTICAL LABORATORY
Over Samples
:`Doc# 27,7i Rev01X
.......................... __.._...,.................. .
Login Sample Receipt Checklist - (Rejection Criteria Listing - Using Acceptance Policy) Any False
Statement will be brought to the attention of the Client - State True or False
Client Al H
Received By
Date
Time
How were the samples a In Cooler �_ No Cooler On Ice i No Ice
11 received? Direct from Sampling Ambient Melted Ice
Were samples within By Gun # 2 Actual Temp - 3, I
Temperature? 2-60C T By Blank # Actual Temp -
Was Custody Seal Intact? .V& Were Samples.Tampered with? N(.4
Was COC Relinquished ? —: Does Chain Agree With Samples? T
Are there broken/leaking loose caps on any samples? _(_
Is C in ink/ Legible?
Did
COC include all C Tent r
pertinent Information? Project
Are Sample labels filled out and legible?
,Are there Lab to Filters?
Are there Rushes?
Are there Short Holds? _ F
Is there enough Volume? _)_
Is there Headspace where applicable? N
'Proper Media/Containers Used? _ T
Were trip blanks received?
!Do all samples have the proper pH?
Were samples received within holding time? T
Analysis �_ Sampler Name T
ID's T Collection Dates/Times 7-
Who was notified?
Who was notified?
Who was notified?
MS/MSD?_ -
Is splitting samples required? _F
On COC? f.:
Acid Tr:2 Base
VAats k
r ";#
contwnerswZiplock
r
# '
Un
1 Liter Amb.
L
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16 oz Amb.
HCL-
500 mL Amb.
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8oz Amb/Clear
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Bisulfate-
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eria
2ozAmb/Clear
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250 mL Plastic
4oz Amb/Clear
Bisulfate-
Col./Bacteria
Flashpoint
2oz Amb/Clear
DI-
Other Plastic
Other Glass
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Thiosulfate-
SOC Kit
Plastic Bag
Frozen:
Sulfuric-
Perchlorate
Zi lock
Comments:
i@
co nt s
AM tq W a.
! WORK ORDER Printed: 10/21/2019 5:38:35PM
19J1151
Con -Test Analytical Laboratory
Client:
Mid -Atlantic Associates, Inc. - Raleigh, NC
Project
Manager:
Kerry K. McGee
Project:
Matlab, Inc.
Project
Number:
R2943.10
Below please find the login confirmation including the CoC and draft invoice.
To ensure that your needs are met, please review these documents to verify
that:
1. The number of samples received and matrix are correct.
2. The methods are correct as well as any specific regulatory requirements.
3. The due date for the final report is correct.
4. The contact information is correct.
5. The pricing is correct.
Thank -you for choosing Con -Test Analytical Laboratories. If you need
further assistance, please contact your project manager.
Page 1 of 7
WORK ORDER Printed: 10/21/2019 5:38:35PM
19J1151
Con -Test Analytical Laboratory
Client:
Mid -Atlantic Associates, Inc.
- Raleigh, NC
Project Manager:
Kerry K. McGee
Project:
Matlab, Inc.
Project Number:
R2943.10
Report To:
Invoice To:
Mid -Atlantic Associates, Inc. - Raleigh, NC
Mid -Atlantic Associates, Inc. - Raleigh, NC
Paul Spangenberg
Paul Spangenberg
409 Rogers View Court
409 Rogers View Court
Raleigh, NC 27610
Raleigh, NC 27610
Phone:(919) 250-9918
Phone :(919) 250-9918
Fax: (919) 250-9950
Fax: (919) 250-9950
Analvsis Due
TAT Expires Comments
19.11151-01 1 l Waterl Sampled 10/16/19 11:00 (GMT-05:00) Eastern Time (US &
I Zinc 6020 Total
10/28/19 13:30
7
04/13/20 11:00
report in mg/L
Solids, Total Suspended (TSS) by SM2540D 10/28/19 13:30
7
10/23/19 11:00
pH by SM4500 H B water
10/28/19 13:30
7
10/16/19 12:00
''Oil and Grease (HEM) by EPA 1664B
10/28/19 13:30
7
11/13/1911:00
Metals Digestion
10/28/19 13:30
7
10/30/19 11:00
'Lead 6020 Total
10/2811913:30
7
04/13/20 11:00
report in mg/L
Copper 6020 Total
10/28/19 13:30
7
04/13/20 11:00
report in mg/L
Reviewed By Date 27
Page 2 of 7
WORK ORDER
1911151
Con -Test Analytical Laboratory
Printed: 10/21/2019 5:38:35PM
Client:
Mid -Atlantic Associates, Inc. - Raleigh, NC
Project Manager:
Kerry K. McGee
Project:
Matlab, Inc.
Project Number:
R2943.10
DRAFT INVOICE
Item
Qh' Surcharge
Unit Price
Test Total
Copper 6020 Total
1 0.00
$10.00
$10.00
Lead 6020 Total
1 0.00
$10.00
$10.00
Metals Digestion
1 0.00
$3.00
$3.00
Oil and Grease (HEM) by EPA 1664B
1 0.00
S40.00
$40.00
pH by SM4500 H B water
1 0.00
$10.00
$10.00
Solids, Total Suspended(TSS) by SM2540D
I
I 0.00
$15.00
$15.00
Zinc 6020 Total
1 0.00
$10.00
$10.00
$98.00
Reviewed By Date
Page 3 of 7
con-tE$C
..umrxuewumn
Phone: 413.525-23:
Fax: 413-525-6405
Email: 1nto0contestlabs.com
Mid Attantic Associates
Address: 409 Rogers Vies
Phone: (919) 624.0630
Nadab, Inc.
Project Location:
495 Campus, Asheboro, NC
Project Number:
R2943.10
Project Manager: Paul W. Spangen
Con -Test Quote Name/H
Inwice Recipient: pSpan0enberOarnaa
Sampled By: Paul W. Spangen.
http:
/ /www.con[estlabs. com
CHAIN OF CUSTODY RECORD (North Carolina/
7-Day ❑
ID -Day
❑✓
Oue Date'
1-Day
❑ 3-Day
❑
2-Day
❑ 4-Day
❑
Format:
PDF ❑' EXCEL
❑
Other:
CLIP Like Data Pkg Required:
Email To:
OBDanOenberO(
Dla
Doc N 379 Rev 1_93242017
39 Spruce Street Page _7_of IEast Longmeadow, MA 01028
IBM
�1 2� 1 1 1 1 P of Containers
1 1^ 1 N N N ' Preservation Code
ANALYSIS
10/16/19, 1t:00
10/16/19, 11:00
X
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10/16/19, 11:00
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10/16/19, 11:00
X
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Please use the fallowing codes to indicate possible sample concentration within the
Conc Code column above:
H - High; M - /Aedlum; L - low; C - Clean; U - Unknown
Relinquished by: (signature)
C./L /0/wrd./w
Dat
❑ 2L
Program Information
DSCA ElUSf/TMI. Fund
SWS Landfill ❑ REC
IHSB Orphaned tandfitt
State Lead
Other:
Rec led by' (signur s e ' /6' 171fq
L' 1 LM;L
Date/TimLi GWPC
SWSL
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Date/Tin❑ Federal ❑ Brotmfleld
Other
❑ Chromatogram
❑ AIHA-LAP,LLC
quished by: (signature)
ived by: (signature)
PCB ONLY
❑ Soahlet
0 Non So hlet
10118/2019 Track your package or shipment with FedEx Tracking
776749850662?�
Delivered
Friday 10/18/2019 at 9:35 am
FROM
Raleigh, NC US
Multiple -piece Shipment
DELIVERED
Signed for by. B.BECCA
GET STATUS UPDATES
OBTAIN PROOF OF DELIVERY
4 Piece shipment
TO
EAST LONGML'+DO4V, MA US
:,SHIPPER CITY, DESTINATION/RECIPIENT TRACKING IJUMBER .SHIP DATE !' STATUS DELIVERY DATE
,STATE �. IT
. ..... :... �..0 Y STATE .. .
776749850662
(master)
776749850581
7767498507,13
d 776749850938
RALEIGH, NC
10/17/2019---e—+-7i°d
10,18/2019 EAST LONGMEADOW. MA
RALEIGH, NC
10/17r 2019 `.,--o—�-�
10/18/2019 y EAST LONGMEADOW, MA
RALEIGH, NC
_. i
'.,"�.1�0/17/2019
10/18/2019 CAST LONGMGADOW, MA
RALEIGH, NC
'10/17/2019
10/18/2019 EAST LONGMEADO4V, MA
Shipment Facts
TRACKING NUMBER
776749850662
WEIGHT
151bs / 6.8 kgs
SERVICE
FedEx Priority Overnight
DIMENSIONS
24xl4xl4 in.
MASTER TRACKING NUMBER
776749850662.
DELIVERED TO
Shipping/Receiving
TOTAL PIECES TOTAL SHIPMENT WEIGHT TERMS
4 60lbs ; 27.22 kgs Third Party
SHIPPER REFERENCE PACKAGING SPECIAL HANDLING SECTION
6tt sllw .fedex.comla s/fedextrack/?action=track&lracknumbers=776749850662&locale=en_US&cntr_code= Pa P PP - ryus ge 5 of 7
I Have Not Confirmed Sample Container
Numbers With Lab Staff Before Relinquishing
AfVALYTICAL LABORATORY
Over Samples _
... Doc# 7Rev 5207
...<..............'
........
Login Sample Receipt Checklist - (Rejection Criteria Listing - Using Acceptance Policy) Any False
Statement will be brought to the attention of the Client - State True or False
Client Al A L
Received By
Ci:35`
How were the samples ° In Cooler _� No Cooler On Ice T No Ice
received? Direct from Sampling Ambient Melted Ice
Were samples within By Gun # 2 Actual Temp - 3. I
Temperature? 2-60C By Blank # Actual Temp -
Was Custody Seal Intact? �U/ Were Samples Tampered with? IV (4
Was COC Relinquished ? T— Does Chain Agree With Samples? T
Are there broken/leaking/loose caps on any samples?
Is COC in ink/ Legible?
Did COC include all C ient r
pertinent Information? Project
Are Sample labels filled out and legible?
,Are there Lab to Filters?
Are there Rushes?
,Are there Short Holds?
Is there enough Volume?
,Is there Headspace where applicable? N
'Proper Media/Containers Used?
Were trip blanks received?
,Do all samples have the proper pH?
Were samples received within holding time? T
Analysis �_ Sampler Name T
ID's _� Collection Dates/Times T
Who was notified?
Who was notified?
Who was notified?
MS/MSD? _F
Is splitting samples required? F
On COC? P
Acid IL2 Base
Viats
5 s"#.Um
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250 mL Plastic
4oz Amb/Clear
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4oz Amb/Clear
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Flash oint
2oz Amb/Clear
Other Plastic
Other Glass
Encore
Thiosulfate-
SOC Kit
Plastic Bag
Frozen:
Sulfuric-
Perchlorate
Zi lock
Comments:
WORK ORDER
1931151
Con -Test Analytical Laboratory
Printed: 10/21/2019 5:38:35PM
Client:
Mid -At lantic Associates, Inc. -Raleigh, NC
Project Alanager:
Kerry K. McGee
Project:
Mullah, Inc.
Project Number:
R2943.10
Reviewed By
Date
Page 7 of 7
http:I/www.cantestiabs.com Doc # 379 Rev 1_03242017
A ` {.
11IIIIII I 1 cO n-lEs` Phone: 413.525-23i CHAIN OF CUSTODY RECORD (North Carolina) 39 Spruce Page _1_ of _7_
East Longmeadow, MA 01028
Fax: 413-525-6405
Email: infopcontestlabs.com 7-Day ❑ 10-Day Q 1 2 1 1 1 1 # of Containers
Mid Atlantic Associates Due Date: H N N N ' Preservation Code
Address: 409 Rogers Vies
'?»,.-' + =fisv;-a,>.^^€ ""fir- . -' .' ... _ .;
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1-Day ❑ 3-Day ❑
2-Day ❑ 4-Day ❑
m
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ANALYSIS
u'
a
REQUESTED'"
re
t' Matlab, Inc.
❑ -Field Filtered `
❑ Lab to Filter
Project Location: 495 Campus, Asheboro, NC
aa` '� r vim' ,. ..-,'
Project Number: R2943.10
Format: PDF Q EXCEL ❑
Other:
CLP Like Data Pkg Required: Lio
Email To: DSDDngenberq(@rTaaonline.CX)m
Fax To #: (919) 250-9950
Project Manager: Paul W. Spangenberg
Con -Test Quote Name/N
❑ Field Filtered
❑ -Lab to filter -
Invoice Recipient: ospengenberg(a)mawnllne.Com
Sampled By: Paul W. Spangenberg
" Can -Test.'
•...'-.
Client Sample ID/Description
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i Beginning Date/Time
-..
Endmg.Date/bme
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WW = Waste.Wnter
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1
10/16/19, 11:00
10/16119, 11:00
X
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A=Air'
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10/16/19, 11:00
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10/16/19, /1:D0
10/16/19, 11:00
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%
%
SOL=Solid
-define) _
] Preservation Codes: -
I = Iced
H.= HCL
M = Methanob _
- -
N = Nitric Acid. ,
_
S = Sulfuric Acid-.
-
B = Sodium Bisulfate
X = Sodium Hydroxide
-
T = Sodium
' -
Thiosulfate
Comments:
10 = Other (please
Please use the following codes to indicate possible sample concentration within the
define)
Conc Code column above:
H - High; M - Medium; L - Low; C - Clean; U - Unknown
'
a ContainerCodes:
- A = Amber Glass
Relinquished by: (signature)
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G = Glass
L'/G
DSCA ❑ UST/Trust Fund
P =.Plastic -
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ST = Sterile .
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GWPC
Rec bY: signature • iVll7/!4(
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V = Vial'
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IHSB Orphaned Landfill
State Lead
5 = Summa Canister
T = Tedlar Bag
SWSL
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Other:
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defineher
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Dat
_. .NELAC and AIHA-LAP;: LLC Accredited._`
Relinquished by: (signature)
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Other
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❑t Government ❑ Municipality
Date/TillFederal ❑ Brownfield
[]
El Chromatogram
❑ AIHA-LAP,LLC
❑ Soxhlet
❑ Non Soxhlet
Received by: (signature)
I Fl atv M School
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
Iv L% D3 L)
DOC TYPE.
❑ HISTORICAL FILE
I-/- MONITORING REPORTS
DOC DATE
❑
YYYYMMDD
Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000
Date submitted 10/28/19
CERTIFICATE OF COVERAGE NO. NCG03 0 6 5 9
FACILITY NAME Matlab, Inc. -Plant 10
COUNTY Randolph
PERSON COLLECTING SAMPLES Mitch Auman
LABORATORY con -test Lab Cert. # 652
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ❑ Jan -June Q July -Dec
or ❑ Monthly' (month)
RECEDISCVHLA.RGINGTOCLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
NOV 13 2019 ❑other
CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
DWR SECTION
n No discharge this periodj2
Outfall No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches3
Total Suspended Solids
pH,
Standard units
Total Copper
Total Lead
Total Zinc
Non -Polar O&G/
Total Petroleum
Hydrocarbons
Total Toxic
Organics'
Benchmarks
_
-
100 mg/L or 50 mg/L4
6.0 - 9.0
0.010 mg/L
0.075 mg/L
0.126 mg/L
15 mg/L
1 mg/L
Parameter Code
-
46529
C0530
00400
01119
01051
01094
00552
78141
01
10/16/19
.51
12
6.3
0.0049
0.00064
0.034
0
N/A
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit, Section B, Table 1 to identify the especially sensitive receiving water classifications where the more protective benchmark applies.
' Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
-- P.ermitDate:.11/1/2018-05/31/2021,. - --- - : - --- - ---- -- - -- - - _ - -.--SWU-245,.IasL.revised.il/1/2018-=--- - - - -- -
Page 1 of 3
Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
Press Brower
Name (Print name)
VP of Engineering
Title (Pri
l0 3/ f
Signature
Date
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical
format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > SS gal of new oil per month.
n No discharge this period?2
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches3
New Motor Oil or
Hydraulic Oil Usage
Non-PolarO&G/ Total
Petroleum Hydrocarbons
Total Suspended
Solids
Benchmarks
-
-
-
15 mg/L
100 mg/L or 50 mg/L4
Parameter Code
-
46529
NCOIL
00552
C0530
Footnotes from Part A also apply to Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit- Date:: 11/1/2018-05/31/2021 . -- -.-- - - - - -- - — - - - - - - - - -- - - - -- - - - -- SWU-245,.last. revised 11/1/2018- _- -- -_
__. - - -- - - - - - _. ._ _. Page 2of3 -
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO Q
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original 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" reports) 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 there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
C\\ /0 3/ /C/
Signature of Permittee
Date
- - -:Permit .Date: 11/1/2018705/31/2021---SWU-245,.last:revised-.11/1/2018-
Page 3 of 3
RAIN EVENT DATA
FACILITY: Matlab, Inc. — Plant #10
ADDRESS: 7307 Jordan Road
Ramseur, NC 27205
CONTACT PERSON: Press Bower TELEPHONE: 336- 629-4161
i' STORM EVENT INFORMATION
DATE
YEAR
MONTH
DAY
19
10
16
HOURS
MINUTES
DURATION
24
0
PRECIP.
AMOUNT (IN.)
0.51
RUNOFF
VOL. GAL.
.034
HOURS
DAYS
PRECEDING
EVENT
0
3
10/16/19
2.5 Acres x 43560 = 108900 x 0.51= 55839 x .0833 = 4626.3 x 7.48 = 34605.4 / 1000000 = 0.034mg
STORMWATER FACILITY INSPECTION FORM
Facility Name:
Location:
Certification of Coverage No.: NCG030659
Mallab, Inc. — Plant #10
Ramseur, North Carolina
Expires: 5/31/2021
Number of
Inspectors Name:
Date:
Outfalls:
10/16/19
Paul W. Spangenberg
1
Contin Areas
Ming
Evidence of pollutants entering system (circle one): Yes No
If yes, describe:
Areas of potential pollutants entering system:
Describe: None
Control measures present (circle one): Yes No
If yes, describe:
Additional control measures needed (circle one): Yes No
If yes, describe:
Sediment and erosion control measures present (circle one): es No
If yes, describe:
Rip -Rap at discharge and drainages ditches
Describe any new structural stormwater management measures:
None
Potential Pollutant Areas
Describe any loading/unloading operations:
Trucking, Tank Truck
Describe any outdoor storage activities:
Wood Pallets, Scrap Metal, Solid waste dumpsters, used equipment
Describe any outdoor manufacturing or processing activities:
None
Describe and dust or particulate generating areas:
None
Describe any onsite waste disposal activities:
None
Significant ks or Spills
Any reportable spills or leaks in the past year (circle one): Yes No
If yes, date: Impact on stormwater system(s):
Certification
By this signature I certify that this report is accurate and complete to the best of my knowledge:
Inspector's Signature: Pad V, S %�>
STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
Certification of Coverage No.:
Permit No: NCG030659
Expires: 5/31/2021
Facility Name:
Matlab, Inc. — Plant #10
Ramseur, North Carolina
County:
Randolph
Inspector Name:
Paul W. S an enber
Date of Inspection:
10/16/19
OUTFALL
DESCRIPTION '
Outfall No.:
1
Structure (pipe, ditch, etc.):
Pipe
Receiving Stream:
Reed Creek
Describe the industrial activities that occur within the outfall drainage area:
Painting & Coating Manufacturing
Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors:
Light Brown
Odor
Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak chlorine odor, etc.):
None
Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very cloudy (circle one):
O2 3 4 5 6 7 8 9 10
Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where 1 is no solids and 10 is
the surface is covered in floating solids (circle one):
O2 3 4 5 6 7 8 9 10
Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge where 1 is no solids and 10
is extremely muddy (circle one):
02 3 4 5 6 7 8 9 10
Foam
Is there any foam in the stormwater discharge (circle one)?: Yes N
. Oil Sheen _
Is there an oil sheen in the stormwater discharge (circle one)?: Yes No
Erosion Deposition
Is there evidence of erosion or deposition at the outfall? (circle one): Yes No
If yes, list and describe:
Other
Is there other obvious indicators of stormwater pollution in the stormwater discharge (circle one): Yes No
If yes, list and describe:
Rain Event
Was this a Representative Storm Event? X Yes _ No Total Event Precipitation (Inches). 0.51
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.
Certification.
By this signature I certify that this report is accurate and complete to the best of my knowledge:
Inspector's Signature: mad?U Sga�
Table of Contents
con -test°
ANALYTICAL LABORATORY
39 Spruce Street' East Longmeadow, MA 01028 *FAX 413/525-6405 * TEL. 4131525-2332
October 24, 2019
'I Paul Spangenberg
Mid-AOantic Associates, Inc. - Raleigh, NC
409 Rogers View Court
Raleigh, NC 27610
Project Location: Plant 10 Ramseur, NC
Client Job Number:
Project Number: R2943.10
Laboratory Work Order Number: 19J 1150
Enclosed are results of analyses for samples received by the laboratory on October 17, 2019. If you have any questions
concerning this report, please feel free to contact me.
Sincerely,
Axkt
i' Kerry K. McGee
Project Manager
Page 1 of 14
Table of Contents
Table of Contents
Sample Summary 3
Case Narrative 4
Sample Results 5
' 19J1150-01 5
i
Sample Preparation Infonnation 7
QC Data 8
Metals Analyses (Total) 8
B243664 8
Conventional Chemistry Parameters by EPA/APHA/SW-846 Methods (Total) 9
� B243622 9
B243639 9
B243698 9
Flag/Qualifier Summary 10
Certifications 11
Chain of Custody/Sample Receipt 12
Page 2 of 14
Table of Contents
O
ao oP u o ou caw wnym uuov, Vino — rnn i «. -r imuc.amouc
Mid -Atlantic Associates, Inc- -Raleigh, NC
409 Rogers View Court RHPORT DATE: 10J242019
Raleigh, NC 27610 PURCHASE ORDER NUMBER:
ATI'N: Paul Spangcabcrg
PROJECT NUMBER: R2943A0
I I
ANALVT'ICAL SUM MARV
WORK ORDER NUMBER: 1911150
'I he results of analyses performcd oa the following samples submitted to the COS -TEST Analytical Laboratory an found in this report.
PROJ17CT LOCATION: Plant 10 Ramscur, NC
J PIELD SAMPLE k LAB ID: MATRIX SAMPLE 017SCRIPTION
TEST SUB LAB
I 19JI150-01 Water
EPA 1664B
SM21-22 2540D
SM21-22 4500 H B
S W-846 6020B
Page 3 of 14
con -test°
' ANALYTICAL LABORATORY
39 Spruce Street' East Longmeadow, MA 01028 *FAX 413/525-6405 * TEL. 4131525-2332
CASE NARRATIVE SUMMARY
All reported results are within defined laboratory quality control objectives unless listed below or otherwise qualified in this report.
Se121-22 4500 11 B
Qualificolluns
11-05
' Holding time was exceeded. pl{ analysis should be performed immediately at time ofsampling. Nominal IS minute holding time was
cxcccdcd.
A riulyte N� Smnples(s) Qualified:
i
pll
191115O-011II
l'he results ofani lyres rcponcd only reline to samples submitted to the Con -Test Analytical Laboratory for testing.
1 ccnify that the analyses listed above, unless spcci fi tally listed as subcontracted, if any, were performed under my direction according to the approved methodologies listed
in this document, and that based upon my inquiry of those individuals immediately responsible for obtaining the information, the material contained in this report is, to the
beet ollny knowledge and belief, Aaceumov and complete.
Lisa A. Worthington
l'cchnical Rcprescnmtivc
Table of Contents
Page 4 of 14
Table of Contents
413/525-6405' TEL. 4131525-2332
Project Local ion: Plant 10 Ramseur, NC Sample Description: Work Ordcr. 19J1150
Dute Received: 10/17/2019
Field Svmplc R: 1 Samplcd: 10116/2019 11:00
Samnlc ID: 19J 1150-01
Metvls Analyses (Total)
Date
WWI ime
�i Analvte
Results
RI,
DI,
Units Dilution Flvg/Quvl
Method
Prepared
Anahzed
Anvkst
Copper
0.0049
0.0010
0.00087
mgJL 1
SW-9466020B
10/19/19
10/21/1913: 18
QNW
Lead
0.00064
0.00050
0.000085
mg/L I
SW-8466020B
10/19/19
10/21/1913: 18
QNW
Ziias,
0.034
0.010
0.0023
mWL 1
SW-8466020B
10/19/19
10/21/1913:IS
QNW
Page 5 of 14
I
conAcsV,
ANALYTICAL LABORATORY
Table of Contents
11 39 Spruce Street' East Longmeadow, MA 01028' FAX 413/525-6405' TEL. 4131525-2332
Project Location: Plant 10 Ramseur, NC Sample DacriPliml: Work Order: 19J1150
Date Received: 10/17/2019
Field Semple #: 1 Sampled: 10/1612019 11:00
II
Sample ID: 19J 1150-01
Con venlional Chemistry Par. meters by EPVAPH1 SW-846 Methods ('Tanal)
Dale
Dwarl ime
Anal)1e
Results RL DI, Units Dilution Flog/Q..l Mclhod
Prepared
Analyzed
Analyst
PH@20.4-C
6.3 pH Units 1 11-05 SM21-2245M11e
10/18/19
10/18/19 20 35
MG2
7 ataI Suspended Solids
12 2.0 0.82 mg/L I SM21-2225401)
10/19/19
10/19/1917:20
LL
Oil & Grease (HEM)
ND 2.8 2.0 mg/L 1 EPA 166413
10121/19
10/21/19 13:10
LL
Page 6 of 14
Table of Contents
39 Spruce Street' East Longmeadow, MA 01028' FAX 413/525-6405 'TEL. 4131525-2332
Sample Extraction Data
EPA 1664B
Lub Number lField ID] Balch Initial [mLI Dale
19J1150-0111] B243698 Soo 10121/19
SM1I21-22 254UD
L.b Namhrr lField IDl Batch Initial lmLl Date
1931150.01(11 B243639 250 10/19/19
SM21-22450011 B
Lab Number lField IDI Batch Initial ImL1 Date
19J1150-0I 111 B243622 50.0 10/18/19
Prep Method: S W-846 3005A-S W-846 6020H
Lab Number lField ID] Batch Initial l.LI Final lml.) Date
19J1150-ol M B243664 50.0 50.0 10/19/19
i
Page 7 of 14
Table of Contents
39 Spruce Street' East Longmeadow, MA 01028 *FAX 413/525-6405 'TEL. 413/525-2332
QUALITY CONTROL
Metals Analyses (fatal) - Quality Control
I
Reporting Spike Source %REC RPD
Analyle Result Limit Units Level Result %REC Limits RPD Limil Notes
Batch B243664 - S W-846 3005A
Blank(B243664-BLKQ Prepared: 10/19/19 Analyzed: 10/21/19
Capper ND 0.0010 mg/L
Lead ND 0,00050 mg/L
-Lino ND 0.010 mg/I.
LCS(B243664-BSI)
Prepared: 10119/19 Analyzed: 10/21/19
Copper
109
0.010
mg/L
1.00 109
80-120
Lead
0.541
0.0050
mWL
0.500 108
80-120
Zinc
I,
1.06
0,10
mg/L
100 106
80.120
I.CS Dup(R243664-BSDI)
Prepared: 10119/19 Analyzed: 10/21/19
Copper
103
0.010
mS)L
1.00 103
80-120
5.76
20
Lead
0.513
0.0050
mg/L
0.500 103
80-120
5.40
20
Zinc
I
11
1.02
0.10
mg/L
IOn 102
80-120
4.30
20
Page 8 of 14
Table of Contents
39 Spruce Street' East Longmeadow, MA O1028 *FAX 4131525-6405 * TEL. 413/525-2332
QUALRY CONTROL
Conventional Chemists Parameters by DPA/APIINSN446 Dlethods (Total)-QnalrhCoutnl
Reporting Spike Source %REC RPD
Anal Rcsull Limit Units Lceel Result %DREG Limits RPD Limit Notes
Batch B243622 - SM21-22 4500 H B
LCS (R243622-RSI)
PH '
Batch B243639 - SM21-22 2540D
II
Blank (3243639-BLKI)
Prepared & Analyzed: 10/21/19
6.00 pH Units 6.00 100 90-110
& Analyzed: 10/19/19
Total Suspended Solids
ND
2.5
mg/L
LCS (B243639-BSI)
Prepamd & Analyzed: 10/19/19
Total Suspended Solids
172
10
mglL
200 86.0 57.6-1I8
Balch B243698 - h:PA 1664R
Blank (B243698-BLKI)
Prepared & Analyzed: 10/21/19
Oil & Grease (III!M)
I
NO
1.4
mg/I,
Blank (B243698-BLK2)
Prepared & Analyzed: 10/21/19
Oil & Grcasc (Ii6M)
ND
14
mg/l.
LCS (B243698-BSI)
Prepared & Analyzed: 10/21/19
Oil & Grease (HEM)
20
mg/1,
20.0 102 78-114
LCS (B24369B-BS2)
Prepared & Analyzed: IOr21/19
Oil & Grease (HEM)- _ 170 mg/L 200
I
i
1
85.5 78-114
Page 9 of 14
Table of Contents
39 Spruce Street' East Longmeadow, MA 01026' FAX 4131525-6405 * TEL. 413/525-2
I
FLAG/QUALIFIER SUMMARY
•
QC result is outside ofestablishcd limits.
t
Wide recovery limits established far diRmull compound.
j
Wide RPU limits established for diRwuh compound.
N
Data cxcccded client recommended or regulatory level
ND
Not Detected
R1.
Reporting Limit is at the level of quantimtion p.OQ)
DL
Dctcction limit is the lower limit ofdctccti.n determined by the MDL study
MCL
Maximum Contaminant Level
Percent recoveries and relative percent differences (RPDs) are determined by the sonvore using values in the
calculation which have not been rounded.
No results have been blank subtracted unless specified in the case narrative section.
H-05 Holding time was exceeded. pH analysis should be performed immediately at time of sampling. Nominal 15
minute holding time was exceeded.
Page 10 of 14
Table of Contents
39 Spruce Street' East Longmeadow, MA 01028 *FAX 413/525-6405' TEL. 413/525-2332
CERFIFICATION'S
Cedificd Anolrses included in this Report
I
Analyte Certifications
EPA 1664E in Il ater
II
Oil & Grease (HEM) CT,MA NH,NY,RI, VC,MI:, VA
SM21-22 2.540D in Rater
Toml Suspended Solids CT,MA,NI I,NY,RI,NC,M Ii,VA
SM21-22 450011 B in Water
pit CT,MA,RI
SW--846 60208 in Water
Copper CT,NILNY,ME,VA,NC
Lead CT,NII,NY,ME,VA,NC
Zinc CTNII,NY,ME,VA,NC
The CON -TEST Environmental Laboratory operates under the following certifications and accmditations:
l'
Code Description
Number
I?.pins
AIIIA AIHA-LAP, LLC-ISO17025:2017
100033
03/1/2020
MA Massachusetts DEP
M-MAIIIO
06/30/2020
CT Connecticut Department of Publile Health
PH-0567
09/30/2021
NY New York State Department of I lealth
10899 NELAP
04/1/2020
NH-S New Hampshire Environmental Lab
2516 NELAP
02/5/2020
RI Rhode Island Department of Health
LAO00112
12/30/2019
NC North Carolina Div. of -Water Quality
652
12/31/2019
NJ New Jersey HIT
MA007 NELAP
06/302020
FL Florida Dcpanmcnt of Health
F871027 NELAP
06130/2020
V'1' Vermont Depanment of Health Lead Laboratory
1.1-015036
07/30/2020
ME State of Msinc
2011028
06/9/2021
VA Commonwealth of Virginia
460217
12/142019
NII-P New Hampshire Environmental Lab
2557 NELAP
09/6/2020
VT-DW Vermont Department of Health Drinking Water
VT-255716
06/12/2020
NC-DW North Carolina Department of Health 25703 07/31/2020
PA Commonwealth of Pennsylvania DEP 68-05812 06/30/2020
Page 11 of 14
http://www.
contestlabs. com
Doc p 379 Rev 1 03242017
tC
rimuyr COnAESt�
••••�II'll�ui(('�III '"°O"114A'
Phone: 413-525-23: ( 5�'
CHAIN OF CUSTODY RECORD
(Nord, Carolina)
39 Spruce Street
East Longmeadow, MA 01028
III III'
Fu: 413-525-6405
Email: lsAo®conlesdabs.com
7-Day ❑
10-Day
❑✓
1 21 11 11 11 1
1Nd Atlantic ASSodates
Due Date:
H N N N
Vi
Address: 409 Rogers e
P
G
P
P
P
P
Phone: (919) 624.0630
1-Day
2-Day
❑•
❑
3-Day
4-Day
❑
❑
ANALYSIS
RE(LFD
Matlab, Inc.
Project Location: Plant 10 Ramseur, NC
rD
Project Number:
R2943./0
Format
Other:
CUP Like Data Pkg Required:
Email To:
IF. To k:
POF
pspanDenberQ(&maa0nHLie.wm
EXCEL
Uo
(9191250.9950
co
F
a
Project Manager: Paul W. Spangenberp
Con -Test Quote Name/h
Im,oice Recipient: DsDanOenber0(a)maa001ine.Wn1
Samoled BY: Paul W. Somtgenbem
10/16119, 11:00 10/16119, 11:00 X 0 L X X
10/16/19, 11:00 10/16/19, 11:00 X 0 L X
10116119, 11:00 10/16/19, 11:00 X O L X X X
Please use the following codes to indicate Possible sample concentration within the
Conic Code column above:
H - High M - Medium; L- Low; C - Clem; U . Unknown
Relinquished by: Isignaturel
fMru A— M/W/ifdV/`.0
r
❑ 2L
k
-
PmWamInformation
DSCA ❑ UST/Tnsst Fund
SINS LantKLL ❑ REC
IHSB Orphaned Landfill
State Lead
ocher:
RecBlred by: (srgn lD 2 /r 4
�Lae
eRl GWPC
rDate
SWSL
(S1gnlitur5)� ((/s /2/TI
/�rZ.' 'l 17.3(1
1HSB
MSCC
Government ❑ Municipality
Federal ❑ Brownfield
A
❑ Chromatogram
❑ AMA.LAP,LLC
Page _I_ of _1_
N of Containers
t Preservation Code
,..PCs
OHLy
m
❑
Sozhlet
O
❑
Non 5ozhlet
0
O
(D
y
10/18/2019 Track your package or shipment with FedEx Tracking Table of Contents
*
776749850662 �
Delivered
Friday 10/18/2019 at 9.35 am
DELIVERED
Signed for by: B.BECCA
GET STATUS UPDATES
OBTAIN PROOF OF DELIVERY
FROM TO
Raleigh, NC US EAST LONGMEADOW, MA US
Multiple -piece Shipment
4 Piece Shipment
TRACKING NUMBER
.;SHIPPER CITY
. STATE I
"'
',SHIP DATE STATUS
DELIVERY DATC
DESTINATION/RECIPIENT ,
CITY STATE
776749850652
(masterasterRALEIGH,
)
IJC
10i17,,2019 a—a—e—(�%
; 10/18/2019
EAST LONGMEADOW, MA
77674y850581
. RALEIGH, NC
i .10/17i'2019—+'—+—:i
10/l8{2019
EAST LONGMEADOW,, MA
776749850743
,, RALEIGII,NC
,....10117/2019 0---►--+—®
10/18,2019
EAST LONGMEADOW, MA
776749850938
RALEIGH, NC
10/17!2019
10/18/2019
EAST LONGMEADOW, IAA
Shipment Facts
TRACKING NUMBER
SERVICE
MASTER TRACKING NUMBER
776749850662
FedEx Priority Overnight
776749850662
I ,
WEIGHT
DIMENSIONS
DELIVERED TO
15 Ibs / 6.8 kgs
I
24x14x14 in.
Shippinq/Recehving
I TOTAL PIECES
TOTAL SHIPMENT WEIGHT
TERMS
4
60 IDS / 27.22 kgs
Third Party
SHIPPER REFERENCE
PACKAGING
SPECIAL HANDLING SECTION
https://www.fedex.com/a ppsRed extrack/?action=track&tracknumbers=776749850662&locale=en_US&cntry_code=us
Page 13 of 14
Table of Contents
® 2',
I Have Not Confirmed Sample Container ism
Numbers With Lab Staff Before Relinquishing AN ALYTIQAL LABORATORY
Over Samples
Login Sample Receipt Checklist - (Rejection Criteria Listing - Using Acceptance Policy) Any False
Statement will be brought to the attention of the Client - State True or False
Client A N /h
Received By
How were the samples
received?
Were samples within
Date
In Cooler 'r No Cooler
Direct from Sampling
By Gun # 2
On Ice j— No Ice
Ambient Melted Ice
Actual Temp - i- I
Temperature? 2-6°C ` — By Blank # Actual Temp -
Was Custody Seal Intact? /�}/ Were Samples Tampered with? A//A
Was CDC Relinquished ?_ Does Chain Agree With Samples? T
Are there broken/leaking/loose caps on any samples? _ F
Is C in ink/ Legible?
11 Did
CDC include all It nt T
;pertinent Information? Project
Are Sample labels filled out and legible?
Are there Lab to Filters?
Are there Rushes? _E
Are there Short Holds? —_
Is there enough Volume? �
Is there Headspace where applicable? N/A
Proper Media/Containers Used? T_
Were trip blanks received?
Do all samples have the proper pH?
Were samples received within holding time? r
Analysis �_ Sampler Name T
ID's Collection Dates/TimesT_
Who was notified?
Who was notified?
Who was notified?
MS/MSD?_—
Is splitting samples required?
On COC? F
Acid Tr--L Base
0Q.111
03'
Page 14 of 14
i
III
t
contest®
11N�,1�tFTl.�t9►� 4iA�QRATO,RIP
WORK ORDER Printed: 10/21/2019 5:36:46PM
19J1150
Con -Test Analytical Laboratory
Client:
Mid -Atlantic Associates, Inc. - Raleigh, NC
Project Manager:
Kerry
K. McGee
Project:
Mullah, Inc.
Project Number:
R2943.10
Below please find the login confirmation including the CoC and draft invoice.
To ensure that your needs are met, please review these documents to verify
that:
1. The number of samples received and matrix are correct.
2. The methods are correct as well as any specific regulatory requirements.
3. The due date for the final report is correct.
4. The contact information is correct.
5. The pricing is correct.
Thank -you for choosing Con -Test Analytical Laboratories. If you need
further assistance, please contact your project manager.
Page 1 of 7
it
p WORK ORDER Printed: 10/21/2019 5:36:46PM
1911150
Con -Test Analytical Laboratory
1
Client:
Mid -Atlantic
Associates, Inc.
- Raleigh, NC
Project Manager:
Kern K. McGee
Project:
Matlab, Inc.
Project Number:
R2943.10
Renurt Tn:
1 mroice To:
Mid -Atlantic Associates, Inc. - Raleigh, NC
Mid -Atlantic Associates, Inc. - Raleigh, NC
Paul Spangenberg
Paul Spangenberg
409 Rogers View Court
409 Rogers View Court
Raleigh, NC 27610
Raleigh, NC 27610
Phone: (919) 250-9918
Phone:(919) 250-9918
Fax:(919) 250-9950
n
Fax:(919) 250-9950
Anolesis Due
TAT
Expires Comments
119JI150-01 1 l Waterl Sampled 10/16/19 11:00 (GMT-05:00) Eastern
Time (US &
Zinc 6020 Tom] 10/28/19 13:30
7
04/13/20 11:00 report in mg/L
Solids, Total Suspended (TSS) by SM2540D 10/29/19 13:30
7
10/23/19 11:00
pH by SM4500 H B water 10/28/19 13:30
r
7
10/16/19 12:00
Oil and Grease (HEM) by EPA 1664B 10/28/19 13:30
7
11/13/19 11:00
Metals Digestion I0/28/19 13:30
7
10/30/19 I1:00
6020 Total 10/28/19 13:30 7 04/13/20 11:00 report in mg/L
cr 6020 Total 10/28/19 13:30 7 04/13/20 11:00 report in mg/L
I'
Reviewed By Date
Page 2 of 7
WORK ORDER Printed: 10/21/2019 5:36:46PNI
19J1150
Con -Test Analytical Laboratory
Client: Mid -Atlantic Associates, Inc. - Raleigh, NC Project Manager: Kerry K. McGee
Project: Matlab, Inc. Project Number: R2943.10
DRAFTINVOICE
Item Qty Surcharge Unit Price 'test Total
Copper 6020 Total
1 0.00
$10.00
$10.00
Lead 6020 Total
1 0.00
$10.00
S10.00
Metals Digestion
11
1 0.00
$3.00
$3.00
Oil and Grease (HEM) by EPA 1664H
1 0.00
$40.00
$40.00
PH by SM4500 H 6 water
1 0.00
$10.00
S10.00
Solids, Total Suspended (TSS) by SM2540D
1 0.00
$15.00
$15.00
Zinc 6020 Total
1 0.00
$10.00
$10.00
$98.00
By Date
Page 3 of 7
httD'//www.cantestlaln.cam
Doc A 379 Rev 1_03242017
�gdq�lII1II�IIR'��'I+'1 con -test
µum �M
Pis.: 413-525-23: (5� (�-O
CHAIN OF CUSTODY RECORD (North Carolina)
39 Smuce Street
East Longmeadow, MA 01028
Page _1_ of _1_
Faz: 413-525-6405
Email: InfeWcontesdabs.com
7-Day ❑
10-Day Q
1
2
1
1
1
1
1
1
1# of Containers
Mad Atlantic Assaiates
Due Date:
H
N
N
IN
r Preservation Code
Address: 409 Rogers Vie
P
G
P
P
P
P
s Container Cade
Phone: 1919) 624-0630
1-Day
01
3-Day ❑
ANALYSeS REQUESTED
s
- -
Matlab, Inc.
2-Day
❑
4-Day ❑
❑4.FiDld F1ItMed
s {;
Project Location:
Plant 10 Ramseur, NC
r.. r
❑ lab to'FRter
}'-:
Project Number:
R2943.10
Format:
PDF +
EXCEL ❑
-�,.,---�'
>'' 4
Project Manager:
Paul W. Spangenberg
Other;
Con -Test Quote Name/N
CLP Like Data Pkg Required:
Lio
�
u'
n
rfField Fitteretl �fi
Imoice Recipient:
psDanOenber0
Email To:
pspanoenberO(aimaaonline
AOm
?'Lab to Filter
Sampled By:
Paul W. Spalgenberg
Fax To s:
(919) 250.9950�`-',�,.`�
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sWaLktAcg1�
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l�.toursd Wetar's
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10/16/19, 1100
10/16/19, 11:00
%
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%
X
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1
10116/19, 11:00
10/16/19, 11;00
%
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%
'jS' SoR
'SSLa Y
10/16/19, 11:00
10116/19, 11.00
%
O
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%
X
%
Please the the following codes to indicate Poslbie sample concentration within the
Con: Corte column above:
H - High; M - Medium; L - Low; C - Clem; U - Unknown -
Relinquished try: Isignature)
Mlf..l ll .r.• /O//6/NeWirAO
Dat
❑ 21
$
$
PnWam IMEirEnatlon
DSCA ❑ UST/Trust Fund:,
SWS Landfill ❑ REC
IHSB Orphaned Landfill
Slate Lead {"
Other: <
Rec&ed by;/ (sign r / Dk 1/1 Y
DatefTfmU GWPC
I Li SWSL
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/
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Da
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Government
Federal
❑ Municipality
❑ Brpwnfleld
n School
PC8 ONLY
❑ Chromatogram ❑ Soxhtet
❑ AMA-tAP,LLE ❑ Non Soxhlet
10/18/2019 Track your package or shipment with FedEx Tracking
bk
li
m:
i� 7 76749850662 ? `,
Delivered
Friday 10/18/2019 at 9:35 am
III
DELIVERED
Signed for hy: B.BECCA
GET STATUS UPDATES
OBTAIN PROOF OF DELIVERY
FROM TO
Raleigh, NC US EAST LONGMEADOW, MA US
i I
Multiple -piece Shipment
4 Piece Shipment
TRACKING NUMBER
I .., .,., •,
SHIPPER CITY,
,STATE
`SHIPDATE
•.
STATUS DELIVERYDATE
;' .,..
DESTINATION/RECIPIENT
':. CITY, STATE
776749850662
RALEIGH, 14C
10/17/2019
10/1812019
EAST LONGMEADOW, MA
,
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RALEIGH, NC
.....,
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776749850743
RALEIGILNC
10/17/2019
10/18/2019
EAST LONGMEADOW, MA
776749850938
y
RALEIGH, NC
10117/2019
101fl 8/2019
EAST LONGMEADOW, MA
Shipment Facts
TRACKING NUMBER
776749850662
iI
WEIGHT
15 Ns 16,8 kys
•� TOTAL PIECES
4
SERVICE
FedEx Priority Overnight
DIMENSIONS
24x14x14in.
TOTAL SHIPMENT WEIGHT
60 Ibs 1 27.22 kgs
MASTER TRACKING NUMBER
776749850662
DELIVERED TO
Shipping/Receiving
TERMS
Third Party
II
SHIPPER REFERENCE PACKAGING SPECIAL HANDLING SECTION
https:/Aw .fedex.comlapps/fadextrackt?action=track&tracknumbers=776749850662&iocale=e r
Pa e5of7
- n_U58cntry_code=us 9
I Have Not Confirmed Sample Container
Numbers With Lab Staff Before Relinquishing ANALYTICAL LABO RATORV
Over Samples �—
Login Sample Receipt Checklist - (Rejection Criteria Listing - Using Acceptance Policy) Any False
Statement will be brought to the attention of the Client - State True or False
Client Al A !t
Received By
Time cr � 3 T
How were the samples 1 In Cooler
No Cooler On Ice -r No Ice
received? Direct from Sampling
l
Ambient Melted Ice
By Gun #
2 Actual Temp - 3. I
Were samples within
Temperature? 2-6°C By Blank #
Actual Temp -
Was Custody Seal Intact? Nl& _
Were Samples Tampered with? A//A
Was CDC Relinquished ? T—
Does Chain Agree With Samples? T
Are there broken/leaking/loose caps on any samples?
_ F
Is COC in ink/ Legible?
Were samples received within holding time? T,
Did CDC include all lent I-
Analysis +_ Sampler Name J:
pertinent Information? Project
ID's Collection Dates/TimesT_
Are Sample labels filled out and legible? IF
Are there Lab to Filters?
Are there Rushes? _E
Are there Short Holds?
Is there enough Volume? _—
Is,there Headspace where applicable? N/A
Proper Media/Containers Used? T
Were trip blanks received? E
Do all samples have the proper pH?
Acid
Who was notified?
Who was notified?
Who was notified?
MS/MSD? _J_
Is splitting samples required? E—
On CDC? F=
Tf--L Base
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Client: Mid -Atlantic Associates, Inc. -Raleigh, NC
Project: Matlab, Inc.
WORK ORDER
1931150
Con -Test Analytical Laboratory
Project Manager: Kerry K. McGee
Project Number: R2943.10
Printed: 10/21/2019 5:36:46PM
Reviewed By
Date
Page 7 of 7
- - - - —'- - - http'//www.cpntestlabs.com Doc # 379 Rev, 1_03242017
CHAIN OF CUSTODY RECORD (North Carolina) 39 Spruce Street Page _1— of —1_
Q COf1—tESta Phone: 413-525-23: East Longmeadow, MA 01028
Fax: 413-525-6405
Email: info(Pcontestlabs.com
Date:
10-Day
of Containers
Address: 409 Rogers Vie,
conszmer, tour
Phone: (919) 624-0630
1-Day ❑ 3-Day ❑
2-Day ❑ 4-Day ❑
x
y
o
F
ANALYSIS
u'
n
REQUESTED
r
❑ Field Filtered
❑ Lab to Filter
Matlab, Inc.
Project Location: Plant 10 Ramseur, NC
Data r'
Project Number: R2943.10
Format: PDF ❑� EXCEL ❑
Other:
CLP Like Data Pkg Required:
Email To: DSDancienberO(Wmaacinllne.com
Fax To #: (919) 250-9950
Project Manager: Paul W. Spangenberg
r " ' '
❑ Field FiUered
❑ Lab to Filter
Con -Test Quote Name/N
Invoice Recipient: pSDancenberQL07mawnline.com
Sampled By: Paul W. Spangenberg
,Y4� Test
Matox
' Max Codes:
Matrix.,
}t '*r
Client Sample IDIDescdpfion
Beginning Dale/Time
Ending DatelTime
Composite
Grab
®
Cone Code
GW=Ground Water
�'. --Woik Orders-w.----�'•s
10/16/19, 11:00
X
Cade
O
WW = Waste Water
DW=Drinking Water
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[
10/16/19, 11:00
L
X
X
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Hip
10/16119, 11:00
10/16/19, 11:D0
X
O
L
X
A=Air
S= SciL
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:.� $ Aw;
10/16119, 11:00
10/16/19, 71:00
%
O
L
%
X
X
SL= 5tudge
SOL=Solid
Other (please
define
�S •,d
.sY4xi..a._x€e«;aa
a Preservation Codes:
I = Iced
ti
H = HCL
M = Methanol
N = Nitric Acid
S =Sulfuric Acid
-
B = Sodium Bisulfate
- 4
X = Sodium Hydroxide
m•-
T = Sodium
Thiosulfate
Comments:
O = Other (please
Please use the following codes to indicate possible sample concentration within the
define)
Conc Code column above:
H - High; M - Medium; L - Low; C - Clean; U - Unknown
Y Container Codes:
A = Amber Glass
Relinquished by: (signature)
Dat
Detection
Program Information
G = Glass
TiYnf (J /O//6//!L•�/(OOI
❑ 2L
DSCA ❑ UST/Trust Fund
SWS Landfi0. ❑ REC
P = Plastic
ST = Sterile
V = Vial
Rec/��/1v,e�d, by:/Isigna e) JO/f7//Y
Date/Tim[] GWPC
ACJ w• �Og
Ili
IHSB Orphaned Landfill
State Lead
S = Summa Canister
T = Tedlar Bag
O = Other(please
SWSL
Relinquished by: (signature)
Date/Tim IHSB
❑MSCC
Other:
define)
Received by: (signature)
Dat
`N Et a—WAIHA:IAP.JILrC{Accredited
I
Relinquished by: (signature)
Dat Project Entity
Other
PCB ONLY
❑ Government ❑ Municipality
Date/Tirt❑ Federal ❑ Brownfield
❑ Chromatogram
❑ AIHA-LAP,LLC
❑ Soxhlet
❑ Non Soxhlet
Received by: (signature)
❑ City ❑ School