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HomeMy WebLinkAboutNCG140246_MONITORING INFO_20190304STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /vLId ciLl� DOC TYPE ❑HISTORICAL FILE � MONITORING REPORTS DOC DATE ❑ Odd/ � U 3 d / YYYYMMDD ANNUAL SUMMARY DISCHARGE MONITORING REPORT (DMR) — STORMWATER SUBMIT TO CENTRAL OFFICE* General Permit No. NCG140000 Calendar Year 2018 *Report ALL STORMWATER monitoring data on this form (include "No Flovd'1"No Discharge" and Benchmark Exceedances) from the previous calendar year to the DEQ by MARCH 1 of each year. Certificate of Coverage No. NCIS 14 ® ]F4 6 Facility Name: Arrowood County: Mecklenburg County Phone Number: (704 ) 529-6364 Certified Laboratory Prism Lab Lab # 402 Lab # Total no. of SDOs monitored 2 Stormwater Discharge Outfall (SDO) No. 001 VMA Outfall? Yes ❑ No ❑✓ Is this outfall currently in Tier 2 for any parameter? Yes ❑ No 0 Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑✓ RECEI F If this outfall was in Tier 2 last year, was monthly monitoring discontinued? T1 V Yes, enough consecutive samples below benchmarks to decrease frequency ❑ MAR 0 4 201 ) Yes, received approval from DEMLR to reduce monitoring frequency 0 CENTRAL FIL! :S Other ❑ WIR SIWCTIC M Outfall No. Total Rainfall, inches Total Suspended Solids (TSS), m II pH, SU Non -polar O&G (EPA Method 1664 S ( GT-HEMJ), mgll (VMA) It applicable New Motor Oil Usage allmo. 9 (9 ) rf applicable Stormwater Benchmarks indicate NO FLOW A applicable Circle Benchmark .� 0�! J (} V 6.0_9 0 .� G J y55 g aVmo. average requires T55 and Non -polar O&G mo nitoring Date Sample Collected 1 molddl r P�� f '. a � fd. 5 4 Sf'° P 3 -A, r i:l 3/6/2018 001 190 7.9 T55 excess due to runs off from Quarry Property 6/27/2018 001 NO FLOW 9/10/2018 NO FLOW 10/26/2018 001 NO FLOW Permit Date 8/1/2017 -- 6/3012022 Last Revised 8-22-2015 Certificate of Coverage No. NCGU 0❑ 2❑®© Additional Outfall Attachment (make copies as needed for additional outfalls) Stormwater Discharge Outfall (SDO) No. 002 VMA Outfall? Yes ❑ No ❑ Is this outfall currently in Tier 2 for any parameter? Yes ❑ No ❑ Was this outfall ever in Tier 2 during the past year? Yes ❑ No ❑ If this outfall was in Tier 2 last year, was monthly monitoring discontinued? Yes, enough consecutive samples below benchmarks to decrease frequency El Yes, received approval from DEMLR to reduce monitoring frequency Other ❑ Outfall No. Total Rainfall, inches Total Suspended Solids (TSS), rp /I pH, SU Non -polar O&G (EPA Method 1664 (SGT-HEM)), mg/1 (VMA) it applicable New Motor Oil Usage (gallmo.) flapplicable S tormwa ter Benchmarks lrrdkare NO FLOW it applicable Circle Benchmark 1 0 o'�a 6.�_9.� � � >55 gallmo, average requires TSS and Non -polar O&Gmonitoring Date Sample Collected, molddl r ° +'"sP` §; `" h a-'i.4 `ap" a , are r' y Paz :, �a 612712018 PW 002 BRL 7.8 10/26/2018 PW 002 BRL 11 Permit Date 8/1/2017 — 6/30/2022 Last Revised 8-22-2015 Certificate of Coverage No. NCG14 0 — L CERTIFICATION "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false informatiory, including the possibility of fines and imprisonment for knowing violations." [Required by 40 CAR §122.22] Signature Date i� Mail Annual Summary Stormwater DMR to the NCDEQ Central Office: Note the address is correct — Central Files is housed in DWR (not DEMLR) N.C. Department of Environmental Quality (DEQ) Division of Water Resources Attn: DWR Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 Central Files Telephone (919) 807-6300 Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at: (919) 707-9220 Permit Date 8/1/2017 — 6/30/2022 Last Revised 8-22-2015 Certificate of Coverage No. NCG14 17,CF- CERTIFICATION I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information}, including the possibility of fines and imprisonment for knowing violations." (Required by 40 C1,,R §122. Signature Date i5 Mail Annual Summary Stormwater DMR to the NCDEQ Central Office: Note the address is correct — Central Files is housed in DWR (not DEMLR) N.C. Department of Environmental Quality (DEQ) Division of Water Resources Attn: DWR Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 Central Files Telephone (919) 807-6300 Questions? Contact DEMLR Stormwater Permitting Staff in the Central Office at: (919) 707-9220 Permit Date 8/1/2017 — 6/30/2022 Last Revised 8-22-2015 W1% Enviranmen1al Quality Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit hMs://deq.nc.goviabout/divisions/energy-mineral-land- resources/energyy-mineral -land -permits/stormwater-pertnits/npdes-industrial-sw#tab-4 Permit No.: NICI _l�l ll�l_l l or Certificate of Coverage No.: N_IC/GI%l 41�1�11 �l Facility Name: , 1g (14d CA I e— Iy 0 County: e— Phone No. 9 l Z-1 1 t1 o fl Inspector: Date of Inspection:�z� I Zip j Time of Inspection: JAN %b Zb13 Total Event Precipitation (inches): 7S GENTRAI- FILES R SEOTIOn All permits require qualitative monitoring to be performed during a "measurable storm event." A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DEMLR Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or Designee) 1. Outfall Description: Outfall No. — Structure (pipe, ditch, etc.): t�e�V1 Receiving Stream: Describe the industrial activities that i the outfall drainage area: 16+4 Page 1 of 2 S"-242, Last modified 07l2W2017 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint • (light, medium, dark) as descriptors: CI*-,r- 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): tit o P) -e- 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 6l 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 (D 3 40 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge; where 1 is no solids and 5 is extremely muddy: 5 2 3 4 5 7. Is there any foam in the stormwater discharge? p Yes • No. 8. Is there an oil sheen in the stormwater discharge? ©Yes ® No. 9. Is there evidence of erosion or deposition at the outfall? o Yes • No. 10. Other Obvious Indicators of Stormwater Pollution: List and describe Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 5AIU-242, Last modified 07/28/2017 - TABLE 9.1 ANALYTICAL MONITORING REQUIREMENTS-STORMWATER READY MIXED CONCRETE COMPANY - PLANT # DISCHARGE UNITS BENCHMARK SAMPLE SAMPLING CHARACTERISTIC VALUES LOCATION SCHEDULE pH Standard Within range , Each Outfall Semi -Annually 6.0 to 9.0 Total Suspended Solids (TSS) mg/L 100 mg/L2 Each Outfall' Semi -Annually Total Petroleum Hydrocarbons3 mg/L 15 mg/L Each Outfall' Semi -Annually Event Duration Minutes Not applicable Each Outfall' Semi -Annually Total Rainfall Inches Not applicable Each Outfall' Semi -Annually New Motor Oil Usage3 Gallons/ Month Not applicable Not applicable Semi -Annually Notes: 1. Samples shall be collected at each stormwater discharge outfall unless representative outfall status has been granted and documented by the Division of Water Quality. A copy of the letter granting representative outfall status shall be kept on site. 2- TSS benchmark for ORW, HWQ, Trout or PNA waters is 50 mg/L. 3. Only required for sites where vehicle maintenance activities occur. 4. All samples must be grab samples. Grab samples shall be collected within the first 30 minutes of discharge from a stormwater discharge outfall (SDO). 5. All samples must be collected during a measurable storm event. A measurable storm event is an event that results in an actual discharge from the permitted site outfalls. The previous measurable storm event must have been at least 72 hours prior. If no discharge occurs during a sampling period, a monitoring report indicating "No Flow" must be submitted within 30-days of the sampling period. 6. For each sampled measurable storm event the total precipitation must be recorded using an on -site rain gauge. 7. The permittee shall complete the analytical samplings in accordance with the schedule specified above, unless adverse weather conditions prevent sample collection. Inability to sample due to adverse weather conditions must be documented in the SPPP and reported on the appropriate DMR form (Appendix A). 8. A minimum of 60 days must separate each monitoring event unless monthly monitoring has been instituted under a Tier Two response 9. The permittee shall compare monitoring results to the above -referenced benchmark values for each discharge characteristic. Exceedances of benchmark values require the permittee to increase monitoring, increase management actions, increase record keeping, and/or install stormwater Best Management Practices (BMPs) in a tiered program, as specified by the general permit. 10. Failure to monitor semi-annually per permit terms immediately institutes monthly monitoring for all stormwater parameters. After six months of monthly monitoring, the permttee may make a request in writing to the Division of Water Quality to return to a semi-annual monitoring schedule. STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCG14 D 2 ~?� FACILITY NAME: PERSON COLLECTING SAMPLES '�w f CERTIFIED LABORATORY c c Lab # 4 Lab # OPTIONAL INFO: Part A: Stormwater Monitoring Requirements SAMPLE COLLECTION YEAR: Zo f O SAMPLING PERIOD: ❑ July -December January -June COUNTY (A&- k t- PHONE NO. (_q)j)_ Z r 7 - ?Too ADD TO LISTSERVE? ❑YES D40 EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA []Trout []Other Outfall Na. Date Sample Collected {mo/dd/yr OR NO FLOW)t pH {Standard Units} TSS (mg/L) Event Duration (minutes) Total Rainfall` (in) In Tier 2 Monthly Monitoring? (y/n) # of Months in2 Tier 2 Sampling - 6-9 100 , - - 1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above. 2 If a value is In excess of the benchmark, or outside the benchmark range ifor pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range. 3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I. `For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge. Permit Date: 7/1/2011-60/30/2015 1 last Revised 7/13/11 • Page 1 of 2 Date of last pH meter calibration: /Z AO/� Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year. Outfall No. Date Sample Collected (mo/dd/yr)' pH (Standard Units) TPH using method 1664ASGT-HEM (mg/L) Total Suspended Solids (mg/L) Event Duration (minutes) Total Rainfall' (in) New Motor Oil Usage (gal/month) In Tier 2 Monthly Monitoring? (y/n) k of Months in Tier 2 Sampling 6-9 15 100 ' - - - - I HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDr AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO HAVE YOU CONTACTED THE REGION? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail Original and one copy of this DMR f includinR all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period in case of "No Flow") to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." � /,y (Signature o ermittee) (Date) Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 2 of 2 TABLE 9.2 ANALYTICAL MONITORING REQUIREMENTS -PROCESS WASTEWATER READY. MIXED CONCRETE COMPANY -- PLANT # DISCHARGE. EFFLUENT SAMPLE SAMPLING' CHARACTERISTIC UNITS LIMITATIONS LOCATION SCHEDULE PH' Standard 6.0 — 9.0 Each Outfall2 Quarterly Total Suspended Solids (TSS) mg/L 30 mgIL3 Each Outfa,12 Quarterly Settleable Solids mLIL 5 mUL Each Outfa,12 Quarterly Total Petroleum Hydrocarbons' mg/L 15 mg/L Each Outfal12 Quarterly Event Duration Minutes Not applicable Each Outfall2 Quarterly Flow$ Gallons/Day Not applicable Each Outfal12 Quarterly New Motor Oil Usage Gallons/ Month Not applicable Not applicable Quarterly Total Volume of Wastewater Not applicable 50% of summer Not Applicable Quarterly Discharged (HQW) 7Q10 Flow Notes: 1. pH range for saltwaters is 6.8 — 8.5. 2. Samples shall be collected at each process wastewater outfali during a discharge event. 3. TSS effluent limitation HQW is 20 mg/L and 10 mg/L for Trout or PNA waters. 4_ Only required for sites where vehicle maintenance activities occur and process wastewater commingles with stormwater. 5. Flow may be measured continuously or calculated. 6. See 15A NCAC 02B .0224 and general permit for explanation. 7. All samples must be grab samples. Grab samples shall be collected within the first 30 minutes of discharge from a process wastewater outfall. 8. If no discharge occurs during a sampling period, record "No Flow" or "No Discharge" within 30-days of the end of the sampling period and file with SPPP. 9. Commingled discharges must be collected during a measurable storm event. A measurable storm event is an event that results in an actual discharge from the permitted site outfalls. The previous measurable storm event must have been at least 72 hours prior. 10. For each sampled measurable storm event the total precipitation must be recorded using an on -site rain gauge. 11. The permittee shall complete the analytical samplings in accordance with the schedule specified above, unless adverse weather conditions prevent sample collection. Inability to sample due to adverse weather conditions must be documented in the SPPP and reported on the appropriate DMR form (Appendix A). 12. For commingled discharges, a minimum of 60 days must separate each monitoring event unless monthly monitoring has been instituted under a Tier Two response 13. The permittee shall compare monitoring results to the above -referenced effluent limitations for each discharge characteristic. Exceedances of effluent limitations will result in a violation of permit conditions and may be subject to enforcement. 14. Failure to monitor process wastewater quarterly per permit terms immediately institutes monthly monitoring for all parameters. After six months of monthly monitoring, the permitee may make a request in writing to the Division of Water Quality to return to a quarterly monitoring schedule. aceAnaljftal ~pacelabs.com Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704 )875-9092 April 30, 2018 Jay Watkins Ready Mix Concrete 3610 Bush Street Raleigh, NC 27609 RE: Project: Plant 1 Knightdale Pace Project No.: 92382336 Dear Jay Watkins: Enclosed are the analytical results for sample(s) received by the laboratory on April 25, 2018. The results relate only to the samples included in this report. Results reported herein conform to the most current, applicable TNIINELAC standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. If you have any questions concerning this report, please feel free to contact me. Sincerely, C�-hl.+LL04 Angela Baioni angela.baioni@pacelabs.com (704)875-9092 Project Manager Enclosures REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 1 of 10 aceARalj cal ' svww.patelabs.com Pace Analytical Services, LLC 9800 Kincey Ave, Suite 100 Huntersville, NC 28078 (704)875-9092 Project: Plant 1 Knightdale Pace Project No.: 92382336 Eden Certification IDS 205 East Meadow Road Suite A, Eden, NC 27288 North Carolina Drinking Water Certification M 37738 CERTIFICATIONS North Carolina Wastewater Certification #: 633 VirginialVELAP Certification #: 460025 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 2 of 10 aceAnalytical www.pacelab$'c= Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704 )8759092 Project: Plant 1 Knightdale Pace Project No.: 92382336 Lab ID Sample ID 92382336001 Outliall #1 Plant 1 SAMPLE ANALYTE COUNT Analytes Method Analysts Reported Laboratory SM 2540D RAY 1 PASI-E REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 3 of 10 aceAnalXical www.pacelabs.com Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersviile, NC 28078 (704)875-9092 ANALYTICAL RESULTS Project: Plant 1 Knightdale Pace Project No.: 92382336 Sample: Outfall #1 Plant 1 Lab ID: 92382336001, Collected: 04/24/18 12:15 Received: 04/25/18 16:20 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No, Qual 2540D Total Suspended Solids Total Suspended Solids Date: 04/30/2018 02:13 PM Analytical Method: SM 2540D 3.1 mg1L 2.7 1 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. 04/27/18 11:29 Page 4 of 10 aceAnalWical - mvw.pacefabs.cam Pate Analytical Services, LLG 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: Plant 1 Knightdale Pace Project No.: 92382336 QC Batch: 408249 QC Batch Method: SM 2540D Associated Lab Samples: 92382336001 METHOD BLANK: 2265174 Associated Lab Samples: 92382336001 Parameter units Total Suspended Solids mg1L LABORATORY CONTROL SAMPLE: 2265175 Parameter Units Total Suspended Solids mg/L QUALITY CONTROL DATA Analysis Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 2.5 04/2711811:28 Spike LCS LCS % Rec Cone. Result % Rec Limits Qualifiers 250 228. 91 90-110 SAMPLE DUPLICATE: 2265176 92382423002 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 26.4 31.4 17 D6 SAMPLE DUPLICATE: 2265177 92382426001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 155 160 3 Results presented on this page are In the units indicated by the "Units" column except where an alternate unit Is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 04/30/2018 02:13 PM without the written consent of Pace Analytical Services, LLC. Page 5 of 10 aceAnalytical W"..pacelabs.com Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 {704)875-9092 QUALIFIERS Project: Plant 1 Knightdale Pace Project No.: 92382336 DEFINITIONS DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot. ND - Not Detected at or above adjusted reporting limit. TNTC - Too Numerous To Count J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit. MDL- Adjusted Method Detection Limit, PQL - Practical Quantitation Limit. RL - Reporting Limit. S - Surrogate 1,2-Diphenyihydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is a combined concentration. Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values. LCS(D) - Laboratory Control Sample (Duplicate) MS(D) - Matrix Spike (Duplicate) DUP - Sample Duplicate RPD - Relative Percent Difference NC - Not Calculable. SG - Silica Gel - Clean -Up U - Indicates the compound was analyzed for, but not detected. Acid preservation may not be appropriate for 2 Chloroethylvinyl ether. A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA Method 8260. N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyze is a combined concentration. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI - The NELAC Institute. LABORATORIES PASI-E Pace Analytical Services - Eden ANALYTE QUALIFIERS D6 The precision between the sample and sample duplicate exceeded laboratory control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 04/30/2018 02:13 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 10 aceAnalytical www.pacelabs.com Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 kuntersville, NC 28078 (704 )875-9092 QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: Plant 1 Knightdale Pace Project No.: 92382336 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92382336001 Outfall #1 Plant 1 SM 2540D 408249 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 04l30I2018 02:13 PM without the written consent of Pace Analytical Services, LLC. Page 7 of 10 Document Name: Document Revised: February 7, 2018 Condition Upon Recelpt(SCUR) Page 1 of 2 Document No.: Issuing Authority: F•CAR-CS•033-Rev.06 Pace Carolinas Quality Office Laboratory receiving samples: Asheville ❑ Eden❑ Greenwood ❑ Huntersvilie ❑ Raleigh Mechanicsville❑ Client Name: t �O z' '923�2336_ ,-.. FroJett #: -_ - - - - Courier, ❑Fed Ex ❑UPS ❑LISPS Client ❑ Commercial ❑Pace ❑Other: j 23368' f + 9238 •` Custody Seal Present? ❑Yes 'QK0____Seals Intact? ❑Yes Date/Initials Person Examining Contents: A- Packing Material: ❑Bubble Wrap ❑Bubble Bags None ❑ Other Thermome er: 7� iR Gun IO:/"Z(� Type of Ice: Wet ❑Blue Cooler Temp ('C): 2-Ar Correction Factor: Add ubtrac ('Ci - Cooler Temp Corrected ('C): :, USDA Regulated Soil P6 N/A, Prater sample) Did samples origi a in a quarantine zone within the United States: CA, NY, or SC (check maps)? F-U.s PFNn Biological Tissue en? ❑None ❑Yes ONO N/A Temp should be above freezing to s'C ❑Samples out of temp criteria. Samples on Ice, cooling process has begun Did samples originate from a foreign source (internati indudinr Hawaii and Puerto Rlco17 11Yes Fie. Comm ants/Discrepancy: Chain of Custody Present? es (]No ❑N!A 1. Samples Arrived within Hold Time? [:IN. N/A 2. Short Hold Time Analysis (<72 hr.)? Elves 2< /A 3. Rush Turn Around Time Requested? Yes o ❑N/A 4. Sufficient Volume? es No CINJA S. Correct Containers Used? -Pace Containers Used? Y es Na No I]N/A ❑N/A 6. Containers Intact? Yes [:]No ❑N/A 7.' ` Dissolved analysis: Samples Field Filtered? ❑Y Na Sample Labels Match COC? -includes Date/Time/ID/Analysis Matrix: es ❑No ❑N/A 9. Headspace in VOA Vials (>S-6mm)7 ElYes ❑Na N/A 10. Trip Blank Present? -- Trip Blank Custody Seals Present? ©Yes (]Yes ❑No ❑No NIA N/A 11. — COMMENTS/SAMPLE DISCREPANCY CLIENT NOTIFICATION/RESOLUTION Person contacted: Project Manager SCURF Review:�� Project Manager SRF Review: Date/fime: Field Data Required? ❑Yes (]Nc, Lot ID of solitcontainers: Date: Date: Page 8 of 10 >z O M 9 O m O ro m 2 c R x C ro � �a CL o m N m 4 .-r A fD n � ^ 3 t-- O (q d `c' Oa � A � a M w m-y -a C C. m ` to c' M ro n � al -a, o � ]a 3 3r CL n n' M n d m , Y .�tl m V th In A1 W N F+ Remq zzzzzzzzzizzz BP4U-125 mL Plastic Unpreserved (N/A) (Q-) BP3U-250 mL Plastic Unpreserved (N/A) OM-500 mL Plastic Unpreserved (N/A) BP1U-1 liter Plastic Unpreserved (N/A) BP4S-125 mL Plastic H2504 (pH < 2) (Cl.) BP3N-250 mL plastic HNO3 (pH < Z) BP42-125 mL Plastic ZN Acetate Rt NaOH 1>9) BP4C-125 mL Plastic NBOH (pH > 12) (Cl-) .WGFU-Wide-mouthed Glass jar Unpreserved AG1U-1 liter Amber Unpreserved (N/A) (CI-) AGIR-1 liter Amber lid (pH < 2) AG3U-250 mL Amber Unpreserved (N/AI (CI-) AGiS-1 liter Amber H2SO4 (pH a 21 //Z 7�7 AG35.250 mL Amber ff2SO4 (pH < 2) zzAG3A(DG3A)-250 nil. Amber NH4C1(N/Aj(Cl•) DG9H-40 mL VOA HCI (N/A) VCMT 40 mL VOA Na25203 (N/A) VG9U-40 mL VOA Unp (N/A) OG9P-40 mL VOA H31304 (N/A) VOAK (5 vials per kitj 5035 kit (N/A) V/GK (3 vials per kit)-VPH/Gas kit (N/A) SPST-125 mLSterile Plastic (N/A —lab) 5PZT-250 mL5terliePlastic (N/A— lab) MA-250 mL Plastic (NH2)2SO4 (9.3-9.7) AGOU-100 mL Amber Unpreserved vials (N/A) VSGU-20 rnL Scintillation vials (N/A) DG9U-40 ml,Amber Unpreserved vials (N/A) 0 O A 3 h N C � 3 d D CL O Cr y 0 @ O d a 0 tu x M CL r T G) V 3 " ro v M m CLI � 7 ro °o C . CL _ rr � S ro m 0 rn �. tra Arl� SOclionA Rrmulred Client Intornurion: S"tiorl 5 R.— �im'k CHAIN -OF -CUSTODY I Analytical Request Document The Chain -of -Custody is a LEGAL DOCUMENT, All relevant fields must be completed accurately, Company: R-adymuConcrete Rawn To, Jay Watkins Atlarglom, Address'. 3611) Bush Street Copy To: Company Name, Raloiqti. NC: 276io L Address Remdatoiy Agency 7,c Purchase Order 0: P - UCQ OL101C PRequestad Project Name: S Containers Pum Project mamager. aNela.baioruP prolabztcaxn, Duo Date. Project N: 09 1 e% J P. Pro'L'. 0: Nc z uArRm CODE COLLECTED Preservatives 0." W.W ow pp - WRt., wr W-W Www — Y is U P S.Q%.J. SAMPLE ID - START E 2 00 OL one Character or box. Wipe WP AA 12 '-3 (A ZatL. 0-9 1, On.. Or Sampla Ids C, >- :K Mu2t he mn;que T- 3: DATE TIME DATE TIME F- 9x #12-ke of.' Vj?' OD I V. r X '12 AOpITSONAL COMMENTS L��CiU BY I AF�19:—'. M [MM 13A7rz,.' AcCEP1TEnBYJA.F.F ;;DATE "PLE V-1 i0viPL6'NAME AND SIGNATURE PRINT NamoofSAMPLER: J�j �Ce-- -8 SIGNATURE of SAMPLER; DATE Signed; S Environmental Quality Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit ht s://de .nc. ov/about/divisions/ener -mineral-land- resources/energy-minera i-land permits/storrnwater-permits/npdes-industrial-sw#tab-4 Permit No.: NICI_I_I_I I l—l—1 or Certificate of Coverage No.: N/C/G/ 1 /N / 014-1 � Fes` Facility Name County: _ Inspector: ch �dar� lg� C- Phone No. 41- Z I - 9500 Date of Inspection: Time of Inspection: 3 ',s O 6vt >1 M q Jti r_ - Total Event Precipitation (inches) ,,,D V c,CNTR,AFILES ,T10;1 GVVRS- All permits require qualitative monitoring to be performed during a "measurable storm event." A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DEMLR Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or Designee) 1. Outfall Description: f Outfall No. I Structure (pipe, ditch, etc.):L"1 Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: G c- ;r " t, o v �, •M Page 1 of 2 SwU-242, Last modified 07/28/2017 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint f (light, medium, dark) as descriptors: A j ' 1J 2 ro-.j - 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,.etc.): uo a C- 4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy: 1 2� 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where I is no solids and 5 is the surface covered with floating solids: CD 2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: a2 3 4 5 7. Is there any foam in the stormwater discharge? Q Yes ® No. 8. Is there an oil sheen in the stormwater discharge? QYes ® No. 9. Is there evidence of erosion or deposition at the outfall? p Yes ® No. 10. Other Obvious Indicators of Stormwater Pollution: List and describe ri p Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SNVU-242, Last modified 07/28/2017 TABLE 9.1. ANALYTICAL MONITORING REQUIREMENTS-STORMWATER READY MIXED CONCRETE COMPANY — PLANT # DISCHARGE UNITS BENCHMARK' SAMPLE SAMPLING CHARACTERISTIC VALUES. 'LOCATION SCHEDULE pH Standard Within range 6.0 to 9.0 , Each Outfall Semi -Annually Total Suspended Solids (TSS) mg/L 100 mg/L2 Each Outfall' Semi -Annually Total Petroleum Hydrocarbons 3 mg/L 15 mg/L Each Outfall' Semi -Annually Event Duration Minutes Not applicable Each Outfall' Semi -Annually Total Rainfall Inches Not applicable Each Outfall' Semi -Annually New Motor Oil Usage Gallons/ Month Not applicable Not applicable Semi -Annually Notes: 1. Samples shall be collected at each stormwater discharge outfall unless representative outfall status has been granted and documented by the Division of Water Quality. A copy of the letter granting representative outfall status shall be kept on site. 2. TSS benchmark for ORW, HWQ, Trout or PNA waters is 50 mg/L. 3. Only required for sites where vehicle maintenance activities occur. 4. All samples must be grab samples. Grab samples shall be collected within the first 30 minutes of discharge from a stormwater discharge outfall (SDO). 5. All samples must be collected during a measurable storm event. A measurable storm event is an event that results in an actual discharge from the permitted site outfalls. The previous measurable storm event must have been at least 72 hours prior. If no discharge occurs during a sampling period, a monitoring report indicating "No Flow" must be submitted within 30-days of the sampling period. 6. For each sampled measurable storm event the total precipitation must be recorded using an on -site rain gauge. 7. The permittee shall complete the analytical samplings in accordance with the schedule specified above, unless adverse weather conditions prevent sample collection. Inability to sample due to adverse weather conditions must be documented in the SPPP and reported on the appropriate DMR form (Appendix A). 8. A minimum of 60 days must separate each monitoring event unless monthly monitoring has been instituted under a Tier Two response 9. The permittee shall compare monitoring results to the above -referenced benchmark values for each discharge characteristic. Exceedances of benchmark values require the permittee to increase monitoring, increase management actions, increase record keeping, and/or install stormwater Best Management Practices (BMPs) in a tiered program, as specified by the general permit. 16. Failure to monitor semi-annually per permit terms immediately institutes monthly monitoring for all stormwater parameters. After six months of monthly monitoring, the permitee may make a request in writing to the Division of Water Quality to return to a semi-annual monitoring schedule. TABLE 9.1 ANALYTICAL MONITORING REQUIREMENTS-STORMWATER READY MIXED CONCRETE COMPANY- PLANT # DISCHARGE' UNITS BENCHMARK SAMPLE SAMPLING CHARACTERISTIC VALUES.-, LOCATION SCHEDULE pH Standard Within range 6.0 to 9.0 i Each Outfall Semi -Annually Total Suspended Solids (TSS) mglL 100 mg/L2 Each Outfall' Semi -Annually Total Petroleum Hydrocarbons3 mg/L 15 mg/L Each Outfall' Semi -Annually Event Duration Minutes Not applicable Each Outfall' Semi -Annually Total Rainfall Inches Not applicable Each Outfall' Semi -Annually New Motor Oil Usage Gallons/ Month Not applicable Not applicable Semi -Annually Notes- 1 . Samples shall be collected at each stormwater discharge outfall unless representative outfall status has been granted and documented by the Division of Water Quality. A copy of the letter granting representative outfall status shall be kept on site. 2. TSS benchmark for ORW, HWQ, Trout or PNA waters is 50 mg/L. 3. Only required for sites where vehicle maintenance activities occur. 4. All samples must be grab samples. Grab samples shall be collected within the first 30 minutes of discharge from a stormwater discharge outfall (SDO). 5. All samples must be collected during a measurable storm event. A measurable storm event is an event that results in an actual discharge from the permitted site outfalls. The previous measurable storm event must have been at least 72 hours prior. If no discharge occurs during a sampling period, a, monitoring report indicating "No Flow" must be submitted within 30-days of the sampling period. 6. For each sampled measurable storm event the total precipitation must be recorded using an on -site rain gauge. 7. The permittee shall complete the analytical samplings in accordance with the schedule specified above, unless adverse weather conditions prevent sample collection. Inability to sample due to adverse weather conditions must be documented in the SPPP and reported on the appropriate DMR form (Appendix A). 8. A minimum of 60 days must separate each monitoring event unless monthly monitoring has been instituted under a Tier Two response 9. The permittee shall compare monitoring results to the above -referenced benchmark values for each discharge characteristic. Exceedances of benchmark values require the permittee to increase monitoring, increase management actions, increase record keeping, and/or install stormwater Best Management Practices (BMPs) in a tiered program, as specified by the general permit. 10. Failure to monitor semi-annually per permit terms immediately institutes monthly monitoring for all stormwater parameters. After six months of monthly monitoring, the permitee may make a request in writing to the Division of Water Quality to return to a semi-annual monitoring schedule. STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM GENERAL PERMIT NO. NC6140000 CERTIFICATE OF COVERAGE No. NCG141.> Z FACILITY NAME: fc, K i I k-F d.,(�. PERSON COLLECTING SAMPLES _PLO4 2 h.1'_ W, Lek II CERTIFIED LABORATORY a - e Lab # q l Lab # OPTIONAL INFO: Part A: Stormwater Monitoring Requirements SAMPLE COLLECTION YEAR: Z01.0 SAMPLING PERIOD: Rfuly-December COUNTY k c ❑ January -June PHONE NO. { 4 2 1 / " ;r; D O ADD TO LISTSERVE? [—]YES g(40 EMAIL: DISCHARGING TO CLASS: []SA ❑HQW ❑PNA ❑Trout ❑Other Outfall No. Date Sample Collected (mo/dd/yr OR NO FLOW)t PH (Standard Units) T5S (mg/L) Event Duration (minutes) Total Rainfall (in) In Tier 2 Monthly Monitoring? (Y/n) # of Months in Tier z z Sampling - - 6-9 100 - - - i I 1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above. 2 If a value is In excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range. 3 TSS benchmark values are 100 mg/!, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I. `For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge. Permit Date: 7/1/2011-60/30/2015 Date of last pH meter calibration: _ / /L/Lo /d _ i Last Revised 7/13/11 Page 1 of 2 Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month --averaged over a calendar year Outfall No. Date Sample collected (mo/dd/yr) pH {Standard Units TPH using method 1664A SGT-HEM (mg/L) Total Suspended Solids (mg/L) Event duration (minutes) ) Total Rainfa all (in) New Motor Oil Usage (gal/month) In Tier 2 Monthly Monitoring? (y/n) 0 of Months in Tier 2 i Sampling 6-9 'is' tJ,I,A -4)Q I HAS YOUR FACILITY HAD a OR MORE BENCHMARK EXCEEV AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO [y HAVE YOU CONTACTED THE REGION? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail Oriainal and one coov of this DMR (including all "No Flow" & "No C ischarge" 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: DWQCentral 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." (Signature of Permittee) ;Date) Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 2 of 2 _117, aceAnalytical www,pacefabs,com yaw nuicey nve. z. ILU iuv Huntersville, NC 28078 (704)875- 9092 November 23, 2018 Bruce Creech Argos USA Corp./Ready Mix Concrete 3200 Spring Forest Road Raleigh, NC 27616 RE: Project: Plant 1 Knightdale Pace Project No.: 92407509 Dear Bruce Creech: Enclosed are the analytical results for sample(s) received by the laboratory on November 15, 2018. The results relate only to the samples included in this report. Results reported herein conform to the most current, applicable TNI/NELAC standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. If you have any questions concerning this report, please feel free to contact me. Sincerely, 0 „r�`Q0L. Angela Baioni angela.baioni@pacelabs.com (704)875-9092 Project Manager Enclosures REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 1 of 13 aceAnalytical. p www.pece)abs.com f Project: Plant 1 Knightdale Pace Project No.: 92407509 CERTIFICATIONS REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC, `JOLV ro lcey MVC. oulw 1vv Huntersville, NC 28078 (704)875-9092 Page 2 of 13 '/7�qxAnalytical www.pacetabs.com f Project: Plant t Knightdale Eden Certification IDs 205 East Meadow Road Suite A, Eden, NC 27288 North Carolina Drinking Water Certification #: 37738 Pace Project No.: 92407509 North Carolina Wastewater Certification #: 633 VirginiaNELAP Certification #; 460025 SAMPLE ANALYTE COUNT REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in furl, without the written consent of Pace Analytical Services, LLC. aovv No icey wvrr. Dune i vv Huntersville, NC 28078 (704)875-9092 Page 3 of 13 � aow nmcey nve_ awe i uu /�ceAnaly real I-luntersvil)e, NC 28078 �pacelabscom {704)875 9092 f/ I Project: Plant 1 Knightdale Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92407609001 Outfall 1 SM 254OD-2011 SAM1 1 PASI-E REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the writlen consent of Pace Analytical Services, LLC.- Page 4 of 13 } 1�ceAnalytical www.Fiaowabs.c" aouu nilluey nvu, oune i uu Huntersville, NC 28078 (704)875-9092 Project: Plant 1 Knightdale Pace Project No.: 92407509 Sample: Outfall 1 Date: 11/23/2018 05:52 PM ANALYTICAL RESULTS Lab ID: 92407509001 Collected: 11/14/18 15:00 Received: 11/15/18 14:46 Matrix: Water REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 5 of 13 ceAnalytical uwwpaCalafM.C= aovu nincey rwe, auua 'U" Huntersville, NC 28078 (704)875.9082 Project: Plant 1 Knightdale Parameters Results Units Report Limit DF 2540D Total Suspended Solids Analytical Method: SM 254OD-2011 Total Suspended Solids ND mg/L 5.8 1 Date: 11/23/2018 05:52 PM Prepared Analyzed CAS No. Qua! REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. 11/19118 09:33 Page 6 of 13 �aceAnaVical wwwpacalabs,mm I Project: Plant 1 Knightdale QUALITY CONTROL DATA Pace Project No.: 92407509 QC Batch: 443112 Analysis Method: SM 254OD-2011 QC Batch Method: SM 254OD-2011 Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92407509001 METHOD BLANK: 2431767 Matrix: Water Associated Lab Samples: 92407509001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mglL ND 2.5 11/19/18 09:33 aovv nsncey mvr. Dune i vu Huntersville, NC 28078 (704)875-9092 LABORATORY CONTROL SAMPLE: 2431768 Spike LCS LCS % Rec Parameter Units Cone. Result % Rec Limits Qualifiers Total Suspended Solids mg/L 250 268 107 90-110 SAMPLE DUPLICATE: 2431769 92407509001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L ND 6.0 Date: 11/2312018 05:52 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 7 of 13 ® aoUU ntnoey nve. 0ueC i uu ��ceAnalj6cal Huntersvllle, NC 28078 (704)875-9092 f www.p"abs,com t Project: Plant 1 Knightdale Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result. QUALIFIERS Pace Project No.: 92407509 DEFINITIONS DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 11/23/2018 05:52 PM without the written consent of Pace Analytical Services, t-LC. Page 8 of 13 acuu nnrcey MV". awe i uu /+p /jn f �+ f ® Huntersville, f+fC 28078 �[�C� /'1i r�Ii{[i�! (704)875-9092 wwwpacerabs.corn t i Project: Plant 1 Knightdale ND - Not Detected at or above adjusted reporting limit. TNTC - Too Numerous To Count J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit. MDL - Adjusted Method Detection Limit. PQL - Practical Quantitation Limit. RL - Reporting Limit - The lowest concentration value that meets project requirements for quantitative data with known precision and bias for a specific analyte in a specific matrix. S - Surrogate 1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is a combined concentration. Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values. LCS(D) - Laboratory Control Sample (Duplicate) MS(D) - Matrix Spike (Duplicate) DUP - Sample Duplicate RPD - Relative Percent Difference NC - Not Calculable. SG - Silica Gel - Clean -Up U - Indicates the compound was analyzed for, but not detected. Acid preservation may not be appropriate for 2 Chloroethylvinyl ether. A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA Method 8260. N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyte is a combined concentration. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI - The NELAC Institute. LABORATORIES PASI-E Pace Analytical Services - Eden Pace Project No.: 92407509 Date: 11/23/2018 05:52 PM QUALITY CONTROL DATA CROSS REFERENCE TABLE REPORT OF LABORATORY ANALYSIS This report shalt not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 9of13 /7WceAnalytkal »tivwpac91ab5.Corn r VOW I"MAly Mve. oulle I UU Huntersville, NC 28078 (704)875-9092 Project: Plant 1 Knightdale Lab ID Sample ID 92407509001 Outfall 1 Date: 1112312018 05:52 PM QC Batch Method 5M 2540D-2011 QC Batch Analytical Method 443112 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Analytical Batch Page 10 of 13 Laboratory receiving samples: Asheville ❑ Eden[] Greenwood ❑ Huntersville ❑ Raleigh Mechanicsville❑ MM Client Name; WO# ,• 92407509 `I f Pra)ett t1: Courier; ❑Fed Ex UP5 ❑u5P Client El Corn []Pace []Other: 92407509 111 111 1 /®®®LI I CustodySeal Present? ❑Yes ®No Seals Intact? [ Yes RNrr f Date/Initials Person Examining contents. // -75- /K Packing Materlal: ❑Bubble Wrap ❑Bubble Bags ONane ❑ Other Biological Tissue Frozen? Thermometer: []Yes ❑No JSNIA �� Type of Ire: �V1tet Cl QNone [Irk Gun ID; Cooler Temp ['Cl: _10 Cot ection Factor: Add/Subtract ('C) T - !�)—' Temp should beabove treating to 6'C Caoier Temp Corrected ('C): -' [Samples out of temp criteria.5amples on ice, cnofing process has heg,n USDA Regulated Sall ��N/A, water sample) Did samples originate ina�quarantine tone within the United States: CA, NY, or SC (check maps)7 old samples originate from a foreign source (internatbatily, rlYnc n,Yn Indudlrs H.: 2if and Puerto Rknl? F-Wes nFlo Comments/DisaepancY: Chain of Custody Present? es Q:vo ©N/A 1. 5amptes Arrived within Hold Time? es NO ❑NIA 2. Short Hold Time Analysis (02 hr.)? QYes No ONJA 3. Rush Turn Around rime Requested? Yes Na EINIA 4. Sufficient Volume? es QNo QrJJA S. Correct Comniners U_ed? -race con tainersused? (Bras ZYes []NO No QN/A ❑NIA S• Containers Intact? ;gYas No Q[JA 7. bissohfed anaiysis: Sarn les Field Fihered? OYes QNo /A S. _ Sample Labels Match CDC? Includes i?ate/Tirne/ID{Analysis Matrix, [Yu ]No []N/A 9. LoeR-iI 16 tLT; 111— Headspace in VOA Vials (75 iimm)i Yes No (N/A 1D. Trip Blank Present? Trip Blank CustodySeais Present? QYes QYes []No ❑No PN/A fart/A 11. COMMENTS/SAMPLE 015CFIEPANCY W ID Di split containers: CLIENT NOTIFICATION/RESOLUTION person contacted: Date rime: Field Data Requiredi []Yes Pla Project Manager SCURF Review: — Date: Project Manager SRF Review: � -S H j , Date: Document Name: Document Revised; February 7, 2019 f Sample Cond'Alan Upon Receipt{SCUR Page 1 of 2 �� � "�� • Document No.: Issuing Authority: F-CAR-CS•033•Rev.06 Pace Carolinas Quality Office 's *Check mark top half of box if pH and/or dechlorination is Project p verified and within the acceptance range for preservation --'-"— samples. — PM: RMIrn1D►te Date:Il'/26/18 CLIENT: 92•�Ready Mix { !'xeeptlntu: VDA, Colhrafm, roc, Off and Greasy olio/aa1S {water) uoc, LLHg A "Bottom half of box is to list number Df bottle G _ i W T. d h Y C1 6 � KI ? a 7 7 L V = U _ Z I x z ow p = �+ a � 1 � � � ? m x V 9 y0N� q I _� C r.1 0 N x N z O j Z Z L� 7 N a�i tv 4 G S ,�. j T y u V Ll u u jG C, E f1 E t Q 5 T Jc _ Y a m L E q ¢ O O a O a; O a a M a a Fr E Q 6 a w j J E E. E E F E E E .L E E E' o u`m u m E E E E _m E E Jt 6 N p n •,,, R _ ry l'1 '� O � O Q •�• > N O G ti Q .Nd n N .i � N rl 1 rs � N .-r 'S V r+ 7 , 7 S 4 a 6 4 2 0. 1 10 !!ll f:7 0 tom c a m M m ss � 41 ( d 4 4 d O > 7 A a 7 3 pH Adjustment Log for Preserved Samples Samplo tD Type of Presenntive pti upon receipt Date preservation adjusted r ne preserration adjusted Amount of Preservative acted Lot # i r<cs: wnenever cnem is oscrepyncy affecting rrerm Caralrna cmmpuance samples, a copy or cols tom ww oe cnnr cc tie noon um—& uw4ivn Li,.m rca;fen urrlce ice. put of gold, iicortect preservm.", out of teinp. incorrect comalners. .11 eAr jfr 1 SocWn A RCquired client infermatienr CHAIN -OF -CUSTODY 1 Anaiyticai Request Document The Chain -of -Custody is a LEGAL_ DOCUMENT. Alt relevant fields must be completed accurately. Sectinn B Section C Reouired Pro1r-ef infnm.ar:n..• ....t.•,. r..r....,.rr,,..� (!f compw •: Reaps Mi. Conaule Report To'. Joy L,v., - Angrcirn: AddfOG.r: 3610 Bush strool COPY TO.- - �- i Company Nprrf. Rn'ciah. NC 27610 Adltesr, Emair:' Sr dy - to Purchase Order rt Project Nano; Ctrrv; t Pace QuOle: Paca Proffer• Mweper, nApela,baioni retabs corn, ;'-:Stite f Ldcstlon `- Phorre t;p Fax Rarue.tea Due Dole: VmpGnq Projed 0: Paco Prsrde rt: NC Rc uestedAnid is Filk6i d- 1N .. , .. ` MATRIX woe A a C COLLECTED ' a Preservatives Z ?. VA" wr m ywx- w— VAN Y t . J z rRaa�n P SAMPLE ID Ee: Saa 5_ ' i iy '� 0 u IFm-' Q. aL START END a One Charter per box o n n Sample Ida mwt he ur>tgw r .,.. ru uW, $o O nc .� 5 C a _ DA3C TtMel OATF, TIML 1 J8'- - 77 a� rig' ` nA, .: , -nH�C :" ACCEPT@DeV111FTpJA74�Nf , r. •_ -< DATl - 71ME SAW042 COWMTtONS AOUiniNlALo3mmEirm ..s ,. RUMQUISHEo81�IAFFiL1ATIn1J fJAU! Z = SAMPLER NAUE AND SIG"TURE, _ PRINT' Rams al SAMPLER: � '& m 61Gr3ATUKE of SAMPLER:' DATE Signed: STORMWATER DISCHARGE OUTFALL (SDO) - Semi -Annual MONITORING FORM GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE No. NCG14Q Z q Z` FACILITY NAME: e PERSON COLLECTING SAMPLES Dw i I k ,-c- CERTIFIED LABORATORY « Lab # .91 Lab # OPTIONAL INFO: Part A: Stormwater Monitoring Requirements SAMPLE COLLECTION YEAR: Z-O f 7 SAMPLING PERIOD: [✓Tiny -December ❑ January -June COUNTY PHONE NO, (�} ADD TO LISTSERVE? ❑YES []NO EMAIL: DISCHARGING TO CLASS: ❑SA ❑HQW ❑RNA ❑Trout []Other Dutfall No. Date Sample Collected (mo/dd/yr OR NO FLOW)1 pH {Standard Units) TSS (mg/L) Event ura Duration (minutes) Total 4 Rainfall (in) In Tier 2 Monthly Monitoring? (y/n) # of Months in Tier 2 Samplings - - 6-9 100 ' - - - - ' v Zola CENTR %# Cn UVVR S ECTI m 1 If "NO FLOW" or "NO D15CHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above. 2 If a value is In excess of the benchmark, or outside the benchmark range ifor pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range. 3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I. For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge. Permit Date: 7/1/2011-60/30/2015 1 Last Revised 7/13/11 Page 1of2 Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using a SS gal of new motor oil/month — averaged over a calendar year. Outfall No. Date Sample Collected 1 (mo/dd/yr) pH (Standard Units) TPH using method 1664A S6T-HEM (mg/L) Total Suspended Solids (mg/L) Event Duration (minutes) Total Rainfall° (in) New Motor Oil Usage (gal/month) In Tler 2 Monthly Monitoring?Sampline [y/n) # of Months in Tier 2 6 9 1S 100 . - - - I HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO ❑ HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail Orieinal and one copy of this DMR (includine all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample for at end of monitoring period in case of "No Flow") to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTEV: "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 significa penalties for submitting ! information, including the possibility of fines and imprisonment for knowing violations." _ c� Z- ,AV (Signature of Permittee) ! (D Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 2 of 2 7� dJ MCDEMR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit: htW://norraimcdenr.Qrc/web/ir.Inpdes-storntyater/ Permit No.: u+ /�;/_f_/ /_/_/^/ ,/ or Certificate of Coverage No.: DULA/YA-/-011MI-P Facility Name: --L , -i,td- , - ii!I VA ICounty: Vi %LL Phone No. Inspector: �Q,Q441 j 1 Date of Inspection: Time of Inspection: .30 P+M Total Event Precipitation (inches): .4 1`f Was this a'Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event"or'measureable storm event' (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a'measureable storm event.' however, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. A'measuirable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature dPer6ttee or Designee) Page 1 of 2 SWU-242. Last modified 7/31/2013 I. Outfall Description: Outfall No. 1 Structure (pipe ditc tc.) Receiving Stream: Describe the jndustrial activities that occur within the outW1 drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: L 6Ar- 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): LXLJe 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 0 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 0 2 3 4 5 b. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: V2 3 4 5 7. Is there any foam in the stormwater discharge? Yes lQ 8. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? s 10. Other Obvious Indicators of Stormwater Pollution: List and describe IV Dti-,-- Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SwU-242, last modified 7/31/2013 IeAftalyticale mrw.peoslsb&=n September 18, 2017 Jay Watkins Ready Mix Concrete 3610 Bush Street Raleigh, NC 27609 RE: Project: Plant 1 Knightdale Pace Project No.: 92355102 Pace Anelyticai Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NO 28078 (704)875-BOD2 Dear .lay Watkins: Enclosed are the analytical results for sample(s) received by the laboratory on September 13, 2017. The results relate only to the samples included in this report. Results reported h erein conform to the most current, applicable TNI/NELAC standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. If you have any questions concerning this report, please feel free to contact me. . Sincerely, `Ml kf vx f't! Angela Baloni angela,baioni@ pacelabs.com (704) 875-9092 :i Project Manager Enclosures REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 1 of 10 IeAnalj4ibal wpw.pa�fahscOm Project: Plant 1 Knightdale Pace Project No.: 92355102 Eden Certification ills 205 East Meadow Road SLdte A, Eden, NC 27288 North Carolina Drinkfrig Water Certification #: 37738 CERTIFICATIONS North Carolina Wastewater Certification M. 633 Virgfnfa/VEtAP Certification 0: 460025 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except In full, without the wri ten consent of Pace Analytical Services, I.I.C. Pace Analytical 8ervlcaa, LI,C 9890 Kinc"Ave. Suite too Huntersvllle, NC 28079 I7o4j875.9092 Page 2 of 10 aceAnaly i al www.yacews cm SAMPLE ANALYTE COUNT Pau Ana"cat Services, LLC 9800 Kinc"Ave. Suite 100 HunteravZo, NC 28078 (704)B7rr9i092 Project: Plant 1 Knightdole Pace Project No.: 92355102 Analysts Lab ID Sample ID Method Analysts Reported Laboratory 92365102001 Outfall #1 Plant 1 Knightdale SM 2540D REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except In Tull, without the mitten consent of Pace Analytical Services, LLC. CTB PASI-E Page 3 of 10 I eAnal(XicSs �nrw.�Gefaba.cpn ANALYTICAL RESULTS Pace Analytical Services, LLC 9800KinceyAve. Sufte100 Huntersvitle, NC 2807$ (704)8759092 Project: Plant 1 Knightdale Pace Project No.: 92355102 Sample: Outtall *1 Plant 1 Lab ID: 92356102001 Collected: D9112I17 15:30 Received: 09113l17 13:55 Matrix: Water Knightdale Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 2640D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 4.2 mg/L 2.9 1 09115M 7 10:36 Date: 091i 512017 03:23 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except In full, without the written consent of Pace Analytical Services, LLC. Page 4 of 10 aceAnalXical www.parPlaEa.ccm I QUALITY CONTROL DATA Project: Plant 1 Knightdale Pace Project No.: 92355102 Pace Anatytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersvllle, NO 28078 (704)B75.9092 QC Batch: 377900 Analysis Method: SM 2540D QC Batch Method: SM 2540D Analysis Description: 25400 Total Suspended Solids Associated Lab Samples: 92355102001 METHOD BLANK: 2093661 Matrix: Water — Associated Lab Samples: 92355102DO1 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg1L ND 2.5 09/15/17 10:33 LABORATORY CONTROL SAMPLE: 2093662 Spike LCS LCS % Rae Parameter Units Cone. Result Rae Limits Quallfiers Total Suspended Solids mg/L 250 240 96 90-110 SAMPLE DUPLICATE: 2093663 92355099001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 159 273 53 D6 SAMPLE DUPLICATE: 2093664 92355067001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 3.7 164 191 D6 Results presented on this page are In the units Indicated by he "Urdu' column except where an attenuate unit Is presented to dw rigtd of the result REPORT OF LABORATORY ANALYSIS This report shell not be feprvduced, except in full, Data: 09/18/2017 03:23 PM without the written consent or Pace Analytical Services, LLC, Page 5 of io Paw Analytical Services, LLC aceAnalj6cal ® W°° "'eyA�. Suite too >iuntntersvE[le, NC 28079 r srwwpecelebs oom (704)875r9092 I QUALIFIERS Project: Plant 1 Knightdale Pace Project No.: 92355102 DEFINITIONS DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot. ND - Not Detected at or above adjusted reporting limit. TNTC - Too Numerous To Count J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit. MDL - Adjusted Method Detection Limit. PQL - Practical Quantitation Limit. RL - Reporting Limit. S - Surrogate 1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte Is a combined Concentration. Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values. LCS(D) -Laboratory Control Sample (Duplicate) MS(D) - Matrix Spike (Duplicate) DUP - Sample Duplicate RPD - Relative Percent Difference NC - Not Calculable. SG - Silica Gel - Ctean-Up U - Indicates the compound was analyzed for, but not detected. Acid preservation may not be appropriate for 2 Chloroethylvinyl ether. A separate vial preserved to a pH of 4-5 Is recommended In SW848 Chapter 4 for the analysis ofAcrolein and Acxylonit0e, by EPA Method 8260. N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyte is a combined concentration. Pace Analytical is TNI accrediled. Contact your Pace Phi for the current list of accredited analytes. TNI - The NELAC Institute. LABORATORIES PASI-E Pate Analytical Services - Eden ANALYTE QUALIFIERS 06 The precision between the sample and sample duplicate exceeded laboratory control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 09/1812017 03:23 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 10 aceAnafjdi a - wrnxpacela6s.crom Pace Analytical Services, LLC 980o Kincey Ave. Suite i o0 Huntersville, NC 28076 (704)8759092 QUALITY CONTROL DATA CROSS REFERENCE TABLE I Project: Plant 1 Knightdale Pace Project No.: 92355102 Lab ID Sample ID QC Batch Method QC Batch Analytical Method 92355102001 041all 81 Plant 1 Knightdale SM 2540D 377900 Date: 09f181201703:23 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except In full, without the written consent of Pace Analytical Services, LLC. Analytical Batch Page 7 of 10 sample Condition VP on Recelpt(s R Ya e i of 2 / CB /ki IC3jR f OOwment No.: Isauing Authority F-CAR-CS-033-Rev.03 Pate CWHIL pljlto tal:oratary receiving samples: Ashevilla ❑ Eden❑ Greenwood ❑ Huntersvllle ❑ peleigho MescllankswBOO C1teMlVame: P_V� � di O# : 923551@2 4 projed0: Colnlen Fed ~it U> QUSps Ient 11111111 HE 11111111111 ❑ Commercial ❑pece ❑Other.. 92339192 Custody Seal "Esanti ❑Yes a i seas wt w ❑yes a r — oae►11nitfab Preen EaeraiNnF Contenla:.,� .� ` padring Material: ❑Bubble Wrap ❑Bubble Bags None / Q Other llolo>sirATisstse Frozen? Thurna :r Z -- _ !R Gun ro: ./ ❑Yes ❑NoI et []Slue ©Hone Type �} !OC r CorreW.,- Fattor: C"er Temp Corretted ('C);- -�--^ [saatpies am of urnp crltarla. samples on Ica, coo Frotew 1u bepa t15DR Regulated Soil N(A water sample} Did sarnr�fes Originate I uarantine zone within the UnRed States: CA, NY, ar SC (Check maps)? Did um}!es orlghute from a forel;n source pntelr I� al -n,V, ` 9 ........... �vswiotra'tfi" �...l,,.lin, u..,,:n ewA O,uRn e1m17 riw.r< Cammwr3t,}Disae Chain ofCustad Presents ru No NIA 1. Samples AfrWwlthlri Hold Thtle? 011A 2. Sham Hold Time Analy2ls 1,972 hr.?? ss Mgo QIJA 3. Rush TurnArosrtd-rtmuRe uested? EJY.s NIA 4 Sufficient Volume? Na ONfA 5. CotrectConla)ners Used? 43teContalners Used? er ar No Na ONfA N!A 6. Containars Intact? ter Na . N/A 7. _ Dlssah*d anahSis: Sam !ea Tkid Filtered? Yes Mo }A L 5,mple Wbels Match CDC? -includesDate/TlmepD/Analysis MaWr, ar 1 ❑No ❑NIA 9. Heads ace In VOA Vials >5-Gmmji Yes 0&.4 Nµ 10, Trip gbt* PrestW Trip Blank Custod Seals present? Oyes Yes ❑No Na WA 4IA 1L [tiF.lat ND71F1r.RT10Nf RtSDLU IILJrr Person Contacted: Comments/Sample Olstrepanty: u Date/Time: nww+ue r,W4y , LJ.m L,J, project Manager SCURF Review: T [''�') kl Date: Project Manger 5RF a ► I •eu?ew: Y b - Date: Note: WhenevertbefeIsadkaepsnLyafteGlnENorthCarvfmacGmMancesareples,a[opyartlrlsrormwillbestMtotheNorthCarolinaOEHNRGntfleatlonOftep,e. Out of twtd, tneorrret presarvntve, Out rdtemp, InCVF4Ct Coatalnersl P ge8of10 Condition *Check mark top h9(6 6ox If pH and/or deEhlofinaWrF--1 Frbjett I is verlfied and within the acceptance range for preservation samples. —Bottom half of box is to list number of bottles Document Pa 2 of 2 13suing Auttiartt}r, WO#+�92355102 PM. pRB Due Data: 69t27/37 CLIENT: 92-Ready Mix Z Zzz 7CLt1 l N v N m ram+ F'i v Li y E . � S $ n E qzq A a O Z 1! 4 S +�E 2 4 7 \L- ��'� pH Adjtj ment Log for preserved 5aml TypeotWwv+ntive pMupennctlpt Darapns��velbaadjutted ThnapftreM e+1USUt Idw P ge11of10 O CHAIN -OF -CUSTODY ! Analytical Request Document o The Ghefn-nfl.L&" isa LEGAL UOCUMENT. M FWWW" Gelds maa ho tgn~ =MdalY aw pcebrsar m 5CUM A 8�t1oR 0 5066M C Pam• at 1 a ROWOW MW%lnipmyEDn- Req~ Pr*0 fafzn`aom pill PdS Tfr. f O CCM TO: mr- jmLoj Email Ttr Ohfv t,ln.: t. Fea throe: agwf�d Dw OatWTAT: LL}nbp: on 0 fWbis Cedes R.pY.edwx aser.cemn ffiftvws . CUDL & O COLLECTED Dwvkg Wear 4w wer m wT Y waste wew wry N ycar> cSOTV" C3 d � n 8 U) SAMPLE 10 0' L , L44-c47:1 Air AR a _ samph iDs MUST BE ULIgtY Ifs o17src TS OT Ti!M. sue- 4 ~ g� a M. i L m DATr TILT£ MTY TINE z _ 2195626 ZtEGULATORY AG'£HCY r NPoE3 i' GROUND WATET, DfilMNG WATER ! UST f"' pz" OTHER PreseyvafA s U gm 0 11 to m w i ND1 Lab i.0.LLLL A j.,.J_.l_J ).-._I _1 12 I - JT- AODRtONALCOitMEin REUNQU:S"M 5Yt:.FF1UAT10"r DATE T 6Y I ATF'1ilATiF,T^^! �—:fAT[ d7C a `_Ft::=,.E vG:iDRIO!!a — SAIAPLE7tsuWE0.NDSS6NATt1RE _`� u I � �'— ORIGINAL PRDIT LIauoa of SJWPLER: SIGNATURE of 6ANPUR: DATE Slgn�d - I Y I I E iaewDrn'I: I �" .. 'Mear�at+ueer. s. s'ryi.� Ian ra va as�r:e 7amy NEI ranr plirti W,er wa p>rnq m W rE.g,. of +SY- w nv�n h� +ny im xw. m� ama , a min. . F-AtL-0-070nw-07, 95-Inv 20V NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report forguidance on filling out this form, please visit: r 1. r1 I l d Permit No.: N/ /—/w / /—I�I�I—/ or Certificate of Coverage No.: N/C/G/L/ylQl.zl.. 1-z Facility Name: Pi01V4 I Kn14h�da1•e & county: W it Vic —. Phone No. ' Z["7 q90o Inspector: D1ul* fr' ;Af it Date of Inspection: _ 313111'l Time of Inspection: lip: 20 &M — Total Event Precipitation (inches): . zb Was this a "Representative Storm Event" or "Measw•eable Storm Event" as defined by the permit? (See information below,) �es ❑ No Please verify whether Qualitative Mnnitorinq must be performed diu•ing o "representative storm event" or "measureable storm event' (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "nneasureable "storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 clays) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive fours of no precipitation. A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous illeasurable. storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval -is representative for local storm events during the sampling period, and the permittee obtains approval from the local DWQ Regional Office. By this signature, 1 certi(y that this report is accurate and complete to the Kest of my knowledge: (Sigra�}+C`1rFof Permittee or Designee) Page 1 of 2 SWO-242, Last modified 7/31/2013 1. Outfall Description: Outfall No. I- Structure (pip ditch,)tc.) Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 00'eor _ 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): Nolae 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 Q 3 4 5 S. Floating Solids: Choose the number which best describes the amount of Floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 b 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 0 3 4 5 7. Is there any foam in the stormwater discharge? Yes 8. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfalI? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe D Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicativeof pollutant exposure. These conditions warrant further investigation. Page 2 of 2 5WU-242, last mod Iried 7/31/2013 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division -of Water Quality General Permit No. NCG060000 Date submitted 010 CERTIFICATE OF COVERAGE NO. NCG06_0 2IZ SAMPLE COLLECTION YEAR 20 1!j FACILITY NAME K1,, &I o igI and- I FACILITY ACTIVITIES INCLUDE.(check all that apply): COUNTY ❑'use/process. meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES u7 au+ YA,+ %Q I( DISCHARGING TO SALTWATERS? []YES (gNO LABORATORY DA(-`f- a Lab Cert. # q t Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO*SIGN ON'THE REVERSE 4 Total event. rainfall i 124 or ❑ No discharge this period3 Outfall No., Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD; mg/L Oil and Grease, mg/L 'Fecal Coliform , Colonies per 100 ml EnterocoW , Colonies per 100 ml Benchmark - 100or50 Within 6.0 — 9.0 120 30 1000 S00 k 3 6) 1-7 1 Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge, 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with,a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Did this facility perform Vehicle -Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfail No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, mg/L pH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - 30 100 or 50 6.0 -- 9.0 'Only applies to facilities that use/process meats. 2The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at awn rr outfalls, you must still submit this discharge monitoring report with a checkmark here. °See General permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. (if es, complete Part B) SWU-249 Last Revised: October 18. 2012 Page 1 of "FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. Y 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 ANYONE OUTFALL? YES []NOR IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR including all "No Discharge" reports within 30 days o receipt o the lab results or at end o monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information -submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information -submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the -possibility of fines and imprisonment for knowing violations." (Signature of gerfftittee) 5/i 117 (Date), Additional copies of this form may be downloaded at: http_//portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4 SWU-249 Last Revised: October 18. 2012 Page 2 of 2 I 16 ^ CHAIN -OF -CUSTODY 1 Analytical Request Document The Chain is LEGAL DOCUMENT. All fields = -at -Custody a relevant must he completed accurately. Section A Section 8 Section c- Reqair.d cileet InterAraxi— Requfres Pro!e -, Wornliation: Roport T o: -say ;nlatkwS Copy To (hveicc Inrormotion: Qa ¢ ; 1 ! W ARenhom Company Namv 1 . company: Rqjdy Mix Concrete A+daresV 3610 Busil Street Raicigh. NC 27609 • Pur.h— Order 9: Ad4refs: Paco 4votu. ;�.;. :-:1;•{• ,,„RLlsic ....A.*n. -- Emalr y+ � K 1'Yt GC. Phane'. - 5i91790-1520 Fax f'roied Nama: CUTFALL Pe- Pro1w Manorgec annela oeim;0pacelans.com fteaucrcd Due Date: Proiect F: f xY Gc r$LZ hi— a Pace Prcfle t! 54BB-5 LH1 Rct anF.; a COOL U COLLECTED Q Preservatives .>..' art.. q Watw CN � U •- w,'.. SAMPLE ID o START END c 7 oil One Character pordos. wie ra rrr a 4 z lA-7- 0r. •i rug .4 a j µ j tl Sampfo Ids must bo uni9ux ras Ts K a a C N o c .G n ill K x O C ti z U C, x IM Q; ;, m x o OA TIME DATE TIME 3 I x Iy z z z O t,, l- •-. r / k / j r 31 to: � of 0 0 0 l-k" 13 etelLaceGon ' ' NC i F i u t�J35Yf K 1 I t 1 1 I e ;aC6Analytical /�'wwpwWabi=n I ANALYTICAL RESULTS Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersvitle, NC 28078 (704)875-9092 Project: Outfall Plant 1 Knightdale Pace Project No.: 92335461 Sample: Outfall #1 Plant #1 Lab ID: 92335461001 Collected: 03/31117 10:20 Received: 03131117 17:00 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No, Qual 2540D Total Suspended Solids Total Suspended Solids Date: 04/06/2017 08:11 AM Analytical Method: SM 2540D 27.8 mg/L 3.8 1 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical services, LLC. 04/05/17 09:59 Page 4 of 10 Laboratory receiving samples: Asheville ❑ Eden❑ Greenwood ❑ Huntersville ❑ Raleigho Mechanicsville❑ • • . • Client Name: WOE : 92335461 Praje x ❑UPS Client �� QDUPS f�ther: 0 Commercial �E'adcz 92335 1 Custody Seal Present? Dyes �lo Seals Intact? DY--2s Po Date/Initials Person Examining Contents: PackingMaterial: ❑auobie151rap [)Bubble [�hiune �` \ ❑other. —A Thermometer: ' x IRGun ID IS-3A92 Vet ❑ _ Type of Ice: []Flue :Noize ❑Samples on ice, coaling process has be;un Correction Factor: Add O.s Cooler Temp Corrected ('C): 3 , Biological Tissue Frozen? Dyes DrJo VI/A Ternp should be above Freezing to 6°C USDA Regulated Soil ( Nlp1, enter samplel Did samples originate in a quarantine zone viithkn the Uoitad States: CA, HY, of 5C (check maps)? Did samples originate from a foreign source (internationals}•, (--lYe5 Fil/ rlo inrludlne Hsiwai'iand Puerto fiscal? r7yes IRK% Comments/Discrepancy: T �� _ Chain aF Custody Present? L� ❑� ❑ 1. _ _ Samples Arrived vAthin Hold Time? 2. Short Hold Time Analysis (02 hr.)? E3 a, ❑ j 3. Rush Turn Around Time Requested'? Cl +i. suHicien, volume? ❑ — ❑ S. Correct Containers Used? U ❑ G. -Pace Containers Used?_❑ ❑_tt — —T — Containers lnt ict? ❑ ❑ i 7, ; Samples Field Filtered? ❑ E, Note if sediment is vlslble in the dissolved container _ Sample Labels ivlatch COC? ❑❑ 9. j 'Includes Date[lime/lD/Analysis , El Headspace in VOA Vials (»-6mm)? Yes No N - - - - JO. ❑ ❑ Trip Blank Present? yes do Id/, ] 1. Trip blank Custody Seals Present? Ye; No N/A CLIENT NOTIFICATION/RESOLUTION Pef,un Contacted: I Comments/Sarnple Discrepancy: Date/Time: Field Dahi Required? (,,, Yes i lHo Project Manager SCURF Review: �ry_J 1_._ Date: (� Project Manager SRF t� - F— _�__ii-evrew:--_,___--.__�__.-.�_--.._.T- Dates—�. ---- — ----- —_ Note: W,"never there is a discrepancy affecting North Carol inic6lnplian a samples, aEcopy of this form ;'itlbe sent to the North Carolina DEHNR Certification Office (Le, Out of hold, incorrect preservative, out or temp, In[orrecCcantalriersl age: P 8of10 2 z i A L I I A - 1/7 AmLAG3A(UG3A)-0T,IL XZX ZZ Ir I U, II/ V�_. Iterna BP41LI-125 mL Plastic; Unpreserved (N/A) (Cl,) BP13U-250 mi. Plastic UrIPre.qer,4Ld(N/A) OP2U-500 rrit Plastic lj.l:jf t�Cr,Jed (EI/A) oplu I liter Plastic UnprLser-ved (N/A) IMS-250 ml. Plastic H2504 (PH < 2) (CI-) BP3N -250 mL plastic I JN03 (Pi 1 < 2) BP3Z-250 niL P[aStiC 7N Acetate & N30H (>9) MC-250 mL Plastic NaGH jpF= 12) (CI-) WGFU-Wide-,r)()UthQCj Glass lar Unpronerwed AGIU-1 litur Amber Unpresrrved (N/A) {Cl-) AG1H-I liter Amber MCI {pli < 7) A63U-250 mL Amber Unpr(,,,,r,,ed (NIA) (Cl-) — --------- --- AG1S-1 liter Amber H2SO4 (pH < 2) MG35.250 mAinbur H2SO4 (pH < 2) 25 Amber 14HIICI (N/A){Cl-) DG9H -40 m L VOA HCI VG9T-40 nil- VOA.',la2S203 (N/A) VGf;(I--10,,Ii.V0A IJn11 (N/A) DG9P-40 mt. VOA H3PC4 (N/A) VOAK 16 vials per kit)-5025 kit (N/A} VJGK (3 vials per kit)-VPF/Gas kit jN/A) SPST-125 ii,I-Szeoril, PID.ifi,. (N/A— I:jb) IZEP3A-2513 x SPZT-250 no-Sierile Plastic (N/A — lab} mL Plastic (NH2)2504 (93-9,7) Cubitainer V5GU-20rnLSdntilldtionvials (N/A) GN LTXWI �ja NC®ENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report 1"orY1ri11nnce err fillil�g (jilt: tllisIbl-ril, lalease visit: rgf webIIr/nI)dCsLtmrnzwater! Permit Na.: LV/C/_/_/—/—/—/__/—/ ar Certificate of Coverage No.: N C LI�CIQ/_Z/ /-Z Facility Name: AL 1 jS1}t W dare Nk County: W_ 4VA Phone No. C01-Z11-gJ00---- h1spector: Dl IV4&-dkielI Date of It1spection: 1131111 Tinge of Inspection: ,,,_ _t0: 'IQ PrPA Total Event Precipitation (inches)- a Zfo Was this a "Representative Storm Event" ar "Measureahle Storm Event" as defined by the permit? (See information below.) Tr"Yes ❑ No Ilease verify whether Quulitcrt.ive M(itlitvrhip arrest be per fijrroed (1ru'iRY Cl "representative Storm event"car "nwasuivable stwin event" OvVAwments vat)+ deperldhiy on the perrnil). Qualitative monitoring requirements vary, Most permits require qualitative monitoring to be performed during a "representative storm event' or during a "measu•eable storm event," However, some pu n As du not have dais recfuil•ement, Please refer to these; definitions, ifaNdwahfe, A "representative storm event" is a sLarm event that measures greater than CI.J inches of rainfaii and that is preceded by ar least 72 haws (3 days) in which no storm event mea.s"ring greater than I l incites has ocan•red. A single sterna event may contain up to J 0 consecutive hours mf no pi eeipHation. A "measurable storm event" is a stor in event that results in art actual discharge from the permitted site outran, The previous measurable- storm event otust have been at feast 72 hocu's prime. "rhe 72-hout-storm interval does not apply if the permit tee is able to document that a shorter haerval is representative for local storni events during the sampling period, and the perniiHee obtains approval from the local DWQ Regional Office. By this signature, I ce.rd y that this rel}cart is accurate and complete to the hest of my knowledge: (Si ggdA1.90f Pernaitr.ee or Designee) Ngc 1 of 2 SIVI1-2.12, Last modified 7/31 /21113 1. Outfall Description: outfall No. 1 Structure (pip ditch)Lc.) Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color oFthe discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: �dar 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): I owe- 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: h 1 Ll/ 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with Floating solids: 1 b 3 4 5 6. Suspended Solids: Choose the number which hest describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 1 0 3 4 5 7. Is there any foam in the stormwater discharge? Yes 8. Is there an oil sheen in the stormwater discharge? Yes Op 9. is there evidence of erosion or deposition at the outfall? Yes Na 10. Other Obvious Indicators of Storrnwater Pollution: East and describe P40we- Note: Low clarity, high solids, and/or the presence of loan-1, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU•242, last modified 7/31/2013 SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 41 # 1 171 CERTIFICATE OF COVERAGE NO. NC ,06_b 2I?- SAMPLE COLLECTION YEAR Za 1!1 FACILITY NAME KK.Q 6310 P1&m± 1 FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY {NiNk or use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES W- i 1( DISCHARGING TO SALTWATERS? DYES [gNO LABORATORY Lab Cert. # q� PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Part A: 51.ormwater Benchmarks and Monitoring Results Totol euenr rainfC112 024 or f No discharge this period Outfall No. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliform , Colonies per 100 ml Erzter0c0cci , Colonies per 100 ml Benchmark 100 or 50' Within 6.0 -9.0 120 30 1000 S00 1 3S1 0 I i I � I I A Only applies to facilities that use/process meats. The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at anv outfahl . You must still submit this discharge monitoring report with a checkmark here. `See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? [ yes ❑ no (if yes, complete hart 6) Part B: Vehicle Maintenance Area Monitoring Results- only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Sample Collected, mo/dd/yr Oil and Grease, mg/L TSS, mg/L PH, Standard units New Motor Oil Usage, Annual average gal/mo Benchmark - I 30 100 or 54 6.0 -- 9.0 I Only applies to facilities that use/process meats. The total precipitation must be recorded using data from an on -site rain gauge. s For sampling periods with no discharge at a eutfails, you must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. SVIU-249 last Revised: October 18. 2012 page I ofi `FOR PART A AND PART 9 MONITORING RESULTS: 6 A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. 0 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. G TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO Nt IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR including all "No Discharge" reports, within 30 days of receipt of the lab results for at end o monitodalperiod in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central riles 1617 Mail Service Center Raleigh, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY 1NF6RMATI01V REPORTED: I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of VerASittee) 51,11-7 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/­tvq/ws/su/nRdesswHtab-4 SWti-719 Last Revised: October IS. 2012 Pnnc 2 of 2 CHAIN -OF -CUSTODY I Analytical Request Document The Chain-w-Custody is a LEGAL DOCUMENT. All relevart fields must be completed accurately. Section a Section C Suction A aequirucl client lnlormJoo-- Rcl.utred Project InrarmaCow invoice Informaticn: I —Page • I C�r n 're .r comparir. Ready WX C�nrrE.I—e amp "uo 'Y Mix R*Gl 10, jay'Nalk.r.s Ar.entl%)N Ajdaresv, 3cln Bush SIMI '1 1 1 ee Copy To' Company Name: Ad4m$s: R.Tei 1 0. NMC27609 r ✓ Ernail! '. - � . I E� F.V(chose Ord� #; - - P.- Q-m-: I Phone: Fax -ALL Project Namt. GvTF Face ProjEcl Monageir. awela, Lgc.66n ". R u�', us Da oquesmd Due Dale: Projecl:V' I je, k $274 e Paw P-tte ;0 54EIE-1 tLH,` INC f2c uested Anal y4iz Fillejed [YtNV, *oTpx CODE r- 0 L L EC rFz L) Preservatives ;z o-, SAMPLE ID S I, .1d SL START END J2 C"I CL One Character per hoe-wl O CT U 21 Eampto Ids rrlq=t bo unique 2 73 x 4 C e?,c:ql i LLI z U 0 DATE TIME z z (9 AA. I-q'Al L-",�,jgP 42. A1 "N M? PFUNT Name of SAMPLER: a. z E SIGNATURE of SAMPLER: DATE Signed: W laceAnalyticale www.pacelabs.com ANALYTICAL RESULTS Project: Outfall Plant 1 Knightdale Pace Project No.: 92335461 Pace Analytical Services, LLC 9800 KinceyAve, Suite too Huntersville, NC 28078 (704)875-9092 Sample: Outfall #1 Plant #1 Lab iD: 92335461001 Collected: 03/31/17 10:20 Received: 03/31/17 17:00 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 27.8 mg/L 3.8 1 04/05/17 09:59 Date: 04/0612017 08:11 AM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 4of10 Document Name: ESI Tech Spat I Document Reris2d: Sept. 21, 2016 ,� Sample Condition Upon Receipt(SCURj j Page t of 2 r .Yu�CEf�Ifi1��ICri� Dctument R'o.: J Issuing Authority: f F-CAR-QA-003-Rev.02 I race Quality Office Laboratory receiving samples: Asheville ❑ Eden[] Greenwood ❑ Fluntersville ❑ RaleighZ Mechanicsville[] • : ,! • +x Client Name: WO : 92335461 . ; Proje ~[IUSP$ Courier: ❑Fed Ex ❑UPS Corninef6al 011ace Oooier: 92335461 Custody Seal Present? 0yeS tq 7NO Seals Intact? []y=_s PPfo / Packing Material: ❑Bubble htrrap ❑Bubble Bags r-Y t„�irione ❑Other. Date/Initials person Examining Contents: ir1� Thermometer; D IR Gun ID: �� IS-3492 — Type of Ice ❑RIuE ❑Naie ❑Sarnp!es on ice, Conlin; process has begun Correction Factor. Addo.fr Cooler Temp Corrected ('C): )`Vet 3 . [ Biological Tissue Frozen? ]yes ❑+`Jo PJ/A Temp should oe above freezing to 6` C ,f�re,� USDA Regulated Soil ( N/A, water sample) ljf Did samples originate in a� quarantine zone vAthin the &'&tad States: CA, NY, or SC (check ir,aps)? Did samptes originate from a foreign micte (internationally, Flyes FiRrm irrl-lire H-,%.V1 i and Puprtn Ricol? MYes 0;lQ6 Comments/Discrepancy: — Chain of Custody Present? _ 1=J� L� - ❑ 1, — Saniples Arri•:ed %vith'En Held Time? _ ❑ ❑ ❑ ❑ � ❑' —I 2. -S--h-o�rtt Hold Time Analysis (02 hr.)? I Rush Turn Around Time Requested? — ❑ 3. _❑4 Sufficient Volum-�? ❑_ ©_ 5. Correct Containers Used?—❑ ❑ -Pace Containers Used? ❑ ❑ 6. Containers Wact? ❑ ❑ 7. _ Samples Field RRered? ❑ kT E. Note ifstdimert is vlsibte inthe dissolved container _© F Sample tabels to3tci, COC? � ❑ ❑ 9. •tnCludes DatefTime/lD/Analysis Heidspaca in VOA Vials (>5-6mmi7 Yes Pin N Trip Blank Present? es Pia N/, JD. 11. ❑ ❑ ❑ _ Trip BlankCui tr)dj Seals Present? Yes No NIA CLIENT NOTIFtC YION/RESOLUTION field Data Rebuired? UYe; l Jtdo PafsOn Contacted: I Datejiime: Comments/Sa+nple Discrepancy: Project Manager SCURF Review: �. }�.._ Date; -- Project Manager 5RF-- ------ ^-Review:--------��_.�--_;L r�l_J l•�� Dafe: •-L'i -� f � w.. ...� rlote: Whenever there Ii a discrepancy affecting North Caia[ins coliipliante samples, a: copy of this form :vitlbe sent to the North Carolina OENMR CanificaLion Office (i.e. 0utol'io16, incorrect preserstive, out of temp, incorrectconfainersY.'! x , .. .. Pdge.'8 of 10' A 3 0 c T �o Q a {/ i I I l I f E I -- — !• /I / --- i��— _/.�'*` z I - j € / ---f I ��I---y z !j �� I •�_ 1 % i /ice — f j� % { I /� /�' / �1 / REMN SA4U-125 mL Plastic Unpresarved (r11A) (CI-j HP31,1-250 mL Plastic UnprPserved {N/A) I � B72U-SOO fill Plas,lc UnprC>Crvetl (N/A) ^- BPIU-3. liter Plastic Unpreserved (N/A) /` 13P3S-a50 mt. Plastic H2501 {pFl < 2} (CI-) BA3N�i50 mL plastic IINp3 {pH��2} BP3Z-250 m: PlasticZN Acetate R NaOH (:9} SP3C-2.50 mL Plastic 14aOH (pH % 12.} (Cl-) WGfU•:^aide-rnoutlied G`ras$;ar Unprescrx:d AG1U-1 literAinber Unpre:arved (N/A) (C)-) _ AG1H-1 I'�ter Amber HCI {pH < 2} AG3U-250 mLAmher Unpi-L-rved (N/A) (CI-) AGIS-1 lii^_r Amber HZ504 (pH < 2} - AG3S-250n7LAtnbeT H25O4 fph<...___-__._._-- AG3A(DG3A)-250 rnt- Amber 141-14CI (N/A)(CI-) rIG9H-40rsILVOAHCI (N/A) III VG9T-40 ml. VOA Na25203 (N/A) -- VG9tlAG n1. VOA s--nfI Fnl/A) — I 0G9P-40mLVOAH'',PCi(NIA) j - I » ( I I —,f I { / VOAK (G vials perl(rt(•5035 kit {N/Aj I!I V/GK (3 Vials per kit)-Vf H/Gits'.ci; jN/A) SPST-1-25rnl-Sterile Plastic(N/A -Iabj SPZT-250 mt.-Sterile Plastic (N/A- lab) / BP3A-•1.5q mL Plastic (NW2)25t34 (9a-9) - Cubkainer V5130-20 mL Scintillation vi2ls (N/A) Gd W n 0 `^ m ro h CL o�y 0 � x r•t- o p i3 U X to =ti u. — o ro e: 0 C Cu _ n d ro ro CL nJ Cr CID CD CL 0 tin � 7 O SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Water Quality General Permit No. NCG060000 Date submitted 6 /Z $ I �+y C0_ YY CERTIFICATE OF COVERAGE NCK lE60&D L 4 ZSAMPLE COLLECTION YEAR Z b t�FACILITY NAMEI �' (� FACILITY ACTIVITIES INCLUDE (check all that apply): COUNTY L— ❑ use/process meats ❑ use animal fats/byproducts PERSON COLLECTING SAMPLES tiny ISCHARGING TO SALTWATERS? []YES ®NO LABORATORY P_A t & Lab Cert. # q 1ZV Part A: Stormwater Benchmarks and Monitoring Results PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall 2 . Sti or ❑ No discharge this period3 OutfallNo. Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COO, mg/L Oil and Grease, mg/L Fecal Coliform , Colonies per 100 ml Enterococci , Colonies per 100,ml Benchmark 100 or 50 Within 6.0-9.0 126 30 1000 500A4V , i e it I U 5A 6.10 // /f 11 // 1 Only applies to facilities that use/process meats. 1 ZThe total precipitation must be recorded using data from an on -site rain gauge. i a For sampling periods with no discharge at � outfalls. You must still submit this discharge monitoring report with a checkmark here. °See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmarkapplies. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ ye of (oyes, complete Part B) Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. co Outfall No. Sample Collected, Oil and Grease, TSS, pH, New Motor oil Usage, mo/dd/yr mg/L mg/L Standard units Annual average gal/mo Benchmark - 30 100 or 50 6.0 — 9.0 - Only applies to facilities that use/process meats. ZThe total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here. 45ee General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. SWU-249 Last Revised: October 18, 2012 Page 1 of 2 *FOR PART A AND PART B MONITORING RESULTS: *'• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 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. y • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NOP IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or 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, NC 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "1 certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (SignAre of Permittee) -7InII(. (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/"wq/­ws/su/npdesswgtab-4 S W U-249 Last Revised: October 18, 2012 Page 2 of 2 97 i�-�Y WIFA NDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance onfilling out thisform, please visit: htt/nortal.ncdenr.ore/web/wq /ws/su/nndessw#tab-4 Permit No.: N/C/_/_/_/_/_/_/_/ or Certificate of Coverage No.: N/C/G/2/-�J/ O/-7-/-q/ Z/ Facility Name: KnIW Aale Plati+ 4 1 County: WAKE _ R Phone No. qlq- 211 - ggyo T Inspector: TAj WATKzja6 Date of Inspection: io In 1 A RECEIVED - Time of Inspection: _ Z;Ha ?r4 Niny�T�'�11Td� Total Event Precipitation (inches): I • L CENTRAL FILES DWR SECTION Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) �es ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, some permits do not have this requirement. Please refer to these definitions, if applicable. A "representative storm event' is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. _ A "measurable storm event' is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (SiWt atuffe of Permittee or Designee) Pagel of 2 SWU-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. 1 Structure (pip ditch tc.) Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: �EADu tM;lt C B la�� 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: --dear 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.). WOW Q 4, Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 0 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of Floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 D 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 02 3 4 5 7. Is there any foam in the stormwater discharge? Yes No B. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe Nolae Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242, Last modified 10/25/2012 1-�i7,r�r��, ��f�T�F� f►�?SC�I�,'�II�G�� O�1TF�1LL �S��OO - S�:�i»i��f�1 �1��:�I i �,��'iTOO"1� 'G F�f';� GENERAL PERMIT NO. NCG 140000 CERTIFICATE OF COVERAGE NO. NCG14 6 Z _q_ Z SAMPLE COLLECTION YE R. _ Z014. FACILITY NAME: Plan+ I IC�� b N-t nW ire SAMPLING PERIOD: [_July -December January -June PERSON COLLECTING SAMPLES j1114`fti4iu5 COUNTY WAI(e CERTIFIED LABORATORY $ALIP— Lab # tl PRONE NO. (Cj _) Z (-1q900 Lab # ADD TO LISTSERVE? AYES [NO EMAIL: OPTIONAL INFO: DISCHARGING TO CLASS: ❑SA ❑HQW ❑PNA ❑Trout ❑Other. Part A: Stormwater Monitoring Requirements OutfalllNo. Date Sample Collected {mo/dd/yr OR NO FLOW)' PH (Standard lJnits) TSS (mg/L) Event Duration {minutes] iota! Rainfall4 (in) In Tier 2 Monthly Monitoring? (y/n) ## of Months in Tier 2 Samplingz - - 6-92 1002,3 - - - - I ro 3s 1 !y a 40.0 yz0 , z, fN 1 If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfall here. Please make sure to mark the sample period above. z if a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range. 3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/I. 4 For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge. Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 1 of 2 Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year Outfall No. Date Sample Collected {mo/dd/yr)1 pH (Standard Units) TPH using method 1664A SG%HEM (mg/L) Total Suspended Solids {mg/L) Event Duration {minutes} Total Rainfa11a {in} New Motor Oil Usage (gal/month) Month) In Tier 2 y Monitoring? {v/ri) # of Months in Tier 2 Z Sampling 6-9z 152 1002,3 - - - - - HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANY ONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO HAVE YOU CONTACTED THE REGION? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail Original and one coov of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (orate rid of monitoring period in case of "No Flow") to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." D /3 (Signature Pe mittee) (Date) Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 2 of 2 �;a?c e Analj cal -..SYNM1Y.pBCAlab9.WVi1 Laboratory Report Jay Watkins Ready Mix Concrete PO Box 27326 Raleigh, NC 27611 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)B75-9092 Page 1 of 1 Report Date: 10/31/2014 Date Received: 10/1612014 Project: KNIGHTDALE PLANT#1 Pace Project No.: 92221760 Sample: OUTFALL #i1PLANT #1 Lab ID: 92221760001 Collected: 10/15/14 14:40 Matrix: Water Parameters Results Units Report Limit Analyzed Qualifiers Total Suspended Solids 40.0 mg/L 4.5 10/22/14 10:10 /1 z"''L Reviewed by: L— Laura J Cooper laura.cooper@pacelahs.com Raleigh Certification IDs 6701 Conference Drive, Raleigh, NC 27607 North Carolina Wastewater Certification #: 67 North Carolina Bioassay Certification #: 16 North Carolina Drinking Water Certification #: 37731 Page 1 of 3 Document Name: Sample Condition Upon Revel (SCUM Doburnent ReVised'.'April 04, Pa e J of 2 Document No.: F-RAL-CS-001-rov.02 lasulngAuthorltles: Pace Ashavilfe OL16TY Office Client Name: C4 Where Recelvod, 0 Huntersyllie 0 Asheville Eden 0i3aleigh Courier Fed Ex UPS U8P'q pon)rnerclal Pace . other Custody Sea) on Coalor[Box Present:DYOS no Sea ls Intaci: rYes El no --Pa6kiri -Mdl!er7j!!'Fj pyppla Wrap, 0' Bubble Bags Non Other CirMe Thermometer Used: lR Gun 5N.12206Aare ofAce., Blue None Samples on Ice, cooling process has bogui ' IP Gun Back Up SN".1229853h Temp Corkoction Factor: Add I Su ct C i ) ' Corrected Cool e1join p..-_ & c� BiologlcalTlssue,ls;F�oxon- Yoe ito Temp should be above freezing to Etc Comm*ents, Dalo'ana initials of pefson axa.rn;Plnq contantsipf Mati n-- chec !Ch81n of CtIsto& Present., 2TY.. 13NO O�WA I-. Chain of Custody-F Illed out: .??4s ONO 0 wA 2, Chain of, CustotRellnqWshed: -a ONO Ot� A 3. .Sam elor. Narnq& Slgnahire on COC: 'Rryts CING 11 KiA 4. .Samples Arrived within Hold Time, '?—�ryes ONo QWA 6. short HoldkTirno Anal ysls'(%72hr): OY03 01Z ONIA 6. Rush Turn Around Tints fie �e3uested.- aye"' Cl NIA 7, SuMolent Volume. 2LY-3 ONO ONIA 8. Correct Containers Used- -:-face Containers Used*, )O? ONO OWA (34A 9. Containers Intact:, phea I ]No OwA 10. I'lltered volume -received for Dissolved tests OY03 ONO g$A 11. Sample Labels match COC: -Includes diteAlmolIRL �81 Is Malik, yes O6 N 04A 12. All containers needing preservation have been checked. All bontalners needing prewrvatl6n. arefouhd to be in oompliance with EPA r000rnmendagon. MeVorw VOA, 0 Iform, TOO, 00, Wl-0110 (water ONO es QN6 2yea ONo ©NIA GWA 13. Samples checked for dechlorinatlon: Dyes ONO &A 14. Heads ace in VOA Vials >6mm): Mes bNo F$LA J& Trip Blank Present: Trip Blank Custody Seals Present Paco TOE Blank Lot* if purchased)._ oycs ONO eWA aydb.or4o )3WA 16, Client Notificallord Resolution, Field Data Required? Y t;44"' Person.Contected-. Datefrlffib: Pommen'ist Resolution: SCURFISRIF Batt`; 0 # 122 kdvlew:: Note: Whenaverthero Is a discrepancy affe&ft North Owolina compliance 68Mples, a copy of this form will be sent to the North Carolina DEHNR 1221.7 92 6 e) *t p- Certificatlon,office (1,o out of hold, Incorrect preservative, out of temp, incorrect containers) V 'Page 2 Of 3 m -.A,,..,n�1, CHAK OF=CUSTODY I AnaWcat �t"uQs�c 11��/p�/�/n • •7 The Ctoh-d•GLslo* is o LEC L DOCUMr:N A4 relevant fkfAs must �e airr�A acairXcly. - .. - .. ..•. .., �. .� C74�,117,KI��jfJ�p! .'J" (L wr[rpa[Pr4Ba.tom Section A Section B' Section G Requhd C6eYt1 �rdarrtsepon: Knquirsd Prciec: hiformailon: V&eice trr o-mabW {y Q 1 ^! 1 S 3 1 , C.anpprr3r To: T ReAM m: V L I Addm=: co7 Cape Ta con+oerrY Nava REC+C1i,A'iORY At3E.4CY r NPDES f GROUND WATER i DRINKING WATER . rtwoTo: r Ja WAik1 lilt .[o PwCfagaOlderNa:. cw" F UST f RCRA OTHER IN 5-241� Fa`F'OiPC"s proled OwDalarfAT: Projen Nub - L 1 Z 3 q vrcen 0. - STATE: - - Roquosterl Anatyais Fff" f fRA) • ` i Section D 1btRt[ Gplq ,.• �• 2 .. I R.wIrwCAm,t oaaa hrATR1X r (Yl1f $ COLLECTED PresermoeS Dr *j% W der ow - f WOW WmIs Water wr 4NmAf � ' Procua P STOW ENDUROB Z SAMPLE ID &Brsow SL o (A-Z, 0-914 wes .Air WP hR p. - w, a w Sanpls IDs MUST BE Ummm Tis m TS p CL OCwr OTcc CL 2 S= Z Z it DATE 77ME DATE TINE # G O .a► Pace Project NnJ Lab I.M. 4 1 P 1 N G »� L:'lo 1 s s s 9, !0 S .17 4 AMVWNAL COiS CK: ' AEUV l/9NEC BYIAFnUATION OATS ilum . ACCEPTED BY DATE TIME SAMPLE CONDriwn OALA 9 �t:orl 'V .r' SAWLERNAME AND SIGNATUR U & K ' • . ,', g U PRIA7 Navw of SAMPLER:. WYK• - :.., +• nn w, ..,-, , . . AtTES`e, r / r dk~i�;rdJ� F 4 .••8V m !_ .M._. '[tnDYlar.Nnlw?w,er.wnn mla lvm unio..�.�,a....o.....,.:r�.....—_��_._�..^—a__._.._,�....�.,. >... ..`. .. ._�. ...._.�..r•r�...—.._._,.�.__.__._... .. ........... ......._a, .....-.-... I.,._. _. ._....�.....�_.. .a..�_ ..:.. ,_.. _.�.- .... �►�� RECEI NCDENR FEB 2 0 Stormwater Discharge Dutfall (SDU) CENTRAL FILL Qualitative Monitoring Report DWQIBOG Forgutdanceon filling out thisform, please visit: littE�:/1nr.,rt�7l.iicclen�.��re/w la 4v[ �t5'sc+/n�icEc::st� t��h-4. PermitNo.: N/C/—/_/_/_/—/_/�/ or Certificate of Coverage No.: N/C/G/J_/A/ D /j/1/j/ Facility Name: P JQA� i.._�N r- County: i. .(C-, Phone No. 919-21-7-9900 _. Inspector: _ _ MA (ap:, Date of Inspection: 3 /31, 4 Time of Inspection: I I : Total Event Precipitation (inches): . q Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) [5Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vag, depending on the permit). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable storm event." However, l some permits do not have this requirement. Please refer to these definitions, if applicable. , A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to 10 consecutive hours of no precipitation. ! A "measurable storm event" is a storm event that results in an actual discharge From the 1 permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter i interval is representative for local storm events during the sampling period, and the permittee ,_obtains approval From the local DWQ Regional Office. By this signature, 1 certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or Designee) RECEIVED MAR 13 2014 Page 1 of 2 CENTRAL FILES DWQIBOG SWu-242, Last modified 10/25/2012 RECEIVED CENTRAL FILES DWQ/BOG 1. Outfall Description: Outfall No. I Structure (pipe, Qi, etc.) Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Cher 3. Odor. Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weals chlorine odor, etc.): #jG&- 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 2 3 4 5 S. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with boating solids: 1 2 (:5,) 4 5 G. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and 5 is extremely muddy: 0 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes S. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes QI 10. Other Obvious Indicators of Stormwater Pollution: List and describe ._._..jt)cr_.__._,. _- (Vote: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242, Last modified 10/25/2012 Si®RMWATER DISCHARGE OUTFALL (S®®) - Semi-AnnuaO MONITORING FORM GENERAL PERMIT NO. NCG140000 CERTIFICATE OF COVERAGE NO. NCGI4 D a 4 FACILITY NAME: NA i_ kn%g4t j j,a 1, r f j C - - PERSON COLLECTING SAMPLES _.0i(}iY CERTIFIED LABORATORY^ PQcn .— Lab # b# OPTIONAL INFO: Part A: Stormwater Monitoring Requirements SAMPLE COLLECTION YEAR: �f SAMPLING PERIOD: ❑ July -December January -June COUNTY 1n%4t PHONE NO. ((/9 _)_�I:Z- 9Roo _ 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)1 pH (Standard Units) TS5 (mg/L) Event Duration (minutes) Total Rainfall a (in) In Tier 2 Monthly Monitoring? (y/n) # of Months in z Tier 2 Sampling - - 5-9z 100 '3 - - - - 7-7 eyZ ROD I If "NO FLOW" or "NO DISCHARGE, Enter "NO FLOW" or "NO DISCHARGE" for each outfalI here. Please make sure to mark the sample period above. z If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier 1 or Tier 2 responses in the General Permit. Tier 2 Monthly sampling shall be done until 3 consecutive samples are below the benchmark or within the benchmark range. 3 TSS benchmark values are 100 mg/I, except when discharging to ORW, HQW, Trout, and PNA waters where they are 50 mg/l. For each sampled measurable storm event the total precipitation must be recorded using data from an on -site rain gauge. Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 1 of 2 Part B: Vehicle Maintenance Activity Monitoring Requirements for facilities using > 55 gal of new motor oil/month — averaged over a calendar year Outfall No. Date Sample p Collected (mo/dd/yr)l pH (Standard Units) TPH using method 1664A SGT-HEM (mg/L) Total Suspended Solids (mg/L) Event Duration (minutes) Total Rainfalla (in) New Motor Oil Usage (gal/month) In Tier 2 Monthly Monitoring? Wri) # of Months in Tier Z 2 Sampling 6-92 is 1002'3 - - - - - HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES AT ANYONE OUTFALL (INCLUDING VEHICLE MAINTENANCE)? YES ❑ NO EJ HAVE YOU CONTACTED THE REGION? YES [:]NO[ I REGIONAL OFFICE CONTACT NAME: Mail Original and, one copy of this DMR (including all "No Flow" & "No Discharge" reports) within 30 days of receipt of sample (or at end of monitoring period in case of "No Flow") to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signatur of Permittee) 313h, (Date) Permit Date: 7/1/2011-60/30/2015 Last Revised 7/13/11 Page 2 of 2 aceAnalylfical ' WW W-Pacelaba.cvm MD Capps Ready Mix Concrete PO Box 27326 Raleigh, NC 27611 Project: PLANT #1 Pace Project No.: 92192349 Sample: OUTFALL 1 Parameters Total Suspended Solids Reviewed by: Nikitia Jones -Jackson nikitia.jones@pacelabs.com Laboratory Report Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Page 1 of 1 Report Date: 03/11/2014 Date Received: 03/0712014 Lab ID: 92192349001 Collected: 03/03/14 12:16 Matrix: Water Results Units Report Limit Analyzed Qualifiers ND mg/L 5.2 03/10/14 20:00 Asheville Certification IDS 2225 Riverside Dr., Asheville, NC 28804 Florida/NELAP Certification #: E87648 Massachusetts Certification #: M-NCO30 North Carolina Drinking Water Certification #: 37712 North Carolina Wastewater Certification #: 40 South Carolina Certification #: 99030001 West Virginia Certification #: 356 Virginia[VELAP Certification #: 460222 Page 1 of 3 =Anaj Report Results to: Ready Mixed Concrete P.O.Box 27326 Raleigh, NC 27611 ATTN: Phone: 919-790-1520 weal"" Chain of Custody if Bill Results to: Standard Report Delivery Ready Mixed Concrete Rush Report Delivery (w/ surcharge) P.O.Box 27326 Requested Due Date: Raleigh, NC 27611 Project Reference: Plants #1 - Knightdale ATTN; 40hff-YV4&Q4* Purchase Order #: J.'5 wau."o Sampled By: MO am 1 -ST.15 Ra t e 0 ffe-- 5 M n V.S1 u; Clutfall 1 G Sw TSS Relinquished by (signature) RMed by n re) D e Time For Lab Use Only Temperature at receipt: Relinquished (signature) Received by isignaturo D e Time Relinquished by (signature) Received by (signature] Date Time n 0 ('4 a) Document Name: Sample Cond aceAnalytical� Receipt SCUR Document No.: F_R I_-CS-001-rev.02 ition Upon Document Revised: April 04. 2013 Pa e 1 of 2 Issuing Authorities: Pace Asheville Quality Office Client, Name:. Where Received: Hunters le ❑ AsheVille Edon r/( Raleigh Courier (Circle): • Fed Ex , UPS LISPS Cfien Commercial Pace . Other Custody. Seal en CoolerlBox Present: yes .. no Seals Intact yes ❑ no Packing Material: ❑ Bubble Wrap s None Other - Circle Thermometer Used: IR Gun N:1222p6655387Type of Ice: Wet Blue :None Samples on ice, cooling process has begun IR Gun B 0 71 Temp Correction Factor: Add I ubtracY - Corrected CoolerTem C �,• Ternp, should be above freezing to B°C C. _..Biological Tissue is Frozen: -Yes N NIA - - - Comments: . Oate'and Initials of person examining Co to ralvT C}1eC_ii- Chain-bf Cttstody.PreSerlt 7. ;-. ..... _ _ .._ _..._.: . Yes CJNa- ❑NfA 1:.- .:__.., ._...._....... -• - _.... _ ..._.. _.__..... ............ ........ Chain of Custody Filled Out: as ;❑No ❑NIA 2.. Ct a'iff6f Custod . Rellnqulshed: Yes .ONn ❑wA 3. Sampler Name & Signature on COC: , 16Yes ❑Na ©Nw,. 4. Sarre' IesAriived-within Hold Time: _. Yes ❑No ❑wA 5.. Short Hold Time Analysis (4721ir): ❑Yes !;A-: ON1A 6. Rusf7 Turri.ftroirnd.7lrne. Requested: ❑Yes No ❑NIA 7,. St7f#icient.Volum8: Yes ONo L3NIA S: COireCt Contafners Used: Pace'Co, ntalners Used: Yes . ❑No Yes [']No ` ❑NIA ❑NIA 9,. ' Confainers Intact Yes ❑No' '❑NIA 10: Flitered Vol 6rne:received.for.Dfssolved tests (Dyes ❑No VINIA 11. Sainple'Labels_rnatch COC: . -Includes dateltimellDlAnalvsis Matrix: Yes' QNo ❑NIA 12.. Ad containers needing'preservatlon have been checked. All containers needing preservation are found to be In compliance with EPA recommendation. exceptions: VOA, coiiferrn TOC, O&G, WI-QRO (water) ❑No ❑ado / Yes ©No ❑NIA C1NJA 13. Samples checked for dechlorinatlon: Yes ❑No ©NIA 14, Heads ace In VOA Vials ( >6mm):. Dyes' ❑No NIA 15. Trip Blank Present 'rip Blank Custody Seals Present Pace Trip Blank l of off purchased}_ - ElYe's 0No NIA ❑Yes []No /NfA 16, .Client Notlflcatlonl Resolution: Field Data Required? Y ! N Person Contacted:. DatelTime: Comments! Resolution: SCURFISRF Place label here . . date: b------- _ - Review:; --- ---- Note: Whenever there is a discrepancy affecting North Carolina compliance I 21923�� samples, a 6epy of this form will be sent to the North Carolina DEHNR + r�+ J Certiftcation•Office ( Le out of hold, incorrect preservative, out of temp, Incorrect containers) 92192 4� rIU! -- ---- - -- -------Pag�3of3