HomeMy WebLinkAboutNCG050151_MONITORING INFO_20171027STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ aotg 10 a�
YYYYM M DD
PERMIT NO.
DOC TYPE
DOC DATE
STORMWATER DIVISION CODING SHEET
NCG PERMITS
/v Lc, I q cc) (-F+
❑ HISTORICAL FILE
9 MONITORING REPORTS
❑ �o�. $ 07 Ds
YYYYM M DD
STORMWATER DISCHARGE OUTFALL (SDO)
IVI� (I- /- -s J ONITORING REPORT
Permit Number NCS ��Q G OCJ ! SAMPLES COLLECTED DURING CALENDAR YEAR:y 1
(This monitoring report shall be received by the Division no later than 30 days from
Q the date the facility receives the sampling results from the laboratory.)
FACILITY NAME —a\ � t \ r 1 I �. ll COUNTY c5_I_C'�,
PERSON COLLECTING SAMPLE(S) rC,dC (�+�-.�/ PHONE NO.
CERTIFIED LABORATORY(S) i -Err Lab #
Lab #
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
Part A: Specific Monitoring Requirements
Outfall
Date
50050
No.
Sample
Collected
Total
Flow if a
Total
Rainfall
mo/dd/�r
MG
inches
jak
kI-
[ :C1 V C►�..
o
- `}IJ
(C
1 1 L_ 17
'..
IV 1 rCML FELL-.J
U
'VM IDLv $ 1�
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes _no
(if yes. complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
00556
00530
00400
Total Flow _
(if applicable).
Total
Rainfall
Oil & Grease
(if appl.)
Non -polar
O&GITPH
(Method 1664
SGT-HEM), if
appl.
Total.
Suspended
Solids
pH
'New Motor
Oil Usage
moldd/yr
MG
inches
m /l
me1L_-- ___
unitgal/mu
Form SWU-247, last revised 21212012
Page I of 2
STORINI 1 VENT CHARACTERISTICS:
Date 2-1} - i) r }
Total Event Precipitation mches): o 1
Event Duration (hours): hcevS (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours): (only if applicable — see pen -nit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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."
CA r
(Signature of Permittee)
(Date)
Form SWU-247, last revised 21212012
Page 2 of 2
8/10/2017
Lenoir, NC Monthly Weather Forecast - weather.com
Lenoir, NC Monthly Weather
12:49 pm EDT
Aug 2016 w
TUE WED THU FRI SAT
30
31 1
2
3
Zoe
6
7 j 8
9
I 10
MONDAY AUGUST 7
A&
800 / 69°
Cloudy
0.51 i n
Full
RECORD HIGH 990
RECORD LOW 490
4
5
=�' `lip
.;'v:
11
12
SUNRISE
6:38 am
MOONRISE 8:27 pm
SUNSET
8:24 pm
MOONSET 6:26 am
I
T
13
14
15
16 17 18
19
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20
21
22
23 24 25
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= Avg
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27
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30 31 1
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Avg
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i
Avg
https:/Iweather.com/weather/monthly/l/USNCO384:1:US 1/1
NPDS Reporting Groundwater
Report To:
Blue Ridge Labs, Inc.
P.O. Box 2940
Lenoir, NC 28645
Telephone (828) 728-0149 Fax (828) 728-0131
Chain of Custody
Sanitary Landfill Hazardous Waste Industrial or QC
UST/Trust Fund Reporting
Bill To:
Field
Project Name:
PO Number:
Ice Present: Y N
Preservatives Lab Check
Non State Reporting
C-Composite
G- Grab
Sample ID
Sample
Type
Date
Time
Time &
Temp
I1R:MM
°C
Field
Sulfide
Check
Y N
Field
Sulfide
Present /
Removed
Y N
Resid
Chlor
Field
Check
Y N
Field
Dechlorination
Y N
pH
Resid
Chlor
POrA
Temp
°C
Sampler
Initials
Analysis Requested
if -fit C
YL f�
/
�U��
/✓� SS /C
UMC
eli u'shed y: Date: Time: Rece' By: Date: Time:
u
Upon submission of samples. client agrees that invoices are due al the time work is completed_ Open accounts are due 20 d4s following invoice date. A finance charge of l .5% per month will be imposed on all pasfue accolmts.
When relinquishing samples w Blue Ridge Labs (BRL), buyer authorizes BRi. to peribnn only the analysis indicted above and also agrees to pay collection and attorney tees if the account becomes delinquent. Blue Ridge Labs
reserves the right to derv. documentation for any work yhere payment has no[ been made_ in effect rendering that data unsupported for regulatory purposes. BRI. cannot guarantee that an} regulatory authority will accept any work
submitted. therefore it is the clients responsibility to request on this form appropriate tests. NC DENR Certified Lab #275
NPDS Reporting Groundwater
R,oporl To:
Blue Ridge Labs, Inc.
P.O. Box 2940
Lenoir, AFC 28645
Telephone (828) 728-0149 Fax (828) 728-0131
Chain of Custody
Sanitary Landfill Hazardous Waste [ndustrial or QC
UST/Trust Fund Reporting
Bill To:
Field
Protect Name:
PO Number:
Ice Present: Y N
Preservatives Lab Check
Non State Reporting
C-Composite
G- Grab
Sample ID
Sample
"I'ype .
Date
Titne
Time &
Temp
HR:MM
°C
Field
Sulfide
Check
Y N
Field
Sulfide
Present /
Removed
Y N
Resid
Chlor
Field
Check
Y N
Field
Dechlorination
Y N
pH
Resid
Chlor
PorA
Temp
°C
Sampler
initials
Analysis Requested
Fr rc #67
91rik
70
OF
eli 'shed y: Date:
Time:
Reeej4k__By:
Date: Time:
� % G; r
I fpnn suhmission of samples. client agrees Ili at invoices are euc at the time wuti, is cornpIctcd. Opcn accounts arc duc 20 dat-s t'oHaw ifig invoice date. A finance charge of 1.5% per month Kill be imposed utt all pasiue accounts.
When relinquishing samples to Blue Ridee Labs (BRI.1, bt:Yet authorizes BRi. to perli)rni only the anal) pis indimcd above and also agrccs to pay wllcction and attorney fees if the account becomes delinquent Glue Ridge Labs
reserves the right to ticny dVCLItrlentation for any wort: where payntem has not hcen made- in effect renderin- that data unsupported for renulalury purpnses. BRL cannot guarantee that any regulatory authority will accep, any Rork
submitted, therefore it is thu client's responsibility to revue:[ on This farm appropriate tests. NC DE:NR Certified Lab #277
INVOICE
Blue Ridge Labs, Inc.
Invoice # 2017- 0624
Date: 9/6/2017
P.O. Box 2940
Lenoir. NC 28645
Phone: 8287280149 Fax: 8287280131
Client: Sealed Air Corporation Bill To: Sealed Air Corporation
PO Box 1018 PO Box 950
Lenoir, NC 28645 Duncan, SC 29334
PO NUMBER I LAB REF. ID�� TERMS LAB CONTACT PROJECT NAME
I
598 Net 10 Days Steve Johnson Stormwater analysis
Sample Name Outfall #2, Outfall #3 817117
TARGET NAME QUANTITY UNIT PRICE EXTENDED PRICE
Oil 8 Grease 1664-A 2 S50.00 S100.00
pH 2 55.00 $10.00
Settleable Solids 2 S20.00 S40.00
Total Suspended Solids 2 S15.00 $30.00
Please Remit: $180.00
Upon submission of samples, buyer agrees that Invoices are due at time of delivery. Open accounts are due 20 days following
the Invoice date. A finance charge.of 1.5 % per month will be imposed on all past -due accounts. When relinquishing samples to
Blue Ridge Labs, buyer agrees to pay all collection and attorneys fees if the account becomes deliquent. Blue Ridge Labs
reserves the right to deny all 4C and support documentation for all open accounts which are greater than 60 days. Additionally.
Blue Ridge Labs also reserves the right to inform the appropriate local, state or federal agency that all support documentation
is not available due to the failure to the above Invoice terms. Data used for compliance purposes will be rendered invalid for
reporting until the account Is cleared.
First Data - POS
Page 1 of 1
TRANSACTION RECORD
BLUE RIDGE LABS INC
522 PINE MTN RD
HUDSON, NC 2863t
United Scates
TYPE: Purchase
ACCT: Mastercard $ 130.00 USD
CARDROLDER NAME Ann'ssia Wilson
CARD NUMBER #@######H###8645
DATE/TIME 07 Sep 17 14:=2:05
REFERENCE # 001. C575354 T
AUTHOR. # 072434
TRANS, REF.
Approved - Thank You 100
Please retain this copy for your records.
Cardholder will pay above amount to
card issuer pursuant to cardholder
agreement.
https://globalgatewayc4.firstdata,com/vpos 9/7/2017
Blue Ridge Labs
PO Box 2940
Lenoir, NC 28645
828-728-0249 blueridgelabsienoir@grnail.com
Client :
Sealed Air Corporation
PO Box 1018
Lenoir, NC 28645
Attention:
Seth Bradshaw
Date Received:
07-Aug-17
Report Date:
06-Sep-17
Sample Date:
07-Aug-17
RRL #:
BRL 2017-0598
Lab Sample ID:
LSID-2017-02192
Client Sample ID:
Otttfal1 #2
Analysis Analysis
Parameter
Result MQL Unit Method Time slate Analyst
Oil & Grease
* 5 mg,'] 1664-A O&G Sf31,12017 W4`trQtly
Reported By:
S. J. nson, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted_
NC Laboratory Certificate No. 275
Page 3 of 6
Blue Ridge Labs
PO Box 2940
Lenoir, AC 28645
828-728-0149
Client: Sealed Air Corporation
PO Box 1018
Lenoir, NC 28645
Attention: Seth Bradshaw
Date Received:
07-Aug-17
Report Date:
06-Sep-17
Sample Date:
07-Aug-17
Bill, #:
BRL,-2017-0598
Lab Sample 11):
LSID-2017-02191
Client Sample ID:
Outfall 92
Parameter
Settleable Solids
Reported By:
blueridgelabslenoir@gmail.com
Result MQL Unit Method
* C.i ml/1 SM19
AO 0
& J. nson, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 2 of 6
Analysis Analysis
Time Datc Analyst
14:21 8/7/2017 KC]
Blue Ridge Labs
PO Rox 2940
Lenoir, NC 28645
828-728-0149
blueridgela bslenoir@gma il.com
Client :
Sealed Air Corporation
PO Box 1018
Lenoir, NC 28645
Attention:
Seth Bradshaw
Date Received:
07-Aug-17
Report Date:
06-Sep-17
Sample Date:
07-Aug-17
BRL #:
BRL-2017-0598
Lab Sample ID:
1,S[D-2017-02190
Client Sample fD:
Outfall 42
Parameter
Result MQL Unit Method
TSS
52.5 12.5 mg/I 2540D 1997
PH
6.811T 0.1 su 45001-1-f-13 200
Reported By:
S. J uson, D.R. Wessinger
Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 1 of 6
Analysis
Analysis
Time
Date
15:55
8/9/2017
1 1:05
8/7l2017
Analyst
KCJ
KCJ
Blue Ridge Labs
PO Roe 2940
Lenoir, NC 28645
828-728-0149
Client ; Scaled Air Corporation
PO Box 1018
Lenoir, NC 28645
Attention: Seth Bradshaw
Date Received: 07-Aug-17
Report Date; 06-Sep-17
Sample Date: 07-Aug-17
BRL #: BRL-2017-0598
Lab Sample fD: LSID-2017-02195
Client Sample ID: Outfall #3
Parameter
Oil & Grease
Reported By:
bIueridgelabsIenoir@gmail.com
Analysis
Result MQL Unit Method Time
* 5 rngil 1664-A O&G
S. J. Wson, D.R Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Page 6 of 6
,Analysis
Date Analyst
&i3112017 WtrQlly
Blue Ridge Labs
PO Box 2940
Lenoir, ;VC 28645
828-728-0149 blueridgelabslerloir@gmail.com
Client:
Sealed Air Corporation
PO Box 1018
Lenoir, NC 28645
Attention:
Seth Bradshaw
Date Received:
07-Aug-17
Report Date:
06-Sep-17
Sample Date:
07-Aug-17
BRL 4:
BKL-2017-0598
Lab Sample Ill:
LSID-2017-02193
Client Sample ID:
Outfall 43
Analysis
Analysis
Parameter
Result MQL
Unit Method Time
Date Analyst
TSS
5
mg/1 2540D 1997 15:56
8/9l2017 KC.1
pH
6.5HT 0.1
su 450011+B 200 11:10
8/7/2017 KCJ
Reported By:
09� . -
S. J nson, D.R. Wessinger
* Concentrations are below inimum Quantification Limit except where noted.
NC La oratory Certificate No. 275
Page 4 of 6
Blue Ridge Labs
PO Box 2940
Lenoir, NC 28645
828-728-0149
blueridgelabsienoir@gmail.com
Client:
Sealed Air Corporation
PO Box 1019
Lenoir, NC 28645
Attention:
Seth Bradshaw
Date Received:
07-Aug-17
Report Date:
06-Sep-17
Sample Date:
07-Aug-17
BRL #:
BRL-2017-0598
Lab Sample TD:
LSID-2017-02194
Client Sample ID:
Outfall #�
Analysis Analysis
Parameter
Result MQL Unit Method Time Date Analyst
Settleable Solids
* 0.1 mlll SM19 15:42 8/7/2017 KCJ
Reported By: f>�W-~ f
�Sl nson, D.R. Wessinger
* Concentrations are below Minimum Quantification Limit except where noted.
NC Laboratory Certificate No. 275
Pale 5 of 6
a
Blue Midge Lahs
PO Box 2940
Lenoir, NC 28645
828-728-0149 blueridgelabsienoir@gmail.com
Data Qualifiers
The following is a list of data qualifiers used on Blue Ridge Labs' Reports. Any of the
qualifiers may make the data unacceptable for state reporting. Data qualifiers are
found in the results column and their definitions are as follows:
* The concentration found is below our minimum concentration value, which is
reported in the MQL column.
*** The concentration reported is an estimated value. The result is above our
highest standard.
HT The sample was received out of hold time.
IC The sample was received in an improper container.
NC The sample was received without proper cooling.
NP The sample was received without proper preservatives.
IC The sample was received in an improper container.
HIS The VOC container was received with headspace present.
NR The sample was not run due to lab error.
UC Unable to confirm analysis due to insufficient sample being submtted.
D Sample was diluted due to physical problems with the sample.
J Value is an estimate from a library search using the nearest internal standard.
NCA Non -certified Analysis
Revised 10/21/16