NCG120082_MONITORING INFO_20151109

STORMWATER DIVISION CODING'SHEET
NCG PERMITS
PERMIT NO.
/V U&
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑� « 1
YYYYM M DD

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. 1MCG120000
Date submitted / -9-15
CERTIFICATE OF COVERAGE NO. NICG120 Q 8 SAMPLE COLLECTION YEAR
FACILITY NAM[ U OL SAMPLE PERIOD ❑ Jan -June uiy-Dec
COUNTY NAAD15DIj or. ❑ Monthly' month
PERSON COLLECTING SAMPLES pEjxu RD$El2- _„„ •,.•,.•__._ DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
LABORATORY PAS, 9 ANAW 6AL_ Lab Cert. # 9Qtv5'7,ri - ❑Zero -flow ❑Water Supply ❑5A
Comments on sample collection of analysis: ❑Other
Part A: Stormwater Benchmarks and Monitoring Results
C�
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PLEASE REMEMBER TO SIGN ON THE REVERSE -)
❑ No dischorge this period ?2
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1111
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10b0 count per 1a0 ml
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1 Monthly sampling (instead of ser4annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
Z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement,
4 See General Permit text, -fable 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note_ResuIts -must-be-reported -inlnumer-ical-format. For-example,-do-not-report-Be.Iow-Detection-Limit,�BDL,<P-QL,_Non�tetgst,-N.D,-sr-other-similax-uon-
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX meJl", where XX is the numerical value of the
detection limit, reporting limit, etc! in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Dale: 11/l/2012-10/31/2017
5WU-248, last revised 10/25/2012
Page 1 of 2

Part B. Ve...cle Maintenance Area Monitoring Results: only for facilities u,reraging > 55 gar of new oil per month.
❑ No discharge this period?z
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in Less of the benchmark, you must implement Tier I, Tier 2, or Tier 3 responses. See General Permit text.
m A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11. SECTION B.
0 2 EXCEELIANCES 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 ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
all
in the case of "No Discharge" renorts)l 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 gath€eying 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 penaltiles for submitting false.information, including the possibility of fines and imprisonment for knowing violations."
69nature of Permittee) I °(Date),;
Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012 _
Page 2 of 2

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-.PaceAna0ca1*
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CHAIN-OF-CU' )DY I Analytical Request Document
The Chain -of -Custody is a Lt-AL DOCUMENT. All relevant fields must be completed accurately.
IPage:
Section A Section B Section C
of
Required Client Informaliow Required Project Information: Invoice Information:
Company: Report TO: Attention:
8
Address:
Copy To:
Company Name:
REGULATORY AGENCY
Address: %
r NPDES r— GROUND WATER r DRINKING WATER
I— LIST F RCRA OTHER
Email To:
Purchase Order No.:
pace amte
A.:—
I
Reference:
Phon(y
Fax:
Proje Name: r
Pace Project
Site Location
Manager
STATE:
Requested Due DatettAT;
ProjeqNumbLr:
Pace Profile
Requested
Analysis
Filtered
(YIN)
Section 0 Matrix Codes
ReqtilmdClient Iniornn;ition MATRIX I CODE
COLLECTED
Preservatives
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ADDITIONAL COMMENTS
RELINQUISHED BY I AFFILIATION
DATE.
TIME,.
ACCEPTED BY I AFFILIATION,
DATE
SAMPLE CONDITIONS
SAMPLER NAME AND SIGNATURE"
PRINT Name of SAMPLER:
2
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DATE Signed
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SIGNATURE of SAMPLER:
(MMIDD/YY):
Important Note: Fly signing this term you are accepting P—o's NET 30 day payment terror, and agreeing to late charges of 1.5% per month for any invoices not pald within 30 days F-ALL-&020rev.07, 15-May-2007

Instructions for completing Chain of Custody (COC)
1. Section A and B: Complete all Client information at top of shout: company name, address, phone, fax. contact (the person to contact if there are
questions, and who will receive the final report.), e-mail address (if available). 110#: Project Name and/or Project Number as you wotild like to see it
appear on the report.
2. Section C: Invoice lnforination: 13illin2 information is included in this section. This information should include
receiving the invoice.
�. Quote Reference should be completed if a cluotat1011 was provided by Pace Analytical, The. Protect Manager, and
Pacc Analytical Services.
4. Site Location: A separate COC must be tilled out for each clay of sample collection. Record the two letter postal
samples were collected.
5. Regulatory Agenc.�,: List the program that is gelding t.hc work to ensure proper regulations are followed.
narric and address of the. person
Prolilc No. will be completed h)r
code for the US state in which the
6. Section D: Complete a Saniplc Description in the `-SAMPLE- ID' suction as you would like it to appear on the laboratory report. Thu following
information should also be included: the sample matrix, sample type (ti (grab) or C (composite). When collecting a Composite, the stall (mic and and
time Iiotild be documented in the respective boxes. The collection time for a grab (0) sample should bQ entered in the boxes marked `Composite
l ndlGrab'} Samplc tcrnp at collection (if required by state), the total number of containers, and prescrvative used.
7. Mark if the sample Nvas filtered in the field by marking. Y or N in T' ilteNd' row by the Analysis requested.
R. Requested Analysis: fist the required analysis and methods on the lines provided and place a check in the column for the salliplc:S reCluilinQ the
analysis. Additional comments should he referenced in the bottom left hand corner or 111CILICIC attachments fOr extended lists of paranlcturs.
9. The sampler should print their mine', 111 the space provided and sign their name followed by the date of thi sampliL eA7,; It at the bottom of the COC Ill
the spacca dusignated for 'SAMPE.I:R NAM; AND SIGNATURE".
10. When relinquishing Custody of the samples to a representative; of the laboratory (it- other organization, indicate the Itcm Numbers of those samples
being transferred; sign relinquished by, dote and time, and include pour affiliation.
"Important Note:
Standard Turnaround Time is 2 Weeks/10 business clays. Results will he delivered by cnd of business on the date duc unless othcrarrangcments
have been Made with your project manager.
Special Project Requirements such as Low Level Detection Limits or level of QC rcpoilud must be included on-fhe chain of custody in the Additional
Comments section.

aceAnapkal
www.Pecelabs.mm
i
November 02, 2015
Mr. James Huff
Madison County Solid Waste
271 Craig Rudisill Road
Marshall, NC 28753
RE: Project; Stormwater Second 2015
Pace Project No.: 92273694
Pace Analytical Services, Inc.
9800 Kincey Mo. Suite 100
Huntersville, NC 28078
[phone]
Dear Mr. Huff:
Enclosed are the analytical results for sample(s) received by the laboratory on October 28, 2015.
The results relate only to the samples included in this report. Results reported herein conform to the
most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless
otherwise noted in the body of the report.
Analyses were performed at the Pace Analytical Services location indicated on the sample analyte
page for analysis unless otherwise footnoted.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Chris Derouen
[e-mail]
Project Manager
Enclosures
r
A7Nl�
4B,�RASp�
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in hell,
without the written consent of Pace Analytical Services, Inc..
Page 1 of 13

Pace Analytical services, Inc.
00
aceAnalyircalr9 9$00 IGnceyAve. Suite 3
ltrG Huntersville. NC 2$078
www.pecgfe &c0m [phone]
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CERTIFICATIONS
Project: Stormwater Second 2015
Pace Project No.: 92273694
Asheville Certification IDs
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87W
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #: 37712
North Carolina Wastewater Certification it: 40
South Carolina Certification #: 99030001
West Virginia Certification #: 356
VirginiaNELAP Certification #: 460222
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc.. Page 2 of 13

aceAnapical
www.pftWobs.com
Pace Analytical Services, tnc.
9B00IGnceyAve. Suite 100
Huntersville, NC 28078
(704 )875-9092
SAMPLE ANALYTE COUNT
Project: Stolmwater Second 2015
Pace Project No.: 92273694
Lab ID - Sample ID Method
Analysts
Ana lytes
Reported
Laboratory
92273694001 Outfall 4 SM 2540D
SAM
1
PASI-A
SM 9222❑
EWS
1
PASI-A
SM 5220D
WRC
1
PASI-A
92273694002 Outfall 5 SM 2540D
MJP
1
PASI-A
SM 9222D
EWS
1
PASI-A
SM 5220D
WRC
1
PASI-A
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 3 of 13

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ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9B00KinccyAve. SOe1DO
Huntcrsville, NC 28078
[phone]
Project: Stormwater Second 2015
Pace Project No.: 92273694
Sample. Ou#all 4
Lab ID: 92273694001 Collected: 10/28115 12:07
Received: 10128/15 13:02 Matrix: Water
Parameters
Results Units
Report Limit
DF
Prepared Analyzed CAS'No.' Qual
2540D Total Suspended Solids
Analytical Method: SM 2540D
Total Suspended Solids
6.1 mg/L
5.9
1
10M115 09:54
MBIO 9222D Fecal Coliform AVL
Analytical Method: SM 9222D
Fecal Coliforms
36.0 CFU1100 mL
1.0
1
10128/15 17:45
522DD COD
Analytical Method: SM 5220D
Chemical Oxygen Demand
N❑ mg/L
25.0
1
10129/15 13:40
Date: 11/0212015 08:39 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 4 of 13

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ANALYTICAL RESULTS
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: Stormwater Second 2015
Pace Project No.: 92273694
Sample: Outfall 5 Lab ID: 92273694002 Collected: 10/28/15 11:53 Received: 10/28/15 13:02 Matrix: Water
Parameters
Results Units
Report Limit DF
Prepared Analyzed CAS No. 'Qual
2540D Total Suspended Solids
Analytical Method: SM 2540D
Total Suspended Solids
6.2 mg1L
4.2 1
10/29/15 18:38
MBIO 9222D Fecal Cotiform AVL
Analytical Method: SM 9299D
Fecal Coliforms
4.0 CFU1100 mL
1.0 1
1012all 5 17:45
5220D COD
Analytical Method: SM 5220D
Chemical Oxygen Demand -
42.0 mg1L
25.0 1
10/29115 13:40
Date: 11/0212015 08:39 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 5 of 13

1�5a'ceAnayical"
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QUALITY CONTROL DATA
Project: Stormwater Second 2015
Pace Project No.: 92273694
Pace Analytical Services, Inc.
98001GnceyAve. Suite 1W
Huntersville, NC 28078
[phone]
QC Batch: WET/41111
Analysis Method:
SM 2540D
QC Batch Method: SM 2540D
Analysis Description:
2540D Total Suspended Solids
Associated Lab Samples: 92273694001
METHOD BLANK: 1594327
Matrix: Water
Associated Lab Samples: 92273694001
Blank Reporting
Parameter
Units
Result Limit
Analyzed Qualifiers
Total Suspended Solids
mg1L
ND 2.5 10129115 09:43
LABORATORY CONTROL SAMPLE: 1594328
Spike LCS
LCS % Rec
Parameter
Units
Conc. Result
% Rec Limits Qualifiers
Total Suspended Solids
mg1L
250 260
104 90-110
SAMPLE DUPLICATE: 1594329
92273806006 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L 46.5 46.5 0
SAMPLE DUPLICATE: 1594330
92273614001 Dup
Parameter Units Result . Result RPD Qualifiers
Total Suspended Solids mg1L ND ND
Results presented on this page are in the units indicated by the 'Units' column except when 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: 11 /02/2015 08:39 AM without the written consent of Pace Analytical Services, Inc.. Page 6 of 13

aceAnalytical
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I
Project: Stormwater Second 2015
Pace Project No.: 92273694
QC Batch: WET141126
QC Batch Method: SM 2540D
Associated Lab Samples: 92273694002
METHOD BLANK: 1595226
Associated Lab Samples: 92273694002
Parameter Units
Total Suspended Solids mg1L
LABORATORY CONTROL SAMPLE: 1595227
Parameter Units
Total Suspended Solids mg1L
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Analysis Method: SM 2540D
Analysis Description: 2540D Total Suspended Solids
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 2.5 10I2911518:36
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
250 238 95 90-110
SAMPLE DUPLICATE: 1595228
92273896001 Dup
Parameter Units Result Result
Total Suspended Solids mg1L 178 182
SAMPLE DUPLICATE: 1595229
92273723002 Dup
Parameter Units Result Result
Total Suspended Solids mg1L 10.8 9.0
RPD Qualifiers
2
RPD Qualifiers
18 J(D6)
PR ults presented on this page are in the units indicated by the'Unita' column except whore an attamate unit is pnsanted to the right of the reeult.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 11/0212015 08:39 AM without the written consent of Pace Analytical Services, Inc.. Page 7 of 13

aceAnapica!®
www.pecelehs.oam
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Project: Stormwater Second 2015
Pace Project No.: 92273694
QC Batch: WET141097
QC Batch Method: SM 9222D
Associated Lab Samples: 92273694001, 92273694002
METHOD BLANK: 1594018
Associated Lab Samples: 92273694001, 92273694002
Parameter Units
Fecal Coliforms CFUI100 mL
SAMPLE DUPLICATE: 1594019
Parameter
Fecal Coliforms
QUALITY CONTROL DATA
Analysis Method: SM 9222D
Analysis Description: 9222D MB10 Fecal Coliform'-AVL
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 1.0 10128/1517:45
92273624005 Dup
Units Result Result RPD
CFUI100 mL 4400 5000 13
QuaOfiers
Pace Analytical Services, tnc.
9800 Kncey Ave. Suite100
Huntersville, NC 28078
(704 )8759092
Results presented on this page are in the units Indicated by the 'knits' column except where an elternete unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 11I0212015 08:39 AM without the written consent of Pace Analytical Services, Inc._
Page 8 of 13

aceAnalytical
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QUALITY CONTROL DATA
Project: Stormwater Second 2015
Pace Project No.: 92273694
QC Batch: WETA125179 Analysis Method: SM 5220D
QC Batch Method: SM 52201) Analysis Description: 5220D COD
Associated Lab Samples: 92273694001, 92273694002
METHOD BLANK: 1594822
Associated Lab Samples: 92273694001. 92273694002
Parameter
Units
Chemical Oxygen Demand
mglL
LABORATORY CONTROL SAMPLE:
1594823
Parameter
Units
Chemical Oxygen Demand
mg1L
Pace Analytical Services, Inc.
9800 Kincey Ave, Suite 100
Huntersville, NC 28078
[phone]
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 25.0 10/29/15 13:40
Spike LCS LCS % Rec
Cone. Result % Rec Limits Qualifiers
750 724 97 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 1594824 1594825
MS MSD
92273613001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Cone. Cone. Result Result % Rec % Rec Limits RPD Qual
Chemical Oxygen Demand mg1L ND 750 750 741 741 97 97 90-110 0
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 1594826 1594827
MS MSD
92273613002 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Cone, Cone. Result Result % Rec % Rec Limits RPD Qual
Chemical Oxygen Demand mg1L 304 1500 1500 1710 1710 93 93 90-110 0
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right or the result
REPORT OF LABORATORY ANALYSIS
This report snail not be reproduced, except in full.
Date: 11/02/2015 08:39 AM without the written consent of Pace Analytital Services, Inc..
Page 9 of 13

Pace Analytical Services, Inc_
aceAnalytieal 9800 Kinsey Ave. C 2 3
00
Huntersville, NC 2807$
/ wwwpwalabsoam [phone]
i
QUALIFIERS
Project: Stormwater Second 2015
Pace Project No.: 92273694
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.
MDL - Adjusted Method Detection Limit.
POL - 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 analyze 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 Get - Clean -Up
U - indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether, Styrene, and Vinyl chloride.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260,
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method B270. 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 analyzes.
TNI -The NELAC Institute.
LABORATORIES
PASI-A Pace Analytical Services - Asheville
ANALYTE QUALIFIERS
J(p6) Estimated Value. The relative percent difference (RPD) between the sample and sample duplicate exceeded laboratory
control limits.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
DatR: 11ID212015 0839 AM without the written consent of Pace Analytical Services, Inc.. Page 10 of 13

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QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Storrnwater Second 2015
Pace Project No.: 92273694
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Lab ID
Sample ID
QC Batch Method
QC Batch Analytical Method
92273694001
Outfall 4
SM 2540D
WET141111
92273694002
Outfall 5
SM 2540D
WET141126
92273694001
Outfall 4
SM 9222D
WET141097
92273694002
Outfall 5
SM 9222D
WET141097
92273694001
Outfall 4
SM 5220D
WETA125179
92273694002
Outfall 5
SM 5220D
WETA125179
Dale: 11/02/2015 08:39 AM
REPORT OF LABORATORY ANALYSIS
This report shalt not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Analytical
Batch
Page 11 of 13

vim.
CHAIN -OF -CUSTODY 1 Analytical Request Document i
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The Chain LEGAL DDCUMENT. All reievani fceids must Ix completed accurately.
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Seatian A
Section B
Section C
Requirod Chem Infommallort
Required Pro;-ocl Information;
Invoice Information:
Report To:
Anernlion: 1
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X 7 X J
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`VVVV 111 llliii�rr VVV LL
Addr
Copy To:
Company Name:
REGULATORY AGEKCY
Address:
7 NPOES ; GROUND WATER
:— DRIKKING WATER
UST RCRA
OTHER
Em
Purchase Order No.:
Pao• Ouow
ftlerarxa,
P e;
Pmject Name:
Praje
ion
SeLo[
maroger:
STATE;
, w
Requested LNInDateAAT
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ierojeccNumeor
Pace P70fmx:
Requested Analysis Filtered
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section D Mairix Codes
Roqulrod CGml In'nrmctian MATRIX „ 1OP9
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+r Pace Project No.1 Lab I.D.
ADDITIONAL COMMENTS RELINQUISHED BY ) AFFILIATION DATE TIME I ACCEPTED BY r AFFILIATION DATE I TIME! SAMPLE CONDITIONS
,a-f.44 1,0 9Q I4:62-f/I 1 1,a -75r; Y 1 /,j I U
SAMPLER NAME AND SIGNATURE
O-!GNAL
PRINT Name of SAMPLER;
SIGNATURE of SAMPLER:
¢npormu r sign ng this farm you am aaoc:4,pti rg PaCWS NET 30 day payment terms and agreadrg to late caargea of 1.5% par month 'or arty inw laid warn 3G days.
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F.ALL-0-020rev.07. t5•May-200

Document Name: Sample Condition Upon
Document Revised: May 15, 2016
aceAnalXical
Receipt (SCUR)
Page 1 of 2*
Document No.:
Issuing Authorities:
F-ASV-CS-003-rev.14
Pace Ashevllle Quality Office
Client Name: inw
* Page 2 of 2 is for Internal Use Only
Courier (Circle): Fed Ex UPS USPS ell Commercial Pace Other
Custody Seal on CooleriBox Present: yes ono Seats intact: yes ❑ no
Packing Material: El Bubble Wrap Q Bubble Bags i iVone Other
ermonleter Use un#3-130285963 Type of Ice; Wet Blue None Samples on Ice, cooling process has begun
IR Gu #R % 140290365 0
e m p Correction Factor: Add ! ubtrac - .L C
`J
Corrected Cooler Temp.: +Ci, _ C
Temp should be above freezing to VC
Biological
gir:al Tissue is frozen: Yes No N1A
Comments:
Datenand Initials of person exa
contents: O p 10
ining
Chain of Custody Present.
161 ON.
❑wA
1.
Chain of Custody Filled Out:
Y ON.
❑wA
2.
Chain of Custody Relinquished:
Y ONO
ONIA
3.
Sam ler Name a Signature on COC:
Y ❑No
❑N1A
4.
Samples Arrived within Hold Time:
Y ❑No
ONrA
5.
Short Hold Time Analysis (472hr):
Vea ❑
❑NIA
6.
Rush Turn Around Time Requested:
❑ No
❑NIA
7.
Sufficient Volume:
Y ©No
DIVA
S.
Correct Containers Used:
-Dace Containers Used:
ONO
0No
0N1A
❑NfA
9.
Corntainers Intact:
Yes ONo
❑ A
IQ
Filtered volume received for Dissolved tests
Oyj ON.
VfNIA
11.
rriple Labels match COC:
-Includes dateltime/ID/Analysis Matrix:
es ONO.
❑N1A
12.
All containers needing preservation have been checked.
All containers needing preservation are round to be In
compliance with EPA recommendation.
exceptions: VOA, lVorm OC, OSG, WI-pR0 (wafer)
Yes ❑No
/Y'❑No
ONO
❑N1A
❑NIA
13.
Samples checke for dechlorinalion:
es ❑No
© A
14.
Hoads ace in VOA Vials ( >6mm):
Dyes ONO
q(wy
15,
Trip Blank Present:
Trip Blank Custody Seals Present
Pace Trip Blank Lot # (ifpurchased):
Dyes ©No
Dyes ONO
A
INIA
16.
Client Notification/ Resolution: Field Data Required? Y ! N
Person Contacted: Date/Time:
Comments/ Resolution: - - - - -
SCURF
SRF Review:1 _ ,l _ ]Date: / er
Note: Whenever there 19a dittrepancy affecting NaCarolina
compliance samples, a copy of this form will be sent to the North
Carolina DEHNR Certification Office (i.e out of hold, incorrect
preservative, out of temp, incorrect containers)
wo # : 92273694
g2273684 available)
Page 13 of 13

Phone [phone]
Fax [phone]
Madison County
Solid Waste Department
9 November 2015
NCDENR/DWQ
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Madison County Landfill
NCG 120082
Madison County, North Carolina
To Whom It May Concern:
Office
271 Craig Rudisill Rd.
Marshall, ITC 28753
RECEIVED
NOV 12 2015
CENTRAL FILES
DWR SECTION
This is the Stormwater Discharge Outfall Monitoring Report submitted by
Madison County Solid Waste Facility as required by General Permit # NCG120000 and
Certificate of Coverage # NCG 120082.
On 28 October 2015 the landfill experienced a rain event of 0.45 inches in the
early morning. Outfall 4 and Outfall 5 were inspected and appropriate samples were
taken. Samples were immediately iced and carried to Pace Analytical in Asheville, NC.
Results from these sample tests were received back at the landfill offices on October 28,
2015.
Results showed all samples for both Outfalls were within benchmark values.
If you have questions about the report please call Jim Huff at 828-649-2311 or
correspond via email at ihuff e,madisoncountync.gov or via postal service at 271 Craig
Rudisill Road, Marshall, NC 28753
Bards,
- - - ----Z.-- -.
James L. Huff. Director
Madison County Solid Waste Department

Semi-annual Stormwater Discharge -Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCG1
Date submitted d /
CERTIFICATE OF COVERAGE NO. NCG12 0 0 ?-
FACILITY NAME ~' ��i �T ry
COUNTY_ Br0 _
PERSON COLLEC ING SAMPLES
LABORATORY P/f{X.4 /flr c,i / Lab Cert. # 2�S%`S (-
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR- G
SAMPLE PERIOD an -June ❑
or ❑ Monthly'
—
DISCHARGING TO CLASS ❑ORW
[]Zero-f
❑Other
b15
tly-Dec
❑HQW ❑Trout ❑PNA
ow ❑Water Sul3ply ❑SA
PLEASE REMEMBER TO SIGN ON THE REVERSE
No disch rge this Period ?2
Outfall No
�2.'�r;.1
4 � ,,
!late Sample "
', , ... , .A: 1
ma dd r
24 hour rainfall
amount, 3,R,:
�q.
Inche
t
�;�a ". � 3f •�
Fucliemrcai 0x gen Demand
� +
Fecal:Colrfarm
.5 -
atal Sus ended.5olids
,6errchmarks >
' err;'r '
Jr
12
tan# per.'100mL
D:mor 5p'mg/L .
gL
157
. „
Z
(
1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same p�
z Fo'r sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a ch
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a wain
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protecti,
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -de
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where X;
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report
Note: If you report a sample value in excess of the ,benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See
Permit Date: 11/1/2012-10/31/2017
AM
ameter at the same outfall.
ckmark here.
of the rain gauge requirement.
benchmark applies.
2ct, ND, or other similar non -
is the numerical value of the
ie result as ">XX".
! Permit text.
SWU-248, last revised 10/25/2012
Page 1 of 2 (a
r�

Part B: Vole Maintenance Area Monitoring Results- only for facilitiefteraging > 55 gat of new oil per month, 40
n No disch ,rpe this period:
Outfali Na
1
Date Sample
1
Collected
(mo%dd/yrj d r -
{ 24 hour rainfall
; amount; f
3 E
yrr nches ;:
" }
Non polar 0&C/TPH by
EP A 1664
Total Suspended Solids
pH
Benchmarks = >
i' i
'a AaSt 'F: ';s _'
' 1S mg/L 1 : �`<;
a ;100 mg/L or 50 mg/L4-,; e
b 0 - 9-0 SU
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See
FOR PART AAND 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 P,
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL?
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
O.7
in the case of "No Discharae" renortsl to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
30 days o
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of Iaw,- that'this"document'and all attachments were prepared under my direction or supervision in accordance v
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons v
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, ti
am aware'that there are significant penalties for submitting false information, including the possibiiity of fines and imprisonment for kno
(SignpftVe of Permittee)
t Permit Date: 11/1/2012-10/31/2017
J
(D(ate}
General Permit text.
ART 11 SECTION B.
(Es ❑ NO ❑
Pith a system designed to
ho manage the system, or
ue, accurate, and complete
Ning violations."
SWU-248, last revised 10/25/2012
Page 2 of 2

Phone [phone]
Fax [phone]
Madison County
Solid Waste Department
6 May 2015
NCDENR/DWQ
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Madison County Landfill
NCG 120082
Madison County, North Carolina
To Whom It May Concern:
Office
271 Craig Rudisill Rd.
Marshall, NC 28753
RECEIVED
MAY 13 2015
CENTRAL FILES
DWR SECTION
This is the Stormwater Discharge Outfall Monitoring Report submitted by
Madison County Solid Waste Facility as required by General Permit # NCG120000 and
Certificate of Coverage # NCG 120082.
On April 7, 2015 the landfill experienced a rain event of 0.43 inches in the early
morning. Outfall 4 and Outfall 5 were inspected and appropriate samples were taken.
Samples were immediately iced and carried to Pace Analytical in Asheville, NC. Results
from these sample tests were received back at the landfill offices on May 1, 2015.
Results showed all samples for both Outfalls were within benchmark values.
If you have questions about the report please call Jim Huff at 828-649-2311 or
correspond via email at [e-mail] or via postal service at 271 Craig
Rudisill Road, Marshall, NC 28753
Regards,
G�
James L. Huff, Director
Madison County Solid Waste Department

laceAnalXical'
m pacelabs,com
!I
9800 Kinsey Ave. Suite 100
Huntersville, NC 28078
(704)875-9G92
April 15, 2015
Mr. James Huff
Madison County Solid Waste
271 Craig sits Road
Marshall, NC 28753
RE: Project: Storm Water First 2015
Pace Project No.: 92244562
Dear Mr. Huff:
Enclosed are the analytical results for sample(s) received by the laboratory on April 08, 2015. The
results relate only to the samples included in this report. Results reported herein conform to the
most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless
otherwise noted in the body of the report.
Analyses were performed at the Pace Analytical Services location indicated on the sample analyte
page for analysis unless otherwise footnoted.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,-
Chris Derouen t-.'
[e-mail]
Project Manager
Enclosures
r'
:Fk
r
P: Ncclt 4
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
ggP�p
without the written consent of Pace Analytical Services, Inc..

I�C'IeAnalytical*
l www.pecefabS.cOm
t
9800 F'ncey Ave. Suite 100
Huntersville, NC 28078
(704)B75-9K2
Project: Storm Water First 2015
I ace Project No.: 92244562
ttsheville Certification IDs
2225 Riverside Drive, Asheville, NC 2BB04
Florida/NELAP Certification It: E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #: 37712
CERTIFICATIONS
North Carolina Wastewater Certification #: 40
South Carolina Certification tt: 99030001
West Virginia Certification #: 356
Virginia/VELAP Certification #: 460222
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..

r P caeAnaiytica1 *
r mvwpacelaCs.com
r'
I
9800 Kincey Ave- Suite 100
Huntersville, NG 28078
[phone]
Project: Storm: Water First 2015
face Project No.: 92244562
Lab I❑ Sample iD
92244562001 Outfall 4
ft21.44562002 Outfall5
SAMPLE ANALYTE COUNT
Method
SM 2540D
SM 9222D
SM 2540D
SM 9222D
SM 5220D
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Analytes
Analysts Reported Laboratory
W RC 1 PASI-A
MLS 1 PASI-A
W RC
1 PASI-A
MLS
1 PASI-A
MAB
1 PASI-A
}

�IaaceAnalyticalo
rr � '� mvwpacelatrs.com
9600 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Projoct: Storm Water First 2015
race Project No.: 92244562
Sample: Outfall 4
Parameters
Lab ID: 92244562001 Collected: 04/08/15 13:40
Results Units Report Limit DF
Received: 04/08/15 14:56 Matrix: Water
Prepared Analyzed CAS No. Qual
25,101) Total Suspended Solids
Analytical Method: SM 2540D
Total Suspended Solids
ND mg/L
3.0 1
04/14/15 16:14
MHO 92221) Fecal Coliform AVI_
Analytical Method: SM 9222D
Fecal Coliforms
121 CFU/100 mL
1.0 1
04/08/15 18:20
:,2 OD COD
Analytical Method: SM 5220D
Chemical Oxygen Demand
ND mg/L
25.0 1
04/09/15 15:15
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in lull,
[late: C411512015 11:40 AM without the written consent of Pace Analytical Services, Inc..

' aceAnalxical
www.peC&ahs.C=
r
I
9300 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
I'rojoct: Storm Water First 2015
Pace Project No.: 92244562
Sample; Outfall 5 Lab ID: 92244562002 Collected: 04/08/15 13:53 Received: 04/08/15 14:56 Matrix: Water
Parameters Results Units Report Limit OF Prepared Analyzed CAS No. Qual
25,= Total Suspended Solids Analytical Method: SM 2540D
Total Suspended Solids 13.8 mglL 4.5 1 04/14/15 16:14
VIBIO 9222D Fecal Coliform AVL Analytical Method: SM 92220
Fecal Coliforms 102 CFU1100 mL 1.0 1 04/08/15 18:20
G21017 COD Analytical Method: SM 5220D
Charnical Oxygen Demand NO mglL 25.0 1 04/09/15 15:15
Data: 04/15/2015 11:40 AM
REPORT OF LABORATORY ANALYSIS
This report shalt not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..

www.pacarabs.com
f
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: Storm Water First 2015
I ace Project No.: 92244562
QC Balch: WET136820
Analysis Method:
SM 2540D
QC Batch Method: SM 2540D
Analysis Description:
2540D Total Suspended Solids
Associated Lab Samples: 92244562001, 92244562002
METHOD BLANK: 1434137
Matrix: Water
. 92244562Bd1;92244502002
Blank Reporting
Parameter Units
Result Limit
Analyzed Qualifiers
1btal Suspended Solids mg/L
ND 2.5 04/14/15 16:10
LABORATORY CONTROL SAMPLE: 1434138
Spike LCS
LCS % Rec
Parameter Units
Conc. Result
% Rec Limits Qualifiers
Tolal Suspended Solids mglL
250 242
97 90-110
SAMPLE DUPLICATE: 1434139
92245185001
Dup
Parameter
Units
Result
Result RPD Qualifiers
Dotal Suspended Solids
mg/L
ND
ND
SAMPLE DUPLICATE: 1434140
92244321003
Dup
Parameter
Units
Result
Result RPD Qualifiers
I'olal Suspended Solids
mg/L
23.0
24.5 6 J(D6)
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: 04/15/2015 11:40 AM without the written consent of Pace Analytical Services, Inc..

�aceAnalytical0
j� www.pacerabs.com
I
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: Storm Water First 2015
face Project No.: 92244562
OC Batch: WETI36708 Analysis Method: SM 9222D
OC Batch Method: SM 9222D Analysis Description: 92220 MBIO Fecal Coliform - AVL
associated Lab Samples: 92244562001, 92244562002
Mt -TROD BLANK: 1429899 Matrix: Water
ated i ab c.,ffTk-1 �-
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
i ecal Coliforms CFU/100 mL ND 1.0 04/08/15 18:20
SAMPLE DUPLICATE: 1429900
92244573001
Parameter Units Result
Fecal Coliforms CFU/100 mL ND
Dup
Result RPD Qualifiers
ND
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: 04/15/2015 11:40 AM without the written consent of Pace Analytical Services, Inc..

aceAnalytical
"
- w�vw.pacelabs.com
i
i
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]-
QUALITY CONTROL DATA
Project: Storm Water First 2015
Pace, Project No.: 92244562
OC Batch: WETA122493 Analysis Method: SM 5220D
OC Batch Method: SM 5220D Analysis Description: 5220D COD
Associated Lab Samples: 92244562001, 92244562002
MI=TROD BLANK: 1430236 Matrix: Water
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Chemical Oxygen Demand mg/L ND 25.0 04/09/15 15:15
LABORATORY CONTROL SAMPLE: 1430237
Spike LCS LCS % Rec
Parameter Units Cone. Result % Rec Limits Qualifiers
Chemical Oxygen Demand mg/L 750 751 100 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 1430238 1430239
MS MSD
92244465003 Spike Spike MS MSD NIS MSD % Rec
Parameter Units Result Cone. Cone. Result Result % Rec % Rec Limits RPD Qual
Chemical Oxygen Demand mg/L ND 750 750 751 751 99 99 90-110 0
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 1430240 1430241
MS MSD
92244343001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Cone. Cone. Result Result % Rec % Rec Limits RPD Qual
Chemical Oxygen Demand mg/L 179 750 750 858 858 91 91 90-110 0
Results presented on this page are in the units indicated by the "Units" column except where an alternate unli Is presented to the rig hi of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 04/15/2015 11:40 AM without the written consent of Pace Analytical Services, Inc..

keAnalytical
wwwpacefabs.com
r
rote—olyt.— .......,
980o Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALIFIERS
Project: Storm Water First 2015
face Project No.: 92244562
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.
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 - SNca Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chlorcelhylvinyl ether, Styrene, and Vinyl chloride.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited anaiyles.
TNI - The NELAC Institute.
LABORATORIES
PASI-A Pace Analytical Services - Asheville
ANALYTE QUALIFIERS
J(D6) Estimated Value. The relative percent difference (RPD) between the sample and sample duplicate exceeded laboratory
control limits.
REPORT OF LABORATORY ANALYSIS
This report shall not he reproduced, except in full,
0ato: 04115/2015 11:40 AM without the written consent of Pace Analytical Services, Inc..

i _'�ar;eAnalyfical
www.pacelabs.c=
1
race rueMyue01 - —
9600 Kincey Ave. Suite 100
Huntersville, NC 2807E
(704)875-909-
QUALITY CONTROL DATA CROSS REFERENCE TABLE
I'roject: Storm Water First 2015
face Project No.: 92244562
Analytical
Lab ID
Sample ID
QC
Batch Method
QC Batch Analytical Method Batch
52244562001
Outfall 4
SM
2540D
WET/36820
92244562002
Outtall 5
SM
2540D
WET/36820
92,3n n�a2001
01,tta14
92244562002
Outfall 5
SM
9222D
WET/36708
92244562001
Outfall 4
SM
5220D
WETA/22493
92244562002
Outfall 5
SM
5220D
WETAl22493
Date: 04/15/2015 11:40 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
0

-� .--FaceAnalytical' ,
CHAIN -OF -CUSTODY 1 Analytical Request Document
The Chaln-of•Custody Is a LEGAL DOCUMENT. All relevant flelds must be completed Accurately.
nx,w.ywara��.•rr
Page: of
Section A Section B Section C
r,
Required Client information; Requl od Project information: fnvoiCe Informa(lom
Attention:
C pan -port To:' 1 /
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tires: �J _ d
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Company Nome:
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P e,SarS`yr No.:
Po Ouom
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Fax:
Pr fdct NamC:
Pace Proidcl
Manager;
Site Locatl On
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equestcd Out DaturTAT:'
Project N11mbe
Pace ProRlo 0:
Requested
Analysis
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(YIN)
Section D Matrix Cods
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Required errant lntormabon MATRIX LCOOE
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ADDITIONAL COMMENTS
RELINQUISHED BY 1 AFF LIA
D TE
TIME
ACCEPTED BY 1 AFFILIATION
DATE
TIME
SAMPLE CONDITIONS
-
SAMPLER NAME AHD SIGNATURE
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-
(MMIDDIYY):
«:,yo�_,r.; nora: ay s.gnrnG in:s ror-: yay are aC:epnng Pxe's ET 30 day paymeiVrms zed n9reC09 to la'- Cingrgas of 15% per monm for any invoicos not p7I0 -thV :p days.
F-ALL-Q-020rev.07,15-May-2007

v Document Narne: Sample Condition upon Document Revised: June 10, 2014
aceArzalytical s Receipt SCl1F� Pa e 1 of 2
Document No'. Issuing Authorities:
F-ASV-CS-003-rev.14 Pace Asheville QuahtZ Office
Client Name,.
Courier (Circle): Fed Ex UPS USPS Q Client � Commercial Pace Other
Custody Seal on Cooler/Box Present: ❑ yes Ej"1110 Seals intact: yes ❑ 110
Packing Material: 0 Bubble Wrap Ej Bubble Bags Q' Rtone ❑ Other
- nc a es m a ys
Thermometer'Used"'I� Gun#3. - 0265953 Typo bf ice: Wat ,Bute None Q'8amples on ice, cooling process has begun
�
rfft Gun #4 S A40290365 Other: —`"
Temp Correction Factor: Add! Subtract �) L' C
Corrected Cooler Temp.: t31 l T3ssua_isFozerae9—rta u�A Date an
! f I '
Temp should be above freezing to WC Comments: contents; a
Chain of Custody Present: .0 EjNo 0141q
1.
Chain of Custody trilled Out: tdyes ,❑No ©NIA
2. `
Chain of Custody Relinquished: 11Yes. •❑No ❑N/A
3,
Sampler Name & Signature on COC: Yes ©No ❑N/A
4.
Samples Arrived within Hold Tittle: Elves ONO 0N/A
5.
Short Hold Time Analysis (<72hr): ©Ye ONO GN/A
6.
Kirsh Tbrri Around Time Requested: ❑Yes ONO ❑N1A
7.
SufflCfent VOICIrbe., ©Yes ©No 0/A
8.
Correct Containers Used: 13<a ❑No ❑N/A
9.
-Pace Containers Used: Qig ON. ❑NIA
Containers. Intact: B ❑No� ❑NIA
-10.
Filtered volume received for Dissolved tests ❑Yes ONO- ©N!A
11.
Sample Labels match COC: dYes ❑No ❑N1A
12.
11 d date/ti ellb/An I Gj j
is M tri
a x.
Ail containers needing preservation have been checked.
' OYes L1No
C)N/A
13.
All containers needing preservation are found to be In
LJYes� ❑No
❑N!A
compllance Wth EPA recommendation. '
;exceptions: VOA, coliferm, TOC, O&G, VVI-DRO (vrater)
❑Yea 13No
Samples checked for dechlorination:
❑Yes ❑No
fl A
14.
Headspace in VOA Vials ( >6m. n):
❑Yes ONO
❑t't/A
15.
Trip Blank Present:
❑Yes ONO
L9rA
16.
Trip Blank Custody Seals Present
DYes ONO
C]NiA
Pace Trio Blank Lot # (if purchased):
Client Notification/ Resolution; Field Data Required? Y 1 N
Person Contacted: Date/Time:
Comments/ Resolution:
SCURF Review:
Date:
SRF Review:) l )Date:
Note: Whenever there is a discrepancy affecting ,Wbrl:6 Carolina
compliance samples, a copy of this form will be sent to the North
Carolina bEHNR Certification Office ( Le out 6thold, incorrect
preservative, out of temp, incorrect containers)

ri
Analytical
lacelabs.com
Sold To:
Mr. James Huff
Madison County Solid Waste
271 Craig Rudisill Road
Marshall, NC 28753
[phone]
' N' VOICE
I Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
Phone: [phone]
Invoice Number: 1592023171
Date: 04/2312015
Total Amount Due: $120.00
Please Remit To:
Pace Analytical Services, Inc.
R O. Box 684056
--CF,ca�C6i -
Cllent'Numb&ClhihflD _ rPtirchas� Order No Pace Pro ecf'M r. Teiins Pa s
92-617532192-Madison Chris Derouen Net 30 Days`" 1
Client Project: Storm Water First 2015 Client Name: Madison County Solid Waste
Pace Project No: 92244562 Sample Received: 4/8/2015
Report Sent To: Mr. James Huff, Madison County Solid Waste
Comments:
ANALYTICAL CHARGES
Quantity Unit
Description
Method
Matrix
Price
Total
2 Ea
2540D Total Suspended Solids
SM 2540D
Water
$15.00
$30.00
2 Ea
5220D COD
SM 5220D
Water
$20.00
$40.00
2 Ea
MBIO 9222D Fecal Cali (Water) AVL
SM 9222D
Water
$25.00
$50.00
Total Number of Charges 6
Samples Received for analysis
Analytical Subtotal $120.00
Total Invoice Amount $120.00
Lab ID Client Sample ID Received
92244562001 Outfall 4 4/812015 2:56:00
92244562002 Outtall 5 4/812015 2:56:00
If you have any questions or to pay by credit card, please contact Chris Derouen at Pace.
Phone: [phone] Email: [e-mail]
Page 1 of 1
**1.5% MONTHLY FINANCE CHARGE ASSESSED AFTER 30 DAYS OR TERMS OF CONTRACT.
PLEASE REFERENCE THE INVOICE NUMBER ON ALL REMITTANCE ADVICE.
AN EQUAL OPPORTUNITY EMPLOYER
Please complete and return copy of invoice with your payment
INVOICE TOTAL $120.00
Amount Paid: $
Check No:
Customer No- 92-617532 invoice No: 1592023171
G

Phone [phone]
Fax [phone]
Madison County
Solid Waste Department
25 September 2014
NCDENRIDWQ -
1617 Mail Service Center
Raleigh,.NC 27699-1617
RE: Madison County Landfill
NCG 120082
Madison County, North Carblina
To Whom It May Concern:
Office
271 Craig Rudisill Rd.
Marshall, NC *53
This is the Stormwater Discharge Outfall Monitoring Report submitted by
Madison County Solid Waste Facility as required by General Permit # NCG120000 and
Certificate of Coverage # NCG 120082.
On September 3, 2014 the landfill experienced a rain event of 0.6 inches in the
early morning. Outfall 4 and Outfall 5 were inspected and appropriate samples were
taken. Samples were immediately iced and carried to Pace Analytical in Asheville, NC.
Results from these sample tests were received back at the landfill offices on September
22, 2014.
Results showed all samples for both Outfalls were within benchmark values.
If you have questions about the report please call Jim Huff at 828-649-2311 or
correspond via email at ihuffct}madisoncountync,org or via postal service at 271 Craig
Rudisill Road, Marshall, NC 28753
Reg rds,
ames L. Huff, Director
Madison County Solid Waste Department
SEP
c�r�rr Z 9 2014
��R S L P N

CERTIFICATE OF COVERAE
FACILITY NAME
COUNTY o
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality Gen ral Permit No. NCG120000
Date submitted 5 TZ111
ENo. NCG12d a8a-
5 Ai �, 9.171, �c G
PERSON COLLECTING SAMPLES
LABORATORY f�i4=4 &sevlrt.Q✓ Lzib Cert. #
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR
SAMPLE PERIOD ❑ Jan -June P uiy-Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑zero -flow ❑Water Supply ❑SA
[]Other
PLEASE REMEMBER TO SIGN ON THE REVERSE -i
El No discharge this period:2
�
s
ty�
yr
.r f 4
c Yit> z
rsr rr g
,,
., n.',Y x°'rr,
>=,w
M
Date Sam le;, .
p
�;,�•r,'
a g
24 hour �a�nfail
y �,aa�
n aw:
o r ti YiY P y x
-ab,,
-AaOutfall N6 ,'�-
•?. -: l
i�-a
r
v ` ..c 'G.
r-., •i -,'r. ti- bpi ti'a,�
�-v t
- ic..�. Y� '. ii.
o
Collected
. �,..i
�tiChemical�OxygenwDemand'
,1 _
Col�form r�,
z, Total Suspendesf Salids
s.(rr�o%dd/yr}.,.;
'Inches;%
Fecal y,
Benchmarks =— >,
t
� �
1Z0 mg/L
IbbQ count per`10o mL
100 mg/L of,50 mg/L
s n�
fly
•o
. r
o, rP
�:3
d
0•
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
z For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
4 See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example,- do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non-
rnume-rical#or--mat WWkhen-resul.t--are-aelow-the-a-pplic,ah[p imits,-the. _must-be.r o.rted.in the format "<XX m L" where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2012-10/31/2017 SWU-248, last revised 10/25/2012
Page 1 of 2

Part B: Ve,.,cle Maintenance Area Monitoring Results: only for facilities aderaging > 55 gal of new oil per month.
❑ No discharge this period?'
Outfall Na
_.
Date Sample
Cone tells—
(mo/dd/yr]
24 hour rainfall
` .mount,
Inches;
TVon po-INr6iG"/TPFihy
EPA 1664 (SGT-HEM) •
di
Total SuspeSnded Solids
pH
Benchmarks --_� r
R
15 rnt/LA
100 mg/C or 5Q mg/l47
-6.0 — 9.0 SU'
Footnotes from Part A also apply to this Part B
Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text,
FOR PART A AND PART B MONITORING RESULTS:
o 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.
o TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail on orfainal and one coov of this DMR. includina all "No Discharae" resorts. within 30 days of receiat of the lab results (or at end of monitorina Deriod
in the case of "No Discharae" resorts) 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."
K W, lip —I j
IA IrEff-RIA021IF"', FA
PermVate: 11/1/2012-10/31/2017 v / SWU-248, last revised 10/25/2012
Page 2 of 2

(�55neAnalilfical
www pacelabs.com
September 16, 2014
Mr. James Huff
Madison County Solid Waste
271 Craig Rudisill Road
Marshall, NC 28753
RE: Project: Stormwater 913
Pace Project No.: 92215733
Dear Mr. Huff:
Pace Analytical Services, Inc.
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
Enclosed are the analytical results for sample(s) received by the laboratory on September 03, 2014,
The results relate only to the samples included in this report. Results reported herein conform to the
most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless
otherwise noted in the body of the report.
Analyses were performed at the Pace Analytical Services location indicated on the sample analyte
page for analysis unless otherwise footnoted.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Chris Derouen
[e-mail]
Project Manager
Enclosures
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Without the written consent of Pace Analytical Services, inc..
Page 1 of 12

aceAnalytical
xww.p9oa1abso=
Project: Stormwater 913
Pace Project No.: 92215733
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Asheville Certification lDs
2225 Riverside Dr., Asheville, NC 28804
Florida/NELAP Certification #: E87648
Massachusetts Certification #; M-NC030
North Carolina Drinking Water Certification #: 37712
CERTIFICATIONS
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
West Virginia Certification #: 356
VrginiaNELAP Certification #: 460222
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc- Page 2 of 12

+m
Ica7uCluAnalXical
wwwpacelabs.com
SAMPLE ANALYTE COUNT
Pace Analytical Services, Inc.
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
Project:
Stormwater913
Pace Project No.:
92215733
Analytes
Lab 1D
Sample ID
Method
Analysts
Reported
Laboratory
92215733001
OUTFALL 4
SM 9222D
MDW
1
PASI-A
SM 2540D
WRC
1
PASI-A
SM 52200
SMW
1
PASI-A
92215733002
OUTFALL 5
SM 9222D
MDW
1
PASI-A
SM 2540D
WRC
1
PASI-A
SM 5220D
SMW
1
PASI-A
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc.. Page 3 of 12

Pace Analytical Services, Inc.
(�55'neMalyficala` 9800 KineyAve. Suite 100
Huntersville, NC 28078
wwwpacerabs.com [phone]
ANALYTICAL RESULTS
Project: Stormwater 9/3
Pace Project No.: 92215733
Sample: OUTFALL 4
Parameters
Lab ID: 92215733001 Collected: 09/03/14 10:35
Results Units Report Limit DF
Received: 09/03/14 11:10 Matrix: Water
Prepared Analyzed CAS No. Qual
MBIO 9222D Fecal Coliform AVL
Analytical Method: SM 9222D
Fecal Coliforms
220 CFU/100 mL
1.0 1
09/03/14 12:49
2540D Total Suspended Solids
Analytical Method: SM 2540D
Total Suspended Solids
15.3 mg/L
5.7 1
09/09/14 19:52 J(D6)
52200 COD
Analytical Method: SM 5220D
Chemical Oxygen Demand
ND mg/L
25.0 1
09/15/14 22:21
REPORT OF LABORATORY ANALYSIS
This report shalt not be reproduced, except in full,
Date: 09/16/2014 09:09 AM without the written consent of Pace Analytical Services, Inc.. Page 4 of 12

Pace Analytical Services, Inc.
aceAnalytical a 9800 Kincey Ave. Suite 100
Huntersville, NC 28078
www.Patwlabs com [phone]
ANALYTICAL RESULTS
Project: Stormwater 913
Pace Project No.: 92215733
Sample: OUTFALL 5 Lab ID: 92215733002 Collected: 09/03/14 10:20 Received: 09/03/14 11:10 Matrix: Water
Parameters
Results Units
Report Limit
DF
Prepared Analyzed CAS No. Qua[
MBIO 9222D Fecal Coliform AVL
Analytical Method: SM 9222D
Fecal Coliforms
490 CFU1100 mL
1.0
1
09/03/14 12:49
2540D Total Suspended Solids
Analytical Method: SM 2540D
Total Suspended Solids
15.2 mg/L
6.7
1
09/09/14 19:53
5220D COD
Analytical Method: SM 5220D
Chemical Oxygen Demand
NO mg/L
25.0
1
09/15/14 22:21
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 09/16/2014 09:09 AM without the written consent of Pace Analytical Services, Inc.. Page 5 of 12

tP
aceAnalytical
wwwpacalsbs-corm
QUALITY CONTROL DATA
Project: Stormwater 9/3
Pace Project No.: 92215733
QC Batch: MB1O/8284 Analysis Method: SM 9222D
OC Batch Method: SM 9222D Analysis Description; 9222D MBIO Fecal Coliform -AVL
Associated Lab Samples: 92215733001, 92215733002
METHOD BLANK: 1277130 Matrix: Water
Associated Lab Samples: 92215733001, 92215733002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Fecal Coliforms CFU/100 mL ND 1.0 09/03/14 12:49
SAMPLE DUPLICATE: 1277131
92215681005 Dup
Parameter Units Result Result RPD Qualifiers
Fecal Coliforms CFU/l00 mL 600 600 0 Z
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Results presented on this page are In the units Indicated by the r,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: 09/16/2014 09:D9 AM without the written consent of Pace Analytical Services, Inc..
Page 6 of 12

ace Analytical
*WW'Pacelabs.can
QUALITY CONTROL DATA
Project: Stormwater 913
Pace Project No.: 92215733
Pace Analytical Services, Inc.
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
QC Batch: WET133076
Analysis Method:
SM 2540D
QC Batch Method: SM 2540D
Analysis Description:
2540D Total Suspended Solids
Associated Lab Samples: 92215733001, 92215733002
METHOD BLANK: 1281860
Matrix:
Water
Associated Lab Samples: 92215733001. 92215733002
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed Qualifiers
Total Suspended Solids
mg/L
ND
2.5 09/09/14 19:48
LABORATORY CONTROL SAMPLE:
1281861
Spike
LCS
LCS % Rec
Parameter
Units
Conc.
Result
% Rec Limits Qualifiers
Total Suspended Solids
mg1L
250
268
107 90-110
SAMPLE DUPLICATE: 1281862
92216168001
Dup
Parameter
Units
Result
Result
RPD Qualifiers
Total Suspended Solids
mglL
156
154 1
SAMPLE DUPLICATE: 1281853
92215733001
Dup
Parameter
Units
Result
Result
RPD Qualifiers
Total Suspended Solids
mg/L
15.3
10.8 35 J(D6)
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,
bate: 09/16/2014 09:09 AM without the written consent of Pace Analytical Services, Inc.. Page 7 of 12

0
aceAnalytical
www.pacelabs.com
Project: Storrnwater 913
Pace Project No.: 92215733
QC Batch: WETA120247
QC Batch Method: SM 5220D
Associated Lab Samples: 92215733001, 92215733002
METHOD BLANK: 1285552
Associated Lab Samples: 92215733001, 92215733002
Parameter Units
Chemical Oxygen Demand mg/L
LABORATORY CONTROL SAMPLE: 1285553
Parameter Units
Chemical Oxygen Demand mg/L
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Analysis Method: SM 5220D
Analysis Description: 5220D COD
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 25.0 09/15/14 22:21
Spike LCS LCS % Rec
Cone. Result % Rec Limits Qualifiers
750 773 103 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 1285554 1285555
MS MSD
92216698001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Cone, Cone. Result Result % Rec % Rec Limits RP[) Qual
Chemical Oxygen Demand mg1L 702 750 750 1420 1410 95 95 90-110 0
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 1285556 1285557
MS MSD
92216717001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Cone. Cone. Result Result % Rec % Rec Limits RPD Qual
Chemical Oxygen Demand mg/L 2090 1500 1500 3690 3680 106 106 90-110 0 J(M1)
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: 09/16/2014 09:09 AM without the written consent of Pace Analytical Services, Inc..
Page 8 of 12

Pace Analytical Services, Inc.
6Analytical 9800KineyAve. Suite 100
aC
Huntersville, NC 2t3078
78
www.pacelab&mn (704)s75-9092
QUALIFIERS
Project Stormwater 913
Pace Project No.: 92215733
DEFINITIONS
OF - Dilution Factor, if reported, represents the factor applied to the reported data due to changes in sample preparation, dilution of
the sample aliquot, or moisture content.
NO - Not Detected at or above adjusted reporting limit.
MDL -Adjusted Method Detection Limit.
PQL - Practical Quantitation Limit.
RL - Reporting Limit.
S - Surrogate
1,2-Dipheny1hydrazine (8270 listed analyte) decomposes to Azobenzene.
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.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Acid preservation may not be appropriate for 2-Chloroethylvinyl ether, Styrene, and Vinyl chloride.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute.
LABORATORIES
PAST -A Pace Analytical Services -Asheville
ANALYTE QUALIFIERS
J(D6) Estimated Value. The relative percent difference (RPD) between the sample and sample duplicate exceeded laboratory
control limits.
J(M1) Estimated Value. Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS)
recovery.
Z Too many colonies were present (TNTC); the numeric value represents the estimated colony counts from the highest
dilution used in this test.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 09/16/2014 09:09 AM without the written consent of Pace Analytical Services, Inc.. Page 9 of 12

laceAnalytical*
wwwpecebbs.com
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Stormwater 9/3
Pace Project No.: 92215733
Lab ID Sample IC GC Batch Method
92215733001
OUTFALL 4
SM
9222D
92215733002
OUTFALL 5
SM
9222D
92215733001
OUTFALL 4
SM
2540D
92215733002
OUTFALL 5
SM
2540D
92215733001
OUTFALL 4
SM
5220D
92215733002
OUTFALL 5
SM
52200
Date: 09/16/2014 09:09 AM
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QC Batch Analytical Method
MB10/8284
MBIO/8284
WET/33076
WET/33076
WETA120247
WETA/20247
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Analytical
Batch
Page 10 of 12

Document Name: Sample Condition Upon
Document Revised: June 10, 2014
aceAnalXical`
Receipt (SCUR)
Page 1 of 2
Document No.:
Issuing Authorities:
.v.,no.pacolobs.cona
F-ASV-CS-003-rev,14
Pace Asheville Quality Office
Client Name: ,Acid" soy (o tin f sn(; 4. W �Sfr
Courier (Circle): Fed Ex UPS USPS Cates Commercial Pace Other=
Custody Seal on Cooler/Box Present: ❑ yes ,no� Seals intact: yes ❑ no
Packing Material: Bubble Wrap El Bubble Bags one Fj
Thermometer Used: IR Gun#3-130265963 Type of Ice: et..
Gun #4 SN:140290365 Other:_._
Temp Correction Factor: Add 16btract ! C
Other
Blue None Samples on ice, cooling process has begun
Corrected Cooler Temp.: l C
Temp should be above freezing to 6'C
Biological Tissue is Frozen: Yes No q
Comments:
Date and Initials of person examining
contents:
Chain of Custody Present:
ON.
❑NIA
1.
Chain of Custody Filled put:
eyes
,YJYes ONO
❑NIA
2.
Chain of Custody Relinquished:
Yes ONO
❑NIA
3.
Sampler Name & Signature on COO:
filly.. ©No
❑N/A
4.
Samples Arrived within Hold Time:
26s ONO
❑NIA
5.
Short Hold Time Analysis (<72hr):
Yes ON9
❑N/A
6.
Rush Turn Around Time Requested:
Dyes dNo
❑NIA
7.
Sufficient Volume:
Yes ❑No
❑NIA
8.
Correct Containers Used:
-Pace Containers Used:
Rryes ONO
Yes ONO
❑NIA
❑NIA
9.
Containers Intact:
12!Yes ONO
❑NIA
10,
Filtered volume received for Dissolved tests
❑yes V(No
❑NIA
11.
Sample Labels match COC:
-includes date/time/ID/Analysis Matrix:
Yes ❑No
❑N1A
12.
Ali containers needing preservation have been checked.
All containers needing preservation are found to be in
compliance with EPA recommendation.
exceptions: VOA, coliform, TOC, O&G, WI -SRO (water)
dyes ONO
Tes ❑No
Dyes I to
❑NIA
❑NIA
13.
Samples checked for dechlorination:
Ves ONO
❑NIA
14.
Headspace in VOA Vials (>6mm):
❑Yes ©No
O/A
15.
Trip Blank Present:
Trip Blank Custody Seals Present
Pace Trip Blank Lot # (if purchased):
❑Yes ONO KNIA
❑Yes ❑No11KN1A
16.
Client Notification! Resolution:
Person Contacted: Date/Time:
Comments/ Resolution:
SCURF Review:
Date: 17131,
SRF Review:1 Z_ Date: I % 1 .c/
Note: Whenever there is a discrepancy affecting North Carolina
compliance samples, a copy of this form will be sent to the North
Carolina DEHNR Certification Office ( Le out of hold, incorrect
preservative, out of temp, incorrect containers)
Field Data Required? Y I N
Page 12 of 12

V.
L
CHAIN -OF -CUSTODY / Analytical Request Document. N
ZAnalytical The Chainol-Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately.
0
www.p2cglab4.com
Page: at 0
Section A Section B Section C
Required Cllenl Informabion: Required Project information: Invoice Information:
pant: To: Attention:
q1 LAl n/x/'� 7
4 2 8 O! 1
�� r �?
1
Ad a / e + -
PY To:
Company Name:
REGULATORY.AGENCY
f
�dro'•'
r NPDES C- GROUND WATER j-, DRINKING WATER
(- UST j- RCRA OTHER t 1
mai To: /' - /_ 1
P rchase r No.:°
o�
Retarence:
e: Fax:
Project Name
Pace Project
Site Location
Manager. r
' -:~STATE.-
,
Requested Due DatalTAT:
Project Number:
Pace Profile #:
Requestetl'Anelysls
filtered
(YIN),
Section D Matrix Codes
'
~`
' _:
RequiradClIen[ Infannation MATRIX 1 Gobi=
Drinking Water - DW
-9
COLLECTED
Preservatives
-
- Water - WT
- PWaste roducWafer WW
t P
�srre
coin
J
Z
.
solusolla sL
o
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SAMPLE ID Oil OL
"
L)
Lu
am
VIAPe WP-,
4A z: 0 9 f i'1 3Y. AIr AR
W
q
...
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¢
D-
Z
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Sample I0a MUST BE UNIQUE Tissue TS
O
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�i
'-y
f'\
Other OT
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'_�
t�%
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9�,1 157 33
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GATE
TIME
DATE
TIME
N
#
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Pace Project NO.! Lab I.D.
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31
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°5 � � ADOITIONAL COMMENTS .-
Ft- UNQUI5HED BY l AFF1LIgT10N
; � DATE �.'
..TIME
r
L9PTEt) f3Y FFILIATION
,� DATE
TiME:,',
SAMPLE CONDITIONS
ORIGINAL
SAMPLER NAME AND SIGNATURE, r
` . -
v
o w
5
PRINT Name of SAMPLER. W
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Z
2
c
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E
0$���
SIGNATURE of SAMPLER:
DATE Signed
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1,
h
N
eponant NOW 8y signing des form you are akkeptW Pa m's NET 30 day pay—i tee NA agreeing to late duwg" of 1.5% Per month for arty invokes not paid within 30 days. F-ALL-0-020rev,07, 15-May-2007

Phone [phone]
Fax [phone]
Madison County
Solid Waste Department
23 June 2014
NCDENR/DWQ
1617 Mail Service Center
Raleigh, NC 27699-1617
RE: Madison County Landfill
NCG 120082
Madison County, North Carolina
To Whom It May Concern:
Office
271 Craig Rudisill Rd.
Marshall, NC 28753
RECEIVED
JUL 0 2 2614
CENTRAL FILES
DWQ180G
This correspondence is part of the Stormwater Discharge Outfall Monitoring
Report submitted by Madison County Solid Waste Facility as required by General Permit
# NCG 120000 and Certificate of Coverage # NCG 120082.
On April 29, 2014 the landfill experienced a rain event of 1/3 inch in the early
morning. Outfall 4 and Outfall 5 were inspected and appropriate samples were taken.
Samples were immediately iced and carried to Pace Analytical in Asheville, NC. Results
from these sample tests were received back at the landfill offices on June 20, 2014.
Results showed all samples for both Outfalls were within benchmark values.
If you have questions about the report please call Jim Huff at 828-649-2311 or
correspond via email at jhuff(rmadisoncountyncrorg or via postal service at 271 Craig
Rudisill Road, Marshall, NC 28753
Regards,
L^
ames L. Huff, Director
Madison County Solid Waste Department

i
• 7
S
Semi-annual Stormwater Discharge Monitoring Report
for North Carolina
i
CERTIFICATE OF COVERAGE NO. NCG12 0 O R'
FACILITY -NAME- �f4dl, �' - _r r'Ae7ei -,o
COUNTY I S�s
PERSON COLLECTING SAMPLES
LABORATORY Lab Cert. #
Comments on sample collecti n or analysis:
Division of Water Quality General Permit No. NCG120000
Date submitted
Z SAMPLE COLLECTION YEAR D2�_
1��l....11.��rf�l.�..�`......_SAMPLE PERIOD 0-111an-June---❑July-Dec ._._ ......-....._ _ _....
or. 0 Monthly' I (month)
DISCHARGING TO CLASS ❑ORW l❑HQW ❑Trout ❑PNA
❑Zero -flaw ❑Water Supply ❑SA
[—]Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Part A: Stormwater Benchmarks and Monitoring Results
❑ No discharge this period?z
Y-
ar
`Date Samples
24 hour rairifafl
h
{'
L.
_ outfall Na
:
t
'
`
Chemical Demand
Fecal
Solids
:< 3
r. .,J°Inches
Oxygen
ColiformTotal
Suspended
(mil/dd/yr}
:Benchmarks _�
ti '�;`
'• <
120 m
7ODU`caunt.per lO0:mL
'•i{ 100 Trig/L or,50
i... [
�� ,
_iY` �, a. .. S
,'
f ...X.°•_�
:;
1. 1 'v.._:: t :3-
F -
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i
'
� 1
' Monthly sampling (instead of semi-anrival) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge', at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waifver Iof the rain gauge requirement.
° See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
I
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format."OX Mg/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Fier 2, or Tier 3 responses. See General Permit text.
i
Permit Date: 11/1/2012-10/31/2017 I 5WU-248, last revised 10/25/2012
I i
Page 1 of 2

• i
Part B: Ve—cle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
n No discharge this period ?z
0utfa11 No
Date Sample
24 hour rarnfall
;
x
Collected'
rriount a ,
Non polar 0&G/TPH by
F
.
/dd% i
Y}
F a
.Inches
w;EPA.'1664 (SGT=HEM}.
t� Total Suspended Solids
I.
pH
o r 7-
Benchmarks ===>
;; -':
15 ni L :_
_ 100 mg/I_ or 50 mg/I
i `'
6 1) 9 O SW"'!
Footnotes from Part A also apply to this Part B
'
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1, or Tier 3 responses. See
f
General Permit text.
FOR PART A AND PART B MON ITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER -AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT
PART II SECTION B.
• TIER 3: HAS YOUR FACILITY kAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER ATANY ONE OUTFAL
? YES ❑ NO ❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the tab '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, 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 perso i s who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belieif, 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
rmittee) {Date}
4/
Permit/1/2012-10/31/2017 I SWU-248, last revised 10/25/2012
Page 2 of 2

r ace*aIxcal
1 J wmpacela6¢ c=
r
1
June 20, 2014
Mr. James Huff
Madison County Solid Waste
271 Craig Rudisill Road
Marshall, NC 28753
RE: Project: STORMVVATER FIRST 2014
Pace Project No.: 92199119
Pace Analytical Services, Inc.
9800 Kincey Ave, Suite 100
Huntersville, NC 28078
[phone]
Dear Mr. Huff:
Enclosed are the analytical results for sample(s) received by the laboratory on April 29, 2014. The
results relate only to the samples included in this report. Results reported herein conform to the
most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless
otherwise noted in the body of the report.
Analyses were performed at the Pace Analytical Services location indicated on the sample analyte
page for analysis unless otherwise footnoted.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Chris Derouen for
Tom Williams
_.__..tom.wilIiams@pace labs.com-- - - - — -- -
__ Project
Enclosures
yt.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 1 of 12

aceAnalytical
(J wwwpacelabs.00m
Project: STORMWATER FIRST 2014
Pace Project No.: 92199119
Asheville Certification IDs
2225 Riverside Dr., Asheville, NC 28804
FloddalNELAP Certification #: E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #: 37712
CERTIFICATIONS
North Carolina Wastewater Certification #: 40
South Carolina Certification 9: 99030001
West Virginia Certification #: 356
VrginiaNELAP Certification #: 460222 _
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Page 2 of 12

aceAnalytical
www.pacelabs.com
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersviile, NC 28078
[phone]
SAMPLE ANALYTE COUNT
Project: STORMWATER FIRST 2014
Pace Project No.. 92199119
Anaiytes
Lab ID Sample ID Method
Analysts
Reported
Laboratory
92199119001 OUTFALL 4 SM 9222D
MDW
1
PASI-A
SM 2540D
WRC
1
PASI-A
SM 5220D
EWS
1
PASI-A
92199119002 OUTFALL 5 SM 9222D
MDW
1
PASI-A
SM 2540D
WRC
1
PASI-A
SM 5220D
EWS
1
PASI-A
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 3of12 '

aceAnalyticaI
' I www.pacelaos.com
i
ANALYTICAL RESULTS
Project. STORMWATER FIRST2014
Pace Project No.: 92199119
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: OUTFALL 4
Lab ID: 92199119001 Collected: 04/29/14 10:17
Received: 04/29/14 11:24 Matrix: Water
Parameters
Results Units
Report Limit OF
Prepared Analyzed CAS No. Qual
MI310 9222D Fecal Colfform AVL
Analytical Method; SM 92220
_
Fecal Coliforms
NO CFU1100 mL
1.0 1
04/29/14 15:08
2540D Total Suspended Solids
Analytical Method: SM 2540D
Total Suspended Solids
17.4 mg/L
6.6 1
05/06/14 16:56
6220D COD
Analytical Method: SM 5220D
Chemical Oxygen Demand
NO mg/L
25.0 1
05/07/14 17:10
Date: 06/20/2014 09:32 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Face Analytical Services, Inc..
Page 4 of 12

aceAnalytical
www.pacelabscom
Pace Analytical Services, Inc.
9800 Kincey Ave, Suite 100
Hunlermille, NC 28078
[phone]
ANALYTICAL RESULTS
Project: STORMWATER FIRST 2014
Pace Project No.: 92199119
Sample: OUTFALL 5
Lab ID: 92199119002 Collected: 04/29/14 10:06
Received: 04/29/14 11:24 Maeix:,`Nater
Parameters
Results Units
Report Limit OF
Prepared Analyzed CAS No. Qual
MBIO 9222D Fecal Coliform AVL
Analytical Method: SM 9222D
Fecal Coiiforms
149 CFU1100 mL
1.0 1
04/29/14 15:08
26400 Total Suspended Solids
Analytical Method: SM 25401)
Total Suspended Solids
9.7 mg1L
2.7 1
05/06/14 16:50
5220D COD
Analytical Method: SM 5220D
Chemical Oxygen Demand
ND mg1L
25.0 1
05/07/14 17:10
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 06/20/2014 09:32 AM without the written consent of Pace Analytical Services, inc. Page 5 of 12

aceAQalyticale
wwwpacelabs.com
ff
I
QUALITY CONTROL DATA
Project; STORMWATER FIRST 2014
Pace Project No.: 92199119
QC Batch: MBI017901 Analysis Method: SM 9222D
QC Batch Method: SM 9222D Analysis Description; 9222D M810 Fecal Coliform -AVL
Associated Lab Samples: 92199119001, 92199119002
METHOD BLANK: 1188968 - � _- -- -- - - -. -- _ Matrix: Water
Associated Lab Samples: 92199119001, 92199119002
Blank Reporting
Parameter Units Result Limit Anaiyzed Qualifiers
Fecal Coliforms CFUI100 mL ND 1.0 04/29/14 15:08
SAMPLE DUPLICATE: 1188970
92199119002 Dup
Parameter Units Result Result RPD Qualifiers
Fecal Coliforms CFU1100 mL 149 162 8
Pace Analytical Services, Inc.
9800KinceyAve- Suitel00
Huntersville, NC 28078
[phone]
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: 06/20/2014 09:32 AM without the written consent of Pace Analytical Services, Inc.. Page 6 of 12

r
aceAnalXical
wwwpacelabs.com
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: STORMWATER FIRST 2014
Pace Project No,: 92199119
QC Batch: WET130875 Analysis Method: SM 2540D
QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples: 92199119001, 92199119002
METHOD BLANK: 1192360 - - -- — Matrix: Water
Associated Lab Samples: 92199119001. 92199119002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Suspended Solids mg1L ND 2.5 05/06/14 16:48
LABORATORY CONTROL SAMPLE:
1192361
Parameter
Units
Total Suspended Solids
mg/L
SAMPLE DUPLICATE: 1192362
Parameter
Units
Total Suspended Solids
mg1L
SAMPLE DUPLICATE: 1192363
Parameter
Units
Total Suspended Solids
mg/L
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
250 242 97 80-120
92199093002 Dup
Result Result
57.0 63.0
92199213001 Dup
Result Result
208 220
RPD Qualifiers
10
RPD Qualifiers
6
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: 06/20/2014 09:32 AM without the written consent of Pace Analytical Services, inc.. Page 7 of 12

aceAnalXical
wvwupacelab.tem
i
QUALITY CONTROL DATA
Project: - STORMWATER FIRST 2014
Pace Project No.: 92199119
QC Batch: WETA/18889 Analysis Method: SM 52200
OC Batch Method: SM 5220D Analysis Description: 5220D COb
Associated Lab Samples: 92199119001. 92199119002
METHOD BLANK:- 1191647 -' -'- _ - -" Matrix: Water
Associated Lab Samples: 92199119001. 92199119002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Chemical Oxygen Demand mg/L ND 25.0 05/07114 17:10
Pace Analytical Services, Inc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE: 1191648
Spike LCS LCS %Rec
Parameter Units Cone. Result % Rec Limits Qualifiers
Chemical Oxygen Demand mg/L 750 735 98 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE:
1191649
1191650
MS
MSD
92199473001
Spike
Spike
MS
MSD
MS
MSD
% Rec
Parameter
Units
Result
Cone.
Cone,
Result
Result
% Rec
% Rec
Limits RPD Qual
Chemical Oxygen Demand
mg1L
721
750
750
1390
1380
89
88
75-125 1
,
MATRIX SPIKE & MATRIX SPIKE DUPLICATE:
1191651
1191652
MS
MSD
92199029013
Spike
Spike
MS
MSD
MS
MSD
% Rec
Parameter
Units
Result
Cone.
Cone.
Result -
Result
% Rec
% Rec
Limits RPD Qual
Chemical Oxygen Demand
mg/L
ND
750
750
763
772
99
100
75-125 1
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: 05/20/2014 09:32 AM without the written consent of Pace Analytical Services, Inc.. Page 8 of 12

aceAnalytical
www.pacelabs.00m
Pace Analytical Services, lnc.
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALIFIERS
Project: STORMWATER FIRST 2014
Pace Project No.: 92199119
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to changes in sample preparation, dilution of
the sample aliquot, or moisture content.
ND -.Not Detected at or above adjusted reporting limit.. -
MDL-Adjusted Method Detection Limit.
PQL - Practical Quantitation Limit.
RL - Reporting Limit.
S - Surrogate
1,2-Diphenythydrazine (8270 listed analyte) decomposes to Azobenzene.
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.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Acid preservation may not be appropriate for 2-Chloroethylvinyl ether, Styrene, and Vinyl chloride.
LOD - Limit of Detection.
LOO - Limit of Quantitation.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute.
LABORATORIES
PASI-A Pace Analytical Services - Asheville
Date: 06/20/2014 09:32 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 9 of 12

F 5aneAna/Acal*
/ wwpacelabsean
I
Pace Analytical Services, Inc.
9800 KirrceyAve. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project:
$TORMWATER FIRST 2014
Pace Project NO-!
92199119
Analytical
Lab ID
Sample ID
QC Batch Method
QC Batch Analytical Method Batch
92199119001
OUTFALL 4
SM 9222D
M131017901
92199119002
OUTFALL 5
SM 9222D
MBIO/7901 -
92199119001
OUTFALL 4
SM 2540D
WET130875
92199119002
OUTFALL 5
SM 2540D
WET130875
92199119001
OUTFALL 4
SM 5220D
WETA/18889
92199119002
OUTFALL 5
SM 5220D
WETA/18889
Date:'06/2012014 09:32 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, Inc..
Page 10 of 12

Jit Name: Sairiple Condition Upon DDCLW�ient Revised: JLJ11e 4. 2013
Document No,: �sstfing Authorities:
F-AS`v`-CS-003-rov.1j Pace Ash eville Quality Office
Where Received: Huntersville Asheville F] Eden Raleigh
COUrier (Ci"Cle): rod Ex tips Usps client", Commercial pace Otber
r BLibble Bags None
GircJcThcrinornetr,,r Used: ik t3unO -130265963 Type of ice: Wet Blue None Wulii)o pruress has be.gun
fj'Sairiplas on ice
Temp Correction Factor: Add I Subtract - C
Corrected Cooler Temp.: C
Biolog�!cal Tissue is Frozen: Yes :�IlAi
Rush Turn Around Time Requested;
1-1 y9s, N/o
ONIA
7
-Includes date/timeff)/Anaiysis Matrix:_---'
All containers needing preservation are found to be in
cj
i Yes ONO,
ONIA
Pace Trip Blank Lot V (if
Cxwntw"onconun n:omuuvn: Field Date Required? , / w
Person Contacted: oa�n�n=:
—__----__----'
Comments/ Resolution:
SCURF
oRpmoview ~
wotc� Whenever there lsadiscrepancy affecting North Carolina
mmplionce sarnplos, a copy ofthis form Mil ovsen(lothe North
unonon°osHmnoortm*ouortOffice <Le. out n/hold, incorrect
Placo lahel here
OR
Handwrite project number
(if no label available)
Page 11cv1z

I
i
• I
,h
CHAIN -CUSTODY 1 Analytical Bequest Document
1
-OF
The Chsirt-nt-Custody is a LcG:+L pOCUR}£NT- AJI ral�:^.,^,i fields mus; x ca�zpletc�: a�ulately.
PaeeAnalyiical`
j
rwu, p•[clahy.[om
i
-
Page: of
Section A
Section 13
Section C I
Required Caene
RecrUlred Praee; Inleauaorl:
Inti :¢ i171ormaLzn:
�1(
7-0
np:.ny:
J
r
eport TO:
2)(�
-S- �-% `�
Cop'y7o:
Co--panyNanle:
REGULATORY AGENCY
Addret;:
NPDES ' GROUND'NATER ; ORiNKING',VVA-T�ERR
G
j
- UST � RCRh OTHER
'
email
Ren:=,sc Orce• 'o.:
®
Waco xjiMla
T
r�Q�
R��'rl:nca.
Pl�enr f ?at:
r1
Ffcre ' nrc.e: .y.�_�t
Pece Pro.eu
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