NCG140071_MONITORING INFO_20061106

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
/V u& ) 7
DOC TYPE.
❑ HISTORICAL FILE
C MONITORING REPORTS
DOC DATE
❑ li D lP I lV
YYYYM M DD

' a
AA'' DISCHARGE OUTFALL MONITORING REP(
NCDENR GENERAL PERMIT NCG140000
(All sample data shall be reported no later than 30 days after receipt of lab results)
Certificate of Coverage
NCG14 ®aMa
Facility Name
E ,�
74
County
n/
Phone Number
_ 9 S
DE`N� AlE1GH RED F
Certified Laboratory #
3
Person Collecting Samples)
p h n W(e Z C"
Collectors Signature
iv
Sample Information
Permit Term
Year
Year Start/End Dates
Place check mark to indicate
applicable sampling period
Discharge Type (check
as appropriate)
Stormwater.
❑
❑ l
®'
❑
❑
Wastewater
❑
El
❑
❑
I
August 1, 2004 to July 31, 2005
11
❑
[�'
❑
❑
2
/ August 1, 2005 to July 31, 2006
3
August 1, 2006 to Jul 31, 2007
4
August 1, 2007 to July 31, 2008
5
August 1, 2008 to July 31, 2009
Part A: Stormwater Discharge Monitoring Data (For stormwater not combined with process wastewater)
Storm Event Characteristics
Date -
Total Event Preci itation (inches)
Event Duration (hours)
LD
' 2-
Stormwater Discharge Monitoring
Outfall
No.
. Date Sample
C611ected
(mo/dd/ 1
Total Flow
a —
Total Event
Precipitation
(inches)
Event Duration
hours
pH
(Std. Units)
Total
Suspended
Solids
(mJl)
0- -O
2
, .
In
Does this facility perform Vehicle Maintenance Activities using on average more than 55 gallons of new motor
of 1 per month? ❑ Ye: No If yes, complete information below.
Stormwater Discharge Monitoring from Vehicle Maintenance Areas
Outfall
No.
Date Sample
Collected
(mo/dd/ r)
Total Flow
(MG)
Total Event
Precipitation
(inches) -
Event
Duration
(hours) .
New
Motor Oil
Usage
(gal/mo)
pH
(Std. Units)
Total
Suspended
Solids
(mg 1)
Oil and
Grease
(mo )
I
SWU-241-080104 Page loft

Part B: Process wastewater discharge monitoring data
a SSample #.
tmas
Effluent Source(s) for this sample
Vehicle / E ui 'ment Cleaning
❑
Raw Material Stock -pile Wettin
❑
Mixing Drum Clean -out
❑
Recycle System Overflow
❑
Parameter
Unit
Data
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration
hours
pH
Std. units
TSS
mgA
Settleable Solids
MIA
Sample #
Effluent Source(s) for this sample
Vehicle / E ui ment Cleanin ❑
Raw Material Stock -pile Wettin ❑
Mixin Drum Clean -out __ ❑
Recycle System Overflow ❑
Parameter
Unit
Data
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration
hours
pH
Std. units
TSS
mgA
Settleable Solids.
ml/1
Mail original and one copy to:
Attn: Central Files
Division of Water Quality
DENR
1617 Mail Service Center
Raleigh, NC 27699-1617
Sample #
Effluent Source(s) for this sample /
Vehicle / Equipment Cleanin ❑
Raw Material Stock -pile Wettin ❑
Mixing Drum Clean -out ❑
Recycle S stem,Overflow ❑
Parameter
Unit
Data
Collection Date
mo/dd/yr ,
Total.Flow
MG
,
Event Duration
hours
pH
Std- units
TSS
mg/1
Settleable Solids
mUl
Sample #
Effluent Sources forthis•sam le
4
Vehicle / Equipment Cleaning
❑
Raw Material Stock -pile Wetting
❑
Mixing Drum Clean -out
❑
Recycle System Overflow
❑
Parameter
Unit
Data
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration
hours
pH
Sid. units
TSS
mg/I
Settleable Solids
MIA
"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 f^-^ 1nd imprisonment for knowing
Nn
of Yermtttee or Designee)
swu-231-080104 `� Page 2 of 2

Stormwater Discharge Outfall (SDO)
uQualitative Monitoring Report
Permit No.: N/C/ I / It� l_d / Ul !l 1 /_/ or Certificate of Coverage No.: N/C/G/_/_/_/_/_/_/
Facility Name: _A
County:
Inspector: 'S'A1,A) W < le
Date of Inspection:
By this signature, I certify th this
% ^ - n..
Phone No.cilii91a
is accurate and complete to the best of my knowledge:
(SignatugI Permittee or Designee)
1. Outfall Description
Outfall No. I— Structure (pipe, ditch, etc.) PJ
Receiving Stream: TO r P�., '.—
Describe the 5'ndustt�jal activities that occur
llrl-L'11na ; 4LO,9.Ct
2. Color
Describe the color of the
dark) as descriptors:
3. Odor
Describe any distinct odors that the
etc.)
the o [fall
T to,
sing basic color (red, brown, blue, etc.) and tint (light, medium,
cC� �: eLr r
may have (i.e., smells strongly of oil, weak chlorine odor,
4. Clarity
Choose the number which best describes the clarity of the discharge where I is clear and 10 is very
cloudy:
1 2 6 4 5 6 7 8 9 10
Page 1
SWU-242-101599

I
5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Ytsb1
8. Oil Sheen I
Is there an oil sheen in the stormwater discharge? Yes b
9. Other Obvious Indicators of Storm/�water Pollution /U List and describe 0 A, t-
Note: Low clarity, high solids, and/or the presence of foam or oil sheen may be indicative of pollutant
exposure. These conditions may warrant further investigation.
Page 2
SWU-242-101599

a
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: N/C // %/%-U or Certificate of Coverage No.: N/C/G/ I / r/L
Facility Name: -A-yea co'iccte -
County: -Pq k l-'1 Phone No. f 4 -
Inspector: O Ha e v
Date of Inspection: Or- t (o
By this signature, I certify that this report is accurate A complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description
Outfall No. _ Structure (pipe, ditch etc J �' p e
Receiving Stream:
Describe the industrial activities that ocGyr within the outfall drainage area:
2. Color
Describe the color of the discharge using basic colors (red,
dark) as descriptors: Ul'ry
blue, etc.) and tint (light, medium,
r
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) AID. -t
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 2 l=/ 4 5 6 7 8 9 10
Page 1
SWU-242-101599

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
V 2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solidsLinthe stormwater discharge
where 1 is no solids and 10 is extremely muddy:
1,01 2 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? YVsP
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes
9. Other Obvious Indicators of Stormwater/'Pollution
/ V List and describe O 4 C,
Note: Low clarity, high solids, and/or the presence of foam or oil sheen may be indicative of pollutant
exposure. These conditions may warrant further investigation.
Page 2
SWU-242-101599

Telephone: [phone]
Fax: [phone]
0
0
VG30TEST
6701 Conference Drive
Raleigh, NC 27607
Laboratory Report
--- Prepared for ---
LYMAN AUSTIN
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, NC 27611
Project No.:
Project ID: PLANT 9
No. Sample ID
001 OUTFALLI
Page 1 of 1
NC/WW Cert. M 067
NC/DW Cert.#: 37731
Report Date: 10/12/2006
Date Received: 10/6/2006
Work Order #: 0610-00491
Cust. Code: RE1520
Cust. P.O.#:
Dale Sampled Time Sampled Matrix Sample Type Condition
10/612006 8:30 SW Grab 4 +/- 2 deg C
Analyzed
Test Performed Method Results Date Time Qualifier
Total Suspended Solids EPA 160.2 58.8 mg/L 10/9/06 16:00
No. Sample ID
002 OUTFALL 2
Date Sampled Time Sampled Matrix Sample Type Condition
10/6/2006 8:30 SW Grab 4 +/- 2 deg C
Analyzed
Test Performed Method Results Date Time Qualifier
Total Suspended Solids EPA 160.2 17.6 mg/L 10/9106 16:00
Reviewed/by:
for Tritest, Inc. xM

U IsZ iiT�ST
6701 Conference Drive, Raleigh, NC 27607
ph: [phone] fax: [phone]
NCWW Can #67, NCDW Con # 37731
Report Results To:
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, NC 27611
Attn: LYMAN AUSTIN
Phone: [phone]
Fax: [phone]
Chain of Custody
Bill Results To:
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, NC 27611
Attn: LYMAN AUSTIN
A-0✓
to((,
06to —60r{a (
Tritest W.O. 19,"t-tT6215— Page 1 of 1
❑ Standard Report Delivery
❑ Rush Report Delivery (w/ surcharge)
Note: Rush projects are subject to prior approval by Lab
Requested Due Date:
Project Reference: PLANT #9
Project Number: PLANT 9
Purchase Order #:
Sampled By: CFO h7 A �VC�Cne i
`Sample Description __
Cpmpos,te
or Grab
a ate <
: top a e
a Ix
sw`cwetc
naysls eques e
Smp'#
Start Time
Stop Time
OUTFALL 1
G
SW
Total Suspended Solids
001
OUTFALL 2
G
SW
Total Suspended Solids
002
Reh e b si nature)
Rec ved by (signatur
Dat //
�(' l0 ' �6
Time r
Jr
For Lab Use Only:
Temperatue at receipt:
ReI ished by ( nature
Q y�
R ce d by (signature)
Date
to p
Time
�S S t
❑ 4+2 C
Temp:S-C% C
Relinci t
d by (signature
Received by (signature)
Date
Time

0
a
� nTEST
SAMPLE
PRESERVATION CHECK -IN SHEET
won:
0�6Ip-tb4a l
Checked in by:
Rwl ,
Date:
10
Time:
a
Temp:
C
Route:
'ITS
TTPU
I USM
FEDX I
GC
UPS
Sample
No. -
Analysis Requested
Sample
Type
Comp/
Crab
Container
Chlorine
Preservative
None
HCL
I12SO4
RN03
NaOH
Thio
OTHER
4Pos/
ne'
HCL
H2SO4
HNO3
Na01{
Thio
OTHER
Z
1
C /
/ G
Nine
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
one
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
one
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Fos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos/neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Fos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos/neg
None
HCL
H2SO4
HNO3
NaOH
Tbio
OTHER
C / G
FIG
Fos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Fos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos /neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos /neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
—Cl
P / G
Pos /neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
COMMENTS:

NCDENR
DISCHARGE OUTFALL MONITORING REPORT
GENERAL PERMIT NCG140000
(All sample data shall be reported no later than 30 days after receipt of lab results)'
Certificate of Coverage
NCG14 ®©ffila
Facility Name
I ' /�. 1p q
r'e p tee%
County
!✓
Phone Number
Certified Laboratory #
3
Person Collecting Sample(s)
: c5 k .1 (/u• ,� i i
Collectors Signature
-V-
J :.� /
4
tv
Sample Information
Permit Term Year.Start/End Dates
Year
Place check mark to indicate
applicable sampling period
Discharge Type (check
as appropriate)
Stormwater.
❑
❑
❑
❑
Wastewater
❑
O
❑
❑
I August 1, 2004 to July 31, 2005
[r-
❑'
❑
❑
2 I August 1, 2005 to July 31, 2006
3 August 1, 2006 to July 31, 2007
4 August 1, 2007 to July 31, 2008
5 August 1, 2008 to July 31, 2009
Part A: Storrnwater Discharge Monitoring Data (For stormwater not combined with process wastewater)
Storm Event Characteristics
Date
Total Event Preci itation (inches)
Event Duration (hours)
I
Stormwater Discharge Monitoring
Outfall
No.
. Date Sample
Collected
(mo/dd/ )
Total Flow
Total Event
Precipitation
(inches)
Event Duration
(hours
pH
(Sid. Units)
Total
Suspended
Solids
(mJl)
J-io-UL
z
a
J(a
D
1 a
q
Does this facility perform Vehicle Maintenance Activities using on average more than 55 gallons of new motor
of 1 per month? ❑ Ye; xNo If yes, complete information below.
.Stormwater Discharge Monitoring from Vehicle Maintenance Areas
Outfall
No.
Date Sample . Total Flow
Collected
(mo/dd/ r) (MG)
Total Event Event
Precipitation Duration
(inches) (hours)
New
Motor Oil
Usage
(gal/mo)
pH
(Std. Units)
Total Oil and
Suspended Grease
Solids
(mom 1) (mom 1)
I
I
I
I
I
I
SWU-241-080104 Page loft

Part B: Process wastewater discharge monitoring data
Sample #
Effluent Source(s) for this sample
Vehicle / Equipment Cleanin ❑
Raw Material Stock -pile Wettin ❑
Mixing Drum Clean -out ❑
Recycle System Overflow ❑
Parameter
Unit
Data
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration
hours
pH
Std. units
TSS
mg/1
Settleable Solids
ml/I
Sample #
Effluent Source(s) for this sample
Vehicle / Equipment Cleaning ❑
Raw Material Stock -pile Wetting ❑
Mixing Drum Clean -out__ ❑
Recycle System Overflow ❑
Parameter
. Unit
Data
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration
hours
pH
Std. units
TSS
mg/l
Settleable Solids
MIA
Mail original and one copy to:
Attn: Central Files
Division of Water Quality
DENR
1617 Mail Service Center
Raleigh, NC 27699-1617
Sample #
Effluent Source(s) for this sample
4
Vehicle / Equipment Cleanin
❑
Raw Material Stock -pile Wettin
❑
Mixing Drum Clean -out
❑
Recycle S stem,Overflow
❑
Parameter
Unit
Data
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration
hours
pH
Std- units
TSS
mg/1
settleable Solids
ml/1
Sample #
Effluent Sources for this,sam le
Vehicle / Equipment Cleaning
❑
Raw Material Stock -pile Wetting
❑
Mixing Drum Clean -out
❑
Recycle System Overflow
❑
Parameter
Unit
Data
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration
hours
pH
Std. units
TSS
mg/l
Settleable Solids
MIA
"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 f,— ,nd imprisonment for knowing
of Yerm nee or Designee)
SwU-241-080104 v Page 2 of 2

0
a
Stormwater Discharge Outfall (SDO)
t� Qualitative Monitoring Report
Permit No.: N/C/ —/ / / �/ V/ —/ /_/ or Certificate of Coverage No.: N/C/G/_/_/_/_/_/_/
Facility Name: geAii
County: F1 Ajn 1C Ir
Inspector: 34Ki IV
Date of Inspection:
By this signature, I certify
h ne No.4ji `f 9y
report is accurate and complete to the best of my knowledge:
(Signatu(TI Permittee or Designee)
1. Outfall Description
Outfall No. I K
Structure (pipe, ditch, etc.)
Receiving Stream: 1 . - 'ur,r
Describe the 'ndus al activities that occur within the o tfall c
2. Color
Describe the color of the discharge using basic
dark) as descriptors: (3 C. C wit
3. Odor
Describe any distinct odors that the
etc.)
a
(red, brown, blue, etc.) and tint (light, medium,
A Lr r
Lay have (i.e., smells strongly of oil, weak chlorine odor,At
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 2 a 4 5 6 7 8 9 10
Page 1
SWU-242-101599

l
5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
V 2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where I is no solids and 10 is extremely muddy:
1 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? YVs�y1
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes b
9. Other Obvious Indicators of Stormwater Pollution
List and describe // 0 .ti C'
Note: Low clarity, high solids, and/or the presence of foam or oil sheen may be indicative of pollutant
exposure. These conditions may warrant further investigation.
Page 2
SWU-242-101599

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: N/�/�/ �%7 IJ / / or Certificate of Coverage No.: N/C/G/ j / / /O/ a/ 7/ 1
Facility Name: egi'l/
County: I'1'a I k V I Phone No. l i `1° y .7 S-
Inspector
Date of Inspection: Or, f & C
By this signature, I certify that this report is accurate anA complete to toe best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description J
Outfall No. _ `Z Structure (pipe, ditch etc.) ' p e
Receiving Stream: / �i.- (� ✓t/
Describe the industrial activities that oc��t}}r within the outfall am ge area:
I r. L b" : )v
2. Color
Describe the color of the discharge using basic colors (red,
dark) as descriptors:
blue, etc.) and tint (light, medium,
r
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) A%C ^ r
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 2 l3/ 4 5 6 7 8 9 10
Page 1
SWU-242-101599

5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
I is no solids and 10 is the surface covered with floating solids:
V 2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where 1 is no solids and 10 is extremely muddy:
10, 2 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yts'1
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes 6°
9. Other Obvious Indicators of StormwaterPo/llution
/
List and describe f � o /I(
Note: Low clarity, high solids, and/or the presence of foam or oil sheen may be indicative of pollutant
exposure. These conditions may warrant further investigation.
Page 2
SWU.242-101599

'1 0
Telephone: [phone]
Fax: [phone]
UK00TEST
6701 Conference Drive
Raleigh, NC 27607
Laboratory Report
--- Prepared for ---
LYMAN AUSTIN
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, NC 27611
Page 1 of 1
NC/WW Cert. #: 067
NC/DW Cert. #: 37731
Report Date: 10/12/2006
Date Received: 10/6/2006
Work Order #: 0610-00491
Project No.: Cust. Code: RE1520
Project ID: PLANT 9 Cust. P.O.#:
No. Sample ID
001 OUTFALL 1
Date Sampled Time Sampled Matrix Sample Type Condition
10/6/2006 8:30 SW Grab 4 +l- 2 deg C
Analyzed
Test Performed Method Results Date Time Qualifier
Total Suspended Solids EPA 160.2 58.8 mg/L 1019/06 16:00
No. Sample ID
002 OUTFALL 2
Date Sampled Time Sampled Matrix Sample Type Condition
10/612006 8:30 SW Grab 4 +1- 2 deg C
Analyzed
Test Performed Method Results Date Time Qualifier
Total Suspended Solids EPA 160.2 17.6 mg/L 1019106 16:00
Reviewed by:
\pa����. l �e
for Tritest, Inc

6701 Conference Drive, Raleigh, NC 27607
ph: [phone] fax: [phone]
NCWW Cert #67, NCDW Cert # 37731
Report Results To:
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, NC 27611
Attn: LYMAN AUSTIN
Phone: [phone]
Fax: [phone]
Chain of Custody
Bill Results To:
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, NC 27611
Attn: LYMAN AUSTIN
l0(6
Tritest W.O. OB68-6?62r Page 1 of 1
Standard Report Delivery
Rush Report Delivery (w/ surcharge)
Note: Rush projects are subject to poor approval by Lab
Reauested Due Date:
Project Reference: PLANT #9
Project Number: PLANT 9
Purchase Order #: ^
Sampled By: �y 1 �7• �y�76^e 1,
t ° ,
Nn
tart+ ate A
t. top ate
x a nx
,;, ?��` na ysls egueste a ks
Sample Descnptlon, - s ,
;! r
=r
Composite
`or
r
r ..
'Stop '
W W DW: +r r
7
zs t�9-4 r q "+u.1- ,.
r
Smp
t a
'� p
"s x
GPab
3"a
StartTlme
Tlme
F
sw cw'etc
"x
E.3"'A� eq t xv
_
xw
OUTFALL 1
G
SW
Total Suspended Solids
001
OUTFALL 2
G
SW
Total Suspended Solids
002
10,t
Relin i e� b si nature)
u
Rec ved by (signatur
Dat
� —lp'06
Time r
S
For Lab Use Only:
Temperatue at receipt:
Rel Dished by (An ature
R ce d by (signature)
Date
Time
QN�
❑ 4±2 C
1 Temp: 5. b C
Relinq t
d by (signature
Received by (signature)
Date
Time

r
0
0
7 o TEST
SAMPLE
PRESERVATION CHECK -IN SHEET
won:
061p Cr)Hat
Checked in by:
A,
Date:
10
Time:
I O
Temp:
Route:
TTS
TTPU
USM FEDX I
GC
I UPS
Sample
No.
Analysis Requested
Sample
Type
Comp/
Grab
-Container
Chlorine
Preservative
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
t
ASS
S"�
C /
/ G
I Pos / g ?
lie,
HCL
H2SO4
IIN03
NaOH
Thio
OTHER
Z
1
C /
G
Pos / n
Nine
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNT03
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
MSO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Fos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OT14ER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / GEP/G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / GPos
/ neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / GPos
/ neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / GPos
/ neg
None
HCL
H2SO4
HNO3.NaOH
Thio
OTfiER
C/GPos
/ neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Th o
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
AinvAuvajol l''s

DISCHARGE OUTFALL MONITORING REPORT ,�JU
NC®ENR GENERAL PERMIT NCG140000
(All sample data shall be reported no later than 30 days after receipt of lab results)
Certificate of Coverage
NCG14
Facility Name
Reig(Ay !?(IelfCvr,r.fZeIle
County
`/J A> ✓.�j % nl
Phone Ntunber
_ y 7 5�
Certified Laboratory #
3 7 / 3'
Person Collecting Sample(s)
Collectors Signature
Sample Information
I
Pemtit Term
Year
Year Start/End Dates
Place check mark to indicate
applicable sampling period
Discharge T (check as appropriate)
Stormwater
Wastewater
1
August 1, 1999 to July 31, 2000
E3
❑
❑
E
❑
❑
❑
❑
❑
❑
El
2
August 1, 2000 to July 31, 2001
3
August 1, 2001 to July 31. 2002
4
August 1, 2002 to July 31, 2003
5
August 1, 2003 to Jul 31, 2004
Part A: Stormwater Discharge Monitoring Data (For stormwater not combined with process wastewater)
Storm Event Characteristics
Date
Total Event Precipitation inches
Event Duration hours
© �?e5'
Stormwater Discharge Monitoring
Outfall
No.
Date Sample
Collected
mo/dd/
Total Flow
G
Total Event
Precipitation
inches
Event Duration
(hours)
pH
(Std. Units
Total
Suspended
Solids
MR/1)
c�
cr ._ 1
p
'3
Does this facility perform Vehicle Maintenance Activities using on average more than 55 gallons of new motor
oil per month? ❑ Yes XNo If yes, complete information below.
Stormwater Discharge Monitoring from Vehicle Maintenance Areas
Outfall
No.
Date Sample
Collected
(mo/dd/
Total Flow
G
Total Event
Precipitation
inches
Event
Duration
ours
New
Motor Oil
Usage
altmo)
pH
(Std. Units)
Total
Suspended
Solids
well)
Oil and
Grease
m )
SwU-241-0801e9 Page lof 2

art B: Process wastewater discharge monitoring data
ample #
Sample # _
Effluent Source(s) for this sample
chicle / Equipment Cleaning ❑
aw Material Stock -pile Wetting ❑
iixine Drum Clean -out ❑
.ec cle System Overflow ❑
Parameter
Unit
Data
ollection Date
mo/dd/yr
Total Flow
MG
:vent Duration
hours
pH
Sid. units
TSS
mg/l
,ettleable Solids
mul
Sample # _
Effluent Source(s) for this sample
!ehicle / Equipment Cleaning ❑
;aw Material Stock -pile Wetting ❑
,Iixing Drum Clean -out ❑
:ec cle System Overflow ❑
Parameter
Unit
Data
Collection Date
mo/dd/yr
Total Flow
MG,+
Event Duration
hours
pH
Std. units
TSS
mg/l
Settleable Solids
ml/1
Mail original and one copy to:
Attn: Central Files
Division of Water Quality
DENR
1617 Mail Service Center
Raleigh, NC 27699-1617
Effluent Source(s) for this sample
Vehicle / E ui ment Cleanin ❑
Raw Material Stock -pile Wettin ❑
Mixing Drum Clean -out ❑
Recvcle System Overflow ❑
Parameter
Unit
Data
Collection Date
mo/dd/yr
Total Flow
. MG
Event Duration
hours
pH
Sid. units
TSS
mg/i
Settleable Solids
mlA
Sample #
Effluent Source(s) for this sample J
Vehicle / Equipment Cleaning ❑
Raw Material Stock -pile Wetting ❑
Mixing Drum Clean -out ❑
Recycle System Overflow ❑
Parameter
Unit
Data
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration
hours
pH
Sid. units
"
TSS
mgA
Settleable Solids
mi/I
"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."
of Permitte4 or
or Designee)
swU-e41-080199 'i/ Page 2 of 2
(Date)

TRITEST, INC.
3909 Beryl Road
Raleigh, NC 27607
Telephone: [phone]
Fax: [phone]
Laboratory Report
NC/W W Cert. #: 067
NC/DW Cert #: 37731
--- Prepared for --- 1 of 1
LYMAN AUSTIN Report Date: 10/1612003
READY MIXED CONCRETE CO. P.O. BOX 27326 Date Received: 10/9/2003
RALEIGH, NC 27611 Work Order #: 0309-00072
Project ID: PLANT 9 Cust. Code: RE1520
Project ID: PLANT #9 Cust. P.O.#:
No. Sample ID
001 OUTFALL 1
Date.Sample( Time Sample Matrix Condition
10/9/2003 05:45 SW 462oC
Test Performed Method Results An Qualifier .
Total Suspended Solids EPA 160.2 9.00 mg/L 10/10/03
No. Sample ID
002 OUTFALL 2
Date Sample( Time Sample Matrix
10/9/2003 05:50, SW
Condition
4a2oC
Test Performed Method Results Analyzed Qualifier
Total Suspended Solids EPA 160.2 8.50 mg/L 10/10/03
Report Certified by:
for Tritest, Inc.

Tritest, Inc.
3909 Beryl Road, Raleigh, NC 27607
ph; [phone] fax: [phone]
NCW W CERT#67, NCDW CERT#37731
Report Results To:
Company: READY MIXED CONCRETE CO.
Address: P-O. BOX 27326
RALEIGH, NC 27611
Attn: LYMAN AUSTIN
Phone: [phone] Fix: 919-981-0910
Sampled by (signature):
Chain of Custody
Bill To:
READY MIXED CONCRETE CO. Project Reference:
P.O. BOX 27326 Project Number:
'--RALEIGH, NC 27611
Purchase Order #:
Tritest W.O. # 0309-00072
Stormwater
PLANT 9
❑ Standard ReportDelivery
❑ Rush Report Delivery (w/surcharge)
"Ruse mfoti ere a *d 10 prior app 1 W me reE Cory
Requested Due Date:
Sample Description
Composite
Start Date
End Date
Matrix
Analyses Requested
Tritest
Grab
NWJ•DW
Sample
nd Time
—
SW,GWS
OUTFALL1
Grab,
S 40
S.' 9
SW
WC-TSS
001
0.
OUTFALL 2
Gr
'Y '
S . O
W
WC-TSS
002.
`
c
Relinqui he y)signature)
Recei ed by (signature)
Date
Time
Relin 15he by (signature)
R calved y (signature)
Date
ime
r
Relinquished by (signature)
Received by (sign t re)
Date
Time
Receipt Conditions (Lab Use Only):
❑ 3rj C OTemp 'C
Res. Chlorine ClAbsent ❑Present ❑n/a
UAcid presew. <2? OYes o ❑n/a
Base presem >12? ❑Yes ❑No ❑nfa—

Tritest, Inc.
3909 Beryl Road, Raleigh, NC 27607
pit:(919) 8344984 fax: [phone]
NCt CERT#67, NCDWCERTU37731
Report Results To-ol
Company: READY MIXED CONCRETE CO.
Address: P.O. BOX 27326
RALEIGH, NC 27611
Attn: LYMAN AUSTIN
Phone: [phone] Fax: 9l
Sampled by (signature): rV
OUTFALL 1 I Grab
a
Chain of Custody
Bill To:
READY MIXED CONCRETE CO.
P.O. BOX 27326
_RALEIGH, NC 27611
— ww,Dw
SW,GWs
� S SW WC-TSS
IOUTFALL 2 I Grab : y S:> o W WC-TSS
Tritest W.O. # 0309-00072
Project Reference: Stormwater
Project Number: PLANT 9
Purchase Order #:
❑ Standard Report Delivery
❑ Rush Report Delivery (w/surcharge)
"RW Mjt .,. s.tj.d to"r -p -lp NeI Wr.W,
Requested Due Date:
Sample
001
002
Receipt Conditions (Lab Use Only):
❑ 4±2'C Temp:. •C
Res. Chlorine OAbsent OF'resent ❑n/a
UAcid preserv. <2? ❑Yes ❑No ❑n/a
Base preserv. >12? ❑Yes ❑No ❑n/a

pop 1
READY WED CONCRETE COMPANY PLANT NO. `I
PLANT NO.- DATE:Oc 2oDD
STORMWATER DISCHARGE OUTFALL VISUAL REPORT
C^e�rti�.f�ic�ate of Coverage No. NCG 1400. Plant Nameti.
ww�q•^Lwe K J.'n
Nepeclad by:. Zn 4 , It I t ,e.
Date of Inapadion: O ;),cc I
By thlo signahw% I certify at" report Is socurate and complete to the beat of my knowledge:
STORUWATER DISCHARGE OUTFALL I WO) VISUAL IIDONRORINQ REPORT
1 OL"I Description ( attach SDO Visual Monitoring Report for sect, add'I SDO)
Outlell No. SDO Structure (pipe, ditch. etc.) (fJl�r
Reoelving St om:
Describe the Industrlel activities that occur within the outfatl drainage area:
L � , uI T-(-Cj t: At -cc"
2 Color
Describe the rotor of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark, etc.) / J
_2- trR G i n Lla Tr i
3 Oclor
Desortbe any distinct odors that the discharge may have (Le. smells strongly of oil, weak chlorine odor, etc.)
4 clwity
Choose the number which best describes the clarky of the discharge where 1 Is clear and 10 is verycloudy:
1D 2 3
6 7 9
4 5
9 10
met
S"PRMCC

nrW'M ;j=ur alga r T= /rV0/ .
% 06 Sheen
Is there any oil sheen In the ahxmwater discharge? YES 4
8 Oufta Staining
Describe any 11taininvround the stormvvater outail:
i
B Oliver Indloolon;
Describe any 1*w obvious indicators of stormwatsr pollution:
NOTE LOW clarity, high solids andJor the presence of foam, OR sheen, or eutfali staining may be
indim" of pollutant espowm. These conditions may warrant further Inveatlpstion.
SWPPRMCC

. _ ....:::' � k.:'QB:::.
1

W
Pop
READY MD(ED CONCRETE COMPANY PLANT NO. Ci_
PLANT NO. DATE:
.Lo,�
STORMWATER DISCH GE OUTFALL VISUAL REPORT
Ce"Mcate VCoverage No. NCG 1400,�_
County: rgn k 4'.n
Inspected by:, -S1 h n WA1 n
Date of ospe<dbn: r; crtt9'
Plant Name: & L I {ci rr r S
By this signature, I certitf that this report Is accurate and complete to the beat of my knowledge:
OYA a..�I���
STOROANAT13t DISCHARGE OUTFALL (SDO) VISUAL MONITORING REPORT
i OLffWl Description ( attach SDO Visual Monitoring Report for each, add'I SDO)
Outten No. SE*
Receiving Stnmm: —�— Structure (POO, ditch, eft.) _- . z
Describe the Industrial activities that ocqur wtihin the outfall drainage area:
r
2 Cetor
Describe the color of the discharge using basic cobra (red, brown, blue, etc.) and tint (light, medium,
dek ett:.)
3 Ocbr
Describe any distinct odors that the discharge may have (Le. smege strongly of oil, weak chlorine odor, etc.)
NO IV4?-
4 Clarity
Choose the number which best describes the clarfty of the discharge where 1 Is clear and 10 is very cloudy.
2 3 4 5
6 7 B g 10
te.t
SWPPRMCC

�.. 5 Scltds
.' Choose the number which best wee the amount of solids .in theft
1 is dear end 10 Is e*"OIy muddy: mtwtibt disc harps where
V 2 3 4 5
e ? 8 9 10
0 Foam
Is there any tam In the stormwater ftduupe? YES Ip
7 OB sheen g
is there any oil sheen In the stmnwater dWdwpe? yEs 1O
8 Outfali Statrnng
Describe any Ia �D�und the stamwater outfall:
9 Other Indicators
Descrbs any'*Or obvloas indicators of stormwater polluann: i.
Ala &
NOTE Lev Clerily, high solids and/Or fire presence of foam, ON Sheen, or outfail staining maybe
brdfcatlue of pollutant e*Csurs. These conditions may warrant further krvsstfaatlon.
eWPPRMCC

V
-ATA
KCDENR
®if cl
GENERAL
OUTFALL MONITORING REPORT
GENERAL PERMIT NCG140000
(All sample data shall be reported no later than 30 days after receipt of lab results)
NCG 14 CernSedlaboratory#
Sample Information
ILA
Part A: Stor,mwater Discharge Monitoring Data (For stormwater not combined with process wastewater)
SUOMIEVent ChRMOnriefire
&—Tmwatff Dischame mnnitniin.
Does this facility perform Vehicle Maintenance Activities using on average more than 55 gallons of new motor
oil per month? 0 Yes NO If Yes, complete information below.
Stormwater Dischame Monitorim from vehicle mn,nt ... �n. A—
Oatf
--mate
Mu�
tot,
SWU-241-090199 - Page lof 2

Part B. Process wastewater discharge monitoring data
Sample #
Effluent Sources for this s le
Vehicle / Equipment Cleanin ❑
Raw Material Stock -pile Wetting ❑
Mixing Drum Clean -out ❑
Recycle System Overflow ❑
'�araiaeter _
flntt
at2
Collection Date
mo/dd/yr
Total Flow.
MG
Event Duration
hours
PH .
Std. units
TSS
mgli
Settleable Solids
ml/I
Sample #
❑
Vehicle /.Equipment Cleanin
Raw Material Stock -pile Wetting
❑
Mixing Drum Clean -out
❑
Recycle System Overflow
❑
3
�` aT' etesS
T mt�"5�n
k
M
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration-
hours
pH
Std. units .
TSS
mg/1
'Settleable Solids.
mM
Mail original and one copy to:
Attn: Central Files
Division of Water Quality
DENR
1617 Mail Service Center
Raleigh, NC 27699-1617
Sample #
Effluent Source(s) for this sample 4
Vehicle / Equipment Cleaning ❑
Raw Material Stock -pile Wettin ❑
Mixing Drum Clean -out ❑
Recycle System Overflow ❑
,-Parameter ; . ,
, Licit
Data "
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration
hours
PH
Std. units
TSS
in
Settleable Solids
ml/l
Sample # _
Vehicle / Equipment Cleaning
❑
Raw Material Stock -pile Wetting
❑
Mixing Drum Clean -out
❑
Recycle System Overflow
❑
..Collection Date:
mo/dd/yr
Total Flow
MG
`•Event.Duration .
hours
pH ::
Std. units
TSS
Mel
Settleable Solids
ml/1
"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." , i1
or
of Permittee or Designee) (Date)
SWU-241-080199 Page 2 of 2

STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
Certificate of Coverage No. NC
Facility Name :
County:—) Phone No.: �)
Inspector. V/l S
Date of Inspection:-. 4,1
. By this signature, I certify that this report is accurate and complete to the best of my
knowledge:
A,,),2 -f4rr7—i,-,�
(Signature of Perinitree or Designee)
1. Outfall Description
2 1
Outfall No.: Structure (pipe, ditch, etc.): P
Receiving Stream- �A
Describe the industrial activities that occur within the outfall drainage area:
2. Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
3. Odor
Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak
chlorine odor, etc.):
11/17/97

4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and
10 is very cloudy:
1 2 C�3 4 5 6 7 8 9 10
S. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater
discharge where 1 is no solids and 10 is the surface covered in floating solids:
01 2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the
stormwater discharge where 1 is no solids and 10 is extemely muddy:
1 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? YES �-O
& Oil Sheen
Is there an oil sheen in the stormwater discharge? YES *0�
9. Other Obvious Indicators of Stormwater Pollution:
List and describe:
h�
NOTE: Low clarity, high solids and/or the presence of foam or oil sheens may be
indicative of pollutant exposure. These conditions may warrant further'
investigation.
11/17/97

STORMWATER DISCHARGE OUTFALL (SDO)
QUALITATIVE MONITORING REPORT
Certificate of Coverage No. NCG4{e� 0
Facility Name: o
County: Phone No.: U V9
Inspector j l 1 Eyf9 Al ':,
Date of Inspection: G%— a ' D /
By this signature, I certify that this report is accurate and complete to the best of my
knowledge:
(Signature of Pernrittee or Designee)
1. Outfall Description
Outfall No.: Structure (pipe, ditch, etc.):
Receiving Stream: %ay_
Describe the industrial activities that occur within the outfall drainage area:
Color
Describe the color. of the discharge usof basic colors (red, brown, blue, etc.) and tint
Vight, medium, dark) as descriptors:
Ai `_ :. _.
3, Odor
Describe any distinct odors that the discharge may have (i.e. smells strongly of oil, weak
chlorine odor, etc.):
11/17/97

4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and
10 is very cloudy:
1 jD 3
S. Floating Solids
10
Choose the number which best describes the amount of floating solids in the stormwater
discharge where 1 is no solids and 10 is the surface covered in floating solids:
11 2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the
stormwater discharge where 1 is no solids and 10 is extemely muddy:
L� 2 3 4 5 6 7 8
7. Foam
Is there any foam in the stormwater discharge? YES ; NO
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? YES ;N
9. Other Obvious Indicators of Stormwater Pollution:
List and describe:
10
NOTE: Low clarity, high solids and/or the presence of foam or oil sheens may be
indicative of pollutant exposure. These conditions may warrant further
investigation.
11/17/97

TRITEST, INC.
3909 Beryl Road
Raleigh, NC 27607
Telephone: [phone]
Fax: [phone]
NC/WW Cart.M 067
NC/DW Cert. #: 37731
Laboratory Report
--- Prepared for --- 1 of 1
LYMAN AUSTIN Report Date: 10/12101
READY MIXED CONCRETE CO. Date Received: 10/1211
P.O. BOX 27326
RALEIGH, NC 27611 Work Order #: 0109-01016
Project ID:
PLANT 9
Cust.
Code: RE1520
Project ID:
PLANT #9 / LOUISBURG
Cust.
P.O.#:
No. Sample ID
001 OUTFALLI
Date Sampled Time Sampled Matrix
9124101 14:30 SW
Condition
4ii2oC
Test Performed Method Results Analyzed Qualifier
Total Suspended Solids EPA 160.2 903 mg/L 10/1/01
No. Sample ID
002 OUTFALL2
Date Sampled Time Sampled Matrix
9/24/011 14:40 SW
Condition
4n2oC
Test Performed Method Results Analyzed Qualifier
Total Suspended Solids EPA 160.2 109 mg/L ' 9/28/01
Report Certified by:
for Tritest, Inc.

Ina
xyl Road, Raleigh, NC 27607
a9) 934-4994 fax: [phone]
.-WW CERT#67. NCDW CERT07731
Report Results To
Company: READY MIXED CONCRETE CO.
Address: P.O. BOX 27326
RALEIGH, NC 27611
tt LYMAN AUSTIN
A n.
Phone: [phone]
Sampled by (signature):
Fax: [phone]
Chain of Custody
Bill To:
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, NC 27611
Dio y- 0 / 0 / (0 l-d�,��
Tritest W.0.31"0707=00653'\, ti�
Project Reference: Stormwater
Project Number: PLANT 9
Purchase Order #:
❑ Standard Report Delivery
❑ Rush Report Delivery (w/surcharge)
� pl*Mi 11bj03b Pby� by bb.4W
Requested Due Dale:
//0l/!S e7dP-,a
Sample Description
composite
Grab
—
Start Date
End Date
Matrix
WWDW
sW,GWs
Analy es Requested
Tritest
Sample
Start Time
End Time
OUTFALL 1
Grab
SW
WC-TSS
001
�.
-7 , c
OUTFALL2
Grab
=f-art_
9-'i_of
SW
WC-TSS
002
0
I
Relinquished' y (signature)
Receiv by (signature) r I
Date
Time
Rd!ilgqulshed by (signature)
Recelved b (signature)
Date
Time
elinquished by (signature)
Receive (signatunai
0ate
Time
Receipt Conditions (Lab Use Only): \
Q, _!]_ 4t2'C ❑Temp: 3 • D 'C a j
Res. Chlodne ❑Absent [Present AVa
Acid preserv. <29 13Yes ON rn/a
`
Base preserv. >12? ❑Yes ONo ya

I ritest, Ina .
3909 Beryl Road, Raleigh, NC 27607 Chain ®f Custody Tritest W.O. # 0107-00653
ph: (919) 8344984 tax: [phone]
NCW W CERTN7. NCDW CEMn7731
Report Results To:
Company: READY MIXED CONCRETE CO.
Address: P.O. BOX 27326
RALEIGH, NC 27611
Attn: LYMANAUSTIN.
Phone: [phone] Fax: [phone]
Sampled by (signature):
Bill To:
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, NC 27611
Project Reference: Stormwater
Project Number: PLANT 9
Purchase Order #:
❑ Standard Report Delivery
❑ Rush Report Delivery (w/surcharge)
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Requested Due Date:
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Sample Description
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Start Date
End Date
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Analyses Requested
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Receipt Conditions (Lab Use Only):
'q, _ O 4t2•C OTemp: 3, • D •C
Res. Chlorine OAbsent OPresent ANa
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