NCG160163_MONITORING INFO_20140428

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE ❑ HISTORICAL FILE
J MONITORING REPORTS
DOC DATE ❑ o9)0) Ll"o a O
YYYYM M D D

STORMWATER DISCHARGE OUTFALL (SDO)
GENERAL PERMIT NO. NCG160000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE NO. NC431619I09M
FACILITY NAME F �s210-e
PERSON COLLECTING SA ES
CERTIFIED LARnRA MDo l fir=
Lab
Monitoring Requirements
NECEI VE®
APR 2 8 1014
CENTRAL FILES
DWQ/BOG
SAMPLES COLLECTED DURING CALENDAR YEAR: s? D 1 L4
(This monitoring report is due at the Division no later than 30 days from the date
the facility receives the sampling results from the laboratory.)
COUNTY tv,LcIz,�,
PHONE NU.t
-----= - S O'1- 2 5 P la
--- , -----^......8 k �" Pnh you must implement the Tier 1 or Tier 2 responses in the General Permit.
Mail original and one copy to:
Division of Water Quality
1617 Mail Service Center
W
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,w irectiy reppoFlegatheri the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete.
Iamaw red ha there are gpenaki�sifor submitting false information, including the possibility of lines and imprisonment for knowing violations."
Y-Zy -Iq
(Date)
SWU-252-051409

r
n
Laboratory Report
P'R ISM
I
EfnWvbronnniocno tal Solutions
04/23/2014
IAOOMIOPiC41xG
Ferebee Corporation
Project: Stormwater
Client Sample ID: S.W.
Atilm Darryl Fincher
Prism Sample ID: 4040183-01
3030 Jeff Adams Dr.
Prism Work Order: 4040183
Charlotte, NC 28206
Sample Matrix: Water
Time Collected: 04/08/14 07:45
Time Submitted: 04/08/14 16:00
Parameter
Result
Units
Report
MDL Dilution Method Analysis Analyst
Batch
Limit
Factor Daterrime
ID
General Chemistry Parameters
Oil 8 Grease (HEM)
BRL
mg/L
5.0
0.37 1 '1664A 4/15114 15:58 JAB
P4D0326
pH
7.7 HT
pH Units
1 'SM4500-H B 4/9114 16:30 MES
P4D0257
Total Suspended Solids
20
mg/L
5.0
0.90 1 'SM 2540 D ' 4/11114 14:45 JAB
P4D0252
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-8001529-6364 - Fax: [phone] F Qbhf W p95

GNAHN OF GlUbTULPT KLUUM)
as+ Full -Service Analytical & N\
P R'p® I , y' I EO
vironmental Solutions PAGE t OF QUOTE # TO ENSURE PROPER BILLING:
®lAWRATOAL&1NC
Project Name:
449 Sprone 70brook Road •Charlotte, NC 0409 Short Hold Analysis: es No UST Pro ect: Yes NO
Phone 704J529-6 4 •Fax: [phone] Y (Yes) ( ) 1 (Yes) ( )
`` / 'Please ATTACH any project specific reporting (QC LEVEL 111 III IV)
Client Company Name: f sV,��1`_ Q (..� f'� provisions and/or QC Requirements
Report To/Contact Name:
Invoice To:
Reporting Address: Address:
Phone: Fax (Yes) (No):
Email Address:
EDD Type:-PDF -Excel — Other_
Site Location Name:
Site Location Physical Address:
Purchase Order NoJBilling Reference TO BE FILLED IN BY CLIENT/SAMPLING PERSONNEL -
- Requested Due Date 01 Day ❑ 2 Days ❑ 3 Days 04 Days Cl e Days Certification: NELAC DOD FL_ INC
"Working Days" ❑ 6-9 Days 0 Standard 10 days 0 Rush Work
Must Be
SC OTHER N/A
Samples received after 14:00 will be processed next business day.
Turnaround time is based on business days, excluding weekends and holidays. Water Chlorinated: YES NO
(SEE REVERSE FOR TERMS d CONDITIONS REGARDING SERVICES
RENDERED BY PRISM LABORATORIES, INC. TO CLIENT) Sample Iced Upon Collection: YES NO
TIME
MATRIX
SAMPLE CONTAINER
I_. ANALYSIS REQUESTED
CLIENT
DATE
COLLECTED
(SOIL,
PRESERVA-
(� /
PRISM
-TYPE
DESCRIPTION
COLLECTED
MILITARY
WATER OR
TIVES
REMARKS
LABSAMPLE
HOURS
SLUDGE)
SEE BELOW
NO.
SIZE
ID NO.
1
c c
vet,
VVI
Sampler's Signature/ I Sampled By (Print Naml i G K I 1 A' .I-t Affiliation
Upon relinquishing, this Chain of Custody is your authorization for Prism to proceed with the analyses as requested above. Any changes must be
submitted in writing to the Prism Project Manager. There will be chargestor any changes after analyses have been initialized.
f
SAMPLES ARE NOT ACCEPTED AND VERIFIED
D Fed Ea ❑ UPS ❑ Hand -delivered ❑ Prism Field Service ❑ I
❑NC❑SCI 0NC ❑SCI O NC ❑SC I ONG ❑SC
0 0
❑
UNTIL RECEIVED AT THE LABORATORY.
Liao a183
fER: O WASTE: BLANDFILL NC ❑ SC ❑ NC O SC O NC ❑ SC O NC O SC U NC 0 SC 01
Additional Comments:

& ISM Fullir orvlca Analytical s
Sample Receipt Summary
�wone.ons Envlronmontnl Solutions 04/23/2014
a„C
Prism Work Order: 4040183
Client Sample ID Lab Sample ID Matrix Date Sampled Date Received
S.W. 4040183-01, Water 04/08/14 04/08/14
Samples were received in good condition at 2.8 degrees C unless otherwise noted.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-8001529-6364 - Fax: [phone]
(Qbhf !3lpd5

NO Certification No. 402 Case Narrative
SC Certification No. 99012
Full -Service Analytical & NC Drinking Water Cert No. 37735
Environmental Solutions VA Certification No.460211 04/23/2014
y LggpPATOPIEs' INC DoD ELAP: L-A-B Accredited Certificate No. L2307
IS04EC 17025: L-A-B Accredited Certificate No. L2307,
Ferebee Corporation Project: Stormwater
Darryl Fincher
3030 Jeff Adams Dr. Lab Submittal Date: 04/08/2014
Charlotte, NC 28206 Prism Work Order: 4040183
This data package contains the analytical results for the project identified above and includes a Case Narrative, Sample
Results and Chain of Custody. Unless otherwise noted, all samples were received in acceptable condition and processed
according to the referenced methods.
Data qualifiers are flagged individually on each sample. A key reference for the data qualifiers appears at the end of this case
narrative.
Please call if you have any questions relating to this analytical report.
Respectfully,
PRISM LABORATORIES, INC.
Terri W. Cole
Project Manager
Data Qualifiers Key Reference
HT Sample received and analyzed outside of the hold time.
BRL Below Reporting Limit
MDL Method Detection Limit
RPD Relative Percent Difference
Reviewed By Terri W. Cole
Project Manager
Results reported to the reporting limit. All other results are reported to the MDL with values between MDL and
reporting limit indicated with a J.
This report should not be reproduced, except in its entirety, without the written consent of Prism Laboratories, Inc.
449 Springbrook Road - P.O. Box 240543 - Charlotte, NC 28224-0543
Phone: [phone] - Toll Free Number: 1-8001529-6364 - Fax: [phone] Page 1 of4

STORMWATER DISCHARGE OUTFALL (SDO)
GENERALPERMIT NO. NCGI60000
DISCHARGE MONITORING REPORT (DMR)
CERTIFICATE OF COVERAGE NO. NCG16®©9©
FACILITY NAME �{S
PERSON COLLECTING SA ES
CERTIFIED LABORATORY r� ,..� v�j Lab# OZ
Lab #
Monitoring Requirements
No; I Sample Cbllec4ed, I Total Rainfall,
mo/dd/ enchmark inches
SAMPLES COLLECTED DURING CALENDAR YEAR: '? O (-1
(This monitoring report is due at the Division no later than 30 days -from date
the facility receives the sampling results from the laboratory.)
COUNTY e�e�11��yPHONE NS�1
Soq- ZSPto
If a value is in excess of the benchmark, or outside the benchmark range (for pH), you must implement the Tier I or Tier 2 responses in the General Mail original and one copy to:
Division of Water Quality
1617 Mail Service Center
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: - -
scertify, under penalty of law, that this document and allua 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 m inquiry of the arson a arsons who manage the
those pe ecti res o y q �.y p I am aw e� ha there erep . le f gatheri the information, the information submitted is, to the best of my knowledge and belief, true, accurate, ansystem, or
d complete.
g penalti for submitting false information, including the possibility of fines and imprisonment for knowing violations.,,
of
'q'Zy-I�
(Date)
S W U-252-051409