NCG030466_MONITORING INFO_20190702

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
�V �� 03'0 LJU�/
DOC TYPE.
❑ HISTORICAL FILE
9--MONITORING REPORTS
DOC DATE
❑ �� / -D % 03
YYYYMMDD

Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000
Date submitted n6/ 29 f 20 19
CERTIFICATE OF COVERAGE NO. NCG03 O 6 6
FACILITY NAME N1
COUNTY {w
PERSON COLLECTING SAMPLES {CH A 6 ES H LH ATA V T
LABORATORY%ALF ANAI_YfIGAL Lab Cert.ft 12 4- L10
Comments on sample collection or analysis:
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLE COLLECTION YEAR 1-' 0 19
SAMPLE PERIOD ❑tan -June ❑ July -Dec
or ❑ Monthly' (month)
���it,D14CH�ARGING TO CLASS ❑ORW ❑HQW []Trout❑PNA
R ❑Zero -flow [:]Watersupply [_]SA
JUL 0 2 Zp19 ❑other
CENTRAL FILES PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 4
0%NP, SECTION
n No discharge this period?'
Outfall No.
Date Sample
24-hour rainfall
Total' Suspended Solids
pH
Total Copper
TotalLead
Total Zinc
Non -Polar O&G/
Total Petroleum
Total Toxic
Organicss
Collected'
amount,
Standard units
Hydrocarbons
(mo/dd/yr)
Inches'
Benchmarks
-
-
100 mg/L or 50 mg/L4
6.0 —9.0
0.010 mg/L
0.075 mg/L
0.126 mg/L
15 mg/L
1 mg/L
Parameter Code
-
46529
C0530
00400
01119
01051
01094
00552
78141
001
6/01 1
('41
94 �21L
-1•$
0.0115 ";IL
c 0 - 0 0 6 }IL
0.11 --)IL
c5.0�sII.
^rA
00 .2
6 17 19
• qI
c .?.6 ^;IL
-l-$
C0.00S IL
L0•005.1JL
o-o S9? It
L 5-o v7(L
NA
0o3
11 19
I.q-)
1-2.g —Pt
61
co-00S' ILl-0•005V1
0-061 AIL
c5•o011L
^,A
off
117 /Iq
1.91"
3' "^ -
.-1
0-oor !21L
2O.OD.; J(
o•o -jI
c 5 - o «^ (L
Na
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
'The 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, Section B, Table 1 to identify the especially sensitive receiving water classifications where the more protective benchmark applies.
s Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes: For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
:Page 1 of 3' _ — _

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
ZC""A D",p ,1(�. y;�K
Name (Print name)
TyU<Print title)
g�a .e� Date
r-
Note: Results must be reported in numerical format. 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 "<XX mg/L" where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
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.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
nAin rlicrhnrno fhfc norin,4J2
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches3
New Motor Oil or
Hydraulic Oil Usage
Non -Polar O&G/ Total
Petroleum Hydrocarbons
Total Suspended
Solids
Benchmarks
-
-
-
15 mg/L
100 mg/L or 50 mg/L4
Parameter Code
-
46529
• NCOIL
00552
C0530
Footnotes from Part A also apply to 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.
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 2 of 3

FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B/.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FORT AME PARAMETER AT ANY ONE OUTFALL? YES El NO rl.J'
IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YESONOEY
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the
case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, 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 perso directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I
am a e that t er"re significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
1`i
Date
Permit Date: 11/1/2018-05/31/2021 SWU7245, last revised 11/1/2018
Page 3bf3

(�,,5ace Analytical
w»w.pacele5s.cnm
I I
June 26, 2019
Mark Buda
Eaton
221 Heywood Rd
Arden, NC 28704
RE: Project: Stormwater 6/17
Pace Project No.: 92433465
Pace Analytical Services, LLC
2225 Riverside Dr.
Asheville, NC 28804
[phone]
Dear Mark Buda:
Enclosed are the analytical results for sample(s) received by the laboratory on June 17, 2019. The
results relate only to the samples included in this report. Results reported herein conform to the most
current, applicable TNI/NELAC standards and the laboratory's Quality Assurance Manual, where
applicable, unless otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Chris Derouen
[e-mail]
[phone]
Project Manager
Enclosures
cc: Mark Buda, Eaton Corporation
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 1 of 13

aceAnalytical
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Project: Stormwater 6/17
Pace Project No.: 92433465
Pace Analytical Services, LLC
2225 Riverside Di -
Asheville, NC 28804
[phone]
Charlotte Certification IDs
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
Louisiana/NELAP Certification At LA170028
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification At: 5342
North Carolina Wastewater Certification At: 12
Asheville Certification IDs
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification At: 37712
CERTIFICATIONS
South Carolina Certification #: 99006001
Florida/NELAP Certification #: E87627
Kentucky UST Certification #: 84
VrginiaNELAP Certification #: 460221
North Carolina Wastewater Certification #: 40
South Carolina Certification #: 99030001
VrginiaNELAP Certification #: 460222
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, -LC. Page 2 of 13

Pace Analytical Services, LLC
2225 Riverside Dr.
aceAnalytical Asheville, NC 28804
w ipacetabscom [phone]
SAMPLE ANALYTE COUNT
Project:
Stormwater6/17
Pace Project No.:
92433465
Analytes
Lab ID
Sample ID
Method
Analysts
Reported
Laboratory
92433465001
OUTFALL 001
EPA 1664B
JMS
1
PASI-C
EPA 200.7 Rev 4.4 1994
SH1
3
PASI-A
SM 254OD-2011
JP1
1
PASI-A
92433465002
OUTFALL 002
EPA1664B
JMS
1
PASI-C
EPA 200.7 Rev 4.41994
SH1
3
PASI-A
SM 254OD-2011
JP1
1
PASI-A
92433465003
OUTFACE 003
EPA 1664B
JMS
1
PASI-C
EPA 200.7 Rev 4.41994
SH1
3
PASI-A
I
SM 2540D-2011
JP1
1
PASI-A
92433465004
OUTFALL 004
EPA 1664E
JMS
1
PASI-C
EPA 200.7 Rev 4.41994
SH1
3
PASI-A
SM 254OD-2011
JP1
1
PASI-A
REPORT OF LABORATORY ANALYSIS
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laceAnalj4icalo
~Pacelabsmm
ANALYTICAL RESULTS
Project: Stormwaler 6/17
Pace Project No.: 92433465
Pace Analytical services, LLC
2225 Riverside Dr
Asheville, NC 28804
[phone]
Sample: OUTFALL 001 Lab ID: 92433465001 Collected: 06/17/19 1345 Received: 06/17/19 16:31 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Oual
Field Data
Collected By
Collected Dale
Collected Time
pH
HEM, Oil and Grease
Oil and Grease
200.7 MET ICP
Copper
Lead
Zinc
2540D Total Suspended Solids
Total Suspended Solids
Analytical Method
Khalesh
1
06/17/19 13:45
Chataut
6117/19
1
06/17/19 13:45
13:45
1
06/17/19 13:45
7.3 Std. Units
0.10
1
06/17/19 13:45
Analytical Method: EPA 1664B
ND mg/L
5.0
1
06/25/1905:42
Analytical Method: EPA 200.7 Rev 4.4
1994 Preparation
Method: EPA 200.7 Rev 4.4 1994
11.5 ug/L
5.0
1
06/22/19 09:15 06/25/19 06:07 7440-50-8
ND ug/L
5.0
1
06/22/19 09:15 06/25/19 06:07 7439-92-1
110 ug/L
10.0
1
06/22/19 09:15 06/25/19 06:07 7440-66-6
Analytical Method: SM 2540D-2011
9.6 mg/L
2.6
1
06/21/1923:02
Sample: OUTFALL 002 Lab ID: 92433465002 Collected: 06/17/19 13:45 Received: 06/17/19 16:31 Matrix: Water
Parameters Results Units Report Limit OF Prepared Analyzed CAS No. Oual
Field Data
Collected By
Collected Date
Collected Time
pH
HEM, Oil and Grease
Oil and Grease
200.7 MET ICP
Copper
Lead
Zinc
2640D Total Suspended Solids
Total Suspended Solids
Date: 06/26/2019 08:04 AM
Analytical Method
Khalesh
1
06/17/19 13:45
Chataut
6117/19
1
06/17/19 13:45
13:45
1
06/17/19 13:45
7.3 Std. Units
0.10
1
06/17/19 13:45
Analytical Method: EPA 1664B
NO mg/L
5.0
1
06/25/19 05:42
Analytical Method: EPA 200.7 Rev 4.4
1994 Preparation
Method: EPA 200.7 Rev 4.4 1994
ND ug/L
5.0
1
06/22/19 09:15 06/2511906A0 7440-50-8
ND ug/L
5.0
1
06/22/19 09:15 06/25/1906:10 7439-92-1
59.2 ug/L
10.0
1
06/22/19 09:15 06/25/19 06:10 7440-66-6
Analytical Method: SM 254OD-2011
NO mg/L
2.6
1
06/21/19 23:02
REPORT OF LABORATORY ANALYSIS
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aceAnalytical®
ww,vpereleba.com
ANALYTICAL RESULTS
Pace Analytical services, LLC
2225 Riverside Dr
Asheville, NC 28804
[phone]
Project: Stormwater 6/17
Pace Project No.: 92433465
Sample: OUTFALL 003
Lab ID: 92433465003 Collected:
06/17/19 13:45
Received: 06/17119 16:31 Matrix: Water
Parameters
Results Units Report Limit
OF
Prepared Analyzed CAS No. Qual
Field Data
Analytical Method:
Collected By
Khalesh
1
06/17/19 13:45
Chalaut
Collected Date
6117119
1
06/17/19 13:45
Collected Time
13:45
1
06/17/19 13:45
pH
6.7 Sid. Units
0.10
1
06/17/19 13:45
HEM, Oil and Grease
Analytical Method: EPA 166413
11
Oil and Grease
ND mg/L
5.0
1
06/25/19 05:44
i
200.7 MET ICP
Analytical Method: EPA200.7 Rev 4.4
1994 Preparation
Method: EPA 200.7 Rev 4.4 1994
Copper
ND ug/L
5.0
1
06/22/19 09:15 06/25/19 06:26 7440-50-8
Lead
ND ug/L
5.0
1
06/22/19 09:15 06/25/19 06:26 7439-92-1
Zinc
61.6 ug/L
10.0
1
06/22/19 09:15 06/25/19 06:26 7440-66-6
2540D Total Suspended Solids
Analytical Method: SM 254OD-2011
i
Total Suspended Solids
ND mg/L
2.8
1
06/21/19 23:02
Sample: OUTFALL 004 Lab ID: 92433465004 Collected: 06/17119 13:45 Received: 06/17/19 16:31 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Oual
Field Data
Analytical Method:
Collected By
Khalesh
1
06/17/19 13:45
Chataut
Collected Date
6117/19
1
06/17/19 13:45
Collected Time
13:45
1
06/17/19 13:45
pH
6.7 Std. Units
0.10
1
06/17/19 13:45
HEM, Oil and Grease
Analytical Method: EPA 1664E
Oil and Grease
ND mg/L
5.0
1
06/25/19 05:44
200.7 MET ICP
Analytical Method: EPA 200.7 Rev 4.4
1994 Preparation
Method: EPA 200.7 Rev 4.4 1994
Copper
5.5 ug/L
5.0
1
06/22/19 09:15 06/25/19 06:29 7440-50-8
Lead
ND ug/L
5.0
1
06/22/1909:15 06/25/1906:29 7439-92-1
Zinc
62.4 ug/L
10.0
1
06/22/19 09:15 06/25/19 06:29 7440-66-6
2540D Total Suspended Solids
Analytical Method: SM 254OD-2011
Total Suspended Solids
3.7 mg/L
2.7
1
06/21/19 23:03
l
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Dale: 06/26/2019 08:04 AM without the written consent of Pace Analytical Services, LLC. Page 5 of 13

laceAnalytical"
vmwpsca;abs.cnm
QUALITY CONTROL DATA
Pace Analytical Services, LLC
2225 Riverside Dr.
Asheville, NC 28804
[phone]
Project: Stormwater 6/17
Pace Project No.: 92433465
QC Batch: 483038
Analysis Method:
EPA 1664B
OC Batch Method: EPA 1664B
Analysis Description:
1664 HEM, Oil and
Grease
Associated Lab Samples: 92433465001,92433465002,92433465003,92433465004
METHOD BLANK: 2611167
Matrix: Water
Associated Lab Samples: 92433465001, 92433465002,
92433465003, 92433465004
Blank Reporting
Parameter
Units
Result Limit
Analyzed
Qualifiers
Oil and Grease
mg/L
ND 4.8
06/25/19 05:39
LABORATORY CONTROL SAMPLE:
2611168
Spike LCS
LCS
% Bee
Parameter
Units
Cone. Result
%Rec
Limits Qualifiers
Oil and Grease
mg/L
38.5 37.2
97
78-114
MATRIX SPIKE SAMPLE:
2611169
92433022001 Spike
MS
MS %Rec
Parameter
Units
Result Cone.
Result
%Rec Limits Qualifiers
Oil and Grease
mg/L
NO 38.5
38.6
95 78-114
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: 06/26/2019 08:04 AM without the written consent of Pace Analytical Services, LLC.
Page 6 of 13

aceAnalytical
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QUALITY CONTROL DATA
,Project: Stormwater 6/17
Pace Project No.: 92433465
HOC Batch: 482724
Analysis Method: EPA 200.7 Rev 4.4 1994
QC Batch Method: EPA 200.7 Rev 4.4 1994
Analysis Description: 200.7 MET
Associated Lab Samples: 92433465001, 92433465002, 92433465003, 92433465004
i
METHOD BLANK: 2609808
Matrix: Water
Associated Lab Samples: 92433465001, 92433465002, 92433465003, 92433465004
Blank Reporting
c Parameter Units
Result Limit
Analyzed Qualifiers
Kopper ug/L
NO 5.0
06/25/19 05:26
(Lead ug/L
ND 5.0
06/25/19 05:26
Zinc ug/L
NO 10.0
06/25/19 05:26
Pace Analytical services, LLC
2225 Riverside Dr.
Asheville, NC 28804
[phone]
LABORATORY CONTROL SAMPLE:
2609809
Spike
LCS LCS % Rec
Parameter
Units
Cone.
Result % Rec Limits Qualifiers
Copper
ug/L
500
502 100, 85-115
Lead
ug/L
500
488 98 85-115
Zinc
ug/L
500
493 99 85-115
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2609810 2609811
MS MSD
92432945004 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Cone, Cone. Result Result %Rec %Rec Limits RPD Qual
Copper ug/L 26.5 500 500 536 546 102 104 70-130 2
Lead ug/L NO 500 500 475 477 95 95 70-130 0
Zinc ug/L NO 500 500 479 487 95 97 70-130 2
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2609812 2609813
MS MSD
92433465004 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Cone. Cone. Result Result %Rec %Rec Limits RPD Qual
Copper ug/L 5.5 500 500 490 490 97 97 70-130 0
Lead ug/L ND 500 500 481 484 96 97 70-130 1
Zinc ug/L 62.4 500 500 558 562 99 100 70-130 1
Results presented on this page arc 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: 06/26/2019 08:04 AM without the written consent of Pace Analytical Services, LLC.
Page 7 of 13

ace Analytical
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QUALITY CONTROL DATA
Pace Analytical services, LLC
2225 Riverside Dr.
Asheville, NC 28804
[phone]
Project: Stormwater 6/17
Pace Project No.: 92433465
QC Balch: 482708
Analysis Method: SM 2540D-2011
QC Batch Method: SM 2540D-2011
Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples: 92433465001, 92433465002, 92433465003, 92433465004
METHOD BLANK: 2609781
Matrix. Water
Associated Lab Samples: 92433465001, 92433465002, 92433465003, 92433465004
Blank Reporting
Parameter
Units
Result Limit Analyzed Qualifiers
Total Suspended Solids
mg/L
ND 2.5 06/22/19 04:41
LABORATORY CONTROL SAMPLE:
2609782
Spike LCS LCS % Rec
Parameter
Units
Conc. Result e/ Rec Limits Qualifiers
Total Suspended Solids
mg/L
251 242 96 90-110
SAMPLE DUPLICATE: 2609789
92433528001 Dup
Parameter
Units
Result Result RPD Qualifiers
Total Suspended Solids
mg/L
132 168 24 D6
SAMPLE DUPLICATE: 2609790
92433600003 Dup
Parameter
Units
Result Result RPD Qualifiers
Total Suspended Solids
mg/L
5300 5850 10 06
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: 06/26/2019 08,04 AM without the written consent of Pace Analytical Services, LLC.
Page 8 of 13

aceAnalytical
www.pacelabs.cen
QUALIFIERS
'Project: Stormwater 6/17
1 Pace Project No.: 92433465
DEFINITIONS
Pace Analytical services, LLC
2225 Riverside Dr.
Asheville, NC 28804
[phone]
OF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
TNTC -Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL- Adjusted Method Detection Limit.
PQL- Practical Quantitation Limit.
l RL - Reporting Limit - The lowest concentration value that meets project requirements for quantitative data with known precision and
bias for a specific analyte in a specific matrix.
I'. 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, unfounded 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.
d Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI -The NELAC Institute.
LABORATORIES
PASI-A Pace Analytical Services - Asheville
PASI-C Pace Analytical Services - Charlotte
ANALYTE QUALIFIERS
D6 The precision between the sample and sample duplicate exceeded laboratory control limits
i
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 06/26/2019 08:04 AM without the written consent of Pace Analytical Services, LLC.
Page 9 of 13

aceAnalytical
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Project: Stounwater 6/17
Pace Project No.: 92433465
Lab ID
92433465001
92433465002
92433465003
92433465004
92433465001
92433465002
92433465003
92433465004
92433465001
92433465002
92433465003
92433465004
92433465001
92433465002
92433465003
92433465004
Sample ID
OUTFALL 001
OUTFALL 002
OUTFALL 003
OUTFALL 004
OUTFALL 001
OUTFALL 002
OUTFALL 003
OUTFALL 004
OUTFALL 001
OUTFALL 002
OUTFALL003
OUTFALL 004
OUTFALL 001
OUTFALL 002
OUTFALL 003
OUTFALL004
Date: 06/26/2019 08:04 AM
QUALITY CONTROL DATA CROSS REFERENCE TABLE
QC Batch Method
EPA 1664E
EPA 1664B
EPA 16648
EPA 1664B
EPA 200.7 Rev 4.4 1994
EPA 200.7 Rev 4.4 1994
EPA 200.7 Rev 4.4 1994
EPA 200.7 Rev 4.4 1994
SM 2540D-2011
SM 2540D-2011
SM 254OD-2011
SM 254OD-2011
Pace Analytical Services, LLC
2225 Riverside Dr.
Asheville, NC 28804
[phone]
QC Batch Analytical Method
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REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Analytical
Batch
EPA 200.7 Rev 4.4 1994 482754
EPA 200.7 Rev 4.4 1994 482754
EPA 200.7 Rev 4 4 1994 482754
EPA 200.7 Rev 4.4 1994 482754
Page 10 of 13

Document Name: Document Revised: February 7, 2018
Sample Condition Upon ReceiptlSCUR) Page 10( 2
/_ 8CB{117z7�ICd1 Document No.: Issuing Authority:
F-CAR-CS-033-Rev.06 Pace Carolinas Quality Office
Laboratory receiving sa pies:
Asheville,F Eden❑ Greenwood ❑
Huntersville❑ Raleigh❑ Mechanicsville❑
Project N: WO# : 92433465
Client 10w III II III �III9II
� L9Znao+o=
Custody Seal Present? ❑Yes 0No Seals Intact? ❑Yes ONO
Date/Initials Person Examining Contents:�
Packing Materlal: ❑Bubble Wrap []Bubble Bags .fNone ❑ Other Biological Tlssue ozen?
ICI Thermo pp71 �yuql Type of ice PWet ❑Blue ❑Plone
❑Yes ONO Z/A
IR Gun ID:
Cooler Temp ('C): a /'1Correction Factor: Add/Subtract (°C) f/ , D Temp should be above freezing to 6°C
Cooler Temp Corrected (°C): I i ❑Samples outof temp criteria. Samples on ice, cooling process
has begun
USDA Regulated Soil (Vf N/A, water sample)
Did samples originate in a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (Internationally,
from
RirnIDn sour rINO
nat
❑Yes ❑No
�,����„���a ,..,......_.._.
Comments/Discrepancy:
Chain of Custody Present?
Yes
❑No
❑N/A
1.
Samples Arrived within. Hold Time?
ves
ONO
❑N/A
2.
Short Hold Time Analysis (02 hr.)?
Dyes
No
❑N/A
3.
Rush Turn Around Time Requested?
[]Yes
No
❑N/A
4.
Sufficient Volume?
Yes
ONO
❑N/A
5.
Correct Containers Used?
Yes
[:]No
❑N/A
6.
-Pace Containers Used?
Yes
❑No
❑N/A
Containers intact?
Yes
ONO
❑N/A
7.
Dissolved analysis: Samples Field Filtered?
[-]Yes
NO
ONO
❑N/A
❑N/n
B.
9. �, �5�"
S r yn ,
Sample Labels Match COC?
Dyes
SS/ Me44S/ C I }f�(eC5e'
w
-Includes Date/Time/ID/Analysis Matrix:
Headspace in VOA Vials (>5-6mm)?
❑Ycs
No
N/A
10.
Trip Blank Present?
❑Yes
ONO
N/A
11.
Trip Blank Custody Seals Present?
Dyes
No
N/A
t
i
COMMENTS/SAMPLE DISCREPANCY
Lot ID of split containers:
CLIENT NOTIFICATION/RESOLUTION
Person contacted:
1
' Project Manager SCURF Review:
I' Project Manager SRF Review:
Date/Time
Field Data Required? IJYes Y'No
Date: r
Date:
Page 11 of 13

r.' l
Document Name:
Document Revised: February 7, 2018
I
PaceARalytical `
Sample Condition Upon Receipt(SCUR)
Page 1 of 2
Document No.:
Issuing Authority:
F-CAR-CS-033
I Pace Carolinas Quality Office j
*Check mark top half of box if pH and/or dechlorination is
verified and within the acceptance range for preservation
samples.
Exceptions: VOA, Coliform, TOC, Oil and Grease, DRO/8015 (water) DOC, LLHg
**Bottom half of box is to list number of bottle
Project # 'W0# : 92433465
PM: CD1 Due Date: 05/27/19
CLIENT: 93-CutlerH
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PH Adjustment Log for Preserved Samples
sample ID
Type of preservative
pH upon recelpt
Date preservation adjusted
Time preservation
adjusted
Amount of Preservative
added
Lot 11
Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form will be sent to the North Carolina DEH NR Certification Office l i. e.
out of hold, incorrect preservative, out of temp, incorrect containers.
Page 12 of 13

v�
-PaceAnalytical *
CHAIN -OF -CUSTODY / Analytical Request Document
The Chairof-Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately.
0
...0acmaos.mm
N
Page: of
Section A � Section B Section C
!T O (� �` f)
a V V 4
Required Client Information Required Project Information: Invoice Information
Company: r y�On I
Report TO; (L
Attention:
Address:.22\ Ke wood
Copy To:
Company Name:
REGULATORY AGENCY
28-7�04
Address:
(- NPDES I- GROUND WATER j DRINKING WATER
r UST F- RCRA OTHER
Emal To: mark
rytafir_(Drwtldi @1 -CA
Purchase Order No.
P"'^O1OI0
Relmmnw
P ne: O Fax:
1. t GV7_3`i
Protect Name: G i��m W tpCt f Q��� �`�
5tv� `CI
Paco Rqm
AW�w9tt:
SItC Location
STATE.
Requested Due DalefTAT: `/.Iq�
/
Protect Number:
Para Pro11v 0:
Requested Analysis Filtered (YIN)
Section D Mean. Code.
Rdgwmdcmmmmm,°boo jMATRIX I CODE
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COLLECTED
Preservatives
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Sample Os MUST BE UNIQUE Tissue TS
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ADDITIONAL COMMENTS
I
RELINQUISHED BV/AFFILIATION
DATE
TIME
ACCEPTED BY I AFFILATION
DATE
TIME
SAMPLE CONDRIONS
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SAMPLER NAME AND SIGNATURE
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SIGNATURE of SAMPLER:
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