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HomeMy WebLinkAboutNCG120097_MONITORING INFO_202001101771A) STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. NL G is 60 9 7 DOC TYPE ❑ HISTORICAL FILE MONITORING REPORTS DOC DATE O I (� YYYYMMDD DocuSign Envelope ID: OC606A63-625D45E9-85EF-165012E4D866 SMITH+GARDNER tN61Nr[fl3 January 2, 2020 NCDEQ Division of Water Quality Attention: Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 ABBAESS IFl WEB 14 N. Boylan Avenue, Raleigh NC 27603 919.828.W? www.smithgaidnerinc.com RE: Discharge Monitoring Report —Second Semiannual Monitoring Event Brownfield Road C&D landfill RErFIVED Certificate of Coverage #NCG120097 General Permit #NCG120000 JAN 10 2020 CEN'I'KAL FILES Dear Sir/Madam: DWR SECTION Smith Gardner, Inc. (S+G) is pleased to submit this second semiannual Discharge Monitoring Report (DMR) for stormwater monitoring at the Brownfield Road C&D Landfilt. The site is Located in Raleigh, North Carolina. The facility is permitted to discharge stormwater related to landfilling activities under the NPDES program by the General Permit No. 120000 Ipermit), issued by the North Carolina Department of Environmental Quality (NCDEQ), Division of Water Quality. Please note that samples were analyzed from one (1) of three (3) outfalls during this event. Sample were collected at SDO-002. The samples exhibited results below all benchmark thresholds. No discharge occurred at SDO-001 and SDO-003 for this sampling period. As required by the permit, analytical and qualitative monitoring of the discharge will continue on a semi-annual basis. If you have any questions, or require further information, please contact us at 19191 828-0577 or by email. Sincerely, SMITH GARDNER, INC. E DocuSigned 6y: U CSECC95C937E4AC... Jesse C. Li, E. I. Staff Engineer, ext. 170 iesse(dsmithgardnerinc.com Attachment CC: Richard Call (GFL) File EH4lynoae , 9620A9406... John R. Fearrington, P.E. Project Engineer, ext. 125 iohnffasmithgardnerinc.com H AP.1e0,Br.,.iald R udN2 BF BF NPBES20WH2019\BR0 npde, 2nd stmi 2019.daa DocuSign Envelope ID: OC606A63-625D-45E9-85EF-165012E4D866 •mar �c �� ' H,. • 7y:. yea•.: This page intentionally left blank. DocuSign Envelope ID: OC606A63-625D-45E9-85EF-165012E4D866 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG120000 Date submitted CERTIFICATE OF COVERAGE NO. NCG12 0 O 9 7 FACILITY NAME Brownfield Road C&D Landfill COUNTY wake PERSON COLLECTING SAMPLES Jesse Li (Smith Gardner, Inc.) LABORATORY Pace Analytical Lab Cert. tJ 37738 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results 2, 2020 SAMPLE COLLECTION YEAR 2019 SAMPLE PERIOD ❑ Jan -June ❑■ July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply []SA XOtherc,Nsw PLEASE REMEMBER TO SIGN ON THE REVERSE -) ❑ No discharge this period2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Chemical Oxygen Demand mg/L Fecal per Col1 0 Colonies per 100 mL Total Suspended Solids mg/L and Standard Units Benchmarks _ - 120 1000 100 or 504 6.0-9.0 Parameter Code - 46529 00340 31616 C0530 00400 SDO-001 12/18/19 0.1 No discharge during this reporting period SDO-002 12/18/19 0.1 ND 400 61.6 SDO-003 12/18/19 0.1 No discharge during this reporting period. ' 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 text, Table 1, 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 - 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. 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: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018 Page 1 of 2 DocuSign Envelope ID: OC606A63-625D-45E9-85EF-165012E4D866 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. n No discharge this Deriodz Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -Polar Oil & Grease mg/L Total Suspended Solids, mg/L New Motor or Hydraulic Oil Usage, gal/mon Benchmarks _ - 15 100 or 504 Parameter Code - 46529 00552 C0530 NCOIL 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: 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 FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO 0 IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑ 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 for at end of monitorina 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 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." DocoSigncd by: Vbw Signature of Permittee Permit Date: 11/1/2018-5/31/2021 1/6/2020 Date SWU-248, last revised 11/1/2018 Page 2 of 2 DocuSign Envelope ID: OC606A63-625D45E9-85EF-165012E4D866 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG120000 Date submitted January 2, 2020 CERTIFICATE OF COVERAGE NO. NCG12 0 0 9 % FACILITY NAME B—nfeld Road C&D Landfill COUNTY Wake PERSON COLLECTING SAMPLES Jesse Li (Smith Gardner, Inc.) LABORATORY Pace Analytical Lab Cert. # 37738 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2019 SAMPLE PERIOD ❑ Jan -June ■❑ July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW [—]Trout ❑PNA [_]Zero -flow ❑Water supply ❑SA ■❑Otherc,NSW PLEASE REMEMBER TO SIGN ON THE REVERSE 4 ❑ No discharge this period' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Chemical Oxygen Demand mg/L Fecal Colonies per per 100 mL Total Suspended Solids mg/L Standard Units Benchmarks _ - 120 1000 100 or 504 6.0-9.0 Parameter Code - 46529 00340 31616 COS30 00400 SDO-001 12/18/19 0.1 No discharge during this reporting period SDO-002 12/18/19 0.1 ND 400 61.6 SDO-003 12/18/19 0.1 No discharge during this reporting period. ' 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. ' See General Permit text, Table 1, 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 - numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/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: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018 Page 1 of 2 DocuSign Envelope ID: OC606A63-625D-45E9-85EF-165012E4D866 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. n No discharge this Deriodz Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -Polar Oil & Grease mg/L Total Suspended Solids, mg/L New Motor or Hydraulic Oil Usage, gal/mon Benchmarks _ - 15 100 or 504 Parameter Code - 46529 00552 CO530 NCOIL 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: • 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 FOR THE SAME PARAMETER ATANY ONE OUTFALL? YES ❑ NO Q IF YES, HAVE YOU CONTACTED THE DEMUR REGIONAL OFFICE? YES ❑ NO ❑ 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 monitorina 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 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." r Doc„sic"ed by: 06W Signature of Permittee Permit Date: 11/1/2018-5/31/2021 1/6/2020 Date SWU-248, last revised 11/1/2018 Page 2 of 2 DocuSi n Envelope ID: OC606A63-625D45E9-85EF-165012E4D866 11 eAnalytical-401" rw.pecsla0a.mrn December 26, 2019 Mary Kennamer Smith Gardner, Inc. 14 N. Boylan Ave Raleigh, NC 27603 RE: Project: BROWNFIELD-13-1 Pace Project No.: 92457912 Dear Mary Kennamer: Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Hunlerwille, NC 28078 (704)875-9092 Enclosed are the analytical results for sample(s) received by the laboratory on December 18, 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, Matthew Brainard matthew.brainard@pacelabs.com (704)875-9092 Project Manager Enclosures 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 11 DocuSi n Envelope ID: OC606A63-625D-45E9-85EF-165012E4D866 �ceAnalytical www.Decd�ba.com Project: BROWNFIELD-13-1 Pace Project No.: 92457912 Pace Analytical Services Raleigh 6701 Conference Drive, Raleigh, NC 27607 North Carolina Wastewater Certification #: 67 Pace Analytical Services Asheville 2225 Riverside Drive, Asheville, NC 28804 Florida/NELAP Certification #: E87648 Massachusetts Certification #: M-NC030 North Carolina Drinking Water Certification #: 37712 Pace Analytical Services Eden 205 East Meadow Road Suite A, Eden, NC 27288 North Carolina Drinking Water Certification #: 37738 CERTIFICATIONS North Carolina Bioassay Certification #: 16 North Carolina Drinking Water Certification #: 37731 North Carolina Wastewater Certification #: 40 South Carolina Certification #: 99030001 YrginiaNELAP Certification #: 460222 North Carolina Wastewater Certification #: 633 VirginiafVELAP Certification #: 460025 REPORT OF LABORATORY ANALYSIS Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 2 of 11 7DocuSi n Envelope ID: OC606A63-625D-45E9-85EF-165012E4DB66 ceAnalytical sttsr.Dacahss.cols SAMPLE ANALYTE COUNT Project: BROWNFIELD-13-1 Pace Project No.: 92457912 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville; NC 28078 (704)875-9092 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92457912001 SDO-2 SM 254OD-2611 AMI 1 PASI-E SM 9222D-2006 WT 1 PASI-R SM 5220D-2011 JPt 1 PASI-A REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the wntten consent of Pace Analytical Services, LLC. Page 3 of 11 DocuSi n Envelope ID: OC606A63-625D-45E9-85EF-165012E4D866 Pace Analytical Services, LLC ceAnalytical ® 9800 Kincey Ave. Suite100 Hunlersville, NC 28078078 rrw.penUbs.com (704)875.9092 ANALYTICAL RESULTS Project: BROWNFIELD-13-1 Pace Project No.: 92457912 Sample: SDO-2 Lab ID: 92457912001 Collected: 12/18/19 11:25 Received: 12/18/19 12:08 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 2540D Total Suspended Solids Analytical Method: SM 254OD-2011 Total Suspended Solids 61.6 ' mg/L 4.0 1 12/19/19 09:59 MBIO 9222D Fecal Coliform RAL Analytical Method: SM 9222D-2006 Preparation Method: SM 9222D-2006 Fecal Coliforms 400 CFU/100 mL 1.0 1 12/18/19 16:58 12/19/19 16:30 5220D COD Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011 Chemical Oxygen Demand ND mg/L 25.0 1 12/23/19 23:10 12/24/19 02:49 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Dale: 12/26/2019 11:40 AM without the written consent of Pace Analytical Services, LLC. Page 4 of 11 DocuSi n Envelope ID: OC606A63-625D-45E9-85EF-165012E40866 Pace Analytical Services, LLC aceAnalytical• 9800 uncey Ave. Suite100 078 Hunlersville, NC 28078 vityw.pacelabs.com (704)875-9092 QUALITY CONTROL DATA Project: BROWNFIELD-13-1 Pace Project No.: 92457912 QC Batch: 515738 Analysis Method: SM 254OD-2011 QC Batch Method: SM 254OD-2011 Analysis Description: 25400 Total Suspended Solids Associated Lab Samples: 92457912001 METHOD BLANK: 2763370 Matrix: Water Associated Lab Samples: 92457912001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg/L NO 2.5 12/19/19 09:52 LABORATORY CONTROL SAMPLE: 2763371 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Suspended Solids mg/L 250 238 95 90-110 SAMPLE DUPLICATE: 2763372 92457802003 Dup Parameter Units Result Result RPD - Qualifiers Total Suspended Solids mg/L 1800 1790 0 SAMPLE DUPLICATE: 2763373 92457883001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 22.7 23.0 2 Results presented on this page are In the units indicated by the -UmW 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, Dale: 12/26/2019 11:40 AM without the written consent of Pace Analytical Services, U.C. Page 5 of 11 7 D S EnDocuSi n Envelope ID: OC606A63-625D-45E9-85EF-165012E4D866 ceAnalytical rw.lunhhs.colo Project: BROWNFIELD-13-1 Pace Project No.: 92457912 QC Batch: 516705 QC Batch Method: SM 9222D-2006 Associated Lab Samples: 92457912001 METHOD BLANK: 2768133 Associated Lab Samples: 92457912001 Parameter Units Fecal Coliforms CFU/100 ml- SAMPLE DUPLICATE: 2768134 Parameter Feral Coliforms QUALITY CONTROL DATA Analysis Method: SM 9222D-2006 Analysis Description: 9222D Fecal Coliform(MF) - RAL Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers NO 1.0 12/19/19 16:30 92457912001 Dup Units Result Result CFU/100 mL 400 600 RPD Qualifiers 40 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 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: 12/26/2019 11,40 AM without the written consent of Pace Analytical Services, L-C. Page 6 of 11 DocuSi n Envelin' D: OC606A63-625D-45E9-85EF-165012E4D866 pace Analytical Services, LLC 5 alytical • 9800 Kincey Ave. Suite 0100 78 Huntersville, NC 28078 .Dectlabicoln (704)875-9092 e QUALITY CONTROL DATA Project: BROWNFIELD-13-1 Pace Project No.: 92457912 OC Batch: 516490 Analysis Method: SM 5220D-2011 QC Batch Method: SM 5220D-2011 Analysis Description: 5220D COD Associated Lab Samples: 92457912001 METHOD BLANK: 2767335 Matrix: Water Associated Lab Samples: 92457912001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Chemical Oxygen Demand mg/L NO 25.0 12/2411902:45 LABORATORY CONTROL SAMPLE: 2767336 Spike LCS LCS %Rec Parameter Units Conic. Result %Rec Limits Qualifiers Chemical Oxygen Demand mg/L 750 759 101 90-110 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2767337 2767338 MS MSD 92457959001 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual Chemical Oxygen Demand mg/L ND 100 100 124 124 - 111 111 90-110 0 Mt MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2767375 2767376 MS MSD 92457959002 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc. Conc, Result Result %Rec %Rec Limits RPD Qual Chemical Oxygen Demand mg/L NO 100 100 119 119 104 104 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 of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 12/26/2019 11:40 AM without the written consent of Pace Analytical Services, LLC. Page 7 of 11 DocuSi n Envelope ID: OC606A63-6250-45E9-85EF-165012E4D866 ceAnalytical Wwc.pactle0s.cam QUALIFIERS Project: BROWNFIELD-13-1 Pace Project No.: 92457912 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. 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. Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersvilie, NC 28078 (704)875-9092 PQL - Practical Quantitation Limit. 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. 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 - Silica Get - Clean -Up U - Indicates the compound was analyzed for, but not detected. 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 PAST-E Pace Analytical Services - Eden PASI-R Pace Analytical Services - Raleigh ANALYTE QUALIFIERS M 1 Matrix spike recovery exceeded OC limits. Batch accepted based on laboratory control sample (LCS) recovery. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 12/26/2019 11:40 AM without the written consent of Pace Analytical Services. LLC. Page 8 of 11 DocuSi n Envelope ID: OC606A63-625D-45E9-85EF-165012E40866 Pace Analytical Services, LLC ceAnalytical" 9800 Kincey Ave. C28078 100 Huntersville, NC 28078 w .psctlsbs.com (7041875.9092 QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: Pace Project No.: BROWNFIELD-13-1 92457912 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92457912001 SDO-2 SM 254OD-2011 515738 92457912001 SDO-2 SM 9222D-2006 516705 SM 92220-2006 516709 92457912001 SDO-2 SM 5220D-2011 516490 SM 5220D-2011 516509 Date: 12/26/2019 11:40 AM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services. LLC, Page 9 of 11 CHAIN -OF -CUSTODY Analytical Reclijest Document "LABusEONLY� or: WO#:92457912 ceAnalytical' 0 Chairv-of-Custody is a LEGAL DOCUMENT -.CoWplete allr elevent fields Company: Billing information: :51yy N m 92457912 < Container Pres,-0 Address: 14 I d I I I Report To: EmailTo: P'.,vm" TV,oi,s: III -1t1k id, 12) W�404. (3)Ayd (6) methanol, 17) sodium bisuffau,, (9) sodium thlow1fate, (9) heune, (A) ascorbic add, (8) animodum sulfa,e. (C) am..iu. Ivrilso.iis, (D) U) kl.le�,v.d. (0) Other COFY To:. Site Collection Info/Address: ........ Customer rojectName/Number: County/City; Time Zone Collected- Analyses lLab Prolfile/L lne�'; t3ro%,(A ke-IA -1 3-1 CT' jz� VVO_ kje I I PT [,j MT f [XET -�Cat8dy 5"Iab'�...6�ifiritjs6i�!j�N M i�� u'it�;iiy �Sijzitttuxen p c Phone:5 P�r-�335-3:09 Site/Facility ID # t4ek)R Xyzfire,�Aon oring? Email: FroWAi4e4 P4 I f No ::Coliectpr!Signi RA: 1z6o m Collected I y (print): purchase Order M DW PWS ID # Quote 9: OW IP Col!:�� �(slgnatuTL Turnaround Date Required: lm-=-d-5-t-eTy:P-acked on Ice: -5+tLr% C4 A. Kyes I No NA c, L-Chic,cine Pcvieiiil� �Y- Sample Dr posal: Rush: Field Filtered jif applicable): 9d Dis,xne is appropriate f I Return Same Day I I Next Day ]yes No w I &chive: I 120ay ( 13Day [ 141) 1 15 Day av saiapl. -0; m I Hold: (Expedite Charges Apply) Analysis: S i r N t.to I S Matmicades (Insert in Matrix box below): DrinldngWater(DW), Grotind Water (GW), Wastewater (WM, Product Soi]?Solid (SQ, Oil (OL), Wipe (Wii), Air (AR), Tissue (TS), Bloassay (8), Vapor {V). Other (OT) I�jsb� S 1 7 Comp/ Collected (or Res of Customer mple ID Matrix Grab Composite Start) I.omposite End Cl Ord V —D—e— at — —o F IT= 2:zk. 12-119 111:25 xrj�,' 0�d k';d r kR4 �N I IZ�, d V) zk 1 Customer! emarks Special Conditions Possible Hazards: Type of IterU B6 N .... so. ply HORT14OLDS PR�gNT 2 tjdqr6k-.'�',,',y N' Y Lab Sample Temperature Info:. . emp 8 ank ecii[yed" Y" N NA �:.qmp nkR PaE164 Matirial us UbTrgbiirijil� I �'A -2,42-F40.8 fherm Oil: -��pann:!ReQcme�lpt- �(.. LTern oc addhern samp�le( ),scneciied cpm,j, Y, S amRI!s!"NTq Cor, F T�0' . act.,r: C * ..FFnEX-'-�'iuPS"1 ou er iuecourie"�",." 6 � I:b rl ; e�e� �: . � ,,, Relinquishild by/Company: (signature) Date/Tinte: Received C my: (Sign ure by/ Datefnme: mTjLLAs USE ONLY _C 1211g 12 r2h 9/11 12 "O� Acctrnim' ,Relinquish dby/Cormpany:(Signamna) Date/Time: Received by/Company, (Signature) Dafe/nnfe: T,1061artk"Rkelv�cl�' zY N -1 NA -HCL �:MeOH 15P Oihe'r' stelinqulMsh by/Company: (Signature) Dateffime: Received by/Company-. (Signature) Date/Time: N�n Confoi�.Acti(s):' Page: of: DocuSign Envelope ID: OC606A63-625D-45E9-85EF-165012E4D866 Document Name: AA�e�� Simple condition Upon Raul r c AMOC81 A • Document No.: FCAR-CS-033-Rev.06 "Check mark top half of box If pH and/or dechlorination is verified and within the acceptance range for preservation samples. Esceptlons: VOA, CoOtorm, TOC, Oil and Grease, DRO/eOIS (water) DOC, LLHg teBottom half of box Is to list number of bottle Project 1: February 7, 1 of Office PM: MWB Due Date: 12/30/19 CLIENT: 92—RSG&R NC Z i Z a 2 2 °' 4d n L6 uo c c u E E E m ¢ ? i yy2� Y n a+ m iy x S C� s E V1 a m n x 9 QryQ E ,pn m O ° O r�J E ,Iry� t ^ x 9 i E N m zLg a =NO E P 3 (j Q pepp g rair a y- a n V O `m = a u i o7 It pE N ry ° 9 Nx y a a v x .4n.. s aCy E ton a a ? 3 x z 1QnE D S > E Q o Z iJ ai .O E U' > c Q� O E Q u' > a m x 0 E to m = ]"i x = > O r3 9 a tR n l at Z a i N E _ a a y u E o m m S u J E p n E ppp2 E p ? 9 N E to 9 E jVj Q E 1 3 9 5 6 7 8 9 30 11 ll PH Adjustment Log for Preserved Samptes Sample 10 Type of Preservative pH upon receipt Oato presemlipn adjusted Time preservation adjusted Anaunt of Presorntiva added Lot g Note: Whenever there Is a discrepancy affacting North Carolina compliance samples. a copy of this form will be sent to the Nonh Carellno DEHNA certification Offts (I.e. Out of hold, Incorract press rvatNe, out of temp. Incorrect co nralnen. Page 11 of 11