NCG140070_COMPLETE FILE - HISTORICAL_20030902

.... - STORMWATER DIVISION CODING SHEET
RESCISSIONS.
PERMIT NO.
N `
DOC TYPE
COMPLETE FILE- HISTORICAL
DATE OF
.RESCISSION
❑ 0 3 n a
YYYYMMDD

Lyman Auston
Ready Mixed Concrete Company
P. O. Box 27326
Raleigh, North Carolina 27611
Subject:
Dear Mr. Auston:
Michael F. Easley
Governor
William G. Ross, Jr., Secretary
North Carolina Department of Environment and Natural Resources
September 2, 2003
Rescission of NPDES Permit
Ready Mixed Concrete Company
NPDES Permit NCG140070
Hamett County
Alan W. Klimek, P. E., Director
Coleen H. Sullins, Deputy Director
Division of Water Quality
Reference is made to your request for rescission of the subject NPDES Permit. Division staff
have confirmed that this permit is no longer required. Therefore, in accordance with your
request, NPDES Permit NCG140070 is rescinded, effective immediately.
If in the future you wish to again discharge stormwater to the State's surface waters, you must
first apply for and receive a new NPDES Permit. Operating a facility without a valid NPDES
Permit will subject the responsible party to a civil penalty of up to $25,000 per day.
If you have questions about this matter, please contact Vanessa Manuel at [phone],
extension 532 or the Water Quality staff in the Fayetteville Regional Office at [phone].
Sincerely,
0 Alan W. Klimek, P.E.
Cc: Paul Rawls, DWQ FRO — w/ attachments
Bradley Bennett, NPDES Stormwater Unit
Fran McPherson, DWQ Budget Office
Central Files — w/ original attachment
Awn
NCDENR
N. C. Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 [phone] Customer Service
1 800 623-7748

Permit Rescission Form
Facility Name
Permit Number /yCG-.)yQQ"70 .
NPDES Permit Type .� WQ Permit Type �—
Discharge Code(s) ..
Regional Office >eli..1 ei 4 e v. i) L
County
Date Requested �'1� i Q ZU(is Permit Expiration F—
Original Request Recei ved b
Q Compliance Group egional Office Q P&E Unit
Request Received in the Form of.
(pSigned Annual Fee Invoice etter Q Other...
Please Check Appropriately
FO
ite Visit Performed
(Should be addressed unlesskroundwater
O Groundwater Concerns Addressed Monitoring is not required). N14
Rescission of the "above. referenced Permit is
pproved ❑ Denied
Note: (if Approved) This permit will be deleted from. the permit tracking
system and the division billing system and if necessary inactivated on the
compliance monitoring system.
Complete (if Approved)
escinded Immediately Q Allow to Expire
O Never Constructed 0 Other...
bandoned
0 Connected to City Sewer
Complete (if Denied)
Reason for Denial
Certifier's Names �l� ����
Date Zo0_1
Return Completed Form to the Facility Assessment Unit PR Form (2/97)

07/09/03 15:22 $919 981 0910
16002/002
nZAMY MIMED O0NCRET3E COMPANY
3610 Bush Street, Raleigh, NC 27609 P.O. Box 27326, Raleigh, NC 27611
_ Telephone [phone]-Jul-03
Mr: cky` Ovels Fax [phone]
Guaa*W~Water Quality
Fayetteville Region
225 Green Street - Suite 714
Fayetteville, N.C. 28301-5043
Subject: NOTICE OF RESCISSION
Ready Mixed Concrete - Angi.
NCG140070 (Angier Plant No. 20)
Harnett County
Dear Mr. Revels:
The subject facility has not been in place for over two years. The actual
plant was disassembled and moved off the property. The land has been for sale
for some time now.
Due to this fact and the fact we do not ever plan to use this land as a concrete
facility again, Ready Mixed Concrete respectfully requests that permit #NCG140070
be rescinded.
Sincerely,
regio
Q.vl_n Austin
n Manager, Ready Mixed Concrete Co.
Box 27326
Raleigh, N.C. 27611
Member National Ready Mixed Conaete Association

ITTState of North Carolina
Department of Environment
and Natural Resources
Division of Water Quality
James B. Hunt, Jr., Governor
Wayne McDevitt, Secretary
Kerr T. Stevens, Director
LYMAN AUSTIN
READY MIXED CONCRETE CO - PLT. #20
3610 BUSH STREET
RALEIGH, NC 27609
Dear Permittee:
_ern
NCDENR
NORTH CAROUNA DEPARTMENT OF
ENVIRONMENT' AND NATURAL.RESOURCES
July 26, 1999
AUG 51999 '
a DWQ
Subject: Reissue - NPDES Stormwater Permit
Ready Mixed Concrete Co - Plt. #20
CDC Number NCG140070
Harnett County
In response to your renewal application for continued coverage under general permit NCG140000, the Division of
Water Quality (DWQ) is forwarding herewith the reissued stormwater general permit. This permit is reissued
pursuant to the requirements of North Carolina General Statute 143-215.1 and the Memorandum of Agreement
between the state of North Carolina and the U.S. Environmental Protection Agency, dated December 6, 1983,
The following information is included with your permit package:
* A copy of general stormwater permit NCG140000
* A Stormwater Pollution Prevention Plan (SPPP) Certification Form. Completion of this form is required to
certify that you have developed and implemented the SPPP as per the conditions of the permit. This form
must be completed and returned to the Division within 30 days of receipt of this letter.
DO NOT SEND the SPPP with the signed form.
* Five copies of the Analytical Monitoring form and five copies of the Qualitative Monitoring form
* A copy of a Technical Bulletin for the general permit which outlines changes in the permit, key requirements,
_ and addresses frequently asked questions
* A Certificate of Coverage
Your coverage under this general permit is not transferable except after notice to DWQ. The Division may require
modification or revocation and reissuance of the Certificate of Coverage. This permit does not affect the legal
requirements to obtain other permits which may be required by DENR or relieve the permittee from responsibility
for compliance with any other applicable federal, state, or local law, rule, standard, ordinance, order, judgment, or
decree._
If you have any questions regarding this permit package please contact Aisha Lau of the Central Office Stormwater
and General Permits Unit at [phone], ext. 578
Sincerely,
for Kerr T. Stevens
cc: Central Files
Stormwater and General permits Unit Files.. _
Fayetteville Regional Office
1617 Mail Service Center, Raleigh, North Carolina 27699-1617 Telephone [phone] Fax [phone]
An Equal Opportunity Affirmative Action Employer 50 % recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT AND NATURAL RESOURCES
DIVISION OF WATER QUALITY
GENERAL PERMIT NO. NCG140000
CERTIFICATE OF COVERAGE No. NCG140070
STORMWATER AND PROCESS WASTEWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and -adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended,
READY MIXED CONCRETE CO - PLT. #20
is hereby authorized to operate a process wastewater treatment system, and is hereby authorized to discharge process
wastewater and stormwater from a facility located at
READY MIXED CONCRETE CO - PLT. #20
HWY 210 W RT 2 BOX 34
ANGIER
HARNETT COUNTY
to receiving waters designated as a UT of West Buies Creek in the Cape Fear River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III,
IV, V, and VI of General Permit No. NCG140000 as attached.
This certificate of coverage shall become effective August 1, 1999.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed this day July 26, 1999.
for Kerr T. Stevens, Director
Division of Water Quality
By Authority of the Environmental Management Commission

i70R:NiWAFFR 0tSC4ARGEOUTFAl,l. fS001
.MONITORING REPORT
:: •-RAL PERMIT NO. NCG140000 -70
.-�Tt,'IC�iEOFCOVtRAGENO.NCG14 V
- Oti COLLECTING S MPLE(S)
TIFF i=P LARORATORY(S) -S eg,h 4-IZ,,e&4 cA L xb
Lab g
';- A: Stitific Monitoring Requ'iremenb
Date
Sarm
Colk
y � 9, 30 —FS
_� this fwHil perform Vehicle
-::s, complete Part B)
sing more
'art B: Vehicle Maintenance Activity Monitoring Reauirementa
SAMPLES COLLECTED DURING CALENDAR YEAR:
(all samples collected during ➢ calendar year shall be reported no later than
January 31 or the fcilowirrt year)
COUNTY lLL• q
PHONE NO. O
IcKIATbRFOF PERMTTTEE OR DESIGNEE)
B thts signature, I certify that this report is accurate
complete to the best of my knowledge
RECEIVE®
of new motor oil per month? _ yes kno
FEB 1,21999
FAYETTEVILLE
REG. OFFICE
ter`➢II
ti ^
D➢tG�t��;,..,
Sample
Collected '
50650 _�i::,:.
Total Fkiw
OOS56 K -'
0[I ➢nd Greau
OIOSI�.:kS+=._.._-
Lead,rTot➢I
ReedGerabk1
:38260 »„. Aw.;..t)04pp
Detergeltb ::
A S Z *
-;= �
pH � .. ''
N _
New Motor Oil.
to o/d df
MG
?:ARM EVENT CHARACTERISTICS:.
Date 130-98
Total Event Precipitation (inches): r J
Event Duration (hours): -31V
(If more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours):
Page I of 2
Mail Original and one copy to:
Atm: Central Files
DEHNR
Division of EnvirormtenLd Mgt.
P.O. Box 29535
Raleigh, NC 27626-0535
Form MR14
Q

J ,.
_"
„�
ttNN E'� �' ' � ;dd.�

M
Sampler's
Date: -30 - `t
am (m
FIGURE 1
READY MIXED CONCRETE COMPANY
PLANT NO.
STORMWATER SAMPLING RECORD
Outfall Number: #
Storm Begin Time: �' 3P
I have verified that no storm event measuring greater than 0.1 inches has occurred
in the 72 hours prior to this storm event and that all information recorded herein is
accurate and true to the best of my knowledge.
Flow Begin Time:_ a' am/pm
pH Test Method: paper / meter
Storm End Time: 3 amf�
Grab Sample Time --a, "3, am/6
pH:(
cs
Storm Duration `iJ� r
Total Precipitation inches

FIGURE 2
READY MIXED CONCRETE COMPANY
PLANT NO.
VISUAL MONITORING RECORD
Sampler's Name: ! d AA C-Al
q -
Date: - 30 - % O
Visual Monitoring Results:
O U 3
Outfall Number:
Describe the presence of any of the following parameters in the stormwater
discharge.
Color:
Odor: L2i2.
Floating
Suspended Solids:
Foa
- Oil Sheen: ! "i
Other Obvious Indicators of Pollution: G✓cx�- dw�aZ,

Sampler's N
Date: q O-
ame
FIGURE 1
READY MIXED CONCRETE COMPANY
PLANT NO.
STORMWATER SAMPLING RECORD
W0
Outfall Number#�" ;�_ Storm Begin Time: = _
I have verified that no storm event measuring greater than 0.1 inches has occurred
in the 72 hours prior to this storm event and that all information recorded herein is
accurate and true to the best of my knowledge.
Signature: rtaa c Q , a \P ,, m .m. )-.
Flow Begin Timer a- 3 am/pm Grab Sample Time: a am/pm
pH Test Method: paper / meter
Storm End Time:_ '3 ` 5 _ am&
H 1
Storm Duration:7ou[s
Total Precipitation: 5/o inches

FIGURE 2
READY MIXED CONCRETE COMPANY
PLANT NO.
VISUAL MONITORING RECORD
Sampler'sName: I ��r)
Date: / " _�n — (�/ b Outfall Number:
ual MRnitoring Results:
Describe the presence of any of the following parameters in the stormwater
discharge.
Color: oZ���nncn�v.
Odor:
Clarity: _; '_. Wc�tv�, (Af+�a Qko�
Floating Solids:Ou ..
Suspended Solids: 9 m�,
Foam: rvrtSZ
- Oil Sheen: fnnm
Other Obvious Indicators of Pollution:` 10--.Q')

FIGURE 1
READY MIXED CONCRETE COMPANY
PLANT NO.
STORMWATER SAMPLING RECORD
Sampler's Name: f&"C.e Q fern r� O n
Date: o Outfall Number: a Storm Begin Time: 2�6(z?�'
am®
I have verified that no storm event measuring greater than 0.1 inches has occurred
in the 72 hours prior to this storm event and that all information recorded herein is
accurate and true to the best of my knowledge.
Signature: RAA.,w G
Flow Begin Time:- 35—am/pm
pH Test Method: paper / meter
Storm End Time: 3' )5 am&
GrabSampleTime:_��G am/pm
pH: lD
Storm Duration-4 'hags
Total Precipitation: -9/jo inches

r
FIGURE 2
READY MIXED CONCRETE COMPANY
Sampler's N
PLANT NO.
VISUAL MONITORING RECORD
Outfall Number: #
Visual Monitoring Results:�/t/anA �� � _ ittem--j
Describe the presence of any of the following parameters in the stormwater
idischarge.
Color:
Odor:_
Clarity:U-r a./L
Floating Solids: 4yn.e_- aL Zz
Suspended Solids: ins we —
Foam: �kr�
- Oil Sheen:Jh�
Other Obvious Indicators of Pollution: /V6-r

FIGURE 1
READY MIXED CONCRETE COMPANY
PLANT NO.
STORMWATER SAMPLING RECORD
Sampler's Name:_1A„�, �l 3 Q c r� ) o, M n
Date: 9-33 -9 X Outfall Number: Storm Begin Time:
am/pm
I have verified that no storm event measuring greater than 0.1 inches has occurred
in the 72 hours prior to this storm event and that all information recorded herein is
accurate and true to the best of my knowledge.
1
Signature:
Flow Begin Time: a am/pm
pH Test Method: paper / meter
Storm End Time: am�
Grab Sample Time: -off __ �-5 ame
pH:s
Storm Duration: houur �
Total Precipitation: id inches

i".- ',
FIGURE 2
READY MIXED CONCRETE COMPANY
PLANT NO.
VISUAL MONITORING RECORD
Sampler's Nam
Date: - 30
Visual Monitoring Resu
CA
V U
Outfall Number: F� `Y
Describe the presence of any of the following parameters in the stormwater
discharge.
Color:_ 1Jit-tAr
Odor: 60- e_
Clarity: Not e-,t2-a,1L—
Floating Solids: YYytix_-
Suspended Solids:
Foam:
Oil Sheen:
Other Obvious Indicators of

I_.
JP�y't Y 3 Eq �(+
Southern Testing & Research Laboratories, Inc.
r� 3809 Airport Drive • Wilson, NC 27896 • [phone] • Fax: [phone] • www.STRLabs.com
9 FAIR PP
SAMPLE No.: H1850-001
R E P O R T of A N A L Y S I S Date Reported: 10/15/98
Lyman Austin
Ready Mixed Concrete
P.O. Box 27326 Phone:[phone] X
Raleigh NC 27611 Fax: [phone]
P. O.: PLT 20
Client Sample ID: ANGIER
Marks: Runoff Back of Conveyor
Collected: 09/30/98 14:30 Matrix: STORMWATER
Received: 10/01/98 13:00 Classification: ENV
CAT No. ANALYSES METHOD ANALYZED by MDL RESULT UNITS
EW-040.1 Solids: Total Susp EPA 160.2 10/07/98 TJ1 13 613 mg/L
COMMENTS:
Laboratory Contact(s):
Debbie Collins
Customer Service Specialist
Page 1 of 4 H1850R.159
Reviewed and A pro
a s B. ox, III, B.S.
an ger, Environmental Dept.
(LP1:V2R08.2) 10/15/98 14:48
Chemical and Microbiological Analyses: Environmen%W_JAndustrial Hygiene • Agrochemical • Foods • Pharmaceuticals

i
stY Sf9
JP 6p
m Southern Testing & Research Laboratories, Inc.
3809 Airport Drive Wilson, NC 27896 • [phone] • Fax: [phone] • wwosrRLabs.com
S PAIR PP
SAMPLE No.: H1850-002
R E P O R T of A N A L Y S I S Date Reported: 10/15/98
Lyman Austin
Ready Mixed Concrete
P.O. Box 27326 Phone:[phone] X
Raleigh NC 27611 Fax: [phone]
P. O.: PLT 20
Client Sample ID: ANGIER
Marks: Runoff Behind Stone Bin
Collected: 09/30/98 14:35 Matrix: STORMWATER
Received: 10/01/98 13:00 Classification: ENV
CAT No. ANALYSES METHOD ANALYZED by MDL RESULT UNITS
EW-040.1 Solids: Total Susp EPA 160.2 10/07/98 TJ1 6 50 mg/L
COMMENTS:
Laboratory Contalct(s): Reviewed and Approved y:
Debbie Collins a es B.DX'-III, B.S.
Customer Service Specialist Ma ger, Environmental Dept.
Page 2 of 4 H1850R.159
(LP1:V2R08.2) 10/15/98 14:48
Chemical and Microbiological Analyses: Environmental • Industrial Hygiene • Agrochemical • Foods • Pharmaceuticals

Southern Testing & Research Laboratories, Inc.
3809 Airport Drive • Wilson, NC 27896 • [phone] • Fax: [phone] • www.STRLabs.com
R E P O R T of A N A L Y S I S
Lyman Austin
Ready Mixed Concrete
P.O. Box 27326
Raleigh NC 27611
Client Sample ID: ANGIER
Marks: Stream Runoff on Right Side Chats Bin
SAMPLE No.: H1850-003
Date Reported: 10/15/98
Phone:[phone] X
Fax: [phone]
P. O.: PLT 20
Collected: 09/30/98 14:40 Matrix: STORMWATER
Received: 10/01/98 13:00 Classification: ENV
CAT No. ANALYSES METHOD ANALYZED by MDL RESULT UNITS
EW-040.1 Solids: Total Susp EPA 160.2 10/07/98 TJ1 8 2,050 mg/L
COMMENTS:
Laboratory Contact(s): Reviewed and Approved by:
Debbie Collins A
B.�ox, III,B.S.Customer Service Specialist er, Environmental Dept.
Page 3 of 4
H1850R.159
(LP1:V2R08.2) 10/15/98 14:48
Chemical and Microbiological Analyses: Environmental`11ndustrial Hygiene • Agrochemical • Foods • Pharmaceuticals

Pest Y •S Fy i
Southern Testing & Research Laboratories, Inc.
i. 3809 Airport Drive Wilson, NC 27896 • [phone] • Fax: [phone] • www.S'PRLabs.com
9 FAIR PP
SAMPLE No.: H1850-004
R E P O R T of A N A L Y S I S Date Reported: 10/15/98
Lyman Austin
Ready Mixed Concrete
P.O. Box 27326 Phone:[phone] X
Raleigh NC 27611 Fax: [phone]
P. O.: PLT 20
Client Sample ID: ANGIER
Marks: Runoff Right Side of Wash out Pit
Collected: 09/30/98 14:45 Matrix: STORMWATER
Received: 10/01/98 13:00 Classification: ENV
CAT No. ANALYSES METHOD ANALYZED by MDL RESULT UNITS
EW-040.1 Solids: Total Susp EPA 160.2 10/07/98 TJ1 8 948 mg/L
COMMENTS:
Laboratory Contact(s): Reviewed and Approved by:
Debbie Collins Aes B. - I B.S.
,Customer Service Specialist ger, Environmental Dept.
Page 4 of 4 H1850R.159
(LP1:V2R08.2) 10/15/98 14:48
Chemical and Microbiological Analyses: Environmektal • 1)(dustrial Hygiene • Agrochemical • Fonds • Pharmaceuticals

State of North Carolina
Department of Environment,
Health and Natural Resources
Division of Environmental Management
James B. Hunt, Jr., Governor
Jonathan B. Howes, Secretary
A. Preston Howard, Jr., P.E., Director
January 20, 1995
Larry Spence
Ready Mixed Concrete Company
3610 Bush Street
Raleigh, NC 27609
IM
W4 24 1995
MY. MANA6f-MF[1T
9'AATxa?L '_LE ;ifG. tOF;•=i0r
Subject: General Permit No. NCG 140000
Ready Mixed Concrete Company
COC NCG140070
Harnett County
Dear Larry Spence
In accordance with your application for discharge permit received on November 30, 1994, we are
forwarding herewith the subject certificate of coverage to discharge under the subject state - NPDES general
permit. This permit is issued pursuant to the requirements of North Carolina General Statute 143-215 .1 and -
the Memorandum of Agreement between North Carolina and the US Environmental Protection agency dated
December 6, 1983.
If any parts, measurement frequencies or sampling requirements contained in this permit are
unacceptable to you, you have the right to request an individual permit by submitting an individual permit
application. Unless such demand is made, this certificate of coverage shall be final and binding.
Please take notice that this certificate of coverage is not transferable except after notice to the Division
of Environmental Management. The Division of Environmental Management may require modification or
revocation and reissuance of the certificate of coverage.
This permit does not affect the legal requirements to obtain other permits which may be required by the
Division of Environmental Management or permits required by the Division of Land Resources, Coastal
Area Management Act or any other Federal or Local governmental permit that may be required.
If you have any question concerning this permit, please contact MS. AISHA LAU at telephone number
919n33-5083.
cc: Fayetteville Regional Office
P.O. Box 29535, Raleigh, North Carolina 27626-0535
An Equal Opportunity Affirmative Action Employer
Sincerely,
ririqitlal
Coieen H. Sullins
A. Preston Howard, Jr. P.E.
Telephone [phone] FAX [phone]
50% recycled/ 10% post -consumer paper

STATE OF NORTH CAROLINA
DEPARTMENT OF ENVIRONMENT, HEALTH, AND NATURAL RESOURCES
DIVISION OF ENVIRONMENTAL MANAGEMENT
GENERAL PERMIT NO, NCG140000
CERTIFICATE OF COVERAGE No. NCG1400ZQ
STORMWATER DISCHARGES
NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM
In compliance with the provision of North Carolina General Statute 143-215.1, other lawful standards and
regulations promulgated and adopted by the North Carolina Environmental Management Commission, and the
Federal Water Pollution Control Act, as amended
Ready Mixed Concrete Co.
is hereby authorized to discharge stormwater from a facility located at
Ready Mixed Concrete Co.
Hwy. #210 W. Route #2 Box 34
Angier
Harnett County
to receiving waters designated as an unnamed tributary to West Buies Creek in the Cape Fear River Basin
in accordance with the effluent limitations, monitoring requirements, and other conditions set forth in Parts I, II, III
and IV of General Permit No. NCGI40000 as attached.
This Certificate of Coverage shall become effective January 20, 1995.
This Certificate of Coverage shall remain in effect for the duration of the General Permit.
Signed, this day January 20, 1995.
Origincm Signed By
t; ,i�c•;:;t H. Sullins
A. Preston Howard Jr., P.E., Director
Division of Environmental Management
By Authority of the Environmental Management Commission

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W 3809 Airport Drive • Wilson, NC 27896
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CHAIN OF CUSTODY
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IMSTRUCTOONS FOR CO,lf'L E TIfJC', (HAIft Of CUtiT OEii'r
1. Name and complete mailing address to which the final report should be forwarded.
2. Primary contact for any questions regarding this Chain of Custody or the indicated samples.
3. Phone and Fax number for primary contact.
4. Name and complete mailing address to which invoicing or additional report should be directed. Please
indicate invoice or -report.
5. Primary contact for any questions regarding invoicing or additional report.
6. Indicate Turn -Around -Time required. *Please note that additional charges may apply for Rush work.
7. Information identifying a particular project name or site location, etc., that will appear on the final report.
8. Project or purchase order number that should be used for invoicing.
9. Southern Testing quote number to be used for invoicing.
10. Each item # represents a unique sample. The last item # should be equal to the number of samples
submitted.
11. Date and Time sampling begun and the Date and Time sampling was completed.
12. Indicate whether the sample is a composite (T = time weighted, F = flow weighted) or a grab.
13. Sample Type: WW = Wastewater, MW = Ground/Monitoring Well Water, SW = Surface Water, DW =
Drinking Water, STW = Storm Water, S = Soil, SL = Sludge, U = Unknown, Etc.
14. Sample Description: Primary Sample Marks for identification of sample on laboratory report.
15. Type of sample container: P = Plastic, G = Glass, AG = Amber glass, V = 40 mL EPA purgeable vial,
AV = Amber vial, Etc.
16. Sample size (1/2 Gal, 500 mL, 1 lb, 100 g, Etc.).
17. Number of sample containers..
18. For preservation indicate Yes/No or indicate the type of preservation used (i.e. HNO3, pH < 2, Etc.).
19. A - Indicate desired analyses and B - check the appropriate boxes for the relevant samples. Please use
Southern Testing catalog numbers when possible.
20. Comments related to required detection limits, method detection limits, expected levels, etc.
21. Individual and date/time samples are turned over to another party.
22. Individual and date/time samples are received by the next party. The only time that the date/time are not
the same for relinquished and received should be if a second party carrier is used.
23. Signature of person collecting the samples.
24. Additional comments about this Chain of Custody (i.e. Send additional copies of reports, invoicing
information, Etc.).

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO; NCGI40000
CFRTIFICATE OF COVERAGE NO. NCG14
FACILITY, NAME &Iled 40LC6.1e- Co. -7-1c
PERSON COLLECTING SAMPLE(S)
CERTTFIFDLABORATOR'!((S)Sot,,T� Lab # Al
Lab #—
Part A: Specific Monitoring Requirements
outraim-
Date
50050 1
004004
00545"i.
TOE
Totid MVK
H
p sexes
s S
Nuspel
%
MG
uni
7,,S3
16-7- 91W
4-
8
1
SAMPLES COLLECTED DURING CALENDAR YEAR:/M
(all samples collected during a calendar year shall be reported no later than
January 31 of the following year)*
COUNTY 16L,yell
PHOIYE NO. (919 1 63 P- 9 902
(SIGNATURE OF PERmrrrEE OR DESIGNEE)
By this signature, I certify that this report is accurate
complete to the best of my knowledge
If 10-7 - 46 /01 V 1 .31
Does this facility perform Vehicle Maintenance Activities using more Ithan 55 gallons of new motor oil per month? — yes/no
(if yes, complete Part B)
a -art n- venicie
mamw--w
-.1
:0055611'%�-4�'Z"M�j
6IW**7-AM*
39260
Outf�
SIV
No
.
Date1.
Samuk
. . . . . . . . . . . .
�Sooso
Total r,'�tO(
Oil and Grease
pffgltfo"
NewMot&r-OiI
STORM EVENT CHARACTERISTICS:
Date -/ o
Total Event Precipitation (inches):
Event Duration (hours): /5 - Z-
(if more than one storm event was sampled)
Date —
Total Event Precipitation (inches):
Event Duration (hours): _
Page I of 2
Mail Original and one copy to:
Attn: Central Files
DEKNR
Division of Environmental Mgt.
P.O. Box 29535
Raleigh, NC 27626-0535
LJ
11997,
FAy-tTTEVILLE
REG. OffiCE
FormMR14

0
Footnotes:
I Applies only for facilities at which fueling occurs.
2 Detergent monitoring is required only at facilities which conduct vehicle cleaning operations.
"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. Rased 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. 1 am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
(S' ature of Permittee) (Date)
Page 2 of 2
i law
Form MR14 1

JP�stx SEq 'o
o � m
9
?�W PA I ItP
a
Southern Testing & Research
3809 Airport Drive
[phone] • Fax: [phone]
Inc.
Wilson, NC 27896
SAMPLE No.: F3057-001
R E P O R T of A N A L Y S I S Date Reported: 10/23/96
Lyman Austin
Ready Mixed Concrete
P.O. Box 27326 Phone:[phone] X
Raleigh NC 27611 Fax:
P. 0.:
Client Sample ID: PLT. #20 ANGIER
Marks: 1 Grab
Collected: 10/07/96 20:10 Matrix: STORMWATER
Received: 10/08/96 16:30 Classification: ENV
CAT No. ANALYSES MDL RESULT UNITS
EW-034 pH (Laboratory) 7.53 SU
EW-040.1 Solids: Total Suspended 3 138 mg/L
COMMENTS:
Laboratory Contact(s): AReewed and Approved by-jChris Mathis s . Cox,B.S.Section Head, Water Quality ger, Environmental Dept.
Page 1 of 4 F3057R.049
(EH1:V2R07.2) 10/23/96 13:07
Chemical and Microbiological Analyses: Environmental • Industrial Hygiene • Agrochemical • Foods • Pharmaceuticals

e9lq�
SU
Southern Testing & Research Laboratories, Inc.
3809 Airport Drive [phone] • Fax: [phone] Wilson, NC 27896
R E P O R T• of A N A L Y S I S
SAMPLE No.: F3057-002
Date Reported: 10/23/96
Lyman Austin
Ready Mixed Concrete
P.O. Box 27326 Phone:[phone] X
Raleigh NC 27611 Fax: ( ) -
P. 0.:
Client Sample ID: PLT. #20 ANGIER
Marks: 2 Grab
Collected: 10/07/96 20:15 Matrix: STORMWATER
Received: 10/08/96 16:30 Classification: ENV
CAT No. ANALYSES
EW-034 pH (Laboratory)
EW-040.1 Solids: Total Suspended
COMMENTS:
MDL RESULT UNITS
9.16 SU
1 7 mg/L
Laboratory Contact(s): Re 'ewed and Apt//gam/) ve by�
Chris Mathis m s B. Cox, III, B.S.
Section Head, Water Quality a ger, Environmental Dept.
Page 2 of 4 F3057R.049 L / (EH1:V2R07.2) 10/23/96 13:07
Chemical and Microbiological Analyses: Environmental • Industrial Hygiene • Agrochemical - Foods • Pharmaceuticals

s11S'tq
m
to
is
Southern
3809 Airport Drive
R E P O R T of A N A L Y S I S
& Research Laboratories, Inc.
[phone] • Fax: [phone] Wilson, NC 27896
Lyman Austin
Ready Mixed Concrete
P.O. Box 27326
Raleigh NC 27611
Client Sample ID: PLT. #20 ANGIER
Marks: 3 Grab
SAMPLE No.: F3057-003
Date Reported: 10/23/96
Phone:[phone] X
Fax:
P. 0.:
Collected: 10/07/96 20:20 Matrix: STORMWATER
Received: 10/08/96 16:30 Classification: ENV
CAT No. ANALYSES
EW-034 pH (Laboratory)
EW-040.1 Solids: Total Suspended
COMMENTS:
MDL RESULT UNITS
6.98 SU
2 90 mg/L
Laboratory Contact(s): Reviewed and Appro 7ed
Chris Mathis es Cox, III„ B.S.
Section Head, Water Quality ager, Environmental Dept.
Page 3 of 4 F3057R.049 V (EH1:V2R07.2) 10/23/96 13:07
Chemical and Microbiological Analyses: Environmental • Industrial Hygiene • Agrochemical • Foods • Pharmaceuticals

Southern Testing & Research Laboratories, Inc.
3809 Airport Drive
R E P O R T of A N A L Y S I S
[phone] • Fax: [phone] Wilson, NC 27896
Lyman Austin
Ready Mixed Concrete
P.O. Box 27326
Raleigh NC 27611
Client Sample ID: PLT. #20 ANGIER
Marks: 4 Grab
SAMPLE No.: F3057-004
Date Reported: 10/23/96
Phone:[phone] X
Fax: ( ) -
P. 0.:
Collected: 10/07/96 20:27 Matrix: STORMWATER
Received: 10/08/96 16:30 Classification: ENV
CAT No. ANALYSES
EW-034 pH (Laboratory)
EW-040.1 Solids: Total Suspended
COMMENTS:
MDL RESULT UNITS
3
10.4 SU
31 mg/L
Laboratory Contact(s): Reviewed and proved_
6
Chris Mathis jes
B.Cox,III,BSSection Head, Water Quality ger, Environmental Dept.
Page 4 of 4 F3057R.049
(EH1:V2R07.2) 10/23/96 13:07
Chemical and Microbiological Analyses: Environmental • Industrial Hygiene - Agrochemical • Foods • Pharmaceuticals

G
SOUTHERN TESTING CHAIN OF CUSTODY
& RESEARCH LABORATORIES, INC. & ANALYSIS REQUEST PAGE Of
3809 Airport Drive • Wilson, NC 27896 SEE REVERSE FOR INSTRUCTIONS
919-237-4175 • Fax: [phone] _
Q ORIGINAL REPORT TO: (Company and Individual)
y(Address)
,A.//// Y l
/V 6- �� K. A 4qN 7
Q CONTACT PERSON (Report)
LOGGED IN G (INRIAQ
G
SAMPLE k �/ , J
JG J7L
C /,
l
TIME
O PHONE N (Report)
-- -----------QL9-6p•8s----REC
FAX k tP- 6.39' ��%.7
ESONOD ON E Temp(_..-
ACCOUMu
Oa ADDITIONAL ADDRESS (Invoice or Report)
Q��� �,�_ ,�} / G
tW J /1 '/{Q — L
Qs CONTACT PERSON/PHONE N (Add'n)
`j/d-893-37QS• Igo•
Ii.W.AN r<�.d IfOU
SAMPLING CHARGES
Time Mileage Other..���.
T NSPC T
o Requested Turnaround Time:
•Normal (2 weeks)
❑ Rush (1 week)*
❑ Emergency Rush (ASAP)*
OPROJECT NAME P
/ L-T # o� 0.
/
Analyses Requested (Please use catalog a s)
Sample Container Info -
g
Qe PROJECTN / PO p
q
Kf iv.j„,,e
O QUOTE kc
10 Start ++ End Comp Grab
Sample
Type Description
Item
k
_ _ _Date _ _ _
Time/
_ _ _Date _ _
Time
_
°
_.
+< Sample Marks -
----------------- --
-
+s
w
0
n
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Comments
/
16-7-yly.
p
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GRA.B
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as�-16---2.94-
aka
srw
`-------------------------/0
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---------
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TRANSFER p
zo RELINQUISHED BY
DATE / TIME
8 RECEIVED BY
DATE / TIME
az SA PLED) IGN`�URE:
I\• y l ./1 AA /
7. b t
' 2
�� COMMENTS:
3
' CA cfil
SAM-F001 (t/95 *ADDITIONAL CHARGES WILL APPLY. t
COPY

INSTRUCTIONS FOR C®MPLETONG CHAIN OF CUSTODY `
1. Name and complete mailing address to which the final report should be forwarded.
2. Primary contact for any questions regarding this Chain of Custody or the indicated samples.
3. Phone and Fax number for primary contact.
4. Name and complete mailing address to which invoicing or additional report should be directed. Please
indicate invoice or report.
5. Primary contact for any questions regarding invoicing or additional report.
6. Indicate Turn -Around -Time required. *Please note that additional charges may apply for Rush work.
7. Information identifying a particular project name or site location, etc., that will appear on the final report.
8. Project or purchase order number that should be used for invoicing.
9. Southern Testing quote number to be used for invoicing.
10. Each item # represents a unique sample. The last item # should be equal to the number of samples
submitted.
11. Date and Time sampling begun and the Date and Time sampling was completed.
12. Indicate whether the sample is a composite (T = time weighted, F = flow weighted) or a grab.
13. Sample Type: WW = Wastewater, MW = Ground/Monitoring Well Water, SW = Surface Water, DW
Drinking Water, STW = Storm Water, S = Soil, SL = Sludge, U = Unknown, Etc.
14. Sample Description: Primary Sample Marks for identification of sample on laboratory report.
15. Type of sample container: P = Plastic, G = Glass, AG = Amber glass, V = 40 mL EPA purgeable vial,
AV Amber vial, Etc.
16. Sample size (1/2 Gal, 500 mL, 1 lb, 100 g, Etc.).
17. Number of sample containers.
18. For preservation indicate Yes/No or indicate the type of preservation used (i.e. HNO3, pH < 2, Etc.).
19. A - Indicate desired analyses and B - check the appropriate boxes for the relevant samples. Please use
Southern Testing catalog numbers when possible.
20. Individual and date/time samples are turned over to another party.
21. Individual and date/time samples are received by the next party. The only time that the date/time are not
the same for relinquished and received should be if a second party carrier is used.
22. Signature of person collecting the samples.L6 oy W
11
23. Additional comments about this Chain of Custody (i.e. Send additional copies of reports, invoicing
information, Etc.). 53l1d Tt*tlll3;) .U9 00ld

` FIGURE 1
READY MIXED CONCRETE COMPANY
PLANT NO. 20
STORMWATER SAMPLING RECORD
Sampler's Name
Date: M-?- 94
am/pm
MEOW
Im
Outfall Number: Storm Begin Time: %S`0 iYl
I have verified that no storm event measuring greater than 0.1 inches has occurred
in the 72 hours prior to this storm event and that all information recorded herein is
accurate and true to the b t of my knowledge.
Signature: Z .
Flow Begin Time: Y"4r am�o
PH Test Method: pa
er / meter
Storm End Time: �rr� am/pm
Grab Sample Time: 91,69g am n
pH:_-2_
Storm Duration: 13Yy hours
Total Precipitation: /-O inches

FIGURE 2
READY MIXED CONCRETE COMPANY
PLANT NO. 20
VISUAL MONITORING RECORD
Sampler's Name: Jef-Q ey �j4YN0/e
Date: /&) - ? - 961 Outfall Number:
Visual Monitoring Results:
Describe the presence of any of the following parameters in the stormwater
discharge.
C o I o r:, CQ /J/LD�n.9i f6ta�
Q
Odor:
CIarlty:_,a4a4,L�x�gQ
Floating Solids:
D
Suspended Solids: •��r�
Foam: l/t�
Oil Sheen: /jLiO-re
Other Obvious Indicators of Pollution:.

FIGURE 1
READY MIXED CONCRETE COMPANY
PLANT NO. 20
STORMWATER SAMPLING RECORD
Sampler's Name:
Date: Outfall Number: Storm Begin Time: %'f 0 ^ti
am/pm
I have verified that no storm event measuring greater than 0.1 inches has occurred
in the 72 hours prior to this storm event and that all information recorded herein is
accurate and true to the best,aj my knowledge.
Signature:
Flow Begin Time: 8 oS amA om Grab Sample Time: �' �a amA0
pH Test Method: paper / meter pH:
Storm End Time: /; 0 am/pm Storm Duration: /3Y hours
Total Precipitation: f• 0 inches

FIGURE 2
READY MIXED CONCRETE COMPANY
PLANT NO. 20
VISUAL MONITORING RECORD
Sampler's Name: FTe-44kQ
Date: Le -I- 96 Outfall Number:
Visual Monitoring Results:
Describe the presence of any of the following parameters in the storrnwater
discharge.
Color: ,vw�
Odor:
Clarity:/'
0
Floating Solids: Zgi-e
Suspended Solids: 1-&1---,
Foam:,
Oil Sheen:
Other Obvious Indicators of Pollution:

FIGURE 1
READY MIXED CONCRETE COMPANY
PLANT NO. 20
STORMWATER SAMPLING RECORD
Sampler's Name: TJ f- t + A Q)z /�/+TND/C
Date: /0 - %- 9% Outfall Number: J Storm Begin Time: ?-'YPIn
am/pm
r
I have verified that no storm event measuring greater than 0.1 inches has occurred
in the 72 hours prior to this storm event and that all information recorded herein is
accurate and true to the best f my knowledge.
Signature:
Flow Begin Time: 8- dS a pm Grab Sample Time: g� an pr
pH Test Method: per / meter pH: /
I'
i.
Storm End Time: am/pm Storm Duration: / 3 hours
Total Precipitation: AO inches

FIGURE 2
READY MIXED CONCRETE COMPANY
PLANT NO. 20
VISUAL MONITORING RECORD
Sampler's Name:_ Amex,
Date:_ M 9r!o Outfall Number: 3
Visual Monitoring Results:
Describe the presence of any of the following parameters in the stormwater
discharge.
Color: /' ret-1
Odor: '71�
Clarity:dza�
Floating Solids: %te-�
Suspended Solids: -
Foam: -A<9 e-
Oil Sheen: 7Ldn�
Other Obvious Indicators of Pollution:
FEW. 7 +,«

F�Eco fir; �E r,i lr,,L Fig S
JAN 3 D : 97
2 l r
r
i
{
1

FIGURE 2
READY MIXED CONCRETE COMPANY
PLANT NO. 20 . -
VISUAL MONITORING RECORD
Sampler's Name: �Ie-f-CAVY
Dater - %- jc� Outfall Number:
Visual Monitoring Results:
Describe the presence of any of the following parameters in the stormwater
discharge.
Color: C�zo
Odor:_ 41�
Clarity: c- eo
Floating Solids: 911 2
Suspended Solids: 7`,9-r
Foam:—
Oil Sheen: 2wk�
Other Obvious Indicators of Pollution:

nccelv�eo
RFG � �/CkE
L6 0C NVC

STORMWATER DISCHARGE OUrFALL (SDO)
MONITORING REPORT
GLNEXA.L PERMIT NO. NCG140M
CERTIFICATE OF covExAcE No. Ncc,4 0 0 70
F A CILM h AME ?"Wv 6�-IL'4 ---'v. :Z . -0��O
1 9, :reeZ PERSON COLLECTING S YW16��� -A "'I — CERITFTEDLABOILATCORYM�:OLL.L-t;,g,�-4"pud,-Y-5�b# Z,1
Lab #—
Part A: speedk monitaieb xftmireats
I ;;m
-1*04w-
-'
-
Tea
dad -Suppen
Sfids-
1TnQ0dcVvr
nmn
SAMPLES COLLEZI7ED DURING CALENDAR YEAJL
(all ample catiecteddwinga tsiendar tear siuL be reported Dointer than
Ja ry 31 of the (aBowing year)
COUN'ry.
(siWiATuRE OF PERmr= OR DESIGNEE)
By this X*nxtwv, I certify that this report is mccurmte
conspiele to the best of may knovrieiige
1�cv l4-,R,4 -97 1 1 H. (P 115-0
DcmtbubL-ix;p=iotmV,4-�Mzn=m=AcdvrtP=Mmgmxx-�th2c 55 P1lm0(wwm0" Oil P-=m001h'7-7Zn0
cir v m , co=ph= P=B)
1. r -4 1 U IcCJ5
FRIETTEVILLE
REG, OFFICE
Oil -and Grt2m Lemd,_7IoW Defvrrefks�zn- New moms M t
CbDeCUd
7-
,;T()RW, L-;E7%T CTLkRACT13=CS-
Date q.L?q--ql
4 ow Event Pre�tioo fimc6es)-.
Eves Dwipbon (60W0 —
re uxx- um ow slots ev wx swuphmm
DOLE
Torn! Event F, (wc1bft)--
Even: Dwsbm (boars;: —
Matt oripmol and acme copv so
Atim cmmaj Film
DE-Im
DrrsKm or Emvvccco==' M
P.O. Bat --'451,5
PAic:gL NCZ-706-0595
Fam, MR) 4

i JPyvZ Y 3 Pq '
° , Southern Testing & Research Laboratories, Inc.
A 3809 Airport Drive • Wilson, NC 27896 • (9l9) 237-4175 • Fax: [phone] • www.STRLabs.com
9 F A I R P
P�
SAMPLE No.: G2573-001
R E P O R T of A N A L Y S I S Date Reported: 10/17/97
Lyman Austin
Ready Mixed Concrete
P.O. Box 27326 Phone:[phone] X
Raleigh NC 27611 Fax: [phone]
Iwil 411
Client Sample ID: PLANT 20 ANGIER
Marks: Outfall by Conveyor
Collected: 09/24/97 12:07 Matrix: STORMWATER
Received: 09/25/97 12:00 Classification: ENV
CAT No. ANALYSES MDL RESULT UNITS
EW-034 pH (Laboratory) 10.3 SU
EW-040.1 Solids: Total Suspended 2 238 mg/L
COMMENTS:
Laboratory Contact(s): Rev wed and Approved by:
Chris Mathis James B. Cox, yii'�B.
Section Head, Water Quality Manager, Environmenta Dept.
Page 1 of 4 G2573R.965 (BK1:V2R07.2) 10/17/97 16:13
Chemical and Microbiological Analyses: Environmental Industrial Hygiene • Agrochemical • Foods • Pharmaceuticals

REW BY Cr?+1 nAL FlLES
JAN 30 98
0

' JP�ytY SFq`(,
° m Southern Testing & Research Laboratories, Inc.
'A 3809 Airport Drive Wilson, NC 27896 • [phone] • Fax: [phone] • www.STRLabs.com
9 F4 I R ?
e
SAMPLE No.: G2573-002
R E P O R T of A N A L Y S I S Date Reported: 10/17/97
Lyman Austin
Ready Mixed Concrete
P.O. Box 27326 Phone:[phone] X
Raleigh NC 27611 Fax: [phone]
P. 0.: 20
Client Sample ID: PLANT 20 ANGIER
Marks: Outfall by Pond Grab
Collected: 09/24/97 12:08 Matrix: STORMWATER
Received: 09/25/97 12:00 Classification: ENV
CAT No. ANALYSES MDL RESULT UNITS
EW-034 pH (Laboratory) 10.2 SU
EW-040.1 Solids: Total Suspended 3 193 mg/L
COMMENTS:
Laboratory Contact(s): Rev
,Uwed and Approved by:
Qi
Chris Mathis James B. Cox, II, B.
Section Head, Water Quality Manager, Environment Dept.
Page 2 of 4 G2573R.965 (BK1:V2R07.2) 10/17/97 16:13
Chemical and Microbiological Analyses: Environmental • Industrial Hygiene • Agrochemical • Foods • Pharmaceuticals

RFCD BY CEtlT ML F
JAN 30.98

JPystI SPq iC
0 m
9 'Al 1n P
a
Southern Testing & Research Laboratories, Inc.
3809 Airport Drive • Wilson, NC 27896 • [phone] • Fax: [phone] • www.SI'RLabs.com
R E P O R T of A N A L Y S I S
Lyman Austin
Ready Mixed Concrete
P.O. Box 27326
Raleigh NC 27611
Client Sample ID: PLANT 20 ANGIER
Marks: Outfall by Wash Pit
SAMPLE No.: G2573-003
Date Reported: 10/17/97
Phone:[phone] X
Fax: [phone]
P. 0.: 20
Collected: 09/24/97 12:11 Matrix: STORMWATER
Received: 09/25/97 12:00 Classification: ENV
CAT No. ANALYSES
EW-034 pH (Laboratory)
EW-040.1 Solids: Total Suspended
COMMENTS:
MDL RESULT UNITS
12.0 SU
1 68 mg/L
Laboratory Contact(s): Revi r� n�ppr� by:
Chris Mathis James B. Cox, III, B.S.
Section Head, Water Quality Manager, Environmental Dept.
Page 3 of 4 G2573R.965 (BK1:V2R07.2) 10/17/97 16:13
Chemical and Microbiological Analyses: Environmental • Industrial Hygiene - Agrochemical - Foods • Pharmaceuticals

RFco er cEMMAL
JAN 30 98

a
Southern Testing & Research Laboratories, Inc.
3809 Airport Drive • Wilson, NC 27896 • [phone] • Fax: [phone] • www.SI'RLabs.com
R E P O R T of A N A L Y S I S
SAMPLE No.: G2573-004
Date Reported: 10/17/97
Lyman Austin
Ready Mixed Concrete
P.O. Box 27326 Phone:[phone] X
Raleigh NC 27611 Fax: [phone]
Hwjwo�t
Client Sample ID: PLANT 20 ANGIER
Marks: Outfall Natural Area
Collected: 09/24/97 12:05 Matrix: STORMWATER
Received: 09/25/97 12:00 Classification: ENV
CAT No. ANALYSES
EW-034 pH (Laboratory)
EW-040.1 Solids: Total Suspended
MDL RESULT UNITS
m
11.6 SU
150 mg/L
COMMENTS:
Laboratory Contact(s): Rev wed and Approved by:
Chris Mathis James B. Cox, III, B.S.
Section Head, Water Quality Manager, Environmental Dept.
Page 4 of 4 G2573R.965 (BK1:V2R07.2) 10/17/97 16:13
Chemical and Microbiological Analyses: Environmental • Industrial Hygiene - Agrochemical • Foods • Pharmaceuticals

tY sEyL
° SOUTHERN TESTING
& RESEARCH LABORATORIES, INC.
3809 Airport Drive •Wilson, NC 27896
CHAIN OF CUSTODY
& ANALYSIS REQUEST
SEE REVERSE FOR INSTRUCTIONS
PAGE / of /
'Ervin°' aio-cor-•afro-ran. yin-cor -yo•+i
+OORIGINAL REPORT TO:pp (Company and Individual)
-------------------------
dress) d
36
Q CONTACT PERSON (Report)
GE !BY (INfT1AEj ^.
p ��
"
Q ONE 4(Repor?/, �,y0./`�O�
FAX a /- 0
REO'DON]l
'NO TTerClp
ACCOUNT M
a� ADDITIONAL ADDRESS (Invoice or Report)
c, a 7Go
CONTACT PERSON/PHONE # (Add IIIL7yrr50
N HA
M�age
Re uested Turnaround TimE
4
RrNormal (2 weeks)
❑ Rush (1 week)*
❑ Emergency Rush (ASAP)*
"
Vdo
Sample Container Info Analyses Requested (please use catalog It's)
° ( 9
o N¢ o a"
o y a c 19 A
# O QUOTE #
Sample
° Start End comp crab type Description
dt�m
#a-
Date
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DATE TIME
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DATE /TIME
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I ': SAM - HX)I (1/97)
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COPY

tiiiM IT Hll»;J '110NOD �:©G3 C00 [,Vd F It,i 7'y`�iC� C0'r 1AIM (O> p cl"12`G'C)����
1. Name and complete mailing address to which the final report should be forwarded.
2. Primary contact for any questions regardmg this Chain of Custody or the indicated samples.
3. Phone and Fax number for primary contact,'
4. Name and complete mailing address to which invoicing or additional report should be directed. Please
indicate invoice or report.
5. Primary contact for'any questions regarding invoicing or additional report.
6. Indicate Turn-Around7Time required. h?iatse mote thza additional chalges may apply for Lush work.
7. Information identifying a particular project name or site location, etc., that will appear on the final report.
8. Project or purchase order number that should be used for invoicing.
9. Southern Testing quote number to be used for invoicing.
10. Each item # represents a unique sample. The last item # should be equal to the number of samples
submitted.
11. Date and Time sampling begun and the Date and Time sampling was completed.
12. Indicate whether the sample is a composite (T = time weighted, F = flow weighted) or a grab.
13. Sample -Type: WW = Wastewater, MW Ground/Monitoring Well Water, SW = Surface Water, DW =
Drinking Water, STW = Storm Water, S = Soil, SL = Sludge, U = Unknown, Etc.
14. Sample Description: Primary Sample Marks for identification of sample on laboratory report.
15. Type of sample container: P = Plastic, G = Glass, AG = Amber glass, V = 40 mL EPA purgeable vial,
AV = Amber vial, Etc.
16. Sample size (1/2 Gal, 500 mL, 1 lb, 100 g, Etc.).
17. Number of sample containers.,
18. For preservation indicate Yes/No or indicate the type of preservation used (i.e. HNO3, pH < 2, Etc.).
19. 6A - Indicate desired analyses and B - check the appropriate boxes for the relevant samples. Please use
Southern Testing catalog numbers when possible.
20. Comments related to required detection limits, method detection limits, expected levels, etc.
21. individual and date/time samples are turned over to another party.
22. Individual and date/time samples are rec66ert16yNVr next party. The only time that the date/time are not
the same for relinquished and rece+aid should be it a second party carrier is used.

FIGURE 1
READY MIXED CONCRETE CQMPANY
PLANT NO. �' I—
STORMWATER SAMPLING RECORD
Sampler's Narne: GE-7 _
Date: 9-0 Y 22 Outfall Number:_ Storm Begin Time://DD mA
am/pm
have verified that no storm event measuring greater than 0.1 inches has occurred
In the 72 hours prior to this storm event and that all information recorded herein is
accurate and true to the best of my knowledge.
p \
Signature: �n..AA-,'CL,e„
Flow Begin Time: anopm Grab Sample Time: /1/ O(o _ am pin
pH Test Method: paper / meter pH: 9
Storm End Time: am/pm Storm Duration: hours
Total Precipitation: inches
I

FIGURE 2
READY MIXED CONCRETE COMPANY
PLANT NO. X)
VISUAL MONITORING RECORD
Sampler's Name: Aoc.�e7 eTF�i✓1 CAN
Date: _ 9- av-9� Outfall Number:
Visual Monitoring Results:
Describe the presence of any of the following parameters in the stormwater
discharge.
Color:
Odor:ti�
Clarity: \4n.. A,. -
Floating Solids:!"
Suspended Solids: Da*., �
Foam: J
Oil Sheen:
Other Obvious Indicators of Pollution: l a
it', --
j

E
FIGURE 1
READY MIXED CONCRETE COMPANY
PLANT NO. ,_
STORMWATER SAMPLING RECORD
Sampler's Name: IftJG,_ JFli^17-N/4n/
Date: y-97 Outtall Number: Storm Begin Time:/;cow
am/pm
I have verified that no storm event measuring greater than 0.1 inches has occurred
In the 72 hours prior to this storm event and that all Informatibn recorded herein is
accurate and true to the best of my knowledge.
Signet
Flow Begin Time:4,oa amho
pH Test Method: paper / meter
Storm End Time: am/pm
Grab Sample Time: 7i'0 amt ®r
PH: ? —
Storm Duration: hours
Total Precipitation: inches
..N

FIGURE 2
READY MIXED CONCRETE COMPANY
PLANT NO. Q_
VISUAL MONITORING RECORD
Sampler's Name:
J E7XI �Ce,4N
Date: 9-t7l`f-97
Outfall Number:
Visual Monitoring
Results:
Describe the presence of any of the following parameters in the stormwater
discharge.
Color:
Odor:
Floating Solids:C;��
Suspended Solids:
Foam: /2 � .
Oil Sheen:
1
Other Obvious Indicators of Pollution,

FIGURE 1
READY MIXED CONCRETE COMPANY
PLANT NO. .910
STORMWATER SAMPLING RECORD
Sampler's Name: tIGC S�iC�jc/IGih/
Date: 907 Outfall Number:- Storm Begin Time: /e
am/prn
I have verified that no storm event measuring greater than 0.1 Inches has occurred
In the 72 hours prior to this storm event and that all information recorded herein is
accurate and true to the best of my knowledge.
Signature: A z _
Flow Begin Time: am pm Grab Sample Time: 17:/D am�
pH Test Method: paper / meter pH: /z2
Storm End Time: am/pm Storm Duration: hours
Total Precipitation: 0,8 inches
0

FIGURE 2
READY MIXED CONCRETE COMPANY
PLANT NO. �J
p VISUAL MONITORING RECORD
Sampler's Name: r�UCE
Date: %,2�/-/2 Outfall Number: .3
Visual Monitoring Results:
Describe the presence of any of the following parameters in the stormwater
discharge.
Color:
Odor:j2zl,,.t A,
Clarity:
Floating Solid
Suspended Solids:
Oil Sheen:_ `, ,, �✓
Other Obvious Indicators of
t
L.I
i
O

WIF
FIGURE 1
READY MIXED CONCRETE COMPANY
PLANT NO. _-2d_
STORMWATER SAMPLING RECORD
Sampler's Name: UGC <T4-�elyz-6A^l
Date: /� ��f `/� Outfall Number:__ Storm Begin Time:
am/pm
I have verified that no storm event measuring greater than 0.1 inches has occurred
In the 72 hours prior to this storm event and that all informatibn recorded herein is
accurate and true to the best of my knowledge.
Signature:
Flow Begin Time: /) ; oa .arn pr Grab Sample Time: /o?%6 V am/0
pH Test Method: paper / meter
Storm End Time: am/pm
FIR
pH: A2
Storm Duration: hours
Total Precipitation: a - inches
;. o

FIGURE 2
READY MIXED CONCRETE COMPANY
PLANT NO._QC�_
VISUAL MONITORING RECORD
Sampler's Name:_
Date: Outfall Number:
Visual Monitoring Results:
Describe the presence of any of the following parameters in the stormwater
discharge''.
Color:_L/
CIarity:dh
Floating Solids: 171r1M I�� Qo
Suspended Solids:
Foam:
Oil Sheen: e
Other Obvious Indicators of•IPollutior% /y�.,p/

RECD SY CL JT7W FILES
JAN 30 98 .