NCS000528_MONITORING INFO_20191023

STORMWATER DIVISION CODING SHEET
NCS PERMITS
PERMIT NO.
�I C � v 001sd
I
DOC TYPE
El FINAL PERMIT
L%( MONITORING REPORTS
❑ APPLICATION
❑ COMPLIANCE
❑ OTHER
�I Cl I
DOC DATE
❑ Ci
YYYYMMDD

ajWrERS EC7GE ENVIRONMENTAL, LLC
434 CHESTER ROAD • RALEIGH, NC 27608 • PHONE [phone]
October 23, 2019
NCDEQ
Division of Water Quality
Central Files
1617 Mail Service Branch
Raleigh, North Carolina 27699-1617
Reference: Year 5- Period 2 Stormwater Monitoring Report
Premiere Fibers Facility
Ansonville, North Carolina
Stormwater Permit No. NCS000528
Waters Edge Job No. R9-21
To Whorn It May Concern:
We are presenting the stormwater monitoring report for Year 5- Period 2 in 2019. All results are within
required parameters with the exception of the following:
• Outfall 005- pH (5.5 versus benchmark between 6-9- unitless)
It is felt that with acid rain, the pl-i across North Carolina and the remainder ofthe country is decreasing
and is not due to any anthropogenic activities at the site. We do not believe it justifies a Tier 11 inspection.
We have attached the DMR, SDO, and laboratory analytical results -see Appendix A and B). Ifyou have
any questions, or if we may be of further assistance, please contact me at prahn a,watersedgeenv.com or
9 l 9.219.5820.
Sincerely,
Waters Edge Environmental, LI-C
Phillip L. Rahn
President
cc: Mr. Dewey Fulton and Mr. Kevin Bowers- Premier Fibers
19-073

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
Permit Number: NCS 000528 or SAMPLES COLLECTED DURING CALENDAR YEAR: 2019
Certificate of Coverage Number: NCG (This monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
FACILITY NAME Premiere Fibers
PERSON COLLECTING SAMPLE(S) T. Haynes
CERTIFIED LABORATORY(S) Pace Lab # 633
Lab #
Part A: Specific Monitoring Requirements
COUNTY Anson
PHONE NO. [phone]
(SIGNATURE OF PERNTITTEE OR DESIGNEE)
By this signature, 1 certiA, that. this report is accurate complete to
the best of my knowledge.
'Outfall
No.
-Date
Sample
Collected
Total
Rainfall
Total
Suspended
Solids (TSS)
COD
pH
Permit Bench
NIA
1Qfl
120
6-9
mo/dd/yr
inches
mg/1
mg/l _
Units
1
10.16.19
See Below
10.2
ND
6.1
2
10.16.19
5.3
ND
6.4
3
10.16.19
5.0
ND
6.3
4
10.16.19
9.2
104
7.0
5
10.16.19
100
85.0
4.3
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes ✓ no (if yes, complete Part B)
Form SWU-246-112608
Pagel of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50056
00556
00530
00400
Total Flow
(if applicable)
Total Rainfall
Oil & Grease
Total
Suspended
Solids
pH
New Motor Oil
Usage
mo/ddiyr
MG
inches
mg/1
mgA
Units
gavmo
STORM EVENT CHARACTERISTICS:
Date 10.16.19
Total Event Precipitation (inches):
Event Duration (hours): NIA
0.32
(if more than one storm event was sampled)
Date NIA
Total Event Precipitation (inches):
Event Duration (hours):
(only if applicable — see permit.)
(only if applicable — see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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."
eignatuW�. &--j
a of Permittee
/zv 11q
Date
Form SV U-246-112648
Page 2 of 2

r
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out Phis form, please visit: http://h2o.enr.state.nc.us/su/Forms Documents.htm#miscfornts
Permit No.: l N I C� S 1 0� 0 10 15 12 18 1 or Certificate of Coverage No.:
Facility Name: Premiere Fibers
County: Anson
Inspector: Thomas Haynes
Date of Inspection: 10.16.19
Time of Inspection: 11:00-12:00/10:30 AM
Total Event Precipitation (inches): 0.32
Phone No. 704,826.8321
Was this a Representative Storm Event? (See information below) ❑ Yes ❑ No
Please check your permit to verify if Qualitalive Monitoring must he performed during a representative storm event
(requirements var)).
A "Representative Storm Invent" is a storm event that measures greater than 0. i inches of rainfall and that
is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.1 inches has
occurred. A single storm event may contain tip to 10 consecutive hours of�no precipitation.
By this signature, I certify that this report is accurate
�and
'complete to the best of my knowledge:
(Signature of Permittee or Designee)
1 Outfall Description:
Outfall No. 001-005 Structure (pipe, ditch, etc.) Pipe to Ditch
Receiving Stream: Buffalo Creek
Describe the industrial activities that occur within the Outfall drainage area:
Textile Manufacturina
2 Color:
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as
descriptors:
Liaht brown
Page I oft
S W U-242-1 12608

3 Odor:
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.):
No odor noted
4 Clarity:
Choose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy:
1 Q 3 4 5
5 Floating Solids:
Choose the number which best describes the amount of floating solids in the stormwater discharge, where l is no
solids and 5 is the surface covered with floating solids:
1 O 3 4 5
6 Suspended Solids:
Choose the number which best describes the amount of suspended solids in the stormwater discharge, where l is no
solids and 5 is extremely muddy:
1 O 3 4 5
7 Is there any foam in the stormwater discharge? Yes No
8 Is there an oil sheen in the stormwater discharge? Yes No
9 Is there evidence of erosion or deposition at the outfall? Yes No
10 Other Obvious Indicators of Stormwater Pollution:
List and describe
None
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be indicative o1'
pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
S W U-242-1 12608

aceAnapical
www.pacelab&=n
October 22, 2019
Mr. Phil Rahn
Waters Edge Environmental
1434 Chester Road
Raleigh, NC 27606
RE: Project: PREMEIRE FIBERS
Pace Project No.: 92449936
Dear Mr. Rahn:
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 27288
Enclosed are the analytical results for sample(s) received by the laboratory on October 16, 2019.
The results relate only to the samples included in this report. Results reported herein conform to the
most current, applicable TNIINELAC 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,
Clayton McCrickard
[e-mail]
[phone]
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,
[phone]
Page 1 of 12

aceAnalytical
www.pscelabs wm
Project: PREMEIRE FIBERS
Pace Project No.: 92449936
Asheville Certification IDs
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #: 37712
Eden Certification IDs
205 East Meadow Road Suite A, Eden, NC 27288
North Carolina Drinking Water Certification #; 37738
CERTIFICATIONS
North Carolina Wastewater Certification #; 40
South Carolina Certification #: 99030001
VirginiaNELAP Certification #: 460222
North Carolina Wastewater Certification #: 633
VirginiaNELAP Certification #: 460025
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pate Analytical Services, LLC,
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Page 2 of 12

aceAnalyfrcal.
wwwpecefaesc=
SAMPLE SUMMARY
Project: PREMEIRE FIBERS
Pace Project No.: 92449936
Lab ID
Sample ID
Matrix
Date Collected
Date Received
92449936001
OUTFALL 001
Water
10/16/19 11:00
10/16/19 15:41
92449936002
OUTFALL 002
Water
10/16119 11:15
10/16/19 15:41
92449936003
OUTFALL 003
Water
10/16/19 11:30
10/16/19 15:41
92449936004
OUTFALL 004
Water
10/16119 11:45
10/16/19 15:41
92449936005
OUTFALL 005
Water
10/16/19 12:00
10/16/19 15:41
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Page 3 of 12

t ,
laneAnalyticai'll'
WW;Wcefab&WM
Project: PREMEIRE FIBERS
Pace Project No.: 92449936
Lab ID Sample ID
92449936001 OUTFALL 001
92449936002 OUTFALL 002
92449936003 OUTFALL 003
92449936004 OUTFALL 004
92449936005 OUTFALL 005
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NO 27288
[phone]
SAMPLE ANALYTE COUNT
Method
Analysts
Analytes
Reported
Laboratory
SM 2540D-2011
NMH
1
PASI-E
SM 4500-H+B-2011
MWF
1
PASI-E
SM 5220D-2011
GC
1
PASI-A
SM 25400-2011
NMH
1
PASI-E
SM 4500-H+6-2011
MWF
1
PASt-E
SM 522OD-2011
GC
1
PASI-A
SM 2540D-2011
NMH
1
PASI-E
SM 4500-H+B-2011
MWF
1
PASI-E
SM 5220D-2011
GC
1
PASI-A
SM 2540D-2011
NMH
1
PASI-E
SM 4500-H+B-2011
MWF
1
PASI-E
SM 52200-2011
GC
1
PASI-A
SM 2540D-2011
NMH
1
PASI-E
SM 4500-H+B-2011
MWF
1
PASI-E
SM 5220D-2011
GC
1
PASI-A
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC, Page 4 of 12

Pace Analytical Services, LLC
aceAnalytical
2fl5 East Meadow Road -Suite A
Eden, NC 27288
www.pacwabs.com
[phone]
ANALYTICAL RESULTS
Project: PREMEIRE FIBERS
Pace Project No.: 92449936
Sample: OUTFALL 001
Lab ID: 92449936001 Collected: 10/16/19 11:00
Received: 10/16/19 15:41 Matrix: Water
Report
Parameters
Results Units Limit MDL DF
Prepared Analyzed CAS No. Qual
2540D TSS, Low -Level, Eden
Analytical Method: SM 2540D-2011
Total Suspended Solids
10.2 mglL 2.0 2.0 1
10/17/19 14:17 D6
4500H+ pH, Electrometric EDN
Analytical Method: SM 4500-H+B-2011
pH at 25 Degrees C
6.1 Std. Units 0.10 0.10 1
10/17/19 15:40 H3
5220D COD
Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Chemical Oxygen Demand
ND mg/L 25.0 12.5 1
10/17/19 19:10 10/18/19 15:23
Sample: OUTFALL 002
Lab ID: 92449936002 Collected: 10/16/19 11:15
Received: 10/16119 16:41 Matrix: Water
Report
Parameters
Results Units Limit MDL DF
Prepared Analyzed CAS No. Qual
2540D TSS, Low -Level, Eden
Analytical Method: SM 254OD-2011
Total Suspended Solids
5.3 mg/L 1.0 1.0 1
10/17/19 14:31
4500H+ pH, Electrometric EDN
Analytical Method: SM 4500-H+B-2011
pH at 25 Degrees C
6.4 Std, Units 0.10 0.10 1
10/17/19 15:43 H3
5220D COD
Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Chemical Oxygen Demand
ND mglL 25.0 12.5 1
10/17/19 19:10 10/18119 15:23
Sample: OUTFALL 003
Lab ID: 92449936003 Collected: 10116/19 11:30
Received: 10/16/19 15:41 Matrix: Water
Report
Parameters
Results Units Limit MDL DF
Prepared Analyzed CAS No. Qual
2540D TSS, Low -Level, Eden
Analytical Method: SM 254OD-2011
Total Suspended Solids
5.0 mg1L 1.0 1.0 1
10/17/19 14:32
4500H+ pH, Electrometric EDN
Analytical Method: SM 4500-H+B-2011
PH at 25 Degrees C
6.3 Std. Units 0.10 0.10 1
10/17/19 15:44 H3
5220D COD
Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Chemical Oxygen Demand
ND mg/L 25.0 12.5 1
10/17/19 19:10 10/18/19 15:23
Sample: OUTFALL 004 Lab ID: 92449936004 Collected: 10/16119 11:45 Received: 1011609 15:41 Matrix: Water
Report
Parameters Results Units Limit MDL DF Prepared Analyzed CAS No. Qual
26400 TSS, Low -Level, Eden Analytical Method: SM 254OD-2011
Total Suspended Solids 9.2 mglL 1.0 1.0 1 10/17/19 14:32
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 10/22/2019 08:26 AM without the written consent of Pace Analytical Services, LLC.
Page 5 of 12

Pace Analytical Services, Li
aceAnalytical a 205 East Meadow Road - Suite A
Eden, NC 27288
WWW pacelabscom [phone]
ANALYTICAL RESULTS
Project: PREMIERE FIBERS
Pace Project No.: 92449936
Sample: OUTFALL 004 Lab iD: 92449936004 Collected: 10/16/19 11:45 Received: 10/16/19 15A1 Matrix: Water
Report
Parameters Results Units Limit MDL DF Prepared Analyzed . CAS No. Qual
4500H+ pH, Electrometric EDN Analytical Method: SM 4500-H+i3-2011
pH at 25 Degrees C 7.0 Std. Units 0.10 0.10 1 10/17/19 15:46 H3
5220D COD Analytical Method: SM 52200-2011 Preparation Method: SM 5220D-2011
Chemical Oxygen Demand 104 mg/L 25.0 12,5 1 10/17/19 19:10 10/18/19 15:23
Sample: OUTFALL 005
Parameters
Lab ID: 92449936005 Collected: 10/16/19 12:00
Report
Results Units Limit MDL DF
Received: 10/16/19 15:41 Matrix: Water
Prepared Analyzed CAS No. Qual
2540D TSS, Low -Level, Eden
Analytical Method: SM 254OD-2011
Total Suspended Solids
100 mg1L 5.9 5.9 1
10/17/19 14:33
45(1 pH, Electrometric EDN
Analytical Method: SM 4500-H+B-2011
pH at 25 Degrees C
4.3 Std. Units 0.10 0.10 1
10/17/19 15:51 H3
5220D COD
Analytical Method: SM 5220D-2011 Preparation Method: SM 52200-2011
Chemical Oxygen Demand
85.0 mg/L 25.0 12.5 1
10/17/19 19:10 10/18/19 15:23
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 10/22/2019 08:26 AM without the written consent of Pace Analytical Services, Li Page 6 of 12

�r
aceAnalytical.
wwwpaoerab.tcoM
QUALITY CONTROL DATA
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Project: PREMEIRE FIBERS
Pace Project No.: 92449936
QC Batch: 504242 Analysis Method: SM 254OD-2011
QC Batch Method: SM 254OD-2011 Analysis Description: 2540D TSS, Low Level, Eden
Associated Lab Samples: 92449936001, 92449936002, 92449936003, 92449936004, 92449936005
METHOD BLANK: 2709815 Matrix: Water
Associated Lab Samples: 92449936001, 92449936002, 92449936003, 92449936004, 92449936005
Blank Reporting
Parameter Units Result Limit MDL Analyzed Qualifiers
Total Suspended Solids mg1L ND 1.0 1.0 10/17/19 14:15
LABORATORY CONTROL SAMPLE: 2709816
Spike LCS LCS % Rec
Parameter Units Conc Result % Rec Limits Qualifiers
Total Suspended Solids mg1L 250 232 93 90-110
SAMPLE DUPLICATE: 2709817
92449941001 Dup Max
Parameter Units Result Result RPD RPD Qualifiers
Total Suspended Solids mg/L <2.0 ND 5
SAMPLE DUPLICATE: 2709818
92449936001 Dup Max
Parameter Units Result Result RPD RPD Qualifiers
Total Suspended Solids mg/L 10.2 7.8 27 5 D6
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: 10/22/2019 08726 AM without the written consent of Pace Analytical Services, LLC. Page 7 of 12

Pace Analytical Services, LLC
205 East Meadow Road - Suite A
aceAnalytical Eden, NC 27288
www.paCelabscom [phone]
QUALITY CONTROL DATA
Project: PREMEIRE FIBERS
Pace Project No.: 92449936
QC Batch: 504489 Analysis Method: SM 4500-H+B-2011
CC Batch Method: SM 4500-H+B-2011 Analysis Description: 4500H+B PH EDEN
Associated Lab Samples: 92449936001, 92449936002, 92449936003, 92449936004, 92449936005
SAMPLE DUPLICATE: 2711046
92449936001 Dup Max
Parameter Units Result Result RPD RPD Qualifiers
PH at 25 Degrees C Std. Units 6.1 6.1 0 10 H3
Results presented an 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: 10122/2019 08:26 AM without the written consent of Pace Analytical Services, LLC.
Page 8 of 12

aceAnalytical"
~..paca'abl=
QUALITY CONTROL DATA
Project: PREMEIRE FIBERS
Pace Project No.: 92449936
QC Batch: 504334 Analysis Method: SM 5220D-2011
QC Batch Method: SM 5220D-2011 Analysis Description: 5220D COD
Associated Lab Samples: 92449936001, 92449936002, 92449936003, 92449936004, 92449936005
METHOD BLANK: 2710417 Matrix: Water
Associated Lab Samples: 92449936001, 92449936002, 92449936003, 92449936004, 924499360D5
Blank Reporting
Parameter Units Result Limit MDL Analyzed
Chemical Oxygen Demand mg1L ND 25.0 12.5 10/18119 15:18
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Qualifiers
LABORATORY CONTROL SAMPLE: 2710418
Spike LCS LCS % Rec
Parameter Units Conc. Result % Rec Limits Qualifiers
Chemical Oxygen Demand mglL 750 750 100 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2710419 2710420
MS MSD
92449632006 Spike Spike MS MSD MS MSD % Rec Max
Parameter Units Result Conc. Conc, Result Result % Rec % Rec Limits RPt7 RPD Qual
Chemical Oxygen Demand mglL 362 100 100 464 457 102 95 90-110 2 3
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2710421 2710422
MS MSD
92449936005 Spike Spike MS MSD MS MSD % Rec Max
Parameter Units Result Conc. Conc: Result Result % Rec % Rec Limits RPD RPD Qual
Chemical Oxygen Demand mglL 85.0 100 100 184 189 99 104 90-110 3 3
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: 10/22/2019 08:26 AM without the written consent of Pace Analytical Services, LLC.
Page 9 of 12

aceAnalytrcal.
www.pecera&="
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 272$8
[phone]
QUALIFIERS
Pro)ect: PREMEIRE FIBERS
Pace Project No.: 92449936
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.
MIX -Adjusted Method Detection Limit.
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 speciFlc 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 Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyt 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.
PASI-A Pace Analytical Services -Asheville
PASI-E Pace Analytical Services - Eden
ANALYTE QUALIFIERS
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
H3 Sample was received or analysis requested beyond the recognized method holding time.
REPORT OF LABORATORY ANALYSIS
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Date: 10/22/2019 08:26 AM without the written consent of Pace Analytical Services, LLC. Page 10 of 12

Pace Analytical
Services, LLC
e
Iacmnalyfica(Eden,
205 East Meadow Road - Suite A
NC 27288
wwwpecelabacam
(�
{336}623-8821
QUALITY
CONTROL DATA CROSS REFERENCE TABLE
Project:
PREMEIRE FIBERS
Pace Project No.:
92449936
Analytical
Lab ID
Sample ID
QC Batch Method
QC Batch
Analytical Method
Batch
92449936001
OUTFALL 001
SM 254OD-2011
504242
92449936002
OUTFALL 002
SM 2540D-2011
504242
92449936003
OUTFALL 003
SM 2540D-2011
504242
92449936004
OUTFALL 004
SM 25400-2011
504242
92449936005
OUTFALL 006
SM 2540D-2011
504242
92449936001
OUTFALL 001
SM 4500-H+B-2011
504489
92449936002
OUTFALL 002
SM 4500-H+B-2011
504489
92449936003
OUTFALL 003
SM 4500-H+B-2011
504489
92449936004
OUTFALL 004
SM 4500-H+B-2011
504489
92449936005
OUTFALL 005
SM 4500-H+B-2011
504489
92449936001
OUTFALL 001
SM 5220D-2011
504334
SM 5220D-2011
504536
92449936002
OUTFALL 002
SM 52200-2011
504334
SM 5220D-2011
504536
92449936003
OUTFALL 003
SM 52200-2011
504334
SM 5220D-2011
504536
92449936004
OUTFALL 004
SM 5220D-2011
504334
SM 5220D-2011
504536
92449936005
OUTFALL 005
SM 5220D-2011
504334
SM 5220D-2011
504536
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 10/22/2019 08:26 AM without the written consent of Pace Analytical $ervices, LLC. Page 11 of 12

ti
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�� CHAIN -OF -CUSTODY Analytical Request Document
LAB USE ONLY- Affix Wor'' !
- Wo# : 92449936
�' �aceAnaV cal+'
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• Chain -of -Custody is a LEGAL DOCUMENT - Complete all releven: fields
WATERS EDGE ENV
information:
(Billing
ALL SHAD(
92449936
1434 CHESTER ROAD
1
Container Preservative 1,
- —T wy
THOMAS HAYNES
µ
I
�'�'�•'•�"•���j
•' Prestrvative Types: (1) nitric acid, f2) sutfuric acid. (3) hydrochloric acid, (4) sodium hydroxide. (5) zinc xeiate,
f6) methanol, (7) sodium bisulfate, JS) sodium thiesul7ate. 191 hexane, JA) ascorbic acid, (8) ammonium sulfate.
PHIL RAHN
Site Collection Info/Address:
IQ ammonium hydroxide, ID) TSP, (u) Unprasrrved, (0) Other
Analyses
Lab Profile/Line: j
PREMIERE FIBERS STORM WATER
RALEIGH, NC 27606
iav Sample Receipt chec'r.list:
Cus Cody Seats Present/Intact Y I j
Custody signatures t ?resenY
Site/Facility ID #:
Compl' ce Monitoring?
1919) 859-9987
,
Yes j j No
collector Signature Present Ott ❑A
Bottles Intact
correct Bottles
Collected ByL .
Purchase Order # :
DW PWS ID #:
-�
.�uoteu:
JJCj_NZ/
/ r
DW Location Code:
Sufficient 'tnlume . art N1
Samples Received on ice A
accepfabl.e
Collected By w re} IiTurnaround
_
Date Required:
immediately Packed on lee.
�,Y
^ssposal:
`
(t.f'Yes [ ) No
VO;, - 3?cads;:ace Y :1.
USN: R gvlaced Sails Y it ,
sa pies in Holding Tine rN:,
Sam
Rush:
Field Filtered(if applicable}:
( ispozeasappropriate ( ] Return
I(
) ) Same Day ] j Next Day
( ) Yes [ ) No
t<esideai .Chlorine P/r�e e t Y +i1
c: strips:. 1.f`SL�
J Archive:
( ] 2 Day [ ] 3 Day ( ] 4 Day [ ] 5 Day
Sample pH ACCeptable 11A
( ] old:
(Expedite CharDes Apply)
Analysis:
d
pH SLi:ps : `'� ✓k�
Sulfide Present Y N un
• Matrix Codes (Insert in Matrix box below}: Drinking Water (DW), Ground Water (GW), Wastewater (WW),
Product (P), Soil/Solid (SQ. Oil (OL), wipe (WP), Air (AR), Tissue (TS), Bioassay JB), vapor (V), Other (OT)
ILL.l.eao
.
Acetate. strips:CL
E
LAB U5_ ONLY:
Comp /
Collected Jpr
Res
# of
Customer Sample ID
Matrix'
Grab
Composite Start}
Composite End
Cl
Ctns
0
Lab Sample # / comatents:
d ,
7
LU
Date
Time
Dale
Time
OUTFALL 001
WT
I IC rL
r/
I
X
X
X
X
OUTFALL 002
WT
I
3
x
x
x
OUTFALL 003
WT
/
3
x
x
x
OUTFALL 004
WT
/
I
x
{ x
X,
OUTFALL 005
WT
,- _�
l
k
x
x
x
-
- -
a
I
I- -
t
- •.€
p
3.
�
_
ter
_
--t.'-.
�
�
! - -__ - '_-.;.I
Customer Remarks / Special Conditions / Possible Hazards:' `
_
ype of foe Used: , t.. Blue: Dry None ;'t}SHORT itOLDS
PRESENT (02 hou`rS)
N/A
r 13 SatnRle Temperature Info: `"
ITS-
�i✓N
91.]'1K 4cR 1L'ed:-',Y y
�iiR•'•✓.
.. -•
TiC x
Tenp uaarin
P" .�.}. i- .p; �.- '• l'IR -
acktn� Male a[,Uscd A. r ,? F S t }tali Trac , g ^ a art
rax.s f'.w 3 T�` r r: r. - w r.,4 +.'. ^ )i Z.'S rr r3 .d- • �f:.
r-'tc
w _ - . -
E., �j /Samples ecerredvta r,
��_
�,<wn
Cooie a The era Ca- 4' aetos;;'. krC
-ale
Radchemsample(s)screened'{c5170cprri} - Y:. N f y'
- - wFEDEX : ' UPS 'Cpuripr •Pace Courier '
1
'
.• nt
Relinnguii shed by, parry: (Signature)
/Date/Time,
Receiyed lay/Comp(an(yy: iig�n/aa u�re)
�Ierime
MTJL LAB USE ONL
Ir:
c anquished by/ p y: (Signature)
D teri ie:
.r[Table
ecei'4d-oiy/Company: (Si�,/tatV4)
DateyTime:
Acctnuirl:
Trip Blank Received: Y N NA
Template:
113felogin:
HCL McOH TSP Other
' !!
IPMw. j`I � L
Relinquished by/Company: (Signaturel
Date/Time:
Received by/Company: (Signature)
Date/Time:
Nan Conforrriance{s):
Page:
I.
` A , _ lot _ q
YE5 / NO
of: i_