NCS000528_MONITORING INFO_20200302

STORMWATER DIVISION CODING SHEET
NCS PERMITS
PERMIT NO.
I
DOC TYPE
❑FINAL PERMIT
�, MONITORING REPORTS
❑ APPLICATION
❑ COMPLIANCE
❑ OTHER
DOC DATE
❑ � U-D 0 D 3 L) a
YYYYMMDD

i WA"I'ERS EDGE ENVIRONMENTAL, LLC
�� 1434 CHESTER ROAD & RALEIGH, NC 27608 , PHONE [phone]
February 24, 2020
NCDEQ
Division of Water Quality
Central Files
1617 Mail Service Branch RECEIVED
Raleigh, North Carolina 27699-1617 MAR 0 2 2020
Reference: Year 5- Period 2 Stormwater Monitoring Report CEN't►-,(AL FILES
Premiere Fibers Facility DWR SECTION
Ansonville, North Carolina
Stormwater Permit No. NCS000528
Waters Edge Job No. R9-21
To Whom 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 001- pH (5.1 versus benchmark between 6-9- unitless)
• Outfall 002- pH (5.8 versus benchmark between 6-9- unitless)
• Outfal1 001- pl-I (5.9 versus benchmark between 6-9- unitless)
It is felt that with acid rain, the pl-I across North Carolina and the remainder of the 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). If you have
any questions, or if we may be of further assistance, please contact me at rahn c watersed eenv,com or
919.219.5820.
Sincerely,
Waters Edge Environmental, I.I.0
Phillip L. Rahn
President
cc: Mr. Dewey Fulton and Mr. Kevin Bowers- Premier Fibers
20-013

Permit Number: NCS 000528
Certificate of Coverage Number: NCG
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
or SAMPLES COLLECTED DURING CALENDAR YEAR: 2019
("Phis 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 COUNTY Anson
PERSON COLLECTING SAMPLE(S) T. Haynes PHONE NO. [phone]
CERTIFIED LABORATORY(S) Pace Lab # 633 —yf /�
Lab # (SIGNATURE OF PERMITTEE OR DESIGNEE)
By this signature, 1 certify that this report is accurate complete to
the best of my knowledge.
Part A: Specific Monitoring Requirements
Outfall '
No.
Date
Sample
Collected
Total
Rainfall
Total
Suspended
Solids (TSS)
COD
ptl
Pe` mii BetscV
NIA '
100 y
120
6-9 -
-
7innfdil�y�_ _,
inches
mg/f
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 S WU-246-112608
Page 1 of 2

Part B: Vehicle Maintenance Activity Monitoring Requirements
Outfall
No.
Date
Sample
Collected
50050
005M, -
00530
00400
Toial Flow
(if applicable)
Total Rainfall
_
Oil & Grease`
_ . Total
Suspended
Solids
pH
New Moter Oil-7
Usage
mo/dd/yr
MG
i.nches.
mg/l
mg/l
Units
gaUmo ,
STORM EVENT CHARACTERISTICS:
Date 10.16.19
Total Event Precipitation (inches): 0.32
Event Duration (hours): NIA (only if applicable - see permit.)
(if more than one storm event was sampled)
Date NIA
Total Event Precipitation (inches):
Event Duration (hours):
(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."
)011 --
Signat a of Permittee
ffA 07-0
Date
Form SWU-246-112608
Page 2 of 2

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling ow this form, please s•isit: http://h2o.enr.state.nc.us/su/Forrns_Documents.htm#miscforms
Permit No.: N i C I S 10 10 105 1 2 8 or Certificate of Coverage No.: I
Facility Name: Premiere Fibers
County: Anson Phone No. 704.82&8321
Inspector: Thomas Haynes
Date of Inspection: 2.11.20
Time of Inspection: 11:00-12:00/10:30 AM
Total Event Precipitation (inches): 0.35
Was this a Representative Storm Event? (See information below) ® Yes ❑ No
Please check your permit to verify if Qualitative Moniforing> must he performed during a representative storm event
(requirements vary).
— - ---- -- - -- .... .. ............_. .--....., ......... . _......_...
A "Representative Storm Event is a storm event that measures greater than 0.1 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 up 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:
_;i� ;Z�/
(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 Manufacturinq
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 of 2
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:
0 2 3 4 5
5 Floating Solids:
Choose the number which best describes the amount of floating solids in the stormwater discharge, where I is no
solids and 5 is the surface covered with floating solids:
1 ZO 3 4 5
6 Suspended Solids:
Choose the number which best describes the amount of suspended solids in the stormwater discharge, where I is no
solids and 5 is extremely muddy:
O 2 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 of
pollutant exposure. These conditions warrant further investigation.
Page 2 o F 2
S W U-242-1 12608

aceMalytical
www.pacalahs.em
February 21, 2020
Mr. Phil Rahn
Waters Edge Environmental
1434 Chester Road
Raleigh, NC 27606
RE: Project: Premiere Fibers 139-21
Pace Project No.: 92464767
Dear Mr. Rahn:
Pace Analytical Services, Ill
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Enclosed are the analytical results for sample(s) received by the laboratory on February 12, 2020.
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 he reproduced, except in full,
without the written consent of Pace Analytical Services, Ll
Page 1 of 12

6
aceAnalXical
www.pacelabs.com
Project: Premiere Fibers R9-21
Pace Project No.: 92464767
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
FloridalNELAP Certification #: E87648
Massachusetts Certification #: M-NC030
North Carolina Drinking Water Certification #: 37712
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 2728E
[phone]
Pace Analytical Services Eden
205 East Meadow Road Suite A, Eden, NC 272BB
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 Pace Analytical Services, LLC. Page 2 of 12

aceAnalytrca!
. .Qacalabs.cam
SAMPLE SUMMARY
Project: Premiere Fibers R9-21
Pace Project No.: 92464767
Lab ID
Sample ID
Matrix
Date Collected
Date Received
92464767001
OUTFALL 001
Water
02/11/20 11:00
02112/20 09:45
92464767002
OUTFALL 002
Water
02/11/20 11:15
02/12/20 09:45
92464767003
OUTFALL 003
Water
02/11/20 11:30
02/12/20 09:45
92464767004
OUTFALL 004
Water
02/11/20 11:45
02/12/20 09:45
92464767005
OUTFALL 005
Water
02/11/20 12:00
02112/20 09A5
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

aceAnalytical`
www.psalies.com
Project. Premiere Fibers R9-21
Pace Project No.: 92464767
Lab ID Sample ID
92464767001 OUTFALL 001
92464767002 OUTFALL 002
92464767003 OUTFALL 003
92464767004 OUTFALL 004
92464767005 OUTFALL 005
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
SAMPLE ANALYTE COUNT
Method
Analysts
Analytes
Reported
Laboratory
SM 254OD-2011
MWF
1
PASI-E
SM 4500-H+6-2011
SOB
1
PASI-E
SM 5220D-2011
LMS1
1
PASI-A
SM 254OD-2011
MWF
1
PASI-E
SM 45D0-H+B-2011
SOB
1
PASI-E
SM 5220D-2011
LMS1
1
PASI-A
SM 254OD-2011
MWF
1
PASI-E
SM 4500-H+B-2011
SOB
1
PASI-E
SM 5220D-2011
LMS1
1
PASI-A
SM 254OD-2011
MWF
1
PASI-E
SM 4500-H+B-2011
SOB
1
PASI-E
SM 5220D-2011
LMS1
1
PASI-A
SM 254OD-2011
MWF
1
PASI-E
SM 45D0-H+B-2011
SOB
1
PASI-E
SM 5220D-2011
LMS1
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

aceAnalytical
WWW.pacalaba.con
ANALYTICAL RESULTS
Project: Premiere Fibers R9-21
Pace Project No.: 92464767
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Sample: OUTFALL 001
Lab ID: 92464767001 Collected: 02/11/20 11:00 Received: 02/12/20 09:45 Matrix: Water
Report
Parameters
Results Units Limit MOL DF Prepared Analyzed CAS No.
Qual
2640D Total Suspended Solids
Analytical Method: SM 254OD-2011
Total Suspended Solids
9.4 mg1L 2.6 2.6 1 02/13/20 09:36
4500H+ pH, Electrometric IEDN
Analytical Method: SM 4500-H+B-2011
pH at 25 Degrees C
5.1 Sid. Units 0.10 0.10 1 02/12/20 13:50
H3
52200 COD
Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Chemical Oxygen Demand
ND mg1L 25.0 12.5 1 02/20/20 10:00 02/21/20 09:32
Sample: OUTFALL 002
Lab ID: 92464767002 Collected: 02/11/20 11:15 Received: 02/12/20 09:45 Matrix: Water
Report
Parameters
Results Units Limit MDL DF Prepared Analyzed CAS No.
Qual
2540D Total Suspended Solids
Analytical Method: SM 254OD-2011
Total Suspended Solids
34.0 mg/L 2.5 2.5 1 02/13120 09:37
4500H+ pH, Electrometric EDN
Analytical Method: SM 4500-H+B-2011
pH at 25 Degrees C
5.8 Std. Units 0.10 0.10 1 02/12/20 13:52
H3
5220D COD
Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Chemical Oxygen Demand
27.3 mg/L 25.0 12.5 1 02/20/20 10:00 02/21/20 09:32
Sample: OUTFALL 003
Lab ID: 92464767003 Collected: 02/11/20 11:30 Received: 02/12120 09:45 Matrix: Water
Report
Parameters
Results Units Limit MDL DF Prepared Analyzed CAS No.
Qual
2540D Total Suspended Solids
Analytical Method: SM 25400-2011
Total Suspended Solids
8.9 mg1L 2.5 2.5 1 02/13/20 09:41
4500H+ pH, Electrometric EDN
Analytical Method: SM 4500-H+B-2011
pH at 25 Degrees C
6.2 Sid. Units 0,10 0.10 1 02/12/20 13:58
H3
5220D COD
Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Chemical Oxygen Demand
ND mglL 25.0 12.5 1 02/20/20 10:00 02/21120 09:32
Sample: OUTFALL 004
Lab ID: 92464767004 Collected: 02/11/20 11:45 Received: 02/12/20 09:45 Matrix: Water
Report
Parameters
Results Units Limit MDL DF Prepared Analyzed CAS No.
Qual
2540D Total Suspended Solids
Analytical Method: SM 254OD-2011
Total Suspended Solids
20.3 mg1L 7.4 7.4 1 02/13/20 09:41
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 02/21 /2020 10:20 AM
without the written consent of Pace Analytical Services, LLC.
Page 5 of 12

aceAnalytical.
www,pacflsbs.com
ANALYTICAL RESULTS
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Project: Premiere Fibers R9-21
Pace Project No.: 92464767
Sample: OUTFALL 004
Lab ID: 92464767004 Collected:
02/11/20 11:45
Received: 02/12/20 09:45 Matrix: Water
Report
Parameters
Results Units Limit
MDL DF
Prepared Analyzed CAS No.
Qual
4500H+ pH, Electrometric EDN
Analytical Method: SM 4500-H+B-2011
pH at 25 Degrees C
7.0 Sid, Units 0.10
0,10 1
02/12/20 14:02
H3
5220D COD
Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Chemical Oxygen Demand
58.4 mg/L 25.0
12.5 1
02/20/20 10:00 . 02121/20 09:32
Sample: OUTFALL 005
LabID: 92464767005 Collected:
02/11/20 12700
Received: 02/12/20 09:45 Matrix: Water
�{
Report
Parameters
Results Units Limit
MDL DF
Prepared Analyzed GAS No.
Qual
2540D Total Suspended Solids
Analytical Method: SM 254OD-2011
Total Suspended Solids
19.6 mg/L 9.6
9.6 1
02/13/20 09:42
4500H+ pH, Electrometric EON
Analytical Method: SM 4500-H+B-2011
pH at 25 Degrees C
5.9 Sid. Units 0.10
0.10 1
02/12/20 14:20
113
5220D COD
Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Chemical Oxygen Demand
51.7 mg1L 25.0
12.5 1
02/20120 1 D:00 02/21120 09:32
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 02/21/2020 10:20 AM without the written consent of Pace Analytical Services, LLC. Page 6 of 12

Pace Analytical Services, LLC
aceAnalytrcal�
205 East Meadow Road - Suite A
Eden, NC 27288
wtw.pacolgbit.com
[phone]
QUALITY CONTROL DATA
Project: Premiere Fibers R9-21
Pace Project No.: 92464767
QC Batch: 524929
Analysis Method: SM 254DD-2011
QC Batch Method: SM 2540D-2011
Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples: 92464767001, 92464767002. 92464767003, 92464767004, 92464767005
METHOD BLANK: 2805789
Matrix: Water
Associated Lab Samples: 92464767001,
92464767002, 92464767003, 92464767004, 92464767005
Blank Reporting
Parameter
Units
Result Limit MDL
Analyzed
Qualifiers
Total Suspended Solids
mg/L
ND 2.5 2.5 02/13/20 09:32
LABORATORY CONTROL SAMPLE:
2805790
Spike LCS LCS
% Rec
Parameter
Units
Conc. Result % Rec
Limits Qualifiers
Total Suspended Solids
mg/L
250 226 90
90-110
SAMPLE DUPLICATE: 2805791
92464692001 Dup
Max
Parameter
Units
Result Result RPD
RPD
Qualifiers
Total Suspended Solids
mg11-
ND 16.8
1 25
SAMPLE DUPLICATE: 2805792
92464822001 Dup
Max
Parameter
Units
Result Result RPD
RPD
Qualifiers
Total Suspended Solids
mg1L
53.6 51.2
5 25
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: 02/21/2020 10:20 AM without the written consent of Pace Analytical Services, LLC. Page 7 of 12

Pace Analytical Services, LLC
to 205 East MeadoEd Eden,Road
- uit B
aceAnalXical
ww.pecelah%.cme [phone]
QUALITY CONTROL DATA
Project: Premiere Fibers R9-21
Pace Project No.: 92464767
QC Batch: 524750 Analysis Method: SM 4500-H+8-2011
QC Batch Method: SM 4500-H+B-2011 Analysis Description: 4500H+B pH EDEN
Associated Lab Samples: 92464767001, 92464767002, 92464767003, 92464767004, 92464767005
SAMPLE DUPLICATE: 2804929
92464767001 Dup Max
Parameter Units Result Result RPD RPD Qualifiers
pH at 25 Degrees C Std. Units 5.1 5.2 1 10 H3
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: 02/21/2020 10:20 AM without the written consent of Pace Analytical Services, LLC.
Page 13 of 12

aceAnalXical
wtrw.pacelabs.com
QUALITY CONTROL DATA
Project: Premiere Fibers R9-21
Pace Project No.: 92464767
QC Batch: 525864 Analysis Method: SM 5220D-2011
OC Batch Method: SM 5220D-2011 Analysis Description: 52200 COD
Associated Lab Samples: 92464767001, 92464767002, 92464767003, 92464767004, 92464767005
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
METHOD BLANK: 2810621 Matrix: Water
Associated Lab Samples: 92464767001, 92464767002, 92464767003, 92464767004, 92464767005
Blank Reporting
Parameter Units Result Limit MDL Analyzed Qualifiers
Chemical Oxygen Demand mg/L ND 25.0 12.5 02/21/20 09:26
LABORATORY CONTROL SAMPLE: 2810622
Spike LCS LCS % Rec
Parameter Units Cone. Result % Rec Limits Qualifiers
Chemical Oxygen Demand mg/L 750 731 97 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2810623 2810624
MS MSD
92464411002 Spike Spike MS MSD MS MSD % Rec Max
Parameter Units Result Cone. Cone. Result Result % Rec % Rec Limits RPD RPD Qual
Chemical Oxygen Demand mg/L 167 100 100 243 249 75 82 90-110 3 3 M1
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2810625 2810626
MS MSD
92464954001 Spike Spike MS MSD MS MSD % Rec Max
Parameter Units Result Cone. Cone. Result Result % Rec % Rec Limits RPD RPD Qual
Chemical Oxygen Demand mg1L 514 100 100 609 613 95 100 90-110 1 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: 02/21 /2020 10:20 AM without the written consent of Pace Analytical Services, LLC.
Page 9 of 12

6
aceAnalylical
www,pacelabs.com
QUALIFIERS
Protect: Premiere Fibers R9-21
Pace Project No.: 92464767
DEFINITIONS
Pace Analytical Services, LLG
205 East Meadow Road - Suite
Eden, NC 27288
[phone]
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.
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-Dipheny1hydrazine 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 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute.
LABORATORIES
PASI-A Pace Analytical Services - Asheville
PASI-E Pace Analytical Services - Eden
ANALYTE QUALIFIERS
H3 Sample was received or analysis requested beyond the recognized method holding time.
M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 02/21 /2020 10:20 AM without the written consent of Pace Analytical Services, LLC. Page 10 of 12

1.
6
aceAnalXical
www.pacetabo.com
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Premiere Fibers R9-21
Pace Project No.: 92464767
Pace Analytical Services, LLC
205 East Meadow Road - Suite A
Eden, NC 27288
[phone]
Lab ID
Sample ID
QC
Batch Method
QC Batch
Analytical Method
Analytical
Batch
92464767001
OUTFALL 001
SM
254OD-2011
524929
92464767002
OUTFALL 002
SM
254OD-2011
524929
92464767003
OUTFALL 003
SM
254DD-2011
524929
92464767004
OUTFALL 004
SM
2540D-2011
524929
92464767005
OUTFALL 005
SM
254DD-2011
524929
92464767001
OUTFALL 001
SM
4500-H+B-2011
524750
92464767002
OUTFALL 002
SM
4500-H+B-2011
524750
92464767003
OUTFALL 003
SM
4500-H+B-2011
524750
92464767004
OUTFALL 004
SM
4500-H+B-2011
524750
92464767005
OUTFALL 005
SM
4500-H+B-2011
524750
92464767001
OUTFALL 001
SM
5220D-2011
525864
SM
5220D-2011
526317
92464767002
OUTFALL 002
SM
5220D-2011
525864
SM
5220D-2011
526317
92464767003
OUTFALL 003
SM
5220D-2011
525864
SM
5220D-2011
526317
92464767004
OUTFALL 004
SM
52200-2011
525864
SM
52200-2011
526317
92464767005
OUTFALL 005
SM
5220D-2011
525864
SM
5220D-2011
526317
Date: 02/21/2020 10:20 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 11 of 12

CHAI[V-OF-CUSTODY Analytical Request Document
557ceAnalytiCal'
Chain-ot-Custody is a LEGAL DOCUMENT - Complete atl relevent fields
LnBusEonftY-AffixWorkord ? WO ; 924V4767 N
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1111111111111111111111
ALL SHADED A 92464767
Container Preservative Type—
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Company: u
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9illing Information:
Address:
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Report To: / r
Email To:
preservative ypes: (1) nitric acid, (7) sulfuric acfd; (3) hydrochloric acid, (4) sodium hydroxide, (51 zint acetate,
(6) methanol,171 sodium bisulfate, [8) sodium Nosuifate, (9) hexane, (A) ascorbic acid, (B) ammonium sulfate,
(C) ammonium hydroxide, (D) TSP,,(U) Unpresmed, (0) Other
Cppy.TO: ,
Site Collection Info/Address:
Analyses
Lab Profile/Line:
Cu tOmer project Name/Number: l
/JCY C �!I
State: �C/qunty/City: Time Zone Collected:
b/ 1 ,90V I ) PT i J MT ! I Cr (j Er
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' r,a1z Sample Receipt Checklist:
Custody Seals Present/Intact Y N tilt'
-Custody Signatures Present Y N ilx
cakiector Signature Prevent ..}- ti NA
Bottles Intact _Sr- N NA
Correct Bottles ;h tt Ha
Sufficient volume -r N Pin
samples Received on T-ce .ad^ N NA
vo_n - Heidspace Acceptable Y N t79
USDA Regulated Soils .. Y. N to
samples in Holding Time ,av rt NA
Residual Chlorin% Rresent Y tf NA
. Sample'pH Ac - ptb�e y+�1t NA
pH Strips: �y
-Sulfide Present y tl 1K
Lead Acetate --Strips:
'
LAB USE 4e - ,
Lab; Sample t" / Coavnents:
„
Phoned
Email;;
Site/Fat:iflty10 N:
Compliance Monitoring?
�(i Yes ( ] NO
- \
Collected By (print):
Purchase Order tt;
Quote 9: —�
DW PWS ID H:
DW Location Code:
Collected B (signat
Turnaround Date Required:
immediately Pa3red on Ice:
es ] ] NO
Sample Disposa
`QDispose as a"propriate [ 1 Return
( J Archive:
1 JHold:
Rush:
( J Same Day [ ) Next Day
[ ] 2 Day [ 1 3 Day [ 1 4 Day I I S Day
(Expedite Charges Apply)
Field Filtered (if appllcable):
( I Yes I ]No
Analysis.
` Matrix Codes (Insert in Matrix box below): Drinking Water (DW), Ground Water (GW), Wastewater JWW],
Product (P), Soil/Solid (SL), Oil (OL), Wipe (WP), Air (AR), Tissue (TS), Sioassay (B), Vapor (V ), Other (OT)
Customer Sample ID
Matrix '
Comp /
Grab
Collected (or
Composite Start)
Composite End
Res
CI
F—&
tns
Date
Time
Date
Time
/ r
'
Customer Remarks /Special Conditions /Possible Hazards:
Type o€ice Used: W -Blue Dry Not1e
SfiOR7 HOLDS PRESENT (q2 haurs): N N/A
Lab Sample Temperature Info:
Temp Blank Receive NA_/�
herm
C000le 1D emP %Pon 6c ipt: oC
Cooler I Therm Corr. Factor:
Cooler 1 Corrected Temp: oG
P s-OC
Comments:
Parking Material Used: -
lab Tracking It:,' " —
{�
2 4 6 0 370 ._
Radchem sample(s) screened (<500 cpm): Y N N/
Sarnples received via:
FEDEX LIPS Cli Courier Pace Courier
Relinquish byJCom ny: [Signature]
Date/Tim
Rece' d by/Company (Signature)
Datefromc:
N1TJL LAB USE ONLY
Table4,
Acctnum:
Template:
Prelogin: j
pMD �.!
�7771
PB: I Z'
elinquishe by/Ca any: ( gnature)
nhteime:
Yeceived by/Company: {Signs e]
Date/Time:
Tri Blank Received: Y N NA
P
HCL McOH TSP Other
Pf inquished by/Company: (Signature]
li
Date/Time:
Received by/Company: (Signature)
Date/Time:
Non Conformance
YES / NO
Page: