NCG030450_DMR_20200220

CF� Electrolux
March 6,2020
Attn: Central Files RECE1
Division of Water Resources(DWR) OR
16 202�
1617 Mail Service Center
Raleigh,NC 27699-1617 GE-N S cY0�
D
RE: Electrolux Storm Water Sampling Event(Year 2-Period 1)
To Whom It May Concern:
Attached to this cover letter please find the analytical results of sampling from a storm event on
2/20/2020 to comply with our NPDES General Permit No.NCG030000.
As you will see,the results from our storm water outfall#1 (Outlet)indicate compliance with our
NPDES General Permit NCG030000 and Certificate of Coverage NCG030450 for Electrolux
Home Products,Kinston,NC.
By submitting this data we have met the monitoring requirements for Year 2(2020)Period 1 of
our permit.
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.
If you have any questions or require additional information feel free to call me at(252)933-9547.
Sincerely,
14,4_
Mike Brown
Manufacturing Engineering/Maintenance Manager/
Environmental Coordinator
ta(Vysk
Glenda Lynch
Plant Manager
ELECTROLUX HOME PRODUCTS NORTH AMERICA
MAILING ADDRESS TELEPHONE SITE
4850 W.Vernon Avenue 252 527 5100 www.frigidaire.com
Kinston,NC 28504-7544 www.electrolux.com
USA
C . g -A..t.a T/1PP/111 'W white-wesunghouse Gibson ®The Electrolux Group.The wodd's No.1 choice.
Classified as Internal

( EIectrolux
STORMWATER DISCHARGE MONITORING REPORT & RESULTS
ELECTROLUX HOME PRODUCTS NORTH AMERICA
MAILING ADDRESS TELEPHONE SITE
4850 W.Vernon Avenue 252 527 5100 www.frigidaire.com
Kinston,NC 28504-7544 www.electrolux.com
USA
TRPPHJI W whiteiVeoononouse Gibson �n.F..oror P1 ®The Electrolux Group.The world's No.1 choice.
Classified as Internal

Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG030000
Date submitted
CERTIFICATE OF COVERAGE NO. NCGO3 0 4 5 u SAMPLE COLLECTION YEAR Z
FACILITY NAME ClRo14,4.3.:7 Horne SAMPLE PERIOD man-June n July-Dec
COUNTY �e,, �,A_ or n Monthly' (month)
PERSON COLLECTING SAMPLES y};l,/,zss 6y„c2vGAe. /A63) DISCHARGING TO CLASS UORW UHQW Trout PNA
LABORATORY fNr L`o`e /46s Lab Cert.# N cot!n rZ /( Zero-flow (Water Supply fSA
Comments on sample collection or analysis: (Other
RECFRECEIVEDor.42
MAR 16 2020 PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 -�
Part A: Stormwater Benchmarks and Monitoring Results CENTRAL FILES
DWR SECTION I ] No discharge this period?2
Date Sample 24-hour rainfall pH, Non-Polar O&G/ Total Toxic
Outfall No. Collected' amount, Total Suspended Solids Standard units Total Copper Total Lead Total Zinc Total Petroleum Organics'
(mo/dd/yr) Inches' Hydrocarbons
Benchmarks - - 100 mg/L or 50 mg/L4 6.0—9.0 0.010 mg/L 0.075 mg/L 0.126 mg/L 15 mg/L 1 mg/L
Parameter Code - 46529 C0530 00400 01119 01051 01094 00552 78141
�/ 42.-ci12.0 ,62I < Z.. (v3 7, s <a. oa3ov 4. 0'4-0 ca, ol-2 ‹'_5• A.) CA- ,
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall.
2 For sampling periods with no discharge at any single outfall,you must still submit this discharge monitoring report with a checkmark here.
'The total precipitation must be recorded using data from an on-site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
See General Permit, Section B,Table 1 to identify the especially sensitive receiving water classifications where the more protective benchmark applies.
'Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture
electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA
Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor
manufacture use the definition as found in 40 CFR 469.12;for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray
tube manufacture use the definition found in 40 CFR 469.31).
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 1 of 3

Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring -
may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General
Permit. For those facilities electing to employ the TTO monitoring waiver,the discharger shall sign the following certification statement:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics
(TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or
stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the
solvent management plan included in the Stormwater Pollution Prevention Plan."
)14l kQ )32aiivn
Name (Print name)
�au'�t< I'L of c 1 Mae, t-c
Title(Print title)
Signature Date
Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non-detect, ND, or other similar non-numerical
format. When results are below the applicable limits,they must be reported in the format, "<XX mg/L",where XX is the numerical value of the detection
limit, reporting limit, etc. in mg/L.
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month.
No discharge this period?2
Outfall No. Date Sample Collected' 24-hour rainfall amount, New Motor Oil or Non-Polar O&G/Total Total Suspended
(mo/dd/yr) Inches' Hydraulic Oil Usage Petroleum Hydrocarbons Solids
Benchmarks - - - 15 mg/L 100 mg/L or 50 mg/L4
Parameter Code - 46529 NCOIL 00552 C0530
Footnotes from Part A also apply to Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 2 of 3

FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO❑
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES E NO❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copy of this DMR, including all"No Discharge"reports, within 30 days of receipt of the lab results(or at end of monitoring period in the
case of"No Discharge"reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"I certify, under penalty of law,that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to
assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or
those 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."
�c
� it-/w /0/2L..o
Signature of Permittee Date
Permit Date: 11/1/2018-05/31/2021 SWU-245, last revised 11/1/2018
Page 3 of 3

•
CO Electrolux
LABORATORY ANALYTICAL RESULTS
(with Chain of Custody)
ELECTROLUX HOME PRODUCTS NORTH AMERICA
MAILING ADDRESS TELEPHONE SITE
4850 W.Vernon Avenue 252 527 5100 www.frigidaire.com
Kinston,NC 28504-7544 www.electrolux.com
USA
W white-Westinghouse Gibson is ev<..aro.- t ®Thu Electrolux Group.The world's No.7 choice.
Classified as Internal

(5MICROBAC ®
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K0B0305
Project Description
No Project
For:
Mr. Mike Brown
Electrolux Home Products North
4850 W.Vernon Avenue
Kinston, NC 28504
Administration
Brittany Smith
Thursday, March 5, 2020
Please find enclosed the analytical results for the samples you submitted to Microbac Laboratories. Review and compilation of
your report was completed by Microbac Laboratories, Inc.-Fayetteville. If you have any questions,comments,or require further
assistance regarding this report, please contact your service representative listed above.
I certify that all test results meet all of the requirements of the accrediting authority listed within this report.Analytical results are
reported on a'as received'basis unless specified otherwise. Analytical results for solids with units ending in (dry)are reported
on a dry weight basis. A statement of uncertainty for each analysis is available upon request.This laboratory report shall not be
reproduced,except in full,without the written approval of Microbac Laboratories.The reported results are related only to the
samples analyzed as received.
Microbac Laboratories,Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1910.864.1920 p I www.microbac.com
Page 1 of 10

OMICROBAC®
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K0B0305
Electrolux Home Products North Project Name: No Project
Mr. Mike Brown Project/PO Number: N/A
4850 W.Vernon Avenue Received: 02/20/2020
Kinston, NC 28504 Reported: 03/05/2020
Sample Summary Report
Sample Name Laboratory ID Client Matrix Sample Type Sample Begin Sample Taken Lab Received
Outfall 1 Inlet, grab K0B0305-01 Stormwater Grab 02/20/20 10:23 02/20/20 11:34
Outfall 2 Outlet,grab K0B0305-02 Aqueous Grab 02/20/20 10:41 02/20/20 11:34
Page 2 of 10

< MICROBAC®
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K0B0305
Analytical Testing Parameters
Client Sample ID: Outfall 1 Inlet,grab
Sample Matrix: Stormwater Collected By: Poythress
Lab Sample ID: K0B0305-01 Collection Date: 02/20/2020 10:23
***DEFAULT GENERAL METHOD*** Result RL Units Dilution Note Prepared Analyzed Analyst
SM 2540 D-2011
Total Suspended Solids <2.63 2.63 mg/L 1 02/24/20 1652 MT
Field Parameters Result RL Units Dilution Note Prepared Analyzed Analyst
Field
Rainfall 0.61 in 1 03/05/20 0822 03/05/20 0823 BNS
Field Observation
Color Clear NA 1 03/05/20 0822 03/05/20 0823 BNS
Odor None NA 1 03/05/20 0822 03/05/20 0823 BNS
Clarity Yes NA 1 03/05/20 0822 03/05/20 0823 BNS
Floating Solids No NA 1 03/05/20 0822 03/05/20 0823 BNS
Suspended Solids(Residue, No NA 1 03/05/20 0822 03/05/20 0823 BNS
Non-Filterable)
Foam No NA 1 03/05/20 0822 03/05/20 0823 BNS
Oil Sheen No NA 1 03/05/20 0822 03/05/20 0823 BNS
Erosion Evidence None NA 1 03/05/20 0822 03/05/20 0823 BNS
Other Pollution Indicators No NA 1 03/05/20 0822 03/05/20 0823 BNS
SM 2550 B-2010
Temperature, Field 12 0.1 °C 1 02/20/20 1023 JMP
SM 4500 H+B-2011
pH,Field Test 7.6 1.0 S.U. 1 02/20/20 1023 JMP
Inorganics Total Result RL Units Dilution Note Prepared Analyzed Analyst
EPA 1664 Rev.B
Oil&Grease(SGT-HEM) <5.10 5.10 mg/L 1 03/03/20 1011 TBM
Metals Total by ICP Result RL Units Dilution Note Prepared Analyzed Analyst
Metals Aqueous/EPA 200.7 Rev 4.4 1994
Lead <0.020 0.020 mg/L 1 02/27/20 2133 02/27/20 2133 JAW
Zinc 0.015 0.005 mg/L 1 02/27/20 2133 02/27/20 2133 JAW
Analyses Subcontracted to: Microbac Laboratories Inc.,-Marietta, OH
Metals Total by ICP Result RL Units Dilution Note Prepared Analyzed Analyst
EPA 200.7,Rv.4.4
Copper <0.00800 0.00800 mg/L 1 Y 02/26/20 0556 02/26/20 1636 LSJ
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville,NC 28306 1910.864.1920 p i www.microbac.com Page 3 of 10

(QMICROBAC®
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K0B0305
Client Sample ID: Outfall 1 Inlet,grab
Sample Matrix: Stormwater Collected By: Poythress
Lab Sample ID: K0B0305-01 Collection Date: 02/20/2020 10:23
Metals Total by ICP Result RL Units Dilution Note Prepared Analyzed Analyst
Microbac Laboratories,Inc.
2592 Hope Mills Rd I Fayetteville,NC 28306 1910.864.1920 p I www.microbac.com Page 4 of 10

* MICROBAC®
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K0B0305
Client Sample ID: Outfall 2 Outlet,grab
Sample Matrix: Aqueous Collected By: Poythress
Lab Sample ID: K0B0305-02 Collection Date: 02/20/2020 10:41
***DEFAULT GENERAL METHOD*** Result RL Units Dilution Note Prepared Analyzed Analyst
SM 2540 D-2011
Total Suspended Solids <2.63 2.63 mg/L 1 02/24/20 1652 MT
Field Parameters Result RL Units Dilution Note Prepared Analyzed Analyst
Field
Rainfall 0.61 in 1 03/05/20 0822 03/05/20 0823 BNS
Field Observation
Color Clear NA 1 03/05/20 0822 03/05/20 0823 BNS
Odor None NA 1 03/05/20 0822 03/05/20 0823 BNS
Clarity Yes NA 1 03/05/20 0822 03/05/20 0823 BNS
Floating Solids No NA 1 03/05/20 0822 03/05/20 0823 BNS
Suspended Solids(Residue, NO NA 1 03/05/20 0822 03/05/20 0823 BNS
Non-Filterable)
Foam No NA 1 03/05/20 0822 03/05/20 0823 BNS
Oil Sheen No NA 1 03/05/20 0822 03/05/20 0823 BNS
Erosion Evidence None NA 1 03/05/20 0822 03/05/20 0823 BNS
Other Pollution Indicators No NA 1 03/05/20 0822 03/05/20 0823 BNS
SM 2550 B-2010
Temperature,Field 11 0.1 °C 1 02/20/20 1041 JMP
SM 4500 H+B-2011
pH, Field Test 7.8 1.0 S.U. 1 02/20/20 1041 JMP
Inorganics Total Result RL Units Dilution Note Prepared Analyzed Analyst
EPA 1664 Rev.B
Oil&Grease(SGT-HEM) <5.00 5.00 mg/L 1 03/03/20 1011 TBM
Metals Total by ICP Result RL Units Dilution Note Prepared Analyzed Analyst
Metals Aqueous/EPA 200.7 Rev 4.4 1994
Lead <0.020 0.020 mg/L 1 02/27/20 2137 02/27/20 2137 JAW
Zinc 0.012 0.005 mg/L 1 02/27/20 2137 02/27/20 2137 JAW
Analyses Subcontracted to: Microbac Laboratories Inc.,-Marietta, OH
Metals Total by ICP Result RL Units Dilution Note Prepared Analyzed Analyst
EPA 200.7,Rv.4.4
Copper <0.00800 0.00800 mg/L 1 Y 02/26/20 0556 02/26/20 1639 LSJ
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville,NC 28306 1910.864.1920 p I www.microbac.com Page 5 of 10

( MICROBAC®
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K0B0305
Batch Quality Control Summary: Microbac Laboratories,Inc.-Fayetteville
Spike Source %REC RPD
***DEFAULT GENERAL Result RL Units Level Result %REC Limits RPD Limit Notes
METHOD***
Batch KB02114-Wet Chem Aqueous-SM 2540 D-2011
Blank(KB02114-BLK1) Prepared&Analyzed:02/24/2020
Total Suspended Solids <2.50 2.50 mg/L
Blank(KB02114-BLK2) Prepared&Analyzed:02/24/2020
Total Suspended Solids <2.50 2.50 mg/L
Blank(KB02114-BLK3) Prepared&Analyzed:02/24/2020
Total Suspended Solids <2.50 2.50 mg/L
Blank(KB02114-BLK4) Prepared&Analyzed:02/24/2020
Total Suspended Solids <2.50 2.50 mg/L
LCS(KB02114-BS1) Prepared&Analyzed:02/24/2020
Total Suspended Solids 32.1 2.50 mg/L 33.1 97 94.5-105.4
Duplicate(KB02114-DUP1) Source:K0B0303-01 Prepared&Analyzed:02/24/2020
Total Suspended Solids 123 25.0 mg/L 130 6 10
Duplicate(KB02114-DUP2) Source:K0B0328-01 Prepared&Analyzed:02/24/2020
Total Suspended Solids 15.0 8.33 mg/L 15.7 4 10
Spike Source %REC RPD
Inorganics Total Result RL Units Level Result %REC Limits RPD Limit Notes
Batch KC00008-Wet Chem Aqueous-EPA 1664 Rev. B
Blank(KC00008-BLK1) Prepared&Analyzed:03/03/2020
Oil&Grease(SGT-HEM) <5.00 5.00 mg/L
LCS(KC00008-BS1) Prepared&Analyzed:03/03/2020
Oil&Grease(SGT-HEM) 19.3 5.00 mg/L 20.4 95 64-116
Matrix Spike(KC00008-MS1) Source:K0B0386-01 Prepared&Analyzed:03/03/2020
Oil&Grease(SGT-HEM) 26.9 4.84 mg/L 20.4 2.50 119 64-132
Spike Source %REC RPD
Metals Total by ICP Result RL Units Level Result %REC Limits RPD Limit Notes
Batch KB02623-Metals Aqueous-EPA 200.7 Rev 4.4 1994
LCS(KB02623-BS1) Prepared&Analyzed:02/27/2020
Lead 0.247 0.020 mg/L 0.250 99 85-115
Zinc 0.245 0.005 mg/L 0.250 98 85-115
LCS(KB02623-BS2) Prepared&Analyzed:02/27/2020
Lead 0.245 0.020 mg/L 0.250 98 85-115
Zinc 0.240 0.005 mg/L 0.250 96 85-115
Duplicate(KB02623-DUP1) Source:K0B0257-01 Prepared&Analyzed:02/27/2020
Lead <0.020 0.020 mg/L ND 10
Zinc 0.444 0.005 mg/L 0.447 0.7 10
Duplicate(KB02623-DUP2) Source:K0B0351-01 Prepared&Analyzed:02/27/2020
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville,NC 28306 1910.864.1920 p I www.microbac.com Page 6 of 10

( MICROBAC®
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K0BO3O5
Spike Source %REC RPD
Metals Total by ICP Result RL Units Level Result %REC Limits RPD Limit Notes
Batch KB02623-Metals Aqueous-EPA 200.7 Rev 4.4 1994
Duplicate(KB02623-DUP2) Source:K0B0351-01 Prepared&Analyzed:02/27/2020
Lead <0.020 0.020 mg/L ND 10
Matrix Spike(KB02623-MS1) Source:K0B0257-01 Prepared&Analyzed:02/27/2020
Lead 0.230 0.020 mg/L 0.250 ND 92 70-130
Zinc 0.672 0.005 mg/L 0.250 0.447 90 70-130
Matrix Spike(KB02623-MS2) Source:K0B0351-01 Prepared&Analyzed:02/27/2020
Lead 0.232 0.020 mg/L 0.250 ND 93 70-130
Zinc 0.313 0.005 mg/L 0.250 0.114 79 70-130
Matrix Spike Dup(KB02623-MSD1) Source:K0B0257-01 Prepared&Analyzed:02/27/2020
Lead 0.226 0.020 mg/L 0.250 ND 90 70-130 2 30
Matrix Spike Dup(KB02623-MSD2) Source:K0B0351-01 Prepared&Analyzed:02/27/2020
Lead 0.241 0.020 mg/L 0.250 ND 96 70-130 3 30
Zinc 0.336 0.005 mg/L 0.250 0.114 89 70-130 7 30
Batch Quality Control Summary: Microbac Laboratories Inc.,-Marietta,OH
Spike Source %REC RPD
Metals Total by ICP Result MDL RL Units Level Result %REC Limits RPD Limit Notes
Batch B0B1306-200.7-EPA 200.7,Rv.4.4
Blank(BOB1306-BLK1) Prepared&Analyzed:02/26/2020
Copper <0.00400 0.00400 0.00800 mg/L
LCS(B0B1306-BS1) Prepared&Analyzed:02/26/2020
Copper 0.265 0.00400 0.00800 mg/L 0.250 106 85-115
Duplicate(BOB1306-DUP1) Source:M0B1752-01 Prepared&Analyzed:02/26/2020
Copper 1.58 0.00400 0.00800 mg/L 1.58 0.0317 20
Matrix Spike(B0B1306-MS1) Source:M0B1752-01 Prepared&Analyzed:02/26/2020
Copper 1.80 0.00400 0.00800 mg/L 0.250 1.58 90.6 70-130
Matrix Spike(B0B1306-MS2) Source:M0B1788-01 Prepared&Analyzed:02/26/2020
Copper 0.266 0.00400 0.00800 mg/L 0.250 ND 106 70-130
Post Spike(B0B1306-PS1) Source:M0B1754-01 Prepared&Analyzed:02/26/2020
Copper 0.428 mg/L 0.250 0.182 98.5 75-125
Microbac Laboratories,Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1910.864.1920 p I www.microbac.com Page 7 of 10

( MICROBAC®
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K0B0305
Definitions
°C: Degrees Celsius
in: Inches
MDL: Minimum Detection Limit
mg/L: Milligrams per Liter
NA: Not Applicable
RL: Reporting Limit
RPD: Relative Percent Difference
S.U.: Standard Units
Y: This analyte is not on the laboratory's current scope of accreditation.
Cooler Receipt Log
Cooler ID: Default Cooler Temp: 4.4°C
Cooler Inspection Checklist
Ice Present or not required? Yes Shipping containers sealed or not required? Yes
Custody seals intact or not required? Yes Chain of Custody(COC)Present? Yes
COC includes customer information? Yes Relinquished and received signature on COC? Yes
Sample collector identified on COC? Yes Sample type identified on COC? Yes
Correct type of Containers Received Yes Correct number of containers listed on COC? Yes
Containers Intact? Yes COC includes requested analyses? Yes
Enough sample volume for indicated tests received? Yes Sample labels match COC(Name,Date&Time?) Yes
Samples arrived within hold time? Yes Correct preservatives on COC or not required? Yes
Chemical preservations checked or not required? Yes Preservation checks meet method requirements? Yes
VOA vials have zero headspace,or not recd.? Yes
Project Requested Certification(s)
Microbac Laboratories Inc.,-Marietta,OH
583 NC Dept.of the Environment and Natural Resources
Microbac Laboratories,Inc.-Fayetteville
11 North Carolina DENR NPDES
Report Comments Reviewed and Approved By:
Samples were received in proper condition and the reported results conform to
applicable accreditation standard unless otherwise noted. pyt-iigOn_3 �rtL
The data and information on this,and other accompanying documents,represents only the
sample(s)analyzed. This report is incomplete unless all pages indicated in the footnote are Brittany Smith
present and an authorized signature is included.The services were provided under and
subject to Microbac's standard terms and conditions which can be located and Administration
reviewed at<https://www.microbac.com/standard-terms-conditions>. Reported: 03/05/2020 22:03
Microbac Laboratories,Inc.
2592 Hope Mills Rd I Fayetteville,NC 28306 1910.864.1920 p I www.microbac.com Page 8 of 10

•
•
Fayetteville Division 2592 Hope Mills Road—Fayetteville,NC 28306 [phone]/864-5714 fax K0B0305*
11111111111111
CHAIN OF CUSTODY RECORD
PAGE i OF 1
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r CONTACT PERSON: !p7
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MARL Qo -es5 1);crvl�A 3 G,Sodium Thto
LAB ID* SAMPLE TYPE DATE TIME Corr WWI PH rH FLOW TErr•c ctAoR�iNE sULPIDE .
01 Okf t't i I rid- ,�;Z>- 610 /b.'23 }( I_ A, 7.1'0 12.5
X 1 g �42
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nqur.bedbpr Dal. Tim. .a.i,,.a cy:{elon.mr.) • Daa^h1 'Time Lib Turnaround time: REGULAR RUSH
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B REVIEWED
ph Fluid: 7.. ph Fluid: '7.2S Water Level it. IS DATA FOR REG.COMPLIANCE PURPOSE?
Temp Fluid 1: 1.2,3o Tamp Flald 2: f f.j a Water Level R2 NO YES WHICH:•
l�J
Page 9 of 10

, /Sala y
STORM WATER - QUALITATIVE MONITORING
OTHER OBVIOUS
EROSION OR INDICATORS OF
STORM DATE FLOATING SUSPENDED DEPOSITION AT STORM WATER
SITE# SAMPLED COLOR ODOR CLARITY SOLIDS SOLIDS FOAM OIL SHEEN THEIOUTFALL POLLUTION
1 2-26-2o2o Cleve /lone ye5 /lo A f o Aa I11o4G 46
2 �_26-pi° Clea - j1ane yes ho /16 Ilo
/lo /1 AL /+D
3
TOTAL RAINFALL(inches): . G
*KOB0305*
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