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L en a o N p � u1 � U �v E.� 10- co N C f4 Y � o -O U U CS G J N O z np E in c E o a CU c q O L *' z d L O Ln N D J O o Q u •3 Z R a 'is z ? x C 3 O E R Nm c s Ln u m 7 4 L N N m a cu 0 c O E �n QJ G o a Z C m t Q °' E v m 4 co 0 N r-i CD r-i CD N {y L u m � '-° m CL Q o C N N y 0. a y N-1r1-._ Environmental Quality Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit https://deq.nc.govlabout/divisions/energy-mineral-land-resources/ npdes-stonnwater-gps Permit No.: N/C/ G/ 0 / 3 / 0l2 12 / 4 / or Certificate of Coverage No.: NIC/G/ 0 / 3 / 0 / 0 / 0 / 0 I Facility Name: Clarios County: Forsyth Phone No. Inspector: Glenn Price Date of Inspection: May 12, 2021 Time of Inspection: 0853 Total Event Precipitation (inches): 0.68 All permits require qualitative monitoring to be performed during a "measurable storm event." A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm interval does not apply if the pernuttec is able to document that a shorter interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DEMLR Regional Office. By this signatur I certify that this raiaccurate and complete to the best of my knowledge: (Signature of Permittee or Designee) 1. Outfall Description: OutfaIl No. 001 Structure (pipe, ditch, etc.): Pond Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: Page I of 2 S WU 242, Last modified 0610112018 f6 6 z 0 Q Uz z w ❑N CC V1 � w CL J � a � LL W CL w p Ln w Lno z z W z � a w x ¢ c LLI LLA = 2 m N ¢ z O "' n LU u ~ w w 2 y w cr ¢ J L¢L O O t5 Z) LLLJ Z w o u 0 d LU z w p unf ¢ W [n lil ua U n Z H W LU U W Y ¢ W _ W w U Q uzo CC m G W w o oC t!i N CC' w W ,on = ch LLF 1- Q p u�r�z 3: LU V Z w ¢ LL o U Z U w O O � u O O a x Q uW LLJ z u M Ln in W W ¢ N p �!- . . ui a u z O u W u LL LL Q J z o_ w Ol C) to r. T N in c c Cf " u ❑ u U fo U M aci .c u N p •� Z a p to fv a < H al L �. ❑ O of a E E 00 V u m fri E Q7 «6+ .0 W a M 4 fb fo +r+ O Q] C 3 o ar Ln C C O � a � w Y CU `a m Q3 c tofu a 12 ❑ cu a L N CL }� U S v o E ate" c o EN L L 0 Ql ❑ C Q1 ❑ i O O a QJ f6 C_ a m c �' C Y•+ � a (U E _c N Si C + 3 ❑ C CL Ln V C fo C L ❑ E o L L Y iwC E ` L ❑ y O CLI a, c c C C Y N t6 E °0 � C o u m to ? io QQ C wL .. a o a .. L P N C. N Q A v, fo C C C 0 ti Cp � .V; `'00 a)ai Q1 L Q- T m C � U Ql rL `~ QS 7 I Y C C - ❑O Y OJai CL (Lp Y a, 3 u vCi O � E fo H to N O N e^i m Ln 0 0o a (V ri r-1 Rl fo 0 E 41 a. 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Light Brown 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): None 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: l_: / 2 3 4 5 5. Floating Solids: Choose the number which best describes the amount of floating solids in the stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids: 1 t1-� 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stonmwater discharge, where 1 is no solids and 5 is extremely muddy: 0 2 3 4 5 7. Is there any foam in the stormwater discharge? O Yes <SVlo. 8. Is there an oil sheen in the stormwater discharge? OYes (I �Vo. 9. Is there evidence of erosion or deposition at the outfall? o Yes . 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 of 2 SWU-242. Last modified 06101 r2018 lacieAnalytical" www.pacalabs.com May 21, 2021 Aaron Kramer Clarjos 2701 Johnson Controls Kernersville, NC 27284 RE: Project: Outfall001 Pace Project No.: 92538508 Dear Aaron Kramer: s Pace Analytical Services, LLC 1377 South Park Drive Kernersville, NC 27284 (704)977-0981 Enclosed are the analytical results for sample(s) received by the laboratory on May 13, 2021. The results relate only to the samples included in this report. Results reported herein conform to the applicable TNIINELAC Standards and the laboratory's Quality Manual, where applicable, unless otherwise noted in the body of the report. The test results provided in this final report were generated by each of the following laboratories within the Pace Network: • Pace Analytical Services -Asheville • Pace Analytical Services - Charlotte • Pace Analytical Services - Eden • Pace Analytical Services - Kernersville, NC If you have any questions concerning this report, please feel free to contact me. Sincerely, Stephanie Knott stephanie.knoft@pacelabs.com 704-977-0981 Project Manager Enclosures REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written censent of Pace Analytical Services, LLC. Page 1 of 11 IaceAnalyficale (-� aarpecelabr.tota CERTIFICATIONS Project: Outfall 001 Pace Project No.: 92538508 Pace Analytical Services Charlotte 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 South Carolina Certification #: 99006001 Loulsiana/NELAP Certification # LA170028 Florida/NELAP Certification #: E87627 North Carolina Drinking Water Certification * 37706 Kentucky UST Certification #: 84 North Carolina Field Services Certification #: 5342 Virginia/VELAP Certification #: 460221 North Carolina Wastewater Certification #: 12 Pace Analytical Services Asheville 2225 Riverside Drive, Asheville, NC 28804 North Carolina Wastewater Certification #: 40 Florida/NELAP Certification #: E87648 South Carolina Certification #: 99030001 North Carolina Drinking Water Certification * 37712 Virginia/VELAP Certification #: 460222 Pace Analytical Services Eden 205 East Meadow Road Suite A, Eden, NC 27288 North Carolina Wastewater Certification #: 633 North Carolina Drinking Water Certification #. 37738 Virginia/VELAP Certification #: 460025 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 1377 South Park Drive Kemersville, NC 27284 (704)977-0981 Page 2 of 11 aceAnalytieal 1141rrp8CR18bl.COrO SAMPLE ANALYTE COUNT Project: Outfall 001 Pace Project No.: 92538508 Pace Analytical Se ices, LLC 1377 South Park Drive Kemersville, NC 27284 (704)977-0981 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92538508001 Outfall 001 SM 254OD-2011 LRB 1 PASI-E EPA 1664E CJM 1 PASI-C EPA 200.7 Rev 4A 1994 DS 3 PASI-A SK 6 PASI-KR PASI-A = Pace Analytical Services - Asheville PASI-C = Pace Analytical Services - Charlotte PASI-E = Pace Analytical Services - Eden PASI-KR = Pace Analytical Services - Kemersville, NC REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, I.I.C. Page 3 of 11 GAnaocal WWW.Paaelabs eam ANALYTICAL RESULTS Project: Outfall 001 Pace Project No.: 92538508 Pace Analytical Services, LLC 1377 South Park Drive Kemersville, NC 27284 (704)977-0981 Sample: Outfall 001 Parameters Lab ID: 92538508001 Collected: 05/12/21 08:53 Results Units Report Limit DF Received: 05/13/21 09:58 Matrix: Water Prepared Analyzed CAS No. Qual 2540D Total Suspended Solids Analytical Method: SM 254OD-2011 Pace Analytical Services - Eden Total Suspended Solids 23.2 mg/L 3.7 1 05/17/21 09:06 1664 SGT HEM, TPH Analytical Method: EPA 1664E Pace Analytical Services - Charlotte Total Petroleum Hydrocarbons ND mg/L 5.3 1 05/19/21 12:54 200.7 MET ICP Analytical Method: EPA 200.7 Rev 4.4 1994 Preparation Method: EPA 200.7 Rev 4.4 1994 Pace Analytical Services -Asheville Copper ND ug/L 5.0 1 05/19/2119:68 05120/2118:59 7440-50-8 Lead ND ug/L 5.0 1 05/19/2119:58 05120/2118:59 7439-92-1 Zinc ND ug/L 10.0 1 05119/2119:58 05/2012118:59 7440-66-6 Field Data Kernersville Analytical Method: Pace Analytical Services - Kernersviile, NC Performed by PACE 1 05/12/21 08:53 Collected By Glenn 1 05/12/21 08:53 Price Collected Date 06112/21 1 05112121 08:53 Collected Time 0853 1 05/12/21 08:53 pH 7.21 Std. Units 1 05112/21 08:53 Temperature 24.8 deg C 1 05112/21 08:53 Date: 05/21/2021 11:13 AM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, U.C. Page 4 of 11 Pace Analytical Sar9lcea, LLC C' Mao iJ® 1377 South Park Drive fjj/ ��lll�� t Kemersville, NC 27284 W MIludel ,eats (704)977-0981 QUALITY CONTROL DATA Project: Outfali 001 Pace Project No.: 92538608 QC Batch: 620784 Analysis Method: SM 254OD-2011 QC Batch Method: SM 254OD-2011 Analysis Description: 2540D Total Suspended Solids Laboratory: Pace Analytical Services - Eden Associated Lab Samples: 92538508001 METHOD BLANK: 3266172 Associated Lab Samples: 92538508001 Parameter Units Total Suspended Solids mg/L LABORATORY CONTROL SAMPLE: 3266173 Parameter Units Total Suspended Solids mg/L Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 2.5 05/17/2109:00 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 250 238 95 90-110 SAMPLE DUPLICATE: 3266174 92538710001 Dup Parameter Units Result Result Total Suspended Solids mg/L 150 155 SAMPLE DUPLICATE: 3266175 92538710002 Dup Parameter Units Result Result Total Suspended Solids mg/L 1010 653 RPD Qualifiers 3 RPD Qualifiers 43 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: 05/21 /2021 11:13 AM without the written consent of Pace Analytical Services, I.I.C. Page 5 of 11 Pace Analytical Services, LLC 1377 South Park Drive antcuemalocal Kernersville, NC 27284 wwwLitacelabs (704)977-0981 a I QUALITY CONTROL DATA Project: Outfall 001 Pace Project No.: 92538508 QC Batch: 621248 Analysis Method: EPA 1664B QC Batch Method: EPA1664B Analysis Description: 1664 SGT-HEM, TPH Laboratory: Pace Analytical Services - Charlotte Associated Lab Samples: 92538508001 METHOD BLANK: 3268995 Matrix: Water Associated Lab Samples: 92538508001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Petroleum Hydrocarbons mgtL ND 5.0 05119/21 12:54 LABORATORY CONTROL SAMPLE: 3268996 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Petroleum Hydrocarbons mg/L 20 20.4 102 64-132 MATRIX SPIKE SAMPLE: 3268997 92537547001 Spike IVIS IVIS % Rec Parameter Units Result Conc. Result % Rec Limits Qualifiers Total Petroleum Hydrocarbons mg/L ND 20 15.2 62 64-132 SAMPLE DUPLICATE: 3268998 92537547002 Dup Parameter Units Result Result RPD Qualifiers Total Petroleum Hydrocarbons mg/L ND ND 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 resuft. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 05/21/2021 11:13 AM without the written consent of Pace Analytical Services, L-C. Page 6 of 11 Pace Analytical So�ces, LLC IaceMalyfibale ern South Park Drive Kemersville, NC 27284 (�WiiMpacelabE. = (704)977-0981 QUALITY CONTROL DATA Project Outfall001 Pace Project No.: 92538508 QC Batch: 621577 Analysis Method: EPA 200.7 Rev 4.41994 QC Batch Method: EPA 200.7 Rev 4.41994 Analysis Description: 200.7 MET Laboratory: Pace Analytical Services -Asheville Associated Lab Samples: 92538508001 METHOD BLANK: 3270564 Matrix: Water Associated Lab Samples: 92538508001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Copper ug/L ND 5.0 05/2012118:33 Lead ug/L ND 5.0 0512012118:33 Zinc ug/L ND 10.0 05120/2118:33 LABORATORY CONTROL SAMPLE: 3270565 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Copper ug/L 500 474 95 85-115 Lead ug/L 500 451 90 85-115 Zinc ug/L 500 436 87 85-115 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 3270566 MS 92538080001 Spike Parameter Units Result Conc. Copper ug/L ND 500 Lead ug/L ND 500 Zinc ug/L ND 500 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 3270568 MS 92538620009 Spike Parameter Units Result Conc. Copper ug/L ND 500 Lead ug/L ND 500 Zinc ug/L 65.5 500 3270567 MSD Spike MS MSD MS MSD % Rec Conc. Result Result % Rec % Rec Limits RPD 500 518 482 103 96 70-130 7 500 495 461 99 92 70-130 7 500 486 455 97 91 70-130 7 3270569 MSD Spike MS MSD MS MSD % Rec Conc. Result Result % Rec % Rec Limits RPD 500 487 509 97 101 70-130 4 500 455 474 90 94 70-130 4 500 512 531 89 93 70-130 4 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: 05/21 /2021 11:13 AM without the written consent of Pace Analytical Services, I.I.C. Qual Qual Page 7 of 11 s2 Is Pace Analytical Services, LLC Cn1-iSouth Park Drive ali cale Kernersville, NC 27284 (704)977-0981 QUALIFIERS Project: outfall001 Pace Project No.: 92538508 iT�I�lyliL•I:F: 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-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 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. ANALYTE QUALIFIERS D5 The precision between the sample and sample duplicate exceeded laboratory control limits. Date: 05/21/2021 11:13 AM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, I.I.C. Page 8 of 11 ceAnalytical wwrLpacdabs c= QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: Outfall 001 Pace Project No.: 92538508 Lab ID Sample ID QC Batch Method 92638508001 Outfall 001 SM 254OD-2011 92538508001 Outfall 001 EPA 1664B 92538608001 Outfall 001 EPA 200.7 Rev 4.41994 92638608001 Outfall 001 Date: 0512112021 11:13 AM Pace Analytical Seces, LLC 1377 South Park Drive Kemersville, NC 27284 (704)977-0981 Analytical QC Batch Analytical Method Batch 620784 621248 621577 EPA 200.7 Rev 4.41994 621711 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. 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