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1'rrvirunm e n tal
Quality
Storrnwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance onfilling out thisform, please visit https://deg.nc.gov/about/divisions/energy-mineral-land-
resources/enera -mineral-land-permits/stormwater-permits/npdes-industrial-sw#tab-4
Permit No.: NICII�I^I—I 1 1—I or Certificate of Coverage No.: N/C/GI A11 /0 /415191
Facility Name: Pack* - Fayetteville
County: Cumberland
Inspector: Gerardo Berrizbeitia
Phone No. 910-364-4041
Date of InspectiotL 06/07/2021
Time of inspection: 07:45 AM R ECv/
Total Event Precipitation (inches): ohs
JUN 0 X 2D21
CENTRAL FILES
aVVR SECTION
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 permittee 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
I------ --------__.- .. _�- -.---- -., ........__._--.-.-.-..-.....- _ _-- ------- - ....... .. .........---
By this sign e, I certify t s report is accurate and complete to the best of my knowledge:
{Sign
1, Outfall Description:
Outfall No. 1
Receiving Stream:
Structure (pipe, ditch, etc.)-. Ditch
Describe the industrial activities that occur within the outfall drainage area:
Page I of 2
sWU-242, Last moditied 07/28/2017
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Light
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:
1 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:
l 2 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:
7.
8.
s.
l 2 3 4 5
Is there any foam in the stormwater discharge? () Yes O No. _
Is there an oil sheen in the stormwater discharge? OYes 0 No. _
Is there evidence of erosion or deposition at the outfall? o Yes o No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe No obvious indicator of storm water pollution.
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 07/28/2017
VMICROBAC
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K1 EO147
Project Description
Stormwater
For:
Mr. Gerardo (Jerry) Berrizbeitia
Pack IQ
880 Technology Drive
Fayetteville, NC 28306
Administration
Brittany Smith
Friday, May 14, 2021
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.
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
�gDMICROBAC-:
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K1 EO147
Pack IQ Project Name: Stormwater
Mr. Gerardo (Jerry) Berrizbeitia Project / PO Number: GET CC
880 Technology Drive Received: 05/10/2021
Fayetteville, NC 28306 Reported: 05/14/2021
Sample Summary Report
Sample Name Laboratory ID Client Matrix Sample Type Sample Begin Sample Taken Lab Received
Outfall#1, Grab K1E0147-01 Stormwater Grab 05/07/21 07:45 05/10/21 15:10
Page 2 of 4
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
K1EO147
Analytical Testing Parameters
Client Sample ID: Outfall #1, Grab
Sample Matrix: Stormwater Collected By: Client
Lab Sample ID: K1 EO147-01 Collection Date: 05/07/2021 7:45
Inorganics Total Result Limit(s) MDL RL Units Note Prepared Analyzed Analyst
Method: SM 2540 D-2011
Total Suspended Solids 53.2 3.39 8.47 mg/L 05/13121 1616 JDP
Method: SM 5220 D-2011
COD, Total 45.3 10.0 10.0 mg/L 05/13/21 1108 TXN
Results in bold have exceeded a limit defined for this project. Limits are provided for reference but as regulatory limits change frequently,
Microbac Laboratories, Inc. advises the recipient of this report to confirm such limits and units of concentration with the appropriate
Federal, state or local authorities before acting on the data.
Definitions
mg/L: Milligrams per Liter
RL: Reporting Limit
Cooler Receipt Log
Cooler ID: Default Cooler
Temp: 8.9°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 (CDC) Present?
Yes
CDC 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
CDC 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 CDC 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
Report Comments
Reviewed and Approved By:
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 Administration
subject to Microbac's standard terms and conditions which can be located and Reported: 05/14/2021 19:34
reviewed at ahopsa/www.microbac.comistandard-teens-conditions>.
Microbac Laboratories, Inc.
2592 Mope Mills Rd I Fayetteville, NC 283061 910.864.1920 p I www.microbac.com Page 3 of 4
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