NCG060095_DMR_20210604

SEMI-ANNUAL STORMWATER DISCHARGE MONITORING REPORT
for North Carolina Division of Water Quality General Permit No. NCG060000
Date submitted
CERTIFICATE OF COVERAGE NO. NCG06 o Q 9 RECEIVE
COLLECTION YEAR a��
FACILITY NAME Gam i.-► _ CC .FACILITY ACTIVITIES INCLUDE (check all that apply):
COUNTY nto n - JUN 14 ZRI ❑ use/process meats Buse animal fats/byproducts
PERSON COLLECTING SAMPLES DISCHARGING TO SALTWATERS? ❑YES FNO
LABORATORY 17Ac. A.It k _ Lab Cert. # CENTRAL FILES
�— r SECTION PLEASE REMEMBER TO SIGN ON THE REVERSE 4
part A• Stormtuater RRnrhmarka and Mnnitnrine Results Total event rain foil 2 O, �1 or ❑ No discharge this period3
Outfa[I No.
Sample Collected,
mo/dd/yr
T55,
mg/L
pH,
Standard units
COD,
mg/L
Oil and Grease,
mg/L
Fecal Coliforml,
Colonies per 100 ml
Enterococcil,
Colonies per 100 ml
Benchmark
100 or 504
Within 6.0 — 9.0
120
30
1000
500
3
s a caL
3, q
o
s!I la�al
,2.
a
s i a t
. o
ND
1 Only applies to facilities that use/process meats.
2The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here.
`See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? ❑ yes ❑ no (if yes, complete Part B)
Part R- VPhirin Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month.
Outfall No.
Sample Collected,
mo/dd/yr
Oil and Grease,
mg/L
TSS,
mg/L
pH,
Standard units
New Motor Oil Usage,
Annual average gal/mo
Benchmark
-
30
100 or 504
6-0 — 9.0
-
' Only applies to facilities that use/process meats.
'The total precipitation must be recorded using data from an on -site rain gauge.
3 For sampling periods with no discharge at any outfalls, you must still submit this discharge monitoring report with a checkmark here.
`See General Permit text, Table 3, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
02
S WU-249
Last Revised: October 18, 2012
Page 1 of 2

*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 11 SECTION JB.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES FN01%
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original and one 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, NC 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
inforrDAion, including the possibility of fines and imprisonment for knowing violations."
of Permittee)
&IL112
(Da e)
Additional copies of this form may be downloaded at: httr)://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-249 Last Revised: October 18, 2012
Page 2 of 2

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: htto://Portal,ncdenr.org/web/wg/ws/cii/nl2dessw#tab-4
Permit No.: N/C/G ! - / 6 / 0 / 0 / 0 / —0/ or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 704-296-6427
Inspector: -Aa" 1l1(1` -r Date of of Inspection: 5 - i -z
Time of Inspection: A( : r j" .r3,ryt
Total Event Precipitation (inches):
Was this a Representative Storm Event? (See information below) Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
j 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 nrecioitation.
By this signature, I certify that this TRort is accurate and complete to the best of my knowledge:
c
of Permittee or
1. Outfall Description:
Outfall No. t Structure (pipe, ditch, etc.) Pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
Wait 43,et11P, tozjA,..
fit
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: C 1w,r-.r
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): n c ^ —e
Page I of 2
SWU-242-20120613

r
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
Cl 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 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
(11) 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes 1
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe IV 0C
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-242-20120613

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on fulling out this form, please visit: littp://portal.ncclenr.orglweb/%va/ws/su/nt)dessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: 1N/C/G/ 0 / 6L 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 704-296-6427
Inspector: .S". , me- TA..M.4' (-
Date of Inspection: S -t z _ 2
Time of Inspection:
Total Event Precipitation (inches): d .29.
Was this a Representative Storm Event? (See information below) J-;�' Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be 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:
1. Outfall Description:
Outfall No. --;2- Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:�-
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): _tea a4,A --
Page 1 of 2
SWU-242-20120613

9
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
V 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:
6 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:
01-
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes 6g
S. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 1410=
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-242-20120613

9�
NCDEINR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: htt :// ortal.ncdenr.oru../web/w /ws/stt/n dessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 704-296-6427
Inspector:
Date of Inspection: `
Time of Inspection: 11 ' .!?&
Total Event Precipitation (inches): ©�a�
Was this a Representative Storm Event? (See information below) Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be 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
j occurred. A single storm event may contain up to 10 consecutive hours of no t)recioitation.
By this sig,ature„I certify thatthisort is ac d complete to the best of my knowledge:
Permittee or
1. Outfall Description:
Outfall No. 3— Structure (pipe, ditch, etc.) PiPe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: _ C [ z
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): AooLp-
Page 1 of 2
SWU-242-20120613

0
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
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:
() 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
I & 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes 60)
10. Other Obvious Indicators of Stormwater Pollution:
List and describe _L1) A -
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-242-20120613

. �x���
);1
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: htta /lporta3.ncdenr.orb/web/wq/ws/su/npdessw#Tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0 / 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc. _
County: Union Phone No. 704-296-6427
Inspector: .lcY, 0A TA.e gt,&n+
Date of Inspection: �` - 12 -
Time of Inspection: I 1 : 410
Total Event Precipitation (inches): 0, )' j
Was this a Representative Storm Event? (See information below) Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be 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. j
By this signature, Testify that this report is accurate and complete to the best of my knowledge:
Permittee or
1. Outfall Description:
Outfall No. *- I— Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smelIs strongly of oil, weak
chlorine odor, etc.):
Page I of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
GD 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:
6) 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
6 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes &
9. Is there evidence of erosion or deposition at the outfall? Yes 6)
10. Other Obvious Indicators of Soormwater Pollution:
List and describe _14 J �}-
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-242-20120613

o:..gn
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: httl2://portal.ncdenr.or2/web/wQ/wS/su/ni)clessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: _Goulston Technolo ies, Inc.
County: Union Phone No. 704-296-6427
Inspector: PA
h, �-
Date of Inspection: - r a
Time of Inspection: r 1 : -4/b
Total Event Precipitation (inches): © .aq
Was this a Representative Storm Event? (See information below) es ❑ No
Please check your permit to verify if Qualitative Monitoring must be 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 nrecit)itation. !
By this signatur fell certify that this report is accurate and complete to the best of my knowledge:
of Petmittee or Desi
1. Outfall Description:
Outfall No. �5-_ Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: G �"f
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): j6,oALo _.
Page i of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
U 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:
k 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
40 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes 4)
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes l o1-j'
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 4) ft
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-242-20120613

Ala*
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: http://port.tl.ncdenr orghweb/wn/ws/Su/nl2dessw#tab-4
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ Q/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 704-296-6427
Inspector:
Date of Inspection: - a
Time of Inspection: -// ; yp
Total Event Precipitation (inches): © , A
Was this a Representative Storm Event? (See information below) 2-le's ❑ No
Please check your permit to verify if Qualitative Monitoring must be performed during a representative
storm event (requirements vary).
"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
t occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
By this signatur I certify that this report is accurate and complete to the best of my knowledge:
- C --t-: ,.:. .57: . , V 4 —
of Permittee or
1. Outfall Description:
Outfall No. le Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): egQ4.,c,,..
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy: t 1
/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:
0 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
]� 2 3 4 5
7. Is there any foam in the stormwater discharge?
Yes 6
8. Is there an oil sheen in the stormwater discharge?
Yes
9. Is there evidence of erosion or deposition at the outfall?
Yes �b
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 12A-
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-242-20120613

A�
Na
NCDENfR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: lutn://Rortal.ncdenr.orL/web/wghvs/su/ni)dessw#tab-4
Permit NO.: NICI G / 0 / 6 / 0 I 0 / 0 J a J or Certificate of Coverage No.: NICIGI 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc
County: Union Phone No. 704-296-6427
Inspector: �� �� J/1 `T&,
Date of Inspection: _ !;3 - i Z,
Time of Inspection: t_ I :yam'
Total Event Precipitation (inches): 0 , ?A
Was this a Representative Storm Event? (See information below) Yes ❑ No
Please check your permit to verify if Qualitative Monitoring must be 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 f
occurred. A single storm event may contain up to 10 consecutive hours of no orecioitation_
By this si natu I certify that this report is
of Permittee or
and complete to the best of my knowledge:
1. Outfall Description:
Outfall No. "I Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: <14,x,0^
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
Page 1 of 2
SWU-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where i is clear
and 5 is very cloudy:
01 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:
V 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
�1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes 'kp.)
8. Is there an oil sheen in the stormwater discharge? Yes T&
9. Is there evidence of erosion or deposition at the outfall? Yes {: --�
10. Other Obvious Indicators of Stormwater Pollution:
List and describe A A
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-242-20120613

NC®ENn
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out t1Tis form, please visit: liltp_I/p,,rtal_n�ilrnr.or /inchhvlh� ckuinp�tr. �� nt �h-d
Permit No.: N/C/G / 0 / 6 / 0 / 010 / 0 / or Certificate of Coverage No.: NUC/G/ 0/ 6/ 0/ C/ 9/ 5/
Facility Name: Goulston Technoloclies, inc.
County: Union Phone No.
Inspector:_ YYl ` q,e
Date of Inspection:
Time of Inspection: /� : 5L-
Total Event Precipitation (inches): 0. %9
704-296-6427
Was this a Representative Storm Event? (See information below) Yes ❑ No
Please check your permit to verify if Qualitative Monitoring mast be performed during a representative
stortn event (requirements vary).
A `Representative Storm Event" is a stonn 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, II certify that this report is accurate and complete to the best of my knowledge:
of Permittee or Des
1. OutfallDescription:
Outfall No. Structure (pipe, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area: _
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 4z,
3. Odor: Describe any distinct odors that the discharge may have (i.e.. smells strongly of oil, weak
chlorine odor, etc.):
Page I of 2
SWt:-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy: ,,,,����
a 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:
co 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:
2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes L J
9. Is there evidence of erosion or deposition at the outfall? Yes Do
10. Other ObAous Indicators of Storm rater Pollution:
List and describe Q> &
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-242-2012061.3

NCDENR.
Stormwater Discharge Outfan (SDO)
Qualitative Monitoring Report
For guidance on filling out This farm, please visit: ht_[PI/ portal_ncilcnr.or��/+vchh+u/�+c/ ,/i,t,�►e��++rrrit, t
Permit No.: N/C/G / O / 6 / 0 / 0 / 0 / O / or Certificate of Coverage No.: N/C/G/ O 6/ 0/ O/ 9/ 5/
Facility Name: Goulston Technolocries, Inc.
County: Union Phone No. 704-296-6427
Inspector: �—
Date of Inspection: t
Time of Inspection: //; .S"b
Total Event Precipitation (inches): (),')'l
Was this a Representative Storm Event? (See information below) yes ❑ No
Please check your permit to verify if Qualitative Monitoring must he performed daring a representative
stonn 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 Q 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, ertify that this repo is accurate and complete to the best of my knowledge:
/
of Pcrmittec or Dcsi
1. Outtall Description:
4utfall No. Structure (pipe, ditch, etc.) pike
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light. medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e.. smells strongly of oil, weak
chlorine odor, etc.): /7v p7A,e---
Page t of 2
S W U-232-20120613

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 1 is no solids and 5 is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
2 3 45
7. Is there any foam in the stormwater discharge? Yes l�fol
S. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes N
10. Other Obvious Indicators of Stormwater Pollution:
List and describe VV G}
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.
Pale 2 of 2
SWU-242-2012()613

NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling Out this form, please visit:
Permit No.: NLC/G LOjL6/ 0/0/0/0/ or Certificate of Coverage No.: 1NLCLG/ 0161 O/ 0/ 9L5(
Facility Name: Goulston Technologies, Inc.
County:- Union Phone No. 7 04-2 9 6- 6427
Inspector: Do -+—
Date of Inspection: -6' - VZ - -4
Time of Inspection:
Total Event Precipitation (inches): Otafi
Was this a Representative Storm Event? (See information below) ®'Yes n No
Please check your permit to verify, if Qualitative Monitoring must be 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 tip to 10 consecutive hours of no precipitation.
By this signature, I certify that this report is accurate and complete to the
---. /'I ---,% A best of my knowledge:
(Signa&rc of Permittee or
1. Outfall Description:
Outfall No. -t6,
Structure (pipe, ditch, etc.) Pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur withiq the outfall drainage area:
% - If I 1 2 1 11� —
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light. medium, dark) as descriptors: Pe
If f
3. Odor: Describe any distinct odors that the discharge may have (i.e.. smells strongly of oil, weak
chlorine odor, etc.): /94�09-4.1 C,
Pave I of 2
SWU-242-201206t3

4. Clarity: Choose the number which best describes the clarity of the discharge, where l is clear
and 5 is very cloudy: l
1 �j 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:
(!! ? 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater 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? Yes a
8. Is there an oil sheen in the stormwater discharge? Yes Al",
lao
9. Is there evidence of erosion or deposition at the outfall? Yes i&
10. Other Obvious Indicators of Storinw•ater Pollution:
List and describe 131 ft
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.
P•i-e 2 of 2
SWU-242-20120613

NCDENlR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out thisform, please visit: ItttL// ortal.ncdcnr.ors=1weh/wqh+'�/�u/n��.le�e++#t ih-d
Permit No.: N/C/G !0 / 6 I 0 / 0I 0 / 0 / or Certificate of Coverage No.: +iICIGI OI 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 704-296-6427
Inspector: -ram
Date of Inspection: _ SS'
Time of Inspection: t/ J 5 T
Total Event Precipitation (inches): b. a")*
Was this a Representative Storm Event? (See information below) O'Yes ❑ No
Please check your permit to verify if Qualitative Monitoring 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 thi report is accurate and complete to the best of my knowledge:
(Signar6rc of Permittce or
1. Outfall Description:
Outfall No. I� Structure (pipe, ditch, etc.) Pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall draina;e area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e.. smells strongly of oil, weak
chlorine odor, etc.): %v/Ye--
Page 1 of
SWti•242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
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:
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:
& ? 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes 1�
9. Is there evidence of erosion or deposition at the outfall? Yes 6
10. Other Obvious Indicators of Stormwater Pollution:
List and describe 414
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
SWt;-242-20120613

4Tr��
NCDENR
Stormwater Discharge OutfalI (SDO►)
Qualitative Monitoring Report
For guidance on filling nut this form, please visit: 1111i)'/%I)(1rt�11.Iti Cit'i]f.O1' ?IWChJ14t I1l'�ISUJI] �a�tSS1c (ab- t
Permit No.: N/C/G / O / 6 / 0 / 0 / 0 / O / or Certificate of Coverage No.: v/C/G/ 0/ 6/ O/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc.
County: Union Phone No. 704-296-6427
Inspector: _S166.1 Vl110
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches)
Was this a Representative Storm Event'? (See information below) Yes ❑ No
Please check your penmit to verify ij'Qualitative Monitoring mast be perfortned during a representative
storm event (requirements vcn v).
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
i 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:
/T .-�
(Signature o&crmittec or Designee)
1. Outfall Description:
Outfall No. 1C2- Structure (pipe, ditch, etc.) PiPe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: ,,L,.f 45:e
3. Odor: Describe any distinct odors that the discharge may have (i.e.. smells strongly of oil, weak
chlorine odor, etc.): _�1-'�.e.�-
Pa-e 1 of 2
5wt1-242-20120613

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 3 4 5
S. 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:
0) ? 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:
3 4 5
7. Is there any foam in the stormwater discharge? yes o
8. Is there an oil sheen in the stormwater discharge? Yes a?
9. Is there evidence of erosion or deposition at the outfall? Yes
00
10. Other Obvious Indicators of Stormwater Pollution:
List and describe AJ i-
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•242-20120613

Xj
NCDENR
Stormwater Discharge OutfaIl (SDO)
Qualitative Monitoring Report
For guidance on filling airs this fonn, please visit: ht_t►�:!/pi�rtal.neilenr.cn ��I++ehhvu/+� c/ / ��,clea++ i,cb-�i
Permit No.: N/C/G / 0 / 6 / 0 / 0 / 0 I 0 / or Certificate of Coverage No.: N/C/G/ O 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc
County: Union Phone No. 704-296-6427
Inspector: n J✓i� Q,[i,,L
Date of Inspection:
Time of Inspection: 1 Q
Total Event Precipitation (inches): ©- -A
Was this a Representative Storm Event'? (See information below) ETYes ❑ No
Please check your penrut to verify if Qualitative Monitoring must be 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
j is preceded by at least 72 hours (3 days) in which no storm event measuring greater than 0.I inches has
occurred. A single storm event may contain up to 10 consecutive hours of no precipitation.
i3y this signature, �� rtify that this ,,port is accurate and complete to the best of my knowledge:
(Sign
or Design
I. Outfall Description:
Outfall No. _i a- Structure (pipe, ditch, etc.) PiDe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area: _
2. Color: Describe the color of the dischge using basic colors (red, brown. blue, etc.) and tint
(light, medium, dark) as descriptors: _A
3. Odor: Describe any distinct odors that the discharge may have (i.e.. smells strongly of oil, weak
chlorine odor, etc.):
Page 1 of 2
SWU-242.20i2ofil3

4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
l 6
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) 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
U` 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
8. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfall? Yes
10. Other Obvious Indicators of Stormwater Pollution:
List and describe Aj A -
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.
Paz-e ? of 2
SWU-242-20120613

-AC4LVXWI
;A*
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out rlus form, please visit: hitL%)r1;Jl.ncctenr.ors==hvchl.ve1hr�hu/nnclec��cgr�b d
Permit No.: NIC/G JO / 6 / 0 / 0 / 0I 0I or Certificate of Coverage No.: N/C/G/ dl 6/ 0/ 0I 9/ 5/
Facility Name: Goulston Technoloqies, Inc.
County: Union
Inspector:
Date of Inspection: - fcq
Time of Inspection: _ /,V s
Total Event Event Precipitation (inches): 0 :?0
No. 704-296-6427
Was this a Representative Storm Event'? (See information below) 2rYes ❑ No
Please check your permit to verify if Qualitative Monitoring must he performed during a representative
storm event (requiremenrs vary
A "Representative Storm Event" is a storm event that measures greater than 0.1 inches of rainfall and that
j 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 cer ify that this report is accurate and complete to the best of my knowledge:
/ Z/
(Signature 2fPermittce or Designee)
1. Outfall Description:
Outfall No. A — Structure (pipe, ditch, etc.) i°e
Receiving Stream: Bearskin. Creek
Describe the industrial activities that occur within the optfall dra page area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e.. smells strongly of oil, weak
chlorine odor, etc.):,. `
Page I of 2
SWU-242-20120613

4. CIarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
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:
? 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 tnuddy:
0 2 3 4 5
7. Is there any foam in the stormwater discharge'? Yes
S. Is there an oil sheen in the stormwater discharge? Yes
9. Is there evidence of erosion or deposition at the outfaIl? Yes Qo
10. Other Obvious Indicators of Stormwater Pollution:
List and describe AA -
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.
Pa�oe 2 of 2
SWU-242-2012061 t

NCDtNR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: htti/Pnrtal.ncilcnr.ur =h� chh., ht �!s lnt��kse�t #t:,b-d
Permit No.: N/C/G I O / 6 / 01 O 1 0 I 0/ or Certificate of Coverage No.. RUC/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: Goulston Technologies, Inc
County: Union Phone No. 704-296-6427
Inspector: Sni.;. /Yl Two,e e
Date of Inspection: S - / a -
Time of Inspection: /6i : 6-2
Total Event Precipitation (inches): ©. a4A
Was this a Representative Storm Event'? (See information below) Yes ❑ No
Please check your permit to veri fi• if Qualitative Monitoring must be petfortned tluring a representative
storm event (requirements vary).
A "Representative Storm Event' is it storm event that measures greater than 0.1 inches of rainfall and that
is preceded by at least 72 hours Q 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:
of Permittee or
1. OutfalI Description:
Outfall No. /-5— Structure (pipe;, ditch, etc.) pipe
Receiving Stream: Bearskin Creek
Describe the industrial activities that occur within the outfall drainage area:
2. Color: Describe the color of the discharge using basic colors (red, brown. blue, etc.) and tint
(light, medium, dark) as descriptors: r lear
3. Odor: Describe any distinct odors that the discharge may have (i.e.. smells strongly of oil, weak
chlorine odor, etc.): LLpe�
Pate 1 of 2
S W C-242-20120613

11
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy: `
(D 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:
b2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
a) 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes
S. Is there an oil sheen in the stormwater discharge:' Yes
9. Is there evidence of erosion or deposition at the outfall? Yes vo
10- Other Obvious Indicators of Stormwater Pollution:
List and describe
:Vote: 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.
Pate 2 of 2
SWG-242-20120613

AZNJ
NCDENR
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit: httv://Dortal.ncdenr.or--/web/L%,Q/ws/stt/nl2dessw#tab-4
Permit No.: NJC/G / 0 4 6 I 0 I 0 / 0 / 0 / or Certificate of Coverage No.: N/C/G/ 0/ 6/ 0/ 0/ 9/ 5/
Facility Name: _Goulston Technologies, Inc.
County: Union _Phone No. 704-296-6427
Inspector:
Date of Inspection: :=
Time of Inspection: _ / c? •' 4?5—
Total Event Precipitation (inches): a `aLf\
Was this a Representative Storm Event? (See information below) E5 Y s ❑ No
Please check your permit to verify if Qualitative Monitoring must be 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
Permittee or
and complete to the best of my knowledge:
1. Outfall Description:
Outfall No. I l& Structure (pipe, ditch, etc.) pipe
Receiving Stream: —Bearskin Creek
Describe the industrial activities that occur within the outfal drainage area:
db�14 - p.."4 .� a
2.
Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium,
as descriptors:
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.):
Page 1 of 2
SWU-242-20120613

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 1 is no solids and 5 is the surface covered with floating solids:
1 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:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
S. 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
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-242-20120613

aceAnalytical
WWW.paCaIOLC9rn
June 02, 2021
John McTaggart
Goulston Technologies
700 N. Johnson Street
Monroe, NC 28110
RE: Project: STORMWATER 2021 #1
Pace Project No.: 92538739
Dear John McTaggart:
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(7D4)875-9092
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
Revision 1-This report replaces the May 20, 2021, report. This report was reissued on June 2, 2021, to updated sample ID
from OF #4 to OF #7 per client's request.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Anq i
Tyriek Hooks
[e-mail]
[phone]
Project Manager
Enclosures
cc: Ms. Sally Duncan, Goulston Technologies
Veronica McKinney, Goulston Technologies
John McTaggart
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 1 of 14

Pace Analytical Services, LLC
aceMaIj6cal a
9800 Kinney Ave. Suite100
Huntersville, NC 28078078
trronr•FNWGbL=
[phone]
CERTIFICATIONS
Project: STORMWATER 2021 #1
Pace Project No.: 92538739
Pace Analytical Services Charlotte
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
South Carolina Certification #: 99006001
Louisiana/NELAP Certification # LA170028
Flodda/NELAP Certification #: E87627
North Carolina Drinking Water Certification #: 37706
Kentucky UST Certification #: 84
North Carolina Field Services Certification #: 5342
YrginiaNELAP Certification #: 460221
North Carolina Wastewater Certification #: 12
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
North Carolina Wastewater Certification M 40
FloridalNELAP Certification #: E87648
South Carolina Certification #: 99030001
North Carolina Drinking Water Certification M 37712
UrginiaNELAP Certification #: 460222
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, I.L.C. Page 2 of 14

ceAnaljftal"
trww.paeelabseam
SAMPLE ANALYTE COUNT
Project STORMWATER 2021 #1
Pace Project No.: 92538739
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersvilie, NC 28078
[phone]
Lab ID
Sample ID
Method
Analysts
Analyses
Reported
Laboratory
92538739001
OF #3
EPA 1664B
CJM
1
PASI-C
SM 254OD-2011
RED
1
PASI-A
SM 5220D-2011
JP1
1
PASI-A
92538739002
OF #7
EPA 1664B
CJM
1
PASI-C
SM 254OD-2011
RED
1
PASI-A
SM 5220D-2011
JP1
1
PASI-A
92538739003
OF #10
EPA 1664B
CJM
1
PASI-C
SM 254OD-2011
RED
1
PASI-A
SM 5220D-2011
JP1
1
PASI-A
92538739004
OF #12
EPA 1664B
CJM
1
PASI-C
SM 254OD-2011
RED
1
PASI-A
SM 5220D-2011
JP1
1
PASI-A
PASI-A= Pace Analytical Services -Asheville
PASI-C = Pace Analytical Services - Charlotte
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 3 of 14

aceAnalj(tical
rrxar pacelabs cram
ANALYTICAL RESULTS
Project: STORMWATER 2021 #1
Pace Project No.: 92538739
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: OF #3 Lab ID: 92538739001 Collected: 05/12/21 11:38 Received: 05/13/21 11:50 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
HEM, Oil and Grease Analytical Method: EPA 1664E
Pace Analytical Services - Charlotte
Oil and Grease NO mg/L 5.0 1 05/19/21 11:05
2540D Total Suspended Solids Analytical Method: SM 254OD-2011
Pace Analytical Services -Asheville
Total Suspended Solids 9.8 mg/L 5.0 1 05/19/21 12:23
5220D COD Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Pace Analytical Services -Asheville
Chemical Oxygen Demand 106 mg/L 25.0 1 05/20/21 02:05 05/20/21 06:35
Sample: OF #7 Lab ID: 92538739002 Collected. 05/12/21 11:45 Received: 05/13/21 11:50 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
HEM, Oil and Grease Analytical Method: EPA 1664B
Pace Analytical Services - Charlotte
Oil and Grease ND mg/L 5.0 1 05/19/21 11:05
2540D Total Suspended Solids Analytical Method: SM 254OD-2011
Pace Analytical Services - Asheville
Total Suspended Solids 3.2 mg/L 2.6 1 05/19/21 12:23
5220D COD Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Pace Analytical Services -Asheville
Chemical Oxygen Demand 35.8 mg/L 25.0 1 05/20/21 02:05 05120/21 06:35
Sample: OF #10 Lab ID: 92538739003 Collected: 05/12/21 11:55 Received: 05/13/21 11:50 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
HEM, Oil and Grease Analytical Method: EPA 1664E
Pace Analytical Services - Charlotte
Oil and Grease ND mg/L 5.2 1 05119/21 12:04
2540D Total Suspended Solids Analytical Method: SM 254OD-2011
Pace Analytical Services -Asheville
Total Suspended Solids 19.8 mg/L 5.0 1 05119/21 12:23
6220D COD Analytical Method: SM 5220D-2011 Preparation Method: SM 522OD-2011
Pace Analytical Services -Asheville
Chemical Oxygen Demand 81.1 mg/L 25.0 1 05/20/21 02:05 05/20/21 06:35
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full.
Date: 06/02/2021 11:36 AM without the written consent of Pace Analytical Services, LLC. Page 4 of 14

aceAnalytical
wurmpaeelabs.eom
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: STORMWATER 2021 #1
Pace Project No.: 92538739
Sample: OF #12 Lab ID: 92538739004 Collected: 05/12/21 12:00 Received: 05/13/21 11:50 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
HEM, Oil and Grease Analytical Method: EPA 1664E
Pace Analytical Services - Charlotte
Oil and Grease ND mg/L 5.0 1 05/19/21 12:04
2540D Total Suspended Solids Analytical Method: SM 254OD-2011
Pace Analytical Services - Asheville
Total Suspended Solids 8.0 mg/L 3.6 1 05/19/21 12:23
5220D COD Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Pace Analytical Services -Asheville
Chemical Oxygen Demand 90.6 mg/L 25.0 1 05/20/21 02:05 05/20121 06:36
Date: 06/02/2021 11:36 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 5 of 14

IceAnalytical®
W. patmlabs.com
QUALITY CONTROL DATA
Project: STORMWATER 2021 #1
Pace Project No.: 92538739
Pace Analytical Services, LLC
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
QC Batch: 621260
Analysis Method:
EPA 1664B
QC Batch Method: EPA 1664B
Analysis Description:
1664 HEM, Oil and Grease
Laboratory:
Pace Analytical Services - Charlotte
Associated Lab Samples: 92538739001, 92538739002
METHOD BLANK: 3269057
Matrix: Water
Associated Lab Samples: 92538739001, 92538739002
Blank Reporting
Parameter
Units
Result Limit
Analyzed Qualifiers
Oil and Grease
mg1L
ND 5.0 05/19/21 11:05
LABORATORY CONTROL SAMPLE:
3269058
Spike LCS
LCS % Rec
Parameter
Units
Conc. Result
% Rec Limits Qualifiers
Oil and Grease
mg/L
40 37.7
94 78-114
MATRIX SPIKE SAMPLE:
Parameter
3269059
Units
92537452002
Result
Spike MS MS % Rec
Conc. Result % Rec Limits Qualifiers
Oil and Grease
mg/L
24.4
44 24.7 1 78-114 M1
SAMPLE DUPLICATE: 3269060
92537457002
Dup
Parameter
Units
Result
Result RPD Qualifiers
Oil and Grease
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 rtght of the result
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 06102/2021 11:36 AM without the written consent of Pace Analytical Services, LLC. Page 6 of 14

aceAnalytical
trtirw.pacala6a.com
QUALITY CONTROL DATA
Project: STORMWATER 2021 #1
Pace Project No.: 92538739
QC Batch: 621261 Analysis Method: EPA 1664B
QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease
Laboratory: Pace Analytical Services - Chariotte
Associated Lab Samples: 92538739003, 92538739004
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersvilie, NC 28078
[phone]
METHOD BLANK: 3269062
Matrix: Water
Associated Lab Samples: 92538739003, 92538739004
Blank Reporting
Parameter
Units
Result Limit
Analyzed
Qualifiers
Oil and Grease
mg1L
NO 5.0
05/19121 12:04
LABORATORY CONTROL SAMPLE:
3269063
Spike LCS
LCS
% Rec
Parameter
Units
Conc. Result
% Rec
Limits Qualifiers
Oil and Grease
mg/L
40 35.8
90
78-114
MATRIX SPIKE SAMPLE:
3269064
92537606001 Spike
MS
MS % Rec
Parameter
Units
Result Conc.
Result
% Rec Limits Qualifiers
Oil and Grease
mg/L
NO 39.6
46.1
114 78-114
SAMPLE DUPLICATE: 3269065
92537633002 Dup
Parameter
Units
Result Result
RPD
Qualifiers
Oil and Grease
mg/L
12.5 9.8
25
Results presented on this page are In the units Indicated by the "UnW column except where an alternate unit Is presented to the right of the resutL
REPORT OF LABORATORY ANALYSIS
This report shall not to reproduced, except in full,
Date: 06/02/2021 11:36 AM without the written consent of Pace Analytical Services, LLC. Page 7 of 14

aceAnalytical
rnrte paceleNf.com
QUALITY CONTROL DATA
Project: STORMWATER 2021 #1
Pace Project No.: 92538739
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QC Batch: 621228
Analysis Method: SM 254OD-2011
QC Batch Method: SM 254OD-2011
Analysis Description: 2540D Total Suspended Solids
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92538739001, 92538739002, 92538739003, 92538739004
METHOD BLANK. 3268722
Matrix: Water
Associated Lab Samples: 92538739001, 92538739002, 92538739003, 92538739004
Blank Reporting
Parameter
Units
Result Limit Analyzed Qualifiers
Total Suspended Solids
mg/L
NO 2.5 05/19/21 12:23
LABORATORY CONTROL SAMPLE:
3268723
Spike LCS LCS % Rec
Parameter
Units
Cone. Result % Rec Limits Qualifiers
Total Suspended Solids
mg/L
250 246 98 90-110
SAMPLE DUPLICATE: 3269120
92538712001 Dup
Parameter
Units
Result Result RPD Qualifiers
Total Suspended Solids
mg/L
153 116 28 D6
SAMPLE DUPLICATE: 3269121
92538846003 Dup
Parameter
Units
Result Result RPD Qualifiers
Total Suspended Solids
mg1L
444 460 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: 06/02/2021 11.36 AM without the written consent of Pace Analytical Services, I.I.C. Page 8 of 14

aceAnalytical
t�rora.ptscela6stcm
QUALITY CONTROL DATA
Project: STORMWATER 2021 #1
Pace Project No.: 92538739
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QC Batch: 621620
Analysis Method: SM 5220D-2011
QC Batch Method: SM 5220D-2011
Analysis Description: 5220D COD
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92538739001, 92538739002,
92538739003, 92538739004
METHOD BLANK: 3270690
Matrix: Water
Associated Lab Samples: 92538739001, 92538739002,
92538739003, 92538739004
Blank Reporting
Parameter Units
Result Limit
Analyzed Qualifiers
Chemical Oxygen Demand mg1L
NO 25.0
05/20121 06:29
LABORATORY CONTROL SAMPLE: 3270691
Spike LCS
LCS % Rec
Parameter Units
Cone. Result
% Rec Limits Qualifiers
Chemical Oxygen Demand mg/L
750 782
104 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 3270692 3270693
MS MSD
92537583001
Spike Spike MS
MSD MS MSD
% Rec
Parameter Units Result
Cone. Cone. Result
Result % Rec % Rec
Limits RPD Qual
Chemical Oxygen Demand mg1L 88.2
100 100 184
186 95 98
90-110 1
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 3270727 3270728
MS MSD
92538646001
Spike Spike MS
MSD MS MSD
% Rec
Parameter Units Result
Cone. Cone. Result
Result % Rec % Rec
Limits RPD Qual
Chemical Oxygen Demand mg/L 88.2
100 100 191
196 103 107
90-110 2
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: 06/02/2021 11:36 AM without the written consent of Pace Analytical Services, LLC.
Page 9 of 14

Paco analytical Services, LLC
aceAnalyticai ® 9800 Kincey Ave. Suite 100
Huntersvilie, NC 28078
trvnw.parsiab3mm [phone]
QUALIFIERS
Project: STORMWATER 2021 #1
Pace Project No.: 92538739
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
NO - 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
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
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: 06/02/2021 11:36 AM without the written consent of Pace Analytical Services, LLC. Page 10 of 14

aceAnalytical
rraatr.�eelatis.eaia
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: STORMWATER 2021 #1
Pace Project No.: 92538739
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
HuntersvERe, NC 28078
[phone]
Lab ID
Sample ID
QC Batch Method
QC Batch
Analytical Method
Analytical
Batch
92538739001
OF #3
EPA1664B
621260
92538739002
OF #7
EPA1664B
621260
92538739003
OF #10
EPA1664B
621261
92638739004
OF #12
EPA1664B
621261
92638739001
OF #3
SM 254OD-2011
621228
92538739002
OF #7
SM 254OD-2011
621228
92538739003
OF #10
SM 254OD-2011
621228
92538739004
OF #12
SM 254OD-2011
621228
92538739001
OF #3
SM 5220D-2011
621620
SM
522OD-2011
621637
92538739002
OF #7
SM 5220D-2011
621620
SM
5220D-2011
621637
92538739003
OF #10
SM 5220D-2011
621620
SM
5220D-2011
621637
92638739004
OF #12
SM 5220D-2011
621620
SM
5220D-2011
621637
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 06/0212021 11:36 AM without the written consent of Pace Analytical Services, LLC. Page 11 of 14

Document Name:
Document Revised: October 28, 2020
r
Sample Condition Upon Receipt(SCUR)
Page 1 of 2
Document No.:
Issuing Authority:
. aceAnalytical
F-CAR-CS-033-Rev.07
Pace Carolinas Quality Office
Laboratory receiving samples:
Asheville ❑ Eden❑ Greenwood ❑ Huntersville ❑ Raleigho Mechanicsville❑ Atlanta[] Kernersville❑
Client Name: WO # : 92538739
("c-,I�'toSt i� I Project
` s • !1 111 111 lid■ II 11 I ■I■1 III
Courier: Fed Ex F JUPS USPS r1cl
Commercial upace ❑other:
Custody Seal Present? ❑Yes �01\la Seals Intact? [:]Yes __1qN0
92536739
Datellnitials Person Examining Contents;
Packing Material: ❑Bubble wrap �3@ubble Bags ❑None ❑ other Biological Tissue Frozen?
� 7 ❑Yes []NoQN/A
Thermometer; v{ JL �t,� ��wet ❑Blue ❑None
IR Gan ID: L u Type of Ice:
/-7. Correction Factor:
Cooler Temp: J Add/Sulgact {°C) OLT Temp should be above freezing to 6'C
❑Samples out of temp criteria. 5amples on ice, cooling process
Cooler Temp Corrected ('C): J hasoegun
USDA Regulated Soil ('Q N/A, water sample)
Did samp`Ies orriiginate in a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source Internationally,
❑Yes I INo includin¢ Hawaii and Puerto Rico)? ❑Yes ONo
Comments/Discrepancy:
Chain of Custody Present?
'Syes
[]NO
NIA
1.
Samples Arrived within Hold Time?
Yes
❑No
N/A
2,
Short Hold Time Analysis (02 hr.l?
❑Yes
❑No
❑N/A
3.
Rush Turn Around Time Requested?
Oyes
IgNo
❑N/A
4.
Sufficient Volume?
• YCS
ONO
❑N/A
S.
Correct Containers Used?
Pace Containers Used?
Lyres
M yes
ONO
ONO
❑N/A
❑N/A
6.
Containers Intact?
'{Xes
(-]No
❑]N/A
7.
Dissolved analysis; Samples Field Flltered?
Yes
(-]No
ON/A
8.
Sample Labels Match COC?
Includes Date[TiMatrix:
'rQYes
�" I
1me/ID/Analysis
Oft❑N/A
9.
Headspace in VOA Vials (>5-bmml?
❑Yes
ONO
N/A
10.
Trip Blank Present?
Trip Blank Custody Seals Present?
❑Yes
❑Yes
❑No
❑No
`QN/A
N/A
11.
COMMENTS/SAMPLE DISCREPANCY Field Data Required? Dyes ❑No
Lot ID of split containers:
CLIENT NOTIFICATION/RESOLUTION
Person contacted:
Project Manager SCURF Review:
Project Manager SRF Review;
Date/Time:
Date:
Date:
Page 12 of 14

Document Name:
Sample Condition Upon Recei
c?CBl
ARr'I�Ical p Document No.:
+' F-CAR-CS-033-Rev,07
*Check mark top half of box if pH and/or dechlorination is
verified and within the acceptance range for preservation
samples.
Exceptions: VOA, Coliform, TOC, Oil and Grease, ORO/801S (water) DOC, LLHg
**Bottom half of box is to list number of bottles
Document Revised: October 28, 2020
Issuing Authority:
Pace Carolinas Qualit!ZOffice
Project #
Wa# : 92538739
PM: TIN Due Date: 05/20/21
CLIENT: 92-Coulsten
I
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■�u��i��iiriuu��i�i
■�iii�0��ii�i���0��=iii
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pH Adjustment Log for Preserved Samples
Sample t0
Type of Preservative
pH upon receipt
Date preservation adjusted
Time preservation
adjusted
Amount of Preservative
added
tot #
Note: whenever there Is a discrepancy affecting North carouna compliance samples, a copy or inis torm will oe sent to the North caroitna utHNN certmcation unice li.e.
Out of hold, incorrect preservative, out of temp, incorrect containers.
Page 13 of 14

f
Section A
2Mulred Client Intortnation
One Charactor per box.
(A-7, 0.91, -)
Samplo Ids must bo unique
UJI
iz
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1
CHAIN -OF -CUSTODY / Analytical Request Document
The Chain -of -Custody is a LEGAL DOCUMENT. Ali relevant fields must be completed accurately. o
v
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d Pwlect Infannatlon. Invoice Information! Page : t Of T
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