NCG090025_2021 DMR_20210807

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG090000
Paints, Varnishes, Lacquers, Enamels, and Allied Products
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCGO9O0 2S—
Person Collecting Samples: L is k; n
Facility Name: Sotyx K s-A "T%c,
Laboratory Name: Vim, Oi 'T n&l +Ico�lL
Facility County: L) j\ drj
Laboratory Cert. No.: LfpA
Discharge during this period: gG Yes ❑ No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ❑ Yes g No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR la Yes ❑ No
Date Uploaded: Og-0%-.26aI
Analytical Monitoring Requirements for Outfalls with Industrial Activities- Benchmarks in 1'ed)
Parameter
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
07 aP aoa1
46529
24-Hour Rainfall in inches
C), as
C0530
TSS in mg/L (100 or 50*)
(y. , s-
00400
pH in standard units (6.0 --9.0)
'7,/p
01027
Cadmium total (as cd) in mg/L'0.002
`� 0, 0010
or 0.003**)
01051
Lead, total recoverable (as Pb) in
<I), OoI®
mg/ L rQ.(171,)
Chromium III, total recoverable (as
C0034
Cr) in mg/ L (0.905)
<0100
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
00552
Non -Polar Oil & Grease in mg/L
NIA
NCOIL
Estimated New Motor/Hydraulic Oil
1 n
Usage in gal/month
N
Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of . All other water classifications have a benchmark of
Outfalls to Trout Waters (Tr) have a benchmark Cadmium limit of 0.002 mg/L. All other water classification have a benchmark of 0.003 mg/L
Notes (optional):
"I certify by my signature below, 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
submittA is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false infoonation, including the possibility of fines and imprisonment for knowing violations."
re of 1130mittee o0elegated Authorized Individual
Email Address Lt�o,. 16 a� (F- b©nO ' co `
g ! 20 oZ
Date u
Phone Number 70V "oZ 0 - %',/

WayPAoint
NALYTICAL
7/9/2021
Bona US
Lisa King
4275 Corporate Center Drive
Monroe, NC, 28110
Ref: Analytical Testing
Lab Report Number: 21-182-0027
Client Project Description: Stormwater 2021
Dear Lisa King:
449 Springbrook Rd, Charlotte, NC 28217
Main 704.529.6364
www.waypointanalytical.com
Waypoint Analytical, LLC (Charlotte) received sample(s) on 7/1/2021 for the analyses presented in the
following report.
The above referenced project has been analyzed per your instructions. The analyses were performed in
accordance with the applicable analytical method.
The analytical data has been validated using standard quality control measures performed as required by the
analytical method. Quality Assurance, method validations, instrumentation maintenance and calibration for all
parameters were performed in accordance with guidelines established by the USEPA (including 40 CFR 136
Method Update Rule May 2012) unless otherwise indicated.
Certain parameters (chlorine, pH, dissolved oxygen, sulfite...) are required to be analyzed within 15 minutes of
sampling. Usually, but not always, any field parameter analyzed at the laboratory is outside of this holding time.
Refer to sample analysis time for confirmation of holding time compliance.
The results are shown on the attached Report of Analysis(s). Results for solid matrices are reported on an as -
received basis unless otherwise indicated. This report shall not be reproduced except in full and relates only to
the samples included in this report.
Please do not hesitate to contact me or client services if you have any questions or need additional information.
Sincerely,
Terri W Cole
Laboratory Project Manager
Laboratory's liability in any claim relating to analyses performed shall be limited to, at laboratory's option, repeating the
analysis in question at laboratory's expense, or the refund of the charges paid for performance of said analysis.
Page 1 of 6

Waypoin-0t,
ANALYTICAL
449 Springbrook Rd, Charlotte, NC 28217
Main 704.529.6364
www,waypointanalytica Isom
Certification Summary
Laboratory ID: WP CNC: Waypoint Analytical Carolina, Inc. (C), Charlotte, NC
State
Program
Lab ID
Expiration Date
North Carolina
State Program
37735
07/31/2021
North Carolina
State Program
402
12/31/2021
South Carolina
State Program
99012
07/31 /2021
South Carolina
State Program
99012
12/31/2021
Page 1 of 1 00016/21-182-0027
Page 2 of 6

� ,Y YI
449 Springbrook Rd, Charlotte, NC 28217
Waypolnt(('�'j' Main 704.S29.6364
ANALYTICAL www.waypointanalytical.corn
Sample Summary Table
Report Number: 21-182-0027
Client Project Description: Stormwater 2021
Lab No Client Sample ID
90813 SW##1
Matrix Date Collected
Aqueous 06/28/2021 17:45
Date Received
07/01/2021 16:30
Page 3 of 6

•
Waypoint
449 Springbrook Rd, Charlotte, NC 28217
Main 704.529.6364
ANALYTICAL
www.waypointanalytical.com
00057
Bona US
Project
Stormwater 2021
Lisa King
Report Date : 07/09/2021
4275 Corporate Center Drive
Information :
Received : 07/O1/2021
Monroe , NC 28110
1�
6A9W
Terri W Cole
Report Number: 21-182-0027
REPORTOFANALYSIS
Laboratory Project Manager
Lab No : 90813
Matrix: Aqueous
Sample ID: SW#1
Sampled: 6/28/2021 17:45
Test
Results
Units
MQL
DF Date / Time By Analytical
Analyzed Method
pH
7.10
S.U.
1 07/02/2110:10 ENM 4500H+B-2011
Total Suspended Solids
6.5
mg/L
3.5
1 07/02/21 08:30 SMW 2540D-2011
Cadmium
<0.0010
mg/L
0.0010
1 07/08/2119:26 EDV 200.8
Chromium
<0.002
mg/L
0.002
1 07/08/2119:26 EDV 200.8
Lead
<0.0010
mg/L
0.0010
1 07/08/2119:26 EDV 200.8
Qualifiers/ DF Dilution Factor L Limit Exceeded
Definitions
Page 4 of 6

Waypoint(b
ANALYTICAL
449 Springbrook Rd, Charlotte, NC 28217
Main 704.529.6364
www.waypointanalytical.com
Shipment Receipt Form
Customer Number: 00057
Customer Name: Bona US
Report Number: 21-182-0027
Shipping Method
0 Fed Ex 0 US Postal # Lab
0 UPS 0 Client 0 Courier
0 Other:
Thermometer ID:
IRT-15 1.2C
Shipping container/cooler uncompromised?
# Yes
0 No
Number of coolers/boxes received
F 1
Custody seals intact on shipping container/cooler?
0 Yes
0 No
# Not Present
Custody seals intact on sample bottles?
0 Yes
0 No
Not Present
Chain of Custody (COC) present?
# Yes
0 No
COC agrees with sample label(s)?
Yes
0 No
COC properly completed
Yes
0 No
Samples in proper containers?
Yes
0 No
Sample containers intact?
# Yes
0 No
Sufficient sample volume for indicated test(s)?
* Yes
0 No
All samples received within holding time?
# Yes
0 No
Cooler temperature in compliance?
# Yes
0 No
Cooler/Samples arrived at the laboratory on ice.
Samples were considered acceptable as cooling
process had begun.
# Yes
0 No
Water - Sample containers properly preserved
0 Yes
0 No
0 N/A
Water - VOA vials free of headspace
0 Yes
0 No
# N/A
Trip Blanks received with VOAs
0 Yes
0 No
# N/A
Soil VOA method 5035 — compliance criteria met
0 Yes
0 No
* N/A
F High concentration container (48 hr) F Low concentration EnCore samplers (48 hr)
F High concentration pre -weighed (methanol -14 d) [_ Low conc pre -weighed vials (Sod Bis -14 d)
Special precautions or instructions included? 0 Yes * No
Comments:
Signature: jLuis E Oviedo Date & Time: 07/01/2021 17:16:13
Page 5 of 6

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