NCG030124_2022 DMR_20221021 (2)

Stormwater NPDES Permit Discharge Monitoringlq
pload
Report (DMR) U
Permit and Facility Information:
Please enter the permit number and other details for this up'c,c
IMPORTANT.• Until your stormwater permit is registered in the eDMR system,an original signed(not digitally
signed)hardcopy of the DMR must be mailed to the address in your permit, in addition to this electronic upload.
Permit Number* Enter COC or Individual Permit Number(NOT General Permit number with all O's)
NCG030124
Must begin with NCS or NCG
Facility Name:* Wieland Copper Products,LLC
County:* Stokes
After uploading here,the original signed hardcopy must be mailed to:
DEQ Winston-Salem Regional Office
Attn: DEMLR Stormwater Program
450 West Hanes Mill Road
Suite 300
Winston-Salem,NC 27105
Further contact details at hftps:/Ideq.nc.gov/contact/regional-offices/mfinston-salem
Monitoring Period Information:
Multiple DMRs from sampling periods within the same year can be uploaded together,but please upload different
years with a new submittal form.
Monitoring Period What is the YEAR of the sampledate(s)?
Year:* 2022
Copies of the lab results and/or qualitative(visual)monitoring should NOT be submitted unless specifically
requested by DEQ staff. Only upload completed and signed DMR forms.
**DMR forms should have original signature(not digital)to comply with requirements in 40 CFR 122.22**
DMR Upload* Click the upload button or drag and crop files here to attach cccument,
SW Report 2nd Qtr 2022-10-21-182037.pdf 3.45MB
Only PDFs are accepted.
Comments: None
* By checking the box and signing box below, I certify that:
o I have given true,accurate,and complete information on this form;
o I agree that submission of this Discharge Monitoring Report(DMR)Upload form is a"transaction"subject to Chapter 66,
Article 40 of the NC General Statutes(the"Uniform Electronic Transactions Act");
• I agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes
(the"Uniform Electronic Transactions Act");
o I understand that an electronic signature on this upload form has the same legal effect and can be enforced in the same
way as a written signature;AND
o I intend to electronically sign and submit this DMR Upload form.

Full Name:* Tony Ryan Sprinkle
Name of person submitting this form
Email Address:* [e-mail]
Phone Number:* 336-816-2591
Signature:
Date:* 1012V2022

SI ORMWATER DISCHARGE OUTFALL(SDO)
MONITORING REPORT
Permit Number NCS NCG030124 SAMPLES COLLECTED DURING CALENDAR YEAR: 2022
(Phis monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
FACILITY NAME: Wieland Copper Products,LLC COUNTY Stokes
PERSON COLLECTING SAMPLE(S) Clifford Cain PHONE NO.(336 )445-4526
CERTIFIED LABORATORY(S) Pace Analytical-Eden Lab tl
[Ali H
SIGNATURE OF FERMI FEE OR DESIGNEE
RL(LUIRED ON PAGE 2.
fart A:Specific.Monitoring Requirements
Outfall Date 50050
No. Sample 'total 'rota) TSS Total CU Lead Oil&Grease Total Zinc PH
Collected Flow ifa Rainfall
mo/ddlvr MG inches
MG/L MG/L MG/L MG/L MG/L
001 9/30/22 1,20 2.25 15.6 0.654 0.0016 NO 0.0655 6.4
002 1 9/30/22 0.223 2.25 10.1 0 239 0-0028 NO 0,0028 6.3
003 9/30/22 0,433 2.25 16.7 0.745 0.0020 NO 0.238 &5
004 9/30/22 0.693 2.25 52.7 1.090 0.0070 NO &0971 6A
005 9130/22 0.347 2,25 16.3 0.637 0.0016 NO 0.184 &6
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor od per month?oyes eno
(if yes,complete fart B)
Part B:Vehicle Maintenance Aciivih Monitories•Rcr uircments
Outfall Date 50050 00556 00530 00400
No. Sample Total Flow Total Oil&Grease Non-polar 'rota) fill New Motor
Collected (ifapplicable) Rainfall (ifappL) O&G/17'H Suspended Oil Usage
(Method 1664 Solids
SGT-HEM),if
appl.
mo/dd/vr MG linches I m I I mg/1 I unit vaurno
NIA
Form S W U 247,last revised 611212015
Page I of 2

STORM EVENT CHARACTERISTICS: Mail Original and one copy to:
Division of Energy Mineral and land Resources
Date 9130/22 Attn:Central Files
Total Event Precipitation(inches): 2.25 1617 Mail Service Center
Event Duration(hours): (only ifapplicable-see permit.) Raleigh,North Carolina 27699-1617
(if more than one storm event was sampled)
Date N/A
Total Event Precipitation(inches):
Event Duration(hours): (only ifapplicable-see permit.)
"I certify,under penally 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 bepef,true,accurate,and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fmp and imprisonment for knowing violations."
( tgnature of Permi ee) (Date)
Form SW U-247,last revised 611212013
Page 2 of 2

Footnotes:
Todd Toxic Organics sampling is applimbic only for those facilities which perform metal finishing operations,manufacture scmicondudont,manufacture cics.-Iraric crystils,or
manufacture cathode ray tubes. For pur'uses of this permit the definitions of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facilities wbjmt
to the requirement to sample(for metal frehirg use the definition as found in 40 CFR 4311 1;for sar k-onduaor manufacture use the definition as found in 40 CFR 469.12;for
cicxxrunic crystal manufacture use the cicfe ition as found in 40 CFR 469 22;and for eatheuk ray,tube manufacture use the definition found in 40 CFR 469-31).
Facilities that develop a solvent management plan to be incorporated into the Stormwater Pollution Prcventiort Plan may make a request to DWQ that monitoring of total toxic
organics be waived The solvent management plan shall include a list of the total toxic organic evmpcwnds used;the method of dlspos:d used instead of dumping,such as
reclamation,contract hauling,or incineration;and the prmudurrs for assuring that toxic organics do not routinely spill or"into the slorm atcr. For those facilities allowed such
a waiver,the discharger shall include the following signed certification stetarrrnt on the dixhargc monitoring rxixnt.
"Based upon my inquiry of the person or persons directly t spcnsble for managing compliince with the permit mcnitcxitg requiranent for
total toxic organics(T"FO),I certify that to the bat of my knowledge and belief,no dumping of concentrated toxic organics into the
stormwa to or areas which are exposed to rain fill]or stormwater runoff has occurred since fling the best discharge monitoring report. 1
further certify that this facility is implanting the whcnt rnanagencni plane included in the Stormwata Pollution
n�Prcvrntion Flan"
ffame u print
n _
rtc pose ��
t
rZU
aturc D=c
\ \J
"i certify,under penalty of law,that this document and all attachments were prepared under my direction or supervislon 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 bellef,true,accurate,and complete.I am aware that there are significant penalties for submitting false information,
including the possibility of fines and imprisonment for knowing violations."
(Signature of Permittee)V (Date)
Form MR-03
✓/ Page 2 of 2

fnti2ronmental
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out thisjorm,please visit httus:!/dea.nc.00v!about!divisionsiener -mineral-land-
resources!enerev-mineral-land-permits/stonnwater-pcmuts/npdec-industrial-s«*tab 4
Permit No.: N/C/_/ l_l J_/_J_l or Certificate of Covera?e No.: N/C/G/0l3/0/
Facility Name: I,JI r✓I OY1 � C ZpLOLC County: el Phone No.
Inspector: Aln
Date of Inspection:
Time of Inspection:
� 2
Total Event Precipitation(inches):
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.
By this signature,I certify that this report is accurate and complete to the best of my knowledge:
r � C
C.�
(Signatur Pennittee or Designee)
1. Outfall Description: F,%IX
Outfall No. o0 1 Stntcture(pipe, ditch,etc.):
Receiving Stream:
Describ the industrial activities that,occur within the outfall drainage area:
S\vU-242,Use modified 07/1-8/2017

2. Color: Describe the color of the discharge using basic colors(red, brown, blue, etc.)and tint
(light, medium, dark)as descriptors: A P-Cr
3. Odor: Describe anY distinct odors that the discharge may have(i.e., smells strongly of oil,weak
chlorine odor,etc.):
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 I is no solids and 5 is the surface covered with floating solids:
G1 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:
`./ 2 3 4 5
7. Is there any foam in the stormwater discharge? O Yes ® No.
8. Is there an oil sheen in the stormwater discharge? oYes do No.
9. Is there evidence of erosion or deposition at the outfall? O Yes 0 No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe �nL
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 07/28P017

i
Ent ironmentat
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out thisfonn,please visit httns:1/deg.nc.eov'about'divisions.'enerey-mineral-land-
resourceslcnerev-mineral-land-nermi is/stormwater-pennitslnpdes-industrial-sw#tab4
Permit No.: N/Cl_I_I_l 1_l l_I or Certificate of Covellrage No.: N/C/GLO131�l 1 1 '�l
Facility Name: W1 f-1 CLY16 C c-, _ f'r'
County: w' -�� p Phone No.
Inspector: 0)t1piLI/' OA in
Date of Inspection: J—a—,;)�
Time of Inspection: )04 D
Total Event Precipitation(inches): t Z
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 pennittee obtains approval from the local DEIVLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Stgna f Permittee or Designee)
1. Outfall Description:
Outfall No. dQ�X, Structure(pipe,ditch, etc.):
Receiving Stream:
Describe Te industrial activities that occur within the outfall drainage area:
9W
l'
Page 1 of 2
SWU-242,Last modified 07/28I2017

2. Color: Describe the color of the discharge using basic colors(red,brown,blue, etc.)and tint
(light, medium,dark)as descriptors: CLPri_r, �"4A4
3. Odor: Describe wnao
stinct odors that the discharge may have(i.e., smells strongly of oil,tweak
chlorine odor,etc.):
4. Clarity: Choose the number which best describes the clarity of the discharge,where I is clear
and 5 is very cloudy: r�
( 1 ) 2 3 4 5
S. 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:
(DI
2 3 4 5
7. Is there any foam in the stormwater discharge? O Yes 40 No.
8. Is there an oil sheen in the stor►nwater discharge? OYes 40 No.
9. Is there evidence of erosion or deposition at the outfall? O Yes Q;No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe M L' n e
Dote: 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 07128 2017

fm rranr.:entrl
Quality
y.
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on filling out this form,please visit harts://deo.nc.eov?about,divisions;`enerQv-mineral-land-
resources.�enerev-mineral-land-permits,'stormwater-n•-nnits/npdes-industrial-sw#tab 4
P mnit No.: N/CI_l_l l /_/_/ 1 or Certificate of Coverage No.: N/C/G/0/3/0/ 1 /av�j
Facility Name: ItiI d C1Y1C1 (',Ynao�� P E'a(..(-L)--,--,
County: S Phone No.
Inspector: AJ
Date of Inspection:
Time of Inspection:
Total Event Precipitation(inches):
i 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 1
local storm events during the sampling period,and the penmittee obtains approval from the local DE1viLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
Wf'w r ,
) ..r-
(Signs of Permittee or Designee)
1. Outfall Description:
Outfall No. Structurc(pipe,ditch,etc.):
Receiving Stream:
Describe the industrial activities t4at occur within the outfall drainage area:
Page 1 of 2
SWU-242,Last modified 0728/2017

2. Color: Describe the color of the discharge using ba is colors(red. brown,blue, etc.) and tint
(light, medium, dark)as descriptors: COCAV -1 M e 12A'11/1
3. Odor: Describe apytdistinet odors that the discharge may have(i.e.,smells strongly of oil, weak
chlorine odor,etc.):
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 1 4 5
5. Floating Solids: Choose the number which best describes the amount officiating solids in the
stornnvater 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:
1 2 ,f,.j 4 5
7. Is there any foam in the stormwater discharge? O Yes &�No.
8. Is there an oil sheen in the storniwater discharge? OYes lw'No.
9. Is there evidence of erosion or deposition at the outfall? O Yes OrNo.
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
S%VU-242,Last modified 07128JUM 7

Environmental
Qua."•
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit httnsJ/dea.nc.eoviabout'divisions�encrs!y-mineral-land-
resources.'enerev-mineral-land-permi is/stonmvater-p,,nnits/npdes-industrial-sw#tab-4
Permit No.: N/C/_/ 1_l I_l_l I or Certificate of Coverage No.: N/C/G/0/3/0/
Facility Name: Cu'1C1 C_C)n10 f(`
County: Phone No.
Inspector: i y t
Date of Inspection: 17—t3b-2:�
Time of Inspection:
Total Event Precipitation(inches):
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 stone 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.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signatur f Permittee or Designee)
1. Outfall Description: t
Outfall No. 1 _ Structure(pipe,ditch, etc.): 1 'N
Receiving Stream:
Describe the indu trial activities that ofcur within the outfall drainage area:
AW Vililml.
Page I of 2
stw-242,Last modified o7r_s2oi 7

2. Color: Describe the color of Vischarge using basic colors(red, brown, blue, erc.) and tint(light, medium, dark)as descriptors: '
3. Odor: Describe any distinct odors that the discharge may have(i.e., smells strongly of oil,tweak
chlorine odor, etc.): N Or)p--
4. Clarity: Choose the number which best describes the clarity of the discharge,where I is clear
and 5 is very cloudy:
1 ? ( 3 ) =1 j
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 cusp m&d solids in
the stormwater discharge,where 1 is no solids and 5 is extremely muddy:
l 2 3 4 5
7. Is there any foam in the stormwater discharge? o Yes No.
8. Is there an oil sheen in the stormwater discharge'? OYes 95 No.
9. Is there evidence of erosion or deposition at the outfall? o Yes VNo.
10. Other Obvious Indicators of Stormtvater Pollution:
List and describe �/1.E.
Note: Lott'clarity,high solids,and/or the presence of foam, oil sheen, or erosion deposition ma} be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2of2
SWU-242,Last modified 07P1.8/2017

p
Ern ircnmentcf
Quc1:•
Stormvatei- Dischai-ge Outfall (SDO)
tn
Qualitative INIonitoring Report
For guidance on filling out this form,please visit https://deg.nc.aov'about'divisionsrenerav-mineral-land
resources/energy-mineral-land-oerniitslstormwater-pennitslnpdes-industrial stittab-4
Permit No.: N/CI l l 1 / / /_/ or Certificate of Coverage No.: N/C/G/O131 of J /�I/
Facility Name: C1 ('(`,y�py/- Pf'rr�C;),U&
County: Phone No.
Inspector:
Date of Inspection: 9 M
Time of Inspection: ! 7igt7
Total Event Precipitation(inches): 2 ` Z
All permits require qualitative monitoring to be perfomied 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 stone
interval does not apply if the pennittee 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
i Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature f enrittee or Designee)
1. Outfall Description:
Outfall No. —0-1-'i Structure(pipe,ditch,etc.): _� {
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
Page 1 of 2
s%VU-242.Last modified 07r8r017

2 Color: Describe the color of discharge us'ng basic colors(red, hrown,blue,etc.)and tint
(light, medium,dark)as descriptors:
3. Odor: Describe an stinct odors that the discharge may have(i.e.,smells strongly of oil,weak
chlorine odor,etc.): i l-)F
4. Clarity: Choose the number which best describes the clarity of the discharge,where I is clear
and 5 is very cloudy: .
1 C2 / 3 4 S
5. Floatin;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:
(I 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? O Yes 41 No.
8. Is there an oil sheen in the stormwater discharge? OYes O'No.
9. Is there evidence of erosion or deposition at the outfall? O Yes `*No.
10. Other Obvious Indi ators 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 2of2
SAU-242,Last modified 07/28/2017

/� Pace Analytical Services,LLC
x ace ^nal. 1i^a J' 1377 South Park Drive
fill�(�I I Y�li Kemersville,NC 27284
wwu.pacelabs.con [phone]
Page 1 of 2
Laboratory Report
Tony Sprinkle Report Date: 10/20/2022
Wieland Copper Products Date Received: 10/03/2022
3990 US 311 Hwy North
Pine Hall, NC 27042
Project: Wieland Copper-SW
Pace Project No.:92628717
Sample: 001 Lab ID: 92628717001 Collected: 09/30/22 16:30 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540D-2015 Total Suspended Solids 15.6 mg/L 2.5 10/04/22 16:49
EPA 1664B Total Petroleum Hydrocarbons ND mg/L 4.9 10/12/22 00:15
EPA 200,8 Rev 5A Copper 654 ug/L 20.0 10/10/22 18:59
EPA 200 8 Rev 5.4 Lead 1.6 ug/L 1.0 10/10/22 05:11
EPA 200.8 Rev 5.4 Zinc 65.5 ug/L 10,0 10/10/22 05:11
Performed by PACE 09/30/22 1630
Collected By Cliff Cain 09/30/22 16:30
Collected Date 09130122 09/30/22 16:30
Collected Time 1630 09/30/22 16:30
pH 6.4 Std.Units 09/30/22 16:30
Temperature 17.0 deg C 09/30/22 16i30
Sample: 002 Lab ID: 92628717002 Collected: 09/30/22 16:40 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540D-2015 Total Suspended Solids 10.1 mg/L 2.5 10/04/22 16:46
EPA 1664E Total Petroleum Hydrocarbons ND mg/L 4.9 10/12/22 00:15
EPA 200.8 Rev 5A Copper 239 ug/L 10.0 10/10/22 19:11
EPA 200.8 Rev 5.4 Lead 2.8 ug/L 1.0 10/10/22 05:22
EPA 200,8 Rev 5.4 Zinc 44.3 ug/L 10.0 10/10/22 05:22
Performed by PACE 09/30/22 16:40
Collected By Cliff Cain 09/30122 16:40
Collected Dale 09130/22 09/30/22 16:40
Collected Time 1640 09/30/22 16A0
pH 6.3 Std. Units 09130/22 16:40
Temperature 16.0 deg C 09/30/22 16:40
Sample: 003 Lab ID: 92628717003 Collected: 09/30/22 16:50 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540D-2015 Total Suspended Solids 16.7 mg/L 2.9 10/04/22 16:51
EPA 1664E Total Petroleum Hydrocarbons ND mg/L 4.9 10/12/22 00:15
EPA 200.8 Rev 5A Copper 745 ug/L 20.0 10/10/22 19:15
EPA 200.8 Rev 5.4 Lead 2.0 ug/L 1.0 10/10/22 05:26
EPA 200.8 Rev 5.4 Zinc 238 ug/L 100 10/10/22 19:15
Performed by PACE 09/30/22 16:50
Collected By Cliff Cain 09/30/22 16:50
Collected Date 09/30/22 09/30/22 16:50
Collected Time 1650 09/30/22 16:50
pH 6.5 Std. Units 09/30/22 16:50
Temperature 18.0 deg C 09/30/22 16:50
Page 1 of 5

Pace Analytical Services,LLC
1377 South Park Dnve
aceHnal�rral
Kemersville,INC 27284
www.pacelabs,com [phone]
Page 2 of 2
Sample: 004 Lab ID: 92628717004 Collected: 09/30/22 16:52 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540D-2015 Total Suspended Solids 52.7 mg/L 4.8 10/04/22 16A6
EPA 1664E Total Petroleum Hydrocarbons ND mg/L 4.9 10/12/22 00:15
EPA 200.8 Rev 5.4 Copper 1090 ug/L 20.0 10/10/22 1 9:18
EPA 200 8 Rev 5.4 Lead 7.0 ug/L 1.0 10/10/22 05:30
EPA 200-8 Rev 5.4 Zinc 97.1 ug/L 10.0 10/10/22 05:30
Performed by PACE 09/30/22 16 52
Collected By Cliff Cain 09/30/22 16:52
Collected Date 09/30122 09/30/22 16:52
Collected Time 1652 09/30/22 16:52
pH 6.4 Std.Units 09/30/22 1&52
Temperature 18.0 deg C 09/30/22 16:52
Sample: 005 Lab ID: 92628717005 Collected: 09/30/22 17:00 Matrix: Water
Method Parameters Results Units Report Limit Analyzed Qualifiers
SM 2540D-2015 Total Suspended Solids 16.3 mg/L 2.7 10/04/22 16:48
EPA 16648 Total Petroleum Hydrocarbons ND mg/L 4.9 10/12/22 00:15
EPA 200.8 Rev 5.4 Copper 637 ug/L 20.0 10/10122 19,30
EPA 200 8 Rev 5.4 Lead 1.6 ug/L 1.0 10/10/22 05:34
EPA 200.8 Rev 5.4 Zinc 184 ug/L 10.0 10/10122 05:34
Performed by PACE 09/30/22 17:00
Collected By Cliff Cain 09/30/22 17:00
Collected Date 09/30/22 09/30/22 17:00
Collected Time 1700 09/30/22 17:00
pH 6.6 Std. Units 09/30/22 17:00
Temperature 16.0 deg C 09/30/22 17:00
.:`2� L1t4�^I:LX
Reviewed by:
Stephanie Knott
704-977-0981
[e-mail]
Pace Analytical Services Charlotte
South Carolina Laboratory ID:99006 South Carolina Certification#: 99006001
9800 Kincey Ave.Ste 100, Huntersville,NC 28078 South Carolina Drinking Water Cert.#:99006003
North Carolina Drinking Water Certification#:37706 Florida/NELAP Certification#:E87627
North Carolina Field Services Certification#:5342 Kentucky UST Certification#:84
North Carolina Wastewater Certification#: 12 Louisiana DoH Drinking Water#: LA029
South Carolina Laboratory ID: 99006 VirginiaNELAP Certification#:460221
Pace Analytical Services Asheville
2225 Riverside Drive,Asheville,NC 28804 South Carolina Laboratory ID:99030
Florida/NELAP Certification#: E87648 South Carolina Certification#:99030001
North Carolina Drinking Water Certification#:37712 VirginiaNELAP Certification#:460222
North Carolina Wastewater Certification#.40
Pace Analytical Services Eden
205 East Meadow Road Suite A,Eden,NC 27288 North Carolina Wastewater Certification#:633
North Carolina Drinking Water Certification#:37738 VirginiaNELAP Certification#:460025
Page 2 of 5

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DCr_Ti;le: ENV-FR+`.1-HJ;J1-003 vC1_Tech Spec sam-
Upon Receipt 1e Condition
; Cc'
.� �..�-2: + E-ective Dare:C5.1:.2�?_
I
Labcr3:Dry receiving samples:
Asheville n Eden 71
i _ ..,_�+�ii
Project,:: /
C�r:rier: LfF?��.< [U?S CUSPS ❑ 11/ I Q f CL.n C/
G IClier.
CC:^.t^2f�ic1 3Ca �CL12f:
Carrier Tracking Numter:
Cus:odp Se31 Present? OYes !?Jc Seals In;act? (Dyes 0:10
C3'!' Eat iri; s Person Exa ninir;Contents:
Po:hlro S13:efiJJ: �EC�E:12:':.."s,7 �Ia7.�.:2-3aa C'Icr'2 C {�`. _•'
•` 8:cicgic3l Tissue Fr an?
Tnermcmeter: ❑IP Gun ID: tlit�2_T O b Z []Yes ❑.Io ,I/A
Tree of Ice: Q:Ye: ❑ Ice ❑?Jcr.?
CaolerTerrp('C): n (v Carre:tionFa::o Ad,/Suttrar_('C)
Correc•.ad Caeler Tamp('C): (i S Temp should to n'CVe frae_irg to 6'C
CISam.;Ies"..Cf cE^c:rt:3',a.San;lesCniC?,ca:firg;,rece:s
USDA Repla:ed Soil(QPJ;A,w3te-sam le) has he;un
p
Cid sample'crg:na:e in a Gusr;r::Ere:_r:e v:i:`;-,t'.-e Uniter Ss'a5'G=,M'r❑ S- .+;,Cr C(_ -:lt r3 s)? a for?;.n
a s ur:a(:n:ar-otEcnaP
inc'. dicq Ftans,i y.
and Pu?r c R:ai?[iv?s Ono
Ccmmarts/Cixraan rf:
Chain of Custcd•r Pr_sent? ff.r's Duo C]rl/A 11.
<_srr,cles Ar-:e; vithin F?cld T:r.e? [dv?: Qr+a f Irv.: 12
Shcr:Hold T.ne Analgsls(e7_hr.)? [ye; Mc 3
Ru:h Turn Around Time Re__es:ad? [f//y:; 14
SufficientVvlume? L_ly' r1a f]v;a S.
Ccrrec:Ccnt3iners Used? [.(°Yes Qvo Q:J/A 16
-Pace C:rtainer;User? Ike: l_lrta QrJ/A
Ccn:s!r.ers Int3C:? L'IYes D,ya ❑n"-, 17.
Gs;clv?r ara;ysis:Ssr..cles Fie'.d Filta•ed? ❑•r>-s Droc Q}Jlr. ( 3•
Sanple Latels ILtat:h COC? CTye-- ONO ❑N/A 9.
Includes Datelrime/ID/An ilvs:s Matrix: W T
He3d:cace in VOA Vials(>S-Emm)? Dye: I]r;a Dn,% I ,�
Trip EIank Present? [Yes C3:+1 ©,yfq ,
Trio Elar. CuStcdV Seals Prot?n;? DY,s Dya
CCYht:.tc'NTS/SAMPLE DISCREPANCY
Field Data Ratluired? []yes ❑No
Lot 10 of sclit containers:
Tamp Lcg:Temp must be maintained CLIENT NOTiFICATIONIRESOLUTION
at<6 C during login,record temp
every 20 minutes.
Time opened:l ZS (,'Temp-. p,S
Time:j 3 00 put in cooler
Time: Temp:
Person Contact_,:
� Da:e/Time:
Project Manager SCURF Review:
Date:
Project Manager SRF Review:
Date:
Qualtr3x Document ID:70677
Page 1 Of 2
Page 4 of 5

Document Name: Cccument Issued:November 15,2021
r Bottle Identification Form(BIF) I Page 1 of 1
1�;alce
Alk?IftiCaj� I Document No.: Issuing Authority:
F-CAR-05-043•Rev.01 Pace Caro'inas Qualit•1 Office
"Check mark top half of box if pH and/or dechlorination is Project#
verified and within the acceptance range for preservation
samples. C
Exceptions:V0.1,Coliform,TOC,Oil and Grease,DRO/8015(water)DOC.LLHg
"Bottom half of box is to list number of bottles
< o < z
2 2 2 — Z G Z
ry ry C N ` ,Z
�OJ 6�1 G L V V 3 A O 9 G V V U
m V U T — \ U V j ti O- _ CI
c c c ° v C C c c O n c O v ^ c ry a >
7 t: O C = = N Z C U O _ = ,G N C O Q j A .o - O_ C
v u 7 u _ u u v C '� , 7 y L C. O
r i V r .0 .r r_r ^ � 7g C Z O Y Y CI d 7
7 V d
O r nl 'C •'f q C C C O C Q G
L L d G G G G Q E J G C N 0 O> O> Q G G N N C n
. `a = n E -;— n E E E E
CL
V C,u Q. a L a a a L C7 V V 0 V V V V V V U CO � a a a V m ccui V m m m m m coC C C C C C C > > C > > N CoC > G
1 1 1 N NKNIN 2 1 ( 1
21 ( NI 2 � 11 I I I T��
3 1 I 11 �4 N1 I I I I I
all III ,NN I 2 I 1\1 I I I I
s I I 12
I 6 I I 11
7 \1\ \1— I
a NN\\ I N I I I L
9 N\\
+
10 I NN 1
11 IN\—
NNI I N I I
12 I I I \\I I T- I I I FFNT
pH Adjustment Log for Preserved Samples
sample to Type of Preservative pH upon receipt Date preservation adjusted Time preservation Amount of Preservative Lout
adjusted added
Note:whenever there is a discrepancy affecting North Carolina compliance samples,a copy of this form will be sent to the North Carolina DEHNR Certification office(i.e
Out of hoed,incorrect preservative,out of temp,incorrect containers.
Page 5 of 5