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HomeMy WebLinkAboutNCS000528_Renewal application_20230606 '!%WATERS EDGE ENVIRONMENTAL, LLC 1434 CHESTER ROAD.RALEIGH, NC 27608• PHONE 919.219.5820 May 23, 2023 Brianna Young, MS (she/her/hers) Industrial Individual Permits Coordinator Stormwater Permitting Program NC DEQ/ Division of Energy, Mineral, and Land Resources (DEMLR) 1612 Mail Service Center, Raleigh,NC 27699 Reference: NPDES Stormwater Permit Renewal Application Premiere Fibers Facility 10056 US S.R. 52N Ansonville, North Carolina 28007 Stormwater Permit No. NCS000528 Waters Edge Job No. R9-21 Dear Ms. Young: �. We are attaching the NPDES Stormwater Permit Renewal application for the above-mentioned facility located in Ansonville, Anson County, North Carolina. We have the following attachments: • EPA NPDES Permit Summary Report-Appendix A • EPA NPDES Renewal- Certification- Appendix A EPA NPDES Supplemental Information Form- Appendix A • EPA Form 3510-1-Appendix B '• • EPA Form 3510-2f-Appendix C • Laboratory Documentation of Representative Sampling Event for parameters specified in Item 7.2 and Table A (oil & Grease, total P, total Kjeldahl N, and total N- Appendix D • Figure I- USGS Project Location Map with Outfall Drainage Areas • Figure 2- Project Location Map • Figure 3- Site Map with five (5) outfalls, groundwater monitoring well locations, and exterior structures including loading and unloading docks. If you have any questions, or if we may be of further assistance, please contact me at prahnL�watersedgeenv.com or 919.219.5820. Sincerely, Waters Edge Environmental, LLC Phillip L. Rahn QED .;� President .,a v .I I.tli.11 cc: Mr. Dewey Fulton and Mr. Chris Fowler- Premier Fibers D �ALR Stprm��ater Program 23-021 , { CaA6y AU- \ E, r _ � r `\ - r' 1: o z Leak Is& PEE DE E _A'CIUU / WILDLIFE REFCiGF. 44 77- se Ro CK haron ., S `• - f ! ~ .J �- E�endshiP CT�gqrch Of God LEGEND Ansonville t ) 1-mile Radius 43� 1 �' Property Boundary fo, 7:,;Iu Cs_, o Outfall 1-2 Drainage Area .:, AYLES 1000 0 1000 20DO 3000 4000 5000 6000 70M 8000 9000 SD000 Outfall 3-5 Drainage Area ; 6Pt: e,nr. FEET Job No. Tuljo Quad Bare Title Project Location Man�silh Outfall Drainage Areas ,MLWATERS EDGE ENVI RONM ENTAL, LLC R9-21 Ansonville 3.15.2023 File Name hi,qure 5'cale Prvjecr 1'rcn,iere Filers 23-023 I bar scale Ansonville.North Carolina _C2 LEGEND Property Boundary 0 5 1,000 500, Job No. Topo Quad Dare rifle Project Locafion map WATERS EDGE ENVIRONMENTAL, LLC AnsonvilIc 1 3 152023 I'de Name iFigure Scale Project Premiere Fibers 23-023 2 bar scale Ansonville.North Caerolina STORAGE LOCATIONS A Nitrogen Tank k '. Kx<�• B Raw Materials Silos C Diesel Fuel Tank D Propane Tank f" E Trash Dumpster ; F Hydrogen Cylinders G Receiving/Loading Dock + owl ,� H Metal Dumpster I Drum Storage 7. S - t 7 �' r � + R t- LEGEND Monitoring Well -in Deep Monitoring Well Outfall Sampling Location Outfall Boundaries job Image/Photo Date Title Site Map with Monitoring Wells and Oull'ail WATERS EDGE ENVIRONMENTAL. LLC R9-21 2022 Google Farth 3 20 2023 Locations File Name Figure Sc Premierrl,ihers 23-023 3 hat scale Anson isle.North Carolina NC Division of Energy, Mineral and Land Resources W NPDES Stormwater Permit Summary NC DCMLR has the following information in our Permit Database for vour perinit as of 3/28/2023. Permit Number: NCS000528 Permit Status: Expired Permit Type: Stormwater Discharge, Individual Facility Name: Premiere_Fibers Facility Addressi: 10056 US Hwy 52 N Facility Address2: City, State&Zip: Ansonyille, NC 28007 Owner Information Details: MUST submit a Change of Name/Ownership form to DEMLR to make any changes to this Owner information. .Click Here for "Change of Name/Ownership"Form) Owner Name: Premiere Fibers Owner Type: Non-Government Owner Type Group: Organization *** Legally Responsible for Permit*** (Responsible corporate officer/p rinci pie executive officer or ranking elected official/general partner or proprietor; or any other person with delegated signatory authority from the legally responsible person.) Owner Affiliation. Dewey Fulton Title: Addressi: PO Box 8930 v. Address2: City,State&Zip: Bristol, VA 24203 Work Phone: 423-306-7339 Fax: 276-669-3304 �. Email Address: dewev.fulton@universalfibers.com *** Permit Annual Fee Billing *** Billing Month: September Invoice Number Invoice Date Invoice Due Date Invoice Amount Invoice Status Owner Contact Person(s) Contact Name Title Address Phone Fax Email Facility Contact Person(s) Contact Name Title Address Phone Fax Email Kevin Bowers PO Box 436,Ansonville, NC 28007-0436 704-826-8321 704-826-6159 kbowers@premierFb ers.com Dewey Fulton PO Box 8930, Bristol, VA 24203 276-645-9719 Permit Contact Person(s) Contact Name Title Address Phone Fax Email 3/28/2023 Page 1 NC Division of Energy,, Mineral and Land Resources NPDES Stormwater Permit Summary NC DEMLR has the following information in our Permit Database for your permit as of 3/28/2023. Contact Name JW& Address Phone Fax EMU Dewey Fulton PO Box 8930,Bristol,VA 24203 276-645-9719 4 Type Contact Name 1-ft Address ne Fax Email air ........... R ..L NOW Tvae Contact Name Title Address one Fax do UP Outfall#: 001 Outfall Description: unknown Outfall Lattitude: 35.212780 Outfall Longitude: -80.110560 Represented by Outfall: %Stormwater: 100 %Industrial: Stream Waterbody Basin Waterbody Name Index Number Classification Yadkin Buffalo Creek 13-18-1 C r. Ad ,w, 3/28/2023 Page 2 r w STORMWATER POLLUTION PREVENTION PLAN DEVELOPMENT AND IMPLEMENTATION CERTIFICATION a North Carolina Division of Energy, Mineral, and Land Resources—Stormwater Program Facility Name: Premiere Fibms Permit Number NCs000528 Location Address: ,Goss us Highway 52 North lid Ansonvi0e,NC 28007 County: Anson I certify, under penalty of law, that the Stormwater Pollution Prevention Plan (SPPP) document and all attachments were developed and implemented under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information required by the SPPP. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information gathered is, to the best of my knowledge and belief, true, accurate and complete." And "I certify that the SPPP has been developed, signed and retained at the named facility location, and the SPPP has been fully implemented at this facility location in accordance with the terms and conditions of the stormwater discharge permit." r And "I am aware that there are significant penalties for falsifying information, including the possibility of fines and imprisonment for knowing violations." .. Sign(according to permit signatory requirements)and return this Certification. DO NOT SEND STORMWATER POLLUTION PREVENTION PLAN WITH THIS CERTIFICATION. a.r Signature _ Da go„�Lkweo GU r A Print or type me of person signing above Itle a14 ems. �u SPPP Certification 10/13 ,r so we SUPPLEMENTAL INFORMATION REQUIRED FOR RENEWAL OF INDIVIDUAL NPDES STORMWATER PERMIT Two copies of each of the following shall accompany this submittal in order for the application to be considered complete: (Do not submit the site Stormwater Pollution Prevention Plan) }4 Initials DF 1. A current Site Map from the Stormwater Pollution Prevention Plan. The location of industrial activities(including storage of materials, disposal areas, process areas and loading and unloading areas),drainage structures,drainage areas for each outfall, building locations and impervious surfaces should be clearly noted. DF 2. A summary of Analytical Monitoring results during the term of the existing permit (if your permit required analytical sampling). Do not submit individual lab reports. The summary can consist of a table including such items as outfall number, parameters sampled, lab results, date sampled,and storm event data. DF 3. A summary of the Visual Monitoring results. Do not submit individual monitoring reports.The summary can consist of a table including such items as outfall number, parameters surveyed, observations, and date monitoring conducted. DF 4. A summary of the Best Management Practices utilized at the permitted facility. Summary should consist of a short narrative description of each BMP's in place at .r the facility. If the implementation of any BMP's is planned, please include information on these BMP's. DF 5. A short narrative describing any significant changes in industrial activities at the permitted facility. Significant changes could include the addition or deletion of work processes, changes in material handling practices, changes in material storage practices, and/or changes in the raw materials used by the facility. DF 6. Certification of the development and implementation of a Stormwater Pollution Prevention Plan for the permitted facility(Sign and return attached form). If the final year analytical monitoring of the existing permit term has not been completed prior to filing the renewal submittal, then the last years monitoring results should be submitted within 30 days of receipt of the laboratory reports. (i.e.do not withhold renewal submittal w waiting on lab results) p EPA Identification Number NPDES Perm t Number Faality Name Form Approved 03105119 NCD986230159 NCSODOS28 Premiere Fibers OMB No.2040-0004 Form U.S.Environmental Protection Agency t t"YEPA Application for NPDES Permit to Discharge Wastewater NPDES GENERAL INFORMATION SECTION ! '• 1 1.1 Applicants Not Required to Submit Form 1 Is the facility a new or existing publicly owned Is the facility a new or existing treatment works 1.i.1 treatment works? 1.1.2 treating domestic sewage? If yes,STOP. Do NOT complete 0 No If yes,STOP. Do NOT No Form 1.Complete Form 2A. complete Form 1.Complete Form 2S. 1.2 Applicants Required to Submit Form 1 1.2.1 Is the facility a concentrated animal feeding 1.2.2 Is the facility an existing manufacturing, E operation or a concentrated aquatic animal commercial,mining,or silvicultural facility that is a production facility? currently discharging process wastewater? Ej Yes 4 Complete Form 1 21 No ❑ Yes -* Complete Form 0 No z and Form 2S. 1 and Form 2C. 1.2.3 Is the facility a new manufacturing,commercial, 1.2.4 Is the facility a new or existing manufacturing, mining,or silvicultural facility that has not yet commercial,mining,or silvicultural facility that commenced to discharge? discharges only nonprocess wastewater? C Yes 4 Complete Form 1 0 No ❑ Yes 4 Complete Form []✓ No R and Form 2D. 1 and Form 2E. d) 47 1.2.5 Is the facility a new or existing facility whose discharge is composed entirely of stormwater a associated with industrial activity or whose discharge is composed of both stormwater and non-stormwater? 0✓ Yes 4 Complete Form 1 ❑ No and Form 2F unless exempted by 40 CFR 122.26(b)(14)(x)or b 15 . SECTIOND•- AND LOCATION(40 2.1 Facilit y Name Premiere Fibers 0 2.2 EPA Identification Number u O NCD986230159 ro 2.3 Facility Contact Name(first and last) Title Phone number Dewey Fuiton Corporate Engineer (276)645-9719 to Email address dewey.fulton@universalfibers.com 2A Facility Mailing Address E Street or P.O.box R PO Box 8930 City or town State ZIP code Bristol VA 24203 EPA Form 3510-1(revised 3-19) Page 1 EPA Identification Number NPDES Permit Number Fa6lity Name Form Approved 03/05/19 NCD986230159 NCS000528 Premiere Fibers OMB No.204M004 y 2.5 Facility Location Street,route number,or other specific identifier Q �0 10056 US Highway 52 North a� 0 County name County code(if known) Anson E City or town State ZIP code E -o z m Ansonville NC 28007 SECTION • NAICS CODES1 3.1 SIC Code(s) Description(optional) 2824 Man made organic fiber N Gl 0 c.3 W u z 3.2 NAICS Code(s) Description(optional) �rs C 325220 U W _ 4.1 Name of Operator Premiere Fibers 0 4.2 Is the name you listed in Item 4.1 also the owner? E 0 ❑✓ Yes ❑ No w 4.3 Operator Status 0 �— 2 ❑ Public—federal ❑ Public—state ❑ Other public(specify) o IDPrivate ElOther(specify) 4.4 Phone Number of Operator (276)645-9719 4.5 Operator Address Street or P.O. Box E PO Box 8930 c .S City or town State ZIP code 0 o Bristol VA 24203 o Email address of operator 0 dewey.fulton@universalfibers.com SECTION • • ! 0 c 5.1 Is the facility located on Indian Land? ❑Yes ❑✓ Na EPA Form 3510-1(revised 3-19) Page 2 EPA IdenbficalJon Number NPDES Permit Number Facility Name Form Approved 03105119 NCD986230159 NC5000528 Premiere Fibers OMB No.2040-0004 SECTION •• I 6.1 Existing Environmental Permits(check all that apply and print or type the corresponding permit number for each) d m NPDES(discharges to surface ❑ RCRA(hazardous wastes) ❑ UIC(underground injection of o water) fluids) NC5000528 NCD986230159 w ❑ PSD(air emissions) ❑ Nonattainment program(CAA) ❑ NESHAPs(CAA) �a X ❑ Ocean dumping(MPRSA) ❑ Dredge or fill(CWA Section 404) ❑ Other(specify) LU SECTI• 1 7.1 Have you attached a topographic map containing all required information to this application?(See instructions for m specific requirements.) ` ❑/ Yes ❑ No ❑ CAFO—Not Applicable(See requirements in Form 213.) SECTIONOF I 8.1 Describe the nature of your business. Man-made organic fiber-SIC 2824 N a c 7 O Gl 7 2 SECTION •! I 9.1 Does your facility use cooling water? �- ❑ Yes ❑ No 4 SKIP to Item 10.1. v ' 9.2 Identify the source of cooling water.(Note that facilities that use a cooling water intake structure as described at � 40 CFR 125,Subparts I and J may have additional application requirements at 40 CFR 122.21(r).Consult with your o Y NPDES permitting authority to determine what specific information needs to be submitted and when.) ca SECTION1 VARIANCE REQUESTS 1 1 10.1 Do you intend to request or renew one or more of the variances authorized at 40 CFR 122.21(m)?(Check all that apply.Consult with your NPDES permitting authority to determine what information needs to be submitted and when.) d ❑ Fundamentally different factors(CWA ❑ Water quality related effluent limitations(CWA Section x Section 301(n)) 302(b)(2)) d ❑ Non-conventional pollutants(CWA ❑ Thermal discharges(CWA Section 316(a)) Section 301(c)and(g)) Not applicable EPA Form 3510-1(revised 3-19) Page 3 EPA ldentir:cat on Number WDES Permit Number Facihty Name Form Approved 03105119 NCD996230159 NCSr10052$ Premiere Fibers OMB No 2040-0004 SECTION1 CERTIFICATION STATEMENT(40 . . 111 In Column 1 below,mark the sections of Form t that you have completed and are submitting with your application. For each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority.Note that not all applicants are r uired to provide attachments. Column 1 Column 2 Section 1:Activities Requiring an NPDES Permit ❑ w/attachments ❑� Section 2:Name,Mailing Address,and Location ❑ wl attachments 0 Section 3:SIC Codes ❑ wl attachments 0 Section 4:Operator Information ❑ wl attachments ❑J Section 5:Indian Land ❑ wl attachments e 0 Section S:Existing Environmental Permits ❑ wl attachments ❑ Section 7:Map 0 w'topographic ❑✓ w/additional attachments 14map n 0 Section 8:Nature of Business ❑ wl attachments a ❑ Section 9:Cooling Water Intake Structures ❑ wi attachments V Section 10:Variance Requests El wi attachments c []� Section 11:Checklist and Certification Statement ❑ w/attachments Y 11.2 Cartificatlon Statement U t 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 property 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. t am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations. Name(print or type first and last name) Official title 4074 � f Sign tufe Dale signed .R � Z5 ZVZ15 EPA Form 3510.1(revised 3-19) Page 4 EPA Identification Number NPDES Permit Number Facility Name Form Approved D3105119 NCD986230159 NCS000529 Premiere Fibers OMB No.2040-0004 Form U.S Environmental Protection Agency 2F 8,EPA Application for NPDES Permit to Discharge Wastewater NPDES STORMWATER DISCHARGES ASSOCIATED WITH INDUSTRIAL ACTIVITY LOCATIONr 1.1 Provide information on each of the facili 's outfalls in the table below Outfall Receiving Water Name Latitude Longitude Number 1 Buffalo Creek 35' 07' 14" N 80° 06' 20" W c a u 2 Buffalo Creek 35' 07 14" N 80' 06' 16" W 0 J 3 Buffalo Creek 35' 07' 11" N 80, 06' 15" W 4 Buffalo Creek 35' 07 08" N 80, 06' 16' W 5 Buffalo Creek 35` 07' 08" N 80, 06' 15 W SECTION - 1 s 2.1 Are you presently required by any federal,state,or local authority to meet an implementation schedule for constructing, upgrading,or operating wastewater treatment equipment or practices or any other environmental programs that could affect the discharges described in this application? ❑ Yes [. No 4 SKIP to Section 3. 2.2 Briefly identify each applicable project in the table below. Brief Identification and Affected Outfalls Final Compliance Dates Description of Project (list outfatl numbers) Source(s)of Discharge Required Projected c m E 0 a. E 2.3 Have you attached sheets describing any additional water pollution control programs(or other environmental projects that may affect your discharges)that you now have underway or planned?(Optional Item) ❑ Yes ❑ No EPA Form 3510-2F(Revised 3-19) Page 1 w EPA Identification Number NPDES Permit Number Facility Name Fors Approved 03/05119 NCD986230259 NC5000528 Premiere Fibers OMB No.2040-0004 SECTION 3.SITE /'A 1 3.1 Have you attached a site drainage map containing all required information to this application?(See instructions for 0 cc C specific guidance.) in 'cc M ® Yes ❑ No r SECTIONPOLLUTANT SOURCESi 4.1 Provide information on the facility's pollutant sources in the table below. Outfall Impervious Surface Area Total Surface Area Drained ` Number (within a mile radius of the fadlity) (within a mile radius of the facility) specify units specify units 1 1.13 acres 30.13 acres —• specify units specify units 2 0.46 acres 30.13 acres specify units specify units 3 0.46 acres 54.54 acres specify units specify units 4 0.55 acres 54.54 acres •--• specify units specify units 5 0.07 acres 54.53 acres specify units specify units 4.2 Provide a narrative description of the facility's significant material in the space below.(See instructions for content requirements.) Premiere Fibers is a converter of Nylon-Type 6,Nylon-Type 6.6 and Polyester pellets into a wound fiber. Synthetic oils a) are applied for future processing. 0 0 4.3 Provide the location and a description of existing structural and non-structural control measures to reduce pollutants in stormwater runoff. See instructions fors ecific uidance. 5tormwater Treatment Codes from Outfall Number Control Measures and Treatment Exhibit 2F-1 list 1 No control measures 2 No control measures 3 No control measures 4 No control measures 5 No control measures EPA Form 3510-2F(Revised 3-19) Page 2 EPA Wenfificaton Number NPDES Permit Number racirrly Name Farm Approved 03105/19 NCD986230159 NC5000528 Premiere Fibers OMB No.2D40-OD04 SECTION •N STORMWATER 1 r 5.1 1 certify under penalty of taw that the outfall(s) covered by this application have been tested or evaluated for the presence of non-stormwater discharges. Moreover, / certify that the outfalls identified as having non-stormwater discharges are described in either an accompanying NPDES Form 2C,2D,or 2E application. Name(print or type first and last name) Official titte Dewey Fulton Signature Date signe 72� 2c�Z s' 5,2 Provide the testing information requested in the table below. OuNall Onsite Drainage Points Number During of Testing Method Used Dates)of Testing Directly Observed Duran Test i Direct Observation 04/25/2023 Yes 2 Direct Observation 04/25/2023 Yes 0 Z 3 Direct Observation 04/25/2023 Yes 4 Direct Observation 04/25/2023 Yes 5 Direct Observation 04/25/2023 Yes SECTIONOR 1 1 6.1 Describe any significant leaks or spills of toxic or hazardous pollutants in the last three years. w None n 0 se a ». c iA SECTION DISCHARGE INFORMATION1 See the instructions to determine the pollutants and parameters you are required to monitor and,in turn,the tables you must com lete.Not all applicants need to complete each table. 7.1 Is this a new source or new discharge? a ❑ Yes 4 See instructions regarding submission of ❑ No 4 See instructions regarding submission of estimated d ata. actual data. CE' Tables A,B,C,and D u 7.2 Have you completed Table A for each outfall? []✓ Yes ❑ No EPA Farm 3510-2F(Revised 3.19) Page 3 AM EPA Identification Number NPDES Permit Number Facility Name Form Approved 03/05/19 NCD986230159 NCSOOO528 FPremiere Fibers OMB No.2040-0004 7.3 Is the facility subject to an effluent limitation guideline(ELG)or effluent limitations in an NPDES permit for its process y„F wastewater? ❑ Yes ❑✓ No 4 SKIP to Item 7.5. 7.4 Have you completed Table B by providing quantitative data for those pollutants that are(1)limited either directly or a� indirectly in an ELG and/or(2)subject to effluent limitations in an NPDES permit for the facility's process wastewater? ❑ Yes ❑✓ No 7.5 Do you know or have reason to believe any pollutants in Exhibit 2F-2 are present in the discharge? ❑ Yes ❑✓ No 4 SKIP to Item 7.7. 7.6 Have you listed all pollutants in Exhibit 2F-2 that you know or have reason to believe are present in the discharge and r� provided quantitative data or an explanation for those pollutants in Table C? ❑ Yes ❑ No 7.7 Do you qualify for a small business exemption under the criteria specified in the Instructions? ❑ Yes 4SKIP to Item 7.18. ❑ No 7.8 Do you know or have reason to believe any pollutants in Exhibit 2F-3 are present in the discharge? .� ❑ Yes ❑✓ No 4 SKIP to Item 7.10. 7.9 Have you listed all pollutants in Exhibit 2F-3 that you know or have reason to believe are present in the discharge in c Table C? 1 ,� �`o� ❑ Yes No 0 7.10 Do you expect any of the pollutants in Exhibit 2F-3 to be discharged in concentrations of 10 ppb or greater? ❑ Yes ❑✓ No-*SKIP to Item 7.12. �+ o 7.11 Have you provided quantitative data in Table C for those pollutants in Exhibit 2F-3 that you expect to be discharged in oM concentrations of 10 ppb or greater? sr El Yes ❑✓ No 7.12 Do you expect acrolein,acrylonitrile,2,4-dinitrophenol,or 2-methyl-4,6-dinitrophenol to be discharged in concentrations of 100 ppb or greater? &d ❑ Yes ❑✓ No 4 SKIP to Item 7.14. 7.13 Have you provided quantitative data in Table C for the pollutants identified in Item 7.12 that you expect to be discharged in concentrations of 100 ppb or greater? *p ❑ Yes [D No 7.14 Have you provided quantitative data or an explanation in Table C for pollutants you expect to be present in the discharge at concentrations less than 10 ppb(or less than 100 ppb for the pollutants identified in Item 7.12)? ❑ Yes ❑✓ No 7.15 Do you know or have reason to believe any pollutants in Exhibit 2F-4 are present in the discharge? ❑ Yes ❑✓ No 4 SKIP to Item 7.17. 7.16 Have you listed pollutants in Exhibit 2F4 that you know or believe to be present in the discharge and provided an explanation in Table C? r.� ❑ Yes 0 No 7.17 Have you provided information for the storm event(s)sampled in Table D? ❑ Yes ❑✓ No .w EPA Form 3510-2F(Revised 3-19) Page 4 ors EPA ideritEfication Number NPDES Permit Number Facility Name Form Approved 03/05/19 NCD986230159 NCS000528 Premiere Fibers OMB No.2040-0004 Used or Manufactured Toxics - 7.18 Is any pollutant listed on Exhibits 21 through 2F-4 a substance or a component of a substance used or 8 manufactured as an intermediate or final product or byproduct? a ❑ Yes �]✓ No 4 SKIP to Section 8. 0 7.19 List the pollutants below,including TCDD if applicable. 1. 4. 7. m cc 2. 5. 8. U c3 3. 6. 9. I SECTIONe eG ICAL TOXICITY TESTING DATA i 8.1 Do you have any knowledge or reason to believe that any biological test for acute or chronic toxicity has been made on ro any of your discharges or on a receiving water in relation to your discharge within the last three years? ❑ Yes ✓❑ No 4 SKIP to Section 9. N 8.2 Identify the tests and their purposes below. Test(s) Purpose of Test(s) Submitted to NPDES gate Submitted x Permitting Authority? Q ~ ❑ Yes ❑ No U_ o ❑ Yes ❑ No m0 ❑ Yes ❑ No SECTION 9.CONTRACT ANALYSIS INFORMATIONi 9.1 Were any of the analyses reported in Section 7(on Tables A through C)performed by a contract laboratory or consulting firm? ❑ Yes ❑ No 4 SKIP to Section 10. 9.2 Provide information for each contract laboratory or consulting firm below. Laboratory Number 1 Laboratory Number 2 Laboratory Number 3 Name of laboratory/firm Pace Analytical 0 .a E 0 N Laboratory address 370 West Meadow Road U) ? Eden,North Carolina �a a U R 0 Phone number ca (336)623-8921 Pollutant(s)analyzed TSS,COD,and pH(analyzed semi-annually 0&G,Total P, Total Kjeldahl nitrogen,and Total Nitrogen were analyzed on 4/25/2023 EPA Form 3510-2F(Revised 3-19) Page 5 EPA IdenVication Number NPpES Permit Number raa_Ihy Name Farm Approved 03/05/19 NCD9S623p159 NCS000528 Premiere Fibers OMB No.2040-0004 SECTION 1 1 CERTIFICATION STATEMENT(40 and 10.1 In Column 1 below,mark the sections of Form 2F that you have completed and are submitting with your application.For each section,specify in Column 2 any attachments that you are enclosing to alert the permitting authority.Note that not all applicants are required to com fete all sections or provide attachments. Column 1 Column 2 ❑✓ Section 1 ❑ w/attachments(e.g„responses for additional outfalls) .....................__..........................._......... _._-----._._._........_....__--_......_...._.._._....._._.._................ ...._........_........._.......... ❑ Section 2 ❑ wi attachments Section 3 ❑ wl site drainage map �. Section 4 ❑ wi attachments ❑ Section 5 ❑ wl attachments .�. ✓n_ Section 6 ❑ wl attachments ❑� Section 7 El Table A ❑ wl small business exemption request .� _ ❑ Table B ❑ wl analyticai results as an attachment 0 ❑ Table C ❑ Table D '~ ❑✓ Section 8 ❑ w/afachments ❑ Section 9 ❑ wlattachments(e.g.,responses for additional contact laboratories or firms) �" ❑ Section 10 ❑ 10.2 Certification Statement l 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.l am aware that there are significant penalties for submitting false information,including the possibility of fine and imprisonment for knowing violations. Name(print or type first and last name) Official title Dewey Fulton Director-Health,Safety and Environment Signatur Date signedff o EPA Form 3510.2F(Revised 3-19) Page 6 EPA Identification Number NPDES Permit Number Facility Name 0utfall Number Farm Approved 03195119 NCD986230159 NCS000523 Premiere Fibers 001 0Mt3 No.2040-0004 TABLE A.CONVENTIONAL AND • • • r You must provide the results of at least one anal sis for every pollutant in this table.Complete one table for each outfall.See instructions for additional details and requirements. Maximum Daily Discharge Average Daily Discharge Source of (specify units) (specify units) Number of Storm information Pollutant or Parameter Grab Sample Taken Flow-Weighted Grab Sample Taken Flow-Weighted Events Sampled (new sourcelnew During First During First dischargers only;use 30 Minutes Composite 30 Minutes Composite codes in instructions) 1. Oil and grease ND 1 NA 2. Biochemical oxygen demand(BOD5) NA NA NA NA NA NA 3. Chemical oxygen demand(COD) NA NA NA NA NA NA 4. Total suspended solids(TSS) NA NA NA NA NA NA 5. Total phosphorus 0.082 mg/L NA NA NA 1 NA 6, Total Kjeldahl nitrogen(TKN) 1.1 mg/L NA NA NA 1 NA 7. Total nitrogen(as N) 1.4 mg/L NA NA NA 1 NA pH(minimum) NA NA NA NA t3. pH(maximum) NA NA NA NA Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3). EPA Form 3510-2F(Revised 3-19) Page 7 EPA IdenKcation Number NPDES Permit Number Facility Name Outfall Number Form Approved 03 D5119 NCD986230159 NCS000528 Premier Fibers 002 OMB No.2040-OOD4 TABLE A. / / 1 NON CONVENTIONALr You must provide the results of at least one anal sis toreveTy pollutant in this table.Complete one table for each autfall.See instructions for additional details and requirements. Maximum Daily Discharge Average Daily Discharge Source of (specify units) (specify units} Number of Storm Information Pollutant or Parameter Grab Sample Taken Flow-Weighted Grab Sample Taken Flow-Weighted Events Sampled (newsourcelnew During First During First dischargers only;use 30 Minutes Composite 30 Minutes Composite codes in instructions) 1. Oil and grease ND 1 NA 2. Biochemical oxygen demand(BOD5) NA NA NA NA NA NA 3. Chemical oxygen demand(COD) NA NA NA NA NA NA 4. Total suspended solids(TSS) NA NA NA NA NA NA 5. Total phosphorus 0.077m8/L NA NA NA 1 NA 6. Total Kjeldahl nitrogen(TKN) 1.3mg/L NA NA NA 1 NA 7. Total nitrogen(as N) 1.6 mg/L NA NA NA 1 NA pH(minimum) NA NA NA NA 8. pH(maximum) NA NA NA NA f Sampling shall be conducted according to sufficiently sensitive test procedures(i.e., methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR chapter 1,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3). EPA Form 3510-2F(Revised 3-19) Page 7 EPA Identificalion Number NPDES Permit Number Facility Name Outfall Number Form Approved 03 05119 NCD986230159 NC5000528 Premier Fibers 003 OMB No.2040-0004 TABLE A.CONVENTIONAL • • s r You must provide the results of at least one anal sis for every pollutant in this table.Complete ane table for each oulfall.See instructions for additional details and requirements. Maximum Daily Discharge Average Daily Discharge Source of (specify units) (specify units) Number of Storm Information Pollutant or Parameter Grab Sample Taken Grab Sample Taken (new source/new During First Flow-Weighted During First Flow•Weighfed Events Sampled dischargers only;use 30 Minutes Composite 30 Minutes Composite ? codes in instructions 1. Oil and grease ND 1 NA 2. Biochemical oxygen demand(BOD5) NA NA NA NA NA NA 3. Chemical oxygen demand(COD) NA NA NA NA NA NA 4. Total suspended solids(TSS) NA NA NA NA NA NA b. Total phosphorus ND NA NA NA 1 NA 6. Total Kjeldahl nitrogen(TKN) 0.72 mg/L NA NA NA 1 NA 7. Total nitrogen(as N) 1.7 mg/L NA NA i NA NA pH(minimum) NA NA NA NA B, pH(maximum) NA NA NA NA 'Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3). EPA Form 3510-2F(Revised 3-19) Page 7 EPA Identification Number NPDES Permit Number Facility Name outfall Number Form Approved 03+95119 NCD986230159 NCS000528 Premier Fibers 004 OMB No.204W004 TABLE A.CONVENTIONAL AND • • • t You must provide the results of at least one anal sis for every pollutant in this table.Complete one table for each out€all.See instructions for additional details and requirements. Maximum Daily Discharge Average Daily Discharge Source of (specify unds) (Specltyt1flit,S) Number of Storm Information Pollutant or Parameter Grab Sample Taken Flow-Weighted Grab Sample Taken Flow-Weighted Events Sampled (new sourcelnew During First During First dischargers only;use 34 Minutes Composite 30 Minutes Composite codes in instructions) 1. Oil and grease ND 1 NA 2. Biochemical oxygen demand(BOD5) NA NA NA NA NA NA 3. Chemical oxygen demand(COD) NA NA NA NA NA NA 4. Total suspended solids(TSS) NA NA NA NA NA NA 5. Total phosphorus 0.080 mg/L NA NA NA 1 NA 6. Total Kjeldahl nitrogen(TKN) 0.70 mg/L NA NA NA 1 NA 7. Total nitrogen(as N) 1.5 mg/L NA NA Alili 1 NA pH(minimum) NA NA NA NA pH(maximum) NA NA NA NA ------------- 'Sampling shall be conducted according to sufficiently sensitive test procedures(i.e., methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3). EPA Form 3514-2F(Revised 3-19) Page 7 l I I b I I 1 1 I I 1 ! 4 ! r I 1 1 EPA Identification Number NPDES Permit Number Facility Name putfall Number Form Approved 03105119 NCD986230159 NC5000528 Premier Fibers 005 OMB No.2040-0004 TABLE A.CONVENTIONAL A • NON CONVENTIONAL You must provide the results of at least one anal sis for every pollutant in this table.Complete one table for each outfall.See instructions for additional details and requirements. Maximum Daily Discharge Average Daily Discharge Source of (specify units) (specify units) Number of Storm information Pollutant or Parameter Grab Sample Taken Flow-Weighted Grab Sample Taken Flow-Weighted Events Sampled (new sourcelnew During First During First dischargers only;use 30 Minutes Composite 30 Minutes Composite codes in instructions) 1. Oil and grease ND 1 NA 2. Biochemical oxygen demand(BOD5) NA NA NA NA NA NA 3. Chemical oxygen demand(COD) NA NA NA NA NA NA 4. Total suspended solids(TSS) NA NA NA NA NA NA 5. Total phosphorus 0.12 mg/L NA NA NA 1 NA 6. Total Kjeldahl nitrogen(TKN) 1.3 mg/L NA NA NA i NA 7. Total nitrogen(as N) 2.6 mg/L NA NA NA 1 NA pH(minimum) NA NA NA NA 8. pH(maximum) NA NA NA NA Sampling shall be conducted according to sufficiently sensitive test procedures(i.e., methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR chapter I:subchapter N or 0.See instructions and 40 CFR 122.21(e)(3). EPA Form 3510.21'(Revised 3-19) Page 7 This page intentionally left blank. EPA Identification Number NPDES Permit Number Facility Name Outfall Number Form Approved 03105119 NCD98623O159 NCSO0O528 Premiere Fibers 001 OMB No.2040-0004 TABLE B.CERTAIN CONVENTIONAL AND NON • • '• 41 CFR 122.26(c)(1)(i)(E)(4) 40 List each pollutant that is limited in an effluent limitation guideline(ELG)that the facility is subject to or any pollutant listed in the facility's NPDES permit for its process wastewater(if the facility is operating under an existing NPDES permit).Complete one table for each outfall.See the instructions for additional details and requirements. Maximum Daily Discharge Average Daily Discharge Source of (spec! units s units Number of Storm, Information Pollutant and CAS Number(ff available) Grab Sample Taken Grab Sample Taken (new sourcehiew During First Flow-Weighted During First Flow-Welghted Events Sampled dischargers only,use Composite During 30 Minutes 30 Minutes codes in instructions) Sampling shall be conducted according to sufficiently sensitive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3). EPA Form 3510-2F(Revised 3-19) Page 9 This page intentionally left blank. EPA Identification Number NPDES Permit Number Facility Name Outtall Number Form Approved 03105I19 NCD986230159 NC5000528 Premiere Fibers 001 OMB No.2040-0004 TABLE C.TOXIC POLLUTANTS,CERTAIN HAZARDOUS SUBSTANCES,AND ASBESTOS(40 CFR 122.26(c)(1)(i)(E)(4)and 40 CIFIR 122.21(g)(7)(vi)(B)and(vii))' List each pollutant shown in Exhibits 2F-2, 2F-3,and 2F-4 that you know or have reason to believe is present.Complete one table for each outfall. See the instructions for additional details and requirements. Maximum daily Discharge Average Daily Discharge Source of s eci units s eci units Number of Storm Information Pollutant and CAS Number(if available) Grab Sample Taken Grab Sample Taken (new sourcelnew During First Flow-Weighted During First Ffow-Weighted Events Sampled dischargers only;use 30 Minutes Composite 30 Minutes Composite codes in instructions) Sampling shall be conducted according to sufficiently sens4ive test procedures(i.e.,methods)approved under 40 CFR 136 for the analysis of pollutants or pollutant parameters or required under 40 CFR chapter I,subchapter N or 0.See instructions and 40 CFR 122.21(e)(3). EPA Form 3510-2F(Revised 349) Paoe 11 --I —This page intentionally left blank. an Pace Analytical Services,LLC ace Analytical 2]5 East Meadow Road-Suite A Eden,NC 27288 www.pacelabsxom {336}623-8921 May 10, 2023 Mr. Phil Rahn Waters Edge Environmental 1434 Chester Road Raleigh, NC 27606 RE: Project: PREMIERE FIBERS R9-21 Pace Project No.: 92664918 Dear Mr. Rahn: Enclosed are the analytical results for sample(s) received by the laboratory on May 01, 2023. The results relate only to the samples included in this report. Results reported herein conform to the applicable TNI/NELAC 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 If you have any questions concerning this report, please feel free to contact me. Sincerely, Matthew Brainard matthew.brainard@pacelabs.com (704)875-9092 Project Manager Enclosures P p,CCAF�. ? '. REPORT OF LABORATORY ANALYSIS ;r+ This report shall not be reproduced,except in full, without the written consent of Pace Analytical Services,LLC. Page 1 Of 16 Pace Analytical Services,LLC 205 East Meadow Road-Suite A aceAnalytieaf Eden,NC 27288 www,paceiabs.com (336)623-8921 i CERTIFICATIONS Project: PREMIERE FIBERS R9-21 Pace Project No.: 92664918 Pace Analytical Services Charlotte South Carolina Laboratory ID:99006 South Carolina Certification#:99006001 9800 Kil 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 Virginia/VELAP Certification#:460221 Pace Analytical Services Asheville 2225 Riverside Drive,Asheville,NC 28804 South Carolina Laboratory ID:99030 Florida/NEtAP Certification#:E87648 South Carolina Certification#:99030001 -- North Carolina Drinking Water Certification#:37712 Virginia/VELAP Certification#:460222 North Carolina Wastewater Certification#:40 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, wiftut the written consent of Pace Analytical Services,LLC. Page 2 of 16 Pace Analytical Services,LLC 1! '2ceAnalytical 205 East Meadow Road-Suite Eden,NC 27288 www.pacalabs.com (336)623-8921 SAMPLE SUMMARY Project: PREMIERE FIBERS R9-21 Pace Project No.: 92664918 Lab ID Sample I❑ Matrix Date Collected Date Received 92664918001 OUTFALL 001 Water 04/25/23 11:00 05/01123 09:12 92664918002 OUTFALL 002 Water 04/25123 11:15 05/01/23 09:12 92664918003 OUTFALL 003 Water 04/25123 11:30 05/01/23 09:12 92664918004 OUTFALL 004 Water 04125/23 11:45 05/01/23 09:12 92664918005 OUTFALL 005 Water 04/25/23 12:00 05/01/23 09:12 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 16 Pace Analytical Services,LLC _ ace Analytical n 205 East Meadow Road-Suite A Eden,NC 27288 www.pacelabs.com (336)623.8921 SAMPLE ANALYTE COUNT Project: PREMIERE FIBERS R9-21 Pace Project No.: 92664918 Analytes Lab ID Sample 10 Method Analysts Reported Laboratory 92664918001 OUTFALL 001 EPA 1664E REL 1 PASI-C TKN+NO3+NO2 Calculation MAB2 1 PASI-A EPA 351.2 Rev 2.0 1993 MFO 1 PASI-A EPA 353.2 Rev 2.0 1993 KDF1 1 PASI-A EPA 365.1 Rev 2.0 1993 Zip 1 PASI-A 92664918002 OUTFALL 002 EPA 1664E REL 1 PASI-C TKN+NO3+NO2 Calculation MAB2 1 PASI-A .. EPA 351.2 Rev 2.0 1993 MFO 1 PASI-A EPA 353.2 Rev 2.0 1993 KDF1 1 PASI-A EPA305.1 Rev 2.01993 Zip 1 PASI-A 92664918003 OUTFALL 003 EPA 1664E REL 1 PASI-C TKN+NO3+NO2 Calculation MAB2 1 PASI-A EPA 351.2 Rev 2.0 1993 MFO 1 PASI-A EPA 353.2 Rev 2.0 1993 KDF1 1 PASI-A EPA 365.1 Rev 2.0 1993 Zip 1 PASI-A 92664918004 OUTFALL 004 EPA 1664B REL 1 PASI-C TKN+NO3+NO2 Calculation MA82 1 PASI-A EPA 351.2 Rev 2.0 1993 MFO 1 PASI-A EPA 353.2 Rev 2.0 1993 KDF1 1 PASI-A EPA 365.1 Rev 2.0 1993 Zip 1 PASI-A 92664918005 OUTFALL 005 EPA 1664B REL 1 PASI-C TKN+NO3+NO2 Calculation MA82 1 PASI-A EPA 351.2 Rev 2.0 1993 MFO 1 PASI-A EPA 353.2 Rev 2.0 1993 KDF1 1 PASI-A EPA 365.1 Rev 2.0 1993 Zip 1 PASI-A PAS I-A=Pace Analytical Services-Asheville PAS I-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 4 of 16 Pace Analytical Services,LLC ac /(n�f' tica J 205 East Meadow Road-Suite A r�t�l'1 I}/t11� l Eden,NC 27288 www.pacelabs.com (336)623-8921 ANALYTICAL RESULTS Project: PREMIERE FIBERS R9.21 Pace Project No.: 92664918 Sample; OUTFALL 001 Lab ID: 92664918001 Collected: 04/25/23 11:00 Received: 05/01/23 09:12 Matrix: Water Report Parameters Results Units Limit MDL DF Prepared Analyzed CAS No. Qual HEM,Oil and Grease Analytical Method:EPA 1664B Pace Analytical Services-Chadotte Oil and Grease ND mglL 4.9 1.1 1 05/10/23 05:03 Total Nitrogen Calculation Analytical Method:TKN+NO3+NO2 Calculation Pace Analytical Services-Asheville Total Nitrogen 1.4 mglL 0.040 0,040 1 05/09/23 12:21 351.2 Total Kjeldahl Nitrogen Analytical Method:EPA 351.2 Rev 2.0 1993 Preparation Method:EPA 351.2 Rev 2.0 1993 Pace Analytical Services-Asheville Nitrogen,Kjeldahl,Total 1.1 mg1L 0.50 0.25 1 05/08/23 19:30 05/09/23 04:41 7727-37-9 353.2 Nitrogen,N021NO3 pros. Analytical Method: EPA 353.2 Rev 2.0 1993 Pace Analytical Services-Asheville Nitrogen,NO2 plus NO3 0.28 mg1L 0.040 0.017 1 05/05/23 08:40 365.1 Phosphorus,Total Analytical Method:EPA 365.1 Rev 2,0 1993 Preparation Method: EPA365.1 Rev 2.0 1993 Pace Analytical Services-Asheville Phosphorus 0.082 mglL 0.050 0.025 1 05I10I2311:40 05I1012315:01 7723-14.0 Sample: OUTFALL 002 Lab ID: 92664918002 Collected: 04/25/23 11:15 Received: 05/01/23 09:12 Matrix:Water Report Parameters Results Units Limit MDL DF Prepared Analyzed CAS No. Qual HEM,Oil and Grease Analytical Method:EPA 1664E Pace Analytical Services-Charlotte Oil and Grease ND mg1L 5.0 1.1 1 05/10/23 05:03 Total Nitrogen Calculation Analytical Method:TKN+NO3+NO2 Calculation Pace Analytical Services-Asheville Total Nitrogen 1.6 mglL 0.040 0.040 1 05/09/23 12:21 351.2 Total Kjeldahl Nitrogen Analytical Method:EPA 351.2 Rev 2.0 1993 Preparation Method:EPA 351.2 Rev 2.0 1993 Pace Analytical Services-Asheville Nitrogen,Kjeldahl,Total 1.3 mglL 0.50 0.25 1 05/08/23 19:30 05/09/23 04A2 7727-37-9 353.2 Nitrogen,NO2/NO3 pres. Analytical Method:EPA 353.2 Rev 2.0 1993 Pace Analytical Services-Asheville Nitrogen,NO2 plus NO3 0.27 mglL 0.040 0.017 1 05/05/23 08:43 365.1 Phosphorus,Total Analytical Method:EPA 365.1 Rev 2.0 1993 Preparation Method:EPA 365.1 Rev 2.0 1993 Pace Analytical Services-Asheville Phosphorus 0.077 mglL 0.050 0.025 1 05/1012311:40 05/10/2315:05 7723-14-0 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, Date:05110/2023 04:39 PM without the written consent of Pace Analytical Services,LLC. Page 5 of 16 Pace Analytical Services,L LC �CBAnaly " 205 East Meadow Road-Suite A i G Il.�l^�f r Eden,NC 27288 www.pacelabs.com (336)623-8921 ANALYTICAL RESULTS Project: PREMIERE FIBERS R9-21 Pace Project No.: 92664918 .r Sample: OUTFALL 003 Lab ID: 92664918003 Collected: 04/25/23 11:30 Received: 05/01/23 09:12 Matrix: Water Report Parameters Results Units Limit MDL DF Prepared Analyzed CAS No. Qual HEM,Oil and Grease Analytical Method: EPA 1664E Pace Analytical Services-Charlotte Oil and Grease ND mg1L 4.8 1.1 1 05/10/23 05:03 Total Nitrogen Calculation Analytical Method:TKN+NO3+NO2 Calculation Pace Analyti cal Services-Asheville Total Nitrogen 1.7 mg1L 0.04D 0.040 1 05/09/23 12:21 351.2 Total Kjeldahl Nitrogen Analytical Method:EPA 351.2 Rev 2.0 1993 Preparation Method: EPA 351.2 Rev 2.0 1993 Pace Analytical Services-Asheville Nitrogen,Kjeldahl,Total 0.72 mg/L 0.50 0.25 1 05/08/23 19:30 05/09/23 04:44 7727-37-9 353.2 Nitrogen,NO2/NO3 pros. Analytical Method: EPA353.2 Rev 2.0 1993 Pace Analytical Services-Asheville Nitrogen,NO2 plus NO3 1.0 mglL 0.040 0.017 1 05/05/23 08:45 365.1 Phosphorus,Total Analytical Method:EPA 365.1 Rev 2.0 1993 Preparation Method:EPA 365.1 Rev 2.0 1993 Pace Analytical Services-Asheville ^ Phosphorus ND mglL 1).050 0.025 1 05110/2311:40 05110/2315:07 7723-14-0 Sample: OUTFALL 004 Lab ID: 92664918004 Collected: 04/25/23 11 A5 Received: 05/01/23 09:12 Matrix: Water ^ Report Parameters Results Units Limit MDL DF Prepared Analyzed CAS No. Qual HEM,Oil and Grease Analytical Method: EPA 1664E Pace Analytical Services-Charlotte Oil and Grease ND mg1L 4.8 1.1 1 05/09/23 03:35 Total Nitrogen Calculation Analytical Method:TKN+NO3+NO2 Calculation Pace Analytical Services-Asheville Total Nitrogen 1.5 mg1L 0.040 0,040 1 05109t23 12:21 351.2 Total Kjeldahl Nitrogen Analytical Method:EPA351.2 Rev 2.0 1993 Preparation Method: EPA 351.2 Rev 2.0 1993 Pace Analytical Services-Asheville Nitrogen,Kjeldahl,Total 0.70 mg/L 0.50 0.25 1 05/08/23 19:30 05/09/23 04:47 7727-37-9 353.2 Nitrogen,NO2/NO3 pres. Analytical Method:EPA353.2 Rev 2.0 1993 Pace Analytical Services-Asheville Nitrogen,NO2 plus NO3 0.81 mg1L 0.040 0.017 1 05/05/23 08:46 365.1 Phosphorus,Total Analytical Method:EPA 365.1 Rev 2.0 1993 Preparation Method:EPA 365.1 Rev 2.0 1993 Pace Analytical Services-Asheville Phosphorus 0.080 mg/L 0,050 0,025 1 05/10/23 11 A0 05/10/23 15:08 7723-14-0 REPORT OF LABORATORY ANALYSIS "^ This report shall not be reproduced,except in full, Date:05/10/2023 04:39 PM without the written consent of Pace Analytical Services,LLC. Page 6 of 16 Pace Analytical Services,LLC 1!2ce p��r,j�^ r' 205 East Meadow Road-Suite A H ly t� f Eden,NC 27288 a www.pacelabs.com (336)623-892 1 ANALYTICAL RESULTS Project: PREMIERE FIBERS R9-21 Pace Project No.: 92664918 Sample: OUTFALL 005 Lab IQ: 92664918005 Collected: 04/25/23 12:00 Received: 05/01/23 09:12 Matrix: Water Report Parameters Results Units Limit MDL DF Prepared Analyzed CAS No. Qual HEM,Oil and Grease Analytical Method:EPA 1664B Pace Analytical Services-Charlotte i Oil and Grease ND mg1L 4.8 1.1 1 05/10123 05:03 Total Nitrogen Calculation Analytical Method:TKN+NO3+NO2 Calculation Pace Analytical Services-Asheville Total Nitrogen 2.6 mg/L 0.040 0.040 1 05/09123 12:21 351.2 Total Kjeldahl Nitrogen Analytical Method:EPA 351.2 Rev 2.0 1993 Preparation Method: EPA 351.2 Rev 2.0 1993 Pace Analytical Services-Asheville Nitrogen,Kjeldahl,Total 1.3 mg1L 0.50 0.25 1 05/08/23 19:30 05/09/23 04:53 7727-37-9 353.2 Nitrogen,NO2IN03 pres. Analytical Method:EPA 353.2 Rev 2.0 1993 Pace Analytical Services-Asheville Nitrogen,NO2 plus NO3 1.3 mg/L 0.040 0.017 1 05/05/23 08:47 365.1 Phosphorus,Total Analytical Method:EPA 365.1 Rev 2.0 1993 Preparation Method:EPA 365.1 Rev 2.0 1993 Pace Analytical Services-Asheville Phosphorus 0.12 mg/L 0.050 0.025 1 05/10/2311:40 05110/2315:09 7723-14-0 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, Date:05/10/2023 04:39 PM without the written consent of Pace Analytical Services,LLC. Page 7 of 16 Pace Analytical Services,LLC accAnalyfical r 205 East Meadow Road-Suite AEden, Eden,NC 27288 www,pacela6s.com (336)623-8921 QUALITY CONTROL DATA ` Project: PREMIERE FIBERS R9-21 Pace Project No.: 92664918 QC Batch: 773091 Analysis Method: EPA 1664B QC Batch Method: EPA 1664E Analysis Description: 1664 HEM,Oil and Grease Laboratory: Pace Analytical Services-Charlotte .� Associated Lab Samples: 92664918004 METHOD BLANK: 4012808 Matrix: Water Associated Lab Samples: 92664918004 Blank Reporting Parameter Units Result Limit MDL Analyzed Qualifiers Oil and Grease mg1L ND 5.0 1A 05/09/23 03:35 LABORATORY CONTROL SAMPLE: 4012809 Spike LCS LCS %Rec ^ Parameter Units Conc. Result %Rec Limits Qualifiers Oil and Grease mg/L 40 34.2 86 78-114 MATRIX SPIKE SAMPLE: 4012810 92665487001 Spike MS MS %Rec Parameter Units Result Conc. Result %Rec Limits Qualifiers Oil and Grease mg/L ND 38.8 32.5 82 78-114 ^ SAMPLE DUPLICATE: 4012811 357959520D1 Dup Max Parameter Units Result Result RPD RPD Qualifiers Oil and Grease mg1L 1.81 1.5J 30 Results presented°n 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:05110/2023 04:39 PM without the written consent of Pace Analytical Services.LLC. Page 8 of 16 Pace Analytical Services,LLC aceAnalyticai` 205 East Meadow Road-Suite A Eden,NC 27283 a www.pacslahs.com (336)623-8921 QUALITY CONTROL DATA Project: PREMIERE FIBERS R9-21 Pace Project No.: 92664918 QC Batch: 773286 Analysis Method: EPA 1664B QC Batch Method: EPA 1664B Analysis Description: 1664 HEM,Oil and Grease Laboratory: Pace Analytical Services-Charlotte Associated Lab Samples: 92664918001,92664918002,92664918003,92664918005 METHOD BLANK: 4013763 Matrix: Water Associated Lab Samples: 92664918001,92664918002,92664918003,92664918005 Blank Reporting Parameter Units Result Limit MDL Analyzed Qualifiers Oil and Grease mg/L ND 5.0 1.1 05/10/23 05:03 LABORATORY CONTROL SAMPLE: 4013764 Spike LCS LCS %Rec Parameter Units Cone. Result %Rec Limits Qualifiers Oil and Grease mg/L 40 35.8 90 78-114 MATRIX SPIKE SAMPLE: 4014797 92665800001 Spike MS MS %Rec 4 Parameter Units Result Cone. Result %Rec Limits Qualifiers Oil and Grease mg/L ND 39.2 35.0 83 78-114 SAMPLE DUPLICATE: 4013766 92665830001 Dup Max Parameter Units Result Result RPD RPD Qualifiers Oil and Grease mg1L ND ND 30 Results presented on this page are In the units Indicated by the"Units"column except where an alternate unit is presented to the tight or the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, Date:05/10/2023 04:39 PM without the written consent of Pace Analytical Services,LLC. Page 9 of 16 Pace Analytical Services,LLC aceAnalyrica1 Y 205 East Meadow Road-Suite A Eden,NC 27288 www.pacolabs.com (336)623-8921 QUALITY CONTROL DATA Project: PREMIERE FIBERS R9-21 Pace Project No.: 92664918 QC Batch: 773107 Analysis Method: EPA 351.2 Rev 2.0 1993 QC Batch Method: EPA 351.2 Rev 2.0 1993 Analysis Description: 351.2 TKN Laboratory: Pace Analytical Services-Asheville Associated Lab Samples: 92664918001,92664918002,92664918003,92664918004,92664918005 METHOD BLANK: 4012953 Matrix: Water Associated Lab Samples: 92664918001,92664918002,92664918003,92664918004,92664918005 Blank Reporting Parameter Units Result Limit MDL Analyzed Qualifiers Nitrogen,Kjeldahl,Total mgJL ND 0.50 0.25 05/09/23 04:25 .� LABORATORY CONTROL SAMPLE: 4012954 Spike LCS LCS %Rec -- Parameter Units Conc. Result %Rec Limits Qualifiers Nitrogen,Kjeldahl,Total mg1L 10 10A 101 90-110 MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4012955 4012956 MS MSD 92664918003 Spike Spike MS MSD MS MSD %Rec Max Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual Nitrogen,Kjeldahl,Total mg/L 0.72 10 10 11.0 10.4 103 97 90-110 5 10 MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4012957 4012958 MS MSD 92664918004 Spike Spike MS MSD MS MSD %Rec Max Parameter Units Result Conc, Conc. Result Result %Rec %Rec Limits RPD RPD Qual Nitrogen,Kjeldahl,Total mg/L 0.70 10 10 10.7 11.5 100 108 90-110 6 10 Results presented on this page are in the units Indicated by the"Units"column except where an alternate unit Is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, Date:05/1012023 04:39 PM without the written consent of Pace Analytical Services,LLC. Page 10 of 16 a� Pace Analytical Services,LLC �ce /!n�ry1ra 1 x 205 East Meadow Road-Suite A ,1! H!1 J !U r Eden,NC 27288 www.pacolabs.com (336)623-8921 QUALITY CONTROL DATA Project: PREMIERE FIBERS R9-21 Pace Project No.: 92664918 QC Batch: 772073 Analysis Method: EPA 353.2 Rev 2.0 1993 QC Batch Method: EPA 353.2 Rev 2.0 1993 Analysis Description: 353.2 Nitrate+Nitrite,preserved Laboratory: Pace Analytical Services-Asheville Associated Lab Samples: 92654918001,92664918002,92664918003,92664918004,92664918005 METHOD BLANK: 4008048 Matrix: Water Associated Lab Samples: 92664918001,92664918002,92664918003,92664918004,92664918005 Blank Reporting Parameter Units Result Limit MDL Analyzed Qualifiers Nitrogen,NO2 plus NO3 mg1L ND 0.040 0.017 05/05123 08:22 LABORATORY CONTROL SAMPLE: 4008049 Spike LCS LCS %Rec Parameter Units Conc. Result %Rec Limits Qualifiers Nitrogen,NO2 plus NO3 mg1L 2.5 2.5 100 90-110 MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4008050 4008051 Ms MSD 10651039001 Spike Spike MS MSD MS MSD %Rec Max Parameter Units Result Conc, Conc. Result Result %Rec %Rec Limits RPD RPD Qual Nitrogen,NO2 plus NO3 mg1L 0.58 2.5 2.5 2.9 3.0 94 95 90-110 1 10 MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4008052 4008053 MS MSD 10651039002 Spike Spike MS MSD MS MSD %Rec Max Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD RPD Qual Nitrogen,NO2 plus NO3 mg1L 0.52 2.5 2.5 2.8 2.8 92 93 90-110 1 10 Results presented on this page are In the units indicated by the"Units'column except where an alternate unit is presented to the right of the result. '— REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, Date:05/10/2023 04:39 PM without the written consent of Pace Analytical Services.LLC. Page 11 of 16 Pace Analytical Services,LLC aceAnalytrcal' 245 East Meadow Road-Suite R / Eden,NC 27288 www.pacelrabs.com (336)623-8921 QUALITY CONTROL DATA Project: PREMIERE FIBERS R9-21 Pace Project No.: 92664918 �- QC Batch: 773403 Analysis Method: EPA 365.1 Rev 2.0 1993 QC Batch Method: EPA 365.1 Rev 2.0 1993 Analysis Description: 365.1 Phosphorus,Total Laboratory: Pace Analytical Services-Asheville Associated Lab Samples: 92664918001,92664918002,92664918003,92664918004,92664918005 METHOD BLANK: 4014363 Matrix: Water Associated Lab Samples: 92664918001,92664918002,92664918003,92664918004,92664918005 Blank Reporting Parameter Units Result Limit MDL Analyzed Qualifiers Phosphorus mg/L ND 0.050 0.025 05/1012315:00 LABORATORY CONTROL SAMPLE: 4014364 Spike LCS LCS %Rec Parameter Units Cone. Result %Rec Limits Qualifiers Phosphorus mg/L 2.5 2.5 101 90-110 MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4014365 4014366 MS MSD 92664918001 Spike Spike MS MSD MS MSD %Rec Max Parameter Units Result Cone. Cone. Result Result %Rec %Rec Limits RPD RPD Qual Phosphorus mg/L 0.082 2.5 2.5 2.7 2.7 106 106 90-110 0 10 MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4014367 4014368 MS MSD 92664918002 Spike Spike MS MSD MS MSD %Rec Max Parameter Units Result Cone. Cone. Result Result %Rec %Rec Limits RPD RPD Qual Phosphorus mg/L 0.077 2.5 2.5 2.7 2.7 105 105 90-110 0 10 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 r' This report shall not be reproduced,except in full, Date:05/10/2023 04:39 PM without the written consent of Pace Analytical Services,LLC. Page 12 of 16 Pace Analytical Services,LLC //*0"aceAnalXical r 2oe East Meadow goad-Suite A Eden,NC 27288 www.pacoiabs.cora (336)623-8921 QUALIFIERS Project: PREMIERE FIBERS R9-21 _. Pace Project No.: 92664918 DEFINITIONS OF-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 3-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. Reported results are not rounded until the final step prior to reporting.Therefore,calculated parameters that are typically reported as "Total"may vary slightly from the sum of the reported component parameters. Pace Analytical is TNI accredited.Contact your Pace PM for the current list of accredited anaiytes. TNI-The NEtAC Institute. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, Date:05/10/2023 04:39 PM without the written consent of Pace Analytical Services,I.I.C. Page 13 of 16 Pace Analytical Services,LLC _ aceAnalytical�� 205 East Meadow Road-Suite A Eden,NC 2728B www.pacelabs.com (336)623-8921 I QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: PREMIERE FIBERS R9-21 Pace Project No.: 92664918 �^ Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92664918001 OUTFAL.L 001 EPA 1664E 773286 92664918002 OUTFALL 002 EPA 1664B 773286 92664918003 OUTFALL 003 EPA 1664B 773286 92664918004 OUTFALL 004 EPA 1664B 773091 92664918005 OUTFALL 005 EPA 1664B 773286 92664918001 OUTFALL 001 TKN+NO3+NO2 773293 Calculation 92664918002 OUTFALL 002 TKN+NO3+NO2 773293 Calculation 92664918003 OUTFALL 003 TKN+NO3+NO2 773293 Calculation 92664918004 OUTFALL 004 TKN+NO3+NO2 773293 Calculation 92664918005 OUTFALL 005 TKN+NO3+NO2 773293 Calculation 92664918001 OUTFALL 001 EPA 351.2 Rev 2.0 1993 773107 EPA 351.2 Rev 2.0 1993 773188 - 92664918002 OUTFALL 002 EPA 351.2 Rev 2.0 1993 773107 EPA 351.2 Rev 2.0 1993 773188 92664918003 OUTFALL 003 EPA 351.2 Rev 2.0 1993 773107 EPA 351.2 Rev 2.0 1993 773188 92664918004 OUTFALL 004 EPA 351.2 Rev 2.0 1993 773107 EPA 351.2 Rev 2.0 1993 773188 92664918005 OUTFALL 005 EPA 351.2 Rev 2.0 1993 773107 EPA 351.2 Rev 2.0 1993 773188 92664918001 OUTFALL 001 EPA 353.2 Rev 2.0 1993 772073 92664918002 OUTFALL 002 EPA 353.2 Rev 2.0 1993 772073 92664918003 OUTFALL 003 EPA 353.2 Rev 2.0 1993 772073 92664918004 OUTFALL 004 EPA 353.2 Rev 2.0 1993 772073 92664918005 OUTFALL 005 EPA 353.2 Rev 2.0 1993 772073 92664916001 OUTFALL 001 EPA 365.1 Rev 2.0 1993 773403 EPA 365.1 Rev 2.0 1993 773582 92664918002 OUTFALL 002 EPA 365.1 Rev 2.0 1993 773403 EPA 365.1 Rev 2.0 1993 773582 92664918003 OUTFALL 003 EPA 365.1 Rev 2.0 1993 773403 EPA 365.1 Rev 2.0 1993 773582 92664918004 OUTFALL 004 EPA 365.1 Rev 2.0 1993 773403 EPA 365.1 Rev 2.0 1993 773582 92664918005 OUTFALL 005 EPA 365.1 Rev 2.0 1993 773403 EPA 365.1 Rev 2,0 1993 773582 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full. Date:05/10/2023 0439 PM without the written consent of Pace Analytical Services.LLC- Page 14 of 16 i • ail # tl Pace'{NorborderN...beror � CHAIN-OF-CUSTODY Analytical Request Document , 4 �, o % .ft'aceAnatytical' X, -» �� t � � r 1 Chain-of-Custody is a LEGAL DOCUMENT-Complete all retevenl fields Coro ny: Billing Information: < a l.. WSE ONLY. Add s: Contatner PreservaEfve t Y ^sots ,c. nape Repor To: ! 1 Email To: ••Preservative types:(1)Mirk add,(?)sulfuric add,(3)bydroddon cad d,(4j sadn+m hydroxide,(5)zinc acetate, (6)methand.Q odlum bisulfate,(B)sodium thiosutfate,(9)hexan m m e,(A)atcorblcadd,(B)amoniu sullate, Copy)1r. (� Site Collection Info/Address: IC)ammonium 1prosddc,(0)TSP,(U)Unpreserved,(0)Other Jl� Analyses b;Proflte no - Custo er Project Name/Nu er, State: County/City: Zone Collected: Same a pi Checltliettt E /�-9-L-t : Time, 1 ,�N��,iJ t t PTt )mT{ )CT t eke t v$todp§¢aXg`Estiaeat7Itttact Y:N Phone SitelFacilityID p: Compliance Monitoring? : Cbgtody Sigaattsrets 4resent• Email: P%,Yes t ]No toliector.Sigaotitre Piengot' 9:•lltl - Bott).eN In.artt �.ill�y NA - Coil By(print): Purchase Order th OW PWs ID rt: - ccrrgct$otslca + �Y NA Quote# T—W DW Location Code r Lois t volttme tm Coitecde By(s' re): TumaraUnd Date R wired: mm iately P on Ice: a i samplesoc•svoa oa 1e0 mn e9 " • VeiC 8eadspnce.ZccbylabYn Y p p8aa.staglflnta�k se31a - Y t ( s [ ]NO ?� `s$ng+2cs 3n tasat3i>iq l�lmoit `Wt Sampl§Disposal: Rush: Field Filtered Iif applicable): , ttaaAdu•l.Cb2prsne.vrnaoat, T N t ., .* Di ' seas ap riate l 1 Return t )Same Day [ j Next Day t )Yes too Sgmpio ACCe bi [ )2 DaY [ 13 DaY t )4 DaY t )S Day Analysis �` ' °j Srtripet (EwpcdttQ Charges APP1Y) :Ld&recap t Z 13 • \ : 'a, rI ead AcrSr stet Stsi •. Matrix Codes(insert 3n Matrix box below):Drinking Water(DW),Ground Water(GW),Wastewater(WW), }•: e= t ? Product(P),Soil/Solid(SL),Oil(OL),Wipe(WP),Air(AR),Tissue(TS),B)oassay(B),Vapor(V),Other(OT) �;: r Y said os»tirlLfs ! Comp/ Collected(or Res #of Customer Sample ID Matrix' Grab Composite Start) Composite End Cl Ctns a, _ • 1: ( Date Time Date Time t ur 1 j ''" r f rAi 2 rl. .l `mil f I T .:Y .r Egg r =. ZN II i<'' 4: ..•3A: r..N'4. L7'!'iT. ' a4A l.f, -tr t.. t nit.; :±:'�-''• 'Xw:i �a `C<-_:s�4... ..c...C�--t.. � v. r Customer Remarks/Special Conditions/Possible Hazards: 7Y)te � � Blue` ':9 Df�3ie ,;. (tX {EjSPAESE�Yi( Z�Itoftr3) fff/A� �` E3b$atnill��@ttlperattJre Info F ''tV>1Ct _ a _ b;', .i , - t = xi i,. Temp BWrlk�tte t� o Y N `)`F '4nrJ.G.•YJ. ,t tr s• jy�� `r..^s}i2f1RI � ; • Carloterx;ielttp.(i�tttnt'tecelpr: •nQ �..Y-Sl-,. t. i r •r mp) u¢d- �'-'�_..} F t r ec t i' COnIeF'�?�1er111 Ctirr,F f'aC�O � Tiadyhemsatnple(Y),saeett�d{�c�00t 1,� N {� ■��"'�j{r /�,� _ ar /r�� �/ .l -..x.. ti t �- vy� }.. •4. tf'.��� t'"i.:.nij�-� i; s� �'6T,.�!• � ;WYtQ�i��d�e'"SI.-�W.�•• Refingi ished by/Comps tM W y:IS'ignature) Datemme: ceiv by/Company:(Signare) bate/f'une: ;tfY(T(t:t/x6 LJ$E 01y1 �+ ehtr» • � �w12 taf�� y� •� , + . Reiln ished ! an . I nature ime: eceiVCd b� gture): Sit Acctrium i �,• 4y g 1 Y t m Da e/Ttme: ( Terylplafe. TSp9(anlRectred ,=Y K' . prerogU, ktCf. McQH TSP °that Relinq 'Shed by/Company:(Signature) Date/Time: Received by/Company:(Signature) Date�me: PM Hon Cotif Page: " I DCi Tltte: ENV-FRM-HUNI.0084 v02 Tech Spec Sample Conditlon Upon 9tfo9Mace- i � Receipt I i11{TfL'i:Rih+Y Effective[)ate: two *Check mark top half of box if pH and/or dechiorination Project e Is verified and within the acceptance range for �n7irf preservation samples. PM ltWB Rus Date 6/23 Exceptions:VOA,Collform,TOC,Oil and Grease,DROJ8015(water)DOC,LLHg **Bottom half of box is to list number of bottles ` ' l�S=Wa ,e's Ed .. ***Check all unpreserved Nitrates for chlorine ; i 13 iI a a 0 a a O1 z v 2 Rro j Z N v Y 2 2 B I a a 9 v v a 3 a a > > T 0 t3 _ 2 N D e ro .f.4 z uo a a a i a a a a.l c Q ? E OQ O G 0¢ a u d E E E a E E E E� �_ u E E J J = Qy :: E E E oaE E E E Q 1pJE� $ o ROE rl i�v v�1 r1 „�. fV H H .q N .•�G ry A 7 N �. p N N ry aY� .. m m m m m m a 3 a a a a a o n a L" in m 1 -N s rr k11Q \\N I 2 2; Z 4 i 1 rr f \\N I 5 j �r ! 6 I i 7I N\ i 8 N\ I NMI i \N\\ iN\ It 10 ff f NEW 11 � i11 \N I 12 - N I I NNNW -N NNN 1 11 1 NN I L i pH Adjustment Log for Preserved Samples Sample lD Type of Preservative pH upon receipt Date preservation adjusted Time preservation Amount of Preservailve Lot a r r If adjusted added rr i ` 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. r.r i Out of hold,Incorrect preservative,out of temp,incorrect containers) Qualtrax Document ID:70677 Page 2 of 2 r.