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HomeMy WebLinkAboutNCG100015_2023 DMR_20230620 ti eurofins Environment Testing ANALYTICAL REPORT PREPARED FOR Attn: Steve Marsh Marsh Truck Parts PO BOX 427 Slier City, North Carolina 27344 Generated 6/12/2023 2.04.00 PM JOB DESCRIPTION Caryard Caryard JOB NUMBER 752-7628-1 Eurofins Raleigh 102-A Woodwinds Industrial Court Cary NC 27511 Page 1 of 18 *i¢¢ See Ia•e two for'ob notes and contact information. mY• Job Notes This report may not be reproduced except in full, and with written approval from the laboratory. The results relate only to the samples tested. For questions please contact the Project Manager at the e-mail address or telephone number listed on this page. The test results in this report relate only to the samples as received by the laboratory and will meet all requirements of the methodology, with any exceptions noted. This report shall not be reproduced except in full, without the express written approval of the laboratory. All questions should be directed to the Eurofins Environment Testing Southeast, LLC Project Manager. Authorization �; Generated t a y ( p� '>, '1i., . 19-3 6/12/2023 2:04:00 PM Authorized for release by Amanda Gaines,Project Manager amanda.gaineset.eurofinsus.com (919)677-1669 Eurofins Savannah is a laboratory within Eurofins Environment Testing Southeast.LLC, a company within Eurofins Environment Testing Group of Companies Page 2 of 18 6/12/2023 Client: Marsh Truck Parts Laboratory Job ID: 752-7628-1 Project/Site: Caryard Table of Contents Cover Page 1 Table of Contents 3 Definitions/Glossary 4 Case Narrative 5 Detection Summary 6 Client Sample Results 7 QC Sample Results 8 QC Association Summary 10 Lab Chronicle 11 Certification Summary 12 Method Summary 13 Sample Summary 14 Chain of Custody 15 Receipt Checklists 17 Eurofins Raleigh Page 3 of 18 6/12/2023 Definitions/Glossary Client: Marsh Truck Parts Job ID: 752-7628-1 Project/Site: Caryard Glossary Abbreviation These commonly used abbreviations may or may not be present in this report. ❑ Listed under the"D"column to designate that the result is reported on a dry weight basis %R Percent Recovery CFL Contains Free Liquid CFU Colony Forming Unit CNF Contains No Free Liquid DER Duplicate Error Ratio(normalized absolute difference) Dil Fac Dilution Factor DL Detection Limit(DoD/DOE) DL, RA, RE. IN Indicates a Dilution, Re-analysis,Re-extraction,or additional Initial metals/anion analysis of the sample DLC Decision Level Concentration(Radiochemistry) EDL Estimated Detection Limit(Dioxin) LOD Limit of Detection(DoD/DOE) LOQ Limit of Quantitation(DoD/DOE) MCL EPA recommended"Maximum Contaminant Level" MDA Minimum Detectable Activity(Radiochemistry) MDC Minimum Detectable Concentration(Radiochemistry) MDL Method Detection Limit ML Minimum Level(Dioxin) MPN Most Probable Number MQL Method Quantitation Limit NC Not Calculated ND Not Detected at the reporting limit(or MDL or EDL if shown) NEG Negative/Absent POS Positive/Present PQL. Practical Quantitation Limit PRES Presumptive QC Quality Control RER Relative Error Ratio(Radiochemistry) RL Reporting Limit or Requested Limit(Radiochemistry) RPD Relative Percent Difference,a measure of the relative difference between two points TEF Toxicity Equivalent Factor(Dioxin) TEQ Toxicity Equivalent Quotient(Dioxin) TNTC Too Numerous To Count Eurofins Raleigh Page 4 of 18 6/12/2023 Case Narrative Client: Marsh Truck Parts Job ID: 752-7628-1 Project/Site: Caryard Job ID: 752-7628-1 Laboratory: Eurofins Raleigh Narrative Job Narrative 752-7628-1 Receipt The sample was received on 5/31/2023 2:10 PM. Unless otherwise noted below,the sample arrived in good condition, and,where required, properly preserved and on ice. The temperature of the cooler at receipt time was 1.0°C GC Semi VOA No additional analytical or quality issues were noted, other than those described above or in the Definitions/Glossary page. Metals No additional analytical or quality issues were noted, other than those described above or in the Definitions/Glossary page. General Chemistry No additional analytical or quality issues were noted, other than those described above or in the Definitions/Glossary page. Eurofins Raleigh Page 5 of 18 6/12/2023 Detection Summary Client: Marsh Truck Parts Job ID: 752-7628-1 Project/Site: Caryard Client Sample ID: Caryard Lab Sample ID: 752-7628-1 Analyte Result Qualifier RL MDL Unit Dil Fac D Method Prep Type Lead 18 10 6.6 ug/L 1 60100 Total Recoverable ' Total Suspended Solids 130 5.0 5.0 mg/L 1 SM 2540D Total/NA This Detection Summary does not include radiochemical test results. Eurofins Raleigh Page 6 of 18 6/12/2023 Client Sample Results Client: Marsh Truck Parts Job ID: 752-7628-1 Project/Site: Caryard Client Sample ID: Caryard Lab Sample ID: 752-7628-1 Date Collected: 05/29/23 08:00 Matrix: Water Date Received: 05/31/23 14:10 Method: SW846 8015C GLY -Glycols-Direct Injection (GC/FID) Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Di!Fac Ethylene glycol <1.7 10 1.7 mg/L 06/06/23 23:51 1 Propylene glycol <0.91 5.0 0.91 mg/L 06/06/23 23:51 1 Method: SW846 6010D -Metals (ICP) -Total Recoverable Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Dil Fac Lead 18 10 6.6 ug/L 06/02/23 06:47 06/02/23 11:19 1 General Chemistry Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Oil Fac Oil&Grease(1664B) <1.4 5.1 1.4 mg/L 06/07/23 07:45 06/07/23 14:35 1 SGT-HEM(1664B) <1.4 5.1 1.4 mg/L 06/07/23 07:45 06/07/23 14:35 1 Total Suspended Solids (SM 130 5.0 5.0 mg/L 06/01/23 08:33 1 2540D) Eurofins Raleigh Page 7 of 18 6/12/2023 QC Sample Results Client: Marsh Truck Parts Job ID: 752-7628-1 Project/Site: Caryard Method: 8015C GLY - Glycols- Direct Injection (GC/FID) Lab Sample ID: MB 680-782261/9 Client Sample ID: Method Blank Matrix: Water Prep Type: Total/NA Analysis Batch: 782261 MB MB Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Dil Fac Ethylene glycol <1.7 10 1.7 mg/L 06/06/23 20:21 1 Propylene glycol <0.91 5.0 0.91 mg/L 06/06/23 20:21 1 Lab Sample ID: LCS 680-782261/5 Client Sample ID: Lab Control Sample Matrix: Water Prep Type: Total/NA Analysis Batch: 782261 Spike LCS LCS %Rec Analyte Added Result Qualifier Unit D %Rec Limits Ethylene glycol 20.0 28.1 mg/L 140 61 _148 Propylene glycol 20.0 26.0 mg/L 130 57.151 Lab Sample ID: LCSD 680-782261/6 Client Sample ID: Lab Control Sample Dup Matrix: Water Prep Type: Total/NA Analysis Batch: 782261 Spike LCSD LCSD %Rec RPD Analyte Added Result Qualifier Unit D %Rec Limits RPD Limit Ethylene glycol 20.0 21.1 mg/L 105 61_148 29 50 Propylene glycol 20.0 20.9 mg/L 104 57.151 22 50 Method: 6010D - Metals (ICP) Lab Sample ID: MB 680-781591/1-A Client Sample ID: Method Blank Matrix: Water Prep Type: Total Recoverable Analysis Batch: 781729 Prep Batch: 781591 MB MB Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Dil Fac Lead <6.6 10 6.6 ug/L 06/02/23 06:47 06/02/23 10:56 1 Lab Sample ID: LCS 680-781591/2-A Client Sample ID: Lab Control Sample Matrix: Water Prep Type: Total Recoverable Analysis Batch: 781729 Prep Batch: 781591 Spike LCS LCS %Rec Analyte Added Result Qualifier Unit D %Rec Limits Lead 500 482 ug/L 96 80.120 Method: 1664B - HEM and SGT-HEM Lab Sample ID: MB 680-782302/1-A Client Sample ID: Method Blank Matrix: Water Prep Type: Total/NA Analysis Batch: 782459 Prep Batch: 782302 MB MB Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Dil Fac Oil&Grease <1.4 5.0 1.4 mg/L 06/07/23 07:45 06/07/23 14:35 1 SGT-HEM <1.4 5.0 1.4 mg/L 06/07/23 07:45 06/07/23 14:35 1 Eurofins Raleigh Page 8 of 18 6/12/2023 QC Sample Results Client: Marsh Truck Parts Job ID: 752-7628-1 Project/Site: Caryard Method: 1664B - HEM and SGT-HEM (Continued) Lab Sample ID: LCS 680-782302/2-A Client Sample ID: Lab Control Sample Matrix: Water Prep Type: Total/NA Analysis Batch: 782459 Prep Batch: 782302 Spike LCS LCS %Rec Analyte Added Result Qualifier Unit D %Rec Limits Oil&Grease 40.0 37.60 mg/L 94 78-114 SGT-HEM 20.0 18.80 mg/L 94 64.132 Lab Sample ID: LCSD 680-782302/3-A Client Sample ID: Lab Control Sample Dup Matrix: Water Prep Type: Total/NA Analysis Batch: 782459 Prep Batch: 782302 Spike LCSD LCSD %Rec RPD Analyte Added Result Qualifier Unit D %Rec Limits RPD Limit Oil&Grease 40.0 37.20 mg/L 93 78-114 1 18 SGT-HEM 20.0 18.20 mg/L 91 64-132 3 34 Method: SM 2540D - Solids, Total Suspended (TSS) Lab Sample ID: MB 752-3068/1 Client Sample ID: Method Blank Matrix: Water Prep Type: Total/NA Analysis Batch: 3068 MB MB Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Oil Fac Total Suspended Solids <2.5 2.5 2.5 mg/L 06/01/23 08:33 1 Lab Sample ID: LCS 752-3068/2 Client Sample ID: Lab Control Sample Matrix: Water Prep Type: Total/NA Analysis Batch: 3068 Spike LCS LCS %Rec Analyte Added Result Qualifier Unit D %Rec Limits Total Suspended Solids 100 96.0 mg/L 96 80-120 Eurofins Raleigh Page 9 of 18 6/12/2023 QC Association Summary Client: Marsh Truck Parts Job ID: 752-7628-1 Project/Site: Caryard GC Semi VOA Analysis Batch: 782261 Lab Sample ID Client Sample ID Prep Type Matrix Method Prep Batch 752-7628-1 Caryard Total/NA Water 8015C GLY MB 680-782261/9 Method Blank Total/NA Water 8015C GLY LCS 680-782261/5 Lab Control Sample Total/NA Water 8015C GLY LCSD 680-782261/6 Lab Control Sample Dup Total/NA Water 8015C GLY Metals Prep Batch: 781591 Lab Sample ID Client Sample ID Prep Type Matrix Method Prep Batch 752-7628-1 Caryard Total Recoverable Water 3005A MB 680-781591/1-A Method Blank Total Recoverable Water 3005A LCS 680-781591/2-A Lab Control Sample Total Recoverable Water 3005A Analysis Batch: 781729 Lab Sample ID Client Sample ID Prep Type Matrix Method Prep Batch 752-7628-1 Caryard Total Recoverable Water 6010D 781591 MB 680-7 8 1 59 1/1-A Method Blank Total Recoverable Water 6010D 781591 LCS 680-781591/2-A Lab Control Sample Total Recoverable Water 6010D 781591 General Chemistry Analysis Batch: 3068 Lab Sample ID Client Sample ID Prep Type Matrix Method Prep Batch 752-7628-1 Caryard Total/NA Water SM 2540D MB 752-3068/1 Method Blank Total/NA Water SM 2540D LCS 752-3068/2 Lab Control Sample Total/NA Water SM 2540D Prep Batch: 782302 Lab Sample ID Client Sample ID Prep Type Matrix Method Prep Batch 752-7628-1 Caryard Total/NA Water 1664E MB 680-782302/1-A Method Blank Total/NA Water 1664B LCS 680-782302/2-A Lab Control Sample Total/NA Water 1664E LCSD 680-782302/3-A Lab Control Sample Dup Total/NA Water 1664E Analysis Batch: 782459 Lab Sample ID Client Sample ID Prep Type Matrix Method Prep Batch 752-7628-1 Caryard Total/NA Water 1664B 782302 MB 680-782302/1-A Method Blank Total/NA Water 1664B 782302 LCS 680-782302/2-A Lab Control Sample Total/NA Water 1664E 782302 LCSD 680-782302/3-A Lab Control Sample Dup Total/NA Water 1664E 782302 Eurofins Raleigh Page 10 of 18 6/12/2023 Lab Chronicle Client: Marsh Truck Parts Job ID: 752-7628-1 Project/Site: Caryard Client Sample ID: Caryard Lab Sample ID: 752-7628-1 Date Collected: 05/29/23 08:00 Matrix: Water Date Received: 05/31/23 14:10 Batch Batch Dilution Batch Prepared Prep Type Type Method Run Factor Number Analyst Lab or Analyzed Total/NA Analysis 8015C GLY 1 782261 DBM EET SAV 06/06/23 23:51 Total Recoverable Prep 3005A 781591 RR EET SAV 06/02/23 06:47 Total Recoverable Analysis 6010D 1 781729 BJB EET SAV 06/02/23 11:19 Total/NA Prep 1664B 782302 TD EET SAV 06/07/23 07:45 Total/NA Analysis 1664B 1 782459 TD EET SAV 06/07/23 14:35 Total/NA Analysis SM 2540D 1 3068 MDF EET ESC 06/01/23 08:33 Laboratory References: EET ESC= Eurofins Raleigh, 102-A Woodwinds Industrial Court,Cary,NC 27511,TEL(919)677-1669 EET SAV=Eurofins Savannah,5102 LaRoche Avenue,Savannah,GA 31404,TEL(912)354-7858 Eurofins Raleigh Page 11 of 18 6/12/2023 Accreditation/Certification Summary Client: Marsh Truck Parts Job ID: 752-7628-1 Project/Site: Caryard Laboratory: Eurofins Raleigh The accreditations/certifications listed below are applicable to this report. Authority Program Identification Number Expiration Date North Carolina (WW/SW) State 591 12-31-23 Laboratory: Eurofins Savannah All accreditations/certifications held by this laboratory are listed. Not all accreditations/certifications are applicable to this report. Authority Program Identification Number Expiration Date AFCEE SAVLAB Alabama State 41450 06-30-23 ANAB Dept.of Defense ELAP L2463 09-22-24 Arkansas DEQ State 19-015-0 02-01-24 California State 2939 06-30-23 Florida NELAP E87052 06-30-23 Georgia State E87052 06-30-23 Georgia(DW) State 803 06-30-23 Guam State 19-007R 04-17-24 Hawaii State <cert No.> 06-30-23 Illinois NELAP 200022 11-30-23 Indiana State C-GA-02 06-30-23 Iowa State 353 06-30-23 Kentucky(UST) State NA 06-30-23 Louisiana NELAP 30690 06-30-23 Louisiana(All) NELAP 30690 06-30-23 Louisiana(DW) State LA009 12-31-23 Maine State GA00006 09-25-24 Maryland State 250 12-31-23 Massachusetts State M-GA006 06-30-23 Michigan State 9925 06-30-23 Mississippi State <cert No.> 06-30-23 Nebraska State NE-OS-7-04 06-30-23 New Jersey NELAP GA769 06-30-23 New Mexico State GA00006 06-30-23 North Carolina(DW) State 13701 07-31-23 North Carolina(WW/SW) State 269 12-31-23 Pennsylvania NELAP 68-00474 06-30-23 Puerto Rico State GA00006 01-01-24 South Carolina State 98001 06-30-23 Tennessee State TN02961 06-30-23 Texas NELAP T1047004185-19-14 11-30-23 Texas TCEQ Water Supply T104704185 06-30-23 USDA US Federal Programs P330-18-00313 09-03-24 Virginia NELAP 460161 06-14-23 Wyoming State 8TMS-L 06-30-23 Eurofins Raleigh Page 12 of 18 6/12/2023 Method Summary Client: Marsh Truck Parts Job ID: 752-7628-1 Project/Site: Caryard Method Method Description Protocol Laboratory 8015C GLY Glycols-Direct Injection(GC/FID) SW846 EET SAV 6010D Metals(ICP) SW846 EET SAV 1664B HEM and SGT-HEM 1664B EET SAV SM 2540D Solids,Total Suspended(TSS) SM EET ESC 1664E HEM and SGT-HEM (Aqueous) 1664E EET SAV 3005A Preparation,Total Recoverable or Dissolved Metals SW846 EET SAV Protocol References: 1664E= EPA-821-98-002 SM="Standard Methods For The Examination Of Water And Wastewater" SW846="Test Methods For Evaluating Solid Waste,Physical/Chemical Methods",Third Edition, November 1986 And Its Updates. Laboratory References: EET ESC= Eurofins Raleigh, 102-A Woodwinds Industrial Court,Cary, NC 27511,TEL(919)677-1669 EET SAV=Eurofins Savannah,5102 LaRoche Avenue,Savannah,GA 31404,TEL(912)354-7858 Eurofins Raleigh Page 13 of 18 6/12/2023 Sample Summary Client: Marsh Truck Parts Job ID: 752-7628-1 Project/Site: Caryard Lab Sample ID Client Sample ID Matrix Collected Received 752-7628-1 Caryard Water 05/29/23 08:00 05/31/23 14:10 Eurofins Raleigh Page 14 of 18 6/12/2023 ref N N 9nn N •,•Mr O U t� ls fl WI•]S fl. U L N U1 M(J D W 'a N C . 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V 'Or 2° .: 0IT) r u u a 0 �_ 0sa C;: o E. c •_ E m m ,r cu or, i= o a J�cr m ( \ -0 1 y x= CP T M C cn N UI ❑ra t "c oN L n # m0 o E • w E o a O Oo u> ,n V) E O. o 0 0 c� a o m '- a 3 a` r y 1 m a r u c m c o C o > U I o-- W 1a°- v c D N K d N w c_ . :. .O yj.mN U co aU a a J o 4 o L Z U O 2 0'' mc c a a) m co a C L U- J Nr LI U 0 .0 co p "'aw 0 1 U ° N a, c"9 o ro L N 0 N_ ti A W C f" ai L E°' c O N d a1 O c O m o °:4 b in C (p C a 51 L is � � ° ' c r 0 N aEe ti Q a cc `- � � > o a C m m w 9Ta ro a c CL o N m p w c u m Y a0.3 N n y n n , C p U C ro x IL L O �' E 'C 2 5 w CO t 1.. 2 Za' — o rn . W m m ..v f- h- a) -o "g a' �:. m Y ° w O a) C U 9 ) c _l L 2-m M Z L L 10 Vl c y >) �` a > -' P E = 8 o C E ` 6 2/a,023 - C �, a E 0 m 5^ L rn w a` .2 r apW- c f 18 z-g a_ m ❑ w a 'rr et Login Sample Receipt Checklist Client: Marsh Truck Parts Job Number: 752-7628-1 Login Number: 7628 List Source: Eurofins Raleigh List Number: 1 Creator: Hyatt, Samantha Question Answer Comment Radioactivity wasn't checked or is </= background as measured by a survey True meter. The cooler's custody seal, if present, is intact. True Sample custody seals, if present, are intact. True The cooler or samples do not appear to have been compromised or True tampered with. Samples were received on ice. True Cooler Temperature is acceptable. True Cooler Temperature is recorded. True COC is present. True COC is filled out in ink and legible. True COC is filled out with all pertinent information. True Is the Field Sampler's name present on COC? True There are no discrepancies between the containers received and the COC. True Samples are received within Holding Time(excluding tests with immediate True HTs) Sample containers have legible labels. True Containers are not broken or leaking. True Sample collection date/times are provided. True Appropriate sample containers are used. True Sample bottles are completely filled. True Sample Preservation Verified. True There is sufficient vol. for all requested analyses, incl. any requested True MS/MSDs Containers requiring zero headspace have no headspace or bubble is True <6mm (1/4"). Multiphasic samples are not present. True Samples do not require splitting or compositing. True Residual Chlorine Checked. True Eurofins Raleigh Page 17 of 18 6/12/2023 Login Sample Receipt Checklist Client: Marsh Truck Parts Job Number: 752-7628-1 Login Number: 7628 List Source: Eurofins Savannah List Number: 2 List Creation: 06101123 11:57 AM Creator: Harley, Tynisha Question Answer Comment Radioactivity wasn't checked or is</= background as measured by a survey N/A meter. The cooler's custody seal, if present, is intact. True Sample custody seals, if present, are intact. True The cooler or samples do not appear to have been compromised or True tampered with. Samples were received on ice. True Cooler Temperature is acceptable. True Cooler Temperature is recorded. True COC is present. True COC is filled out in ink and legible. True COC is filled out with all pertinent information. True Is the Field Sampler's name present on COC? True There are no discrepancies between the containers received and the COC. True Samples are received within Holding Time(excluding tests with immediate True HTs) Sample containers have legible labels. True Containers are not broken or leaking. True Sample collection date/times are provided. True Appropriate sample containers are used. True Sample bottles are completely filled. True Sample Preservation Verified. N/A There is sufficient vol.for all requested analyses, incl. any requested True MS/MSDs Containers requiring zero headspace have no headspace or bubble is N/A <6mm (1/4"). Multiphasic samples are not present. True Samples do not require splitting or compositing. True Residual Chlorine Checked. N/A Eurofins Raleigh Page 18 of 18 6/12/2023 NCDEQ Division of Energy, Mineral and Land Resources Stormwater Discharge i kr. ls=io, e.t Report or: (DIM) Form for NCSI00000 Used Motor Vehicles Click here for instructions Complete,sign,scan and submit the DMR via the Stormwater NPDES Permit Data Moni tiring.Report.,DMR) Upload form within 30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the appropriate DEML.R.._Regional Office. Certificate of Coverage No. NCG10 0015 Person Collecting Samples: Jimmie Marsh Facility Name:Marsh Car Yard Laboratory Name: Eurofins Facility County:Chatham Laboratory Cert. No.: NC 591 Discharge during this period:0 Yes ri No (if no,skip to signature and date) Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?E Yes El No If so,which Tier(I, II,or III)?Tier I A copy of this DMR has been uploaded electronically via https://edocsided.nc,..gov/Fornis/SW-DMR SW-DMR El Yes El No Date Uploaded: Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in (Red) Parameter Parameter Outfall 001 Outfall Outfall Outfall Outfall Code N/A Receiving Stream Class C N/A Date Sample Collected MM/DD/YYYY 05/29/2023 46529 24-Hour Rainfall in inches 1.5 C0530 TSS in mg/L(100 or 50*) 130 00400 pH in standard units(6.0—9.0 FW, 6.8 6.8—8.5 5W) 00340 Chemical Oxygen Demand in mg/L N/A (120) Lead,total recoverable(as Pb)in 01051 0.018 mg/L(0.075 FW,0.22 SW) Ethylene Glycol in mg/L(any amount 77023 detected Tier One;8,000 mg/L Tier <10 Two and Three) 00552 Non-Polar Oil&Grease in mg/L(15) <5.1 NCOIL Estimated New Motor/Hydraulic Oil N/A Usage in gal/month *Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HQW),Trout Waters(Tr)and Primary Nursery Areas(PNA) have a benchmark TSS limit of SO mg/L.All other water classifications have a benchmark of 100 mg/I. FW(Freshwater)SW(Saltwater) Notes(optional): Chemical Oxygen Demand will be collected during subsequent events. "I certify by my signature below,under penalty of law,that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information,the information submitted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting false information,including the possibility of finesand imprisonment for knowing violations."/ Signature of Permittee or Delegated Authorized Individual Date marshallsteve09@gmail.com 336-669-9858 Email Address Phone Number