NCG120034_2023 DMR_20230719

Winston-Salem/Forsyth County
Utilities
Water•Wastewater•Solid Waste
Hanes Mill Road Solid Waste Facility,325 W Hanes Mill Road,Winston-Salem,NC 27105
0:336-727-8000, F:336-661-4905, utilities.cityofws.org
July 19,2023
Attn DEMLR Stormwater Program
North Carolina Department of Environmental Quality
Division of Mineral, Energy, and Land Resources,Stormwater Division
Land Quality Section, Winston-Salem Regional Office
450 West Hanes Mill Road, Suite 300
Winston-Salem, NC 27105
Re: Second Quarter NPDES Compliance Submittal for 2023
Hanes Mill Road Landfill, Forsyth County, North Carolina
Permit No. NCG120034
To Whom It May Concern:
As you are aware, the Winston-Salem/Forsyth County City/County Utilities Commission is monitoring
stormwater under Permit No. NCG120034 at the Hanes Mill Road Landfill located at 325 West Hanes Mill
Road in Winston-Salem, North Carolina (NC). The purpose of this correspondence is to provide the
required reporting and results for the second quarter compliance period for 2023.
Quarterly samples were collected from three of the eight compliance monitoring points (SDO-A2, SDO-F,
SDO-3) on June 7, 2023. Outfalls SDO-J, 0S-1, OS-2, OS-3, and OS-4 did not have flow during the June 7,
2023 representative rainfall event. The required discharge monitoring report (DMR) is attached for this
sampling event.
If you have any questions or require any additional information, please contact us. We appreciate your
assistance with this project.
Sincerely,
WINSTON-SALEM/FORSYTH COUNTY CITY/COUNTY UTILITIES COMMISSION
C . .144"411‘.. (...C44-4
Gordon Dively
Solid Waste Operations Supervisor
GEMZE11) City Council:Mayor Allen loines;Denise D.Adams,Mayor Pro Tempore,North Ward;Barbara Hanes Burke,Northeast Ward;Robert C.Clark,West Ward;
John C.Larson,South Ward;Jeff Macintosh,Northwest Ward;Kevin Mundy,Southwest Ward;Annette Scippio,East Ward;lames Taylor,Jr.,Southeast Ward;City Manager:
Lee D.Garrity
County Commissioners:David R.Plyler,Chair;Don Martin,Vice Chair;Fleming El Arnin;Ted Kaplan;Richard V.Linville;Tonya McDaniel;Gloria D.Whisenhunt;County
Call 311 or 336 727 8000
Manager:Dudley Watts,Jr.
[e-mail] Winston-Salem/Forsyth County Utility Cornmission:Rands II S.Tuttle,Chair;L.Wesley Curtis,Jr.,Vice Chair;Harold E.Day;Tom Griffin;Yvonne H Hines;Duane Long;Hugh
w ia..,;e,,,•n.<�<oF <•n..�r,i eea..,.r rho<ie<ur,l<.,,,eu.,,v.,,��ae.

iinston-Saletn•Forsyth County
/County Utilities
Attachments: DMR, Qualitative Monitoring Reports, Laboratory Certificates-of-Analyses
C: Jamal Clark, Stormwater Operations Supervisor, City of Winston-Salem, Suite 232, City Hall, 101
N. Main Street, Winston-Salem, NC, 27101, P.O. Box 2511, Winston-Salem, NC, 27102-2511,
[e-mail]
Darren Cox,WSP USA Inc., 5B Oak Branch Drive,Greensboro, NC, 27047, [e-mail]
ill

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR) Form for NCG120000
Landfills
Click here for instructions
Complete,sign,scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report(DMR)Upload form within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG12 0034 Person Collecting Samples: Johnathan Serencsics
Facility Name: Hanes Mill Road Landfill Laboratory Name: Pace Analytical
Facility County:Forsyth Laboratory Cert. No.: NC633
Discharge during this period:❑ Yes ❑✓ No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑Yes ❑✓ No
If so,which Tier(I,II,or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/SW-DMR ✓❑ Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall 3 Outfall A2 Outfall F Outfall Outfall
Code
N/A Receiving Stream Class C C C
N/A Date Sample Collected MM/DD/YYYY 6/7/23 6/7/23 6/7/23
46529 24-Hour Rainfall in inches 0.23 0.23 0.23
C0530 TSS in mg/L(100 or 50*) 105 825 80
00400 pH in standard units(6.0—9.0) 8.2 8.14 7.01
00340 Chemical Oxygen Demand in mg/L
(120) 43.1 107 43.1
31616 Fecal Coliform in ff per 100 ml(1000) 12000 12000 12000
Additional parameters for outfalls in drainage areas that use>55 gallons per month of new hydraulic oil on average
00552 Non-Polar Oil&Grease in mg/L(15) - <5 - -
NCOIL Estimated New Motor/Hydraulic Oil >55 gal - -
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 50 mg/L.All other water classifications have a benchmark of 100 mg/L
Notes(optional):
"I certify by my signature below, under penalty of law,that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information,the information
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 informa on,incl iding t ossibil y of fines and imprisonment for knowing violations."
/ 17/24 2-3
Sirgnature of Permittee or Delegatp Authorized Individual Date
Email Address [e-mail] Phone Number 336-734-1502

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N_/C/f,/ 1 /2/ 6/0/3/ / or Certificate of Coverage No.: N_/C/G/ / / / / / /
Facility Name: &K.S Ne,r‘ gvo-c
County: co cs N., Phone No. 556 61,o&o
Inspector: 3C,liv,4 .,w, /evt,CS;tS
Date of Inspection: c l - I Z3
Time of Inspection: t 4 4 rD
Total Event Precipitation(inches): O•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 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:
(Signatu e of Permittee or Designee)
1. Outfall Description:
Outfall No. 9O- 41 Structure(pipe, ditch, etc.): f i(k
Receiving Stream: /���
-�-r;t9,4{-tzry GC- (�v e s y
Describe the industrial activities that occur within the outfall drainage area:
Cio5aii iAc-tl
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2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.)and tint
(light,medium, dark)as descriptors: �ir.,i- t0^6un
3. Odor: Describe any distinct odors that the discharge may have(i.e.,smells strongly of oil, weak
chlorine odor, etc.): 1n MC-
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 ® 4 -5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
I 2 l3 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 j0 No.
9. Is there evidence of erosion or deposition at the outfall? o Yes t/No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
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Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-storm water-gp s
Permit No.: N/C/(,/ I /Z/f)/G/X/ A/ or Certificate of Coverage No.: N/C/G/ / / / / / /
Facility Name: /'.‘11 PaucP
County: rersy Phone No. 354 — $.140
Inspector:
Date of Inspection: (P (3423
Time of Inspection: 14340
Total-Event Precipitation(inches): 0. Z 3
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:
(Signature o Permittee or Designee)
1. Outfall Description:
Outfall No. V() -AZ Structure(pipe, ditch, etc.): Concyck. p
Receiving Stream:
r t b tAA-t� e+- C,rrAersy Grtk
Describe the industrial activities that occur within the outfall drainage area:
CAD 5Gd /00(1-P
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2. Color: Describe the color of the discharge using basic colors(red,brown, blue, etc.)and tint
(light, medium, dark)as descriptors: idav1
3. Odor: Describe any distinct odors that the discharge may have(i.e., smells strongly of oil, weak
chlorine odor, etc.): Ow(-
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 -5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 3 5
7. Is there any foam in the stormwater discharge? 0 Yes /No.
8. Is there an oil sheen in the stormwater discharge? g Yes 0 No.
9. Is there evidence of erosion or deposition at the outfall? 0 Yes ,�No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity,high solids, and/or the presence of foam, oil sheen,or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242,Last modified 06/01/2018

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N/C/6/ i / 2/0/c'/3/4/ or Certificate of Coverage No.: N_/C/G/ / / / / / /
Facility Name: 'gc iw;j IA;it 'tea& 1�
County: -Fd(Sr Phone No. 4- 'Z - 30011
Inspector:p .501hvre-tl-Pn,w,
Date of Inspection: 6(44?-3
Time of Inspection: 142S
Total Event Precipitation(inches): C ��
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:
6„,-
(Signature of Permittee or Designee)
1. Outfall Description:
Outfall No. Q0 P 13 Structure(pipe, ditch, etc.): );
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
(,1049 4 t 1
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2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.)and tint
(light, medium, dark) as descriptors: fb clu iJ
3. Odor: Describe any distinct odors that the discharge may have(i.e.,smells strongly of oil, weak
chlorine odor, etc.): Yl ti v'
4. Clarity: Choose the number which best describes the clarity of the discharge,where 1 is clear
and 5 is very cloudy:
1 2 3 4 -5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge,where l 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 l is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? 0 Yes 0 No.
8. Is there an oil sheen in the stormwater discharge? 0Yes 0 No.
9. Is there evidence of erosion or deposition at the outfall? 0 Yes /No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe c1.014
A.Y/
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 06/0 1/20 1 8

INC
Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
2
Permit No.: N/C/G/ j /r5/G /O/y/ H/ or Certificate of Coverage No.: N/C/G/ / / / / / /
Facility Name: owtc., JVtiUU Q©cic LF "TO-
County: carst54, Phone No. 356 - 7'le- 2-90
'sS
Inspector: rv4 \an wrc6:c6
Date of Inspection: 4 F1-1 Z3
Time of Inspection: 14ZO
Total Event Precipitation(inches): O-Z3
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:
(Signature of rmittee or Designee)
1. Outfall Description:
Outfall No. S90- t. Structure(pipe, ditch, etc.): ?gee'
Receiving Stream:
TN;bt u O bre•Ssr Gre.4,-k
Describe the industrial activities that occur within the outfall drainage area:
(A.Ciat c,
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2. Color: Describe the color of the dischar e using basic colors(red, brown, blue, etc.)and tint
(light, medium, dark)as descriptors: 110 *l d Lt
3. Odor: Describe any distinct odors that the discharge may have(i.e.,smells strongly of oil, weak
chlorine odor, etc.): no eIvr!
4. Clarity: Choose the number which best describes the clarity of the discharge,where 1 is clear
and 5 is very cloudy:
1 2 3 4 -5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? 0 Yes 0 No.
8. Is there an oil sheen in the stormwater discharge? oYes 0 No./
9. Is there evidence of erosion or deposition at the outfall? 0 Yes ¢5 No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242,Last modified 06/01/2018

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N/C/(,/ ( /Z/0/0/3/ 4( or Certificate of Coverage No.: N/C/G/ / / / / / /
Facility Name: Hama, AA,it aa, L-F ItZ}
County: ' VsY}4., Phone No. 3s 6 - 2Pc60
5.5
Inspector:P za,04u14.1„" .i.,frkc`J+
Date of Inspection: 4 s'1 123
Time of Inspection: lL 13
Total Event Precipitation(inches): 0.2 S
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:
(Signature Permittee or Designee)
1. Outfall Description:
Outfall No. 3190 -p Structure(pipe, ditch, etc.): P)a31-,C Re-
Receiving Stream:
LtrLIA,fivy m-C 6reA46y Cy4-Zr
Describe the industrial activities Ithatt occur within the outfall drainage area:
C,teXo /02, 2e19-1:)1
Page 1 of 2
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2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.)and tint
(light, medium, dark)as descriptors: + -v
3. Odor: Describe any distinct odors that the discharge may have(i.e.,smells strongly of oil, weak
chlorine odor, etc.): 'v16
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 3 (4) -5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
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 4Q 5
7. Is there any foam in the stormwater discharge? 0 Yes /No.
8. Is there an oil sheen in the stormwater discharge? oYes �No.
9. Is there evidence of erosion or deposition at the outfall? 0 Yes (No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity,high solids, and/or the presence of foam,oil sheen,or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242,Last modified 06/01/2018

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N/C/G/i /Z/D/G/3/4/ or Certificate of Coverage No.: N_/C/G/ / / / / / /
Facility Name: HaAnc6 /U1,I1 2O¢til 1-F
County: �ars , Phone No. 33 —4.4.Z — &GdO
35
Inspector: ,T0„v14k1.u4A ,e_Ar c6;vS
Date of Inspection: 6 14.j ZS
Time of Inspection: 55 ' tad I
Total Event Precipitation(inches): 0.23
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:
(Signature f Permittee or Designee)
1. Outfall Description:
Outfall No.STh— E Structure(pipe, ditch, etc.): 131Ce };<,
Receiving Stream:
�( i burtcR%y Q,� s Lrce
Describe the industrial activities that occuYitwithin the outfall drainage area:
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2. Color: Describe the color of the discharge using basic colors(red, brown, blue, etc.)and tint
(light, medium, dark) as descriptors: VaVIA, �a.t% I
3. Odor: Describe any distinct odors that the discharge may have(i.e., smells strongly of oil, weak
chlorine odor, etc.): nbv'�c.
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 4 -5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
�f1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where l is no solids and 5 is extremely muddy:
1 2 4 5
7. Is there any foam in the stormwater discharge? o Yes S.No.
8. Is there an oil sheen in the stormwater discharge? oYes jNo.
9. Is there evidence of erosion or deposition at the outfall? o Yes /No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen,or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
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C
Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Pen-nit No.: N/C/C,/ I /Z/0/0/ /N/ or Certificaten of Coverage No.: N/C/G/ / / / / / /
Facility Name: �omtz, M, iJ+tl 'Rc
County: For y -t. Phone No. S3/2- 4Z7- - `760C
Inspector: In+f-N✓.A ,wo s `6
Date of Inspection: (o f /23
Time of Inspection: 1354
Total Event Precipitation(inches): O•Z3
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:
(Signatu of Permittee or Designee)
1. Outfall Description:
Outfall No. 590 - F Structure(pipe, ditch, etc.): tlGre+c pi�
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
CI0'./ C 4i II
Page I of 2
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2, Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: 1; t - 4'O41
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:
1 2 Q 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:
(j 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 ® 4 5
7. Is there any foam in the stormwater discharge? 0 Yes �No.
8. Is there an oil sheen in the stormwater discharge? oYes /No.
9. Is there evidence of erosion or deposition at the outfall? o Yes INo.
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 WU-242.Last modified 06,01 2018

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N/C/(,/ I/Z/O/0/;/y/ or Certificate of Coverage No.: N/C/G/ / / / / / /
Facility Name: H ONUS f/vV%`► 120* LF
County: Phone No. — -toed
Inspector: T y,v, On
Date of Inspection: 6(4—/�.3
Time of Inspection: L 53
Total,Event Precipitation(inches): C.
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:
(Signature of P mittee or Designee)
1. Outfall Description:
Outfall No. 5QO — T Structure(pipe, ditch, etc.): Ft F;,
Receiving Stream:
4C,b+n4-ar 0-c ,6 y exceK
Describe the industrial activities6,that occur within the outfall drainage area:
Page 1 of 2
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2. Color: Describe the color of the discharge using basic colors(red, brown, blue, etc.)and tint
(light, medium, dark)as descriptors: 1_ �.•F- 4-c-v+
3. Odor: Describe any distinct odors that the discharge may have(i.e., smells strongly of oil, weak
chlorine odor, etc.): (1614(.,
4. Clarity: Choose the number which best describes the clarity of the discharge,where 1 is clear
and 5 is very cloudy:
1 3 4 -5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
(1) 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 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 0/No.
9. Is there evidence of erosion or deposition at the outfall? o Yes 'No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity,high solids, and/or the presence of foam,oil sheen,or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242,Last modified 06/01/2018

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N_/C/1,/ 1 /2 i6 le /3i 4/ or Certificate of Coverage No.: N_/C/G/ / / / / / /
Facility Name: 4404vu 5 MI11 124 LF
County: cb re1 t-(„ Phone No. 336.- I-Z} -$tom
Inspector: e4./r4/14-6:IS
Date of Inspection: 4/4-/Z3
Time of Inspection: I LI (
Total Event Precipitation(inches): O i?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
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:
(Signat ire of Permittee or Designee)
1. Outfall Description:
Outfall No. 3 -J Structure(pipe, ditch, etc.): PVe. p;Pe,
Receiving Stream:
btit &my,r Lraok
Describe the industrial activities that occur within the outfall drainage area:
Goo jc-%l�
Page 1 of 2
SWU-242,Last modified 06/01/2018

2. Color: Describe the color of the discharge sing basic colors(red, brown, blue, etc.)and tint
(light, medium, dark) as descriptors: Id 1-)'
3. Odor: Describe any distinct odors that the discharge may have(i.e.,smells strongly of oil, weak
chlorine odor, etc.): tlp
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 3 4 -5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge,where 1 is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? 0 Yes 0 No.
8. Is there an oil sheen in the stormwater discharge? 0Yes 0 No.
9. Is there evidence of erosion or deposition at the outfall? 0 Yes 0 No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Pa i4
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 06/01/2018

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N_/C/(,/ I / Z/0/O/3/4/ or Certificate of Coverage No.: N_/C/G/ / / / / / /
Facility Name: ho , 5 t j l\ R c d LF
County: core., Phone No. 336 — 3-1c. -42000
Inspector: (36%;11.20 ,e,n 'errryK ,i c 3
Date of Inspection: (1—(Z3
Time of Inspection: f,53
Total Event Precipitation(inches): 6.23
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:
( V v
(Signature Permittee or Designee)
1. Outfall Description:
Outfall No. S©O I Structure(pipe, ditch, etc.):
Receiving Stream:
frbt4 r 6 G- yr,- 'Lt,r e/e
Describe the industrial activities that occur within outfall drainage area:
1;014`' hf, rafc (out li
Page 1 of 2
SWU-242.Last modified 06/01/2018

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: QO -V10
3. Odor: Describe any distinct odors that the discharge may have(i.e., smells strongly of oil, weak
chlorine odor, etc.): V}bl�kJ
4, Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 3 4 =5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? 0 Yes 0 No.
8. Is there an oil sheen in the stormwater discharge? °Yes 0 No.
9. Is there evidence of erosion or deposition at the outfall? 0 Yes 0 No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
ko . 1o)
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 06%O1/2018

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Pen-nit No.: N/C/s/I /2/0/G/3/4/ or Certificate of Coverage No.: N_/C/G/ / / / / / /
Facility Name: 14a✓1ti5 JW;I I P6da L-F
County: 'Farryl-t, Phone No. 33( - - `36O0
Inspector: n*-6 tarKlifIrvziriGytt- ;IS
Date of Inspection: ‘( 4./`3
Time of Inspection: 15%
Total Event Precipitation(inches): 0°a5
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:
(Signatt e of Permittee or Designee)
1. Outfall Description:
Outfall No.Spo-Z Structure(pipe, ditch, etc.): pi
Receiving Stream:
-f r bu ✓y <54 C,T r GrcCK,
Describe the industrial activities that occur within the outfall drainage area:
.62G1-4c. I anJF:lI
Page 1 of 2
SWU-242.Last modified 06/01/2018

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: I't,\,* oc -> t,- 4o
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): flO M-
4, Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 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:
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 4 5/No.
7. Is there any foam in the stormwater discharge? o Yes
8. Is there an oil sheen in the stormwater discharge? oYes 6 No.
9. Is there evidence of erosion or deposition at the outfall? 0 Yes 'No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242.Last modified 06,01'2018

INIZ,' ,
Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N/C/6/ t/Z/b/G/3/4/ or Certificate of Coverage No.: N/C/G/ / / / / / /
Facility Name: H c, ,CS M.11 041rA,G9 /-F
County: Far y fL Phone No. 5 4— 1-Zf - Od
Inspector: - „onrnsl.en,et/1 d�'i. :45
Date of Inspection: 6 0- Iz 3
Time of Inspection: 11.156
Total Event Precipitation(inches): O, LS
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:
X....,........ .___
(Signatur of Permittee or Designee)
1. Outfall Description:
Outfall No. SR1-3 Structure(pipe, ditch, etc.): Mthct t p:Pe—
Receiving Stream:
-IT;b u (7 s - ire e►c
Describe the industrial activities that occur within the outfall drainage area:
Oakei 616P&,tt
Page 1 of 2
SWU-242,Last modified 06/01/2018

2. Color: Describe the color of the discharge using basic colors(red, brown, blue, etc.)and tint
(light,medium, dark)as descriptors: I Zat Vv4-
3. Odor: Describe any distinct odors that the discharge may have(i.e., smells strongly of oil, weak
chlorine odor, etc.): (IOW.
4. Clarity: Choose the number which best describes the clarity of the discharge,where 1 is clear
and 5 is very cloudy:
1 2 Q 4 -5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
1 2 Q 4 5
7. Is there any foam in the stormwater discharge? 0 Yes No.
8. Is there an oil sheen in the stormwater discharge? oYes 9(No.
9. Is there evidence of erosion or deposition at the outfall? 0 Yes .6 No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity,high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242,Last modified 06/01/2018

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N_/C/(,/ , /Z/6/6/3/ 4/ or Certificate of Coverage No.: N_/C/G/ / / / / / /
Facility Name: Hai 1-5 M'I l gv LF L}
County: c6Y1jet^ Phone No. 33.6 # '2)6"
Inspector: jeSp i y,pai,,, €4'l6 c%.3
Date of Inspection: (v(T/
Time of Inspection: i5 12-
Total Event Precipitation(inches): 0,25
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:
(Signatur of Permittee or Designee)
1. Outfall Description:
Outfall No. 500—tI Structure(pipe, ditch, etc.): @c.,
Receiving Stream:
+r i inn'Val. c COY erG t
Describe the industrial activities that occur within thl outfall drainage area:
IP5in))1-; II
Page 1 of 2
SWU-242,Last modified 06/01/2018

2. Color: Describe the color of the discharge using basic colors(red, brown, blue, etc.)and tint
(light, medium, dark)as descriptors: "t'a.v
3. Odor: Describe any distinct odors that the discharge may have(i.e.,smells strongly of oil, weak
chlorine odor, etc.): 00 aru..
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 9 -5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
�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 5
7. Is there any foam in the stormwater discharge? 0 Yes it<No.
8. Is there an oil sheen in the stormwater discharge? oYes /No.
9. Is there evidence of erosion or deposition at the outfall? 0 Yes "No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity,high solids, and/or the presence of foam,oil sheen,or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242,Last modified 06/01/2018

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N_/C/(�/ 1/Z/0/©/3/1/ or Certificate of Coverage No.: N/C/G/ / / / / / /
Facility Name: 14041(..$4 20 j
County: o,rs.�i�, Phone No. 334 - — Sow
Inspector: yl„ .¢tJn enCSIUs
Date of Inspection: 614 L3
Time of Inspection: 1 ZO
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:
/24;
(Signature Permittee or Designee)
1. Outfall Description:
Outfall No. 696- Structure(pipe, ditch, etc.): Pa5fIc—
Receiving Stream:
``// o'v- Gram � k
Describe the industrial activities that occur within the outfall drainage area:
0 q 41'ti 1
Page 1 of 2
SWU-242.Last modified 06/01/2018

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.)and tint
(light, medium, dark) as descriptors: ()rvt-r►'N
3. Odor: Describe any distinct odors that the discharge may have(i.e., smells strongly of oil, weak
chlorine odor, etc.): nOvU,
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 =5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
1 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 5
7. Is there any foam in the stormwater discharge? 0 Yes KNo.
8. Is there an oil sheen in the stormwater discharge? oYes 7(No.
9. Is there evidence of erosion or deposition at the outfall? 0 Yes "No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
S WU-2-2.Last modified 06 0 U2018

NCH
Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Pennit No.: N/C/&/ I /2/6/O/3/w/ or Certificate of Coverage No.: N/C/G/ / / / / / /
Facility Name: 1-40.44.6 AA111 Kpwd LF
County: cov- y H., Phone No. 336- 3 a -`1 00
Inspector: celAvt a.W.,.ty 4-"—C5
Date of Inspection: C/T (C.3
Time of Inspection: 1 5 2 LI
Total Event Precipitation(inches): 0 2 3
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:
(Signature o Permittee or Designee)
1. Outfall Description:
Outfall No. 6 5— ( Structure (pipe, ditch, etc.):
Receiving Stream:
bti+ ' trc- ruk
Describe the industrial activities that occur within the outfall drainage area:
no vv.
Page 1 of 2
SWU-242.Last modified 06/01/2018

2, Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark)as descriptors: '1,6 r�
3, Odor: Describe any distinct odors that the discharge may have(i.e., smells strongly of oil, weak
chlorine odor, etc.): Ob —1O inl
4, Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 3 4 =5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 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 3 4 5
7. Is there any foam in the stormwater discharge? 0 Yes ° No.
8. Is there an oil sheen in the stormwater discharge? °Yes ° No.
9. Is there evidence of erosion or deposition at the outfall? 0 Yes 0 No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Aid 0 W
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 06%01/2018

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N/C/(y/ / 2/b/0/3/ I/ or Certificate of Coverage No.: N/C/G/ / / / / / /
Facility Name: tiann W 11 acki LF
County: �pr5.1 , Phone No. 336-1-2-' - $6(Q
Inspector: J41nna44,+.tn LertielLS:&S
Date of Inspection: 6j*(23
Time of Inspection: 1 '2$
Total Event Precipitation(inches): o.z3
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:
(Signature o ermittee or Designee)
1. Outfall Description:
Outfall No. 03- Z Structure(pipe, ditch, etc.): PFe
Receiving Stream:
+1lb v►�we- of G y 6ruk
Describe the industrial activities that occur within the outfall drainage area:
kilo tit,
Page 1 of 2
SWU-242.Last modified 06/01/2018

2, Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark)as descriptors: N© 4,111,1
3. Odor: Describe any distinct odors that the discharge may have(i.e., smells strongly of oil, weak
chlorine odor, etc.): Ct,0_iA
4, Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 2 3 4 =5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 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 3 4 5
7. Is there any foam in the stormwater discharge? 0 Yes 0 No.
8. Is there an oil sheen in the stormwater discharge? ()Yes () No.
9. Is there evidence of erosion or deposition at the outfall? ()Yes 0 No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe nn
Ak teco W
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 WU-242.Last modified 06%0 1/2018

INO
Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N/C/Ca/ /2/0/0/ /44/ or Certificate
of Coverage No.: N_/C/G/ / / / / / /
Facility Name: 1-64 206(! L
County: -tj , Phone No. 3 - - 2000
Inspector: .Z/1
Date of Inspection: '/' -(23
Time of Inspection: 1633
Total Event Precipitation(inches): O.Z3
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:
(Signature Permittee or Designee)
1. Outfall Description:
Outfall No. 0 3 Structure(pipe, ditch, etc.): P`
Receiving Stream:
+r;),u,ctrr of Gs-69,6y ,,k.
Describe the industrial activities that occur within the outfall drainage area:
00 --
Page 1 of 2
SWU-242.Last modified 06/01/2018

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.)and tint
(light, medium, dark) as descriptors: f jt3 -cta►4
3. Odor: Describe any distinct odors that the discharge may have(i.e., smells strongly of oil, weak
chlorine odor, etc.): A)6!
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
1 2 3 4 =5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 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:
2 3 4 5
7. Is there any foam in the stormwater discharge? 0 Yes o No.
8. Is there an oil sheen in the stormwater discharge? oYes 0 No.
9. Is there evidence of erosion or deposition at the outfall? 0 Yes 0 No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe clOk
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 06,01/2018

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https://deq.nc.gov/about/divisions/energy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N_/C/(,/ j /Z/o l0 l3/'il or Certificate of Coverage No.: N_/C/G/ / / / / / /
Facility Name: 44 oitt,S M'l aac LF
County: rS,/1-en Phone No. 3 - Soca
Inspector: 3.01r,rva ,un
Date of Inspection: C/3-I Z3
Time of Inspection: 153'
Total Event Precipitation(inches): 'e3
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:
//)
(Signature f Permittee or Designee)
1. Outfall Description:
Outfall No. i " y Structure (pipe, ditch, etc.): rip-e.
Receiving Stream:
+r%b 04-0 , & Gre hb 7 (Xt c!t
Describe the industrial activities that occur within the outfall drainage area:
()art_
Page 1 of 2
SWU-242.Last modified 06/0 1/2 0 1 8

2. Color: Describe the color of the discharge usingr basic colors (red, brown, blue, etc.)and tint
(light, medium, dark) as descriptors: GVD ec'l> 1
3. Odor: Describe any distinct odors that the discharge may have(i.e., smells strongly of oil, weak
chlorine odor, etc.): VC cl t'iJ
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy:
I 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:
2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
1 2 3 4 5
7. Is there any foam in the stormwater discharge? 0 Yes 0 No.
8. Is there an oil sheen in the stormwater discharge? oYes 0 No.
9. Is there evidence of erosion or deposition at the outfall? 0 Yes 0 No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
( o loy4
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-2-12.Last modified 06-01/2018

aceAnalytical
Pace Analytical Services,LLC
Kincey Ave.
te 100
0 9800Hunte sv Ile,NC128078
www.pacelabs.com [phone]
June 15, 2023
Darren Cox
Golder Associates Inc.
5B Oak Branch Drive
Greensboro, NC 27407
RE: Project: Hanes Mill Rd LF SA SW
Pace Project No.: 92671152
Dear Darren Cox:
Enclosed are the analytical results for sample(s)received by the laboratory on June 07, 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
• Pace Analytical Services-Eden
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Angela Baioni
[e-mail]
[phone]
Project Manager
Enclosures
��ipc
z REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
.t without the written consent of Pace Analytical Services,LLC. Page 1 of 16
Q:2,rlf.!.

Pace Analytical Services,LLC
0 9800 Kincey Ave. Suite 100
(6/?e Analytical® Huntersville,NC 28078
www.pacelabs.com [phone]
CERTIFICATIONS
Project: Hanes Mill Rd LF SA SW
Pace Project No.: 92671152
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
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
without the written consent of Pace Analytical Services,LLC. Page 2 of 16

Pace Analytical Services,LLC
Kincey Ave.
m 98o0Huntersv C Ile, Suite ace Analytical®
www.pacelabs.com [phone]
SAMPLE ANALYTE COUNT
Project: Hanes Mill Rd LF SA SW
Pace Project No.: 92671152
Analytes
Lab ID Sample ID Method Analysts Reported Laboratory
92671152001 SDO-3 SM 2540D-2015 LRB 1 PASI-E
SM 9222D-2015 DAW 1 PASI-E
SM 5220D-2011 JP1 1 PASI-A
92671152002 SDO-F SM 2540D-2015 VLG 1 PASI-E
SM 9222D-2015 DAW 1 PASI-E
SM 5220D-2011 JP1 1 PASI-A
92671152003 SDO-AZ SM 2540D-2015 LRB 1 PASI-E
SM 9222D-2015 DAW 1 PASI-E
EPA 1664B REL 1 PASI-C
SM 5220D-2011 JP1 1 PASI-A
PASI-A=Pace Analytical Services-Asheville
PASI-C=Pace Analytical Services-Charlotte
PASI-E=Pace Analytical Services-Eden
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
Kincey Ave.
te 100
aceAnalytical 0 9800Huntersville,NCf28078
www.pacelabs.com [phone]
ANALYTICAL RESULTS
Project: Hanes Mill Rd LF SA SW
Pace Project No.: 92671152
Sample: SDO-3 Lab ID: 92671152001 Collected: 06/07/23 14:56 Received: 06/07/23 16:30 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method:SM 2540D-2015
Pace Analytical Services-Eden
Total Suspended Solids 105 mg/L 11.9 1 06/09/23 10:09
MBIO 9222D Fecal Coliform EDN Analytical Method:SM 9222D-2015 Preparation Method:SM 9222D-2015
Pace Analytical Services-Eden
Fecal Coliforms 12000 CFU/100 mL 1.0 1 06/07/23 18:45 06/08/23 16:49 u2
5220D COD Analytical Method:SM 5220D-2011 Preparation Method:SM 5220D-2011
Pace Analytical Services-Asheville
Chemical Oxygen Demand 43.1 mg/L 25.0 1 06/13/23 01:38 06/13/23 05:25
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:06/15/2023 05:04 PM without the written consent of Pace Analytical Services,LLC. Page 4 of 16

Pace Analytical Services,LLC
aceAnalytical® 9800Hul ntersv lle.NC Suitencey Ave. 1008
www.pecelabs.com [phone]
ANALYTICAL RESULTS
Project: Hanes Mill Rd LF SA SW
Pace Project No.: 92671152
Sample: SDO-F Lab ID: 92671152002 Collected: 06/07/23 13:54 Received: 06/07/23 16:30 Matrix:Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method:SM 2540D-2015
Pace Analytical Services-Eden
Total Suspended Solids 80.0 mg/L 9.8 1 06/08/23 14:22
MBIO 9222D Fecal Coliform EDN Analytical Method:SM 9222D-2015 Preparation Method:SM 9222D-2015
Pace Analytical Services-Eden
Fecal Coliforms 12000 CFU/100 mL 1.0 1 06/07/23 18:45 06/08/23 16:49 u2
5220D COD Analytical Method:SM 5220D-2011 Preparation Method:SM 5220D-2011
Pace Analytical Services-Asheville
Chemical Oxygen Demand 43.1 mg/L 25.0 1 06/13/23 01:38 06/13/23 05:25
•
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:06/15/2023 05:04 PM without the written consent of Pace Analytical Services.LLC. Page 5 of 16

Pace Analytical Services,LLC
Kincey Ave.
100
te
__ aceAnalytical® 9800Huntersv vle,NC'28078
www.pacelabs.com [phone]
ANALYTICAL RESULTS
Project: Hanes Mill Rd LF SA SW
Pace Project No.: 92671152
Sample: SDO-AZ Lab ID: 92671152003 Collected: 06/07/23 14:30 Received: 06/07/23 16:30 Matrix:Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
2540D Total Suspended Solids Analytical Method:SM 2540D-2015
Pace Analytical Services-Eden
Total Suspended Solids 825 mg/L 25.0 1 06/09/23 10:09
MBIO 9222D Fecal Coliform EDN Analytical Method:SM 9222D-2015 Preparation Method:SM 9222D-2015
Pace Analytical Services-Eden
Fecal Coliforms 12000 CFU/100 mL 1.0 1 06/07/23 18:45 06/08/23 16:49 u2
HEM,Oil and Grease Analytical Method:EPA 1664B
Pace Analytical Services-Charlotte
Oil and Grease ND mg/L 4.9 1 06/09/23 15:00
5220D COD Analytical Method:SM 5220D-2011 Preparation Method:SM 5220D-2011
Pace Analytical Services-Asheville
Chemical Oxygen Demand 107 mg/L 25.0 1 06/13/23 01:38 06/13/23 05:25
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:06/15/2023 05:04 PM without the written consent of Pace Analytical Services,LLC. Page 6 of 16

Pace Analytical Services,LLC
aceAnalytical 9800 Kincey Ave. Suite 100
Huntersville,NC 28078
www.pacalabs.com [phone]
QUALITY CONTROL DATA
Project: Hanes Mill Rd LF SA SW
Pace Project No.: 92671152
QC Batch: 779186 Analysis Method: SM 2540D-2015
QC Batch Method: SM 2540D-2015 Analysis Description: 2540D Total Suspended Solids
Laboratory: Pace Analytical Services-Eden
Associated Lab Samples: 92671152002
METHOD BLANK: 4042100 Matrix: Water
Associated Lab Samples: 92671152002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Suspended Solids mg/L ND 2.5 06/08/23 14:17
LABORATORY CONTROL SAMPLE: 4042101
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Total Suspended Solids mg/L 250 254 102 90-110
SAMPLE DUPLICATE: 4042102
92670745001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L 40.8 35.8 13
SAMPLE DUPLICATE: 4042103
92670670001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L 5560 4200 28 D6
Results presented on this page are in the units Indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:06/15/2023 05:04 PM without the written consent of Pace Analytical Services.LLC. Page 7 of 16

Pace Analytical Services,LLC
(1Kincey Ave.
aceAnalytical0 9800Huntersv vle, Suite00 NC 178
www.pacelabs.com [phone]
QUALITY CONTROL DATA
Project: Hanes Mill Rd LF SA SW
Pace Project No.: 92671152
QC Batch: 779449 Analysis Method: SM 2540D-2015
QC Batch Method: SM 2540D-2015 Analysis Description: 2540D Total Suspended Solids
Laboratory: Pace Analytical Services-Eden
Associated Lab Samples: 92671152001,92671152003
METHOD BLANK: 4043524 Matrix: Water
Associated Lab Samples: 92671152001,92671152003
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Suspended Solids mg/L ND 2.5 06/09/23 10:06
LABORATORY CONTROL SAMPLE: 4043525
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Total Suspended Solids mg/L 250 234 94 90-110
SAMPLE DUPLICATE: 4043526
92671068001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L 127 133 5
SAMPLE DUPLICATE: 4043527
92671058001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L 128 124 3
Results presented on this page are In the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:06/15/2023 05:04 PM without the written consent of Pace Analytical Services,LLC. Page 8 of 16

Pace Analytical Services,LLC
aceAnalytical 9800 Kincey Ave. Suite 100
Huntersville,NC 28078
www.pacelabs.com [phone]
QUALITY CONTROL DATA
Project: Hanes Mill Rd LF SA SW
Pace Project No.: 92671152
QC Batch: 779296 Analysis Method: SM 9222D-2015
QC Batch Method: SM 9222D-2015 Analysis Description: 9222D Fecal Coliform(MF)-EDN
Laboratory: Pace Analytical Services-Eden
Associated Lab Samples: 92671152001,92671152002,92671152003
METHOD BLANK: 4042360 Matrix: Water
Associated Lab Samples: 92671152001,92671152002,92671152003
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Fecal Coliforms CFU/100 mL ND 1.0 06/08/23 16:49
METHOD BLANK: 4042362 Matrix: Water
Associated Lab Samples: 92671152001,92671152002,92671152003
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Fecal Coliforms CFU/100 mL 1.0 1.0 06/08/23 16:49 C8
SAMPLE DUPLICATE: 4042361
92671152002 Dup
Parameter Units Result Result RPD Qualifiers
Fecal Coliforms CFU/100 mL 12000 12000 0 u2
Results presented on this page are in the units Indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:06/15/2023 05:04 PM without the written consent of Pace Analytical Services.LLC. Page 9 of 16

Pace Analytical Services,LLC
aceAnalytical0 9800 Kincey Ave. Suite:
Huntersville,NC 28078
www.pacelabs.com [phone]
QUALITY CONTROL DATA
Project: Hanes Mill Rd LF SA SW
Pace Project No.: 92671152
QC Batch: 779645 Analysis Method: EPA 1664E
QC Batch Method: EPA 1664E Analysis Description: 1664 HEM,Oil and Grease
Laboratory: Pace Analytical Services-Charlotte
Associated Lab Samples: 92671152003
METHOD BLANK: 4044443 Matrix: Water
Associated Lab Samples: 92671152003
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Oil and Grease mg/L ND 5.0 06/09/23 15:00
LABORATORY CONTROL SAMPLE: 4044444
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Oil and Grease mg/L 40 32.9 82 78-114
MATRIX SPIKE SAMPLE: 4044445
35804029001 Spike MS MS %Rec
Parameter Units Result Conc. Result %Rec Limits Qualifiers
Oil and Grease mg/L 1.1 38.8 34.8 86 78-114
SAMPLE DUPLICATE: 4044446
92671282001 Dup
Parameter Units Result Result RPD Qualifiers
Oil and Grease mg/L ND 1.6J
Results presented on this page are in the units Indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:06/15/2023 05:04 PM without the written consent of Pace Analytical Services,LLC. Page 10 of 16

Pace Analytical Services,LLC
0
aceAnalytical 9800 nceyAve. Suite 100
Huntersville,NC 28078078
www.pacelabs.cam [phone]
QUALITY CONTROL DATA
Project: Hanes Mill Rd LF SA SW
Pace Project No.: 92671152
QC Batch: 780101 Analysis Method: SM 5220D-2011
QC Batch Method: SM 5220D-2011 Analysis Description: 5220D COD
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 92671152001,92671152002,92671152003
METHOD BLANK: 4046722 Matrix: Water
Associated Lab Samples: 92671152001,92671152002,92671152003
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Chemical Oxygen Demand mg/L ND 25.0 06/13/23 05:21
LABORATORY CONTROL SAMPLE: 4046723
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Chemical Oxygen Demand mg/L 750 780 104 90-110
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4046724 4046725
MS MSD
92670681001 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Chemical Oxygen Demand mg/L 398 100 100 455 472 57 74 90-110 4 M1,R1
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4046726 4046727
MS MSD
92671285004 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Chemical Oxygen Demand mg/L ND 100 100 124 127 110 112 90-110 2 M1
Results presented on this page are in the units Indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:06/15/2023 05:04 PM without the written consent of Pace Analytical Services,LLC. Page 11 of 16

Pace Analytical Services,LLC
ace Analytical' 980o Kincey Ave. Suite 178
Huntersville,NC 28078
www.pacelabs.com [phone]
QUALIFIERS
Project: Hanes Mill Rd LF SA SW
Pace Project No.: 92671152
DEFINITIONS
DF-Dilution Factor,if reported,represents the factor applied to the reported data due to dilution of the sample aliquot.
ND-Not Detected at or above adjusted reporting limit.
TNTC-Too Numerous To Count
J-Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL-Adjusted Method Detection Limit.
PQL-Practical Quantitation Limit.
RL-Reporting Limit-The lowest concentration value that meets project requirements for quantitative data with known precision and
bias for a specific analyte in a specific matrix.
S-Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270.The result for each analyte is
a combined concentration.
Consistent with EPA guidelines,unrounded data are displayed and have been used to calculate%recovery and RPD values.
LCS(D)-Laboratory Control Sample(Duplicate)
MS(D)-Matrix Spike(Duplicate)
DUP-Sample Duplicate
RPD-Relative Percent Difference
NC-Not Calculable.
SG-Silica Gel-Clean-Up
U-Indicates the compound was analyzed for,but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
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 analytes.
TNI-The NELAC Institute.
ANALYTE QUALIFIERS
C8 Result may be biased high due to carryover from previously analyzed sample.
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample(LCS)recovery.
R1 RPD value was outside control limits.
u2 Colonies are too numerous to count. Actual result may be greater than reported.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:06/15/2023 05:04 PM without the written consent of Pace Analytical Services,LLC. Page 12 of 16

Pace Analytical Services,LLC
aceAnalytical0 9800 Kincey Ave. Suite 100
Huntersville,NC 28078
www.pecelabs.com
[phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Hanes Mill Rd LF SA SW
Pace Project No.: 92671152
Analytical
Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch
92671152001 SDO-3 SM 2540D-2015 779449
92671152002 SDO-F SM 2540D-2015 779186
92671152003 SDO-AZ SM 2540D-2015 779449
92671152001 SDO-3 SM 9222D-2015 779296 SM 9222D-2015 779297
92671152002 SDO-F SM 9222D-2015 779296 SM 9222D-2015 779297
92671152003 SDO-AZ SM 9222D-2015 779296 SM 9222D-2015 779297
92671152003 SDO-AZ EPA 1664B 779645
92671152001 SDO-3 SM 5220D-2011 780101 SM 5220D-2011 780111
92671152002 SDO-F SM 5220D-2011 780101 SM 5220D-2011 780111
92671152003 SDO-AZ SM 5220D-2011 780101 SM 5220D-2011 780111
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:06/15/2023 05:04 PM without the written consent of Pace Analytical Services,LLC. Page 13 of 16

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L3Gt _Title: ENV-PRIG-HUN1-00134 vol,Tech Spec Sample Condition
= ace' Upon Receipt _ _____.
I ,..,.,Karr:.us Effective Date: 0 511 212 02 2
aboratory receiving samples:
esheville Li Eden n Greenwood U j Huntersville ri Raleigh❑ Mechanicsvi(ler Atlanta❑ Kernersvllle
5at�p,1e Condition Upon Client Name:
Receipt 0___
V e Project 11:
:ourier: EFed Ex ]UPS USPS f lent
Commercial [Pace []Other:
Carrier Tracking Number:
Custody Seal Present? DYes Seals intact? Les fNo Date/Initials Person Examining Contents __,
'acking Material: Detibble Wrap ['Bubble Bags r]None [1 Other Biological Tissue Frozen?
Dyes [iNo OK A
'hermometer: C]IRGun ID: r...1tMType of ice: buret ❑ague 0 None
Toler Temp('Cl: c .() Correction Factor:Add/Subtr3ct ('C I -TO s I
.� Temp should be above freezing to 6°C
©Samples out of temp z,itefia.Samples on ace,coo':rg proce
orrected Cooler Temp)'C):
has begun
ASDA Regulated Soil((SIA,water sample)
lid samples originate in a quarantine tone within the United States:CA,NY,or SC(check maps)? C•d camp es originate from a foreign source(interna:ioea'y.
DYes ONe including Hawaii and Puerto Rico)?ayes _ CINo
1 Comments/Discrepancy:
^W Chain of Custody Present? _ ides DN.:, DN/A 1 1
Samples Arrived within Hold Time? 2<es ❑No ON/A 2
Shod Hold Time Analysis(<72 hr.)? [ s ❑No ❑N/A 3 ^ �V,-- _�
Rush Turn Around Time Requested? Oyes Lit ON/A A _
Sufficient Volume? Gies ONO N/A S j�
Correct Conta hers 1;sed? 1Yes Ow — (DN/'A „'
.Pace Containers Lsed' j2'res ONo ©NaA
Containers Intact) es [ONo N/A 7,
Dissolved ana ysis Samples f e d Filtered? Oyes ON,:. /A 8
t Sample Labels Match COC? Rs ON:, ONIA 9
-Includes Date/Time(ID/Analysis tvtatrix ,Z___
Headspace in VOA Vials(›S-6mm)? Des 0No [y�3f/A IC. _,_• �_
Trip Blank Present? ❑Yes ONO ( T/A 11
Trip Blank Custody Seals Present? Oyes ❑No
COMMENTS/SAMPLE DISCREPANCY Field Data Required? DYe, Dh.,
__ Lot ID of spilt containers _
Temp Log:Temp must be maintained CLIENT NOTIFICATION/RESOLUTION
at<6 C during login,record temp
every 20 minutes. -- --Time opened: d Temp: }— - —.� M
Time: 1 put in cooler
Time: Temp: _ ____ —
Person Contacted v......... __.__. _ _..._._...........:. .. Date/Ti.:ne -------_-_.. W.__._...
Project Manager SCURF Review: Date:
Project Manager SRF Review: ...:,:>..____. -_ „._,. ........__......................_._.....-.--..__ Date:
Qualtrax Document ID: 70677 Page 1 of 2 Page 15 of 16

•
0- Document Name i?;tr.ument Issued November 15.2021
/ Bottle Identification Form(81F) i Page 1 of 1
Pace eAiinl,T al
Document No Issuing Authority i
F-CAR•CS.-043-Rev.01 Pace Carolinas Cluakty Office
"Check mark top half of box if pH and/or dechlorination is Project 14
verified and within the acceptance range for preservation
samples.
Exceptions,VOA,f:oliferm: WC,041 and grease t;Rrl;8015(water)INK Wig � ^ (Gä &e
�,�`
.*f ottorri half of box is to list number of bottles *A�, /1
__
i! a
C3 t j .1 j Y� J = i1. f€ H
. L E !.Z'3 t 'd V rA i T
Alli y II, D v V 1 — > v 7 I ? Y iE i I j T N k ly
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n a ta. itf , O O Q p 0 "' d 3 vi a I a l J ^ € '^ y N o, L
v! & c E t a, I sr 2 a x c c n
;4 ::' C i z , i v , c V -, ry 2 4 I ci •n O h y :. m 2 I 7 i O
i x V �: .J = ,- N Q i M O. a I u L 1 4 _ U C
N .u.. .n y •d �. N 1r •I i Z 7 S i[ Y91 O # fJ
l A is A m A =;; m o a: A E A E 1 c� 4 I Q `t d o f -§ t E c A
i a- ti. u. ie J a a.. & F- T T s q Q t n 5' t> i Oy a Q. I .n .n ': 4 ,Ni 4
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o .n v, n 3 ' = n ty1 v { E 4 a raj } n o mo o o
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jo E Lr m N 2 Q 2 tl tz N 0 M H M (2 w f m rh w i 4 try IA N +*. i,'} CI
a �t p
w o. a co co is a 1I a i7 t.9 l7 l7 l7 G7 0 > 0 O >, v p, a vt vs
s m m as m m m in t in Q d Q Q Q 4 0 > D > vl v! m d >
1 .\ t.-N).\\ I' N I —I\ ---r\ \ 'S7"--- ...„:„ -7:\
I-- 1 \ \ .
3 �� ___._.i 1_ ��, -�. _.1i ,� .. .__ I N 1. \\' \ ...
\ \ -_
• 11---•
.. _. . \ i ... ... .. \ \ _ \! \ \__,T,.... _ -It \ 1 \
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ra -.\-). \I ---------1
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\......... 7 I, \,1 _1,_. -1, \l,,.._\ _\\__ . \\11\4_ \l,.. - E
\ 1 \ NI\ N r..„ \ , \ tr�
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, . 1 --‘i . .. \_:,..,\\,1 \ 1
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i. .. _.
.-- pH Adjustment log for Preserved Samples
Sample ID type of Preservative i pHupon receipt pate preservation adjusted 7;me preservation upon
Amount of Preservative tot a.
adders
.......... • _ _ .. ._....... — —__..._.._._. .. r..... .._..._...._...... —.._.................._....._... _ ..._._..__..__ __!._.........
Note: whenever there is a discrepancy aftar.t.nii North Carolina compliance saroplitc.a cony aI this form wilt be tent to the North Carolina Dfl1 lft CI!rtificatirin Office li.a-
out of hold,Ii1C7i'i Cct preservative,ooS of limns•int:0:1Cit cniltai nail
Page 16 of 16

THE
RESOURCE
REMIT TO: INVOICE:
THE RESOURCE COMPANY INC. 526393
1292 South Stratford Rd
Winston-Salem, NC 27103 INVOICE DATE:
Phone [phone] 7/13/2023
Fax [phone]
BILL TO: DUE DATE:
8/2/2023
City of Winston Salem - Hanes Mill
Landfill 5702 PO NUMBER:
325 W Hanes Mill Road
Winston-Salem, NC 27105
DESCRIPTION QUANTITY RATE TOTAL
City of Winston Salem - Hanes Mill Landfill 5702
Bryant, Willie - REG - Laborer 22.45 $ 19.80 $ 444.51
Bryant, Willie - HOL- Laborer 8.00 $ 19.80 $ 158.40
Griffith, Casey- REG - Laborer 40.00 $ 25.25 $ 1,010.00
Griffith, Casey- HOL-Laborer 8.00 $ 37.88 $ 202.00
Griffith, Casey-OT- Laborer 2.42 $ 25.25 $ 91.67
Mabe,Matthew- REG - Laborer 36.45 $ 19.80 $ 721.71
Mabe,Matthew- HOL- Laborer 8.00 $ 19.80 $ 158.40
McCloud, Josiah - REG - Laborer 14.18 $ 19.80 $ 280.76
SUBTOTAL: $ 3,067.45
City of Winston-Salem- Hanes Mill Landfill 5702
Martin-Hauser, Briana- REG -Weighmaster 26.18 $ 19.80 $ 518.36
Martin-Hauser, Briana- HOL-Weighmaster 8.00 $ 19.80 $ 158.40

DESCRIPTION QUANTITY RATE TOTAL
McAtee-Hall, Breeanna - REG -Weighmaster 30.82 $ 19.80 $ 610.24
McAtee-Hall, Breeanna - HOL-Weighmaster 8.00 $ 19.80 $ 158.40
Sheff, DeQuan- REG - Laborer 13.07 $ 19.80 $ 258.79
Sheff, DeQuan- HOL- Laborer 8.00 $ 19.80 $ 158.40
Williams, Orlando- REG - Laborer 23.50 $ 19.80 $ 465.30
Williams, Orlando- HOL - Laborer 8.00 $ 19.80 $ 158.40
SUBTOTAL: S 2,486.29
TOTAL DUE -...�.-._._..._-..- .._.____ $ 5,553.74
2