NCG120099_DMR_20211101

N C Department of
Environmental Quality
Received
NOV 0 1 2021
Winston lem
Regional Office
environmental
October 21, 2021
Mr. Levi Hiatt, EIT, Assistant Regional Engineer
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
([e-mail])
RE: QUARTERLY NPDES COMPLIENCE SUBMITTAL FOR SEPTEMBER 2021
WI HIGH POINT LANDFILL, GUILFORD COUNTY, NORTH CAROLINA
PERMIT NO. NCG120099
Dear Mr. Hiatt,
WI High Point Landfill, LLC is monitoring stormwater under Permit No. NCG120099 at the WI
High Point Landfill. The purpose of this correspondence is to report the quarterly sampling
results from outfall SB-1. There were no benchmark exceedances for the samples from outfall
SB-1. There was no discharge at outfall ST-1 and SB-2 during this event. The Stormwater
Discharge Monitoring Report is attached.
If you have any questions or require any additional information, please contact us. We
appreciate your assistance with this project.
Sincerely,
WI High Point L dfil , LLC
Seth He
General Manager
C: Dusty Reedy, PG, Golder Associates NC, Inc., 5B Oak Branch Drive, Greensboro, North
Carolina, 27407, [e-mail]
Travis Hitchcock, GFL Environmental, 3301 Benson Drive, Raleigh, North Carolina, 27609.
[e-mail]
Bryan Wuester, Regional Landfill Manager, GFL Environmental, 7434 Roseboro Highway,
Roseboro, Sampson County, North Carolina 28382, [e-mail]
Joseph Santangelo, Regional Environmental Compliance Manager,3301 Benson Drive,
Suite 601, Raleigh, North Carolina 27609,[e-mail]
Attachment: DMR
1236 Elon Place High Point NC, 27263
Tel.:[phone] Fax:[phone] gflenv.com

NC Depai trnent cf
Environmental Quality
Received
NCDEQ Division of Energy,Mineral and Land Resources NOV;`•` 0 1 Lc;21
Stormwater Discharge Monitoring Report(DMR) Form for NCG120000
Landfills �`inston :Iem
Click here for instructions R';ional Office
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 0099 Person Collecting Samples: David Reedy
Facility Name:WI High Point C&D Landfill Laboratory Name: Pace Analytical
Facility County:Guilford Laboratory Cert.No.: NC633
Discharge during this period:0 Yes ❑ No (if no,skip to signature and dote)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑Yes ❑Q 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 SB-1 Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class
N/A Date Sample Collected MM/DD/YYYY 9/21/2021
46529 24-Hour Rainfall in inches 1.5
C0530 TSS in mg/L(100 or 50') 15.1
00400 pH in standard units(6.0-9.0) 7.87
00340 Chemical Oxygen Demand in mg/L 40.6
1120)
31616 Fecal Coliform in f7 per 100 ml(1000) 5
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)
NCOIL Estimated New Motor/Hydraulic Oil
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 pe ons o manage e system,or those persons directly responsible for gathering the information,the information
submitted is,to the best my nowledge belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false information,ind ing possibility fines and imprisonment for knowing violations."
ICE Ili
Signatur f rm' ee or of ated Authorized Individual Date
Email Address [e-mail] Phone Number 336-886-3560

Pace Analytical Services,LLC
s 9800 Kincey Ave. Suite 100
aceAnalytical Huntersville,NC 28078
www.pacelabs.cam [phone]
September 30, 2021
David Reedy
Golder Associates, Inc.
5B Oak Brank Dr
Greensboro, NC 27407
RE: Project: WI High Point LF
Pace Project No.: 92562434
Dear David Reedy:
Enclosed are the analytical results for sample(s)received by the laboratory on September 21, 2021. 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-Eden
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Nicole D'Oleo
nicole.d'[e-mail]
[phone]
Project Manager
Enclosures
.+ •' REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
.„� without the written consent of Pace Analytical Services,LLC. Page 1 of 11

Pace Analytical Services,LLC
0
aceAnalytical 9800 Kincey Ave. Suite 100
Huntersville,NC 28078
www.pacelabs.com
[phone]
CERTIFICATIONS
Project: WI High Point LF
Pace Project No.: 92562434
Pace Analytical Services Asheville
2225 Riverside Drive,Asheville,NC 28804 North Carolina Wastewater Certification#:40
Florida/NELAP Certification#:E87648 South Carolina Certification#:99030001
North Carolina Drinking Water Certification#:37712 VirginiaNELAP Certification#:460222
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 11

Pace Analytical Services,LLC
® 9800 Kincey Ave. Suite 100
aceAnalytical Huntersville,NC 28078
wvw.pacelabs.cem [phone]
SAMPLE ANALYTE COUNT
Project: WI High Point LF
Pace Project No.: 92562434
Analytes
Lab ID Sample ID Method Analysts Reported Laboratory
92562434001 SBA SM 2540D-2011 AED 1 PASI-E
SM 9222D-2006 AMI 1 PASI-E
SM 5220D-2011 JP1 1 PASI-A
PASI-A=Pace Analytical Services-Asheville
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 11

Pace Analytical Services,LLC
9800 Kincey Ave. Suite100
aceAnalytical
Huntersville,NC 28078078
www.pacelabs.com [phone]
ANALYTICAL RESULTS
Project: WI High Point LF
Pace Project No.: 92562434
Sample: SB-1 Lab ID: 92562434001 Collected: 09/21/21 13:45 Received: 09/21/21 14:50 Matrix:Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Dual
2540D Total Suspended Solids Analytical Method:SM 2540D-2011
Pace Analytical Services-Eden
Total Suspended Solids 15.1 mg/L 6.4 1 09/23/21 11:19
MBIO 9222D Fecal Coliform EDN Analytical Method:SM 9222D-2006 Preparation Method:SM 92220-2006
Pace Analytical Services-Eden
Fecal Coliforms 5.0 CFU/100 mL 1.0 1 09/21/21 18:58 09/22/21 16:59
5220D COD Analytical Method:SM 5220D-2011 Preparation Method:SM 5220D-2011
Pace Analytical Services-Asheville
Chemical Oxygen Demand 40.6 mg1L 25.0 1 09/30/21 02:40 09/30/21 06:48
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:09/30/2021 04:10 PM without the written consent of Pace Analytical Services,LLC. Page 4 of 11

Pace Analytical Services,LLC
is 9800 Kincoy Ave. Suite 100
aceAnalytical
Huntersville,NC 28078
www.pacelabs.com [phone]
QUALITY CONTROL DATA
Project: WI High Point LF
Pace Project No.: 92562434
QC Batch: 648955 Analysis Method: SM 2540D-2011
QC Batch Method: SM 2540D-2011 Analysis Description: 2540D Total Suspended Solids
Laboratory: Pace Analytical Services-Eden
Associated Lab Samples: 92562434001
METHOD BLANK: 3403750 Matrix: Water
Associated Lab Samples: 92562434001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Suspended Solids mglL ND 2.5 09/23/21 11:16
LABORATORY CONTROL SAMPLE: 3403751
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Total Suspended Solids mg/L 250 248 99 90-110
SAMPLE DUPLICATE: 3403752
92562736001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L 17.8 15.0 17
SAMPLE DUPLICATE: 3403753
92562444001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L ND ND
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:09/30/2021 04:10 PM without the written consent of Pace Analytical Services,LLC. Page 5 of 11

Pace Analytical Services,LLC
it
aceAnalytical 9800 Kincey Ave. Suite100
Huntersville,NC 28078078
www.paceltb.com
[phone]
QUALITY CONTROL DATA
Project: WI High Point LF
Pace Project No.: 92562434
QC Batch: 648529 Analysis Method: SM 9222D-2006
QC Batch Method: SM 9222D-2006 Analysis Description: 9222D Fecal Coliform(MF)-EDN
Laboratory: Pace Analytical Services-Eden
Associated Lab Samples: 92562434001
METHOD BLANK: 3401333 Matrix: Water
Associated Lab Samples: 92562434001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Fecal Coliforms CFU/100 mL ND 1.0 09/22/21 16:59
SAMPLE DUPLICATE: 3401334
92562247001 Dup
Parameter Units Result Result RPD Qualifiers
Fecal Coliforms CFU/100 mL 2400 2400 0
SAMPLE DUPLICATE: 3401715
92562247002 Dup
Parameter Units Result Result RPD Qualifiers
Fecal Coliforms CFU/100 mL 1300 1400 7
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:09/30/2021 04:10 PM without the written consent of Pace Analytical Services.LLC. Page 6 of 11

Pace Analytical Services,LLC
m
aceAnalytical 9800 Kincey Ave. Suite100
Huntersville,NC 28078078
www.pacelabs.cotn [phone]
QUALITY CONTROL DATA
Project: WI High Point LF
Pace Project No.: 92562434
QC Batch: 650068 Analysis Method: SM 5220D-2011
QC Batch Method: SM 5220D-2011 Analysis Description: 5220D COD
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 92562434001
METHOD BLANK: 3409558 Matrix: Water
Associated Lab Samples: 92562434001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Chemical Oxygen Demand mg/L ND 25.0 09/30/21 06:47
LABORATORY CONTROL SAMPLE: 3409559
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Chemical Oxygen Demand mglL 750 766 102 90-110
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 3409560 3409561
MS MSD
92562363001 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 100 100 130 120 119 109 90-110 8 M1,R1
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 3409641 3409642
MS MSD
92563024001 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Chemical Oxygen Demand mg/L 45.6 100 100 160 167 114 122 90-110 5 M1,R1
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:09/30/2021 04:10 PM without the written consent of Pace Analytical Services,LLC. Page 7 of 11

Pace Analytical Services,LLC
aceAnalytical® 9800 kincey Ave. Suite 100
Huntersville,NC 28078
www.pacetabs.com
[phone]
QUALIFIERS
Project: WI High Point LF
Pace Project No.: 92562434
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
M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample(LCS)recovery.
R1 RPD value was outside control limits.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:09/30/2021 04:10 PM without the written consent of Pace Analytical Services,LLC. Page 8 of 11

Pace Analytical Services,LLC
a 9800 Kincey Ave. Suite 100
aceAnalytical Huntersville,NC 28078
www.pacelabs.ccm [phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: WI High Point LF
Pace Project No.: 92562434
Analytical
Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch
92562434001 SB-1 SM 2540D-2011 648955
92562434001 SB-1 SM 92220-2006 648529 SM 9222D-2006 648708
92562434001 SB-1 SM 5220D-2011 650068 SM 5220D-2011 650113
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:09/30/2021 04:10 PM without the written consent of Pace Analytical Services,LLC. Page 9 of 11

i CHAIN-OF-CUSTODY Analytical Request Document LAB USE ONLY-Affix Workorder/'- I ahel Here or List Pace Wurkorder Number or
PaceAnalytical M W0# : 92562434
Chain-of-Custody is a LEGAL DOCUMENT-Complete ail relevent fields
Company: Billing Information:
-�.•1,tr:,�sroe.'_�.s ALL SHADED 111111 I IIIIII II IIII III
Address: 5-6, 0 K ems, --,,-5 of.)...-. Container Preservative Type'• 92562434
Report To: ��O Email To: efiGPAy� d icier-.ee.+r ••Preservative Types:(1)nitric acid,(2)sulfuric acid,(3)hydrochloric aao,i i suoi..,,..,,_._
���' 'f J (6)methanol(7)sodium bisulfate,(8)sodium thiosulfate,(9)hexane,(A)ascorbic acid,(8)ammonium sulfate,
Copy To: Site Collection Info/Address: (C)ammonium hydroxide,(0)TSP,(U)Unpreserved.(0)Other
Analyses Lab Profile/Line:
Customer protect Name/Number: WV" h1:)4 / ^r State: County/City: Time Zone Collected: Lab Sample Receipt Checklist:
Zc}/' 7 ,? /a L-� Ate I G. /r '-' I (PT) WTI ICT 44'6
Custody Seals Present/Intact Y fJ NA
Phone: 7 ^��c-•� C Site/Facility ID N: Compliance Monitoring? Custody Signatures Present N NA
Email:33i; 'Q J "'f I e 11'es I ]No Collector Signature Present N NA
Bottles Intact Ti NA
Collected By(print): Purchase Order If: DW PWS ID it: Correct Bottles N NA
(12Av._ e,,r'4 Quote 4: DW Location Code: Sufficient Volume N NA
Samples Received on ice ri NA
Collect (signal Turnaround Date Required: Immediately Packed on Ice:
''�r�' q VOA - Headspace Acceptable Y N �$
........,4--; �r [ ]Yes l I No USDA Regulated Soils Ye NA
C/ Samples in bolding 'dame N NA
Sample Disposal: Rush: Field Filtered(if applicable): r Residual Chlorin-e.IPent Y&NA
I..)'Orspose as appropriate ( (Return I I Same Day [ I Next Day I I Yes [ ]No s' Cl Strips: L-•C _
yri
1 I Archive: I 12 Day [ ]3 Day [ 14 Day 115 Day t4 Sample pH Acceptab N NA
I I Hold: Analysis: pH Strips:
(ExpediteChargesApply) C Sulfide Present A Y N g
•Matrix Codes(Insert in Matrix box below):Drinking Water(OW),Ground Water(GW),Wastewater(WW), Lead Acetate Stripe: /✓ �'
( ! ! 1 ( I Wipe( ) ( ) I 1BioassayO Vapor(V), ! !
Product P,Soil/Solid SL,Oil OL, WP,Air AR,Tissue TS, D, Other OT g LAB USE ONLY:
Camp/ Collected(or Res Not Lab sample a / comments:
Composite End •Q kj IN
Customer Sample ID Matrix" Grab Composite Start) Cl Ctns
Date Time Date Time
.-5.8—/ 5%-z G,-�S S-'r u 1145 X X X
Customer Remarks/Special Conditions/Possible Hazards: Type of Ice Used: Wet Blue Dry None SHORT HOLDS PRESENT(<72 hours): Y N N/A Lab Sample Temperature Info:
Packing Material Used: Lab Tracking II: Temp Blank R�/meeccte�iiveed^- Y NA
2 610 2 5 3 Therm IDN: ITT S7-'.)....
Cooler 1 Temp Upon Receipt:2'I oC
Samples received via: Cooler 1 Therm Corr.Factor: z----oC
Radchem sample(s)screened(<500 rpm): V N NA FEDEX UPS Client Courier Pace Courier Cooler 1 Corrected Temp: --•I oC
Relinquished by/Company:/Coom (Signature) Date/Time: Rece' d by/ ny:(Signature) Dat-e�/TTiim�ems: /�1' 'V MT.IL LAB USE ONLY Comments:
W/LAP /6v/ Cj • f-L(//c/'S(/ �4''!Y�'� Y, Table 4:
o Acctnum:
Relgiquished by/Company:(Signature) Date/Time: Received by/Company:(Signature) Date/Time:
Template: Trip Blank Received: Y ‘) NA
iD c Prelogin: HCL McOH TSP Other
Rekr quished by/Company:(Signature) Date/Time: Received by/Company:(Signature) Date/Time: PM:
Non Conformances) Page.
PB: YES / NO of:

Document Name, Document Revised:October 23,20'_D
Sample Condition Upon Receipt(SCUR) Page 2 of 2
aceAnalrea! Document No.: Issuing Authority: l
/ F•CAR-CS-033-Rev.07 ! Pa:e Carolinas Quaaty Office
*Check mark top half of box if pH and/or dechlorination is Project#
verified and within the acceptance range for preservation
samples.
Exceptions:VOA,Coliform,TOC,Oil and Grease,DR0/3015(water)DOC,LLHg
**Bottom half of box is to list number of bottles
Z Z Z7. _ 1. .`.. _ Z \ 2. oi A N
1.2 W Z Y n `> v N _ n Z v, ` z e ? d
a 32 N � i z Y " ON co =
rn c p C yli- �� • _ a, n N
O < N m >
G j j c O Z O a c v 0N = < z DI •_ O '2 a a r' c c
u u u c u ,, ? c _ c J E n c fLn �- ,. y a 2 D j
:. 'N u N .. .. .7 - r, d .c V 2 E Z O z �c .s u a u Cu IV. 2 _a a A n n o .n E E o < < < < = 'G •= E 4,
a l22 i a - t < < < < J ';' >0 O> 0> >0 a o. H a ¢ u E
C., J N J J J in c c E E E E E m y E rJ E Co'. E ' E E a _m E E E E J J
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in in
er m m - a ' m ma <> X i Q > >E v a m a w '• .. m --, m ci ci o+ = FNuma m a a a C m ta7 ta7 ta a at a C Ig > O p > m C la.,a lom >
1 \ 1. \\\\ _ N \\\ I I I ' I \\
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3 \ I\\ \ \\\j I I I N\
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pH Adjustment Log for Preserved Samples
Sample ID Type of Preservative pH upon receipt Date preservation adjusted Time preservation Amount of Preservative Lot It
adjusted added
I
Note: Whenever there is a discrepancy affecting North Carolina compliance samples,a copy of this form will be sent to the North Carolina DEHNR Certification Office(i.e.
Out of hold,incorrect preservative,out of temp,incorrect containers.
Page 11 of 11

Em tronmental
QuaTit;
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit https:lldeq.nc.govlabouddivisionsienergy-mineral-land-resources/
npdes-stormwater-gps
Permit No.: N/C/ / / / / / / / or Certificate of Coverage No.: N/C/G/ /rl./0/0/(4/ 9
Facility Name: \tc#. CkQ
County: Cnu,l -L,fci Phone No. _ - 866--'356 d
Inspector: D curd Qeocl1
Date of Inspection:
Time of Inspection: 13 (.($
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:
Signature oT Permittee(Signature estgnee)
1. Outfall Description:
Outfall No. S6-( Structure (pipe, ditch, etc.): p pe_
Receiving Stream:
U cA.nle_01 '4‘pbLAaft 't y ce.ot U'-e K.
Describe the industrial activities that occur within the outfall drainage area:
Page I of 2
SWU-242,Last modified 06/01'20I S

2. Color: Describe the ruler of the discharge using basic colors(red, brown, blu_, etc )and tint
(light, medium,dark)as descriptors: CVoY'
3. Odor: Describe any distinct odors that the discharge may have(i.e.,smells strongly of oil, weak
chlorine odor,etc.): hob C
4. Clarity: Choose the number which best describes the clarity of the discharge, where I is clear
and 5 is very cloudy'
2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge,where I is no solids and 5 is the surface covered with floating solids:
0 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:
0 2 3 4 5
7. Is there any foam in the stormwater discharge? 0 Yes Ob.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 Q .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
5%U•242,Last modified 06'01'2U t 8