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�` RESEARCh & ANA(yTICA(
LAboRATORIES INC.
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Report of Analy is
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For: PowerLab Inc.
3352 Old Lexington Road ..• .'' '% p"
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Winston-Salem, NC 27127 0 N; ili
=a`o NC#34 a Cif
Attn: Jeff Ward
s NC#37701 f
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Sample ID: 001
Site: Power Labs Lab Sample ID: 8235-01
IParameter Collection Date: 8/24/2015 18:45
Method Result Units Rep Limit Analyst Analysis DateJma I
Lead,Total EPA 200.7 <0.005 mg/L 0.005 AA
8/31/2015
Total Suspended Solids(TSS) SM 2540 D-1997
15.6 mg/L 5 YJ 8/28/2015
NA=not analyzed
0.Box 473 106 Short Street Kemersville,North Carolina 27284 Tel:336-996-2841 Fax:336-996-0326 www.randalabs.com v1d . m Pag 1
- 4
RECEIVED
SEP 17 2015
Stormwater Discharge Outfall (SDO) CENTRAL FILES
®wR SECTION
Qualitative Monitoring Report
For guidance on filling out this form,please visit http://portal.ncdenr.org/web/wq/ws/su/npdesswittab-4
Permit No.: N/C or Certificate of Coverage No.: N/C/G
Facility Name:Power Labs
County: Forsyth Phone No. 336-650-0706
Inspector: Glenn Price(RAL)
Date of Inspection: August 24,20I5
Time of Inspection: 1845
Total Event Precipitation(inches): 0.10
Was this a"Representative Storm Event"as defined by the permit?
(See information below.)
❑Yes ❑No
Please verb whether Qualitative Monitoring must be performed during a"representative storm event or"measureable storm
event"(requirements vary,depending on the permit)
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a
"representative storm event"or during a"measurable storm event" However,some permits do not have this requirement.
Please refer to these definitions,if applicable.
A"representative storm event"is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72
hours(3 days)in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to
10 consecutive hours of no precipitation.
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 h
able to document that a shorter
approval from the local DWQ Regional Office.
By this signature,I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permitee or Designee)
5WU-242-020705
Outfall No. 001 Structure(pipe,ditch,etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2.Color:Describe the color of the discharge using basic colors(red,brown,blue,etc.)and tint
(light,medium,dark)as descriptors: Clear
3.Odor:Describe any distinct colors that the discharge may have(i.e.,smells strongly of oil,weak chlorine odor,etc.)
None
4: Clarity: Chose 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:
I 2 3 4 5
6.Suspended Solids:Choose the number which best describes the amount of suspended solids in the stormwater
discharge,where 1 is no solids and 5 is extremely muddy:
1 2 3 4 5
7.Is there any foam in the stormwater discharge? Yes No
8.Is there an oil sheen in the stormwater discharge? Yes
No
9.Is there any evidence of erosion or deposition at the outfall?
Yes No
10.Other Obvious Indicators of Stormwater Pollution:
List and describe:
Ve light floating debris(twigs/leaves)
I
II
11
Note:Low clarity,high solids,and/or the presence of foam,oil sheen,or errosion/deposition maybe indicative of pollutant exposure.
These conditions warrant further investigation.
SWU-242-020705
,'. ,RESEARCH & ANAlyriCA!
,-.111111111,; L.AbORA1®RIES INC. CHAIN OF CUSTODY RECORD
i ;: Analytical/ Process Consultations
Phon- (336) 996-2841
COMPANY 1 �,,S
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STREET ADDRESS
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PROJECT �a�• �y �2p'
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SAMPLER NAME SE PRIN, o m
CONTACT (9/>1dlG'I �1 RC2 �9 OiA 'Z,`'p :�cQ Q,/4,Z f
PHONE SAMPLER SIGNATURE •t' C� F G1 p =• y o
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SAMPLE NUMBER DATE TIME A - ` ` r ` `m
0 ` ,
RES CHLORINE SAMPLE
0 Q C9 Q o O1 o Q• p '
(LAB USE ONLY) TEMP s REntov�o AUTRIX v IP of of Q• p Q• Q• Q Z
C (m�) Iv%M FTcE SAMPLE LOCATION ILO. °Y h h v v 5
$vZ3 �' �fg1 111111111111111111111111111
iiiI— w " " " " REQUESTED ANALYSIS
1111 ,
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11111 111111111111111
RELINQUI HEi;Y •r T IME RECEIVED BY
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q'y REMARKS:
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RELINQUISHED BY DATE/TIME REC IV D yD�7• �Q ��f
•.....11.mm ' 'PLETERFEVATURE AT RECEIP ' °C
ininieTh\ WS,6 60 6,?
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form,please visit http://portal.ncdenr.org/web/wq/ws/su/nodessw#tab-4
Permit No.: N/C or Certificate of Coverage No.: N/C/G
Facility Name: Power Labs
County: Forsyth Phone No. 336-650-0706
Inspector: Glenn Price(RAL)
Date of Inspection: October 27,2015
Time of Inspection: 1420
Total Event Precipitation(inches): 1.16
RECEIVED
Was this a"Representative Storm Event" as defined by the permit?
(See information below.) N O V 2 Z015
rs'Yes o No CENTRAL FILES
DWR SECTION
Please ver whether Qualitative Monitoring must be performed during a"representative storm event or"measureable storm
event"(requirements vary,depending on the permit.)
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a
"representative storm event"or during a"measurable storm event." However,some permits do not have this requirement.
Please refer to these definitions,if applicable.
A"representative storm event"is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72
hours(3 days)in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to
10 consecutive hours of no precipitation.
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 h
able to document that a shorter
approval from the local DWQ Regional Office.
By this signature,I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permitee or Designee)
SWU-242-020705
1.Outfall Description
Outfall No. 001 Structure(pipe,ditch,etc.)Pipe
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2.Color:Describe the color of the discharge using basic colors(red,brown,blue,etc.)and tint
(light,medium,dark)as descriptors: Light Grey
3.Odor:Describe any distinct colors that the discharge may have(i.e.,smells strongly of oil,weak chlorine odor,etc.)
None
4: Clarity: Chose the number which best describes the clarity of the discharge,where 1 is clear and 5 is very cloudy:
I 1 I 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 I 3 I 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 1 I 2 3 4 5
7.Is there any foam in the stormwater discharge? Yes I No I
- 8.Is there an oil sheen in the stormwater discharge? Yes I No I
9.Is there any evidence of erosion or deposition at the outfall? Yes No
10.Other Obvious Indicators of Stormwater Pollution:
List and describe:
Floating solids in the form of light leaf/twig material.
1
I
I Note:Low clarity,high solids,and/or the presence of foam,oil sheen,or errosion/deposition may be indicative of pollutant exposure.
These conditions warrant further investigation.
SWU-242-020705
RESEARCH & ANALYTICAL Report of Analysis
•
LABORATORIES, INC. 11/6/2015
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v...............0„.` \h- l'1W 4)77, 1
For: PowerLab Inc. 4
3352 Old Lexington Road '°�'= •
~� �`' 4... 11
Winston-Salem, NC 27127 :°C at NC#34 z;•
w NC#37701 : E
Attn: Jeff Ward '� s :
.F.+�ED At`��vs�
rrisia<ti
Client Sample ID: 001 Lab Sample ID: 10925-01
Site: Power Labs Collection Date: 10/27/2015 14:20
Parameter Method Result Units Rep Limit Analyst Analysis Date/Time
Lead,Total EPA 200.7 0.163 mg/L 0.005 AA 11/3/2015
pH SM 4500 H+B-2000 6.49 Std. Units 10/27/2015 1420
Temperature(Thermometric) SM 2550B 17.6 °C 10/27/2015 1420
Total Suspended Solids(TSS) SM 2540 D-1997 12.6 mg/L 5 YJ 11/2/2015
NA=not analyzed
•
P.O.Box 473 106 Short Street Kemersville,North Carolina 27284 Tel:336-996-2841 Fax:336-996-0326 www.randalabs.com Page 1
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