NCG030689_2018 SWD Annual Result_20190305

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) / SPPP Annual Update DATA REVIEW FORM
Calendar Year 1oiB
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or
Certificate of Coverage (COC) No. NCG 0❑ 3❑00®®
This monitoring report summary of the calendar year should be kept on File on -site with the facility SPPP.
Facility Name: Tyta> NC
County: 17„•1,.,...
Phone Number: (2L ) 4'79 - 2.2.113 Total no. of SDOs monitored
Ouffall No. O 3
Is this outfall currently in Tier 2 (monitored monthly)?
Yes ❑ No 110
Was this outfall ever in Tier 2 (monitored monthly) during the past year?
Yes ❑ No
If this outfall was in Tier 2last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency
❑
Received approval from DWQ to reduce monitoring frequency
❑
Other
❑
Was this SDO monitored because of vehicle maintenance activities?
Yes ❑ No
Tom
Inc
Parameter,
unMs
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Benchmark
Date sample
Collected,
mmlddtyy
03 on 201
I WA
too .,. SO
IA,$
1 4.0- 1.0
4,3
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Laboratt
Asheville ❑ EdenO Greenwood ❑
Client Name: AWWC,
Courier: QFe []UPS ❑LISPS
❑Commercial ace ❑Other:_
Custody Seal Present? (]Yes I_ItJ� Seals Intact? Dyes
Huntersville ❑ Raley Mechanicsville[]
o ���
Project WO# : 92375378
�Cllent III II' I II IIII IIII II III
— / 92375378
0
Date/InItlab Parson Examining Contents:
Packing Material: ❑Bubble wrap
bble Bags ]None Other
Biological iLssue F
Thermometer:
AIR Gun ID: �S_35�p2
Type of ice:
et ❑Blue
QNone yes QNO N/A
Cooler Temp ('C): correction Factor: Add/Subtract ('C)
cl, /
Cooler Temp Corrected ('C):
Temp should be above freezing to 6'C
❑Samples out of temp criteria. Samples on Ice, cooling
USDA Regulated Rom~ N/A, water sample)
process
hasbegun
Did samples nate In a quarantine tone within the United States: CA, NY, or
Y No
SC (check maps)?
old samples originate from a fcrelgnsaume(Internation
Induding Hawaii and Puerto Rico)? ❑Yes
Comments/Discrepan
Chain ofCustady Present?
es No
N/p 1.
Samples Arrived within Hold Time?
es No
N/A 2.
Short Hold Time Analysis <72 hr.?
Yes o
x/q 3.
Rush Turn Around Time R uestedl
Dyes o
NA 4.
Sufficient Volume?
es ON.
UNIA S.
Correct Containers Used?
sample Labels Match COC?
Trip
COMMENTS/SAMPLE DISCREPANCY
❑No❑N/A 19.
CIJENT NOTIFICATION/RFSOlUT10N Lot lD of split Containers:
Person contacted:
Date/fine:
Field Data Required? Ores []No
Project Manager SCURF Review:
Date:
Project Manager SRF Review:
Date:

Document Name:
Document Revised: February 7, 2018
Sample Condition Upon Recelpt(SCUR)
Page 1 of 2
Document No.:
Issuing Authority:
aceAnalytiral"
'
F-CAR-CS-033-Rev.06
Pace Carolinas Quality Office
*Check mark top half of box if pH and/or dechlorinatlon is
verified and within the acceptance range for preservation
samples.
exceptions: VOA, Coliform, TOC, Oil and Grease, DRO/801S (water) DOC, LLHg
**Bottom half of box is to list number of bottle
Project W0# : 92375378
PM: COI Due Date: 03/16/18
CLIENT: 91-AWNC
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pH Adjustment Log for Preserved Samples
Sample ID
Type of Preservative
pH upon receipt
Date preservation adjusted
Time preservation
adjusted
Amountof Preservative
added
Lot
Note: Whenever there Is a discrepancy affecting North Carolina compliance samples, a ropy of this form will be sent to the North Carolina OEHNR Certification Office (I.a.
Out of hold, Incorrect preservative, out of temp, Incorrect containers.

ITEM 0
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I OF CONTAINERS
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HNO3
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ET
N&2.qgna_
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VOC 524
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L—J
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— = —
—

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) / SPPP Annual Update DATA REVIEW FORM
Calendar Year Zota
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or
Certificate of Coverage (COC) No. NCG o❑ d❑❑o ©8❑hal
This monitoring report summary of the calendar year should be kept on role on -site with the facility SPPP.
Facility Name: () W NL
County
Phone Number: 9( 19 Total no. of SDOs monitored 3
Outfall No. o j_
Is this outfall currently in Tier 2 (monitored monthly)? Yes ❑ No 1Z
Was this outfall ever in Tier 2 (monitored monthly) during the past year? Yes ❑ No
If this outfall was in Tier 2last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency ❑
Received approval from DWO to reduce monitoring frequency ❑
Other ❑
Was this SDO monitored because of vehicle maintenance activities? Yes ❑ No CK
Parameter, lunitel
Total
Rainfall
Inch"
i 55
PW
Tr..t C.pp...
T.f•1 L.
-6F.l'ir.,<
CV-1 tL
TT
ieto
Benchmark
Date Sample
Collected,
mmlddlyy
03 0l aor
WA
23.5
L.1
lb,00sa
I N
A n0ll
I N
ND
28.
5.3
0
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NO
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SW U-264 - Generic Annual DMR
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Document Name: Document
Document No.:
Laboratory receiving samples:
Asheville Edeno Greenwood rf Huntersville
❑./�Ralele@#[I rnechaniavilla[]
AWWC,
Client Name: Project p: WO#:92375423
Courier: ❑Face []UPS OtUSPS
her: r._ Client II III' I II III IIII I I I III
❑
— / 92375423
Custody Seal Present? QYes 1 ipttf Seals intact? QYes (,k�
7 ZZZ o
Date/Initials person Emmining Contaats:, a3— Q-0,
Packing Material: []Bubble wrap r-t, bbbl/e Ba s
I-,a�" 8 []None Other Biological Tissue Fr
Thermometer: !!! QYes []No N/A
AIR Gun 10: 5 -3 `f�a TYpe of ice: et [Blue (]None
Cooler Temp (°C): Correction Factor: Add/subtract (•C) ^ d, 1
Cooler Temp Corrected (•C): Temp should be above freezing to 6'C
[]Samples out of temp crheda. Samples on Ice, cooling Process
USDA Regulated oil` N has begun
/A, water sample)
Didsamples qi nete in a quarantine zone within the United States: CA, NY, or SC(check maps)? oidsamples originate from a foreign source (Income
�YeE. �N0 Including Howell and Puerto RIeM? rlv.. n.✓ "
Correct Containers Used? e, ONo 011A +
Sample Labels Match COC?
as ON- -ON/A I S.
COMMENTS/SAMPLE DISCREPANCY
CLIENT NOTIFICATION/RESOLUTION Lot ID of spilt containers:
Person contacted:
Date/Time:
Field Data Required? ❑Yes [3No
Project Manager SCURF Review: /( n
� y Date:
Project Manager SRF Review: �.
Date: i, (1,7

Document Name: Document Revised: February 7, 2018
a dn�hdMaf° Sample Condltlon Upon Recelpt(SCUR) Page 1 of 2
"""' ""°'r"""' I Document No.: Issuing Authority:
&CAR-CS•033-Rev 06 Pace Carolinas Quality Office
'Check mark top half of box if pH and/or dechlorination is
verified and within the acceptance range for preservation
samples.
Exceptions: VOA, Conform, TOC, Oil and Grease, DRO/8015 (water) DOC, LLHg
"Bottom half of box is to list number of bottle
Project# ijn# ^ 9237542?
PM: C01 Due Date: 03/16/18
CLIENT: 91—AWNC
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9
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12
PH Adjustment Log for Preserved Samples
Sample ID
Type of Preservative
pN upon recelpt
Date preservation adjusted
Time preservation
adjusted
Amount of preservative
added
Lot#
Note
..-
- ------ --- - ---^-.-••-r -••-••�•a­... .......un,pnanca sampres, a copy or ris rorm %nu oe sent to the North Carolina DEHNR Certincatlon Office (i.e.
Out of hold, incorrect preservative, out of temp, Incorrect containers.

STORMWATER DISCHARGE OUTFALL (SDO)
ANNUAL SUMMARY DATA MONITORING REPORT (DMR) I SPPP Annual Update DATA REVIEW FORM
Calendar Year ZOIR
Individual NPDES Permit No. NCS❑❑❑❑❑❑ or
Certificate of Coverage (COC) No. NCG o❑ 3❑ O❑©®E
This monitoring report summary of the calendar year should he kept on rile on -site with the facility SPPP.
Facility Name: F) W rAC
County:il ....1.,. --
Phone Number, (919 ) 4't 9 - 7a43 Total no, of SDOs monitored 3
Outfall No.
Is this outfall currently in Tier 2 (monitored monthly)?
Yes ❑ No [�
Was this ouffall ever in Tier 2 (monitored monthly) during the past year?
Yes ❑ No
If this outfall was in Tier 2 last year, why was monthly monitoring discontinued?
Enough consecutive samples below benchmarks to decrease frequency
❑
Received approval from DWQ to reduce monitoring frequency
❑
Other
❑
Was this SDO monitored because of vehicle maintenance activities?
Yes ❑ No
Parameter, units
Tool
kWh"
TSS
Cha (-�
P�
Cstd- �W7+�
Toad C-pp,
Cw U.�
TYi-�)t.C.
IL
CHI L�t..c
w•-RI..
(w L
1-To
)
Benchmark
Date Sample
Collected,
mmlddlyy
031.1 faots13.1
WA
•f a. .. a°ia
4.0-9•0
4.1.
0.010
0.005
o,oTS
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1
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6.3
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NO
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SWU-264 - Generic Annual DMR
L.St mWsed WIMIe

Laboratory receiving samples: Asheville[] Eden[] Greenwood ❑ Huntersville ❑ >�j
6" Ralelgj� Mechanicsville0
Client Name: _
AWN Pro, WW 92375377
ElCoCourier: Fate []UPS USPS ❑Other;_ ❑Gient
❑ Commercial � � II I II' I II I�IIIII I II III
Custody seal Present? QYes �JpF� seals Intact? 92375377
QYes o
Date/Initials Person Esamining Cantents:�—�
Packing Material: ❑Bubble Wrap bble Bags QNone
Other
Thermometer: Biological Tissue Fr
,xIRGun ID:.Z.S •35p2 TYpe ar lte: et QYes glue ❑None ONO N/A
Cooler Temp (-C): Correction Factor: Add/Subtract (-C) �, 1
Cooler Temp Corrected (°C): Temp should be above freezing to 6°C
❑Samples out of temp criteda, samples on Ice, cooling process
USDA Regulated N/A, water sample) has begun
Did samples I nate In a quarantine zone within the Unned States: CA, NY, of SC (check maps)? Did samples originate from a foreign soufre nntomen.....u..
❑Ye . ❑No
Correct Containers Used?
-Pace Containers ifcndt
Sample Labels Match COC?
Trip
COMMENTS/SAMPLE DISCREPANCY
F}
ON/A ( 6.
ONO DIVA I9.
[UENT NDTIFICATION/RESOLU710N Lot ID of split containers:
Person contacted:
Date/Time:
Project Manager SCURF Review:
Project Manager SRF Review:
neld Day Raqulredr Des ONO
Date: j Z IS•
Date:

Condition Upo
Document
'Check mark top half of box if pH and/or dechlorination Is
verified and within the acceptance range for preservation
samples.
Exceptions: VOA, Collform, TOC, Oil and Grease, DRO/8015 (water) DOC, LLHg
"Bottom half of box is to list number of bottle
I: February
1 of
Projec WON: 15377
NM: CDJ Due Date: 03/16/18
CLIENT: 91-pWNC
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PM walustment Log for Preserved Samples
Sample 10 Type of Preservative pH upon receipt Date preservation adjusted Time preservation Amount of Preservative Loth
adjusted added
rail.......__n________�__
Note: Whenever there is a diecrenanN aHanhe North Ca
______,...
. ....
- - -"""'_ North -•• -^••� comp••ance SaMPIES, a mvr ar thls form will be sent to the North Carolina DEHNR Certification Office (i.e. Out of hold, Incorrect preservative, out of temp, Incorrect wmalnen,

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SAIPLETEMPAT COLLECTION
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Phenol Total
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i N
TEMP In C
Residual CWMne(Y/N)
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"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a
system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person
or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the
best of my knowledge and belief, ate, and complete. I am aware that there are significant penalties for submitting false information,
including the possibility of fi and imprisonm nt for knowing violations."
Signature �L d/'o✓��aJ-
Date ; 2 Z /9
For questions, contact your local Regional Office:
DEMLR Regional Office Contact Information:
ASHEVILLE REGIONAL OFFICE
2090 US Highway 70
Swannanoa, NC 28778
[phone]
ItALEIGR REGIONAL OFFICE
3800 Barrett Drive
Raleigh, NC 27609
(919) 7914200
WINSFONSALF,M REGIONAL OFFICE
450 Hanes Mill Rd. Suite 300
Winston-Salem, NC 27105
[phone]
FAYETTEVILLB REGIONAL OFFICE
225 Green Street
Systel Building Suite 714
Fayetteville, NC 28301-5043
(9�10�)433-3300
WASHR�( NAL OFFICE
943 Washington Square Mall
Washington, NC 27889
[phone]
CENTRAL OFFICE - ----- _-
1617 Mail Service Center
Raleigh, NC 27699-1617
[phone]
MOORESVILLE REGIONAL OFFICE
610 East Center Avenue/Suite 301
Mooresville, NC 28115
[phone]
WR.MINGTON REGIOIVAI, OFFICE
127 Cardinal Drive Extension
Wilmington, NC 28405-2845
[phone]
SWU-264 - Generic Annual DMR
Last mvi ed MI anra