NCG120053_MONITORING INFO_19960122

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
IV L& 5 3
DOC TYPE
0 HISTORICAL FILE
2� MONITORING REPORTS
DOC DATE
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YYYYMMDD

STURNIWATE It DISCHARGE OUIT. ALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG120000
CERTUPICATE OF COVERAGE NO. NCGI210,53
SAMPLES COLLECTED DURING CALENDAR YEAR:
(all samples colkded during a calendar year, shalt be reported no 121tr than Janusry3l of
the following year)
FACILITY NAME I LL.� 11C,­eN14,Ag,7,1T Lc,"'r COUNTY
PERSON COLLECTINGSAMPLE(S) 'rxaddicK - PKONF-140-
CERTIFIED LABORATORY(S) `Pa� c Amalrca � �,'-,z, roc- Lab # -37
2ab # (SICNATURR, 73r, PERMMEE OR DESIGNE
Part A: Specific Monitoring Requirements
By this signature, I certify that this report Is accurate and complete
to the best or my knowledge.
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Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? —yes �no
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity Monitoring Requirements
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'JAN 22 1997
OfliS1011 OF [1,X'Ar;',-1?[NTAL :rk41N-.'L-J9T-
marVISMIE REC:�fjhj OFFICE
Form MR 12

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STORM EVENT CHARACTERISTICS:
Total Event Precipitation (inches):
Event Duration (hours): S
(if more than one storm event was sampled)
Total Event Precipitation (inches):
went Duration (hours):
1 Applies only for facilities at which fueling occurs.
2 Detergent monitoring is required only at facilities which conduct vchicle cleaning operations.
Mail Original and one copy to:
Attn: Central Files
Division of Environmental Mgt.
DEHNR
P.O. Box 29535
Raleigh, NC 27626-0535
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 nmnage the system, or those persons directly responsible
for gathering the information, the infornmtion submitted is, to the best of my knowledge and belief, true, accurate, and
t c�nplete. I am aware that -there are significant penalties for submitting false information, including the passibility of
fi#es and imprisonment for knowing violations."
`''(Signature of Pernlittee)ate
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Form MR12

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S'TORMWATER DISCHARGE OUTF. ALL (SDO)
MONITORING REPORT
GENERAL PERMIT N0. NCG]2f)i)(?O SAMPLES COLLECTED DURING CALENDAR YEAR:
CERTW ICATE OF COVERAGE NO. NC(:1:• _ 0 o S 3 (oil samples collected during a calendar year, shall be reported no later than.lanuary3l of
the following year)
FACILITY NAME Clyl S 'Dew w to e ca,i ��� ' COUNTY �4 be-fk�
PERSON COLLEt, v' PH , N ��4-z.z
CERTIFIED LABORATORY(S) _ � ab s • ' a�C/
�'Lab # A F
By this signature., I certify that this report is accurate and complete
to the best of my knowledge .
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Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new �rol'�`Tx,yes Xno
(if yes, complete Part B) & NATURAL RESOURCES -'
Part B: Vehicle Maintenance Activity Monitoring Re tiirements MAR 22 1995
IiIY�� E RV MM � Ef�pll
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Form MR I2
e.

STORM EVENT CHARACTERISTICS:
Mail Original and one copy to:
Total Event Precipitation (inches): Attn: Central Files
Event Duration (hours): 3 Division of Environmental Mgt.
DEHNR
(if more than one storm event was sampled) P.O. Box 29535
Total Event Precipitation (inches): Raleigh, NC 27626-0535
Event Duration (hours):
1 Applies only for facilities at which fueling occurs.
2 Detergent monitoring is required only at facilities which. conduct vehicle cleaning operations.
f 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, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of
fines and imprisonment for knowing violations."
(Signature of Permittee)ate
Form MR12

)ZATquaChem
ENVIRONMENTAL LABORATORIES, INC.
11176 Downs Road
Pineville, NC 28134
704/588-5076
FAX 704/58&2454
NC Certification Number: 305
SC Certification Number: 99032
Date of Report: 04/19/94
Date Received : 04/06/94
Approved
Richard P. King
Laboratory Supervisor
Client: BFI Waste Systems
5105 Morehead Road
Harrisburg, North Carolina 28075
Contact: Mr. David Cradduck
Customer Number: 1315
LABORATORY REPORT
LAB ID: 521K01
SAMPLE ID: PT. 1
Det.
Analysis
Parameter
Result
Limit
Unit
Method
Time
Date
Anal
BOD-5 Day
5
1
ppm
SM 507
08:40
04/07/94
RCD
TSS
280
4
ppm
SM209C
08:30
04/08/94
RPK
Ammonia
BDL
1
ppm
EPA350.2
11:55
04/07/94
RCD
Oil & Grease
2
1
ppm
SM 503
09:00
04/13/94
RPK
Cyanide
BDL
0.002
ppm
EPA335.2
08:10
04/12/94
RCD
Arsenic
BDL
0.005
ppm
EPA206.2
14:00
04/12/94
KRR
Cadmium
BDL
0.01
ppm
EPA200.7
08:00
04/12/94
KRR'
Chromium
BDL
0.05
ppm
EPA200.7
08:00
04/12/94
KRR
Copper
BDL
0.02
ppm
EPA200.7
08:00
04/12/94
KRR
Lead
BDL
0.05
ppm
EPA200.7
08:00
04/12/94
KRR
Nickel
BDL
0.03
ppm
EPA200.7
08:00
04/12/94
KRR
Zinc
0.08
0.01
ppm
EPA200.7
08:00
04/12/94
KRR
Fecal Coliform
1520
1
C/100
SM908C
15:30
04/06/94
TML
Acenaphthene
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
Acenaphthylene
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
Anthracene
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
Benzo (a) Anthracene
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
Benzo (a) Pyrene
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
Benzo (b) Fluoranthene
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
Benzo (g,h,i) Perylene
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM'
Benzo (k) Fluoranthene
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
Bis (2-Chloroethoxy) M
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
Bis (2-Chloroethyl) Et
BDL
10
PPS
EPA 625
15:14
04/11/94
FDM

BFI Waste Systems
04/19/94
Page 2
LAB ID: 521K01
SAMPLE ID: PT. 1
Det.
Analysis
Parameter
Result
Limit
Unit
Method
Time
Date
Anal..
Bis (2-Chloroisopro_pyl
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Bis (2-Ethylhexyl) Pht
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
4-Bromophenyl Phenyl E
BDL
10
PPS
EPA
625
15:14
04/11/94
FDM
Benzyl Butyl Phthalate
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
2-Chloronaphthalene
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
4-Chlorophenyl Phenyl
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Chrysene
BDL
10
PPS
EPA
625
15:14
04/11/94
FDM
Dibenzo (a,h) Anthrace
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
1,2-Dichlorobenzene
BDL
10
PPB
EPA
625.
15:14
04/11/94
FDM
1,3-Dichlorobenzene
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
1,4--Dichlorobenzene
BDL
10
PPS
EPA
625
15:14
04/11/94
FDM
3,3'--Dichlorobenzidine
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Diethyl Phthalate
BDL
10
PPB
EPA
625
1.5:14
04/11/94
FDM
Dimethyl Phthalate
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Di-N-Butyl Phthalate
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
2,4-Dinitrotoluene
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
2,6-Dinitrotoluene
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Di-N-Octylphthalate
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Fluoranthene
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Fluorene
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Hexachlorobenzene
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Hexachlorobutadiene
BDL
10
PPB
EPA
625
I5:14
04/11/94
FDM
Hexachlorocyclopentadi
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Hexachlorcethane
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Indeno (1,2,3-cd) Pyre
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Isophorone
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Naphthalene
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Nitrobenzene
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
N-Nitroso-Di-N-Propyla
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
N-Nitrosodiphenylamine
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
Phenanthrene
BDL
10
PPB
EPA
625 -15:14
04/11/94
FDM
Pyrene
BDL
10
PPS
EPA
625
15:14
04/11/94
FDM
1,2,4-Trichlorobenzene
BDL
10
PPS
EPA
625
15:14
04/11/94
FDM
Benzidine
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
1,2-Diphenylhydrazine
BDL
10
PPS
EPA
625
15:14
04/11/94
FDM
N-Nitrosodimethylamine
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
4-Chloro-3-Methylpheno
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
2-Chlorophenol
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
2,4-Dichlorophenol
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM
2,4-Dimethylphenol
BDL
10
PPB
EPA
625
15:14
04/11/94
FDM

BFI Waste Systems
04/19/94
Page 3
LAB ID: 521K01
SAMPLE ID: PT. 1
Det.
Analysis
Parameter
Result
Limit
Unit
Method
Time
Date
Anal.
2,4-Dinitrophenol
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
2-Methyl-4,6-Dinitroph
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
2-Nitrophenoi
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
4-Nitrophenol
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
Pentachlorophenol
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
Phenol
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
2,4,6-Trichlorophenol
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
1,2-Diphenylhydrazine
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
4,6-Dinitro-o-cresol
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
P-chloro-m-cresol
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
Trans-1,3-dichloroprop
BDL
10
PPB
EPA 625.
15:14
04/11/94
FDM
4-Methylphenol
BDL
10
PPB
EPA 625
15:14
04/11/94
FDM
Nitrobenzene-d8
a Rec
EPA 625
15:14
04/11/94
FDM
2-Fluorobiphenyl
°s Rec
EPA 625
15:14
04/11/94
FDM
p-Terphenyl-d14
t Rec
EPA 625
15:14
04/11/94
FDM
Phenol-d6
a Rec
EPA 625
15:14
04/11/94
FDM
2-Fluorophenol
g Rec
EPA 625
15:14
04/11/94
FDM
2,4,6-Tribromophenol
o Rec
EPA 625
15:14
04/11/94
FDM
Endrin
BDL
0.01
PPM
SW 846
15:14
04/11/94
FDM
Lindane
BDL
0.01
PPM-
SW 846
15:14
04/11/94
FDM
Methoxychlor
BDL
0.01
PPM
SW 846
15:14
04/11/94
FDM
Toxaphene
BDL
0.01
PPM
SW 846
15:14
04/11/94
FDM
2,4-D
BDL
0.01
PPM
SW 846
15:14
04/11/94
FDM
2,4,5-TP (SILVEX)
BDL
0.01
PPM
SW 846
15:14
04/11/94
FDM
TOC
4.60
1
ppm
EPA415.1
15:25
04/07/94
JCH
COD
27
5
ppm
EPA410.1
09:15
04/08/94
RCD
Mercury
BDy
0:0002
PPM
EPA245.1
08:15
04/14/94
RPK
LAB ID: 521K02
SAMPLE ID: PT. 2
BOD-5 Day
5
1
ppm
SM 507
09:05
04/07/94
RCD
COD
17
5
ppm
EPA410.1
09:15
04/08/94
RCD
TSS
120
4
ppm
SM209C
08:30
04/08/94
RPK
Ammonia
BDL
1
ppm
EPA350.2
12:10
04/07/94
RCD
Cyanide
BDL
0.002
ppm
EPA335.2
08:10
04/12/94
RCD
Oil & Grease
3
1
ppm
SM 503
09:00
04/13/94
RPK
Arsenic
BDL
0.005
ppm
EPA206.2
14:00
04/12/94
KRR
Cadmium
BDL
0.01
ppm
EPA200.7
08:00
04/12/94
KRR
Chromium
BDL
0.05
ppm
EPA200.7
08:00
04/12/94
KRR
Copper
BDL
0.02
ppm
EPA200.7
08:00
04/12/94
KRR

BFI Waste Systems
04/19/94
Page 4
LAB ID: 521K02
SAMPLE ID: PT. 2
Det.
Analysis
Parameter
Result
Limit
Unit
Method
Time
Date
Anal.
Lead _
BDL
0.05
ppm
EPA200.7
08:00
04/12/94
KRR
Nickel
BDL
0.03
ppm
EPA200.7
08:00
04/12/94
KRR
Zinc
0.11
0.01
ppm
EPA200.7
08:00
04/12/94
KRR
TOC
3.10
1
ppm
EPA415.1
15:25
04/07/94
JCH
Fecal Coliform
1160
1
C/100
SM908C
15:30
04/06/94
TML
Acenaphthene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Acenaphthylene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Anthracene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Benzo (a) Anthracene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Benzo (a) Pyrene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Benzo,(b) Fluoranthene
BDL
10
PPS
EPA
625.
16:33
04/11/94
FDM
Benzo (g,h,i) Perylene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Benzo (k) Fluoranthene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Bis (2-Chloroethoxy) M
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Bis (2-Chlorcethyl) Et
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Bis (2-Chloroisopropyl
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Bis (2-Ethylhexyl) Pht
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
4-Bromophenyl Phenyl E
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Benzyl Butyl Phthalate
BDL
10
PPS
EPA
625
16:33
04/11/94
FDM
2-Chloronaphthalene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
4-Chlorophenyl Phenyl
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Chrysene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Dibenzo (a,h) Anthrace
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
1,2-Dichlorobenzene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
1,3-Dichlorobenzene
BDL
1.0
PPB
EPA
625
16:33
04/11/94
FDM
1,4-Dichlorobenzene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
3,3'-Dichiorobenzidine
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Diethyl Phthalate
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Dimethyl Phthalate
BDL
10
PPS
EPA
625
16:33
04/11/94
FDM
Di-N-Butyl Phthalate
BDL
10
PPS
EPA
625 -16:33
04/11/94
FDM
2,4-Dinitrotoluene
BDL
10
PPS
EPA
625
16:33
04/11/94
FDM
2,6-Dinitrotoluene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Di-N-Octylphthalate
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Fluoranthene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Fluorene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Hexachlorobenzene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Hexachlorobutadiene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Hexachlorocyclopentadi
BDL
10
PPS
EPA
625
16:33
04/11/94
FDM
Hexachloroethane
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Indeno (1,2,3-cd) Pyre
BDL
10
PPS
EPA
625
16:33
04/11/94
FDM

BFI waste Systems
04/19/94
Page 5
LAB ID: 521K02
SAMPLE ID: PT. 2
Det.
Analysis
Parameter
Result
Limit
unit
Method
Time
Date
Anal.
Isophorone
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Naphthalene
BDL
10
PPS
EPA
625
16:33
04/11/94
FDM
Nitrobenzene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
N-Nitroso-Di-N-Propyla
BDL
10
PPA
EPA
62'5
.16:33
04/11/94
FDM
N-Nitrosodzphenylamine
BDL
10
PPS
EPA
625
16:33
04/11/94
FDM
Phenanthrene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Pyrene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
1,2,4-Trichlorobenzene
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Benzidine
BDL
10
PPS
EPA
625
16:33
04/11/94
FDM
1,2-Diphenylhydrazine
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
N-Nitrosodimethylamine
BDL
10
PPB
EPA
625.
16:33
04/11/94
FDM
4-Chloro-3-Methylpheno
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
2-Chlorophenol
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
2,4-Dichlorophenol
BDL
10
PPS
EPA
625
16:33
04/11/94
FDM
2,4-Dimethylphenol
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
2,4-Dinitrophenol
BDL
10
PPS
EPA
625
16:33
04/11/94
FDM
2-Methyl-4,6-Dinitroph
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
2-Nitrophenol
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
4-Nitropheno3
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Pentachlorophenol
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Phenol
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
2,4,6-Trichlorophenol
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
1,2-Diphenylhydrazine
BDL
10
PPS
EPA
625
16:33
04/11/94
FDM
4,6-Dinitro-o-cresol
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
P-chloro-m-cresol
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
Trans-1,3-dichloroprop
BDL
10
PPB
EPA
625
16:33
04/11/94
FDM
4-Methylphenol
BDL
10
PPB
EPA
625
16:33
04/ 11/94
FDM
Nitrobenzene-d8
e Rec
EPA
625
16:33
04/11/94
FDM
2-Fluorobiphenyl
'a Rec
EPA
625
16:33
04/11/94
FDM
p-Terphenyl-d14
"s Rec
EPA
625 _16:33
04/11/94
FDM
Phenol-d6
°s Rec
EPA
625
16:33
04/11/94
FDM
2-Fluorophenol
a Rec
EPA
625
16:33
04/11/94
FDM
2,4,6-Tribromophenol
t Rec
EPA
625
16:33
04/11/94
FDM
Endrin
BDL
0.01
PPM
SW 846
16:33
04/11/94
FDM
Lindane
BDL
0.01
PPM
SW 846
16:33
04/11/94
FDM
Methoxychlor
BDL
0.01
PPM
SW 846
16:33
04/11/94 .
FDM
Toxaphene
BDL
0.01
PPM
SW 846
16:33
04/11/94
FDM
2,4-D
BDL
0.01
PPM
SW 846
16:33
04/11/94
FDM
2,4,5-TP (SILVEX)
BDL
0.01
PPM
SW 846
16:33
04/11/94.
FDM
Mercury
BDL
0.0002
ppm
EPA245.1
08:15
04/14/94
RPK

LAqU
em
ENVIRNTAL LABORATORIES, INC,
11176 DOWNS ROAD 7041588.5076
PINEVILIL NC 28134 FAX 7041NII-2454
Client: � n S Div. �o""'.0
Address: S"/OS
City 7V 2,-41- Is h h
Contact Person Z)a c t"2t'SA
Sampled By: -Jas t
CHAIN CUSTODY
Stater
a
0
fi
Phone Number:
Fax Number: (. j
Purchase Order Number: 2 30 G
Certification Requirement:. !V /0CS - --
Project Name: SA't� w4,1rA ,VC h 17,0000
Rush Charges Authorized ❑ Yes ❑ No
By relinquishing this sample(s) to Labor6tory Personnel, I warrant that I am authorized to enter into this agreement for the Client named above and that I authorize the below analysis subject to the terms and conditions on the reverse hereof.
This agreement Is governed by the 0�ea)74
conditions on the rev rse s' e �r_eaI Analysis charges shall be as included In the Laboratories fee schedule in effect at the lime of the analysis.
Relinquished By: 0 1 ��V`—Date: / �0 % Time: ^ �y� ZS� -
Received By: Date: f Time: /y'2-c�
Relinquished By: t2 Date: ci/P Time: /S/O
s
Received By: i 1 < ` /�1/`J- Date: Time: /`>
y
a� Date S Time
Sample ID Sampled Lab ID
Samples received on ice? Yes ❑ No ❑
Other Analysis Preservative
o�
I
11111111
HIM
ell
Autosamater Sampler Location Field pH
Date Installed Time Installed Flow CF/GPD Resull % 0`
Date Picked Up Time Picked Up Flow Analyst C'Rad� 4. c f�
Composite Type: ❑ Flow XTime Kland Time/Date a 91/ 03 5 p
(OA/OC Separate)
Please sign and return the white and yellow copies
to the Laboratory.

WITNESSETH:
WHEAEAS. CLIENT AS IDENTIFIED ON THE REVERSE SIDE REQUIRES THE ANALYSIS OF SAMPLES BY A LABORATORY, AND
WHEREAS, AOUACHEM ENVIRONMENTAL LABORATORIES, INC. {HEREWAFTERRE=ERRED TO AS iILAB) MAINTAINS A LABORATORY WNrCH ANALYZES SAMP'.ES.
- ­�W THEREFORE, rN CCySICERA ICN OF SERVICES PROVIDED BY LAB. ANO FEES PA<'D BY CLIENT, CLIENT AND LAB AGREE TO BE BCUND BY THE AGREEMENT INCLUDED ON %rr=
.ONJAND [TACK SIDES OF `H:S ;EOUEST AND AGREEMENT FOR LASORAT OAy ANALYSIS:
C
TERMS -AND CONDITIONS
1. PAYMENT - C (rent wig oay Lab tot Swvicvs and erpenses in accvcance with Virs A;tse?mrlt and Lab's Fee Scnaduse in stlect at:he time of the analysis. Lab wit submit progress lnvoioes
to C lism morrhty any a hew invoice upon completion d as Sarvroes. Ead . Ice oiee. on presentation. s cue and payable by Ckarit invoices are past due 10 days ter ate Cato of Imps invoice.
Past due anounts are swjeCi 10 a service Charge DI one and one -hag perceh: Der monin (1 N percent per annum) on the outstanding balance. Amdfneys foes and other casts incurred rn
Doagai ng past due amounts shall be paid by Ceeril.
Lab shaft be pad in lull for all Services unoor Ills Agraarrenl. including any arcaronei servPms as speefiwy aurnon:ed in writing by Ctenr in excess or thosa sated in this Agraemsnr_
The Client's obligation io flay for the Services contracted for is to r.: way vooe,,den: uoon:he Client's AtAdty to optatn 5naneng, payrnmre from third Partin or, apdrpya; Dl govemrnamal or
regulatory agenaas_
2. WARRANTY AND STANDARD OF CARE -Lab shall perform services for Cl-err..,-;sing ganeraly axeppsd labormory prn.^.gss. In the ever, any portion ofthe Services tails to comply wrtn
Ens warranty 001igafiar. area Lac a prorrnTly novtise in writing pnor to 3C nays after cgrolenon of s:•ctn portion cl ire Servton. Lab will prorndtry nf-perlarm su.= po-tar: o! ,no Service`, or it
re-periar.:.ar.m is im„tamcabls. Lew wd! re.`,.'nd the a.'naiu n: a: cDrpansalAon;.id :a LA.- Ian Sut.'i pp.^.ion a` ;her Services. The remedies sii lrtn nrein are ax=stve.
THIS WARRANTY IS IN LIEU OF ALL OTHER WARRANTIES- NO OTHER WARRANTY. EXPRESSED OR IMPLIED, INCLUDING WARRANTIES OF MERCHANTABILI Y AND
FITNESS FOR A PART;C'JLAR PURPOSE IS MADE OR INTENDED BY =1jP'0Swf!8G AN Cr+A_ R£PCR7 Or I r =- AiNALYSIS nES:JLTS OR BY ANY ncsnESENTATtOtvS Lf.A:rc
REGARDING TrfE LAS S SERVICES-
3- DISCLAIMER OF CONSEDUENTTAL DAMAGES - in no went shal Lab or client Zia kaoie to the other for any speaal, inaract. tnrideftud or mirmaquential loss or camages.
LIMITATION OF UABfUTY - The total rrabdty of Lab whether in Contract, tor, )inciudng nagiaence whether sore or eon=rran;), or outewase arising our of. Connected with or resuhin; trail
the Services prdvtdad oursuanftc this Agreemrant shag not axdeed zee Loral fees Daic by cier pursuam to ins Agreement-
5. REPORTS - In con ea:on win tra performanta of the Services. Lab shalt deliver to Client, for Cgettt's &aim cue, one or mom rations or other written document rel eGms Satvi®a araviaed.
iris resuu d sum Services or lab's evacuation Of Ire result of sum ServiO6s. Air rapttr-S and wrtdts docurrants Delivered to Clent are insimments reftecteng the services prarioed by Lan
pursuant to this Agreemren: and are made eveiebis for Client's use subject to Erie GTr:arions of ints Agraernern. All such reparm. other wrtten docur nenns, aU oeigxat Gat gesnerW by Lac
and work papers ;VW 6u a by Lab in the pefformanice d the SMRtiei are: and shaD ro:itae:, Lie ogle and a=11 wive property of Lab. - - - - - -
The Services, arts any data, remmmenaatwns. proposals. reports. design often& and sirrtilar Information provided by Lab to Mien: towsuant io this Agreement ars provided for the exclusive
use of Client and are rem to be usso or rekd upon by mad parties- - - - - -- - - - -
~6. SAFETY • With resbian to the performance d the Services, Lao stag take safety precautions reauied Ley rtfderaf, state and bawl law& arias- regulations, s mutits a arclingtric"-
SAMPLES - Unless otnerwiae requested. test saacirri frs or sarnDm will be dspdaed of imrriediatey upon corpieticn of ansysis. Ltpon written request. Lab wtl retain sar:pies •'or a =
muttatly actax=ia. s:craae aces:- and period d 11rrre. in pie errem that saimDAt contain ncardous marerwds. Lib thall. aher lion of testing antral C vWs sxowsss. (a) return sure
samplee to Client. or (y ,ring a man#= aigned by Client as generator, have sucli sam Nes transported to a location selected by Cisnr for final disposal. Client fecognixes and agrees Era:
L ita is acing as a bailee and at no time assumes title to said sarrelies.
8. REPRESENTATION OF CLIENT - Client warrants and Covenants that sutWisprff funds are available of wil be walabis upon receid of Lab's iwoitup n make paymsrn In tuft forth @
Servioss pertorred to iris Isrmiration case plus real nad tarrmu fionoMefWi and Cleat shag be proviaeo with cOPiae of as reports which am ColSGkte as of the tartnnatidn date. Lab
and Cfiertt wave air other claims arising from the tertnrratiort-
t D. UNFORESEEN OCCURRENCES - if. Curing the performance of ssrvioet herw:roar. any urdoreseec hQarCOus substance, final f. Clears" or cansMuent of other unforeseen condslora
or xwrrences are encourdwaid which, in Lab`s soie judgemam 4nifficamty affects or may affect the services, the risk irimaivad in providing the servsrss. -or the re0omtennded s„-ape of
ssrvicm. Lao wet prorroty notify Client Meted- Subsequent to mat nofilirst p%:Lact may: fp if txarsiuibte. in Lao's cols judgerr>.nr And weer agpo wal of Ciwt. Complete Uwartirtal scope
d ssrvicea in acGoroance waft tree procedures origiha:y aWasd uoon: ib) Agr" with Cif vg to moolty the s=ps of s"ces and the etiin=a of ctargas w inigme study of the previously
unforeseen conditions or Dcaurrericas. such revision to be in writing Arid sgntit by The paniet and nclrporated herein: w Cc) Termnate the cervion efiieiive an tips date of notification
purstsam to the farms of TERMINA T ION. - - --- -- - - -
11. FORCE MAJEURE - Should mrrpletion d any portion of the Sauces be delayed ter Causes beyond the reasonable ointroi of or without the faun or negfigertas of Lab inducing faros
majnrre, the titre for pe'orrtartoe &hat be eidended tot a period adtaf to the Delay and the parties anal M rtually agree on the forms, area conditions upon which Lha Sorvic" may cis
continued. Face Majeus i=udes bo s riot resmuted to. act of God or Eta public arrsrry, acts of the Gover m st t of this, Untad Staff" or m the ssrsraf static, or any tweign cminvy, of
any of therfi aCirg in their soversgn rapacity, strifes. tinrl itsurtecYeru. freight embargoss, and unusually severe weather. .
12. r' INSURANCE - Lab shot¢ maintain at to own aspens the bgewng insurance suiject to normal industry arclusidris: (t) Warkrren's Oarosrtsaticn Insurance for z=uwfy obrgatiow
Irrpaed by Workmen's Co^aansatdrs or occuDatwtei d aaasa taws: Employers' Llaoitny lnsuranos with a fins of 5100=00 per aeodent. (2j Carraraheisive Arnoenobde Uaodlty
Insuance with limits of f30O.ODO. (3) General Liability lmurarlee rmh krTtis d ST.000.00C.00. Certificates can be sued upon request imenWytng d"a avid lerutf of Coverage. -
13. NO WAIVER - No waiver by ofther party of any default by the other party in the performance of any provision of Ma Agreernant shag operate as or be Construed as a waiver of any fulure -
0OLauL vA%&UWr tiko or different it Character. --
sot. - LAW TO APPLY - The valids y, hnterprearov n, and perfamnce W this Agrre earrm snag be governed by and construed in aCcordau nwith the taws of the state of Noah Carolina
J 75- VALIDITY OF PROVISIONS - Should any partron of out Agreement be deerrtinad to be invaW. than Ens parties is to have the nvafid provision rewman so as to wam as cbsety as -
possible, the meaning of the anginal provison. 0 the provision fan not be rewritten then pie provision shall be d~ from the contract snd the remainder of the contract: slat[ on valid.
16, EKTIAE AGREEMENT - This Agrseaertt ratirssens the Wife understanding of Lab and CLynt and stpsrsedes an prim agreements w hstber written or oral that may oxtsL
LAB HEREBY BYES NOTICE OF ITS OE JFC71ON TO ANY DIFFERENT OR ADDITIONAL TERMS AND CONDITIONS.
To the warm lilt any d dom's addhkiihal or diReraft IMme or candkbns Ccnfict with to Twrte and Conditions of this Agreem om and apply to this request and agrsernent, mass Terms and Conditions
shaft gdvsrn. No amandfnern or mCEtfcaon to this Agreement or anywanrer of any provt&6om hereof Shan be sffoctue unless in writing, signed by both wales. Any reienn4 to Croert's purchase order
L.
of Contrac on this form is for sarrple fdennfre zion purposes and io assist diem's reeordkeepin,;- As provisions of such purchase order or contract are specifically rejected.
J

AL qu em CHAINOUSTODY
ENVFNTAL LABORATORIES, INC.
11178 DOWNS ROAD 7041588-5076
PINEVILLE, NC 28134 FAX [phone]
Client: X F I C'Ms e C'oR.
Address: S G rL f? h ead 2.
C4 -//w/u.6 btAM State:zip:
Contact Person cv Q & dd (44c +C
Sampled By:
By relinquishing this sample(s) to Laboratory P jr Tne
This agreement is governed by ti�a +sm+ and��con ro/n
Relinquished By:
Received By:
Relinquished By: `
Received By:
Phone Number: 7
Z Z nji2V
Fax Number:
Purchase Order Number:
Z34 Co
Certification Requirement:
s
Project Name:
Rush Charges Authorized ❑ Yes ❑ No
I warrant that I am authorized to enter into this agreement for the client named above and that 1 authorize the below analysis subject to the terms and conditions on the reverse hereof,
Anrev side reol, Analysis charges shall be as included In the Laboratories fee schedule in effect at theecthe of the analysis.
— Date: _ y �� 17 Time: /;2- S'
Date:
Date:
Date:
Dale d Time
Sample ID /,/,/Sampled Lab ID
Time:.?S
Time: /LIQ
Time:
Samples received on ice?
Other Analysis
Yes ❑ No ❑
Preservative
�
me�aoo
m
�o�u�■n
n
�
Hill
HIM
mill 111111 1 f
I
i
I�i
HIM
Rill
m�
Rid
ni
AutosamRler Sampler Location
Date Installed Time Installed Flow CF/GPD
Date Picked Up Time Picked Up Flow
Composite Type: ❑ Flow XTime ,Hand
Field pH
Result 7' 6 0
Analyst C46 trc
Time/Date � 9 162"
(QA/QC Separate)
Please sign and return the white and yellow copies
to the Laboratory.
T, tr.;

W ITN ESSETH :
Y WHEREAS, CLIENT AS IDENTIFIED ON TNr REVERSE SID=_ REOUIRcS THE ANA_YS(S OF SAMPLES BY A LABORATORY. AND
WHEREAS, AOUACHEM ENVtPONMEN'rAL LABORATORIES. INC: (riEri ;NA`ERnEFERRED TO AS Lam) MAINTAINS A LABORATORY WHICH ANALYZES SAMPLES.
TiiE REFOn IN CONSIDZ.RATfON C F SER VICES PROVIDED BY LAB. AND FccS PAID 9Y CLI=I."T, CLIENT AND LAB AGnE= TC BE SOUND 9Y TMc AGREEMc tiT INCLUDED ON THr
NT AND aACK SICES CF T. ,S a€OUEST AND AGRE'cMFNT FOR LAnORATORY ANALYSIS:
TERMS AND COND]TtON
1.7 PAYMENT - Ckehi whir pay Lai rot somoes arc exDarsas in aaditnoe wth this Ag:aernmril and Lab's Fee Seher31e in effaa C L'te Lute of the analysis. Lab wilt submit progress invoices
to CTrent monthly and a final nvdiee upon mmioW.Lon of its Services. Each nvoicw. on presentation, is due and payabte by Chant Invoices are past duo IC days after the dais of the imaoe.
Past due arriounm a•a suDise to a service charge of one and Dna-had Demon; ppr rronm (iQ percent per annum) on the ouuLaMing t]atanCe. A^.Orner s I&" and Other : %is rnctroc in
cReearrig past due atnouns shall be paid by Chem �
Lab snap be paid in full tot ad Sofv4ms untie.' this Agrsernont incivai :g Any azamonaf services as seed&Gaily avihorzed in wrwg by Client in exosss or those s:aiw in this Agreemxiit.
The GMC.'s ob2gaton to Day W the Samces mn:ratted for is in no way aependem upon. the Cfw'r's aDJty to optam financing, puym*m trom third panes or. aporaval d! gpvsrrr:•ertal or
regulatory agencies.
Z. WARRANTY AND STANDARD OF CARE - Lad shall peritim-n services tar Chent. ring ganeraDy adapted laboratory practices. In the were any portion of the Services tails to ccroy wan
this warranty obligation and Lac is prarttotiy noa!ied in wrrtmg poor to 30 days atror vn>a,e;on of s_cii porion of ins Sennac. Lao wil prompty re -perform such ponjen or the Services. or if
ro.pedomtanss as fmpr2r.cable, Lab will re'unc the amount of Qxroensatton paid to Lab to: such Ocnjon of The Services. The rernsdies sattarth herein are exetlrxire. -
THIS WARRANTY !S IN LIEU OF ALL OTHER WARRANTIES. NO OTHEcii• WARRANT', EXPRESSED OR IMPLIED. INCLUDWG WARRANTIES OF MERCHANTABP :.Y AND
FITNESS FOR A PAnT!C:)LAR PURPOSE IS MADE OR INTENOvD SY FURNISHING AN ORAL REPORT OF THE ANALYSIS RESULTS OR BY ANY REPRESENTATIONS MADE
RE(6;RDtNG TrlE LA9'S SEgViCES,
3. DISCLAIMER OF CONSEOUENTIAL DAMAGES . 1^ no eves, soak Lab o- ctieh+ bs stale to the oche' fa, any spscaT. inc4rec r.:iderna-° Cr apseCser::a Css or cz: a_�m.
A. ' - LIMITATION OF LIABILITY - TM total li=ky or Lab whether in contract, tor; (including naghgome whether sole or Cond.irmt), or other rise arising our al. mnneaeo with or resOftsty-rm.m.
the services prowoaC pun uant:o this ASreeriein; Snas rear ex Sled the Iptal fees ParC Oy Cieril DurSUant td This ASreemehL -
5. REPORTS - In mrrwcion wan trio performance C trip Services. Lab snalf deliver to Chem, for C,am's sale use, one or more reports Cr:Laser vv=an oocurnerinii refiecung Se!vaes Drovioad.
the results of sum Services or Lab's evaluation of 1ne results of suCn Services. A;I reports and wrmen documents delivered to Chem are hWrurrints reflecing the sarvicas �roviced by La,
pursuant to finis Agreeman! and are rnaoe avaianw tar C4nts use suciee to the h.-TAtr,afts of ihs Agreement. All such reports, other *=On aoarmenis, All anginal Giza;mares icy :ac
and worn papers prpd'JCoo by Lad in the pomarmanm at the Somms are. and -shall rom m. the solo and eseka" Property d! Lab. -
The Services, and any da:k roaxna>•noxPons. Proposals• reports. design crttaria. and rim w inlr. rmian provided by Lab to CAen: Pursuant to this Agroerrom are provided fat ate or_iuwve
use of CLieM and are not to be used or relied upon by third patties. - - -
SAFETY - Wxh resDoG to vie Porlom%Mm of the Services. Lab sriaA take safety precautions required by tederY, stale and focal Taws• rubs. regulations, stxutas or ordLmancas.
7- SAMPLES - Unless arnorw as requested. test soecvrwrs or sarples will be disposed of imavodirnely upon co d ana"is. Upon written request Lab waif retain sarmies for a
mutuaty acaeoraoa storage charge and period of time. inat the event thaarrsaee nt coain hazardous mazertals. Lab shack ahor i'drrroleton at tmtstg and at Client's expense. fa) retL n such
sanplas to Cliwr, or M) using a manlem agned by Client es gerwatur. haw such sampled transported to at lculcn somcW by Gent for Snarl disposal. Chant r"nizes and &;rem ma:
` Lab is acing as a ba ise and at no tints As=mm Mle to said wrrpies. -
8. REPRESENTATION OF CLIENT - Ciam warrants and covenant that sufToerK tunds are avaitade or volt be avasabio Croon reasiat d Lao's.itvoce to maua payrnmM In fuv for tie
Servirm pemor rac :: trio lormniLion axe plus reasoraa mynulatianexperlies area Clint &Rill be provided with cars of all reports whC.1 are cDnplefe as of tote ierTww on Iwo. Lab
and Chant waive at Omer claim ankle !rum the Iorntnation. .
i0. UNFORESEEN OCCURRENCES • 9, curing the peridrrrLaricl t% services ferovrtder, any unforeseen hazardous subslarCe. maeriaL alerrtert or carmUrusrtt or artier untamseen eonetions -
or occunsrtms are ana-urnered which, in Lab's soil judgement sigrrficamy affects Of may affee: ins servers, the risk involved in providing, the SeirviCas, dr the recommended sc e d
srrvims. Lab will pronely notify CGartt thereof. Subsequertt to that notification. Lao may. (a) if prAGjmble, in Lab's soh juttpertlra Arta with approval of Cher; oortpale the original sCCOs
of services in ao ofztwice with the procee:+res Grigrlaly agreed upon; 10) Agree with Client to Modify oho sniped ssrvees and the e1sting7e of C tatgss to induce study of the Previously
unforeseen conditions or oazurrone s, such rovis an to be. in wrtin^y and signed by the parfim and incorporated herein; or 1c) Torriinme the services eflocive on the date or notftrjon
Pursuant to me terms Of TERMINATION.
III FORCE MAJEURE . Sno,id axroleiion of any portion at tuts Sa imm be delayed tar muses beyond the reasonattia eomtol d or wildicut rho lauh cr negigence of tab including force
maisure, the tirtie for pertarnwLcs shalt be arnonoed for a period equal to fire osiay and the patties snag mrtualy agree or the utrrris arts conditions upon wnjct tow Services maybe
mr&ued- Forst Majeure induoes but s nix reC-•imad 1o. a= a(God or the public ommy, ads df the Govemmers d the Unsed Stales or of thosovara' mates, or anytoreign col mry. or
airy of ?rm-s acing in their sovereign rapacity. strides. cW irmufroctcns, freight entowgoes, and unusually swan vreather,
12 INSURANCE • Lao atW maintain at iu own anpenee the foCawng insurance subied to rmrmai industry expopipns: (1) WwWwrt's Cortperisation Invzanee for watwory obligabdrm
hTobeed by Workmen's Corrpstsauan or occupationr disease laws; Emrbyen' Liability Insurance with a lint at $100.0=00 per apdenL (Z) Cortorehensive Automwde _laaa.sy
nsuranmwith firms ii, s3D0.om. (3) General Liabixy Insurarom with imks of S1,o00,omm. Ceniticatm can fad slued upon request AenUiying details and Lomm of mverago.
13. - - NO WAIVER -No waiver by either party of" oetaut by the oihsr party in tore prrlormanm of arry provision of ms Agmemisnt shall operate as or bo cortstrwd as a waiver o! any future
dNew, whether side Or 01tfarem in Character.
14- ' —LAW TO, APPLY - The vaiday, nterpre;alim and perfarmande of this Agreement stall be govwrrod by and construed in a curdarim with the tawa of the state of North Carolina.
5- VALIDITY OF PROVISIONS . Should any ❑c'son pl our Agreemen. to detarnired to be invalid. tnen the parties is to have the itvoid provaton mmilden to as to aitam As croeely as
paeaihls:lhe rriewung of the original provision. It the provhjon can not be rewralon then rho provscn shall be dshised Irom the rewrap art the rernainder of the contrast shall be valid.
t6. `ENTIRE AGREEMENT - This Agreement represents the entire understanding at Lab ono Client and aziporsedse tfa prior agiesrrwits wfelhw wrrUen or dal treat may extSL ---
LAB HEREBY C2VES NOTICE OF ITS OBJECTION TO ANY DIFFERENT OR ADDITiDNAL TERMS AND CONDITIONS,
To the extent ttsat arty of diahrs additional or different IWM or mndkions conflict with the Terms and Conditions of this Agreement and apply to this request and agmemmriL dime Torras aril Conditions
shall parent. No Artrrd;nertt or micalfcatnn In this Agrasmoni or any waiver of any prortsions herool shall W inactive unless in wiling, signed by both pandas. Any Weronco to Cliorrrs purchase order
Or Contract on this )orm is for sa.-rtpe identification pufttosm and to asset diont's recordkeeping- At provisions d --inch purchase order or contract are spsrEica))y rejected.