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HomeMy WebLinkAboutNCG080696_MONITORING INFO_20181116STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. I /V C� � �D��� DOC TYPE I ❑ HISTORICAL FILE 0 MONITORING REPORTS DOC DATE ❑ aD18 it /(p YYYYMMDD ir '.1 MCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit: b=ap-Qrtal,ncdenr.orgf webZwQ/v /su/ng essw#tali-4 Permit No.. I_v/c/_I_I-1—I_l_l�l or Certificate of Coverage No.: Facility Name: _! sr J.,_oj-ZL G.�L�- ���1, Wry ^— — - County: ttip�e_ _ Phone No. 69 Inspector:-' 1C',r_ 11 ra - - _ - Date of Inspection Zo _ 96-1 Time of Inspection: // s1` � _ RErOVED Total Event Precipitation (inches): vh NOV 16 2018 QW4TRAL FILES Was this a "Representative Storm Event" or "Measureable Storm Event" as dew SfEhmimit? (See information below.) ® Yes ❑ No Please verify 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 "measureable 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 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 aor)roval from the local DWO Reeional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (SignatuV'of Permittee or Designee) Pagel of 2 5Wi1-242, Last modified 10/25/2012 L Out -fall Description: Outfall No. Structure (pipe, ditch, etc.) Receiving Stream: un ioi—ooi �f41,)/gy Describe the industrial activities that occur within the outfall drainage area: ki t�11A1 A.� 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors:. 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): _ _ A Z/�_ 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 L% 3 4 5 S. 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:. 7. 8. 9. 10 a2 3 Is there any foam in the stormwater discharge? 4 5 Yes Is there an oil sheen in the stormwater discharge? Yes No No Is there evidence of erosion or deposition at the outfall? Yes Other Obvious Indicators of Stormwater Pollution: No Listanddescribe pjk-ti Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition � yn may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 5WU-242, Last modified 10/25/2012 A �'. �{ MCDENR Stormwater Discharge Outfall (SD4) Qualitative Monitoring Report Forguidance on filling out this form, please visit: hhUp://portal ncdenr or /we /wa/ws/su/nndessw#tab-4 Permit No.: N/C/�/�/^/�/�/_/�/ or Certificate of Coverage No.: Facility Name: w� _�{ _��� !� �. z2,t d County: wAke Phone No. ."_ 00 - 5—d L " Inspector:. V AUS- Date of Inspection: Time of inspection: i� Total Event Precipitation (inches): Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) ® Yes ❑ No Please verify 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 "measureable 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 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 DWQ Regional Office. By this signature,) certify that this report is accurate and complete to the best of my knowledge: re of Permittee or Designee) Page 1 of 2 5WU•242, Last modified 10/25/2012 1. Outfall Description: Outfall No. Structure (pipe, ditch, etc,) J�s� Sk��� Receiving Stream: 6•1 A"",- Describe the industrial activities that occ r within the outfali drainage area:, agt-4ve 1 L}LVk hilt 2. Color: Descriibe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 1-g hl -)A.-2 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 3 4 5 S. 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 �7 3 4 5 5. Suspended Solids: Choose the number which best describes the amount of suspended i 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? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes CRD 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: A List and describe��+ {��� i r - ci�� Aq �� & ,// e,)r Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition wrl may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 5wU-242, Last modified 10/25/2012 C Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE NO. NCG08 n 6 i 6 FACILITY NAME W COUNTY _-tJjq1 e- PERSON COLLECTING SAMPLES — I env Atof 0 LABORATORY Agee- / Lab Cert. # i Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR :90)9 SAMPLE PERIOD 0 Jan -June N July -Dec or E] Monthly' (month) DISCHARGING TO CLASS 0ORW 0HQW EjTrout [:IPNA Dzero-flow ElwaterSupply []SA E]Other PLEASE REMEMBER TO SIGN ON THE REVERSE 4 0 No discharge this period' r p Da"t -all c pie (C e te 6 Od , '; 3 ilx 000w 4 -A',* �OP#QQ MYRI - K �51*56 RX W­4 xl� .11 I!, S Med "-l"'4 jspgn e WMAllid 1 An i. �?r 32 '34 E R- I N o0jFq la r.,,u il� qqj EPM K t OT 7-1 i m. V; 'NeW.,lMotof�OW113 sage, a- A=! ROR W ft"i 1 1 5i� j Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals jf 4 O.'� -P-.N6 7P'61Sfj'oiI-,6'h fV 'AM th -11 d `diGfe6gd7,,T!.PH. 1P A 6 61 x M n --&tal-­ ..T -bolid �uspen e S Z M TIMM�'Xtl PHA y �M Z; 5 Mai 4 iWif ­2R. n tsf... 2� k R'i R, �`,2,0 itm� Omw 52-,, x 10 101) For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised October 25, 2012 Page 1 of 2 C D STORM EVENT CHARACTERISTICS: Date 10-A -19 (first event sampled) 7* Total Event Precipitation (inches). 6110 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): O Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: + A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. + 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES 0 NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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, 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." Permittee) //-/3-/9 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 S W U-250 last revised October 25, 2012 Page 2 of 2 STORMWATER SAMPLING TIMELINE Friday, October 26, 20I8 6:30am — rain started (fight) 7:00am — light rain (no discharge) 7:55am — heavy rain (no discharge) 8:45am — light rain (no discharge) 4in in bottom of pond 10:15am — light rain (no discharge) pond °/2 full 11:40am — heavy rain (pond discharging) 11:55am — sample take (tss & oil/grease) 12:OOpm — pH reading — 7.87 pH Total rainfall at time of sampling = 0.4" Ph meter was calibrated on 10/26118@ 7:50am by Tony Rose Sample taken by Tony Rose, Stormwater Superintendent r aceAna1j&a1 * "M..P80amt,=" November 09, 2018 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: Stormwater Pace Project No.: 92405029 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Dear Mr. Ray: Enclosed are the analytical results for sample(s) received by the laboratory on October 26, 2018. The results relate only to the samples included in this report. Results reported herein conform to the most current, applicable TNIINELAC standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. If you have any questions concerning this report, please feel free to contact me. Sincerely, O*a, 'To - t$cu.,ond Angela Baioni angela.baioni@pacelabs.com (704)875-9092 Project Manager Enclosures cc: Ms. Robyn Snow, Town of Zebulon REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analyticai Services, LLC. Page 1 of 11 Pace Analytical Services, LLC ace ^ gall, lira' a 9800 Kinsey Ave. Suite 100 hrC. �f j Y( trG Huntersville, NC 28078 www.pwokbs.com (704)875.9092 CERTIFICATIONS Project: Stormwater Pace Project No.: 92405029 Charlotte Certification IDs 9800 KinceyAve. Ste 100, Huntersville, NC 28078 Louisiana/NELAP Certification # LA170028 North Carolina Drinking Water Certification #: 37706 North Carolina Field Services Certification #: 5342 North Carolina Wastewater Certification #: 12 Asheville Certification IDs 2225 Riverside Drive, Asheville, NC 28804 Florida/NELAP Certification #: E87648 Massachusetts Certification #: M-NC030 North Carolina Drinking Water Certification #: 37712 South Carolina Certification #: 99006001 FloridalNELAP Certification #: E87627 Kentucky UST Certification #: 84 VirginiafVELAP Certification #: 460221 North Carolina Wastewater Certification #: 40 South Carolina Certification #: 99030001 VirginiafVELAP Certification #: 460222 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 aceAnaljdical • w w.pacelabs.cnrrr SAMPLE ANALYTE COUNT Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: Stormwater Pace Project No.: 92405029 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92405029001 Stormwater #1 & #2 EPA 1664E JMS 1 PASI-C SM 254OD-2011 CRV 1 PASI-A 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 aceAnalytical s www.pacams.com ANALYTICAL RESULTS Project: Stormwater Pace Project No.: 92405029 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Sample: Stormwater #1 & #2 La6 ID: 92405029001 Collected: 10/26/18 11:55 Received: 10/26/18 14:40 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 1664B Oil and Grease ND mg/L 5.0 1 11/09/18 04:54 2540D Total Suspended Solids Analytical Method: SM 2540D-2011 Total Suspended Solids 18.6 mg/L 3.8 1 10/30/18 20:17 Date: 11109l2018 03:15 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC, Page 4 of 11 aceftlytical. www.pttpelabo-oom QUALITY CONTROL DATA Project: Stormwater Pace Project No.: 92405029 QC Batch: 441311 Analysis Method: EPA 1664B QC Batch Method: EPA 1664E Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92405029001 METHOD BLANK: 2423457 Matrix: Water Associated Lab Samples: 92405029001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Oil and Grease mg[L ND 4.8 11/09/18 04:49 Pace Analytical Services, LLC 9600 Kincey Ave. Suite 100 Huntersville, NC 28078 {704}875-9092 LABORATORY CONTROL SAMPLE: 2423458 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Oil and Grease mg/L 38.5 36.5 95 78-114 MATRIX SPIKE SAMPLE: 2423459 92404990003 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Qualifiers Oil and Grease mg/L 15.4 40 51.5 90 78-114 Results presented on this page are in the units Indicated by the "Unite" 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: 11109/2018 03:15 PM without the written consent of Pace Analytical Services, LLC. Page 5 of 11 aceAn4 tical. WWW..paceda6s.cvrlr QUALITY CONTROL DATA Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: Stormwater Pace Project No.: 92405029 QC Batch: 439304 Analysis Method: SM 2540D-2011 QC Batch Method: SM 254OD-2011 Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92405029001 METHOD BLANK: 2414421 Matrix: Water Associated Lab Samples: 92405029001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg1L ND 2.5 10/30/18 20:15 LABORATORY CONTROL SAMPLE: 2414422 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Suspended Solids mglL 250 246 98 90-110 SAMPLE DUPLICATE: 2414423 92405026002 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 34.5 36.2 5 SAMPLE DUPLICATE: 2414424 92405069004 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mglL ND 7.3 Results presented on this page are In the units inditated 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 f0, Date: 11/09/2018 03:15 PM without the written consent of Pace Analytical Services, LLC, Page 6 of 11 acmnalyfrcal wWW,PVC OB.onm QUALIFIERS Project: Slormwater Pace Project No.: 92405029 DEFINITIONS DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot. NO - 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. Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 POL - 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. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI - The NELAC Institute. LABORATORIES PAST -A Pace Analytical Services - Asheville PASI-C Pace Analytical Services - Charlotte REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 11 /09/2018 03:15 PM without the written consent of Pace Analytical Services, LLC. Page 7 of 11 aceAnalytical www,mcW3ftcam QUALITY CONTROL DATA CROSS REFERENCE TABLE Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: Stormwater Pace Project No.: 92405029 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92405029001 Stormwater 41 & #2 EPA 1664B 441311 92405029001 Stormwater #1 & #2 SM 2540D-2011 439304 Date: 11 /09/2018 03:15 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 8 of 11 Laboratory receiving samples: Asheville ❑ Eden❑ Greenwood ❑ Fluntersville ❑ Ralelgh Mechanicsville[] Client Name: Pro;ert a: to n' Courfar. []Fed Ex ❑UPS USPS ❑Client ❑ Commerdaf space ❑Other: Custody Seal Present? []Yes �@ha Seals Intact? ❑Yes ❑No IJO#:92405029 Jill ,I,N I I991191I I IB uatefrmuais rrfrson txamrmng i ntvnca; Packing Material: ❑Bubble Wrap IoBubble Bags ❑None ❑ Other Bioloillcal Tissue Frozen? Thermometer. � ❑Yes ❑No []N/A ;.I IR Gun ID: Type of Ice: 75et []Blue []None Cooler Temp ('C): _ �, 3 Correction Factor: Add/Subtract (t o. (} - � - Temp should be shave freezing to 6'C Cooler Temp Corrected -C : ❑SImpfes out of temp criteria. Samples on Ice, cooling prccess has begun USDA Regulated Sail ( N/A, water sample) Did samples originate i a quarandne zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (Internelonally, nYes nNn inr udina Hamil and hr to Rlcol? I—lYe's IINa Comments/Discrepa Chain of Custody Present? JOY, ON. 0 N A 1. Samples Arrived within Hold Time? pyes ❑No ©NIA 2. Short Hold lime Analysis (<72 hr.)? Yes No ONfA 3. Rush7urn Around Time Requested? LJyeI 04N. NIA 4. SuffldentVotume? I@Yes OND A S. Correct Containers Used? _pacLContainercU=e`, . es ". Ye:•LIN.0O3 C]No QN/A N/A..... 6. Containers Intact? c3 QNo EINIA 7. Dissolved analysis: Samples Field Filtered? ❑Yes No N/A 8, Sample Labels Match COC? -Includes Date/Time/ID/Analysis Matrix: ;@yes ❑Na ❑N/A 9. Headspace In VOA Vials (>5-6mm)7 DYes QN0 /A 10. Trip Blank Present? Trfp Blank Custody Seals Present? QYes ❑No DO No p1%A /A 11. COMMENTS/SAMPLE OLSCREPANCY _ Lot ID of split containers: CLIENT NOTIFICATIONIRESOLUTLON T Person contacted' OateMme: Field Data Required? ©Yes ,K Na Project Manager SCURF Review: Data: Y Project Manager SRf Review: Date: Page 9 of 11 3 v v G A f0 s 0 a � 3 Qt Y � A b ry_ A 3 eb Q4 n r 0 ~ n a � to W M M 9 n o CCD CL a � G a n f9 � w Y y d ro a C c' P 0 g 3 1 Remo BP4U•125 mL Plastic Unpreserved (N/A) (Cl-) SP3U-250 mL Plastic Unpreserved (N/A) MU-500 ml Plastic Unpreserved (NIA) BP1U-1 liter Plastic Unpreserved (NIA} BP45.125 mt Plastic H2SO4 (PH < 2) (C[.) MN-250 mt plastic HNO3 (pH <2) BP4Z-125 mt Plastic ZN Acetate & NaOH (>9) 1 I BP4C-125 mL Plastic NaOH (pH > 12) (Cl-) WGFU-Wide-moulhedGlass jar Unpreserved AGIU-1 liter Amber Unpreserved (N/A) (CI } zzzAG1H-1 I1ter Amber HCI (pH < 2) AG3U-256 mt Amber Unpreserved (N/A) (Cl-) AGI--1 liter Amber HZSO4 (PH < 2) AG35-25(1 mL Amber H2504 (pH < 2) AG3A(OG3A)-25D mLArnber N1440 (N/A)(CI-) OG9H-00 ml VOA HCI (N/AI I a. VGST-40 mL VOA Na25203 (N/A) j, V69U-40 ml VOA Unp (NJA) 0G9P-40 mLVOA H3PO4 (N/A) VOAK (6 Vlsls per klt)-5035 kit (N/A) vJGx (3 vlais per kit)-vPH/Gas kit IN/A) SPST-125 mL Sterile plastic (N/A — lab) SP2T-250 mI.SterilePlastic (N/A —lab) SP3A-250 mL Plastic (NH2)25O4 (9.3-9.7) AGOU-1aD mLAmber Unpreserved vlais (N/A) VSGU-20mL5dntillatlonvl3ts (NIA) DG9U-40 mL Amber Unpreserved vials (N/A) tun 4 ao P1 m p � N a 7c- 3 a a 3 cr X 1 T O O CT fD � n A C Q C o o Cr C CL A T A p ro o N � y M !a o = a O � w � � CHAIN -OF -CUSTODY 1 Analytical Request Document o The Chain-ol-Custody is a LEGAL.. DOCUW ENT. WI relevant fields must be completed acwrately. a� Section A SwcUon C cry R.—,6-d fJ1..t I n_.. . M O_ Cacvan, Zae.,un Crown co Report Ta ,t S After ion: AddrDss: 450 Fast Mogan SU%ot Copy To: Company Marne: ZebuiM NC 275V Addrasi: Emad:jt-4:3-5j—Purcsaee Orew e: Pew cw":. PI>ene: 9l8 sm I Fax PFOj= Name'. Stombywer Pace PFojep Manager• wbaioni UEs.eom. ..::� � r, • .. .-. . . "`• .....t�rE.;<'r'•St�ii i Requested die oat= Propxs e: Pace PWds M: IM&t _ NC fir.+✓{'� - R FAna1 FLU end.CrWe., M cooE COLLECTED = Preservatives Y' :r, r : Fu '•_r,. •.;'. ' is Odr4Jt♦~.- Wr W7 S Frngp P S SAMPLE 1D �° w Ono Char=ter wtP. i START END per nom tivP {A.7, 6-2 1. Ak AA •1 r' U Sample Ida must t be wd4n..tw Ts F W J t}w Y O : rtr i$S LU � O 6 � 'a � i z � PATE TIME DATE TIME w � x 2 i O � '�i h O IN IU LE- � SE L L 1 V TI Vj�+.t:5.-�.�i^,. BY���'y},•ice}.i.;*��'� y%c.'iREL1Eb61'FA1cFtl-fA���`�. �AfEr�.u-:%'t"�^yE^ �+:i-� �¢ a',�/.r�,}.yrF!!a 110Ff�i`: ..,y-}yy� • y--.,"..i�_,� :.c�+y' -:IF. ��`'.�'.::'%YI:7i;-.5�i�.�':. !R"a!•iYisY/ � J:..W`f}!'ni :Sa'f . �.G`'FiS'��'. �Pi�[-h i'-1::s•�.1 '�+.±r RC:i oil. :I1.1:�1� .'.S,'�':" a*e. P .,441 0 '. �ine � - f • Ajlt% SNMF'.L'ER�UPF� .� 7Ry-•t.v,.r r -� t ✓... • ;...+.. Pfwa rtvm or SAMIPLew , �. CL 8 g U Z MGMAT M of SAYJILM- riATt: Si9hedc w C Semi-annual Stormwater Discharge Monitoring ReRort for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE NO. NCG08 0 ­r FACILITY NAME aw, 0.+ COUNTY CJA�e PERSON COLLECTING SAMPLES Jd- LABORATORY P6� 6- Lab Cert. # /9 Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR Qbj 9 5 A� _J�LE4ERIOD N Jan -June [:] July -Dec RE( E] Monthly' (month) J 111ISf HA [:]Trout I,JFGING TO CLASS 0ORW E:]HQW [-]PNA UN k 18 EjZero-flow E]Water Supply E]SA CEN I '-<AL FILES 00ther DWR SECTION - PLEASE REMEMBER TO SIGN ON THE REVERSE 4 F-1 No discharge this period' 7. i ' a I C TO 1 n 'Non-polar: HIEMktoto ne. ilN64 i,u sag4n1 Rt � �Annualaverage3gal/,mo-; `N0 -- -xS ' ii X ­ SGA ,l 1 lard1 -07 c Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? —yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum -Bulk Stations and Terminals bif R ;'M "­R 049O NtZ e&n iM6 monTolareyn-ana3r-ease/i,mxryAivNeT nouW0.--T -- it al ga�-u,p _ 4 ;g MLVP.jr t gj" �ipx 1i.-II-1k-P - -n� W,100Isqpg?M1 A p 3- 17.- 1 an r�,91L IL 7.9 1 I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised October 25, 2012 Page] of STORM EVENT CHARACTERISTICS: Date ,5 11 14 (first event sampled) Total Event Precipitation (inches): _ Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 910 Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART Il SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and _one -cosy of this DMR, including oil "No Discharae" reports, within 30 days of receipt of the lab results for at end of monitoring period in the case o "No Discharge"' reports) to: Division of Water Quality Attn: DWQ Central files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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, 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." (Signattj;4'of Permittee) (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.orglweb(wc/ws/su/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 a .e..ra�a� RCDE R Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit., hU://.portal.qcdenr.grg/MbIwq/ws/su.4nDdessw#tab-4 Permit No.: _ or Certificate of Coverage No.: Facility Name: �� f ze-'j AL61--c War kS _ County: lilyd — - Phone No. 6Iju- o?6a- Inspector: `I ` �ns e- Date of Inspectio - 1-7- 18 Time of Inspection: _ I ' aA_1 Total Event Precipitation (inches): W 10 Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) 9 Yes ❑ No Please verify 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 "measureable 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 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 DWQ Re a] Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signat'i'ire of Permittee or Designee) 5WU-242, Last modified 10/25)(2012 Page 1 of 2 1. Outfall Description: Outfall No. -,I- - Structure (pipe, ditch, etc.) r)rnPan &jJA d;),h Receiving Stream: _ ttn nAn� � r:b(. nr~r Describe the industrial activities that occur within the outfall drainage area: gijX - e [,'moo W �1-ti oiAS r GiifStf Jol�sl q S loi , A.,,95e /ud. oron i ;261 S,'rM Jed 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: %Shl_ f,7 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): /Y 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 S. 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: 0 2 3 4 5 r b. 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: . 7. 8. 9 f T 3 Is there any foam in the stormwater discharge? 4 5 Yes Is there an oil sheen in the stormwater discharge? Yes Is there evidence of erosion or deposition at the outfall? 10. Other Obvious Indicators of Stormwater Pollution: List and describe c -M-� h de" n«) "1 .'2 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 10/25/2012 7 �. MCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit- htW:L/portal.ncdenrrore/weblwq/ws/su/nodessw#tab-4 Permit No.: �I/C/_/_/_/_/_/—/�/ or Certificate of Coverage No.: Facility Name: —Sown u'_ z'L.-I.', *),c— County: OAkG Phone No. �1419- 20 • 5_,965 Inspector: _� .Ao.Le_ - _ _ Date of Inspection: 13 Time of Inspection: _ J ` 3 Arn _ Total Event Precipitation (inches): 4 to Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below,) X Yes ❑ No Please verify 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 "measureable 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 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: �� (Signa6ure of Permittee or Designee) Pagel of 2 SWU-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. ^& is Structure (pipe, ditch, etc.) IRIS sWed V"54 S"de d A ;�� Receiving Stream: can nA,,d _4,! of LJ'✓Pr Describe the industrial activities that occur within the outfall drainage area: g1A,e,ly w 4-.� S40(alG 04 enu:0,-e4 AA ve�iJrs n],,_% 6 1 k S7ofAze 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): _ 11119 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 0 3 4 5 S. 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 0 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 evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: Listanddescribe 00A st�� ifl Swtl� 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 10/25/2012 STORMWATER SAMPLING "TIMELINE Thursday, May l7, 2018 12:20 pm - light rain (no discharge) 12:45 pm — heavy rain (no discharge) 1:00 pm — heavy rain (no discharge) pond }/4 full 1:05 pm — pond discharging, heavy rain 1:23 pm — pulled first sample (oil and grease) 1:24 pm -- pulled second sample (TSS) 1:31 pm — pFl reading — 7.91 pl-I Total rainfall at time of sampling = 0.4" Ph meter was calibrated on 5/16/18 by Tony Rose Sample taken by Tony Rose, Stormwater Superintendent , 7PacmnalJ����}ical' xwrr-pacelahs.wm Section A Required Client Information: Company_]�wn 0T ZeY7vt IU Address: — ' L-1-5 0 r -A-5 4 I0 i,-11 -St 7e6K1�r,. NG 9707 Email To: r 6n" Q �uwnci lr��tn,W P r-f 1 y - X 9. 5"08 5, Fax: Requested Due DaterTAT: Section B Required Project Information: Report 70: CODv To: >e Order No.: Name: Number: CHAIN -OF -CUSTODY 1 Analytical Request Document The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately. Page: of Section C Invoice Information: Attention: � O � � � � + 2 Company Name: Section D Matrix Codes Required Client tnformaWn MATRIX I CODE m g COLLECTED Drinking Water DW u 0 Water WT $ U O Waste Water WW n m COMPOSITE COMPOSITE Product P m START ENDIGRAB J Soil/Solid SL m p Co SAMPLE ID 00 IL N O v Wipe � Sample IDs MUST 13E UNIQUE - Tissue TS O a w t` Other OT U r z O a X a w a w LLO w ~ a TIME DATE TIME 1 5�si r, �rA1�S' OT /� C7 q+DATEn J"17 ,1 I 1,r. ' 5 1743 1.,zI3//R Z 01 (r 5-►7 rJ 1=X� 5- 17-fh 1 Barr, 3 n REGULATORY AGENCY ass: r NPDES r GROUND WATER r DRINKING WATER Quote r UST r RCRA r OTHER once: Prom Site Location ger: Profile tt: STA TE: Requested Analysis Filtered (YIN) Z T-P,-Ser,vatives Y . -0 N H An y O C T O p L c f i z z 2 0 2 } 0 L U Iaj I Pace No./ Lab I.D. ADDITIONAL COMMENTS RELINQUISHED BY 1 AFFILIATION DATE TIME ACCEPTED BY 1 AFFIUATION DATE I TIMESAMPLE CONDITIONS - R n�-_ s"�Q-�� Rn �c�rn►n� Cntrlat4j- 54K-1t 9:Yq a. �-- n I (16 `'-,ter �O / 4 SAMPLER NAME AND SIGNATURE o PRINT Name of SAMPLER: e a �} t o CJ z m z SIGNATURE of SAMPLER: DATE Signed v m i"y V ~ rn } E v a (MM)Dor(y); V) 'Important Note: By signing this form you are accepting Pace's NET 30 day payment terns and agreeing to We charges of 1.5% permonth for any invoices not paid within 30 days. F-ALL-Q-1120rev.07, 15-May-2007 Instructions for completing Chain of Custody (COC) I. Section A and B: Complete all Client information at top of sheet: company name. address: phone, fax. contact (the person to contact if there arc question-,- and vyho will receive the final report.), c-mail address (if available)_ POH, PrQjcet Name. and/or Project Number as you `vould like to see it appear on the report. 2. Section C: Invoice Information: Billing information is included in this section. This infonnation should include the name: and address of the person receiving the invoice. 3. Quote; Reference should be: completed if a quotation was provided by Pace Anab, ical. The Project Manager, and Profile No. will be completed by Pace Analytical Services. 4. Site Location: A separate COC must be: tilled out for each day of sample: collection. Record the two letter postal code for the US state in which the samples wen; collected. 5. Remulatory Agency: List the program that is guiding the work to ensure proper regulations are followed. 6. Section D: Complete a Sample. Description in the "SAMPLE ID' section as you would like it to appear on the laboratory report. The following information should also be included: the sample matrix, sample. type (G (grab) or C (composite). When collecting a composite, the; start time and end time should be documented in the respective bones. The collection time: for a grab (G) sample should be entered in the boxes marked `Composite End/Grab); Sample temp at collection (if required by state), the total number of containers. and preservative used. 7. Mark if the sample was filtered in the field by marking Y or N in 'I=iltered' row by the Analysis requested. ' 8. Requested Analysis: List the required analysis and methods on the lines provided and place: a check in the column for the samples requiring the; analysis. Additional comments should be referenced in the bottom left hand comer or include; attachments for extended lists of parameters. 9. The sampler should print their name in the space provided and sign their name followed by the date of the sampling event at the bottom of the COC in the: spaces designated for 'SAMPLER NAME AND SIGNATURE'. 10. When relinquishing custody of the samples to a representative of the laboratory or other organization, indicate the Item Numbers of those samples being transferred; sign relinquished by, date and time, and include your affiliation. *Important Note: Standard Turnaround Time is 2 Weeks/10 business days. Results will be delivered by end of business on the date due unless other arrangements have been made with your project manager. Special Project Requirements such as Low Level Detection Limits or. level of QC reported must be included on the chain of custody in the Additional Comments section. aceAnalytical� wwwpaoefahswm June 04, 2018 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: Stormwater Sampling Pace Project No.: 92385363 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875.9092 Dear Mr. Ray: Enclosed are the analytical results for sample(s) received by the laboratory on May 18, 2018. The results relate only to the samples included in this report. Results reported herein conform to the most current, applicable TNIINELAC standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. If you have any questions concerning this report, please feel free to contact me. Sincerely, Angela Baioni angela. baioni@pacelabs.com (704)875-9092 Project Manager Enclosures cc: Ms. Robyn Snow, Town of Zebulon 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 aceMalytical6 98D0 Kinsey Ave. Suite 100 Huntersville, NC 28078 www.pacelabs.wm (704)875-9092 CERTIFICATIONS Project: Stormwater Sampling Pace Project No.: 92385363 Charlotte Certification Ds 9800 Kincey Ave. Ste 100, Huntersville, NC 2807E South Carolina Certification #: 99006001 Louisiana/NELAP Certification # LA170028 Florida/NELAP Certification #: E87627 North Carolina Drinking Water Certification #: 37706 Kentucky UST Certification #: 84 North Carolina Field Services Certification #: 5342 VrginiaNELAP Certification #: 460221 North Carolina Wastewater Certification #: 12 Asheville Certification IDs 2225 Riverside Drive, Asheville, NC 28804 North Carolina Wastewater Certification #: 40 Flodda/NE1AP Certification #: E87648 South Carolina Certification #: 99030001 Massachusetts Certification M M-NCC30 VirginiaNELAP Certification #: 460222 North Carolina Drinking Water Certification M 37712 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 aceAnalytical� www.pacelabs.com Project: Stormwater Sampling Pace Project No.: 92385363 Lab ID Sample ID 92385363001 Stormwater#1&2 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 SAMPLE ANALYTE COUNT Analytes Method Analysts Reported Laboratory EPA 1664B JMS 1 PASI-C SM 2540D NAL 1 PASI-A 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 aceAnaly#ica! "M4Wcefebs cW ANALYTICAL RESULTS Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: Stormwater Sampling Pace Project No.: 92385363 Sample: Stormwater#1&2 Lab ID: 92385363001 Collected: 05/1711813:23 Received: 05/18/1814:47 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 1664B Oil and Grease ND mg1L 5.0 1 06/04/18 05A6 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 53.8 mg1L 11.9 1 05/24/18 14:55 Date: 06/04/2018 02:58 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 4 of 11 aceAnalytical, wWw.P&M0b3.0DM QUALITY CONTROL DATA Project: Stormwater Sampling Pace Project No.: 92385363 QC Batch: 413580 Analysis Method: EPA 1664B QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92385363001 METHOD BLANK: 2293447 Associated Lab Samples: 92385363001 Parameter Units Oil and Grease mglL LABORATORY CONTROL SAMPLE: 2293448 Parameter Units Oil and Grease mg1L MATRIX SPIKE SAMPLE: 2293449 Parameter Units Oil and Grease mg/L Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 2807B (704)875-9092 Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers NO 5.0 06/04/18 05:44 Spike LCS LCS % Rec Cone. Result % Rec Limits Qualifiers 38.5 37.8 98 78-114 92385604001 Spike MS MS % Rec Result Cone. Result % Rec Limits Qualifiers ND 38.5 37.5 97 78-114 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: 06/04/2018 02:58 PM without the written consent of Pace Analytical Services, LLC. Page 5 of 11 aceAnalytical .pacefabs.cam QUALITY CONTROL DATA Project: Stormwater Sampling Pace Project No.: 92385363 QC Batch: 412272 Analysis Method: SM 2540D QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92385363001 METHOD BLANK: 2286996 Associated Lab Samples: 92385363001 Parameter Units Total Suspended Solids mg1L LABORATORY CONTROL SAMPLE: 2286997 Parameter Units Total Suspended Solids mg/L SAMPLE DUPLICATE: 2286998 Parameter Units Total Suspended Solids mg1L Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 2.5 05/2411814:50 Spike LCS Conc. Result 250 244 92385254007 Dup Result Result 30.2 33.4 SAMPLE DUPLICATE: 2286999 92385342003 Dup Parameter Units Result Result Total Suspended Solids mg/L 13.0 16.2 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersvilte, NC 28078 (704)B75-9092 LCS % Rec % Rec Limits Qualifiers 98 90-110 RPD Qualifiers 10 D6 RPD Qualifiers 22 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 shag not be reproduced, except in full, Date: 06/04/2018 02:58 PM without the written consent of Pace Analytical Services, LLC. Page 135 of 11 aceAnalytica! www.psoelebs.00m QUALIFIERS Project: Stormwater Sampling Pace Project No.: 92385363 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. Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 26078 (704)875-9092 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 -Nitrosodiphenyla mine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyte is a combined concentration. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI - The NELAC Institute. LABORATORIES PASI-A Pace Analytical Services - Asheville PASI-C Pace Analytical Services - Charlotte ANALYTE QUALIFIERS D6 The precision between the sample and sample duplicate exceeded laboratory control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 06104/201 B 02:58 PM without the written consent of Pace Analytical Services, PLC, Page 7 of 11 aceAnalytical wwwpecalsbscom QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: Stormwater Sampling Pace Project No.: 92385363 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Lab ID Sample ID QC Batch Method QC Batch Analytical Method 92385363001 92385363001 Stormwater #1 &2 Stormwater #1 &2 EPA1664B SM 25400 413580 412272 Date: 06/04/2018 02:58 PM REPORT OF LABORATORY ANALYSIS This report shall not he reproduced, except in full, without the written consent cf Pace Analytical Services, LLC- Analytical Batch Page 8 of 11 ' pmwrb M.r m —=11. 1. 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Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR J017 SAMPLE PERIOD [:]Jan -June Njuly-Dec or [:] monthly' (month) DISCHARGING TO CLASS DORW DHQW F]Trout [:]P'NA E]Zero-flow F]Water Supply [:ISA []Other PLEASE REMEMBER TO SIGN ON THE REVERSE 4 0 No discharge this period' w :ate a lei R "NjM. PA- we..1 m I IST &rAk NCRek . �M -1 ULditaubpencleclAk M W� q ACM,WuRitsw, M6 9CILRt�W,(S4­-, 9XWAI!hua—rii NW4 4 4 6, i4l W W - W Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals 0 6 t f 6 11 -.,Date �%KT.4 %m 6j �7 WLE IMMY 6'4- 5 WS' -d�Grease'/ ItEP"A We' rk larjOil an thod �T ended "d �9 -� 11­Sb i H ON- �6 w 22 A V" 4EM)- -7, !&74f( ILM9 v� d &ng CW. qrmitA M 0l7An. q I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised October 25,2012 Page 1 of 2 s STORM EVENT CHARACTERISTICS: Date I/ 9 -/Z (first event sampled) Total Event Precipitation (inches): 0-5 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART 11 SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER Z REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES FIND ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an oriainal and one coov of this DMR, includina all "No Discharae" reports, within 30 dovs of receipt of the lab results for at end of monitoring period in the case_offNo Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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, 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) //-a7-/7 (Date) Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/wg/`ws/su/npdessw#tab-4 S W U-250 last revised October 25, 2012 . Page 2 of 2 STORMWATER SAMPLING TIMELINE Thursday, November 9, 2017 6:40 a.m. — checked pond, no discharge, water level 4" below discharge pipe (light rain) 7:20 a.m. — checked pond, no discharge, water level 1" below discharge pipe (light rain) 8:20 a.m. — checked pond, no discharge, water level close to discharge point 8:50 a.m. — pond discharging, light rain 9:00 a.m. — pulled first sample (oil and grease) 9:03 a.m. — pulled second sample (TSS) 9:10 a.m. — pH reading — 7.53 pH Total rainfall at time of sampling = 0.3" Ph meter was calibrated on 11 /7/17 by Tony Rose Sample taken by Tony Rose, Stormwater Superintendent acmnalytical e WWW pacelebs corm November 21, 2017 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: Stormwater Pace Project No.: 92362774 Pace Analytical Services, LLC 9800 KinceyAve. Suite 100 Huntersville, NC 28078 (704)875-9092 Dear Mr. Ray: Enclosed are the analytical results for sample(s) received by the laboratory on November 09, 2017. The results relate only to the samples included in this report. Results reported herein conform to the most current, applicable TNIINELAC standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. If you have any questions concerning this report, please feel free to contact me. Sincerely, lc- " . Angela Baioni angela.baioni@pacelabs.com (704)875-9092 Project Manager Enclosures cc: Ms. Robyn Snow, Town of Zebulon 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 5aneAna1j&a1" wwn:pecsl b&= Project: Stormwater Pace Project No.: 92362774 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville. NC 28078 (704)875-9092 Charlotte Certification IDs 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 LouisianalNELAP Certification # LA170028 North Carolina Drinking Water Certification #: 37706 North Carolina Field Services Certification #: 5342 North Carolina Wastewater Certification #: 12 Eden Certification IDs 205 East Meadow Road Suite A, Eden, NC 27288 North Carolina Drinking Water Certification #: 37738 CERTIFICATIONS South Carolina Certification #: 990060D1 FloridalNEL.AP Certification #: E87627 Kentucky UST Certification M 84 Virginia/VELAP Certification #: 460221 Norlh Carolina Wastewater Certification #: 633 Virginia/VELAP Certification #: 460025 REPORT OF LABORATORY ANALYSIS This report shall not he reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 2 of 11 aceAnalytical wwwpecelab&c0M SAMPLE ANALYTE COUNT Project: Stormwater Pace Project No.: 92362774 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersvi0e, NC 28078 (704)875-9092 Ana lytes Lab ID Sample ID Method Analysts Reported Laboratory 92362774001 Stormwater #1 SM 2540D CTB 1 PASI-E 92362774002 Stormwater #2 EPA 1664E JMS 1 PASI-C 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 aceAnalytical" »ww'PWObxcom ANALYTICAL RESULTS Project: Stormwater Pace Project No.: 92362774 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 2807B (704)875.9092 Sample: Stormwater #1 Lab ID: 92362774001 Collected: 11/09/17 09:03 Received: 11/09/17 13:26 Matrix: Water Parameters Results Units Report Limit OF Prepared Analyzed CAS No. Qual 2540D Total Suspended Solids Analytical Mothod: SM 2540D Total Suspended Solids 18.4 mglL 2.5 1 11/10/17 12:39 Sample: Stormwater #2 Lab ID: 92362774002 Collected: 11/09/17 09:00 Received: 11/09/17 13:26 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 1664B Oil and Grease ND mg1L 5.0 1 11/21/17 04:58 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 11 /21/2017 03:06 PM without the written consent of Pace Analytical Services, LLC. Page 4 of 11 aceAnalytical" w wpacalabacorn f QUALITY CONTROL DATA Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: Stormwater Pace Project No.: 92362774 QC Batch: 386229 Analysis Method: SM 2540D QC Batch Method: SM 25400 Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92362774001 METHOD BLANK: 2142177 Matrix: Water Associated Lab Samples: 92362774001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg/L ND 2.5 11/10/17 12:30 LABORATORY CONTROL SAMPLE: 2142178 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Suspended Solids mg1L 250 246 98 90-110 SAMPLE DUPLICATE: 2142179 92362760004 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 22.6 417 179 D6 SAMPLE DUPLICATE: 2142180 92362796001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mglL 372 362 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: 11 /21/2017 03:06 PM without the written consent of Pace Analytical Services, LLC. Page 5 of 11 aceArralytica! wwrrpacelabs.rom Project: Stormwater Pace Project No.: 92362774 OC Batch: 387739 QC Batch Method: EPA 1664B Associated Lab Samples: 92362774002 METHOD BLANK: 2151120 Associated Lab Samples: 92362774002 Parameter Units Oil and Grease mglL LABORATORY CONTROL SAMPLE: 2151121 Parameter Units Oil and Grease mglL Pace Analytical Services, LLC 9800 KinceyAve. Suite 10o Huntersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA Analysis Method: EPA 1664E Analysis Description: 1664 HEM, Oil and Grease Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 5.0 11/21/17 04:53 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 40 37.6 94 78-114 MATRIX SPIKE SAMPLE: 2151122 92362746001 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Qualifiers Oil and Grease mglL ND 40 37.0 93 78-114 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: 11/21/2017 03:06 PM without the written consent of Pace Analytical Services, LI-C. Page 6 of 11 aceAnalXical *"..paoetabs.c= QUALIFIERS Project: Stormwater Pace Project No.: 92362774 DEFINITIONS Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 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 Quantilation Limit. RL - Reporting Limit. 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. Pace Analytical is TN accredited. Contact your face PM for the current list of accredited analytes. TNI - The NELAC Institute. LABORATORIES PASI-C Pace Analytical Services - Charlotte PASI-E Pace Analytical Services - Eden ANALYTE QUALIFIERS D6 The precision between the sample and sample duplicate exceeded laboratory control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 11/21/2017 03:06 PM without the written consent of Pace Analytical Services, LLC. Page 7 of 11 aceAnalytical" xww.pacdabacom QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: Stormwater Pace Project No.: 92362774 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92362774001 Stormwater #1 SM 2540D 386229 92362774002 Stormwater #2 EPA 1664B 387739 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 11 /21/2017 03:06 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 11 Document Name: Document Revised: 7uty 25, 207 * Sample Condhfon YpT R SCUR} pap 1 of 2 Document No.: Issuing Authority: F-CAR CS-033-Rev.D3 Pare QuaittV Office Asheville ❑ Edeno Greenwood ❑ Huntersvllle 0 Raleigh, ///j��� /�M charilles Niel-1 M11[YlentNetne: f/Ia�J 9236 • 74 Project ❑DUSPS- Commercial Pace UPS []Other._ lll9lll23l16271174 Custody Seal Present? ❑Yes to Seals Intact? Dyes WNa DataJlnhtahparsanEaamin]ngCanten—- 4:��i+41 packing Material: []Bubble wrap gMble Bags []None ❑ Other Biological Tissue F teni Thermo r. 1`� Jet Osstre ❑None []Yes ❑O J11A IR Gun ILk'� S'I Type of la: •�.—t4t�tRiVR%actor:---fAO}ar�101p-COri2C:a�{�C1r—_ � �NR1�ShBkad-tie-abBvC-fTeE.4i11�-t9�c— []Samples out of temp crterla. Sample$ on has Sagan USDA Regulated Soil (�N/A, water sample) 0kl samples o nate In quarantine tone wtthtn the United States: CA, NY, or SC (check reaps)? Dld samples originate froma foreign source r'mt 13Yes o Incluti NaAil and Puerto Rico)? Chas cooling process l.ommenb Disce ChaSn of Custody Prewat7 es No /A 1. Samples ArrFmd w0in Hold Time? a ' Elft A 2. Short Hold TimaAna ais e72 hr.)? UY. o N/A 3. Rush Turn Around Time RequesteR o,. EK. nNIA 4. Sufficient Yolume7 es ND A 5. Correct Containers Used? -Pace Contalners Used? es es ON. No ❑N!A N A G. Con tainersIntact? a OL. N/A 7. Dissolved are sis: Sam les Field Flhered? No ZkA g, Sample Labels Match COC? -hdudeilDaWnmeADWatVsIS Matrbr: Ya ONa QN/A a Heads ace In VOA Vials �S- m 7 QYes QND A 10. Trip Blank Present? T Blank Custody seals Present? C]Yes Yes [IN* C11,19 N/A A 11. CLIENT NDriFICATIDN/RESDLurtoN Person Contacted: Comments/Sample Discrepancy: u DatelTlme: Field Data Raqutredt ©Yes LJNo "act Manager SCURF Review: _ d _ Date: 1 I Pre)ect Manager SRF Review: C1 l 1 1V n Date: Note: whenever there Is a d4crepaacy affecting North Carolina eompitanoe se mples, a copy of this form will be sent to the North Carorma DEHNR Coruncatl Dnlce (i.e. Qut of hold, Incorrect preservative, oat of temp, Incorrect oontalnen) Page 9 of I I Document Name: Dowment Revised: July 25, 2 27 C@ fCa�• Sample Condition U Reme! sa Page 2 of 2 Document No,: Issuing Authorltyi t F-M-M-033-R1v.Q3 Pau. Ouallw r ira *Che if pH and/ordechlodnation• —project� W0 923627?4 is verified and within the acceptance range for preservation samples. PM: AMB Due Dale: 11/27/17 "Bottom half of box is to list number of bottles CLIENT: 92-Zebu 1 on 1U-'UUUL.U..;UU' UU..4U U U1 YI D M ■ a 04►1►�►ii0�l ME ISO 0 10 110 0 0\ilk a M 0. ���iii����ii�i��i�i■iiiiiii pH Adjustment log for Preserved -Samples Semple m Type of P=eurratlae PH upon MOM pate pmnmwftn Wlomd flme PMMx atlon adl�ted Amoum of Preeenattve added Fats Page 10 of 11 �sgwr w wa lLdred Clam Wannndan: rw,r,u edOf a 8 r ww wr ww vrr vnv Y SAMPLE ID ° a ; erwr Oa+ Cl.aractar Var bm (A-4041.i s- . 9a.4" tdw rwet a w9qw CR i rurc r CHAIN -OF -CUSTODY ! Analytical Request Document The Chab-Of Cwtody is a LEGAL DOCUMENT. All relevant fields Rust tye [anVleted Sacra,C END n 4 e rNa� o �jpyyQg {z '1c 11c: � 0 I -,i 4Le., .„ e- I I I I I-f l I I Na ILocadon _ wC 7 a O CD M a .iru� ,0 NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit: h t I/portal,ncdenr.org/web/wg1ws/suInadessw#tab-4 Permit No.: �f/C/^/_/�/�/_/�/�/ or Certificate of Coverage No.: N/C/G/ Q1$/ D/ 6/_q/ lL/ Facility Name: =u­_ A _ZC- 0-6 ALb 1; c LJ,rK-s County: W "e. Phone No. q 1 A - ,Wi I - 519 95 Inspector: T= ,,V r4a3-e- Date of Inspection: _ i/_1 17_ Time of inspection: c7> /r R,-,) Total Event Precipitation (inches): _ D, 1 Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) ® Yes ❑ No Please verify 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 "measureable 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 i permitted site outfall. The previous measurable storm event must have been at least 72 hours i 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or Designee) Page 1 of 2 sWU-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. . j;l- _ Structure (pipe, ditch, etc.) (doss 5e ��� �yrs� 5:c4� Receiving Stream: unIA-A Ir;!j P-�nnl . L., ale Ro,r Describe the industrial activities that occur ithin the outfall drainage area: Grp"` I Af T 16� 5'lat &e oT efAwe-e/A A -A ue k.eirs ,71-t b..lk s'/.: 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: ha 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): _ ALA d. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 0 3 4 5 S. 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: © 2 .3 4 5 7. Is there any foam in the stormwater discharge? Yes No B. Is there an oil sheen in the stormwater discharge? Yes o 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe oj�Wl ;f 'I" _ 5' j ShAOx `® 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 10/25/2012 Semi-annual Stormwater Discharge MonitoringRe ort Rep or North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted �— Q- 1% CERTIFICATE OF COVERAGE NO. NCG08 p _�_ g b FACILITY NAME =&wn of ZbLLn ubb c url( COUNTY b 14a PERSON COLLECTING SAMPLES LABORATORY NcG Lab tert. # lc3 Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements ECEPOPE! B COLLECTION YEAR c?017 SAMPLE PERIOD ® Jan -June ❑ July -Dec APR 18 2017 or ❑ Monthly' month DISCHARGING TO CLASS ❑ORW ❑HCtW ❑Trout ❑PNA CENTRAL FILES ❑Zero -flow [:]Watersupply [:]SA DWR SECTION ❑Other PLEASE REMEMBER TO SIGN ON THE REVERSE 4 No discharge this period' •O�u�ytqfall No -„er , ; , '� Date .Sample Collected,, .. ,� m_o/dd/y_r,��; � m.20 �. 00556 ; tY�.Y .�.C9.�o-'Y•Y�Y-'.Y+Y �' ��' • TotalsSuspended .., '4. . a ..'e'^�3.+ , ,! t, Sol,tds, rng/L-, - ` � y ,I, _ L -, �pFi,r` -, ' - - ___- � StancJard. units ;; .-�i�..yam :,. ��. -.- �.. ,•. Non -Polar Oiloand Grease%iP.HEPA `?irs'. �'F 'e` -e =. ..... M_ ethocl,1664s(SGT;HEMj mg%L y'; �.� rn...��....�g-•ft�-1.7.�.. .. ,_d "•'fG'f y-'^: y.}�•,� ,New,;MbtorOil.Gsage ;. .4��'..`�e' s.34-zF�ri f".��u Ai1n.yar erage`gal%m-o :Benchmarks � ' 50 or 1 D�see }iermit �l llVithin 6 0� 9 a � �? ❑ 2 'gge" ,'Fes r; Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals Ouwl g xiis '.} NO� - z..: '� Collected, , ;mFTo ,cld r ; � Z ;OOS56 _ �-"•x' ic�e:..e....�s .a:s" a"pus. •:,.,fir -�- ; Non=Polar�0il and>Grease/TR1=I EPAMethod _': :1664+ SGT`kiEM m�. D053D _. rr- u.w^�o"v* i:r-•� _ Tatal%SuspendedSol�ds, �; ..�,.s1C m /L _. � WO };r•,35am/ate ,'-.-,.5d. Standardun�ts lvll iR r, t,Limi .. ..r -:-3"c. 0 _ - a— _ T5 " � L �� � ` SQkor 100'See9permiti ;-A _ ,- — ',� - P ,H : � 6 � 9 0� i For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised October 25, 2012 Page 1 of 2 STORM EVENT CHARACTERISTICS: Date 3-3i -/7 (first event sampled) Total Event Precipitation (inches): 1. Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS. • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER Al ANY ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mall an oriainal and one copy of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results for at end of monitorina Period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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 vtf-e-H-n—g-thN information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there si n Senalties4fors itting false information, including the possibility of fines and im ison ent for knowing violations." /Z /7 (Signs ermittee) (Date) Additional copies of this form may be downloaded at: http://portal,ncdenr.org/web/wq/ws/su/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of'2 to NCDEN Stormwater Discharge Outfaii (SDO) Qualitative Monitoring Report Forguidance on f lling out this form, please visit: h ortal.nc enr.or. web w s su n de sw#ta -4 Permit No.: Nl�l_/—l�l�l�l^I—1 or Certificate of Coverage No.: N/CIGI vII vl�l �l%/ Facility Name: 26-1w_+,1-� Lblk� FAe:L� County: (,)X-e- Phone No. 4'fq-? -.57VT Inspector: Date of Inspection: 1 Time of Inspection: `7: 7,5 Av^ Total Event Precipitation (inches): Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below,) Kyes ❑ No Please verify 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 "measureable 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. i A "measurable storm event" is a storm event that results in an actual discharge from the i 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 l interval is representative for local storm events during the sampling period, and the permittee ? obtains approval from the local DWQ Regional Office. i By this ig ur , certify tha (Signature of permittee or DE s report is accurate and complete to the best of my knowledge: SWU-242, Last modified 10/25/2012 Pagel of 2 1. Outfall Description: Outfali No. —I — - Structure (pipe, ditch, etc.) _.�(1'1A �`t�►+.1��^ Receiving Stream: wJ Nfwgb V L. t Jeti Describe the industrial activities that occur within the outfall drainage area: !-Scru Y-rwL-s , YdA>', a,,la,!eI pet�L-q 1,64- 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: _ L, IAnJ 3. Odor: Describe any distinct weak chlorine odor, etc.): 1 that the discharge may have (i.e., smells strongly of oil, 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 (D 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 20 3 4 5 7. is there any foam in the stormwater discharge? Yes j Np 8. Is there an oil sheen in the stormwater discharge? Yes 9. is there evidence of erosion or deposition at the outfall? Yes DNo 10. Other Obvious Indicators of Stormwater Pollution: List and describe 0" FPVI� .4 �Eo,Jd ARE T-- -d 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 5WU-242, Last modified 10/25/2012 A !r NC. DENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on f lling out this farm, please visit: hnp://portal.licdenr.org/weblwq/ws/su/ripdessw#Lab-4 Permit No.: N/C/—/—I—I—I�I^l`l or Certificate of Coverage No.: N/C/G/w-%/ U/kd/ A' Facility Name: _ M4ginK Z66—xw 4jab-c-bbLkxl P�-OT.Ir1x County: (kce Phone No. — � qtR- &J- Sja 5 Inspector: ei ors.-O �+ � �,.eGa a� blLc Wo2Yti Date of Inspection: Time of Inspection: Total Event Precipitation (inches): Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event"or "measureablestorm 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 "measureable 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 1.0 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 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 DWQ Regional Office. By this signature, I certify�this report is accurate and complete to the best of my knowledge: (Signature of Permittee or D SWU-242, Last modified 10/2S/2012 Page 1 of 2 I. Outfall Description: n Outfall No. Z Structure (pipe, ditch, etc.) (n S swe ode Receiving Stream: -tv, b'GF L. e Describe the industrial activities that occur within the outfall drainage area: CAP e fi -I— 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: _ l.tjk�- Thin) _ 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): 1 664 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: 0 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: (D 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 S 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe oukFA it as dale W orJ Ub l 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 10/25/2012 STORMWATER SAMPLING TIMELINE FRIDAY, March 31, 2017 5:15 a.m. — light rain 6:00 am — no discharge (light rain) 6:33 a.m. — water in pond approx. 10 inches below discharge pipe (light rain) 7:25 a.m. — discharge begins (heavier rain) 7:42 a.m. — Sample taken (light rain) 7.52 a.m. — pH reading — 7.91 pH Total rainfall at time of sampling = 0.4" Ph meter was calibrated on 3/28/17 by Tony Rose Sample taken by Chris Ray, Public Works Director laceAnalytical" www.Aecafeltacam April 11, 2017 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: Stormwater Pace Project No.: 92335412 Pace Analytical Services, LLC 9800 KinceyAve. Suite 100 Huntersville, NC 28078 (704)875-9092 Dear Mr. Ray: Enclosed are the analytical results for sample(s) received by the laboratory on March 31, 2017. The results relate only to the samples included in this report. Results reported herein conform to the most current, applicable TNIINELAC standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. If you have any questions concerning this report, please feel free to contact me. Sincerely, wo- `-h`l , `A� Angela Baioni angela.baioni@pacelabs.com (704)875-9092 Project Manager Enclosures cc: Ms. Robyn Snow, Town of Zebulon P.C" I"J 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 acmnalXiical0 WmPecebucom Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 CERTIFICATIONS Project: Stormwater Pace Project No.: 92335412 Charlotte Certification IDs 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 South Carolina Certification #: 99006001 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 VirginiWVELAP Certification M 460221 Asheville Certification IDs 2225 Riverside Drive, Asheville, NC 28804 FloridalNELAP Certification #: E87648 Massachusetts Certification #: M-NC030 North Carolina Drinking Water Certification #: 37712 North Carolina Wastewater Certification #: 40 South Carolina Certification #: 99030001 VirginiaNELAP Certification M 460222 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 aceAnalj6cal wnw.pacelaeamm Project: Stormwater Pace Project No.: 92335412 Lab ID Sample ID 92335412001 Stormwater #1 92335412002 Stormwater #2 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 SAMPLE ANALYTE COUNT Analytes Method Analysts Reported Laboratory SM 2540D CJH1 1 PASI-A EPA 1664B JMS 1 PASI-C 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 a aceAnaIXical sww.pacelahsoom ANALYTICAL RESULTS Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersvllle, NC 28070 (7o4)875-9092 Project: Stormwater Pace Project No.: 92335412 Sample: Stormwater #1 Lab ED: 92335412001 Collected: 03/31/17 07:42 Received: 03/31/17 12:36 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 25.6 mg1L 5.0 1 04/05/17 14:32 Sample: Stormwater #2 Lab ID: 92335412002 Collected: 03/31/17 07:42 Received: 03/31/17 12:36 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Oil and Grease Date: 04/11/2017 02:23 PM Analytical Method: EPA 1664B ND mg1L 5.0 1 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC, 04/11/17 06:50 Page 4 of 11 ace Analytical WWW.P C&W1Cam QUALITY CONTROL DATA Project: Stormwater Pace Project No.: 92335412 QC Batch: 356094 Analysis Method: EPA 1664B QC Batch Method: EPA 1664E Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92335412002 METHOD BLANK: 1975278 Associated Lab Samples: 92335412002 Parameter Units Oil and Grease mg1L LABORATORY CONTROL SAMPLE: 1975279 Parameter Units Oil and Grease mg1L MATRIX SPIKE SAMPLE: 1975280 Parameter Units Oil and Grease mg/l_ Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28076 (704)875-9092 Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 5.0 04/11/17 06:38 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 40 37.0 93 78-114 92336170001 Spike MS MS % Rec Result Conc. Result % Rec Limits Qualifiers ND 40 36.6 92 78-114 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: 04/11 /2017 02:23 PM without the written consent of Pace Analytical Services, LLC, Page 5 of 11 to ace Analytical wxw.pacebba.com Project: Stormwater Pace Project No.: 92335412 QC Batch: 355255 QC Batch Method: SM 2540D Associated Lab Samples: 92335412001 METHOD BLANK: 1970606 Associated Lab Samples: 92335412001 Parameter Units Total Suspended Solids mg/L LABORATORY CONTROL SAMPLE: 1970607 Parameter Units Total Suspended Solids mg1L Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huniersville. NC 28078 (704)875-9092 QUALITY CONTROL DATA Analysis Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 2.5 04/0511714:27 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 250 238 95 90-110 SAMPLE DUPLICATE: 1970608 92335297001 Dup Parameter Units Result Result Total Suspended Solids mg[L ND ND SAMPLE DUPLICATE: 1970609 92335412001 Dup Parameter Units Result Result Total Suspended Solids mg1L 25.6 25.8 RPD Qualifiers RPD Qualifiers 1 Results presented on this page are In the units Indicated by the "Units' column except when an attemale unit is presented to the right of the result REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 04/11/2017 02:23 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 11 aceAnalWicalo www.peadab&oom QUALIFIERS Project: Stormwater Pace Project No.: 92335412 DEFINITIONS Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 26078 (704)875-9092 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. 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. S - Surrogate 1,2-Diphenythydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyze 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. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analyzes. TNI - The NELAC Institute. LABORATORIES PASI-A Pace Analytical Services - Asheville PASI-C Pace Analytical Services - Charlotte REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 04111 /2017 02:23 PM without the written consent of Pace Analytical Services, t_LC. Page 7 of 11 laceAnalyticalo www.pecWabs com Project: Stormwater Pace Project No.: 92335412 Lab ID 92335412002 92335412001 Sample ID Stormwater #2 Stormwater #1 Date: 04/11/2017 02:23 PM QUALITY CONTROL DATA CROSS REFERENCE TABLE QC Batch Method QC Batch EPA 16646 356094 SM 2540D 355255 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Analytical Analytical Method Batch Page 8of11 /�.-�aceArralytical ` r Laboratory recehdng samples: Ashevijle ❑ Eden❑ Uocument Name: ESI Tent Spee Sample Condition Upan Recelpt(SCUR) Document No.: F-CAR-QA-WI3 Rev.02. Greenwood [] Huntersville ❑ Document Revised: Sept. 21, 2016 Page 1 of 2 Issuing Authority: Pace Quality Office RalefghA Mechanicsville❑ • Client Name: pre W, 92335412. Courier. EJW Ex OUPS EIUSPS —_ talent ❑ Commercial 012ace ❑Other. i 4 j I I1 1 i 92335412 Custody Seat Present? 0yes XC Seals Intact? ❑Yes 260 Date/InittaEs Person Examining Cnmerrtf.�"`-� Packing Matedal: ❑bubble Wrap �bble Bags ❑None []Other:p e f Thermome 'r: 4 .. (j Wet ❑Blue ❑None El amp on ke, c InS process has begun tR Gun ID:� / G of Ite: Correction actor: "&, Coder Temp Corrected IT): Biological Tissue Frozen? (]Yes ❑No'ON/A Temp should be above freezing to VC USDA Regulated Sol]( i�ti/A, water sample) [aid samp}l orfglnate 120uarantine gone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (inte tionally, Oyes fJNo includinglNwaliandPuenoRlto►?oyes 0o Comments/Disci Chain of Custody Present?. 1. Sam les Arrived within Bold Time? ❑ 2. Short Hold Time Analysis 102 hr.)? 3. Rush Turn Around Time Requested? ❑ 4. Sufficient Volume? 5. Correct Containers Used? -Pace Containers Used? 6. Containers Intact? V Samples Field Filtered? 9. Noted sediment is visible in the dissolved container Sample Labels Match COC? -includes Date/Time/ID/Analysis U. LJ 9. Headspace in VOA Vials (>5-6mm)? Yes No N/A lt7 Trip Blank Present? Trip Blank Custody Seals Presets? Yes Yes0 No JA -HJA 11. CLIENT NWHCATION/1115MLiTtoN Person Contacted: I Comments/Sample Discrepancy: Date/Time: Field Data Required? UYes UNo Project Manager SCURF Review: ► i I 1 l � _ _ Date, Project Manager SRF Review; n„ ^ Y Date: L1-Z-f 1 Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form win be sent to the North Carolina DEHNR CertRkation Office (Le. Out of hold, Incorrect preservative, out of temp, incorrect containers) Page 9 of 11 0 0 a v S a V b r. C p 1p 3 r �d n d LA 2 o a w Mum/MIMMEMIMMIMI I/II/I/I/III�I/ =' _ MEMO ■■■ �© MIAr/I /I/III 1Plastic ,ARMMM / rJsirliiriir� ■ ■■■■■■■■ ■■ ■■MOMMIMM■ ■■ , ���►��.�irr��►�Ai ENE ■EME■NIM■ , i ice► ii�iiii . - ■OMMEMI e�M■ . MENNEN No ' , .. . . ■ ■■■■■■■■■WGK(3vlah oerMI,VPHIG., kit (N/A) SMT-250'MLSterile- Plastic irI-i iiiir �r W.: ,. . i m�� V, o � =r O at 17 6i C 7r a 3 o la Cr d :� ::; N,� a _ x C y = Cr M n A Cr n d p n 3 tiC ' � c O b � ..Cr d. .a o v a A N r p r C C R ZArWcal' CHAIN -OF -CUSTODY / Analytical Request Document The CWrod-C I y Is a LEGAL DOCUMENT. AN relmrd Holds must bs complotod aowrgaelr. .I �Z:�F O IL c-&-mCv Pap: Seetlan A Section B eecoon C of Raquirad Ci-tt Inlon+aYnn; Regoir" ProjeCl lnhxnrafton: iavdm Warn tkr Comppalr_ Romn7o: Attarraan: 7 Q rl1 R A /F•�� 1 V f.- V T �+ ss: Pgai �'1 Sf- Cagy Ta: COOifflrry Nemr: REGULATORY AGENCY a: NPDES GROUNDWATER i DRINKING WATER UST ? RCRA i- OTHER Etnall TO: Purchase Order No.: -/ n e� �sh . of / �! Ral"Once: 1Roci2, sw Losatbn STATE:: ueated Due DzukiTAT: Proi ml Number: P•"• proms r Requested Analysts Filtered (Y" Section D Ratrta Cod" li x n.aredClrrlNomw� MATRIX r CODE COLLECTED PreSClY8f1H9S i• Dm*wg Warr DW Walor Wr Vasty Water W W Product P ^ U In cawscertr sriwr c d)13R rC aomraa -+ Z �LLJ r Q V SAMPLE ID%Mpa (A-7- a9l : I Air AR C3 a 4 4 Sample sea MkJST DE UNIQUE Tissue TS p U Other OT X : .Q n" `1233S�t�z W c oic3°s" tIATT_ TIME DATE TINE a 7 z z x Z O a Pace PTOjaCt NoJ Lab I.D. rw•, _t . • �+- � OI' G J•�-lJ ]• 4a 3•Jl-f 7 7' err. a 4. 6 7 8 9 10 11 12 ADOITIONALC014MENtS ItEOB AFFILIATION DATE Tun ACCEPTED DATEEM SAIPLEC.ORerTIONS �6'•Iv • IS N 3f ,7 Lai- ! 2-54 PLER NAME AtiD JiCAiA RE c PRINTN.m.orSAMPIXR; fD (:�ilGI N A L SIGNATURE o1 SAhV4ZW. 1 'I'v. nl HUM: 84 sity.ag a- bm yw are aooap" P. '. Wr X mr val+ncra tcmu -1 a7taY1`-ALL-O-ZUMV.07. 154fty.ZUU7 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No.'NCGO80000 Date submitted 16 -,20 - 14 CERTIFICATE OF COVERAGE NO— NCGO8 0 6 ci 6 SAMPLE COLLECTION YEAR QOIL FACILITY NAME 27zbxlc'l Axhl"C' . 1�u ks SAMPLE PERIOD ❑ Jan -June 5fl July -Dec COUNTY or ❑ Monthly' (Month) PERSON COLLECTING SAMPLES IVEE[:]Zero- DISCHARGING TO CLASS F]ORW EJHQW F]Trout [:]PNA D F LA130RATORY PACE,Lab Cert. # /,a Ft flow _]Water Supply [:]SA Comments on sample collection or analysis: OCT 2 5 2016 ElOther CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Part A- Vehicle Maintenance Areas Monitoring Requirements DWR SECTION El No discharge this period' Ul -,Rrm 6­ mo - ended"_ , 11tH 'N6 onrFolaryipandqreas( t 0--New' otor�OWW,a4;9i­F"gV-` V—r',ZA 1 N;ft. ' K 1 '2 Ns,mg/P g/ AA Ad %permi Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals MA "'RQN, ZjN - W 04 . . "' 4anVeWC67T1 5E0ARefo' I � lotaISusp W-A 5rd d L �Cjnit 4, gn 07 I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SV%rU-250 last revised October 25, 2012 Page I of 2 STORM ]EVENT CHARACTERISTICS: Date 0-7- (first event sampled) Total Event Precipitation (inches): 0. Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): 0, I Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART iI SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, inrluding all "No Discharge" reports, within 30 days o receipt of the lab results (or at end a monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR -ANY INFORMATION REPORTED: "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, 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 Permi (Date) Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 0&1Fklta►%11] last revised October 25, 2012 Page 2 of 2 Semi-annual Stormwater Discharge Monitoring Report' � � for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted iV -aS - !� CERTIFICATE OF COVERAGE NO. N,CGU8 (�� — FACILITY NAME COUNTY tl1AkE PERSON COLLECTING SAMPLES. %v-�✓ Rases _ LABORATORY._ PAc-e Lab Cert. # ja _ ^� Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR ;lbl� SAMPLE PERIOD Jan -June ❑ July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA ❑Zero -flow ❑Water supply ❑SA [—]Other #4,1 , 3 ���� PLEASE REMEMBER TO SIGN ON THE REVERSE 4 /0,�T 10�6 [,1 ❑ No discharge this period' 1p116, 1 P �,�,,�Oi:itfall .r; a7} -•{ �. M "�s..,�r=F. le;Colle_cted, y yr «ail K ;, *�.^�' _ � e _ o/dd/,yr�5olttls,,mg/L� ��0.0...r�-- G'' r''x" F.-.6Ti"�^. -•T,.F.'±. '¢ 'Y.Y :,•.,��0053oF, �•� -S. d.'---,-�S. F' z�x��-x: t--. �totallSusnendedpp Yencl clj,i, , ��'-r~u a�,, - .u,;. .�: � �;;, �00400�� ti F ..�-Lot[.. — —{_ ..m:x..'vC'� sa�"yt},�' pFi;��j"",;' `h -�L'.n��� F `Standarclunits paOy�E'('`iyy '�. t �`s '^'v�` y . ���`�Q055b ,��,�> �.�� a"r.W�,.� �s.*t;... -^'.:t-a�i'.�-f f�: 1NonPalaraOilsandG'tease/sTP,HEPAs = f.";n' -. ,� ,- Method1664r(5GT;HEM) mg/..L ''rj • - ��,.���. �. _rr-":•..•�-[•,Y�a,�a-._ _'7 New;Motor,Oil:UsaQe; 'N .5 .• F Annual average:gal/,mo Benchmarks rixts`!� A,{" t f<50 or;1�C�see ermtta mmithtn;6ig Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals j� .:„ Ie;Coilected`� rdSx- +r+` 3,r.:`�-._,.,;, s;`mn/dd/yr54 +, a �:. ��� c s a $ �. 4w.. •�. in .. - �- "�.. X {a '� i .�—..,^��c..�:G..;. - �t - _.y ..,v `��c.:.�". - Non`�olar Oil addlGrease TPHaE0. Method R _. r .Y; • :rw�tz�. .ssr,_.r.Pvs ��`"'~_.-.`�h [SGTHENi)_,m /L�`m _._ g _� �. "3.-^��hc!s Ffki'4�.: nRA . "�K. J. i?t t ' lotalrSus ended^Solids^; ,� �, p ,.., �:,^� - ' �' ,r-i /L�+ la _ F....P+•> •_� , ".. pH# _- s a Standar.dunits' __ — - •r'�"'b1a":"«.: Y sl' Per1mii,Limit u 'c:ES J1"�..v,:�y_ .- K." d, i.S-.r� _.#``v` -° � 1 `"r` r 'y, y - cY itp'F' .,yT�3ti .4•�-w`r -'-.�-Y+"r^.9��'�` T.. }Lr w.•,? '".. E ,'. or^100;see;,permlt: �kx �". -x,'^,,.,�r.....� h33! -AW" 5 oi- _ -U m L 3 L1j, 7 33 t t For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU 250 last revised October 25, 2012 Page 1 of 2 • o e STORM EVENT CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): _ Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): rj/,, N Note: if you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2,, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART it SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an oriainal and one copy of this DMR, includina all "No Discharge" reports, within 30 dovs of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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, 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) y--as,— /6 (Date) Additional copies of this form may be downloaded at: http://portal.ricdenr.org/web/wq/ws/5u/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of • MC EN31 Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidanee on filling out this form, please visit: htW:mortal.ncdenr.org/web/wq/wslsulnpdQssw#tab-4 Permit No.: N//�/� /�/�/�/�/_/ or Certificate of Coverage No.: Facility name: ' e in d Zr P.k.,c _ t j,r/ss _ T County: W&I-, e- Phone No. 69_- 5-QV5' _ Inspector: .-T-6,V Pee Date of Inspection: Time of Inspection: '3S` Am Total Event Precipitation (inches): _ I/le {h Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) Z Yes ❑ No Please verify 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 "measureable 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 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Si,grfafure of Permittee or Designee) Page 1 of 2 SWU-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. 1 Structure (pipe, ditch, etc.) Ae)"711111 ,penal w,'��► al� h Receiving Stream: wilo^4 Ar:. ,, a4 Ger Describe the industrial activities that occur within t+he outfall drainage area: k, ty_���. GFi(Ic 9r! �:yJr/. un �PROr�c` Si3so�i�e f7'/0 i/•gfr� 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): A,7e 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 LZ,- 3 4 5 S. 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 T 3 4 5 b. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where 1 is no solids and S is extremely muddy: 1 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 evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe 6�4-0i_ , ,'� �r ram% c•��' �`�� -� ����� J�9r 6.1 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 10/25/2012 • Ai`�*A RUNERR Stormwater Discharge Outfall (00) Qualitative Monitoring Report For guidance on filling out this form, please visit: http://portal.ncdenr.orglweb/wa/ws/su/npdessw#tab-4 Permit No.; N/C/_/_/�/�/,/�/� / or Certificate of Coverage No.: Facility Name: --ro -n a4 Z< L,,I, 4 P4 )e- aJrl�-f _ County: _ Inspector Phone No. IP9- •Zf - f�?95 Date of Inspection: Time of Inspection: Total Event Precipitation (inches): Z d4` Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) 9 Yes []No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the permit). µQualitative monitoring requirements vary. Most permits require qualitative monitoring to be _ performed during a "representative storm event" or during a "measureable 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 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge; re of Permittee or Designee) Page 1 of 2 SWU-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. r' Structure (pipe, ditch, etc.) �y S.14G Receiving Stream: u,? 4.'Wh- , rr Describe the industrial activities that occur within the outfall/drainage area: �?v�l 41-h' - -f4.,a}e Vi . }ant 1� Sli/!;�ssr---} 4-e/ /4M PWu.I'll 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Lj .y"'? 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 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 G) 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 IVo 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe Ot'i W1 -, c , o'� 54790-- Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition ID may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 SWU-242, Last modified 10/25/2012 7ace Analytical' r _ www.patelabs.com CHAIN -OF -CUSTODY! Analytical Request Document The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately. Page: of Section A SectlQn B Section C Required Client Information: ! Required Project Information: Invoice Information: o Report To: Attention: 1782845 f ;, a efAUW � O 'ZCbul Addresg :� Copy Y To: Company Name: REGULATORY AGENCY A !k G �7 Address: r NPDES r GROUNDWATER r DRINKING WATER r UST r RGRA r OTHER Email To: /� } s Purchase Order No.: Pace Quote Reference- Ph Project Name: J71101 Jer Pace Project Site Location 14 &/ Manager, STATE: Requested Due Date/TAT: Project Number: Pace Profile u, Requested Analysis Filtered (YIN) Section D Matrix Codes -, --EL z RequiredClient Infomiation MATRIX r CODE o 2 COLLECTED Preservatives > Drinking Water DW OU z O Water WT Waste Water WW Product P o COMPOSITE START co�ePonrr ENorcRae J Z Soil/Solid SL �, Of p fin �► ti } SAMPLE ID oil OL L) IX Wipe WP (A-Z, 0-9 ! ;) Air AR p w a w Z Samp?e IDs MUST BE UNIQUE Tissue TS O a w F e7 v U Other OT X w D 'AC m N co 0) y ~ DATE TIME DATE TIME x 0 _ _ = Z Z 2 O Pace Project No./ Lab I.D. Z}�f++ti.JA'�-t� T ti 1�•' �:3{'i►n C}-�►i �:3fnw, 3 4 5 6 7 8 9 10 11 12 1 ADDITIONAL COMMENTS RELINQUISHED BY I AFFILIATION DATE TIME ACCEPTED BY I AFFILIATION n DATE TIME SAMPLE CONDITIONS .4 ,.a: SAMPLER NAME AND SIGNATURE .n m y o U z z PRINT Name of SAMPLER: _ DATE Signed SIGNATURE of SAMPLER: {MMJDDIYY): ~ a N 'Impprtani Note' By signing this fprm you are accepting Pace's NET 30 day payment terms and agreeing 10 tale Charges of 1.5% per month for any invoices not paid within 30 days. F-ALL-Q-020rev.07, 15-May-2007 Instructions for completing Chain of Custody (COC) 1. Section A and B: Complete all Client information at top of sheet: company name, address; phone, fax; contact (the person to contact if there arc (que foes, and who will rccoive the; final report.); e-mail address (if available), PO#, Project Name and/or Project Number as you would like to sec it appear (>n the report. 2. Section C: Invoice information: Billing information is included in this section. This information should include the name and address of the person receiving the invoice. 3. Quote Reference should be completed if a quotation was provided by Pace Anal,,lical. The Project Manager, and Profile No. will be completed by Pace Analytical Services. 4. Site Location: A separate COC must be filled out for each day of sample collection. Record the two letter postal code: for the US state in which the samples were collected. 5. Regulatory Agency: List tilt program that is guiding the work to ensure proper regulations are followed Section D: Complete a Sample Description in the "SAMPLE, ID' section as you would like: it to appear on the laboratory report. The; following infurtuation should also be included: the sample matrix, sample typo (G (grab) or C {composite). When collecting a composite, the start time and end time should be documented in the respective bores. The collection time for a grab (G) sample should be entered in the boxes marked 'Composite End/Grab'), Sample temp at collection (if required by state), the total number of containers, and preservative used. Mark if the; sample was filtered in the field by marking Y or N in 'filtered' row by the.Analysis requested Requested Analysis: List the required analysis and methods on the lines provided and place a check in the column for the samples requiring the analysis. Additional comments should be referenced in the bottom left hand corner or include attachments for extended lists of parameters. 9. The sampler should print their name in the space provided and sign their name followed by the date of the sampling event at the bottom of the COC in the spaces designated for 'SAMPLER NAME AND SIGNATURE. 1.0. When relinquishing custody of the samples to a representative of the laboratory or other organization, indicate; the Item Numbers of those samplers being transferred; sign relinquished by, date and time, and include your affiliation. *Important Note: Standard Turnaround Time is 2 Weeks/10 business days. Results will be delivered by end of business on the date due unless other arrangements have; boon made with your project manager. Special Project Requirements such as Low level Detection Limits or level of QC reported must be included on the chain of custody in the Additional Comments suction. STORMWATER SAMPLING TIMELINE TUESDAY, APRIL 12, 2016 5:45 a.m. -- Light rain 6:05 a.m. — Light rain — site visit — no discharge 6:40 a.m. — Light rain — site visit — no discharge 7:10 a.m. — Light rain — site visit — no discharge 8:05 am. — Heavy rain - site visit — pond starting to discharge 8:35 a.m. — Sample taken — moderate to heavy rain 8:45 a.m. — pH reading — 7.33 pH Total rainfall at time of sampling = 7/10" Sample taken by Tony Rose, Stormwater Superintendent (�55'neAnalyticalo WWW.Paaefabs.com April 27, 2016 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: STORMWATER Pace Project No.: 92293676 Pace Analytical Services, Inc. 9800 KinceyAve. Suite 100 Huntersviile, NC 28078 (704)875-9092 Dear Mr. Ray: Enclosed are the analytical results for sample(s) received by the laboratory on April 13, 2016. The results relate only to the samples included in this report. Results reported herein conform to the most current TNi standards and the laboratory's Quality Assurance Manual, where applicabie, unless otherwise noted in the body of the report. Analyses were performed at the Pace Analytical Services location indicated on the sample analyte page for analysis unless otherwise footnoted. If you have any questions concerning this report; please feel free to contact me. Sincerely, V�, CX-- t_iamm Harrison liamm.harrison@pacelabs.com Project Manager Enclosures cc: Ms. Robyn Snow, Town of Zebulon REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 1 of 10 5-3ceAnalyfical. www.yacels6awm Pace Analytical services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 CERTIFICATIONS Project: STORMWATER Pace Project No.: 92293676 Charlotte Certification IDs 9800 Kincey Ave. Ste 100, H u ntersville, NC 28078 South Carolina Certification #: 99006001 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 Virginia/VELAP Certification #: 460221 Eden Certification IDs 205 East Meadow Road Suite A, Eden, NC 27288 North Carolina Wastewater Certification #: 633 North Carolina Drinking Water Certification #: 37738 Virginia/VELAP Certification #: 460025 REPORT OF LABORATORY ANALYSIS This report shall not he reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 2 of 10 (�5a'cieAnalyfical* www.P@CW*bs.c0m SAMPLE ANALYTE COUNT Project: STORMWATER Pace Project No.: 92293676 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92293676001 STORMWATER SM 2540D DWJ 1 PASI-E EPA 16648 JMS 1 PASI-C i REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 3 of 10 0 aceAnalytrcal wwwpscelebs cum ANALYTICAL RESULTS Project: STORMWATER Pace Project No.: 92293676 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Sample: STORMWATER Lab ID: 92293676001 Collected: 04/12/16 08:35 Received: 04/13/16 10:42 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed GAS No. Qual 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 67.3 mg/L i 8.3 1 04/18/16 14:56 HEM, Oil and Grease Analytical Method: EPA 1664B Oil and Grease ND mg/L i 5.0 1 04/27/16 06:32 Date: 04/27/2016 03:07 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 4 of 10 aceAnalytical www.pacefts mm QUALITY CONTROL DATA Project: STORMWATER Pace Project No.: 92293676 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QC Batch: EDEN122513 Analysis Method: SM 2540D QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92293676001 METHOD BLANK; 1713221 Matrix: Water Associated Lab Samples: 92293676001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg/L ND 2.5 04/18/16 14:54 LABORATORY CONTROL SAMPLE: 1713222 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Suspended Solids mglL 250 274 110 90-110 SAMPLE DUPLICATE: 1713223 92293662001 Dup Parameter Units Result j Result RPD Qualifiers Total Suspended Solids mg1L 178 192 8 D6 SAMPLE DUPLICATE: 1713224 92293674001 Dup Parameter Units Result , Result Total Suspended Solids mglL 105 104 RPD Qualifiers 1 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: 04/27/2016 03:07 PM without the written consent of Pace Analytical Services, Inc.. Page 5 of 10 aceAnalytrcale *W..pacalls ow QUALITY CONTROL DATA Project: STORMWATER Pace Project No.: 92293676 QC Batch; GCSV124801 Analysis Method: EPA 1664B QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92293676001 METHOD BLANK: 1720159 Associated Lab Samples: 92293676001 Parameter Units Oil and Grease mg1L LABORATORY CONTROL SAMPLE: 1720160 Parameter Units Oil and Grease mg/L MATRIX SPIKE SAMPLE: 1720161 Parameter Units Oil and Grease mg/L Matrix; Water Blank Reporting Result Limit Analyzed Qualifiers ND 5.0 04/27/16 06:29 Spike LCS LCS Conc. Result % Rec 40 38.5 96 92293708002 Spike MS Result; Conc. Result 9.3 40 44.8 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 % Rec Limits Qualifiers 78-114 MS % Rec 89 % Rec Limits Qualifiers 78-114 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: 04/27/2016 03:07 PM without the written consent of Pace Analytical Services, Inc.. Page 6 of 10 5aa7tc. te A na ly fica / »wwpacewncom QUALIFIERS Project: STORMWATER Pace Project No.: 92293676 DEFINITIONS Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 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. 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. 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, Styrene, and Vinyl chloride. 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- Nitrosodiphenyla mine decomposes and cannot be separated from Diphenylamine using Method 8270, The result reported for each analyte is a combined concentration. Pace Analytical is TN accredited. Contact your Pace PM for the current list of accredited analytes. TNI -The NELAC Institute. LABORATORIES PASI-C Pace Analytical Services - Charlotte PAST-E Pace Analytical Services - Eden ANALYTE QUALIFIERS D6 The precision between the sample and sample duplicate exceeded laboratory control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 04/27/2016 03:07 PM without the written consent of Pace Analytical Services, Inc.. Page 7 of 10 aceAnalytrcal wmpecale6acom QUALITY CONTROL DATA CROSS REFERENCE TABLE Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: STORMWATER Pace Project No.: 92293676 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92293676001 STORMWATER SM 2540D EDEN122513 92293676001 STORMWATER EPA 1664E GCSV124801 Date: 04/27/2016 03:07 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 8 of 10 DOcument•Name:, '• Document Revised: 26FE82016 • .; 'Sam pie Condition U on Recei E SCUR : Page 1 of 2 r = CB,�i1alj�iCBi Issuing Authority: ! F-RAL-CS-001-rev.05• Pate Raleigh Quality Office •' • • • Client Name: WO 92293fi76 O V Project # : Courier- x UPS USPS ❑Client ❑ commercial Pace 00ther. 82293676 Custody Seat Present? Des Vo Seals Intact? Oyes �!fNo Packing Material: [:]Bubble wrap ❑Bubble Bags JZNone ❑Other: pate/Initials Person Examining Conterr V Thermometer: � IR SN:122065aV ❑IR SN: 122065371 Type of I ' VWet []Blue []Nona 05amplas an ice, cooling process has begun Correction Factor: 0.0•C Cooler Temp Corrected (•C): Slological Tissue Frozen? ❑Yes ❑No VN/A Temp should be abovegfezing to VC • .USDA Regulated Soil (N/A, water sample) Did sample originate Inuarantine zone within the United States: CA, NY; or SC (check maps)? nYeS NO Aid samples originate from a foreign source (fater(�tlonally, inrl- ina 143w It anri Puarrn Rirn17 rTVnt Rn COMMENTS: Chain of Custody Present? QfYes ONO N/A I. Chain of Custody Filled Out? Yes 0 No QNJA 2. Chain of Custody Relln uished? Yes Nd N A 3. Sampler Name and/or Si nature on COC?. Yes ONO N/A 4. Samples Arrived within Hold Time? Yes No N/A S. Short Hold Time Analpis (<72 fir)? ❑Yes . No ' DtA 6. ' Rush Turn Around Tlme Re nested? Chas No N A 7. Sufficient Volume? 16yes ONO N/A 8. Correct Containers Used? -Pace Containers Used?�(Y- X Yes ONO ONO, ❑N/A ❑N/A 9. Containers Intact? JZfY1 a No N A 10. Filtered Volume Received for Dissolved Tests? Yes No N/A 11, Note if sediment Is visible In the dissolved container Sample Labels klatch C06 -Includes Datc/ lime D/Ana sis Matrix; 0Yes []No ❑N/A 12. All containers needing.add/base preservation have been 11 checked? �jYes ' All containers needing preservation are found to be in (HNO,, Hi50., HCIt2; NaOH >9 Sulfide, NaOH?12 Cyanide) es compliance with EPA recommendatfen? �Vy Exceptions: VOA, Coliform, TOC, Oil and Grease, DRO/8015 (water ODC,LLH Yes ❑NO ❑No No [:)N/A ❑N/A N/A 13. Samples checked for dechlorination Yes No []NIA 14. •Headspace in VOA Vials >5.6mm)? Yes QNo N/A 15. Trip Blank Present? Trip Blank Custody Seals Present? Pace Trip Blank lot It (if puichaseft. ❑Yes []Yes ' ❑No/A []NoN/A ]6. CLIENT NOTIFICATION/RESOLUTION - Field Data Requlra? []Yes []No Person Contacted: Day nme: Comments/Resolution: Project Manager SCURFRevlew; lA Date: _,Ll41 Project Manager SRF Review: UI_ Date: �)L"I 0 l ce_ Note: Whenaver there Is a discrepancy affecting North Carolina compliance samples, a copy of this Corm ►dfl be sent to the North Carolina DEHNR Certification Office (I.e. Out of hoid, Incorrect preserwttve, out of temp, Incorrect containers) Page 9 of 10 CHAIN -OF -CUSTODY 1 Analytical Request Document �� n„ �t Cl, Tho ChatrO-Cwody m a LEGAL OOCUMEW. AD r*Wvant fides mu compiled accuratalyr. f Ana a wrr.ptd��.mor S&tt on A Section B Section C Pa9e: Requir-d Clot Inlorma5on: RaqutnM Prnioct Inim-maborr: b�v0ica L Jy To: Alen: 1782845 Zab"I Report �. Aaerrss:, ` l s{- Copy To: C°noonyNanw REGULATORY AGENCY n G �fq • Addm-w NPDES GROUNO WATER E" DRINKING WATER - UST :•- RCRA OTHER EmaO To: 1 l Gl C. 'isuv�o7t.' �i J. rn P.uchfx Qmw No.: if �!' � 46� R.Iw.„m. r - �E9• J:73� Fa ' -29- —111 PrOj4GE NBma: / f�� 71rrw•►w�Iu Pam "_ Sit* LO abw STATE' - - Raquntad Duo DatwTAT: Project Numbar. Pre. Prarl. h C'i l ... I Requested Arsaysia F1".. d (YIN) Socllon D Ntat u Coa4 z I.W rJ�rx lnloienMn rAA-TRrK CODS s COLLECTED Prese"Lives r_ Dr"Img Waa-r Erx c� az Water wr waswwaw my �ST�� W Proou�q P � u Z } SL x 01dGold SAMPLE ID oL K5pc WP {w Z r} (A 2. 0-9r:) .L DS MUST BE UNIQUE Tit TS Omer OT QaSomple } U.o � DATE nasE exrt ruaE a z z x i i O , y ¢ Paco Project NoJ Lab LD. }-, X4e.— or is q•42-+L ,a - er -� i :3r_.,. '2 tires -r r •u=A , -3j-m^ 2.1E : 3f a: 4 5 6 7 •B 9 10 11 12 ADDITIONAL COMMENTS RELINQUISHED BY I AFFDJATION DATE TIME ACCEPTED BY! AFFILIATION DATE TIME SAMPLE CONDITIONS I 3-d I I MIA 'A SAMPLER NAME AND SIGNATURE u -, _ PRINT Name at SAMPLER: ORIGINAL c G �Y °A? Z• ` j --. F is = — rj SIGNATURE e1 SAMPLER: DATE SIGnetl (MwoDfYYi: 0 a Ewrti•:+•+ Y:yt. Gs s,Jrn7 Iws fow-i 4z me r�cF.�:,i •-r_r: t:*_ r :::r� aarwar� [crew• .,re=r..�-r._ .i ry. GMr.�..• ed f.•i�: rn �.w-In r: ,n .,.r.<. � tic, r„c .,.p.: � I� r:.y., F-dLL-G•-?7.(1: ur,U7, 15-M7y26[F7 . . C Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted /_/- /3 -,15- CERTIFICATE OF COVERAGE No. NCG08 o 6 q 6 FACILITY NAME ­rc-r} o F Zfeb, lu) PA l.'C- uj�,t KS COUNTY L,) rq� e_ PERSON COLLECTING SAMPLES --Tc,,y 6.,e LABORATORY Pricc-, I Lab Cert. # is Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR �01-5- SAMPLE PERIOD E] Jan -June 0 July -Dec or ❑ monthly' (montpj F?SC@FV6TNG TO CLASS ❑DORW E]HCJW DTrout E]PNA NOV Dzero-flow DwaterSupply E]SA 18 2015 ❑Other C0EW1VRTEC-«N fLo8 PLEASE REMEMBER TO SIGN ON THE REVERSE F--1 No discharge this period' OutfalrS b QA4 p iq L Sam p ended -ci Uidf&ibf(r� sage,­.,i­ WOW 46 rt? Z!, Solids',- 1; YWE", 5 t 9 ndard u sx., E (Wk'M),j ubla Wtqagelg it.M6tlidd -Ct g/C§�*-i , - - I ,tS dr 100 seL­�F -nii .. -- ;Benchmark,; mi A- ,4j, With!W6 9 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? —yes _no (if yes, report your analytical results in the table immediately below) Part 8: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals Nou Sll,,`W-� dite­­- E� 't. R WN :RZt�-T&ENAIFI 005� bn�Po ar4Oi (aiddiGre6te TPH--EP­A1,jM-iht-h-@ ag j� - uti —ar.S- 5—ndi-id-Sblids,747- , 11 n"'? M 'i 4 xz wl - P A, %fi 7R, 0 yt 0 d T; kQI�4� Sq PAL W ,'HE � Y- SIMICA perM! + I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 5WU-250 last revised October 25, 2012 Page 1 of 2 STORM EVENT CHARACTERISTICS: Date 10-df -I3` (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2,. or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEFDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this OMR, includinq all "No Discharqe" reports, within 30 days of receipt of the lab results for at end of monitoring period in the case of "No Discharae" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "-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 far submitting false information, including the possibility of fines and imprisonment for knowing violations." of Permittee) (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 1-i WY FAA �. MCPENR r ' Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this farm, please visit- hU://portal.ncdenr.org/web/wq/ws/su/npdessw4tab-4 Permit No.: N/C/_/_/�/_/_/_/T/ or Certificate of Coverage No.: Facility Name: -7 own o f Zrjmdt-i ��4/-s� xlur k s _ County: W» �e Phone No. _ ir9%9 } c',tF 9-s'as'f Inspector: 1 o� Pg6e— Date of 1 nspection: o - a y - /S Time of Inspection: 4 ! )o 9r--7 Total Event Precipitation (inches): Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) N Yes ❑ No Please verify 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 "measureable 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 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or Designee) Page 1 of 2 SSW-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. _ Structure (pipe, ditch, etc.) m'..' a n'1 W-JA h� Receiving Stream: _ tnnnx,Cd �;b� .J off_ L',J/0 &.'e/' Describe the industrial activities that occur within the outfall drainage area:/ .1i"M 64 f.4i<,?o_ y,jv _ A,re f o7 f f oAd d ,' ejeLy___K - 1D �5!A3 61wi I Q���.'z 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: _L{15�0_ -yk 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): Mine 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 S. 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 b. 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: Ol 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 evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe /Yoffie A o d io l y 411 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, Lastmodified 10/25/2012 .I 'M, NCDENR 1 Stormwater Discharge 4utfall (SD4) Qualitative Monitoring Report Forguidance on filling out this form, please visit: bUp://portal.ncdenr,org/web/wq/wsu n s5w#t b-4 Permit No.: N/C/_/_/�/�/�/^/�/ or Certificate of Coverage No.: N/C/G/ D/ g/ 0/ 1-111/ Facility Name: 77�.., &f Z e kJi,7 Ayhk& "jam / s County: LJ6kc. _ — _ _ J� Phone No. 04) (90 -00- Inspector:•y Date of Inspection: /0 - n-/S Time of Inspection: 9i9.� Total Event Precipitation (inches): .:1 Was this a "Representative Storm Event" or "Measureabie Storm Event" as defined by the permit? (See information below.) ® Yes ❑ No Please verify 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 "measureable 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 outfail. 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signklf6re of Permittee or Designee) Page 1 of 2 SWU-2Q, Last modified 10/25/2012 I. Out -fall Description: Outfali No. 2__i__ Structure (pipe, ditch, etc.) /J4.s-5 S•+1,918 Receiving Stream: a_nn6m*4 j r,_f,,4n„1 d 1—,4j1, Describe the industrial activities that occur within the outfali drainage area: /A e l /U � tlf .Syone Sf�al S�/'(•`rtf G?tir+Pw�' 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Y� 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 0 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 20 3 4 5 b. 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? Yes No 8. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe A —le , -7 "I Soed SA -A A-O/ h196 P 40 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 5WU-242, Last modified 10/25/2012 STORMWATER SAMPLING TIMELINE TUESDAY, OCTOBER 27, 2015 5:30 a.m. — Light misting rain, off and on all day 4:00 p.m. — Amount of rain = 0.2" Overnight — Light mist, light showers WEDNESDAY, OCTOBER 28, 2015 7:05 a.m. — No discharge 8:00 a.m. — Steady rain 8:45 a.m. — Begins discharging 9.10 a.m. — Samples taken 9:21 a.m. — pH reading of 791 Total rainfall at time of sampling = 0.5" Total rain event = 1" Sample taken by Tony Rose, Stormwater Superintendent ace Analytical wrvw.PaDelabs.com November 12, 2015 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: STORMWATER Pace Project No.: 92274170 Pace Analytical Services, Inc. 9800 Kincey Ave. suite 100 Huntersville, NC 28078 (704)875-9092 Dear Mr. Ray: Enclosed are the analytical results for sample(s) received by the laboratory on October 30, 2015. The results relate only to the samples included in this report. Results reported herein conform to the most current TNl standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. Analyses were performed at the Pace Analytical Services location indicated on the sample analyte page for analysis unless otherwise footnoted. If you have any questions concerning this report, please feel free to contact me. Sincerely, �1� .)lc>b4_ Liamm Harrison liamm.harrison@pacelabs.com Project Manager €ndosures cc: Ms. Robyn Snow, Town of Zebulon NC�i I Id REPORT OF'LABORATORY ANALYSIS This report shall not be reproduced, ezoept in full, without the written oonsent of Pace Analytical Services, Inc.. Page 1 of 10 Pace Analytical Services, Inc. 9800 K leac,Analyficale insey Ave. Surte100Huntersville, NC 28078 www.pacelabs.com (704)875-9092 CERTIFICATIONS Project: STORMWATER Pace Project No.: 92274170 Charlotte Certification IDs 9800 Kinoey Ave. Ste 100, Hunlersville, NC 28078 North Carolina Drinking Water Certification #: 37706 North Carolina Field Services Certification #: 5342 North Carolina Wastewater Certification #; 12 South Carolina Certification #: 99006001 Asheville Certification IDs 2225 Riverside Drive, Asheville, NC 28804 RoridalNELAP Certification #: E87648 Massachusetts Certification #: M-NC030 North Carolina Drinking Water Certification M 37712 Florida/NEtAP Certification #: E87627 Kentucky UST Certification #: 84 West Virginia Certification #: 357 MrginiaNELAP Certification M 460221 North Carolina Wastewater Certification #: 40 South Carolina Certification #: 99030001 West Virginia Certification #: 356 VirginialVELAP Certification M 460222 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 2 of 10 aceAnalytrcal wwwpacelabs.com SAMPLE ANALYTE COUNT Project: STORMWATER Pace Project No.: 92274170 Pace Analytical Services, Inc. 9800 Kinoey Ave. Suite 100 Huntersville, NC 28078 (704)8759092 Analytts Lab ID Sample ID Method Analysts Reported laboratory 92274170001 STORMWATER #1 SM 2540D SAM 1 PASI-A 92274170002 STORMWATER #2 EPA 1664E JMS 1 PASI-C REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 3 of 10 (�15'cieAnalyficalo +rww.paoClRUCOM ANALYTICAL RESULTS Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875.9092 Project: STORMWATER Pace Project No.: 92274170 Sample: STORMWATER #1 Lab ID: 92274170001 Collected: 10/28/15 09:10 Received: 10/30/15 13:00 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 4.2 mg1L 2.8 1 11/01/15 15:17 Sample: STORMWATER #2 Lab ID: 92274170002 Collected: 10/28/15 09:10 Received: 10/30/15 13:00 Matrix: Water Parameters Results Units Report Lim$ DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Oil and Grease Date: 11/12/2015 04:25 PM Analytical Method: EPA 16648 ND mg1L 5.0 1 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written Consent of Pace Analytical Sarwes, Inc.. 11/12/15 07:38 Page 4 of 10 aceAnalyfical www.pecefabscom QUALITY CONTROL DATA Project: STORMWATER Pace Project No.: 92274170 QC Batch: GCSV123181 Analysis Method: EPA 1664B QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92274170002 METHOD BLANK: 1604434 Matrix: Water Associated Lab Samples: 92274170002 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Oil and Grease mg1L ND 5.0 11112/15 07:35 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 LABORATORY CONTROL SAMPLE: 1604435 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Oil and Grease mg1L 40 33.7 84 78-114 MATRIX SPIKE SAMPLE: 1604436 92275153001 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Qualifiers Oil and Grease mglL ND 40 35.0 88 78-114 Results presented on this page are in the units indicated by the -Units" column except where an atiemate unit Is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 11/12/2015 04:25 PM without the written consent of Pace Analytical Services, Inc.. Page 5 of 10 acmnalyticalm Nww.pmelabs.cwn Project: STORMWATER Pace Project No.: 92274170 QC Batch: WET141157 QC Batch Method: SM 2540D Associated Lab Samples: 92274170001 METHOD BLANK: 1596407 Associated Lab Samples: 92274170001 Parameter Units Total Suspended Solids mg/L LABORATORY CONTROL SAMPLE: 1596408 Parameter Units Total Suspended Solids mg/L Pace Analytical Services, Inc. 9800 KinceyAve. Suite 100 Huntersville, NC 28078 (704)875-9092 DUALITY CONTROL DATA Analos Method: SM 2540D Analysis Description: 25400 Total Suspended Solids Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 2.5 11/01/15 15:06 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 250 240 96 90-110 SAMPLE DUPLICATE: 1596409 92274207001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 173 179 3 SAMPLE DUPLICATE: 1596410 92273916001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L ND ND ttesuns presented on tms page am In the units rndlcated by the "Units" column except where an alternate un t is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 1111212015 04:25 PM without the written consent of Pace Analytical Services, Inc.. Page 6 of 10 Pace Analytical Services, Inc. aceAnalytical ® 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 WWPb•arn (704)875.9082 QUALIFIERS Project: STORMWATER Pace Project No.: 92274170 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. 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. 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, Styrene, and Vinyl chloride. A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis ofAcrolein 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. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNl - The NELAC Institute. LABORATORIES PAST -A Pace Analytical Services - Asheville PASI-C Pace Anatytical Services - Charlotte REPORT OF LABORATORY ANALYSIS This report "I not be reproduced, except in full, Date: 11/12/2015 04:25 PM without the written consent of Pace Analytical Services, Inc.. Page 7 of 10 aceAnalytical o WWW..Peoelabs.cam QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: STORMWATER Pace Project No.: 92274170 Pace Analytical Services, Inc. 9800 1(incey Ave. Suite 100 Huntersville, NC 28078 (704)875.9092 Analytical Lab 11) Sample ID QC Batch Method QC Batch Analytical Method Batch 92274170002 STORMWATER #2 EPA 1664B GCSV123181 92274170001 STORMWATER #1 SM 2540D WET141157 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 11 /12/2015 04:25 PM without the written consent of Pace Analytical Services, Inc.. Page 8 of 10 Document Name: Sampre Condltlon Upon Document Revised: May 15.20 Receipt SCU!� Page 1 of 2' Document NO.: Issuing Authorities: F-RAL-CS-001-fev.03 Pace Raleigh guar' Office 'Page 2 of 2 is for Internal Use Only Client Na e: Courier (Circle): F Ex UPS USPS Client Commercial then Custody Seal on Coole ox Present: yes &no Seals Intact: yes K no Packing Material: ❑ B bble Wrap Bubble Bags None Other Circle Thenmamater Us d: fR Gun SN122085387Typa of ice; Blue None Samples on Ice, cooQng process hes begun rR flun Aack lln SM-149119M71 Temp Correction Factor Add f Subtract Corrected Cooler Temp. �' `� C Temp ahoutd he above froM ig to VC O• 6 C Data and Inli als of person examining Biological Tissue Is Frozen: Yea N4( sontsn ! Presmaiten chock: �a-3d-ram Comments: Chain of Custody Presen ON. CINlA 1. Chain of Cuslode Filled 0 A._Dl. ❑NIA 2. Chain of Custody Reli f hed: No OWA 3. Sam er Name & SI natu on COC: Yea No ❑wA 4. Samples Arrived within H d Time: C4, 010 NrA S. Short Hold Time Anal e72h : 0Y CINIA (1. Rush Turn Around Time a uested: o ❑IWA I - Sufficient Volume: Y No ❑WA 8. Correct Containers Used: -Pace Containers Used: No ❑NfA 28-'�No❑NIA g. Containers Intact: RK.. C3ido OKA A Filtered volume received 1`4 Dissolved tests ❑Yea JONO O<A 11. Sample Labels match COC -Includes dateMmeADIA al is Matrix ea pro ❑w 12. AU oontalners needing gmservad n hava been rhacked. All contalners needing prosew tion are found to be In cornpliance with EPA racomM dation. exoepeon: VOA ratlfaan. Tor G. WUDRO water) QYes ONo OYea ONO Dye, ONO NIA NIA 13. Sam es checked for dechi rinatlon: Ores ONO C WA114. Headspace in VOA Vials s mm : OYes ❑Na C 91A 15, Trip Blank Present: Trip Blank Custody Seals Pr nent Paoe Trf Btank Lot # if trr hasad : ❑Yes ONO E ❑Yes ONO C UA YA 16. Client Notmcatlon/ Resolu ion: Fbakl Date Required? Y I N Person Contacted: DateMme: Comments) Resolution: SCURF ISRF LYr to3ar5 Data: . Review::LA l0 5 Note: Whenever there to ajInhct ancy afTectlng North Carotins compliance samples. a oopy of thisl be sent to lie Non Carlin dEHNR CoMcation OHIoe ( 1,8 old, incorrod preservative, out of temp. COYotflfners) WOi6 : 92274170 IT]N1111111111111111 Page 9 of 10 C) Pace Analytical CHAIN -OF -CUSTODY I Analytical Request Document The Cft91n1o9.C4%1.-x!,-iS I LEGAL DOCtIMEN1 Page: Section A section a Section C Of Requ-0 Cu-K4 lr!ofrrruSw Required Pfeqee. co­;!-�,, -, J-S - 1782844 c f.e r 1 L r1 J.'-f REGULATORY AGENCY Q1noJd--) Ai( UPDES GR0U-4DVMTr:K Vk.'ATER LIST Rcwk A- L-L2 --�r Vel'i).2vl -211.7 It 0 t. r Sita Low -Von S TA TLIE.' R*q—d 0-s DaWTAT; Requested Analysis Filtered (YIN) Str Lion 0 KIWI, Codes R.q.16dZ: IT—V i COLLECTED Prestirvati,,os 5 SAMPLE ID Z ID. t.,L;5: Pr I mir"t'L 2 '7 — --7 Ll I L: IVJE If 4-*: <" Ir Pace Project Nod Lab 1,D, 'r- 7� Le 4' 121 ;43017- IONAL COMULN'S Rt7LINQUiStILD BY J AFFILIATION DATE TIME A(;CEPTED By! AFFILIATION I DATE TIME, SAMPLE CONDITIDN'S P 0.3hr 13 SAMPLER HAKIE AND SfGNATUnE ptJJ!jT .1 S..!.IPI t1p, TURU of SA10'LEr. 14CII DATE S,U,—I LIAM OD,YYI Q20, 411- Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted -b--q 0.1-r- CERTIFICATE OF COVERAGE NO. NCGO8 O 9 FACILITY NAME 74jin n f t-- coursITY WAke- PERSON COLLECTING SAMPLES_ K411 LABORATORY )OA-16 LaCert. # A2 Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR 2c> 15- SAMPLE PERIOD E] Jan -June [] July -Dec or El Monthly' (month) DISCHARGING TO CLASS EJORW DHQW ❑Trout []PNA EjZero-flow DWater Supply OSA RECEIVED E]Other JUN 16 2015 PLEASE REMEMBER TO SIGN ON THE REVERSE 4 CENTRAL FILES ❑ No discharge this period' DWR SECTION V ZA 00 N� �5 Y- U 0 lec 6&... P -NdnL. -:1 t tandarawnit Mt Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum ,Bulk Stations and Terminals F'Outil'51U.- W, In. p.-,.55 ftfowco lh!cb� Nun7riulai� to Rr d -'�pi�pi�nddd�.Sdilj s W, "'0 0 :1�5 j,' Stafit art. h Limit--�F 0- 0 Mow pisrmit ;T- P, 'i q , b - 3 0, 9 r-AqIL I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 5WU-250 last revised October 25, 2012 Page i of 2 STORM EVENT CHARACTERISTICS: Date t ' "13T (first event sampled) Total Event Precipitation (inches): 9 /p Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Nate: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text - FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER.TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. + TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES 0 NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR including all "No Discharge" reports, within 30 da s of receipt of the lob results jor at end of monitoring eriod in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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, 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." of Permittee) (Date) Additional copies of this form may be downloaded at: http://Portal.ncdenr.orgZweb/wci/ws/su/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 I aceAnaWal www.pecela6scom June 09, 2015 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: STORMWATER Pace Project No.: 92252988 Pace Anatytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-g092 Dear Mr. Ray: Enclosed are the analytical results for sample(s) received by the laboratory on June 04, 2015. The results relate only to the samples included in this report. Results reported herein conform to the most current TN standards and the laboratory's�Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. Analyses were performed at the Pace Analytical Services location indicated on the sample analyte page for analysis unless otherwise footnoted. If you have any questions concerning this report, please feel free to contact me. `Sincerely, y� c-- Liamm Carrubba liamm.carrubba@pacelabs.com Project Manager Enclosures cc: Ms. Robyn Snow, 'town of Zebulon PLC 0 it sTNI REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 1 of 12 F1 acmnalytical wmpacelabs.oam Project: STORMWATER Pace Project No.: 92252988 Raleigh Certification IDs 6701 Conference Drive, Raleigh, NC 27607 North Carolina Wastewater Certification #: 67 Charlotte Certification IDs 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 North Carolina Drinking Water Certification M 37706 North Carolina Field Services Certification #: 5342 North Carolina Wastewater Certification M 12 South Carolina Certification #: 99006001 CERTIFICATIONS North Carolina Bioassay Certification M 16 North Carolina Drinking Water Certification #: 37731 FloridalNELAP Certification #: E87627 Kentucky UST Certification #: 84 West Virginia Certification #: 357 VirginiaNELAP Certification #: 460221 REPORT OF LABORATORY ANALYSIS Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875.9092 This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 2 of 12 aceAnalytical www.Pacelab&oom SAMPLE ANALYTE COUNT Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: STORMWATER Pace Project No.: 92252988 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92262988001 STORMWATER #1 SM 2540D RC 1 PASI-R 92252988002 STORMWATER #2 EPA 1864E CLW 1 PASI-C REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Anaytical Services, Inc.. Page 3 of 12 acmnalyiical. Kww.pace&ftcom ANALYTICAL RESULTS Pace Analytical Services, Inc. 9800 Kincey Ave, Suite 100 Huntersville, NC 28078 (704)8759092 Project: STORMWATER Pace Project No.: 92252988 Sample: STORMWATER #1 Lab ID: 92252988001 Collected: 06/03/15 13:56 Received: 06/04/15 15:45 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 2540D Total Suspended Solids Analytical Method: SM 2540d Total Suspended Solids 10.9 mgtL 3.6 1 06/05/15 10:47 Sample: STORMWATER #2 Lab ID: 92252988002 Collected: O6I03115 13:58 Received: 06/04/15 15:45 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 1664E Oil and Grease ND mg[L 5.0 1 06/08/15 09:03 Date: 06/09/2015 10:12 AM REPORT OF LABORATORY ANALYSIS This report shalt not be reproduced, except in full, without the written consent of Pace Anatytical Services, Inc.. Page 4 of 12 aceAnaIXical www.pwolobs.com QUALITY CONTROL DATA Project: STORMWATER Pace Project No.: 92252988 QC Batch: GCSV121573 Analysis Method: EPA 1664E QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92252988002 METHOD BLANK: 1478267 Matrix: Water Associated Lab Samples: 92252988002 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Oil and Grease mg1L ND 5.0 0610&15 08:54 Pace Analytical Services, Inc. 9800 Kinoey Ave. Suite 100 Huntersville, NC 28078 (704)8759092 LABORATORY CONTROL SAMPLE: 1478268 Spike LCS LCS % Rec Parameter Units Conc. t Result % Rec Limits Qualifiers Oil and Grease mglL 40 38.3 96 78-114 MATRIX SPIKE SAMPLE: 1478269 92252978001 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Qualifiers Oil and Grease mglL ND 40 35.1 88 78-114 Results presented on this page are in the untta Indicated by die "Units" column except where an alternate unit is presented to the right of the resutL REPORT OF LABORATORY ANALYSIS This report shall riot be reproduced, except in full, Date: W09/2015 10:12 AM without the written consent of Pace Analytical Services, Inc.. Page 5 of 12 aceAnalytrcal� wwwpacelebaoom QUALITY CONTROL DATA Project: STORMWATER Pace Project No.: 92252988 Pace Analytical Services, Inc. 9800 itinceyAve. Suite 100 Huntersville, NC 28078 (704)875r9092 QC Batch: RWET18383 Analysis Method: SM 2540D QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92252988001 METHOD BLANK: 1477579 Matrix: Water Associated Lab Samples: 92252986001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg/L ND 2.5 06/05/15 10:43 LABORATORY CONTROL SAMPLE: 1477680 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Suspended Solids mg1L 250 272 109 90-110 SAMPLE DUPLICATE: 1477581 92252755001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 353 342 3 SAMPLE DUPLICATE: 1477582 92252758001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 180 195 8 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 fun, Date: 0610912015 1Oil AM without the written consent of Pace Anaytical Services, Inc.. Page 6 of 12 aceAirnalytical MW.peastab.com QUALIFIERS Project STORMWATER Pace Project No.: 92252988 DEFINITIONS DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot. NO - Not Detected at or above adjusted reporting limit. 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. Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 S - Surrogate 1,2-Diphenythydrazine decomposes to and cannot be separated from Azobenzene using Method 8270, The result for each anatyte 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, Styrene, and Vinyl chloride. A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis ofAcrolein and Acrylonitrile by EPA Method 8260. N-Nitrosodiphenylamine decomposes and cannot be separated.from Diphenylamine using Method 8270. The result reported for each analyze is a combined concentration. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI - The NELAC Institute. LA130RATORIES PASI-C Pace Analytical Services - Charlotte PASI-R Pace Analytical Services - Raleigh ANALYTE QUALIFIERS D6 The relative percent difference (RPD) between the sample and sample duplicate exceeded laboratory control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 0610912015 10:12 AM without the written consent of Pace Analytical Services, Inc.. Page 7 of 12 acmnalytical wwwpeaKabs.com QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: STORMWATER Paoe Project No.: 92252988 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)8759092 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92252988002 STORMWATER #2 EPA 1664B GCSV121573 92252988001 STORMWATER #1 SM 2540D RWET18383 REPORT OF LABORATORY ANALYSIS This report shall not he reproduced, except in full, Dale: 06/09/2015 10:12 AM without the written oonsent of Pace Analytical Services, Inc.. Page 8 of 12 7acmnap..Iical Document Name: Sample Condition Upon Document Revised: May 15, 2015 f . Recel t SCAR Pa e 1 of 2• Document No.: Issuing Authorities: °"' F-RAt--CS-001-rev.03 Pace Raleigh Quality Office 'Page 2 of 2 la for Internal Use Only Client Name:��y�N� O-� ��Al�Y1 Courier (Circle): Fed Ex UPS LISPS Client Commercial Pace Other Custody Sea] on Cooler/Box Present: ❑ yes e no Seals Intact: ,0 yes no Packing Material: E] Bubble Wrap B Bags None r 1 Other Circle Thermometer Used: IR Gun : 2206538TT of Ice:Blue None Samples on Ice. cooling process has began IR dun 8 :122065371 Tsmp Correction Factor: Add C'u C Data and initials of person examloina Corrected Cooler Temp.: j C Biological Tissue Is Frozen: Yes No NIA co to li P es chock: 'temp should be above freezing to SIC Comments: Chain of Custody Present: ae ❑No ❑NrA 1, Chain of Custod Filled Out: es ❑No IQNIA 2. Choln of Custo Relin ulshed: 46Y. ❑No ❑N% 3. Sampler Name & Si nature on COC: 6Y.. ❑No ❑Nm A. Samples Arrived within Hold Time: Yes ❑No ❑NIA 5. Short Hold Time Analysis 472hr : ❑Yes No ❑NIA 8. Rush Turn Around Time Requested: ❑Yes No ❑NIA 7. Sufficient Volume: VY. ❑No ❑NrA 8. Correct Containers Used: Yes ❑No LIMA 9. -Pace Containers Used: �(Yqs ❑No ❑NfA Containers Intact: Yes ❑% 13WA 10. Flitered volume received for Dissolved tests ❑Yes ONO N!A 11. Ssmpla Labels match COG: Y ONo ❑WA 12. Includes dateilime/lIDJAnatysis Matrix: Ail containers needing preservation have been checked. ?"10% ❑No ❑NrA 13. All containers needing preservation are found to be in Ye! ❑tfD 13NrA compliance YAM EPA moommendation. excoptions. VOA, oofrom 70C.0&0. WMRO(Weler 4ee ONo Samples checked for dechlorinalion: Yes ❑No ❑wA 14, Hoads ace in VOA Vials !timrn : Dyes ❑No wA 16. Trip Blank Present: Oves ❑No WA 16, Trip Blank Custody Seals Present ❑Yes ❑No VWA Pace Trip Blank Lot* if purchased ), - Client Nottfieationl Resolution: Field Data Requlmd7 Y I N Person Contacted: Datef ime: Comments/ Resolution: SCURF ISRF Rev:ew:: bate: 'wale: Whenever Uwe is a discrepancy affecting North Carolina compliance samples, a copy of this form will be sent to the North Carolina DEHNR Certification Office ( Le out of hold, Incorrect preservative, out or temp, incorrect Containers) W0#:92252988 1111111111111111111111 92252988 Page 9 of 12 N O O f2ceAnalytical. CHAIN -OF -CUSTODY I Analytical Request Document'', Ttta Ctminct-Cuamdy is a LEGAL DOCumENT. Aft rekvom fields must w coffoWded acouateM. wJs itMR1 ®� f +. SAMPLE ID 04 • P♦ r ■.. . • mill e ►a it-_ I �-� � :�:��l�rl^+Ky��I�F���,.1��7�//��''�■.■.�■�■�. i•>t■■■�■■■■■■�� i _ �'•?li�`�s,1.i�iCIF01iiJarl!f�i aka . �own I 'k„vw•.ama N" Dir vo it -n farm you are a= p5v' g to btcdlo" of t,Yo oc montR krMy inra,Crs r N DQII *-dtw 70W Yr - F-ALL-0-020rtw.07.154ay•2007 �2 Document Name: Sample Condition Upon Document Revised: May 15, 2015 .�aceArralrIC�?I- Receipt SCUR Page 1 of 2• !-" .+wwpeeue6�eo,n Document No.: Issuing Authorities: F-RAL-CS-001-rev.03 Pace Raleigh Quality Office Page 2 of 2 is for Internal Use Only Client Name: --rn\o 1 &- �k\oU�1�C�y_1 Courier (Circle): Fed Ex UPS LISPS Client Commercial Pace Other Custody Seat on Cooler/Box present: l] yes W no Seals Intact: Z yes l] no Parking Material: ❑ Bubble Wrap B Bags VNone Other Circle Thermometer Used: IR Gun : 2206538;T of ice:�8lue None ❑ Samples on ice, cooling process has begun IR Gun 9 :122005371 Temp Correction Factor: Add (D"u^ C hate and Init alb of parson aXamining Corrected Cooler Temp.: C Blot ogical Tissue is Frozen: Yes No Nu eha k t s Is ea Temp should be above freezing to WC Comments: Chain of Custody Present: 0.. ONO ❑NIA 1. Chain of Custody Filled Out: ec ONO QNIA 2. Chain of C6stoq Relinquished: 46y,, ON. ❑NrA 3. Sampler Name & Si nature on COC: 6Y.. ON. ❑NrA 4. Samples Arrived wlthln Hold Time: Yes ONO ❑NIA S. Short Hold Time Anal sls <72hr): wee No ONIA 6. Rush Turn Around Time Requested: I res No ❑NIA 7. Sufficient Volume: as ❑No ❑NIA S. Correct Containers Used: Yes ❑No ❑NIA 9. -Pace Containers Used: A. ONO ❑NrA Containers Intact: Yes ON. 13w!A 1D, Filtered volume received for Dissolved tests OYes ONO RINIA. 11. Semple Labels match COC: Y ONO OwA 12. -Includes datellimellDlAnai sls Matrix: All containers needing preservation have been checked, Os❑No OW/A 13. All containers needing preservation are found to be In as CINo V'Y ❑WA compliance with EPA recommendation. excoptfona: VOA, oollbrm TOC, OAG. WI-DitO water)XY" 13NO Samples checked for dechlorinatlon: 16Y. ONO OWA 14. Roads ace in VOA Vlais (>6mm): OYes ©No NIA 16. Trip Blank Present: OYes ONo NIA 16. Trip Blank Custody Seals Present DYas ❑No INIA Pace Trip Blank Lot # Itpurchased): Client Notifieatianl Resolullon: Field Data Required? Y 1 N Person Contacted: Dater -me: Comments/ Resolution: SCURFf$RF Rev;ew:: Date: !vole: Whenever there Is a discrepancy affecting North CaroSne compliance samples, a copy of this form will be sent to the North Carolina DEHNR Cerllncetion Ofto ( Le out of hold, Incorrect preservative, out of temp, Incorrect containers) wo:92252988 02232968 Page 11 of 12 r 2ceAnalyfical' CHAIN -OF -CUSTODY / Analytical Request Document' . The CN*b -ofC[lr+meY is a LEGAL DOCUMENT. Aq reievaM fmift must ne mmmoAd a=wvt N. . mill jj�� 1111111, 111 1� lfir• rNL ANNE'• -r 0RJNKrNG MW �i • 1 1� r SAMPLE r 01 OLAir AR odw Orr Sal _li[G•r[^.KIFaai!:';VM■■■■■■..■■ r1.],■■■■■■■■■■■■ i" V, NOV e ■■�■■_�■■■■�■■■■■■■■■ ■■■■■■■■■■■m■ loss loss Is e ■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■ loss loss loss Is e ■■�■■■■■rr■■■■■■■■■■■■ ■■■■■■e■■■■■■ e ■■■■�■■■■■■■■■■�■■■■ ■■■■■■■■■■■■■ loss loss � Is e ■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■ 101101101101 loss Is m ■■■�■�=■m■i■i■■ii■si i■■■■■iiiiiiIr TRRSHMP m MIA .: ,._ ... - - _ -gin ►: z.,�,11"kaVA jai. StGNATURE of E. O N d) a k rWr ra Nova. G) wmmp 4vs Wn ym m. AW.It-I P .i'c NET ID any- jm,r.—a •—m :.W o7u q m um Chvf. a or 1.50% 9Q mo= tv"m.om= nor asia Mmn W myr - .. F-ALL-O-=rev.07.15Uay-2007 k NCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit: b—U-p--,Z/portal.ncdenr.orglweblwQ/ws/­su/npdessw#tab-4 Permit No.: �(/c/_l� l_I_I_/_// or Certificate of Coverage No.: Facility Name: Z7r Lt140,-C- t,&lA6 F & County: _ ki4k c-_ Phone No. _ (91g) ,2t q - gfs' inspector: _�l�r,`� _GV Date of Inspection: - 3-13" Time of Inspection: / S1 p•» Total Event Precipitation (inches): lyio �/ Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) 9 Yes ❑ No Please verify 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 "measureable 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 E 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 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Sigi�e of Permittee or Designee) Page l of 2 SWU-242, Las[ modified 10/25/2012 1. Outfall Description. Outfall No. 1 Structure (pipe, ditch, etc.) -A Receiving Stream: kn .?r— K- IQ'vr Describe the industrial activities that occur/within the autfall drainage area: LWr/i--1,-A1 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: _ 1;���)� 76911 3. Odor: Describe any distinct odors that the discharge may have Ci.e., smells strongly of oil, weak chlorine odor, etc.): 10.6, 4. Clarity. Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 20 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: (D 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: a2 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 evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe /V"'� 6A11"ll "2 /, // c / I (Vote: 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 5WU-242, Last modified 10/25/20 L2 NODE R Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit: htt�/4Rortal.ncdenr.orelweb/wq/­ws/su/npdessvvv#tzb-4 Permit No.: i�f/C/_/�/_/_/_/�/�/ or Certificate of Coverage No,: NICI I-s?I sI DI I1I0 Facility Name: oWA County: L')f4ke Inspector-, _ CA, L� �. Date of Inspection: �- Time of Inspection: /•'SY Dom? _ _ _ Total Event Precipitation (inches): Phone No. (11i9) 66-Y U-f- _ Was this a "representative Storm Event" or "measureable Storm Event" as defined by the permit? (See information below.) 0 Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" (requirements vary, depending on the perm(t). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be _ performed during a "representative storm event" or during a "measureable storm event." However, r 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 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 DWQ Regional Office.� By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signa�ofPermittee or Designee) Page 1 of 2 SwU-2,F2, Last modified l0/25/2012 1. Outfall Description: Outfall No. S Structure (pipe, ditch, etc.) Receiving Stream: [L- - Describe the industrial activities that occur within the outfall drainage area: < ye 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 7"��,-7 _ 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): ArG 4. Clarity; Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 L% 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 Q 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? Yes No S. Is there an oil sheen in the stormwater discharge? Yes '1N 9. Is there evidence of erosion or deposition at the outfall? Yes No 1.0. Other Obvious Indicators of Stormwater Pollution: List and describe Ae� T 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. Pane 2 of 2 5wU-242, Lastmodiried 10/25/2a12 f CHAIN -OF -CUSTODY ! Analytical Request Document ��aceAnalyfical • , The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately, www_oatelabs.com ti Section A Section B Section C Page: of Required Client Information: Required Project Information: Invoice Information: Cam (� j Report To: i - Attention: 1782843 Address- Copy To: • Company Name: REGULATORY AGENCY ` f t 4?G + �1f . :) 7,-�,Ir %mil � 4� Address: r NPDES r GROUND WATER r DRINKING WATER r UST j� RCRA r OTHER Email To: Purchase 41 I Order Nq� l Pace Ouole 1t VA %t l -, ;1, P, 7P `l,1 f ??'tr .r ! �l1 1 Reference: Phone: r `f-�l `t`•'(� Fax:., - Pro-dct �`7 7 Name: ( I , r • Pace Protect Site Location I�i 77- -,.� i'Y'1� r rT 1 izJ/4 Y-{� Manager: STATE: Requested Due DaterrAT; Pr Iect Number: Pace Profile N: Requested Air iysis Filtered (YIN) Section D Matrix Codes o Required Client Intomaeon MATRIX 1 CODE COLLECTED Preservatives `> Drinking Water DW o �U z O Y f Water WT Waste Water - WW 8 U m COMPOSITE COMPOSITE r` U C i Product P START ENn1GRAa J SoillSolid SL N (9 p SAMPLE ID Oil OL a w pe WP Wipe (A-Z, 0-9 1,Air AR '' �\ - O Sample IDS MUST BE UNIQUE Tissue TS O (L F H t Other OT U X � w � w Z OU p 7, TL rG Q a (n O C)� C to L-' L M 0 ~ W 0 _ _ = z O ` _ DATE TIME DATE TIME lY Pace Project No./ Lab I.D. tom, Lf-ir 11- 0 r 11 0: `�,..,I � : 5t , . .j 2 � r 3 4 5 ) 6 7 13 9 J12 ADDITIONAL COMMENTS lr RELITIQUISHED BY I AFFIDATION� DATE TIME ACCEPTED BY I AFFILIATION DATE TIME SAMPLE CONDITIONS Lhilj-7 /} it D _ SAMJLER NAME AND SIGNATURE ~ U c `m m 'a > _ cn a } C _ TO PRINT Name of SAMPLER: .` v " 0 u U v E v DATE Signed SIGNATURE of SAMPLER: (MMlDDlYY}: ~ Of 'Important Note: By signing this form you are accepting Pace's NET 30 day payment terms and agreeing to late charges of 1.5% per month for any invoices not paid within 30 days. F-ALL-0-020rev.07, t 5-May-2007 Instructions for completing Chain of Custody (COC) 1. Section A and B: Complete all Client information at top of sheet: company name;, address, phone, fax, contact (the person to contact if there are (` rqutstions. and who will receive the; final report.), e-mail address (if available), PO#, Project Name and/or Project Number as you would like to see it appear oil the report. 2. Section C: Invoice Information! Billing information is included in this section. This information should include the name and address of the person receiving the invoice.. 3. Quote; Reterence should be completed if a quotation was provided by Pace Anahlical. The Project Manager, and Profile No. will be completed by Pace Anal)lical Services. 4. Site Location: A separate COC must be filled out for each daN, of sample collection. Record the two letter postal code for the; US state in which the: samples were collected. 5. Re2ulatory Agency: List the program that is guiding the; work to ensure proper regulations are followed. 6. Section D: Complete a Sample Description in the "SAMPLE ID' section as you would like it to appear on the laboratory report. The following information should also be included: the: sample matrix, sample type (G (grab) or C (composite). When collecting a composite; the start time and end time should be documented in the: respective bones. The collection time for a grab (G) sample should be entered in the boxes marked 'Composite End/Grab'), Sample temp at collection (if required by state), the total number of containers, and preservative used. 7. Mark if the sample was filtered in the field by marking Y or N in =Piltered' row by the Analysis requested. 8. Requested Analysis: List the required analysis and methods on the: lines provided and place a check in the column for the: samples requiring the analysis. Additional comments should be referenced in the bottom left hand corner or include attachments for extended lists of parameters. 9. The sampler should print their name in the space provided and sign their name followed by the date of the sampling event at the bottom of the COC in the: spaces designated fir `SAMPf ER NAME AND SIGNATURE, 10. When relinquishing custody of the samples to a representative of the laboratory or other organization, indicate the Item Numbers of those samples being transferred; sign relinquished by, date, and time, and include your affiliation. *Important Note: Standard Turnaround Time is 2 Weeks/10 business days. Results will be delivered by end of business on the date due unless other arrangements have; been made with your project manager. Special Project Requirements such as Low Level Detection Limits. or levels of QC reported must be included on the chain of custody in the Additional Comments section.—'- ' STORMWATER SAMPLING TIMELINE WEDNESDAY, JUNE 3, 2015 10:00 a.m. — Light misting rain 11:15 a.m. — Rain (light), no discharge 1.45 p.m. — Rain (heavy), no discharge 1.52 p.m. — Moderate to heavy rain, beginning discharge 1:58 p.m. — Sample taken (moderate to heavy rain) 2:05 p.m. — pH reading of 7.46 Total rainfall = 0.9" Sample taken by Chris Ray, Director of Public Works Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE NO. N0008 4 FACILITY NAME 6li7n 2Ankj� COUNTY I.JO VP SAMPLE COLLECTION YEAR 1z)jr - b i H! SAMPLE PERIOD ❑ !an -June [] July -Dec r/ or ❑ Monthly' (month) PERSON COLLECTING SAMPLES DLO LABORATORY ROC e► _ Lab Cert. # Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements DISCHAR4VTO CLASS ❑ORW ❑HQW ❑Trout ❑PNA � ❑Zero -flow ❑Water Supply ❑SA ❑Other a� M-MMLEASE REMEMBER TO SIGN ON THE REVERSE 4 F D�lFzg ❑ No discharge this period >O`;uNtofallk " p.ae - Sample7CoIlect rsample mo .dd/.yf-a, {uU0534S WA TotaSuspended_ k� iEds .m L OHA, y 'L _L Standard units - _.. iU0 Non=Polaar OilndGiease%TPHEPANew?Mo�tyo�r�0ii_Usage, 3a~s�yC,�:S�-�}«�N �.`���5`"`Y=�� r3�+. _•h' Method=1664i; SGT iIEM ,•_m %L` - r �'��f•, "Y.i`��• ,'_.Si.���' "w .�• Annualba�era e_ al .mo. µ '.'-ti�}•�-t�.:i"„:. �".itA i ;Benchmark:«s50ior�1Q0 'dN'.-'k.,t- -... .:Sd° .,.4..'. nr:` �....:..,. � m:w.... Ix1Yt" _..i .:: �8: 7•e..�xi see' ermitr�W�thin'f090�5� ..-,.: .: :[ y'P'.. .�= h 3 S4•'. m Si ^'"z]I h4 2 .'ZrF:, Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? , yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals Outfa���ila+'� .4�'.+'-'•".:hyr{--�'x.",Htl IVo t'h� ° spate Sample:Collected; > ..r;.. ' �m�/tld/>Yr1654,(SGTH£Mr►1ga 00556 x ` ,R 0053Q� 00400 x k rim: 1 NpnP.alarfOil PRSWZ s y6 ,,�-. '9 s� i�.tiiE _ s!T!g/����.5tandard uI --•• r �_ .%,. r�F Pe.rmrt,LEmit.;"„ �,, �"i"` -- .. , =i^ $�� f�>r:. fir. --. � ��'15�50korw1Q0.seer - _ _.� .;-Yaz,�•^. pe: „r�`MEtl��?u � . .� �6 Oa9 0�) I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised October 25, 2012 Page; 1 of 2 STORM EVENT CHARACTERISTICS: _ Date +- b s(first event sampled) I� Total Event Precipitation (inches): I Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): ! Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANYONE OUTFALL? YES [] NO M IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Marl an original and one cony of this DMR, including all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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 gatheri a information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are„significant pena ies for sub itting false information, including.the possibility of fines and imprisonment for knowing violations." (Signatu?16-of Permittee) r/ (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 acmnalytir'cal s www.paeerabs.com May 11, 2015 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: STORMWATER Pace Project No.: 92247948 Pace Anayticat Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Dear Mr. Ray: Enclosed are the analytical results for sample(s) received by the laboratory on May 01, 2015. The results relate only to the samples included in this report. Results reported herein conform to the most current TN standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. Analyses were performed at the Pace Analytical Services location indicated on the sample analyte page for analysis unless otherwise footnoted. If you have any questions concerning this report, please feel free to contact me. Sincerely, Liamm Carrubba liamm.carrubba@pacelabs.com Project Manager Enclosures cc: Ms. Robyn Snow, Town of Zebulon pCCAE�� REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 1 of 10 Pace Analytical Services, Inc. aceAnalytrcal s 9800 Knoey Ave. Suite 100 Huntersville, NC 28078 www.pwe1ab&wm (704)875-9092 CERTIFICATIONS Project: STORMWATER Pace Project No.: 92247948 Raleigh Certification IDs 6701 Conference Drive, Raleigh, NC 27607 North Carolina Wastewater Certification #: 67 North Carolina Bioassay Certification #: 16 North Carolina Drinking Water Certification #: 37731 Charlotte Certification IDs 9800 Kinsey Ave. Ste 100, Huntersville, NC 28078 Florida/NELAP Certification #: E87627 North Carolina Drinking Water Certification M 37706 Kentucky UST Certification M 84 North Carolina Field Services Certification #: 5342 West Virginia Certification #: 357 North Carolina Wastewater Certification #: 12 VirginiaNELAP Certification #: 460221 South Carolina Certification #: 99006001 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the mitten consent of Pace Analytical Services, Inc.. Page 2 of 10 • aceAnalytfcal Kww.pa0ei8b& n SAMPLE ANALYTE COUNT Project: STORMWATER Pace Project No.: 92247948 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Analysts Lab ID Sample ID Method Analysts Reported Laboratory 92247948001 STORMWATER #1 SM 2540D RC 1 PASI-R 92247948002 STORMWATER #2 EPA 16646 CLW 1 PASI-C REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written oonsent of Pace Analytical Services, Inc.. Page 3 of 10 aceAnalytical www.pacelehs.corn ANALYTICAL RESULTS Pace Analytical Services, Inc. 98001GnceyAve. Suite 100 Huntersville, NC 20078 (704)8759092 Project: STORMWATER Pace Project No.: 92247948 Sample: STORMWATER #1 Lab ID: 92247948001 Collected: 04/30/15 09:55 Received: 05/01/15 14:40 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No, Qual 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 27.0 mg1L 8.3 1 05/06/15 09:55 Sample: STORMWATER #2 Lab ID: 92247948002 Collected: 04=/15 09:55 Received: 05/01/15 14A0 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Oil and Grease pale: 05/11/2015 08:04 AM Analytical Method: EPA 1664B ND mg/L 5.0 1 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pate Analytical Services, Inc.. 05/06/15 09:02 Page 4 of 10 accAnalytical' www.pacelabacom QUALITY CONTROL DATA Project: STORMWATER Pace Project No.: 92247948 QC Batch: GCSV121203 Analysis Method: EPA 1664B QC Batch Method: EPA 1664E Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92247948002 METHOD BLANK: 1451118 Associated Lab Samples: 92247948002 Parameter Units Oil and Grease mg1L Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 5.0 05/06/15 08:53 Pace Analytical Services, Inc. 9800 KGncey Ave. Suite 100 HuntersvUle, NC 28078 (704)8759092 LABORATORY CONTROL SAMPLE: 1451119 Spike LCS LCS % Rec Parameter Units Cone. Result % Rec Limits Qualifiers Oil and Grease mg1L 40 33.4 83 78-114 MATRIX SPIKE SAMPLE: 1451120 35186609001 Spike MS MS % Rec Parameter Units Result Cone. result % Rec Limits Qualifiers Oil and Grease mg1L 28.8 41.7 67.8 94 78-114 Results presented on this page are In the units indleated by the -Units- cotumn except where an atternate unit Is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall rat be reproduced, except in full, Date: 05/11/2015 08:04 AM without the written consent of Pace Analytical Services, Inc.. Page 5 of 10 aceAnalytical wwwpace0ftcom QUALITY CONTROL DATA Project: STORMWATER Pace Project No.: 92247M Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QC Batch: RWET18288 Analysis Method: SM 2540D QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92247948001 METHOD BLANK: 1449920 Matrix: Water Associated Lab Samples: 92247948001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg1L NO 2.5 05/05/15 09:52 LABORATORY CONTROL SAMPLE: 1449921 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Suspended Solids mg/L 250 242 97 90-110 SAMPLE DUPLICATE: 1449923 92247926001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 774 762 2 SAMPLE DUPLICATE: 1450285 92247860003 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 16.0 15.1 6 D6 Results presented on this page are in the unite Indicated by the "tlntIV column except where an alternate unit Is presented to the right of the resutL REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 05/11/2015 08:04 AM without the written consent of Pace Analytical Services, Inc.. Page 6 of 10 s IacleAnalytical (�rnvw.pscefabamm QUALIFIERS Project: STORMWATER Pace Project No.: 92247948 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. 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. Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 26076 (704)875.9092 S - Surrogate 1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is a combined oonoentration. 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, Styrene, and Vinyl chloride. A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis ofAcrolein 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. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI - The NELAC Institute, LABORATORIES PASI-C Pace Analytical Services - Charlotte PASI-R Pace Analytical Services - Raleigh ANAILYTE QUALIFIERS D6 The relative percent difference (RPD) between the sample and sample duplicate exceeded laboratory control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 05/11/2015 08:04 AM without the written consent of Pace Analytical Services, Inc.. Page 7 of 10 (�Ia'neAnalyfical* *W'G cefaC C= QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: STORMWATER Pace Project No.: 92247948 Pace Analytical Services, Inc. 9800 Kincey Ave, Suite 100 Huntersville, NC 28078 (704)875.9092 Analytical Lab ID Sample ID OC Batch Method OC Batch Analytical Method Batch 92247948002 STORMWATER #2 EPA 16646 GCSVI21203 92247948001 STORMWATER 91 SM 2540D RWET18288 REPORT OF LABORATORY ANALYSIS This report shall not he reproduosd, except in full, bale: 05119l2015 08:04 AM wMiorrt the written consent of Pate Analytical Services, Inc - Page 8 of 10 Document Name: Sample Condition Upon 7 Document Revised: April 04, 2013 �PaCB,4r?afytiCai^ Receipt SCU.R Page 1 of 2 Document No.: Issuing Authofitles: F-RAL-CS-001-rev,02 Pace Asheville Quality Office Client Name: -�ju Djn. _ Where Received: n Huntersville Asheville ❑ Edon Raleigh Courier (Circle): - Fed Ex UPS LISPS Client - Commercial Pass . other_ Custody Seal on Coo lerlBox Present: f[] yes Imo' no Seals Intact.. � yes n no Packing Material: 0 Bubble Wrap B e Brigs �/ None Other Circle Thermometer Used: IR Gun N-122065387T ' e of Ice: Wot Blue None ❑ Samplos on ice, cooling process has begun _ If�Gun HBUu 22065371 Temp Correction Factor: Add 1 ubtract C Date and Initials of Person examining co to 1 i Pr " ry on Ccrrected.Cooler Temp.: �� C liiologfcaf Tissue is Frozen:.Yeb xo 'A check Temp. should be above treezing to VC Comments: Chdin of CUStod . Present: s' ONO • ©wA 1 Chairs of Custody F111W Out: Yes ONo ❑wA 2- Chain of Custod , Relinquished: Y a. ONO ONiA 3. Sampler Name & Signature on COC: Yes ❑No .C]N1A 4., Sane les Arrived within Hold Time: os 11No C1wA 5. Short Hold Time Anal is <72hr : ❑Yos No DIVA G. , Rush Turn Around Time Requeeted: ©Yes No ©wA 7. Sufficient Volume Yae pNo OYL 8. Correct Containers Used: -Pace Containers Used: Yes ONo Yes ONo ©NIA QwA 9. ' Containers Intact: zyes ONo OWA 10. Filtered volume received for Dlssolvod tests OYes ONo nrrA 11. Sample Labels match COG: -Includes dateltimellDlAnal sis Matrix: f�Yes ❑f�to rtUn -- OWA 12. AU containers needing preservation have been checked. All containers needing preservation are found to be in compliance avith Ff A reeommordetion. excepilws: VOA, Conform, TOC, 090, Wl DRO (victor) "Yes QNo 17r�e3 ©No Yes 13 No OhllA OWA 13, Samples checked.for dechlorinotion: Yes DNo 1:3rvA 14, Headspace in VOA Vials ( >6mm): ❑Yes ONa Q91A 15. Trip Blank Present: Trip Blank Custody Seals Present ,Pace Trip Blank Lot # (if purchased):, t]yes ❑No Wk Oyoe L7lio )XWA 16. Client Notification! Resolution: Field Data Required? Y .1 N Person Contacted> Dale/Time: Commenisf Resolution: SCURF 15RF Q�9 I pate: J—i"rT Rvvivw:: kS Note: Whenever there Is a discrepancy affecting North Carolina compliance samples, a copy of this form rill be sent to tho North Carolina DE=HNR Cortififmtlon Office (i R out of hold, incorrect preservative, out of temp, incorrect containers) Wpg922.47948 IIIIIIIIII�➢IUININ Page 9 of 10 CHAIN -OF -CUSTODY i Analytical Request Document The Chakn &-Custody Is a LEGAL DOCUMENT. An relevant Saida must be co npwocl aocuratefy. aceAinafyt,ca!'. P� - wwr.sesNaea.cum e. 4 Section A Section a Section C Page: of Roqulted Gent InTorn8WrLsatlom Req-1ned Project Info nnUm- Inwtce Information: °°"- b� ReportT° �° 1510622 Addr,g CoPYTO: Company Nana: '- - REGiiLA70iiY AGENCY. b, 0foss' i NPDES r GROUNO WATER T— DRINIc1NG WATER F UST >— RCRA 7 OTHER Email, Ta Order No.: OUae IA. 711L .reraKa. P F NamO: Pace Prged Site Location . STA7E: Requ ted Due 0ate1TAT: Propct NurnW.. Pars owe. t: Q 1 Requested Analysis Filtered (Y" Section D 111t1<trol Codes A.ymr-dC%-t ena� n�raoc-,._eoe� z s a COLLECTED PreservaWa,Y i Oinkltq Water DW z wow v,r wasmwater ww COMPO +re oo.rr"oare I' Product P STAFU EW-U 9 IN Z SaNSOO SL p 0 SAMPLE ID wig - " w W ,(X (A.Z, 0.91, l A+ AR p a � c Sarrgle IDS MUST BE UN10UE T'ssua TS O a- r $ tJ1 a OT�� X m Wzto t1� z_ Tgq 0 OIS DATE TIME OArw TIME N a = Z z Q y tz Pace Project Not Lab I.D. 5� O s` $;ST Y 1 z r y R� 3 E $ 6 r a 9 10 11 12 ADO17TONAL COMMENTS REllY =tSHED BY I AFFFLIAT;ON DATE . TIME ACCEPTED BY 1 AFFUATION DATE THEE SAMPLE CONDITIONS Uqo 3 Ci SAMPLER N, Iw AND SIGNATURE � � ^ ANGINAL V 2 4 PRINT Name OI $AMPLER: C n ¢ u ? w = SIGNATURE of SAMPLER DATE Slpned = U c n (MMlDD1YY): y w tT Cc a inpomtnl Nde: eY av-n e.s bm iw rs acaeparq P.ce-s NET JO e.y Parm<*Km.ra::.w sPreeeq w ts� + of 1.5%pr, eranr, w +(�'rs� na ytia wtFtiM1 `a "Vt F-ALL-0-92I3rev.07, 15-May-26D7 AFry , Vj 0, YA ..w:.a ' m�.r� HCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit. hU:� /portal.ncdenr.orewebiwoJws/su/npdess/w4tab-4 Permit No.: iV/G/—J_ I�I—I�I�I—I or Certificjto of Coverage No.: NJC/GI�IgII�2II Facility Name: _ � _ !?F 2tiv�� %rG�ic L��t� Alf rl County: Inspector: Phone No. q14 - R 6$ -Sd � Date of Inspection: iS Time of Inspection: _ _ isr'g-rt_ tt Total Event Precipitation (inches): I_,_• { `� Was this a "Representative Storm Event" or " Measureable Storm Event" as defined by the permit? (See information below.) yYes Q No Please verify 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 "measureable 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 1.0 consecutive hours of no precipitation. A "measurable storm event" is a storm event that results in an actual discharge from the z 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 DWQ Regional Office. By this signature, I ce Fy that this report is accurate and complete to the best of my knowledge: (SignUdre of Permittee or Designee) Page 1 of 2 SWU-2,12, Last modified 1M25/2012 1. Outfall Description: Outfall No. l Structure (pipe, ditch, etc.) Receiving Stream: kn" -'cty p-� ti4q delC', k d% 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors:,ari 3. Odor: Describe any distinc odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): No^C. 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: f� 1 (9 3 4 5 S. 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: L./ 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: . 0 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes 8. Is there an oil sheen in the stormwater discharge? Yes 9. Is there evidence of erosion or deposition at the outfall? Yes 10. Other Obvious Indicators of Stormwater Pollution: List and describe iU06j- 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 5WU-242, Last modified 10/25/2012 MDER Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit art 1,ncdenr.or web w ws su n d ssw# a - Permit No.: iv/C/,/�/,/�/_/_/,/ or Certific to of Coverage No.: Facility Name: �wn SE -2eho 42n C, L br LAO J1,20rl County: Phone No. _Q(4 - o? 64 'S Inspector: � _ rD �--- Date of Inspection: 4YI-V /S Time of Inspection: 1:35tm Total Event Precipitation (inches): I -� Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) [x Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureuble 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 "measureabte 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. s 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 DWQ Regional Office. By this signature, I cePttfy that this report is accurate and complete to the best of my knowledge: [SignLkf're of Permittee or Designee) Pane 1 of 2 SWU-2,P, Last modified 10/25/2012 1. Outfall Description: Outfall No. �( Structure (pipe, ditch, etc.)( Receiving Stream: : i U 12,iri Describe the industrial activities that occur with' 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: 3. Odor: Describe any d weak chlorine odor, etc.): — s that the discharge may have (i.e., smells strongly of oil, 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 12/ 3 4 5 S. 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 'j2 3 4 5 6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the stormwater discharge, where is no solids and 5 is extremely muddy: 1 '(21 3 4 5 7, is there any foam in the stormwater discharge? Yes B. Is there an oil sheen in the stormwater discharge? Yes 9. is there evidence of erosion or deposition at the outfall? Yes 19 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 10/25/N iZ Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000A, Date submitted 6L 9 - /,f— CERTIFICATE OF COVERAGE No. NCG08 0 t 9 � FACILITY NAME-7o,J/1 af jdak� COUNTY tVAXe- PERSON COLLECTING SAMPLES LABORATORY A,9ce- Lab Cert. # Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR ­001J'- SAMPLE PERIOD 0 Jan -June El July -Dec or L] Monthly'" (Mofith) e402A DISCHARGING TO CLASS E]ORW OHQW []Trout'WPNffi A* Dzero-flow Owater Supply ❑SAO, [:]Other PLEASE REMEMBER TO SIGN ON THE REVERSE 4 F] No discharge this period' &1 Date9-1v 2 2 I I Uz U �q�tz�u:o P1= gk id 4 rd11-ij 6 1 �ss ihrad (�GT`,HEM), �,averagq,.,g�� 9- . . . 4- ��WW i t h i fi!'6 oedodk qrrn K�: 7.. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? — yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals �y--- pa ,o ­,-TI-4;i',MNZA­". , o4wQ040Q;1gpT1 C' - o�Sahm PHo AR 'Ai -;)1 40 linq&� L 77 I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised October 25, 2012 Page 1 ot'2 STORM EVENT CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches); 3/16, Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALLTRIGGER.TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES F-1 NO [] IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR including all "No Discharge" reports within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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, 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." of Permittee) y- 9 /r (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wglws/su/npdesswhtab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 i r Q-Cls-- RUDER Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report For guidance on filling out this form, please visit. h ortal ncdenr-ors web w /w su n dcssw#it bb-4 Permit No.:/C/_//_/_/_l�l_I or Certificate of Coverage No.: Facility Name: _ ��., of zcioulo,,i Pb);z ,-ids Fin l.� County: u] � _ _ Phone No. _0�1) Inspector:.' = u-9050 Date of Inspection: J- J-- /3' _ _- Time of Inspection: __11:S ii Total Event Precipitation (inches): 1,9 Was this a "Representative Storm Event" or "Measur a le Storm E 4n�Qt�"a2s,3d,e ied by the the pe rmit? (See information below.) 20/$ ® Yes ❑ No Q 'T 4 Please verify 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 "measureable 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 ID 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 1.0 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 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 DWQ Regional Office, By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Sig�ure of Permittee or Designee) 'k., . Page 1 of 2 SWU-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. .2 Structure (pipe, ditch, etc.).�i/_ ��i•dr��.� �,� .�� Receiving Stream: _n4.-d fr,'& ver Describe the industrial)/ activities that occur within the outfall drainage area: hw! u/ '• r rI/eAo✓ . r�r/ un +' •.� o�.�r -/� 41rc� ,Ql�, .+� 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: /. 121- �g,7 A 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.); Norte 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 LC) 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: 7. 8. 9, 10. 0 2 3 4 5 Is there any foam in the stormwater discharge? Is there an oil sheen in the stormwater discharge? Yes No Yes No Is there evidence of erosion or deposition at the outfall? Other Obvious Indicators of Stormwater Pollution: Yes No List and describe _ o o �,O ; n �bk CoAd,4""7 A,,,/ )Vote: 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 5WU-242, Last modified 10/25/2012 i . 'r. .sP�a��n...� H-CDE R Stormwater Discharge Outfall (00) Qualitative Monitoring Report Forguidance on filling out this form, please visit: h ortal.nc enr.or web w ws su n d ssw#tab-4 Permit No.: N/C/_/_/—/!/—/`/,/ or Certificate of Coverage No.: Facility Name: _� if - `Z-r_bA,/, Pub/;c _ti.,A-, &,`/. k County: cJake _ Phone No. Or &E9 r S Inspector: ' tq,c_ Date of Inspection: Time of Inspection: _ ll 2 iy, Total Event Precipitation (inches):0 n Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) XT Yes ❑ No Please verify 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 "measureable 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 have been at least 72 hours j prior. The 72-hour storm interval does not apply if the permittee is able to document that a shorter I interval is representative for local storm events during the sampling period, and the permittee obtains approval from the local DWQ Regional Office. By this signature, l certify that this report is accurate and complete to the best of my knowledge: (Signatu"'re of Permittee or Designee) Page 1 of 2 SWU-242, Last modified 10/25/2012 1. Outfali Description: Outfall No. a Structure [pipe, ditch, etc.) i -s- Receiving Stream: u,AA,-,uA rj 'bu IA,,l o4 Describe the industrial activities that occur vithin the outfall drainage area: s/gv / � � •'/n [ d 7 Sfc�nG ti •ctPPh• �ho'l C c !� %+-i r.� 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint Clight, medium, dark) as descriptors: 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): _ "'� _ w 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 S. 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 a 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: . 12 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 evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe _ oiS f 51ll__; 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 2of2 SWU•242, Last modified L4/2S/2012 %� PaceAnal .yrical www.oacelabi.com CHAIN -OF -CUSTODY 1 Analytical Request Document The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately. Section A Section B Section C Page: of Required Client Information: Required Project Information: Invoice information: Compagy� ! i Report To: Attention: ,/�4 /� 1 5 J Q6 2 3 t1.V n U t e=r-} ,1 Address: S Copy To: Company Name: REGULATORY AGENCY ZrtY1ia )'- fi�G �7 Address- r NPDES r GROUND WATER [- DRINKING WATER r UST r RCRA r OTHER Email To: r Purchase ,--tA,i -L-,,s f Z��4�•/t. urt Order No.: Pace Quote Reference: Phone: M,-u 13E: Faz: Project ei �! - JiS Name: Pace Project Manager. Site Location STATE: Requested Due DaterTAT: Project Number: Pace Profile 0: Requested Analysis Filtered (YIN) Section D Matrix Codes a z Required Client Information MATRIX I CODE o COLLECTED Preservatives r Drinking Water DW w Water WT 11 0 _ .: Waste Water WW COMPOSITE `EDiGRIS W Product P m 4 w Z Scilisolid SL p y 4 } SAMPLE ID Ope OL V L) W H (A-Z. 0-9 ! ,-) Air AR a z H `o Sample IDS MUST BE UNEQUE Tissue TS p O w o_ m w r 01 Other OT U r- z m o f i ty t a w I. o -1 0a p a p' O D m L r E ` 0 W ' i - a U) DATE TIME DATE TIME ¢ rn 4t 0 y = Z S U 2 m Z nz Z w 2 D Q y a) � 1• Pace Pr o)lect No./ Lab I.D. 1 -* Z 6Jcr0,w;v 1 fr OT 2 S} rn3 +n��r ; y-Ir 11'�fra� ; i tS 11•'�i;;'= �( 3 a a 7 s ' s 10 11 ' 12 ADDITIONAL COMMENTS BY I AFFILIATION DATE TIME ACCEPTED BY I AFFILIATION DATE SAMPLE CONDITIONS �;•-RELINQUISHED f /TIME 65L�(� J"Jff ``�` 'G"1.7 ( Iilli 3't7'�� F rytiv:`:t is 1.7JIV-,fir .'1: i� ,cis 6l SAMPLER NAME AND SIGNATURE U o • ;= ? r Y Cm } PRINT Name of SAMPLER: `-' U;m } mrr DATE Signed W SIGNATURE of SAMPLER: (MMIDDIYY): i U) *Important Note: By Signing this form you are accepting Pace's NET 30 day paymer l terms and agreeing tp tale charges of 1.5% per month for any invoices not paid within 30 days. F-ALL-0-020rev.07,15-May-2007 � as` Instructions for completing Chain of Custody (COC) 1. Section A and B: Complete all Client information at top of sheet: company name, address, phone,. fax, contact (the person to contact if there arc questions, and who will receive the: final report.), e-mail address (if available), PO##, Project Name and/or Project Number as you would like to sec it appear on the report. 2. Section C: Invoice Information: Billing information is included in this section. This information should include the: name and address of the person receiving the invoice. 3. Quote Reference should be completed if a quotation was provided by Pacc Analytical. The Project Manager, and Profile No. will be completed by Pace Analvtical Services. . 4. Site Location: A separate COC must be filled out for each day of sample collection. Record the two letter postal code for the US state in which the samples were collected. 5. Regulatory Agency: List the program that is guiding the work to ensure proper regulations are followed. 6. Section D: Complete; a Sample: Description in the "SAMPLE ID' section as you would like it to appear on the laboratory report. 'Che following information should also be included: the sample matrix, sample type (G (grab) or C (composite). When collecting a composite; the start time and end time; should be documented in the respective boxes. The collection time for a grab (G) sample should be entered in the boxes marked 'Composite; End/Grab'), Sample temp at collection (if required by state), the total number of containers, and preservative used. 7. Mark if the sample was filtered in the; field by marking Y or N in 'Filtered' row by the; Analysis requested. 8. Requested Analysis: List the required analysis and methods on the lines provided and place a check in the column for the samples requiring the analysis. Additional comments should be referenced in the bottom left hand corner or include attachments for extended lists of parameters. 9. The sampler should print their najne in the space provided and sign their name followed by the date of the sampling event at the bottom of the: COC in the: spaces designated for `SAMPLER NAME AND SIGNATURE'., 10. When relinquishing custody of the samples to a representative of the laboratory or other organization, indicate the Item Numbers of those samples being transferred; sign relinquished by, date and time, and include your affiliation. *Important Note: Standard Turnaround Time is 2.Weeks110 business days. Results will be delivered by end of business on the date due unless other arrangements have: been made with your project manager. ti Special Project Requirements such as Low Level lletection Limits or level of QC reported must be included on the chain of custody in the Additional Comments section. STORMWATER SAMPLING TIMELINE THURSDAY, MARCH 5, 2015 8:30 a.m. — pH calibration 9:30 a.m. — Light rain, no discharge 10:00 a.m. — Light rain continues, no discharge 10:30 a.m. — Heavy rain, no discharge 11.00 a.m. — Light rain, no discharge 11:15 a.m. — Light rain, discharge begins 11:25 a.m. — Sample taken, light rain 11:31 a.m. — pH 7.38 Total rainfall = 8I10" Sample taken by Tony Rose, Stormwater Superintendent s aceAnalyfical wvrw.pacelahs.com March 18, 2015 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: Town of Zebulon Pace Project No.: 92240179 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite100 Huntersville, NC 28078 (704)875-9992 Dear Mr, Ray: Enclosed are the analytical results for sample(s) received by the laboratory on March 06, 2015. The results relate only to the samples included in this report. Results reported herein conform to the most current TNi standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. Analyses were performed at the Pace Analytical Services location indicated on the sample analyte page for analysis unless otherwise footnoted. If you have any questions concerning this report, please feel free to contact me. Sincerely, `n, C, cc,, -, L2:` -- Liamm Carrubba liamm.carrubba@pacelabs.com Project Manager Enclosures cc: Ms. Robyn Snow, Town of Zebulon REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 1 of 10 e 5acMnalytical (�Mnrpaaela &C0m Project: Town of Zebuion Pace Project No.: 92240179 Raleigh Certification IDs 6701 Conference Drive, Raleigh, NC 27607 North Carolina Wastewater Certification #: 67 Pace Analytical Services, Inc_ 9800 Kinsey Ave. Suite 100 Huntersville, NC 28078 (704)875.9092 Charlotte Certification Ms. 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 North Carolina Drinking Water Certification #: 37706 North Carolina Field Services Certification #: 5342 North Carolina Wastewater Certification #: 12 South Carolina Certification #: 99006001 CERTIFICATIONS North Carolina Bioassay Cerlificalion #: 16 North Carolina Drinking Water Certification #: 37731 FloridalNELAP Certification #: E87627 Kentucky UST Certification #: 84 West Virginia Certification #: 357 VrginialVELAP Certification #: 460221 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 2 of 10 leAnalj&,al www.pwWabaaom SAMPLE ANALYTE COUNT Project: Town of Zebulon Pace Project No.: 92240179 Pace Analytical Services, Inc. 9800KinceyAve. Suite100 Huntersville,.NC 28078 (704)87.5-9092 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92240179001 #1 Stormwater SM 2640D RC 1 PASI-R 92240179002 #2 Stormwater EPA 1664B CLW 1 PASI-C REPORT Of LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc., Page 3 of 10 acmnalyticala www.pamlaGsc= ANALYTICAL RESULTS Pace Analytical Services, Inc. 9800 KinceyAve, Suite 100 Huntersville, NC 28078 (704)875r9092 Project: Town of zebulon Pace Project No.: 92240179 Sample: #1 Stormwater Lab ID: 92240179001 Collected: 03/05115 11:25 Received: 03106115 12:45 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 123 mg1L 25.0 1 03110/15 09:15 Sample: #2 Stormwater Lab ID: 92240179002 Collected: 03/05/15 11:25 Received: 03106115 12:45 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Oil and Grease Date: 03/18/2015 06:11 PM Analytical Method: EPA 1664B ND mg/L 5.0 1 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. 03/17/15 10:55 Page 4 of 10 aceAnaljdical. wwwpacelabsoom Project: Torun of Zebulon Pace Project No.: 92240179 QC Batch: GCSV120651 QC Batch Method: EPA 1664B Associated Lab Samples: 92240179002 METHOD BLANK: 1412166 Associated Lab Samples: 92240179002 Parameter Units Oil and Grease mg1L LABORATORY CONTROL SAMPLE: 1412167 Parameter Units Oil and Grease mg/L Pace Analytical Sdrvices, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875.9092 QUALITY CONTROL DATA Analysis Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 5.0 03/17/1510:45 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 40 36.9 92 78-114 MATRIX SPIKE SAMPLE: 1412168 92240674002 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Qualifiers Oil and Grease mg/L ND 40 34.2 84 78-114 Results presented on this page are In the units Indicated by the "Units" column except where an afternate unit Is presented to the right of the result REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 03/18/2015 06:11 PM without the written consent of Pace Analytical Services, Inc.. Page 5 of 10 aceAnalyiical www4 acelabsmm QUALITY CONTROL DATA Project: Town of Zebulon Pace Project No.: 92240179 QC Batch: RWET18134 Analysis Method: SM 2540D QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92240179001 METHOD BLANK: 1406508 Associated Lab Samples: 92240179001 Parameter Units Total Suspended Solids mg/L Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 2.5 03/10/15 09:14 LABORATORY CONTROL SAMPLE: 1406509 Spike LCS Parameter Units Conc. Result Total Suspended Solids mg/L 250 268 SAMPLE DUPLICATE: 1406646 92240337001 Dup Parameter Units Result Result Total Suspended Solids mg/L 1270 1350 Pace Analytical Services,] na 9800KinceyAve. Suite100 Huntersville, NC 28078 (704)8759092 LCS % ReC % Rec Limits Qualifiers 107 90-110 RPD Qualifiers 6 D6 Results presented on this page are In the units Indicated by the "Units" column except where an alternate unit is presented to Ure right of the rasufl. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 03/18/2015 06:11 PM without the written consent of Pace Analytical Services, Ina. Page 6 of 10 aceAnalyiical www.pacelabs.mm QUALIFIERS Project: Torn of Zebulon Pace Project No.: 92240179 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. J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit. MDL-Adjusted Method Detection Limit. POL - Practical Quantitation limit. RL- Reporting Limit. Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9992 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, Styrene, and Vinyl chloride. A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acryfonitrile 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. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes, TNI -The NELAC Institute. LABORATORIES PASI-C Pace Analytical Services - Charlotte PASI-R Pace Analytical Services - Raleigh ANALYTE QUALIFIERS D6 The relative percent difference (RPD) between the sample and sample duplicate exceeded laboratory control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 03118/2015 06:11 PM without the written consent of Pace Analytical Services, Inc.. Page 7 of 10 (�IaneAnalyficala %ww.pacelabs.c= Project: Town of Zebulon Pace Project No.: 92240179 Lab ID 92240179002 92240179001 Sample ID #2 Stormwater #1 Stormwater Pace Analytical Smvlces,.lnc. 9800 Kincey Ave. Suite 100 Huntersvitle. NC 28078 (704)87!r9092 QUALITY CONTROL DATA CROSS REFERENCE TABLE QC Batch Method QC Batch Analytical Method EPA 16648 SM 25400 GCSVI20651 RWETI8134 REPORT OF LABORATORY ANALYSIS Analytical Batch This report shall not be reproduced, except in full, Date: 03/18/2015 06:11 PM without the written consent of Pace Analytical Services, Inc.. Page 8 of 10 Document Name: Sample Condition Upon Document Revised: April 04, 2013 Recel t (SCUR) Page 1 of 2 ,�PaCe�}rlaICal� Document No,: Issuing Authorities: ' F- L-C-001-ray.02 Pace Asheville QuaRy Office Client Name: U YW 0 Where Received: [] Huntersville Asheville ❑ Eden aaielgh Courier (Circle): - Fed Ex UPS USPS Client Commerclal Pa A ther Custody Seal on Coolo►lSox Present: Q yes to no Seals intact: 0 yes El no Packing Material: [I Bubble Wrap 1SubWeBaas /None Other Circle Thermometer Used; ill Gun 2065387T of Ice. Wet Blue None Samples on toe, cooling process has begun IR Gun as :12: 22065371 Temp Correction Factor: Add ! t tract } U �� C Date and Initlais of person n eK mining Corrected Cooler Temp.: C Biological Tissue Is Frozen: Yes No CA 0e t J pr e 1 check: Temp" should be above freezing to 6'C Comments: Chain of Custody Present: es Epic UWA 1•. Chain of Custody -Filled Out: Yo ONO DWA 2. Chain of Custody Relinquished- Yes ❑No ONIA 3. Sam lar Name & Signature on COC: os • C)No OwA 4. Sam les Arrived within Hold Time: Yes ONO" DNIA b, Short Hold Time Anal sis <72hr : OYos PNO DWA 6. Rush Turn Around Time its uested: OYes No OWA 7. Sufficient Volume: ZYes ONO ❑N1A 8. Correct Containers Used: es ONO ONIA 9. -Pace-Containers Used: es ONO ❑Nk Contalnors Intact: Yoe ON* OWA 10, Filtered volume.recelved for Dissolved tests Dyos ONO ONIA 11, Sample Labels match COC: byap oHo OWA 12. -Includes date/timoflD/Analysis Matem All containers needing -preservation have been checked. Yes ONo OWA 13. All contalners'naodlna preservation are found to be in Yes ONO OwjN compliance with EPA reoornmenda8on. exceptions: VOA, eolform, TOG, O&G, WWRO (War) Yea ONO Sam les chocked fpr deehlorinatlon: Yes ONO 1~]N/A M. Heads ace in VOA Vials >6mm): Ores ONO NIA 15. Trip Blank Preseni: OYos ONO NIA 16, Trip Blank Custody Seats Present Oyes ONO /WA Pace Trl Blank Lot# N purchased): Client NotlfIcatloN Resolution: Field Data Required? Y ! N Person Contacted, DatelTime: Commenfs/ Resolution: SCURF/SRF Date � -�'I�• i Review:: `•c t Note: Whanever there is a discrepancy affecting North Carolina compliance samples, a copy of this form will be sent to the North Carolina DEHNR t Certific"on0ffice (Le out of hold, incorred preservathe, out of temp, Incorrect containers) ` WOi:92240179 II&I4017IIIII�V191111 0 CHAIN -OF -CUSTODY! Analytical Request Document P+e (hatwf-Custody is a LEGAL OOCumtEliT. Nt roterwrt llelgs muss be mn oe ed aacu: y Ca rn I pSoetlart A 5oe!{mr 6 d C Requued CbM WAGrMPUM Revdfed P.Jeq 1nAxentbn: wypr; RCpart Tw 1510623 f g "' Tar. Namc REGPLATORY AGENCY ' Ze6J,. Ale- 8759 R.— r ►aPDEs r GRO61N1DwATER r- DRIMNG WATER F LIST r" RCRA r' OTHER EmaA To: L am ztbtl.n. e/ Pwaose Order �r� 6 Sa [f FQf 4 d69 d� 1 P 'a'°Fq- ...5TA7r: Repunted Dow DaWrAT: Nwrbw. . wofre r. l G� :v t Requested Af3alyafs Fihered j1fM) - ., Swoon D VmWx Codes p,e„rr.aareaereaa.nen �pE ¢ o COLLECTED Aresarrdtives r Dewy water ow = c, vvgw wr wneir sv a a °L C SA1111PLE ID uA � m � (A-7-rya LIJ AU AR Sampb IOs WJST BE LR OCI1E T,4=n TS a CL F 6 [ ORwr OT .g n a o�� m � we Tim and Tt1AE M = x = z z 2 O K Pace Project keJLab 1A. ref- eT6 -s-rs w;irm iLr•!s z SJrm„+,4! 315,-)5, Wn- s 4 d i e !e 12 ADCfr10NAL C01019:T] iiFJ A1017HItfED BY 1 AFFK 1AT14i1 1CCETEBN . DATE £D SAMPLE CONDMONS 7S,- �` -L4 h a ,Lf! 7Z SCR NAME AND SIGNATURE ORi[ iNAL a 2 PRINT NwnwdSAMPLEk cj StGNATWRE or SAMPLER: NM7D tr �-J 'fmparaal Nate: 91*PN then kam you am wxe7bw Pack NET 30 day pvm+ . uwm ON agraeap to lace cnargn of 1.5% per Kw* W pry Mahn nat poid Mt 4n 30 owa F-ALL-0t20mv.07. 1-- May-2007 a (�5a'cmnalytical ~ pacelabs.com Samples Submitted By: Zebulon {Town of) Client Project ID: Town of Zebulon Client PO#: CC: Mr. Chris Ray,Ms. Robyn Snow 9800 Kinsey Ave., Suite 100 Huntersville, NC 28078 (704)875-9092 SAMPLE ACKNOWLEDGMENT Pace Project Manager: t_iamm Carrubba Phone(704)875-9092 liamm.carrubba@pacelabs.com Pace Analytical Project ID: 92240179 Samples Received: March 6, 2015 12:4S PM Estimated Completion: March 20, 2015 Pace Analytical DateMme Customer Sample ID Lab ID Matrix Collected Method 41 Slormwater 92240179001 Water 03/05/15 11:25 2540D Total Suspended Solids 92 Storrnwater 9224017%02 Water 03/05/15 11:25 HEM, Oil and Grease Please contact your project manager if you recognize any discrepancy in this form or have any questions about your project. Thank you for choosing Pace Analytical Services, Inc. Page 1 of 1 Document Name: Sample Condition Upon Document Revised: April 04, 2013 iaace�ifaalytrcal" Receipt (SCM Page 1 of 2 Document No,: Issuing Authorities: F- L-C-001-rev.02 Pace Asheville Ouality Offlce Client Name: UY1�t Where Received,- [] Huntersvitle C3 Asheville Eden Raleigh Courier (Circle): • Fed Ex UPS LISPS Client Commercial Pace ther Custody Seal on Cooler/Box Present: [] yes no Seats Intact: yes n no Packing Material: 0 Bubble Wrap�1220653�87Tofjce% e [$�� [None Other Circle Thermometer Used; IR Gun Wet Blue None ❑ Samples on lee,000ffng process has begun tR Gun 8a0653Tt Temp Correction Factor: Add ! tract ) C) U C Sato and Initlat p rson oltamining • Corrected Cooler Temp.: C chockk:: Biological Tissue Is Frozen: You No IfA t P► e I Temp should be above freazing to VC Comments: Chain of Custody Present: Wes E]No ❑WA 1•. Chain of Custody Filled Out: Yes ON. ❑WA 2. Chaln of Custody Relin ulshed: Yes ❑No Ota A 3. Sam ler Name & SI nature an COC: es ON* ❑NJA 4. Sam les Arrived within Hold Time: Yes (]No'_OWA 6• Short Hold Time Anal sis c12hr : ❑Yea j0hlo ©NIA 6. Rush Turn Around Time Re uested: ❑Ye9 Nn ❑NfA 7. Sufflolent Volume: ZYaq ©No ❑WA 8• Correct Containers Used: es Elmo ❑ILIA 9. -Pece'Contalners Used: es ❑No ❑NiA Containers Intact: Yes 0140 OWA 10. Filtered volume -received for Dissolved tests OYes €]No OWA 11. Sample labels match COC: Pyq Q] o ❑WA 12. -includes dateltime/10/Anal sis Matrix: All containera needfng'preservallon have been checked. Yes EINv C1NIR 13. All contalners'neading preservellon are found to be in �Yos ONO OWA compliance with EPA recoinmendatlon. axaepl9ons; YOA, Conform, TOO, O&G, WI-DRa {�Yater Yes ONO Samples checked for de -chlorination: Yes ❑No OWA 14. Heads ace In VOA Vials >6mm}: []Yea ONo WA 15. Trip Blank Present: ❑Yea UNo AVA 16. Trip Blank Custody Seals Present ❑Yes ❑No NJA r Pace Trip Blank Lot # (if Client Notification/ Resolution: Kleld Dale Requlred7 Y ! N Person Contacted. Dale/Time: Comments/ Resolution: S Ra Review,. �C ,.� Hate: -� . � Wo : 92240179 Note: Whenever there is a discrepancy affoUng North Carolina compliance Cerlisamploa, a copy of this form vdli be sent to the North Carolina D5HNR ficalioa-Office Le out of hold, Incorrect ff( preserval", out of temp, Y11111111 Incorrect containers) ! 9224009 CHAIN -OF -CUSTODY / Analytical Request Document Tne Chalr,orCuftey Is a LEWL DOCUM&M Alf refseach Golds fnusl be mnO~ a=raLsy. SocDon A Soalon B ! c4e-C4 Lon C P+Oa: et R@gUhVd Cam 1111pmllo= Re¢ui1ed P!eJed Lnftm bw; yKotmOtlptt: Rwn Ta 1510623 c,Vr A 3 r "To: mpany Name: REGlJWTORYAGENGY ' . !rn Air- g7�i r NPDEs f GROUND WATER r DRINMG WATER r UST RCRA r OTHER Email Ta Pumhose Oodw No.: no ow e if 6 -S�iS— -r4 454-A(J p7j.-wr' a0a°' a SIfe.Los+rrion .'.STATE Rownted Due DaWAr. Numou: as Hone R • L, �-; Requested Anig"Is F+Rered (YIN) ' dl Soon D Nabu Oxwo i 2 Rputradcko ft., mn tis 7mx r oppe 4 COLLECTED PreservaVwls i - - 06*k B water aw $ weml wr Prod Yv7iO' vr a c3 co> slulr ea>+'oale troves w _ LZ S SAMPLEID 0 , L r w m c (4&I:) z Air AR Ssnpb IasMI!NITs UST RE QUE iyu a Ortw DT Qd at x V. a ~ a a ears i O O o, DATE TIME CATS TIME ac i s z z Q Paco Pro eet Nol Lab I.D. N!>ris,1 �?L.r,i Z J l M 6=J 3 3 7 6, B 10 <.1 !Y ADDrrKM^L C01/MfNM 1;1112 I JSMM SY r AfFl ATIOM p M: T1ML` ACCEP, 6Y 1 AMJAY10N . DAYS ra fE SAMPLE CONDtrf[M 3 IL SAUPLFA Wf1EANoSIGNATURE . {� iNAL PRINT Namw ofSAMPLER: � $ t� SIGNATURCofSAMPLER: DATE S:ywd (hf3VyDnA'Y►: � - - 'Impw Ml hot: 91 �ipeYq dais h+m yas am rsejte% 0*o % WT 30 daand -on erq to kka dnagrx at 1.5% pa mVn4m,a any Ywelwn"paid weeln 30 =M F^AU-0420rev.07. IS.May2007 A, jZA NCDER Stormwater Discharge Dutfall (00) Qualitative Monitoring Report Forguidance on filling out this form, please visit: rtal.ncdenr.o web w ws su de w#tab-4 Permit No.:/C/—/—/�/_/�/_/�/ or Certificate of Coverage No.: lV/C/GJv l�I �I12f �� Facility Name: ., il-, ci.iAA County: 006- Phone No. 9i 0 '1E J I Inspector: —1 °v ,,!re - Date of Inspection: -3 Time of Inspection: •',�S p,, Total Event Precipitation (inches): Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) RI Yes ❑ No Please verify whether Qualitative lylonitoring must be performed during a "representative storm event" or "measureable storm event" (requ(rements 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 "measureable 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 0A 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 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or Designee) Page 1 of 2 SWU-242, Last modified 10/25/20I2 I. Outfall Description: Outfail No. _ J= _ Structure (pipe, ditch, etc,) Receiving Stream: -,m--'j , : b'4,0'n f ' We 4 "r. Describe the industrial activities that occur within the outfall drainage area: / �_7 - 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: _L'41 7;w 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 � 3 4 5 S. 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: V 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 8. is there an oil sheen in the stormwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: Listanddescribe C«A(A ;� n _ f4ep 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 5WU-242, Last modified 10/25/2012 1yy T. 95E P Stormwater Discharge Dutfall (00) Qualitative Monitoring Report For guidance on filling out thisform, please visit: hn://portal.ncdenr.oCgZweb/wa/ws/su/nodessw##tab-4 Permit No.: N/C/�/�/�/_/_/_/_/ or Certificate of Coverage No.: NILIL/Q/-f/ -Al -Zljl -�-1 Facility Name: County: Inspector: Date of Inspection: 0 /s- Time of Inspection: l:aT e— Total Event Precipitation (inches): Xlce-" Phone No. Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below,) 21 Yes ❑ No Please verify 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 "measureable 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 have been at least 72 hours I 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 DWQ Regional Office. By this signature, l certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or Designee) Pagel of 2 SwU-2,�2, Last modified 10/25/2012 1. Outfall Description: Outfall No. Structure (pipe, ditch, etc.) ors Swa/� T Receiving Stream: nf}�^1) r,4, 41 rr Describe the industrial activities that occur within the ou/tfall drainage/area: 15 Q-gl d-_ 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.): _ me, 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' 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 L2_) 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? Yes 8. is there an oil sheen in the stormwater discharge? Yes 9. is there evidence of erosion or deposition at the outfall? Yes 3) 10. Other Obvious Indicators of Stormwater Pollution: List and describe o��� ��tl _ i3 n �vvd 9/2 , Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may he indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 5WU-242, Last modified 10/25/2012 STORMWATER SAMPLING TIMELINE THURSDAY, MARCH 27, 2015 l 0:30 a.m. — light rain started 11:00 a.m. — Light rain, no discharge 11:45 a.m. — Light rain continues, no discharge 11:50 a.m. — PH meter calibration 1:10 pm- Light rain, discharge 1:25 pm. — Sample taken, light rain 1:35 pm PH taken 7.68 Total rainfall = 3/10 Sample taken by Tony Rose, Stormwater Superintendent aceAnalytical" xnrw.pacelabs.mrr April 07, 2015 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: Ray Pace Project No.: 92243287 Pace Analytical Services, Inc. 9800 Kinney Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Dear Mr. Ray: Enclosed are the analytical results for sample(s) received by the laboratory on March 30, 2015. The results relate only to the samples included in this report. Results reported herein conform to the most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. Analyses were performed at the Pace Analytical Services location indicated on the sample analyte page for analysis unless otherwise footnoted. If you have any questions concerning this report, please feel free to contact me. Sincerely, kX, ,,— Liamm Carrubba liamm.carrubba@pacelabs.com Project Manager Enclosures cc: Ms. Robyn Snow, Town of Zebulon REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 1 of 11 aceAnalytical` www.pwgbb&cam Project: Ray Pace Project No.: 92243287 Raleigh Certification IDs 6701 Conference Drive, Raleigh, NC 27607 North Carolina Wastewater Certification #: 67 CERTIFICATIONS North Carolina Bloassay Certification #: 16 North Carolina Drinking Water Certification #: 37731 Charlotte Certification IDs 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 Florida/NELAP Certification #: E87627 North Carolina Drinking Water Certification #: 37706 Kentucky UST Certification #: 84 North Carolina Field Services Certification #: 5342 West Virginia Certification #: 357 North Carolina Wastewater Certification #: 12 VirginialVELAP Certification #: 460221 South Carolina Certification #: 99006001 REPORT OF LABORATORY ANALYSIS Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Hunlersville, NC 28078 (704)8759092 This report shall not be reproduced, except in full, without the mitten consent of Pace Analytical Services, Inc.. Page 2 of 11 e IMnalytical +`wwpacalab&=n SAMPLE ANALYSE COUNT Project: Ray Pace Project No.: 92243287 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875r9092 Analysts Lab ID Sample ID Method Analysts Reported Laboratory 92243287001 Stonriwater #1 SM 25400 RC 1 PASI-R 92243287002 Stormwater #2 SPA 1664B REP 1 PASI-C REPORT OF LABORATORY ANALYSES This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc- Page 3 of 11 IielAnalyfical" wwwpxelaba=n ANALYTICAL RESULTS Project: Ray Pace Project No.: 92243287 Pace Anaiytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Sample: Stormwater 01 Lab ID: 92243287001 Collected: 03/27/15 13:25 Received: 03/30/15 16:00 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Oual 2540D Total Suspended Solids Analytical Method: SM 25400 Total Suspended Solids 70.0 mg1L 16.7 1 04101/15 10:23 Sample: Stormwater#2 Lab ID: 92243287002 Collected: 03/27/15 13:25 Received: 03/30/15 16:00 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEWN, Oil and Grease Analytical Method: EPA 1664E Oil and Grease ND mg1L 5.0 1 04/07/15 09:21 Date: 04/07/2015 02:28 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, tnc.. Page 4 of 11 aceAnalytical QUALITY CONTROL DATA Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: Ray Pace Project No.: 92243287 QC Balch: GCSV720879 Analysis Method: EPA 1&648 QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92243287002 METHOD BLANK: 1427832 Matrix: Water Associated Lab Samples: 92243287002 t Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Oil and Grease mg1L ND 5.0 04/07/15 09:18 ! LABORATORY CONTROL SAMPLE: 1427833 Spike LCS LCS % Rec Parameter Units Conc. ! Result % Rec Limits Qualifiers Oil and Grease mg1L 40 39A 98 78-114 MATRIX SPIKE SAMPLE: 1427834 92243865001 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Qualifiers Oil and Grease mg1L ! ND 40 39.3 90 78-114 Results presented on this page am In the units indicated by the -UnIW column except where an altemate unit Is presented to the ABM of the resutt REPORT OF LABORATORY ANALYSIS This report shell not be reproduced, except in full, Date: 04/07/2015 0228 PM without the written consent of Pace Analytical Services, Inc.. Page 5 of 11 IeAnalytical www'mcalabs'= Project: Ray Pace Project No.: 92243287 QC Batch: RWET18194 QC Batch Method: SM 2540D Associated Lab Samples: 92243287001 METHOD BLANK: 1423901 Associated Lab Samples: 92243287001 Parameter Units Total Suspended Solids mg1L LABORATORY CONTROL SAMPLE: 1423902 Parameter Units Total Suspended Solids mglL SAMPLE DUPLICATE: 1423903 Parameter Units Total Suspended Solids mglL SAMPLE DUPLICATE: 1423904 Parameter Total Suspended Solids Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA Analysis Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Matiix: Water i Blank Reporting Result i Limit Analyzed Qualifiers ND 2.5 04101115 10:19 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 250 244 98 90-110 92243217001 Dup Result I Result RPD Qualifiers 24.8 24.0 3 92243438003 Dup Units Result i Result mg1L P8 118 RPD Qualifiers 0 Results presented on this page are In the units indicated by the -Units" cohumr except where an att state unit Is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 04/07/2015 02:28 PM without the written consent of Pace Analytical Services, Inc.. Page 6 of 11 I'elAnalyfical" w+vw.p8C1Wb .cam QUALIFIERS Project: Ray Pace Project No.: 92243287 DEFINITIONS OF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot. NO - Not Detected at or above adjusted reporting limit, i i J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit. MDL -Adjusted Method Detection Limit. Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 PQL - Practical Quantitation Limit. RL - Reporting Limit. 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. I 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(0) - 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, Styrene, and Vinyl chloride. 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. 1 N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270_ The result reported for each analyle is a combined concentration. i Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI -The NELAC Institute. LABORATORIES PASI-C Pace Analytical Services - Charlotte PASI-R Pace Analytical Services - Raleigh Date: 04/07/2015 02:28 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the mitten consent of Pace Analytical Services, Inc.. (704)875.9092 Page 7 of 11 aceAnalytica!• www.pecelsb&Cw QUALITY CONTROL DATA CROSS REFERENCE TABLE Projed: Ray Pace Project No.: 92243287 Pace Analytical Services, Inc. 9800 Kinoey Ave. Suite 100 HuntersvUle, NC 28078 (704)8759092 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92243287002 Stonnwater #2 EPA 1654E GCSV120879 92243287001 Stormwater #1 SM 2540D RWET18194 Date: 04/07/2015 02:28 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc_. Page 8 of 11 Document Name: Sample ConditioOpon 006UMant Revised: April 04, 2013 �PaceArlalca!" j Receipt SCUR Page 1 o1`2 r 'a "' Documett No.: Issuing Authorities: F-RAL--001-rev.02 Pace Asheville Ouali OMCO Client Name: e Where Received: [] Huntersvllie Asheville Eden Raleigh Courier (Circle): - Fed Ex UPS USPS Client - Commercial Pam, or Custody Seal on Cooler/Box Present: ❑ yes 0` no Seals fntact: yes 11 no Packing Material: ❑ Bubble Wrap Bubble $aps [,-KNonv Other Circle Thermometer Used: IR Gun SN 2 065387T of Ice: Wet Blue None 0 Samples on tea, 000ftng Room has begun Ili Gun eaokito N: 1 Temp Correction Factor: Add 1 �Jbtraet Corrected Cooler Temp.: C Temp should be above freezing to 614C C Biolagicaf Tlesue is Frozen- Yea No A Comments: Date and InItIalS of person exapinling co 1 1rV It shack Chain of Custody Present: yea ONO - OWA. 1. Chain ofCustod •FIIIodOut: Yes ONo OwA 2. ' Chain of Custody Relln Wshed: Yes ONo OwA 3. Sampler Name & 8i nature on COC: ee ❑No OWA 4. Sam les Arrived within Hold Time f0Y1,'ONo_ OWA 6'. Short Hold Time Anal Is' c72hr : 13Yea ONO ❑WA 6. Rush Turn Around Time Re nested: ❑yes 41.40 OwA 7. Sufficient Volume: Yes ❑No OWA 8. Correct Conlainers Used: -Pace Containers Used: yea E2No kY. (IN. OwA ❑WA 9. ' Containers Intact yea Ciao ©WA 10. Filtered volume.recelved for Dlssvlved tests OYea ONO VrIVA 11. . Sample Labels match WC: -Includes date/ttme11DIAnal sls Matrix: kites C)rb OWA 12. Ail oonteiners needng preservation have been thadted. All containers needing preservalon are found to be in compllance with EPA reoommendatlon. exceprionr VOA, WIlorm. TOC, OdO, WWRO water flea ONo l � ONo Yes ONo OWA OWA 13. Sam lss checked for dechlorinallon: Yes ONo , OWA 14. Heads ace in VOA Vials >8mm . Oyes ONo Trip Blank Present: Trip Blank Custody Seals Present Pace Trip Blank Lot # if urchesed : OYes ONo Dyes ONo MA XWA 16. Client Notificationl Resolution: Held Data Required? Y l N Person Contacted: Datelrime: Comments! Resolution: SCURPISRF Review:. Date: Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form vdill be sent to the North Carolina DEHNR Certification Office (I.e out of gold, Incorrect preservative, out of temp, Incorrect cantalners) 0#:92243287 1111111111111111111111iu •4: Page 9 of 11 ' I�dCeAfialjl ci3f� CHAIN -OF -CUSTODY I Ana"cal Requsst•Document The Chw,*f4wtody is a LEGAL DOCUMENT. AN mW., d Suds +swat Ee avpWW a=ratdy. I • GRouNDwATER r ommG wATER UST RCRA OTIPIER Codn I CODE SAMPLE ID 09 OL M AR San** We MUST BE UNPOM Team Ts - 13o:� WIT JoIrrmWN■0■■■■■■■■ ©■■M■.■■■■■■■ ��+il�JICL:.■■■�■�■.■■ ■©■■■■■■■■■■■ ram I• 1 r• omen. 0 m a 1nvartarlt Noa %sViV W5 fa-rm yw am a W-V Pam& NtR 30 day Caymart Wm wd oomoq to Ift 0WIft m t.S% oar nO W F-AL L-C 04 V.67, 15-May-2007 00cumert !Name: Sample Condition Upon Document Revl9ed: P,nril Oa, 2013 I...:29A�!ilC2f' Receipt SCUR Page 2 of 2 Document -No., Issuing Authorities: F-RAL-CS-001-rev.02 Dace Asheville Qual Office Sample Bottle Codes - is 1 AA AA ■ . . . . . . # ■ v ■■rr■■■r■�r■■rrr■r■■■■■rr■■■ ■■r■■■err■■■�rrr■■■■■■■■■■�r■ ■�■■■■■err■■■rr�r■■■■■■■■■■r■ r■■■■■■vim■■�■®■�r�■r■�■■■■� Client Samde ID(s) Sample Dlscre anc PH Adjustment Log for Preserved Samples Sample ID Type of Preservative. pH upon receipt Date proservalion Adjusted Tlme Preservation Adjusted Amount of Pnmr rvativa added Lot# of Presetvathre Bottle Code Key 125 ml Plastic Unp: BP4U 250 ml Plastic Unp: l3P3U 500 ml Plastic Unp: BP2U 1 Liter Plastic Unp: BP1U 250 ml Plastic H2SO4: BP3S 250 mi Plastic HNO3:13P3N 250 ml Plastic ZN Acetate: BP3Z 250 ml Plastic NaOH: BP3C Wide mouthed glass jar unp: WGFU 1 Liter Amber Unp: AG1 U 1 Liter Amber HCI: AG1 H 500 ml Amber Unp: AG2U 1 Liter Amber H2SO4: AG1S 250 ml Amber H2SO4: AM 250 ml Amber NH4CL: AGM 40 ml VOA HCI: OG9H 40 ml VOA Na2S203: VG9T 40 ml VOA Unp: VQ9U 40 ml VOA H2SO4: DG9S 5035 Klt: VOAK VPH I Gas Kit: VIGK 125 ml Sterile Plastic: SP5T 260 ml Sterile Piastic: SP2T Page III of 11 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted ,T- / F - 1261.51-- CERTIFICATE OF COVERAGE No. NCGO8 o t 9 � FACILITY NAME J gj COUNTY PERSON COLLECTING SAMPLES LABORATORY Awe- Lab Cert. # /a Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR "IfR7.00P SAMPLE PERIOD [] Jan -June 0 July -Dec or El monthly' (month) DISCHARGING TO CLASS OORW L]HQW E]Trout F]PNA DZero-flow DWater Supply DSA [:]Other PLEASE REMEMBER TO SIGN ON THE REVERSE 4 n No discharge this period' y� Ouffa 11-1 1351- 0053 kr 0.1 0400 � 7.,� 'N'-4A 'Non-Polar.0 EPA g S 'kAod, 56 g/ L -lbb4j THEM �:B&nthffiar a Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals S 6 7- Q055— n 06 tir'011.5" & WEPAiMetii1od.,U: 5,,,TotaI'1Su end d,, 6 is `5 iid§ -P -W 'k i M;Standard units ; A� `Ojr--� J166 i r I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised October 25, 2012 Page I of 2 STORM EVEN' CHARACTERISTICS: . Date 3' 5- /S(first event sampled) Total Event Precipitation (inches): 1�/0 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION Q. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR including all "No Discharge" reports, within 30_days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reportsl to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina '27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR -ANY INFORMATION REPORTED: "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. Rased on my inquiry of the person or persons who manage the system, cr 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." of Permittee) /�,-/�r— (Date) Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 ol'2 Semi-annual Stormwater Discharge Monitoring Report Ab � for North Carolina Division of Water Quality General Permit No. NCG(E& 80000t- Date submitted Q - i2 - c? - del-f- CERTIFICATE OF COVERAGE NO. NCG08 0 b_ ck FACILITY NAME Ptktli-c- W,,ks F;.,-.,1J COUNTY PERSON COLLECTING SAMPLES —'T—,,t/ Ause LABORATORY Poce- Lab Cert. # I OL Comments on sample collection or analysis: Part A- Vehicle Maintenance Areas Monitoring Requirements Aveh G3010V SAMPLE COLLECTION YEAR 6101-5- SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or Monthly'_ )SL-& (monthl 10% EffiCEN 121�HARGING TO CLASSE]ORW EjHQW E]Trout OPNA E]zero-flow owaterSupply OSA FEB [jOther CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 J)WR SECTION F] No discharge this period' I' Outfall,, 0,11� ARMN&k D ;15 am I i .00 . 0040UT`f7� - A N. 1, nm I otapSuspendedAM -Ai �.P ��Non:tY"i'�PbffinOil*an'� sEP-.,1NeW.jVI6to'r.'�OWUs'5 �qrease'TP !�Pk(S �HEM ) EAE'rAnnual "V" L V, avers a of mod OAF011��iEklr`.!.A�10 R Rko&R"M KIIAITM &MIN Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum -Bulk Stations and Terminals cam- •fay -� 9, ®Ma Z,� jT Hpr-I�Aqvletnod. v aA §1 e nm -N� -X-jota �qsp e 'S /,dd`/"Vr.f- 7 Per '4; at ndlr -Ml X� I R3- go IS AID nq J4 13- 11jZ4. 75-8 I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 5WU-250 last revised October 25, 2012 Page 1 of 2 STORM EVENT.CHARACTERISTICS: Date i a3 -!S" (first event sampled) Total Event Precipitation (inches): / '%o Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART II SECTION B. 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER.TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES Q NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, includinq all "No Discharge".reports, within 30 days of receipt of the lab results for at end of monitoring period in the case of "No Discharge" reports] to: Division of Water Quality Attm DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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, 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." - I a3 a a.� (Signature of Permittee) (Date) Additional copies of this form may be downloaded at: http:Zyportal.ncdenr.org/web[wg/w�s/su/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of'2 NCDE R Stormlwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit: http://portal.ncdenr org/web lwa /ws/su/npdessw#tab-4 Permit No.:/C/�/_/_/_/�/_/_/ or Certificate of Cove Facility Name: o �cb�l�_� �K�1•z �j County: W !J k e Phone No. Inspector: 7,-,(,-se. e No.: (Crr�11 atA -'sr Date of Inspection: _/_- 93 -_ao 0- Time of Inspection: 6' 610 �Q 0 Total Event Precipitation (inches): /0 Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) 0, 1:CE `ED ® Yes ❑ No FEB 1z2�a� Please verify whether Qualitative Monitoring must be performed during cC W +storm event' or "measureable storm event" (requirements vary, depending on th��rmrt . Qualitative monitoring requirements vary, Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable 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 i 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: i (Signature of Permittee or Designee) Pagel of 2 Swill-242, Last modified 10/25/2012 Y y�� 1. Outfall Description: Outfall No. _I- Structure (pipe, ditch, etc.) S��/� ��a�r�,��., o��� �, A, ,/40 Receiving Stream: ub,�� 9� o Describe the industrial activities that occur within the outfall drainage area: rj r�i>✓ rrJla�S G /D, r//���� ®i�•. �r .✓� 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): -,a 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 O 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 S is the surface covered with floating solids: Q 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: . 0 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 evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe a«�E��� ;S ,`� �uQr� Co,7d, --7 All ���h� of fr Note: how 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 10/25/2012 -AL RME Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit: h ortal.ncdenr.or w b w ws u n dessw#tab-4 Permit No.: N/C/_/_/�/�/�/�/�/ or Certificate of Coverage No. -- Facility Name: 3 �� £_ h.,l,� Abl.�- L. ! ,4j-&-,Y,'lv County: W Ak,- _ _ Phone No. Inspector: « ✓l,3c: Date of Inspectio . ! a3 - a015- Time of Inspection: _b=al Am _ Total Event Precipitation (inches): f d1l0 // Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.] N Yes ❑ No RECEIVED Please verify whether Qualitative Monitoring must be performed during a "reprel8 a;ve storm event" or "measureable storm event" (requirements vary, depending on the �TW&L FILES CTION Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable 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 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signa'ture of Permittee or Designee) Page 1 of 2 Styli-242, Last modified 10/25/2012 '" , , -W. 1. Outfall Description: Outfall No. _& Structure (pipe, ditch, etc.) Receiving Stream: (AnoP4—rC- Je b JA,g 6-f G, ¢,� l 14.,.er _ Describe the industrial activities that occur within the outfall / drainage area: �f/9.jc ) D9r A. i la 4u, G o S ryc Ant c�rrn:> s r f4 *�T 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: Zi§6� 3. Odor. Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.); X1-,-- _ 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 S. 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 ( D2 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: . 7. E✓ 9 1 (2j 3 Is there any foam in the stormwater discharge? 4 5 Yes No Is there an oil sheen in the stormwater discharge? Yes Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe ockO,RIl Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may he indicative of pollutant exposure. These conditions warrant further investigation. Page2of2 SWU-242, Last modified 10/25/20t2 STORMWATER SAMPLING TIMELINE FRIDAY, JANUARY 23, 2015 8:00 a.m. -- pH calibration 11:30 a.m. — Light rain, no discharge 2:00 p..m. — bight rain continues, no discharge 4:30 p.m. — Light rain continues, no discharge 6.10 p.m. — Light rain, very little discharge 6:20 p.m. — Light rain, sample taken 6:29 p.m. — pH 7.58 Total rainfall = 12I1o" Sample taken by Tony Rose, Stormwater Superintendent aceAnalytl{cal www.p=elab&= February 05, 2015 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: STORMWATER Pace Project No.: 92235067 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Dear Mr. Ray: Enclosed are the analytical results for sample(s) received by the laboratory on January 27, 2015, The results relate only to the samples included in this report. Results reported herein conform to the most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. Analyses were performed at the Pace Analytical Services location indicated on the sample analyte page for analysis unless otherwise footnoted. If you have any questions concerning this report, please feel free to contact me. Sincerely, Liamm Carrubba liamm.camfbba@pacelabs.com Project Manager Enclosures cc: Ms. Robyn Snow, Town of Zebulon PkCC 2� `d 41 fi TNI 9B0 A�� REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 1 of 10 aceArralyiical www.pacelahs.c m Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 CERTIFICATIONS Project: STORMWATER Pace Project No.: 92235067 Raleigh Certification IDs 6701 Conference drive, Raleigh, NC 27607 North Carolina Bioassay Certification M 16 North Carolina Wastewater Certification #: 67 North Carolina Drinking Water Certification #: 37731 Charlotte Certification IDs 9800 Vincey Ave. Ste 100, Muntersville, NC 28078 FloridalNELAP Certification #: E87627 North Carolina Drinking Water Certification M 37706 Kentucky UST Certification #: 84 North Carolina Field Services Certification #: 5342 West Virginia Certification M 357 North Carolina Wastewater Certification #: 12 VirginiaNELAP Certification #: 460221 South Carolina Certification M 99006001 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 2 of 10 acmnalytical www.pacelab&orm SAMPLE ANALYTE COUNT Project: STORMWATER Pace Project No.: 92235067 Pace Analytical Services, Inc. 9800icinceyAve. Suite100 Huntersville, NC 28078 (704)875-9092 Anatytes Lab ID Sample ID Method Analysts Reported Laboratory 92235067001 STORMWATER EPA 1664E AM1 1 PASI-C SM 2540D RC 1 PASI-R REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 3 of 10 1aceAnalyfical www.pacelaft= ANALYTICAL RESULTS Project: STORMWATER Pace Project No.: 92235067 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Sample: STORMWATER Lab lD: 92235067001 Collected: 01/23/1518:20 Received: 01127/15 13:20 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 16646 Oil and Grease ND mg/L 5.0 1 01/29/15 16:01 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 13.1 mg/L 3.6 1 01/29/15 10:06 Date: 02/05/2015 09:04 AM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 4 of 10 leAnalj6cal* www.pacelabs.com QUALITY CONTROL DATA Project: STORMWATER Pace Project No.: 92235067 QC Batch: GCSV120213 Analysis Method: EPA 1664E QC Batch Method: EPA 16645 Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92235067001 METHOD BLANK: 1380777 Matrix: Water Associated Lab Samples: 92235067001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Oil and Grease mglL ND 5.0 01/29/15 15:58 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 LABORATORY CONTROL SAMPLE: 1380778 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Oil and Grease mglL 40 38.0 95 78-114 MATRIX SPIKE SAMPLE: 1380779 92235246004 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Qualifiers Oil and Grease mglL ND 40 38.3 94 78-144 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: 02l05I2015 09:04 AAA without the written consent of Pace Analytical Services, Inc.. Page 5 of 10 aceAnalytical www.paufts.aom Project: STORMWATER Pace Project No.: 92235067 QC Batch: RWETl7970 QC Batch Method: SM 2540D Associated Lab Samples: =35067001 METHOD BLANK: 1379859 Associated Lab Samples: 92235067001 Parameter Units Total Suspended Solids mg1L LABORATORY CONTROL SAMPLE: 1379860 Parameter Units Total Suspended Solids mg/L SAMPLE DUPLICATE: 1379861 Parameter Units Total Suspended Solids mg1L SAMPLE DUPLICATE: 1379862 Parameter Units Total Suspended Solids mg1L Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704 )87r9092 QUALITY CONTROL DATA Analysis Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 2.5 01/29/1510:02 B Spike LCS LCS % Rec Cone. Result % Rec Limits Qualifiers 250 256 102 90-110 92235063001 Dup Result Result 5370 5030 92235063002 Dup Result Result 5270 4630 RPD Qualifiers 6 RPD Qualifiers 13 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: 02/05/2015 09:04 AM without the written consent of Pace Analytical Services, Inc.. Page 6 of 10 aceAnaly4ical wmr pacefabacom QUALIFIERS Project: STORMWATER Pace Project No.: 92235067 DEFINITIONS Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 1tm Huntersville, NC 28078 (704)8759092 DF - Dilution Factor, if reported, represents the factor applied to the reported data due to changes in sample preparation, dilution of the sample aliquot, or moisture content. ND - Not Detected at or above adjusted reporting limit. 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. S - Surrogate 1,2-Diphenylhydrazine (8270 listed analyte) decomposes to Azobenzene. Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPI) 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. N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenyla mine using Method 8270. The result reported for each analyte is a combined concentration. A separate vial preserved to a pH of 4-5 is recommended in SWa46 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA Method 8260. Acid preservation may not be appropriate for 2-Chloroethylvinyl ether, Styrene, and Vinyl chloride. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI - The NELAC Institute. LABORATORIES PASI-C Pace Analytical Services - Charlotte PASI-R Pace Analytical Services - Raleigh ANALYTE QUALIFIERS B Analyte was detected in the associated method blank. D6 The relative percent difference (RPD) between the sample and sample duplicate exceeded laboratory control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 02/05/2015 09:04 AM without the written consent of Pace Analytical Services, Inc.. Page 7 of 10 aceAnalytical" rn+w.pacWbs.carn QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: STORMWATER Pace Project No.: 92235067 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92235067001 STORMWATER EPA 1664B GCSV120213 92235067001 STORMWATER SM 2540D RWET17970 Date: =05/2015 09:04 AM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in Full, without the written consent of Pace Analytical Services, Inc.. Page 8 of 10 Document Name: Sample Condition Upon Document Revised: April 04, 2013 ,PaceAnal kale Receipt (SCUR) Page 1 of l Document No.: Issuing B Authorities: ' F-RAL-CS-001-rev.02 Pace Asheville Qualit Office Client Name Where Received: ❑ Huntersville C] Asheville Eden Raleigh Courier (Circle): Fad Ex UPS USPS Client • Commercial Pace .Other Custody Sea] on CoolorlBox Present: 0 yes no Seals intact yes ❑ no Packing Material: ❑ Bubble Wrap Bubble Begs Yf None Other Circle Thermometer Used: IR Gun "V9f-2206538ZjyA of Ice We Blue None I] Samples on Ice, oDang process has begun IR Gun 8e 0633T1 Temp Correction Factor: Add ! u trac Corrected Cooler Tern �� C P•: Tomp Shedd be above freezing to 8'C C Biological Tissue Is Frozen: Yee No A $ Comments: Date and Initials of person ox mining co a Ire 1 check; CNilh of Custody Present: Yes • QNa ONIA 1. Chain of Custod -Filled Out: Yas ONO OwA 2. ' Chain of Custod Rolla ulshed: : C]No ONIA 3. Sampler Name & Signature on COC: Yea ON- QmA 4. Sam fee Arrived within Hotd Tlme: Yes 0No' ❑NIA 6.. Short Hold 71mo Anal sis <72hr : ❑Yee No ❑NIA 6. Rush Turn Around 71me Requested: ©Yea No ❑WA T. Suflieiontvolume: piyes ONO OwA 8. Correot Containers Used: -Pace Contalners Used: Yae ONO Vy.. ONO DWA 04A 9. Containers Intact: cs ONO DNA 10. Filtered volumo•recolved for Dissolved tests C1Yae ONO XWA 11. Sample Labels match COC: -includes datedimelID/Anal sis Matrix: Yes Qho ONIA 12. All containers needing presanralton have been chodked. All containors needing preservation are found to be in compliance with EPA r000mmendatlon. amptions: VQk Wiform, TOO, O&G. WI-DRO (Water} Yes ONO 1,,( ❑No 5a7°S ( ea LINO ❑wA ❑N!A 13. Sam los checked for dechlorinatlon: Yes ONO ❑WA .14. Heads ace 1n VQA vials >6mm : OYae ONO EAA 15. Trip Blank Present: Trip Blank Custody Seals Present Pace Trip Blank Lot f#(lf up rchasad , OYae ONO [ Yea ❑No N1A 41A I& Client Notipcationl Resolution; Field Data Required? Y / N Person Contacted: Cammen(sl Resolution: SCURFIsRF Review:: Dateffi me: Note: Whenever there Is a discrepancy affecting North Carolina oomptlance samplos, a copy of this form will be sent to the North Carolina DEHNR Certification Office t I.o out of hold, Incorrect preservatioa, out of temp, incorret:l containers} l here Ild0#:92235067 �SII611811@IN��1II .l t II t Page 9 of 10 aceAnalyhcal' CHAIN -OF -CUSTODY 1 Analytical Request Document The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must be completed aocoratety. Section A Section B Section C Page: of Required Client Information: Required Project Information: invoice Information: Report To: t�,: Copan� mk 1651840 ,�.f` 1�-60vh , Address;j: y� il -N g Copy AGi:1 5� To: Company Name: REGULATORY AGENCY ZA.- it 06-dis7t -7 Address' F NPDES r GROUND WATER (- DRINKING WATER r UST F RCRA r OTHER Email To,,, k� qy : r Purchase �►u �r-�'r " Order No.: Pace Quota C-ff+ll--e' �v 4 r ©rl Reference: P,hone:: rp C i) Fax: r j^+ Project °I Vil I b161 � 6.* r 1 Name: Pace Proiact Manager. Site Location STATE: _ Requested Due DatefTAT: Project Number. Pace Pruhle s: Requested Analysis Filtered (YIN) SecdGn D Matrix Codes = Required client lntarmatkn MATRIX r CODE o COLLECTED Preservatives r _ Drinking Water DW - . z LD Water WT WW V U m COWOS E COMPO E Z ���eoWater -�, srutl MWORlla J Soil/Solid SL 8 0 � � } SAMPLE ID Oil DL � � m c Wipe wP (A-Z. 0-9I ,-) Air AR p ur- a z 1,16 Sample IDS MUST BE UNIQUE Tissue TS O a H m �'l Other OT U x w uJ to Oz 'a a u. m p = rn t m m 7 - v N ~ �• DATE TIME DATE TIME in 4* D _ _ = Z Z O .ay Pace ISrOJBCt NOJ Lab I.D. 2 Al fin' 3 I 4 f 5 6 7 s e 9 10 A 12- gg; - ADDITIONAL COMMENTS - RELINQUISHED -BY / AFFILIATION DATE - '' TIME = ACCEPTED BY f AFFILIATION - DATE TIME SAMPLE CONDITIONS L p V-. .,. SAMPLER NAME AND SIGNATURE - F PRINT Name of SAMPL.I:R: T l g zq � {- z_ .... .,�. : ,•�- DATE Signed SIGNATURE of SAMPLER[ - m m = �j�7C: '' V:-m m a (MMIDDlYY): 'Important Note: By signing this form you are accepting Pace's NET 30 day payment terms and agreeing to late charges of 1.5% per month for any invoices not paid within 30 days. f F-ALL-0-020rey.07,_ 15-May=2007 • ��• -�'� mac. :a , :. 'cb' :,;. .. � - C.. Instructions for completing Chain of Custody (COC) 1. Section A and B: Complete all Client information at top of sheet: company' name; address_ phone, fax, contact (the person to contact if there are que tioris; and who will receive the final report.), e-mail address (if available), PO#, Pm'ect Name; and/or Project Number as you would like to sec: it appear on the report. 2. Section C: Invoice Information: Billing information is included in this section. This information should include; the name and address of the person receiving the invoice:. ;. Quote Reference should be completed if quotation was provided by Pacc Analytical. The Project Manager, and Profile No. will be completed by Pace Analytical Services. 4. Site Location: A separate COC must be tilled out for each day of sample collection. Record the two letter postal code; for the US state in which the samples were collected. 5. Regulatory Agency: List the program that is guiding the work to ensure proper regulations are followed. 6. Section D: Complete a Sample Description in the "SAMPLE ID' section as you would like it to appear on the laboratory report. The following information should also be included: the sample; matrix; sample type (G (grab) or C (composite). When collecting a composite; the start time and end time should be documented in the respective boxers. The collection time for a grab (G) sainple should be entered in the; boxes marked 'Composite End/Grab'), Sample temp at collection (if required by state), the total number of containers, and preservative used. 7. Mark if the sample was filtered in the field by marking Y or N in 'Filtered' row by the Analysis requested. 8. Requested Analysis: List the required analysis and methods on the: lines provided and place a check in the column for the samples requiring the analysis. Additional comments should be referenced in the bottom left hand corner or include attachments for extended lists of parameters. 9. The sampler should print their name in the space provided and sign their name followed by the date of the sampling event at the bottom of the COC in the: spaces designated for `SAMPLER NAME. AND SIGNATURE'. 10. When relinquishing custody of the samples to a representative of the laboratory or other organization, indicate the Item Numbers of those samples being transferred; sign relinquished by, date and time, and include your affiliation. *Important Note: Standard Turnaround Time is 2 Weeks/10 business days. Results will be delivered by end of business on the date due unless other arrangements have; been made with your project manager. Special Project Requirements such as Low Level Detection Limits or level of QC reported must be included on the; chain of custody in the. Additional Comments section. CHAIN -OF -CUSTODY 1 Ana"ca! Raqu"4 Document Trio Ch■ m oFCuclady is a i.EGAt DOCUMENT. AD reWdard gelds ffAM be MMO.ftd -Wy. p I% d11 aj• ,ra wft - -' - - E. GROUNDWATER OTHER lV - 717 _ 1 SMPLE ■ � ii(ll�:.s-!►�.ir � il�r'•7�I■)t�S�I��L.Tii�■_� MOW. 7 WIM, ETISCA sr�1 r L��G�.'s►b.�%L�Si+,�=���\'.�����I i�11�► �f ��►� �1��©�i� ���'�f� �.♦ Bin * ., •Iraan =Now. BY sovrks rotor you are a=f0etQ Paw's NFT30d2ypWh* immar+d d 1.5% Dar marsh tarenly invo not MW w9N, 30 days. .. F-ALL-Q-Mrev.07. 15-Wy-2007 I— Semi-annual Stormwater Discharge Monitoring Report ele for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted CERTIFICATE OF COVERAGE NO. NCG08_C_ 6 FACILITY NAME 'Twzn ZQIoA-n P-,� 1+'c, COUNTY PERSON COLLECTING SAMPLES �n4 PvsC, LABORATORY PNc,1- I Lab Cert. # Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR 4X)1q SAMPLE PERIOD F] Jan -June F] July -Dec 0A or 0 Monthly' (montbj �k DISCHARGING TO CLASS L]ORW DHQW EjTrout OPNA oZero-flow [:]WaterSupply OSA RECEIVE!j) 00ther JAN 12 2015 PLEASE REMEMBER To SIGN ON THE REVERSE 4 CENTRAL FILES DWR SECTION Fj No discharge this period' D 4- e, 00530%M ..... ..... ',.,.-. ended LIZ i� -4�, -y q -..'o "T 1,� rl­� 1Z�,�e, . ­ 'al iz irW d a Zj.+�M Solids d; g h d a- r -,unt s-Eg� d; _ �01974R N- Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? (if yes, report your analytical results in the table immediately below) Part B: Oit/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals yes _no R q5�q`. K nMr}i­;M1K- �1. � 0 5 0 " Am 4, g buspencle M -yg ;R �k air.W, T4 �4w . P!?,rl W .3 ml IL r7- W I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised October 25, 2012 Page 1 of 2 - .. STORM EVENT CHARACTERISTICS: Date la- b- 19 (first event sampled) / Total Event Precipitation (inches): 3//0 Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS, SEE PERMIT PART 11 SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALLTRIGGER.TIER 2 REQUIREMENTS. SEE PERMIT PART it SECTION B. ■ TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES 0 NO IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO REGIONAL OFFICE CONTACT NAME: Mail an original and one copy -of this DMR, including all "No Discharge" reports within 30 days of receipt of the lab results for at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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, 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." ose- re of Permitteej la-1t- ly (Date) Additional copies of this form may be downloaded at: http://.portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 S W U-250 last revised October 25, 2012 Page 2 of 2 W-1 A 7-; - A 6' rCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit: Permit No.: N/C/_/_/_/_/_/_/_/ or Certificate of Covers e No.. N1C15101$1_a1j1j1j1 Facility Name: - TcW,, of Zebolo,, P.6).c:: k -SFAr— A-y County: GJ ake _ _ Phone No. 9 14 - -1b ,�a85 Inspector: Ic,, 11.Jc Date of Inspection: 1 o1- 16 ,ao lq Time of Inspection: N. 3-_pin _ Total Event Precipitation (inches): �/ O Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit?'� (See information below.) EC Yes ❑ No Please verify 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 "measureable 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 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or Designee) Page 1 of 2 SWU-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. -'� Structure (pipe, ditch, etc.) .nQ Receiving Stream: c n A ,�d 4r:hkAof Ljtle. 4"Ver _ Describe the industrial[ activitiesff that occur within the outfall drainage area: hulk fur/ 0,Q:6 y.� _ �S@1C *�ua�....p�1rSz, , uhlr1061e�/4AUDI',C t-10 , f/eYr� AWYA,., III . 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: &Aj -/,qn _ 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 0 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 b. 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 ZO 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 evidence of erosion or deposition at the outfall? Yes Na 10. Other Obvious Indicators of Stormwater Pollution: List and describe oc.A All Soj C o J : f:+n I01"i /'93 5)01/ Q 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 5WU-242, Last madifted 10/25/2012 STORMWATER SAMPLING TIMELINE TUESDAY, DECEMBER 16, 2014 1 1:30 a.m. — Light rain 11:45 a.m. — Rain (heavy), no discharge 12:32 p..m. — Sample taken 12:35 p.m. — pH calibration 12:47 p.m. — pH reading of 7.61 Total rainfall = 3/10" Sample taken by Tony Rose, Stormwater Superintendent /�;aceAnalytical* www.pacelabs.com CHAIN -OF -CUSTODY 1 Analytical Request Document y y The Chain -Of -Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately. Section A Section B Section C Page: of Required Client Information: Required Project Information: Invoice Wormation: - Com Report To: Attention: p� tJ N p° //�� /r� /� )q L 4 VV Y 666...... AddreS$� E 1 ` Y C� HH FT J Copy To: Company Name: REGULATORY AGENCY 1 }} y� Zeh i l a-tt �—1 Address: r NPUES r GROUNDWATER r DRINKING WATER UST j RCRA j� OTHER Email To:f1 y} Purchase Drder NO.: Pace Quote V Q Lt317 T Z E Lc f L31t r1i Reference: Phone: Vi�1-'�4-5�85 F x: -��`}�.7� "ect Name: Pace Project Manager Site Location STATE: Requested Due Date/TAT: Project Number Pace Profile a: ,Requested Analysis Filtered (YIN) Section D Matrix Codes z RequiredClient Information MATRIX f CODE o � COLLECTED Preservatives Y Drinking Water DW g L) z `Z1 Water WT Waste Water VVVV a rj COMPOSITE START COMPOSITE ENDrGRA6 L) Q} _ Product P — y Q R J Z SoiVSolid SL t7 q rq ~ t } SAMPLE ID Oil O " 0 M . H a) (A-Z, 0-91,) Air AR p w a Z H a Sample IDS MUST BE UNIQUE Tissue TS Q U a F y U - Other OT - ?C w F- J z O Q7 C 7. U� N - CJ d > O C O O C `^ Vy C 3 < DATE TIME DATE TIME S W U # C 7 N T Z T U X I4 Z N Z al 2 Q a � Pace Project No.1 Lab I.D. 2 JTbrrnuJa BT G. to-iol P19, +a-11.1 14)'3; 3 4 i 5 6 7 8 9 10 11 12 ADDITIONAL COMMENTS RELINQUISHED BY AFFILIATION DATE TIME ACCEPTED BY f AFFILIATION DATE TIME SAMPLE CONDITIONS A'-/ la-rL-1 9 : yS it 741 9 yS PZ• if 1H 7' 1 S ,�7 I74 7 IS -ISM `7:.7 9175-Ur . ,4 r -/�o SAMPLER NAME AND SIGNATURE U o 4i Y 9 _c v `> 0 o U z Y = z PRINT Name of SAMPLER: m U T SIGNATURE of SAMPLER: DATE Signed ~ 8 ¢ E (MMIDDlYY)- w m 'Important Note: By signing this forth you are aceepting Pace's NET 30 day payment terms and agreeing to late charges of 1.5% per month for any invoices not paid within 30 days. F-ALL-0-020rev.07, 15-May-2007 Instructions for completing Chain of Custody (COC) 1. Section A and B: Complete all Client information at top of shoes: company name:. address, phone, fax; contact (the person to contact if there are } 1quustions, and who will receive the final report.); c-mail address (if available), 1'O# Project Name and/or Project Number as you would like to sce-it appea on the report. 2. Section C: Invoice: Infonnation: Billing information is included in this section. This information should include: the name: and address of the person, receiving the invoice. s 3. Quote Reference should be completed if a quotation was provided by Pace Analytical. The Project Manager, and Profile No. will be completed by Pace Analytical Services. 4. Site Location: A separate COC must be filled out for each day of sample collection. Record the. two le;ttcr postal code; for the US state in which the samples weiv collcct4d. . . 5. Rej!ulatorY Agency: List the program that is guiding the work to ensure proper regulations are followed. 6. Section D: Complete; a Sample Description in the "SAMPLE ID' section as you would like it to appear on the laboratory report. The following information should also be included: the sample: inatrix,'sample type (G (grab) or C (composite). When collecting a composite, the; start time and end time should be documented in the: respective boxes. `-hc collection time fora grab (G) sample should be entered in the boxes marked `Composite End/Grab'), Sample temp at collection (if required by state;), the total number of containers, and preservative used. 7. Mark if the sample was filtered in the fielU by marking Y or N in 'filtered' row by the Analysis requested. S. Requested Analysis: List the; required analysis and methods on the lines provided and place a check in the column for the; samples requiring the analysis. Additional -comments should be referenced in the; bottom Leif hand corner or include attachments for extended lists of parameters. 9. Tbe sampler should print their name in the space: provided and sign their name; followed by the date of the sampling event at the bottom of the COC in the: spaces designated for `SAMPLER NAME AND SIGNATURE'. 10. When relinquishing custody of the samples to a representative of the laboratory or other organization, indicate the item Numbers of those; samples being transferred; sign relinquished by, date and time:, and include: your affiliation. *Important.Note: Standard Turnaround Time is.2 Weeks/10 business days. Results will be delivered by end of business on'the date due unless other arrangements have been made with your project manager.,- , Special Project Requirements such as Low Level Detection Limits or level,of QC reported must be included on the chain of custody in the Additional Comments section. V -{' acmnalytical *%w.pacelab-%wm December 23, 2014 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: STORMWATER Pace Project No.: 92230361 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Dear Mr. Ray: Enclosed are the analytical results for sample(s)l received by the laboratory on December 18, 2014. The results relate only to the samples included in this report. Results reported herein conform to the most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. Analyses were performed at the Pace Analytical ,Services location indicated on the sample analyte page for analysis unless otherwise footnoted. If you have any questions concerning this report; please feel free to contact me. Sincerely, kX, cam-_ cc,n Liamm Carrubba liamm.carrubba@pacelabs.com Project Manager Enclosures cc. Ms. Robyn Snow, Town of Zebulon REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pate Analytical Services, Inc.. Page 1 of 10 acmnalyfical www.pecelabs.com Project: STORMWATER Pace Project No.: 92230361 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Charlotte Certification IDs 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 North Carolina Drinking Water Certification #: 37706 North Carolina Field Services Certification #: 5342 North Carolina Wastewater Certification #: 12 South Carolina Certification #: 99006001 Asheville Certification IDs 2225 Riverside Drive, Asheville, NC 28804 Ftorida/NELAP Certification # E87648 Massachusetts Certification #: M-NC030 North Carolina Drinking Water Certification #: 37712 CERTIFICATIONS Florida/NELAP Certification #: E87627 Kentucky UST Certification #: 84 West Virginia Certification #: 357 VirginiaNEt AP Certification #: 460221 North Carolina Wastewater Certification #: 40 South Carolina Certification #: 99030001 West Virginia Certification #: 356 VirginiaNELAP Certification #: 460222 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in lull, without the written consent of Pace Analytical Services, Inc.. Page 2 of 10 Pace Analytical Services, Inc. aceAnalytica!• 9800KinceyAve, Suite100 Huntersville, NC 28078 www.pawabs.com (704)875.9092 SAMPLE ANALYTE COUNT Project: STORMWATER Pace Project No.: 92230361 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92230361001 STORMWATER #1 EPA 1664B CLW 1 PASI-C SM 2540D SER 1 PASI-A REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written oonsent of Pace Analytical Services, Inc.. Page 3 of 10 aceAnalytical wwwpaoelatL&C" ANALYTICAL RESULTS Project: STORMWATER Pace Project No.: 92230361 Pace Analytical Services, Inc. 9800 Kinsey Ave. Suite 100 Huntersville, NC 28078 (704)8759092 Sample: STORMWATER #1 Lab ID: 92230361001 Collected: 1211611412:32 Received: 12/18/14 13:26 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 1664B Oil and Grease ND mg/L 5.0 1 12/22/14 16:43 2540D Total Suspended Solids Analytical Method: SM 25400 Total Suspended Solids 46.3 mg/L 8.3 1 12/23/14 03:01 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 12/23/2014 11:12 AM without the written consent of Pace Analytical Services, Inc -. Page 4 of 10 aceAnalyticale www.pacelabs.aom QUALITY CONTROL DATA Project: STORMWATER Pace Project No.: 92230361 QC Batch: GCSV119881 Analysis Method: EPA 1664B QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92230361001 METHOD BLANK: 1358035 Associated Lab Samples: 92230361001 Parameter Units Oil and Grease mg1L LABORATORY CONTROL SAMPLE: 1358036 Parameter Units Oil and Grease mg/L Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 5.0 12/22/14 16:40 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 40 38.0 95 78-114 MATRIX SPIKE SAMPLE: 1358037 92230565001 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Qualifiers Oil and Grease mg1L ND 40 39.0 94 78-114 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: 12/23/2014 11:12 AM without the written consent of Pace Analytical Services, Inc.. Page 5 of 10 aceAnalytical www.pacelabs.com Project: STORMWATER Pace Project No.: 92230361 QC Batch: WET134927 QC Batch Method: SM 2540D Associated Lab Samples: 92230361001 METHOD BLANK: 1358277 Associated Lab Samples: 92230361001 Parameter Units Total Suspended Solids mg/L LABORATORY CONTROL SAMPLE: 1358278 Parameter Units Total Suspended Solids mg1L SAMPLE DUPLICATE: 1358279 Parameter Units Total Suspended Solids mg/L SAMPLE DUPLICATE: 1368280 Parameter Units Total Suspended Solids mg/L Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA Analysis Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers NO 2.5 12/23/14 03:01 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 250 254 102 90-110 92230361001 Dup Result Result RPD Qualifiers 46.3 48.0 4 92230024001 Dup Result' Result RPD Qualifiers NO NO 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: 12/23/2014 11:12 AM without the written consent of Pace Analytical Services, Inc-. Page 6 of 10 acmnalyfical� %W.pacelab&Mn Pace Analytical Services, Inc. 9800 KinceyAve. Suite 100 Huntersville, NC 28078 (704)8759092 QUALIFIERS Project: STORMWATER Pace Project No.: 92230361 DEFINITIONS DF - Dilution Factor, if reported, represents the factor applied to the reported data due to changes in sample preparation, dilution of the sample aliquot, or moisture content. ND - Not Detected at or above adjusted reporting limit. 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. S - Surrogate 1,2-Diphenylhydrazine (8270 listed analyte) decomposes toAzobenzene. 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 Dupticate RPD - Relative Percent Difference NC - Not Calculable. SG - Silica Gel - Clean -Up U - Indicates the compound was analyzed for, but not detected. N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyte is a combined concentration. Acid preservation may not be appropriate for 2-Chloroethylvinyl ether, Styrene, and Vinyl chloride. Pace Analytical is TN accredited. Contact your Pace PM for the current list of accredited analytes. TNI - The NELAC Institute. LABORATORIES PASI-A Pace Analytical Services -Asheville PASI-C Pace Analytical Services - Charlotte REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 1212WO14 11:12 AM without the written consent of Pace Analytical Services, Inc.. Page 7 of 10 aceAnalytical www.pacelabsoom QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: STORMWATER Pace Project No.: 92230361 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)8759092 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92230361001 STORMWATER #1 EPA 1664B GCSV119881 92230361001 STORMWATER #1 SM 2540D WET134927 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 12/23/2014 11:12 AM without the written consent of Pace Anaiy ical Services, Inc.. Page 8 of 10 V AM164Wl' e Condition Upon Recei� Document Number: F-CHR-CS-003-rev.15 Page 1 of 2 Issuing Authority: Pace Huntersville Quality Office Client Name:- Courier: El Fed Ex ❑ UPS❑ USPS❑ Client❑ Commerga' Pace Other r ii . i)etg3' a� Custody Seal on Cooler/Box Present-, ❑ yes �'=710 Seals intact: ❑yes ❑ no �j. pst�� ,,p; • ut...., .' rU Packing Material: ❑, Bubble , Bubble Bags lone ❑ Other Thermometer Used: IR Gun T1 4 Type of Ice: Wei Blue None ,� amples on ice, cooling process has begun Temp Correction Factor T1401 No Correction Corrected Cooler Temp.. -C Temp should be above freezing to 6'C Biological Tissue is Frozen: Yes to wA Comments: Date and lniti Is f arson examining contents: w 1 ! a r y Chain of Custody Present: kWs []No ❑NIA 1. Chain of Custody Filled Out: Wes ONO ❑NIA 2. Chain of Custody Relinquished: es ©No ❑NIA 3. Sampler Name & Signature on COG: ❑Yes a ❑NIA 4. Samples Arrived within Hold Time: es ❑No ONIA 5. Short Hold Time Analysis <72hr : Dyes a ❑NIA 6. Rush Turn Around Time Requested: ❑Yea No ❑NIA 7. Sufficient Volume: hs ONO ❑NIA 8. Correct Containers Used: -Pace Containers Used: Yes ❑No Ves ❑No ❑NIA ❑NIA 9. Containers Intact: )9es ❑No ❑NIA 10. Filtered volume received for Dissolved tests Dyes ONO A 11, Sample Labels match COC: -Includes date/time/ID/Analysis Matrix: )7Nes ONO I ❑NIA 12. All containers needing preservation have been checked. All containers needing preservation are found to be in compliance with EPA recommendation. exceptions: VOA, colirorm, TOC, O&G, WI•DRO (water) Dyes ONO Dyes ONO Yes ❑No NIA `f�ik�/A 13. Samples checked for dechlorination: Dyes ONO NaNIA 14, Heads ace in VOA Vials >8mm : ❑Yes ONO IA 16. Trip Blank Present: Trip Blank Custody Seals Present Pace Trip Blank Lot # if purchased): []Yes ❑No ❑Yes ❑No;�A 16. Client Notification/ Resolution: Field Data Required? Y / N Person Contacted: Daterrime: Comments/ Resolution: SCURF Review: -{' Date: d ~ ��` It Place label here SRF Review: t Dato: IJ,hs -(v ® : 9223Q361 Note: Whenever there a rpa cY affecting North Carolina compliance samples, a copy of this s form will be sent to the North Carolina DEHNR Certification Office ( i.e out of hold, incorrect preservative, out of temp, 92230381 incorrect containers) Page 9of10 • • • Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling outthis form, please visit: http://portal.ncdenr,org/web/wa/ws/su/npdessw#tab-4 Permit No.: Facility Name: I County: L4)a�V4 Inspector: e . Date of Inspection: ins I Time of Inspection: _ � ]4 or Certificate of Coverage No.: 1_f • I '%- _1__ Ir_ -- 1• 1. Phone No. `1lR�;vY-- Total Event Precipitation (inches): - DEC 10 N14 Was this a "Representative Storm Event" or °Measureable Storm Event" as defin �Mftf (See information below.) ❑ Yes Z No Please verify 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 "measureable 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 0.2 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 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge. (Signature of Permittee o Designee) Paget of 2 Swu-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. J-- Structure (pipe, ditch, etc.) Receiving Stream: _ A YXW,�vt,O4 4r.i.ktAn,�Tb Describe the industrial activities that oc(ur within the ou � • r. 1 �L 1�'ie t CC area:7 4. 2. Color: Describe the color of the dischar e using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 3. Odor: Describe any distinct odors weak chlorine odor, etc.): f the discharge may have (i.e., smells strongly of oil, 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 S. 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? 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? 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 10/25/2012 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted /cR - 2 - � I CERTIFICATE OF COVERAGE No. NCGO8 0 FACILITY NAME 1,.,­1 0 1 Zcb,&­ )10,A6 F,C COUNTY W M6 e- PERSON COLLECTING SAMPLES LABORATORY Lab Cert. # Comments on sample collection or analysis, Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR � 014 SAMPLE PERIOD Jan -June [j July -Dec or Monthly' N,)ye-r;qber lmoqh) DISCHARGING TO CLASS E:1ORW [-]HQW E:]Trout OPNA nzero-flow Water Supply [:]SA Dother PLEASE REMEMBER TO SIGN ON THE REVERSE 4 X No discharge this period' a 0 rK` �' M ifs 4�f otal�suspen ­­-N ,p: j,' "W-P611 -,,0 d T H-EPA-f­' jje i ;j5ff j7d Nc M sage jN ... 5P nua"averagogal/6om ---------- '10 1 's 9 0 nl oy. p 9 W 0 5-F, f�� -3,� M -­R Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? — yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals o Aw" N . ...... 4 ne 30 "f; , Lqz, �n t -,, TPHEPX et v - - - 0 qjdita "c"Susp R� .w iz� N rR -1ftiitM­ Ift NN 5.1 W N �N 0 RZ. NO I For sampling periods with no discharge at any single outfatl, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised October 25, 2012 Page 1 of 2 STORM EVENT CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): _ Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES [-]NOD REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR _includin all "No Discharge" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharge" reports) to: — -- _ Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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, 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." (Signs re of Permittee) — 1-�2, Y--/ (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4 SWO-250 last revised October 25, 2012 Page 2 of 2 Memo To: Public Works Staff CC: Chris D. Ray, Director From: Tony Rose, Stormwater Superintendent Date: 10/28/2014 Re: Tier 2 Response We took stormwater samples at Outfall # 1 on April 15, 2014 and September 24, 2014. Both samples registered above the Total Suspended Solids (TSS) limit of 100 mg/ L. The April sample TSS level was 220 mg/ L and the September sample, following maintenance efforts in June, was 130 mg/ L. The steps taken in June to lower the TSS level were not effective enough to reach under the limit of 100 mg/ L. The following additional items were completed between October 2, 2014 and October 23, 2014 to improve the entire site and the drainage area for the site: • Removed all rip -rap from detention pond and check dams • Removed all silt fence • Removed trees around detention pond and approximately 30' x 100' along the outside of the chain link fence • Cleaned and graded detention pond and swell along the outside of the chain link fence (approximately 30' x 100) • Installed new liner & rip -rap in bottom of detention pond up to the discharge level • Installed new check dams (approximately 3) along chain link fence • Installed sod in 30'x100' graded area, the areas between the check dams, and a 30' circumference around the detention pond • Installed #5 stone along the inside of chain link fence from pole barn to light pole approximately 10' out and covered any bare areas with stone • Installed sediment filter fabric on invert of 6" discharge pipe • Installed additional check dams at the rear of the pole barn • Added approximately 50' of silt fence material and #5 stone along and behind pole barn • Re -graded discharge ditch to form sloping side walls; seeded, matted and placed straw • Installed 15" black corrugated pipe in pathway to improve access to site for landscaping and maintenance crew • Aerated and overseeded outfall area with a fescue/rye blend from the fuel containment area to the sodded area • Installed silt fence around topsoil stockpile behind the fence The following table details the material costs and labor: Materials/Labor Expense Roger Silver - Crew Leader 42 hours $1,071.00 Sam Jar uin -- Equipment Op I 75 hours $1,912.50 Taylor Johnson - Equipment Op II 28 hoursi $714.00 Corbin Johnson - Equipment Op I 8 hours $204.00 Tony Rose - Stormwater Superintendent 56 hours $2,240.00 Dale Matthews - Sanitation Superintendent 12 hours $480.00 Chris Ray - Director of Public Works 2.5 hours $150.00 Temporary Labor - Labor Read 19 hours $272.65 Lime -- 200 pounds $42.64 10-10-10 Fertilizer - 200 pounds $75.00 Fescue Sod - 15 allets 35 yds per pallet $1,350.00 Matting, fescue seed, rye seed, staples $481.06 Wheat straw - 11 bales $27.50 15" Corrugated black pipe $140.00 Grand Total $9,160.35 Total number of labor hours = 242.5 Total cost of labor = $7,044.15 Total cost of materials = $2,116.20 We will collect the next stormwater sample after November 7, 2014. This will allow 2 weeks for the sod and grass seed time to stabilize the area. Hopefully, all of these improvements to the detention pond area will reduce the Total Suspended Solids to an acceptable level. See attached pictures. Additional progress pictures are located on the server Y drive. Action Plan 1) Collect 3 monthly samples (Nov 7-30, Dec 1-31, Jan 1-31). Report to DWQ. 2) Clean detention pond with vacuum trailer, including changing the sediment filter fabric monthly. 3) Continue with monthly outfall inspections. 4) No parking lot box blading during collection period. ate+. � � ,• `f.l.�,� �r � .,.y y at"rld 7. _' L'� Q � �� wry �� • ,(ie a I • ` � � .� ww. 7 �1 =.(+rat .• •r:� a� .. t ¢ •� i o- � ram; >` }` �. ti �W# �S} � +4•ary{'�`r 1.7 t + +.7 ? ! +. {r �1i, ? Y .i _ ` � y ��'�� ��«.:1�+�.7 ��. �`� 1' , ,��>r 's;��`! r' a M. * ~�✓,,� ... �1R � ..j°M1�-�'K; �.�lrL� •Yifl�k ',s. i ri'��. i� �/.of/ -.� y° y• •� i .� 'r. �v: �y,.r "'.�.{�.Y'1��t�.. it '�'�J I `.�' 7 ( y.. �► `��-• �4si�4f �v � ro 41°. L 73�' 1 i Ct n • IFFA RCDEN.R Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit h ortal.ncdenr.or web w ws su n d ssw#tab Permit No.: N/C/ _/_/_l�l_I_I_I or Certificate of Coverage No.: N/C/G/ 4 9/ 0/ b/l/l/ Facility Name: —r-- Zeb.A1or% lac, :.J-1 ks [Addy County: LL)Ake. Phone Inspector: _ T� 1!iuse; ._ Date of Inspection: 9- )q - as Time of Inspection: I a :ao pm _ Total Event Precipitation (inches): 1 RJ1io Was this a "Representative Storm Event" or "Measureable Storm Event" as KECEIVED ined by the permit? (See information below.) X Yes ❑ No OCT 0 8, Z014 CENTRAL FILES Please verify whether Qualitative Monitoring must be performed during a "reRrWPnFCzVA-fVgrn 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 "measureable 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 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 DWQ Regional Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Signature of Permittee or Designee) Page 1 of 2 5WU-2,42, Last modified 10/25/2012 1. Outfall Description: Outfall'No. . I — Structure (pipe, ditch, etc.) 5-4 w 4k of,''c� Receiving Stream: _ L n n6"t—A ;_b��Afy RJ � : ALMe A:ie,,� _ Describe the industrial activities that occur within the outfall drainage area: U ,t fuel 5 an d 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): AIe. 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 S. 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: G) 2 3 4 5 b. 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: O 2 3 4 5 7. Is there any foam in the stormwater discharge? Yes No S. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes No. 10. Other Obvious Indicators of Stormwater Pollution: List and describe n - o'�Wa "5 u' Cun ,.�-� .� %% c;T ..s Dote: Low clarity, high solids, and/or the presence of foam, oil sheen, or erasion/deposition may be indicative of pollutant exposure. These conditions warrant further investigation. Page 2 of 2 sWU-242, Lastmodifled 10/25/2012 E • LTC, MCDENR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on frlling out this form, please visit: hU:Z/porta1.ncdenr.org/web/wgLws/,sunpdessw#tab Permit No.: Facility Name: K,, or Certificate of Coverage No.: County: _ Wgkg_ Phone No. ij4- Inspector: 1 -' ,4_ Also - - - Date of Inspection: q-0 '40h Time of Inspection: too r Total Event Precipitation (inches): L 8/10 Was this a "Representative Storm Event" or "Measureable Storm Event" as -defined by the permit? (See information below.) x Yes ❑ No Please verify 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 "measureable 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 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 DWQ Regionai Office. By this signature, I certify that this report is accurate and complete to the best of my knowledge: (Sirature of Permittee or Designee) Page 1 of 2 5WU-242, Last modified 10/25/2012 1. Outfail Description: 10 Outfall No. A Structure (pipe, ditch, etc.) rAs3 ,Swale Receiving Stream: 4AAA►ne t ir�;jfvv o{ 1.41e. ;per _ Describe the industrial activities that occur within the outfall drainage area: jowzl eAi �5J.,54n�_Scrret_ 2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: G Ak 11'2 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): None 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 (D 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 O2 3 4 5 b. 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 O 3 4 5 7. Is there any foam in the.stormwater discharge? Yes No B. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes 10. Other Obvious Indicators of Stormwater Pollution: List and describe ate — jo-A C eh Lelf '41 do 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 10/25/2012 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE NO. N CGO8 o 6 9 6- FACILITYNAME ­T�",­, ok 7,LA,on P,i I", COUNTY tJ nV,(V- PERSON COLLECTING SAMPLES I ahV Aoj LABORATORY SAC 2 Lab Cert. # /13 Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR ru I q SAMPLE PERIOD F] Jan -June M July -Dec or El Monthly' (month] DISCHARGING TO CLASS []ORW [:IHQW DTrout LJPNA OZero-flow [:]Water Supply OSA E]Other PLEASE REMEMBER TO SIGN ON THE REVERSE -) 0 No discharge this period 1-'1 116 0. '0'! 3 zK­ -TA' ".t`z 40:0?� wg 'd rd-9q j s4! EtWINIRKS =Tlla —p. T. -r"Wuf PHIEPAP. 0--ri t E(SGTI-7 d fxKFNA ijj 0-1�­ lk��A' 0 a "AM., Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _ yes _no (if yes, report your analytical results in the table immediately below) Part B. Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals leC6G f A M Met ocife IV f `9§m' WM $06--vo andii tan K -A' V . 0 ij� -tp 0RMS 4, J� -L X�M'N!� HEM 64, SGTL 7­"�.- VJ­�.'��7.V­1­1-1" My . ".. �' ;­.i-TotA1,PSi!speffde iSolids,;'t 'C� - �- - k -W . '� T units tari6i ­T�i WF.' OR ilt�� t 6,6--i-i-, Of 5 51MMA�� EMT 7 ORN WOkff` �P SM, %�� 1 9 -a%k- aoN Al 0 IL I For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised October 25, 2012 Page I of 2 0 • • STORM EVENT CHARACTERISTICS: Date 9-614- f q (first event sampled) 8 Total Event Precipitation (inches): E'' JO Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART 11 SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one coon of this OMR. including all "No Discharge" reports. within 30 days of receipt of the lab results for at end of monitorina period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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, 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." (Signat0e' of Permittee) (Date) Additional copies of this form may be downloaded at: http://Portal.ncdenr.org/web/"wq/w5/su/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 . STORMWATER SAMPLING TIMELINE WEDNESDAY, SEPTEMBER 24, 2014 6:05 a.m. — Light misting rain 10:30 a.m. — Rain (light), no discharge 10:45 a.m. — Calibrated pH meter 11:00 a.m. — Moderate to heavy rain, checked discharge pipe, no discharge 11:40 a.m. --- Began discharging (moderate to heavy rain) 12:00 p.m. — Sample taken (moderate to heavy rain) 12:10 p.m. — pH reading of 7.77 Total rainfall = 1.8" Sample taken by Tony Rose, Stormwater Superintendent • 0 5ceAna1j cal wwwpaoafah com October 07, 2014 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: 9/24/14 Stormwater Pace Project No.: 92218954 Pace Analylkal Services, Inc. 9800 Kirmy Ave, Suite 100 Huntersville, NC 26078 (704)875-9092 Dear Mr. Ray: Enclosed are the analytical results for sample(s) received by the laboratory on September 25, 2014. The results relate only to the samples included in this report. Results reported herein conform to the most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. Analyses were performed at the Pace Analytical Services location indicated on the sample analyte page for analysis unless otherwise footnoted. If you have any questions concerning this report, please feel free to contact me. Sincerely, Liamm Carrubba liamm.carrubba@pacelabs.com Project Manager Enclosures cc: Ms. Robyn Snow, Town of Zebulon REPORT OF LABORATORY ANALYSIS This report shall nat be reproduced, except in full, without the mitten consent of Pace Analytical Services, Inc.. Page 1 of 10 acmnaiyticai www.pecefabs.com Project: 9/24114 Stormwater Pace Project No.: 92218954 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)8759092 Charlotte Certification IDs 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 North Carolina Drinking Water Certification #: 37706 North Carolina Field Services Certification #: 5342 North Carolina Wastewater Certification #: 12 South Carolina Certification #: 99006001 Asheville Certification IDs 2225 Riverside Dr., Asheville, NC 28804 Florida/NELAP Certification #: E87648 Massachusetts Certification #: M-NC030 North Carolina Drinking Water Certification #: 37712 CERTIFICATIONS Florida/NELAP Certification #: E87627 Kentucky UST Certification #: 84 West Virginia Certification M 357 VirginiaNELAP Certification #: 460221 North Carolina Wastewater Certification M 40 South Carolina Certification M 99030001 West Virginia Certification M 356 VirginiaNEtAP Certification M 460222 REPORT OF LABORATORY ANALYSIS This report shall riot be reproduced, except in lull, without the written consent of Pace Analytical Services, Inc.. Page 2 of 10 aceAnalytical wmpwelatm.cam SAMPLE ANALYTE COUNT Project: 9/24114 Stormwater Pace Project No.: 92218954 Pace Analytical Services, tnc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Anatytes Lab ID Sample ID Method Analysts Reported Laboratory 92218954001 Stormwater #1 SM 2540D TEP 1 PASI-A 92218954002 Stormwater #2 EPA 1664E CLW 1 PASI-C REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 3 of 10 s aceAnalytical wwAacela cam ANALYTICAL RESULTS Project: 9124/14 Stormwater Pace Project No.: 92218954 Pace Analytical Services, We. 9800 KinceyAve. Suits 100 Huntersville, NC 28078 (704)875.9092 Sample: Stormwater #1 Lab ID: 92218954001 Collected: 09/24/14 12:00 Received: 09/25/14 16:36 Matrix: Water Parameters Results Units Report Limit OF Prepared Analyzed CAS No. Qual 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 130 mg1L 25.0 1 09/27/14 02:24 Sample: Stormwater #2 lab ID: 92218954002 Collected: 09/24/14 12:00 Received: 09125114 16:36 Matrix: Water Parameters Results Units Report Limit OF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 1664E Oil and Grease NO mg1L 5.0 1 09/26/14 14:50 Date: 10/07/2014 09:23 AM REPORT OF LABORATORY ANALYSIS This report shall not t>e reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 4 of 10 e acmnalytical ru+epacelabs.carn QUALITY CONTROL DATA Project: 9124114 Stormwater Pace Project No.: 92218954 QC Batch: GCSV119027 Analysis Method: EPA 166413 QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92218954002 METHOD BLANK: 1294468 Associated Lab Samples: 92218954002 Parameter Units Oil and Grease mglL LABORATORY CONTROL SAMPLE: 1294469 Parameter Units Oil and Grease mglL Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersvilie, NC 28078 (704)875-9092 Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 5.0 0912611414:40 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 40 37.4 94 78-114 MATRIX SPIKE SAMPLE: 1294470 92218718002 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Qualifiers Oil and Grease mglL <5.0 40 36.6 90 78-114 Resuf s presented on this page are in the unit Indkated by tie 'Unfts' 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: 10/07/2014 09:23 AM without the written consent of Pace Analytical Services, Inc.. Page 5 of 10 aceAnalytical wwrepacelatrarx>rn QUALITY CONTROL DATA Pace Analytical Ser.1ces, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)8759092 Project: 9/24114 Siormwater Pace Project No.: 92218954 QC Batch: WET133420 Analysis Method: SM 2540D QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92218954001 METHOD BLANK: 1295024 Matrix: Water Associated Lab Samples: 92218954001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg1L ND 2.5 09/27/14 02:19 LABORATORY CONTROL SAMPLE: 1295025 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Suspended Solids mg1L 250 240 96 90-110 SAMPLE DUPLICATE: 1295026 92219071001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 1240 1200 4 SAMPLE DUPLICATE: 1295027 92218952005 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L ND ND Resutts presented on this page am In the units indicated by the 'Units" column except where an alternate unit is presented to the right of the resutL REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 10/07/2014 09:23 AM without the written consent of Pace Analytical Services, Inc.. Page 6 of 10 aceAnalXical mw.paceWs.corn QUALIFIERS Project: 9/24/14 Stormwater Pace Project No.: 92218954 DEFINITIONS Pace Ana"cai Services, Inc. 9800 Kincey Ave. Suite 100 Nuntersville, NC 28078 (704)8759092 DF - Dilution Factor, it reported, represents the factor applied to the reported data due to changes in sample preparation, dilution of the sample aliquot, or moisture content. ND - Not Detected at or above adjusted reporting limit. 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. S - Surrogate 1,2-Diphenylhydrazine (8270 listed analyte) decomposes to Azobenzene. 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. N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyte is a combined concentration. Acid preservation may not be appropriate for 2-Chloroethylvinyl ether, Styrene, and Vinyl chloride. Pace Analytical is TN accredited. Contact your Pace PM for the current list of accredited analytes. TNI - The NE=LAC Institute. LABORATORIES PASI-A Pace Analytical Services -Asheville PAST C Pace Analytical Services - Charlotte REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 10/07/2014 09:23 AM without the written consent of Pace Analytical Services, Inc.. Page 7 of 10 aceAnalytical. www.pacalahs.cw QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: 9124114 Stormwater Pace Project No.: 92218954 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875.9092 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92218954002 Stormwater #2 EPA 1664B GCSV119027 92218964001 Stormwater #1 SM 2540D WET133420 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 10/07/2014 09:23 AM without the written consent of Pace Analytical Services, Inc.. Page 8 of 10 t' �-XeAnaoical' UVUU1 11CILL 1`I0Ii1C. Sample Condition Upon Recei Document Number: F-CH R-CS-003-rev.15 Page 1 of 2 Issuing Authority: Pace Huntersville Quality Office Client Name: Courier: ❑ Fed Ex ❑ UPS❑ uSPS❑ Client[] Commercial❑_ Other Q tl0lial �� ry, Custody Seal on CoolerBox Present: ❑ yes � Seals intact: ❑ yes ❑ no,y ^ B' NO Packing Material: ❑ p El Btt Bubble V❑bb; Bags ❑ None ❑ Other Tl iermomoter Used: IR Gun 14 4 Type of Ice; 1!y Blue hone ��Samplas on ice, cooling process has begun Temp Correction Factor T1401 No Correction y Corrected Cooler Temp.: -C Biological Tissue is Frozen: Yes No NrA Date and I�yi-tlai f a son exanflning content's�"Y` Temp shou!. lie abov-freezing to VC Comments: Chain of Custody Present: es ❑No ❑NIA 1. Chain of C=elody Filled Out: ea El No 0N!A'2. _ 3.� Chain of Custody Relinquished: .es ❑No Own Sampler Name & Signature on COC: ❑y No ❑NrA 4. Samples Arrived within Hold Time: t]Yes ❑No ❑NrA 5. Short Hold Time Analysis (a72hr): ❑Yes o'" ©NIA 6. Rush Turn Around Time Requested: ❑Yes 145­' ❑NrA 7, Sufficient Volume; Yes ONO ONiA g. Correct Containers Used: -0 e - ONO ❑NIA g, -Pace Containers Used: Yes ❑No ❑NIA Containers Intact: OONo ❑NIA 10. Filtered volume received for Dissolved tests, _. ❑Yes ❑NoFA 11. Sample Labels match COC: /QYi:s�❑No ❑NrA 12. -includes dateltimeliDlAnal sis Matrix: All containers needing preservation have been checked. ©Yes E)Na,,Ei1KJ-A 13. All containers needing preservation are found to be in Dyes ❑No ❑ compliance with EPA recommendation, excepUens: VOA, coliforin, TOC, O&G, Wl-DRO (water) Yes ON. Samples checked for dechlorination: Oyes ❑No .-eM-1A 14. Head space in VOA Vials ( >6mm): ❑Yes DNo IA 15. Trip Blank Present: Dyes ONO HN�iA 16. Trip Blank Custody Seals Present ❑Yes ONO �LNIA Pace Trip flank! of #.► (if purchased)._ _ Client Notification/ Resolution: Field Data Requiled7 Y I N Person Contacted: Date/Time: Comments) Resolution., SCURF Review: I NV b jDate: SRF Review: Date: L��} 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) WOp_92218954 92218954 Page 9 of 10 .. — _- ._ .L — - ;aceAnalyfical' rranr.paselabs.cam CHAIN -OF -CUSTODY 1 Analytical Request Document The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately. Section A Section S Section C Page: of Required Client Information: Required Project Information: formation: Invoice In ReportTo: Attenban: 1651839 Address: ^£ uI rt t Copy To: Company Name: REGULATORY AGENCY _ Address' r" NPDES f" GROUND WATER (" DRINKING WATER F UST r RCRA (- OTHER Email To: Purchase rq 1 o}'t LcbKlnn Order No.: PaQuote ce Reference: hone: Fax: Q l y) �i y - �a �61 y} fit, q • of 61 Project Name: Pace Proect manager; Site Location STATE., - - _ . Requested Due DaterrAT: Protect Number. Pau Profile 0: //i r f ' / 1 Requested Analysis Filtered (YINj=' •. Section O Matrix Codes a = . Wulrad chant information MAralx , coD s COLLECTED Preservatives Drinking Water DW o v az Water WT WaastecWater WW v m POSTART _ EoKtnnB PATE m SGo Soil/Solid SL g C�7 Y SAMPLE ID oilk - �_ ot wOL (A-Z. o-s ! :) Air AR p a tu Z H .o Sample 09 MUST BE UN IOUE Tissue TS Other D7 O a W w Z U X a u~i a O w m O o T m ��/1 // q z— V t ! tf C d c z U m CE' a, I— to DATE TIME DATE TIME N # Y = z Z O y Pace Project NoJ Lab I.D. .1' 1 ty is r-rn Wh:�Pf 'S '? t �• U" �: �,i •I� it4�0U �,'b�f -I `; �t�''Qv _ - 1: z Skdf� , va?•r a 9 aI 1�E Ialoa -2v-ly '.06 DOZ `s a s 6 7 8 9 10 11 12 ADDITIONAL COMMENTS •-. - -RELINQUISHED BY l AFFILIATION DATE � _.• TIME ' ACCEPTED BY l AFFILIATION DATE TIME' .. SAMPLE CONDITIONS ,e.. .�� as :r c✓ z a 1 !«? 36 q ��t� �� 3� . S SAMPLER NAME AND SIGNATURE i ORIGINAL PRINT Name of SAMPLER: $ ? Z DATE Signed ~ SIGNATURE of SAMPLER: (MMlDDY): 1 lY or "Important Note: By signing this Corm you are eempting Pace's NET 30 day peymem terms and agreeuq Id lam charges of 1.5% per month for any imroims not paid within 30 days. F-ALL-0-020fav,07, 15-May-2007 + lkii .. NO Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on felling out this form, please visit: rtalm r.org/web/wg/`w5/5ulnpdw# a - Permit No.: N/C/—/.._/._ 1-1—/ Facility Name: County: — -Lt,7 e - Inspector: _ _ _ 0. L s Date of Inspection: 5' Time of Inspection: :n /—/ or Certificate of Coverage No.. NI C/G/l0/ FI&W-2141 �U ffy.- hl . Phone No. 419 - Q q-, gk) I- - — � Total Event Precipitation (inches): V-1b ^r-a 1k.J L-1 APR 3 0 2014 Was this a "Representative Storm Event" or "Measureable Storm Event" as defined'by it e permit? (See information below.) E11dVL, ISOU ® Yes ❑ No Please verify whether Qualitative Monitoring must be performed during a "representative storm event" or "measureable storm event" jrequirements vary, depending on the perm(t). Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a "representative storm event" or during a "measureable 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 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 aooroval from the local DWO Rezional Office. By this sijgrqtVj-kcertify th4l- its report is accurate and complete to the best of my knowledge: (Signature ofPermittee or DesiAe) Page 1 of 2 SWLi-242, Last modified 10/25/2012 1. Outfall Description: Outfall No. I— Structure (pi e, ditch, etc.) Receiving Stream: I-' Describe the industrial activities that occur within he outfall drainage area: U , 14u)v (41 rsel, t�,Wroa�i lr-0,'JJrwo." 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: LA114Th 3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): Nnfk6'_ 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 S. 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: C) 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: 0 2 3 4 S 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 evidence of erosion or deposition at the outfall? 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 1414- 1 �m+ 5WU-242, Last modified 10/25/2012 Aw =i A- NC EHR Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Forguidance on filling out this form, please visit: hU://portal.ncdenr,org/web/wq/ws/su/npdessw#Lab-4 Permit No.: N/C/_f_/_ / _f_I,l_/ or C Facility Dame: County: W _2 Inspector: 0 '� Date of Inspection:~ Time of Inspection: -T. M Total Event Precipitation (inches): of Coverage No,:P. I Phone No. Was this a "Representative Storm Event" or "Measureable Storm Event" as defined by the permit? (See information below.) 0 Yes ❑ No Please verify 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 "measureable 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 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 DWO Regional Office. By this si&"ty. kl certff7lhat t is report is accurate and complete to the best of my knowledge: (Signature of Permittee or Des Page 1 of 2 SWU-242, Last modified 10/25/2012 1. Outfall Description: Outfali No. Structure ( ipe, ditch, etc.) Receiving Stream: i Describe the industrial ac �vities that occur within the o fall drainage area .L_ . _ - - r _, __ - I )-C 2. Color: Describe.the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors: b' ►J 3. Odor: Describe any distinct -odors that the'discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.): _ Non1c _ 4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy: 1 0 3 4 5 S. 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 0 3 4 5 7. is there any foam in the stormwater discharge? Yes oNo 8. Is there an oil sheen in the stormwater discharge? Yes No 9. Is there evidence of erosion or deposition at the outfall? Yes No 10. Other Obvious Indicators of Stormwater Pollution: List and describe _ "QN5 -- 0e.f 11_ma, sioz8 Oht�a.��tjn`. {Vote: 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 10/25/2012 • • 0 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted CERTIFICATE OF COVERAGE NO. NC H L 9 + FACILITY NAME 7,— lni. I m[ lu V_l l i i /.t COUNTY PERSON COLLECTAG SAMPLES LABORATORY KQ 1'e-, Lab Cert. # i a Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR �D 14 SAMPLE PERIOD ® Jan -June ❑ July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow []water Supply ❑SA ❑Other PLEASE REMEMBER TO SIGN ON THE REVERSE 4 ❑ No discharge this period' 'Outfall - 9No r by r 1iZ' r Date • 1 � Samp,leiCbllected; r - aly . k ' 00530 y �2M '. T .. 3s�. 1�1i . �s Ob400 {: .rP' �«'�. Y il�-,. `"00556 .... �.... -" -:,�. Y1 � •f-.. �4. Sj, i��1f M - �n.•+u: ����+'�akr-"' =Total Suspended, -_ F ,ti r '? �. Sol ds, mg/..L- _ -3 �, '" .' _ _ Siandard�unit_&, .�v..:g. Non Polar 0ii and'Grease/,TPH I PA 's'`�c'}. �`,.=.z:s+4a1"-x`.[, f:-t;`, ..` y Method 664 (SGT;HEMJ; mg/L _. _ � .xr •+,.ian .�M �".:t - a', `7a New'Moton, ,Usage;'` .�} fir'``-*}`?q'uu,La'•'-•>'f�e, Annual average;gal/mo - — _ _ - w•s.`.3a:; G�1-� ..5.1:'# rBenahmarkr , �'� - _.a.�'+,-.,�...�.�. , ` �.�xnTi -,.n fFC-.ti,. z .:']Cvi:-.. 1 5 l or,lQOssee?permit, 'fz'y,'4,.. - ':.a,5' •._�.� �r� ".Yti�".; v_. "�' iv �:�aus - 4y.Y ...F.y..-..:. mac. � R # +�, A n._ t VS_s:C. _'1' Tm• Did this facility perform Vehicle Maintenance Activities using more than 5S gallons of new motor oil per month? _ yes _no (if yes, report your analytical results in the table immediately below) Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals !'- Outfall d''3 Na .rficc:,§F'c, ��` f�.� Dot $h�s� .... , �'�...���•�"a��"��� 5arn0WiCollected; m,.oldd/yr749'(SGT�HEM):�mg/tip.' � &� 00556" 's:.�. s... t A'. r-�� _ .__ .. - � � `�'�-�s-.v:.._: _..,... _�;�....cszae• .--�`_.._.,,—r era„_t�; «,• y -: Non=rGrease/TPHAEPA Methad . .�..�,-r.-�-'vr��-;<trc'czw i.io ;..c .., s+_i�»�:• ��. Total 5uspended`Solids " n ; - r.r-�— _ ' "`mg/�_ = # `� pH; � -: --�x�-� Ili S _ —=Stan_dard;units� `Permtt;Lirnit.� �• �;>-� r��:;���;1•�� :�� �t s� _ e..9k4►�'. _�._. is p.. rmi.�c ��6 U , D: 1151alq For sampling periods with no discharge at any single outfail, you must still submit this discharge monitoring report with a checkmark here. SWU-250 last revised October 25, 2012 Page 1 of 2 STORM EVENT CHARACTERISTICS: Date q-15 (first event sampled) Total Event Precipitation (inches): s l a Date (list each additional event sampled this reporting period, and rainfall amount) Total Event Precipitation (inches): Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO Djj IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail on original and one copy of this DMR, including all "No Discharge" reports, within 30 days of of the lab results (or at end of monitoring period in the case of "No Discharge" re orts) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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 ga nformation, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there r L t pe lties for su nitting false information, including the possibility of fines and imp ri onme ;,k,nowing violations." (Signature of Permittee) (Date) Additional copies of this form may be downloaded at: http:/�portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 SWU-250 last revised October 25, 2012 Page 2 of 2 aceAnalytical r wwwpacerebs.corn I April 23, 2014 Mr. Chris Ray Town of Zebulon 450 East Horton Zebulon, NC 27597 RE: Project: STORMWATER Pace Project No.: 92197771 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersviile, NC 28078 (704)875-9092 Dear Mr. Ray: Enclosed are the analytical results for sample(s) received by the laboratory on April 16, 2014. The results relate only to the samples included in this report. Results reported herein conform to the most current TNI standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report. Analyses were performed at the Pace Analytical Services location indicated on the sample analyte page for analysis unless otherwise footnoted. If you have any questions concerning this report, please feel free to contact me. Sincerely, Liamm Carrubba liamm.carrubba@pacelabs.com Project Manager Enclosures cc: Ms. Robyn Snow, Town of Zebulon REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 1 of 8 aceAnaiytica! —pacelabs.=n Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875.9092 Project: STORMWATER Pace Project No.: 92197771 Charlotte Certification IDs 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 North Carolina Drinking Water Certification #: 37706 North Carolina Field Services Certification #; 5342 North Carolina Wastewater Certification #: 12 South Carolina Certification #; 99006001 Asheville Certification IDs 2225 Riverside Dr., Asheville, NC 28804 Florida/NELAP Certification #: E87648 Massachusetts Certification #: M-NC030 North Carolina Drinking Water Certification #: 37712 CERTIFICATIONS Florida/NELAP Certification #: E87627 Kentucky UST Certification #: 84 West Virginia Certification #: 357 VirginialVELAP Certification #: 460221 North Carolina Wastewater Certification #: 40 South Carolina Certification #: 99030001 West Virginia Certification #: 356 VirginialVELAP Certification #: 460222 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 2 of 8 ?!;aceAnaVical www.pscelehs.com j SAMPLE ANALYTE COUNT Project: STORMWATER Pace Project No.: 92197771 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92197771001 STORMWATERS #1 EPA 1664B CLW 1 PASI-C SM 2540D WRC 1 PASI-A REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 3 of 8 aceAnalytical www.pacelabs.c= i ANALYTICAL RESULTS Project: STORMWATER Pace Project No.: 92197771 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Sample: STORMWATERS #1 Lab ID: 92197771001 Collected: 04/15/14 07:59 Received: 04/16/14 17:25 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 1664E Oil and Grease ND mglL 5.0 1 04/18/14 07:57 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids 220 mg/L 35.7 1 04/22/14 20:57 Date: 04/2312014 02:17 PM REPORT OF LABORATORY ANALYSIS This report shall not he reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 4 of 8 aceAnalytical www.pacalaDs.com i 1 Project: STORMWATER Pace Project No.: 92197771 QC Batch: GCSV117293 QC Batch Method: EPA 1664B Associated Lab Samples: 92197771001 METHOD BLANK: 1181043 Associated Lab Samples: 92197771001 Parameter Units Oil and Grease mg/L QUALITY CONTROL DATA Analysis Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 5.0 04/18/14 07:50 Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)B75-9092 LABORATORY CONTROL SAMPLE & LCSD: 1181044 1181045 Spike LCS LCSD LCS LCSD % Rec Max Parameter Units Conc. Result Result % Rec % Rec Limits RPD RPD Qualifiers Oil and Grease mg/L 40 39.1 38.2 98 96 78-114 2 30 Date: 04/23/2014 02:17 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 5 of 8 acmnalytical wwwpacelabs.=n Pace Analytical Services, Inc, 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA Project: STORMWATER Pace Project No.: 92197771 QC Batch: WET130655 Analysis Method: SM 2540D QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92197771001 METHOD BLANK: 1183321 Associated Lab Samples: 92197771001 Parameter Units Total Suspended Solids mg/L LABORATORY CONTROL SAMPLE: 1183322 Parameter Units Total Suspended Solids mg/L SAMPLE DUPLICATE: 1183323 Parameter Total Suspended Solids SAMPLE DUPLICATE: 1183324 Parameter Total Suspended Solids Date: 04/23/2014 02:17 PM Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 2.5 04/22/14 20:44 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 250 252 101 80-120 92197561001 Dup Units Result Result mg/L ND ND 92197643001 Dup Units Result Result mg/L 10.0 12.6 RPD Qualifiers RPD Qualifiers 23 D6 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, Inc.. Page 6 of 8 aceAnalytical ,' J www.pacelabs.com i I QUALIFIERS Project: STORMWATER Pace Project No.: 92197771 DEFINITIONS Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 DF - Dilution Factor, if reported, represents the factor applied to the reported data due to changes in sample preparation, dilution of the sample aliquot, or moisture content. NO - Not Detected at or above adjusted reporting limit. J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit. MDL - Adjusted Method Detection Limit. PRL - Pace Reporting Limit. RL - Reporting Limit. S - Surrogate 1,2-Diphenylhydrazine (8270 listed analyte) decomposes to Azobenzene. 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. N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result repotted for each analyte is a combined concentration, Acid preservation may not be appropriate for 2-Chloroethylvinyl ether, Styrene, and Vinyl chloride. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI -The NELAC Institute. LABORATORIES PASI-A Pace Analytical Services - Asheville PASI-C Pace Analytical Services - Charlotte ANALYTE QUALIFIERS D6 The relative percent difference (RPD) between the sample and sample duplicate exceeded laboratory control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 04/23/2014 02:17 PM without the written consent of Pace Analytical Services, Inc.. Page 7 of 8 aceAnalytical www.pscelaDs.rom Pace Analytical Services, Inc. 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: STORMWATER Pace Project No.: 92197771 Analytical Lab I❑ Sample ID QC Batch Method QC Batch Analytical Method Batch 92197771001 STORMWATERS #1 EPA 1664B GCSV117293 92197771001 STORMWATERS #1 SM 2540D WET130655 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 04/2312014 02:17 PM without the written consent of Pace Analytical Services, Inc.. Page 8 of 8 ■E Document Name: Document Revised: April 07. 2014 aceArtalytFc71- Sample Condition Upon Receipt (SCUR) Page 1 of 2 Document Number: Issuing Authority: - ' F-CHR-CS-003-rev.14 Pace Huntersville Quality Office Client Name:o 7 �26n Courier: ❑ Fed Ex ❑ UPS❑ LISPS❑ Client❑ Commerciale Pace Other CustodySeal on Cooler/Box Present: ❑ y ❑��a'fs'� 1. yes no Seals intact: ❑ es no c• w �• � IP�ro�Na e• _ Packing Material: ❑ Bubble Wrap ZIBubble Bags ❑ None ❑ Other Thermometer Used: IR Gun T1102 40 Type of Ice: et Blue None Samples on ice, cooling process has begun Temp Correction Factor T1102: No Correction T1301: No Correction Corrected Confer Temp.: 'C Biological Tissue is Frozen: Yes No IA g Date and Inlli of person examining { contents: n Temp should be above freezing to 6*C Comments: Chain of Custody Present: Yes ❑No ❑NIA 1. Chain of Custody Filled Out: Yes ON, ❑NIA 2. Chain of Custody Relinquished: Yes ❑No ❑N/A 3. Sampler Name & Signature on COC: es ONO ❑NIA 4, Samples Arrived within Hold Time: Yes ❑No ❑NIA 5. Short Hold Time Analysis (<72hr): Dyes gNo ❑NIA 6. Rush Turn Around Time Requested: Dyes No ❑NIA 7, Sufficient Volume: �es ONO ❑NIA 8. Correct Containers Used: - ONO ❑NIA g. -Pace Containers Used: Ze. ❑No ❑NIA Containers Intact; Yes ❑No ❑N./A 10, Filtered volume received for Dissolved tests Dyes ❑No NIA 11. Sample Labels match COC: Yes ONO ❑NIA 12, -Includes dateltime/ID/Anal sis Matrix: All containers needing preservation have been checked. ❑Yes ❑No "1VIA 13. All containers needing preservation are found to be in Dyes ❑No L�I NrA compliance with EPA recommendation. exceptions? VOA, coliform, TOC, O&G, WI•DRO (water) es ONO Samples checked for dechlorination: ❑Yes ONO X NIA 14. Headspace in VOA Vials >6mm : ©Yea ©No NIA 15. Trip Blank Present: Dyes ONO VfNIA 16, Trip Blank Custody Seals Present Dyes ONO &A Pace Trip Blank Lot # (ifpurchased): Client Notification/ Resolution: Field Data Required? Y / N Person Contacted: Date/Time: Comments/ Resolution: SCURF Review: lk" Date: SRF Review: Dateit Note: Whenever there is a dis repancy 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) WOti:92197771 9219EII10 S PaceAnalytical' .I. CHAIN -OF -CUSTODY 1 Analytical Request Document The Chainof-Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately. ------------- Page: of Section A Section B Section C 1783798 Required Client Information: Required Project Informaton: Invoice Information: Go Repon To: Attention: ^- ` p1�--� Addr Copy � To: Company Name: REGULATORY AGENCY r � �I 0.59 ilk't Address- F NPDES I GROUND WATER j DRINKING WATER I UST F-RCRA r OTHER E ail To: Purchase Order No-: Pace Oeale Reference: me: Pace Protect Site Location Manager: STATE: 1 I Requested Due DatefTAT: Project Number: Paee Prone r: n r, Requested Analysis Filtered (YIN) Section D Matrix Codas q Z Requlied Oient Information MATRIX.I CODE o 2 COLLECTED Preservatives > Drinking Water DW 8 U ZO Water WT wastewater WW 8 m COMPOSITE COMPOSITE F Product P cc srw�r ENarGILe -iI 0MI SoiVSokd SL 9L) 77 SAMPLE ID wipe F- W w °p (A-Z. 0.9 1r) Air AR p a Z a 0 Sample IOs MUST BE UNIQUE Tissue TS O a 1¢— a1 u U Other OT V x r to 0 p Z N p° N a Cr a J a " D x c C 'R y F DATE TIME Dn7E TIME N O _ ? x z - 2 4 ea 8 Pace Project No./ 6 l.q. 1 //��� 0& rN 5 1. S I z - 0 q S q 7:0` 'f- 4 5 6 7 B 9 1 t) tt t2 ADDITIONAL COMMENTS L1NQ SHE BY! AFFILIATION DATE,' TIME ACCEPTED BY 1 AFFILIATION DATE TIME SAMPLE CONDITIONS S '2d U � .dU SAMPLER NAME AND SIGNATURE o `a• ��, ORIGINAL w r R o t93 z E _ a PRINT Name of SAMPLER: N } r Q } SIGNATURE of SAMPLER DATE Signed F t 1 tt 2 L) (µ/ [MWDDIYY): y u� NOW ey sg=V trrrc form you are accepting Pace's NET 30 day payment leans and agreeing to late charges of 1.5% per monthTMaMy invoices not paid witmn 30 ty. , F-ALL-0-020rev.07. 15-May-2007