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HomeMy WebLinkAboutNCS000106_MONITORING INFO_20170324STORMWATER-DIVISION-CODING-SHEET PERMIT NO. lVcSGoo J04� DOC TYPE ❑ FINAL PERMIT 0 MONITORING INFO ❑ APPLICATION ❑ COMPLIANCE ❑ OTHER DOC DATE ❑ 01-410` -) `/ YYYYM M D D AS KAPSTONE May 15, 2017 Division of Water Resources Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 KAPSTONE KRAFT PAPER CORPORATION A Division of KAPSTONE PAPER AND PACKAGING CORPORATION 100 Gaston Road Roanoke Rapids. NC 27870 kapstonepapeccom RECEIVED MAY 2 h 2011 CENTRAL FILES DWR SECTION Re: Stormwater Discharge Outfall Monitoring Report 2017, KapStone Kraft Paper Corporation, Roanoke Rapids NC, NCS000106. To Whom It May Concern; As required by the Division of Water Quality, enclosed are three copies of the KapStone Kraft Paper Corporation, Roanoke Rapids, NC, Stormwater Discharge Outfall Monitoring Report for 2017. The permit number is NCS000106. Results are for the monitoring period February 1, 2017 through July 31, 2017. If there are any questions or concerns. I can be reached by phone at 252-533-6295. Sincerely, r� Nea�s Environmental Engineer Enclosures STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number: NC NCS 000106 SAMPLES COLLECTED DURING CALENDER YEAR: 2017 Certificate of Coverage Number: NCG (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME KA13STONE KRAFT PAPER CORP., ROANOKE RAPIDS, NC. COUNTY IIALIFAX PERSON COLLECTING SAMPLE(S) Neal Davis PHON 52) 533 95 CERTIFIED LABORATORY (S) MERITECH, INC. ENVIRONMENTAL LAB LABORATORY CERTIFICATION No. 165 (SIGNA URE OF PF,RMhI TEE OR DESIGNEE) By this igniture, I certify that this report is accurate complete to the best of my knowledge. Part A: Specific Monitoring Re uirements Outfall No. 50050 EPA 410.4 SM 2540 D EPA 200.7 EPA 200.7 SM 4500 H 11 EPA 1664A Date Sample Collected Total Flow COD TSS Total Phosphorus Total Rec. LEAD Ph OIL R GREASE mo/dd/ r MG mg/L mg/L m L m L standard m TENT 5/1/2017 0.0519 36 6 <0.020 <0.010 6.7 <5 Does this facility perform Vehicle Maintenance Activities using more then 55 gallons of new motor oil per month? _X_yes _no (if yes, complete part B) *** ALL SUCH MAINTENANCE AREAS ARE INSIDE BUILDINGS WITH DRAINS TO MILL WASTEWATER FACILITIES Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected 50050 00556 00530 00400 Total Flow Oil and Grease Total Suspended Solids pH New Motor Oil Usage mo/dd/yr MG mg mg/I unit gaUmo Form SWU-246-051100 Page I of 2 STORM EVENT �% C�HA�RACTERISTICS:.. Date �j__/L[ ott? Total Event Precipitation (inches): to, Event Duration (hours): (— (only if applicable— see permit.) (if more than one storm event was sampled) Dale Total Event precipitation (inches): Event Duration (hours): (only if applicable — see permit.) Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "1 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 or 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." 0 ��N (Signature of ermttee) (Dale) Form SWU-247, last revised 21212012 Page 2 of 2 Meritech, Inc. Environmental Laboratory Laboratory Certification No.165 c Contact: Neal Davis Report Date: 5/11/2017 Client: Kapstone Paper & Packaging NPDES#: NCS000106 100 Gaston Rd. Project#: Annual Roanoke Rapids, NC 27870 Date Sample Rcvd: 5/2/2017 Meritech Work Order # 05021797 Sample: Stormwater -Tent Grab 5/1/17 Parameters Result s Analysis Date Reporting Limit Method COD 36 mg/L 5/3/17 15 mg/L EPA 410.4 Total Suspended Solids 6 mg/L 5/4/17 2.5 mg/L SM 2540 D Lead, total <0.010 mg/L 5/9/17 0.010 mg/L EPA 200.8 Phosphorus, total <0.020 mg/L 5/9/17 0.020 mg/L EPA 200.7 Oil & Grease (HEM) <5 mg/L 5/8/17 5 mg/L EPA 1664A I hereby certify that I have reviewed and approve these data. G- Laboratory Representative 642 Tamco Road, Reidsville, North Carolina 27320 tel.(336)342-4748fax.(336)342-1522 Chain of Custody Record (COC) CliEnt: Kapstone Paper Corp Address: 100 Gaston Rd. Roanoke Rapids, NC 27870 Attention: Aml0avis NPDES#: c- 6600\ tC Phone: Vf33_L,29S Fax:--5.�-•S33 - Email: A14 1A4101 (214iAP51atc1001t Project: Annual PO#: MERITECH INC. Environmental Laboratories A Division of Water Technology and Control, Inc. 642TamcoRd Phone 1-336-342-4748 Reidsville, NC Fax: 1-336-342-1522 27320 Email: wtclab(&bellsouth.net Web Site: www.meritech-labs.coln Turn Around Time* Std ( 0 days) 3 - 5 Day 24 - 48 Hr O Annual Sample p Location/ID # Sampling Dates & Times Person Taking Sample (Signature): Lab Use Only START END qof Conts. Tests equired On Ice? pH OK? C12 OK? Date Time Date Time Stormwater 1eAT rG 1 1 TSS COD - w/H2SO4 1 Pb, Ptot wJHNO3: `— G 1 Oil & Grease w/HCL G pH: Method of Shipment: Comments: UPS - Fed Ex Will these results lbfed for regulatory purposes? Yes No *RUSH worlf must be approved prior to submitting samples. �f �,�i Hand Delivery IT\ Other Relinquished by' Date: Time: .� L' Re<eiv d by: / Date: Time: O L �� O Relingi' ed by: _ Date:-7 / l e: �` �Z / % Receive y: Date: Time: Relinquished by' Date: Tlmet eived at I b Da Time: C J MAY 15 2017 EONS k` e August 19, 2016 KAPSTONE KRAFT PAPER CORPORATION A Division of KAPSTONE PAPER AND PACKAGING CORPORATION 100 Gaston Road Roanoke Rapids. NC 27870 kapstonepaper.com z RECEI ,E" SEP 01 2016 CENTRAL FILES Division of Water Resources DWR SECTION Attn: Central Files 1617 Mail Service Center ° Raleigh, North Carolina 27699-1617 r Re: Stormwater Discharge Outfall Monitoring Report 2016, KapStone Kraft Paper Corporation, Roanoke Rapids NC, NCS000106. To Whom It May Concern; As required by the Division of Water Quality, enclosed are three copies of the KapStone Kraft Paper Corporation, Roanoke Rapids, NC, Stormwater Discharge Outfall Monitoring Report for 2016. The permit number is NCS000106. Results are for the monitoring period August 1, 2016 through January 31, 2017. If there are any questions or concerns. I can be reached by phone at 252-533-6295. Sincerely, r Ne R. Davis Environmental Engineer Enclosures STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number: NC NCS 000106 SAMPLES COLLECTED DURING CALENDER YEAR: 2016 Certificate of Coverage Number: NCG ('Phis monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME KAPSTONE KRAFT PAPER CORP., ROANOKE RAPIDS, NC. COUNTY HALIFAX PERSON COLLECTING SAMPLE(S) Neal Davis PHOO. N25233; CERTIFIED LABORATORY (S) MERITECII, INC. ENVIRONMENTAL LAB ������ fuy—C/ L/ LABORATORY CERTIFICATION No. 165 (SIGN TURE OF PERMITTEE OR DESIGNEE) By th' signiture, I certify that this report is accurate complete to the best of my knowledge. Part A: Specific Monitoring Requirements Outfall No. 50050 EPA 410.4 SM 2540 D EPA 200.7 EPA 200.7 SM 4500 H B EPA 1664A Date Sample Collected Total Flow COD TSS 'Total Phosphorus Total Rec. LEAD Ph OIL & GREASE mo/dd/yr MG mg/L mg/L mg/L mg/L standard mg/L TENT 8/2/2016 0.831 35 14 0.39 0.01 6.85 <5 Does this facility perform Vehicle Maintenance Activities using more then 55 gallons of new motor oil per month? _X—yes _no (if yes, complete part B) ***ALL SUCH MAINTENANCE AREAS ARE INSIDE BUILDINGS WITH DRAINS TO MILT, WASTEWATER FACILITIES **** MOVED TENT SAMPLE LOCATION TO 100 FEET ABOVE CITY 1ST OUTFALL AS SUGGESTED DURING STATE INSPECTION 2009 Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected . 50050 00556 00530 00400 Total Flow Oil and Grease Total Suspended Solids pH New Motor Oil Usage mo/dd/yr MG mg/l mg/1 unit gal/mo Form SWU-246-051100 Page I of 2 STORM EVENT CHARACTERISTICS: Date Total Event Precipitation (inches): Event Duration (hours): &1k 3.- (only if applicable — see permit.) (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours): (only if applicable — see permit.) Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "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 property 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." d �b (Date) Form SWU-247, last revised 21212012 Page 2 of 2 Meritech, Inc. Environmental Laboratory Laboratory Certification No. 165 or 4 Contact: Neat Davis Report Date: Client: Kapstone Paper & Packaging NPDES#: 100 Gaston Rd. Projeatt: Roanoke Rapids, NC 27870 Date Sample Rcvd: Meritech Work Order tt 080316141 Parameters Results Sample: Stormwater - Tent Grab 8/16/2016 NCS000106 Annual 8/3/2016 8/2/16 Analysis Date Reporting Limit Method COD 35 mg/L 8/3/16 15 mg/L EPA 410.4 Total Suspended Solids 14 mg/l. 8/8/16 2.5 mg/L SM 2540 D Lead, total <0.010 mg/L 8/11/16 0.010 mg/L EPA 200.8 Phosphorus, total 0.390 nhg/L 8/11/16 0.020 mg/L EPA 200.7 Oil & Grease (H.EM) <5 mg/L 8/6/16 5 mg/L EPA 1664A I hereby certify that I have reviewed and approve these data. Laboratory Representative 6421'anico Road, Reidsville, North Carolina 27320 tel.(336)342-4748 fax.(336)342-1522 Chain of Custody Record (CVC) Client: Kapstone Paper Corp NPDES#: C-S oar (o Phone 1 Co gYl ERITEC INC. Environmental Laboratories Fax y ` A Division of Water Technology and Control, Inc. Address: 100 Gaston Rd. Email y�Cg.^r 1�r 'r' j• j /.} ,7/�'y% ti Roanoke Rapids, NC Project: Annual 642 Tamco Rd Phone 1336-342-4748 27870 JP0 #: Turn Around Time" Reidsville, NC Fax: 1-336-342-1522 Std ((O,days) 3-5Day 24-48Hr 27320 Email: wtclab(cDbel lsouth. net Attention: Neal Davis Web Site: www.meritech-labs.com Annual / -Lj E. L� Sample p P g Sampling Dates & TimTTimeGab? g Sample (Signature): / /_ L_„.� i Lab Use Only Location/ID# START ENcents Tests Required ice P2OKI Date Time Date ts.Stormwater -TSSCOD - wIH2SO4Pb, Not wlHNO3 G 1 JOil & Grease wlHCL G pH: Comments: Method of Shipment: UPS Will these results be u for regulatory purposes? *RUSH work must be approved prior to submitting samples. [� Fed Ex Yes No i' Relinquished by I,' �( Date OTime: �! /��.: Rece d by: Date: Tilpe: / OL/ -o [] Hand Delivery %,r.,;.� �!,% ..t�... •3 " ' Relin hed by: r-Dat¢ / imc: J/7 C,/} 3 / Recei d by: Date: Time: Other 1.,�.i Relinqui etl by: Date: Time: ReyeK%ed ay labity,__ Time'.. �, °l�( LA ) C ... — ae KAPSTONE August 16, 2016 Division of Water Resources Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 KAPSTONE KRAFT PAPER CORPORATION A Division of KAPSTONE PAPER AND PACKAGING CORPORATION 100 Gaston Road Roanoke Rapids, NC 27870 252.533.6000 fax252.533.6401 KAPSTONEPAPER.conn Re: Stormwater Discharge Outfall Monitoring Report 2016, Corporation, Roanoke Rapids NC, NCS000106. To Whom It May Concern; RECEIVED 2 3 201b CENTRAL FILES DWR SECTION Paper As required by the Division of Water Quality, enclosed are three copies of the KapStone Kraft Paper Corporation, Roanoke Rapids, NC, Stormwater Discharge Outfall Monitoring Report for 2016. The permit number is NCS000106. We are reporting No Flow for the monitoring period February 1, 2016 through July 31, 2016. If there are any questions or concerns. I can be reached by phone at 252-533-6295. Sincerely, Neal . Davis Environmental Engineer Enclosures \' Permit Number: NC NCS 000106 Certificate of Coverage Number: NCG STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT SAMPLES COLLECTED DURING CA LENDER YEAR: 2016 (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME KAPSTONE KRAFT PAPER CORP., ROANOKE RAPIDS, NC. COUNTY HALIFAX PERSON COLLECTING SAMPLE(S) Neal Davis CERTIFIED LABORATORY (S) NIERITECH, INC. ENVIRONMENTAL LAB LABORATORY CERTIFICATION No. 165 Part A: Specific Monitoring Requirements PHONE NO. (252) 533-6295 (SIGNATURE OF PERMITTEE OR DESIGNEE) By this signature, I certify that this report is accurate complete to the best of my knowledge. Oulfall No. Date Sample Collected 50050 EPA 410.4 SM 2540 D EPA 200.7 EPA 200.7 SM 4500 H B EPA 1664A 'Total Flow COD 'I'SS Total Phosphorus 'total Rec. LEAD Ph OIL & GREASE mo/dd/ r MG mg/L mg/L mg/L mg/L standard mg/L TENT Feb./1/2016 July 31,2016 NO FLOW NO FLOW NO FLOW NO FLOW NO FLOW NO FLOW NO FLOW Does this facility perform Vehicle Maintenance Activities using more then 55 gallons of new motor oil per month? _X_yes _no (if yes, complete part B) *** ALL SUCH MAINTENANCE AREAS ARE INSIDE BUILDINGS WITH DRAINS TO no WASTEWATER FACILITIES **** MOVEDTENT SAMPLE LOCATION TO 100 FEET ABOVE CITY 1ST OUTFALL AS SUGGESTED DURING STATE INSPECTION 2009 Part It: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected 50050 00556 00530 00400 Total Flow Oil and Grease 'Total Suspended Solids pH New Motor Oil Usage mo/dd/yr MG mg/I mgA unit gal/mo' RECEIVED AUG 2 3 2016 CENTRAL FILES DWR SECTION Form SWU-246-051100 Page I of 2 STORM EVENT CHARACTERISTICS: Date �' �o/ 6 — Juc 3/I Z0/61 Total Event Precipitation (incltz: Event Duration (hours): (only if applicable— see permit.) (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours): (only if applicable— see permit.) Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "1 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. 1 am aware that there are significant penalties for submitting false information, including the possibility of lines and imprisonment for knowing violations." (Signal ur of Permittee) (Date) Form SWU-247, last revised 21212012 Page 2 of 2 STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT 'Perm1Number: NC NCS 000106 SAMPLES COLLECTED DURING CALENDER YEAR: 2015 Certificate of Coverage Number: NCG (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME, KAPSTONE KRAFT PAPER CORP., ROANOKE RAPIDS, NC. COUNTY HALIFAX PERSON COLLECTING SANIPLE(S) Neal Davis PHONE NO. (252) 533-6295 CERTIFIED LABORATORY (S) MERITECH, INC. ENVIRONMENTAL LABRECER /jrF1 LABORATORY CERTIFICATION No. 165 (SIGNA6'URE OF PFRMITTFE OR DESIGNEE) JAN 1 1 BMYs signature, I certify that this report is accurate complete to the best of my knowledge. Part A: Specific Monitoring Requirements CENTRAL FILES Outfall No. 50050 EPA 410.4 SM 2540 D EPA 20("7;k t IEPA 200.7 SM 4500 11 B EPA 1664A Date Sample Collected Total Flow COD 'I'SS 'Total Phosphorus Total Rec.=c;o; LEAD Ph OIL & GREASE _ mo/dd/yr MG n[g/L mg/C mg/I, mg/C standard mg/L e"er TENT 12/7/2015 0.145 11 18 0.02 0.01 6.75 7 �a w Does this facility perform Vehicle Maintenance Activities using more then 55 gallons of new motor oil per month? _X_yes _no (if yes, complete part B) *** ALL SUCH MAINTENANCE AREAS ARE INSIDE BUILDINGS WITH DRAINS TO MILL WASTEWATER FACILITIES **** MOVED TENT SAMPLE LOCATION TO 100 FEET ABOVE CITY IST OUTFACE AS SUGGESTED DURING STATE INSPECTION 2009 Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected 50050 00556 00530 00400 Total Flow Oil and Grease 'Total Suspended Solids pH New Motor Oil Usage mo/dd/ r MG mg/I mg/I unit gal/mo Form SWU-246-051100 Page I of 2 STORM EVENT CHARACTERISTICS: Date IZ-7-,ZO1,5' Total Event Precipitation (inches): .3S Event Duration (hours): _(o. (only if applicable — see permit.) (if more than one storm event was sampled) Date _ Total Event Precipitation (inches): Event Duration (hours): — (only if applicable —see permit.) Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "1 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. 1 am aware that there are significant penalties for submitting false information, including the possibility of fineslind imprisonment for knowing violations." (Signatur of Permittee) (Date) Form SWU-247, last revised 21212012 Page 2 of 2 Meritech, Inc. Environmental Laboratory ,- Laboratory Certification No.165 Contact: Neal Davis Client: Kapstone Paper & Packaging 100 Gaston Rd. Roanoke Rapids, NC 27870 Report Date: NPDES#: Project#: Date Sample Rcvd: 12/17/2015 NCS000106 Annual 12/9/201S Meritech Work Order # 12091511S Sample: Stormwater Grab 12/7/15 Parameters Results Analysis Date Reporting Limit Method COD 11 mg/L 12/10/15 1S mg/L EPA410.4 Total Suspended Solids 18 mg/L 12/11/15 2.5 mg/L SM 2540 D Lead, total <0.010 mg/L 12/17/15 0.010 mg/L EPA 200.8 Phosphorus, total <0.020 mg/L 12/16/15 0.020 mg/L EPA 200.7 Oil & Grease (HEM) 7 mg/L 12/12/15 5 mg/L EPA 1664A PFC[RaVED DEC 2 8 2015 E®H,S I hereby certify that I have reviewed and approve these data. Laboratory Representative 642 Tamco Road, Reidsville, North Carolina 27320 tel.(336)342-4748 fax.(336)342-1522 Chain of Custody Record (COC) j Client: Kapstone Paper Corp Address: 100 Gaston Rd. Rapids, NC 27870 Attention: Nei -,I Oavis NPDES #: NC-S coo Phone: dj:,) -,33 3-� R,52� Fax: -�)5- 'Y . '? - J5�3P3, - 6 -51 ----------- Email: 19IL-4e Project: Annual PO #: MERITECH INC. X� Environmental Laboratories A Division of Water Technology and Control, 642 Tamco Rd Phone 1 -336-342-4748 Reidsville, NC Fax: 1 -336-342-1522 27320 Email: vvtclab(c7bellsouth.net Web Site: www.meritech-labs.corn I Inc. IRoanoke I Turn Around Time" Slid ( days) 3 - 6 fy=ir 2�=4 11 H Annual Sample Location/lD # Sampling Dates & Times Person Taking Sample (Signahurie) Lib Use Only START END comp? Grab? # of Cents. Tests Required On Ice? pin OK? C12 OK? Date Time Date Time Stormwater G 1 TSS G I COD - vv/H2SO4ul ca G 1 Ph, Ptot w1HNO3 Z, G 1 Ol I & s w CL Oil& Grease vv/HCL G pH: Method of Shipment: Comments: UPS ❑ Fed Ex Will these results be u for regulatory purposes? Yes -1 *RUSH work must be approved prior to submitting samples. /FkHand Delivery []Other Re in D, I wlyn by: r/ Z111 /Zia: 1. lel,5' Relinqu edby:D 12- - 7-1, k�-': 4 Date Received b Time o-, -� �L — ( RA- Received by: DUG: Time: Rehnqws6d by: Date: Time Received at IV Date- Time: +� STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number: NC NCS 000106 SAMPLES COLLECTED DURING CALENDER YEAR: 2015 Certificate of Coverage Number: NCG (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME KAPSTONE KRAFT PAPER CORP., ROANOKE RAPIDS, NC. COUNTY HALIFAX PERSON COLLECTING SAMPLE(S) Neal Davis PHONE CERTIFIED LABORATORY (S) MERITECH, INC. ENVIRONMENTAL LAB LABORATORY CERTIFICATION No. 165 (SIGNATU E OF PERMITTEE OR DESIGNEE) By this sign ture, I certify that this report is accurate complete to the best of my knowledge. Part A: Specific Monitoring Requirements Outfall No. Date Sample Collected 50050 _ EPA 410.4 SM 2540 D EPA 200.7 EPA 200.7 SM 4500 H B EPA 1664A Total Flow COD TSS Total Phosphorus Total Rec. LEAD Ph OIL & GREASE ' mo/dd/ r MG m /L m /L m /L m /L standard m L TENT 5/21/2015 0.135 16 21 0.114 0.01 6.6 <5 ` Does this facility perform Vehicle Maintenance Activities using more then 55 gallons of new motor oil per month? _Xyes no (if yes, complete part B) ***ALL SUCH MAINTENANCE AREAS ARE INSIDE BUILDINGS WITH DRAINS TO MILL WASTEWATER FACILITIES **** MOVED TENT SAMPLE LOCATION TO 100 FEET ABOVE CITY 1ST OUTFALL AS SUGGESTED DURING STATE INSPECTION 2009 Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected 50050 00556 00530 00400 Total Flow Oil and Grease Total Suspended Solids pH New Motor Oil Usage mo/dd/ r MG m /l mg/1 unit gaumo Form SWU-246-051100 W Page] of2 A STORM EVENT CHARACTERISTICS: Date Q Total Event Precipitation (inches): Event Duration (hours): 3 &*e (only if applicable — see permit.) (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours): (only if applicable — see permit.) Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "1 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." 0011 (Signatur/of Permittee) (Date) Form SWU-247, last revised 21212012 Page 2 of 2 J Meritech, Inc. ,q Environmental Laboratory Laboratory Certification No.165 Contact: Neal Davis Report Date: 6/2/2015 Client: Kapstone Paper & Packaging NPDES#: NCS000106 100 Gaston Rd. Project#: Annual Roanoke Rapids, NC 27870 Date Sample Rcvd: 5/21/2015 Meritech Work Order # 05211592 Sample: Stormwater- Tcnt Grab Parameters Results Analysis Date Reporting Limit Method COD 16 mg/L 5/29/15 15 mg/L EPA 410.4 Total Suspended Solids 21 mg/L 5/21/15 2.5 mg/L SM 2540 D Lead, total <0.010 mg/L 5/28/15 0.010 mg/L EPA 200.7 Phosphorus, total 0.114 mg/L 5/28/15 0.020 mg/L EPA 200.7 Oil & Grease (HEM) <5 mg/L 6/1/15 5 mg/L EPA 1664A hereby certify that I have reviewed and approve these data. �(,a Laboratory Representative 642 Tamco Road, Reidsville, North Carolina 27320 tel.(336)342-4748 fax.(336)342-1522 a& KAPSTONE RECEIVED JUN 11 2015 June 9, 2015 CENTRAL FILES DWR SECTION Division of Water Resources Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 KAPSTONE KRAFT PAPER CORPORATION ADivisionof KAPSTONE PAPER AND PACKAGING CORPORATION 10O Gaston Road Roanoke Rapids, NC 27870 252.533.6000 fax:252.533.0401 KAPSTONEPAPER.com Re: Stormwater Discharge Outfall Monitoring Report 2015, KapStone Kraft Paper Corporation, Roanoke Rapids NC, NCS000106. To Whom It May Concern; As required by the Division of Water Quality, enclosed are three copies of the KapStone Kraft Paper Corporation, Roanoke Rapids, NC, Stormwater Discharge Outfall Monitoring Report for 2015. The permit number is NCS000106. Results are for the monitoring period Februaryl, 2015 through July 31, 2015. If there are any questions or concerns. I can be reached by phone at 252-533-6295. Sincerely, -/e A'� deal R. Davis Environmental Engineer Enclosures -"ounty: Halifax River Basin RDA Report To RROSP Collector: A HOBAN Region: RRO Sample Matrix: Surfacewater Loc.Type: Effluent Emergency Yes/No COC Yes/No Location ID: RROSPNLC El VisillD Loc. Descr.: KAPSTONE PAPER Collect Date: 12/10/2008 Collect Time: Sample Qualifiers and Comments Routine Qualifiers Sample ID: AB38767 PO Number# BW9354 Date Received: 12/1112008 Time Received: 09:00 Labworks LoginlD DSAUNDERS Date Reported: 1112109 Report Generated: 01/12/2009 01:50 Sample Depth For a more detailed description of these qualifier codes refer to www.dwqlab.org under Staff Access A -Value reported is the average of two or more determinations ® B1-Countable membranes with <20 colonies; Estimated B2- Counts from all filters were zero. B3- Countable membranes with more than 60 or 80 colonies; Estimated B4-Fillers have counts of both >60 or 80 and < 20; Estimated 85-Too many colonies were present; too numerous to count (TNTC) J2. Reported value failed to meet OC criteria for either precision or accuracy; Estimated J3-The sample matrix interfered with the ability to make any accurate determination; Estimated J6-The lab analysis was from an unpreserved or improperly chemically preserved sample; Estimated Nt-The component has been tentatively identified based on mass spectral library search and has an estimated value LAB N3-Estimated concentration is < POL and >MDL NE -No established POL P-Elevated PQL due to matrix interference and/or sample dilution 01-Holding time exceeded prior to receipt at lab. 02- Holding time exceeded following receipt by lab PQL- Practical Quantitation Limit -subject to change due to instrument sensitivity U. Samples analyzed for this compound but not detected X1- Sample not analyzed for this compound JAN 1 6 ?009 Laboratory Sectlon» 1623 Mall Service Center, Raleigh, INC 27699.1623 (919) 733-3908 Page 1 of 4 - SampleID A638767 NC (DWQ La6oratory Section Results Location ID: RROSPNLC Collect Date: 12/10/2008 Lot. Descc: KAPSTONE PAPER Collect Time:: 01:50 Visit ID CAS # Analyte Name POL Result Qualifier Units Analyst/Date Approved By IDale Sample temperature at receipt by lab 1.8 °C DSAUNDERS HPARKER Method Reference 12111/08 12/1110B BOD, 5-Day In liquid Method Reference APHA5210B Resldue_Suspended In liquid Method Reference APHA2540D-20th 2.016 mg/L BSWANSON CGREEN 12/12/08 12122/OB 6.2 10 mg/L LBUCK ESTAFFORD 12/12/08 1/5109 ® YYCI Ion Chromatography TITLE_ mg/L AWILLIAMS CGREEN Method Reference EPA 300.0 1/6109 1112109 Phernolics_Total In liquid 10 31 ug/L MIBRAHIMI CGREEN Method Reference LAC10-210-00.1-A 12/19/08 1MM9 Total Dissolved Solids In liquid 12 946 mgfL AWILLIAMS CGREEN Method Reference APHA254OC-18TH 12/16108 12/22/O8 Chloride 1.0 20 U,P mg/L AWILLIAMS CGREEN Method Reference EPA 300,0 116/09 1A2109 Fluoride 0.4 8.0 U,P mg/L AWILLIAMS CGREEN Method Reference EPA 300.0 116109 1112109 Sulfate 2.0 460 mg/L AWILLIAMS CGREEN Method Reference EPA 300.0 116109 1112109 NH3 as N In liquid 0.02 1.5 ri as N MAJAYI CGREEN Method Reference LaclO-107-06-1.J 12112/OB 12/22/08 Total Neldahl N as N In liquid 0.2 4.0 mg/L as N MOVERMAN CGREEN Method Reference Lachat107-06-2-11 ® 12/19/08 1222/08 NO2+NO3 as N In liquid 0.02 0.02 mg/L as N MAJAYI CGREEN Method Reference Lac10-107-04-1a 12/12108 1222/08 Phosphofus_total as P In liquid 0.02 0.44 mg/L as P GBELK CGREEN Method Reference Lac10-115-01-IEF 12/18108 1223M8 744D-22.4 Ag by ICPMS 5.0 5.0 U ug/L PGAUTHIER ESTAFFORD Method Reference EPA 200.8 12/29109 1q/09 7429-90-5 Al by ICP 50 610 ugli- DSTANLEY ESTAFFORD Method Reference EPA 200.7 12/18/08 V7109 7440-38-2 As by ICPMS 2.0 33 ug/L PGAUTHIER ESTAFFORD Method Reference EPA 200.8 12/29/08 11`7109 Laboratory Section» 1623 Mail Service Center, Raleigh, NC 27699-1623 (919) 733-3908 . Page 2 of 4 NC (DWWQ Laboratory Section 1ResuCts Sample ID AB38767 Location ID: RROSPNLC Collect Date: 12/10/2008 Loc. Descr.: KAPSTONE PAPER - Collect Time:: 01:50 Visit lD = ,r CAS Of Analyte Name POL Result Qualifier Units Analysvuate Approves cy ware Method Reference EPA 2003 12/22/08 IRM9 744041-7 Be by ICP 5.0 5.0 - U ugfL DSTANLEY ESTAFFORD Method Reference EPA 200.7 12/18/08 12/09 7440-70-2 Ca by ICP 0.10 37 mgfL DSTANLEY ESTAFFORD Method Reference EPA 200.7 12/22/08 12/09 7440-43-9 Cd by ICPMS 1.0 1.0 U ug7L PGAUTHIER ESTAFFORD Method Reference EPA 200.8 1229108 117109 7440-084 Cobalt by ICP 50 50 U ug/L DSTANLEY ESTAFFORD Method Reference EPA 200.7 12/18/08 1O/09 7440<7-3 Cr by ICPMS 10 10 U ug/L PGAUI MItH tJ l Arl-UMU Method Reference EPA 200.8 12/29108 1/7/09 7440-50-8 Cu by ICPMS 2.0 f 4.4 ug7L PGAUTHIER ESTAFFORD Method Reference EPA 200.8 12/29108 1A/09 7440.48-4 Fe by ICP 50 240 ug/L DSTANLEY ESTAFFORD Method Reference EPA 200.7 12/19/08 1RI09 7439-97-6 Hg 245.1 0.2 0.20 U ug/L BSKINNER ESTAFFORD Method Reference EPA245.1 12/30108 1/7109 7440-09-7 Kby ICP 0.10 17 mgfL DSTANLEY ESTAFFORD Method Reference EPA 200.7 12122/08 12/09 7439-93-2 U ICP 25 25 U ug/L DSTANLEY ESTAFFORD Method Reference EPA 200.7 12/18/08 1/7109 7439-95-4 Mg by ICP 0.10 7.3 mgfL DSTANLEY ESTAFFORD ' Method Reference EPA 200.7 1222/08 1f7/09 7439-96-5 Mn by ICP 10 600 ug/L DSTANLEY ESTAFFORD ® Method Reference EPA200.7 12/18108 V7/09 7439-98-7 Mo by ICPMS 10 10 U ug/L PGAUTHIER ESTAFFORD Method Reference EPA 200.8 1229/08 1/7109 7440-23-4 Na by ICP 0.10 300 mg/L DSTANLEY ESTAFFORD Method Reference EPA 2003 - 1222/08 1/7/09 7440-02-0 Ni by ICPMS 10 10 U ug7L PGAUTHIER ESTAFFORD Method Reference EPA 200.8 1229108 1R/09 7439-92-1 Pb by ICPMS 10 10 U ug/L PGAUTHIER ESTAFFORD Method Reference EPA 200A 1229/08 V7/09 7440-36-0 Sb by ICPMS 10 10 U ug/L PGAUTHIER ESTAFFORD Method Reference EPA 200,8 1229108 12/Og Laboratory Section» 1623 Mail Service Center, Raleigh, NC 27699-1623 (919) 733-3908 Page 3 of 4 NC (DWQ Laboratory Section Xesufts Sample ID A638767 Location ID:... RROSPNLC Collect Date: 12/10/2008 Lod. Descr.: KAPSTONE PAPER Collect Time:: 01:50 Visit ID C FULL Method Reference EPA 200.8 Units 12/29/08 V7/09 7440-31-5 Sn by ICPMS 10 10 U ugfL PGAUTHIER ESTAFFORD Method Reference EPA 200.8 1229/08 la/09 7440-28-0 Thallium (rl) ICPMS 10 10 U ug/L PGAUTHIER ESTAFFORD Method Reference EPA 200.8 12/29/08 1(7/09 7440-32.6 TI Mtenlum) by ICP 10 10 U ug/L DSTANLEY ESTAFFORD Method Reference EPA 200.7 12/19/08 V7109 7440-62-2 Vby ICP 25 25 U ug/L DSTANLEY ESTAFFORD ® Method Reference EPA 2003 12118108 V!/09 7440-66-6 Zn by ICPMS 10 10 U ug/L PGAUTHIER ESTAFFORD Method Reference EPA 200.8 1229108 117109 Laboratory Section>> 1623 Mail Service Center, Raleigh, NC 27699-1623 (919) 733-3908 Page 4 of 4 E qZl) 935y DIVISION OF WATER QUALITY Chemistry Laboralory Report / Water Quality Lab N VL/ �/ _ COUNTY � 7 ! ❑ SAMPLETYPE Dale Received) RIVER BASIN: P NT ❑ ❑ Time Received t/V n`_0 ❑1 AMBIENT QA STREAM 'K EFFLUENT Received By YYWWYY�� REPORT TO t21 `A�` Regional Once Iw COMPLIANCE ❑ CHAM OF CUSTODY ❑ LAKE /❑' _MFLUENT Other�—_, ❑EMERGENCY VISIT ID ESTUARY 5—� Data Releaud: COLLECTOR(S) i�"1T��✓'er Date Reported: Estimated eOD Rangy. Smlon Locatlan: Seed: Chlarioaled:— R.... I.: (/lM IJITV� i�D I — 2Clri✓!p �`!'� e.� Station N/Loctlion Cod Date In( mm/dd) Dale End�y /mm/ ) Tim. Begin TI eEvd De th-DM, DB, DBM Value Type - A, II,L Com oalte-T, S,B Sa IeT ^ Od00')Sa00/ Om �o nul1.?- 1 �: sn, .n ,�� >p COMMENTS: November 11, 2014 Division of Water Resources Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 KAPSTONE KRAF'T PAPER CORPORATION A Division of KAPSTONE PAPER AND PACKAGING CORPORATION 100 Gaston Road Roanoke Rapids. NC 27870 252,533.6000 W:252.533.6401 KAPSTONEPAPER.00m RECEIVED DEC 12 Z014 CENTRAL FILES OWR SECTION' Re: Stormwater Discharge Outfall Monitoring Report 2014, KapStone Kraft Paper Corporation, Roanoke Rapids NC, NCS000106. To Whom It May Concern; As required by the Division of Water Quality, enclosed are three copies of the KapStone Kraft Paper Corporation, Roanoke Rapids, NC, Stormwater Discharge Outfall Monitoring Report for 2014. The permit number is NCS000106. Results are for the monitoring period August 1, 2014 through January 31, 2015. If there are any questions or concerns. I can be reached by phone at 252-533-6295. Sincerely, Neal R. Davis Environmental Engineer Enclosures STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number: NC NCS 000106 SAMPLES COLLECTED DURING CALENDER YEAR: 2014 Certificate of Coverage Number: NCG (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME KAPSTONE KRAFT PAPER CORP., ROANOKE RAPIDS, NC. COUNTY HALIFAX PERSON COLLECTING SAMPLE(S) Neal Davis PHONE N (2 ) 3- 5 CERTIFIED LABORATORY (S) MERITECH, INC. ENVIRONMENTAL LAB LABORATORY CERTIFICATION No. 165 (SIGIqATVIRE OF PERMITTEE OR DESIGNEE) By this si niture, I certify that this report is accurate complete to the best of my knowledge. Part A: Specific Monitorin¢ Requirements Outfall No. 50050 EPA 410.4 SM 2540 D EPA 200.7 EPA 200.7 SM 4500 H B EPA 1664A Date Sample Collected Total Flow COD TSS Total Phosphorus Total Rec. LEAD Ph OIL & GREASE mo/dd r MG m /L m /L m /L m /L standard m /L TENT 11/6/2014 0.132 43 5 0.045 0.01 6.8 <5 Does this facility perform Vehicle Maintenance Activities using more then 55 gallons of new motor oil per month? _Xyes no (if yes, complete part B) ***ALL SUCH MAINTENANCE AREAS ARE INSIDE BUILDINGS WITH DRAINS TO MILL WASTEWATER FACILITIES **** MOVED TENT SAMPLE LOCATION TO 100 FEET ABOVE CITY 1ST OUTFALL AS SUGGESTED DURING STATE INSPECTION 2009 Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected 50050 00556 00530 00400 Total Flow Oil and Grease Total Suspended Solids pH New Motor Oil Usage mo/dd/ r MG m I m /I unit al/mo Form SWU-246-051100 Pagel of 2 STORM EVENT CHARACTERISTICS: Date Total Event Precipitation (inches): Event Duration (hours):. & (only if applicable — see permit.) (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours): (only if applicable — see permit.) Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "1 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 rums and imprisonment for knowing violations." of Permittee) IZ/b //;�-/ (Date) Form SWU-247, last revised 21212012 Page 2 of 2 �ev KAPSMNE July 23, 2014 Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 KAPSTONE KRAFT PAPER CORPORATION A Division of KAPSTONE PAPER AND PACKAGING CORPORATION 100 Gaston Road Roanoke Rapids, NC 27870 252.533.6000 fm:252.533.6401 KAPSTONFPAPER.com RECEIVED JUL 2 4.2014 CEDWQIBOGES Re: Stormwater Discharge Outfall Monitoring Report 2014, KapStone Kraft Paper Corporation, Roanoke Rapids NC, NCS000106. To Whom It May Concern; As required by the Division of Water Quality, enclosed are three copies of the KapStone Kraft Paper Corporation, Roanoke Rapids, NC, Stormwater Discharge Outfall Monitoring Report for 2014. The permit number is NCS000106. Results are for the monitoring period February 1, 2014 through July 31, 2014. If there are any questions or concerns. I can be reached by phone at 252-533-6295. Sincerely, Neal . Davis Environmental Engineer Enclosures STORM WATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number: NC NCS 000106 SAMPLES COLLECTED DURING CALENDER YEAR: 2014 Certificate of Coverage Number: NCG (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME KAPSTONE KRAFT PAPER CORP., ROANOKE RAPIDS, NC. COUNTY HALIFAX PERSON COLLECTING SAMPLE(S) Neal Davis PHONENO. (2 2) 5 3-6295 CERTIFIED LABORATORY (S) MERITECH, INC. ENVIRONMENTAL LAB LABORATORY CERTIFICATION No. 165 (SIGNiTVRE OF PERM ITTEE OR DESIGNEE) By this si niture, I certify that this report is accurate complete to the best of my knowledge. Part A: Specific Monitoring Requirements Outfall No. 50050 EPA 410.4 SM 2540 D EPA 200.7 EPA 200.7 SM 4500 H B EPA 1664A Date Sample Collected Total Flow COD TSS Total Phos horns Total Rec. LEAD Ph OIL & GREASE mo/dd/ r MG m L m /L m /L m /L standard m /L TENT 6/25/2014 0.066 34 12 0.02 0.011 7.1 < 5 Does this facility perform Vehicle Maintenance Activities using more then 55 gallons of new motor oil per month? _Xyes no (if yes, complete part B) *** ALL SUCH MAINTENANCE AREAS ARE INSIDE BUILDINGS WITH DRAINS TO MILL WASTEWATER FACILITIES **** MOVED TENT SAMPLE LOCATION TO 100 FEET ABOVE CITY 1ST OUTFALL AS SUGGESTED DURING STATE INSPECTION 2009 Part B: Vehicle Maintenance Activity Monitoring Requirements Outfall No. Date Sample Collected 50050 00556 00530 00400 Total Flow Oil and Grease Total Suspended Solids pH New Motor Oil Usage mo/dd/ r MG mg/1 m /I unit al/mo Form SWU-246-051100 Page 1 of 2 STORM EVENT CHARACTERISTICS: Date Total Event Precipitation (inches): H Event Duration (hours): i t! (only if applicable— see permit.) (if more than one storm event was sampled) Date Total Event Precipitation (inches): Event Duration (hours): (only if applicable — see permit.) Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 "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) /10 ' (Date) Form S WU-247, last revised 21212012 Page 2 of 2 Meritech, Inc. Environmental Laboratory Laboratory Certification No. 165 Report Date: 7/3/2014 Contact: Neal Davis NPDES#: NCS000106 Client: Kapstone Paper & Packaging Project#: Annual 100 Gaston Rd. Date Sample Rcvd: 6/26/2014 Roanoke Rapids, NC 27870 Meritech Work Order # 06261471 Sample: Stormwater Grab Parameters Results Analysis Date COD 34 mg/L 6/27/14 Total Suspended Solids 12 mg/L 7/1/14 Lead, total 0.011 mg/L 7/2/14 Phosphorus, total < 0.020 mg/L 7/2/14 Oil & Grease (HEM) < 5 mg/L 7/1/14 6/25/14 Reporting Limit Method 15 mg/L EPA 410.4 2.5 mg/L SM 2540 D 0.010 mg/L EPA 200.7 0.020 mg/L EPA 200.7 5 mg/L EPA 1664A I hereby certify that I have reviewed and approve these data. Laboratory Representative 642 Tamco Road, Reidsville, North Carolina 27320 tel.(336)342-4748fax.(336)342-1522 Chain of Custody Record (CCC) Client: Kapstone Paper Corp Address: 100 Gaston Rd. Roanoke Rapids, NC 27870 Attention: Nef J Oavis NPOES#: CS 0 Phone: of -J-3 — Q5 Fax: j4rW-S33-6S Email: 61699V Project: Annual PO#: MERITECH INC. ,. H� Environmental Laboratories X/H .. � wi A Division of Water Technology and Control, Inc. 642 Tamco Rd Phone 1-336-342-4748 Reidsville, NC Fax: 1-336-342-1522 27320 Email: wtclabpbellsouth.net Web Site: www.meritecii-labs.com Turn Around Time" Std to ays) Ea2 3 - 5 Day o 24 - 48 Hr 0 Annual A Sample Location/ID # Sampling Dates & Times Person Taking Sample (Signature): Lab Use Only START END Comp' Grab. ont Copts. T St Required On Ice. -1 1 OK; C[20K. Dale Time Date Time Stormwater G 1 TSS G 1 COD -w/H2SO4 G 1 Pb, Not w/HNO3 C G 1 Oil & Grease w/HCL G pH: Method of Shipment: Comments: UPS Fed Ex Hand Delivery Will these results be UeTfor regulatory purposes? Yes No "RUSH work must be approved,prior to submitting samples. Relings d by: D te: Time: Z 1Y' Receiv by: Dan .' - y' 7"me: O / t, Other Relm ed by: / Dyte:� Time: G//D Received by: Date; Time: Relinquished by: Date: Time: Received at I by: Date; Time: to �EeErvE;p� 2014 i � S _ � }i l i