NCG060413_Monitoring Report_20211019

NCDEQ Division of Energy, Mineral and Land Resources .' C (E VEQ
Stormwater Discharge Monitoring Report (DMR) Form for NCGO60006CT I a 2021
Food and Kindred
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR�yl�pfoaii''fifilrh Ufthin
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG06 0413
Person Collecting Samples: Parker Cliatt
Facility Name: Amazon.com Services LLC - DLT3
Laboratory Name: Eurofins TestAmedca
Facility County: Cabarrus
Laboratory Cert. No.: 269
Discharge during this period:U
Yes
No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? MYes RNo
If so, which Tier (I, 11, or III)? Tier I
A copy of this DMR has been uploaded electronically via https://edoc5.deg.nc.goy/Forms/SW-DMR 0Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
Outfall 001
Outfall 002
Outfall 003
Outfall
Outfall
Code
N/A
Receiving Stream Class
C
C
C
N/A
Date Sample Collected MM/DD/YYYY
9/8/2021
9/8/2021
9/8/2021
46529
24-Hour Rainfall in inches
0.3
0.3
0.3
C0530
TSSin mg/L (100 or50*)
12
7.8
11
pH in standard units (6.0-9.0 FW,
00400
7.29
7.14
6.54
6.8 — 8.5 SW)
00556
Oil & Grease in mg/L (30)
< 1.4
< 1.4
< 1.4
Fecal Coliform per 100 ml of
31616
freshwater (if required) (1000)
N/A
N/A
NIA
Enterococci per 100 ml of saltwater
61211
(if required) (500)
N/A
N/A
N/A
Chemical Oxygen Demand in mg/L
00340
(120)
13
6.3
13
Additional parameters foroutfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
Estimated New Motor/Hydraulic Oil
NCOIL
Usage in gal/month
N/A
N/A
N/A
00552
1 Non -Polar Oil & Grease in mg/L (1S)
I N/A
I N/A
I NIA
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 30o mg/L
FW (Freshwater) SW (Saltwater)
Notes (optional):
"I certify by my signature below, 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, orthose 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 inforNtion, including theytpssibility of fines and Imprisonment for knowing violations."
Signature of Permittee c r Delegated Authorized Individual
[e-mail]
Email Address
to
Date
[phone]
Phone Number

u rof i n s
Environment Testing
America
ANALYTICAL REPORT
Eurofins TestAmerica, Savannah
5102 LaRoche Avenue
Savannah, GA 31404
Tel:[phone]
Laboratory Job ID: 680-204374-1
Laboratory SDG: 413 Goodman Road, Concord, NC 28027
Client ProjectiSite: Storm Water - Amazon Warehouses (DLT3)
For:
ERM-West
1920 Main Street
Suite 300
Irvine, California 92614
Attn: Doug J Wade
R"atint (A"ras
Authorized for release by:
9/27/2021 2:57:13 PM
Roxanne Cisneros, Senior Project Manager
[phone]
[e-mail]
The test results in this report meet all 2003 NELA C, 2009 TNI, and 2016 TNI requirements for
accredited parameters, exceptions are noted in this report. This report may not be reproduced
except in full, and with written approval from the laboratory. For questions please contact the
Project Manager at the e-mail address or telephone number listed on this page.
This report has been electronically signed and authorized by the signatory. Electronic signature is
intended to be the legally binding equivalent of a traditionally handwritten signature.
Results relate only to the items tested and the sample(s) as received by the laboratory.
0

Definitions/Glossary
Client: ERM-West
Project/Site: Storm Water - Amazon Warehouses (DLT3)
Job ID: 680-204374-1
SDG: 413 Goodman Road, Concord, NC 28027
Qualifiers
General Chemistry
Qualifier Qualifier Description
J Result is less than the RL but greater than or equal to the MDL and the concentration is an approximate value.
Glossary
Abbreviation These commonly used abbreviations may or may not be present in this report.
rr Listed under the "D" column to designate that the result is reported on a dry weight basis
%R Percent Recovery
CFL Contains Free Liquid
CFU Colony Forming Unit
CNF Contains No Free Liquid
DER Duplicate Error Ratio (normalized absolute difference)
Dil Fac Dilution Factor
DL Detection Limit (DoD/DOE)
DL, RA, RE, IN Indicates a Dilution, Re -analysis, Re -extraction, oradditional Initial metals/anian analysis of the sample
DLC Decision Level Concentration (Radiochemistry)
EDL Estimated Detection Limit (Dioxin)
LOD Limit of Detection (DoD/DOE)
LOQ Limit of Quantitation (DoD/DOE)
MCL EPA recommended "Maximum Contaminant Level'
MDA Minimum Detectable Activity (Radiochemistry)
MDC Minimum Detectable Concentration (Radiochemistry)
MDL Method Detection Limit
ML Minimum Level (Dioxin)
MPN Most Probable Number
MQL Method Quantitation Limit
NC Not Calculated
ND Not Detected at the reporting limit (or MDL or EDL if shown)
NEG Negative/Absent
POS Positive / Present
PQL Practical Quantitation Limit
FIRES Presumptive
QC Quality Control
RER Relative Error Ratio (Radiochemistry)
RL Reporting Limit or Requested Limit (Radiochemistry)
RPD Relative Percent Difference, a measure of the relative difference between two points
TEF Toxicity Equivalent Factor (Dioxin)
TEQ Toxicity Equivalent Quotient(Dioxin)
TNTC Too Numerous To Count
Eurofins TestAmerica, Savannah
Page 2 of 15 9/27/2021

Sample Summary
Client: ERM-West
Project/Site: Storm Water - Amazon Warehouses (DLT3)
Lab Sample ID Client Sample ID
680-204374-1 DLT3_SamplePoint 01_20210908
680-204374-2 DLT3 SamplePoint 02 20210908
680-204374-3 DLT3_SamplePoint 03_20210908
Job I D: 680-204374-1
SDG: 413 Goodman Road, Concord, NC 28027
Matrix
Collected
Received
Water
09/08/2109:12
09/15/2108:45
Water
09/08/2109:05
09/15/2108:45
Water
09108/2109:20
09/15/2108:45
Page 3 of 15
Eurofins TestAmerica, SOM1

Case Narrative
Client: ERM-West
Project/Site: Storm Water - Amazon Warehouses (DLT3)
Job ID: 680-204374-1
Laboratory: Eurofins TestAmerica, Savannah
Narrative
Job ID: 680-204374-1
SDG: 413 Goodman Road, Concord, NC 28027
a
Job Narrative
680-204374-1
Comments
No additional comments.
Receipt
The samples were received on 9/15/2021 8:45 AM. Unless otherwise noted below, the samples arrived in good condition, and where
required, property preserved and on ice. The temperature of the cooler at receipt was 0.90 C.
General Chemistry
Methods 1664A: Insufficient sample volume was available to perform a matrix spike/matrix spike duplicate/sample duplicate
(MS/MSD/DUP) associated with preparation batch 680-685957.
No additional analytical or quality issues were noted, other than those described above or in the Defin@ions/Glossary page.
Eurofins TestAmerica, Savannah
Page 4 of 15 9/27/2021

Client Sample Results
Client: ERM-West Job ID: 680-204374-1
Project/Site: Storm Water - Amazon Warehouses (DLT3) SDG: 413 Goodman Road, Concord, NC 28027
Client Sample ID: DLT3_SamplePoint_01_20210908 Lab Sample ID: 680-204374-1
Date Collected: 09108/21 09:12 Matrix: Water
Date Received: 09115/21 08:45
General Chemistry
Analyte
Result Qualifier
RL
MDL Unit
D Prepared Analyzed oil Fac
Oil & Grease (HEM)
<1.4
5.0
1.4 mg/L
/22/21 08:49 09/22/21 11:1
090 1
Total Suspended Solids
12
10
10 mg/L
09/15/21 17:35 1
Chemical Oxygen Demand
13
10
5.0 mg/L
09/25/21 13:15 1
Eurofins TestAmerica, Savannah
Page 5 of 15 9/27/2021

Client Sample Results
Client: ERM-West
Job ID: 680-204374-1
Project/Site: Storm Water - Amazon Warehouses (DLT3)
SDG: 413 Goodman Road, Concord, NC 28027
Client Sample ID: DLT3_SamplePoint_02_20210908
Lab Sample ID: 680-204374-2
Date Collected: 09/08/21 09:05
Matrix: Water
Date Received:09115/21 08:45
General Chemistry
Analyte Result Qualifier RL
MDL Unit
D Prepared Analyzed oil Fee
Oil & Grease (HEM) <1.4 5.1
1.4 mg/L
09/22/21 08:49 09/22/21 11:10 1
Total Suspended Solids 7.8 5.0
5.0 mg/L
09/15121 17:35 1
Chemical Oxygen Demand 6.3 J 10
5.0 mg/L
09/25/21 13:15 1
Eurofins TestAmerica, Savannah
Page 6 of 15 9/27/2021

Client Sample Results
Client: ERM-West Job ID: 680-204374-1
Project/Site: Storm Water - Amazon Warehouses (DLT3) SDG: 413 Goodman Road, Concord, NC 28027
Client Sample ID: DLT3_ SamplePoint_03_20210908 Lab Sample ID: 680-204374-3
Date Collected: 09108/21 09:20 Matrix: Water
Date Received: 09/15/21 08:45
General Chemistry
Analyte
Result Qualifier
RL
MDL Unit
D Prepared Analyzed oil Fac
Oil & Grease (HEM)
<1.4
4.9
1.4 mg/L
09/22121 08:49 09/22121 11:10 1
Total Suspended Solids
11
5.0
5.0 mg/L
09115/21 17:35 1
Chemical Oxygen Demand
13
10
5.0 mg/L
09/25121 13:15 1
Eurofins TestAmerica, Savannah
Page 7 of 15 9/27/2021

QC Sample Results
Client: ERM-West
Project/Site: Stone Water - Amazon Warehouses (DLT3)
Method: 1664A - HEM and SGT-HEM
Lab Sample ID: MB 680-685957/1-A
Matrix: Water
Analysis Batch: 685989
Job ID:680-204374-1
SDG: 413 Goodman Road, Concord, NC 28027
Client Sample ID: Method Blank
Prep Type: Total/NA
Prep Batch: 685957
MB MB
Analyte Result Qualifier
RL MDL Unit D Prepared
Analyzed DII Fac
Oil &Grease (HEM) <1.4
5.0 1.4 mg/L 0912221 08:49
092221 11:10 1
Y
Lab Sample ID: LCS 680-685957/2-A
Client Sample ID:
Lab Control Sample
Matrix: Water
Prep Type: Total/NA
Analysis Batch: 685989
Prep Batch: 685957
Spike
LCS LCS
%Rec.
Analyte
Added
Result Qualifier Unit D %Rec
Limits
Oil & Grease (HEM)
40.0
38.60 mg/L 96
78 -114
Lab Sample ID: LCSD 680-68595713-A
Client Sample ID: Lab
Control Sample Dup
Matrix: Water
Prep Type: Total/NA
Analysis Batch: 685989
Prep Batch: 685957
Spike
LCSD LCSD
%Rec. RPD
Analyte
Added
Result Qualifier Unit D %Rec
Limits RPD Limit
Oil & Grease (HEM) -
40.0
38.80 mg/L 97
78-114 1 18
Method: 2540 D-2011 - Total Suspended Solids (Dried at 103-105°C)
Lab Sample ID: MB 680-685060/1
Client Sample ID: Method Blank
Matrix: Water
Prep Type: Total/NA
Analysis Batch: 685060
MB MB
Analyte Result Qualifier
Total Suspended Solids <2.5
Lab Sample ID: LCS 680-685060/2
Matrix: Water
Analysis Batch: 685060
Analyte
Total Suspended Solids
Lab Sample ID: LCSD 680-68506013
Matrix: Water
Analysis Batch: 685060
Analyte
Total Suspended Solids
Method: 410.4-1993 R2.0 - COD
Lab Sample ID: MB 680-68657213
Matrix: Water
Analysis Batch: 686572
RL MDL Unit D Prepared Analyzed oil Fac
2.5 2.5 mg/L 09/15/21 17:35 1
Client Sample ID: Lab Control Sample
Prep Type: TotalINA
Spike LCS LCS %Rec.
Added Result Qualifier Unit D %Rec Limits
951 898 mg/L 94 80-120
Client Sample ID: Lab Control Sample Dup
Prep Type: Total/NA
Spike LCSD LCSD %Rec. RPD
Added Result Qualifier Unit D %Rec Limits RPD Limit
951 882 mg/L 93 80-120 2 25
Client Sample ID: Method Blank
Prep Type: Total/NA
MB MB
Analyte Result Qualifier RL MDL Unit D Prepared Analyzed oil Fac
Chemical Oxygen Demand <5.0 10 mo mg/L 09/2521 13:15 1
Eurofins TestAmerica, Savannah
Page 8 of 15
9/27/2021

QC Sample Results
Client: ERM-West Job ID: 680-204374-1
Project/Site: Storm Water - Amazon Warehouses (DLT3) SDG: 413 Goodman Road, Concord, NC 28027
Method: 410.4-1993 R2.0 - COD (Continued)
Lab Sample ID: LCS 680-68657214 Client Sample ID: Lab Control Sample
Matrix: Water Prep Type: Total/NA
Analysis Batch: 686572
Spike LCS LCS %Rec.
Analyte Added Result Qualifier Unit D %Rec Limits
Chemical Oxygen Demand 50.0 49.3 mg/L 99 90-110
Eurofins TestAmerica, Savannah
Page 9 of 15 9/27/2021

QC Association Summary
Client: ERM-West Job ID: 680-204374-1
Project/Site: Storm Water - Amazon Warehouses (DLT3) SDG: 413 Goodman Road, Concord, NC 28027
General Chemistry
Analysis Batch: 686060
Lab Sample ID
Client Sample ID
Prep Type
Matrix
Method Prep Batch
680-204374-1 -
DLT3_SamplePoint 01_20210908
TotaVNA
Water
2540 D-2011
680-204374-2
DLT3_SamplePoint_02_20210908
Total/NA
Water
2540 D-2011
680-204374-3
DLT3_ SamplePoint_03_20210908
TotaVNA
Water
2540 D-2011
MB 680-68506011
Method Blank
TotaVNA
Water
2540 D-2011
LCS 680685060/2
Lab Control Sample
TotaVNA
Water
2540 D-2011
LCSD 680-68506013
Lab Control Sample Dup
Total/NA
Water
2540 D-2011
Prep Batch: 685957
Lab Sample ID
Client Sample ID
Prep Type
Matrix
Method
Prep Batch
680-204374-1
DLT3_SamplePoint 01_20210908
TotaVNA
Water
1664A
680-204374-2
DLT3_ SamplePoint_02_20210908
TotaVNA
Water
1664A
680-204374-3
DLT3_SamplePoint 03_20210908
TotaVNA
Water
1664A
MB 680-68595711-A
Method Blank
Total/NA
Water
1664A
LCS 680-685957/2-A
Lab Control Sample
Total/NA
Water
1664A
LCSD 680-685957/3-A
Lab Control Sample Dup
TotaVNA
Water
1664A
Analysis Batch: 685989
Lab Sample ID
Client Sample ID
Prep Type
Matrix
Method
Prep Batch
680-204374-1
DLT3_SamplePoint 01_20210908
Total/NA
Water
1664A
685957
680-204374-2
DLT3_SamplePoint_02_20210908
Tota11NA
Water
1664A
685957
680-204374-3
DLT3_SamplePoint 03_20210908
TotaVNA
Water
1664A
685957
MB 680-685957/1-A
Method Blank
Total/NA
Water
1664A
685957
LCS 680-685957/2-A
Lab Control Sample
TotaVNA
Water
1664A
685957
LCSD 680-685957/3-A
Lab Control Sample Dup
TotaVNA
Water
1664A
685957
Analysis Batch: 686572
Lab Sample ID
Client Sample ID
Prep Type
Matrix
Method
Prep Batch
680-204374-1
DLT3_SamplePoint_01_20210908
Total/NA
Water
410.4-1993 R2.0
680-204374-2
DLT3_ SamplePoint_02_20210908
TotaVNA
Water
410.4-1993 R2.0
680-204374-3
DLT3_SamplePoim_03_20210908
TotaVNA
Water
410.4-1993 R2.0
1 MB 680-686572/3
Method Blank
TotaVNA
Water
410.4-1993 R2.0
LCS 680-686572/4
Lab Control Sample
TotaVNA
Water
410.4-1993 R2.0
Eurofins TestAmerica, Savannah
Page 10 of 15 9/27/2021

Lab Chronicle
Client: ERM-West
ProjectlSite: Storm Water - Amazon Warehouses (DLT3)
Client Sample ID: DLT3_SamplePoint_01_20210908
Date Collected: 09/08/21 09:12
Date Received: 09116/21 08:45
Batch Batch
Dll
Initial
Prep Type Type Method Run
Factor
Amount
Total/NA Prep 1664A
500 mL
TotaVNA Analysis 1664A
1
Instrument ID: NoEquip
Total/NA Analysis 2640 D-2011
1
260 mL
Instrument ID: NOEQUIP
TotaVNA Analysis 410.4-1993 R2.0
1
2 mL
Instrument ID: SPC7
Client Sample ID: DLT3_ Sam plePoint 02_20210908
Date Collected: 09/08/21 09:05
Date Received: 09/15/21 08:45
Job ID: 680-204374-1
SDG: 413 Goodman Road, Concord, NC 28027
Lab Sample ID: 680-204374-1
Matrix: Water
Final
Batch
Prepared
Amount
Number
or Analyzed
Analyst
Lab
500 ­­mL
685957
09/22/21 08:49
JAS
TAL SAV
685989
09/22/21 11:10
JAS
TAL SAV
1000 mL
685060
09/1521 17:35
PG
TAL SAV
2mL 686572 09252113:15 ALG TAL SAV ©'
Lab Sample ID: 680-204374-2
Matrix: Water
•
Prep Type
Batch Batch
Type Method Run
oil
Factor
Initial
Amount
Final
Amount
Batch
Number
Prepared
or Analyzed
Analyst
Lab
Total/NA
Prep 1664A
486 mL
500 mL
685957
092221 08:49
JAS
TAL SAV
TotayNA
Analysis 1664A
1
685989
09222111:10
JAS
TAL SAV
Instrument ID: NoEquip
Total/NA
Analysis 2540 D-2011
1
500 mL
1000 mL
685060
09/1521 17:35
PG
TAL SAV
Instrument ID: NOEQUIP
Total/NA
Analysis 410.4-1993 R2.0
1
2 mL
2 mL
686572
09/25/21 13:15
ALG
TAL SAV
Instrument ID: SPC7
Client Sample ID: DLT3 SamplePoint_03_20210908
Lab
Sample ID: 680-204374-3
Date Collected:
09/08/21 09:20
Matrix: Water
Date Received:
09/15/21 08:45
Batch Batch
oil
Initial
Final
Batch
Prepared
Prep Type
Type Method Run
Factor
Amount
Amount
Number
or Analyzed
Analyst
Lab
TotaVNA
Prep 1664A
511 mL
500 mL
685957
09/2221 08:49
JAS
TAL SAV
TotaUNA
Analysis 1664A
1
685989
09/2221 11:10
JAS
TAL SAV
Instrument ID: NoEquip
Total/NA
Analysis 2540 D-2011
1
500 mL
1000 mL
685060
09/1521 17:35
PG
TAL SAV
Instrument ID: NOEQUIP
TotayNA
Analysis 410.4-1993 R2.0
1
2 mL
2 mL
686572
092521 13:15
ALG
TAL SAV
Instrument ID: SPC7
Laboratory References:
TAL SAV = Eurofins TestAmerica, Savannah, 5102 LaRoche Avenue, Savannah, GA 31404, TEL [phone]
Eurofins TestAmerica, Savannah
Page 11 of 15 9/27/2021

Accreditation/Certification Summary
Client: ERM-West
Project/Site: Storm Water - Amazon Warehouses (DLT3)
Laboratory: Eurofins TestAnnerica, Savannah
The accreddations/certifications listed below are applicable to this report.
Authority Progi
North Carolina (WW/SW) State
Job ID:680-204374-1
SDG: 413 Goodman Road, Concord, NC 28027
Identification Number Expiration Date
269 12-31-21
Eurofins TestAmerica, Savannah
0
Page 12 of 15 9/27/2021

Method Summary
Client: ERM-West Job ID: 680-204374-1
Project/Site: Storm Water - Amazon Warehouses (DLT3) SDG: 413 Goodman Road, Concord, NC 28027
Method Method Description Protocol Laboratory
1664A HEM and SGT-HEM 1664A TAL SAV
2540 D-2011 Total Suspended Solids (Dried at 103-105°C) SM TAL SAV
410.4-1993 R2.0 COD MCAWW TAL SAV
1664A HEM and SGT-HEM (Aqueous) 1664A TAL SAV
Protocol References:
1664A = EPA-821-98-002
MCAWW = "Methods For Chemical Analysis Of Water And Wastes", EPA-600/4-79-020, March 1983 And Subsequent Revisions.
SM = "Standard Methods For The Examination Of Water And Wastewater'
Laboratory References:
TAL SAV = Eurofins TestAmerica, Savannah, 5102 LaRoche Avenue, Savannah, GA 31404, TEL [phone]
Eurofins TestAmerica, Savannah
Page 13 of 15 9/27/2021

Eurofins TestAmerica, Savannah
5102 LaRoche Avenue
Savannah. GA 31404
Phone [phone] Fax [phone]
Chain of Custody Record
Z� eurofins .
$amD�fl
Lab PM
Cam«incbnq NP(.
COC N.
Client Information
Evans Lauren R
240-78217.31058
cwm CPnun
"One
EM.� -
--
s ax w D°D«
Doug Wade
- ,�
Lauren Evans@Eurofmset com
Page of
Company
PWSID
_
lobe
ERM-Wesi
Analysis Requested
cnalna
Due oab Rpuaafad:
Pn uirvafibn coda.�
1920 Main Street Suite 300
MCL MNNaM
Gry
TAT RpWlM1dldayal;
hwna
a -NN
C GMa D AaK. Ox
DMcP-Na2
91eLP
ComplOnce Prolpn D Yu 4 No
CA 92614
E . NlMSN p wxsm
F - W W R Na25103
Pf+Pne
PO a
443 812 0046(Tel)
Purchase Order Requested
-
i
D�AmWy
5 M}sNN. A.iXt.c AW - 1SP I3mp.+niP.,Y
I - Ice o Acaone
Emaa
Y.O e
duug [e-mail]
B
a
C
J. a Waui v Mcrae
a EDTA W PH a5
gplM lyme
Pn iPfa
Slorm Wale, Amazon Warehouses ( 1
24024260
CA.
�
LEna
. :.ome, nPecw:
01ner
Ste
ssOVaa
E
m
e
_'
m
a
t
s
0
o
a
E
Sample
Matrix
Type
1«�«.,.
€
u
i
Sample
(C=c.p,
os-may.+
0
m
g21
Sample Identification
Sample Date
Time
Grab
e+n„.«. a•w
G
'�«
'aO
i°-
S eclat Ins tructionslNote:
FesemOon Code:
N
S
S
- Soirripte P - Z O
-O
1
ti
S
3- Sampir ?btnt- a g
j:o&-21
6
Z
I
o
J
P
/7
O0
_
C -
C
O --
O.
I TT-
Sample Disposal f A zee maybe assessed if samples are retained long,
Possible Hazard Identification
C-3 M
Non -Hazard flammable Stan Amman Poison a Unknown Radiological
Return i0 Clrenl DrspoSal B Lab Amhne, For Months
Deliverable Requested 1. 11, III. IV, Other (specify)
Speoal Insiruclrons/OC Requvemenls
Empty Ni Relinquished by Dale
Time wmm a 9.a.am
Riiinq day
motat
Dalert.me
C.M."
Re.,,e. 1
Dmemm 7
Company
emroenb.e b -
1 1,�11 �.Q.�'%
o�
C°'nwer
Rlu,.ed Cr
own
Caron r
Rmmp,.enao by
DaMrtime
C.-Panr
R.c—M by
Daien m,.
cnmpanr
1 l
Cuslooy Seals Intact
CusladY Seal No
eoNer Te Wgivia and Oa1ei Remaraa
a Yes A No
0.9
Ver 01i16,2019

Login Sample Receipt Checklist
Client: ERM-West
Login Number: 204374
List Number: 1
Creator: Tyler, Matthew M
Question
Job Number. 680-204374-1
SDG Number: 413 Goodman Road, Concord, NC 28027
List Source: Eurofins TestAmerica, Savannah
Answer Comment
Radioactivity wasn't checked or is </= background as measured by a survey
N/A
meter.
The cooler's custody seal, if present, is intact.
True
Sample custody seals, if present, are intact.
True
The cooler or samples do not appear to have been compromised or
True
tampered with.
Samples were received on ice.
True
Cooler Temperature is acceptable.
True
Cooler Temperature is recorded.
True
COC is present.
True
COC is filled out in ink and legible.
True
COC is filled out with all pertinent information.
True
Is the Field Sampler's name present on COC?
True
There are no discrepancies between the containers received and the COC.
True
Samples are received within Holding Time (excluding tests with immediate
True
HTs)
Sample containers have legible labels.
True
Containers are not broken or leaking.
True
Sample collection datettimes are provided.
True
Appropriate sample containers are used.
True
Sample bottles are completely filled.
True
Sample Preservation Verified.
NIA
There is sufficient vol. for all requested analyses, incl. any requested
True
MS/MSDs
Containers requiring zero headspace have no headspace or bubble is
N/A
<6mm (1/4').
Multiphasic samples are not present.
True
Samples do not require splitting or compositing.
True
Residual Chlorine Checked.
NIA
'1N
Eurofins TestAmerica, Savannah
Page 15 of 15 9/27/2021

Login Sample Receipt Checklist
Client: ERM-West Job Number: 680-204374-1
SDG Number: 413 Goodman Road, Concord, NC 28027
Login Number: 204374 List Source: Eurofins TestAmerica, Savannah
List Number: 1
Creator. Tyler, Matthew M
Question Answer Comment
Radioactivity wasn't checked or is </= background as measured by a survey NIA
meter.
The cooler's custody seal, if present, is intact. True
Sample custody seals, if present, are intact. True