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HomeMy WebLinkAboutNCG030636_MONITORING INFO_201909054TW STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. vu V3o DOC TYPE ❑ HISTORICAL FILE C MONITORING REPORTS DOC DATE ❑ U� �� / D C� YYYYM M D D August 29, 2019 vertiqu�e Rw7rr--1VED SEP 05 Z019 Central Files CLIt r�AL FILES Division of Water Quality bwR SECTION 1617 Mail Service Center Raleigh, NC 27699-1617 RE: Systems Logistics-Vertique Semi-annual discharge monitoring reports (DMR) Monitoring period Year 2-Period 2 To Whom it May Concern, The Systems Logistics-Vertique ("Systems Logistics") facility located in Arden, North Carolina is submitting the following information to the Division of Water Quality ("Division") in regards to the facility general industrial permit NCG030636. Please note, Systems Logistics was formerly named ITW Warehouse Automation. The current monitoring period is recognized as July 1, 2019 through December 31, 2019. The sample analysis attached was collected from outfall 002. The results were reported within 30 days of the date of collection. For 2019, facility personnel are scheduled to be trained to the SPPP and best management practices. Also, specific personnel were identified to properly collect samples and report out as needed. Attached is the discharge monitoring report required for monitoring period year 1-period 2. The sampling requirements per Section D of the General Permit are below: a. July 22, 2019/Systems Logistics location outfall 002/1:30pm b. Scott Phillips/Safety Manager c. July 29, 2019 d. Pace Analytical e. See attached analysis f See attached analysis The benchmark level for pollutants has not been exceeded this monitoring period. Appalachian Environmental Resources, Inc. has been contracted to handle the water quality program at the facility. The Storm water Pollution Prevention Plan (SPPP) has been developed and all information pertaining to the NPDES permit for Metal Fabrication has been completed. 115 Vista Boulevard • Arden, NC 28704 • Tel: 828-654-7500 • Fax: 828-654-8908 Email: info@systemlogistics.com • w .systemlogistics.com Partnership. Innovation. Creating Supply Chain Solutions. If you have any questions or require additional information in regards to this submittal, please contact me at (828)-654-7500 or Michael Fox at (423)-956-2900. 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. Scott Phillips Safety Manager Systems Logistics Cc: File copy Attachments 115 Vista Boulevard • Arden, INC 28704 • Tel: 828-654-7500 • Fax: 828-654-8908 Email: info@systemlogistics.com • w .systemlogistics.com Partnership. Innovation. Creating Supply Chain Solutions. Semi-annual Stormwater Discharge Monitoring; Report for North Carolina Division of Water Quality General Permit No. NCG030636 Date submitted 8/29/2019 CERTIFICATE OF COVERAGE NO. NCG030363 FACILITY NAME Systems Logistics COUNTY Buncombe PERSON COLLECTING SAMPLES Scott Phillips LABORATORY Pace Analytical Lab Cert. Jf L1123125 Comments on sample collection or analysis: Total rainfall event 0.98" Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2019 SAMPLE PERIOD ❑ Jan -June ® July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply ❑SA ®Other SDO PLEASE REMEMBER TO SIGN ON PAGES 2 AND/OR 3 --> ❑ No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Total Suspended Solids PH Standard units Copper Lead Zinc Non -Polar O&G/ Total Petroleum Hydrocarbons Total Toxic Organics' Benchmarks =__> - - 100 mg/L or 50 mg/L" 6.0 — 9.0 0.007 mg/L 0.03 mg/L 0.067 mg/L 15 mg/L 1 mg/L 002 7/22/2019 1 0.98 1 ND 7.8 ND ND ND ND ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfaii. 'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. ° See General Permit, Table 3 identifying the especially sensitive receiving water classifications where the more protective benchmark applies. 'Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing operations, manufacture semiconductors, manufacture electronic crystals, or manufacture cathode ray tubes. For purposes of this permit the definition of Total Toxic Organics is that definition contained in the EPA Effluent Guidelines for the facility subject to the requirement to sample (for metal finishing use the definition as found in 40 CFR 433.11; for semiconductor manufacture use the definition as found in 40 CFR 469.12; for electronic crystal manufacture use the definition as found in 40 CFR 469.22; and for cathode ray tube manufacture use the definition found in 40 CFR 469.31). Permit Date: 11/1/2018-10/31/2022 SWU-245, last revised 10/25/2012 Page 1 of 3 Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may so certify, and the requirement for TTO monitoring may be waived. The solvent management plan shall include a list of the total toxic organic compounds used and the other elements listed in the General Permit. For those facilities electing to employ the TTO monitoring waiver, the discharger shall sign the following certification statement: "Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxic organics into the stormwater or areas which are exposed to rainfall or stormwater runoff has occurred since filing the last discharge monitoring report. I further certify that this facility is implementing the all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Scott Phillips Name (Print name) Safety Manager Title (Print title) .Z3ej-2-9-3v19 (Signature) (Date) Note: Results must be reported in numerical format. Do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier Z or Tier 3 responses. See General Permit text. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. n No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Non -polar O&G/TPH by EPA 1664 (SGT-HEM) Total Suspended Solids pH Benchmarks =__> _ - 15 mg/L 100 mg/L or 50 mg/L* 6.0 — 9.0 Still Footnotes from Part A also apply to this Part B * See General Permit text, Table 5, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Permit Date: 11/1/2018-10/31/2022 SWU-245, last revised 10/25/2012 Page 2 of 3 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 oriainal 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." (Signature of Permittee) (Date) Permit Date:11/1/2018-10/31/2022 SWU-245, last revised 10/25/2012 Page 3 of 3 1Ceqt/t2Kv.,.p ANALYTICAL REPORT c�O August O5, 2019 rTc Appalachian Environmental Resources Sample Delivery Group: L1123125 Samples Received: 07/27/2019 Project Number: Vertique Description: System Logistics Report To: Mike Fox 395 Steel St. Johnson City, TN 37601 Entire Report Reviewed By: LI�J.Ln_ , , Liana M Dranes Project Manager Results relate any to the items tested or calibrated and are reported as rounded values. This test report shall not be reproduced, except In full, without written approval of the laboratory. Where applicable, sampling conducted by Pace Analytical National is performed per guidance pleaded In laboratory standard operating procedures ENV-SOP-MTJL-0067 and ENV-SOP-MTJL-0068. Where sampling conducted by the customer, results relate to the accuracy of the Information provided, and as the samples are received. I b rl y' ACCOUNT: PROJECT: SDG: DATErrIME: PAGE: Appalachian Environmental Resources Vertique L1123125 08/0511917:29 1 pill TABLE OF CONTENTS ONE LAB. NATIONWIDE. Cp: Cover Page 1 Cp Tc: Table of Contents 2 Ss: Sample Summary 3 Cn: Case Narrative Sr: Sample Results 4 5 3Ss STORMWATER OUTFALL 001 L1123125-01 5 Cn Qc: Quality Control Summary 6 Gravimetric Analysis by Method 2540 D-2011 6 5Sr Wet Chemistry by Method 1664A Metals (ICP) by Method 200.7 7 8 6Qc GI: Glossary of Terms 9 7GI Al: Accreditations & Locations 10 Sc: Sample Chain of Custody 11 oAl ACCOUNT: PROJECT: 5DG: DATEMME: PAGE: Appalachian Environmental Resources Venique L1123125 08/0511917:29 2of11 SAMPLE SUMMARY ONE LAB, NATIONWIDE. STORMWATER OUTFALL 001 L1123125-01 WW Collected by Scott Phillips Collected date/time 07/2211913:30 Received date/time 07mn908:00 Method Batch Dilution Preparation Analysis Analyst Location date/time date/time Gravimetric Analysis by Method 2540 D-2011 WG1319350 1 07/2911916*08 07/2911916:41 TH Mt. Juliet, TN Wet Chemistry by Method 1664A WG1321044 1 08/0211915:23 08/02/1920:19 MBP Mt. Juliet, TN Metals )ICP) by Method 200.7 WG1319024 1 07/29/1916:56 07/3111919:12 TRB Mt. Juliet, TN ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: Appalachian Environmental Resources Vertique L1123125 08105/1917:29 3 of 11 CASE NARRATIVE ONE LAB, NATIONWIDE. All sample aliquots were received at the correct temperature, in the proper containers, with the appropriate preservatives, and within method specified holding times, unless qualified or notated within the report. Where applicable, all MDL (LOD) and RDL (LOQ) values reported for environmental samples have been corrected for the dilution factor used in the analysis. All Method and Batch Quality Control are within established criteria except where addressed in this case narrative, a non-conformance form or properly qualified within the sample results. By my digital signature below, I affirm to the best of my knowledge, all problems/anomalies observed by the laboratory as having the potential to affect the quality of the data have been identified by the laboratory, and no information or data have been knowingly withheld that would affect the quality of the data. Liana M Dranes Project Manager ACCOUNT: PROJECT: SDG: DATEJTIME: Appalachian Environmental Resources Vertique L1123125 09/0511917:29 STORMWATER OUTFALL 001 SAMPLE RESULTS - 01 ONE LAB. NATIONWIDE. J0 Collected dateltlme: 07/22119 13:30 L1123125 Additional Information Result Units C p Analyte pH (On Site) 7.8 su TC Temperature (on -site) 22.8 Deg C Ss Gravimetric Analysis by Method 2540 D-2011 Result Qualifier RDL Dilution Analysis Batch Cn Analyte mgll mgll date/ time Suspended Solids NO 2.50 1 07/291201916:41 WG1319350 Wet Chemistry by Method 1664A 6 Result Qualifier RDL Dilution Analysis Batch QC Analyte mgll mgll date/time Oil & Grease (Hexane Extr) NO 5.56 1 08/02/2019 20:19 WG1321044 [GI Metals (ICP) by Method 200.7 eAl Result Qualifier RDL Dilution Analysis J Batch Analyte mgll mgll date/time Copper NO 0.0100 1 071311201919:12 WG1319024 SC Lead ND 0.00500 1 07/31/201919:12 WG1319024 Zinc NO 0.0500 1 07/31/201919:12 WG1319024 ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: Appalachian Environmental Resources Venlque L1123125 OB/05/1917:29 5of 11 WG1319350 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE. Gravlmetric Analysis by Method 2540 D-2011 L7123125-01 Method Blank (MB) ' C P (MB) R3435613-1 07/29/1916:41 MB Result Anayte n Suspended Solids U MB Oualifier MB MDL MB RDL mgll mg/I 0.350 2.50 L1120154-01 Original Sample (OS) • Duplicate (DUP) (OS) L1120154-01 07/29/1916:41 • (DUP) R3435613-3 07/29/19 16:41 Original Result DUP Result Dilution DUP RPD DUP Oualifer DUP RPD Limits Anayte mgll mgA % % Suspended Solids 86.0 82.0 1 4.76 5 Laboratory Control Sample (LCS) (LCS) R3435613-2 07/29/19 16:41 Spike Amount LCS Result LCS Rec. Rec. Limits LCS Oualifler Analyte mgll mg/I % % Suspended Solids 773 764 98.8 85.0-115 ACCOUNT: PROJECT: SDG: DATERIME: PAGE: Appalachian EnWonmental Resources Venique L1123125 08/0511917:29 - 6 of 11 WG1321044 QUALITY CONTROL SUMMARY ONE LAB, NATIONWIDE. Wet Chemistry by Method 1664A L1123125-01 Method Blank (MB) (MB) R3437001-1 08/02/19 20:19 MB Result Anayte mgi Oil & Grease (Hexane Extr) u MB Oualifier MB MDL MB ROL mg/I mg/I 1.16 5.00 Laboratory Control Sample (LCS) • Laboratory Control Sample Duplicate (LCSD) (LCS) R3437001-2 08/02/19 20:19 • (LCSD) R3437001-3 08/02/19 20:19 Spike Amount LCS Result LCSD Result LCS Rec. LCSD Rec. Rec. Limits LCS Oualifier LCSD Qualifier RPD RPD Limits Analyte mg4 mg4 mgA % % % % % Oil & Grease (Hexane Extr) 40.0 38.4 37.0 96.0 92.5 78.0-114 3.71 20 ACCOUNT: Appalachian Environmental Resources PROJECT: Vertique SDG: DATE/TIME: L1123125 08/05/19 17.29 PAGE: 7 of 11 WG1319024 QUALITY CONTROL SUMMARY ONE LAB, NATIONWIDE. Metals LOP) by Method 200.7 L7123125-07 - Method Blank (MB) (MB) R3436206-1 07/3V1918:53 MB Result Analyte in Copper U Lead U Zinc U MB Qualifier MB MOIL MB RDL mgll mgll 0.00700 0.0100 0.00200 0.00500 0.00340 0.0500 Laboratory Control Sample (LCS) • Laboratory Control Sample Duplicate (LCSD) (LCS) R3436206-2 07/31/19 18:56 • (LCSD) R3436206-3 07/31/1918:58 Spike Amount LCS Result LCSD Result LCS Rec. LCSD Rec. Rep. Limits LCS Qualifier LCSD Qualifier RPD RPD Limits Analyte mgll mg/1 mgll % % % % % Copper 1.00 0.977 0.997 97.7 99.7 85.0-115 1.97 20 Lead 1.00 0.983 0.996 98.3 99.6 85.0-115 1.35 20 Zinc 1.00 0.968 0.982 96.8 98.2 85.0-115 1.41 20 L1122606-01 Original Sample (OS) • Matrix Spike (MS) • Matrix Spike Duplicate (MSD) (OS) L1122606-01 07/31/19 19:01 • (MS) R3436206-S 07/31/1919:07 • (MSD) R3436206-6 07/31/19 19:09 Spike Amount Original Result MS Result MSD Result MS Rec. MSD Rec. Dilution Rec. Limits MS Qualifier MSD Qualifier RPD RPD Limits Analyte ri mgll mg/I mg4 % % % % % Copper 1.00 NO 1.01 0.987 101 98.7 1 70.0-130 2.67 20 Lead LOO NO 1.01 0.998 101 99.8 1 70.0-130 1.47 20 Zinc 1.00 NO 0.995 0.975 98.5 96.5 1 70.0-130 2.02 20 - L1123125-01 Original Sample (OS) • Matrix Spike (MS) • Matrix Spike Duplicate (MSD) (OS) L1123125-01 07/31/1919:12 • (MS) R3436206-7 07/31/1919:15 - (MSD) R3436206-8 07/3111919:18 Spike Amount Original Result MS Result MSD Result MS Rec. MSD Rec. Dilution Rec. Limits MS Qualifier MSD Qualifier RPD RPD Limits Analyte mg/I mg/1 mg/I mgll % % % % % Copper 1.00 NO 1.00 0.988 100 98.3 1 70.0-130 1AB 20 Lead 1.00 ND 1.00 0.980 100 98.0 1 70.0-130 2.08 20 Zinc 1.00 NO 1.00 0.982 98.0 95.8 1 70.0-130 224 20 ICp zTc aSs 4Cn Fr-1 7GI 8AI 9Sc ACCOUNT: PROJECT: Appalachian Environmental Resources Venique SOO: L1123125 DATE7TIME: 08/05/19 1T29 PAGE: 8 of 11 GLOSSARY OF TERMS ONE LAB. NATIONWIDE. Guide to Reading and Understanding Your Laboratory Report The Information below Is designed to better explain the various terms used in your report of analytical results from the Laboratory. This is not intended as a comprehensive explanation, and if you have additional questions please contact your project representative. Results Disclaimer - Information that may be provided by the customer, and contained within this report, include Permit Limits, Project Name, Sample ID, Sample Matrix. Sample Preservation. Field Blanks, Field Spikes, Field Duplicates, On -Site Data, Sampling Collection Dates/TIme5, and Sampling Location. Results relate to the accuracy of this information provided, and as the samples are received. Abbreviations and Definitions MDL Method Detection Limit ND Not detected at the Reporting Limit (or MOIL where applicable). RDL Reported Detection Limit. Rec. Recovery. RPD Relative Percent Difference. SDG Sample Delivery Group. U Not detected at the Reporting Limit (or MOIL where applicable). The name of the particular compound or analysis performed. Some Analyses and Methods will have multiple analytes Analyte reported. If the sample matrix contains an interfering material, the sample preparation volume or weight values differ from the standard, or if concentrations of analytes in the sample are higher than the highest limit of concentration that the Dilution laboratory can accurately report, the sample may be diluted for analysis. If a value different than t Is used in this field, the result reported has already been corrected for this factor. These are the target % recovery ranges or %difference value that the laboratory has historically determined as normal Limits for the method and analyte being reported. Successful OC Sample analysis will target all analytes recovered or duplicated within these ranges. The non -spiked sample In the prep batch used to determine the Relative Percent Difference (RPD) from a quality control Original Sample sample. The Original Sample may not be included within the reported SDG. This column provides a letter and/or number designation that corresponds to additional information concerning the result Qualifier reported. If a Qualifier is present, a definition per Qualifier Is provided within the Glossary and Definitions page and potentially a discussion of possible implications of the Qualifier in the Case Narrative If applicable. The actual analytical final result (corrected for any sample specific characteristics) reported for your sample. If there was no measurable result returned for a specific analyte, the result in this column may state "No" (Not Detected) or'BDL' Result (Below Detectable Levels). The information in the results column should always be accompanied by either an MOIL (Method Detection Limit) or RDL (Reporting Detection Limit) that defines the lowest value that the laboratory could detect or report for this analyte. Uncertainty (Radiochemistry) Confidence level of 2 sigma. A brief discussion about the included sample results, including a discussion of any non -conformances to protocol Case Narrative (Cn) observed either at sample receipt by the laboratory from the field or during the analytical process. If present, there will be a section in the Case Narrative to discuss the meaning of any data qualifiers used in the report. This section of the report includes the results of the laboratory quality control analyses required by procedure or Quality Control analytical methods to assist in evaluating the validity of the results reported for your samples. These analyses are not Summary (Qc) being performed on your samples typically, but on laboratory generated material. This is the document created In the field when your samples were initially collected. This is used to verify the time and Sample Chain of date of collection, the person collecting the samples, and the analyses that the laboratory is requested to perform. This Custody (Sc) chain of custody also documents all persons (excluding commercial shippers) that have had control or possession of the samples from the time of collection until delivery to the laboratory for analysis. This section of your report will provide the results of all testing performed on your samples. These results are provided Sample Results (Sr) by sample ID and are separated by the analyses performed on each sample. The header line of each analysis section for each sample will provide the name and method number for the analysis reported. Sample Summary (Ss) This section of the Analytical Report defines the specific analyses performed for each sample ID, Including the dates and times of preparation and/or analysis. Qualifier Description The remainder of this page intentionally left blank, there are no qualifiers applied to this SDG ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: Appalachian Environmental Resources Venique L1123125 08/05/1917.29 9 of 11 ACCREDITATIONS & LOCATIONS ONE LAB. NATIONWIDE. jo Pace National Is the only environmental laboratory accredltedlcer0fied to support your work nationwide from one location. One phone call, one point of contact, one laboratory. No other lab is as accessible or prepared to handle your needs throughout the country. Our capacity and capability from our single location laboratory Is comparable to the collective totals of the network laboratories In our Industry, The most significant benefit to our one locallon design Is the design of our laboratory campus. The model Is conducive to accelerated productivity, decreasing tumaround time, and preventing cross contamination, thus protecting sample Integrity. Our focus on premium quality and prompt service allows us to be YOUR LAB OF CHOICE. Not all certifications held by the laboratory are applicable to the results reported in the attached report. ' Accredltatlon Is only applicable to the test methods speclfiea on each scope of accreditation held by Pace National. State Accreditations Alabama 40660 Nebraska NEOS-15-05 Alaska 17-026 _ Nevada TN-03.2002-34 Arizona AZ0612 New Hampshire 2975 Arkansas 88-0469 New Jersey—NELAP TNO02 Cailtornla 2932 New Mexico' We Colorado TN00003 New York 11742 Connecticut PH-0197 North Carolina Env375 Florida E87487 North Carolina OW21704 Georgia NELAP North Carolina ° 41 Georgia' 923 North Dakota R-140 Idaho TN00003 Ohio—VAP CL0069 Indiana C-TN-01 Iowa 364 Kansas E-10277 Kentucky16 90010 Kentucky' 16 Louisiana A130792 Louisiana' LA180010 Maine TN0002 Maryland 324 Massachusetts M-TN003 Michigan 9958 Minnesota _ 047-999-395 Mississippi TN00003 Missouri 340 Montana CERT0086 Third Party Federal Accreditations 1461.02 Canada 1461.01 EPA —Crypt) TN00003 Oklahoma 9915 Oregon TN200002 Pennsylvania 68-02979 Rhode Island LA000356 South Carolina 94004 South Dakota me Tennessee " 2006 Texas T104704245.18-15 Texas' LABO152 Utah TN00003 Vermont - VT2006 Virginia 460132 Washington C847 West Virginia 233 Wisconsin 9980939910 Wvomina QLA DOD 1461.01 USDA P33045-00234 'Drinking Water' Underground Storage Tanks' Aquatic Toxicity 4 ChemlcallMicroblologlcal °Mold °Wastewater Na Accreditation not applicable Our Locations Pare National has sixty-four client support centers that provide sample pickup anclor the delivery of sampling supplies. If you would like assistance from one of our support offices, please contact our main office. Pace National Performs all testing at our central laboratory. WA MT NO OR MN T 10 SO T V"1 NY WY MI T T NV T NE IA OHT T PA x UT T COT T IL IrT WV VAT CA IeS MO KY T T _ T N T `T • T� NM OTC AR T T SC MS A••f. GA T Tx T IA • , o FL o � —o HI i ME ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: Appalachian Environmental Resources Vertique L1123125 OR/05/1917:29 10 of 11 Wiling Information: not is/Container Preserv i r ative [FaincKunody �r]e_c(_ Pre! �\J�� Chk .2cCii/la"1jr11C2r I !bi•/f ArN�lr�vl.n V lxmtt,�aawiN])1)] Report W: - Email To: d/Va>_Proiet;�Cil/SldteJY Moans lu NN, corrected: Description: U.._+ lw- � 2 3 q S Phone: erL3�r1 S6'-2900 Client Project R Lab Project isLn - TableR Fax: l d } II Collected 6y (prints: Site/Facility ID R P.O. q � Acctnum: � � � Template: Collected try (sl natwe): Rush? (Lab MUST Be Notified) Quote H i S C J'H' �h pt'iogin: Same Day _ Five Day -� l Im�dtelY / _Next Day _spay (Rod Only) Date Re91t![S Needed _Two Dry _iD Ory(Rad Only) ,`��L+ 1 �• I � TSR: P4: Packed on Ice N Y ✓ Three Dry of _P �� Ship?e6 Vfa: Renurkf samgeerye wdr) Sample lO Comp/Grab Matrix' Depth Da:a Time - f l r jy ' Matrix: Remarks: TB Sarecle Receint F W - • PreaenL/In[eC[ Y' S-Sall 'AIR -Air F-Firter • � � p M Tzm.P2Z.,$�-, riW- GrUuntlWdter B-Bioassay O a98,/• cGc Seal —NP Cn.: Signed/Accurate: .uzaze: .,�_N. 0oalea arrnve ncect: —}'/—N WW . WaSteWdter Q OCt?r RAD CEiEt COire]L bncLlea used: N" � J