Loading...
HomeMy WebLinkAboutNCG060133_MONITORING INFO_20191216Ow STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. NCG Db o 13 3 DOC TYPE ❑ HISTORICAL FILE C MONITORING REPORTS DOC DATE ❑ b 1 I a YYYYMMDD STORMWATER DISCHARGE MONITORING REPORT for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG060000 Date submitted 12-10-2019 CERTIFICATE OF COVERAGE NO. NCG06 0 1 3 3 FACILITY NAME Cargill Feed & Nutrition Barber COUNTY Rowan PERSON COLLECTING SAMPLES Glen LABORATORY Pace Analytical Services, LLC Lab Cert. # 1 RECEIVED DEC 16 2019 CENTRAL FILES DWR SECTION D•. A. ct,.rmu,�m.'RnD�hma4c onrl Mnnitnrino Rnailtc SAMPLE COLLECTION YEAR 2019 SAMPLE PERIOD ❑ Jan -June Q July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply ❑SA ❑■ OtherC FACILITY ACTIVITIES INCLUDE (check all that apply): ❑ use/process meats 0 use animal fats/byproducts PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Total event rainfall20.5 or n No discharge this period' Outfall No. Date Sample Collected, mo/dd/yr TSS, mg/L pH, Standard units COD, mg/L Oil and Grease, mg/L Fecal Coliform, Colonies per 100 ml Enterococci, Colonies per 100 ml Benchmark - 100 or 50' Within 6.0-9.0 120 30 1000' Soo' Parameter Code -- - C0530 00400 00340 00556 31616 61211 001 11/12/19 6.5 6.8 49.2 Not Detected - 002 11/12/19 34.0 6.4 28.0 Not Detected 1 Only applies to facilities that use/process meats. ' The total precipitation must be recorded using data from an on -site rain gauge. 3 For sampling periods with no discharge at any outfalls. You must still submit this discharge monitoring report with a checkmark here. 'See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. =Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? ❑ yes ■❑ no (if yes" complete Part B) Permit Date:11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018 Page 1 of 2 Part B• Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new motor oil/month. Outfall No. Date Sample Collected (mo/dd/yr) 24-hour rainfall amount, Inches= New Motor Oil or Hydraulic Oil Usage Non -Polar O&G/Total Petroleum Hydrocarbons Total Suspended Solids Benchmarks ' - - - - - -- - - - - - - 15 mg/L _. -. :100 mg/L or 50 mg/0., Parameter Code - -= - - - = 46529 - NCOIL - _ - - 00552 _ -- C053o Footnotes from Part A also apply to Part B *FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART If 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 Q IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original 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, NC 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 O) Date Permit Date: 11/1/2018-05/31/2021 SWU-249, Last Revised 11/5/2018 Page 2 of 2 aceAnalytical vw.pacelaea.cam Pace Analytical Services, LLC 6701 Conference Drive Raleigh, NC 27607 (919)834-4984 November 26. 2019 Glen Fisher Cargill Barber Feed Mill 9150 Statesville Blvd Cleveland, NC 27013 RE: Project: Stormwater Pace Project No.: 92453646 Dear Glen Fisher: Enclosed are the analytical results for sample(s) received by the laboratory on November 13, 2019. The results relate only to the samples included in this 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, V5� . falr� Amanda Payne amanda.payne@pacelabs.com (704)875-9092 Project Manager Enclosures 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 14 aceMaljitical e erca.pacelatasam Pace Analytical services, LLC 6701 Conference Drive Raleigh, NC 27607 (919)834-4984 CERTIFICATIONS Project: Stormwater Pace Project No.: 92453646 Pace Analytical Services Charlotte 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 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 VirginiaNELAP Certification #: 460221 North Carolina Wastewater Certification #: 12 Pace Analytical Services Asheville 2225 Riverside Drive, Asheville, NC •28804 North Carolina Wastewater Certification #: 40 Florida/NELAP Certification #: E87648 South Carolina Certification #: 99030001 Massachusetts Certification #: M-NC030 VirginiafVELAP Certification #: 460222 North Carolina Drinking Water Certification #: 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 14 YweAnalyfical* wr.pecelabssmn Pace Analytical Services, LLC 6701 Conference Drive Raleigh, NC 27607 (919)834-4984 SAMPLE ANALYTE COUNT Project: Pace Project No.: Stormwater 92453646 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92453646001 Outfall 001-Retention Pond EPA 1664E HH 1 PAST-C SM 254OD-2011 CJL 1 PASI-A EPA9040C SMK 1 PASI-A SM 5220D-2011 GC 1 PASI-A 92453646002 Outfall 001-Storm Drain EPA 16646 HH 1 PASI-C SM 254OD-2011 CJL 1 PASI-A EPA9040C SMK 1 PASI-A SM 5220D-2011 GC 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 14 aceAnalytical o .. paceleEaxam Pace Analytical Services, LLC 6701 Conference Drive Raleigh, NC 27607 (919)834-4984 ANALYTICAL RESULTS Project: Stormwater Pace Project No.: 92453646 Sample: Outfall 001-Retention Pond Lab ID: 92453646001 Collected: 11/12/19 07:30 Received: 11/13119 12:36 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qua] 1664 SGT-HEM, TPH Total Petroleum Hydrocarbons 2540D Total Suspended Solids Total Suspended Solids 9040 pH pH at 25 Degrees C 5220D COD Chemical Oxygen Demand Date: 11/26/2019 07:27 AM Analytical Method: EPA 1664E NO mg/L 8.3 1 11/25/1912:09 Analytical Method: SM 254OD-2011 6.5 mg/L 3.3 1 11/15/19 11:12 Analytical Method: EPA 9040C 6.8 Std. Units 0.10 1 11/24/19 15:52 Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011 49.2 mg/L 25.0 1 11/19/19 16:37 11/19/19 23:26 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, U.C. H3 Page 4 of 14 aceAnalytical e a .ptcalaDasma Pace Analytical Services, LLC 6701 Conference Drive Raleigh, NC 27607 (919)834-4984 ANALYTICAL RESULTS Project: Stormwater Pace Project No.: 92453646 Sample: Outfall 001-Storm Drain Lab ID: 92453646002 Collected: 11/12/19 07:45 Received: 11/13/19 12:36 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 1664 SGT-HEM, TPH Analytical Method: EPA 1664B Total Petroleum Hydrocarbons ND mg/L 5.0 1 11/25/19 12:10 2540D Total Suspended Solids Analytical Method: SM 254OD-2011 Total Suspended Solids 34.0 mg/L 5.0 1 11/15/19 11:12 9040 pH Analytical Method: EPA 9040C pH at 25 Degrees C 6.4 Std. Units 0.10 1 11/24/19 15:58 H3 5220D COD Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011 Chemical Oxygen Demand 28.0 mg/L 25.0 1 11/19/1916:37 11/19/192326 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 11 /26/2019 07:27 AM without the written consent of Pace Analytical Services, L-C. Page 5 of 14 aceAnalytical e www.pacelabsta s Pace Analytical services, LLC 6701 Conference Drive Raleigh, NC 27607 (919)834-4984 QUALITY CONTROL DATA Project: Stormwater Pace Project No.: 92453646 QC Batch: 511565 Analysis Method: EPA 1664B OC Batch Method: EPA 1664E Analysis Description: 1664 SGT-HEM, TPH Associated Lab Samples: 92453646001, 92453646002 LABORATORY CONTROL SAMPLE: 2743986 Spike LCS LCS % Rec Parameter Units Conc. Result %Rec Limits Qualifiers Total Petroleum Hydrocarbons mg/L 20 19.9 100 64-132 Results 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 result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 11/26/2019 07:27 AM without the written consent of Pace Analytical Services, LLC. Page 6 of 14 aceAnalj6cal rrtary.pacalsh.com Pace Analytical Services, LLC 6701 Conference Drive Raleigh, NC 27607 (919)834-4984 QUALITY CONTROL DATA Project: Stormwater Pace Project No.: 92453646 QC Batch: 509675 Analysis Method: SM 2540D-2011 OC Batch Method: SM 254OD-2011 Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92453646001, 92453646002 METHOD BLANK: 2735345 Matrix: Water Associated Lab Samples: 92453646001, 92453646002 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg/L ND 2.5 11/15/19 11:09 LABORATORY CONTROL SAMPLE: 2735346 Spike LCS LCS %Rec Parameter Units Conc. Result %Rec Limits Qualifiers Total Suspended Solids mg/L 250 248 99 90-110 SAMPLE DUPLICATE: 2735396 92453583001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 988 922 7 SAMPLE DUPLICATE: 2735397 92453583003 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 306 295 4 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: 11126/2019 07:27 AM without the written consent of Pace Analytical Services, L-C. Page 7 of 14 ac"Analytical rwr.Dacelabltcoet Pace Analytical Services, LLC 6701 Conference Drive Raleigh, NC 27607 (919)834-4984 QUALITY CONTROL DATA Project: Stormwater Pace Project No.: 92453646 QC Balch: 511439 Analysis Method: EPA 9040C QC Batch Method: EPA 9040C Analysis Description: 9040 pH Associated Lab Samples: 92453646001, 92453646002 SAMPLE DUPLICATE: 2743493 Parameter pH at 25 Degrees C SAMPLE DUPLICATE: 2743494 Parameter pH at 25 Degrees C Units 92453233003 Result Dup Result Std. Units 4.0 3.9 Units 92453407001 Result Dup Result Std. Units 5.7 5.2 RPD Qualifiers 1 H3 RPD Qualifiers 10 D6,H3 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: 11/26/2019 07:27 AM without the written consent of Pace Analytical Services, L-C. Page 8 of 14 YaceAnalytical terr.pealaEums Pace Analytical Services, LLC 6701 Conference Drive Raleigh, INC 27607 (919)634-4964 Project: Stormwater Pace Project No.: 92453646 QC Batch: 510480 QC Batch Method: SM 5220D-2011 Associated Lab Samples: 92453646001, 92453646002 METHOD BLANK: 2738913 Associated Lab Samples: 92453646001, 92453646002 Parameter Units Chemical Oxygen Demand mg/L QUALITY CONTROL DATA Analysis Method: SM 5220D-2011 Analysis Description: 5220D COD Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers NO 25.0 11/19/1923:22 LABORATORY CONTROL SAMPLE: 2738914 Spike LCS LCS %Rec Parameter Units Conc. Result %Rec- Limits Qualifiers Chemical Oxygen Demand mg/L 750 755 101 90-110 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2738915 2738916 MS MSD 92453801001 Spike Spike MS MSD MS MSD %Rec Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual Chemical Oxygen Demand mg/L 19700 100 100 18100 16000 -1650 -3760 .90-110 12 M1,R1 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2738917 2738918 MS MSD 92453397008 Spike Spike MS MSD MS MSD %Rec Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual Chemical Oxygen Demand mg/L 2710 100 too . 2860 2880 151 169 90-110 1 Mt Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right or the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 11 /26/2019 07:27 AM without the written consent of Pace Analytical Services, L-C. Page 9 of 14 MAnalytical �rr.pectl�bswm Pace Analytical Services, LLC 6701 Conference Drive Raleigh, NC 27607 (919)834-4984 QUALIFIERS Project: Stormwater Pace Project No.: 92453646 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. PQL - 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. 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. H3 Sample was received or analysis requested beyond the recognized method holding time. M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery. R1 RPD value was outside control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 11 /26/2019 07:27 AM without the written consent of Pace Analytical services, LLC. Page 10 of 14 aceAnalytical rrr.pacNabs ces Pace Analytical Services, LLC 6701 Conference Drive Raleigh, NC 27607 (919)834-4984 QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: Pace Project No.: Stormwater 92453646 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92453646001 Outfall 001-Retention Pond EPA 1664E 5l1565 92453646002 Outfall 001-Storm Drain EPA 1664B 511565 92453646001 Outfall 001-Retention Pond SM 254OD-2011 509675 92453646002 Outfall 001-Storm Drain SM 254OD-2011 509675 92453646001 Outfall 001-Retention Pond EPA 9040C 511439 92453646002 Outfall 001-Storm Drain EPA 9040C 511439 92453646001 Outfall 001-Retention Pond SM 5220D-2011 510480 SM 5220D-2011 510532 92453646002 Outfall 001-Storm Drain SM 5220D-2011 510480 SM 5220D-2011 510532 Date: 11 /26/2019 07:27 AM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 11 of 14 uocument Name: Uocument nevtwu: reurua,y ,, comae nditlan Upon Receipt(SCUR) I Page 1 of 2 Document No.: Issuing Authority: Laboratory receiving samples: Asheville ❑ Eden[] Greenwood ❑ Huntersville ©-'� Raleigh❑ Mechanicsville[] client Name: prcJectR: W®# : 92453646 UT��,•l i I ������ ��I �I �� I�� �A ��� Coaster: ❑Fed,Ex ❑UPS ❑LISPS ❑Client ❑ Commercial QPace []Other:_ 92463646 Custody Seal Present? ❑Yes ONO' Seals Intact? ❑Yes ❑No f/��j Date/Initiah Person Examining Contents,—�\ J -� Pecking Material:- ❑Bubble Wrap [213ubble Bags ❑None ❑ Other Biological Tissue Frozen? Thermometer:- ❑Yes �No ❑N/A ❑IRGun ID:_ Type Dille: Qwet []Blue ❑None Cooler Temp ('Cl: 0. Correction Factor: Add/Subtract ('C) O.00C �� Tempshould be above freezingto VC Cooler Temp Corrected('C):' []Samples outof temp criteria. Samples an ice, coolingprocess hasbegun i USDA Regulated Sall (Q N/A, water sample) Old samples originate In a quarantine tone within the United States: CA, NY, or SC (check maps)? , Did sampleacdglnate from a foreign source (Internationally, Yes No Indudug Hawaii and Puerto Rico)?❑Yes []NO Comments/Discrepancy. Chain of Custody Present? - Yv No N/A 1. Samples Arrived within Hold Time? Yes Na N A 2. Short Hold Time Analysis <72 hr.)? tt,� 11�'IS4`4 es No N A 3. Rush Turn Around Time Requested? ❑Yes Cl I�o [�N/A Sufficient Volume? ❑Yu ❑Na ❑N/A _4. 5.. Correct Containers Used? O'res []NO ❑N/A 6. -Pace Containers Used? ❑Ve/f []NO ❑N[r. Containers Intact? yei NO N A 7. Dissolved analysis; Samples Field Flhered? QYes C]Nn ❑N%A B. Sample labels Match COC? L]Yes .ONO ❑N/A 9. ' -Includes Date/rime/ID/Analysis Matrlr: to . ) Heads ace In VOA Vials >5-6mm ? "❑Yes ❑No❑N/A 10. Trip Blank Present? .. ❑Yes []No- ❑N/A 11. .. Trip Blank Custody Seals Present? Yes QNO N/A COMMENTS/SAMPLE DISCREPANCY . Lot ID of sollt containers: CLIENT NOTIFICA710N/RESOLUTION Person contacted: Date/Tme: Fleld Data Required? Des ONO Project Manager SCURF Review: (/jI—j�[J _ Dater Project Manager SRF Review: V (V ( Date: 4 I Ll�_ Page 12 of 14 Document Name: Document No.: uonlment Koviwa: rearuary t, ausa Porte 1 of 2 *Check mark top half of box If pH and/or dechlorination Is Project 1 verified and within the acceptance range for preservation samples. Exceptions: VOA, Caliform, TOC, Oil and Grease, DRO/8015 (water) DOC, LLHg "Bottom half of box is to list number of bottle 17 J Due Date: 11/27/19 PM: AP CLIENT: 91—Car-9111 U > g a E U i E U 4 c' 6 `Y E < « i aF C O SEA d S 1uxVl a E a 'd tJJ = SE' d E Zy E Q F1' 1 ? i E O Q O E Z E O E GOi +� Y JJ '� .� N E u z ,'n E I _� �d S 4 CC g`r E E q C E E.]sE n E G > 'r� E X 7 g u -' S s V O s E 2 ,/ ' I 1 Z 3 \ 4 I S 6 7 8 3 30 I 11 -I 12 N NNNI 1 !TT1-q. NN pH Adjustment Log for Preserved Samples Sample ID type of preservative pH upon recelpt Date preservation adjusted Time preservation adjusted Amount of preservative added tot a Note: Whenever there is a discrepancy anemng Norm t.aronna compaance samples, awpy u, mn—,..,,, ucsc,.% w olc,..u.,1 Out of hold, Incorrect preservative, out of temp, Incorrect containers. Page 13 of 14 a CHAIN -OF -CUSTODY / Analytical Request Document - The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must be Completed aa umtely- don A section B Sa ftn C .Imd Climt ImomoOon: Regeifed Project I^fon+allon: Imoke W ofation: Page : 1 Of 1 +Pant Camill. tr,c. Report To: Glm Fis , Attention: Tess: 9150 statewille BNd Copy To: CWPNV roWW, NC 27013 Atltlress: Regulfrto- A:.. 'if: glenjsner@carpill.com Pu &,, Omer e: Pace Duct.: M. 704-278-2941 JFM Project Name: Saa ier Pecs Proje Manager Amanda. pacelaCs.mm. _ 'x4 = :]stetefl.ocdon;.:>.- _ uc W Due Date. Prq O A: Pace Preflo P: 9 1 NC Ariodysi. R1brW ffft C. a o COLLECTED z Preservatives 0.vJuq WM ON WM W! e B U o U wxw Wan < 2 p Heitl P SAMPLE ID p e 0 a CO u_ START END O 0 1, m 4 $ One Per Eos. µw w w $ a 8 m O ^ q fA-7 0-9 tAZ o-9l -) Ann 07 0 ! - S..'Ie Ids m,st I,e unlg T..r T. w TOATME w $ ie v0 J a i 4 o w o O r `• -c Q w O b n - DATE TIME . z i z x i i 0 r u ''o n 2 Z L s I UP I Oudall 001 - Retentim Pond I I I I X I X fx IX I I I I I 1 001 I.. 3 2 Oudall 002 - Storm Drain WT l l) j/ X x x X I 3 I 1 i i I 3_ 1 i . 1 0 I ADDRIONRL COYYENTS =.: +t .. - a r�_ BYIAFFAL11gN '. DATE. -TD1E ACCEPTEDWIAF"710N 7 DATE'•: - YE BAIPLE COlIDmONe I. SAMPLER NAPE AND SIGNANRE � PR Name of SAMPLER: 1 w u $ i $ $I m SIGNATURE of SAMPLER: DATE signed: +1 r I 1 rn G