NCG080961_MONITORING INFO_20200121

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STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
ECG
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑� �' /
YYYYMMDD

AV
NV ATC
—AN ATLASCOMPANY-
December 20, 2019
Natalie Owens
FedEx Ground Environmental Services
1000 FedEx Drive
Moon Township, PA 15108
Subject: Stormwater Discharge Monitoring Report
FedEx Concord Ground — ZCON 280
4350 Fortune Avenue NW
Concord, North Carolina 28027
ATC Project No.: 199FED19C2
Dear Ms. Owens
7606 Whitehall Executive Center Drive, Suite 800
Charlotte. North Carolina 28273
Telephone [phone]
Fax [phone]
www.atcqroupservices.com
RECF!\/FD
JAN 21 2020
CEN I riNL FILES
DWR SECTION
ATC was contracted to perform a semi-annual stormwater monitoring event for the FedEx Concord Ground facility
(ZCON 280) at 4350 Fortune Avenue NW in Concord, North Carolina. The stormwater sampling event included the
collection of a stormwater sample and outfall observations for qualitative parameters during a measurable storm
event. The monitoring was conducted in general conformance with the requirements of the Slate of North Carolina
Department of Environmental Quality (NCDEQ), National Pollutant Discharge Elimination System (NPDES),
General Permit NC800000, which is effective from November 1, 2018 to May 31, 2021.
On November 24, 2019, a stormwater sample was collected at the designated discharge point, Outfall #1 (OF-1),
the outfall from a stormwater retention pond for surface runoff from the facility, based on a storm event that met the
requirements for monitoring. Figure 1 is provided depicting the stormwater sampling location. The collected
sample was submitted to North Carolina -accredited Prism Laboratories, Inc. in Charlotte, North Carolina, for
analysis of total suspended solids (TSS) by EPA Method SM2540D-11, Non -Polar Oil and Grease (O&G)/Total
Petroleum Hydrocarbons by EPA Method 1664A (SGT-HEM), and pH by field analysis. A total rainfall amount
reading was collected from a nearby gauging location. Results of visual observations, qualitative parameters, and
the total rainfall readings are provided in the attached Stormwater Discharge Outfall (SDO) Qualitative Monitoring
Report and Semi -Annual SDO Monitoring Report.
Based on the specified monitoring parameters, as outlined in Part II, Section C of the NPDES for North Carolina
General Permit NC800000 or Certificate of Coverage No. NCG080961, the laboratory results of the O&G of <5.0
mg/L (milligrams/liter) did not exceed the discharge benchmark of 15 mg/L. The laboratory results of the TSS of
4.3 mg/L did not exceed the discharge benchmark of 100 mg/L. The pH result of 7.51 (field reading) is within the
range of the discharge benchmark values.
Please note that the SDO Monitoring Report requires certification by signature of permittee (FedEx employee)
before submittal of the entire report to the address on page one of the SDO Monitoring Report. Please sign on
Page 2 of 2 of the SWU-250 SDO form and then send to the DWQ. Please provide a copy of the signed Semi -
Annual SDO Monitoring Report to ATC. If you have any questions, please contact us at 704-529-3200.
Sincerely,
Diana Lanier
Project Manager
ATC
Email: diana.lanier(d)a atcgs.com
Attachments:
Figure 1 — Stormwater Sample Location Map
SDO Qualitative Monitoring Report
Semi -Annual SDO Monitoring Report
A" - ® 0 `_
Elliot J. Nightingale, P.G.
Senior Consultant
ATC
Email: elliot.nightingale(a)atcgs.com

Environmental
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit https:Hdeu.nc.gov/about/divisions/enerev-mineral-land-
resources/enerev-mi nera I -I and -peen it s/stormwater-perm it s/npdes-i nd ust ri al-sw#tab-4
Permit No.: N/C/ 8 / 0 / 0 / 0 / 0 / 0 or Certificate of Coverage No.: N/C/G/ 0 / 8 / 0 / 9 / 6 / 1
Facility Name: FedEx Ground Concord (ZCON 280)
County: Cabarrus Phone No. _I-800-863-3339
Inspector: Diana Lanier with ATC Group Services LLC (For stormwater discharge sampling only)
Date of Inspection: 11-24-2019
Time of Inspection: 1 1:00
-Total Event Precipitation (inches): 0.99
JAN 21 2020
CEN'I WL t-ILES
DWR SECTION
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
Q� with ATC Group Services LLC for FedEx Ground
(Signature of Petmittee or Designee)
Outfall Description:
Outfall No. _I Structure (pipe, ditch, etc.): One pipe drain to an intermittent stream
Receiving Stream: Intermittent tributary of Afton Creek
Describe the industrial activities that occur within the outfall drainage area: No industrial activities are
performed at the outfall area. A stormwater retention pond is located adjacent to the southeast of Outfall
No. I. The Fedex facility is located further northeast.
Page I of 2
SWU-242, last modified 07/28/2017

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Clear, slight light green tint
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, ctc.): None
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 ❑2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
2 ❑3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where 1 is no solids and 5 is extremely muddy:
❑2 3 4 5
7. Is there any foam in the stormwater discharge? o Yes
8. Is there an oil sheen in the stormwater discharge'? OYes
No
No
9. Is there evidence of erosion or deposition at the outfall? O Yes O No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe Generally clear, with slight green tint. Fallen leaves present on surface.
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
SWU-242, Last modified 07/28/2017

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCGO80000
Date submitted December 20, 2019
CERTIFICATE OF COVERAGE NO. NCG08 0 9 6 1
FACILITY NAME FedEx Ground (ZCON 280)
COUNTY Cabarrus
PERSON COLLECTING SAMPLES Diana Lanier with ATC RFCF I v ED
LABORATORY Pace Analytical Lab Lab Cent. N 12 �1 Z�ZO
Comments on sample collection or analysis:
a L FILES
vQWR SECTION
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD Q Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply [:]SA
QOther
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? ❑ yes ■❑ no (if ves, complete Part A)
Part A: Vehicle & Equipment Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period2
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches'
Non -Polar Oil & Grease
mg/L
Total Suspended Solids,
mg/L
New Motor or Hydraulic Oil Usage,
gal/mon
Benchmarks
-
-
15
100 or 504
Parameter Code
-
46529
00552
C0530
NCOIL
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outtall.
' For sampling periods with no discharge at any single outtall, you must still submit this discharge monitoring report with a checkmark here.
'The 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.
4 See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, 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. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018
Page 1 of 2

Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (if applicable) ❑ No discharge this periodz
Outfall
No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches'
Sample Collected'
mo/dd/yr
Total Suspended
Solids,
mg/L
pH,
Standard units
Non -Polar Oil &
Grease,
mg/L
Permit Limit
-
-
-
100 or 504
6.0 — 9.0
15
Parameter Code
-
46529
-
COS30
00400
00552
Outfall #1
November 24, 2019
0.99
November 24, 2019
4.3
7.51
< 5.0
Footnotes from Part A also apply to this Part B
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 1, 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 DEMUR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copv of this DMR, including all "No Discharge" reports within 30 days of receipt of the lob 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 theje are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
7
Permit Date: 11/1/2018-5/31/2021
ANTHONYSPALVIERI
Assistant Secretary
SWU-248, last revised 11/1/2018
Page 2 of 2

aceAnalytical p
rw.pacdlluixers
December 05, 2019
Ms. Diana Lanier
ATC Group Services LLC
7606 Whitehall Executive Cente
Suite 800
Charlotte, NC 28273
RE: Project: FEDEX-ZCON 280
Pace Project No.: 92455285
Dear Ms. Lanier:
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Enclosed are the analytical results for sample(s) received by the laboratory on November 26, 2019.
The results relate only to the samples included in this report. Results reported herein conform to the
most current, applicable TNI/NELAC standards and the laboratory's Quality Assurance Manual,
where applicable, unless otherwise noted in the body of the report.
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
7� /
Taylor Ezell
[e-mail]
[phone]
Project Manager
Enclosures
cc: Elliot Nightingale, ATC Associates
&1takV90"
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the voitten consent of Pace Analytical Services, LLC.
Page 1 of 11

aceAnalytical
e .pacelmhs.wm
CERTIFICATIONS
Project: FEDEX-ZCON 280
Pace Project No.: 92455285
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
Virginia/VELAP Certification #: 460221
North Carolina Wastewater Certification #: 12
Pace Analytical Services Asheville
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
2225 Riverside Drive, Asheville, NC 28804
North Carolina Wastewater Certification #: 40
Florida/NELAP Certification #: E87648
South Carolina Certification #: 99030001
Massachusetts Certification #: M-NC030
VirginiaNELAP 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 11

(�55?eAnalyfical'
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SAMPLE ANALYTE COUNT
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project:
Pace Project No.:
FEDEX-ZCON 280
92455285
Analytes
Lab ID
Sample ID
Method Analysts Reported
Laboratory
92455285001
Outfall #1
EPA 1664E HH 1
PASI-C
SM 2540D-2011 MJP 1
PASI-A
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, -LC. Page 3 of 11

aceAnalytical m
rw.pacelabs.com
ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: FEDEX-ZCON 280
Pace Project No.: 92455285
Sample: Outfall #1 Lab ID: 92455285001 Collected: 11/24/19 11:00 Received: 11/26/19 12:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Oual
1664 SGT-HEM, TPH Analytical Method: EPA 1664E
Total Petroleum Hydrocarbons ND mg/L 5.0 1 12/05/19 11:30
2540D Total Suspended Solids Analytical Method: SM 254OD-2011
Total Suspended Solids 4.3 mg/L 2.6 1 11/27/19 12:24
Date: 12/05/2019 0453 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, -LC.
Page 4 of 11

aceAnalytical
rrrr.pacdaba.cem
Project: FEDEX-ZCON 280
Pace Project No.: 92455285
QC Batch: 513041
QC Batch Method: EPA 1664B
Associated Lab Samples: 92455285001
LABORATORY CONTROL SAMPLE: 2750314
Parameter Units
Total Petroleum Hydrocarbons mglL
QUALITY CONTROL DATA
Analysis Method: EPA 1664B
Analysis Description: 1664 SGT-HEM, TPH
Spike LCS LCS e/ Rec
Conic. Result e/ Rec Limits
20 15.3 76 64-132
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Qualifiers
MATRIX SPIKE SAMPLE: 2750315
92455285001 Spike MS MS % Rec
Parameter Units Result Conc. Result e/ Rec Limits Qualifiers
Total Petroleum Hydrocarbons mi NO 20 NO 12 64-132
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,
Dale: 12/05/2019 04:53 PM without the written consent of Pace Analytical Services, L-C.
Page 5 of 11

aceAnalytical e
rrr,pecaleAs.com
QUALITY CONTROL DATA
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)a75-9092
Project:
FEDEX-ZCON 280
Pace Project No.:
92455285
OC Batch:
512118 Analysis Method: SM 254OD-2011
QC Batch Method:
SM 254OD-2011 Analysis Description: 2540D Total Suspended Solids
Associated Lab Samples:
92455285001
METHOD BLANK: 2746362 Matrix: Water
Associated Lab Samples: 92455285001
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Suspended Solids mg/L NO 2.5 11/27/19 12:22
LABORATORY CONTROL SAMPLE:
2746363
Spike
LCS LCS
% Rec
Parameter
Units
Cone.
Result % Rec
Limits Qualifiers
Total Suspended Solids
mg/L
250
248 99
90-110
SAMPLE DUPLICATE: 2746364
92455018001
Cup
Parameter
Units
Result
Result RPD
Qualifiers
Total Suspended Solids
mg/L
142
152
7
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: 12/05/2019 04:53 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 11

0
ace Analytical
rw.panlabf.com
QUALIFIERS
Project: FEDEX-ZCON 280
Pace Project No.: 92455285
DEFINITIONS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
OF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
TNTC - Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MOIL - Adjusted Method Detection Limit.
POL - Practical Ouantitation Limit.
RL - Reporting Limit - The lowest concentration value that meets project requirements for quantitative data with known precision and
bias for a specific analyte in a specific matrix.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI -The NELAC Institute.
LABORATORIES
PASI-A Pace Analytical Services - Asheville
PASI-C Pace Analytical Services - Charlotte
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Dale: 12/05/2019 04:53 PM without the written consent of Pace Analytical Services, LLC. Page 7 of 11

laceAnalyfical'
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QUALITY CONTROL DATA CROSS REFERENCE TABLE
ProjecT. FEDEX-ZCON 280
Pace Project No.: 92455285
Lab ID
Sample ID
QC Batch Method
QC Batch
92455285001
92455285001
Outfall #1
Outfall #1
EPA 1664E
SM 2540D-2011
513041
512118
REPORT OF LABORATORY ANALYSIS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 1DO
Huntersv,lle, NC 28078
[phone]
Analytical Method
Analytical
Batch
This report shall not be reproduced, except in full,
Dale: 12/05/2019 04:53 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 11

Document Name:
Document Devised: February 1, 2018
aceAnaVicalo
Semple Condition Upon Recel t(SCUR)
Page 1 of 2
Document No.:
Issuing Authority:
(
F-CAR•CS-033-Rev.06
Pace Carolinas Quality Office
Laboratory receiving samples:
Asheville ❑ Eden❑ Greenwood ❑
Huntersville Raleigh❑ MechanicsvilleM
•
�#
10# : 92455285
nClienntt Name: `
{+ I L wDy/1 3eNiGes
Protect a:
111
❑�— ,
Courier: Fed Ex ❑LISPS
❑Client
HIM 111111111111
❑ Commercial —[]Other:_
92455285
'Place
Custody Seal Present? ❑Yes "[DNtf Seals Intact? ❑Yes
Data/ Initials Person Examining [gnlanis:& a46'// f
Packing Material; []Bubble Wrap Bubble Bags ❑None
❑ Other Blolaglcal TissueF zen?
Thermometil Type of ice: et ❑glue ❑None ❑YeS ❑NoN/A
/EIIP Gun ID: _ 92T058
Coder Temp ('C): a ' S Correction Factor: Add/Subtract IT)
0.00C
S
Temp should be above freezing to 6'C
Cooler Temp Corrected IT): '�
❑Samples out of temp criteria. Samples on ice, cooling process
USDA Regulated Soil N/A, water samplel
hasbegun
Did samples originate a quarantine zone within the United States: CA, NY, or SC
(check maps)? Old samples originate from a foreign source (internationally,
1-1v.. I'lu.
Inrindlne Hawaii and Pupnn Rico)? MYes FIN.
Comments/Dlscre anc :
Chain of Custody Present?
n No
N/A
1.
Samples Arrived within Hold Time?
M41 No
N/A
2.
Short Hold Time Analysis 1<72 hr.)?---
- yes ja L.
NA
3. --" -"- ----"—"—'—"-"'---— — -�—
RushTomArotlndTlmeRequested?
Dyes No
❑N/A
4.
Sufficient Volume?
fi�-sv�es ONO _•
N/A
5. _
Correct Containers Used?
-Pace Containers Used?
"s' ONO
OGs ONO
❑N/A
N A
6.
Containers Intact?
Z< ONO
N/A
7.
Dissolved analysis: Samples Field Flltered?
Dyes Zfr.
❑N/A
8. -
Sample labels Match Ct7CI
-Includes Date/Time/10/Analysis Matrix:
Yes ONO
-]N/A
9.
Heads ace in VOA Vials (>5-6mm)7
DYes No
EINTA
10.
Trip Blank Present?
Trip Blank Custody Seals Present?
Dyes ONO
MY11 ONO
/A
/A
11.
COMMENTS/SAMPLE DISCREPANCY
Lot 10 of split containers:
CLIENT NOTIFICATION/RESOLUTION
Person contacted:
Project Manager SCURF Review:
Project Manager SRF Review:
Date/Time:
Field pata Required? Dyes ❑No
Date: f� 2%
17
Date: /Z
Page 9 of 11

Document Name:
Document Revised: February 7, 2018
aceAnafytical�
Sample Condition U on Recel t SCUR
Page 1 of 2
Document No.:
Issuing Authority:
(
F-CAR-CS-033-Rev.06
Pace Carolinas Quality Office
*Check mark top half of box If pH and/or dechlorination is
verified and within the acceptance range for preservation
samples.
Exceptlons: VOA, Coliform, TOC, Oil and Grease, DRO/801S (water) DOC, LLHg
"Bottom half of box Is to list number of bottle
Project# W0# : 92455285
PM: PTE Due Date: 12/05/19
CLIENT: 92-ATC
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pH Adjustment Log for Preserved Samples
Sample ID
Type of Preservative
pH upon receipt
Dote pres+rvadon adjusted
Time preservation
adjusted
Amount of Preservative
added
Lot
Note: Whenever there is a discrepancy affecting North Catalina compliance samples,a copy of this form will be tent to the North Carolina DEHNR Certification Office(Lo.
Out of hold, incorrect preservative, out of temp, incorrect containers.
Page 10 of 11

102kWa. CHAIN -OF -CUSTODY / Analytical Request Document o
The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must he completed accurately.
iJf�✓ _ - F1. N
section A sold. B ' ` n -L-UN LCi\ I Beaten C
a
Requmed Client wermat)on: Requi2E Project Information: I Invoice lnformalion:
Page:
I 1 Of 1
Company: ATC Group Services LLC-Cerbtte
lReloon To: Diem Lanior I
lAftem., SC4'nG
Aetre. 76M Mdehall Eeeaaive Came
Copy To: I
Company Name
M:
Coda. NC 28273
i
AGErass:
- . R " Wat
-
Emil diana Ianieri®atcgs.Cam
Purcrvoo Order e: ;.
Pace Orae:
I
Ptane: 7oa)s2'.13 w IF.
Project Name: FedEz GrourM East �I
Pace Prgea Manager: t Iorezell ,welabs win
- State
f Location _.
Requested Due Date: }R, ,_ 1 ���; F\TC_
Pmpct K I--,[ 1=F0 iIZ. 1
Pace Pra . N. m—r s
INC
--Requested
AeW.
Fillrod
vwteu com
8
COLLECTED
Preservatives
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pnYmq Wuer OW
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SAMPLE ID oL
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START
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