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Home My WebLink AboutNCG100119_MONITORING INFO_20191231STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. DOC TYPE ❑ HISTORICAL FILE MONITORING REPORTS DOC DATE ❑ /c) YYYYMMDD STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. DOC TYPE ❑ HISTORICAL FILE ❑ MONITORING REPORTS DOC DATE ❑ YYYYMMDD r' Mid Atlantic Engineering 8 Envlronmantal Solutions September 25, 2017 NCDEQ/DWR Attention: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 RECEIVED DEC 81 2A19 %ifiNTRAL FILES LWR SECTIOPI Subject: STORMWATER SAMPLING RESULTS FOSS RECYCLING INC. 901 LAKE ROAD HAVELOCK, NORTH CAROLINA 28532 NPDES PERMIT NO. NCG100119 To Whom It May Concern: 409 Rogers Vrow Court Ralaigh. NC 77610 office 919 250 99 18 faainsda 919 50.9950 MAAONLINE.COM Attached please find the Stormwater Discharge Monitoring Report (DMR) and analytical report for the sampling conducted at the above -referenced site. A stormwater sample was collected from Outfall 001 on August 28, 2017 and analyzed for total suspended solids (TSS), pH, total recoverable lead, oil and grease and ethylene glycol. As summarized on the attached DMR, all parameters were reported below or within their respective benchmark values. If you have any questions or need additional information, please contact me at 919-250-9918. Sincerely, MID -ATLANTIC ASSOCIATES, INC. Charles B. Hoffman, PG Principal Geologist Attachment: Stormwater Discharge Monitoring Report Laboratory Analytical Report EXPERIENCED CUSTOMER FOCUSED INNOVATIVE STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT CERTIFICATE OF COVERAGE NO. NCGIO0119 SAMPLES COLLECTED DURING CALENDAR YEAR: 2017 (This monitoring report shall be received by the Division no later than 30 days from the date the facility receives the sampling results from the laboratory.) FACILITY NAME Foss Recycling Inc Havelock NC COUNTY Craven PERSON COLLECTING SAMPLE(S) William Combs PHONE NO. 252) 566-3167 CERTIFIED LABORATORY(S) Pace Analytical Lab #12 ' Lab # PLEASE REMEMBER TO SIGN ON THE REVERSE � Part A: Stormwater Benchmarks and Monitoring Results For sampling periods with no discharge, you must submit this discharge monitoring form noting "No Flow" or "No Discharge" within 30 days of the end of that period to comply with permit reporting requirements. Outfall No. Date Sample Collected, mo/dd/year Total Rainfall, inches 00400 00530 ---- 77023 01051 78141 pH, Standard Units Total Suspended Solids (TSS), mg/L Non -polar O&G/TPH (Method 1664 SGT-HEM), mg/L Ethylene Glycol, mg/L Lead, Total Recoverable, mg/L Total Toxic Organics3, mg/L Benchmark - - 6.0 — 9.01 100/502 15 8,000 (Tiers 2 and 3) 0.03 1.0 Outfall001 08/28/15 0.72 <2.5 <5.0 <5.0 <0.005 NA Note: If you report a sampled value in excess of the benchmark value, or outside the benchmark range for pH, you must implement Tie[ 1 or Tier L responses In Me vener a Permit. 1See If pH values outside this range are recorded in sampled stormwater discharges, but ambient precipitation pH levels are lower, then the lower threshold of this benchmark range is the pH of the precipitation (within instrument accuracy) instead of 6 S.U. Readings from an on -site or local rain gauge (or local precipitation data) must be documented to demonstrate background concentrations were below the benchmark pH range of 6-9. 2See General Permit text to identify whether the more protective benchmark applies for especially sensitive receiving waters. 3For purposes of this permit the definition of Total Toxic Organics is that list as stated in Appendix D, Table II of Chapter 40 Code of Federal Regulations (CFR) Part 122. Form SW U-251, last revised October 25, 2012 Page 1 of 2 STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Facilities that incorporate a solvent management plan into the Stormwater Pollution Prevention Plan may request that DWQ waive monitoring of total toxic organics. 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 allowed such a waiver, the discharger shall sign the following certification statement: Solvent Management Plan 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 fling the last discharge monitoring report. I further certify that this facility is implementing all the provisions of the solvent management plan included in the Stormwater Pollution Prevention Plan." Name (Print name) Title (Print title) Signature Mail Original and one copy to: Division of Water Quality Attn: Central Files 1617 MailServiceCenter Raleigh, North Carolina27699-1617 Date "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 or lv-2 -I''? (Date) Form SW U-251, lost revised October 25, 2012 Page 2 of 2 aceAnalytical w vpacefabs.cnm Pace Analytical Services, LLC 9800 Kincey Ave. Suite too Huntersville, NC 28078 (704)875-9092 September 17, 2017 Chuck Hoffman Mid -Atlantic Associates, Inc 409 Rogers View Court Raleigh, NC 27610 RE: Project: Foss Recycling Inc -Havelock Pace Project No.: 92353813 Dear Chuck Hoffman: Enclosed are the analytical results for sample(s) received by the laboratory on September 01, 2017. 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, 1`4uy'6vt _41. Nicole Gasiorowski nicole.gasiorowski@pacelabs.com (704)875-9092 Project Manager Enclosures cc: Ron Davis, Mid Atlantic Associatees, Inc. 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 13 aceAnalytical i~..pawlabs.= Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: Foss Recycling Inc -Havelock Pace Project No.: 92353813 Indiana Certification IDs 7726 Moller Road, Indianapolis, IN 46268 Illinois Certification #: 003971 Indiana Certification #: C-49-06 Kansas/NELAP Certification #:E-10177 Kentucky UST Certification #: 80226 Kentucky WW Certification #:98019 Charlotte Certification IDs 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 Louisiana/NELAP Certification # LA170028 North Carolina Drinking Water Certification #: 37706 North Carolina Field Services Certification #: 5342 North Carolina Wastewater Certification #: 12 Asheville Certification IDs 2225 Riverside Drive, Asheville, NC 28804 Florida/NELAP Certification #: E87648 Massachusetts Certification #: M-NC030 North Carolina Drinking Water Certification #: 37712 CERTIFICATIONS Ohio VAP Certification #: CL-0065 Oklahoma Certification #: 2016-075 Texas Certification #: T104704355-16-10 West Virginia Certification #: 330 Wisconsin Certification #: 999788130 USDA Soil Permit #: P330-16-00257 South Carolina Certification #: 99006001 Florida/NELAP Certification #: E87627 Kentucky UST Certification #: 84 Virginia/VELAP Certification #: 460221 North Carolina Wastewater Certification #: 40 South Carolina Certification #: 99030001 VirginiaNELAP Certification #: 460222 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 13 aceAnalytical w ..Pacefabs.com SAMPLE ANALYTE COUNT Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875.9092 Project: Pace Project No.: Foss Recycling Inc -Havelock 92353813 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92353813001 Outfall No. 1 EPA 1664E JMS 1 PASI-C EPA 8015 Alcohol -Glycol BJW 1 PASI-I EPA 6010 SHi 1 PASI-A SM 2540D SLB 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 13 lceAnalytical t ..0acelabs.corn Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 ANALYTICAL RESULTS Project: Foss Recycling Inc -Havelock Pace Project No.: 92353813 Sample: Outfall No. 1 Lab ID: 92353813001 Collected: 08/28/17 17:45 Received: 09/01/17 10:30 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 1664 SGT-HEM, TPH Analytical Method: EPA 1664E Total Petroleum Hydrocarbons ND mg/L 5.0 1 09/13/17 05:52 8015M Glycols in water Analytical Method: EPA 8015 Alcohol -Glycol Ethylene glycol ND mg/L 5.0 1 09/05/17 14:42 107-21-1 6010 MET ICP Analytical Method: EPA 6010 Preparation Method: EPA 3010A Lead ND ug/L 5.0 1 09/13/17 17:10 09/14/17 21:10 7439-92-1 2540D Total Suspended Solids Analytical Method: SM 2540D Total Suspended Solids ND mg/L 2.5 1 09/03/17 09:59 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 09/17/2017 05:06 AM without the written consent of Pace Analytical Services, LLC. Page 4 of 13 lceAnalytical ~pacelaoa.com Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA Project: Foss Recycling Inc -Havelock Pace Project No.: 92353813 QC Batch: 377436 Analysis Method: EPA 1664E QC Batch Method: EPA 1664E Analysis Description: 1664 SGT-HEM, TPH Associated Lab Samples: 92353813001 METHOD BLANK: 2091344 Associated Lab Samples: 92353813001 Parameter Units Total Petroleum Hydrocarbons mglL Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers NO 5.0 09/13/17 05:38 LABORATORY CONTROL SAMPLE: 2091345 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Petroleum Hydrocarbons mglL 20 19.7 98 64-132 MATRIX SPIKE SAMPLE: 2091346 92354046002 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Qualifiers Total Petroleum Hydrocarbons mglL NO 20 19.1 96 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: 09/17/2017 05:06 AM without the written consent of Pace Analytical Services, L.L.C. Page 5 of 13 5'ceAnalytical o wwwpacelabs.cern Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA Project: Foss Recycling Inc -Havelock Pace Project No.: 92353813 QC Batch: 404158 Analysis Method: EPA 8015Alcohol-Glycol QC Batch Method: EPA 8015AIcohol-Glycol Analysis Description: EPA 8015 Modified Associated Lab Samples: 92353813001 METHOD BLANK: 1859527 Associated Lab Samples: 92353813001 Parameter Units Ethylene glycol mg/L Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers NO 5.0 09/05/1712:46 LABORATORY CONTROL SAMPLE: 1859528 Spike Parameter Units Conc. Ethylene glycol mg/L 25 LCS LCS % Rec Result % Rec Limits Qualifiers 30.8 123 41-162 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 1859529 1859530 MS MSD 30228429001 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual Ethylene glycol mg/L ND 25 25 33.0 35.3 122 132 20-172 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 of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 09/17/2017 05:06 AM without the written consent of Pace Analytical Services, LLC. Page 6 of 13 ceAnalytical wxw.pacalahs.corn Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: Foss Recycling Inc -Havelock Pace Project No.: 92353813 QC Batch: 377566 QC Batch Method: EPA 3010A Associated Lab Samples: 92353813001 METHOD BLANK: 2092041 Associated Lab Samples: 92353813001 Parameter Units Lead ug/L QUALITY CONTROL DATA Analysis Method: EPA 6010 Analysis Description: 6010 MET Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers NO 5.0 09/14/17 20:08 LABORATORY CONTROL SAMPLE: 2092043 Spike LCS LCS % Rec Parameter - Units Conc. Result %Rec Limits Qualifiers Lead ug/L 500 466 93 80-120 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2092044 2092045 MS MSD 92353874001 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual Lead ug/L ND 500 500 449 446 90 89 75-125 1 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: 09/17/2017 05:06 AM without the written consent of Pace Analytical Services, LLC. Page 7 of 13 aceAnalytical wwwpacelaid.com Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA Project: Foss Recycling Inc -Havelock Pace Project No.: 92353813 QC Batch: 376210 Analysis Method: SM 2540D QC Batch Method: SM 2540D Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92353813001 METHOD BLANK: 2084220 Associated Lab Samples: 92353813001 Parameter Units Total Suspended Solids mg/L Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers NO 2.5 09/03/17 09:58 LABORATORY CONTROL SAMPLE: 2084221 Spike LCS LCS %Rec Parameter Units Conc. Result %Rec Limits Qualifiers Total Suspended Solids mg/L 250 258 103 90-110 SAMPLE DUPLICATE: 2084222 92353353001 Cup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 31.6 29.6 7 D6 SAMPLE DUPLICATE: 2084223 92353769001 Cup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 13.6 16.4 19 D6 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: 09/17/2017 05:06 AM without the written consent of Pace Analytical Services, LLC. Page 8 of 13 (12151ce Analytical w ..pacefabs.com QUALIFIERS Project: Foss Recycling Inc -Havelock Pace Project No.: 92353813 DEFINITIONS Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 DF - 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. MDL -Adjusted Method Detection Limit. PQL - Practical Quantitation Limit. RL- Reporting Limit. 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 EPAguidelines, 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 PASI-I Pace Analytical Services - Indianapolis ANALYTE QUALIFIERS D6 The precision between the sample and sample duplicate exceeded laboratory control limits. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 09/17/2017 05:06 AM without the written consent of Pace Analytical Services, L-C. Page 9 of 13 aceAnalytical w w.pacelabs.cvm Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: Pace Project No.: Foss Recycling Inc -Havelock 92353813 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92353813001 Outfall No. 1 EPA 1664E 377436 92353813001 Outfall No. 1 EPA 8015 Alcohol -Glycol 404158 92353813001 Outfall No. 1 EPA 3010A 377566 EPA 6010 377621 92353813001 Outfall No. 1 SM 2540D 376210 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 09/17/2017 05:06 AM without the written consent of Pace Analytical Services, LLC. Page 10 of 13 Document Name: Document Revised: August 4, 2017 ! Sample Condition Up Is Recel t(SCUR) Page 1 of 2 Document No.: Issuing Authority: I . 'ze AnaIj/i1C2I" F-CAR-CS-033-Rev.04 Pace Quality Office Laboratory receiving samples: Asheville ❑ Eden[] Greenwood ❑ Huntersviliq/ Raleigh[:] Mechanicsville❑ • Client Name: Wp# : 92353813 IAld I Project N: Courier: UVed Ex ❑UPS ❑USPS ❑Client III IIB I I II I II II II I I III ❑ Commercial nPace ❑Other:_ 92353813 Custody Seal Present? [—]Yes �NO Sealslntact? ❑Yes 1S1 .—S I /Date/Initials Person Examining Co s: �' Packing Material: ❑Bubble Wrap Bubble Bags ❑None ❑ Other Biological Tissue Frozen? Thermo ete , unto. Typo of IcO: (�fet (]Blue ❑None ❑yes [ —]N/A Correction Factor: Cooler Temp Corrected ('C): V Temp should be above freezing to 6'C ❑Samples out of temp criteria. Samples on ice, cooling process has begun USDA Regulated Soil 61/A, water sample) Did sample o 7gYsate in a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (internationally. ayes No including Hawaii and Puerto RicoR❑Yes ,aA Comments/Discrepancy: Zes Chain of Custody Present? No N/A 1. Samples Arrived within Hold Time? -14ts N/A 2. Short Hold Time Analysis c72 hr.)? ❑Yes `ONo -f4dis ❑N/A 3. Rush Turn Around Time Requested? Yes o N/A 4. Su Ificie nl Vo l um e? �rCl rS ❑No ❑N/A S. Correct Containers Used? ,C} ❑No ❑N/A 6. -Pace Containers Used? ��^',/1/e,s �I.-Is� No N/A Intact? YCS NaNA ,j,,ut' uContainers 7.G '41QK Dissolved analysis: Samples Field Filtered? Yes EjNo /A 8. Sample Labels Match COC? .: ItL s ` ❑No ❑N/A 9. L -Includes Date/Time/ID/Analysis Matrix: Heads ace in VOA Vials 1>5.6mm)? &es ONO ❑N/A 10. Trip Blank Present? EFYes ❑N/A 11. TripBlank Custody Seals Present? yes /-os No ❑N/A CLIENT NOTIFICATION/RESOLUTION Person Contacted: Comments/Sample Discrepancy: Lot ID of split containers: Date/Time: Project Manager SCURF Review: I �/ �.�% �(I Date: Project Manager SRF Review: 1i IUtl�1 Date: Field Data Required? ❑Yes LINO Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form Trill be sent to the North Carolina DEIINR Certification Office (i.e. Out of hold, incorrect preservative, out of temp, incorrect containers) Page 11 of 13 �% Document Name: Document Revised: August 4, 2017 J 'A Sample Condition Upon Recei tISCURI Page 2 of 2 Document No.: Issuing Authority: f ceAnalyrlCaj r- 1 p-CAR-CS-033-Rev.04 Pace Quality Office "Check mark top half of box if pH and/or dechlorination is verified and within the acceptance range for preservation samples. "Bottom half of box is to list number of bottles Project' WO# : 92353813 PM: NMG Due Date: 09/18/17 CLIENT: 92-MID ATLAN 's V e V J 6 E J 6 m Q it V J 6 E J 2 as < it j 6 E J 6 m _ 2 z n J a w J a- m N N E C m ry tl 6 E Z T as n iO Z N H E N 6 m v O Z E V 6 m Z y n V in 3 l'J p E 4 LL 3 u Q z W w c E ar .. n V a V = V sa E a .- ,_. U' a a ? y N Q. J E a E m U' a O n` Q `v .�i U' a ry n 0 I a E a E n Ur a u — a Z pV Z Q E N .� n V' a E. > E P U' o _ ry Z > E m U' > n J > E a V > D a > E m U' o a N -.2 N .2 a O > ¢ q j O ' >< > u Vt E 6 n a _ i N E 6 r, — of q O Z 6 of ran 6 m a ] u Z o E J > > 2 u I 2 3 4 5 6 7 a 9 10 11 12 . N\M I N N\1\1 I \1\1 pH Adjustment Log for Preserved Samples Sample ID Type of Preservative pH upon receipt Date preservation adjusted Time preservation adjusted Amount of Preservative added Lot a Page 12 of 13 aceAnalytical Section A Section B RPnulrmd ChPM IM—I nn R... lmd P CHAIN -OF -CUSTODY 1 Analytical Request Document The Chain -of -Custody is a LEGAL DOCUMENT All relevant fields must be completed acLurately Section C Invoice Info V rn Page: of d company Mid -Atlantic Associates, Inc. Report To: Chuck Hoffman (choffman@maaonline.com) Anenbon: Chuck Hoffman Address. 409 Rogers View Court Copy To Ron Davis (rdavis@maaonline.00m Company Name: Mid -Atlantic Associates, inc. REGULATORY AGENCY Raleigh, NC 27610 Addreaa: 409 Rogers View Court. Raleigh, NC r- NPDES F GROUNDWATER ,— DRINKING WATER r UST 7RCRA OTHER Email To: choHman@maaonline.com Ptocnase Omer No.: R2066.05 Pace ou u, Remmacc Phone 919-250-9918 Fa<: 919-250-99so Project Name: Foss Recycling, Inc. - Havelock P.Cn P.,w3 Nicole Gasiorovrski Site Location Manna..: STATE: NC Requesmd Due DaterTAT: sune.m Project Number R2066.00 Task 50000 ^dc<Pmlae s: _ Requested Analysis Filtered (YIN) - Section D Valid Matda Codes ea z R.owmd Ca.m mr.muauon MATRU LODE - 2 COLLECTED Preservatives 3-1N v N v d WwprG.TER ON e O U z p W"TE.TER coy NY/COMPOSITE A$iE w1iER NY/ 8 U TE S P COMPOST - U N 2 aiMT FNwGRIa W N } scausc �oaaoEO c, w O m r ttoo m m SAMPLE ID `ATE "' ' : w m c m Aw aR w a Z (A-Z, M1;) OINER OT p W n Q to L L Sample IDa MUST BE UNIQUE 11aaVE Ts U Z w o m fe too J( W W O N O C T C F m J 7^ -1 F a K y d O p = N L d D N w ¢ a LL o m z U O m t C Q y T To a N DATE TIME DATE TIME TIME N a c' �= S 2 m 2 To Z O r c- W 3 Pace Project NOJ Lab I.D. Rainfall (inches): (Do 1 Outfall No. 1 WT G .Ep 5 7 4 t 2 x x z x 2 H: 3 4" s 8 7 8 9 10. L 71 12 ADOn10NAL OOMMENTS -/ - RELINOUISNEDBY/MRLUITON_-:. - DATE TIME. _ ACCEPTED BY I 4RU,TION DATE TIME! SAMPLECONDITIONS , 7 'J SAMPLER NAME AND SIGNATURE ' c m� in L. mz A Qa'1 PRINT Name Of SAMPLER: R A a $ m o 0 o � m SIGNATURE of SAMPLER: .f�i' 4y e �e!!e JJllI igned (MMD„,,, g 2 V 17 'Imoenam Noe:ev,,u+Reve loonyRa an aceeplNp Pacer NET 30dry paymem temp am.s N I.M. o Wq af1.5% eelnemhfucoy NvaNes ndl ea"-e 30 drys. F-ALL-0-020rev.08. 12-00-2007