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HomeMy WebLinkAboutNCG100036_Monitoring Report_202206290 Mid Atlantic Experienced. Customer Focused. Innovative. e9��di �o REPORT DATE: June 14, 2022 PROJECT NO: R2472.00 STORMWATER SAMPLING RESULTS Schronce Used Parts and Cars Inc. 2256 Recycling Road, Conover, Catawba County, North Carolina ENGINEERING & ENVIRONMENTAL SOLUTIONS PREPARED FOR: I PREPARED BY: Schronce Used Parts & Cars Inc. MID ATLANTIC ASSOCIATES, INC. PO Box 1267 409 Rogers View Court, Raleigh, NC 27610 Conover, NC 28613 919.250.99181 MAAONLINE.COM NCDEQ Division of Energy, Mineral and Land Resources Stormwater Discharge Monitoring Report (DMR) Form for NCG106009 Used Motor Vehicles o��yppG2� Click here for instructions �N07 Q Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) 01aj6ad form within 30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLRiegional Office. Certificate of Coverage No. NCG10 0036 Person Collecting Samples: Keith Shronce Facility Name: Shronce Used Parts & Cars Inc. Laboratory Name: Pace Analytical Facility County: Catawba Laboratory Cert. No.: 12 Discharge during this period: E]Yes 13 No (if no, skip to signature and date) Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?©Yes No If so, which Tier (I, II, or III)? A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR Y1717 es RNo Date Uploaded: Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red) Parameter Code Parameter Outfall 001 Outfall Outfall Outfall Outfall N/A Receiving Stream Class WS-IV N/A Date Sample Collected MM/DD/YYYY 05/24/2022 46529 24-Hour Rainfall in inches 0.50 C0530 TSS in mg/L (100 or 50*) 26.0 pH in standard units (6.0 — 9.0 FW, 00400 6.8 — 8.5 SW) 6.2 Chemical Oxygen Demand in mg/L 00340 (120) 35.2 Lead, total recoverable (as Pb) in 01051 mg/ L (0.075 FW, 0.22 SW) 0.02 Ethylene Glycol in mg/ L (any amount 77023 detected Tier One; 8,000 mg/L Tier <5.0 Two and Three) 00552 Non -Polar Oil & Grease in mg/L (15) <4.8 Estimated New Motor/Hydraulic Oil NCOIL Usage in gal/month N/A * Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA) have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L FW (Freshwater) SW (Saltwater) Notes (optional): "I certify by my signature below, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons Who manage the system, 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." Email Address 6-.Q 6 ^ a 0 Date Phone Number _ aceAnalytical www.pacelabs.com June 08, 2022 Chuck Hoffman Mid -Atlantic Associates, Inc 409 Rogers View Court Raleigh, NC 27610 RE: Project: SCHRONCE USED AUTO & CARS Pace Project No.: 92606687 Dear Chuck Hoffman: Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 o °!0, Enclosed are the analytical results for sample(s) received by the laboratory on May 25, 2022. The results relate only to the samples included in this report. Results reported herein conform to the applicable TNI/NELAC Standards and the laboratory's Quality Manual, where applicable, unless otherwise noted in the body of the report. The test results provided in this final report were generated by each of the following laboratories within the Pace Network: • Pace Analytical Services -Asheville • Pace Analytical Services - Charlotte • Pace Analytical Services - Peachtree Corners, GA • Pace Analytical Services - Indianapolis If you have any questions concerning this report, please feel free to contact me. Sincerely, Tyriek Hooks tyriek.hooks@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 14 I^aAnalytical xw.poelabsmn CERTIFICATIONS Project: SCHRONCE USED AUTO & CARS Pace Project No.: 92606687 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Pace Analytical Services Indianapolis 7726 Moller Road, Indianapolis, IN 46268 Michigan Drinking Water Laboratory #9050 Illinois Accreditation M 200074 Ohio VAP Certified Laboratory #: CL0065 Indiana Drinking Water Laboratory M C-49-06 Oklahoma Laboratory M 9204 Kansas/TNI Certification M E-10177 Texas Certification #: T104704355 Kentucky UST Agency Interest #: 80226 Wisconsin Laboratory #: 999788130 Kentucky WW Laboratory ID #: 98019 USDA Soil Permit #: P330-19-00257 Pace Analytical Services Charlotte South Carolina Laboratory ID: 99006 South Carolina Certification #: 99006001 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 South Carolina Drinking Water Cert. #: 99006003 North Carolina Drinking Water Certification #: 37706 Florida/NELAP Certification M E87627 North Carolina Field Services Certification #: 5342 Kentucky UST Certification #: 84 North Carolina Wastewater Certification #: 12 Louisiana DoH Drinking Water #: LA029 South Carolina Laboratory ID: 99006 Virginia/VELAP Certification M 460221 Pace Analytical Services Asheville 2225 Riverside Drive, Asheville, NC 28804 South Carolina Laboratory ID: 99030 Florida/NELAP Certification #: E87648 South Carolina Certification #: 99030001 North Carolina Drinking Water Certification #: 37712 Virginia/VELAP Certification #: 460222 North Carolina Wastewater Certification M 40 Pace Analytical Services Peachtree Corners 110 Technology Pkwy, Peachtree Corners, GA 30092 North Carolina Certification #: 381 Florida DOH Certification #: E87315 South Carolina Certification #: 98011001 Georgia DW Inorganics Certification M 812 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 latCAUAnalytical SAMPLE ANALYTE COUNT Project: SCHRONCE USED AUTO & CARS Pace Project No.: 92606687 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92606687001 OUTFALL NO.01 EPA 1664B REL 1 PASI-C EPA 8015 Alcohol -Glycol CPH 1 PASI-I EPA 601 OD KH 1 PASI-GA SM 254OD-2015 MA132 1 PASI-A SM 5220D-2011 JP1 1 PASI-A PASI A = Pace Analytical Services -Asheville PASI-C = Pace Analytical Services - Charlotte PASI-GA = Pace Analytical Services - Peachtree Comers, GA PASI-I = Pace Analytical Services - Indianapolis 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 ICeAnalytical ° ANALYTICAL RESULTS Project: SCHRONCE USED AUTO & CARS Pace Project No.: 92606687 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Sample: OUTFALL NO.01 Lab ID: 92606687001 Collected: 05/23/22 15:30 Received: 05/25/22 14:58 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 1664 SGT-HEM, TPH Analytical Method: EPA 1664B Pace Analytical Services - Charlotte Total Petroleum Hydrocarbons ND mg/L 4.8 1 06/01/22 01:00 8015M Glycols in water Analytical Method: EPA 8015 Alcohol -Glycol Pace Analytical Services - Indianapolis Ethylene glycol ND mg/L 5.0 1 06/06/22 16:53 107-21-1 601 OD ATL ICP Analytical Method: EPA 601 OD Preparation Method: EPA 3010A Pace Analytical Services - Peachtree Corners, GA Lead ND ug/L 20.0 1 05/27/22 14:28 05/28/22 05:09 7439-92-1 2540D Total Suspended Solids Analytical Method: SM 254OD-2015 Pace Analytical Services -Asheville Total Suspended Solids 26.0 mg/L 4.2 1 05/27/22 11:29 5220D COD Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011 Pace Analytical Services -Asheville Chemical Oxygen Demand 35.2 mg/L 25.0 1 06/02/22 02:44 06/02/22 05:58 Date: 06/08/2022 03:22 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 4 of 14 Pace Analytical Services, LLC ® 9800 Kincey Ave. Suite 100 laucmnalytical Huntersville, NC 28078 www.pacelabs.com (704)875-9092 QUALITY CONTROL DATA Project: SCHRONCE USED AUTO & CARS Pace Project No.: 92606687 QC Batch: 701430 Analysis Method: EPA 1664B QC Batch Method: EPA 1664B Analysis Description: 1664 SGT HEM, TPH Laboratory: Pace Analytical Services - Charlotte Associated Lab Samples: 92606687001 METHOD BLANK: 3661318 Matrix: Water Associated Lab Samples: 92606687001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Petroleum Hydrocarbons mg/L ND 5.0 06/01/22 01:00 LABORATORY CONTROL SAMPLE: 3661319 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Petroleum Hydrocarbons mg/L 20 23.0 115 64-132 MATRIX SPIKE SAMPLE: 3661320 92606817002 Spike MS MS % Rec Total Petroleum Hydrocarbons mg/L <5.0 19.6 SAMPLE DUPLICATE: 3661321 92606684002 Parameter Units Result Total Petroleum Hydrocarbons mg/L ND Dup 25.1 127 64-132 RPD Qualifiers ND 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: 06/08/2022 03:22 PM without the written consent of Pace Analytical Services, LLC. Page 5 of 14 lacmnalj4ical www.pacelabs.com QUALITY CONTROL DATA Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: SCHRONCE USED AUTO & CARS Pace Project No.: 92606687 QC Batch: 680280 Analysis Method: EPA 8015 Alcohol -Glycol QC Batch Method: EPA 8015 Alcohol -Glycol Analysis Description: EPA 8015 Modified Laboratory: Pace Analytical Services - Indianapolis Associated Lab Samples: 92606687001 METHOD BLANK: 3131067 Associated Lab Samples: 92606687001 Parameter Units Ethylene glycol mg/L LABORATORY CONTROL SAMPLE: 3131068 Parameter Units Ethylene glycol mg/L Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 5.0 06/06/2216:44 Spike LCS LCS % Rec Conc. Result % Rec Limits Qualifiers 25 21.2 85 34-150 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 3131069 3131070 MS MSD 92606687001 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 25.1 19.5 100 78 39-168 25 R1 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: 06/08/2022 03:22 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 14 'D IUuAnalytical ..rcwewrmn QUALITY CONTROL DATA Project: SCHRONCE USED AUTO & CARS Pace Project No.: 92606687 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QC Batch: 701011 Analysis Method: EPA 601 OD QC Batch Method: EPA 3010A Analysis Description: 601 OD ATL Laboratory: Pace Analytical Services - Peachtree Corners, GA Associated Lab Samples: 92606687001 METHOD BLANK: 3659064 Matrix: Water Associated Lab Samples: 92606687001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Lead ug/L ND 20.0 05/28/22 03:28 LABORATORY CONTROL SAMPLE: 3659065 Spike LCS LCS % Rec Lead ug/L 1000 1040 104 80-120 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 3659066 3659067 MS MSD 92601240001 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual Lead ug/L ND 1000 1000 1040 1040 104 104 75-125 0 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: 06/08/2022 03:22 PM without the written consent of Pace Analytical Services, LLC. Page 7 of 14 ICeAnalyticalwwpacellbstom QUALITY CONTROL DATA Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: SCHRONCE USED AUTO & CARS Pace Project No.: 92606687 QC Batch: 700922 Analysis Method: SM 2540D-2015 QC Batch Method: SM 2540D-2015 Analysis Description: 2540D Total Suspended Solids Laboratory: Pace Analytical Services -Asheville Associated Lab Samples: 92606687001 METHOD BLANK: 3658575 Matrix: Water Associated Lab Samples: 92606687001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg/L ND 2.5 05/27/22 11:25 LABORATORY CONTROL SAMPLE: 3658576 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Suspended Solids mg/L 250 240 96 90-110 SAMPLE DUPLICATE: 3658723 92606519002 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 25.6 26.0 2 SAMPLE DUPLICATE: 3658724 Parameter Total Suspended Solids 92606043001 Dup Units Result Result RPD Qualifiers mg/L 21.2 35.0 49 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, Date: 06/08/2022 03:22 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 14 raneAnalytical www.pacelabs.com QUALITY CONTROL DATA Project: SCHRONCE USED AUTO & CARS Pace Project No.: 92606687 QC Batch: 701773 Analysis Method: SM 5220D-2011 QC Batch Method: SM 5220D-2011 Analysis Description: 5220D COD Laboratory: Pace Analytical Services -Asheville Associated Lab Samples: 92606687001 METHOD BLANK: 3662902 Associated Lab Samples: 92606687001 Parameter Units Chemical Oxygen Demand mg/L Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 25.0 06/02/22 05:54 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 LABORATORY CONTROL SAMPLE: 3662903 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Chemical Oxygen Demand mg/L 750 767 102 90-110 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 3662904 3662905 MS MSD 92605852001 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual Chemical Oxygen Demand mg/L 37.6 100 100 149 149 112 112 90-110 0 M1 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 3662906 3662907 MS MSD 92606687001 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual Chemical Oxygen Demand mg/L 35.2 100 100 137 140 102 105 90-110 2 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: 06/08/2022 03.22 PM without the written consent of Pace Analytical Services, LLC. Page 9 of 14 lacoceAnalytical vaMen.ee.� QUALIFIERS Project: SCHRONCE USED AUTO & CARS Pace Project No.: 92606687 DEFINITIONS 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. Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 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. Reported results are not rounded until the final step prior to reporting. Therefore, calculated parameters that are typically reported as "Total" may vary slightly from the sum of the reported component parameters. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI - The NELAC Institute. ANALYTE QUALIFIERS D6 The precision between the sample and sample duplicate exceeded laboratory control limits. M 1 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: 06/08/2022 03:22 PM without the written consent of Pace Analytical Services, LLC. Page 10 of 14 IUvAnalytical� QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: SCHRONCE USED AUTO & CARS Pace Project No.: 92606687 Lab ID 92606687001 92606687001 92606687001 92606687001 92606687001 Sample ID OUTFALL NO.01 OUTFALL NO.01 OUTFALL NO.01 OUTFALL NO.01 OUTFALL NO.01 Date: 06/08/2022 03:22 PM Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QC Batch Method QC Batch Analytical Method EPA 1664B 701430 EPA 8015 Alcohol -Glycol 680280 EPA 3010A 701011 EPA 601 OD SM 2540D-2015 700922 SM 5220D-2011 701773 SM 5220D-2011 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Analytical Batch 701074 701796 Page 11 of 14 : Mpt-MMIM! Date: 05421202105[12/2022 AstmW-Ef Ecren eustady,seauoresnn "m Dyes Raleigh[]' Mechadcsv&[] Atlantao K&p NO#: 92606687 Ouient IIIIII 92608687 5 . Gibladcatrissue Fmin Dyes Duo �fa Greenwood Ifuntersvilte 9WO__-" S.04 ltk6al Elves Offivne El Other V t/ % V %A, J Typed lee "ismpastor: Cooler Temp.: 4-t -1 Add/Suarget 1 — Cooler Temp. Correctect rtjr L)5PA-,ReZ;Afi3ted'SoA fvNlk, *der .51inpio Oref mnJOlaarWoaMn irq.uaTardIne"t1e.VtfkA the United StatAp CAjAy.,.6rSe MY c1rane T-err# shad. bea[bove freezkta s-c Noosoutd tEffip-OTeft. Saiinpl6on ice, umllh& pr,,m fiastiegun Did implaadditau kc)rrL-a Foreign source OnWizatronsilk incurang. rawas ana vuerto Chaj"FE"dy Pcft.enO OWA Saml*Affbied wMAMId-arae? QKq E191A 2. 5 h a mt E rd Ic F T I ift'gria Lys� to 1 rw. KtahTijrn.AraiinctTiMeKequestid?. OId OWA SuffidenNstiume? ebrredContainers 45ed! yeq [IN* [INfA rm. -RamCentaiiiers Usedrt Om. EIWA OWb. [3WA 7. OlsselwdanaN11- Sam.pies FieltrFifteFecp k Sam-p.feUbeN Nraidh CDC? ;6es pegEINtA -Mc1udes.DatqtE1-meAQJAmlysN MN., & 0 ' Np! 0Ot- A Ia. .Tarp WdrikPresent? Ores 26 Tnp Wank Cus.WcJVSqab.pMsj!ntT QYes OOK./ ONIA, MEpfrs/§Ampu OISCIFPANFV- neon uam nequtre*7 UYes... UNo Lot Ir—L CMW NOTIFICATION/RESOLUTION Person contacted--. Datemme. Project Manager SCURF Review: Date: Pro edManAFerSRF_Revie,.,v__ Qualtrax IDA96T4 Page 1 of 2 Page 12 of 14 O �� GO Go, .. o a � a o C4 -11aaaaaaa 0*: CL 4, At. W. im. a, a Cl, CL. St Ic {VA4VISIA PermasmodkAll 4 'A (Rel'" WO -AWId 110161-t-ItV dtZ--tl*dl; MIA-; W/M) allseld.-011ms (VIN) "dfH'V*A jkV -CW-ASbO - - - t. -&*- Vwf") POP-04"011"dun 'WAD^ WN) WkStW VbA !W-60-11-66A. (41b � N)-*btpjqN.A;bqWV""IW GSZAV19!90- zzv Zz. ZK7 Qll "d).V.Ogtj4 A4tAiV,j%0-0ft-,fl!bV Z.- Z It-P Hd) jbqWVjjwosvne9v y f-M.) R/N) 00m#t&rd6A jb4W* Jahfarunmv I -(Ijz)..(tr;n- 14d)- mem OP'F.eld:IW. s QNSodis. - ZZ it NO) 9ONN -01TORd4W b9Z-Ai9d ZI W--- a �-p) (.VIN) -1parAjft6.rdUfV 01106191W §ltz-htwifil !F "It ,1'!aceAnalytical CHAIN -OF -CUSTODY / Analytical Request Document The Chain -of -Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately. Section A Section B Section C Page: of Required Client Information: Required Project Information: Invoice Information: Campany. Mid -Atlantic Associates, Inc. Report To: Ron Davis (rdavis@maaonline.com) Attention: Ron Davis Address: 409 Rogers View Court Copy To: Beverly Oglesby (boglesby@maaonline.com Company Name: Mid -Atlantic Associates, inc. REGULATORY AGENCY Raleigh, NC 27610 Address: 409 Rogers View Court, Raleigh, NC F NPDES r GROUND WATER (— D Purchase Ober No.: R2472.00 Pace quote -- UST i— RCRA I— O Email To: rdavis@maaonline.com Reference: Phone: 919-250-9918 Fax: 919-250-9950 Projed Name: Schronce Used Auto & Cars R�� �' Nicole Gasiorowski site Location NC Requested Due DateITAT: Standard Project Number. R2472.00 Pace Profile: -- STATE: Requested Analysis Filtered (YIN) INKING WATER ER w l= Section D Valid Matrix Codes Required Client infonnatlon MATRIX 99 DRINXING WATER OW WATER WT WASTE WATER WW PRODUCT P SOOIUSQLID SAMPLE I D �R E AIi IL OL (A-Z, 0-9 i,-) OTHER OT Sample IDs MUST BE UNIQUE nssuE Ts Outfall No. 1 m .2 a 1 � 2 I `" p U X f�.. a WT ii o U 0 cc O " W CL W a a rn G3 COLLECTED Z 1— J O Q a 0. a N Co z Q z t� U. o 7 Preservatives z 1;* N Y N Y Ar COMPOSITE START COMPOSITE ENDIGRAB yy a c 4 '� 0 N _ 0— Z _ 1 t� = 2 _ O M Z 4 t N ro z o tCII m L t -- 0 � iA c 4 '♦ CO 13: CO x CO � .0 a x — � (' c m t .0.0 W x N 12 > t'i � O 1— tU _I x M 4) � 0 m � O c� m t U x Z } C 0 (� .0 a Pace Rainfall eject NoJ Lab I.D. ches : 21' DATE .. TIME DATE �' TIME 3= H: � 2 3 4 5 6 7 8 9 10 11 12 ADDITIONAL COMMENTS RELINQUISHED BY / FILIATION DATE TIME ,ACCEPTED !21.IFFIUATION DATE TIME SAMP CONDITIONS 5;7- S PAa HvL I&IT, y t*--f SAMPLER NAME AND SIGNATURE m Q� PRINT Name of SAMPLER: ! O i �V V DATE Signed �� ,`�� ,� SIGNATURE of SAMPLER: MMfDD vtJ a m o } a�� �— ? } o .. '' L 30 � 1 g t', v M .. m E.. e, N 'important Note: By signing this form you are accepting Pace's NET 30 day payment terms and agrooing to late charges of 1.6% per month for any involcos not paid wtthin 30 days. F-ALL-0-020rev.0 , 12-Oct 2007