MO-29269_48436_CA_WSW_20211129_WSW Sample Results for 15103 Cramur Drive

CHARLOTTE
Laboratory Analysis Report
W tj
E R
Report Date: 11/29/2021
12:01
Environmental Laboratory Services
LOCATION: GWO-96858
CHAIN OF CUSTODY
#: 211117018
LOC ID:
G-PRIV
SAMPLE
DATE -TIME: 11/17/2021 10:35
SAMPLE DESCRIPTION: Grab
Parameter
Result
Units
RL
Method
Start Date / Time
Analyst
Sample ID: A109856
A109856
Pesticide/PCB Extraction
3510C LLE
11/18/2021
12:54
SLT
A109856
Continuous Liq-Liq Extraction
Completed
3520C
11/22/2021
07:54
WMC
A109856
1,1,1,2-Tetrachloroethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,1,1-Trichloroethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,1,2,2-Tetrachloroethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,1,2-Trichloroethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,1-Dichloroethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,1-Dichloroethylene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,1-Dichloropropene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,2,3-Trichlorobenzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,2,3-Trichloropropane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,2,4-Trichlorobenzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,2,4-Tri methyl benzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,2-Dibromo-3-chloropropane (DCP)*
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,2-Dibromoethane (EDB)*
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,2-Dichloroethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,2-Dichloropropane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,3,5-Tri methyl benzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
1,3-Dichloropropane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
2,2-Dichloropropane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Benzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Bromobenzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Bromochloromethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Bromodichloromethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Bromoform
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Bromomethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Carbon Tetrachloride
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Chlorobenzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Chlorodibromomethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Chloroethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Chloroform
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Chloromethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Cis-1,2-Dichloroethylene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Cis-1,3-Dichloropropene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Dibromomethane
<
ug/L
0.5
EPA524.2
11/18/2021
12:51
MLL
A109856
Dichlorodifluoromethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Dichloromethane (methylene chloride)
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Ethylbenzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Fluorotrichloromethane
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Hexachlorobutadiene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
lsopropyl benzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
m&p-Xylene
<
ug/L
1.0
EPA 524.2
11/18/2021
12:51
MLL
A109856
m-Dichlorobenzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Methyl-t-butyl ether (MTBE)
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Naphthalene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
n-Butylbenzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
n-Propylbenzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
o-Chlorotoluene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
o-Dichlorobenzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
o-Xylene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
p-Chlorotoluene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
p-Dichlorobenzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
Page 1 of 4

CHARLOTTE
Laboratory Analysis Report
Wb,TER
Report Date: 11/29/2021
12:01
Environmental Laboratory Services
LOCATION: GWO-96858
CHAIN OF CUSTODY #: 211117018
LOC ID:
G-PRIV
SAMPLE
DATE -TIME: 11/17/2021 10:35
SAMPLE
DESCRIPTION: Grab
Parameter
Result
Units
RL
Method
Start Date / Time
Analyst
A109856
p-Isopropyltoluene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Sec -Butyl benzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Styrene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Tert-Butylbenzene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Tetrachloroethylene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
AI09856
Toluene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Trans-1,2-Dichloroethylene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Trans-1,3-Dichloropropene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MILL
A109856
Trichloroethylene
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
Vinyl Chloride
<
ug/L
0.5
EPA 524.2
11/18/2021
12:51
MLL
A109856
4,4'- DDD
<
ug/L
0.10
SW846 8081B
11/19/2021
12:38
SLT
A109856
4,4'- DDE
<
ug/L
0.10
SW846 8081B
11/19/2021
12:38
SLT
A109856
4,4'- DDT
<
ug/L
0.10
SW846 8081B
11/19/2021
12:38
SLT
A109856
Aldrin
<
ug/L
0.05
SW846 8081 B
11/19/2021
12:38
SLT
AI09856
alpha-BHC
<
ug/L
0.10
SW8468081B
11/19/2021
12:38
SLT
A109856
beta-BHC
<
ug/L
0.10
SW846 8081B
11/19/2021
12:38
SLT
A109856
Chlordane (Technical)
< 0.40
ug/L
0.40
SW846 8081 B
11/22/2021
13:34
SLT
A109856
delta-BHC
<
ug/L
0.05
SW8468081B
11/19/2021
12:38
SLT
A109856
Dieldrin
<
ug/L
0.10
SW8468081B
11/19/2021
12:38
SLT
A109856
Endosuifan I
<
ug/L
0.05
SW846 8081 B
11/19/2021
12:38
SLT
A109856
Endosuifan II
<
ug/L
0.10
SW846 8081 B
11/19/2021
12:38
SLT
A109856
Endosuifan sulfate
<
ug/L
0.10
SW846 8081 B
11/19/2021
12:38
SLT
A109856
Endrin
<
ug/L
0.10
SW846 8081 B
11/19/2021
12:38
SLT
A109856
Endrin aldehyde
<
ug/L
0.10
SW846 8081 B
11/19/2021
12:38
SLT
A109856
gamma-BHC (Lindane)
<
ug/L
0.05
SW846 8081 B
11/19/2021
12:38
SLT
A109856
Heptachlor
<
ug/L
0.05
SW8468081B
11/19/2021
12:38
SLT
A109856
Heptachlor epoxide
<
ug/L
0.10
SW846 8081B
11/19/2021
12:38
SLT
A109856
Methoxychlor
<
ug/L
0.10
SW846 8081 B
11/19/2021
12:38
SLT
A109856
Toxaphene
< 1.0
ug/L
1.0
SW846 8081 B
11/19/2021
12:34
SLT
A109856
1,2,4,5 Tetrachlorobenzene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
1,2,4-Trichlorobenzene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
1,2-Dichlorobenzene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109866
1,3-Dichlorobenzene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
1,4-Dichlorobenzene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
1-Chloronaphthalene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2,3,4,6-Tetrachlorophenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2,3-Dichloraniline
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2,4,5-Trichlorophenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2,4,6-Trichlorophenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2,4-Dichlorophenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2,4-Dimethylphenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2,4-Dinitrophenol
<
ug/L
20
SW846 8270E
11/22/2021
17:03
WMC
A109856
2,4-Dinitrotoluene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2,6-Dichlorophenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2,6-Dinitrotoluene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2-Chloronaphthalene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2-Chlorophenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2-Methyl naphthalene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2-Methylphenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2-Nitroaniline
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
2-Nitrophenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
3,3'-Dichlorobenzidine
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
3-Nitroaniline
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
Page 2 of 4

CHARLOTTE
Laboratory Analysis Report
W6TER
Report Date: 11/29/2021
12:01
Environmental Laboratory Services
LOCATION: GWO-96858
CHAIN OF CUSTODY #: 211117018
LOC ID:
G-PRIV
SAMPLE
DATE -TIME: 11/17/2021 10:35
SAMPLE DESCRIPTION: Grab
Parameter
Result
Units
RL
Method
Start Date / Time
Analyst
A109856
4,6-Dinitro-2-methylphenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
4-Bromophenyl-phenylether
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
4-Chloro-3-methylphenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
4-Chloroaniline
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
4-Chlorophenyl-phenylether
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
4-Methylphenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
4-Nitroaniline
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
4-Nitrophenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Acenaphthene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Acenaphthylene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Acetophenone
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Alpha-Terpineol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Aniline
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Anthracene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Benzidine
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Benzo [g,h,i] perylene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Benzo(a) anthracene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Benzo[a]pyrene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Benzo[b]fluoranthene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Benzo[k]fluoranthene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Benzoic acid
<
ug/L
25
SW846 8270E
11/22/2021
17:03
WMC
A109856
Benzyl alcohol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
bis(2-Chloroethoxy)methane
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Bis(2-chloroethyl) ether
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
bis(2-chloroisopropyl) ether
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
bis(2-Ethylhexyl)phthalate
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Butylbenzylphthalate
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Carbazole
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Chrysene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Dibenz[a,h]anthracene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Dibenzofuran
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Diethylphthalate
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Dimethylphthalate
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Di-n-butylphthalate
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Di-n-octylphthalate
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Diphenylhydrazine
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Fluoranthene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Fluorene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Hexachlorobenzene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Hexachlorobutadiene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Hexachlorocyclopentadiene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Hexachloroethane
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
lndeno[1,2,3-cd]pyrene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
AI09856
lsophorone
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
AI09856
Napthalene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
n-Decane
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Nitrobenzene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
N-Nitrosodimethylamine
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
n-Nitroso-di-n-propylamine
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
N-Nitrosodiphenylamine
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
n-Octadecane
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Pentachlorobenzene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Pentachlorophenol
<
ug/L
10
SW846 8270E
11/22/2021
17:03
WMC
Page 3 of 4

CHARLOTTE
Laboratory Analysis Report
WtReport Date: 11/29/2021 12:01
jTER
Environmental Laboratory Services
LOCATION: GWO-96858 CHAIN OF CUSTODY #: 211117018
LOC ID: G-PRIV
SAMPLE DATE -TIME: 11/17/2021 10:35
SAMPLE DESCRIPTION: Grab
Parameter
Result
Units
RL
Method
Start Date / Time
Analyst
A109856
Phenanthrene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Phenol
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Pyrene
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Pyridine
<
ug/L
5
SW846 8270E
11/22/2021
17:03
WMC
A109856
Nitrate
1.2
mg/L
0.05
EPA353.2-93
11/18/2021
14:16
MSC
A109856
Nitrate/Nitrite
1.2
mg/L
0.05
EPA353.2-93
11/18/2021
14:16
MSC
A109856
Nitrite
<0.05
mg/L
0.05
EPA353.2-93
11/18/2021
13:22
MSC
A109856
E. Coli-PA
Absent
P/A
SM 9223B
11/17/2021
15:21
KAH
A109856
Total Coliform- P/A
Absent
P/A
SM 9223B
11/17/2021
15:21
KAH
Comment: 524: EPA 524.2 is not an approved method for 1,2-dibromo-3-chloropropane (DBCP)
and 1,2-dibromoethane (EDB).
Gina H. Kimble, Laboratory Supervisor:
.'° `" The results contained in this report are specific to the samples listed above.
CHARLOTTE WATER -Environmental Laboratory Services
4222 Westmont Drive, Charlotte, North Carolina 28217
N.C. Certification 192, N.C.DHHS Certification 37417, EPA Cert 01215
Page 4 of 4

CHARLOTTE-MECKLENBURG UTILITY DEPARTMENT
ENVIRONMENTAL LABORATORY SERVICES CHAIN OF CUSTODY RECORD
4222 Westmont Drive, Charlotte, NC 28217 (704) 336 - 2854 or (704) 622 - 7280 CHARIDTTE- COC #;
CHAR 0 KLEHsUA�
NC DENR Certification No.192; NC DHHS Certification No. 37417; US EPA Certification No. 01215 CHA8 OU E-MECKL'ENZURG z�1117 / ! PAGE 1 OF 1
LITY UTIDECAR—EN 0L
CLIENT: Mecklenburg County, LUESA- Groundwater & Wastewater Services Send REPORT To: Send INVOICE To: Sa Ied By (Print Na
FACILITY: Groundwater (POTABLE WATER) Heather Ray Jeremy Michael -iT / C{
ADDRESS: 15915 Cramur Or 3205 Freedom Drive, Suite 8000 3205 Freedom Drive, Suite 8000 W tnessed By (Print & Sign Nam - If Applicable):
LAB CODE: REAL PRIG NEW TNC MPL PME AMB LM OTHER Charlotte, NC 28208 Charlotte, NC 28208
(circle one)
IN
Sample Collection
logo
mm�IN�NI�
Chemical
Preservative
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Instructions: Complete all yellow shaded areas. Blue areas are for LAB USE ONLY.
Relinq ' h y: (Sig re)
Receiv by: (Signature)
Date:
Military Time:
For each parameter requested, circle the "x" to verify your request.
l 17 f
L3a
Relinquished by: (Signature)
R ceived by: (Signature)
Date:
MilitaryTime:
Nutrients include: Nitrate/Nitrite, TKN, Total Phosphours, Ammonia
Itemize Metals Here:
Relinquished by: (Signature)
Received by: (Signature)
Date:
Military Time:
For Composite samples, record the autosampler BEGIN and END date/time.
For Grab samples, record the collection time as the BEGIN date/time only.
Relinquished by: (Signature)
Received by: (Signature)
Date:
Military Time:
Comments: —3-DAY TAT REQUESTED—
Form Revision U8; Ettective April 1, 202 LaD GooeS: KCAL = Neal tSiaie; i-Kiv = t'nvate Well; INtvv = riew t-ermlttea vven; i Ivl = i ransient ivon-UOmmunity; AlvlC7 = AmDlerlt; uvl = L"dna00

CHARLOTTE WATER - Environmental Laboratory Services
Sample Receipt Checklist
Completed by Initials: Date/Time: &J J-I / / 5c/ COC#: 21111701
Sample Matrix: Wastewater ElDrinking Water DCryptolGiardia (LT2) Other:
Field Analysis/Information Only (No cooler)
CustodySeal(s) Intact?: Yes E]No F_-_JN/A Type of Ice Used: Wet Blue
Shipping Container Intact: Yes E]No [§N/A Dry Ice ONone
Thermal Preservation: *Sample Temperature measured immediately after removal from cooler.
*Notify management immediately of any sample that did not meet temperature requirements or frozen.
*If multiple parameters, in additional to BacT are collected for a site, a receipt temperature for the BacT plus
another bottle must be measured and recorded on the COC.
Requirements: DW: <_ WC WW: <_ WC BacT: <_ 10°C LT2 Crypto/Giardia: <_ 20°C LT2 E. coli: <_ 10°C
Do sample receipt temperatures meet requirements (including requirement by downward trend)? EYes []No, explain below.
Downward trend required to meet requirement? DYes
* At time of receipt into the laboratory, the allowed downward trend may be applied to meet temperature requirement. Initial temperature
from the sample collector becomes critical. If samples are received next day, receipt temperatures must meet requirements listed above.
Chemical Preservation: Note: *If samples are not preserved correctly, notify Personnel. Do not check BacT, TOC, VOA, THM and HAA.
All containers needing preservation are found to be in EPA compliance? F�]`l'es E]No F]N/A
If no, explain.
*If the pH of a metals(excluding H is incorrect these steps are followed: *If the pH of any other chemically preserved sample is incorrect
1. On COC, document sample pH prior to adding additional preservative. (not including metals), follow these steps:
2. Document "pH NOT MET" on container. 1. Notify immediately of sample incorrectly preserved. Qualify
Date/time of preservation will be captured on the lid, when additional sample not properly preserved on the COC and in LIMS.
HNO3 Acid is added to achieve pH < 2. No comment in LIMS required.
Option: Substitute a correctly preserved bottle. Document on COC & notify personnel. Write "DO NOT USE" on the incorrectly preserved bottle.
No comment in LIMS requires when a sample with correct preservative is substituted.
COC Properly Filled Out? ®Yes E]No If no, explain.
COC Correction sent to Project Manager? Yes RNo ®N/A
Do sample labels agree with the COC? ®Yes E]No If no, explain.
All sample bottles accounted for? ®Yes No Samples Arrived within Hold Time? P-4l'es RNo, & notify Project Mgr.
Correct Bottles Used? MYes E]No
VOA Vials have Zero Headspace (< 6 mm)? ❑Yes RNo DN/A *Bubbles should be no larger than:
If no, notify Laboratory Section Supervisor.
Short Hold Analyses (< 48 hrs.)? D (es No Rush Turn Around Time (TAT)? Yes —
If yes, notify Laboratory Section(s). If yes, notify Project Manager
Addition Information Comments:
Preliminary COC Review (Optional): Initials: Date:
REC-100_FORM_Sample_Rec_Checldist
EFF030521 This printed copy is an UNCONTROLLED copy of the online CONTROLLED document.