HomeMy WebLinkAboutNCG140072_MONITORING INFO_20061106STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE.
❑ HISTORICAL FILE
V MONITORING REPORTS
DOC DATE
❑ a U() L4
YYYYMMDD
DISCHARGE OUTFALL MONITORING REP [
NCDENR GENERAL PERMIT NCG140000 1
I Nrn► 6 2006
(All sample data shall be reported no later than 30 days after receipt of tab results)- - DENR RALEIGH REGIONAL OFFICE
Certificate of Coverage
NCG14 pD D�fl ij
Facility Name
County
/
F. t ahL I'd .•-a
Phone Number
- ' S { 7 $!r 1
Certified Laboratory #
3
Person Collecting Sample(s)
f
Collectors Signature
Sample Information
Permit Term
Year
Year Start/End Dates
-
Place check mark to indicate
applicable sampling plod
Discharge Type (check
as appropriate)
Stormwater.
❑
❑ "
❑
❑
Wastewater
❑
❑
❑
❑
❑
I
August 1, 2004 to Jul 31, 2005
[�
❑
(
❑
❑
2
August 1, 2005 to July 31, 2006
3
August 1, 2006 to July 31, 2007
4
August 1, 2007 to July 31, 2008
5
August 1, 2008 to Jul 31, 2009
Part A: Stormwater Discharge Monitoring Data (For stormwater not combined with process wastewater)
Storm Event Characteristics
Date
Total Event Preci itation (inches)
Event Duration (hours)
— lei — 6S'
S'
Stormwater Discharge Monitoring
Outfall
No.
. Date Sample
Collected
(mo/dd/vr)
Total Flow
Total Event
Precipitation
(inches)
Event Duration
hours
pH
(Std. Units)
Total
Suspended
Solids
(mJl)
Does this facility perform Vehicle Maintenance Activities using on average more than 55 gallons of new motor
oil per month? ❑ YeS XNo If yes. complete information below.
Stormwater Discharge Monitoring from Vehicle Maintenance Areas
Outfall
No.
Date Sample
Collected
(mo/dd/ r)
Total Flow
(MG)
Total Event
Precipitation
(inches) ,�.
Event
Duration
(hours)'
New
Motor Oil
Usage
(gaUmo)'
pH
(Std. Units)
Total
Suspended
Solids
mg O
Oil and
Grease
(mg 1)
SwU-241-080104 Page lof2
Part B;: Process wastewater discharge monitoring data
.... ...... ......... .
Ca.
Sample #
Effluent Source(s) for'this sample
Vehicle / Equipment Cleaning
Raw Material Stock -pile Wettin ❑
Mixing Drum Clean -out ❑
Recycle System Overflow ❑
Parameter '•
Unit , .1
Dgta
) ,I —
Collection Date
mo/dd/yr
Total Flow'-
MG
Event Duration
hours
f _ i
pH
Sid. units
Z
TSS
mgft
Settleable Solids
MIA
Sample #
Effluent Source(s) for this sample
Vehicle / E ui ment Cleaning
❑
Raw Material Stock -pile Wetting
❑
Mixing Drum Clean -out
❑
Recycle System Overflow
❑
Parameter
Unit
Data
Collection Date
mo/dd/yr
'
Total Flow
MG
Event Duration
hours
pH
Std. units
TSS
mgn
Settleable Solids
mul
Mail original and one copy to:
Attn: Central Files
Division of Water Quality
DENR
1617 Mail Service Center
Raleigh, NC 27699-1617
SW IJ-24 t -080I o4
Sample # 7-
Effluent Source(s) for this sample
4 �
Vehicle / Equipment CleaningImo'
Raw Material Stock -pile Wetting
❑
Mixing Drum Clean -out
❑
Recycle- System Overflow
❑
Parameter'• •'
- • Unit -.,
Data
Collection Date :
�,mo/dd/yr
Total Flow,
<,MG
l
Event Duration
hours
pH
Std. units
,
TSS
mg/l
,Settleable Solids
MIA
Sample # _
Effluent Sources forthis•sam le
/
Vehicle / Equipment Cleaning
❑
Raw Material Stock -pile Wettin
❑
Mixing Drum Clean -out
❑
Recycle System Overflow
❑
Parameter
Unit
Data
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration
hours
pH
Std. units
TSS
mg/1
Settleable Solids
myl
"1 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 f,--- Ind imprisonment for knowing
violations."
(Print N*(Sirl-
,— r n 1:re. ,.__')
of Yermtttee or t)esignee tDate)/
Paec 2 of 2
a
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
. ,i__ r,
Permit No.: N/C/_/ /_/ / / /_/ or Certificate of Coverage N
Facility Name: e % .4-- or
County: fig' a ej Phone No.
Inspector: kol 6 y 60`
Date of Inspection:
i
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
%(cr� .4%e�
(Signature of Permittee or Designee)
1. Outfall Description
Outfall No. _I Structure (pipe,. ' ch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage
2. Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors: e- i r g% r
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) _ 7 .D I -e-
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
2 3 4 5 6 7 8 9 10
Page 1
SWU-242-101599
5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1 (2) 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose, the number which best describes the amount of suspended solids in the stormwater discharge
where Lis no solids and 10 is extremely muddy:
1 2 3 4 5 6 7 8 9 "Vjv: d 0'
7. Foam
Is there any foam in the stormwater discharge? Yts' No
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
N_ -
9. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam or oil sheen may be indicative of pollutant
exposure. These conditions may warrant further investigation. Z
Page 2
SWU-242-101599
.. F.vi
y e y
t j
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: N/C/_/_/_1 /—/—/_/ or Certificate of Coverage No.: N/OG�I Y
Facility Name: A4—
County: o .4 G I;+ Phone No.
Inspector: Aob D,'// c
Date of Inspec
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description
Outfall No. 2 Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage
2. Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors: e_ / .a a1 /�
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) la 1_40 L' —
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 �' 3 4 5 6 7 8 9 10
Page 1
SWU-242-101599
5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
I is no solids and 10 is the surface covered with floating solids:
I (�2 3 4 5 6 7 8 9 10
6. Suspended Solids
Choose the number which best. describes the amount of suspended solids in the stormwater discharge
where 1 is'no*solids and 10 is extremely muddy:
1 2 3 4 5 6 7 8 10
7. Foam A.
i
Is there any foam in the stormwater discharge? Yvs' No
.n
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
_a
9. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam or oil sheen may be indicative of pollutant
exposure. These conditions may warrant further investigation.
Page 2
SVM-242-I01599
0
0
Telephone: (919)834-4984
Fax: (919)834.6497
7 0 TE ST
6701 Conference Drive
Raleigh, NC 27607
Laboratory Report
--- Prepared for ---
LYMAN AUSTIN
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, NC 27611
Project No.:
Project ID: PLANT 8
No. Sample ID
001 OUTFALL 1
Page 1 of 1
NCM/W Cert. #: 067
NCIDW Cent. #: 37731
Report Date: 10112/2006
Date Received: 10/6/2006
Work Order #:
Cust. Code:
Cust. P.O.#:
0610-00492
RE1520
Date Sampled Time Sampled Matrix Sample Type Condition
10I6/2006 9:15 SW Grab 4 +/- 2 deg C
Analyzed
Test Performed Method Results Date Time Qualifier
Total Suspended Solids EPA 160.2 24.8 mg/L 10I9I06 16:00
No. Sample ID
002 OUTFALL 2
Date Sampled Time Sampled Matrix Sample Type Condition
10/6/2006 9:15 SW Grab 4 +/- 2 deg C
Analyzed
Test Performed Method Results Date Time Qualifier
Total Suspended Solids EPA 160.2 23.6 mg/L 10I9/06 16:00
Reviewed by: n
for Tritest, Inc.
O
O
VRoTE ST
SAMPLE
PRESERVATION CHECK -IN SHEET
WO#:
6 G Io -oo i
Checked in by:
Date:
(Q 6
Time:
I�Q
Temp:
L
<
Route:
CD
TTS
I TTPU I USM
FEDX
GC
UPS
Sample
Analysis Requested
7S.mpleC.,n.�p/No.
Container
Chlorine
Preservative
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C l
G
Pos / gTe
HCL
H2SO4
IIN03
NaOH
Thin
OTHER
C /
G
Pos / 1 g
HCL
H2SO4
HNO3
NaOH
Th o
OTHER
C/G
P/G
Pos/neg
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos /neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
C / G
P / G
Pos/neg
None
HCL
H2SO4
I IN03
NaOH
Thio
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
JOTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
I-IN03
NaOH
Thio
CIG
P / G
Pos / neg
None
HCL
H2SO4
hfNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
I-IN03
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos /neg
None
HCL
Hi
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
NOne
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
CIG
P / G
Pos /neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
CVMMEN 1 J:
`I1 G? uT�ST
6701 Conference Drive, Raleigh, NC 27607
ph: (919) 834-4984 fax: (919)834-6497
NCWW Cart #67, NCDW Cert # 37731
Report Results To:
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, NC 27611
Attn: LYMAN AUSTIN
Phone: 919-790-1520
Fax: 919-981-0910
Chain of .Custody
Bill Results To:
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, NC 27611
Attn: LYMAN AUSTIN
(�'Vv
ta(6
Q6ro-66ggZ
Tritest W.O. G6484462'#' Page 1 of 1
❑ Standard Report Delivery
❑ Rush Report Delivery (w/ surcharge)
Note: Rush projects are subject to prior approval by Lab
Reauested Due Date:
Project Reference: PLANT #8
Project Number: PLANT 8
Purchase Order #:
Sampled By:
Sample Description
Composite
or Grab
Startate
top Date; : WW.oW,
Stop Time : sW cw etc
Analysis. Requested
_
Smp #
Start Time
OUTFALL 1
G
�- O
'
=1
SW
Total Suspended Solids
001
OUTFALL 2
G
c
` IL
V
SV�'
Total Suspended Solids
002
OUTFACE 3
G
_S.W
Total Suspended-SelidS� S
003
Pell ui ed by (sig to
Rec ed by (signatur
Dat /jam _ �
Time
1% 0 A&
For Lab Use Only:
Temperatue at receipt:
R*,,Jsheefi=
Re
by (signatur
DateTime
❑ 4+2 C
Temp: S'J C
R
by (signature IRec
iv d by (signature)
Date
Time
ARA DISCHARGE OUTFALL MONITORING REPORT
NCDENR GENERAL PERMIT NCG140000
(All sample data shall be reported no later than 30 days after receipt of lab results)'
Certificate of Coverage
NCG14 p�D�4dL
Facility Name
A6
County
FP ��
Phone Number
- ' S 3 $'S l
Certified Laboratory #
Person Collecting Sample(s)
r
-507
Collectors Signature
Sample Information
Permit Term
Year
Year Start/End Dates
Place check mark to indicate
applicable sampling pe7 od
Discharge Type (check as appropriate)
Stormwater.
Wastewater
I
August 1, 2004 to July 31, 2005
Ej
❑'
❑
❑
❑
❑
❑
❑
E3
El
❑
❑
2
August 1, 2005 to July 31, 2006
3
August 1, 2006 to July 31, 2007
4
August 1, 2007 to July 31, 2008
5
August 1, 2008 to July 31, 2009
Part A: Stormwater Discharge Monitoring Data (For stormwater not combined with process wastewater)
Storm Event Characteristics
Date
Total Event Precipitation (inches)
Event Dilmdon (hours)
Stormwater Discharge Monitoring
Outfall
No.
Date Sample Total Flow
Collected
(mo/dd/vr) —
Total Event
Precipitation
(inches)
Event Duration
(hours
pH
(Std. Units)
Total
Suspended
Solids
(mJtl
1
Does this facility perform Vehicle Maintenance Activities using on average more than 55 gallons of new motor
of I per month? ❑ Ye5 XNo If yes. complete information below.
. Stormwater Discharge Monitoring from Vehicle Maintenance Areas
Outfall
No.
Date Sample Total Flow
Collected
(moldd/ ) (MG)
Total Event
Precipitation
(inches)
Event
Duration
(hours)
New
Motor Oil
Usage
(,-aVmo)
pH
(Std. Units)
Total
Suspended
Solids
(mo l)
Oil and
Grease
(me/q
SWU-241-080104 Page loft
Part B: Process wastewater discharge monitoring data
r
L..
Sample # 1
Effluent Source(s) for this sample
Vehicle / Equipment CleaningL'J
Raw Material Stock -pile Wettin
❑
Mixing Drum Clean -out
❑
Recycle System Overflow
❑
Parameter
Unit
i?ata
'
Collection Date
mo/dd/yr
Total Flow
MG
1 -z—
Event Duration
hours
f _ 1
pH
Std. units
7,
TSS
mg/l
Settleable Solids
myl
Sample #
Effluent Source(s) for this sample
Vehicle / Equipment Cleanin ❑
Raw Material Stock -pile Wettin ❑
Mixing Drum Clean -out ❑
Recycle System Overflow ❑
Parameter
Unit
Data
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration
hours
pH
Std. units
TSS
mg/l
Settleable Solids
ml/1
Mail original and one copy to:
Attn: Central Files
Division of Water Quality
DENR
1617 Mail Service Center
Raleigh, NC 27699-1617
6Y^l�ltF:itlD�
Sample # Z-
Effluent Source(s) for this sample
4 �
Vehicle / Equipment Cleaning
1
Raw Material Stock -pile Wetting
❑
Mixing Drum Clean -out
❑
Recycle- System Overflow
❑
Parameter-,,;'
.Unit.-.,.,
Data
Collection Date
me/dd/yr
Total Flow
.-MG
1
Event Duration
hours
,
PH
Std_ units
,
TSS
mg/I
5ettleabie Solids
mill
Sample #
Effluent Source(s) forthis sam le
4
Vehicle / Equipment Cleaning
❑
Raw Material Stock -pile Wetting
❑
Mixing Drum Clean -out
❑
Recycle System Overflow
❑
Parameter
unit
Data
Collection Date
mo/dd/yr
Total Flow
MG
Event Duration
hours
PH
Std. units
TSS
mg/l
Settleable Solids
myl
"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 r--- Ind imprisonment for knowing
violations."
Lulti �u.s�i,Rl
(Sir jr6 of eermtttee or Designee) tDate)/
Pa4e 2 of 2
a
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Permit No.: N/C/_'/_/_/�/_/_/_/ or Certificate of Coverage No.: N/C/G/.Z/YQ�/ �C
Facility Name: �c �g 0
County: E ¢ 4 f�{� el Phone No.
Inspector: B 0 6 y r7` d '/l.
Date of Inspection: -/ q .. (- - 4 4_ -_
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
(Signature of Permittee or Designee)
1. Outfall Description
Outfall No. _� Structure (pipe, ch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage
2. Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors: F'. i r 4,, j"
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) fly 4 .y
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
1 R/ 3
4 5 6 7
Page I
8 9 10
SWU-242-101599
5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
1 is no solids and 10 is the surface covered with floating solids:
1 0 3 4 5 6 7 8 9 10 .
6. Suspended Solids
Choose. the number which best describes the amount of suspended solids in the stormwater discharge
where Lis no solids and 10 is extremely muddy:
1 2 3 4 56 7 8 9 10'
7. Foam B 5
Is there any foam in the stormwater discharge? YVs' No 17
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam or oil sheen may be indicative of pollutant
exposure. These conditions may warrant further investigation.
Page 2
SWU-242-101599
7
Permit No.: N
Facility Name:
County: 'C
Inspector: -A
Date of Inspec
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
/ / or Certificate of Coverage No.: N/CQG�I � J A�ll 7 zl
'Vo.� R
Phone No.
By this signature, I certify that this report is accurate and complete to the best of my knowledge:
J
(Signature of Permittee or Designee)
1. Outfall Description
Outfall No. 2 Structure (pipe, ditch, etc.)
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area:
2. Color
Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint (light, medium,
dark) as descriptors: L'_ / .naa- /'
3. Odor
Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,
etc.) %y if t-
4. Clarity
Choose the number which best describes the clarity of the discharge where 1 is clear and 10 is very
cloudy:
O' 3 4 5 6 7
Page 1
8 9 10
SWU-242-101599
5. Floating Solids
Choose the number which best describes the amount of floating solids in the stormwater discharge where
l,is no solids and ]0 is the surface covered with floating solids:
1 �2 3 4 56 7 8 9 10
6. Suspended Solids
Choose the number which best describes the amount of suspended solids in the stormwater discharge
where I is'no solids and 10 is extremely muddy:
1 2 3 4 5 6 7 8 9 10
7. Foam
Is there any foam in the stormwater discharge? Yvs' No
8. Oil Sheen
Is there an oil sheen in the stormwater discharge? Yes No
9. Other Obvious Indicators of Stormwater Pollution
List and describe
Note: Low clarity, high solids, and/or the presence of foam or oil sheen may be indicative of pollutant
exposure. These conditions may warrant further investigation.
Page 2
SWU-242-101599
o
Telephone: (919) 834-4984
Fax: (919) 834-6497
U TE ST
6701 Conference Drive
Raleigh, NC 27607
Laboratory Report
--- Prepared for ---
LYMAN AUSTIN
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, NC 27611
Project No.:
Project ID: PLANT 8
No. Sample ID
001 OUTFALL 1
Page 1 of 1
NC/WW Cert. #: 067
NCIDW Cert. M 37731
Report Date: 10/12/2006
Date Received: 10/612006
Work Order #: 0610-00492
Cust. Code: RE1520
Cust. P.O.#:
Date Sampled Time Sampled Matrix Sample Type Condition
10/6/2006 9:15 SW Grab 4 +/- 2 deg C
Analyzed
Test Performed Method Results Date Time Qualifier
Total Suspended Solids EPA 160.2 24.8 mg1L 10/9/06 16:00
No. Sample ID Date Sampled Time Sampled Matrix Sample Type Condition
002 OUTFALL 2 10/6/2006 9:15 SW Grab 4 +/- 2 deg C
Analyzed
Test Performed Method Results Date Time Qualifier
Total Suspended Solids EPA 160.2 23.6 mg/L 10/9/06 16:00
Reviewed by:
for Tritest, Inc
UG�TEST
SAMPLE
PRESERVATION CHECK -IN SHEET
won:
6�Io -OoYC2
Checked in by:
Date:
i0 6
Time:
i70
Temp:
Route:
C
TTS
TTPU I USM
FEDX GC
I UPS
Sample
No. -
Analysis Requested
Sample
Type
Comp/
Grab
Container
Chlorine
Preservative
None
HCL
112SO4
HNO3
NOOH
Thin
OTHER
C /
4G
Pos / g
Oe
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C /
/ G
Pos / 19
N
ne
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
IIN03
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thin
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HN 03
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
14NO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None'
HCL
H2SO4
HNO3
NaOH
Thio
OTHER
C / G
P / G
Pos / neg
None
HCL
H2SO4
IiNO3
NaOH
Thio
OTHER
COMMENTS:
6701 Conference Drive, Raleigh, NC 27607
ph: (919) 834-4984 fax: (919) 834-6497
NCWW Cert #67, NCDW Cert # 37731
Report Results To:
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, NC 27611
Attn: LYMAN AUSTIN
Phone: 919-790-1520
Fax: 919-981-0910
Chain of Custody
Bill Results To:
READY MIXED CONCRETE CO.
P.O. BOX 27326
RALEIGH, INC 27611
Attn: LYMAN AUSTIN
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Tritest W.O. t3668$1if24� Page 1 of 1
Standard Report Delivery
Rush Report Delivery (w/ surcharge)
Note: Rush projects are subject to prior approval by Lab
Requested Due Date:
Project Reference
Project Number:
Purchase Order #:
Sampled By:
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