NCG030124_MONITORING INFO_20191014

STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
Iv C& D 3 b 01 y
DOC TYPE.
❑ HISTORICAL FILE
1 MONITORING REPORTS
DOC DATE
❑ a�I! ./ CI zJ
YYYYMMDD

4 )).
October 9, 2019
NCDENR
Division of Energy, Mineral, and Land Resources
Land quality Section
450 West Hanes Mill Rd., Suite 300
Winston-Salem, NC 27105
Attention: Sue White
Subject: Permit No. NCG030124
Stormwater Report —Semi -Annual
Dear Sue:
Enclosed are the sampling results for the second half of 2019.
There are no issues to report at this time.
If you have any questions please feel free to call me at [phone].
i
ncere
ony R. rinkle
Environmental Supervisor
Cc: Central Files
Wieland Copper Products, LLC
3990 US 311 Hwy N
Pine Hall, NC 27042
Phone: [phone]
Fax: [phone]
[e-mail]
www.wielandcopper.com
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RESEARCH & ANA1yTICAI
LAbORATOR1ESi INC.
Analytical/Process Consultations
August 5, 2019
Wieland Copper Products, LLC
3990 US 311 I lwy N
Pine Hull, North Carolina 27042
Attention: Mr. Tony Sprinkle
Chemical Analysis for Selected Sampling Location Identified as Stormwater
J ss6 PH4(1)>'
110NC M39z1
. �'•aRECTOP
ynuuoO
Pruden Numhen NIA
NPlWSh: NC(;lJJ01E4
Sample
IdemiOcation
RAL
Sample
Number
Sampling
DM
Sumpling
'Time
Tout
Smpended
Solids
me/1.
Oil
&
Greaae
Merl.
Copper,'Ibul
mg/L
Lmd,Tutnl
Merl.
zh,y, raw
me/1,
Umea
Analynd
001
69842-01
07/23/19
1326
<5
<5
0.576
10.005
0.016
07Q3 08,01119
002
69e42 02
07/23/19
1314
15
<5
0.278
<01105
0.034
07/23-08/01119
003
69842-03
07/23/19
1341
23.6
<5
1.33
<0.005
0.144
07M OK01/19
1104
6442-04
07/23/19
1346
46.1
<5
1.62
0.007
0.134
07/23 08/01/19
"-005
69X42-05
- 07/23/19 —
102.5 — -
- - E4.6- —
<5
0.420
W.003' --
--0.06(
07/27-08/01/19
Anal)st: Jl:. FE &AW
Rr infall Amoun 0.3 in. Rain Duration: 40 min.
mgll. = milligrams Per Lite, = puns per million (ppm) <= less than or Below Quantization Limit (RQL)
SO = Sundard Units

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG030000 SAMPLES COLLECTED DURING CALENDAR YEAR: 2019
CERTIFICATE OF COVERAGE NO. NCGO 30124 (all samples collected during a calendar yea, shall be reported no later
i than January, 31 of the following year)
FACILITY NAME Wieland Copper Products, LLC COUNTY Stokce
PERSON COLLECTMG SAMPLE(S) Cliffnd Cain PHq�NO. 336 7-06 1 1119
CERTIFIED LABORATORY(S) R g. A Iabmetotlm, Inc. Lab g ,,9_
Lab g SIGNATURE OF PERMEM IG E)
By this sternum, I artily ma Nb repan ts accmac W
cumplem to the bast of my knowledge.
Part A: Specific slumbering Re9eircmeab
OutWl
No.
Date
Sample
Collected
50050
00400
00530
01051
005%
78141
Total
Flow
PH
Total
Suspended
Solid$
Id
Total Copper
Total Tina
Oil and
Greaae
Tau] Toxic
orgamice,
moidd/yr
MG
unit
mgA
.94
MBA
mgA
mgA
mgA
001
0723/19
0.160
7.6
O
<0.005
0.576
0.046
<5
N/A
" 002
0723/19
0.030
7.0
<5
<0.005
0.279
0.034
<5
N/A
003
OW23/19
0.058
7.2
23.6
<0.005
1.33
0.144
<5
N/A
004
07123/19
0.093
7.2
46.7
0.007
1.62
0.134
<5
N/A
003
07/23/19
0.104
6.9
24.6
<0.005
0.420
0.066
<5
N/A
Does this facility perform Vehicle Maintenance Activities; using mom Dun 55 gallons ofnew trumr ail per month? __yes V no
(ifye, colnplew PM B)
Pact B: Vehicle Maintenance Activkv Monitorine Reauiremenh
Outfall
Na.
d
Doh
Sample
Call
50050
00356
00530
--. 00400
Total
Flow
Oil and
Grasse
I Total
Suspended
—'Solids
pH,
New Motor
Oil Usage
mo/ddlyr
MG
m
u
unit
mo
_STORM EVENT.CHARACIERISTICS:
Date 7/232019
Teed Beat Precipitadon (Inchus): 0,30
Event Duration (boon): 40 mIm
(if more than arc amml evem con sempkd)
I time
Total Event Paelpinatlan (Indust,
Evenl Duration (boon):
Mail Original and one copy h:
Division of Water Quality
Amu Central Film
1617 Mail Service Center
Raleigh, NC 27626-1617
Copy of Farm SWU.24S420399
Page I of 2

Footnotes:
"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 inquirey 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."
(Date)
Form MR-18
Page 2 of 2

Footnotes:
i I Total Toxic Organics sampling is applicable only for those facilities which perform metal finishing opeitions, mmalsetum semiconductor, menufau ne electronic crystals,«
manufacture cathode raymbar Fa purposes of this permit the defmitlms of Tonal Toxic Oigmics is that definition contained in the EPA Effluent Guidelines fa the facilities subject
an the requirement m simple (fin metal finishing use the definition sat found in 40 CPR 433.11; fin semicondutta manufacture use the definition in found in 40 CFR 469.12; fa
electronic cysts] manufacmm use the defmbion at, found in 40 CFR 469.22; and fm cathode my tube manufacture use the Monition found in 40 CPA 469.31).
Facilities then develop a wlvent management plan to be imseepwmed into the Stoenwate Pollution Prevention Plan may make a national m DWQ that monitoring of total nixie
:organs be waived The advent management plan shall include a list of the total mxic organic compounds used; the method of dhpmal used instead of dumpinj such as
reclamation, contract hauling, or incineration; and the procedmv for winning that toxic organics do not mutinely will or Ink imm the smrmwata. Fa those facilities allowed such
a waiver, the discharge shall include the following signed certification stausnrnt on the discharge monitoring report.
"Bawd upon my inquiry of the person or persons duMly responsible for managing compliance with the permit monitoring requirement for
Wool toxic organics (TTO), I certify that to the best of my knowledge and belief, no dumping of concentrated toxx organics into the
stexmwmc m areas which me exposed to minfall or normwater nonoff has occurred since filing the last discharge monitoring report. I
further cMify, that this facility is implementing the aclvmt management plan included in the Stmmwaw Pollution Pmmlim Plan"
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ere time pest
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"1 certify, under penalty of law, that this dewment and all Attachments were prepared under my direction or supervision In accordance with a
system designed to assure that qualified pencanel properly gather and evaluate the information submitted Based on my Inquiry of the person
or persons who manage the system, or tome persons directly responsible far gathering the information, the information submitted Is, to the best
of my knowledge and belief, true, accurate, and complete. 1 am aware that there are significant peaMes for submitting false Information,
Including the possibility of Dees and Imprisonment for owing violations."
Oa
(Signature of of Permittee)
t
Form MR-03
Page 2 of2

Stormwater Discharge Calculations
WIELAND COPPER PRODUCTS, LLC
2019 Calendar Year
Rationale for Discharge Calculations
The rational formula is used for the basis of the calculations. The rational formula has been
developed to calculate the rate of run-off from a rain event of a given intensity over a given area.
The formula is written:
Q=CIA
where: Q is the rate of run-off flow in cubic feet per second (CFS)
I is the rain intensity in inches per hour
A is the land area contributing run-off to the discharge point
and: C is a run-off coefficient which ranges from 0 for a completely pervious surface to
1.0 for a completely impervious surface.
The rational formula results from the fact that, for a completely impervious surface, a rainfall of
one inch over a period of one hour on an area of one acre will result in a run-off discharge of one
CFS. The run-off coefficient C can be thought of as a correction factor based on the percentage
of the total rainfall which will run off from a given area due to how pervious or impervious the
surface of that area is. Since the discharge permit for this facility requires an es ate of the total
discharge from the storm event during which samples are collected, we will use a modified form
of the rational formula to calculate the total discharge as follows:
Qt = CRA (0.027)
where: Qt is the total discharge in Million Gallons
C is the run-off coefficient as defined above
R is the total amount of rainfall in inches
A is the surface area contributing flow to the sample location in acres
and: The constant 0.027 in the modified equation corrects the units to Million Gallons
(MG) based on the fact that 1 acre -inch = 0.027 MG
For drainage areas which are comprised of a combination of pervious and impervious areas, the
formula can be written as follows:
Qt = [CIA, + C2A21(R) (0.027)
where: Ci = C factor for pervious areas
Ai = pervious area contributing to the outfall in acres
C2 = C factor for impervious areas
A2 = impervious area contributing to the outfall in acres

Discharge Calculations
The total rainfall for the July 23, 2019 storm during which samples were collected at this facility
was 0.3 inches. We will use generally accepted conservative estimates of the runioff coefficient of
C=1.71 for impervious areas, and C= 0.50 for pervious areas.
The drainage areas contributing to each of the five outfalls as follows:
Outfall
Total Area (acres)
Pervious Area (acres)
@ C=0.50
Impervious Area
(acres) @ C=0.90
001
30
18 (60%)
12 (40%)
003
5.26
2.63 (50%).63
(50%)
004
11.5
8.05 (70%)
3.45 (30%)
002
15.5
6.2 (40%)
9.3 (60%)
005
25.7
25.7 (100%)
0
Total Discharge at Stormwater Discharge Outfall 001
Qi = [(0.50)(18) + (0.90)(12)] (0.3) (0.027)
Qt = 0.160 MG
Total Discharge at Stormwater Discharge Outfall 002
Qt _ [(0.50)(2.63) + (0.90)(2.63)] (0.3) (0.027)
Qt = 0.030 MG
Total Discharge at Stormwater Discharge Outfall 003
Qt = [(0.50)(8.05) + (0.90)(3.45)] (0.3) (0.027)
Qt = 0.058 MG
Total Discharge at Stormwater Discharge Outfall 004
Qt = [(0.50)(6.2) + (0.90)(9.3)] (0.3) (0.027)
Qt = 0.093 MG
Total Discharge at Stormwater Discharge Outfall 005
Qt _ [(0.50)(25.7)(0.3) (0.027)]
Qt = 0.104 MG
Page 2 of 2

O�Of wA rf qOG
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Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out thisform, please visit humaortal.ncdenr.org/web/wq
Permit No.: N/C or Certificate of CoveralN/C/G030124
Facility Name: Wieland Copper Products, LLC
County: Stokes Phone No.
Inspector: Clifford Cain (RAL)
Date of Inspection: 0723119
Time of Inspection: 1326
Total Event Precipitation (inches): 0.3
Was this a "Representative Storm Event" as defined by the permit?
7'nformation below.)
oNo
iI
Please ver J& whether Qualitative Monitoring must be performed during a "representative storm event or "mearureable storm
event" (requirements vary, depending on the permit.)
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a j
"representative storm event" or during a "measurable storm even" However, some permits do not have this requirement.
Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is precedi d by at least 72
hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred A single storm event may co itain up to
10 consecutive hours of no precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. T ic previous
measurable storm event most Is
able to document that a shorter
approval from the local DWQ Regional Office.
By this signaVq, I certify #ia)'khis report iq ac4Wte and complete to the best of my knowledge:
or
swu-242.o2mm

1.Outfall Description
Outfall No. 001 Structure (pipe, ditch, etc.) Pipe
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: No color or clear and light
3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.)
None
4: Clarity: Chose the number which best describes the clarity of the discharge, where I is clear and 5 is very cloudy
I
i
0 2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of foating 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? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there any evidence of errosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
None
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure.
These conditions warrant further investigation.

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance onfilling out this form, please visit tt ://portal.ncdenr.orvJweb/wq
Permit No.: N/C
Facility Name: Wie
County: Stok
Inspector: Clifl
Date of Inspection:
Time of Inspection:
07/23/19
1334
or Certificate of CoveraIN/C/G030124
Phone No.
Total Event Precipitation (inches): 0.3
Was this a "Representative Storm Event" as defined by the permit?
i
7es
'formation below.)
o No
Please verify whether Qualitative Monitoring must be performed during a "representative storm event or "measureable storm
event" (requirements vary, depending on the permit.)
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a
"representative storm event" or during a "measurable storm event.' However, some permits do not have this requirement.
Please refer to these definitions, if applicable.
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72
hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may contain up to
10 consecutive hours of no precipitation.
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. The previous
measurable stone event must h
able to document that a shorter
approval from the local D WQ Repional Office.
this signyaile, I certify Quit this�repott iA accurate and complete to the best of my knowledge:
or
SWLL242-020705

1.Outfall Description
Outfall No. 002 Structure (pipe, ditch, etc.) Pipe
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
i (light, medium, dark) as descriptors: Clear and light
i
3. Odor.. Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak
None
4: Clarity: Chose the number which best describes the clarity of the discharge, where I is clear and 5 is
2 3 4 5
5. Floating Solids: Choose the number which best describes the amount of foaling solids in the storms
I is no solids and 5 is the surface covered with floating solids:
0 2 3 4 5
i
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in the su
discharge, where I is no solids and 5 is extremely muddy:
2 3 4 5
1 7. Is there any foam in the stormwater discharge?
i
Yes No
8. Is there an oil sheen in the stormwater discharge?
Yes No
9. Is there any evidence of errosion or deposition at the outfall?
Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe None
i�
odor,etc.)
cloudy:
discharge, where
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure.
These conditions warrant further investigation.

O�Of w F T c
9
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Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit httD://Dortal.ncdenr.ore/web/wa
Permit No.: N/C
Facility Name: Wielar
County: Stokes
Inspector: Cliffor
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): 0.3
or Certificate of CoveraiN/C/G030124
Phone No.
Was tho a "Representative Storm Event' as defined by the permit?
(Sce fo rmation below.) )es ❑ No
Please ver jy whether Qualitative Monitoring must be performed during a "representative storm event or "measurealle storm
event" (requirements vary, depending on the permit.)
Rive monitoring requirements vary. Most permits require qualitative monitoring to be performed duri
curative storm event" or during a "measurable storm event." However, some permits do not have this
refer to these definitions, if applicable.
h "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72
hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred A single storm event may cc n up to
10 consecutive hours of no precipitation.
A "measurable storm event' is a storm event that results in an actual discharge from the permitted site outfall. a previous
measurable storm event must h
able to document that a shorter
approval from the local D WQ Regional office.
I
By this sig,tllture, I c%tk that thikre0pr4is accurate and complete to the best of my knowledge:
Permitee or
aWU-247-02mo5

1.Outfall Description
Outfall No. 003
Receiving Stream:
Describe the industrial
Structure (pipe, ditch, etc.) Ditch
occur
area:
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Grey and medium
3.Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlo
I.
None
4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is
i
odor,etc.)
cloudy:
1 2 4 5
S. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwater discharge, where
I 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
discharge, where I is no solids and 5 is extremely muddy:
1 2 4 5
7. Is there any foam in the stormwater discharge?
8. Is there an oil sheen in the stormwater discharge?
li
9. Is there any evidence of errosion or deposition at the outfall?
10.Other Obvious Indicators of Stormwater Pollution:
List and describe None
Yes No
Yes No
Yes Na
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure.
These conditions warrant further investigation.

Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit httr):Hportal.ncdenr.org/web/wa
Permit No.: N/C
Facility Name: Wie
County: Stop
Inspector: Cliff
Date of Inspection:
Time of Inspection:
LLC
Total Event Precipitation (inches): 0.3
or Certificate
rnone
Was this a "Representative Storm Event" as defined by the permit?
:/Yes
See formation below.)
o No
124
Please verify whether Qualitative Monitoring must be performed during a "representative storm event or "measureable storm
event" (requirements vary, depending on the permit.)
itive monitoring requirements vary. Most permits require qualitative monitoring to be performed during a
entative storm event" or during a "measumble storm event." However, some permits do not have this rey
refer to these definitions, if applicable.
"representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preced�jd by at least 72
urs (3 days) in which no storm event measuring greater than 0.1 inches has occurred. A single storm event may co fain up to
consecutive hours of no precipitation.
"measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. lie previous
mumble storm event must It
le to document that a shorter
nroval from the local DWO Regional Office.
By this si�attyq tI card
fy thatthis r�epo6rt is
./ . _ M
(Signature of Permitee or Designee)
and complete to the best of my knowledge:
i
i
i
it
Swu-242-020705

1.Outfall Description
Outfall No. 004 Structure (pipe, ditch, etc.) Ditch
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: Grey and medium
3.Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor,etc.)
None
4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is very cloudy:
2 4 5
I
S. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwa�ter 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 storinwater
discharge, where 1 is no solids and 5 is extremely muddy:
1 2 0 4 5
7. Is there any foam in the stonmwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is there any evidence of errosion or deposition at the outfall? Yes No
10. Other Obvious Indicators of Stormwater Pollution:
List and describe None
I
i
n Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be indicative of pollutant exposure.
These conditions warrant further investigation.
i
i

0�Of wa rEgQG
y 9
r
Stormwater Discharge Outfafi (SDO)
Qualitative Monitoring Report
For guidance on filling out this form, please visit http://portal.ncdenr.org/web/wq
Permit No.: N/C
Facility Name: Wie
County: Stok
Inspector: Clifl
Date of Inspection:
Time of Inspection:
1352
Total Event Precipitation (inches): 0.3
or Certificate of
Phone No.
Was this a "Representative Storm Event" as defined by the permit?
(See' formation below.)
7Yes o No
Please verb whether Qualitative Monitoring must be performed during a "representative storm event or "measureake storm
event" (requirements vary, depending on the permit.)
Qualitative monitoring requirements vary. Most permits require qualitative monitoring to be performed during a
"representative storm event" or during a "measurable storm event" However, some permits do not have this requirement.
Please refer to these definitions, if applicable.
I
A "representative storm event" is a storm event that measures greater than 0.1 inches of rainfall and that is preceded by at least 72
hours (3 days) in which no storm event measuring greater than 0.1 inches has occurred A single storm event may co tain up to
10 consecutive hours of no precipitation.'
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site outfall. ie previous
measurable storm event must h
able to document that a shorter
anoroval from the local DWO Reaional Office.

1.Outfall Description
Outfall No. 005 Structure (pipe, ditch, etc.) Ditch
Receiving Stream:
Describe the industrial activities that occur within the outfall drainage area: Copper fitti
2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium, dark) as descriptors: Tan/brown and light
3. Odor: Describe any distinct colors that the discharge may have (i.e., smells strongly of oil, weak
None
4: Clarity: Chose the number which best describes the clarity of the discharge, where 1 is clear and 5 is ve
I 0 3 4 5
5. Floating Solids: Choose the number which best describes the amount of foating solids in the stormwa t
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 store
discharge, where 1 is no solids and 5 is extremely muddy:
1 0 3 4 5
7. Is there any foam in the stormwater discharge? Yes No
8. Is there an oil sheen in the stormwater discharge? Yes No
9. Is them any evidence of errosion or deposition at the outfall? Yes No
10.Other Obvious Indicators of Stormwater Pollution:
List and describe None
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or errosion/deposition may be Indic
These conditions warrant further investigation.
odor,etc.)
cloudy:
discharge, where
of pollutant exposure.

yj RESEARCII & ANALyTICAI
LAbORATORIES, INC.
Analytical / Process ConsUltations
Phone [phone]
CHAIN OF CUSTODY RECORD
WATER I WASTEWATER I MISC.
COMPANY - u
JOB NO.
r
o
_
� 4 td v9`Yr e d,.
O.Sq hO h�mBp`°`LPO
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'� ry ry ry � + n" 59 REQUESTED ANALYSIS
ADDRESS STREET nDDRE55
PROJECT
J'telrn'�1,,1C1 yT;.I�
CITY, STATE. ZIP
SAMP ER NAME IPFFCA$6PRIND
CONTACTPHONE
5PM/PyI'MIISG
I ,Ill
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