NCG100027_MONITORING INFO_20191030

jz o
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
c-G I DOD -7
DOC TYPE
❑ HISTORICAL FILE
YMONITORING REPORTS
DOC DATE
❑ u n U
YYYYM M D D

Mid Atlantic
Engineering 9 Environmental Solutions
October 10, 2019
Mr. Jesse Price
Price's Auto Parts LLC
14473 NC 96 Highway
Knightdale, NC 27597
RECE
-`1 av2019
CEP4.1
7h'R SEC-r1OA/
Subject: STORMWATER SAMPLING RESULTS
PRICE'S AUTO PARTS LLC
1900 OLD CREWS ROAD
KNIGHTDALE, NORTH CAROLINA
NPDES PERMIT NO. NCG100027
MID -ATLANTIC JOB NO. 000112900.00
Dear Mr. Price:
409 Rogers View Court
Raleigh, NC 27610
office 919.250.9918
facilmile 919,250,9950
MAAONLINE.COM
Attached please find three copies of the Stormwater Discharge Monitoring Report (DMR) for the
above -referenced site. Please follow the instructions below to complete this sampling event.
1. If known, please fill in the rainfall total and pH for the sample collected August 27, 2019;
2. Sign and date each DMR on page 2;
3. Forward the first two copies of the report along with the attached cover letter to the
Division of Water Quality (mailing address is on the first page of the DMR); and
4. Insert the third copy (labeled "FILE") into Appendix C of your Stormwater Pollution
Prevention Plan.
These results satisfy the analytical monitoring requirements for the second period (July -
December) of 2019. The next sampling event can be conducted on or after January 1, 2020. Mid -
Atlantic will arrange for cooler delivery prior to this date. If you have any questions, please contact
me at 919-250-9918.
Sincerely,
MID -ATLANTIC ASSOCIATES, INC.
Ron Davis
Stormwater Services Manager
Attachments: Cover Letters
Stormwater Discharge Monitoring Reports
Laboratory Analytical Reports
EXPERIENCED CUSTOMER FOCUSED INNOVATIVE

109 aogen View court
Mid Atlantic
fficoRalaih.NC2761
olOce 919,750.4918
Engineering 8 Environmental Solutions
facsimile 919$509950
MAAOM,INE.COM
October 10, 2019
NCDEQ/DWR
Attention: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: STORMWATER SAMPLING RESULTS
PRICE'S AUTO PARTS LLC
1900 OLD CREWS ROAD
KNIGHTDALE, NORTH CAROLINA
NPDES PERMIT NO. NCG100027
To Whom It May Concern:
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 27, 2019 and analyzed for total suspended solids
(TSS), pH, total recoverable lead, oil and grease and ethylene glycol. As indicated 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.
Ron Davis
Stormwater Services Manager
Attachment: Discharge Outfall Monitoring Report
Laboratory Analytical Report
EXPERIENCED CUSTOMER FOCUSED INNOVATIVE

STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
CERTIFICATE OF COVERAGE NO. NCG100027
FACILITY NAME Price's Auto Parts LLC
PERSON COLLECTING SAMPLE(S) Jesse Price III
CERTIFIED LABORATORY(S) Pace Analytical Lab #12
Lab #
Part A: Stormwater Benchmarks and Monitoring Results
SAMPLES COLLECTED DURING CALENDAR YEAR: 2019
COUNTY Wake
PHONE NO. [phone]
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
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
Outfall 001
08/27/19
3.5
< 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 Tier 1 or Tier 2 responses in the Generai
Permit.
iSee 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 SWU-251, last revised October25, 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 filing 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 a nd belief, true, accurate, and complete. I
am aware that there are jjgnificant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations."
(Signature oT'Permittee or Designee)
`B /1
(Date)
Form SWU-251, last revised October25, 2012
Page 2 of 2

aceAnalytical.
www.pace/ebscom
Pace Analytical services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
September 10, 2019
Chuck Hoffman
Mid -Atlantic Associates, Inc
409 Rogers View Court
Raleigh, NC 27610
RE: Project: Price's Auto Parts
Pace Project No.: 92443443
Dear Chuck Hoffman:
Enclosed are the analytical results for sample(s) received by the laboratory on August 29, 2019. 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,
Tyriek Hooks
[e-mail]
[phone]
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.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: Price's Auto Parts
Pace Project No.: 92443443
Indiana Certification IDs
7726 Moller Road, Indianapolis, IN 46268
Illinois Certification #: 200074
Indiana Certification #: C-49-06
Kansas/NELAP Certification M E-10177
Kentucky UST Certification #: 80226
Kentucky W W Certification M 98019
Michigan Department of Environmental Quality, Laboratory
#9050
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 #: CL0065
Oklahoma Certification #: 2018-101
Texas Certification #: T104704355
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, L-C. Page 2 of 13

aceAnalytical e
www.peceleba.can
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: Price's Auto Parts
Pace Project No.: 92443443
Lab ID Sample ID
92443443001 Outfall No. 1
SAMPLE ANALYTE COUNT
Method
Analysts
Analytes
Reported
Laboratory
EPA 1664B
JMS
1
PASI-C
EPA 8015 Alcohol -Glycol
CPH
1
PASI-I
EPA 601 OD
SH1
1
PASI-A
SM 2540D-2011
CEH
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

mAnalytical
~.psalabs.cwn
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: Price's Auto Parts
Pace Project No.: 92443443
Sample: Outfall No. 1 Lab ID: 92443443001 Collected: 08127119 07:30 Received: 08/29/19 10:10 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 09/05/19 06:50
8015M Glycols in water Analytical Method: EPA 8015 Alcohol -Glycol
Ethylene glycol ND mg/L 5.0 1 09/04/19 12:50 107-21-1
6010 MET ICP Analytical Method: EPA 6010D Preparation Method: EPA 3010A
Lead ND ug/L 5.0 1 09/05/19 16:10 09/06/19 09:06 7439-92-1
2540D Total Suspended Solids Analytical Method: SM 254OD-2011
Total Suspended Solids 3.5 mg/L 2.5 1 08/31/19 03:19
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 09/10/2019 01:59 PM without the written consent of Pace Analytical Services, -LC. Page 4 of 13

JaceAnalytical"
wmepacalabluc m
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: Price's Auto Parts
Pace Project No.: 92443443
QC Batch: 496063
Analysis Method:
EPA 1664B
QC Batch Method: EPA 1664E
Analysis Description:
1664 SGT-HEM, TPH
Associated Lab Samples: 92443443001
METHOD BLANK: 2672108
Matrix: Water
Associated Lab Samples: 92443443001
Blank Reporting
Parameter
Units
Result Limit
Analyzed Qualifiers
Total Petroleum Hydrocarbons
mg/L
ND 4.8
09/05/19 06:46
LABORATORY CONTROL SAMPLE:
2672109
Spike LCS
LCS % Rec
Parameter
Units
Conic. Result
e/ Rec Limits Qualifiers
Total Petroleum Hydrocarbons
mg/L
19.2 21.4
111 64-132
MATRIX SPIKE SAMPLE:
2672110
92443907002 Spike
MS MS %Rec
Parameter
Units
Result Conic.
Result % Rec Limits Qualifiers
Total Petroleum Hydrocarbons
mg/L
NO 19.2
19.8 98 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,
Date: 09110/2019 01:59 PM without the written consent of Pace Analytical Services, L-C. Page 5 of 13

aceAnalytical
enw.pecitabs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: Price's Auto Parts
Pace Project No.: 92443443
QC Batch: 519800
Analysis Method: EPA
8015 Alcohol -Glycol
QC Batch Method: EPA 8015 Alcohol -Glycol
Analysis Description: EPA
8015 Modified
Associated Lab Samples: 92443443001
METHOD BLANK: 2397744
Matrix: Water
Associated Lab Samples: 92443443001
Blank Reporting
Parameter Units
Result Limit
Analyzed Qualifiers
Ethylene glycol mg/L
ND 5.0
09/04/19 13:13
LABORATORY CONTROL SAMPLE: 2397745
Spike LCS
1-CS % Rec
Parameter Units
Conic. Result
% Rec Limits Qualifiers
Ethylene glycol mg/L
25 26.7
107 48-150
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2397746 2397747
MS MSD
92443443001
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 32.7
23.1 128 90 34-153 34 R1
Results presented on this page are in the units indicated by the wUnits' 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: 09/10/2019 01:59 PM without the written consent of Pace Analytical Services, LLC.
Page 6 of 13

(AaceA
www.nalytical to
pewlebxcwn
QUALITY CONTROL DATA
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project:
Price's Auto Parts
Pace Project No.:
92443443
QC Batch:
496202 Analysis Method: EPA 6010D
QC Batch Method:
EPA 3010A Analysis Description: 6010 MET
Associated Lab Samples:
92443443001
METHOD BLANK: 2672626
Associated Lab Samples: 92443443001
Parameter Units
Lead ug/L
LABORATORY CONTROL SAMPLE: 2672627
Parameter Units
Lead ug/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 5.0 09/06/19 08:31
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
500 500 100 80-120
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2672628 2672629
MS MSD
92443516002 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result e/ Rec % Rec Limits RPD Qual
Lead ug/L NO 500 500 498 497 99 99 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: 09/10/2019 01:59 PM without the written consent of Pace Analytical Services, LLC.
Page 7 of 13

aceAnalytical
www.pacelabs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: Price's Auto Parts
Pace Project No.: 92443443
OC Batch: 495521
Analysis Method:
SM 254OD-2011
QC Batch Method: SM 25400-2011
Analysis Description:
2540D Total Suspended Solids
Associated Lab Samples: 92443443001
METHOD BLANK: 2669750
Matrix: Water
Associated Lab Samples: 92443443001
Blank Reporting
Parameter
Units
Result Limit
Analyzed Qualifiers
Total Suspended Solids
mg/L
NO
2.5 08/31/19 03:14
LABORATORY CONTROL SAMPLE: 2669751
Spike LCS
LCS % Rae
Parameter
Units
Cone. Result
e/ Rae Limits Qualifiers
Total Suspended Solids
mg/L
250 248
99 90-110
SAMPLE DUPLICATE: 2669764
92443124001 Dup
Parameter
Units
Result Result
RPD Qualifiers
Total Suspended Solids
mg/L
2240 4200 61 D6
SAMPLE DUPLICATE: 2669765
92443210001 Dup
Parameter
Units
Result Result
RPD Qualifiers
Total Suspended Solids
mg/L
89.2
103 15 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: 09110/2019 01:59 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 13

ace Analytical.
w Paceiabs cvm
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALIFIERS
Project: Price's Auto Parts
Pace Project No.: 92443443
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
NO - 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 - 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 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.
Rt RPD value was outside control limits.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 09/10/2019 01:59 PM without the written consent of Pace Analytical Services, LLC. Page 9 of 13

aceAnalytical
w xpacelab&vvvn
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Price's Auto Parts
Pace Project No.: 92443443
Lab ID
Sample ID
QC Batch Method
QC Batch
92443443001
Outfall No. 1
EPA 1664B
496063
92443443001
Outfall No.1
EPA8015AIcohol-Glycol
519800
92443443001
Outfall No.1
EPA3010A
496202
92443443001
Outfall No. 1
SM 2540D-2011
495521
Date: 09/10/2019 01:59 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Analytical Method
EPA6010D
Analytical
Batch
496261
Page 10 of 13

aceAnalylical"
Document Name:
Sample Condition Upon Receipt(SCU11)
Document Revised: February 7, 2018
Page 1 of 2
Document No.:
F-CAR-CS-033-Rev.06
Issuing Authority:
Pace Carolinas Quality Office
Laboratory receiving samples:
Asheville ❑ Eden[_
Client Name:
❑ Commercial
Greenwood ❑
Custody Seal Present? ❑Yes ©No Seals Intact? ❑Yes
i
HuntersvilleI,I Raleigh[]Mechanicsville[]Mechanicsville
Project k: ^®# : 92443443
1 Cli nt IIIII I III II II II III III
92443443
ONo
Date/Initials Person Examining Contents:.
Packing Material: ❑Bubble Wrap EgBubble Bags ❑None ❑ Other Biological Tissue Frozen?
Thermometer:
Type of ice: ❑Wet ❑Bue ❑None Dyes ❑No QN/A
DiR bun to: 92T049
Cooler Temp ('c): 1 '?, .% Correction Factor: Add/Subtract ('C) 0.0
'-MP shos•Id bo ibova froaa ing to 6°6
Cooler Temp Corrected ('C): ❑Samples out of temp criteria, Samples on Ice, cooling process
has begun
USDA Regulated Soil (Q'N/A, water sample)
Did samples originate in a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (internationally,
eyes MNo and PI-11 nve. nu„
Comments/Discrepancy:
Chain of Custody Present?
Ely/es
ONO
❑N/A
1.
Samples Arrived within Hold Time?
19Y i
❑No
(-]N/A
2.
Short Hold Time Analysis (02 hr.)?
❑Yes
QNo
❑N/A
3.
Rush Turn Around Time Requested?
[]yes
ONO
❑N/A
4.
Sufficient Volume?
❑Yes
ONO
❑N/A
5.
Correct Containers Used?
©Yes
ONO
❑N/A
6.
-Pace Containers Used?
❑`-yes
ONO
❑N/A
Containers Intact?
' Yes
ONO
❑N/A
7.
Dissolved analysis: Samples Field Filtered?
Oyes
No
©N/A
S.
Sample Labels Match CDC?
[]Yes
ONO
❑N/q
9.
I/J
-Includes Date/Time/ID/Analysis Matrix;
Heads ace in VOA Vials (>5-6mm)?
❑Yes
ONO
: N/A
10.
Trip Blank Present?
[-]yes
ONO
GN/A
11.
Trip Blank Custody Seals Present?
Yes
ONO
I]N /A
DISCREPANCY
Lot IDof split containers:
CLIENT NOTIFICATION/RESOLUTION -
Person contacted:
Date/T'ime:
Field Data Required? Oyes ONO
j� s /—
Project Manager SCURF Review: tYi 'i Date:
11vjj sII (7
Project Manager SRF Review: _ ryjlL Date: �J /^t� �G%
.
Page 11 of 13

Document Name:
Document Revised: February 7, 2018
. BCBAl18jy(IC21
Sample Condition Upon Receipt(SCUR)
Page 1 of 2
Document No.:
Issuing Authority:
F-CAR-CS-033-Rev.06
Pace Carolinas Quality Office
'Check mark top half of box if pH and/or dechlorination is Project k
verified and within the acceptance range for preservation
samples.
Exceptions: VOA, Coliform, TOC, Oil and Grease, DRO/8015 (water) DOC, LLHg
"Bottom half of box is to list number of bottle
WO#:92443443
PM: TIH Due Date: 09/10/19
CLIENT: 92—MID RTLRN
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pH Adjustment Log for Preserved Samples
Sample ID
Type of Preservative
pH upon receipt
Date preservation adjusted
Time preservatlon
adjusted
Amount of Preservative
added
Lot a
Note: Whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this farm will be sent to the North Carolina DEHNR Certification Office jl.e.
Out of hold, incorrect preservative, out of temp, incorrect containers.
Page 12 of 13

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1
CHAIN -OF -CUSTODY / Analytical Reques Document
The Chain --Custody is a LEGAL DOCUMENT. Aa relevant fields must be co leted accurately.
JaeNan A Section IS Section C
Reputed Client Information Rethi ted P1.jW Information: 1. INomalion
Page: of
Company: Mid -Atlantic Associates, Inc.
Rel+on To: Chuck Hoffman (choHman@maaonline.00m)
Atenbon: ChuckHoffman
Address: 409 Rogers View Court
Copy To: Ron Davis ([e-mail]
Company Name; Mid -Atlantic Associates. Inc.
'
REGULATORY AGENCY
Raleigh, NC 27610
Address: 409 Rogers View Court, Raleig
NC
GRO
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