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Home My WebLink AboutNCG120080_MONITORING INFO_20200113STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. DOC TYPE ❑ HISTORICAL FILE I MONITORING REPORTS DOC DATE ❑��av��13 YYYYMMDD DocuSign Envelope ID: 1A5E7709-27D4ADCC-A69C-a928DOCBOF3E ABORM SMITH+GAR NER 4N TEL WEB N. Boylan Avenue, Raleigh NC27s03 919.B2B.0577 wwwsmithgartlnerinccom E 06I11 EERS December 31. 2019 NCDED Division of Water Quality Attention: DWO Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 RECEIVED RE: December Tier 22019 Discharge Monitoring Report South Wake MSW landfill JAN 1 a, on Certificate of Coverage #NC6120080 CENTRAL FILES General Permit ONEG120000 DWR SECTION Dear Sir/Madam: On behalf of South Wake MSW Landfill ISWLFI, Smith Gardner, Inc. (S+G) is submitting this required Tier 2 discharge monitoring report. The SWLF facility is located in Wake County, North Carolina. The facility is currently permitted discharge stormwater related to landfilting activities under Certificate of Coverage NCG120080, General Permit NCG120000. The facility is required to monitor discharge at the Stormwater Discharge Outfalls (SDOs) 1, 4, and 6. Semiannual sampling was completed at SDO-4 and SOO-6 during the August event and November event respectively. The site is currently in Tier 2 status at SDO-1 (fecal coliform). SDO-1 exceeded the benchmark threshold for fecal coliform. We are providing two (2) copies of the DMR report for this submittal. If you have any questions about this report or require additional information, please contact us at 19191-828-0577. Sincerely, SMITH GARDNER, INC. E Docu81gna0 Oy: U CSECC95C937E4AC Jesse C. Li, E.I. Staff Engineer, ext. 170 iessefasmithgardnerinc.com Attachment CC: Troy Mitchell, Wake County Disposal, LLC File �nooc�siaa �Ca4980AW06— John R. Fearrington, P.E. Project Engineer, ext. 125 0ohnffasmithgardnerinc.com DocuSign Envelope ID: tA5E7709-27D4-4DCC-A69CA928DOCBOF3E 2*4 This page intentionally left blank. DocuSign Envelope ID: 1A5E7709-27D4-4DCC-A69C-4928DOCBOF3E Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG120000 CERTIFICATE OF COVERAGE NO. NCG12 0 O 8 0 FACILITY NAME South Wake MSW Landfill COUNTY Fake Date submitted December 31, 2019 SAMPLE COLLECTION YEAR 2019 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or * Monthly' December (month) PERSON COLLECTING SAMPLES Seth Rickerts (Smith Gardner, Inc) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA LABORATORY Pace Analytical Lab Cert. p 37738 ❑Zero -flow []WaterSupply ❑SA Comments on sample collection or analysis: 1RECEIVED *Otherc AN 13 2OZO PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Part A: Stormwater Benchmarks and Monitoring Results CENTRAL FILES . DWR SECTION 0 No discharge this period' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Chemical Oxygen Demand mg/L Fecal Collform Colonies per 100 mL Total Suspended Solids mg/L pH' Standard Units Benchmarks _. - 120 1000 100 or 504 6.0-9.0 Parameter Code - 46529 00340 31616 C0530 00400 SDo-1 12/17/19 0.25 72.1 3000 26.2 ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. ' For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 3The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. 4 See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non - numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX". Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018 Page 1 of 2 DocuSign Envelope ID: tA5E7709-27D4-4DCC-A69C-4928DOCBOF3E Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. El No discharge this period2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -Polar Oil & Grease mg/L Total Suspended Solids, mg/L New Motor or Hydraulic Oil Usage, gal/mon Benchmarks _ 15 100 or 504 Parameter Code - 46529 00552 C0530 NCOIL Footnotes from Part A also apply to this Part B Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier Z or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO Q IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an oriainal copy of this DMR, including all "No Discharae" reports, within 30 days of receipt of the lab results for at end of monitorina period in the case of "No Discharge" reports/ to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center „E- :" rjr F Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: . , "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 fines and imprisonment for knowing violations." �DocuSiBned by: kf&& Signature of Permit Date: 11/1/2018-5/31/2021 1/7/2020 Date SWU-248, last revised 11/1/2018 Page 2 of 2 DocuSign Envelope to: 1A5E7709-27D4-4DCC-A69CA928DOCBOF3E Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG120000 Date submitted December 31, 2019 CERTIFICATE OF COVERAGE NO. NCG12 0 0 8 0 FACILITY NAME South Wake MSW Landfill COUNTY wake PERSON COLLECTING SAMPLES Seth Rickets (Smith Gardner, Inc) LABORATORY Pace Analytical Lab Cert. tJ 37738 Comments on sample collection or analysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2019 SAMPLE PERIOD ❑ Jan -June ❑ July -Dec or *Monthly' December (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water supply [:]SA #Other C PLEASE REMEMBER TO SIGN ON THE REVERSE 4 n No discharge this period' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Chemical Oxygen Demand mg/L Fecal Coliform Colonies per 100 mL Total Suspended Solids mg/L pH, Standard Units Benchmarks _ - 120 1000 100 or 504 6.0-9.0 Parameter Code - 46529 00340 31616 C0530 00400 SDO-1 12/17/19 0.25 72.1 3000 26.2 1 Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 'For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here: 'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement. ° See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non - numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L", where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX". Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018 Page 1 of 2 DocuSign Envelope ID: 1A5E7709-27D4ADCC-A69C-4928DOCBOF3E Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. n No discharae this neriod2 Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -Polar Oil & Grease mg/L Total Suspended Solids, mg/L New Motor or Hydraulic Oil Usage, gal/mon Benchmarks _ - 15 - 100 or 504 Parameter Code - 46529 00552 CO530 NCOIL Footnotes from Part A also apply to this Part B Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text. FOR PART A AND PART B MONITORING RESULTS: • A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO Q IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original copy of this DMR, including all "No Discharge" reports within 30 dovs of receipt of the lab results for at end of monitorina Period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED: "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 fines and imprisonment for knowing violations." �—Docu Signed by: Signature of Permit Date: 11/1/2018-5/31/2021 1/7/2020 Date SWU-248, last revised 11/1/2018 Page 2 of 2 1, G) J ]".'I I"hb.195 �•' (�IaceAnalyticale rww.pr celabs.ca , January 03, 2020 Jesse Li Smith Gardner, Inc 14 N. Boylan Ave Raleigh, NC 27603 RE: Project: Samples -Revised Report Pace Project No.: 92457785 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Dear Jesse Li: Enclosed are the analytical results for sample(s) received by the laboratory on December 17, 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. This revision was issued on 01/03/19 to report the samples on separate reports, per client request. If you have any questions concerning this report, please feel free to contact me. Sincerely, Matthew Brainard matthew.brainard@pacelabs.com (704)875-9092 Project Manager Enclosures REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services. U.C. Page 1 of 11 (�15'ce Analytical w .DarrhSa.aam Project: Samples -Revised Report Pace Project No.: 92457785 - Pace Analytical Services Raleigh 6701 Conference Drive, Raleigh, NC 27607 North Carolina Wastewater Certification #: 67 Pace Analytical Services Asheville Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville. NC 28078 (704)875-9092 2225 Riverside Drive, Asheville, NC 28804 Florida/NELAP Certification #: E87648 Massachusetts Certification #: M-NC030 North Carolina Drinking Water Certification #: 37712 Pace Analytical Services Eden 205 East Meadow Road Suite A, Eden, NC 27288 North Carolina Drinking Water Certification #: 37738 CERTIFICATIONS North Carolina Bioassay Certification #: 16 North Carolina Drinking Water Certification #: 37731 North Carolina Wastewater Certification #: 40 South Carolina Certification #: 99030001 VirginiaNELAP Certification #: 460222 North Carolina Wastewater Certification #: 633 VirginiaNELAP Certification #: 460025 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 11 s (�15?eAnalyficale ww.pacdabs.cara SAMPLE ANALYTE COUNT Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: Pace Project No.: Samples -Revised Report 92457785 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92457785001 SWAKE SM 2540D-2011 AMI 1 PASI-E SM 9222D-2006 WT 1 PASI-R SM 5220D-2011 NAL 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 11 (�15'ceAnalyfical* rrrw.pacalahs.cam ANALYTICAL RESULTS Project: Samples -Revised Report Pace Project No.: 92457785 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Sample: SWAKE Lab ID: 92457785001 Collected: 12/17/19 13:25 Received: 12/17/19 15:05 Matrix: Water Parameters Results Units Report Limit OF Prepared Analyzed CAS No. Oual 2540D Total Suspended Solids Total Suspended Solids MBIO 9222D Fecal Coliform RAL Fecal Coliforms 5220D COD Chemical Oxygen Demand Date: 01/03/2020 12:48 PM Analytical Method: SM 254OD-2011 26.2 mg/L . 3.5 1 12/19/19 09:44 Analytical Method: SM 9222D-2006 Preparation Method: SM 9222D-2006 3000 CFU/100 mL 1.0 1 12/17/19 17:46 12/18/19 16:15 Analytical Method: SM 5220D-2011 Preparation Method: SM 52200-2011 72.1 mg/L 25.0 1 12/19/19 17:12 12/19/19 19:56 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 11 aceAnalytical rwr.pecNabs.cetn QUALITY CONTROL DATA Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: Samples -Revised Report Pace Project No.: 92457785 OC Batch: 515732 Analysis Method: SM 25400-2011 QC Batch Method: SM 254OD-2011 Analysis Description: 25400 Total Suspended Solids Associated Lab Samples: 92457785001 METHOD BLANK: 2763350 Matrix: Water Associated Lab Samples: 92457785001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg/L NO 2.5 12/19/19 09:38 LABORATORY CONTROL SAMPLE: 2763351 Spike LCS LCS % Rec Parameter Units Conc. Result %Rec Limits Qualifiers Total Suspended Solids mg/L 250 246 98 90-110 SAMPLE DUPLICATE: 2763352 92457579002 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 100 101 1 SAMPLE DUPLICATE: 2763353 92457741001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 412 450 9 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: 01/03/2020 12:48 PM without the written consent of Pace Analytical Services, LLC, Page 5 of 11 (�I?ceAnalyfimlo tmr.pacalaEa.cate Project: Samples -Revised Report Pace Project No.: 92457785 QC Batch: 516407 QC Batch Method: SM 92220-2006 Associated Lab Samples: 92457785001 METHOD BLANK: 2766807 Associated Lab Samples: 92457785001 Parameter Units Fecal Coliforms CFU/100 mL SAMPLE DUPLICATE: 2766808 Parameter Units Fecal Coliforms CFU/100 mL QUALITY CONTROL DATA Analysis Method: SM 9222D-2006 Analysis Description: 9222D Fecal Coliform(MF) - RAIL Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers NO 1.0 12/18/1916:15 92457785002 Dup Result Result RPD Qualifiers 2600 2500 4 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Results presenter) 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, Dale: 01/03/2020 12:48 PM without the written consent of Pace Analytical Services, L-C. Page 6 of 11 C % Pace Analytical Services, LLC IaceMalytical ` 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 rtas.pacelabs.com (704)875-9092 QUALITY CONTROL DATA Project: Samples -Revised Report Pace Project No.: 92457785 OC Batch: 515648 Analysis Method: SM 52200-2011 OC Batch Method: SM 5220D-2011 Analysis Description: 52200 COD Associated Lab Samples: 92457785001 METHOD BLANK: 2763111 Matrix: Water Associated Lab Samples: 92457785001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Chemical Oxygen Demand mg/L. NO 25.0 12119/19 19:51 LABORATORY CONTROL SAMPLE: 2763112 ' Spike LCS LCS % Rec Parameter Units Conic. Result %Rec Limits Qualifiers Chemical Oxygen Demand mg/L 750 760 101 90-110 MATRIX SPIKE 8 MATRIX SPIKE DUPLICATE: 2763113 2763114 MS MSD 92457795001 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conic. Cone. Result Result %Rec %Rec Limits RPD Qual Chemical Oxygen Demand mg/L 193 100 100 306 306 113 113 90-110 0 Mll MATRIX SPIKE 8 MATRIX SPIKE DUPLICATE: 2763115 2763116 MS MSD 92457795002 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc. Conic. Result Result % Rec % Rec Limits RPD Qual Chemical Oxygen Demand mg/L 53.6 100 100 158 162 104 109 90-110 3 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, Dale: 01/03/2020 12:48 PM without the written consent of Pace Analytical Services, LLC. Page 7 of 11 aceAnalytical Ww.becalabs.com QUALIFIERS Project: Samples -Revised Report Pace Project No.: 92457785 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 POL - Practical Quantitalion 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. 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-E Pace Analytical Services - Eden PASI-R Pace Analytical Services - Raleigh ANALYTE QUALIFIERS Mt Matrix spike recovery exceeded OC limits. Batch accepted based on laboratory control sample (LCS) recovery. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 01/03/2020 12:48 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 11 e aceAnalytical ww.pactleM.cao QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: Samples -Revised Report Pace Project No.: 92457785 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 - Huntersville, NC 28078 (704)875-9092 Lab ID Sample ID QC Batch Method QC Batch Analytical Method 92457785001 SWAKE SM 2540D-2011 515732 92457785001 SWAKE SM 9222D-2006 516407 SM 9222D-2006 92457785001 SWAKE SM 5220D-2011 515648 SM 5220D-2011 Date: 01/03/2020 12:48 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Analytical Batch 516409 515896 Page 9 of 11 CHAIN -OF -CUSTODY Analytical, Request Document 'LB_USEONiv W®tt : d2457755 pE. ceAna"cal' ,_, {I Chainof Custody isaLEGAL gImor anon. '-'Complote all relevent fields .,'I II'II'I��'�II'II I�I'II Company: _ ' ` i Billing Information :Al 92as77as Container Pms'k i= Report To'Irvla nap. 1 EmailT : 1T PresemtlwT " MM YDOs:111 nkdcadd,(2)tudca<kl,(3)Aydrodtloric add, 01 sodium trdrwide.(5) Nntacetate, Copy To: I t6�methanol, (7) sodium bkupate, (a) sodium thiosuxate, (9) hexane, (A) ascorbic ackl, (a) ammonium wlfate, Site Collection Into/Atltlmss:. �=�. (e) ammonium hydrexidG (OI TSP, (U) Unpresen, tl, (0) Other Customer PProjett Name/Number. State: County/City; Time Zone Collected: Analyses Lab Profile/Uh, ` / F:1?TI ]MTI ]CT 1 )ET >= k `' — r_ F'nan• Cpei Phone: I - - She/Facility ID #: Compban<e Monitoring? Email: No<cuet a - Purchase Order#: DW PWSID:#: Quote#: DW !oration Cade: ): ;2;Turnaround *mW�: Date Required: Immedutey Pac onI 1 r6s 1 1No 4. UIRA svtvp Rush: Field Filtered (if ;pp licahie): ] Dispose s appropdate ( I Return I ] Same Day I I Next Day ( )Yes , ] IN. Mhh'e ' 1 ] 2 Day 1 13 Day r Rest 1 ] 4 Day I ] S DaV ]Hold: (Expedite On me: Apply) Analysis:. ,amp Cbdes(inertin Ma[riil box hebw): Drinking Water (DW), Ground Water (GW), Wastewater (WW), €P�, ! DR 5 suit Prod Product Soil/Solid (SL), Oil (OQ, Wipe (WP), Air (AR), Tissue (TS), Bloassay (8), Vapor (V), Other JOT) y _ � �L LcaE, s Customer Sam le ID COR1p / Collected (or Res p of P Matriz • Gmb Composite Start) Composlte End U Ctns Date Time Date Time - - ._ . +; 4 .-. .... .. . I�t®NPr�t� :ustomer Remarks/ Special Conditions Possible Hazards: Type of ice Used - -Wet s <" Blue 'Dry o • SHORT HOLDS PRESEfJT(g2htit PazIdngMatedif Used s lab7racki6g # 24; ened (<$DD cpm). .. SSmPles rnoelved via! Radchemsample(s)slYe''V N ��; NA y t-" :CFEDEX' UPS '= GieM elinquish / any; (Si ture)" Date - /Time. ReceHe /Co pang (5- ture^ Date/Time: 1Z/)77- 1S .,,mmn i /Company: (Signature) Oatenime: Received b n pa y: (Signature) DaAi tenime: Te oe18 PCO.gpt I teet Y ®trA lgnatureS Pree9nt Y $ ttA 91gnn6 ra Piee at N NA . ntact -. Oitlenr p NA: C yoitvoe ; x'xA'. N YClye d'; on iea pA Y &pA ,apnea Acceptebl.e Y N_ I& leted Sollc I N dk) s Roldiny Tyne Sr• N " hlorino P Oec t p fNINi�' Aoeoptnble -Y p pp ; R.Y ♦ / Co®ante ample'Temperature Info': mp Blank:Receivetl Y.'. NiNA' solerlTernp Upon'R. elpt' 9k: loler3Therm wler 1 Chrcetted Temp .. CC rmments p Blank Received: „ �Y,„N NA <. N1eOH...:"-TSP� Other Confdnnance(s)i(. `Page: YES 1 No of: I I io I I abed La Document Nam, Sample Condition U on Re aceAnarytkal' Document No.; *Check mark top half of box If pH and/or dechlorination Is verified and within the acceptance range for preservation samples. Exceptions: VOA, Coliform, * Oil and Grease, ORO/6015 (water( DOC, U.Hg "Bottom half of box is to list number of bottle I: February 1 of PM: MWB Due Date: 12/27/19 CLIENT: 92—RSO" NC d m u d 2 a' x z z 3 a ° d 2 a ay ay o = n p Z •n• c = v n A 9 V O V C 'e Z n n _ z d ` Z a a yy yy V J V J N 2 V V D 1 4 4 JX El rVl y Y a n _q S y a 6 m E E E vE� E E' E EEE E E E o i r PH Adjustment Log for Preserved Samples pn upon rtcelpt 08te preservation adjusted Time preservedoa Amount of Prc Native adjusted added Lot t a copy Out of hold, incorrect preaemtive, ouof tamp, InW'Mt mntalnersV • �'amwas,