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HomeMy WebLinkAboutNCG160111_MONITORING INFO_20191220Vv STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. NCG DOC TYPE ❑ HISTORICAL FILE MONITORING REPORTS DOC DATE ❑ �� I P I o� �' V YYYYMMDD Semi-annual Stormwater Discharge Monitoring Report(DMR) for North Carolina DEMLR General Permit No. NCG160000 - Asphalt Date submitted 11/30/2019 CERTIFICATE OF COVERAGE NO. NCG16 0111 FACILITY NAME APAC Atlantic, Inc. Plant 9 COUNTY Randolph PERSON COLLECTING SAMPLES Kenneth Sorrell LABORATORY ENCO Laboratories Lab Cert. # 591 Comments on sample collection oranalysis: Part A: Stormwater Benchmarks and Monitoring Results SAMPLE COLLECTION YEAR 2019 SAMPLE PERIOD ❑ Jan -June ® July -Dec or ❑ Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ❑Zero -flow ❑Water Supply ❑SA ❑Other Back Creek PLEASE REMEMBER TO SIGN ON THE REVERSE --) n No discharge this period?z Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, -. Inches' Total Suspended Solids Benchmarks =__> - - 100 mg/L or 50 mg/L4 Outfall01 10/31/19 1.0 <2.5 Outfall02 10/31/19 1.0 <2.5 'Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. 2For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a check mark 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 4requirement. 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/I.", where XX is the numerical value of the detection limit, reporting limit, quantitation limit, etc. in mg/L. 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: 08/01/2019-05/31/2024 SWU-252, last revised 09/04/2019 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. ❑ No discharge this period?2 Outfall No. Date Sample Collected' (mo/dd/yr) - 24-hour rainfall amount, -IncheO . " Non -polar O&Gby EPA 1664 (SGT-HEM)" Total Suspended Solids New Motor Oil or Hydraulic Oil Usage, Annual averages - '*'gal/mo - - Benchmarks =__> - .. - . 15 mg/L 100 /L or 50 mg1l! _ 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 SINGLE BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONEOUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BYTHE PERMIT? YES ❑ NO ❑ REGIONAL OFFICE CONTACTNAME: Mail an oriainol and one copv of this DMR. includina all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitoring period in the case of "No Discharae" reports) to: Division of Water Resources Attn: DWR 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." (Signature of Permittee) /30/2019 (Date) Permit Date: 08/01/2019-05/31/2024 SWU-252, last revised 09/04/2019 Page 2 of 2 ME' ENCO ' es Accurate. Timely. Responsive. Innovative. 102-A Woodwinds Industrial Court Cary NC, 27511 Phone: 919.467.3090 FAX: 919.467.3515 Tuesday, November 12, 2019 EI Group, Inc. (TH005) Attn: Parker Alvis 2101 Gateway Center Blvd., Suite 200 Morrisville, NC 27560 RE: Laboratory Results for Project Number: [none], Project Name/Desc: APAC Plant 9 ENCO Workorder(s): CC18286 Dear Parker Alvis, Enclosed is a copy of your laboratory report for test samples received by our laboratory on Friday, November 1, 2019. Unless otherwise noted in an attached project narrative, all samples were received in acceptable condition and processed in accordance with the referenced methods/procedures. Results for these procedures apply only to the samples as submitted. The analytical results contained in this report are in compliance with NELAC standards, except as noted in the project narrative if applicable. This report shall not be reproduced except in full, without the written approval of the Laboratory. This report contains only those analyses performed by Environmental Conservation Laboratories. Unless otherwise noted, all analyses were performed at ENCO Cary. Data from outside organizations will be reported under separate cover. If you have any questions or require further information, please do not hesitate to contact me. Bill Scott Project Manager Enclosure(s) FINAL This report relates only to the sample as received by the laboratory, and may only be reproduced In full. Page 1 of t t: SAMPLE SUMMARY/LABORATORY CHRONICLE Client ID: Outfall #1 Lab ID: CC18286-01 Sampled: 10/31/19 09:00 Received: 11/01/19 14:24 Parameter Preparation Hold Date/Time(s) Prep Date/Time(s) Analysis Date/Timefsl SM 254OD-2011 NO PREP 11/07/19 11/04/19 09:53 11/04/19 09:53 Client ID: Outfall#2 Lab ID: CCIS286-02 Sampled: 10/31/19 09:30 Received: 11/01/19 14:24 Parameter Preparation Hold Date/Time(s) Prep Date/Timefsl Analysis Date/Tir l SM 254OD-2011 NO PREP 11/07/19 11/04/19 09:53 11/04/19 09:53 FINAL This report relates only to the sample as received by the laboratory, and may only tR reproduced in full. I Page 2 Ot 7 w .encolabs.coro SAMPLE DETECTION SUMMARY No positive results detected. FINAL This report relates only to Me sample as received by the laboratory, and may only be reproduced in full. I Page 3 Of 7 vrW W.encolabs.com ANALYTICAL RESULTS Description: Outfall #1 Lab Sample ID:CC18286-01 Received: 11/01/19 14:24 Matrix: Water Sampled: 10/31/1909:00 Work Order: CC18286 Project: APAC Plant 9 Sampled By: Kenneth Sorrell (Classical Chemistry Parameters ^-EN CaryrerUbetlanayte(NC 5911 Analyte (CAS Numbed Results Flao Units Total Suspended Solids^ ND mg/ Description: Outfall #2 Matrix: Water Project: APAC Plant Classical Chemistry Parameters Analyte rCAS Numbed Total Suspended SolidsA DF MDL PPOL Batch Method Analwed By Notes 1 2.5 2.5 9KO4012 SM 254OD-2011 11/04/1909:53 BDC Lab Sample ID:CC18286-02 Received: 11/O1/19 14:24 Sampled: 10/31/1909:30 Work Order: CC18286 Sampled By:Kenneth Sorrell Besot SS %laa Units PE MDL P91 Batch Method Analvred By Notes ND mg/L 1 2.5 2.5 9K04012 SM 254OD-2011 11/04/19 09:53 BDC FINAL This repot relates only to Ne sample as received by the laboratory, and may only be reproduced in full. I Page 4 Of www.encolabs.com QUALITY CONTROL DATA Classical Chemistry Parameters - Quality Control Batch 9KO4012 - NO PREP Blank (9K04012-BLK1) Prepared & Analyzed: 11/04/2019 09:53 Spike Source O/oREC RPD -Analyte Result FIa9 P_OL Units Level Result 0/oREC Limits RPD li B]t Notes Total Suspended Solids 2.5 U 2.5 mg/L LCS (91<04012-BSI) Prepared & Analyzed: 11/04/2019 09:53 Spike Source %REC RPD Analvte Result Flag POL Units Level Result O/oREC Limi RPD LIMA Notes Total Suspended Solids 88 2.5 m9/L 100 88 80-120 Duplicate (9K04012-DUPI) Prepared & Analyzed: 11/04/2019 09:53 Source: CC17685-01 Spike Source O/oREC RPD Analyte Result Flaa PQ Units Level Result %RECLim! RPD limit Notes Total Suspended Solids 340 62 mg/L 350 5 20 Duplicate (9K04012-DUP2) Prepared & Analyzed: 11/04/2019 09:53 Source: CC12557-03 Spike Source %REC RPD Analyte Result Flag PQL Units Level Result O/oREC Limits RPD 1.1i Dtt Nptei- Tolal Suspended Solids 99 25 mg/L 120 18 20 FINAL This reppd relates only to the sample as received by the laboratory, and may only be reproduced In full. Page 5 Of 7 www.encolabs.com FLAGS/NOTES AND DEFINITIONS B The analyte was detected in the associated method blank. D The sample was analyzed at dilution. J The reported value is between the laboratory method detection limit (MDQ and the laboratory method reporting limit (MRL), adjusted for actual sample preparation data and moisture content, where applicable. U The analyte was analyzed for but not detected to the level shown, adjusted for actual sample preparation data and moisture content, where applicable. E The concentration indicated for this analyte is an estimated value above the calibration range of the instrument. This value is considered an estimate. MRL Method Reporting Limit. The MRL is roughly equivalent to the practical quantitation limit (PQL) and is based on the low point of the calibration curve, when applicable, sample preparation factor, dilution factor, and, in the case of soil samples, moisture content. PQL PQL: Practical Quantitation Limit. The PQL presented is the laboratory MRL. The analysis indicates the presence of an analyte for which there is presumptive evidence (85% or greater confidence) to make a "tentative identification". Greater than 25% concentration difference was observed between the primary and secondary GC column. The lower concentration is reported. [CALC] Calculated analyte - MDUMRL reported to the highest reporting limit of the component analyses. FINAL Titls report relates only to the sample as received W the lab ator, , and may only t,e reproduced m full. I Page 6 Of 7 - --- ---- .�..�.......�........ Por•.or. 4alDExa..F Valk ne In lneuS:eia1 C,. �� © t0Ado, rL 3f G-OX9 CrWndo. FL 32824 ,JAriamilla,R3221 G-cWe Cnry. NC 2]511 Cary. NC 9 (407)82&5314 Fax (401350.G945 eN)29&3W7 Fax(994)29&a210 1919)aa]3000 Fa. 19191467-3515 .B @ Oi Page Client Nam9 El Group, Inc. (TH005) Prgod Numper - (none] Requested! Analyses Requested Turnaro Times Address Projeal NamNDe r; 2101 Gateway Center Blvd., Suite 200 APAC Plant 9 Nate: Rds6 ea uess soli by Van We it d City/ST/LP PO 41 Billing late Morrisville, NC 27560 rop Standard TO - W-7500 FM_ Raporling Contact (919) Doug Albrecht N _Expedited Samplar(s) Name, AlNretlenn (Prtrltl �( Bi➢ing Canna Doug Albrecht _.. � '. Samp1 r(s) Si / 5ila Lceutbn I Tima Zona _ Lab:Wdrkorder U �• G Presarvatlon (See Codes) (Combine, as necasseInd Collodion Main. retail 9 d - Its.4 -Sample to(Feld histeikail On). COILVdan Dale T411a Conti /Drab ism some), conlgme:5 a p(e Comments ovf-& I # Z D 3/r 19 �.3D WA t X it- Semple k1 Prepared By DamJrna S-ty-f� Retail fished B 1 11 eata/nme .._ - trji%/ i /. i y Rasirted By %� Datv/rimen_ -fiJ 1�'' CommanlySpedal Roping Rasuhemaee Relvano hed By Datem. flaelvatl By Date/I-ana fr Relinquished By; ' - Dalelnmm Be .1kad By Dala?mo Cooler a's 8 Tamps an Receipt , e Condili0n pdn Regipl L' Acceptahle _Unacceptable ......-.-....-..-•w .-�.,.,,.., .---- ,...- .... ...... r ......axurvamr, r.-nu. vsnn'r 1 I HNO3 S-H25D4 NO-N.OH O-Oh s, transit sit in comments) Near: All samples submitted as ENCO lobs are in manaia a vnh the Cans and c'orldl4ons listed an the revere of his term, unless poor rvsilten aproements ends, Semi-annual Stormwater Discharge Monitoring Revort(DMR) for North Carolina DEMLR General Permit No. NCG160000 - Asphalt Date submitted 11/30/2019 CERTIFICATE OF COVERAGE NO. NCG16 0111 SAMPLE COLLECTION YEAR 2019 FACILITY NAME APAC Atlantic. Inc. Plant 9 SAMPLE PERIOD ❑ Jan -June ® July -Dec COUNTY Randolph or ❑ Monthly' (month) PERSON COLLECTING SAMPLES Kenneth Sorrell n ry l^�DISCHARGINGTOCLASS ❑ORW ❑HQW ❑Trout ❑PNA LABORATORYENCOLaboratories LabCert.# 591 RECEIVED ❑Zero -flow [:]Watersupply ❑SA Comments on sample collection or analysis: DEC O 9 2019 [—]Other Back Creek • tNTRAL FILES DWR SECTI0�1 PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Part A: Stormwater Benchmarks and Monitoring Results No discharge this period?z Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches Total Suspended Solids Benchmarks =__> - - 100 mg/L or 50 mg/L4 utfall01 10/31/19 1.0 <2.5 utfall 02 10/31 / 19 1.0 < 2.5 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 check mark 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 4requirement. 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, quantitation limit, etc. in mg/L. 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: 08/01/2019-05/31/2024 SWU-252, last revised 09/04/2019 Page 1 of 2 Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. n No discharge this periodj' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -polar O&G by EPA 1664 (SGT-HEM) Total Suspended Solids New Motor Oil or Hydraulic Oil Usage, Annual average gal/mo Benchmarks =__> - - 15 mg/L 100 /L or 50 mg/L" - 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 AND PART B MONITORING RESULTS: • A SINGLE BENCH MARK EXCEEDANCE TRIGGERS TIER I REQUIREMENTS. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. • TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDANCES FOR THE SAME PARAMETER AT ANY ONEOUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BYTHE PERMIT? YES [—]NO[:] REGIONAL OFFICE CONTACTNAME: Mail an original and one copy of this DMR including all "No Discharge" reports within 30 days of receipt of the lab results for at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Resources Attn: DWR 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." (Signature of Permittee) Permit Date: 08/01/2019-05/31/2024 11/30/2n19 (Date) SWU-252, last revised 09/04/2019 Page 2 of 2 F NCO zqa�� Laboratories Accurate. Timely. Responsive. Innovative. 102-A Woodwinds Industrial Court Cary NC, 27511 Phone: 919.467.3090 FAX: 919.467.3515 Tuesday, November 12, 2019 EI Group, Inc. (TH00S) Attn: Parker Alvis 2101 Gateway Center Blvd., Suite 200 Morrisville, NC 27560 RE: Laboratory Results for Project Number: [none], Project Name/Desc: APAC Plant 9 ENCO Workorder(s): CC18286 Dear Parker Alvis, Enclosed is a copy of your laboratory report for test samples received by our laboratory on Friday, November 1, 2019. Unless otherwise noted in an attached project narrative, all samples were received in acceptable condition and processed in accordance with the referenced methods/procedures. Results for these procedures apply only to the samples as submitted. The analytical results contained in this report are in compliance with NELAC standards, except as noted in the project narrative if applicable. This report shall not be reproduced except in full, without the written approval of the Laboratory. This report contains only those analyses performed by Environmental Conservation Laboratories. Unless otherwise noted, all analyses were performed at ENCO Cary. Data from outside organizations will be reported under separate cover. If you have any questions or require further information, please do not hesitate to contact me. Bill Scott Project Manager Enclosure(s) FINAL This report relates only to the sample as received by the laboratory, and may oNy be reP'oduced In full. I Page 1 Of 7 SAMPLE SUMMARY/ LABORATORY CHRONICLE Client ID: Outfall #1 lab ID: CC18286-01 Sampled: 10/31/19 09:00 Received: 11/01/19 14:24 Parameter Preparation Hold Date/Time(s) Prep Date/Time(sl Analysis Date/T1me(sl SM 2540D-2011 NO PREP 11/07/19 11/04/19 09:53 11/04/19 09:53 Client ID: Dutfall#2 Lab ID: CCIS286-02 Sampled: 10/31/19 09:30 Received: 11/01/19 14:24 Parameter Preparation Hold Date/Time(s) Prep Date/Time(s) Analysis Date/Time(s) SM 2540D-2011 NO PREP 11/07/19 Il/04/19 09:53 11/04/19 09:53 FINAL Thls report relates only to the sample as receivod by the laboratory, and may only be reprotluce0 mfull. I Page 2 Qf ] ,a www.encolabs.com SAMPLE DETECTION SUMMARY No positive results detected. FINAL Thls report relates only to the sample as mr elved by Me laboratory, and may only be reproduced in full. I Page 3 O1 W W W.encolabs.com ANALYTICAL RESULTS Description: Outfall #1 Lab Sample ID:CC18286-01 Received: 11/01/19 14:24 Matrix: Water Sampled: 10/31/19 09:00 Work Order: CC18286 Project: APAC Plant 9 Sampled By: Kenneth Sorrell Classical Chemistry Parameters ^ - FNW an, rertiled We [NC 5911 Analyte [CAS Numberl Results Mae Units DF MDL PPL Batch Method Analyzed ft Notes Total Suspended SolidsA ND mg/L 1 2.5 2.5 9K04012 SM 2540D-2011 11/04/19 09:53 BDC Description: Outfall #2 Lab Sample ID:CC18286-02 Received: 11/O1/19 14:24 Matrix: Water Sampled: 10/31/19 09:30 Work Order: CC18286 Project: APAC Plant 9 Sampled By: Kenneth Sorrell Chemistry Parameters Analyte [CAS Numberl Total Suspended SolidsA su FL49 Units DF My POL Batch Method Analned Ay Notes ND mg/L 1 2.5 2.5 9K04012 SM 2540D-2011 11/04/19 09:53 BDC FINAL This report relates only to the sample as received by the laboratory, and may oNy be reproduced In full. I Page 4 Qj vsww.encolabs.com QUALITY CONTROL DATA Classical Chemistry Parameters - Quality Control Batch 9KO4O12 - NO PREP Blank (9K04012-BLK1) Prepared & Analyzed: 11/04/2019 09:53 Spike Source %REC RPD Analvte Result Haar PD1 Units Level Result a/ REC Limits RPD Limi Notes Total Suspended Solids 2.5 U 2.5 m9/L LCS (9K04012-BSI) Prepared & Analyzed: 11/04/2019 09:53 Spike Source %REC RPD Fnalvte Result F.la9 COL Units Level Result %REC Limit RPD iinia Notes Total Suspended Solids 88 2.5 mg/L 100 88 80-120 Duplicate (9K04012-DUPI) Prepared & Analyzed: 11/04/2019 09:53 Source: CC17685-01 Spike Source %REC RPD Analvte Result Flag POL Units Level Result %REC Limits RPD Lmtii Notes Total Suspended Solids 340 62 mg/L 350 5 20 Duplicate (9K04012-DUP2) Prepared & Analyzed: 1I/04/2019 09:53 Source: CC12557-03 Spike Source %REC RPD Analvte Result Hag QQL Units Level Result o%REC Limits RPD LIM11 Notes Total Suspended Solids 99 25 mg/L 120 18 20 FINAL This report relates only to Na sample as rxeived by the laboratory, and may only be reproduced m full. I Page 5 01 7 11MIN www.encolabs.com FLAGS/NOTES AND DEFINITIONS B The analyte was detected in the associated method blank. D The sample was analyzed at dilution. J The reported value is between the laboratory method detection limit (MDL) and the laboratory method reporting limit (MRL), adjusted for actual sample preparation data and moisture content, where applicable. U The analyte was analyzed for but not detected to the level shown, adjusted for actual sample preparation data and moisture content, where applicable. E The concentration indicated for this analyte is an estimated value above the calibration range of the instrument. This value is considered an estimate. MRL Method Reporting Limit. The MRL is roughly equivalent to the practical quantitation limit (PQL) and is based on the low point of the calibration curve, when applicable, sample preparation factor, dilution factor, and, in the case of soil samples, moisture content. PQL PQL: Practical Quantitation Limit. The PQL presented is the laboratory MRL. N The analysis indicates the presence of an analyte for which there is presumptive evidence (85% or greater confidence) to make a "tentative identification". Greater than 25% concentration difference was observed between the primary and secondary GC column. The lower concentration is reported. [CALL] Calculated analyte - MDUMRL reported to the highest reporting limit of the component analyses. FINAL This report relates only to the sample as received by the laboratory, and may only be reproduced In fun. I Page 6 Of 7 tOFPort Or. 3810 Erosuwe Pail, Coud.Suite tlt 102-A tJWRI 7d91adO5b4al Ct. Orlando, ntlq FL PL 32024 Jackmmpb. FL 322fGG069 C&ry2 ,NC ]511 (407j MG-5314 Pox(407)550.0945 (9041296.3007 Fax(904)296.6210 (9114467-0090 Fax(9nh,167-3515 Chem Herne El Group, Inc. (TH005) PO iw NunA.r [none] Requested Analyses CI C) N rn 2Lice r- 2101 Gateway Center Blvd., Suite 200 P. APAC Plant 9 Cl1y1ST Zip Morrisville, NG 27560 F'D p J Dining into Tut (919),657-7500 FA Reporting Contact I Doug Albrecht Sja�mpttt(sj NamO. AlfWation (Print) , 1 aco-A� Y Win, Comas, Doug Albrecht Smnpl I(5, S19n1,lwe Sit. Locaivn J Tlme 2ona rD�J- C- ' Preservatfon (See Cvdes) (Combine as nocssaary) 11.0 Sampl. ID Mind ldentuiwtipi) CdlegGon Data CO teCtlpn Tlme 'CompJGmb MnviR (:.ee codovji TOW #Of "Comeinei. ='7g3M9`;":q.av WA :' 1" X'. Ou I WA - 1 X I m s i r i- l :I <-. Tntml A of Cnnm nnm Page _ of Requested Turnaro 0 Times Note Rush re'Suesls subje ho BCCEPIar1W by bro bCY1 a _ Standard _ Expedited abWorkordnr' Semple Kit Prepared By - D.I.Tima Rallhq ishetle owenlme Recomed By DatdrOnq - -' CovlmenjslSpmal Reporting Regtefemelds Rerngisho By DaKrtlme - RecalMO 6y Dat.T. Relinquished By. Dalem.0 Roc.Ned 9y DateJ{ene CoOler 0.6 d Temps on Receipt Is C.ndtbn pon Receipt L Acceptable _ Unacceptable maurs mra�er nva.n un-urmmng vra;.r ae< Oven; aw-aunaee v+amcwmwasrewawr_w-Jur utnnm tvmanm wmmontsp Proearvation: Nee M-11);t N-Ht1D3 SN25174 NO-NuON 04]Iher (uahti in commons) 1 NOW; All samples submitled 10 ENCO Labs aro in.c. ante wilb Me Imms GOO WOCIliOnu linOd On the mverep Of this form, unless prior written aghtenroms exist