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Home My WebLink AboutNCG160135_MONITORING INFO_20190711Nv � o STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. rl V ) l o' 3 5 DOC TYPE ❑ HISTORICAL FILE D� MONITORING REPORTS DOC DATE ❑ a d I YYYYM M D D Semi-annual Stormwater Discharge Monitoring Report (DMR) for North Carolina DEMLR General Permit No. NCG160000 - Asphalt Date submitted June 27, 2019 CERTIFICATE OF COVERAGE NO. NCG160135 FACILITY NAME APAC Atlantic, Inc. Plant #5 COUNTY Forsyth PERSON COLLECTING SAMPLES Robby Lewis LABORATORY ENCO Lab Cent. If 591 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' (month) T--rDISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA ` ❑Zero -flow ❑Water Supply ❑SA JUL 1 1 2019 ®Other C - MillCreek CE-N I ,IAIt f:IL.G.q PLEASE REMEMBER TO SIGN ON THE REVERSE 4 ��C7'IO�i ❑ No discharge this period?z Outfall No. ' Date Sample, Lollected'' (mo/dd/yr),. 24=hour: rainfall :amount,'. -..Inches3 ` Total Suspended Solids Benchmarks - 100 nig/L or 50 mg/O 001 06/12/2019 0.75 6.7 002 06/12/2019 0.75 6.6 003 06/12/2019 0.75 14.0 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 3, 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 m¢/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. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014_ Page 1-of2 ❑ No discharge this period?2 Outfall No:_,`. -- Date.5ample Collected' (mo/dd/yr) , 124-hour rainfall. amount, -- Inches' Non -polar O&Gby EPA 1 1664.(SGT-HEM) Total suspended Solids, Benchmarks =__> - 15 mg/L _ YOO mg/L or,SO mg/O 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 ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: 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. am aware at there are significant penalties submitting false information, including the possibility of fines and imprisonment for knowing violations." ✓r • 06/27/2019 (Signature of Permittee) Permit Date: 10/1/2014-9/31/2019 (Date) SWU-252, last revised 9/17/2014 Page 2 of - ��a=� NCO ores i ENCO ' TV Accurate. Timely. Responsive. Innovative. 102-A Woodwinds Industrial Court Cary NC, 27511 Phone: 919.467.3090 FAX: 919.467.3515 Wednesday, June 26, 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 8 ENCO Workorder(s): CCO1110 Dear Parker Alvis, Enclosed is a copy of your laboratory report for test samples received by our laboratory on Monday, June 17,2019. 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 nxell by the laboratory, and may only he reproduced In full. Page 1 of 7 e� www.enwlabs.mm SAMPLE SUMMARY/LABORATORY CHRONICLE ClientlD: Out/all-OS Lab ID: CCO1110-01 Sampled: 06/12/19 16:30 Received: 06/17/19 09:50 Parameter Preparation Hold Date/Time(s) Prep Date/Time(s) Analysis Date/Time(s) SM 254OD-2011 NO PREP 06/19/19 06/18/19 07:23 06/18/19 07:23 ClientlD: Outfa11-02 Lab ID: CCO1110-02 Sampled: 06/12/19 16:30 Received: 06/17/19 09:50 Parameter Preparation Hold Date/Time(sl Prep Date/Time(s) Analysis Date/Time(s) SM 254OD-2011 NO PREP 06/19/19 06/18/19 07:23 06/18/19 07:23 Client ID; Outfa11-03 Lab ID: CCO1110-03 Sampled: 06/12/19 16:30 Received: 06/17/19 09:S0 Parameter Preparation Hold Date/Time(s) Prep Date/Time(s) Analysis Date/Time(s) SM 254OD-2011 NO PREP 06/19/19 06/18/19 07:23 06/18/19 07:23 FINAL This report relates only to the sample as receives by the iabmatorv, and may only be reproduced is full. PdgE! 2 Of 7 SAMPLE DETECTION SUMMARY Client ID: Outfall-01 Lab ID: CCO1110-01 . Anal vte Total Suspended Solids sul flag MDL P4L 6.7 2.8 2.8 unm mg/L Client ID: Outfall-02 Lab ID: CCO1110-02 Analvte Total Suspended Solids R€sulfa Elba MPL P9S 6.6 2.5 2.5 Yoits mg/L Client ID: Outfall-03 Lab ID: CCO1110-03 Analyte Total Suspended Solids FINAL Results EW5 MDL EQL u31111 14 4.2 4.2 mg/L This report relates only to the sample as recelved by the laboratory, and may only Ee reproduced In full. w .encolabs.com Method Dotes SM 2540D-2011 Page 3 of 7 WwW.encolabs.com ANALYTICAL RESULTS Description: Outfall-01 Lab Sample ID:CCO1110-01 Received: 06/17/19 09:50 Matrix: Water Sampled:06/12/19 16:30 Work Order: CC01110 Project: APAC Plant 8 Sampled By:CLIENT Classical Chemistry Parameters ^ - ENCO Cary reKllM analyfe(NC 5911 Analyte [CAS Numbed R sul Flag Units DF MDL POI, Batch Method Analyzed IY Notes Total Suspended Sond$A 6.7 mg/L I'll 2.8 2.8 9F18002 SM 2540D-2011 06118/1907:23 LG Description: Outfall-02 Lab Sample ID:CC01110-02 Received: 06/17/19 09:50 Matrix: Water Sampled:06/12/19 16:30 Work Order: CC01110 Project: APAC Plant Sampled By:CLIENT 1 Classical Chemistry Parameters ^ - ENCD CarycerVfied analyte [NC 5911 Analyte [CASNumberl Results Lin units PE MDL E" Batch Method AB&lv3ed By Notes Total Suspended Solids^ 6.6 mg/L 1 2.5 2.5 9F18002 SM 2540D-2011 06/18/19 07:23 LG Description: Oudall-03 Lab Sample ID:CCOS 110-03 Received: 06/17/19 09:50 Matrix: Water Sampled: 06/12/1916:30 Work Order: CCO1110 Project: APAC Plant 8 Sampled By:CLIENT Classical Chemistry Parameters ^ . EN Cary cert fled anayle [NC 591] Analyte [CAS Numbed Results Flog 1I11123 PF MDL P46 Batch Method Analyzed Dy Notes Total Suspended Solids- 14 mg/L 1.67 4.2 4.2 9F18002 SM 2540D-2011 06/18/19 07:23 LG FINAL This report relates only to the sample as received by the laboratory, and may only he reproduced In Full. Page 4 Of 7 UMNeP www.encolabs.com QUALITY CONTROL DATA Classical Chemistry Parameters - Quality Control Batch 9F18002 - NO PREP Blank (9F18002-BLRI) Prepared & Analyzed: 06/18/2019 07:23 Spike Source %REC RPD Analyte Result F.la9 POL Units Level Result %REC Limits RPD Lbij Rotes Toral Suspended Solids 2.5 U 2.5 mg/L LCS (9F18002-BSI) Prepared & Analyzed: 06/18/2019 07:23 Spike Source %REC RPD .Analyte Result Flag POL ()nits Level Result ^loRECLim! RPD Lllelt Notes Toml Suspended Solids 95 2.5 mg/L 100 95 80-120 Duplicate (9F38002-DUP3) Prepared & Analyzed: 06/18/2019 07:23 Source: CCO1111-01 Spike Source %REC RPD Analyte Result Flaq POL Itnits Level Result %REC Limits RPD Limit Notes Total Suspended Solids 37 8.3 mg/L 39 4 20 FINAL This report relates only to the sample as rmeiyed 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 (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 - MDL/MRL reported to the highest reporting limit of the component analyses. FINAL This report relates only to the sample as recaved by the iahwatory, and may only trz reoroeuree In full. Page 6 0f 7 10]]5 Central Port Dn 4810 Eze0u6ve Parh Carat Sul- ill 102-A Woodwinds Industrial Cl. Orlando.FL3262a ( FL 322t6 Cary.462]611 aM (dol)B2(:5314 Faz (aW) BSU6?t5 (a )2nwlle )-2 (90a) 296J00] Faz 19Ba) 296-62t0 (919) au]-3090 Fes (919) a6]-35t6 Client Name Pali Number Requested Analyses El Group, Inc. (TH005) [none] Addross 2101 Gateway Center Blvd., Suite 200 P, ed N..UO e PAC Plant 8 Cay(ST0. PO 3l elilln9lnto Morrisville, NC 27560 p 0 Tel Fox Reponinq Gon4 ct (919) 657-7500 Parker Alois N 2 (n Sammar(s) Name. AtfAiation (Fria) Bllla Collard Parker Alois U) Sampler(s) Signature Site Location ] Tore zone It Preservation (See Cedes) (Combine as nece: C01:xtbn #, aXi TmaI a o1 ham a Somme ID Witeld idantllkmlon) CmlecuOn Data Time Camp l Gratt had modes) Cgmxmers 1_13z, Page of r Requested Turnarou Times o Nate: Rush requests suhje m aeceptmoee bythe Writ a ✓�Standard Expedited Due G r x, : N._ : �a (�� . 2lOoif�]! 03 1214� ,IG3Q _=gmb z,°.�wA u1. 1•=. : n o Sample 1(it Propamd By Om Mme RetirpushN DmMrere Received By DWOMri e Comnantr✓Special Reporting Requvomems $ Relinquished By Daterrime Received By DataTne Relinqushed By DetaTme RacoivM By Datdtime Cooler e's 3 Temps an Recalpt �] cemd tlw{7 upon Receipt Acceptable Unaceeptable wills:GW-GrowWwater Su-aee uw-vnrum9 vvamroe-aemmem........ ...._• ..------ .._._ -- Note : All samples submitted to ENCO labs are m eccordance'.riN the terms aeM artdtions listed on this rercrse of itus form. bless prior whitish a9mmamits exist Semi-annual Stormwater Discharge Monitoring Report (DMR) for North Carolina DEMLR General Permit No. NCG160000 - Asphalt Date submitted June 27, 2019 CERTIFICATE OF COVERAGE NO. NCG160135 SAMPLE COLLECTION YEAR 2019 FACILITY NAME APAC Atlantic, Inc. Plant #5 SAMPLE PERIOD ® Jan -June ❑ July -Dec COUNTY Forsyth or ❑ Monthly' (month) PERSON COLLECTING SAMPLES Robby Lewis cP DISCHARGING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA RCl'I'��>°�� ❑Zero -flow ❑Water Supply ❑SA LABORATORY ENCO Lab Cert. ri 591 > Comments on sample collection or analysis: ®Other C - MiIlCreek JUL 11 2019 Part A: Stormwater Benchmarks and Monitoring Results Cci`� I tF L PLEASE REMEMBER TO SIGN ON THE REVERSE 4 CV?/R SECTION ❑ No discharge this period?z - OutfallNo::. - -Date Sample _ J Collected', (mo/dd/yr) ' 24-hour rainfall . ' amount, Inches - Total Suspended Solids - - Benchmarks ===> -: - - - . - 100 mg/L or 50 mg/L* 001 06/09/2019 1.0 67 ' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outfall. z 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. a See General Permit text, Table 3, 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. Part B: Vehicle Maintenance Area Monitoring Results: only for facilities averaging > 55 gal of new oil per month. Permit Date: 10/1/2014-9/31/2019 SWU-252, last revised 9/17/2014 - - - - - - - - - - - - - Page 1 of 2 - ❑ No discharge this period?' 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 ' - - - : ._.r - , -� Benchmarks =__> ' - 15 mg/L - ,100 mg/L or S01mg/0 -' 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 ANYONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DEMUR REGIONAL OFFICE AS REQUIRED BY THE PERMIT? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: 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 MUSTSIGN 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. am aware at there are significant penalties submitting false information, including the possibility of fines and imprisonment for knowing violations." � " • 06/27/2019 (Signature of Permittee) Permit Date: 10/1/2014-9/31/2019 (Date) SWU-252, last revised 9/17/2014 Page 2of 2 - - 1BQgRN� riles Accurate. Timely. Responsive. Innovative. 102-A Woodwinds Industrial Court Cary NC, 27511 Phone: 919.467.3090 FAX: 919.467.3515 Friday, June 21, 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 5 ENCO Workorder(s): CCO1108 Dear Parker Alvis, Enclosed is a copy of your laboratory report for test samples received by our laboratory on Wednesday, June 12, 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. I Page 1 Of 7 W C 01 www.enwlabs.com SAMPLE SUMMARY/LABORATORY CHRONICLE COMM Outfalll Lab ID: CCO1108-01 Sampled: 06/09/19 10:32 Received: 06/12/19 13:10 Parameter Preparation Hold Date/Time(sl Prep Date/Time(sl Analysis Date/Timefsl SM 2590D-2011 NO PREP 06/16/19 06/13/19 07:37 06/13/19 07:37 FINAL This report relates only to the sample as received by the laboratory, and may only be reproduced in full. Page 2 Qf % a www.encolabs.com SAMPLE DETECTION SUMMARY Client ID: Outfall 1 Lab ID: CCO1108-01 Analvte Results Flan MDL POL Units Method Notes Total Suspended Solids 67 10 10 mg/L SM 2540D-2011 FINAL This report relates only to the sample as receiyed by the laboratory, and may only be reproduced in full. Page 3 Of 7 www.encolabs.com ANALYTICAL RESULTS Description: Outfall 1 Lab Sample ID:CCO1108-01 Received: 06/12/19 13:10 Matrix: Water Sampled:06/09/19 10:32 Work Order: CCO1108 Project: APAC Plant 5 Sampled By:Jason Suiter Classical Chemistry Parameters Analyte ICAS Number'! Total Suspended SolidsA Results Flag Units DF Mal. POL Batch Method Analyzed By Note 67 mg/L 4 10 10 9F13001 SM 251OD-2011 06/1311907:37 LG FINAL This report relates only to the sample as received by the laboratory, arm may only be reproduced In Full. Page 4 of 7 www.encolabs.com QUALITY CONTROL DATA Classical Chemistry Parameters - Quality Control Batch 9F13001 - NO PREP Blank (9F13001-BLRS) Prepared & Analyzed: 06/13/2019 07:37 Spike Source %REC RPD -Analvte Result Flan P-OL Units Level Result "/REC Limits RPD i i Notes Total Suspended Solids 2.5 U 2.5 mg/L LCS (9F13001-BS1) Prepared & Analyzed: 06/13/2019 07:37 Spike Source %REC RPD Analyte Result Elao P-OL Units Level Result %REC Limits RPD MaIll Notes Total Suspended Solids 97 2.5 mg/1- 100 97 80-120 Duplicate (9F13001-DUP1) Prepared & Analyzed: 06/13/2019 07:37 Source: CC01339-01 Spike Source °/aREC RPD .Analyse Result Ela9 Poi Units Level Result %REC UrniSs RPD Limit Notes Total Suspended Solids 43 14 mg/L 42 3 20 Duplicate (9FL3001-DUP2) Prepared & Analyzed: 06/13/2019 07:37 Source: CC08542-01 Spike Source %REC RPD Analvte Result F.IaR P-OL Units Level Result %REC Limits RPD Lima Notes Total Suspended Solids 200 45 mg/1- 210 6 20 FINAL This report relates only to the sample as received by the laboratory, and may only to reproduced in full. Page 5 Of 7 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". P Greater than 25% concentration difference was observed between the primary and secondary GC column. The lower concentration is reported. [CALC] Calculated analyte - MDL/MRL 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 full. I Page .. tOT15 C¢nhal Port Dr. 4810 Executive Park Court, Suite t11 f 02-A Woodmnds Indusmal Cl. Drendo. FL 32JN24Jacksonville. FL 32 Car) NC DSt t (gW)6261i3 to Faa (w!)D5063:3 (9Dt)296300> Fa.. (9N) (904)298 Fx210 (919)4673090 Far (Dt9)a6.35t5 Page Of _ Gi¢nt Name Project Numbed Requested AnetyS¢s Requested TDrnarDB O El Group, Inc. (TH005) [none] Times n M Npta: Rush requests subje m Address Project NamJDesc 2101 Gateway Center Blvd., SuRe 200 APAC Plant 5 ..,Naamo m; the litain n. C'tYfSTlGQ PO s f Billing into Mornsville, NC 27560 p Standard _ TO Fax Repeat,, Corneal (919) 657-7500 Parker Alvis cN¢ C cn _Expedited Due Samplers) Nam.. Afi9iation (Print Bill Contact Parker Alvis S�. Lab WOtkordef -_ Sample{1q$iynu Sire Lcv Scn f Time all. \\\\x CC011Q8_- - Pr¢servatlon (See God¢s)ICombine as neraasaryY Carerajon Wtrlx Total a of Sample Comments It¢ma Sample ID(F eld ldr n9icehoI CdwnTimelacData Time GOMP JGrab (see codes) Cando a P 01 i., •'... 4 t.r• . r":i, %-S:y ,T S t ...Te 9}'t. .i ai _:a nf:'C a' kS-; ,'t a _ y u. F '. v. a T. .x. _ l l " I I i Sample Kit Prepared By DWOTMO RaGrquis !i Catertime .Read y Ccmmantsrsperial Papering Requimmsue, Reprpuishod By i therm ma ¢c - l aim 13/0 Relinquished By ( Datamme, Race By ratervaPe Coolor W. b Temps oa Receipt / /1d Condition V/P Receipt Acceptable _ Unacceptable Matrix:GW-Gmundheater SO-SO) DW-Drinking weerse-semmemt s)-sunace vrerer vr'_.aspamia'. .' vwmirwm..•a. .........,.r •_�••_••..•.•.^••••••.._.,•.-.,•--^...---..___._. .__._..... �...... _..._, Note: AN samples submitted ;o ENCO Labs are in accordance with the than,, are cand.was listed on the reverse at this form, unbsss pow wrdlan aWeemenls super