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Home My WebLink AboutNCG210168_MONITORING INFO_20190702Vol`R)b STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. NCG a D ((a g DOC TYPE 11 HISTORICAL FILE LN MONITORING REPORTS DOC DATE ❑ C�.� d YYYYMMDD Georgia-Pacific Certified Mail # 7017 0190 0000 2521 9112 June 25, 2019 Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, NC 27699-1617 RE: Georgia-Pacific Wood Products LLC Dudley Plywood Facility NPDES General Storimvater Permit DMR Submittal Certificate of Coverage No. NCG210168 To Whom It May Concern: Georgia-Pacific Wood Products LLC Dudley Plywood 139 Brewington Road Dudley, NC 28333 JUL 0 2 2019 CEN I kAL PILES OI'VR SEC-r ON As required by the referenced permit in condition Part III, Section E.I, attached are the original and one copy of the signed discharge monitoring report (DMR) and laboratory analytical results for Year 2019 Period 1 for the Georgia-Pacific Wood Products LLC (GP) Dudley Plywood Facility Outfall 001. Please note that all required monitoring paramcters are within their respective benchmarks. Certification: "I certify, under penalty of /an,, 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 gcilher 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 fhnes and imprisonment for knowing violations. " Should you have any questions or need additional information, please contact Brandy Turley at 919-705- 0526 or brandy.turley��pac.com . Thank you. Sincerel;Gol v Michael en Plant Manager Dudley Plywood Attachments (2 copies): DMR Year 2019 / Period I; Laboratory Report Semi-annual Stormwater Discharge Monitoring Report for North Carolina DEMLR General Permit No. NCG210000 Date submitted _June 25, 2019 CERTIFICATE OF COVERAGE NO. NCG210168 FACILITY NAME _Georgia Pacific - Dudley Plywood COUNTY Wayne PERSON COLLECTING SAMPLES _Brandy Turley LABORATORY —Pace Analytical Lab Cert. If 12 Comments on sample collection or analysis: 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 PLEASE REMEMBER TO SIGN ON THE REVERSE -) Part A: Stormwater Benchmarks and Monitoring Results (Monitoring is required only if the facility stores exposed accumulations of sawdust, wood chips, bark, mulch, or other similar material on site for longer than seven (7) days.) No discharge this period?' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches3 Chemical Oxygen Demand Total Suspended Solids Benchmarks =__> - - 120 mg/L 100 mg/L or 50 mg/L4 001 6/5/2019 0.23 67.6 mg/L 14.3 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. 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. ' 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, 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: 8/1/2013-7/31/2018 - SWU-245, last revised 7/31/2013 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?z 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 Benchmarks =__> - - 15 mg/L 100 mg/L or 50 mg/L4 001 6/5/19 0.23 <4.8 mg/L 14.3 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 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 ANYONE OUTFALL? YES ❑ NO X IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an original and one copy of this DMR, including all "No Discharge" reports, within 30 dolts of receipt of the lab results for at end of monitoring 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. am aware that (Signature of4 penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations. (Date) Permit Date: 8/1/2013-7/31/2018 SWU-245, last revised 7/31/2013 Page 2 of 2 aceAnalytical" w paceleesmn June 14, 2019 Brandy Turley Georgia-Pacific 139 Brewerton Road Dudley, NC 28333 RE: Project: PLY STORMWATER SAMPLING Pace Project No.: 92432130 Dear Brandy Turley: Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Enclosed are the analytical results for sample(s) received by the laboratory on June 07, 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 report was revised on 6/14119 to inlclude TSS and COD analyses, per client request. If you have any questions concerning this report, please feel free to contact me. Sincerely, Nicole Gasiorowski nicole.gasiorowski@pacelabs.com (704)875-9092 Project Manager Enclosures cc: Sean Coury, Georgia Pacific Accounts Payable c/o GP, Georgia Pacific 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 12 Pace Analytical Services, LLC IaceAnalyfical* Kincey Ave te 100 9800 Hunte sdlle, NC128078 www.pacelabscam (704)875-9092 CERTIFICATIONS Project: PLY STORMWATER SAMPLING Pace Project No.: 92432130 Charlotte Certification IDs 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 South Carolina Certification #: 99006001 Louisiana/NELAP Certification # LA170028 Florida/NELAP Certification #: E87627 North Carolina Drinking Water Certification #: 37706 Kentucky UST Certification #: 84 North Carolina Field Services Certification #: 5342 Virginia/VELAP Certification #: 460221 North Carolina Wastewater Certification #: 12 Asheville Certification IDs 2225 Riverside Drive, Asheville, NC 28804 North Carolina Wastewater Certification #: 40 Florida/NELAP Certification #: E87648 South Carolina Certification #: 99030001 Massachusetts Certification #: M-NC030 VirginiafVELAP Certification #: 460222 North Carolina Drinking Water Certification #: 37712 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 12 aceAnalytical e ~..paceleba.cam SAMPLE ANALYTE COUNT Project: PLY STORMWATER SAMPLING Pace Project No.: 92432130 Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92432130001 PLYWOOD 001 EPA 1664B JMS 1 PASI-C SM 2540D-2011 MDW 1 PASI-A SM 5220D-2011 GC 1 PASI-A REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, I.I.C. Page 3 of 12 aceAnalytical ~,pscelabs.corr ANALYTICAL RESULTS Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: PLY STORMWATER SAMPLING Pace Project No.: 92432130 Sample: PLYWOOD 001 Lab ID: 92432130001 Collected: 06/05/19 18:05 Received: 06/07/19 10:17 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 1664E Oil and Grease NO mg/L 4.8 1 06/12/19 05:59 2540D Total Suspended Solids Analytical Method: SM 254OD-2011 Total Suspended Solids 14.3 mg/L 7.1 1 06/12/19 22:25 D6 5220D COD Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011 Chemical Oxygen Demand 67.6 mg/L 25.0 1 06/12/19 17:45 06/13/19 16:33 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Dale: 06/14/2019 05: 11 PM without the written consent of Pace Analytical Services, L-C. Page 4 of 12 aceAna/Xical" xwvpecelebs= QUALITY CONTROL DATA Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Project: PLY STORMWATER SAMPLING Pace Project No.: 92432130 QC Batch: 480559 Analysis Method: EPA 16648 QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92432130001 METHOD BLANK: 2599794 Matrix: Water Associated Lab Samples: 92432130001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Oil and Grease mg/L ND 4.8 06/12/1905:55 LABORATORY CONTROL SAMPLE: 2599795 Spike LCS LCS % Rec Parameter Units Cone. Result % Rec Limits Qualifiers Oil and Grease mg/L 38.5 37.4 97 78-114 MATRIX SPIKE SAMPLE: 2599796 92432130001 Spike MS MS e/ Rec Parameter Units Result Cone. Result % Rec Limits Qualifiers Oil and Grease mg/L ND 38.5 38.1 96 78-114 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: 06/14/2019 05:11 PM without the written consent of Pace Analytical Services, i Page 5 of 12 aceAnalytical. rawwpaceleb.annr QUALITY CONTROL DATA Project: PLY STORMWATER SAMPLING Pace Project No.: 92432130 QC Batch: 480804 Analysis Method: SM 2540D-2011 QC Balch Method: SM 2540D-2011 Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92432130001 METHOD BLANK: 2600970 Associated Lab Samples: 92432130001 Parameter Units Total Suspended Solids mg/L LABORATORY CONTROL SAMPLE: 2600971 Parameter Units Total Suspended Solids mg/L SAMPLE DUPLICATE: 2600972 Parameter Total Suspended Solids SAMPLE DUPLICATE: 2600997 Parameter Total Suspended Solids Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 Matrix: Water Blank Reporting Result Limit Analyzed Qualifiers ND 2.5 06/12/1922:25 Spike LCS LCS e/ Rec Conc. Result % Rec Limits Qualifiers 250 236 94 90-110 92432130001 Dup Units Result Result mg/L 14.3 13.3 92432132001 Dup Units Result Result mg/L 135 137 RPD Qualifiers 7 D6 RPD Qualifiers 2 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: 06/14/2019 05: 11 PM without the written consent of Pace Analytical Services, -I-C. Page 6 of 12 aceAnalytical wxwpecefa0acom QUALITY CONTROL DATA Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)B75-9092 Project: PLY STORMWATER SAMPLING Pace Project No.: 92432130 QC Batch: 480786 Analysis Method: SM 5220D-2011 QC Batch Method: SM 5220D-2011 Analysis Description: 5220D COD Associated Lab Samples: 92432130001 METHOD BLANK: 2600854 Matrix: Water Associated Lab Samples: 92432130001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Chemical Oxygen Demand mg/L ND 25.0 06/13/19 16:31 LABORATORY CONTROL SAMPLE: 2600855 Spike LCS LCS %Rec Parameter Units Conc. Result % Rec Limits Qualifiers Chemical Oxygen Demand mg/L 750 755 101 90-110 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2600856 2600857 MS MSD 92431578001 Spike Spike MS MSD MS MSD %Rec Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual Chemical Oxygen Demand mg/L 57.9 100 100 162 164 104 107 90-110 1 MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2600858 2600859 MS MSD 92432193001 Spike Spike MS MSD MS MSD %Rec Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual Chemical Oxygen Demand mg/L 84.5 100 100 179 181 94 97 90-110 1 Results presented on this page are In the units Indicated by the"Units" column except where an alternate un It Is presentee to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Dale: 06/14/2019 05: 11 PM without the wntten consent of Pace Analytical Services, LLC. Page 7 of 12 aceAnalytical s �pecelsb&cnm QUALIFIERS Project: PLY STORMWATER SAMPLING Pace Project No.: 92432130 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. MOIL -Adjusted Method Detection Limit, Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Hunlersville, NC 28078 (704)875-9092 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 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 analyles. TNI - The NELAC Institute. LABORATORIES PASI-A Pace Analytical Services -Asheville PASI-C Pace Analytical Services - Charlotte ANALYTE QUALIFIERS D6 The precision between the sample and sample duplicate exceeded laboratory control limits. This report shall not be reproduced, except in full, Dale: 06/14/2019 05: 11 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 12 aceAnalytical" www.peceleAt= QUALITY CONTROL DATA CROSS REFERENCE TABLE Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Hunlersville, NC 28078 (704)875-9092 Project: Pace Project No.: PLY STORMWATER SAMPLING 92432130 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92432130001 PLYWOOD 001 EPA 16648 480559 92432130001 PLYWOOD 001 SM 254OD-2011 480804 92432130001 PLYWOOD 001 SM 5220D-2011 480786 SM 5220D-2011 480834 Date: 06/14/2019 05:11 PM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytcal Services, LLC. Page 9 of 12 Document Name: Document Revised: February 7, 2018 Sample Condition Upon Recei t SCUR Patio 1 of 2 aceAnaocale Document No.; Issuing Authority: F-CAR-CS•033.1 Big Pace Carolinas QualitV Office Laboratory receiving samples: Asheville ❑ Eden[] Greenwood ❑ Huntersville Ralelgh❑ Mechanicsville❑ Client Name: �•pp aj�. Project g: W�•• 92 2130 Courier: ❑ ed Ex / .ZIUPS [JUSOS❑Client 'II�I�� I� �I�II�I �II I �I� ❑ Commercial ❑Pace ❑Other:_ 82432130 Custody Seal Present? []Yes No Sealsintact? []Yes No Date/Initials Person Esemining Contents:i Packing Material: ❑Bubble Wrap 0Buhble Bags ❑None ❑ Other Biological T sue Frozen? Thermometer: []Yes[]N/AGu01D: 92TO48 Type of ice: QV?et ❑clue ❑None Cooler Temp ('Cj: // -I I orrectlon Factor: Add/Subtract ('C) O,Q Temp should be above freezing to 6'C Cooler Temp Corrected (.C): []samples out of temp criteria. Samples on Ice, cooling process hasbegun USDA Regulated Soll (QN/A, water sample) Did samples oigloo a in a quarantine zone within the United Slates: CA, NY, or SC (check maps)? DItl samples originate from a foreign source Ilnterna[lonally, m,,,l,nyea nNA Comments/Discrepancy: Chain of Custody Present? ElYes ONO ONJA 1. Sample Arrived within Hold Time] r Yes ONO ❑N/A 2. Short Hold Time Analysis <72 hr.)? Dyes 2L. DNIA 3. Rush Turn Around Time Requested? ❑Yes o ❑N/A q. Sufficient Volume) Yes ONO O NA S. Correct Containers Used? -Pace Containers Used? �Vee - [']Yes ONO No ❑N/A ONIA B. Containers Intact? of NO N/A 7. Dissolved analysis: Samples Field Filtered? Dyes ❑No N/A a. Sample labels Match COC? -Includes Date/Time/ID/Analysis Matrix: )'✓ ei ONO ❑N/A 9. Headspace in VOA Vlals (>S-Gmm)? Dyes ❑No N/A 10. Trip Blank Present? Trip Blank Custody Seats Present? Dyes DYC3 ErNo ONO ❑N/A /A 11. COMMENTS/SAMPLE DISCREPANCY Lot ID of split containers: CLIENT NOTIFICATION/RESOLUTION Person contacted: Date/Time: Project Manager SCURF Review: SRF Review: Field Data Required? Dyes ONO C Date: Date: U 1010 Page 10 of 12 Document Name: Document Revised: February 7, 2018 aceAnaljrtical� Sample Condition Upon Recel t(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 verified and within the acceptance range for preservation samples. Exceptions: VOA, Coliform, TOC, Oil and Grease, ORO/8015 (water) DOC, LLHg "Bottom half of box is to list number of bottle Project If , wo :.92432130 !PM: NMG Due Date: 06/18/19 CLIENT: 82-GP NC a 8 t In, E Cy d v 6 E O Z .. 4 E T C 6 g N VVypC °� y 6 , o Q 6 E V. nl N n Q E m S Z. d n 6 E O _ D — O 9 d E O 9 G g5p[ V d9 li ¢ z e a E 0, ~ •• m aE Q ~ Q 3 n ar E a of = [Jp�, a E a, IV •1 a a E d E M G 2 Z D E N N ,� I� Z Z ¢ E N Z ¢ E q 2 ¢ E T Z ¢ E u T O Y a 6 ¢ >> Y r m a w u N E F4 ~ n N E u, ,~., n On S u 6 .. E rQ ,I, 9 C x E ¢ 8 .y/ G C = c N E ray w n Ca g E ¢ E A 1 2 3 a s 6 7 a 9 10 11 12 pH Adjustment Log for Preserved Samples sample 10 Type of Preservative pH upon recelpt Date preservation adjusted Time preservation adjusted Amount of preservative added Lot a Note: whenever there is a discrepancy affecting North Carolina compliance samples, a copy of this form will ee tent to the Norm Carolina OEM NilUn1lintion unite (i.e. Out of hold, incorrect preservative, out of temp, Incorrect containers. Page 11 of 12 i�2 CHAIN -OF -CUSTODY / Analytical Request Document A.. Analj( ecal The Chair-ofb a LEGPL DOCUMENT. AA relevant f1eMs mmt Ce compleleE acwrstey. _o at e,a.P.ar.eamn, I a Section A So don B Section C Required Client Informalbn: Re Pa9e: of Ired Project Wotmalnn: Imairn In(omutirn: m: Brandy Turley Moral Kellen AmeyJohnson ' comlamT. Georgia Pacific Re Adana:,: 139 Brewington Drive cc yTo: brandy.tudey@gapac.wm Company Name: Georgia Pacific REGULATORY AGENCY - Dudley, NC 28333 /•chess: 139 Brewington Or Dudley NC 28333 r- NPDES 1- GROUND WATER r DRINKING WATER .. To: brandy.wrley@gapac.com Po ha+e Order NP.: P152146862 Pale Dume Zerenee: I- UST 1- RCRA f OTHER Phone: 919-705-0526 Faz 919-735-7140 eu Name: PLY Stommvater Sampling nicole.gasionowski@pacelabs.com u-ar`a1eu Site Location NC Requested Due OalaliAT: P. Kt Numeor: Pace Plates s. 4552-2 - STATE: Requested Anatysis Filtered (YIN)i' Seclleta Valid Matrix Coda 2 Ra9mrt4cuaNlNanvalar. PSTEd -_ COLLECTED Preservatives L dINYf WwiU PY i U U L) wArEa yr 8 . .w.TaR caA=oeTo TE AiraUCT P soersdn ^.t ' ; In STMT rxicnen to re N Z SAMPLE ID va wi t3a u S w O U (A-2, t19I;) Om R or 0 w v F d L) D i Sample IOs MUST BE UNIQUE tvo m TS -O o. u yI r>= in TDAM�MET�MTIME F< aad Q U w U m 2 m ad a l3 f a. o. e. O y t O O m �2�3Z a S 2 S Z Z :OF O — m OU O w Pace Project Nol Lab I.D. 1 Plywood 001 N/T G &&to I Be 4 1 1 121 1 1 1 1 % I I I I N 001 ' 2 a 4 5 6 7 B YO i9 1T --- -------- #11 2 1 11111, • - ADDITIONAL COMMENTS - . REUNQUISNEO BY I AFFILIATION. DATE. THE ACCEPTED B/Y�I AFFILIATION' DATE TIME SAMPLE SAMPLE CONDITIONS Brats Turle &5/19 7:20 m y U'" rr,"��Q '01 / .� !�� ' SAMPLER NAME AND SIGNATURE - O 52. a 3 5 E i 0 4 C , PRINT Novato of SAMPLER" BR" Turley/ vz ATE 519ned " `-S O SIGNATURE of SAMPLE A 12 $ E // Mnvoolrr: 6/5119 w G 'ondad MN Me: By-19" etl+ 1. yea on, acceplmo Pac NET )e day paymCp lam+ and trade, le We cM1v9eid1.511 Per anN^Ierav aWa¢n�.mun>o�ay+/ F-ALL-0-020rev.08. 12-Oct-2007I t