NCG120064_DMR_20200602

..::ram•::
May 27, 2020
Chambers Development of NC, Inc. and
Waste Connections of the Carolinas, Inc.
Anson Waste Management Facility
375 Dozer Road
Polkton, NC 28135
Attention: Mr. Tyler Fitzgerald
Reference: Monthly Stormwater Monitoring
Anson Waste Management Facility
Polkton, North Carolina
S&ME Project No. 4140-15-007
Dear Mr. Fitzgerald:
pL(1-FAYE�I EVILLE REGIONAL OFFICE
S&ME, Inc. (S&ME) is pleased to submit this report detailing the results of the May 2020 stormwater monitoring
activities conducted at the Anson Waste Management Facility (AWMF) in Polkton, North Carolina. This work was
completed in accordance with our Master Services Agreement dated January 2, 2017, and in accordance with Task
2 in S&ME Proposal No. 41-1600394 (Rev. 1) dated August 8, 2016. This letter summarizes results of sampling
efforts conducted by facility personnel.
® Background
Stormwater sampling is required on a semi-annual basis as defined by the National Pollutant Discharge
Elimination System (NPDES) General Permit for Landfills NCG120000 for the facility outfalls. The following outfalls
are identified at the facility: Outfall 1, Outfall 2, Outfall 3, Outfall 4, Borrow Area North Outfall, and Borrow Area
West Outfall. Outfall 2 was eliminated in August 2018 by the expansion of Sediment Basin 3 and, therefore, is no
longer sampled. Monthly sampling has been initiated following December 2019 results at Outfall 3 and Outfall 4,
in response to Tier 2 and Tier 3 response actions at the facility. Parameters for quantitative analysis include
chemical oxygen demand (COD) per Standard Method (SM) 2540D, fecal coliform per SM 9222D, and total
suspended solids (TSS) utilizing SM 2540D. In addition to the previously listed parameters, Outfall 1 and Outfall 3
are also sampled for chemical parameters associated with vehicle maintenance which include total petroleum
hydrocarbons (TPH) per Environmental Protection Agency (EPA) Method 1664B and pH utilizing SM 4500.
® Stormwater Sampling and Quantitative Analyses
AWMF personnel collected the May stormwater samples at two (2) designated outfall locations on May 14, 2020.
The total rainfall for the May 14, 2020 storm event was reported as approximately 0.1 inch in 24 hours. Sampling
was performed during that storm event.
S&ME, Inc.] 644 Eastern Star Road I Kingsport, TN 37663 1 p 423.349.2800 1 www.smeinc.com

e e
First Semi -Annual Stormwater Monitoring
Anson Waste Management Facility
S&ME Project No; 4140-15-007
Quantitative chemical laboratory results for the monitoring event are compared to benchmark values as
established by your NPDES permit on the attached Discharge Monitoring Report (DMR). Exceedances of
benchmark values are summarized in bold type below for your reference.
Benchmark 120 100 1000 15 6-9
Outfall 3
Sed Basin 3
46.7
166
<1.0
<5.0
6.49
Outfall 4
Sed Basin 4
30.3
288
131
ANR
6.26
ANR = Analvte
not requested
and not reouired by the NPDES Permit
mg/l= milligrams per liter
CFU/ml= colony -forming units per milliliter
The DMR is included with this letter as Attachment? for your signature and submittal to the North Carolina
Department of Environmental Quality (NCDEQ), Division of Water Quality. The Laboratory Data Report for this
sampling event is included as Attachment N for your records.
® Closure
S&ME appreciates this opportunity to be of service to you and Waste Connections. We trust this information is
responsive to your needs at this time. If you have any questions, please contact us at your convenience.
Sincerely,
S&ME, Inc.
rdAOrris James R. Bruce
Project Manager Senior Reviewer
Attachments: Discharge Monitoring Report
Laboratory Data Report
Site SWPPP Map
cc: Mike Lawyer, Fayetteville Regional Office
Lana Brown, Waste Connections
Nelson Breeden, Waste Connections of the Carolinas, Inc.
Page 2

Attachments

Attachment I Discharge Monitoring Report

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Attachment II - Laboratory Data Report

aceAnaIXical
www.picalabo.com
May 21, 2020
Lindsey Harris
S&ME, Inc.
644 Eastern Star Road
Kingsport, TN 37663
RE: Project: Anson Landfill SW -monthly
Pace Project No.: 92477687
Dear Lindsey Harris:
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Enclosed are the analytical results for sample(s) received by the laboratory on May 14, 2020, The results relate only to the
samples included in this report. Results reported herein conform to the applicable TNI/NELAC Standards and the
laboratory's Quality Manual, where applicable, unless otherwise noted in the body of the report.
The test results provided in this final report were generated by each of the following laboratories within the Pace Network:
• Pace Analytical Services -Asheville
• Pace Analytical Services - Charlotte
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Angela Baioni
[e-mail]
[phone]
Project Manager
Enclosures
qe�
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 14

(�IaceAnallyticale
www.picalabs.com
CERTIFICATIONS
Project: Anson Landfill SW -monthly
Pace Project No.: 92477687
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Pace Analytical Services Charlotte
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
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
North Carolina Wastewater Certification #: 40
Florida/NELAP Certification #: E87648
South Carolina Certification #: 99030001
Massachusetts Certification #: M-NC030
Virginia/VELAP 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 14

(�15'neAnalyfica(
www.pacelabs.com
SAMPLE ANALYTE COUNT
Project: Anson Landfill SW -monthly
Pace Project No.: 92477687
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Anatytes
Lab ID Sample ID
Method
Analysts
Reported
Laboratory
92477687001 OUTFALL 3
EPA 1664E
WAM
1
PASI-C
SM 9222D-2006
CLW
1
PASI-C
SM 254OD-2011
MJP
1
PASI-A
SM 5220D-2011
LMS1
1
PASI-A
92477687002 OUTFALL 4
SM 9222D-2006
CLW
1
PASI-C
SM 2540D-2011
MJP
1
PASI-A
SM 5220D-2011
LMS1
1
PASI-A
92477687003 OUTFALL 1
EPA 1664B
WAM
1
PASI-C
PASI-A = Pace Analytical Services - Asheville
PASI-C = Pace Analytical Services - Charlotte
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 14

aceAnaljdical
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SUMMARY OF DETECTION
Pace Analytical Services, LLC
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
Project: Anson Landfill SW -monthly
Pace Project No.: 92477687
Lab Sample ID Client Sample ID
Method Parameters Result Units Report Limit Analyzed Qualifiers
92477687001 OUTFALL 3
SM 254OD-2011 Total Suspended Solids 166 mg/L 25.0 05/19/20 18:26
SM 5220D-2011 Chemical Oxygen Demand 46.7 mg/L 25.0 05/16/20 12:59 M1
92477687002
SM 9222D-2006
SM 254OD-2011
SM 5220D-2011
OUTFALL 4
Fecal Coliforms
Total Suspended Solids
Chemical Oxygen Demand
131 CFU/100 mL 1.0 05/15/20 15:14
288 mg/L 33.3 05/19/2018:27
30.3 mg/L 25.0 05/16/2012:59
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 14

aceAnalytical
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ANALYTICAL RESULTS
Project: Anson Landfill SW -monthly
Pace Project No.: 92477687
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: OUTFALL 3 Lab ID: 92477687001 Collected: 05/14/20 09:14 Received: 05/14/20 14:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qua[
1664 SGT-HEM, TPH Analytical Method: EPA 1664E
Pace Analytical Services - Charlotte
Total Petroleum Hydrocarbons ND mg/L 5.0 1 05/15/20 09:50
MBIO 9222D Fecal Coliform CHT Analytical Method: SM 9222D-2006 Preparation Method: SM 9222D-2006
Pace Analytical Services- Charlotte
Fecal Coliforms ND CFU/100 mL 1.0 1 05/14/20 16:37 05/15/20 15:14
2540D Total Suspended Solids Analytical Method: SM 254OD-2011
Pace Analytical Services -Asheville
Total Suspended Solids 166 mg/L 25.0 1 05/19/20 18:25
6220D COD Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Pace Analytical Services - Asheville
Chemical Oxygen Demand 46.7 mg/L 25.0 1 05/15/20 20:15 05/16/20 12:59 M1
Sample: OUTFALL 4 Lab ID: 92477687002 Collected: 05/14/20 09:40 Received: 05/14/20 14:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
MBIO 9222D Fecal Coliform CHT Analytical Method: SM 9222D-2006 Preparation Method: SM 9222D-2006
Pace Analytical Services - Charlotte
Fecal Coliforms 131 CFU/100 mL 1.0 1 05/14/20 16:37 05/15/20 15:14
2540D Total Suspended Solids Analytical Method: SM 2540D-2011
Pace Analytical Services -Asheville
Total Suspended Solids 288 mg/L 33.3 1 05/19/20 18:27
5220D COD Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Pace Analytical Services -Asheville
Chemical Oxygen Demand 30.3 mg/L 25.0 1 05/15/20 20:15 05/16/20 12:59
Sample: OUTFALL 1 Lab ID: 92477687003 Collected: 05/14/20 09:28 Received: 05/14/20 14:00 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
1664 SGT-HEM, TPH Analytical Method: EPA 1664E
Pace Analytical Services - Charlotte
Total Petroleum Hydrocarbons ND mg/L 5.0 1 05/15/20 09:50
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/21/2020 08:59 AM without the written consent of Pace Analytical Services, LLC. Page 5 of 14

CPO
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QUALITY CONTROL DATA
Project: Anson Landfill SW -monthly
Pace Project No.: 92477687
QC Batch: 541781 Analysis Method: EPA 1664B
QC Batch Method: EPA 1664E Analysis Description: 1664 SGT-HEM, TPH
Laboratory: Pace Analytical Services - Charlotte
Associated Lab Samples: 92477687001, 92477687003
METHOD BLANK: 2886833 Matrix: Water
Associated Lab Samples: 92477687001, 92477687003
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Petroleum Hydrocarbons mg/L ND 5.0 05/15/20 09:50
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE: 2886834
Spike LCS LCS % Rec
Parameter Units Conc. Result % Rec Limits Qualifiers
Total Petroleum Hydrocarbons mg/L 20 14.8 74 64-132
MATRIX SPIKE SAMPLE: 2886835
92477441001 Spike MS MS % Rec
Parameter Units Result Conc. Result % Rec Limits Qualifiers
Total Petroleum Hydrocarbons mg/L ND 20 19.5 88 64-132
Results presented on this page are In the units indicated by the "Units" column except where an alternate unit Is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/21/2020 08:59 AM without the written consent of Pace Analytical Services, LLC.
Page 6 of 14

aceAnalytical
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QUALITY CONTROL DATA
Project: Anson Landfill SW -monthly
Pace Project No.: 92477687
QC Batch: 541661 Analysis Method: SM 9222D-2006
QC Batch Method: SM 9222D-2006 Analysis Description: 9222D Fecal Coliform(MF) - CHT
Laboratory: Pace Analytical Services - Charlotte
Associated Lab Samples: 92477687001, 92477687002
METHOD BLANK: 2886531 Matrix: Water
Associated Lab Samples: 92477687001, 92477687002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Fecal Coliforms CFU/100 mL ND 1.0 05/15/20 15:14
SAMPLE DUPLICATE: 2886532
92477674001 Dup
Parameter Units Result Result RPD Qualifiers
Fecal Coliforms CFU/100 mL <1.0 ND
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
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: 05/21/2020 08:59 AM without the written consent of Pace Analytical Services, LLC.
Page 7 of 14

Pace Analytical Services, LLC
9800Huntersvlle, NC128078
(�IaneAnaljdicalo
www.pacelabs.com [phone]
QUALITY CONTROL DATA
Project: Anson Landfill SW -monthly
Pace Project No.: 92477687
QC Batch: 542402
Analysis Method:
SM 254OD-2011
QC Batch Method: SM 2540D-2011
Analysis Description:
2540D Total Suspended Solids
Laboratory:
Pace Analytical Services -Asheville
Associated Lab Samples: 92477687001, 92477687002
METHOD BLANK: 2889995
Matrix: Water
Associated Lab Samples: 92477687001, 92477687002
"
Blank Reporting
Parameter
Units
Result Limit
Analyzed Qualifiers
Total Suspended Solids
mg/L
ND
2.5 05/19/20 18:02
LABORATORY CONTROL SAMPLE:
2889996
Spike LCS
LCS % Rec
Parameter
Units
Conc. Result
% Rec Limits Qualifiers
Total Suspended Solids
mg/L
250 250
100 90-110
SAMPLE DUPLICATE: 2890078
92477660001 Dup
Parameter
Units
Result Result
RPD Qualifiers
Total Suspended Solids
mg/L
204
245 18 MW
SAMPLE DUPLICATE: 2890079
92477694001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L 8400 6700 23
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: 05/21/2020 08:59 AM without the written consent of Pace Analytical Services, LLC.
Page 8 of 14

qD
aceAna1j4ica1
www.pacelabs.com
QUALITY CONTROL DATA
Project: Anson Landfill SW -monthly
Pace Project No.: 92477687
QC Batch: 541876 Analysis Method: SM 5220D-2011
QC Batch Method: SM 5220D-2011 Analysis Description: 5220D COD
Laboratory: Pace Analytical Services - Asheville
Associated Lab Samples: 92477687001, 92477687002
METHOD BLANK: 2887629 Matrix: Water
Associated Lab Samples: 92477687001, 92477687002
Pace Analytical Services, LLC
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed Qualifiers
Chemical Oxygen Demand
mg/L
ND 25.0
05/16/20 12:58
LABORATORY CONTROL SAMPLE:
2887630
Spike
LCS
LCS % Rec
Parameter
Units
Conc.
Result
% Rec Limits Qualifiers
Chemical Oxygen Demand
mg/L
750
765
102 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2887631
2887632
MS
MSD
92477354001
Spike
Spike MS
MSD MS MSD % Rec
Parameter
Units Result
Conc.
Conc. Result
Result % Rec % Rec Limits RPD Qual
Chemical Oxygen Demand
mg/L 650000
100
100 5050
5050 -1450 -1450 90-110 0 M1
0 ug/L
MATRIX SPIKE &MATRIX SPIKE DUPLICATE: 2887633 2887634
MS MSD
92477687001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Chemical Oxygen Demand mg/L 46.7 100 100 159 157 112 110 90-110 1 M1
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
i
This report shall not be reproduced, except in full,
Date: 05/21/2020 08:59 AM without the written consent of Pace Analytical Services, LLC.
Page 9 of 14

aceAnalytical
www.pacelobs.com
QUALIFIERS
Project: Anson Landfill SW -monthly
Pace Project No.: 92477687
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
[phone]
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 analytes.
TNI -The NELAC Institute.
ANALYTE QUALIFIERS
M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery.
MW Due to matrix interference, achieving a constant weight is not possible.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/21/2020 08:59 AM without the written consent of Pace Analytical Services, LLC. Page 10 of 14

aceAnalytical
www.pacolabs.com
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Anson Landfill SW -monthly
Pace Project No.: 92477687
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Analytical
Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch
92477687001 OUTFALL 3 EPA 1664E 541781
92477687003 OUTFALL1 EPA1664B 541781
92477687001
OUTFALL 3
SM
9222D-2006
541661
SM
9222D-2006
541663
92477687002
OUTFALL 4
SM
9222D-2006
541661
SM
9222D-2006
541663
92477687001
OUTFALL 3
SM
254OD-2011
542402
92477687002
OUTFALL 4
SM
2540D-2011
542402
92477687001
OUTFALL 3
SM
5220D-2011
541876
SM
5220D-2011
541978
92477687002
OUTFALL 4
SM
5220D-2011
541876
SM
5220D-2011
541978
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 05/21/2020 08:59 AM without the written consent of Pace Analytical Services, I.I.C. Page 11 of 14

Laboratory receiving samples:
Asheville ❑ Eden❑
Document Name: Document Revised: February 7, 2018
ndltlon Upon Recel t(SCUR) Pa e 1 of 2
Document No.: Issuing Authority:
rno_re:.na2.ae1, Ar Pace Carolinas Quality Office
Greenwood ❑ Huntersville
So 1)l. Client Name:
9powliecc
J Project is
pt
Courier, ❑F� Ex ❑UPS USPS []ClientC]Commercial Is QOther:
Custody Seal Present? []Yes U4 Seals Intact? ❑Yes ©No
Packing Material: []Bubble Wrap [Bubble Bags [:]None Other
Thermometer: Type of Ice:�4ert []Blue
[I Gun ID: — 92TO61
Cooler Temp ('C): J' Correction Factor: Add/Subtract (*C) +0.1
Cooler Temp Corrected ('C)
USDA Regulated Soil ( N/A, water sample)
Did samples originate in a quarantine zone within the United States: CA, NY, or SC (check maps)?
Raleigh[] Mechanicsville❑
WO#:92477887
III I III ,I,111111111111111
I
Date/Initials Pelson Examining Contents: hJ � i 20 •!L—
Biological Tissue KJA
?
❑Yes ❑No
None
Temp should be above freezing to 6'C
❑Samples out of temp criteria. Samples on Ice, cooling process
has begun
Did samples originate from a foreign source (internationally,
u....eu -A o".". AJ-1) rivoa I-1Na
Yes LJNo
.....__...p.._ -
Comments/oiscre anc :
Chain of Custody Present?
es
❑No
Samples Arrived within Hold Time?
Short Hold Time Analysis <72 hr.)?
s
as
No
No
❑N/A
N/A
2.
3.
Rush Turn Around Time Re nested?
❑Yes
Md.
N/A
4.
Sufficient Volume?
a
❑No
❑N/A
S.
Correct Containers Used?
-Pace Containers Used?
a
es
[]NO
[]No
❑N/A
❑N/A
6.
Containers intact?
Of
No
N
7.
Dissolved analysis: Samples Field Filtered?
❑Y s
Ozer
0No
JJNo
PNIA
N A
8.
9.
-Includes Date/Time ID/Analysis Matrix:
Heads ace in VOA Vials >5-6mm)?
❑Yes
[]No
/
10.
Trip Blank Present?
TripBlank Custody Seals Present?
QYes
❑Yes
(:]No
No
®7/A
11.
COMMENTS/SAMPLE DISCREPANCY
Lot ID of split containers:
CLIENT NOTIFICATION/RESOLUTION
Person contacted:
Project Manager SCURF Review:
Project Manager SRF Review:
Date/Time:
Date:
Date:
field Data Required? []Yes ❑No
Page 12 of 14

BCBAWYMc
Document Name:
Sample Condition Upon Recel t(SCUR)
Document Revised: February 7, 2018
Pa e 1 of 2
Document No.:
F•CAR•CS•039•Rev.06
Issuing Authority:
Pace Carolinas Quality Office
*Check mark top half of box if pH and/or dechlorination is Project # Wp : 92477687
verified and within the acceptance range for preservation PM: AMB Due Date; 05/21/20
samples. CLIENT: 82-5gME TN
Exceptions: VOA, coliform, TOC, Oil and Grease, DRO/8015 (water) DOC, LLHB
**Bottom half of box is to list number of bottle
NONE
HIM
0
man
0
0141
MIN
0
son
100k
on
M
0
on
in
-0
mom
MEW
IN
INLIMMILILILlIL40
IMMEM16'a
no
memo
annem
0
NINE
M
0
long
ELI
mono
-on
on
MENOMONEE
on
HOMMMIENOMMIlon,
100
pH Adjustment
tog for Preserved Samples
Sample ID
Type of Preservative
pH upon receipt'
Date preservation adjusted
-
Time preservation
adjusted
Amount of Preservative
added
lot If
_e
.��. e....., ...ni tie r.,. r.. #k.
Nnrrr, rnrnnna nRHNR fortification
Office (i.e.
Note: W heneverthere Is a discrepancy affecting North carouna compeance mprc-
sa, a w„ py
Out of hold, Incorrect preservative, out of temp, Incorrect containers.
Page 13 of 14

ITEM #
0
0
0
0
0
Cx
00
0
'n
J2
4—
M
A
0 ;V
0 0
0!
6
to
MATRIXCODE (see valid codes to lefl)
0
SAMPLETYPE (G-GRAB C-COMP)
O
La
-0
In
0
z
6
C,
m
Ln
U3
In
M
lu
SAMPLE TEMP AT COLLECTION
I�pp
IF OF CONTAINERS
UnpFaserved
e e
op
1-12804
0
HNO3
"n
HCI
A
0
NsOH
K10.15203
Methanol
Other
0
U
na
COD
X
Fecal Coli (8 Hr Hold)
x
TPH Oil and Grease by 166,
7?
x
x
TSS
to
LP
Residual Chlorine (YIN)`EL--
TEMP in C
b
z
0
ec
Received do n
Received on
Ice
r i,
(YIN)
eated
Sealed
C)
Cooler
(YIN)
Samples
nlact
(YIN)
Page 14 of 14

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