The URL can be used to link to this page

Home My WebLink AboutNCG080583_MONITORING INFO_20190211DIVISION CODING SHEET NCG PERMITS PERMIT NO. /v Cc 6� U J a 3 DOC TYPE 0 HISTORICAL FILE N/MONITORING REPORTS DOC DATE ❑ a%�� % �a � i YYYYMMDD Semi-annual Stormwater Discharge Monitoring Resort for North Carolina Division of Energy, Mineral and Land Resources General Permit No. NCG080000 Date submitted >✓ — 3/- Z.0 CERTIFICATE OF COVERAGE NO. N0008 O 3 D 3 SAMPLE COLLECTION YEAR FACILITY NAME SCA^d k`gfl—ca-f Cy_0oc �SAMPLE PERIOD KJan-June ❑July -Dec COUNTY or ❑ Monthly' (month) PERSON COLLE ING SAMPLES cw Lvr� '" DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA LABORATORY Rac.� A+l.(r�ca ( Lab Cert. # �� D ❑Zero -flow ❑Water supply ❑SA Comments on sample collection or analysis: FEB 1 2019 ❑Other uIz_iVTRAL FILEC, PLEASE REMEMBER TO SIGN ON THE REVERSE 4 0WR SEC-60nr Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? M yes ❑ no (if yes, complete Part A) Part A: Vehicle & Equipment Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period' Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Non -Polar Oil & Grease mg/L Total Suspended Solids, mg/L New Motor or Hydraulic Oil Usage, gal/mon Benchmarks _ - 15 100 or S& - Parameter Code - 46529 00552 C0530 NCOIL l p1 f3 ?020 ,2 S' 5.3 166 z OD 30 3 D6 `t N -97 Lv 1 '7z-f ' 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 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies. Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non - numerical format. When results are below the applicable limits, they must be reported in the format, "<XX mg/L". where XX is the numerical value of the detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX". 6` 1/13/2w� - 2� N {� 6_0-3 Permit Date: 11/1/2018-5/31/2021 5WU-248, last revised 11/1/2018 Page 1 of 2 Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) ❑ No discharge this periodz Outfall No. Date Sample Collected' (mo/dd/yr) 24-hour rainfall amount, Inches' Sample Collected' mo/dd/yr Total Suspended Solids, mg/L pH, Standard units Non -Polar Oil & Grease, mg/L Permit Limit _ - - 100 or 50' 6.0 — 9.0 15 Parameter Code - 46529 - C0530 00400 00552 6 c.l 7 Footnotes from Part A also apply this Part B 0. 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 it 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 ATANY ONE OUTFALL? YES ❑ NO ❑ IF YES, HAVE YOU CONTACTED THE DEMLR REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an oriainal copy of this DMR, includina all "No Discharae" reports, within 30 days of receipt of the lab results (or at end of monitorina period in the case of "No Discharge" reportsl 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: 1 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." ] 31 .2-0 Date Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018 Page 2 of 2 aceAnalytical unwi.plcdebs.com Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28076 (704)875.9092 January 27, 2020 Mr. Michael DeBraske Schneider National, Inc. PO Box 2545 Green Bay, WI 543062545 RE: Project: SNI-Charlotte, NC Pace Project No.: 92460626 Dear Mr. DeBraske: Enclosed are the analytical results for sample(s) received by the laboratory on January 14, 2020. 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. 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: Mr. Michael DeBraske, GEI Consultants, Inc. Derek Townsend, Schneider National REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, OLC. Page 1 of 12 aceAnalytical www pacd66l.com Pace Analytical Services, LLC 9800 Kincey Ave, Suite 100 Huntersville, NC 28078 (704)875-9092 CERTIFICATIONS Project: SNI-Charlotte, NC Pace Project No.: 92460626 Pace Analytical Services Charlotte 9800 Kincey Ave. Ste 100, Huntersville, NC 28078 South Carolina Certification #: 99006001 LouisianalNEL.AP Certification # LA170028 Florida/NELAP Certification #: E87627 North Carolina Drinking Water Certification #: 37706 Kentucky UST Certification M 84 North Carolina Field Services Certification #: 5342 VirginiaNELAP Certification #: 460221 North Carolina Wastewater Certification #: 12 Pace Analytical Services Asheville 2225 Riverside Drive, Asheville, NC 28804 Florida/NELAP Certification #: E87648 Massachusetts Certification #: M-NC030 North Carolina Drinking Water Certification #: 37712 North Carolina Wastewater Certification #: 40 South Carolina Certification M 99030001 VirginiaNELAP Certification #: 460222 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 www.pacolabs.com Pace Analytical Services, LLC 9800 Kinsey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 SAMPLE ANALYTE COUNT Project: SNI-Chatiotte, NC Pace Project No.: 92460626 Analytes Lab lD Sample ID Method Analysts Reported Laboratory 92460626001 SP-1 (pH 5) EPA 1664B HH 1 PASI-C SM 254OD-2011 MJP 1 PASI-A EPA 9040C ECH 1 PASI-A 92460626002 SP-3 (pH 5) EPA 1664E HH 1 PASI-C SM 254OD-2011 ,MJP 1 PASI-A EPA 9040C ECH 1 PASI-A 92460626003 SP-4 (pH 5) EPA 1664E HH 1 PASI-C SM 254OD-2011 CJL 1 PASI-A EPA 9040C ECH 1 PASI-A 92460626004 SP-5 (pH 5) EPA 1664B HH 1 PASI-C SM 254OD-2011 CJL 1 PASI-A EPA 9040C ECM 1 PASI-A 92460626005 SP-6 (pH 5) EPA 1664E HH 1 PASI-C SM 2544D-2011 CJL 1 PASI-A EPA 9040C ECH 1 PASI-A 92460626006 SP-7 (pH 5) EPA 1664E HH 1 PASI-C SM 254OD-2011 CJL 1 PASI-A EPA 9040C ECH 1 PASI-A REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 3 of 12 aceAnalXical® www.peculabs.com Pace Analytical Services, LLC 9800 Kincey Ave, Suite 100 Huntersville, NC 28078 (704)875-9092 ANALYTICAL RESULTS Project: SNI-Charlotte, NC Pace Project No.: 92460626 Sample: SP-1 (pH 5) Lab ID: 92460626001 Collected: 01/13/20 13:00 Received: 01/14/20 12:48 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 16648 Oil and Grease 5.3 mglL 4.8 1 01/24/20 15:38 2540D Total Suspended Solids Analytical Method: SM 254OD-2011 Total Suspended Solids 166 mglL 20.0 1 01/16/20 12:41 9040 pH Analytical Method: EPA 9040C pH at 25 Degrees C 6.2 Std. Units 0.10 1 01/19/20 12:49 H3 Sample: SP-3 (pH 5) LabiD: 92460626002 Collected: 01/13/20 13:15 Received: 01Y14120 12A8 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Oil and Grease 2540D Total Suspended Solids Total Suspended Solids 9040 pH pH at 25 Degrees C Analytical Method: EPA 16W ND mg1L Analytical Method: SM 254OD-2011 1130 mglL Analytical Method: EPA 9040C 6.2 Std. Units 4.8 1 33.3 1 0.10 1 01 /24/20 15:38 01/16/20 12:42 01/19/20 12:55 H3 Sample: SP-4 (pH 5) Lab ID: 92460626003 Collected: 01/13/20 13:30 Received: 01/14/20 12:48 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Oil and Grease 2540D Total Suspended Solids Total Suspended Solids 9040 pH pH at 25 Degrees C Analytical Method: EPA 1664B ND mglL Analytical Method: SM 254OD-2011 306 mglL Analytical Method: EPA 9040C 6.1 Std. Units 4.8 1 50.0 1 0.10 1 01/24/20 15:39 01/17/20 16:53 01119/20 13:00 H3 Sample: SP-5 (pH 5) Lab ID: 92460626004 Collected: 01/13/20 13:40 Received: 01/14/20 12A8 Matrix: Water Parameters Results Units Report Limit OF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Oil and Grease Date: 01/27/2020 07:17 AM Analytical Method: EPA 1664B ND mglL 4.8 1 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC, 01/24/20 15:39 Page 4 of 12 aceAnalytrcal www.pasalaes.com Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704 )875.9092 ANALYTICAL RESULTS Project: SNI-Charlotte, NC Pace Project No.: 92460626 Sample: SP-5 (pH 5) Lab ID: 92460626004 Collected: 01/13/20 13:40 Received: 01/14/20 12:48 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual 2540D Total Suspended Solids Analytical Method: SM 254OD-2011 Total Suspended Solids 87.0 mg/L 25.0 1 01/17/20 16:53 9040 pH Analytical Method: EPA 9040C pH at 25 Degrees C 6.2 Std. Units 0.10 1 01/19/20 13:06 H3 Sample: SP-6 (pH 5) Lab ID: 92460626005 Collected: 01/13/20 13:55 Received: 01/14/20 12:48 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Quaff HEM, Oil and Grease Analytical Method: EPA 1664E Oil and Grease ND, mg1L 4.8 1 01/24/20 15:39 2540D Total Suspended Solids Analytical Method: SM 254OD-2011 Total Suspended Solids 174 mg/L 25.0 1 01/17/20 16:54 9040 pH Analytical Method: EPA 9040C pH at 25 Degrees C 6.3 Std. Units 0.10 1 01/19/20 13:12 H3 Sample: SP-7 (pH 5) Lab ID: 92460626006 Collected: 01/13/20 14:10 Received: 01/14/20 12:48 Matrix: Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM, Oil and Grease Analytical Method: EPA 1664E Oil and Grease ND mg/L 4.8 1 01/24/20 15:40 2540D Total Suspended Solids Analytical Method: SM 254OD-2011 Total Suspended Solids 60.3 mg/L 8.3 1 01/17/20 16:54 9040 pH Analytical Method: EPA 9040C pH at 25 Degrees C 5.6 Std. Units 0.10 1 01/19/20 13:18 H3 REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 01 /27/2020 07:17 AM without the written consent of Pace Analytical Services, LLC. Page 5 of 12 aceAnalytical www.picalabi.com Pace Analytical Services, LLC 9800 KinceyAve. Suite 100 Huntersville, NC 28078 (704)875.9092 QUALITY CONTROL DATA Project: SNI-Charlotte, NC Pace Project No.; 92460626 QC Batch: 521340 Analysis Method: EPA 1664E QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease Associated Lab Samples: 92460626001, 92460626002, 92460626003, 92460626004, 92460626005, 92460626006 METHOD BLANK: 2789133 Matrix: Water Associated Lab Samples: 92460626001, 92460626002, 92460626003, 92460626004, 92460626005, 92460626006 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Oil and Grease mglL - ND 5.0 01/24/20 15:36 LABORATORY CONTROL SAMPLE: 2789134 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Oil and Grease mglL 40 36.5 91 78-114 MATRIX SPIKE SAMPLE: 2789135 92460906001 Spike MS MS % Rec Parameter Units Result Conc. Result % Rec Limits Qualifiers Oil and Grease mg/L ND 38.5 35.1 89 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: 01/27/2020 07:17 AM without the written consent of Pace Analytical Services, LLC. Page 6 of 12 aceAnalytical www.pacelet,s.com Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA Project: SNI-Charlotte, NC Pace Project No.: 92460626 OC Batch: 519753 Analysis Method: SM 254OD-2011 QC Batch Method: SM 254OD-2011 Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92460626001, 92460626002 METHOD BLANK: 2781578 Matrix: Water Associated Lab Samples: 92460626001, 92460626002 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg1L ND 2.5 01/16/20 12:37 LABORATORY CONTROL SAMPLE: 2781579 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Suspended Solids mg/L 250 230 92 90-110 SAMPLE DUPLICATE: 2781580 92460563001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 167 167 0 SAMPLE DUPLICATE: 2781581 92460565001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 17000 16100 5 Results presented on this page are In the units Indicated by the "Units" column except where an alternate unit is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 01/27/2020 07:17 AM without the written consent of Pace Analytical Services, I.I.C. Page 7 of 12 aceAnalytical® www.pacalatta.cola Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704 )875-9092 QUALITY CONTROL DATA Project: SNI-Charlotte, NC Pace Project No.: 92460626 QC Batch: 520057 Analysis Method: SM 254OD-2011 QC Batch Method: SM 254OD-2011 Analysis Description: 2540D Total Suspended Solids Associated Lab Samples: 92460626003, 92460626004, 92460626005, 92460626006 METHOD BLANK: 2783143 Matrix: Water Associated Lab Samples: 92460626003, 92460626004, 92460626005, 92460626006 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg/L ND 2.5 01/17/20 16:52 LABORATORY CONTROL SAMPLE: 2783144 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Suspended Solids mg/L 250 254 102 90-110 SAMPLE DUPLICATE: 2783145 92460641001 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg1L 17.5 16.5 6 SAMPLE DUPLICATE: 2783146 92460764003 Dup. Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L 1420 1220 15 Results presented on this page are In the units Indicated by the "Units" column except where an alternate unit Is presented to the rlght of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 01/27/2020 07:17 AM without the written consent of Pace Analytical Services, LLC. Page 8 of 12 4eAnalyfical"' www.pacalabs.com Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704 )875-9092 QUALITY CONTROL DATA Project: SNI-Charlotte, NC Pace Project No.: 92460626 QC Batch: 520143 Analysis Method: EPA 9040C QC Batch Method: EPA 9040C Analysis Description: 9040 pH Associated Lab Samples: 92460626001, 92460626002, 92460626003, 92460626004, 92460626005, 92460626006 SAMPLE DUPLICATE: 2783510 92460426001 Dup Parameter Units Result Result RPD Qualifiers pH at 25 Degrees C Std. Units 5.9 5.7 3 D6,H3 SAMPLE DUPLICATE: 2783511 92460684004 Dup Parameter Units Result Result RPD Qualifiers pH at 25 Degrees C Std. Units 6.2 5.8 5 D6,H3 Results presented on this page are In the units Indicated by the "Units" column except where an aaemate unit Is presented to the right of the result. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 01/27/2020 07:17 AM without the written consent of Pace Analytical Services, LLC. Page 9 of 12 JacieAnalytical" Mffl.paealaha.cam Pace Anatytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 QUALIFIERS Project: SNI-Charlotte, NC Pace Project No.: 92460626 DEFINITIONS DF - Dilution Factor, it 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. 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 i$ recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA Method 8260. N-N itrosodi phenyla mine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyte is a combined concentration. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI -The NELAC Institute. LABORATORIES PASI-A Pace Analytical Services -Asheville PASI-C Pace Analytical Services - Charlotte ANALYTE QUALIFIERS D6 The precision between the sample and sample duplicate exceeded laboratory control limits. H3 Sample was received or analysis requested beyond the recognized method holding time. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, Date: 01l2712020 07:17 AM without the written consent of Pace Analytical Services, LLC. Page 10 of 12 m aceAnalytical www.pactlabs.com Pate Analytical Services, LLC 9800 Kincey Ave. Suite 100 Hunlersville, NC 28078 (704)875-9092 QUALITY CONTROL DATA CROSS REFERENCE TABLE Project: SNI-Charlotte, NC Pace Project No.: 92460626 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92460626001 SP-1 (pH 5) EPA 1664B 521340 92460626002 SP-3 (pH 5) EPA 1664B 521340 92460626003 SP-4 (pH 5) EPA 1664B 521340 92460626004 SP-5 (pH 5) EPA1664B 521340 92460626005 SP-6 (PH 5) EPA 1664B 521340 92460626006 SP-7 (pH 5) EPA 1664B 521340 92460626001 SP-4 (pH 5) SM 254OD-2011 519753 92460626002 SP-3 (pH 5) SM 2540D-2011 519753 92460626003 SP-4 (pH 5) SM 25400-2011 520057 92460626004 SP-5 (pH 5) SM 254OD-2011 520057 92460626005 SP-6 (pH 5) SM 254OD-2011 520057 92460626006 SP-7 (pH 5) SM 2544D-2011 520057 92460626001 SP-1 (pH 5) EPA 9040C 520143 92460626002 SP-3 (pH 5) EPA 9040C 520143 92460626003 SP-4 (pH 5) EPA9040C 520143 92460626004 SP-5 (pH 5) EPA 9040C 520143 92460626005 SP-6 (pH 5) EPA 9040C 520143 92460626006 SP-7 (pH 5) EPA 9040C 520143 Date: 01/27/2020 07:17 AM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC. Page 11 of 12 iAs tisEonrtY-as=/ �9�f� �� d CHAIN -OF -CUSTODY Analytical'Request Document C4 1. x7 aceAnaVical' II 1` o Chain -of -Custody is a LEGAL DOCUMENT - Complete all relevent fields I lII �I j N ff I y ALL! 92460626 impany: •r Billing Information: GIl !��R vom4G _. � - - - a - aNro]ect Manager: " idress :port To: „' Email -To: _ _� ' ` Preservative Types: 11) nitric acid, (2) sulfuric acid, (3) hydrochloric acid, (4) sodium hydroxide, (5) zinc acetate, %� f (6) methanol, (7) sodium bisulfate; (B) sodium thiosulfate, (9) hexane, (A) ascorbic acid, (B) ammonium sulfate, (el ammanium hydroxide, (U) TSP, (U) Unpreserved, (o) other Spy To: In tRij�Jlec' nfl/ lN� si.}C �i6alf� Y�7 Analyses - Lab Prole/Line:'. - -. istomer Project'Name/Number: .-- �slC �lgo['] State County/Cit Time Zone Collected: PT_[ I MT ( ] cr : 1 :Lao sample -.Receipt checklist: A •' - �-' - ' [,JET — - ^•• - I �' ,cu;tody Sea1i Present/intact,_Y(EITL'• , -•'Custody signatures Present- Y N )T ' ione�dj/ Jl� 7711ra• Site/F cility ID fs: M +- Compliance Monitoring? 4aili - f i �m r- ^ -( ]No [ ] Yes-, - t]Co11et or; Signatucc -Present tt !]A :Bottle InLdCt N. NA tllected By (paint : - ' ' • "- Purchase order ti:_ DW PWS ID tt: -� correct soti iqs (((LLryyyyS]�� tt' Ns /`•`,' a, �! ` Quote #: _, - DW Location Code: - - — '. . j. snffieient volumeN NA - - _: - _ 5ampless Received on, Ice N rrA voA-- Readspaac Acoepcabie Y H , Soils '. Y tt," Alecte Bfl( lg t e]: Turnaround Date Required: immediately acked on Ice: '-'' ". [ ] Yes ' ' [ I ND- .^s ' t = = , `! ,'USDA Regulated -samples in 1161ding Time C:�p ti NA - ales idudl'Ch lgrine Present Y' N• t> cL'strips':rb ample Disposal: Rush: = Day c• = Field Filtered (if applicable): = ° ] Dispose as appropriate I 1 Return [ I Same.Day [ ]Next ',] [ ] Yes [ J No `' ,: - — r .Sample pH, Acceptable Y N �1 ] Archive Hold: - _ [ ] 2Day [- ] 3'DdY [ ] 4 Day' [ 5 Day ' •• (Ezpetli[e Charges Applq] +i- ..J = _ Analysis— - - ±- s "+' T t = 1 � t _ _ _ pH •scrips -. _Sulfide Present ti - Y 11�0 Lead Acetate strips: Matrix Codes (Insert in Matrix box below): Drink(ng:VJater (DW),-,Ground Water (GW): Wastewater (WW), - Product (p), Soil/Solid (SL), Oil (OL), Wipej( iP), Air (AR), Tissue (TS),.Bioassey (B]; Vapor (V),,Other (OT)•- __. .- LAB USE oNLY: - - Lab sample f / Co=aents: _ _ = Comp / Collected {nr = Composite End Res ! '# of ustomer Sample ID Matrix • Grab Composite 5tartJ' Cl Ctns t; ,: Date I .Time Date. Time - 13 'P - P - LS /3:/L, -_ •. 17. tstomer Remarks /Special Conditions /Possible Hazards: Type,of Ice Used: Wet Blue Dry None SHORT HOLDS PRESENT (272'hours): Y N/A, Lab Sample Temperature lrifo: -Temp Blank Recei=ed: Y N. Tfterm IDS: /o Patiyng Ma er al Usjd: - f7cl �G ' tab Tracking q t . ` ,2.4 1 0705 _ •'Cooler I Temp Upon __j Receipt..oC ^ Cooler i Therm Carr. Factor: G aC ' Cooler i Corrected Temp: 3 - _ r ' ' -; . ' .r, « Radcliem samples) screened (<50D cprti): Y N NA ' Samples received via: • ] ` - c : FEDEX UPS Client ace Courier w - _Coupe[ . .oC Comments: 4e, _- ainquished by/Company: (Signature) Date ime: ', ceive'd by/Com an Si nature] Dke/Time:� MT1L LAB = . able t::. _ F _ Acctnum: Template: :linquished by/Co parry: (5ignature) D to ime: Received by/Co pa (Signature) / Date/Time: Trip Blank Received:Y`, N . '.Other Pretogin: " MCC 1Vte0H TSP PM; f ;linquished by/Cornpany: (Signature) Date/Time; Received by/Company: (Sig azure Date/Time: Non Conforman a{sJ: Page: FB: YES