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STORMWATER DIVISION CODING SHEET
NCS PERMITS
PERMIT NO.
000 � o
NL s
DOC TYPE
❑FINAL PERMIT
*MONITORING REPORTS
❑ APPLICATION
i.e'COMPLIANCE
❑ OTHER
DOC DATE
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YYYYMMDD
SHEALY ENVIRONMENTAL SERVICES, INC.
Report of Analysis
Rohm And Haas Company
6101 Orr Road
Charlotte, NC 28213
Attention: Alanna Smith
Project Name2inc Testing
Lot Number:PJ15090
Date Completed:10/1712014
71Tk'TyL'C_/
Kelly M. Maberry
Project Manager
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This report shall not be reproduced, except in its entirety, without the written approval of Shealy Environmental Services, Inc.
The following non -paginated documents are considered part of this report: Chain of Custody Record and Sample Receipt Checklist.
Shealy Environmental Services, Inc. Page: 1 of 5
106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.sheatylab.com Level 1 Report v2.1
SHEALY ENVIRONMENTAL SERVICES, INC.
SC DHEC No: 32010 NELAC No: E87653
NC DENR No: 329 NC Field Parameters No: 5639
Case Narrative
Rohm And Haas Company
Lot Number: PJ15090
This Report of Analysis contains the analytical result(s) for the sample(s) listed on the Sample Summary following this Case Narrative. The sample
receiving dale is documented in the header information associated with each sample.
All results listed in this report relate only to the samples that are contained within this report.
Sample receipt, sample analysis, and data review have been performed in accordance with the most current approved NELAC standards, the
Shealy Environmental Services, Inc. ("Shealy") Quality Assurance Management Plan (QAMP), standard operating procedures (SOPs), and Shealy
policies. Any exceptions to the NELAC standards, the QAMP, SOPS or policies are qualified on the results page or discussed below.
If you have any questions regarding this report please contact the Shealy Project Manager listed on the cover page.
a
Shealy Environmental Services, Inc. Page: 2 of 5
106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.sheelylab.com Level 1 Report v2.1
SHEALY ENVIRONMENTAL SERVICES, INC.
Sample Summary
Rohm And Haas Company
Lot Number: PJ15090
Sample Number Sample ID Matrix Date Sampled Date Received
001 SDO #2 Shipping Receiving Aqueous 10/14/2014 0540 10/15/2014
(1 Sample)
Shealy Environmental Services, Inc. Page: 3 of 5
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SHEALY ENVIRONMENTAL SERVICES, INC.
Executive Summary
Rohm And Haas Company
Lot Number: PJ15090
Sample Sample ID Matrix Parameter Method Result Q Units Page
001 SDO #2 Shipping Receiving Aqueous Zinc 200.8 77 ug/L 5
(1 detection)
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iCP-MS
Client: Rohm And Haas Company Laboratory ID: PJ15090-001
S
Description: SDO #2 Shipping Receiving Matrix: Aqueous
Date Sampled:1011412014 0540
Date Received:10/1512014
Run Prep Method Analytical Method Dilution Analysis Date Analyst Prep Date Batch
1 200.2 200.8 1 10/16/2014 2335 CDF 10/16/2014 0913 58450
CAS Analytical
Parameter Number Method Result Q POL Units Run
Zinc 7440-66-6 200.8 77 10 ug/L 1
POL = Practical quantitation limit B = Detected in the method blank E = Ouantltation of compound exceeded the calibration range H = Out of holding time
ND = Not detected at or above the POL J = Estimated result < POL and? MDL P = The RPD between two GC columns exceeds 40% N = Recovery is out of criteria
Where applicable, all soil sample analysis are reported on a dry weight basis unless flagged with a "W'
Shealy Environmental Services, Inc. Page: 5 of 5
106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.shealylab.com Level 1 Report v2.1
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CWA I NPDES
SHEALY
Chain of Custody Record
Shealy Environmental Services, Inc.
106 vantage P(Ant Drive
(Nest Columbia, South Carolina 29172
Telephone No. (803) 791-9700 Fax No. (803) 791s91 i t
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Page
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data
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Preservative
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2. Reliingoi he
Data
Time
/Off
2. Recelved fry if
Date
Time
3. Rfingidr�hed by
Date
Tim
3. Received by
Date
Time
4. Rellnciulshed by
late
Tulle
4, Lammtory Recei.*d by
Mole
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Timm
4b3 �
Note: All samples are retairled for six weeks rrum receipt
unless other arrangments are made_
LAB USE ONLY
9omi ed cn ine i;,hedc} ids n No ❑ Ice Pack
Aaceµ�l TrrrrF. 3 •C
Tamp. Blank q+<,' a N
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SHEALY ENVIRONMENTAL SERVICES INC.
SbmlY F'nvimMikel" Suvices, Lne. 1'2ge t of 1
Mwment Number. F-AD•016 ReplUas DEC 03.107e14
Re%islam Mumhcr. 15 Effcative Derr 47l13i 14
Sample Receipt Checklist (SRC)
Client- '�-o�c.r... -k' % �CkS Cooler Inspected byidate: MCr+1 Lot t: T ,,ztiS o"U-0
Means ofrieceipt: ErSESI ❑ Client ❑ UPS ❑ FedF,x ❑ Akbornel;xp ❑ Other
Ycs
No
1. Wcre cltstody �teala present on the cooler?
Yes Na NA 2. If custody seals were prcscnt, were they i otact and unbroken?
Cooler ID/Origimal 1=peratare upon mccipt/Derived (cor7'ect4temperature gran rc cipt:
Method: cmperature Blank ❑ Against Bottics TR Gun m: 0 IR Gun Correction Factor: cx
Method of coolant: awct Ioo Blue. Ice ❑ rce ❑ None
Yes ❑
No ❑
NA
I if temperature cf any cooler exceeded fi.0°C, was Project Manager notified?
PM notified by SRC, phone, note (circle one), other:__
(For coolers received via commercial courier, PMs are to he notified
imnaediatel
Ycs
❑
Nv ❑
NA [j'
A. Is the comirmcr6al cuurier s packing sliR attachrd to this form?
Yes
❑
Nn ❑
5. WCrC Proper custody rocodtlres relin uishc&rsl:ei%vd followed?
Yea
❑I
No
NA01
Sa Were sam 1cs rclinr wished by cbent to commercial catiricr?
Yeti
Of
No
❑
6. Wcrc sample IDs listed on the COC?
psyyle
No
❑
7. Were sam le. Ms listed nn all s= le containers?
No
❑
8. Way colicetion date & time listed can the COC7
Ycs
Nu
❑
5. Was colkection date & Banc listed on all sample wrltainers?
No
❑
10, Did al container label information (ID, date, time a e with the C:OC'?
p
No
❑
11. Were tests to be performed listed on tha C:OCi?
NO
12. Did all samples arrive in the ra er containers for each test?
Ycs
No
❑
13. Did all containers arrive in good condition unbroken, lids a etc.)?
Yes
Na
14. Was adequate sample volume atimailable'?
Yes
No ❑
15• Were all samplm receivedwithin 1i the hooding time or 48 hours, whichever
comes first?
Yes ❑
No [}"
16. Were My sam lcs containem tnissin ?
Ycs ❑
Into tp
17. Were there an excess sour les not listtA an COO
Yes
NA
iS. Were bubbles rescari>` a -size" !d"or6rrun in diameter) in an `0A Vials?
Ycsn
ka
NA ❑
19.th't re AruetalsfO&fi![iEA1%nutrient sxmglt s received at a gH of 41?
Yes
tr
NA
20. 1�'ere all c snide anci%'or sulfide samples received at a p14 }I2?
Yes ❑
No ❑
NA
21. Were all applicable NH3.TK1Nlcyanid&phenol (-0,2mg/L) samples frcc of
residual chlarinc?
Yev
No ❑
NAO
22. Wcrc aallection tero eratum dncumentcd un the CCC for NC samples?
Yes ❑
Win ❑
NA O
23. Were client remarks.'mgUCStS (i,e. requested dilutions, lti'fSrM5D dcsipafions,
ctc.,.) correctly transcribed from the COC into the comment section in I.MS?
Yes ff
No
24. Was the aulatc number used taken from ilac wi tainer label?
Sample Preservation (Must be completed for any sample(s) incorrectly preserved or with IlWspacc.)
Sample(s)_ _ _ _ _-were received incorrectly preserved and were adjusted
accordingly ins le receivin with (H29QiJ1ClrNa4 wing SR 4
Sam le s were received with bubbles >6 mm in diameter.
sample(s) w= received with TRC >0,2 m fL (If #21 is No)
SC Drinking Water Project Sample(s) pH verified to be > 2 by Date:
Sampl4s) were not received at a pH of'-2 and were adjusted acoindin lu usi2g SRY
_
Sample Ixlaels a lied by: Verified bv: Date: yo
Comments:
Shealy Environmental Services, Inc.
106 Vantage Point Drive West Columbia, SC 29172 (803) 791-9700 Fax (803) 791-9111 www.shealylab.com Level 1 Report v2.1