HomeMy WebLinkAboutNCS000582_MONITORING INFO_20190411STORMWATER DIVISION CODING SHEET
NCS PERMITS
PERMIT NO.
n/� � � b 6 5
l v
DOC TYPE
El FINAL PERMIT
MONITORING REPORTS
❑ APPLICATION
❑ COMPLIANCE
❑ OTHER
DOC DATE
❑ �U I '1 � � I
YYYYMMDD
STORMWATER DISCHARGE OUTFALL (SDO)
IION'ITORINGG REPORT
Permit Number NCS 000582 � � � 5'AiMPLES COLLECTED DURING CALENDAR YEAR: 2019
APR j I 2019`I'his monitoring report shall be received by the Division no later than 30 days from
the date the facility receives the sampling; results from the laboratory.)
FACILITY NAME Ennis -Flint (High Point facilit) D1;"J fir~ CENTRALCENTRALFILE�CS
PERSON COLLECTING SAMPLE(5) Nick Murphrey
ION
CERTIFIED LABORATORY(S) Pace Analytical Lab # 375
Lab #
Part A: Specific Monitoring Requirements
COUNTY Guilford
PHONE NO. ( 336) 475-6600
SIGNATURE OF PERMITTEE OR DESIGNEE
REQUIRED ON PAGE 2.
`Outtali ' -
'No.-
=Date
;Sample
:Collected
'50050
- '
_.. -
;(Q0530r
00310. i
-00340'
00610
00400
Total
Flow if a
,Total �
_Rainfall :'Solids'
!Total 5uspt;
TSS i
f'Biochem: Oxy:a
i Dcmand� BOI)
Ctiemical`Oxy. 1
yDemand+" COD
;Ammonia as
• Nitrogen
pH
fmo/dd/ r
MG
inches
-•m of
m IG -
: m /L
mg/L
SU
benchmark
--
--
--
IOU
30
120
8.4
6.0 - 8.0
001
02/20/19
0.4
8.5
<2.0
25.4
<0.1
7.8
Does this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?_ yes Xno
(if yes, complete Part B)
Part B: Vehicle Maintenance Activity MonitorinV Requirements
Outfall` V ;,Date,
50050
"'.':
056`. _'_ - -
:
j00530
-00400
'No.:
�Sainple
.'I'otalPFlow
` Total_.
'0�1,8& Grease
!Yon polar i
Tbfal
pH
New Motor
Collected
; (if applicable)=
Raiiifali
k(tfappl )•y..
xQBc;G/Tf'H
;Suspended
Oil Usage
.
- ...
�{Method•1664
:Solids
i
:SC'I-A-IEM);,if!
a l
-_
mo/dd/vr
MG
_inches ..
^m I-.
-
m 1
unit
gaumo
Form SWU-247, last revised 21212012
Page 1 of 2
STORM EVENT CHARACTERISTICS:
Date 02/20/19
Total Event Precipitation'(inches): 0.4
Event Duration (hours): (only if applicable — see permit.)
(if more than one storm event was sampled)
Date
Total Event Precipitation (inches):
Event Duration (hours); (only if applicable -- see permit.)
Mail Original and one copy to:
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
"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 oil 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."
�01
(S gnature of Permittee (Date)
Form SWU-247, last revised 21212012
Page 2 oi'2
r
aceAnalytica!
National Center ror resnng R lnnovarion
I'
ANALYTICAL REPORT
February 28, 2019
Piedmont Geologic
Sample Delivery Group:
Samples Received:
Project Number:
Description:
Site:
Report To:
Li072170
02/21/2019
1914
Ennis Flint - High Point
HIGH POINT, NC
Pete Dressel
6003 Chapel Hill Rd
Ste 145
Raleigh, NC 27607
Entire Report Reviewed By
Heather J Wagner
Project Manager
Results relate only to the items tested 01 calibraled and are reported as rounded values. This test report shall not be
reproduced. ertept in lull, wrlhout written approval of the laboratory, Where applicable, sampling conducted by Pace National
is perlovirM per gurtlarr promded in laboratorystandard operating procedures: 060302, 060303, and 050304. .
� i
TABLE OF CONTENTS ONE LAi3.NATIONWIDE
Cp: Cover Page
1
Tc: Table of Contents
2
H
Ss: Sample Summary
3
Cn: Case Narrative
4
Sr: Sample Results
5
3Ss
OUTFALL 001 L1072170-01
5
Qc: Quality Control Summary
6
Cn
Gravimetric Analysis by Method 2540 D-2011
6
F
Wet Chemistry by Method 350.1
7
Wet Chemistry by Method 410.4
8
6�C
Wet Chemistry by Method 5210 B-2011
9
,
Gi
GI: Glossary of Terms
11
Al: Accreditations & Locations
12
Al
Sc: Sample Chain of Custody
13
F 7C
ACCOUNT: PROJECT: $DG: DATEITIME: PAGE:
Piedmont Gpalcgic 1914 L1072170 02l28119 Ml$ 2 of 13
OUTFALL 001 L1072170-01 GV1
SAMPLE SUMMARY ONE LAB, NATIONWIDE,
Collected by Collected rlatellime Peceived datiMlme
Nicholas Muphrey 021201190915 02121A9 08 45
P
Method
Balch
Dilution Preparation
Analysis
Anaiyst
dateltime
date/time
Grnvimetric Analysis by Method 2540 D 2011
WG1240467
1 02123119 09:59
02l23119 11:07
AEC
Wet Chemistry dy Melhad 350.1
WG1242453
1 02/28119 10:56
0212311910:56
BRJ
Wet Chemistry by Method 410.4
WG1240771
1 02122113 1335
0212211916:55
MJA
Wet Chemistry by Method 5210 13-2011
WG1240263
1 02121119 16:11
02/2611910.53
ARM
Lacation
Mt. Juliet, TN
Mt. Juliet. TN
Mt. Juliet. TN
Mi. Juliet, TN
ACCOUNT: PROJECT: SDG, DATE/TIME: PAGE:
Piedmont Gealegic 1914 L1072170 02/28/19 14:15 3 of 13
CASE NARRATIVE ONE LAB NATIONWIDE
All sample atiquots were received at the correct temperature, in the proper containers. with the
appropriate preservatives. and within method specified holding times. unless qualified or notated within
the report. Where applicable, all MOL (LOD) and RDL (LOO) values reported for environmental samples
have been corrected for the dilution factor used in the analysis. All Method and Batch Quality Control
are within established criteria except where addressed in this case narrative, a non-conformance farm
of properly qualified within the sample results. By my digital signature below, I affirm to the best of my
knowledge, all problems/anomalies observed by the laboratory as having the potential to affect the
quality of the data have been identified by the laboratory, and no information or data have been
knowingly withheld that would affect the quality of the data.
Heather J Wagner
Project Manager
ACCOUNT: PROJECT: 50G: OATUTIME: PAGE:
Piedmont Geologic 1914 L1072i70 02/2811914:15 4 of 13
OUTFALL 001
SAMPLE RESULTS - 01
ONE LAB. NATIONWIDE.
Collected dateltime: 02120119 09:15
L1072170
Additional Information
Result Units
Rp
Analyte
--- -- -- -
pLI(On Site) 7.8 su-
FC
Graviflietric Analysis by Method 2540 D-2011
E
Result Qualifier
RDL
Dilution Analysis
Batch
Analyte ugll
ugil
date 1 time
Suspended Solids 9500
250)
1 02123.201911 07
WG12.10467
[Cn]
Wet Chemistry by Method 350.1
Result 4ualitier
RDL
Dilution Analysis
Batch
5
Analyte ugll
ug;l
date! time
QC
Ammonia Nitrogen ND
IDO
1 02/29.2019 10:56
WGI242453
Wet Chemistry by Method 410.4
GI
Result Qualifier
RDL
Dilution Analysis
Batch
F
Analyte ugll
ugd
date I time
COD 25400
10000
1 02/221201916:55
WG1240771
rqC
Wet Chemistry by Method 5210 B-2011
Result Qualifier
RDL
Dilution Analysis
Batch
Analyte ugA
ug;l
date 1 time
BOD NO J-K1
2000
1 0212612019 10 53
WG1243263
ACCOUNT: PROJECT: 5DG: DATEITIME: PAGE:
Piedmont Geologic 1914 L1072170 021281]914:15 5 of 13
WG1240467
QUALITY CONTROL SUMMARY
ONE LAB. NATIONWIDE.
GraVlmetrie Analysis by Method 2540 D-2011
L1072170-01
Method Blank (MB)
(MB) P3386413-1 02/23/19 11:07
Fp
ME Result MR Oualifier MR MDL
MR ROL
Anelyte ugll ugll
ug)l
Suspended Solids U 350
2500
SS
L1072166-01 Original Sample (OS) • Duplicate (DUP)
(OSI 1-1072166-01 02/23/19 1107 • (DUP) R3386413-3 02123A9 1107
]I
FC
Original Result OUP Result Dilution DUP RPD
DUP Qualifier DUP RPD
Limits
s
Sr
Analyte ugll ugfl %
%
Suspended Solids 37000 37500 1 34
5
_ _
M
L1072187-04 Original Sample (OS) • Duplicate (DUP)
GI
(OS) L1072187-04 02/23/19 11:07 • (DUP) R3386413-4 02/23/19 11.07
Original Result DUP Result Oiilution DUP RPD
DUP Oualifier DUP RPD
Limits
uAl
Analyte ugll ugll %
o
Suspen&dSolids 54000 46000 1 16.0
J3 5
'SC
Laboratory Control Sample (LCS)
(LCS) R3386413-2 02/23/19 11:07
Spike Amount LCS Result LCS Rec.
Rec. Limits LCS Oualifier
Analyte ugll ugll %
Suspended Solids 773000 800000 103
85.0-115
ACCOUNT:
PROJECT:
SDG:
DATElTWE:
PAGE:
Piedmor>t Geologic
1914
L1072170
02128n91a:15
6 01 13
WG1242453
Wet Chemistry by Method 350.1
Method Blank (MB)
(IAB) P3387569-1 02/28/19 10:50
M8 Result M8 Qualifier M9 MDL MB RDL
Analyte ugll ugll ugll
Ammonia Nitrogen U 31.7 100
L1071710-01 Original Sample (OS) • Duplicate (DUP)
QUALITY CONTROL SUMMARY
L1072170-01
(OS} L1071710-01 02/28119 10:53 • (DUP) R3387569-3 02,28119 10:54
Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD
Limits
Analyte ugll ugll % %
Ammonia NrtragEn ND 0.000 1 0.000 10
L1072217-01 Original Sample (OS) • Duplicate (DUP)
(0S) L1072217-01 02/28/19 1120 • (DUP) R3387569-6 02!28/19 11:21
Original Result DUP Result Dilution DUP RPD DUP Oualifier DUP RPD
Limits
Analyte ugll ugll % %
Ammonia Nitrogen ND 0,000 1 0.000 10
Laboratory Control Sample (LCS)
(LCS) R3387569-2 02/28/19 10:51
Spike Amount LCS Result LCS Rec. Rec. Limits tCS Qualifier
Analyte ugll ugll %
Ammonia Nitrogen 7500 7800 104 90.0-110
L1072260-01 Original Sample (OS) • Matrix Spike (MS)
(OSI L1072260-01 02/28/19 lt23 • (MS) R3387569-7 02!23i19 11:25
Spike Amount Original Result MS Result MS Rec. Dilution Rec. Limits MS Qualifier
Analyte ug11 ugll ugll
Ammono Nitrogen 5000 ND 5270 105 1 90.0-110
ONE LAB. NATIONWIDE.
Cp
E
E
�GI
yAl
CSC
ACCOUNT:
PROJECT:
50G'.
DATEMME:
PAGE:
Piedmont Geologic
4914
L1072170
021M1914.15
7 at 13
WG1240771 QUALITY CONTROL SUMMARY ONJE LAD. NATIONWIDE.
Wet Chemistry by Method 410.4 L1072170-01
Method Blank (MB)
(MB) R3386304-1 02/22/19 16-51 FCp
MB Result MB Qualifier MB MDL MB RDL
Analyse ugll ugll ugil F
COD U 3000 10000
L1069704-01 Original Sample (OS) • Duplicate (DUP)
(OS) L1069704-01 02/22/19 16:52 • (DUP) R3386304-3 02/22/19 16:52
Original Result DUP Result Dilution DUP RPO DUP Qualifier DUP RPD
Limits
Analyte ug1l ugll % %
COD 286000 2880DO 1 0.596 20
L1072344-02 Original Sample (OS) • Duplicate (DUP)
(OS) L1072344-02 02/22/19 16 57 • (DUP) R3386304-4 02/22/19 15:57
Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD
Limits
Analyte ugll ugll %
COD U 0,000 1 0.000 20
Laboratory Control Sample (LCS)
(LCS) R3386304-2 02/22/19 16 S1
Spike Amount LCS Result LCS Rec. Rec. Limits LC5 Qualifier
Analyte ugll ugll % %
COD 2.22000 208000 939 90.0-110
L1072411-02 Original Sample (OS) • Matrix Spike (MS) • Matrix Spike Duplicate (MSD)
(OS) L1072411-02 02/22/19 16:58 • (MS) R3396304-5 02/22/19 16:58 • (MSD) R3386304-6 02/22119 16:58
Spike Amount Original Result MS Result M50 Result M5 Rec. MSD Rec. Dilution Rec. Limits MS Qualifier MSD Qualifier RPD RPD Limits
Analyte ugA ugll ugll ug)l % % % % %
COD 400000 23600 451000 449000 107 106 1 80.0-120 0.745 20
ACCOUNT; PROJECT; SDG:
Piedmont Geologic 1914 L1072170
DATE(71ME:
02128/19 1415
PAGE:
8oi13
WG1240263
QUALITY CONTROL SUMMARY
ONE LAB. NATIONWIDE. �
Wet Chemistry by Method 5210 8-2011
L1072170-01
Method Blank (MB)
(ME) R3386934-1 02/26/19 11,44
17p]
MB Result MB Qualifier MB MDL MB RDL
^TC
Analyte ugll ugll ugll
ROD U 200 200
FS
L1072097-02 Original Sample (OS) • Duplicate (DUP)
(OS) L1072097-02 02/26/19 09.26 • (DUP} R3386934-5 02126/19 09:27
FC
Original Result DUP Result Dilution DUP RPD
DUP Oudlifier DUP RPD
Limits
s
Analyze ugll ugll %
%
ROD 6900 10600 1 17
30
L1072187-01 Original Sample (OS) • Duplicate (DUP)
E
LI
(OS) L1072187-01 02/25/19 10:56 • (DUP) R3386934-6 02/26119 10:58
Original Result DUP Result Dilution DUP RPD
DUP Qualifier DUP RPD
Limits
IF]
Analyze ugll ugli %
BCD ND 0,000 1 0
30
'SC
L1072189-01 Original Sample (OS) • Duplicate (DUP)
(OS) L1072189-01 02/26119 11:10 • (DUP) R3386934-7 02/26/19 11:12
Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD
Limits
Analyte ug11 ugll % %
BOD ND 0.000 1 0 30
L1072250-01 Original Sample (OS) • Duplicate (DUP)
(US) L1072250-Oi 02/26i19 11:33 - (DUP) R3386934-8 02/26/19 11:35
Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD
Limits
Analyte ugll ugli % %
BCD 14300 15100 1 6 30
ACCOUNT: - PROJECT: 50G: DATEITIME: PAGE:
Piedmcnt Geologic 1914 L1072170 O?Q8139 14,15 9 of 13
WG1240263 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE. �
Wet Chemistry by Method 5210 8-2011 L1072170-01
Laboratory Control Sample (LCS)
(LCS) R3386934-2 02/26/19 08AS FP
Spike Amount LCS Result LCS Rec. Stec. Limits LCS Qualifier
Analyte ugll u9A % %
BCD 198000 160000 30,6 84.6-115 J-
Laboratory Control Sample (LCS)
(LCS) R3386934-3 02/26/191i.04
Spike Amount LCS Result LCS Rec. Rec. Limits LCS Qualifier
Analyte ugll ug11 },
BOD 198000 221000 112 84 6-11S,,
Laboratory Control Sample (LCS)
(LCS) R3386934-4 02/26/19 1142
Spike Amount LCS Result LCS Rec Rec, Limits LCS Qualifier
Analyte ugll ug11 % o
B01) 198000 231000 117 84.E-115 J+
ACCOUNT: PAGE.
10 of 13
PROJECT:
SDG:
DATHTIME:
Pledment Geologic
1914
L1072170
02/28/19 14:15
GLOSSARY OF TERMS
ONE LAB NATIONWIDE.
Guide to Reading and Understanding Your Laboratory Report
The information below is designed to better explain the various terms used in your report of analytical results from the Laboratory. This is not
RPintended
as a comprehensive explanation. and if you have additional questions please contact your project i ep asentative.
Abbreviations and Definitions
Fc
MDL
Method Detection Limit.
ND
Not detected at the Reporting Limit (or MDL where applicable).
E
ROL
Reported Detection Limit.
Rec.
Recovery.
t
RPD
Relative Percent Difference.
Cn
SOG
Sample Delivery Group,
U
Not detected at the Reporting Limit (or MDL where applicable).
s
5r
Analyte
The name of the particular compound or analysis performed. Some Analyses and Methods will have multiple analytes
reported
If the sample matrix contains an interfering material, the sample preparation volume or weight values differ from the
6
QC
Dilution
standard, or if concentrations of analytes in the sample are higher than the highest limit of Concentration that the
laboratory Can accurately report, the sample may be diluted for analysis, If a value different than I is used In this field, the
iesult,eported has already been corrected for this factor.
These are the target % recovery ranges or % difference value that the laboratory has historically determined as normal
Limits
for the method and analyta being reported. Successful QC Sample analysis will target all analytes recovered or
duplicated within these ranges.
Original Sample
The non -spiked sample in the prep batch used to determine the Relative Percent Difference (RPD) From a quality control
LEI
sample. The Original Sample may not be included within the reported SDG.
This column provides a letter andlor number designation that corresponds to additional information concerning the result
a
Qualifier
reported. If a Qualifier is present, a definition per Qualifier is provided within the Glossary and Definitions page and
5C
potentially a discussion of possible implications of the Qualifier in the Case Narrative if applicable.
The actual analytical final result !corrected for any sample specific characteristics) r eported for your sample. If there was
no measurable result returned for a specific analyze, the result in this column may state "ND" lNot Detected) or "BDL"
Result
(Below Detectable Levels). The information in the results column should always be accompanied by either an MDL
(Method Detection Limit) or ROL ;Reporting ()election Limit) that defines the lowest value that the laboratory could defect
cr report for this analyte.
Uncertainty
(Radiochemistry)
Confidence level of 2 sigma.
A brief discussion about the included sample results, including a discussion of any non -conformances to protocol
Case Narrative (01)
observed either at sample receipt by the laboratory from the field or during the analytical process. If present. there will
be a section in the Case Narrative to discuss the meaning of any data qualifiers used in the report.
Quality Control
This section of the report includes the results of the laboratory quality control analyses required by procedure or
Summary (Oc)
analytical methods to assist in evaluating the validity of the results reported for your samples. These analyses are not
being performed on your samples typically, but on laboratory generated material.
This is the document created in the field when your samples were initially collected. This is used to verify the time and
Sample Chain of
date of collection, the person collecting the samples. and the analyses that the laboratory is requested to perform. This
Custody (5c)
chain of custody also documents all persons (excluding commercial shippers) that have had Conti of or possession of the
samples from the time of collection until delivery to the laboratory for analysis,
This section of your report will provide the results of all testing performed on your samples. These results are provided
Sample Re5Ui15 (Sr)
by sample ID and are separated by the analyses performed on each sample. The header line of each analysis section for
each sample will provide the name and method number for the analysis reported.
Sample Summary {5s)
This section of the Analytical Report defines the specific analyses performed for each sample ID, including the dates and
times of preparation and/or analysis,
Qualifier
Description
J3
The associated batch QC was outside the established quality control range for precision.
J-
The associated batch OC was outside the lower control limits; associated data has a potential negative bias.
J+
The associated batch QC was outside the upper control limits; associated data has a potential positive bias.
Ki
The sample dilutions set-up for the BOD/CBOD analysis did not meet the oxygen depletion criteria of at least 2 mg/L.
Reported result is an estimated value.
ACCOUNT: PROJECT: SDG: DATEITINIE: PAGE:
Piedmont Geologic 1914 L1072170 02/28/1914:15 11 of 121
ACCREDITATIONS & LOCATIONS ONELA3 NArl&r VIDE 0
Pace National is the only environmental laboratory accrecirtedkerUhed to support your work nationwide tram one location. One phone call, one point of contact. one laboratory. No other lab is as
accessible or prepared to handle your needs throughout the country. Our capacity and capability from our single locatron laboratory is comparable to the collective totals of the network
laboratories in our industry, The most significant benefit to our one location design is the design of our laboratory campus, The model is conducive to accelerated productivity, decreasing
twirr ound time. and pievenfing cross contamination, thus protecting sample integrity, Our focus an premium quality and prompt service allows us to be YOUR LAB OF CHOICE,
Not all certifications held by the laboratory are applicable to the results reported in the attached report.
Accreditation is only applicable to the test methods specified on each scope of accreditation held by Pace National,
State Accreditations
Alabama
4D650
Nebraska
NE-CS-15-05
Alaska
17-026
Nevada
TN-03-2002.34
Arizona
AZO612
New Hampshire
2975
Arkansas
_ 88-046_9
_ New Jersey-N_ELAP _
TNO0_2_
California
2932
New Mezrc_o_'
Wa
Colorado
TNO0003
_ _ _ New_Yoik_ _ _ _
_ _ 11742
Connecticut
PH-0197
North Carolina
Ena375
EB7487
North Carolina'
OW_21704
_Florida _
Georgia
- -
_ NELAP
- - - - - - _ - -
_
North Carolina'-
- �- �-
T _
41 _
--R-140- - - - -
Georgia'--
-- - -
923 ----
- - - - ---
North Dakota _ -
-
Idaho
TNO0003
--
Ohio -VA>' _-_
CL0069_-_ -
Illinois _ -
T 200008
-
Oklahoma _- -
-� 9915 _
Indiana
-----
C-TN-01
Oregon — _--
TN200002
---
Iowa
_ --_- - - 364 _ - _ ._ _, -
Pennsylvania
6&02979
E-10277
Rhode Island
LA000355
_Kansas
Kentucky' "
_ _ _ _
90010
South Carolina
_ _ _ �-
84004
Kenlucky=_
16
South Dakota
-
_--.
Louisiana___
- _ - _-� -_ - _ _ _ ___ _ _ _ T
_ _ AI30792 _ _
�._____ _
_ _ Tennessee"
-_ _nla _ T
_ 2005
Louisiana'
LA180010
Texas
T104704245-18-15
Maine
_
— — _ - TN0002 �... - -
Texas
LABO152
Maryland
324
Utah
T TNO0003 �_v -
Massachusetts-
M-71%1003
Vermont
VT2006
_Michigan
_ _ 9958
Virginia
460132
_Minnesota
047-999.395
Washington
C847
_Mississippi
_ _ _ _ TNO0003 _ _ _ _
West Virginia _
_ _ 233 _
Missouri
W _ 340 _ _ _
Wisconsin
_ 9980939910
Monlana
CERT0086
Wyoming
A2LA
Third Party
Federal Accreditations
A21LA - ISO 17025
1461.01 _ �
AIHA-LAP,LLC EMLAP
ID0789
A2LA- ISO 170255
1461.02
DOD
1461.01
Canada—____
1461X1
USDA
P330-15-00234_�___�
EPA-C(ypto
TNO0003
' Drinking Water ' Underground Storage Tanks 'Aquatic Toxicity ' ChemicaliMicrobrological s Mold 'Wastewater War Accreditation not applicable
Our Locations
Pace Nationai has sixty-four client support centers that provide sample pickup andlDr the delivery of sampling supplies. If you would like assistance from one of our support offices, please contact
our main office. Pace National performs all testing at our central laboratory.
WA
R MT ND
OR MN
T ID SD T WI
WY MI T
IA
T
NV T NE IL Icy OH
CA - CO KS MC) T
IZ,T KY
�! `AZ
T T Tx T
e AK T
.o
�b
H I CV �,
ACCOUNT: PROJECT:
Piedmont Geclogrc 1914
AR MS j Al � GA
LA
SDG:
L1072170
PA r=_
NY
T PA
VVV VAT
TAT
SC
--s
FIL
DATE7T IM E: PAGE:
02128719 14:15 12 of 13
Billing Information:
Analysis
/
Container
/ Preservative
Chain of Custody Page _- of
Piedmont Geologic
Accounts Payable Pies
ch.
6003 Chapel Hill Rd Ste 145
�ice ' 19
6003 Chapel Hill Rd
Raleigh, NC 27607
Ste 145
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Resort to:
Pete Gressel
Email To:pjdressel@piedmontgeologic.com;
jmurphrey@pledmontgeologic.com
Project
Description: Ennis Flint - High Point
City/State
Collected: r � r
W t "A Po�.,_i /�+{�
E236
Phone: 19-85 -9532
Fa.; 919-854-9532
Client Project a
1914
Lab Project fl
PIEGEO-ENNIS-FLINT
Collected by (print):
k
N)�L �U �S l� VMS !l►
site/Facility ID t+
HIGH POINT, NC
P.O. is
acunum: PIfGEO
7emplate:T132067
Prelogin: P691390
TSR: 873 -Heather 1 Wagner
PB: s
Collected by lsignature};
J J
C�
Immediately
Paci ed on Ice N Y
Quote J+
Rush? (tab MUST Be Notified)Quote0.
_ $anu oaf _Frye Daq
He-t 03y sDay (ard only) Date Resuits Needed
— Two pay , 10 Day Iliad Ontyl Ne.
^— three Da: of
Sample ID
Comp/Grab
matri- '
Depth
Date
Time
ntrs
shipped %9a:Fed Ex Ground
Remarks
S.mptr $ (i.b entyt
00
(;ra6
GW
--IQ
O 1 q,
qJS
4
x
x
x
x
1
Matrix:Remarks;
SS -Soil AIR -Air F- Filter
GW- Groundwater B- Bioassay
yW- WasteWatei
OW - DrinkingWater
OT -Other
{ i pH Temp
i
Flow Other
Samples returned via: r
UPS _ Fedcx _ Courier _ 7racking a i AL ) 7 %
t �/1
Sn--ie tzecei nt ctic^kli st
CtJC Seai _esens/int.ect: L11PN
COC SScnodiAecvra:e: - N
Bottles a.rr"J i. nact: �—tt
Coccect bcttlea UaQJ:
S:afi:zeht voluzw sent-: •_N
l�8_=:pllcnble
Vo:+ Zerp Headapace: Y N
p=eservacier, correct/Checceuo _N
. IWU G._.�'i4 ON: <c
Re6 i edby:(Sig natur
Dater (]
Time: O
,
105
Aeceivedby: at
�'
TripBlaMReceived: yes/Ito
TpailMeo1
elinquished by; (Si } !u } /
Date.
"T.'Received
a/c e I u 1
Temp: r[ Bottles fiecei:ed:
if preservation required by Login; Date/rimeitelinquishe
ur"
Date:
for lab b : (5'rg"nature)
Date- Time: C
Hold:
Condid