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Home My WebLink AboutNCS000582_MONITORING INFO_20190830�,\j Z5-1 Z-,,o STORMWATER DIVISION CODING SHEET NCS PERMITS PERMIT NO. DOC TYPE ❑FINAL PERMIT � MONITORING REPORTS ❑ APPLICATION ❑ COMPLIANCE ❑ OTHER DOC DATE ❑ a00 YYYYMMDD STORMWATER DISCHARGE OUTFALL (SDO) MONITORING REPORT Permit Number NCS 000582 R EC E I E QAMI'LES COLLECTED DURING CALENDAR YEAR: 2019 AUG 3 20,9 (This 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 facility) CENTRAL FILES PERSON COLLECTING SAMPLE(S) Niclloltts MLirphreNt _ 'ON CERTIFIED LABORATORY(S) Pace National Lab ## 1 Lab ## Part A: Specific Monitoring Requirements COUNTY Guilford PHONE NO. ( -336) 475-6600 SIGNATURE OF PERMITTEE OR DESIGNEE REQUIRED ON PAGE 2, Outfall, No. Date Sample Collected 50050 U0530 60310 003 U 00610 00400 Total Flow if a Total 'Rainfall TotahSusp.,- Solids: -SS), Biochern`Osv:. Demand; BOD ,Chemical�Oxy. Demand COD Ammonia as Nitrogen PH imo/dd/yr MG inches m IL m ''/L m61L . mg/L SU henchmark -- -- -- 100 30 12U 8.4 6.0 - 8.0 001 07/2'V19 -- 0.17 20.8 9.7 29.4 0.262 8.0 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 13: Vehicle Maintenance Activity Monitoring Requirements Outfall No. f bate :Sample Collected .50050 E00556. i00530 00400 Total Flow` (if applicable).. .Total Rainfall' - E(3i1.& Grea► e, ; :(it ippl.). Non=polar O&GTI:P.II {1lethod 1664 ; °SGT-IIEM), if a 1. "=Total !Suspended k5.olids pH New Motor Oil Usage mo/dd/vr \1G inches nrr I m /l unit al/mo Form SWU-247. lasr raised 21212012 Page 1 of 2 STOR11 EVENTCHARACTERISTICS: Date 07/2'V 19 Total Event Precipitation (inches): 0.17 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 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." OIJ4 Mai O (Sign afli re of erniittee) (Date) Form SWU-247. last revised 21212012 Page 2 of 2 aceAnalyiical n ANALYTICAL REPORT NaliOndl Cerrlg+ to Tesnnq S rnnwatw++ July 30, 2019 i l Piedmont Geologic I Sample Delivery Group: Samples Received: i j Project Number: I Description: FS1 L1121645 07/24/2019 F 1914 ! Ennis Flint - High Paint FO I E Pete Dressel 6003 Chapel Hill Rd uAl Ste 14S Raleigh, NC 27607 95c Entire Report Reviewed By: 4�41� Heather J Wagner Project Manager ` Results relate only to the items tested or Calibrated dnd are reported as rounded values. This test report shail not be J reproduced, except in lull, w'thout written approval of the laboratory. Where �rpphwblr, sampling conducted by Pace ,,,,,+��-rrrw.- Anulstical National is peeiormed per guidance provided in laboratory standard operating procedures ENV-SOP-MTJL-06fi7 and '. ENV-SOP-MLL-0068, Where samplrnq mnducted by the customer, results relate to the accuracy of the information p'robrded, ' and as the samples are received, fr ACCOUNT: PROJECT: SDG: OATEITIME: PAGE: Piedmont Geciogic 1914 L1121645 07/30/19 15A7 1 of 14 TABLE OF CONTENTS ONE LAB NATIONWIDE Cp: Cover Page t Tc: Table of Contents 2 Ss: Sample Summary 3 Cn: Case Narrative 4 Sr: Sample Results 5 FS OUTFALL-001 L1121645-01 5 Oc: Ouality Control Summary 6 Fn Gravimetric Analysis by Method 2540 D-2011 6 Fr Wet Chemistry by Method 350.1 7 Chemistry by Method 410.4 8 roWet Wet Chemistry by Method 5210 B-2011 9 GI: Glossary of Terms 11 F Al: Accreditations & Locations 12 F Sc: Sample Chain of Custody 13 ID ACCOUNT: PROJECT: SDG: DATEITIM E: PAGE: Piedmens Geologic 19Z4 L1121645 07130r91547 2 of 14 SAMPLE SUMMARY ONE LAB. NATIONWIDE. Colleted by Collected datLmimo Received dateAlme OUTFALL-001 L1121645-01 GW 07123,191030 07)241190345 Method Batch Dilution Piepaiation Analysis Analyst Location doLt!Itime datLkF11e Gravimetric Analy.Sis by M;rthod 2540 0-2011 WG1315741 1 CW27119 21:53 0712W19 23:45 TH Mt. Julie,, TN Wel Chemimiy by Method 350.1 WG1317714 1 07l26119 20:58 07126i19 20:53 JER Mt. Juliet, TN Wet Chemist+y by Method 4T0.4 WG1317938 1 07/26119 14A7 07126n9 20:59 RDW Mt. Juliet, TN Wet Chemistjy by Method 5210 B-2011 WG1316726 1 07/2469 16:42 0712911911,09 ARM Mt. Juliet, TN ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE: Piedmont Geclegic 19M L112164S 07130fl915A7 3 of 14 CASE NARRATIVE ONE LAB NATIONWIDE Ali sample aliquots were received at the correct temperature, in the proper containers, with the Cp appropriate preservatives, and within method specified holding times, unless qualified or notated within the report. Where applicable, all MDL (LOD) and RDL (LOO) values reported for environmental samples F 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-confofmance form or properly qua}ified within the sample results. By my digital signature below, I affirm to the best of my F 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. Fr Fc F Heather J Wagner Project Manager F, FC ACCOUNT: PROJECT: SDG: DATEITIM E: PAGE: Piedmont Geologic 1914 L112W5 0713011915,47 4 of 14 OUTFALL-001 SAMPLE RESULTS - 01 ONE LAB. NATIONWIDE. Collected date/time: 07/23119 10:00 L1121645 Additional Information Result Units FC Analyte PH ;On Site] S su T C Gravimetric Analysis by Method 2540 D-2011 r q Result Oualifier RDL Dilution Analysis Batch Analyte ugll ugil dale /time Suspended Solids 20800� 2650 1 07127f2019 23 46 WG1315741 R Wet Chemistry by Method 350.1 0 Result OualiFler RDL Dilution Analysis Batch ugn ugil datu /time FAnalyte Ammmnia Nitrogen 202 10D 1 07125i2019 20:58 W01317711 Wet Chemistry by Method 410.4 El Result Qualifier RDL Dilution Analysis Batch F Analyte ugll ugil date t time COD 29400 10000 1 07/261201920:59 WG13i7933 rq5c Wet Chemistry by Method 5210 B-2011 Result Qualifier RDL Dilution Analysis Batch Analyte Ug11 ugtl date 1 time BOD 9700 J- 2000 1 071291201911:09 WG1315725 ACCOUNT: PROJECT: SDG: ❑ATEITIME: PAGE: Piedmont Geologic 1914 L1121645 0713011915:47 5 of 14 WG1316741 QUALITY CONTROL SUMMARY ONE LAB, NATIONWIDE. Gravimelric Analysis by Method 2540 D-2011 Ll121645-01 Method Blank (MB) (W) R3435043-1 07/27/19 23:46 MB Result Analyte ugll Suspended Solids U MB Qualifier M8 MDL M8 RDL ugA ugA 350 2500 L1121614-01 Original Sample (OS) • Duplicate (DUP) (OS) 1-1121614-01 07/27119 23:46 • (DUP) R343SO43-3 07/27/19 23:46 Original Restilt DUP Result Dilution DUP RPD DUP Qualifier DUP RPD Limits Analyte ug11 ug1l % Suspended Solids 63500 64500 1 1.56 5 L1121946-01 Original Sample (OS) • Duplicate (DUP) (OS) L1121946-01 07/27/19 23:46 • (DUP) R3435043-4 07/27/19 23:46 Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD Limits Analyte ugli ugll % Suspended Solids 137000 139000 1 0.727 5 Laboratory Control Sample (LCS) (LCS) R3435043-2 07/27/19 2346 Spike Amount LCS Result LCS Rec. Rec. Limits LCS Qualifier Analyte ugp ugll % % Suspended Solids 713000 764000 98.8 85.0-115 ACCOUNT: PROJECT: SDG: Piedmont Geologic 1914 L1121645 DATE/TIME: 07/3011915A7 PAGE: 6of14 WG1317714 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE. Wet Chemistry by Method 350.1 L1121545-01 Method Blank (MB) FID (MB) R3434936-1 07/26/39 17:47 MR Result MR Qua[Aisr MR MDt MR RDL Analyze ug/I ugll uyll Arnnionia Nitrogen U 31.7 100 L1121569-01 Original Sample (OS) • Duplicate (DUP) (OS) 1-1121569-01 07/26/19 17:53 • (DUPI R3434936-3 07/26/19 17:55 Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD Limits Analyte ug/I ugll % % Ammonia Nitrogen ND 0.000 1 0.000 10 L1121744-02 Original Sample (OS) • Duplicate (DUP) (OS) L1121744-02 07/26/19 2101 • (DUP) R3434936-5 07/26/19 21:02 Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD Limits Analyze ug/I ug/I % % Ammonia Nitrogen U 0.000 1 0.000 10 Laboratory Control Sample (LCS) (LCS) R3434936-2 07/26/19 17:49 Spike Amount LCS Result LCS Rec, Rec. Limits LCS Qualifier Analyte ug/I ug/I % % Ammonia Nitrogen 7500 7180 95.7 90.0-110 L1121586-01 Original Sample (OS) • Matrix Spike (MS) (OS) L1121586-01 07/26/19 17:S6 • (MS) R3434936-4 07/26/19 17:58 Spike Amount Original Result MS Result MS Rec. Dilution Rec. Limits MS Qualifier Analyze ugll ug/I ug/I Ammonia Nitrogen 5000 ND 4720 94.4 1 90.0-110 L1121749-01 Original Sample (OS) • Matrix Spike (MS) • Matrix Spike Duplicate (MSD) (OS) L1121749-01 07/26/19 2104 • (MS) R3434936-6 07/26/19 21:05 • (MSD} R3434936-7 07/26/19 21:07 Spike Amount Original Result MS Result MSD Result MS Rec. MSD Rec. Analyte ug/I ugll ugfl ugll % % Ammonia Nitrogen 5000 7040 10100 115DO 61.1 89.2 ACCOUNT: PROJECT: Piedmont Geologic 1914 Dilution Rec. Limits MS Qualifier MSD Oualifier RPD RPD Limits 1 90.0-110 E J6 E J3 J6 13.0 10 — SDG: DATEITIME: PAGE: 1-1121645 07/30/1915A7 7 al 14 WG1317938 QUALITY CONTROL SUMMARY ONE LAS. NATIONWIDE. 40 Wet Chemistry by Method 410.4 L1121645-01 ' Method Blank (MB) (mB) R3434847-1 C7126/19 20:58 RP MB Result MB Qualifier MB MDL Analyte ugll ugll MB ROL ugll COD U 3000 10000 3 5s L1121745-01 Original Sample (OS) • Duplicate (DUP) (OS) L1121745-01 07/26/19 21:00 • (DUP) R3434847-5 07/26/19 21:0) Fqn Original Result DUP Result Dilution DUP RPD DUP OualiTier DUP RPD Limi[5 s Sr Analyte ugll ugll % a, COD 62000 58900 1 5.73 — 20 ---_ — - Laboratory Control Sample (LCS) �GI (LCS) R3434847-2 07/26/19 20:58 Spike Amount LCS Result LCS Rec. Rec. Limits LCS Qualifier Analyte ugll ug/I % AI COD 222000 207000 93.2 — — - -- 90.0-110 -_---- — BSc L1121697-01 Original Sample (OS) . Matrix Spike (MS) . Matrix Spike Duplicate (MSD) (OS) L1121697-01 07/26/19 20:59 • (I` -AS) R3434847-3 07/26/19 20:59 - (MSO( R34348474 07/26/19 20:59 Spike Amount Original Result MS Result MSD Result MS Rec. MSD Rec. Dilution Rec. Limits MS Qualifier MSD Oualifier RPD RPD Limits Analyte ug/I ug/I ugll ugll % % % % % COD 400000 ND 378000 376000 94.5 94.0 1 80.0-120 0.568 20 ACCOUNT: PROJECT: SDG: DATEITIME: PAGE: Piedmcnt Geologic 1914 L1121645 07/30/19 15A7 8 of 14 WG1316726 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE. Wet Chemistry by Method 5210 B-2011 L1121645-01 Method Blank (MB) L l� (MR) P3435205-1 07/29/19 11;27 MB Result MB Oualifier MB MDL MB RDL Analyte ugll ugll ugll ITC BOD U 200 200 L1121368-01 Original Sample (OS) • Duplicate (DUP) (OS) 1-1121368-01 0709119 09.19 • (DUP) R3435205-5 07/29/19 09:22 Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD Limits Analyte ugll ugll % % BCD 55300 50300 1 9 30 L1121602-01 Original Sample (OS) • Duplicate (DUP) (OS) 0121602-01 07/29/19 10:31 • (DUP) R3435205-6 07/29/19 10:33 Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD Limits Analyze ug/l ugll % % BOO 3600 4000 1 11 30 L1121614-02 Original Sample (OS) • Duplicate (DUP) (OS) L1121614-02 07/29/19 10:45 • (DUP) R3435205-7 07/29/19 10:46 Original Result DUP Result Dilution DUP RPD OUP Qualifier DUP RPD Limits Analyte ugll Ugli % % BCD 3900 3600 1 6 30 L1121615-01 Original Sample (OS) • Duplicate (DUP) (OS) L1121615-01 07/29A9 1115 - (DUP) R34352CS-8 07/29/19 11:16 Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD Limits Analyte ugll ugil % % BOD 7400 7200 1 3 30 ACCOUNT: PROJECT: SDG' Piedmont Geologic 1914 L1121645 DATEITWEI 07130119 ISA7 PAGE: 9of14 WG1316726 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE. � Wet Chemistry by Method 5210 8-2011 L1121645-01 Laboratory Control Sample (LCS) (LCS) R3435205-2 07/29/19 09 14 Spike Amount LCS Result LCS Rec. Rec. Limits LCS Qualifier Analyte ugll ugll % SOD 198000 149000 75.4 84.6-115 J- Laboratory Control Sample (LCS) (LCS) P3425205-3 07/29/19 10:34 Spike Amount LCS Result LCS Rec. Rec Limits LCS Qualifier Analyte ugA ugll % % SOD 198000 153000 77.1 84.6-115 J- LaborMaiy Control Sample (LCS) (LCS) R3435205-4 07129/1911:25 Spike Amount LCS Result LCS Rec. Rec. Limits LCS Qualifier Analyte ugh ugll % SOD 198000 201000 102 84 6-115 ACCOUNT: PROJECT: SDG'. DATE/TIME: PAGE: Piedmont Geologic 1914 L1121645 07/3011915:47 10 of 14 GLOSSARY OF TERMS ONE LAB NATIONWIDE, 0 Guide to Reading and Understanding Your Laboratory Report The information below is designed to better explain the various terms used in your report Of 8nalytical results from the Laboratory. This is not H intended as a comprehensive explanation, and if you have additional questions please contact your project representative, Results Disclaimer - Information that may be provided by the customer, and contained within this report, include Permit Limits, Project Name. TC Sample ID. Sample Matrix. Sample preservation. Field Blanks. Field Spikes. Field Duplicates. On -Site Data. Sampling Collection Dates/Times, and Sampling Location. Results relate to the accuracy of this information provided, and as the samples are received. Abbreviations and Definitions I qs MDL ND Method Detection Limit. Not detected at the Reporting Limit;or MDL where applicable), Rn RDL Reported Detection Limit. Rec. Recovery. y RPD Relative Percent Difference. Sr SDG U Sample Delivery Group. Not detected at the Reporting Limit (or MDL where applicable). FO Analyte The name of the particular compound or analysis performed. Some Analyses and Methods will have multiple anal}2es reported. If the sample matrix contains an interfering material, the sample preparation volume or weight values differ fiern the Dilution standard, or if concentrations of analytes in the sample are higher than the highest limit of concentration that the laboratory can accuretely report, the sample may be diluted for analysis. If a value different than 1 is used in this field, the result reported has already been corrected for this factor. F These are the target % recovery ranges or % difference value that the laboratory has historically determined as normal Limits for the method and analyte being reported. Successful CC Sample analysis will target all analyzes recovered or duplicated within these ranges. 9 Original Sample The non -spiked sample in the prep batch used to determine the Relative Percent Difference (RPD) from a quality control SC sample, The Original Sample may not be included within the reported SDG. This column provides a letter and/or number designation that corresponds to additional information concerning the result Qualifier reported. If a Qualifier is present, a definition per Qualifier is provided within the Glossaty and Definitions page and 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) reported for your sample. If there was no measurable result returned for a specific analyte, the result in this column may state "ND" (Not 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 RDL (Reporting Detection Limit) that defines the lowest value that the laboratory could detect Or report for this analyze, Uncertainty (RadiochemisUy) Confidence level of 2 sigma. A brief discussion about the included sample results, including a discussion of any non -conformances to protocol Case Narrative (Cn) 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 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 elate of collection. the person collecting the samples, and the analyses that the laboratory is requested to perform. This Custody (Sc) chain of custody also documents all persons (excluding commercial shippers) that have had control 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 Results (Sr) by sample ID and are separated by the analyses performed on each sample. The header line of each analysis section for each sample wily provide the name and method number for the analysis reported. Sample Summary (Ss) This section of the Analytical Report defines the specific analyses performed for each sample ID. including the dates and times of preparation aridlor analysis. Qualifier Description E The analyze concentration exceeds the upper limit of the calibration range of the instrument established by the initial calibration (ICAL). J3 The associated batch QC was outside the established quality control range for precision. J6 The sample matrix interfered with the ability to make any accurate determination: spike value is low. J- The associated batch QC was outside the lower control limits, associated data has a potential negative bias. ACCOUNT: PROJECT: SDG: DATEITIME: PAGE: i Piedmont Geologic 1914 L1121645 07/30/19 15:47 It of 14 ACCREDITATIONS & LOCATIONS ONE LAD NATIONWIDE Pace National is the only environmental laboratory accreditedlcertified to support your work nationwide from 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 location laboratory is comparable to the collective tolais 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 CA tum.around time. and preventing cross contamination, thus protecting sample integrity. Our focus on 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 FC State Accreditations Alabama 40660 _ _ _Nebraska_ _ _ NE-OS-15-05 3 55 Alaska - - - 17-026 - _ Nevada - -- TN-03-2_00_2.34 - Arizona - _- _- ---- __- AZ0612 -- - - - - - - New Hampshire - 2975 �__ Arkansas 88-0469 NewJers_ey-NELAP TN002 FCn California w - - -- - 2932 _ - - - - -- -- _ _ _ New Mexico' _-- -- _-. -- _--nla- Colorado_ _ Connecticut _ _ _ TN00003 _ _ _ PH-0197 New _Y_oiIr _ North Carolina _ 11742 Env375 SF Florida E87487 North Carolina DW21704 — _ -- Georgia _ _ _ _ Georgia' - �- - - - - NELAP _ _ 923 North Carolina' 41 _ R-140 FO North Dakota Idaho TN00003 � A_ Ohio-VAP CL0069 Illinois _ Indiana _ C-TN-01_ C-TN-01 _ -_ Oklahoma _ TN2 TN200002 Oregon Iowa 364 Pennsylvania 68-02979 - Kansas Kentucky's E•10277 Rhode Island tA000356 South Carolina _ Kentucky' 16 15 Y — -- South Dakota nM nla Louisiana A130792 Tennessee' ` r� 2005 Louisiana' LA180010 Maine TN0002 Maryland 324 Massachusetts M-TNO03 Michigan 9958 Minnesota 047-999395 Mississippi TN00003 Missouri 340 Montana CER10086 Third Party Federal Accreditations Texas T104704245-18-15 SC Texas` _ LABO152 Utah TN00003 Vermont VT2006 Virginia 460132 Washington C847 West Virginia 233 _ Wisconsin 9980939970 Wyoming A2LA A2tA - ISO 17025 1461.01 AIHA-LAP.LLC EMLAP 100789 A2LA - ISO 17025 s 1461.02 DOD 1461.01 Canada 1461.01 USDA P330-15.00234 EPA-Crypto TN00003 ' Drinking Water ' Underground Storage Tanks 'Aquatic Toxicity ' ChemicalfMicrobiologicai s Mold 'Wastewater nfa Accreditation not applicable Our Locations Pace National has sixty-four client support centers that provide sample pickup andlor 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 OR T ID T NV CA T MT ND M N SD T rot WY IA T NE OF T • • CO KS MO l NM AK .O 4 ,�O rn Fri ( S ACCOUNT: V' Piedmont Geologic T TX T T PROJECT 1914 Mr T IL lit OH 1 Iy AMS Al �T GA LA SDG: L1121645 ME NY T PA T VVV VAT TdT 1 SC FL T DATEITIME: 07/30/1915:47 PAGE: 12 of 14 Company Name/Address: Piedmont Geologic 6003-145 Chapel Hill Road (Raleigh, NC 27607 Billing Information: 5c` o— Analysis / Container Preservative Chain of Custody Page _ of _ E C,A-B S,C.r•E•N.C.V.S 1206s Lebanon xd �: ii Mount lurr, 3i177 % Pho— GIs S•7583ESY Pwne:xo0761-sass ra.ats.'rsa-sass 2 CL CL � o V) ' 0 M 0 N a a- E. CAI 0 O U 0 0 ty Cq W. � ro tV th = 1 Z - LLI 0. _.-�., . « N 0 I N Report to: Pete Dressel Email Tq; pjdressel@piedmontgeologic.com: Project Ennis Flint - High Point Description:g City/State A Colled: cte�� •y �p r'� ,y J La 1 �� Table � Phone: (9i 97 1i54-9700 Far: Client Project ri i 4 1914 tab Project q - CollectelIdby (print}: h Site/Facility ID a P.D. p Acctnum: PIEGEO Template: - Prclogin: TSR: Wagner Cooler; Collected by (signature): .. n lrrtmediaiely-7woDay Packed on Ice , N - -• Y V - Rush? (Lab MUST Be Notified) Same Day ......... ............_.... 200% _Next Dar............_ .........toa% • ....:.........:..:.-...,.,..SO% ThFee Day._.._._-...-......_..75% Date Results Needed0. _ Email? No Yes - FAX? `No —yes - w No. of - Shipped via. Sample ID Comp/Grab Matrix' Depth Date Time ntrs Re.jComammant S. pk Pilab onto Matrix: SS - Sol]1GW - Groundwater' WW' wastewater DW - Drinking Water OT - Other pH '� � O Tem Rearks: H .._ S t 0 tr7U , 01 i( J'' Flow Other Hold it m� p Relinquished by: (Signature) Relinquished by: (' na; �^ Date:. - Date: f > !� Time; Received Time: Receiv �rf �= by: (Sig tu: e) - . u:- - Samples returned via: ❑ UPS' tSi Fed Ex ❑ Courier ❑ _ Temp: )Y�� Bottles Received: .[ 1`l.� Conaitionr, (lab use only) ��/� _ " "' SCREEN 4;A9 ftiAN CDC Seal Intact: _Y _N ✓ NA _ Relin ed Uy gn3lure) S ` pate: Time: Received bby:(Signature) -. Jlfoorycr%lab Date: 7 Timec:/a,, pH Checked: - NCF: n w . • Client: SDG#:. /i u�y� Cooler Received/Opened On: 7 1 L /1 9 Temperature: 2. Received' B : Rile Dem se S i nature: Receipt Check List -Yes COC Seal Present / Intact? -• COC Signed / Accurate? Bottles arrive intact? Correctbottles used? Sufficient volume sent? If Applicable VOA Zero headspace?� Preservation Correct / Checked? - :r