WQ0005135_Response to NOV-2020-DV-0338_20200831 (2)

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According to U.S. Code of Federal Regulations 29 CFR 1910.1200, Hazard Communication.
SECTION 1 • Identification of the substance/mixture and of the company/undedaft
1.1. Product identifier
Product name: AXFLOC AF 9740
Type of product. Mixture.
7.2. Relevant identified uses of the substance or mixture and uses advised against
Identified uses: Processing aid for industrial applications.
Uses advised against: None.
1.3. Details of the supplier of the safety data sheet
Axchem USA Inc.
Company:
6C Oak Branch Drive
Greensboro, NC 27407
United States
Telephone:
336-632-0500
Telefax:
336-632-1177
E-mail address:
[e-mail]
1.4. Emergency telephone number -
24-houremergency number: Chemtrec: 1-800-424-9300 (CCN 2174), Outside U.S. 703-527-3887
SECTION 2: Hazards identification
2.1. Classification of the substance or mixture
Classificafion according to paragraph {d) of29 CFR 1910.1200:
-Not classified.
2.2. Label elements
Labelling according to paragraph (0 of29 CFR 1910.1200:
Print Date: 01/1212017 Revision date: 03/02t2017
Page: 1 / 12

SAFETY DATA SHEET
Hazard symbol(s): None.
Signal word.- None.
Hazard statement(s): None,
Precautionary statement(s): None.
2.3. Other hazards
Aqueous solutions or powders that become wet render surfaces extremely slippery.
For explanation of abbreviations see Section 16.
SECTION 3• Co mP9sitionftnformation on ingredients
3.1. Substances
Not applicable, this product is a mixture.
3.2. Mixtures
Hazardous components
Sulfamic acid
Concentrationl-range:
CAS Number:
Classification according to paragraph (d)
of29 CFR 1910.1200:
For explanation of abbreviations see section 16
SECTION 4• First aid measures
4.1. Description of first aid measures
Inhalation:
Move to fresh air. Get medical attention if symptoms occur.
2.5 - 10%
5329-14-6
Sldn Irrit. 2;H315, Eye Irrit. 2A;H319
Skin contact:
Wash off with soap and plenty of water. Get medical attention if irritation develops and persists.
Eye contact.
Rinse immediately with plenty of water, also under the eyelids. Get medical attention.
AXFLOC AF 9740
Ingestion:
Rinse mouth. If conscious, give the victim plenty of water to drink. Induce vomiting, but only if victim is fully conscious.
Print Date: 01/1212017 Revision date: 03/0212017 Page: 2112

SAFETY DATA SHEET
4.2. Most important symptoms and effects, both acute and delayed
AXFLOC AF 9740
Powder can cause localised skin irritation in folds of the skin or under tight clothing. Contact with dust can cause
mechanical irritation or drying of the skin.
4.3. Indication of any immediate medical attention and special treatment needed.
None.
Other information:
None.
SECTION 5: Fire -fighting measures
5.1. Extinguishing media
Suitable extinguishing media:
Water. Water spray. Foam Carbon dioxide (CO2). Dry powder.
Warning! Aqueous solutions or powders that become wet render surfaces extremely slippery
Unsuitable extinguishing media:
None.
5.2. Special hazards arising from the substance or mixture
Hazardous decomposition products:
Thermal decomposition may produce: hydrogen chloride gas, nitrogen oxides (NOx), carbon oxides (COx). Hydrogen
cyanide (hydrocyanic acid) may be produced in the event of combustion in an oxygen deficient atmosphere.
5.3. Advice for fire-fighters
Protective measures:
No special protective equipment required. Wear self contained breathing apparatus for fire fighting if necessary.
Other information:
Aqueous solutions or powders that become wet render surfaces extremely slippery.
CTION 6: Accidental release measures
6.1. Personal precautions, protective equipment and emergency procedures
Personal precautions:
Aqueous solutions or powders that become wet render surfaces extremely slippery.
Protective equipment:
Wear adequate personal protective equipment (see Section 8 Exposure Controls/Personal Protection).
Emergency procedures:
Keep people away from spill/leak. Prevent further leakage or spillage if safe to do so.
6.2. Environmental precautions
As with all chemical products, do not flush into surface water.
Print !late: 0111212017 Revision date: 03/0212017 Page: 3 / 12

SAFETY DATA SHEET
AXFLOC AF 9740
6.3. Methods and material for containment and cleaning up
Small spills:
Do not flush with water.Clean up promptly by sweeping or vacuum.
Large spills:
Do not flush with water.Prevent unauthorized access. Sweep up and shovel into suitable containers for disposal..
Residues:
Sweep up to prevent slip hazard. After cleaning, flush away traces with water.
6.4. Reference to other sections
SECTION 7: Handling and storage; SECTION 8: Exposure controls/personal protection; SECTION 13: Disposal
considerations;
SECTION 7: Handling and storage
7.1. Precautions for safe handling
Avoid contact with skin and eyes. Avoid dust formation. Avoid breathing dust. Wash bands before breaks and at the end of
workday.
7.2. Conditions for safe storage, including any incompatibilities
Deep in a dry place. Incompatible with oxidizing agents.
7.3. Specific end uses)
Processing aid for industrial applications.
SECTION 8: Exposure controls/personal protection
B.1. Control parameters
Occupational exposure limits:
None known.
8.2. Exposure controls
Appropriate eneineering controls
Use local exhaust if dusting occurs. Natural ventilation is adequate in absence of dusts.
Individual Protection measures such as personal protective equomenh
= , a)-Tye/face protection:
,ifrafety glasses with side -shields.
-b) Skin protection:
Workelothes protecting arms, legs and body.
Print Date: 01/12/2017 Revision date: 0310212017 Page: 4l 12

SAFETY DATA SHEET
AXFLOC AF 9740
i) Hand protection:
PVC or other plastic material gloves.
c) Respiratory protection:
No personal respiratory protective equipment normally required. Dust safety masks recommended where working powder
concentration is more than 10 mg/m3.
d) Additional advice:
Handle in accordance with good industrial hygiene and safety practice.
Environmental exposure controls
Do not allow uncontrolled discharge of product into the environment. Do not flush into surface water.
SECTION 9• Physical and chemical properties
9.1. Information on basic physical and chemical properties
a) Appearance:
b) Odour
c) Odour Threshold:
d) pH.
e) Melting point/freezing point
0Initial boiling point and boiling range:
g) Flash point:
h) Evaporation rate:
i) Flammability (solid, gas):
1) Upper1lower flammability or explosive limits:
k) Vapourpressurs:
I) Vapourdensiv
m) Relative density.
n) Solubility(tes):
o) Partition coefficient
p) Autoignition temperature:
q) Decomposition temperature:
r) Viscosity
s):-Explosive properties:
Granular solid, White.
None.
Not applicable.
2.5-4.5@5g/L
> 100°C
Not applicable.
Not applicable.
Not applicable.
Not combustible.
Not expected to create explosive atmospheres,
Not applicable.
Not applicable,
0.6 - 0.9
Soluble in water,
<0
Not applicable.
> 2000C
See Technical Bulletin.
Not expected to be explosive based on the chemical structure.
Print Date: 0111212017 Revision date:03/02/2017 Page: 5112

SAFETY DATA SHEET
t) Oxidizing properties:
9.2.Other information
None.
SECTION 10: Stability and reactivity
10.7. Reactivity
Hazardous polymerisation does not occur.
1D.2. Chemical stability
Stable.
10.3. Possibility of hazardous reactions
Oxidizing agents may cause exothermic reactions.
140.4. Conditions to avoid
None known.
10.5. Incompatible materials
Oxidizing agents.
10.6. Hazardous decomposition products
AXFLOC AF 9740
Not expected to be oxidising based on the chemical structure.
Thermal decomposition may produce: hydrogen chloride gas, nitrogen .oxides (NOx), carbon oxides (COx). Hydrogen
cyanide (hydrocyanic acid) may be produced in the event of combustion in an oxygen deficient atmosphere.
SECTION 11: Toxicological information
11.1. Information on toxicological effects
Information on the product as suoolied:
Acute oral toxicity.
LD50/oral/rat > 5000 mg/kg
Acute dermal toxicity:
LD50/dermal/rat> 5000 mg/kg
Acute inhalation toxicity:
The product is not expected to be toxic by inhalation.
Skin corrostonfirritation:
Not irritating.
Serious eye damage%ye irritation:
Testing conducted according to the Draize technique showed the material produces no
corneal or iridial effects and only slight transitory conjuctival effects similar to those
which all granular materials have on conjuctivae.
Respiratory/skin sensitisation:
The results of testing on guinea pigs showed this material to be non -sensitizing.
Mutagenicity:
Not mutagcnic.
Print Date: 01112R017 Revision date: 03/02t2017 Page: 6112

SAFETY DATA SHEET
AXFLOC AF 9740
Carcinogenicity: Not carcinogenic.
Reproductive toxicity: Not toxic for reproduction.
STOT -single exposure: No known effects.
STOT-repeated exposure: No known effect.
Aspiration hazard: No hazards resulting from the material as supplied
Relevant information on the hazardous components:
Sulfamic acid
Acute oral toxicity:
Acute dermal toxicity.:
Acute inhalation toxicity:
Skin corrosionfirritation:
Serious eye damageleye irritation:
Respiratory/skin sensitisation:
Mutagenicity:
Carcinogenicity:
Reproductive toxicity:
STOT - single exposure:
STOT-repeated exposure:
Aspiration hazard:
SECTION 12• Ecological information
12.1. Toxicity
LD50/oral/rat > 2000 mg(kg
NOAEL/dermal/rat = 2000 mg/kg (OECD 402)
The product is not expected to be toxic by inhalation.
Not irritating. (OECD 404) (SNF)
Moderately irritating to the eyes, (EPA OPPTS 870,2400)
The product is not expected to be sensitizing.
Negative in the Ames Test (OECD 471) Negative in the In vitro Mammalian Cell
Gene Mutation Test (OECD 476). Not mutagenic. (OECD 472, 487)
based on the absence of mutagenicity, it is unlikely that the substance is carcinogenic.
Information on the product as supplied:
No data available.
No known effects.
No known effect.
No known effects.
Print Date: 01112/2017 Revision date: 0310212017 Page: 7112

SAFETY DATA SHEET
Acute toxicity to fish:
Acute toxicity to invertebrates:
Acute toxicity to algae:
Chronic toxicity to fish:
Chronic toxicity to invertebrates:
Toxicity to microorganisms:
Effects on terrestrial organisms:
Sediment toxicity.
AXFLOC AF 9740
LC50/Danio rerio/96 hours = 5 - 10 mg/L (OECD 203)
EC50/Daphnia magna/48 hours = 20 - 50 mg/L. (OECD 202)
Algal inhibition tests are not appropriate. The flocculation characteristics of the
product interfere directly in the test medium preventing homogenous distribution which
invalidates the test.
No data available.
No data available.
No data available.
No data available. Readily biodegradable, exposure to soil is unlikely,
No data available. Readily biodegradable, exposure to sediment is unlikely.
Relevant information on the hazardous components•
Sul fiamic acid
Acute toxicity to fish: LC50/Pimephales promelas/96 hours = 70.3 mg/L (OECD 203)
Acute toxicity to invertebrates: EC50/Daphnia magna/48 hours = 71.6 mg/L. (OECD 202)
Acute toxicity to algae: ]C50/Scenedesmus subspicams/72 hours = 48 mg/L (OECD 201)
Chronic toxicity to fish: No data available.
Chronic toxicity to invertebrates: - No data available.
Toxicity to microorganisms: EC50/activated sludgO3 hours > 200 mg/L (OECD 209)
Effects on terrestrial organisms: No data available.
Sediment toxicity No data available.
12.2. Persistence and degradability
Information on the product as supplied
Degradation: Readily biodegradable.
Hydrolysis: At natural pHs (>6) the polymer degrades due to hydrolysis to more than 70% in 28
days. The hydrolysis products are not harmfid to aquatic organisms.
Photolysis: No data available.
Print We: 01/1212017 Revision date: 0310212017 Page: 8112

SAFETY DATA SHEET
Relevant information on the hazardous components:
Sulfamic acid
Degradation: Not relevant (inorganic).
Hydrolysis: Does not hydrolyse,
Photolysis: No data available,
12.3. Bioaccumulative potential
Information on the product as supplied:
The product is not expected to bioaccumulate.
Partition co -efficient (Log Pow): < 0
Bioconcentration factor (BCF): No data available.
Relevant information on the hazardous components:
Sul famic acid
Partition co -efficient (Log Pow): -4,34 @ 20°C
Bioconcentration factor (BCF): No data available.
12.4. Mobility in soil
Information on the product as supplied.'
No data available.
Relevant information on the hazardous components:
Sulfamic acid
Koo.
No data available.
12.5. Other adverse effects
None known.
SECTION 13: Disposal considerations
13.1. Waste treatment methods
i3:40141193;&U.":
Print Date: 01/1212017 Revision date:03/0212017 Page: 9112

SAFETY DATA SHEET
AXFLOC AF 9740
Waste from residues/unused products:
Dispose in accordance with local and national regulations. Can be landfilled or incinerated, when in compliance with local
regulations.
Contaminated oackapinp:
Rinse empty containers with water and use the rinse -water to prepare the working solution. If recycling is not practicable,
dispose of in compliance with local regulations. Can be landfilled or incinerated, when in compliance with local regulations.
Rec clin
In accordance with local and national regulations.
SECTION 147 Transport information
Land transport (DOT)
Not classified
Sea transport (IMDG)
Not classified
Air transport (IATA)
Not classified
SECTION 157 Reaulato y information
15.1. Safety, health and environmental regulationsflegislation specific for the substance or mixture
Information on the product as supplied:
TSCA Chemical Substances Invantorv:
All components of this product are either listed on the inventory or are exempt from listing.
US SARA forting Requirements:
SARA (Section 3111312) hazard class:
Not concerned.
SARA Title 111 Sections:
Section 302 (TPQ) - Reportable Quantity:
Not concerned
Section 304 - Reportable Quantity.
Not concerned.
Print Date: 01/1212017
Revision date: 0310212017 Page: 10112

SAFETY DATA SHEET
Section 313 (De minimis concentration):
Not concerned.
Clean Water Act
Section 311 Hazardous Substances (40 CFR 117.3) - Reportable Quantity:
Not concerned.
Clean Air Act
Section 112(r) Accidental release prevention requirements (40 CFR 68) - Reportable Quantity:
Not concerned-
CERCLA
Hazardous Substances List (40 CFR 302.4) - Reportable Quantity:
Not concerned.
RGRA status:
Not RCRA hazardous.
AXFLOC AF 9740
California Proposition 651nformation:
WARNING? This product contains a chemical known to the State of California to cause cancer and birth defects or other
reproductive harm, Acrylamide
NFPA and HMIS Ratinas:
NFPA:
Health:
Flammability:
Instability:
1
HMIS.
Health: 0
Flammability: 8
Print Date: 01102017
Revision date: 03107J2017
Page: 11112

SAFETY DATA SHEET
Physical Hazard. u
PPE Code: B
This data sheet contains changes from the previous version in section(s):
AXFLOC AF 9740
SECTION 5. Fire -fighting measures, SECTION 15. Regulatory information, SECTION 16. Other Information.
Kev or leaend to abbreviations and acronvms used in the safety data sheet
Abbreviations
Eye Irrit. 2A = Serious eye damageleye irritation Category Code 2A
Skin Irrit. 2 = Skin corrosion/irritation Category Code 2
H-Phrases
H315 - Causes skin irritation
H319 - Causes serious eye irritation
This SDS was prepared in accordance with the following:
U.S. Code of Federal Regulations 29 CFR 1910.1200
Version: 17.01.a
PRCCO09
The information provided in this Safety Data Sheet is correct to the best of our knowledge, information and belief at the
date of its publication. The information given is designed only as a guidance for safe handling, use, processing, storage,
transportation, disposal and release and is not to be considered a warranty or quality specification. The information relates
only to the specific material designated and may not be valid for such material used in combination with any other materials
or in any process, unless specified in the text.
Print Date: 01/1212017 Revision date: 03102/2017 Page: 12112

RPOMICROBAC
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
KOF0140
Project Description
Effluent sample - Mthly
For:
Mr. Chris Fowler
Von Drehle Corporation
126 First Street
Cordova, NC 28330
Administration
Brittany Smith
Tuesday, June 16, 2020
Please find enclosed the analytical results for the samples you submitted to Microbac Laboratories. Review and compilation of
your report was completed by Microbac Laboratories, Inc. - Fayetteville. If you have any questions, comments, or require further
assistance regarding this report, please contact your service representative listed above.
I certify that all test results meet all of the requirements of the accrediting authority listed within this report. Analytical results are
reported on a'as received' basis unless specified otherwise. Analytical results for solids with units ending in (dry) are reported
on a dry weight basis. A statement of uncertainty for each analysis is available upon request. This laboratory report shall not be
reproduced, except in full, without the written approval of Microbac Laboratories. The reported results are related only to the
samples analyzed as received.
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 283061910.864.1920 p i www.microbac.com
Page 1 of 7

VMICROBAC°
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
KOF0140
Von Drehle Corporation Project Name: Effluent sample - Mthly
Mr. Chris Fowler Project / PO Number: N/A
126 First Street Received: 06/09/2020
Cordova, NC 28330 Reported: 06/16/2020
Sample Summary Report
Sample Name Laboratory ID Client Matrix
Effluent, composite KOF0140-01 Aqueous
Effluent, grab KOF0140-02 Aqueous
Sample Type Sample Begin Sample Taken Lab Received
Composite 06/08/20 12:37 06/09/20 12:37 06/09/20 15:01
Grab 06/09/20 12:40 06/09/20 15:01
Page 2 of 7

*MICROBAC@
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
KOF0140
Analytical Testing Parameters
Client Sample ID: Effluent, composite
Sample Matrix: Aqueous Collected By: Wright
Lab Sample ID: KOF0140-01 Collection Date: 06/09/2020 12:37
*** DEFAULT GENERAL METHOD *"" Result RL Units Dilution Note Prepared Analyzed Analyst
SM 2540 D-2011
Total Suspended Solids 73.0 25.0 mg/L 10 06/10/20 1543 TBM
SM 5210 B-2011
BOD 2670 2.00 mg/L 1 G5 06/10/20 1137 06/15/20 1529 MT
Inorganics Total Result RL Units Dilution Note Prepared Analyzed Analyst
SM 5220 D-2011
COD, Total 7120 10.0 mg/L 1 06/12/20 1125 MT
Client Sample ID: Effluent, grab
Sample Matrix: Aqueous Collected By: Wright
Lab Sample ID: KOF0140-02 Collection Date: 06/09/2020 12:40
Field Parameters Result RL Units Dilution Note Prepared Analyzed Analyst
SM 2550 B-2010
Temperature, Field 36 0.1 °C 1 06/09/20 1240 MJW
SM 4500-H+ B-2011
pH, Field Test 7.4 1.0 S.U. 1 06/09/20 1240 MJW
Inorganics Total Result RL Units Dilution Note Prepared Analyzed Analyst
SM 4500-H+ B-2011
pH at 25'C 7.2 1.0 S.U. 1 H 06/11/20 1410 TBM
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1910.864.1920 p I www.microbac.com page 3 of 7

+7 '
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
KOF0140
Batch Quality Control Summary:
Microbac Laboratories, Inc. - Fayetteville
Spike Source %REC
RPD
*** DEFAULT GENERAL
Result
RL
Units Level Result %REC Limits
RPD Limit Notes
METHOD ***
Batch KFOD907 - Wet Chem Aqueous - SM 2540 D-2011
Blank (KF00907-BLK1)
Prepared &Analyzed: 06/10/2020
Total Suspended Solids
<2.50
2.50
mg/L
Blank (KF00907-BLK2)
Prepared & Analyzed: 06110/2020
Total Suspended Solids
<2.50
2.50
mg/L
Blank (KF00907-BLK3)
Prepared &Analyzed: 06/10/2020
Total Suspended Solids
<2.50
2.50
mg/L
Blank (KF06907-BLK4)
Prepared &Analyzed: 06/10/2020
Total Suspended Solids
<2.50
2.50
mg/L
LCS (KF00907-BSI)
Prepared & Analyzed : 06/10/2020
Total Suspended Solids
27.5
2.50
mg/L 28.1 98 94.5-105.4
Duplicate (KF00907-DUP1)
Source: KOF0027.01
Prepared & Analyzed: 06/10/2020
Total Suspended Solids
13800
833
mg/L 14000
1 10
Duplicate (KF00907-DUP2)
Source: KOF0085-01
Prepared &Analyzed: 06/10/2020
Total Suspended Solids
112
33.3
mg/L 92.0
20 10
Duplicate (KF00907-DUP3)
Source: KOF0086.01
Prepared &Analyzed: 06/10/2020
Total Suspended Solids
118
25.0
mg/L 121
3 10
Duplicate (KF00907-DUP4)
Source: KOF0137-01
Prepared &Analyzed: 06110/2020
Total Suspended Solids
48.0
25.0
mg/L 27.0
56 10
Batch KFO1219 - Wet Chem Aqueous - SM 5210 B-2011
Blank (KFO1219-BLK1)
Prepared:
06/10/2020 Analyzed:
06/15/2020
BOD
LCS (KF01219-BSI)
<2.00 2.00 mg/L
Prepared:
06/10/2020 Analyzed:
06/15/2020
BOD
Duplicate(KFO1219-DUPI)
164 mg/L
Source: KOF0141-01 Prepared:
198
06/10/2020 Analyzed:
83 .59596-115.4
06/15/2020
BOD
443 2.00 mg/L
480
8 10
Spike Source %REC RPD
Inorganics Total Result RL Units Level Result %REC Limits RPD Limit Notes
Batch KFO1105 -Wet Chem Aqueous -SM 4500-H+ B-2011
Duplicate (KFO1105-DUP1) Source: KOF0131-02 Prepared &Analyzed: 06/11/2020
pH at 25 °C 6.2 1.0 S.U. 6.2 0 10 H
Batch KF01216 -Wet Chem Aqueous - SM 5220 D-2011
Blank (KFO1216-BLK1) Prepared & Analyzed: 06/12/2020
COD, Total <10.0 10.0 mg/L
Blank (KFO1216-BLK2) Prepared & Analyzed: 06/12/2020
COD, Total <10.0 10.0 mg/L
Microbac Laboratories, Inc.
2592 Hope Mills Rd I Fayetteville, NC 28306 1910.864.1920 p I www.microbac.com Page 4 of 7

OMICROBACO
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
KOF0140
Spike Source %REC RPD
Inorganics Total Result RL Units Level Result %REC Limits RPD Limit Notes
Batch KFO1216 - Wet Chem Aqueous - SM 5220 D-2011
Blank (KFO1216-BLK3)
Prepared & Analyzed: 06/12/2020
COD, Total
<10.0
10.0
mg/L
LCS (KFO1216-BS1)
Prepared & Analyzed: 06/12/2020
COD, Total
505
10.0
mg/L 500 101 90-110
Duplicate (KFO1216-DUP1)
Source: KOF0214-01
Prepared &Analyzed: 06/12/2020
COD, Total
39.0
10.0
mg/L 39.0 0 20
Duplicate (KFO1216-DUP2)
Source: KOF0216.01
Prepared & Analyzed: 06/12/2020
COD, Total
37.0
10.0
mg/L 41.0 10 20
Matrix Spike (KF01216-MSt)
Source: KOF0214-01
Prepared & Analyzed: 06/12/2020
COD, Total
68.1
10.0
mg/L 25.0 39.0 116 80-120
Matrix Spike(KF01216-MS2)
Source: KOF0216.01
Prepared&Analyzed: 06/12/2020
COD, Total
76.1
10.0
mg/L 25.0 41.0 116 80-120
Definitions
°C: Degrees Celsius
G5: The glucose/glutamic acid standard exceeded the range of 198 t 30.5 mg/L.
H: Analyte was prepared and/or analyzed outside of the analytical method holding time
MDL: Minimum Detection Limit
mg/L: Milligrams per Liter
RL: Reporting Limit
RPD: Relative Percent Difference
S.U.: Standard Units
Cooler Receipt Log
Cooler ID: Default Cooler
Temp: 12.3°C
Cooler Inspection Checklist
Ice Present or not required?
Yes
Shipping containers sealed or not required?
Yes
Custody seals intact or not required?
Yes
Chain of Custody (COC) Present?
Yes
CDC includes customer information?
Yes
Relinquished and received signature on COC?
Yes
Sample collector identified on COC?
Yes
Sample type identified on COC?
Yes
Correct type of Containers Received
Yes
Correct number of containers listed on COC?
Yes
Containers Intact?
Yes
COC includes requested analyses?
Yes
Enough sample volume for indicated tests received?
Yes
Sample labels match COC (Name, Date & Time?)
Yes
Samples arrived within hold time?
Yes
Correct preservatives on COC or not required?
Yes
Chemical preservations checked or not required?
Yes
Preservation checks meet method requirements?
Yes
VOA vials have zero headspace, or not recd.?
Yes
Project Requested Certification(s)
Microbac Laboratories, Inc. - Fayetteville
11
North Carolina DENR NPDES
Microbac Laboratories, Inc.
2592 Hope Mills Rd i Fayetteville, NC 28306 1910.864.1920 p I www.microbac.com Page 5 of 7

0MICROBAC°
Microbac Laboratories, Inc. - Fayetteville
CERTIFICATE OF ANALYSIS
KOF0140
Report Comments
Samples were received in proper condition and the reported results conform to
applicable accreditation standard unless otherwise noted.
The data and information on this, and other accompanying documents, represents only the
sampleis) analyzed. This report is incomplete unless all pages indicated in the footnote are
present and an authorized signature is included. The services were provided under and
subject to Microbac's standard terms and conditions which can be located and
reviewed at<httos.11w .mlcrobac.com/standard-terms-contlitions>.
Reviewed and Approved By:
Brittany Smith
Administration
Reported: 06/16/2020 20:08
Microbac Laboratories, Inc.
2592 Hope Mills Rd i Fayetteville, NC 28306 1910.864.1920 p I www.microbac.com Page 6 of 7

# Fayetteville Division 2592 Hope Mills Road — Fayetteville, NC 28306 [phone] / 8( *KOF0140*
*
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Cordova - Mthly
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TYPE OF
ANALYSIS
PRESERVATION CODE
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fj)DATE
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a
(D
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a
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3
CODE: A = <4°C ONLY
B m HNO3 (ph<2) + <4°C
C = H2SO4 (ph<2) + -WC
D = NaOH + <4°C
E = ZN Acetate + cq°C
F=Sodium Thio.
T PERSON:
hds Fowler
10-9131
IETHOO OF SHIPMENT:
Microbac
TIME
COMP
GRAB
PH
D.O.
TEMP °C
RES.
CHLOR N
6/s,n
IL 3 7
x
z
A
tZj
1Z:J'J
x
1
C
GZ
0
x
1
A
Time
Wetl SI nature .`
Y 2
ate
Tim
ILL
Time
Received by:(Signature)
Date
Time
4
Time
Received by. (Signature)
Date
Tlme
6
Time
Received by: (Signature)
Date
T(me
8
Comments or Special Hazards: Ice,
Field pH: -' 4(2
Field Temp: 351,
Page 7 of 7

/$v0
NUCO'Nater
An Ec.tab Company
SAFETY DATA SHEET
NALCLEARTM'8173PULV
'"�l^^ 6 6 `/ c; P o
Section: 1. PRODUCT AND COMPANY IDENTIFICATION
Product name NALCLEARTM 8173 PULV /6
/#5
Other means of identification
Recommended use
Restrictions on use
Not applicable.
FLOCCULANT
Refer to available product literature or ask your local Sales Representative for
restrictions on use and dose limits.
Company Nalco Company
1601 W. Diehl Road
Naperville, Illinois 60563-1198
USA
TEL: [phone]
Emergency telephone [phone] (24 Hours) CHEMTREC
number
Issuing date : 05/11/2018
Section: 2. HAZARDS IDENTIFICATION s
GHS Classification
Not a hazardous substance or mixture.
GHS Label element
Hazard Statements
If swallowed a jelly mass may form which in digestion may cause blockage.
Precautionary Statements
Prevention:
;
Wash hands thoroughly after handling. Water in contact with the product will
cause slippery floor conditions.
Response:
Get medical advice/ attention if you feel unwell.
Storage:
Store in accordance with local regulations.
Other hazards
None known.
Section: 3, COMPOSITION/INFORMATION ON INGREDIENTS
No hazardous ingredients
Section: 4. FIRST AID MEASURES
In case of eye contact
Rinse with plenty of water. Get medical attention if symptoms occur.
In case of skin contact
Wash off with soap and plenty of water. Get medical attention if symptoms
occur.
If swallowed Rinse mouth. Get medical attention if symptoms occur.
1.�9

SAFETY DATA SHEET
NALCLEARTM 8173 PULV
If inhaled . Get medical attention if symptoms occur
Protection of first-aiders In event of emergency assess the danger before taking action. Do not put
yourself at risk of injury. If in doubt, contact emergency responders. Use
personal protective equipment as required.
Notes to physician Treat symptomatically. If swallowed a jelly mass may form which in digestion
may cause blockage.
Most important symptoms See Section 11 for more detailed information on health effects and symptoms.
and effects, both acute and
delayed
Section: 5. FIREFIGHTING MEASURES
Suitable extinguishing media Use extinguishing measures that are appropriate to local circumstances and the
surrounding environment.
Unsuitable extinguishing None known.
media
Specific hazards during
Not flammable or combustible.
firefighting
Hazardous combustion
Decomposition products may include the following materials: Carbon oxides
products
nitrogen oxides (NOx) Sulphur oxides Oxides of phosphorus
Special protective equipment
Use personal protective equipment.
for firefighters
Specific extinguishing
Fire residues and contaminated fire extinguishing water must be disposed of in
methods
accordance with local regulations.
Section: 6, ACCIDENTAL RELEASE MEASURES
Personal precautions,
Refer to protective measures listed in sections 7 and B. Spills of this product are
protective equipment and
very slippery.
emergency procedures
Environmental precautions
No special environmental precautions required.
Methods and materials for
Sweep up and shovel into suitable containers for disposal.
containment and cleaning up
Section: 7. HANDLING AND STORAGE
Advice on safe handling
For personal protection see section 8. Wash hands after handling.
Conditions for safe storage
Keep out of reach of children. Keep container tightly closed. Store in suitable
labelled containers.
2rs

� SAFETY DATA SHEET
NALCLEARTM 8173 PULV
Suitable material The following compatibility data is suggested based on similar product data
and/or industry experience: Shipping and long term storage compatibility with
construction materials can vary; we therefore recommend that compatibility is
tested prior to use.
Unsuitable material not determined
Section: 8. EXPOSURE CONTROLS/PERSONAL PROTECTION
Components with workplace control parameters
Contains no substances with occupational exposure limit values.
Engineering measures Good general ventilation should be sufficient to control worker exposure to
airborne contaminants.
Personal protective equipment
Eye protection Safety glasses
Hand protection Wear protective gloves.
Gloves should be discarded and replaced if there is any indication of
degradation or chemical breakthrough.
Skin protection Wear suitable protective clothing.
Respiratory protection No personal respiratory protective equipment normally required.
Hygiene measures : Wash hands before breaks and immediately after handling the product.
Section: 9. PHYSICAL AND CHEMICAL PROPERTIES
Appearance
Granular
Colour
white
Odour
Slight
Flash point
does not flash
pH
7.0 - 9.0,(0.5 %)
Odour Threshold
no data available
Melting point/freezing point
no data available
Initial boiling point and boiling
no data available
range
Evaporation rate
no data available
Flammability (solid, gas)
no data available
Upper explosion limit
no data available
Lower explosion limit
no data available
Vapour pressure
no data available.
Relative vapour density
no data available
Relative density
no data available

SAFETY DATA SHEET
NALCLEARM 8173 PULV
Experience with human exposure
Eye contact No symptoms known or expected.
Skin contact
No symptoms known or expected.
Ingestion
No symptoms known or expected.
Inhalation
No symptoms known or expected.
Toxicity
Product
Acute oral toxicity
Acute toxicity estimate: > 5,000 mg/kg
Acute inhalation toxicity
no data available
Acute dermal toxicity
Acute toxicity estimate: > 5,000 mg/kg
Skin corrosion/irritation
no data available
Serious eye damage/eye
no data available
irritation
Respiratory or skin
no data available
sensitization
Carcinogenicity
no data available
Reproductive effects
no data available
Germ cell mutagenicity
no data available
Teratogenicity
no data available
STOT - single exposure
no data available
STOT - repeated exposure
no data available
Aspiration toxicity
no data available
Section: 12. ECOLOGICAL INFORMATION
Ecotoxicity
Environmental Effects : This product has no known ecotoxicological effects
Product
Toxicity to fish LC50 Oncorhynchus mykiss (rainbow trout): > 100 mg/I
Exposure time: 96 hrs
Test substance: Product
LC50 Lepomis macrochirus (Bluegill sunfish): > 100 mg/I
Exposure time: 96 hrs
Test substance: Product
LC50 Pimephales promelas (fathead minnow): > 1.000 mg/I
Exposure time: 96 hrs
Test substance: Product

SAFETY DATA SHEET
NALCLEARTm 8173 PULV
taken to an approved waste handling site for recycling or
disposal. Do not re -use empty containers.
Section: 14. TRANSPORT INFORMATION
The shipper/consignor/sender is responsible to ensure that the packaging, labeling, and markings are in compliance
with the selected mode of transport.
Land transport (DOT)
Proper shipping name PRODUCT IS NOT REGULATED DURING TRANSPORTATION
Air transport (IATA)
Proper shipping name PRODUCT IS NOT REGULATED DURING TRANSPORTATION
Sea transport (IMDGIIMO)
Proper shipping name PRODUCT IS NOT REGULATED DURING TRANSPORTATION
Section: IS. REGULATORY INFORMATION
TSCA list No substances are subject to a Significant New Use Rule.
No substances are subject to TSCA 12(b) export notification
requirements.
EPCRA - Emergency Planning and Community Right -to -Know Act
CERCLA Reportable Quantity
This material does not contain any components with a CERCLA RQ.
SARA 304 Extremely Hazardous Substances Reportable Quantity
This material does not contain any components with a section 304 EHS RQ.
SARA 3111312 Hazards No SARA Hazards
SARA 302 This material does not contain any components with a section 302
EHS TPQ.
SARA 313 This material does not contain any chemical components with known
CAS numbers that exceed the threshold (De Minirnis) reporting levels
established by SARA Title III, Section 313.
California Prop 65
This product does not contain any chemicals known to State of California to cause cancer, birth defects, or any other
reproductive harm.
INTERNATIONAL CHEMICAL CONTROL LAWS:
United States TSCA Inventory
The substances in this preparation are included on or exempted from the TSCA 8(b) Inventory (40 CFR 710)
Australia. Industrial Chemical (Notification and Assessment) Act
All substances in this product comply with the National Industrial Chemicals Notification & Assessment Scheme
(NICNAS).
.719

SAFETY DATA SHEET
NALCLEARTM 8173 PULV
Canadian Domestic Substances List (DSL)
The substance(s) in this preparation are included in or exempted from the Domestic Substance List (DSL)
Japan. ENCS - Existing and New Chemical Substances Inventory
All substances in this product comply with the Law Regulating the Manufacture and Importation Of Chemical
Substances and are listed orfthe Existing and New Chemical Substances list (ENCS).
Korea. Korean Existing Chemicals Inventory (KECI)
All substances in this product comply with the Chemical Control Act (CCA) and are listed on the Existing Chemicals
List (ECL)
Philippines Inventory of Chemicals and Chemical Substances (PICCS)
All substances in this product comply with the Republic Act 6969 (RA 6969) and are listed on the Philippines
Inventory of Chemicals & Chemical Substances (PICCS).
China Inventory of Existing Chemical Substances
All substances in this product comply with the Provisions on the Environmental Administration of New Chemical
Substances and are listed on or exempt from the Inventory of Existing Chemical Substances China (IECSC).
New Zealand. Inventory of Chemicals (NZIoC), as published by ERMA New Zealand
All substances in this product comply with the Hazardous Substances and New Organisms (HSNO) Act 1996,and
are listed on or are exempt from the New Zealand Inventory of Chemicals.
Taiwan Chemical Substance Inventory
All substances in this product comply with the Taiwan Existing Chemical Substances Inventory (ECSI).
Section: 16. OTHER INFORMATION )
NFPA: HMIS III:
Flammability
s
m
x
Special hazard.
3
m
Q
Revision Date 05/1112018
Version Number 12
Prepared By Regulatory Affairs
0 = not significant, 1 =Slight,
2 = Moderate, 3 = High
4 = Extreme,' = Chronic
REVISED INFORMATION: Significant changes to regulatory or health information for this revision is indicated by
a bar in the left-hand margin of the SDS.
The information provided in this Safety Data Sheet is correct to the best of our knowledge, information and belief
at the date of its publication. The information given is designed only as a guidance for safe handling, use,
8/9

North Carolina Division of Water Resources
Laboratory (Water Sciences Section) Water Sample Collection & Submittal Form
GDLaboratory
Visit ID:
Iaptional)
_
Tag
m
YD,
Lob Use Only:
_________________ ____________________
sample Number.•
Location Description:
1
�b�y { �"71� jf' '5/ �/p /
II YKG (,r 3 XXVV'�aV
Location Code:
oats Received.
M/Dr
Time Received:
(24 hrjormat)
County:
I C vr)3 0A/%�
Collector:
Priority.
____
_____
Ambient
Routine
Compliance
COC
Emergency
CIA
Water
___
Maoix:
_________
Surface
Ground
Waste
Blank
Solution
__
Location Type:
__________ ___
River/Stream
Estuary
Stormwater
Monitoring Well
Effluent
Field Blank
Filter Blank
_____________
lake
Canal
Water Supply
Influent
Trip Blank
lab DI Water
Other:
OWR Fe9ion:
(bored on manly)
A _ r-vicCC-
DWRo$ office!_
(nropencynameJ �" �%
Received By:
River Basin:
+}���a f'.�-'�
/'jV r
(rn/d/Y):
Time(24 hrJ:
(begin/er d)
['
l / /2
'� / /��'+
Delivery Method:
State Courier
Notes:
-
t,_
/3 j ✓
�!
J "� ,�`
Hand Delivered
Other:
Chlorinated
De -chlorinated in
Field
Sampling
Method:
Grab
Other
Composite
Filtered in Dissolved analysis: Enter"DIS" in check-
Field bores for parameters
Sample
Depth:
�..r
G /d1r1� / /� /
. •+ l C
Temperature on
Bi zj o:
Collector's tommeats:
Field Parameters (optional):
Preservative : Y
Water Temp('C):
--.---
PH(s.u.):
—.-....
Dissolved Oxygen
(PPm):
Conductivity
IPmhos/cm):
Salinity
IPPt):
i,
LAB COMMENTS:
Microbiology Parameters:
Preservative
Wet Chemistry Parameters:
Preservative
Metals Parameters:
Preservative
Metals Parameters Can't:
Preservative
Alkalinity, as CaCO3, to pH 4.5/8.3
A
-
Bromide
None
^Alumimum
(AI)
E
Thallium (TI)
E
SOD: Biochemical Oxygen Demand, 5-day
A
Chloride
None
Antimony (Sb)
E
Tin (Sn)
E
cBOD: Carbonaceous BOD, 5-day
A
Fluoride
None
Arsenic (As)
E
Titanium (Ti)
E
Coliform: Fecal MF
B-C-L-N
Sulfate
A
arium(Be)
E
V nadium(V)
E
Coliform: Total MF
B-C-L-N
Chlorophyll
erylllurn(Be)
E
Zinc(Zn)
E
Specific Conductance, at 25°C
A
Color: ADMI
A
cadmium(Cd)
E
yarcuri, 1531, low-level
TOC-Total Organic Carbon
A-E-F-G
Color: Platinum Cobalt
A
Falcium(Ca)
E
Boron(B)
E
Turbidity
A
COD: Chemical Oxygen Demand
A-D
Chromium (Cr), Total
E
Hardness, Total as CaCO3-by titration
D-E
Other Parameters:
Cyanide, Total
A-H-P
Cobalt (Co)
E
Organics Parameters:
PH
None
Formaldehyde
Copper(Cu)
E
Acid Herbicides
A-C
H exaval.nt Chromium(Cr6t)
A-O
ran(Fe)
E
Organochlorine Pesticides
A-C-K
Nutrients Parameters:
MBAS(surfactenis)
A
Lead (Ph)
E
Organonitrogen Pesticides
A-C-K
Ammonia as N(NH3-N)
A-D-Z
Oil and Grease, HEM, Total Recoverable
A-D-F'[hium
(U)
E
Organophosphorus Pesticides
A-C-K
y1trate-Nitrite as N(NO3+NO2-N)
A-D-Z
Phenols, Total Recoverable
A-D
agnesium(Mg)
E
PCBs (polychlorinated biphenyls)
A-K
tal Kjeldahl Nitrogen as N(TKN)
A-D-Z
Resi due: Total(Totalsonds)
A
Manganese (Mn)
E
Semi -Volatile Orgamics(BNAs)
A-C-K
Total Phosphorus as P(TP)
A-D-Z
Residue: Volatile/Fixed, Total
A
Mercury(Hut
E
TPH Diesel Range
A-K
Nitrite as N(NO2-N)
A
sidue: Settleable
A
Molybdenum(Mo)
E
Volatile Organics (VOA)
A-C-F-S
Nitrate as N (NO3-N calculated)
A
-
Residue: Suspended (Suspended Solids)
A
Nicial (Ni) -
E
1,4-Diozane
C
Orthophosphate as P(PO4)
A-Z
Residue; Volatile/Fixed, Suspended
A
Potassium(K)
E
TPH Gasoline Range
A-C-F-S
Cyanotoxins:
TDS - Total Dissolved Solids
A
Selenium (Se)
E
Biological:
Microcystin
Silica
A
Silver(Ag)
E
Phytoplankton/Algae
A-R
Sulfide
A-J _JASodiuni
E
Tannin&Ugmn
I
I Strontium (Sr)
E
�._._.._.:
noH) lal rnnl
<s-c IBI cool <10"C.
IC10.008%Na,5,0, [when chlorine is present], (D)
H,,SO, to pH <2, (E)
HNO,
to pH <2, (F) HCI to PH <2, (G) HSPO, to PH <2, (H) 6N
NaDH to PH>30<11, (I) PH=9.3-9.7, (L) zinc
acetate &
NaOH to PH to >9, (K) PH 6-9 ascorbic acid [when chlorine is present], (L) EDTA, (M) NaHSO• to pH <2, (N) 15% EDTA, (0) ammonium sulfate buffer pH= 9.3-9.7, (P) ascorbic acid (when chlorine is present], (R) Lugols, (S) NaH50a to pH <2, (Y) analyzed within 15
minutes of sample collection, (Z) filtered in field within 15 minutes
Required: 2) Collector Initials and Date, 2) Circling of Utilized Preservative next to each Parameter Revision: 8/1/2018