NCG120064_DMR_20200924

� a A
August 28, 2020
Chambers Development of NC, Inc. and
Waste Connections of the Carolinas, Inc.
Anson Waste Management Facility
375 Dozer Road
Polkton, NC 28135
Attention: Mr. Tyler Fitzgerald
Reference: Monthly Stormwater Monitoring
Anson Waste Management Facility
NCG120064
Polkton, North Carolina
S&ME Project No. 4140-15-007
Dear Mr. Fitzgerald:
l69 `3
DEVAYETTEVILLE REGIONAL OFFICE
S&ME, Inc. (S&ME) is pleased to submit this report detailing the results of the August 2020 stormwater
monitoring activities conducted at the Anson Waste Management Facility (AWMF) in Polkton, North Carolina. This
work was completed in accordance with our Master Services Agreement dated January 2, 2017, and in accordance
with Task 2 in S&ME Proposal No. 41-1600394 (Rev. 1) dated August 8, 2016. This letter summarizes results of
sampling efforts conducted by facility personnel.
® Background
Stormwater sampling is required on a semi-annual basis, as defined by the National Pollutant Discharge
Elimination System (NPDES) General Permit for Landfills (Permit No. NCG120000) for the facility outfalls. The
following outfalls are identified at the facility: Outfall 1, Outfall 2, Outfall 3, Outfall 4, Borrow Area North Outfall,
and Borrow Area West Outfall. Outfall 2 was eliminated in August 2018 by the expansion of Sediment Basin 3 and,
therefore, is no longer sampled. Monthly sampling was initiated following December 2019 results at Outfall 3 and
Outfall 4, in response to Tier 2 and Tier 3 response actions at the facility. Parameters for quantitative analysis
include chemical oxygen demand (COD) per Standard Method (SM) 2540D, fecal coliform per SM 9222D, and total
suspended solids (TSS) utilizing SM 2540D. In addition to the previously listed parameters, Outfall 1 and Outfall 3
are also sampled for chemical parameters associated with vehicle maintenance which include total petroleum
hydrocarbons (TPH) per Environmental Protection Agency (EPA) Method 1664B and pH utilizing SM 4500.
Stormwater Sampling and Quantitative Analyses
AWMF personnel collected the August stormwater samples at two (2) designated outfall locations on August 18,
2020. The total rainfall for the August 18, 2020 storm event was reported as approximately 0.83 inches in 24
hours. Sampling was performed during that storm event.
S&ME, Inc. 1 644 Eastern Star Road l Kingsport, TN 37663 1 p 423.349.2800 1 www.smeinc.com

X 9
a
Monthly Stormwater Monitoring
Anson Waste Management Facility
S&ME Project No. 4140-15-007
Quantitative chemical laboratory results for the monitoring event are compared to benchmark values established
by the facility NPDES permit on the attached Discharge Monitoring Report (DMR). Parameter exceedances of
benchmark values, if any were documented through field and laboratory analyses, are summarized in bold type
below.
Benchmark
120:
100 .
1000
15
6 - 9
Outfall3
Sed Basin 3
<25.0
54.7
450
<7.6
6.63
Outfall 4
Sed Basin 4
31.7
11.4
3500
ANR
6.81
ANR = Analyte not requested and not required by the NPDES Permit
mg/l= milligrams per liter
CFU/ml= colony -forming units per milliliter
The DMR is included with this letter as Attachment I for signature and submittal to the North Carolina
Department of Environmental Quality (NCDEQ), Division of Water Quality. The Laboratory Data Report for this
sampling event is included as Attachment II.
® Closure
S&ME appreciates this opportunity to be of service to Waste Connections and trust this information is responsive
to your current needs. If you have any questions, please contact us at your convenience.
Sincerely,
S&ME, Inc.
rdAOrris
Project Manager
Attachments: Discharge Monitoring Report
Laboratory Data Report
Site SWPPP Map
Victor M. Augspurger
Senior Reviewer
cc: Mike Lawyer, Fayetteville Regional Office
Lana Brown, Waste Connections
Nelson Breeden, Waste Connections of the Carolinas, Inc.
Page 2

Attachments

Attachment I — Discharge Monitoring Report

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Attachment II - Laboratory Data Report

aceAnalytical
www.pacelabs.com
August 24, 2020
Lindsey Harris
SWE, Inc.
644 Eastern Star Road
Kingsport, TN 37663
RE: Project: Anson LF Stormwater - Monthly
Pace Project No.: 92491267
Dear Lindsey Harris:
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Enclosed are the analytical results for sample(s) received by the laboratory on August 18, 2020. The results relate only to
the samples included in this report. Results reported herein conform to the applicable TNI/NELAC Standards and the
laboratory's Quality Manual, where applicable, unless otherwise noted in the body of the report.
The test results provided in this final report were generated by each of the following laboratories within the Pace Network:
• Pace Analytical Services Asheville
• Pace Analytical Services - Charlotte
If you have any questions concerning this report, please feel free to contact me.
Sincerely, "
cwc
Angela Baioni
[e-mail]
[phone]
Project Manager
Enclosures
- AS,'RBO-
2-
qe�
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 1 of 14

P {
aceAnalytical
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CERTIFICATIONS
Project: Anson LF Stormwater - Monthly
Pace Project No.: 92491267
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Pace Analytical Services Charlotte
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
South Carolina Certification #: 99006001
Louisiana/NELAP Certification # LA170028
Florida/NELAP Certification #: E87627
North Carolina Drinking Water Certification #: 37706
Kentucky UST Certification #: 84
North Carolina Field Services Certification #: 5342
VirginiaNELAP Certification #: 460221
North Carolina Wastewater Certification #: 12
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804 North Carolina Wastewater Certification #: 40
Florida/NELAP Certification #: E87648 South Carolina Certification #: 99030001
Massachusetts Certification #: M-NC030 VirginiaNELAP Certification #: 460222
North Carolina Drinking Water Certification #: 37712
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 2 of 14

aceAnalytical
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SAMPLE ANALYTE COUNT
Project: Anson LF Stormwater - Monthly
Pace Project No.: 92491267
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Analytes
Lab ID
Sample ID
Method
Analysts
Reported
Laboratory
92491267001
Outfall 3
EPA 1664B
HH
1
PASI-C
SM 9222D-2006
KDF
1
PASI-C
SM 254OD-2011
RED
1
PASI-A
SM 5220D-2011
NAL
1
PASI-A
92491267002
Outfall 4
SM 9222D-2006
KDF
1
PASI-C
SM 2540D-2011
RED
1
PASI-A
SM 5220D-2011
NAL
1
PASI-A
92491267003
Outfall 1
EPA 1664B
HH
1
PASI-C
PASI-A = Pace Analytical Services -Asheville
PASI-C = Pace Analytical Services - Charlotte
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 3 of 14

aceAnalytical
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SUMMARY OF DETECTION
Project: Anson LF Stormwater - Monthly
Pace Project No.: 92491267
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Lab Sample ID Client Sample ID
Method Parameters Result Units Report Limit Analyzed Qualifiers
92491267001 Outfall 3
SM 9222D-2006 Fecal Coliforms 450 CFU/100 mL 1.0 08/19/20 13:40
SM 254OD-2011 Total Suspended Solids 54.7 mg/L 6.3 08/20/20 18:33
92491267002
Outfall 4
SM 9222D-2006
Fecal Coliforms
3500 CFU/100 mL
SM 2540D-2011
Total Suspended Solids
11.4 mg/L
SM 5220D-2011
Chemical Oxygen Demand
31.7 mg/L
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
1.0 08/19/2013:40
3.3 08/20/2018:34
26.0 08/24/2014:48
Page 4 of 14

y 'r
aceAnalytical
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ANALYTICAL RESULTS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: Anson LF Stormwater - Monthly
Pace Project No.: 92491267
Sample: Outfall 3 Lab ID: 92491267001 Collected: 08/18/20 08:29 Received: 08/18/20 11:39 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
1664 SGT-HEM, TPH
Analytical Method: EPA 1664E
Pace Analytical Services - Charlotte
Total Petroleum Hydrocarbons
ND mg/L
7.6 1 08/24/20 10:51
MBIO 9222D Fecal Coliform CHT
Analytical Method: SM 9222D-2006
Preparation Method: SM 9222D-2006
Pace Analytical Services - Charlotte
Fecal Coliforms
460 CFU/100 mL
1.0 1 08/18/20 14:24 08/19/20 13:40
2540D Total Suspended Solids
Analytical Method: SM 254OD-2011
Pace Analytical Services -Asheville
Total Suspended Solids
64.7 mg/L
6.3 1 08/20/20 18:33
6220D COD
Analytical Method: SM 5220D-2011
Preparation Method: SM 5220D-2011
Pace Analytical Services -Asheville
Chemical Oxygen Demand
ND mg/L
25.0 1 08/23/20 16:21 08/24/20 14:48
Sample: Outfall 4 Lab ID: 92491267002 Collected: 08/18/20 08:01 Received: 08/18/20 11:39 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
MBIO 9222D Fecal Coliform CHT Analytical Method: SM 9222D-2006 Preparation Method: SM 9222D-2006
Pace Analytical Services - Charlotte
Fecal Coliforms 3500 CFU/100 mL 1.0 1 08/18/20 14:24 08/19/20 13:40
2540D Total Suspended Solids Analytical Method: SM 254OD-2011
Pace Analytical Services -Asheville
Total Suspended Solids 11.4 mg/L 3.3 1 08/20/20 18:34
5220D COD Analytical Method: SM 5220D-2011 Preparation Method: SM 5220D-2011
Pace Analytical Services - Asheville
Chemical Oxygen Demand 31.7 mg/L 25.0 1 08/23/20 16:21 08/24/20 14:48
Sampler Outfall 1 Lab ID: 92491267003 Collected: 08/18/20 08:14 Received: 08/18/20 11:39 Matrix: Water
Parameters
1664 SGT-HEM, TPH
Total Petroleum Hydrocarbons
Results Units Report Limit DF Prepared Analyzed CAS No. Qual
Analytical Method: EPA 1664E
Pace Analytical Services - Charlotte
ND mg/L 7.5 1 08/24/2010:51
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 08/24/2020 05:15 PM without the written consent of Pace Analytical Services, LLC. Page 5 of 14

Y Y
Pace Analytical Services, LLC
te 100
aceAnalytical ® 9800Hunte svlle, NCKincey Ave. 128078
www.pacelabs.com [phone]
QUALITY CONTROL DATA
Project: Anson LF Stormwater - Monthly
Pace Project No.: 92491267
QC Batch: 561898 Analysis Method: EPA 1664B
QC Batch Method: EPA 1664E Analysis Description: 1664 SGT-HEM, TPH
Laboratory: Pace Analytical Services - Charlotte
Associated Lab Samples: 92491267001, 92491267003
METHOD BLANK: 2980095 Matrix: Water
Associated Lab Samples: 92491267001, 92491267003
Blank Reporting
Parameter Units . Result Limit Analyzed Qualifiers
Total Petroleum Hydrocarbons mg/L ND 5.0 08/24/20 10:43
LABORATORY CONTROL SAMPLE:
2980096
Spike LCS
LCS
% Rec
Parameter
Units
Conc. Result
% Rec
Limits
Qualifiers
Total Petroleum Hydrocarbons
mg/L
20 18.6
93
64-132
MATRIX SPIKE SAMPLE:
2980097
92491329001 Spike
MS
MS
% Rec
Parameter
Units
Result Conc.
Result
% Rec
Limits Qualifiers
Total Petroleum Hydrocarbons
mg/L
ND 20
15.3
74
64-132
Results presented on this page are In the units Indicated by the "Units" column except where an alternate unit Is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 08/24/2020 05:15 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 14

aceAnaljdical
www.pacelabs.com
QUALITY CONTROL DATA
Project: Anson LF Stormwater- Monthly
Pace Project No.: 92491267
Pace Analytical Services, LLC
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
QC Batch: 560742
Analysis Method:
SM 9222D-2006
QC Batch Method: SM 9222D-2006
Analysis Description:
9222D Fecal Coliform(MF) - CHT
Laboratory:
Pace Analytical Services - Charlotte
Associated Lab Samples: 92491267001, 92491267002
METHOD BLANK: 2974810
Matrix: Water
Associated Lab Samples: 92491267001, 92491267002
Blank Reporting
Parameter Units
Result Limit
Analyzed Qualifiers
Fecal Coliforms CFU/100 mL
ND
1.0 08/19/20 13:40
SAMPLE DUPLICATE: 2974811
92491267001 Dup
Parameter Units
Result Result
RPD Qualifiers
Fecal Coliforms CFU/100 mL
450'
460 2
Results presented on this page are in the units Indicated by the "Units" column except where an alternate unit Is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 08/24/2020 05:15 PM without the written consent of Pace Analytical Services, LLC.
Page 7 of 14

r
aceAnalytical
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QUALITY CONTROL DATA
Project: Anson LF Stormwater - Monthly
Pace Project No.: 92491267
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QC Batch: 561370
Analysis Method:
SM 254OD-2011
QC Batch Method: SM 254OD-2011
Analysis Description:
2540D Total Suspended Solids
Laboratory:
Pace Analytical Services - Asheville
Associated Lab Samples: 92491267001, 92491267002
METHOD BLANK: 2977740
Matrix: Water
Associated Lab Samples: 92491267001, 92491267002
Blank Reporting
Parameter
Units
Result Limit
Analyzed Qualifiers
Total Suspended Solids
mg/L
ND
2.5 08/20/20 18:20
LABORATORY CONTROL SAMPLE:
2977742
Spike LCS
LCS % Rec
Parameter
Units
Conc. Result
% Rec Limits Qualifiers
Total Suspended Solids
mg/L
250 244
97 90-110
SAMPLE DUPLICATE: 2978122
92491381001 Dup
Parameter
Units
Result Result
RPD Qualifiers
Total Suspended Solids
mg/L
230
232 1
SAMPLE DUPLICATE: 2978123
92491263001 Dup
Parameter
Units
Result Result
RPD Qualifiers
Total Suspended Solids
mg/L
111
98.7 11
Results presented on this page are in the units Indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 08/24/2020 05:15 PM without the written consent of Pace Analytical Services, LLC.
Page 8 of 14

(�IaceAnaljdical"
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Project: Anson LF Stormwater - Monthly
Pace Project No.: 92491267
QC Batch: 561812
QC Batch Method: SM 5220D-2011
Associated Lab Samples: 92491267001, 92491267002
QUALITY CONTROL DATA
Analysis Method:
Analysis Description:
Laboratory:
SM 5220D-2011
5220D COD
Pace Analytical Services -Asheville
METHOD BLANK: 2979829 Matrix: Water
Associated Lab Samples: 92491267001, 92491267002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Chemical Oxygen Demand mg/L ND 25.0 08/24/20 14:41
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
LABORATORY CONTROL SAMPLE:
2979830
Spike
LCS
LCS
% Rec
Parameter
Units
Cone.
Result
% Rec
Limits
Qualifiers
Chemical Oxygen Demand
mg/L
750
751
100
90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2979831
2979832
MS
MSD
92490400002
Spike
Spike
MS
MSD
MS
MSD
% Rec
Parameter
Units Result
Cone.
Cone.
Result
Result
% Rec
% Rec
Limits RPD Qual
Chemical Oxygen Demand
mg/L 1660
100
100
1730
1730
69
69
90-110 0 M1
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 2979833
2979834
MS
MSD
92490474001
Spike
Spike
MS
MSD
MS
MSD
% Rec
Parameter
Units Result
Cone.
Cone.
Result
Result
% Rec
% Rec
Limits RPD Qua[
Chemical Oxygen Demand
mg/L 68.7
100
100
175
175
106
106
90-110 0
Results presented on this page are in the units Indicated by the "Units" column except where an alternate unit Is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 08/24/2020 05:15 PM without the written consent of Pace Analytical Services, LLC.
Page 9 of 14

1�
aceAnaljftal
www.pacelabs.com
QUALIFIERS
Project: Anson LF Stormwater - Monthly
Pace Project No.: 92491267
DEFINITIONS
DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot.
ND - Not Detected at or above adjusted reporting limit.
TNTC - Too Numerous To Count
J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
MDL -Adjusted Method Detection Limit.
PQL - Practical Quantitation Limit.
RL - Reporting Limit - The lowest concentration value that meets project requirements for quantitative data with known precision and
bias for a specific analyte in a specific matrix.
S - Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is
a combined concentration.
Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values.
LCS(D) - Laboratory Control Sample (Duplicate)
MS(D) - Matrix Spike (Duplicate)
DUP - Sample Duplicate
RPD - Relative Percent Difference
NC - Not Calculable.
SG - Silica Gel - Clean -Up
U - Indicates the compound was analyzed for, but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TNI - The NELAC Institute.
ANALYTE QUALIFIERS
M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 08/24/2020 05:15 PM without the written consent of Pace Analytical Services, LLC. Page 10 of 14

AnalXical(�Iac
www.pacelabo.com
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project:
Anson LF Stormwater - Monthly
Pace Project No.:
92491267
Analytical
Lab ID
Sample ID
QC Batch Method
QC Batch
Analytical Method
Batch
92491267001
Outfall 3
EPA 1664B
561898
92491267003
Outfall 1
EPA 1664B
561898
92491267001
A
Outfall 3
SM 9222D-2006
560742
SM 9222D-2006
560743
92491267002
Outfall 4
SM 9222D-2006
560742
SM 9222D-2006
560743
92491267001
Outfall 3
SM 2540D-2011
561370
92491267002
Outfall 4
SM 2540D-2011
561370
92491267001
Outfall 3
SM 5220D-2011
561812
SM 5220D-2011
561992
92491267002
Outfall 4
SM 5220D-2011
561812
SM 5220D-2011
561992
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 08/24/2020 05:15 PM without the written consent of Pace Analytical Services, LLC. Page 11 of 14

aCBAnalyficaI
Document Name:
Sample Condition Upon Recei t(SCUR)
Document Revised: February 7, 2018
Page 1 of 2
Document No.:
Issuing Authority:
F-CAR-CS-033-Rev.06
Pace Carolinas Quality Office
Laboratory receiving samples:
Asheville ❑ Eden❑ Greenwood ❑ Huntersville� Raleigh❑ Mechanicsville[]
ConditionSamplo Client Name: Upon Receipt r ^ Project t:
WII O(I'# II I. I�9LI2II 49l l'1I�
267
C❑ Commercial �Cll�entourier: ❑FedEx�U�P�SEDIUSPS
f4paceezaeizs
F-6.A., cnal Prntnnf? Mvac IWNn Seals Intact? I IYes ONO
Date/InitlalsPerson Examining
Packing Material: ❑Bubble Wrap �Bubble Bags ❑None ❑ Other Biological Tlss Frozen? /J p1
�� Thermom: 92FTO61 Type of Ice; b4wet []Blue []None None
[]Yes❑NoV/A R Gun ID;
Cooler Temp (•C): Correction Factor: Add/Subtract (•C) 0.0 Temp should be above freezing to 6•C
Cooler Temp Corrected (•C):_ ❑Samples out of temp criteria, Samples on ice, cooling process
has begun
USDA Regulated Soil (tQI/A, water sample)
Old samples originate In a quarantine zone within the United States: CA, NY, or SC (check maps)? Did samples originate from a foreign source (internationally,
ram.. rt_. .,.6�.n.,•u�u��i� ..A Du 'tn A1r 171- 1vat r 1Nn
Comments/Discrepancy:
Chain of Custody Present?
Yes
EJN0
N/A
1.
Samples Arrived within Hold Time?
Yes
No
N/A
2.
Short Hold Time Analysis 02 hr.)?
Yes
Pbo
N/A
3.
Rush Turn Around Time Requested?
Yes
No
E1NtA
4.
Sufficient Volume?
MYes
QNo
❑N/A -
5.
Correct Containers Used?
-Pace Containers Used?
es
Yes
[:]No[
oft
--]N/A
N/A
6.
Containers Intact?
MYes
[:]No
N A
7.
Dissolved analysis: Samples Field Filtered?
❑Yes
INNO
N n
8.
Sample Labels Match COC?
(FlYes
❑No
❑N/A
9.
-Includes Date/Time/ID/Analysis Matrix;
Heads ace in VOA Vials >5-6mm ?
C3Yes
C3No
/A
10.
Trip Blank Present?
Trip Blank Custody Seals Present?
❑Yes
[]Yes
❑No
QN0
N/A
/A
11.
COMMENTS/SAMPLE DISCREPANCY
Lot ID of split containers:
CLIENT NOTIFICATIONIRESOLUTION
Person contacted:
Project Manager SCURF Review:
Project Manager SRF Review:
Date/Time:
Date:
Date:
Field Data Required? Oyes ❑No
Page 12 of 14

a
". aCeAnaliftal
Document Name:
Sample Condition Upon Recel t(SCUR)
Document Revised: February 7, 2018
Page 1 of 2
Document No.:
Issuing Authority:
/-
F-CAR•CS-033-Rev.06
Pace Carolinas Quality Office
*Check mark top half of box If pH and/or dechlorination Is
verified and within the acceptance range for preservation
samples.
Exceptions: VOA, Coiiform, TOC, Oil and Grease, DRO/8015 (water) DOC, LLHg
**Bottom half of box is to list number of bottle
Project ri r
WQ## : 92491267
PM: AMB Due Date: 08/25/20
CLIENT: 92-SAME TN
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Log for Preserved Samples
Sample ID
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adjusted
Amount of Preservative
added
Lot N
Note: wnenevertnere is a oiscrepancy aneccing rvvnn %.drmum w,,,P„u„Lc aumP,ca, o ..vpr I� �••�� ••+^^ ^ • ••�+•••• •" •••- ••"• •••--•-••••- __...... __.
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Page 13 of 14

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Page 14 of 14

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