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WQ0004910_Monitoring - 10-2020_20201123 (2)
GW-59A COMPLIANCE REPORT FORM Permit # GlI D D (Submit one each monitoring period with GW-59 forms.) 1l 1 Enter date monitoring results were due. 12L 'u Will this monitoring report (GW-59 and GW-594) YES NO be submitted after the established due date. r c,)„j Ne II Jock- dowru 6v: c� � 2 Was any required information missing on the GW-59 report forms? YES NO IF the answer to question 1 or 2 is "YES'; list in the space provided below the well identification number(s) and explain the problems encountered in obtaining the required information. %w PJl�kl� i��<< 1 �� 10W A.7 3 Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing YES NO identification plate, area overgrown, etc.)? If the answer is "Yes", contact the Regional Officeforguidance. 4 Are any monitored constituents equal to or above the established standards? YES N If the answer to question 4 is "NO'; skip to section 8. If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s) exceeding standards in the space provided below: 5 For the constituents identified in question 4 above, have standards been exceeded previously for the YES NO same constituent(s) in the same well(s) in the last two years? If the answer to question 5 is "NO'; skip to section 8. If the answer to question 5 is "YES", list in the space provided below, each well with constituent(s) exceeding standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years). Are the monitoring wells listed in section 5 located at or beyond the review boundary? YES NO If the answer is "YES", a groundwater quality problem may be occurring. CONTACT THE REGIONAL OFFICE IMMEDIATELY FOR GUIDANCE. If the answer is "NO", monitoring wells maybe improperly located; contact the Regional Office. 7 Is the permittee implementing previously approved actions required by the Division involving this YES NO groundwater quality problem? If the answer to question 7 is "YES", describe those actions in the space provided below. If the answer to question 7 is "NO", contact the Regional Office within 90 days; an evaluation may be required to determine the impact the waste disposal system is havifto at the review and compliance boundaries surrounding this facility. Failure to do so may subject e permittee to a Notice of Violation, fines, and/or penalties. 77 3 00) 8 The person completing this portion (GW-59A) of the monitorin port iNbuld Sign below and submit this form with GW-59 forms for required wells to the address provided at the topw�the current GW-59 form. w.� 1 hereby acknowledge that the above information was evaluated and the information submitted in this report (Compliance Report GW-59A) is true and complete to the best of my knowledge. V 2- tigrAture of Permittee (or Aufhorized Agent) Date' GW-59A 12/8/2003 SUBMIT FORM ON YELLOW PAPER ONLY • DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: 919.807-6306 FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 11/16/20 Facility Name: Town of Woodland Non -Discharge WQ0004910 UIC Permit Name (if different): NPDES Other Facility Address: 414 Jameson Ave Woodland NC 27897 TYPE OF PERMITTED OPERATION BEING MONITORED 414 Jameson Ave Woodland NC 27897 County Northampton ❑■ Lagoon ❑ Remediation: Infiltration Gallery ❑■ Spray Field ❑ Remediation: Contact Person: Raymond S. Eaton Telephone#: 252-209-1759 ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: WWTP irrigation fields No. of wells to be sampled: 5 ❑ Water Source Heat Pump ❑ Other: (from Permit) SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW1 Date sample collected: 10/06/20 FIELD ANALYSES: WAS Well Depth: 18 ft. Well Diameter: 2 in. pH 00400: 7 units Temp. 000lo: 19.5 °C DRY at Depth to Water Level 82546:6.5 ft. below measuring p g point Screened Interval: 13 ft. to 18 ft. Spec. Cond. 000sa: µ Mhos time of sampling, Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none check Volume of water pumped/bailed before sampling: 4 gallons Appearance clear here: ❑ Samples for metals were collected unfiltered: ❑■ YES El NO and field acidified: El YES ❑ NO LABORATORY INFORMATION Date sample analyzed:10/06/20-10/14/20 Laboratory Name: Envirnment 1, Inc Certification No. PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead 01051 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 0.28 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.06 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): Dissolved Solids:Total 70300 97 mg/L Al - Aluminum oilo5 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 <1.00 mg/L Ca - Calcium 00916 mg/L Chloride 00940 19 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS *Ld�SSING UjVi , Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑■ Yes (1) ❑ No (0) Specific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 <0.04 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen: NH, as N; Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L , method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% GW-59 Rev.05-02-2017 SUBMIT FORM ON YELLOW PAPER ONLY DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: 919-807-6306 FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 11/16/20 Facility Name: Town of Woodland Non -Discharge WQ0004910 UIC Permit Name (if different): NPDES Other Facility Address: 414 Jameson Ave Woodland NC 27897 TYPE OF PERMITTED OPERATION BEING MONITORED 414 Jameson Ave Woodland NC 27897 County Northampton 0 Lagoon ❑ Remediation: Infiltration Gallery ❑■ Spray Field ❑ Remediation: Contact Person: Raymond S. Eaton Telephone#: 252-209-1759 ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: WWTP irrigation fields No. of wells to be sampled: 5 ❑ Water Source Heat Pump ❑ Other: (from Permit) SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW3 Date sample collected: 10/06/20 FIELD ANALYSES: WAS Well Depth: 18 ft. Well Diameter: 2 in. pH 00400: 6.8 units Temp. 000lo: 19.9 °C DRY at Depth to Water Level 82546:6.9 ft. below measuring point Screened Interval: 13 ft. to 18 ft. Spec. Cond. 00094: µMhos time of — sampling, Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none check Volume of water pumped/bailed before sampling: 4 gallons Appearance clear here:❑ Samples for metals were collected unfiltered: ❑■ YES ❑ NO and field acidified: ❑ YES ❑ NO LABORATORY INFORMATION Date sample analyzed:10/06/20-10/14/20 Laboratory Name: Envirnment 1, Inc Certification No. PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead o1o51 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 0.10 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P006650.07 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 114 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 1.04 mg/L Ca - Calcium 00916 mg/L Chloride 0094o 39 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ■❑ Yes (1) ❑ No (0) Specific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia oo610 0.04 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH,as N: Ammonia Nitrogen, Total) Mn - Manganese o1o55 ug/L , method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% GW-59 Rev.05-02-2017 r SUBMIT FORM ON YELLOW PAPER ONLY • DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM • • . • 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: 919.807-6306 FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 11/16/20 Facility Name: Town of Woodland Non -Discharge WQ0004910 UIC NPDES Other Permit Name (if different): Facility Address: 414 Jameson Ave Woodland NC 27897 TYPE OF PERMITTED OPERATION BEING MONITORED ❑■ Lagoon ❑ Remediation: Infiltration Gallery 414 Jameson Ave Woodland NC 27897 County Northampton ❑■ Spray Field ❑ Remediation: Contact Person: Raymond S. Eaton Telephone#: 252-209-1759 ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: WWTP irrigation fields No. of wells to be sampled: 5 ❑ Water Source Heat Pump ❑ Other: (from Permit SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW6 Date sample collected: 10/06/20 FIELD ANALYSES: WAS Well Depth: 18 ft. Well Diameter. 2 in. pH 00400: 6.8 units Temp. 000lo: 19.1 °C DRY at Depth to Water Level 82546:6.7 ft. below measuring point Screened Interval: 13 ft. to 18 ft. Spec. Cond. 00094: µMhos time of — sampling, Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none check Volume of water pumped/bailed before sampling: 4 gallons Appearance clear here:❑ Samples for metals were collected unfiltered: K YES ❑ NO and field acidified: ❑ YES ❑ NO LABORATORY INFORMATION Date sample analyzed:10/06/20-10/14/20 Laboratory Name: Envirnment 1, Inc Certification No. PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead o1o51 ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 0.18 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.14 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 703oo 202 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 <1.00 mg/L Ca - Calcium 00916 mg/L Chloride 0094o 79 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) Specific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 <0.04 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen, NH, as N; Ammonia Nitrogen, Total) Mn - Manganese 01055 ug/L method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% I certify that. to the best of my knowledge and belief, the information submitted in this report is true, accurate, and complete, and that the laboratory analytical data was produced using approved methods of analysis by a DWR-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of fines an,: imprisonment for knowing violations. Perrinittew1or Authorized Aqent) Name and Title - Please print or type Siq.4turgrbf Permittee (or Authorized Aqent) (Date) GW-59 Rev. 05-02-2017 SUBMIT FORM ON YELLOW PAPER ONLY • . DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: 919-807-6306 FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 11/16/20 Facility Name: Town of Woodland Non -Discharge WQ0004910 UIC NPDES Other Permit Name (if different): Facility Address: 414 Jameson Ave Woodland NC 27897 TYPE OF PERMITTED OPERATION BEING MONITORED 414 Jameson Ave Woodland NC 27897 County Northampton ❑■ Lagoon ❑ Remediation: Infiltration Gallery ❑■ Spray Field ❑ Remediation: Contact Person: Raymond S. Eaton Telephone#: 252-209-1759 ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: WWTP irrigation fields No. of wells to be sampled: 5 ❑ Water Source Heat Pump ❑ Other: (from Permit) SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW8 Date sample collected: 10/06/20 FIELD ANALYSES: WAS Well Depth: 18 ft. Well Diameter: 2 in. pH 00400: 6.7 units Temp. 000io: 19.2 °C DRY at Depth to Water Level 82546:7.1 ft. below measuring point Screened Interval: 13 ft. to 18 ft. Spec. Cond. 00094: µMhos time ofsampling, Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none check Volume of water pumped/bailed before sampling: 4 gallons Appearance clear here:❑ Samples for metals were collected unfiltered: ❑■ YES ❑ NO and field acidified: ❑ YES ❑ NO LABORATORY INFORMATION Date sample analyzed:10/06/20-10/14/20 Laboratory Name: Envirnment 1, Inc Certification No. PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead o1o5i ug/L Coliform: MF Fecal 31616 <1 /100mL Nitrate (NO3) as N 00620 <0.04 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.25 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): issolved Solids:Total 70300 109 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 <1.00 mg/L Ca - Calcium 00916 mg/L Chloride 00940 14 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) Specific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 0.05 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total) Mn -Manganese 01055 ug/L ,method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% GW-59 Rev.05-02-2017 SUBMIT FORM ON YELLOW PAPER ONLY DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES GROUNDWATER QUALITY MONITORING: INFORMATION PROCESSING UNIT COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: 919-807-6306 FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 11/16/20 Facility Name: Town of Woodland Non -Discharge WQ0004910 UIC NPDES Other Permit Name (if different): &e 414— _2TY V % Facility Address: TYPE OF PERMITTED OPERATION BEING MONITORED County Northampton ❑■ Lagoon ❑ Remediation: Infiltration Gallery ❑■ Spray Field El Remediation: Contact Person: Raymond S. Eaton Telephone#: 252-209-1759 ❑ Rotary Distributor ❑ Land Application of Sludge Well Location/Site Name: WWTP irrigation fields No. of wells to be sampled: 5 ❑ Water Source Heat Pump ❑ Other: (from Permit) SAMPLING INFORMATION If WELL WELL ID NUMBER (from Permit): MW9 Date sample collected: 10/06/20 FIELD ANALYSES: WAS Well Depth: 18 ft. Well Diameter: 2 in. pH 00400: 6.3 units Temp. 000lo: 20.0 °C DRY at Depth to Water Level 82546:7 ft. below measuring point Screened Interval: 13 ft. to 18 ft. Spec. Cond. 00094: µMhos time of sampling, Measuring Point is 2 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: none check Volume of water pumped/bailed before sampling: 4 gallons Appearance clear here:❑ Samples for metals were collected unfiltered: ❑■ YES ❑ NO and field acidified: ❑ YES ❑ NO LABORATORY INFORMATION Date sample analyzed:10/06/20-10/14/20 Laboratory Name: Envirnment 1, Inc Certification No. PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations. COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead o1o51 ug/L Coliform: MF Fecal 31616 rl /100mL Nitrate (NO3) as N 00620 0.09 mg/L Zn - Zinc 01092 mg/L Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 0.08 mg/L (Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units): Dissolved Solids:Total 703oo 216 mg/L Al - Aluminum 01105 mg/L pH (Lab) 00403 units Ba - Barium 01007 ug/L TOC 00680 1.08 mg/L Ca - Calcium 00916 mg/L Chloride 0094o 83 mg/L Cd - Cadmium 01027 ug/L Arsenic 01002 ug/L Chromium: Total 01034 ug/L Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC) Phenol 32730 ug/L Fe - Iron 01045 ug/L (Specify test and method #. ATTACH LAB REPORT.) Sulfate 00945 mg/L Hg - Mercury 71900 ug/L Lab Report Attached? ❑ Yes (1) ❑ No (0) Specific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 7873 method # Total Ammonia 00610 0.06 mg/L Mg - Magnesium 00927 mg/L method # (Ammonia Nitrogen; NH, as N; Ammonia Nitrogen, Total) Mn - Manganese o1o55 ug/L , method # TKN as N 00625 mg/L Ni - Nickel 01067 ug/L method # For Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal% GW-59 Rev.05-02-2017 ��doQo��c��� Flo ��c�oQpoQa�c�d 114 OAKMONT DRIVE GREENVILLE, N.C. 27858 TOWN OF WOODLAND P.O. BOX 297 WOODLAND ,NC 27897 PARAMETERS BOD, mg/l Fecal Coliform (MF), /100 Mls Total Suspended Residue, mg/l Ammonia Nitrogen as N, mg/l Total Kjeldahl Nitrogen as N,mg/1 Nitrate -Nitrite as N, mg/l (calc) Nitrate Nitrogen as N, mg/l Nitrite Nitrogen as N, mg/l Total Phosphorus as P, mg/l Total Phosphorus as P, mg/l Total Organic Carbon, mg/l Chloride, mg/l Total Dissolved Residue, mg/l Total Nitrogen, mg/l (calc) Effluent 34 210 82 1.16 10.84 0.43 0.06 0.37 3.69 870 1370 11.27 Drinking Water ID: 37715 Wastewater ID: 10 PHONE (262) %bb-o2UO FAX (252) 756-0633 ID#: 254 DATE COLLECTED: 10/06/20 DATE REPORTED : 11/10/20 REVIEWED BY: Well #1 Well #3 Well #6 Well #8 Analysis Method Date Analyst Code 10/06/20 KDS 521OB-11 < 1 < 1 < 1 < 1 10/06/20 HJO 9222D-06 10/07/20 HJO 2540D-11 <0.04 0.04 <0.04 0.05 10/07/20 KES 350.1 112-93 10/08/20 KES 351.2 112-93 353.2 112-93 0.28 0.10 0.18 < 0.04 10/07/20 DTL 353.2 112-93 10/06/20 KES 353.2 112-93 10/08/20 TLH 365.4-74 0.06 0.07 0.14 0.25 10/13/20 DTL 365.4-74 < 1.00 1.04 < 1.00 < 1.00 10/14/20 SEJ 531 OC-11 19 39 79 14 10/12/20 JMS 4500CLB-11 97 114 202 109 10/08/20 HJO 2540C-11 EADmIMEOPM % hmpudid 114 OAKMONT DRIVE GREENVILLE, N.C. 27858 CLIENT: TOWN OF WOODLAND P.O. BOX 297 WOODLAND, NC 27897 REVIEWED BY: VOLATILE ORGANICS STD. METHODS 620OC-11 PHONE (252) 756-6208 FAX (252) 756-0633 CLIENT ID: 254 ANALYST: DTL DATE COLLECTED: 10/06/20 Page: 1 DATE ANALYZED: 10/09/20 DATE REPORTED: 11/10/20 PARAMETERS, ug/l Well #6 Well #8 Well #9 1. Benzene <0.50 <0.50 <0.50 2. Bromobenzene <0.50 <0.50 <0.50 3. Bromochloromethane <0.50 <0.50 <0.50 4. Bromodichloromethane <0.50 <0.50 <0.50 5. Bromoform <0.50 <0.50 <0.50 6. Bromomethane <0.50 <0.50 <0.50 7. N-Butylbenzene <0.50 <0.50 <0.50 8. Sec-Butylbenzene <0.50 <0.50 <0.50 9. Tert-Butylbenzene <0.50 <0.50 <0.50 10. Carbon Tetrachloride <0.50 <0.50 <0.50 11. Chlorobenzene <0.50 <0.50 <0.50 12. Chloroethane <0.50 <0.50 <0.50 13. Chloroform <0.50 <0.50 <0.50 14. Chloromethane <0.50 <0.50 <0.50 15. 2-Chlorotoluene <0.50 <0.50 <0.50 16. 4-Chlorotoluene <0.50 <0.50 <0.50 17. Dibromochloromethane <0.50 <0.50 <0.50 18. 1,2-Dibromo-3-Chloropropane <0.50 <0.50 <0.50 19. 1,2-Dibromoethane <0.50 <0.50 <0.50 20. Dibromomethane <0.50 <0.50 <0.50 21. 1,2-Dichlorobenzene <0.50 <0.50 <0.50 22. 1,3-Dichlorobenzene <0.50 <0.50 <0.50 23. 1,4-Dichlorobenzene <0.50 <0.50 <0.50 24. Dichlorodifluoromethane <0.50 <0.50 <0.50 25. 1,1-Dichloroethane <0.50 <0.50 <0.50 26, 1,2-Dichloroethane <0.50 <0.50 <0.50 27. 1,1-Dichloroethene <0.50 <0.50 <0.50 28. Cis-1,2-Dichloroethene <0.50 <0.50 <0.50 29. trans-1,2-Dichloroethene <0.50 <0.50 <0.50 30. 1,2-Dichloropropane <0.50 <0.50 <0.50 31. 1,3-Dichloropropane <0.50 <0.50 <0.50 32. 2,2-Dichloropropane < 0.50 < 0.50 < 0.50 33. 1,1-Dichloropropene <0.50 <0.50 <0.50 34. Cis-1,3-Dichloropropene <0.50 <0.50 <0.50 35. trans- 1,3-Dichloropropen e <0.50 <0.50 <0.50 36. Ethylbenzene <0.50 <0.50 <0.50 37. Hexachlorobutadiene <0.50 <0.50 <0.50 38. Isopropylbenzene <0.50 <0.50 <0.50 39. 4-Isopropyltoluene <0.50 <0.50 <0.50 40. Methylene Chloride <0.50 <0.50 <0.50 41. Naphthalene <0.50 <0.50 <0.50 42. Propylbenzene <0.50 <0.50 <0.50 43. Styrene <0.50 <0.50 <0.50 44. 1,1,1,2-Tetrachloroethane <0.50 <0.50 <0.50 45. 1,1,2,2-Tetrachloroethane <0.50 <0.50 <0.50 46. Tetrachloroethene < 0.50 < 0.50 <0.50 47. Toluene < 0.50 < 0.50 < 0.50 48. 1,2,3-Trichlorobenzene <0.50 <0.50 <0.50 ElMonamM Flo hcupumbd 114 OAKMONT DRIVE GREENVILLE, N.C. 27858 CLIENT: TOWN OF WOODLAND P.O. BOX 297 WOODLAND, NC 27897 REVIEWED BY: VOLATILE ORGANICS STD. METHODS 620OC-11 Drinking Water ID: 37715 Wastewater ID: 10 PHONE (252) 756-6208 FAX (252) 756-0633 CLIENT ID: 254 ANALYST: DTL DATE COLLECTED: 10/06/20 Page: 2 DATE ANALYZED: 10/09/20 DATE REPORTED: 11/10/20 PARAMETERS, ug/l Well #6 Well #8 Well #9 49. 1,2,4-Trichlorobenzene <0.50 <0.50 <0.50 50. 1,1,1-Trichloroethane <0.50 <0.50 <0.50 51. 1,1,2-Trichloroethane <0.50 <0.50 <0.50 52. Trichloroethene <0.50 <0.50 <0.50 53. Trichlorofluoromethane <0.50 <0.50 <0.50 54. 1,2,3-Trichloropropane <0.50 <0.50 <0.50 55. 1,2,4-Trimethylbenzene <0.50 <0.50 <0.50 56. 1,3,5-Trimethylbenzene <0.50 <0.50 <0.50 57. Vinvl Chloride <0.50 <0.50 <0.50 58. Total Xylenes < 1.00 < 1.00 < 1.00 59. Methyl Tert Butyl Ether < 1.00 < 1.00 < 1.00 Enw,umn(PRI Flo hmpumbd 114 OAKMONT DRIVE GREENVILLE, N.C. 27858 CLIENT: TOWN OF WOODLAND P.O. BOX 297 WOODLAND, NC 27897 REVIEWED BY: VOLATILE ORGANICS RTD. METHODS 620OC-11 PHONE (252) 756-6208 FAX (252) 756-0633 CLIENT ID: 254 ANALYST: DTL DATE COLLECTED: 10/26/20 Page: 1 DATE ANALYZED: 10/29/20 DATE REPORTED: 11/03/20 PARAMETERS, ug/l Well #1 Well #3 1. Benzene <0.50 <0.50 2. Bromobenzene <0.50 <0.50 3. Bromochloromethane <0.50 <0.50 4. Bromodichloromethane <0.50 <0.50 5. Bromoform <0.50 <0.50 6. Bromomethane <0.50 <0.50 7. N-Butvlbenzene <0.50 <0.50 8. Sec-Butylbenzene < 0.50 < 0.50 9. Tert-Butvlbenzene <0.50 <0.50 10. Carbon Tetrachloride <0.50 <0.50 11. Chlorobenzene < 0.50 < 0.50 12. Chloroethane <0.50 <0.50 13. Chloroform < 0.50 < 0.50 14. Chloromethane <0.50 <0.50 15. 2-Chlorotoluene <0.50 <0.50 16. 4-Chlorotoluene <0.50 <0.50 17. Dibromochloromethane <0.50 <0.50 18. 1,2-Dibromo-3-Chloropropane <0.50 <0.50 19. 1,2-Dibromoethane < 0.50 < 0.50 20. Dibromomethane <0.50 <0.50 21. 1,2-Dichlorobenzene <0.50 <0.50 22. 1,3-Dichlorobenzene <0.50 <0.50 23. 1,4-Dichlorobenzene <0.50 <0.50 24. Dichlorodifluoromethane <0.50 <0.50 25. 1,1-Dichloroethane <0.50 <0.50 26. 1,2-Dichloroethane <0.50 <0.50 27. 1,1-Dichloroethene <0.50 <0.50 28. Cis-1,2-Dichloroethene <0.50 <0.50 29. trans- 1,2-Dichloroethene <0.50 <0.50 30. 1,2-Dichloropropane <0.50 <0.50 31. 1,3-Dichloropropane <0.50 <0.50 32. 2,2-Dichloropropane <0.50 <0.50 33. 1,1-Dichloropropene < 0.50 < 0.50 34. Cis-1,3-Dichloropropene <0.50 <0.50 35. trans -1,3-Dichloropro pene <0.50 <0.50 36. Ethylbenzene <0.50 <0.50 37. Hexachlorobutadiene < 0.50 < 0.50 38. Isopropylbenzene <0.50 <0.50 39. 4-Isopropyltoluene <0.50 <0.50 40. Methylene Chloride <0.50 <0.50 41. Naphthalene <0.50 <0.50 42. Propylbenzene <0.50 <0.50 43. Styrene <0.50 <0.50 44. 1,1,1,2-Tetrachloroethane <0.50 <0.50 45. 1,1,2,2-Tetrachloroethane <0.50 <0.50 46. Tetrachloroethene <0.50 <0.50 47. Toluene <0.50 <0.50 48. 1,2,3-Trichlorobenzene <0.50 <0.50 Bmwohnum Flo hmpumUd 114 OAKIviurV I uFiiVc GREENVILLE, N.C. 27858 CLIENT: TOWN OF WOODLAND P.O. BOX 297 WOODLAND, NC 27897 REVIEWED BY: VOLATILE ORGANICS STD. METHODS 620OC-11 Drinking Water ID: 37715 Wastewater ID: 10 iiUNL (2bL) io6-0206 FAX (252) 756-0633 CLIENT ID: 254 ANALYST: DTL DATE COLLECTED: 10/26/20 Page: 2 DATE ANALYZED: 10/29/20 DATE REPORTED: 11/03/20 PARAMETERS, ug/l Well #1 Well #3 49. 1,2,4-Trichlorobenzene <0.50 <0.50 50. 1,1,1-Trichloroethane <0.50 <0.50 51. 1,1,2-Trichloroethane <0.50 <0.50 52. Trichloroethene < 0.50 < 0.50 53. Trichlorofluoromethane < 0.50 < 0.50 54. 1,2,3-Trichloropropane <0.50 <0.50 55. 1,2,4-Trimethyylbenzene < 0.50 < 0.50 56. 1,3,5-Trimethylbenzene <0.50 <0.50 57. Vinyl Chloride <0.50 <0.50 58. Total Xvlenes < 1.00 < 1.00 59. Methyl Tert Butyl Ether < 1.00 < 1.00 ENW'r@flH(M Flo hmpudid 114 OAKMONT DRIVE GREENVILLE, N.C. 27858 TOWN OF WOODLAND P.O. BOX 297 WOODLAND ,NC 27897 Well #9 Analysis Method PARAMETERS Date Analyst Code Fecal Coliform (MF), /100 Mls < 1 10/06/20 HJO 9222D-06 Ammonia Nitrogen as N, mg/l 0.06 10/07/20 KES 350.1 R2-93 Nitrate Nitrogen as N, mg/l 0.09 10/07/20 DTL 353.2 R2-93 Total Phosphorus as P, mg/l 0.08 10/13/20 DTL 365.4-74 Total Organic Carbon, mg/l 1.08 10/14/20 SEJ 531OC-11 Chloride, mg/l 83 10/12/20 JMS 4500CLB-11 Total Dissolved Residue, mg/l 216 10/08/20 HJO 2540C-11 Drinking Water ID: 37715 Wastewater ID: 10 PHUNE (252) 756-6206 FAX (252) 756-0633 ID#: 254 DATE COLLECTED: 10/06/20 DATE REPORTED : 11/10/20 REVIEWED BY: ;y TI P. w (2 Environment 1, Inc. P.O. Box 7085, 114 Oakmont Dr. ov ..aio XTr- 17QCQ CHAI OF CUSTODY RECORD Page I of 2 environment l inc .com DISINFECTION CHLORINE NEUTRALIZED AT COLLECTION Phone (252) 756-6208 •Fax (252) 756-0633 CHLORINE CLIENT: 254 Week: 46 ❑ UV 40--N � Z pH CHECK (LAB) P P P P P P 1p P P IP P P I G G IG CONTAINER TYPE,P/G AWN OF WOODLAND ❑ NONE O. BOX 297 CHEMICAL PRESERVATION OODLAND NC 27897 ❑ A G A C C C A A C C A A E E E a,o U) A -NONE D-NAOH 52) 587-7161 E L Ld z � w Z w E 1.CC L v — N ell cn w B- HNO, E- HCL 0 p _ Ir O Z a 2 'o L ca y Z c a „ o a G a a. C� cc Uj C - HZSO, F -ZINC ACETATE/NAOH Uj jt COLLECTION ¢ F o0 o UJ pp� O �" a w Q " u C4 ° ° ! x `� °`. z W .% T y z °^ a r n = c Cam. rn E= o o J 0 o o ¢ G NATHIOSULFATE cc a SAMPLE LOCATION DATE TIME Effluent / U % 2L `� N E , . 3 7 �, CLASSIFICATION: WASTEWATER (NPDES) ❑ DRINKING WATER Well # 1 / i / 2 ; 3 �i,4 . , c Z i q,' 11 �.:s ! Well #3 (, ? ) C (c�2G �, y� �, 0 3 19.9 y -e11 #6 r 7 1.. I� DWR/GW ❑ SOLID WASTE SECTION Weil #8 G,7 14 Aw0, z s I9• �` << 9 : :, :> :; a r : ,� Well #9 CHAIN OF CUSTODY (SEAL) MAINTAINED DURING SHIPMENT/DELIVERY N SAMPLES COLLECTED BY: (Please Print) SAMPLES RECEIVED IN LAB AT —1j, °C R"QUISH BY (S .) AM LER) DATE/TIME RECE D B (SIG.) l� DATElT1ME COMMENTS: << 1 ;� �4_ 2C h 3 u �- RELIN UISHED BY (SIG.) DATErnME RECEIVED Y ( DATFJTIME RELINQUISHED BY (SIG.) DATEITIME RECEIVED BY (SIG.) DATEIrIME PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for FORM #5 Grab sample in the blocks above for each parameter requested. NQ w 385516 SAMPLING INSTRUCTIONS AND FORM COMPLETION FAILURE TO PROPERLY CHILL, CHEMICALLY PRESERVE, COLLECT IN PROPER BOTTLE TYPES, MEET REQUIRED HOLDING TIMES, NEUTRALIZE CHLORINE IN CHLORINE SENSITIVE SAMPLES, AND SEAL COOLERS WITH TAPE WILL RESULT IN SAMPLES BEING REJECTED BY THIS LABORATORY AS PER NORTH CAROLINA REGULATORY CODE. 1) Samples not falling within the required guidelines will need to be re -collected. The client will be contacted and informed of any deviation and asked to collect another set of samples. The client may request the laboratory to proceed with the analyses of the current samples. Any samples analyzed outside of the required guidelines will be "qualified" This means that a note will be included on the sample result and "Chain of Custody" specifying the deviation. The laboratory is also required to send a letter to the State noting the deviations. 2) Sample Temperature. Samples for compliance monitoring must be chilled with wet ice to a temperature of 6C or less. Freezing is not permitted. Samples delivered to the lab shortly after collection may not have had enough time to be chilled below 6C. In this case the temperature at time of collection must be noted in the space provided. The samples will meet the requirements of the regulation if there is a temperature drop from the time of collection until received in the lab. Regardless, all samples should be packed in wet ice using as much ice as will fit in the cooler. 3) Sample Chemical Preservation. Many samples require a chemical preservation such as Sulfuric Acid or Sodium Hydroxide. The laboratory will either provide the preservative in the sample bottle, or in the case of 40 ml. Volatiles Vials, provide a bottle of Acid with detailed instructions on how to collect the sample. Never rinse sample bottles before collecting samples. Any residue or liquid in the bottle is required for proper chemical preservation. Unless specific instructions are provided for a test or bottle (example: cyanide or volatile organics), fill sample bottles to the bottom of the bottle threads. This will leave a small air space for shaking the sample to mix with any preservative and again prior to analysis. The lab must verify proper chemical preservation upon arrival in the lab and will note this information in the spaces provided on the front of this form. 4) Chlorine Neutralization. Some samples require that any Total Chlorine Residual be removed at the time of collection. The lab will provide the proper neutralizing agent in the sample bottle when technically possible. There are some samples (Total Kjeldahl Nitrogen and Ammonia Nitrogen) where this is not possible due to interferences between the required chemical preservation (Acid) and the dechlorinating agent. Therefore, these samples must be de -chlorinated at the time of collection before being placed in our sample bottles. Sodium Thiosulfate is the chemical of choice to neutralize chlorine. It must be added to your sample and then the sample checked for Total Chlorine before the sample is poured in our bottle. Facilities using chlorine for disinfection should have a means of measuring Total Chlorine. Non -chlorinated sample sources will not need to be checked. The person neutralizing the chlorine must put his initials in the "Chlorine Neutralized at Collection" row on the front of this form above the proper parameter. Samples such as Coliforms (which have Thiosulfate in the bottles shipped from the lab) will be checked for proper neutralization upon arrival in the lab. It is also required that you note the "Total Chlorine at Collection" on the front of this form for any sample locations applicable. This value would be before any neutralization is performed. S) A "C" for Composite Sample or a "G" for Grab Sample should be placed in the box for all requested parameters. Grab temperatures as well as Composite start dates and times can be recorded in the "comments" section. 6) Other information required to be completed by the client are: Collection Date and Collection Time for each sample location Temperature at Time of Collection Printed name of person or persons collecting samples Signature, Date, and Time samples are relinquished Other added sample locations and analyses required Type Of Disinfection Deletion on the form for any samples which are not needed (example: dry upstream location) Any other information felt to be pertinent should be included in the "Comments" section CONSIDERATIONS: Coliform and Enterococci samples have a holding time of 6 hours from time of collection to time of analysis. Therefore, samples should be collected as late in the day as possible to allow enough time for transportation, checking in at the lab and analysis. BOD, Nitrate, Ortho Phosphorus, Settleable Matter, Turbidity, Color, and MBAS samples have a 48 hour holding time. The lab reserves the right to establish required sample collection and delivery dates in order to meet the required holding times. CAUTION Sample bottles may contain acids or other corrosive and potentially harmful chemicals. Laboratories are required to add these chemicals for certain analyses in order to comply with EPA preservation requirements. Use extreme care when opening and handling the shipping container and bottles. If any chemical should get into your eyes, on your skin or on your clothes, flush liberally with water and seek medical attention. Material Safety Data Sheets (MSDS) are available upon request which specify proper handling and personal protection. Ti P. W (2� Environment 1, Inc. CHAIN OF CUSTODY RECORD P.O. Box 7085, 114 Oakmont Dr. Page 2 of 2 C7 PPn,,d1P NJC 77RSR environment 1 inc.com DISINFECTION CHLORINE NEUTRALIZED AT COLLECTION Phone (252) 756-6208 •Fax (252) 756-0633 CHLORINE pH CHECK (LAB) CLIENT: 254 Week: 46 Ij UV G G CONTAINER TYPE, P/G DWN OF WOODLAND NONE Ij O. BOX 297 CHEMICALPRESERVAT10N OODLAND NC 27897 ❑ E E � A - NONE D - NAOH m o EL 52) 587-7161 z � Z ir IT C B- HNO, E- HCL 0J O 0 Er O v Z Q C ,c [r LU C- H,SO, F- ZINC ACETATE/NAOH COLLECTION F c A LU < G - NATHIOSULFATE 0 o a N° n SAMPLE LOCATION DATE TIME Effluent 16141240 �'; Y4„ p zq Je, 3 7 CLASSIFICATION: WASTEWATER (NPDES) DRINKING WATER Well#1 /c/6/20 8;3VpI-w Well #3 ICA/20 �`t yk kN d.D 3 9 Well#5 �c b/Lc of,/Z 0•�Z_ )�l / 9 :> ❑ DWR/GW A�' � �'`> Well #8 lQ/6 /" c R� c, z5 1 P, 2 9 ❑ SOLID WASTE SECTION Well #9 ZQ q 7R 0, 7 a c 9 CHAIN OF CUSTODY (SEAL) MAINTAINED DURING SHIPMENT/DELIVERY N SAMPLES COLLECTED BY: (Please Print) SAMPLES RECEIVED IN LAB AT q 1C R INQUIS D Y(SI (S PLER) DATETIME RECEI ED (SIG.) 1 DATEMME COMMENTS: c & zo 0_ 3 J RELIN UISHED BY (SIG.) DATEMME RECEIVED BY (SI :) DATE/TIME RELINQUISHED BY (SIG.) DATEMME RECEIVED BY (SIG.) DATEMME PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C for composite sample or a "G" for FORM #5 Grab sample in the blocks above for each parameter requested. N A 385515 SAMPLING INSTRUCTIONS AND FORM COMPLETION FAILURE TO PROPERLY CHILL, CHEMICALLY PRESERVE, COLLECT IN PROPER BOTTLE TYPES, MEET REQUIRED HOLDING TIMES, NEUTRALIZE CHLORINE IN CHLORINE SENSITIVE SAMPLES, AND SEAL COOLERS WITH TAPE WILL RESULT IN SAMPLES BEING REJECTED BY THIS LABORATORY AS PER NORTH CAROLINA REGULATORY CODE. 1) Samples not falling within the required guidelines will need to be re -collected. The client will be contacted and informed of any deviation and asked to collect another set of samples. The client may request the laboratory to proceed with the analyses of the current samples. Any samples analyzed outside of the required guidelines will be "qualified" This means that a note will be included on the sample result and "Chain of Custody" specifying the deviation. The laboratory is also required to send a letter to the State noting the deviations. 2) Sample Temperature. Samples for compliance monitoring must be chilled with wet ice to a temperature of 6C or less. Freezing is not permitted. Samples delivered to the lab shortly after collection may not have had enough time to be chilled below 6C. In this case the temperature at time of collection must be noted in the space provided. The samples will meet the requirements of the regulation if there is a temperature drop from the time of collection until received in the lab. Regardless, all samples should be packed in wet ice using as much ice as will fit in the cooler. 3) Sample Chemical Preservation. Many samples require a chemical preservation such as Sulfuric Acid or Sodium Hydroxide. The laboratory will either provide the preservative in the sample bottle, or in the case of 40 ml. Volatiles Vials, provide a bottle of Acid with detailed instructions on how to collect the sample. Never rinse sample bottles before collecting samples. Any residue or liquid in the bottle is required for proper chemical preservation. Unless specific instructions are provided for a test or bottle (example: cyanide or volatile organics), fill sample bottles to the bottom of the bottle threads. This will leave a small air space for shaking the sample to mix with any preservative and again prior to analysis. The lab must verify proper chemical preservation upon arrival in the lab and will note this information in the spaces provided on the front of this form. 4) Chlorine Neutralization. Some samples require that any Total Chlorine Residual be removed at the time of collection. The lab will provide the proper neutralizing agent in the sample bottle when technically possible. There are some samples (Total Kjeldahl Nitrogen and Ammonia Nitrogen) where this is not possible due to interferences between the required chemical preservation (Acid) and the dechlorinating agent. Therefore, these samples must be de -chlorinated at the time of collection before being placed in our sample bottles. Sodium Thiosulfate is the chemical of choice to neutralize chlorine. It must be added to your sample and then the sample checked for Total Chlorine before the sample is poured in our bottle. Facilities using chlorine for disinfection should have a means of measuring Total Chlorine. Non -chlorinated sample sources will not need to be checked. The person neutralizing the chlorine must put his initials in the "Chlorine Neutralized at Collection" row on the front of this form above the proper parameter. Samples such as Coliforms (which have Thiosulfate in the bottles shipped from the lab) will be checked for proper neutralization upon arrival in the lab. It is also required that you note the "Total Chlorine at Collection" on the front of this form for any sample locations applicable. This value would be before any neutralization is performed. 5) A "C" for Composite Sample or a "G" for Grab Sample should be placed in the box for all requested parameters. Grab temperatures as well as Composite start dates and times can be recorded in the "comments" section. 6) Other information required to be completed by the client are: Collection Date and Collection Time for each sample location Temperature at Time of Collection Printed name of person or persons collecting samples Signature, Date, and Time samples are relinquished Other added sample locations and analyses required Type Of Disinfection Deletion on the form for any samples which are not needed (example: dry upstream location) Any other information felt to be pertinent should be included in the "Comments" section CONSIDERATIONS: Coliform and Enterococci samples have a holding time of 6 hours from time of collection to time of analysis. Therefore, samples should be collected as late in the day as possible to allow enough time for transportation, checking in at the lab and analysis. BOD, Nitrate, Ortho Phosphorus, Settleable Matter, Turbidity, Color, and MBAS samples have a 48 hour holding time. The lab reserves the right to establish required sample collection and delivery dates in order to meet the required holding times. CAUTION Sample bottles may contain acids or other corrosive and potentially harmful chemicals. Laboratories are required to add these chemicals for certain analyses in order to comply with EPA preservation requirements. Use extreme care when opening and handling the shipping container and bottles. If any chemical should get into your eyes, on your skin or on your clothes, flush liberally with water and seek medical attention. Material Safety Data Sheets (MSDS) are available upon request which specify proper handling and personal protection. Environment 1, Inc. CHAIN OF CUSTODY RECORD P.O. Box 7085, 114 Oakmont Dr. Page 1 of 1 Greenville, NC 27858 environment 1 inc.com DISINFECTION CHLORINE NEUTRALIZED AT COLLECTION Phone (252) 756-6208 • Fax (252) 756-0633 CHLORINE CLIENT: 254 Week: 46 Ij UV a- L t G pH CHECK (LAB) GOWN OF WOODLAND '.O. BOX 297 NONE P P P P P P P G G G G G CONTAINER TYPE, P/G G C A C C A A E E E E E CHEMICAL PRESERVATION NOODLAND NC 27897 A - NONE D - NAOH m o 252) 587-7161 L w z -� N M C B- HNO E HCL 00 oc0 � z CL o 7 U C 3 _ A A A A c w C- H,SO, F- ZINC ACETATE/NAOH COLLECTION 0 a a o o Lp a 8 o o 0 0 0 0 o 0 N cc G- NATHIOSULFATE SAMPLE LOCATION DATE TIME e C , �9 n. I l / 7 Z 11 :.. :: :: :: ::: .: :: :: :: :: : ...... ------ ....... ....... ....... CLASSIFICATION: WASTEWATER(NPDES) Well f{3 ©,G ` 9 DRINKING WATER DWR/GW SOLID WASTE SECTION CHAIN OF CUSTODY (SEAL) MAINTAINED DURING SHIPMENT/DELIVERY N SAMPLES COLLECTED BY: (Please Pri SAMPLES RECEIVED IN LAB AT °C REIN QUISHEJ� B (SIG.) SAMPLER) DATEITIME / REC�Y (SIG. DATEMME COMMENTS: l !c zo l�lSI I Z,'17 RELIN UISHED BY (SIG.) ATEli1ME RECEIVED BY ( DATE/TIME RELINQUISHED BY (SIG.) DATE/TIME RECEIVED BY (SIG.) DATE/TIME PLEASE READ Instructions for completing this form on the reverse side. Sampler must place a "C" for composite sample or a "G" for FORM #5 Grab sample in the blocks above for each parameter requested. N _ 384119 SAMPLING INSTRUCTIONS AND FORM COMPLETION FAILURE TO PROPERLY CHILL, CHEMICALLY PRESERVE, COLLECT IN PROPER BOTTLE TYPES, MEET REQUIRED HOLDING TIMES, NEUTRALIZE CHLORINE IN CHLORINE SENSITIVE SAMPLES, AND SEAL COOLERS WITH TAPE WILL RESULT IN SAMPLES BEING REJECTED BY THIS LABORATORY AS PER NORTH CAROLINA REGULATORY CODE. 1) Samples not falling within the required guidelines will need to be re -collected. The client will be contacted and informed of any deviation and asked to collect another set of samples. The client may request the laboratory to proceed with the analyses of the current samples. Any samples analyzed outside of the required guidelines will be "qualified" This means that a note will be included on the sample result and "Chain of Custody" specifying the deviation. The laboratory is also required to send a letter to the State noting the deviations. 2) Sample Temperature. Samples for compliance monitoring must be chilled with wet ice to a temperature of 6C or less. Freezing is not permitted. Samples delivered to the lab shortly after collection may not have had enough time to be chilled below 6C. In this case the temperature at time of collection must be noted in the space provided. The samples will meet the requirements of the regulation if there is a temperature drop from the time of collection until received in the lab. Regardless, all samples should be packed in wet ice using as much ice as will fit in the cooler. 3) Sample Chemical Preservation. Many samples require a chemical preservation such as Sulfuric Acid or Sodium Hydroxide. The laboratory will either provide the preservative in the sample bottle, or in the case of 40 ml. Volatiles Vials, provide a bottle of Acid with detailed instructions on how to collect the sample. Never rinse sample bottles before collecting samples. Any residue or liquid in the bottle is required for proper chemical preservation. Unless specific instructions are provided for a test or bottle (example: cyanide or volatile organics), fill sample bottlestbFpf.the. bottle threads. This will leave a small air space for shaking the sample to mix with any preservative and again prior to analysis. 'the lab must verify proper chemical preservation upon arrival in the lab and will note this information in the spaces providc4,on the fronto€this (Qrm„ 4) Chlorine Neutralization. Some samp*s+r tdre that and Total Chlorine Residual be removed at the time of collection. The lab will provide the proper neutralizing agent in the sample bottle when technically possible. There are some samples (Total Kjeldahl Nitrogen and Ammonia Nitrogen) where FM is ndt possible due 1b interferences between the required chemical preservation (Acid) and the dechlorinating agent. Therefore, these sampl mpst be de-c lorinated at the time of collection before being placed in our sample bottles. Sodium Thiosulfate is the chemical of choictto n(utralize'Klorine. It must be added to your sample and then the sample checked for Total Chlorine before the sample is pound in our bottle. Fa 'lities using chlorine for disinfection should have a means of measuring Total Chlorine. Non -chlorinated sample sources will not need toe checked. The person neutralizing the chlorine must put his initials in the "Chlorine Neutralized at Collection" row orphe front oftlls form above the proper parameter. Samples such as Coliforms (which have Thiosulfate in the bottles shipped from the lab) will be checked for proper neutralization upon arrival in the lab. It is also required that you note the "Total Chlorine at Collection" on the front of this form for any sample locations applicable. This value would be before any neutralization is performed. 5) A "C" for Composite Sample or a "G" for Grab Sample should be placed in the box for all requested parameters. Grab temperatures as well as Composite start dates and times can be recorded in the "comments" section. 6) Other information required to be completed by the client are: Collection Date and Collection Time for each sample location Temperature at Time of Collection Printed name of person or persons collecting samples Signature, Date, and Time samples are relinquished Other added sample locations and analyses required Type Of Disinfection Deletion on the form for any samples which are not needed (example: dry upstream location) Any other information felt to be pertinent should be included in the "Comments" section CONSIDERATIONS: Coliform and Enterococci samples have a holding time of 6 hours from time of collection to time of analysis. Therefore, samples should be collected as late in the day as possible to allow enough time for transportation, checking in at the lab and analysis. BOD, Nitrate, Ortho Phosphorus, Settleable Matter, Turbidity, Color, and MBAS samples have a 48 hour holding time. The lab reserves the right to establish required sample collection and delivery dates in order to meet the required holding times. CAUTION Sample bottles may contain acids or other corrosive and potentially harmful chemicals. Laboratories are required to add these chemicals for certain analyses in order to comply with EPA preservation requirements. Use extreme care when opening and handling the shipping container and bottles. If any chemical should get into your eyes, on your skin or on your clothes, flush liberally with water and seek medical attention. Material Safety Data Sheets (MSDS) are available upon request which specify proper handling and personal protection.