WQ0029653_Monitoring - 11-2020_20210108 (2)

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
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: Expiration Date: 2/28/2026
Facility Name: SCOTCH HALL PRESERVE WWTP
Non -Discharge WQ0029653 UIC
Permit Name (if different):
NPDES Other
Facility Address: MERRY HILL
TYPE OF PERMITTED OPERATION BEING MONITORED
MERRY HILL "' `' NC
27957 County BERTIE
❑ Lagoon ❑ Remediation: Infiltration Gallery
(C"' (Staff..
❑■ Spray Field ❑Remediation:
Contact Person: BRIAN JERNIGAN
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:SCOTCH HALL PRESERVE
No. of wells to be sampled: 3
❑ Water Source Heat Pump ❑ Other:
from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW1
Date sample collected: 11/16/2020
FIELD ANALYSES:
WAS
Well Depth: 20 ft.
Well Diameter: 2 in.
pH 00400: 5.2 units Temp. 000lo: 20 °C
DRY at
Depth to Water Level 82546:4•8 ft. below measuring point Screened Interval: 5 ft.
to 20
ft. Spec. Cond. 00094: µMhos
time of
sampling,
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation:
ft.
Odor 000m: N/D
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: 11 /1612020
Laboratory Name: ENVIRONMENTAL CHEMISTS INC Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 <0.02
mg/L
Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 25
/100mL
Nitrate (NO3) as N 00620 .12
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 0.43
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300 93
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 5.20
units
Ba - Barium 01007
ug/L
I
TOC 0068o 2.7
mg/L
Ca - Calcium 00916
g/L-��-
Chloride 00940 9
mg/L
Cd - Cadmium 01027
ye/L
Arsenic 01002
ug/L
Chromium: Total 01o34 j
/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)
pecific Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia 00610 <0.2
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 •12
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%
DANIEL SUMEREL, GENERAL MANAGER
Permittee (or Authorized Aqent) Name and Title - Please print or type
GW-59 Rev.06-07-2018

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
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: Expiration Date: 2/28/2026
Facility Name: SCOTCH HALL PRESERVE WWTP
Non -Discharge WQ0029653 UIC
Permit Name (if different):
NPDES Other
Facility Address: MERRY HILL
TYPE OF PERMITTED OPERATION BEING MONITORED
MERRY HILL (Street; NC
27957 CountyBERTIE
❑Lagoon El Remediation: Infiltration Gallery
(State)
(Zip!
A Spray Field El Remediation:
Contact Person: BRIAN JERNIGAN
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:SCOTCH HALL PRESERVE
No. of wells to be sampled: 3
❑ Water Source Heat Pump ❑ Other:
from Permit
36MPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW2
Date sample collected: 11/16/2020
FIELD ANALYSES:
WAS
Well Depth: 20 ft.
Well Diameter: 2 in.
pH 00400: 4.6 units Temp. 000lo: 19.2 °C
DRY at
Depth to Water Level 82546:11.6 ft. below measuring point Screened Interval: 5 ft.
to 20
ft. Spec. Cond. 00094: µMhos
time ofsampling,
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation:
ft.
Odor 00085: N/D
check
Volume of water pumped/bailed before sampling:
4.5
gallons
Appearance TAN
here: El
Samples for metals were collected unfiltered: ® YES
❑ NO and field acidified: X YES
❑ NO
LABORATORY INFORMATION
Date sample analyzed:11/16/2020
Laboratory Name: ENVIRONMENTAL CHEMISTS INC Certification No. 94
PARAMETERS NOTE: Values should reflect
dissolved
and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 <0.02
mg/L Pb - Lead olo51 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 <0.02
mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P006650.47
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
issoived Solids:Total 703oo 42
mg/L
Al - Aluminum oilo5
mg/L
pH (Lab) 00403 4.6
units
Ba - Barium 01007
ug/L
TOC 00680 2.5
mg/L
Ca - Calcium oo916
mg/L
Chloride 00940 <5
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•2
mg/L
Mg - Magnesium 00927
mg/L method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L method #
TKN as N 00625 <0.02
mg/L
Ni - Nickel 01067
ug/L method #
Far Remediation Systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
DANIEL SUMEREL, GENERAL MANAGER
ftirmittee (or Authorized Aqent) Name and Title - Please print or type
r
(or Authorized Agent)
WISE
GW-59 Rev.06-07-2018

SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
• •
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: Expiration Date: 2/28/2026
FAcility Name: SCOTCH HALL PRESERVE WWTP
Non -Discharge WQ0029653 UIC
Permit Name (if different):
NPDES Other
Focility Address: MERRY HILL
TYPE OF PERMITTED OPERATION BEING MONITORED
MERRY HILL "` "" NC
27957 CountyBERTIE
El Lagoon ❑Remediation: Infiltration Gallery
® Spray Field ❑ Remediation:
Dpntact Person: BRIAN JERNIGAN
Telephone#: [phone]
ElRotary Distributor ElLand Application of Sludge
Well Location/Site Name:SCOTCH HALL PRESERVE
No. of wells to be sampled: 3
❑ Water Source Heat Pump ❑ Other:
from Permit
SIMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): MW3
Date sample collected: 11/16/2020
FIELD ANALYSES:
WAS
Well Depth: 20 ft.
Well Diameter: 2 in.
pH 00400: 7.30 units Temp. 000lo: 19.5 °C
DRY at
Depth to Water Level 82546:14.9 ft. below measuring
point Screened Interval: 5 ft.
to 20
ft. Spec. Cond. 00094: µMhos
time of
sampling,
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation:
ft.
Odor 00085: N/D
check
Volume of water pumped/bailed before sampling:
2
gallons
Appearance BROWN
here:❑
S@m les for metals were collected unfiltered: ® YES
❑ NO and field acidified: N YES
❑ NO
BORATORYINFORMATION
D@te sample analyzed:11/1612020
Laboratory Name: ENVIRONMENTAL CHEMISTS INC Certification No. 94
IbARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615 <0.02
mg/L Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 <1
/100mL
Nitrate (NO3) as N 00620 0.02
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL
Phosphorus: Total as P 00665 0.95
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L Other (Specify Compounds and Concentration Units):
igsolved Solids:Total 703oo 61
mg/L
Al - Aluminum 01105
mg/L
pH (Lab) 00403 7.30
units
Ba - Barium 01007
ug/L
TOC 00680 <0.5
mg/L
Ca - Calcium 00916
mg/L
Chloride 0094o 6
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)
cific Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia 00610 <0.2
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3 as N; Ammonia Nitrogen, Total)
Mn - Manganese o1o55
ug/L
method #
TKN as N 00625 0.02
mg/L
Ni - Nickel 01067
ug/L
method #
Ate' Remediation Systems Only (Attach Lab Reports)
QANIEL SUMEREL, GENERAL MANAGER
ittee (or Authorized Aqent) Name and Title - Please print or type
Influent Total VOCs:
mg/L Effluent Total VOCs:
mg/L
VOC Removal%
GW-59 Rev.06-07-2018

Environmental Chemists,
Inc.
• ;7
6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
sM
255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS
[e-mail]
Scotch Hall Preserve
Date of Report: Dec 01, 2020
105 Scotch Hall Court
Manteo Report #: 20M-2062
Merry Hill NC 27957
Report #: 2020-19518
Attention: Brian Jernigan
Customer ID: 17050011
Project ID: Monitoring Wells
Lab ID Sample ID:
Collect Date/Time
Matrix Sampled by
20-49650 Site: MW-1
11/16/2020 8:29 AM
Water Tom Beasley
Test
Method
Results Date Analyzed
Color
Color
Clear
11/16/2020
Depth to water, ft.
Depth to water, Ft
4.8 feet
11/16/2020
Ammonia Nitrogen
EPA 350.1
< 0.2 mg/L
11/20/2020
Gallons bailed before sampling
Gallons Bailed before sampling
4.0 gallons
11/16/2020
Odor
Qualitative
N/D
11/16/2020
Total Dissolved Solids (TDS)
SM 2540 C
93 mg/L
11/18/2020
Temperature
SM 2550 B
20.0 C
11/16/2020
Chloride
SM 4500 Cl E
9 mg/L
11 /24/2020
pH
SM 4500 H B
5.20 units
11/16/2020
Total Phosphorus
SM 45M P F
0.43 mg/L
11 /24/2020
Total Organic Carbon (TOC)
sM 5310 B
2.7 mg/L
11/17/2020
Nitrate Nitrogen (Calc)
Nitrate+Nitrite-Nitrogen
EPA353.2
0.12 mg/L
11/23/2020
Nitrate Nitrogen
Subtraction Method
0.12 mg/L
12/01 /2020
Lab ID Sample ID:
Collect Date/Time
Matrix Sampled by
20-49651 Site: MW-2
11/16/2020 8:10 AM
Water Tom Beasley
Test
Method
Results Date Analyzed
Color
Color
Tan
11/16/2020
Depth to water, ft.
Depth to Water. Ft.
11.6 feet
11/16/2020
Ammonia Nitrogen
EPA350.1
<0.2 mg/L
11/20/2020
Gallons bailed before sampling
Gallons Bailed before sampling
4.5 gallons
11/16/2020
Odor
Qualitative
N/D
11/16/2020
Total Dissolved Solids (TDS)
SM 2540 C
42 mg/L
11 /18/2020
Temperature
SM 2550 B
19.2 C
11/16/2020
Chloride
SM 4500 C1 E
< 5 mg/L
11 /24/2020
pH
sM4500HB
4.60 units
11/16/2020
Total Phosphorus
SM 45M P F
0.47 mg/L
11 /24/2020
Total Organic Carbon (TOC)
SM 5310 B
2.5 mg/L
11/17/2020
Nitrate Nitrogen (Calc)
Nitrate+Nitrite-Nitrogen
EPA 353 2
< 0.02 mg/L
11 /23/2020
Nitrate Nitrogen
Subtraction Method
<0.02 mg/L
12/01 /2020
Report #:: 2020-19518 Page 1 of 3

• Environmental Chemists, Inc.
6602 Windmill Way, Wilmington, NC 28405 • 910.392,0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 • 252.473.5702 Lab/Fax
sm. 255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS [e-mail]
Scotch Hall Preserve
Date of Report: Dec 01, 2020
105 Scotch Hall Court
Manteo Report #: 20M-2062
Merry Hill NC 27957
Report #: 2020-19518
Attention: Brian Jernigan
Customer ID: 17050011
Project ID: Monitoring Wells
Lab ID Sample ID:
Collect Date/Time
Matrix Sampled by
20-49652 Site: MW-3
11/16/2020 7:52 AM
Water Tom Beasley
Test
Method
Results Date Analyzed
Color
Color
Brown
11/16/2020
Depth to water, ft.
Depth to water Ft
14.9 feet
11/16/2020
Ammonia Nitrogen
EPA 3501
< 0.2 mg/L
11/20/2020
Gallons bailed before sampling
Gallons Bailed before sampling
2.0 gallons
11/16/2020
Odor
Qualitative
N/D
11/16/2020
Total Dissolved Solids (TDS)
SM 2540 C
61 mg/L
11 /18/2020
Temperature
SM 2550 B
19.5 C
11/16/2020
Chloride
SM4500CIE
6 mg/L
11/24/2020
pH
SM 4500 H B
7.30 units
11/16/2020
Total Phosphorus
SM 4500 P F
0.95 mg/L
11/24/2020
Total Organic Carbon (TOC)
SM 5310 8
<0.5 mg/L
11/17/2020
Nitrate Nitrogen (Calc)
Nitrate+Nitrite-Nitrogen
EPA353.2
0.02 mg/L
11/23/2020
Nitrate Nitrogen
Subtraction Method
0.02 mg/L
12/01/2020
Lab ID Sample ID: M-3598
Collect Date/Time
Matrix Sampled by
20-49654 Site: MW-1
11/16/2020 8:29 AM
Water Tom Beasley
Test
Method
Results Date Analyzed
Fecal Coliform
Idexx Colilert- 18
25 MPN/100ml
11/16/2020
Nitrite Nitrogen
SM4500NO2-B
<0.02 mg/L
11/17/2020
Lab ID Sample ID: M-3599
Collect DatelTime
Matrix Sampled by
20-49655 Site: MW-2
11/16/2020 8:10 AM
Water Tom Beasley
Test
Method
Results Date Analyzed
Fecal Coliform
IdexxColilert-18
<1 MPN/100ml
11/16/2020
Nitrite Nitrogen
SM4500NO2-B
<0.02 mg/L
11/17/2020
Lab ID Sample ID: M-3600
Collect Date/Time
Matrix Sampled by
20-49656 Site: MW-3
11/16/2020 7:52 AM
Water Tom Beasley
Test
Method
Results Date Analyzed
Fecal Coliform
IdexxColilert-18
<1 MPN/100ml
11/16/2020
Nitrite Nitrogen
SM4500NO2-B
<0.02 mg/L
11/17/2020
Report #::2020-19518 Page 2 of 3

Environmental Chemists, Inc.
envirochem 6602 Windmill Way, Wilmington, NC 28405 • 910.392.0223 Lab • 910.392.4424 Fax
710 Bowsertown Road, Manteo, NC 27954 + 252.473.5702 Lab/Fax
sM 255-A Wilmington Highway, Jacksonville, NC 28540 • 910.347.5843 Lab/Fax
ANALYTICAL & CONSULTING CHEMISTS info@environmentalchemismcom
Scotch Hall Preserve Date of Report: Dec 01, 2020
105 Scotch Hall Court Manteo Report #: 2OM-2062
Merry Hill NC 27957 Report M 2020-19518
Attention: Brian Jernigan Customer ID: 17050011
Project ID: Monitoring Wells
Comment:
Reviewed by: t
Report #:: 2020-19518 Page 3 of 3

Date: t,-,�j-Z� �� /rtificationd qt
r Facitit% Name: �JC ]�fJ U
Anaisst: j �] - 3
Permit if; �e[•-Y�s,"�Q
PH
Ca' Ca` Bu
Ref rence Atatbod SM45i0 H-B -2011 instrument [D I� �1 - c70
ratio- T,me ti_, ; [ s u Ca' Buffer 17.0 s u Check Buffer 7 C s u
Comm:-t!S
�7140 `i U ``' rv, d� ``' (`)
`1.
'pH check buaar musl read a ithln 0 I pH units of tr._ b.Ciar's true %
4Subt:ff rLot= Ricca 200i620 Exa1i2022 7 a!Je
s biffer Lot= •• Ricca 2 O8993 Ex:;. 7 2020-
10 su buffer Low. Ricca 100179 i 7 2' ' 1
Sample Co'iection 53rtp' H Res ! ► r
Sa:rp'e lxa>:cr � : Arz'•ais ~
Time • F Post-anti:%;s B ffar
Time s u Check %a!ue s ❑ , Comrer.G D, Q a! t
Z 0 7 2 7. I
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fit= 0� d d 8qd .34 1 7, v S
► Post ana'};t; beferch:eck is re,air-d ti. I per fam rg ana[t;a; at mu!tipla szmI — ivcatiorS aad rr.-,;t ba ;%ith:n 0 t un;ts ofth_ %ar e
Al PH t a' -; in pH u,-.it; ri e , s u i ne:ard ail data to the nearest 0 01 s u and report to the mare;! 0 [ s u
Total Residual Chlorine (TRC)
Re(:rence Meth<od S`.I 45[:O Ci-G2011 Hach 8167 HR
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C hr:h t3,nd.trdi mus! reco%ar ttithin_!0%ofth: heck tand3rds trueazCePaaloe ran=e.__ i _ __ ._}i4 i or m? 1.
Anruul Ca!i^raG,:n Cune Verification Date
R:a_.r,t Wank Value 30 APlZ Zv z t
_ .____(�1'hcn appllt ably 1n31%�r aad document a reagent blank %then sianduJs. Sample diii.iOns or PT Sampl,; arc p11p31,d
Dissolved Oxcgen (DO)
R ^ar:rca \Lthnd S, d55G O G.-?•J I I
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i
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1Te an.. %zed l%ou!d be re:vrdeJ, Lit±,? a r.or !::a: L?a• dra meliafe..+ !^ iitL Ur Ira Tt,a. a:a't ..
Temperature
'Sam Re[:rence Sfethod Ski 255J B-3GtG instrument ID P C-) O
f Sample i In;.ntme
S:rn;:': Letza:c Collet P!e Temperate„
-ace A-ahss •C r
Time i Time Comment; Da:a Qt.a t:
Ma{1 .3 075Z q 7) Z. �' f
M� Z t r� i Z
M w D Z © ,?Z
to
lets measa?wn Date rzd d:re-tit !r. 'he s±rear- 3r4 ororsite. Dr
nnc:a' t• �_nr;cation at t: ne 3.na!%zed t%d x + recorded. u:rh a rota that :he. are measured in si:v or immedVata'%
��- cu!
Field Personnel .\are•
Rev 9 2020 Q k'00I

Environmental Chemist, Inc., Wilmington, NC tab #94 6602 Windmill W,
Wilmington, NC 284{
910.392.021
Sample Receipt Checklist
Client CCC` 4 A L-1 P(QS Date: ` � I� 2(7. Report Number: W 4 t S f
Receipt of sample: E HEM Pickup ❑ Client Delivery ❑ UPS FedEx ❑ Other ❑
❑ YES ❑ NO Pg N/A 11. Were custody seals present on the cooler?
❑ YES 10,_ NO 19 N/A 2. If custody seals were present, were they intact/unbroken?
Original temperature upon receipt °C Corrected temperature upon receipt °C
How temperature taken: ❑ Temperature Blank Against Bottles
IR Gun ID: Thomas Traceable S/N 192511657 IR Gun Correction Factor °C: 0.0
❑
YES
10
NO
1 3. If temperature of cooler exceeded 6°C, was Project Mgr./QA notified?
YES
10
NO
4. Were proper custody procedures (relinquished/received) followed?
YES
10
NO
5. Were sample ID's listed on the COC?
16.
YES
10
NO
Were samples ID's listed on sample containers?
YES
10
NO
7. Were collection date and time listed on the COC?
YES
❑
NO
1 8. Were tests to be performed listed on the COC?
YES
❑
NO
1 9. Did samples arrive in proper containers for each test?
YES
10
NO
110. Did samples arrive in good condition for each test?
YES
10
NO
Ill. Was adequate sample volume available?'
YES
10
NO
112. Were samples received within proper holding time for requested tests?
YES
10
NO
113. Were acid preserved samples received at a pH of <2?
❑
YES
I ❑
NO
114. Were cyanide samples received at a pH >12?
❑
YES
10
NO
115. Were sulfide samples received at a pH >9?
YES
❑
NO
116. Were NH3/TKN/Phenol received at a chlorine residual of <0.5 m/L? **
❑
YES
❑
NO
17. Were Sulfide/Cyanide received at a chlorine residual of <0.5 m/L?
❑
YES
10
NO
118. Were orthophosphate samples filtered in the field within 15 minutes?
* TOC/Volatiles are pH checked at time of analysis and recorded on the benchsheet.
** Bacteria samples are checked for Chlorine at time of analysis and recorded on the benchsheet_
Sample Preservation: (Must be completed for any sample(s) incorrectly preserved or with headspace)
Sample(s) were received incorrectly preserved and were adjusted accordingly
by adding (circle one): H2SO4 HNO3 HCI NaOH
Time of preservation: If more than one preservative is needed, notate in comments below
Note: Notify customer service immediately for incorrectly preserved samples. Obtain a new sample or
notify the state lab if directed to analyzed by the customer. Who was notified, date and time:
Volatiles Sample(s) were received with headspace
COMMENTS:
DOC. QA.002 Rev 1

Way
dmill
ENVIRONMENTAL CHEMISTS, INC OFFI E'n910.3 2022311FAX 9t10-3922-44245
Analytical & Consulting Chemists NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 [e-mail]
Cril 1 I=rTlntJ Akin r_41AIi r1G r 1l ICTnnv
Client: Scotch Hall Preserve
PROJECT NAME: Monitoring Wells
REPORT NO:
ADDRESS: 105 Scotch Hall Court
CONTACT NAME: Brian Jernigan
PO NO: Z
Merry Hill, NC 27957
REPORT TO:
PHONE/FAX:
COPY TO: Rick Harrell [e-mail]
email: [e-mail]
Sampled Bv: SAMPLE TYPE I = Influent F = Fffluant W = Wall CT = Cfrn!am cn = Binh Qi - c�as nrti...•
Sample Identification
Collection
E
A f.
�'
a o
E
co
c a
a
; �,
t E
"
m
z
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp
W
z
Z
g
_"
.,
o
r
_
0
z
9
«
=
o
MW:
-IG-ZD
C
P
30
X
Chloride, NO2, TDS
G
G
Depth to water: ��
(?
LD
C
P
��
4Cf (5
x
`
NH3,NO3, TP
G
G
Gallons Bailed: .
C
P
X
Fecal Coliform
G
G
pH (field): 5,
C
P
X
ITOC
G
G
Color: �� �
C
P
G
G
Odor: �j 0
C
P
G
G
C
P
G
G
C
P
G
G
C
P
G
G
Total of 3 wells (1,2,3) due March, July,
November
Transfer
Relinquished By:
Date/Time
Received By:
Date/Time
210
2.
cnlFulcatulu vnncll cL.cwctKesample equ7%��
Delivered B 9-�.p�
y: Received By: Date: j ,
Comments: TI tRktORnl tin•

Way
ton, NC
dmill
ming
ENVIRONMENTAL CHEMISTS, INC OFFI E'n 10392-0223'IFAX910-392-44245
Analytical 8 Consulting Chemists
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY
Client: Scotch Hall Preserve
PROJECT NAME: Monitoring Wells
REPORT NO: 0C' D`
ADDRESS: 105 Scotch Hall Court
CONTACT NAME: Brian Jernigan
PO NO: 7- C)
Merry Hill, NC 27957
REPORT TO:
PHONE/FAX:
COPY TO: Rick Harrell [e-mail]
email:[e-mail]
Sampled B SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludge, Other:
Sample Identification
Collection
m
p T
N a
C `o 2
u
ct�
c `o
toi a
m
c�
o rn
v E
ow
mR g
J Z
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp
z
i
=
$
_
o
=
o
z
g
~
w
o
MW:
C
P
X
Chloride, NO2, TDS
G
G
Depth to water:
C
P
4
����
X
JNH3,NO3, TP
G
G
Gallons Bailed:
„
C
P
X
Fecal Coliform
G
G
�7
pH (field). "� r `� r
C
P
X
TOC
G
G
Coior qyj
C
P
G
G
Odor: 0
C
P
11- -2-0
610
G
G
C
P
G
G
C
P
G
G
C
P
G
G
Total of 3 wells (1,2,3) due March,
July, November
Transfer
Relinquished By:
Date/Time
Received By:
Datefrime
If 4-�
2. IV
Tempdfature when Received *C: .fr^ (_ '�Acce<1615ed: % R ilected: F Resample Req ested:_
Delivered By: �. LC Received By: -_ -V C�r4_ SZ-��`- ` Date: t l Time:
Comments: i TURNAROUND:

dm
ton
ENVIRONMENTAL CHEMISTS, INC OFFICE,n910'392-0223iFAXg910-392-44245
Analytical 8 Consulting Chemists
NCDENR: DWQ CERTIFICATION # 94 NCDHHS: DLS CERTIFICATION # 37729 [e-mail]
COLLECTION AND CHAIN OF CUSTODY
Client: Scotch Hall Preserve
PROJECT NAME: Monitoring Wells
REPORT NO:
ADDRESS: 105 Scotch Hall Court
CONTACT NAME: Brian Jernigan
PO NO:
Merry Hill, NC 27957
REPORT TO:
PHONE/FAX:
COPY TO: Rick Harrell [e-mail]
email: [e-mail]
Sampled By: 13 SAMPLE TYPE: I = Influent, E = Effluent, W = Well, ST = Stream, SO = Soil, SL = Sludoe. Other:
Sample Identification
Collection
a
E
w a
E `o
C
U
m _
r
o
C a
u
C
c o�
L E>
"
o ul
m co
PRESERVATION
ANALYSIS REQUESTED
Date
Time
Temp
O z
z
u
o
h
_
0
z
0
a
z
o
=
~
w
o
MW.
it -( -20
075 2
C
P
3
Q©
X
Chloride, NO2, TDS
G
G
�!
Depth to water: It 1 I�
��j , `�
C
P
��
X
`.
INH3,NO3, TP
G
G
Gallons Bailed: Z. J
C
P
X
Fecal Coliform
G
G
pH (field): 7
C
P
X
TOC
G
G
Color:
C
P
G
G
Odor: D-J
C
P
-ZO0
7-57T
G
G
C
P
G
G
C
P
G
G
C
P
G
G
Total of 3 wells (1,2,3) due March,
July,
November
Transfer
Relinquished By: 4>
DatelTime
Received By:
Date/Time
2.
Temperatuw when Received 'C: .4 V5- C Actepted: _ Rej cted: Resample Requested.
Delivered By: �, Received By, L' Date: ' ' ' �� Time: �y
Comments: TUR AR UND: