Loading...
HomeMy WebLinkAboutNCG030166_MRO Copy MONITORING REPORT_20201030NCDEQ Division of Energy, Mineral and Land Resources Stormwater Discharge Monitoring Report (DMR) Form for N00030000 Metal Fabrication Click here for instructions Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload form within 30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office. Certificate of Coverage No. NCG03 0 1 6 6 Person Collecting Samples: Doug Simmons Facility Name: Lincolnton Bearing Plant Laboratory Name: Pace Analytical Facility County: Lincoln 0 Laboratory Cert. No.: 5342 Discharge during this period: 0 Yes ❑ No (if no, skip to signature and date) Has your facility implemented mandatory Tier response actions for any benchmark exceedances? ❑ Yes ❑ No If so, which Tier (I, II, or III)? Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red) Parameter Code Parameter Outfall )01 Outfall Outfall Outfall Outfall N/A Receiving Stream Class water supply N/A Date Sample Collected MM/DD/YYYY 09/17/2020 46529 24-Hour Rainfall in inches 2" 00552 Non -Polar Oil & Grease in mg/L (15) <5.0mg/I o; o C0530 TSS in mg/L (100 or 50*) 6.2mg/1 00400 pH in standard units (6.0 — 9.0) 7.18 NCOIL New Motor/Hydraulic Oil Usage in 0•0 m 3 gal/month 01119 Copper, total recoverable in mg/L <0.005mg/1 m (0.010 FW, 0.005 SW) 01051 Lead, total recoverable in mg/ L <0.005m /I g (0.075 FW, 0.220 SW) 01094 Zinc, total recoverable in mg/ L (0.3.26 <0.010m /1 g FW, 0.095 SW) 78141 Total Toxic Organics (TTO) in mg/L(1) * Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA) have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L. Motes (option a I): Metal Fabrication General permit. TTO not required.Original report mailed to Central File. Copy including analyticals attached with this submittal to DEMLR Mooresville "I certify by my signature below, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." / / 4�' Signature of Permittee or Delegated Authorized Individual /U -2� vz t7 Date TIMKEN Where You Turn Douglas R. Simmons Sr. Environmental Engineer The Timken Company Mail Code: LIN-01 1000 Timken Place Iron Station, N.C. 28080 Telephone: (704)736.2783 Facsimile: (704) 736-2930 doug.simmons 0limken.com s CERTIFIED MAIL RETURN RECEIPT REQUESTED Q ,-° G October 16, 2020 ;: Attn: Central Files' Division of Water Resources (DWR) 1617 Mail Service Center Raleigh, NC 27699-1617 Re: Certificate of Coverage No. NCG030166 Enclosed is the discharge monitoring report (SDMR) signed by Lincolnton Bearing Plant manager Marty Hallman and the analytical results from storm water sampling completed at the Timken Company's Lincolnton Bearing Plant located at Iron Station, N.C. This sampling was performed to comply with the analytical monitoring requirements of the LBP's Metal Fabrication Storm Water General Permit, Certificate of Coverage NCG030166, which requires sampling once during the first and second half of each year respectively. The attached analytical reports and Storm water discharge monitoring report is for the 2nd Half of 2020 Sincerely, / l / 6 /(. ZC] Douglas R. Simmons Sr. Environmental Engineer Enclosure - Pace Storm water analytical results report # 92496057 - Signed Semi-annual Storm Water Discharge Monitoring report Cc: Gensuite Task — Storm Water monitoring Lincolnton Storm water hardcopy File — LIN-0I aa � a� a" L s E ni u7 L Jf~ L N I � n 0 , � tH N E10❑ CC O QQ Go oID ua S ui Lai a m C z N rWq V 0. z z H O rr w ca w w in a. X. Q ice.+ a C3 U 'O NRECEIVED Ntth uENR-UEMLR Land Quality Section Mooresville Regional Office 9I . ._ �t1 J c u ..., a m z 2 a c o V a ""'► a U �2 UO0� � zE 0 w c0LU V u.U&5U O. to w It l�7 eam a E � g a 0.0 Q f Z o L a L CL N M N C ❑ M 0 LA o d a ~ o V U I. E m v m 0 r O Q v _ C G � 'a 0,J } 6L t0 G w Z H W O V V J E J ° o 1^Ir Vej1 a J Ln 0 to E IN 3 C , C N _ A Y a E L e C a% m E c � C �— C � a N a� > E A W a r m m aas C ,Q a ti Z N Q m s t C 00 41 CL E Vi yam, O 3 a G r 4 Cr Q C m , a ° " a atv Y c ` t`C E i U d E C ` .C•L t37 ri Ql C O m s to C C m ow: h a > oc IL v E ° U NCL a ..� to m u Cs cr C C 0 aiLn r C +_ m C y U a C t 4-w = m = ,o o2=ML.5� a� -a '''w E O vi � V m C 0 `o m m c C m ; a.r° v a E u � o f In th m m = QJ M G a L M� Mw r W Z m 'a -C Y C m,E..• c y, C E .. io m E Etw 0E�_ wwCLE� L L' CL _ tw La •tu 7 c E 'vf H 41 N }, G jo . +' E O E N 7 p ai p u. CI m v lq c C C.0 w m -0o .- c Ln m•xy o.�� � ca Cl U co v C i] oa C to C m e E t E a E a,• o 3 a `n LA yy{{ 'Q 'Y , V Q w W 7 0EcN��m CL a s °mL° ;Q � in 3 C Q ` u a m C O u a 0 l� ~ c c E o c a a C' E U. H vi Fq a r m v o aw E� a. oa L c o 0 m pa c co E c w o E O 0 o D A a a c N Q L Y 0CL N o c ax, > ° C Cl a d Q cu .. ro a E • � 0.C! O—Im � �+ a _ r- E [ � c ?; a a d 47 E i y m y L a w a c 3 ,� c n a v ° G a m o to E a E E O m ro a a r o E ru E ° Ln KL C L C t G O •=n 3 `D o E _ u o u 7 ,O o T O u a L o D a a oac E a c L ro ° 0 0 s .. to u _ 00 0 -0 c c a o m o a m E a c O O •C C 3:.c.> 0 c G n n C ao E o tw a _ .c m a r•�' C 0 t7 o 0 as =u d V J] L E u E (U acli C C© p C m c a cu C LA Q 4i C +' C m to E o Q E c a► a a•I a C c E o > u C a ' E .c y a Ecu « oa a ? R C « C C o E v a IA W LA y Ln C• C C > AV C m a m `o E o Q m E a to ro a c o c o a w n E t LO m 0 0 3 - e � "u a• � m w E CL d G v E 4 E m z E E .Q a m� V � E a Q c ai C ,. a a a E` C a 3 � w 'S a rt ro °1 E 0 z o J c v w E c t 0 a v c K 'K 0 4- 0 " Et c O m w in IA A C m a m a u m .a c 0 vi N OQ C O m a 4 u C m cc a c a u i t m a J d E C � a VCL I V 'A^ L 0 f" Ln u � O n � � c i FO- A � o � ' cis LM 0 E LM GZ = � S a a� 0 0 z a T�4 O �q N 0 O o w g� v z M Z � r c O E R ie d N m e v O t N a as Q! M E O E mm o z � v i Gq m t m a 0 a a 0 22 m Q X m CL N a « 0 pC �O _ [ U. a \ / 3 3 wd ) m \ � CL e ® 3 / uj � 0 \ z $ ° z z uj 'I < gg , Cr } ■ � k L.L. § k § \ §q� § § 2 o u �f / / k z I ,. � It § / $ ° § § C) 0 \ \ CC aft Ln o c / o / \§\Q 2 z & « L o z °b u k§ k LA k § § tf;I Lu 5 o b # z g 3 ) V � \ \ /}k\ :LL c 2 u o u m E _ \u Ulk m § ° 5 I k\§ac cu aka ƒ E /8 /7e a©m# {Ir E « k§� 3 7t2� ( m E \ / CL > , o E \ / } \ c cr @ k E \ / �oo- E io CL \ \ \ED OL e§E.\ a'nZ. ) \ \ m _ E \ E moo' } k \ U me\o m a � E E �g ] � 5 I27f r E (f } u _ - kA §gym 0 CL}0\\ CL �ƒ0 %§EE k>m m = ® kW Q w =�g !z IA 2 �k� � % Li § § % r ; a /m � ( � « \ . n � g \ » .77 4 * � § � { _ CL �",;a7ceAnalytical' rww.NcdatEsrom September 28, 2020 Mr, Doug Simmons Timken Company - Lincolnton Bearing Plant 1000 Timken Place Iron Station, NC 28080 RE Project Stormwater Kit Pace Project No 92496057 Dear Mr Simmons Pace Analytical Services, LLC 2C5 East Meadow Road - Suite A Eden. NC 27288 Q35)623-8921 Enclosed are the analytical results for sample(s) received by the laboratory on September 17 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 Bonnie Vang bonnie vang@pacelabs com (704)875-9092 Project Manager Enclosures cc Wendy Leonard Timken Steel REPORT OF LABORATORY ANALYSIS Th s report shall not be reproduced except .n full without the written:Ansenl of Pace Analytical Services ..._ Page 1 of 12 aceAnalytical trww.paulsh.tam Protect Stormwater Kit Pace Project No 92496057 Pace Analytical Services Charlotte 9800 Kincey Ave Ste 100, hluntersville NC 28078 LouisianalNELAP Certification # 1A170028 North Carolina Drinking Water Certification # 37706 North Carolina Field Services Certification # 5342 North Carolina Wastewater Certification # 12 Pace Analytical Services Asheville 2225 Riverside Drive, Asheville. NC 28804 Fiodda/NELAP Certification # E87W Massachusetts Certification # M•NC030 North Carolina Drinking Water Certification # 37712 CERTIFICATIONS South Carolina Certification # 99006001 FlondalNELAP Certification # E87627 Kentucky UST Certification # 84 VrginiaNELAP Certification # 460221 North Carolina Wastewater Certification # 40 South Carolina Certification # 99030001 UrginiaNELAP Certification # 460222 REPORT OF LABORATORY ANALYSIS This report she not he reproduced except in full without the written consent of Pace Analytical Services. i LG Pace Analytical Services, LLC 205 East Meadow Road • Suite Eden NC 27288 (336)623-8921 Page 2 of 12 (�IaceAnalytical' wwtepsabStl com SAMPLE ANALYTE COUNT Project Stormwater Kit Pace Project No 92496057 Pace Analytical Services, LLC 205 East Meadow Road - Suite A Eden NC 27288 (336)623.8921 Analytes Lab 10 Sample ID Method Analysts Reported Laboratory 92496057001 Stormwater Outtall #001 EPA 16648 HH 1 PASI-C EPA 200 7 Rev 4 4 1994 SH1 3 PASI-A SM 254OD-2011 RED 1 PASI-A 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 12 aceAnalytical WWW.Pacalaes.um ANALYTICAL RESULTS Pace Analytical Services, LLC 205 East Meadow Road - Suite A Eden, NC 27288 ;3W623-6921 Project Stormwater Kit Pace Project No. 92496057 Sample: Stormwater Outfall #001 Lab 10: 92496057001 Collected 09/17120 08 00 Received 09/17/20 11 16 Matrix Water Parameters Results Units Report Limit OF Prepared Analyzed CAS No Oual 1564 SGT•HEM, TPH Analytical Method EPA 1664E Pace Analytical Services - Chartotte Total Petroleum Hydrocarbons NO mg/L 50 1 09/24/20 09 32 200.7 MET ICP Analytical Method EPA 200 7 Rev 4 4 1994 Preparation Method EPA 200 7 Rev 4 4 1994 Pace Analytical Services - Asheville Copper ND ug/L 5 0 1 09123/20 17 45 09/25/20 00 38 7440-50.8 Lead ND ug/L 5 0 1 09123/20 17 45 09/25/20 00 38 7439-92-1 Zinc NO ug/L 100 1 09/23/20 17 45 09125/20 00 38 7440-66-6 2540D Total Suspended Solids Analytical Method SM 2540D-2011 Pace Analytical Services -Asheville Total Suspended Solids 6.2 mglL 3 1 1 09/22/20 01 21 Date 09128/2020 08 39 AM REPORT OF LABORATORY ANALYSIS This report shelf not be reproduced except n lull without the written consent of Pace Analytical Services. I i c. Page 4 of 12 aeeAnalytical arter.sacwahs-cats QUALITY CONTROL DATA Pace Analytical Services, LLC 205 East Meadow Road Suite A Eden 127288 .336)623.8921 Project Stormwater Kit Pace Project No 92496057 QC Batch 568623 Analysis Method EPA 16648 QC Batch Method EPA 1664E Analysis Description 1664 SGT-HEM TPH Laboratory Pace Analytical Services - Charlotte Associated Lab Samples 92496057001 METHOD BLANK 3012694 Matrix Water Associated Lab Samples 92496057001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Petroleum Hydrocarbons mg/L ND 50 09t24120 09 29 LABORATORY CONTROL SAMPLE. 3012695 Spike LCS LCS % Rec Parameter Units Conc. Result % Rec Limits Qualifiers Total Petroleum Hydrocarbons mg1L 20 156 78 64-132 MATRIX SPIKE SAMPLE 3012696 92495108001 Spike MS MS % Rec Parameter Units Result Conc Result % Rec Limits Qualifiers Total Petroleum Hydrocarbons mgfL NO 20 10.5 50 64.132 M1 Results presented on this page ere in the units Indicated by the "Units" column except where an alternate unit is presented to the night of the rasuff. REPORT OF LABORATORY ANALYSIS This report shall not be reproduced except n full Date 09/2812020 08 39 AM without the written consent of Pace Analytical Services LLC Page 5 of 12 aceAnalytical enw.!lacelaEsson QUALITY CONTROL DATA Pace Analytical Services, LLC 205 East Meadow Road - Su le Eden 1 27288 !21W623-8921 Project: Stormwater Kit Pace Project No,: 92496057 QC Batch: 568447 Analysis Method EPA 200 7 Rev 4 4 1994 QC Batch Method: EPA 200.7 Rev 4A 1994 Analysis Description 200 7 MET Laboratory Pace Analytical Services -Asheville Associated Lab Samples: 92496057001 METHOD BLANK: 3011863 Matrix Water Associated Lab Samples: 92496057001 Blank Reporting Parameter Units _.w•-ug/L _ ._.,_...- Result Limit Analyzed Qualifiers Copper NO 5 0 09/24/20J23 44 Lead ug/L NO 5 0 09124120 23 44 Zinc ug/L NO 10 0 09/24/20 23 44 LABORATORY CONTROL SAMPLE 3011864 Spike LCS LCS % Rec Parameter Units Conc Result % Rec Limits Qualifiers Copper ugiL 500 496 99 85-115 Lead ug+L 500 465 93 85"115 Zinc ug1L 500 454 91 85-115 MATRIX SPIKE & MATRIX SPIKE DUPLICATE 3011865 3011866 MS MSD 92495623001 Spike Spike MS MSD MS MSD % Rec Parameter Units Result Conc one Result Result . Rec % Rec Limits RPO Qual Copper ug/L ND 500 500 $14 523 103 105 70-130 2 Lead ug/L ND 500 500 489 494 98 99 70-130 1 Zinc uglL NO 500 500 487 494 97 98 70130 2 MATRIX SPIKE & MATRIX SPIKE DUPLICATE 3011867 MS MSD 92496057001 Spike Spike Parameter Units Result Conc one Copper ug/L _ NO 500 _ 500 Lead ug1L ND 500 500 Zinc ug/L NO 500 500 3011868 MS MSD MS MSD % Rec Result Result Rec % Rec Limits RPD Qual 533 527 107 105 70-130 1 499 497 99 99 70-130 0 499 495 99 98 70 130 1 Results pretemed on this page are in the unlit indicated by the "Units" column except where an alternate unit Is presented to the right of the result. REPORT OF LABORATORY ANALYSIS Th s report shall not be reproduced except in full, Date 09/28/2020 08 39 AM without the wr tten consent of Pace Analytical Services, LLC Page 6 of 12 aceAnalytical i<rtztr.paealaba caa (QUALITY CONTROL DATA Project Stormwater Kit Pace Project No 92496057 QC Batch 567948 Analysis Method SM 25400-2011 QC Batch Method SM 264OD-2011 Analysis Description 25400 Total Suspended So ids Laboratory Pace Analytical Services • Asheville Associated Lab Samples 92496057001 METHOD BLANK, 3009496 Associated Lab Samples 92496057001 Parameter Units Total Suspended Solids mg/L Matrix Water Blank Reporting Result Limit Analyzed Qualifiers ND 2.5 09/22120 0114 Pace Analytical Services, LLC 205 East Meadow Road - Suite A Eden. NC 2728a ;336j82M921 LABORATORY CONTROL SAMPLE 3009497 Spike LCS L,:-S % Rec Parameter Units Conc Result % Rec Limits Qualifiers Total Suspended Solids mg/L 250 246 98 90.110 SAMPLE DUPLICATE 3009496 Parameter Units Total Suspended Solids rng/L 92496448001 7up Result ReSUR RPD Qualifiers 168 155 8 SAMPLE DUPLICATE 3009542 92496151003 Dup Parameter Units Result Result RPD Qualifiers Total Suspended Solids mgrL 3970 3950 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 or the result REPORT OF LABORATORY ANALYSIS This report shell not be reproduced except in full Dale 09/28/2020 08 39 AM without the written consent of Pace Ana ytica Services LLC Page 7 of 12 Pace Analytical Services, LLC A n I i J ¢ 205 East Meadow Road - Suite A Q l U / I ! Eden, NC 27296 i336)6234921 I QUALIFIERS Project Stormwater Kit Pace Project No 92496057 DEFINITIONS OF • Dilution Factor if reported represents the factor applied to the reported data due to dilution of the sample aliquot NO - Not Detected at or above adjusted reporting omit. TNTC - Too Numerous To Count J - Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit MDL - Adjusted Method Detection Limit. POL - Practical Quantitation Lim I 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-Diphenythydraz ne 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 RPO values LCS(D) Laboratory Control Sample (Duplicate) MS(D) - Matrix Spike (Duplicate) OUP • Sample Dupicate RPD Relative Percent Difference NC Not Calculable SG Silica Gel - C can -Up U Indicates the compound was analyzed for but not detected Acid preservation may not be appropriate for 2 Chloroethylv.nyt ether A separate vial preserved to a pH of 4 5 .s recommended in SW846 Chapter 4 for the analysx of Acrolein and Acrylonitrile by EPA Method 8260 N-Nitrosodiphenylamine decomposes and annot be separated from Diphenylamine using Method 8270 The result reported for each analyte is a combined concentration Pace Anaytical is TNI accredited Contact ysur Pare PM for the current i,st 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 09i28t2020 08 39 AM w thout the wntten consent of Pace Analytical Services LLC Page 8 of 12 aceAnafytica! x►rw.pitdtbs.eam QUALITY CONTROL DATA CROSS REFERENCE TABLE Project Stormwater Kit Pace Project No 92496057 Pace Analytical Services, LLC 205 East Meadow Road Suite A Eden NC 27288 (336(623-8921 Analytical Lab ID Sampla ID QC Batch Method QC Batch Analytical Method Batch 92496057001 Storrrlwater Outfall #001 EPA 16646 568623 92496057001 Stormwater Outtall #001 EPA 200 7 Rev 4 4 1994 568447 EPA 200 7 Rev 4 4 1994 568549 92496057001 Stormwater Outtall #001 SM 25400 2011 567948 Date 09/2812020 08 39 AM REPORT OF LABORATORY ANALYSIS This report shall not be reproduced. except in full without the mitten consent of Pace Analytical Services Page 9 of 12 1 Document Name %cament Revised: February 7, 2013 3GB�l�31i tiCc7a1 Sample Condition U on Recei t(SCUR) 1 Page t of 2 Document No. Issuing authority F-CAR-0-033-Rev,05 f Pace Carolinas Quailty Office Laboratory receiving samples: Asheville'(? EdenM Greenwood ❑ Huntersville CI' Raleigh[] Mechanicsville❑ Client Name- j s rsi J` project ; WO# : 92496057 Courier ❑Fed x CUPS ❑USPS ❑ Commerc al ❑ Pate ❑Cthe. ___ 82498057 Ottellnitlais Person Emmininr Contents: t7-, y / 7 ' " Packing Material: abbie Wrao fuhhle Bags _;None ❑ Other Biological Tissue Froteni Thermometer: / 7 Tvpe of �cc: ,�"` R .iun i0 92 05 j : r ❑91ue ❑None Cooler Temp I'q: t l� Correction Factor: Add/Subtract ('C) 0.0 """ Temp staWd of, at2aye rreeZmg to o'C Cooler Temp Corrected ('Q: �� ❑Sarplet out of temp ;rrtena, 5amples on ce, tcaanq process his begun USDA Regulated Soil 1 N/A, water sample) Did samples or'ginate :n a aoarantine !one %vAbin :he ;nited States CA NY or SC (check maps)? Cm samdes Ingr. ace from s `.oreign icurce lint e(nwonalty i iyes [—Itlo Inc:udtra lanall and P,:er a menP nYes r1rin i Comments/Dllcrepancl: Chain of Custod•r Present? ( ❑Na N/A 1 Samoies Ar,ived ,.v.thin -Wd Time? C, Yts Q Nn N!A ? Short Hold rime analysis (02 nr )? ✓ Yt, No QwA 3 Rush Turn Around Time Requested? C3res rra Nla a Sutfcent volumes es ["No N1A 5 i Correct Container; Used? Pace Ccntaine,s Jsed' QYes_ es ONO No ON1A N/A 6 Containers ntacts 041 ❑No N/A Dissolved ana,ysis Samo'e,, Fled Flitered? Qv . at40 N/A B Sample Labels Match a70 es C]Na ❑NIA 9 Includes Cate,Tsmer'10iAnalysis %Ijtr,r s• T_ Heads ace n VOA Vials {>5 6mm) ] ❑Yes Np I N!A 10 Trip 3lankPreseW Trip 3ianK Custody Seals ?resent: ❑Ves Yes Ef�Noo �o h!N/A )LN/a 11 I COMMENTS/SAMPLE DISCREPANCY Field Oeta aequtred? DY?S ONO _ Lot D of sF,t tontamers "LIENT NOTIFICAVON/RMLUTION Person contacted Project Manager SCURF :Review: Project (Manager SRF Review: Datel'Time oate_ Data Page 10 of 12 ' ZAnalytrcal' Document Yame. Occument No. F•CAR-0-033-Rev.06 'Check mark top half of box If pH and/or dechlorination Is verified and within the acceptance range for preservation samples. Exceptloru. 1CA, ZMform 'OC oil and rirease, ORO/RO15 Maier': ;CC, LL.-Ill "Bottom half of box is to list number of bottle 7ocurten0evised 7,ebruarl 7, ZOIR page 1 of 2 ssuing Authority Pace Project ' WO# ; 92496057 PM: ®V Due Dale 09/28/20 CLIENT 95—Tirriktn i r Z r y v Z 7 V w Q z 1 1 .Jl d J a 7 > > ] M = 2 Z 0 a a c E G R$ a a i a E a ¢` ,, a 4 'r d O Q d 'c y A y 7 N tR 7 ^f N a 7 .y i N 'AZI O a N a I N Y Q a V 4 a V t7 i ./ t7 M v w 'A M 0 ( ( M S I A fh > h d ? U AH -. a 3 y >n rdl i>f � 7 T t� 8 I[t 1 \-J XJ11 {{ I\ ,\ IZL 9 9 c'° I \\N � I IF\ P-1 I '\1 Jff� \ \ \N C 12 I � _-�___ _iI._ I \ \N i I \ " 1 -z I pH Adjustment log for Preserved Samples-�� f 5ample,, ___w I Type of Preservative ��_ PH upon re<elpt A Date oleservation adlusted time preseratlan Amount of areaervatrve lot x adlusted +dtled 'Date: 'evnenever Cher? is a jlSUepancv tifec=g Noah CJrplinS camphance ;amofes, a copy of ;his form xdt �@ ;rtC'0'he Vows:arO�Jnd DENiJR 17rtrKauon t)ffICP_ ll e Out of hold, incovec; ]reserwive, out of Iemo, ngrrea -ontainers Page 11 of 12 'Kt g' N c a c3 ti rn cn a u w r ITEM S p m r n r•• a iS r• (\ ) t 7�.p[pp `4 a J y _ W ` , pp M ik 0 N :!4TRIX -DVE Sea a„4 070 4 #A) a Cii SAMPLE TYPE (G •GRAB t � N 5 � b x Z ->i Z X Y m 2 O m m � A � ¢ m m 4 m p p m m 2 a , 5.1.1PLE E1,1= tT CCLLECNON A m [ o p Urpra3c.&i G H2SO4 3 NNOJ v a z k1CV / Neal{ O Nd25201 @ N 3 A!othar.- to Olher G �' � -1Anatyses g Test YIN `'—' 1. r] J - 14 ad ird i✓p e,9 by ,�rJS n C DOD 5• 3v `0m f x t5S j� n 2007 Latab � '3 � Cyan�Ca C' a rro i f RO6t? y 'e JI p NO 52= COD a n 3 a i i at tEL1P :n C g N a n r Z FTOS":4d�Ch�: 'O YNI Ruce..47 on Y'N e n i SBa'ea {" 'Cole, YIN! Saw fii C Inlact YiNt n R 1 cl �z D u ? z 0 0 c 'n N 1 so vi cn a —} � Q D C c Lt m, z � D ro �m N Q �n n r am �a a n Page 12 of 12