NCG210354_2021 DMR_20211216

PLLF;Z
PROMPT•ACCURATE-RELIABLE
LABORATORIESy INC
W W W.PARLABS.COM
REPORT OF ANALYSES
Attn: JORDIN DRURY
UNILIN US-MDF A MOHAWK COMPANY PROJECT NAME: DEC 21
149 HOMANIT USA ROAD DATE: 12/10/21
MOUNT GILEAD, NC 27306-
SAMPLE NUMBER- 143173 SAMPLE ID- UNL POND WATER
DATE SAMPLED- 12/01/21
DATE RECEIVED- 12/02/21 SAMPLER- JD
TIME RECEIVED- 1020 DELIVERED BY- FEDEX
Page 1 of 1
SAMPLE MATRIX- WW
TIME SAMPLED- 0917
RECEIVED BY- DJ
TYPE SAMPLE- Grab
ANALYSIS
ANALYSIS
METHOD
DATE
TIME
BY
RESULT
UNITS
pH VALUE
SM 4500H+B
12/02/21
1025
DJ
7.43
units
CHEM.OXY.DEMAND
EPA 410.4
12/08/21
0745
CT
146
mg/L
OIL & GREASE
EPA 1664
12/08/21
0905
CT
43
mg/L
TOTAL SUSPENDED SOLIDS
SM 2540 D
12/06/21
0825
DJ
< 5
mg/L
LABORATORY DIRECTOR
2217 Graham Park Drive • Charlotte, NC 28273
Phone: [phone] • Fax: [phone]

LLAR CHAIN OF CUSTOD Y
AeoRATORIES.INC. PAR Laboratories, Inc
Phone [phone]
www.partabs.com Fax [phone]
Shipping: Mailing:
2217 Graham Park Drive PO Box 411483
Charlotte, NC 28273 Charlotte, NC 28241-1483
It is essential that all information be recorded on this Chain of Custody document for acceptance by PAR Laboratories, Inc. and the
North Carolina Department of Environmental and Natural Resources.
Company Name (billing) Comments/ Special Instructions
Mohawk Ind./Unilin
Address
149 Homanit Usa Rd
City, State Et zip code
MT GILEAD, NC 27306
Point of Contact Et Telephone Number
Jordin Drury 910-469 r
Sample
Taken By: SIGNATURE
PAGE 1_ OF-1
PRINTED NAME Jordin Dru
ARE SAMPLES FOR ST%Tt: or EPA REPORTING? YES X NO
*Sample Type: Dw ww x Gwnnw Hw Soil other
Sample Temp at time of sampling: ° C Sample Temp upon receipt: ° C
**Field Preserved: Yes X No Teflon Liner/Zero Headspace: Yes No n/a X
Residual Chlorine checked at time of sampling (Y/N): N Dechlorination Necessary (Y/N): N
Client Sample I.D.
(Sample Location / Number)
Comp
Grab
Preserv.
Set Up
Date/Time
Collection
Date/Time
Analyses
Requested
Pond Water Samples
Sample #1
X
<4C
12/1/21 C
930am
12/1/21 @
917am
SS, PH
Sample #2
X
H2SO4
12/1/21 C
930am
12/1/21 @
918arn
OD
Sample #3
X
H2SO4
12/1/21 @
30am
12/1/21 @
919arn
Oil and Grease
elinquished by: u tei I ,menecawcu .,y.
Z 1 2 ,—
Relinquish Y.
D te/Time Received by: Date/Time