HomeMy WebLinkAboutNC0000078_Groundwater Monitoring Report March 2022_20220412 (2) GW-59A COMPLIANCE REPORT FORM Permit# /YG 74
(Submit one each monitoring period with GW-59 forms.)
1 Enter date monitoring results were due.( ' ) Will this monitoring report(GW-59 and GW-59A) YES NO/
be submitted after the established due date.
2 Was any required information missing on the GW-59 report forms? YES
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.
3 Are any of the monitor wells in need of repair or maintenance(damaged casing,unlocked or missing cap,missing YES N
identification plate,area overgrown,etc.)?If the answer is "Yes'',contact the Regional Office for guidance.
4 Are any monitored constituents equal to or above the established standards? YE5 NO
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:
A 14-G41
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, concentrations)reported, and sample collection date for each occurrence(for the last two years).
6 Are the monitoring wells listed in section 5 located at or beyond the review boundary? YES N(�
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 having at the review and compliance
boundaries surrounding this facility. Failure to do so may subject the permittee to a Notice of Violation,
fines, and/or penalties.
8 The person completing this portion(GW-59A)of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
I hereby acknowledge that the above information was evaluated and the information submitted in this
report mpliance Report GW-592
A)is true and complete to the best of my knowledge.
/1k
j 2)2-2--
Signature of Permittee(or Authorized Agent) to
GW-59A 12/8/2003
Davidson River Village, LLC
Permit Number NC 0000078
Exceedance from Standards Question 5 Form GW59-A
March 31 2022
Difference Exceeded in the
Well Number Constituent from Standard Last Two Years
Q88V2 pH (1.36) Std. Units Yes
ASB01 pH (0.61) Std. Units Yes
ASB01 iron 860 ug/L Yes
ASB01 Managese 1630 ug/L Yes
ASB01 Cobalt 2.60 ug/L Yes
ASB02 pH (0.91) Std. Units Yes
SUBMIT FORM ON YELLOW PAPER ONLY
Mail origina DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: (919) 733-3221
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 08/31/2020
Facility Name: Davidson River Village, LLC Non-Discharge UIC
Permit Name (if different): NPDES NC 0000078 Other
Facility Address: 1 Ecusta Road TYPE OF PERMITTED OPERATION BEING MONITORED
Brevard NC 28712 County Transylvania ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
Contact Person: Bernard M. Kelly Telephone#: 828-884-5544 ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Along Old Highway 64 No. of wells to be sampled: 3 ❑ Water Source Heat Pump 0 Other: ASB
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER (from Permit): Q88V2 Date sample collected: 5 /g/ FIELD ANALYSES: WAS
Well Depth: 70.39 ft. — Well Diameter: 2.0 in. pH 0040 ,JAG units Temp. 00010: ( �r�1: J °C DRY at
Depth to Water Level 82546: , time of
p �� �S ft. below measuring point Screened Interval: 5.0 ft. to 15.0 ft. Spec. Cond. 00094: i �v - �� µMhos
sampling,
Measuring Point is 3.11 ft. above land surface i Relative M.P. Elevation: 2222.5 ft. Odor 00085: /j0A-)jz check
Volume of water pumped/bailed before sampling: / - gallons Appearance -_L%- - here: is
Samples for metals were collected unfiltered: VI YES ❑ NO and field acidified: 1 YES ❑ NO
LABORATORY INFORMATION
Date sample analyzed: / -.2� Laboratory Name: Pace Analytical Certification No. 40
PARAMETERS NOTE: Values shout re ect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead 01051 / --, ug/L
Coliform: MF Fecal 31616 /100mL Nitrate (NO3) as N 00620 mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 < � 0 mg/L Al - Aluminum 01105 mg/L
pH (Lab) 00403 units Ba - Barium 01007 ug/L Sodium 00929 coo D, c ug/I
TOC 00680 . I s v mg/L Ca - Calcium 00916 mg/L Cobalt 01037 1 , 6 ug/I
Chloride 00940 mg/L Cd - Cadmium 01027 ug/L Dissolved Oxygen 00300 �:�{ mgL
Arsenic 01002 c / G , L ug/L Chromium: Total 01034 ., . .• 0 ug/L Turbidity f , 1-ti NTU
Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe - Iron 01045 J�v : 2. ug/L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 .-- , . C) mg/L Hg - Mercury 71900 / , Z i ug/L Lab Report Attached? ❑■ Yes (1) ❑ No (0)
Specific Conductance 00095 µMhos K - Potassium 00937 mg/L VOC 78732: , method #
Total Ammonia 00610 - _ : t 0 mg/L Mg - Magnesium 00927 mg/L , method #
(Ammonia Nitrogen; NH3as N: Ammonia Nitrogen, Total) Mn - Manganese 01055 CI. i 2_ 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
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.
Bernard M. Kelly, Business Manager / -'— k „� [ 1'� �f /l ? .2._
Permittee (or Authorized Agent) Name and Title - Please print or type Signagtu - of Permittee (or Authorized Agent) (D e)
GW-59 Rev. 2/2010
SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT & NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER, RALEIGH, NC 27699-1617 Phone: (919) 733-3221
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 08/31/2020
Facility Name: Davidson River Village, LLC Non-Discharge UIC
Permit Name (if different): NPDES NC 0000078 Other
Facility Address: 1 Ecusta Road TYPE OF PERMITTED OPERATION BEING MONITORED
Brevard NC 28712 County Transylvania ❑ Lagoon ❑ Remediation: Infiltration Gallery
❑ Spray Field ❑ Remediation:
Contact Person: Bernard M. Kelly Telephone#: 828-884-5544 ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Along Old Highway 64 No. of wells to be sampled: 3 ❑ Water Source Heat Pump El Other: ASB
(from Permit)
SAMPLING INFORMATION If WELL
WELL ID NUMBER (from Permit): ASB01 Date sample collected:3/21) Z-v FIELD ANALYSES: WAS
Well Depth: 15.0 ft. Well Diameter: 2.0 i . pH 00400: 5, units Temp. 00010: / 74r y°C DRY at
Depth to Water Level 82546?/ '' ft. below measuring point Screened Interval: 5.0 ft. to 15.0 ft. Spec. Cond. 00094: .,_.31 ,� pMhos time of
l sampling,
Measuring Point is 3.00 ft. above land surface Relative M.P. Elevation: ft. Odor 00085: N U /If E. check
Volume of water pumped/bailed before sampling: 3 o (-14'i gallons Appearance ---L /4- 1 here:❑
Samples for metals were collected unfiltered: [OYES ❑ NO and field acidified: 171 YES NO
LABORATORY INFORMATION
Date sample analyzed: - - ' Z Laboratory Name: Pace Analytical Certification No. 40
PARAMETERS NOTE: Values sh 1 reflect dissolved and colloidal concentrations. _
COD 00335 mg/L Nitrite (NO2) as N 00615 mg/L Pb - Lead 01051 �j ug/L
Coliform: MF Fecal 31616 /100mL Nitrate (NO3) as N 00620 mg/L Zn - Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus: Total as P 00665 mg/L
(Note Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 ZjCJ mg/L Al - Aluminum 01105 mg/L
pH (Lab) 00403 units Ba - Barium 01007 ug/L Sodium 00929 yic, �. '" ug/I
TOC 00680 er. 1, . C mg/L Ca - Calcium 00916 mg/L Cobalt 01037 g ug/I
Chloride 00940 mg/L Cd - Cadmium 01027 ug/L Disolved Oxygen 00300 3 7 mg/I
j
Arsenic 01002 � l C • C• ug/L Chromium: Total 01034 �` > , C ug/L Turbidity C� , p NTU
Grease and Oils 00552 mg/L Cu - Copper 01042 mg/L ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730 ug/L Fe - Iron o1045 //( 1 ug/L (Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945 .4. 1 mg/L Hg - Mercury 71900 , Zc ug/L Lab Report Attached? ■ Yes (1) ❑ No (0)
Specific Conductance 00095 pMhos K - Potassium 00937 mg/L VOC 78732: , method #
Total Ammonia 00610 tp i 0 mg/L Mg - Magnesium 00927 mg/L , method #
(Ammonia Nitrogen; NH,as N; Ammonia Nitrogen, Total) Mn - Manganese 01055 /6".& 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
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.
Bernard M. Kelly, Business Manager 'L i J1 i 21
2
Permittee (or Authorized Agent) Name and Title - Please print or type Signature of Permittee (or Authorized Agent) (Date)
GW-59 Rev. 2/2010
SUBMIT FORM ON YELLOW PAPER ONLY
Mail original DEPARTMENT OF ENVIRONMENT&NATURAL RESOURCES
GROUNDWATER QUALITY MONITORING: and 1 copy to: DIVISION OF WATER QUALITY-INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM 1617 MAIL SERVICE CENTER,RALEIGH,NC 276 9 9-1 61 7 Phone:(919)733-3221
FACILITY INFORMATION Please Print Clearly or Type PERMIT Number: Expiration Date: 08/31/2020
Facility Name: Davidson River Village,LLC Non-Discharge UIC
Permit Name(if different): NPDES NC 0000078 Other
Facility Address: 1 Ecusta Road TYPE OF PERMITTED OPERATION BEING MONITORED
Brevard (street) NC 28712 County Transylvania ❑ Lagoon ❑ Remediation: Infiltration Gallery
(City) (Slate) (Zip) ❑ Spray Field ❑ Remediation:
Contact Person: Bernard M.Kelly Telephone#: 828-884-5544 ❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name:Along Old Highway 64 No. of wells to be sampled: 3 ❑ Water Source Heat Pump ❑t Other: ASB
(from Permit)
SAMPUNG INFORMATION ` If WELL
WELL ID NUMBER(from Permit): ASB02 Date sample collected: 3/2) /22" FIELD ANALYSES: 2 WAS
Well Depth: 12.0 ft. Well Diameter: 2.0 in. pH oo400:S.c/units Temp.00010: 13.3 °C DRY at
Depth to Water Level 82546: 7, ! 7 ft.below measuring point Screened Interval: 4.0 ft. to ft. Spec. Cond. 00094: 7,S', 1 µMhos time of
sampling,
Measuring Point is 3.0 ft. above land surface - Relative M.P. Elevation: ft. Odor 00085: Ae O w 4. check
Volume of water pumped/bailed before sampling: f, -) gallons Appearance C L `2— here:❑
Samples for metals were collected unfiltered: 0 YES ❑ NO and field acidified: ®YES ❑NO
LABORATORY INFORMATION
Date sample analyzed: / 2-L Laboratory Name: Pace Analytical Certification No. 40
PARAMETERS NOTE:Values shoo r flect dissolved and colloidal concentrations.
COD 00335 mg/L Nitrite(NO2)as N 00615 mg/L Pb-Lead o1os1 G 5;a ug/L
Coliform: MF Fecal 31616 /100mL Nitrate(NO3)as N o0szo mg/L Zn-Zinc 01092 mg/L
Coliform: MF Total 31504 /100mL Phosphorus:Total as P 00665 mg/L
(Note: Use MPN method for highly turbid samples) Orthophosphate 70507 mg/L Other(Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300 (p4- O mg/L Al-Aluminum 01105 mg/L
pH(Lab)00403 units Ba-Barium 01007 ug/L Sodium 00929 ,SOO 0 ug/l
TOC 00680 < l , Q mg/L Ca-Calcium 00916 mg/L Cobalt 01037 Z l 0 6 ugll
Chloride 00940 mg/L Cd-Cadmium 01027 ug/L Dissolved Oxygen 00300 1/4, , mg/I
Arsenic o1002 C I O•v ug/L Chromium:Total 01034 z .S',0 ug/L Turbidity o 17 NTU
Grease and Oils 00552 mg/L Cu-Copper 01042 mg/L ORGANICS:(by GC,GC/MS, HPLC)
Phenol 32730 ug/L Fe-Iron o1o4s S—O,0 ug/L (Specify test and method#.ATTACH LAB REPORT)
Sulfate 00945 713 mg/L Hg-Mercury 71900 G ' Z4' ug/L Lab Report Attached? 0 Yes(1) ❑ No(0)
Specific Conductance o0095 µMhos K-Potassium 00937 mg/L VOC 78732: ,method#
Total Ammonia 00610 I. 1 0 mg/L Mg-Magnesium 00927 mg/L ,method#
(Ammonia Nitrogen;NH3as N;Ammonia Nitrogen,Total) Mn-Manganese otoss ' . 0 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
DWQ-certified laboratory. I am aware that there are significant penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations.
Bernard M.Kelly,Business Manager / n'C �'`" -- /2/22,
Permittee(or Authorized Agent)Name and Title-Please print or type Sign re of Permittee(or Authorized Agent) (Date)
GW-59 Rev.2/2010
Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
April 07, 2022
Mr. Bernie Kelly
Davidson River Village, LLC
P.O. Box 880
Pisgah Forest, NC 28768
RE: Project: MW'S MARCH 2022
Pace Project No.: 92596049
Dear Mr. Kelly:
Enclosed are the analytical results for sample(s)received by the laboratory on March 29, 2022. 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
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
-. --�
Lorri Patton
lorri.patton@pacelabs.com
1(828)254-7176
Project Manager
Enclosures
9 pCCR
_41bail REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
� without the written consent of Pace Analytical Services,LLC. Page 1 of 18
Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
CERTIFICATIONS
Project: MW'S MARCH 2022
Pace Project No.: 92596049
Pace Analytical Services Asheville
2225 Riverside Drive,Asheville,NC 28804 South Carolina Laboratory ID:99030
Florida/NELAP Certification#: E87648 South Carolina Certification#:99030001
North Carolina Drinking Water Certification#:37712 VirginiaNELAP Certification#:460222
North Carolina Wastewater Certification#:40
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
without the written consent of Pace Analytical Services,LLC. Page 2 of 18
Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
SAMPLE ANALYTE COUNT
Project: MW'S MARCH 2022
Pace Project No.: 92596049
Analytes
Lab ID Sample ID Method Analysts Reported Laboratory
92596049001 Q88V2 EPA 6010D CBV 6 PASI-A
EPA 6020E JOR 1 PASI-A
EPA 7470A DBB1 1 PASI-A
SM 2540C-2015 ZMC 1 PASI-A
EPA 300.0 Rev 2.1 1993 CDC 1 PASI-A
EPA 350.1 Rev 2.0 1993 NDS 1 PASI-A
SM 5310B-2014 MJP 1 PASI-A
92596049002 ASB-01 EPA 6010D CBV 6 PASI-A
EPA 6020E JOR 1 PASI-A
EPA 7470A DBB1 1 PASI-A
SM 2540C-2015 ZMC 1 PASI-A
EPA 300.0 Rev 2.1 1993 CDC 1 PASI-A
EPA 350.1 Rev 2.0 1993 NDS 1 PASI-A
SM 5310B-2014 MJP 1 PASI-A
92596049003 ASB-02 EPA 6010D CBV 6 PASI-A
EPA 6020E JOR 1 PASI-A
EPA 7470A DBB1 1 PASI-A
SM 2540C-2015 ZMC 1 PASI-A
EPA 300.0 Rev 2.1 1993 CDC 1 PASI-A
EPA 350.1 Rev 2.0 1993 NDS 1 PASI-A
SM 5310B-2014 MJP 1 PASI-A
PASI-A=Pace Analytical Services-Asheville
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 18
Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
ANALYTICAL RESULTS
Project: MW'S MARCH 2022
Pace Project No.: 92596049
Sample: Q88V2 Lab ID: 92596049001 Collected: 03/29/22 12:05 Received: 03/29/22 17:05 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
6010 MET ICP Analytical Method: EPA 6010D Preparation Method:EPA 3010A
Pace Analytical Services-Asheville
Arsenic ND ug/L 10.0 1 03/31/22 01:00 04/01/22 11:54 7440-38-2
Chromium ND ug/L 5.0 1 03/31/22 01:00 04/01/22 11:54 7440-47-3
Iron ND ug/L 50.0 1 03/31/22 01:00 04/01/22 11:54 7439-89-6
Lead ND ug/L 5.0 1 03/31/22 01:00 04/01/22 11:54 7439-92-1
Manganese 9.2 ug/L 5.0 1 03/31/22 01:00 04/01/22 11:54 7439-96-5
Sodium ND ug/L 5000 1 03/31/22 01:00 04/04/22 15:06 7440-23-5
6020 MET ICPMS Analytical Method: EPA 6020E Preparation Method: EPA 3010A
Pace Analytical Services-Asheville
Cobalt ND ug/L 1.0 1 03/31/22 11:03 04/04/22 20:31 7440-48-4
7470 Mercury Analytical Method: EPA 7470A Preparation Method: EPA 7470A
Pace Analytical Services-Asheville
Mercury ND ug/L 0.20 1 04/02/22 14:38 04/07/22 11:23 7439-97-6
2540C Total Dissolved Solids Analytical Method:SM 2540C-2015
Pace Analytical Services-Asheville
Total Dissolved Solids ND mg/L 25.0 1 03/30/22 15:15
300.0 IC Anions 28 Days Analytical Method: EPA 300.0 Rev 2.1 1993
Pace Analytical Services-Asheville
Sulfate ND mg/L 1.0 1 03/30/22 19:14 14808-79-8
350.1 Ammonia Analytical Method: EPA 350.1 Rev 2.0 1993
Pace Analytical Services-Asheville
Nitrogen,Ammonia ND mg/L 0.10 1 04/07/22 15:58 7664-41-7
5310B TOC Analytical Method:SM 5310B-2014
Pace Analytical Services-Asheville
Total Organic Carbon ND mg/L 1.0 1 03/31/22 19:42 7440-44-0
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:04/07/2022 05:07 PM without the written consent of Pace Analytical Services,LLC. Page 4 of 18
Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
ANALYTICAL RESULTS
Project: MW'S MARCH 2022
Pace Project No.: 92596049
Sample: ASB-01 Lab ID: 92596049002 Collected: 03/29/22 15:35 Received: 03/29/22 17:05 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
6010 MET ICP Analytical Method: EPA 6010D Preparation Method:EPA 3010A
Pace Analytical Services-Asheville
Arsenic ND ug/L 10.0 1 03/31/22 01:00 04/01/22 11:57 7440-38-2
Chromium ND ug/L 5.0 1 03/31/22 01:00 04/01/22 11:57 7440-47-3
Iron 1160 ug/L 50.0 1 03/31/22 01:00 04/01/22 11:57 7439-89-6
Lead ND ug/L 5.0 1 03/31/22 01:00 04/01/22 11:57 7439-92-1
Manganese 1680 ug/L 5.0 1 03/31/22 01:00 04/01/22 11:57 7439-96-5
Sodium 26900 ug/L 5000 1 03/31/22 01:00 04/04/22 15:10 7440-23-5
6020 MET ICPMS Analytical Method: EPA 6020E Preparation Method: EPA 3010A
Pace Analytical Services-Asheville
Cobalt 3.6 ug/L 1.0 1 03/31/22 11:03 04/04/22 20:56 7440-48-4
7470 Mercury Analytical Method: EPA 7470A Preparation Method: EPA 7470A
Pace Analytical Services-Asheville
Mercury ND ug/L 0.20 1 04/02/22 14:38 04/07/22 11:25 7439-97-6
2540C Total Dissolved Solids Analytical Method:SM 2540C-2015
Pace Analytical Services-Asheville
Total Dissolved Solids 239 mg/L 25.0 1 03/30/22 15:15
300.0 IC Anions 28 Days Analytical Method: EPA 300.0 Rev 2.1 1993
Pace Analytical Services-Asheville
Sulfate 8.1 mg/L 1.0 1 03/30/22 19:30 14808-79-8
350.1 Ammonia Analytical Method: EPA 350.1 Rev 2.0 1993
Pace Analytical Services-Asheville
Nitrogen,Ammonia ND mg/L 0.10 1 04/07/22 15:59 7664-41-7
5310B TOC Analytical Method:SM 5310B-2014
Pace Analytical Services-Asheville
Total Organic Carbon ND mg/L 1.0 1 03/31/22 19:57 7440-44-0
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:04/07/2022 05:07 PM without the written consent of Pace Analytical Services,LLC. Page 5 of 18
Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
ANALYTICAL RESULTS
Project: MW'S MARCH 2022
Pace Project No.: 92596049
Sample: ASB-02 Lab ID: 92596049003 Collected: 03/29/22 14:00 Received: 03/29/22 17:05 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
6010 MET ICP Analytical Method: EPA 6010D Preparation Method:EPA 3010A
Pace Analytical Services-Asheville
Arsenic ND ug/L 10.0 1 03/31/22 01:00 04/01/22 12:01 7440-38-2
Chromium ND ug/L 5.0 1 03/31/22 01:00 04/01/22 12:01 7440-47-3
Iron ND ug/L 50.0 1 03/31/22 01:00 04/01/22 12:01 7439-89-6
Lead ND ug/L 5.0 1 03/31/22 01:00 04/01/22 12:01 7439-92-1
Manganese ND ug/L 5.0 1 03/31/22 01:00 04/01/22 12:01 7439-96-5
Sodium 7100 ug/L 5000 1 03/31/22 01:00 04/04/22 15:13 7440-23-5
6020 MET ICPMS Analytical Method: EPA 6020E Preparation Method: EPA 3010A
Pace Analytical Services-Asheville
Cobalt ND ug/L 1.0 1 03/31/22 11:03 04/04/22 21:00 7440-48-4
7470 Mercury Analytical Method: EPA 7470A Preparation Method: EPA 7470A
Pace Analytical Services-Asheville
Mercury ND ug/L 0.20 1 04/02/22 14:38 04/07/22 11:27 7439-97-6
2540C Total Dissolved Solids Analytical Method:SM 2540C-2015
Pace Analytical Services-Asheville
Total Dissolved Solids 64.0 mg/L 25.0 1 03/30/22 15:15
300.0 IC Anions 28 Days Analytical Method: EPA 300.0 Rev 2.1 1993
Pace Analytical Services-Asheville
Sulfate 4.3 mg/L 1.0 1 03/30/22 19:45 14808-79-8
350.1 Ammonia Analytical Method: EPA 350.1 Rev 2.0 1993
Pace Analytical Services-Asheville
Nitrogen,Ammonia ND mg/L 0.10 1 04/07/22 16:00 7664-41-7
5310B TOC Analytical Method:SM 5310B-2014
Pace Analytical Services-Asheville
Total Organic Carbon ND mg/L 1.0 1 03/31/22 20:21 7440-44-0
REPORT OF LABORATORY ANALYSIS
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Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
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QUALITY CONTROL DATA
Project: MW'S MARCH 2022
Pace Project No.: 92596049
QC Batch: 688569 Analysis Method: EPA 7470A
QC Batch Method: EPA 7470A Analysis Description: 7470 Mercury
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 92596049001,92596049002,92596049003
METHOD BLANK: 3598386 Matrix: Water
Associated Lab Samples: 92596049001,92596049002,92596049003
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Mercury ug/L ND 0.20 04/07/22 10:56
LABORATORY CONTROL SAMPLE: 3598387
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Mercury ug/L 2.5 2.5 99 80-120
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 3598388 3598389
MS MSD
92594684002 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Mercury ug/L ND 2.5 2.5 2.5 2.8 100 110 75-125 9
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
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Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
QUALITY CONTROL DATA
Project: MW'S MARCH 2022
Pace Project No.: 92596049
QC Batch: 688185 Analysis Method: EPA 6010D
QC Batch Method: EPA 3010A Analysis Description: 6010 MET
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 92596049001,92596049002,92596049003
METHOD BLANK: 3596596 Matrix: Water
Associated Lab Samples: 92596049001,92596049002,92596049003
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Arsenic ug/L ND 10.0 04/01/22 11:11
Chromium ug/L ND 5.0 04/01/22 11:11
Iron ug/L ND 50.0 04/01/22 11:11
Lead ug/L ND 5.0 04/01/22 11:11
Manganese ug/L ND 5.0 04/01/22 11:11
Sodium ug/L ND 5000 04/04/22 14:59
LABORATORY CONTROL SAMPLE: 3596597
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Arsenic ug/L 500 489 98 80-120
Chromium ug/L 500 494 99 80-120
Iron ug/L 5000 5010 100 80-120
Lead ug/L 500 495 99 80-120
Manganese ug/L 500 496 99 80-120
Sodium ug/L 5000 4930J 99 80-120
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 3596598 3596599
MS MSD
92595950001 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Arsenic ug/L ND 500 500 524 504 104 100 75-125 4
Chromium ug/L 3.9J 500 500 516 499 102 99 75-125 3
Iron ug/L 3300 5000 5000 9440 9030 123 115 75-125 4
Lead ug/L ND 500 500 504 488 100 97 75-125 3
Manganese ug/L 149 500 500 661 638 102 98 75-125 3
Sodium ug/L 16800 5000 5000 22600 21700 117 98 75-125 4
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
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Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
QUALITY CONTROL DATA
Project: MW'S MARCH 2022
Pace Project No.: 92596049
QC Batch: 688511 Analysis Method: EPA 6020B
QC Batch Method: EPA 3010A Analysis Description: 6020 MET
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 92596049001,92596049002,92596049003
METHOD BLANK: 3598129 Matrix: Water
Associated Lab Samples: 92596049001,92596049002,92596049003
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Cobalt ug/L ND 1.0 04/04/22 20:24
LABORATORY CONTROL SAMPLE: 3598130
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Cobalt ug/L 50 48.4 97 80-120
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 3598131 3598132
MS MSD
92596049001 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Cobalt ug/L ND 50 50 49.3 49.3 98 98 75-125 0
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
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Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
QUALITY CONTROL DATA
Project: MW'S MARCH 2022
Pace Project No.: 92596049
QC Batch: 688103 Analysis Method: SM 2540C-2015
QC Batch Method: SM 2540C-2015 Analysis Description: 2540C Total Dissolved Solids
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 92596049001,92596049002,92596049003
METHOD BLANK: 3596389 Matrix: Water
Associated Lab Samples: 92596049001,92596049002,92596049003
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Dissolved Solids mg/L ND 25.0 03/30/22 15:15
LABORATORY CONTROL SAMPLE: 3596390
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Total Dissolved Solids mg/L 250 258 103 90-110
SAMPLE DUPLICATE: 3596391
92595832001 Dup
Parameter Units Result Result RPD Qualifiers
Total Dissolved Solids mg/L 108 113 5
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
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Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
QUALITY CONTROL DATA
Project: MW'S MARCH 2022
Pace Project No.: 92596049
QC Batch: 688233 Analysis Method: EPA 300.0 Rev 2.1 1993
QC Batch Method: EPA 300.0 Rev 2.1 1993 Analysis Description: 300.0 IC Anions
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 92596049001,92596049002,92596049003
METHOD BLANK: 3596754 Matrix: Water
Associated Lab Samples: 92596049001,92596049002,92596049003
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Sulfate mg/L ND 1.0 03/30/22 14:35
LABORATORY CONTROL SAMPLE: 3596755
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Sulfate mg/L 50 49.9 100 90-110
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 3596756 3596757
MS MSD
92595933002 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Sulfate mg/L 74.0 50 50 117 118 86 87 90-110 0 M1
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
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Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
QUALITY CONTROL DATA
Project: MW'S MARCH 2022
Pace Project No.: 92596049
QC Batch: 689852 Analysis Method: EPA 350.1 Rev 2.0 1993
QC Batch Method: EPA 350.1 Rev 2.0 1993 Analysis Description: 350.1 Ammonia
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 92596049001,92596049002,92596049003
METHOD BLANK: 3604848 Matrix: Water
Associated Lab Samples: 92596049001,92596049002,92596049003
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Nitrogen,Ammonia mg/L ND 0.10 04/07/22 15:23
LABORATORY CONTROL SAMPLE: 3604849
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Nitrogen,Ammonia mg/L 5 4.8 96 90-110
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 3604850 3604851
MS MSD
92595814001 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Nitrogen,Ammonia mg/L 0.20 5 5 5.0 5.0 97 97 90-110 0
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 3604852 3604853
MS MSD
92595830001 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Nitrogen,Ammonia mg/L 1.2 5 5 6.2 6.2 99 99 90-110 0
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
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Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
QUALITY CONTROL DATA
Project: MW'S MARCH 2022
Pace Project No.: 92596049
QC Batch: 688549 Analysis Method: SM 5310E-2014
QC Batch Method: SM 5310E-2014 Analysis Description: 5310E TOC
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 92596049001,92596049002,92596049003
METHOD BLANK: 3598254 Matrix: Water
Associated Lab Samples: 92596049001,92596049002,92596049003
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Organic Carbon mg/L ND 1.0 03/31/22 15:28
LABORATORY CONTROL SAMPLE: 3598255
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Total Organic Carbon mg/L 25 24.3 97 90-110
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 3598256 3598257
MS MSD
92595832001 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Total Organic Carbon mg/L 1.7 25 25 26.1 26.2 98 98 90-110 0
Results presented on this page are in the units indicated by the"Units"column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
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Date:04/07/2022 05:07 PM without the written consent of Pace Analytical Services,LLC. Page 13 of 18
Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
QUALIFIERS
Project: MW'S MARCH 2022
Pace Project No.: 92596049
DEFINITIONS
DF-Dilution Factor,if reported,represents the factor applied to the reported data due to dilution of the sample aliquot.
ND-Not Detected at or above adjusted reporting limit.
TNTC-Too Numerous To Count
J-Estimated concentration above the adjusted method detection limit and below the adjusted reporting limit.
MDL-Adjusted Method Detection Limit.
PQL-Practical Quantitation Limit.
RL-Reporting Limit-The lowest concentration value that meets project requirements for quantitative data with known precision and
bias for a specific analyte in a specific matrix.
S-Surrogate
1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270.The result for each analyte is
a combined concentration.
Consistent with EPA guidelines,unrounded data are displayed and have been used to calculate%recovery and RPD values.
LCS(D)-Laboratory Control Sample(Duplicate)
MS(D)-Matrix Spike(Duplicate)
DUP-Sample Duplicate
RPD-Relative Percent Difference
NC-Not Calculable.
SG-Silica Gel-Clean-Up
U-Indicates the compound was analyzed for,but not detected.
Acid preservation may not be appropriate for 2 Chloroethylvinyl ether.
A separate vial preserved to a pH of 4-5 is recommended in SW846 Chapter 4 for the analysis of Acrolein and Acrylonitrile by EPA
Method 8260.
N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for
each analyte is a combined concentration.
Reported results are not rounded until the final step prior to reporting.Therefore,calculated parameters that are typically reported as
"Total"may vary slightly from the sum of the reported component parameters.
Pace Analytical is TNI accredited.Contact your Pace PM for the current list of accredited analytes.
TNI-The NELAC Institute.
ANALYTE QUALIFIERS
M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample(LCS)recovery.
REPORT OF LABORATORY ANALYSIS
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Pace Analytical Services,LLC
ace Analytical® Asheville,RiversideNC28 04
NC 28804
www.pacelabs.com (828)254-7176
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: MW'S MARCH 2022
Pace Project No.: 92596049
Analytical
Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch
92596049001 Q88V2 EPA 3010A 688185 EPA 6010D 688448
92596049002 ASB-01 EPA 3010A 688185 EPA 6010D 688448
92596049003 ASB-02 EPA 3010A 688185 EPA 6010D 688448
92596049001 Q88V2 EPA 3010A 688511 EPA 6020B 688629
92596049002 ASB-01 EPA 3010A 688511 EPA 6020B 688629
92596049003 ASB-02 EPA 3010A 688511 EPA 6020B 688629
92596049001 Q88V2 EPA 7470A 688569 EPA 7470A 689125
92596049002 ASB-01 EPA 7470A 688569 EPA 7470A 689125
92596049003 ASB-02 EPA 7470A 688569 EPA 7470A 689125
92596049001 Q88V2 SM 2540C-2015 688103
92596049002 ASB-01 SM 2540C-2015 688103
92596049003 ASB-02 SM 2540C-2015 688103
92596049001 Q88V2 EPA 300.0 Rev 2.1 1993 688233
92596049002 ASB-01 EPA 300.0 Rev 2.1 1993 688233
92596049003 ASB-02 EPA 300.0 Rev 2.1 1993 688233
92596049001 Q88V2 EPA 350.1 Rev 2.0 1993 689852
92596049002 ASB-01 EPA 350.1 Rev 2.0 1993 689852
92596049003 ASB-02 EPA 350.1 Rev 2.0 1993 689852
92596049001 Q88V2 SM 5310B-2014 688549
92596049002 ASB-01 SM 5310E-2014 688549
92596049003 ASB-02 SM 5310E-2014 688549
REPORT OF LABORATORY ANALYSIS
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Document Name: Document Revised,November 15,2021
ace Sample Condition Upon Receipt(SOUR) Page 1 of 2
Ar►afytrca! Document No.: Issuing Authority:
F-CAR-CS-033•Rev.08 Pace Carolinas Quality Office
Laboratory receiving samples:
Asheville 0 EdenL Greenwood n Huntersville n Raleigh❑ Mechanicsville Atlanta❑ Kernersville❑
Sample Condition Client Name: WO# : 92596049
Upon Receipt Project#
avld son Ri Ycr� � la9 C
Courier: ❑FedEx COS ❑LISPS ['ClientClient
� 1111111hill)) I 111111
❑Commercial ❑Pace ❑Other:
92596049
Custody Seal Present? Eyes ❑No Seals Intact? ['Yes ❑No
Date/Initials Person Examining Contents:J -1 q d-Y7/i
Packing Material: ['Bubble Wrap ;Bubble Bags ['None ❑ Other Biological Tissue Frozen?
Thermometer: (� ❑Yes ❑No , ']N/A
[�IR Gun ID: q —7 ( ]Wet [(Blue ❑None
1 Type of Ice:
� / Correction Fat
Cooler Temp: Add/Subtract(*C) ---
0 Temp should be above freezing to 5°C
/6CooTemp Corrected('C):
ler
7, [(Samples out of temp criteria.Samples an ice,cooling process
y, r has begun
USDA Regulated Soil( j N/A,water sample)
Did samples originate in a quarantine zone within the United States:CA,NY,or SC(check maps)? Did samples originate from a foreign source(internationally,
EYes MNo including Hawaii and Puerto Rico)?[(Yes ONo
Comments/Discrepancy:
Chain of Custody Present? _ (0Yes No ❑N/A 1.
Samples Arrived within Hold Time? DrlYes ❑No ❑N/A 2.
Short Hold Time Analysis(<72 hr.)? Oyes [ jNo ❑N/A 3.
Rush Turn Around Time Requested? ❑Yes (kitio ❑N/A 4.
Sufficient Volume? GklYes ❑Na ❑N/A _ 5.
Correct Containers Used? j ]Yes [(No ❑N/A 6-
-Pace Containers Used? 11]Yes ❑No ❑N/A
Containers Intact? [ Yes ❑No ❑N/A 7.
Dissolved analysis:Samples Field Filtered? Oyes ❑No 'N/A 8.
Sample Labels Match COC? itYes Ohio ❑N/A 9
-Includes Date/Time/ID/Analysis Matrix: 1 /T
Heads pace in VOA Vials(>5-6mml? [(Yes rEN. ❑N/A 10.
Trip Blank Present? [(Yes ]No ❑N/A 11.
Trip Blank Custody Seals Present? ❑Yes A]No ❑N/A
COMMENTS/SAMPLE DISCREPANCY Field Data Required? [(Yes ❑No
Lot ID of split containers:
CLIENT NOTIFICATION/RESOLUTION
Person contacted: Date/Time:
Project Manager SCURF Review: Date:
Project Manager 5RF Review: Date: Page 16 of 18
Document Name: Document Revised:November 15,2021
I�t
Sample Condition Upon Receipt(SLUR) Page 2 of 2
aCeArralytical Document No.: Issuing Authority:
F-CAR-CS-033-Rev.08 Pace Carolinas Quality Office
*Check mark top half of box if pH and/or dechlorination is Project ti WO# : 92596049 __
verified and within the acceptance range for preservation
samples. PM: CD1 Due Date: 04/12/22
Exceptions:VOA,Coliform,TOC,Oil and Grease,DRO/8015(water)DOC,LLHg CLIENT: 93-Dav idsonR
**Bottom half of box is to list number of bottles
v - u a? Q
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a r v .E . ro a N v a Z > Q Y 2 Z Z 9, , e.
iu m v v '' Q S a, a a O n d 0 N 2 m u N 4- - d)
7 3 c 0 2 O O 2 4 Z DI N ` a o n ? 0 0 7
Z va
U V u V 4 ` V N m N : u r3
u _U `_' _ U a`i 2 E S z 7 I 'se x o, .0 .L = ar
;v es n n E .a i E a < < Q 4 ar Y " E c Q
a E. a m a a a• a E E Q 4 e l ¢ . 0 0 O 0 N a ,n in a < ) E
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E E E E E E E vy `v m E a, E e4rt E E E ° ro E E E E E E
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di a N a d a a l7 l7 t? W t9 t4 t7 tR t7 t7 t7 O 37 a 0. a 0U'' in ll9
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pH Adjustment Log for Preserved Samples
Sample ID Type of Preservative pH upon receipt bate preservation adjusted Time preservation Amount of Preservative Lott!
adjusted added
Note; Whenever there is a discrepancy affecting North Carolina compliance samples,a copy of this form will be sent to the North Carolina DEHNR Certification Office(i.e.
Out of hold,incorrect preservative,out of temp,incorrect containers
Page 17 of 18
eo
0
CHAIN-OF-CUSTODY 1 Analytical Request Document
.7-7-Face The Chain-of-Custody is a LEGAL DOCUMENT.All relevant fields must be completed accurately. w
l Submitting a sample via this chain of custody constitutes acknowledgment and acceptance of the Pace Terms and Conditions found at https:llinfo.pacelabs.comlhubfslpas-standard-terms.pdf. CO
Section A Section B Section C
Required Client Information: Required Project Information: Invoice Information: Page: 1 Of 1
Company: Davidson River Village.LLC Report To: Bernie Kelly Attention:
Address: P.O.Box 880 Copy To: Company Name:
Pisgah Forest,NC 28768 Address: Regulatory Agency
Email: bmkeity@greenlightdevelopmentpartners.com Purchase Order#: Pace Quote:
Phone: (828)a84-5544 I Fax Project Name: MWs March 2022 Pace Project Manager: lorri.patIon@pacelabs.com, State 1 Location
Requested Due Date: Project#: Pace Profile#: DRV
Requested Analysis Filtered(Y/N)
a Z
MATR1x CODE e o COLLECTED Preservatives }
Drinuire Water OW a U o '
Water WT o
woos Water WW mtit
o _
Pmdecl P i r Z
SAMPLE ID o's°d o START END o rn ~ m [_/�I y�
One Character per box. wipe we a w c �V V f-�
liA
(A-Z,0-9 i,-) Air AR p A. ur F m ttaa r �] (7 /'
Sample Ids must be unique Other
Ts x w w zo m p m `—° Tv !L,5 7 (7 o y 9
y C
F- 1- 4 2 I.L.
c Z U m N L t Q m m E U a
m DATE TIME DATE TIME 5 = 2 m Z Z E O 2 i- En a, 1-
Q88V2 WT 3--A IaaS ), I I 3 x XXX x -CO/
2 ASB-ot WT 3']9I635 a I 3 X X X X X `oO,2„_
3 Asa-oz WT 3'.3.1 IHoO 9- ( i 3 x x x x x —co&
4
5
I
6
1
7
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8
9
10
11
t
12
ADDETIONAL COMMENTS RELINQUISHED BY I AFFILATION DATE TIME ACCEPTED eY 1 AFFILIATION DATE TOME SAMPLE CONDITIONS
1 r q �h}��J�) �p I
:Metals required:A$.Cr,Fe.Pb,Mn,Na by E010,Co by 6020,Fig 7470 Ltd `[On C 1C„ 3_a/) - 'bob /17, /ract 3�9? 164a
� �� A f`Nct 3-�9-33- 0°5 �J116u lcrl/9/9(�E1i�v f .3-27-i247O,5 yl6 % ,N 7
c/i j N y .
SAMPLER NAME AND SIGNATURE
c
PRINT Name of SAMPLER: "11{a` //-
U
X D11 C
G !` W
SIGNATURE of SAMPLER , � Sc. N �' 3; C�/r, w u Z_ _ °o z e m?
� fit„' �V^' r DATE Signed: J / O(
1 'I F IC u} U U} (j c}
Document Name:Field data Sheet Date Issued:November 27,2018
,/1819aCfittritt
e2I' Page: 1 of
Issuing Authority:Pace Huntersville Quality
Document Number:F-CAR-FLD-001-rev.02 Office
Field Data Sheet Ol�]5' �(La
Client: 2 54 Location: g f e v<<;o i NL Project#: 1)`Q.U !✓I /4' (( lJ
Name and Affiliation(Sampler(s):PTi.e/le .-C. la i.Ief/ ce Field Data Sheet Review:
Name and Affiliation(Inspector):
Well Information Date: 3`3/4 L By: A/1
Well ID: 6v Well Locked: s/NO)
i'
Well Diameter: Construction: at Steel/Stainless Steel)
Total Well Depth: ii.4. to ft Multi Factor*:O. I(3 [*(Radius/12)2 0.14 x 7.48]
Static Water Level: 11 S' 35 ft. Casing Volume: 3, 3 b gallons
Height of Water Column:0 0•)S ft Cal.3 Volumes: et, 1 ° gallons • v
1*1_ .„S3
Pump Intake:t-31 ft
Purge Information
Date Purged:O 3 / (21 / ' )- Start: I?y(J Finish: 19 G 5 Purge Rate: 136.M L/M%r1
Purging Method: IM 00SOb, -rLI M f Total Volume Purged:3 2 S D (gallons/6)
Sampling Information 1
Date Collected:63 /01/_ Time Collected: f 0 5 r( m)am/
Sampling Equipment Used: 1 j- 1Pro P144S Instrument ID: 6 )(a-
a,;crt 1Q1,%) T14.r7 ,‘vfcr n€aays
.1,,,5 ottle Type Preservation Analysis Required
3- V)) I4s4 C V Ilk f resej- `J. D S , Si I- -te
314541c gas°y AtkM on;o•
ligCS-ham )+CI me-felt( (Ul o/ o 2 of `7 v'70
Field Measurements/Observations 1 t,/
Sample Temp CC): ).5'S Time: 0 05 Turbidity(ntu): I' f ) Time: )d 05
Diss Oxy(m 'g/L): a• I Time: ))0 5 Fe 2+mg/L: ill 4. Time: A./q _
Specific Cond.(uS): 1 3.g Time: 1-O 5 Res.CI(mg/L)/(µg/L): NA- Time: "p'
Sample pH(s.u.): C. f'L/ Time: I)°5 Odor: Alb Ike Time: 1 d o S
-or ReDox(mV):. . ..a 5 r 9 Time: 12-6 5 Appearance: CI e ti r . Time: I a IS S-. ..
ReDox(EH value):YSI ProPlus+200mV 9 5 a"' y Other: Time:
General/Weather Observations: '4 r ft, S 10vt , I
1 (60y/ t y/rainy) Temp. 'l'fe CP) Windiz____(mph)
P Signature:Sampler Si ature: 1 '-C s //41 -' Date: d 3 /g(1l 9
Stabilization Test �/
Time Tmp. Diss Oxy. Spec. ReDox Turbidity Volume Water I.SS a �`
I �( Purged (°C) a's.{ - Cond. pH(s.u.) (mV) (ntu) (gallons/removed ) level(ft) Other
�, /o stir v (N L
'Y� 11 y5 1(0.0 gs,fi )y s a), < ya,9 03 v S' ' y8 i')
115o 1(,. 3 V-1,6 Iti, i 5. 90 2Y(a.1 1,05 1300 yg- O 11.1 y
11 s5 15,y ?",S_L2. 13.7 s' a 05)-8 }(6g i tSo 10,,,pf I,/
1aoo i5,') '1 6° 13_S 5, ) S 997,1 (, aS . .G r
zO6 vg,4 ? y� 7, 5
11 II"" V �G� i.. (.,,Ill, i..I�iS Co11Cn/qu 4
- r�ei Mete WhS n-•`f r� ��I�r�,-� I,. �� .�r a`�� '7�' oft, 6/e sq-' von, e
Document Name:Field data Sheet Date Issued November 27,2018
/2ceAnaV ca« Page:1 of y2
1 f Document Number:F-CAR FLD-001-xev.02 Issuing Authority:Pace Huntersville Quality
Office
`� Field Data Sheet l
Client: 1`3 5 j Skh$ Location: $0 tU 4 r,11 N C- Project#: 'D�U
Name and Affiliation(Ssmpler(s):�l'elle 5,-t u ler /N C Field Data Sheet Review:
Name and Affiliation(Inspector):
Date: 3 By: P
Well Information j 1 )- /—
Well ID: A s3 is a Well Locked: a,NO)
Well Diameter: !inn Construction: (PV Steel/Stainless Steel)
' Total Well Depth: l g ft Multi Factor*: O`it"3 [*(padius/12)2 x3.14 x 7,48] •
Static Water Level: '1,/ .7 ft. Casing Volume: O. (o`7 gallons
u
Height of Water Column:Y r o 3 ft ' Cal.3 Volumes: I r 9'7 gallons •- .
Pump Intake:' I ft
Purge Information /
Date Purged:5 3 / d rn�q / 0 a" Start: 13 a S Finish: 1 ybb Purge Rate: )'G ri t / f 1,',/1
Purging Method Te r;S 4-q/1> C Total Volume Purged: .C4 U (gallons/6
Sampling Information
Date Collected: 0 1 /)//t ,� Time Collected: r . - (am/6
Sampling Equipment Used: `f SS T`O Instrument ID: a a(2 a
Bottle Type M'�, TP w Preservation f+rc2Analysis Required
Pas-h( (..)K ce e ru-e 4 --rbr S,t f-
-pi As �� a o y 4M,� 6A;A
Tiq.S.—kC _ 1+C1 he-Lals bo)of1Q6a0 , 17y7o
G-[cs- v 4,115 4tbs fl,x0v1 c M`a --roc
Field Measurements/Observations
Sample Temp (°C): )3. 3 Time: 1�b b Turbidity(ntu): O. / Time: )y b
Diss Oxy(mg/L): ylo- to Time: 1"I,/ ✓��/7 7.)
U
d 0 Fe 2+mg/L: � Time: N
s t ��
Specific and.(uDS)s �• 7Time: t�(6 Res.Cl(mg/L)/(µg/L): P 4- Time:
Sample pH(s.u.): 5' -S 9 Time: 1 II b° Odor: M.e Time: A1A
4 ReDox(mV): of 7�'11 Time: i'1 b b Appearance: C i CO r Time: Alit
ReDox(EH value):YSI ProPlus+200mV it if L Other: Time:
General/Weather Observations: 1)4'r- y C /U°t cl). (s /.0:P./rainy) Temp. it --D (°F) Wind (o (mph)
Sampler Signature: / i• s Date: & / L )2
P /�
Stabilization Test
Time Temp. Diss Oxy. Spec, 4/ReDox Turbidity Volume Water `DiSS (i1
aa7S Cond. pH(s.u,) (mV) (n ) removed Other -kj3
Purged (°C) e.4- }- ( ) (goons/ Ls level(ft) (h )L)
130b ia.) y11 75,i. 4.. 51 a(,rro.S 0 47 So rkel 1-1 .a
13 ,a s 16,5 -5.ipo a�tf.I 0, s-5 Sob `�,ri'7 i1, 1
3s )4' II 5 SA S. 9.75.8 e 1600 11 41 1
) 3tib _g•? fa "NI , 1 2176 I, 0 '7 isou 1, 11a
1311S 13, 't 't C, 0 7S•5 C• 3 a(lg,) o, ct 1 0-0120 t7. 16
�x`l�a �,. �,�,�/� w its
- PIS N e cgs h d C4 2 Cet 4e e1 t r\ f� r' 6R P r it .ti lr, As H .1 b S(I'f"
Document Name: Document Issued:November 27,2018
Field Data Sheet Page)of
Document Number: Issueing Authority:
F-CAR-FLD-001.rev.02 Pace Huntersville Quality Office
Client: S•-ie,k 5
Location:
•
•
Project: - v 01.6.3-0
Well ID: V V
•
• 4 0,6530
Reviewed Date and By: 31141-7- (''1 ( 1 Rt
Stabilization Test •
• : -61 i
Spec. Volume Removed �- y„f
Time Temp, Diss Oxy. Turbidity Water level
n i- Cond. pH(s.u.) ReDox(mV) / s)
(ntu) (ft)(gallons Other
Purged (°C) �{tt�gJEy b,,5s. dX)),,,l
(uS) circle one
j'') SU 13, 160 '1; D S•$v J_S `7 O.k r ,(06 7, ii'-5-
-. ss i 3. Y . y`/� (v '-1 S. i 5,c7 ) s6,,P o i--) Y . 660 '7, `lj 7. 3 -
- -
r
Document Name Field data Sheet Date Issued:November 27,2018
,FNCe! IyU1r( Page: 1 of'�..
Issuing Authority:Pace Huntersville Quality
F Document Number:F-CAR-FLD-001-rev.o2 Office
S Field Data Sheet J
Client: • `� M- Location: D.l eo q' , N c- Project#:
Name and Affiliation(Sampler(s)Dn•et le Sc[,-ter �Pi , Field Data Sheet Review:
Name and Affiliation(Inspector):
Well Inform ation Date:3I ) I i 1- 1'- By' q i_
Well ID: /4 s 13° I Well Locked: /NO)
t�
Well Diameter: a • Construction: 'V ' feel/Stainless Steel)
Total Well Depth: 15 ft Multi Factor*:°`f 4'3 [*(Radius/12)2 x 3.14 x 7.481
Static Water Level: r. I(Li ft. Casing Volume: 'D 3 gallons -
Height of Water Column:1' S a ft Cal.3 Volumes: 3`(P g gallons •- .
Dt1I7 I1
Pump Intake:3-31 I - ft
Purge Information . l
• Date Purged:0..3 / P9 / a Start: I T�l s Finish: 15 3S Purge Rate: )t b I'll-- IAN••✓►
Purging Method:Ter.,54-4 l-L Total Volume Purged: -/ S°b (gallons/0'
Sampling Information s 3 S
Date Collected: 3 / 9/ as Time Collected: (am/1�m •
Sampling Equipment Used: -C..T 'Po) -Pk-IS Instrument ID: 0. (o 9-
fr‘Bottle Type ``��� ��0 Preservation �� y$Analysis Required
`P1454 c UA.pce-seryeel 1-ir, c r-1 Ole
114S.4"f C - 1faSe y trittn aA'ia.
04 s-fig H-ct Ap Ike.�¢7gyls L20/6/ l oJd ')/00
C-las>. lIf'1 is ` OS p1l 6r�_ A-,) a ) -�
Field Measurements/Observations
Sample Temp(°C): 1 Li,11 Time: s 5 Turbidity(ntu): 61`J° Time: 15 S.
Diss Oxy(mg/L): 3 yui'7 Time: 15)S Fe 2+mg/L: NIA— Tune: !V�'
Specific Cond.(uS): / 1'' Time: 15 35 Res.CI(mg/L)/(µg/L): PA-Time: /Ibtl-
Sample pH(s.u,): . VII Time: I S 35 Odor: M2i6 Time: )S 5
4ReDox(mV): ocO�3'' Time: 1 S 3S Appearance: CALetc Time: 1.0 3s .
ReDox(EH value):YSI ProPlus+200mV )0 3‘ Other: Time:
General/Weather Observations: ?4(.11 C 1 ou v
(s ,/c a .y//rainy) Temp.!(°F) Wind�___-(mph)
Sampler Signature. Date: o92 d 1 ) -
Stabilization Tes
Time Temp. Disc Oxy. Spec, .*ReDox Turbidity Volume Water
Purged (°C) "y{mg/L) Cond. pH(s.u.) (mV) (ntu) removed Level(ft) Other b�SS1 l k ey,
y °/a SFt( (uS) _ (gallons/lk) (h,)it)
`I{y� Sns l(y�, I., I^I '35G1,5 s-q�'/7 •/a��3 51 _ `P-/s y To �y7,(1/(�ik(1 _ . 0, 7
itl ) '1 '4 )s/.3_ 51 alsA . 'jiJ. o 5OO (, ( CJ _ Or ci
L500 _ iY-5 0-3 3cq,3-- sSi )29.'7 3/. 36 lobo 9, y9 _ of g •
tsos /y,c 3wf.-? 35(L5(11 . aa,g. 3t(, 12- l.s.00 `1.y l 3 , :2
lslo Ili-3 3S.y 55` 1 5• 9j a17_j _3S,L90 D•00e 11.'0 3, I/
Bela he4-er w9s hok CaIi cti 44 d All. aT? `n M�lL `4" .c -
i r r„r,., 1,,srs .Fh,M
Document Name: Document Issued:November 27,2018
Field Data Sheet Page-of cd-
e , e t t .
Document Number: Issueing Authority:
F-CAR-FLD-001.rev.02 Pace Huntersville Quality Office
� n cell Diameter I'vf 1 ?licai}on Fac r`�
Client: '
� 0.5.
Location: c eAm r l` t /V L 1.2 t_ 91
Project: -k V 7 O_1&30
Well ID: tYS 6 1
4 116530
Reviewed Date and By: 7J (//-• - �} M(ii 6 1_468
Stabilization Test 5 2_610:0
Spec. Volume Removed
Time Temp. Diss Oxy. Turbidity Water level
bio y-, Cond. pH(s.u.) ReDox(mV) (gallons/0 Other �;SS. qcj
Purged (°C) • I?th" (uS) (ntu) circle one (ft) (h G
lv Set r `�/
0
i 9I PO 31.3 3S'),? .- ./6 ') )s, _ it,(or 05e20 `7-s6 _ —_3 t7
,..
) cdb it/LP- 4D,r 3se.) S,tel 7)d,k 11 Y/ 300o '7,5o 3,q
) 53. 5 )11• I :.Fs,y 357,'t 5 , -,k 9I1-5 ►) ' 77 3S6o `7J'o 3- 7
j530 Pi. ii 3fv,a •3sy,ci s. -' az7.I7 7, '17 /oao 'T. s I, 3, 'i
_ ate•
• Y �