NCG030535_Monitoring Report_20211206 (2)

NCDEQ Division of Energy, Mineral and Land Resources
Click here for instructions
©�b
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report DMR U or ithMO
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEML a
Certificate of Coverage No. NCG03 0535
Person Collecting Samples: William Edens �P
Facility Name: ZF Chassis Components, LLC.
Laboratory Name: Pace Analytical
Facility County: Catawba
Laboratory Cert. No.: 92572462
Discharge during this period: ✓❑ Yes
❑
No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ❑ Yes ❑✓ No
If so, which Tier (I,11, or III)?
A copy of this DMR has been uploaded electronically via https:Hedocs.deg.nc.goy/Forms/SW-DMR ❑✓ Yes ❑ No
Date uploaded:12/3/2021
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
Outfall#1
Outfall#2
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
N/A
Date Sample Collected MM/DD/YYYY
11 /12/2021
11 /12/2021
46529
24-Hour Rainfall in inches
.2
.2
C0530
TSS in mg/L (100 or 50')
4.8
7.5
00400
pH in standard units (6.0-9.0)
6.3
6.4
01119
Copper, total recoverable in mg/L
ND
.016
(0.010)
01051
Lead, total recoverable in mg/ L
ND
ND
(0.075)
01094
zinc, total recoverable in mg/ L
.049
.079
(0.126)
78141
Total Toxic Organics (TTO) in mg/L(1)
N/A
N/A
(if required)
00552
Non -Polar Oil & Grease in mg/L (15)
1ND
ND
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
Estimated New Motor/Hydraulic Oil
NCOIL
Usage in gal/month
+ Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark T551Imit of 50 mg/L All other water classifications have a benchmark of 100 mg/L
Notes (optional): Very low flow from the previous night's rainfall
"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."
of Permittee or Delegated Authorized Individual
12/3/2021
Date
Email address [e-mail] Phone Number 828-468-3340

Total Toxic Organics Certification:
"Based upon my inquiry of the person or persons directly responsible for managing compliance with the permit monitoring
requirement for total toxic organics (TTO), I certify that to the best of my knowledge and belief, no leak, spill, or dumping of
concentrated toxic organics into the stormwater or onto areas which are exposed to rainfall or stormwater runoff has occurred since
filing the last discharge monitoring report. I further certify that this facility is implementing all the provisions of the Solvent
Management Plan included in the Stormwater Pollution Prevention Plan."
Signature of Permittee or Delegated Authorized Individual
12/3/2021
Date
Email Address [e-mail] Phone Number 828-468-3340

��eAnalj4ical'
www.pacelabsxom
November 29, 2021
William Edens
ZF Chassis Components LLC
1570 E. P St. Ext.
Newton, NC 28658
RE: Project: STORMWATER SAMPLING
Pace Project No.: 92572462
Dear William Edens:
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Enclosed are the analytical results for sample(s) received by the laboratory on November 12, 2021. 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,
.,R
Tyriek Hooks
[e-mail]
[phone]
Project Manager
Enclosures
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except In full,
vdthout the vmtten consent of Pace Analytical Services, LLC.
Page 1 of 15

ace Analytical
www.pacelobs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: STORMWATER SAMPLING
Pace Project No.: 92572462
Pace Analytical Services Charlotte
South Carolina Laboratory ID: 99006
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
North Carolina Drinking Water Certification M 37706
North Carolina Field Services Certification M 5342
North Carolina Wastewater Certification M 12
South Carolina Laboratory ID: 99006
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification M E87648
North Carolina Drinking Water Certification M 37712
North Carolina Wastewater Certfcation M 40
CERTIFICATIONS
South Carolina Certification M 99006001
South Carolina Drinking Water Cert. M 99006003
Florida/NELAP Certification M E87627
Kentucky UST Certification #: 84
Louisiana DoH Drinking Water #: LA029
Virginia/VELAP Certification M 460221
South Carolina Laboratory ID: 99030
South Carolina Certification M 99030001
Virginia/VELAP Certification M 460222
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 15

aceAnalXical
www.patelabs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
SAMPLE ANALYTE COUNT
Project: STORMWATER SAMPLING
Pace Project No.: 92572462
Lab ID Sample ID Method
Analysts
Analytes
Reported
Laboratory
92672462001 11-2021 #1 EPA 1664B
ICO
1
PASI-C
EPA 200.7 Rev 4A 1994
CBV
3
PASI-A
SM 254OD-2015
ZMC
1
PASI-A
EPA 9040C
SMK
1
PASI-A
92572462002 11-2021 #2 EPA 1664B
ICO
1
PASI-C
EPA 200.7 Rev 4.4 1994
CBV
3
PASI A
SM 254OD-2015
MJP
1
PASI-A
EPA 9040C
SMK
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 15

aceAnalXical
www pacelabs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: STORMWATER SAMPLING
Pace Project No.: 92572462
Sample: 11-2021 #1
Parameters
Lab ID: 92672462001 Collected: 11/12/21 09:00
Results Units Report Limit DF
Received: 11/12/21 10:40 Matrix: Water
Prepared Analyzed CAS No. Qual
HEM, Oil and Grease
Analytical Method: EPA 1664B
Pace Analytical Services - Charlotte
Oil and Grease
ND mg/L
4.8
1
11/16/21 08:50
200.7 MET ICP
Analytical Method: EPA 200.7 Rev 4.41994
Preparation Method: EPA 200.7 Rev 4.4 1994
Pace Analytical Services -Asheville
Copper
ND mg/L
0.0050
1
11/19/2111:16 11/24/2105:28 7440-50-8
Lead
ND mg/L
0.0050
1
11/19/2111:16 11/24/2105:28 7439-92-1
Zinc
0.049 mg/L
0.010
1
11/19/2111:16 11/24/2105:28 7440-66-6
2640D Total Suspended Solids
Analytical Method: SM 254OD-2015
Pace Analytical Services -Asheville
Total Suspended Solids
4.8 mg/L
2.5
1
11/17/21 16:24
9040 pH
Analytical Method: EPA 9040C
Pace Analytical Services -Asheville
pH at 25 Degrees C
6.3 Std. Units
0.10
1
11/23/21 10:55 H3
Date: 111291202105:23 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 4 of 15

aceAnalXkal
www paaelabs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: STORMWATER SAMPLING
Pace Project No.: 92572462
Sample: 11-2021 #2
Lab ID: 92572462002 Collected:
11/12/21 09:00
Received: 11/12/21 10:40 Matrix: Water
Parameters
Results Units Report Limit
DF
Prepared Analyzed CAS No. Qual
HEM, Oil and Grease
Analytical Method: EPA 1664B
Pace Analytical Services - Charlotte
Oil and Grease
ND mg/L
4.8
1
11/16/21 08:50
200.7 MET ICP
Analytical Method: EPA 200.7 Rev 4.41994
Preparation Method: EPA 200.7 Rev 4.4 1994
Pace Analytical Services -Asheville
Copper
0.016 mg/L
0.0050
1
11/19/2111:16 11124/2105:32 7440-50-8
Lead
ND mg/L
0.0050
1
11 /19/21 11:16 11 /24/21 05:32 7439-92-1
Zinc
0.079 mg/L
0.010
1
11/19/2111:16 11/24/2105:32 7440-66-6
2540D Total Suspended Solids
Analytical Method: SM 2540D-2015
Pace Analytical Services - Asheville
Total Suspended Solids
7.6 mg/L
2.5
1
11/18/21 13:40
9040 pH
Analytical Method: EPA 9040C
Pace Analytical Services - Asheville
pH at 25 Degrees C
6.4 Std. Units
0.10
1
11/23/21 10:57 H3
Date: 11129/202105:23 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 5of15

aceAnalXical
www.pacelabs.com
s
Pace Analytical Services, LLC
9800 IGncey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: STORMWATER SAMPLING
Pace Project No.: 92572462
QC Batch: 659972 Analysis Method: EPA 1664B
QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease
Laboratory: Pace Analytical Services - Charlotte
Associated Lab Samples: 92572462001, 92572462002
METHOD BLANK: 3458296 Matrix: Water
Associated Lab Samples: 92572462001, 92572462002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Oil and Grease mg/L • ND 5.0 11/16/21 08:50
LABORATORY CONTROL SAMPLE: 3458297
Spike LCS LCS % Rec
Parameter Units Conc. Result % Rec Limits Qualifiers
Oil and Grease mg/L 40 36.3 91 78-114
MATRIX SPIKE SAMPLE: 3458298
Parameter Units
Oil and Grease mg/L
SAMPLE DUPLICATE: 3458299
Parameter
Oil and Grease
35676265001 Spike MS MS
Result Conc. Result % Rec
1 A U 39.2 31.8
% Rec
Limits Qualifiers
81 78-114
35676262001 Dup
Units Result Result RPD Qualifiers
mg/L 11.6.1 1.9J
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
This report shall not be reproduced, except in full,
Date: 11/29/2021 05:23 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 15

'*
ace Analj cal
www.patelabs.com
Pace Analytical Services, LLC
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: STORMWATER SAMPLING
Pace Project No.: 92572462
QC Batch: 661080 Analysis Method: EPA 200.7 Rev 4.41994
QC Batch Method: EPA 200.7 Rev 4.4 1994 Analysis Description: 200.7 MET
Laboratory: Pace Analytical Services - Asheville
Associated Lab Samples: 92572462001, 92572462002
METHOD BLANK: 3463891
Associated Lab Samples: 92572462001, 92572462002
Parameter Units
Copper
Lead
Zinc
mg/L
mg/L
LABORATORY CONTROL SAMPLE: 3463892
Parameter Units
Copper
Lead
Zinc
... I. -
mg/L
mg/L
Matrix: Water
Blank Reporting
Result Limit
Analyzed
ND 0.0050
11/24/21 05:02
ND 0.0050
11/24/2105:02
ND 0.010
11/24/21 05:02
Spike LCS LCS % Rec
Cone. Result % Rec Limits Qualifiers
0.5 0.50 99 85-115
0.5 0.50 100 85-115
0.5 0.50 100 85-115
MATRIX SPIKE & MATRIX SPIKE DUPLICATE:
3463893
3463894
MS
MSD
92572323001
Spike
Spike
MS
MSD
MS
MSD
% Rec
Parameter Units
Result
Conc.
Conc.
Result
Result
% Rec
% Rec
Limits
RPD
Copper mg/L
0.0075
0.5
0.5
0.49
0.56
97
111
70-130
13
Lead mg/L
ND
0.5
0.5
0.50
0.56
100
112
70-130
12
Zinc mg/L
0.035
0.5
0.5
0.54
0.62
101
116
70-130
13
MATRIX SPIKE & MATRIX SPIKE DUPLICATE:
3463895
MS
92572999001
Spike
Parameter Units
Result
Conc.
Copper mg/L
7.9 ug/L
0.5
Lead mg/L
ND
0.5
Zinc mg/L
ND
0.5
3463896
MSD
Spike
MS
MSD
MS
MSD
% Rec
Cone.
Result
Result
% Rec
% Rec
Limits RPD Qual
0.5
0.54
0.55
107
108
70-130 1
0.5
0.51
0.52
102
104
70-130 2
0.5
0.50
0.51
100
101
70-130 1
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
This report shall not be reproduced, except in full,
Date: 11/29/202105:23 PM without the written consent of Pace Analytical Services, LLC.
Page 7 of 15

aceAnalytical
www.pacelabs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: STORMWATER SAMPLING
Pace Project No.: 92572462
QC Batch: 660563 Analysis Method: SM 254OD-2015
QC Batch Method: SM 254OD-2015 Analysis Description: 2540D Total Suspended Solids
Laboratory: Pace Analytical Services - Asheville
Associated Lab Samples: 92572462001
METHOD BLANK: 3461115
Associated Lab Samples: 92572462001
Parameter Units
Total Suspended Solids mg/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 2.5 11/17/21 16:17
LABORATORY CONTROL SAMPLE: 3461116
Spike LCS LCS % Rec
Parameter Units Conc. Result % Rec Limits Qualifiers
Total Suspended Solids mg/L 250 252 101 90-110
SAMPLE DUPLICATE: 3461446
92572266002 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L 184 180 2
SAMPLE DUPLICATE: 3461447
Parameter
Total Suspended Solids
92572266004 Dup
Units Result Result RPD Qualifiers
mg/L 83.0 77.0 8
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
This report shall not be reproduced, except in full,
Date: 11 /29/2021 05:23 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 15

aCmalytical
www.pacelabs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: STORMWATER SAMPLING
Pace Project No.: 92572462
QC Batch: 660791 Analysis Method: SM 254OD-2015
QC Batch Method: SM 254OD-2015 Analysis Description: 2540D Total Suspended Solids
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92572462002
METHOD BLANK: 3462269 Matrix: Water
Associated Lab Samples: 92572462002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Suspended Solids mg/L ND 2.5 11/18/21 13:39
LABORATORY CONTROL SAMPLE: 3462270
Spike LCS
Parameter Units Conc. Result
Total Suspended Solids
mg/L 250
LCS
% Rec
246 98
% Rec
Limits Qualifiers
90-110
SAMPLE DUPLICATE: 3462555
92572876001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L 242 242 0
SAMPLE DUPLICATE: 3462556
Parameter
Total Suspended Solids
92572607009 Dup
Units Result Result RPD Qualifiers
mg/L 193 212 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
This report shall not be reproduced, except in full,
Date: 11/29/202105:23 PM without the written consent of Pace Analytical Services, LLC. Page 9 of 15

aceAnalj&al
www.pacolabs.com
s
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersvilie, NC 28078
[phone]
QUALITY CONTROL DATA
Project: STORMWATER SAMPLING
Pace Project No.: 92572462
QC Batch: 661789 Analysis Method: EPA 9040C
QC Batch Method: EPA 9040C Analysis Description: 9040 pH
Laboratory: Pace Analytical Services - Asheville
Associated Lab Samples: 92572462001, 92572462002
SAMPLE DUPLICATE: 3467284
Parameter
pH at 25 Degrees C
SAMPLE DUPLICATE: 3467285
Parameter
pH at 25 Degrees C
Units
Std. Units
92572259001 Dup
Result Result
RPD Qualifiers
7.9 7.9 0 H3
92572800001 Dup
Units Result Result
Std. Units 6.8
RPD Qualifiers
6.8 0 H3
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
This report shall not be reproduced, except In full,
Date: 11 /29/2021 05:23 PM without the written consent of Pace Analytical Services, LLC. Page 10 of 15

aceAnalXical
www.pacelabs.com
Pace Analytical Services, LLC
9800 IGncey Ave. Suite 100
Huntersvilie, NC 28078
[phone]
QUALIFIERS
Project: STORMWATER SAMPLING
Pace Project No.: 92572462
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 Chloroethylvinyi 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 TN accredited. Contact your Pace PM for the current list of accredited analytes.
TN I - The NELAC Institute.
ANALYTE QUALIFIERS
H3 Sample was received or analysis requested beyond the recognized method holding time.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 11 /29/2021 05:23 PM without the written consent of Pace Analytical Services, LLC. Page 11 of 15

aceAnalytical
www.pacetabs.com
Pace Analytical Services, LLC
9800 IGncey Ave. Suite 100
Huntersville, NC 28078
[phone]
S
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: STORMWATER SAMPLING
Pace Project No.: 92572462
Lab ID
Sample ID
QC Batch Method
QC Batch
Analytical
Analytical Method Batch
92572462001
11-2021 #1
EPA1664B
659972
92672462002
11-2021 #2
EPA1664B
659972
92572462001
11-2021 #1
EPA 200.7 Rev 4.4 1994
661080
EPA 200.7 Rev 4.4 1994 661260
92572462002
11-2021 #2
EPA 200.7 Rev 4.41994
661080
EPA 200.7 Rev 4.41994 661260
92572462001
11-2021 #1
SM 254OD-2015
660563
92572462002
11-2021 #2
SM 254OD-2015
660791
92572462001
11-2021 #1
EPA 9040C
661789
92572462002
11-2021 #2
EPA 9040C
661789
Date: 11129/202105:23 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 12 of 15

Document No.:
Laboratory receiving Samples:
Asheville ❑ Eden[] Greenwood ❑ Huntersville1K Raleigh❑ Mechanicsville[] Atlanta❑ Kernersville❑
Client Name:
.Z r- <.(�ss; s-��w1,L'� ProjectgWO## :92572462
Courier: ❑Fed Ex ❑UPS ❑USPS []Client
❑ Commercial [pace ❑Other._
Custody Seal Present? ❑Yes 2No Seals Intact? []Yes "�JLo
Packing Material: Nubble Wrap gEBubble Bags ❑None ❑ Other
ThermometeJ:
DU cre In. 92, W F j>�Wet [:]Blue
ypeo ce:
Correction Factor:
Cooler Temp: Add/Subtract (°C) (/ • L
Cooler Temp Corrected( Q
USDA Regulated Soil (bN/A, water sample)
Did samples originate in a quarantine zone within the United States: CA, NY, or SC (check maps)?
P 1111 I111111111111111
92572462
Dne/In ials Person Examining Contents:)
Biological Tissue Frozen?
[]Yes ❑No ❑N/A
Temp sNuld be above freezing to 6'C
❑sanples out of temp cdteda. Samples on ice, cooling process
has btvn
Did samo!sonpnate from a foreign source (Internationally,
Yes ❑No
IndudlnlHiwaD and Puerto Nrn)?❑Yes ONO
Comments/Discrepancy:
Chain of Custody Present?
Yes
❑No
❑N/A
1.
Samiles Arrived within Hold Time?
Yes
ONO
❑N/A
2.
Short Hold Tons Analysis j<72 hr.)?
byes
MNo
❑N/A
3.
Rush Turn Around Time Requested?
❑Yes
jpNo
❑N/A
4.
Sufficient Volume?
WYW
QNo
ON/A
S.
Correct Containers Used?
-Pace Containers Used?
J§Yes
Dyes
ON.
ONO
❑N/A
❑N/A
6.
Containers Intact?
es
ONE
❑N/A
7.
Dissolved analysis: Samples Field Filtered?
❑Yes
ONE
'MNIA
8.
Sample Labels Match COC?
-Includes DatetrimeAD/Analysis Matrix:
rzfyes
vV f
ONO
❑N/A
9.
Heads ace in VOA Vials >S-6mm)7
OYES
ONO
N/A
10.
Trip Blank Present?
Trip Blank Custody Seals Present?
❑Yes
QY1[:]No
Efso
❑N/A
/A
11.
COMMENTS/SAMPLE DISCREPANCY
Lot ID of spit containers:
CLIENT NOTIFICATION/RESOLUTION
Project Manager SCURF Review:
tale:
Project Manager SRF Review: late:
Field Data Required? []Yes ❑No

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