NCG060387_2022 DMR_20220428

(8)Anaergia
April 26, 2022
North Carolina Department of Environmental Quality
Mooresville Regional Office
610 East Center Avenue, Suite 301
Mooresville. NC 28115
RE: Quarterly Stormwater Discharge Monitoring Report Q1 - 2022
General Permit No. NCG060000
Certificate of Coverage No. NCG060387
Orbit Energy Charlotte, LLC
600 Johnson Road, Charlotte, NC
To whom it may concern:
Anaergia Services LLC
705 Palomar Airport Rd. Suite 200
Carlsbad, CA 92011 USA
+1.760.517-7259
www.anaergia.com
This letter is being delivered by Anaergia Services, LLC as the owner of Orbit Energy Charlotte, LLC (Orbit Energy),
located at 600 Johnson Road in Charlotte, North Carolina. Enclosed is the completed Stormwater Discharge
Monitoring Report (DMR) Form for North Carolina Division of Water Resources General Permit No. NCG060000
(Food and Kindred) and the corresponding analytical data. The 2022 first quarter (Q1) stormwater monitoring was
conducted on March 9, 2022; all analyzed parameters are within or below benchmark criteria.
Should you have any questions or need anything further, please do not hesitate to contact me on my cell phone at
646-236-3439 or at Alex. [e-mail].
Sincerely,
Alexander MacFarlane
VP, Anaergia Services, LLC
Enclosures
cc: Miguel Lugo, Anaergia Services, LLC
Rhiad Gajraj, Anaergia Services, LLC
Ashwani Kumar, Anaergia Services, LLC
Nicole Mulanaphy, SAGE Environmental, Inc.

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
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. NCG06 0387
Person Collecting Samples: Miguel Lugo
Facility Name: Orbit Energy Charlotte LLC
Laboratory Name: Pace Analytical Services Charlotte
Facility County: Mecklenburg
Laboratory Cert. No.: 12 (Wastewater)
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 ONO
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR ❑✓ Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities— Benchmarks in (Red)
Parameter
Parameter
Outfall 1
Outfall
Outfall
Outfall
Outfall
Code
N/A
Receiving Stream Class
Class C
N/A
Date Sample Collected MM/DD/YYYY
03/09/2022
46529
24-Hour Rainfall in inches
2.41
C0530
TSS in mg/L (100 or 50*)
70.0
00400
pH in standard units (6.0 —9.0)
7.2
00556
Oil & Grease in mg/L (30)
<5.3 mg/L
Fecal Coliform per 100 ml of
31616
freshwater (if required) (1000)
864
Enterococci per 100 ml of saltwater
61211
(if required) (500)
Chemical Oxygen Demand in mg/L
00340
(120)
70.0
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
00552
Non -Polar Oil & Grease in mg/L (15)
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark T55 limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
Notes (optional):
"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."
Permittee or Delegated Authorized Individual
April 26, 2022
Date
Email Address [e-mail] Phone Number 646-236-3439

aceAnalytical
www.pacelabs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
March 22, 2022
Judson Gerbier
Anaergia Services, LLC
600 Johnson Rd.
Charlotte, NC 28206
RE: Project: STORMWATER
Pace Project No.: 92592783
Dear Judson Gerbier:
Enclosed are the analytical results for sample(s) received by the laboratory on March 10, 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
• Pace Analytical Services - Charlotte
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Sara Poulson
[e-mail]
[phone]
Project Manager
Enclosures
cc: Miguel Lugo, Anaergia Services, LLC
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 15

aceAnalytical
www.paeelabs.enm
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Project: STORMWATER
Pace Project No.: 92592783
Pace Analytical Services Charlotte
South Carolina Laboratory ID: 99006
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certification #: 12
South Carolina Laboratory ID: 99006
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87648
North Carolina Drinking Water Certification #: 37712
North Carolina Wastewater Certification #: 40
CERTIFICATIONS
South Carolina Certification #: 99006001
South Carolina Drinking Water Cert. #: 99006003
Florida/NELAP Certification #: E87627
Kentucky UST Certification #: 84
Louisiana DoH Drinking Water#: LA029
Virginia/VELAP Certification #: 460221
South Carolina Laboratory ID: 99030
South Carolina Certification #: 99030001
Virginia/VELAP Certification #: 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

aceAnalytical
www.paeelabs.enm
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
SAMPLE ANALYTE COUNT
Project:
Pace Project No.:
STORMWATER
92592783
Analytes
Lab ID
Sample ID
Method
Analysts
Reported
Laboratory
92592783001
SW(2)2022
EPA 1664B
ICO
1
PASI-C
SM 254OD-2015
MAB2
1
PASI-A
EPA 9040C
YEG
1
PASI-A
SM 5220D-2011
JP1
1
PASI-A
92592783002
SW(2)2022-FC
SM 9222D-2015
KDF
1
PASI-C
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

aceAnalytical
www.paeelabs.enm
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: STORMWATER
Pace Project No.: 92592783
Sample: SW(2)2022 Lab ID: 92592783001 Collected: 03/09/22 12:00 Received: 03/10/22 14:25 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
5.3 1
03/15/22 00:10
2540D Total Suspended Solids
Analytical Method: SM 2540D-2015
Pace Analytical Services - Asheville
Total Suspended Solids
70.0 mg/L
25.0 1
03/12/22 10:54
9040 pH
Analytical Method: EPA 9040C
Pace Analytical Services - Asheville
pH at 25 Degrees C
7.2 Std. Units
0.10 1
03/14/22 14:44
5220D COD
Analytical Method: SM 5220D-2011
Preparation Method: SM 5220D-2011
Pace Analytical Services - Asheville
Chemical Oxygen Demand
70.0 mg/L
25.0 1
03/22/22 01:56 03/22/22 05:33
Date: 03/22/2022 04:19 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
H3
Page 4 of 15

aceAnalytical
www.paeelabs.enm
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: STORMWATER
Pace Project No.: 92592783
Sample: SW(2)2022-FC Lab ID: 92592783002 Collected: 03/10/22 12:00 Received: 03/10/22 14:25 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
MBIO 9222D Fecal Coliform CHT Analytical Method: SM 9222D-2015 Preparation Method: SM 9222D-2015
Pace Analytical Services - Charlotte
Fecal Coliforms 864 CFU/100 mL 1.0 1 03/10/22 17:01 03/11/22 15:16
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03/22/2022 04:19 PM without the written consent of Pace Analytical Services, LLC. Page 5 of 15

aceAnalytical
www.pacelabs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: STORMWATER
Pace Project No.: 92592783
QC Batch: 684653 Analysis Method: EPA 1664B
QC Batch Method: EPA 1664B Analysis Description: 1664 HEM, Oil and Grease
Laboratory: Pace Analytical Services - Charlotte
Associated Lab Samples: 92592783001
METHOD BLANK: 3580525
Associated Lab Samples: 92592783001
Parameter
Units
Oil and Grease
mg/L
LABORATORY CONTROL SAMPLE:
3580526
Parameter
Units
Oil and Grease
mg/L
MATRIX SPIKE SAMPLE:
3580527
Parameter
Units
Oil and Grease
mg/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 5.0 03/15/22 00:10
Spike LCS LCS % Rec
Cone. Result % Rec Limits Qualifiers
40 33.1 83 78-114
50310920002 Spike MS MS % Rec
Result Cone. Result % Rec Limits Qualifiers
<5.0 39.6 31.5 77 78-114 M1
SAMPLE DUPLICATE: 3580528
92592634001 Dup
Parameter Units Result Result
Oil and Grease mg/L ND 1.3J
RPD Qualifiers
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: 03/22/2022 04:19 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 15

aceAnalytical
www.pacelabs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: STORMWATER
Pace Project No.: 92592783
QC Batch: 683991 Analysis Method: SM 9222D-2015
QC Batch Method: SM 9222D-2015 Analysis Description: 9222D Fecal Coliform(MF) - CHT
Laboratory: Pace Analytical Services - Charlotte
Associated Lab Samples: 92592783002
METHOD BLANK: 3577641 Matrix: Water
Associated Lab Samples: 92592783002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Fecal Coliforms CFU/100 mL ND 1.0 03/11/22 15:16
SAMPLE DUPLICATE: 3577642
Parameter
Fecal Coliforms
92592783002 Dup
Units Result Result RPD Qualifiers
CFU/100 mL 864 870 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: 03/22/2022 04:19 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
Pace Project No.: 92592783
QC Batch: 684317 Analysis Method: SM 2540D-2015
QC Batch Method: SM 254OD-2015 Analysis Description: 2540D Total Suspended Solids
Laboratory: Pace Analytical Services - Asheville
Associated Lab Samples: 92592783001
METHOD BLANK: 3579131
Associated Lab Samples: 92592783001
Parameter
Units
Total Suspended Solids
mg/L
LABORATORY CONTROL SAMPLE:
3579132
Parameter
Units
Total Suspended Solids
mg/L
SAMPLE DUPLICATE: 3579168
Parameter
Units
Total Suspended Solids
mg/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 2.5 03/12/2210:54
Spike 1-CS LCS % Rec
Conc. Result % Rec Limits Qualifiers
250 242 97 90-110
92592695001 Dup
Result Result RPD Qualifiers
ND ND
SAMPLE DUPLICATE: 3579169
92592702001 Dup
Parameter Units Result Result
Total Suspended Solids mg/L 16.5 15.5
RPD Qualifiers
6
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: 03/22/2022 04:19 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 15

aceAnalytical
www.pacelabs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: STORMWATER
Pace Project No.: 92592783
QC Batch: 684432 Analysis Method: EPA 9040C
QC Batch Method: EPA 9040C Analysis Description: 9040 pH
Laboratory: Pace Analytical Services - Asheville
Associated Lab Samples: 92592783001
SAMPLE DUPLICATE: 3579474
92591530002
Dup
Parameter
Units
Result
Result RPD Qualifiers
pH at 25 Degrees C
Std. Units
6.5
6.6 0 H3
SAMPLE DUPLICATE: 3579475
92592767002
Dup
Parameter
Units
Result
Result RPD Qualifiers
pH at 25 Degrees C
Std. Units
7.0
7.0 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: 03/22/2022 04:19 PM without the written consent of Pace Analytical Services, LLC. Page 9 of 15

aceAnalytical
www.pacelabs.com
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: STORMWATER
Pace Project No.: 92592783
QC Batch: 686286 Analysis Method: SM 5220D-2011
QC Batch Method: SM 5220D-2011 Analysis Description: 5220D COD
Laboratory: Pace Analytical Services - Asheville
Associated Lab Samples: 92592783001
METHOD BLANK: 3588139
Associated Lab Samples: 92592783001
Parameter Units
Chemical Oxygen Demand mg/L
LABORATORY CONTROL SAMPLE: 3588140
Parameter Units
Chemical Oxygen Demand mg/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 25.0 03/22/22 05:29
Spike 1-CS LCS % Rec
Cone. Result % Rec Limits Qualifiers
750 764 102 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 3588141 3588142
MS MSD
92592594001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Cone. Cone. Result Result % Rec % Rec Limits RPD Qual
Chemical Oxygen Demand mg/L ND 100 100 100 105 100 105 90-110 5 R1
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 3588143 3588144
MS MSD
92592714001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Cone. Cone. Result Result % Rec % Rec Limits RPD Qual
Chemical Oxygen Demand mg/L 556 100 100 638 631 82 75 90-110 1 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
This report shall not be reproduced, except in full,
Date: 03/22/2022 04:19 PM without the written consent of Pace Analytical Services, LLC.
Page 10 of 15

aceAnalytical
www.paeelabs.enm
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALIFIERS
Project: STORMWATER
Pace Project No.: 92592783
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 ofAcrolein 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
H3 Sample was received or analysis requested beyond the recognized method holding time.
M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery.
R1 RPD value was outside control limits.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 03/22/2022 04:19 PM without the written consent of Pace Analytical Services, LLC. Page 11 of 15

aceAnalytical
www.paeelabs.enm
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: STORMWATER
Pace Project No.: 92592783
Lab ID
Sample ID
QC Batch Method
QC Batch Analytical Method
92592783001
SW(2)2022
EPA 1664B
684653
92592783002
SW(2)2022-FC
SM 9222D-2015
683991 SM 9222D-2015
92592783001
SW(2)2022
SM 254OD-2015
684317
92592783001
SW(2)2022
EPA 9040C
684432
92592783001
SW(2)2022
SM 5220D-2011
686286 SM 5220D-2011
Date: 03/22/2022 04:19 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Analytical
Batch
683992
686293
Page 12 of 15

Document Name:
Document Revised: November 15, 2021
�ceAnalXical'
Sample Condition Upon Receipt (SOUR)
Page 1 of 2
Document No,:
Issuing Authority:
F-CAR-CS-033-Rev.08
Pace Carolinas Quality Office
Laboratory receiving samples:
Asheville ❑ Eden[] Greenwood ❑ HuntersvilleRaleigh❑ Mechanicsville[] Atlanta❑ Kernersviile❑
Sample 1nn .ConditionCllentName: eceipt Projectli WO# . 92592783
Courier: 0Fed Ex ❑UP5 ❑ ❑Client
❑Oche f I I `I� I Ills I� 1 I I I �II
❑ Commercial n�6`�ce Other:
92592183
Custody Seal Present? ❑Yes ,❑No Seals Intact? ❑Yes ❑No
Date/Initlals Person Examining Contents; 3 I �� 2 I`
Packing Material: ❑Bubble Wrap _- Bubble Bags [:]None ❑' Other Biological Tissue ozen?
Thermometer: []Yes❑No ON/A
ElIRCun ID: 2 r, ❑Wet ❑9[ue ❑Nano
�SJ� Typo of Ice:
Correction Factor.
Cooler Temp: `� Add/Subtract (°C) L) Temp should be above freezing to 6°C
r I� Cooler Temp Enrrectedj'E}: ❑Samples out of temp criteria. Samples on ice, cooling process
ugun
2 —
USDA Regulated Soll 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 lintemationally,
MY.. FIN. .e.a .—.inl -J o _11 M. 1'l.
Comments/Discrepancy: V -
Chain of Custody Present?
es
[]No
❑NIA
1.
Samples Arrived within Hold Time?
OYes
❑No
❑NIA
2.
Short Hold Time Analysis (c72 hr.)?
-ZYes
[]NO
N/A
3.
Rush Turn Around Time Requested?
QYes —4ETN'0
[]N/A
4.
Sufficient Volume?
Yes
No
❑N/A
5.
Correct Containers Used?
-Pace Containers Used?
Oyes
©Yes
(-]No
❑No
❑N/A
❑NIA
6.
Containers Intact?
❑Yes
[]No
QNJA
7.
Dissolved analysis: Samples Field Filtered?
[]Yes
[]No
r N/A
S.
Sample Labels Match COC?
-Includes Date/Time/ID/analysis Matriic;
Ifyes
W l
[]No
❑N/A
9.
Headspace in VOA Vials (>5.6mm)7
❑Yes
o
�
. H/A
10.
Trip Blank Present?
Trip Blank Custody Seats Present?
❑Yes
❑Yes
.BNo
[]NoA
❑]NNIA
11,
COMMENTS/SAMPLE DISCREPANCY
CLIENT NOTIFICATION/RESOLUTION
Project Manager SCURF Review:
Project Manager SRF Review:
Lot ID of split containers:
me:
Date:
Date:
Field Data Required? ❑Yes [-]No
Page 13 of 15

Document Name:
Document Revised; November 15, 2021
aceAna[y[r'ca[
Sample Condition Upon Receipt {SCUR)
Page 2 of 2
Document No.:
Issuing Authority:
F-CAR•C5-033-Rev.08
Pace Carolinas Quality Office
*Check mark top half of box If pH and/or dechlorination is
verified and within the acceptance range for preservation
samples,
Exceptions: VOA, Coliform, TOC, Oil and Grease, DR0/g015 (water) DOC, Li_Hg
"Bottom half of box is to list number of bottles
Project I 01t : 92 592783
PM: SI, Due Date: 03/24/22
MEW: 92-MantB10
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I
N-NN\�
pH Adjustment log for Preserved Samples
Sample 10
Type of Preservative
pH upon receipt
Date preservation adjusted
Time preservation
Amount of Preservative
Lot R
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 14 of 15

3
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Page 15 of 15