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HomeMy WebLinkAboutNCG060387_2022 DMR_20220428 (2)(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. Macfarlane@anaergia.com. 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 Alex.Macfarlane@anaergia.com Phone Number 646-236-3439 aceAnalytical www.pacelabs.com Pace Analytical Services, LLC 9800 Kincey Ave. Suite 100 Huntersville, NC 28078 (704)875-9092 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 sara.poulson@pacelabs.com (704)875-9092 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 (704)875-9092 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 (704)875-9092 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 (704)875-9092 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 (704)875-9092 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 (704)875-9092 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 (704)875-9092 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 (704)875-9092 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 (704)875-9092 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 (704)875-9092 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 (704)875-9092 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 (704)875-9092 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 n u " — z Z a v v a n 7 ro v Q1 v � a z m a v y m a a c a c a a N z u O = Ym_v N j25= ii d nn N w u �m•, u _ V U V V •C 71 V = Z � L Se e u 1] = N a v a m a m A a ro a M a ° E d E A E E ¢ a E E ¢ o N ¢ O a O ¢ O ¢ o � C a ° a 8 " u n E G c 9 E E E a C 4 ¢ J 7 7 ? 7 1 ,n ¢ E :i E E E E b ° Y a E ran E E E E A c E E o E E O O T in O .v� vo - — v1 = O O O O LA O Ln O O O m U 0 0 0 t7 C7 V` l7 l7 L9 O � N a N y M a O 0 V1 GI to _ m m m m co m m a a Q a ¢ Q O ? ? G 7 7 vt m 4 7 O 1 2 f 7 3 1 4 f 5 k t 6 7 9 t0 11 12 �,NNN 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 N � G� m > 1 A C z c a m A m m o z z w w v N y y z Z m m a � A C m w TEMP m C T�� Ice (YIN) cs�"tpdy` Sealed Cooler (WIN) Samples ntact (Y1N) lV p fD 00 y d7 L A m n a n g 3 n o r m ITEM 9a c m 3 n 1 .. W W CD CD a �. N O C] N N N fl 0 R 0 v n ci} a G) 0 ca y °c n N 2 > o o g 3W3 G EL M N N 3 N J m o x 2 3 a n T A 5. 7 r o ^�01r M an m 3 i r �o v m ' �� N e W N Mpn�po�m f4 ae��x �„� 0 0 0 o m m n n a n 9 n m o m o o Cl dJ Q 3 O -0m m a MATRIX CODE (see valid codes to left) o 3 m- 5 SAMPLETYPE (G=GRAB C-COMP) o m w c Q 0 0 p .d. N N N 0 N 0 N q m m a y a r � 0 pNp O N O N 0 N o N b 0 O a w w w m m go M CD m o 0 z m �L D � l� N N b M N o N s pNp N o N 10- m r � N O C 0 SAMPLE TEMP AT COLLECTION n y V f #OF CONTAI NERS m x Unpreserved 3 0 » b ,131'o' m ° r- x� o .. •7, a (y rrl H2SO4H2SD4 - 3 m`n m 0 0® HNO3 # d w x HCI w l 0 w� NaDH p2i Lmi C � � Na2S203 C m < Z rn Methanol Fi m Dther m r Analyses Test YIN < 1.~ n pH M � z x TSS254CD a x r� x CDD c C 1664 Oil & Grease Q x FI 0 Fecal coli M G I n m Residual Chlorine (Y/N) �N m N O U � T ri � Ci m a n c 2 P� ro z n 0 Page 15 of 15