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HomeMy WebLinkAboutWQ0016376_Monitoring - 08-2022_20221115Monitoring Report Submittal Permit Number #* WQ0016376 Name of Facility:* S&J VILLARI LIVESTOCK PROCESSING FACILITY - WARSAW Month: * August Year: * 2022 Report Information .......................... .................... Type* Upload Document* NDMR, NDAR-1, NDAR-2, NDMLR wwt August 2022.pdf 8.17MB PDF Only Please upload one PDF containing all applicable monitoring reports (i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59). Confirmation Email Address:* gerald.m@vfgmail.com Name of Submitter: * Gerald Matthews Signature: Date of submittal: 11/15/2022 This will be filled in automatically Initial Review Reviewer: Gerald, Wanda Is the project number correct?* WQ0016376 Is the monitoring report accepted?* Yes No Regional Office* Wilmington Reviewer: _anonymous Review Date: 11/17/2022 0 R, NON -EA, S'CHARG E IM ORI NG REP Rl NDMR 03 -` ISCHARGE ;'AGNITORING R NEW, -1 - '03 - N 0 �N' A R G E !"-0,3 0 R I N G R EE R'T (N D M R) FORM INDMR�11_i',, Sampling Person(s) Name: GERALD LAMAR MATTHEWS NON -DISCHARGE fOONiTCRING PEPORT (tNDI R) Certified Laboratories Name: Environmental: Chemists INC. Name: Water Agricultural Laboratories uL Compliant 77 NPn-C©napllant If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance, Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. operator in Resporl ibie Charge (oRC) Certification Permittee Certification ORC: GERALD LAMAR MATTHEWS Permittee: SAM VILLARI Certification No.: 993131 signing official: Grade: 51 Phone Number: 910-289-7500 signing official's Title: OWNER Has the oRC changed since the previous NDMR? Yes No Phone Number: 910-293-2157 Permit Expiration: 11/30/2025 Signature Date Signature Date By th€s signature. I certify that this report is aecurrate and complete to thye best of ±ny kno, rtedge, I certify under penalty of law, that this document and all attachments were Prepared Under my direction or supervision in accordance °w th a system designed to assure that all qualified personnel property gathered and evaluated the information submitted, Based on my inquiry of the person or persons who manage the systemor those persons directly responsible for ,gathering the information, the information submitted is, to the nest of my knowledge are belief. !rue, accurate. and vomplete. I am a vare that there are significant penalties for submiuing false information, including the possibility o€ fines and imprisonment for knavring violations. Mail Original and Two Copies to: Division of Water Quality Information Processing Unit 1617 bail Service Center Raleigh, North Carolina 2769x61 ' 'Tv z= ,"I3. _> <_ .GiA MA52Ei LOADING a i.,.tI=i7 ... F I .a'`— -�j-- --t .. � - _ = _ _o,-.Fb � �i_ `_ .mot-L__ 2 idJa1IE.= -C;\ .m1arrte 77, '! ger..- 7s'^ 5 Y .�, C }~i p N Field Zone Area i (acres}; 0,65 Area (acres): �i$.= tr 3} \ '. Area (ayes ( Cover Crop_ C av _ De.r G e Cover Crop: ' a ? - Cover CropdCoaszal Bermi ich Load Type `,N Field Loade€?I L-`L �\ \ \ +r,-.., � Y� \ ��4� \ � _ t Load Type. A Y � �� � sF� ld Loaded_ LI i , ` ��� Type \F[e c e P� � I Load Type.1, PAN =°`; C _' Field eaded?' [� \\ [} \ \ CL CL a. � ?' t) - fit`; \\ \ p \ ,� �\ .EL �" > \ � � \ # \ � i > 0 _ Month 1 gal III, gtL lbslac !b�ta� I ,: \ aJ \\ \ ��1� _ =.$3 #�sfa� bsl��, n� � Sal g/L 1 lbs1ac 1 lbslac iS. ;s. € i gal mg/L Ibs!ac lbsf ac .. t E Cac{ cu--= 52,g98 38 I 25.8 43.0` q a \.f _ ?8 43.0 .—_ , November 1== 3c,906 M 27.7 �}1 \ `\ $ 91 leo 38 68.8 Deeembes - 4,138419. 3 '.:8Q9 J28.--- "fig ! $ 3,8 43.E i _ $79 r9t ..._ \13, ,4 43.E g Jar a, 55 6 1 2p 7 �1 � ti T \ \ 108 � � � � g. 7 �x, ; t�8 g7 t 7 \ `� \\f r �83, 8.6r Febrowv 24,865 55. 6 = i7.-T �� 2� 12� - 42,845 1 7 12� A�,� €% . __.. � '3 55.5 3 5 �� 55.8 17,7 E23 3 e-,g1 '51 I #[€,.,. �.:51v� v �1 v ?55%^ 43.F �5 i 11 4'A _ 4�� 4�3.5 35 At -- — _ , �?,32t 7.4 -- I :373.: �� 1£ �2;3 '-1$r ,` v? v v 7T2,3 = 43 �`? t1a_ r— 54,$45 38 1 26.8 i `, 8 2b 8° a C7 u 35 38.1 ,3 1 t5 5 ..?\ Sfi `... \ 7 5?' 1C00,4 2 ' 38.1 26,v 5.5 "tine Q- _ m y_ 31,77 ! _ 1d.n r_ 11q`7Q:`v �358`�f$� _ yy �a i 5.t. i 5t 35.8 - 93 1 52 3Et `� 3 "� ..� �t. 1 1 5 91 5t3, 35.8 14 519G.1 -y 23200 14,1 v 5 d t 7 5 1 v Q 6 ��. 73 4t 5 2 4.2 8¢ t 1 2i d2 � 5 ' 04 3 � v 4. } August 80,508 30, 8 4 A 147,392 � q � r� 39_8 ..1 7\ ,392 E \ ` \ „�\ \ � t. �.[ r�-_3 r �vC�A[YLoad Limit! �`.\ 3 .. P k >>`C=16 6 e t i"t � MU . - ari Livestoak _ Kesa? g-. a-`':-1-,..c`u���1('d � r*, `,`,�" �LE'-� .�, � _ _ _ - _ hU--Ust Year: . eI d Narne. Zone 6rt d a ttTI eki Name, A Reed Name;' 2e^e '1 area (acres _ .s_ 1.` 7 \ � \ a aacras}c -m g r Fxaa � \ \ � � , �` : l 6 -- area ;are 1- m Covet' Crop-_ o e-�r f udj. csv �a r giver Crop: !Cca B � ` .... Pv�1 � a � � Cover Crop: 'Coastal Bg �a da � ._:. � ��� - i 21 e r . Loa T�� - FAQ � \����T�iP i��s% m R Lead Type: t��� PAN ���ad Type, � �a Field d Loader.. - \ ` \...... �. t 1 \ i-mot ? - \ - ,: \' L1 i .\ \ T'-Y.( LS1aC�ali. - \ 1 \\\ \' \ 14. t L,t38d2d? t.-= YES tau 7 PL ? t r \ \ \Q} \ `\ \ s\ 1 flt BLS ` € f \r�\Y" \\ \ `C :tj `®\i\ 1 �i 1? G 0 m o Y ` \\` \ T \ (a �J €° G�i € j �` T.\l{lr�V \ \\ \, 4_ \ spiv +\ $? ! ���` - €` �F Month i gal t t'4 '- �F tbs..fac lti3 \.\ a�,ii �5lk,:i € 5 [r1 6 Pia+S{a ,: i \\ i tbgf [b{ dal mglL (bsfac aI�siac \ € \ 48 3 1 2 2 �y 4i#~lo e' ,i cat€ ` - 5 - FF- 95,3 v8 2 4u.9 18 38 25 3 43 _ _= .8 _Nove 25,8 $ 6 \ \ 25 # f '42 38 25.8 58 818,634 3B 6.8 83,8 December 6,,448 4_, 9. , f 8 1 \ \` \ \ (`M Z, 6-5,650 43,5 _ 19,`- 87-9 3 43,> is ? E 87.9 January �. 52, € . -_ € _ � I i F :\ V \ Op �\ \ 7 555 699 55.0 i 20 r o Fe.-..i=iCtl ±- 44.7 a-_.s?-Si r ^o m 177 `'] 4: E \ 7 \ € 68` €, 17 - 8 v 7.' 126 r `3$` \ IIR? `� _ m - _ 5-5,8 a 55.6 1: 48.440 - 3 e - 1 G' 5.= #i1,751 #_. - . 141 .E 8-446 43.6 a.4 a Anne' 9 i 7148 i \ f 430 \ 7 \ \ 1485 25,628 41 4148 F. �_-_..���.. a3 Iti' y 98,724 3 8. -�� .4--® Y 26.$ ii 75 51G5,474 \ ; 381 2e,$ 175,5 123,193 38.1 26L8_ 75.4 at1- It 57,194 a5 14.6 1 3 61,195 3 -M 6 - 190 �- \ 884 \ \ -198. _ ,t \8 - 35.8 5 i 41.759 4; 14.1 s 2 .� i\ \4 C41` 2t_ y414 F 4f 5 -4.i- 2t143 1\ 5t\ Y 74 \ 5 f,.4 2.;9 47.0 14. AUgLISt 144.915 1 39,8 1 41.1 45 it, iT \�; 1 t\ '; `� - v 3'�z � k245.4 � s - "e�.,�F.� .�,.. <..:'.b,...��. . ating PAN Loa- 245 .4� .. -454 � � _ \ \ Y Ai nual PAN Load Limit \ `, p.. �F \\\ gk F 0 R h N DIA 101 A 3 h ONI-11"ISCHARIG-ZE P ASS LOME-111- G RE'IPOWRT !N110-nuMILM"', Pernik W00016,3 76 Faclfli4f ame-, G& pia' ariLives-to ckProcessing acifit GOUFAV: Ry—u Duplin at Zb a, eMd NanisA Zone i 0- Field Namc- —6,Dne- 13 Area (acresi- 1 143 Area facr 216 �Coas-�- Covert Load Ty P N Load Type PA�N pe, Field L'�aded?' EJ YFS Field Loaded? Yrs I 1 z z MEMBER 0 z M < -4 - 0 a z E > 0 0 > CL > nth gai Mg/L (sac 1 ibstac gal 3291L3 fbstac lbsiac 6 1 7777-2-- +1- 4& 1 47.2 IT2 I -Sep ember �i4Z 48.1 2 92,6C-8 October 116; 5s�i 38 758 1 4 0 A 1761 1 3-8 25.8 43.1 -7 'November -3 38 1 25 �8 6588 '7110#0`5 i -M' 17581- 1 25.8 68.8 7 3 43-5 December u january 63, 119 556 -3&6 SE6 '7 7 126-3 i-eb--ary A, 82, 2 7, 55Z 17,7 126 3 1; K Plarch 1 59,2t0a 43 �14t4 5.1 L 42- 3 1 141 -4 Apr.1 1 7,4 1 148,7 7:�IK 43 44,285 7.4 14&7 R may M,66� 138A 2 182,259 1 38-1 26.8 N un I 69,-904�5 1901 1 o 0 35.8 14.6 ISGA 5,59 JUN [-57,039 47.5 1 1,11 1 204.3 '1 A 210 4, 2 77,092 A 17 -1 August 77, 1117 39 8 ' 41 945A 267,534 3M 1 41 1 245 4; -41 'MRIM-1 12 Rhonth Poat.ncj PAN Loadl MR, fibs!aci r): 24b.4 245A P�A,` Load Li REM 350.00 Nionth: August Year: 2`022 -�Ield.Name&' 4one 14W Area ',acres). T7 Cover Crop a Bmud Load Type P A N Field Loaded? Ed Y F'S NO z & < 2 < > EL a.- 2 < _j E z > 0 IL < �E; gal Mg/L lbstac lbstac 280,585 48.11 14,6 38 26-2 40.8 382,268 38 t-7 W6 331,612 435 15-6 72-2 397,856 556 - 723,181 4-3.6 342 1471 - 568.71.3 I 7 31-1 178.3 713,224 381 990 4 207.7 1 691 103 3155-18 2e.8 234,5 4 729.657 39,8 3f.5 276., 27f,7 r . T _' Q av out. jMonth: �a 2lProcess- �� r W-IIs'; Zone > %` Area :fires};= 5.3'2 dare} '77"cn X Field N Zone 1 ld h1 �ii� =��! Name: Area ra yes:? ,82 �. reaao1 4Area {acres); Cover Crop_ cover Crop:; c�as al ua �t r t Cover Crop: l 1 p #. gad Type; PAN ad "` I- l I Load Tyne: PAN L aar3 y PAS Load Type: PAN 11 Fiefs Loaded?, = rd I'\i e d L ad t YFS t Field Loaded? ' Y€ _� NO�'_ Fi Lo o3 f FieldLoaded w ` 0 � � i , � � � � � z \ , � � e B - MI � 3-aI. . _ MI. � R€ \4}a \4� M. ypp.. yx. \^�' E -anq/L .: XX 1Y1{)jj xll --_ i lbs/a lbs/ac •_._ val : �JwV. 'IA jai 3 ]l��/� c s/a� b \ \ a�te�\ , \ fT1 September 33 45 32.8 1 127 12.7 ..Fit^ 1�, 48 1 � October 16 4�8.1 — 24 9 m � 55 ;8 4, F . v t1 12,918 ?8 5 �i v� y li YeRlb r 1 t �H \ \ December H 59.4 18 38 1 25.8 '. 81.5 ; � �� 1�7 :..-.. .�� `� � 15 1 � �r3.5 �' r - �'� � \ �v i January 8 '" 435 1 € i 0t 6 r& 6 t 3. 7,531 55.5 4.3 82 February r 1 t 1 2 1 15:485 [�.ar�!? J April —�_ 5 5 :.� " :'� ? 43.6 p1�5 �i ] \ 35 7 ` 4' �l 15:� _ 43.6 23, 43 6 14 _ ` v — May—,Yr�Z1 Jiire 967 . r 1611.4 $ 1 617 38 26,8 188.2 s 16, 7ix 38.1 6 3 r� July s 35 5 5 15,1 5 _ 36.$ - 5,a 8 6,054 47 2023 r, 15,8 8 47.5 73,5 \ ` August ,ja1t 3 i 2435 i3 e_ 244 a4 9- 39.8 12 Morith Floating PAN Load- 7 Ilbs/actyrl 4 rt g vv� \\ \ \ �+ V A. r,"a r AN Load Umir v 5 ` `3 (fbs/ac!irl< [ � i7 FORM NE)M t; -13 NON -DISCHARGE MASS 'LOADING REPORT N ML ' Page siiiiiiiiiIl• r :j Compliant _ � . CQ=npl am If the facility is non-cornphant please explaan in the space befog the reason(s) the facility was not in compliance. Provide In your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification Permittee Certification 0RC: Gerald Lamar Matthews Permittee: SAM VILLARI Certification Number: 993131 Signing Official: Grade: Si Phone Number: 910-289-7500 Signing Official's Title: OWNER Has the ORC changed since the previous NDMLR? i Yes i ° No Phone No.: 910-293-2157 Permit 111 11 /30125 - —z— 7_ 21 Signature Date Signature Date By this signature 'certify that this report is accurrate and complete to the nest of my knos;ledge I certfy, under penalty of ,aw That this document and 311 attachments were prepa`ed unaer my direction or supei v,s;o„ accordance wilh a sysism gesigned to assure thatall qualated rersunnel. properly gathered* and evaluated the Lnrormaimir s smitted. used on my inquiry or the porson x pe€sans v.,ro mgage he system c, those persons d eec.iy responsible for gatder ny ine in'ormabori the i 3f ination submite in � I'* o si of my a ov ledge aria e'ier a ue_ I! accurate, and Complate I am avisire that there are significant pei-a es f0i anm tying raise info,, :ati n icluding the possibility of tines d :r»vnsonmen! ;cir kh �r� .� vioiat,ons. Mail Original and Two Copies to: Division of Water Resources information Processing Unfit 1617 Mail Service Center Raleigh, North Carolina 27699-1 17 pP.. IN,'! N DA 7:-'PORT;MW,­ ,,, � N -DISC APPLICA"*"._,,_-. R_. a. -NON ' `.� DAR TiO N RE I, ILI N CHAR YlL --�A-TAK �N I.J t ,, ,, NON -DISCHARGE APPLICATION REPO;-,.T (NDAR-11 jil r the application rates exceed the limits in AttachmentB of Were adequate measures taken to prevent effluent ponding in or runoff from the sites? Was a suitable vegetative ea on Were all setbacks listed in your permit maintained for every application to each permitted site? Were all freeboards maintained in accordance 'e specified freeboard heights on; !ia=:; compilant -' Non Compliant Compilan� Non -Cc pfianr corrani+ant Non-Comphant Cnmpliant L�, Non-Complorit If the facility is non -compliant, please expfain in the space below the reason(s) the facility was not in compliance Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach additional sheets if necessary. Operator in Responsible Charge (ORC) Certification Permittee Certification ORC: Gerald Lamar Matthews Permittee: Sam Villari Certification No.: 993131 Signing Official: Grade: Sl Phone dumber: 910-239-7000 Signing Official's Title-, Owner Has the ORC changed since the previous df3AR- ? J Yes No Phone dumber: 910-293-2157 Permit Exp.: 11/302025 �® Signature Date a Signature Date By, th S sirs !we, I caru'y !hat this -eport .s accarrate and compute to Ilse best of my kne,.vreuge. 1. ee; t€fy.. under ocralty of ?a -. ;hal this cocuraenf and all atfacnmenis .tare prepared unce-r my direction: or supe ✓is,on o accordance wth a system aLsigned to assure that all Clnalif ed personrfc properly gatf eyed :any 34alLsated the nfornl alaon sub.,mf[ed. Based on my inquiry of ffae pe. son or 4•e-soi;s 4alao manage ?rfe system. or those persons dirr:r'Iy respcn5ibie fcr Bathe inn tt:.F . so-maitola: the i> for-rralion submitted is. In the best of nay knu wleoge any! belief_ Irue wcir a e, ar a complIte I at; avrare that there axe stgnicant penalties for suomztting ?also Enformat:3on r c:vtlin> the pcssbil ty 54. 'r-,es an d n pnsonmenl for kia ing vs ­,at ons. Mail Original and Two Copies to: Division of Water Quality Information Processing Unit 117 Mail Service Center Raleigh. North. Carolina 1-7 99yi6117 y;uEnvironmental Chemists, inc. ,.. s r ° t 4 f J .� 7 3? h6� �' 71�a�'[9"B ti�x'k'3i 1; 1,�'i%� � �1 L1'f"V r� tf�, ,�� � ��°'� �- i � � kr '� 7 i9Q air; � d e & A .i��rt?L iS.r .nvi t. ,'v: 2540 P_, 3.1.", 5,..'J. L' U i,. ANALY'i" CAL & CONSULTING CHEMISTS The Pork Company Date of Report: Sep, 12. 2022 892 Penny Branch Road Customer p , arr�a NC; 28398 CustomerID: 08100099 Gerald Matthews Report . 2022-17686 Project 0., `»VWTF Fff - Wily Lab ID Sam @e 1 Collect at /Time Matrix r.rlx ampled is ' r-41 T38 Site: E lueni Graft 8/31/20 2 Water Gerald Matthews Method Results Date An?.„ yze d PAN caiculaflon 39,8 rnq/L_ 091071 /2322 Used :�0�r'� t�ti�rera3�zation Rate, Fer_a} Cofforl'i'k Wexx C 6!ert-10 1 12N) POFIN/? 00m.1 0813 I P✓2022' i ut5i!t Dissolved Soids (TDS J SM 2540 C•201S 339 rills / i lCi 1!?02 ,; R&e idue. Suspended (TSS) SM 2540 D-2015 145 m /L_ OGY'O112022 Arr1!i"tC?nia Nitrogen Ski 45CO W', C-201 i 68„0 i gl L 09/ 1/2622 Total KOdahl Nitrogen (TKN) F;M 4600 Nf.),q B-2a11 85 7 rrwq/ln C? 1f71l2622 Fola3 Pil Q':apharus S9M 4500 P (F-H)-2011 7.7; fi` g/ L OgiOB12022 13 }ux 5M 5210 B-2016 42 rr g/L 08/31/20222 III QC requ,rsrle,nts for C)o Jepevar not inet. Result estmiated, (7hIni, irlr; S;�i�1500 0,'!;?', 58 mg/I_ � l � tW01 /2022 Nitrate Nitrogen (Cale) Nlitr!",e Nitrogen EPA 353 2. Rey? 2 6 1993 0.02 rnglL 09/01 20 "2 <f;Vi r?If Nitrite -Nitrogen riaA 353 2 Rev 2 C3. 19 3 0.5520rng/L aryryl ,l1011�,0�22 N� trate "�4ogen if w4lteo kP. r /I_ V N VC Total Nitrogen (1) TntAl Nitrogen 'natal Nivap#� 86 2 rng11_ 09107I )E" 22 -- fR M. �<.' , �t"�611i—x ,---- " �---,--,�. —,.�.. ri..,,,�.�,,.M�,,,�m�——,.,—,�.�,v��.m ,e xn 3 F 8 ,w, FY, �,�..-- ANAU IUAL & UUN5ULTiNG CHEMISTS The Pork Company plate otReport- Sep '12,2022 892 Penny Branch Road Customer PO M Warsaw NC 23398 Customer ID: 08100099 Attention, Gerald Matthews Report 9: 2022-17086 Project ID: VVWTF Eff - Mthly Lab ID Sample ID: Collect Date/Time Matrix Sampled by 22-41739 Site: PPI-002 Upstream 8/3112022 Water Gerald Matthews I= Ammonia Nitrogen Total Phosphorus Fecal Coliform, Nitrate Nitrogen (Cale) Nitrite Nitrogen Nitrate-l-Nitrite-Nitrogen Nitrate Nitrogen Total Nitrogen (Cale) Total Keldahl Nitrogen (TKN) Total Nitrogen Method Results Date Analyzed . .. ...... . SM 4500 NH3 C-2011 0,57 nngiL 09/01/2022 SM 4500 P (F-H)-231 I < 0.04 mg/L 09/08/2022 SM 9222 D-2015 IVIF 91 Colonies/100rnL 08/3112022 EPA 363 2 Rev 2 0,1993 EPA 353 2, Rev 2.0. 1993 Subtraction Method SM 4500 Norg B-2011 Total Nitrogen Lab ID Sample ID: 22-41740 SlteP:PI-00!3 Downstream FMI Collect Date/Time Matrix 8/3112022 Water < 0.02 mg/L 1.07mg/L 1.07 mg/L 09101/2022 09/01/2022 09/07/2022 2.3 mg/L 09/01/2022 3.4 mgIL 09/07/2022 Sampled by Gerald Matthews Results Date Anafyzed Ammonia Nitrogen SM 4500 NH3 C-2011 <Q, 1 rngIL 09/01/2022 Total KJeldahl Nitrogen (TKN) SM 4500 Norg B-2011 2.9 mg/L 09/01/2022 Total Phosphorus SPO 4500 P (F-H)-2011 0.46 mg/L 09/08/2022 Fecal Coliform SM 9222 0-2015 MF >30000Colonies/lOOmL 08/31/2022 Nitrate Nitrogen (Cato) Ntrite Nitrogen EPA 353,2, Rev, 2 0,1293 < 0.02 mg/L 09/01/2022 N ' rate +Nitrite -Nitrogen EPA 353 24 Rev 2 0, 1993 < 0.02 mg/L 09/01/2022 Nitrate Nitrogen SuOlracUon Method <0.02 mg/L O9/0712022 Total Nitrogen (Cale) Tota� Nitrogen TotM Ndrogen 2'.9 mg/L 09107/2022 Comment- Reviewed by: t_� Ya 'Z_ '', Remrl 9 2022-17066 Fqo 2Q, 2 Environmental Chemist, fnc., Wilmington, NC Lab #94 6602 MndrniN way V,10,mMgtan, NC 28ao'�' SamPle Receipt Checklist 9103 9 2,02 2 3 L/ Date: Report Number: 2022- 17C'7)(%'i'L"-�' ........... C 1 1, were ctpst odysea!5 ' pre5ent on the c a e r N, N/A 2, ffcustody5ealswer 0 0 Pre'sent, were they inta'f/Unbrcken? riginal-temperature upon receipt m. Corre T cted temperature upon PHo�v att � sre taken; v Temperature B[allk Against BotJEII Gun lJ) Thomas Traceable SIN 192511657 IR Gun Corre C Factor'C: C,O 3- If O'Cooler exLeeded FC, was Pr ect N?1;7r,/QA rjot�fjp Ey YES 0 NO 5, YES NO 6, Were samples ID's listed on sample containers? Y 11: 5 NO effan date and time listed Dn the COC? Vi/ere call .... YES Fj .-)ere m 'tests to b© Perfored listed on the CO C? ntainprs for e] YES arriVe ill 'Opc Cc, YE5 P i r - in good cand�tioft for ej s riVE' ct, t.4i YES "0 r rr.samples received within proper holdingo ES y 0 Ot— te aclo preserved Samples rya "c_Iived at a pi-i o2'j CYEl�ide sarnples received at a pi-J, >1� YES M-in sdan,'Ties received at a pF? YES F1 nn NHKN/Phenc,' received FL a ClJjorjne q I 1 -1 M, L ------ — ----- ------ ---- e, e 5 Ll lfid e/Cva n id a received at a ch lo!,j n e res i U 'o orlhophosphate sample5 f44ered in thc- field vJth�,'� 15 rri�nutn�' Bacte,ia sarnp; e5 2-e cho7cked for Chdor'Me� at ti nj -2 of a i ysl 5 a 61 d reroraed o n, the ...... . .... . . S-ZIMPic Preservation., Must be completed for any sample(s) fncorrecdy preserved or w;,h heacispace) sa P le l S 1 1 � v.,e. re, received i�IcOrrect�v Pl"�S,� rved P nd wcrj� 2 dj� �sted :.,, Ccorchrig! yr by addinc- (circle opeil� H N 0 H C N FiMP- of preservatiam li mc-e than one preservative is needed, noat- il" corrtrr,,cn'tb6o,.­ a­"1jzed by tRe %').'Ic was robfiew'; dar-m aric tir7e: /aiatdle,sSarrll3leisl' received with headspace '10 M, M SITS: Q.a k xv Analytical & Consulting Chemists x _. Sample identification - mom + � r C P rG G G G C P G x P G G P G G P X x X C P P G 12. Temperature when Received ,_ Accepted Delivered Comments: _ --Received IM f r ...... ._. ,u SIudge',--O&tjhA ANALYSIS REQUESTEJ BOD,TSS,NO2 NO3,NH3>TK , Total lam, PAi Fecal Coiilorm T N�NHZI,NO3,NO2,Total P, Fecal i <N. NH3,NO3,N 2,Total P. Fecal N-