HomeMy WebLinkAboutNC0000272_June 2023 Tox Monitoring_20230621 PO Box 7565
Asheville, NC 28802
.............................. __._ - Phone: (828) 350-9364
Environmental Testing 5olutions,Inc. Fax: (828) 350-9368
June 21, 2023
Mr.Tracy Willis
Evergreen Packaging
175 Main Street
Canton, NC 28716
ETS Project Number: 17983
Test Start Date: 06-14-23
Facility Tested: Canton Mill
Enclosed are toxicity test results for samples received by Environmental Testing Solutions Inc.
Parameter
Code Test Procedure, Method Number Result (ChV)
North Carolina Ceriodaphnia dubia Phase II Chronic Effluent Toxicity Procedure
THP36 EPA-821-R-02-013, Method 1002.0 <45/
All toxicity testing results required as part of your permit must be entered on the Effluent Discharge
Monitoring Form (MR-1) for the month in which it was performed, using the parameter code THP36.
Additionally,the DMR Reporting Form AT-3 must be signed and e-mailed or mailed to the following
address:
ATForms.ATB(@ncdenr.gov
North Carolina Division of Water Resources
Water Sciences Section/Aquatic Toxicology Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
Please call if you have any questions concerning these results.
Sincerely,
Or
Jim Sumner
Laboratory Supervisor
North Carolina Certificate Numbers: Biological Analyses: 037, Drinking Water: 37786,Wastewater: 600
South Carolina Certificate Number: Clean Water Act: 99053-001
PO Box 7565
Asheville,NC 28802
Phone: (828)350-9364
E„w--ntalrnetlmsulwims,l"`' Fax: (828)350-9368
Effluent Toxicity Report Form- Phase II Chronic Ceriodaphnia dubia Date: June 21,2023
Facility: Evergreen Packaging NPDES#: NC 0000272 Pipe#: 001 County: Haywood
Canton Mill
Laboratory Performing Test: Environmental Testing Solutions,Inc.,Certificate#037 Comments:
Signature of Operator in Responsible Charge(ORC):
ORC Phone/E-mail: Project#: 17983
Signature of Laboratory Supervisor: Sample#: 230613.03,230615.08
e-Mail to: ATForms.ATB@ncdenr.kov
Or Mail Original to: North Carolina Division of Water Resources
Water Sciences Section/Aquatic Toxicology Branch
1621 Mail Service Center Start date: End date: I Start time: End time:
Raleigh,NC 27699-1621 06-14-23 06-21-23 1052 0614
Sample Information Sample 1 Sample 2 Control
Collection start date: 06-12-23 06-14-23 Test Information start Renewal 1 Renewal2 start Renewal 1 Renewal
Grab: Treatment: 100% 100% 95% Control Control Control
Composite duration: 24-h 24-h Initial pH(SU): 8.06 7.86 7.84 7.78 7.70 7.75
Alkalinity(mg/L CaCO,): 61 Final pH(SU): 8.08 7.97 7.91 7.79 7.96 7.90
Hardness(mg/L CaCOJ: 86 Initial DO(mg/L): 7.3 8.1 8.0 7.8 7.7 7.9
Conductivity(µmhos/cm): 351 257 301,293,303 Final DO(mg/L): 7.7 8.0 7.7 7.8 7.9 7.7
Total residual chlorine(mg/L): <0.10 <0.10 Initial Temp.(°C): 25.0 25.0 25.0 24.7 j 24.8 24.9
Sample Temp.at Receipt(°C): 0.9 3.2 Final Temp.(°C): 25.1 24.9 25.1 24.9 1 25.1 1 25.2
Organism Number
Control Organisms 1 2 3 4 5 6 7 8 9 10 Mean Chronic Test Results
Number of Young Produced 29 30 29 26 27 31 29 32 28 31 29.2 Final Control Mortality(%): 0
Adult Survival: (L)ive,(D)ead L L L L L L L L L L %Control with 3rd Broods: 100
Control Reproduction CV: 6.4
Effluent Percentage EEI 48 Hour Mortality
Treatment 2 Organisms 1 2 3 4 5 6 7 8 9 10 Mean control: 0 of 10
Number of Young Produced 7 13 12 5 2 7 5 13 17 7 8.8 1 Iwc: o of 10
Adult Survival: (L)ive,(D)ead L L L L L L L L L L 69.9 significant?: No
Reduction Final Mortality Significant at: 90%
Effluent Percentage =
Treatment 3 Organisms 1 2 3 4 5 6 7 8 9 10 Mean Reproduction Analyses
Number of Young Produced 1 0 4 0 2 0 0 0 1 3 1.1 Reproduction LOEC: 45%
Adult Survival: (L)ive,(D)ead L L L L L L L L L L 96.2 Reproduction NOEC: <45%
•Reduction Overall Method: Steel's
Effluent Percentage 9o% Normal Distribution: Yes
Treatment 4 Organisms 1 2 3 4 5 6 7 8 9 10 Mean Method: Shapiro-Wilk's
Number of Young Produced 0 0 0 0 0 0 0 0 0 0 0.0 statistic: o.96a
Adult Survival: (L)ive,(D)ead D D L L D L D L D L 1 100.0 Critical Value: 0.900
i Reduction Equal Variances: No
Effluent Percentage 95% Method: Bartlett'sTest
Treatment 5 Organisms 1 2 3 4 5 6 7 8 9 10 Mean Statistic: 13.440
Number of Young Produced 0 0 0 1 0 0 1 0 0 0 1 0 1 0 1 Critical Value: 9.210
Adult Survival: (L)ive,(D)ead D L D L D D D I D D D 100.0 Non-Parametric Analysis(if applicable)
h Reduction Method: Steel's
Effluent Percentage 100% Effluent% Rank sum Critical sum
Treatment 6 Organisms 1 2 3 4 5 6 7 8 9 10 Mean 45% 55.0 79.0
Number of Young Produced 0 0 0 0 0 0 0 0 0 0 0.0 75% 55.0 79.0
Adult Survival: (L)ive,(D)ead D D D D D D D D D D 100.0 90%
•Reduction 95%
Overall Analysis: 100%
Result: FAIL LOEC: 45% NOEC: <45% ChV: <45%
DWR Report Form AT-3
Page 1 of 4
North Carolina Chronic Phase II Whole Effluent Toxicity Test,Species: Ceriodaphnia dubia
(EPA-821-R-02-013 Method 1002.0,NC Modification—December 2010,Version 3.0)
Client Evergreen Packaging NPDES 9 NC0000272
Facility Canton Mill outfall 001
Project q 1-0 8 Z) County Haywood
Chronic Limit 90%
Dilution Preparation:
Test concentrations(%) 45 75 90 95 100 Sample was not aerated or treated unless otherwise noted on
mL Sample 90 150 180 190 200 this form. Sample was warmed to 25.0±1.0'C in a warm water
mL Dilution water 110 50 20 10 0 bath and then diluted to the test concentrations with
moderately hard synthetic water.
Total volume(mL) 200 200 200 200 200
Chemical Analyses:
Parameter Reporting limit Method number Meter Serial number
PH 0.1 S.U. SM 4500-H+B-2011 Accumet AR20 93312452
Dissolved oxygen 1.0 mg/L SM 4500-0 G-2016 YSI Model 52CE 1BD104324
Conductivity 24.9 pmhos/cm SM 2510 B-2011 Accumet AR20 93312452
Alkalinity 5.0 mg Ca00,/L SM 2320 B-2011 Accumet AR20 93312452
Hardness S.0 mg CaCO,/L SM 2340 C-2011 Not applicable Not applicable
Total residual chlorine 0.1 mg/L I ORION 97-70-1977 Accumet AB250 92349123
Temperature 0.1'C SM 25SOB-2010 11Digital Thermometer
Daily Renewal Information
Test Initiation,renewal,'feeding or
termination Selenastrum YWT Location Randomizing
Day Date Sample Number MHSW Batch
Time Analyst Batch Batch Incubator/Shelf Template
D Inlllation/Feeding Sample 1
06-14-23 ktisi— OS-Ti•11 6-3%i•13 �-4�— Crc1�erJ
1 FeedQing 7
06-15-23 G U 21
2 Renewal l/Feeding 5ample2
06-16-23
3 Feeding
06-17-23 6100 A t
4 Feeding rTIT
06-18-23 0 It's p
5 Renewal 2/Feeding 5ample 2
06.19-23 w%%k(
6 F "t30b�S.oC Ola Og-11$
aI
06-20-23 J V
u
7 06-21-23 Terminatlon
Ob 1.1
Test was initiated using Sample 1.Sample 2 was use for Renewals One(day 2)and Two(day 5). 'Organisms fed daily 50 µL Selenastrum and 50 µL YWT per replicate
using HandyStep repeat pipettor SN 17E59354,
Test Organism Information: Final Results-Summary of Test Endpoints:
Organism Source: In-house Culture
7-day LCso(%) / 7.
Age: <24-hours old �1 o•3
Source(culture board):
7.
Replicate# 1 2 3 4 5 6 7 8 9 10 NOEC(Vol t-,S
Culture board cup#
Date and time organisms LOEC(%) LAS T.
were born between: ChV(%) <'A5 `
Average transfer volume: <0.25m1
Transfer bowl information: pH(S.U.): .1
Temperature('C): 1.��•`1
SOP AT13-Revision 4-Exhibit AT33.2
Page 2 of 4
North Carolina Chronic Phase II Whole Effluent Toxicity Test,Species: Ceriodaphnia dubia
(EPA-821-R-02-013 Method 1002.0,NC Modification—December 2010,Version 3.0)
Facility Evergreen Packaging
Project#
Survival and Reproduction Data:
Control
Observations Replicate number
Day 1 2 3 4 5 6 7 8 9 10
2 Adult mortality
Renewal One (L=Live,D=dead) �--- �--- �'
Number of broods present LL 'L L 1- L—7!-
5 Number of young produced 11(n l 1 1 ,� IS \1 1 3 1 t t— 1'1
Renewal Two Adult mortality
(L=Live,D=dead)
Number of broods present t \ \ t t t \ \ 1 \
Number of young produced 1"� 1� 1(� 1� t•L l lip IZ l
7 Total young produced
Final Z,�\ 0 lot -L6 -L-, 3
Final adult mortality
(L=Live,D=dead)
X for 3rd Broods
Survival Mean offspring
per female Z�'
Test concentration: 45%
Observations Replicate number
Day 1 2 3 1 4 5 6 7 8 9 1
2 Adult mortality
Renewal One (L=Live,D=dead)
Number of broods present \ 1 \ \ \ p L
5 Number of young produced I q LA I— y b I
Renewal Two Adult mortality
(L=Live,D=dead)
Number of broods present \ , t LL Lo ` t t Lt 1
Number of young produced
7 Total young produced
Final
Final adult mortality l
(L=Live,D=dead)
Survival Mean offspring Y.Reduction q to
1 d0 �• per female �' from Control (O�'
Test concentration: 75%
Observations Replicate number
Day 1 2 3 4 5 6 7 8 9 10
2 Adult mortality 1
Renewal One (L=Live,D=dead) �-
Number of broods present
5 Number of young produced
Renewal Two Adult mortality L ` L
(L=Live,D=dead)
Number of broods present L\ OLQL LT O O L U L T t
Number of young produced
7 Total young produced Q O A_ O U Q 1
Final
Final adult mortality
(L=Live,D=dead)
Survival I �• Mean offspring ,1 Y.Reduction a 2 y
per female from Control 1 1
SOP AT13-Revision 4-Exhibit AT13.2
Page 3 of 4
North Carolina Chronic Phase II Whole Effluent Toxicity Test,Species: Ceriodaphnia dubia
(EPA-821-R-02-013 Method 1002.0,NC Modification—December 2010,Version 3.0)
Facility Evergreen Packaging
Project# t1ott-%)
Survival and Reproduction Data:
Test concentration: 90%
Observations Replicate number
Day 1 2 1 3 4 5 6 7 8 9 10
2 Adult mortality
Renewal One (L=Live,D=dead)
Number of broods present O U O 0 O 0 G 0
s Number of young produced
Renewal Two Adult mortality
(L=Live,D=dead)
Number of broods present
Number of young produced V ()
7 Total young produced
Final O C) U U V O
Final adult mortality
(L=Live,D=dead)
\,— L n L
Survival 56 7, Mean offspring O.O %Reduction from I o01,
per female Control
Test concentration: 95%
Observations Replicate number
Day 1 2 3 4 5 6 7 8 9 10
2 Adult mortality
Renewal One (L=Live,D=dead)
Number of broods present 11 D TO tl!!`` 0 0
V 0 0 p
5 Number of young produced V 0 V Q D 0
Renewal Two Adult mortality
(L=Live,D=dead)
!
Number of broods present 0
Number of young produced Q (�
7 Total young produced
Final v V V V
Final adult mortality 1 t�
(L=Live,D=dead) `,
Survival 'ZO'l. Mean offspring O I O %Reduction from
per female Control
Test concentration: 100%
Day Observations Replicate number
1 2 3 4 5 6 7 8 9 10
2 Adult mortality
RenewdlOne (L=Live,D=dead) l--" \—
Number of broods present U D 0 0 U 0 0 jf
5 Number of young produced O O O
Renewal Two Adult mortality
(L=Live,D=dead) �1
Number of broods present
Number of young produced
7 Total young produced
Final V V V
Final adult mortality \ 1� D v� b
(L=Live,D=dead)
Survival
Mean offspring Y.Reduction from
b per female �• ® Control
SOP AT13-Revision 4-Exhibit AT33.2
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Statistical Analyses Environmental Taring Solutions.In<.
eriodaphnia Survival and ReproductionTest-7 Day Survival
Start Date: 6/14/2023 Test ID: CdFRCRNC Sample ID: Evergreen
End Date: 6/21/2023 Lab ID: ETS-Envir.Testing Sol. Sample Type: DMR-Discharge Monitoring Report
Sample Date: Protocol: FWCHR-EPA-821-R-02-013 Test Species: CD-Ceriodaphnia dubia
Comments:
Conc-% 1 2 3 4 5 6 7 8 9 10
D-Control 1.0000 1.0000 1.0000 1.0000 1.0000 1.0000 1.0000 1.0000 1,0000 1.0000
45 1.0000 1.0000 1.0000 1.0000 1.0000 1.0000 1.0000 1.0000 1.0000 1.0000
75 1.0000 1.0000 1.0000 1.0000 1.0 00 0 1.0000 1.0 000 1.0000 1.0000 1.0000
90 0.0000 0.0000 1.0000 1.0000 0.0000 1.0000 0.0000 1.0000 0.0000 1.0000
95 0.0000 1.0000 0.0000 1.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000
100 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0.0000 0,0000 0.0000 0.0000
Not Fisher's 1-Tailed Number Total
Conc-% Mean N-Mean Resp Resp Total N Exact P Critical Resp Number
D-Control 1.0000 1.0000 0 10 10 10 0 10
45 1.0000 1.0000 0 10 10 10 1.0000 0.0500 0 10
75 1.0000 1.0000 0 10 10 10 1.0000 0.0500 0 10
*90 0.5000 0.5000 5 5 10 10 0.0163 0.0500 5 10
'95 0,2000 0.2000 8 2 10 10 0,0004 0.0500 8 10
100 0.0000 0.0000 10 0 10 10 10 10
Hypothesis Test(1-tail,0.05) NOEC LOEC ChV TU
Fisher's Exact Test 75 90 82.1584 1.33333
Treatments vs D-Control
Maximum Likelihood-Probit
Parameter Value SE 95%Fiducial Limits Control Chi-Sq Critical P-value Mu Sigma Iter
Slope 47,1204 18.7101 10.4486 83.7922 0 0.41571 7.81472 0.93698 1.95575 0.02122 5
Intercept -87.156 36.8055 -159.29 -15,017
TSCR 1.0
Point Probits % 95%Fiducial Limits
EC01 2.674 80.6077 49.1777 85.9985 0.9
ECO5 3.355 83.3373 57.0844 87.7199 0.8
EC10 3.718 84.83 61.7867 88.6803 0 7
EC15 3.964 85,8522 65.1616 89.3541
EC20 4.158 86.6734 67.9615 89.9111 w 0.6
EC25 4.326 87.3841 70.4449 90.41
0.5 I
EC40 4.747 89.2011 76.9975 91.8167 �
EC50 5.000 90.3122 81.0549 92.8731 0.4
EC60 5.253 91.4373 84.9881 94.3151 0.3
EC75 5.674 93.3385 90,0428 98.815 0.2
EC80 5.842 94.1039 91.289 101.588
EC85 6.036 95.004 92.3756 105.36 0.1
EC90 6.282 96,1488 93A383 110,686 0.0
EC95 6.645 97.871 94.7303 119.463 1 10 100 1000
EC99 7.326 101.185 96.8338 138.373 Dose
Dose-Response Plot
1
0.9
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0.7
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Statistical Analyses
Envkonmental Tes,ing 5olotions.Inc.
eno ap ma Survival and ReproductionTost- eproduction
Start Date: 6/14/2023 Test ID: CdFRCRNC Sample ID: Evergreen
End Date: 6/21/2023 Lab ID: ETS-Envir.Testing Sol. Sample Type: DMR-Discharge Monitoring Report
Sample Date: Protocol: FWCHR-EPA-821-R-02-013 Test Species: CD-Ceriodaphnia dubia
Comments:
Conc-% 1 2 3 4 5 6 7 8 9 10
D-Control 29,000 30.000 29.000 26.000 27.000 31.000 29.000 32.000 28. 000 31.000
45 7.000 13.000 12.000 5.000 2.000 7.000 5.000 13.000 17.000 7.000
75 1.000 0.000 4.000 0.000 2,000 0.000 0.000 0.000 1.000 3.000
90 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
95 0.000 0.000 0.000 0.000 0,000 0.000 0.000 0.000 0.000 0.000
100 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000 0.000
Transform:Untransformed Rank 1-Tailed Isotonic
Cone-% Mean N-Mean Mean Min Max CV% N Sum Critical Mean N-Mean
D-Control 29.200 1.0000 29.200 26.000 32.000 6.417 10 29.200 1.0000
*45 8.800 0.3014 8.800 2.000 17.000 53.246 10 55.00 79,00 8.800 0.3014
*75 1.100 0.0377 1.100 0.000 4.000 131.740 10 55.00 79.00 1.100 0.0377
90 0,000 0.0000 0.000 0.000 0.000 0.000 10 0.000 0.0000
95 0.000 0.0000 0.000 0.000 0.000 0.000 10 0.000 0.0000
100 0.000 0.0000 0.000 0.000 0.000 0.000 10 0.000 0.0000
Auxiliary Tests Statistic Critical Skew Kurt
Shapiro-Wilk's Test indicates normal distribution(p>0.01) 0.96764 0.9 0.4502 1.38042
Bartlett's Test indicates unequal variances(p=1.21 E-03) 13.4401 9.21035
Hypothesis Test(1-tail,0.05) NOEC LOEC ChV TU
Steel's Many-One Rank Test <45 45
Treatments vs D-Control
Linear Interpolation(200 Resamples)
Point % SD 95%CL Skew
ICO5' 3.221 0.233 2.831 3.652 0.3401
IC10' 6.441 0.466 5.662 7.304 0.3401
IC15` 9.662 0.699 8.494 10.956 0.3401 1.0
IC20` 12.882 0.932 11.325 14.609 0.3401
IC25` 16.103 1.165 14.156 18.261 0.3401 0.9
IC40' 25.765 1.864 22.650 29.217 0.3401 0.8
IC50' 32.206 2.330 28.312 36.521 0.3401 0.7
indicates IC estimate less than the lowest concentration
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_ Page 4 of 4
North Carolina Chronic Phase II Whole Effluent Toxicity Test,Species: Ceriodaphnia dubia
(EPA-821-R-02-013 Method 1002.0,NC Modification—December 2010,Version 3.0)
Facility Evergreen Packaging
Project N 1 A95
Chemical Analyses: Initiation Renewal One Renewal Two
Initial Final Initial Final Initial Final
Concentration Analyst f3L SL VU t$L !jL Q t_
pH(S.u.) 7.7
t 7. -70 7. 9G 7.75 7.60
Dissolved oxygen(mg/L)
Conductivity(µmhos/cm)
Control 13 303
MH5W *Alkalinity(mg/L CaCOJ
*Hardness(mg/L CaCO,) CC it 4%•111*31 h
ab
*Temperature(°C) � tS-
1a.-t tiv1.ti t�.
pH(S.U.) 7.49
Dissolved oxygen(mg/L) 6.0
as i
Conductivity(µmhos/cm)
325 ZVI 2FG
*Temperature(°C) c, 1`{.y ZS,D 15.0 ZS-�
pH(s.u.) v2
7RS 7•SsL ttrol 7.90 "7.'fy'
Dissolved oxygen(mg/L)
Conductivity(µmhos/cm)
333 2c.G 272.
*Temperature(°C) . 1S. Z�•tf �•t 1S•0
pH(S.u.) $.0!.
$�2 7.5-& 7.9 7 7.79 7.1-0
Dissolved oxygen(mg/L)
Conductivity(µmhos/cm)
34') 260 2�•
*Temperature CC) -L� ZS 1 Lq-CA .0.1— 1S•o ZS.
pH(s.u.) Y.D$
$.OS 794, 7.19 7 Fef 7.91
Dissolved oxygen(mg/L)
95
Conductivity(µmhos/cm)
3lfS 251 2(,5
*Temperature(°c) %S.0 �.�•� ZS•n ZS.L •LS_O LS-
pH(S.u.) _ 1<'a
Sf.Ora �SOf1 78'C� ?•`� 7 7•V IS'
Dissolved oxygen(mg/L) n Q,( g 0 e.O
100% Conductivity(µmhos/cm) j v
3SI 257 2�3
*Total residual chlorine(mg/L) C 0-t p e-0
*Temperature(°C)
15 .0 %S.1 AS 0 9
*Analyst identified for each day,performed pH,dissolved oxygen and conductivity measurements only. Temperatures performed at the lime of test initiation,renewal
or termination by the analyst identified in the Daily Renewal Information table. Alkalinity,hardness and total residual chlorine performed by the analysts identified on
the test specific bench sheets and transcribed to this bench sheet.
SOP AT13-Revision 4-Exhibit AT13.2
351 Depot Street
Asheville,NC 28801
Phone: (828)350-9364
Fax: (828)350-9368
Environmental Testing Solutions,Inc.
Whole Effluent Toxicity Chain-of-Custody Form
Facility: Evergreen Packaging NPDES#: NC0000272 Pipe#: 001 County: Haywood
Purchase order: 890165008
Species: Ceriodaphnia dubia Effluent dilution: 45,75,90,95, 100%
Test type: Phase II Chronic Parameter code: THM
Sample information: (to be completed by sample collector)
Composite sampI : Sample location: SedivkdA/ d
Start date: Time: —]"317 ,fn Volume collected for testing:
End date: 'L3 Time: Number of containers filled for testing:
Number of samples per hour: 3 Method of transport to laboratory: warrrd
Chilled during collection? ye y Comments:
If chilled,specify temperature: I I (:
Triple rinse sample container with sample before filling. Completely fill the sample container with no air space.
Pack the sample container completely in ice. The sample must be<6.0°C upon receipt at the laboratory.
Sam.plc custody: (to be completed by sample coil;ctor and facility personnel)
BY SIGNING BELOW,I CERTIFY THAT THE PERMIT AND TEST REQUIREMENTS IDENTIFIED ON THIS FORM ARE ACCURATE
Sample collected by:
W613 3
Pik i T �:=fe-00
Print signature Date and time
Relinquished by: Received by:
IfS�23 G s3
�< A q1A,
Pnnt OF Signature 11Date and time Print V signor Datc and time
Relinquished by: Received by:
Print Signature Date and time Print Sign—, Date and time
Sample receipt information: (to be completed by ETS personnel)
Relinquished to ETS by: Received at ETS by:
• � � �� z-3 0(D•13-23
rKl 0 J O
rinl U S4.we Datcand time Print signature Dateondtime
Custody seals intact?: ® ® Sample temperature upon receipt at ETS(°C): Q
Yes No Not used O 1
Samples received in good condition?:
Yea N. Total residual chlorine upon receipt at ETS:
Tracking number:
(DPD PreseneelAbsense Indicator,MDL=0.10 mg/L) P` art Absent
��
Project number: 1Gl7 Sample number: 43 OLD 11U3
Comments:
•
� 351 Depot Street
Asheville,NC 28801
Phone: (828)350-9364
Fax: (828)350-9368
Environmental Testing Solutions,Inc.
Whole Effluent Toxicity Chain-of-Custody Form
Facility: Evergreen Packaging NPDES#: NC0000272 Pipe#: 001 County: Haywood
Purchase order: 890165008
Species: Ceriodaphnia dubia Effluent dilution: 45,75,90,95, 100%
Test type: Phase I1 Chronic Parameter code: THM
Sample information: (to be completed by sample collector)
Composite sample: Sample location:
Start date: / 0A3 Time: `]:3D a l Volume collected for testin—T�;
End date: ,Zb� Time: 7; Number of containers filled for testing: f
Number of sam les per hour: 3 Method of transport to laboratory:
Chilled during collection? Y, Comments:
If chilled,specify temperature: q°
Triple rinse sample container with sample before filling. Completely fill the sample container with no air space.
Pack the sample container completely in ice. The sample must be<6.0eC upon receipt at the laboratory.
Sample custody: (to be completed by sample collector and facility personnel)
BY SIGNING BELOW,I CERTIFY THAT THE PERMIT AND TEST REQUIREMENTS IDENTIFIED ON THIS FORM ARE ACCURATE
Sample collected by:
3
Print signature Dat�and lime
Relinquished by: Received by:
Pdnt signature Dam and Lime Print Sign-m Date aad Lime
Relinquished by: Received by:
ll4hie11�oPk�/ts loss
Print Signature Date and time Print signaiure Date and lime
Sample receipt information: (to be completed by ETS personnel)
Relinquished to ETS by: Received at ETS by:
Q`•li•t�
SJI'IiTx� �o
Pd., SiPM— Damand time Print .S.gnmme D-md lime
Custody seals intact?: = = Sample temperature upon receipt at ETS(°C): Z
Yes No Not used J•�•
Samples received in good condition?: =
Y° NO Total residual chlorine upon receipt at ETS:
(DPD Presence/Absense Indicator,NtDL=0.10 mg/L) Pm=<-nt AN-1
Tracking number: (J� yy�Q ppp
Project number: 1 � { '� Sample number: v .0-8
Comments:
Ceriodaphnia dubia
Chronic Reference Toxicant Control Chart
Environmental Testing Solutions,Inc. Source: In-house Culture
1.14
1.12 Control Limits (± 2 Standard Deviations)
1.08 • n � � _ m � • •
1.06
M 1.04
Z
� 1.02
b.0
o
Ln
_V
a 1.15
cu Warning Limits
1.10 •
1.05
1.00 ..........................................
0.95 ti ti ILL ti 2 ti 1- ti ��1- ti ti
0$� 0�� Oa 05�I-.03� 0�� 1�-� Otis 1''� Op� 0$� 1� ti3 �� 1� Op 13
Test date
• 7-day IC25=25%inhibition concentration. An estimation of the sodium chloride concentration
which would cause a 25%reduction in Ceriodaphnia reproduction (calculated using ToxCalc).
Central Tendency(mean logarithmic IC25 converted to anti-logarithmic values)
- =-y Control Limits (mean logarithmic IC2S±2 standard deviations converted to anti-logarithmic values)
Laboratory Warning Limits(mean logarithmic IC2S±2 coefficent of variations converted to anti-logarithmic values)
USEPA Warning Limits (mean logarithmic IC25±SA.io converted to anti-logarithmic values,
SA to=10th percentile of CVs reported nationally by USEPA)
EnI land
PevieweE by
lim Sumner