WQ0004972_Monitoring - 07-2023_20230830 (3)

Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month:* July
Report Information
Type *
GW-59
WQ0004972
Forest Lake RV WWTP
Confirmation Email Address: *
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2023
Upload Document*
2023_July_GW Monitoring_WQ0004972 9.6MB
complete.pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Amanda Grenier
ol�"a
8/30/2023
This will be filled in automatically
Reviewer: Wanda.Gerald

Is the project number correct?* WQ0004972
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Reviewer: _anonymous
Review Date: 9/8/2023

DocuSign Envelope ID: 90A1EB8F-DB1E-4E10-BA1E-CE057359BA3E
SUBMIT FORM ON YELLOW PAPER ONLY
GROUNDWATER QUALITY MONITORING:
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
COMPLIANCE REPORT FORM
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617
FACILITY INFORMATION
Please Print Cleady or Type
PERMIT Number: Expiration Date: 10/31/2027
Facility Name: Forest Lake RV WWTP
Non -Discharge WQ0004972 UIC
Permit Name (if different):
NPDES Other
Facility Address: 192 Thousand Trails Dr.
TYPE OF PERMITTED OPERATION BEING MONITORED
Advance °"" NC
27006
County Davie
❑ Lagoon ❑ Remediation: Infiltration Gallery
IN Spray Field ❑ Remediation:
Contact Person: Amanda Grenier
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Forest Lake RV Spray Irrigation Field
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other:
from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): 1
Date sample collected: 7/11/2023
FIELD ANALYSES:
WAS
Well Depth: 72 ft.
Well Diameter: 2 in.
pH 00400: 5.8 units Temp. 000lo: 16.7 oC
DRY at
Depth to Water Level 82546: 69.2 ft. below measuring
point
Screened Interval: ft. to
ft. Spec. Cond. oo094: 70.7 µMhos
time of
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation: ft,
a
Odor 00085: None
sampling,check
Volume of water pumped/bailed before sampling:
4.5
gallons
Appearance Clear
here:®
Samples for metals were collected unfiltered: ❑ YES N NO and field acidified: ❑ YES © NO
LABORATORY INFORMATION
Date sample analyzed: 7/12/2025
Laboratory Name: Pace Analytical
Certification No. 12
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead 01o51 ug/L
Coliform: MF Fecal 31616 23
/100mL
Nitrate (NO3) as N 00620 <0.04
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL Phosphorus: Total as P 00665 0.18
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids:Total 70300
mg/L
Al - Aluminum oil o5
mg/L
pH (Lab) 00403 6.3
units
Ba - Barium 01007
ug/L
TOC 00680 6.9
mg/L
Ca - Calcium oo916
mg/L
Chloride 00940 1.9
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia oo610 0.11
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen, NHaas N; Ammonia Nitrogen, Total)
Mn -Manganese 01055
ug/L
method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
ror Memealatlon systems Only (Attach Lab Reports): Influent Total VOCs: mg/L Effluent Total VOCs: mg/L VOC Removal%
George Gudgeon, Sr. Vice President
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.06-07-2018

DocuSign Envelope ID: 90A1EB8F-DB1E-4E10-BA1E-CE057359BA3E
SUBMIT FORM ON YFl I CHIN PAPER MIl Y
GROUNDWATER QUALITY MONITORING:
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
COMPLIANCE REPORT FORM
•
• • •
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: Expiration Date: 10/31/2027
Facility Name: Forest Lake RV WWTP
e
Non -Discharge WQ0004972 UIC
Permit Name (if different):
NPDES Other
Facility Address: 192 Thousand Trails Dr.
TYPE OF PERMITTED OPERATION BEING MONITORED
Advance NC
27006
County Davie
❑ Lagoon ❑ Remediation: Infiltration Gallery
K Spray Field ❑ Remediation:
Contact Person: Amanda Grenier
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Forest Lake RV Spray Irrigation Field
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other:
from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): 2
Date sample collected: 7/11/2023
FIELD ANALYSES:
WAS
Well Depth: 46 ft.
Well Diameter: 2 in.
pH 00400: 5.5 units Temp. 000lo: 16.3 oC
DRY at
Depth to Water Level 82546: 38.3 ft. below measuring point
Screened Interval: ft.
to
ft. Spec. Cond. 00094: 51.6 µMhos
time of
Measuring Point is 3 ft. above land surface
Relative M.P. Elevation:
ft.
Odor 00085: None
sampling,check
Volume of water pumped/bailed before sampling:
3.75
gallons
Appearance Clear
here:
Samples for metals were collected unfiltered: ❑ YES ©
NO and field acidified: ❑ YES N NO
❑
LABORATORY INFORMATION
Date sample analyzed: 7/12/2023
Laboratory Name: Pace Analytical
Certification No. 12
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N o0615
mg/L
Pb - Lead olo51 uglL
Coliform: MF Fecal 31616 86
/100mL
Nitrate (NO3) as N 00620 0.45
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL Phosphorus: Total as P 00665 0.18
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
Dissolved Solids:Total 70300
mg/L
Al -Aluminum oil o5
mg/L
pH (Lab) 004o3 5.8
units
Ba - Barium 01007
ug/L
TOC 00680 9.5
mg/L
Ca - Calcium 00916
mg/L
Chloride 0094o 3.4
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia 00610 <0.10
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen, N%as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
9
ug/L
,method #
TKN as N 00625
mg/L
Ni - Nickel 01067
ug/L
method #
�iJr ncmncuauvn ayslerns vniy tAi cn LaD Keports/: innuent I otal vU(;s: mg/L Effluent Total VOCs: mg/L VOC Removal%
by:
George Gudgeon, Sr. Vice President
Permittee (or Authorized Agent) Name and Title - Please print or type
Agent)
8/30/2023
GW-59 Rev.06-07-2018

DocuSign Envelope ID: 90A1EB8F-DB1E-4E10-BA1E-CE057359BA3E
SUBMIT FORM ON YFI I OW PAPER OK11 Y
GROUNDWATER QUALITY MONITORING:
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
COMPLIANCE REPORT FORM
•
• • •
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, INC 27699-1617
FACILITY INFORMATION
Please Print Clearly or Type
PERMIT Number: Expiration Date: 10/31/2027
Facility Name: Forest Lake RV WWTP
Non -Discharge WQ0004972 UIC
Permit Name (if different):
NPDES Other
Facility Address: 192 Thousand Trails Dr,
TYPE OF PERMITTED OPERATION BEING MONITORED
Advance " NC
27006
County Davie
❑ Lagoon
g ❑Remediation: Infiltration Gallery
Spray Field ❑ Remediation:
Contact Person: Amanda Grenier
Telephone#: [phone]
❑ Rotary Distributor ❑ Land Application of Sludge
Well Location/Site Name: Forest Lake RV Spray Irrigation Field
No. of wells to be sampled: 4
❑ Water Source Heat Pump ❑ Other:
from Permit
SAMPLING INFORMATION
If WELL
WELL ID NUMBER (from Permit): 3
Date sample collected: 7/11/2023
FIELD ANALYSES:
WAS
Well Depth: 20.4 ft.
Well Diameter: 2 in,
pH 00400: 4.5 units Temp. 000lo: 17.4 oC
DRY at
Depth to Water Level 82546: 9.3 ft. below measuring point
Screened Interval: ft.
to
ft. Spec. Cond. oo094: 207 µMhos
time of
MeasuringPoint is 3 ft. above land surface
Relative M.P. Elevation:
ft.
Odor 000s5: None
sampling,
check
Volume of water pumped/bailed before sampling:
5
gallons
Appearance Clear
here:❑
Samples for metals were collected unfiltered: ❑ YES ®
NO and field acidified: ❑ YES ❑■ NO
LABORATORY INFORMATION
Date sample analyzed: 7/12/2023
Laboratory Name: Pace Analytical
Certification No. 12
PARAMETERS NOTE: Values should reflect
dissolved and colloidal concentrations.
COD 00335
mg/L
Nitrite (NO2) as N 00615
mg/L
Pb - Lead o1o51 ug/L
Coliform: MF Fecal 31616 6
/100mL
Nitrate (NO3) as N 00620 13.6
mg/L
Zn - Zinc 01092 mg/L
Coliform: MF Total 31504
/100mL Phosphorus: Total as P 00665 <0.05
mg/L
(Note: Use MPN method for highly turbid samples)
Orthophosphate 70507
mg/L
Other (Specify Compounds and Concentration Units):
issolved Solids;Total 70300
mg/L
Al -Aluminum o11o5
mg/L
pH (Lab) 00403 4.9
units
Ba - Barium 01007
ug/L
TOC oo68o 1.1
mg/L
Ca - Calcium 00916
mg/L
Chloride 0094o 26
mg/L
Cd - Cadmium 01027
ug/L
Arsenic 01002
ug/L
Chromium: Total 01034
ug/L
Grease and Oils 00552
mg/L
Cu - Copper 01042
mg/L
ORGANICS: (by GC, GC/MS, HPLC)
Phenol 32730
ug/L
Fe - Iron 01045
ug/L
(Specify test and method #. ATTACH LAB REPORT.)
Sulfate 00945
mg/L
Hg - Mercury 71900
ug/L
Lab Report Attached? ❑ Yes (1) ❑ No (0)
Specific Conductance 00095
µMhos
K - Potassium 00937
mg/L
VOC 7873 method #
Total Ammonia 000lo <0.10
mg/L
Mg - Magnesium 00927
mg/L
method #
(Ammonia Nitrogen; NH3as N; Ammonia Nitrogen, Total)
Mn - Manganese 01055
ug/L
method #
TKN as N 00625
P
mg/L
Ni - Nickel 01067
ug/L
method #
. wi ..curcurauvrt 5yowitis Only jAUacn Lao meports): inrluent I otal vucs: mg/L Effluent Total VOCs: mg/L VOC Removal%
George Gudgeon, Sr. Vice President
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59
Rev. 06-07-2018

DocuSign Envelope ID: 90A1EBSF-DB1E-4E10-BA1E-CE057359BA3E
SUBMIT FORM ON YFI I ntint pnaFR nnu v
NDWATER QUALITY MONITORING:
LIANCE REPORT FORM
I-AGILI I Y INFOKMATION r-iease t-nnr ueany or type
Facility Name: Forest Lake RV WWTP
Permit Name (if different):
Facility Address: 192 Thousand Trails Dr.
Advance NC 27006 County Davie
act Person: Amanda Grenier Telephone#: [phone]
Location/Site Name: Forest Lake RV Spray Irrigation Field No. of wells to be sampled: 4
DEPARTMENT OF ENVIRONMENTAL QUALITY - DIV. OF WATER RESOURCES
INFORMATION PROCESSING UNIT
1617 MAIL SERVICE CENTER, RALEIGH, NC 27699.1617
PERMIT Number: Expiration Date: 10/31/2027
Non -Discharge WQ0004972 UIC
NPDES Other
TYPE OF PERMITTED OPERATION BEING MONITORED
❑ Lagoon ❑ Remediation: Infiltration Gallery
ME Spray Field ❑ Remediation:
❑ Rotary Distributor ❑ Land Application of Sludge
❑ Water Source Heat Pump ❑ Other:
°LL ID NUMBER (from Permit): 4 Date sample collected: 7/24/2023
?II Depth: 39 ft. Well Diameter: 2 in.
pth to Water Level 82546: 9.7 ft. below measuring point Screened Interval: ft. to ft.
asuring Point is 3 ft. above land surface Relative M.P. Elevation: ft.
lume of water pumped/bailed before sampling: 5 gallons
mples for metals were collected unfiltered: ❑ YES It NO and field acidified: ❑ YES ® NO
Date sample analyzed: 7/25/2023 Laboratory Name: Pace Analytical
PARAMETERS NOTE: Values should reflect dissolved and colloidal concentrations.
COD oo335 mg/L Nitrite (NO2) as N 00615 mg/L
Coliform: MF Fecal 31616 1 /100mL Nitrate (NO3) as N 00620 4.2 mg/L
Coliform: MF Total 31504 /100mL
(Note: Use MPN method for highly turbid samples)
Ived Solids:Total 70300
mg/L
pH (Lab) 00403
units
TOC 0068o 2.5
mg/L
Chloride 0094o 7.4
mg/L
Arsenic 01002
ug/L
Grease and Oils 00552
mg/L
Phenol 32730
ug/L
Sulfate 00945
mg/L
fic Conductance 00095
µMhos
Total Ammonia 00610 <0.10
mg/L
(Ammonia Nitrogen; N%as N; Ammonia Nitrogen, Total)
TKN as N 00625
mg/L
Phosphorus: Total as P 00665 0.14
mg/L
Orthophosphate 70507
mg/L
Al -Aluminum o11o5
mg/L
Ba - Barium 01007
ug/L
Ca - Calcium 00916
mg/L
Cd - Cadmium 01027
ug/L
Chromium: Total 01034
ug/L
Cu - Copper 01042
mg/L
Fe - Iron 01045
ug/L
Hg - Mercury 71900
ug/L
K- Potassium 00937
mg/L
Mg - Magnesium 00927
mg/L
Mn - Manganese o1o55
ug/L
Ni - Nickel 01067
ug/L
If
FIELD ANALYSES: I
WAS
pH 00400: 8.4 units Temp. 000lo: 16.3 °C DRY at
Spec. Cond. 00094: 87.9 µMhos time of
Odor 00085: None sampling,
check
Appearance Clear here: El
Certification No. 12
Pb - Lead 01051 ug/L
Zn - Zinc 01092 mg/L
Other (Specify Compounds and Concentration Units):
ORGANICS: (by GC, GC/MS, HPLC)
(Specify test and method #. ATTACH LAB REPORT.)
Lab Report Attached? ❑ Yes (1) ❑ No (0)
VOC 7873 method #
method #
method #
method #
—• •- ..., ,..W,.,,., WY-1 a v.ny J�LWUu a.au FXVFIURSI: 1t111U6Ri 1 otat vut.s: mg/L Ltrluent Total VOCs: mg/L VOC Removal%
George Gudgeon, Sr. Vice President
Permittee (or Authorized Agent) Name and Title - Please print or type
GW-59 Rev.06-07-2018

DocuSign Envelope ID: 90AI EB8F-DB1 E-4E1 0-BA1 E-CE057359BA3E
UW-3JA L.V1VJrE1A1Nt-t, KhjrVRT FORM Permit # WQ0004972
(Submit one each monitoring period with GYV-59 forms.)
1
Enter date monitoring results were due. (7/31 /23 ) Will this monitoring report (GW-59 and GW-59A)
YES
NO
be submitted after the established due date?
X
2
Was any required information missing on the GAT 59 report forms?
YES
NO
IF the answer to question 1 or 2 is "YES", list in the space provided below the well identification number(s) and
explain the problems encountered in obtaining the required information.
X
3
Are any of the monitor wells in need of repair or maintenance (damaged casing, unlocked or missing cap, missing
YES
NO
identification plate, area overgrown, etc.)? If the answer is "Yes ", contact the Regional Office for guidance.
X
4
Are any monitored constituents equal to or above the established standards?
YES
NO
if the answer to question 4 is NO", skip to section 8.
If the answer to question 4 is "YES" list the affected wells individually with constituent(s) and concentration(s)
exceeding standards in the space provided below:
MW #1 - pH was 5.8, lab pH was 6.3. MW #2 - pH was 5.5 consistent with background
MW #3 - pH was 4.5, Nitrate was 13.6 mg/I.
X
5
For the constituents identified in question 4 above, have standards been exceeded previously for the
YES
NO
same constituent(s) in the same well(s) in the last two years?
If the answer to question 5 is NO", skip to section 8_
If the answer to question 5 is "YES", list in the space provided below, each well with constituent(s) exceeding
standards, concentration(s) reported, and sample collection date for each occurrence (for the last two years).
X
6
Are the monitoring wells listed in section 5 located at or beyond the review boundary?
YES
NO
If the answer is "YES", a groundwater quality problem maybe occurring. CONTACT THE REGIONAL
OFFICE IMMEDIATELY FOR GUIDANCE if the answer is "NO", monitoring wells maybe improperly
located; contact the Regional Office.
7
Is the permittee implementing previously approved actions required by the Division involving this
YES
NO
groundwater quality problem?
If the answer to question 7 is "YES", describe those actions in the space provided below.
If the answer to question 7 is "NO" contact the Reaional Office within 90 days: an evaluation may be
required to determine the impact the waste disposal system is having at the review and compliance
boundaries surrounding this facility. Failure to do so may subject the permittee to a Notice of Violation
fines, and/or penalties.
g
The person completing this portion (GIN--59A) of the monitoring report should sign below and submit this
form with GW-59 forms for required wells to the address provided at the top of the current GW-59 form.
1 hereby acknow%tl�e #�ai�ie above tnfo�C[rtafrcta �tvas eual�iat�cl and tk�e {nformatcol0 subbmitted to axis `
repor#{Gomplranee �epcet�G1AT-591�) [s true and �omplete�tQ the best,of y iCrrowfedge
Signed by: 8/30/2023
Z
L-AA Iti,
Signature o ftt"ti MAQ#iorized Agent) Date
GW-59A 12/8/2003

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
August 08, 2023
Amanda D. Grenier
Greener EHS Solutions
21 Selby Ct.
Holly Springs, NC 27540
RE: Project: Forest Lake MW- July
Pace Project No.: 92679133
Dear Amanda Grenier:
Enclosed are the analytical results for sample(s) received by the laboratory on July 25, 2023. 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,
Matthew Brainard
[e-mail]
[phone]
Project Manager
Enclosures
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 16

ace
Pace Analytical Services, LLC
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
Project: Forest Lake MW- July
Pace Project No.: 92679133
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 M 37712
North Carolina Wastewater Certification #: 40
CERTIFICATIONS
South Carolina Certification M 99006001
South Carolina Drinking Water Cert. #: 99006003
Florida/NELAP Certification M E87627
Kentucky UST Certification M 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 16

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
SAMPLE ANALYTE COUNT
Project: Forest Lake MW- July
Pace Project No.: 92679133
Analytes
Lab ID Sample ID
Method
Analysts
Reported
Laboratory
92679133001 Monitoring Well #4
EPA 350.1 Rev 2.0 1993
ARJ
1
PASI-A
EPA 353.2 Rev 2.0 1993
MFO
1
PASI-A
EPA 365.1 Rev 2.0 1993
Zip
1
PASI-A
SM 4500-CI-E-2011
Zip
1
PASI-A
SM 531OB-2014
MJP
1
PASI-A
92679133002 Monitoring Well #4 Fecal
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 16

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: Forest Lake MW- July
Pace Project No.: 92679133
Sample: Monitoring Well #4
Lab ID: 92679133001 Collected: 07/24/23
14:30
Received: 07/25/23 16:00 Matrix: Water
Parameters
Results Units Report Limit
DF
Prepared Analyzed
CAS No. Qual
350.1 Ammonia
Analytical Method: EPA 350.1 Rev 2.0 1993
Pace Analytical Services -Asheville
Nitrogen, Ammonia
ND mg/L 0.10
1
08/03/23 12:36
7664-41-7
353.2 Nitrogen, NO2/NO3 unpres
Analytical Method: EPA 353.2 Rev 2.0 1993
Pace Analytical Services -Asheville
Nitrogen, Nitrate
4.2 mg/L 0.040
1
07/25/23 23:55
14797-55-8
365.1 Phosphorus, Total
Analytical Method: EPA 365.1 Rev 2.0 1993 Preparation
Method: EPA 365.1 Rev 2.0 1993
Pace Analytical Services -Asheville
Phosphorus
0.14 mg/L 0.050
1
08/04/2316:29 08/07/2314:39
7723-14-0
4500 Chloride
Analytical Method: SM 4500-CI-E-2011
Pace Analytical Services -Asheville
Chloride
7.4 mg/L 1.0
1
08/01/2315:31
16887-00-6
5310B TOC
Analytical Method: SM 531OB-2014
Pace Analytical Services -Asheville
Total Organic Carbon
2.5 mg/L 1.0
1
08/02/23 00:24
7440-44-0
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 08/08/2023 02:12 PM without the written consent of Pace Analytical Services, LLC. Page 4 of 16

ANALYTICAL RESULTS
Project: Forest Lake MW- July
Pace Project No.: 92679133
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Sample: Monitoring Well #4 Fecal Lab ID: 92679133002 Collected: 07/25/23 11:30 Received: 07/25/23 16:00 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 1.0 CFU/100 mL 1.0 1 07/25/23 17:11 07/26/23 16:30
Date: 08/08/2023 02:12 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 5 of 16

QUALITY CONTROL DATA
Project: Forest Lake MW- July
Pace Project No.: 92679133
QC Batch: 789181 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: 92679133002
METHOD BLANK: 4090584 Matrix: Water
Associated Lab Samples: 92679133002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Fecal Coliforms CFU/100 mL ND 1.0 07/26/23 16:30
SAMPLE DUPLICATE: 4090585
Parameter
Fecal Coliforms
92679133002 Dup
Units Result Result RPD Qualifiers
CFU/100 mL 1.0 ND
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
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: 08/08/2023 02:12 PM without the written consent of Pace Analytical Services, LLC.
Page 6 of 16

QUALITY CONTROL DATA
Project: Forest Lake MW- July
Pace Project No.: 92679133
QC Batch: 791089 Analysis Method: EPA 350.1 Rev 2.0 1993
QC Batch Method: EPA 350.1 Rev 2.0 1993 Analysis Description: 350.1 Ammonia
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92679133001
METHOD BLANK: 4099668
Associated Lab Samples: 92679133001
Parameter Units
Nitrogen, Ammonia mg/L
LABORATORY CONTROL SAMPLE: 4099669
Parameter Units
Nitrogen, Ammonia mg/L
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 0.10 08/03/23 12:09
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
5 5.1 101 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4099670 4099671
MS MSD
92680284001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Nitrogen, Ammonia mg/L ND 5 5 5.1 5.1 101 101 90-110 0
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4099672 4099673
MS MSD
92680284002 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Nitrogen, Ammonia mg/L ND 5 5 5.2 5.2 102 102 90-110 0
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: 08/08/2023 02:12 PM without the written consent of Pace Analytical Services, LLC.
Page 7 of 16

QUALITY CONTROL DATA
Project: Forest Lake MW- July
Pace Project No.: 92679133
QC Batch: 789214 Analysis Method: EPA 353.2 Rev 2.0 1993
QC Batch Method: EPA 353.2 Rev 2.0 1993 Analysis Description: 353.2 Nitrate + Nitrite, Unpres.
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92679133001
METHOD BLANK: 4090710
Associated Lab Samples: 92679133001
Parameter Units
Nitrogen, Nitrate mg/L
LABORATORY CONTROL SAMPLE: 4090711
Parameter Units
Nitrogen, Nitrate mg/L
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 0.040 07/25/23 23:53
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
1.5 1.6 107 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4090712 4090713
MS MSD
92679133001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Nitrogen, Nitrate mg/L 4.2 1.5 1.5 5.8 5.8 109 106 90-110 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: 08/08/2023 02:12 PM without the written consent of Pace Analytical Services, LLC.
Page 8 of 16

QUALITY CONTROL DATA
Project: Forest Lake MW- July
Pace Project No.: 92679133
QC Batch: 791302 Analysis Method: EPA 365.1 Rev 2.0 1993
QC Batch Method: EPA 365.1 Rev 2.0 1993 Analysis Description: 365.1 Phosphorus, Total
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92679133001
METHOD BLANK: 4100941
Associated Lab Samples: 92679133001
Parameter Units
Phosphorus mg/L
LABORATORY CONTROL SAMPLE: 4100942
Parameter Units
Phosphorus mg/L
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 0.050 08/07/23 14:38
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
2.5 2.6 103 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4100943 4100944
MS MSD
92680207001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Phosphorus mg/L ND 2.5 2.5 2.6 2.6 105 106 90-110 1
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4100945 4100946
MS MSD
92680207002 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Phosphorus mg/L ND 2.5 2.5 2.6 2.6 106 105 90-110 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: 08/08/2023 02:12 PM without the written consent of Pace Analytical Services, LLC.
Page 9 of 16

QUALITY CONTROL DATA
Project: Forest Lake MW- July
Pace Project No.: 92679133
QC Batch: 790385 Analysis Method: SM 4500-CI-E-2011
QC Batch Method: SM 4500-CI-E-2011 Analysis Description: 4500 Chloride
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92679133001
METHOD BLANK: 4096280
Associated Lab Samples: 92679133001
Parameter Units
Chloride mg/L
LABORATORY CONTROL SAMPLE: 4096281
Parameter Units
Chloride mg/L
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 1.0 08/01 /23 13:32
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
20 19.6 98 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4096282 4096283
MS MSD
92679133001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Chloride mg/L 7.4 10 10 17.4 17.2 100 98 90-110 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: 08/08/2023 02:12 PM without the written consent of Pace Analytical Services, LLC.
Page 10 of 16

QUALITY CONTROL DATA
Project: Forest Lake MW- July
Pace Project No.: 92679133
QC Batch: 790647 Analysis Method: SM 531 OB-2014
QC Batch Method: SM 531 OB-2014 Analysis Description: 5310E TOC
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92679133001
METHOD BLANK: 4097589
Associated Lab Samples: 92679133001
Parameter Units
Total Organic Carbon mg/L
LABORATORY CONTROL SAMPLE: 4097590
Parameter Units
Total Organic Carbon mg/L
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 1.0 08/01 /23 16:30
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
25 24.7 99 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4097591 4097592
MS MSD
92678043024 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Total Organic Carbon mg/L ND 25 25 24.2 24.1 95 95 90-110 0
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4097593 4097594
MS MSD
92678043025 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Total Organic Carbon mg/L ND 25 25 23.9 24.0 95 95 90-110 0
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: 08/08/2023 02:12 PM without the written consent of Pace Analytical Services, LLC.
Page 11 of 16

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALIFIERS
Project: Forest Lake MW- July
Pace Project No.: 92679133
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 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 TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TN -The NELAC Institute.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 08/08/2023 02:12 PM without the written consent of Pace Analytical Services, LLC. Page 12 of 16

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Forest Lake MW- July
Pace Project No.: 92679133
Analytical
Lab ID
Sample ID
QC Batch Method
QC Batch
Analytical Method Batch
92679133002
Monitoring Well #4 Fecal
SM 9222D-2015
789181
SM 9222D-2015 789182
92679133001
Monitoring Well #4
EPA 350.1 Rev 2.0 1993
791089
92679133001
Monitoring Well #4
EPA 353.2 Rev 2.0 1993
789214
92679133001
Monitoring Well #4
EPA 365.1 Rev 2.0 1993
791302
EPA 365.1 Rev 2.0 1993 791807
92679133001
Monitoring Well #4
SM 4500-CI-E-2011
790385
92679133001
Monitoring Well #4
SM 5310E-2014
790647
Date: 08/08/2023 02:12 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 13 of 16

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Page 16 of 16

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
July 26, 2023
Amanda D. Grenier
Greener EHS Solutions
21 Selby Ct.
Holly Springs, NC 27540
RE: Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
Dear Amanda Grenier:
Enclosed are the analytical results for sample(s) received by the laboratory on July 12, 2023. 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,
Matthew Brainard
[e-mail]
[phone]
Project Manager
Enclosures
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 22

ace
Pace Analytical Services, LLC
9800 KinceyAve. Suite 100
Huntersville, NC 28078
[phone]
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
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 M 37712
North Carolina Wastewater Certification #: 40
CERTIFICATIONS
South Carolina Certification M 99006001
South Carolina Drinking Water Cert. #: 99006003
Florida/NELAP Certification M E87627
Kentucky UST Certification M 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 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
SAMPLE ANALYTE COUNT
Project:
Pace Project No.:
FOREST LAKE-MW'S JULY
92676922
Analytes
Lab ID
Sample ID
Method
Analysts
Reported
Laboratory
92676922001
MW#1
EPA 9040C
YEG
1
PASI-A
EPA 350.1 Rev 2.0 1993
EGC
1
PASI-A
EPA 353.2 Rev 2.0 1993
MFO
1
PASI-A
EPA 365.1 Rev 2.0 1993
MDW
1
PASI-A
SM 4500-CI-E-2011
Zip
1
PASI-A
SM 531OB-2014
MJP
1
PASI-A
92676922002
MW#2
EPA 9040C
YEG
1
PASI-A
EPA 350.1 Rev 2.0 1993
EGC
1
PASI-A
EPA 353.2 Rev 2.0 1993
MFO
1
PASI-A
EPA 365.1 Rev 2.0 1993
MDW
1
PASI-A
SM 4500-CI-E-2011
Zip
1
PASI-A
SM 531OB-2014
MJP
1
PASI-A
92676922003
MW#3
EPA 9040C
YEG
1
PASI-A
EPA 350.1 Rev 2.0 1993
EGC
1
PASI-A
EPA 353.2 Rev 2.0 1993
MFO
1
PASI-A
EPA 365.1 Rev 2.0 1993
MDW
1
PASI-A
SM 4500-CI-E-2011
Zip
1
PASI-A
SM 531OB-2014
MJP
1
PASI-A
92676922004
MW #1
SM 9222D-2015
KDF
1
PASI-C
92676922005
MW #2
SM 9222D-2015
KDF
1
PASI-C
92676922006
MW #3
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 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
Sample: MW#1
Lab ID: 92676922001 Collected: 07/11/23
12:45
Received: 07/12/23 14:00 Matrix: Water
Parameters
Results Units Report Limit
DF
Prepared Analyzed
CAS No. Qual
9040 pH
Analytical Method: EPA 9040C
Pace Analytical Services -Asheville
pH at 25 Degrees C
6.3 Std. Units 0.10
1
07/18/23 12:22
H3
350.1 Ammonia
Analytical Method: EPA 350.1 Rev 2.0 1993
Pace Analytical Services -Asheville
Nitrogen, Ammonia
0.11 mg/L 0.10
1
07/25/23 16:50
7664-41-7
353.2 Nitrogen, NO2/NO3 unpres
Analytical Method: EPA 353.2 Rev 2.0 1993
Pace Analytical Services -Asheville
Nitrogen, Nitrate
ND mg/L 0.040
1
07/13/23 00:19
14797-55-8
365.1 Phosphorus, Total
Analytical Method: EPA 365.1 Rev 2.0 1993 Preparation
Method: EPA 365.1 Rev 2.0 1993
Pace Analytical Services -Asheville
Phosphorus
0.18 mg/L 0.050
1
07/24/23 18:34 07/24/23 22:05
7723-14-0
4500 Chloride
Analytical Method: SM 4500-CI-E-2011
Pace Analytical Services -Asheville
Chloride
1.9 mg/L 1.0
1
07/18/2315:50
16887-00-6
531013 TOC
Analytical Method: SM 531 OB-2014
Pace Analytical Services -Asheville
Total Organic Carbon
6.9 mg/L 1.0
1
07/17/23 18:03
7440-44-0
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC. Page 4 of 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
Sample: MW#2
Lab ID: 92676922002 Collected: 07/11/23
13:32
Received: 07/12/23 14:00 Matrix: Water
Parameters
Results Units Report Limit
DF
Prepared Analyzed
CAS No. Qual
9040 pH
Analytical Method: EPA 9040C
Pace Analytical Services -Asheville
pH at 25 Degrees C
5.8 Std. Units 0.10
1
07/18/23 12:26
H3
350.1 Ammonia
Analytical Method: EPA 350.1 Rev 2.0 1993
Pace Analytical Services -Asheville
Nitrogen, Ammonia
ND mg/L 0.10
1
07/25/23 16:51
7664-41-7
353.2 Nitrogen, NO2/NO3 unpres
Analytical Method: EPA 353.2 Rev 2.0 1993
Pace Analytical Services -Asheville
Nitrogen, Nitrate
0.45 mg/L 0.040
1
07/13/23 00:20
14797-55-8
365.1 Phosphorus, Total
Analytical Method: EPA 365.1 Rev 2.0 1993 Preparation
Method: EPA 365.1 Rev 2.0 1993
Pace Analytical Services -Asheville
Phosphorus
0.18 mg/L 0.050
1
07/24/23 18:34 07/24/23 22:05
7723-14-0
4500 Chloride
Analytical Method: SM 4500-CI-E-2011
Pace Analytical Services -Asheville
Chloride
3.4 mg/L 1.0
1
07/18/2315:51
16887-00-6
531013 TOC
Analytical Method: SM 531 OB-2014
Pace Analytical Services -Asheville
Total Organic Carbon
9.5 mg/L 1.0
1
07/17/23 19:09
7440-44-0
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC. Page 5 of 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
Sample: MW#3
Lab ID: 92676922003 Collected: 07/11/23
15:47
Received: 07/12/23 14:00 Matrix: Water
Parameters
Results Units Report Limit
DF
Prepared Analyzed
CAS No. Qual
9040 pH
Analytical Method: EPA 9040C
Pace Analytical Services -Asheville
pH at 25 Degrees C
4.9 Std. Units 0.10
1
07/18/23 12:30
H3
350.1 Ammonia
Analytical Method: EPA 350.1 Rev 2.0 1993
Pace Analytical Services -Asheville
Nitrogen, Ammonia
ND mg/L 0.10
1
07/25/23 16:52
7664-41-7
353.2 Nitrogen, NO2/NO3 unpres
Analytical Method: EPA 353.2 Rev 2.0 1993
Pace Analytical Services -Asheville
Nitrogen, Nitrate
13.6 mg/L 0.20
5
07/13/23 00:32
14797-55-8
365.1 Phosphorus, Total
Analytical Method: EPA 365.1 Rev 2.0 1993 Preparation
Method: EPA 365.1 Rev 2.0 1993
Pace Analytical Services -Asheville
Phosphorus
ND mg/L 0.050
1
07/24/23 18:34 07/24/23 22:07
7723-14-0
4500 Chloride
Analytical Method: SM 4500-CI-E-2011
Pace Analytical Services -Asheville
Chloride
26.0 mg/L 1.0
1
07/18/2315:52
16887-00-6
531013 TOC
Analytical Method: SM 531 OB-2014
Pace Analytical Services -Asheville
Total Organic Carbon
1.1 mg/L 1.0
1
07/17/23 19:35
7440-44-0
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC. Page 6 of 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
Sample: MW #1 Lab ID: 92676922004 Collected: 07/12/23 09:45 Received: 07/12/23 14:00 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 23.0 CFU/100 mL 1.0 1 07/12/23 15:09 07/13/23 13:35
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC. Page 7 of 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
Sample: MW #2 Lab ID: 92676922005 Collected: 07/12/23 09:49 Received: 07/12/23 14:00 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 86.0 CFU/100 mL 1.0 1 07/12/23 15:09 07/13/23 13:35
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC. Page 8 of 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
ANALYTICAL RESULTS
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
Sample: MW #3 Lab ID: 92676922006 Collected: 07/12/23 09:59 Received: 07/12/23 14:00 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 6.0 CFU/100 mL 1.0 1 07/12/23 15:09 07/13/23 13:35
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC. Page 9 of 22

QUALITY CONTROL DATA
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
QC Batch: 786340 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: 92676922004, 92676922005, 92676922006
METHOD BLANK: 4076941 Matrix: Water
Associated Lab Samples: 92676922004, 92676922005, 92676922006
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Fecal Coliforms CFU/100 mL ND 1.0 07/13/23 13:35
SAMPLE DUPLICATE: 4076942
Parameter
Fecal Coliforms
92676922006 Dup
Units Result Result RPD Qualifiers
CFU/100 mL 6.0 ND
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
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: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC.
Page 10 of 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
QC Batch: 787442 Analysis Method: EPA 9040C
QC Batch Method: EPA 9040C Analysis Description: 9040 pH
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92676922001, 92676922002, 92676922003
SAMPLE DUPLICATE: 4082193
92676714001 Dup
Parameter Units Result Result RPD Qualifiers
pH at 25 Degrees C Std. Units 6.8 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: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC.
Page 11 of 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
QC Batch: 788581 Analysis Method: EPA 350.1 Rev 2.0 1993
QC Batch Method: EPA 350.1 Rev 2.0 1993 Analysis Description: 350.1 Ammonia
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92676922001, 92676922002, 92676922003
METHOD BLANK: 4087722
Matrix:
Water
Associated Lab Samples: 92676922001, 92676922002, 92676922003
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed Qualifiers
Nitrogen, Ammonia
mg/L
ND
0.10
07/25/23 15:57
LABORATORY CONTROL SAMPLE:
4087723
Spike
LCS
LCS % Rec
Parameter
Units
Conc.
Result
% Rec Limits Qualifiers
Nitrogen, Ammonia
mg/L
5
5.1
102 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4087724 4087725
MS MSD
92677689005 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Nitrogen, Ammonia mg/L <0.10 5 5 5.2 5.1 103 103 90-110 0
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4087726 4087727
MS MSD
92677689006 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Nitrogen, Ammonia mg/L <0.10 5 5 4.9 4.9 98 98 90-110 0
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: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC.
Page 12 of 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
QC Batch: 786421 Analysis Method: EPA 353.2 Rev 2.0 1993
QC Batch Method: EPA 353.2 Rev 2.0 1993 Analysis Description: 353.2 Nitrate + Nitrite, Unpres.
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92676922001, 92676922002, 92676922003
METHOD BLANK: 4077400
Matrix:
Water
Associated Lab Samples: 92676922001, 92676922002, 92676922003
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed Qualifiers
Nitrogen, Nitrate
mg/L
ND
0.040
07/13/23 00:07
LABORATORY CONTROL SAMPLE:
4077401
Spike
LCS
LCS % Rec
Parameter
Units
Conc.
Result
% Rec Limits Qualifiers
Nitrogen, Nitrate
mg/L
1.5
1.5
100 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4077402 4077403
MS MSD
92676765001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Nitrogen, Nitrate mg/L ND 1.5 1.5 1.5 1.5 101 102 90-110 0
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4077404 4077405
MS MSD
92677039001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Nitrogen, Nitrate mg/L ND 1.5 1.5 1.5 1.6 102 103 90-110 2
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: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC.
Page 13 of 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
QC Batch: 788796 Analysis Method: EPA 365.1 Rev 2.0 1993
QC Batch Method: EPA 365.1 Rev 2.0 1993 Analysis Description: 365.1 Phosphorus, Total
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92676922001, 92676922002, 92676922003
METHOD BLANK: 4088548
Matrix:
Water
Associated Lab Samples: 92676922001, 92676922002, 92676922003
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed Qualifiers
Phosphorus
mg/L
ND
0.050
07/24/23 22:00
LABORATORY CONTROL SAMPLE:
4088549
Spike
LCS
LCS % Rec
Parameter
Units
Conc.
Result
% Rec Limits Qualifiers
Phosphorus
mg/L
2.5
2.5
101 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4088550 4088551
MS MSD
92676938001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Phosphorus mg/L 19.9 2.5 2.5 22.7 21.9 114 80 90-110 4 M1
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4088552 4088553
MS MSD
92676938002 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Phosphorus mg/L 4.1 2.5 2.5 6.7 6.5 104 97 90-110 3
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: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC.
Page 14 of 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
QC Batch: 787298 Analysis Method: SM 4500-CI-E-2011
QC Batch Method: SM 4500-CI-E-2011 Analysis Description: 4500 Chloride
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92676922001, 92676922002, 92676922003
METHOD BLANK: 4081493
Matrix:
Water
Associated Lab Samples: 92676922001, 92676922002, 92676922003
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed Qualifiers
Chloride
mg/L
ND
1.0
07/18/2315:23
LABORATORY CONTROL SAMPLE:
4081494
Spike
LCS
LCS % Rec
Parameter
Units
Conc.
Result
% Rec Limits Qualifiers
Chloride
mg/L
20
20.6
103 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4081495 4081496
MS MSD
92677137001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Chloride mg/L 144 10 10 160 152 160 75 90-110 5 M1
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4081497 4081498
MS MSD
92677215001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Chloride mg/L 26.3 10 10 34.5 34.8 82 84 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: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC.
Page 15 of 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
QC Batch: 787206 Analysis Method: SM 531 OB-2014
QC Batch Method: SM 531 OB-2014 Analysis Description: 5310E TOC
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92676922001, 92676922002, 92676922003
METHOD BLANK: 4080912
Matrix:
Water
Associated Lab Samples: 92676922001, 92676922002, 92676922003
Blank
Reporting
Parameter
Units
Result
Limit
Analyzed Qualifiers
Total Organic Carbon
mg/L
ND
1.0
07/17/23 13:29
LABORATORY CONTROL SAMPLE:
4080913
Spike
LCS
LCS % Rec
Parameter
Units
Conc.
Result
% Rec Limits Qualifiers
Total Organic Carbon
mg/L
25
24.8
99 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4080914 4080915
MS MSD
92677541001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Total Organic Carbon mg/L 9.1 25 25 33.1 32.6 96 94 90-110 1
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4080916 4080917
MS MSD
92677541004 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Total Organic Carbon mg/L 8.0 25 25 31.9 32.1 95 96 90-110 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: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC.
Page 16 of 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALIFIERS
Project: FOREST LAKE-MW'S JULY
Pace Project No.: 92676922
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 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 TNI accredited. Contact your Pace PM for the current list of accredited analytes.
TN -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.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 07/26/2023 12:07 AM without the written consent of Pace Analytical Services, LLC. Page 17 of 22

Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
[phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project:
Pace Project No.:
FOREST LAKE-MW'S JULY
92676922
Analytical
Lab ID
Sample ID
QC Batch Method
QC Batch
Analytical Method
Batch
92676922004
MW #1
SM 9222D-2015
786340
SM 9222D-2015
786341
92676922005
MW #2
SM 9222D-2015
786340
SM 9222D-2015
786341
92676922006
MW #3
SM 9222D-2015
786340
SM 9222D-2015
786341
92676922001
MW#1
EPA 9040C
787442
92676922002
MW#2
EPA 9040C
787442
92676922003
MW#3
EPA 9040C
787442
92676922001
MW#1
EPA 350.1 Rev 2.0 1993
788581
92676922002
MW#2
EPA 350.1 Rev 2.0 1993
788581
92676922003
MW#3
EPA 350.1 Rev 2.0 1993
788581
92676922001
MW#1
EPA 353.2 Rev 2.0 1993
786421
92676922002
MW#2
EPA 353.2 Rev 2.0 1993
786421
92676922003
MW#3
EPA 353.2 Rev 2.0 1993
786421
92676922001
MW#1
EPA 365.1 Rev 2.0 1993
788796
EPA 365.1 Rev 2.0 1993
788880
92676922002
MW#2
EPA 365.1 Rev 2.0 1993
788796
EPA 365.1 Rev 2.0 1993
788880
92676922003
MW#3
EPA 365.1 Rev 2.0 1993
788796
EPA 365.1 Rev 2.0 1993
788880
92676922001
MW#1
SM 4500-CI-E-2011
787298
92676922002
MW#2
SM 4500-CI-E-2011
787298
92676922003
MW#3
SM 4500-CI-E-2011
787298
92676922001
MW#1
SM 531OB-2014
787206
92676922002
MW#2
SM 531OB-2014
787206
92676922003
MW#3
SM 531OB-2014
787206
Date: 07/26/2023 12:07 AM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 18 of 22

I'Pace I _ ....r._ �........�....r„ , ..`..�.N
Effective Date: 11/14/2022
Laboratory receiving samples:
Asheville ❑ Eden❑ Greenwood ❑ Huntersviiie ❑- Raleigh❑ Mechanicsville❑ Atlantan Kernersville❑
Upon
: Client Name:
Project ft: W�# 92676922
Courier: [-]Fed Ex [-]UPS ❑USPS ❑Client II I III I II II I I II I I I I III
❑ Commercial 'QPace ❑Other:
92676922
Custody Seal Present? ❑Yes -❑No Seals Intact? ❑Yes —❑No
Packing Material: ❑Bubble Wrap ❑Bubble Bags ❑None ❑ Other
Thermometer:
IRGun ID:
Type of Ice: ---OWet []Blue
Correction Factor:
Cooler Temp: ` Add/Subtract (°C)
Cooler Temp Corrected
USDA Regulated Soil (,A, water sample)
Did samples originate in a quarantine zone within the United States: CA, NY, or SC
(check maosl? MYes f-1Nn
Date/Initials Person Examining Contents: \ ti)
Biological Tissue Frozen?
❑Yes ❑No ❑N/A
❑None
Temp should be above freezing to 6°C
❑Samples out of temp criteria. Samples on ice, cooling process
has begun
Did samples originate from a Foreign source (internationally,
Lj.Cz, UIVu
Comments/Discrepancy:
Chain of Custody Present?
--Dyes
[]No
❑N/A
1.
Samples Arrived within Hold Time?
Oyes
[]No
[]N/A
2.
Short Hold Time Analysis (<72 hr.)?
-QYes
❑No
[]N/A
3.
Rush Turn Around Time Requested?
❑Yes
[]No
DN/A
4.
Sufficient Volume?
.DYes
❑No
❑N/A
S.
Correct Containers Used?
-Pace Containers Used?
]Yes
❑Yes
❑No
❑No
❑N/A
❑N/A
6.
Containers Intact?
[]Yes
❑No
❑N/A
7.
Dissolved analysis: Samples Field Filtered?
[]Yes
[:]No
❑N/A
8.
Sample Labels Match COC?
-Includes Date/Time/ID/Analysis Matrix:
Headspace in VOA Vials (>S-6mm)?
[]Yes
❑Yes
❑No
❑No
❑N/A
.❑N/A
9.
10.
Trip Blank Present?
Trip Blank Custody Seals Present?
❑Yes
[-]Yes
[]No
❑No
❑N/A
❑N/A
11.
COMMENTS/SAMPLE DISCREPANCY
-77
CLIENT NOTIFICATION/RESOLUTION lot ID of split containers:
Person contacted:
Project Manager SCURF Review:
Project Manager SRF Review:
Date/Time:
Date:
Date:
Field Data Re— /g7uired? LYes LINo
l), ),):;z_�
Qualtrax ID: 69614
Page 1 of 2
Page 19 of 22

Iav VVIII./III VII V VII I\CL.CI L
ace -
Effective Date: 11/14/202.2
"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, DRO/8015 (water) DOC, Mig
"Bottom half of box is to list number of bottles
""Check all unpreserved Nitrates for chlorine
WO#:92676922
r 1 vac« n
PM: MWB Due Date: 07/26/23
CLIENT: 92-Greener
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pH Adjustment Log for Preserved Samples
Sample 10
Type of Preservative
pH upon receipt
Date preservation adjusted
Time preservation
adjusted
Amount of Preservative
added
Lot #
Note: Whpnpvpr
thprp Ic a rif--n—, off—f-
e1,.,,6 r.._I:--
--'--_-- _
-- - - - - •- .• -ter+ . 11
Out of hold, incorrect preservative, out of temp, incorrect containers. vc,ern UJ Inc Ivorul laronna UtNR CertiliWllon 011ice (i,C.
Qualtrax ID: 69614
Page 2 of 2
Page 20 of 22

ITEM #
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Page 21 of 22

ce Analyircal
Sample Receiving
Date: ,i ` I Evaluated by:
Client: e 1-4
Non -Conformance Form (NCF)
Affix Workorder/Login Label Here or List Pace
Workorder Number or MTJL Log -in Number
Here
1. If Chain -of -Custody (COC) is not received: contact client and if necessary, fill out a COC and indicate that it was filled out by
lab personnel. Note issues on this NCF.
2. If COC is incomplete. check anolicable issues below and add details where annronriate:
Collection date/time missing or
Analyses or analytes: missing or
V
Samples listed on COC do not match samples
incorrect
clarification needed
received (missing, additional, etc.
Sample IDs on COC do not
match sample labels
Required trip blanks were not received
Required signatures are missing
Comments/Details/Other Issues not listed above:
TO c vt6'-,, ��,(-:'e-��
3. Samr)le intearitv issues: check aoolicable issues below and add details where annronriate:
Samples: Condition needs to be brought to
Samples: Past holding time
lab ersonnel's attention details below
Preservation: Improper
Temperature: not within acceptance criteria (typically
Samples: Not field filtered
Containers: Broken or compromised
0-6C
Samples: Insufficient volume
received
Containers: Incorrect
Temperature: Samples arrived frozen
Samples: Cooler damaged or
Custody Seals: Missing or compromised on
compromised
samples, trip blanks or coolers
Vials received with improper heads ace
Samples: contain chlorine or
sulfides
Packing Material: Insufficient/Improper
Other:
Comments/Details:
4. If SamDles not oreserved Dronerly and Samnle Receiving adiusts nH_ add details halnw-
Sam le ID:
Date/Time:
Amount/ty a pros added:
Preserved by:
Initial and Final H:
Lot # of pres added:
Sample ID:
Date/Time:
Amount/type res added:
Preserved by:
Initial and Final H:
Lot # of pres added:
Sample ID:
Date/Time:
Amount/type pres added:
Preserved by:
Initial and Final H:
Lot # of pres added:
5. Client Contact: If client is contacted for any issue listed above, fill in details below:
Client: I Contacted per: I
PM Initials: I Date/Time:
Client Comments/Instructions:
F-ALL-C-01 1 -rev.00, 05Ju12018
Page 22 of 22