HomeMy WebLinkAboutWQ0004972_Monitoring - 02-2024_20240430Monitoring Report Submittal
Permit Number#*
Name of Facility:*
Month: * February
Report Information
WQ0004972
Forest Lake RV WWTP
Type *
Revised - NDMR, NDAR-1, NDAR-2, NDMLR
Year:* 2024
Upload Document*
2024_February_Forest Lake_WQ0004972_REV 1.54MB
Complete.pdf
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
Confirmation Email Address: * agrenier@greenerehssolutions.com
Name of Submitter: * Amanda Grenier
Signature:
6VIO'W ada e*Aw t
Date of submittal: 4/30/2024
This will be filled in automatically
Initial Review
Reviewer: Wanda.Gerald
Is the project number correct?* WQ0004972
Is the monitoring report accepted?* Yes No
Regional Office* Winston-Salem
Reviewer: _anonymous
Review Date: 5/20/2024
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB NON -DISCHARGE MONITORING REPORT NDMR
Permit No.: WQ0004972
Facility Name: Forest Lake Preserve ELS
County: Davie
Month: February
Year: 2024
PPI: 001
Flow Measuring Point:
Parameter Monitoring Point:
Parameter Code
50050
00400
50060
70300
00530
00310
31616
00600
00610
00625
00630
00620
00615
00665
00940
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24-hr
hrs
GPD
su
mg/L
mg/L
mg/L
mg/L
#/100 mL
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
mg/L
1
08:00
5
31,504
6.39
3.6
2
08:00
5
25,446
6.41
4.2
3
21,313
4
20,590
5
08:00
5
21,822
6.53
0.6
6
08:00
5
21,729
6.74
0.7
267
11.2
10.2
7
40.2
35.1
40.1
0.065
7.7
7
08:00
5
24,019
6.9
1.3
8
8:00
5
20,628
6.65
2.4
9
08:00
5
17,598
6.59
2.8
10
30,147
11
27,532
12
08:00
5
41,017
7.1
0.1
13
08:00
5
43,599
7.12
0.3
14
08:00
5
29,529
7.16
1.2
15
08:00
5
22,631
6.55
0.6
16
08:00
5
22,935
6.37
0.8
17
21,490
18
28,987
19
08:00
5
34,800
6.9
0.2
20
08:00
5
26,858
6.97
0.6
21
08:00
5
28,531
6.93
0.6
22
08:00
5
23,723
6.94
0.8
23
11:00
21,425
6.9
0.5
24
34,988
25
30,782
26
08:00
5
23,192
7.26
0.8
27
08:00
5
25,300
7.18
0.8
28
08:00
5
42,084
7.07
1.1
29
08:00
5
47,313
7.21
0.9
30
31
Average:
27,983
1.19
267.00
11.20
10.20
7.00
40.20
35.10
40.10
0.07
7.70
Daily Maximum:
47,313
7.26
4.20
267.00
11.20
10.20
7.00
40.20
35.10
40.10
0.07
7.70
Daily Minimum:
17,598
6.37
0.10
267.00
11.20
10.20
7.00
40.20
35.10
40.10
0.07
7.70
Sampling Type:
Monthly Avg. Limit:
Daily Limit:
LSample Frequency:
Continuous
5x/Week
5X/Week
Monthly
Monthly
Monthly
Monthly
Monthly
Monthly
Monthly
Monthly
Monthly
Monthly
Monthly
3X/year
Law TLLL
Sam Perry (Apr 30, 202 16:38 EDT)
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB
Sampling Person(s)
Certified Laboratories
Name: Sam Perry
Name:
Name: Greener EHS Solutions, LLC
Name: Pace Analytical
Does all monitoring data and sampling frequencies meet the requirements in Attachment A of your permit? ❑ Compliant O Non -Compliant
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.
The Monthly average flow exceeded the permitted flow of 24,400 gpd. The permitted application rate was not exceeded. The flow meter was calibrated on June 27, 2023 and the meter was reading significantly
low before the calibration. This was noted on the June 2023 NDMR. The plant is in the process of an upgrade to increase the capacity as well as investigating extraneous flow for 1/1 and leaking fixtures. Lab
Qualifiers, February 6, 2024 - Fecal Coliform, D6 - The precision between the sample and sample duplicate exceeded laboratory control limits. TKN, R1 - RPD value was outside control limits. Phosphorus and
TKN, M1 - Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery.
Operator in Responsible Charge (ORC) Certification
Permittee Certification
ORC: Sam Perry
Permittee: MHC TT, LP
Certification No.: 1014038
Signing Official: George Gudgeon
Grade: SI Phone Number: 919-548-2381
Signing Officials Title: Sr. Vice President
Has the ORC changed since the previous NDMR?
Phone Number: 312-279-1400 Permit Expiration: 10/31/2027
Saw e
4/29/2024 �
4/30/24
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for
gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am
aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for
knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB
Permit No.: WQ0004972
Facility Name: Forest Lake
County: Davie
Month: February
Year: 2024
Did irrigation
Field Name:
Field Name:
Field Name:
Field Name:
occur
Area (acres):
6
Area (acres):
Area (acres):
Area (acres):
at this facility?
Cover Crop:Grass/Trees
Cover Crop:
p�
Cover Crop:
p�
Cover Crop:
p:
Hourly Rate (in):
0.11
Hourly Rate (in):
Hourly Rate (in):
Hourly Rate (in):
Annual Rate (in):
46.8
Annual Rate (in):
Annual Rate (in):
Annual Rate (in):
Weather
Freeboard
Field Irrigated?
Field Irrigated?
Field Irrigated?
Field Irrigated?
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in
ft
ft
gal
min
in
in
gal
min
in
in
gal
min
in
in
gal
min
in
in
1
C
56
0
2.3'
2
CL
61
0
2.2'
45,617
300
0.28
0.06
3
C
53
0
4
CL
53
0
5
C
56
0
2.5'
54,709
360
0.34
0.06
6
C
50
0
1 3.6'
7
C
51
0
3.5'
8
CL
56
0
3.2'
38,310
240
0.24
0.06
9
CL
54
0
4'
10
CL
67
0
11
R
57
0.25
12
CL
56
0.73
3'
13
C
57
0
2.8'
14
C
59
0
2.5'
48,249
300
0.30
0.06
15
CL
64
0
3.1'
16
CL
55
0
2.9'
17
CL
51
0
18
CL
46
0
19
C
55
0
2.6'
41,549
240
0.26
0.06
20
CL
54
0
3.3'
21
C
55
0
3'
30,549
180
0.19
0.06
22
CL
66
0
3.6'
23
CL
58
0
3.25'
24
C L
54
0
25
C
51
0.5
26
CL
69
1.5
2.6'
37,993
240
0.23
0.06
27
CL
62
0
3.4'
28
CL
67
0
3.2'
29
CL
49
2.75
3'
33,088
240
0.20
0.05
30
PC
0
0
311
CL
1 0
1 0
Monthly Loading:
330,064
2.03
0
0.00
0
0.00
0
0.00
12 Month Floating Total (in):
23.89
FORM: NDAR-1 05-16 NON -DISCHARGE APPLICATION REPORT (NDAR-1) Page of
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB
Did the application rates exceed the limits in Attachment B of your permit? Ll Compliant ❑ Non -Compliant
Were adequate measures taken to prevent effluent ponding in or runoff from the sites? O Compliant ❑ Non -Compliant
Was a suitable vegetative cover maintained on all sites as specified in your permit? O Compliant ❑ Non -Compliant
Were all setbacks listed in your permit maintained for every application to each permitted site? O Compliant ❑ Non -Compliant
Were all freeboards maintained in accordance with the specified freeboard heights in your permit? O Compliant ❑ Non -Compliant
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 Responsible Charge (ORC) Certification
Permittee Certification
ORC: Sam Perry
Permittee:
MHC TT, LP
Certification No.: 1014038
Signing Official: George Gudgeon
Grade: SI Phone Number: 919-548-2381
Signing Officials Title: Sr. Vice President
Has the ORC changed since the previous NDAR-1?
Phone Number: 312-279-1400 Permit Exp.: 10/31/27
Sawn TLL; 4/30/24
Sam Per A r 30 2022r16:38 EDT
4/29/2024
Signature Date
Signature Date
By this signature, I certify that this report is accurrate and complete to the best of my knowledge.
I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in accordance
with a system designed to assure that all qualified personnel properly gathered and evaluated the information submitted. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the
information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant
penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.
Mail Original and Two Copies to:
Division of Water Resources
Information Processing Unit
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
):05
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB
,ace -
February 19, 2024
Amanda D. Grenier
Greener EHS Solutions
21 Selby Ct.
Holly Springs, NC 27540
RE: Project: FOREST LAKE- MONTHLY
Pace Project No.: 92711960
Dear Amanda Grenier:
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
Enclosed are the analytical results for sample(s) received by the laboratory on February 06, 2024. 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
matthew.brainard@pacelabs.com
704-977-0942
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 17
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB
,ace -
Project: FOREST LAKE- MONTHLY
Pace Project No.: 92711960
Pace Analytical Services Charlotte
South Carolina Laboratory ID: 99006
9800 Kincey Ave. Ste 100, Huntersville, NC 28078
North Carolina Drinking Water Certification #: 37706
North Carolina Field Services Certification #: 5342
North Carolina Wastewater Certification #: 12
South Carolina Laboratory ID: 99006
Pace Analytical Services Asheville
2225 Riverside Drive, Asheville, NC 28804
Florida/NELAP Certification #: E87648
North Carolina Drinking Water Certification #: 37712
North Carolina Wastewater Certification #: 40
CERTIFICATIONS
South Carolina Certification #: 99006001
South Carolina Drinking Water Cert. #: 99006003
Florida/NELAP Certification #: E87627
Kentucky UST Certification #: 84
Louisiana DoH Drinking Water #: LA029
VirginiaNELAP Certification #: 460221
South Carolina Laboratory ID: 99030
South Carolina Certification #: 99030001
VirginiaNELAP Certification #: 460222
REPORT OF LABORATORY ANALYSIS
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC. Page 2 of 17
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB Pace Analytical Services, LLC
�ace- 9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
SAMPLE ANALYTE COUNT
Project: FOREST LAKE- MONTHLY
Pace Project No.: 92711960
Analytes
Lab ID Sample ID
Method
Analysts
Reported
Laboratory
92711960001 EFFLUENT
SM 9222D-2015
KDF
1
PASI-C
SM 2540C-2015
JMH1
1
PASI-A
SM 2540D-2015
JMH1
1
PASI-A
SM 521OB-2016
MDM
1
PASI-A
TKN+NO3+NO2 Calculation
MDW
1
PASI-A
EPA 350.1 Rev 2.0 1993
NCF
1
PASI-A
EPA 351.2 Rev 2.0 1993
MFO
1
PASI-A
EPA 353.2 Rev 2.0 1993
NCF
1
PASI-A
EPA 365.1 Rev 2.0 1993
Zip
1
PASI-A
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 17
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB
,ace
ANALYTICAL RESULTS
Project: FOREST LAKE- MONTHLY
Pace Project No.: 92711960
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
Sample: EFFLUENT Lab ID: 92711960001 Collected: 02/06/24 11:25 Received: 02/06/24 12:20 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
7.0 CFU/100 mL 1.0
1
02/06/24 17:58 02/07/24 15:59
2540C Total Dissolved Solids
Analytical Method: SM 2540C-2015
Pace Analytical Services -Asheville
Total Dissolved Solids
267 mg/L 25.0
1
02/09/24 17:36
2540D Total Suspended Solids
Analytical Method: SM 2540D-2015
Pace Analytical Services -Asheville
Total Suspended Solids
11.2 mg/L 5.0
1
02/09/24 17:27
5210B BOD, 5 day
Analytical Method: SM 521OB-2016
Pace Analytical Services -Asheville
BOD, 5 day
10.2 mg/L 2.0
1
02/08/24 07:09 02/13/24 07:31
Total Nitrogen Calculation
Analytical Method: TKN+NO3+NO2 Calculation
Pace Analytical Services -Asheville
Total Nitrogen
40.2 mg/L 0.040
1
02/16/24 14:05
350.1 Ammonia
Analytical Method: EPA 350.1 Rev 2.0 1993
Pace Analytical Services -Asheville
Nitrogen, Ammonia
35.1 mg/L 1.0
10
02/17/24 02:14 7664-41-7
351.2 Total Kjeldahl Nitrogen
Analytical Method: EPA 351.2 Rev 2.0 1993 Preparation
Method: EPA 351.2 Rev 2.0 1993
Pace Analytical Services -Asheville
Nitrogen, Kjeldahl, Total
40.1 mg/L 2.5
5
02/15/24 14:17 02/16/24 04:48 7727-37-9
353.2 Nitrogen, NO2/NO3 unpres
Analytical Method: EPA 353.2 Rev 2.0 1993
Pace Analytical Services -Asheville
Nitrogen, Nitrate
0.065 mg/L 0.040
1
02/07/24 01:19 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
7.7 mg/L 0.10
2
02/19/2411:31 02/19/2416:47 7723-14-0
Date: 02/19/2024 08:09 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 4 of 17
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB Pace Analytical Services, LLC
�ace- 9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
QUALITY CONTROL DATA
Project: FOREST LAKE- MONTHLY
Pace Project No.: 92711960
QC Batch: 830457 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: 92711960001
METHOD BLANK: 4292376
Associated Lab Samples: 92711960001
Parameter
Fecal Coliforms
SAMPLE DUPLICATE: 4292377
Parameter
Fecal Coliforms
Matrix: Water
Blank Reporting
Units Result Limit Analyzed Qualifiers
CFU/100 mL ND 1.0 02/07/24 15:59
92711901001 Dup
Units Result Result RPD Qualifiers
CFU/100 mL 97.0 70.0 32 D6
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: 02/19/2024 08:09 PM without the written consent of Pace Analytical Services, LLC.
Page 5 of 17
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB Pace Analytical Services, LLC
�ace 9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
QUALITY CONTROL DATA
Project: FOREST LAKE- MONTHLY
Pace Project No.: 92711960
QC Batch: 831333 Analysis Method: SM 2540C-2015
QC Batch Method: SM 2540C-2015 Analysis Description: 2540C Total Dissolved Solids
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92711960001
METHOD BLANK: 4296466
Associated Lab Samples: 92711960001
Parameter
Units
Total Dissolved Solids
mg/L
LABORATORY CONTROL SAMPLE:
4296467
Parameter
Units
Total Dissolved Solids
mg/L
SAMPLE DUPLICATE: 4296468
Parameter
Units
Total Dissolved Solids
mg/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 25.0 02/09/24 17:34
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
250 258 103 90-110
92711015024 Dup
Result Result RPD Qualifiers
1490 1520 2
SAMPLE DUPLICATE: 4296469
92711696002 Dup
Parameter Units Result Result
Total Dissolved Solids mg/L 198 203
RPD Qualifiers
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: 02/19/2024 08:09 PM without the written consent of Pace Analytical Services, LLC. Page 6 of 17
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB Pace Analytical Services, LLC
�ace 9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
QUALITY CONTROL DATA
Project: FOREST LAKE- MONTHLY
Pace Project No.: 92711960
QC Batch: 831331 Analysis Method: SM 2540D-2015
QC Batch Method: SM 2540D-2015 Analysis Description: 2540D Total Suspended Solids
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92711960001
METHOD BLANK: 4296458
Associated Lab Samples: 92711960001
Parameter Units
Total Suspended Solids mg/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 2.5 02/09/24 17:26
LABORATORY CONTROL SAMPLE & LCSD: 4296459 4297713
Spike LCS LCSD LCS LCSD % Rec Max
Parameter Units Conc. Result Result % Rec % Rec Limits RPD RPD Qualifiers
Total Suspended Solids mg/L 250 244 246 98 98 90-110 1 25
SAMPLE DUPLICATE: 4297126
92712235001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L 3550 3350 6
Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 02/19/2024 08:09 PM without the written consent of Pace Analytical Services, LLC.
Page 7 of 17
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB Pace Analytical Services, LLC
�ace 9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
QUALITY CONTROL DATA
Project: FOREST LAKE- MONTHLY
Pace Project No.: 92711960
QC Batch: 830836 Analysis Method: SM 521 OB-2016
QC Batch Method: SM 521OB-2016 Analysis Description: 5210E BOD, 5 day
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92711960001
METHOD BLANK: 4294221
Associated Lab Samples: 92711960001
Parameter
Units
BOD, 5 day
mg/L
LABORATORY CONTROL SAMPLE:
4294223
Parameter
Units
BOD, 5 day
mg/L
SAMPLE DUPLICATE: 4294224
Parameter
Units
BOD, 5 day
mg/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 2.0 02/13/24 05:49
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
198 224 113 84.6-115
92711922002 Dup
Result Result RPD Qualifiers
2.2 2.2 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: 02/19/2024 08:09 PM without the written consent of Pace Analytical Services, LLC. Page 8 of 17
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB Pace Analytical Services, LLC
�ace 9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
QUALITY CONTROL DATA
Project: FOREST LAKE- MONTHLY
Pace Project No.: 92711960
QC Batch: 832844 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: 92711960001
METHOD BLANK: 4303880
Associated Lab Samples: 92711960001
Parameter Units
Nitrogen, Ammonia mg/L
LABORATORY CONTROL SAMPLE: 4303881
Parameter Units
Nitrogen, Ammonia mg/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 0.10 02/16/24 23:12
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
5 5.0 100 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4303882 4303883
MS MSD
92711832001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Nitrogen, Ammonia mg/L 19.5 5 5 24.4 24.6 99 102 90-110 1
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4303884 4303885
MS MSD
92711944001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Nitrogen, Ammonia mg/L 2.8 5 5 7.8 7.8 101 101 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: 02/19/2024 08:09 PM without the written consent of Pace Analytical Services, LLC.
Page 9 of 17
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB Pace Analytical Services, LLC
�ace 9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
QUALITY CONTROL DATA
Project: FOREST LAKE- MONTHLY
Pace Project No.: 92711960
QC Batch: 832576 Analysis Method: EPA 351.2 Rev 2.0 1993
QC Batch Method: EPA 351.2 Rev 2.0 1993 Analysis Description: 351.2 TKN
Laboratory: Pace Analytical Services -Asheville
Associated Lab Samples: 92711960001
METHOD BLANK: 4302481
Associated Lab Samples: 92711960001
Parameter Units
Nitrogen, Kjeldahl, Total mg/L
LABORATORY CONTROL SAMPLE: 4302482
Parameter Units
Nitrogen, Kjeldahl, Total mg/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 0.50 02/16/24 02:39
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
10 9.7 97 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4302755 4302756
MS MSD
92712559001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Nitrogen, Kjeldahl, Total mg/L 0.72 10 10 10.5 28.9 98 282 90-110 94 M1,R1
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4302757 4302758
MS MSD
92712559002 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Nitrogen, Kjeldahl, Total mg/L 3.7 10 10 13.4 13.5 96 97 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: 02/19/2024 08:09 PM without the written consent of Pace Analytical Services, LLC.
Page 10 of 17
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB Pace Analytical Services, LLC
�ace 9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
QUALITY CONTROL DATA
Project: FOREST LAKE- MONTHLY
Pace Project No.: 92711960
QC Batch: 830491 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: 92711960001
METHOD BLANK: 4292525
Associated Lab Samples: 92711960001
Parameter Units
Nitrogen, Nitrate mg/L
LABORATORY CONTROL SAMPLE: 4292526
Parameter Units
Nitrogen, Nitrate mg/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 0.040 02/07/24 01:07
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
1.5 1.5 101 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4292527 4292528
MS MSD
92711832001 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 98 101 90-110 4
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: 02/19/2024 08:09 PM without the written consent of Pace Analytical Services, LLC.
Page 11 of 17
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB Pace Analytical Services, LLC
�ace 9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
QUALITY CONTROL DATA
Project: FOREST LAKE- MONTHLY
Pace Project No.: 92711960
QC Batch: 832923 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: 92711960001
METHOD BLANK: 4304132
Associated Lab Samples: 92711960001
Parameter Units
Phosphorus mg/L
LABORATORY CONTROL SAMPLE: 4304133
Parameter Units
Phosphorus mg/L
Matrix: Water
Blank Reporting
Result Limit Analyzed Qualifiers
ND 0.050 02/19/2413:46
Spike LCS LCS % Rec
Conc. Result % Rec Limits Qualifiers
2.5 2.6 103 90-110
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4304134 4304135
MS MSD
92711774001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Phosphorus mg/L 0.27 2.5 2.5 2.7 2.7 97 96 90-110 1
MATRIX SPIKE & MATRIX SPIKE DUPLICATE: 4304136 4304137
MS MSD
92711801001 Spike Spike MS MSD MS MSD % Rec
Parameter Units Result Conc. Conc. Result Result % Rec % Rec Limits RPD Qual
Phosphorus mg/L 10.3 2.5 2.5 13.3 13.5 120 128 90-110 2 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: 02/19/2024 08:09 PM without the written consent of Pace Analytical Services, LLC.
Page 12 of 17
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB
,ace
QUALIFIERS
Project: FOREST LAKE- MONTHLY
Pace Project No.: 92711960
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.
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
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
D6 The precision between the sample and sample duplicate exceeded laboratory control limits.
M1 Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery.
R1 RPD value was outside control limits.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
Date: 02/19/2024 08:09 PM without the written consent of Pace Analytical Services, LLC. Page 13 of 17
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB
,ace -
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Pace Analytical Services, LLC
9800 Kincey Ave. Suite 100
Huntersville, NC 28078
(704)875-9092
Project:
Pace Project No.:
FOREST LAKE- MONTHLY
92711960
Analytical
Lab ID
Sample ID
QC Batch Method
QC Batch
Analytical Method
Batch
92711960001
EFFLUENT
SM 9222D-2015
830457
SM 9222D-2015
830458
92711960001
EFFLUENT
SM 254OC-2015
831333
92711960001
EFFLUENT
SM 2540D-2015
831331
92711960001
EFFLUENT
SM 521OB-2016
830836
SM 521OB-2016
830896
92711960001
EFFLUENT
TKN+NO3+NO2
833012
Calculation
92711960001
EFFLUENT
EPA 350.1 Rev 2.0 1993
832844
92711960001
EFFLUENT
EPA 351.2 Rev 2.0 1993
832576
EPA 351.2 Rev 2.0 1993
832840
92711960001
EFFLUENT
EPA 353.2 Rev 2.0 1993
830491
92711960001
EFFLUENT
EPA 365.1 Rev 2.0 1993
832923
EPA 365.1 Rev 2.0 1993
833334
Date: 02/19/2024 08:09 PM
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full,
without the written consent of Pace Analytical Services, LLC.
Page 14 of 17
101-_l I DG#_Title: ENV+KIYI-HUN1-0083 v03_5ample Condition Upon Keceipt
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB
Effective Date: 11/29/202-3 4:16:30 PM
Laboratory receiving samples:
Asheville ❑ Eden❑ Greenwood ❑ Huntersville E Raleigh❑ Mechanicsville❑ Atlanta❑ Kernersville❑
• Client Name:
-Uponc-r S S fib 5 Project #: WO#:92711960
Courier. ed Ex L1 UPS Ll USPS Client 111111111111
IIII I II III
❑ Commercial Pace ❑ Other:
Custody Seal Present? ❑ Yes El No
Packing Material: ❑ Bubble Wrap
Thermom er•
,,��,,// 92711960
Seals Intact? El Yes ❑No IJN/A
Date/Initials Person Examining Contents-, ! ��
Bubble Bags ❑ None ❑ Other Biological Tissue FF zen?
❑ Yes ❑ No L�J N/A
KI IR Gun ID: 9�T4�
_ Type of Ice: Wet El Blue
Correction Factor: ]
Cooler Temp: «' V Add/Subtract (°C) �' I
C.
Cooler Temp Corrected (°
USDA Regulated Soil ( Ed N/A, water sample)
Did samples originate in a quarantine zone within the United States: CA, NY, or SC
(check mancl? F1 Yes n Nn
❑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,
includine Hawaii and Puerto Ricol? MYPS ❑No
Comments/Discrepancy:
Chain of Custody Present?
Yes
❑ No
] N/A
1.
Samples Arrived within Hold Time?
❑ No
❑ N/A
2.
Short Hold Time Analysis (<72 hr.)?
,2Yes
ICJ Yes
❑ No
❑ N/A
3.
Rush Turn Around Time Requested?
❑ Yes
0 No
❑ N/A
4.
Sufficient Volume?
Mes
Cl No
❑ N/A
S.
Correct Containers Used?
Pace Containers Used?
(eyes
E Yes
[I No
❑ No
❑N/A
❑ N/A
6.
Containers Intact?
Yes
❑ No
❑ N/A
7.
Dissolved analysis: Samples Field Filtered?
❑Yes
e-No
❑N/A
8.
Sample Labels Match COC?
-Includes Date/Tme/ID/Analysis Matrix:
(�� es
"" r
❑ No
❑ N/A
9.
Headspace in VOA Vials (>5-6mm)?
❑ Yes
ClNo
U✓ N/A
10.
Trip Blank Present?
TripBlank Custody Seals Present?
❑Yes
❑ Yes
❑No
O No
`N/A
[� N/A
11.
COMMENTS/SAMPLE DISCREPANCY
CLIENT NOTIFICATION/RESOLUTION
Person contacted:
Project Manager SCURF Review:
Project Manager SRF Review:
Lot ID of split containers:
Date/Time:
Date:
Date:
Field Data Required? U Yes U No
Qualtrax ID: 69614 Paae 1 of 2
Page 15 of 17
�I Jnnn I V VTr_ a.c. �.�. . .�In-..v.� .-v vv.r• vv6_�7anIF.JIG LVIIV Ill V11 uf,/Vll RCI.Clt.1l
DocuSign Envelope ID: E2B64DB8-9491-48F9-B05D-A55CB17A27FB
I I -
Effective Date: 11/14/2022
*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. LLHS
**Bottom half of box is to list number of bottles
***Check all unpreserved Nitrates for chlorine
Projec
WO#:92711960
PM: MWB Due Date: 02/20/24
CLIENT: 92-Greener
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pH Adjustment Log for Preserved Samples
Sample ID
Type of Preservative
pH upon receipt
Date preservation adjusted
Time preservation
adjusted
Amount of Preservative
added
Lot #
rJuie. Whenever ureic Is a discrepancy anecung iqortn Carohna compliance samples, a copy of this form will be sent to the North Carolina DENR Certification Office (i.e.
Out of hold, incorrect preservative, out of temp, incorrect containers.
Qualtrax ID: 69614 Page 2 of 2
Page 16 of 17
Pace` Location Requested (City/State):
Pace Analytical Charlotte CHAIN -OF -CUSTODY Analytical Request Document
LAB USE ONLY- Affix Workorder/Login Label Here
ace4 9800 Kincey Ave. Suite 100, Huntersville, NC 28078 Chain -of -Custody is a LEGAL DOCUMENT - Complete all relevant fields
cti0
gip.• /
loriTI,
Company Name: Greener EHS Solutions
Street Address: 192 Thousand Trail Dr., Advance, NC 27006
contact/Report To: Amanda Grenier
Phone u: (919)356-6509
E-Mail:
s . Scan QR Coddtions
Cc E-Mall:
Customer Project n;
Specify Container Size "
"Container 5i2a: (1) 1L, (2) 500mL, (3) 250mL, (4)
Project Name: Forest Lake- Monthly
1 y
12SmL, IS) 100m1, (6) 40n,:v�. �r'ae. (8)
TerraCore, (9) 90mL, (10) Other
Invoice To:
�' .
Invoice E-Mall:
Identify Container Preservative Type"
••• Preservative Types: (1) None, 12) HNO3, (31
Site Collection Info/Facility ID (as applicable):
Purchase Order p (if
H2504, 14) NCI, 15) Mott, (6) Zn Acetate, (7)
applicable):
NaHSO4, 181 Sod. Thiosulfate, (9) Ascorbic Acid, (10)
Analysis Requested
MCOH, 1111 Other
Quote 4:
Prof. Mgr:
Matthew Brainard
a
-
Time Zone Collected: [ ] AK ( ] PT [ ] MT [ ] CT [ JET
County/ State origin of sample(s): North Carolina
Data Deliverables:
Regulatory Program (DW, RCRA, etc.) as applicable: Reportable [ ] Yes [ ]NO
AcctNum / Client ID:
( ) Level II I ] Level III I ] Level IV
U
Rush (Pro -approval required):
DIN PWSID g or WW Permit R as applicable:
p`
Table R:
I I Same Day [ I 1 Day I ] 2 Day ( ] 3 Day [ ] Other
Z
N
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[ ) EQUIS
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Date Results
Field Filtered (if applicable): [ ] Yes [ ] No
Profile /Template:
e E
Other
Requested:
Analysis:
ii
H
T
E
o
"d
a)Water
on
14849-8
• Matrix Codes (Insert in Matrix box below): Drinking Water (DWI, Ground (GW), Waste Water (WW), Product (P), Sail Solid (SS), Oil OL), Wipe (WP), Tissue TS), Bioassay
Prelog /Bottle Ord. ID:
B , Vapor IV), Surface Water SW ,Sediment SEO Sludge SL Caulk CK , Leachate (ILL), Biosolid BS , Other (Or)0
E
11'
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Customer Sample ID
Matrix
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Sample Comment
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Customer Remarks /Special Conditions /Possible Hazards:
(Printed Name) l L��y
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Slgnatur �-='--� /
g Cooloa: Thefmometer to: Correction to VC); Obi. Temp. (*Cl Corrected Temp. ('Cl On Ice:
8 m ulfitCby(]Company: (Sign
Date/Time:: /� -
Received b a urel
Date/Time: /'t
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R C wished by/Company: (Signature)
Dale/Time:
Received by/Company: (Signature)
Date/Time:
Lu
Page: of
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5 Flitting a sample via this chain of custody constitutes acknowledgment and acceptance of the Pace* Terms and Conditions found at https://www.pacelabs.com/resource-library/resource/pace-terms-and-conditions/ ENV-FRM-CORQ-0019_v02_110123
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