NCG030669_2024 DMR_20240715

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG030000
Metal Fabrication
Click here for instructions
Complete,sign,scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report(DMR) Upload form within
30 days of receiving sampling results. Mail the original,signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCGO3 0669 Person Collecting Samples: Robert Hensley
Facility Name: AFS MFG LLC Laboratory Name: Pace Analytical
Facility County: ROWAN Laboratory Cert. No.: DW#37706,WW#12, DW#37712,WW#40
Discharge during this period: ✓)Yes 0 No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?rjYes Ei No
If so,which Tier(I, II,or Ill)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/SW-DMR es El No
Date Uploaded: 1 1 } 5 1 . y
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall 1B Outfall 2 Outfall Outfall Outfall
Code
N/A Receiving Stream Class C C
N/A Date Sample Collected MM/DD/YYYY 6/27/2024 6/27/2024
46529 24-Hour Rainfall in inches 0.23" 0.23"
C0530 TSS in mg/L(100 or 50*) <2.5 mg/L <2.5 mg/L
pH in standard units(6.0-9.0 FW,
00400 7.39 7.21
6.8-8.5 SW)
01119 Copper,total recoverable in mg/L <0.0050 mg/L <0.0050 mg/L
(0.010 FW,0.0058 SW)
01051 Lead,total recoverable in mg/L <0.0050 mg/L <0.0050 mg/L
(0.075 FW,0.22 SW)
Zinc,total recoverable in mg/L(0.126
01094 FW,0.095 SW) <0.0100 mg/L <0.0100 mg/L
00340 Chemical Oxygen Demand(COD)in <25.0 mglL <25.0 mg/L
mg/L(120)
00552 Non-Polar Oil&Grease in mg/L(15) <4.9 mg/L <4.8 mg/L
*Outfalls to Outstanding Resource Waters(ORW),High Quality Waters(HQW),Trout Waters(Tr)and Primary Nursery Areas(PNA)
have a benchmark TSS limit of 50 mg/L.All other water classifications have a benchmark of 100 mg/L
FW(Freshwater)SW(Saltwater)
Notes(optional):
"I certify by my signature below,under penalty of law,that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my
inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information,the information
submitted is,to the best of my knowledge and belief,true,accurate,and complete.I am aware that there are significant penalties for submitting
false informati n,including the ossibility of fines and imprisonment for knowing violations."
.S gnat re of Permittee or Delegated Authorized Individual Date
K1emA . ►c\CV1btI hey.i,gd.11Csi\ Al . COrY-N - 1 0y 210 3 512.
Email Address Phone Number

�/J/ p�f Pace Analytical Services,LLC
}°�n 9800 Kincey Ave. Suite 100
Huntersville,NC 28078
6�[VVV 66JJ [phone]
July 05, 2024
Robert Hensley
Agility Fuel Systems
1010 Corporate Center Drive
Salisbury, NC 28146
RE; Project: Stormwater
Pace Project No.: 92739249
Dear Robert Hensley:
Enclosed are the analytical results for sample(s)received by the laboratory on June 28, 2024. The results relate only to the
samples included in this report. Results reported herein conform to the applicable TNVNELAC 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,
Tyriek Hooks
[e-mail]
704-977-0947
Project Manager
Enclosures
cc: Kulema McKoy, Hexagon Agility
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 i 4

Pace Analytical Services,LLC
� 9800 Kincey Ave. Suite 100
aceHuntersville,NC 28078
[phone]
CERTIFICATIONS
Project: Stormwater
Pace Project No,: 92739249
Pace Analytical Services Charlotte
South Carolina Laboratory ID:99006 South Carolina Certification#:99006001
9800 Kincey Ave.Ste 100,Huntersville,NC 28078 South Carolina Drinking Water Cert.#:99006003
North Carolina Drinking Water Certification#:37706 Florida/NELAP Certification#:E87627
North Carolina Field Services Certification#:5342 Kentucky UST Certification#:84
North Carolina Wastewater Certification#:12 Louisiana DoH Drinking Water#:LA029
South Carolina Laboratory ID:99006 VirginiaNELAP Certification#:480221
Pace Analytical Services Asheville
2225 Riverside Drive,Asheville,NC 28804 South Carolina Laboratory ID:99030
Florida/NELAP Certification#:E87648 South Carolina Certification#:99030001
North Carolina Drinking Water Certification#:37712 VirginiaNELAP Certification#:460222
North Carolina Wastewater Certification#:40
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 14

Pace Analytical Services,LLC
9800 Kincey Ave. Suite 100
'ace'P°1� Huntersville,NC 28078
m�irf 1F./ [phone]
SAMPLE ANALYTE COUNT
Project: Stormwater
Pace Project No.: 92739249
Analytes
Lab ID Sample ID Method Analysts Reported Laboratory
92739249001 OUTFALL 1B GRAB EPA 1664E DVR 1 PASI-C
EPA 200.7 Rev 4.4 1994 DBB1 3 PASI-A
SM 2540D-2015 MOW 1 PASI-A
SM 5220D-2011 JP1 1 PASI-A
92739249002 OUTFALL 2 GRAB EPA 1664B DVR 1 PASt-C
EPA 200.7 Rev 4.4 1994 DBB1 3 PASt-A
SM 2540D-2015 MDW 1 PAS1-A
SM 5220D-2011 JP1 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 14

Pace Analytical Services,LLC
�]/'� �°� 9800 Kincey Ave. Suite 100
•a 1 e Huntersville,NC 28078
"ace-
{✓ [phone]
ANALYTICAL RESULTS
Project: Stormwater
Pace Project No.: 92739249
Sample: OUTFALL 1B GRAB Lab ID: 92739249001 Collected: 06/27/24 08:30 Received: 06/28/24 13:45 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No, Qual
1664 SGT-HEM,TPH Analytical Method:EPA 1664E
Pace Analytical Services-Charlotte
Total Petroleum Hydrocarbons ND mg/L 4.9 1 07/01/24 20:26
200.7 MET ICP Analytical Method:EPA 200.7 Rev 4.4 1994 Preparation Method:EPA 200.7 Rev 4.4 1994
Pace Analytical Services-Asheville
Copper ND ug1L 5.0 1 06/29/24 12:25 07/02/24 15:07 7440-50-8
Lead ND ug/L 5.0 1 06/29/24 12:25 07/02/24 15:07 7439-92-1
Zinc ND ug/L 10.0 1 06/29/24 12:25 07/02/24 15:07 7440-66-6
2540D Total Suspended Solids Analytical Method:SM 2540D-2015
Pace Analytical Services-Asheville
Total Suspended Solids ND mg/L 2.5 1 07/04/24 12:05
5220D COD Analytical Method:SM 5220D-2011 Preparation Method:SM 5220D-2011
Pace Analytical Services-Asheville
Chemical Oxygen Demand ND mg/L 25.0 1 07/03/24 01:55 07/03/24 05:16
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:07/05/2024 11:27 AM without the written consent of Pace Analytical Services,LLC. Page 4 of 14

Pace Analytical Services,LLC
9800 Kincey Ave. Suite 100
'ace
/�°� Huntersvitle,NC 28078
l�6✓VV [phone]
ANALYTICAL RESULTS
Project: Stormwater
Pace Project No.: 92739249
Sample: OUTFALL 2 GRAB Lab ID: 92739249002 Collected: 06/27/24 09:30 Received: 06/28/24 13:45 Matrix: Water
Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual
1664 SGT-HEM,TPH Analytical Method:EPA 16648
Pace Analytical Services-Charlotte
Total Petroleum Hydrocarbons ND mg/L 4.8 1 07/01/24 20:26
200.7 MET 1CP Analytical Method:EPA 200.7 Rev 4.4 1994 Preparation Method:EPA 200.7 Rev 4.4 1994
Pace Analytical Services-Asheville
Copper ND ug/L 5.0 1 06/29/24 12:25 07/02/24 15:16 7440-50-8
Lead ND ug/L 5.0 1 06/29/24 12:25 07/02/24 15:16 7439-92-1
Zinc ND ug/L 10.0 1 06/29/24 12:25 07/02/24 15:16 7440-66-6
2540D Total Suspended Solids Analytical Method:SM 2540D-2015
Pace Analytical Services-Asheville
Total Suspended Solids ND mg/L 2.5 1 07/04/24 12:05
5220D COD Analytical Method:SM 5220D-2011 Preparation Method:SM 5220D-2011
Pace Analytical Services-Asheville
Chemical Oxygen Demand ND mg/L 25.0 1 07/03/24 01:55 07/03/24 05:16
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:07/05/2024 11:27 AM without the written consent of Pace Analytical Services,LLC. Page 5 of 14

,., Pace Analytical Services,LLC
9800 Kincey Ave. Suite 100
pace
Huntersville,NC 28078
[phone]
QUALITY CONTROL DATA
Project: Stormwater
Pace Project No.: 92739249
QC Batch: 865383 Analysis Method: EPA 1664B
QC Batch Method: EPA 1664E Analysis Description: 1664 SGT-HEM,TPH
Laboratory: Pace Analytical Services-Charlotte
Associated Lab Samples: 92739249001,92739249002
METHOD BLANK: 4461318 Matrix: Water
Associated Lab Samples: 92739249001,92739249002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Petroleum Hydrocarbons mg/L ND 5.0 07/01/24 20:18
LABORATORY CONTROL SAMPLE: 4461319
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Total Petroleum Hydrocarbons mg/L 20 17.0 85 64-132
MATRIX SPIKE SAMPLE: 4461320
35887265001 Spike MS MS %Rec
Parameter Units Result Conc. Result %Rec Limits Qualifiers
Total Petroleum Hydrocarbons mg/L 4.9U 19.4 15.9 70 64-132
SAMPLE DUPLICATE: 4461321
92738981001 Dup
Parameter Units Result Result RPD Qualifiers
Total Petroleum Hydrocarbons mg/L ND ND
Results presented on this page aro 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:07/05/2024 11:27 AM without the written consent of Pace Analytical Services,LLC. Page 6 of 14

Pace Analytical Services,LLC
'/'� 9800 Kincey Ave. Suite 100
ace, Huntersville,NC 28078
4[666ddd [phone]
QUALITY CONTROL DATA
Project: Stormwater
Pace Project No.: 92739249
QC Batch: 865137 Analysis Method: EPA 200.7 Rev 4.4 1994
QC Batch Method: EPA 200.7 Rev 4.4 1994 Analysis Description: 200.7 MET
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 92739249001,92739249002
METHOD BLANK: 4460410 Matrix: Water
Associated Lab Samples; 92739249001,92739249002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Copper ug/L ND 5.0 07/02/24 14:42
Lead ug/L ND 5.0 07/02/24 14:42
Zinc ug/L ND 10.0 07/02/24 14:42
LABORATORY CONTROL SAMPLE: 4460411
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Copper ug/L 500 509 102 85-115
Lead ug/L 500 509 102 85-115
Zinc ug/L 500 513 103 85-115
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4460412 4460413
MS MSD
92738675001 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Copper ug/L 0.023 500 500 696 684 135 132 70-130 2 M1
mg/L
Lead ug/L ND 500 500 486 474 97 95 70-130 2
Zinc ug/L 0.024 500 500 471 460 89 87 70-130 2
mg/L
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4460416 4460417
MS MSD
92738668002 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Copper ug/L 0.066 500 500 597 613 106 109 70-130 3
mg/L
Lead ug/L 0.0097 500 500 524 536 103 105 70-130 2
mg/L
Zinc ug/L 0.10 500 500 622 638 104 107 70-130 2
mg/L
Results presented on this page are In the units indicated by the"Units"column except whore 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:07/05/2024 11:27 AM without the written consent of Pace Analytical Services,LLC. Page 7 of 14

Pace Analytical Services,LLC
/� 9800 Kincey Ave. Suite 100
/ Hunlersvllie,NC 28078
6�L 6J [phone]
QUALITY CONTROL DATA
Project: Stormwater
Pace Project No.: 92739249
QC Batch: 866170 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: 92739249001,92739249002
METHOD BLANK: 4465360 Matrix: Water
Associated Lab Samples: 92739249001,92739249002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Total Suspended Solids mg/L ND 2.5 07/04/24 12:02
LABORATORY CONTROL SAMPLE: 4465361
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Total Suspended Solids mg/L 250 242 97 90-110
SAMPLE DUPLICATE: 4465380
92739227001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L 47.3 38.0 22
SAMPLE DUPLICATE: 4465381
92739310001 Dup
Parameter Units Result Result RPD Qualifiers
Total Suspended Solids mg/L 328 303 8
Results presented on this page are in the units indicated by the"Units"column except whore 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:07/05/2024 11:27 AM without the written consent of Pace Analytical Services,LLC. Page 8 of 14

Pace Analytical Services,LLC
/� 9800 Kincey Ave. Suite 100
p d _¢�G V Huntersville,NC 28078
�•! [phone]
QUALITY CONTROL DATA
Project: Stormwater
Pace Project No.: 92739249
QC Batch: 865855 Analysis Method: SM 5220D-2011
QC Batch Method: SM 5220D-2011 Analysis Description: 5220D COD
Laboratory: Pace Analytical Services-Asheville
Associated Lab Samples: 92739249001,92739249002
METHOD BLANK: 4463630 Matrix: Water
Associated Lab Samples: 92739249001,92739249002
Blank Reporting
Parameter Units Result Limit Analyzed Qualifiers
Chemical Oxygen Demand mg/L ND 25.0 07/03/24 05:11
LABORATORY CONTROL SAMPLE: 4463631
Spike LCS LCS %Rec
Parameter Units Conc. Result %Rec Limits Qualifiers
Chemical Oxygen Demand mg/L 750 775 103 90-110
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4463632 4463633
MS MSD
92738821001 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Chemical Oxygen Demand mg/L 30.3 100 100 142 142 111 111 90-110 0 M1
MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 4463634 4463635
MS MSD
92739723004 Spike Spike MS MSD MS MSD %Rec
Parameter Units Result Conc. Conc. Result Result %Rec %Rec Limits RPD Qual
Chemical Oxygen Demand mg/L ND 100 100 125 118 109 102 90-110 6 R1
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:07/05/2024 11:27 AM without the written consent of Pace Analytical Services,LLC. Page 9 of 14

Pace Analytical Services,LLC
9800 Kincey Ave. Suite 100
Huntersville,NC 28078
GGE���iii✓✓✓ [phone]
QUALIFIERS
Project: Stormwater
Pace Project No.: 92739249
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.
TNI-The NELAC Institute.
ANALYTE QUALIFIERS
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 he reproduced,except in full,
Date:07/05/2024 11:27 AM without the written consent of Pace Analytical Services,LLC. Page 10 of 14

Pace Analytical Services,LLC
9800 Kincey Ave. Suite 100
,,' ce' Huntersvllle,NC 28078
[phone]
QUALITY CONTROL DATA CROSS REFERENCE TABLE
Project: Stormwater
Pace Project No.: 92739249
Analytical
Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch
92739249001 OUTFALL 1B GRAB EPA 1664E 865383
92739249002 OUTFALL 2 GRAB EPA 1664E 865383
92739249001 OUTFALL 1B GRAB EPA 200.7 Rev 4.4 1994 865137 EPA 200.7 Rev 4.4 1994 865165
92739249002 OUTFALL 2 GRAB EPA 200.7 Rev 4.4 1994 865137 EPA 200.7 Rev 4.4 1994 865165
92739249001 OUTFALL 1B GRAB SM 2540D-2015 866170
92739249002 OUTFALL 2 GRAB SM 2540D-2015 866170
92739249001 OUTFALL 1B GRAB SM 5220D-2011 865855 SM 5220D-2011 865874
92739249002 OUTFALL 2 GRAB SM 5220D-2011 865855 SM 5220D-2011 865874
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in tut),
Date:07/05/2024 11:27 AM without the written consent of Pace Analytical Services,LLC. Page 11 of 14

DC#_Title: ENV-FRM-HUN1-0083 v05_Sample Condition Upon Receipt
'iraace
Effective Date: 05/24/2024 i
Laboratory receiving samples:
Asheville ❑ Eden❑ Greenwood ❑ Huntersville [r Raleigh Mechanicsvillefl AttantAi`1 ,r.....�--•.,r-r'
Sample Condition Client Name: Pro ect#: WO# : 92739249
Up on Recet t �_
'AO(I1 f y j G!P( f 4-rim. '
Courier:
Commercial Opade Ex
❑LP5 Other: ['ClientEllClienEll111 ' 1 111111
92739249
Custody Seal Present? Des ❑No Seals Intact? Dyes ❑No ✓[IN/A �,//r
Date/Initials Person Examining Content01
:/i�/ (-'
Z3.2�Packing Material: ['Bubble Wrap [/Bubble Bags ['None E Other Biological Tissue roren?
7hermomete f� -�rr;I /�(/,1 Des ONo [ N/A
IR Gun ID: f lt " f
Type of Ice: 2Net ❑Blue ['None
1 3 Correction Factor: /�c,
Cooler Temp: Add/Subtract(°C) V. Temp should be above freezing to 6°C
�" ❑Samples out of temp criteria.Samples on ice,cooling process
Cooler Temp Corrected(°C): v has begun
USDA Regulated Soil(2/N/A,water sample)
Did samples originate in a quarantine zone within the United States:CA,NY,or SC Did samples originate from a foreign source{internationally,
(check maps)?Eves ❑No including Hawaii and Puerto Rico)?Des ❑No
1 Comments/Discrepancy:
Chain of Custody Present? fes ❑Na ❑N/A 1 1.
Samples Arrived within Hold Time? beg ❑No ON/A 12.
Short Hold lime Analysis(<72 hr.)? Dyes QNo
Rush Turn Around Time Requested? Eves bl'o EN/A 4.
Sufficient Volume? [14es :No ❑N/A 5.
Correct Containers Used? Oyes ❑No ❑N/A 6.
-Pace Containers Used? 'mires ®No ❑N/A
Containers Intact? tyres ❑No ❑N/A 7.
' t
Dissolved analysis:Samples Field Filtered? Dyes ONO IfIrN/A 8.
Sample Labels Match CDC? lis ❑No ❑N/A 9.
--
-Includes Date/Time/ID/Analysis Matrix:
Headspace in VOA Vials(s.5-6mm)? Dyes Otto [a/N/A 10,
Trip Blank Present? ❑Yes ❑No [ ]jell/A ; 11.
Trip Blank Custody Seals Present? Des ❑N 61 I
COMMENTS/SAMPLE DISCREPANCY Field Data Required? Oyes ❑No
Lot ID of split containers:
CLIENT NOTIFICATION/RESOLUTION
Person contacted: Date/Time:
Project Manager SCURF Review: Date:
Project Manager SRF Review: Date:
Qualtrax ID: 69614 Page 1 of 2 Page 12 of 14

DC# Title: ENV-FRM-HUN1-0083"Facev05_Sample Condition Upon Receipt
! Effective Date: 05/24/2024
'Check mark top half of box if pH and/or dechlorination is verified and within the M `: V 39249
acceptance range for preservation samples. Project �
PM: TIH Due Date: 07/08/24
Exceptions:VOA,Coliform,TOC,Oil and Grease,DRO/8015(water)DOC,Wig
••Bottom half of box is to list number of bottles CLIENT: 82—Agility F
"'Check all unpreserved Nitrates for chlorine
Laboratory Receiving Location:Asheville❑ Eden❑ Greenwood❑ Huntersville Er RaleighO Mechanicsville❑ AtlantaD Kernersville❑
Client .r
4 Profile/e(Circle ono)3 f 2?.(5t Notes
2 :1 ! z I M1 a 2 A ri M E 2_ _'. ^ !. V 0 {y, i -7: L. .., Y ` i - 7 ^ . ; z V = `z z . n z 4
7 7 ' G x I C.'
O V_ ; n 8 h j 1 nF. 1 2 7 O G
Y. i - Y .. a T 7 u �. v _
E E 1 Y e c - o E e c E E c ' € ' E J c E
g ' 'v. o _ c o 4 o N M 1 ^ I o 2 H o
t '> 7 7 7 I 4 m o * M 7 N N — f g t, 7 X ' 1- N 1 1 c a 7
V 4 6 4 •M M1 Al 4l {{O771 Q, O� O,7t {] ` L� U'
= G m G O t m o �S K 2 2 2 2 O C 2 > E Y > v+ I N i I m 2 7 i f
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pH Adjustment Log for Preserved Samples
Sample ID Type of Preservative pH upon receipt Date preservation adjusted Time preservation ! Amount of Preservative Lot It
adjusted added
Note: Whenever there is discrepancy affecting North Carolina 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 13 of 14

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