NC0026051_Lab analyses_20031231

Laboratory Benchsh ets
and Statistical Anal\ es
Enviroomental Testing Solutions, Inc.Page 1 of 1
Project #Control H
^25
"ii5 09.
% Adults having S'" Broods (> 80%):^22-ito?.
% Mortality (< 20%);
ALlul
Date Analyst
0
•k-
i Feeding
2 Renewal I Crag-4C
3 Feeding
4 Feeding
5 Renewal 2 nb--2^-a^<-
6 Feeding
7 Terminadon
1 2 3 5 7 129
Adult mortalityI L_L L_CL
5 \ oung produced )S 1^ISI?llo
Adult mortalityI L_I—C_v
6 or 7 Young produced / SIS If1£n iL>\81^9
Total young produced
3U 343331 3S 3<-l 3333di32
Final Adult Mortality
L_L_k_L_L_S
X (or 3r0 Broods
3 Note .An X
< 24-hours old_______
VSl€ TC
^>3^
9.0
^5.0
Final
2MS
Final
_32.
1^3
Final
25^
Initial
‘<Z£A-
Sample numbers
used
Test organism information:
Organism age______________
Date and times organisms
were bom between:__________
Organism source:___________
Transfer bowl information:
Daily renewal infonnalion:
Day
Acceptance Criteria:
°/o of Male Adults (< 20%):
ABS
ABS
Test information:
Randomizing template:
Incubator number and
shelf location:
YCT batch:
Selenastrum batch:
Hi
Mean Offspring/Female
(> 15 offsprin^surviving female):
% C V (< 40.0%):
15^
Z 132-
/O-O^
Renewal One
i3b^-
•T.-51
g.O
I 0O
Day
2
4
L
73,2-
Initial
Survival and Reproduction Dola
________ Replicate number
6
Control water
batch used (SSYV)
/o-2a^3
Test grouping information:
8 10
L
Renewal Two
3.60
3.0
07
33.6
W
of the number of young produced indicates the presence of two broods
Control Information, North Carolina Chronic Whole Effluent Toxicity Test (EPA.-821-R-02-013
Method 1002.0, NC Modification-February, 1998) Species: Ceriodaphnia dubia
z
BRe-'
in the upper right comer
a4
M
GET - 'boZAPH___________
57gW’ - \fj'\cDN-ylucJT?
4 nine lajiutp
3 ScMcH Axto m i+P
I CONTROL
/L05O3
//■Dk.Q3
//•01-Q3
II.D&-D3
U-lb-te
I/.1/^03
11-12-03
Daily chemistry:_________
Parameter______
Analyst
pH(S.U.)______________
DO (mg/L) ___________
Conductivity (pmhos/cm)
Alkalinity (mg CaCOj/L)
Hardness (mg CaCO^/L)
Temperature (°C)
Ko"
'C .
i
■ g
I
_______Initiation
•7.3®
e>.2-
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Initial
«■
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11
Date ll-CS-b?)
lO'Zf-CTb ______________
pH = SU Temperature=7^.t-( °C
Test initiation, renewal,
feeding, or termination time
Initiation , , _ OA! , ,
Q015>
tfizis
O0IQ
0^2-
Environ mental Testing Solutions, Inc.Page 1 of 1
zProject #Control H
^5
^-21-
% Mortality (< 20%):
pH = 7.7^ sir
Date Analyst
0
■lc
1 Feeding
2 Renewal 1
3 Feeding
4 Feeding
5 Renewal 2
?Jc
6 Feeding
7 Termination
I
1 2 3 4 5 6 129
Adult mortalityI L_U e.L_cu
5 Young produced It?iiZ /GISISl?
Adult mortalityI L_C_l—
6 or 7 Y oung produced I Ulg l£IS I?ICis \8IG
Total young produced 3^3U 343331 38 34 33333132
Final Adult Mortality
L LL_L CL VLU
X for 3,d Broods
I
L
< 24-hours old
rsi-f -re.
Final Final Final
2S-4
Initial
Sample numbers
used
<c_
At
Test grouping information:
IO-2g-c5^ fi-V^______________
Temperature=-^,t4 °C
the upper right comer of the number of young produced indicates the presence of two broods
Test organism information:
Organism age:______________
Date and times organisms
were bom between:_________
Organism source:___________
Transfer bowl information:
Daily renewal information:
Day
Acceptance Criteria:
% of Male Adults (< 20°o):
ABS
ABS
2
Q.o
Day
2
Mean OffspringTemale
(> 15 offspring/surviving female):
% CV (< 40.0%):
Test information:
Randomizing template:
Incubator number and
shelf location:
YCT batch:
Selenastrum batch:
ZS.T-
Initial
Survival and Reproduction Data
__________ Replicate number
7
Renewal One
S.SI
3-0
| 0O
5.0
I3±^
1^3
Control water
batch used (SSYV)
10-23^3
8
Renewal Two
S.6Q
3.0
10
0?
33.6
W
Control Information, North Carolina Chronic Whole Effluent Toxicity Test (EPA-821-R-02-013
Method 1002.0, NC Modification- February, 1998) Species: Ceriodaphnia dubia
//■DU.D3
ii.oeoz
1/-10.03
I/.I/-03
11-12'03
Daily chemistry:_________
________Parameter______
Analyst________
pH (S.U.) ~~~
DO (mg/L)_____________
Conductivity (pmhos/cm)
Alkalinity (mg CaCO/L)
Hardness (mg CaCOj/L)
Temperature (°C)
GST - ~ku£rW__________
I
isp* --
»■
I
Initiation
e>.z_
l (r /
G
Initial
% Adults having 3rd Broods (> 80%):
-Yore .-Vi X in
I5X
4 Sc£t~[as~\d rvo/jc ujujtp
3 m bpp
1 CONTROL
11 I
Test initiation, renewal,
feeding, or termination time
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7ANALYSES REQUIRED
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ADDRESS
ATTENTION
PROJECT NO PROJECT NAME
COLLECTED BY (SifjntHure)PRINTED NAME
TIMEDATE SAMPLE I.D.REMARKS
Ir7'-/C,)i iH
RELINQUISHED BY (Signature)DATE RECEIVED BY (Signature)TIME DATE TIME
DATE TIME
13^H-05-C3 I3S§0^TsmP - 1 -‘3‘ C-
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RECEIVED FOR LABORATORY BY:
REl INQUISHED BY (Signature)
_______[) ~n-o4<S
ADDITIONAL INSTRUCTIONS.DATE TIME
CET
SAMPLE A
SAMPLE
COM
TYPE
GRAB
Normal (2 weeks)
L J Rush (1 week)*
Q Rush (48 hours)*
O Rush (24 hours)*
SAMPLE
MATRIX
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CONTAINERS
PRESERVED IN LAD
RECEIVED ON ICE
CLIENT
NAME
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54 AT e
ADDRESS:
___
PRESERVATIVES
hou, i-ied Trsy tw, --
CTTiv-ica! & Environmental lechnologY, Inc.
102-A Woodwinds Industrial Ct. Cary, NC 27511
[phone] FAX: [phone]
of,
Environmental resting Solutions, Inc.
hole Effluent Toxicitv Chain-of-Custody Form
Hicilux \C()0265()l Pipe . 001 DurhamCountv:
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Sumple inl'orm.ition:(lo be ci.'iiiplclci! b\ suiiiplc cnllcclori
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Sample custody:no be coinpicled b> sample collector and facility personnel)
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Sample receipl inl'nrmation:i lo be coinpicled In I IS pci v'lincl)
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^25 O3llo<!-0Z-Prujcci nimila-i Sample nimihci
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raw
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Dale:
Time
Time
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Parameter code
Phone [phone]
Fax. [phone]
NPDPS-
Purchase order
> * - i■ ...
Shipping address:
351 Depot Street
Asheville. \C 28801
A) c Jjiy
m UAS
Samples recehed in ly.a.il cnmliiiim',’: [ y^'\
('eriodaphnid duhia
Pa.ss7Fa.il Chronic
90%
TCP3B
CET________________________
Durham Co. - Triangle W \VTP
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Volume collected for testing / ///ZC
Number of containers filled for testing
Total residual chlorine (mg L):
fcmpcralurc al time of collection ("C):
Method of transport to laboratory : ,
.\/;re DO NOT collect samples before 8:00 AM. Triple rinse sample container m idi sample hi fore filling. Completely fill
the sample container with no airspace. Pack the container completely in ice. The sample mu-.. I • received at < 4.()°C.
Composite sample:
Slarl dale ill Ao 3
1 ■ni1 dale: n 1'1/0 3-> 7 f
Number ol samples per hour
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0.9 -
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1.00
Sodium Chloride Chronic Reference Toxicant Control Chart
for Ceriodaphnia dubia
using Moderately Hard Synthetic Water
Laboratory Warning and Control Limits
Limits Set According io 10^ and 25t" Percentile CVs
O
Cm z
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—•— 7-day IC,. = 25% inhibition concentration. An estimation of tlie concentration of sodium chloride
that would cause a 25% reduction in Ceriodaphnia reproduction for the test population
------Central Tendency (mean IC-.J
— — Warning Limits (mean IC,. = S
Control Limits (mean IC,. ± S
4?Z(5'
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State and USEPA Mandated Control Limits
Limits Set According to ± 2 Standard Deviations
Environmental Testing Solutions, Inc.
Precision of Endpoint Measurements
Test date MSI)PMSD CTCTCVCT
(offspring/female)for PMSD (%)(%)(%)(%)
\’ote:
I l-D-J x/s
L’SEI’A. 2000 Understanding and Accounting for Method Variability in Whole Effluent Toxicity Applications Under the National Pollutant Discharge
Elimination Program EPA-833-R-00-003 US Environmental Protection Agency, Cincinnati, 01!
Control
Survival
100
100
100
90
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
Sodium Chloride Chronic Reference Toxicant Data
for Ceriodaphnia dubia
using Moderately Hard Synthetic Water
Control Mean
Reproduction
for Control Mean
Reproduction
(offspring/female)
10.4
6.7
9.2
8.0
6.2
6.0
11.0
13.7
7.4
7.0
8.1
5.1
6.2
10.8
5.9
11.6
6.6
4.3
8.0
7.3
8.6
8.8
8.6
8.1
7.8
8.2
8.9
8.7
8.5
8.5
8.2
8.1
8.3
8.1
8.3
8.2
8.0
8.0
8.0
The lower and upper bounds were calculated by the USEPA using 393 tests conducted from 33 laboratories for Ceriodaphnia reproduction in chronic
reference toxicant tests.
Test
number
for Control
Reproduction
CV (%)
9.5
9.4
8.4
8.0
9.9
9.8
10.0
8.5
9.4
8.6
8.4
12.1
9.6
11.5
10.1
10.9
14.1
10.7
9.5
8.3
1
2
3
4
6
8
9
10
11
12
13
14
15
16
17
18
19
20
31.3
30.7
31.5
31.8
32.0
31.6
31.9
31.7
31.9
31.9
31.7
31.2
31.0
30.6
30.5
30.7
30.6
30.8
30.8
9.4
9.1
8.8
9.0
9 2
9.3
9 2
9.2
9.1
9.1
9.3
9.3
9.5
9.5
9.6
9.9
9.9
9.9
9.8
09-04-02
10- 08-02
11- 05-02
12- 03-02
12-03-02
12-04-02
12-06-02
12-11-02
12-18-02
01-07-03
02-04-03
03-05-03
04-11-03
05-06-03
06-04-03
07-08-03
08-05-03
09-10-03
10- 07-03
11- 04-03
31.4
31.1
29.5
34.0
33.2
32.5
29.7
33.8
30.5
33.2
32.3
28.7
26.3
27.6
25.9
29.0
33.3
29.3
33.4
31.0
3.0
2.9
2.5
2.7
3.3
3.2
3.0
2.9
2.9
2.9
2.7
3.5
2.5
3.2
2.6
3.2
4.7
3.1
3.2
2.6
» » t
CV = Coefficient of variation for control reproduction.
On average, the CV for control reproduction is 8.0% in Environmental Testing Solutions, Inc. Ceriodaphnia chronic
toxicity tests.
Lower CV bound determined by USEPA (10Lh percentile) = 8.9%.
Upper CV bound determined by USEPA (90U1 percentile) = 42%
MSD = Minimum Significant Difference
PMSD = Percent Minimum Significant Difference
PMSD is a measure of test precision. The PMSD is the minimum percent difference between the control and treatment that
can be declared statistically significant in a whole effluent toxicity test. On average, a significant difference occurs for
Environmental Testing Solutions, Inc. chronic toxicity tests when a toxicant reduces Ceriodaphnia reproduction by 9.8%
from the control.
Lower PMSD bound determined by USEPA (10c'percentile) = 11%.
Upper PMSD bound determined by USEPA (90th percentile) = 37%.
CT = Central Tendancy (Mean Control Reproduction, CV, or PMSD)
March 12, 2004
RE:ETS PROJECT NUMBER: 1094
Dear Mr. Thrower:
Test Procedure
EPA-821-R-02-013TGP3B PASS
Final
Result
If this test was performed as an NPDES requirement or by Administrative Letter, please
enter a P on the Effluent Discharge Monitoring Form (MR-1) for the collection date
February 23, 2004 using the parameter code TGP3B.
Additionally, please sign and submit the enclosed DWQ Aquatic Toxicity Form (AT-1)
to the following address. The original AT-1 form must be mailed by
March 30, 2004.
.\'ortli Carolind Ceriificate Numbers: Biological Analyses: 37. Drinking Water: 37786, Wastewater: 600
Sourli Carolina Certificate Number: Clean Water Act: 99053-001
Enclosed are toxicity test results for samples from the Durham County Triangle WWTP
received by Environmental Testing Solutions, Inc. February 25 through
February 28, 2004.
Parameter
Code
North Carolina Ceriodaphnia Chronic Effluent
Toxicity Procedure - December 1985, Revised:
February 1998
[Ceriodaphnia Pass/Fail Toxicity Test)
PO Box 7565
Asheville, NC 28802
North Carolina Department of Environment and Natural Resources
DWQ/Environmental Sciences Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
EPA Method
Number
Mr. Link Thrower
Chemical & Environmental Technology, Inc.
102-A Woodwinds Industrial Court
Cary, NC 2751 1
Sincerely,
Laboratory Director
If you have any questions concerning these results, please feel free to contact me.
Environmental Testing Solutions, Inc.
Phone: [phone]
Fax: [phone]
E-mail: [e-mail]
Dale March 09, 2004
Pipe#: 001 County: Durham
Comments: .
North Carolina Ceriodaphnia Chronic Pass/Fail Reproduction Toxicity Test Percent
Pass Fail
X
Test Start Date:02-25-04
7.52
Sample 2 02-26-04
Duration
24-h
24-h
J 1=
to
Control
FtigJi Cone.
Organism Tested:Ceriodaphnia duhia Duration:7-days pH (ST .)DO (mg/L)
DWQform AT-1 (3/87) rev. 11/95
i
Concentration (%)
Mortality (%)
D.O. (mg/L)
Control
Treatment 2
pH (S.U.)
Control
Treatment 2
Sanple 1
Sanple 2
Alkalinity (nig CaCO3/L)
Hardness (nig CaCOj/L)
Conductivity (pniios'cm)
Total Residual Chlorine (rng<L)
Sanple Tettp. at Receipt f’C)
Chronic Test Results
Calculated t:
Tabular t:
% Reduction:
Mail Original To: North Carolina Department of Environment and Natural Resources
DWQ/ Environmental Sciences Branch
1621 Mail Service Center
Raleigh, NC 27699-1621
Method of Determination
Trimmed Spearman Karber
Probit
Other:
—*----------------------
PO Box 7565
Asheville, NC 28802
f
1II
Treatment 2
34.9
1 I
Morality
Control
0.0
Average
Reproduction
Control
32.8
Control Organisms_________
Number of Young Produced
Adult Survival: (L)ive, (D)ead
8.1
8.2
2
36
L
3
35
T
4
27
T”
5
33
T
7.9
T9
6
35
T
6
38
T"
7
30
L
8
34
T"
9
31
L
10
34
L
11
37
11
34
L
1094
040225.02, 040228.01
7.82
7.77
8.1
Io
1
37
L
1
32
T
4
34
L
7
34
T
8
34
T
9
39
L
12
33
T
Project:
Sanpies:
43
5. lie
157 495
<0.10
0.3
-2.111
2.508
-6.3
3
32
T"
35
L
10
34
T"
12
33
T
1st Sample
7.84
7.53
2
32
I"
2nd Sample
7.72 | 7.82
7.65
554
<0.10
0.7~
2nd Sample
8.3
8.2
Treatment 2
0.0
Control CV
8.6
S control orgtvusjiz
producing 3rd brood
100
Environmental Testing Solutions, Inc.
Phone: [phone]
Fax: [phone]
E-mail: [e-mail]
Sample Type/Duration
Grab Comp.
y
x“
LCyo/Acute Toxicity Test
(Mortality expressed as %, combining replicates.)
LC50=
95'.7 Confidence Limits
1st Sample
7.72 7,75
7.17 7.70
1st Sample
8.0
8.0
1st Sample
8.3
y
Collection (Start) Date:
Sample 1 02-23-04
Facility: CET NPDES #: NC- 0026501
Durham County Triangle WWTP
Laboratory Performing Test. Environmental Testing Solutions, Inc.
Signature of Operator in Responsible Charge:
Signature of Laboratory Supervisor:
Effluent Toxicity Report Form - Chronic Pass/Fail and Acute LC50
a
Effluent Percentage 90%
Treatment 2 Organisnis
Number of Young Produced
Adult Survival: (L)ive, (D)ead
Chain-of-Custody Forms
Environmental Testing Solutions, Inc.
Whole Effluent Toxicity Chain-of-Custody Form
Facility:Pipe #: 001 County: Durham
C er io daphnia dubia
Comments:
Time:
Sample custody: (to be completed by sample collector and facility personnel)
Sample collected by:
(J 6/^
SiputfuA f / Dale and Lune
Sigjuiiurc
(to be completed by ETS personnel)
Relinquished to ETS by:Received at ETS b\:
Sample temperature upon receipt at ETS (°C):Custody seals intact?:
?•.’( Ua€»l
Samples received in good condition?:
Sample number: Project number:
Comments:
Shipping address:
351 Depot Street
Asheville, NC 28801
Grab sample:
Date:
Effluent dilution:
Parameter code:
Phone: [phone]
Fax: [phone]
NPDES #: NC0026501
Purchase order:
huu
o
90%
TGP3B
GET________________________
Durham Co. - Triangle WWTP
Stputfure
Priu
Relinquished by:
Dale and lone
A-s *
Dale .niil tunc
OS -H
D;dc jut tunc
v A'
Dale jiid tune
huii Stputnire
S-' C
Sipcilure
I
I
i
Species:
Test type: Pass/Fail Chronic
X SignatuPh / / Dale and tune
F(
w:K
Time:
Time: _
_____
INote: DO NOT collect samples before 8:00 AM. Triple rinse sample container with sample before filling. Completely fill
the sample container with no air space. Pack the container completely in ice. The sample must be received at < 4.0°C.
■ ODfinfill
Pruu
Relinquished by:
Fruit
_____I C'Cc
D.Jc ;oid tunc
I
Sample receipt information:
Received by:
C_.z-r !
Prud
Received by:
Pruu
CC -rv'c’.^
\'A' Uf5 s,’’1-'aure
Plenary ■ UV
7
——f
Sample information: (to be completed by sample collector) :j
Composite sample:
Start date: Spllp^
End date:
Number of samples per hour:
Chilled during collection?
If chilled, specify temperature:
Sample location: AAV////? / (0; \P(d//-Ci^O 5
Volume collected for testing: / l/CCC______________
Number of containers filled for testing: /
Total residual chlorine (mg/L): ___
Temperature at time of collection (°C):
Method of transport to laboratory: (ZTCoorfit'r Dlfk l)f)
CHAIN OF CUSTODY
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client N/XME Chemical and Environmental Technology BILL TO: Chemical and Environmental TechnologyTurnaround Time:
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an.
□ Rush 24 Hours*H5:
BILLING CONT.
ATTENTION:
Link Thrower INITIALS:
SAMPLES PRESERVED APTER SAMPLING UPON RETURN TO LAB □PROJECT //PROJECT NAME:
54400 TRACTIONS AND PRESERVATION
COLLECTED BY (Signatures):
SAMPLE IDENTIFIERDATETIMEGRAB
O5/1S/O4 0925 X 04051802 3ww X
RECEIVED BY (Signature)DATE TIME RELINQUISHED BY (Signature)DATE TIME RECEIVED BY (Signature)
i[^D
RELINQUISHED BY (Signature)RECEIVED FOR LABORATORY BYTIME DATE TIME ADDITIONAL INFO/INSTRUCTIONSDATE
CET LI MS
SAMPLE It
PRINTED NAME(s):
Neil A. O’Driscoll
PHONE: [phone]
FAX: [phone]
□ 10 Business Days
□ Rush 5 Business Days*
□ Rush 48 Hours*
SAMPLE
MATRIX
PO Box 12298
RTF, NC 27709
if OF
CONTAtNT’RS
CHEMICAL & ENVIRONMENTAL TECHNOLOGY, INC.
102-A Woodwinds Industrial Court, Cary, NC 2751 1
[phone] - Phone [phone] - Fax
<
GO
<Z)
< O
CQ
Purchase Order//: S- 1 509
SAMPLE CONTAINERS INCLUDED PRESERVATIVES PRIOR TO SAMPLING ■
SAMPLE TYPI-
CONI'
MATRIX CODE DW= Drinking Water
WW = Wastewater GW = Groundwater
S= Soil/Soltds
SAMPLE REMARKS/COMMENTS
RELINQUISHED BY (Signature)
’ /O/
6 A //
Sample Receiving:
Verify proper fraclions
are received and inilial
below.
ADDRESS:
102-A Woodwinds Industrial Court
Cary, NC 27511
CHECK HERE IE
RECEIVED ON
ICE Q
COOLER TEMPS
♦>
Environmental Testing Solutions, Inc.
Whole Effluent Toxicity Chain-of-Custody Form
Pipe#: 001 County: DurhamFacility:
(to be completed by sample collector)
L
PlComments:
/Time:
| Sample custody: (to be completed by sample collector and facility personnel)
Sample collected by:
Sipuirure
■ 4
Reliii<| uislied to ETS by:
Sample temperature upon receipt at ETS (°C):Custody seals intact?:1.1
Samples received in good condition?:
Sample number:Project number:
Coninxmls:
I
Species:
Test type:
Note: 1)0 NOT collect samples before ?>':00 AM. Triple rinse sample container with sample before Filling. Completely fill
the sample container with no air space. Pack the container completely in ice. The sample must be received at < 4.0°C.
Composite sample:
Start date:
End date:
Number of samples per hour:
Chilled during collection?
If chilled, specify temperature:
Grab sample:
Date:
Effluent dilution:
Parameter code:
Phone: [phone]
Fax: [phone]
Slipping address:
351 Depot Street
Asheville. NC 28801
I
II
NPDES #: NC0026501
Purchase order:
(Z TCrx) rn pick up
/ /
Cerioclaphnia dubia
Pass/Fail Chronic
90%
TGP3B
U "V
D:tfe ;oul lune
0^50
Pnni
Relinquished by:
CET________________________
Durham Co. - Triangle WWTP
is 8 c/
11>
D.Uc .cid mne
Dtde ton! Untc
Ft.u
Received at ETS by:
1‘rjj Sipuaure
O Dnseni! • oya'o
£niil Signature ** 7 ^Dale and time
Relinquished by:
GdrjdJr
Prud
Signature'” ' ' Date and time
I
£
I
III
^wl|
Sample location:
Volume collected for testing: / /ih f
Number of containers filled for testing:
Total residual chlorine (mg/L):
Temperature at time of collection (°C):
Method of transport to laboratory:
I
Time: _
Time: ±
Sigjutture
4Y-z^
s,'w'
MN
Dale :cal Unie
Date and Lune
r——
Sample information:
Received by:
/
Pruu
Received by:,
------
Pniu Signature
^rirmry lli^ifikcbcn ■I)'/
L
Sample receipt information: (to be completed by ETS personnel)
Chain-of-Custody Forms
Environmental Testing Solutions, Inc.
Whole Effluent Toxicity Chain-of-Custody Form
Facility:Pipe#: 001 County: Durham
Ceriodaphnia dubia
L
I
Jil/Afj/A Time:
Sample collected by:
Sigialure
I
(to be completed by ETS personnel)Sample receipt information:
40 13
Relinquished to ETS by:
Sample temperature upon receipt at ETS (°C):Custody seals intact?:3 5-gNot usedYes
Samples received in good condition?:
Sample number: 1&-03Project number: (UfNoes
Comments:
Shipping address:
351 Depot Street
Asheville, NC 28801
Grab sample:
Date:
Composite sample:
Start date:
End date:
Number of samples 'per hour:
Chilled during collection?
If chilled, specify temperature:
/Z2ZZ
/z/T
Effluent dilution:
Parameter code:
Phone: [phone]
Fax: [phone]
Ups
A
('.^T Cmrrierpick un
Nfil A- ODriscrill
Prim
Relinquished by:
I
NPDES#: NC0026501
Purchase order:
Comments: Pdrmiy /)isin^c}/Dn ' UV
90%
TGP3B
GET______________________
Durham Co. - Triangle WWTP
fZ/T/W
Prim
A PTici^o//
Print
Relinquished by:
j o
Signature
06-15-0^
/Ol^
Dale and lime
Dale and time
Received at ETS by:
Print Signarire
Pnnl Dale and lime
Species:
Test type: Pass/Fail Chronic
Received by:
Print
Received bj^,
I'ri-'il Signature
7W#- phk/ /Wo
Signature^ ' 'Dale and time
Sample location: / 1^.01 W0?/ 7Z)7
Volume collected for testing: / Z A/-
Number of containers filled for testing:
To tai residual chlorine (mg/L):
Temperature at time of collection (°C):
Method of transport to laboratory:
Sample information: (to be completed by sample collector)
5
gl/ijov |j‘ i/W I:
Dale and time
Dale and lime
Note: DO NOT collect samples before 8:00 AM. Triple rinse sample container with sample before filling. Completely fill
the sample container with no air space. Pack the container completely in ice. The sample must be received at < 4.0°C.
Time: _
Time:__±
Signature
SigjiatuA / Zlale and lime
S Sample custody: (to be completed by sample collector and facility personnel)
Environmental Testing Solutions, Inc.
Whole Effluent Toxicity Chain-of-Custody Form
Facility:Pipe#: 001 County: Durham
C er io daphnia dubia
I
I
Comments:
A//aj^lA Time:
§
Sajnple collected by:
Dale and time
Sample receipt information:(to be completed by ETS personnel)
Received at ETS by:
Sample temperature upon receipt at ETS (°C):Custody seals intact?:!-2CYesNoNot used
Samples received in good condition?:
(^13 Sample number: 0*40674 -O1/Yes Project number:
Comments:
Note: DO NOT collect samples before 8:00 AM. Triple rinse sample container with sample before filling. Completely fill
the sample container with no air space. Pack the container completely in ice. The sample must be received at < 4.0°C.
Grab sample:
Date:
Time:
Time:
Effluent dilution:
Parameter code:
L
Composite sample:
Start date: 1
End date:
Number of samples per hour:
Chilled during collection?
If chilled, specify temperature:
Phone: [phone]
Fax: [phone]
PriffYiry Djsininiinn
I
NPDES #: NC0026501
Purchase order:
Shipping address:
351 Depot Street
Asheville, NC 28801
90%
TGP3B
#1*0)0^
Dale and lime
Received by:
GET________________________
Durham Co. - Triangle WWTP
Prim
.L■ /911
Signature Dale and lime
Signature
! (pO'D
Dale and Lime Dale and time
V___
yd5
Prim Signature
Received bj:_________
X/7/
Prim
Species:
Test type: Pass/Fail Chronic
■ 09/5
Print Signature • /Dale and time
Relinquished by:
Sample information: (to be completed by sample collector)
I ------------------------------1-------------
I
f Sample custody: (to be completed by sample collector and facility personnel)
A • Ghfiscnll
Print Signature^- I 4)ale and time
Relinquished by:
Print Signature
Reluiqnisiied to ETS by.
Prim Signature
Sample location: / 6J/.WW ' <;V 0^
Volume collected for testing: /
Number of containers filled for testing:
Total residual chlorine (mg/L):
Temperature at time of collection (°C):
Method of transport to laboratory:
065-/'-^L/ /C1C’?
A
C^ T'CpDcr^i' Dick up r 7
• uV
h
0 2v- I
CHAIN OF CUSTODY
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client name Chemical and Environmental Technology BILL TO: Chemical and Environmental TechnologyTurnaround Time:
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IL.Hl:
□ Rush 24 Hours’»±.H5:•E BILLING CONT :ATTENTION
Link Thrower INITIALS:
SAMPLES PRESERVED AFTER SAMPLING UPON RETURN TO LABPROJECT U □PROJECT NAME
S-1555 FRACTIONS AND PRESERVATION
COLLECTED BY (Signatures):
SAMPLE IDENTIFIERDATETIME
GRAB
08/17/04 Effluent Outfall 040817021015X ww 1 X
DATE RECEIVED BY (Signature)TIME RELINQUISHED BY (Signature)DATE TIME RECEIVED BY (Signature)
UPs
RECEIVED FOR LABORATORY BY DATE TIME ADDITIONAL INFO/INSTRUCTIONS
•RUSH WORK REQUIRES LABORATORY APPROVAL PRIOR TO SAMPLE SUBMISSION ADDITIONAL CHARGES MAY APPLY
05
DATE
I boo
TIME
RELINQUISHED BYpignature)
RELINQUISHED BY (Signature)
CET UMS
SAMPLE II
PRINTED NAME(s):
Neil A. O’Driscoll
□ 10 Business Days
□ Rush 5 Business Days*
□ Rush 48 Hours*
SAMPLE
MATRIX
I OF
CONTAINERS
POBox 12298
RTP, NC 27709
CHEMICAL & ENVIRONMENTAL TECHNOLOGY, INC.
102-A Woodwinds Industrial Court, Cary, NC 2751 1
[phone] - Phone ' [phone] - Fax
o 'Z o
H
o
’S
o
-c
O
SAMPLE TYPE
COMP
Purchase Order#: S-1555
SAMPLE CONTAINERS INCLUDED PRESERVATIVES PRIOR TO SAMPLING ■
MATRIX CODE DW= Drinking Water
WW = Wastewater GW = Groundwater
S= Soil/Solids
SAMPLE REMARKS/COMMENTN
Sample Receiving;
Verify proper fractions
are received and initial
below.
PHONE: [phone]
FAX: [phone]
ADDRESS:
102-A Woodwinds Industrial Court
Cary, NC 2751 1
CHECK HERE IF
RECEIVED ON
ICE Q
COOLER TEMPS