NCG060227_2024 DMR_20241112

NCDEQ Division of Energy,Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR) Form for NCG060000
Food and Kindred
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 samaling results. Mail the original,signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NICG06 0117 Person Collecting Samples:MA), L. L'. 'fir
Facility Name: w P f7) LaboratoryName:
Facility County: ",Ay'6i it ✓� Laboratory Cert. No.: be/
Discharge during this perioc:I Yes ❑ No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑Yes [K No
If so,which Tier(I,II,or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/SW-DMR ❑Yes ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter Parameter Outfall r Outfall ., Outfall 3 Outfall r Outfall
Code
N/A Receiving Stream Class Nj I"14" F 1-7J F `+.1 r'W
N/A Date Sample Collected MM/DD/YYYY 1-'i j 2- 2 J/ Z eigi t� _IZ ,?
46529 24-Hour Rainfall in inches „ (S'',' .)5 y •-7).)n_1e if' .(
C0530 TSS in mg/L(100 or 50*) "35y7o Lei -`-)b -52,,(o Aqa_ V
00400 pH in standard units(6.0—9.0 FW,
6.8-8.5 SW) 6 r
_
raj.
31616 Fecal Coliform:er 100 ml of
freshwater(if required)(1000) a tt 9.0 2.'j 1 ,-, 20 :n7 y7 D 2,4 2-0
61211 Enterococci per 100 ml of saltwater ,_.— V' ..---
(if recuired)(500) `'—
Chemical Oxygen Demand in mg/L �J �"� °j ;
00340 (120) / (j f/ ICI & / -0 yv V ,4
Additional parameters for outfalls in drainage areas that use>55 gallons per month of new hydraulic oil on average
NCOIL Estimated New Motor/Hydraulic Oily
Usage in gal/month MO A G] ✓ j
00552 Non-Polar Oil&Grease in mg/L(15) Ai /J 7 iv 7) /.)1) /a;
*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(Saltwatel
Notes(optional): e-'.„9..4,1►---^ont.v ,g' VC-2. 1e e44 it INC e-
"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 information,including the possibili fines and imprisonment for knowing violations."
` - /1-12---29
Signature of Permittee or Delegated Authorized Individual Date
it14117* 611-641'N' - cob, '?i9- 92 2.-- . 2 )1
Email Address Phone Number

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report(DMR) Form for NCG060000
Food and Kindred
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. NCGO6 0 ° j Person Collecting Samples:/1/ ,41 L ,°r„'
Facility Name: Cpt,e r rn$ Pr `�r514� 04,,07 Laboratory Name: poleiel d A.A
Facility County: jp.o/ Laboratory Cert. No.: (aI7
Discharge during this perioc: es ❑ No (if no,skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?❑Yes [rNo
If so,which Tier(I,II,or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.gov/Forms/SW-DMR IY:es ❑ No
Date Uploaded: i 1 1 )V. t 2,1t
Analytical Monitoring Requirements for Outfalls with Industrial Activities—Benchmarks in(Red)
Parameter
Code Parameter Outfall Outfall ( Outfall Outfall Outfall
N/A Receiving Stream Class •y� rw
N/A Date Sample Collected MM/DD/YYYY a/j+ 't 4 91)1a)2„
46529 24-Hour Rainfall in inches ll I�? )l�r� Si IS."
C0530 TSS in mg/L(100 or 50*) eg'
00400 pH in standard units(6.0-9.0 FW,6.8-8.5SW) CIO 39' Le,,,
q
31616 Fecal Coliform per 100 ml of 7
freshwater(if required)(1000) a9 ),\-1 Z;b
61211 Enterococci per 100 ml of saltwater
(if required)(500)
00340 Chemical Oxygen Demand in mg/L .�
(120) 55 p/ hiS)
Additional parameters for outfalls in drainage areas that use>55 gallons per month of new hydraulic oil on average
NCOIL Estimated New Motor/Hydraulic Oil y�
Usage in gal/month °lb k �t)
00552 Non-Polar Oil&Grease in mg/L(15) 1n N
*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): fii).eGf,- ,1 C, i 5 ve& tikr, p 04 116't 'S
"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 information,including the possibility of fines and imprisonment for knowing violations."
Signature of Permittee or Dele ted Authorized Individual Date
Email Address Phone Number

Pace Analytical Services,LLC
6701 Conference Drive
ace Raleigh,NC 27607
[phone]
October 09, 2024
Mayon Lam
Case Farms -Goldsboro
PO Box 729
Troutman, NC 28166
RE: Project: 3RD QTR
Pace Project No.: 92753605
Dear Mayon Lam:
Enclosed are the analytical results for sample(s)received by the laboratory on September 16.2024. This report is a
summary of the results based upon our understanding of your data quality objectives. Please contact us if itemized quality
control results are needed.These results relate only to the samples included in this report.
The test results provided in this final report were generated by each of the following laboratories within the Pace Network:
•Pace National-Mt.Juliet
• Pace Analytical Services-Asheville
• Pace Analytical Services-Eden
• Pace Analytical Services-Raleigh
If you have any questions concerning this report, please feel free to contact me.
Sincerely,
Terri Page
[e-mail]
336-904-4231
Project Manager
Enclosures
cc: Daniel Lane,Case Farms-Goldsboro
JASON MARTINEZ
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 14

Pace Analytical Services,LLC
ace6701 Conference Drive
Raleigh,NC 27607
[phone]
CERTIFICATIONS
Project: 3RD QTR
Pace Project No.: 92753605
Pace Analytical Services National
12065 Lebanon Road,Mt.Juliet,TN 37122 Nevada Certification#:TN-03-2002-34
Alabama Certification#:40660 New Hampshire Certification#: 2975
Alaska Certification 17-026 New Jersey Certification#:TN002
Arizona Certification# AZ0612 New Mexico DW Certification
Arkansas Certification#:88-0469 New York Certification#: 11742
California Certification#:2932 North Carolina Aquatic Toxicity Certification#:41
Canada Certification#: 1461.01 North Carolina Drinking Water Certification#:21704
Colorado Certification#:TN00003 North Carolina Environmental Certificate#:375
Connecticut Certificaticn#:PH-0197 North Dakota Certification#:R-140
DOD Certification:#1461.01 Ohio VAP Certification#:CL0069
EPA#TN00003 Oklahoma Certification#:9915
Florida Certification#:E87487 Oregon Certification#:TN200002
Georgia DW Certification#:923 Pennsylvania Certification#:68-02979
Georgia Certification:NELAP Rhode Island Certification#:LA000356
Idaho Certification#:TN00003 South Carolina Certification#:84004
Illinois Certification#:200008 South Dakota Certification
Indiana Certification#: -TN-01 Tennessee DW/Chem/Micro Certification#: 2006
Iowa Certification#:364 Texas Certification#:T 104704245-17-14
Kansas Certification#:E-10277 Texas Mold Certification#:LAB0152
Kentucky UST Certification#: 16 USDA Soil Permit#: P330-15-00234
Kentucky Certification#:90010 Utah Certification#:TN00003
Louisiana Certification#:A130792 Vermont Dept.of Health:ID#VT-2006
Louisiana DW Certification#:LA180010 Virginia Certification#:VT2006
Maine Certification#:TN0002 Virginia Certification#:460132
Maryland Certification#:324 Washington Certification#:C847
Massachusetts Certification#:M-TN003 West Virginia Certification#:233
Michigan Certification#:9958 Wisconsin Certification#:998093910
Minnesota Certification#:047-999-395 Wyoming UST Certification#:via A2LA 2926.01
Mississippi Certification#:TN00003 A2LA-ISO 17025 Certification#:1461.01
Missouri Certification#:340 A2LA-ISO 17025 Certification#: 1461.02
Montana Certification# CERT0086 AIHA-LAP/LLC EMLAP Certification#:100789
Nebraska Certification#:NE-OS 5-05
Pace Analytical Services Raleigh
4915 Waters Edge Dr.#120, Raleigh,NC 27606 North Carolina Drinking Water Certification#:37731
North Carolina Wastewater Certification#:67
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
Pace Analytical Services Eden
205 East Meadow Road Suite A,Eden,NC 27288 North Carolina Wastewater Certification#:633
North Carolina Drinking Water Cerification#:37738 VirginiaNELAP Certification#:460025
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
6701 Conference Drive
Pace' Raleigh,NC 27607
[phone]
SAMPLE ANALYTE COUNT
Project: 3RD QTR
Pace Project No.: 92753605
Analytes
Lab ID Sample ID Method Analysts Reported Laboratory
92753605001 OUTFALL 1 SM 2540D-2015 TMM1 1 PASI-E
Colilert-18 HGH 1 PASI-R
EPA 1664B DAL 1 PAN
SM 5220D-2011 MDW 1 PASI-A
92753605002 OUTFALL 2 SM 2540D-2015 TMM1 1 PASI-E
Colilert-18 HGH 1 PASI-R
EPA 1664B DAL 1 PAN
SM 5220D-2011 MDW 1 PASI-A
92753605003 OUTFALL 3 SM 2540D-2015 TMM1 1 PASI-E
Colilert-18 HGH 1 PASI-R
EPA 1664B DAL 1 PAN
SM 5220D-2011 MDW 1 PASI-A
92753605004 OUTFALL 6 SM 2540D-2015 TMM1 1 PASI-E
Colilert-18 HGH 1 PASI-R
EPA 1664B DAL 1 PAN
SM 5220D-2011 MDW 1 PASI-A
92753605005 OUTFALL 9 SM 2540D-2015 TMM1 1 PASI-E
Colilert-18 HGH 1 PASI-R
EPA 1664B DAL 1 PAN
SM 5220D-2011 MDW 1 PASI-A
92753605006 OUTFALL 10 SM 2540D-2015 TMM1 1 PASI-E
Colilert-18 HGH 1 PASI-R
EPA 1664E DAL 1 PAN
SM 5220D-2011 MDW 1 PASI-A
92753605007 OUTFALL 11 SM 2540D-2015 TMM1 1 PASI-E
Colilert-18 HGH 1 PASI-R
EPA 1664B TJL 1 PAN
SM 5220D-2011 MDW 1 PASI-A
PAN=Pace National-Mt.Juliet
PASI-A=Pace Analytical Services-Asheville
PASI-E=Pace Analytical Services-Eden
PASI-R=Pace Analytical Services-Raleigh
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
6701 Conference Drive
ace` Raleigh,NC 27607
[phone]
ANALYTICAL RESULTS
Project: 3RD QTR
Pace Project No.: 92753605
Sample: OUTFALL 1 Lab ID: 92753605001 Collected: 09/16/24 10:05
Parameters Results Units Report Limit DF Qualifiers
Total Suspended Solids 3370 mg/L 83.3 1
Fecal Coliforms 2420 MPN/100mL 1.0 1 El
Oil and Grease ND mg/L 5.00 1
Chemical Oxygen Demand 780 mg/L 25.0 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/09/2024 11:55 AM without the written consent of Pace Analytical Services,LLC. Page 4 of 14

Pace Analytical Services,LLC
6701 Conference Drive
Pace- Raleigh,NC 27607
[phone]
ANALYTICAL RESULTS
Project: 3RD QTR
Pace Project No.: 92753605
Sample: OUTFALL 2 Lab ID: 92753605002 Collected: 09/16/24 10:12
Parameters Results Units Report Limit DF Qualifiers
Total Suspended Solids 69.0 mg/L 5.0 1
Fecal Coliforms 2420 MPN/100mL 1.0 1 El
Oil and Grease ND mg/L 5.00 1
Chemical Oxygen Demand 99.6 mg/L 25.0 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full.
Date: 10/09/2024 11:55 AM without the written consent of Pace Analytical Services,LLC. Page 5 of 14

Pace Analytical Services,LLC
ace- 6701 Conference Drive
Q/ e Raleigh,NC 27607
V [phone]
ANALYTICAL RESULTS
Project: 3RD QTR
Pace Project No.: 92753605
Sample: OUTFALL 3 Lab ID: 92753605003 Collected: 09/16/24 10:17
Parameters Results Units Report Limit DF Qualifiers
Total Suspended Solids 390 mg/L 27.8 1
Fecal Coliforms 2420 MPN/100mL 1.0 1 El
Oil and Grease ND mg/L 5.00 1
Chemical Oxygen Demand 150 mg/L 25.0 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:10/09/2024 11:55 AM without the written consent of Pace Analytical Services,LLC. Page 6 of 14

Pace Analytical Services,LLC
6701 Conference Drive
ace` Raleigh,NC 27607
[phone]
ANALYTICAL RESULTS
Project: 3RD QTR
Pace Project No.: 92753605
Sample: OUTFALL 6 Lab ID: 92753605004 Collected: 09/16/24 10:35
Parameters Results Units Report Limit DF Qualifiers
Total Suspended Solids 32.6 mg/L 5.4 1
Fecal Coliforms 2420 MPN/100mL 1.0 1 El
Oil and Grease ND mg/L 5.00 1
Chemical Oxygen Demand ND mg/L 25.0 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/09/2024 11:55 AM without the written consent of Pace Analytical Services,LLC. Page 7 of 14

Pace Analytical Services,LLC
6701 Conference Drive
ace Raleigh,NC 27607
[phone]
ANALYTICAL RESULTS
Project: 3RD QTR
Pace Project No.: 92753605
Sample: OUTFALL 9 Lab ID: 92753605005 Collected: 09/16/24 11:10
Parameters Results Units Report Limit DF Qualifiers
Total Suspended Solids 49.4 mg/L 5.3 1
Fecal Coliforms 2420 MPN/100mL 1.0 1 El
Oil and Grease ND mg/L 5.00 1
Chemical Oxygen Demand 53.9 mg/L 25.0 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:10/09/2024 11:55 AM without the written consent of Pace Analytical Services,LLC. Page 8 of 14

Pace Analytical Services,LLC
ace`J 6701 Conference Drive
Raleigh,NC 27607
[phone]
ANALYTICAL RESULTS
Project: 3RD QTR
Pace Project No.: 92753605
Sample: OUTFALL 10 Lab ID: 92753605006 Collected: 09/16/24 11:55
Parameters Results Units Report Limit DF Qualifiers
Total Suspended Solids 185 mg/L 11.4 1
Fecal Coliforms 2420 MPN1100mL 1.0 1 El
Oil and Grease ND mg/L 5.00 1
Chemical Oxygen Demand 85.9 mg/L 25.0 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/09/2024 11:55 AM without the written consent of Pace Analytical Services,LLC. Page 9 of 14

Pace Analytical Services,LLC
Pace'
6701 Conference Drive
Raleigh,NC 27607
[phone]
ANALYTICAL RESULTS
Project: 3RD QTR
Pace Project No.: 92753605
Sample: OUTFALL 11 Lab ID: 92753605007 Collected: 09/16/24 10:45
Parameters Results Units Report Limit DF Qualifiers
Total Suspended Solids 31.9 mg/L 2.5 1
Fecal Coliforms 2420 MPN/100mL 1.0 1 El
Oil and Grease ND mg/L 5.00 1
Chemical Oxygen Demand ND mg/L 25.0 1
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date: 10/09/2024 11:55 AM without the written consent of Pace Analytical Services,LLC. Page 10 of 14

Pace Analytical Services,LLC
6701 Conference Drive
ace` Raleigh,NC 27607
[phone]
QUALIFIERS
Project: 3RD QTR
Pace Project No.: 92753605
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 De:ection 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 it 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 Contrcl 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 tc 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.
ANALYTE QUALIFIERS
El Reported value should be considered a minimum estimate since it is the maximum reportable number for this method
based on the sample volume used.The true value is likely greater than the value reported.
REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced,except in full,
Date:10/09/2024 11:55 AM without the written consent of Pace Analytical Services,LLC. Page 11 of 14

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tit?o aged DC# Title: ENV-FRM-HUN1-0083 v05_Sample Condition Upon Receipt
,lumiruiaicn
Effective Date: 05/24/2024
--Laboratory-receiving-samples,- - - - • .. ....._______
Asheville❑ Edenn Greenwood❑ Huntersville❑ Raleig J Mechanicsville❑ Atlanta❑ Kernersville❑
Sample Condition Client Name: G 111 !
Upon Receipt / t n Project#:
r I9,
Courier: ❑Fed Ex ❑UPS ❑USPPS ❑Client
LI Commercial Pace ❑Other:
Custody Seal Present? ['Yes Ng Sealslntact? Des Duo /A _!g ("
r Date/Initials Person Examining Contents::1 \T /j
Packing Material: ['Bubble Wrap Bubble Bags ❑None ❑ Other Biological Tissue Frozen?Ct/16r `�'
❑Yes Duo 4N/A '
Thermometer; r� 1
0lR Gun ID: l� � Type of Ice: )jwet ❑Blue ❑None
11L+- Correction Factor: ��qq
Cooler Temp: Add/Subtract CC) CS/' Temp should be above freezing to 5'C
Cooler Temp Corrected('Ci: 3- QSamples out of temp criteria.Samples on ice,cooling process
has begun
USDA Regulated Soil(❑N/A,water sample)
Did samples originate in a quarantne zone within the United States:CA,NY,or SC Did samples originate from a foreign source(internationally,
(check ma s)?Dyes DNo Including Hawaii and Puerto Rico)?Oyes Duo
Corn ments/Discrepancy:
Chain of Custody Present? ,es ❑No ❑N/A 1.
Samples Arrived within Hold Time? ,, Yes ❑No ❑N/A 2. ,
Short Hold Time Analysis(<72 hr.)? )cs Duo ❑N/A 3.
Rush Turn Around Time Requested? Yes 4o ❑N/A 4.
Sufficient Volume? Aes Duo ON/A 5.
Correct Containers Used? > YYes Duo ❑N/A 6.
-Pace Containers Used? es ❑No ❑N/A •
Containers Intact? ,L Yes ❑No ❑N/A 7. .
Dissolved analysis:Samples Field Filtered? Dyes Duo N/A a.
Sample Labels Match COC? ]Yes Duo N/A 9.
111-Includes Date/Time/10/Analysis Matrix: v"
Headspace In VOA Vials(>5-6mm)? ❑Yes Duo N/A 10.
Trip Blank Present? ❑Yes ❑No N/A 11.
Trip Blank Custody Seals Present? Dyes No —t'i/A
COMMENTS/SAMPLE DISCREPANCY q Field Data Required? DYes END
Lot ID of split containers:
CLIENT NOTIFICATION/RESDLUTION
Person contacted: Date/Time:
_—..__---P.rAeot,MaaagetaS F r
Project Manager SRF Review: Date:
Qualtrax fa 69614 Page 1 of 2

v4 Jo •.86ed DC#_Title: ENV-FRM-HUN9-0083 v05_Sample Condition Upon Receipt '
CO
t. imatic iiariti
Effective Date: 05/24/2024
'Check mark top half of-box if pH awn Jor dechlarinatian is verified arid within the Project# I
acceptance range for preservation samples.
Exceptions:VOA,Coilform,TOC,Oil and Grease,DRO/6015(water)DOC,LLNg
'*Bottom half of box Is to list number o=bottles
***Check all unpreserved Nitrates for chlorine
Laborato Receiving atiion::Asheville❑ Eden❑ Greenwood IDHuntersvllle❑ Raleigh Mechanicsville❑ Atlanta❑ Kernersville❑
Client (.( r PYt Profile/EZ(Circle one)_ _Moles —
•
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Adjustment Log for Preserved Samples
Sample ID Type of Preservative pH upon receipt Date preservation adjusted Time preservation Amount of Preservative Lot#
adjusted added
•
Note: Whenever there is a discrepancy aFecting North Carolina compliance samples,a copy of this form will be sent to the North Carolina DEN R Certification Office(i.e.
Out of hold,incorrect preservative,out of temp,incorrect containers,
Qualtrax ID: 69614 Page 2 of 2
i

CASE FARMS STORMWATER OUTFALL DATE l/ ' /?/4-
330 PECAN ROAD pH MONITORING
DUDLEY, NC NCG060227
Time pH Initials
Outfall #001 //1//y co, 5-7 vj .
Outfall #002 //,' 8
Outfall #003 t / 3 6. s 7 IV)8
Outfall #006 / r ; 9 C,33
Outfall #009 11 : 21 , a 0'16
Outfall #010 / / ; (p, 53
Outfall #011 // ;3O (, 37 P7