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Home My WebLink AboutNCG030430 DMR SW 6$ RIgetThtaLsCorp. , 180 Mills Gap Rd•PO Box 189• Fletcher,NC 28732•Tel(828)687-2525• Fax(828)687-1551 I c 7 3 D 31_7) OeCebr'23, 2014 North Carolina Department of Environment and Natural Resources Division of Water Quality 1617 Mail Service Center Raleigh, NC 27699-1617 JAN 142Ui CENTRAL FILES RE: 2014 Stormwater Sampling- ®►SIR SECTION Blue—Ridge Metals Corp. Fletcher, NC 28732 • To Whom It May Concern: ' Please find enclosed two copies of the Stormwater Sampling Report for Blue Ridge Metals.Corp. If you have any questions or require additional information feel free to contact me. - Carroll Morgan Environmental Supervisor Blue Ridge Metals Corp. 828-974-9242 • yac Pace Analytical Services,Inc. ® 2225 Riverside Dr. °Analytical Asheville,NC 28804 wwwpacelabs.com (828)254-7176 November 24, 2014 Mr. Carroll Morgan Blue Ridge Metal Corp. 180 Mills Gap Road Fletcher, NC 28732 RE: Project: STORMWATER 2014 Pace Project No.: 92226024 Dear Mr. Morgan: Enclosed are the analytical results for sample(s) received by the laboratory on November 18, 2014. The results relate only to the samples included in this report. Results reported herein conform to the most current TNI standards and the laboratory's Quality Assurance Manual,where applicable, unless otherwise noted in the body of the report. Analyses were performed at the Pace Analytical Services location indicated on the sample analyte page for analysis unless otherwise footnoted. - If you have any questions concerning this report, please feel free to contact me. S`incerely, 1{s:t • Liamm Carrubba liamm.carrubba@pacelabs.com Project Manager Enclosures Q-*pCG7F0 ��• / REPORT OF LABORATORY ANALYSIS ��. This report shall not be reproduced,except in full, •..',(011r eO. o without the written consent of Pace Analytical Services,Inc Page 1 of 14 9 Pace Analytical Services,Inc. ® 2225 Riverside Dr. °aceAnalyfical Asheville,NC 28804 www pacelabs corn (828)254-7176 CERTIFICATIONS Project: STORMWATER 2014 Pace Project No.: 92226024 Charlotte Certification IDs 9800 Kincey Ave.Ste 100,Huntersville,NC 28078 Florida/NELAP Certification*:E87627 North Carolina Drinking Water Certification#:37706 Kentucky UST Certification#.84 North Carolina Fuld Services Certification# 5342 West Virginia Certification#.357 • North Carolina Wastewater Certification#:12 VirginiaNELAP Certification#.460221 South Carolina Certification#:99006001 • Asheville Certification IDs 2225 Riverside Drive,Asheville,NC 28804 North Carolina Wastewater Certification#:40 Flonda/NELAP Certification#'E87648 South Carolina Certification#:99030001 Massachusetts Certification#:M-NC030 West Virginia Certification#•356 North Carolina Drinking Water Certification# 37712 VirginiaNELAP Certification#:460222 • • • • • REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, without the written consent of Pace Analytical Services,Inc Page 2 of 14 i Pace Analytical Services,Inc. 7,P 'ceAnaIytica/® Asheville,NC 28804 v,w.pacelabs corn (828)254-7176 SAMPLE ANALYTE COUNT Project. STORMWATER 2014 Pace Project No• 92226024 Analytes Lab ID Sample ID Method Analysts Reported Laboratory 92226024001 OUTFALL 001 EPA 1664B CLW 1 PAST-C EPA2007 JMW 3 PASI-A SM 2540D WRC 1 PASI-A EPA 9040 MAB 1 PAST-A 92226024002 OUTFALL 002 EPA 1664B CLW 1 PAST-C EPA2007 JMW 3 PAST-A SM 2540D WRC 1 PAST-A EPA 9040 MAB 1 PAST-A • • • REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, without the written consent of Pace Analytical Services,Inc Page 3 of 14 e Pace Analytical Services,Inc. ® 2225 Riverside Dr. aceAnalytical Asheville,NC 28804 www.pacelabs com (828)254-7176 ANALYTICAL RESULTS Project: STORMWATER 2014 Pace Project No.: 92226024 Sample: OUTFALL 001 Lab ID: 92226024001 Collected: 11/17/14 07.00 Received 11/18/1413.45 Matrix:Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM,Oil and Grease Analytical Method:EPA 1664B Oil and Grease ND mg/L 5.0 1 11/20/1415.04 200.7 MET ICP Analytical Method:EPA 200.7 Preparation Method:EPA 200.7 Copper ND ug/L 5.0 1 11/19/14 15:15 11/20/1411.37 7440-50-8 Lead ND ug/L 5.0 1 11/19/1415.15 11/20/14 11:37 7439-92-1 Zinc 86.9 ug/L 10 0 1 11/19/1415.15 11/20/14 11:37 7440-66-6 2540D Total Suspended Solids Analytical Method.SM 2540D Total Suspended Solids ND mg/L 2 9 1 11/20/1417.46 9040 pH Analytical Method.EPA 9040 pH 6.2 Std Units • 0.10 1 11/19/1413.17 Q • REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, Date:11/24/2014 05:30 PM without the written consent of Pace Analytical Services,Inc. Page 4 of 14 Rx Pace Analytical Services,Inc. 2225 Riverside Dr aceAnalytical Asheville,NC 28804 w4wipacelabs corn (828)254-7176 ANALYTICAL RESULTS Project. STORMWATER 2014 Pace Project No: 92226024 Sample: OUTFALL 002 Lab ID: 92226024002 Collected: 11/17/14 07.00 Received• 11/18/1413.45 Matrix:Water Parameters Results Units Report Limit DF Prepared Analyzed CAS No. Qual HEM,Oil and Grease Analytical Method.EPA 1664B Oil and Grease ND mg/L 5.0 1 11/20/1415 04 200,7 MET ICP Analytical Method:EPA 200 7 Preparation Method.EPA 200.7 Copper - ND ug/L 5 0 1 11/19/14 16:10 11/21/14 06.51 7440-50-8 Lead ND ug/L 5.0 1 11/19/14 16:10 11/21/14 06 51 7439-92-1 Zinc 104 ug/L 10 0 1 11/19/1416.10 11/21/14 06,51 7440-66-6 2540D Total Suspended Solids Analytical Method:SM 2540D Total Suspended Solids 3.3 mg/L 2.6 1 11/20/1417.46 9040 pH Analytical Method EPA 9040 pH 5.8 Std Units 010 1 11/19/14 13:28 Q • REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, Date 11/24/2014 05:30 PM without the written consent of Pace Analytical Services,Inc. Page 5 of 14 Pace Analytical Services,Inc m 2225 Riverside Dr aceAnalyt/cal Asheville,NC 28804 www (828)254-7176 QUALITY CONTROL DATA Project STORMWATER 2014 Pace Project No. 92226024 QC Batch: GCSV/19563 Analysis Method. EPA 1664B QC Batch Method: EPA 1664B Analysis Description. 1664 HEM,Oil and Grease Associated Lab Samples: 92226024001,92226024002 METHOD BLANK: 1335001 Matrix: Water Associated Lab Samples: 92226024001,92226024002 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Oil and Grease mg/L ND 5 0 11/20/1415.01 LABORATORY CONTROL SAMPLE. 1335002 Spike LCS LCS %Rec Parameter Units Conc Result %Rec Limits Qualifiers Oil and Grease - • frig/L= -- -- --_ -40 36 6 - 92- - 78-114 MATRIX SPIKE SAMPLE: 1335003 92226323004 Spike MS - MS %Rec Parameter Units Result Conc. Result %Rec Limits Qualifiers Oil and Grease mg/Lf - ND 40 37.2 93 78-114 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.11/24/2014 05:30 PM without the written consent of Pace Analytical Services,Inc. Page 6 of 14 4, Pace Analytical Services,Inc. ® 2225 Riverside Dr. °accAnalytical Asheville,NC 28804 www.pacelabo corn (828)254-7176 QUALITY CONTROL DATA Project' STORMWATER 2014 Pace Project No: 92226024 QC Batch' MPRP/17383 Analysis Method. EPA 200.7 QC Batch Method: EPA 200.7 Analysis Description: 200.7 MET Associated Lab Samples. 92226024001 METHOD BLANK: 1333934 Matrix: Water Associated Lab Samples: 92226024001 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Copper ug/L ND 5 0 11/20/14 09:55 Lead ug/L ND 5.0 11/20/14 09.55 Zinc ug/L ND 10 0 11/20/14 09`55 LABORATORY CONTROL SAMPLE 1333935 - - - Spike - LCS LCS %Rec . Parameter Units Conc Result %Rec Limits Qualifiers Copper ug/L 500 473 95 85-115 Lead ug/L 500 471 94 85-115 Zinc ug/L 500 447 89 85-115 • • MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 1333936 1333937 '' MS MSD • 92226164003 Spike Spike MS MSD MS MSD %Rec Parameter Units Result Conc Conc. Result Result %Rec %Rec Limits RPE) Qual Copper ug/L 10 2 500 500 495 488 97 96 70-130 1 Lead ug/L ND 500 500 475 473 95 94 70-130 0 Zinc ug/L 55.4 500 500 506 500 90 89 70-130 1 MATRIX SPIKE&MATRIX SPIKE DUPLICATE 1333938 1333939 MS MSD 92225834003 Spike Spike MS MSD MS MSD %Rec Parameter Units Result Conc Conc. Result Result %Rec %Rec Limits RPD Qual Copper ug/L ND 500 500 467 482 93 96 70-130 3 Lead ug/L ND 500 500 465 479 93 95 70-130 3 Zinc ug/L 0.020 500 500 467 479 89 92 70-130 3 mg/L 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:11/24/2014 05:30 PM without the written consent of Pace Analytical Services,Inc.. Page 7 of 14 Pace Analytical Services,Inc. ® 2225 Riverside Dr. raceArialytical Asheville,NC 28804 www pacelabs cpm (828)254-7176 QUALITY CONTROL DATA Project. STORMWATER 2014 Pace Project No• 92226024 QC Batch. MPRP/17385 Analysis Method. EPA 200.7 QC Batch Method: EPA 200.7 Analysis Description 200 7 MET Associated Lab Samples. 92226024002 METHOD BLANK: 1334142 Matrix: Water Associated Lab Samples: 92226024002 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Copper ug/L ND 5.0 11/21/14 06.45 Lead ug/L ND 5.0 11/21/14 06 45 Zincug/L ND 10.0 11/21/14 06;45 LABORATORY CONTROL SAMPLE: 1334143 _ Spike: LCS _ ___ _ LCS __ _ _%Rec Parameter Units Conc Result %Rec Limits Qualifiers Copper ug/L 500 485 97 85-115 Lead ug/L 500 456 91 85-115 Zinc ug/L 500 463 93 85-115 • MATRIX SPIKE&MATRIX SPIKE DUPLICATE. 1334144 1334145 MS MSD 92226024002 Spike Spike MS MSD MS MSD %Rec Parameter - Units Result Conc Conc. Result Result %Rec %Rec Limits RPD Qual Copper ug/L ND 500 500 490 479 97 - 95 70-130 2 Lead ug/L ND 500 500 466 455 93 91 70-130 2 Zinc ug/L 104 500 500 576 563 94 92 70-130 2 • MATRIX SPIKE&MATRIX SPIKE DUPLICATE: 1334146 1334147 MS MSD 92226156001 Spike Spike MS MSD MS MSD %Rec Parameter Units Result Conc Conc. Result Result %Rec %Rec Limits RPD Qual Copper ug/L 16.0 500 500 505 528 98 102 70-130 5 Lead ug/L ND 500 500 457 482 91 96 70-130 5 Zinc ug/L 114 500 500 574 580 92 93 70-130 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:11/24/2014 05.30 PM without the written consent of Pace Analytical Services,Inc.. Page 8 of 14 I Pace Analytical Services,Inc. ° 2225 Riverside Dr LaceArralytical Asheville,NC 28804 www pacelabs own (828)254-7176 QUALITY CONTROL DATA Project: STORMWATER 2014 Pace Project No.. 92226024 QC Batch. WET/34380 Analysis Method SM 2540D QC Batch Method: SM 2540D Analysis Description. 2540D Total Suspended Solids Associated Lab Samples: 92226024001,92226024002 METHOD BLANK: 1335352 Matrix. Water Associated Lab Samples: 92226024001,92226024002 Blank Reporting Parameter Units Result Limit Analyzed Qualifiers Total Suspended Solids mg/L ND 2 5 11/20/1417 43 LABORATORY CONTROL SAMPLE 1335353 Spike LCS LCS %Rec Parameter Units Conc. Result %Rec Limits Qualifiers Total Suspended Solids • mg/L - 250 -- - -230 - - 92- • 90-110 - - - SAMPLE DUPLICATE. 1335354 92225937001 Dup Parameter Units Result Result RPD Qualifiers - Total Suspended Solids mg/L 2640 ' - 2740 4 SAMPLE DUPLICATE: 1335355 92226135013 Dup _ Parameter Units Result Result RPD Qualifiers Total Suspended Solids mg/L ND ND • 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:11/24/2014 05'30 PM without the written consent of Pace Analytical Services,Inc Page 9 of 14 Pace Analytical Services,Inc. • —(34 ® 2225 Riverside Dr. 7,PceAnaIyticaI® Asheville,NC 28804 wwwpacelabs cram (828)254-7176 QUALITY CONTROL DATA Project STORMWATER 2014 Pace Project No.: 92226024 QC Batch. WET/34343 Analysis Method: EPA 9040 QC Batch Method: EPA 9040 Analysis Description: 9040 pH Associated Lab Samples. 92226024001,92226024002 SAMPLE DUPLICATE. 1333555 92226024001 Dup Parameter Units Result Result RPD Qualifiers pH Std.Units 6 2 5.7 8 Q SAMPLE DUPLICATE: 1333556 92226177001 Dup Parameter Units Result Result RPD Qualifiers pH Std.Units 5 1 4.8 6 J(D6),Q 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:11/24/2014 05 30 PM without the written consent of Pace Analytical Services,Inc. Page 10 of 14 • e F • Pace Analytical Services,Inc. ® acEAnalytical 2225 Riverside Dr Asheville,NC 28804 mwrpacelab$com (828)254-7176 QUALIFIERS Project: _ STORMWATER 2014 Pace Project No: 92226024 DEFINITIONS DF-Dilution Factor,if reported,represents the factor applied to the reported data due to changes in sample preparation,dilution of the sample aliquot,or moisture content. ND-Not Detected at or above adjusted reporting limit MDL-Adjusted Method Detection Limit PQL-Practical Quantitation Limit RL-Reporting Limit S-Surrogate 1,2-Diphenylhydrazine(8270 listed analyte)decomposes toAzobenzene. 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. N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyte is a combined concentration Acid preservation may not be appropriate for 2-Chloroethylvinyl ether,Styrene,'and Vinyl chloride. Pace Analytical is TNI accredited.Contact your Pace PM for the current list of accredited analytes TNI-The NELAC institute. LABORATORIES - • PASI-A Pace Analytical Services-Asheville PAST-C Pace Analytical Services-Charlotte ANALYTE QUALIFIERS The reported value is between the laboratory method detection limit and the laboratory practical quantitation limit. J(D6) Estimated Value.The relative percent difference(RPD)between the sample and sample duplicate exceeded laboratory control limits, Q Sample held beyond the accepted holding time.Analysis initiated more than 15 minutes after sample collection REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, Date:11/24/2014 05:30 PM without the written consent of Pace Analytical Services,Inc. Page 11 of 14 Pace Analytical Services,Inc. . ( 0 2225 Riverside Dr ace�nalytical Asheville,NC 28804 wwwpacelabs cqm (828)254-7176 QUALITY CONTROL DATA CROSS REFERENCE TABLE Project' STORMWATER 2014 Pace Project No.: 92226024 Analytical Lab ID Sample ID QC Batch Method QC Batch Analytical Method Batch 92226024001 OUTFALL 001 EPA 1664B GCSV/19563 92226024002 OUTFALL 002 EPA 1664B GCSV/19563 92226024001 OUTFALL 001 EPA 200 7 MPRP/17383 EPA 200.7 ICP/15663 92226024002 OUTFALL 002 EPA 200,7 MPRP/17385 EPA 200.7 ICP/15665 92226024001 OUTFALL 001 SM 2540D WET/34380 92226024002 OUTFALL 002 SM 2540D WET/34380 92226024001 OUTFALL 001 EPA 9040 WET/34343 92226024002 OUTFALL 002 EPA 9040 WET/34343 • REPORT OF LABORATORY ANALYSIS This report shall not be reproduced,except in full, Date:11/24/2014 05:30 PM without the written consent of Pace Analytical Services,Inc. Page 12 of 14 ' Document Name: Sample Condition Upon– DocrgtientRevised:Jolie 10,2014 v . c�GB,�f7c?JyfIGc3/' - Receipt(SLUR) - _ Page I oft tnlvrpaonlr7,,.ee,S7 _. Document No:: issuing Authbtities: ' F-ASVVCS-08 ' Pace Asheville Quality Office 'C1ie�it Name:- t'7�,/41_ (•._ '''t Courier(Circle); Fed EX UPS USPS (2Cll nth Commercial Pace Mei , - Custody Seal onCooler/Box t�reserif: ]:-.es ti-----ho Seals intact: byes LI no Packing Material: bble Wrap„n. Bubble Bags C1 None❑ Other Therrttotneter•-Used-:.Ig Gtn/#a•130266063 ' Typo df IceyVJ "'Blue None p-Samples on ice,cooling process has begun IR G un 'aSN:14 213036 Other: - . m Tep Correoflo►t Factor: Add/c tract J C 0 .q,„...4, Corrected Cooler Temp.; I-1 ,.tj`,-f•, C Biological Tissue is Frozert: Yes No 1.1/ADate and Initials of person a aminhrg Temp should be al eve freezing to °C contents: 7 rC Comments Chain of:61.1a ody Preseilt: ;.�7Yes,ONs I-7N/A 1, _ ' - Chain of Custody Filled Out: , , „ s' Ohio ONIA 2. Chain of Ciistoc(y Relinquished: - 4ElYes ONo [:IN/A 3. Sampler Nanie&Signature on COO: gYes.ONe OwA 4., Sarnplds Arrivedwithin Hold Time:' .pY s Our) ON/A, 5. •Sh,or'f,Hold Time-Analysis(g72til•):, ElYes plc' OwA 6. _ s Rush Turn Around Time Requested: CIYes,gNo ON/A 7-. ' ;Sufficient-Volume:-- - - Correct Containers Used; f1JYes ONo 60 9. -Pace Containers Used: p e"s ONo ONA , Containers Intact: i's.ONo IJN%A 10. - Filtered volume received for Dissolved tests Oyes ONo i N1A 11. .. _ Sample Labels rttatch:COO: g15s (41.10 ❑N//1 12. •.>`' • -Includes date/time/ID/Analysis Matrix: /A11— - R All containers needing preservation have bean checiced; ,DYes ONo ON/4 13. , , All containers needing preselvatien pre found to be In compliance with EPA recommendattpn. �ZiYes Me C7NIA oo cepAoes:VOA coliform,TO ---- I•DRi)(water) es O Ne , . . . _ Samples checked-for dec(iurination; Dyes bNo_Ar 14. , i-leadspace in VOA Vials(>6mm): Oyes 0110 ,> v?$ 15, Trip Blank Present: OYes CINe ,aNiti 16, t Trip Blank Custody Seals Present Oyes ONo T a/A r Pace-Trip Blank Lot/#(if purchased): / Client Notification!,Re'solution; Field Oda Required? Y i N Person Contacted: Date/Time: Cornnients/Resolution; SCURF Review:1111111U2 Pato: 1114;x1''! Place label here SR t*Review; ' �'' _ Date: i1~lK-1`'l Note; Whenever there is a discrepancy affecting North Carolina - "_ - mt. ' ' --”"__ ` ' - compliance samples, copy of this form will be sent to the Notth I Carolina DEHNR Certification Office(Le out of hold,incorrect �_ `� ��® preservative,out of temp,Moment containers) ;; -" Il 111111111111,',::, . 92226022 . ' " ' , , ' Y Page 13 of 14 • • sr CH N-O -CUSTODY,/Analyt ea Request Document •r P acel rralytica/n The Ct am-of-Custodyls a LEGAL OOCUMENT.M relevant tclds must be completed accurately. T enety.parcelabs,com I N Section A 4 p > CO Required Cuen:Infortnauon Section B Section C Paget of D- Required-Projeot information Company;�(r /''p RepotZ To: �/: ��$f•• Invoice lnfocmauonr Gide, f!a ryier,;( f o j Attention: 8_Q 95 j 4 '' Addresk- r J ' �1" ? Copy To: ;/t ` tea, !Company Name: �1 p jtL� 'f I REGULATORYAGENCY ( tG'(/ j�V C 9:8'730:— I Address: 7 NPDES ! GROUND WATER i DRINKING WATER Email To: Purchase.Order No,; Pace ouote �i may'_ _ Fote encs: ". r UST RCt2A- i OTHER{ 17, --Zf-J",�i,J-f r Fa,t &9'f` r5-5 ProlectNam y�j 4 ,nn --.--,: AO/C/ � Paco Project ' � mss" ""� F6•� rte-; e7'^v Morugcr: -1-�'\ SIte,Lotz5tion Requested Due Data/TAT: Project Numbed - 'Pace PmBle it; ,,, ' 1 f t —"D 3 ..S..-.1 •STATE: 1 1 •R'e_quesded Analysis Filtered(YIN)- . Section D Matrix Codes — - - RegwrodClientlnformation MATRIX/CODE .5 a COLLECTS[} _ Preservatives }a Dunking Water -DV., c.) - Water Wr 1 U • Waste Water fi A m 'CCMPOSn. C0100511E Product P _ t START - ENaGRAS Solt/Sad .SL 2 E- I zSAMPLE ID Oil OZ. -- 8- • , 0ix WSample IDs MUST BE UNIQUE Yrssue 7S AR p 9- ' ' $_Other ,OT c> - F- ` ;-1, - 1,,, C U IF C:,�- I a �v,-V\�/,,tl`/,NCW\I _ - co 'DATE TIME ' DATa *. x�= a- 0.:q & Race Project NoJ Lab I-D. .,- fL?77 ( ( CO- W r -..11._ .I 74 ' � l .y RIO 1.11111111111 In II � ..... Vir— lid II 131 w��JJI iF:I �--NIlIIomr.i' ■. ...r ■■.n , ■■■...■■.�.I.M El MIMI illi) a� ..Mmo I 11111111111MMIIIII=1111111111111111111MMIIIMIIIMIllit IMI III. L , • ::: _ niiii��Iiii��■M11n��- ~12 I- I I I I I . ADDmONAL COMMENTS _ REUNQLISNP-D'BY/AFFILIATION -;•-' ' -'DATE , TIME . ti • ACCEP O BYOAFFJLIAT1O_N • _DATE'•. SAMPLEECONDITIONS (:Ct . ,4rnC\u I/ 4d- /:c1 C. ' )I J, rtf v. - -1 1 ORIGINAL SAMPLER M1IAMElAND SIGNATURE - U o.. PRINTName of SAMPLER: - c,r..�oi f "Oyu.cy- Q y oto , y�r� } sIGN0.7tIREofSAMPLER- r l,t y( j.r� --- DATE5tgned h ." c� V E'er` 3 x 1 eF/�/,! (MM/DDIYY): I /e., Lei •% vi y •• -Imporant Note:Sysigning ttsstorm you Pre accepting Pace's NET 30 cay payment:orms and agreeing to lateedergesorl.5l permomh Nreay invokes not pard wdhm3oCays• F-ALL-G2-02oreV.07,"f5-May-2007