FELLSMERE WATER CONTROL DISTRICT

INDIAN RIVER COUNTY
Special Board Meeting March 21, 2024
5:30 P.M.

Special District Services, Inc.
The Oaks Center 2501A Burns Road
Palm Beach Gardens, FL 33410
www.fellsmerewcd.org 561.630.4922 Telephone 877.SDS.4922 Toll Free 561.630.4923 Facsimile

AGENDA FELLSMERE
WATER CONTROL DISTRICT
109 North Willow Street Fellsmere, Florida 32948 SPECIAL BOARD MEETING
March 21, 2024
10:00 A.M.

Call to Order
Proof of Publication	Page 1
Establish Quorum
Additions or Deletions to Agenda
Comments from the Public
Approval of Minutes
January 11, 2024 Regular Board Meeting	Page 2
Old Business
New Business
Consider Discontinuing Warrants for Invoice Approval
Update on RFPs for Park Lateral, Lateral U and Main Canal
Consider Resignation of Supervisor Tillman
Discussion Regarding Higher Maintenance Levels in the Gravity System Sub Lateral
Administrative Matters
Financials	Page 5
Water Quality Reports	Page 16
Attorney
Manager
Board Members Comments
Adjourn

Publication Date 2024-03-08

Subcategory Miscellaneous Notices

FELLSMERE WATER CONTROL DISTRICT NOTICE OF SPECIAL BOARD MEETING
NOTICE IS HEREBY GIVEN that the Board of Supervisors (Board) of the Fellsmere Water Control District (District) will hold a Special Board Meeting (Meeting) on March 21, 2024, at 5:30 p.m. in the Fellsmere City Hall located at 22 South Orange Street, Fellsmere, Florida 32948.
The purpose of the Special Board Meeting is for the Board to address regular district business that would have been scheduled for the March 14, 2024, meeting, and to allow for a larger venue for the public to attend. The Board may also consider any other business which may properly come before the Board. The meeting is open to the public and will be conducted in accordance with the provisions of Florida law. There may be occasions when Board members or District Staff may participate by speaker telephone. A copy of the Agenda for the meeting may be obtained from the Districts website (www.fellsmerewatercontroldistrict.org) or by contacting the District Manager at (772) 345-5119.
Any person requiring special accommodations at this meeting because of a disability or physical impairment should contact the District Managers Office at least forty-eight (48) hours prior to the meeting. If you are hearing or speech impaired, please contact the Florida Relay Service by dialing 7-1-1, or 1-800-955-8771 (TTY)
/ 1-800-955-8770 (Voice), for aid in contacting the District Managers Office.
Each person who decides to appeal any decision made by the Board with respect to any matter considered at the public hearing or meeting is advised that person will need a record of proceedings and that accordingly, the person may need to ensure that a verbatim record of the proceedings is made, including the testimony and evidence upon which such appeal is to be based.
FELLSMERE WATER CONTROL DISTRICT
www.fellsmerewatercontroldistrict.org PUBLISH: INDIAN RIVER
PRESS JOURNAL 03/08/24#9922161

Page 1

FELLSMERE WATER CONTROL DISTRICT REGULAR BOARD MEETING MINUTES JANUARY 11, 2024

CALL TO ORDER

The Regular Board Meeting of the Fellsmere Water Control District (“District”) of January 11, 2024, was called to order at 10:10 a.m. in the District office located at 109 North Willow Street, Fellsmere, Florida 32948.

PROOF OF PUBLICATION

Proof of publication was presented that showed notice of the Regular Board Meeting had been published in the Indian River Press Journal on December 29, 2023, as legally required.

ESTABLISH A QUORUM

Mr. Sakuma stated that the attendance of Supervisors Greg Nelson and Richard Carnell constituted a quorum and it was in order for the meeting to proceed.

Also in attendance were: District Manager Frank Sakuma of Special District Services, Inc.; District Attorney Jonathan Johnson of Kutak Rock LLP (by phone); and District Engineer George Simons, P.E. of Carter Associates.

ADDITIONS OR DELETIONS TO AGENDA

There were no additions or deletions to the agenda.

COMMENTS FROM THE PUBLIC

The following individuals submitted comment cards and addressed the Board: Karen Ruby, Regina Zack, Julie Steiner, Duncan Thomas, Nina Nichelson, Bryan Hosack, Daniel Perret, Sandra Allan, Linda Hart, Allen Sembler, Mark Kopechy, Josh Miller, Butch Barnes.

APPROVAL OF MINUTES

November 9, 2023, Regular Meeting
The November 9, 2023, Regular Meeting minutes were approved on a motion made by Mr. Carnell, seconded by Mr. Nelson and the motion passed unanimously.

OLD BUSINESS

There were Old Business matters to come before the Board.

NEW BUSINESS

Update on RFPs for Park Lateral, Lateral U and Main Canal

The District Engineer advised of the progress of building the request for proposals (RFPs) for work on Park Lateral, Lateral U and Main Canal. Several elements of the proposals are clearing the top of bank, clearing 15’ down the slope, using long-stick to dip out canal buildup, “no hauling” of material and a mandatory pre-bid meeting, among others. RFPs will be created to allow for global bidding, or bidding on one or more elements of the work to allow for a broader response.

Update on RFP for Eastern Levy

The Board discussed the importance of ensuring the eastern levy being sufficiently maintained to avoid failure during significant wind and rain events. Elements of the RFP will primarily be the cutting of trees on the levy. Mark Mathes, Fellsmere City Manager, noted several areas of the levy may be maintained by City projects which are adjacent to the levy.
Update on RFP for 121st Street and Park Lateral

The District Engineer updated the Board on repairs to the junction of ditch 2 and Park Lateral, along 121st Street. He was asked to obtain several bids for the work.

Discussion Regarding City Canal Maintenance

Fellsmere City Manager, Mark Mathes, addressed the Board and advised that the City might be willing to take over maintenance of several District owned canals and ditches within/near the City limits. The City’s decision will partly be guided by any cost share the District may offer. Mr. Sakuma was asked to follow up with the City to address the cost share question.

Note: At approximately 11:29 a.m., Mr. Sakuma recessed the Regular Meeting and convened a meeting of the Auditor Selection Committee.

AUDITOR SELECTION COMMITTEE

Ranking of Proposals/Consider Selection of an Auditor

Mr. Sakuma advised that a responsive proposal had been received from only one firm, Grau & Associates. He indicated that the firm was qualified to provide financial auditing services to the District. The Committee recommended the selection of Grau and Associates for the District’s auditor.

Note: At approximately 11:31 a.m., Mr. Sakuma closed the Committee meeting and simultaneously reconvened the Regular Meeting.

A motion was made by Mr. Carnell, seconded by Mr. Nelson that Grau & Associates be hired to perform the September 30, 2023, September 30, 2024 and September 30, 2025 annual government audits and also be selected, subject to fee adjustments for inflation, to perform the fiscal year end audits for the following two years (FYE 9/30/26 and 9/30/27). The motion passed unanimously.

ADMINISTRATIVE MATTERS
Financials
Mr. Sakuma noted that the financials were included in the Board package.
Attorney

Mr. Johnson advised the legislative update would be sent to Mr. Sakuma for a future Board meeting.

Manager

Mr. Sakuma had nothing further for the Board.

BOARD MEMBER COMMENTS

Mr. Nelson directed staff to notice a Special Meeting of the District to be held at Fellsmere City Hall on March 21, 2024, at 5:30 p.m.

K.	ADJOURNMENT

There being no further business to come before the Board, the meeting was adjourned at 11:50 a.m. There were no objections.

Secretary/Assistant Secretary	President/Vice-President

Fellsmere Water Control District

Financial Report For February 2024

FELLSMERE WATER CONTROL DISTRICT MONTHLY FINANCIAL REPORT FEBRUARY 2024

REVENUES	
Annual Budget
10/1/23 - 9/30/24	

Actual Feb-24	Year To Date Actual
10/1/23 - 2/29/24	
Tax Revenue	529,849	14,921	494,562	
Revenue Other	0	750	8,150	
Interest Income	1,800	0	11,775	
Direct Bill	0	0	46,400	
Total Revenues	$	531,649	$	15,671	$	560,887	
				
ADMINISTRATIVE EXPENDITURES				
Conversion Consultant	0	0	7,778	
Legal and Professional	10,000	403	5,371	
Management Fees	72,000	6,000	30,000	
Audit Fees	11,000	0	0	
Engineering	24,000	0	72,039	
Website Management	3,000	250	1,250	
Office Supplies	1,000	69	324	
Miscellaneous - General Admin	0	988	1,387	
Postage	150	281	530	
Insurance - General Admin	13,500	0	16,741	
Transportation - General Admin	1,100	0	0	
Sundry	0	0	0	
Licenses/Permits	0	0	175	
Memberships	2,790	0	2,000	
Legal Advertising	900	0	274	
Maintenance Buildings and Grounds	2,300	140	1,080	
Utilities	4,000	483	2,168	
Telephone	4,500	109	546	
Property Taxes	850	0	892	
Property Appraiser Fees	0	0	1,800	
Assessment Roll Preparation	500	0	0	
Reserve	500	0	0	
Bank Service Charges	0	0	206	
Payroll Processing Fee	0	94	552	
Total Administrative Expenditures	$	152,090	$	8,817	$	145,113	
				
TOTAL MAINTENANCE EXPENDITURES (Details On Page 2)	$	347,660	$	15,566	$	191,706	
				
Total Expenditures	$	499,750	$	24,383	$	336,819	
				
EXCESS/ (SHORTFALL)	$	31,899	$	(8,712)	$	224,068	
				
Debt Payments	0	0	0	
				
Balance	$	31,899	$	(8,712)	$	224,068	
				
Tax Collector Fee	(10,597)	0	(1,500)	
Discounts For Early Payments	(21,194)	(236)	(19,029)	
				
NET EXCESS/ (SHORTFALL)	$	108	$	(8,948)	$	203,539	

Bank Balance As Of 2/29/24	$	1,645,741.53	
Accounts Payable As Of 2/29/24	$	81,566.35	
Accounts Receivable As Of 2/29/24	$	-	
Designated For Contingency As Of 2/29/24	$	300,000.00	
Other Assets As Of 2/29/24	$	-	
Available Funds As Of 2/29/24	$	1,264,175.18	

Note:
Deferred Inflow Pension As Of 2/29/24: $66,177 - Deferred Outflow Pension As Of 2/29/24: $46,328

FELLSMERE WATER CONTROL DISTRICT MONTHLY FINANCIAL REPORT FEBRUARY 2024

MAINTENANCE EXPENDITURES	

Annual Budget
10/1/23 - 9/30/24	

Actual Feb-24	
Year To Date Actual
10/1/23 - 2/29/24	

Contract Services				

Aerial Spraying	
45,000	
0	
0	

Contract/Mechanical	
60,000	
7,112	
126,256	

Canal/Ditch Spraying	
94,000	
0	
0	

Canal/Ditch Mowing	
37,600	
0	
20,000	

Water Testing	
2,200	
651	
651	

Chemical Control				

Equipment R & M/Supplies - Chemical Control	
0	
0	
0	

Gas & Oil - Chemical Control	
0	
0	
0	

Insurance - Chemical Control	
0	
0	
0	

Chemicals Used				

Rodeo	
0	
0	
0	

Invert Blend	
0	
0	
0	

Chemicals Miscellaneous	
0	
0	
0	

Ditch Maintenance				

Labor/Equipment Operations - Ditch Maintenance	
56,860	
4,374	
22,197	

Payroll Taxes - Ditch Maintenance	
5,000	
335	
1,698	

State Retirement - Ditch Maintenance	
9,200	
1,318	
7,042	

Workers Comp - Ditch Maintenance	
2,300	
0	
2,299	

Group Med/Life Insurance - Ditch Maintenance	
19,800	
1,401	
8,437	

Equipment R & M - Ditch Maintenance	
1,000	
0	
1,579	

Supplies/Services - Ditch Maintenance	
2,500	
0	
72	

Gas & Oil - Ditch Maintenance	
4,500	
0	
0	

Insurance - Ditch Maintenance	
0	
0	
0	

Transportation - Ditch Maintenance	
3,700	
375	
1,475	

Contingency - Ditch Maintenance	
4,000	
0	
0	

Total Maintenance Expenditures	
$	347,660	
$	15,566	
$	191,706	

Expenditures
4000 Contract Services

4006 Canal/Ditch Mowing	
11/16/2023	
17417	
A Quality Bushog Services Inc	
right of way mowing and hedge clearing	
20,000.00	
Total 4006 Canal/Ditch Mowing
4003 Contract/Mechanical	

10/06/2023	

CTS73	

Cates Tractor Service LLC	

canal on 99th St - clean and reshape canal	20,000.00

25,700.00	
	10/27/2023	34542453	Caterpillar Financial Services Corporatio	wheeled hydraulic excavator payment	9,630.45	
	11/20/2023	34667188	Caterpillar Financial Services Corporatio	wheeled hydraulic excavator payment	4,726.55	
	12/20/2023	34795164	Caterpillar Financial Services Corporatio	wheeled hydraulic excavator payment	4,468.45	
	01/14/2024	34926984	Caterpillar Financial Services Corporatio	wheeled hydraulic excavator payment January 2024	4,468.45	
	01/19/2024	001-70125528	Caterpillar Financial Services Corporatio	wheeled hydraulic excavator payment	70,149.35	
	02/07/2024	347844	Cat Financial	refund of invoices 14692975, 14692976, 14692977	-54,100.18	
	02/28/2024		Caterpillar Financial Services Corporatio	wheeled hydraulic excavator payment	61,212.45	
Total 4003 Contract/Mechanical
4005 Water Testing	

02/27/2024	

2435598522	

Pace Analytical Services LLC	

canal sampling	126,255.52

650.89	
Total 4005 Water Testing					650.89	
Total 4000 Contract Services
4100 Ditch Maintenance
4111 Labor-Equip Oper	

10/06/2023	

PR 10/20/23		

Payroll 10/20/2023 09/30/23 thru 10/13/23 - salaries	146,906.41

2,123.22	
	10/30/2023	PR 11/03/23		Payroll 11/03/2023 10/16/23 thru 10/29/23 - salaries	2,123.22	
	11/13/2023	PR 11/17/23		Payroll 11/17/2023 10/30/23 thru 11/12/23 - salaries	2,314.35	
	11/27/2023	PR 12/01/23		Payroll 12/01/2023 11/13/23 thru 11/26/23 - salaries	2,515.01	
	12/11/2023	PR 12/15/23		Payroll 12/15/2023 11/27/23 thru 12/08/23 - salaries	2,186.93	
	12/26/2023	PR 12/29/23		Payroll 12/29/2023 12/09/23 thru 12/22/23 - salaries	2,186.93	
	01/08/2024	PR 01/12/24		Payroll 01/12/2024 12/23/23 thru 01/05/24 - salaries	2,186.93	
	01/22/2024	PR 01/26/24		Payroll 01/26/2024 01/08/04 thru 01/21/24 - salaries	2,186.93	
	02/05/2024	PR 02/09/24		Payroll 02/09/2024 01/22/04 thru 02/04/24 - salaries	2,186.93	
	02/20/2024	PR 02/23/24		Payroll 02/23/2024 02/05/04 thru 02/16/24 - salaries	2,186.93	
Total 4111 Labor-Equip Oper					22,197.38	

4121 Payroll Taxes	

10/06/2023	

PR 10/20/23		

Payroll 10/20/2023 09/30/23 thru 10/13/23 - ER SS&MED liab	

162.42	
	10/30/2023	PR 11/03/23		Payroll 11/03/2023 10/16/23 thru 10/29/23 - ER SS&MED liab	162.43	
	11/13/2023	PR 11/17/23		Payroll 11/17/2023 10/30/23 thru 11/12/23 - ER SS&MED liab	177.05	
	11/27/2023	PR 12/01/23		Payroll 12/01/2023 11/13/23 thru 11/26/23 - ER SS&MED liab	192.39	
	12/11/2023	PR 12/15/23		Payroll 12/15/2023 11/27/23 thru 12/08/23 - ER SS&MED liab	167.30	
	12/26/2023	PR 12/29/23		Payroll 12/29/2023 12/09/23 thru 12/22/23 - ER SS&MED liab	167.31	
	01/08/2024	PR 01/12/24		Payroll 01/12/2024 12/23/23 thru 01/05/24 - ER SS&MED liab	167.30	

	01/22/2024	PR 01/26/24	Payroll 01/26/2024 01/08/04 thru 01/21/24	- ER SS&MED liab	167.30	
	02/05/2024	PR 02/09/24	Payroll 02/09/2024 01/22/04 thru 02/04/24	- ER SS&MED liab	167.30	
	02/20/2024	PR 02/23/24	Payroll 02/23/2024 02/05/04 thru 02/16/24	- ER SS&MED liab	167.30	
Total 4121 Payroll Taxes					1,698.10	
4122 State Retirement						
	10/06/2023	PR 10/20/23	Payroll 10/20/2023 09/30/23 thru 10/13/23	- FRS ER expense	288.12	
	10/17/2023		Fl Div of Retirement	June retirement contribution (confirm 231770652629)	703.63	
	10/30/2023	PR 11/03/23		Payroll 11/03/2023 10/16/23 thru 10/29/23 - FRS ER expense	288.12	
	11/13/2023	PR 11/17/23		Payroll 11/17/2023 10/30/23 thru 11/12/23  - FRS ER expense	314.06	
	11/14/2023		Fl Div of Retirement	November retirement contribution (confirm 233170728207)	735.31	
	11/27/2023	PR 12/01/23		Payroll 12/01/2023 11/13/23 thru 11/26/23  - FRS ER expense	341.29	
	12/11/2023	PR 12/15/23		Payroll 12/15/2023 11/27/23 thru 12/08/23  - FRS ER expense	296.77	
	12/26/2023		Fl Div of Retirement	December retirement contribution (confirm 233600757807)	1,141.49	
	12/26/2023	PR 12/29/23		Payroll 12/29/2023 12/09/23 thru 12/22/23  - FRS ER expense	296.77	
	01/08/2024	PR 01/12/24		Payroll 01/12/2024 12/23/23 thru 01/05/24 - FRS ER expense	296.77	
	01/22/2024	PR 01/26/24		Payroll 01/26/2024 01/08/04 thru 01/21/24 - FRS ER expense	296.77	
	01/23/2024		Fl Div of Retirement	January retirement contribution (confirm 240220784614)	724.75	
	02/05/2024	PR 02/09/24		Payroll 02/09/2024 01/22/04 thru 02/04/24  - FRS ER expense	296.77	
	02/20/2024	PR 02/23/24		Payroll 02/23/2024 02/05/04 thru 02/16/24 - FRS ER expense	296.77	
	02/21/2024		Fl Div of Retirement	FRS February 2024	724.75	
Total 4122 State Retirement					7,042.14	
4123 Workers Comp						
	10/01/2023	20004	Egis Insurance Advisors	policy WC 100123939 10/1/23 - 10/1/24	2,298.53	
Total 4123 Workers Comp					2,298.53	
4124 Group Med, Life Ins.						
	10/01/2023		Blue Cross Blue Shield	October health insurance	1,406.45	
	10/05/2023		aflac	September 2023	52.32	
	10/06/2023	PR 10/20/23		Payroll 10/20/2023 09/30/23 thru 10/13/23 - health insurance	-28.95	
	10/30/2023	PR 11/03/23		Payroll 11/03/2023 10/16/23 thru 10/29/23 - health insurance	-28.95	
	10/31/2023		Blue Cross Blue Shield	November health insurance	1,406.45	
	11/07/2023		aflac	October 2023	78.48	
	11/13/2023	PR 11/17/23		Payroll 11/17/2023 10/30/23 thru 11/12/23 - health insurance	-28.95	
	11/27/2023	PR 12/01/23		Payroll 12/01/2023 11/13/23 thru 11/26/23 - health insurance	-28.95	
	11/30/2023		Blue Cross Blue Shield	Decebmer health insurance	1,406.45	
	12/07/2023		aflac	November 2023	52.32	
	12/11/2023	PR 12/15/23		Payroll 12/15/2023 11/27/23 thru 12/08/23 - health insurance	-28.95	
	12/26/2023	PR 12/29/23		Payroll 12/29/2023 12/09/23 thru 12/22/23 - health insurance	-28.95	
	12/29/2023		Blue Cross Blue Shield	January health insurance	1,406.45	
	01/05/2024		aflac	December 2023	52.32	
	01/08/2024	PR 01/12/24		Payroll 01/12/2024 12/23/23 thru 01/05/24 - health insurance	-28.95	
	01/22/2024	PR 01/26/24		Payroll 01/26/2024 01/08/04 thru 01/21/24 - health insurance	-28.95	

Date	Invoice #	Vendor	Memo	Amount
01/31/2024		Blue Cross Blue Shield	February health insurance	1,406.45 02/05/2024	PR 02/09/24		Payroll 02/09/2024 01/22/04 thru 02/04/24 - health insurance		-28.95
02/07/2024	aflac	Januryar 2024	52.32
02/20/2024	PR 02/23/24		Payroll 02/23/2024 02/05/04 thru 02/16/24 - health insurance		-28.95 02/29/2024		Blue Cross Blue Shield	February health insurance	1,406.45
Total 4124 Group Med, Life Ins.	8,436.96
4131 Equipment R & M
11/20/2023	SC469840	Kelly Tractor	trip charge	491.00
11/29/2023	SVI524247	Kelly Tractor	trip charge	 1,088.00 Total 4131 Equipment R & M				1,579.00
4132 Supplies & Services
11/03/2023	335973	Cole Auto Supply	supplies	72.23
Total 4132 Supplies & Services	72.23
4137 Transportation
10/31/2023	Oct 2023	Rob Vereen (reimbursement)	mileage for Oct 2023 560.6 miles @ $0.655 (367.19)	367.19
11/30/2023	Nov-23	Rob Vereen (reimbursement)	mileage for Nov 2023 556.4 miles @ $0.655 ($364.44)	364.44
01/31/2024	01-24	Rob Vereen (reimbursement)	mileage for Jan 2024 miles @ $0.67 ($368.77)	368.77
02/29/2024	Feb 24	Rob Vereen (reimbursement)	mileage for Jan 2024 miles @ $0.67 ($368.77)	374.40
Total 4137 Transportation	1,474.80
Total 4100 Ditch Maintenance	44,799.14
5000 General Admin
5019 Conversion Consultant
10/01/2023	5599	Vogel Group	consulting services October 2023	7,777.78
Total 5019 Conversion Consultant	7,777.78
5018 Bank Service Charges
10/31/2023	Service Charge	3.00
10/31/2023	Service Charge	52.84
11/30/2023	Service Charge	3.00
11/30/2023	Service Charge	53.00
12/29/2023	Service Charge	3.00
12/29/2023	Service Charge	53.00
01/31/2024	Service Charge	3.00
01/31/2024	Service Charge	35.44
Total 5018  Bank Service Charges	206.28
5079 Postage
10/31/2023	2023-1309	Special District Services	FedEx - September 2023	178.43
11/30/2023	2023-1646	Special District Services	FedEx	8.53
12/31/2023	2023-1897	Special District Services	FedEx	61.88
02/29/2024	2024-0207	Special District Services	postage	3.15
02/29/2024	2024-0207	Special District Services	FedEx	278.14
Total 5079  Postage	530.13

5003 Miscellaneous

Date	Invoice #	Vendor	Memo	Amount
10/31/2023	2023-1309	Special District Services	travel - September 2023	168.99
11/30/2023	2023-1646	Special District Services	travel	91.05
12/31/2023	2023-1897	Special District Services	travel	114.64
01/31/2024	2024-0083	Special District Services	travel	24.24
02/06/2024	3457	Window Solutions Inc.	install window film on CAT Excavator	800.00
02/29/2024	2024-0207	Special District Services	travel	187.60

Total 5003 Miscellaneous	1,386.52
5002 Website management
10/31/2023	2023-1309	Special District Services	webstire fee - October 2023	250.00
11/30/2023	2023-1646	Special District Services	website fee	250.00
12/31/2023	2023-1897	Special District Services	website fee	250.00
01/31/2024	2024-0083	Special District Services	website fee	250.00
02/29/2024	2024-0207	Special District Services	website fee	250.00
Total 5002 Website management	1,250.00
5091 Payroll processing fee
10/06/2023	PR 10/20/23	Payroll 10/20/2023 09/30/23 thru 10/13/23 - payroll fee	66.65
10/30/2023	PR 11/03/23	Payroll 11/03/2023 10/16/23 thru 10/29/23 - payroll fee	73.25
11/13/2023	PR 11/17/23	Payroll 11/17/2023 10/30/23 thru 11/12/23 - payroll fee	20.45
11/27/2023	PR 12/01/23	Payroll 12/01/2023 11/13/23 thru 11/26/23 - payroll fee	46.85
12/11/2023	PR 12/15/23	Payroll 12/15/2023 11/27/23 thru 12/08/23 - payroll fee	109.80
12/26/2023	PR 12/29/23	Payroll 12/29/2023 12/09/23 thru 12/22/23 - payroll fee	46.85
01/08/2024	PR 01/12/24	Payroll 01/12/2024 12/23/23 thru 01/05/24 - payroll fee	46.85
01/22/2024	PR 01/26/24	Payroll 01/26/2024 01/08/04 thru 01/21/24 - payroll fee	46.95
02/05/2024	PR 02/09/24	Payroll 02/09/2024 01/22/04 thru 02/04/24 - payroll fee	46.95
02/20/2024	PR 02/23/24	Payroll 02/23/2024 02/05/04 thru 02/16/24 - payroll fee	46.95
Total 5091 Payroll processing fee	551.55
5017 Management Fee
10/31/2023	2023-1309	Special District Services	management fee October 2023	6,000.00
11/30/2023	2023-1646	Special District Services	management fee November 2023	6,000.00
12/31/2023	2023-1897	Special District Services	management fee December 2023	6,000.00
01/31/2024	2024-0083	Special District Services	Management fee - January 2024	6,000.00
02/29/2024	2024-0207	Special District Services	Management fee - February 2024		6,000.00 Total 5017 Management Fee				30,000.00
5015 Engineeering
10/27/2023	202329094	Carter Associates, Inc	October 2023	19,642.38
11/30/2023	202333741	Carter Associates, Inc	November 2023	18,716.32
12/31/2023	202337428	Carter Associates, Inc	December 2023	16,219.58
01/26/2024	202401515	Carter Associates, Inc	January 2024	17,460.70
Total 5015 Engineeering	72,038.98
5013 Legal & Professional

Date	Invoice #	Vendor	Memo	Amount
10/31/2023	3312459	Kutak Rock	general representation October 2023	1,037.00
11/30/2023	3327637	Kutak Rock	general representation November 2023	170.00
11/30/2023	3341228	Kutak Rock	board meeting November 9, 2023	600.00
12/31/2023	3341227	Kutak Rock	general representation December 2023	2,561.28
01/31/2024	3355307	Kutak Rock	board meeting January 2024	600.00
02/29/2024	3355306	Kutak Rock	legal January 2024	403.19
Total 5013 Legal & Professional	5,371.47
5014 Insurance
10/01/2023	19999	Egis Insurance Advisors	 policy 100123939 10/01/23 - 10/01/2024	15,961.00 10/09/2023	20533	Egis Insurance Advisors	policy 012896090 11/14/23 - 11/14/24 storage tank liability		558.89
01/25/2024	21046	Egis Insurance Advisors	policy # 100123939 10/01/23 - 10/01/24 add/delete inland marine	221.00
Total 5014 Insurance	16,740.89
5053 Prop Appraiser Fees
10/02/2023	2023/2024	Indian River County Property Appraiser	property appraiser fees	 1,800.00 Total 5053 Prop Appraiser Fees				1,800.00
5074 Property Taxes
12/01/2023	Lincoln St	IRC Tax Collector	property tax	117.65
12/01/2023	109 N Willow St	IRC Tax Collector	property tax	232.32
12/01/2023	143 Willow St	IRC Tax Collector	property tax	542.29
Total 5074  Property Taxes	892.26
5076 Licenses, Permits
10/02/2023	87952	Dept of Economic Opportunity	Special District fee 2023/2024	175.00
Total 5076 Licenses, Permits	175.00
5077 Memberships
10/01/2023	536	FASD	FASD memebership	2,000.00
Total 5077 Memberships	2,000.00
5078 Advertising
10/23/2023	0005987469	Gannett Florida LocaliQ	FY 23/24 Mtg Schedule	152.88
01/31/2024	0006204012	Gannett Florida LocaliQ	Notice of Reg Board Mtg	121.52
Total 5078  Advertising	274.40
5082 Maint Bldg & Grounds
10/01/2023	2023-10-01	Herrera Lawn Care	monthly lawn care	140.00
10/12/2023	001931	Red Services Solutions	office cleaning	100.00
10/26/2023	002020	Red Services Solutions	office cleaning	100.00
11/01/2023	2023-11-01	Herrera Lawn Care	monthly lawn care	140.00
11/21/2023	54231150	Stark Exterminators	interior and exterior service	40.00
12/01/2023	2023-12-01	Herrera Lawn Care	monthly lawn care	140.00
01/01/2024	2024-01-01	Herrera Lawn Care	monthly lawn care	140.00
01/08/2024	54932450	Stark Exterminators	interior and exterior service	40.00
01/09/2024	002621	Red Services Solutions	office cleaning	100.00
02/01/2024	2024-02-01	Herrera Lawn Care	monthly lawn care	140.00

Date	Invoice #	Vendor	Memo	Amount
Total 5082 Maint Bldg & Grounds	1,080.00
5083 Utilities
10/06/2023	85682-24037 1023	FPL	85682-24037 09/07/23 - 10/07/23	184.30
10/10/2023	287326384239X1018202	AT&T (287326384239)	wireless 10/11/23 - 11/10/23	70.47
10/19/2023	4965673803	AT & T	account # 831-001-3105 966	100.00
10/21/2023	326232638	AT&T (326232638)	internet	96.30
10/26/2023	9204519517	City of Fellsmere	water usage and stormwater fee	29.60
11/06/2023	85682-24037	FPL	85682-24037 10/06/23 - 11/06/23	144.42
11/10/2023	287326384239X1118202	AT&T (287326384239)	wireless 11/11/23 - 12/10/23	70.47
11/19/2023	2989604804	AT & T	account # 831-001-3105 966	100.00
11/21/2023	326232638	AT&T (326232638)	internet	96.30
11/29/2023	9204519517	City of Fellsmere	water usage and stormwater fee	35.28
12/05/2023	85682-24037	FPL	85682-24037 11/06/23 - 12/05/23	154.12
12/10/2023	287326384239X1218202	AT&T (287326384239)	wireless 12/11/23 - 01/10/24	70.78
12/19/2023	5786954802	AT & T	account # 831-001-3105 966	100.00
12/21/2023	326232638	AT&T (326232638)	internet	96.30
12/28/2023	9204519517	City of Fellsmere	water usage and stormwater fee	59.20
01/10/2024	287326384239X011820	AT&T (287326384239)	wireless 01/11/24 - 02/10/24	70.78
01/19/2024	2098785800	AT & T	account # 831-001-3105 966	100.00
01/21/2024	326232638	AT&T (326232638)	internet	106.29
02/06/2024	85682-24037 0224	FPL	85682-24037 01/05/2024 - 02/06/2024	173.78
02/10/2024	287326384239X0218202	AT&T (287326384239)	wireless 02/11/24 - 03/10/24	70.60
02/19/2024	4620117807	AT & T	account # 831-001-3105 966	100.00
02/21/2024	326232638	AT&T (326232638)	internet	106.29
02/27/2024	9204519517	City of Fellsmere	water usage and stormwater fee	0.78
02/29/2024	2024-0207	Special District Services	City of Fellsmere utility chargeback	31.60
Total 5083 Utilities	2,167.66
5086 Telephone
10/07/2023	9541363802	AT&T (831-001-2595 734)	10/7/23 - 11/6/23	109.24
11/07/2023	831-001-2595 734	AT&T (831-001-2595 734)	11/7/23 - 12/6/23	109.24
12/07/2023	9509825802	AT&T (831-001-2595 734)	12/7/23 - 01/6/24	109.24
01/07/2024	5185985804	AT&T (831-001-2595 734)	01/7/24 - 02/6/24	109.24
02/07/2024	0318917806	AT&T (831-001-2595 734)	02/7/24 - 03/06/24	109.29
Total 5086  Telephone	546.25
5090 Office Supplies
10/31/2023	2023-1309	Special District Services	copier charges - September 2023	98.40
10/31/2023	2023-1309	Special District Services	meeting books - September 2023	28.00
11/30/2023	2023-1646	Special District Services	copier charges	46.20
11/30/2023	Nov-23	Rob Vereen (reimbursement)	Dollar General reimbursement $38.48	38.48
12/31/2023	2023-1897	Special District Services	copier charges	2.25
12/31/2023	2023-1897	Special District Services	meeting books	24.00

	Date		Invoice #		Vendor			Memo		Amount	
	01/31/2024		2024-0083		Special District Services		copier charges			17.55	
	02/29/2024		2024-0207		Special District Services		copier charges			45.45	
	02/29/2024		2024-0207		Special District Services		meeting books			24.00	
Total 5090 Office Supplies										324.33	
Total 5000 General Admin										145,113.50	
Total Expenditures										336,819.05	

TAX COLLECTIONS 2023-2024

#	

ID#	

PAYMENT FROM	

DATE	

FOR	

Tax Collect Receipts	

Interest Received	

Commissions Paid	

Discount	

Net From Tax Collector	O & M Assessment Income (Before Discounts & Fee)	O & M Assessment Income (After Discounts & Fee)	
									$529,849.00	$529,849.00	$529,849.00	
									$497,950.00	$497,950.00	$497,950.00	
1		Paid to Indian River County Prop Appraiser	10/02/23	Fees			$	(1,800.00)		$	(1,800.00)		$	(1,800.00)	
2	1	Indian River County Tax Collector	11/03/23	NAV Taxes/Interest	$	9,538.12	$	12.36	$	(180.74)	$	(414.25)	$	8,955.49	$	9,550.48	$	8,955.49	
3	2	Indian River County Tax Collector	11/09/23	NAV Taxes	$	24,012.00		$	(461.03)	$	(960.50)	$	22,590.47	$	24,012.00	$	22,590.47	
4	3	Indian River County Tax Collector	11/17/23	NAV Taxes	$	24,360.00		$	(108.23)	$	(974.52)	$	23,277.25	$	24,360.00	$	23,277.25	
5	4	Indian River County Tax Collector	11/22/23	NAV Taxes	$	37,555.00			$  (1,502.24)	$	36,052.76	$	37,555.00	$	36,052.76	
6	5	Indian River County Tax Collector	12/08/23	NAV Taxes	$	118,989.00		$	(1.15)	$  (4,759.61)	$	114,228.24	$  118,989.00	$	114,228.24	
7	6	Indian River County Tax Collector	12/15/23	NAV Taxes	$	236,825.43		$	(748.85)	$  (9,421.64)	$	226,654.94	$  236,825.43	$	226,654.94	
8	7	Indian River County Tax Collector	12/21/23	NAV Taxes	$	3,620.15			$	(109.17)	$	3,510.98	$	3,620.15	$	3,510.98	
9	8	Indian River County Tax Collector	12/29/23	NAV Taxes	$	3,541.41			$	(106.25)	$	3,435.16	$	3,541.41	$	3,435.16	
10	9	Indian River County Tax Collector	01/12/24	NAV Taxes	$	8,490.16			$	(254.70)	$	8,235.46	$	8,490.16	$	8,235.46	
11	10	Indian River County Tax Collector	01/26/24	NAV Taxes/Interest	$	12,564.22	$	(29.70)		$	(289.47)	$	12,245.05	$	12,534.52	$	12,245.05	
12	Int - 1	Indian River County Tax Collector	01/26/24	Interest		$	162.38			$	162.38	$	162.38	$	162.38	
13	11	Indian River County Tax Collector	02/16/24	NAV Taxes	$	8,425.49			$	(168.20)	$	8,257.29	$	8,425.49	$	8,257.29	
14	12	Indian River County Tax Collector	02/23/24	NAV Taxes	$	6,496.00			$	(68.15)	$	6,427.85	$	6,496.00	$	6,427.85	
15									$	-			
16									$	-			
17									$	-			
18									$	-			
19									$	-			
20									$	-			
21									$	-			
22	EF	Indian River County Tax Collector		Excess Fees					$	-			
23									$	-			
24									$	-			
25									$	-			
26									$	-			
					$	494,416.98	$	145.04	$	(3,300.00)	$ (19,028.70)	$	472,233.32	$  494,562.02	$	472,233.32	

$	494,416.98
$	145.04

$	472,233.32

Note: $529,849 is 2023/2024 Budgeted assessments before discounts and fees.

$	(494,562.02)

$  (472,233.32)

$497,950 is 2023/2024 Budgeted

$	-	$	-	assessments after discounts and fees.

February 27, 2024

Frank Sakuma Felllsmere WCD
10807 SW Tradition Square Port Saint Lucie, FL 34987

RE:	Project:	Quarterly SW
Pace Project No.:	35859787

Dear Frank Sakuma:
Enclosed are the analytical results for sample(s) received by the laboratory on February 12, 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 - Ormond Beach
Pace Analytical Services - South Florida
If you have any questions concerning this report, please feel free to contact me. Sincerely,

David Hernandez david.hernandez@pacelabs.com (205)614-6630
Project Manager

Enclosures

CERTIFICATIONS

Project:
Pace Project No.:

Quarterly SW 35859787

Pace Analytical Services Ormond Beach
8 East Tower Circle, Ormond Beach, FL 32174 Alaska DEC- CS/UST/LUST
Alabama Certification #: 41320 California Certification# 3096
Colorado Certification: FL NELAC Reciprocity Connecticut Certification #: PH-0216 Delaware Certification: FL NELAC Reciprocity DoD-ANAB #:ADE-3199
Florida Certification #: E83079 Georgia Certification #: 955
Guam Certification: FL NELAC Reciprocity Hawaii Certification: FL NELAC Reciprocity Illinois Certification #: 200068
Indiana Certification: FL NELAC Reciprocity Kansas Certification #: E-10383
Kentucky Certification #: 90050
Louisiana Certification #: FL NELAC Reciprocity Louisiana Environmental Certificate #: 05007 Maine Certification #: FL01264
Maryland Certification: #346 Massachusetts Certification #: M-FL1264 Michigan Certification #: 9911

Mississippi Certification: FL NELAC Reciprocity Missouri Certification #: 236
Montana Certification #: Cert 0074 Nebraska Certification: NE-OS-28-14 New Hampshire Certification #: 2958 New Jersey Certification #: FL022 New York Certification #: 11608
North Carolina Environmental Certificate #: 667 North Carolina Certification #: 12710
North Dakota Certification #: R-216 Ohio DEP 87780
Oklahoma Certification #: D9947 Pennsylvania Certification #: 68-00547 Puerto Rico Certification #: FL01264 South Carolina Certification: #96042001 Tennessee Certification #: TN02974 Texas Certification: FL NELAC Reciprocity
US Virgin Islands Certification: FL NELAC Reciprocity Virginia Environmental Certification #: 460165
West Virginia Certification #: 9962C Wisconsin Certification #: 399079670
Wyoming (EPA Region 8): FL NELAC Reciprocity

Pace Analytical Services South Florida
3610 Park Central Blvd N, Pompano Beach, FL 33064	Florida Certification #: E86240

SAMPLE SUMMARY

Project:
Pace Project No.:

Quarterly SW 35859787

Lab ID	Sample ID	Matrix	Date Collected	Date Received		
35859787001	BRIDGE	Water	02/12/24 10:35	02/12/24 17:00		

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 21

	SAMPLE ANALYTE COUNT		
Project:	Quarterly SW			
Pace Project No.:	35859787			

Lab ID	
Sample ID	
Method	
Analysts	Analytes Reported	
Laboratory		
35859787001	BRIDGE	EPA 6010	TMA	1	PASI-O		
		SM 9222D	NMT	1	PASI-O		
		SM 2520B Modified	LTP	1	PASI-SF		
		SM 2540D	WW1	1	PASI-O		
		SM 5210B	SAH	1	PASI-O		
		EPA 300.0	AMD1	1	PASI-O		
		EPA 350.1	MWD	1	PASI-O		
		EPA 351.2	AGS	1	PASI-O		
		EPA 353.2	JTK	3	PASI-O		
		EPA 365.1	JTK	1	PASI-O		
		EPA 365.4	AGS	1	PASI-O		
		FLDEP SOP 10/03/83	NMT	2	PASI-O		

PASI-O = Pace Analytical Services - Ormond Beach
PASI-SF = Pace Analytical Services - South Florida

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 21

ANALYTICAL RESULTS

Project:
Pace Project No.:

Quarterly SW 35859787

Sample: BRIDGE	Lab ID: 35859787001	Collected: 02/12/24 10:35  Received: 02/12/24 17:00  Matrix: Water

Field Data

Collected By

Analytical Method:
Pace Analytical Services - Ormond Beach
Jim Norton 2/12/2024
1035

1

02/16/24 11:05

Collected Date
Collected Time

1
1

02/16/24 11:05
02/16/24 11:05

6010 MET ICP

Analytical Method: EPA 6010 Preparation Method: EPA 3010
Pace Analytical Services - Ormond Beach

9222D Fecal Coliform

Analytical Method: SM 9222D Preparation Method: SM 9222D
Pace Analytical Services - Ormond Beach

Fecal Coliforms	60.0 CFU/100 mL	1.0	1.0	1	02/12/24 18:20 02/13/24 18:09	Z

Salinity by Conductivity

Analytical Method: SM 2520B Modified
Pace Analytical Services - South Florida

Salinity	7.0 U	ppt	7.0	7.0	1	02/16/24 12:43

2540D Total Suspended Solids

Analytical Method: SM 2540D
Pace Analytical Services - Ormond Beach

5210B BOD, 5 day

Analytical Method: SM 5210B
Pace Analytical Services - Ormond Beach

300.0 IC Anions 28 Days

Analytical Method: EPA 300.0
Pace Analytical Services - Ormond Beach

350.1 Ammonia

Analytical Method: EPA 350.1
Pace Analytical Services - Ormond Beach

Parameters	Results	Units

PQL

MDL

DF	Prepared	Analyzed	CAS No.	Qual

Field pH	7.22	Std. Units	1	02/16/24 11:05		
Field Temperature	22	deg C	1	02/16/24 11:05		
Field Specific Conductance	1119	umhos/cm	1	02/16/24 11:05		
Oxygen, Dissolved	5.88	mg/L	1	02/16/24 11:05	7782-44-7	
Turbidity	6.08	NTU	1	02/16/24 11:05		

Iron	0.94	mg/L	0.040	0.025	1	02/13/24 05:01	02/13/24 22:30	7439-89-6	

Total Suspended Solids	5.0 U	mg/L	5.0	5.0	1	02/15/24 15:23	PP	

BOD, 5 day	2.0 U	mg/L	2.0	2.0	1	02/13/24 10:25	02/18/24 12:35	V	

Chloride	208	mg/L	25.0	12.5	5	02/13/24 21:22	16887-00-6	

Nitrogen, Ammonia	0.035 U	mg/L	0.050	0.035	1	02/15/24 20:09	7664-41-7	

351.2 Total Kjeldahl Nitrogen

Analytical Method: EPA 351.2 Preparation Method: EPA 351.2 Pace Analytical Services - Ormond Beach

Nitrogen, Kjeldahl, Total	1.2	mg/L

0.50	0.20	1

02/15/24 06:56

02/27/24 13:12 7727-37-9	V

Date: 02/27/2024 05:43 PM

REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC.

Page 5 of 21

ANALYTICAL RESULTS

Project:
Pace Project No.:

Quarterly SW 35859787

Sample: BRIDGE	Lab ID: 35859787001	Collected: 02/12/24 10:35  Received: 02/12/24 17:00  Matrix: Water

353.2 Nitrogen, NO2/NO3 unpres

Analytical Method: EPA 353.2
Pace Analytical Services - Ormond Beach

365.1 Orthophosphate as P

Analytical Method: EPA 365.1
Pace Analytical Services - Ormond Beach

Orthophosphate as P	0.056	mg/L	0.0040	0.0038	1	02/13/24 08:00

365.4 Phosphorus, Total

Analytical Method: EPA 365.4 Preparation Method: EPA 365.4
Pace Analytical Services - Ormond Beach

Un-ionized Ammonia, Ammonium	Analytical Method: FLDEP SOP 10/03/83
Pace Analytical Services - Ormond Beach

Parameters	Results	Units

PQL

MDL

DF	Prepared	Analyzed	CAS No.	Qual

Nitrogen, NO2 plus NO3	0.20	mg/L	0.050	0.015	1	02/13/24 07:45		
Nitrogen, Nitrate	0.20	mg/L	0.050	0.025	1	02/13/24 07:45	14797-55-8	
Nitrogen, Nitrite	0.025 U	mg/L	0.050	0.025	1	02/13/24 07:45	14797-65-0	

Phosphorus, Total (as P)	0.070 U	mg/L	0.10	0.070	1	02/15/24 06:56	02/27/24 13:12	7723-14-0	

Nitrogen, Ammonium	0.035 U	mg/L	0.050	0.035	1	02/21/24 18:14	7764-41-7	N2	
Nitrogen, Ammonia (Unionized)	0.020 U	mg/L	0.020	0.020	1	02/21/24 18:14			

Date: 02/27/2024 05:43 PM

REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC.

Page 6 of 21

QUALITY CONTROL DATA

Project:
Pace Project No.:

Quarterly SW 35859787

QC Batch:
QC Batch Method:

989131
SM 9222D

Analysis Method: Analysis Description:

SM 9222D
9222D MBIO Fecal Coliform

Laboratory:	Pace Analytical Services - Ormond Beach
Associated Lab Samples:	35859787001

METHOD BLANK:  5438798
Associated Lab Samples:	35859787001

Matrix: Water

Parameter	Units

Blank Result

Reporting Limit

MDL

Analyzed

Qualifiers

Fecal Coliforms	CFU/100 mL	1.0 U	1.0

1.0

02/13/24 18:09

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.

Date: 02/27/2024 05:43 PM

REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC.

Page 7 of 21

QUALITY CONTROL DATA

Project:
Pace Project No.:

Quarterly SW 35859787

QC Batch:
QC Batch Method:

988576
EPA 3010

Analysis Method: Analysis Description:

EPA 6010
6010 MET

Laboratory:	Pace Analytical Services - Ormond Beach
Associated Lab Samples:	35859787001

METHOD BLANK:  5435949
Associated Lab Samples:	35859787001

Matrix: Water

Parameter	Units

Blank Result

Reporting Limit

MDL

Analyzed

Qualifiers

LABORATORY CONTROL SAMPLE:		5435950		
				Spike		LCS			LCS			% Rec		
Parameter		Units		Conc.		Result			% Rec			Limits	Qualifiers		
Iron		mg/L		2.5			2.6			102		80-120		

Iron	mg/L	0.025 U	0.040

0.025

02/14/24 13:05

MATRIX SPIKE & MATRIX SPIKE DUPLICATE:

5435951
MS

MSD

5435952

Parameter	Units

35859497006
Result

Spike Conc.

Spike Conc.

MS
Result

MSD
Result

MS
% Rec

MSD
% Rec

% Rec Limits

Max RPD  RPD

Qual

Iron	mg/L

651 ug/L

2.5

2.5

3.2	3.2

102

101

75-125

1	20

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.

Date: 02/27/2024 05:43 PM

REPORT OF LABORATORY ANALYSIS
This report shall not be reproduced, except in full, without the written consent of Pace Analytical Services, LLC.

Page 8 of 21

QUALITY CONTROL DATA

Project:
Pace Project No.:

Quarterly SW 35859787

QC Batch:
QC Batch Method:

989872
SM 2520B Modified

Analysis Method: Analysis Description:

SM 2520B Modified Salinity Conductivity

Laboratory:	Pace Analytical Services - South Florida
Associated Lab Samples:	35859787001

METHOD BLANK:  5443276
Associated Lab Samples:	35859787001

Matrix: Water

Parameter	Units

Blank Result

Reporting Limit

MDL

Analyzed

Qualifiers

Salinity	ppt	7.0 U	7.0

7.0

02/16/24 12:37

LABORATORY CONTROL SAMPLE:		5443277		
Spike		
LCS		
LCS		
% Rec		
Parameter		Units		Conc.		Result		% Rec		Limits	Qualifiers		
Salinity		ppt		35		34.4		98		 
90-110		
SAMPLE DUPLICATE:  5443278												

Parameter	Units

35859787001
Result

Dup Result

RPD

Max
RPD	Qualifiers

Salinity	ppt

7.0 U

7.0 U	5

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.

QUALITY CONTROL DATA

Project:
Pace Project No.:

Quarterly SW 35859787

QC Batch:
QC Batch Method:

989549
SM 2540D

Analysis Method: Analysis Description:

SM 2540D
2540D Total Suspended Solids

Laboratory:	Pace Analytical Services - Ormond Beach
Associated Lab Samples:	35859787001

METHOD BLANK:  5441278
Associated Lab Samples:	35859787001

Matrix: Water

Parameter	Units

Blank Result

Reporting Limit

MDL

Analyzed

Qualifiers

Total Suspended Solids	mg/L	5.0 U	5.0

5.0

02/15/24 15:23

Total Suspended Solids		mg/L		1060		1140			7			10 PK		
SAMPLE DUPLICATE:  5441281														

Parameter		
Units		35859751001
Result		Dup Result		
RPD			Max RPD	
Qualifiers		
Total Suspended Solids		mg/L		5.0 U		5.0 U						10		

LABORATORY CONTROL SAMPLE:

Parameter	5441279

Units	
Spike Conc.	
LCS
Result	
LCS
% Rec	
% Rec Limits	

Qualifiers	
Total Suspended Solids		mg/L		
99.7	99.0		99		90-110			
SAMPLE DUPLICATE:  5441280

Parameter		

Units		
35859646004
Result	
Dup Result		

RPD		
Max RPD		

Qualifiers	

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.

QUALITY CONTROL DATA

Project:
Pace Project No.:

Quarterly SW 35859787

QC Batch:
QC Batch Method:

988627
SM 5210B

Analysis Method: Analysis Description:

SM 5210B
5210B BOD, 5 day

Laboratory:	Pace Analytical Services - Ormond Beach
Associated Lab Samples:	35859787001

METHOD BLANK:  5436080
Associated Lab Samples:	35859787001

Matrix: Water

Parameter	Units

Blank Result

Reporting Limit

MDL

Analyzed

Qualifiers

BOD, 5 day	mg/L	2.0 U	2.0

2.0

02/18/24 11:53  V

LABORATORY CONTROL SAMPLE:	5436082		
		Spike	LCS	LCS	% Rec		
Parameter	Units	Conc.	Result	% Rec	Limits	Qualifiers	
BOD, 5 day		mg/L		
198	210		106		
85-115 V		
SAMPLE DUPLICATE:  5436083

Parameter		

Units		
35859683001
Result	
Dup Result		

RPD		
Max RPD	

Qualifiers	

BOD, 5 day	mg/L

62.9

55.1

13	20 V

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.

QUALITY CONTROL DATA

Project:
Pace Project No.:

Quarterly SW 35859787

QC Batch:
QC Batch Method:

988662
EPA 300.0

Analysis Method: Analysis Description:

EPA 300.0
300.0 IC Anions

Laboratory:	Pace Analytical Services - Ormond Beach
Associated Lab Samples:	35859787001

METHOD BLANK:  5436217
Associated Lab Samples:	35859787001

Matrix: Water

Parameter	Units

Blank Result

Reporting Limit

MDL

Analyzed

Qualifiers

Chloride	mg/L	2.5 U	5.0

2.5

02/13/24 15:28

LABORATORY CONTROL SAMPLE:		5436218		
				Spike		LCS			LCS			% Rec		
Parameter		Units		Conc.		Result			% Rec			Limits	Qualifiers		
Chloride		mg/L		50			47.8			96		 
90-110		

MATRIX SPIKE & MATRIX SPIKE DUPLICATE:	5439267
MS			
MSD		5439268		
35859811001	Spike			Spike		MS	MSD		MS		MSD	% Rec			Max	
Parameter	Units	Result	Conc	.		Conc.		Result	Result		% Rec		% Rec	Limits	RPD		RPD  Qual	
Chloride	mg/L	32.4	50		50		
84.2	84.5		104		104	90-110	0		 
20	

MATRIX SPIKE & MATRIX SPIKE DUPLICATE:	5439270
MS	
MSD	5439271		
35859330006	Spike	Spike	MS	MSD	MS	MSD	% Rec	Max		
Parameter	Units	Result	Conc	Conc.	Result	Result	% Rec	% Rec	Limits	RPD  RPD	Qual	
Chloride	mg/L		16.4	50		50		66.5		67.3		100		102	90-110	1		20			

.

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.

QUALITY CONTROL DATA

Project:
Pace Project No.:

Quarterly SW 35859787

QC Batch:
QC Batch Method:

989652
EPA 350.1

Analysis Method: Analysis Description:

EPA 350.1
350.1 Ammonia

Laboratory:	Pace Analytical Services - Ormond Beach
Associated Lab Samples:	35859787001

METHOD BLANK:  5442105
Associated Lab Samples:	35859787001

Matrix: Water

Parameter	Units

Blank Result

Reporting Limit

MDL

Analyzed

Qualifiers

Nitrogen, Ammonia	mg/L	0.035 U	0.050

0.035

02/15/24 19:52

LABORATORY CONTROL SAMPLE:

5442106

Spike

LCS

LCS

% Rec

Parameter	Units
Nitrogen, Ammonia	mg/L

Conc.
1

Result

1.0

% Rec

Limits	Qualifiers
103	90-110

MATRIX SPIKE & MATRIX SPIKE DUPLICATE:	5442108
MS			
MSD			5442107		
35859178002	Spike			Spike			MS	MSD		MS		MSD	% Rec			Max	
Parameter	Units	Result	Conc.			Conc.			Result	Result		% Rec		% Rec	Limits	RPD		RPD  Qual	
Nitrogen, Ammonia	mg/L	6.5	1			1		
7.5	7.5		100		99	90-110	0		 
20	

MATRIX SPIKE & MATRIX SPIKE DUPLICATE:	5442109
MS	
MSD	5442110		
35859855004	Spike	Spike	MS	MSD	MS	MSD	% Rec	Max		
Parameter	Units	Result	Conc.	Conc.	Result	Result	% Rec	% Rec	Limits	RPD  RPD	Qual	
Nitrogen, Ammonia	mg/L		0.035 U	1		1		1.1		1.1		107		106	90-110	1		20			

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.

QUALITY CONTROL DATA

Project:
Pace Project No.:

Quarterly SW 35859787

QC Batch:
QC Batch Method:

989313
EPA 351.2

Analysis Method: Analysis Description:

EPA 351.2
351.2 TKN

Laboratory:	Pace Analytical Services - Ormond Beach
Associated Lab Samples:	35859787001

METHOD BLANK:  5440317
Associated Lab Samples:	35859787001

Matrix: Water

Parameter	Units

Blank Result

Reporting Limit

MDL

Analyzed

Qualifiers

Nitrogen, Kjeldahl, Total	mg/L	0.74	0.50

0.20

02/27/24 12:37

LABORATORY CONTROL SAMPLE:		5440318		
				Spike		LCS			LCS			% Rec		
Parameter		Units		Conc.		Result			% Rec			Limits	Qualifiers		
Nitrogen, Kjeldahl, Total		mg/L		20			21.0			105		 
90-110		

MATRIX SPIKE & MATRIX SPIKE DUPLICATE:	5440320
MS			
MSD		5440319		
35859772001	Spike			Spike		MS	MSD		MS		MSD	% Rec			Max	
Parameter	Units	Result	Conc	.		Conc.		Result	Result		% Rec		% Rec	Limits	RPD		RPD  Qual	
Nitrogen, Kjeldahl, Total	mg/L	1.7	20		20		
21.7	21.6		100		100	90-110	0		 
20	

MATRIX SPIKE & MATRIX SPIKE DUPLICATE:	5440322
MS	
MSD	5440321		
35859776003	Spike	Spike	MS	MSD	MS	MSD	% Rec	Max		
Parameter	Units	Result	Conc	Conc.	Result	Result	% Rec	% Rec	Limits	RPD  RPD	Qual	
Nitrogen, Kjeldahl, Total	mg/L		2.2	20		20		22.3		22.4		101		101	90-110	0		20			

.

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.

QUALITY CONTROL DATA

Project:
Pace Project No.:

Quarterly SW 35859787

QC Batch:
QC Batch Method:

988584
EPA 353.2

Analysis Method: Analysis Description:

EPA 353.2
353.2 Nitrate + Nitrite, Unpres.

Laboratory:	Pace Analytical Services - Ormond Beach
Associated Lab Samples:	35859787001

METHOD BLANK:  5435982	Matrix: Water

Associated Lab Samples:	35859787001							
				Blank		Reporting		
Parameter		Units		Result		Limit		MDL		Analyzed		Qualifiers	
Nitrogen, Nitrate		mg/L		0.025 U		0.050		0.025		02/13/24 07:05			
Nitrogen, Nitrite		mg/L		0.025 U		0.050		0.025		02/13/24 07:05			
Nitrogen, NO2 plus NO3		mg/L		0.015 U		0.050		0.015		02/13/24 07:05			

LABORATORY CONTROL SAMPLE:

5435983

Spike

LCS

LCS

% Rec

Parameter	Units
Nitrogen, Nitrite	mg/L
Nitrogen, NO2 plus NO3	mg/L

Conc.
1
2

Result

0.98
2.1

% Rec

Limits	Qualifiers
98	90-110
103	90-110

MATRIX SPIKE & MATRIX SPIKE DUPLICATE:

5435985
MS

MSD

5435984

	35859724001	Spike			Spike			MS		MSD		MS		MSD	% Rec			Max	
Parameter	Units	Result	Conc.			Conc.			Result		Result		% Rec		% Rec	Limits	RPD		RPD  Qual	
Nitrogen, Nitrite	mg/L	0.025 U		1			1		0.94		0.96		94		96	90-110	2		 
20 Q	
Nitrogen, NO2 plus NO3	mg/L	0.015 U		2			2		2.0		2.0		99		101	90-110	2		20 Q	

MATRIX SPIKE & MATRIX SPIKE DUPLICATE:

5435987
MS

MSD

5435986

	35859839002	Spike			Spike			MS		MSD		MS		MSD	% Rec			Max		
Parameter	Units	Result	Conc.			Conc.			Result		Result		% Rec		% Rec	Limits	RPD		RPD		Qual	
Nitrogen, Nitrite	mg/L	0.025 U		1			1		0.95		0.95		95		95	90-110	1		20			
Nitrogen, NO2 plus NO3	mg/L	0.015 U		2			2		1.9		1.8		92		92	90-110	1		20			

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.

QUALITY CONTROL DATA

Project:
Pace Project No.:

Quarterly SW 35859787

QC Batch:
QC Batch Method:

988586
EPA 365.1

Analysis Method: Analysis Description:

EPA 365.1
365.1 Orthophosphate as P

Laboratory:	Pace Analytical Services - Ormond Beach
Associated Lab Samples:	35859787001

METHOD BLANK:  5435994
Associated Lab Samples:	35859787001

Matrix: Water

Parameter	Units

Blank Result

Reporting Limit

MDL

Analyzed

Qualifiers

Orthophosphate as P	mg/L	0.0038 U	0.0040

0.0038

02/13/24 07:31

LABORATORY CONTROL SAMPLE:		5435995		
				Spike		LCS			LCS			% Rec		
Parameter		Units		Conc.		Result			% Rec			Limits	Qualifiers		
Orthophosphate as P		mg/L		0.1			0.10			103		 
90-110		

MATRIX SPIKE & MATRIX SPIKE DUPLICATE:	5435997
MS	
MSD	5435996		
35859761002	Spike	Spike	MS	MSD	MS	MSD	% Rec		Max	
Parameter	Units	Result	Conc.	Conc.	Result	Result	% Rec	% Rec	Limits	RPD	RPD  Qual	
Orthophosphate as P	mg/L		0.19	0.1		0.1		0.27		0.28		88		91	90-110	 
1	20 J(M1)	

MATRIX SPIKE & MATRIX SPIKE DUPLICATE:	5435999
MS	
MSD	5435998		
35859738006	Spike	Spike	MS	MSD	MS	MSD	% Rec	Max	
Parameter	Units	Result	Conc.	Conc.	Result	Result	% Rec	% Rec	Limits	RPD  RPD  Qual	
Orthophosphate as P	mg/L		0.078	0.1		0.1		0.17		0.17		93		93	90-110	0		20			

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.

QUALITY CONTROL DATA

Project:
Pace Project No.:

Quarterly SW 35859787

QC Batch:
QC Batch Method:

989314
EPA 365.4

Analysis Method: Analysis Description:

EPA 365.4
365.4 Phosphorus

Laboratory:	Pace Analytical Services - Ormond Beach
Associated Lab Samples:	35859787001

METHOD BLANK:  5440324
Associated Lab Samples:	35859787001

Matrix: Water

Parameter	Units

Blank Result

Reporting Limit

MDL

Analyzed

Qualifiers

Phosphorus, Total (as P)	mg/L	0.070 U	0.10

0.070

02/27/24 13:14

LABORATORY CONTROL SAMPLE:

5440325

Spike

LCS

LCS

% Rec

Parameter	Units
Phosphorus, Total (as P)	mg/L

Conc.
4

Result

4.1

% Rec

Limits	Qualifiers
102	90-110

MATRIX SPIKE & MATRIX SPIKE DUPLICATE:	5440327
MS			
MSD			5440326		
35859772001	Spike			Spike			MS	MSD		MS		MSD	% Rec			Max	
Parameter	Units	Result	Conc.			Conc.			Result	Result		% Rec		% Rec	Limits	RPD		RPD  Qual	
Phosphorus, Total (as P)	mg/L	0.21	4			4		
4.8	4.8		114		115	80-120	1		 
20	

MATRIX SPIKE & MATRIX SPIKE DUPLICATE:	5440329
MS	
MSD	5440328		
35859776003	Spike	Spike	MS	MSD	MS	MSD	% Rec	Max		
Parameter	Units	Result	Conc.	Conc.	Result	Result	% Rec	% Rec	Limits	RPD  RPD	Qual	
Phosphorus, Total (as P)	mg/L		0.16	4		4		4.3		4.3		104		104	80-120	0		20			

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.

QUALIFIERS

Project:
Pace Project No.:

Quarterly SW 35859787

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
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.
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

U J(M1)
N2

PK
PP Q V Z

Compound was analyzed for but not detected.
Estimated Value. Matrix spike recovery exceeded QC limits. Batch accepted based on laboratory control sample (LCS) recovery.
The lab does not hold NELAC/TNI accreditation for this parameter but other accreditations/certifications may apply. A complete list of accreditations/certifications is available upon request.
Sample volume was decreased because complete filtration was not achieved within the maximum method-specified timeframe.
The mass of dried residue obtained did not meet the test method requirements based on volume used. Sample held beyond the accepted holding time. Sample was received outside EPA method holding time. Indicates that the analyte was detected in both the sample and the associated method blank.
Too many colonies were present for accurate counting.

QUALITY CONTROL DATA CROSS REFERENCE TABLE

Project:

Pace Project No.:

Quarterly SW 35859787

Lab ID	
Sample ID	
QC Batch Method	
QC Batch	
Analytical Method	Analytical Batch	
35859787001	BRIDGE					
35859787001	BRIDGE	EPA 3010	988576	EPA 6010	988625	
35859787001	BRIDGE	SM 9222D	989131	SM 9222D	989132	
35859787001	BRIDGE	SM 2520B Modified	989872			
35859787001	BRIDGE	SM 2540D	989549			
35859787001	BRIDGE	SM 5210B	988627	SM 5210B	990175	
35859787001	BRIDGE	EPA 300.0	988662			
35859787001	BRIDGE	EPA 350.1	989652			
35859787001	BRIDGE	EPA 351.2	989313	EPA 351.2	992393	
35859787001	BRIDGE	EPA 353.2	988584			
35859787001	BRIDGE	EPA 365.1	988586			
35859787001	BRIDGE	EPA 365.4	989314	EPA 365.4	992394	
35859787001	BRIDGE	FLDEP SOP 10/03/83	991128			

Pace• Location Requested (City/State):

LAB USE ONLY Affix Wofk.order/Login Label Here

-  -..a--

(?ace;,

Pace Analytical Ormond Beach	CHAIN-OF-CUSTODY Analytical Request Document
8 East Towe C'rcle, Ormond Beach, FL 32174	Cha'n-of-Custody is a LEGAL DOCUMENT - Compete al relevant felds

l!J

LJQ#: 35859787

Company Name.	Fellsmere WCD

Contact/Reoon To:  Joyce Hartel	I

IIIII

-

-

Street Address:

Customer Project Fl:

P.O. Box 438 Fellsmere, Fl 32948

Phone#:	(772) 571-0640
E-Mail: C:c E-Mai:
Invoice To:

i- -1 -·1

I!]

. '	-
............

I
11111111111111111
35859787

ProJect Name:	Quarterly SW

-
Invoice 1:.-Mail:

Specify Container Size • ..
1	3	-a.	3	5	3	4	4

••container Size: (1) IL, (2) 500ml, (3) 250ml, (4)
125ml, (5) 100ml, (6) 40ml vial, (7) Encore, (8)
TenaCore, (9) Other

Site Collection Info/Facility ID (as applicable}

Time Zone Col ected: I ] AK	I : PT	I j MT	I I CT	I XI ET

Pu:-chase O·der # {if aopl:ca□leJ:
Quote :

County/ State orig·n of sample(s):	Florida

Identify Conta·ne· Preservative Tyoe•••
1	1	1	3	8	2	1	1
Analysis Requested

••• Pr servat1ve Types· f1) Nore, (2) H\J03, (3) H2S04, (4) MCI, (S) fl.aOH, (6) Zn Acetate, (7)
NaHS04, (8) Sod Th1osultate, (9) A corb1c Acid, (10)
MeOH, (11) Other

j

Proj. Mgr:	.9

Data De iverables:	egulatory P·ogra'Tl {OW, RCRA, etc) as aop icable:

I I Level 11	I ] Level Ill	I ] Level IV

OW PWSID fl or WW Permit# as applicable:

C")

Daivld Hernandez	-0
AcctNum / Client ID:
>

I l EQUIS

Rush (Pre-approval required):
I 12 Day I I 3 day [ ] S day [ ] Othe·		

Iz
C	lL

8 Table#:

8

:,

E a:

I ] Other	

Date Results

Fte d Fi tered {if a:ip icab e): I X] Yes  [ I No

::)
0..:-	§

-" Profile/ Template:	- CCE

Requested:

Anatv,1,: OP04

u	I-

z

"'

4640	C
g

0

Matrix Codes {Insert in Matrix box below): Drinking Water (OW), Ground Water (GW), Waste Water (WW), Product (P), so·I/Solid (5S), Oil (Ol), Wipe (WP), Tissue (TS), Bioassay (B), Vapor (V),
Other (OT), Surf.ice Water (SW),Sediment {SEO), Sludge (SL), Caulk	z

:,,:'.
I-

0
(_)

c	«I'

Prelog / Bottle Ord 10·	C
-

Customer S:imple ID

Matrix•

Comp/ Grab

Collected
(or Composite St.irtl

Composite End

Res.
CL2

Number & Type of 0
Cont.airu:	0

{')
0

(/)
(/)

{')
I

ruo
Q)

·c
Q)	rn

0
0..

Sample Comment	0:

BRIDGE

SW	Grab

O:ite

Time

12ate
1-- -\1;2t\

Time
la>'6

Plastic

8

Glass  co	z	I-

1	1	1

z	u..	lL
1	1	1

(/)	0

1	1

CU$\;Of11"r Remarks / Special Conditions/ Possible Hazards

i-1--j	.

Collected By:

j

Pr"nted Name:
Sia,.,, ,	l

Vu\ }\,oVl_ ,)
-1/IA1l1Ai-!v

Additional lnstructioris from Pace :

ttCoolNs:	Thermometer ID:	Correction Factor re):	Ob . l rrip ("C)	Cmr"'l/.ct d Temp ("C)
_f

1<.nn,

v,d1J1rr;::r

1/ vJ'!Al

7

Oaterirr.e:
.11_,--z.4-	121.

ltw:JVl'd by/Ccmp.iny (Slstrir/1  V V  V	I ll'v---	Q;a1

r o-f.'N

.frack.ing NumhPr:
(<f.:J-

' •'7• ,..,,5 by/<Empanr, l nrnr?7)•I.

Page 20 of 21

(.,	A •

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Rf.Cl(.'ed by/Company: (S1tti11Jiot

,J6  I .)/"A e;,.	,_

;;l,_- I·,·1•:.",.',"..'v/

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Delivered by: I ] In- Person  I ] Courier

(. rR"!lilA'uished by/Company: (Signt:_ure) V	V -	l	Daterit'e.·   -	, .

'

cccived by/Company: (Signature)	Date/irne:

[ ] FedEX  I I UPS  I ] Other

RelinqUtshed by/Corrpar,y: (Signature)

Oate/T1me:

Received by/Company (Signature)

Date/Time:

Page:	1	of	1

Submitting 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_v01_082123 ©

Pl'\:
CLIENT:

DC#_Title: ENV-FRM-ORB1-0093 Sample Condition Upon Receipt Form Version: 5 I Effective Date: 4/4/2023 / Issued by: Ormond Beach

Project# Project Manager:
Client:

!Pace
Date and Initials of person:

ver:	...Nr...,. \--

1 \o---------

Examining contents: 	 Label:
Dell
pH:	

Thermometer Used: 1-LJ:Ui

Date:	Time: I Jao

Initials:

State of Origin.----,,- ---	0For WV projects. all containers verifiaa lo s6 'C

Cooler #1 Temp.-da {Vlsual} -10-  Q	 (Correction Factor} 4 3 (Actual) Cooler #2 Temp.'C 	4( (Visual) 	(Correction Factor) l/:f)	(Actual)

□Samples on ice, cooling process has begun.
□Samples on ice, cooling process has begun.

Cooler #3 Temp.•c 	{Visuall

	{Correction Factor) 	,(Actual)

□Samples on ice, cooling process has begun.

Cooler #4 Temp.°C	 {Visual) 	 (Correction Factor)	 (Actual) Cooler #5 Temp.°C	(Visual} 	(Correction Factor) 	(Actual) Cooler #6 Temp.°C	 (Visual) 	 (Correction Factor)	 (Actual)

□Samples on ice, cooling process has begun
□Samples on ice, cooling process has begun.
□Samples on ice, cooling process has begun.

Recheck for OOT •c 	(Visual) 	(Correction Factor) 	(Actual)	Time: 		_ Courier: □Fed Ex □UPS □USPS □Client □Commercia ace	□Other:
Shipping Method: □Standard Overnight □First Overnight □Priority Overnight □Ground □International Priority	□Other:
Billing: □Recipient □Sender □Third Party □Credit Card □Unknown

Initials: 	

Tracking# 			 Custody Seal Present: □Yes	No Seal properly placed and intact: □Yes	Ice:  Wei □Blue □Dry □None □Melted

Samples shorted to lab:..12!'Yes 0No  (II yes, complete the following)
Shorted Date:---=di'-'---_.l..,_.""-"---= ...	,,_

Shorted Time: J J 00

Packing Material: □Bubble Wrap □Bubble Bags	one	□Other:

 1Present:.21'Yes □No I Filled Out: s □No ON/A I SamplerName: es □No ON/A		 Chain of Custody:I	□	I	□	I	□
Relinquished To Pace;,.0'<es  No ON/A  Sampling Date(sJ.;JdYes  No ON/A  Sampling Tlme(s) es  No ON/A	
Samples Arrived within Hold Time	/4es	□No	ON/A	Comments:	
Rush Turnaround Requested on COC,	□Yes  efNo	ON/A	Comments:	
Sufficient Volume	Eefe's_ □No	ON/A	Co111/11ents:	
Correct Containers Used.	ffisJ  □No	ON/A	Commonts:		
Containers Intact.	,.......-dves	□No	□NIA	Comment.	
Sample Labels Match COG (Sample 10, DatefTime of Collection)	□No	ON/A	Comments:	
All containers needing acid / base preseNation have been ctieckelf"	□No	ON/A	Preservation Information	
		Preservative:

Lot/ Trace:

Amount added (ml): 		Date:	

All containers needing preseNation are found to be in compliance with
EPA recommendation:	Yes	□No	

ON/A		
Time:	
				
Exceptions: Vials, Mlcrotilology. O&G, PFAS			Initials:	
				
Headspace in Volatile Vials? ( >6mm)·	□Yes	□No	..e-J'NiA		
Trip Blank Present:	□Yes	□No	ANIA		
Comments/ Resolutions (use back for additional comments):		

Page 21 of 21
Oualtrax Document ID: 33786	Pag/:fl>1 ot1