TestAmericaTHE LEADER IN ENVIRONMENTAL TESTING
TESTAMERICA - ST. LOUIS
TestAmerica Laboratories, Inc.
ANALYTICAL REPORT
REVISED·
PROJECT NO. 1991-135-11/002
Boneywe11 Ponds E
Lot #: F9E010259
sean Chisek
Andrews Engineering, Inc.3300 Ginger Creek Drive~ringfield, IL 6271~
TESTAMERICA LABORATORIES I :INC.
January 7, 2010
LOT#F9E010259_REVISED1~71 ~ RioprTritil North F~rth (itv. MO n~n4r; t91 ~14.,qA.Rt;nti fax ~14.?qR_R757 www.testamericainc.com
1 of 36
F9E010259 (7): E-62F9E010259 (8): E-61F9E010259 (9): E-60F9E010259 (10): E-59F9EO10259 (11): E-58F9E010259 (12): E..57
TESTAMERICA - ST. LOUIS
Case NarrativeLOT NUMBER: F9E010259
Revised
This report contains the analytical results for the 12 samples received under chain of custody by STL81. Louis on May 1,2009. These samples are associated with your HoneyYIell Ponds E project.
The analytical results included in this report meet all applicable quality control procedure requirementsexcept as noted on the following page.
The test results in this report meet all NELAP requirements for parameters in which accreditations areheld by STL St Louis. Any exceptions to NELAP requirements are noted in the case narrative. Thecase narrative is an integral part of this report.
All chemical analysis results are based upon sample as received, wet weight, unless noted otherwise.All radiochemistry results are based upon sample as dried and ground with the exception of tritium,unless requested wet weight by the client.
This report Is revised to report Chemistry data on a wet-weight basis.
ObservationslNonconformances
Reference the chain of custody and condition upon receipt report for any variations on receipt conditionsand temperature of samples on receipt.
Trace ICP Metals
Batch 9125076:The MS (MSD) recovery for uranium is outside the established QC limits. The RPD is within methodacceptance criteria indicating a possible matrix interference. Method performance is demonstrated byacceptable LeS recovery.Affected Samples:F9E010259 (1): E-52F9E010259 (2): E-53F9E010259 (3): E-54F9E010259 (4): E-55F9E010259 (5): E-63F9E010259 (6): E-56
There were no nonconformances or observations noted with any other analysis on this lot.
LOT#F9EOI0259 REVISED 2 of 36
TESTAMERICA - ST. LOUIS
METHODS SUMMARY
F9E010259
.ANALYTICAL_P_ARAME-T-E_R M_ET_H~O_D _
PREPARATIONMETHOD
Method D2216 Percent H20 Dry 105 Degrees C, WeighTrace Inductively Coupled Plasma (Iep) Metals
References:
ASTM Moisture,SW846 GOlOB
ASTM ASTM 2216
ASTM
SW846
Annual Book Of ASTM Standards.
"Test Methods for Evaluating Solid Waste, Physical/ChemicalMethods n , Third Edition, November 1986 and its updates.
LOT#F9EOI0259 REVISED 3 of 36
TESTAMERICA - ST. LOUIS
SAMPLE SUMMARY·
F9BOI0259
04/29/09 08:2504/29/09 09:0504/29/09 09:4504/29/09 10:3004/29/09 12:3004/29/09 12:~O
04/29/09 13:0004/29/09 14:3004/30/09 08:4504/30/09 10:3004/30/0.9 12:4504/30/09 13:05
wo # SAMPLE# CLIENT SAMPLE ID
LA7EN 001 E-52
LA7EV 002 E-53LA7EW 003 E-54LA7EO 004 E-55LA7E2 005 E-63LA7E3 006 E-56LA7E6 007 E-62LA7E8 008 E-61LA7FA 009 E-60
LA7FC 010 E-59
LA7FE 011 E-58LA7FG 012 E-57
HOTE(S) :
• The analytical results of the samples listed above arc presented on the following pages.
- All calculations are performed. before rounding to avoid round-off errors in calculated results.
- Results noted as liND" were not detected at or above the stated limit.
- This report must not be reproduced. except in full~ without the wriuen approval oCthe laboratory.
- Results for Ute following parameters are Dever reported on a dry weight basis: color. corrosivity, density, flashpoint, ignitability~ layers, odor,
paint filter test, pH, porosity pressure, reactivity, redox potential, specific gravity, spot tests, solids. solubility. temperarore, viscosity ~ and weight.
SAMPLEDDATE
SAMPTIME
LOT#F9EOI0259 REVISED 4 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering. Inc.
Client Samp1e ID: E-52
TOTAL Meta1s
Lot-Sample # •.. : F9E010259-001Date Sampled... : 04/29/09 08:25 Date Received.• : 05/01/09% MOisture...•. : 47
Matrix..... ~.: SOLID
REPORTING PREPARATION- WORK_PARAM:__E_T_E_R RE_S_UL_T LIMIT _UN_I_T_S ,;.",;,ME.;...T""-H_O_D__----- ANALYSIS DATE ORDER #
Dilution Factor: 1
Prep BatCh ft .•• : 9125076Uraniwn 96 • 4
LOT#F9EOI0259 REVISED
50.0 mg/kg SW846 6010B'Analysis Time .. : 23:17
05/05/09 LA7ENlAD
5 of 36
Lot-Sample I ... : F9EOI0259-001Date ~led.•. : 04/29/09 '08:25% Moisture•.... : 47
Andrews Engineering./ Inc_
Client Sample ID: E-52
Genera1 Chemistry
Work Order # ... : LA7EN
Date Received.• : 05/01/09
TESTAMERICA - ST. LOUIS
Matrix..•. _..•. : SOLID
PARAMETER
Percent MoistureRESULT47.1
LOT#F9E010259 REVISED 6 of 36
TESTAMERICA - ST. LOUIS
Andrews EngineeringJ Inc.
Client Sample ID: E-53
TOTAL Metals
Lot-Samp1e I : F9E010259-002Date Sampled : 04/29/09 09:05 Date Received.. : 05/01/09'Moisture : 44
Matrix : SOLID
WORKORDER #RESULTPARAMETER
REPORTING PREPARATION-LIMIT UNITS METHOD ANALYSIS DATE---------- ~~~-~~ ----- ---------
Dilution Factor: 1
Pr~ BatCh I ••• : 9125076Uranium 215 50.0 mg/kg SW846 6010B
Analysis Time .. : 23:55
05/05/09 LA7EVlAD
LOT#F9E010259 REVISED 7 of 36
Andrews Engineering, Inc_
Client S~le 10: E-53
General Chemistry
TESTAMERICA - ST. LOUIS
Lot-Sample I : F9E010259-002Date Sampled : 04/29/09 09:05% Moisture : 44
PARAMETERPercent MOisture
Work Order :It ••• : LA7EV
Date Received•• : 05/01/09Matrix•......•. : SOLID
Dilution Pactor: 1
LOT#F9E010259 REVISED 8 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering, Inc.
Client Sample ID: B-54
TOTAL Metals
Lot-Sample I : F9EOI0259-003Date Sampled : 04/29/09 09:45 Date Received.. : 05/01/09% MOisture•••.. : 46
Matrix._._._.: SOLID
RESULTPARAMETERREPORTING PREPARATION- WORKLIMIT UNITS METHOD ANALYSIS DATE ORDER #------- ----~~ ~--~----------
Dilution Factor: 1
Prep Batch I ... : 9125076Uranium 125 50.0 mg/kg SW846 6010B
Analysis Time .. : 00:02
05/05-05/06/09 LA7EW1AD
LOT#F9E010259 REVISED 9 of 36
Andrews Engineering, Inc.
Client S~le ID: E-54
General Chemistry
TESTAMERICA - ST. LOUIS
Lot-Sample I ... : F9E010259-0Q3Date ~led••• : 04/29/09 09:45., Moisture..•.. : 46
PARAMETERPercent Moisture
Work Order # •.• : LA7EWDate Received.• : 05/01/09
Matrix•..•..•.. : SOLID
Dilution Factor: 1
LOT#F9E010259 REVISED 10 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering, Inc.
Client Sample ID: E-55
TOTAL Metals
Lot-Sample I : F9EO~0259-004
Date Sampled : 04/29/09 10:30 Date Received.. : 05/01/09, MOisture••••• : 44
Matrix.•..... : SOLID
RESULTPARAMETERREPORTING PREPARATION- WORKLIMIT UNITS METHOD ANALYSIS DATE ORDER #------- ------ ----- ---------
Dilution Factor: 1
Prep Batch I ... : 9125076uranium 184 50.0 mg/kg 811846 6010B
Analysis Time.~: 00:08
05/05-05/06/09 ·LA7BO~
LOT#F9EOI0259 REVISED 11 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering, Inc_
Client Sample ID: E-55
General Chemistry
Lot-sample I ... : F9E010259-004Date sampled•.• : 04/29/09 ~O:30
t Moisture••.•• : 44
Work Order I ... : LA7EODate Received.. : 05/01/09
Matrix•.••....• : SOLID
Dilution Factor: 1
PREPARATION- PREP_PARAMET_E_R_- - _RE_S_UL_T__ RL _UN_I_T_S ME__TH_O_D ANALYSIS DATE BATCH #Percent Moisture 44.3 0.10 t ASTM MOisture. % 05/09-05/11/09 9131060
Analysis Time .. : 00:00
LOT#F9E010259 REVISED 12 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering, Inc ..
Client Sample ID: E-63
TOTAL Metals
Lot-sample i ... : F9E010259-005Date Sampled..• : 04/29/09 12:30 Date Received•• : 05/01/09'Moisture..... : 47
Matrix••..... : SOLID
REPORTING_P_ARMJIE__T_E_R_~~ _RE_S_UL_T~~__ LIMIT UNITS METHOD
WORKORDER #
Prep BatCh I ... : 9125076Uranium . 142 50 .. 0 mg/kg 8W846 6010B 05/05-05/06/09 LA7E2~
LOT#F9E010259 REVISED
Dilution Factor: 1 Analysis Time .. : 00:15
13 of 36
Andrews Engineering I Inc.
Client sample 10: E-63
Genera1 Chemistry
TESTAMERICA - ST. LOUIS
Lot-Sample I ... : F9E010259-005Date ~led••• : 04/29/09 12:30% MOisture.. __ .: 47
PA.RAr-mTERPercent Moisture
work Order :It ••• : LA7E2Date Received•• : 05/01/09
Matrix.......•. : SOLID
Dilution Factor: 1
LOT#F9E010259 REVISED 14 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering, Inc.
C1ient Sample ID: E-56
TOTAL Metals
Lot-Sample 1_ •• : F9E010259-006Date Sampled : 04/29/09 12:10 Date Received.• : 05/01/09'Moisture : 50
Matrix : SOLID
PARAMETERREPORTING PREPARATION-LIMIT UNITS METHOD ANALYSIS DATE------ ---------
WORKORDER #
Prep Batch 1_ •• : 9125076Uranimn 120
LOT#F9EOI0259_REVISED
50.0 mg/kgDilution Factor: 1
SN846 6010B 05/05-05/06/09 LA7E3~
Analysis Time .. : 00:21
15 of 36
Andrews Engineering, Inc.
Client sample ID: E-56
General Chemistry
Lot-sample i ... : F9E010259-006 Work Order I ... : LA7E3Date ~1ed.•. : 04/29/09 12:10 Date Received•• : 05/01/09% Moisture•.•.• : 50
PARAMETERPercent Moisture
LOT#F9EOI0259_REVISED
TESTAMERICA - ST. LOUIS
Matrix...•••••. : SOLID
16 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering. Inc_
C1ient Sample ID: E-62
TOTAL Metals
Lot-Sample 1 : F9E010259-007
Date Sampled•.. : 04/29/09 13:00 Date Received•. : 05/01/09\ Moisture••••. : 46
Matrix_. __ ._.: SOLID
RESULTPARAMETERREPORTING PREPARATION- WORKLIMIT UNITS METHOD ANALYSIS DATE ORDER #------- ------ ----- ---------
Dilution Factor: 1
Prep BatCh I ... : 9125076Uranium 261 50.0 mg/kg SW846 6010B
Analysis Time .. : 00:27
05/05-05/06/09 LA7E61AD
LOT#F9E010259_REVISED 17 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering, Inc.
Client Sample ID: E-62·
General Chemistry
Lot-Sample # ... : F9E010259-007Date sampled•.. : 04/29/09 13:00% Moisture.•... : 46
Work Order # ••• : LA7E6Date Received•• : 05/01/09
Matrix....•••.. : SOLID
Dilution Factor: 1
PARAMETERPercent Moisture
LOT#F9EOI0259_REVISED
PREPARATION- PREPRL _UN__I_T_S ME_T_H_O_D - ANALYSIS DATE BATCH #0.10' ASTM MOisture, % 05/09-05/11/09 9131060
Analysis Time .. : 00:00
18 of 36
TESTAMERICA - ST. LOUIS
Andrews Engin~ering, Inc.
C1ient Sample ID: E-61
TOTAL Metals
Lot-Sample I : F9EOI0259-008Date Sampled : 04/29/09 14:30 Date Received•• : 05/01/09t MOisture : 49
Matrix : SOLID
PARAMETERREPORTING PREPARATION-LIMIT UNITS METHOD ANALYSIS DATE----- .;...~......;...------
WORKORDER #
Dilution Factor: 1
Prep Batch I ... : 9125076Uranium 137
LOT#F9EOI0259 REVISED
50.0 mg/kg SW846 6010BAnalysis Time .. ~ 00:34
05/05-05/06/09 LA7B81AD
19 of 36
Andrews Engineering. Inc.
Client S~le ID: E-61
General Chemistry
TESTAMERICA - ST. LOUIS
Lot-sample I ... : F9E010259-008Date Samp1ed••. : 04/29/09 14:30% MOisture ..... : 49
PARAlVIETER
Percent Moisture
Work Order :ft. ••• : LA7E8Date Received•• : 05/01/09
Matrix...•..... : SOLID
Dilution Factor: 1
LOT#F9EOI0259_REVISED 20 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering, Inc.
Client sample ID: E-60
TOTAL Metals
Lot-S~le #_._: F9E010259-009Date S~led••• : 04/30/09 08:45 Date Received.. : 05/01/09% MOisture..... : 48
Matrix.•..... : SOLID
PARAMETER RESULT
Dilution Factor; 1
Prep Batch I ... : 9125076Uranium 410
LOT#F9EOI0259 REVISED
50.0 mg/kg SW846 6010BAnalysis Time .. : 00:40
05/05-05/06/09 LA7FA1AD
21 of 36
Andrews Engineering, Inc.
Client Sample ID: E-60
General Chemistry
TESTAMERICA - ST. LOUIS
Lot-Sample I : F9EOI0259-009Date Sampled : 04/30/09 08:45% MOisture•.•.. : 48
PARAMETERPercent Moisture
Work Order 1: .... : LA7FADate Received•. : 05/01/09
Matrix...•..... : SOLID
Dilution Factor: 1
LOT#F9E010259_REVISED 22 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering, Inc.
C1ient Sample ID: E-59
TOTAL Metals
Lot-Sample I : F9E010259-010Date Samp1ed : 04/30/09 10:30 Date Received.• : 05/01/09t Moisture : 46
Matrix•...... : SOLID
RESULTPARAMETERREPORTING PREPARATION- WORKLIMIT UNITS METHOD ANALYSIS DATE ORDER #
------~ ------ ----- ----~~---
Dilution Factor: 1
Prep BatCh I ... : 9125076Uranium 297 50.0 mg/kg SW846 6010B
Analysis Time .. : 01:00
05/05-05/06/09 LA7FC~
LOT#F9EOI0259_REVISED 23 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering, Inc.
Client Sample ID: E-59
General Chemistry
Lot-Sample # ••• : F9E010259-010·Date S~led..• : 04/30/09 10:30'MOisture..... : 46
Work Order #•.• : LA7FCDate Received•• : 05/01/09
Matrix...•..... : SOLID
Dilution Factor: 1
PARAMETERPercent Moisture
LOT#F9E010259_REVISED
PREPARATION- PREPRL UNITS METHOD ANALYSIS DATE BATCH #----- ---------0.10' ASTM Moisture, % 05/09-05/11/09 9131060
Analysis Time .. : 00:00
24 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering, Inc.
Client sample ID: B-58
TOTAL Meta1s
Lot-Sample 1 __ .: F9E010259-011Date S~led_ .. : 04/30/09 12:45 Date Received.. : 05/01/09'MOisture•.•.. : 49
Matr~ : SOLID
WORKORDER #RESULTPARAMETER
REPORTING PREPARATION-LIMIT UNITS METHOD ANALYSIS DATE
--~~--- -~~~-~ ~---- ---------
Dilution Factor~ 1
Prep BatCh I ... : 9125076Uranium 122 50 ... 0 mg/kg SW846 6010B
Analysis Time .. : 01:06
05/05-05/06/09 LA7FBLAD
LOT#F9EOI0259 REVISED 25 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering, Inc.
·Client Sample In: 8-58
General Chemistry
Lot-Sample I ... : F9E010259-011Date Samp1ed•.. : 04/30/09 12:45'Moisture..... : 49
Work Order I ... : LA7FEDate Received.. : 05/01/09
Matrix....•.... : SOLID
Dilution Factor: 1
PA.R.AI"!ETER
Percent Moisture
LOT#F9EOI0259_REVISED
PREPARATION- PREPRL _UN_I_T_S ~ME_T_H~O_D ANALYSIS DATE BATCH #0.10 \ ASTM MOisture. t 05/09-05/11/09 9131060
Analysis Time .. : 00:00
26 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering, Inc.
C1ient ~le ID: E-57
TOTAL Metals
Lot-Sample I ... : F9EOI0259-012Date S~led._.: 04/30/09 13:05 Date Received•• : 05/01/09~ Moisture .•••• : 46
Matrix•...... : SOLID
PARAMETERREPORTING PREPARATION-LIMIT UNITS METHOD ANALYSIS DATE----- --------~---
WORKORDER #
Dilution Factor: 1
Prep BatCh •••• : 9125076uranimn 693
LOT#F9EOI0259_REVISED
50.'0 mg/kg 8W846 6010BAnalysis Time~.: 01:13
05/05-05/06/09 LA7FG1AD
27 of 36
TESTAMERICA - ST. LOUIS
Andrews Engineering, Inc.
Client Samp1e ID: E-57
Genera1 Chemistry
Lot-Sample # : F9EOI0259-012Date Sampled : 04/30/09 13:05% MOisture ••••• : 46
Work Order 1: .... : LA7FGDate Received.. : 05/01/09
Matrix•..•.•..• : SOLID
Dilution Factor: 1
PARAMETERPercent Moisture
LOT#F9E010259_REVISED
PREPARATION- PREP
RL UNITS METHOD ANALYSIS DATE BATCH #----- ---------0.10 \ ASTM MOisture. t 05/09-05/11/09 9131060
Analysis Time .. = 00:00
28 of 36
TESTAMERICA - ST. LOUIS
METHOD BLANK REPORT
TOTAL Meta1s
Client Lot B... : F9E010259 Matrix : SOLID
PARAMETERREPORTING PREPARATION-LIMIT UNITS METHOD ANALYSIS DATE----- ---------
WORKORDER #
MB Lot-Sample I: F9E050000-076 Prep BatCh I ... : 9125076Uranium ND 50.0 mg/kg SW846 GOlOB
Dilution Factor: 1
Analysis Time .. : 23:04
HOTE(S) :
Calculations are performed before rounding to avoid round-off errors in ~Iculated resulrs.
LOT#F9E010259_REVISED
05/05/09 LCA6K1AA
29 of 36
TESTAMERICA - ST. LOUIS
LABORATORY CONTROL SAMPLE EVALUATION REPORT
TOTAL Metals
Client Lot I ... : F9E010259 Matrix : SOLID
METHODPARAMETERPERCENTRECOVERY
RECOVERY
LIMITSPREPAR.A.TION-ANALYSIS DATE WORK·ORDER #---------
LCS Lot-S~le#: F9EOSOOOO-D76 Pr~ Batch # ... : 9125076Uranium 110 {SO - 120} SW846 60l0B 05/05/09 LCA6KIAC
Dilution Factor: 1
HOTElS) :Calculations are performed before rounding to avoid round-off errors in calculated results.
LOT#F9EOI0259 REVISED
Analysis Time AA: 23:10
30 of 36
MATRIX SPIKE SAMPLE BVALtIATIOll REPORT
TOTAL Metals
Client Lot ft ••• : F9E010259Date S~led._.: 04/29/09 08:25 Date Received•• : 05/01/09
TESTAMERICA - ST. LOUIS
Matrix : SOLID
PARAMETERPERCENTRECOVERY
RECOVERY
LIMITS RPD
RPD
LIMITS METHODWORKORDER #
MS Lot-samp1e #: F9E010259-001 Prep Batch 1_ •• : 9125076
Uranium 147 N210 N
(75 - 125)(75 - 125) 23
SW846 60l0B(O-30) SW846 60l0B
t MOisture..... : 4705/05/09 LA7EN1AE05/05/09 LA7ENIAF
NOTE(S) :
Dilution Factor: 1
Analysis Time .. : 23:42
Calculations are performed before rounding to avoid round-off errors in calculated results.
N Spiked analyte recovery is outside stated control limits.
LOT#F9EOI0259_REVISED 31 of 36
TESTAMERICA - ST. LOUIS
MATRIX SPIKE SAMPLE DATA REPORT
TOTAL Metals
Client Lot B••• : F9E010259Date S~1ed.•• : 04/29/09 08:25 Date Received.. : 05/01/09
Matrix.••..•••. : SOLID
SAMPLE SPIKE MEASRD PERCNT PREPARATION-PARAMETER AMOUNT AMT AMOUNT UNITS RECVRY RPD METHOD ANALYSIS DATE---- ~----- -------
MS Lot-~le #: F9EOI0259-001 Prep Batch I ... : 9125076t MOisture .•.•. : 47
Uranium
WORKORDER #
96.4 100 244 N mg/kg 147 SW846 GOlOB96.4 100 307 N mg/kg 210 23 SW846 6010B
Dilution Factor: 1
Analysis Time •. : 23:42
05/05/0905/05/09
LA7EN1AELA7ENIAF
NOTE(S) :
Calculations are perfonned before rounding to avoid round-off errors in calculated results..
N Spiked analyte recovery is outside Stated control limits.
LO.T#F9E 010259_REVI SED 32 of 36
TESTAMERICA - ST. LOUIS
SAMPLE DUPLICATE EVALUATION REPORT
General Chemistry
Dilution Factor: 1
Matrix.••.••. : SOLID
RPD PREPARATION- PREPLIMIT METHOD ANALYSIS DATE BATCH #
SD Lot-Sample #: F9E010259-012(0-0.0) ASTM Moisture/ % 05/09-05/11/09 9131060
Analysis Time .. : 00:000.13
RPD
Work order I ... : LA7FG-SMPLA7FG-DUP
Date Received•• : 05/01/09
%46.3
tmITS-----PARAM RESULTPercent Moisture
46.2
Client Lot # ... : F9E010259
Date ~1ed••• : 04/30/09 13:05% Moisture.•... : 46
DUPLICATERESULT
LOT#F9E010259_REVISED 33 of 36
J. THE LEADER IN ENVIRONMENTAL TESTING
.TestAmericaDrinking Water? Yes 0 No Qt
Temperature on Receipt~--~\A\
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sample 1.0. No. and Oeser/pHon(Containers for each sample may be combined on one line)
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(A fSfll1JI1y bs IlSSBSSBd Ifssmples-are retainedo Archive For Months longerthan 1month)~DisposaJBy Lab
E"$~ 1't'!3c>!o,I/O:Je>
t.Re~8Ji~~r
Tum Around Time Required
o 24 Hours 0 48 Hours 0 7 Days 0 14 Days 0 21 Days
PossIbIB Hazard Identlflcatton -I SsmpJe-fJiiijjiiiiiil
o Non-Hazard 0 Flammable ~Skin Irritant 0 Poison B 0 Unknown 0 Rstum To Clisnt
~ DISTBlSUTION: WHITE- Retumed ta Clisnt with RspOrl: CANARY - Stays with the Sample; PINK .. Field Copy
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THE LEADER IN ENVIRONMENTAL TESTING
TestAmerrca
ao Requirements (Specify)
Drinking Water? Yes 0 Noli(
Temperature on Receipt---
CHent11fIcJrre IfIf Enil"" I/(J,. ..~ Cit
.Project?get'Ch .~s·eJ1 oa~/ / /0'1 Chain oI1C:~7299eCf",
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(; .'" 'ted Cre-~K 2. \ 'l--l; 22 1 -----"- ~ \fllge I~ ~
5; r.t"..r.'eJJ OJ Ix:L I,ittI ISile Contact Lab Oontact Anlfys/~ttaoh 11s('i{ ~.I. j ~
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'7lo,.,eV (;,)e1/ /11~ i I'O/Pi7{.'f1_ :l ~ ~ 'n ~ ~ ~ ! ~ ~ tal In~orWOordrsc:1lPllf!"'1tfierIGuo/e No.
. C:OfK ~tl0l! eee/ptCanta/nelS &q - 36--/1 Matrix PreservativBS
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.2~~~~~~ l~j1 2- t! \\JSample I.D. No. and D680ription I ! ~ i ~ ~i
~ -CDate lims J ! ~ ~ ~ ~~ ~ F:! ,'oJ ~ ..!:;r: ~ ~ ~ ~ ~ '-J(Containers tor each sample maybo combined on one Nne) ~ § ~ t..:: . ~~Qt. U . .\\...
A--s8 '-I/10"/i /Z:'1.$ l- V V75 .. -S-7 '1/,IJ/o' /3: t::lI
~ V V
\ ) lPossible Hazard Idsntification ISample DIsposBJ
..o Non-Hszsrd o RammabJe Ci(SkJn Irritant o PoJsonB o Unknown 0 Return To Client ~a1ByLab
o (A ffHJ may be assessed ifsamples are mfa/nedArchive For __ Months longer than 1month)
Tum Around Time Requlr6d
o 24 Hours D 48 Hours D 7 Days D 14 Days 0 21 Days
1.R~Y
2~
8. ReUnqulshed By
~ Comments
o n~,..nj'ftlrrl"'.J~ .JlSU'T~ J""I'~••__...z._..I"\f:__••••U&.. ri' .... ~ ... i.ii ........- ...:..·:...- .~.t... ..L~ ..._~__ • __ ....... " - ....- ••~.....::----------
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.~Cha;n of~Custody RecordI-l .
~ TAL-4124 (1007)
U1\D
I::utIj<::H(f.)tIjtJ
9. ------10. -------
TESTAMERICA - ST. LOUIS
Time~ ------_......._--
4. -----5. -----
3. -----
Multiple Packages:
Sample Temperature (8):**
.l.~ 6. _
2. V~ 7.~S-/r;' --~
/8. -------
441
Wt#(s):t:4'0'Of~fi)
~.l'-----
Date: 6-/-oj~ Information
Courier~ Other: __- _
6. ------------7. ------------8. ---------------9. "-------------
10. ------------
DHLUPSFedEx
THE L.EADER IN ENVtRONMENTAL T£STJNG
CONDmON UhON RECEIPT FORMClient: And!~
Quote No: 11 ~qlJ
COCIRFA No: I g.,3C?() .. J21:;Jq'l
_ _ ~ Jlnitiated By: ~
TestAmerica
Shipper:
Shippipg # (8):*
1. -_-...---------2. -------------3. ------------4. ------------5. ------------
*Numbered shippi.ng lines correspond to Numbered Sample Temp lines ••Sample must be received at40C :I::ZOC"lfn~ note contents below. Temperaturevariance does NOT affect the fol1owing: Metals-Liquid or Rad tests· Uquid or Solids
1~..y
1.
2.
3..
4.
5.
6.
. 7.
Was sample received broken?
Is sample volume sufficient foranal sis?
8.
9.
10.
11.
12."
13. y
Are there custody seals present on bottles?
Do custody seals ort bottles appear to betam red with?Was sample received with proper pH'? (If not,make note below)
Sample received in proper containers?
Headspace in VOA or TOX liquid samples?(If Yes. note sample 10's below)
Was Internal COC/Workshare received?
Was pH taken by original TestAmerica lab?
1 For DOE..AL (pantex, LANL. Sandia) sitcs~ pH of ALL containers received must be verified, EXCEPTVO~ TOX and soils.
Notes:
Informed by: _Corrective Action:D Client Contact Name:o Sample(s) processed ~'as is~
o Sa~l~~onh~duntit ffrcl~~~n6ti~: ~~~~~~~~~~~~~~~~_
Project Management Review: Date: S(!l.l...09~------------THIS FORM MUST BE COMPLETED AT E TIME THE ITEMS ARE BEING CHECKED IN. IF ANY ITEM IS COMPLETED BY SOMEONE OTHER THANTHE lNITIATOR, THEN THAT PERSON IS UtRED TO APPLY THE1R INITIAL AND THE DATE NEXT TO THAi ITEM.
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