Document 6bbzgZrrynJyp8m3O0wZVE6Rm
lPrecise Research. . Proven Results.
Analytical Report
Fliiprochemical Characterization of Aqueous Samples Decatur Outfall 001 FC Monitoring (E04-0548)
Exygen Research Laboratory Report No. L0003445
Testing Laboratory Exygen Research
3058 Research Drive State College, PA 16801
Project Lead Jess Eldridge 3M Environmental Technology and Safety Services 935 Bush Avenue Building 0002-03-E-09 PO Box 33331 St. Paul, MN 55133-3331
.3058 Research Drive State College, PA 16801, USA
exygen.com
1 Introduction
Results are reported for the analysis of aqueous samples received by Exygen Research (Exygen) from PACE Analytical. The Exygen study number assigned to the project is L0003445.
Specific fluorochem ical characterization by liquid chrom atography / tandem mass spectrometry (LC/MS/MS) was requested for all samples. A total of 8 samples (including field duplicates, blanks, and spikes) were received for analysis.
The samples were prepared and analyzed by LC/MS/MS for the following list of fluorochemicals:
Table 1: Target Analysis
Compound Name Perfluorobutanesulfonate (PFBS) Perfluorohexanesulfonate (PFHS) Perfluorooctanesulfonate (PFOS) Perfluorobutvric Acid PerfiuoroDentanoic Acid Perfluorohexanoic Acid Perfluoroheotanoic Acid Perfluorooctanoic Acid Periluorononanoic Acid Perfluorodecanoic Acid Periluoroundecanoic Acid Periluorododecanoic Acid Perfluorobutanesulfonamide (PFB Amide) P eriluorooctanesulfonam ide 2-(N-methvlDerluorobutanesulfonamido)ethvl alcohol
Acronvm C4 Sulfonate C6 Sulfonate C8 Sulfonate C4 Acid C5 Acid C6 Acid C7 Acid C8 Acid C9 Acid C10 Acid C11 Acid C12 Acid FBSA FOSA Me-FBSE-OH
The analytical methods used were originally developed for groundwater samples and were validated by Exygen. The validation protocol and results are on file with Exygen. Only the C8 Sulfonate, FOSA, and C8 Acid were included in the original method validation. It should be noted that the quality control elements included in this analysis demonstrate the applicability of the method to the additional analytes.
2 Sample Receipt
The water samples were submitted in plastic containers. Samples were received at ambient temperature. Samples were stored at 4C from receipt until analysis. Eight individual containers were received. Field samples were collected on 9/21/04 and 9/22/04. Samples were received on 9/23/04. Chain-of-custody information is presented in Attachm ent C.
PAGE2 OF5
3 Holding times
Field and laboratory spikes of these fluorochemicals have shown stability for periods greater than 90 days. Samples were analyzed within 60 days of collection.
4 Methods - Analytical and Preparatory
4.1 LC/MS/MS
4.1.1 Sample Preparation for LC/MS/MS Analysis
W ater samples were initially treated with 200 uL of 250 m g/L sodium thiosulfate solution to remove residual chlorine. Solid phase extraction (SPE) was used to prepare the samples for LC/MS/MS analysis. A 40 mL portion of sample was transferred to a C i8 SPE cartridge. The cartridge was eluted with 5 mL of 100% methanol. This treatm ent resulted in an eight-fold concentration of the diluted samples prior to analysis.
4.1.2 Sample Analysis by LC/MS/MS
In HPLC, an aliquot of extract is injected and passed through a liquid-phase chromatographic column. Based oh the affinity of the analyte for the stationary phase in the colum n relative to the liquid m obile phase, the analyte is retained for a characteristic am ount of tim e. Following HPLC separation, ES/MS provides a rapid and accurate means for analyzing a wide range of organic compounds, including fluorochemicals. Electrospray is generally operated at relatively mild temperatures; molecules are ionized, fragmented, and detected. Ions characteristic of known fluorochem icals are observed and quantitated against standards.
A Hewlett-Packard HP1100 HPLC system coupled to a Micromass Ultima MS/MS was used to analyze the sam ple extracts. Analysis was performed using selected reaction monitoring (SRM). Samples were extracted on 9/27/04. Samples were analyzed on 9/27/04 and 9/28/04. Raw analytical data is provided in Attachm ent D.
5 Analysis
5.1 Calibration
A 9-level calibration curve was analyzed at the beginning and throughout the analytical sequence for the compounds of interest. The calibration points were prepared at 0, 25, 50, 100, 250, 500, 1000, 2500, and 5000 ng/L (ppt) for LC/MS/MS analysis. The instrument response versus the concentration was plotted for each point. Using linear regression with 1/x weighting, the slope, y-intercept and correlation coefficient (r) and coefficient of determination (r2) were determined. A calibration curve is acceptable if r >0.985 (r2 > 0.970).
Calibration standards are prepared using the same SPE procedure used for samples.
All calibration criteria were met for this analysis.
5.2 Blanks
Extraction blanks were prepared and analyzed with every extraction batch of samples. The extraction blanks should not have any target analytes present at or above the concentration of the low-level calibration standard. For these samples, the extraction blanks were compliant.
PAGE3 OFS
instrum ent blanks in the form of clean methanol solvent were also analyzed after every highlevel calibration standard, and after known high-level samples. Again, the blanks should not have any target analytes present at or above the low-level calibration standard. For the samples presented here the instrument blanks are compliant.
5.3 Surrogates
Surrogate spikes are not a component of the LC/MS/MS analytical methods.
5.4 Matrix Spikes
Field and laboratory spikes were prepared using all compounds of interest. Field spikes were prepared by adding a measured volume of field sample to a container spiked with the target analytes by the laboratory prior to shipping containers for sample collection. Laboratory spikes consisted of aliquots of un-spiked field samples that were fortified at the laboratory at the tim e of extraction. Field blank spikes consisted of laboratory water fortified at the laboratory and shipped with the sample containers to the field and back to the laboratory for analysis. Laboratory control spikes (see section 5.6) are samples of laboratory water spiked at the tim e of extraction. Each type of spike provides information needed to assess analyte stability, extraction efficiency, and matrix effects that may impact analytical results. M atrix spike recoveries are given in Attachment B. Please see Section 5.7 for additional discussion of m atrix spike recoveries.
5.5 Duplicates
Field and laboratory duplicates were prepared for each field sample. Duplicate results are given along with the sample results in Attachm ent A.
5.6 Laboratory Control Samples
For LC/MS/MS analyses, Milliq water was spiked with all compounds of interest at 100 and 500 ng/mL during each extraction set. All recoveries for all compounds were between 70 130% in each LCS. Results are given along with the raw data in Attachm ent D.
5.7 Statement of Accuracy
Based on results of field spikes, laboratory fortified field samples, field blank spikes, and laboratory control spikes, the analytical accuracy of all analytes is 30% for all compounds with the following exceptions. Results for the C12 acid and FBSA are accurate to 50%. Results for C5 Acid, C4 Sulfonate, and MeFBSE-OH should be considered as screening quality data. The statements of accuracy are based on an overall evaluation of recoveries of field and laboratory spikes, field blank spikes and laboratory control spikes.
5.8 Data Summary
Please see Attachm ent A for a detailed listing of the analytical results. Results are reported in parts per billion (ppb) (ng/mL). Please note that the lim it of quantitation is 1.0 ng/mL for all compounds except MeFBSE-OH and C4 Acid, which have a quantitation lim it of 4.0 ng/mL.
6 Data/Sample Retention
Samples are disposed of one month after the report is issued unless otherwise specified. All electronic data is archived on retrievable media and hard copy reports are stored in data folders maintained by Exygen.
PAGE4 OF5
7 Attachments
7.1 Attachment A: Results 7 2 Attachment B: Matrix Spike Recoveries 8.3 Attachm ent C: Chain of Custody 8.4 Attachm ent D: Raw Analytical Data
9 Signatures
O ther Lab Members Contributing to Data Karen R lsha
Date Date
PAGE5 OF5
SECTION A
L Report1 Analytical 1
Proven Resulte.
Summary of Fluorochem ical Residues in Outfall 001 Effluent for E04-0548
Sam ple ID
Sample Outfall 001 Sample Outfall 001* Sample Outfall 001 Dup
Equipment Blank Field Blank
C4 Acid** Perfluorobutyric Acid
35.6 39.6 38.2 ND , ND
Analyte Found (ng/mL)
C5 Acid
C6 Acid
Perfluoropentanoic Acid Perfluorohexanoic Acid
8.93 11.1
9.52 11.6
10.4 11.2
ND ND
ND ND
C7 Acid Perfluoroheptanoic Acid
5.71 5.89 5.76 ND ND
Sam ple ID Sample Outfall 001 Sample Outfall 001* Sample Outfall 001 Dup
Equipment Blank Field Blank
Sample ID Sample Outfall 001 Sample Outfall 001* Sample Outfall 001 Dup
Equipment Blank Field Blank
Sample ID Sample Outfall 001 Sample Outfall 001* Sample Outfall 001 Dup
Equipment Blank Field Blank
C8 Acid Perflurooctanolc Acid
22.3 22.8 22:6 ND . ND
Analyte Found (ng/mL)
C9 Acid
C10 Acid
Perfluorononanoic Acid Perfluorodecanoic Acid
ND ND
ND ND
ND ND
ND ND
ND ND
C11 Acid Perfluoroundecanoic Acid
ND ND ND ND ND
C12 Acid Perfluorododecanoic Acid
ND ND ND ND ND
Analyte Found (ng/mL)
C4 Sulfonate
C6 Sulfonate
Perfluorobutanesulfonate Perfluorohexanesulfonate
149 4.48
168 4.61 '
149 4.82
ND ND
ND ND
C8 Sulfonate Perfluorooctanesulionate
22.7 23.5 22.8 ND ND
Analyte Found (ng/mL)
FBSA
12.8 13.3 12.8 ND ND
FSA
2.23 2.28 2.26 . ND ND
Me-FBSE-OH**
4.38 4.28 4.28 ND ND
ND = Not detected = Response between 0 and 1 ng/mL. **ND = Not detected * Response between 0 and 4 ng/mL.
Laboratory Duplicate
.\
<J#^m3 0s.3t5S0a5tat8teRCeoselleagrceh,
Drive PA 16801,
USA
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SECTION B
CH
Recovery Summary of Fluorochemical Residues in Outfall 001 Effluent for E04-0548
Sample Description
Outfall 001 Low Flaid Spiks
Amount Spiked (ng/mL)
C4 Acid*
AmtFound Amount
Amt Found
In Sample Recovered Recovery in Sample
(ng/mL) (ng/mL)
(%)
(ng/mL)
C5 Acid
CSAcid
Amount
Amt Found Amount
Amt Found
Recovered Recovery in Sample Recovered Recovery in Sample
(n g /m L )
(/.)
(ng/mL) (ng/mL)
(%)
(ng/mL)
C7 Acid
Amount
Recovered Recovery
(ng/mL)
<%>
10
35.6
47.9
123
8.93
37.2
372
11.1
21.3
102
5.71
12.3
66
Outfall 001 High Flald Spiks
250
35.6
.224
75
8.93
856 342
11.1
263 101 5.71
202 79
Outfall 001 Spk C
Low Lab Spika
1
35.6
3 9 .2
*
8.93
20.3
*
11.1
12.6
**
5.71 6.97 *
Outfall 001 Spk D High Lab Spiks
500
35.6
1970
387
8.93
3990
798
11.1
816 161 5.71
731 145
Field Blank
Low Flald Spiks
10
ND
12.2
122
ND
11.2 112
ND
9.13
91
ND
11.5
115
Field Blank
High Flsld Spiks
250
ND
246
98 \
ND
222 89
ND
240 96
ND
246 98
Sample Description Outfall 001 Low Flald Spika
Amount Spiked (ng/mL)
Amt Found in Sample
(ng /m L)
C Acid
Amount
AmtFound
Recovered Recovery in Sample
(ng/mL)
(%)
(ng/mL)
C9 Acid
C10 Acid
C11 Acid
Amount
Amt Found Amount
Amt Found Amount
Recovered Recovery in Sample Recovered Recovery in Sample Recovered Recovery
(nfl/mL)_____ (%1,, .. (ng/mL) (ng/mL)
(%)
(ng/mL) (ng/mL)
(%>
10 22.3 28.5 62 0.0421 6.44 64 0.0128 6.99 70
ND
6.98
70
Outfall 001
High Flald Spika
250
22.3
236
86 0.0421 264 106 0.0128 267 107
ND
281 112
Outfall 001 Spk C Low Lab Spika
Outfall 001 Spk D High Lab Spika
1 500
22.3 22.3
23.5 697
* 0.0421 135 0.0421
1.33
129
711 . 142
0.0128 0.0128
1.23 782
122 156
ND ND
1.25 880
125 176
Field Blank
Low Flald Spika
10
ND
11.3 113
ND
11.2
112
ND
10.9
109
ND
12.3
123
Field Blank
High Flald Spika
250
ND
247 99
ND
251
100 ,
ND
250 100
ND
241 96
ND = Not detected Response between 0 and 1 ng/mL. *ND N ot detected = Response between 0 and 4 ng/mL.
J ^ 3 035058 Research Drive iT m s tSatatte College, PA 16801, USA
VT: 800.281.3219 F: 814.272.1019 exygen.com
CH
Recovery Summary of Fluorochemical Residues in Outfall 001 Effluent for E04-0548 Continued
Sample Description Outfall 601 Low Flald Splka
Amount Spiked (ng/mL)
C12 Acid______________________ C4 Sulfonate____________________ C6 Sulfonate____________________ C8 Sulfonate
Amt Found Amount
Amt Found Amount
Amt Found Amount
Amt Found Amount
in Sample Recovered Recovery In Sample Recovered Recovery in Sample Recovered Recovery in Sample R ecovered R ecovery
Ino/mL) (ng/mL)
(%)
(ng/mL) (ng/mL)
(%)
(ng/mL) (ng/mL)
(%)
(ng/mL) (ng/mL)
(%)
10
ND , 4.31
43
149
178 **
4.48
14.7
102
22.7
32.1 94
Outfall 001 High Flald Splks
250
ND
216 86
149
1010
344
4.48
311 123 22.7
341 127
Outfall 001 Spk C Low Lab Splka
1
ND
1.11 \
111
149
159 "
4.48
5.74
"
22.7
24.7
**
Outfall 001 Spk D High Lab Splka
500
ND
874 \ 175
149
1890
348
4.48
614 122 22.7
665 128
Field Blank
Low Fiold Spiko
10
ND
10.3
13
ND
10.2
102
ND
11.0
110
ND
10.8
108
Field Blank
High Flald Splka
250
ND
177 71
ND
256 102
ND
252 101
ND
248 99
Sample Description Outfall 0 0 i Low Flald Splka
Amount Spiked (ng/mL)
FBSA
FOSA
Me-FBSE-OH*
Amt Found Amount
Amt Found Amount
Amt Found Amount
in Sample Recovered Recovery in Sample Recovered Recovery in Sample Recovered Recovery
(ng/mL) (ng/mL)
{%)
(ng/mL) (ng/mL)_____ (%)___ (ng/mL) (ng/mL)
(/.)
10
12.8
23.9
111
2.23
12.4
102
4.38
17.3
129
Outfall 001
High Flald Splka
250
12.8
389 150 2.23
338 134 4.38
0
0
Outfall 001 S pkC Low Lab Splka
Outfall 001 Spk D High Lab Splka
1 500
12.8 12.8
14.3 964
" 190
2.23 2.23
3.48 763
125 152
4.38 4.38
4.07 496
" 98
Field Blank
Low Flald Splka
10
ND
10.7
107
ND
12.2
122
ND
8.35
84
Field Blank
High Flald Splka
250
ND
242 97
ND
256
102 ,
ND
320 128
ND = Not detected = Response between 0 and 1 ng/mL.
\
*ND = Not detected = Response between 0 and 4 ng/mL.
.
" Sample residue exceeded the spiking level by more than 4 times; therefore an accurate recovery cannot be calculated.
J ^ 3 03055f8 Research Drive x r m s tSataite College, PA 16801, USA
VT: 800.281.3219 F: 814.272.1019 exygen.com
SECTION C
3058 Research Drive State College, PA 16801
Phone: 814-272-1039 Fax: 814-231-1580
i p i i f i f s p r e r e n p T
Login #: P ro je c t:
3555 P0000689
Company Name: 3M
Subm itted By: Jess Eldridge
Login Type:
Im m ediate Receipt o f Sam ples
S ta rte d :
True
Date Start:
09/23/2004
Due Date:
10/23/2004
Received Date: 09/23/2004
Received By:
Am m erm an, M ark
Spread Sam ple:
Label:
Exygen SD/PI: Risha, Karen Project Title/Type: D ecatur O utfall 001 FC M onitoring / ROUTINE
Login Notes:
Conform Notes:
;ontorm
am pie:
Conform COC:
Conform Sam ple:
Conform Request:
rue True True True
Package PK0004220
C a rto n
Packages / Containers
Mail Date / C ondition
S h ip p e r/ ID
9/23/2004 2:08:11PM Package & Contents Uncompromised
FEDEX 8479 6709 6571
Temp. Control/Tem p.
None 23.4
D irection / Handled By
RECEIVED Ammerman, Mark
Container # C0045991 C0045992 C0045993 C0045994 C0045995 C0045996 C0045997 C0045998
Gross Weight pH
Container Type
615.70 g
500 ml Clear Plastic Narrow
612.20 g
500 ml Clear Plastic Narrow
595.50 g 247.40 g
500 ml Clear Plastic Narrow
500 ml Clear Plastic Narrow
255.00 g 261.30 g 257.90 g 258.10 g
500 ml Clear Plastic Narrow
500 ml Clear Plastic
Narrow 500 ml Clear Plastic
Narrow 500 ml Clear Plastic
Narrow
Preservative NONE NONE NONE NONE NONE NONE NONE NONE
Mfg. Lot
Mfg. ID
9/23/2004 Login.rpt
Report Version: Sep 3 2004 9:36AM Page 1 of 2
Instance:
R0121893 ^
Sample ID L0003445-0001 L0003445-0002 L0003445-0003 L0003445-0004 L0003445-0005 L0003445-0006 L0003445-0007 L0003445-0008
Container C0045991 C0045992 C0045993 C0045994 C0045995 C0045996 C0045997 C0045998
Matrix LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID
Fraction Water
Samples
Sample Equipment Blank
Water
Sample Outfall 001
Water
Sample Outfall 001 Dup
Water
Outfall 001 Low Spk (10 ppb)
Water
Outfall 001 High Spk (250 ppb)
Water
Field Blank
Water
Field Blank Low Spk (10 ppb)
W ater
Field Blank High Spk (250 ppb)
Date Sampled Date Received Date Due
09/21/2004 09/23/2004
10/23/2004
09/22/2004 09/23/2004 10/23/2004
09/22/2004 09/23/2004
10/23/2004
09/22/2004 09/23/2004 10/23/2004
09/22/2004 09/23/2004
10/23/2004
09/22/2004 09/23/2004 10/23/2004
09/22/2004 09/23/2004 10/23/2004
09/22/2004 09/23/2004
10/23/2004
9/23/2004 Login.rpt
Report Version: Sep 3 2004 9:36AM Page 2 of 2
Instance:
R0121893
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Required Client Information:
3 m e r f s sCompany
Section A
Address
CHAIN-OF-CUSTODY / Analytical Request Document
The Chaln-of-Custody Is a LEGAL DOCUMENT. A ll relevant fields must be completed accurately.
Required Client Information:
Section B
___________________
857010
for.Report To:
CopyI TTao*:
s. fldr, eke. *
Page: / of j
To Be Com pleted by Pace Analytical and C lient Quote Reference:
Client Information (Check quote/contract):
Invoice To:
Requested Due Date:
TAT:
Project Manager:
Section C
P.O. *Tum around time less than 14 days subject to
Project Name: ->e-e*-"er-' " ~
j l A .
laboratory and contractual obligations and may result in a Rush Turnaround Surcharge.
Ko{J
P C l r ir h r tflt) 3 n i A. Turn Around Time (TAT) in calendar days.
Fax
h>)7W - 2&
Project Number: --
OUT f a n
OOt
~
________L___
. ._
S e ctio n D
Required Client Informatio i:
Valid Matrix Codes
MATRIX
CODE
DRINKING WATER DW
GROUNDWATER GW
SAMPLE ID
SURFACE WATER SW WASTE WATER WW
One character per box. (A-Z, 0-9 /.-)
Sample IDs MUST BE UNIQUE
PRODUCT SOIL
O IL WIPE AIR OTHER
P SL
OL WP AR OT
COLLECTED
START
^ ---------
DATE
TIME
END
DATE
TIME
Preservatives
1C<ICO5M 01zCOoX XozCOzCj [
p
\s
4
t
M
L
j
2?f
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i
fi\ k V c
r
Ate u O k / / a btm
OtJ t
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Mill
ft
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d L
Wc 1
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3 l/W c
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*/-4 y o ? & - 1 ^ ief I y k 3 0 $ t i c 1
fl2 j(o < i i o 5 L < 1
t ------- V -- 3
n |>v-. 111
t-r. '
t.
M ATRIX CODE SAMPLE TYPE G=GRAB C=COMP. SAMPLE TEMP AT COLLECTION
Unpreserved WT i
Project #:
to y -o s tS Profile #.
/ q Tr f Hf y /
// // / / / / / > i >
---- 1 U f,
/Remaries Lab ID
IS
-
IS !f
1__
1
,, _
SITE LOCATION
REGULATORY AGENCY
NC SC GA Qther
NPDES GROUND WATER DRINKING WATER
UST
RCRA
Other_________
SAMPPLUE CONDITION
SAMPLE NOTES
Temp in C R eceived on Ice Y/N
U ife y .
.
' )> / s j , 7-fO i -
"> 7A i_
tv
0- - /"6 ^ / L
c i* f 6,,o < L
Sealed C ooler Y/N
S am ples Intact Y/N Additional Comments:
fa /b i
` Oos 0 0 1 rvjC-
V^
3
( 0 0 ^ d r Pb
Vis/
i
RELINQUISHED B Y /AFFILIATIO N
JLDATE i TIM E I ACC EPTED BY / AFFILIATION
DATE TIME
SAMPLER NAME AND SIGNATURE
~fPRINT Name of SAMPLER^
q C jZ fo l b 'S i
DATE Signed: (M M /D D /Y Y ).
9/
jn d m u o o G la su p o fl !o ily!sn A \ Y q 0 T 3 U 0 -1 Q ~ K B 0
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DC .jO-IO-
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X 1. Complete al Client lnfrmation''at:td ^ li^ .M ||^ ^ |g L m o , address, pinone, contact (person to whom
report will be sent and contact can be m ade ifufijyfistians arise), billing information if different from
\ . . client,
3roject Name and/or Project Number as it will a'ppear oh the report. "
\ \ ' r v \ v-,\
x2 . uote Reference, Project Manager, Project No. and ProfilCNQ-iwill b dprriplifed by Pace.
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. jSampler should print their ipam initmspaqq `pn^dfed ^d, sign;theif nan^, fqlipwpd by thq date of | , C l
thesam pling event, i ; , ! N i ! j
^ " ; 1 J ;* l
;:
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1
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5.;Complete!simple Description as.it.will appeanon.the laboratoiiy
jsample matrix, no^ of cqnfainers^and presery^tive used. | J
report; .:>
include j .
thfoi jj
of
s`^lu1m.'p,.ing,
' ' ^^
4. "y
; -v -v y
IL*
:
!6. jAnalysis Requested; Complete analysis on the fines provided ahd place a chepk jn tjhe column for, j the samples requiring the analysis, it may be necessary to use the.space provided for additional: 1
1comments of
;
7, Submission of samples to laboratory: Indicate Itenrj Number of those samples beirig transferred;
sign relinquished by, and include your affiliation. ;
1i ! ' i ;
!
IMPORTANT NOTE:
m*P,
If this does not satisfy your requirements, arrangements
c,
iO rau
Special Project Requirements such as Low
Detection Limits or level of QC repOif^f-iffiMs!
be indicated on th4 chain of custody. (Use Additional Comments Section.)
npirrirwi`'twwt
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'aceAnalytical*
R e tir e d Client Information: Company
3 /7 7 e
Address
SGCtiOF) A rf ss
CH/UN-OF-CUSTODY / Analytical Request Document
The Chaln-of-Custody is a LEGAL DOCUMENT. A ll relevant fields m ust be com pleted accurately.
Required Client Information:
Section B
_____ ______
857010
Report To:
oe ? r. J ? S 5 S . f i d r . clrf e
Copy To:
Page: t of
A To Be Completed by Pace A nalytical and C lient
Quote Reference:
Client Information (Check quote/contract):
Invoice To:
Requested Due Date:
Project Manager:
Section C
Phpne
Fax
P.O.
Pn ^ u i iNluaiMmve.:
[)C
--
q fu /V -- Je-
Ofj F C G/fi
Project Number:
o u > Ta l l o d i
*Tum around time less than 14 days subject to laboratory and contractual obligations and may result in a iRiuu- sa hii Tl uuiri Knauruouunnud gSuuiruchi aairygce..
, Turn Around Time (TAT) in calendar days.
S e ctio n D
Required Client Information:
S A M P L E ID
One character per box. (A-Z, 0-9 /.-)
Sample IDs MUST BE UNIQUE
Valid M atrix Codes MATRIX
DRINKING WATER GROUNDWATER SURFACE WATER WASTE WATER PRODUCT
SOIL O IL WIPE AIR OTHER
CODE
DW GW SW WW P
SL OL WP AR OT
i4 ? -- JOl
'*rr k 2 *
0 ' i U Q /v7 l i .
O O-L ?
E
O
l
i > /1 t o r 1r IJZ
r 2\ uT
j n. , 7r IS
ile
-MJ
IL 0 l
1
,/4 h
ft 2 u H i
of G
llll e
c
1
Preservatives
COLLECTED
START
END
DATE
^ TIME
DATE
TIME
0CO
0
CO
1w
0zCO 0
XX
X
Od CO
<z3
9
z
/i,
- i|
/$'- j
'I: ^ lc ? o 5 1 %c i
tOM'S f.W it>s j o 5
I
a ......... v ; V
^ ....... -- *
MATRIX CODE SAMPLE TYPE G=GRAB C=COMP. SAMPLE TEMP AT COLLECTION
Unpreserved Methanol
Project #:
Profile #.
Analysis:
<D .C
O r-
*Prg;-;
.
1 S:!
*
.
Ill
l-Vr;
|G -
-*
...
j
SITE LOCATION
REGULATORY AGENCY
NC SC - GA ] OQtlher________
NPDES GROUND WATER DRINKING WATER
UST
RCRA
Other_________
SAMPLE CONDITION Temp in C
SAMPLE NOTES
ri1 ^ y
RELINQUISHED BY /AFFILIATIO N j DATE | TIME I ACCEPTED BY / AFFILIATION DATE I TIME
V ^ - U e r ----------------
p /l ----- '
/
------------ f /------, f-:i -----------
R eceived on Ice Y/N
Sealed C ooler Y/N
Sam ples Intact Y/N Additional Comments:
4
0 ' /
^ / _
uO*-,,
..... "
~7P~
f i AH-
G OI
(C.
!} \ O HiM K o I
i 1 r< I '
f ,;J
T :/. t ^ v
*
- ^
J-
SAMPLER NAME AND SIGNATURE PRINT Name of SAMPLER*.
___________ SIG NYU R EjJ SAMPLER:
DATE Signed: (MM / D D / YY)>
9 / -> / - * A / 0 y
I0V ? 8
's-'A ' Y
- TBW
.. **\ ' - a/:-
* V'
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Instructions for completing Chain of Custody (COC)
1. Complete-all' Client In fd fffl^ fltf laMisg'
address, phone, contact (person to whom
report will be sent and contact can be m ade ^questions arise), billing information if different from
client, P O # /Project Name and/or Project Number as it will appear on the report. |
\
.. - V
5.
-
-.1
2. Quote Reference, Project M e a g e r, Project No. and Profile No. will be completed by Pace.
; : i!
J -1 ; ' '}
3. A separate COC must be filled out for each day of sample collection.
>,
4. Sampler should print their name in the space provided and sign their name followed by the date of
the sampling event.
\
;
5. Complete Sample Description as it will appear on the laboratory report; include time of sampling,
sample matrix, no. of containers and preservative used.
V
6. Analysis Requested: Complete analysts-ofvthe lines provided and place a check in the column for the samples rquiring the analysis. It may be necessary to use the space provided for additional comments or include attachments for extended lists of parameters.
7. Submission of samples to laboratory: Indicate Item Number of those samples being transferred; sign relinquished by, and include your affiliation.
* IMPORTANT NOTE:
Standard Turnaround.Time is 2 weeks. If this does not satisfy your requirements, arrangements must be made prior to samples being subm ittM bM the laboratory. Contact your project manager.
Special Project Requirements such as Low Levtfl Detection Limits or level of QC reported must be indicated on the chain of custody. (Use Additional Comments Section.)
9/22/2004
Project: E04-0548
3M ENVIRONMENTAL LABORATORY Preliminary/Unauthorized Report
Page 1 o f2
R equester: Schnobrich, D ana M (223-1N -08) D epartm ent: 530711 Project N um ber 0022674449 D ate R eceived: 8/4/2004 P roject D escription: D ecatur O utfall 001 FC M onitoring Q uarterly Com m ents:
C om pletion D ate:
Project Lead: Jess S. E ldridge Phone N um ber 651-778-5233 E m ail A ddress: jseldridge@ m m m .com
Project Results/Activitv P ace F ield Sam pling E vent
3M Sample Number
Sampled Date
Sample Description
E04-0548-72462
9 /2 1 /2 0 0 4
Outfall 001 Effluent - Composite
LAB EXYGEN
Analytical Method LCMS
E04-0548-72463
9 /2 1 /2 0 0 4
Components PFOS
Result
PFHS
PFBS
FOSA
PFBAmide
MeFBSE-OH
C 4acid
C5 acid
C6 acid
C7 acid
PFOA
C9 acid
CIO acid C ll acid
C12 acid
Outfall 001 Effluent - Composite Duplicate
LAB EXYGEN
Analytical Method LCMS
Components PFOS PFHS PFBS FOSA PFBAmide MeFBSE-OH C4 acid C5 acid C 6 acid C7 acid PFOA C 9 acid CIO acid C ll acid
Result
RL RL
Qualifier Qualifier
9/22/2004
3M ENVIRONMENTAL LABORATORY Preliminary/Unauthorized Report
Project: E04-0548 (coot.)
3M Sample Number
Sampled Date
Sample Description
E04-0548-72463 (cont.) 9/21/2004
Outfall 001 Effluent - Composite Duplicate
LAB EXYGEN
Analvtical Method LCMS (cont)
Cooinonentx C12 acid
Result
E04-0548-72464
9/21/2004
Field Control/Travel Blank
LAB EXYGEN
Analvtical Method LCMS
Comoonents PFOS PFHS PFBS FOSA PFBAmide MeFBSE-OH C 4 acid CS acid C 6 acid C7 acid PFOA C 9 acid CIO acid C l I acid C12 acid
Result
E04-0548-72465
9 /2 1 /2 0 0 4
Equipment Blank
LAB EXYGEN
Analvtical Method LCMS
Components PFOS PFHS PFBS FOSA PFBAmide MeFBSE-OH C4 acid C 5 acid C 6 acid C7 acid PFOA C 9 acid CIO acid C ll acid C12 acid
Rwult
Page 2 o f 2
L Qualifier RL Qualifier
RL Qualifier
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t a s t e deliver this shipment w ithout obtaining a signature
m i aeneto indemnifyandhold us harmless from any resulting claims.
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