Document 8RLeMgdv2d63O9o6YD7Rn9qok

T W RESEARCH Precise Research. Proven Results. Analytical Report Fluorochemical Characterization of Aqueous Samples Decatur Outfall 001 FC Monitoring (E05-0368) Exygen Research Laboratory Report No. L0005336 Testing Laboratory Exygen Research 3058 Research Drive State College, PA 16801 Requester Gary A, Hohenstein Environmental Manager, Special Projects, EHS Operations 3M Bldg, 42-2E-27 St. Paul, MN 55133 .3058 Research Drive i State College, PA 16801, USA if: 800.281.3219 kF: 814.272.1019 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 L0005336. Specific fluorochemical characterization by liquid chromatography / 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) Perfiuorooctanesulfonate (PFOS) Perfluorobutvric Acid Perfluorooentanoic Acid Perfluorohexanoic Acid Perfluoroheotanoic Acid Perfluorooctanoic Acid Perfluorononanoic Acid Perfluorodecanoic Acid Perfluoroundecanoic Acid Perfluorododecanoic Acid Perfluorobutanesulfonamide (PFB Amide) Perfluorooctanesulfonamide 2-(N-methvlperluorobutanesulfonamido)ethvl alcohol Acronym 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 5/24/05 and 5/25/05. Samples were received on 5/26/05. Chain-of-custody information is presented in Attachment C. PAGE 2 O F5 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 Water samples were initially treated with 200 uL of 250 mg/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 C18 SPE cartridge. The cartridge was eluted with 5 mL of 100% methanol. This treatment 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 on the affinity of the analyte for the stationary phase in the column relative to the liquid mobile phase, the analyte is retained for a characteristic amount of time. 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 fluorochemicals are observed and quantitated against standards. A Hewlett-Packard HP1100 HPLC system coupled to a PE Sciex API 4000 MS/MS was used to analyze the sample extracts. Analysis was performed using selected reaction monitoring (SRM). Samples were extracted on 6/2/05. Samples were analyzed on 6/2/05 and 6/3/05. Raw analytical data is provided in Attachment 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. PAGE 3 OF5 Instrument 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 time 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 time of extraction. Each type of spike provides information needed to assess analyte stability, extraction efficiency, and matrix effects that may impact analytical results. Matrix spike recoveries are given in Attachment B. Please see Section 5.7 for additional discussion of matrix 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 Attachment 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 Attachment 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 C4 Sulfonate, 4 Acid and C5 Acid should be considered as screening quality because of high and variable field and laboratory matrix spike recoveries. 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 Attachment A for a detailed listing of the analytical results. Results are reported in parts per billion (ppb) (ng/mL). Please note that the limit of quantitation is 1.0 ng/mL for all compounds except MeFBSE-OH and C4 Acid, which have a quantitation limit 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. PAGE 4 OF 5 7 Attachments 7.1 Attachment A: Results 7.2 Attachment B: Matrix Spike Recoveries 8.3 Attachment C: Chain of Custody 8.4 Attachment D: Raw Analytical Data 9 Signatures Other Lab Members Contributing to Data Karen Risha PAGE 5 OF 5 Section A Summary of Fluorochemical Residues in Outfall 001 Effluent for E05-0368 Sample ID Outfall 001 Effluent Outfall 001 Effluent* Outfall 001 Effluent Dup Field Control/Travel Blank . C4 Acid** Perfluorobutyric Acid 22.3 25.2 21.1 ND Analyte Found (ng/mL) C5 Acid C6 Acid Perfluoropentanoic Acid Perfluorohexanoic Acid 2.59 6.02 2.54 5.65 2.37 6.21 ND ND C7 Acid Perfluoroheptanoic Acid 1.32 1.30 1.30 ND Sample ID Outfall 001 Effluent Outfall 001 Effluent* Outfall 001 Effluent Dup Field Control/Travel Blank C8 Acid Perfluorooctanoic Acid 8.33 8.38 8.77 ND Analyte Found (ng/mL) C9 Acid C10 Acid Perfluorononanoic Acid Perfluorodecanoic Acid ND ND ND ND ND ND ND ND C11 Acid Perfluoroundecanolc Acid ND ND ND ND Sample ID Outfall 001 Effluent Outfall 001 Effluent* Outfall 001 Effluent Dup Field Control/Travel Blank C12 Acid Perfluorododecanolc Acid ND ND ND ND Analyte Found (ng/mL) C4 Sulfonate C6 Sulfonate Perfluorobutanesulfonate Perfluorohexanesulfonate 26.2 1.05 26.1 26.9 ND 1.03 0.966 ND C8 Sulfonate Perfluorooctanesulfonate 16.3 16.0 16.3 ND Analyte Found (ng/mL) Sample ID Outfall 001 Effluent Outfall 001 Effluent* Outfall 001 Effluent Dup Field Control/Travel Blank FBSA 9.24 9.16 9.54 ND FOSA . 2.51 2.46 2.55 ND Me-FBSE-OH** ND ND ND ND ND = Not detected = Response between 0 and 1 ng/mL. **ND = Not detected = Response between 0 and 4 ng/mL. 'Laboratory Duplicate 0006 \ TJ^30.350E58 Research Drive > # m s tSatatte College, PA 16801, USA J: 814.272.1039 F: 814.231.1580 exygen.com Section B CH Recovery Summary of Fluorochemical Residues in Outfall 001 Effluent for E05-0368 Sample Description Outfall 001 Low Field Spike C4 Acid*____________________ C5 Acid______________________ CBAcid______________________C7 Acid Amount Amt Found Amount Amt Found Amount Amt Found Amount Amt Found Amount Spiked in Sample Recovered Recovery in Sample Recovered Recovery in Sample Recovered Recovery in Sample Recovered Recovery (ng/mL) (ng/mL) (ng/mL) (%) (ng/mL) (ng/mL) (%) (no/mL) (ng/mL) (%) (ng/mL) (ng/mL) (%) 10 22.3 40.1 178 2.59 30.4 278 6.02 13.3 73 1.32 11.0 97 Outfall 001 High Field Spike 250 22.3 ,402 152 2.59 513 204 6.02 180 70 1.32 187 74 Outfall 001 Spk C Low Lab Spike 1 22.3 26> ** 2.59 6.00 341 6.02 7.69 167 1.32 2.81 149 Outfall 001 Spk D High Lab Spike 500 22.3 2080 412 2.59 1620 324 6.02 674 134 1.32 514 103 Field Blank Low Field Spike 10 ND 11.8 1.18 ND 8.71 87 ND ic i 111 ND 9.27 93 Field Blank High Field Spike 250 ND 295 118 . ND 94.6 38 ND 254 102 ND 230 92 Sample Description Outfall 001 Low Field Spike CS Acid C9 Acid CIOAcid C11 Acid Amount Amt Found Amount Amt Found Amount Amt Found Amount Amt Found Amount Spiked in Sample Recovered Recovery In Sample Recovered Recovery in Sample Recovered Recovery in Sample Recovered Recovery (ng/mL) (ng/mL) (ng/mL) (%) (ng/mL) (ng/mL) (%) (ng/mL) (ng/mL) (%) (ng/mL) (ng/mL) (%) 10 8.33 16.4 81 ND 9.15 92 ND 9.25 93 ND 7.64 76 Outfall 001 High Field Spike 250 8.33 197 75 ND 203 81 ND 214 86 ND 183 73 Outfall 001 Spk C Low Lab Spike 1 8.33 9.85 ** ND 1.19 119 ND 1.06 106 ND 1.01 101 Outfall 001 S p k D High Lab Spike 500 8.33 531 105 ND 481 , 96 ND 490 98 ND 497 99 Field Blank Low Field Spike 10 ND 10.0 100 ND 10.1 ,101 ND 10.7 107 ND 11.4 114 Field Blank High Field Spike 250 ND 235 94 ND 247 99 , ND 252 101 ND 243 97 ND = Not detected = Response between 0 and 1 ng/mL. *ND = Not detected = Response between 0 and 4 ng/mL. 0007 J& 3300558 Research Drive -/Tm StSata)te 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 E05-0368 Continued Sample Description Outfall 001 Low Fiald Spika C12 Acid C4 Sulfonate C6 Sulfonate CS Sulfonate Amount Amt Found Amount Amt Found Amount Amt Found Amount Amt Found Amount Spiked in Sample Recovered Recovery In Sample Recovered Recovery in Sample Recovered Recovery in Sample Recovered Recovery (ng/mL) (ng/mU (ng/mL) (%) (ng/mL) (ng/mL) (%) (ng/mL) (ng/mL) (%) (ng/mL) (ng/mL) (%) 10 ND . 7 .1 3 71 2 6 .2 4 7.3 211 1 .0 5 1 1 .6 106 1 6 .3 2 5 .5 92 Outfall 001 High Fiald Spiks 250 ND 222 89 2 6 .2 500 190 1 .0 5 246 98 1 6 .3 243 91 Outfall 001 Spk C Low Lab Spika 1 ND 1 .2 9 129 2 6 .2 2 9.2 " 1 .0 5 2 .3 4 129 1 6 .3 1 8 .2 " Outfall 001 Spk D High Lab Spika 500 ND 640 , 128 2 6.2 936 182 1 .0 5 510 102 16.3 544 106 Field Blank Low Fiald Spika 10 ND 1 7 .2 172 ND 1 2 .8 128 ND 1 0 .8 108 ND 1 0 .5 105 Field Blank High Fiald Spika 250 ND 213 85 ND 182 73 ND 241 96 ND 238 95 Sample Description Outfall 001 LowFialdSpika FBSA FOSA Me-FBSE-OH* Amount Amt Found Amount Amt Found Amount Amt Found Amount Spiked in Sample Recovered Recovery in Sample Recovered Recovery In Sample Recovered Recovery (ng/mL) (ng/mL) (ng/mL) (%) (ng/niL) (ng/mL) (V.) (ng/mL) (ng/mL) (*/.) 10 9 .2 4 1 9 .7 105 2.51 , 13.1 106 0 .9 7 3 1 5 .7 147 Outfall 001 HighFialdSpika 250 9 .2 4 257 99 2.51 ,2 5 1 99 0.973 244 98 Outfall 001 Spk C LowLabSpika Outfall 001 Spk D HighLabSpika 1 500 9 .2 4 9 .2 4 1 1 .3 561 - 110 2.51 2.51 3.58 107 0 .9 7 3 532 106 0 .9 7 3 1 .7 6 532 79 106 Field Blank LowFialdSpika 10 ND 9 .6 2 96 ND 1 0 .6 106 ND 1 1 .3 113 Field Blank HighFialdSpika 250 ND 259 104 ND 266 106 ND 393 157 ND = Not detected = Response between 0 and 1 ng/mL. *ND a Not detected * Response between 0 and 4 ng/mL. . "S am ple residue exceeded the spiking level by more than 4 times; therefore an accurate recovery cannot be calculated. J&30,3505E8 Research Drive jr m s tSatatte College, PA 16801, USA V,T: 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 Loain | Login Group: L0005336 Login #: Project: 5447 P0000689 Company Name: 3M Submitted By: Jess Eldridge Login Type: Immediate Receipt of Samples Started: True Date Start: 05/26/2005 Due Date: 06/25/2005 Received Date: 05/25/2005 Received By: Ammerman, Mark Spread Sample: Label: Exygen SD/PI: Risha, Karen Project Title/Type: Decatur Outfall 001 FC Monitoring / ROUTINE Login Notes: Conform Notes: Conform COC Sample: Conform COC: Conform Sample: Conform Request: True True True True Packaae PK0006272 Carton Date / Condition Packages / Containers ShiDDer/ ID Received Date: 6/25/05 10:20 Package & Contents Uncompromised FEDEX 8517 8989 4480 TemD. Control/TemD. None 23.3 Direction / Handled Bv RECEIVED Ammerman, Mark Container # C0072884 C0072885 C0072886 C0072887 C0072888 C0072889 C0072890 Gross W eiaht dH Container TvDe 604.20 g 500 ml Clear Plastic Narrow 612.80 g 500 ml Clear Plastic Narrow 245.80 g 500 ml Clear Plastic Narrow 247.30 g 258.30 g 500 ml Clear Plastic Narrow 500 ml Clear Plastic Narrow 258.00 g 500 ml Clear Plastic Narrow 259.00 g 500 ml Clear Plastic Narrow Preservative NONE NONE NONE NONE NONE NONE NONE Mfa. Lot Mfa. ID 5/26/2005 Login.rpt 0009 Report Version: Apr 15 2005 1:04PM Page 1 of 2 Instance: R0168416 R0168416 Sample ID L0005336-0001 L0005336-0002 L0005336-0003 L0005336-0004 L0005336-0005 L0005336-0006 L0005336-0007 Container C0072884 C0072885 C0072886 C0072887 C0072888 C0072889 C0072890 Matrix LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID LIQUID Login Fraction Water Samples Sample Outfall 001 Effluent Water Outfall 001 Effluent Dup Water Outfall 001 Effluent 10 ppb Spk Water Outfall 001 Effluent 250 ppb Spk Water Field Control/Travel Blank Water Field Control/Travel Blank 10 ppb Spk Water Field Control/Travel Blank 250 ppb Spk Date Sampled 05/25/2005 05/25/2005 05/25/2005 05/25/2005 Date Due 06/25/2005 06/25/2005 06/25/2005 06/25/2005 06/25/2005 06/25/2005 06/25/2005 Login Reviewed By: Date/Time: S h lc 'F 0 }/S " 5/26/2005 Login.rpt Report Version: Apr 15 2005 1:04PM Page 2 of 2 Instance: R0168423 llllllllllllllllWllllllHil CHAIN-OF-CUSTODY / Analytical Request Document PaceAnalytical www.pacelabs.com Required Client Information: Company 3 no g Address Section A r 4 ss Fax The Chain-of-Custody is a LEGAL DOCUMENT. All relevant fields must be completed accurately. Required Client Information: R eportjb: ff[ r, Copy/ TTon-: Section B FI^v-ido e. f Page: / of / 857096 To Be Completed by Pace Analytical and Client Q uote Reference: Client Information (Check quote/contract): Invoice To: P.O. Project Name: F& Project Number: Requested Due Date: ` TAT: 0 u tfA U - SC [ kv It T *Tum around time less than 14 days subject to laboratory and contractual obligations and may result in a Rush Turnaround Surcharge. Turn Around Time (TAT) in calendar days. L A Project Manager: Project #: E 0 S '- 0 3 ( a8 Profile #: Section C Section D Required Client Information: ValidMatrixCodes SAMPLE ID O ne character per box. (A -Z, 0-9 /.-) Sam ple IDs M U S T BE U N IQ U E 0 L. o o \ Ivu X 'Mr itL L < \ i f L OGWASSWOPOUIRRITARILPRHOIOSLEFEDUTAREUNCDCWEWTAWATATEERTERR WAWOSSOGPRLWLTWPW COLLECTED START END DATE TIME DATE TIME s c* IW$VIloSs f i Ci 1 1 u(U C, //.'S3 Sbdos to S H o r // SJ s/asbs tlX3 _p <\ k Cc id k e.\ % kn lL_ a j * |t4 //:5-3 oCXCOM OzXCO oX oX03OC(CCCQOMMO zz \ <1ecL 5 MATIRXCOD G=SGARMAPBLEC=TYCPO ASTACMOPLLLEETCIETMC Unpreserved Methanol Other /M / / / / / / m / / Remarks/LsabID si jj HBsBBSsHSsBi ----- -- -- -- =*=== --- --- if < 1 SITE LO CATIO N NC SC GA Other_______ NPDES UST REGULATORY AGENCY G RO UND WATER DRINKING WATER RCRA Other___________ SAMPLE CONDITION SAMPLE NOTES Temp in C Received on Ice Y/N A/OTf?-. 6 / t ^ K S A g y o NOT Sealed Cooler Y/N Samples Intact Y/N Additional Comments: "To ta l. RdsTcttuit cijIofnMt -- in i+ tA t- owM-a u - o o \ 0*18 C o w vp o srti oo v. O RIG INA L P iw ed o u f A w - o o I I R ELIN Q U ISH ED B Y / AFFILIATION | DATE I TIM E | AC C EPTED B Y / A FFILIA TIO N MS m s , .. DATE TIME /C f- SA M PLER NAME AND F'G N A TU R E PRINT Name of SAMijER- / 1 / ___ J ( W ^ I t J 7i= r _____ S -/*rJbsSIGNATURE^ SANDLER/ /J // DATE Signed: (MM / DD / YY) SEE /ERSE SIDE FOR INSTRUCTIONS Form COC01 Rev. 0304 f u t 3 / 7 * D r c & 'k s i 5/18/2005 Project: E05-0368 3M ENVIRONMENTAL LABORATORY Preliminary/Unauthorized Report Page 1o f2 Requester: Schnobrich, Dana M (223-1N-08) Department: 530711 Project Number: 0022674449 Date Received: 5/17/2005 Project Description: Decatur Outfall 001 FC Monitoring Quarterly Comments: Completion Date: Project Lead: Kent Lindstrom Phone Number: 651-778-5352 Email Address: krlindstrom@mmm.com Statement of Accuracy:____________________________________________ ProjePcatcRe eFsiuelldts/SAacmtipvliitnvg Event 3M Sample Number______Sampled Date______Sample Description____________ E05-0368-82837 5/24/2005 Outfall 001 Effluent - Composite LAB EXYGEN Analytical Method LCMS Components PFOS PFHS PFBS FOSA PFBAmide MeFBSE-OH C4 acid C5 acid C6 acid C7 acid PFOA C9 acid CIO acid Cll acid C12 acid Result E05-0368-82838 5/24/2005 Outfall 001 Effluent - Composite Duplicate LAB Analytical Method EXYGEN LCMS Components PFOS PFHS Result PFBS FOSA PFBAmide MeFBSE-OH C4 acid C5 acid C6 acid C7 acid PFOA C9 acid CIO acid Cll acid C12 acid RL Qualifier RL Qualifier 2 f in 5/18/2005 3M ENVIRONMENTAL LABORATORY Preliminary/Unauthorized Report Project: E05-0368 (cont.) 3M Sample Number______Sampled Date______ Sample Description_______ E05-0368-82839 5/24/2005 Field Control/Travel Blank LAB EXYGEN Analytical Method LCMS Components PFOS PFHS PFBS FOSA PFBAmide MeFBSE-OH C4 acid C5 acid C6 acid C7 acid PFOA C9 acid CIO acid Cil acid C12 acid E05-0368-82840 5/24/2005 Equipment Blank LAB Analytical Method EXYGEN LCMS Components PFOS PFHS PFBS FOSA PFBAmide MeFBSE-OH C4 acid C5 acid C6 acid C7 acid PFOA C9 acid CIO acid Cil acid Result Result Page 2 o f2 RL Qualifier RL Qualifier  US A irb ill fl517fll3flc44flD s h <; \o ; M ar's T . t Q u ,, ?fc` _i H?- P V PfitC r A tr'o 't] II' a l -Ww/cC-i. 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SAMPLE CONDITION SAMPLE NOTES Temp in C Received on Ice Y/N a Jt? : Ce//ft4cef Sealed Cooler Y/N Samples Intact Y/N Additional Comments: 3 'Total. i A,+ I A L irvuu c?o \ C^posrt en1 oov OUif*Lt- 00{ -- rrwj/-_ G `I2 R ELIN Q U ISH ED B Y / AFFILIATION DATE TIME ACCEPTED BY / AFFILIATION jh ^4^ A " -------- ----------- _ / 7 - DATE TIM E SA M PLER NAME AND SIG N A TU R E PRINT Name o f SAMI m , /^ ; uTa DATE Signed: (MM / DD / YY) SEE SIDE FOR INSTRUCTIONS Form COC01 Rev. 0304 CHAIN-OF-CUSTODY / Analytical Request Document 'aceA nalytical* www.pacelahs.eom Required Client Information: Company 3 jr ) e Address Section A r i, s s Q 7IS- The Chain-of-Custody is a LEGAL DOCUMENT. A ll relevant fields must be completed accurately. Required Client Information: Report To: ffif. Copy<TTVov: S. Section B E l d r tcktg, I _______ ___________ Page: / of / 857096 To Be Completed by Pace Analytical and Client Quote Reference: Client Information (Check quote/contract): Invoice To: Requested Due Date: *TAT: Project Manager: " . LAP.O. 'T u rn around time less than 14 days subject to Project #: Project Name: O u if A U t- o o | laboratory and contractual obligations and may result in a Rush Turnaround Surcharge. Turn Around Time (TAT) in calendar days. Profile #: Project Number: T Section C Section D Required Client Information: SAMPLE ID Valid Matrix Codes MATRIX DRINKING WATER GROUNDWATER SURFACE WATER WASTE WATER CODE DW GW SW WW CL clO >o UJOh Preservatives O ne character per box. (A-Z, 0-9 / . - ) Sam ple IDs M U S T BE U N IQ U E PRODUCT SOIL OIL WIPE AIR OTHER P SL OL WP AR OT Jm 5;-<c0c *h o 5l e Sa 3 H .r - ALL C<>i l Sl* ik // S3 Shs!o$ < * i t I i l ii& Q jj. A I L i oo VB t* <2 i l l Ct v*t ajj Sk,f tt.o i // Si sfa bs U- < 1e Ft Co A Q ' B \AA ^ /c Remarks / U b >01 NC SC ,] GA Other_________ NPDES GROUND WATER UST RCRA SAMPLE CONDITION SAMPLE NOTES DRINKING WATER O th er.__________ Temp in C Received on Ice Y/N ;I C e l/ftM AfbT Sealed Cooler Y/N Samples Intact Y/N Additional Comments: 4 Torni- I c(tlorndE -- In ,4 1a L. ow* Fp Lu oo t O i <? Cnvnpotrtf O iA 1 1*1.1 o o ( t i t O tol ! y* S A M P LE R NAME AND PiG N A TU R E PRINT Name o f SAM] SIGNATURE rn L L f DATE Signed: (MM / DD / YY) S /J trjo s eliSEE ERSE SIDE FOR INSTRUCTIONS Form COC01 Rev. 0304