Document GmkE943qGRX1XJ2d62wgr9Xkm
RECYCLED
Ul co
AR226-2663
Proven Results.
AR226-2663
Analytical Report
v Air Sampling Fiuorochemical Report
DuPont Washington Works - Air Sampling Program Round 8 xygen Research Report No. L00Q1448
12./l
Testing Laboratory
Exygen Research . 3058 Research Drive State College, PA 16801
Requester
Michael D Aucoin URS Corporation Barley Mill Plaza Building 27 Room 1260 Lancaster Pike and Rt 141 Wilmington, D E , 19805
ALL DATA CONTAINED IN THIS REPORT WAS GENERATED BY EXYGEN RESEARCH
Page 1 of 7
3058 Research Drive
\State College, PA 16801, USA T: 800.281.3219
F: 814.272.1019
' lIif'
Summary
;\ :
Seven solid media samples were received by Centre Analytical Laboratories, Inc. (dba Exygen Research) (Exygen) from DuPont Corporation. The media represent samples of air collected on OVS tubes. Please see Table 1 for a completed listing of samples received and field air volumes collected. Sample WWK-A-AMS6-E8 had sampler problems during collection. No results are
reported for this sample.
The samples were analyzed for Perfluorooctanoic Acid (C8 Acid) using liquid chromatography / mass spectrometry (LCMS). The method employed is entitled "Method of Analysis for the Determination of Perfluorooctanoic Acid (PFOA) in OVS Airtubes by LCMS" (James Miller, Exygen Research, February 17, 2003).
The OVS tubes were separated into three fractions for specific fluorochemical analysis. Fraction A consisted of the filter, backing material and plastic ring. Fraction B contained the first bed of XAD resin and the PUF backing. Fraction C contained the second bed of XAD \ resin and PUF backing. Fractions A and B were extracted with 1 mL of methanol. Fraction C jwas not analyzed but saved for possible future analysis. Perfluorodecanoic Acid (CIO Acid) was added as a surrogate spike to each fraction prior to extraction.
Instrument operating conditions can be found at the beginning of each analytical run. Raw
instrument data is given in Appendix A. Chain-of-custody information can be found in
Appendix B.
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ALL DATA CONTAINED IN TfflS REPORT WAS GENERATED BY EXYGEN RESEARCH
Page 2 o i l
Results Summary
Request #
WWK-A-AMS1-E8 A WWK-A-AMS1-E8B WWK-A-AMS1-E8C WWK-A-AMS1-E8 (Total)
-
Air Volume Sampled (L)
.
: 1666 1666 1666
C8 Acid ' (mq/m3)
: <0.00006 < 0.00006 NA <0.00012
/a j
< 0 ' I 2--
WWK-A-AMS2-E8 A WWK-A-AMS2-E8 B WWK-A-AMS2-E8 C
WWK-A-AMS2-E8 (Total)
.
WWK-A-AMS3-E8 A WWK-A-AMS3-E8 B WWK-A-EMS3-E8 C
WWK-A-EMS3-E8 (Total)
: WWK-A-AMS4-E8 A WWK-A-AMS4-E8B . WWK-A-AMS4-E8 C
WWK-A-AMS4`E8 (Total)
WWK-A-AMS5-E8 A WWK-A-AMS5-E8 B WWK-A-AMS5-E8 C
WWK-A AMS5-E8 (Total)
1461
: 1461
1461
-
1400 1400 1400
1521 1521 1521
1431 1431 1431
<0.00007 < 0.00007
NA <0.00014
< 0.00007 < 0.00007 \ NA <0.00014
< 0.00007 <0.00007
NA <0.00014
<0.00007 < 0.00007
NA <0.00014
<ot 0. if < 0 , [L \ < 0,)f
NA - Not Analyzed. B fraction was below the quantitation limit, therefore the backup fraction does not require analysis.
1. "<" is defined as not detected at or above the reported level.
. 2. Sample results have not been corrected for blank results or control spike recoveries.
3. Please note the following descriptions of the OVS sample tube fractions:
Fraction
Fraction Description
.A B C
Frit Extract 1st set beads extract 2nd set beads extract (not analyzed)
9 ALL DATA CONTAINED IN THIS REPORT WAS GENERATED BY EXYGEN RESEARCH Page 3 of 7
OC Data
lcs
..
, v. -
.
Please note: One control sample was spiked with each perfluorooctanoic acid to give a final concentration of 500 ppb. Air was pulled
through the tube at a rate of 1-liter per minute for one hour (60 liters of air). The fractions Were separated and analyzed. The
acceptable range for control recovery is 75-125%.
'
Request # Control 1
C8 Acid (amount spiked - ppb)
500
C8 Acid (amount recovered - ppb)
435
C8 Acid (percent recovery
87
Blanks
Request # WWK-A-AMSFBLK-E8 A WWK-A-AMSFBLK-E8 B
Voi. Of Air (L)
0 -0
C8 Acid . (uq/fraction)
<0.10 <0.10
ALL DATA CONTAINED IN THIS REPORT WAS GENERATED BY EXYGEN RESEARCH Page 4 of 7
.arrogates
. . ' ;
: ' .
A surrogate spike (CIO Acid) was added to all O V S tubes to give a final concentration of 500 ppb in the extract.
Surrogate spike recoveries are given in the fo llo w in g table. There are no set criteria for surrogate spike
recoveries. A dvisory ranges are 75-125% .
\ :;
Sample #
WWK-A-AMSFBLK-E8 A WWK-A-AMSFBLK-E8 B
WWK7A-AMSI-E8 A WWK-A-AMS1-E8B WWK-A-AMS2-E8 A ' WWK-A-AMS2-E8 B WWK-A-AMS3-E8 A WWK-A-AMS3-E8 B WWK-A-AMS4-E8 A WWK-A-AMS4-E8 B WWK-A-AMS5-E8 A WWK-A-AMS5-E8 B
Control Spike A Control Spike B
Amount Spiked
(ppb)
. 500
.
500
500
500
500
500
500
500
500
: 500
500
500
500 T
500
Amount Recovered Percent Recovery
(PPb) r 454
318 434 253 475 283 502 269 . 447 373 447 394
V : 437 278
:
; .
.
(%) . 91 64* 87 51* .... . . 95 57* 100 5 4 * . ., 89 75 89 79 87 56*
* Surrogate recovery outside of advisory range.
tl
.
-
. a l l DATA CONTAINED IN THIS REPORT WAS GENERATED BY EXYGEN RESEARCH
Page 5 of 7
Calculations
Request #
WWK-A-AMSFBLK-E8 A WWK-A-AMSFBLK-E8 B
WWK-A-AMS1-E8 A WWK-A-AMS1-E8 B , WWK-A-AMS2-E8 A WWK-A-AMS2-E8 B WWK-A-AMS3-E8 A WWK-A-AMS3-E8 B WWK-A-AMS4-E8 A WWK-A-AMS4-E8 B WWK-A-AMS5-E8 A WWK-A-AMS5-E8 B
Control Spike A Control Spike B
Vol. Of Air (L) 0 0
1666 1666 1461 1461 1400 1400 1521 1521 1431 1431
0 0
C8 Acid (raw-ppb)
< 10 <10 < 10 < 10 31 <10 27 <10 53 . <10 71 <10 435 <10
C8 Acid (ug/fraction)
<0.10 <0.10 <0.10 <0.10 <0.10 <0.10 <0.10 <0.10 <0.10 <0.10 <0.10 <0.10 0.44 <0.10
C8 Acid (mg/m3)
< 0.00006 , <0.00006 <0.00007 <0.00007 <0.00007 < 0.00007 < 0.00007 <0.00007 <0.00007 <0.00007
:
ALL DATA CONTAINED IN THIS REPORT WAS GENERATED BY EXYGEN RESEARCH Page 6 of 7
Exam ple Calculation
\ ' " '
^ iV
For sample WWK-A-AMS2-E8 A C8 Acid,
:= y. .
[31 ng/ml of C8 Acid x (1 ml) x (1 ug / 1000 ng) x (1 mg / 1000 ug) ] / [(1461 L) x (1 m3 /
iooo L)]
;-
: . . ;
.
= ; < 0.00007 mg / m3
v: y'
'
Signatures
ALL DATA CONTAINED IN THIS REPORT WAS GENERATED BY EXYGEN RESEARCH Page 7 of 7
JU
Table 1. Login Information / Field Data
Sample ID
Exygen Lab ID
Date Received Description
WWK-A-AMSFBLK-E8 A WWK-A-AMSFBLK-E8 B WWK-A-AMSFBLK-E8 C
WWK-A-AMS1-E8 A WWK-A-AMS1-E8 B WWK-A-AMS1-E8 C ' WWK-A-AMS2-E8 A WWK-A-AMS2-E8B WWK-A-AMS2-E8 C WWK-A-AMS3-E8 A WWK-A-AMS3-E8 B WWK-A-AMS3-E8 C WWK-A-AMS4-E8 A WWK-A AMS4-E8 B WWK-A-AMS4-E8 C WWK-A-AMS5-E8 A WWK-A-AMS5-E8 B WWK-A AMS5-E8 C
Control Spike A Control Spike B Control Spike C
L0001448-1 L0001448-2 L0001448-3 L0001448-4 L0001448-5 L0001448-6 L0001448-7 L0001448-8 L0001448-9 L0001448-10 L0001448-11 L0001448-12 L0001448-13 L0001448-14 L0001448-15 L0001448-16 L0001448-17 L0001448-18 L0001448-19 L0001448-20 L001448-21
12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/3
12/13/03 12/13/03 12/13/03 .1 2 /1 3 /0 3 12/13/03 12/13/03 12/13/03 12/13/03
Frit extract 1st set beads extract 2nd set beads extract Frit extract 1st set beads extract 2nd set beads extract Frit extract 1st set beads extract 2nd set beads extract Frit extract 1st set beads extract 2nd set beads extract Frit extract 1st set beads extract , 2nd set beads extract Frit extract 1st set beads extract 2nd set beads extract Frit extract , 1st set beads extract 2nd set beads extract
.
Air Volume Sampled (L)
, 0 . "."O' ; ' 0 1666 1666 1666 1461 1461 1461 1400 1400 1400 1521 1521 1521 ,1431 1431 1431 '' O. ' -0' 0
' '.
jjBUBsess
Table 2. Chain of Custody
Sample ID
WWK7A-AMSFBLK-E8 A WWK-A-AMSFBLK-E8 B WWK-A-AMSFBLK-E8 C
WWK-A-AMS1-E8 A WWK-A-AMS1-E8 B WWK-A-AMS1-E8 C WWK-A-AMS2-E8 A WWK-A-AMS2-E8B WWK-A-AMS2-E8 C WWK-A-AMS3-E8 A WWK-A-AMS3-E8 B WWK-A-AMS3-E8 C WWK-A-AMS4-E8 A WWK-A AMS4-E8 B WWK-A-AMS4-E8 C WWK-A-AMS5-E8 A WWK-A-AMS5-E8 B WWK-A AMS5-E8 C
Control Spike A Control Spike B Control Spike C
Date Collected
12/12/03 12/12/03 : 12/12/03 12/12/03 . 12/12/03 12/12/03 12/12/03 12/12/03 12/12/03 12/12/03 12/12/03 12/12/03 12/12/03 12/12/03 12/12/03 12/12/03 12/12/03 12/12/03
NA NA NA
Date Received at Exygen
Date Extracted by Exygen
12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 ; 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03 12/13/03
12/30/03 12/30/03
NA 12/30/03 12/30/03
NA 12/30/03 12/30/03
NA 12/30/03 12/30/03
NA 12/30/03 12/30/03
NA 12/30/03 12/30/03
NA . . 12/30/03
12/30/03 NA
Date Analyzed by Exygen
12/30-12/31/03 12/30 -12/31/03
NA 12/30-12/31/03 12/30 -12/31/03
NA 12/30 -12/31/03 12/30 -12/31/03
NA 12/30-12/31/03 .12/30 -12/31/03
NA 12/30 -12/31/03 12/30 -12/31/03
NA 12/30-12/31/03 12/30-12/31/03
NA 12/30 -12/31/03 12/30-12/31/03
NA :
Login#: Project:
1558
:.
P0000419 ;
^:
Conform CC Sample: True
Conform COC:
True
Project Storage:
;-
Conform Sample:
True
Company Name: DUp 0nt de Nemours & Co, Inc. Submitted By: Michael D. Aucoin .
T ;
Conform Request: : . ,.
True
Status:
Unreceived
. .. :
:
;
Login Type:
Immediate Receipt of Samples
Started: . . T .. '
T
. " .
y -
;" ' .:,
Date Start:
12/15/2003
\
Due Date:
12/29/2003
^ ;v / ^
Received Date: 12/13/2003
.
.
.
. Received By:
AMMERMAN, MARK
:
Spread Sample:
;
v
Label:
;
;
.:
''
._- '
Project Title/Type: Analysis of PFOA in OVS Tubes / ROUTINE
Exygen SD/PI: MILLER, JAMES
Login Notes:
As per Mike Auco|n-sampleWWK-A-AMS6-E8 Is cancelled.. MSA 12/15/03
^ .
Conform Notes:
:
Package 1K0002039
J
Carton
Packages / Containers
Mail Date / Condition
Shipper / ID
12/13/2003 1:30:47PM Package & Contents Uncompromised
FEDEX 8353913019500200 *
Container# CO021141 C0021142 C0021143 C0021144
. C0021145 C0021146 C0021147 C0021148 C0021149 C0021150 C0021151 C0021152 C0021153 C0021154 C0021155 C0021156 C0021157 - C0021158 C0021159 C0021160 C0021161
Gross Weight
7.1 g
7.1 g
7.1 g
7.1 g 7.1 g
7.1g
7.2 g
.
7.2 g
7.2 g ;
7.2 g
7.2g
7.2 g
7.1 g
7.1 g
7.1 g
7.2 g .
7.2 g -
7.2 g
7.1 g - . , .
7.1 g
7.1g .
P
Container Type
. Other Other Other Other Other Other Other Other Other Other Other Other Other Other . Other Other Other Other Other Other Other
Preservative NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE
Temp. Control/Temp. None 23.3
Mfg. Lot
Miscellaneous item Key
,) None
Description
ICOC
Direction / Handled By RECEIVED
AMMERMAN, MARK
Mfg, ID
12/15/2003 Login, rpt
. o llb j
Report Version: Dec 12 2003 11:28AM Page 1 of 4
Instance:
R0076149
R0076149
Sample ID .. Matrix
' 0001448-0001
GAS
,001448-0002
GAS
L0001448-0003
GAS
L0001448-0004
GAS
L0001448-0005 GAS
L0001448-0006
GAS
' L0001448-0007 GAS
L0001448-0008 GAS
L0001448-0009 GAS
, L0001448-0010
GAS
L0001448-0011
GAS
. L0001448-0012
GAS
L0001448-0013 GAS
i L0001448-0P14 GAS
L0001448-0015
GAS
' L0001448-0016 GAS
L0001448-0017
GAS
L0001448-0018 ; GAS
. L0001448-0019
GAS
L0001448-0020 GAS
, L0001448-0021
GAS
Samples
Fraction . Sample
:
OVS Tubes , WWK-A-AMSFBLK-E8 A
OVS Tubes WWK-A-AMSFBLK-E8 B
v
OVS Tubes WWK-A-AMSFBLK-E8 C
:- , ,
OVS Tubes WWK-A-AMS1-E8 A
OVSTubes . WWK-A-AMS1-E8 B '
- ,\ :
OVSTubes WWK-A-AMS1-E8C
OVSTubes;; WWK-A-AMS2-E8 A
OVSTubes WWK-A-AMS2-E8 B
\
OVS Tubes / WWK-A-AMS2-E8 C . ' v ; ^
,;
OVS Tubes WWK-A-AMS3-E8 A / ; : *
OVSTubes WWK-A-AMS3-E8 B
OVSTubes WWK-A-AMS3-E8 C ' .
-
OVS Tubes WWK-A-AMS4-E8 A
--^
:
OVS Tubes WWK-A-AMS4-E8 B
OVS Tubes WWK-A-AMS4-E8 C
;:
OVSTubes WWK-A-AMS5-E8 A
OVSTubes WWK-A-AMS5-E8 B . ; -
:
OVSTubes. WWK-A-AMS5-E8 C
OVSTubes Control 1 A i .
-
OVSTubes Control 1 B
:.
OVSTubes Control 1 C
.
: .
Date Sampled Date Received 12/12/2003 12/13/2003 12/12/2002 12/13/2003 12/12/2002 12/13/2003 12/12/2003 12/13/2003
. 12/12/2003 12/13/2003 12/12/2003 12/13/2003 12/12/2003 12/13/2003 12/12/2003 12/13/2003
. 12/12/2003 12/13/2003 ' 12/12/2003 12/13/2003
12/12/2003 12/13/2003 12/12/2003 12/13/2003 12/12/2003 12/13/2003 12/12/2003 12/13/2003 12/12/2003 12/13/2003 12/12/2003 12/13/2003 12/12/2003 12/13/2003 12/12/2003 12/13/2003 12/15/2003 12/13/2003 12/15/2003 12/13/2003 12/15/2003 12/13/2003
Date Due 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003 12/29/2003
. 12/15/2003 ' Login.rpt
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Report Version: Dec 12 2003 11:28AM Page 2 of 4
Instance:
R0076149
R0076149
\0 0 0 1 4 4 8 -0 0 0 1
Container 1 o0021141 /Other/NONE
'
':
B o ttle s ; Method
'
.
L 0 0 0 1 4 4 8 -0 0 0 2
Container
:
C0021142/Other/NONE
' v
./ ...v- -
Method
L 0 0 0 1 4 4 8 -0 0 0 3
Container
'
C0021143/ Other / NONE
. /
. Method -
/
;
L 0 0 0 1 4 4 8 -0 0 0 4
Container C0021144/Other /NONE
-
/ - Method
.
.
L 0 0 0 1 4 4 8 -0 0 0 5
Container C0021145/Other/NONE
: ::
. V-Method
..
L.0001 448-00 06
. Container V-0021146/Other/NONE j\
L 0 0 0 1 4 4 8 -0 0 0 7
. Container C0021147/Other/NONE
:: ';
:
.
' ; Met hod Method
:
L 0 0 0 1 4 4 8 -0 0 0 8
Container C0021148/Other/NONE
Method
V
L00 0 1448-0009
Container C0021149/Other/NONE
'
Method
L 0 0 0 1 4 4 8 -0 0 1 0
Container C0021150/ Other /NONE
Method
L 0 0 0 1 4 4 8 -0 0 1 1
. Container . C0021151 /Other/NONE
/
Method
^001448-0012 Container
.-
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Method
u Ubo
Report Version: Dec 12 2003 11:28AM Page 3 of 4
Instance:
R0076149
R0076149
.
C0021152/O th e r/N O N E
L0001448-0013
^ Container ~ ,0021153/Other/NONE
'` . ' , . / "
Method ' V . . . ..
L 0001448-0014
Container C0021154 / Other / NONE
Method
L0001448-0015
Container C0021155/Other/NONE
.Method
L0001448-0016
. ; \yv
^
- Container C0021156/Other/NONE
; ''
;. ..
. Method ; .: ....
L0001448-0017
. A ' ' -' ,
.' . 'A A A
` Container
. 00021157/Other/NONE . ' ~
; L0001448-0018
' V /' . ;
A
.
' .. Method
V ,:
Container
X C0021158/Other/NONE
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) ,. . . .
... .. . .
' lA(D01448-0019
..
.
. ... .
Method
. .^
-
Container 00021159/Other/NONE
' '.
v Method . . .'
L0001448-0020
Container C00211 6 0 /O th e r/N O N E
Method
,.
.
L0001448-0021
Container C0021161 /Other/NONE .
.
Method .
I
12/15/2003 Login.rpt
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Report Version: Dec 12 2003 11:28AM Page 4 of 4
Instance:
R0076149
R0076149
F vw n
RESEARCH
PROJECT ItviFQRMTiN Client (name & address):
C H A IN O F C U STO D Y/A N A LYSIS REQUEST F O R M
Exygen Research Sample Receiving * 3117 Research Drive State College, PA 16801, USA T: 814.231.8032 F: 814.231.1580 exygenresearch.com
Page
, ? of
i! Project Manager (Name & E-mail Address):
ES
rn
Phone: Fax:
Sampler:
A c)
/ 2 ft f t ) g>[ % ~ \ M f t '
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Project Name: >->
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RO. # :
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Q uotation#:
Please fill out this form c o m p le te ly to ensure correct analysis and proper handling of your samples.
eQ
?
Composite Number of Containers
SAMPLE A N A L Y S I S -
Collection Collection -rQd
ExyLIMS# Client Sample Identification
Date
Time o
u iu O ^ -A - ArmSA - G 8 io u o \c-ft-iv< Y \sa--$
CT1S
1 C7oi ft
<0706 ft "o7 Yn
u) u M - A - f v m S M - e g
0715 T
--'lo--'i--^ --v--'-ijv--
W
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x/*-
LAB USE ONLY
/ 4rt / !
C H A IN t
3 JSTODY
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Specify Matrix Comments
\ A yC
fid A ftW A
V fVvC
\ 3.
P t\o
' 1f r i i _
SC
jl
' 1n i r
A-
_________ <**> tt+sCi d ^fc /f.7 .-`---A1l1in1yI""
) _____
<?/(<! /
,
Cooler ID # id >c /- Cooler Temp. (C) A j
PROJECT REQUIREMENTS
Results D eadline:
R elinquished by ----- yi l-.------_ V ' ....;.y...l.'fM- f ' -
OTHER INFORMATION
D a te
Tim e
It i t Io 3 .. I""'"
nr .
^
Received by \ 4 ) 1<A .
/ $ ! / / / , --- -- --- - -- --~
LAB USE ONLY
Date /* - !'} h
Time CMb
/J A
Laboratory Report O ptions: j | Sample results only
Add case narrative I I Add quality control summary
[~1 A dd calibration sum m ary
CD Add raw data CD O th e r____
Sam pler(s): SO, AC
DuPont W ashington Works A ir Sampling Program
FedEx A irb ill #: 836391301950
L b (
Event Number
Event 8
Pump # 669842 669908 669878 669890 669769 669848 Hours
0 1 2 3 4
Field Blank:
Station # AMS-1 AMS-2 AMS-3 AMS-4 AMS-5 AMS-6 Minutes 0 60 120 V 180 240
yes , yes or no
Exygen ID WWK-A-AMS1-E8 WWK-A-AMS28: WWK-A-AMS3-E8 WWK-A-AMS4-E8 WWK-A-AMS5-E8 WWK-A-AMS6-E8
Hours 5
' 6 : .7
. 8 9'
WWK-K-AMSFBLK-E8
C a libration (pre) Date Start Time : i i S l S top Time C a libration (post) Total M inutes
1.006
11-Dec 0622 12-Dec 0701
1.247
1480
1,002
11-Dec 0632 12-Dec 0706
0.9806
1478
0.9949
11-Dec 0640 ; 12-Dec 0707
0.9132
1471
1.006
11-Dec 0650 12-Dec 0715
1.071
1465
0.9943
11-Dec 0702 12-Dec 0725
0.9626
1462
0.9917 Minutes
11-Dec 0719 12-Dec 0732 Hours Minutes Hours Minutes
1.17 Hours
939 Minutes
300 10 600 15 900
20 .
1200
360 11 660 16 960 420 12 720 17 1020 480 13 780 18 1080
21 22 23
1260 1320 1380
540
14 840 19 .1140 .
24
1440
Total Volum e
OQ ZD ZD
W eather: 12/11 =
Overcast, 37 degrees, possible snow flurries.
12/12=
Overcast, 28 degrees, few flurries.
SAFER operational
yes yes or no
C om m ents Total minutes column is the reading from the monitor counter. Pump AMS-6 stopped with 939 minutes on the counter but would restart to calibrate.
Had difficulty getting pump AMS-3 to start to calibrate.
12/12/2003
Page 1 of 2
airdataevent8.xls
Proven Results.
Sample ^Condition Upon Receipt" Form
Protocol #
..
Exvgen Study #
- p M lS
Date & Time Received 1
n /? i< ? f? ft
Condition o f Samples Temporary Storage Location
ft
a ftft
Initials & Date
. / { f t / i f j l ) f ft
Waybill #
* (o U f o
Comments:
__i-rC -flv e J A ft
r
Mav 24, 2002/3
Q: WORD ,pruevss-louin/SiunpIcCondiiiononReceipt.due
"
J59
J05J Research Drive k Slate College, PA 10801, USA
: 800.281.3219 P: 814.272.1019
e'.'.een.cnni
\
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k.
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4b Express Freight Service
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Delivery commitment may be later in some sreas.
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H I FedEx3DayFreight 1 1-- Third business day
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*Declared value limit S5Q0
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includes FedEx Smell Pek, FedEx Large Pak. and FedEx Sturdy Pak
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/JASvAaiTlaUbleRoDnlAyfYorDFeedlEivxePnryority
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. Ooes t liis shipm ent con ta in dangerous goods?
select locations
-- One box must be checked.
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0' "No I--I Yes s. |___| As per attached
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Shipper's Declaration
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. O^igerous Goods (including Dry leal cannotbe shipped in FedExpackaging.
|___| CargoAircraft Only
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To -HOLD" at FedEx location, print FedEx address
.Jjyecannot deliver to P.0, boxes or P.O.ZIP codes,
I I Obtain Recip.
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Total Weight
Total DeclaredValue* $ .00
Total Charges
a3b3 130 SO
*0 u r liability Is limited to Si 00 unless you declare a higher value. See back'for details.
8 -RciCBSBSignature signtoauthorizedeliverywithoutobtainingsignature.
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By sinning you authorize us to deliver this Shipment without obtaining a signature
and agree to indemnify and hold us harmless from any resuiting claims.
Questions? V isit our Web site a t fedex.com or call 1.80.Go.FedEx:' B00.463.3333. Rev.Oai9 t0/'Ql-Pari/l57BI2*<ibtg31- 200tFedEx` PRIN1E0 INU.SA. WCSL02
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