Document MGxrq8zw03LyegyBdwMLp611M
CoSlcThLesBteurr,liVngetromnont
Extended Data Package SDG: 117633
Case Narrative Chain of Custody................................................................................................ Sample Report Summary - Geotechnical......................................................... Supportive Documentation - Geotechnical...................................................... Sample Handling................................................................................................. Last Page of this Document...............................................................................
1 2 5 23 29 32
Case Narrative
i
ST LS E V E R N
TRENT
November 30, 2006
Mr. Charlie Young Weston Solutions 1400 Weston Way West Chester, PA 19380
STL Burlington 208 South Park Drive, Suite 1 Colchester, VT 05446
Tel: 802 655 1203 Fax: 802 655 1248 www.stl-inc.com
Re: Laboratory Project No. 26000 Case: 26000; SPG: 117633
Dear Mr. Young:
Enclosed are the analytical results for the samples that were received by STL Burlington on October 18th, 2006. Laboratory identification numbers were assigned, and designated as follows:
Lab ID
Client Samle ID
Sample Date
Sample Matrix
Received: 10/18/06 ETR No: 117633
692378 692379 692380 692381 692382 692383 692384 692385 692386 692387 692388 692389 692390 692390DP 692391 692392 692393
DL3F01MSF0050041105 DMCF01IPW0030041105 DMCF01IPW0040041105 DMCF01IPW0050041105 DMCF01MSW0030041105 DMCF01MSW0040041105 DMCF01MSW0050041105 DMCF01MSF0020041105 DMCF01MSF0030041105 DMCF01MSF0040041105 DMCF01MSF0050041105 DMCF01IPF0030041105 DMCF01IPF0040041105 DMCF01IPF0040REP DMCF01IPF0050041105 DL3F01IPF0040041021 DL3F01IPF0050041021
11/05/04 11/05/04 11/05/04 11/05/04 11/05/04 11/05/04 11/05/04 11/05/04 11/05/04 11/05/04 11/05/04 11/05/04 11/05/04 11/05/04 11/05/04 10/21/04 10/21/06
TISSUE TISSUE TISSUE TISSUE TISSUE TISSUE TISSUE TISSUE TISSUE TISSUE TISSUE TISSUE TISSUE TISSUE TISSUE TISSUE TISSUE
Documentation of the condition of the samples at the time of their receipt and any exception to the laboratory's Sample Acceptance Policy is documented in the Sample Handling section of this submittal.
In order to accommodate field length limitations in processing the data summary forms, the laboratory did, in certain instances, abbreviate the sample identifiers. Dashes have been removed from the client identifiers in this delivery group. The electronically formatted data provides the full sample identifier.
Leaders in Environmental Testing
1.1
Severn Trent Laboratories, Inc.
STL
November 30, 2006 Mr. Charlie Young Page 2 of 2
Lipids: There were no exceptions to the method quality control criteria during the analyses of these samples.
The analytical results associated with the samples presented in this test report were generated under a quality system that adheres to requirements specified in the NELAC standard. Release of the data in this test report and any associated electronic deliverables is authorized by the Laboratory Director's designee as verified by the following signature.
If there are any questions regarding this submittal, please contact me at 802 655-1203.
O I r
r/~\l \ I
Ron Pentkowski Project Manager
Enclosure
1.2
Chain of Custody
2
COPY -ORIGiNAt ON BUS
^sJ_lJjSfrraw m s z
CHAIN OF CUSTODY / ANALYSIS REQUEST FORM
EXYGEN RESEARCH SAMPLE RECEIVING
T: 814-231-8032
F: 814-231-1580
3048 Research Drive
State College, PA 16801
PAGE 5 of 6
PROJECT INFORMATION Client: W eston Solutions, Inc.
1400 Weston Way, Bldg. 5-2 West Chester, PA 19380 T: 610-701 -3761 F: 610-701-7401
Project Manager: Jal Kesarl emrtil: I.kesarl(westonsol utio ns.com
Project Name: Reference No:
Decatur, Alabama 02181-129-081-0001
ANALYSES REQUESTED
I
Sampler:
Charles Young
P.O. #: Quotation #:
Grab Sample Composite
No. of Containers Percent Lipids (STL)*
SAMPLE ANALYSIS
ExyLIMS #
Collection
Client Samipie Identification | | Date DL3 F01 MSF003 0 041105 5-NOV-04 DL3 F01 MSF004 0 041105 5-NOV-04 DL3 F01 MSF005 0 041105 5-NOV-04 DMC F01 IPW003 0 041105 5-NOV-04 DMC F01 IPW004 0 041105 S-Nov-04 DMC F01 IPW005 0 041105 5-NOV-04 DMC F01 MSW003 0 041105 S-Nov-04
! DMC F01 MSW004 0 041105 5-NOV-04 DMC F01 MSW005 0 041105 5-NOV-04 DMC F01 MSF002 0 041105 5-NOV-04
Collection
Time
8:10 8:15 8:20 8:20 8:25 8:30 8:45 8:50 8:55 9:10
X X X X X X X X X X
Sample
Matrtx
1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue
CHAIN OF CUSTODY
^ f e lio q u is h e d ^ :
C
/tJDartMe
Cooler ID No.: (oauM
Time
Received By: Fed Ex
Cooler Temp. (C):
Date Time
tenikis
/fo o
* Subsample of macerated tissue to be sent to STL for Percent Lipid analyses
Comments
< Ou.
CL
XX
XX XX
XX
XX
XX
XX XX
XX
XX
PROJECT REQUIREMENTS
f a Results Deadline:
Laboratory Report Options:
Sample Results Only
Add Case Narrative
Add Quality Control Summary
Add Calibration Summary
Add Raw Data Other:
CHAIN OF CUSTODY / ANALYSIS REQUEST FORM_______
EXYGEN RESEARCH SAMPLE RECEIVING
T: 814-231-8032
F: 814-231-1580
3048 Research Drive
State College, PA 16801
PAGE J3_ of _6
PROJECT INFORMATION Client: Weston Solutions, Inc.
1400 Weston Way, Bldg. 5-2 West Chester, PA 19380 T: 610-701-3761 F: 610-701-7401
Project Manager: Jai Kesari em<ail: i.kesarkStwestonsolutions.com
Project Name: Reference No:
Decatur, Alabama 02181-129-081-0001
ANALYSES REQUESTED
Sampler:
Charles Young
P.O. #: Quotation #:
Grab Sample Composite No. of Containers
Percent Lipids (STL)*
SAMPLE ANALYSIS
ExyLIMS #
[Client Samipie Identification [
DMC F01 MSF003 0 041105
DMC F01 MSF004 0 041105
DMC F01 MSF005 0 041105
JV -ic Ft>f i P F o o 0
P' 1
oh n t F
Z)Aic
IF F * *? 0
Collection Collection
Date
5-NOV-04 5-NOV-04 5-NOV-04
Time
9:15 9:20 9:30
X X X
f ' N t j-tH
5"-AAi -tfM
0 :/d fi: v i ;rr
jL <
X-
Sample Matrix
1 Tissue 1 Tissue 1 Tissue
/ T u t * /
<
Comments
< O
ou .. XX XX XX
</ X. X
CHAIN OF CUSTODY
^^RelinquishedJBy:
Date
Cooler ID No.:
Time
Received By:
FedEx
------ r~------------------------
Cooler Temp. (C): Date Time
i j r n c (tilo
" --7 1
* Subsample of macerated tissue to be sent to STL for Percent Lipid anafyses
Ox,
PROJECT REQUIREMENTS
Results Deadline: Laboratory Report Options:
Sample Results Only Add Case Narrative Add Quality Control Summary Add Calibration Summary
Add Raw Data Other:
Sample Report Summary - Geotechnical
5
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL3F01MSF0050041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSLIE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692378 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Liplds Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL Cone. Qual.
1 0.1
0.1
U
Printed on: 11/28/06 01:21 PM
6
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DMCF01IPW0030041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692379 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Llpfds Determination
Analytical Analytical
Run Date Batch
Units DF RL Cone. Quai.
11/28/06
% 1 0.1 0.9
Printed on: 11/28/06 01:21 PM
7
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DMCF01IPW0040041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692380 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Llpids Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL
1 0.1
Cone.
2.9
Qual.
Printed on: 11/28/06 01:21 PM
8
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DMCF01IPW0050041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692381 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL
1 0.1
Cone.
0.8
Qual.
Printed on: 11/28/06 01:21 PM
9
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DMCF01MSW0030041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDG No.: 117633 Lab Sample ID: 692382 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical
Run Date Batch
Units
DF RL
Cone. Qual.
11/28/06
% 1 0.1 0.8
Printed on: 11/28/06 01:21 PM
10
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DMCF01MSW0040041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692383 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL Cone. Qual.
1 0.1
2.1
Printed on: 11/28/06 01:21 PM
11
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DMCF01MSW0050041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692384 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL
1 0.1
Cone.
0.7
Qual.
Printed on: 11/28/06 01:21 PM
12
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DMCF01MSF0020041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692385 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL 1 0.1
Cone. 0.1
Qual.
Printed on: 11/28/06 01:21 PM
13
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DMCF01MSF0030041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692386 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Llpids Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL
1 0.1
Cone.
0.2
Qual.
Printed on: 11/28/06 01:21 PM
14
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DMCF01MSF0040041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SOG No.: 117633 Lab Sample ID: 692387 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Llplds Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL Cone. Qual.
1 0.1
0.3
Printed on: 11/28/06 01:21 PM
15
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DMCF01MSF0050041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692388 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Llpids Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL
1 0.1
Cone.
0.2
Qual.
Printed on: 11/28/06 01:21 PM
16
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DMCF01IPF0030041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692389 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL Cone. Qual.
1 0.1
0.1
u
Printed on: 11/28/06 01:21 PM
17
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DMCF01IPF0040041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692390 Date Received: 10/18/06
Method
LIPIDS
Parameter
VoLlpIds Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL Cone. Qual.
1 0.1
0.9
Printed on: 11/28/06 01:21 PM
18
GEOTECHNICAL / GENERAL CHEMISTRY
Duplicate Sample Report Summary
Client Sample No. DMCF01IPF0040REP
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692390DP Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/28/06
Units
Sample
Duplicate
Result
Sample Result
Cone. Qual. Cone. Qual. RPD*
0.9 0.8 12
* Control Limit for RPD is +/- 20%, unless otherwise specified. Printed on: 11/28/06 01:21 PM
19
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DMCF01IPF0050041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692391 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL Cone. Qual.
1 0.1
0.2
Printed on: 11/28/06 01:21 PM
20
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL3F01IPF0040041021
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692392 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL Cone. Qual.
1 0.1
9.0
Printed on: 11/28/06 01:21 PM
21
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL3F01IPF0050041021
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117633 Lab Sample ID: 692393 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Liplds Determination
Analytical Analytical Run Date Batch
11/28/06
Units %
DF RL
1 0.1
Cone.
4.1
Qual.
Printed on: 11/28/06 01:21 PM
22
Supportive Documentation - Geotechnical
23
STLS E V E R N TRENT
PERCENT LIPIDS
24
Percent Lipids Calculations
Date: Time:
11/28/2006 0930
Analyst: ETR(s):
Client:
CGC 117633 WESTN2
Sample ID
mbl12706f 692378 692379 692380 692381 692382 692383 692384 692385 692386 692387 692388 692389 692390 692391 692392 692393
692390DP
Sample Weight
(g ) 10.00 10.01 9.96 10.04 10.04 10.00 10.00 10.04 10.02 10.04 9.96 10.04 10.01 9.97 10.00 10.01 10.01 10.00
Dish ( Dish/Residue
g) 1.0224 0.9997 1.0306 1.0082 0.9967 0.9912 1.0042 1.0238 1.0194 1.0296 1.0192 0.9846 1.0172 1.0278 1.0069 0.9961 1.0142 1.0081
(g ) 1.0224 1.0004 1.0394 1.0378 1.0046 0.9993 1.0253 1.0311 1.0207 1.0314 1.0217 0.9867 1.0179 1.0366 1.0088 1.0857 1.0557 1.0164
Extract Final Volume (mLs)
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
Aliquot Used in Determination
( mLs )
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
% Lipids
<0.1 <0.1 0.9 2.9 0.8 0.8 2.1 0.7 0.1 0.2 0.3 0.2 <0.1 0.9 0.2 9.0 4.1 0.8 #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
STL Burlington
117633westn2 25
11/28/2006
Percent Lipids Calculations
Date: Time:
11/28/06 0930
Analyst: ETR(s):
Client:
CGC 117633 WESTN2
Sample ID
mbll2706f 692378 692379 692380 692381 692382 692383 692384 692385 692386 692387 692388 692389 692390 692391 692392 692393
692390DP
Sample Weight
(g ) 10.00 10.01 9.96 10.04 10.04 10.00 10.00 10.04 10.02 10.04 9.96 10.04 10.01 9.97 10.00 10.01 10.01 10.00
Dish ( Dish/Residue
g) 1.0224 0.9997 1.0306 1.0082 0.9967 0.9912 1.0042 1.0238 1.0194 1.0296 1.0192 0.9846 1.0172 1.0278 1.0069 0.9961 1.0142 1.0081
(g ) 1.0224 1.0004 1.0394 1.0378 1.0046 0.9993 1.0253 1.0311 1.0207 1.0314 1.0217 0.9867 1.0179 1.0366 1.0088 1.0857 1.0557 1.0164
Extract Final Volume (mLs)
10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10 10
Aliquot Used in Determination
( mLs )
1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1
% Lipids
<0.1 <0.1 0.9 2.9 0.8 0.8 2.1 0.7 0.1 0.2 0.3 0.2 <0.1 0.9 0.2 9.0 4.1 0.8 #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
STL Burlington
117633westn2 26
11/28/06
----- & y Percent Lipids Calculations
CO
Date: Time:
11/28/06 930
Analyst: ETR(s):
Client:
CGC 117633 WESTN2
3
Sample
Weight
Sample ID ( g )
mbl12706f 10.00
692378
10.01
692379
9.96
692380
10.04
692381
10.04 .
692382
10.00
692383 10.00
692384
10.04
692385
10.02
692386
10.04
692387
9.96
692388
10.04
692389
10.01
'692390
9.97
<692391
10.00
692392
10.01
692393
10.01
692390DP 10.00 ------ --------
Extract Final Aliquot Used in
Dish ( Dish/Residue
Volume
Determination
g) (g)
(mLs)
( mLs ) 1
1 HI Uo o .^ T 7 1,0
10 1 t' 10 1
i o Sog ! .o ^ Y
10
1
.covx l.oyjtf
10
1
0.<tlG7 I0OYG
10 . 1
0 9 V X O ti S 3
10
1
i.O iX i. o a s 3
10
1
i .023# Olii
10
1
i , Gi<L/ i C J0 7 i A*<?fc 07>/tf
10 10
1 1
i 0qx 0
i oan
10 10
1 1
.0I7 i 0171
10
1
i oxid 1-OQH
. C3&G |O C ^
10 10
1 1
t O6 S 7
10
1-
i O^/a I C ' i l
10
1
Oo7(
I.O/G*Y
10 -----------10-----------
1 1
40 \
1 ___
[1 h a J O f ^ ------ T
~ --
^
1 /O10 *
1, 1I
10 ' 1
10 1
m1
% Lipids
<0.1 <0.1 <0.1 <0.1 <0.1 <0.1, ,<0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 <0.1 #DTV/0!
#DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0! #DIV/0!
STL Burlington
117633westn2 27
11/28/06
STL BURLINGTON
8Z
o
o ..o c
> mw > m
mh h^ OD mw nz
X >> c-J , X F'
x M 0 y. rJ 0 ^ 0 ^ x; O' c-
r*
q M >|
mw( f )
mX^
w-<
--I
% LIPIDS
O X
ro
Oi-
ro
v~ OH % 0 V/'i
fe V/i
I
Sample Handling
29
,- 1
* f ' ' - 4
.\c ~ * "-*"-
a i v ; ' ;. ;
FedEx IShip Manager | Label 7985 2242 2182
From: Origin ID: (814)231-8032 MarkAmmerman EXYGEN RESEARCH 3058 RESEARCH DRIVE
STATE CO LLE GE , PA 16801
FedM .
Ship Date: 17OCT06 ActWgt: 36 LB System#: 5675287/IN ET2500 Account: S *********
Dry Ice: 11 KGS
REF:
7208 SOUTH PARK DRIVE SUITE 1
If7'
- i * n- K t , 1 -A. *r ,
W'i
u. v' f:
C L S M 14U /tt/23
SHIP TO: (802)655-1203
Ktrk Young
i BILL SENDER
Delivery Address Bar Code .
Severn-Trent Lab-Buriirigton
208 South Park Drive Suite 1
w
o Colchester, VT 05446
^
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J
n ?VI* t l[
'f
PRIORITY OVERNIGHT*
W ED
[)> 01 0205446 840 11 7985224221820201 FDE 133455337 290 1/1 36LB N 208 South PDealirvkerDByr:ive Suite 1 Colchester VT Kirk Young 06
TRK# 7985 2242 2182 F0201
18O C T06
BTV AA
XH BTVA05 44 6 -VT-us ICE 30544693110003217985224221822011
, ^ ^ f',: i * ^
Shipping Label: Your shipment
1 lr.n
irr? > ,
M - *
\ , I
STL BURLINGTON
SAM PL E RECEIPT & LOG IN C HECKLIST
,.
Client: W F S T / J '2 .
Date Received: / Q - i y; - Q f o
Log In Date: / ( / 0 . 7 / # f a
TR^ SDG:
It 7 6 5 s
: Time Received:
Received By:
C(_j--
By: / H t f r Signature:
~
Project: X jc o o
# Coolers Received: *)_
Samples Delivered By: ^Shipping Service Courier o Hand Other (specify)
PM Signature:
Date:
/
/
List Air bill Number(s) df Attach a photocopy of the Air Bill:
*
. X '.
'
COOLER SCREEN
,
There is n o evidence to indicate tampering
Custody seals are present and intact
Custody seal numbers are present
If yes, list custody seal numbers:
-
YES ( NO
X X
*.
NA ; A A L - A COMMENTS LL.i
X
Thermal Preservation Type: Wet Ice Blue Ice None p o th e r (specify)
IR Gun ID: ( ,, 2 -
Correction Factor (CF) = 0
`C
\C 3 ^
^
'
`t j
Cooler 1: Cooler 2:
' 2 S .D "C Cooler 6 - 2 U . U ` C Cooler 7
' C Cooler 11 "C Cooler 12
C Cooler 16 "C Cooler 17
*C "C
Cooler 3: Cooler 4:
' C Cooler 8 ' C Cooler 9
` C Cooler 13 ` C Cooler 14
"C Cooler 18
*C Cooler 19 '
*C C
Cooler 5
C Cooler 10
' C Cooler 15
"C Cooler 20 .
"C
Unless otherwise documented, the recorded temperature readings are adjusted readings to account fo r the CF o f the IR Gun
EPA Criteria: 0-6C, except fo r a ir and geo sam ples which should be a t am bient temperature and tissue samples, which m ay be frozen.
Some clients require therm al preservation cnteria o f 2 -4 ` C o r other such catena. The P M m ust n o tify S M when alternate criteria is specified.
SAMRliEaCON DMONJ - C f e S XWX \ i f i f f T
Sample containers were received intact Legible sample labels are affixed to each container
COC Is present and Includes the following information for each container: Sample ID / Sample Description
-.-YESf S i o l N S:
X
X
-Ly e s
-f^ ilffriiC O M M E N T S s i;^
X .a
Date of Sample Collection Time of Sample Collection Identification of the Sampler . Preservation Type Requested Tests Method(s) Necessary Signatures Internal Chain of Custody (ICOC) Required If yes to above, ICOC Record initiated for every Worksheet s^iyi iPiLEijiNTeg
X
X X
X X X X
L y e s ,'
*
lr ~ . NA.-; i%i` ^ 'lj- IC O M M E N T S > ^ h' F J iF
The sample container matches the COC Appropriate sample containers were received for the tests requested Samples were received within holding time Sufficient amount of sample is provided for requested analyses VOA vials do not have headspace or a bubble >6mm (1/4" diameter) Appropriate preservatives were used for the tests requested pH of inorganic samples checked and is within method specification If no, attach Inorganic Sample pH Adjustment Form
X" X X
X X
X
X L _
^
b > e \r< u y
$ A J cj 'Y x / 'v t s - ^ \ C < . \ C c c > s \
X ) F,
c L ^ J b i s ' R t i / i V i ; tlA
%
1
V'T'f / / '' j A -C cv'I e
**
S )3 ~ r T .P
f jtriF s
!O
S o < A r\p \e
Fb<~ <x\\
' O cjC ` S -e> C
\ c o i' a
o - F O - VA
-F Co
T A k ? A -f ck \ \
>J 1 in d
~ f i - J P F *C~ c H l e /
/V\ J t X 'f - f , z-c\ b-XJJ PcS~
>\:S 1 f)n + -
FSM002:10.26.05:2 STL Burlington
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