Document MMBLqpgVD2kMVJaErq5wxz81z
STL Burlington Colchester, Vermont
Extended Data Package
SDG: 117632
Case Narrative Chain of C ustody........................................................................................................ Sample Report Summary - G eotechnical............................................................. Supportive Documentation - G eotechnical.......................................................... Sample Handling......................................................................................................... Last Page of this Document......................................................................................
1 2 14 36 42 45
Case Narrative
i
STLS 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: 117632
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 Sample ID
Sample Date
Sample Matrix
Received: 10/18/06 ETR No: 117632
692358 692359 692360 692361 692362 692363 692363DP 692364 692365 692366 692367 692368 692369 692370 692371 692372 692373 692374 692375 692376 692377
DL1F01MSF0030041104 DL1F01MSF0040041104 DL1F01MSF0050041104 DL1F01IPW0010041104 DL1F01IPW0020041104 DL1F01IPW0030041104 DL1 FOI IPW0030REP DL1F01IPW0040041104 DL1F01IPF0020041104 DL1F01IPF0030041104 DL1F01IPF0040041104 DL1F01IPF0050041104 DL3F01MSW0010041105 DL3F01MSW0020041105 DL3F01MSW0030041105 DL3F01MSW0040041105 DL3F01MSW0050041105 DL3F01MSF0010041105 DL3F01MSF0020041105 DL3F01MSF0030041105 DL3F01MSF0040041105
11/04/04 11/04/04 11/04/04 11/04/04 11/04/04 11/04/04 11/04/04 11/04/04 11/04/04 11/04/04 11/04/04 11/04/04 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
TISSUE TISSUE TISSUE TISSUE 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.
Leaders in Environmental Testing
1.1
Severn Trent Laboratories, Inc.
STL
November 30, 2006 Ms. Kelly Spittler Page 2 of 2
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.
Lipids: The replicate analysis of the field sample DL2F01IPF0010 yielded a Relative Percent Difference (RPD) that was outside the control limits (0-20%) at 44%. The laboratory attributes this anomaly to sample non-homogeneity.
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.
S ' --------------
Ron pentkowski Project Manager
Enclosure
1 .2
Chain of Custody
2
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 3 of 6
PROJEX INFORMATION- J 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
ema il: i.kesarit&westonsolutions.com
Project Name: Reference No:
Decatur, Alabama 02181-129-081-0001
H E 5 E S C d=tl
Sampler:
Charles Young
P.O. #: Quotation #;
Grab Sample Composite No. of Containers
Percent Lipids (STL)* |
S A M P L E A N A L Y S IS
w
____________________ _ _____________________I Collection Collection
ExyLIMS # Client Samiale Identification | | Date
Time
Sample Matrix
Comments
< Ou.
CL
DL1 F01 MSF001 0 041104 4-NOV-04 - DL1 T MSF002 0 041104 4-NOV-D4
~DL1 F01 MSF003 0 041104 4-NOV-04
21:00 21:05 21:10
X X X
1 Tissue 1 Tissue 1 Tissue
_x_i X Ix j X
X
i i
DL1 F01 MSF004 0 041104 4-NOV-04 DL1 F01 MSF005 0 041104 4-NOV-04
21:15 21:20
X X
1 Tissue 1 Tissue
XX XX
DL1 F01 IPW001 0 041104 4-NOV-04 21:25 X
1 Tissue
XX
DL1 F01 IPW002 0 041104 4-NOV-04 DL1 F01 IPW003 j 0 041104 4-NOV-04 DL1 F01 IPW004 0 041104 4-NOV-04 DL1 F01 IPF002 0 041104 4-NOV-04
21:30 21:35 21:40 21:45
X X X X
1 Tissue
1 Tissue
1 Tissue 1 Tissue
XX XX XX XX
PROJECT.REQUIREMENfS. , . -
C H A IN O F C U S T O D Y
Cooler ID No.:
Cooler Temp. (C):
Results Deadline:
.^-Relinquished B y.
Date Time
c ' .... A /y /w y 'V0c>
Received By: Fed Ex
Date Time
^^
///
/ / / / / - --------------- --
//M ilu /h
L. Q - / L j = i -
c f\ VJ
* Subsample of macerated tissue to be sent to STL for Percent Lipid analyses
Laboratory Report Options: Sample Results Only Add Case Narrative Add Quality Control Summary Add Calibration Summary Add Raw Data
Other:
C C P V - O W -. V - ,,!V
*
I
CHAIN OF CUSTODY / ANALYSIS REQUEST FORM
EXYGEN RESEARCH SAMPLE RECEIVING
T: 814-231-8032
F: 814-231-1580
3048 Research Drive
Slate College, PA 16801
PAGE _4_ 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. Jal Kesari emjiil: i.kesarifSwestonsolutions.com
Project Name: Reference No:
Decatur, Alabama 02181-129-081-0001
ANALYSES REQUESTED
Sampler:
Charles Young
P.O. #: Quotation #:
Composite No. of Containers
Percent Lipids (STL)*
SAMPLE ANALYSIS
ExyLIMS #
| Collection Client Samjpie Identification | j ate DL-1 F01 IPF003 0 041104 4-Nov-04
DL-1 F01 IPF004 0 041104 4-Nov-04 DL-1 F01 IPF005 0 041104 4-Nov-04 DL3 F01 MSW001 0 041105 5-Nov-04 DL3 F01 MSW002 0 041105 5-Nov-04 DL3 F01 MSW003 0 041105 5-Nov-04 DL3 F01 MSW004 0 041105 5-Nov-04 DL3 F01 MSW005 0 041105 5-NOV-04 DL3 F01 MSF001 0 041105 5-Nov-04 DL3 F01 MSF002 0 041105 5-Nov-04
-I
Collection
Time
21:50 21:55 22:05 7:45 7:47 7:50 7:52 7:55 8:00 8:05
* a <</>0
n
a2 X X X X X X X X X X
Sample
Matrix
1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue
CHAIN OF CUSTODY
.^-"Relinquished
Date
O' y
Cooler ID No.:
Time /ytw
Received By: Fed Ex
Cooler Temp. (C): Date Time
L ----------- - - . ^ r
Subsample of macerated tissue to be sent to STL for Percent Lipid analyses
Comments
< Ou.
Q.
X J<J
X
X X
JirLi
XX
XX
XX
iX X
XX
XX
PROJECT REQUIREMENTS
ci 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 _5_ 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: Jal Kesari emeill: l.kesari@iwestonsolutions.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
PFOA 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 5-Nov-04 DMC F01 IPW005 0 041105 5-Nov-04 DMC F01 MSW003 0 041105 5-Nov-04 DMC F01 MSW004 0 041105 5-Nov-04 DMC F01 MSW005 0 041105 5-Nov-04 DMC F01 MSF002 0 041105 S-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 Xi
Sample
Matrix
1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue 1 Tissue
CHAIN OF CUSTODY
^-"F^elirjquishedJty:
Date
// s'
Cooler ID No.:
Time
Received By:
FedEx
Cooler Temp. (C): Date Time
A ------------ --------------------
/?<m
* Subsample of macerated tissue to be sent to STL for Percent Lipid analyses
Comments
X x!
!X X XX
XX XX XX XX XX
XX
X " x-
PROJECT REQUIREMENTS
0 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
3117 Research Drive
State College. PA 16801
PAGE _2_ of _4
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 email: i.kesari(5)westonsolutions.com
Project Name: Reference No:
Decatur, Alabama 02181-129-081-0001
ANALYSES REQUESTED
Sampler:
Charles Young
P.O. #: Quotation #:
SAMPLE ANALYSIS
oc
CTl
ExyLIMS # Client Sample Identification
Collection Collection
Date
Time
'zSoo. o*co-*
Sample M a trix
Comments
DL2 F01 IP F 0 0 3 DL2 F01 IPF004
041021 21 -Oct-04 21:50 041021 21-Oct-04 22:00
Tissue Tissue
DL2 F01 1PF005
041021 21 -Oct-04 22:10
Tissue
DL2 F01 IPW001
041021 21-Oct-04 22:15
Tissue
DL2 F01 MSF001
041021 21-Oct-04 22:25
Tissue
D L 2 F01 MSF002
041021 21-Ocl-04 22:30
Tissue
DL2 F01 MSF003
041021 21 -Oct-04 22:35
Tissue
DL2 F01 MSF004
041021 21-Oct-04 22:40
Tissue
DL1 F01 IPF001
041021 21 -Oct-04 22:45
Tissue
DL3 F01 IPF001
041021 21-Oct-04 22:50
Tissue
KH
^
CHAIN OF CUSTODY
Cooler ID N o .: s / r ^ - f
^R g lin g u ^h ^y:
Date Time
Received By:
Cooler Temp. (C): 0*0 Date Time
PROJECT REQUIREMENTS Results Deadline: Laboratory Report Options:
10/22/04 12:00
Fed Ex
_____ --
1 0 /2 2 /0 4
yj i / w
i f lotC
1 2 :0 0 j * 1-
Sample Results Only Add Case Narrative Add Quality Control Summary Add Calibration Summary
Add Raw Data
Other:
l
3058 Research Drive State College, PA 16801
Phone: 814-272-1039 Fax: 814-231-1580
Loain
Login Group: L0003772
Login #: Project:
Company Name: Submitted By: Login Type: Started: Date Start: Due Date: Login Initiated*:
3882 P0000760 Weston Solutions, Inc. Jaisimha Kesari, P.E., DEE Immediate Receipt of Samples True 11/08/2004
11/06/2004
Conform COC Sample: Conform COC: Conform Sample: Conform Request:
True True True True
* Dates entered into "Login Initiated" field prior to 1/5/06 reflect dates of receipt. The field was formerly called "Received Date"
Received By:
Ammerman, Mark
Spread Sample:
Label:
Exygen SD/PI: Flaherty, John
Project Title/Type: Analysis of Perfluorooctanoic Acid (PFOA) in Water, Soil, Sediment, Fish, Clams, Vegetation, Small
Mammal Liver and Small Mammal Serum Using LC/MS/M S for the 3M Decatur Monitoring Program /
ROUTINE
Login Notes:
Conform Notes: Samples DMC-F01-IPF003-0-041105, DMC-F01-IPF004-0-041105, and DMC-F01-IPF005-0-041105 were not on the chain of custody . As per Charles young, add the samples to the chain. MSA 11/08/04
Packaae PK0004581
Carton
Date / Condition
Packages / Containers
S hioo er/ ID
Received Date: 11/9/04 8:34 Package & Contents Uncompromised
FEDEX 8443 9556 8032
TemD. Control/TemD.
Dry Ice 0.0
Direction / Handled Bv
RECEIVED Ammerman, Mark
Container# C0049450 C0049451 C0049452 C0049453 C0049454 C0049455 C0049456 C0049457 C0049458 C0049459 CO049460 C0049461 C0049462 C0049463 C0049464 C0049465 C0049466 C0049467
Gross Weiaht 115.30 g 115.40 g 103.20 g 94.40 g 76.80 g 116.50 g 108.30 g 475.60 g 341.90 g 867.10 g 849.30 g 1,415.00 g 1,739.70 g 1,305.70 g
2,149.40 g 71.60 g 165.70 g 77.20 g
pH
Container TvDe 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag
Preservative NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE
Mfa. Lot
Mfa. ID
10/17/2006
I nnin rnt
Report Version: Oct 12 2006 9:14AM Dana 1 rf 7
7
Instance:
R0291811 Iiiiiiinuimuinninninninninnmimi
Login
Login Group: L0003772
Login #: Project:
Company Name: Submitted By:
3882 P0000760
Weston Solutions, Inc. Jaisimha Kesari, P.E., DEE
Conform COC Sample: Conform COC: Conform Sample: Conform Request:
True True True True
Login Type:
Immediate Receipt of Samples
Started:
True
Date Start:
11/08/2004
Due Date:
Login Initiated*: 11/06/2004
* Dates entered into "Login Initiated" field prior to 1/5/06 reflect dates of receipt. The field was formerly called "Received Date"
Received By:
Ammerman, Mark
Spread Sample:
Label:
Exygen SD/PI: Flaherty, John
Project Title/Type: Analysis of Perfluorooctanoic Acid (PFOA) in Water, Soil, Sediment, Fish, Clams, Vegetation, Small
Mammal Liver and Small Mammal Serum Using LC/MS/MS for the 3M Decatur Monitoring Program /
ROUTINE
Login Notes:
Conform Notes: Samples DMC-F01-IPF003-0-041105, DMC-F01-IPF004-0-041105, and DMC-F01-IPF005-0-041105 were not on the chain of custody . As per Charles young, add the samples to the chain. MSA 11/08/04
Packaae PK0004581
Carton
Date / Condition
Packages / Containers
S hipper/ ID
Received Date: 11/9/04 8:34 Package & Contents Uncompromised
FEDEX 8443 9556 8032
Temp. Control/Temp.
Dry Ice 0.0
Direction / Handled Bv
RECEIVED Ammerman, Mark
Container# C0049468 C0049469 C0049470 C0049471 C0049472 C0049473 C0049474 C0049475 C0049476 C0049477 C0049478 C0049479 C0049480 C0049481
Gross Weiaht 77.50 g 78.30 g 142.40 g 98.00 g 136.20 g 78.50 g 74.50 g 809.60 g 974.70 g
1,111.20g 1,091.70 g 254.60 g 174.10 g 169.90 g
dH
Container Tve 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag
Preservative NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE
Mfa. Lot
Mfa. ID
PK0004582
Container# C0049482 C0049483 C0049484 C0049485 C0049486
Received Date: 11/9/04 8:50 Package & Contents Uncompromised
Gross Weiaht 226.60 g 168.70 g 232.40 g 118.40 g 108.00 g
dH
Container Tvpe 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag
FEDEX 8443 9556 8065
Preservative NONE NONE NONE NONE NONE
Dry Ice 0.0
Mfa. Lot
RECEIVED Ammerman, Mark
Mfa. ID
10/17/2006 1 onin rnt
Report Version: Oct12 2006 9:14AM Dona Ortf7
8
Instance:
R0291811 Illllllll IIIMill Hill mil Hill Dll Hill llllINI
Login
Login Group: L0003772
Login #: Project:
Company Name: Submitted By: Login Type: Started: Date Start: Due Date: Login Initiated*:
3882 P0000760 Weston Solutions, Inc. Jaisimha Kesari, P.E., DEE Immediate Receipt of Samples True 11/08/2004
11/06/2004
Conform COC Sample: Conform COC: Conform Sample: Conform Request:
True True True True
* Dates entered into "Login Initiated" field prior to 1/5/06 reflect dates of receipt. The field was formerly called "Received Date"
Received By:
Ammerman, Mark
Spread Sample:
Label:
Exygen SD/PI: Flaherty, John
Project Title/Type: Analysis of Perfluorooctanoic Acid (PFOA) in Water, Soil, Sediment, Fish, Clams, Vegetation, Small
Mammal Liver and Small Mammal Serum Using LC/MS/MS for the 3M Decatur Monitoring Program /
ROUTINE
Login Notes:
Conform Notes: Samples DMC-F01-IPF003-0-041105, DMC-F01-IPF004-0-041105, and DMC-F01-IPF005-0-041105 were not on the chain of custody . As per Charles young, add the samples to the chain. MSA 11/08/04
Packaqe PK0004582
Carton
Date / Condition
Packages / Containers
ShiDDer/ ID
Received Date: 11/9/04 8:50 Package & Contents Uncompromised
FEDEX 8443 9556 8065
Temp. Control/TemD.
Dry Ice 0.0
Direction / Handled Bv
RECEIVED Ammerman, Mark
Container # C0049487 C0049488 C0049489 C0049490 C0049491 C0049492 C0049493 C0049494 C0049495 C0049496 C0049497 C0049498 C0049499 C0049500 C0049501 C0049502 C0049503 C0049504 C0049505
Gross Weiaht 104.50 g 188.20 g 133.20 g 126.50 g 103.70 g 64.20 g 910.20 g 1,094.90 g 983.90 g 112.90 g 111.80g 88.10 g 177.70 g 67.30 g 69.40 g 45.60 g 232.80 g 287.50 g 222.80 g
dH
Container TvDe 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag 1 gallon ziploc bag
Preservative NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE NONE
Mfa. Lot
Mfa. ID
10/17/2006
I onin rnt
Report Version: Oct 12 2006 9:14AM
D o n o *5 n f 7
9
Instance:
R0291811
ilimili inmumuinnmumumumi mi
Samle ID L0003772-0001
Container C0049450
Matrix SOLID
L0003772-0002
C0049451
SOLID
L0003772-0003
C0049452
SOLID
L0003772-0004
C0049453
SOLID
L0003772-0005
C0049454
SOLID
L0003772-0006
C0049455
SOLID
L0003772-0007
C0049456
SOLID
L0003772-0008
C0049457
SOLID
L0003772-0009
C0049458
SOLID
L0003772-0010
C0049459
SOLID
L0003772-0011
C0049460
SOLID
L0003772-0012
C0049461
SOLID
L0003772-0013
C0049462
SOLID
L0003772-0014
C0049463
SOLID
L0003772-0015
C0049464
SOLID
L003772-0016
C0049465
SOLID
L0003772-0017
10/17/2006 Login.rpt
SOLID
Loqin
Fraction Fish
Sam ples
SamDle DBC-F01-MSW001 -0-041104
Date SamDled 11/04/2004
Date Due
Fish DBC-F01-MSW002-0-041104
11/04/2004
11/08/2004
Fish DBC-F01-MSW003-0-041104
Fish Fish Fish Fish Fish Fish
DBC-F01-MSW004-0-041104 DBC-F01-MSW005-0-041104 DBC-F01-MSF001-0-041104 DBC-F01-MSF002-0-041104 DBC-F01-IPF004-0-041104 DBC-F01-IPF005-0-041104
05 a
f w* f n
i :1
'
Jm Ma yR
f f fV
o (5
z r s' K_ O
O O
sqt
Fish DBC-F01-IPW004-0-041104
11/04/2004 11/04/2004 11/04/2004 11/04/2004 11/04/2004 11/04/2004 11/04/2004 11/04/2004
11/08/2004 11/08/2004 11/08/2004 11/08/2004 11/08/2004 11/08/2004 11/08/2004 11/08/2004
Fish DBC-F01-IPW005-0-041104
11/04/2004
11/08/2004
Fish DOU-F01-IPW003-0-041104
11/04/2004
11/08/2004
Fish DOU-F01-IPW004-0-041104
11/04/2004
11/08/2004
Fish DOU-F01-IPW005-0-041104
11/04/2004
11/08/2004
Fish DL2-F01-IPW002-0-041104
11/04/2004
11/08/2004
Fish DL1-F01-MSW001-0-041104
11/04/2004
11/08/2004
Fish DL1-F01-MSW002-0-041104
Report Versin: Oct12 2006 9:14AM Paqe 4 of 7
10
11/04/2004
11/08/2004
Instance:
R0291811
IIII III lili IIII II lili
C0049466
L0003772-0018
C0049467
SOLID
L0003772-0019
C0049468
SOLID
L0003772-0020
C0049469
SOLID
L0003772-0021
C0049470
SOLID
L0003772-0022
C0049471
SOLID
L0003772-0023
C0049472
SOLID
L0003772-0024
C0049473
SOLID
L0003772-0025
C0049474
SOLID
L0003772-0026
C0049475
SOLID
L0003772-0027
C0049476
SOLID
L0003772-0028
C0049477
SOLID
L0003772-0029
C0049478
SOLID
L0003772-0030
C0049479
SOLID
L0003772-0031
C0049480
SOLID
L0003772-0032
C0049481
SOLID
L0003772-0033
C0049482
SOLID
L0003772-0034
SOLID
10/17/2006
I nnin rnt
Login
Fish DL1-F01-MSW003-0-041104 Fish DL1-F01-MSW004-0-041104 Fish DL1-F01-MSW005-0-041104 Fish DL1-F01-MSF001-0-041104 Fish DL1-F01-MSF002-0-041104 Fish DL1-F01-MSF003-0-041104 Fish DL1-F01-MSF004-0-041104 Fish DL1-F01-MSF005-0-041104 Fish DL1-F01-IPW001-0-041104 Fish DL1-F01-IPW002-0-041104 Fish DL1-F01-IPW003-0-041104 Fish DL1-F01-IPW004-0-041104 Fish DL1-F01-IPF002-0-041104 Fish DL-1-F01-IPF003-0-041104 Fish DL-1-F01-IPF004-0-041104 Fish DL-1-F01-IPF005-0-041104 Fish DL3-F01-MSW001 -0-041105
Report Version: Oct 12 2006 9:14AM
Dorm K s\f 7
11
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/04/2004
11/08/2004
11/05/2004
11/08/2004
Instance:
R0291811
iiiiiiiii iiimumuiiiii iiiiiiiiijummimi
C0049483
L0003772-0035
C0049484
SOLID
L0003772-0036
C0049485
SOLID
L0003772-0037
C0049486
SOLID
L0003772-0038
C0049487
SOLID
L0003772-0039
C0049488
SOLID
L0003772-0040
C0049489
SOLID
L0003772-0041
C0049490
SOLID
L0003772-0042
C0049491
SOLID
L0003772-0043
C0049492
SOLID
L0003772-0044
C0049493
SOLID
L0003772-0045
CO049494
SOLID
L0003772-0046
C0049495
SOLID
L0003772-0047
C0049496
SOLID
L0003772-0048
CO049497
SOLID
L0003772-0049
C0049498
SOLID
L0003772-0050
C0049499
SOLID
L0003772-0051
SOLID
Login
Fish DL3-F01-MSW002-0-041105 Fish DL3-F01-MSW003-0-041105 Fish DL3-F01-MSW004-0-041105 Fish DL3-F01-MSW005-0-041105 Fish DL3-F01-MSF001-0-041105 Fish DL3-F01-MSF002-0-041105 Fish DL3-F01-MSF003-0-041105 Fish DL3-F01-MSF004-0-041105 Fish DL3-F01-MSF005-0-041105 Fish DMC-F01-IPW003-0-041105 Fish DMC-F01-IPW004-0-041105 Fish DMC-F01-IPW005-0-041105 Fish DMC-F01-MSW003-0-041105 Fish DMC-F01-MSW004-0-041105 Fish DMC-F01-MSW005-0-041105 Fish DMC-F01-MSF002-0-041105 Fish DMC-F01-MSF003-0-041105
10/17/2006 I nnin mt
Report Version: Oct 12 2006 9:14AM
12
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
11/05/2004
11/08/2004
Instance:
R0291811 iiliumillmumuiiiiimumumumimi
C0049500
L0003772-0052
C0049501
SOLID
L0003772-0053
C0049502
SOLID
L0003772-0054
C0049503
SOLID
L0003772-0055
C0049504
SOLID
L0003772-0056
C0049505
SOLID
Login
Fish DMC-F01-MSF004-0-041105 Fish DMC-F01-MSF005-0-041105 Fish DMC-F01-IPF003-0-041105 Fish DMC-F01-IPF004-0-041105 Fish DMC-F01-IPF005-0-041105
11/05/2004 11/05/2004 11/05/2004 11/05/2004 11/05/2004
11/08/2004 11/08/2004 11/08/2004 11/08/2004 11/08/2004
Login Reviewed By: _______________________________________________ Date/Time:
10/17/2006
I rtnin rnt
Report Version: Oct 12 2006 9:14AM
t --x t
13
Instance:
R0291811
iiiiiiiiiiiim iliiiiiiiiiiiiiiiiiiiiiiiiiiiiiiiii
Sample Report Summary - Geotechnical
14
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL1F01MSF0030041104
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692358 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical
Run Date Batch
Units DF RL Cone. Qual.
11/27/06
% 1 0.1 0.5
Printed on: 11/28/06 01:04 PM
15
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL1F01MSF0040041104
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692359 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL Cone. Quai.
1 0.1
0.4
Printed on: 11/28/06 01:04 PM
16
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL1F01MSF0050041104
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692360 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL 1 0.1
Cone. 0.1
Qual.
u
Printed on: 11/28/06 01:04 PM
17
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL1F01IPW0010041104
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692361 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Liplds Determination
Analytical Analytical
Run Date Batch
Units
DF RL Cone. Qual.
11/27/06
% 1 0.1 6.6
Printed on: 11/28/06 01:04 PM
18
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL1F01IPW0020041104
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692362 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Llpids Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL Cone. Qual.
1 0.1
10.3
Printed on: 11/28/06 01:04 PM
19
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL1F01IPW0030041104
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692363 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL Cone. Qual.
1 0.1
13.4
Printed on: 11/28/06 01:04 PM
20
GEOTECHNICAL / GENERAL CHEMISTRY
Duplicate Sample Report Summary
Client Sample No. DL1F01IPW0030REP
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692363DP Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/27/06
Units
%
Sample Result Cone. Qual.
13.4
Duplicate Sample Result
Cone. Qual.
8.6
RPD*
44
Control Limit for RPD is +/- 20%, unless otherwise specified. Printed on: 11/28/06 01:04 PM
21
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL1F01IPW0040041104
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692364 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL
1 0.1
Cone.
0.9
Qual.
Printed on: 11/28/06 01:04 PM
22
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL1F01IPF0020041104
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692365 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL
1 0.1
Cone.
8.8
Qual.
Printed on: 11/28/06 01:04 PM
23
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL1F01IPF0030041104
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692366 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL Cone. Qual.
1 0.1
0.1
Printed on: 11/28/06 01:04 PM
24
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL1F01IPF0040041104
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692367 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL Cone. Qual.
1 0.1
1.2
Printed on: 11/28/06 01:05 PM
25
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL1F01IPF0050041104
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692368 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Llpids Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL
1 0.1
Cone.
3.4
Qual.
Printed on: 11/28/06 01:05 PM
26
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL3F01MSW0010041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692369 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Llplds Determination
Analytical Analytical
Run Date Batch
Units DF RL Cone. Qual.
11/27/06
% 1 0.1 2.7
Printed on: 11/28/06 01:05 PM
27
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL3F01MSW0020041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692370 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Liplds Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL
1 0.1
Cone.
0.9
Qual.
Printed on: 11/28/06 01:05 PM
28
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL3F01MSW0030041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692371 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical
Run Date Batch
Units DF RL Cone. Quai.
11/27/06
% 1 0.1 0.9
Printed on: 11/28/06 01:05 PM
29
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL3F01MSW0040041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692372 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Llplds Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL Cone. Qual.
1 0.1
1.4
Printed on: 11/28/06 01:05 PM
30
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL3F01MSW0050041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692373 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Liplds Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL Cone. Qual.
1 0.1
1.0
Printed on: 11/28/06 01:05 PM
31
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL3F01MSF0010041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692374 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL
1 0.1
Cone.
0.2
Qual.
Printed on: 11/28/06 01:05 PM
32
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL3F01MSF0020041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692375 Date Received: 10/18/06
Method
UPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL
1 0.1
Cone.
0.4
Qual.
Printed on: 11/28/06 01:05 PM
33
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL3F01MSF0030041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692376 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Lipids Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL
1 0.1
Cone.
0.3
Qual.
Printed on: 11/28/06 01:05 PM
34
GEOTECHNICAL / GENERAL CHEMISTRY
Sample Report Summary
Client Sample No. DL3F01MSF0040041105
Lab Name: STL BURLINGTON Lab Code: STLVT Matrix: TISSUE % Solids:
Contract: Case No.: 26000 Client: WESTN2
SDGNo.: 117632 Lab Sample ID: 692377 Date Received: 10/18/06
Method
LIPIDS
Parameter
%Llplds Determination
Analytical Analytical Run Date Batch
11/27/06
Units %
DF RL
1 0.1
Cone.
0.3
Qual.
Printed on: 11/28/06 01:05 PM
35
Supportive Documentation - Geotechnical
36
STLS E V E R N
TRENT
PERCENT LIPIDS
37
Percent Lipids Calculations
Date: Time:
11/27/2006 2100
Analyst: ETR(s):
Client:
TPB 117632 WESTN2
Sample ID
MB112706A 692358 692359 692360 692361 692362 692363 692364 692365 692366 692367 692368 692369 692370 692371 692372 692373 692374 692375 692376 692377
692363DP
Sample Weight
(g ) 10.00 9.96 9.98 10.01 10.03 9.99 9.99 10.03 9.98 10.04 9.96 10.05 9.99 10.03 10.00 9.99 10.04 10.00 9.99 10.03 9.96 9.99
Dish (
g) 1.0193 0.9983 1.0098 1.0312 0.9928 0.9936 0.9692 0.9875 1.0288 1.0013 1.0046 0.9984 1.0121 1.0151 1.0196 1.0151 0.9940 0.9988 1.0075 0.9936 0.9961 0.9899
Dish/Residue
(g ) 1.0188 1.0029 1.0138 1.0321 1.0585 1.0965 1.1030 0.9969 1.1170 1.0028 1.0163 1.0324 1.0388 1.0246 1.0289 1.0286 1.0042 1.0009 1.0115 0.9967 0.9992 1.0761
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
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
% Lipids
<0.1 0.5 0.4 <0.1 6.6 10.3 13.4 0.9 8.8 0.1 1.2 3.4 2.7 0.9 0.9 1.4 1.0 0.2 0.4 0.3 0.3 8.6 #DIV/0! #DIV/0! #DIV/0! #DIV/0!
S T L B u r lin g to n
11763 2M B 1 1 27 0 6A
38
1 1 /2 8 /2 0 0 6
Percent Lipids Calculations
Date: Time:
11/27/06 2100
Analyst: ETR(s):
Client:
TPB 117632 WESTN2
Sample ID
MB112706A 692358 692359 692360 692361 692362 692363 692364 692365 692366 692367 692368 692369 692370 692371 692372 692373 692374 692375 692376 692377
692363DP
Sample Weight
(g ) 10.00 9.96 9.98 10.01 10.03 9.99 9.99 10.03 9.98 10.04 9.96 10.05 9.99 10.03 10.00 9.99 10.04 10.00 9.99 10.03 9.96 9.99
Dish (
g) 1.0193 0.9983 1.0098 1.0312 0.9928 0.9936 0.9692 0.9875 1.0288 1.0013 1.0046 0.9984 1.0121 1.0151 1.0196 1.0151 0.9940 0.9988 1.0075 0.9936 0.9961 0.9899
Dish/Residue
(g ) 1.0188 1.0029 1.0138 1.0321 1.0585 1.0965 1.1030 0.9969 1.1170 1.0028 1.0163 1.0324 1.0388 1.0246 1.0289 1.0286 1.0042 1.0009 1.0115 0.9967 0.9992 1.0761
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 0.5 0.4 <0.1 6.6 10.3 13.4 0.9 8.8 0.1 1.2 3.4 2.7 0.9 0.9 1.4 1.0 0.2 0.4 0.3 0.3 8.6 #DTV/0! #DIV/0! #DIV/0! #DIV/0!
S T L B u r lin g to n
117632M B112706A
39
1 1 /2 7 /0 6
Percent Lipids Calculations
Date: Time:
11/27/06 2100
Analyst: ETR(s):
Client:
*^
TPB
117632
WESTN2
S T L B u r lin g to n
117632M B 112706A
40
1 /2 7 /0 6
STL BURLINGTH
LfNj f O~ (fv^ iNi i r i N rI rl J r ) f J r J r , r J r ' ^
l|rC4>
V j-i
rcN/i t./*> -b. . il o-S *<2T1.
VUi, -J <TArs
iifUi wA' rc/Nf -u -J -J iZc Vi yJ1 rr--JJ
f0N\ -P
>xAj\ -+>
cry
('S ,
b *v
r J r J Hr 1 rr>| r--rr-Ji CD r?
> STL Sample ID
.-- 0*3 'U ^W t >> P A T j i ^ ^ r 3^ i Bottle ID
O
>O m >O md HHOwz
m TJO m n
ja "T -A O o J> c> C*"
--1 _' 0 - G - P & o
Weigh 10gm sample into a 400ml glass
rj
j-<`d- . -
(T'-Lu . A
c-* b J - o
o _ c __ct o
b- '-D- ,-o
o j __i> w
^'>0<
CP_l,
'O V 'O J;o {? > O it D _ o ^ f l y) r~ w i IT CJ
beaker
>Add 10gm Na2S04
g QCO.'
K~
A d d 60mls CH2CL2 KS ^Tissuemize 3 min. '^Decant thru a Na2S04 funnel into a K-D setATfup
^Repeat 2(X) ^ .................................... 'V^sJConc. extract to 10ml
~ - ^ F ilte r extract thru a 0.45um filter _'SiPull 1.0ml for % Lipids. See % Lipids
^C a lcu la tio n s sheet.
com co
CO 73 H
IIA
% LIPIDS
6T
o
-X NO O iNO
Io-
-H 4fc
o JO
vn $ vN
Sample Handling
42
FedEx |Ship Manager j L ab el 7985 2242 2182
From: Origin ID: (814)231-8032 MarKAmmerman EXYGEN RESEARCH 3058 RESEARCHDRIVE
FedM .
Ship Dale: 17OCT06 AdWgl: 36 LB
System#: 5675287/INET2500 AccounW:S *********
STATE COLLEGE, PA 16801
SHIPTO: (802)655-1203
BILL SENDER
Kirk Young
Severn-Trent Lab-Burlington
208 South Park Drive Suite 1
CLSM U M /ttm
7208 SOUTH PARK DRIVE SUITE 1
U>
Colchester, VT 05446
ip:
PR IO R ITY O VER N IG H T
W ED
[)> 01 0205446 840 11 7985224221820201 FDE 133455337 290 TRK# 7 9 8 5 2 2 4 2
1/1 36LB N 2 1 8 2 F0M1
208 South DP1e8alOirvkeCrTDB0yr6: ive Suite 1
Colchester
VT
Kirk Young
06
BTV
AA
m &i
0 5 4 4 6 -VT-us
ICE XH BTVA
30544693110003217985224221822011
STL BURLINGTON
SAMPLE RECEIPT & LOG IN CHECKLIST
Client: W F T / J 'S.
Date Received: / 0 ~ /5< ' OCr>
Log In Date: | 1
7 /o A
ETR:
V O A X 'a
Time Received:
By:
yi
SDG:
Received By:
Jk>F5t
Signature:.'XXX
Project:
(~ n O O
# Coolers Received: 2
Samples Delivered By: ^Shipping Service o Courier Hand Other (specify)
List Air bill Number(s) of Attach a photocopy of the Air Bill:
PM Signature: / /
f!
COOLER SCREEN There is no evidence to indicate tampering Custody seals are present and intact Custody seal numbers are present If yes, list custody seal numbers:
- YES : NO NA : :
X
X
X
COMMENTS
Thermal Preservation Type: o Wet Ice o Blue Ice o None J^Other (specify)
\C.L
IR Gun ID: / ,, 2 -
Correction Factor (CF) = C>
C
j
Cooler 1: Cooler 2:
- 2 S . C Cooler 6
~2.(e.L> C Cooler 7
C Cooler 11 C Cooler 12
C Cooler 16 C Cooler 17
C C
Cooler 3:
C Cooler 8
C Cooler 13
C Cooler 18
: *C
Cooler 4:
C Cooler 9
C Cooler 14
C Cooler 19 '
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 for the CF of the IR Gun
EPA Criteria: 0-6C, except for air and geo samples which should be at ambient temperature and tissue samples, which may be frozen.
Some clients require thermal preservation criteria of 2-4C or other such criteria. The PM must notify SM when alternate criteria is specified.
SAMPLE CONDITION
.
-'
"
- YES ',,NO'- . NA .
Sample containers were received intact Legible sample labels are affixed to each container CHAIN OF CUSTODY (COC)
X X ^ * YES :.N0 NA rt3^t ^?5 C O M M E N T &
COC is present and includes the following information for each container:
Sample ID / Sample Description
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 SAMPLE INTEGRITY/USABILITY - ` 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
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FSM002:10.26.05:2 STL Burlington
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Last Page of this Document
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