Document b1rGdKJGBnB5jYe2oBYn3mD6

TestA m e rica THE LEADER IN ENVIRONMENTAL TESTING ANALYTICAL REPORT PFOA/PFOS Analysis Lot#:: D8C180234 Laura Vancho New Jersey American Water 213 Carriage Lane Delran, NJ 08075 TestAmerica Denver licheile A. Johnston Project Manager March 31, 2008 4955 Yarrow Street Arvada, CO 80002 tel 303.736.0100 fax 303.431.7171 www.testamericainc.com DEP2-SDWB-000433 Table Of Contents Standard Deliverables Report Contents Standard Deliverables (The Report Cover page is considered an integral part o f this Standard Deliverable package. This report is incomplete unless all pages indicated in this Table o f Contents are included.) Total Number of Pages Table of Contents Case Narrative Executive Summary - Detection Highlights Methods Summary Method/Analyst Summary Lot Sample Summary Analytical Results QC Data Association Summary QC Results Chain-of-Custody TestAmerica l DEP2-SDWB-000434 Case Narrative D8C180234 The results included in this report have been reviewed for compliance with the Laboratory Quality Manual. All results have been found to meet all requirements of NELAC and any exceptions are noted below. This report shall not be reproduced except in full, without the written approval of the laboratory or sponsor. Dilution factors and footnotes have been provided on each datasheet to assist in the interpretation of the results. Sample Arrival and Receipt The nine water samples presented in this report were received at the TestAmerica Denver laboratory at temperatures of 2.3C and 0.9C on March 18,2008. No anomalies were observed during sample receipt. Standards Analytical standards were prepared using the acid form of the compound perfluorooctanoic acid (PFOA). PFOS is a commercial prepared and certified solution. Perfluoro-n-[1,2,3,4-13C4]octanoic acid was introduced at the extraction step and was used as an internal standard for quantitation of PFOA. Perfluoro-1-[t,2,3,4-13C4]octanatesuifonate was introduced at the extraction step and was used as an internal standard for quantitation of PFOS. Sample Extraction and Analysis The samples presented in this report were analyzed for the target analytes by TestAmerica Denver's SOP DEN-LC-0012. For water samples a 250 mL aliquot of each sample is acidified with 1 mL of 6N HCI solution and it is extracted using solid phase extraction technique with methanol conditioned C18 cartridges. Each sample is spiked with the nternal standard, prior to extraction. After the sample is passed through the cartridge, the analytes are eluted with 4 mL of methanol. The final volume is brought to 5 mL using methanol and the extract is analyzed by LC/MS/MS. Method QC Samples The Method Blank is processed reagent water spiked with surrogate and prepared with each batch of 20 samples of the same matrix. The method blank was non-detect at the reporting limit for the target analytes. Each batch is prepared with Laboratory Control Samples (LCS). The LCS recoveries for both levels were within established control limits. Analytical Comments The internal standard recovery for 13C4 PFOS was below the lower control limit in sample RANNEY WELL 2B associated with QC batch 8084336. The control limits for this internal standard have not yet been determined; therefore, no corrective action was necessary. The PFOS result for this sample is less than the reporting limit. No other anomalies were noted. TestAmerica 2 DEP2-SDWB-000435 EXECUTIVE SUMMARY - Detection H ighlights D8C180234 PARAMETER SANNEY POE 03/17/08 11:10 001 PFOS PFOA RANNEY WELL #7 03/17/08 10:38 002 PFOS PFOA RANNEY WELL 1A 03/17/08 10:32 003 PFOS PFOA RANNEY WELL 2B 03/17/08 10:38 004 PFOS PFOA LAYTON POE 03/17/08 11:29 005 PFOA LAYTON WELL 4 03/17/08 11:35 007 PFOS PFOA LAYTON WELL 2 03/17/08 11:50 008 PFOS PFOA RESULT REPORTING LIMIT UNITS 0.0021 J 0.010 0.024 0.015 ug/L ug/L 0.0023 J 0.010 0.040 0.015 ug/L ug/L 0.0061 J 0.010 0.043 0.015 ug/L ug/L 0.0060 J 0.010 0.0.58 0.015 ug/L ug/L 0.053 0.015 ug/L 0.0329 J 0.010 0.073 0.015 ug/L ug/L 0.0331 J 0.010 0.033 0.015 ug/L ug/L ANALYTICAL METHOD DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 TestAmerica DEP2-SDWB-000436 METHODS SUMMARY D8C180234 ANALYTICAL P A R A M E T E R ____________________________________ METHOD______ LC/MS/MS, PPOA DEN -LC-0012 References: DEN Severn Trent Laboratores, Denver, Facility Standard Operating Procedure. PREPARATION METHOD TestAmerica DEP2-SDWB-000437 METHOD / ANALYST SUMMARY D8C180234 ANALYTICAL METHOD ANALYST DEN -LC-0012 Jagueline Bonnett References: DEN Severn Trent Laboratores, Denver, Facility Standard Operating Procedure. ANALYST ID 003601 TestAmerica DEP2-SDWB-000438 SAMPLE SUMMARY D8C180234 WO # SAMPLE# CLIENT SAMPLE ID KJRV6 001 RANNEY POE KJRWA 002 RANNEY WELL #7 KJRWC 003 RANNEY WELL 1A KJRWD 004 RANNEY WELL 2B KJRWE 005 LAYTON POE KJRWG 006 LAYTON WELL I1A KJRWJ 007 LAYTON WELL 4 KJRWK 008 LAYTON WELL 2 KJRWN 009 TRIP BLANK NOTB(S); ______________________________________________________________ - The analytical results of the samples listed above are presented on the following pages. - All calculations are performed before rounding to avoid round-off errors in calculated remits. - Results noted as "ND" were not detected at or above the stated limit. - This report must not be reproduced, except in full, without die written approval of the la>oratory. - Results for the following parameters are never reported on a dry weight basis: color, corrosivity, density, flashpoint, ignitability, layers, odor, paint filter test, pH, porosity pressure, reactivity, redox potential, specific gravity, spot tests, solids, solubility, temperature, viscosity, and weight. SAMPLED SAMP DATE TIME 03/17/08 11:10 03/17/08 10:38 03/17/08 10:32 03/17/08 10:38 03/17/08 11:29 03/17/08 11:22 03/17/08 11:35 03/17/08 11:50 03/17/08 08:00 TestAmerica DEP2-SDWB-000439 American Water Company Client Sample ID: RANNEY POE HPLC Lot-Sample # __ Date Sampled__ Prep Date..... Prep Batch # __ Dilution Factor DSC180234-001 Work Order #...: KJRV61AA 03/17/08 11:10 Date Received..: 03/18/08 03/24/08 Analysis Date..: 03/28/08 8084336 Analysis Time..: 16:18 1 Method........ : DEN -LC-0012 Matrix PARAMETER PFOS PFQA RESULT 0.0021 J 0.024 REPORTING LIMIT UNITS 0.010 ug/L 0.015 ug/L MDL 0.0020 0.0031 SURROGATE 13C4 PFOA 13C4 PFOS PERCENT RECOVERY 89 76 RECOVERY LIMITS (50 - 200) (50 - 200) BOTB(S) :_____________ I Estimated result. Result is less than RL. WATER TestAmerica DEP2-SDWB-000440 American Hter Company Client Sample ID: HANNEY WELL #7 HDLC Lot-Sample # __ : D8C180234-002 Work Order # __ : KJRWA1AA Date Sampled__ : 03/17/08 10:38 Date Received..: 03/18/08 Prep Date..... : 03/24/08 Analysis Date..: 03/28/08 Prep Batch # __ : 8084336 Analysis Time..: 16:31 Dilution Factor: 1 Method.... ....: DEN -LC-0012 Mtrix........ : WATER PARAMETER PFOS PFQA RESULT 0.0023 J 0.040 REPORTING LIMIT 0.010 0.015 UNITS ug/L ug/L MDL 0.0020 0.0031 SURROGATE 13C4 PFOA 13C4 PFOS PERCENT RECOVERY 90 71 RECOVERY LIMITS (50 - 200) (50 - 200) M O T E (S) :______________ J Estimated result. Result is less than RL. TestAmerica DEP2-SDWB-000441 American Wat: Company Client Sample ID: RANNEY WELL 1A HPLC Lot-Sample # -- : D8C180234-003 Work Order t . : KJRWC1AA Date Sampled___ :03/17/08 10:32 Date Received. 03/18/08 Prep Date...... :03/24/08 Prep Batch # --- :8084336 Analysis Date. 03/28/08 Analysis Time. 16:44 Dilution Factor: 1 Method.... . DEN -LC-0012 Matrix PARAMETER PFOS PFQA SURROGATE 13C4 PFOA 13C4 PFOS RESULT 0.0061 J 0.043 PERCENT RECOVERY 89 64 REPORTING LIMIT 0.010 0.015 UNITS ug/L ug/L RECOVERY LIMITS (50 - 200) (50 - 200) MDL 0.0020 0.0031 NOTB(S) :_______________ J Estimated result. Result is less than RL. WATER TestAmerica DEP2-SDWB-000442 American Kater Company Client Sample ID: RANNEY WELL 2B HPLC LotSample # __ Date Sampled__ Prep Date..... Prep Batch # __ Dilution Factor D8C180234-004 Work Order #... 03/17/08 10:38 Date Received.. 03/24/08 Analysis Date.. 8084336 Analysis Time.. 1 Method........ KJRWD1AA 03/18/08 03/28/08 17:11 DEN -LC-0012 Matrix PARAMETER PFOS PFOA RESULT 0.0060 J 0.058 REPORTING LIMIT 0.010 0.015 UNITS_____ ug/L ug/L MDL 0.0020 0.0031 SURROGATE 13C4 PFOA 13C4 PFOS HOTB(S):__________________ * Surrogate recovery is outside stated control limits. J Estimated result. Result is less than RL. PERCENT RECOVERY 82 48 * RECOVERY LIMITS (50 - 200) (50 - 200) WATER TestAmerica 10 DEP2-SDWB-000443 American Water Company Client Sample ID: LAYTON POE HPIjC Lot-Sanple # __ : D8C180234-005 Work Order f __ : KJRWE1AA Date Sampled__ : 03/17/08 11:29 Date Received..: 03/18/08 Prep Date..... : 03/24/08 Analysis Date..: 03/28/08 Prep Batch #...: 8084336 Analysis Time..: 17:24 Dilution Factor: 1 Method........ : DEN -LC-0012 Matrix PARAMETER PFOS PFQA RESULT ND 0.053 REPORTING LIMIT 0.010 0.015 UNITS ug/L ug/L MDL 0.0020 0 .0031 SURROGATE 13C4 PFOA 13C4 PFOS PERCENT RECOVERY 88 66 RECOVERY LIMITS (50 - 200) (50 - 200) WATER TestAmerica 11 DEP2-SDWB-000444 American Mater Company Client Sample ID: LAYTON WELL 11A HDLC Lot-Sample # __ : D8C180234-006 Work Order #... Date Sampled : 03/17/08 11:22 Date Received.. Prep Date..... : 03/24/08 Analysis Date.. Prep Batch #...: 8084336 Analysis Time.. Dilution Factor: 1 Method KJRWG1AA 03/18/08 03/28/08 17:37 DEN -LC-0012 Matrix PARAMETER PFOS PFOA RESULT ND ND REPORTING LIMIT 0.010 0.015 UNITS ug/L ug/L MDL 0.0020 0.0031 SURROGATE 13C4 PFOA 13C4 PFOS PERCENT RECOVERY______ 92 71 RECOVERY LIMITS (50 - 200) (50 - 200) WATER TestAmerica 12 DEP2-SDWB-000445 American Hater Company Client Sample ID: LAYTON HELL 4 HFLC Lot-Sample # __ : D8C180234-007 Hork Order #... Date Sampled : 03/17/08 11:35 Date Received.. Prep Date..... : 03/24/08 Analysis Date.. Prep Batch ff...: 8084336 Analysis Time.. Dilution Factor: 1 Method KJRWJ1AA 03/18/08 03/28/08 17:50 DEN -LC-0012 Matrix. PARAMETER PFOS PFOA RESULT 0.0029 J 0.073 REPORTING LIMIT 0.010 0.015 UNITS ug/L ug/L MDL 0.0020 0.0031 SURROGATE 13C4 PFOA 13C4 PFOS MOTE(S) :_____________ J Estimated result. Result is less than RL. PERCENT RECOVERY 91 53 RECOVERY LIMITS (50 - 200) (50 - 200) WATER TestAmerica 13 DEP2-SDWB-000446 American Mater Company Client Sample ID: LAYTON WELL 2 HPIiC Lot-Sample # __ Date Sampled... Prep Date..... Prep Batch # __ Dilution Factor D8C180234-008 Work Order #...: KJRWK1AA 03/17/08 11:50 Date Received..: 03/18/08 03/24/08 Analysis Date..: 03/28/08 8084336 Analysis Time..: 18:03 1 Method.... ... ; DEN -LC-0012 Matrix PARAMETER PFOS PFOA RESULT 0.0031 J 0.083 REPORTING LIMIT UNITS o .oio ug/L 0.015 ug/L MDL 0.0020 0.0031 SURROGATE 13C4 PFOA 13C4 PFOS PERCENT RECOVERY 83 62 RECOVERY LIMITS (50 - 200) (50 - 200) Horsts) :_____________ J Estimated result. Result is less than RL. WATER TestAmerica 14 DEP2-SDWB-000447 American Hater Company Client Sample ID: TRIP b l a n k HPLC Lot-Sample # __ : D8C180234-009 Work Order #...: KJRWN1AA Date Sampled__ : 03/17/08 08:00 Date Received..: 03/18/08 Prep Date......: 03/24/08 Analysis Date..: 03/28/08 Prep Batch # ___: 8084336 Analysis Time..: 18:16 Dilution Factor: 1 Method DEN -LC-0012 Matrix PARAMETER PFOS PFOA RESULT ND ND REPORTING LIMIT 0.010 0.015 UNITS ug/L ug/L MDL 0.0020 0.0031 SURROGATE 13C4 PFOA 13C4 PFOS PERCENT RECOVERY 92 84 RECOVERY LIMITS (50 - 200) (50 - 200) WATER TestAmerica 15 DEP2-SDWB-000448 QC DATA ASSOCIATION SUMMARY D8C180234 Sample Preparation and Analysis Control Numbers SAMPLE# 001 002 003 004 005 006 007 008 009 MATRIX WATER WATER WATER WATER WATER WATER WATER WATER WATER ANALYTICAL METHOD DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN -LC-0012 DEN - L C - 0 0 1 2 LEACH BATCH # PREP BATCH # 8084336 8084336 8084336 8084336 8084336 8084336 8084336 8084336 3084336 MS RON# 8084194 8084194 8084194 8084194 8084194 8084194 8084194 8084194 8034194 TestAmerica DEP2-SDWB-000449 METHOD BLANK REPORT HFLC Client Lot # __ : D8C180234 MB Lot-Sample #: R8C240000-336 Analysis Date..: 03/28/08 Dilution Factor: 1 Work Order #...: KJ4M51AA Prep Date..... : 03/24/08 Prep Batch # __ : 8084336 Matrix........ : WATER Analysis Time..: 15:00 PARAMETER PFOA PFOS RESULT________ ND ND REPORTING LIMIT UNITS 0.015 ug/L 0.010 ug/L METHOD______ DEN -LC-0012 DEN -LC-0012 SURROGATE 13C4 PFOA 13C4 PFOS PERCENT RECOVERY 91 78 RECOVERY LIMITS (50 - 200) (50 - 200) MOTB(S): ______________________________ Calculations are performed before rounding to avoid round-off errors in calculated results. TestAmerica DEP2-SDWB-000450 LABORATORY CONTROL SAMPLE EVALUATION REPORT HPLC Client Lot # __ LCS Lot-Sample# Prep Date..... Prep Batch # __ Dilution Factor D8C18Q234 Work Order #... : KJ4M51AC R8C240000-336 03/24/08 Analysis Date..: 03/28/08 8084336 Analysis Time..: 15:13 1 Matrix.... ___ : WATER PARAMETER PFOA PFOS PERCENT RECOVERY 94 87 RECOVERY LIMITS (70 - 130) (39 - 120) METHOD DEN -LC-0012 DEN -LC-0012 SURROGATE 13C4 PFOA 13C4 PFOS PERCENT RECOVERY 91 82 HOTE(S) :____________________________________ Calculations are performed before rounding to avoid round-off errors in calculated results. Bold print denotes control parameters RECOVERY LIMITS (50 - 200) (50 - 200) TestAmerica 18 DEP2-SDWB-000451 LABORATORY CONTROL SAMPLE DATA REPORT HPLC Client Lot # __ : LCS Lot-Sample#: Prep Date..... : Prep Batch Dilution Factor: D 8C180234 Work Order # . . . : R 8C 240000-336 0 3 /2 4 /0 8 Analysis Date.. : 8084336 Analysis Time.. : 1 K J4M 51A C 0 3 /2 8 /0 8 1 5 :1 3 Matrix........ : WATER PA R A M ETER PFOA PROS S P IK E AMOUNT 0.200 0.200 MEASURED AMOUNT 0.187 0.175 U N ITS ug/L ug/L PERCENT RECOVERY 94 87 M ETH O D ___________ DEN -LC-0012 DEN -LC-0012 SURROGATE 1 3 C4 PFOA 13C 4 PFOS PERCENT RECOVERY 91 82 MOTB(S) : _______________________________ Calculations are performed before rounding to avoid round-off errors in calculated results. Bold print denotes control parameters RECOVERY L IM IT S (50 - 2 0 0 ) (50 - 200) TestAmerica 19 DEP2-SDWB-000452 LABORATORY CONTROL SAMPLE EVALUATION REPORT HPLC client Lot # __ : D8C180234 Work Order #...: KJ4M51AD LCS Lot-Sample#: R8C240000-336 Prep Date..... : 03/24/08 Analysis Date..: 03/28/08 Prep Batch # __ : 8084336 Analysis Time..: 15:26 Dilution Factor: 1 Matrix PARAMETER PFOA PFOS PERCENT RECOVERY 101 95 RECOVERY LIMITS (70 - 130) (39 - 120) METHOD______ DEN -LC-0012 DEN -LC-0012 SURROGATE 13C4 PFOA 13C4 PFOS PERCENT RECOVERY 95 84 RECOVERY LIMITS (50 - 200) (50 - 200) NOTB(S) :_____ ______________________________ Calculations are performed before rounding to avoid round-off errors in calculated results. Bold print denotes control parameters WATER TestAmerica 20 DEP2-SDWB-000453 LABORATORY CONTROL SAMPLE DATA. REPORT HPLC Client Lot #...: D8C180234 Work Order #...: KJ4M51AD LCS Lot-Sample#: R8C240000-336 Prep Date..... : 03/24/08 Analysis Date..: 03/28/08 Prep Batch # -- : 8084336 Analysis Time..: 15:26 Dilution Factor: 1 Matrix....... .: WATER PARAMETER PFQA PFOS SPIKE AMOUNT 0.0200 0.0200 MEASURED AMOUNT 0.0202 0.0191 UNITS ug/L ug/L PERCENT RECOVERY 101 95 METHOD DEN -LC-0012 DEN -LC-0012 SURROGATE 13C4 PFOA 13C4 PFOS PERCENT RECOVERY 95 84 RECOVERY LIMITS (50 - 200) (50 - 200) NOTE(S) :____________________________________ Calailaliens are performed before rounding to avoid round-off errors in calculated results. Bold print denotes control parameters TestAmerica 21 DEP2-SDWB-000454 MATRIZ SPIKE SAMPLE EVALUATION REPORT HPLC Lot-Sample #...: D8C1S0234 Work Order #...: KJRN71AC MS Lot-Sample #: D8C180215-001 Date Sampled...: 03/17/08 09:30 Date Received..: 03/18/08 Prep Date..... : 03/24/08 Analysis Date..: 03/28/08 Prep Batch ff__ : 8084336 Dilution Eactor: 1 Matrix........ : WATER PARAMETER PFOA PFOS PERCENT RECOVERY 94 89 RECOVERY LIMITS (70 - 130) (39 - 120) SURROGATE 13C4 PFOA 13C4 PFOS PERCENT RECOVERY 86 80 H O T E (S): ____________________________________ Calculations arc performed before rounding to avoid round-off errors in calculated results. Boldprintdenotes control parameters METHOD______ DEN -L C -0 0 1 2 DEN -L C -0 0 1 2 RECOVERY LIMITS (50 - 200) (50 - 200) TestAmerica 22 DEP2-SDWB-000455 MATRIX SPIKE SAMPLE DATA REPORT HPLC Lot-Sample # __ : D8C180234 Work Order #. MS Lot-Sample #: D8C180215-001 Date Sampled__ : 03/17/08 09:30 Date Received Prep Date......: 03/24/08 Analysis Date Prep Batch # __ : 8084336 Dilution Factor: 1 : KJRN71AC : 03/18/08 : 03/28/08 Matrix........ : WATER PARAMETER PFOA PFDS SAMPLE SPIKE MEASRD AMOUNT AMT AMOUNT 0.0060 0.200 0.194 0.0054 0.200 0.183 UNITS ug/L ug/L SURROGATE 13C4 PFOA 13C4 PFOS PERCENT RECOVERY 86 80 BOTB(S) :____________________________________ Calculations are performed before rounding to avoid round-off errors in calculated results Bold print doiotes control parameters PERCENT RECOVERY 94 89 METHOD DEM -LC-0012 DEN -LC-0012 RECOVERY LIMITS (50 - 200) (50 - 200) TestAmerica 23 DEP2-SDWB-000456 SAMPLE DUPLICATE EVALUATION REPORT HPLC Client: Lot #... : D8C180234 SD Lot-Sample # : D8Cl80215-001 Date Sampled... : 03/17/08 09:30 Prep Date..... : 03/24/08 Prep Batch # __ : 8084336 Dilution Factor 1 Work. Order # __ Date Received.. Analysis Date.. Analysis Time.. KJEN71AA KJRN71AD 03/18/08 03/28/08 16:05 -SMP Matrix...... : WATER -DUP MS Run # ...... : PARAMETER PFOA PFOS SAMPLE RESULT 0.0060 J 0.0054 J DUPLICATE RESULT 0.0071 J 0.0048 J UNITS ug/L ug/L RPD RPD LIMIT 17 (0-20) 10 (0-20) METHOD DEN -LC-0012 DEN -LC-0012 SURROGATE RECOVERY 13C4 PFOA 13C4 PFOS NOTB(S) :__________ SAMPLE % RECOVERY 87 67 DUPLICATE t RECOVERY 91 81 RECOVERY LIMITS (50 - 200) (50 - 200) Calculations are performed before rounding to avoid round-off errors in calculated results. J Estimated result. Result is less than RL. TestAmerica 24 DEP2-SDWB-000457 [PFOA/PFOS 1 DEP2-SDWB-000458 STL Denver 4955 Yarrow Street 7 i o r e S' ` ^ I Chain of Custody Record STL Arvada, CO 80002 phone 303-736-0100 fax 303-431-7171_______________________________________________________________________________________________________________________________ S e v e rn T r e n t L a b o ra to rie s , Inc. Client Contact Project Manager: Laura Vancho Site Contact: Gail D eR uao Date: \ - \ T ' O S T COC No: New Jersey American W ater A18TECH02 Tel/Fax:856-764-4905 856-764-3889 Lab Contact: C arrier: of COCs 213 C arriage Lane Analysis Turnaround Time Job No. Delran NJ 08075 Calendar ( C ) or Work Days (W) 856-764-4905 856-764-3889 Project Nam e: Site: P O # 74433 TAT i f dfferentfiroir, B dow (ZD 2 weeks 1 week a l days day I SDG No. Sample Identification Sample Date Sample Time S am p le Of Type M atrix Cont. Sample Specific Notes: RANNEY POE RANNEY WELL #7 RANNEY WELL 1A RANNEY WELL 2B LAYTON POE LAYTON WELL 11A LAYTON WELL 4 LAYTON WELL 2 TRIP BLANK 3/17/08 3/17/08 3/17/08 3/17/08 3/17/08 11:10 10:38 10:32 10:38 11:29 /" \ i l& jc S J S /0 3 U. Q o o V j Ou O h o 3/17/08 11:22 j/i im 3/17/08 3/17/08 1 1 3 ; f CiTo j 8 ) 11:50 ' 08:00 (lip 2 1 1 1 2 1 i 1 1 X X X X X X X X X LO CM Preservation Used: 1= Ice, 2= HCI; 3= H 2S04; 4=H N 03; 5=NaOH; 6 - O ther Possible H azard Identification ^ Non-Hazard ^ Flammable ' Skin Irritant ^ Poison B Special Instructions/Q C Requirem ents & Comments: Unknown Sam ple Disposal ( A fee m ay be assessed If sam ples are retained longer than 1 month) ' R eturn To C lient D isp o sa l By Lab ^ A rch ive F o r M onths Rei iaquished. by: ^ Relinquished by: Relinquished by: n Company: kJ S A u^ Company: Company: Date/Time: ..'O C Received b y / ------------------------- __---- Company: Date/Time: Received by: / S ' K_^S Company: Date/Time: Received by: Company: Date/Time: - y . x 'p t r t D * * Date/Time: Date/Time: rd U H u <u I to cu H Xerox 4110 Banner Sheet feeney_patricia_a i |T . . Date/Time : 08/01/2008 10:37 AM User Name : feeneypatriciaa File Name : Start Page DEP2-SDWB-000459