ML16293A389
Text
{{#Wiki_filter:I, ~ .,. ..* *.J
- i App E-Sub-Area 2.1.COC Forms
~p\(?;\ fnriA/ ! ' a g e : - - - - - - of Project II:
GEL Chain of Custody and Analytical Request Gl!L J.nbornlaries, LLC . 2040 Savage Road l f) GEL.Quot~#:
""'See www.gcl.com for GEL'S Sample Acceptance SOP** Charleston, SC 29407 COC Number !ll; . **-*** *-* . -*- -*-- - ... -- GEL W(ll'k Order Numb.er: Phone: (843) S56-817l PO Number; fall.: (84.3) 766-J I78 Client Name: Plume II: Sample Analysis Requested {5) (Fil I in Ilic 1rnmbe1* of conlainers for each lest)
Should Projeci/Site Name: Fax#: !his <-- Proscrv6!ivc TYJlC (6} samfllt bo Address: consltler<d I Comments Collected by: Send Results To: Note: extra sample is "Timi! required for sample:
*01u0: Co\!cckd Cul:~"1!1N QC' ficl<I Sum11fo TSC specific QC ll*dl 11 Sample ID Fnr<.*umnosl/e.\' .. Jndicalt< :tlarJ a11U slim t/ulelllmD (l*Jll*dd*);')
(MIU,.ryl (lthn1m) Ctxk"' FJ!Ccnd
µ1 Mc.trix OACtl "
Rtuu 1:1E~cl htrG I. 3, C.. I l~-'lHS'" Of*.?fo N
/13,G,2- lh--1..H~ q:50 {\.l I '3 J I (...., 3 ll)-1.,,\-"'\$" !D'*OO f\l*
i I 3 t C.,6 10-'21-f~ q:~o Ft> l13. (,_,{; flY'1\ ...1S" q~55 i;~
*3 r \ L.{, i2., I 10-£..H(' (Q'.q:; t1 3,\,t../1£r2 r6 --1.,!--l'{ ll'-c6 \1'\ ~.Llfff?-<3 10-l.J**t< ll" 11?' tr-l 10-&H~ W;N) N ~
3, /, '-!,e,f..f *- TAT Rccucsl~d: Norm~l: SuccifJ'; fSubJ.c11u Soiol>~*n*l JFax Rc~ul1s: Yc3 No l I level 2 I Lc~cl J I Level 4
.Rush:
Re111nr/cs: Are there any known hazardr applicable to these samples? lf.w. please lirt the hazard~ ' Circle Dcliwrable: C of A I QCS11111man- I J...~11cl SJ!mpl!.' CQl[~Qlion Iim~ Zs:m~ Eastem J>ocifir. Central Oihcr _ _ _ Mountain Clialn of Custody Signatures Sample Shipping and Delivery Details
)teli11q11ishttl lly (Sigr.c.J) Dnlc TllllC Rocolvcd by (signed) Date Timo GEL PM:
I l MoJhu~ of Sbromc~t: P~t~ Shinned: 2 2 Alrbillll: 3 3 Alrbill ~: t) Chl'IJil cf Cu~to:ly Number:... Cli::ht D.e:tcrm!ric-d Fur Luh 11.~~u/\*lng Us* 011/y
- Z.) QC Ccd:J$: N .. N(lnllal Sttmplc1 TB* Tri)"t B1~ntc' 1 FD - FiQJd Dupli~slcJ F;ll .. 'Rqutprr.tn\ Rhut.,, MS ,. Melri~ Splkc S&mptr:. :\fSD
- Mtill'f:c SpU:.~ Durl1t.111l1!1 Sr:rnpl~ G
- Cltflb, C
- Ci)nlJJ-:ifilit~
J) FitlrJ f1llCltd: Fer liquld malrlcc.5, lndic.DJ.c wjth., .. v .. foryez; 1lu;: samp1:: WOi!. nc.td f!Jt~rtd Cf. l'f. for sornpl(' WU r101 Jii:ifd m:et¢d. C11.r1ody s~al Jn1111:t? 4.l M:11rl>e Cc!Jc1'! DW=-Drin\ing W:t1er1 G\V1110rc1u1t[hvt11.t:r, S\\Pc:S!.11i11ct! \V.111c.t, \\'\V.,,\l/ti$lc Wu1r:1J WcW.ith.*r, ML=-M1:sc Llq:rid, SO~s~,:ftSD""'S"dim~J\!, Sl ...'="Slu-.ll!.rJ,SS""SQf\d Wtt:;tlt! 1 OQOI!, f:aF1l1{'.\. r=Wl11e-, U11Uti1"'* F""t"!'c-e'J.t, N*I l'ES NO 5.) Son>pl< An11ly;b R"1U01Lo.t' /\n*lytlool mclho<l requ*;t<*I (I.e. guon, GCIGDfl4?0A) *11d 11un1b" .r cnn!ftlws pl~vlde-1 for coch {i.o. 816~8. 3, 60/Y!Jlll?OA. 1). C11vlr!rT~mp: l'.i..) jljc~cr'ta!fvc Type: UA .. Uy[rrti-chlwii; A.cld, ru o:i Nilric J\chJ, SH.,. Sorlmrn lty~lrcic.1cfo,$SI'\;.. Sutfufrc Acidf Alt. .. Atcwbit A~fd. HX"' llCXll!li;', ST-Sodium Tiriow.lt1u~.1r1:0 f}T~CJ'\'l\!ive I\ iu!rli:<l. tc-avc-flc\d blari.k c WHl'fIT. ~LADORATORY \'F.1,LOW = F[Lii; l'INK =CLIENT j
Page:---*--**- of .. ---* GEL Chain of Custody and Analytical Request OEL Lobornrories, LLC Projccll/: 2040 Snvoge Rnad uscc www.gcl.com for GEL's Sample Acceptance SOPh Charleston, SC 29407 GEL Quote h: * ._ .. * - - - - - - * ***- COC Number l'l: Phone: (843) 556-8 l 7_ I
" GEL Work Orde1* Number:
PO Number: Falt: !843) 766-1.178 Clic11t Name: Phone#: Sam11le Analysis Requested 151 (Fill in the number or conrninotS for cnch test) Should Project/Site Name: Fux fl: !hi* ..:.- Proscrvativc '!'ype (6} sanlpl~ be Address: ~omld*rtil Comments Collected by: Send Rcsnhs To: Note: extra sample is
'Time- required for sample *Q;ii)c Cdtcctcd ficl~ Sil.mp!<: TSC Cu~IL-crL-J Q{'
specific QC Sample ID
+For e:mm:tJ..ri1e.r-
- irrd1caf~ .sturl uud .-rfou datell1111c.
(mm..Jll-i*y) 1 IMillt.ryJ (hhmm) Cix!e~Z) F1:lCTt:d
*~
Murri* R&dl A oadl R.rgu l*ltol >ero / \, l .Cl ID -Z.'l.{ f) , ! I .CJ. 10 ii ts ./ I 1 .l.3 ID 2-Z. (') ti t.~ .c ( IC '2,-Z,f / ) / I . d. (;.::2_ /0 z:i.. /) 1 r/ I ?, .c.3 1o{i.i. o*
\.I. (Z. S IQ 7-'l- r'S e.s l ...... or ~ - " ,,,
_v
~ 1'1 ,.,,. {..
TA r Rcqucsrcd: Ncnn~ !: Rush: Succify: (S*bJ<<llo Surchorgo) ) Fax Results: Yas I N<l Circle Dclivc:r~blc~ C of A I QCSummary I Level 1 I Level 2 I L"vd 3 I Level 4 Remark~*: Are 1here any known*hazm*ds_ applicable tu rhe.~e samplits? lf.m, please list the hazard1* mpl1; c~l]c~ti~D Iim£ Z!JOC Ea stem P~cilfo Ccnlral Mounroin Other Cl1aiu of Custody Sign:iturcs Snmple Shipping nnd Delivery Detail~ Rolm<Jlli1hcd_ Dy (Signctl) Dnlo Time Received by (aigncd) OHie Time GELl'M: I I Mc1nod ofS1"0111enl: D~li:> Sl1i1m~6: 2 2 Aorbillll: 3 3 Airbill#: L.) Cl~<lJlt or Cl;s;~od)' 'Nu~rib<:1 - C1knl Oi!termincd Fol" Lab Rec:eiving Us" 011/y 2.) QC Ccdz~: N - Nom101I Samp!c:. TD c T:ri(l tllnnk. m ... Field l)~1pll,Mc, P.J\"' r!q;Jlf-MC11l Blan}., MS .. ~falrh: Spi~~ Si!~r.plc, \-Jso* .. M"1rho Spike Ol!fllJCJ!C Si!lrr<p:c, G u.(;r;;i,h, c" (.\mlpcliltoi:.
). ) Field. f*!tcrod: Fc:ir l1qutd fllR.lrt('CS-. "ir.dttnli: w1tb [J- v. (i>rytt.11:c £~Hl1,PIC. \\'4i r-cld til(crcc.1 (IT- r-; ~ for$;:n~pl:: was ncl Jlcl.~ fi11;11!d, C11srody Se11/ l>llacr" *I} M.t~11:iic Cnafi::ir.: DW**Orl11kmg W~tcr, G\\'c.Qmt;1;..f*,.,.arcr, SW,..S.J1(.:u:.:c W11t~r. \VW=W~t.: W"'~cr-, .*w*.*w.111'-'r, Ml.* ML~ L111111d, SO:'ISml, .SD:"S.:.dm1cr,1, St.**si.:~,g~, SS**Sul1d W~s!G. O**Oil. P*MJ;11t.ct, 1~=*Wiri1:, \l.,t;nn~, f*il7ci.:u!. :'II*.} YES NO $) $.;1mph: /\ri11ly~i:c itt.q\.lcstc:J l'\n...1ly*i~i.1l me1J-~l,}c1 J'C"l}'ilC"~H:d (1 ~. 816D:B. 60JG.W147rJAJ and 11m,1t:i:'I" ur ~u!1lltil~eu l]IO\-'Ldr'\t tc.r C'1\:~ (tt: . .'U6'1111
- 3, {DUJR/74711A - ! l Crwl~r Tomp:
6.} PrC!\cr\lpHve Ty11~~ HA :. ur~.t:-v.;bl<1.1ir: Ac Kit NJ =i N11n( t\Citl, SH .. Sod tum Hy(.ro:imt~. SAT: s~m:ru~ AcLd, AA ... f\.:>catl:i1c Ac:J~, nx ::" Ha*41:PC, GT "2 .Sodu.m1 Tbcrnlf:Uc, lr 110 f1C!Cf1>'1.tio.:.: i11. :uM~d "' 1~...*t; fo::ld bl11!lk c WHITE~ LABORATOR.Y YELl,OW = FrLE PINK= CJ.TENT
Page: _ _ _ _ _ _ of l ec GBL U.bur~torics, LLC 1:JL( -- ij {f Project#; GEL Chain of Custody and Analytical Request 2040 Savage Road
**See www.gel.com for GEL's Sample Acceptance SOP** Charlesian, SC 29407 GEL Quote ff: - - - * - -
COC Number Ul; .. .. !'hone: (843) 556-8171 GEL Work Order Number: PO Number: Fa~: (843) 766-1 In Client Name: Phone#: Sample Analysis Requested (51 (Fill m the nnmber of containers for each 1esl) SJwuld Projecl/Site Name: fox#. lhi1 <.- !'rcscrV'1tivc Typ~ (6)
**mplebe Address: considord Comments Collected by: Send Results To: Nole: extra sample is *rrme required for sample *o;.1rc:CLltJ;::ctcd Field :S.i.tn?JlC TSC Col1'<*oJ QC P*l1trc<l Mo;iui:r. l\odE A specific QC Sample ID (IOln*<fO-))') !Mlllfary) c~~e !11 !lJ f') Ollcil R1gu *Fm: camr-0:1Jt~.t- ;mJt,*&11t1 .'ffl1rt mul .rluµ datdlim~ (hilmm) VO l;ttrd 1cr o v2.1.1.i2.j. ru .13...,s- 6)1) tJ .lz:.l. \' \2. . 2. 1U ;-z.y\-:i 12>3o N **~ ~** ../2' \. I 12.. - ~ I \0 ~ "VH ( )'-1.W N ~~ ./ 2. J, ) 'i2.5 10 --i'J *t r3J~ Si r J7,,I, z
- JZ, J I Jo ~'23 *1r' 13'..'2 }'\
./2. I, Z., e_, 2- io -2~~1r /L/! tJj N ..lz. 11*3, i~. I /0 **l.3 **I~ IY"I~ N -iz.. I 1 3. 12.. IL ID (5 ~
ilf:% N
/?,, l 15 ,Q.5 iv- z..~*-1 ~ j~~'d-'5 }:"l::: *-
Jz I .~ fL. I ' Ib-7;-?J-I S"' 1'-t~D N TAT ReQucsrcd: Nanna!* Rush: S11ccify !Sub*"' ro Su"'h>rc<l lfo~ Rcsul1s. Yes I No Circle Dcl1vcmblo: C of A I QCSmr.nmy I I.eve! I I [.~vcl 2 I Level 3 I l.cwl 4
~ CQll~~!i!!O Tim~ Zon~
Remai*ks: Are there any known hazardr applicable to th(!se samples? ff.m, pleas!! list the hazcirilf Easten1 Pacific Cemrnl Olhcr .. .............._-~. Mountnin Chain ofCU5tudy Signatures Sample Shipping and Delivery Details Rclillijtrishcd By (Sigr.od) Dnlc Trmc Rcce1vc<l by ('1gncd) Date Ttmc GEL PM: l I Me!hod ofSliinmonl'. Dale Shir>ncd. 2 2 Airbi:I ~ 3 3 Aub:ll#* l ) Cl::im or Cbstody Nun1bc1..:. Clii:n~ DcLmn;l!til Fur Lah Ri:wh*mg U>~ 011(1 L> QC Ccd~r;.: N:.. No1'ftrnl S:m11riJ~. TB* Tf1p Olar.\:, FO ... r'tcld Dt:ptu:a:l'.l', En= f.~u~pmtN llhmk, MS .. M:a.td.: Spike S;s:ri~lc, '.\TSD-MAiln:it Spike Duphcat-:. Sa.mp!c. G ... r,r~b, C ... Ci;1!lpo.site l) Fi Bid. flhCl'.00. For tiql.i.ltl tlli'l'.Ht:t.S., md~i:nt~ w1:1, ll .. v . re, yes. o~~ sinnpk \VM rlcld (Ht.r;rcd c.r AN - for 31ln1jlJe WBS not lkM fi\~etl C11s10dy Seal Jnract?
- 4) l\.falti:( C11J~~* J)\V-=01i:~:.Or.i: W~b~r. G\\l=Gm::udwi'lltt, S\Yo::Surfoc..; Willer, W\'\h\V.i1sle W.ucr, W""Wat;:r, ML.::1M1sc Llt1'1id. SO .. SuiJ, SD**~i:thp~eul, SL:*Sti...tl~~* .SS.::S-:;;~d WD.<tlc, O==Ctt. ft**Fi-!11:1 1 ) 1 :..Wr~;i:, U":Jrmc, f ***fcLJ.I, :--::*) l'l>S NO S) S41npk An*lytl> llt'11l<>'c,j ~nolyl1col mclhoo rcq~om~ {1.e 82600, MI Dll/7470,\) ood lllllnbcr of <ni:I**""" ~,,,,.;<led for "'h (i.e. <<1~08 - J, d,;J~b!N10A
- I~ CtJo/er Temp 6} P1'clCrY:\frYC lyrt: UA"' l!y~~t:h\0111:? l\cict. Nl .. Nttri.c- Ae1d, sn :a Scti~um HydrQ)l:dc, SJ\ ... 8:}Jfrric: Ai:ui* .\. .\ .. Asicelrb:c Acid. HX,,,. Hcx::.:.c:. S'f ""SfJdH:m Th~~r.llf:,ri:., /(l':u (:tCsc:rv~fr~: JS a1[rJ.c:t1 ~ lc>PiC lic;d bl~rtA: c WHlTE = LABORATORY YELLOW= FXLF; PINK= CLIENT
I I Co1p~ (-' (,. Page:----* ___ or **------- GEL [,aboratari\ls, LLC Project ii'. GEL Chain of Custody and Analytical Request 2040 Savago Road
"*Sec www.gel.com foi* GEL'S Sample Acceptance SOP'"~.
GEL Quote#: -**----*~*- C!iadcaton, SC 294ll"l CCC Number <*I: *- *- , .. Phone: (843) 556-8171
*
- GEL Wo1*k Order Number:
PO Number: "Fax: (843) 766-li 7g Client Name: Phone#: Sample Analysis Rcque~tcd l5l (Fill in the n1nnber of container$ foreuch test) Slrould Project/Site Name: Fax fl.- I his ~-- l'rcscrva1ivc Type (6) son1plollo Address: can*id<red C1m1111cnts Collected by: Send Rcsu!rs To: Note: ci<lrn sample is required for sample
.. p,,_1c CoiTecrcd 'T\1f'.ll C'utlccrcd QC fi.J<l S:am;,!tt rsc specific QC .. A Fill<<<"! M':ltrjx. Rodi Sample ID {Rllll-~~-)')'}
(Milll.ry) Ceodc:lll'
'~ *~
O;tr;tl R.t'gu (hhn1m)
"Fo1* com1m.!i/e.'( - ziultcalt' start and .\'/01> d~fellhJJtJ l:Utd hero .J.2... }.L/, /2. z.. 10-T.YIS" /~'.<;[) N 4-1 . ti K(p /0* l)* 1( 15:9) g{!;>
Jz. I, '-f (2- 7 iO* :.t> IS° !JJJJ ',CD Q~ TAT Requested: Normal. Rush: S~ccifv: (Sub1w 10 s,.n.h>rg*) r Fa~ Rcsuhs. Yes I No Circle Deliverable: C of A I QCSumm~rv I Level I I Lcvol 2 I Level) I l.~v~l4 Remarks: Are there any known hazardr applicahle lo ihese sample..~? !f.w1, plea,1*e /fat th!! hazardr Snnllll~ r.2il~c1i*Qa Iim~ 7,Qn~ Ea~1ern Pacific Ccntrn! Other -~-- Mcninrnin Clmln of Cu.~tody Signatures Snmp!e Shipping and O~livery Dl!tails Relim1uishcd By (Signed) D>IC Tinb: Rcoci\*ccl by (,ignod) Dole Time OELl'M: l l Molhod uf SJ1iomo111. Daro Shmpcd 2 2 Airhii!I/. J 3 Airbllltt* I } CJu1i;1 of Custody N~mbcr ... Cli~111 Dc1:irmfoed Fur Lob Rec~iving 1.he 011/r l' QC Cedc!I~ N ... l"form~I Se~plc:, TH ""'Trip Bf~m~:. JC()"" FieJd bllplii!~tc:. t:n"' f.:~1.uprr.~nl nli!::*k, MS .. M31fix SJ]iit.:~ Sa.ir.p1c. MSD.,. Ma:r*x Sp1~c Dur;l:talo !:a;npr~. G ~ {jra~. C.,,, Ccmr.vf.1tc 3.} Ft~ld r1;u:rc:J. f~\" !lq\otd r.t.0.1Tll'l~,;, mdotal!C \\111;1 II. - v. fr;!(~.!!. ltu1 Hml?lC \V~S t1~1d micrctl t)f"* N .. for .s:imp:c Y/i3~ 1~0: flctd iillcn:d. Cu.wdySeal /11111r1? .J ) Ma!rix Cod~ D'V""~dnkmu, Water, OW=Gnnhtdw-1\tc.r, SW*=Si.ufr.~ Wil!a, W\V=\Vw.1c W;'1.:r. \V=War..:r, Ml...'"'Mt:ii: Liq::1J. SO:=.Sotl. SDr-S1!dJ1::1~r.1, SL"'$Jti~.i;.: 1 Ss"'.c;:c)hd W.i1~!o;.:c 1 ()*:Q1J,.F**F1i;~r. r **W~F'"* U""'Urmc, l-~*,f'c~l. N=l YES NO 5.J S;implc 1\r.clyns n~11cnciJ* 1\Ml)'l*;~1:1f 1;1~tllCd ttqt:;s1cd (t~- !:12C-OIJ. COl(l0f747iJA} om.I *~1t11ibcr o.r <:cnHu~e.rs: pJo.vW~d for cllC!l (i.t 8260D -J, 60JOJll747fJA - I). C"c:/a~Temp (i.) #".(C.it;l V;l!JVI! Typ~: Hh u ({)'cfroch!onc Aci.i, Nl """Nini"' Acid, .)'U Sodium H:ii,!i:cnucie. SA"' Sulfot*e Aw1, .\t\::.. J\i:corbit' Acal, BX Jtcx.1111c:, ST ... ~kd~i.:m 11u~s;.,lfatc, U' !\ol fl~l'i~TVt'lhv.:- n; 11.1McQ '= Je:l1ve li~lil blair.k D Cl c WHtTE"' LABORATORY YR(,LOW"" FILE rINK = CLfENT
App E-Sub-Area 2.1. Instrument Field Sheets
~n; UJW 'TE~CAC. .S~V}'C"ES Rev 110/18/15 Instrument Field Response Check Log
- 1. Instrument lnformation 1 .
Ratemeter: Make/Model: fo/ki,.11/1- ;p 'ii* 2. Serial No. ?. W).. I S-1 Cal. Due Date: Detector 1: Bicron MicroRem Meter: Make/Model: LvfJLv1'\ 'N*1 a Serial No. I/( /JI I;;? I Serial No. I) ;;;.12 if Y- Cal. Due Date: E.4l?
- 2. Check Source Information:
Source 1 lsotope: fh i 31. Serial No.: 11 <.v Activity: ~ units:~ Assay Date: ti/7;,;,/io Response Acceptance Range {+/-20%}: uRem/hr +20% _ _ uRem/hr -20% _ _ net cpm + 20% net cpm -20% _ __ Source 2 Isotope:(~ IS ) Serial No.: f1 ![ IJ., if~r Activity: .o L- units:~ Assay Date: Mo Response Acceptance Range {+/-20%}: uRem/hr +20% _ _ uRem/hr -20% _ _ net cpm + 20%_ __ net cprn -20% _ __
- 3. Technician/Worker Performing Checks:
Name: .$"72".1/.(. K/,.v~A..V
Title:
_ _ _ _ __ Date: /c/21/t) Time: 01o.:..'> r I
- 4. Site or location: Site/Job:._""".2_,...' - - ' / ' - - - - - - - - - - - Location
Description:
GPS Coordinates (when required): X-Coord: A/'IZc 1-i.f J t 4> Y-Coord: v 'l?. 1or'-( 1-l Instrument Field Response 2 I Use Acceptance Criteria Remarks I i Meter Bkg Bkg Counts Source Source Response +/-20% lnst. Battery Time Ambient Initials and Comments I l Cnt {cpm) or Cnt (gross cpm or source Calib. Check Of Ternp. . (add'l tnfo: inst. Condition, etc.} (oF) l i Time uRem/hr) Time uRem/hr) gross cpm oruRem/hr {Y/NJ current (Y/N} (Y/N) check ! Ratemeter I/ {fi((i} l"-101 / 1}1 IAJ Jgsz..rn '( v D'"ic" *r1.., lit,i.n. I ! Ratemeter ) !111/t/ l!../01 I WI. I J./ Io !\L75 y y 11'*1.., *:* *11. '1 (d>l l j Ratemeter / 1111 r.I 9(.,'1(... JrM1V JqJl.(o v v* ; *2 3 c:i l.f 1. >( IA 211 I ! Ratemeter Jmr;V irt.:. Cl (;,. J,.yu ,V F2 I q 2. y' 'f f'Z. ;,.) ~ ~- '{ Lin l Ratemeter J ~n1~ J ') 1 z I IJll: sv' fl 111 '/ y y 1(10 r1.? ~/c..U7 I Ratemeter /mrrJ /(Z~ /(Iii}./ I C)(YL- y I .>1 o ( l .. S' .lYf5 . 1 -L 7- ; 7- 1. 1 Bicron NA (o NA I~ y y r><ioo 77.1 I j Bicron NA "7 NA I 'i?' *y y* l'!..1.J 'i 9. *( I i Bicron NA /,.,
. NA I fl y y' /)10 <z.? i I
- 1. lnstrurnent designated check source is listed on calibration sticker. Record check source response (net cprn) prior to field deployment for all check sources being used.
- 2. Source and Background count rate should be determined from the average of three static counts at the same location. Repeat counts should be within 20%. If count rate diverges significantly, perform addltional counts to evaluate instrument stability
Rev 110/18/15 Instrument Field Response Check Log 1 C)~/c1 1 /1 ~~
- 1. Instrument lnformatlon Ratemeter: Make/Model: Serial No. c;9C(:~*c7£* Cal. Due Date:
Detector 1: Make/Model: Serial No. f'R;;)..{:if.) Bicron MicroRem Meter: serial No.-~--- Cal. Due Date: _ __
- 2. Check Source Information: * ,
Source 1 Isotope: l/i-:;)9 Serial No.: ff ( Activity:~ units: pt-., Response Acceptance Range (+/-20%): uRem/hr +20%_-~- uRem/hr -20% _ _ Source 2 lsotope:C.:;* rn Serial No.: Uf0:3-i?- Activity: 6..02 units~4/t..~* Assay Date: /U/ -- Response Acceptance Range (+/-20%): uRem/hr+20%___ uRem/hr -20% _ _ net cpm + 20%1,;>~:.? 7.'> net cpm -20% g-,,_,*v'?
- 3. Checks:
Title:
_ _.LU=. :....T ___ Date: /L>~ Time:D'JO 2
- 4. Site or location: Site/Job:._ __,_,4__._ri_~_llt._J-
__._,_(______ <::> Location
Description:
._ _ ..,X='-""-.;.:..J,_yl--'~----t:7.;-~------ GPS Coordinates (when required): X-Coord: N L{g. l/421?- Y-Coord: Wa?!. 76177° I I l Instrument Field Response 2 Use Acceptance Criteria Remarks i I Meter Bkg Bkg Counts Source Source Response +/- 20% Inst Battery Time
- Ambient Initials and Comments t
source Check Of (add'J Info: lnst. Condition, etc.) l Cnt TI me (cpm) or uRem/hr) Cnt TI me {gross cpm or uRem/hr) _,.gross cpm Ca!ib. current (Y/N) check Temp. (oF} l! I 1
*er uRem/hr (Y/N)
(Y/N) i l j f Rate meter ( ,..,.. ..*, ~:* 1 JS i:: "*
- I . ~-1,"' l/If '1 ( ,. //kf.. \/ y v 01o1 'Sl/. 7 . 111. J_!) J.)? !
Rate meter l { vt-1 ,*,. '- I() 5 '-f°t'c..IJ?,.;-. '{/ i:; VI IJ112... <:<./' q /'c. 1.?7 7:,7~. I ( I I £/. Ratemeter Rate meter Bicron NA NA Bicron NA NA Bicron NA NA Bicron NA NA
- 1. Instrument designated check source is listed on cahbrnt1on sticker. Record check source response (net cpm) prior to field deployment for all check sources being used.
- 2. source and Background c:ount rate should be determined from the average of three static c:ounts at the same location. Repeat counts should be within 20%. If count rate diverges signlflcantly, perform additional counts to evaluate instrument stability
Rev 110/18/l'S Instrument Field Response Check Log 1
- 1. Instrument lnformatlon Ratemeter: Make/Model: Serial No.,.;JtJ6f!1.F Cal. Due Date: ~;)&
Detector 1: Make/Model: Setial No. &!_IJ?V Bicron MlcroRem Meter: Serial No.
- CaL Due Date: _ __
- 2. Check Source Information:
Source 1 lsotope: n;.752 Serial No.: ti I Activity: CL>. I units:~- Assay Date: /;J/!>rJ/lt'
- Response Acceptance Range (+/-20%): uRern/hr +20% _ _* uRern/hr -20% _ _ net cpm + 2Q%Tiill net cpm -20% 3)8£.C Source 2 Isotope: C$-{>7 Serial No.: uq~.f?- Activity: l), cJ)- units:,,1'.'.:C: Assay Date: A)k Response Acceptance Range (+/-20%): uRem/hr +20% uRem/hr-20% _ _ net cpm + 20% 13.:??!. net cpm -20% $ft./']
- 3. Technician/Worker Performing Checks:
Name: X,.£/J.,. .,-,,15
Title:
_ _~---- Date:/p/.?.J//J Time:P~ r1
- 4. Site or Location: Site/Job:_ _ -=A--"'Vi.~~~4~,2_._/___,:---*-*__ Location
Description:
- 5cc.by -$"1'1.
GPS Coordinates (when required): X-Coord: /'If.;...-¥'!;../ rE Y-Coord: Wt>Z$. 7o(t:!/1° i I i Instrument Field Response 2 Use Acceptance Criteria Remarks I I Meter Bkg Bkg Counts Source Source Response +/*20% Inst. Battery Time Ambient Initials and Comments I 1 I Cnt (cpm) or Cnt ' (gross cpm or source Calib. Check Of Temp. {add'i Info: inst. Condition, etc.} II J Time uRem/hr} Time uRem/hr) gross cpm current (YIN) check (F) I or uRem/hr (Y/N) (Y/N} I Rat~meter /11A,)1 t:/31'1 LAI.. / 1t1.n. l./,6.t:i/ ~ t;>>,,,. \( v \( l;tJlf <;O. ( II.. -.)-'$;i.. A ~ Rate meter / tA...,'/,f, // <<..:z-;___,,. .JJ l/ \'r /,l 3"! SC>. 3' :/'._c-/"s 7 '2A-~ I { Rate meter J I ?-" I I Rate meter l Bicron NA NA Bicron NA NA v Bicron NA NA Bicron NA NA
- 1. Instrument designated check source Is ltsted on cahbrat1on sticker. Record check source response (net cpm) prior to field deployment for al! check sources being used.
- 2. Source and Background count rate should be determined from the average of three static counts at the same location. Repeat counts should be within 20%. If count rate diverges significantly, perform additional counts to evaluate lnstrument stablfity
Grid Pattern Manual Data Collection Form 10/19/15 1 hreej r:;:_ l-
.)\JJWllM?L\
AREA d *I 11\ y 11.*t:.~
-, . ~ 9 -~ ~:'.
(T-Lf;. ID .J,
\\. J.
1\.5 (x,o) Up= N S 1._'E) w LP- b {circle) 1...,,.., I v' 7;:ll1**,1-, u
""' o .). I 6 LQN r*1 i..kt ,:; . ' --
Three bat." ~ ;;i_v ~'()IL/~ .0\ WA. v.J 1't. '-f,;J. c. ~ *5 \ Dimension {1 to 2) !~ Meters
...>>1"1 I . 4 1 s- l.-C....t. . / .
Four .bet. ft l.J J..1* ~~* - * .5 -lm:l. \) 7'8 *q J..
- o;;:,. ~ ~ Dimensions (1to3) 1'\ Meters
App E-Sub-Area 2.1.Sample Data Sheets
SAMPLE LOCATION DATA SHEET Date; ru-21-1 ~ Weather: --21J_v,_n1 1 r c.c \ d
- 1. Sample Arca (SA):
SA Designation: 2.1
Description:
_ _ _ \J_.oJds* SA Origin Location: l\I '11..'i7j'i*-r -~ </, 7 o:.?.~ Coard. System: ~µ~1-~.J_ __ SA Land Mark Descri1ition: _Md 6Wob:r--l!?.~- _ Coard: ~ LJZ. ~'t~l.E'.:._ .W Tt -, <.11t.tl"
- 2. Sample Location Data:
Sample Area ID: 2.1.1 Matrix: __ci~'._I ___ _ Location Coord: W7.f(, 7ocnd' -** /\/ ...1...?- '-/7793 _,
\'i Alternate Location Measurements (distance from SA origin and Local Coord.) ---rr-e..t i \'\
~- X Dist. fi em Origi~ (G,B)_r-J ~ 2 /1101¥1" ¥Dist Flom Ot igin:vJ 7 <l. ]().)'?}.:>
\~1 L'I -ro 1ojz.:'.:i Site Sketch Attached (Yes) ~
Sample Location
Description:
__yns\.e5 *~ j ti{) Canopy Type: Wood.gel Land Lise: J:L..~'-'-'{l=cJ1--- . Soil Moisture (Wet, dry, etc.): T)'\l1 I
- 3. L ocat10n Rd" a Ia f IOil R ca d"mgs:
2x2 NaI I Bicron ! Notes (cpm) (uRemfhr) Count time ! cm i Ill i I cm Im (min) j J/}?;1~ 9&25' ii ..}j_ . . 7. NIP..
*->--*q~L.1-~* *~.
I i{}f5 !I I
; .. ~---- --*- fJ i 11- ~* ***-** --* ... ., *-*-*-***-'----******
1!
- 4. Sample Information: Sample Area TD: 2.1. l . R.
- l -~ '5 Description b y D epth ....
Dept/1 Soil Type Soil Sample ID Sampling Description Jnter1*al (Org; clay; Color (Suiface litter type/depth, sample depth retention,
,____,(cm) sand, etc.) refusal, stone or rock, topography, erosion features)
()-JS s- 1 l5 c._o ~)
</"'~ \ ~
bvn (\. 2.t.l.ILt 2., \I I,~ .1...
<;o\'\'\..<l mo-1--S r D ~ IL< -e:P----1t1.s~s J<":) -/o() CD~-+ S* '.\ .fu.n -Z.. \, L 1L. 'i tj~; c. v~"'-9-~~ ~ i,JG..S \.\~ co>-.~
n-i-s
., ~ >-~*,\ ~..
b..-.:itJr- ....-?-' I\
- t ........ ,~
\2:. I '5 --1-~~ '.':>,,.*~ vi:>'-'lr°> *--*-...... *****~*~~ *A~** ._s;~ple Rc~o;ded on Luboratory.COC form and Container Labeled: (N) 10/20/15
-~:r.s ~ -n;-~c SEWVR:".E;l!<"
SAMPLE LOCATION DATA SHEET Date: ; v 5-/S Weather: ___5.~JIAY,
- 1. Sample Area (SA):
SA Designation: 2 .\ _ -
Description:
_ __.__W,_c_.-_J_5_ _ _ _ _ _ __ SA Orig;n Location: tJ'l2."f1'11'( W 7'{,}tJvls Coord. System: r-J "'1 SA Land lvfark
Description:
So.:~ (7.>9--d _ei1-..d Coord: t-141,'-!t~
- 2. Sample Location Data:
Sample Area ID: Z. \ . L Matrix: -5.~ Location Coard: \tJ 7 ?;'. 7 UJ& i.:; ' __ _l:!__':/2 Ji 7 Cf '16'" Alternate Location Measurements (distance from SA origin and Local Coord.) 0\\ l'C-$+ ~,4 0~ 'Qv-,:. c.;,{O*' X Dist. from Origin {O,O)_MJJ~--- Y Dist. from Origin: JJ-'----,1-'-_
/f'.'t __ IJ5 1;~ I r-v.dP\.<. Cf 5,d_
Site Sketch Attached (Yes) -~ Sample Location
Description:
_ _w_~-~1 fu\l,o i1 k_g_,-r- co1.,r;.rJ . n l.fo...vc,__.,,s'---_ Canopy Type: ____1!'\o:..iW _Land Use:__ Hi\i'!(l;) Soil Moisture (Wet, dry, etc.):_-ck_~*- ci
- 3. Location Radiation Readings~
------ 2x2 NaI -~
i
------.~---
B1cron Notes 1 {cpm) , (uRein/llr) Count time lcm Im 1cm lm I (min) I Cf&ffJ Cf?91 c,* - 'i NJA I qt?"f% '1553__ - I k.li..&_
- 4. Sample Information: Sample Area ID: __ 2, \ 1 2. , K.. f -3 Descri tion b Depth_:-.--------.-----------.----------------------.
Depth Soil Type Soil Sample ID Sampling Description Interval (Org; clay; Color (Surface litter type/depth, sample depth retention, (cm) sand, etc.) refusal, stone or rock, topocrraphy, erosion features) () - 5__ ---5.oll__--+~= _b_!~~-----+------+-"""---""---'"S::;,.___&.. me t..5 . )~ ~ -- I 5 _t~ :1 --+-"*"'-'=---'--+--2 ,J_t___!&_'? __Y?A:* h" _9.-we.-f-C...:; -------------
$":! --------------+-----*---- *---------------+--------+--------i--------*--------------1 ------------------------4 r-------+-------+---------**---+----- - - - - - - - - - - - - - - - -
- Sample Recorded on Laboratory COC form and Container Labeled: ( (N) 10/20/15
~ **~1.3>
SAMPLE LOCATION DATA SHEET Dute: tO -.z.3 -f ) Project: N'fSlt2DPt Weather: S>J*N1j, wen*"* l.* Sample Area (SA): SA Designation: 2. J
Description:
-"'"/JJ~o~"'-'ci_s; ___~---- 'A Origin Location: ...tsl~- # ]J&~ i*Qi, 7 0' 1 ~ ** 3- Coord. System:~ i.J Z1 0 'A Land Mark
Description:
_,_S"ux\1,,j~c0- <Ilf~_d__ Coord: rJ~Z,-tfu_*_
~~2..4/ 'fi4' j,N'7&-, 7067)""
- 2. Sample Location Data:
Sample Area ID: ____2_,__L_l ____ Matrix: _ ....~ .. - D Location Coard: N4Z.17'io1...-~ __ ..1.~ 73,7oofflg
- Alternate Location Measurements (distance from SA origin and.Local Coord.)
X Dist. from Origin (0,0)4__,,
- Y Dist. from Origin: N/ft Site Sketch Attached (Yes) ~
Sample Location
Description:
Vl"lck- hr.0,.___fkt..._pJ.a:fd!L---12t--2ML c;.;*/Y\J2...r" J Lf17...,-! j
- Canopy Type: jtJCoc\.eJ etc.): .'D...,,'---~--+---
Land Use: hit; J-*-.. Soil Moisture {Wet, di}', -3. Location Radiation Readings: 2x2 Nal
.. I.~"
Bicron Notes (cpm) (uRem/hr) Count time {mil~) lcm Im 1c1nI Im I
.._!L. _ _____g_
I 07fJ'-7 JtJi35 t-.dP- >-*-r- ..~L..£2.J{ _ . i 0 Di./ g ._ 1,-JJ~ 1¥ _._.,.,..--~ . --- ~**---"
- 4. Sample Information: . Sample Area ID: 2. l , 3 , R-. I ~?..
D C!Scnpt10n bIY D ~pt i: Dept/J Soil 1)'pe Soil Sample ID Sampling Description Interval (Org; clay; Color (Surface litter type/depth, sample depth retention, (cm) sand, etc.) refusal. stone or rock, toEogra:Phy, erosion features) 6-5 5o.\ b{l:;>u.>n 2,\,3,,R,\ s~~
".1-J~ sc: \ h ....... .,.._ 2..., I*~. 12.. ';l.. 5rvv** 1.1 l('bQt, 5-1r- 'Srl ; \ hvuw 2.-; I,~,~*~-- r----***----:--*
S'r'YlDL\\. V\)(>'\' s
*- C-"-****~*
Sample Recorded on Laboratory COC form and Container Labeled: (j1 (N) 10/20/15
* ~ *"
- d SAMPLE LOCATION DATA SHEET Date:_~TI_-§ Project: ~ .i'.'...5J;E::!2&. ****--*. -
- Weather: 5.."vi+,
I. Sample Area (SA): SA Designation: 2. I
Description:
___trJ_o..,_d_-s_________ SA Origin Location: ;.l}j_Z. '17H'*i"' W7 If. 70o7'J<; Coord. System; _.AJ)J SA Land lvfark
Description:
.,;w:.~L~---~- Coord: ~ 'f&<.1'0-Siv"" _id._7"8'. 701'*(Z-~
- 2. Sample Location Data:
Sample Area lD: -----2. . L.:t_____ ._ Matrix:_ 5'1.t *, \ Location Coord: N !:/-~77'/ "Z... " Alternate Location Measurements {distance from SA origin and Local Coard.) X Dist from Origin (O,OLt!fi_ _ _ Y Dist. from Origin: -Mfj_ Site Sketch Attached (Yes) (@> Sample Location
Description:
--~~s,..~-6~-~r-*- - - - - - - - -
Canopy Type: tuo~6 Land Use: Hi IL.\.~_ Soil Moisture (Wet, dry, etc.):__l?~___,+~--
- 3. Location Radiation Readings:
2x2 NaJ Bicron. ~ Notes (cpm) ' (uRem/hr) Count time lcm lm !cm Im ' (min) ,. 4 'i7Lf , I __ __::_;_ ~11\ J I Wfi
~* *~]___- ,___°!377 *- 'r--*- * -1 [ 1 - - - - - - - - - ----*- r-gjvt
- 4. Sample Information: San?ple Area JD: 2. \. '1, 't. l - -Z.,
D escnption b}' D eE th Depth SoH Type Soil Smnple ID Sampling Descriptim1 Interval (Org; clay; Co/rJr (Surface Jitter type/depth, sample depth retention, (cm) sand, etc.) _refusal. stone or rock, topography, erosion features) .. D-~ ~-l bVU<..-h\ ~.\,t..\.\2-.\ I hl\I\.\./
~LJ.,:- _z, 1. 'i.~. 0 5-1 ~
i2,;'(1re;. k IT'ir: -H.O "i,d
~ 'w'-c.. - ~-..;;,.;___ ~
roc:,-t-s
~ I . 'i . 12. * (,,,_ r - - - - - - - - * ? 1...1.__f?:_J_ ***--*--** ~
Sample Recorded on Laboratory COC form and Container Labeled: © (N) 10/20/15}}