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App E-Sub-Area 2.2.COC Forms
C1 eJd Q.[)DA--
l'a6c* --* --- -* of GEL Chain of Custody and Analytical Request GEL Labornlorics; LLC I 0 ProJcct IJ~
- "See VlWW.gel:com for GEL's Sample Acceptance sopu 2040 Sa~agc Road GEL Quote#: -**-**----**
Charleston, SC 2.9407 COCNumbcr!'I:
- GEL Work Order Number:
Phone: {843) 556-&111 PON11mber:
Fax; (&43) 766-1178 Clicllt Nanie.
Phone II:
Sample Analysis Reqneskd {SJ (FIJl in lhe number df contniner.s for each lest)
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No Circle Dclivcr>1blc; C of A I QC Summary ; LC*Ci I I Lwcl 2 ' Lcvci J I Lncl**I Remal'its: Are there any known hazarrh appiic:abfe lo !11ese sample.~? (f.vo, please list the hazard~
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WHITE~ LABO RA TORV YEl.LOW ~ FtLF.
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GEL Chain of Custody and Analytical Request GEL Lnboralories, Ll-C 0
Pro1ecl fl:
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- See www.gel.com for GEL's Sample Acceptance SOP*+
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.. GEL Work Order Number:
Phone: {843) 556-8 ! 71 PO Number:
Fax: (~431 '766-1178 Client Name:
Phone ll:
Snmple Analysis Requested (SJ (l*ill in 1he Illltnber of containers for each les1)
Project/Sit~ Name:
Fax ii:
Sl1oulu 1hi.*
<-* Prcscrv"111:0 Type ( 6)
>ample be Address:
conr!d~nd Comments Collected by:
Send Results To:
Note: extra sample is
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No Circle Dciivembk: C of A I QCSmnmary I Level I i luwlZ I Level 3 I Level 4 Remarks; Are there any knovm hazard.~ applicable to these samples? lf.w, plea.~e list the hazard~
S;Jm11I~ ~ls!cliQn Tim~ 220~
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Muunlnin Ch:iin of Custody Slgnatul'cs Sample Shipping and Delivery DctaUs Roh111111ishot! Uy (Sii;ne.!J Dn.Lc T'mr:
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YES NO s} s.~mple Ar.alyJIS Rc::i11u1c:<J* An:il;iHCi>hl\\~~h;Jd reqi::t~td fie. 8Z60ll, 6CHODl147i.JA) :ir:d 11wnbe:r dca.n1oinct'S [UO\\',*Llcd rort;1CI\\ (Le. R2MiB -J, t.rUOR/147l~tf. 1).
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App E-Sub-Area 2.2. Instrument Field Sheets
Rev 110/18/15 Instrument Field Response Check log
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Makt>/Model:
LUDLUM 2241-2 Detector I:
Make/Model: _._L._l)._Q),JJJ~..4~10. __..
Bicron MicroRem Meter:
- 2.
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Serial No. -2,62737 Serial No. _..P£.. 1U127..
Seri<ll No. _l\\2).~"""tJ,___
Source 115otope: Tb-232 S.~rial No.. _JJ_9 Activitv: 5-Q..l.... units:.u.cL..
- Ca! Due Date: 9/2/16 Cal. Due Date: _8/4/16 A:>say Date. 12/30/10 Reo;pon~e Acceptance Range U/*W%): uRem/hr +20%... **-**.. _
uRem/hr -20% __.-
net rpm+ ?.0%_?.l.!.U§_ net cpm -20% 15284 Source2 Isotope:.C.S.-::l37...... SE-mil No.:...81£13.-48.... --
Activity:..O...QL_._units:_µcL Assay Datp* JJ2!J/J.0 Fl.espo'1se Acceptance Range { +/ 20%)* uRem/hr +20% __
uRem/l1r -20% ___
net cpm + 20%.. 133?.S... net cpm -20%.. 8.9.19.....
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Technfc:ian/Wor!cer Performing Checks:
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~A.. -***.. l....... lg........
......'!.....,....Y.. L.. Y.... l 9 r1~.~ i 1 r ~...... -*- *--*-. *--- '"
'. Bicron
]I NA Y-NA
/ f?
'/....... +
..... Y....
1 y... j !.'3 ~.{:.~ ?~. ~:*:*. *. **.....
- 1~.~i~-r~n........... ~A--
..... £.. *-..... NA..... ~.... Jl -*----
__ y __..
~...Y _... J. _ _t_~J1_'f_J_o_~~5_2_~(,,_,~-----
. -.......... -.......... ~
- 1.
r;*~:',.IT'Mt d":':i;3'la':ed ch°"~\\.: ~OJr<:~ i$ *i!to~d vn !'.ii'itraticr: ~t'rd;:r. RCC<Jni *:'1e*:~ 50<.1" :Y-Ce~pu 1~3':°: (n~t q.irr*i p*rv t'J f;-.!'d :;l(!p:oymtn~ f ;,r al~ ci~ed ~OL*: c~~ b\\;)S:g 'J5t!::l.
J.
Sou~c~ and lla4.:kgrourd r..oi.!nT r a+-~ ~h.:-U~j. bP !1~tprrn~n~d frcrr. ~he> averag9 cf ttiree st.atk count~ at tiie ~-?Im~ ~::.::a'!t!:*~
P.f=Pf-J!... o~~r. rs ~-h.~u:d i~~ *.Ji..*;:r=i*1 20~~. tr :;..~~.
.-n~ ri.Jtt: c.!i"1.:rg~1~
S'£n!f.ca11Ll*~. p2rlorrn add*tior.ai Cc>l111t~ tv ev.;i'uat irJitrume11t st.itoit!t)"
J
I
("
r i I I
I Instrument Field Response Check Log
- 1.
Instrument lnformation1 lvJ/uri, >>7'1-2 serial No. r)..~&<Yf'i Ratemeter:
Make/Madel:
Detector 1:
Make/Model: I v,//vm ft/_#
Serra! No. l'~!lLGfL Cal. Due Date: tJ~?/i (
Sieren MlcroRem Meter:
Serial No. ____ _
Cal. Due Date: __ _
- 2.
Check Source Information:
Source 1 Isotope: -77.-;J-3).. Serial No.:
/I J Activity: <:(). I units:~*
Response Acceptance Range (+/-20%): uRem/hr +20% _~-
uRem/hr-20% __
Assay Date: l#>>,}'o net c:prn + 20% ~.:5?'19 net cpm -20% 3'~.CG Source 2 Isotope: {s~f S?
Serial No.: f /jEJ..>-/.2..
Activity: cJ.o,;z.. units:,eC::. Assay Date: tJ.lA Response Acceptance Range (+/-20%): uRem/hr +20% _~-
uRem/hr -20% __
net cpm + 20% 1$../.-13 net cpm -20% ~f 1[C]
- 3.
Checks:
Title:
__ EJ---"---c---r
- 4.
Site or Location:
Site/Job:
fl-r=f! e....2. ;L Location
Description:
,_~---W~8 o~o:.::J.~s ____ _
GPSCoordinates(whenrequired):
X-Coord: N4J.-.lf7'*f7t.f ~ Y-Coord: W DW.t:.10,2 °
- l Instrument Field Response~
Use Acceptance Criteria Remarks I
Rev 110/18/15 Meter Bkg Bkg Counts Source Source Response
+/-20%
Inst.
Battery Time Ambient Initials and Comments Cnt (cpm) or Cnt (gross cpm or source Ca lib.
Check Of Temp.
(add' I Info: inst. Condition, etc.)
Time uRem/hr)
Time uRem/hr) gross cpm current (Y/N) check (oF) or uRem/hr (Y/N)
(Y/N)
! Ratemeter f iM*-;... ~ 7 (7 (. /Jid-I.....,\\I\\ '-I.,. (/ '7 t:..#,...
v
...j
~1;.5 zq.)
/h-;;. '('J llF Rate meter I
) Mn**
I O 7 () '-f,,._)~""
\\..)
\\/
.JJ i/Jt/'?CJ
~7.~
/,,. -!-7:1 P' /)y Rate meter J
I
{
I 7 (7 Rate meter Bicron NA NA Bicron NA NA Bicron NA NA Bicron NA NA
- 1.
Instrument designated check source is listed on cahbrat1on sticker. Record check source response {net cpm) prior to field deployment for all check sources being used.
- 2.
Source and Sackgrou nd count rate shou Id be determined from the average of three statfc counts at the same location. Repeat counts should be within 20%. If count rate diverges significantly, perform additional counts to evaluate instrument stabllity i
I l
j i I I Rev 110/18/15 Instrument Field Response Check Log
- 1.
- Instrument lnformation1 Ratemeter:
Make/Model:
Detector 1:
Make/Model:
Bicron MlcrCJRem Meter:
Serial No. dlOG()d}[;
Serial No. Pf!..! /.,2.C,.<-()_
Serial No.-----
Caf. Due Date: __ _
- 2.
Check Source Information:
Source 1 lsotope:":Zk~2 Serial No.:
/{ f Activity:<O./ units: PC/
Assay Date:!Ubf~
Response Acceptance Range (+/-20%}: uRem/hr +20% __
uRem/hr -20% ~
net cpm + 2~
7'7~
net cpm -20%.l>°U6 Source 2 lsotope:Cs-13'7 Serial No.; f /1~-12 Activity: t?.o;-
units:~Assay Date: /1/A Response Acceptance Range (+/-20%): uRem/hr +20% __
uRem/hr-.20%~~*
net cpm + 20% 1~75 net cprn-20%
~lJt"j
- 3.
Technician/Worker Performing Checks:
Name:.:£ E.Pw,_,.P.,,
Title:
__ !ZC
__ r __ _
- 4.
Site or Location:
Site/Job:. __
__,_,&~..:;;~~""'2--'-'. ;L.__ ____ _
GPS Coordinates (when required):
X-Coord: Al ij.Z. 't7'f7 'i
- Location Description : ___
_..W{.;;..;:;.c.;::;;~=.l-$--=---------
Y-Coord: W D7f'. ~9!>? 2 ° 1
Instrument Field Response 2
Use Acceptance Criteria Remarks i
Meter Bkg Bkg Counts Source Source Response
+/-20%
Inst.
Battery Time Ambient Initials and Comments Cnt
. (cpm] or Cnt (gross cpm* or source Ca lib.
Check Of Temp.
(add'l Info: inst. Condition, etc.)
Time uRem/hr)
Time uRem/hr) gross cpm current
. (Y/N) check
("F) or uRem/hr (Y/N}
(V/N)
Rate meter I Mir fSb" I;,,,,.,.. f...,r, t.J~ or C.>>N' y
v v
V3~ S".y'. &
/A-...2..S 2.
r:;;;;:
Rate meter
,,,A........
/0 J,..2.'f ;.,.,..._
/.../
f......I I\\/
'!~'5?
5t,r i"
/5~/37 C//lt:;
Rate meter f
f
(
,(/
Ratemeter Bicron NA NA Bicron NA NA Bicron NA NA Bicron NA NA
- 1.
Instrument designated check source Is listed on cahbratloo sticker. Record check source response (net cpm) prlor to fleld 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 dlvergas significantly, perform additional count~ to evaluate instrument stability I l 1 i l I I
App E-Sub-Area 2.2. Sample Data Sheets
-~
..w:JW T~ot.
S~~-'ll!:E'fi" SAMPLE LOCATION DATA SHEET Project:
bl Y5 r: i2.00 Name: ~
...--, ___.... ~"0.-*... ____ _
Weather:
'S"1 u1rn /
l.oo l _
fJ
- 1. Sample Area (SA):
SA Designation:-*- 2, 2.
==
Description:==
_k-:Joo~.~--- *****-- ---*--*-*... **--*-
SA Origin Location:
~...!:JJ.-; z., "l'~_,_"1_.t./'_Jt.}._]_rf i.f (.§..~, 77" Coord. System: J#_.W, __.......
SA Landi\\tlark
Description:
__ _j5 o_.. ~.--'&.a.-1~----***
Coord:.-$---. *-*-
___,__tJ""'f~Pr,___ __
e-.~°'f,v
- 2. Sample Location Data:
Sample Area ID: Z, 2.. I
. ***-Matrix: 3_u_J_f._J.....~d..
Location Coord: ~
{. &9£/0 4'F
_J~L.Lf 1- ~ I./7 3 'i 07 ~---
Alternate Location Measurement:; {distance from SA origin and Local Coord.)
X Dist. from Origin {0,0)... t:l.fl2r____
Y Dist. from Origin:
- J_,_/_t'>< __
Site Sketch Attached (Yt:s) @
Sample Location
Description:
[Noud:?-r-:pl(ll('... i'\\..udl"!
C.cwt:.fo.~ )
Canopy Type: Ir-! lluCt,_.j,.
etc.): :t)"\\,
I Land Use: _tL_\\L'..¥!~)-**-*--* Soil Moisture (Wet, dry, J ')O ~J_) £ o~ ~~-'=~d\\
ey,,"{;)'1 1-..i t,r\\.l.lf-
.,J*c..--
("'"~~
c~~~<- (l--l r.,.~ ~*.-'.,~)
- 3. Location Radiation B.cadings:
2x2 Nal Bicron (uRem/lff)
Notes (c m)
Count time J
- crn Im 1 cm Im (min)
~~------***'"**-*-....
- 4. Sainple Information:
Sample..fr<!lt JD: 2. 2.. I. R..1- "5 1 $.
D~:~7,~tion.S~~,n~~~:,_Sc~l--**s~~-;,pie.iD*--1-*****
-Sampling Description *-*--**-*****~
lnlerval (Org; clay; Color
{Surface litter type/depth. sample depth retention, (cm) sand, etc.)
refusai,_.stone or roe~, topography, er<?~ion fea~~~~)
o-5
'~?:i>L~" _-z,.L.d~R..1
~...,, a
~.1L.~'t:$. ____ _
'5-15" [!_,~ 1$0**,\\
C..i'fnt'b;wf,.. Z. r 2, \\ 1 t?,,~-
_....[yQ'i.Q 1 Sow**t.
!\\";'\\-1.Nl
~!~~-------<
' o- /QO,so';\\ L <'11'> J
!l\\ll~ 'l, "'l. * \\ * \\2... *5 -~-£:1.?f..ll,_1'12.C,-,_~
0 - 5
/,~.v...'-'I s.- \\
~-_le_~_:!...:..&.'?.... __
~f'N-~----1:::::2~.5~
yg:..~"':::.~* -------
l------+----*-t----*-**---*****-***- ---1--------**--*-**********-****-*** ---
1 1-------t------- **-----+---------f--
Sample Reco~ded on Laboratory *cocronn ;~;d~~;;t~incr L;b-~i~d~)
--...........- *- - ~----!
10/20/15
SAMPLE LOCATION DATA SHEET Date: J.~:.?::r-1 (
Project: t-J'/'5 !S:/Z-DA-x-,.
Name:
on Weather; -~Oj 1 e,...o<.,>.L *.. _. ___ _
- 1.
Sampl~ Area (SA):
SA Designation: --2.-J~.
==
Description:==
_*_WCJv J '.:>
0:4 Oris;in Location:11 ~],,_"_]...~' ~~~
-~1'1~41'3'1, n**.
Coord. System: b(11J SA Land Mark
Description:
~~--<'if!t
____ M ___ -* '\\-
Coord: -.N/ipr-Njff (iro yJ:.
(
~>
- 2. Sample Location Data:
- Sample Area ID: _7-_. 2---'-..;;...z'------ Matrix: __sd...
Location Coord:
V 7 8, li>J LjJ{) ~~--*--
Alternate Location Measurements {distance from SA origin and Local Coord.)
X Dist. from Origin (0,0).. N/t+ _ ___._
Y Dist. from Origin: -~LI+_...
Site Sketch Attached (Yes) ~
Sample Location
Description:
. words f "r1~..fly-_d:_Lu IM' 'i Cc?~~-c'j)l/ l-@cv<)
~
j Canopy Type: L...i oc>Md etc.):...D~~---
____ Land Use: JJ.;_10.,"7***.. *---.. Soil tvloisture (Wet, dry.
- 3. Loca.tion Radiation Rea.~i.11~: -*
2x2 NaI
- --~---*Bic1:~;;1***---
- = ----- *---N-oi-es------*.. *-*-----*--
(cpm)
(uRem/hrJ Count time I cm t m l cm Im 1,
(min)
~-~.
-*~---,.
.... *~*~={-1,
-...----+----...Ji!-~~~-----~
t.zo1. __.__6_?-2J- ---:e-._!f__--~*-*/L._..
f'.IP..
,____f _____ LP~l.e_ ___,___?(;7 g'
- ---.....;i.._---'-'.,._"'Jli,_~ _____________ _
L_ ___
.. i -
- 4. Sample Information:
Sample Area ID: '1, l. 2. 12..
- 1-3
- -~---*-***--*~-
S()i/
Sample ID Samplbtg Description Color 1----'--~--+--~------<--*-*--.
{Surface litter type/depth, sample depth retention.
refusal, stone or rock. topography, erosion features) b1:tJ\\..
4JJ..(DL'lS
{mc..lt c:?.=l.l,_G--::::_:, _______ _,
I 1----"--'----+=......+-=-"----'----l~r'W<\\...... ~°?:. -~. fL.-'2-
$'[)1t...'-\\. V"c>i"Sr-~'-l.. i'CC\\<:.-$ __ --*-.... ---*---
I -
(i*I. ~
- z...Z.."?-~--. SMlilL...tt.k~'T-ll!~'.1:... ------**-------;
1------**---*--*-.. **--1-------1---------+
--=~=-~~--=-:*r-==... -~:~==-~-. _,.._.. __ -=---.. --....
'----__.l.-----"--*-.. --.l---*-.. ___.,..,..., _____.. J _______________,,___
Sample Recorded on Laboratory COC form and Container Labeled: © (N) 10/20/1$
SAMPLE LOCATION DATA SHEET Project: NYS e gOA Name;_~ &-,,__,'/\\ _
Weather: __5-un~l.f c:co l
- 1. Sample Area (SA):
SA Designation:.
- 2. Z.
==
Description:==
SA Origin Location; N '-12PZ.8 1l.'t.'/b_Jt.J2jj:_ _ _I/;'*37f. 77" Coord. System: ---'-t-J~.....,iwc..:......*_
SA Land Mark
Description:
~"
~f} N {)soyJ s £. ;,f) Coord:
Ni P<
rJ/ f\\
- 2. Sample Loeation Data:
Sample Area ID:
- 2. 2. 3 Matrix:._'fi;::;;:_o_\\,____
Location Coord:
W 7 '$. f.i:81::JD8(
tv '12, ! 7 3 i lP f u Alternate Location Measurements (distance from SA origin and Local Coard.)
X Dist. from Origin (0,0)
- Nj.P.
Y Dist.. from Origin: -~
-~-
Site Sketch Attached (Yes) @
Sample Location
Description:
W oJc.i. 5 I. rlfto/u "1-~
~-}-L~v~
Land Use:
./-t; b °)
Soil Moisture {Wet, dry, Canopy Type: j,Joockd etc.): Dr"/--
3 L ti Rad" f R
d" oca &n ia wn ca mgs:
-~--*-***- -*-..----------**-
2x2 Nal Bicron Notes (cpm)
'1 (uRem/hr)
Count time
!cm lm 1 cm l lm (min) 5'F 8$
f>sa7
- ~Is. N)ff I
to r----
-~---**-
J
(_pi. 3 7...
5'6&3
'>--;J) I~
I
~-*---
- 4. Sample Information:*
D b D th escnot1on y en Deptlz Soil 1)-pe Interval (Org; clay; (cm) sand, etc.)
n~S 50',\\
5-15
.:::..r.'.\\
16~ JOO l<r-."\\/.,_t,;_.... A
- -r--***
Soil Sample ID Color r
--*-*---sm;;pling D~cription --~** *---
(Surface litt~r type/depth, sample deptb retention,
~f.u.sal, stonli! or rock, topograph:r1 erosionfeatures)
\\) "°"....,-..
Z.2.3.~, l
~...,.....
2,-Z., ~ iZ. 2...
i..--r A btv-"'" 2..Z..3. ~-5 l Sfilp.,l\\.
yO 0 '4.- ~"\\!--"--r'l;(,I<.. ~
~~
s~.. *-<>-'-'-
,-pc:,._!;,,~---------i
~~
{OC..\\!.~
+--*-*- *------
.... *--~--***--*
- --* +*-
1
t***----*****
Sample Recorded t>D Laborato?' COC fom1 and Container Labeled:~ O'Q~--- ---....
10/20/15
...:..uw~.i.5'ER~~
SAMPLE LOCATION DATA SHEET Date: /tJ --Z (,:; -1 ~
Weather; 3...,.-nY\\y C."-'""'
I
- 1. Sample Area (SA):
Name: --r;;;;
ESn,.__,!\\..___._._
SA Designation:
2..2
==
Description:==
Wcr:d,;:.
SA Origin Location:
~z:2Y\\2'f-11:r' W19~'1 J'}s. 77"'
Ctiord. Sy--s-te_m_;--N-~-w-,-
SA Land Mark
Description:
~~.t'rl E>-"\\'Y -~~)'ds.b..;;t='}:oord:
tljk
--11/---1\\-
- 2. Sample Location Data:
Sample Area ID: _2_, 2_.--i,__ ___ Matrix: l$..Qi] __
Location Coord: \\N7"'15,i..oC;'-( J'+Z.:> __
Alternate Location Me.aSurements (distance fi-om SA origin and Local Coord.)
X Dist from Origin (0,0) jV/f+
Y Dist. from Origin:.&.'/ d Site Sketch Attached (Yes) c@D Sample Location
Description:
Canopy Type:
l~d etc.): ~
w~.
f°'1'\\.\\:..,, {xOJ.-est f1N*11 co,,*.. -c.'f"-~ ~---**---
.. Land Use: ~
tlJ----- Soil Moisture (Wet, dry,
- 3. Location Radiation Readings:
2x2 NaI
---,,-***--Bicron ****--~--*----***--N-ot-*es*-----*--
(cpm)
(uRem/hr)
Count time I cm Im
- . 1 cm j
lm (min) 1 1-->---_-_,-' ::~~:::r*~~....:;.3 5
-~-~-'---""~'--.~-~t~ ~-~, I T __ *=:': =~-,...,/-~--_*~--~.:_-=.=-=-=-~-_._*~n-----~--.. *~-.*_
.. ~*==
'----------------'-"--- --~~~'-___ __J_ ____ __,._ _______ -------------'
- 4. Sample Information~
"-i-.1, w.. z,
. J]-* 2
~-~\\._md:-.,, Qls\\
....,,{ _
_,.~
It:. *"D,,_."'
2-. Z..
R.., 3 1 (ti. i,(. -S vo.Yts.
'--=-'=---+--"""-'--'------t-'\\-;:i,.,_fU.1""""'....l::..;,'l'l.:..+?:..!_~.~{2. ~s- '.. 11{.Yl'f,.,$
11>.Y.'-'-"'<,.-=---------
1------l--==~c.:.~=--..
'Z.':~i:1
- R._to_J____.l!/t~
__.. ---*----1
---~-+---._-----_ ~-~c--~=-===~----*-***-*
J Sample Recorded on Laboratory COC form and CQntainer Labeled: (!JJ (N) 10/20/15