ML16293A393
Text
- - -
App E-Sub-Area 3.2 - COC Forms
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tequiredfor sa1npfo
- specific. Q~
No.
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- Sainiile Colfoc1iorr'!'ime Zone Elisiefn
- Pacific C61tr~r Other *
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CCC.Number <1>:._
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GEL ChuinofCustody and Analytical,Request
~*Seeww~v.gd.com:Tor.GEI:.'s *sample Acc~ptance SOP"'*
QEC L;iboratories, LLC 1 ()
- 2040.Savago Road Chaf!e:;ton; sc:29407 P!t'qnu!-(843) 556~.s rn fax: 18431766~1178 Glient-Namc:
'.Phone#:'
Sam11le-An11lysls *Req11este<fJ5I, (:f'ill itl-ilie number of contalners*Jor.eacl< iest)
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Fax#:
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'*Time.
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.commen~
Note: extrasamplds i-eqi1fred for sample.
speci!ic' QC
'TAT.Rcqucslcd: Normal:
Rush:
Succifv:
(Su1li<<t '" Suwharg<Jl l'a:1. Rrn1l1s; Yes
.Circle Odivcrabic;: Cof 1\\ l OC Summarv I Level l /' Level 2 I L<:v<:f.3. I Level 4*
Re111a1-ks: A r<1: there.apy ~rJown.hazardr appli¢ahfe to these samples?)[ so; plea.1*e /if;t the. hazard~
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- sa1µple Shipping aml Delivei:y mitalls
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'l Mctbod of SliinmCJll:
1 Date'Shioncd:
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- I,)' tlramoCCu*tody N_un1b~--~ CliC11I Oot<'nnii:~
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- GEL Chain of Custody and Analytical Request l'!OJCCt#.
NI A,, i G~L_ ... 'Q~otetl: -.. ~-*Pt, _.. . *. *t'* .. "Sccwww.gcl.com for-GEL's*SamplcAcccptancc.SOP"*'" OllL Laboratories. LL{'. 2{)<1Q S~yagc Roud COC.N\\11nbcr 1: !";~ P~T 'GRL-Wor.k Order.Number*: PO Number: 1\\1 t A
- cimr1es1on, sc:29407 Phone: (84'.l) 556-8171 Fali:J843l 76.6-l l7li Client ~ame:
Phone#: Sample Analysis Requested !Sl (Fiirin the.number of containers ibr ench test) Shouhl 1* Projec1/Si1c Name: 11111 1--------------------------'---"'--~----------------I ~am11l~ be'.;
- . Address:
i'!11)ld<~<<l*
- Collected by:
Send *Results *To: .Sample ID ~:ftm: comn"sitr.r.,. imlu:atr,J/1Jr/,mul ~ffm <lut~llimr: 11Tnne _C'"lki;;tcrl (Millt.,y) H1ht11rrt) QC.-
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l*tr- i;J/ A: N /AN 1\\J r <--..l'rcscrvatiw Type (<1) Comment~. Note: cxtr;i sample is -required for sample spec.ific QC' 3,1_7 R, l N~~~~ ~-:~~6+1-~~---*-~+JA~-+~N~.1~-~+**~N+**-~~~i~--~~i~-~~~~~~~~~~~~~~
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- Rush:
- S!lccify:
(~cbiccnvSwd>>ti:*; lrax'Rcsults:.
- Yes No.*
Cirde-Dcl!vcrublc: :c~ofi\\ I QC.S~mmaf\\' Level I i Level.! l l.c\\'cl 3 I Level 4 Remm*ks: Are /here.* (J11y.k1io.w1i-hawrd,v applfr.;c1bf e.io :11ie.wsa111pi es? f/.1'(J, plet1s<1 /i~*f'fhe.hazarrfs .S.i*lllplo Collccligu Tirr:c Zon~
- !!astem Pacific
- Ccnu al*
Other l\\founn1ii1.
- Clmi11 :pf_(:J!stody.Signnt~rt:~
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Date Shinu~d: 2 Airbif!k: ,,.t.~<1r L:a/J,,Rt!,1iving. llse.Q1i!r i.. ;-* QC Coc!~'~:*x*... *xo:iu:d ~amr!C *. TH... Tri1>.0lan1t:. ffl;,,;,, "J~!d Ot1pJk;..1c,*En*"" RquipT)1cnL.Bbl1k. ;\\J$ t::' Maui:t: Spf~C.Sa:;"11ple,*:\\1S~)- Mr:11ix 5pi~o. Dt1r.lt.otc S\\'1~r1e, G.~ {i~.3b/-C *.C\\'mpu,illl! i) ::yi~td;Pi!l.cr~di fpt liquid.r.1airice~~ inditntc w1t_l101- "/.a.for y~Jhlr~~in;:~. ~~l!--.,*.fi~ldi;it~r~d o~... ':';.. 'r1;r J.<liUp!~ *\\~~£.not,Jkld r~~cted C11:umly Seal ln!iJct'I*
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App E-Sub-Area 3.2 - Instrument Field Sheets
Rev 110/18/15 I I I i
- l. Instrument tnformation1 Ratemeter:
Make/Model: Detector l: Make/Model: Bicron MicroRem Meter: Instrument Field Response Check Log Serial No. rl()6~'lf Serial No. /?,etJ;1£}1.2. Serial No.----- Cal. Due Date: - Cal. Due Date: __ _ 2.. Check Source Information: Source 1 Isotope: 76-232. Serial No.: I [ { Activity:<:O. I units:,vl'.:: Response Acceptance Range {+/-20%): uRem/hr +20% ___ uRem/hr -20% f'L-Assay Date:IQ/'§/l'o net cpm + 20 " S:i ~9' net cpm -20% 3r¥6.t: Source 2 Isotope: LJ",/57 Serial No.; l(Cf£;3..-( 2-Activitv: 0-02 units;.vu* Assay Date: _&&_ Response Acceptance Range {+/-20%): uRem/hr +20% ___ uRem/hr -20% __ net cpm + 20% /$.:Z7s net cpm -20% B f't'1'
- 3.
Checks:
Title:
- fZC{ Date: !O/l-;--/15 Time: /Do.)" i
- 4.
Site or Location: Site/Job: Ar~,.,..'J. ?- Location
Description:
£-',,,'"""":....""°' GPS Coordinates (when required): X-Coord: rJ A V-Coord:~_--<.;1/_.___,A-__ ~- Instrument Field Response 2 Use Acceptance Criteria Remarks Meter Bl<g 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'! Info: inst. Condition, etc.) Time uRem/hr) Time uRem/hr) gross cpm current (Y/Nl check (oF) or uRem/hr {Y/N) (Y/N) Ratemeter I Mil\\. ql{3 / t"l:W I Juin l/'{i.~.1 C/JIV'. y v v !Olfs 5"~7 fh-~32 J}y i Ratemeter t All;v... /O'l1L,;,,.,. YI v ...:/ //)~ 5"-'-~ cs-/!.7 VtJC Rate meter I I I I (/- Ratemeter Bicron NA NA Bicron NA NA Bicron NA I NA i Bicron NA NA 1, Instrument designated check source Is Usted on calibration sticker. Record check source response (net cpm} 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 additional counts to evaluate instrument stabllitY i i I i l
Instrument Field Response Check Log
- 1.
Instrument lnformatlon 1 Ratemeter: Make/Model: ~ICRMJ ~YHC12D 0;7A Serial No. /t)) l/ Ll. Detector 1: Make/Model: '"It1('71:{£iVA L. Serial No. ...v/ri Cal. Due Date: ~ lo Detector 2: Make/Model: Serial No. ____ _
- 2.
Check Source Information: source 1lsotope:/hl-1 l.. Serial No.: 11 le Activity:~ units:MkL_ Instrument Response Acceptance Range (source cpm
- bkg +/*20%):
- Assay Date: --t:Z/-;.)1 v net cpm + 20%
net cpm -20% __ Source 2 Isotope: Serial No.: Activity; -~-units: __ Assay Date: __ _ Instrument Response Acceptance Range (source cpm - bkg +/-20%): net cpm + 20% __ net cprn -20% __
- 3.
Technician/Worker Performing Checks: Date:~ Time: 01.S"J. Name: S~v'e" KtN~t11Ar--.i
Title:
- 4.
Site or Location: Site/Job:_"'"3-'--,-'--=---------- Location Descript ion:__,6'-'-,q'-',e~&'\\"-'----------- ' I U o I
- I GPS Coordinates (when required):
X-Coord: N Li. *z..t ?Y.1 /j Y*Coord:V)C>*1¥ '::{p' ;n.z. I_
- - -- ___.._ _ _.,_,,_~*-~-------*-*-... --*-----'----***~ -*--~- ----*-------
Instrument Field Response2
- I Use Acceptance Criteria
~ Remarks I Det. BKg Bkg Source Source +I-20% of Inst. Battery I Time I Ambient ti Initials and Comments j No. Cnt (~) Cnt
Response
source Net Ca fib. Check, Of I [add' I Info: temperature, Inst. Condition, j T~~P* ~j . (1/2) Time {.cPfAt Time [q.ta -bk~) cpm current (Y/N) check etc.) ..IA ill#!l Net efJm {Y/N) (Y/N) LlJ..R/ 't? y v n75:1 !../%. z_ .Sit: I~ f I m
- 1.
Instrument designated check source is listed on calibration st1c:ker. Record check source response (net cprn) prior to field deployment for all check sources bein{l' used.
- 2.
source and Background count rate should be determined from the average of tliree static counts at the same locatio11. Repeat counts should be within 20%. If count rate diverges slgnlflcantly, perform additional counts to evaluate instrument stability l i l ! i I
Instrument Field Response Check log
- 1.
Instrument lnformatlon 1 Ratemeter: Make/Model; L uOLli;A. J-;lf {.) Detector 1: Make/Model: lvAv/'A 'I L/~t o Detector 2: Make/Model:
- 2.
Check Source Information: Serlal No. 21./l,, I 31 Serial No. /Jt..U! I~) Serial No. ____ _ Source 1 Isotope: 'fh Z 12-Serial No.: // lp Activity: ~ units:,.,v-c.i Cal. Due Date: 3}-2} / lo Assay Date: Ii{ 1° /1 ° Instrument Response Acceptance Range (source cpm - bkg +/-20%): net cpm + 20% net cpm -20% __ _ Source 2!sotope: Cs lJ7 Serial No.: f'7£1?*-<li' Activity: *. 02 units:~- Assay Date: Mo Instrument Response Acceptance Range (source cpm - bkg +/-20%): net cpm + 20%. __ _ net cpm -20% __
- 3.
Technic:lan/Worker Performing Checks: Name: 5'17fV'l£ t:1cJVAW
Title:
Date:12.}_,~/rS" Time: /DOD
- 4.
Site or Location: Site/Job:_"3=-'-=Z...=---------- Location Descrlptlon: _ _._6q..!...!..~:...=_;;,_ ________ _ GPS Coordinates {when required): X-Coord: _________ Y-Coord : ________ _
- (! +/* 20% of '
Inst. BatWy 1 Time Of cha ck Ambient Temp. (F) Initials and Comments j !1 source Net Calib. Check j ii cpm , current (V/N) I j (add'l lnfo: temperature, inst. CondJtion, J etc.) j l
- i (Y/N)
(Y/N)
- ~-~*~~-==-*
_*L~-=-*_ 2
- _":~~v~~~::y-;:::::,~n=~D=O~-=-~~:~~r.~.:L;::::5:*~::::::::::::*:::_:_==-
9 l----+---*-.. *-1--------+----+-------i:,J----"""*-"------- --~-~1----+---~ .. --------------i
- 1.
Instrument de!>ignated check source 1s listed on calibration sticker. Record check source response (net cpm) prior to field deployment for all check sources being used.
- 2.
Source and Background count rate should be determined from the averafie of three static counts at the same location. Repeat counts should be within 20%. If count rate diverges stgnificantly, perform additional counts to evaluate instrument stability.
Instrument Field Response Check Log
- 1.
Instrument lnformatJon1 0 Ratemeter: Make/Mode!: \\l)\\c..fatJ /Y\\lC£b e f!}A. Detector 1: Make/Model: feA/-tCWlf l Detector 2: Make/Model:
- 2.
Check Source Information: Serial No. A '?.-?.-l( lA Serial No. _____M.A=---- Serial No. ____ _ Source 1 Isotope: *Tf, ()J. "2-Serial No.: I I (p Activity: ~ units:~ Cal. Due Date: r/lf/1~ Assay Date: 12 /s "i>/r o Instrument Response Acceptance Range (source cpm - bkg +/-20%}: net cpm + 20% net cpm -20% __ Source 2lsotope: Serial No.: Activity: ___ units: __ Assay Date: __ _ Instrument Response Acceptance Range {source cpm - bkg +/-20%): net cpm + 20% __ _ net cprn -20% __
- 3.
Technician/Worker Performlng Checks: Name: r-reve K<rVJf'.yl,tV
Title:
- 4.
Site or Location: Site/Job: __ J_, _'--_________ _ Date: f"il}rc,./1<Time:/L/_Db Location o*escrip1ion:-'h'"'"~:....<..;.;~"'-i,___ ________ _ GPS Coordinates (when required): X-Coord: Y-Coord: ________ _ Source 1 +/- 20% of
Response
('"~ Ncl-epm 1\\ -~ source Net cpm (V/Nl Inst. Ca lib.
- 1 current t lY/N)
Battery j Time Check Of (Y/N) l check
- ~**-.
-~ -..:1 y Jl(OO
- ~-+---+---v;<------1----+---.1'-"9_.._,...,.,,,,~.R~IN,..:~---+---'----1---'---+--<--'
Remarks Ambient l'j Initials and Comments Temp. 1 1,dd'liofoo temperntm*,>o'1. C°"dittoo. (F) j etc.) j - + **- ~= 5"1. f.p
- ~
i I I ! i f------t----+------+-----1~------lt------j~----+----f----+----4~-----~-------~
- 1.
Instrument designated check source is listed on calibration sticker. Record check source response (net cprnj prlor to field deployment for all check sources being usecl.
- 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%. Jf count rate diverges significantly, perform add ltlonal counts to evaluate iostru ment stability _J
Instrument Field Response Check Log
- 1.
Instrument lnformatlon 1 Ratemeter: Make/Model; f.:_llQLu,Vi_ 21!-(f, 2-Detector 1: Make/Model: lv!JL UtVL 1-(1./-t v Detector 2: Make/Model:
- 2. Check Source Information:
serial No.a k& 131 Serial No. f!llll t 7-. 1 Serial No. ____ _ Source 1 Isotope: TbJ? 2 Serial No.:~-- Activity:~ units:~ Cal. Due Date:~ L.- Assay Date:~/ o Instrument Response Acceptance Range (source cpm - bkg +/-20%): net cpm + 20% net cprn -20% __ Source 2 lsotope: G:._/1..l_seria! No.:f 1 [ { J- '(.f Activity: - o i. units~i;;t* Assay Date: J}Q}i._c, Instrument Response Acceptance Range (source cpm - bkg +/-20%): net cpm + 20% __ net cpm -20% __
- 3.
Tedmlcian/Worker Performing Checks; Name: S1J?.!if l<1#Jrr-.1r,,_/
- 4.
Site or location: Slte/Job:_'3_*_. 7-_________ _
Title:
Date: t<Jh~f1s"' Time:"'""/_,_Y_ro __ I Location
Description:
~ GPS Coordinates {when required): X-Coord: _______ _ Y-Coord: ___ _ . <rule~ Instrument Field Response < vP?-S* --!1 __.. *-- ---- --*----*------**-*---* --*---------*-- ---,i-- C-r-; Use Acceptance Criteria ~ Remarks ~- BKg Bkg Source Source
- +/- 20% of
~ Inst. Battery l Time / Ambient 1[1 Initials and Comments (avg of 3) I (udd'l Info: temperature, inst. Condition, No. Cnt Cnt
Response
source Net I_ Ca lib. Check Of
- Temp,
{1/2) Tl me (cpm) Time (~.I cpm current (Y/N} check l (F) etc.) ~Jet er:it'l'r (Y/N) (Y/N) M--~-1 --~-
- (/.,JTt lf'llttV
/lv"l I I mq,.; i19J.) y' y I '?Io ~1~ '-" 5t I I~ /~1 /,,, /Jo/
- 1~ 2.1 I nitfo,/
ii/(,,/ v y I l( l{ C?.0 ' 5~
- 1.
Instrument designated check source is l1stad on calibration sticker. Record check source response (net cpm) 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 locatton. Repeat counts should be wlthln 20%. If count rate diverges slgntflcantly, perform addltlona! counts to evaluate instrument stability
Instrument Field Response Check Log
- 1.
Instrument lnformatlon 1 Ratemeter: Make/Model: j_ uf) l U.N'-- 'J-? '-ff-* Z.. Detector 1: Make/Model: l uh VA/\\.. lfll-1 o Detector 2: Make/Model:
- 2.
Check Source Information: Serial No. 2<,,, LJ 3 J Serial No.{£. 111/'l 'I Serial No. ____ _ Caf.DueDate: q{z./14'- Source 1 Isotope: fl, 2['2. Serial No.: )! lo Activity: Lo. I units:~ Instrument Response Acceptance Range [source cpm - bkg +/-20%): Assay Date: 1 ?,. f 'Si;/, L:> net cpm + 2~ net cpm -20% __ Source 2 Isotope:{. 5 ll7 Serial No.: Kl If/ l ~'If Activity:
- 0 2-units~ Assay Date: ~c::.
tnstrument Response Acceptance Range (source cpm - bkg +/-20%}: net cpm + 20% __ _ net cpm -20% ~--
- 3.
Technician/Worker Performing Checks: Name: S'il~Va' K./,.-./f ~:r.-/
Title:
~-
Date: 10/110/1{r1me: /r;/')'
- 4.
Site or Location: Site/Job:--~--------...,...-- Location
Description:
GPS Coordinates (when required): X-Coord: _________ Y-Coord: ________ _ 6..es-r-s-----*-. ---- (TS
- ----.. ---*~----*---------*-,
Remarks Use Acceptance Criteria Ii d}et: BKg Bkg Source No. Cnt (avg of 3) Cnt (1/2) Time {cprn) Time Source , +/- 20% of
Response
source Net (~g) cpm Inst. Battery ! Time I Ambient Ca lib. Check Of I Temp. current {Y/N) check (F) Initials and Comments I (add'! Info: temperature, inst. Condition, ! etc.) j N.~,J [Y/N) (Y/N) .... 't%7S;rta'<* y y !~;) SJ-(,,. i m ..... ****.J "/ y r rz. a Sl-to I
- 1.
Instrument designated check source is listed on calibration sticker. Record check source response {net cpm) prior to field deployment for llll check sources being used.
- 2.
Source and Backgroun()' coL1nt rate should be determined from the average of three static counts at tha same locatfon. Repeat counts should be within 20%. If count rate diverges significantly, perform addltfonal counts to evaluate Instrument stabllltv
Instrument Field Response Check Log
- 1.
Instrument lnformatloni Raterneter: Make/Model:GJ£,.1f2t>fJ /I'd Clo /(81\\ Detector 1: Make/Mode/:.J.rV"ffW.fil..- Detector 2: Make/Model:
- 2.
Check Source Information: SerJal No. 'A-Z-Z..l/ (,{_ Serial No.--~- Serlal No.----...,...- Source l lsotope:*17l 2?2..- Serial No.: // b9 Activity:..cro.. 1. units:~ Cal. Due Date: f4/µ ~ Assay Date; I z/1b /t 0 Instrument Response Acceptance Range {source cpm - bkg +/-20%): net cpm + 20% net cpm -20% ___ ~ Source 2 Isotope: Serial No.: Activity: ___ units: __ Assay Date: __ _ Instrument Response Acceptance Range (source cpm - bkg +/-20%): net cpm + 20% __ net cpm -20% __ _
- 3. *Technician/Worker Performing Checks; Name: ST¢v{' /<11-')f".\\A/\\/
Title:
- 4.
Siteorlocatlon: Site/Job: '3... 7- --~---------- Date: I o/, b hs Time: /...5.:./ )' Location Deicription:.......... f&rt.__,_*-"--'f1'--'----------- GPS Coordinates (when required): X-Coord: ________ ~ Y-Coord:_-'-------- lnstrument Field Response2 ---.-~----.. ***** Use Acceptance Criteria Remarks BKg Bkg Source Source i1 +/- 20% of Inst. I ~ source Net Ca/ib. Battery ) Check (Y/N) Time Of check j Ambient Temp. (fl Initials and Comments i {add'I Info; temperature, inst. Condition, I, Cnt {~ Cnt
Response
Time (c~ Time Vi {~kg) n)e/t!.- _ #i.~lr-Net c_pm -r 17 etc.) I 1 cpm current ~--="""'(Y~/~N)"""""'**~-~(Y~/~N)~~"""""=*==*=-=-~""-=~*-=*~jF: ~"="<<==='"""""'"""""'====~-=**~ Y V 15"/i{ S&,3 L I ~~--r----r--------r------r--~-~-11-----+----~t----1------+--------lltf-----------~----1 1j
- 1.
Instrument deslenated check source is listed on <:alibratlo n sticker. Record check source. response {net cpm} prior to fie!d deployment for al I check sources being used.
- 2.
Source and Background count rate should be determined from the average of three static counts at the s.ame location. Repeat counts should be within 20%. If c:ount rate diverges s!gnlficantly, perform additlona I counts to evaluate Instrument sta billty
Rev 110/18/15 J
- 1.
Instrument lnformation 1 R.atemeter: Make/Model: J...v0LVM. n Lf /. '"l-- Detector 1: Make/Model: Lu I) l Utvl. o/Y* I o Bicron MlcroRem Meter: Instrument Field Response Check Log serial No. 2 G>:rn I Serial No./JlJ ! 11 z. 1 Serial No. fl t.1-'1 u Cal.DueDate: CJ/z./rr... Cal. Due Date: f,/tf V /., *
- 2.
Check Source Information: Source 1 Isotope: -fJ1 Z) Z-- Serial No.: // 0 Activity:~ units:~ Assay Date:£LDdl'"' Response Acceptance Range (+/-20%): uRem/hr +20% __ uRem/hr -20% __ net cpm + 20% net cpm -20% __ Source21sotope:(sU] SerialNo.: <({lEtJ-lff Activity:.07-units~ AssayDate:Mo
- Response Acceptance Range (+/-20%): uRem/hr +20% __
uRem/hr *20% __ net cpm + 20% __ net cprn -20% __
- 3.
Technician/Worker Performing Checks: Name: ;;p::vt!' K--ct11S/11AtV
Title:
-~----
- 4.
Site or Location: Site/Job:_J_.-'-2-_________ _ GPS Coordinates {when required): X-Coord: 7ff * &.> 7 1.../ 1 7" I Instrument Field Response 2 Location Desr.ri ption:_..fr;__,*-'-'-;?,,_,10'------------ Y-Coord: tf 2 ; J.-f 8Vl O~ Use Acceptance Criteria Remarks ~ Meter Bkg Bkg Counts Source Source Response +/-20% Inst. . Battery Time Ambient Initials and Comments I Cnt (c.pm) or Cnt {gross cpm or source Ca fib. Check Of Temp. {add'l Info: inst. Condition, etc.) lime uRem/hr) Trme uRerh/hr) gross cpm current (Y/N) check (aF) or uRem/hr (Y/N} I (Y/N} I y v I Ratemeter IAttJ
- 115q *~
/,z,t,J \\ q(.1 l/ Cf""- ocp<
- ~z. Lf
'71. i:rz... i Ratemeter I i'Jr1 c(I) ... q,,qi IMl*J 11 7-1--fflf./.I\\ '{ y f',Q./ 1'l J ~ Cf I' ' ( 51 ! Ratemeter / rfi ltJ
- 1 )\\ l_..
l 1A1rV J1>sl UJA 'f '{ 11 *ic; si. s "//. 1. s*z., I Ratemeter I Mt.V 1 )(7,,, l,,.,,,,,,1 [O ltJ ~'l UM y y I '3 it) 'i'f. -~ ({I? '"J I Bicron NA (;"'#f(ffifl NA J '7.l..V fl. IN,- I v y Dq~o '3"7. c-{ ! Bicron NA f,,, i/uz NA 11, I/Ht"- -{ y )~'2r7. i;- '(. 'S i Bicron NA 1.... *'w
- } /1./(i' NA I { '"* 12./ //,,,.
v y (!{.(9 I Bicron NA I NA I I
- 1.
Instrument designated check source 1s fisted on calibration stu::ker. Record check source response (net cpm) prior to field deployment for all check sources being used.
- z.
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 Instrument stability
- ==-
t-=i J I ! I I t i I I i i I I I
Rev 110/18/15 Instrument Field Response Check Log
- 1.
Instrument lnformation1 Ratemeter: Make/Model: Serial No. ____ _ Cal. Due Date: __ _ Detector 1: Make/Model: Serial No. ____ _ Bicron MfcroRetn Meter: Serial No.----- Cal. Due Date: __ _ 2.. Check Source Information: Source l Isotope: serial No.: Activity: ___ units: __ Assay Date: __ Response Acceptance Range ( +/-20%): u Rem/hr +20% ___ uRem/hr-20% __ _ net cpm + 20%. ___ _ net cpm *20% __ _ Source 2 Isotope: Serial No.: Activity: units: __ Assay Date: __ _ Response Acceptance Range {+/-20%): uRem/hr +20% ___ u Rem/hr -20% __ net cpm + 20%.~-- net cpm -20% __
- 3.
Technician/Worker Performing Checks: Name:.~-'-------- ntle: ______ _ Date: fo/t r/t(nrne: ___ _
- 4.
Site or Location: Site/Job:. ____________ _ Location
Description:
GPS Coordinates (when required): X-Coord:. ________ _ Y-Coord: ________ l 1 Instrument Field Response2 Use Acceptance Criteria Remarks I Meter Bkg Bkg Counts Source Source Response +/- 20% Inst. Battery Time Ambient Initials and Comments l ! Cnt (cpm) or Cnt (gross cpm or source Ca lib. Check Of Temp. (add'l Info: inst. Condition, etc.) I Time uRem/hr) Time uRem/hr) gross cpm current (V/N) check (cF) I or uRem/hr (Y/N) l i (Y/N) Rate meter jM(;) .ffS"f lPM I~,,"' I 1 51 l cf,Vt y y J{Lfo 5t.c~ 1-n.nc j Ratemeter I rrt1iJ If(<;<{ c,fM } Mltv 17 L/l L {ff\\A... i Ratemeter 'Y y f <-'fl{' c:-ir_ {_ Cxl3"1 Ratemeter I Bicron NA NA Bicron NA NA Bicron NA NA Bicron NA NA
- l.
Instrument designated check source is listed on calibration sticker. Record check source response (net cpm) 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 sho.uld be within 20%. If count rate diverges significantly, perform additional counts to evaluate instrument stabillty I I i i 1 I l i I I I
App E-Sub-Area 3.2 - Sample Data Sheets
- -***-f.
- ~--
f \\, Date: iO~JtJ-() Project: Af\\f.~6 @-OA SAMPLE LOCATION DATA SHEET Name: ~ Bfil..J V'\\ Weather: c.Loocl~ ~_c_\\ ___
- 1. Sample Area (SA):
SA Designation:
- 3. Z.
== Description:== f=Zr\\'VJ.CY"-d ~-~~~~~------- SA Origin Location: Coord. System: -~* ~-- SA Land Mark
Description:
~~- Coord: JJlf-: A.J/fr I .P'f-1 '-0._--
- 2. Sample Location Data:
Sample Area ID:
- 3. 'l ~ \\
Matrix: -5'0-1 \\ Location Coard: N Y '2, l/ ~ 0'1 ~ Alternate Location Measurements (distance from SA origin and Local Coord.) X Dist. from Origin (0,0)~} f\\ Y Di~;t. from Origin: µf If\\. .:...--+.---'------ Site Sketch Attached (Yes) ~) k~ &v~\\ef ~ Sampte Location
Description:
f'c.v ~6~ ct'o() d-*i ""-~'O ~ &< Land Use:~r-M-Soil Moisture (Wet, dry, etc):--d,,._~""*f1--- Canopy Type: o:p-e (\\ 3 L t" R d' t" R d' oca ion a la U)Il ea mgs: 2x2 Nal B:cron Notes (cpm) I! (uRem/hr) Count time l cm lm 1 cm L~ (min) '..* ~. r;_,....rr,.<;: -w -I rrP -*
- /7;,{q lkd'i
{.Q__ 6 ff39 7 17-z.O _. ____ +/-=
- 4. Sample Information:
Sample Area ID: ~ _ Z..., 1.- R-r=-1, 5IU iu/,~ J, 2, 5 Soil Sample ID Sampling Description Calor (Surface litter type/depth, sample depth retention, 'S() *,' ~"1v*"n 3.z..1.i2-I 1------'---'---<---'-----<-----+-----+-------;--;:_efusal, stone or rock, to o a h, erosion features . r i't
- .o', \\
'n\\O'-Y"'
- _ 'L- '* {2.- l.
o- '~ \\.:h-i---.....>.I\\ s.*z.1.1Z.S Sample Recorded on Laboratory COC fonn and Conta'
Project: tJ ~Sf;--g. PA Weather: {)ydCc.S~ l au \\ I . 1. Sample Area (SA): SAMPLE LOCATION DATA SHEET ..-.--- R Name: ! an ~*-'D'-'-'V\\. SA Designation: 3 4 Z. L
== Description:== fu~GY"b-SA Origin Location: ~-~ ...B. '1¥/6M T13fi/11,._C_,_o..;_o_rd-_~S.:..:y=-st_e_m_:_/;ftf-_: -u.-,-,.,,_-.G-.. --=77f......-ta._ri.,...r<., SA land Mark
Description:
- {i;a '" Jv11d-
&.fllr:__ Coard: N/& ~N"'-"l~~~-- -"0>1uh(
- 2. Sample Locati<Jn Data:
Sample Area ID; 9:,. *2" L Location Coord: \\...\\71;. U> 71Z8"7 Matrix: 'S:i\\ L_ ~ ~2/-f fr/(lU/ Alternate Location Measurements (distance from SA origin and Local Coord.) - {y fl ~..... -Rhc.c... o..{,0~ X Dist. from Origin (0,0)--tJj!A Y Dim. from Origin: JJ/ A-NI;.) I 1YL4. Site Sketch Attached (Yes) ~ Sample Location
Description:
~FC~G.~f"_,__M~l~O't~~d,----------------*----*--
Canopy Type:~ n Land Use: hrrv. Soil Moisture (Wet, dry, etc):_12=---6f-+----
- 3.
0 L Rd'. R d' ocatmn a lation ea mirs: 2x2 NaI
- B*cron Notes (cpm)
(uRem/hr) Count time l cm Im 1 cm lm (min) I 'WOW /{fi/7 J ~ 1,Lf 5 7 '1 g'/s,
- 4. Sample Information:
Sample Area W: 2,. 2, Z.., tz... / -"L D
- f b D th escnp* ion >Y ep.
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, topography, erosion features) 0 -1'5 <;;oi\\ "R~A"\\ 3/l z..£., f Al/ fl:. 1-::.- ~n ~')\\\\ Q~'"""'rs,'Z.., 1.., tz. * ~ "'[rt¥ ~ Sample Recorded on Laboratory COC form and Container Labeled: ~ (N) i
. SAMPLE LOCATION DATA SHEET Date: [0-Jfo-1) Name:~. ~- Weather; 'S'.omy
- 1. Sample Area (SA):
SA Designation: ___ _3, 2..,~ 1clib
Description:
Ftif1'V\\. l Of\\J SA Origin Location: ~'l\\0.l. SA Land Mark
Description:
rJ/t Coord. System: ____ _ Coord: ~~--- _J/~A: __ _
- 2. Sample Location Data:
Sample Area ID: 3,- 2, '3
- Matrix: _$.?~~L Location Coord: W ] 8'", l.17i../JO1 N '-/ 2. 1f <4 0 f6{
Alternate Location Measurements (distance from SA origin and Local Coord.) <;l.l'O.(4:. ~"' dt\\'lrC~ X Dist. from Origin (0,0)_,J)_il_ Y Di~t. from Origin: ~!"+Q_,_fr"""--- Site Sketch Attache.d (Yes) § Sample Location
Description:
. &.fl"l'\\. I [()1,,J"C'.'.rrd loy wd. -pi k Canopy Type: 0 pen Land Use: ~}1d ___ Soil Moisture (Wet, dry, etc): TJ01.... _ 3 Lo f R d" ti R d" ca ion a 1a on ca mgs: 2x2 Nal B'.cron Notes. {cpm) (uRern/hr) Count time \\cm lm lc~l lm 1: (min) I ///-:,\\ 10/pf lo r 11 I llo'i .:I_Q_.:i I I ~ ___ E_
- 4. Sample Information:
Sample Area ID: S. '2..: *3, \\Z * \\-'Z.. D . ti b D th cscnp on 1y ep1 : Depth Soil Type Soil Sample ID Sampling Description Interval (Org; clay; Color (Surface litter type/depth, sample depth retention, (cm) sand, etc)
- efusal, stone or rock. topoITTaphy, erosion features) c _.. 15
- O,\\
~¥[......... 3.l.3.\\'Z.., I -So,~...-.:..cx:::C \\ri ¥11,t~~ ~ l'l '§i,C<.~ I? '4!0. -So: { lS.i;.vV"I 3 :z. ;~. IZ.'L w IPr Sample Recorded on Laboratory COC form and*Container Labeled: (Y) (N)
SAMPLE LOCATION DATA SHEET Project: ;Jy St.fl.'DA "77 Name: fnn
- Dfui..,..)Yl
\\ SA Designation: 3, L-.
== Description:== ~r~l<Yl-cl ~--"--'~~.-......---~---- SA Origin location: Coord. System: SA Land MarkDescriplion: -r1101Y.:S6"\\ (.,OJ'yu..r- ~---- Coord:
- 2. Sample Location Data:
Sample Area ID: --'3=*'-* 2..~, _t.-J_,___ Matrix: ~ o ~ \\ Location Coord: v.J 7'6*U1'1 I q <6 Alternate Location Measurements (distance from SA cirigin and Local Coord.) X Dist. from Origin (0,0) Y Di:;t. from Origin: ---~ Site Sketch Attached (Yes) @) Sample Location
Description:
__,_h-=c:r~m_,___l~~---"b'--;;;'--""v_=C_._*_P--1=<~----------- Canopy Type: 0 P & /\\J Land Use:~\\. __ Soil Moisture (Wet, dry, etc):__l~
- 3. Location Ra..
diatmn Rea d' mgs: 2x2NaI ~ B'cron Notes
- (cpm)
(uRem/hr) Count time 1 cm lm I~ ;1 ~m r {min) ~-~ I 7777 ll-f 43 J /7Ci'1 1112'_1__ =t=~ ff 1-
- 4. Sample Information:
Sample Area ID:
- 3. 2, 'i, f2- / J-5 Depth Soil Type Soil Sample WI Sampling Description Interval (Org; c1ay; Color I (Surface litter type/depth, sample depth retention, 1--~C.:..:.cm~).---1_s_an_d....;.,_et_c-'-}-+-~--~-------+;... ~efusal,_ stone or rock, to oo-ra hv, erosion features) 1--D_-_1_c;;-_...+.-~~i*"----'-+---~4=-'-""'-'-'-.=L.~~--+-So\\~~:Q~
C - µ1~'5--3"-'0""--+.:;....:-'-'-~--t=----t.=..:...;"'-'---~-"::---~jJ ~----------------; 30-U.o Sample Recorded on Laboratory COC form and Container Labeled:}}