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=Text=
=Text=
{{#Wiki_filter:App E-Sub-Area 5.6 -COC Field Forms
{{#Wiki_filter:App E-Sub-Area 5.6 - COC Field Forms  


~l;bncll:
f;';i:cli:
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Shuuhl -! '1111s* -. "'"*
Shuuhl -!  
Mll!ilk lit,
'1111s*  
* 1 f l. l l .; ' ' J J .-.. .
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LLC.
* romilil'~r.~
* 1040  
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.  
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$C*294117  
l l  
{1\4'.I)
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S56,8J 71 766', lJ.78 . I' .. <c.  
. :GiJ!;..Lal~~ra1ijtii:s, LLC.
(6) . ..,11-. --+-------.,.--,.---
* 1040 Sa*1~g(ll_(incJ
.. !. T I i .I l J I 1. l Cimuncnts Nolc:*cx.trn is for sample
. Ch91le~1011, $C*294117 l'hon~: {1\\4'.I) S56,8J 71 fa~: (84~\\ 766', lJ.78  
* specifkQC No .. Circle Dclivcr.luk"Cof.A*
. I'  
I QCSn111i1my.  
<c. Prcscrvetivc-TyP,~ (6)  
;. Lcvd 1* / Level 2* i tevci 3. I [;cvcl4 Remm*lcs:.Are*thiire any knownhc1z<1rds.c1pJllfoali!ti to !liese.:.v.'m;ple.1*?Jf:.to,  
...,11-. --+-------.,.--,.---.. !.
*p/ea.ve li.vi*tlie  
T I i  
: hazards, SJmjplc Collcctior.:Ptnc*ZoM  
.I l J
.Eastern "Phcipc.
I
* Oilier_:_;_  
: 1.
... Moi1:11nln S:u!lplc'SlilJ1pl11g aud*i>ellvcry Details Dato*
l Cimuncnts Nolc:*cx.trn.~a1111ile is require~! for sample
by GEL PM: Ii Method ornhmmc111:  
* specifkQC No  
.. !Jato Shhnm!; Airb1!111;  
.. Circle Dclivcr.luk"Cof.A* I QCSn111i1my. ;. Lcvd 1* / Level 2* i tevci 3. I [;cvcl4 Remm*lcs:.Are*thiire any knownhc1z<1rds.c1pJllfoali!ti to !liese.:.v.'m;ple.1*?Jf:.to, *p/ea.ve li.vi*tlie hazards, SJmjplc Collcctior.:Ptnc*ZoM  
; l\irllill'll::  
.Eastern "Phcipc. *
:*1.j .. hJt:.  
:cc:m~I Oilier_:_;_...
**2J  
Moi1:11nln S:u!lplc'SlilJ1pl11g aud*i>ellvcry Details Dato*  
... l!ielrt l)ujiil,cate.:Ril  
~,
: r.  
~c.C9iv~-9 by.(~l&l)i~f GEL PM:
.:\fS __ z:-
Ii Method ornhmmc111:..  
.... ,M ..
!Jato Shhnm!;
Stake  
Airb1!111;  
.... 01ab;C  
; l\\irllill'll::
*:l) 'fie!!!  
:*1.j Ch.iil11cC't~1nlly,r-'1uiitb~11 -cticl)tD~Jtr::!l~~J
.. Fen  
'};'(~t.'.LaliRh:&#xa3;!iVing ~.. hJt:. Oi~I..''
.. \'" .. f(1r ye\* the Sill!lflic)vM  
**2J Qc*cau~~~ N~~ Nonn~1-SamrJc,*1~:=!7j1p.D:iank,*j;j)... l!ielrt l)ujiil,cate.:Ril r. l!~t!Jp:_n.:l!l ~.l:\\.IJk,.:\\fS __ z:- Mri~ri.~.5Pi.~:c~~:11rite:;;~tSl,>....,M.. ~r~"' Stake i>u11Jk~11~Sl1r.pJ~;<;*.... 01ab;C "'.(\\1wrt*~;::
,;:;f.!cd ur--N ... for  
1----~~-~--~~~-~--
\\a.Ii not fidd'tihcrcd.
*:l) 'fie!!! f'il1~cc1~.. Fen !iqu~d ~11u~i<<~. ~nd!cr.1c.w:_1!1.'!i.. \\'".. f(1r ye\\* the Sill!lflic)vM li:e~n,;:;f.!cd ur--N... for $a~pJ1: \\\\a.Ii not fidd'tihcrcd.
Cu."ioJ_v Se((/: Jntac/? **I.)  
Cu."ioJ_v Se((/: Jntac/?  
..
**I.) *,M.&11~.. 6'.ll~s:.i ~W":..31 b1'd*1g Wri1~[;.(;,"\\'&#xa5;(\\r.1t.i1;Jwi!lt:f, *~\\yr~s1J1t~W/.Y~iti:1~ :'\\~ ~\\*~*Wro:.tc W.iil*!i,.,~
b1'd*1g W.iil*!i,  
1.,,.W.~~1,*Ml-* *~iJ~*L'fi'J~:id. S01*S1d. s*n*Si;il:11ti:oi 1.~tt~""S\\:."~J~::._S~..,5,ilirl.... \\\\1.-.tc; I>~ o;: ~ p-.... f ~!~~ 1**~Wi1:::.* V;;J~i1~t._ 11~r~i:.dl,, N,~ ;f-* ___  
,*Ml-*
..;l:.:'f:"';S'-' -:---:::---'-'N-'0'-----I
S01*S1d.  
:s;l S_nmplt A~!:l_ly.sii l\\cqii~s1e.i" ~~~ly_fi~~1l il~_d\\1,1~l,*Ctl\\lfUC1l (t,t'. ~ll$QQ/t9.l(1_nn:11~A' ~ntJ. upu\\~~:r 1)f:rn1l<<;iiU!~). i:rO.-JtJ.e~i* l~r ~"'*" (Lc.. i!2~n,n w~. 641!JBl7.11oi -,1).
..,5,ilirl  
l;"mile,.~7iN~Jp.
.... \\1.-.tc; o;: p-. ... f ;f-* ___ ..;l:.:'f:"';S'-'  
:r,:1 l're<<t\\a'ive,Typodf,\\" 1.ly1!mchlor:e A<l~il'll**'N11ti>/"jd; ~U*=~Q~ium,!t;-11?~,.ufe, S.~ **.Sd1\\1*.;o>-Mo;J,,,~A.~;<1.1<orh1< N.id,,i~)t~ lf<,.uo, ifr.*. s.,ili<1111.ihu,s1>J!.,l*.,,tf:ho t>r<*<rv*uvo.:p:'d*:l**" l~"~ 00111 ~fai.k C
-:---:::---'-'N-'0'-----I  
:wH~TE "'1,,\\B,()~<'iTogx; n:r,L.OW"'-1!:1!,_!L PINK~* c1:11.wr  
:s;l S_nmplt  
 
,*Ctl\lfUC1l (t,t'.  
l'iig_c: __. __ -.-*----~of~_., __._.. ___ *_*_:  
(Lc .. 641!JBl7.11oi  
.Project ii:
-,1). .  
GEL Chain.of*Custo(1ly aJid. Analyti'calReq*&#xb5;~st.  
:r,:1 l're<<t\a'ive,Typodf,\"
.. CIELlabom1orics, LLC 2040*Savage Road OELQuotc,11:.. _. __  
1.ly1!mchlor:e lf<,.uo, ifr .*. s.,ili<1111.ihu,s1>J!.,l*.,,tf:ho t>r<*<rv*uvo.:p:'d*:l**"
.:~
00111  
.. ----'-~--....-.* __ _  
. C
'*!Se<M*1ww,ge!.com'forGEL'$'SaropJeAc.ceptanceSQP*"..  
* n:r,L.OW"'-1!:1!,_!L c1:11.wr l'iig_c:
* !'..'l!~dcs1011;,sc 29407' Phonc:.(843).5~6-817 l Fa~1 (84'.l)765*l l18*
__ . __
.CQC~Nu!Jlbcrm:*
__ ._ .. ___ *_*_: .Project ii: GEL Chain.of*Custo(1ly aJid.  
PO Number:
.. CIELlabom1orics, LLC 2040*Savage Road OELQuotc,11:  
GEI:''Wm"kOrder*Numlier:
.. _. __ ..  
Client *Name:.  
. ...-.* __ _ '*!Se<M*1ww,ge!.com'forGEL'$'SaropJeAc.ceptanceSQP*"  
.,, * -~
..
.. ': 1':rojeciJSiie_Na11ie:
* 29407' l  
(84'.l)765*l l18*
PO Number: GEI:''Wm"kOrder*Numlier:
Client *Name:. .,, * .. ': 1':rojeciJSiie_Na11ie:
Address:
Address:
Send Rcsulis:ro:*
Send Rcsulis:ro:*  
* SamplelD  
*.!Dnte.C'i~!lcctcd SamplelD  
*-For itim;io.dltts  
*-For itim;io.dltts - i11dic.'U'-te:s1"i"I and :tl1m J11te/1ime"  
-i11dic.'U'-te:s1"i"I and :tl1m J11te/1ime"  
, f;.. lQ.(:\\. "-* \\.~
, f; .. lQ.(:\. "-* _.li.:.{
_.li.:.{ 17(i<
17(i< Plione#:  
Plione#:  
(:'olli<t<<I (Millt*ry)  
~Tiinc
.. '(lllll!uil)  
(:'olli<t<<I (Millt*ry)..  
<ons1dc1;<i*l  
'(lllll!uil)
<SJ*(FiJl in*thQ*!lllll)bei"-ofcontaiilers for each test)  
Shouid-
'I'ypc (6)
-'.ttils-
Noie:_ exlra .sample*
.&~UflJll~.b~
is requijed-for sample* specilic'QC  
<ons1dc1;<i*l S}lltlPle:A11a.ly~ls:!lcqulistj!!I <SJ*(FiJl in*thQ*!lllll)bei"-ofcontaiilers for each test)  
,...,. 5. \.ilp..
<-:.Prcs~rvativc 'I'ypc (6) 9~:mm1c!1ts.
* a.. .. \-:"-*.-.:lit;,.,.'
Noie:_ exlra.sample* is requijed-for sample*
f,:,J_,,:f-:'1:;..,._'.  
specilic'QC  
+'  
,...,. 5. \\.ilp..
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* a.... \\-:"-*.-.:lit;,.,.'..,---:>-~----"~-'-'I"-_,'
*  
f,:,J_,,:f-:'1:;..,._'. +' ~----"1-=-c--+-__,.,.,,...~__,.;,f-.,....-j.~~+--+-~-+-+'--l;,...;_+--+......'4---+--+-----~--,----,.
. I "'-'I It*!-'\ No .. Circle Dcliveiabll!':
6-~~ ~Q.. \\. \\
C'cfA I .QC.S11mmnrv*.1 Level J I Level 2 */' Lcvcl3 f. Levc1'4 -i>uriiplC Colkc!illnijmpZonc
i'l:,., 1d11  
* Eastern l'aciffo, Cou\rnl . *other __ ..,..._ M<!1mtmn  
'...; /._.  
'l;ime, *'Rcccivod.by.(iiigncd}  
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\\~"2..
. I "'-'I It*!-'\\
No..
Circle Dcliveiabll!': C'cfA I.QC.S11mmnrv*.1 Level J I Level 2 */' Lcvcl3 f. Levc1'4 -
i>uriiplC Colkc!illnijmpZonc
* Eastern l'aciffo, Cou\\rnl.  
*other __..,..._
M<!1mtmn  
'l;ime,  
*'Rcccivod.by.(iiigncd}  
'Dl!tc,.
'Dl!tc,.
GEL.I'M;  
GEL.I'M;  
*1 , 'Airbiilll; 3 , Airl>1ll6:  
*1  
. . , ,):  
, 'Airbiilll; 3  
.NUmlJc"t  
, Airl>1ll6:.
...
.,,): Cl~ill.of Cust~)'.NUmlJc"t... ~licnt Oclcrinini4 lJ. qc Co~~.;*:N::; Wi~11al sr.mpi~;1:8 ~-:frin ni;"k* f'l) ~ f.Foldfii1nlko10,_!IB," 1r<111i~o**~\\ ~1011~, i-fS ~Ma:rix-S1iii<c saniplo, :\\1sfr,, ~i... ;. SpliiQP,up_liwe*sampl<;,'<;'- Gial>, :c-~ c~,t11pl>>!Jc Filr Loli Receiving.U>>~ '()iily 1.):Fi~ld.. FihC!ll<!: *Fqfliq\\lid OIJ1UicC:&#xa3;iindicutc~vith B.. y.. for.yet. lhC s&,11~p}e.\\Wlj n~io*rii1~r~d.cr *,N :' &#xa3;~{ ~n~ptc.WI)~ nUJ"li~!~ m~~J>"iJ,  
Oclcrinini4 lJ. qc ni;"k* f'l) f.Foldfii1nlko10,_!IB,"
.C(fg'ot/Y'S,tt!!l:lnt~t.'I?
i-fS  
: 4.)' Mi:i~~)~ -91~ia~.'DWt=f)(inl<ing ~Vawr~ GW:'!:Gf~~~1thlfflit:r,,S\\Y:.,,.Snsiai.:1; Wti:tcr1* \\YW~Wa~1e.w ~~l!r, *\\\\'"' \\\\r~11!1 1,Mc;_..~t.Ji~~ 1:.~r(~tid~ SO::S.Od, *SU~-So:d ii1ii;n1~* :u.e.-~t~dti:. ss~soli~ W~~J'1, 91'10H;~t*.. pjjrq~ r~Wipc; U#U.iiui:.;.it.*. i:c.;111. *N..,),l----~1'..::'E;,,:S-* --:::--'N=0--~-1
: saniplo,  
.SJ S*~1ilt;.Lo0ly!i* R<qu~l1e~;. i\\11~lylk.'nlJ;,cuioil.r<\\<Jll<>l<il'!i.e. ~UDD. ~OIOW7,4.7Ml ond 1'1ni1b<1'of<<i11l11inm*pro*i<lcd for **ch. (l.<.1120~~.* J.. ~O*IVBtri70A: I);-.
:\1sfr,, ... ;. SpliiQP,up_liwe*sampl<;,'<;'-
C11v/er T<imp:  
Gial>,
.G.)* J>(c:1(tV'l1ive*Typc:-HJ\\." llydmtillori~.A~lt(N.1.~*N1~ric'Acitl,:Sli*=.~~tiiu~ Hydro;u~lc~~,;;~~... 1 S1i!01!U: Ati~.. AA ""Areoibfc J\\'l;id; HX*~ Htxan"* ST7'i.,.~rlittmTJJl91.u.lfo~c; lfoop1vi~~a1jy~ h :'!ilde~."'! ~c1w~.field blaril C
Filr Loli Receiving  
*\\:Vi;UTE... LA.BORAT(:my" YEp.~ow*~FH,;E l'INK~ 0 q:.1ENJ"'  
'()iily  
 
.. FihC!ll<!:  
App E-Sub-Area 5.6 - Field Survey Checklists
*Fqfliq\lid B .. y .. for.yet.
 
lhC  
The MJW Companies GPS Field Survey Checklist The following field survey chE>cklist i~ u~ed on{ l' thv *.!JrvPY trilrn ha:; wa lkecJ to th~: loc;1tion that they will begin a GPS survey. This checklist is intendPd !u wrify nf!m.* of the ~-nbl~~ or :.i~tting-; changed or cables came loo:.e. between th<~ initial setup lo<.at1or 1 and tlw th~ld *,1irv1"v leti:.dt1on. Lornpi~'h' *;tf.'p 9 once the current walkover segml:'nt i'., romp!eto;>
*,N :'
: 1.  
.  
.. __;,._,j;~-- Verify the Ludlum l\\rlett'r h in R.. 11;.> rnnclP r*
: 4.)'
: j.
,S\Y:.,,.Snsiai.:1; Wti:tcr1*
: 2.  
.w
--i.,.~~:'. _ Verify that the l.url!um Meter 1::,1ite1 ridlllrE; dhpl<iy of "DlJP" and "V;1h1P"
*\\'"'
: 3.
SO::S.Od,  
t)
..
.=
U#U.iiui:.;.it
: 4.
.*. i:c.;111.
--~Verify that Antennd ~.tat;:*~, "btr>rnal"
.SJ
: 5.  
.r<\<Jll<>l<il'!i.e.
. *---'~:..__: i~.. - Set Menu l to "Data''
ond 1'1ni1b<1'of<<i11l11inm*pro*i<lcd for **ch.  
5
.* J ..
... i 1 *::
I);-. * * . C11v/er T<imp: .G.)* J>(c:1(tV'l1ive*Typc:-HJ\."
Mam<?. a file to start thi:' (*u1a~nt 'l.ln'~V.:ind ~t.ut thP data loggH
... 1 S1i!01!U:  
!-ilename: ---.... ---..
.. AA ""Areoibfc J\'l;id; Htxan"*
1;
h blaril C . *\:Vi;UTE
/
... LA.BORAT(:my"
: 7.  
. ,
.-<~;2_._ Set Menu l lo."SlallJ',' iHHl M*:*n'.I.1 t1.1 **sc*11*-.nr"
. ', ..
: 8.
App E-Sub-Area 5.6 -Field Survey Checklists The MJW Companies GPS Field Survey Checklist The following field survey chE>cklist on{ l' thv *.!JrvPY trilrn ha:; wa lkecJ to loc;1tion that they will begin a GPS survey. This checklist is intendPd
_.::.:-..fl~::__. __._ Verify that th~ ~en.sor iic~ld 1:: r~drh1"\\ thf-' *,r11rit:;.,1!, tht* di--plc.iy 11n thE* I udh,irn
!u wrify nf!m.* of the or changed or cables came loo:.e. between initial setup lo<.at1or 1 and tlw
: 9.  
*,1irv1"v leti:.dt1on.  
.* -~&#xb5;) __ Wht*n fini~hed. set Menu l to.. D.1ia'' and close the c.urrent file.
*;tf.'p 9 once the current walkover segml:'nt i'., romp!eto;>
*1
: 1. ..
~.~. -
Verify the Ludlum l\rlett'r h in R .. 11;.> rnnclP r* j. 2.
Name:--*... :":::..o4-_! _* _:'_.....'
_ Verify that the l.url!um Meter 1:: ,1ite1 ridlllrE; dhpl<iy of "DlJP" and "V;1h1P"
f**'
* 3. t) .= . . 4.
f
that Antennd "btr>rnal"  
*l"..
: 5. . .. -Set Menu l to "Data'' 5 ... i 1 *:: Mam<?. a file to start thi:'  
Date. _________ _  
.:ind thP data loggH ! .. ..."'! ..... , ** !-ilename:
 
---.... ---.. 1; / ! ; 7.
The MJW Companies GPS Initial Setup Checklist
Set Menu l lo ."SlallJ','
: 1. __ L Complete ',ource c:herk c.f i udlum fvl~tPr
iHHl M*:*n'.I
: 2.
.1 t1.1 **sc*11*-.nr"
____ LL.__ __ Power off Lutlluni lv1dl'.'r
; ' 8.
: 3.  
__ ._ Verify that 1::
. -*-.~~---Verify Trimble J'i ~h11tdown \\rint rn *,11:,pi>ncl m(lc)(.~)
thf-' *,r11rit:;  
: 6. --.-6,.-
.,1!, tht* di--plc.iy 11n thE* I udh,irn _,., ,... 9. .*
... ~ Con:1ectthe Serial cable~ to tl1P ftimble SIA
__ Wht*n set Menu l to .. D.1ia'' and close the c.urrent file. *1 ' -. -. .;... *' .. Name:--*
: 7.
... :":::..o4-_!
____ L
_* _:'_ .... .' f**' . f*l" .. .. Date. _________
__ Conn.e-c.1 t~xternal uF''.:> dt1t~r11i.1 1..-1hlf~ to tlH' l r1111ble
_
: 8.
The MJW Companies GPS Initial Setup Checklist
L/
: 1. __ L Complete
: 9.
',ource c:herk c.f i udlum
J..,/
: 2. ____ LL.__ __ Power off Lutlluni lv1dl'.'r
/
: 3. .
: 10.
Trimble J'i
v
\rint rn *,11:,pi>ncl
/
: 6. --.-6,.-... Con:1ectthe Serial to tl1P ftimble SIA 7. ____ L __ Conn.e-c.1 uF''.:>
_ Verify that the ! udlum Mt'tr>r i~ altr:*rnat ing d1~.play of "DUP'' dlHl "V,liul~"
1 .
Po.wt;>r on th~ Trim bk,ind ~'ftHt It.'! rt t<J compielely bout
to tlH' l r1111ble
: 12. -*_-~:*... _~et Merrn l to ''Statu:;" Jnd i\\kn11.) lo* h~**.. *"*vPr''
: 8. L/ 9. J..,/ / 10. v / _ Verify that the ! udlum Mt'tr>r altr:*rnat ing of "DUP'' dlHl Po.wt;>r on Trim bk ,ind It.'! rt t<J compielely bout 12.  
./,,'
...
H. ------*Set Menu 1 to "D.it,1**
Merrn l to ''Statu:;"
1!:!. ***--*--J... /._. _ Name a t8l>l file.md ~r <Jrl t hr* 11~1t,1 logr'.F*r
Jnd i\kn11 .) lo*  
: 16. **---~*Set Menu 1 to "Statu-:;" ;md MentJ.J tn *"-..cn,.r:ir"
.. *"*vPr''
: 17. ----~,--. V~rify that thi:* sen~OT tiE!l~1 i*, ri::.idini,; the,.mip ;i~. the db&#xb5;lay Llll tlit: Ludlum
./,,' H. ------*Set Menu 1 to "D.it,1**
: 18. ____ _j./~~----Set MP.nu 1 to "Dnt./' and,*,lrJ>* th>.' cur ;1_:11l. til~-
1!:!. ***--*--J
\\...
... /._. _ Name a t8l>l file .md <Jrl t hr*
 
logr'.F*r
App E-Sub-Area 5.6-Instrument Field Sheets
: 16.
 
Menu 1 to "Statu-:;"
Instrument Field Response Check log
;md MentJ .J tn *"-..cn,.r:ir"
: 1.
: 17.
Instrument lnformationl  
that thi:*
i*, ri::.idini,;
the ,.mip the db&#xb5;lay Llll tlit: Ludlum 18. ____
MP.nu 1 to "Dnt./' and ,*,lrJ>*
th>.' cur ;1_:11l.  
\...
App E-Sub-Area 5.6-Instrument Field Sheets Instrument Field Response Check log 1. Instrument lnformationl  
/1 Ratemeter:
/1 Ratemeter:
Make/Model:
Make/Model:
LvJf 4,.,fi.,tfl.'
LvJf 4,.,fi.,tfl.' J-Detector 1:
J-Detector 1:
* Make/Model: --z-;;z{[,,H-" _ -/ d Blcron MicroRem Meter:
* Make/Model:  
2..
--z-;;z{[,,H-"
Check Source Information:
_ -/ d Blcron MicroRem Meter: 2.. Check Source Information:
Serial No. ;:>c:(.,~'5 Serial No. fl(/UJ.?&#xa3;..2.
Serial No.
Serial No. ____ _
Serial No. fl(/UJ.?&#xa3;..2.
Cal. Due Date: 07A7f (.,
Serial No. ____ _ Cal. Due Date: 07A7f (., Cal. Due Date: __ _ Source 1 Isotope:  
Cal. Due Date: __ _
('/. -il J;2 Serial No.: i / { Activity:  
Source 1 Isotope: ('/. -il J;2 Serial No.:
<.cJ
i / {
* I Response Acceptance Range {+/-20%):
Activity: <.cJ
uRem/hr +20% ___ uRem/hr -20% _. __ Assay Date: lq/fof O net cpm + 20% il . net cpm -20% _3 Source 2 lsotope:LsJJ7 Serial No.: l (Cfe'.?-1--
* I units:~*
\ 2--Activity:  
Response Acceptance Range {+/-20%): uRem/hr +20% ___
{:M;l units: d;Assay Date: Response Acceptance Rani:i;e  
uRem/hr -20% _. __
{+/-20%}:
Assay Date: lq/fof O net cpm + 20% il ~.!. net cpm -20% _3 <~~,&
uRem/hr +20% ___ uRem/hr -20% ___ net cpm + 20%Lif6 7$ net cpm -20% '11'79' 3. Techniclan/Worker Performing Checks: Name: :J.
Source 2 lsotope:LsJJ7 Serial No.: l (Cfe'.?-1-- \\ 2--
Time: o.g15-Title: __ T?""'-"',._1'----
Activity: {:M;l units: d;Assay Date: ~
: 4. Site nr Location:
Response Acceptance Rani:i;e {+/-20%}: uRem/hr +20% ___
Site/Job:
uRem/hr -20% ___
___
net cpm + 20%Lif6 7$ net cpm -20% '11'79'
Location
: 3.
Techniclan/Worker Performing Checks:
Name: :J. /5.~r'i}.<
Date:ld.J-1~/('F Time: o.g15-


==
==Title:==
Description:==
__ T?""'-"',._1'----
: 4.
Site nr Location:
Site/Job: ___
A_-_fC_
1_v._t;".~.~~----S-~*~Go=--
Location


== Description:==
lA..J C.-r:!*rO"::>
lA..J C.-r:!*rO"::>
GPS Coordinates  
GPS Coordinates {when required}:
{when required}:
X-Coord: ________ _
X-Coord:
Y-Coord:. ________ _
________
Instrument Field Responsez Use Acceptance Criteria Remarks Rev 1 10/18/15 Meter Bkg Bkg Counts Source Source Response  
_ Y-Coord:.
+/-20%
________
Cnt (cpm) or Cnt (gross cpm or source Inst.
_ Instrument Field Responsez Use Acceptance Criteria Remarks Rev 1 10/18/15 Meter Bkg Bkg Counts Source Source Response  
Battery Ca lib.
+/-20% Cnt (cpm) or Cnt (gross cpm or source Inst. Battery Ca lib. Check Time Of Amblent Temp. lniti<ils and Comments (add'! Info; inst. Condition, etc.) 'Time uRem/hr)
Check Time Of Amblent Temp.
lniti<ils and Comments (add'! Info; inst. Condition, etc.)  
'Time uRem/hr)
TI me uRem/hr}
TI me uRem/hr}
gross cpm current {Y/N) check {of) or uRem/hr (Y/N) {Y/N} Ratemeter  
gross cpm current
. Ratemeter 1 1 Ratemeter  
{Y/N) check
., ' : Ratemeter 1 Bicron NA
{of) or uRem/hr (Y/N)
* Bicron NA j Bicron NA 1. Instrument designated check source is listed on alibr tian sticker.
{Y/N}
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 ofthree static counts at the same location.
Ratemeter  
Repeat counts should be within 20%. If count rate diverges.
. Ratemeter 1 1 Ratemeter
* signific;rntly, perform additional counts to eva1uzite instrument stability App E-Sub-Area 5.6 -Sample Data Sheets VTS .. #-
: Ratemeter 1 Bicron NA
SAMPI,E I"OCA TION DA TA SHEET Date:
* Bicron NA j Bicron NA
Name: /J.. .. ...., \_)ril'._-
: 1.
.. *" 1 weather:
Instrument designated check source is listed on alibr tian sticker. Record check source response (net cpm) prior to field deployment for all check sources being used.
u (j* ;::.: <-r i..i u' ) d..r ; *i z ( .;i:_ .-,, **--r-* ..
: 2.
**
Source and Background count rate should be determined from the average ofthree static counts at the same location. Repeat counts should be within 20%. If count rate diverges.
: 1. Sample Area (SA): SA Designation:
* signific;rntly, perform additional counts to eva 1uzite instrument stability  
___ '5.:_(.p_A_.
_____ ... ____ ..


== Description:==
App E-Sub-Area 5.6 - Sample Data Sheets


(1J :i ,dvl l#-SA Origin Location:
VTS
coora. System: ___ _ SA. Land Mark De:scription.
~--* T~
.. _ ........... .. .. Coord: 2. Sample Location Data: Sample Area ID: ..
.. #- $&#xa3;R~'l!ClE'S SAMPI,E I"OCA TION DA TA SHEET Date: J:CtJ.~!5_
... Matrix: ....
Name:  
........
/J....  
Location Coord: H!J..'?0 'M_J,;,_\_:1_2"_*
\\_)ril'._-.. *"
__ Alternate Location Measurements from SA origin and Local Coord.) X Dist. from Origin (0,0) tJ/ 19 Y from Origin: ___,J_J_f'L
1 weather: u (j* ;::.: <-r i..i u' ) d..r ; *i z (.;i:_
*-. Site Sketch Attached (Yes) Sample Location
.-,, **--r-*.. -*&'N*,~-
**.~-----
: 1. Sample Area (SA):
SA Designation: ___
'5.:_(.p_A_. _____... ____..  


==
==
Description:==
Description:==
"'-! 1{b.J.
(1J :i,dvl l#-
1
SA Origin Location:
...d.:i.'{
coora. System: ___ _
Canopy Typec &#xb5;>d.c*J U sec hri'lL!;,J.:t<o___
SA. Land Mark De:scription. ----*-~
Soil Moisture (Wel dcy, . . * ( ;;, t *<. 1 { r I;,**
........... ~
* etc.):
Coord:
_ -* . . 3. Location Radiation Readings:
: 2. Sample Location Data:
* 1*---*
Sample Area ID:.. --~.._\\.!!fi*'iS*'---... Matrix:.... s.~iJ.........
i Notes *-* .. ---'
Location Coord: H!J..'?0 'M_J,;,_\\_:1_2"_* __
time 1 .. cm I l L
Alternate Location Measurements (di~tance from SA origin and Local Coord.)
11.k..J \**--------1'-.--'1.j_}_}_
X Dist. from Origin (0,0) tJ/ 19 Y Di~L from Origin: ___,J_J_f'L *-.
__ f __
Site Sketch Attached (Yes) ~
____ l-*----.l--*-**-*--
Sample Location
' t='tt. *---*--... * '
* _L_ _____ l__. l\,: ... ,, CAA G f'S fi'\1c "*;(:._-.. .,.,if" I '-Jlq. 4. Sample Information:
Sample: Arca ID: 6.. \..E_!:'
* \2.... \ * \-_lo_ 10/20/l':J TS SAMPLE I"OCATION DA TA SHEET Date: Project:
N V5 /;'R.'.P.1\_
___ _ Weather: \o.M 1 vo* 1 1. Sample Area {SA): SA Designmion:
___
___ .. ____ *---.. **---.


== Description:==
== Description:==
_
~4.~.rn__uf_~D!.~ll ~" "'-! 1{b.J. y(;.;,~tcl 1 Jon~.,, *fr~~<...d.:i.'{
\il
Canopy Typec &#xb5;>d.c*J ~"-*Land U sec hri'lL!;,J.:t<o___ Soil Moisture (Wel dcy,
______ _ SA Origin Location:
.. * ( ;;, t *<. 1 { r I;,** * ;~
______ ---***
etc.): d().
Coord. System: SA Land Mark Description-----------*-*----**----
1mf*-*~ _ -*
Coord: ___ **--*-____ _ 2. Sample Location Data: Sample Area ID: 5 .t_., R. 2. Matrix:
: 3. Location Radiation Readings:
\ -*--
1*---*
..... *-**-Location Coord:
2~p*~~1.
__ Alternate Location Measurements (distance from SA,_origin and Local Coord.) X Dist from Origin (0,0). JJ.JA_.....  
--r-*;!~:~-;-* i Notes
'{Dist. from Origin: ___N_/-A-Sfre Sketch Attached (Yes) Sample Location
' Coun~ time 1.. cm I
l ;;;-*----T~~~-T--*1-~- *~*'&"i c:.o~-~~?.O~!
t;~,_--
L
<~7r 1~0-L_.3IIL~--.s::t::.k -=l:i~ '!.;~~~!~' 11.k..J
\\**--------1'-.--'1.j_}_}_ __ f __.J~G_k ____ l- *----.l--*-**-*--
-~"'"'' ~ t='tt.
\\~_tJ.'-\\'2.. ~
_L_ _____ l__.
l\\,:...,, CAA d~ G f'S fi'\\1c "*;(:._-...,.,if" I '-Jlq.
: 4. Sample Information:
Sample: Arca ID: 6.. \\..E_!:' * \\2.... \\ * \\-_lo_
10/20/l':J
 
TS
~T~L$Eff'V~
SAMPLE I"OCATION DA TA SHEET Date: J_l_~19.~ I~_
Project:
N V5 /;'R.'.P.1\\_ ___ _
Weather:
c~, \\o.M 1 ~&~~ vo* 1
: 1. Sample Area {SA):
SA Designmion: ___ ~4,. ___.. ____ *---.. **---.


==
==
Description:==
Description:==
_ \\il o~.s SA Origin Location: ______ ---*** -~----
Coord. System:
SA Land Mark Description-----------*-*----**----
Coord:
: 2. Sample Location Data:
Sample Area ID:
5.t_., R. 2.
Matrix: ~-~. \\
-~P-_..... *-**-
Location Coord:
~i-~~Ll']_,,._. __
Alternate Location Measurements (distance from SA,_origin and Local Coord.)
X Dist from Origin (0,0). JJ.JA_.....
'{Dist. from Origin: ___N_/-A-Sfre Sketch Attached (Yes) ~
Sample Location


Canopy Type:
== Description:==
Use:
Canopy Type: ----.0.-t~'f~\\~_Land Use: J:h.&#xa5;.-,n.~- Soil Moisture (Wet, dry, etc_):. ___ ~-----**
Soil Moisture (Wet, dry, etc_):. ___
3.. Location Radiation Readings:
3.. Location Radiation Readings:
I 2.x2 NaJ  
I 2.x2 NaJ  
--Bicron----* -.....
=---~~-. -- Bicron-- --* -
Notes I {c m) (uRem/hr)  
..... ~.----**-~-~ ---~
Notes I
{c m)
(uRem/hr)
: 4. Sample Information:
: 4. Sample Information:
Soil Color Sample Area ID: 6. LDA. IL. ?.. . I -l... Sample ID ---r--. Sampling Description  
Soil Color Sample Area ID: 6. LDA. IL. ?... I - l...
! (Surface Htter type/depth, sample depth retention, st_one or rocJs hy, erosion features s 'GI f""I'  
Sample ID ---r--.
.. 4ltML 1 ... ......,,S)'"'-""Yll\.....,\.1....!
Sampling Description (Surface Htter type/depth, sample depth retention,
__.Vl._,.,X""'"J"-'"\-c...5_,.__
'-~-1---"---'---<-----+----------+---re_fi_1_sa_l;_, st_one or rocJs toP-9.~a hy, erosion features s 'GI f""I' R;.~~.. 4ltML 1.........,,S)'"'-""Yll\\.....,\\.1....! __.Vl._,.,X""'"J"-'"\\-c...5_,.__ _________ ~
_________ I *-**-:i r
I  
__
*-**-:i r  
**-****--*-.. --.... **--*-!-*----
-~'--'-"'<:;::...::--+-'s:::.;.c::::L:>=r~~-s~~-1.~~.-~~~s..__ __ ---*-*--------~-1
--*-****---
------*~*-----*----------l Sa;ple Recorded OU Lab~ratory c~c form an~i"~t~i~;;:-Lab;;l;d: (N) 10/20/lS  
----Sa;ple Recorded OU form Lab;;l;d:  
 
(N) 10/20/lS  
SAMPLE LOCATION DATA SHEET Date: _l],,:::.' '{~
.,
Project:
SAMPLE LOCATION DATA SHEET Date: _l],,:::.' Project:
N Y~J'.F;DfL_.
N Weather:
Weather: f.Lt.\\IJ-.'.-1 -pt&-f-L\\~ J...dl t-
f.Lt.\IJ-.'.-
: 1. Sample Area (SA):
1 J...dl t-1. Sample Area (SA): SA  
SA Designation:--~-~--*****----*


==
==
Description:==
Description:==
 
_ _\\-J_cod-_-'S=-----------
_ _\-J_cod-_-'S=-----------
SA Origin Location:
SA Origin Location:
Coord. System: ____ _ SA Land Mark
Coord. System: ____ _
SA Land Mark


== Description:==
== Description:==
Coord: ----**- --... *---
: 2. Sample Location Data:
Sample Area JD: fl, v. ~ *--
Matrix: _&:,~_\\_ __ _
Alternate Location Measurements (distance from SA origin and Local Coord.)
X Dist from Origin (O,O) __ J!J.-1-A___
Y Dist from Origin: _..bl.j.A __
Site Sketch Attached (Yes) (@
Sample Location


______ ---*--*-***
== Description:==
Coord: ----**---... *---2. Sample Location Data: Sample Area JD: fl, v. *--Matrix:
_.t:O:''\\
__ _ Alternate Location Measurements (distance from SA origin and Local Coord.) X Dist from Origin (O,O) __ J!J.-1-A___
r.:....~... ~~-':...ct'\\.....,~....,....,.1_,,l...,.ec...._,IJ('-=--S..._ _________ _
Y Dist from Origin: _..bl.j.A
Canopy Type:. -*.Q.poo.. **-__ Land Use:..1::\\.\\ t."4-_ Soil Moisture (Wet, dry, etc.): *-***I:::b.-1'--**---
__ Site Sketch Attached (Yes) (@ Sample Location
: 3. Location Radiation Read!!!~.  
-------..--------------~
2x2 Naf
~
Bicron
( cpm).
~
( uRe.m/hr)
Notes
: 4. Sample Information:
Sample Area ID:~. <...:>A. (L ~- t - 2 escnption v ept D
b D h
I Depth Soil Type Seil Sample 1 Interval (Org; clay; Colar D
Sampling Descripticn 1s I sc-\\
&-.,,.,~
**71-,.-<'
: s. U..1\\.1....~.
6' l,; ~~.d<.
i (Surface. litter typefdepth, sample depth retention, I refosal, st~e or ro-9_~ topoe;raphy, erosion foatur<:s)
~m) sand etc.)  
-_"3~~<2_;\\ __  
--+*-***
:~~i-~;~'1. -- ~-'.~'.:~--~--
*--1*-n-* *-+=-j ___ -n *
--t--__;-----------
___ _L__..
Sample Recorded on Laboratory COC form and Container Labeled:
?) (N) 10/20/15.


==
Description:==
_.t:O:''\
...
. ...,.1_,,l...,.ec...._,IJ('-=--S..._
_________
_ Canopy Type: . -* .Q.poo .. **-__ Land Use: . .1::\.\ t."4-_ Soil Moisture (Wet, dry, etc.): *-***I:::b.-1'--**---
* 3. Location Radiation 2x2 Naf Bicron ( cpm) . ( uRe.m/hr)
Notes 4. Sample Information:
Sample Area
<...:>A.
(L t -2 escnption v ept D b D h ------*-**--------*--
I Depth Soil Type Seil Sample 1 Interval (Org; clay; Colar D Sampling Descripticn 1s I sc-\
**71-,.-<'
..:;,.,.....,.
"' *----s. U..1\.1... 6' l,;
. i (Surface.
litter typefdepth, sample depth retention, I refosal, or topoe;raphy, erosion foatur<:s) sand etc.)
__ --+*-***
...
--
*--1*-n-*
*-+=-j ___ -n * --t--__;----
------------**** ---**-**-
___ _L__ .. Sample Recorded on Laboratory COC form and Container Labeled:
?) (N) 10/20/15
.
SAMPLE LOCATlON DATA SHEET Date: _!1.:l4_:.J5.
SAMPLE LOCATlON DATA SHEET Date: _!1.:l4_:.J5.
Project:  
Project:.. N y5~_F..4.)~*--*--
.. N  
: 1. Sample Area (SA):
: 1. Sample Area (SA): SA Designmion:
SA Designmion: --o-~-:. c.o ___. *-*... *-***--*****  
c.o ___ . *-* ... *-***--*****  


==
==
Description:==
Description:==
 
__ \\,,..N--'--o..... c"~><l:_,5~-------
__ \,,..N--'--o  
SA Origin Location: ----**--*- ___
.....
Coord. System: __
SA Origin Location:  
SA Land Afark Description-Coord:
----**--*-
: 2. Sample Location Data:
___ Coord. System: __ . ___ _ SA Land Afark Description-Coord: ______ * --**-_. *-**---2. Sample Location Data:
Samp!~ Area ID: *- ~- ~
Area ID: *-* _ 12
* _ 12
* 4j ___ Mattix:  
* 4j ___ Mattix: _&sect;?.~.. -......
.. -...... Location Coard: _f'L..!:L?::.._&#xa3;.?.1.*  
Location Coard:
-*** ' ..... ____ \i-::d . .2.Y 5 -... 'icJ ._v_' __ _ A ltemate Location Measurements (distance from SA origin and Local Coord.} X Dist. from Origin (O,OL. N /A ---* Y Dist. from Origin: _bl_f.A--
_f'L..!:L?::.._&#xa3;.?.1.* '-i~**
Site Sketch Attached (Yes)@ Canopy Type:  
____ \\i-::d..2.Y 5 ~ -... 'icJ._v_' __ _
.. -... -Land Use:
A ltemate Location Measurements (distance from SA origin and Local Coord.}
Soil Moisture (Wet, dry,
X Dist. from Origin (O,OL. N /A ---*
_ ........
Y Dist. from Origin: _bl_f.A--
__ 3. Locatiol!._
Site Sketch Attached (Yes)@
Radiation
Canopy Type: *--~~.. -
__ _ 2x.2 Nal (cpm) 4. Sample Information:
... -Land Use: _aj<:-.~~-*-- Soil Moisture (Wet, dry, etc_):_~'::f-** _........ __
: 3. Locatiol!._ Radiation Readi_n~g~s_: __ _
2x.2 Nal  
~
(cpm)
: 4. Sample Information:
Bicron (uRem/hr)
Bicron (uRem/hr)
Notes* Sample Area JD: 5. lPf\. '1 . 1-l Sample Recorded oo Labi:lratory COC form and Container Labeled:
Notes*
ff (N) 10/20/15  
Sample Area JD: 5. lPf\\. ~. '1. 1-l Sample Recorded oo Labi:lratory COC form and Container Labeled: ff (N) 10/20/15  
' ...}}
'...}}

Latest revision as of 19:43, 9 January 2025

Radiological Survey and Dose Assessment Report for the Western New York Nuclear Service Center and Off-Site Areas in Follow Up to Aerial Gamma Radiation Survey Conducted in 2014, Rev. 0, Appendix E, Part 17 of 24
ML16293A812
Person / Time
Site: West Valley Demonstration Project, P00M-032
Issue date: 08/22/2016
From:
MJW Technical Services
To:
Office of Nuclear Material Safety and Safeguards, Office of Nuclear Reactor Regulation
Shared Package
ML16293A155 List: ... further results
References
Download: ML16293A812 (13)


Text

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.,,): Cl~ill.of Cust~)'.NUmlJc"t... ~licnt Oclcrinini4 lJ. qc Co~~.;*:N::; Wi~11al sr.mpi~;1:8 ~-:frin ni;"k* f'l) ~ f.Foldfii1nlko10,_!IB," 1r<111i~o**~\\ ~1011~, i-fS ~Ma:rix-S1iii<c saniplo, :\\1sfr,, ~i... ;. SpliiQP,up_liwe*sampl<;,'<;'- Gial>, :c-~ c~,t11pl>>!Jc Filr Loli Receiving.U>>~ '()iily 1.):Fi~ld.. FihC!ll<!: *Fqfliq\\lid OIJ1UicC:£iindicutc~vith B.. y.. for.yet. lhC s&,11~p}e.\\Wlj n~io*rii1~r~d.cr *,N :' £~{ ~n~ptc.WI)~ nUJ"li~!~ m~~J>"iJ,

.C(fg'ot/Y'S,tt!!l:lnt~t.'I?

4.)' Mi:i~~)~ -91~ia~.'DWt=f)(inl<ing ~Vawr~ GW:'!:Gf~~~1thlfflit:r,,S\\Y:.,,.Snsiai.:1; Wti:tcr1* \\YW~Wa~1e.w ~~l!r, *\\\\'"' \\\\r~11!1 1,Mc;_..~t.Ji~~ 1:.~r(~tid~ SO::S.Od, *SU~-So:d ii1ii;n1~* :u.e.-~t~dti:. ss~soli~ W~~J'1, 91'10H;~t*.. pjjrq~ r~Wipc; U#U.iiui:.;.it.*. i:c.;111. *N..,),l----~1'..::'E;,,:S-* --:::--'N=0--~-1

.SJ S*~1ilt;.Lo0ly!i* R<qu~l1e~;. i\\11~lylk.'nlJ;,cuioil.r<\\<Jll<>l<il'!i.e. ~UDD. ~OIOW7,4.7Ml ond 1'1ni1b<1'of<<i11l11inm*pro*i<lcd for **ch. (l.<.1120~~.* J.. ~O*IVBtri70A: I);-.

C11v/er T<imp:

.G.)* J>(c:1(tV'l1ive*Typc:-HJ\\." llydmtillori~.A~lt(N.1.~*N1~ric'Acitl,:Sli*=.~~tiiu~ Hydro;u~lc~~,;;~~... 1 S1i!01!U: Ati~.. AA ""Areoibfc J\\'l;id; HX*~ Htxan"* ST7'i.,.~rlittmTJJl91.u.lfo~c; lfoop1vi~~a1jy~ h :'!ilde~."'! ~c1w~.field blaril C

  • \\:Vi;UTE... LA.BORAT(:my" YEp.~ow*~FH,;E l'INK~ 0 q:.1ENJ"'

App E-Sub-Area 5.6 - Field Survey Checklists

The MJW Companies GPS Field Survey Checklist The following field survey chE>cklist i~ u~ed on{ l' thv *.!JrvPY trilrn ha:; wa lkecJ to th~: loc;1tion that they will begin a GPS survey. This checklist is intendPd !u wrify nf!m.* of the ~-nbl~~ or :.i~tting-; changed or cables came loo:.e. between th<~ initial setup lo<.at1or 1 and tlw th~ld *,1irv1"v leti:.dt1on. Lornpi~'h' *;tf.'p 9 once the current walkover segml:'nt i'., romp!eto;>

1.

.. __;,._,j;~-- Verify the Ludlum l\\rlett'r h in R.. 11;.> rnnclP r*

j.
2.

--i.,.~~:'. _ Verify that the l.url!um Meter 1::,1ite1 ridlllrE; dhpl<iy of "DlJP" and "V;1h1P"

3.

t)

.=

4.

--~Verify that Antennd ~.tat;:*~, "btr>rnal"

5.

. *---'~:..__: i~.. - Set Menu l to "Data

5

... i 1 *::

Mam<?. a file to start thi:' (*u1a~nt 'l.ln'~V.:ind ~t.ut thP data loggH

!-ilename: ---.... ---..

1;

/

7.

.-<~;2_._ Set Menu l lo."SlallJ',' iHHl M*:*n'.I.1 t1.1 **sc*11*-.nr"

8.

_.::.:-..fl~::__. __._ Verify that th~ ~en.sor iic~ld 1:: r~drh1"\\ thf-' *,r11rit:;.,1!, tht* di--plc.iy 11n thE* I udh,irn

9.

.* -~µ) __ Wht*n fini~hed. set Menu l to.. D.1ia and close the c.urrent file.

  • 1

~.~. -

Name:--*... :":::..o4-_! _* _:'_.....'

f**'

f

  • l"..

Date. _________ _

The MJW Companies GPS Initial Setup Checklist

1. __ L Complete ',ource c:herk c.f i udlum fvl~tPr
2.

____ LL.__ __ Power off Lutlluni lv1dl'.'r

3.

. -*-.~~---Verify Trimble J'i ~h11tdown \\rint rn *,11:,pi>ncl m(lc)(.~)

6. --.-6,.-

... ~ Con:1ectthe Serial cable~ to tl1P ftimble SIA

7.

____ L

__ Conn.e-c.1 t~xternal uF.:> dt1t~r11i.1 1..-1hlf~ to tlH' l r1111ble

8.

L/

9.

J..,/

/

10.

v

/

_ Verify that the ! udlum Mt'tr>r i~ altr:*rnat ing d1~.play of "DUP dlHl "V,liul~"

Po.wt;>r on th~ Trim bk,ind ~'ftHt It.'! rt t<J compielely bout

12. -*_-~:*... _~et Merrn l to Statu:;" Jnd i\\kn11.) lo* h~**.. *"*vPr

./,,'

H. ------*Set Menu 1 to "D.it,1**

1!:!. ***--*--J... /._. _ Name a t8l>l file.md ~r <Jrl t hr* 11~1t,1 logr'.F*r

16. **---~*Set Menu 1 to "Statu-:;" ;md MentJ.J tn *"-..cn,.r:ir"
17. ----~,--. V~rify that thi:* sen~OT tiE!l~1 i*, ri::.idini,; the,.mip ;i~. the dbµlay Llll tlit: Ludlum
18. ____ _j./~~----Set MP.nu 1 to "Dnt./' and,*,lrJ>* th>.' cur ;1_:11l. til~-

\\...

App E-Sub-Area 5.6-Instrument Field Sheets

Instrument Field Response Check log

1.

Instrument lnformationl

/1 Ratemeter:

Make/Model:

LvJf 4,.,fi.,tfl.' J-Detector 1:

  • Make/Model: --z-;;z{[,,H-" _ -/ d Blcron MicroRem Meter:

2..

Check Source Information:

Serial No. ;:>c:(.,~'5 Serial No. fl(/UJ.?£..2.

Serial No. ____ _

Cal. Due Date: 07A7f (.,

Cal. Due Date: __ _

Source 1 Isotope: ('/. -il J;2 Serial No.:

i / {

Activity: <.cJ

  • I units:~*

Response Acceptance Range {+/-20%): uRem/hr +20% ___

uRem/hr -20% _. __

Assay Date: lq/fof O net cpm + 20% il ~.!. net cpm -20% _3 <~~,&

Source 2 lsotope:LsJJ7 Serial No.: l (Cfe'.?-1-- \\ 2--

Activity: {:M;l units: d;Assay Date: ~

Response Acceptance Rani:i;e {+/-20%}: uRem/hr +20% ___

uRem/hr -20% ___

net cpm + 20%Lif6 7$ net cpm -20% '11'79'

3.

Techniclan/Worker Performing Checks:

Name: :J. /5.~r'i}.<

Date:ld.J-1~/('F Time: o.g15-

Title:

__ T?""'-"',._1'----

4.

Site nr Location:

Site/Job: ___

A_-_fC_

1_v._t;".~.~~----S-~*~Go=--

Location

Description:

lA..J C.-r:!*rO"::>

GPS Coordinates {when required}:

X-Coord: ________ _

Y-Coord:. ________ _

Instrument Field Responsez Use Acceptance Criteria Remarks Rev 1 10/18/15 Meter Bkg Bkg Counts Source Source Response

+/-20%

Cnt (cpm) or Cnt (gross cpm or source Inst.

Battery Ca lib.

Check Time Of Amblent Temp.

lniti<ils and Comments (add'! Info; inst. Condition, etc.)

'Time uRem/hr)

TI me uRem/hr}

gross cpm current

{Y/N) check

{of) or uRem/hr (Y/N)

{Y/N}

Ratemeter

. Ratemeter 1 1 Ratemeter

Ratemeter 1 Bicron NA
  • Bicron NA j Bicron NA
1.

Instrument designated check source is listed on alibr tian 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 ofthree static counts at the same location. Repeat counts should be within 20%. If count rate diverges.

  • signific;rntly, perform additional counts to eva 1uzite instrument stability

App E-Sub-Area 5.6 - Sample Data Sheets

VTS

~--* T~

.. #- $£R~'l!ClE'S SAMPI,E I"OCA TION DA TA SHEET Date: J:CtJ.~!5_

Name:

/J....

\\_)ril'._-.. *"

1 weather: u (j* ;::.: <-r i..i u' ) d..r ; *i z (.;i:_

.-,, **--r-*.. -*&'N*,~-

    • .~-----
1. Sample Area (SA):

SA Designation: ___

'5.:_(.p_A_. _____... ____..

==

Description:==

(1J :i,dvl l#-

SA Origin Location:

coora. System: ___ _

SA. Land Mark De:scription. ----*-~

........... ~

Coord:

2. Sample Location Data:

Sample Area ID:.. --~.._\\.!!fi*'iS*'---... Matrix:.... s.~iJ.........

Location Coord: H!J..'?0 'M_J,;,_\\_:1_2"_* __

Alternate Location Measurements (di~tance from SA origin and Local Coord.)

X Dist. from Origin (0,0) tJ/ 19 Y Di~L from Origin: ___,J_J_f'L *-.

Site Sketch Attached (Yes) ~

Sample Location

Description:

~4.~.rn__uf_~D!.~ll ~" "'-! 1{b.J. y(;.;,~tcl 1 Jon~.,, *fr~~<...d.:i.'{

Canopy Typec µ>d.c*J ~"-*Land U sec hri'lL!;,J.:t<o___ Soil Moisture (Wel dcy,

.. * ( ;;, t *<. 1 { r I;,** * ;~

etc.): d().

1mf*-*~ _ -*

3. Location Radiation Readings:

1*---*

2~p*~~1.

--r-*;!~:~-;-* i Notes

' Coun~ time 1.. cm I

l ;;;-*----T~~~-T--*1-~- *~*'&"i c:.o~-~~?.O~!

t;~,_--

L

<~7r 1~0-L_.3IIL~--.s::t::.k -=l:i~ '!.;~~~!~' 11.k..J

\\**--------1'-.--'1.j_}_}_ __ f __.J~G_k ____ l- *----.l--*-**-*--

-~"'" ~ t='tt.

\\~_tJ.'-\\'2.. ~

_L_ _____ l__.

l\\,:...,, CAA d~ G f'S fi'\\1c "*;(:._-...,.,if" I '-Jlq.

4. Sample Information:

Sample: Arca ID: 6.. \\..E_!:' * \\2.... \\ * \\-_lo_

10/20/l':J

TS

~T~L$Eff'V~

SAMPLE I"OCATION DA TA SHEET Date: J_l_~19.~ I~_

Project:

N V5 /;'R.'.P.1\\_ ___ _

Weather:

c~, \\o.M 1 ~&~~ vo* 1

1. Sample Area {SA):

SA Designmion: ___ ~4,. ___.. ____ *---.. **---.

==

Description:==

_ \\il o~.s SA Origin Location: ______ ---*** -~----

Coord. System:

SA Land Mark Description-----------*-*----**----

Coord:

2. Sample Location Data:

Sample Area ID:

5.t_., R. 2.

Matrix: ~-~. \\

-~P-_..... *-**-

Location Coord:

~i-~~Ll']_,,._. __

Alternate Location Measurements (distance from SA,_origin and Local Coord.)

X Dist from Origin (0,0). JJ.JA_.....

'{Dist. from Origin: ___N_/-A-Sfre Sketch Attached (Yes) ~

Sample Location

Description:

Canopy Type: ----.0.-t~'f~\\~_Land Use: J:h.¥.-,n.~- Soil Moisture (Wet, dry, etc_):. ___ ~-----**

3.. Location Radiation Readings:

I 2.x2 NaJ

=---~~-. -- Bicron-- --* -

..... ~.----**-~-~ ---~

Notes I

{c m)

(uRem/hr)

4. Sample Information:

Soil Color Sample Area ID: 6. LDA. IL. ?... I - l...

Sample ID ---r--.

Sampling Description (Surface Htter type/depth, sample depth retention,

'-~-1---"---'---<-----+----------+---re_fi_1_sa_l;_, st_one or rocJs toP-9.~a hy, erosion features s 'GI f""I' R;.~~.. 4ltML 1.........,,S)'"'-""Yll\\.....,\\.1....! __.Vl._,.,X""'"J"-'"\\-c...5_,.__ _________ ~

I

  • -**-:i r

-~'--'-"'<:;::...::--+-'s:::.;.c::::L:>=r~~-s~~-1.~~.-~~~s..__ __ ---*-*--------~-1


*~*-----*----------l Sa;ple Recorded OU Lab~ratory c~c form an~i"~t~i~;;:-Lab;;l;d: (N) 10/20/lS

SAMPLE LOCATION DATA SHEET Date: _l],,:::.' '{~

Project:

N Y~J'.F;DfL_.

Weather: f.Lt.\\IJ-.'.-1 -pt&-f-L\\~ J...dl t-

1. Sample Area (SA):

SA Designation:--~-~--*****----*

==

Description:==

_ _\\-J_cod-_-'S=-----------

SA Origin Location:

Coord. System: ____ _

SA Land Mark

Description:

Coord: ----**- --... *---

2. Sample Location Data:

Sample Area JD: fl, v. ~ *--

Matrix: _&:,~_\\_ __ _

Alternate Location Measurements (distance from SA origin and Local Coord.)

X Dist from Origin (O,O) __ J!J.-1-A___

Y Dist from Origin: _..bl.j.A __

Site Sketch Attached (Yes) (@

Sample Location

Description:

_.t:O:\\

r.:....~... ~~-':...ct'\\.....,~....,....,.1_,,l...,.ec...._,IJ('-=--S..._ _________ _

Canopy Type:. -*.Q.poo.. **-__ Land Use:..1::\\.\\ t."4-_ Soil Moisture (Wet, dry, etc.): *-***I:::b.-1'--**---

3. Location Radiation Read!!!~.

..--------------~

2x2 Naf

~

Bicron

( cpm).

~

( uRe.m/hr)

Notes

4. Sample Information:

Sample Area ID:~. <...:>A. (L ~- t - 2 escnption v ept D

b D h

I Depth Soil Type Seil Sample 1 Interval (Org; clay; Colar D

Sampling Descripticn 1s I sc-\\

&-.,,.,~

    • 71-,.-<'
s. U..1\\.1....~.

6' l,; ~~.d<.

i (Surface. litter typefdepth, sample depth retention, I refosal, st~e or ro-9_~ topoe;raphy, erosion foatur<:s)

~m) sand etc.)

-_"3~~<2_;\\ __

--+*-***

~~i-~;~'1. -- ~-'.~'.:~--~--
  • --1*-n-* *-+=-j ___ -n *

--t--__;-----------

___ _L__..

Sample Recorded on Laboratory COC form and Container Labeled:

?) (N) 10/20/15.

SAMPLE LOCATlON DATA SHEET Date: _!1.:l4_:.J5.

Project:.. N y5~_F..4.)~*--*--

1. Sample Area (SA):

SA Designmion: --o-~-:. c.o ___. *-*... *-***--*****

==

Description:==

__ \\,,..N--'--o..... c"~><l:_,5~-------

SA Origin Location: ----**--*- ___

Coord. System: __

SA Land Afark Description-Coord:

2. Sample Location Data:

Samp!~ Area ID: *- ~- ~

  • _ 12
  • 4j ___ Mattix: _§?.~.. -......

Location Coard:

_f'L..!:L?::.._£.?.1.* '-i~**

____ \\i-::d..2.Y 5 ~ -... 'icJ._v_' __ _

A ltemate Location Measurements (distance from SA origin and Local Coord.}

X Dist. from Origin (O,OL. N /A ---*

Y Dist. from Origin: _bl_f.A--

Site Sketch Attached (Yes)@

Canopy Type: *--~~.. -

... -Land Use: _aj<:-.~~-*-- Soil Moisture (Wet, dry, etc_):_~'::f-** _........ __

3. Locatiol!._ Radiation Readi_n~g~s_: __ _

2x.2 Nal

~

(cpm)

4. Sample Information:

Bicron (uRem/hr)

Notes*

Sample Area JD: 5. lPf\\. ~. '1. 1-l Sample Recorded oo Labi:lratory COC form and Container Labeled: ff (N) 10/20/15

'...