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'T\1f'.ll fi.J<l S:am;,!tt rsc required for sample Sample ID C'utlccrcd QC Fill<<<"! M':ltrjx. Rodi A specific QC (Milll.ry) Ceodc:lll' O;tr;tl R.t'gu "Fo1* com1m.!i/e.'( -ziultcalt' start and .\'/01> (hhn1m) .. 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 TAT Requested: Normal. Rush: (Sub1w 10 s,.n.h>rg*) r Rcsuhs. Yes I No Circle Deliverable: C of A I I Level I I Lcvol 2 I Level) I Remarks: Are there any known hazardr applicahle lo ihese !f.w1, plea,1*e /fat th!! hazardr Pacific Ccntrn! Other Mcninrnin Clmln of Signatures Snmp!e Shipping and 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 ... Dc1:irmfoed Fur Lob 1.he 011/r l' QC N ... TH ""'Trip JC()"" FieJd t:n"' nli!::*k, MS .. M31fix Sa.ir.p1c. MSD.,. Ma:r*x Dur;l:talo G C.,,, Ccmr.vf.1tc 3.} r1;u:rc:J. !lq\otd mdotal!C \\111;1 II. -v. ltu1 Hml?lC micrctl t)f"* N .. for .s:imp:c flctd iillcn:d. Cu.wdySeal /11111r1? .J ) Ma!rix Water, OW=Gnnhtdw-1\tc.r, Wil!a, W\V=\Vw.1c W;'1.:r. \V=War..:r, Ml...'"'Mt:ii: Liq::1J. SO:=.Sotl. Ss"'.c;:c)hd r U""'Urmc, N=l YES NO 5.J S;implc 1\r.clyns ttqt:;s1cd !:12C-OIJ. COl(l0f747iJA} om.I o.r for cllC!l (i.t 8260D -J, 60JOJll747fJA -I). (i.) #".(C.it;l V;l!JVI! Hh u ({)'cfroch!onc Aci.i, Nl """Nini"' Acid, .)'U D Sodium H:ii,!i:cnucie. SA"' Sulfot*e Aw1, .\t\::.. J\i:corbit' Acal, BX Cl Jtcx.1111c:, ST ... U' !\ol n; 11.1McQ '= Je:l1ve blair.k c WHtTE"' LABORATORY YR(,LOW"" FILE rINK = CLfENT App E-Sub-Area 2.1. Instrument Field Sheets UJW Rev 110/18/15 i I l l i ! 1. Instrument lnformation 1 . Ratemeter: Make/Model: fo/ki,.11/1-
- p 'ii* 2. Detector 1
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LvfJLv1'\ 'N*1 a Bicron MicroRem Meter: 2. Check Source Information: Instrument Field Response Check Log Serial No. ?. W).. I S-1 Serial No. I/( /JI I;;? I Serial No. I) ;;;.12 if Y-Cal. Due Date: Cal. Due Date: E.4l? Source 1 lsotope: fh i 31. Serial No.: 11 <.v Activity: Assay Date: ti/7;,;,/io Response Acceptance Range {+/-20%}: uRem/hr +20% __ uRem/hr -20% __ net cpm + 20% net cpm -20% __ _ Source 2 IS ) Serial No.: f1 ![ IJ., Activity: .o L-Assay Date: Mo Response Acceptance Range {+/-20%}: uRem/hr +20% __ uRem/hr -20% __ net cpm + 20% __ _ 3. Technician/Worker Performing Checks: Name: .$"72".1/.(. Title: _____ _ Date: /c/21/t) Time: 01o.:..'> r I net cprn -20% __ _ 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 Meter Bkg Bkg Counts Source Source Response +/-20% lnst. Battery Time Ambient Initials and Comments Cnt {cpm) or Cnt (gross cpm or source Calib. Check Of Ternp. . (add'l tnfo: inst. Condition, etc.} Time uRem/hr) Time uRem/hr) gross cpm current (Y/N) check (oF) oruRem/hr (Y/N} {Y/NJ --! Ratemeter I/ {fi((i} l"-101 / 1}1 IAJ Jgsz..rn '( v D'"ic" *r1.., lit,i.n. ! Ratemeter ) !111/t/ l!../01 I WI. I J./ Io !\L75 y y 11'*1.., *:* *11. '1 (d>l j Ratemeter / 1111 r.I 9(.,'1(... JrM1V JqJl.(o v v* ; *2 3 c:i l.f 1. >( IA 211 ! Ratemeter Jmr;V irt.:. Cl (;,. J ,.yu ,V F2 I q 2. y' 'f f'Z. ;,.) '{ Lin Ratemeter J J ') z 1 I IJll: sv' fl 111 '/ y 1(10 r1.? Ratemeter /mrrJ /(Iii}./ I C)(YL-y y I .>1 o (l .. S' .lYf5 .. 1 -L 7-; 7-1 Bicron NA (o NA y y r><ioo 77.1 j Bicron NA "7 NA I 'i?' *y y* l'!..1.J 'i 9. *( i Bicron NA /,., NA I fl y y' /)10 <z.? . 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 I l I l I 1 . I I i I I I I l I 1 f Rev 110/18/15 Instrument Field Response Check Log 1. Instrument lnformatlon 1 Ratemeter: Make/Model: Detector 1: Make/Model: Bicron MicroRem Meter: Serial No. Serial No. f'R;;)..{:if.) serial
- 2. Check Source Information:
- , Source 1 Isotope: l/i-:;)9 Serial No.: ff (
units: pt-., Response Acceptance Range (+/-20%): uRem/hr uRem/hr -20% __ Cal. Due Date: /1 Cal. Due Date: __ _ Source 2 lsotope:C.:;* rn Serial No.: Uf0:3-i?-Activity: 6..02 Assay Date: /U/ --Response Acceptance Range (+/-20%): uRem/hr+20%___ uRem/hr -20% __ net cpm + 7.'> net cpm -20% g-,,_,*v'?
- 3. Checks: Title: _ _.LU=. :....T __ _ Date:
Time:D'JO 2 Location
Description:
. __ Y-Coord: Wa?!. 76177° I 4. Site or location: Site/Job:. _ __ ._,_(______ <::> GPS Coordinates (when required): X-Coord: N L{g. l/421 ?-l Instrument Field Response 2 Use Acceptance Criteria Remarks Meter Bkg Bkg Counts Source Source Response +/-20% Inst Battery Time
- Ambient Initials and Comments Cnt (cpm) or Cnt {gross cpm or source Ca!ib. Check Of Temp. (add'J Info: lnst. Condition, etc.) TI me uRem/hr) TI me uRem/hr) _,.gross cpm current (Y/N) check (oF} *er uRem/hr (Y/N) (Y/N) Rate meter ( ,..,.. ..* , 1 JS i:: "*
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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 Ratemeter I ( I I £/. 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 t l ! i l j ! i i I I I J I I I Rev 110/18/l'S
- 1. Instrument lnformatlon 1 Ratemeter:
Make/Model: Detector 1: Make/Model: Bicron MlcroRem Meter: 2. Check Source Information: Instrument Field Response Check Log Serial No.,.;JtJ6f!1.F Setial No. &!_IJ?V Serial No.
- Cal. Due Date:
CaL Due Date: __ _ Source 1 lsotope: n;.752 Serial No.: ti I Activity: CL>. I Response Acceptance Range (+/-20%): uRern/hr +20% __
- uRern/hr -20% __ Assay Date: /;J/!>rJ/lt'
- net cpm + 2Q%Tiill net cpm -20% 3)8£.C Source 2 Isotope: C$-{>7 Serial No.:
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% $ft./'] 3. Technician/Worker Performing Checks: Name: X,.£/J.,. .,-,,15 Title: __
- 4. Site or Location:
Site/Job: __ _/___,:---*-* __ GPS Coordinates (when required): X-Coord: /'If.;...-¥'!;../ rE I Instrument Field Response 2 i Meter Bkg Bkg Counts Source Source Response +/*20% Date:/p/.?.J//J r1 Location
Description:
- 5cc.by -$"1'1. Y-Coord: Wt>Z$. 7o(t:!/1° Use Acceptance Criteria Remarks Inst. Battery Time Ambient Initials and Comments Cnt (cpm) or Cnt ' (gross cpm or source Calib. Check Of Temp. {add'i Info: inst. Condition, etc.} Time uRem/hr} Time uRem/hr) gross cpm current (YIN) check (F) or uRem/hr (Y/N} (Y/N) *-
/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 Rate meter I { J I ?-" -Rate meter Bicron NA NA Bicron NA NA 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 1 I I I l v I Grid Pattern Manual Data Collection Form r:;:_ hreej < AREA d
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Description:
___ \J_.oJds* SA Origin Location: l\I '11..'i7j'i*-r </, 7 Coard. System: __ _ SA Land Mark Descri1ition: _Md _ Coard: LJZ. .W Tt -, <.11t.tl" 2. Sample Location Data: Sample Area ID: 2.1.1 Matrix: __ ___ _ Location Coord: W7.f(, 7ocnd' -** /\/ ... 1...?-'-/7793 _, \'i Alternate Location Measurements (distance from SA origin and Local Coord.) ---r r-e..t i \'\ X Dist. fi em (G,B)_r-J 2 /1101¥1" ¥Dist Flom Ot igin:vJ 7 <l. ]().)'?}.:> \ L'I -ro 1 ojz.:'.:i Site Sketch Attached (Yes) Sample Location
Description:
__ yns\.e5 ti{) j Canopy Type: Wood.gel etc.): T)'\l1 Land Lise: . Soil Moisture (Wet, dry, I 3. L Rd" f R d" ocat10n a Ia IOil ca mgs: 2x2 NaI I Bicron Notes ! (cpm) (uRemfhr) Count time ! cm i Ill i I cm Im (min) ! j 9&25' i }j_ 7. NIP.. -** i . . . . I i{}f5 !I I fJ i 11----** ; .. --*-. ***-** --* ... ., *-*-*-***-'----****** 1! 4. Sample Information: Sample Area TD: 2.1. l . R.
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---*-- on Luboratory.COC form and Container Labeled: (N) 10/20/15
SEWVR:".E;l!<" SAMPLE LOCATION DATA SHEET Date: ; v 5-/S Weather: ___
- 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:
(7.>9--d _ ei1-..d Coord:
- 2. Sample Location Data: Sample Area ID: Z. \ . L Matrix:
Location Coard: \tJ 7 ?;'. 7 UJ& i.:; ' __ _l:!__':/2 Ji 7 Cf '16'" Alternate Location Measurements (distance from SA origin and Local Coord.) X Dist. from Origin Y Dist. from Origin: JJ-'----,1-'-/f'.'t __ _ 0\\ l'C-$+ 'Qv-,:. c.;,{O*' IJ5 I r-v.dP\.<. Cf 5,d_ Site Sketch Attached (Yes) Sample Location
Description:
_ 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, ci 3. Location Radiation
2x2 NaI 1 i B1cron Notes {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 __ me t..5 . -I 5 :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
Dute: tO -.z. 3 -f ) Project: N'fSlt2DPt Weather: S>J*N1j, wen*"* l.* Sample Area (SA): SAMPLE LOCATION DATA SHEET SA Designation:
- 2. J
Description:
___ 0'A Origin Location:
i*Qi, 7 0'1 ** Z1 3-Coord. i.J 'A Land Mark
Description:
Coord: _ 'fi4' j,N'7&-, 7067)"" 2. Sample Location Data: Sample Area ID: ____2_,__L_l ____ Matrix: _ .... .. -D Location Coard: __ 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.):
Land Use: hit; J-*-.. Soil Moisture {Wet, di}', 3. Location Radiation Readings: -.. 2x2 Nal Bicron Notes (cpm) (uRem/hr) 1c1nI -Count time lcm Im Im I .. ... " I 07fJ'-7 JtJi35 .. _!L. _ ___ __g_ t-.dP->-*-r-.. _ . i 0 Di./ g ._ 1¥ .. ---" ___ ,. __ '---*--*-****
- ---*--* 4. Sample Information: . Sample Area ID: 2. l , 3 , R-. I D b D C!Scnpt10n IY 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,\
sc: \ h ....... .,.._ 2..., 12.. ';l.. 5rvv** 1.1 l('bQt, 5-1r-'Srl ; \ hvuw 2.-; S'r'YlDL\ \. V\)(>'\' s r----***----:--*
- -----* ***-**----*--
.. *- Sample Recorded on Laboratory COC form and Container Labeled: (j1 (N) 10/20/15
- * "
- d SAMPLE LOCATION DA TA SHEET 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"'
W 7 If. 70o7'J<; Coord. System; _.AJ)J ___ _ SA Land lvfark
Description:
Coord: 'f&<.1'0-Siv"" _id._7"8'.
- 2. Sample Location Data: Sample Area lD: -----2 .... L.:t _____ ._ Matrix:_ 5'1.t *, \ " Location Coord: N "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:
Canopy Type:
Land Use: Hi Soil Moisture (Wet, dry, 3. Location Radiation Readings: 2x2 NaJ Bicron. Notes (cpm) ' (uRem/hr) Count time lcm lm !cm Im ' (min) ,. J Wfi 4 'i7Lf *-, I __ __::_;_ ' I 1[1--------- -*--**- ,___°!377
- -'r--*-----*-r-gjvt -----------.... ***** 4. Sample Information:
San?ple Area JD: 2. \. '1, 't. l --Z., D b D th escnption }' eE 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) bVU<..-h\ I hl\I\.\./ -.. -*--*--5-1 "i,d -_z, 1. 0 roc:,-t-s i2,;'(1re;. k --I . 'i . 12. * (,,,_ -r--------* IT'ir: -H.O 'w'-c.. ? 1...1.__f?:_J_ ***--*--**
Sample Recorded on Laboratory COC form and Container Labeled: © (N) 10/20/15}}