HomeMy WebLinkAboutWater sample results test 2.pdfOctober 29, 2020
PBS Engineering & Environmental
Pat Togher
Attention Pat Togher:
RE:Renton Mazda
Work Order Number:2010443
214 E Galer St. Suite 300
Seattle, WA 98102
3600 Fremont Ave. N.
Seattle, WA 98103
T: (206) 352-3790
F: (206) 352-7178
info@fremontanalytical.com
Fremont Analytical, Inc. received 2 sample(s) on 10/27/2020 for the analyses presented in the
following report.
Brianna Barnes
This report consists of the following:
- Case Narrative
- Analytical Results
- Applicable Quality Control Summary Reports
- Chain of Custody
All analyses were performed consistent with the Quality Assurance program of Fremont Analytical,
Inc. Please contact the laboratory if you should have any questions about the results.
Thank you for using Fremont Analytical.
Sincerely,
Project Manager
Diesel and Heavy Oil by NWTPH-Dx/Dx Ext.
Gasoline by NWTPH-Gx
pH by SM 4500H+B
Total Metals by EPA Method 200.8
Turbidity by EPA Method 180.1
Volatile Organic Compounds by EPA Method 8260D
www.fremontanalytical.com
Original
DoD-ELAP Accreditation #79636 by PJLA, ISO/IEC 17025:2017 and QSM 5.3 for Environmental Testing
ORELAP Certification: WA 100009 (NELAP Recognized) for Environmental Testing
Washington State Department of Ecology Accredited for Environmental Testing, Lab ID C910
Page 1 of 17
10/29/2020Date:
Project:Renton Mazda
CLIENT:PBS Engineering & Environmental
Work Order:2010443
Work Order Sample Summary
Lab Sample ID Client Sample ID Date/Time ReceivedDate/Time Collected
2010443-001 Vault 10/27/2020 12:10 PM 10/27/2020 12:59 PM
2010443-002 Trip Blank 10/23/2020 2:35 PM 10/27/2020 12:59 PM
Note: If no "Time Collected" is supplied, a default of 12:00AM is assigned
Original
Page 2 of 17
Project:Renton Mazda
CLIENT:PBS Engineering & Environmental
10/29/2020
Case Narrative
2010443
Date:
WO#:
I. SAMPLE RECEIPT:
Samples receipt information is recorded on the attached Sample Receipt Checklist.
II. GENERAL REPORTING COMMENTS:
Results are reported on a wet weight basis unless dry-weight correction is denoted in the units field on the
analytical report ("mg/kg-dry" or "ug/kg-dry").
Matrix Spike (MS) and MS Duplicate (MSD) samples are tested from an analytical batch of "like" matrix to
check for possible matrix effect. The MS and MSD will provide site specific matrix data only for those
samples which are spiked by the laboratory. The sample chosen for spike purposes may or may not have
been a sample submitted in this sample delivery group. The validity of the analytical procedures for which
data is reported in this analytical report is determined by the Laboratory Control Sample (LCS) and the
Method Blank (MB). The LCS and the MB are processed with the samples and the MS/MSD to ensure
method criteria are achieved throughout the entire analytical process.
III. ANALYSES AND EXCEPTIONS:
Exceptions associated with this report will be footnoted in the analytical results page(s) or the quality
control summary page(s) and/or noted below.
Original
Page 3 of 17
10/29/2020
Qualifiers & Acronyms
2010443
Date Reported:
WO#:
Qualifiers:
* - Flagged value is not within established control limits
B - Analyte detected in the associated Method Blank
D - Dilution was required
E - Value above quantitation range
H - Holding times for preparation or analysis exceeded
I - Analyte with an internal standard that does not meet established acceptance criteria
J - Analyte detected below Reporting Limit
N - Tentatively Identified Compound (TIC)
Q - Analyte with an initial or continuing calibration that does not meet established acceptance criteria
(<20%RSD, <20% Drift or minimum RRF)
S - Spike recovery outside accepted recovery limits
ND - Not detected at the Reporting Limit
R - High relative percent difference observed
Acronyms:
%Rec - Percent Recovery
CCB - Continued Calibration Blank
CCV - Continued Calibration Verification
DF - Dilution Factor
DUP - Sample Duplicate
HEM - Hexane Extractable Material
ICV - Initial Calibration Verification
LCS/LCSD - Laboratory Control Sample / Laboratory Control Sample Duplicate
MB or MBLANK - Method Blank
MDL - Method Detection Limit
MS/MSD - Matrix Spike / Matrix Spike Duplicate
PDS - Post Digestion Spike
Ref Val - Reference Value
REP - Sample Replicate
RL - Reporting Limit
RPD - Relative Percent Difference
SD - Serial Dilution
SGT - Silica Gel Treatment
SPK - Spike
Surr - Surrogate
Original
www.fremontanalytical.com
Page 4 of 17
Project:Renton Mazda
Client Sample ID:Vault
Collection Date:10/27/2020 12:10:00 PM
Matrix:Stormwater
Client:PBS Engineering & Environmental
Lab ID:2010443-001
Analyses Result Qual Units Date AnalyzedDFRL
Analytical Report
10/29/2020
2010443
Date Reported:
Work Order:
Diesel and Heavy Oil by NWTPH-Dx/Dx Ext.Analyst:IHBatch ID: 30181
Diesel (Fuel Oil)10/28/2020 5:12:57 PM50.0 µg/L 1ND
Heavy Oil 10/28/2020 5:12:57 PM100µg/L 1194
Surr: 2-Fluorobiphenyl 10/28/2020 5:12:57 PM50 - 150 %Rec 183.4
Surr: o-Terphenyl 10/28/2020 5:12:57 PM50 - 150 %Rec 167.4
Gasoline by NWTPH-Gx Analyst:KTBatch ID: 30170
Gasoline 10/28/2020 3:38:42 AM50.0 µg/L 1ND
Surr: Toluene-d8 10/28/2020 3:38:42 AM65 - 135 %Rec 1100
Surr: 4-Bromofluorobenzene 10/28/2020 3:38:42 AM65 - 135 %Rec 1102
Volatile Organic Compounds by EPA Method 8260D Analyst:KTBatch ID: 30170
Vinyl chloride 10/28/2020 3:38:42 AM0.200 µg/L 1ND
cis-1,2-Dichloroethene 10/28/2020 3:38:42 AM1.00 µg/L 1ND
Benzene 10/28/2020 3:38:42 AM1.00 µg/L 1ND
Trichloroethene (TCE)10/28/2020 3:38:42 AM0.500 µg/L 1ND
Toluene 10/28/2020 3:38:42 AM1.00 µg/L 1ND
Tetrachloroethene (PCE)10/28/2020 3:38:42 AM1.00 µg/L 1ND
Ethylbenzene 10/28/2020 3:38:42 AM1.00 µg/L 1ND
m,p-Xylene 10/28/2020 3:38:42 AM1.00 µg/L 1ND
o-Xylene 10/28/2020 3:38:42 AM1.00 µg/L 1ND
Surr: Dibromofluoromethane 10/28/2020 3:38:42 AM84.8 - 113 %Rec 1109
Surr: Toluene-d8 10/28/2020 3:38:42 AM88.5 - 110 %Rec 1105
Surr: 1-Bromo-4-fluorobenzene 10/28/2020 3:38:42 AM89.9 - 108 %Rec 1102
Total Metals by EPA Method 200.8 Analyst:COBatch ID: 30195
Arsenic 10/28/2020 4:25:18 PM1.00 µg/L 11.25
Cadmium 10/28/2020 4:25:18 PM0.200 µg/L 1ND
Chromium 10/28/2020 4:25:18 PM1.00 µg/L 12.51
Lead 10/28/2020 4:25:18 PM0.500 µg/L 1ND
pH by SM 4500H+B Analyst:EHBatch ID: R62886
Hydrogen Ion (pH)10/27/2020 1:16:33 PMpH17.95
Original
Page 5 of 17
Project:Renton Mazda
Client Sample ID:Vault
Collection Date:10/27/2020 12:10:00 PM
Matrix:Stormwater
Client:PBS Engineering & Environmental
Lab ID:2010443-001
Analyses Result Qual Units Date AnalyzedDFRL
Analytical Report
10/29/2020
2010443
Date Reported:
Work Order:
Turbidity by EPA Method 180.1 Analyst:EHBatch ID: R62887
Turbidity 10/27/2020 1:17:17 PM0.200 NTU 12.51
Original
Page 6 of 17
Project:Renton Mazda
CLIENT:PBS Engineering & Environmental
Work Order:2010443 QC SUMMARY REPORT
pH by SM 4500H+B
10/29/2020Date:
Sample ID:MB-R62886
Batch ID:R62886 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:pH
RL
Client ID:MBLKW
RunNo:62886
SeqNo:1262256
MBLKSampType:
Hydrogen Ion (pH)8.35
Sample ID:LCS-R62886
Batch ID:R62886 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:pH
RL
Client ID:LCSW
RunNo:62886
SeqNo:1262257
LCSSampType:
Hydrogen Ion (pH)7.000 101 95 10507.07
Sample ID:2010443-001DDUP
Batch ID:R62886 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:pH
RL
Client ID:Vault
RunNo:62886
SeqNo:1262259
DUPSampType:
Hydrogen Ion (pH)107.950 0.6278.00
Original Page 7 of 17
Project:Renton Mazda
CLIENT:PBS Engineering & Environmental
Work Order:2010443 QC SUMMARY REPORT
Turbidity by EPA Method 180.1
10/29/2020Date:
Sample ID:MB-R62887
Batch ID:R62887 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:NTU
RL
Client ID:MBLKW
RunNo:62887
SeqNo:1262235
MBLKSampType:
Turbidity 0.200ND
Sample ID:LCS-R62887
Batch ID:R62887 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:NTU
RL
Client ID:LCSW
RunNo:62887
SeqNo:1262236
LCSSampType:
Turbidity 10.00 106 90 1100.200 010.6
Sample ID:2010443-001DDUP
Batch ID:R62887 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:NTU
RL
Client ID:Vault
RunNo:62887
SeqNo:1262238
DUPSampType:
Turbidity 200.200 2.510 2.832.44
Original Page 8 of 17
Project:Renton Mazda
CLIENT:PBS Engineering & Environmental
Work Order:2010443 QC SUMMARY REPORT
Total Metals by EPA Method 200.8
10/29/2020Date:
Sample ID:2010432-001ADUP
Batch ID:30195 Analysis Date:10/28/2020
Prep Date:10/28/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:BATCH
RunNo:62950
SeqNo:1263547
DUPSampType:
Cadmium 300.200 4.466 3.684.63
Chromium 301.00 165.4 2.86170
Sample ID:2010432-001AMS
Batch ID:30195 Analysis Date:10/28/2020
Prep Date:10/28/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:BATCH
RunNo:62950
SeqNo:1263548
MSSampType:
Cadmium 25.00 99.8 70 1300.200 4.46629.4
Chromium 500.0 109 70 1301.00 165.4712
Sample ID:2010432-001AMSD
Batch ID:30195 Analysis Date:10/28/2020
Prep Date:10/28/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:BATCH
RunNo:62950
SeqNo:1263549
MSDSampType:
Cadmium 25.00 109 70 130 300.200 4.466 29.41 7.2431.6
Chromium 500.0 109 70 130 301.00 165.4 711.7 0.394709
Sample ID:MB-30195
Batch ID:30195 Analysis Date:10/28/2020
Prep Date:10/28/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:MBLKW
RunNo:62950
SeqNo:1263564
MBLKSampType:
Cadmium 0.200ND
Chromium 1.00ND
Original Page 9 of 17
Project:Renton Mazda
CLIENT:PBS Engineering & Environmental
Work Order:2010443 QC SUMMARY REPORT
Total Metals by EPA Method 200.8
10/29/2020Date:
Sample ID:LCS-30195
Batch ID:30195 Analysis Date:10/28/2020
Prep Date:10/28/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:LCSW
RunNo:62950
SeqNo:1263565
LCSSampType:
Cadmium 5.000 106 85 1150.200 05.29
Chromium 100.0 110 85 1151.00 0110
Original Page 10 of 17
Project:Renton Mazda
CLIENT:PBS Engineering & Environmental
Work Order:2010443 QC SUMMARY REPORT
Diesel and Heavy Oil by NWTPH-Dx/Dx Ext.
10/29/2020Date:
Sample ID:MB-30181
Batch ID:30181 Analysis Date:10/28/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:MBLKW
RunNo:62925
SeqNo:1263048
MBLKSampType:
Diesel (Fuel Oil)49.2ND
Heavy Oil 98.4ND
Surr: 2-Fluorobiphenyl 78.73 84.6 50 15066.6
Surr: o-Terphenyl 78.73 71.3 50 15056.2
Sample ID:LCS-30181
Batch ID:30181 Analysis Date:10/28/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:LCSW
RunNo:62925
SeqNo:1263049
LCSSampType:
Diesel (Fuel Oil)997.8 52.6 52 10749.9 0525
Surr: 2-Fluorobiphenyl 79.83 80.5 50 15064.2
Surr: o-Terphenyl 79.83 61.1 50 15048.8
Sample ID:2010450-003BDUP
Batch ID:30181 Analysis Date:10/28/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:BATCH
RunNo:62925
SeqNo:1263631
DUPSampType:
Diesel (Fuel Oil)3049.6 0ND
Heavy Oil 3099.3 0ND
Surr: 2-Fluorobiphenyl 79.43 84.0 50 150 066.8
Surr: o-Terphenyl 79.43 65.0 50 150 051.6
Sample ID:2010401-001AMS
Batch ID:30181 Analysis Date:10/28/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:BATCH
RunNo:62925
SeqNo:1263639
MSSampType:
Diesel (Fuel Oil)982.5 36.8 23.6 13049.1 33.27395
Surr: 2-Fluorobiphenyl 78.60 85.3 50 15067.0
Surr: o-Terphenyl 78.60 39.0 50 150 S30.6
Original Page 11 of 17
Project:Renton Mazda
CLIENT:PBS Engineering & Environmental
Work Order:2010443 QC SUMMARY REPORT
Diesel and Heavy Oil by NWTPH-Dx/Dx Ext.
10/29/2020Date:
Sample ID:2010401-001AMS
Batch ID:30181 Analysis Date:10/28/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:BATCH
RunNo:62925
SeqNo:1263639
MSSampType:
NOTES:
S - Outlying surrogate recovery(ies) observed.
Sample ID:2010418-001BDUP
Batch ID:30181 Analysis Date:10/28/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:BATCH
RunNo:62925
SeqNo:1263644
DUPSampType:
Diesel (Fuel Oil)3049.6 46.29 17.054.9
Heavy Oil 3099.1 0ND
Surr: 2-Fluorobiphenyl 79.30 97.6 50 150 077.4
Surr: o-Terphenyl 79.30 76.6 50 150 060.7
Original Page 12 of 17
Project:Renton Mazda
CLIENT:PBS Engineering & Environmental
Work Order:2010443 QC SUMMARY REPORT
Gasoline by NWTPH-Gx
10/29/2020Date:
Sample ID:LCS-30170
Batch ID:30170 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:LCSW
RunNo:62916
SeqNo:1262856
LCSSampType:
Gasoline 500.0 102 65 13550.0 0510
Surr: Toluene-d8 25.00 101 65 13525.2
Surr: 4-Bromofluorobenzene 25.00 103 65 13525.7
Sample ID:MB-30170
Batch ID:30170 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:MBLKW
RunNo:62916
SeqNo:1262857
MBLKSampType:
Gasoline 50.0ND
Surr: Toluene-d8 25.00 99.9 65 13525.0
Surr: 4-Bromofluorobenzene 25.00 101 65 13525.2
Sample ID:2010414-001DDUP
Batch ID:30170 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:BATCH
RunNo:62916
SeqNo:1262848
DUPSampType:
Gasoline 3050.0 0ND
Surr: Toluene-d8 25.00 100 65 135 025.1
Surr: 4-Bromofluorobenzene 25.00 101 65 135 025.3
Sample ID:2010415-003ADUP
Batch ID:30170 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:BATCH
RunNo:62916
SeqNo:1262850
DUPSampType:
Gasoline 3050.0 0ND
Surr: Toluene-d8 25.00 100 65 135 025.0
Surr: 4-Bromofluorobenzene 25.00 102 65 135 025.4
Original Page 13 of 17
Project:Renton Mazda
CLIENT:PBS Engineering & Environmental
Work Order:2010443 QC SUMMARY REPORT
Volatile Organic Compounds by EPA Method 8260D
10/29/2020Date:
Sample ID:LCS-30170
Batch ID:30170 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:LCSW
RunNo:62914
SeqNo:1262817
LCSSampType:
Vinyl chloride 20.00 109 62.3 1480.200 021.8
cis-1,2-Dichloroethene 20.00 102 83.7 1221.00 020.5
Benzene 20.00 104 80.5 1261.00 020.7
Trichloroethene (TCE)20.00 98.9 75.5 1320.500 019.8
Toluene 20.00 105 82.9 1241.00 021.0
Tetrachloroethene (PCE)20.00 108 90.5 1211.00 021.6
Ethylbenzene 20.00 111 85.3 1231.00 022.3
m,p-Xylene 40.00 108 85.8 1221.00 043.2
o-Xylene 20.00 111 85.4 1211.00 022.3
Surr: Dibromofluoromethane 25.00 99.7 84.8 11324.9
Surr: Toluene-d8 25.00 98.3 88.5 11024.6
Surr: 1-Bromo-4-fluorobenzene 25.00 102 89.9 10825.6
Sample ID:MB-30170
Batch ID:30170 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:MBLKW
RunNo:62914
SeqNo:1262818
MBLKSampType:
Vinyl chloride 0.200ND
cis-1,2-Dichloroethene 1.00ND
Benzene 1.00ND
Trichloroethene (TCE)0.500ND
Toluene 1.00ND
Tetrachloroethene (PCE)1.00ND
Ethylbenzene 1.00ND
m,p-Xylene 1.00ND
o-Xylene 1.00ND
Surr: Dibromofluoromethane 25.00 107 84.8 11326.7
Surr: Toluene-d8 25.00 104 88.5 11026.0
Surr: 1-Bromo-4-fluorobenzene 25.00 101 89.9 10825.2
Original Page 14 of 17
Project:Renton Mazda
CLIENT:PBS Engineering & Environmental
Work Order:2010443 QC SUMMARY REPORT
Volatile Organic Compounds by EPA Method 8260D
10/29/2020Date:
Sample ID:2010414-001DDUP
Batch ID:30170 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:BATCH
RunNo:62914
SeqNo:1262801
DUPSampType:
Vinyl chloride 300.200 0ND
cis-1,2-Dichloroethene 301.00 0ND
Benzene 301.00 0ND
Trichloroethene (TCE)300.500 0ND
Toluene 301.00 0ND
Tetrachloroethene (PCE)301.00 0ND
Ethylbenzene 301.00 0ND
m,p-Xylene 301.00 0ND
o-Xylene 301.00 0ND
Surr: Dibromofluoromethane 25.00 107 84.8 113 026.7
Surr: Toluene-d8 25.00 104 88.5 110 025.9
Surr: 1-Bromo-4-fluorobenzene 25.00 101 89.9 108 025.4
Sample ID:2010415-003ADUP
Batch ID:30170 Analysis Date:10/27/2020
Prep Date:10/27/2020
Analyte Result SPK value SPK Ref Val %REC RPD Ref Val %RPDLowLimitHighLimit RPDLimit Qual
Units:µg/L
RL
Client ID:BATCH
RunNo:62914
SeqNo:1262805
DUPSampType:
Vinyl chloride 300.200 0ND
cis-1,2-Dichloroethene 301.00 0ND
Benzene 301.00 0ND
Trichloroethene (TCE)300.500 0ND
Toluene 301.00 0ND
Tetrachloroethene (PCE)301.00 0ND
Ethylbenzene 301.00 0ND
m,p-Xylene 301.00 0ND
o-Xylene 301.00 0ND
Surr: Dibromofluoromethane 25.00 108 84.8 113 027.0
Surr: Toluene-d8 25.00 105 88.5 110 026.2
Surr: 1-Bromo-4-fluorobenzene 25.00 102 89.9 108 025.5
Original Page 15 of 17
Date Received:10/27/2020 12:59:00 PM
Client Name:PBS Work Order Number:2010443
Sample Log-In Check List
Clare GriggsLogged by:
Item Information
How was the sample delivered?Client
Is Chain of Custody complete?Yes No Not Present
Was an attempt made to cool the samples?Yes No NA
Are samples properly preserved?Yes No
Was preservative added to bottles?Yes No NA
Did all samples containers arrive in good condition(unbroken)?Yes No
Does paperwork match bottle labels?Yes No
Are matrices correctly identified on Chain of Custody?Yes No
Is it clear what analyses were requested?Yes No
Is there headspace in the VOA vials?Yes No NA
1.
2.
6.
10.
11.
12.
13.
14.
15.
16.
17.Were all holding times able to be met?Yes No
Chain of Custody
Log In
7.Were all items received at a temperature of >2°C to 6°C Yes No NA
8.Sample(s) in proper container(s)?Yes No
9.Sufficient sample volume for indicated test(s)?Yes No
Special Handling (if applicable)
18.
19.
Was client notified of all discrepancies with this order?Yes No NA
Person Notified:Pat Togher Date:10/27/2020
Regarding:TAT pushed to 2 days
Via:eMail Phone Fax In Person
Additional remarks:
Client Instructions:Acknowledged, proceed as soon as possible
By Whom:Matt Langston
Coolers are present?Yes No NA3.
Unknown prior to receipt.
Shipping container/cooler in good condition?Yes No4.
Custody Seals present on shipping container/cooler?
(Refer to comments for Custody Seals not intact)
Yes No Not Present5.
*
Item #Temp ºC
Sample 17.7
Page 1 of 1Note: DoD/ELAP and TNI require items to be received at 4°C +/- 2°C*
Original Page 16 of 17
Page 17 of 17