18
ADC2.8199 Weston Solutions, Inc. Federal Programs Division Suite 201 1090 King Georges Post Road Edison, New Jersey 08837-3703 iiiuioiiiiininiiiiiiii 201068 REMOVAL SUPPORT TEAM EPA CONTRACT 68-W-00-113 l» 732-225-6116 Fax 732-225-7037 www.westonsolutions.com June 30, 2004 Mr. Louis DiGuardia, On-Scene Coordinator U.S. Environmental Protection Agency, Region II Removal Action Branch 2890 Woodbridge Avenue Edison, New Jersey 08837 AMERICAN DRIVE-IN CLEANERS SITE, LEVITTOWN, NEW YORK Dear Mr. DiGuardia: Enclosed please find the Air Sampling Trip Report for the Indoor Air, Sub Slab Vent, and Soil Vapor Extraction (SVE) System sampling event conducted at the American Drive-In Cleaners Site on June 16 and 17, 2004. If you have any questions or comments, please contact me at (732) 225-6116, extension 225. EPA CONTRACT NO: 68-W-00-113 TDD NO: 02-03-08-0001 DOCUMENT CONTROL NO: RST-02-F-01535 SUBJECT: AIR SAMPLING TRIP REPORT Sincerely, WESTON SOLUTIONS, INC Enclosure cc: TDD #02-03-08-0001 employee-owned company In Association with Scientific and Environmental Associates, Inc. Innovative Technological Solutions, Inc., and Terranear Technologies Group

AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

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Page 1: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

ADC2.8199

Weston Solutions, Inc. Federal Programs Division Suite 201 1090 King Georges Post Road Edison, New Jersey 08837-3703

iiiuioiiiiininiiiiiiii 201068

REMOVAL SUPPORT TEAM EPA CONTRACT 68-W-00-113

l» 732-225-6116 • Fax 732-225-7037 www.westonsolutions.com

June 30, 2004

Mr. Louis DiGuardia, On-Scene Coordinator U.S. Environmental Protection Agency, Region II Removal Action Branch 2890 Woodbridge Avenue Edison, New Jersey 08837

AMERICAN DRIVE-IN CLEANERS SITE, LEVITTOWN, NEW YORK

Dear Mr. DiGuardia:

Enclosed please find the Air Sampling Trip Report for the Indoor Air, Sub Slab Vent, and Soil Vapor Extraction (SVE) System sampling event conducted at the American Drive-In Cleaners Site on June 16 and 17, 2004. If you have any questions or comments, please contact me at (732) 225-6116, extension 225.

EPA CONTRACT NO: 68-W-00-113 TDD NO: 02-03-08-0001 DOCUMENT CONTROL NO: RST-02-F-01535 SUBJECT: AIR SAMPLING TRIP REPORT

Sincerely,

WESTON SOLUTIONS, INC

Enclosure

cc: TDD #02-03-08-0001

employee-owned company

In Association with Scientific and Environmental Associates, Inc. Innovative Technological Solutions, Inc., and Terranear Technologies Group

Page 2: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

ADC2.8200

SAMPLING TRIP REPORT

SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

EPA SITE ID: RA

SAMPLE DATES: June 16 and 17, 2004

Site Location: American Drive-In Cleaners Site 3801 Hempstead Turnpike Levittown, Nassau County, New York

Sample Descriptions: Ten sub-slab vent and SVE air samples were collected using 150 mg charcoal sorbent tubes. Nine air samples (interior/exterior) were collected using six Liter Summa Canisters. The SVE system was operational at the time of the sampling event. Refer to Tables 1 and 2 and Figure 1 for detailed sampling information.

3. Laboratory Receiving Samples:

Sample Type

Coconut Charcoal Sorbent Tube, 150mg

Name/Address of Laboratory

Datachem Laboratories 960 West Levoy Drive Salt Lake City, Utah 84123

Parameters

Halogenated Hydrocarbons plus TCE via NIOSH Method 1003

Summa Canisters Datachem Laboratories 960 West Levoy Drive Salt Lake City, Utah 84123

Volatile Organic Compounds via EPA Method TO-15

1

Page 3: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

ADC2.8201

Sample Dispatch Data:

On June 16, 2004, ten air samples including one field duplicate, one field blank, and one lot blank were shipped by Removal Support Team (RST) personnel to Datachem Laboratories, Inc., for Halogenated Hydrocarbon analysis. The samples were shipped via overnight Federal Express Airbill No'. 815280597964. Refer to the Chain of Custody Record and Federal Express Airbill iri Appendix C.

On June 17, 2004, nine Summa Canister samples including one field duplicate and one trip blank were shipped by RST personnel to Datachem Laboratories, Inc., for Volatile Organic Compounds via EPA Method TO-15. The samples were shipped via Federal Express Airbill No. 815280597975. Refer to the Chain of Custody Record and Federal Express Airbill in Appendix C. 1

Personnel On Site-

Name Affiliation

John Brennan Region II RST

Steve Cannon John Getz

Region II RST Region II RST

Duties On-Site

Site Project Manager, Air Sampling Coordinator, Sample Shipment, QA/QC, Site H&S Officer Sample Collection Sample Collection

Additional Comments:

RST collected seven sub-slab vent and one SVE system air samples utilizing 150 mg coconut charcoal sorbent tubes connected to SKC Model 224-PCXR8 sampling pumps. An approximate flow rate of 0.2 liters/minute for a period of 600 minutes was targeted. However, RST was not able to obtain access to the interior of the structure until after 0900 hours. To compensate, RST modified the flow rate to 0.25 liters/minute and the sample time to 480 minutes. Modifying the sample collection rate allowed RST to achieve the desired total sample volume of approximately 120 liters.

Pump flow rates were measured (calibrated) before and after sample collection utilizing a BIOS Dry Cell flow meter. A total of ten samples, including one field blank, and one lot blank, were submitted for Halogenated Hydrocarbons and TCE analyses via NIOSH Method 1003. See Table 1 for additional information and Figure 2 for sample locations.

Six interior and two exterior background air samples were collected by RST utilizing six liter Summa Canisters that were fitted with flow control valves calibrated by the labora-

2

Page 4: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

tory to collect samples over a 24 hour period. A total of nine samples, including one trip blank were submitted for analysis via EPA Method TO-15. Refer to the Table 2 for additional information and Figure 1 for sample locations.

The SVE system was operational when RST arrived on site. The SVE system had run for a total of 15,344 hours since initial start-up. Site temperatures ranged from approxi­mately 75 to 90 0 F with high humidity and sunny skies.

Appendix A contains the Sample Location Map. Appendix B contains the Air Sampling Data Sheets. Attachment C contains the Chain of Custody Records and the Federal Express Air Bills.

RST Operations Manager

3

Page 5: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

• • • • • • • •

TABLE 1 SAMPLE COLLECTION INFORMATION

SUB-SLAB VENT AND SVE SYSTEM

Sample ID Location Pump ID Sample Date Total Sample Time Sample Volume Notes

ADC-SVE-INF Combined SVE Influent

584565 and

665327

June 16, 2004 608 minutes 129.95 Liters None

ADC-SUB-BLIMP Blimpies Subs 584600 June 16,2004 600 minutes 126 Liters None

ADC-SUB-BARB Roberts Barber Shop 584594 June 16, 2004 600 minutes 128.4 Liters None

ADC-SUB-ADCF American Drive-In, Front

584122 June 16,2004 480 minutes 122.9 Liters None

ADC-SUB-USF Urban Speed, Front 584134 June 16, 2004 472 minutes 118.29 Liters None

ADC-SUB-ADCB American Drive-In, Back

665283 June 16, 2004 480 minutes 125.28 Liters None

ADC-SUB-USB Urban Speed, Back 665287 June 16, 2004 480 minutes 126.72 Liters None

ADC-SUB-USB2 Urban Speed, Back 665101 June 16, 2004 480 minutes 122.4 Liters Duplicate Sample of ADC-SUB-USB2

LB061604 Lot Blank N/A June 16, 2004 N/A N/A Sorbent Tube Not Opened

FB061604 Field Blank N/A June 16, 2004 N / A ' N/A None

> D O NJ bo to (—>

Page 6: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

TABLE 2 SAMPLE COLLECTION INFORMATION

INDOOR AND OUTDOOR AIR

Sample ID Location Time / Date Started Time / Date Completed

Summa ID Orifice ID Pressure Gauge (Start)

Pressure Gauge (End)

ADC-IA-US Urban Speed 0957/June 16, 2004 0957/June 17, 2004 108855 108774 >30" 2"

ADC-IA-CHRIS Christine's Alterations

0959/June 16, 2004 0959 /June 17,2004 108712 108871 29" 0"

ADC-IA-CHRIS2 Christine's Alterations

0959/June 16, 2004 0959/June 17, 2004 108611 108624 >30" 2"

ADC-IA-BARB Robert's Barber 1002/June 16, 2004 1002 /June 17,2004 108737 108598 >30" 3"

ADC-IA-THRIFT Thrifty Beverage 1002/June 16, 2004 1002 /June 17, 2004 108681 108780 30" 0"

ADC-IA-EXT Exterior, Behind American Drive-In

1009/June 16, 2004 1009 /June 17, 2004 108813 108579 25" 6"

ADC-IA-EXT2 Exterior, Behind Blimpie

1010/June 16,2004 1010/June 17, 2004 108869 108623 >30" 0"

ADC-IA-BLIMP Blimpie's Subs . 1109/June 16,2004 1109/June 17,2004 108862 108821 29" 0"

TB061604 Trip Blank Not Opened Not Opened 108899 N/A N/A N/A

Page 7: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

ADC2.8205

APPENDIX A Sample Location Map

American Drive-In Cleaners Site Levittown, New York

Page 8: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

Frank's Nursery Fence

N © 0

CD CD / Q \ / 4 \ / 2 \ A CD

American Drive-ln Cleaners

Urban Speed Christine's Alterations

Robert's Barber Shop

Blimpie's

®

Legend

| -j |- Combined Influent SVE System Sample ID- ADC-SVE-INF

SVE - Soil Vapor Extraction GAC - Granular Activated Carbon

- Summa Canister Sample Locations

1 - ADC-IA-BLIMP 2 - ADC-IA-BARB 3 - ADC-IA-CHRIS 4 - ADC-IA-CHRIS2 5 - ADC-IA-US 6 - ADC-IA-THRIFT 7-ADC-IA-EXT 8 - ADC-IA-EXT2

O - Sub Slab Vent Sample Locations

1 - ADC-SUB-BLIMP 2 - ADC-SUB-BARB 3 - ADC-SUB-USB and ADC-SUB-USB2 4 - ADC-SUB-ADCB 5 - ADC-SUB-ADCF

6 - ADC-SUB-USF

Note: Drawing Not to Scale

Hempstead Turnpike

(3ifi>s+orlnCT n « j o u r c a E f f l o t o n e v

Weston Solutions, Inc. FEDERAL PROGRAMS DIVISION US EPA Region]]

IN ASSOCIATION WITH Scientific and Environmental Associates, Inc., Innovative Technological Solutions, Inc.,

and Tenranear Technologies Group, Inc.

| EPA OSC: • Lou DiGuardia

j RST Site PM: j John Brennan I

| Figure: 1 1 Sample Location Plan , June 16-17, 2004

American Drive-In Cleaners Site Levittown, NY

Page 9: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

APPENDIX B Air Sampling Data Sheets

American Drive-In Cleaners Site Levittown, New York

Page 10: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

ADC2.8208 Page / of 2

United States Environmental Protection Agency Removal Support Team

Air Sampling Work Sheet

Weston Solutions, Inc. EPA Contract No. 68-W-00-113

Site: American Drive-In Cleaners Site

Sampler: ^fif/A> tfte"^*^

Date:

U.S. EPA: Lou DiGuardia

RST Site Project Manager J. Brennan

Sample #

Location

Pump #

Media

Analysis/Method

Time (Start)

Time (Stop)

Total Time

Pump Fault

Flow Rate (Start)

Flow Rate (End)

Flow Rate (Average)

Sampling Volume

/ruf=i r~

150mg Coconut Charcoal

NIOSH 1003

C7oo -

4-72^ n 2 t >

( Y ) N

<£jjg L/min

6av^

Liters

/lb C'SvS-gii"/'

&6

150mg Coconut Charcoal

NIOSH 1003

Y/(

o.ioB V m i n

Z f l L/min

o-%to L/min

/Z&> Liters

150 mg Coconut Charcoal

NIOSH 1003

67/O

/ I / O

Y / i

O • Z/o L/min

L/min

L/min

/ I f f Liters

/ID/- SoB-Aoce

/ftvtr~ /*J

/=*<"J7'

SSY/'-Z'L

150 mg Coconut Charcoal

NIOSH 1003

/ - 7 / Z .

Y/<££>

O.ZS'I L/min

0-M>O L/min

L/min

/ZZ.9 L i t e r s

U/64*-> sSrrt^

150 mg Coconut Charcoal

NIOSH 1003

*4*->/>

/37o -/7Z5~

ZZ7 r- Z-YS~=

£2)/N

6 L/min

Q . z S t L/min

< g? L/min

//•?• Z l Liters

ADC-fo6-/>QtB

150 mg Coconut Charcoal

NIOSH 1003

/7Z7

czsri, L/min

Oli><t> L/min

L/min

/ I f . I? Liters

J NOTES

O-2-oi

fie/i/Hef //"-"/ MS32-

l , } jo. tlV

(St*)- / l i - f t - i -

/If.f'S-t-

O-7-ll-

ene / ,.-Ln

\o-zoo

<S>.?V7 \ 6 ZSZ> v

OZ0>(e>

o.zrr

e>-2*2/127)=£t>-4°L

Page 11: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

Page 2. of Z_

United States Environmental Protection Agency Removal Support Team

Air Sampling Work Sheet

ADC2.8209

Weston Solutions, Inc. EPA Contract No. 68-W-00-113

American Drive-ln Cleaners Site Site: _

Sampler:

Date: 2°o>i

U.S. EPA: Lou DiGuardia

RST Site Project Manager J. Brennan

Page 12: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

ADC2.8210

AMERICAN DRIVE-IN CLEANERS SITE Sheet No. / INDOOR AIR QUALITY INVESTIGATION

FIELD SAMPLE DATA SHEET

Use Cateqorv: Other ( )

initial Site Visit Date: ,Tvt-- '4> SamDlma Team: 7 0A6-**A>J /S • CA*>^V*->

Sample ID /to c-jrs?- uS /I6<:- £#<?'S

Location Description Category (circle) ( SSmpj^

Duplicate Field Blank

Sample! Duplicate Field Blank

SampJ§_ Pd^ficatey FlelcTTJlank

Analysis EPA Method TO-15 EPA Method TO-15 EPA Method TO-15

Summa ID /c 8 8SS~

Orifice ID /08B7/

Time (Start) 0 9S7

Time (Finish) a <?

Total Time

Pressure Guage (Start)

_ r/

, f " Pressure Guage (Finish) 2" L"

^

Comments/Weather ro^a^M/ttf c/>*rr~

Field Comments

Page 13: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

AMERICAN DRIVE-IN CLEANERS SITE Sheet No. 2-INDOOR AIR QUALITY INVESTIGATION

FIELD SAMPLE DATA SHEET

UseCateqorv: Other ( )

vuit nate: . r ^ c /6, SamDlina Team: - J J A ~>. S.CA~**>~'

Sample ID /IDC- ZA- ?W?/FT-

Location Description

ffi&*7i'fat y^rV/A 'Y /gc ^ - ^ " ^ N / ,y— •

Category (circle) t ^ a m p j ^ Duplicate Field Blank

DuDlicate Field Blank

Duplicate Field Blank

Analysis EPA Method TO-15 EPA Method TO-15 EPA Method TO-15

Summa ID

Orifice ID /o es~f£ Time (Start)

/ a o Z.

Time (Finish) / o o "Z— /oo 2- /oo T

Total Time

Pressure Guage (Start) 3o" Pressure Guage (Finish) O"

/o c*r>ri> '+>

Comments/Weather f/tc/exry/./So/c*>~'<f

Field Comments

Page 14: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

ADC2.8212

AMERICAN DRIVE-IN CLEANERS SITE INDOOR AIR QUALITY INVESTIGATION

Sheet No. -3

FIELD SAMPLE DATA SHEET

Use Category: Other( J

Initial Site Visit Date:

Sample ID

/t.7**y Sampling Team: J/?/?^/'^ -T CAS**>J*J

7 ~ S v < o ' o y

Location Description Category (circle)

Duplicate_ <5amp]

Field Blank Duplicate Field Blank Held Blank

Analysis EPA Method TO-15 EPA Method TO-15 EPA Method TO-15

Summa ID

Orifice ID Time (Start)

/ o / o //af Time (Finish)

/of 6 f / 0 ? Total Time

Pressure Guage (Start) 29 Pressure Guage (Finish)

Comments/Weather

Field Comments

Page 15: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

ADC2.8213

APPENDIX C Chain Of Custody Records

and Federal Express Airbills

American Drive-In Cleaners Site Levittown, New York

Page 16: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

ADC2.8214

CHAIN OF CUSTODY RECORD

RFP No.:

PO No.:

oo </</ v i Restoring Resource Efficiency

Removal Support Team EPA CONTRACT 68-W-00-113

Phone (732)225-6116 Fax: 732-225-7037

'. Matrix-Box No.:

Preservative Box No.: J

J. Surface 1. HCI 2. Ground Water 2. HN03 3. Leachate 3. Na2S04 4. Rinsate 4. H2S04 5. Soil/Sediment 5: Other (Specify) 6. Oil 6. Ice Only 7. Waste N. Not Preserved 8. Air

Send verbal and written results to: Weston Solutions , Inc. Suite 201, 1090 King Georges Post Road, Edison, New Jersey 08837-3703 Attention: Smita Sumbaly, RST Analytical Coordinator

Sampling ID Sample Matrix (Enid Box I)

Tmal Run Time

Initial Canister PICSSUJC (Inches of Mercury)

/ oc -JT>4-os 2 V*'/ /a -/$

A')<- JTAI-^'S

AOC- Trt -0+/"-*l

Abc-X/i- TMP/F r

^3o if

Jo v /oS8 99 AJ6T 0fe+J<?A

/o&ZZt 21"

Comments: *• / ' y-f- r / ? * t oA!c e~ r/st/uC- A-~£) f</s(csc rrr**sJ*

Person Assuming Responsibility for Samples: <Jja ft/J / ^ . / t t M f ^ A ^ Time/Date

Sample Number Relincojished By: Time

/yao Date

H, Reason for Change of

Sample Number Relinquished By: Time Date Received By: Reason for Change of Custody

Sample Number Relinquished By: Time Date Received By: Reason for Change of Custody

1 4 Weston Solutions, Inc. FEDERAL PROGRAMS DIVISION In Association with Scientific and Environmental Associates, Inc., Resource Applications, Inc., and Innovative Technical Solutions, Inc.

Page 17: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

CHAIN OF CUSTODY RECORD ADC2.8215

«WV< ~J

r:No.:

PONo.:

SOLUTIONS Restoring Resource Efficiency

Removal Support Team EPA CONTRACT 68-W-00-113

Phone (732)225-6116 Fax: 732-225-7037

Matrix Box Preservative Box No.: No.;

1. Surface 1. HCI 2. Ground Waler 2. HN03 3. Leachate 3. Na2S04 4. Rinsale 4. H2S04 5. Soil/Sediment 5. Other (Specify) 6. Oil 6. Ice Only 7. Waste N. Not Preserved 8. Air

Send verbal and written results lo: Weston Solutions , Inc. Suite 201, 1090 King Georges Post Road, Edison, New Jersey 08837-3703 Attention: Smita Sumbaly, RST Analytical Coordinator

Sampling Local ton (Lat ia I S U M Location)

Sample Matrix (Ento Box I)

Date Colletlcd

Run Time (Minutes)

^ m ^ S l e (Liters' Minute)

Volume (Liters)

Number of Sorhuil Tube;

Preservative (Enter Box 2)

£/Sc'*-j <>/,(/ rot* > Y JL

/Z6> 6>OQ t28,H V3o

V3Q A0<- Su,l- /& US f «/•; z //#• ??

Mo

Ad/- 3*0- w e z </&o

/A v/A t j / A

Comments: f / y / t j U'/i/ft^y ru/f+Z /?/?ci"')> A Sot <A& St*/ft

Person Assuming Responsibility for Samples: Time/Date

Sample Number Relinquished By:

<£%&C* " Relinquished By:

Time Date Received B' Reason for Change of

Sample Number Time Date Received By: Reason for Change of Custody

Sample Number Relinquished By: Time Date Received By: Reason for Change of Custody

Weston Solutions, Inc. FEDERAL PROGRAMS DIVISION In Association with Scientific and Environmental Associates, Inc., Terranear Technologies Group, and Innovative Technical Solutions, Inc.

Page 18: AIR SAMPLING TRIP REPORTJUNE 16-17, 2004 SAMPLING - EPA ... · ADC2.8200 SAMPLING TRIP REPORT SITE NAME: American Drive-In Cleaners Site DCN#: RST-02-F-01535 TDD #: 02-03-08-0001

ADC2.8216

/ _ / / _ Sender's FedEx n=to / / "? « Account Number

pn—iZ^Zi ITS-t"4

Comnanv UM*>7Z>A S a t » T7«*S,

Address C ^ / ^ T ACT /OJM

State A X f ~ ZIP ^ a?%/7

Your Internal Billing Reference rial MchenKanswfl appear cncmee.

l^>*T*cM&A* L/h£f

r*. SILT OlML dry

Questions? Call 1-800-Go-FedEx* (800-463-3339) V i s i t o u r W e b s i t e a t w w w . f e d e x . c o m

By using the AirbtB you a»jree to the service condrboos on me back of t rw AtrWI ind in our currant Service Guide, including terms that Emit our Babfety.

4a Express Package Service Packages up* 150 Ba. / DBtv i ryewrn i in^ ' i i ^b^ taMi t igmaaw^

fEff^ExPriorrryOAremight f~] FedEx Standard Overnight j I FedEx Rrst Overnight Htabusntamomni ' — 1 Hoibusincniftcmoan — E v t a l o t x t b o s t o n m o r r ^

• FedEx 2TJay* I - ] FedEx Express Saver* 1— Ibedbi- *~

4b Express Freight Service

r~l FedEx IDay Freight* <— 1 Neaheanesseav

P I FedExfflayFreight Saconxtcuuiau day

r ISO He.

I - ! FedEx 30ay Freight ^—^ Trad businest day

S Packaging • FedEx Letter* • FedEx Pak*

* 0*dbv*d nkm M l SOD

Other Pkg. hriudw FaJbtflg^ FadExTbba,

6 Special Handling

• Saturday Detnery

Ownaataa^radUOay _

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I—.HOLD Weekday r-. HOU)Saturday L l at FedEx Location l_l at FedEx Location '•**

DanotroiaGoodic»^b«rf»pp»di>FidbnicfclQfcig. I I Cargo Aircraft Only

7 Payment Biuu ^ ^ ^ U . ^ ^ ^ . , Q Sender PJ Recipient QjThini Party f j Credit Card •Cash/Ctieck

Acd No. in Sacbon t

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*Our iatxvtr b enured u SIOO unless you declare a hajher value. S«e bade frx deals. FedEx UseOrey

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a

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From m*tt***frM=i>tf Date

Senders Name

Senders FedEx Account Number

Phone

Company

Address

fay C f h / S o ^ State AJJ^UP ^ ^ - ^ 7

Your Internal Billing Reference j n - ? 0 2 &o'/' OoTtWfv'Z Fe»»d»racierieJappe»onBi«»ie a t - C / e * - * " ^ - * ^

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Address m cawao^ffaytB RO. bora i WjrxP_O.ZIP codes. /

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