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App E- Sub-Area 4.2 - COC Forms

App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

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Page 1: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

App E­Sub-Area 4.2 - COC Forms

Page 2: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

P!!ge: ---·---· of. GEL Chain of Custody. and Azmlyticrihl Request Cim. ta\Jnratoric$, LLC

1 Projcet II: 204Q.$avagc Road

GEL Quote JI: -¥«•-·--·--·-**See www,i,;;el.com for GEL's Sample:Acceptance SOP** .Cl11Jrlesto11, SC 29407

(:;OC Number (I~ .,.,. ·~~·- ······~ '"'~;<-•¥-·-·-··- ··· PEL Work Order Number: Phonc:(843) 556-817i PO Number: Fax: (8431766-1178

Client Name; Phone#: · Sam11le Analy§is Requc>ted <5l (Fill in· the number of containers fo1: each to~!)

Projcc!/Si~e Name: Fax II:- Sh\lµl:l·. <-- Prl!scrvotivc Typ•: {()) J.l1i5

·. ••mplrbc Address: ~t,tns.itl~n.:d .. Commi;iJts Collcclcci ~y: ScndRcsttlls Io: Note; e11.tra sample·.is

... required' for sample

1!11J~1i0 Colkckd '"'.Tim: F'leM SlJmP,lo TSC Co1lcd1,;d'. Q(' specific QC Sample ID (MJ11Wy.). ~otle·m Filler<d M1.:ild:t ltruli· A

(nun-d<l-)'J') ()) ,,, ••<11 Rcgu • FoFcnm1>osi!eJ1·~ imlit.:ale·sturt and attm J111el1ime (lihmm) ..• l•1td ~er-o

y. ?..(\.i. '~. \ i·t-1,-\s-' ;

~ .·tf\. \?.., '1, 2. \'b7.-1S' ·L\ • 1.A· il,.. "\ · \ )'1~1--15"" - ·~

y l lPI . \{ . Li I l. 1t.J'L'1S Lo.\ I 1.A .Q;,. 41. '? 11:--l-'\~

' ,.;."

j 4 .1A- ,-Q;,. «.-\. G o .... L""'l"-:J 4. to, IL It. 1 l ?:·1"1~ - r ~. Li) I IL.\\ ;1.- 11~115" .. .. . ..... 4,·1~ R..iD .1 \1,l:"\~ ·-'i 11\') i !L1t;,l 'L ;,( n ....... P

TAT RcQucs1cd:·Norma.l: Rush: Sp;:dfy: (Subj.ct 1ucSunhuri:<l I Fax Jl.c~ul!s: Y~s I No Cinil~ Dcliver~hlc: C' of;\ I QCSummarv /. 'Level.! I Lcwl2 I Levcl3 i Lcvd4

Remarks: Are there an;; known hazr:wefs.applicable tcJ"the.rn .rnmph:.i?!fso, please list the }l(lztmj,i· ~C!l!l~~1iQD Iime Zsllli': Ea$tern Pad fie Ccntr~I Other ___

·Mo11ntain

Cimin ·of Custody Slgmi.tnrcs SlimtJlc0Sbipping ;md Delivers Details R•!il1quishcd.!ly.(Signcd~ Date Tl inc l\i;ceivcd by.(,ignc,d) D~t• Time

GEL:PM;

r .l M<lhud of Shipment: Dale Sliioned: ...

2 2 AfrbHlll:

3 3 Al1bHLef:· .. 'L) Oiain o~ Custody N~in~ """ Clh:nl Ucb?i'fn.hicd

2.) Qt Codtri: ·N·= Normal'SamJili:t '.TB--Trip;UJank~_FJ) .""' Field Dup!iC~ic1 EU"" f-e;\1iprpont ·Blan)i1 MS.·"" M~l~!:rSp~c S.~mplc,:~~~m = M~irh·Snjke DupHc~t: St.1l1filc. G *"Orab. C"" C~"'i?"siic . f'11r Lab Rec~fvi11g U.~e Oi1/y

3)- Field F'ihcr.c.d: For Uqu!.~ nu1trkc.,,indicotc widfrv· Y·4u-r-.y.ey;Jl1': sampl-c.wai; f1(id fil(cr~d 01:,t; .. fo1'·ll.Jltnplc Wi15 nttl Jfold fJ.hon~d. Custody Seai !ntacl? •n Ma1ri:t,C~*':!t; D\V~D1inklng \Vnt~·. GWnGwuntl\\'M¢_rt S,\V..,..St!lf.>!J~(:··11\futc1, '\'YW~Wti!\tl!: W.at;J, \1~~wa1e1t :r.iL=tvfo:c·LF1.H1fJ,,SOi.tSotl{S!O-"S•aHm~ur.:SlflSluJce. ~~'""S.11Jid'\Vn~1c,-Oi;Oil,-l;~.,f.th~r-, .f,-,:W,it~-. _v,._LJ_iiw.!.,r<"'Fc~~t ~'"'r . YES 'NO

. S.) Sa_mp1c- Ana1yi-is.R-t{i.M&t<:d: ,-\onlyif~~fiuclh.1JJr:::qucir.ed {i.e, Si666,'tit.llil.W./470A) ~t)ii h.nn!bt::~·.o(~O!<!>tiMJ~ jH.VVitJ<:rl for ~ai:h {i;t, ti1fl08 .. J. 6Ql08/i4lfl.4.• a). Cooler Temp . I 6.) r•re$t:Jntivc 1'ypc: HA"" Hyi1fo~l1torie Achj;Nl"" Niu~C Addoti_ll....-.~kajiwn 1 l:ir1m~hk;Si\..., ~~ilfuriC (l.cM: AA.':-' P.1.;.urJ~!i: Ac_id~ U.;<.·.,,. ·Hi!:cll~ri~, s·r ...-7'm~iom Th!nnMri:<:, if nu prL!!\!':-ll":uh:'1 is, .11t!rlc:l w: l.e;rv~ fief.d ~)~uk c YELL-OW= FILE PINK·~ CLIENT

Page 3: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

···-·-· -·-·---·-T . . . GEL Chain of Custody a~d Anal~. ,tk~l .lRequest oEtt.aborn1Qrie~.1..L<::

· '.;'040 :savage RO!ld

'Pnge:. _______ of ______ ~

P!'oj~ct#!

GEL' Quote#: ---"-----------· **See www.gel.corn forGEL's Sampl~ Acceptance~SopH ·

coc Niimbc.r<n: ........... " .. ···-·~··-----·,-·-· ······~GEL Work Order Number: P0Numbei::

Charleston; SC 29407 Phone: (843) .5Sl)·ll171 fox:{843) 766·1178

Client·Name: Phone#: l!j~mplc Am1lysis Requ.ested <51 ·(Fill. in the numbe«of.containers for each test)

•• .. ·'li~" Projecl/Sitc;Name;

Address:

S.cnd RcsuUs To:·

"DatQ Ct.iHGi!lcd

Sample JD _..Fm· w11wo.'il1!1s"' Jndir..•aft' .1tarl mUh'fffJP dqte/Ome

(mm'<ltl·YY)

4 \ 7,;13 I \l., t \? ,'L 11.C:,1'1 ~

•nmc: Coll<i!<~ Q(.'' (Allltt.iry) (oil1i~) (hllmm)

field Sumpl<. '.Fli•m4 Mu11k

{Jj :w

.S1w~1ii !Ills

s~mple:llc {.:"Jn!ild'fre/.I

1SC Rodi A ... 11: ·Rtgli

•• latrd' JQJ'.{)

Commllnts Note: .extra sarppie is r~quired for sample

specific QC

Sf\..)\\\??.\ .l'l---1-~<5 .............. ~-~.-..:::-"-"'-'--""b.<--'3,......-=-~~~~---~~~-1-~~~-~-1-~~~-+:--~-t-~~-1-~~-¥-~-+-~-t-~-t-~-l-~-l-~-,.J~~}--~f-~·l--~+---l-----l-~.,.J--~-~~~~-~~-;

~~-~~~~'~1~~~·~·1~7~·~1-=---~~·~-r-J1_I0~M~.<~--~~--t---1~-t----it--t--+-+--1-+--t----+-..,-+-+-+~~---+~i,__~~~~~--; LI, S"C. it..\. \ Jt-t-'\<

1---~~~~-'-'~"'-~::....::::::..:...i."-' ........ ~~~~---~~--t-"-=--....::;....."--~t---~~---t------ii--~---t--~--i,..,...--1~~·1--....,.,1--~1~...-1------+-~-l-~-l-~-·~~1~-'t~---l~---1--~~------~------·~

1--......,...--4~,~~~L~.~~·~'~·~~·~-,--~---r-n~·~~~~~\~~~· ~-'j-~t---;---1--+--t--+--l--+--b--+--~~--+---+---t--+--~~~--_,,,,

.TAT Rc:auestcd: Normal: Rush; Spccifv: (S•\>i;-.111> Surd•l'flJ•) J Fa~ R~s11Jts: . YIIB. I No Cir<:!<" Di:Hvcrnb!c;. C of A QC Summary I Level} /' ·Level 2 f kvcr3 I .L~vcl 4 Remarlrs: Are there.any lit1own·htiwrds applicablft tiJ tliese la!iJpfes? ff so, plea.wilist the.liazard~ ~tforiTime'U>M

· Ea~em · ·Pad fie CcutrnJ Olhcr __ _ .Mount3i.n

.Clrnln 9f Custody Slgnntures. S11mpleShlpping 11nd DcJiveryJ'.ldallJ Rclinqi•i~bcd lly (Sigil~d) Recoivod tiy . .(signctlj Pi110

GEL PM:

bah:Shiooed;

2 . Airbill#:

3 Alrbli'lll:

I.) .C11•in of.CU•tody Nambor :...clionlDi?lonuiJ>«1 For Lail Receiving Use DniJ.· • ~;) Qt; Codo" .N·" tlorin•I S•~I~, TB.w Trip ~lajik; l(D·,,. Field Dl•J'li<'"'· mi·.: P.quipmruitlllOJJ1<, NS Q M•l<i>< S11ike'Samp!e, :WS!l ~ Molri.• Spikd)it)llij.,tcS~mp[o, G - Grob, C ~ Comi"'!h<

1.) ·F.Jot_d micretl: ~ol'li<)>lkl ... 1rk<0rirnllcmo wilb'•. v. for ye> llX> "''"''·''' w.s ficld'.Jlh<mJ "'•.fl. for .<M>plc w•s 110! Jldd Dlioml.. Cu.>(ody Seal hitact? .. (}c,.l-:i~_iri1fCml'125:·0\\i~l_)~fak~2, Wat~r,'..G\Y""9~u1111~>vnt-\!r 1 S'Vooc.S1.1ifoc¢ Wm1.:r;"\VW.-c:W~.~ W~t~r::'\\f•iW;Jto;_t, M,I~.eol\lfiw Lhi1lii:"J,·so~sun, ~P~5'!<lim1.~11~·S1.PSlw.lt'-O,S.~t11Sol~d Wa!l(!·Ot>Oit,·F:!r<flJtcJ, l'""Wip'",·U~Urinc, l-'~f~-¢;.ai, 7i'"'t}--~--'t:.;;:X:.OS'-,-:::--i"N_,0_~--; 5.r:~~1pl• /l.llllly~i• .\l«p1_esleol: Aooly!i<ol met!>t>d IM~<~!•il li:<. 81601.l, ~OHlllT/4'1UA) ~nu nu1ribrr of.<uo1oin'";pwvi<kd,fur '"ii {i,e, 82~1lli ·J, M/0.8/74'1.GA ·:I l: · Cw/er :]'emp: O;) P,ie5tJ'Yat5~J)p~·tlA '!" Hy~roehlorit /\tiid;NI "Nilrit:,A~id, &Jl ~Sodium Hy~l~xideJ.SA "".Sulf~m: Aci.rl, ,\A.o:i:~l'.!iscofb:e A~!Jl, UX're He~:t1lC, Sf w ~-Mimn 1lljvsulftl!~~;lf.t~!'3 f)J!iicr;.>~li~j.~ ;i1!_rled ..i ,ieaVe fie~d-bbm~ C

WH!Jrf. ~ 1.A:BORA TO.HY y ELiow,. Fiu: .PIN~ n.•(:U])N'J' -r-.

Page 4: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

P3ge· ------- .• of ... . ··-·------- GEL Chain of Custody and Analytical Request GEL Laboratories, LLC

Project#. 2040 Savage Rnad

GEL Quote 11: ......... ... usce www.gel.com for GEL's Snmple Acceptance SOP** Charleston, SC 29407 ·-· ......... ·-

COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l

PO Number: Fox: (R43) 766- l J78

Client Name: l'hmie #: Sample Anolysls Rcquc.1tcd 1>> (Fill in the number of can miners for each 1cs1)

·~ -PinjecUSite Name; Fax II:

Should <·- Prc.1crv~1ivc Ty~c (6j ll1ls

Address: .un1nk. h~ con1ttlered

: Cor;nmonts Collected by: Send Results To: Nole: extrn sample is

'Daft' Cnllcdul. .. Tim~

flr.:h.I i;J.lT-!"i~ 1·sc required for sample ,.,:i~·i;:'l:d or specific QC Sample ID (M11it.tyl CoJ1:-m r;1het~d M.:itrix Rodi A

(mm-dd·n) Ul HI fJMCll R"gu • F{}r L'ampa~·i.1el·· mdu.:uli' .-;tizJ( 1.md "/IJIJ J:.1Jt'ltmte (hllo1ru)

\'C bred l<!l'O

Y .·1.o. 'R.1~. 1 n ... ~1S" Li I iQ '12.,l"l, I?... J 1-3·-JS' L\,(,\)i i?. ~ ' / l/3-1 l)'

l.j I l i ,fl_,'\ ,'l rl---3--1( 4 11,~, R' JS-,1 11-31< '"417i, (L. l)'L 11...-1-is-

l.i I 'l. ~ ; \?.. • IL;l. 'I rz.-3---1(

Y1l~. iL.\t;,1. l-i-3--rS

~ Ii i1:> • !Z.-, fl/ l I I?~"\..\) ~ ,{_)j i 1L. 14.2.., \1..-:i-t{

TAT Requested: Ncnnal: Rusb: Specify· l:iC~;c•l Iv s .. ,c1 .. ,,,, IF~~ Result~: Yes ( ~o Ciro le Ddivcrnbk C or A I QC Summmy I Level I ' Level 2 ; Lcvd3 i l.cvcl •l ' Remm·ks: Are there any known hozCl/·ds app/Jcobh.< to the,~e .~amph-.~? !{so, plem,e list the hazard~ Sl!nml~ C':olJc~tira Iim~ ZQr.i:

Eastern Poc1fic Ccmrnl Other ...... ...... .. Mountain

CJrnln ofCustady Sign:iturc.~ S~111ple Shipping ~nd Delivery Details Rolin~uishou By (S1~.cJ) Dale time R~,;dvcd hy (Mgnc<lJ D;:lo Tt1no

GEL PM:

l I Mclhod ofShrurn"r.1: Date Shinned.

2 i A1tb1IJll

3 5 Airbill #: J .) (1i~i11 ar C;:u;t~dy N1~1;~~c:r '"- Ciic:n' P;ti;nnin~rt

Foi• Lab Rect•f11111g Use Or•/r 2..) Qf:," Ce~::~: N.,,. N(Jm:.ol S:an«11lc. TB• Tr;p Bhti;k, lllJ .. fil!ltl Oup!ii.-al~, EB• 'r.c;;u1pmcrH Lll;n:k, MS"" MiUrl1\" Sp.1kt: Sa=r.r::c-, '\.1~D .. M:i.!ri,; Splko!- r.J\J)ll!C:!tC ~l\,'Bjll~, G • Cj1"Jl.11 C -C'lln~pomc

! } F1dd P'1!1r;1~d F~rih1ui:;l nar;•rit:;~. mdicn\~ w.t~ ti.-" -for yc$1l1c S.l!in~pl~ Wll~ li<i!d micr:iJ Cf .. ~ .. for<!:;mi>:c '...a,; ~~VI t'1:::ld n:lcfcd. Cmtudy s~al lniac·t? ~ l i\1~!Ji~ (f11lc1i· 1.J\V=t::cmkng W;1~i:r. GW=-C1rdu::~.hvc1~r. SW"'Sl;Jf::i::e W.1!c:r. 'vn·-·w.i:::;rc \Y.i!cr, W· W~:·.:t •. \.'Slc M;.!ic L:ttl~;'1!, SO=-~rJ:!, SD"'-'lcdr:1;.:r;t, SL"·~h:1lr.c 1 ~S··"'~:~!i(: Wa:m:, O::Cil. I•",,·F!::.t::~. l'-::Wij1"!1 l·'r\1rm..:, F· Fc:L"I·:.. ·, l'ES ,\'0

~.) SJ'l':pl~ ,\n~lys1:'i ?..l'qtesied: ATl:ll}l:i::il m!!thr.:.tl rc~jllt:i':ell (1 c. 82600, tt6103'747UA) rm::l nm~.Crr ~r 1..m:d.1.iac:1?> rl·ov:c.le<l fot c;:.i.:h {L~ ,rtJ(.()B - l. (,(}/r)f;l/147/JA - IJ. Cooler Temµ. !i J t'ra~l\'mivc Typo:. Ur\ '1 liyd;o-;l1~m: •\~id. Nl = Ntrr::~ Acu.l. Sli .... Sodil..'rn liy,ln)•t:k, s~\ ~ S11lr:.-!"[.: Ac.11J, ."\.:\ •· A'corbu· Acid, llX .... Hc;x'3nc, ST .... ~::-fh1~m Th10.::i1.:f:-!!:;, If 1~0 plc~nt.lwc: i~ .:a{c!i,::d - ic.n=c field bl;i,:1l., c

WHITE= LABORATORY YELLOW ~ FILE l'INK~CL!ENT

Page 5: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

Page·.--·-··---·-· ··--··· of ··------------ GEL Chain of Custody an(l Analytical Request GEL Loboralcric>, I.LC

i'rojc~tll. 2040 S~v~gc Road

GEL Quote#: 0 Sce www.gel.com for GEL's Sample Acceptan~e SOP,... Cl1arles!on, SC 29407 -··· ...... ______ ,,, ····-·· ...

COC Number l'l: .. . . ,. . . GEL Work Order Number: Phone· (843) 556-8171 PO Number: !'1x· (lM3) 766-J 178

Client Name: Phm1c II: Sample Am1lysis Requested 15> (Fi!l in rhe number of containers for e•n:h tcsl)

Project/Site Name: Fax II· Shuold

<-- Prcscrvalivc Type (6) llli• ••mpl~ b~

Addrc;s: COTililde~elf

: Comm~nts

Collc~1cd by: Send Rcsuhs To: Note: extr.1 sample is

'D1u-: Cdl::.;.1;:d '"Tm•1;1 F1dd Sa~i::r•k:: TSC

required for sample c~:l;:;r-=.\I QC' specific QC Sample ID IMil!l.r>l O:::c.lt=fll r~uearJ Mlilnit RntH ,\

(mm·d•l-.1')') '" "' Q;lCtl ktgu "Fm,· ,_omr.·m11e-.· • mdu:wfe ."tlun uml ~lot> dmelfunr! (hlunm)

YO hi.h:d ~ro1

L\ I 2.~. IL l'IS. I ll-3...\<

Y17C\ ;~. lri .1 \7 - ~-\.; l.{7;2._ • 'Q., I \'-h ,5 rz.-s-\ r{ 4 -io. Q., 1r1 LY \ 1.~:r·\ S" -l-1 tz..C, I i2.. n. I i1.r'3i1( L\ i1 ~ I rz_. 11.1., \{-'.,-\(

Y.7.6, V--' n.s- J?. .. - j ·1-r'

--

TAT Rcquosted: Nonn~J: Rush: Su~cif\» (S"o'<d •• s"""' .. ~'J I Fax Results: Yc!l i No Circle Dctlvcrob!t:" C of 1\ I QC Summary I Level I I Lc,•cl :! ' L<:vcl 3 I Lc•·cl 4

Rem111·/1s; Are rlwre a11y (mown hazards applicaMe to these .mmph·.r? ({.w, plrnse lfl-i rh., h,rzanls S"m~I~ !:'..,Jl~~!ian Tm1c zguc East~m Pacific Cciin-al Olh~r ....... ···--MounLiln

Chain of Ciutody Si~nMnre~ Sample Shipping ancJ Delivery l)etuils l\clinq,i1i~hcd lly (Signed) DLltC Tlmc Rc.:civcd by (·'l~r.<JI Dolo Til'C.C

GEL PM:

I I Mclhod of Slm·m~nt D~te Shinned;

2 2 A11b1llll

3 J Airbill #: : } Cha::i orC:.il10lly N;.;.tdicr - Cl:cnl lklermn:i;d

Fnr L11/1 Rarell'i11g {Ne 011"' 7..} Qt.' Cod~'i· N "'Normal S~rnplc:. T'B= Trir. Hl:;mk, J.'D -F:ctd TJlip:;i::11L'I:. En .. F.q!.llp•UtnL Bl;,i•k. '.\'iS,. M211nx Sp1kD Sarr.p:c:. ;\fSD-Matn,,; Sp1kr: Ot!rlic-a:c ~fllr:p·;c, G-· !.ir.ibo. C-= (\l~;po1;;1Lc:

).} Fielil F1hcrcd· Fc111quid matri:cs, irnf:,4le 1'vitl': o:i .. \' - f<.r >c! 01.:: san11p!-.: wr.~ fr~ld flJJpt:d er- N - for ~!!.::?1pli:: WL3S 1~c~ tic!J f1:tc1'cd C11slodySeal lnloJ<(l

.q Mntff< Cric!~:s: D\'\r''l"Dfi11king \lr'.:itcr, G\\'·'Cln~1~ndw·ii1.:.:r. S\V ,5~tf.-ic.-c W:icc:t, \VW:--W.-:u1't~ \Vait·i, W==·Wi1l!f, MI ... ·M-c:1t: L:'imJ. S():·S~11'.·, :tO~,S..::lia:cd, Sl .... .SIL!~J.:11, Ss~·~ JL1I \\l~sti:, O:;Oil, F -1:t!:er, r-w._,i::, t:.·U11:':·:=, F· F~c..i.1. ~··t YES NO 5) Sump!r: Arl4[~·>i;'.I. Rc111:es1etl· An11l}·11..::JI m:tho.J Jeq\Jt:!i:.i:rJ ~i.eo 8260n, '6GlGlJ.i74?0A) ru~J r.'111:tiu l'f i:-'1nlri:ricn: ~~c(lv11Jed for e;?ch (1 f!! • • 'i26JJB . .J, (J{}U1B.,7.,,1,14 ~ 1). Cu"h·r Temp. 6.) ~'rct.;:.r~3li\C Ty~~ Hh."' H}<!r<:e:iilcm~ Acid, Nl,.,. r..:rtnc. Ac.hi, SU - Socfl":n Hyd:\l~Col~, S.\" ~1!Uir;1c Ac?d. ,\;\ .., /\H."~b:c Ac1d, llX -=· H.:x:'lneo, ST.,. Sml1t~m 'Ih.::.1•·lfate, U 1·11 ]'rc:s.~p.:;tc1·.~ ~ .. :"ldr;t:; .. 1 ::::o Jt'ai.,c- !'ictd bf;;;s); c

WHITE~ L\BORATORY YELLOW~ l"ILE PINK~ CLIENT

Page 6: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

\.

P~g~:_· _· __ · _· __ _-._Qf~------·-­Projcci#!

GE,LQuo_te/1:- ·-.--·""· --------~~

GElrC~ain o'f C.Ii$tody ®n,cL~11;:alyttc.~J l{equest **~ee ww_w,&:et.comfor OEC's S<\mpJ~ Ai;cepuiriceBQP** ·

CbC Number f1):

·po Number:. · - ··---~----,., ··· · GJ!:L,:Work-.Qrfier.Number:

GEL l.aboraMics, l..LC

2040 Sav~gc Road

Clilirfos1011, SC 29407 Phone.: (81)3) .5~.6-8 ,17 l !'ax: (843) 766~1'!78

ClicntNam.,1:: Sample,A;nalysls Rcquested<5l (Fill.fa tl1e'1i111nbcr ofcontainerirforeai?h test)

!""" .... ~ .... ,.,, · ·· · · ~~jcct/pitc,,N.flme:.

-Should iii is'

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Rclfoqujsl1cd_l>y (Sigr)oJ)

3

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specifi~QC

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Sampfo .!iliipping and Delivery .Details.

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Airbill'!J:·

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Page 7: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

roge: ------- of --------· GEL Chain of Custody and Analytical Request GEL Laboratnries, U.r

Project I/: 2040 Savage Read

GEL Quote#: _. ·-· **"See www.gcl.com for G EL's Sample Acceptance SOP**

Charle~IC)n, SC 29407 ··-···· ......... COC Numb<!l" llJ: .. .. GEL Worl1 Order Number: PhGnc· /8~)) 556-8!7 I

PO Number: Fax: (M3) 766-1178

Client Name: Phone#: Sample Analysis Requcst~d m (Frll in the ni1mher of contniner!' for each test)

Proj~ct/Site Nome: Fax Ii: Should ·· ... Prcscrv.!•vcT>·1•" C6l tlils

.u1mpleht! Address: considered

: Cornmcuts

Collected by: Send Results To: Note: extrn s~mplc is

• Di'1~ C.::i::c<.:tcd 'Ttmc

Fi chi ~;.1mpli.:- TSC required for sample

0.1~l .. 't::kc! or spcdfic QC Sample JD (MUifL•r)'I ('cJe sl.~ Filtt:1"c'J ~falm: n•dl A (mm·dd-y)') Ch hmm)

,,, .~l O~('tl l\rg• • Fn~ t.rmrJ)c>si1r!T - 1nJ1t.:fllt' W.:..lrt n;!i/ ~llJ/J fk•U.'if1me ,.. lated Der ul

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Remark~: Ar!! therf! an;i k11ow11 hazards applicable lo these samples? !f sv, please list t/1e hazard1 Si~Ql!ccti•!O Iimo ZQn' Ea$tetn Pncifk

- Cenlml 01hcr __ .............. _ Mo11n1ain

Chain of Custody Signatures Sample Shipping :incl Delivery Details Rclmq11i>lic.t By (S1gnc.J) Dale Time Receive~ by (Sign<~) Dare Time

GEL PM·

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2 2 AirbiHH-

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WHITE= LAnORA'rORY YELLOW= FILE PINK = CUENT

Page 8: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

Pag~: --·· ____ ·- ···- of . -··-------- GEL Chain of Custody and Analytical Request GEL Laborntorics, LLC

Project IJ: 2040 Savag~ R~~d

GEL Quote II: "'*See www.gcl.com for GEL's Sample Acceptance SOP"" Charleston, SC 29407 ......... ·-.-----··-·- ··-··--

COCNumbcr"l. ... GEL Work Order Number: Phone: (643) 556-8171 PONumb~r: Fax· {843) 166-1178

Client Name: Phone#: Sampfo Analysis Rcquc~ted rsi {Fill i11 t11c number ot'conmincrs foreoch test)

.~ ... Project/Site Name: Fax.#:

Should .., __ Prc~crvativc Typ~ (6) llii•

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: Comme111s

Collci:tcd b:y. Send R~sulls To: Note; extm sample is

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Frdd Sitmp:c TSC required for sample

Culk..:1~d o::- specific QC Sample TD {~Ii!;(,.~) [~e.r11 f!1J!t1t?J Mu!t1ic. Rodi A.

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TAT Rcaucs1cd: N~nnru: Rush· Soccsfv; (Su~~C"L1 tu S:irdri.Jr~i:) f fax R.csuh;S )'cs .. No Cuclc Ddiv~rablc. CofA ( QC SuJTlmary : Level\ I Level 2 1.Cl'CI 3 I Level 4

Re1m1tl!s: Are there any known hazar<l~ applicable ro these samples? ffstJ, ple<Ise list rh" hazard~ S,ump,W..Q;i !filli!ll!..Ilmt..llll!; Ea;tern Pad fie Cctttrol Other ---·-·-M011ntnin

Chain of Custodr Sig11at11n~ Sample Shipping and Delivery De1alls Rclir.tJHishcd Uy CSsg .. cJJ D~lc Tlmc RcccivcJ by (<1~1:<il) D;>I" Time

GELJlM·

1 l ~klhuJ of Sl11~mcr.t: D:tte Shipped:

2 2 A1rboll Y·

3 l Atrbill Y l .l Gioo:iof C••lody N;11r.bor ~ C\icr.i Downi;,,,J

For Loh Rcceiw1g U.1·~ Only l) QC Cad>:~: N-: N(irt11.1I S~plc, 'l'U •Trip Dlrrnk, 'm · ~·i~ltl f1t.pi1..:~1c, Ell,,.. Pq:uy:-ntcnl TH1tr.~ 1 \.f!a.:: M::mJx ~pkc S.;mplc, ~t:;t> .... M°.);it~ s:uke n •. rlt(::ii~{': Sa.111ri:~. c;.,.. C1ra'.'1. C =- t"cmr~~ite

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Page 9: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

- ---·--?'age: __ ._ .. --·-- .. __ .. of . ·- - --·----·· GEL Chain of Custody and Analytical Request GEL labor<itor;cs, LLC

Projecl fl. 2040 S~•agc R~od

GEL Quote ti: -··· -· *"See www.gel.com for GEL'~ Sample Acceptance sopu Chorles1011, SC 29407 ........ ·~ . -·-----·~---"

COC Number('': ... · GEL Work OJ'dcr Number: !'hone· (843) 556-$171

PO Number: fnx· (H43) 766-lln

Client Name: Phone#: S~m11le Am1lysis Requested 151 (Fill in tl1c number (>f contauiers for each tcsl)

.,,.. ·· Project/Sire Name: Fax II:

ShouM tl1i• <---Preservative Type (6)

••mpl< be

Address: cL1Usjdere:1J :

Comments Collected by: Send Rcrnl!s To: Note: cxtrn sumple 15

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Fi~~d $a~ii'~C TSC required for sample

Ci.:il!l..::u~ QC specific QC Sample ID (~h!l!•r)') Coc.lc !:i F1ltl!'1ed Mulr;X ll•dl A

(mm.-J.J-~·y) '" "' crac!I Re-Gu • Fer t'1.1111J~·b\'i!e'i. mJi::x1/f! :riorl w;J 1•/cm J.:ue/fimt! .(hhumtJ .. h•led Jcr ol

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TAT RcQuestcd: Normal: Rush: Spccifr: ~Sub!t'l'! [.;) S11!d:.Jr~~) r Fax Result~: Yes I No Circle Dclivcrnblc: C of A I QC Summary J Level I I Level 2 J Lcvcl 3 I Lc..-cl 4

Remrrr/cs: Are /here any know,, hazards applicable to rhese .~amp/es? lf.w, pleast list the hazard.\ fu!wphi;.oll~'-T.lJ!!ll..ZfilIB Eastern Pacific Ccimal Olhcr -·--·-Mc1mmi11

Chain of Cusf<ldy Signatures Smnple Sllipping aud Delivery Occall.1 Rcli11•111isl10J !ly !Signe<J) bate Time Rccchod by (<igr,cd) D11I~ Tin:.t

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2 2 A1rb1ll/1

3 3 Airbill fl J ) (jl~>J• af C\/!tilr.-dy thnnb:r-· C1:cnl Dc?cnni1~cd

For Lob Rec<"i••;11g U.•c 011/)' 2) QC' Ccd~:'i. N..: N(;rn!.11 Si!mplg,, TB"" Tnp 'Blank, FD - Fi~ld Dup'.ic11lC, En• LPiu1pm..:-ru Bl111:Sc. :ns = ~~fatrt"t ~p;b; Sa1r:pti::, ~1Sl> u: M~lrl:< Sp1;:-e n-.:pS1c:;i~c Sarnr~~. G v C1~J:J. <.: =- Cun~p~:m~~

3) F1dr..l F1lu:red. Pcrhqui!l rr.;1:1i"e~. 1r\d1tat<: \\oflh a .. v .. fot >'I!'~ ~h~ Ucl'!:plc \Vil1 fi~Jd m:cr.:d or ... ix -for .~.imp~c W~S 11~ ikld m:{"rntl. C11Y1<-d:~ S1!al ln1a<"li' 4) Mi.!'fl~ C<;t~:5. D\.Y .. Drmkvac Wat~r. GW···Gr~\l;:Jw.i.h:r1 SW :~mf:i.t'> W'ah.:r, W\\'.,-\1r'1,:i.:c W.,itef. \\"r.·W.,10:1, \'iL•·Mm: Ll!jL;:tl, 50 ·S11:l, SD··!'i.:d'Tln'1;I, SJ.,'=!;!,1.lci:, SS··S·Jltd W,\:i:tc, D··Cd, (-"·.fd:I!;, Pi W~p~. {;· ·l!rilll!', J-': Fc_;il, ~· , i'f!S NO $ ~ S.un1>'-: Ar.llt".!i~ Rtqt::u:C-d ,\11~Jy1•C.l, 1l1dh~u.I trqi:C$1cd (1 i: ,1;26bl1. 60UH?n47111~) B;:d j~:Ullb:r -0rcr.-~.::i!ilCI~ pan·;tl~d rt:r e:ch (i.e 81(/.08 . . l, UllfJ8t741dA - I'. Cooler 1(-mp · 6) ~'J'Cli~l.,.J\ll'rt. T)'po· EIA .... J-Jy,!r~.ch!ott::- Ae:d. Nl ""'Ni!rii: Acr11, SU.., S"djllm 1Jy.i~1;;:11ri'3·.:.,S:\"" ~~uUi.r1c: Acid, AA..,_ At<:m'J:c Ac:1d UX •• Hc:<A11c-, .ST-So,~:1.!~11 Tlnc;h1lfaLc. ffl:<> rre;:1.or..·r1.hv.:: .,. .::·.lrl.:.:~ ·~ :t"a"'i: fi::::Lit l>la:1k. c

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Page 10: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

GEL Chain .of Custody and Analytical-Request . "''*$ee ww"'.'l'.gel.coµ, (9r GEL's. Sample Acceptance SOf*~

Page: __ , ____ of. ______ _

Prqjectl!:

G.ELQuotcf/:· -----.-~·----~ COC-Numbcr<•.I: ......... , ...... "~· .--··-.- G.IDL Wor:kOrderNu'mber~ !'0.Nuniber:

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Cli•m!Nami:: ,P.honc#: Sample An.alysls.Requested ·<5>· (Fill 'in thC. ll}lmbe1· ofcon1aincrsJor.cacb. tes.l)

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specific QC::

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21) :Qt~ Code~.: ·N·~ Non,Jial Sa~pk, ·TB ~·inp_'·Btank, FD ""'-f°k~d· Duµ,fi.a1_i;-,,E~."' F.q\_11.f?m.eRt:B!~.ik •. MS ::-:fy1a1rb::stnkc-~~pte~':'ti~~ .... Maul.'<·SPllt~ f?~ph.c~~·sa111)k;·c;.. Gr;i:b~. C·.,, c~r-po»tc

l,) Fkld Flitcrcd:, Fodlquidrnankcs;indkotc Wilh .,.y ~ ror yoO"th• .sample .... fwtd.0!1md0

or- N - ,.·,""'Pl• wnrnot'licld illl<o;d. Ci~#ody Seol'Ji:uu:I? 4,) :~ut~x Co~~s;._DW=P~iiiklns ·Willi:~. ~nyr~Gn.IUdd\_\-ptCr:.-sw~,Suff~Cc.'W~.1¢1' ;·\YW~\~O:!itO \V)ll~J.· w~w~f.?•. ML~Mb.: Lii111id;',SO,~S,uil;. SQ·.-:S-vJ~Jl~pl,:SL.i;.SIWls~;SSb-Soli\l·Wa~'~;:o~c;J, 11.~fJlt<r I P"-•WiJh: •. U= lJrit1~ •. lt.,,F~wat.-N "''l'------'Y:..:'Eo.;So__ __ ---'-N_O ___ --; ~:) S•nip!ioA~•l)>$iiRcq11.;;1~d:.' Anolylicol merhotl rtqu<>i.~J.(i.e. 8~690, 60lOlU7•170A) ;nd ·munb~r of co~ne1; pro•W<~ 'ror e4<h (Lo. SJ~QB -.1.: 6Q/08fl./70A - 1_); . · . . C110./~1Jemp: (!,).:; Pc~~cl'\l~tjvc Typt; I.IA .... lly~roc.hforic·Ac~~~ NI ""·.Ni1.rii: ·:\~i_d. fi!JJ, .. ,Sodium.Hydro~idc) SA """S1J~~ui~)\d9l,AA 71\s~9rbl~ ,.t\d4,. HX·-=__.HC.x:ino,;:ST #•So~i111n T.hiinnJfnlc .. if.no PJ';$Ch~H\'C 1'\ a~dp~.~ l.c_a1!t:7~cl(I blank . /.!:

WHJTni"' L/i;BOH:ATO~Y YRl:.LO,:W·=J1lLE PINK,,,,CU~NT .

~------------------·---- ------·--------- - ____________________________________________ _,

Page 11: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

, ..

App E-Sub-Area 4.2 - Instrument Field Sheets

Page 12: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

lnstrurn~ield Response Check Log .

1. Instrument l.nformati_qn1

Ratemf>t-r.r: Ma~e/Model: LUDLUM 2241:.L__ Detector 1: Make/Mode!: _JJ.LQ..lJ.U;lJ..A.4..:.l..Q ---· Elicron M!croRem Meter:

2.. ~@~k Source lnformatfon: Source. J. 1.sotop.:: Itt.:2.3.2.__Serial No.: 11..-.:6 __ _ Respcm!,t' Acr.eµti:lnce Range (·~f-20%): uRem/t1r +20% ...... .

Serial No. 2.62737 Serial No. _P.R 111127. Serial No. A22~4...,,U __

Acttvlty: .:SP-:.L .. unlts: .JJ.C.L. uRern/hr -2.0o/c _· _

Cal. DU<'! Oa te · _9..L2J1fi

Cal.. Due Date; 8/4/16

r~ssa11 Datt~: .12/30/10 net cpm., 20% 229~.2...... net cpm -20% 15284

Source 2 isotoP'~: .C.s:.U.7 ..... S~rla! Ne.: •. ..81£13..:;48..___ At:livity: .ll.ill. __ units: -U.CL As.~ay Date· J . .Q .. Q.l:I.0 R.esponsi:: /\::.cept;mce R;;inge i+/.20~): uRern/hr ·! 20°·'-. -~- unem/lv ·20% --~--- nP.t cprr-. ' 20%.J..3..3.15... nT>! com -20'H• _ _891~

3. I~s:hnld<1.nl'll/9rker.J>_~rfoL111lng Checks: Name:_m.vG' __ KuJ..5.MP. mtf': .ft.~r. -· ······-·--

4 Sl~~-g.rJo.c_atipn: S1te/Job·_£{:1-___ ------··-· . __ ,_ _______ 1.oc.::iriori rir.r.criptim1·--'-W_<'_o_J!l_J ____ _

GPS CoordtnC1!c~ iwhen required): K Coma:_ ~:fl,"__?:.J~.?,__'i. "'/~---- Y-Coord: W 7 rt''5"{ S "_. ...

Rev 110/18/15

-~;i-~-t~-·~kg Bkg Coun~-Sc;~rc<": Sourcn Respon~e +/- 2.0% lnsL Battery Time Ambient J r1itials and Comments I Cnt fcprn) or · Cnt [g'"oss cpm or source

I Tirne uRem/hr). Time uRem/t,r) gross cpm Ca fib. Check Of Temp.

current ' (Y/N) r~r:J (Y/1-J) l

(Md'l Into· mst.-Condition. etc.)

(Mt~) 1 r-INJ or~~;:ifhr ~-;j~~_ter 1 · ·; · · ~ 2;·m. ='i'-~_F'_""" __ -__ ~. -=y~~"""~~~ ..... -;~~===-~~,,-"""*"""""q"""Q_"'"o~""·[p=.=_="i~==v=· ;=vc=~~=-~::J _Ra_te_m_eter 1 J ~5(!,_ L ____ .. {/})() _ ...... _. __ y _________ y____ _ ... _<21a_g ___ r~ _(>.Jll_.5L..~----------! -::-:-:-~-:-!:-~-l--'-,· -+----'-"'---"-..c,_._-+--1__ J b (_ y _1 : ~ i> -~_!;~_ 'l ________ T.:\Vf----· -~~ ______ ... _____ -·-- .. __ .. j

_!____ =>.fr.fl . --~ -- __ lj_fL( 7--- ---·- - -- ____ y____ 1 L 2 I ~;f~~~fi~- .. +------;f-?:;ti __ -"·-!- .. ·--~ .. ;·}·~}? -·· .. -+-- -¥----- '~ -7;-?{r- ~-L~- CJ,'-;~-~-:! -1 ~_!_c_~~_!l___ NA _______ h_ __ _B_~---·I L1 ......... ____ y___ _______ '/__ ___ ,, __ _t_J__Qj~ -~-----·-:,r~iji .... i ......... ---------·--·--1 Bicron NA NA ___ _Y. __ ........ _. _ _'(__ ____ (_ij_r;i __ -~] .... ~ "'(~1J....1=._~--------~----~---! ~icron NA {_,,. NA I 1 . I --·-·---·-· ---·-·- ----·- -------·-·· ___ .J_·~- ...... . . . ......... ".---·-··.I

1. ln5trvmr;m r1e!lgniltt>d check source ii llm~d on calibn:itio11 sticker. Record check sourc·~ response [net cpm} prior Lo lidd dep:oyment for iii! c.hetJ.. sources be;ng usPd. 7. Sourer. <ind l~ackground count fil l.e should be de.t1"rrnlnt>ri frorn the average of three mit!c counts at the same inr.atior. Rtipeat couHs >he>uld b{~ •t1ithin ;•(l')·.\. if mun~ r att'. cive1ges

si5nif1ranlt1•, ~mrfcrm additiorial rnu11f~ to evaluate mstrurnenl stabi!lty

Page 13: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

~~~,Jllt~

--~T.$ W1-•V T~'IC .. -t.lt. !&ER'VICt:S

1. mstrument lnformatio111

Rate meter: Make/Mode!: Detector 1: Make/Model: Bic:ron IVHcroRf.'!m Meter:

2. Check So.~i:..i;,~ lnformatlo11:

lnstrum~.i/ield Response Check Log

LUDLUM 224J-..:1._ Ser!al No _262737 LUDLUM 44-10_·--~· 5erlal No ... ERll 1.127

Serial No. _4_2=2_4~U~-

Ca!. Oue Date: 9/2/16

cat. Due Date: 8/4/16

s.ource l Isotope: Th-232 Serial No.: 116 Activity: .~Q.L_ unils.· _IJ-CL .. Assav Date: . .12£3.Q/10 Re~pon!.e Acr.epti:lnct? Range (-t/-20%): uRem/hr +20% _____ ,___ uRem/hr -(0% net cpm + 2.0%..]]_~ net cpm -20% 15284

Source 21sotop1:1: .C.~J] ___ Serial f':o.: _lITE.13.::4.8..._ Activity: 0 02 units: _j!CL Assay Dat~: ..J.L2.QL)O Re;.ponse Acceptance Range (+/-20%}: uRem/hr +20'1·o __ LI Rem/hr 20% net cpm ~ 20%__13.3.Z5..... riet cprn -·20';(, .. S9l9 .

3. Technician/Worker Performing: Checks:

Narnc-$'_'1E'__('...Kf.1Jf.~1'r/./ Tttle: _/.~.'[ __ . -··-- __ _

4. ~i.tEt.~.rJo~atJ9.rr · C.ite/Job:_f. ___ z.__ ___________________ _

GPS Coordin.;it.es (...-,.hen rcqL1ired): Location Desr.riptinn: /A,)O()(J~ -·-.. ·--·--·- ·-·-

'r'-C\10rd: -:.i ·~" & 2..' 2.]) d~ rJ @ c-..nv .ra,..-.....,,i.- ~~~-t.. t::.J-, Id·,..-.)

. . ... ... ..... "'l""'"·-=··r"'· ... ·~·=:-JI~._ -.... , . "":'T' ·-..:r;--r -:-•• -.":'T~-~':."'" "'f<'-~r.. ... ~"1 ~~- ... ~.r -~·,,...

i lnstrumer:t Field Response· Use Acceptance Criteria Remarks ----·-·-·-r--- -----.. ----r'·' ___ ,,, ..........

Rev 110/18/15

Meter Bkg Bkg Counts : Source

Cnt (cpm) or Cnt Source Response

(gross cpm or uRem/hr)

+/- 20% source

Inst.

Cal!b. Battery

Check (Y/N)

Time

Of Ambient Temp.

{~F)

Initials and Comment~ (add'l Info: Inst. (onditio11. ttc.;

uRem/hr) Time gross cpm curre11t check

(rt11r.i\ or uRem/hr (Y/N) {Y/N) i ~~ ~S"iX-"W?ri"'f''i'"'"""F'T\o: ·--~·· ¥ ~~~~~

Rateme!~ ...... L. f d_o:r"i[ '/ Y i 1__ 081D -F z.n. .Sil ' Raterneter I _ -·-,--.·~--.~~-.-._fJ"j_9-_8:._~..... --~~=~-~----Y~-'.. v--···. 0~1.L .K!i..~-- Lr_LJJ ___ J~--------- --! Ratemeter I _I__ Z.01 (e~ l/S__J_ ___ , .. f..~.l11 .... .J.'. ... .,.---------·--- ....... ·--··_/ Ratemeter I __ f -·-· -1illJ_ Z. 3 o f.f< .f -~ C ( . j

~~;~~-~!:!:_. ____ L__ -- .. '·-·------1--~J:J ·--········ ___ '/.__ L ____ {__r-;o _ _!!_ rr,, 1li.fil.fl . _ --i Ratemeter DO] 'f:S-3". Y ~ _,/;f 3o __ i/I{ ~---· _{ /ll___JL __ ~-·---·······-·-_ .... J BiC:~.£1___ f>!A - - - s ___ , ·--~~ -- - _ _l_l____ -·-·· - --f ·- _y_______ __y_~_j..___O__g)o 1~. a h z 1-Z s k: I Sieren NA NA ) _:i__ ___ ____ _'( ___ .f.?..1_ Q ____ 'f(j ___ _I./J, ZJ.!_f(. ·-··- .. -·-···---t 3icr_£!:'.._ ______ ~.f-. '-f !:!~--- _ ·_ Y IS lJ • ~ z.. --·-·--·- ....... ______ _/

1. Instrument deslgriated check source is fisted on callbration Hicker, Record check sou ce response (net cpm) p1ior to field deployment fot all chec-1<. sources being u:IE!d.

;i. Source and Background coimt rate shoiild be determln?.d from thP ;,iverage of tnree static counts ~t th!!' same lnc~tion. ~[;!peat CO\mts ~hould be wjriJin 20%. If ('1J11• 1t rate ~iv1;:r~1.is signlfir.~11tly, perform additional c:oun!s to evaluate instrument stability

Page 14: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

Rev 110/18./15

Jnstrum~ield Response Check Log

:1. .!n.~!:\:Lrrull!.Unformation 1

Rate-meter: Make/r.,'lodel: • LUDLUM 2241-2 Serial No. 262237 Cal. Du& Oate: .... 212ll.6 Detector 1: Make/Model: _J._UDLUrjj_44:liL ___ . serlal No. _J~R 111127 Bicron MicroRem Meter: Serial No. _t\ill.!L __ Cat Du~ Date: 8/4/16

2. ~heck Source Information: source l Isotope: Ih·2 32 Serial /\Jo.: 116 Activity: .s..Q,J __ units~ Jill __ .il..s.;.ay Di.He: .12/3DJ10 Respo:1~e Acr.f!UWnc.e Range (.i/-20'i':.): uRem/hr +20~{ _______ uRem/hr -20% net cpm -i. ?JJ% 22926 nP.t cprn -20'i~ 15284

;>ource 2 l~atope: .C.S:::.UL ... smal ~Jo.: ... 82E13-:4.8....~ Activity: Jl.{12__ units: .u.c.L Assay Date: .J..L2QLJ.O Re!ip0'1oe Ac..ceptance Range (~.f-20%): uRem/hr +20% ~~ ut<em/hr -WX ---~-- net cprn ·f 20%.J..3.iZ.$_ net cprn -20% _ 8_!.;JJ,9 ......

3. Technici11J1.L\J\forker Performing Checks;

Name:.::li::ii_ on_~-- ___ _ Title; ...... ····-···--·~-. Dalt"_!_~?. -J_ [__ T1tn.:·· .. Q.[~.!2 __

4. · ~l.t~ !?J.Lo_i;_atiQtr S'te/lob · ___ t/., .. L ............... ·---·-···--····-- lr:i•':<tion Df.!~cript1<,rL___,f:._-,_,.e.._\'""d,-~-------.. -····- --·· GPS Coordinate~ (whl':-n required): X-Coord: .... ~. :a:~1'_'-!fb>'~---- Y-Cuord: IN ·1.;" (12. • t ~'. n

--:-.-•r·j-•-:--:-:-...:.=''""·•""'···"l•.·..:·.,:,,r.,,.1~·'!'''i' ,.,_,~~,..,,::,::·::--::::~"!".''":"...,.,,.,.-,., •• ,-, • --;•:···'··~·.•·~:·.~·:-••,-•."·::-•T::.• •r"'":-'":', •,\ \ r.·.~"""' 1:7·,••'.--r:""'f.~.a~..,,..:1.:"!....~------~---~~-< ~--,,..~---·--~~-~-··-=• ...... .._ ................ ,,_,..,._..,. [ lnstrumer:t Field Response· Use Acceptance Criteria Remarks

----------- ---

Page 15: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

-~-TS ~ ·. '•

Rev 110/18/15

I j

i j )

l

Instrument Field Response Check Log

1. Instrument lnformation 1

serial No. J.Ll-61 fl Serial No. fri:__/ l:zt.f!)... Serial No.-----

Cal. Due Date: o;Jo -~ C Ratemeter; Make/Model: Detector 1: Make/Model: Bicron MlcroRem Meter: Cal. Due Date: __ _

. 2. Check Source Information: _ Source l lsotope:-r/...~.?7.2.. Serial No.: t ( ( Activity:..:::::'6. 1 units: :_/JL..L; Response Acceptance Range (+/-20%): uRem/hr -t20% ___ uRem/hr -20% __ _

Assay Date:f";;l./Jo/ (J

net cpm + 20%$7~'7 I" net cpm -20% J~:c;,

Source 2 lsotope&-r?·t Serial No.; I ft'tQ 5,.-/.l- Activity: 6. o;;i_ units: /1.1( Ar.say Date: _.f!.A:: Response Acceptance Range (+/-20%): uRem/hr +20% ___ uRem/hr -20%_. __ net cpm + 20% ''J. 71 net cpm -20% ';?W1

3. Checks: Title; fZ..cr

4. Site or Location: Site/Job: Nl'g l.f,;L.. , . ,,,,

GfS Coordinates {when required): X-Coord: J\/ "-11- 0 :f.). '/),:L Y-Coord:

> - "·.:•tt// s . Location Description:. ___ ~ __ . _______ _

wei 71.:iW. ~117 h·

' Instrument Field Response2 Use Acceptance Criteria Remarks

Meter Skg Bkg Counts Source Source Response +/-20% Inst. Battery

I nme Ambient Initials and Comments

Cnt (cpm)or Cnt (gross cpm or source Ca lib. Check Of Temp. (add'l Info: inst. Condition, etc.)

TI me uRem/hr) Time uRem/hr) gross cpm current {Y/N) check {°F) or uRem/hr (Y/N) l (Y/N)

- ·- ·-·

i Ratemeter l1.1tn-1 ~rttu1 ,·;l'i.,. I ·~ ,'Y\. l/'7/,). ,; ~pi,,.. v \,j l/ ~3°1 .27 '3 (. ~ ... ;J-~::2- Jt: [ Ratemeter

I

l ·~"J" ·r:: . ( r l ' ·' I l" Jl"/'A /,1 ...!.1 ..!1 IJ~'-15 ~1~(: (.., ·' 'n 'Or.:·

! Ratemeter I Mil'\. /()i{d 'tu:'M I Iv'., I'\ 4'?:: 'L" r·~,-....... I..// \.{_/ ../.} ill f"r 4·.;i_.,il..o -rt... -·J ~ J .,., £'~ ..... Ratemeter I I t,.A: I"\. }f(j(i I ~ \} \/ /OS£ i/:J. ()' !"'" <:. - i "? -) ~re · t i:'I ....

Rate meter , .1 I e:?7

I Ratemeter Bicron NA NA Bicron NA NA

I Bicron NA NA 1. Instrument designated check source is listed on calibration sticker. Record theck source response (net cpm) prior to field deployrne.nt 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%. Jf ::aunt rate diverges

. signiflcantly, pe1form additional counts to evaluate instrument stability

! I I I

i ! r

j I I l l

. i

l i I

Page 16: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

App E-Sub-Area 4.2 - Sample Locations

Page 17: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

~~ ~If.>

,.::V;,.,vr~.c. sw::R~ SAMPLE LOCATION DATA SHEET

1. Sample Area (SA):

SA Designa1ion: 4 , -z... '=\ Description: Wo.""'cd..=..>.-5,_______ ________ _

SA Origin Location: Coord. System: ____ _ SA Land Afark Description: _______ _ Coo rd:

2. Sample Location Data:

Sample Area ID: -~:_Z{~ .ti_.\ ___ Matrix: 5.Q.J ___ .. ~

Location Coord: N '12" "3 ~ · i 'i. !;°'5~ __ W T( ul ~ ~ _?'-·._0_7 ___ _

Alternate Location Measurements {distance from SA origin and Local Coord.) X Dist. from Origin (0,0)_ tJi g. Y Dist. fi-orn Origin: IV i ~

Site Sketch Attached ~'~ (Yes)~~

Sample Location Description: ~~~--)f4S\. fc .. -fnv_.:.1

lPO.v! '}

Can~py Type: -~--~_Land Use: _ji;,_t..,;_ nry Soi! Moisture (Wet, dry. etc.)._D ry -

3. Location Radiation Readings:

~ --------·r 2x2Nal Bicron Notes {cpm) G (uRem/hr) ·

.. • ~,..,;;,'4-"l.L>L1~7 Count ti me I l cm I 1 m ·--i-i · c~ --T - i~ ] e:.,1.1'\>~ • L0-S-Cu~- z_"2-'t 1- ;>.

~-~'7-~) ~- f76_s - 72c;r; --_ ~--""G'~--t~- s--·-.. 1\ w-· ~~';;·~~- ;~~1~ .. - -···

·-·-·-

E1: --1-1'1'12- ~-'IJ~-=±=-~~1---- -~-- ~~; ·~:~·,;:' ~ '1<."li'iv

4. Sample Information: Sample Area ID: -3~J--ft, \2--. \, 1 -1-f·

__ _.._--.-_,,_____._-.----.,.-------··-,-- ·----------~

Soil Sample ID +· Sampling Description Color (Surface litter type/depth, sample depth retention,

1-----,-~cm~) o.---1--.--------'"---~r-------r·--- __ _ . refusal, sto~~ or rock, topography, erosion features)

1-"-0_-_l_f"--t--"'-' ""'-'----t-='--'...,.__,__--+'-1 '-z.FL ~ - I · l rJ-+J~A-".___ ______________ ---1

~-___,_,.._.."-=----+-==· ---'i--'-\"\""-'-~,\ .;;_-~:~_.__._ ________________ ---!

~------if-><.=...:....'-/-.--==~~""'""~-~~~·\ • '

Y. 'Z.{:\. 2-.\_.'-\ .$c~L~1id sro..;,;,<.\ I 6"fY\C'-"-'I.. V1llL<:.~ • cl -; '

·-----+-----+-----·--~-----------------------;

'-----~'--------·------"'-----'-· J----------------,~-...-~---------' Sample Recorded on Laboraiory COC form and Conlaiuer Labeled: (N)

10/20/15

Page 18: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date:)~ ¥~IS. Project: ~f:~~---------

Weather: t"-\"fJ'-1 ;:x:ril7 ~J.9...1.'._~r-U r·f

l. Sample Area (SA):

SA Designation: 4. 2 F\ Description: _'v-1..:.._;;.o"'-""'o_,_A....,),__ ________ _

SA Origin Location: ----- ----·- Coord. System: _ SA Land Mark Descrip(ion: ___ Coard:

2. Sample Location Data:

Location Coard: N '-t '--"'...i5-Z.' ~.p1"" _.

Alternate Location Measuremerrts (distance from SA origin and Local Coord.) X Dist. from Origin (O,O}__lllt.]:-_ 1

L· Dist. from Origin: ..._bl_,_J &L_· ......___

Site Sketch Attached {Yes\ @ Sample I~.ocation Description: --~__0i¥l-J.-___ _.b......,_rV_~_~_1 -"Le-"-'"""'"-.:::;.....i.::..=· """'~----------

Canopy Type: Ope o ··- .. ---Land Use: J:t!J_l-;vi, __ Soil Moisture (Wet, dry, etc.): _ _Dr--¥-·· ·

3. Location Radiation Readings: 2x2 NaI ~ ·sicrori·--· ~ · Notes (cpm) (uRemihr) ft

4. Sample Information: !::!ample Area ID: ~- ·tf\· • fZ. Z. i -"(

Soil Sample Jv-·1- Sampling Description Color (Surface litter type/depth, sample depth retention,

r-~~-:--+---~---'---+----+---. . _Lrefosnl, sto~~__?.rrock, topography, erosion features) £.( • w .iZ- . '-- • " J /v.;_ t+

+--~-+---i-f_;i_A_·J:·~~~ N.l~ . --------r3_0_---~~,o-+--==~----+-=,._._,,~=-+-~~·~~-A~·~---2_._~-1-~'-'A"=--~----------~----1 f-Vo __ -_L£A>_-+-"'"'-'-....___ __ _...=.:....:--1--Y...:..•_z._1_:>i -~jL. • °l • 'I_.,._, -'--#-_..__,_.,,

---i-·-···-··-----+-----·-------------~

~--- --.=r--------~.~=~------==~,-----~-------Sample Recorded on Laboratory COC form and Conta!_ncr Labeled: (N)

~~

10/20/15

_J

Page 19: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date: i 2. -2 ·-1'<

L Sample Area (SA):

SA Designation: '-/. 2.. .A Description: Wouds SA Origin Location: ···- ---·-·-··--·-- Coord. System. ___ _

SA Land Mark Description: __ _ Coo rd:

. 2. Sample Location Data:

Sample Area ID: 4. 2.A-.R..s ..... _Matrix: _°5..Q..1.L __ _ ~

Location Coord: N 4 z." '?'l..' -z 5 _ _,:f____ __W__i<1<~9.J.,.~_3_'-J_, &_7 ___ _

Alternate Location Measurements (distance from SA origin and Local Coord.) X Dist. from Origin (O,O)__l,J)l.L.__ Y Dist. from Orip:in: tJ/~3

Site Sketch Attached (Yes} @

Sample Location Description: __ Jbl_c._~~-h_1\r\1s_ __ ~_ie_<:i.Y_C.~---

Canopy Type:.. O~-·· ___ .Land Use: _ ili .. ~~'i\'-1 Soi[ i'v1oisture (Wet, dry. etc.): T.'.:lr'I _ )

3. Location Radiation Readin1· s: _ .. __ T 2x.2 Nal l31cron Notes (cpm) (uRem/hr)

C~(;~-~~me 1 cgm I -=-~-g~=J~lm~+-N;i-~~---· --_ ___ _ _t Y'5l.D 8•JO'J . (q __ _J_ _ _S__ ·-···· _______ -------1

L-'--·----;--~~ ---~~f.J ______ " ------·-±···--······. -----pU.~L---·· --------1 L_ __ . - -- ---- ------'"""-~-----------'

4. Sample Information: Sample Area ID: ____ 4. 2. A., R_J~. 1- '2:

. Descri tion b De th:

Depth s.u Type Soil sample 11r ·r-< Interval (Org; clay; Color

(cm) sand, etc.) re

D- If -~·_,\___ 'B(bl.J" 4'.!.. ~- ~_._}.\ ~ I. -1D 50 • \ __ ....... ·&~•'1>'-""-"--<-~---2.._f>._, !?::.::..~--

··-·--·-·-- ·- .. -------·--.--- .. Sampling Description

Surface litter type/depth, sample depth retention, x~.s~1_~t.o.~~ ?~_~k..!....~?_~graphy, erosion features)

~---·-~ It\ ---

-·· ·-·----....... ·---~-. .. _· .. ~=:~~-·-~-~-=±--1-------- I

----···---· ........ -l .... . ~··-···---·--··- ·--·-·-·-

Sample Recorded on Laboratory COC form and Contaiuer Labeled: {Y) (N)

10/20/15

Page 20: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date: /2-1.-l) Name: ·=r;; n '\?:iro ..... 11\

u1 I j ,.H \ .-Jo~; f. neat 1er: _ C.5_,,__.__,, .... C.J~:::>-"'-'1, :::1.' ___ _

1. Sample Area (SA):

SA Designation: ____ ':i_._.2/1._ __ . ... Description: Woe~~-~-------SA Origin Location: · ~---- ----·· ...... _,._,,___ Coord. System: ____ _

SA La;;d Mark Description:---·---· ... ·---·- ..... ___ _ Coord:

2. Sample Location Data:

Alternate Location Measurements (distance from SA origin and Local Coord.) X Dist iTom Origin (0,0)___L'/ A_,... Y Dist. from Origin: -~-.... f.~_,___

Site Sketch Atcii.ched (Yes) <@

Sample Location Description: ____ 1~;.._l)_<i-_d,.'!..\ .. N.-~ .. ,..~':\J'C'.~.~,,____ ___________ _

Canopy Type: -~:?LO... ______ Land Use: __ J:L1: 1'::~_Q1-- Soil Moisture (Wet, dry, etc.): 1)"'1

3. Locatio!J. Radiation Rea_~~-1-~~s_:~--.r-2x2 Na1 Bicron

(uRem/hr) Notes

(cpm)

Count time 1 cm l m l 1 r.m (min)

P>=~=-"=•=oo.J,~=====>=~~~=~<1=~----1---~-!F-=-~~-':"':'~·=-.,.=· -,=· ===~~=="""!

lm

1--------''---l---"-YJ . .:....;=..2...;,..'i _+--_'(4'i,{ .. , _____ ...... t....__ "- ...... ~5 ___ lll ...... 1J_t\ ..... , ___ --------·-'-~· ..... ,.__S"~f~f_Z _ _,__.~-~~~ -·---ll-'-rJ~lu.~....:.~-------------'I '-----~--~---~~- L ___ ... ~-.. - ··-- ····· ·----_________ __,

4. Sample Information: Sample Area ID: _4.'Ll-&¥-. __ '"i · l - ~J. .. )-(;:>

_..:..;;.__... __ -"----'L...-~--------~-·--- .......... ., __ ,, _____________ -.,

Sample JD Sampiil1g Description Soil Color l (Surface litter typeldepth, sample depth retention,

_____ .. -r~fusal, s~ne or rock, to ogra hy, erosion features) I R-· '4. \ _f:::' I p-..

J...!...:::::.=..=:...-+..;:;,,:,~_._,~--~u..:::::t,.»...~·.::..+-'-'-='Ze-...J?_.~.~ IV~-------------------; ......,. y. 1-~y,.~ ~II A

"---'----~-----~~A~~-:='·-~~ ~J..~-~·-- ·-----------l

Sample Recorded cm Laboratory COC form and Container Labeled· (N)

10/20/15

Page 21: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

. . r Weather: _~.1·-~-'"-

1. Sample Area (SA):

SA Designation: _4. 2 B Description: _\ ...... cl...-0<~-)~J~~--------SA Origin Location: --··----- Coord. System: ____ _

SA Land Mark Description: ·---- Coord:

2. Sample Location Data:

Sample Area ID: Lf • 2 D. R. I l\fatrix: ~L.. __

"' \r.l '?Cir. c ~ :_._'34. u ~

Alternate Location Measurements (distance from SA origin and Local Coord.) X Dist. from Origin (O,O)_clt'<'i Y Dist. from Origin: r-'I A"

Site Sketch Attached (Yes) c@ Sample Location Description: \N c .. c:Q-=- / ck.ltd h-.e.~, lgp.~,:::.; 'K"1 l.1~b~ b(l7.;"­

Canopy Type: .-.0..p.c.J'.l__ __ Land Use: J:L.~l'lf---- Soil Moisture (Wet, dry, etc.):_:I)r..4------ ___ . )

3. ·Location Radiation Reading.__s=-~,.-....---··--·-····--~-----------··-2x2 Nal H (cpm) ~

Bicron (uRem/hr)

Notes

4. Sa.mple Information; Sample Area JD: J~ 2.?:. K.. \. 1-'-l

Sample ID -1----- Sampling Description j (Surface litter type/depth, sample depth retention,

-'----+--~--'--~ ----1-----,---------+·· ~~f~sal, ston_e or rock, topography, erosion features)

~'----_;_-+---""""-'--'---J-""""-·~~-lf ..... :·-~-'~ • V-,1 .I f!J-k-'-----------------~

Soil Color

--+--- --+--~--+_Y_._zo_. R,. ~~HL~A~-----30 ... Li~ So: t '-"=>~-+--'--'-'' 2.=t3:.:..' • l, 3 Al ~~~-+29A--I-='--"'=-''"'-+---'--' 2=..:.....3 ~ .. .!? 'j ,<j 'Y{--J ~@=_,,.. '---------

· ·· -· ·---t-' -~------------" r----~------ -t·····------~-------i ~~--'--------'--~~-------'--

Sample Recorded on Labora.tory COC form and Container Labeled: .... (N)

10/20/15

Page 22: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Prqject: ___ ..t:lt..~-~-~-- ·--·-----· _ . .,(-

Weather: _(.A.~-~'1-·-·~

L Sample Area (SA):

SA Designation: 'f. 2'3 Description: _.\Ncx.d=...,S'----------SA. Origin Location: _ ---···------ Coon!. System: ____ _

SA LandMark Descriprion: ----·- ----···--·· Coord:

2. Sample Location Data:

Sample Area ID: ~ .'. (<.. "'1.. Matrix: ?~~-l __ _

Location Coord: _t,3_4~~~<-.' 1...J.J.,'' W 77" 62..' _i5.·& 0 ·•·

Alternate Location Measurements (distance from SA origin and Local Coord.) X Dist from Origiti (0,0)~/. A Y Dist. from Origin; ___,..J./-d__

Site Sketch Attached (Yes) ~

Sample Location Description: \:o'n± bt~-r Jead ~1 Lfp .. v-e 5 \

Canopy Type: .... 4~'\--. Land Use: -~U~m___ Soil Moisture (Wet, dry~ etc.):_~_ .J 3. Location Radiation Readim~:s:

2x2 NaI (cpm)

4. Sample Information:

·--···---·---r:-----------------. Bicron

(uRem/hr) Notes

----··----------------. Deptli Soil Type Soil Sample ID 1 Sampli11g Description

Interval (Org; clay; Color 1 (Surface titter type/depth, sample depth retention, _(cm) sand, etc.) ·-----· _!!--_fusal,~!on~ or rock, to~graphy, erosion features)

f----'o~-_;._l"S"'-'=----l~60:=...~~l __ ~=-:!'--'--j~~~·~-~=-=-'~R~.z_.1 __ Cl.::;C>:b___.~~---------~-l 1-s-~oQ 5o1 I _ -~_,..,~"'--'-+--='..:::2..c..:1"3=-', """-'' L=.:....."-=-('Vo~-----------------l

.._.3~0_-~lo_D_._S~u-· -_,I_,____. , .~il..:..:...· ·::::'-·:..::3-+1~--L-\s.!..=... _____________ -I

~- ·,"Id ·~?.:§•_ p,.J:::! __ _'(_ .N-1~------·-·-------------1

r-------+------·-+----t----·--··- -·-·--+·---------------------! 1

.__ __ _,_ ____ _,_ __ _,_ _______ _L_ ________ --7"'-"'t-:--------~__l

Sample Recorded on Laboratory COC for.m and Container Labeled: (N)

10/20/15

Page 23: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date: .. /2-°K_·-y(' P-roject ~'IS(: f.PA ____ _ • r:

\Vi::ather: _Q;J_~--\XX't\ i_(_l..Q..A.'1+.YO

1. Sample Area (SA):

SA Designa1ion: ___ 'i.L~.?- ........ ·---·-- Description: __,\0,...\~c~ecl:>="':!............--------SA Origin Location: ~------·- .. - ......... ---·-··- Coord .. System:-· SA Land Mark Description:·- _. -· .. ·-·---· .. _ .. ---· Coord:

2. Sample Location Data:

Sample Area JD: __ .!:£ ... ?-B.:_&~~--- .... i\.!atrix: 'QcuL.

~, 'Lli" 0'2.' ~s. s , 1..'-··-~ --·--··--·· -----·--·~ --

Alternate Location Measurements (di<:tance from SA origin and Local Cooni) X Dist. from Origin (0,0)...Njli____ Y Dist. from Origin: _d..J-ft __ _

Site Sketch Attached (Yes_! @» Sample Locarion De.;,cription: -~L±t:eJ' .... ·~., lcWJ.es....__ __

Canopy Type: _Q_:pe..o _____ Land Use: _t\.~\~~ Soil M6isture (Wet, dry, ctc .. ):_J::>.~ ...... _ .. _. J .

_}. Loc?tion Radiation .. Re~din_g~:_--.,...-----~- __ · _____ ..... r-·- .. ·-----------~ I 2x2 NaI ~ . Bicron · Notes I ~

{cpm) \• (uRem/hr)

4._ Sample Information: Sample Area ID: -.:lj-~ "B , 'R.. 3 I - \.o

Descri tion b De th: ·--.-----·--· ·~·------·

Deptft Soil Type Soil Sample fl) Sampling Description Interval (Org; clay; Color . I (Surface litter type/ depth,· sam pie depth retention,

(cm) sand, etc .. ) . t r

o-- Is"' V0

\\ ---T~;~. lf...:?-~-~ 3_~_..L.t" .'.:~~al, stone or rock, to:e£_graPhY, erosion features)

~/~ LL::..3.P. ~o ; \ ~flll"'" i "'· 2 [!, ..:_l?. .• ~!..:.G. A 'lA 3.J ·-le c.• ~il c;er-0 . '-'\It. .'i· z. 3. g.J.,..:.~- I .v w .. · u1:-i1i• .,,..,_....... i2. .. r ___ ::-JCO .~. : __ ..... +£a-_~ ·+~f3 ..... _~_J_._:t_ __ l _ .59 .. .J ·-'I Scr1a ~ s:o. \.

~.: .. ~~.\_JiG¥1......J2 .. t~~-i:I'-~.P· ..B::.:-1::§:... _~ .. Pl . ~ j_~-....5.....~ -~ Sc··\

------ --· l~_p- '.=_C-~-~!~~~ jQ~rl1~2-~ .. ::~~ .. -_!e __ '.)

Sam1>le Recorded on ·Laboratory COC form and Container Labeled: 0 (N)

10/20/15

Page 24: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

' SAMPLE LOCATION DATA SHEET

Date: \"7..11 (1L_ Project: 1'.H ~E R-1)ti _ -· _ ·-· Name: -S. tS,t.,.,.,

1. Sample Area (SA):

SA Desigriatfon: L\ . d-. 6 Description: ~l..,:u.-...:•)_·:-d._.:.....:··~-'--'\L-'Crt~--SA Origin Location: Coord. System: ----­SA Land ldark Description: Coord: ·-----·----

2. Sample Location Data:

Sample Area ID:_ .1.\. J_ . C!:, . k'. LI . I M . "· \ atnx: -=-.'..-~

Location Coard: L\ 'J" '.) l ' I If . I) •' .rJ

Alternate Location Measurements (distance from SA origin and Local Coord.) X Dist. from Origin (0,0)_ Y Di5t. from Origin: ___ _

Site Sketch Attached (Yes) ~o~

Sample Location Description: ~\~.t 1 f(·:rl(.cr·;, d":li* \~J-.v_~.:....· ):.._...:('--(_. \-'PJ:....;.f'_··)_,,1~-'--0-1----------Canopy Type: f'('J,,. ')y Ii\~·?'\ etc.):j~~- __

Land Use: \~y.. tic.,_ Soil Moisture (Wet, dry, -· j I .

3. L~cation Radiation Readings: 2x2 NaI Blcron

(uRem/hr) Notes

(cpm)

4- Sample Information:

D b D h ~cnption rv ept : l Depth Soil Type Soil Intenal (Org; clay; Color

{cm) sand, etc.}

0 =--!..S'. >----'--- ·- '-~lD~·· I b~~- .. ~ ... 1

1<; · ~o -h~~- \::,,:.,~-

·-· ,____ ____ , ____

Sample Areci ID: LJ , ·l. & . ~-~ . I - 1.

Sampling Description Sample/D=u (Su rface Jitter type/depth, sample depth retention, ~al, stone or rock, to~&raphy, erosion features) refu

. -Y.J.Df?..'"'·' I

<4, ~- & .. R . 4 , ~ . +~:: •.

-. .. -- -------------------1 ~-±==~- ··-·-l--L ___ .. - --Sam.pie Recorded on Labornfory COC form and Container Labeled: ~- (N)

10/20/15

Page 25: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

~­·~1~·

~ ~(. sm'VIC"eli" SAMPLE LOCATION DATA SHEET

Project: r-Jy :.i~ K oA Name: J. g 11';.A-~

1. Sample Area (SA):

SA Designation: _L\_._),_.£____ Description: _l.i_.J~_ .. d_. __ :-;\_\_er{-_______ _ SA Origin Location: ________ Coord. System: ___ _

SA Land Afark Description:---·-·-···-·--- Coord:

2. Sample Location Data:

Sample Area TD: - l..\. )_. e. R. s L Matrix: Sc-:_I __

Alternate Location Measurements (distance /Tom SA origin and Local Coord.) X Dist. from Origin (0,0) Y Dist. from Origin: ··----

~ Site Sketch Attached (Yes) ~~j

Sample Location Description: -f[r'd g1~•v.-.d ,_;_t~_,b_j-E"---~ f'J"·r.¥.->.--~: r,\3:;t:-l, (.:iJ .. .J~) ((\,Ju.:>~.) ~ --r-r t

Canop~ Type: p~•-'.!l ... r "I''\

etc.): ~::1-f---Land lfse: _ h,1~1~:·4+-lth_ __ Soil Moisture (Wet, dry,

3 L ti R d" ti R di . oca on a Ia. on ea ngs: 2x2 Nal Bicron Notes (cpm) (uRemfhr)

{min) ; .1c~ -Jm Counttime ~=r .lm

!==-' I_ ... = -9'1-~J~-·~ ·. ~~D ·--! 1--l-::; H -

---- __r. \'izc1"·~ r ... 1-:. ~« ~.'\<\.:t 14~7 · r .iJ rh1e r../r'! I .__l._. ·.i ... ~~~~~n ~ 1Y~ .... ___ . :.idkt"' n1.11· '2... 4 Lo(:D"IX'

·- .-l .. \ . .,+t'\ f'l""b. 41.J .. ft) J. 11.2..~.<J L. · qldJ.j.~

4. Sample Information: SampleArealD: 4.J..D.l<."S".1- .:l.

D b D b escnptron 'Y ept ---=µ--Dept It Sui/ T;pe Soil Sample 1D Sampling Description · llzterval (Org; clay; Color (Surface litter type/depth, sample depth retention,

(cm) sand, etc.) " .:.--· ref1:1saL stone or rock, topography, erosion features) !HS -h:~ii· I .61?-;""' ~ .1.. L) . R. _:_i,J . . . -IS-10 +(,~:<;1,,I b,r;,...,.., 4.'J..C,.(\.. 'S', :;i_ ···- ~:•.j Cjm ·-

-·· ·-

·--· ·-· --· -·--··-- ....... ·---·--- -·····--- --- .......

--·-·-~- ·-···~ .. -

··-·-Sample Recorded on Laburntory COC form and Container Labeled! ~ (N)

10/20/15

Page 26: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date: J3:.{tl£ Project: N "\ ".)f_ K;_DA- . -~- __ _

1. Sample Area (SA):

SA Designation: ~ . J. . 3 Description: _ w~d_. :._;1 ___ h+_ ... ______ _ SA Origin Location: . ----··-----···-- Coord. Sysrem: ____ _ SA Land Mark Description: .. ·--···--··- _______ __ Coord:

2. Sample Location Data:

Sample Area ID: ~ :;l. . (3. [<._. ( ~ Matrix: Sc:; j -~

Location Coord: .Y ).(; -)) ' I~ .J) '1 /J _]_~:;),' 33. 3J'_' \=:J,____

Alternate Location Measurements (dist.wee !Tom SA origin and Local Coord.) X Dist. from Origin (0,0) Y Dist. from Origin: ___ _

Site Sketch Attached (Yes) ·ti:NO)) Sample Location Description: +(~-, ~+-1...-..).::. iru:»di~..d.J-'~·-1'_-vt~~-(~c_(_;iJ-<~~-)~)-r-------Can~p:y Ty~: ~f\\\,1 IJyt.:i Land Use: h1b~5 ,_?n:. ___ Soil Moisture (Wet, dry, etc.).__Q.t"-M·.I-· - ..

3. Location Radiation Readings: -··--· .. 2x2 Nal Bicron Notes (cpm) (uRem/hr)

Count tim~ , ... - ..•

j .. ..

!cm lm lcm lm (min)

. ·~-·~~ L.~~-t-·~ -. c E~ ·~::~ .. IG -D'!i) -···- -------- _ __1 Bic..~., fl\::tZ~'tt 11.1'X'1. r.J dwlt r../,

IC. . I j 1 : -i-.. - .. wd~ ...... ., "iz."! I· z. v l . ..:Gll'IY

4. Sample Information:.

D b D h escnption 1y •ept -

Deptll Soil Type Soil ltiten'al (Org; clay; Color

(cm) sand, etc.) o·;S" -It~~~·.' t,~.l·..1'"'1 -1S ·1t· +c..,.c;6, \ bi..,,-....,.

l

---- ·-

~. ____ ,__j_, ...... -1-t- ...... b.;, '( 4 "/(;"ll" fl ). (,,•/ J. -( .:>.\ ~!\~

Sample Area ID: Lf.J-. 13. R .CJ-) ., (r ( 11,

·~-··- -Sample ID Sampling Descriptlon

(Surface li tter type/depth, sample depth retention, e or rock, to ogra hy, erosion features) ref.usal, ston

t..J .;).B :.r<. ~ .. f I -f-h.; cv•t5 q . d. e,. I(_{., ;). ~L...rf.;.;

-----·· ...

·->-·-·-·

·t=---·-·- .. . -- ·--···-· - --

...___.~. --· Sample Rocorded on Laboratory COC form and Container Labeled:~! (N)

10/20/15

In

Page 27: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date: J::~:.b 11 <;

1. Sample Area (SA):

SA Designation: 4 , d-. ·b _______ . Description: _ _,\.,_.,\)"""O_':i-'-d~_· ... ,'""'"i---'-'(J"--', ~----~-SA Origin Location: ---·· ·----- Coord. System: ____ _ SA Land Mark Description:_ ··----·- Coord:

2. Sample Location Data:

Sample Area ID: _ L..\ • d. .[3, - R.. . 1 Matrix: 1&J. .. __ LocationCoord: ~Ju":)~' !9 .77'1 :V __ t~_J_i4 .I/ If•!,,)

Alternate Location Measurements (distance from SA origin and Local Coord.) X Dist. from Origin (0,0) Y Dist. from Origin: ___ _

Site Sketc.h Attached (Yes) ~-?I)

Sample Location Description: +l<tl ,-h1 • ...- +~ '<-).~Jt·~""k"}, :Sc'<~6, d.\l.o.~ \ ~J.v~ ~ (c i P;uiJJ Canopv Type: t'>y'l..V\ Land Use: .hJb r~'.' ;k . Soil Moisture (Wet, dry, etc.): d11,,~--

3. Location Radiation Readings: 2x2 Nal Bicron Notes (cpm) (uRem/hr)

4. Sample Information:

D b D th escnption ~y ep; -·-· -·

Depth Soil Type Soil SamplellJ I Sampling Description lntenal (Org; clay; CO'/Qr J {Surface littt:r type/depth, sample depth retention,

(cm) sand, etc.) _ _ refl:!sal, stone or rock, topography, erosion features) _Q_:j£ ___ fr.,."'c· I L•=· ~"1 l1 . ~. 13 . rt. 1- .. ! ..C.0t i 1n.:.r.t'\

--...t......=:...~ -!S- :l.t, --f't,;.,..:i_oc I b,,,.~ ·-La. <5. R 1_ L .. _r_~~·.r'l._ l"V.:±r

·-· .•.

.... .......... - .. --~·

>------··- ····--·-··· ··-·-- ---~

······ -·--·- ····--··

--Sample Recorded o~ LaboratC>ry COC f~rm and Container Laheled=(CV:._;(N)

10/20/15

Page 28: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SA1'1PLE LOCATION DATA SHEET

Date: i,;, \,q.h__ Project: N"\ ~C:.RC_fu_-·----···-·Weather: cl.c.·A·-1,<-~·-'I 1u1~:·( ...... ?JJ'-'_5_· __

1. Sample Arca (SA):

SA Designation: ~L\_._J_._f!:i____ Description: l.1..:icd~J kl SA Origin Location: ___ _ Coard. System: -----SA Land Mark Description: ___ _ Coord:

2. SampJe Location Data:

Sample Area ID: ... Y · J.Y .f< · E' __ Matrix: ~i L-Location Coord: iJ.1;,-~l' ~o .10' 1 rJ _JJ. • J.' ?>~ .1·1 •_' """L.c,_) __ _

Alternate Location Measurements (distance from SA origin and Local Coord,) X Dist. from Origin (0,0) Y Dist. from Oiigin: ___ _

Site Sketc.h Attached (Yes) ~~

Sample Location Description: .f.h} :)or,.,t +n.~L . .R~ ~ c.k.'4'"} dv.:d. \-eo . .AJQ) ( c \, . .;.r<-AJ

Cano1A:' Type: ~-A-1~!1·.1 Of~!:L._:__ Land Use: }:.0:_i_r~} ... ~~---· SoiJ Moisture (Wet, dry, etc.}: , •J-M_,:1 __ _

~:__ l,ocation Ra~ia:tion Readings: _ ---------.,,,------------------, 2x.2 Nal -----ii Bicron Notes (cpm) (uRern/hr)

4. Sample Infon;nation:

Description by Depth:

G~w Soil Type Soil ntenal (Org; clay; Color

cm) sand, etc.) (). I<; -hn'<o;,.1 k·-t·t..,.,Y) ~-- "--· 'f-""-'-

I'S" JC + ..... -~,\ \,:i,.-,;,,._~ ·-···

.. ,_.........

~-

···- ....

"----·····

Sample Area ID: li · J.. ~ .rZ. '( g

Sample ID Sampling Descrlptirm (S urtace Jitter type/depth, sample depth retention,

isal, stone or rock, topography_, erC!_sion features) ref\

1-l. :i. .cs ./l_ .1_. ~~u-1' ", 6 I< ~_::l

~v.:. ('to'*..s . . 4,~_1cvt5 ____________ __,

I

--·~·-+·· ·----- --- .... ·-·-----------------!

I

Sample Recorded on Laboratory COC form and Container Labeled: (N)

10/20/15

Page 29: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

Date: /.2/}-\~ Project: ~_'i. __ ~_S·~_b:& ..... ····---

Weather: .. (1.~"1,-- .. 9.Q~f·-------·---·· __ .

1. Sample Area (SA):

SAMPLE LOCATION DATA SHEET

SA Designation: ___ tj_.__?.__~---·--- Description: ~_pD~->-----·--~-·---SA Origin Location: ___ ·-----· __ ·- ..... _ -·---- __ .. Coord. System:--·---SA Land A-lark Description:---··-·-- .. ··--··----- Coard:

2. Sample Location Data.:

Sample Area ID: _±i · 2. B...'.~ -. 'L._ ... ~Matrix: _;?g_J ___ --·

l . ( d Ai W "">"'~)"-,'-? ·"" .-... OCaflOn oor : J-:.>--J-.!.< . ... <e.~----··

Alternate Location l'vleasurements (distance from SA origin and Local Coord.) X Dist. from Origin (0,0) N_1A Y Disr. from Origin: ...r!J. r-... __

Site Sketch Attached (Yes) <@

Sample Location Description: _-W.M.~t·- .derctJ -bu,s1 ... ~u..~----·-··

Canop:y Type: Dpen ... __ . Land Use: ... J:'.hl~n)--- Soil Moisture (Wet, dry. etc.): U..:1"10 --·-

3~ Loc.?:.flt>.n Radiation Readin~ 2x2 NaI -·--··--Bi·croii ... ······--.-·-----Notes--··-

(cpm (uRtlm/hr) -

Descri tion b 'De th: Depth Soil Type Soil Sample ID 1--- - - ·- ·--- Sampling-Description. -

Interval (Org; clay; Color l (Surface litter type/depth, sample depth n:tention, 1

(cm) sand, etc.) -·. --·-··. _____ ret~s_a! •. ~!o_i:i~-~r__I_~c~. topo~hy, erosion feature~] ~~?- ~c ... l ' '-i. 2f~. R~. \ I ·.i.-'__,_f~Pr __ _

1s--sQ._P'9~- ~· __.... ·. 1 _:~_tt:...:- .. tl:'--1.l\ ______________________ _

~~. --=~=~~~r-=~-~~-1-~~-~~-------------i i

SampkRecordcd on Laboratory COC form and C~l!tainer Labei~-;-~ (N)

10/20/15

Page 30: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date: /2-Z··1S'

\\leather: cc~\""" - ~.. '

Project: -~$._(?. ~ P-~-- -----··· ·r .

Clv~1 _,, _ _!f__ct'~-

1. Sample Area (SA):

SA Designation: 4. 2 B Description: SA Origin Location: ______ ---·-· -··-····---- .. SA Land Mark Description: -----·---__ _

2. Sample Lo<:ation Data:

Sample Area ID: _...':LJ::_B. ... f?.: !.~--··- _Matrix: _SL'.,.L_ .....

Location Coord: 11_':12 ·' 32'" ________ _

\'1ov6 _s;..,...· ----~-Cuord. System: _ ....... _. ____ _

Coo rd:

Alternate Location Measurements tdistanc~ from SA origin and Local Coord.)

X Dist. from Origin (0,0)~--- Y Dist_ from Origin: -c.....,~,_..ZP<~--

Site Sketch Attached (Yes) ~

Sample Location Description: .. -~-aa.d~.J.~_v...~.r_:?.>_ .... _ ·-- ·---·

Canopy Type: 0 pe Y\

etc.): _Land Use: J:L._¥.,_~.,_"f\_"""l=+--- Soil Moisture (Wet, dry.,

----·

3. Location Radiation Readin s: 2x2 Nal . Blcron

(uRem/hr)

···--·--------------. Notes

{cpm)

4. Sample Information:

D b D th cscnption 1y ep·

Deptlz Soil Type Soil Interval (Org; clay; Color

(cm) -- sand, etc.)

0·- IS"' -~S--30 ,..._ ...

--····· ......• ·-----~ -·--·---

----·-- ··--

Sample Area ID:-~· "Z.1$, \Z.. l 0, 1-2.

----.·-·· .... ··-~·-------~ Sampling Description

. SamP/elD T (Surface litter type/depth, sample depth retention, ~~l!~~!f __ s~~~ or ro<:ls_.~pogt'aphy, erosion features)

t1~·zo·R--\o, 1 . ·--

1.j i ,-z.b.~~ \0.2_..j. t

----~--=~~--~~~:~ -1-- .. -----·-...... ··· --···---·----------···-------·· ·-···--·----------1

-- --- .. 1----·-----·---t-

Sample Recorded on Laboratory COC form and Container Labeled: (Y) (N)

10/20/15

Page 31: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date: J?.::.-7:::.:J.S_

1. Sample Area (SA):

SA Designation: ----~·_2_.B ____ ·-·- Description: __j£J_Q~~~-.__ ______ _ SA Origin Location: -·--·--·---- --·-- .... ·-···- .. ___ Coord. System: ____ _ SA Land Mark Description:_,. _______ ·····---~---- Coord:

2. Sample Location Data:

Sample Area lD: . ... ':J..~.]"'B, g_'.\\. .. _ ·--Matrix: __ 'So~_L .....

Location Coord: ... ~_l.) 32.'Jl_-'-·/ ·-·· \ < l 7'Y' l'I. z. I -~,-3 . 1?4 \\. -··~-- ·--·-·'.!i.._r ___ , __ .... ~ ....... ~ __ ..._..... __ _

Alternak Location Measurements (distance fi·om SA origin and Local Coord.) X Dist. from Origin (0,0)_tj_/ A Y Dist. from Origin: 1.,_/ ~1·'.:\~-

Site Sketch Attached (Yes)®

Sample Location Description: __ \tJ Oosh \J 1 (\4 ~ t--kc.'-\.1(.s._ I

Canop_y Type: ___Q_p .... :~/). ___ Land Use: _µ_i.~1-- Soil Moistur~ {Wet. dry.

(;tc.): DDf-- . -··--

3. Location Radiation Readin s: 1~·-· --·--··-·-""---· ~·--······-····-·-· 1 2x2 NaI Bicron

-·--------------Notes

( cpm ( uRem/hr)

4. Sample Information:

Deptlt Soil Type Interval (Org; clay; . (cm) sand, etc.)

-- !:{ Sc·,\

Soil Color

Sample ArM JD: !f...:J:..B .\Z.. I~, 1-1..

Sample ID -r--·-··-----·- . Sampling Descripti;;;---

1

(Surface litter type/depth, sample depth retention,

-·--·-··--···ref~~.h_stone or...£._o._~~..i.~~?J?£g_I"!1.Phy, erosiDn features) '2.\) .K.., I . ' I A ..

&_ _____________ ----!

·-----+-----+--- ~~= __ :~~-=:=--~-:=~~--- .. ·-----!

Sampl~ Recorded-:: LaooratorJ COC form ::tt_a_;ne:~~beled;@ (N) I 10/20/15

Page 32: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date: /l-..:..~:.IL

l. Sample Area (SA):

SA Designarion: L/, 2 3 Description: ___k!_c;.10d~· :')~--------SA Origin Location: Coard. System: _____ _

SA Land lvfark Description:. Coo rd:

2. Sample Location Data:

Sample Area ID: --·- 4, 2~ . ~: ... '-~:.·--Matrix: __ ~-'-'------..... ~ ~'"' "-Location Coord: JJ '-12u·{'l.' z.~,~r_'_.. ___J{.-J.]J __ Q~ -~-· 77

Alternate Location Measurements (distance from SA origin and Local Coord.) X Dist. from Origin (0,0) tJ) B __ w_ Y Dist. from Origin:~·--

' Site Sketch Attached (Yes) @ Sample Location Description: __ IJ-Jc.'lod~.i-- D'£?E'f'i, ~(-~;.Q,'l) .• \lr~:h.0_1~1 _________ .

Canopy: Type: -~~,,_, __ Land Use: ___ l1.~ .. bi. OG Soil Moisture (Wet., dry, etc.): Dry J

~. LocatiOn Radiation Re~-~!~gL __

1. __ ._,. -..... _,, ___ ,,_, ....... _. -~----

2x2 Nal j Bicron (cpm) : (uRem/hr)

Notes

4. Sample Information;

Description by Depth Depth I Soil Type Soil Slltnple ID - ·1··-·-· ...... _._ ... Sampli-;,g-D~;~~lpti~~-- ··--

l11terval (Org; clay; Color \ (~urface litter typeldepth, sample depth retention,

f---~( c_m_)'---+--sa_n_d""", e_t_c.-"-)-+-~·---i-· .... _. ___ --+ '.~t'~s!!_!" .:S.!?i:'.~ sir ro.ck, topograpb.J::, erosion .fS!i!.1:!:'re.~ 0·-1-S- ~o\\ Bl'='"'"" 'J,Z..l?:..~.1z..1 .NiP-r·

_ _IJ--3ei ,,., ,'\ ___ R...._t~C"~"·' .... __,__'-1~· Z..B .. J?.}L.Z.. N/ B ·------------------l

--··--·-- -----+----+--.. --·-·-·---+-·---·------------------l ~-----i-----t-----r---·--· -·-----~---·------ .. ------------<

~----<---·~--'--~--'--~--~-----------'~- ·---·--==:~.:====---=--=--=--=--=--=--=---=--=--=--=--=---=--: Sample Recorded on Laborato11· COC form and Container Labeled: eJ (N)

10/20/15

Page 33: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date: _n:-3-1 s: Project: ~_y$e.:~9f'I ____ -·-·-·-·-"

Weather: _I •9 ht n;_; n~_cJoJd't, _.tp··~

t. Sample Area (SA}:

SA Designation: __ 1. ?.-_&__ -· ........ _ ··-·· De~cription: W~?,___~--~~ SA Origin Location: ---·-- -··-·-····-·········-·--··· Coord. System; ·---·· _____ _

SA Land Mark Description: ---··-·· ____ _ Coord:

2. Sample Location Data:

. Sample Area ID: :. __ l[__ 2 B~ _?.. 13 . -· __ . Matrix: . ~ '-? ·. l ___ _

Alternate Location Measurements (distance from SA origin and local Coord.) X Dist. from Origin (0,0).--#-#1--··· .. Y Dist. from Origin:. /'.f-.J/ A'--'----

Site Sketch Attached {Yes} ® Sample Locatiun Description: __ JtJ_QQ_i:.\~ __ J.s..(o..6-.._h~ri.:~.,_l.ii~_\l_(_'l~-----------­

Cai~~l'Y. Type: ·-~-::>_f..D ..... -·--Land llsc: _ .H1.~b1---- Soil Moisture (Wet, dry. etc.)._OOf--- .. _ .

~-~oca~_ion Radiati~!l Re~dings: 2x2 NaI (cpm)

4. Sample Information:

Notes

··-~--·- . __ .,.,._. _____ Soil

Co/JJr

Sample 1.D··--r·· ··· ·-··· Sampling Description litter type/depth, sample depth retention, (Surface

refusal, sto Brw~ Lf;iB[C·,-?,-\---~ -~~l~- -

··--~. ~~~:.L<3_~ __ :~~-J;+~ _·-~---+------+------+----·---4------

.1!..e ":='~.roe~, toeograf!hy, erosion features)

·-·---· -·-···'-·--·· ·--~--·-······

-----···~··-·-

--L--;t,-;fed: {Q)i (N) '---~----~--~--------'~····---

Sample Recorded on Laboratory COC f~rm and Container

10/20/15

l

Page 34: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date: fl:::_3- t\ ___.:__ Project: N"l S6 ~t:>~- -· ·----

Weather: _._e l..,...()'1, L/r;t__!__ _____ _

1. Sample Area (SA):

SA Designation: 4. Z_\3 ________ _ SA Origin Location:

Description: _Y-),____,cx.<=-H=-)-=_".:>'----------­Coord. System:

SA Land Mark Description: ___ _ Coo rd:

2. Sample Location Data:

Sample Area ID:~~ ¥-.!j ___ Matrix: _-SJ'.~J---·-

.Location Coord: ~'i1''2..0.1c~·-···--·

Alternate Location Measurements (distanre from SA origin and Local Coord.) X Dist. from Origin {0,0) Ni r~ .. " Y Dist. from Origin:. t:J 1v~

' l

Site Sketch Attached {Yes) @ Sample Location Description: __ ___.W__o.QcLS. .. -t--.d...ed ~k~~-"-=~'-----------

Canopy Type: Q~ _____ Land Use. __H_,_6__nc., ___ Soil Mo1sture(Wet, dry,

etc.):. ~-=·~t' (

~- Location Radiation Read}!!,@:__........,.,. ____ _ 2x2 NaI

(cpm) · Bicron

(uRern/hr) Notes

~C=o~~m=nt=i~o£.~m~e""r __ -~· ~1 =c=m==-+====lm=~~li .1 cm. r ··--1~ : ·-·----- .... --- - ,

-~ :.~-~·,"-·---+--~~£ -·;0- JY~:~Y~=~~-=-·=·.""'.==9 ,____ __ ... ~- __]___ -- ,,_. \. _ _.,, ........ ·.·_· __ .1 ·--·--- - :-........ _ .... ___ --. ___ ,, ________ ,,_ ..

~-----·- ...,.___.... .... _ .... ----------·-

4. Sample Information:

D b D h escnptton •Y cpt Deptlz Soj/ Type Soil

Interval (Ow clay· 0' , Color (cm) sand, etc.)

_Q._- I~-- .. -S.D. l R·('b..r-

IS-- ~O Sc..1.L __ ~.""t> .. ,...K"'\

.... -·-·-···---.. ·--~

-

>-----.. F·-··--.. ....-· ---- ·--------~

·------.. ·---\,. ·--... - ... --- Sampling DescriptT;;,;-·--Sample JD

'-l-'Z~.R ,11-t,

i l\ . z & .12· 14 .

·----~- ................. ~ ..

{Surface litter type/depth, sample dep_ th retention, -·· -~~fusal, _:;~~~~ o~ rock, topography, erosion features)

,_,,, .. .H.1-·~----,-----------------; z _a;>o+ -

-------- -·------.. ·----

--··---~·--··-

=t~----------~ Sample Recorded ou Laboratory COC form and Container Labeled: (N)

10/20/15

Page 35: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date: _ 11--s-rs _

l. Sample Area (SA):

SA Designation: __ _J__,_ L3 Description: _V\l OQd '.) --~-SA Origin Location: -·- ---·--- _______ ------------ Coord. System:--------------SA Land Mark Description:---------------·-- __ ------·------- Coord:

2. Sample Location Data:

Sample Area ID: .. D~ ·.B-1~- __ _ Matrix: _ .:?oJ .. __ _

Alternate Location Measurement~ (distance from SA origin ai1d Local Coord.) X Di5t. from Origin (O,D)_~--t-ft-- Y Dist. from Origin: __ J: .. JJB__

Site Sketch Attached (Yes) @ Sample Location Description: __ _jN_c~~1 ___ dA:~_4 __ ~.-- L:::<;:~-:'.)---------~--

Canopy_ Type:_ Ope D ___ Land Use: _t:\.!'-~~:il('}--- Soil Moisturi; (Wet. dry, etc.):_!J-~-- __ _

3:_ Loe=!!!()~ Radiation Readings: 1

___ -·--- _______ __ _ __ ·-------------------. 2x2 Nal Bicron Notes (cpm) (uRem/hr)

4. SampJe Information:

Descri )tion b De th: Deptlt Soil Type Soil Sampi~-W-- ·r--- -----Sampling Description

Interval (Org; clay; Color 1· (Surface litter type/depth, sample depth retention,

r-----::-(c_'m~)~--r---sa_n_d~, _et_c~.)--i-- -----1------ _ r~f~~~h_s!9~~r ro~~.?J.£12£.~~.!.1Y, erosion features) O--IS"" $:,:> \ i~, 2.iS. i?-.fi,1. tJ1 fr

~..J..l..C..,~.:..J· ~:~i~----·=·=---1.S- ----~- ----·----· ·--- -- ________ __J__ ___ ----- ----------- -- ------ - ~~_L- ---

---- - ---- ------ --------- --------------f-----· - -- i ----------~-----i

Sampt~ Recorded on Laboratory CO(' form and Co~taine1· I~-b~l~d; ~ (N)

10/20/15

Page 36: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DAT A SHEET

Date: _a:}__:j_f.._ Project:--~~--~----·----·-· Name: To ... ~. ~v-•1 ---

Weather: _.S~.'?.~'t. ~o"~-----····-·-·-

1. Sample Area (SA):

SA Designalion: '1. 2.~ ----· ··- Description: \,J oqd.".:>: ________ _ SA Origin location: --·-----··- _ ·····---- Coord. System: _____ _

SA Land }vfark Description: __ ~-·--··--····--·--- Coo rd:

2. Sample Loc~tfon Data:

Sample Area ID: t.-f, 2B, 12.Jv ___ ... Matrix.: __ 2£~-~'

_\!.:: 11_<-~0- ~~---ii-\, I~

Alternate Location Measurements (distance from SA origin and Local Coord.) X Dist. from Origin (0,0) //VJ- 'V Dist. from Origin: /'1 p.

Site Sketch Attached (Yes) @ Sample Location Descrip~ion: __ ._"~_QQ_.i~, ~-.: )__,___x]?J.l..D ___ .. _____ _

Canopy Type:-·--~· Land Use: .B..d~r'l SL)i! Moisture (\Vet, dry. etc.): De-~~

3. Location Radiation ReadinO"s; ,....:;_:__:::;..:...=::.; _ _.;...;c__..-=.._=.=___:_c--'--'-'-_:....;...=.:..;_-~--····--·· .... ···--···....,..-----------

2x2 Naf {cpm)

Bicron (uRem/hr)

Notes

4. Sample Information;

-----··-·---1------1---·---·--T-------~------------j

·-·-···········- --1 ···--····--·--- ----------·-·-- ·-··· ·- ....... ___ ..._,

------ ·-------, :-- ... ·--l-=-~-· =--=--=----_-----·-. ··-····-·--······-··---Sample Recorded on Laboratory COC form and Coutniner Labeled: (N)

10/20/15

'

Page 37: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date: ./_?_-~~£ Name: .T.~, .. ~ ~ __ _

Weather: __ tl~;--!f..O..~.!-· -·---·-··-

1. Sample Area (SA):

SA Designation: 4. 2 ~ ______ Description: _J;-Jou~d~)~----SA Origin Location: ____________ .. Coord. System: __ _

SA Land Mark Description: Coard:

2. Sample Location Data:

Sample Area ID: -~L/ .2~ 1 K~.f.7. ___ Matrix: _$' o _ _J ____ _

Location Coord: _!':) i./b'"Ji:.. 11, U! • ~ W 7 t;" (.)1' 3'-1· 7G ~~ ··--·-~• •r .. -·--~----

Alternate Location Measurements {distance from SA origin and Local Coord.) X Dist. from Origin (0,0)_..N J ~ Y Dist. from Origin:~! (:-

Site Sketch Attached {Yes) @

Sample Location Description: ---~Douj ~-,.--~--~:L_±n:e.s.--1-1~"1..-\ DM"\\) lgo.\Jt' ')

Canopy Type: ~ o ·--·Land Use: -~n.£1- Soil Moisture (Wet, dry, etc.):~~~ )

·3. Location Radiation Readin2s: 2x2 NaI (cpm)

Bicron (uRem/hr)

·-~·· ····~· ~. ~··~·

Count time I cm Im 1 cm 1 m

----·------··---~

Notes

-.~~~r- . ~ ·Y1 c;. .. .. <t_lli_.,_ ..... :· ·-··--~"7;-:.t~s==----·'~-· '··~ 1 ~--------=-~="_·:=~:.:_--_'" _·-_ __, . I .. -.-~_R_ _____ ~:1l[ --~±~--- _____ ~--=-~---·----------!

4. Sample Information: Sample Area ID: _'-I ·'2.0 .K.._•7~ Fl

D b D h escnotmn IY ept ,. ~- T------···-· -·-·· -

Depth Soil Type Soil Sample JD · Sampling Description 111terval (Org; clay; Color (Surtace litter type/depth, sample depth retention,

(cm) sand, etc.) refusal, ~~O_!!~ or rock, topogra2hy, erosion features) 0--1-::- s"()·ll ·- &·~~-.- L{. 2-~-~ ,(J, I .. ~L~)... 1<:-< Q_ Sci,\ l"R~ ......... L\, 73. i2~/. z....._ ./\)l~

' ·-····· ···--

- '--"------i----- ~--··-· ·--· ·--. . ... ............ ..

I t ..

I -~t--·-·-------- .

Sample Recorded on Laborafory COC form and Container Labeled: CJ (N)

10/20/15

Page 38: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

SAMPLE LOCATION DATA SHEET

Date: .1.l.-.::,:3-1) . Project: _N't~eg~--- --··--· _

Weather: _.C.\ AA.1 , 4t:f.. .. ~. ·-------

1. Sample Area (SA):

SA Designation: __ 1i_~6_ ........ _ Description: _1'1._g;d_S__ _____ .. __ . _______ . SA Origin Location: __________ .... ··-· _____ Coord. System: ____ _

SA Land Mark Description:--···-·- ..... _ -····---· __ Coard: .... ____ _

2. Sample Location Data:

Sample Area ID: __!t!_?~ .~:\&: .. ____ Matrix:.~-~)-.. -

Location C'oord: _tJ..j ?...~ ·~2~ /1·J7~ --~iLQ~~.3~·s'-'-'-"~~-"'----

Alternate Location Measurements (distance from SA origin and Local Coord.) X Dist. from Origin (O,O)____t:~_ Y Dist. from Origin:. J.J l t~

Site Sketch Attached {Yes) ~

Sample Location Description: \-1~.~J;_~\,-\- f.:._n.:::;)\..__ l.Qf~~-~--­

Canopy Type: Of?t?n ··--··-· ... Land llse: ... J::i!..k.~11'.i--- Soil Moisture (Wet. dry. etc.): U,~.-~.Li. -· J ·

3. Location Radiation Readings: · ._ •-••••--""'----------·•·-""J.------'•r••••• ,. ·---·-·-.-.,-.------------~

2x2 NaJ · Bicron Notes (cpm) (uRem/hr)

4. Sample Information:

Soil Sample ID -r-:--- Samplir~g-D~~crfption.

J (Surface titter type/depth, sample depth retention,

1--'---<---+--"---'--1----+-----·· _i:_~fusal, stone or roe_~ topogl_ap_h.~, erosion fe~tures) --+-:_t .• 23.U...111. .. L.tr..Jlt __ ---------------i

Colar

,z?:. .tz... f-6', -z. --~~_,_fr_ ______ . ________ ----·

·-· ---+----+-':8-o-·:.i.~:i~'~·.s:. t=~\1.\-------·-·-····-··-····--------------<

>-----+--···--···-····--·· ·----·-- ·'"··-------. ..l-~-·-------------------' I I --·-·-- -····-·- ------··---·1·--···---~----------------i

Sample RecOC"ded on Laboratory COC form 11~;:.h=.:i~;;;-;iner Labeled@ (N)

10/20/15

Page 39: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

. '

SAMPLE LOCATION DATA SHEET

Weather: -~!':,~~~-~f

1. Sample Area (SA):

SA Designation: -:/, 2.. C -----·---- Description: -~W=cco==---=-d;)=----------SA Origin Locacion: Coord. System: ____ _

SA Land Mark Description .... --·-····-- __ ··--- Coo rd:

2. Sample Location Data:

Sample Area ID: 1(. 2..C. R: ... _l __ Matrix: _S_!l_.J_ ....

Location Coo rd: _ N '1 i:= ~.t i 3 • o 'i "

Alternate Location Measurements \distance from SA origin and Local Coord.) X Dist. from Origin (0.0)__1'/J_Es..___ . Y Dist. from Origin: · f'JI Pr

Site Sketch Attached (Yes)§>

Sample Location Description: Woc..-d:s, ~6. ·~s. 1 __,~={)..~·=v<~S--.. ________ ~

Canopy Type: ~-Q-Fe.n._- ___ Land LI se: -~~--Soil Moisture (Wet, dry, etc.): -----1:).c.'1=-----

,.....3 __ L_o_c.~tion R3diation Rcadi_n~t~~:s·_. -......----·---·· ·----~---------------. 2x2 NaI (cpm)

Bicron (uRemfhr)

Notes

Count time - ,-cm 1 ··- Im I cm T -1 m - i g ;c.~~' ~~~·~{;· ~i-!-~-J-(min) ·~· _ _ . -~~L~ ... , _ <.,,,., <!."'-' ,, z,; 1 tt

=~L-. ~171 ~~~.Q ______ . .__5.-·-±- 5· l.-.,?.·. LuDL-<.l'v"'- 1-j"'!·ID

~-~I_.-... ___ 'i-'? _I "i~_,__~'6_1--·-l------·-· .. __ _ -------~:!, ---~-•_i c..._~-~-'-=I"R.:..:..I ~"-\\'""''2.;;_7_W_..;._A_"l._~_.i.i1.1--l --- ___ _,_____ _____ ..___ ____ -"-~ __________ .L ___ . ~--_,c~·J;\.=11~c1.u=·-c:~_<t..._J--i_,J"'"J""--~------'

4. Sample Information: Sample .l rea ID: n~ . I~ • l - 1-'1

Soil Sample ID·---i---- Sampiing Description · 11· (Surface litter typefdepth, sample depth retention,

1---'----t--~--'--+--·-----+------- refusal, sto~.7 or rock, topography, erosion features} 1---0_·-_\_.;_-i---;~=c;;'-'· -._,_\ __ -+-B~ll:"-'"". =-""-'-! 4. '-c. R .\. 1 £~

Color

IS-- 3-.o 1 ·s rn"""' ~"L~-:Z:- .. --ro-o-~-----------------;

--t-~,.-'---,---~ .4.7.C.. ~ ... __._t "-"'~=---t-'~--'-------------------1 BID........ ._f.~1l.. t. <-/ __ , .. ,c:'tk._------------------;

······--~---l--·-·-----+----------------------1

... -·--· ······---!-----··-··--··-_____________ __,

-~-------L-------___,,,=.,-----------' Sample Rec-0rded on Laboratory COC foTm and Confajner Labeled: (I\')

10/20/15

Page 40: App E Sub-Area 4.2 -COC Forms·-· usce for GEL's Snmple Acceptance SOP** Charleston, SC 29407 COC Nnmhcr \'l: GEL Work Order Number: Phm:~: {843} 556-&17 l PO Number: Fox: (R43) 766-l

' '

SAMPLE-.LOCATION DATA SHEET

Date: 12· 7-l';l Project: N)'St..i?:U-ft.... ... __ _ N ---· ~ ame: Ice ~'"'

•. f Weather: _ ~..._1-.:..,......,.......:c-'. 1...::.0_·'~~~'-t. _'f=-b ___ _

1. Sample Area (SA):

SA Designation: 'J ·2C Description: _v~Ju:-==-=-,,.:C .... .:s"'""---------

SA Origin Location: Coord. System: ____ _

SA Land 1Wark Description: ··--------· -Coord:

2. Sample Loeatfon Data:

Sample Area JD: _J__. ZC. ~ L. Matrix: ... ~9..:J .. ___ _

Location Coord: ~.'1Z '~51.: ·u . &"-\"" -~ 7<.i "C· '2' i3 o. D \~-

Alternate Location Measurements (distance from SA Clrigin and Local Coord.) X Dist from Origin (0,0) rJj ~ Y Dist from Origin: t-J{ Pr

Site Sketch Attached (Yes) (® Sample Location Description: \,.,) uc:.6.~ I t~ \)lv,s \-\ ( ·Ji ilJ. st 1£0...1-r 5

Canopy Type: $~-i=--t\ ___ Land Use: \.t~~ Soil Moisture (Wet, dry, etc.}: 1?-'--C"1-+--- /

.3. L-0cation Radiation Readings: 2x2 Nar ~ Bicron Notes (cpm) (uRemnir)

- - ··- ·- - . ·i , ~~";\-;--ur~i.:(;·r rz::J!3;z:.· Count time lcm Im !cm lm

ti61-'o.l '2.L.t. (min)

- .. - .... ··- • G:u d.ve• ct /-z,J J ~

J !?~ 4t11 ~1.8" " 4· '.f-1"-Z· Lu J~1..-0 ..... 'l'f -10

I ~~3 qi.IS"'( ::e,.,,,\ .ff P1i~u.~ -i.1 i:t' j\ z.:z. 't e;, -~ - i Ct<. r d..(...'\!'.~ 'IS' J.o

4. Sample Information; Sample Area ID: 't. Z C. ii:..1. . j - 2

D b D h escn.pt1on 1y ept : Depth Soil Type Soil Sample ID Sampling Description

Interval (Org; clay; Color (Surface litter type/depth, sample depth retention, (cm) sand, etc.) refusal, stone or rock, topography, erosion features)

'SC.\ q. 2.S.,, R.: __ i.. I ·--·--0-lt" 2>~ l:"J r-r-· l~-:b 60~ \ R1111\/' 4 . z . .c. (2. . '- • '2: NI~

I

l ..

-·-· ! --··-----·- --~-t---·--· I

-~

Sample Recorded on Laboratory C'OC form and Container Labeled:(;> (N)

10/20/15