1 2 3 4 5 ANALYTICAL REPORT 6 10 -...

ANALYTICAL REPORTTestAmerica Laboratories, Inc.TestAmerica Burlington30 Community DriveSuite 11South Burlington, VT 05403Tel: (802)660-1990

TestAmerica Job ID: 200-42450-1Client Project/Site: Former Ithaca Gun Factory #C755019A

For:New York State D.E.C.615 Erie Blvd., WestSyracuse, New York 13204

Attn: Gary Priscott

Authorized for release by:3/21/2018 1:35:43 PM

Judy Stone, Senior Project Manager(484)[email protected]

The test results in this report meet all 2003 NELAC and 2009 TNI requirements for accreditedparameters, exceptions are noted in this report. This report may not be reproduced except in full,and with written approval from the laboratory. For questions please contact the Project Managerat the e-mail address or telephone number listed on this page.

This report has been electronically signed and authorized by the signatory. Electronic signature isintended to be the legally binding equivalent of a traditionally handwritten signature.

Results relate only to the items tested and the sample(s) as received by the laboratory.

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mailto:[email protected]

I certify that this data package is in compliance with the terms and conditions of the contract, both technicallyand for completeness, for other than the conditions detailed within the body of this report. Release of the datacontained in this sample data package and in the electronic data deliverable has been authorized by theLaboratory Manager or his/her designee, as verified by the following signature.

Judy StoneSenior Project Manager3/21/2018 1:35:43 PM

Client: New York State D.E.C.Project/Site: Former Ithaca Gun Factory #C755019A

TestAmerica Job ID: 200-42450-1

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Table of Contents

Client: New York State D.E.C.Project/Site: Former Ithaca Gun Factory #C755019A

TestAmerica Job ID: 200-42450-1

of 27TestAmerica Burlington

3/21/2018

Cover Page . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Table of Contents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Definitions/Glossary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Case Narrative . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Detection Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Client Sample Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

QC Sample Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

QC Association Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Lab Chronicle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Certification Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20

Method Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21

Sample Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Chain of Custody . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Receipt Checklists . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26

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Definitions/GlossaryTestAmerica Job ID: 200-42450-1Client: New York State D.E.C.

Project/Site: Former Ithaca Gun Factory #C755019A

Qualifiers

Metals

Qualifier Description

4 MS, MSD: The analyte present in the original sample is greater than 4 times the matrix spike concentration; therefore, control limits are not

applicable.

Qualifier

Glossary

These commonly used abbreviations may or may not be present in this report.

¤ Listed under the "D" column to designate that the result is reported on a dry weight basis

Abbreviation

%R Percent Recovery

CFL Contains Free Liquid

CNF Contains No Free Liquid

DER Duplicate Error Ratio (normalized absolute difference)

Dil Fac Dilution Factor

DL Detection Limit (DoD/DOE)

DL, RA, RE, IN Indicates a Dilution, Re-analysis, Re-extraction, or additional Initial metals/anion analysis of the sample

DLC Decision Level Concentration (Radiochemistry)

EDL Estimated Detection Limit (Dioxin)

LOD Limit of Detection (DoD/DOE)

LOQ Limit of Quantitation (DoD/DOE)

MDA Minimum Detectable Activity (Radiochemistry)

MDC Minimum Detectable Concentration (Radiochemistry)

MDL Method Detection Limit

ML Minimum Level (Dioxin)

NC Not Calculated

ND Not Detected at the reporting limit (or MDL or EDL if shown)

PQL Practical Quantitation Limit

QC Quality Control

RER Relative Error Ratio (Radiochemistry)

RL Reporting Limit or Requested Limit (Radiochemistry)

RPD Relative Percent Difference, a measure of the relative difference between two points

TEF Toxicity Equivalent Factor (Dioxin)

TEQ Toxicity Equivalent Quotient (Dioxin)

TestAmerica Burlington

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Case NarrativeClient: New York State D.E.C. TestAmerica Job ID: 200-42450-1Project/Site: Former Ithaca Gun Factory #C755019A

Job ID: 200-42450-1

Laboratory: TestAmerica Burlington

Narrative

Job Narrative200-42450-1

Receipt The samples were received on 3/2/2018 10:00 AM; the samples arrived in good condition, properly preserved and, where required, on ice. The temperature of the cooler at receipt was 2.9º C.

Metals

Method(s) 6010C: The samples were air dried, and then run through a #4 (4.75mm) sieve to eliminate larger portions of the sample that would interfere with sample analysis. A 2-D slabcake was then used for incremental sampling to provide a 10g aliquot for analysis. The digestion was a modified process in which the 10g aliquot was divided up into 5x2g aliquots to ensure complete digestion of the sample.

The 5 digested aliquots where then combined after digestion to create one representative aliquot of 500mL for the analysis. Subsequent

dilutions were required to get the sample concentrations within the calibration range for the target analyte.

Method(s) 6010C: Due to sample matrix effect on the internal standard (ISTD) Indium, a dilution was required for the following samples: SS008B (200-42450-13), SS009B (200-42450-14), SS010B (200-42450-15) and SS014B (200-42450-16), SS018B-2 (200-42450-21), (200-42450-A-21-H MS), (200-42450-A-21-I MSD) and (200-42450-A-21-G PDS).

Method(s) 6010C: Due to the high concentration of Lead, the matrix spike and matrix spike duplicate (MS/MSD) for preparation batches 200-127333 and 200-127355 and analytical batch 200-127566 could not be evaluated for accuracy and precision. The associated laboratory control sample (LCS) met acceptance criteria.

No additional analytical or quality issues were noted, other than those described above or in the Definitions/Glossary page.

Geotechnical Method(s) Sieve/MIS: This is sieve only through a #4 sieve per client direction prior to incremental sampling.

No additional analytical or quality issues were noted, other than those described above or in the Definitions/Glossary page.

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Detection SummaryTestAmerica Job ID: 200-42450-1Client: New York State D.E.C.


Client Sample ID: SS001C Lab Sample ID: 200-42450-1

Lead

RL

4.9 mg/Kg

MDL

1.0

Analyte Result Qualifier Unit Dil Fac D Method Prep Type

Total/NA103110 6010C


Lead

RL

0.91 mg/Kg

MDL

0.19


Total/NA2480 6010C


Lead

RL

23.6 mg/Kg

MDL

5.0


Total/NA5014000 6010C


Lead

RL

3.6 mg/Kg

MDL

0.77


Total/NA81630 6010C


Lead

RL

93.6 mg/Kg

MDL

19.7


Total/NA20069800 6010C


Lead

RL

9.7 mg/Kg

MDL

2.0




Lead

RL

9.7 mg/Kg

MDL

2.0




Lead

RL

9.6 mg/Kg

MDL

2.0




Lead

RL

2.3 mg/Kg

MDL

0.48


Total/NA51220 6010C


Lead

RL

46.5 mg/Kg

MDL

9.8


Total/NA10025000 6010C



This Detection Summary does not include radiochemical test results.

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Client Sample ID: SS011C (Continued) Lab Sample ID: 200-42450-11

Lead

RL

92.3 mg/Kg

MDL

19.4


Total/NA20061000 6010C


Lead

RL

18.9 mg/Kg

MDL

4.0


Total/NA4011100 6010C

Client Sample ID: SS008B Lab Sample ID: 200-42450-13

Lead

RL

2.3 mg/Kg

MDL

0.48


Total/NA536.5 6010C


Lead

RL

2.3 mg/Kg

MDL

0.49


Total/NA56.7 6010C


Lead

RL

2.3 mg/Kg

MDL

0.49


Total/NA528.3 6010C


Lead

RL

2.3 mg/Kg

MDL

0.48


Total/NA5101 6010C


Lead

RL

1.9 mg/Kg

MDL

0.40


Total/NA4800 6010C


Lead

RL

1.9 mg/Kg

MDL

0.40


Total/NA4717 6010C


Lead

RL

18.3 mg/Kg

MDL

3.8


Total/NA4011800 6010C

Client Sample ID: SS018B-1 Lab Sample ID: 200-42450-20

Lead

RL

91.2 mg/Kg

MDL

19.2


Total/NA20040700 6010C

Client Sample ID: SS018B-2 Lab Sample ID: 200-42450-21



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Client Sample ID: SS018B-2 (Continued) Lab Sample ID: 200-42450-21

Lead

RL

24.0 mg/Kg

MDL

5.0


Total/NA5011500 6010C



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Client Sample ResultsTestAmerica Job ID: 200-42450-1Client: New York State D.E.C.


Lab Sample ID: 200-42450-1Client Sample ID: SS001CMatrix: SolidDate Collected: 02/28/18 10:10

Date Received: 03/02/18 10:00

Method: 6010C - Metals (ICP)RL MDL

Lead 3110 4.9 1.0 mg/Kg 03/12/18 10:19 03/15/18 18:02 10

Analyte Dil FacAnalyzedPreparedUnit DResult Qualifier




Lead 480 0.91 0.19 mg/Kg 03/12/18 10:19 03/15/18 18:22 2





Lead 14000 23.6 5.0 mg/Kg 03/12/18 10:19 03/15/18 18:29 50





Lead 1630 3.6 0.77 mg/Kg 03/12/18 10:19 03/15/18 18:55 8





Lead 69800 93.6 19.7 mg/Kg 03/12/18 10:19 03/15/18 19:02 200





Lead 4830 9.7 2.0 mg/Kg 03/12/18 10:19 03/15/18 19:08 20





Lead 4440 9.7 2.0 mg/Kg 03/12/18 10:19 03/15/18 19:15 20



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Lead 5160 9.6 2.0 mg/Kg 03/12/18 10:19 03/15/18 19:21 20





Lead 1220 2.3 0.48 mg/Kg 03/12/18 10:19 03/15/18 19:28 5





Lead 25000 46.5 9.8 mg/Kg 03/12/18 10:19 03/15/18 19:34 100





Lead 61000 92.3 19.4 mg/Kg 03/12/18 10:19 03/15/18 19:41 200





Lead 11100 18.9 4.0 mg/Kg 03/12/18 10:19 03/15/18 19:47 40


Lab Sample ID: 200-42450-13Client Sample ID: SS008BMatrix: SolidDate Collected: 02/28/18 08:15



Lead 36.5 2.3 0.48 mg/Kg 03/12/18 10:19 03/16/18 16:16 5





Lead 6.7 2.3 0.49 mg/Kg 03/12/18 10:19 03/16/18 16:23 5



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Lead 28.3 2.3 0.49 mg/Kg 03/12/18 10:19 03/16/18 16:30 5





Lead 101 2.3 0.48 mg/Kg 03/12/18 10:19 03/16/18 16:36 5





Lead 800 1.9 0.40 mg/Kg 03/12/18 10:19 03/15/18 20:41 4





Lead 717 1.9 0.40 mg/Kg 03/12/18 10:19 03/15/18 20:47 4





Lead 11800 18.3 3.8 mg/Kg 03/12/18 10:19 03/15/18 20:54 40


Lab Sample ID: 200-42450-20Client Sample ID: SS018B-1Matrix: SolidDate Collected: 02/28/18 09:30



Lead 40700 91.2 19.2 mg/Kg 03/12/18 10:19 03/15/18 21:00 200


Lab Sample ID: 200-42450-21Client Sample ID: SS018B-2Matrix: SolidDate Collected: 02/28/18 09:35



Lead 11500 24.0 5.0 mg/Kg 03/14/18 10:03 03/20/18 11:48 50



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QC Sample ResultsTestAmerica Job ID: 200-42450-1Client: New York State D.E.C.


Method: 6010C - Metals (ICP)

Client Sample ID: Method BlankLab Sample ID: MB 200-127274/1-AMatrix: Solid Prep Type: Total/NAAnalysis Batch: 127444 Prep Batch: 127274

RL MDL

Lead ND 0.50 0.11 mg/Kg 03/12/18 10:19 03/15/18 17:43 1

MB MB

Analyte Dil FacAnalyzedPreparedDUnitResult Qualifier

Client Sample ID: Lab Control SampleLab Sample ID: LCS 200-127274/2-AMatrix: Solid Prep Type: Total/NAAnalysis Batch: 127444 Prep Batch: 127274

Lead 5.00 4.76 mg/Kg 95 80 - 120

Analyte

LCS LCS

DUnitResult Qualifier %Rec

Spike

Added

%Rec.

Limits

Client Sample ID: Lab Control Sample DupLab Sample ID: LCSD 200-127274/3-AMatrix: Solid Prep Type: Total/NAAnalysis Batch: 127444 Prep Batch: 127274

Lead 5.00 4.88 mg/Kg 98 80 - 120 3 20

Analyte

LCSD LCSD


Spike

Added

%Rec.

Limits LimitRPD

RPD

Client Sample ID: Method BlankLab Sample ID: MB 200-127355/1-AMatrix: Solid Prep Type: Total/NAAnalysis Batch: 127566 Prep Batch: 127355

RL MDL

Lead ND 0.50 0.11 mg/Kg 03/14/18 10:03 03/20/18 11:35 1

MB MB

Analyte Dil FacAnalyzedPreparedDUnitResult Qualifier

Client Sample ID: Lab Control SampleLab Sample ID: LCS 200-127355/2-AMatrix: Solid Prep Type: Total/NAAnalysis Batch: 127566 Prep Batch: 127355

Lead 5.00 5.06 mg/Kg 101 80 - 120

Analyte

LCS LCS


Spike

Added

%Rec.

Limits

Client Sample ID: SS018B-2Lab Sample ID: 200-42450-21 MSMatrix: Solid Prep Type: Total/NAAnalysis Batch: 127566 Prep Batch: 127355

Lead 11500 2.44 15370 4 mg/Kg 15792

2

80 - 120

Analyte

MS MS


Spike

Added

Sample

Result

Sample

Qualifier

%Rec.

Limits

Client Sample ID: SS018B-2Lab Sample ID: 200-42450-21 MSDMatrix: Solid Prep Type: Total/NAAnalysis Batch: 127566 Prep Batch: 127355

Lead 11500 2.42 16660 4 mg/Kg 21233

0

80 - 120 8 20

Analyte

MSD MSD


Spike

Added

Sample

Result

Sample

Qualifier

%Rec.

Limits LimitRPD

RPD


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QC Association SummaryTestAmerica Job ID: 200-42450-1Client: New York State D.E.C.


Metals

ISM Prep Batch: 127212

Lab Sample ID Client Sample ID Prep Type Matrix Method Prep Batch

Solid Sieve/MIS200-42450-1 SS001C Total/NA












Solid Sieve/MIS200-42450-13 SS008B Total/NA







Solid Sieve/MIS200-42450-20 SS018B-1 Total/NA

Prep Batch: 127274


Solid 3050B 127212200-42450-1 SS001C Total/NA












Solid 3050B 127212200-42450-13 SS008B Total/NA







Solid 3050B 127212200-42450-20 SS018B-1 Total/NA

Solid 3050BMB 200-127274/1-A Method Blank Total/NA

Solid 3050BLCS 200-127274/2-A Lab Control Sample Total/NA

Solid 3050BLCSD 200-127274/3-A Lab Control Sample Dup Total/NA

ISM Prep Batch: 127333


Solid Sieve/MIS200-42450-21 SS018B-2 Total/NA

Solid Sieve/MIS200-42450-21 MS SS018B-2 Total/NA


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QC Association SummaryTestAmerica Job ID: 200-42450-1Client: New York State D.E.C.


Metals (Continued)

ISM Prep Batch: 127333 (Continued)


Solid Sieve/MIS200-42450-21 MSD SS018B-2 Total/NA

Prep Batch: 127355


Solid 3050B 127333200-42450-21 SS018B-2 Total/NA

Solid 3050BMB 200-127355/1-A Method Blank Total/NA

Solid 3050BLCS 200-127355/2-A Lab Control Sample Total/NA

Solid 3050B 127333200-42450-21 MS SS018B-2 Total/NA

Solid 3050B 127333200-42450-21 MSD SS018B-2 Total/NA

Analysis Batch: 127444


Solid 6010C 127274200-42450-1 SS001C Total/NA












Solid 6010C 127274200-42450-17 SS015B Total/NA



Solid 6010C 127274200-42450-20 SS018B-1 Total/NA

Solid 6010C 127274MB 200-127274/1-A Method Blank Total/NA

Solid 6010C 127274LCS 200-127274/2-A Lab Control Sample Total/NA

Solid 6010C 127274LCSD 200-127274/3-A Lab Control Sample Dup Total/NA









Solid 6010C 127355200-42450-21 SS018B-2 Total/NA

Solid 6010C 127355MB 200-127355/1-A Method Blank Total/NA

Solid 6010C 127355LCS 200-127355/2-A Lab Control Sample Total/NA

Solid 6010C 127355200-42450-21 MS SS018B-2 Total/NA

Solid 6010C 127355200-42450-21 MSD SS018B-2 Total/NA


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Lab ChronicleClient: New York State D.E.C. TestAmerica Job ID: 200-42450-1Project/Site: Former Ithaca Gun Factory #C755019A

Client Sample ID: SS001C Lab Sample ID: 200-42450-1Matrix: SolidDate Collected: 02/28/18 10:10


ISM Prep Sieve/MIS 03/08/18 16:53 MAP127212 TAL BUR

Type

Batch Batch

MethodPrep Type LabAnalystRun

Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA

Prep 3050B 127274 03/12/18 10:19 MLB TAL BURTotal/NA

Analysis 6010C 10 127444 03/15/18 18:02 SJO TAL BURTotal/NA




Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA






Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA






Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA






Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA




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Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA






Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA






Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA






Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA






Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA




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Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA






Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA



Client Sample ID: SS008B Lab Sample ID: 200-42450-13Matrix: SolidDate Collected: 02/28/18 08:15



Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA






Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA






Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA




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Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA






Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA






Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA






Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA



Client Sample ID: SS018B-1 Lab Sample ID: 200-42450-20Matrix: SolidDate Collected: 02/28/18 09:30



Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA




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Client Sample ID: SS018B-2 Lab Sample ID: 200-42450-21Matrix: SolidDate Collected: 02/28/18 09:35



Type

Batch Batch


Prepared

or Analyzed

Batch

Number

Dilution

Factor

Total/NA



Laboratory References:

TAL BUR = TestAmerica Burlington, 30 Community Drive, Suite 11, South Burlington, VT 05403, TEL (802)660-1990


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Accreditation/Certification SummaryClient: New York State D.E.C. TestAmerica Job ID: 200-42450-1Project/Site: Former Ithaca Gun Factory #C755019A

Laboratory: TestAmerica BurlingtonUnless otherwise noted, all analytes for this laboratory were covered under each accreditation/certification below.

Authority Program EPA Region Identification Number Expiration Date

New York 103912NELAP 04-01-18 *

Analysis Method Prep Method Matrix Analyte

Laboratory: TestAmerica BuffaloThe accreditations/certifications listed below are applicable to this report.

Authority Program EPA Region Identification Number Expiration Date

New York 100262NELAP 03-31-18 *


* Accreditation/Certification renewal pending - accreditation/certification considered valid.

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Method SummaryTestAmerica Job ID: 200-42450-1Client: New York State D.E.C.


Method Method Description LaboratoryProtocol

SW8466010C Metals (ICP) TAL BUR

Protocol References:

SW846 = "Test Methods For Evaluating Solid Waste, Physical/Chemical Methods", Third Edition, November 1986 And Its Updates.

Laboratory References:

TAL BUR = TestAmerica Burlington, 30 Community Drive, Suite 11, South Burlington, VT 05403, TEL (802)660-1990


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Sample SummaryTestAmerica Job ID: 200-42450-1Client: New York State D.E.C.


Lab Sample ID Client Sample ID ReceivedCollectedMatrix

200-42450-1 SS001C Solid 02/28/18 10:10 03/02/18 10:00

200-42450-2 SS002C Solid 02/28/18 10:11 03/02/18 10:00

200-42450-3 SS003C Solid 02/28/18 10:17 03/02/18 10:00

200-42450-4 SS004C Solid 02/28/18 10:18 03/02/18 10:00

200-42450-5 SS005C Solid 02/28/18 10:23 03/02/18 10:00

200-42450-6 SS006C Solid 02/28/18 10:24 03/02/18 10:00

200-42450-7 SS007C Solid 02/28/18 10:30 03/02/18 10:00

200-42450-8 SS008C Solid 02/28/18 10:32 03/02/18 10:00

200-42450-9 SS009C Solid 02/28/18 10:38 03/02/18 10:00

200-42450-10 SS010C Solid 02/28/18 10:41 03/02/18 10:00

200-42450-11 SS011C Solid 02/28/18 10:48 03/02/18 10:00

200-42450-12 SS012C Solid 02/28/18 10:50 03/02/18 10:00

200-42450-13 SS008B Solid 02/28/18 08:15 03/02/18 10:00

200-42450-14 SS009B Solid 02/28/18 08:25 03/02/18 10:00

200-42450-15 SS010B Solid 02/28/18 08:35 03/02/18 10:00

200-42450-16 SS014B Solid 02/28/18 08:50 03/02/18 10:00

200-42450-17 SS015B Solid 02/28/18 08:57 03/02/18 10:00

200-42450-18 SS016B Solid 02/28/18 09:05 03/02/18 10:00

200-42450-19 SS017B Solid 02/28/18 09:15 03/02/18 10:00

200-42450-20 SS018B-1 Solid 02/28/18 09:30 03/02/18 10:00

200-42450-21 SS018B-2 Solid 02/28/18 09:35 03/02/18 10:00


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Login Sample Receipt Checklist

Client: New York State D.E.C. Job Number: 200-42450-1

Login Number: 42450

Question Answer Comment

Creator: Hahl, Victoria L

List Source: TestAmerica Burlington

List Number: 1

N/ARadioactivity wasn't checked or is </= background as measured by a survey meter.

Lab does not accept radioactive samples.

TrueThe cooler's custody seal, if present, is intact. 850363

TrueSample custody seals, if present, are intact.

TrueThe cooler or samples do not appear to have been compromised or tampered with.

TrueSamples were received on ice.

TrueCooler Temperature is acceptable.

TrueCooler Temperature is recorded. 2.9ºC

TrueCOC is present.

TrueCOC is filled out in ink and legible.

TrueCOC is filled out with all pertinent information.

TrueIs the Field Sampler's name present on COC? Not requested on COC.

TrueThere are no discrepancies between the containers received and the COC.

TrueSamples are received within Holding Time (excluding tests with immediate HTs)

TrueSample containers have legible labels.

TrueContainers are not broken or leaking.

TrueSample collection date/times are provided.

TrueAppropriate sample containers are used.

N/ASample bottles are completely filled.

TrueSample Preservation Verified.

TrueThere is sufficient vol. for all requested analyses, incl. any requested MS/MSDs

TrueContainers requiring zero headspace have no headspace or bubble is <6mm (1/4").

TrueMultiphasic samples are not present.

TrueSamples do not require splitting or compositing.

N/AResidual Chlorine Checked. No analysis requiring residual chlorine check assigned.


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Login Sample Receipt Checklist

Client: New York State D.E.C. Job Number: 200-42450-1

Login Number: 42450

Question Answer Comment

Creator: Hahl, Victoria L

List Source: TestAmerica Burlington

List Number: 2

Radioactivity either was not measured or, if measured, is at or below background

The cooler's custody seal, if present, is intact.

The cooler or samples do not appear to have been compromised or tampered with.

Samples were received on ice.

Cooler Temperature is acceptable.

Cooler Temperature is recorded.

COC is present.

COC is filled out in ink and legible.

COC is filled out with all pertinent information.

Is the Field Sampler's name present on COC?

There are no discrepancies between the sample IDs on the containers and the COC.

Samples are received within Holding Time (Excluding tests with immediate HTs)..

Sample containers have legible labels.

Containers are not broken or leaking.

Sample collection date/times are provided.

Appropriate sample containers are used.

Sample bottles are completely filled.

Sample Preservation Verified

There is sufficient vol. for all requested analyses, incl. any requested MS/MSDs

VOA sample vials do not have headspace or bubble is <6mm (1/4") in diameter.

If necessary, staff have been informed of any short hold time or quick TAT needs

Multiphasic samples are not present.

Samples do not require splitting or compositing.

Sampling Company provided.

Samples received within 48 hours of sampling.

Samples requiring field filtration have been filtered in the field.

Chlorine Residual checked.


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