SAF-RC- 107 100-H Remaining Sites Burial Grounds ... - Hanford Site
SAF-RC- 107 100-H Remaining Sites Burial Grounds ... - Hanford Site
SAF-RC- 107 100-H Remaining Sites Burial Grounds ... - Hanford Site
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TestAmerica<br />
THE LEAE NEVIOMENTAL. TESTING Qut rtcl 2g...<br />
Analytical Due:<br />
Report Due: 1<br />
Sample Check-in List<br />
Date/Time Received: to 0S 93D GM Screen Result indcroR/hr<br />
Client: Washinzton Closure <strong>Hanford</strong> SDG #: f OO7 NA[ I <strong>SAF</strong> #: 12CjI 07 NA I<br />
Lot Number: 3,511 Chain of Custody # R2C 10 ; V<br />
Shipping Container ID: ___________ Air Bill # -~3 4 t7-<br />
1 . Custody Seals on shipping container intact? NA [1] Yes [drNo [<br />
-2. Custody Seals dated and signed? - -NAL [] Yes[~io<br />
3. Chain of Custody record present? NA [ I Yes ..b No<br />
4. Cooler Temperature: 4 ~ NA [I 5. Vermiculite/packing materials is NA RWet []Dry [<br />
6. Number of samples in shipping container:____<br />
7. Sample holding ties exceeded? NA [] Yes[I] No **<br />
8 Sam -he:<br />
* "Tape :5_A-azard Lables<br />
SCustody Seals _____ Appropriate Sample Lables<br />
9. Samples arei-<br />
~ In Good Condition _____Leaking<br />
____Broken _ ___Have Air Bubbles<br />
(Only for samples requiring no head space.)<br />
10. Sample pH taken? NArrH2 I] p11>9 [] Amount HiNO3 Added______<br />
11. Sample Location, Sample Collector Listed?*<br />
*For documentation only. No corrective action needed.<br />
12. Were any anomalies identified in sample receipt? Yes []No p!!'-<br />
13. Description of anomalies (include sample numbers):___________________________<br />
Sample Custodian: _Date: 4i<br />
Client Sample ID F Analysis Repuested ICondition I Comments/Action<br />
Client Informed on ________by____________<br />
No action necessary; process as is.<br />
Person Contacted __________<br />
Project Manager % 7 /("Date _________<br />
LS-023, Rev. 7, 1/08 Page 57 of 58 06/07/2010