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SAF-RC-047 100 & 300 Area Component of the ... - Hanford Site

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Washington Closure <strong>Hanford</strong> CHAIN OF CUSTODY/SAMPLE ANALYSIS REQUEST <strong>RC</strong>-<strong>047</strong>-267 j pxv 1. d I<br />

Collector<br />

TILLER, B. TH KLINCKMAN<br />

C[mmanv Cantact<br />

JOAN KESSNER<br />

Teletsbone No.<br />

375-4688<br />

Prolect Coordinator<br />

KESSNER, JH Price Code 9N<br />

Protect DesienaGon<br />

<strong>100</strong> & <strong>300</strong> <strong>Area</strong> <strong>Component</strong> <strong>of</strong> <strong>the</strong> <strong>RC</strong>BRA Sediment and n<br />

Ice Chest No.r<br />

y j^(J -- ^^<br />

Satnpbne Location<br />

1 I6-N-3 OFFAL<br />

Field Logbook No.<br />

FL-1595<br />

COA<br />

BESRAS6520<br />

<strong>SAF</strong> No.<br />

<strong>RC</strong>-<strong>047</strong><br />

Method <strong>of</strong> Shipment<br />

FED EX<br />

Air Quality<br />

Data Trrrnarourssm<br />

V<br />

45 Days m<br />

CD<br />

m—<br />

m<br />

m<br />

CD<br />

Ship<br />

L•RLINE SERVICES LIONVILLE _<br />

ORsile Pronety No. / p<br />

Q(/Q J^L/<br />

Bib <strong>of</strong> Ladlisit/A ir BIB No.<br />

SEEOSPC<br />

POSSIBLE SAMPLE HAZARD6/ItEMARKS<br />

POTENTIAL RADIOACTIVE eDOTUMITS<br />

Special Handling and/or Storage<br />

COOL 4C "MATRIX COMPOSED OF MICE"<br />

SAMPLE ANALYSIS<br />

S ^, 41<br />

Presevauon<br />

Type <strong>of</strong> Container<br />

No. <strong>of</strong> Contalaer(s)<br />

Volume<br />

Iw ® 3<br />

Sample No. Max Matrix •<br />

Sam Date Sample Time<br />

J11KL6 OTHER SOLID APR 0 3 2006 Wo k<br />

Coal Node Cu l 4C Goes 4C eu4C m Cu,d4C<br />

aG<br />

GIP G/P aG aG aG<br />

1 I 0 0 0 0<br />

25% log 158 30s 508 508<br />

Seeias(11n Seeinn(21in<br />

Speid Spew<br />

Seelam(3)in<br />

speew<br />

Porn-tion Peabides.<br />

anal<br />

SeriVOA-<br />

IMA (TCL)<br />

Ihharahfom Inamnbna I.urununa.<br />

_ r r<br />

k x<br />

r` £<br />

CHAIN OF POSSESSION Sign/Print Name SPECIAL INSTRUCTIONS<br />

Matrix'<br />

Re6nryished By/Remond From /K smc<br />

EAS LOCKED STOR ts^ ey'°,.^<br />

Dalefrime<br />

-<br />

NOTE: Ebalme. Perform Gaorna Spec *am baa+hp book I01Jomil le Labs, if possib le maintain 4 C<br />

Gong. <strong>of</strong>i L'omil le.Pulorm me ta Nk/V DalHnme<br />

NOW<br />

7h C)<br />

ell uis d B /Rmnuved F s Daemme<br />

aq<br />

Rttt^i ved By/5[aed In<br />

!<br />

r".<br />

Received B Y/Sward N<br />

Date/rime<br />

IeT^<br />

Z<br />

ls, FCBXEST,SVOC in order as simp le is avai lable. Contract Coact Joan<br />

Kessocr salon macipa. _<br />

(1) Gamma Spa-(Full lisp lAmencima:fl, Anrirraay-125. Be rylinm7, Cesitmn134-Cesium137,<br />

Cobalt-60. Europiuml52. Europium-154, Etaopiam155, P erassiu -40, Radium22 ( , Radlam226.<br />

•sa<br />

f^s E.s 4ma<br />

so-ASw<br />

sksh hs.<br />

W. W.<br />

OcO 1<br />

A.A.<br />

O/ RurlcniumlOO.Unoium235,Uracium23s) Relic 'hed e F DotNrmle<br />

X Yt^ ^! 6 OG ^G 17/7<br />

eGuquishe By/R Hued From Dame<br />

x<br />

4linqui 5hc y/Removedroom Daerfacc<br />

T*TA<br />

Received /S din<br />

D^—<br />

rived<br />

Received By/Stonfl 14<br />

_<br />

b<br />

)me<br />

DdeTme<br />

Durerring<br />

l^ (2) ShootinmB9.90--Tarsi Sr. lsaopk Tho ium(Tnaiwsr23?); Isotopic U ranium l Uranium-233834,<br />

Uranium235,Unomm238);lsouocPlalonium<br />

(3) ICP Meala-60101Fu11 IJsq lAlurhiaam Antieay.rse n Anic• Barium 8cryllium Bismank aca B.<br />

Cadmium Ca lcium, Chromium Cabal, Copper, bra, lead. IAtdum Magnesium Manganese,<br />

Molybdenum L ybdenum Nickel. Phosphdos, Po pnium Seleainm Silicon. Silver, Sodium Strontium Thallium<br />

Uranium. Vanadium Zinc ): Mercu ry - 7471 - (CV)<br />

uM<br />

sK.o, &"<br />

a.ne.,,ugy<br />

T.Ta..<br />

wr.w^l.<br />

'd<br />

z.alh.<br />

LAAORATORY Received By TitleDateTme<br />

`^+VS<br />

SECTION<br />

FINAL SAMPLE Disposal Method Disposed By D+INfime<br />

UISPOtiI'I'ION<br />

SHI-EE-011 (08/29/2005)

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