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

Lionville Laborato ry Sample Discrepancy Report (SDR) SDR#: 8 16 be ' L 4,
Initiator Jo %N. Batch:
Parameter. PY s3 , P UR
Date: 'T1-1 to 6
Sampl Matrix: •. d w t
Client: Ttv.J Metho Prep Batch: nb e o^,^
4-E=e
1. Reason for SDR
a. COC Discrepancy _Tech Profile Er ror Client Request — Error on C-O-C
Transcription Error _ Wrong Test Code Other
b. General Discrepancy
Missing Sample/Extract _ Container B roken —Wrong Sample Pulled _ Label ID's Illegible
Hold Time Exceeded _ Insufficient Sample _ Preserva ti on Wrong _ Received Past Hold
_ Improper Bottle Type _ Not Amenable to Analysis
Note * : verified by [Lo In] or [Prep Group] (circle)... signaturaldate:
c. Problem (Include all relevant specific results; attach data if necessa ry )
It
sr%^ tf rf G mot! 11 af'T /'f cJ .....t.^k a Z
2. Known or Probable Causes(s)
3. Discussion and Proposed Action Other Descrip ti on:
_ Re-log
_ En ti re Batch
Following Samples:
_ Re-leach
_ Re-extract
_ Re-digest
_ Revise EDD
Change Test Code to
_ Place On/Take Off Hold (circle)
4. Project Manager Instructions ... signature/date:
Concur with Proposed Action
_ Disagree with P roposed Action; See Ins truction
_ Include in Case Narrative
_ Client Contacted:
Date/Person
_ Add
Cancel
5. Final Ac tion... signature/date:
—
Other Explana tion:
Verified re-[log][leach][extractildigest][an y0sl 016e) e)
_ Included in Case Narrative
_ Hard Copy COG Revised
Electronic COG Revised
_ EDD Corrections Completed
When Final Action has been recorded, forward original to QA Specialist for distribu tion and filing.
Route Distribution of Completed SDR Route Dis tribu ti
X Ini
on of Completed SDR
ti
ator
X Lab General Manager. M, Taylor
X P roject Mgr. Stone/Johnson
Data Management: S
_
_ _ Metals: Beegle
_ _ Inorganic: Perrone
_ _ GC/LC: IGger
ti
lwell
_ Sample Prep: Beegle/Kiger
_ MS: Rychlak/Daley
_ _ Login: Per ry
Admin:
Other.
QA-105-A-0805
4^u 1
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7/7/6
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