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Bechtel <strong>Hanford</strong> Inc. CHAIN OF CUSTODY/SAMPLE ANALYSIS REQUES T 1198-061-02<br />

Collector Company Contact 'I elephant No. Project Coordinator DATA "I urnaround<br />

R. Fahlbcrg Steve Manske 3734316 WEISS, RL<br />

21 Days<br />

Project Design ation Sampling Location AF No.<br />

105-C Ph as e 1 R Phase II - Concrete Samples 100 Area B99-061<br />

Ice Ch est No. Field Logbook No. Method or Shipment<br />

Iland deliver<br />

Shipped To Mile Property 1. Bill of Ladin A BIII No.<br />

Quanterra In co rporated<br />

POSSIBLE SAMPLE IIAZARDS/REMARKS<br />

Radioactive<br />

Special Handling And/or Storage<br />

SAMPLE ANALYSIS<br />

903W -burin 6031(^I - ILLcr-<br />

Prae vAlinn<br />

Type of Container<br />

No. of Container(s)<br />

Volume<br />

Sample No. Matrix • Sample Dale Sample Time<br />

ONSB1 N Other Soliq<br />

P<br />

2<br />

IL<br />

6m imm,l, in<br />

Specid<br />

^o/^ D3/,<br />

3 /x/ Z- ^\Ir/ ^^ /d A ^ I<br />

SPECIAL[ TRUC'IIONS Q tau is<br />

CHAIN OF POSSESSION Sign/Print Names Vd ^.,. i<br />

(I)ICI'Meais- 6010A ISupenrace) 1[rid), 7471 (CV) Cluumimn Ile.-7196.<br />

e[i<br />

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uished<br />

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Dale/Time<br />

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G<br />

DAINI'ime<br />

Reuiv<br />

ive<br />

B<br />

Y On<br />

Date/Time<br />

151<br />

- s<br />

PCBs-80801Atoclor 12541, Gamma Spectnosc. py(Cesium-U7. Cohxll-60, Europium-152,<br />

r-opium; 154, Eumpimm-1551; Amencium-241. Isotopic Plutonium; Isotopic IIranium, Sele<br />

SdPnl sn -^9<br />

r Ni[J^N (03 i Sr- $9 9a-- 7G I S^ "<br />

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1 c-C7<br />

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tc<br />

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'nquished By Date/Time Received By DaterTime !'^ 1<br />

ZD<br />

'ntonshed By Dalelfime Received By Dalerlime<br />

BORATORY 0.euived By<br />

SECTION<br />

Tine naie'I une<br />

FINAL SAMPLE<br />

DISPOSITION_<br />

Diallo»I Mahod<br />

--<br />

Uisrysscd -- By -- -<br />

- W(" (une<br />

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