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Home My WebLink AboutDEQ-CFW_00071346TestAmehca THE LEADER IN ENVIRONMENTAL TESTING Shipping Order ID: 65745 Shipping Order Form -Bottle Order Ship To Information Project Manager: Michelle Johnston Company Name: NC-DWR Attention: Attn: Jim Gregson Address 1: 127 Cardinal Drive Extension Address 2: Address 3: City: City: Wilmington State: NC Zip: 28405 Phone #: 252-671-4778 Project Ref: FAY-NC-DWR HFPO-DA SAMP Notes to Bottle/Shipping Department Please include cooler, cooler liner, custody seals, pre-printed labels, pre-printed chains of custody, pre-printed FedEx return labels for TA Denver, DI water and temperature blanks. Please use plastic, non-teflon lined bottles for DI water. Please relinquish the COCs. Please label cooler "FAY - NC-DWR HFPO-DA SAMPLING' Shipping Order ID: 65745 Shin Via: FedEx Std Overnight 0 Ready to Fill 0 Seals on Coolers ❑ Seals on Bottle ❑ Bottle Sets ❑ Ice Cooler TestAmerica Denver 4955 Yarrow Street Arvada, CO 80002 Phone (303) 736-0100 Fax (303) 431-7171 Due On: 6/29/2017 12:00:OOPM Q Labels with Bottles 0 Preprinted []Labels on Bottles Q Preprinted COC ❑ Rebill Freight 0 Return Shipment Labels Number of Return Shipment Labels (Prepaid Return) Please notify us immediately if an error is found in shipment Page 1 of 3 Printed on 6/28/201710:06:38AM Shipping Assets Assets 1 Quantity Description Filled Blank labels 1 pre-printed, per container ❑ COCs 3 pre-printed, please relinquish ❑ Cooler liners 1 per cooler ❑ Coolers 1 as needed ❑ Custody Seals 2 per cooler ❑ DI Water 2 x 1 L bottles ❑ Pre-printed Fed Ex Labels 1 per cooler for TA DENVER ❑ Temperature Blanks 1 per cooler ❑ Please notify us immediately if an error is found in shipment Shipping Order ID: 65745 Page 2 of 3 Printed on 6/28/201710:06:38AM Bottle Order Information Order Completion Information 0 m p n n I O O O w cw Bottle Order: FAY-NC-DWR HFPO-DA SAMP Bottle Order #: 22335 Request From Client: 612812017 Date Order Posted: 612812017 9:53:37AM Order Status: Ready To Process Prepared By: Dylan Bieniulis Deliver By Date: 612912017 12:00:OOPM Lab Project Number: 28016914 Creator: Dylan Bieniulis Filled by: Sent Date: Sent Via: Tracking #: Sets Bottles/Set Qty Bottle Type Description Preservative Method Matrix Sample Type Comments Lot # 14 2 28 Plastic 250ml - unpreserved None Water Normal HFPO-DA Notes to Field Staff: Health and Safety Notes: Preservative Comment Relinquished By Company Date Time Received By Company Seal #. Seal #: Seal #: Seal #: Relinquished By Company Date Time Received By Company Seal #: Seal #: Shipping Order ID: 65745 Please notify us immediately if an error is found in shipment Page 3 of 3 Printed on 6/28/201710:06:38AM Approved Lot Numbers for Sample Bottles and Preservatives TAma 6/27/2017 ESS v,c,r_nnen,.-3ev.o,N�fwrµ.r cr,+rs or -Type ;; Lot# Pressrvative s L01t0 1 Gallon Amber 4000-0250-QC 0103101 C Unpreserved NA 1 Gallon CUbitalrr@r.3785-1030-QC . 0320601Y , ;"_ Uiipres ryed" NA 1 L Amber 1000-0150-QC 0104101 B/0108201 C Hydrochloric Acid 56134/56293 1 1 iter Amber 1000-0150 QC 01D4tb1$ : i. 5odlurt#f�roaulfafe 6000d$6Ib0.00b�{285]_ .' 1 Liter Amber 1000-0150-QC 0108201 C Sulfuric Acid 0000161554 LiterAmbe`r.1p00ir�0{2C -.' 010$2d1C ` Un ivedJJA 1 Liter Poly 1000-1901-QC 0206901C Nitric Acid 0000162027/0000042514 1,Liter Piny 14100 19013C, 012$9017J0109TfliC, _'a" 3Utiutic`Ac)d 0000Q56441 t) 611 1 Liter poly 1000-1901-QC 0206901C Upreserved NA `f 25 mL Amtier'QG Di26=0150-QG ' 0724401A Uh rese ved 7 NA 125 mL Plastic 0125-1060-QC 0418201Y Upreserved NA 1 Stn1 LDPE dropper - CIEC' _ 04.1017=ii2$04 $ulfunc llcid 949780 ` 15ml LDPE dropper - QEC 051016-HCU041017-H LL Hydrochloric Acid 1328801162118 15m1'LDPE dropper L1EC mso�eie+x+roa,o,� Ow4t�r,Noa" Qlifna _fi itl 133393%1.6 Q2Z1104! 17_ 16 oz Jar 0500-0015-QC 0110101 Y Unpreserved NA 10;zp ly.lar 0$06; 41=QC _ •_ 0202507Y, UnprpseNetL - 2 oz Jar 0060-0015-QC 0410101Y Unpreserved NA 250�LAirlf�'e�0250�7a0-QC "' UA00511!1A10;�08�41*r Mon4cl�torga�+sttcpGd_ ., , ` _`: $04�231TU3tiQ5= - 250 mL Amber 0250-0150-QC 04010501A/0308201C Sulfuric Acid 0000161554 25() mL A(nber 0250 Q1;'SQ; 250 mL Poly NA NOT IN USE Sodium Hydroxide NA 25fl.ni Poly {)250 :1901 QC . ,: _ . " U3139a i8 F -'. Suffititic:Acid D0091Si221 250 mL Poly 0250-1901-QC 0406901 C Unpreserved NA 250r»(.1?olyt)2501901=L2C: .. '= 04069A1G. • " ZinA. tee`'_ r OODOf3l3$O5/0844$2_ 250rL Froly}250=1J01-0C ` `_-` 04b68010" Att 32 oz Jar 0950-0010-QC 0316901 B Unpreserved NA 4.64'far 0 t25 Q055 �2C :`'. ' = fl26Q01$ " linpre?[t Nq 40 mL VOA 40AA-0300-QC 0213801 B Ascorbic Acid K39581 40_mL VOA 402ti 5fl35 QG 0122901B:. - b) WatBr. 7 NA .-' . . 40 mL VOA 4025-300-QC 0219601 B Hydrochloric Acid 56134/56293 40 mL; VOA 40U8-5035-QC : 0322901'a Nlethariol° 40 mL VOA 4049-5035-QC 0327101X Sodium Bisulfate 143424 40 mL V0A 0DT0-300-QC 0213i301B -,, ` - % Soditiiit 7 hio3uifat 000015 7 40 mL VOA 0040-300-QC 0213801 B/013213801 B Unpreserved NA 60 mL VOA 7260-0410-QC 0522801A/on P O.'2685379_ Unprgsearei� _ . = _ NA ,- 40 mL VOA 0040-0410-QC 0119601B Unpreserved Amber NA 500 mL Aj6W-r�0300 01$0.=QC 020822 C _ : Sulfuric Acid 0000161$,rA 500 mL Amber 0500-0150-QC 0405901Y/0208201 C Unpreserved NA 500 ml PbIy.05001901-QC 0208201C/4i300Dj0MO ba201C Nitric Acid • 0600162022-7/0000042514` 500 mL Poly 0500-1901 -QC 0306901C Unpreserved NA 60 mL VOA 7260-0410-0C 0522601$%0522601A Monochloroacetic Acid 3040281703005= 8 oz Jar 0250-0055-QC 0 22600113/012801 C Unpreserved NA 8 oz Poly Jar 0250-104i QC 0234301Z - Unpreserved - NA En Core Sampler (En Novative) 14281 NA NA Sterilee 125 mL Plastic (FISHER) 0009/0018 NA NA Sterile 20 mL Syringe (FISHER) 6354862/6217791 NA NA Sterile 60 mL Syringe (Fisher) 6327854 NA NA Syringe filter, 0.2um Sterile (FISHER) 14616044/24616060 NA NA Syringe Filter, 045um (MG Scientific) 06 70441 ]Sodium NA NA 125ML 0125-2052-sp 1193422 NA Trip Blank 4025-0300-QC - 7 By Date Hydrochloric Acid By Date Trip Blank 0040-0300-QC By Date Thiosulfate By Date Trip Blank 0040-0300-QC, By Date Unpreserved . By Date 4ozjarAmber (Qec) G=7-067-406 Unpreserved NA 500ml Poly Amber 0500-1270-QC 0218201 Y Unpreserved INA 250mlPoly Amber 6250-1270-QC 0318201Y _ SodiumHytlroxide-- 1344$2_ DF-F-0057-3-17-2017Rev 0 G:\Login\Bottle Prep\Lot Numbers\ Page 1 of 1 Bottle Prep Lot Numbers List_6-27-17 DEQ-CFW 00071349