HomeMy WebLinkAboutNCD980602163_19820824_Warren County PCB Landfill_SERB C_Analysis Report-OCRNorth Carolina Department of H~man Resources
Division of Health Services
Occupational Health Laboratory
ANALYSIS REPORT
Company: ---~._A.__U;;;_L.;;:;;.._ __ fr"""o .. t.-'E..__---=--~=-R...;.,;, v'--L<,e ...... 1£ __ ___,;;.~---&:-:-l;;;...l.;...J __________ _
Address: SJ -------------------------------------
Service Requested: J.f]G'd!JJ..!:l'JL_ __ ...::;z;t:11~A.~1!]t$~7i~e~/:t.1i~Z~=--____;~~~c~,!i':!~&t'=-~JH~£4;-qJ;,i)L_~S!.t'.'t_',:J~C]E~--
/
Sample Taken On: __ 2 __ '( __ &.£.....1.J__.6,.,__ __ <i?:_2.~------By: -;;;0 kA./PAIDSK/
Submitted To Laboratory On:_-=2~Y ......... l/-_u~6 ______ t~2-=----
Date of Analysis: -&'-~ -~ 2... -------.:.--=---------------
An al y zed By: ~~
LABORATORY SAMPLE NUMBER
NUMBER
G11~2 .t ..... "'-··
(;,1193
(
I
CuMMENTS:
OHS Form 1440 (Rev. 2-75)
Occupational Health
DESCRIPTION
#Ou.SE LvE..ll
rtOIJ/l.£ l-/()/'7r_ lvtlL
By: 7";"'n ):';:;;p,vO~J:/
Date Reported: 8"'-d>-'/ -? 2-
/l e-~:s--§::2...
REMARKS RE~~b IN
I ,
L.../400
-</Oo
Location of Sampling:
Solid & Hazardous Waste Management Branch
Division of Health Services
N.C. Department of Human Resources
P.O. Box 2091, Raleigh, N.C. 27602
CHAIN OF CUSTODY RECORD
~a.rnrclotts Waste Materials
Generator Transporter Treatment Facility
Storage Facility Disposal Facility Landfill
/ Other: fRIV>r Tl t.vElLS
Company's Name -~£~B~LJ~( __ ~l1~o-~f.-'E~---------Telephone (JJ..!L) 2S 7 -2sg I
Address SR 16°'-f litrorv
number street
C. -) J/tY
Collector's Name __ '3~-L~-~AZ-----~~~-~~-----Telephone
signature
NC
state zip
Date Sample _2,_y~_l}~(.)~{,-~cg~2 __________ Time Sampled --0~9~0_0 _____ hours
Type of Process Generating Waste ___________________________ _
Field Information (sketch sampling location on back)
Field Sample No. --"'-I IYO Bil£
Chai'.'._'." Possession ~
1. ~) ~ C . EAJu. EN, 1i[:_ 2 Y /J Cib ~2
signature title inclusive dates
2. ~
signature
/Ina. Chem L oZ#-li~ 8'2-.
title inclus-1 -e dates
3.
signature title inclusive dates
Results Reported
signature title date