The URL can be used to link to this page

Home My WebLink AboutNCD980602163_19841012_Warren County PCB Landfill_SERB C_State Laboratory of Public Health - Field Sampling-OCRN. C. DEPARTMENT OF HUMAN RESOURCES DIVISION OF HEALTH SERVICES STATE LABORATORY OF PUBLIC HEALTH P.O. BOX 28047 -306 N. WILMINGTON ST., RALEIGH 27611 Site Number f.1-00o6c/ OC-0 Jc' Field Sample Number (J ~ I ;-fO I Name of Site fC,8 La.-d £·11 Site Location AF-f-1,;, /). (' - ;J Collected By ffi-<.TE« IDIJ ___ ~_t ____ Date Collected /O /fo/.<lf Time )/ 6£f~ Type of Sample: Environmental Groundwater Surface Wa ter Soil Other Extractables Concentrate Solid __ Liquid __ Sludge Other INORGANIC CHEMISTRY Total Comments ll'IIFL-i.Acrvr Parameter Results mg 1 Pa r ameter Results mg/1 Parameter Arsenic Barium Cadmium Chromium Lead Me s Arsenic Barium Cadmium Chromium Lead Mercury Selenium Silver ORGANIC CHEMISTRY Chloride Conductivity Copper Fluoride Iron Manganese Nitrate pH Sulfates TDS Zinc TOC Results m /1 Parameter Endrin Lindane Results rag/~l=-+_P~a=r~a=m=e~t~e~r __ ~R£e~s~u..!a..!..t~s-l.!.!~-+--=-~.;:c:.::~c.::..::------"'-"-"......._.--'---:::,.____,_.-'q+-'-1 Toxaphene Methoxychlor ____ _ 2,4-D 2,4,5-TP(Silvex) Petroleum EDB MICROBIOLOGY Parameter (MF) Colifo rm Colonies/lOOmls -(MPN) Coliform Colonies/lOOmls - - - Date Received I oiol yi_ 6 JL. Date Extracted=~ fi ~ Reported By ~~ DHS 3191 (Revised 2/84) Solid and Hazardous Waste ---TOX RADIOCHEMISTRY Parameter Results PCi/1 Gross Alpha Gross Beta - - - Date Rep or ted_ ....... l....:D+/,..L,1;-"--z-~l--"-t-'t/'--,0._'i(}-"--------- Da te Analyzed /0 /It/ ft/ lf',)f) Lab Number __ -_-_~_~:,_~:_,~-=--=-~4 __ ~Q-·~•-.:l~~-=-6-=--==5-=--4=---_-_-_-_-_--= GENERAL I NFORMATION A sample analyses request form (DHS 3191) mus t be completed for each t ype of evaluation requested (e.g., inorganic, organi c, microbiology , radio- chemistry). For sampling conditions which require more t h an one (1) container (i.e., ground or surface water from l andfills) a s ample label must be affixed t o one of the containers. The collector mus t then write the site and sample number on the du plicate. Do not submit an analysis request sheet with no parameters indicated. Equivalent measurements: ppm = pg/ml = mg /1 = )Jg/ g = mg/kg ppb = µg/1 = pg/lOOOg = ]Jg/kg DEFINITIONS/INSTRUCT ION S Site Number - A twelve-digit site/l ocation identifier, assigned only by the district field representative . Field Sample Number - A six-digit sample i dentifier which is pre-printed on the sample label. Name of Site -Name of landfill, fac i l i t y, etc. Site Location -Address, street number , state road, etc. Collected By -Name and ID of sample collector. Date and Time Collected -Self-explanatory. Env ironmental -A sample of a naturally occurring substance such as ground- water, surface water or soils which may be contaminated. Concentrate -A sample of a wa s te, including but not limited to, sludges, resins, treatment effluents or drummed wastes. Comments -Lists details regarding s ample or sample point, including bu t limited to, phase separation, and/or odor s. Inorganic Chemistry -Check (v) the desired parameters to be analyzed. Extractables are only performed on a s olid or semi-solid. For r outine landfill samples, check all parameters in t he second and third columns. Organic Chemistry -Check (v) the desired parameter to be analyz ed. If not listed, enter the name in the space provided. Microbiology and Radiochemistry -The Ra lei gh of fice should be consulted prior to sampling for either of these . N. C. DEPARTMENT OF HUMAN RESOURCES DIVISION OF HEALTH SERVICES STATE LABORATORY OF PUBLIC HEALTH P. 0. BOX 28047 -306 N. WILMINGTON ST., RALEIGH 27611 Site Number_9.L...:3_---"-().,.Q""'/;""6__,,()...,/'-'0"'-'=0'-t?=---~'-----------Field Sample Number t:JO/ j-~ :2 Name of Site eee Lq_,. el -h'I/ Site Location fl£'Teµ , (I). (! • Collected By_~t-&.~&---=--Te'-=-'R--'--___ ID#_---'~'--'6 ____ ___:Da te Collected J(J/1 "/2y' Time II~ r AM Type of Sample: Comments Environmental Groundwater Surface Water Soil Concentrate Solid __ Liquid __ Sludge Other cF-Fl.-~GfVY Other Extractables Parameter Results mg 1 Arsenic Barium Cadmium Chromium Lead Mercury Sel CE -="""---------Si Parameter Results rag/1 Endrin Lindane Methoxychlor ----- MICROBIOLOGY INORGANIC CHEMISTRY Total Parameter Results mg/1 Parameter Arsenic Barium Cadmium Chromium Lead Mercury Selenium Silver ORGANIC CHEMISTRY Parameter Res Toxaphene 2,4-D 2,4,5-TP(Silvex) --- Chloride Conductivity Copper Fluoride Iron Manganese Nitrate pH Sulfates TDS Zinc TOC Petroleum EDB TOX RADIOCHEMISTRY Results m /1 Parameter Parameter Results PCi/1 (MF) Coliform Colonies/lOOmls -(MPN) Coliform Colonies/lOOmls - - - Date Received Jt:>/;o/f{ 8.,() ~ I Date Extracte~;/ £'-/ ,6'1) Reported By ~~M;c: DHS 3191 (Revised 2/84) Solid and Hazardous Waste Gross Alpha Gross Beta - - - :: :: ::::::::--'-;-:-,1-~'----'/'-z~~~_;:tiCJ_~--·=:=------ --'-----"~, -,,..L./-r--U--,<--_L,""--"-1,!.._------- La b Number ___ ---=4~011t:-5~6F¼,,--'5tr5½------- GENERAL INFORMATION A sample analyses request form (DHS 3191) must be completed for each type of evaluation requested (e.g., inorganic, organic, microbiology, radio- chemistry). For sampling conditions which require more than one (1) container (i.e., ground or surface water from landfills) a sample label must be affixed to one of the containers. The collector must then write the site and sample number on the duplicate. Do not submit an analysis request sheet with no parameters indicated. Equivalent measurements: ppm = pg/ml = mg/ 1 = pg/ g = mg/kg ppb = pg/1 = ,ug/lOOOg = pg/kg DEFINITIONS/INSTRUCTIONS Site Number - A twelve-digit site/location identifier, assigned only by the district field representative. Field Sample Number - A six-digit sample identifier which is pre-printed on the sample label. Name of Site -Name of landfill, facility, etc. Site Location -Address, street number, state road, etc. Collected By -Name and ID of sample collector. Date and Time Collected -Self-explanatory. Environmental - A sample of a naturally occurring substance such as ground- water, surface water or soils which may be contaminated. Concentrate - A sample of a waste, including but not limited to, sludges, resins, treatment effluents or drummed wastes. Comments -Lists details regarding sample or sample point, including but limited to, phase separation, and/or odors. Inorganic Chemistry -Check(-'' t'le desired parameters to be analyzed. Extractables are only performed on a solid or semi-solid. For routine landfill samples, check all parameters in the second and third columns. Organic Chemistry -Check (v) the desired parameter to be analyzed. If not listed, ente~ the name in the space provided. Microbiology and Radiochemistry -The Raleigh office should be consulted prior to sampling for either of these. ..