NCG020330_2023 DMR_20240119 (3)

•
%% eurofins
Environment Testing
ANALYTICAL REPORT
PREPARED FOR
Attn: Daniel Christman
3M Company
4191 Hwy 87 South
Moncure, North Carolina 27559
Generated 12/14/2023 2:53:07 PM
JOB DESCRIPTION
3M WMS - SW Inorganics Pittsboro NC
JOB NUMBER
410-152202-1
Eurofins Lancaster Laboratories Environment Testing, LLC
2425 New Holland Pike
Lancaster PA 17601
Page 1 of 16 ��`�
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See page two for job notes and contact information. g o

111
Eurofins Lancaster Laboratories Environment Testing, LLC
Job Notes
This report may not be reproduced except in full, and with written approval from the laboratory. The results relate only to the
samples tested. For questions please contact the Project Manager at the e-mail address or telephone number listed on this
page.
Analytical test results meet all requirements of the associated regulatory program (i.e., NELAC (TNI), DoD, and ISO 17025)
unless otherwise noted under the individual analysis.
Authorization
Generated
12/14/2023 2:53:07 PM
Authorized for release by
Nicole Brown,Project Manager
[e-mail]
[phone]
Eurofins Lancaster Laboratories is a laboratory within Eurofins Lancaster Laboratories Environment Testing, LLC,a company within Eurofins Environment
Testing Group of Companies
Page 2 of 16 12/14/2023

Eurofins Lancaster Laboratories Environment Testing, LLC
Compliance Statement
Analytical test results meet all requirements of the associated regulatory program (e.g., NELAC (TNI), DoD, and ISO 17025)
unless otherwise noted under the individual analysis. Data qualifiers are applied to note exceptions. Noncompliant quality
control (QC) is further explained in narrative comments.
• QC results that exceed the upper limits and are associated with non-detect samples are qualified but further narration is not
required since the bias is high and does not change a non-detect result. Further narration is also not required with QC blank
detection when the associated sample concentration is non-detect or more than ten times the level in the blank.
Matrix QC may not be reported if insufficient sample or site-specific QC samples were not submitted. In these situations, to
demonstrate precision and accuracy at a batch level, a LCS/LCSD is performed, unless otherwise specified in the method.
Surrogate and/or isotope dilution analyte recoveries (if applicable)which are outside of the QC window are confirmed
unless attributed to a dilution or otherwise noted in the narrative.
Regulated compliance samples (e.g. SDWA, NPDES) must comply with the associated agency requirements/permits.
Measurement uncertainty values, as applicable, are available upon request.
Test results relate only to the sample tested. Clients should be aware that a critical step in a chemical or microbiological
analysis is the collection of the sample. Unless the sample analyzed is truly representative of the bulk of material involved,
the test results will be meaningless. If you have questions regarding the proper techniques of collecting samples, please
contact us. We cannot be held responsible for sample integrity, however, unless sampling has been performed by a member
of our staff. Times are local to the area of activity. Parameters listed in the 40 CFR Part 136 Table II as "analyze
immediately" and tested in the laboratory are not performed within 15 minutes of collection.
This report shall not be reproduced except in full, without the written approval of the laboratory.
WARRANTY AND LIMITS OF LIABILITY- In accepting analytical work, we warrant the accuracy of test results for the
sample as submitted. The foregoing express warranty is exclusive and is given in lieu of all other warranties, expressed or
implied, except as otherwise agreed. We disclaim any other warranties, expressed or implied, including a warranty of fitness
for particular purpose and warranty of merchantability. In no event shall Eurofins Lancaster Laboratories Environmental, LLC
be liable for indirect, special, consequential, or incidental damages including, but not limited to, damages for loss of profit or
goodwill regardless of(A)the negligence (either sole or concurrent) of Eurofins Lancaster Laboratories Environmental and
(B)whether Eurofins Lancaster Laboratories Environmental has been informed of the possibility of such damages. We
accept no legal responsibility for the purposes for which the client uses the test results. Except as otherwise agreed, no
purchase order or other order for work shall be accepted by Eurofins Lancaster Laboratories Environmental which includes
any conditions that vary from the Standard Terms and Conditions, and Eurofins Lancaster Laboratories Environmental
hereby objects to any conflicting terms contained in any acceptance or order submitted by client.
77(
Page 3 of 16 12/14/2023

Client: 3M Company Laboratory Job ID:410-152202-1
Project/Site: 3M WMS-SW Inorganics Pittsboro NC
Table of Contents U
Cover Page 1
Table of Contents 4
Definitions/Glossary 5
Case Narrative 6
Detection Summary 7
Client Sample Results 8
QC Sample Results 9
QC Association Summary 10
Lab Chronicle 11
Certification Summary 12
Method Summary 13
Sample Summary 14
Chain of Custody 15
Receipt Checklists 16
Eurofins Lancaster Laboratories Environment Testing LLC
Page 4 of 16 12/14/2023

Definitions/Glossary
Client:3M Company Job ID: 410-152202-1
Project/Site: 3M WMS-SW Inorganics Pittsboro NC
Qualifiers
General Chemistry
Qualifier Qualifier Description
J Result is less than the RL but greater than or equal to the MDL and the concentration is an approximate value.
Glossary
Abbreviation These commonly used abbreviations may or may not be present in this report.
c Listed under the"D"column to designate that the result is reported on a dry weight basis
%R Percent Recovery
CFL Contains Free Liquid
CFU Colony Forming Unit
CNF Contains No Free Liquid
DER Duplicate Error Ratio(normalized absolute difference)
Dil Fac Dilution Factor
DL Detection Limit(DoD/DOE)
DL,RA,RE,IN Indicates a Dilution,Re-analysis,Re-extraction,or additional Initial metals/anion analysis of the sample
DLC Decision Level Concentration(Radiochemistry)
EDL Estimated Detection Limit(Dioxin)
LOD Limit of Detection(DoD/DOE)
LOQ Limit of Quantitation(DoD/DOE)
MCL EPA recommended"Maximum Contaminant Level"
MDA Minimum Detectable Activity(Radiochemistry)
MDC Minimum Detectable Concentration(Radiochemistry)
MDL Method Detection Limit
ML Minimum Level(Dioxin)
MPN Most Probable Number
MQL Method Quantitation Limit
NC Not Calculated
ND Not Detected at the reporting limit(or MDL or EDL if shown)
NEG Negative/Absent
POS Positive/Present
PQL Practical Quantitation Limit
PRES Presumptive
QC Quality Control
RER Relative Error Ratio(Radiochemistry)
RL Reporting Limit or Requested Limit(Radiochemistry)
RPD Relative Percent Difference,a measure of the relative difference between two points
TEF Toxicity Equivalent Factor(Dioxin)
TEQ Toxicity Equivalent Quotient(Dioxin)
TNTC Too Numerous To Count
Eurofins Lancaster Laboratories Environment Testing, LLC
Page 5 of 16 12/14/2023

Case Narrative
Client: 3M Company Job ID:410-152202-1
Project/Site: 3M WMS-SW Inorganics Pittsboro NC
Job ID: 410-152202-1
Laboratory: Eurofins Lancaster Laboratories Environment Testing,LLC 4
Narrative
Job Narrative
410-152202-1
Analytical test results meet all requirements of the associated regulatory program listed on the Accreditation/Certification Summary Page
unless otherwise noted under the individual analysis. Data qualifiers are applied to indicate exceptions. Noncompliant quality control
(QC)is further explained in narrative comments.
Matrix QC may not be reported if insufficient sample or site-specific QC samples were not submitted. In these situations,to
demonstrate precision and accuracy at a batch level,a LCS/LCSD may be performed,unless otherwise specified in the method.
Surrogate and/or isotope dilution analyte recoveries(if applicable)which are outside of the QC window are confirmed unless attributed
to a dilution or otherwise noted in the narrative.
Regulated compliance samples(e.g.SDWA, NPDES)must comply with the associated agency requirements/permits.
Receipt
The samples were received on 11/22/2023 10:12 AM. Unless otherwise noted below,the samples arrived in good condition,and,where
required,properly preserved and on ice. The temperatures of the 3 coolers at receipt time were 0.3°C, 1.8°C and 3.3°C
Receipt Exceptions
The Field Sampler was not listed on the Chain of Custody.The client responded that the field sampler was Faelan Hoese.
The following sample was listed on the Chain of Custody(COC);however, no sample was received:OF-002(410-152202-2).
Samples start with"OF",not"3M"as listed on the COC.The client was contacted and provided instructions to login the samples with the
prefix"OF-".
General Chemistry
No additional analytical or quality issues were noted,other than those described above or in the Definitions/Glossary page.
Eurofins Lancaster Laboratories Environment Testing, LLC
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Detection Summary
Client: 3M Company Job ID: 410-152202-1
Project/Site: 3M WMS-SW Inorganics Pittsboro NC
Client Sample ID: OF-001 Lab Sample ID: 410-152202-1
Analyte Result Qualifier RL MDL Unit Dil Fac D Method Prep Type
Total Suspended Solids 2.9 J 3.0 1.0 mg/L 1 2540D-2011 Total/NA
Total Organic Carbon 6.0 1.0 0.50 mg/L 1 5310C-2011 Total/NA
Client Sample ID: OF-005 Lab Sample ID: 410-152202-3 El
Analyte Result Qualifier RL MDL Unit Dil Fac D Method Prep Type
Total Suspended Solids 37 7.5 2.5 mg/L 1 2540D-2011 Total/NA
Total Organic Carbon 6.3 1.0 0.50 mg/L 1 5310C-2011 Total/NA
Client Sample ID: OF-008 Lab Sample ID: 410-152202-4
Analyte Result Qualifier RL MDL Unit Dil Fac D Method Prep Type
Total Suspended Solids 3.1 3.0 1.0 mg/L 1 2540D-2011 Total/NA
Total Organic Carbon 7.1 1.0 0.50 mg/L 1 5310C-2011 Total/NA
Client Sample ID: OF-006 Lab Sample ID: 410-152202-5
Analyte Result Qualifier RL MDL Unit Dil Fac D Method Prep Type
Total Suspended Solids 19 5.5 1.8 mg/L 1 2540D-2011 Total/NA
Total Organic Carbon 2.9 1.0 0.50 mg/L 1 5310C-2011 Total/NA
This Detection Summary does not include radiochemical test results.
Eurofins Lancaster Laboratories Environment Testing, LLC
Page 7 of 16 12/14/2023

Client Sample Results
Client: 3M Company Job ID:410-152202-1
Project/Site: 3M WMS-SW Inorganics Pittsboro NC
Client Sample ID: OF-001 Lab Sample ID: 410-152202-1
Date Collected: 11/21/23 11:40 Matrix: Stormwater
Date Received: 11/22/23 10:12
General Chemistry
Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Dil Fac
HEM(Oil&Grease)(1664B) ND 5.3 1.5 mg/L 12/12/23 19:36 1
Total Suspended Solids(SM 2.9 J 3.0 1.0 mg/L 11/28/23 12:10 1 6
2540D-2011)
Total Organic Carbon(SM 6.0 1.0 0.50 mg/L 12/14/23 03:06 1
5310C-2011)
Client Sample ID: OF-005 Lab Sample ID: 410-152202-3
Date Collected: 11/21/23 11:55 Matrix: Stormwater
Date Received: 11/22/23 10:12
General Chemistry
Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Dil Fac
HEM(Oil&Grease)(1664B) ND 5.2 1.5 mg/L 12/12/23 19:36 1
Total Suspended Solids(SM 37 7.5 2.5 mg/L 11/28/23 12:10 1
2540D-2011)
Total Organic Carbon(SM 6.3 1.0 0.50 mg/L 12/14/23 03:50 1
5310C-2011)
Client Sample ID: OF-008 Lab Sample ID: 410-152202-4
Date Collected: 11/21/23 12:00 Matrix: Stormwater
Date Received: 11/22/23 10:12
General Chemistry
Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Dil Fac
HEM(Oil&Grease)(1664B) ND 5.3 1.5 mg/L 12/12/23 19:36 1
Total Suspended Solids(SM 3.1 3.0 1.0 mg/L 11/28/23 12:10 1
2540D-2011)
Total Organic Carbon(SM 7.1 1.0 0.50 mg/L 12/14/23 04:05 1
5310C-2011)
Client Sample ID: OF-006 Lab Sample ID: 410-152202-5
Date Collected: 11/21/23 15:00 Matrix: Stormwater
Date Received: 11/22/23 10:12
General Chemistry
Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Dil Fac
HEM(Oil&Grease)(1664B) ND 5.6 1.6 mg/L 12/12/23 19:36 1
Total Suspended Solids(SM 19 5.5 1.8 mg/L 11/28/23 12:10 1
2540D-2011)
Total Organic Carbon(SM 2.9 1.0 0.50 mg/L 12/14/23 05:16 1
5310C-2011)
Eurofins Lancaster Laboratories Environment Testing, LLC
Page 8 of 16 12/14/2023

QC Sample Results
Client: 3M Company Job ID:410-152202-1
Project/Site: 3M WMS-SW Inorganics Pittsboro NC
Method: 1664B - HEM and SGT-HEM
Lab Sample ID: MB 410-453196/1 Client Sample ID: Method Blank
Matrix:Water Prep Type:Total/NA
Analysis Batch:453196
MB MB
Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Dil Fac
HEM(Oil&Grease) ND 5.0 1.4 mg/L 12/12/23 19:36 1
Lab Sample ID: LCS 410-453196/2 Client Sample ID: Lab Control Sample U
Matrix:Water Prep Type:Total/NA
Analysis Batch:453196
Spike LCS LCS %Rec
Analyte Added Result Qualifier Unit D %Rec Limits
HEM(Oil&Grease) 40.0 31.6 mg/L 79 78.114
Lab Sample ID: LCSD 410-453196/3 Client Sample ID: Lab Control Sample Dup
Matrix:Water Prep Type: Total/NA
Analysis Batch:453196
Spike LCSD LCSD %Rec RPD
Analyte Added Result Qualifier Unit D %Rec Limits RPD Limit
HEM(Oil&Grease) 40.0 33.3 mg/L 83 78-114 5 13
Method: 2540D-2011 -Solids, Total Suspended (TSS)
Lab Sample ID: MB 410-447531/1 Client Sample ID: Method Blank
Matrix:Water Prep Type:Total/NA
Analysis Batch:447531
MB MB
Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Dil Fac
Total Suspended Solids ND 3.0 1.0 mg/L 11/28/23 12:10 1
Lab Sample ID: LCS 410-447531/2 Client Sample ID: Lab Control Sample
Matrix:Water Prep Type:Total/NA
Analysis Batch:447531
Spike LCS LCS %Rec
Analyte Added Result Qualifier Unit D %Rec Limits
Total Suspended Solids 150 147 mg/L 98 89.105
Method: 5310C-2011 -Total Organic Carbon/Persulfate - Ultrav
Lab Sample ID: MB 410-454076/36 Client Sample ID: Method Blank
Matrix:Water Prep Type:Total/NA
Analysis Batch:454076
MB MB
Analyte Result Qualifier RL MDL Unit D Prepared Analyzed Dil Fac
Total Organic Carbon ND 1.0 0.50 mg/L 12/14/23 00:14 1
Lab Sample ID: LCS 410-454076/35 Client Sample ID: Lab Control Sample
Matrix:Water Prep Type:Total/NA
Analysis Batch:454076
Spike LCS LCS %Rec
Analyte Added Result Qualifier Unit D %Rec Limits
Total Organic Carbon 25.0 25.5 mg/L 102 91-113
Eurofins Lancaster Laboratories Environment Testing, LLC
Page 9 of 16 12/14/2023

QC Association Summary
Client: 3M Company Job ID: 410-152202-1
Project/Site: 3M WMS-SW Inorganics Pittsboro NC
General Chemistry
Analysis Batch: 447531
Lab Sample ID Client Sample ID Prep Type Matrix Method Prep Batch
410-152202-1 OF-001 Total/NA Stormwater 2540D-2011
410-152202-3 OF-005 Total/NA Stormwater 2540D-2011
410-152202-4 OF-008 Total/NA Stormwater 2540D-2011
410-152202-5 OF-006 Total/NA Stormwater 2540D-2011
MB 410-447531/1 Method Blank Total/NA Water 2540D-2011
LCS 410-447531/2 Lab Control Sample Total/NA Water 2540D-2011
Analysis Batch: 453196 8
Lab Sample ID Client Sample ID Prep Type Matrix Method Prep Batch
410-152202-1 OF-001 Total/NA Stormwater 1664B
410-152202-3 OF-005 Total/NA Stormwater 1664B
410-152202-4 OF-008 Total/NA Stormwater 1664B
410-152202-5 OF-006 Total/NA Stormwater 1664B
MB 410-453196/1 Method Blank Total/NA Water 1664B
LCS 410-453196/2 Lab Control Sample Total/NA Water 1664B
LCSD 410-453196/3 Lab Control Sample Dup Total/NA Water 1664B
Analysis Batch:454076
Lab Sample ID Client Sample ID Prep Type Matrix Method Prep Batch
410-152202-1 OF-001 Total/NA Stormwater 5310C-2011
410-152202-3 OF-005 Total/NA Stormwater 5310C-2011
410-152202-4 OF-008 Total/NA Stormwater 5310C-2011
410-152202-5 OF-006 Total/NA Stormwater 5310C-2011
MB 410-454076/36 Method Blank Total/NA Water 5310C-2011
LCS 410-454076/35 Lab Control Sample Total/NA Water 5310C-2011
Eurofins Lancaster Laboratories Environment Testing, LLC
Page 10 of 16 12/14/2023

Lab Chronicle
Client: 3M Company Job ID: 410-152202-1
Project/Site: 3M WMS-SW Inorganics Pittsboro NC
Client Sample ID: OF-001 Lab Sample ID: 410-152202-1
Date Collected: 11/21/23 11:40 Matrix: Stormwater
Date Received: 11/22/23 10:12
Batch Batch Dilution Batch Prepared
Prep Type Type Method Run Factor Number Analyst Lab or Analyzed
Total/NA Analysis 1664B 1 453196 QT6L ELLE 12/12/23 19:36
Total/NA Analysis 2540D-2011 1 447531 M98K ELLE 11/28/23 12:10-11/29/23 07:10'
Total/NA Analysis 5310C-2011 1 454076 P684 ELLE 12/14/23 03:06
Client Sample ID: OF-005 Lab Sample ID: 410-152202-3
Date Collected: 11/21/23 11:55 Matrix: Stormwater
Date Received: 11/22/23 10:12
Batch Batch Dilution Batch Prepared
Prep Type Type Method Run Factor Number Analyst Lab or Analyzed 1"
Total/NA Analysis 1664B 1 453196 QT6L ELLE 12/12/23 19:36
Total/NA Analysis 2540D-2011 1 447531 M98K ELLE 11/28/23 12:10-11/29/23 07:10'
Total/NA Analysis 5310C-2011 1 454076 P684 ELLE 12/14/23 03:50
Client Sample ID: OF-008 Lab Sample ID: 410-152202-4
Date Collected: 11/21/23 12:00 Matrix: Stormwater
Date Received: 11/22/23 10:12
Batch Batch Dilution Batch Prepared
Prep Type Type Method Run Factor Number Analyst Lab or Analyzed
Total/NA Analysis 1664E 1 453196 QT6L ELLE 12/12/23 19:36
Total/NA Analysis 2540D-2011 1 447531 M98K ELLE 11/28/23 12:10-11/29/23 07:10'
Total/NA Analysis 5310C-2011 1 454076 P684 ELLE 12/14/23 04:05
Client Sample ID: OF-006 Lab Sample ID: 410-152202-5
Date Collected: 11/21/23 15:00 Matrix: Stormwater
Date Received: 11/22/23 10:12
Batch Batch Dilution Batch Prepared
Prep Type Type Method Run Factor Number Analyst Lab or Analyzed
Total/NA Analysis 1664B 1 453196 QT6L ELLE 12/12/23 19:36
Total/NA Analysis 2540D-2011 1 447531 M98K ELLE 11/28/23 12:10-11/29/23 07:10'
Total/NA Analysis 5310C-2011 1 454076 P684 ELLE 12/14/23 05:16
'This procedure uses a method stipulated length of time for the process. Both start and end times are displayed.
Laboratory References:
ELLE=Eurofins Lancaster Laboratories Environment Testing,LLC,2425 New Holland Pike,Lancaster,PA 17601,TEL[phone]
Eurofins Lancaster Laboratories Environment Testing, LLC
Page 11 of 16 12/14/2023

Accreditation/Certification Summary
Client: 3M Company Job ID:410-152202-1
Project/Site: 3M WMS-SW Inorganics Pittsboro NC
Laboratory: Eurofins Lancaster Laboratories Environment Testing, LLC
Unless otherwise noted,all analytes for this laboratory were covered under each accreditation/certification below.
Authority Program Identification Number Expiration Date
North Carolina(WW/SW) State 521 12-31-23
The following analytes are included in this report,but the laboratory is not certified by the governing authority. This list may include analytes
for which the agency does not offer certification.
Analysis Method Prep Method Matrix Analyte
2540D-2011 Stormwater Total Suspended Solids
10
Eurofins Lancaster Laboratories Environment Testing, LLC
Page 12 of 16 12/14/2023

Method Summary
Client: 3M Company Job ID:410-152202-1
Project/Site: 3M WMS-SW Inorganics Pittsboro NC
Method Method Description Protocol Laboratory
1664B HEM and SGT-HEM 1664B ELLE
2540D-2011 Solids,Total Suspended(TSS) SM ELLE
5310C-2011 Total Organic Carbon/Persulfate-Ultrav SM ELLE
Protocol References:
1664B=EPA-821-98-002
SM="Standard Methods For The Examination Of Water And Wastewater"
Laboratory References:
ELLE=Eurofins Lancaster Laboratories Environment Testing,LLC,2425 New Holland Pike,Lancaster,PA 17601,TEL[phone]
a
Eurofins Lancaster Laboratories Environment Testing, LLC
Page 13 of 16 12/14/2023

Sample Summary
Client: 3M Company Job ID:410-152202-1
Project/Site: 3M WMS-SW Inorganics Pittsboro NC
Lab Sample ID Client Sample ID Matrix Collected Received
410-152202-1 OF-001 Stormwater 11/21/23 11:40 11/22/23 10:12
410-152202-3 OF-005 Stormwater 11/21/23 11:55 11/22/23 10:12
410-152202-4 OF-008 Stormwater 11/21/23 12:00 11/22/23 10:12
410-152202-5 OF-006 Stormwater 11/21/23 15:00 11/22/23 10:12
EE
Eurofins Lancaster Laboratories Environment Testing, LLC
Page 14 of 16 12/14/2023

vironme
Chain of Custody Record ti:=eurofins 1
Environment Testing
410-152202 Chain of Custody Isarrn'er Lab PM Carrier Tracking No(s) COO No
Brown.Nicole 410 101661.29021 1
Prone E-Mail State of Ongm Page
Daniel Christman Nicole Brown@et eurofinsus corn Page 1 of 1
Company PWS'.D Job p
3M Company Analysis Requested
Address Due Date Requested. ' Preservation Codes:
4191 Hwy 87 South M Hexane
City TAT Requested(days): 8-NaOH N•None
Moncure 0-AsNaO2
m C-Zn Acetate p-Na204S
State,Zip .N- D-Nitric And D.Na2903
NC,27559 Compliance Project: A Yes A No v E•NaH504 R-Na2S203
Phone PO e P-McOH hlor S S.H2504
919.642-4010(Tel) Purchase Order Requested El a H-Abic
-Ascorbic Acid T-TSP Dodecahydrate
Email WO a Z m I-Ice U-Acetone
`pp w J-DI Water V V.MCAA
dchristman@mmm corn .e Z o e `m K-EDTA W-PH 45
Project Name Project x } w Wm I. EDA Z•other(specify)
3M MS-SW Inorganics Pittsboro NC 41017322 m 0 ' v `
Site SSOW# a O 0 y a ID Other,
y i ZC C CI
a w ❑ O m`
Matrix = coSamPle m E
Type (W....br. LL E z, rni Z
Sample (C=com n
p, o•W..du a -
Sample Identification Sample Date Time G=grab) ei•iv.u..A•Air C N' 9 iC S F° Special Instructions/Note:
Preservation Code A N >( — — ------
�.✓lll Ud t I1Iz1(7-3 l l'i-Le (� Water ., - X
Al 0 } (7-;7c) (.y Water Y sk
lix Ail C165- ll-$S t.. Water X s.
M Cog 1.: \y.Qb ( Water `f 1/41 y. Ela
3-tit OV 6 - -- V 3=te a (7 , X Y X
_
Possible Hazard Identification Sample Disposal(A fee may be assessed if samples are retained longer than 1 month)
CI 0 Non-Hazard O Flammable C�1 Skin Irritant Poison B Unknown Radiological 0 Return To Client O Disposal By Lab U Archive For Months
Deliverable Requested I,II.III,IV,Other(specify) Special Instructions/OC Requirements
Empty Kit Relinquished by !Date ITlme t`Method of Shipment
Relinquished by Date/Time Company Received by Date/Time Company
per— ‘(t2i I23 - 7. CD .0
Relinquished by Date/Time Company Received by + ." batenime Company
--.
•
Relinquished by Dare/ ima Company Received by ^ �f)���' Dateire �3 2/„ pa y
Cus��gc�dyy Seals Intact Custody Seal No c Cooler Temperature(s)°C and Other RReemJarrkss • ;•
.1.Yes A No 14S 2- 1 l 1c -2 :�""/3i Qr3 9./ 2.,90.�
Ver 0610tl;2(121
- ^ Page 15 of 16 12/14/2

Login Sample Receipt Checklist
Client:3M Company Job Number:410-152202-1
Login Number: 152202 List Source:Eurofins Lancaster Laboratories Environment Testing,LLC
List Number: 1
Creator:McCaskey,Jonathan
Question Answer Comment
The cooler's custody seal is intact. True
The cooler or samples do not appear to have been compromised or True
tampered with.
Samples were received on ice. True
Cooler Temperature acceptable,where thermal pres is required(</=6C,not True
frozen).
Cooler Temperature is recorded. True
WV:Container Temp acceptable,where thermal pres is required(</=6C,not N/A
frozen).
WV: Container Temperature is recorded. N/A
COC is present. True
COC is filled out in ink and legible. True
COC is filled out with all pertinent information. True
There are no discrepancies between the containers received and the COC. False Refer to Job Narrative for details.
Sample containers have legible labels. True 14
Containers are not broken or leaking. True
Sample collection date/times are provided. True
Appropriate sample containers are used. True
Sample bottles are completely filled. True
There is sufficient vol.for all requested analyses. True
Is the Field Sampler's name present on COC? False Refer to Job Narrative for details.
Sample custody seals are intact. N/A
VOA sample vials do not have headspace>6mm in diameter(none,if from N/A
WV)?
Eurofins Lancaster Laboratories Environment Testing,LLC
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