HomeMy WebLinkAboutNC0000396_J15050773report_20150823DUE Analytical Laboratory
ENERGY
13339 Hagers Ferry Road
Huntersville, NC 28078-7929
McGuire Nuclear Complex - MG03A2
Phone: 980-875-5245 Fax: 980-875-4349
Order Summary Report
Order Number: J15050773
Project Name: ASHEVILLE - AB GW ASSESSMENT WATER
Customer Name(s): Todd Plating, Kathy Webb, John Toepfer, Tim Hunsucker
Customer Address: 200 CP and L Drive
Arden,NC 28704
Lab Contact: Mary Ann Ogle Mary Ann OP�e: 980-875-5274
Report Authorized By:� / 2015.06.20 Date:
(signature) ✓✓✓ 12:39:17 -04'00'
Mary Ann Ogle
Program Comments:
Please contact the Program Manager (Mary Ann Ogle) with any questions regarding this report.
Data Flags & Calculations:
6/20/2015
Analytical Lab
Page 1 of 21
Any analytical tests or individual analytes within a test flagged with a Qualifier indicate a deviation from the method quality
system or quality control requirement. The qualifier description is found at the end of the Certificate of Analysis (sample results)
under the qualifiers heading. All results are reported on a dry weight basis unless otherwise noted. Subcontracted data
included on the Duke Certificate of Analysis is to be used as information only. Certified vendor results can be found in the
subcontracted lab final report. Duke Energy Analytical Laboratory subcontracts analyses to other vendor laboratories that have
been qualified by Duke Energy to perform these analyses except where noted.
Data Package:
This data package includes analytical results that are applicable only to the samples described in this narrative. An estimation of
the uncertainty of measurement for the results in the report is available upon request. This report shall not be reproduced, except
in full, without the written consent of the Analytical Laboratory. Please contact the Analytical laboratory with any questions. The
order of individual sections within this report is as follows:
Job Summary Report, Sample Identification, Technical Validation of Data Package, Analytical Laboratory Certificate of Analysis,
Analytical Laboratory QC Reports, Sub -contracted Laboratory Results, Customer Specific Data Sheets, Reports &
Documentation, Customer Database Entries, Test Case Narratives, Chain of Custody (COC)
Certification:
The Analytical Laboratory holds the following State Certifications : North Carolina (DENR) Certificate #248, South Carolina
(DHEC) Laboratory ID # 99005. Contact the Analytical Laboratory for definitive information about the certification status of
specific methods.
Sample ID's & Descriptions:
Sample ID Plant/Station
Collection
Date and Time Collected By
Sample Description
2015016489
ASHEVILLE
28 -May -15 9:55 AM
illegible
ABMW-02S
2015016517
ASHEVILLE
28 -May -15 11:05 AM
illegible
ABMW-07S
2015016518
ASHEVILLE
28 -May -15 8:55 AM
illegible
ABMW-02
3 Total Samples
Analytical Lab
Page 2 of 21
Technical Validation Review
Checklist:
COC and .pdf report are in agreement with sample totals 0 Yes No
and analyses (compliance programs and procedures).
All Results are less than the laboratory reporting limits. 0 Yes E] No
All laboratory QA/QC requirements are acceptable. 0 Yes F-] No
Report Sections Included:
E%-'] Job Summary Report
❑� Sample Identification
Technical Validation of Data Package
❑� Analytical Laboratory Certificate of Analysis
❑ Analytical Laboratory QC Report
Analytical Lab
Page 3 of 21
❑d Sub -contracted Laboratory Results
❑ Customer Specific Data Sheets, Reports, & Documentation
❑ Customer Database Entries
❑� Chain of Custody
❑� Electronic Data Deliverable (EDD) Sent Separately
Reviewed By: Mary Ann Ogle Date: 6/20/2015
Certificate of Laboratory Analysis
This report shall not be reproduced, except in full.
Order # J15050773
Site: ABMW-02S
Collection Date: 28 -May -15 9:55 AM
Analyte Result Units Qualifiers RDL DF
RADIOLOGICAL - (Analysis Performed by GEL)
Vendor Parameter Complete
Sample #: 2015016489
Matrix: GW—WW
Analytical Lab
Page 4 of 21
Method Analysis Date/Time Analyst
Vendor Method
v GEL
Certificate of Laboratory Analysis
This report shall not be reproduced, except in full.
Order # J15050773
Site: ABMW-07S
Collection Date: 28 -May -15 11:05 AM
Analyte Result
RADIOLOGICAL - (Analysis Performed by GEL)
Vendor Parameter
Sample #: 2015016517
Matrix: GW—WW
Analytical Lab
Page 5 of 21
Units Qualifiers RDL DF Method Analysis Date/Time Analyst
1 Vendor Method v_GEL
Certificate of Laboratory Analysis
This report shall not be reproduced, except in full.
Order # J15050773
Site: ABMW-02
Collection Date: 28 -May -15 8:55 AM
Analyte Result
RADIOLOGICAL - (Analysis Performed by GEL)
Vendor Parameter
Sample #: 2015016518
Matrix: GW—WW
Analytical Lab
Page 6 of 21
Units Qualifiers RDL DF Method Analysis Date/Time Analyst
1 Vendor Method v_GEL
® Laboratories LLC
a member of The GEL Group Ilei;
June 18, 2015
Mrs. Mary Ann Ogle
Duke Energy Analytical Laboratory
13339 Hagers Ferry Road
Mail Code: MGO3A2
Huntersville, North Carolina 28078
Re: AB GW Assessment Water
Work Order: 374139
SDG: J15050773
Dear Mrs. :
,Analytical Lab
age 7 of 21 is
Po Box 30712 Charleston, SC 29417
2040 Savage Road Chad"an. SC 29407
F 843.556.8171
F 843.766.1178
GEL Laboratories, LLC (GEL) appreciates the opportunity to provide the enclosed analytical results for the
sample(s) we received on June 02, 2015. This revised data report has been prepared and reviewed in accordance
with GEL's standard operating procedures. Rev01: This data package is revised to include the correct Duke job
number.
Our policy is to provide high quality, personalized analytical services to enable you to meet your analytical needs
on time every time. We trust that you will find everything in order and to your satisfaction. If you have any
questions, please do not hesitate to call me at (843) 556-8171, ext. 4443.
Purchase Order: 1142110
Enclosures
Page 1 of 14
Sincerely,
JAY ,
Lindsay Fabra
Project Manager
gel.com
Analytical Lab
Page 8 of 21
GEL LABORATORIES LLC
2040 Savage Road Charleston SC 29407 - (843) 556-8171 - www.gel.com
Certificate of Analysis Report
for
DUP0002 Duke Energy
Client SDG: J15050773 GEL Work Order: 374139
The Qualifiers in this report are defined as follows:
* A quality control analyte recovery is outside of specified acceptance criteria
** Analyte is a Tracer compound
** Analyte is a surrogate compound
J Value is estimated
U Analyte was analyzed for, but not detected above the MDL, MDA, or LOD.
Where the analytical method has been performed under NELAP certification, the analysis has met all of the
requirements of the NELAC standard unless qualified on the Certificate of Analysis.
The designation ND, if present, appears in the result column when the analyte concentration is not detected above
the limit as defined in the 'U' qualifier above.
This data report has been prepared and reviewed in accordance with GEL Laboratories LLC
standard operating procedures. Please direct any questions to your Project Manager, Lindsay Fabra.
Reviewed by
Page 2 of 14
JU,&Y ,
Analytical Lab
GEL LABORATORIES LLC Page 9 of 21
2040 Savage Road Charleston SC 29407 - (843) 556-8171 - www.gel.com
Certificate of Analysis
Company:
Duke Energy Analytical Laboratory
Address :
13339 Hagers Ferry Road
Mail Code: MG03A2
SW846 3010A/6020A Liquid "As Received"
Huntersville, North Carolina 28078
Contact:
Mrs. Mary Ann Ogle
Project:
AB GW Assessment Water
Client Sample ID:
Sample ID:
Matrix:
Collect Date:
Receive Date:
Collector:
2015016489
374139001
Ground Water
28 -MAY -15 09:55
02 -JUN -15
Client
Report Date: June 18, 2015
Project: DUKE00225
Client ID: DUP0002
Parameter Qualifier Result DL RL Units DF Analyst Date Time Batch Method
Metals Analysis -ICP -MS
SW846 3010A/6020A Liquid "As Received"
Uranium -238 U 0.000163
0.000335
0.001
ug/mL
5 SKJ 06/11/15
0738 1483666 1
Uranium -233 U 0.00
0.00001
0.00005
ug/mL
1 SKJ 06/11/15
0959 1483666 2
Uranium -234 U 0.00
0.00001
0.00005
ug/mL
1
Uranium -236 U 0.00
0.00001
0.00005
ug/mL
1
Rad Gas Flow Proportional Counting
GFPC, Ra228, Liquid "As Received"
Radium -228 U 0.870
2.34
3.00
pCi/L
AXM6 06/09/15
1430 1483210 3
Rad Radium -226
Lucas Cell, Ra226, liquid "As Received"
Radium -226 0.701
0.630
1.00
pCi/L
CXP3 06/08/15
1000 1482632 4
The following Prep Methods were performed:
Method Description
Analyst
Date
Time Prep Batch
SW846 3010A SW 846 3010 Acid Digestion
JP1
06/08/15
1545 1483665
The following Analytical Methods were performed:
Method Description
Analyst Comments
1 SW846 3010A/6020A
2 SW846 3010A/6020A
3 EPA 904,0/SW846 9320 Modified
4 EPA 903.1 Modified
Surrogate/Tracer Recovery Test
Result
Nominal Recovery%
Acceptable Limits
Barium -133 Tracer GFPC, Ra228, Liquid "As Received"
75.9
(15%-125%)
Notes:
Page 3 of 14
Analytical Lab
GEL LABORATORIES LLC Page 10 of 21
2040 Savage Road Charleston SC 29407 - (843) 556-8171 - www.gel.com
Certificate of Analysis
Company:
Duke Energy Analytical Laboratory
Address :
13339 Hagers Ferry Road
Mail Code: MG03A2
SW846 3010A/6020A Liquid "As Received"
Huntersville, North Carolina 28078
Contact:
Mrs. Mary Ann Ogle
Project:
AB GW Assessment Water
Client Sample ID:
Sample ID:
Matrix:
Collect Date:
Receive Date:
Collector:
2015016517
374139002
Ground Water
28 -MAY -15 11:05
02 -JUN -15
Client
Report Date: June 18, 2015
Project: DUKE00225
Client ID: DUP0002
Parameter Qualifier Result DL RL Units DF Analyst Date Time Batch Method
Metals Analysis -ICP -MS
SW846 3010A/6020A Liquid "As Received"
Uranium -238 J 0.000102
0.000067
0.0002
ug/mL
1 SKJ 06/17/15
1443 1486340 1
Uranium -233 U 0.00
0.00001
0.00005
ug/mL
1 SKJ 06/18/15
0859 1486340 2
Uranium -234 U 0.00
0.00001
0.00005
ug/mL
1
Uranium -236 U 1.00E-06
0.00001
0.00005
ug/mL
1
Rad Gas Flow Proportional Counting
GFPC, Ra228, Liquid "As Received"
Radium -228 U 0.670
2.34
3.00
pCi/L
AXM6 06/09/15
1430 1483210 3
Rad Radium -226
Lucas Cell, Ra226, liquid "As Received"
Radium -226 1.79
0.644
1.00
pCi/L
CXP3 06/08/15
1000 1482632 4
The following Prep Methods were performed:
Method Description
Analyst
Date
Time Prep Batch
SW846 3010A SW 846 3010 Acid Digestion
JP1
06/16/15
1630 1486339
The following Analytical Methods were performed:
Method Description
Analyst Comments
1 SW846 3010A/6020A
2 SW846 3010A/6020A
3 EPA 904,0/SW846 9320 Modified
4 EPA 903.1 Modified
Surrogate/Tracer Recovery Test
Result
Nominal Recovery%
Acceptable Limits
Barium -133 Tracer GFPC, Ra228, Liquid "As Received"
77.0
(15%-125%)
Notes:
Page 4 of 14
Analytical Lab
GEL LABORATORIES LLC Page 11 of 21
2040 Savage Road Charleston SC 29407 - (843) 556-8171 - www.gel.com
Certificate of Analysis
Company:
Duke Energy Analytical Laboratory
Address :
13339 Hagers Ferry Road
Mail Code: MG03A2
SW846 3010A/6020A Liquid "As Received"
Huntersville, North Carolina 28078
Contact:
Mrs. Mary Ann Ogle
Project:
AB GW Assessment Water
Client Sample ID:
Sample ID:
Matrix:
Collect Date:
Receive Date:
Collector:
2015016518
374139003
Ground Water
28 -MAY -15 08:05
02 -JUN -15
Client
Report Date: June 18, 2015
Project: DUKE00225
Client ID: DUP0002
Parameter Qualifier Result DL RL Units DF Analyst Date Time Batch Method
Metals Analysis -ICP -MS
SW846 3010A/6020A Liquid "As Received"
Uranium -238 0.0625
0.000067
0.0002
ug/mL
1 SKJ 06/17/15
1448 1486340 1
Uranium -233 U 0.00
0.00001
0.00005
ug/mL
1 SKJ 06/18/15
0904 1486340 2
Uranium -234 U 4.00E-06
0.00001
0.00005
ug/mL
1
Uranium -236 U 0.00
0.00001
0.00005
ug/mL
1
Rad Gas Flow Proportional Counting
GFPC, Ra228, Liquid "As Received"
Radium -228 1.91
1.66
3.00
pCi/L
AXM6 06/09/15
1430 1483210 3
Rad Radium -226
Lucas Cell, Ra226, liquid "As Received"
Radium -226 0.695
0.624
1.00
pCi/L
CXP3 06/08/15
1000 1482632 4
The following Prep Methods were performed:
Method Description
Analyst
Date
Time Prep Batch
SW846 3010A SW 846 3010 Acid Digestion
JP1
06/16/15
1630 1486339
The following Analytical Methods were performed:
Method Description
Analyst Comments
1 SW846 3010A/6020A
2 SW846 3010A/6020A
3 EPA 904,0/SW846 9320 Modified
4 EPA 903.1 Modified
Surrogate/Tracer Recovery Test
Result
Nominal Recovery%
Acceptable Limits
Barium -133 Tracer GFPC, Ra228, Liquid "As Received"
82.6
(15%-125%)
Notes:
Page 5 of 14
GEL LABORATORIES LLC
2040 Savage Road Charleston, SC 29407 - (843) 556-8171 - www.gel.com
QC Summary
Duke Energy Analytical Laboratory
13339 Hagers Ferry Road
Mail Code: MG03A2
Huntersville, North Carolina
Contact: Mrs. Mary Ann Ogle
Workorder: 374139
Analytical Lab
Page 12 of 21
Report Date: June 18, 2015
Page 1 of 4
Parmname
NOM
Sample
Qual
QC
Units
RPD%o
REC%
Range Anlst
Date Time
Metals Analysis - ICPMS
Batch 1483666
QC1203331839
374139001
DUP
Uranium -233
U
ND
U
ND
ug/mL
N/A
SKJ
06/11/1510:01
Uranium -234
U
ND
U
ND
ug/mL
N/A
Uranium -236
U
ND
U
ND
ug/mL
N/A
Uranium -238
U
ND
U
ND
ug/mL
N/A
06/11/15 07:39
QC1203331838
LCS
Uranium -238
0.0496
0.0528
ug/mL
106
(80%-120%)
06/11/15 07:37
QC1203333067
LCS
Uranium -233
0.0005
0.000502
ug/mL
100
(80%-120%)
06/11/15 08:45
Uranium -234
0.00055
0.000529
ug/mL
96.2
(80%-120%)
Uranium -236
0.005
0.0056
ug/mL
112
(80%-120%)
QC1203331837
MB
Uranium -233
U
ND
ug/mL
06/11/15 08:44
Uranium -234
U
ND
ug/mL
Uranium -236
U
ND
ug/mL
Uranium -238
U
ND
ug/mL
06/11/15 07:36
QC1203331840
374139001
MS
Uranium -238
0.0496
U
ND
0.0529
ug/mL
106
(75%-125%)
06/11/15 07:41
QC1203333068
374139001
MS
Uranium -233
0.0005
U
ND
0.000395
ug/mL
79
(75%-125%)
06/11/1510:02
Uranium -234
0.00055
U
ND
0.000415
ug/mL
75.5
(75%-125%)
Uranium -236
0.005
U
ND
0.0044
ug/mL
87.9
(75%-125%)
QC1203331841
374139001
SD1LT
Uranium -233
U
ND
U
ND
ug/L
N/A
06/11/1510:03
Page 6of14
Workorder: 374139
U
Parmname
U
Metals Analysis - ICPMS
ug/mL
Batch 1483666
(75%-125%)
Uranium -234
ND
Uranium -236
ND
Uranium -238
N/A
Batch 1486340
U
QC1203338454 374139002
DUP
Uranium -233
ug/mL
Uranium -234
Uranium -236
0.000102
Uranium -238
0.0000775
QC1203338453 LCS
27.3 ^
Uranium -238
QC1203338461 LCS
Uranium -233
ug/mL
Uranium -234
0.0005
Uranium -236
QC1203338452 MB
0.000522
Uranium -233
Uranium -234
Uranium -236
Uranium -238
u9/mL
QC1203338455 374139002
MS
Uranium -238
QC1203338462 374139002
MS
Uranium -233
Uranium -234
Uranium -236
U
QC1203338456 374139002
SDILT
Page 7 of 14
Analytical Lab
Page 13 of 21
GEL LABORATORIES LLC
2040 Savage Road Charleston, SC 29407 - (843) 556-8171 - www.gel.com
QC Summary
Page 2 of 4
NOM Sample Qual QC Units RPD% REC% Range Anlst Date Time
U ND U ND ug/L N/A
U ND U ND ug/L N/A (0%-10%) SKJ 06/11/1510:03
U ND U ND ug/L N/A (0%-10%) 06/11/15 07:42
(+/-0.0002)
105 (80%-120%)
104 (80%-120%)
102 (80%-120%)
115 (80%-120%)
106
U
ND
U
ND
ug/mL
N/A
(75%-125%)
U
ND
U
ND
ug/mL
N/A
U
ND
U
ND
ug/mL
N/A
J
0.000102
J
0.0000775
ug/mL
27.3 ^
0.0496
0.052
ug/mL
0.0005
0.000522
ug/mL
0.00055
0.000559
u9/mL
0.005
0.00575
ug/mL
U
ND
ug/mL
U
ND
ug/mL
U
ND
ug/mL
U
ND
ug/mL
0.0496
J
0.000102
0.0529
ug/mL
0.0005
U
ND
0.000506
ug/mL
0.00055
U
ND
0.000559
ug/mL
0.005
U
ND
0.00582
ug/mL
(+/-0.0002)
105 (80%-120%)
104 (80%-120%)
102 (80%-120%)
115 (80%-120%)
106
(75%-125%)
101
(75%-125%)
102
(75%-125%)
116
(75%-125%)
SKJ 06/18/15 09:00
06/17/15 14:44
06/17/15 14:39
06/18/15 08:55
06/18/15 08:53
06/17/15 14:37
06/17/15 14:45
06/18/15 09:02
Analytical Lab
Page 14 of 21
GEL LABORATORIES LLC
2040 Savage Road Charleston, SC 29407 - (843) 556-8171 - www.gel.com
Page 8 of 14
QC Summary
Workorder: 374139
Page 3 of 4
Parmname NOM
Sample Qual QC Units
RPD%
REC% Range Anlst
Date Time
Metals Analysis - ICPMS
Batch 1486340
Uranium -233 U
ND U ND
ug/L
N/A
06/18/15 09:03
Uranium -234 U
ND U ND
ug/L
N/A
SKJ
Uranium -236 U
ND U ND
ug/L
N/A
(0%-10%)
Uranium -238 1
0.102 U ND
ug/L
N/A
(0%-10%)
06/17/1514:47
Rad Gas Flow
Batch 1483210
QC1203330594 374139003 DUP
Radium -228
1.91 U 0.803
pCi/L
81.4
(0% - 100%) AXM6
06/09/15 14:30
QC1203330595 LCS
Radium -228 30.9
28.3
pCi/L
91.6 (75%-125%)
06/09/1515:52
QC1203330593 MB
Radium -228
U 1.08
pCi/L
06/09/1515:52
Rad Ra -226
Batch 1482632
QC1203329123 374139001 DUP
Radium -226
0.701 1.07
pCi/L
41.4
(0% - 100%) CXP3
06/08/15 10:30
QC1203329125 LCS
Radium -226 24.7
26.1
pCi/L
106 (75%-125%)
06/08/1510:30
QC1203329122 MB
Radium -226
U 0.478
pCi/L
06/08/1510:00
QC1203329124 374139001 MS
Radium -226 124
0.701 131
pCi/L
105 (75%-125%)
06/08/1510:30
Notes:
The Qualifiers in this report are defined as follows:
** Analyte is a Tracer compound
< Result is less than value reported
> Result is greater than value reported
BD Results are either below the MDC or tracer recovery
is low
E %difference of sample and SD is >10%. Sample
concentration must meet flagging criteria
FA Failed analysis.
FB Mercury was found present at quantifiable concentrations in field blanks received with these samples.
Data associated with the blank are deemed
invalid for reporting to regulatory agencies
Page 8 of 14
GEL LABORATORIES LLC
2040 Savage Road Charleston, SC 29407 - (843) 556-8171 - www.gel.com
QC Summary
Workorder: 374139
Parmname NOM Sample Qual QC Units RPD% RF,C'%o
H Analytical holding time was exceeded
J Value is estimated
K Analyte present. Reported value may be biased high. Actual value is expected to be lower.
L Analyte present. Reported value may be biased low. Actual value is expected to be higher.
M M if above MDC and less than LLD
Analytical Lab
Page 15 of 21
Range Anlst
M REMP Result > MDC/CL and < RDL
N Metals --The Matrix spike sample recovery is not within specified control limits
N/A RPD or %Recovery limits do not apply.
N 1 See case narrative
ND Analyte concentration is not detected above the detection limit
NJ Consult Case Narrative, Data Summary package, or Project Manager concerning this qualifier
Q One or more quality control criteria have not been met. Refer to the applicable narrative or DER.
R Sample results are rejected
U Analyte was analyzed for, but not detected above the MDL, MDA, or LOD.
UI Gamma Spectroscopy --Uncertain identification
UJ Gamma Spectroscopy --Uncertain identification
UL Not considered detected. The associated number is the reported concentration, which may be inaccurate due to a low bias.
X Consult Case Narrative, Data Summary package, or Project Manager concerning this qualifier
Y Other specific qualifiers were required to properly define the results. Consult case narrative.
^ RPD of sample and duplicate evaluated using +/-RL. Concentrations are <5X the RL. Qualifier Not Applicable for Radiochemistry.
h Preparation or preservation holding time was exceeded
Page 4 of 4
Date Time
N/A indicates that spike recovery limits do not apply when sample concentration exceeds spike cone. by a factor of 4 or more or %RPD not applicable.
^ The Relative Percent Difference (RPD) obtained from the sample duplicate (DUP) is evaluated against the acceptance criteria when the sample is greater than
five times (5X) the contract required detection limit (RL). In cases where either the sample or duplicate value is less than 5X the RL, a control limit of +/- the
RL is used to evaluate the DUP result.
* Indicates that a Quality Control parameter was not within specifications.
For PS, PSD, and SDILT results, the values listed are the measured amounts, not final concentrations.
Where the analytical method has been performed under NELAP certification, the analysis has met all of the
requirements of the NELAC standard unless qualified on the QC Summary.
Page 9 of 14
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Page 10 of 14
Analytical Lab
Page 16 of 21
Page 10 of 14
Analytical Lab
Page 16 of 21
This Shipping Order must be legibly tilled in, in Ink, in Indelible Pencil, or in
-* 7 r Ii Carbon and retained by the Agent ShippeA��lytiC81 Lab
x,xla �z i�ff�e),5.� 1, Page 17of21
CARY, ( 1,519 Carrier No.
(91 9) c- d BMs Date
(Name of Carrier) (SCAC)
TO: n FROM
f
Consignee k �-, Shipper
On CoIecf on Delivery shipments, ttjo letters COD" must appear belotoconslgnee s name -- or as othervdse provided in Item 430 Sec 1
i
Street .. ( (' i f t Street �.
Destinatwn s t -'- Zip Code Origin' e ` Zip Code
Vehicle U.S. DOT Hazmat
Number Reg. Number
No. Shipping
*
Kind of Packaging, Description of Articles,
Weight
(Subject to
RATE
CHARGES
Units
HM
Special Marks and Exceptions
Correction)
0>> r :`
-i
CPoll b Cdr r
8N
REMIT t
C.O.D. FEE:
C.O.D. TO: %COD
PREPAID O $
ADDRESS
Amt:$
COLLECT ED
Note – Where the rate is dependent on value, shippers are required to
This is to certify at the above materials are properly
Subject to -Section 7 of the conditions, if this shipment is to be
TOTAL
state specifically in writing the agreed or declared value Of the property.
.1—ifiad, described, packaged, marked, and labeled,
delivered to the consignee without recourse on the consignor, the
consignor shall sign the following statement:
$
CHARGES:
The agreed or declared value of the property is hereby specifically stated
and are in proper condition for transportation to
The carrier shall not make daiivery of this shipment without paymant
FREIGHT CHARGES
by the shipper to be not exceeding
thea bier latiorR of me De anm.nf of Trans rtfftion.
ppi1C° 3u p Po
of heand ail other lawful charges.
FREIGHT PREPAID Chack ti
¢xcapt when nehsrges aro
flak at ru)hl labe
$ per
ch¢.ketl Had
bi nature
nature o onsi nor
RECEIVED, subject to the classifications and lawfully filed tariffs in effect on the date or the Issue or UP$ stn or t.aomg, me property aescnaeo some it, apple—' S.— uau:pr a3 „�,v� tw,„r,w o„„ ,.,,,,..,,,.. ,.. r.v�,..0.... ................ ............
consigned, and destined as indicated above which said carrier (the word carrier being understood throughout this contract as meaning any person or corporation in possession of the property under the contract) agrees to carry to Its usual place of delivery at laic
destination, If on its route, otherwise to deliver to another carrier on the route to said destination. It is mutually agreed as to each carrier of all or any of, said property mar all or any portion of said route to destination and as to each parry at any time interestec
in all or any of said property, that every service to be performed hereunder shall be subject to all the bill of lading terms and conditions in the governing classification on the date of shipment. -
Shipper hereby contrast that he is familiar with all the bill of lading terms and conditions in file governing classification and the said terms and conditions are hereby agreed to by the shipper and accepted for himself and his assigns.
SHIPPER „�*&
PER
EMERGENCY RESPONSE
TELEPHONE NUMBER:
Monitored at all times the Haze
BLCC-602-3
PRINTED IN U.S.A.
Page 11 of 14
CARRIER
PER jam}
DATE (`�)
orlatlon Including storage inceiantal to trar pQlra aIn (3Ile War
* M fk x ih an % to dg11te Har,adkralrflrf at f—i aI in 0 PIna ail .1 '—P.tar. Raa r 1 to ca g The Ira pc 1 al et h.: mawai5..
The of th, ' rri..1 111-d Ter lo-d—',atcsres on b'ilY f i ag Ps' 5 cion 1r22tlt(a)ti)f T:ka 19 .nae al Fedeef
q gulp; or .AIA 1a?n SW png h-1e.r. et tai the 1-. s erH - "stamen, ps ,bed Sec.on t72[W(a)..f 11,a( (. !a. Ile a —a be
rdcated en n e bit al le;i«xj. r. £t:.s a ..p. tF —Wr— far' Iii.feG.1r', vk is p wrfad 1n .ire R..,) I.;.':rm (w .:r (-'kv maleral,
Analytical Lab
Page 18 of 21
Laboratories LLC
SAMPLE RECEIPT & REVIEW FORM
Client: LAAKE SDG/AWCOC1Work Order: i
Received By: 71V—Vj Date Received: G,� / 0 /
Suspected Hazard Information
Ii Z *If Net Counts > 100cpm on samples not marked "radioactive", contact the Radiation Safety Group for further
>" investigation.
COC/Samples marked as radioactive?
Maximum Net Counts Observed* (Observed Counts - Area Background Counts): L44z Vj,
Classified Radioactive II or III by RSO?
If yes, Were swipes taken of sample contatiners < action levels?
COC/Samples marked containing PCBs?
Package, COC, and/or Samples marked as
beryllium or asbestos containing?
If yes, samples are to be segregated as Safety Controlled Samples, and opened by the GEL Safety Group.
Shipped as a DOT Hazardous?Hazard
Class Shipped: UN#:
Samples identified as Foreign Soil?
Sample Receipt CriteriaZ
z
Comments/Qualifiers (Required for Non -Conforming Items)
Shipping containers received intact
Circle Applicable:
I
and sealed?
V
Seals broken Damaged container Leaking container Other (describe)
2
Samples requiring cold preservation
Preservation Method: Ice bags Blue ice Dry ice None Other (describe)
within (D < 6 deg. C)?*
all temperatures are recorded in Celsius
2a
Daily check performed and passed on
Temperature Device Serial #:
�t Secondary Temperature Device Serial # (If Applicable):
IR temperature gun?
?
Chain of custody documents included
3
with shipment?
Circle Applicable:
4
Sample containers intact and sealed?
Seals broken Damaged container Leaking container Other (describe)
Samples requiring chemical
Sample ID's, containers affected and observed pH:
$
preservation at proper pH?
If Preservation added #:
Do Low Level Perchlorate samples
Sample ID's and containers affected:
6
(EPA 6850) have headspace as
required?
VOA vials free of headspace (defined
Sample ID's and containers affected:
as < 6mm bubble)?
If yes, immediately deliver to Volatiles laboratory)
8
Are Encore containers present?
V
Samples received within holding
ID's and tests affected:
9
time?
Sample ID's on COC match ID's on
Sample ID's and containers affected:
10
bottles?
Date & time on COC match date &
Sample ID's affected:
11
time on bottles?
Number of containers received match
Sample ID's affected:
12
number indicated on COC?
13
Are sample containers identifiable as
GEL provided?
COC form is properly signed in
14
relinquished/received sections?
Circle Applicable:
FedEx Air FedEx Ground UPS Field Services Courier ther
15
Carrier and tracking number.
li
Comments (Use Continuation Form if needed):
PM (or PMA) review: Initials Date... page Page of \ GL -CHL -SR -001 Rev 1
Page 12 of 14
List of current GEL Certifications as of 18 June 2015
State
Certification
Alaska
UST -110
Arkansas
88-0651
CLIA
42D0904046
California
2940 Interim
Colorado
SC00012
Connecticut
PH -0169
Delaware
SC000122013-10
DoD ELAP/ ISO 17025 A2LA
2567.01
Florida NELAP
E87156
Foreign Soils Permit
P330 -12-00283,P330-12-00284
Georgia
SC00012
Georgia SDWA
967
Hawaii
SC000122013-10
Idaho Chemistry
SC00012
Idaho Radiochemistry
SC00012
Illinois NELAP
200029
Indiana
C—SC-01
Kansas NELAP
E-10332
Kentucky SDWA
90129
Kentucky Wastewater
90129
Louisiana NELAP
03046 (A133904)
Louisiana SDWA
LA150001
Maryland
270
Massachusetts
M—SC012
Michigan
9976
Mississippi
SC000122013-10
Nebraska
NE—OS-26-13
Nevada
SC000122014-1
New Hampshire NELAP
2054
New Jersey NELAP
SC002
New Mexico
SC00012
New York NELAP
11501
North Carolina
233
North Carolina SDWA
45709
Oklahoma
9904
Pennsylvania NELAP
68-00485
Plant Material Permit
PDEP-12-00260
S.Carolina Radchem
10120002
South Carolina Chemistry
10120001
Tennessee
TN 02934
Texas NELAP
T104704235-15-10
Utah NELAP
SC000122015-17
Vermont
VT87156
Virginia NELAP
460202
Washington
C780
West Virginia
997404
Page 13 of 14
Analytical Lab
Page 19 of 21
Analytical Lab
There are no "Data Exception Reports" associated with this analytical rel.20 of 21
Page 14 of 14
CHAM OF CUSTODY RECORD AND ANALYSIS REQUEST FORM
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