|
� � �.
<br /> � �• r
<br /> ' OrderZDi 351505263
<br /> ' Asbestos Chain of Custody �':�SL ti�.�.: . ��., �-;
<br /> � rY ,:i��J r.'..; .�.=_ nl�_i';��.'
<br /> � �= EMSL Order Number�cab use o��y,_ ;,.,E 4,�,�,5 r�r���:::��
<br /> ; �- _ // ((�/j�2] ��, �._ �7e�,-i=1:; a�31:,
<br /> � tM61 11VA1YtICAI.INC � ....... ..._. ..,.. ...-_..�L.�V✓ ... . . �
<br /> ...c..•�..-...e..-...�.....a _..__ : ,r r�t •� � �i_�u�.
<br /> � EMSL-BIII to; Same , Uift�rent
<br /> Compan�r:Nick�Consuttants ; if nni�,�5.^�dio•c�".rpfe+nstnx'iors n�om-�rrls"
<br /> � Street:4301 Spruce Way' _� ThtrdParti Hr,�i�rnqu�res w�tten authonratian Irom thirA{:arty
<br /> ; City: 1Maple Ptain I State/Province:MN Zip:PostN Code:5535Y Country:U5A
<br /> � Report To{Name): Douglas E.Hickey Fax#: 763�79�294
<br /> ' telephone!1� ]63-479-3214 Email Address: dhickeymn��rahoo.com
<br /> _ _ __.,__. _. _ __
<br /> Pro)oct NamelNumber. SWD91615
<br /> _- -- - - _ _ -- -
<br /> + Please Provide Rosutts: �;_I Fax �Errwi! j PurchaseOrder: � U.S.State Sam Iss Takent MN
<br /> , .. - - _ _._ ..__._._..a-__.___.�. ..�_ __..__ __. .
<br /> _. _. _ . _ .—__ ..
<br /> � Turnaround Time(TAT!Options•-Pfoaae Check
<br /> „ . . -- - .___ -
<br /> � �3 Hour y�,;6 Hour �24 Hour 1❑48 Hour � L; 7T Hour�(� 96 Hour_, i'I Weak �I�2 Wt3Bk
<br /> 't ot 7f:1rf A�r:!A�fhmuQn 6 hr,'NCase Car d���a^,t�s���.^.C��o'�he;�;i,s�premi�m G/:a:gc lt�r 31!uw T�M ANER11 rN LPA Leve/!I 7R 1 Yo:r wd!Ih;esked fo sryi�
<br /> ' an aciMonzafror/or�r/cr M�s m�r^e �i�ai s:•s�:�m tiNeA err a(�!d�r7�Y7 wr:h,FMSt S T�rms.3r�(:�nerjRr.�:s b�efeC/!rhe An rcw Pr�Cwrde.
<br /> __
<br /> � M•Air TEM-Air Q 4�.Shr TAT(AHERA oMy� TEM-UUfi
<br /> ❑ NiOSH 1400 [� ANE�Zq 40 CF K,Part 763 'hlicrovac-ASTM D 5755
<br /> (_ wi dSHA$hr.TWl� Q NiOSH 74R2 I [Wi,^.r. ASTM 7fi480
<br /> ___ _ _.___._..__ _ _
<br /> PLNi-Bulk innortin9 ti t ❑ EPA l ovel It ❑Ca�et Snnication{EPA 60Q;J-93/t67)
<br /> �PLM FPA 600rR-93;116(<1�0) � ❑ iS0 1Q312 5y,of1lRockNormicuNta _ _
<br /> _ ._ _ _- __
<br /> ❑P�M EPA NUEI(<1�k) � M-Su ❑PLM CARB 435-A(0.25°k sensitivity)
<br /> Pomt Count } ❑TEM EPA N08 ❑PLM CARB 435-8(0.1°o sansiiivity)
<br /> ❑40Q{<0.25%}0 1000(<0.196) i ❑NYS NOB 198.4(non-friab4e-WY) I ❑TEM CARB 435-B(0.14b sensitiwty)
<br /> Po�nt Count w/Grevimetric ' ❑Chatfield SOP ❑TEM CARB 435-C(0.0'.%scsnsitivity►
<br /> ' ❑400(<0.25°�,}�1000(<0.1%) � ❑TEM Mass Anafysls-EPA 600 sec.2.5 j ;]EPA Protocol(Sart�i-QuanHtaGve)
<br /> � ❑ f�YS 198.1(tnaWe in NYj ° TEM-Wats�:FPA 100.7. 1 L;EPA Protocol(Quantitative)
<br /> 3 Q NYS 198.G 1J08{non-fnaWe-NY) Fibers?10um []Waste []Drinking Other.
<br /> i � NIOSH 9002(�1°!0) � All Fibc;r 5i�es L�Waste ❑DrinkirG i :�
<br /> �Check For Positive Stop-Clearl Identify Homogenous Group
<br /> -- _ _ _.. _.�p. . . --- _... _ .��---
<br /> ._._-
<br /> Sampiers iYame:aouglas Hickey S�np�era Sipeature: :�) r'�
<br /> furrw/Area{Airj OatalTime
<br /> sa►�� Sampla pescriptiwt HA iF Bulk Sa {ed
<br /> .?1 - 61,D Z. _ /t ud-�i,iG_ Sf/i.✓G/.�S �� r�c,Lyp , ��Ar.n �l 2�/
<br /> -�).n� �t .1,v I,:1 '� ! L'+ }�2 �,k � .:.L< � d i
<br /> 'j' ' r�' t n i r�G .
<br /> �,__._..
<br /> !
<br /> �a�- �`�.0 � �'P� .- -v L �� Y,=.l�.• �, .'�+--.v>�.ir-- ! .__ . ._
<br /> � . U o �r" fa•,.� 1. ��l.,., --� .c.,�
<br /> , ,
<br /> ,. � .. - , • .-- , �
<br /> �.:.; ,�- (i. ! � `1f. �. _� i>til._..��:,� - ��� � ''L',_Q i
<br /> %�'' ��.____ �'� � ,, Tf iZ�'�__ �
<br /> - __ _...______..,_._._ ._____,.�._
<br /> . , '
<br /> ��*,_ /3,<</ '�� ,ti. T, r"_�x`� � '
<br /> _ __,__ _��._____ _- --_.
<br /> �_��- � �c.� s►�; �'��% _ �.,,— ��� <.. 1 ��.�
<br /> Client Sa►r�ple#isj_ • - - -- Total 0 of Sam�plqs: _ .
<br /> . __ _ . _ _._. �
<br /> ___
<br /> _,_
<br /> Relinquished(Client): �� � Dato:-_�_�� Tima:
<br /> Racelved(Lab�: OatQ: � ��_I�__ Time: `7�. Yf�
<br /> Gomme�tslSpoclal at ctions:
<br /> _____.__ _ _ ..� _
<br /> c,.A.�ana.�-...-�.cac-w ,��v,e�. Page t ot.. .. .P�Jes
<br /> Paqe 1 Of 2
<br /> ��
<br />
|