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0 <br />D. DEARING <br />Sampling Request <br />RECEIVED <br />DEC 04 2015 <br />ENVIRONMENTAL <br />Date Requested: 11/16/15 <br />Send Results To: D. KRAMER I <br />Phone: 3-9136 <br />® <br />Normal Sampling <br />❑ <br />® G&A (Overhead Account) or <br />❑ Other Client: <br />❑ <br />Special Projects <br />❑ <br />Sample ID (s): (WDR / Q number or unique <br />Project #: <br />❑ <br />IGD Verification <br />608 <br />identifier. If no WDR provide description and <br />DLISTTCLP <br />❑ <br />Flash Point <br />❑ <br />bldg. number.) <br />Task #: <br />❑ <br />New IGD <br />FLIST <br />874 Dus Bin, 874 Machine Area, 843 Outdoor <br />Form Code: <br />❑ <br />GAB <br />❑ <br />Work Area, 875 Machine Shop Area, 827B <br />CC Approval: (InitiaMate) <br />IGD#: Machine Shop. <br />❑ Potentially Radioactive <br />TAT: ❑ Normal ❑ Sample may contain Beryllium RCA Approval: (In�tiaVDate) <br />❑ Rush ❑ HF or Ammonium Bifluoride @ % <br />❑ HCI @ % <br />Off-site Analysis (Certified): <br />❑ pH/N <br />❑ <br />❑ <br />Anions <br />❑ <br />DLIST <br />❑ <br />Fish Toxicity <br />❑ <br />Potassium only <br />❑ <br />608 <br />❑ <br />DLISTTCLP <br />❑ <br />Flash Point <br />❑ <br />HEX Chrome <br />❑ <br />624 <br />❑ <br />FLIST <br />❑ <br />Percent H2O <br />❑ <br />GAB <br />❑ <br />625 <br />❑ <br />FLISTTCLP <br />❑ <br />Explosives <br />❑ <br />Tritium <br />❑ <br />8260 Total <br />❑ <br />PCBs <br />❑ <br />TATB <br />❑ <br />Gamma Spec. <br />❑ <br />TCLP 8260 <br />❑ <br />Oil and Grease <br />❑ <br />TTLC Metals <br />❑ <br />TUPA <br />❑ <br />8270 Total <br />❑ <br />TPH gas <br />❑ <br />STLC Metals <br />❑ <br />Curium <br />❑ <br />TCLP 8270 <br />❑ <br />TPH oil/diesel <br />❑ <br />TCLP Metals <br />❑ <br />Carbon-14 <br />❑ <br />WVORG <br />❑ <br />Total Cyanide <br />❑ <br />Beryllium only <br />❑ <br />Sr -90 or Tc-99 <br />❑ <br />Other Analysis: <br />On-site Analysis (Non -certified): <br />❑ pH/N <br />❑ <br />Carbon-14 <br />❑ <br />Hydrometer ❑ Paint Filter ❑ Flash Point <br />❑ Radscreen <br />❑ <br />XRF <br />❑ <br />Specific Gravity ❑ Solubility ❑ Boiling Point <br />❑ Rad Dec <br />❑ <br />Peroxide Strip <br />❑ <br />Liquefaction ❑ SCO Swipe & Survey <br />❑ Field Gamma <br />❑ <br />Oxidizer Strip <br />® <br />Other Analysis: PARTICLE SIZE <br />Date Sampled: <br />11/17/15 <br />Logbook Entry: DV -7; 30,31,32 <br />Comments: <br />Time Sampled: 1000,1015,1030,1045,1100 <br />COC#: 20219 <br />Beta/Gamma (cpm) = Beta/Gamma BKG (cpm) = Alpha (cpm) = Alpha BGK (cpm) _ <br />Container Activity (Ci) = Sample Activity (uCi) = Sample Volume (ml) = <br />WGS 0009 Effective Date: 8/12/15 <br />See WIC 111 Expiration Date: 1/15/16 <br />