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i <br />Sampling Request I <br />FEB o 9 2017 <br />Re uestor: Donald Dearing <br />Analysis (Certified): <br />Date Requested: 11 dON = NTAt <br />Send Results To: Donald Dearing, CC's <br />Phone: 35509 <br />❑ Normal Sampling <br />G&A (Overhead Account) or <br />❑ Other Client: <br />❑ Special Projects <br />Sample ID (s): (WDR / Q number or unique <br />Project #: <br />❑ IGD Verification <br />identifier. If no WDR provide description and <br />❑ HEX Chrome <br />❑ <br />bldg. number.) <br />Task #: <br />❑ New IGD <br />GAC#1-W356453, GAC#2-W356456 <br />Form Code: <br />625 <br />❑ Potentially Radioactive <br />CC Approval: mlruvDaro) <br />IGD#: <br />❑ Sample may contain Beryllium <br />8260 Total <br />D21 . I , <br />❑ HF or Ammonium Bifluoride @ 11/6 <br />❑ Gamma Spec. <br />❑ <br />TAT: ® Normal <br />❑ HCl @ % <br />RCA Approval: ti�����taaki <br />❑ Rush <br />I3Lbc- _ 6:34 <br />8270 Total <br />Off-site <br />Analysis (Certified): <br />❑ pH/N <br />❑ <br />Anions <br />❑ DUST <br />❑ Fish Toxicity <br />❑ Potassium only <br />❑ <br />608 <br />❑ DLISTTCLP <br />❑ Flash Point <br />❑ HEX Chrome <br />❑ <br />624 <br />❑ FLIST <br />❑ Percent H2O <br />❑ GAB <br />❑ <br />625 <br />❑ FLISTTCLP <br />❑ Explosives <br />❑ Tritium <br />® <br />8260 Total <br />❑ PCBs <br />❑ TATB <br />❑ Gamma Spec. <br />❑ <br />TCLP 8260 <br />❑ Oil and Grease <br />❑ TTLC Metals <br />❑ TUPA <br />❑ <br />8270 Total <br />❑ TPH gas <br />❑ STLC Metals <br />❑ Curium <br />❑ <br />TCLP 8270 <br />❑ TPH oil/diesel <br />❑ TCLP Metals <br />❑ Carbon-14 <br />❑ <br />WVORG <br />❑ Total Cyanide <br />' ❑ Beryllium only <br />❑ Sr -90 or Tc-99 <br />❑ <br />Other Analysis: <br />On-site Analysis (Non -certified): <br />❑ pH/N <br />❑ Carbon-14 <br />❑ <br />Hydrometer ❑ Paint Filter ❑ Flash Point <br />❑ Radscreen <br />❑ XRF <br />❑ <br />Specific Gravity ❑ Solubility ❑ Boiling Point <br />❑ Rad Dec <br />❑ Peroxide Strip <br />❑ <br />Liquefaction ❑ SCO Swipe & Survey <br />❑ Field Gamma <br />❑ Oxidizer Strip <br />❑ <br />Other Analysis: <br />Date Sampled: " 1A <br />Logbook Entry -D V " `t 7 <br />Comments: <br />Time Sampled: 14 3 e <br />COC#: <br />2 125mil samples of GAC for VOC's analysis. w <br />Beta/Gamma (cpm) = Beta/Gamma BKG (cpm) = Alpha (cpm) = Alpha BGK (cpm) _ <br />Container Activity (Ci) = Sample Activity (uCi) = Total Sample Volume (ml) _ <br />Sample Activity Concentration (uCi'ml) = <br />WCG 0009 Effective Date 12/16/15 <br />See WIC 111 Expiration Date- 12/16/18 <br />=ALTH <br />