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Sampling Request <br />Re uestor: Alexander Blane-Zimberg <br />Date Requested: 11/17/16 <br />Send Results To: Hector Pedemonte / Alexander Blane-Zimber <br />Phone: 22549 <br />® Normal Sampling <br />M 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 />❑ GAB <br />FEB g <br />bldg. number. <br />number. <br />Task <br />Task #: <br />❑ New IGD <br />W356466/ 2�Q q b� <br />Form Code: W114 <br />IGD#: 00910 <br />F]Potentially Radioactive <br />CC Approval: 06«iat-oaic> <br />❑ Gamma Spec. <br />❑ Sample may contain Beryllium <br />❑ TCLP 8260 <br />Oil and Grease <br />❑ HF or Ammonium Bifluoride @ % <br />❑ TUPA <br />ENVIRONVIENTA <br />TAT: ® Normal <br />❑ HCl @ % <br />RCA Approval: 0.iIi; WoaI.t <br />❑ Rush <br />DEPARTN, <br />❑ TCLP 8270 <br />Off-site Analysis (Certified): <br />❑ Anions <br />❑ DUST <br />® Fish Toxicity <br />17�,NW, p r <br />77 <br />❑ Potassium onl'' <br />❑ 608 <br />❑ DLISTTCLP <br />❑ Flash Point <br />❑ HEX Chrome <br />- <br />❑ 624 <br />❑ FLIST <br />❑ Percent H2O <br />❑ GAB <br />FEB g <br />❑ 625 <br />❑ FLISTTCLP <br />❑ Explosives <br />[:]Tritium <br />Other Analysis: <br />❑ 8260 Total <br />❑ PCBs <br />❑ TATB <br />❑ Gamma Spec. <br />❑ TCLP 8260 <br />Oil and Grease <br />® TTLC Metals <br />❑ TUPA <br />ENVIRONVIENTA <br />❑ 8270 Total <br />❑ TPH gas <br />❑ STLC Metals <br />❑ Curium <br />DEPARTN, <br />❑ TCLP 8270 <br />❑ TPH oil/diesel <br />❑ TCLP Metals <br />❑ Carbon-14 <br />❑ WVORG <br />❑ Total Cyanide <br />❑ Beryllium only <br />❑ Sr -90 or Tc-99 <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: 11/17/16 <br />Logbook Entry: DV— -7 1 <br />Comments: <br />Time Sampled: 10:30am <br />COC#: d,06 I % <br />W356466, aqueous mix (TTLC, PPM OIL/Grease, Fish Tox) <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: 12/16118 <br />H _ AI_TH <br />NT <br />