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• r <br /> 9 <br /> A <br /> 9. Other (use addit nal sheets or tach suppleme ary information, <br /> needed) : <br /> Attached i a copy of the S EPA Regio 9 Laboratory QC S ary <br /> Report" rm <br /> a. is form is t be completed b the Laboratory Man er or designee <br /> and submitte with each data ackage <br /> The form 's to reflect th conditions containe'd/within the data <br /> package ith which it is submitted <br /> C. Labo atories may mak additional copies ofthis form as needed <br /> d separate form i to be completed and ttached to the Regio <br /> opy (original) each data package bmitted This form 's to <br /> be placed dire ly behind the SDG na ative <br /> e This form w' 1 be used to identify areas of noncomplia ce with the <br /> required Q limits that may resu s in resampling or eduction in <br /> payment <br /> f. Answer to questions are des' ned so that a YES nswer indicates <br /> compl ante and requires no rther explanation A NO answer <br /> ind ates noncompliance an requires a short planation. If a <br /> le gthy explanation is re fired (or desired) write See SDG <br /> N rrative in the blank s ace and include th explanation in the <br /> /DG narrative <br /> i <br /> i <br /> UJFT1295 CRF Page 13 of 13 Revision 12/3oc/95 <br /> Approved <br /> I <br />