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PNNL-18895
Analytical Data Report of Water Samples Collected For I-129 Analysis Michael Lindberg October 2009
DISCLAIMER This report was prepared as an account of work sponsored by an agency of the United States Government Neither the United States Government nor any agency thereof nor Battelle Memorial Institute nor any of their employees makes any warranty express or implied or assumes any legal liability or responsibility for the accuracy completeness or usefulness of any information apparatus product or process disclosed or represents that its use would not infringe privately owned rights Reference herein to any specific commercial product process or service by trade name trademark manufacturer or otherwise does not necessarily constitute or imply its endorsement recommendation or favoring by the United States Government or any agency thereof or Battelle Memorial Institute The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof PACIFIC NORTHWEST NATIONAL LABORATORY operated by BATTELLE for the UNITED STATES DEPARTMENT OF ENERGY under Contract DE-AC05-76RL01830 Printed in the United States of America Available to DOE and DOE contractors from the Office of Scientific and Technical Information
PO Box 62 Oak Ridge TN 37831-0062 ph (865) 576-8401 fax (865) 576-5728
email reportsadonisostigov Available to the public from the National Technical Information Service US Department of Commerce 5285 Port Royal Rd Springfield VA 22161
ph (800) 553-6847 fax (703) 605-6900
email ordersntisfedworldgov online ordering httpwwwntisgovorderinghtm
This document was printed on recycled paper
(92003)
PNNL-18895
Analytical Data Report of Water Samples Collected For I-129 Analysis M Lindberg October 2009 Prepared for the US Department of Energy under Contract DE-AC05-76RL01830 Pacific Northwest National Laboratory Richland Washington 99352
101909 1120 To Dale Dyekman From Michael J Lindberg Environmental Sciences Laboratory Energy and Environment Directorate Pacific Northwest National Laboratory Subject Analytical Data Report for Ground Water Samples Collected for I-129 Groundwater Sample Delivery Group ESL090004 SAF Number S09-004 This letter contains the following information for sample delivery group ESL090004 bull Cover Sheet bull Narrative bull Analytical Results bull Chain of Custodies
0905001 FINAL
Page 1 of 32
Introduction Between April 14 2009 and August 25 2009 groundwater samples were received for I-129 analysis Analytical ResultsMethodology The analyses for this project were performed at the 325 building located in the 300 Area of the Hanford Site The analyses were performed according to Pacific Northwest National Laboratory (PNNL) approved procedures andor nationally recognized test procedures The data sets include the sample identification numbers analytical results estimated quantification limits (EQL) and quality control data Quality Control The preparatory and analytical quality control requirements calibration requirements acceptance criteria and failure actions are defined in the on-line QA plan ldquoConducting Analytical Work in Support of Regulatory Programsrdquo (CAW) This QA plan implements the Hanford Analytical Services Quality Assurance Requirements Documents (HASQARD) for PNNL Definitions Dup Duplicate RPD Relative Percent Difference NR No Recovery (percent recovery less than zero) ND Non-Detectable REC Percent Recovery Sample Receipt Samples were received with a chain of custody (COC) and were analyzed according to the sample identification numbers supplied by the client All samples were refrigerated upon receipt until prepared for analysis All samples were received with custody seals intact unless noted in the Case Narrative Holding Times Holding time is defined as the time from sampling to the time of analyses The prescribed holding times were met for all analytes unless noted in the Case Narrative Analytical Results All reported analytical results meet the requirements of the CAW or client specified SOW unless noted in the case narrative
0905001 FINAL
Page 2 of 32
Case Narrative Report
Hold Time No discrepancies noted
Preparation Blank (PB) No preparation was performed therefore no blanks were analyzed
Duplicate (DUP) No preparation was performed therefore no duplicates were analyzed
Laboratory Control Samples (LCS)
No preparation was performed therefore no LCSs were analyzed
Post Spike (PS) No preparation was performed therefore no PSs were analyzed
Matrix Spike (MS) Not applicable
Other QC Criteria None noted
DISCLAIMER
This report was prepared as an account of work sponsored by an agency of the United States Government Neither the United States Government nor any agency thereof nor Battelle Memorial Institute nor any of their employees makes any warranty express or implied or assumes any legal liability or responsibility for the accuracy completeness or usefulness of any information apparatus product or process disclosed or represents that its use would not infringe privately owned rights Reference herein to any specific commercial product process or service by trade name trademark manufacturer or otherwise does not necessarily constitute or imply its endorsement recommendation or favoring by the United States Government or any agency thereof or Battelle Memorial Institute The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof
0905001 FINAL
Page 3 of 32
SAMPLES INCLUDED IN THIS REPORT
I-129 Groundwaters
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 4 of 32
The following analyses were performed on the following samples included in this report
Iodine 129 Water by ICPMS
SAMPLES ANALYZED IN THIS REPORT
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 5 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No B203D8 Lab ID 0905001-01
15046-84-1 Iodine-129 126E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203F3 Lab ID 0905001-02
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203F8 Lab ID 0905001-03
15046-84-1 Iodine-129 136E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203M8 Lab ID 0905001-04
15046-84-1 Iodine-129 130E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203P9 Lab ID 0905001-05
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203R4 Lab ID 0905001-06
15046-84-1 Iodine-129 114E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203V1 Lab ID 0905001-07
15046-84-1 Iodine-129 916E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203V5 Lab ID 0905001-08
15046-84-1 Iodine-129 116E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203H3 Lab ID 0905001-09
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B202Y0 Lab ID 0905001-10
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B20979 Lab ID 0905001-11
15046-84-1 Iodine-129 330E-2 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20980 Iodine-129
Lab ID
431E-2 ugL0905001-12
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20981 Iodine-129
Lab ID
366E-2 ugL0905001-13
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20982 Iodine-129
Lab ID
lt505E-3 ugL0905001-14
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20983 Iodine-129
Lab ID
lt505E-3 ugL0905001-15
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20984 Iodine-129
Lab ID
lt505E-3 ugL0905001-16
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LP2 Iodine-129
Lab ID
lt505E-3 ugL0905001-17
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20LR4 Iodine-129
Lab ID
753E-3 ugL0905001-18
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT1 Iodine-129
Lab ID
lt505E-3 ugL0905001-19
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT4 Iodine-129
Lab ID
140E-2 ugL0905001-20
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MX3 Iodine-129
Lab ID
lt505E-3 ugL0905001-21
9I14002 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20PJ5 Iodine-129
Lab ID
171E-2 ugL0905001-22
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20PP7 Iodine-129
Lab ID
135E-2 ugL0905001-23
9I14002 PNNL-AGG-41592409100E-2
0905001 FINAL
Page 6 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No 15046-84-1
B20P35 Iodine-129
Lab ID
179E-2 ugL0905001-24
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20NX6 Iodine-129
Lab ID
135E-2 ugL0905001-25
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MY5 Iodine-129
Lab ID
lt505E-3 ugL0905001-26
9I14002 PNNL-AGG-415100709505E-3
0905001 FINAL
Page 7 of 32
-------
middot~-~ COc ~~
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST 109-033-97
Page 1 of 1 Collector a ContactReauester Telephone No MSIN laquoAX-shy f)HnH Widri ~09 762RSR SAF No Samplinl Orilin Purchase OrderCharee Code
109middot033 Hanford Site Proiect Title
ut1r nR- a~ I r 0 Ice Chest No 6VJS middottlf I Temp 2ZPI APRil 2009
Shipped To fLab) Method of Shipment Bill of LadinliAir Bill No ISdenlt I nov Vehicle
Protocol Priority 45 Days Offsite Propertv No
rlIU1 A
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRlJCTIONS Hold Time Total Activitv Exemption Yes iofJ NQ L Contains Radioactive Material at concentrations that are not regulated figtr transportation per 49 CFR but are not 200 Area Generator Knowledge Infmmation Form applies releasable per DOE Order 54005 (1990J993)
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
B202YO W 1-f )(__df 10)D 1 x125middotmL GP 1129_ICPMS 1middot129LL (1) 6 Months NaOH to pH gt 9 r---
~ ~
r-- shy=-----shy L ALl iJ--shy _J1L) g
V~ ---- ---shy ----- ---shy - ~~-~
--shy~ gt
RelinquisbedBSOverdah~~~ Daterrime
- - -h c 71 2 9 200g-Received By Print Sign Dateffime
63uci I APR 29 2009 S SF so ~
SI W 0 ~
A
Matrix bull
Soil OS Sediment OJ Solid T =--
SIciQe WI Water L Oil V =
Air X
Omm Solid Dmm Ij(1lli Tis~lle Wine Limlin VCQetatlon Other
Relinquishetl By DatefflmeOGOO
5Sll 1 APR 302009 Received BK8 Hulse
amp~~pound Daterrimc DYeO
CtlPRC APR 3 0 2009 Rc1inquish4(ampHulse
f7)~k Datefflme II -f r
CHPRC APR 3a2009 ReL Lu~4ML 9I7f-J DateffimeIIishyltfh~
Relinquished By Dateffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By ( I v Dateffime f
FINAL SAMPLE Disposed By
DISPOSITION I
DateTime I
5gtb (7 ESL rn oooS4~ tAl 0 ~ ()Ci() hPQ J t Page 8 of 32
-
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-276
Page 1 of I
CollectKR a ContactlReQuester Telephone No MSIN FAX-laquoYI nan Winri ~0()-17h-)~~~
SM No Samplinl Orilin Purchase OrderCharle Code i
S09middot004 Hanford Site Proiect Title HNF-N-506- 2- I ~ Ice Chest No eMIIJ Temp
SllRV APRil 2009 Shinned To 1Iabl Method of Shipment Bill of LadinlAir Bill No
h Sin I Gnvl Vehick Protocol Priority 45 Days Offsite PrOnerty No
SlJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge lnfonnation FornI applies
Total Activitv ExemDtion Yes lllI No I~
releasable per DOE Order 54005 (19901993)
Sample No Lab ID bull Date
B203D8 W -Lq-o~
-shy ---shy --shy ---shy
Time NoType Container Sample Analysis
D~55 1x125-mL GP 1129_ICPMS 1-129LL (1)
---shy --- -r-shy illbJJ ~
----shy1-(Llf --oC-j ----
--shy -
---
shy
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ---shy ----shy ----shyRelinquished By Print Sign Matrix bull
Soil OS Omm Solid
Relinquished By R~
Sediment DI f)mm linlli Solid T Tjs~lleAPR D3errOm2009received~~~raquo~~ S111drre WI Wine55Lt I Water L Liollid
() Oil V VeQelatTonRelinquitAlftulSEshyA ~ Air X Other--)~~ APRDa~toeioor~i~~L( LCHPRC
Rclinqmshed By Daterrime Received By
)ltINAL SAMPLE I Disposal Method (eg Return 10 cuslomer per lab proccdure uscd in process) Disposed By Dateffime DISPOSITION
oq oS OtJlOb- c~L- 01oJ11 VJo -shy Page 9 of 32
middot ~
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-284
Page 1 of 1
CollectoR Mchtvr- ContactlReQuester Telephone No MSIN FAX Dana Widri ~O9middot376-2858
SAIltNo Sampline Oriein Purchase OrderCharee Code S09-nn4 Hanford Site
Proiect Title UIUC I OR 11- I Ice Chest No CtA6_1111 Temp SIJRV APRTl2OD9
Shipned To (Lab) Method of Shipment Bill of Ladinel Air Bill No I Scienc~s I Govt Vehicle
Protocol Priority 45 Days OtT site Propertv No
SIJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~J No Lbullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge Inormation Fonn applies
releasable per DOE Order 54005 (199011991)
-
Sample No LablD bull Date Time NoType Container Sample Analysis
B203F3 W -IIi-Y~ Oc-l 1 x125-mL GP 1129_ICPMS 1-129LL (1)
r----shy ---rshy ---- -~ ----shy ----shy
f fVfJJ J -1lt1 -~9
----shy ---shy
-
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ----- ~ ~ ~ ~
I
I
I
I
I
Matrix bull RelinA~h~ Sign APP lte~ill~riyenIReceived By
S Soil OS Omm Solid SF Serliment DJ Drllm (iolllRelinquished By SO Solid T Tissue SL SllIdQC WI Wine W Water l li(1Il1rl
RelinquishRffHulse
55 (J 0 Oil V =- Veictation A Air X - OtherAPRatc3illO2009re~ LCHPRC
Relinquished By Dateffime Received By
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime DISPOSITION
Page 10 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
DISCLAIMER This report was prepared as an account of work sponsored by an agency of the United States Government Neither the United States Government nor any agency thereof nor Battelle Memorial Institute nor any of their employees makes any warranty express or implied or assumes any legal liability or responsibility for the accuracy completeness or usefulness of any information apparatus product or process disclosed or represents that its use would not infringe privately owned rights Reference herein to any specific commercial product process or service by trade name trademark manufacturer or otherwise does not necessarily constitute or imply its endorsement recommendation or favoring by the United States Government or any agency thereof or Battelle Memorial Institute The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof PACIFIC NORTHWEST NATIONAL LABORATORY operated by BATTELLE for the UNITED STATES DEPARTMENT OF ENERGY under Contract DE-AC05-76RL01830 Printed in the United States of America Available to DOE and DOE contractors from the Office of Scientific and Technical Information
PO Box 62 Oak Ridge TN 37831-0062 ph (865) 576-8401 fax (865) 576-5728
email reportsadonisostigov Available to the public from the National Technical Information Service US Department of Commerce 5285 Port Royal Rd Springfield VA 22161
ph (800) 553-6847 fax (703) 605-6900
email ordersntisfedworldgov online ordering httpwwwntisgovorderinghtm
This document was printed on recycled paper
(92003)
PNNL-18895
Analytical Data Report of Water Samples Collected For I-129 Analysis M Lindberg October 2009 Prepared for the US Department of Energy under Contract DE-AC05-76RL01830 Pacific Northwest National Laboratory Richland Washington 99352
101909 1120 To Dale Dyekman From Michael J Lindberg Environmental Sciences Laboratory Energy and Environment Directorate Pacific Northwest National Laboratory Subject Analytical Data Report for Ground Water Samples Collected for I-129 Groundwater Sample Delivery Group ESL090004 SAF Number S09-004 This letter contains the following information for sample delivery group ESL090004 bull Cover Sheet bull Narrative bull Analytical Results bull Chain of Custodies
0905001 FINAL
Page 1 of 32
Introduction Between April 14 2009 and August 25 2009 groundwater samples were received for I-129 analysis Analytical ResultsMethodology The analyses for this project were performed at the 325 building located in the 300 Area of the Hanford Site The analyses were performed according to Pacific Northwest National Laboratory (PNNL) approved procedures andor nationally recognized test procedures The data sets include the sample identification numbers analytical results estimated quantification limits (EQL) and quality control data Quality Control The preparatory and analytical quality control requirements calibration requirements acceptance criteria and failure actions are defined in the on-line QA plan ldquoConducting Analytical Work in Support of Regulatory Programsrdquo (CAW) This QA plan implements the Hanford Analytical Services Quality Assurance Requirements Documents (HASQARD) for PNNL Definitions Dup Duplicate RPD Relative Percent Difference NR No Recovery (percent recovery less than zero) ND Non-Detectable REC Percent Recovery Sample Receipt Samples were received with a chain of custody (COC) and were analyzed according to the sample identification numbers supplied by the client All samples were refrigerated upon receipt until prepared for analysis All samples were received with custody seals intact unless noted in the Case Narrative Holding Times Holding time is defined as the time from sampling to the time of analyses The prescribed holding times were met for all analytes unless noted in the Case Narrative Analytical Results All reported analytical results meet the requirements of the CAW or client specified SOW unless noted in the case narrative
0905001 FINAL
Page 2 of 32
Case Narrative Report
Hold Time No discrepancies noted
Preparation Blank (PB) No preparation was performed therefore no blanks were analyzed
Duplicate (DUP) No preparation was performed therefore no duplicates were analyzed
Laboratory Control Samples (LCS)
No preparation was performed therefore no LCSs were analyzed
Post Spike (PS) No preparation was performed therefore no PSs were analyzed
Matrix Spike (MS) Not applicable
Other QC Criteria None noted
DISCLAIMER
This report was prepared as an account of work sponsored by an agency of the United States Government Neither the United States Government nor any agency thereof nor Battelle Memorial Institute nor any of their employees makes any warranty express or implied or assumes any legal liability or responsibility for the accuracy completeness or usefulness of any information apparatus product or process disclosed or represents that its use would not infringe privately owned rights Reference herein to any specific commercial product process or service by trade name trademark manufacturer or otherwise does not necessarily constitute or imply its endorsement recommendation or favoring by the United States Government or any agency thereof or Battelle Memorial Institute The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof
0905001 FINAL
Page 3 of 32
SAMPLES INCLUDED IN THIS REPORT
I-129 Groundwaters
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 4 of 32
The following analyses were performed on the following samples included in this report
Iodine 129 Water by ICPMS
SAMPLES ANALYZED IN THIS REPORT
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 5 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No B203D8 Lab ID 0905001-01
15046-84-1 Iodine-129 126E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203F3 Lab ID 0905001-02
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203F8 Lab ID 0905001-03
15046-84-1 Iodine-129 136E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203M8 Lab ID 0905001-04
15046-84-1 Iodine-129 130E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203P9 Lab ID 0905001-05
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203R4 Lab ID 0905001-06
15046-84-1 Iodine-129 114E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203V1 Lab ID 0905001-07
15046-84-1 Iodine-129 916E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203V5 Lab ID 0905001-08
15046-84-1 Iodine-129 116E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203H3 Lab ID 0905001-09
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B202Y0 Lab ID 0905001-10
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B20979 Lab ID 0905001-11
15046-84-1 Iodine-129 330E-2 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20980 Iodine-129
Lab ID
431E-2 ugL0905001-12
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20981 Iodine-129
Lab ID
366E-2 ugL0905001-13
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20982 Iodine-129
Lab ID
lt505E-3 ugL0905001-14
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20983 Iodine-129
Lab ID
lt505E-3 ugL0905001-15
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20984 Iodine-129
Lab ID
lt505E-3 ugL0905001-16
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LP2 Iodine-129
Lab ID
lt505E-3 ugL0905001-17
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20LR4 Iodine-129
Lab ID
753E-3 ugL0905001-18
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT1 Iodine-129
Lab ID
lt505E-3 ugL0905001-19
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT4 Iodine-129
Lab ID
140E-2 ugL0905001-20
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MX3 Iodine-129
Lab ID
lt505E-3 ugL0905001-21
9I14002 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20PJ5 Iodine-129
Lab ID
171E-2 ugL0905001-22
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20PP7 Iodine-129
Lab ID
135E-2 ugL0905001-23
9I14002 PNNL-AGG-41592409100E-2
0905001 FINAL
Page 6 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No 15046-84-1
B20P35 Iodine-129
Lab ID
179E-2 ugL0905001-24
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20NX6 Iodine-129
Lab ID
135E-2 ugL0905001-25
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MY5 Iodine-129
Lab ID
lt505E-3 ugL0905001-26
9I14002 PNNL-AGG-415100709505E-3
0905001 FINAL
Page 7 of 32
-------
middot~-~ COc ~~
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST 109-033-97
Page 1 of 1 Collector a ContactReauester Telephone No MSIN laquoAX-shy f)HnH Widri ~09 762RSR SAF No Samplinl Orilin Purchase OrderCharee Code
109middot033 Hanford Site Proiect Title
ut1r nR- a~ I r 0 Ice Chest No 6VJS middottlf I Temp 2ZPI APRil 2009
Shipped To fLab) Method of Shipment Bill of LadinliAir Bill No ISdenlt I nov Vehicle
Protocol Priority 45 Days Offsite Propertv No
rlIU1 A
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRlJCTIONS Hold Time Total Activitv Exemption Yes iofJ NQ L Contains Radioactive Material at concentrations that are not regulated figtr transportation per 49 CFR but are not 200 Area Generator Knowledge Infmmation Form applies releasable per DOE Order 54005 (1990J993)
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
B202YO W 1-f )(__df 10)D 1 x125middotmL GP 1129_ICPMS 1middot129LL (1) 6 Months NaOH to pH gt 9 r---
~ ~
r-- shy=-----shy L ALl iJ--shy _J1L) g
V~ ---- ---shy ----- ---shy - ~~-~
--shy~ gt
RelinquisbedBSOverdah~~~ Daterrime
- - -h c 71 2 9 200g-Received By Print Sign Dateffime
63uci I APR 29 2009 S SF so ~
SI W 0 ~
A
Matrix bull
Soil OS Sediment OJ Solid T =--
SIciQe WI Water L Oil V =
Air X
Omm Solid Dmm Ij(1lli Tis~lle Wine Limlin VCQetatlon Other
Relinquishetl By DatefflmeOGOO
5Sll 1 APR 302009 Received BK8 Hulse
amp~~pound Daterrimc DYeO
CtlPRC APR 3 0 2009 Rc1inquish4(ampHulse
f7)~k Datefflme II -f r
CHPRC APR 3a2009 ReL Lu~4ML 9I7f-J DateffimeIIishyltfh~
Relinquished By Dateffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By ( I v Dateffime f
FINAL SAMPLE Disposed By
DISPOSITION I
DateTime I
5gtb (7 ESL rn oooS4~ tAl 0 ~ ()Ci() hPQ J t Page 8 of 32
-
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-276
Page 1 of I
CollectKR a ContactlReQuester Telephone No MSIN FAX-laquoYI nan Winri ~0()-17h-)~~~
SM No Samplinl Orilin Purchase OrderCharle Code i
S09middot004 Hanford Site Proiect Title HNF-N-506- 2- I ~ Ice Chest No eMIIJ Temp
SllRV APRil 2009 Shinned To 1Iabl Method of Shipment Bill of LadinlAir Bill No
h Sin I Gnvl Vehick Protocol Priority 45 Days Offsite PrOnerty No
SlJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge lnfonnation FornI applies
Total Activitv ExemDtion Yes lllI No I~
releasable per DOE Order 54005 (19901993)
Sample No Lab ID bull Date
B203D8 W -Lq-o~
-shy ---shy --shy ---shy
Time NoType Container Sample Analysis
D~55 1x125-mL GP 1129_ICPMS 1-129LL (1)
---shy --- -r-shy illbJJ ~
----shy1-(Llf --oC-j ----
--shy -
---
shy
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ---shy ----shy ----shyRelinquished By Print Sign Matrix bull
Soil OS Omm Solid
Relinquished By R~
Sediment DI f)mm linlli Solid T Tjs~lleAPR D3errOm2009received~~~raquo~~ S111drre WI Wine55Lt I Water L Liollid
() Oil V VeQelatTonRelinquitAlftulSEshyA ~ Air X Other--)~~ APRDa~toeioor~i~~L( LCHPRC
Rclinqmshed By Daterrime Received By
)ltINAL SAMPLE I Disposal Method (eg Return 10 cuslomer per lab proccdure uscd in process) Disposed By Dateffime DISPOSITION
oq oS OtJlOb- c~L- 01oJ11 VJo -shy Page 9 of 32
middot ~
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-284
Page 1 of 1
CollectoR Mchtvr- ContactlReQuester Telephone No MSIN FAX Dana Widri ~O9middot376-2858
SAIltNo Sampline Oriein Purchase OrderCharee Code S09-nn4 Hanford Site
Proiect Title UIUC I OR 11- I Ice Chest No CtA6_1111 Temp SIJRV APRTl2OD9
Shipned To (Lab) Method of Shipment Bill of Ladinel Air Bill No I Scienc~s I Govt Vehicle
Protocol Priority 45 Days OtT site Propertv No
SIJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~J No Lbullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge Inormation Fonn applies
releasable per DOE Order 54005 (199011991)
-
Sample No LablD bull Date Time NoType Container Sample Analysis
B203F3 W -IIi-Y~ Oc-l 1 x125-mL GP 1129_ICPMS 1-129LL (1)
r----shy ---rshy ---- -~ ----shy ----shy
f fVfJJ J -1lt1 -~9
----shy ---shy
-
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ----- ~ ~ ~ ~
I
I
I
I
I
Matrix bull RelinA~h~ Sign APP lte~ill~riyenIReceived By
S Soil OS Omm Solid SF Serliment DJ Drllm (iolllRelinquished By SO Solid T Tissue SL SllIdQC WI Wine W Water l li(1Il1rl
RelinquishRffHulse
55 (J 0 Oil V =- Veictation A Air X - OtherAPRatc3illO2009re~ LCHPRC
Relinquished By Dateffime Received By
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime DISPOSITION
Page 10 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
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CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
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COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
PNNL-18895
Analytical Data Report of Water Samples Collected For I-129 Analysis M Lindberg October 2009 Prepared for the US Department of Energy under Contract DE-AC05-76RL01830 Pacific Northwest National Laboratory Richland Washington 99352
101909 1120 To Dale Dyekman From Michael J Lindberg Environmental Sciences Laboratory Energy and Environment Directorate Pacific Northwest National Laboratory Subject Analytical Data Report for Ground Water Samples Collected for I-129 Groundwater Sample Delivery Group ESL090004 SAF Number S09-004 This letter contains the following information for sample delivery group ESL090004 bull Cover Sheet bull Narrative bull Analytical Results bull Chain of Custodies
0905001 FINAL
Page 1 of 32
Introduction Between April 14 2009 and August 25 2009 groundwater samples were received for I-129 analysis Analytical ResultsMethodology The analyses for this project were performed at the 325 building located in the 300 Area of the Hanford Site The analyses were performed according to Pacific Northwest National Laboratory (PNNL) approved procedures andor nationally recognized test procedures The data sets include the sample identification numbers analytical results estimated quantification limits (EQL) and quality control data Quality Control The preparatory and analytical quality control requirements calibration requirements acceptance criteria and failure actions are defined in the on-line QA plan ldquoConducting Analytical Work in Support of Regulatory Programsrdquo (CAW) This QA plan implements the Hanford Analytical Services Quality Assurance Requirements Documents (HASQARD) for PNNL Definitions Dup Duplicate RPD Relative Percent Difference NR No Recovery (percent recovery less than zero) ND Non-Detectable REC Percent Recovery Sample Receipt Samples were received with a chain of custody (COC) and were analyzed according to the sample identification numbers supplied by the client All samples were refrigerated upon receipt until prepared for analysis All samples were received with custody seals intact unless noted in the Case Narrative Holding Times Holding time is defined as the time from sampling to the time of analyses The prescribed holding times were met for all analytes unless noted in the Case Narrative Analytical Results All reported analytical results meet the requirements of the CAW or client specified SOW unless noted in the case narrative
0905001 FINAL
Page 2 of 32
Case Narrative Report
Hold Time No discrepancies noted
Preparation Blank (PB) No preparation was performed therefore no blanks were analyzed
Duplicate (DUP) No preparation was performed therefore no duplicates were analyzed
Laboratory Control Samples (LCS)
No preparation was performed therefore no LCSs were analyzed
Post Spike (PS) No preparation was performed therefore no PSs were analyzed
Matrix Spike (MS) Not applicable
Other QC Criteria None noted
DISCLAIMER
This report was prepared as an account of work sponsored by an agency of the United States Government Neither the United States Government nor any agency thereof nor Battelle Memorial Institute nor any of their employees makes any warranty express or implied or assumes any legal liability or responsibility for the accuracy completeness or usefulness of any information apparatus product or process disclosed or represents that its use would not infringe privately owned rights Reference herein to any specific commercial product process or service by trade name trademark manufacturer or otherwise does not necessarily constitute or imply its endorsement recommendation or favoring by the United States Government or any agency thereof or Battelle Memorial Institute The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof
0905001 FINAL
Page 3 of 32
SAMPLES INCLUDED IN THIS REPORT
I-129 Groundwaters
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 4 of 32
The following analyses were performed on the following samples included in this report
Iodine 129 Water by ICPMS
SAMPLES ANALYZED IN THIS REPORT
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 5 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No B203D8 Lab ID 0905001-01
15046-84-1 Iodine-129 126E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203F3 Lab ID 0905001-02
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203F8 Lab ID 0905001-03
15046-84-1 Iodine-129 136E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203M8 Lab ID 0905001-04
15046-84-1 Iodine-129 130E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203P9 Lab ID 0905001-05
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203R4 Lab ID 0905001-06
15046-84-1 Iodine-129 114E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203V1 Lab ID 0905001-07
15046-84-1 Iodine-129 916E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203V5 Lab ID 0905001-08
15046-84-1 Iodine-129 116E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203H3 Lab ID 0905001-09
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B202Y0 Lab ID 0905001-10
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B20979 Lab ID 0905001-11
15046-84-1 Iodine-129 330E-2 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20980 Iodine-129
Lab ID
431E-2 ugL0905001-12
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20981 Iodine-129
Lab ID
366E-2 ugL0905001-13
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20982 Iodine-129
Lab ID
lt505E-3 ugL0905001-14
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20983 Iodine-129
Lab ID
lt505E-3 ugL0905001-15
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20984 Iodine-129
Lab ID
lt505E-3 ugL0905001-16
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LP2 Iodine-129
Lab ID
lt505E-3 ugL0905001-17
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20LR4 Iodine-129
Lab ID
753E-3 ugL0905001-18
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT1 Iodine-129
Lab ID
lt505E-3 ugL0905001-19
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT4 Iodine-129
Lab ID
140E-2 ugL0905001-20
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MX3 Iodine-129
Lab ID
lt505E-3 ugL0905001-21
9I14002 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20PJ5 Iodine-129
Lab ID
171E-2 ugL0905001-22
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20PP7 Iodine-129
Lab ID
135E-2 ugL0905001-23
9I14002 PNNL-AGG-41592409100E-2
0905001 FINAL
Page 6 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No 15046-84-1
B20P35 Iodine-129
Lab ID
179E-2 ugL0905001-24
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20NX6 Iodine-129
Lab ID
135E-2 ugL0905001-25
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MY5 Iodine-129
Lab ID
lt505E-3 ugL0905001-26
9I14002 PNNL-AGG-415100709505E-3
0905001 FINAL
Page 7 of 32
-------
middot~-~ COc ~~
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST 109-033-97
Page 1 of 1 Collector a ContactReauester Telephone No MSIN laquoAX-shy f)HnH Widri ~09 762RSR SAF No Samplinl Orilin Purchase OrderCharee Code
109middot033 Hanford Site Proiect Title
ut1r nR- a~ I r 0 Ice Chest No 6VJS middottlf I Temp 2ZPI APRil 2009
Shipped To fLab) Method of Shipment Bill of LadinliAir Bill No ISdenlt I nov Vehicle
Protocol Priority 45 Days Offsite Propertv No
rlIU1 A
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRlJCTIONS Hold Time Total Activitv Exemption Yes iofJ NQ L Contains Radioactive Material at concentrations that are not regulated figtr transportation per 49 CFR but are not 200 Area Generator Knowledge Infmmation Form applies releasable per DOE Order 54005 (1990J993)
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
B202YO W 1-f )(__df 10)D 1 x125middotmL GP 1129_ICPMS 1middot129LL (1) 6 Months NaOH to pH gt 9 r---
~ ~
r-- shy=-----shy L ALl iJ--shy _J1L) g
V~ ---- ---shy ----- ---shy - ~~-~
--shy~ gt
RelinquisbedBSOverdah~~~ Daterrime
- - -h c 71 2 9 200g-Received By Print Sign Dateffime
63uci I APR 29 2009 S SF so ~
SI W 0 ~
A
Matrix bull
Soil OS Sediment OJ Solid T =--
SIciQe WI Water L Oil V =
Air X
Omm Solid Dmm Ij(1lli Tis~lle Wine Limlin VCQetatlon Other
Relinquishetl By DatefflmeOGOO
5Sll 1 APR 302009 Received BK8 Hulse
amp~~pound Daterrimc DYeO
CtlPRC APR 3 0 2009 Rc1inquish4(ampHulse
f7)~k Datefflme II -f r
CHPRC APR 3a2009 ReL Lu~4ML 9I7f-J DateffimeIIishyltfh~
Relinquished By Dateffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By ( I v Dateffime f
FINAL SAMPLE Disposed By
DISPOSITION I
DateTime I
5gtb (7 ESL rn oooS4~ tAl 0 ~ ()Ci() hPQ J t Page 8 of 32
-
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-276
Page 1 of I
CollectKR a ContactlReQuester Telephone No MSIN FAX-laquoYI nan Winri ~0()-17h-)~~~
SM No Samplinl Orilin Purchase OrderCharle Code i
S09middot004 Hanford Site Proiect Title HNF-N-506- 2- I ~ Ice Chest No eMIIJ Temp
SllRV APRil 2009 Shinned To 1Iabl Method of Shipment Bill of LadinlAir Bill No
h Sin I Gnvl Vehick Protocol Priority 45 Days Offsite PrOnerty No
SlJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge lnfonnation FornI applies
Total Activitv ExemDtion Yes lllI No I~
releasable per DOE Order 54005 (19901993)
Sample No Lab ID bull Date
B203D8 W -Lq-o~
-shy ---shy --shy ---shy
Time NoType Container Sample Analysis
D~55 1x125-mL GP 1129_ICPMS 1-129LL (1)
---shy --- -r-shy illbJJ ~
----shy1-(Llf --oC-j ----
--shy -
---
shy
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ---shy ----shy ----shyRelinquished By Print Sign Matrix bull
Soil OS Omm Solid
Relinquished By R~
Sediment DI f)mm linlli Solid T Tjs~lleAPR D3errOm2009received~~~raquo~~ S111drre WI Wine55Lt I Water L Liollid
() Oil V VeQelatTonRelinquitAlftulSEshyA ~ Air X Other--)~~ APRDa~toeioor~i~~L( LCHPRC
Rclinqmshed By Daterrime Received By
)ltINAL SAMPLE I Disposal Method (eg Return 10 cuslomer per lab proccdure uscd in process) Disposed By Dateffime DISPOSITION
oq oS OtJlOb- c~L- 01oJ11 VJo -shy Page 9 of 32
middot ~
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-284
Page 1 of 1
CollectoR Mchtvr- ContactlReQuester Telephone No MSIN FAX Dana Widri ~O9middot376-2858
SAIltNo Sampline Oriein Purchase OrderCharee Code S09-nn4 Hanford Site
Proiect Title UIUC I OR 11- I Ice Chest No CtA6_1111 Temp SIJRV APRTl2OD9
Shipned To (Lab) Method of Shipment Bill of Ladinel Air Bill No I Scienc~s I Govt Vehicle
Protocol Priority 45 Days OtT site Propertv No
SIJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~J No Lbullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge Inormation Fonn applies
releasable per DOE Order 54005 (199011991)
-
Sample No LablD bull Date Time NoType Container Sample Analysis
B203F3 W -IIi-Y~ Oc-l 1 x125-mL GP 1129_ICPMS 1-129LL (1)
r----shy ---rshy ---- -~ ----shy ----shy
f fVfJJ J -1lt1 -~9
----shy ---shy
-
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ----- ~ ~ ~ ~
I
I
I
I
I
Matrix bull RelinA~h~ Sign APP lte~ill~riyenIReceived By
S Soil OS Omm Solid SF Serliment DJ Drllm (iolllRelinquished By SO Solid T Tissue SL SllIdQC WI Wine W Water l li(1Il1rl
RelinquishRffHulse
55 (J 0 Oil V =- Veictation A Air X - OtherAPRatc3illO2009re~ LCHPRC
Relinquished By Dateffime Received By
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime DISPOSITION
Page 10 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
101909 1120 To Dale Dyekman From Michael J Lindberg Environmental Sciences Laboratory Energy and Environment Directorate Pacific Northwest National Laboratory Subject Analytical Data Report for Ground Water Samples Collected for I-129 Groundwater Sample Delivery Group ESL090004 SAF Number S09-004 This letter contains the following information for sample delivery group ESL090004 bull Cover Sheet bull Narrative bull Analytical Results bull Chain of Custodies
0905001 FINAL
Page 1 of 32
Introduction Between April 14 2009 and August 25 2009 groundwater samples were received for I-129 analysis Analytical ResultsMethodology The analyses for this project were performed at the 325 building located in the 300 Area of the Hanford Site The analyses were performed according to Pacific Northwest National Laboratory (PNNL) approved procedures andor nationally recognized test procedures The data sets include the sample identification numbers analytical results estimated quantification limits (EQL) and quality control data Quality Control The preparatory and analytical quality control requirements calibration requirements acceptance criteria and failure actions are defined in the on-line QA plan ldquoConducting Analytical Work in Support of Regulatory Programsrdquo (CAW) This QA plan implements the Hanford Analytical Services Quality Assurance Requirements Documents (HASQARD) for PNNL Definitions Dup Duplicate RPD Relative Percent Difference NR No Recovery (percent recovery less than zero) ND Non-Detectable REC Percent Recovery Sample Receipt Samples were received with a chain of custody (COC) and were analyzed according to the sample identification numbers supplied by the client All samples were refrigerated upon receipt until prepared for analysis All samples were received with custody seals intact unless noted in the Case Narrative Holding Times Holding time is defined as the time from sampling to the time of analyses The prescribed holding times were met for all analytes unless noted in the Case Narrative Analytical Results All reported analytical results meet the requirements of the CAW or client specified SOW unless noted in the case narrative
0905001 FINAL
Page 2 of 32
Case Narrative Report
Hold Time No discrepancies noted
Preparation Blank (PB) No preparation was performed therefore no blanks were analyzed
Duplicate (DUP) No preparation was performed therefore no duplicates were analyzed
Laboratory Control Samples (LCS)
No preparation was performed therefore no LCSs were analyzed
Post Spike (PS) No preparation was performed therefore no PSs were analyzed
Matrix Spike (MS) Not applicable
Other QC Criteria None noted
DISCLAIMER
This report was prepared as an account of work sponsored by an agency of the United States Government Neither the United States Government nor any agency thereof nor Battelle Memorial Institute nor any of their employees makes any warranty express or implied or assumes any legal liability or responsibility for the accuracy completeness or usefulness of any information apparatus product or process disclosed or represents that its use would not infringe privately owned rights Reference herein to any specific commercial product process or service by trade name trademark manufacturer or otherwise does not necessarily constitute or imply its endorsement recommendation or favoring by the United States Government or any agency thereof or Battelle Memorial Institute The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof
0905001 FINAL
Page 3 of 32
SAMPLES INCLUDED IN THIS REPORT
I-129 Groundwaters
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 4 of 32
The following analyses were performed on the following samples included in this report
Iodine 129 Water by ICPMS
SAMPLES ANALYZED IN THIS REPORT
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 5 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No B203D8 Lab ID 0905001-01
15046-84-1 Iodine-129 126E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203F3 Lab ID 0905001-02
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203F8 Lab ID 0905001-03
15046-84-1 Iodine-129 136E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203M8 Lab ID 0905001-04
15046-84-1 Iodine-129 130E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203P9 Lab ID 0905001-05
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203R4 Lab ID 0905001-06
15046-84-1 Iodine-129 114E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203V1 Lab ID 0905001-07
15046-84-1 Iodine-129 916E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203V5 Lab ID 0905001-08
15046-84-1 Iodine-129 116E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203H3 Lab ID 0905001-09
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B202Y0 Lab ID 0905001-10
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B20979 Lab ID 0905001-11
15046-84-1 Iodine-129 330E-2 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20980 Iodine-129
Lab ID
431E-2 ugL0905001-12
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20981 Iodine-129
Lab ID
366E-2 ugL0905001-13
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20982 Iodine-129
Lab ID
lt505E-3 ugL0905001-14
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20983 Iodine-129
Lab ID
lt505E-3 ugL0905001-15
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20984 Iodine-129
Lab ID
lt505E-3 ugL0905001-16
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LP2 Iodine-129
Lab ID
lt505E-3 ugL0905001-17
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20LR4 Iodine-129
Lab ID
753E-3 ugL0905001-18
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT1 Iodine-129
Lab ID
lt505E-3 ugL0905001-19
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT4 Iodine-129
Lab ID
140E-2 ugL0905001-20
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MX3 Iodine-129
Lab ID
lt505E-3 ugL0905001-21
9I14002 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20PJ5 Iodine-129
Lab ID
171E-2 ugL0905001-22
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20PP7 Iodine-129
Lab ID
135E-2 ugL0905001-23
9I14002 PNNL-AGG-41592409100E-2
0905001 FINAL
Page 6 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No 15046-84-1
B20P35 Iodine-129
Lab ID
179E-2 ugL0905001-24
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20NX6 Iodine-129
Lab ID
135E-2 ugL0905001-25
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MY5 Iodine-129
Lab ID
lt505E-3 ugL0905001-26
9I14002 PNNL-AGG-415100709505E-3
0905001 FINAL
Page 7 of 32
-------
middot~-~ COc ~~
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST 109-033-97
Page 1 of 1 Collector a ContactReauester Telephone No MSIN laquoAX-shy f)HnH Widri ~09 762RSR SAF No Samplinl Orilin Purchase OrderCharee Code
109middot033 Hanford Site Proiect Title
ut1r nR- a~ I r 0 Ice Chest No 6VJS middottlf I Temp 2ZPI APRil 2009
Shipped To fLab) Method of Shipment Bill of LadinliAir Bill No ISdenlt I nov Vehicle
Protocol Priority 45 Days Offsite Propertv No
rlIU1 A
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRlJCTIONS Hold Time Total Activitv Exemption Yes iofJ NQ L Contains Radioactive Material at concentrations that are not regulated figtr transportation per 49 CFR but are not 200 Area Generator Knowledge Infmmation Form applies releasable per DOE Order 54005 (1990J993)
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
B202YO W 1-f )(__df 10)D 1 x125middotmL GP 1129_ICPMS 1middot129LL (1) 6 Months NaOH to pH gt 9 r---
~ ~
r-- shy=-----shy L ALl iJ--shy _J1L) g
V~ ---- ---shy ----- ---shy - ~~-~
--shy~ gt
RelinquisbedBSOverdah~~~ Daterrime
- - -h c 71 2 9 200g-Received By Print Sign Dateffime
63uci I APR 29 2009 S SF so ~
SI W 0 ~
A
Matrix bull
Soil OS Sediment OJ Solid T =--
SIciQe WI Water L Oil V =
Air X
Omm Solid Dmm Ij(1lli Tis~lle Wine Limlin VCQetatlon Other
Relinquishetl By DatefflmeOGOO
5Sll 1 APR 302009 Received BK8 Hulse
amp~~pound Daterrimc DYeO
CtlPRC APR 3 0 2009 Rc1inquish4(ampHulse
f7)~k Datefflme II -f r
CHPRC APR 3a2009 ReL Lu~4ML 9I7f-J DateffimeIIishyltfh~
Relinquished By Dateffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By ( I v Dateffime f
FINAL SAMPLE Disposed By
DISPOSITION I
DateTime I
5gtb (7 ESL rn oooS4~ tAl 0 ~ ()Ci() hPQ J t Page 8 of 32
-
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-276
Page 1 of I
CollectKR a ContactlReQuester Telephone No MSIN FAX-laquoYI nan Winri ~0()-17h-)~~~
SM No Samplinl Orilin Purchase OrderCharle Code i
S09middot004 Hanford Site Proiect Title HNF-N-506- 2- I ~ Ice Chest No eMIIJ Temp
SllRV APRil 2009 Shinned To 1Iabl Method of Shipment Bill of LadinlAir Bill No
h Sin I Gnvl Vehick Protocol Priority 45 Days Offsite PrOnerty No
SlJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge lnfonnation FornI applies
Total Activitv ExemDtion Yes lllI No I~
releasable per DOE Order 54005 (19901993)
Sample No Lab ID bull Date
B203D8 W -Lq-o~
-shy ---shy --shy ---shy
Time NoType Container Sample Analysis
D~55 1x125-mL GP 1129_ICPMS 1-129LL (1)
---shy --- -r-shy illbJJ ~
----shy1-(Llf --oC-j ----
--shy -
---
shy
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ---shy ----shy ----shyRelinquished By Print Sign Matrix bull
Soil OS Omm Solid
Relinquished By R~
Sediment DI f)mm linlli Solid T Tjs~lleAPR D3errOm2009received~~~raquo~~ S111drre WI Wine55Lt I Water L Liollid
() Oil V VeQelatTonRelinquitAlftulSEshyA ~ Air X Other--)~~ APRDa~toeioor~i~~L( LCHPRC
Rclinqmshed By Daterrime Received By
)ltINAL SAMPLE I Disposal Method (eg Return 10 cuslomer per lab proccdure uscd in process) Disposed By Dateffime DISPOSITION
oq oS OtJlOb- c~L- 01oJ11 VJo -shy Page 9 of 32
middot ~
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-284
Page 1 of 1
CollectoR Mchtvr- ContactlReQuester Telephone No MSIN FAX Dana Widri ~O9middot376-2858
SAIltNo Sampline Oriein Purchase OrderCharee Code S09-nn4 Hanford Site
Proiect Title UIUC I OR 11- I Ice Chest No CtA6_1111 Temp SIJRV APRTl2OD9
Shipned To (Lab) Method of Shipment Bill of Ladinel Air Bill No I Scienc~s I Govt Vehicle
Protocol Priority 45 Days OtT site Propertv No
SIJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~J No Lbullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge Inormation Fonn applies
releasable per DOE Order 54005 (199011991)
-
Sample No LablD bull Date Time NoType Container Sample Analysis
B203F3 W -IIi-Y~ Oc-l 1 x125-mL GP 1129_ICPMS 1-129LL (1)
r----shy ---rshy ---- -~ ----shy ----shy
f fVfJJ J -1lt1 -~9
----shy ---shy
-
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ----- ~ ~ ~ ~
I
I
I
I
I
Matrix bull RelinA~h~ Sign APP lte~ill~riyenIReceived By
S Soil OS Omm Solid SF Serliment DJ Drllm (iolllRelinquished By SO Solid T Tissue SL SllIdQC WI Wine W Water l li(1Il1rl
RelinquishRffHulse
55 (J 0 Oil V =- Veictation A Air X - OtherAPRatc3illO2009re~ LCHPRC
Relinquished By Dateffime Received By
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime DISPOSITION
Page 10 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
Introduction Between April 14 2009 and August 25 2009 groundwater samples were received for I-129 analysis Analytical ResultsMethodology The analyses for this project were performed at the 325 building located in the 300 Area of the Hanford Site The analyses were performed according to Pacific Northwest National Laboratory (PNNL) approved procedures andor nationally recognized test procedures The data sets include the sample identification numbers analytical results estimated quantification limits (EQL) and quality control data Quality Control The preparatory and analytical quality control requirements calibration requirements acceptance criteria and failure actions are defined in the on-line QA plan ldquoConducting Analytical Work in Support of Regulatory Programsrdquo (CAW) This QA plan implements the Hanford Analytical Services Quality Assurance Requirements Documents (HASQARD) for PNNL Definitions Dup Duplicate RPD Relative Percent Difference NR No Recovery (percent recovery less than zero) ND Non-Detectable REC Percent Recovery Sample Receipt Samples were received with a chain of custody (COC) and were analyzed according to the sample identification numbers supplied by the client All samples were refrigerated upon receipt until prepared for analysis All samples were received with custody seals intact unless noted in the Case Narrative Holding Times Holding time is defined as the time from sampling to the time of analyses The prescribed holding times were met for all analytes unless noted in the Case Narrative Analytical Results All reported analytical results meet the requirements of the CAW or client specified SOW unless noted in the case narrative
0905001 FINAL
Page 2 of 32
Case Narrative Report
Hold Time No discrepancies noted
Preparation Blank (PB) No preparation was performed therefore no blanks were analyzed
Duplicate (DUP) No preparation was performed therefore no duplicates were analyzed
Laboratory Control Samples (LCS)
No preparation was performed therefore no LCSs were analyzed
Post Spike (PS) No preparation was performed therefore no PSs were analyzed
Matrix Spike (MS) Not applicable
Other QC Criteria None noted
DISCLAIMER
This report was prepared as an account of work sponsored by an agency of the United States Government Neither the United States Government nor any agency thereof nor Battelle Memorial Institute nor any of their employees makes any warranty express or implied or assumes any legal liability or responsibility for the accuracy completeness or usefulness of any information apparatus product or process disclosed or represents that its use would not infringe privately owned rights Reference herein to any specific commercial product process or service by trade name trademark manufacturer or otherwise does not necessarily constitute or imply its endorsement recommendation or favoring by the United States Government or any agency thereof or Battelle Memorial Institute The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof
0905001 FINAL
Page 3 of 32
SAMPLES INCLUDED IN THIS REPORT
I-129 Groundwaters
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 4 of 32
The following analyses were performed on the following samples included in this report
Iodine 129 Water by ICPMS
SAMPLES ANALYZED IN THIS REPORT
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 5 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No B203D8 Lab ID 0905001-01
15046-84-1 Iodine-129 126E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203F3 Lab ID 0905001-02
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203F8 Lab ID 0905001-03
15046-84-1 Iodine-129 136E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203M8 Lab ID 0905001-04
15046-84-1 Iodine-129 130E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203P9 Lab ID 0905001-05
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203R4 Lab ID 0905001-06
15046-84-1 Iodine-129 114E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203V1 Lab ID 0905001-07
15046-84-1 Iodine-129 916E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203V5 Lab ID 0905001-08
15046-84-1 Iodine-129 116E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203H3 Lab ID 0905001-09
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B202Y0 Lab ID 0905001-10
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B20979 Lab ID 0905001-11
15046-84-1 Iodine-129 330E-2 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20980 Iodine-129
Lab ID
431E-2 ugL0905001-12
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20981 Iodine-129
Lab ID
366E-2 ugL0905001-13
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20982 Iodine-129
Lab ID
lt505E-3 ugL0905001-14
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20983 Iodine-129
Lab ID
lt505E-3 ugL0905001-15
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20984 Iodine-129
Lab ID
lt505E-3 ugL0905001-16
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LP2 Iodine-129
Lab ID
lt505E-3 ugL0905001-17
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20LR4 Iodine-129
Lab ID
753E-3 ugL0905001-18
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT1 Iodine-129
Lab ID
lt505E-3 ugL0905001-19
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT4 Iodine-129
Lab ID
140E-2 ugL0905001-20
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MX3 Iodine-129
Lab ID
lt505E-3 ugL0905001-21
9I14002 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20PJ5 Iodine-129
Lab ID
171E-2 ugL0905001-22
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20PP7 Iodine-129
Lab ID
135E-2 ugL0905001-23
9I14002 PNNL-AGG-41592409100E-2
0905001 FINAL
Page 6 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No 15046-84-1
B20P35 Iodine-129
Lab ID
179E-2 ugL0905001-24
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20NX6 Iodine-129
Lab ID
135E-2 ugL0905001-25
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MY5 Iodine-129
Lab ID
lt505E-3 ugL0905001-26
9I14002 PNNL-AGG-415100709505E-3
0905001 FINAL
Page 7 of 32
-------
middot~-~ COc ~~
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST 109-033-97
Page 1 of 1 Collector a ContactReauester Telephone No MSIN laquoAX-shy f)HnH Widri ~09 762RSR SAF No Samplinl Orilin Purchase OrderCharee Code
109middot033 Hanford Site Proiect Title
ut1r nR- a~ I r 0 Ice Chest No 6VJS middottlf I Temp 2ZPI APRil 2009
Shipped To fLab) Method of Shipment Bill of LadinliAir Bill No ISdenlt I nov Vehicle
Protocol Priority 45 Days Offsite Propertv No
rlIU1 A
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRlJCTIONS Hold Time Total Activitv Exemption Yes iofJ NQ L Contains Radioactive Material at concentrations that are not regulated figtr transportation per 49 CFR but are not 200 Area Generator Knowledge Infmmation Form applies releasable per DOE Order 54005 (1990J993)
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
B202YO W 1-f )(__df 10)D 1 x125middotmL GP 1129_ICPMS 1middot129LL (1) 6 Months NaOH to pH gt 9 r---
~ ~
r-- shy=-----shy L ALl iJ--shy _J1L) g
V~ ---- ---shy ----- ---shy - ~~-~
--shy~ gt
RelinquisbedBSOverdah~~~ Daterrime
- - -h c 71 2 9 200g-Received By Print Sign Dateffime
63uci I APR 29 2009 S SF so ~
SI W 0 ~
A
Matrix bull
Soil OS Sediment OJ Solid T =--
SIciQe WI Water L Oil V =
Air X
Omm Solid Dmm Ij(1lli Tis~lle Wine Limlin VCQetatlon Other
Relinquishetl By DatefflmeOGOO
5Sll 1 APR 302009 Received BK8 Hulse
amp~~pound Daterrimc DYeO
CtlPRC APR 3 0 2009 Rc1inquish4(ampHulse
f7)~k Datefflme II -f r
CHPRC APR 3a2009 ReL Lu~4ML 9I7f-J DateffimeIIishyltfh~
Relinquished By Dateffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By ( I v Dateffime f
FINAL SAMPLE Disposed By
DISPOSITION I
DateTime I
5gtb (7 ESL rn oooS4~ tAl 0 ~ ()Ci() hPQ J t Page 8 of 32
-
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-276
Page 1 of I
CollectKR a ContactlReQuester Telephone No MSIN FAX-laquoYI nan Winri ~0()-17h-)~~~
SM No Samplinl Orilin Purchase OrderCharle Code i
S09middot004 Hanford Site Proiect Title HNF-N-506- 2- I ~ Ice Chest No eMIIJ Temp
SllRV APRil 2009 Shinned To 1Iabl Method of Shipment Bill of LadinlAir Bill No
h Sin I Gnvl Vehick Protocol Priority 45 Days Offsite PrOnerty No
SlJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge lnfonnation FornI applies
Total Activitv ExemDtion Yes lllI No I~
releasable per DOE Order 54005 (19901993)
Sample No Lab ID bull Date
B203D8 W -Lq-o~
-shy ---shy --shy ---shy
Time NoType Container Sample Analysis
D~55 1x125-mL GP 1129_ICPMS 1-129LL (1)
---shy --- -r-shy illbJJ ~
----shy1-(Llf --oC-j ----
--shy -
---
shy
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ---shy ----shy ----shyRelinquished By Print Sign Matrix bull
Soil OS Omm Solid
Relinquished By R~
Sediment DI f)mm linlli Solid T Tjs~lleAPR D3errOm2009received~~~raquo~~ S111drre WI Wine55Lt I Water L Liollid
() Oil V VeQelatTonRelinquitAlftulSEshyA ~ Air X Other--)~~ APRDa~toeioor~i~~L( LCHPRC
Rclinqmshed By Daterrime Received By
)ltINAL SAMPLE I Disposal Method (eg Return 10 cuslomer per lab proccdure uscd in process) Disposed By Dateffime DISPOSITION
oq oS OtJlOb- c~L- 01oJ11 VJo -shy Page 9 of 32
middot ~
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-284
Page 1 of 1
CollectoR Mchtvr- ContactlReQuester Telephone No MSIN FAX Dana Widri ~O9middot376-2858
SAIltNo Sampline Oriein Purchase OrderCharee Code S09-nn4 Hanford Site
Proiect Title UIUC I OR 11- I Ice Chest No CtA6_1111 Temp SIJRV APRTl2OD9
Shipned To (Lab) Method of Shipment Bill of Ladinel Air Bill No I Scienc~s I Govt Vehicle
Protocol Priority 45 Days OtT site Propertv No
SIJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~J No Lbullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge Inormation Fonn applies
releasable per DOE Order 54005 (199011991)
-
Sample No LablD bull Date Time NoType Container Sample Analysis
B203F3 W -IIi-Y~ Oc-l 1 x125-mL GP 1129_ICPMS 1-129LL (1)
r----shy ---rshy ---- -~ ----shy ----shy
f fVfJJ J -1lt1 -~9
----shy ---shy
-
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ----- ~ ~ ~ ~
I
I
I
I
I
Matrix bull RelinA~h~ Sign APP lte~ill~riyenIReceived By
S Soil OS Omm Solid SF Serliment DJ Drllm (iolllRelinquished By SO Solid T Tissue SL SllIdQC WI Wine W Water l li(1Il1rl
RelinquishRffHulse
55 (J 0 Oil V =- Veictation A Air X - OtherAPRatc3illO2009re~ LCHPRC
Relinquished By Dateffime Received By
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime DISPOSITION
Page 10 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
Case Narrative Report
Hold Time No discrepancies noted
Preparation Blank (PB) No preparation was performed therefore no blanks were analyzed
Duplicate (DUP) No preparation was performed therefore no duplicates were analyzed
Laboratory Control Samples (LCS)
No preparation was performed therefore no LCSs were analyzed
Post Spike (PS) No preparation was performed therefore no PSs were analyzed
Matrix Spike (MS) Not applicable
Other QC Criteria None noted
DISCLAIMER
This report was prepared as an account of work sponsored by an agency of the United States Government Neither the United States Government nor any agency thereof nor Battelle Memorial Institute nor any of their employees makes any warranty express or implied or assumes any legal liability or responsibility for the accuracy completeness or usefulness of any information apparatus product or process disclosed or represents that its use would not infringe privately owned rights Reference herein to any specific commercial product process or service by trade name trademark manufacturer or otherwise does not necessarily constitute or imply its endorsement recommendation or favoring by the United States Government or any agency thereof or Battelle Memorial Institute The views and opinions of authors expressed herein do not necessarily state or reflect those of the United States Government or any agency thereof
0905001 FINAL
Page 3 of 32
SAMPLES INCLUDED IN THIS REPORT
I-129 Groundwaters
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 4 of 32
The following analyses were performed on the following samples included in this report
Iodine 129 Water by ICPMS
SAMPLES ANALYZED IN THIS REPORT
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 5 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No B203D8 Lab ID 0905001-01
15046-84-1 Iodine-129 126E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203F3 Lab ID 0905001-02
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203F8 Lab ID 0905001-03
15046-84-1 Iodine-129 136E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203M8 Lab ID 0905001-04
15046-84-1 Iodine-129 130E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203P9 Lab ID 0905001-05
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203R4 Lab ID 0905001-06
15046-84-1 Iodine-129 114E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203V1 Lab ID 0905001-07
15046-84-1 Iodine-129 916E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203V5 Lab ID 0905001-08
15046-84-1 Iodine-129 116E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203H3 Lab ID 0905001-09
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B202Y0 Lab ID 0905001-10
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B20979 Lab ID 0905001-11
15046-84-1 Iodine-129 330E-2 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20980 Iodine-129
Lab ID
431E-2 ugL0905001-12
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20981 Iodine-129
Lab ID
366E-2 ugL0905001-13
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20982 Iodine-129
Lab ID
lt505E-3 ugL0905001-14
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20983 Iodine-129
Lab ID
lt505E-3 ugL0905001-15
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20984 Iodine-129
Lab ID
lt505E-3 ugL0905001-16
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LP2 Iodine-129
Lab ID
lt505E-3 ugL0905001-17
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20LR4 Iodine-129
Lab ID
753E-3 ugL0905001-18
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT1 Iodine-129
Lab ID
lt505E-3 ugL0905001-19
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT4 Iodine-129
Lab ID
140E-2 ugL0905001-20
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MX3 Iodine-129
Lab ID
lt505E-3 ugL0905001-21
9I14002 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20PJ5 Iodine-129
Lab ID
171E-2 ugL0905001-22
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20PP7 Iodine-129
Lab ID
135E-2 ugL0905001-23
9I14002 PNNL-AGG-41592409100E-2
0905001 FINAL
Page 6 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No 15046-84-1
B20P35 Iodine-129
Lab ID
179E-2 ugL0905001-24
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20NX6 Iodine-129
Lab ID
135E-2 ugL0905001-25
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MY5 Iodine-129
Lab ID
lt505E-3 ugL0905001-26
9I14002 PNNL-AGG-415100709505E-3
0905001 FINAL
Page 7 of 32
-------
middot~-~ COc ~~
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST 109-033-97
Page 1 of 1 Collector a ContactReauester Telephone No MSIN laquoAX-shy f)HnH Widri ~09 762RSR SAF No Samplinl Orilin Purchase OrderCharee Code
109middot033 Hanford Site Proiect Title
ut1r nR- a~ I r 0 Ice Chest No 6VJS middottlf I Temp 2ZPI APRil 2009
Shipped To fLab) Method of Shipment Bill of LadinliAir Bill No ISdenlt I nov Vehicle
Protocol Priority 45 Days Offsite Propertv No
rlIU1 A
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRlJCTIONS Hold Time Total Activitv Exemption Yes iofJ NQ L Contains Radioactive Material at concentrations that are not regulated figtr transportation per 49 CFR but are not 200 Area Generator Knowledge Infmmation Form applies releasable per DOE Order 54005 (1990J993)
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
B202YO W 1-f )(__df 10)D 1 x125middotmL GP 1129_ICPMS 1middot129LL (1) 6 Months NaOH to pH gt 9 r---
~ ~
r-- shy=-----shy L ALl iJ--shy _J1L) g
V~ ---- ---shy ----- ---shy - ~~-~
--shy~ gt
RelinquisbedBSOverdah~~~ Daterrime
- - -h c 71 2 9 200g-Received By Print Sign Dateffime
63uci I APR 29 2009 S SF so ~
SI W 0 ~
A
Matrix bull
Soil OS Sediment OJ Solid T =--
SIciQe WI Water L Oil V =
Air X
Omm Solid Dmm Ij(1lli Tis~lle Wine Limlin VCQetatlon Other
Relinquishetl By DatefflmeOGOO
5Sll 1 APR 302009 Received BK8 Hulse
amp~~pound Daterrimc DYeO
CtlPRC APR 3 0 2009 Rc1inquish4(ampHulse
f7)~k Datefflme II -f r
CHPRC APR 3a2009 ReL Lu~4ML 9I7f-J DateffimeIIishyltfh~
Relinquished By Dateffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By ( I v Dateffime f
FINAL SAMPLE Disposed By
DISPOSITION I
DateTime I
5gtb (7 ESL rn oooS4~ tAl 0 ~ ()Ci() hPQ J t Page 8 of 32
-
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-276
Page 1 of I
CollectKR a ContactlReQuester Telephone No MSIN FAX-laquoYI nan Winri ~0()-17h-)~~~
SM No Samplinl Orilin Purchase OrderCharle Code i
S09middot004 Hanford Site Proiect Title HNF-N-506- 2- I ~ Ice Chest No eMIIJ Temp
SllRV APRil 2009 Shinned To 1Iabl Method of Shipment Bill of LadinlAir Bill No
h Sin I Gnvl Vehick Protocol Priority 45 Days Offsite PrOnerty No
SlJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge lnfonnation FornI applies
Total Activitv ExemDtion Yes lllI No I~
releasable per DOE Order 54005 (19901993)
Sample No Lab ID bull Date
B203D8 W -Lq-o~
-shy ---shy --shy ---shy
Time NoType Container Sample Analysis
D~55 1x125-mL GP 1129_ICPMS 1-129LL (1)
---shy --- -r-shy illbJJ ~
----shy1-(Llf --oC-j ----
--shy -
---
shy
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ---shy ----shy ----shyRelinquished By Print Sign Matrix bull
Soil OS Omm Solid
Relinquished By R~
Sediment DI f)mm linlli Solid T Tjs~lleAPR D3errOm2009received~~~raquo~~ S111drre WI Wine55Lt I Water L Liollid
() Oil V VeQelatTonRelinquitAlftulSEshyA ~ Air X Other--)~~ APRDa~toeioor~i~~L( LCHPRC
Rclinqmshed By Daterrime Received By
)ltINAL SAMPLE I Disposal Method (eg Return 10 cuslomer per lab proccdure uscd in process) Disposed By Dateffime DISPOSITION
oq oS OtJlOb- c~L- 01oJ11 VJo -shy Page 9 of 32
middot ~
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-284
Page 1 of 1
CollectoR Mchtvr- ContactlReQuester Telephone No MSIN FAX Dana Widri ~O9middot376-2858
SAIltNo Sampline Oriein Purchase OrderCharee Code S09-nn4 Hanford Site
Proiect Title UIUC I OR 11- I Ice Chest No CtA6_1111 Temp SIJRV APRTl2OD9
Shipned To (Lab) Method of Shipment Bill of Ladinel Air Bill No I Scienc~s I Govt Vehicle
Protocol Priority 45 Days OtT site Propertv No
SIJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~J No Lbullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge Inormation Fonn applies
releasable per DOE Order 54005 (199011991)
-
Sample No LablD bull Date Time NoType Container Sample Analysis
B203F3 W -IIi-Y~ Oc-l 1 x125-mL GP 1129_ICPMS 1-129LL (1)
r----shy ---rshy ---- -~ ----shy ----shy
f fVfJJ J -1lt1 -~9
----shy ---shy
-
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ----- ~ ~ ~ ~
I
I
I
I
I
Matrix bull RelinA~h~ Sign APP lte~ill~riyenIReceived By
S Soil OS Omm Solid SF Serliment DJ Drllm (iolllRelinquished By SO Solid T Tissue SL SllIdQC WI Wine W Water l li(1Il1rl
RelinquishRffHulse
55 (J 0 Oil V =- Veictation A Air X - OtherAPRatc3illO2009re~ LCHPRC
Relinquished By Dateffime Received By
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime DISPOSITION
Page 10 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
SAMPLES INCLUDED IN THIS REPORT
I-129 Groundwaters
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 4 of 32
The following analyses were performed on the following samples included in this report
Iodine 129 Water by ICPMS
SAMPLES ANALYZED IN THIS REPORT
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 5 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No B203D8 Lab ID 0905001-01
15046-84-1 Iodine-129 126E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203F3 Lab ID 0905001-02
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203F8 Lab ID 0905001-03
15046-84-1 Iodine-129 136E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203M8 Lab ID 0905001-04
15046-84-1 Iodine-129 130E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203P9 Lab ID 0905001-05
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203R4 Lab ID 0905001-06
15046-84-1 Iodine-129 114E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203V1 Lab ID 0905001-07
15046-84-1 Iodine-129 916E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203V5 Lab ID 0905001-08
15046-84-1 Iodine-129 116E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203H3 Lab ID 0905001-09
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B202Y0 Lab ID 0905001-10
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B20979 Lab ID 0905001-11
15046-84-1 Iodine-129 330E-2 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20980 Iodine-129
Lab ID
431E-2 ugL0905001-12
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20981 Iodine-129
Lab ID
366E-2 ugL0905001-13
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20982 Iodine-129
Lab ID
lt505E-3 ugL0905001-14
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20983 Iodine-129
Lab ID
lt505E-3 ugL0905001-15
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20984 Iodine-129
Lab ID
lt505E-3 ugL0905001-16
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LP2 Iodine-129
Lab ID
lt505E-3 ugL0905001-17
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20LR4 Iodine-129
Lab ID
753E-3 ugL0905001-18
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT1 Iodine-129
Lab ID
lt505E-3 ugL0905001-19
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT4 Iodine-129
Lab ID
140E-2 ugL0905001-20
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MX3 Iodine-129
Lab ID
lt505E-3 ugL0905001-21
9I14002 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20PJ5 Iodine-129
Lab ID
171E-2 ugL0905001-22
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20PP7 Iodine-129
Lab ID
135E-2 ugL0905001-23
9I14002 PNNL-AGG-41592409100E-2
0905001 FINAL
Page 6 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No 15046-84-1
B20P35 Iodine-129
Lab ID
179E-2 ugL0905001-24
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20NX6 Iodine-129
Lab ID
135E-2 ugL0905001-25
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MY5 Iodine-129
Lab ID
lt505E-3 ugL0905001-26
9I14002 PNNL-AGG-415100709505E-3
0905001 FINAL
Page 7 of 32
-------
middot~-~ COc ~~
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST 109-033-97
Page 1 of 1 Collector a ContactReauester Telephone No MSIN laquoAX-shy f)HnH Widri ~09 762RSR SAF No Samplinl Orilin Purchase OrderCharee Code
109middot033 Hanford Site Proiect Title
ut1r nR- a~ I r 0 Ice Chest No 6VJS middottlf I Temp 2ZPI APRil 2009
Shipped To fLab) Method of Shipment Bill of LadinliAir Bill No ISdenlt I nov Vehicle
Protocol Priority 45 Days Offsite Propertv No
rlIU1 A
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRlJCTIONS Hold Time Total Activitv Exemption Yes iofJ NQ L Contains Radioactive Material at concentrations that are not regulated figtr transportation per 49 CFR but are not 200 Area Generator Knowledge Infmmation Form applies releasable per DOE Order 54005 (1990J993)
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
B202YO W 1-f )(__df 10)D 1 x125middotmL GP 1129_ICPMS 1middot129LL (1) 6 Months NaOH to pH gt 9 r---
~ ~
r-- shy=-----shy L ALl iJ--shy _J1L) g
V~ ---- ---shy ----- ---shy - ~~-~
--shy~ gt
RelinquisbedBSOverdah~~~ Daterrime
- - -h c 71 2 9 200g-Received By Print Sign Dateffime
63uci I APR 29 2009 S SF so ~
SI W 0 ~
A
Matrix bull
Soil OS Sediment OJ Solid T =--
SIciQe WI Water L Oil V =
Air X
Omm Solid Dmm Ij(1lli Tis~lle Wine Limlin VCQetatlon Other
Relinquishetl By DatefflmeOGOO
5Sll 1 APR 302009 Received BK8 Hulse
amp~~pound Daterrimc DYeO
CtlPRC APR 3 0 2009 Rc1inquish4(ampHulse
f7)~k Datefflme II -f r
CHPRC APR 3a2009 ReL Lu~4ML 9I7f-J DateffimeIIishyltfh~
Relinquished By Dateffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By ( I v Dateffime f
FINAL SAMPLE Disposed By
DISPOSITION I
DateTime I
5gtb (7 ESL rn oooS4~ tAl 0 ~ ()Ci() hPQ J t Page 8 of 32
-
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-276
Page 1 of I
CollectKR a ContactlReQuester Telephone No MSIN FAX-laquoYI nan Winri ~0()-17h-)~~~
SM No Samplinl Orilin Purchase OrderCharle Code i
S09middot004 Hanford Site Proiect Title HNF-N-506- 2- I ~ Ice Chest No eMIIJ Temp
SllRV APRil 2009 Shinned To 1Iabl Method of Shipment Bill of LadinlAir Bill No
h Sin I Gnvl Vehick Protocol Priority 45 Days Offsite PrOnerty No
SlJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge lnfonnation FornI applies
Total Activitv ExemDtion Yes lllI No I~
releasable per DOE Order 54005 (19901993)
Sample No Lab ID bull Date
B203D8 W -Lq-o~
-shy ---shy --shy ---shy
Time NoType Container Sample Analysis
D~55 1x125-mL GP 1129_ICPMS 1-129LL (1)
---shy --- -r-shy illbJJ ~
----shy1-(Llf --oC-j ----
--shy -
---
shy
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ---shy ----shy ----shyRelinquished By Print Sign Matrix bull
Soil OS Omm Solid
Relinquished By R~
Sediment DI f)mm linlli Solid T Tjs~lleAPR D3errOm2009received~~~raquo~~ S111drre WI Wine55Lt I Water L Liollid
() Oil V VeQelatTonRelinquitAlftulSEshyA ~ Air X Other--)~~ APRDa~toeioor~i~~L( LCHPRC
Rclinqmshed By Daterrime Received By
)ltINAL SAMPLE I Disposal Method (eg Return 10 cuslomer per lab proccdure uscd in process) Disposed By Dateffime DISPOSITION
oq oS OtJlOb- c~L- 01oJ11 VJo -shy Page 9 of 32
middot ~
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-284
Page 1 of 1
CollectoR Mchtvr- ContactlReQuester Telephone No MSIN FAX Dana Widri ~O9middot376-2858
SAIltNo Sampline Oriein Purchase OrderCharee Code S09-nn4 Hanford Site
Proiect Title UIUC I OR 11- I Ice Chest No CtA6_1111 Temp SIJRV APRTl2OD9
Shipned To (Lab) Method of Shipment Bill of Ladinel Air Bill No I Scienc~s I Govt Vehicle
Protocol Priority 45 Days OtT site Propertv No
SIJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~J No Lbullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge Inormation Fonn applies
releasable per DOE Order 54005 (199011991)
-
Sample No LablD bull Date Time NoType Container Sample Analysis
B203F3 W -IIi-Y~ Oc-l 1 x125-mL GP 1129_ICPMS 1-129LL (1)
r----shy ---rshy ---- -~ ----shy ----shy
f fVfJJ J -1lt1 -~9
----shy ---shy
-
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ----- ~ ~ ~ ~
I
I
I
I
I
Matrix bull RelinA~h~ Sign APP lte~ill~riyenIReceived By
S Soil OS Omm Solid SF Serliment DJ Drllm (iolllRelinquished By SO Solid T Tissue SL SllIdQC WI Wine W Water l li(1Il1rl
RelinquishRffHulse
55 (J 0 Oil V =- Veictation A Air X - OtherAPRatc3illO2009re~ LCHPRC
Relinquished By Dateffime Received By
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime DISPOSITION
Page 10 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
The following analyses were performed on the following samples included in this report
Iodine 129 Water by ICPMS
SAMPLES ANALYZED IN THIS REPORT
HEIS No B203D8 B203F3 B203F8 B203M8 B203P9 B203R4 B203V1 B203V5 B203H3 B202Y0 B20979 B20980 B20981 B20982 B20983 B20984 B20LP2 B20LR4 B20LT1 B20LT4 B20MX3 B20PJ5 B20PP7 B20P35 B20NX6 B20MY5
Laboratory ID 0905001-01 0905001-02 0905001-03 0905001-04 0905001-05 0905001-06 0905001-07 0905001-08 0905001-09 0905001-10 0905001-11 0905001-12 0905001-13 0905001-14 0905001-15 0905001-16 0905001-17 0905001-18 0905001-19 0905001-20 0905001-21 0905001-22 0905001-23 0905001-24 0905001-25 0905001-26
Date Collected 42909 0955 42909 0847 42909 1053 42609 0918 41009 0840 42009 1204 42009 1331 42009 1231 43009 0939 42909 1050 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 61609 1030 62309 1338 62309 1244 62309 1130 62309 1000 61709 1035 62409 1045 7809 0938 62609 1126 62509 1230 81409 1100
MatrixWATER
Date Received43009 1145
WATER 43009 1145WATER 43009 1145WATER 42309 0850WATER 41409 1415WATER 42309 0850WATER 42309 0850WATER 42309 0850WATER 5409 1340WATER 43009 1145WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 61709 1130WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62409 1028WATER 62309 1247WATER 62509 1200WATER 71409 1300WATER 62909 0930WATER 62909 0930WATER 82509 1300
0905001 FINAL
Page 5 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No B203D8 Lab ID 0905001-01
15046-84-1 Iodine-129 126E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203F3 Lab ID 0905001-02
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203F8 Lab ID 0905001-03
15046-84-1 Iodine-129 136E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203M8 Lab ID 0905001-04
15046-84-1 Iodine-129 130E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203P9 Lab ID 0905001-05
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203R4 Lab ID 0905001-06
15046-84-1 Iodine-129 114E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203V1 Lab ID 0905001-07
15046-84-1 Iodine-129 916E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203V5 Lab ID 0905001-08
15046-84-1 Iodine-129 116E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203H3 Lab ID 0905001-09
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B202Y0 Lab ID 0905001-10
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B20979 Lab ID 0905001-11
15046-84-1 Iodine-129 330E-2 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20980 Iodine-129
Lab ID
431E-2 ugL0905001-12
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20981 Iodine-129
Lab ID
366E-2 ugL0905001-13
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20982 Iodine-129
Lab ID
lt505E-3 ugL0905001-14
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20983 Iodine-129
Lab ID
lt505E-3 ugL0905001-15
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20984 Iodine-129
Lab ID
lt505E-3 ugL0905001-16
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LP2 Iodine-129
Lab ID
lt505E-3 ugL0905001-17
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20LR4 Iodine-129
Lab ID
753E-3 ugL0905001-18
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT1 Iodine-129
Lab ID
lt505E-3 ugL0905001-19
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT4 Iodine-129
Lab ID
140E-2 ugL0905001-20
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MX3 Iodine-129
Lab ID
lt505E-3 ugL0905001-21
9I14002 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20PJ5 Iodine-129
Lab ID
171E-2 ugL0905001-22
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20PP7 Iodine-129
Lab ID
135E-2 ugL0905001-23
9I14002 PNNL-AGG-41592409100E-2
0905001 FINAL
Page 6 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No 15046-84-1
B20P35 Iodine-129
Lab ID
179E-2 ugL0905001-24
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20NX6 Iodine-129
Lab ID
135E-2 ugL0905001-25
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MY5 Iodine-129
Lab ID
lt505E-3 ugL0905001-26
9I14002 PNNL-AGG-415100709505E-3
0905001 FINAL
Page 7 of 32
-------
middot~-~ COc ~~
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST 109-033-97
Page 1 of 1 Collector a ContactReauester Telephone No MSIN laquoAX-shy f)HnH Widri ~09 762RSR SAF No Samplinl Orilin Purchase OrderCharee Code
109middot033 Hanford Site Proiect Title
ut1r nR- a~ I r 0 Ice Chest No 6VJS middottlf I Temp 2ZPI APRil 2009
Shipped To fLab) Method of Shipment Bill of LadinliAir Bill No ISdenlt I nov Vehicle
Protocol Priority 45 Days Offsite Propertv No
rlIU1 A
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRlJCTIONS Hold Time Total Activitv Exemption Yes iofJ NQ L Contains Radioactive Material at concentrations that are not regulated figtr transportation per 49 CFR but are not 200 Area Generator Knowledge Infmmation Form applies releasable per DOE Order 54005 (1990J993)
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
B202YO W 1-f )(__df 10)D 1 x125middotmL GP 1129_ICPMS 1middot129LL (1) 6 Months NaOH to pH gt 9 r---
~ ~
r-- shy=-----shy L ALl iJ--shy _J1L) g
V~ ---- ---shy ----- ---shy - ~~-~
--shy~ gt
RelinquisbedBSOverdah~~~ Daterrime
- - -h c 71 2 9 200g-Received By Print Sign Dateffime
63uci I APR 29 2009 S SF so ~
SI W 0 ~
A
Matrix bull
Soil OS Sediment OJ Solid T =--
SIciQe WI Water L Oil V =
Air X
Omm Solid Dmm Ij(1lli Tis~lle Wine Limlin VCQetatlon Other
Relinquishetl By DatefflmeOGOO
5Sll 1 APR 302009 Received BK8 Hulse
amp~~pound Daterrimc DYeO
CtlPRC APR 3 0 2009 Rc1inquish4(ampHulse
f7)~k Datefflme II -f r
CHPRC APR 3a2009 ReL Lu~4ML 9I7f-J DateffimeIIishyltfh~
Relinquished By Dateffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By ( I v Dateffime f
FINAL SAMPLE Disposed By
DISPOSITION I
DateTime I
5gtb (7 ESL rn oooS4~ tAl 0 ~ ()Ci() hPQ J t Page 8 of 32
-
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-276
Page 1 of I
CollectKR a ContactlReQuester Telephone No MSIN FAX-laquoYI nan Winri ~0()-17h-)~~~
SM No Samplinl Orilin Purchase OrderCharle Code i
S09middot004 Hanford Site Proiect Title HNF-N-506- 2- I ~ Ice Chest No eMIIJ Temp
SllRV APRil 2009 Shinned To 1Iabl Method of Shipment Bill of LadinlAir Bill No
h Sin I Gnvl Vehick Protocol Priority 45 Days Offsite PrOnerty No
SlJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge lnfonnation FornI applies
Total Activitv ExemDtion Yes lllI No I~
releasable per DOE Order 54005 (19901993)
Sample No Lab ID bull Date
B203D8 W -Lq-o~
-shy ---shy --shy ---shy
Time NoType Container Sample Analysis
D~55 1x125-mL GP 1129_ICPMS 1-129LL (1)
---shy --- -r-shy illbJJ ~
----shy1-(Llf --oC-j ----
--shy -
---
shy
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ---shy ----shy ----shyRelinquished By Print Sign Matrix bull
Soil OS Omm Solid
Relinquished By R~
Sediment DI f)mm linlli Solid T Tjs~lleAPR D3errOm2009received~~~raquo~~ S111drre WI Wine55Lt I Water L Liollid
() Oil V VeQelatTonRelinquitAlftulSEshyA ~ Air X Other--)~~ APRDa~toeioor~i~~L( LCHPRC
Rclinqmshed By Daterrime Received By
)ltINAL SAMPLE I Disposal Method (eg Return 10 cuslomer per lab proccdure uscd in process) Disposed By Dateffime DISPOSITION
oq oS OtJlOb- c~L- 01oJ11 VJo -shy Page 9 of 32
middot ~
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-284
Page 1 of 1
CollectoR Mchtvr- ContactlReQuester Telephone No MSIN FAX Dana Widri ~O9middot376-2858
SAIltNo Sampline Oriein Purchase OrderCharee Code S09-nn4 Hanford Site
Proiect Title UIUC I OR 11- I Ice Chest No CtA6_1111 Temp SIJRV APRTl2OD9
Shipned To (Lab) Method of Shipment Bill of Ladinel Air Bill No I Scienc~s I Govt Vehicle
Protocol Priority 45 Days OtT site Propertv No
SIJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~J No Lbullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge Inormation Fonn applies
releasable per DOE Order 54005 (199011991)
-
Sample No LablD bull Date Time NoType Container Sample Analysis
B203F3 W -IIi-Y~ Oc-l 1 x125-mL GP 1129_ICPMS 1-129LL (1)
r----shy ---rshy ---- -~ ----shy ----shy
f fVfJJ J -1lt1 -~9
----shy ---shy
-
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ----- ~ ~ ~ ~
I
I
I
I
I
Matrix bull RelinA~h~ Sign APP lte~ill~riyenIReceived By
S Soil OS Omm Solid SF Serliment DJ Drllm (iolllRelinquished By SO Solid T Tissue SL SllIdQC WI Wine W Water l li(1Il1rl
RelinquishRffHulse
55 (J 0 Oil V =- Veictation A Air X - OtherAPRatc3illO2009re~ LCHPRC
Relinquished By Dateffime Received By
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime DISPOSITION
Page 10 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No B203D8 Lab ID 0905001-01
15046-84-1 Iodine-129 126E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203F3 Lab ID 0905001-02
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203F8 Lab ID 0905001-03
15046-84-1 Iodine-129 136E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203M8 Lab ID 0905001-04
15046-84-1 Iodine-129 130E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203P9 Lab ID 0905001-05
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203R4 Lab ID 0905001-06
15046-84-1 Iodine-129 114E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203V1 Lab ID 0905001-07
15046-84-1 Iodine-129 916E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B203V5 Lab ID 0905001-08
15046-84-1 Iodine-129 116E-2 9I14001 ugL PNNL-AGG-41592409100E-2
HEIS No B203H3 Lab ID 0905001-09
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B202Y0 Lab ID 0905001-10
15046-84-1 Iodine-129 lt505E-3 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No B20979 Lab ID 0905001-11
15046-84-1 Iodine-129 330E-2 9I14001 ugL PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20980 Iodine-129
Lab ID
431E-2 ugL0905001-12
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20981 Iodine-129
Lab ID
366E-2 ugL0905001-13
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20982 Iodine-129
Lab ID
lt505E-3 ugL0905001-14
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20983 Iodine-129
Lab ID
lt505E-3 ugL0905001-15
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20984 Iodine-129
Lab ID
lt505E-3 ugL0905001-16
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LP2 Iodine-129
Lab ID
lt505E-3 ugL0905001-17
9I14001 PNNL-AGG-415100609505E-3
HEIS No 15046-84-1
B20LR4 Iodine-129
Lab ID
753E-3 ugL0905001-18
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT1 Iodine-129
Lab ID
lt505E-3 ugL0905001-19
9I14001 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20LT4 Iodine-129
Lab ID
140E-2 ugL0905001-20
9I14001 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MX3 Iodine-129
Lab ID
lt505E-3 ugL0905001-21
9I14002 PNNL-AGG-415100709505E-3
HEIS No 15046-84-1
B20PJ5 Iodine-129
Lab ID
171E-2 ugL0905001-22
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20PP7 Iodine-129
Lab ID
135E-2 ugL0905001-23
9I14002 PNNL-AGG-41592409100E-2
0905001 FINAL
Page 6 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No 15046-84-1
B20P35 Iodine-129
Lab ID
179E-2 ugL0905001-24
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20NX6 Iodine-129
Lab ID
135E-2 ugL0905001-25
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MY5 Iodine-129
Lab ID
lt505E-3 ugL0905001-26
9I14002 PNNL-AGG-415100709505E-3
0905001 FINAL
Page 7 of 32
-------
middot~-~ COc ~~
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST 109-033-97
Page 1 of 1 Collector a ContactReauester Telephone No MSIN laquoAX-shy f)HnH Widri ~09 762RSR SAF No Samplinl Orilin Purchase OrderCharee Code
109middot033 Hanford Site Proiect Title
ut1r nR- a~ I r 0 Ice Chest No 6VJS middottlf I Temp 2ZPI APRil 2009
Shipped To fLab) Method of Shipment Bill of LadinliAir Bill No ISdenlt I nov Vehicle
Protocol Priority 45 Days Offsite Propertv No
rlIU1 A
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRlJCTIONS Hold Time Total Activitv Exemption Yes iofJ NQ L Contains Radioactive Material at concentrations that are not regulated figtr transportation per 49 CFR but are not 200 Area Generator Knowledge Infmmation Form applies releasable per DOE Order 54005 (1990J993)
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
B202YO W 1-f )(__df 10)D 1 x125middotmL GP 1129_ICPMS 1middot129LL (1) 6 Months NaOH to pH gt 9 r---
~ ~
r-- shy=-----shy L ALl iJ--shy _J1L) g
V~ ---- ---shy ----- ---shy - ~~-~
--shy~ gt
RelinquisbedBSOverdah~~~ Daterrime
- - -h c 71 2 9 200g-Received By Print Sign Dateffime
63uci I APR 29 2009 S SF so ~
SI W 0 ~
A
Matrix bull
Soil OS Sediment OJ Solid T =--
SIciQe WI Water L Oil V =
Air X
Omm Solid Dmm Ij(1lli Tis~lle Wine Limlin VCQetatlon Other
Relinquishetl By DatefflmeOGOO
5Sll 1 APR 302009 Received BK8 Hulse
amp~~pound Daterrimc DYeO
CtlPRC APR 3 0 2009 Rc1inquish4(ampHulse
f7)~k Datefflme II -f r
CHPRC APR 3a2009 ReL Lu~4ML 9I7f-J DateffimeIIishyltfh~
Relinquished By Dateffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By ( I v Dateffime f
FINAL SAMPLE Disposed By
DISPOSITION I
DateTime I
5gtb (7 ESL rn oooS4~ tAl 0 ~ ()Ci() hPQ J t Page 8 of 32
-
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-276
Page 1 of I
CollectKR a ContactlReQuester Telephone No MSIN FAX-laquoYI nan Winri ~0()-17h-)~~~
SM No Samplinl Orilin Purchase OrderCharle Code i
S09middot004 Hanford Site Proiect Title HNF-N-506- 2- I ~ Ice Chest No eMIIJ Temp
SllRV APRil 2009 Shinned To 1Iabl Method of Shipment Bill of LadinlAir Bill No
h Sin I Gnvl Vehick Protocol Priority 45 Days Offsite PrOnerty No
SlJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge lnfonnation FornI applies
Total Activitv ExemDtion Yes lllI No I~
releasable per DOE Order 54005 (19901993)
Sample No Lab ID bull Date
B203D8 W -Lq-o~
-shy ---shy --shy ---shy
Time NoType Container Sample Analysis
D~55 1x125-mL GP 1129_ICPMS 1-129LL (1)
---shy --- -r-shy illbJJ ~
----shy1-(Llf --oC-j ----
--shy -
---
shy
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ---shy ----shy ----shyRelinquished By Print Sign Matrix bull
Soil OS Omm Solid
Relinquished By R~
Sediment DI f)mm linlli Solid T Tjs~lleAPR D3errOm2009received~~~raquo~~ S111drre WI Wine55Lt I Water L Liollid
() Oil V VeQelatTonRelinquitAlftulSEshyA ~ Air X Other--)~~ APRDa~toeioor~i~~L( LCHPRC
Rclinqmshed By Daterrime Received By
)ltINAL SAMPLE I Disposal Method (eg Return 10 cuslomer per lab proccdure uscd in process) Disposed By Dateffime DISPOSITION
oq oS OtJlOb- c~L- 01oJ11 VJo -shy Page 9 of 32
middot ~
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-284
Page 1 of 1
CollectoR Mchtvr- ContactlReQuester Telephone No MSIN FAX Dana Widri ~O9middot376-2858
SAIltNo Sampline Oriein Purchase OrderCharee Code S09-nn4 Hanford Site
Proiect Title UIUC I OR 11- I Ice Chest No CtA6_1111 Temp SIJRV APRTl2OD9
Shipned To (Lab) Method of Shipment Bill of Ladinel Air Bill No I Scienc~s I Govt Vehicle
Protocol Priority 45 Days OtT site Propertv No
SIJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~J No Lbullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge Inormation Fonn applies
releasable per DOE Order 54005 (199011991)
-
Sample No LablD bull Date Time NoType Container Sample Analysis
B203F3 W -IIi-Y~ Oc-l 1 x125-mL GP 1129_ICPMS 1-129LL (1)
r----shy ---rshy ---- -~ ----shy ----shy
f fVfJJ J -1lt1 -~9
----shy ---shy
-
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ----- ~ ~ ~ ~
I
I
I
I
I
Matrix bull RelinA~h~ Sign APP lte~ill~riyenIReceived By
S Soil OS Omm Solid SF Serliment DJ Drllm (iolllRelinquished By SO Solid T Tissue SL SllIdQC WI Wine W Water l li(1Il1rl
RelinquishRffHulse
55 (J 0 Oil V =- Veictation A Air X - OtherAPRatc3illO2009re~ LCHPRC
Relinquished By Dateffime Received By
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime DISPOSITION
Page 10 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
Radionuclides By ICP-MS
CAS Analyte Results Batch Units EQL Analyzed Method
HEIS No 15046-84-1
B20P35 Iodine-129
Lab ID
179E-2 ugL0905001-24
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20NX6 Iodine-129
Lab ID
135E-2 ugL0905001-25
9I14002 PNNL-AGG-41592409100E-2
HEIS No 15046-84-1
B20MY5 Iodine-129
Lab ID
lt505E-3 ugL0905001-26
9I14002 PNNL-AGG-415100709505E-3
0905001 FINAL
Page 7 of 32
-------
middot~-~ COc ~~
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST 109-033-97
Page 1 of 1 Collector a ContactReauester Telephone No MSIN laquoAX-shy f)HnH Widri ~09 762RSR SAF No Samplinl Orilin Purchase OrderCharee Code
109middot033 Hanford Site Proiect Title
ut1r nR- a~ I r 0 Ice Chest No 6VJS middottlf I Temp 2ZPI APRil 2009
Shipped To fLab) Method of Shipment Bill of LadinliAir Bill No ISdenlt I nov Vehicle
Protocol Priority 45 Days Offsite Propertv No
rlIU1 A
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRlJCTIONS Hold Time Total Activitv Exemption Yes iofJ NQ L Contains Radioactive Material at concentrations that are not regulated figtr transportation per 49 CFR but are not 200 Area Generator Knowledge Infmmation Form applies releasable per DOE Order 54005 (1990J993)
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
B202YO W 1-f )(__df 10)D 1 x125middotmL GP 1129_ICPMS 1middot129LL (1) 6 Months NaOH to pH gt 9 r---
~ ~
r-- shy=-----shy L ALl iJ--shy _J1L) g
V~ ---- ---shy ----- ---shy - ~~-~
--shy~ gt
RelinquisbedBSOverdah~~~ Daterrime
- - -h c 71 2 9 200g-Received By Print Sign Dateffime
63uci I APR 29 2009 S SF so ~
SI W 0 ~
A
Matrix bull
Soil OS Sediment OJ Solid T =--
SIciQe WI Water L Oil V =
Air X
Omm Solid Dmm Ij(1lli Tis~lle Wine Limlin VCQetatlon Other
Relinquishetl By DatefflmeOGOO
5Sll 1 APR 302009 Received BK8 Hulse
amp~~pound Daterrimc DYeO
CtlPRC APR 3 0 2009 Rc1inquish4(ampHulse
f7)~k Datefflme II -f r
CHPRC APR 3a2009 ReL Lu~4ML 9I7f-J DateffimeIIishyltfh~
Relinquished By Dateffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By ( I v Dateffime f
FINAL SAMPLE Disposed By
DISPOSITION I
DateTime I
5gtb (7 ESL rn oooS4~ tAl 0 ~ ()Ci() hPQ J t Page 8 of 32
-
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-276
Page 1 of I
CollectKR a ContactlReQuester Telephone No MSIN FAX-laquoYI nan Winri ~0()-17h-)~~~
SM No Samplinl Orilin Purchase OrderCharle Code i
S09middot004 Hanford Site Proiect Title HNF-N-506- 2- I ~ Ice Chest No eMIIJ Temp
SllRV APRil 2009 Shinned To 1Iabl Method of Shipment Bill of LadinlAir Bill No
h Sin I Gnvl Vehick Protocol Priority 45 Days Offsite PrOnerty No
SlJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge lnfonnation FornI applies
Total Activitv ExemDtion Yes lllI No I~
releasable per DOE Order 54005 (19901993)
Sample No Lab ID bull Date
B203D8 W -Lq-o~
-shy ---shy --shy ---shy
Time NoType Container Sample Analysis
D~55 1x125-mL GP 1129_ICPMS 1-129LL (1)
---shy --- -r-shy illbJJ ~
----shy1-(Llf --oC-j ----
--shy -
---
shy
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ---shy ----shy ----shyRelinquished By Print Sign Matrix bull
Soil OS Omm Solid
Relinquished By R~
Sediment DI f)mm linlli Solid T Tjs~lleAPR D3errOm2009received~~~raquo~~ S111drre WI Wine55Lt I Water L Liollid
() Oil V VeQelatTonRelinquitAlftulSEshyA ~ Air X Other--)~~ APRDa~toeioor~i~~L( LCHPRC
Rclinqmshed By Daterrime Received By
)ltINAL SAMPLE I Disposal Method (eg Return 10 cuslomer per lab proccdure uscd in process) Disposed By Dateffime DISPOSITION
oq oS OtJlOb- c~L- 01oJ11 VJo -shy Page 9 of 32
middot ~
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-284
Page 1 of 1
CollectoR Mchtvr- ContactlReQuester Telephone No MSIN FAX Dana Widri ~O9middot376-2858
SAIltNo Sampline Oriein Purchase OrderCharee Code S09-nn4 Hanford Site
Proiect Title UIUC I OR 11- I Ice Chest No CtA6_1111 Temp SIJRV APRTl2OD9
Shipned To (Lab) Method of Shipment Bill of Ladinel Air Bill No I Scienc~s I Govt Vehicle
Protocol Priority 45 Days OtT site Propertv No
SIJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~J No Lbullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge Inormation Fonn applies
releasable per DOE Order 54005 (199011991)
-
Sample No LablD bull Date Time NoType Container Sample Analysis
B203F3 W -IIi-Y~ Oc-l 1 x125-mL GP 1129_ICPMS 1-129LL (1)
r----shy ---rshy ---- -~ ----shy ----shy
f fVfJJ J -1lt1 -~9
----shy ---shy
-
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ----- ~ ~ ~ ~
I
I
I
I
I
Matrix bull RelinA~h~ Sign APP lte~ill~riyenIReceived By
S Soil OS Omm Solid SF Serliment DJ Drllm (iolllRelinquished By SO Solid T Tissue SL SllIdQC WI Wine W Water l li(1Il1rl
RelinquishRffHulse
55 (J 0 Oil V =- Veictation A Air X - OtherAPRatc3illO2009re~ LCHPRC
Relinquished By Dateffime Received By
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime DISPOSITION
Page 10 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
-------
middot~-~ COc ~~
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST 109-033-97
Page 1 of 1 Collector a ContactReauester Telephone No MSIN laquoAX-shy f)HnH Widri ~09 762RSR SAF No Samplinl Orilin Purchase OrderCharee Code
109middot033 Hanford Site Proiect Title
ut1r nR- a~ I r 0 Ice Chest No 6VJS middottlf I Temp 2ZPI APRil 2009
Shipped To fLab) Method of Shipment Bill of LadinliAir Bill No ISdenlt I nov Vehicle
Protocol Priority 45 Days Offsite Propertv No
rlIU1 A
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRlJCTIONS Hold Time Total Activitv Exemption Yes iofJ NQ L Contains Radioactive Material at concentrations that are not regulated figtr transportation per 49 CFR but are not 200 Area Generator Knowledge Infmmation Form applies releasable per DOE Order 54005 (1990J993)
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
B202YO W 1-f )(__df 10)D 1 x125middotmL GP 1129_ICPMS 1middot129LL (1) 6 Months NaOH to pH gt 9 r---
~ ~
r-- shy=-----shy L ALl iJ--shy _J1L) g
V~ ---- ---shy ----- ---shy - ~~-~
--shy~ gt
RelinquisbedBSOverdah~~~ Daterrime
- - -h c 71 2 9 200g-Received By Print Sign Dateffime
63uci I APR 29 2009 S SF so ~
SI W 0 ~
A
Matrix bull
Soil OS Sediment OJ Solid T =--
SIciQe WI Water L Oil V =
Air X
Omm Solid Dmm Ij(1lli Tis~lle Wine Limlin VCQetatlon Other
Relinquishetl By DatefflmeOGOO
5Sll 1 APR 302009 Received BK8 Hulse
amp~~pound Daterrimc DYeO
CtlPRC APR 3 0 2009 Rc1inquish4(ampHulse
f7)~k Datefflme II -f r
CHPRC APR 3a2009 ReL Lu~4ML 9I7f-J DateffimeIIishyltfh~
Relinquished By Dateffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By ( I v Dateffime f
FINAL SAMPLE Disposed By
DISPOSITION I
DateTime I
5gtb (7 ESL rn oooS4~ tAl 0 ~ ()Ci() hPQ J t Page 8 of 32
-
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-276
Page 1 of I
CollectKR a ContactlReQuester Telephone No MSIN FAX-laquoYI nan Winri ~0()-17h-)~~~
SM No Samplinl Orilin Purchase OrderCharle Code i
S09middot004 Hanford Site Proiect Title HNF-N-506- 2- I ~ Ice Chest No eMIIJ Temp
SllRV APRil 2009 Shinned To 1Iabl Method of Shipment Bill of LadinlAir Bill No
h Sin I Gnvl Vehick Protocol Priority 45 Days Offsite PrOnerty No
SlJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge lnfonnation FornI applies
Total Activitv ExemDtion Yes lllI No I~
releasable per DOE Order 54005 (19901993)
Sample No Lab ID bull Date
B203D8 W -Lq-o~
-shy ---shy --shy ---shy
Time NoType Container Sample Analysis
D~55 1x125-mL GP 1129_ICPMS 1-129LL (1)
---shy --- -r-shy illbJJ ~
----shy1-(Llf --oC-j ----
--shy -
---
shy
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ---shy ----shy ----shyRelinquished By Print Sign Matrix bull
Soil OS Omm Solid
Relinquished By R~
Sediment DI f)mm linlli Solid T Tjs~lleAPR D3errOm2009received~~~raquo~~ S111drre WI Wine55Lt I Water L Liollid
() Oil V VeQelatTonRelinquitAlftulSEshyA ~ Air X Other--)~~ APRDa~toeioor~i~~L( LCHPRC
Rclinqmshed By Daterrime Received By
)ltINAL SAMPLE I Disposal Method (eg Return 10 cuslomer per lab proccdure uscd in process) Disposed By Dateffime DISPOSITION
oq oS OtJlOb- c~L- 01oJ11 VJo -shy Page 9 of 32
middot ~
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-284
Page 1 of 1
CollectoR Mchtvr- ContactlReQuester Telephone No MSIN FAX Dana Widri ~O9middot376-2858
SAIltNo Sampline Oriein Purchase OrderCharee Code S09-nn4 Hanford Site
Proiect Title UIUC I OR 11- I Ice Chest No CtA6_1111 Temp SIJRV APRTl2OD9
Shipned To (Lab) Method of Shipment Bill of Ladinel Air Bill No I Scienc~s I Govt Vehicle
Protocol Priority 45 Days OtT site Propertv No
SIJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~J No Lbullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge Inormation Fonn applies
releasable per DOE Order 54005 (199011991)
-
Sample No LablD bull Date Time NoType Container Sample Analysis
B203F3 W -IIi-Y~ Oc-l 1 x125-mL GP 1129_ICPMS 1-129LL (1)
r----shy ---rshy ---- -~ ----shy ----shy
f fVfJJ J -1lt1 -~9
----shy ---shy
-
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ----- ~ ~ ~ ~
I
I
I
I
I
Matrix bull RelinA~h~ Sign APP lte~ill~riyenIReceived By
S Soil OS Omm Solid SF Serliment DJ Drllm (iolllRelinquished By SO Solid T Tissue SL SllIdQC WI Wine W Water l li(1Il1rl
RelinquishRffHulse
55 (J 0 Oil V =- Veictation A Air X - OtherAPRatc3illO2009re~ LCHPRC
Relinquished By Dateffime Received By
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime DISPOSITION
Page 10 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
-
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-276
Page 1 of I
CollectKR a ContactlReQuester Telephone No MSIN FAX-laquoYI nan Winri ~0()-17h-)~~~
SM No Samplinl Orilin Purchase OrderCharle Code i
S09middot004 Hanford Site Proiect Title HNF-N-506- 2- I ~ Ice Chest No eMIIJ Temp
SllRV APRil 2009 Shinned To 1Iabl Method of Shipment Bill of LadinlAir Bill No
h Sin I Gnvl Vehick Protocol Priority 45 Days Offsite PrOnerty No
SlJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge lnfonnation FornI applies
Total Activitv ExemDtion Yes lllI No I~
releasable per DOE Order 54005 (19901993)
Sample No Lab ID bull Date
B203D8 W -Lq-o~
-shy ---shy --shy ---shy
Time NoType Container Sample Analysis
D~55 1x125-mL GP 1129_ICPMS 1-129LL (1)
---shy --- -r-shy illbJJ ~
----shy1-(Llf --oC-j ----
--shy -
---
shy
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ---shy ----shy ----shyRelinquished By Print Sign Matrix bull
Soil OS Omm Solid
Relinquished By R~
Sediment DI f)mm linlli Solid T Tjs~lleAPR D3errOm2009received~~~raquo~~ S111drre WI Wine55Lt I Water L Liollid
() Oil V VeQelatTonRelinquitAlftulSEshyA ~ Air X Other--)~~ APRDa~toeioor~i~~L( LCHPRC
Rclinqmshed By Daterrime Received By
)ltINAL SAMPLE I Disposal Method (eg Return 10 cuslomer per lab proccdure uscd in process) Disposed By Dateffime DISPOSITION
oq oS OtJlOb- c~L- 01oJ11 VJo -shy Page 9 of 32
middot ~
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-284
Page 1 of 1
CollectoR Mchtvr- ContactlReQuester Telephone No MSIN FAX Dana Widri ~O9middot376-2858
SAIltNo Sampline Oriein Purchase OrderCharee Code S09-nn4 Hanford Site
Proiect Title UIUC I OR 11- I Ice Chest No CtA6_1111 Temp SIJRV APRTl2OD9
Shipned To (Lab) Method of Shipment Bill of Ladinel Air Bill No I Scienc~s I Govt Vehicle
Protocol Priority 45 Days OtT site Propertv No
SIJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~J No Lbullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge Inormation Fonn applies
releasable per DOE Order 54005 (199011991)
-
Sample No LablD bull Date Time NoType Container Sample Analysis
B203F3 W -IIi-Y~ Oc-l 1 x125-mL GP 1129_ICPMS 1-129LL (1)
r----shy ---rshy ---- -~ ----shy ----shy
f fVfJJ J -1lt1 -~9
----shy ---shy
-
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ----- ~ ~ ~ ~
I
I
I
I
I
Matrix bull RelinA~h~ Sign APP lte~ill~riyenIReceived By
S Soil OS Omm Solid SF Serliment DJ Drllm (iolllRelinquished By SO Solid T Tissue SL SllIdQC WI Wine W Water l li(1Il1rl
RelinquishRffHulse
55 (J 0 Oil V =- Veictation A Air X - OtherAPRatc3illO2009re~ LCHPRC
Relinquished By Dateffime Received By
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime DISPOSITION
Page 10 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
middot ~
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-284
Page 1 of 1
CollectoR Mchtvr- ContactlReQuester Telephone No MSIN FAX Dana Widri ~O9middot376-2858
SAIltNo Sampline Oriein Purchase OrderCharee Code S09-nn4 Hanford Site
Proiect Title UIUC I OR 11- I Ice Chest No CtA6_1111 Temp SIJRV APRTl2OD9
Shipned To (Lab) Method of Shipment Bill of Ladinel Air Bill No I Scienc~s I Govt Vehicle
Protocol Priority 45 Days OtT site Propertv No
SIJRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~J No Lbullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not Site-Wide Generator Knowledge Inormation Fonn applies
releasable per DOE Order 54005 (199011991)
-
Sample No LablD bull Date Time NoType Container Sample Analysis
B203F3 W -IIi-Y~ Oc-l 1 x125-mL GP 1129_ICPMS 1-129LL (1)
r----shy ---rshy ---- -~ ----shy ----shy
f fVfJJ J -1lt1 -~9
----shy ---shy
-
Holding Time Preservative
6 Months NaOH to pH gt 9
---shy ----- ~ ~ ~ ~
I
I
I
I
I
Matrix bull RelinA~h~ Sign APP lte~ill~riyenIReceived By
S Soil OS Omm Solid SF Serliment DJ Drllm (iolllRelinquished By SO Solid T Tissue SL SllIdQC WI Wine W Water l li(1Il1rl
RelinquishRffHulse
55 (J 0 Oil V =- Veictation A Air X - OtherAPRatc3illO2009re~ LCHPRC
Relinquished By Dateffime Received By
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime DISPOSITION
Page 10 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-292
Page 1 of 1 I
Collector Aft Mcfntvrr
ContactlReQuester Telephone No MSIN FAX I
DanaWidri 509-376middot2858 SAFNo Sampline Oriein Purchase OrderCharee Code I
SOQ-()()4 Hanford Site Proiect Title LIU hi JH l Ice Chest No btv5 -IIf( Temp I
SlJRV APRII 2009 I -Y ---
Shipoed To (Labl Method of Shipment Bill of LadineAir Bill No I ~I Science~ 1~hnr~ln Govt_ Vehicle
Protocol Priority 45 Days Offsite Property No
SUIlV POSSIBLE SAMPI~E HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes 1-1 No U bullbull bullbull Contains Radioactive Matenal at concentrations that are not regulated for transportation per 49 CFR hut are not Sile-Wide Generator Knowledge Information Form applies
releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203F8 W -1J-o V)-) 1x125middotmL GP 1129_ICPMS 1middot129LL (1)
I--shy ---- ---shy ---r--shy- ---r- nn
~
-----JJ 96-
-
----shy
-shy
Holding Time Preservative
6 Months NaOH to pH gt 9
--- ----- ----
-----shy -----shy ---shyPrint SignRelinquiAA IMcintym
APP 2Datemme I f(b Matrix bull Sign APR rtgrrZOOif1Received BYgt5 c)
APRat3ioe2009IReceive~ - 9 n09
1 n nnQ~APR
Soil DS Drum Sol] Sediment DL Dmm T i(lHlRelinquished By Solid T Tisslle
~ Sludrre WI Wine Water L -= Lin1lid
$SU ~0 Oil V Ve(Cmt1(Hl
A Air X OlherRelinquishcl(B Hulse
CHPAC shyRelinquished By
FINAL SAMPLE I Disposal Melhod (eg Return 10 customer per lab procedure used in process) Disposed By Dateffime
DISPOSITION Page 11 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
COCII
CHPRC CHAIN OF CUSTODY ISAMPLE ANALYSIS REQUEST S09-004-72
Page 1 of 1 Collector AR Mcintyftt ContactlReQuester Telephone No MSIN lAX
Dana Willri iOQ71i2RiR
SAFNo Sampline Oriein Purchase OrderfCharee Code S09-004 Hanford Site
Proiect Title UfJI= ti J~M- 2 g1amp Ice Chest No (tIJS _11 Temn
SIJRV APRil 2009 Shinned To (Lab) Method of Shinment Bill of LadinelAir Bill No
Fn S~in 1 Gov Vhid Protocol Priority 45 Days
Offsite Pronerty No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Contains RadioactIve Material at concentrations that are not regulated filr transportation per 49 CFR but are 1I0t Sitemiddot Wide Generator Knowledge Infonnalion Fonn applies
releasable per DOE Order 54005 (19901993)
-r-shy
Sample No Lab ID bull Date Time NoType Container Sample Analysis
6203MB W -(rt(pl d1~ 1 x125-mL GfP 1129JCPMS 1-129LL (1)
- r---t-shy ---- Yl~~ ---shy I~ ~ -shy -J C-- ----shy ~ ----shy~ - L J
C-shy shyI C
-shy
----shy-shy - ---7
Holding Time Preservative
6 Months NaOH to pHgt 9
----shy ---- ---shy ---shy-------shy~
Relinquished By Print Sign APRD~rrrei609IRe=d By Print Sign APIf~rrfe20091 Matrix bull
S SF SO Sf W 0 A
~ Soil OS Sediment m Solid T Sludge WI Woter 1 Oil V Air X
[)nnTI Solid J)fllm IloBi TisHe Wine Tiotlid Verret)tion Other
HNAL SAMPLE DISPOSITION
I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Dateffime
Page 12 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
---COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-104
Page 1 of 1 Collector n n~HJ-r ContactReQuester Telephone No MSIN FAX
CHPRC Dana W idril 5D9-316-2l58 SAl- No Samplinl Orilin Purchase OrderChafle Code
S09-004 Hanford Site
Proiect Title HNF-N-506- j I 02 Ice Chest NOmiddotGUJ 5 _ III TempSURV APRil OO
Shipped To (Iab) Method of Shipment Bill of LadinllAir Bill No I Sciences L Govt Veh icle
Protocol Priority 45 Days Offsite Property No
SIJRV
POSSIBLE SAMPLE HAZARDSfREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes lV1 No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge Information FOllD applies eleasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis
B203P9 W ltfifOV o2i(O 1x125-mL GP 1129_ICPMS 1-129LL (1) -shy - r--shy -- ---- --shy 7 () I L ~L-(14 j 7 ~ -l I n I
~I
-------shy
-shy -shyHolding Time Preservative
6 Months NaOH to pH gt 9
----shy ~ i---shy~ ~ ~ ~
Relinquis~ Jo4A_
j
~
Ikcwp
Sign
DatelTime
S SE SO SI W 0 A
Matrix Soil DS
- Sediment Df -shy Solid T
ShIrlee WI Watcr L Oil V
~ AIr X
~
Dmm Solid Drnm Ijoni TislIe Wine liouirl VCletati()n Other
FINAL SAMPLE I Disposal Method (cg Return to customer per lab procedure used in process)
DISPOSITION Disposed By Dalcrrirne
Page 13 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-1 12
Page J of 1 Collector
~ )tfvaA 7 r-v ContactlReQuester Telephone No MSIN AX Dana Widri~ ~OQ_11i_)l~)l
SAFNo I Samplin2 Oriin Purchase OrderChare Code S09-0fl4 Hanford Site
Proiect Title u r Nt ) ~ I lty Ice Chest N0btJ5 _ 111 Temp
SlJRV APRlI )009 Shipped To (Lab) Method of sJliUl~t --shy = Bill ofl_adinllAir Bill No
T S -jlt 1 GovLVehide Protocol Priority 45 Days
Offsite Property No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRllCTIONS Hold Time Total Activity Exemption Yes llJ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not SIte-Wide Generator Knowledge Infonnation rorm applies
releasable per DOE Order 54005 (199011993)
Sample No LabID bull Date Time NoType Container Sample Analysis
B203R4 W _rZtHr7 jf)cI-j 1 x125-mL GP 1129_1CPMS 1-129LL (1)
----shy ----shy -r--r- --f- --shy LL ---shy i I ~ ---- ----shy ~ r- )
J ---shy i --- -------shy--- L 1shy 1~
- L
Holding Time Preservative
6 Months NaOH to pH gt 9
-------shy --- -----shy-----shy -----shy ~
Print Sign
oSsa DateTime
Matrix bull
S Snil DS llrnm Snlid SF - Sediment Of DrUI11 (ioui SO Solid T Tisme SL Slnde WI Wine W Water L - T_louicl () Oil V Veeetation A Air X ~ Other
FINAL SAMPLE I Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 14 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-004-132
n Page I of I
Collector -
ContactIRequester Telephone No MSIN FAXCHPRC Dana Winri S09-l7t1-2RSR
SAFNo SamJlline Oriein Purchase OrderCharec Code SD9-004 Hanford Site
Proiect Title HNF-N-506- 2 D I~- Ice Chest NO(uJS ~III I Temp SlJRV APRil 2009
Shipped To (Lab) Method of Shipment Bill of Ladinel Air Bill No
Sciencelt I Goyl V hide
Protocol Priority 45 Days
Offsite Propertv No SURV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes I~ No L bullbull Contains Radioactive Material at concentrations that arc not regulated for transportation per 49 CFR but arc not Site-Wide Generator Knowledge [nfoonation Fornl applies releasable per DOE Order 54005 (19901993)
shy shySample No Lab ID bull tate Time NoType Container Sample Analysis Holding Time Preservative
B203V1 W i-h f~ )11 1x125-mL GP l129_ICPMS l-129LL (1) 6 Months NaOH to pH gt 9
~ --r-shy - r---- shy---shy J--- - Jr -~ IdL l ---
I ~-r ---- ---
-- i
-- ~ I
- A ~
I
A ~j I - fir 1 AIItshy
RelillqUiS=rij~~ro~ Received By fIshy Print Sign APR DtoZreggS~ I s ~
Sf so SI =
W -= ()
A
Matrix
Snil OS ~
Seniment m Soli) T Sluo1c WI -= Water L Oil V Air X
Dmm Solid Drum ItOld Tllime Wine Linllirl Vegetation Other
Re~15e(J v 0 ~ Dateffimeo~1 0) 0 fOe) R5tdlA1~~4~oWAIILfhJoeoamp-c
Relinquished By
iJL1ttrlzttud~ vime yen)O)(0J1711A1 tttfl 1r~r~1h1~ poundv~ Y~4 ~2~rritsv Relinquished By
Daterrimc
IDisposal Method (eg Return to customer per lab procedure used in process)
RlIeived By f Daterrime
FINAL SAMPLE Disposed By
DISPOSITION DatelTime
Page 15 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
CHPRC
Collector AASheparO
SAFNo OQ004
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactiReQuester f)~t1i1 Wirlro
Sampline Oriein Hnfc)f(l it
Telephone No (lQ7hSI
MSIN
Purchase OrderCharee Code
S09-004-140
Page 1 of 1 FAX
Proiect Title 1lRV APRil (lOQ HNF-N-506- 2gt I 8-=t- Ice Chest No GtuS_ Temp
Shipped To (Labl ~lliTf1onrnpnt~1 ~Itpnrp~ f bull
Protocol qnv
Method of Shipment Govt Vhicle
Bill of LadineAir Bill No
Priority 45 Days Offsite Property No
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No bullbull bullbull Conlains Radioactive Material at concentrations that are nol regulated for transportation pltr 49 CFR but arc not
releasable per DOE Order 54005 (199011993) SitemiddotWide Generator Knowledge Information Fonn applies
Sample No Lab ID NoType Container I Sample Analysis Holding Time
B203V5 W I Jlz--ft rill 31 1x125middotmL GP I 1129_ICPMS 1middot129LL (1) 6 Months
~ ~
F+ ~ ~ ~ ~ 7 J7f ~ 7l~
7 ~ flo 7t) ~ ---= I 7 ~
~ ~
u--
Preservative
NaOHto pH gt 9
~ ~ ~
I 727 Arshy~lodIilBrJ ~ I
Relinquished Bv
5Sit
I~~AAAt~L
Print Sign APR 20at200~~ S sr so Sf W o A
Matrix bull
Soil DS ~
Sedimenl m Solid T Sldrre WI Valer I
Oil V Air X
rJrllln Solid f)rllm Iiolli Tissue Wine T-iclIlirl Vegetation Other
Relinquished By Ifaterrime lampfeivcd By
FINAl SAMPLE T 1 (fI V Dalerrime
DISposal Method (eg Return to customer per lab procedure used in process)
DISPOSITION Disposed By DatefTime
Page 16 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
----
-f COc
CHPRC S09-004-300CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
Collector JP Herrick vnrnvSAIltNo
S09-004 Proiect Title
SIJRV APRlT2009 Shipped To (Lab)
P Sciences I Protocol
SITRV POSSIBI~E SAMPU HAZARDSIREMARKS
Site-Wide Generator Knowledge lntonnation Fonn applies bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
Sample No
B203H3
Lab ID
~ r----shy
Date W -30~
ContactRCQuester Dana Widri2
Samplinl Orilin Hanfiml Site
2shy1-INF-N-506- t- Method of Shipment
Govt Vehicle
Priority 45 Days
Page 1 of 1 Telephone No MSIN FAX
509-376-2858 Purchase OrderCharle Code
Ice Chest No ltF41~ 1 Temp
Bill of LadinlAir Bill No
Offsite Property No
SPECIAL INSTRlJCTlONS Hold Time Total Activity Exemption Yes i~ No i~
Time
()U~
Noffype Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
---shy --- ---shy ffJ )
~-
-=--shy1-30-0-1 ---shy -r---- ---- -~ - shy ---
~
t
Print Sign
DatetTimc
Matrix bull Relinrj~C1rick CHPRC S - Soil OS Orum Sohd
~Relinquished fly SF Sedment Of Dnnn J10111 SO Soli1 T Tj~Jle
Sf Sludge WI Wine W Water L Jjullid
Relinquished By 0 Oil V Vetctation A Air X Other11
Relinquished fly
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposell By DateTime
DISPOSITION Page 17 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
--
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-113
Page of Collector t11~~le ContactReQuester Telephone No MSIN )ltAX
tHt-Hl n~n Willr 50Q-17h-2lltiR
SAFNo Sampling Origin Purchase OrderChare Code TOlt)_011 Hanford Site
Project Title ~tII-N-~ 211lto Ice Chest No C - _I Temp
2ZPl APRIl 2009 Shipned To (Iab) Method of Shipment Bill of Lading Air Bill No
el ~kinlt I nov Vgthid
Protocol Priority 45 Days
Offsite Property No CERCLA
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_ Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnation Fom applies releasable per DOE Order 54005 (19901993)
Sample No LabID bull Date Time NoType Container Sample Analysis Holding Time Preservative
820979 W bIM 11070 1x125-mL GfP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
r-shy ---shy --- r-- --shy ~ ~
-----shy I ~ gt-r--- ~ ~
laquo~ ~ C__ j ~ )
rshy___ gt ---shy( ( ~ - --shy ----shy---) ~-~ -----shy--- -----shy ------- -shy
- -
~
RelinqUi~~~~le ~gn Datemm~ 1Ct
JUN 1 6 2009 Received By Print Sign
5~l1 I JUNDajrIae2DD9
Ytgti s SF SO Sl W 0 A
~
=
~ =
Matrix bull
Soil OS Seolment OL - Solid T Sillde WI Water L Oil V = Air X
Orum Solid Drum Ijoni Tissue Wine liouid V Cletatlon Other
Relinquished By DaterIime
~tI~1 67~9 tJ7J-o ~=AMALtpounddar-ffiAJ~J~ DaterIime
6h7itJ ~O RelinqUi~F~aker iJlrttrjl~hrA tit7)tjim13() RcCeivcd By lt
U(1(l VQUL1deg-JIlltlUlk VGtio ( DaterIime
(111(( ItQU RelinquiSlredBy shy r ( DatefTime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Datc([jme
FINAL SAMPLF Disposed By
DISPOSITION DatcrIime
N0 ot10SOO~ bull I~ ~ J
I
Page 18 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
COc
CHPRC CHAIN OF CUSTODYISAMPLE ANALYSIS REQUEST 109-033-114
Page 1 of Collector RT SICKle ContactiReauester Telephone No MSIN FAX
nan Winri ~OQ-17_)RR
SAFNo Samplinl Orilin Purchase OrderCharle Code TOQ-033 Hanford Site
Proiect Title HNF-N-506- 2-pound J 0 Ice Chest No CtU I Temp 2ZPl APRII200Q
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No r bullbull Sjtgtnrflt I flnvt _Vehicle
Protocol Priority 45 Days Offsite Propertv No
CERCLA POSSIBIoE SAMPLE HAZARDSIREMARKS SPECIAl INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L_bullbull bullbull Contams Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but arc not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 I 9901 993)
-
Sample No Lab ID bull Date Time NoType Container Sample Analysis Holding Time Preservative
620980 W 6- 16middot()1 1tJ1lgt 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9--shy ----shy ---shy c---
---shy l~ shy -=gt ---shy I ~-shy~ ---rshy ) -shy
~ r-shy ) V ---shy -
~ ) ---shy ~ ~ ---shy~ -shy rshy ) -~Q ----shyshy
~ I ----I ---shy ---shy0shy ---shy~ shy
Received By Print Sign Dateffiml -ICORelinquished By _~ Datefrim~ fa Matrix bull
RTSickle ~ JUN 1 6 2009 55 t-(~I JUN 1 6 200~ S Soil DS ~ Dmm Solid SE Sediment m Drllm LJ(11l10shyRelinq11flMIi B~ DateITimc DaleITime so = Solid T Tis~lIe
Sf Slude WI - WineRS~A1A~l-d1tltrflAMJ1-~ 7167 41)1)lt~I 112- 67~9 nro W = Water f = Liollid 0 = Oil V Vel7etatinnbull Diterrime A Air X OtherRelinquishC~ Hamaker JCf1lff~~ tat~c RlA~~ VJJenrah1wtth Wo tJ I111 cq 1l~0- - J - ( 7 of 113tgt
Relinquished By Datlrrime Received By Dateffime
FINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure IIsed in process) Disposed By DateTime
DISPOSITION Page 19 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-115
Page 1 of 1 Collector ~~~~~le ContactlReauester Telephone No MSIN FAX
nn Wield ~O-7h-)R~R
SAFNo Sampling Origin Purchase OrderCharge Code 109-033 Hanford Site
Proiect Title HNF-N-508shy 21 40 Ice Chest No (l)- I Temp
7ZPI APRIL JOO
Shipped To (Lab) Method of Shipment Bill of LadingAir Bill No inp~ l flovL Vehicle
Protocol Priority 45 Days
Offsite Property No CFRnA
POSSIBIE SAMPIE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes llI No L Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies eleasable per DOE Order 54005 (199011993)
-r--- _ r- _
Sample No Lab lD bull Date Time NoType Container Sample Analysis Holding Time Preservative
820981 W 6-tl()1 VPO 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOHto pH gt 9 -I ~ i
---shy C ------Ishy (
---shyI---shy I J
-------shyr1 ) j
---= -shy shy I ------r I
-shy 1
-----shybi ~ ~ j - r--
f ~ - ( ) ---shy I
---shy --J C J ------shy l-
I
~
---shy
------shyi
shy -----~ RclinquishedBy ~ JUNDr6m20~RT Sickle ~
n
Received By Print Sign Daterrit6cVCJGJ
-gt541 JUN 1 6 2On~ S ~
SF SO SL ~
W 0 A =
Matrix
Soil DS Sediment DJ Solirl T =-SluMe WI Water L Oil V =
A)f X
Drum Solin Dmm 1jc1Hl Tisslle Wine Iinuid VCQctation Other
I
Relinqmsnea ny If~ ~ Daterrime
~J1f 617LJ IItzro R111 9poundUktttt1J~M~h- ft ~9mgzo Relmq~~maker 0tittttIM~ ItDh
ime
CHPRC~M i) 6 17 OJ 110 Received By
JaUlr[U~111lttLL Wo Daterrime
kVULt~t 1Jr1 cq 1l3a Relinquished By Dlterrime
IDisposal Method (eg Return 10 customer per lab procedure used in process)
Received By Dalerrime
FINAL SAMPLE Disposed By
DISPOSITION Daterrilne
shy
Page 20 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
------
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-116
Page 1 of J Collector ~T~~~e ContactiReQuester Telephone No MSIN AX
Dana Widrh 509-116-2amp58 SAFNo Samplinl Orilin Purchase OrderCharle Code
109-033 Hanford Site Proiect Title
HNF-N-506- 21 I ttI Ice Chest NomiddotCV I Temp 27PI APRIl OOq
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No E Sciences I Govt Vehicle
Protocol Priority 45 Days Offsite Property No
CFRCIA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Excmption Yes l~ No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infonuation FOnTI applies
releasable per DOE Order 54005 (19901993)
-shy --
SamplcNo Lab lD Date Time NolType Container Sample Analysis Holding Time Preservative
820982 W 6-161 ItJb 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
1shy -- r- -r-shy~ r-- -r-shy shy -
---shy f I shyshy- (
----shy ~ 7shy
) ~ ~
L - -lt ~ ~ -- J ---r--Y ~
- ~-shy ~ ~ -----~
Relinmslample ~Pr~ JUN ~a16i20oF CHPRC~~~
Received By Print Sign Dateriml VtlO
55CI-1 JUN 1 6 2009 S SE SO = Sl W 0 = A
Matrix
Soil OS ~ Drum ~olid Sediment I)l Drum T1ellli Solid T TislIe SilIrlge WI -= Wine Water L liOllici Oil V Ve2ctJrion Air X Other
Relinquished By ~e- - DateiTime
C~(J lit 6J17jp ~ I114~europoundItturflu~I~AIt- 71000 Reli~mlnaker rJ( LL~M ~ 6It ~me30CHPRC etlVf aJ L-
Received By I f Qatrrime
thJNtlt VllUlrO- mWtti1- Wo ampnLq Ir3D Relinquished By
batcffime
IDisposal Method (eg Return to customer per lab procedure used in process)
Received By Daterrime
FINAL SAMPLE Disposed By
DISPOSITION -shy
Dalerrme
--shy -~ -~ -~
Page 21 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
~-
COc I
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-117
Page 1 of 1 Collector RTSlckle ContactiReQuester TeleDhone No MSIN IAX
nn nana Widri 509-17n-2RSR SAF No SamDlinl Orilin Purchase OrderCharle Code
IIlQ01 HanfilTll ilp
Proiect Title HNF-N-506- 21 I It) Ice Chest No CtJmiddot I TemD 2ZPI APRIl 2009
ShiDDed To (Lab) Method of ShiDment Bill of Ladin2lAir Bill No i Sciencelt lahoratorv novl Vehicle
Protocol Priority 45 Days Offsite ProDertv No rPRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes Illi No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Infommtion Fonn applies elcasable per DOE Order 54005 (990993)
shy
Sample No Lab ID Dale Time NoType Container Sample Analysis Holding Time Preservative
820983 W amp-bol Lt7ligt 1x125middotmL GP l129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-- ---shy --r- ~---shy ~
I---shy ( I shy
shy---shy - ~
-----shy 0 L ------------shy
)
( ~ shy ------shy- ~- J J ---shy( r ~ lt ---shy--- ) ---rl- --I-- ---- ----shyr
-~- -shy
~~ Received By Print Sign MatriX bull
~--
JU Dateffink VOdRehnq~~~Ieuro~rgn JUNatjim
55Cl-L N162009 S Soil DS f)rnm Solid 14t1deg09 SF ~ Sedimen1 0) Drnm TT(miDateTime Dateffime I tgto D SO ~ Solid T Ti~sueReceived By teurott~ 1 Li-lL JRelinSh~tllr SL Sinone WI Wineb7fo 1tZffJ )t~JlIJIt1A ItIitfjJPUllI- 67k9 W Water l Li(Hdo=
0 ~ Oil V Vcpeta1ionReceived By - DaiefrimeRelinq~ifamaker A Air X OtheriA LWlk- V(JJU1(qJ MlU~ Vabraquo 011( I -30CHPRC
iJlit((~~i1L I Ja~c 113c Relinquished By I DatampTime ReceIVed By DateITime
liINAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) DIsposed By DateITimc
DISPOSITION Page 22 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
-- -eOc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-033-118
Page 1 of 1 Collector RT Sickle ContactRequester TeleDhone No MSIN FAX
l11fIIU~ nana Widri ~Oqmiddot1762RSR
SAFNo SamDlin~ Oriein Purchase OrderChar~e Code TOqOi I-Innfnrtl Sit
Proiect Title HNF-N-508- 2 I 110 Ice Chest No (JW- f TemD
2ZPl APRil 2009 ShiDned To (Lab) Method ofShiDment Bill of ladinelAir Bill No
F Science I (vt Vehicle Protocol Priority 45 Days Offsite Proncrtv No
CFRrTA
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes III No L bullbull bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge Information Form applies
releasable per DOE Order 54005 (199011993)
--shy shy
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative _
820984 W hlamp() 1076 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9 i___ -I----shy
-I--shy --
---shy ~ ( -----shy ~
---_V ---shy ( -- cshy ---=- ) ~ ---shy ~
( ~ lt ---shy~ ~ )---shy _-0 -r-shyt - ( ) ----shy ---shy ----- ---- ~ --shy
Received By Print SignRelinquished By ~ ~~ DatelTlPrltCGgt Matrix JUN or~On9AT Sickle ~ 5Ct-L 1ttkJ S Soil DS ~ Dmm Solid SE Sediment DL -- Dmmljo1l1 SO ~ Solid T Ti~$ale
- - JUN 1 FLnnO
Sf ~ Sllld~e WI WineR)~heU ~ -7 6It 7ft Da~o 5clfIVlttb1llJettr~~a6~ 67J~O
W Wafer L -- jjmdd Relinquished By 0 Oit V Vefletatinn
A Air X Other RcceiIltCJ By (c Dattrimc
oSEHamaker yf(lfti(iP1411jjel~ 6_ale~i9c It30 ~AlLltllJLmiddot ~t(Lf 111 WIJiL UaJbo lc11LG~ II ()- Rclin~n1 f rlatelTime Received By DatelTime
HNAL SAMPLE IDisposal Method (eg Return to customer per lab procedure used in process) Disposed By Daterime
DISPOSITION Page 23 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST 109-042-14
011 sneuampd Page 1 of 1
Collector CHPRC ContacllReQuester Telephone No MSIN FAX Dana Widri 509-376-2858
SAIltNo Sampling Origin Purchase OrderCharge Code 109-042 I Ian ford Site
Proiect Title W Jil1A- ~ ~(laquoII Ice Chest No Temp
[ TPl II fNF oot) Shipped To (Lab) Method orShipment Bill of LadingAir Bill No
E Sciences I Clovi Vehicle Protocol
Priority 45 Days Offsite Propertv No SIJRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes l~ No l bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not 200 Area Generator Knowledge nfonnation Fonn applies releasable per DOE Order 54005 (19901993)
Sample No Lab ID Date Time NoType Container Sample Analysis Holding Time Preservative
B20MX3 W itrr16t log-Sshy 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
-shy i
- shy I
- ~ 4 ---shy A n
---r-shy (1-- ---shy f __ shy
~ - LY ~ L ----shy ----shy ----- -~
- -
VIshy -I J l il e iCM-
RelinqMflMParf1l)Jt ~ 1rmp~CHPRC VJl~ R~t
l Sign JUN Df21Ii
S SF
~O ~oL
0 = A
Matrix
Soil f)S Serliment DI Solin T Sllln~e WI Vafer I Oil V Air j(
Orllfn Solid Dmmfiolli TislIe Wine Iiollio Vefct~tion
Other
~~~(Ad By (J tI f z DO JUND2~e2009 Received By
R ElUngsworth l~ 1200 Joc~im2 3 2(
RelinR~Worth Pr tr Datcrrime
JUN 232009
- i~Q~~~ 1middot~Yl DatelTime
JUN 2 3 nn~ Relinquished Fly Daterrime
IDisposal Method (eg Return to customer per lab procedure used in process)
ReceivMf3~b Datcrrime
FINAL SAMPLE DISPOSITION
Disposed By DaleITirne Page 24 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUY-UUU- -----shy
Page 1 of 1 -
=0Ilecto~11tOn ContactReauester Telephone No MSIN FAX CHPR Donn Winri iOQ-7n-7X~R
iAFNo Samplinl Orilin Purchase OrderCharle Code ~Q2-Q(6 Hanford Sile _ ___ -
roieet Title nlfr-n-NO-_ ~-I _- Ice Chest No Temp lI ~M81l-Pil U[)lF 2QQCJ
hipped To (Labi Method ofShioment Bill of LadineAir Bill No F cenmiddotpc I Govl Vhicl
Iroloeoi Priority 45 Days
Offsite Propertv No 0111[
POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~I No L= Contams Radioactive Material at wnccntrations that are not regulated lor transportation per 49 CFR but are not 200 Area Generator Knowledge lnfbnnation Fonn applies
releasable per DOE Order 54005 (19901993) ESL - Hold all samples until aU 10 are received and 11m the comptete set at ONE time
--shy - -shy-shySample No Lab ID Date Time NoType Contamcr Sample Analysis Holding Time
B20LP2 W 6-23middot01 13gt l 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months --shy
shy ~
~~~
~ -shy ~ ~~ b shy - ~(II) __
~ ~l
~ ---shy ~----
--shy
--shy
--shy --shy
-shy
Preservative --
NaOH to pH gt 9 --shy --shy
-----shy
-----shy
RelmRtft~milton CHPRC ~ t
Print Daterrime
Relinquished By
Ss U J4 DaterTime
DatcrTime
DateITimc
IReceived By Print Sign DaterTime
Received By DatcfTime
dYlrXJ
J()l~
Matrix
SSLI JUN 2 3 2009 LL()11lt-(~ S Soil DS DrllmSn1irl SF Sediment 1)1 OfHI11 Iioll1 SO Solin T Tisclle S1 Stnpe Wl Wine W Water 1 Iinllirl 0 Oil V - Veocttinn A Air X Other
INA I SAMPLE I Disposal Method (e g Retum to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 25 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST A09-00b-b
Page 1 of 1
Collector RAShepard ContactIRequester Telephone No MSIN FAX klPI=lt Dana Widri i 09-37 6-2858
SAFNo Samplin Orin Purchase OrderChare Code A09middot006 Hanford Site
Proiect Tille HNFNf)(J6- 2- J L~ Ice CheS~t -33 Temp LLWMAI Il-Pi I INI 1l1l9
Shinned To (Lab) Method of Shinment Bill of Ladin21 Air Bill No Fnvirnt1mpnt~1 Sciences I Govt Vehir1e
iProtocol Priority 45 Days Offsite Propcrtv No
Other
POSSIULE SAMPLE HAZARDSRftMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Exemption Yes I No L_ Contains Radioactive Material at concentrations that are not regulated for transportatJon per 49 erR but are not 200 Area Generator Knowledge Infonnatlon Fonn applies releasable per DOE Order 54005 (19901993) ESLmiddot Hold all samples umil all 10 are received and run the complete set at ONE lime
----- shy
Sample No Lab ID Date Time NoTypc Container Sample Analysis Holding Time Preservative
B2QLR4 W ~ZSc1 1244 1 x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pH gt 9
~ --t--shy - -shy - -r---shy ---shy I
~tff
I ---shy(rZ-f~7 ==------shy --shy ~ --------shy-------- shy
~ ~
I I
~
-- ~
Print Sign DalefTm~i~RelinqllSh~~SilePari~nQ J1JN D2fmf609 ssLl JUN 23 2009 HPRC Received By h ~ DatefTime o 2-Y~ ratefTim ) 00f~Ui~d6i ( vV
~NJtCj (170-0 gttlllcZHiiy atv4 Relinquished By ltU DatefTime DatefTimeReQey~~ f t r10
6 2 07 j(Yl~vZ111 c~iq ~4 t ~9 jO~L6 Relinquished By I ( I f Datefrime ReceivedBy itgt I DatefTime I FINAL SAMPIE IDisposal Method (eg Return to cuslomer per lab procedure used in process) Disposed Hy
DISPOSITION --_ shy
Matrix bull
s SF SO SL W 0 A
~
=
~
0
~
=
Soil Sediment Solid Shuile Wter Oil Air
DC DI T WI r V X
=
-
-shy=
Dnnn Solid Drll11l Tinui Tissl1e Wine TjClllid V CQeltlOn
Other
I DateTime
I Page 26 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
CHPRC
ollectol RAShepard ~Inn
iAFNo ~
A09-006
roiee Title JllliE 2009 )) WMAm-IA
CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
ContactlReauester nm~WidriJ
Sampline Oriein HHnfiml Site
HNFN506= ZtJ laquo~
Telephone No MSIN S09-171-7RiR
Purchase OrdcrCharee Code
Ice ches~L - 51 ~ Bill of LadineAir Bill No
AUJ-UUO-J
Page 1 of 1 -
FAX
Temp
ihipped To (Lab) IMethod of Shipment EnYironmental Scjences I ahQratqry ____1-~GuuQlYJt_YueJJhwicltJlse_______________----------+-------------------------------1
rotocol Other
rOSSIBLE SAULE HAZARIgtSREMARKS bullbull Contains Radioattive Material at concentrations that are not regulated for transportatIon per 49 erR but are not
eleasable per DOE Order 54005 (199011993)
__shy
Priority 45 Days Oflsitc Proper tv No
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes iyi 200 Area Generator Knowledgl infonnation Form applies ESt Hold all samples until all 10 are received and run the complete sel at ONE lime
Sample IU ~ale Time NoType Container Sample Analysis Holding Time
6 Months
Preservative
820LTl W tUol 1130 lx125-mL GP 1129_ICPMSI-129LL(1) NaOH to pH gt 9 ___ 1~
shy~
I ~ -fd ------+-I-shy
~ 7 r ~~ ~71~
7tl13Jt1 ----f----shy 1--shy
----shy1---- -------------I-shy -+--shy ~
=p-~ ~--r-j---~~--~------~--------------------------~--------~------~~=---
~ Matrix Relinqlisl~ashepard Print Sign DatefTilllp
RS~~ S Soil DS Dnlln Snlid SE Serlimcm DI Dm1l1 lmli SO Solin T Tisltlle
CHPRC JIIN 2middot~ nnaSSl1iU BYdl7 C7 b l~tqerrimelt)~IR~~t~ ~~ oVI~~atCrrilOO SL Slueige WI Wine
W Wilter L f j(lIIid
Relinquished By Oatetrimc () Oil V Ve1et)tion A Air X Other~ fr~eqm~~r~(~s~~ 7 C~~~ Jta- fl~M Olb
DatefIimeRelinquished By 7 Y DatefIimc Receiv~-77 FJAL SAiIlLE Disposal Method (eg Retum to customer per lab procedure used in process) Disposed By OateTime
DISPOSITION Page 27 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST AUJ-UUb-1S --shy
Page 1 of 1 --shy
unector RAShepara ContactlReQuester Telephone No MSIN FAX ~HPR( nana Winr S09-376-2858
AFNo Sampiine Oriein Purchase OrderCharee Code AOlt)-OO6 Hanford Site
~ --shy ---shyroiect Tille HNFt~-~ -Z I Ilt4i Ice Che~1YL-3(3 Temp
II ~M8(Jl-ICJ l J1lF2QQ9 lipped To (Lab) Method of Shipment Bill of LadiogAir Bill No
E Sicnces Iahoratorv nvl VphicJ rotocol
Priority 45 Days OtTsite Property No
Other OSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activltv Exemption Yes VINo--I-shy Contams Radioactive Material at concentrations lhat arc not regulated for tmnsportation per 49 eFR but are not 200 Area Generator Knowledge lnfonnation Fonn applies
elcasable pcr DOE Order 54005 (199011993) ESL Hold all samples IIntil all 10 are received and run the complete set at ONE time
----shy _shy --shy --shy --shy
Sample No Lab lD Date Time NoType Container Sample Analysis Holding Time Preservative
B20LT4 W (Ph 3t ltt 1000 1x125-mL GP 1129_ICPMS 1-129LL (1) 6 Months NaOH to pHgt 9 shy
~ --shy --shy
~ ---shy -r--shy- ---shy I ----shy I 1 -----shy-
~vJ-L-----shy v ---shy(p 2-3 I J ----shy ---~
----r--
------shy ---shy ----shy --- ~ --shy
~ --shy --shy
~ h dl() I~
Received By ti- Print Sign JUN nr~n~OO9RelinqUisectE~~par~~$k~N ~~at~~e~Y ~I l Received By
Rt5r~d Jt j if I 210 93tefTir 700 Uif4- ~2Y2eime olo-cI4JlAA1rZ-t~ Relinquished By i ~~ DatefTime Rflt~ I ftff tyfTime
M1~Qr Wyen4 II C lt) 2 ~ ~~o )OmiddottS Reitnquished By DateiTime Recerv~~ Daten-imeI I
Disposed ByF1iAL SAIPLE IDisposal Method (eg Return to customer per lah procedure used in process)
Matnx
s Sf SO ST W
--
=
Snil Sediment Solid ShldUc Water
DS Ill T WI
-0 Ofllill Solid DrllwlH1Il1 TlSlIe Wine Liouirl
0 A
~ Oil Air
V X ~
Ve~elHmn
Other
DatelTime
DISPOSITION Page 28 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
COc
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-78
- Page 1 of Collector ContaetlReQuester Telephoue No MSIN FAXCHPRC Om Widr SOQ-17fi-RSR
SAl- No Sampline Oriein Purchase OrderCharee Code ltOQ_OOfi Hanford Site
Proiect Title HNF-N-506- 2( 1 4ft Ice Chest No Temp SI JR V II JNF 200Q
Shipped To (Lab) Method of Shipment Bill of LadinlAir Bill No HI Sciences I Govl Vehicle
Protocol Priority 45 Days Offsite Property No
JRV POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCnONS Hold Time Total Activitv Exemption Yes llI No l_ bullbull Contains Radioactive Material at concentrahons that are not regulated for transportation per 49 CIR but arc not Site-Wide Generator Knowledge Information Fonn applies releasable per DOE Order 54005 (l 990l 993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
t-----------shy ----_ -_
Sample No LablD bull Date Time NoType Container Sample Analysis Holding Time
820PJ5 W 62-l-tJ1 otc- f-1x125-mL GP 1129_1CPMS 1-129LL (1) 6 Months
~ shy
shy~ ~ ~
JUN J ~ V -T mlJJtJ1
-shy
Preservative
NaOH to pH gt 9
Re~9I1lli~bcd B~ N Hamilton CHPRC
Relinquished By
~LA t
Daterime Received By
1( f S$ L fil Daterime
-2gt Or Daterrime
~Gz--~ Daterime
Pnnl Sign Dalerllne
JUN 2 4 20nn l-I)~ Daterime
(~ Z-s za-1) Dateffime
4gt - 1 If - ()ltj Dalemmc
Matrix bull
S Soil ns Drum Solid SF -- Sediment DI Dnlm SO Snlid T Ti~slle
SL SIIIe WI Wine W Wlter I Jicl11iri 0 Oil V Vcpettltinn A Air X Other
HNAL SAMPI~E I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By Datmime
DISPOSITION Page 29 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
COc
S09-006-94 middotCHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST Page 1 of 1
Collector KE Hamilton ContactlReQuester Telephone No MSIN FAX I~~ Dana Widriff 509middot376-2amp5amp
SAF No II - Samplinl Orilin Purchase OrderCharle Code
bull
S09middot00fi Ihnfon1 Sit
Proiect Title ulIn_~-506- ] ( Ilt~- Ice Chest No Temp
SIJRV ITlNE2009
Shipped To (Lab) Method of Shipment Bill of Ladinl Air Bill No r Science I ahOfalorv novt Vhid
Protocol Priority 45 Days Offsite Property No
SlJRV POSSIBLE SAMPLE HAZARDSREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activity Ex~mption Yes llJ No II Contains Radioactive Material at concentrations that are not regulated for transportatIOn per 49 CFR but arc not Site-Wide Generator Knowledge Infonnation Fom1 applies eleasable per DOE Order 54005 (199011993) ESL Hold all samples until all 10 are received and run the complete set at ONE time
------shy -----shy -----shy
Sample No Lab 10 bull Date Time NofType Container Sample Analysis Holding Time
B20NX6 W 6-2 I (2)0 1x125-mL GP 1129_ICPMS 1middot129LL (1) 6 Months
shy~
-
shy
~ -v~
IlIIIJfJ
Wt ~
~
----shy -------shy -------shy
Preservative
NaOH to pH gt 9
~N 252009
oq~b JUN I 9 ong Relinquished By
Datcrrirne Received By Print Sign DateTimc
s-- S S L ft( JUN 2 5 2009 I
DateTime feceiveltJft) J 0 JUN 9 nn~ CHP~~an t8Joltm~mg on
DateTimc DateTime
MP olJ 30 JUN 9 009 DateTimc Received By DateTime
FINAl SAMPLE I Disposal Method (eg Retulll to customer per lab procedure used in process) Disposed By
DISPOSITION
Matrix bull
S Soil ns Onnn Solid SF Sediment 111 Orum ll(mi SO Solid T Tisstle SL SIiI(I~e WI Wine~
-W WAter L Licllid 0 Oil V Ve~etatil)n
A Air X Other~
DateTilllc Page 30 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST
COc
S09-006-176
Page 1 of 1 _________
-Collector i1S lianO
IWOOI ContactlReauester
Dana Widrigt Telephone No MSIN FAX
509-376-2amp5amp
SAF No S09-006
Sampline Oriein Hanford Site
Purchase OrderCharee Code
Proiect Title SITRV IIINF 009 ~W~N~~ 21 i -lip Ice Chest No Temp
Shipped To (Lab) Fnvil Sciences I
Method of Shipment Govt Vehicle
Bill of LadineAir Bill No
Protocol SlJRV
Priority 45 Days Offsite Propertv No
POSSIBLE SAMPLE HAZARDSIREMARKS bullbull Contains Radioactive Material at concentrations that are not regulated for transportation per 49 CFR but are not releasable per DOE Order 54005 (19901993)
SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemption Yes ~ No L Site-Wide Generator Knowledge Infonnation Fonn applies ESL - Hold all samples until all 10 are received and run the complete set at ONE time
Sample No
B20P35
- -shyLab ID bull
W
Date
c~11
Time
tc NoType Container
1x125-mL GP
Sample Analysis
1129_ICPMS 1-129LL (1)
Holding Time
6 Months
Preservative
NaOH to pH gt 9
-shy -r--shy rshy -shyr--shyr---shy -shy-shy ~
~o4 ~lt
----~--shy ---shy --shy r-shy ---- ---shy -shy -
DateTime Received By Print Sign DateTimeRelinqfBI ~n( L JU~L6 2009 5 S IA 11 ICHPRC
IReceived By
I 9 mnb ~_ Vlt1lOtr-()IrM~
JUN 2 Relinquished By DateTime DateTime
oggtUJUN I 9 550 tJ og3 0 JlIN I 9 O DateTime DateTimeRelinqtmd]dlian
0130 JUN amp150 JlIN I 9 70Q9CHoq~
DateTime DateTimeRelinquished By
Matrix bull
S ~ Soil J)S Dnnn Solin SF Seeiment J)J Dnnn T-i(llIi SO Solie T Tiswe SJ Slnege WI Wine W Weter J l-ielllici o Oil V Veetation A Air X Other
FINAL SAMPLE I Disposal Method (eg Return to customer per lab procedure used in process) Disposed By DateTime
DISPOSITION Page 31 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32
---------shy
COC
CHPRC CHAIN OF CUSTODYSAMPLE ANALYSIS REQUEST S09-006-422
Page J of 1 Collector DJSpar1cs ContactIReQuester Telephone No MSIN IAX
DHnH Widri iOQ-176-2RiR
SAF No Samplin20rieJn Purchase OrderCharee Code ltOQ_006 Hanford Site
Proiect Title HNF-N-5OA- J I 3 Ice Chest No Temp Sl fRV Il INF )009
Shipped To (Lab) Method of Shipment Bill of LadinelAir Bill No t Sciences I [iov Vehicle
Protocol Priority 45 Days
Offsite Property No ltIlRV
POSSIBLE SAMPLE HAZARDSIREMARKS SPECIAL INSTRUCTIONS Hold Time Total Activitv Exemotion Yes IJ No I bullbull Contains Radioactive Material at concentralions that arc not regulated for transportation per 49 CFR bUI are not Site-Wide Generator Knowledge Information Form applies releasable per DOE Order 54005 (19901993) ESL - Hold all samples until all 10 arc received and run the complete sel at ONE time
---------shy
Sample No Lab ID bull Date Time NolType Container Sample Analysis
B20PP7 W ~I)q ol 15 1x125-mL GP 1129_ICPMS 1-129LL (1) ---shy -t---shy --shy r--- ---shy ---shy ~ OJl)
~ 1-7J-O
---- --shy------shy
---------shy
Holding Time
6 Months
----shyt-
~ ---shy
Preservative
NaOH to pHgt 9
---shy ---- -shyRelinquished By Dalcrrirne
DJSpar1cS
Received By -
CrtdJ11z ~ Datcrrimc
tZ dJUL 1 4 2009 -
JUL ore1W1009 200
iYbDjrr4 lC2009
Dateffime
Matrix bull eceived By Print Sign Daterrime~ I1111 n R 2009 -SSudt- S Soil os Orum Solid
Datelfime Sf Sediment 01 Drum I i(mi SO Solid 1 Ti~lle
Received By
S1 Shui1c WI WineJUL 1 4 2009 Q-v jvJCA~ W Woter L iClllirl 0 Oil V VClclLllion
A Air X Other
DaleTime R~Ccived By
FINAL SAMPLE I Disposal Method (eg Return 10 cusromer per lab procedure used in process) Disposed By Dateffime
DISPOSITION
p- lt II )IlAJ
Page 32 of 32