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SAMPLING TRIP REPORT Site Name: Tutu Wellfield Site Sampling Dates: July 22-30, 1992 SASNos: 7382B-Oi;7382B-02 RAS Nos: 18503 through 7/24 and 18544 through 7/31 1. Site Location: St. Thomas, USVI 2. Sampling Location: See Tables 1-4. 3. Sample Descriptions: COM FEDERAL PROGRAMS CORPORATION (COM Federal) is conducting ongoing oversight of the monitoring well installation, investigatory borings, and groundwater sampling programs being conducted by the Tutu Wellfield site contractor Geraghty & Miller (G&M). During this segment of oversight, CDM Federal split 5 soil samples and 1 water sample (rinsate blank) with G&M. CDM Federal's samples were analyzed via routine analytical services (RAS) for Target Compounds List (TCL) volatile organic compounds (VOC), TCL base-neutral/acid extractables (BNAs); Target Analyte List (TAL) metals and cyanide. Samples were also analyzed via special analytical services (SAS) for methyl-tertiary-butyl-ether (MTBE), 1,2-dibromoethane, n- propylbenzene and total petroleum hydrocarbons (TPH). Extensive sampling information is found in Tables 1-4. 4. Laboratories Receiving Samples: Organics (VOCs, BNA) Inorganics (Metals, Cyanide) 7/20/92-7/24/92 7/29/92-7/31/92 MBTE 1,2 dibromomethane n-propylbenzene TPH Compuchem Laboratories 3308 Chapel Hill/Nelson Highway Research Triangle Park, NC 27709 Skinner & Sherman 300 Second Avenue Waltham, MA 02254 US, EPA ESD Laboratories 2890 Woodbridge Avenue Bldg. 209 Edison, NJ 08837 RECRA Environmental, Inc. 8320 Guilford Road Building F Columbia, MD 21046 GP Environmental Services 202 Perry Parkway Gaithersburg, MD 20877 Till OO6 O21.3 *64577* 64577 5. Sample Dispatch Data: Samples were shipped via Federal Express International Priority. A United States Department of Agriculture (USDA) permit was included with each shipment to each individual laboratory. U.S. Customs and/or USD A inspections delayed arrival of samples to laboratories in some cases up to 4 days. More details for sample dispatch data are found in Tables 1-4. 6. Sampling Personnel: CDM Federal sampler Susan Collagan split samples with G&M during this segment of oversight at the Tutu Wellfield site. TUT 006 0214 TABLE 1 TUTU WELLFIELD SPLIT SAMPLE SUMMARY TCL VOC AND BNA Sample No. BHR65 BHR64 BHR63 BHR69 BHR67 BHR66 Sampling Date/Time 7/20/92 <a> 1015 7/21/92 0 1500 7/24/92 ® 1030 7/29/92 ® 0830 7/30/92 0 0925 7/30/92 (9 1300 Sample Matrix Soil Soil Soil Rinsate Soil Soil Airbill No. 400-5269-6206 400-5269-6206 400-5269-6243 400-5269-6615 400-5269-6615 400-5269-6615 Date Shipped 7/22/92 7/22/92 7/24/92 7/30/92 7/30/92 7/30/92 Sample Location TUMW8 TUMW6D* MW9 FB072992 B6 Bl MS/MSD TABLE 2 TUTU WELLFIELD SPLIT SAMPLE SUMMARY TAL METALS AND CYANIDE ^pgple N" MBES58 MBES57 MBES56 105429 105426 105427 Sampling Date/Time 7/20/92 & 1015 7/21/92 O 1500 7/24/92 dt) 1030 7/29/92 Q 0830 7/30/92 <2 0925 7/30/92 O 1300 Sample Matrix Soil Soil Soil Rinsate Soil SoU Airbill Np, 400-5269-6210 400-5269-6210 400-5269-6254 400-5269-6582 400-5269-6582 400-5269-6582 Date Shipped 7/22/92 7/22/92 7/24/92 7/30/92 7/30/92 7/30/92 Sample Location TUMW8 TUMW6D* MW9 FB072992 B6 Bl MS/MSD TUT OO6 O21.5 TABLES TUTU WELLFIELD SPLIT SAMPLE SUMMARY - MTBE 1,2-dibromomethane, n-propylbenzene Sample No. 7382B-01-01 7382B-01-02 738213-01-03 7382B-01-04 7382B-01-06 7382B-01-07 Sampling Date/Time 7/20/92 <2> 1015 7/21/92 & 1500 7/24/92 ® 1030 7/29/92 <3> 0830 7/30/92 ® 0925 7/30/92 ® 1300 Sample Matrix Soil Soil Soil Rinsate Soil Soil Airbill No. 400-5269-6221 400-5269-6221 400-5269-6276 400-5269-6604 400-5269-6604 400-5269-6604 Date Shipped 7/22/92 7/22/92 7/24/92 7/30/92 7/30/92 7/30/92 Sample Location TUMW8 TUMW6D MW9 FB072992 B6 Bl TABLE 4 TUTU WELLFIELD SPLIT SAMPLE SUMMARY TPH Sample No. 7382B-02-01 7382B-02-02 738213-02-03 7382B-02-04 7382B-02-06 7382B-02-07 Sampling Date/Time 7/20/92 <3> 1015 7/21/92 ® 1500 7/24/92 Q 1030 7/29/92 Q 0830 7/30/92 9 0925 7/30/92 9 1300 Sample Matrix Soil Soil Soil Rinsate Soil Soil Airbill No. 400-5269-62232 400-5269-6232 400-5269-6265 400-5269-6593 400-5269-6593 400-5269-6593 Date Shipped 7/22/92 7/22/92 7/24/92 7/30/92 7/30/92 7/30/92 Sample Location TUMW8 TUMW6D MW9 FB072992 B6 Bl TUT OO6 O216 ( United SUM Environmental Protection Ag*ncy Orar Traffic Reort ^^^^^O^&IS^S^0^ & Chain of c'ustcd'y'Hecord ,«„ «,,>». ,-,««,—— (For Organic CLP Analysis)______ , 703-SS7-2400 FTSSS7-2490 SASNo. (ifappticabto) Caste. 1. Project Code Account Code Regional Information Non-Superfund Program Site Name CHy. State Site SpiM ID 2. Region No. Sampling Co. Sampler (Name; Signature of Activity ' B^^RIPS RMH.MPO PA SSI LSI RA 0AM r_, NPLDCDUST M REMA REM OIL 4. Date Shipped Carrier Alrbil Number i Ship To 1yOM.C^t^) 6. Preser- vative fEnfer In Column D) 1.HCI 2. HN03 3. NaHSO4 7. Sample Description "" ATTN: e. ear N. Not preserved rn Column A) 1. Surf ace Water ^ Ground Water 3. Leachate 4. Rlnsate 5. SoiVSedlment 6. Oil (High only) 7. Waste (High only) fl. Other (Specify) CLP Sample Numbers (from labels) A Enter * from Box? B Cone. Low Med High C Sample J^^ Compy Grab D Preser- vative 'from Box 6 RAS Analysis VGA' BNA Pest/ PCB Hah onl TOX Regional SpecrW ,Tracking Number; •or Tag Numbers Q Station Location Number H , Mo/Day/ Year/Time Sample Collection I Sampler Initials J Corresp. ' CLPlnorg. Samp. No. Enter Appropriate QuaWer for Designated Field QC - B-Btai* S-Spfta PE.Pwtorm.Ew*. — iNdUaC Samel* & 6 •X G rrUMn/bb \ifijij Shipment for Cue complete? (YJN) P«g«iotJL_ Sample used for a spike and/or duplicate Chain of Custody Seal Number CHAIN OFieJUSTODYREO)^ Date /Time 7/2^A 106 Received by: (Signature) Rejinqulshed by: Date/Time Received by: (Signature) I Relinquished by/ (Signature) Date/Time Me/Time Received by: (Signature) Remark* Is custody seal Intact? Y/N/none Relinquished by: (Signature) Date/Time" Received tor Laboratory by: (Signature) Date /Time iPA Form tllO-l (R»w. i-f 1) MvetacM EPA form (2079-7). pravtaM •dHton wlllch may IM wad Split S«mplM [^Accepted (Signature) EPM United States Environmenial Protection Agency Contract Laboratory Program Sample Management Office PO Box 818 Alexandria, VA 22313 703-557-2480 FTS 557-2490 Inorgaf Traffic Report & Chain 01 Custody Record (For Inorganic CLP Analysis) SASNo. (il applicable) Case i CHAIN OF CUSTODY RECORD by: (Signature) Date/Time ReceivedbyT Date /Time Received by: (Signature) r^ i "^ Relinquished by Date/Time Date/Time Received by: (Signature) Remarks Is custody seal intact? Y/N/none Relinquished by: (Signature) Date; Time Received for Laboratory by: (Signature) Date/Time ERA Form «110-1 (Rev. *>1) Repleoee Ef>A Form <207S-«), prevtowa edition which may be weed DISTRIBUTION: B»I«« n«m> Dink . «uo CAM While . Lab Canv lor return te Realen Yellow • Lab Split Samplea r— | Accepted (Signature) Declined Contract Laborato!yP^a1li)*SampletM^^em^n?Office SpOCIdl Al18lVtiCal SefViCC P080K818 Atoxandria^MIS ^ packjng ^^^ of Cus|ody . 703-557-2490 FTS 557-2490 SAS No. 73933-O/ 1. Project Code Account Code Regional Information Non-Superfund Program She Name , State 7 * ^^"r^*TA SnsSplHID 2. Region No. Sampling Co. Sampler (Name) SamolM signature 8P PRPi ST FED 2«^ffi^ Of Activity AMmdUlMUoMl ~CCEM—1 — REMA RA ~REM 0AM ~ OIL NPLD_UST 4. Date Shipped Carrier AlriSiH Number 5. Ship To Mb 6. Sample Description (Enfer in Column A) 1. Surf ace Water 2. Ground Water 3. Leachate 4. Rlnsate 5. Soil/Sediment 6.011 7. Waste 8. Other (Sptdty) 7. Preservative (Enter in Column C) 1.HCI 2. HN03 3. NAHSO4 4. H9SO4 5. NAOH 6. Other 7. Ice only N. Not preserved Sample Numbers A Matrix Enter from Box 6 B Cone Low Med High C Preserv- ative Used from Box 7 D Analysis Regional Specific Tracking Number or Tag Number F Station Location Identifier G Mo/Day/ Year/Time Sample Collection H Sampler Initials Designated Field QC 5. 7. 8. 10. Shipment for SAS oomplete? (YJR) Page 1 of _/ Sample Used for Spike and/or Duplicate Chain of Custody Seal Number CHAIN OrVCUSTODY ishedby: (Signature) Date /Time ___________ Received by: (Signature) Relinquished by: (Signature) uk Received by: (Signature) Relinquished by: ReMlvedby: (Signature Received by: (Signature) Remarks Is custody seal Intact? Y/N/nona Relinquished by: (Signature) ~Dite TTmT Received for Laboratory by: (Signature) Date/Time ERA Form: 1110-3 (7/S1) DISTRIBUTION: Whtt* * Regjen Copy^ Yellow ^SMO Copy Odd • Ub Copy for Return to Region Split Samples Q Accepted (Signature) ft^ 1"™ p^ A United Slates Environmental Protection Agent ^HP^f l_ 1 J / \ Contract Laboratory Program Sample Managemen m f \ r^ A~\ PO Box 818 Alexandria, VA 22313 ^^ •—— 1 » % 703-557-2490 FTS 557-2490 1. Project Code /\ccountCode Regional Information Non-Superfund Program Site Name City, State wt« Spill ID ^yfclliWNuQ i/'C tff- ' t> — *- —— '" *^ i y « — ' *^ ————— ' Sample Numbers 1 ItfZB'Oa-Ol 2- 739a8-O3-Ooi 3. 4. 5 6. 7. 8. 9. 10. Shipment for SAS complete? ( Y<N) Matrix Enter from Box 6 5 6 B Cone Low Mad High L L. Page 1 of 1. Office Special Analytical Service Packing List/Chain of Custody 2. Region No. Sampling Co. 4. Date Shipped Carrier Sampler (Name) SampjacSlgnature ^ ' 3. Tfre of Activity R«T»«* •^ Pre- RIFS "P 8F_f— ]B«n-WRD — PHP _ PA ^ ST SS FED LSI C Preserv- ative Used from Box 7 7 7 _ RA _ O&M NPLD Alrhlll Mfimhar (tiilvr Airoiii Number jfl Column A 1-qOs^ 7^9 ' vfTe?6^- £>3S3 1 Surfaca Wa ^ 5. Ship To ^*— SPF/ C/Hemo»d _ _ / [CLEM ~ o?£>«* * REMA- (g>^ UST ~ A$h; .<2 D Analysis -T~P4 " Sample Used for Spike and/or Duplicate B ~*~~~ I'Ml -/*\^ _. . - ~LJo*» t> «-•• .. 2. Ground Wal jjirfffi T0-/ 4' Rjn9at€| 5£/iA^ 7*U&*Uj | Soll/Sedlme vLQ%*g,Mb J;8J|p E Regional Specific Tracking Number or Tag Number /rt76<? lO'J^L) F Station Location Identifier *J/?rtjW •> tf />?^" / / iAjji^. C fvf^j ruMvtfbb AddUlon^ Sampler Sirtiatures SAS No. 7. Preservative (Enter in Column C) ) ler 1.HCI er 2. HNO3 3. NAHSO4 4. H2SO4 nt 5. NAOH 6. Other 7. Ice only N. Not preserved Q Mo/Day/ Year/Time Sample Collection ll^oh^ Vtf/s ^.V/^ ^ ATO« / / H Sampler Initials S£2. M< 1 Designated Field QC Chain of Custody Seal Number CHAIN Of/CUSTODY REC^D Relinquished by: (Signature) Date /Time Received by: (Signature) Relinquished by: (Signature) Date /Time Received by: (Signature) ' Relinquished by/(Slgnature) 'Date /Time Received by: (Signature)^ Relinquished by: (Signanjre) Date /Time Received by: (Signature) Relinquished by (Signature) Date /Time Received for Laboratory by: Date /Time Remarks Is custody seal intact? Y/N/none (Signature) EPAForm: 9110-3(7/91) Split Samples [— [Accepted (Signature) DISTRIBUTION: White - Region Copy Yellow • SMO Copy Gold • Lab Copy lor Return lo Region - . . . ---...-,.....„ ,,,c«uo r~lDadined ( <fa> f"1" f" N A UnlMd Slant Environmental Protactfon Agency 1&^ |__ 1 J / \ Contact Laboratory Program Sample Management Office fm P^ P^A'A P° 8°* 81B Alexandria. VA 22313 %^ 1— 1 / V 703-557-2400 FTS 557-2490 Inorganic ..attic Report & Chain of Custody Record (For Inorganic CLP Analysis) SAS No. Case No. 1950S Relinquished by! (Signature) Received by: (Signature) shed by: (Signature) Received by: (Signature) ved for Laboratory by Relinquished by: (Signature) '». r_ «11(M ,R.v t-ai) Meptaoa* EPA Form (20714), etwrloM odHlon which may be ueed Spilt Samples [~] Accepted (Signature) t United Slate* Environmental Prelection Agency Contract Laboratory Program Sample Management Office PO Box 818 Alexandria. VA 22313 703-557-2400 FTS 557-2400 OrJ c Traffic Report & Chain of Custody Record (For Organic CLP Analys ysis SAS No. (if applicable) Case . 1. Project Code Account Code Regional Information Non-Superfund Program She Name City, St / Site Spill ID 2. Region No. Sampling Co. /=P(L 4. Date Shipped Sampler (Name) SF PRP ST FED of Activity " P» RIFS «——RD SS LS O4M _ OIL __ NPLD—UST __ Carrier Airbill Nrjmber 5. Ship To -$s& 6. Preser- vative flEnfar in Column D) 1.HCI 2. HNO3 3. NaHSO4 „ 4. H2S04 5. only '„• N. Not :' preserved 7. Sample Description (Enter ' in Column A) 1. Surf ace Water 2. Ground Water 3. Leachate 4. Rinsate 5. Soil/Sediment 6. Oil (High only) 7. Waste (High only) 8. Other . (Specify) ' CLP Sample Numbers (from labels) A Enter * from Box 7 B Cone. Low Med High c Sample Type: Comp7 Qrab D Preser vative from Box 6 !RAS Analysis VOA BNA Pest/ PCB High only TOX Regional Specific .Trackina Number , or Tag Numbers Q Station Location Number H Mo/Day/ Year/Time Sample Collection I Sampler Initials J Corresp. CLP Inorg. Samp. No. Enter Appropriate Qualifier k» Designated Field OC B-Ber* S-SpN» O-Ouptoaw j ~ PE • Pwum. EMI. f. — .NotaQCSemole 101*13 SflL Shipment tofjQase complete? Pace 1 of / Sample used tor a spike and/or duplicate Chain of Custody Seal Number CHAIN OF CUSTODY RECO Date/Time Received by: (Signature) X7 ~&(4** ^ceivedbyi (dS* : (Signature) Relinquished by: (Signature) ReDriquished by: (i Data /Time Received by: (Signature) Date/Time Received by: (Signature) I Remarks Is custody seat Intact? Y/N/none Relinquished by: (Signature) Date/Time Received for Laboratory by: (Signature) Date /Time EPA Form •110-2 (Re*. S-»1) Replaeea EPA Form (2075-7). previous edition which may be ueed DISTRIBUTION: _, . «..^ ...... un.1.. . I .h r«nw «nr Raiurn ta Raolan Yellow . Lab Spilt Samples [~] Accepted (Signature) Declined —1 ' — t 5- •~j kiw AtPA 1. Project Code / United Stales Environm< PO Box 81 8 Alext Account Code Regional Information Non-Superfund Program Site Name -TZSu. M/^ City-state Sample Numbers I fa/I Site Spill ID A Matrix Enter from Box 6 19*9- ^ 3. 4. 5. 6. 7. 8. 9. 10. Shipment for SAS complete? ( Y@) 7 B Cone Low Med Ugh L. Page lot/. ReUqquished by: (SJanat C<U^&U(<-/lA^C Sample Manage indria, VA 22313 2. Region Nc Sampler Sk Sampler 3f^yfSe< LMd SF — PRP~ ST _ FED )en< nennoifice Spec. , Analy Packing LJst/Cna i. Sampling Co. 4. Date Shipped Carrier (Name) Signature^ »*•**_ /_^ gf Activity R«, n^Idw RIFS PA SSI LSI C Preserv- ative Used from Box 7 7 Sample / HA O&M NPLD litM-o "SSTsatf-M ticsl Service in of Custody /T" 6. Sample ^-X Description (Enter 6S" 1. Surf ace Wa 5. Ship To 2. Ground Wat ^^^^P/^7^^)^^^^ JnSSf •dwl t- — REMA~ (3ttyV^ REM . OIL iu , ( UST nftn. o D Analysis -7?M Used for Spike and/or Duplicate 10rt£ }*&irLL4 /»o£iv«U/ 5. Soil/Sedime ift t^7 6- °il 'AjkMru,, A/J£X 7. Waste ^o)oF'77 8 Other E Regional Specific Tracking Number or Tag Number /07V? F Station Location Identifier /1W-7 AddWoc/al Sampler Signatures CHAIN OF^USTODY RE SAS No. ( 7. Preservative ("Enter /n Column C) ) er 1.HCI er 2. HNO3 3. NAHSC-4 4. H2SO4 nt 5. NAOH 6. Other (Specify) 7. Ice only N. Not preserved G Mo/Day/ Year/Time Sample Collection ^|^*i|1l(!^03C^ H Sampler Initials &/C- 1 Designated Field QC Chain of Custody Seal Number CORD ur*J Date /Time Received by: (Signature) ' Relinquished by: (Signature) Date /Time Received by: (Signature) Relinquished b/: (Signature) ' Date/TTn 1 w Received by: (Signature^ Relinquished by: (SlgnafiM) Date /Time Received by: (Signature) Relinquished by: (Signature) Date /Time Received for Laboratory by: Date ^ ' y (Signature) ERA Form: 9110-3(7/91) DISTRIBUTION: White - Region Copy Yellow - SMO Copy Oold- Plnk- Ubliopy for Return to SMO 'Time Remarks Is custody seal Intact? Y/N/none Split Samples r— | Accepted (Signature) Lab Copy for Return to Region (~| Declined &tpA xaFTS155*24M Specidl Analytical Service Packing Utl/cLn of Custody SAS No. 1. Project Code Account Code Regional Information Non-Superfund Program Site Name %?&*>**. V? Sampk> Numbers SHe Spin ID £"r — A Matrix Enter from Box 6 B Cone Low Med High 6. Sample Description (Enter In Column A 2. Ground Water 3. Leachata 4. Rlnsate 5. Soil/Sediment 7. Waste 8. Other (Specify) F Station Location Identifier 7. Preservative (Enter in Column C} 1.Ha 2. HNO3 3. NAHSC-4 4. H9SO4 5. NAOH 6. Other 7. Ice only N. Not preserved G Mo/Day/ Year/Time Sample Collection H Sampler Initials Designated Field QC 2. 3. 5. 6. 7. 10. Page 1 of _/ Sample Used for Spike and/or Duplicate H CH Shipment for complete? ( Chain of Custody Seal Number __________CHAIN OF/ Received by: (Signature) Date/Time Received by: (Signature) ishad by: (Signature) Date /Time Relinquished : (Signature) by: (Signature) & Date/Time Received by: (Signature) Remarks Is custody seal Intact? Y/N/none Relinquished by: (Signature) Data /Time Received for Laboratory by: (Signature) Date /Time EPAForm: 8110-3(7/91) DISTRIBUTION: WMte - Roglon Copy Yollow • SMO Copy QoM - Ub Copy for Rolurn to Roolon Pink. Ub Copy for Return lo BUO Split Samples Q Accepted (Signature) f~l Declined FIELD DATA SHEET ENVIRONMENTAL PROTECTION AGENCY - Region II, Edison, New Jersey ENVIRONMENTAL SERVICES DIVISION roject Name. Collector(s) _: .Affiliation r/=r SAMPLING METHOD (Circle) Kemmerer Dredge Ponar Manual Nlskln Net Seine Trawl Bucket Trowel Cream Dipper Automatic Other ____________________ LDMS CODE DATA BASE CODE. STA. TYPE CODE _ SUBSTRATE TYPE (Circle) Aqueous Sediment Sludge Oil Biological Solvent Extract Other ( ) BOD — Seed Supplied D Yes D No Source: Sample Preparation (Circle) Container Glass Jar Plastic Jar Metal POA Vial Cubltainer Acetate Core Paper Cap Teflon Cap Foil Cap Jther____ Preservation Acid___ Solvent_ Chemical. Wet Ice Dry lc» Ambient Other__ Cleaning Procedure Detergent Wash Water Rinse Acid Rinse Solvent Rinse: Acetone Hexane Methylene Chloride Other (Specify): , Sample Source Type (Circle) Landfill Leachate Drum Test Well Depth: Other__ Storage Tank Top Middle Bottom Truck Drum Tank Other. Wells Monitoring Production Drinking Private Industrial Effluent Process Stream Holding Pond Drum Waste Pile Municipal Treatment Influent Effluent-d Effluent-Non Cl Sludge Ambient Lake Stream Pond Ocean Estuary Sample Location Description: J &a ~TAL r<? XSL. ^Lp /</\s / :^ca/ -J Form: FTB RPO-11-82-2 Samples to: Bact Bio Chem Other Station No. Sample Depth (Ft.)/Fac. LOG. Code Lab Number 105429 Type of Sample Grab Composite Time Space Collection (Boding) Date Yr Mo Day Ead^TTiifie (24 Hr) 0 9 3 O Beginning Date Yr 1 Mo I Day | Beginning Time (24 Hr) PH Sample Temp. (*C) DO (mg/l) Cond. (uMHOS/CM) Sallnity(%.) Sample Split Eixfes IO No If Yes With Whom? ~~TZ fa Receipt O-Yes D No TUT OO6 02 FIELD DATA SHEET ENVIRONMENTAL PROTECTION AGENCY • Region II, Edison, New Jersey ENVIRONMENTAL SERVICES DIVISION Project Name. Collector(s) Affiliation SAMPLING METHOD (Circle) Kemmerer Dredge Ponar Manual Niskin Net Seine Trawl Bucket Trowel Cream Dipper Automatic Other____________________ LDMS CODE DATA BASE CODE. STA. TYPE CODE _ SUBSTRATE TYPE (Circle) Aqueous Sediment Sludge Oil Biological Solvent Extract Other ( ) Samples to: Bact Bio Chem Other Station No. Sample Depth (R.)/Fac. Loc. Code Lab Number 105427 BOD — Seed Supplied D Yes D No Source: Sample Preparation (Circle) Container Glass Jar Plastic Jar Metal POA Vial Cubitainer Acetate Core Paper Cap Teflon Cap Foil Cap Other____ Preservation Acid___ Solvent_ Chemical. Wet Ice Dry Ice Ambient Other__ Cleaning Procedure Detergent Wash Water Rinse Acid Rinse Solvent Rinse: Acetone Hexane Methylene Chloride Other (Specify):' Sample Source Type (Circle) Landfill Leachate Drum Test Well Depth: Other__ Storage Tank Top Middle Bottom Truck Drum Tank Other. Wells Monitoring Production Drinking Private Industrial Effluent Process Stream Holding Pond Drum Waste Pile Municipal Treatment Influent Effluent-CI Effluent-Non Cl Sludge Ambient Lake Stream Pond Ocean Estuary Sample Location Description: Bl <r^o } 0 11* \ Remarks: i I -f-o he Form: FTB RPO-1142-2 Type of Sample Grab Composite K Time Space Collection (Ending.) Date Yr Mo -"\ U Day / 3 o o Beginning Date Yr 1 Mo | Day 1 Beginning Time (24 Hr) PH Sample Temp. (*C) DO(mg/l) Cond. (uMHOS/CM) Sallnity(Vo.) Sample Spin P^Yes D No If Yes With Whom? Receipt CXYes D No TUT OO6 O226 FIELD DATA SHEET ENVIRONMENTAL PROTECTION AGENCY - Region II, Edison, New Jersey ENVIRONMENTAL SERVICES DIVISION Project Name. Collectors) _ f^Tfflliation. SAMPLING METHOD (Circle) Kemmerer Dredge Ponar- Manual Niskin Net Seine Trawl Bucket Trowel Cream Dipper Automatic Other ____________________ LDMS CODE DATA BASE CODE. STA. TYPE CODE _ SUBSTRATE TYPE (Circle) Aqueous Sediment Sludge Oil Biological Solvent Extract Other { ) BOD — Seed Supplied D Yea D No Source: Sample Preparation (Circle) Container Glass Jar Plastic Jar Metal POA Vial Cubitalner Acetate Core Paper Cap Teflon Cap Foil Cap Other____ Preservation Acid___ Solvent_ Chemical. Wet Ice Dry Ice Ambient Other__ Cleaning Procedure Detergent Wash Water Rinse Acid Rlns« Solvent Rinse: Acetone Hexane Methylene Chloride Other (Specify):, Sample Source Type (Circle) Landfill Leachate Drum Test Well Depth: Other__ Storage Tank Top Middle Bottom Truck Drum Tank Other. Wells Monitoring Production Drinking Private Industrial Effluent Process Stream Holding Pond Drum Waste Pile Municipal Treatment Influent Effluent-CI Effluent-Non Cl Sludge Ambient Lake Stream Pond Ocean Estuary Sample Location Description: Remarks: -TTtL. C if? Form: FTB RPD-1142-2 Samples to: Bact Bio Chem Other Station No. Sample Depth (Ft.)/Fac. Loc. Code Lab Number 105426 Type of Sample Grab Composite ^ Time Space Collection (Oiling) Date Yr 0\7 Mo Day ime (24 Hr) 0 Beginning Date Yr 1 Mo 1 Day 1 Beginning Time (24 Hr) PH Sample Temp. (»C) DO (mg/l) Cond. (uMHOS/CM) Salinity(%.) Sample Split q^Ves D No If Yes With Receipt Xes D No TUT' 006 0227 f"f j A Unllad StaM Environmental Proiaclion Agancy Off 1C Traffic ReDOlt Hi JA ^'"^^.^.^A^T™'0"1" & Cha... of Custody Record /%______703-557-2490 FTS 557-2490____________(Frjr Organic CLP Analysis)_____ a Code Account Code 2. Region No. Sampling Co. 4. Date Shipped Carrier SASNo. (it applicable) Case No./ 1. Project Code Non-Superfund Program 6. Preser- vative /Enter /n Column D)_ ;l.Ha h2.HNO3 . "3. NaHSO4 2;4. . 5, 7. Sample Description (Enter ' .* In Column A) t~1. Surface Water 2. Ground Water, . 6, Ice only . N. Not J ! preserved ;4.Rlnt«te >V5,SoiUSedlrnfnt n:6;OH(Htahonly) «.57. Watte (High only) : ?8, Other .*, Srr (Specify)* - • • • '-' Sample Numbers . (from labels) Enter * from Box 7 B Cone. Low *Med High Grab _ Preter vative (from Box 6 VGA! BNA Pest/ PCB Hah only AFICV TOX c . F i. .. 'RegTonaJSpecmd ' 'Tracking Number'' ( v or Tag Numbers 5 1 ^ • : . • • : , < 1 ' . .i Q .Station^ , r Location0 f •„: .Number' ji K ^ -•'• •'. r ii .c.: f- Year/Time <• Sample ^Collection I Sampler Initials .. J Corresp. CLP Inorg; Samp. No.- i' '"I l^ • a. '' - . :.- i K »-< f- « Bitair Ap xopriate CuaWler for Dee gnated Field QC " r-B-Bank S-SpNw *: o-rxofcM* o «-• PE • Pvnomt EML s- y—NaaQCSampla -.y i v •' r. v I * Shipment fobCase complete? (V^N) Pace 1 of I Sample used for a spike anoYor duplicate Chain of Custody Seal Number ^ CHAIN OP/CUSTODY RECOI Received by: (SIgnalun) Received by: (Signature) &~~,&2£ w£~~~^^^^^^^^m^^—^^^^^^^^± Received by: (Slgnature){ Received by: (Signature) Intact? Y/N/none Relinquished by: (Signature) ved for Laboratory byT (Signature) EPA Form S110-2 (Rov. 141) Roptaooo EPA Form (2075-7). provloua odKton whkh may ba ua^ DISTRIBUTION: B.... . o.«i.n OM.W oinb. BUO Ceey Wh»» - Ub Copy tor Roturn to Ragton Yallow • Lab Split Samples Q Accepted (Signature) Declined |~~ p^f L» I—A i Ji •—— I United SI«M Environment* Prot«c*on Agency InOTCiar TtafflC ReDOlt . Contact Laboratory Program SwnptaManag«riMniOffioi »r»ulT.Tl ». -»1!.J. D^-1.W t\ poBo/818 Aj«x^ri. VA223T3 & Chain V Justodv Record 1 _!_____ 703.557-2490 FTS 557-2490 (For Inorganic CLP Analysis) SASNo. Case No. 1. Project Code Account Cod* 6, Preser- !vatlve 7. Sample Description (Enter . in. Column A) ^ .Column D) 1.HCI 2.HN03 3. NaOH 4. H2SO4 - 5. KfCRoO? 6. teeonly 7. Other Regional Information Sampler (Name) Airbll Number Surface Water. x ' 2. Ground Water-, 3. Leachate 4.Rln»ate , 5. Soll^ediment 8. Oil (High onlyp >. • - 7. Watte (High only) ;*• 8. Other Non-Sup«riund Program Conk Sample Low CLP Sample Numbers1 a (from - -;• 1 ^ Enter Appropriate Qualfler for Designated Field QC /'^Year/Time t Tracklna Number or Tag Numbers; , ' Sample "Collection . . l-.NoiaQCSwnpl* S97SD «*«* inpM ueedfori and/or duplcat Addhkxial Sampler Signatures Chain of Custody Seal Number "•"f-. -. \. , \ t -'Vf •-.:' ,. . CHAIN OF CUSTODY RECORD Relinquished by: (Slgntun) Daternme 4 Received by: (Slgnttin) Received by: (Slgnatun) Relinquished by:. (Slgntturt) Relinquished by; (Signature) .-•- '.. -.4 -•-'.• 5'. '$•','•.' Date/Time Date / Time Received by: (Slgnatun) Received by: (Signatura) Remarks Is custody seal Intact? Y/N/none Received for Laboratory by" Date /Time. Split Samples [^Accepted (Signaturt) '' ^ ' Declined .' EPA Fenw S110-1 (R«v. C4l) K*plMM EPA Perm (207M), pravtow •dHton «hMi may to UMd DISTRIBUTION: • :^' F;77'.""•"~ T,r • *• -"^"r^ - ' OfMn.N«glanC«py Hnfc-«MOConr .^ WWU- UbCe»yforradimtoItoglon Y«Now- Spec t Analytical Service Ust/cLnof Custody SASNo. 1. Project Code Sample Numbers 6. Sample Description (Enter in Column A) 1. Surf ace Water 2. Ground Water 3. Leachate 4. Rinsate 5. Soil/Sediment 6. Oil 7. Waste 8. Other -77V Regional Specific Tracking Number or Tag Number F Station Location Identifier 7. Preservative (Enter In Column C) 1.HCI 2. HNO3 3. NAHS04 4. H2SO4 5. NAOH 6. Other 7. Ice only N. Noj preserved G Mo/Day/ Year/Time Sample Collection H Sampler Initials Designated Field QC I6133L «4r ,/-?7/fr/a/y */!" '/ '" *• ' ' 3 0930 S/c •Bl 6. 7. 10. Shipment for complete? ( Pagel Sample Used for SpiKe and/or Duplicate CHAIN OfVCUSTOOY RECORD Chain of Custody Seal Number Date /Time Received by: (Signature) Received by: (Signature) ( Date /Time Received by: (Signature) Data /Time Date /Time Received by: (Signature) Kj C.M Remarks Is custody seal intact? Y/N/none Relinquished by: (Signature) Date/Time Received for Laboratory by: (Signature) Date /Time EPAForm: 9110-3(7/91) DISTRIBUTION: Whlt» - R*fllon Copy V«N«w - 8MO Copy OoM • Ub Copy lor Return to Roglon Pink- uPbopytorRoturntoSMO SpHt Samples Q Accepted (Signature) Q Declined United States Environmental Protection Agency Contract Laboratory Program Sample Management Office PO Box 818 Alexandria. VA 22313 703-557-2490 FTS 557-2490 Spea Analytical Service Packing List/Chain of Custody SAS No. . Project Code 6. Sample Description (Enter in Column A) 1. Surf ace Water 2. Ground Water 3. Leachate 4. Rinsate 5. Soil/Sediment 6. Oil 7. Waste 8. Other (Specify) Regional Specific Tracking Number or Tag Number F Station Location Identifier 7. Preservative (Enter in Column C) 1.HCI 2. HNO3 3. NAHSO4 4. H2S04 5. NAOH 6. Other (Specify) 7. Ice only N. Not preserved G Mo/Day/ Year/Time Sample Collection H Sampler Initials Designated Field QC 3 II Bt. 5. 6. 8. Chain of Custody Seal Number Sample Used for Spike and/or Duplicate Shipment for Sf£ complete? ( YTN Received by: (Signature) Received by: (Signature) Received by: (Signature Relinquished by: (I Date/Time Remarks Is custody seal Intact? Y/N/none Received for Laboratory by (Signature) Relinquished by: (Signature) ERA Form: 9110-3(7/91) DISTRIBUTION: WhH« • Region Copy Yellow - SMO Copy QoM • Lab Copy for Return to Region Pink- Lartopy lor Return to SMO SpNt Samples [~| Accepted (Signature) Declined