USVI Public Records

Document text

FIELD DATA SHEET ENVIRONMENTAL PROTECTION AGENCY - Region II, Edison, New Jersey ENVIRONMENTAL SERVICES DIVISION Project Name Collector(s) c ±J-^ Affiliation SAMPLING METHOD (Circle) Kemmerer Dredge Ponar Manual Niskin Net Seine Trawl Bucket Trowel Cream Dipper Automatic Other_ C \ ^ LDMS CODE DATA BASE CODE. STA. TYPE CODE _ SUBSTRATE TYPE (Circle) Aqueous Solvent (Sediment (Sedim Extract Sludge Other( Oil Biological Samples to: Bact Bio Chem Other Station No. Sample Depth (Ft.)/Fac. Loc. Code 0 Lab Number 109401 BOD — Seed Supplied D Yes D No Source: Sample Preparation (Circle) Container (Glass Jar PlasTTc"Jar Metal POA Vial Cubitalner Acetate Core Paper Cap Teflon Cap Foil Cap Other____ Preservation Acid. Solvent. Chemical. , Wet Ice ury 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 rvc-/ r<r Sample Location Description: Remarks: Form: FTB RPD-11-82-2 Type of Sample , Grab Composite •v/ Time Space Collection (Ending) Date Mo .1 > Day Ending Time (24 Hr) Beginning Date Mo L' \\ Day ON Beginning Time (24 Hr) / / 5 '•) PH Sample Temp. ffG) DO (mg/l) Cond. (uMHOS/CM) Salinity(%.) X Yes Sample Split D No If Yes With Whom? Receipt D Yes O No *64514* 64514 ANALYSIS REQUEST CHEM BIO. BACT OTHER ENVIRONMENTAL PROTECTION AGENCY Environmental Services Division EDISON, N.J. Date of Request. Priority D Immediate /^Normal D Deferred Source of Sample(s). Sample Number(s)_ tl Type of Sample D Water '^Sediment D Oil D Air DOther (Specify) PHYSICAL CHARACTERISTICS D Turbidity D Volatile Solids D Total Suspended Solids D Volatile Suspended Solids D Color D Total Solids D Dissolved Solids D Settleable Solids D Specific Gravity D Viscosity D % Solids D Ignitability (RCRA) D Corrosivity (RCRA) D Other________ ORGANIC/DEMAND ANALYSES n nay Ron n D COD D X TOC n n TOD n n PCB-S n n Total n D Specific Aroclors D INORGANIC ANALYSES a PH D Conductivity ^^ D Salinity D Chloride D SO4 D SO, D Dissolved S D Hardness D Ca D Mg D Total/METHOD SENSITIVITY / METHOD D COD D High Level ( > 50 mg/l) D Low Level ( < 50 mg/l) Phenol Pesticides Herbicides _ _..... ..._ .. _ .._ ft^ Priority Pollutants D POA CUT \ n NVOA <-<--' ' n Other Maior Paaks D /cYL Long-term O, Demand (Carbon) D EP Toxicity Long-term O, Demand (Total) Volatile Acids Oil (Identify) D Alkalinity n co, n Total D HCO, D Chlorine Demand D Chlorine Residual D Free D Total D Acidity D Free D Total D Phosphorous D Total D Dissolved D Pesticides D Herbicides D Oil & Grease (Quantitate) D TKN D OrgN D NH,-N D NO.-N D NO,-N D Total P D AH-P D Ortho-P D Metal Scan D EP Toxicity (Metals) D Hg D Phenol D 0-1,000ppb D Above 1,000 ppb n Cd n Co D Cu n Pb D Zn D Fe D Cr D As D CN D F- D Ni Specific Compound n Identify > n Ouantitate O Ba D Se D Ag D Asbestos D Hexavalent Cr - D Metals D Total D Dissolved D Low Sensitivity D High Sensitivity MICROBIOLOGY MF MPN Est. Range Tr n n n oi<vstr'd|um perfring<*s Fr PI PI n M,,1a0emrity TftSt* FR n n n AmesTest D Pathogens D Viral Enhancement D Bacterial D Other (Specify) D Viral D ATP BIOLOGY D 24 Hour Bioassay D 48 Hour Bioassay D 96 Hour Bioassay D Chronic Bioassay D Benthos ID D Fish ID Requested hy ^~ ' ',„.'., <•-/ Data Approved hy Remarks K "^ D Static D Flow-Through D Static Replacement D Laboratory D On Site D Identify D Quantitate Date Form: FTB RPD-11-«2-1 FIELD DATA SHEET ENVIRONMENTAL PROTECTION AGENCY - Region II, Edison, New Jersey ENVIRONMENTAL SERVICES DIVISION Project Name _ Collector(s) £} C — Affiliation ./ / SAMPLING METHOD (Circle) Kemmerer Dredge Ponar Manual Niskin Net Seine Trawl Bucket Trowel Cream Dipper Automatic Other__ A u x LDMS CODE DATA BASE CODE. STA. TYPE CODE _ SUBSTRATE TYPE (Circle) Aqueous Qjedimenl^ Sludge Solvent Extract Other ( Oil Biological BOD — Seed Supplied D Yes D No Source: Sample Preparation (Circle) Glass_Jar Plastic Jar Metal POA Vial Cubitainer Acetate Core Paper Cap Teflon Cap Foil Cap Other____ Preservation Acid 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: X' " IL l ,-> ^ ' ~ \ ~> • I I c .'L-/.1"^ —/ Remarks: Form: FTB RPD-11-B2-2 TUT o i': Samples to: Bact Bio Chem Other Station No. Sample Depth (Ft.)/Fac. Loc. Code Lab Number . 109404 Type of Sample /3 / Sp 2- 7 Grab Composite Time Space Collection (Ending) Date Yr ^ MC; C h Day - if Ending Time (24 Hr) Beginning Date Yrr Mo Day Beginning Time (24 Hr) r pH Sample Temp. (°C) DO (mg/l) Cond. (uMHOS/CM) Salinity(%,) Sample Split s D No If Yes With Whom? Receipt D Yes O No ANALYSIS ENVIRONMENTAL PROTECTION AGENCY Environmental Services Division • Date of Request II Source of Sample^) /^ /'/ / . />/• .' • ,'" / ..' / Sf»mpl« Numbftr(s) 7^?^**^^ Type of Sample D Water $/ Sediment D Oil D Air PHYSICAL CHARACTERISTICS D Turbidity D Color n Volatile Solids D Total Solids D Total Suspended Solids n Dissolved Solids D Volatile Suspended Solids D Settleable Solids ORGANIC/ DEMAND ANALYSES n Hay BOD D Phnnnl D COD D Pesticides D TOC D Herbicides D TOD D Long-term O, Demand (Carbon) D PCB's D Long-term O, Demand (Total) D Total D Volatile Acids D Specific Aroclors D Oil (Identify) INORGANIC ANALYSES D pH D Alkalinity D D Conductivity D CO, D X_^ D Salinity D Total D D Chloride D HCO, D D SO. D Chlorine Demand D D SO, D Chlorine Residual D D Dissolved S D Free D D Hardness D Total D D Ca D Acidity D D Mg D Free D D Total /METHOD D Total D SENSITIVITY / METHOD D COD D Phosphorous D High Level ( > 50 mg/l) D Total D Low Level ( < 50 mg/l) D Dissolved MICROBIOLOGY MF MPN Est. Range TO n n n Clostridium perf FC n n n Mutagenlcity Te FR n n n A mo* Test D Pathogens D Viral Enhan D Bacterial D Other (Spec D Viral D ATP RaniiAstarl hv f '/' * ''' Oatn REQUEST CHEM Bl° BACT OTHER EDISON, N.J. Priority D Immediate D Normal D Deferred .'\ ' , / .-•'.'• / ' • • • ' ',''': ' ^/^V ^ £ ? </ D Other (Specify) D Specific Gravity D Corrosivity (RCRA) n Viscosity n Other D % Solids D Ignitability (RCRA) C('Priorlty Pollutants D Specific Compound n POA .' / ' f l~l Identify D NVOA ' D Other Major Peaks D EPToxicity n Ouantitate D Pesticides D Herbicides D Oil & Grease (Quantitate) TKN D Cd D Ba Org N D Co D Se NH,-N D Cu D Ag NO,-N D Pb D Asbestos NOj-N D Zn D Hexavalent Cr Total P D Fe AH-P D Cr Ortho-P D As Metal Scan D CN- EP Toxiclty (Metals) D F- Hg D Ni D Phenol D Metals D 0-1,000ppb D Total D Above 1 ,000 ppb D Dissolved D Low Sensitivity n High Sensitivity BIOLOGY D Static ringes D 24 Hour Bioassay D Flow-Through sts D 4B Hour Bioassay D Static Replacement D 96 Hour Bioassay D Laboratory cement D Chronic Bioassay D On Site ify) D Benthos ID D Identify D Fish ID D Quantitate Apprnwarf hy Plata Remarks Form: FTB RPD-11-82-1 FIELD DATA SHEET ENVIRONMENTAL PROTECTION AGENCY • Region II, Edison, New Jersey ENVIRONMENTAL SERVICES DIVISION Project Name Collectors) X-- _L . Affiliation 6 SAMPLING METHOD (Circle) Kemmerer Dredge Ponar Manual Niskin Net Seine Trawl Bucket Trowel Cream Dipper Automatic ± LDMS CODE DATA BASE CODE. STA. TYPE CODE _ SUBSTRATE TYPE (Circle) Sediment J Sludge let Other ( Oil Biological Samples to: Bact Bio Chem Other Station No. Sample Depth (Ft.)/Fac. Loc. Code Lab Number 109403 BOD — Seed Supplied D Yes D No Source: Sample Preparation (Circle) ^Container- Glass Jar/ tesWe-tfar Metal POA Vial Cubitainer Acetate Core Paper Cap Teflon Cap Foil Cap Other Preservation Acid__ Solvent_ Chemical. Wet lce_. ~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: Oihar: Storage Tank Top Middle Bottom Truck Drum Tank Other. Wells Monitoring Production Drinking Private Type of Sample '.~ «• ""> Grab Composite 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: t-2 If Remarks: Form: FTB RPO-11-82-2 Time Space Collection (Ending) Date Yr , ' \\ Day . I:' Ending Time (24 Hr) / •? ^ i Beginning Date .Yr -JIT : h Day -' IV' Beginning Time (24 Hr) I '2 $ C Sample Split / O Yes D No If Yes With Whom? Receipt D Yes D No ANALYSIS REQUEST CHEM BIO. BACT OTHER ENVIRONMENTAL PROTECTION AGENCY Environmental Services Division EDISON, N.J. Date of Request. Source of Sample(s) (, Sample Priority D Immediate Normal D Deferred Type of Sample D Water < Sediment D Oil a Air DOther (Specify) PHYSICAL CHARACTERISTICS D Turbidity D Volatile Solids D Total Suspended Solids D Volatile Suspended Solids D Color D Total Solids D Dissolved Solids D Settleable Solids D Specific Gravity D Viscosity D % Solids D Ignitability (RCRA) D Corrosivity (RCRA) D Other________ ORGANIC/DEMAND ANALYSES n Hay ROD H D COD D D TOD D D PCB's D D Total D D Specific Aroclors D INORGANIC ANALYSES D pH D Conductivity \__x D Salinity D Chloride D SO. D SO, D Dissolved S D Hardness D Ca D Mg D Total/METHOD SENSITIVITY / METHOD D COD D High Level ( > 50 mg/l) D Low Level ( < 50 mg/l) Phenol Pesticides Herbicides _ _..._. ..._,-. . _ .._ ^/Priority Pollutants / D POA X"V /^ - {_ D NVOA^ —— D Other Maior Peaks D 'e* t> Long-term O, Demand (Carbon) D EP Toxicity Long-term O, Demand (Total) Volatile Acids Oil (Identify) D Alkalinity D CO, D Total D HCO, D Chlorine Demand D Chlorine Residual D Free n Total D Acidity D Free D Total D Phosphorous D Total D Dissolved D Pesticides D Herbicides D Oil & Grease (Quantitate) D TKN D OrgN D NH.-N D NO.-N D NO,-N D Total P D AH-P D Ortho-P D Metal Scan D EP Toxicity (Metals) D Hg D Phenol D 0-1,000ppb D Above 1,000 ppb D Cd D Co D Cu D Pb D Zn D Fe D Cr D As Specific Compound n Identify n QnanHtate D Ba D Se D Ag D Asbestos D Hexavalent Cr D CN- D F- D Ni D Metals D Total D Dissolved D Low Sensitivity D High Sensitivity MICROBIOLOGY MF MPN TC n n FC n n FS n n Est. Range D Pathogens D Bacterial D Viral Requnstftd hy ' Remarks Fofm: FTB RPD-11-82-1 : ',/ ^ f\^P'^ D Clostridlum perfringes D Mutagenicity Tests n Amfis Test D Viral Enhancement D Other (Specify) D ATP BIOLOGY D 24 Hour Bioassay D 48 Hour Bioassay D 96 Hour Bioassay D Chronic Bioassay D Benthos ID D Fish ID Rate Apprnvnd hy D Static D Flow-Through D Static Replacement D Laboratory D On Site D Identify D Quantitate natfl FIELD DATA SHEET ENVIRONMENTAL PROTECTION AGENCY • Region II, Edison, New Jersey ENVIRONMENTAL SERVICES DIVISION .- / • U'L M Project Name \_^' Collector(s) Ql ^' -^ ^T7 .ftfcH> J Affiliation | "7 (Q&. 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) Sludge Oil Solvent Extract Other ( Biological ) Samples to: Bact Bio Chem Other Station No. Sample Depth (Ft.)/Fac. Loc. Code it* Lab Number 109410 ••> BOD — Seed Supplied D Yes D No Source: Sample Preparation (Circle) Glass Jap SsficJar Metal POA Vial Cubltainer Acetate Core Paper Cap Teflon Cap Foil Cap Other____ Preservation Acid 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 Type of Sample f^. Grab ^ Composite Industrial Effluent Process Stream Holding Pond Drum Waste Pile Municipal Treatment Influent Effluent-CI Effluent-Non Cl Sludge Ambient Lake Stream Pond Ocean Estuary P'T Sample Location Description: x -- r> -- y- 2-0 Remarks: Form: FTB RPO-11-82-2 Time Space Collection (Ending) Date Yr I Mo I Day Ending Time (24 Hr) 0 Beginning Date Yr 1 Mo I Day | Beginning Time (24 Hr) Sample Split ^J2"Yes D No If Yes With Whom? Receipt D Yes D No 1 7 FIELD DATA SHEET ENVIRONMENTAL PROTECTION AGENCY - Region II, Edison, New Jersey ENVIRONMENTAL SERVICES DIVISION Project Name, Collector(s) CT rzfr D i .Affiliation CO/? 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 I Sediment Sludge ON Biological Solvent Extract Other ( ) BOD — Seed Supplied D Yes D No Source: Sample Preparation (Circle) ier sGlass. Plastic Jar Metal POA Vial Cubitainer Acetate Core Paper Cap Teflon Cap Foil Cap Other____ Preservation Acid ___ Solvent _ Chemical. et lce~~ 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: y r D ic <> <-- A '3 Remarks: 6- 6f-U<:A Form: FTB RPO-11-82-2 Samples to: Bact Bio Chem Other Station No. Sample Depth (Ft.)/Fac. Loc. Code 5 Lab Number 109409 Type of Sample Grab Cd slte Time Space Collection (Ending) Date r Mo 'lS 01 Ending Time (24 Hr) ^ I % <;t r Beginning Date Day Beginning Time (24 Hr) pH Sample Temp. DO (mg/l) Cond. (uMHOS/CM) Sallnity(%.) Sample Split ,JZf*1m D No If Yes With Whom? Receipt D Yes O No FIELD DATA SHEET ENVIRONMENTAL PROTECTION AGENCY - Region II, Edison, New Jersey ENVIRONMENTAL SERVICES DIVISION Project Name_X Collectors) 4^ Affiliation "7 f SAMPLING METHOD (Circle) Kemmerer Dredge Ponar Manual Niskin Net Seine Trawl Bucket Trowel Cream Dipper Automatic/- Other_L pper Y /"" C ^\ , / S - S ) 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) Glass eiastTcTjar Metal POA Vial Cubitainer Acetate Core Paper Cap Teflon Cap Foil Cap Other____ Preservation Acid Solvent _ ChfiinjcaL lce 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 , -r" I Sample Location Description: V 7V ! 1'Lc 3 /-'~ •, f - 4 > f -C+l Remarks: /=-«•'' CLC Form: FTB RPO-11-82 2 Samples to: Bact Bio Chem Other Station No. Sample Depth (Ft.)/Fac. Loc. Code "X-7 5 Lab Number 109405 Type of Sample/5y 5 W ~> Grab ___ Composite / ' I/ Time Space Collection (Ending) Date Ending Time (24 Hr) / / o Q Beginning Date r~LYrr L 1 S -o DaX-> 1 1 y Beginning Time (24 Hr) i 5s ?, Sample Split D No If Yes With Whom? Receipt D Yes O No A ". FIELD DATA SHEET ENVIRONMENTAL PROTECTION AGENCY - Region II, Edison, New Jersey ENVIRONMENTAL SERVICES DIVISION Project Name ( . Collector(s) (S* ^ i- 1C. <- .Affiliation T SAMPLING METHOD (Circle) Kemmerer Dredge Ponar Manual Niskin Net Seine Trawl Bucket Trowel Cream Dipper AutomaticA . / £~ n.h» ML't-V .1 I J" LDMS CODE DATA BASE CODE. STA. TYPE CODE _ SUBSTRATE TYPE (Circle) Aqueous Solvent Extract Sludge Other( Oil Biological BOD — Seed Supplied D Yes G No Source: Snt Sample Preparation (Circle) 4ass Plastic Jar Metal POA Vial Cubitainer Acetate Core Paper Cap Teflon Cap Foil Cap Other____ Preservation Acid Solvent 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 Industrial Effluent Process Stream Holding Pond Drum Waste Pile Municipal Treatment Influent Effluent-CI Effluent-Non Cl Sludge Ambient Lake Stream Pond Ocean Estuary Monitoring Production Drinking Private Sample Location Description Form: FTB HPD-11-82-2 Samples to: Bact Bio Chem Other Station No. Sample Depth (Ft.)/Fac. Loc. Code a -fc , -^ Lab Number 109408 " i———.— ^- —-. / -. Type of Sampl/-^ X ^>y :D Grab Composite / Time Space Collection (Ending) Date Ending Time (24 Hr) I 6'2 r Beginning Date Beginning Time (24 Hr) / L- L T Sample Split D No If Yes With Whom? Receipt D Yes D No 17 FIELD DATA SHEET ENVIRONMENTAL PROTECTION AGENCY - Region II, Edison, New Jersey ENVIRONMENTAL SERVICES DIVISION Project Name (.' K^r/Wc"-} t.L-fc/r{t-'J^/Z~ IV,ll«rtnr(«) (f\ /VV C tJ A /£_P Affiliation / ""7 C&f^jC* SAMPLING METHOD (Circle) Kemmerer Dredge Ponar Manual Niskin Net Seine Trawl Bucket (frowej; Cream Dipper Automatic Other 1 DMS CODF DATA BASE C( STA. TYPE CO 1DF IF 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^ Metal POA Vial Cubitainer Acetate Core Paper Cap Teflon Cap Foil Cap Other s~— ' 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 Location Description: i/- - r^" V ( ~ C 7\~) ~> - V'' -^ p ^ C J fl * Remarks: /- !) 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 J^V/" A i, ft 7/u •- ppry.^A., Lf^cL^ \ / • •// / Samples to: Bact Bio Chem Other Station No. Sample Depth (Ft.)/Fac. Loc. Code 9- ^ V .^ Lab Number • ( v 109407- / o^ Type of Sample /~^-^>C^ 2 -3 Grab ^^Jomposite ' I/ Time Space Collection (Ending) Date / 5 '/J°> r^ 1 ———— ' -•- •- '/ ' Ending Time (24 Hr) ' / 6 d C 1 Beginning Date (TV ,Mo c-B C ?|^? / Beginning Time (24 Hr) ( / ^ / ( PH Sample Temp. <?C) DO (mg/l) 3ond. (uMHOS/CM) Sallnlty(%.) C«k«kHlA C*»*II4 D No If Yes With Whom? Receipt D Yes D No Form. FTB RPD-11-82-2 J7 FIELD DATA SHEET ENVIRONMENTAL PROTECTION AGENCY - Region II, Edison, New Jersey ENVIRONMENTAL SERVICES DIVISION Project Name. Collector(s) _ £/J Affiliation SAMPLING METHOD (Circle) Kemmerer Dredge Ponar Manual Niskin Net Seine Trawl BucKet Cream Dipper matic 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) ; Glass fJar Metal POA Vial Cubitainer Acetate Core Paper Cap Teflon Cap Foil Cap Other____ Preservation Acid__ Solvent. Chemical. (.Wet Ice, Dry Fee 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 C'/f P'T Sample Location Description: Y 6 - > 0 ••c Remarks: h ccf- Font): FTB HPD-11-82-2 Samples to: Bact Bio Chem Other Station No. Sample Depth (Ft.)/Fac. Loc. Code Lab Number Type of Sample Grat;___Compo V ^ site V Time Space Collection (Ending) Date Ending Time (24 Hr) Beginning Date [ Beginning Time (24 Hr) •> ) PH Sample Temp. DO (mg/l) Cond. (uMHOS/CM) SalinityfVo.) Sample Split D No If Yes With Whom? Receipt D Yes D No JT CHAIN OF CUSTODY RECORD ENVIRONMENTAL PROTECTION AGENCY - REGION II Environmental Services W. vision EDISON, NEW JERSEY 01117 N... .. u.. ..d Add,.- ?* C , u Sample Number Number of Containers! Desert pt)*n *l S OIK pies 33 / - 0 ?r \ f\ // £ >- I L,u,rC'| Ptvson Assuming Responsibility far Sample: O 10 Dale Sample Number R*linqui)h«d By: Received By: Date Reaten far Ckantje of Custody Sompl* Numbtr Rtlinquiihtd By: Received By: Time Dote Reason far Change of Custody Sample Number R«linquish«d By: Received By: Time Date Reason lor Change of Custody Sampl* Number Relinquished By: Received By: Time Date Roasdn for Change of Custody N*. CHAIN OF CUSTODY RECORD ENVIRONMENTAL PROTECTION AOENCY - REGION II Environmental Services Division EDISON, NEW JERSEY OM17 Nome ol Unit and Address: /O #5/3 <-j Sample Number Number ol Containers Description el Samples B- 5 \}">~ Person Assuming Responsibility for Sample: 'M Time / fa* Sampl* Numb*r R*linqui»h«d R«c*iv«d fty: Tim. R»i*n lor Chan|« el Custody Sampl* Nvmbtr Rftlinquishtd By: Received ly: Timt Date Reosen ler Change ef Custody Sample Number Relinquished By: Received By: Date Reason lor Change ol Custody Sample Number Relinquished By: Received By: Date Reason for Change ol Custody •og. Ne.