environment a l testing s e rvices

• SClnde;rsl""""=-\ Laboratories Environment a l Testing S e rvices

Ft. Myers Lab02

10090 Bavaria Rd.

Fort Myers, FL 33913

TEL: (239) 590-0337 FAX: (239) 590-0536

Website: www.sanderslabs.net

Jon Meyer

MSKP Town and Country Utility, LLC

12150 S.R. 31

Babcock Ranch, FL 33982

TEL: (561) 624-4000

FAX: (561) 799-2353

RE: PFAS Testing Order No.: 2001884

Dear Jon Meyer:

Sanders Laboratories, Inc received 2 sample(s) on 1/23/2020 for the analyses presented in the

following report.

These results only pertain to the samples as received. These pages may include, but are not

limited to: Analytical Data, Chains of Custodies, Subcontracted Data and Case Narratives for

samples. Results relate only to the samples in the report.

Reports are archived for a minimum of 5 years. Copies of reports are available for a fee of

$50.00. Copies will be provided within 2 weeks of the time of the request.

Laboratory PQL's are available upon request.

Test results meet all the requirements of the NELAP standards, unless otherwise noted.

Nokomis Certificate # E84380 Fort Myers Certificate # E85457

A statement of estimated uncertainty of results is available upon request.

Laboratory report shall not be reproduced except in full, without the written approval of Sanders

Laboratories.

Sanders Laboratories follows DEP standard operating procedures for field sampling, unless

otherwise noted.

Katie Strothman

Laboratory Director

Revision v1 of 2

www.sanderslabs.net

A Sc.nde;r:s l~\ Laboratories Env1ronmentol Testing Services

Ft. Myers Lab02 Definition Only

10090 Bavaria Rd.

Fort Myers, FL 33913 WO#: 2001884 TEL: (239) 590-0337 FAX: (239) 590-0536

Date: Website: www.sanderslabs.net

Definitions:

B: Results based upon colony counts outside the acceptable range.

G: Sample value indicates that the analyte was detected at or above the method detection limit in both

the sample and the associated field blank, equipment blank, or trip blank, and the blank value was

greater than 10% of the associated sample value. The value in the blank shall not be subtracted from

associated samples.

I: The reported value is greater than or equal to the laboratory MDL but less than the laboratory PQL.

J: Estimated Value.

J7: Excessive amounts of Sodium Sulfite used to dechlorinate the sample due to high levels of chlorine

present.

K: Off scale low, actual value is known to be less than the value given.

L: Off scale high, actual value is known to be greater than the value given.

NC: Not Certified. Parameter was ran but is not covered under laboratory accredited scopes.

Q: Sample held beyond acceptable holding time.

U: The compound was analyzed for, but not detected.

V: Indicates that the analyte was detected at or above the MDL in both the sample and the associated

method blank and the value of 10 times the blank value was equal to or greater than the associated

sample value.

Y: The laboratory analysis was from an improperly preserved sample.

Z: Too many colonies were present for accurate counting.

Revision v1

of 2

www.sanderslabs.net

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Pace Analytical Services, LLC 8 East Tower Circle

Ormond Beach, FL 32174 (386)672-5668

February 04, 2020

Tami BrightSanders Laboratories, Inc. 1050 Endeavor Court Nokomis, FL 34275

RE: Project: 2001884 Pace Project No.: 35526328

Dear Tami Bright: Enclosed are the analytical results for sample(s) received by the laboratory on January 24, 2020. The results relate only to the samples included in this report. Results reported herein conform to the most current, applicable TNI/NELAC standards and the laboratory's Quality Assurance Manual, where applicable, unless otherwise noted in the body of the report.

If you have any questions concerning this report, please feel free to contact me.

Sincerely,

Sakina Mckenzie [email protected] (386)672-5668Project Manager

Enclosures

cc: Katie Strothman, Sanders Katie Strothman, Sanders Laboratories, Inc.

REPORT OF LABORATORY ANALYSIS This report shall not be reproduced, except in full,

without the written consent of Pace Analytical Services, LLC. Page 1 of 12

mailto:[email protected]

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Ormond Beach, FL 32174 (386)672-5668

CERTIFICATIONS

Project: 2001884 Pace Project No.: 35526328

Pace Analytical Services Ormond Beach 8 East Tower Circle, Ormond Beach, FL 32174 Alaska DEC- CS/UST/LUST Alabama Certification #: 41320 Arizona Certification# AZ0819 Colorado Certification: FL NELAC Reciprocity Connecticut Certification #: PH-0216 Delaware Certification: FL NELAC Reciprocity Florida Certification #: E83079 Georgia Certification #: 955 Guam Certification: FL NELAC Reciprocity Hawaii Certification: FL NELAC Reciprocity Illinois Certification #: 200068 Indiana Certification: FL NELAC Reciprocity Kansas Certification #: E-10383 Kentucky Certification #: 90050 Louisiana Certification #: FL NELAC Reciprocity Louisiana Environmental Certificate #: 05007 Maryland Certification: #346 Michigan Certification #: 9911 Mississippi Certification: FL NELAC Reciprocity

Missouri Certification #: 236 Montana Certification #: Cert 0074 Nebraska Certification: NE-OS-28-14 New Hampshire Certification #: 2958 New Jersey Certification #: FL022 New York Certification #: 11608 North Carolina Environmental Certificate #: 667 North Carolina Certification #: 12710 North Dakota Certification #: R-216 Oklahoma Certification #: D9947 Pennsylvania Certification #: 68-00547 Puerto Rico Certification #: FL01264 South Carolina Certification: #96042001 Tennessee Certification #: TN02974 Texas Certification: FL NELAC Reciprocity US Virgin Islands Certification: FL NELAC Reciprocity Virginia Environmental Certification #: 460165 West Virginia Certification #: 9962C Wisconsin Certification #: 399079670 Wyoming (EPA Region 8): FL NELAC Reciprocity



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Ormond Beach, FL 32174 (386)672-5668

SAMPLE SUMMARY


Lab ID Sample ID Matrix Date Collected Date Received

35526328002 2001884-001 Blank Water 01/23/20 07:25 01/24/20 12:00

35526328003 2001884-002 Water 01/23/20 07:25 01/24/20 12:00



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Ormond Beach, FL 32174 (386)672-5668

SAMPLE ANALYTE COUNT


Lab ID Sample ID Method Analysts Analytes Reported Laboratory

35526328002 2001884-001 Blank EPA 537.1 SWR 22 PASI-O

35526328003 2001884-002 EPA 537.1 SWR 22 PASI-O



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ANALYTICAL RESULTS


Sample: 2001884-001 Blank Lab ID: 35526328002 Collected: 01/23/20 07:25 Received: 01/24/20 12:00 Matrix: Water

Parameters Results Units PQL MDL DF Prepared Analyzed CAS No. Qual

537.1 PFAS Compounds, Water Analytical Method: EPA 537.1 Preparation Method: EPA 537.1

11Cl-PF3OUdS 0.00073 U ug/L 0.0038 0.00073 1 01/28/20 10:23 01/29/20 22:45 763051-92-9 9Cl-PF3ONS 0.00050 U ug/L 0.0038 0.00050 1 01/28/20 10:23 01/29/20 22:45 756426-58-1 ADONA 0.00071 U ug/L 0.0038 0.00071 1 01/28/20 10:23 01/29/20 22:45 919005-14-4 HFPO-DA 0.0016 U ug/L 0.0038 0.0016 1 01/28/20 10:23 01/29/20 22:45 13252-13-6 NEtFOSAA 0.00091 U ug/L 0.0038 0.00091 1 01/28/20 10:23 01/29/20 22:45 2991-50-6 NMeFOSAA 0.0015 U ug/L 0.0038 0.0015 1 01/28/20 10:23 01/29/20 22:45 2355-31-9 Perfluorobutanesulfonic acid 0.00065 U ug/L 0.0038 0.00065 1 01/28/20 10:23 01/29/20 22:45 375-73-5 Perfluorodecanoic acid 0.00099 U ug/L 0.0038 0.00099 1 01/28/20 10:23 01/29/20 22:45 335-76-2 Perfluorohexanoic acid 0.0012 U ug/L 0.0038 0.0012 1 01/28/20 10:23 01/29/20 22:45 307-24-4 Perfluorododecanoic acid 0.0012 U ug/L 0.0038 0.0012 1 01/28/20 10:23 01/29/20 22:45 307-55-1 Perfluoroheptanoic acid 0.00099 U ug/L 0.0038 0.00099 1 01/28/20 10:23 01/29/20 22:45 375-85-9 Perfluorohexanesulfonic acid 0.00072 U ug/L 0.0038 0.00072 1 01/28/20 10:23 01/29/20 22:45 355-46-4 Perfluorononanoic acid 0.0014 U ug/L 0.0038 0.0014 1 01/28/20 10:23 01/29/20 22:45 375-95-1 Perfluorooctanesulfonic acid 0.0012 U ug/L 0.0038 0.0012 1 01/28/20 10:23 01/29/20 22:45 1763-23-1 Perfluorooctanoic acid 0.00086 U ug/L 0.0038 0.00086 1 01/28/20 10:23 01/29/20 22:45 335-67-1 Perfluorotetradecanoic acid 0.0018 U ug/L 0.0038 0.0018 1 01/28/20 10:23 01/29/20 22:45 376-06-7 J(L1) Perfluorotridecanoic acid 0.00079 U ug/L 0.0038 0.00079 1 01/28/20 10:23 01/29/20 22:45 72629-94-8 Perfluoroundecanoic acid 0.0012 U ug/L 0.0038 0.0012 1 01/28/20 10:23 01/29/20 22:45 2058-94-8 Surrogates 13C2-PFDA (S) 111 % 70-130 1 01/28/20 10:23 01/29/20 22:45 13C2-PFHxA (S) 98 % 70-130 1 01/28/20 10:23 01/29/20 22:45 NEtFOSAA-d5 (S) 104 % 70-130 1 01/28/20 10:23 01/29/20 22:45 HFPO-DAS (S) 87 % 70-130 1 01/28/20 10:23 01/29/20 22:45

Sample: 2001884-002 Lab ID: 35526328003 Collected: 01/23/20 07:25 Received: 01/24/20 12:00 Matrix: Water



11Cl-PF3OUdS 0.00072 U ug/L 0.0038 0.00072 1 01/28/20 10:23 01/29/20 23:03 763051-92-9 Y 9Cl-PF3ONS 0.00049 U ug/L 0.0038 0.00049 1 01/28/20 10:23 01/29/20 23:03 756426-58-1 Y ADONA 0.00070 U ug/L 0.0038 0.00070 1 01/28/20 10:23 01/29/20 23:03 919005-14-4 Y HFPO-DA 0.0016 U ug/L 0.0038 0.0016 1 01/28/20 10:23 01/29/20 23:03 13252-13-6 Y NEtFOSAA 0.00089 U ug/L 0.0038 0.00089 1 01/28/20 10:23 01/29/20 23:03 2991-50-6 Y NMeFOSAA 0.0015 U ug/L 0.0038 0.0015 1 01/28/20 10:23 01/29/20 23:03 2355-31-9 Y Perfluorobutanesulfonic acid 0.00064 U ug/L 0.0038 0.00064 1 01/28/20 10:23 01/29/20 23:03 375-73-5 Y Perfluorodecanoic acid 0.00097 U ug/L 0.0038 0.00097 1 01/28/20 10:23 01/29/20 23:03 335-76-2 Y Perfluorohexanoic acid 0.0012 U ug/L 0.0038 0.0012 1 01/28/20 10:23 01/29/20 23:03 307-24-4 Y Perfluorododecanoic acid 0.0012 U ug/L 0.0038 0.0012 1 01/28/20 10:23 01/29/20 23:03 307-55-1 Y Perfluoroheptanoic acid 0.00097 U ug/L 0.0038 0.00097 1 01/28/20 10:23 01/29/20 23:03 375-85-9 Y Perfluorohexanesulfonic acid 0.00071 U ug/L 0.0038 0.00071 1 01/28/20 10:23 01/29/20 23:03 355-46-4 Y Perfluorononanoic acid 0.0013 U ug/L 0.0038 0.0013 1 01/28/20 10:23 01/29/20 23:03 375-95-1 Y Perfluorooctanesulfonic acid 0.0012 U ug/L 0.0038 0.0012 1 01/28/20 10:23 01/29/20 23:03 1763-23-1 Y Perfluorooctanoic acid 0.00084 U ug/L 0.0038 0.00084 1 01/28/20 10:23 01/29/20 23:03 335-67-1 Y


Date: 02/04/2020 10:02 AM without the written consent of Pace Analytical Services, LLC. Page 5 of 12

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Ormond Beach, FL 32174 (386)672-5668

ANALYTICAL RESULTS


Sample: 2001884-002 Lab ID: 35526328003 Collected: 01/23/20 07:25 Received: 01/24/20 12:00 Matrix: Water



Perfluorotetradecanoic acid Perfluorotridecanoic acid Perfluoroundecanoic acid Surrogates 13C2-PFDA (S) 13C2-PFHxA (S) NEtFOSAA-d5 (S) HFPO-DAS (S)

0.0018 U 0.00077 U 0.0012 U

103 99 99 96

ug/L ug/L ug/L

% % % %

0.0038 0.0038 0.0038

70-130 70-130 70-130 70-130

0.0018 0.00077

0.0012

1 1 1

1 1 1 1

01/28/20 10:23 01/28/20 10:23 01/28/20 10:23

01/28/20 10:23 01/28/20 10:23 01/28/20 10:23 01/28/20 10:23

01/29/20 23:03 376-06-7 01/29/20 23:03 72629-94-8 01/29/20 23:03 2058-94-8

01/29/20 23:03 01/29/20 23:03 01/29/20 23:03 01/29/20 23:03

J(L1),Y Y Y



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----------------------------------------


Ormond Beach, FL 32174 (386)672-5668

QUALITY CONTROL DATA


QC Batch: 605365 Analysis Method: EPA 537.1 QC Batch Method: EPA 537.1 Analysis Description: 537.1 PFOA Compounds, Water Associated Lab Samples: 35526328002, 35526328003

METHOD BLANK: 3290171 Matrix: Water Associated Lab Samples: 35526328002, 35526328003

Blank Parameter Units

Reporting Result Limit MDL Analyzed

11Cl-PF3OUdS ug/L 0.00077 U 0.0040 0.00077 01/29/20 18:13 9Cl-PF3ONS ug/L 0.00052 U 0.0040 0.00052 01/29/20 18:13 ADONA ug/L 0.00074 U 0.0040 0.00074 01/29/20 18:13 HFPO-DA ug/L 0.0017 U 0.0040 0.0017 01/29/20 18:13 NEtFOSAA ug/L 0.00095 U 0.0040 0.00095 01/29/20 18:13 NMeFOSAA ug/L 0.0016 U 0.0040 0.0016 01/29/20 18:13 Perfluorobutanesulfonic acid ug/L 0.00068 U 0.0040 0.00068 01/29/20 18:13 Perfluorodecanoic acid ug/L 0.0010 U 0.0040 0.0010 01/29/20 18:13 Perfluorododecanoic acid ug/L 0.0013 U 0.0040 0.0013 01/29/20 18:13 Perfluoroheptanoic acid ug/L 0.0010 U 0.0040 0.0010 01/29/20 18:13 Perfluorohexanesulfonic acid ug/L 0.00075 U 0.0040 0.00075 01/29/20 18:13 Perfluorohexanoic acid ug/L 0.0013 U 0.0040 0.0013 01/29/20 18:13 Perfluorononanoic acid ug/L 0.0014 U 0.0040 0.0014 01/29/20 18:13 Perfluorooctanesulfonic acid ug/L 0.0012 U 0.0040 0.0012 01/29/20 18:13 Perfluorooctanoic acid ug/L 0.00089 U 0.0040 0.00089 01/29/20 18:13 Perfluorotetradecanoic acid ug/L 0.0019 U 0.0040 0.0019 01/29/20 18:13 Perfluorotridecanoic acid ug/L 0.00082 U 0.0040 0.00082 01/29/20 18:13 Perfluoroundecanoic acid ug/L 0.0012 U 0.0040 0.0012 01/29/20 18:13 13C2-PFDA (S) % 99 70-130 01/29/20 18:13 13C2-PFHxA (S) % 98 70-130 01/29/20 18:13 HFPO-DAS (S) % 92 70-130 01/29/20 18:13 NEtFOSAA-d5 (S) % 96 70-130 01/29/20 18:13

Qualifiers

LABORATORY CONTROL SAMPLE & LCSD: 3290172 3290173 Spike LCS LCSD LCS LCSD % Rec Max

Parameter Units Conc. Result Result % Rec % Rec Limits RPD RPD Qualifiers

11Cl-PF3OUdS ug/L 0.008 0.0096 0.0094 120 117 70-130 3 30 9Cl-PF3ONS ug/L 0.008 0.0086 0.0085 108 106 70-130 1 30 ADONA ug/L 0.008 0.0082 0.0089 103 112 70-130 8 30 HFPO-DA ug/L 0.008 0.0061 0.0090 76 113 70-130 39 30 J(R1) NEtFOSAA ug/L 0.008 0.0096 0.0088 120 110 70-130 8 30 NMeFOSAA ug/L 0.008 0.0076 0.0089 94 112 70-130 17 30 Perfluorobutanesulfonic acid ug/L 0.008 0.0078 0.0090 98 113 70-130 15 30 Perfluorodecanoic acid ug/L 0.008 0.0081 0.0084 102 106 70-130 4 30 Perfluorododecanoic acid ug/L 0.008 0.0097 0.0094 122 117 70-130 4 30 Perfluoroheptanoic acid ug/L 0.008 0.0092 0.0098 116 122 70-130 6 30 Perfluorohexanesulfonic acid ug/L 0.008 0.0078 0.0085 98 106 70-130 8 30 Perfluorohexanoic acid ug/L 0.008 0.0072 0.0082 90 102 70-130 13 30 Perfluorononanoic acid ug/L 0.008 0.0098 0.0096 122 120 70-130 2 30 Perfluorooctanesulfonic acid ug/L 0.008 0.0079 0.0079 99 98 70-130 1 30

Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.



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Ormond Beach, FL 32174 (386)672-5668

QUALITY CONTROL DATA


LABORATORY CONTROL SAMPLE & LCSD: 3290172 3290173 Spike LCS LCSD LCS LCSD % Rec Max

Parameter Units Conc. Result Result % Rec % Rec Limits RPD RPD Qualifiers

Perfluorooctanoic acid ug/L 0.008 0.0080 0.0084 100 105 70-130 5 30 Perfluorotetradecanoic acid ug/L 0.008 0.011 0.010 136 126 70-130 8 30 J(L1) Perfluorotridecanoic acid ug/L 0.008 0.010 0.0095 126 118 70-130 6 30 Perfluoroundecanoic acid ug/L 0.008 0.010 0.0097 124 122 70-130 2 30 13C2-PFDA (S) % 99 106 70-130 13C2-PFHxA (S) % 82 94 70-130 HFPO-DAS (S) % 93 83 70-130 NEtFOSAA-d5 (S) % 87 92 70-130

LABORATORY CONTROL SAMPLE:

Parameter

11Cl-PF3OUdS 9Cl-PF3ONS ADONA HFPO-DA NEtFOSAA NMeFOSAA Perfluorobutanesulfonic acid Perfluorodecanoic acid Perfluorododecanoic acid Perfluoroheptanoic acid Perfluorohexanesulfonic acid Perfluorohexanoic acid Perfluorononanoic acid Perfluorooctanesulfonic acid Perfluorooctanoic acid Perfluorotetradecanoic acid Perfluorotridecanoic acid Perfluoroundecanoic acid 13C2-PFDA (S) 13C2-PFHxA (S) HFPO-DAS (S) NEtFOSAA-d5 (S)

3290174

Units

ug/L ug/L ug/L ug/L ug/L ug/L ug/L ug/L ug/L ug/L ug/L ug/L ug/L ug/L ug/L ug/L ug/L ug/L % % % %

Spike Conc.

0.002 0.002 0.002 0.002 0.002 0.002 0.002 0.002 0.002 0.002 0.002 0.002 0.002 0.002 0.002 0.002 0.002 0.002

LCS LCS Result % Rec

0.0019 I 94 0.0020 I 102 0.0021 I 106

0.0017 U 74 0.0013 I 64 0.0020 I 98 0.0023 I 114 0.0022 I 110 0.0023 I 116 0.0024 I 118 0.0020 I 100 0.0022 I 108 0.0024 I 118 0.0018 I 92 0.0021 I 104 0.0026 I 128 0.0023 I 114 0.0024 I 122

104 93 93 94

% Rec Limits Qualifiers

50-150 50-150 50-150 50-150 50-150 50-150 50-150 50-150 50-150 50-150 50-150 50-150 50-150 50-150 50-150 50-150 50-150 50-150 70-130 70-130 70-130 70-130

Results presented on this page are in the units indicated by the "Units" column except where an alternate unit is presented to the right of the result.



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QUALIFIERS


DEFINITIONS

DF - Dilution Factor, if reported, represents the factor applied to the reported data due to dilution of the sample aliquot. ND - Not Detected at or above adjusted reporting limit. TNTC - Too Numerous To Count MDL - Adjusted Method Detection Limit. PQL - Practical Quantitation Limit. RL - Reporting Limit - The lowest concentration value that meets project requirements for quantitative data with known precision and bias for a specific analyte in a specific matrix. S - Surrogate 1,2-Diphenylhydrazine decomposes to and cannot be separated from Azobenzene using Method 8270. The result for each analyte is a combined concentration. Consistent with EPA guidelines, unrounded data are displayed and have been used to calculate % recovery and RPD values. LCS(D) - Laboratory Control Sample (Duplicate) MS(D) - Matrix Spike (Duplicate) DUP - Sample Duplicate RPD - Relative Percent Difference NC - Not Calculable. SG - Silica Gel - Clean-Up U - Indicates the compound was analyzed for, but not detected. N-Nitrosodiphenylamine decomposes and cannot be separated from Diphenylamine using Method 8270. The result reported for each analyte is a combined concentration. Pace Analytical is TNI accredited. Contact your Pace PM for the current list of accredited analytes. TNI - The NELAC Institute.

LABORATORIES

PASI-O Pace Analytical Services - Ormond Beach

WORKORDER QUALIFIERS

WO: 35526328 [1] The laboratory analysis was from an improperly preserved sample. The data may not be accurate.

ANALYTE QUALIFIERS

I The reported value is between the laboratory method detection limit and the laboratory practical quantitation limit. U Compound was analyzed for but not detected. J(L1) Estimated Value. Analyte recovery in the laboratory control sample (LCS) was above QC limits. Results for this analyte in

associated samples may be biased high. J(R1) Estimated Value. RPD value was outside control limits. Y The laboratory analysis was from an improperly preserved sample. The data may not be accurate.



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Ormond Beach, FL 32174 (386)672-5668

QUALITY CONTROL DATA CROSS REFERENCE TABLE


Lab ID Sample ID QC Batch Method QC Batch Analytical Method Analytical Batch

35526328002 35526328003

2001884-001 Blank 2001884-002

EPA 537.1 EPA 537.1

605365 605365

EPA 537.1 EPA 537.1

605739 605739



Clf AlN OF C.JTSTOnv Rli'.rn on l Omeg• COCID 11546 I PA.GI:: l I OF: 1 ADDRESS Ft. Myers Lab02

1()()90 BCTVaria Rd_

FonMyers.FL 33913 TEL: (239) 590-0337 FAX: (239) 590-0536

Website: www.sanderslabs.net

Sonders.Q Laboratories

W0#:36626328 UJJ."Jll 11111111111

sus coN'!llAroRcPace COMPANY: Pace Analytical ADDRESS:

8 Eut Tower Circle

cITY, STA1E.ZlP: Ormond Beach, FL 32174

PHONE: (386) 676-4837 FAX: (386) 673-40()1 EMAIL:

ACCOv'NT#:

ITEM # SA.\lPLEID I Cl.lENT SAMPLE TO I BOTTLE T'fJ>E I MA.TRJX I 2001884-00lA IFRB I !Deionized W'ater I 1 See Attached

2001884-002A jOISTRIBVTION WAI !Deionized Water I 2 See Attached

Rdinquisloo Bye

R,Jinqllish<d By:

SP£ClAL =nuJCTI(l,:S I a)MM£Ni'S:

DAU COlLECTED I NUMBER Of I COMMEN'ra: Mcihard Pr...erved Weights COITTAINRRS IUf Sample Notabon, Addilinnal Simple Descrip6:n.

1/23/2020 7:25:00 AMI 1 I PFAS BY 537, PFAS BY 537 EQUIPMENT BLANK --

1/23/2020 7:25:00 AM] 1 I PFAS BY 537, PFAS BY 537 EQUIPMENT BLANK

REPORT TRA..."ISMITTAL DESIRED:

0 HAADCOPY(<Xlnrool) !] FAX □ EMAIL

Re-Jinqlli&hedBy Tune: R=ivod By. Dale: TmHO.

T,:mp oflamples TAT: Sbmdud 0 RUSH NcxtBD 0 2ndBD O ltd.BO 0

Page 11 of 12

r el;l,:,:~!r.f.~Cf!!.(.,.

Project#

Project Manager:

Client:

Thermometer Used:

Document Name: Sample Condition Upon Receipt Form

u ocument No.: F-FL-C-007 rev. 13

- -W0#:35526328 PM: SMM Du• Qa\e: 02/14/20

CLIENT: SANLA&

Time:

uocument 1-<ev1sed: May 30, 2018

1ssu1ng Aulnort!y: Pace Florida Quality Office

(SCUR)

Date and Initials of person: Examining contents: d)"') I Label: _______ _ f7 __ _ Deliver: __________ _

taOD I

pH:. ______ -,-_ _ _

Initials: _-1-f{!-<..:._{J ____ _ State of 0?9in:

Cooler #1 Temp.'C / l?-'5(Visual)

For ~Jects all containers verified to $6 "C

f:- (,) (Correction Factor) t IJ- j (Actual) D Samples on ice, cooling process has begun

Cooler #2 Temp:C ____ (Visual) ____ (Correction Factor) _ _ ___ (Actual) D Samples on ice, cooling process has begun

Cooler #3 Temp:C ____ (Visual) ____ (Correction Factor) ___ __ (Actual)

Cooler#4 Temp.'C (Visual) ____ (Correction Factor) (Actual)

Cooler#S Temp.'C (Visual) ____ (Correction Factor) (Actual)

Cooler #6 Temp.'C (Visual) ____ (Correction Factor) (Actual)

Courier: ~ ed Ex D UPS D USPS D Client D Commercial D Pace

D samples on ice, cooling process has begun

D Samples on ice, cooling process has begun



D Other _ ________ _

Shipping Me,d: , □ F1rsl Overnight

D other

□ Priority Overnight □ Standard Overnight_rround □ International Priority

Billing: r/ Unknown

Tracking#

Custody Sear on Cooler/Box Present: □Yes No _ / Seals intact

Packing Material: □Bubble Wrap D Bubble Bags 9None □Other ___ _

D Yes 0No Blue Dry None

tt.J>~ r \)(;flj1i\Kb Samples shorted to lab (If Yes, complete) Shorted Date: _______ _ Qty: __ _ Shorted Time: ----

Chain of Custody Present

Chain of Custody Filled Out

Relinquished Signature & Sampler Name COC

Samples Arrived within Hold Time

Rush TAT requested on COC

Sufficient Volume

Correct Containers Used

Containers I nlacl Sample Labels match COC (sample IDs & date/time of collection)

All containers needing acid/base preservation have been checked.

All Containers needing preservation are found to be in compliance with EPA recommendation:

D No ON/A

□ No ON/A

□ No ON/A

J.ffes □ No □NIA

□Yes

□Yes

□ No □NIA

□ No □NIA

□ No ~IA

□ No ~A Exceptions: VOA, Coliform, TOC, O&G. Carbamates

Headspace in VOA Vials? ( >6mm): □Yes □ No ~A

Trip Blank Present: □Yes □ No IA

Client Notification/ Resolution: Person Contacted: - - ------------

Comments:

Preservation Information: Preservative: _ ____ _ ____ _ Lot#rTrace #: _ _ _ _ ___ _ _ _ _ Dale: ______ Time: _____ _

Initials:

Date/Time: _______________ __ _

\ /?; 531) fu:- ID,~\g .\ w l( Dl H2,0'"'

Project Manager Review: Date: _ ___ ________ _

Page 12 of 12

environment a l testing s e rvices

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