2014-06-20_PERMIT FILE - M1980131

• Permit No: M1980131
• IBM Index Class Name: Permit File
• Doc Date: 6/20/2014
• Doc Name: Fuel Leak Report
• From: CDPHE
• To: Elam Construction
• Email Name: SJM
• Media Type: D
• Archive: No

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Laboratories, Inc.
2773 Downh9l Drtm Stomrrpoaf Sprtrrpa,CO 8W7 (800)334-M93 - •
Elam Construction,Inc. ACZ Project ID. L18858
Date Received: 08/12/201415:22
Received By: ear
Date Printed: 8/13/2014
YES NO NA
1)Is a foreign soil permit Included for applicable samples? �— X
2)Is the Chain of Custody or other directive shipping papers present? X
3)Does this project require special handling procedures such as CLP protocol?
4)Are any samples NRC licensable material?
6)If samples are received past hold time, proceed with requested short hold time analyses? X
_i
6)Is the Chain of Custody complete and accurate? X
7)Were any changes made to the Chain of Custody prior to ACZ receiving the samples? fX
YES NO NA
8)Are all containers Intact and with no leaks? I ^
9)Are all labels on containers and are they Intact and legible?
10)Do the sample labels and Chain of Custody match for Sample ID, Date,and Time? -X
11)For preserved bottle types was the pH checked and within limits? t w, -� X
12)Is there sufficient sample volume to perform all requested work?
13)Is the custody seal intact on all containers? i I- _ X
14)Are samples that require zero headspace acceptable?
15)Are all sample containers appropriate for analytical requirements? l X —_'
16)Is there an Hg-1631 trip blank present? X
17)Is there a VOA trip blank present?
18)Were all samples received within hold time?
Cooler Id Temp (°C) Rad (µR/Hr) Custody Seal Intact?
-------- --------------------
NA19833 23.3 11 N/A
Was ice present in the shipment container(s)?
No - Wet or gel ice was not present in the shipment container(a) .
CI#erd must contact an ACZ Prc(ect Manager If analysis shouid not proceed for samples received
outside of their thermal preservation acceptance criteria.
REPAD LPII 2012-03
L18858-1406191536 Page 12 of 13