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2023-04-26_HYDROLOGY - M2007044
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2023-04-26_HYDROLOGY - M2007044
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Entry Properties
Last modified
4/27/2023 8:33:54 PM
Creation date
4/27/2023 8:32:38 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M2007044
IBM Index Class Name
Hydrology
Doc Date
4/26/2023
Doc Name
Hydrology Report
From
Energy Fuels Resources Inc
To
DRMS
Annual Report Year
2023
Report Quarter_Month
1
Email Name
ACY
THM
Media Type
D
Archive
No
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CHAIN-OF-CUSTODY Analytical Request Document LAB USE ONLY-Mix Warkorder/Login Label Nero or tht Pace Worka der Number or <br /> Both?/ ical- Submitting a sample via thh chain of custody constitutes acknowledgment and acceptance of the Pace Terms end WX Logan Number Ham <br /> Conditions found at:https://Info pacclabs.com/bubts/papstandard•terrm.pdf <br /> Chain-0-Custody Is a LEGAL DOCUMENT-Complete as relevant fields <br /> Company: Billing Information: <br /> . QCCo�t^�5 PaY�� All BOLD OUTLINED AREAS are for LAB USE ONLY <br /> Address: <br /> Z�(,�Shl i� Container Preservative T c e' Lab Project Manager: <br /> Report To: Email To: =EJ <br /> '�LL nn 1Able r ` <br /> � ( /m t C V21S.CO Preservative Types:(1)nitric acid,(2)sulfuric acid,(3)hydrochlorle acid,(4)sodium hydroxide,(S)tint acetate, <br /> Copy To: Site Collection Info/A dress: 161 methanol,(7)sodium bisulfate,(8)sodium thlosulfate,19)hexane,(A)ascorbic acid,(6)ammonium sulfate, <br /> (C)ammonium hydroxide,(0)TSP,(U)Unpreserved,(0)Other <br /> Analyses lab Profile/une: <br /> Customer Projec Name/Number: State: County/City: Time Zone Collected: Lab Sample Receipt Checklist: <br /> PT MT CT ET Custody Seals Present/IntactIN <br /> R NA <br /> Phone: SOS- Ste- N11,1 Site/Facility ID N: Compliance Monitoring? _ stody signatures PresentN NA <br /> Email: P ,� ( Yes [ )NO ollector Signature PresentN NA <br /> Bottles Intact N NA <br /> .Collected By( tint). Purchase Order N DW PWS 10 N: Correct Bottles N NA <br /> t Quote N: DW Location Code: Sufficient Volume NA <br /> Cqkcted By(siglaluref Turns ound Date Required. Immediately Packed on ice: c? Samples Received on Ice Y N <br /> •, ;j,./�i .11 1' O L Yes NO VOA - Headspaca Acceptable Y N A4 <br /> USDA Regulated Soils fj Y N`� <br /> Sample Disposal / Rush: (Expedite Charges Apply) Field Filtered(If applicable) Samples in Holding Time/j;% N NA <br /> fA Dispose as appropriates/ [ )Same Day ( )Next Day [ )Yes rA No ° �}. Residual Chlorine Preaent j <br /> [ ]Return [ )2 Day [ )3 Day 1 Strips: <br /> Sam le R Acceptable Y N NA <br /> I ]ArchNe' [ ]4 Day [ ]5 Day Analysis:. p P P <br /> Hold: m PR Strips: <br /> n M Sulfide Present__ Y N NA <br /> a Matrix Codes(Insert In Matrix box below):Drinking Water(DW),Ground Water(GW),Wastewater(WW), read Acetate stripe: <br /> Product(P),Soil/Solid(SL),Oil(OL),Wipe(WP),Air(AR),Tissue(TS),Bioassay(B),Vapor(V),Other(OT) p) <br /> Comp/ Collected(or Res Nof u -i O LAB USE ONLY: <br /> Customer Sample ID Matrix• Grab Com osite Start Composite F.nd Cl Ctns a tab Sample g / commence: <br /> Date Time Date Time o <br /> u <br /> Customer Remarks/Special Conditions/Possible Hazards: Type of ice Used; Wet Blue Dry a SHORT HOLDS PRESENT(<72 hours): Y N N/A LAB Sample Temperature Info: <br /> PackingMaterial Used: LabTraddn N: Temp Blank Received: Y N NA <br /> Pay g Therm IDa: <br /> I' ooler 1 Temp Upon Receipt: _oC <br /> eC-1% Samples received via: ooler : Therm Corr. Factor:__ oC <br /> adchemsample(s)screened(<Soocpm): Y /N NA FEDEx Ulent Courier Pace Courier <br /> ooler I Corrected Temp: _oC <br /> U1_ 'Dements <br /> Re_llnquished b Comp ny:4Signature) Date/Time: /. Rece d by/Company:(Signatyr�e) Date/Time: rPrelogin: <br /> B USE ONLY <br /> n�_'l /d ^ I �L�.�D�•�_ ``' FF-Cr //.3//(? 1a a� <br /> Relinquished by/Company:( ature) Date/Time: eceived by/Company:(Signature) Date�me: Trip Blank Received: Y N NA <br /> HCL McOH TSP Other <br /> Relinquished by/Company:(Signature) Date�me: Received by/Company:(Signature) Date/Time: Non Cordormance(s): Page: _ <br /> PB: YES / NO of: —_ <br />
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