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Asbestos CWn of Custody EWSL AiL_'•Y-IOAL,INC. <br /> EPASL Order Number (Lab Use Only): 1 L'375 '3R' AV-NOR'H <br /> •�/�/ �40 .i' 1!"NEAPOUS.MN 55447 <br /> i1 <br /> EMSL NALYSICAL,IHC. FAx. I(7635 AY�`S�924 <br /> uuaarmwr.swanwre.nuomo " <br /> EMSL-Bill to:M Sarre ❑ Different <br /> Company:Environmental Property Audits,Inc. it Bili to is Different note instructions in comments- <br /> Street:2701 N e Avenue Third Patty Billing re M s whiten arrfhorrmhon from third pgq <br /> City: Anoka StatelPr mince:MN ?!M!Gstal Code:55M Country:USA <br /> Resort To(Name): Jim Lindahl Fax#: 763-323-6677 <br /> Telephone#: 763-323-5700 Email Address: lindahlj@epaconsultaffts.com <br /> Pro"ect NamelAlumber: / <br /> Please Provide Results: Fax M Email I Purchase Order. - - U.S.State Sara fes Takers: <br /> Tun'ta 48 Hoes ❑ 72 HO "ons*-Please Check <br /> El Hour ❑6 Hour El 24 Hour our ❑ 9S Hour ❑1 1lileek ❑ Z 6Afeek <br /> Tor TEM Air 3 hr Hvwgh 6 hr;please call ahead to scheduf . rmvm charge for 3 Hour TEAS AHERA or EPA Level It TAT. You will be asked tu sign <br /> an authorization farm for this s&-vice. An is in aco wdanae A4M EMSt's Terms and CondWons located in the Anafyftal Price Guide. <br /> PCNL-Air TENT-Air ❑"Shr TAT(AHERA only) TENT-Dust <br /> ❑ NIOSH 7400 ❑ AHIRA 40 GFR, Part 763 ❑Microvac-ASTM D 5755 <br /> ❑ wr OSHA 8hr.TWA ❑ NIOSH 7402 ❑Wipe-ASTM D6480 <br /> PLAIT-Bulk froportlratr limit) ❑ EPA Level it ❑Carpet Sonication(EPA 6001,!-931167) <br /> PLM EPA.6OM-931116(moi%) ❑ ISO 10312 Soil/RocklNermiculite <br /> PLM EPA NOB(<1%) TEM-Bulk ❑PLM GARB 435-A(0.25%sensitivity) <br /> Point Count ❑TEM EPA NOB ❑PLAIT GARB 435-B(0.1%sensitivity) <br /> ❑400(C0.25%)❑1000(<0.1%) ❑ NYS NOB 198.4(non-friable-NY) ❑TEM CARB 435-B(0.1%sensitivity) <br /> Point Count w/Gravimetric ❑Chatfield SOP ❑TEM CARB 435-C(0.01%sensitivity) <br /> ❑400(-c0.25%)❑ 1000(<0.1%) []TEM Mass Analysis-EPA 600 sec.2.5 ❑EPA Protocol(Semi-Quantitative) <br /> ❑ NYS 198.1 (friable in NY) TEAL!-►Mater:EPA 100.2 ❑EPA Protocol(Quantitative) <br /> ❑ NYS 198.6 NOB(non-friable-" Fibers>10Nm ❑Waste Q Drinking Other: <br /> ❑ NIOSH 9002 a1% Alf Fibersizes ❑Waste ❑Drinking ❑ <br /> ❑Check Far Positive Stop-Clearly identify Hounogerwous Gmuap <br /> Samplers Name: lTSamplers Signature: <br /> Volume/Area(Air) DatelTime <br /> Sample## Sample Bescri tions HA#(Bulk) Sampled <br /> lip\ 5 t <br /> 1 <br /> � Y <br /> I <br /> Client Sam le#(s): - Total#of saran ies: <br /> Relinquished(Ctlerrt): i¢� Date: f - 1 '� - 2 C� Time: <br /> Received[Lab): APA <br /> Date: <br /> I �G Time: w� <br /> Com m entrApecial Instructions: <br /> Co,Amiled ooc�ment-Asbula COC-R2-III MOi0 Page 1 of pages <br />