Laserfiche WebLink
Asbestos Chu: n of Custody <br />E`i1SL Order Number (Lab Use Only): <br />EMS! ANALYTICAL, ram. <br />Company : Environmental Property Audits, inc. <br />Street: 2701 N 41" Avenue City: Anoka <br />Report To (Name): Jim Lindahl <br />7890 <br />Staate/Province: MN <br />EMSL Ary-. Y11CAL, INC. <br />10375 3R` Av' NORTH <br />}"-NEAPOLiS, MN 55447 <br />PHONE: (.':3) 4E"4-"" ) <br />FAX: (763) 4 9-L-924 <br />ENISL-Bill to: M Same ❑ Different <br />If Bill to is Different mote instructions in Comments" <br />Third Party Billing requires written authorization from thin) parry <br />ZrpIPostal Code: 55303 Country: USA <br />Fax #: 763-323-6677 <br />Telephone #: 763-323-6700 Email Address: lindatilleepaconsultants.com <br />Project Name/Number: (4 / <br />Please Provide Results: ❑ Fax Email Purchase Oyler: <br />Turner T]bons* - Please Check <br />0 3 Hour i ❑ 6 Hour 1 ❑ 24 Hour 48 ou 1❑ 72 Hour [ ❑ 96 Hour I IA Week 1 ❑ 2 Week <br />Tor TEM Air 3 hr though 6 hr, please call ahead to schedul m charge for 3 Hour TEM AHERA or EPA Level 11 TAT: You will be asked to sign <br />an authorization form for this service- Analysis completed in accordance with EMSL's Terms and Conditions located in the Analytical Price Guide <br />PCM - Air <br />• NIOSH 7400 <br />❑ w/ OSHA 8hr• TWA <br />PLM - Bulk (reporting limit) <br />PLM EPA 600/R-93/116 (<1%) <br />PLM EPA NOB (<1%) <br />Point Count <br />❑ 400 (c0.25%) 0 1000 (<0.1 %) <br />Paint Count w/Gravimetric <br />❑ 400 (<0.25%) ❑ 1000 (<0.1%) <br />❑ NYS 198,1 (friable in NY) <br />❑ NYS 198.6 NOB (non -friable -NY) <br />❑ NlOSH 9002 (<1%) <br />I.I.S. State Samples Taken: <br />TEM - Air ❑ 4-4.5hr TAT AHERA only) <br />❑ AHERA 40 CFR, Part 763 <br />❑ NIOSH 7402 <br />❑ EPA Level!' <br />[] 1S010312 <br />TEM Bulk <br />[ITEM EPA NOB <br />❑ NYS NOB 198.4 (non -friable -NY) <br />Ili Chatfield SOP <br />❑ TEM Mass Analysis -EPA 600 sec. 2.5 <br />TEM -- Water: EPA 100.2 <br />Fibers >10pm ❑ Waste ❑ Drinking <br />All Fiber Sizes ❑ Waste ❑ Drinking <br />IYI&J <br />TiEllll- Dust <br />❑ Microvac - ASTM D 5755 <br />❑ Wipe - ASTM D6480 <br />Carpet Sonication (EPA 6001J-931167) <br />SoillRockf Vernilculite <br />❑ PLM GARB 435 - A (0.25% sensitivity) <br />] PLM CARB 435 - B (0.1 % sensitivity) <br />❑ TEM CARB 435 - B (0.1 % sensitivity) <br />❑ TEM GARB 435 - C (0.01% sensitivity) <br />❑ EPA Protocol (Semi -Quantitative) <br />❑ EPA Protocol (Quantitative) <br />Other: <br />❑ Check For Positive Stop - Clearly Identify Homogenous Group <br />Samplers Name: J 1"yy L--l� f Lt .1 <br />Sample # <br />la -045 f0 A-479 = <br />yh� <br />Sample Description <br />Samplers Signature: <br />Volume/Area (Air) <br />HA # (Bulk) <br />Arip fa )009 <br />16-holven ni'LLL.alubdikbe <br />1 <br />Client Sample # (s): 6-- - 6 - '--IJ <br />Relinquished (Client): - A T I -/-- Date: ` / 0 <br />• <br />f Received (Lab): _1/� I �j Date: (C <br />CommentslSpecial Instructions: <br />Total # of Samples: <br />7-U f .. <br />Date/Time <br />Sampled <br />Time: "9 c'? <br />Time: <br />Cairolled Document - Asi?ee!os COC - R2-111212010 <br />Page 1 of _ !f pages <br />