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OrderlD: 351607999 <br />EMSL ANALYTICAL, INC <br />.,.o,. ,,o,,Y....o CT.. o <br />Asbestos Chain of Custody <br />EMSL Order Number (Lab Use Only): <br />Company Name : Braun Intertec Corporation <br />Street: 11001 Hampshire Avenue South <br />Zip/Postal Code: 55438 I Country: USA <br />Report To (Name): Robert Nordby & Eric Bieniek <br />Email Address: RNordby / EBieniek @braunintertec.com <br />EMSL Customer ID: <br />City: Bloomington <br />Telephone #: 952.995.2424 <br />EMSL ANALYTICAL, INC. <br />200 ROUTE 130 NORTH <br />CINNAMINSON, NJ 08077 <br />PHONE: (800) 220-3675 <br />FAX: (856) 786-5974 <br />StatelProvince: MN <br />Fax #: 952.995.2020 <br />Please Provide Results: ❑ Fax ® Email <br />Purchase Order: <br />Project Name/Number: AlC- 5~ w /B16 l O HZ cO EMSL Project ID (Internal Use Only): <br />U.S. State Samples Taken: Minnesota CT Samples: El Commercial/Taxable ❑ Residential/Tax Exempt <br />EMSL-Bill to: ❑ Same ® Different - If Bill to is Different note instructions in Comments" <br />Third Party Billing requires written authorization from third party <br />Turnaround Time (TAT) 0 <br />❑ 3 Hour I ❑ 6 Hour I ❑ 24 Hour I ❑ 48 Hour <br />ase Check <br />111 96 Hour ] ❑ 1 Week I ❑ 2 Week <br />'For TEM Air 3 hr through 6 hr, please call ahead to schedule *There is a premium 3 our TEM AHERA or EPA Level 1t 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 ['Check if samples are from NY TEM - Air ❑ 4-4.5hr TAT (AHERA only) <br />❑ NIOSH 7400 <br />❑ wl OSHA 8hr. TWA <br />PLM - Bulk (reuortincj limit) <br />PLM EPA 600/R-93/116 (<1%) <br />❑ PLM EPA NOB (<1%) <br />Point Count <br />❑ 400 (<0.25%) ❑ 1000 (<0.1%) <br />Point Count w/Gravimetric <br />© 400 (<0.25%) ❑ 1000 (<0.1%) <br />[J NYS 198.1 (friable in NY) <br />0 NYS 198.6 NOB (non -friable -NY) <br />[] NYS 198.8 SOF-V <br />0 N1OSH 9002 (<1%) <br />❑ AHERA 40 CFR, Part 763 <br />❑ NIOSH 7402 <br />❑ EPA Level II <br />❑ ISO 10312 <br />TEM - Bulk <br />❑ TEM EPA NOB <br />❑ NYS NOB 198.4 (non -friable -NY) <br />❑ Chatfield SOP <br />❑ TEM Mass Analysis -EPA 600 sec. 2.5 <br />TEM - Water: EPA 100.2 <br />Fibers >10um D Waste ❑ Drinking <br />All Fiber Sizes ❑ Waste 0 Drinking <br />® Check For Positive Stop - Clearly Identify Homogenous Group <br />Samplers Name: Eric Bieniek <br />Sample # <br />(A —'2 f <br />TEM- Dust <br />❑ Microvac - ASTM D 5755 <br />❑ Wipe - ASTM D6480 <br />❑ Carpet Sonication (EPA 600/J-93/167) <br />Soi I/RockNermi cul ite` <br />❑ PLM GARB 435 - A (0.25% sensitivity) <br />❑ PLM CARS 435 - B (0.1 % sensitivity) <br />❑ TEM CARB 435 - B (0.1 % sensitivity) <br />❑ TEM CARB 435 - C (0.01 % sensitivity) <br />❑ TEM Qual. via Filtration Technique <br />❑ TEM Qual. via Drop -Mount Technique <br />'Can not accept New York State Loose FI Vermiculite samples <br />Other: <br />• Point Count (400-non-gray) if <1 %. <br />Do not paint count if None Detected. <br />Filter Pore Size (Air Samples): ❑ 0.8pm ❑ 0.45 m <br />ISamplers Signature: <br />Sample Description <br />See Attached "Table II <br />me/Area (Air) DateTme <br />HA # (Bulk) Sampled <br />it f lt' e 0t(a <br />4t4/(-i <br />Client Sample # (s): IA - Z '-( Total # of Samples: '2 e) <br />Relinquished (Client): ,e.-: _ Date: I t 111 /za r(v Time: Y - '7U r'M <br />Received (Lab): e 1 II i I f! I/O <br />( ) l r �I Date: 1 I l I il! Time:' i <br />Comments/Special I stru ions: Okay to sendo other EMSL to ans. Forint count up to 5 samples; if >5 samples <1%, call <br />for approval. Invoice. braunintertec.com) - same address. <br />.i;is/ f7torr . I rrz-R7P . <br />Cot rolled Document — Asbestos COC — R9— 10/30/2014 <br />Page 1 Of 3 <br />