Laserfiche WebLink
FOR LAB USE ONLY <br />Properly Contained IV NO N/A <br />1ASTM E1792 wipes YES NO COPII <br />Adequate Ph Adjust YES NO NIAT <br />Lab acidified: ay/Date'yG <br />P.O./Pro) #: MN 3192 1 <br />Job Location: <br />Lino Lakes, MN <br />Special Instructions: <br />also email reports and invoice to <br />lsylte@klmengineering.com <br />and <br />Isy157@agmail,com <br />*Same Day turn around not available for TCLP or PM10; <br />additional fees may apply, contact lab for pricing. <br />WIPES 1 AIR SAMPLES <br />11f <br />UNITS 1 <br />FLOW I <br />a <br />O <br />i -- <br />co <br />START <br />TIME <br />a <br />O <br />1— <br />CHAIN OF CUSTODY FORM <br />Send To: <br />orrosion Control Consultants & Labs, Inc, a GPI: company <br />4403 Danker Ct Kentwood MI 49512-4054 <br />ph: 616-940-3112 fx: 616-940-8139 web -sites: www.ccclabs.com www.gpinet.com <br />Company Contact: Matt Erickson <br />Telephone_ _ 651-773-5111 1 <br />E -Mail: merickson@klmengineering.com <br />START <br />Area wiped <br />(sq.ft.) <br />MISC. TESTS <br />❑ pH (Corrosivity) <br />Ignitability <br />VOC (Method 24) <br />❑ Other <br />w <br />2 <br />a <br />z <br />D <br />0 <br />it <br />Q <br />z <br />reD <br />F— <br />❑ Same Day* <br />❑ Rush* <br />❑✓� Standard <br />❑ Other <br />r information. <br />Sample Identification/Location <br />Interior Wet <br />Interior Dry <br />Exterior Roof <br />Exterior Bottom <br />Address: 3394 Lake Elmo Ave N <br />PO Box 897 <br />Lake Elmo, MN 55042 <br />TOTAL CONCENTRATION <br />LEAD <br />✓❑ LEAD, CAD, CHROME <br />❑ RCRA (8) METALS <br />❑ OTHER <br />WASTE CHARACTERIZATION <br />L LEAD TCLP <br />Q RCRA (8) METALS TCLP <br />❑ OTHER <br />CCC&L accepts Visa, MasterCard, and American Express. Please call fo <br />MATRIX <br />11 PAINT CHIPS <br />C. SOIL <br />❑ SPENT ABRASIVE <br />❑ WIPE brand <br />❑ WASTEWATER <br />❑ 37 rim CASSETTE <br />❑ TSP FILTER <br />❑ PM 10 FILTER <br />• OTHER <br />Company: <br />KLM Engineering, Inc, <br />Date/Time <br />Sampled <br />r <br />7 <br />4 4 <br />I0 <br />wt <br />1 <br />1 <br />0 <br />ID <br />T <br />1 <br />° <br />LLS <br />x- <br />I <br />tib <br />6 <br />d N <br />d <br />E E <br />W Z <br />NCI <br />V- <br />CCC&L <br />Lab Na. <br />f <br />c'si <br />,. <br />rz <br />- r- <br />f� <br />r~ <br />C <br />y <br />9? <br />z <br />rts <br />c <br />g) <br />mai <br />E <br />v <br />0 <br />-0 <br />ay <br />E.t .0) <br />-aa <br />E <br />co <br />as <br />0 <br />ay <br />0 <br />rn <br />0 <br />R7 <br />0 <br />ai <br />E <br />w <br />a <br />d <br />as <br />ET a <br />m m <br />Lip <br />Ci Submittal <br />v. <br />