Sink faucet Kohler 2007 X 5:

Transcription

1 Page _1_of _5 CLIENT INFORMANTION Name: Lansingburgh Central School District Date of Sampling: 10/18/2016 Address: 576 Fifth Ave Troy NY Samples Taken By: Tim LeVan Client Rep: Bob Schongar Samples Taken By: Craig Hansen SCHOOL/PROJECT INFORMATION BLDG NO./NAME: Lansingburgh HighSchool BLDG ADDRESS: 320 Seventh Ave Troy NY CONTACT NAME & NUMBERS: Bob Schongar (1) Yr. Built (2) Yr 1st Add: (3) Yr 2nd Add: (4) Yr 1st Mod: (5) Yr. 2nd Mod: SAMPLE DATA Sample Description ID (ID must match container label) Lab Sample # Outlet Information BOCES Sample # Location Outlet Description Outlet Make & Model Construct. Date First Draw Time of Collection (24hr) Lead Copper 82 LHS-GF-SC-P-82 Pump room Service connection : Remediati on 83 LHS-GF-KS1-P-83 Kitchen Sink Faucet 2015 X 4: LHS-GF-KS2-P-84 Kitchen Sink faucet 2015 X 4: LHS-GF-KS3-P-85 Kitchen Sink faucet 2015 X 4: LHS-GF-KS4-P-86 Kitchen Sink faucet 2015 X 4: LHS-GF-KS5-P-87 Kitchen Sink faucet 2015 X 4: LHS-GF-KS6-P-88 Kitchen Sink faucet 2015 X 4: LHS-GF-KS7-P-89 Kitchen Sink faucet 2015 X 4: LHS-GF-DW-P-90 Cafeteria Water fountain Elkay 2015 X 5: LHS-GF-CF-P-91 Cafeteria Sink faucet Delta 2015 X 5: LHS-GF-BF-P-92 Boys room Sink Faucet Chicago 1965 X 5: LHS-GF-BF-P-93 Girls room Sink faucet Chicago 1965 X 5: LHS-GF-CF-P-94 Auto shop Sink faucet Speakman 1965 X 5: LHS-GF-CF-P-95 Wood shop Sink faucet 1965 X 5: LHS-GF-DW-P-96 Corridor by locker rooms Water fountain Halsey Taylor 1965 X 5: Shut off 97 LHS-GF-BF-P-97 Girls PE coach office Sink faucet Kohler 2007 X 5:

2 98 LHS-GF-GIM-P-98 Girls PE coach office Ice Machine Marvel Scientific 2007 X No result 99 LHS-GF-BF-P-99 Girls locker room Sink faucet Chicago 2007 X 5: LHS-GF-DW-P-100 Girls locker room Water fountain 2007 X 5: LHS-GF-BF-P-101 Boys PE coach office Sink faucet Kohler 2007 X 5: CHAIN OF CUSTODY Relinquished By: Received By: Time: Date: INSTRUCTIONS TO THE LABORATORY - Analize all samples for both lead and copper (Pb and Cu) Lab: Pace Analytical Contact: Comments: Provide Laboratory Data Report (LDR) and Chain of Custody

3 Page _2_of _5 CLIENT INFORMANTION Name: Lansingburgh Central School District Date of Sampling: 10/18/2016 Address: 576 Fifth Ave Troy Ny Samples Taken By: Tim LeVan Client Rep: Bob Schongar Samples Taken By: Craig Hansen SCHOOL/PROJECT INFORMATION BLDG NO./NAME: Lansingburgh High School BLDG ADDRESS: 320 Seventh Ave Troy NY CONTACT NAME & NUMBERS: Bob Schongar (1) Yr. Built (2) Yr 1st Add: (3) Yr 2nd Add: (4) Yr 1st Mod: (5) Yr. 2nd Mod: SAMPLE DATA Sample Description ID (ID must match container label) Lab Sample # BOCES Sample # Location Outlet Description Outlet Information Outlet Make & Model Construct. Date First Draw Time of Collection (24hr) Lead Copper Remediaito n 102 LHS-GF-BIM-P-102 Boys PE coach office Ice Machine Marvel Scientific 2007 X 5: LHS-GF-BF-P-103 Boys locker room Sink faucet Chicago 2007 X 5: LHS-GF-DW-P-104 Weight room Water fountain Elkay 2007 X 5: LHS-GF-HC-P-105 Outdoors of weight room Hose connection 2007 X 5: LHS-GF-KF-P-106 Outside concession stand Sink Faucet 2007 X 5: Shut off LHS-GF-DW1-P- ADA water 107 Gym lobby Elkay 2007 X 5: fountain LHS-GF-DW2-P- 108 Gym Lobby Water fountain Elkay 2007 X 5: LHS-GF-KF-P-109 Inside concession stand Sink faucet Moan 2007 X 5: LHS-GF-BF-P-110 Girls room Sink faucet Chicago 2007 X 5: LHS-GF-BF-P-111 Boys room Sink faucet Chicago 2007 X 5: LHS-GF-BF1-P-112 Girls room off gym Sink faucet 1 Chicago 2007 X 5: LHS-GF-BF2-P-113 Girls room off gym Sink faucet 2 Chicago 2007 X 5: LHS-GF-BF1-P-114 Boys room off gym Sink faucet 1 Chicago 2007 X 5: LHS-GF-BF2-P-115 Boys room off gym Sink faucet 2 Chicago 2007 X 5: LHS-GF-HC-P-116 Outdoors of boys room Hose connection 2007 X 5: LHS-GF-BF-P-117 Athletic director office Sink faucet Chicago 2007 X 5:

4 118 LHS-GF-IM-P-118 Athletic director office Ice machine Manitowoc 2007 X 5: < LHS-GF-HC-P-119 Outdoors Northeast end of gym Hose connection : LHS-01-BF-P-120 Music wing faculty ladies room Sink faucet X 5: LHS-01-BF-P-121 Music wing faculty ladies room Sink faucet : LHS-01-BF-P-122 Music wing boys room Sink faucet X 5: All containers are pre-cleaned/pre-certified 250ml plastic bottles and will be preserved w/hno3@ ph by lab CHAIN OF CUSTODY Relinquished By: Received By: Time: Date: INSTRUCTIONS TO THE LABORATORY - Analize all samples for both lead and copper (Pb and Cu) Lab: Pace Analytical Contact: Comments: Provide Laboratory Data Report (LDR) and Chain of Custody

5 Page _3_of _5 CLIENT INFORMANTION Name: Lansingburgh Central School District Date of Sampling: 10/18/2016 Address: 576 Fifth Ave Troy Ny Samples Taken By: Tim LeVan Client Rep: Bob Schongar Samples Taken By: Craig Hansen SCHOOL/PROJECT INFORMATION BLDG NO./NAME: Lansingburgh High School BLDG ADDRESS: 320 Seventh Ave Troy NY CONTACT NAME & NUMBERS: Bob Schongar (1) Yr. Built (2) Yr 1st Add: (3) Yr 2nd Add: (4) Yr 1st Mod: (5) Yr. 2nd Mod: SAMPLE DATA Sample Description ID (ID must match container label) Lab Sample # Outlet Information BOCES Sample # Location Outlet Description Outlet Make & Model Construct. Date First Draw Time of Collection (24hr) Lead Copper Remediati on 123 LHS-01-BF-P-123 Music wing boys room Sink faucet 2 Kohler 1965 X 5: LHS-01-BF1-P-124 Girls room near 156 Sink faucet 1 Chicago 1965 X 5: LHS-01-BF2-P-125 Girls room near 156 Sink faucet 2 Chicago 1965 X 5: LHS-01-BF1-P-126 Boys room near 156 Sink faucet 1 Chicago 1965 X 5: LHS-01-BF2-P-127 Boys room near 156 Sink faucet 2 Chicago 1965 X 5: LHS-01-DW-P-128 Corridor across from 152 Water fountain Haley Taylor 1965 X 5: Shut off 129 LHS-01-CF1-P Sink faucet X 5: Shut off 130 LHS-01-CF2-P Sink faucet X 5: LHS-01-CF1-P Sink faucet 1 T&S 1965 X 5: LHS-01-CF2-P Sink faucet X 5: LHS-01-CF3-P Sink faucet 3 T&S 1965 X 5: LHS-01-DW-P-134 Corridor across from 147 Water fountain Elkay 1965 X 5:40 < LHS-01-CF1-P Sink faucet 1 Chicago 1965 X 5: LHS-01-CF2-P Sink faucet 2 Chicago 1965 X 5: LHS-01-CF3-P Sink faucet 3 Chicago 1965 X 5: LHS-01-BF1-P-138 Boys room Sink faucet X 5: LHS-01-BF2-P-139 Boys room Sink faucet X 5:

6 140 LHS-01-BF1-P-140 Girls room Sink faucet X 5: LHS-01-BF2-P-141 Girls room Sink faucet X 5: LHS-01-BF3-P-142 Girls room Sink faucet X 5: LHS-01-BF4-P-143 Girls room Sink faucet X 5: All containers are pre-cleaned/pre-certified 250ml plastic bottles and will be preserved w/hno3@ ph by lab CHAIN OF CUSTODY Relinquished By: Received By: Time: Date: INSTRUCTIONS TO THE LABORATORY - Analize all samples for both lead and copper (Pb and Cu) Lab: Pace Analytical Contact: Comments: Provide Laboratory Data Report (LDR) and Chain of Custody

7 Page _4_of _5_ CLIENT INFORMANTION Name: Lansingburgh Central School District Date of Sampling: 10/18/2016 Address: 576 Fifth Ave Troy Ny Samples Taken By: Tim LeVan Client Rep: Bob Schongar Samples Taken By: Craig Hansen SCHOOL/PROJECT INFORMATION BLDG NO./NAME: Lansingburgh High School BLDG ADDRESS: 320 Seventh Ave Troy NY CONTACT NAME & NUMBERS: Bob Schongar (1) Yr. Built (2) Yr 1st Add: (3) Yr 2nd Add: (4) Yr 1st Mod: (5) Yr. 2nd Mod: SAMPLE DATA Sample Description ID (ID must match container label) Lab Sample # BOCES Sample # Location Outlet Description Outlet Information Outlet Make & Model Construct. Date First Draw Time of Collection (24hr) Lead Copper Remediaiton 144 LHS-01-CF-P Sink faucet Chicago 1965 X 5: LHS-01-CF-P Sink faucet Chicago 1965 X 5: LHS-01-CF1-P Sink faucet 1 Chicago 1965 X 5: LHS-01-CF2-P Sink faucet 2 Chicago 1965 X 5: LHS-01-CF3-P Sink faucet 3 Chicago 1965 X 5: LHS-01-DW-P-149 Corridor outside 142 Water fountain Halsey Taylor 1965 X 5: Shut off 150 LHS-01-CF1-P Sink faucet 1 Chicago 1965 X 5: LHS-01-CF2-P Sink faucet 2 Chicago 1965 X 5: LHS-01-CF3-P Sink faucet 3 Chicago 1965 X 5: LHS-01-HC-P-153 Courtyard media center side Hose connection 1965 X 5: Capped off 154 LHS-01-HC-P-154 Outside southeast corner of Cafeteria Hose connection 1965 X 5: Shut off/capped 155 LHS-01-BF-P-155 Media center Sink faucet Chicago X 5: LHS-01-SF-P-156 Media center office Sink faucet X 5: LHS-01-DW-P LHS-02-DW-P-158 Corridor across from 1st floor media center Corridor across from 2nd floor media center Water fountain Elkay X 5: Water fountain Elkay X 5:

8 159 LHS-02-BF-P-159 Media center 2nd floor Sink faucet Chicago X 5: LHS-02-BF1-P-160 Boys room across from 248 Sink faucet X 5: LHS-02-BF2-P-161 Boys room across from 248 Sink faucet X 5: LHS-02-BF3-P-162 Boys room across from 248 Sink faucet X 5: LHS-02-BF-P-163 Faculty men s room Sink faucet 1965 X 5: All containers are pre-cleaned/pre-certified 250ml plastic bottles and will be preserved w/hno3@ ph by lab CHAIN OF CUSTODY Relinquished By: Received By: Time: Date: INSTRUCTIONS TO THE LABORATORY - Analize all samples for both lead and copper (Pb and Cu) Lab: Pace Analytical Contact: Comments: Provide Laboratory Data Report (LDR) and Chain of Custody

9 Page _5_of _5 CLIENT INFORMANTION Name: Lansingburgh Central School District Date of Sampling: 10/18/2016 Address: 576 Fifth Ave Troy Ny Samples Taken By: Tim LeVan Client Rep: Bob Schongar Samples Taken By: Craig Hansen SCHOOL/PROJECT INFORMATION BLDG NO./NAME: Lansingburgh High School BLDG ADDRESS: 320 Seventh Ave Troy NY CONTACT NAME & NUMBERS: Bob Schongar (1) Yr. Built (2) Yr 1st Add: (3) Yr 2nd Add: (4) Yr 1st Mod: (5) Yr. 2nd Mod: SAMPLE DATA Sample Description ID (ID must match container label) Lab Sample # BOCES Sample # Location Outlet Description Outlet Information Outlet Make & Model Construct. Date First Draw Time of Collection (24hr) Lead Copper 164 LHS-02-BF-P-164 Faculty women s room Sink faucet 1965 X 5: Remediati on 165 LHS-02-CF-P Faculty room Sink faucet Delta 1965 X 5: LHS-02-DW-P-166 Corridor outside 242 Water fountain Halsey Taylor 1965 X 5: Shut off 167 LHS-02-DW-P-167 Corridor outside 250 Water fountain Elkay 1965 X 5: LHS-02-DW-P-168 Corridor outside 251 Water fountain Halsey Taylor 1965 X 5: Shut off 169 LHS-02-CF1-P Sink faucet 1 Kohler 1965 X 6: LHS-02-CF2-P Sink faucet 2 Kohler 1965 X 6: LHS-02-BF-P-171 Boys room across from 260 Sink faucet Chicago 1965 X 6: LHS-02-BF-P-172 aculty across from 260 Sink faucet Chicago 1965 X 6: LHS-02-BF1-P-173 Girls room next to stairwell Sink faucet X 6: LHS-02-BF1-P-174 Girls room next to stairwell Sink faucet X 6: LHS-02-BF1-P-175 Girls room next to stairwell Sink faucet X 6: A LHS-GF-KS8-P-89A Kithchen Kitchen Steam X 4: B LHS-GF-KS9-P-89B Kitchen Kitchen Steam X 4: A LHS-01-DW-P-123A Corridor near 185 X 5:

10 All containers are pre-cleaned/pre-certified 250ml plastic bottles and will be preserved ph by lab CHAIN OF CUSTODY Relinquished By: Received By: Time: Date: INSTRUCTIONS TO THE LABORATORY - Analize all samples for both lead and copper (Pb and Cu) Lab: Pace Analytical Contact: Comments: Provide Laboratory Data Report (LDR) and Chain of Custody