BIO-REMEDIATION ASSESSMENT

Transcription

1 Air Quality Management Services, Inc. Discovering Solutions for Healthier Living BIO-REMEDIATION ASSESSMENT Manchester Elementary School 17 School Street Manchester, Maine PREPARED FOR RSU #38 C/o Curt Morse 2250 Millard Harrison Drive Readfield, Maine Date of Inspection: January 19 th, 2017 AQM PROJECT # Revised Report Date 1/31/17 Randy Geoffroy, CMI Industrial Hygienist OFFICE: PO Box 2491 Lewiston, Maine Phone Fax

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3 AQM SUMMARY REPORT: Project # Report Type: Cause & Origin Initial Inspection Date: January 19 th, 2017 Onsite Industrial Hygienist: Randy Geoffroy, CMI Client: RSU #38 - C/o Curt Morse Property Owner: Same / Unknown Mailing Address: 2250 Millard Harrison Drive Readfield, Maine Location: 17 School Street Manchester, Maine Reported Cause of Loss: Failed Plumbing Failed Heating System Bulkhead / Basement Entry Groundwater Sewage Backup Roof Leak Deck / Porch / Stair Related Ice Dams Attic Moisture Condensation Appliance Venting High Humidity Other Flashing Issues ( Door Window Roof Related ) See Comments Comments: No reported loss; Client concerned with well-being of teachers and students in Classrooms (Collins, Mitchell, Henry, Galletta), Stage and in Hallways outside of these areas and inside the Gymnasium. Actions to Date: No Actions To Date Repairs Made Dewatering Dehumidification Other Comments: No known actions to date, regarding the areas / Classrooms tested. Uncontrolled Removal of Wet / Mold Impacted Material(s) Controlled Removal of Wet / Mold Impacted Material(s) Actions Taken By Owner Actions Taken By Contractor See Comments Sampling Decision Logic: Air samples were collected to determine airborne fungal concentrations. Surface samples were collected to characterize suspect fungal contamination. Health Issues Reported ( None Allergies Asthma Other See Comments) Comments: No known health issues reported for the areas / Classrooms tested. # of Air Samples 9 # of Surface Samples 4 # of Bulk Samples 0 # of Dust Samples 3 OBSERVATIONS Each area tested determined as a condition #1 location. Condition #1 environment could not be established. Comments: AQM observed dusty conditions in and under the Baseboard heat registers and inside the return air ducts (See Photos for examples). AQM observed water damage at the sinks (See Photos for examples). Wood surfaces appeared damaged with no visible mold growth. AQM observed water damage to ceiling and wall systems in the Stage & Closet area. Damage reportedly due to roof leaks or flashing issues; cause of damage has reportedly been repaired (surfaces tested dry at time of this inspection). The cavity under the Stage steps was found to be dusty. This area was not accessible and only observable from the grilles at the steps (See Photos). FUNGAL GROWTH - See laboratory results for details Results are as follows: Air Air samples not collected / analyzed: Not authorized / requested Not Applicable Samples Concentrations similar to outdoor control and/or typical levels seen in occupied indoor environments Concentrations above background (outdoor control) Trace Low Moderate High Surface Samples Surface samples for mold growth not collected / analyzed: Not authorized / requested No visible Fungi Fungal Growth Detected Trace Low Moderate High Settled Dust / Horizontal Surface Samples Collected see below Carpet Dust Samples Comments: Extremely low levels of mold detected in carpet(s) / surface(s) tested (<10,000 cfu/g) (Note Comment Below) Typical to Excessive levels of fungi detected: Low Risk (10, ,000 cfu/g) Moderate Risk (100,000 - <1,000,000 cfu/g and/or Elevated Fungi of Concern) High Risk (>1,000,000 cfu/g). Carpets have visible fungal growth or impact. There is no significant evidence of mold exposure of concern or atypical mold levels for each location sampled. In some samples there were some minor (low-level) elevations of common outdoor-type mold spores (for example, Basidiospores). This is commonly seen in winter months when outdoor spore levels are extremely low due to winter conditions and snow cover. For example, Basidiospore levels are usually in the tens of thousands (counts per cubic meter) during warmer months outdoors (and often indoors as well). Some amounts of these common spore types will often remain indoors, settled in dust. Sampling of horizontal surfaces (dust) identified varying levels of mold spores. The spores identified were common outdoor types which is consistent with deposition from the outdoors (outdoor air infiltration, open windows, etc.). Spore levels were higher in some areas versus others, likely due to greater amounts of dust (consistent with visual observations of dusty surfaces). Carpet dust contained extremely low levels of viable mold spores and no significant levels of mold spore types of concern. AQM All Rights Reserved AQM 1 of 3

4 AQM SUMMARY REPORT: Project # RECOMMENDATIONS checked items apply as well as those noted in the Comments Section Remove and replace materials per the attached remedial CAD drawing. No remedial drawing provided; contamination is isolated to an unfinished attic, basement, crawlspace or Stage Area / see below. Remove affected insulation, affected wall systems, affected ceiling systems, affected floor system, see comments. Enlist the services of a certified / qualified mold remediation company. Consult a Professional Engineer or a competent qualified contractor to determine the integrity of structural members / supports / building systems. Identify / Repair / Control moisture intrusion sources, ensure area is clean and dry prior to refinish to prevent recurrent damages and microbial influences. Replace building materials ONLY after a successful post remedial evaluation. Detail clean all surfaces / contents in the affected areas (including the floor, walls, ceiling and any horizontal surfaces) because of the elevated levels of airborne fungi and / or probability of settled spores. Detail Clean, Dry and Shield / Treat all exposed surfaces. Personal contents have significant microbial impact and should be evaluated by the restoration specialists for cleaning or disposal. Sentimental items should be identified and restored if feasible. Permanently dehumidify the Basement Crawl Space to control relative humidity / moisture. If a dehumidifier is to be used, ensure the unit is appropriately sized for the area, has a humidistat to afford for comfort / ideal humidity levels, and is attached to a plumbing drain. Other systems are available to accomplish this task that maybe more energy efficient such as an air to air exchanger or like system. Remove, retain and reset cabinets and / or fixtures to facilitate repairs to underlying surfaces. Evaluate for cleaning and resetting or replacement. Ensure that the ( bathroom ceiling exhaust fan, dryer exhaust or any other appliance exhaust ), is properly sealed and vents directly outdoors to control the release of the exhausts preventing structural impact in attic, basement, crawlspace or other interior location. All building materials to be replaced in the Basement Crawlspace should be non-porous building materials that will not sustain mold growth when in contact with moisture / damp or wet surfaces. Cover open soils in the Basement Crawlspace with a polyethylene vapor barrier, seal the seams, and ballast with crushed stone. This will help to reduce / control organic / environmental influences in the Basement / Crawlspace resulting from exposed soils. Ensure a sump hole or source of drainage is provided in conjunction with covering open soils. Ensure the Bulkhead s mounting surface is sealed with caulking / gasketing to control water intrusion. Consult a Professional Engineer or a competent qualified contractor to control groundwater intrusion into the; Basement Crawlspace by: installing exterior foundation perimeter drainage, sloping the ground away from the foundation 5% (6 for every 10 ), installing gutters (If gutters are to be installed ensure they are kept free of debris and the downspouts direct water away from the foundation), and water proofing the foundation walls or utilizing other like systems. A more thorough evaluation of all the Crawlspaces and the Attic should be conducted to fully evaluate conditions within, when access is available. Control pipe condensation in the Basement by insulating the pipes / water tanks or other similar methods. Repair / fix the flashing around the ( chimney, window, doors, deck, roof, vents ), to eliminate the reported leak. Control the rodent activity. Enlist the services of a qualified pest control specialist. Maintain the greenery around the house to keep moisture away from the siding / foundation. With any recommendations for material removal (e.g. wall or ceiling systems), expand area of removal if damages and/or mold growth are found to extend beyond the boundaries initially specified. * Areas of immediate impact should be isolated from the unaffected areas of the building to prevent contaminant communications thus limiting damages and exposure risks, both before and during renovations / remediation. Comments: In addition to and/or to clarify the recommendations checked above: AQM is recommending closing off the Stage Area as mentioned in an dated 1/23/17. This is a pro-active recommendation and to err on the side of most caution. Water damaged wall and ceiling systems should be removed four (4) feet in all direction of water staining. Flooring below water stains should also be removed four (4) in each direction to expose framing. Clean and treat exposed surfaces if mold growth is observed. Removing the floor will also provide access to the space below the Stage to affect cleaning of dust. Also, remove and replace all water stained ceiling tiles in the Stage Area. Remove water damaged sink cabinets / plywood surfaces to inspect for mold behind and under these units. Remove wallboard behind sinks (if present and found to be water damaged) and flooring below the sinks (if present and found to be water damaged). Ensure to refer to Asbestos Management Plan if floor tiles are uncovered below these units, tiles could contain asbestos and will have to be addressed following MEDEP Asbestos Management Regulations (if removal is warranted). Detail clean Classrooms and Hallways (as listed on Page 1 of this Summary Report) to address dusty conditions. Ensure to clean in hard to reach / clean areas and insides the heat registers. Cleaning should involve damp wiping with a mild detergent and HEPA vacuuming of carpets (if present). Ensure to gain access to return air ducts and clean inside. AQM All Rights Reserved AQM 2 of 3

5 AQM SUMMARY REPORT: Project # TESTING METHODOLOGIES Air-O-Cell / Allergenco-D Cassettes - Air Samples for Mold Analyzed by Direct Microscopy Surface Samples for Special Slides with Tape Mount - Mold Analyzed by Direct Microscopy IR Thermography Camera Thermal Surface/Scan Moisture - Delmhorst or SurveyMaster Moisture Penetrating Meter Non-Penetrating Viable Air Samples N6 Culture Plates for Temperature/RH% Mold Bacteria EXTECH Pen Bulk Material Direct Analysis for Mold Asbestos Viable Culture - Swab Sewage Samples for Bacteria Gray And / Or Mold Black Water Other Testing: None As Described: Carpet-dust collected via vacuum filter-cartridge and analyzed via laboratory culture. Moisture Readings Outdoor Ambient Location Weather Conditions Temp. F Relative Humidity Collected Parking Lot Not Collected See Comments Cloudy Comments: None Area Location Material Moisture Elevated Temp. F Relative Humidity Yes No Collins Central Location Ambient air Mitchell Central Location Ambient air Henry Central Location Ambient air Galletta Central Location Ambient air Stage Central Location Ambient air Note: Readings indicating elevated moisture are comparatively higher than similar readings collected from like material that are considered non-affected or outside of immediate areas of known impact. Readings are also compared to criterion suggested by Delmhorst and / or other moisture equipment manufacturer for wood, gypsum, cement or other materials and / or components. Drying: Indoor Relative Humidity (RH%) should typically be maintained between 30% to 60% for comfortable living conditions as recommended by ASHRAE. For drying, optimally the relative humidity should be lowered to 20% to 30% for optimal drying conditions by removing excess moisture. Thermal conditions should also be considered when a drying effort is undertaken to determine an optimal approach. A complete understanding of psychrometry (measuring atmospheric moisture) and the relationships between surrounding air masses is essential for successful drying. DEFINITIONS: Finished System includes the underlying wall / ceiling insulations and appropriate vapor barriers. Detail Cleaning involves HEPA vacuuming and damp wiping with a mild detergent. Clean / Treat involves the application of an appropriate cleaning / treatment system. Additional Comments: None As described: This concludes the findings and recommendations for this evaluation. In the event you have questions or require additional information, please do not hesitate to contact us. AQM All Rights Reserved AQM 3 of 3

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12 Collins Classroom: AQM Project # View of bookshelf, heat system is behind Signs of water damage under the sink Dusty conditions under the bookshelf View of return air grille Dusty conditions under the heat fins The flap at the top of the return air appears to be in the closed position View of sink area 1 AQM

13 Mitchell Classroom AQM Project # View of return air grille View of bookshelf, heat system is behind The grille flaps appear to be closed Dusty conditions under the bookshelf Dust in the return air duct Dusty conditions under the bookshelf The flap at the top of the return air appears to be in the open position Dusty conditions under the heat fins 2 AQM

14 Henry Classroom: AQM Project # View of sink area View of baseboard heat Signs of water damage at sink Some dust under the baseboard heat unit Signs of water damage under the sink Some dusty in the baseboard heat unit Dehumidifier in this classroom, not currently in use 3 AQM

15 Galletta Classroom: AQM Project # View of return air grille View of sink area AQM could not completely removed the return air grille without damaging the unit, therefore observations limited Signs of water damage at sink View of return air grille Dust inside the return air grille, AQM did not remove this grille due to health concerns in this Classroom (did not want to disturb dust) 4 AQM

16 Stage: AQM Project # Dust inside baseboard heat register General view General view Water damage at Ceiling Water damage at Ceiling 5 AQM

17 Gymnasium: AQM Project # Water damage to wall General view View of Closet Door to Gym Closet Water damaged wall systems in Closet Water stained ceiling tiles in the Closet Water stained ceiling tiles General view 6 AQM

18 AQM Project # Maintenance removed grille on Stage Steps (inside the Gymnasium) Dusty conditions under the Stage Steps 7 AQM

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22 Micro Diagnostic Services, LLC 349 Randall Rd, Unit 5 Lewiston, ME info@microdiagnostic.net Lab Number: B B B B -4 Sample Description: A1 Outdoor A2 Collins Classroom A3 - Hall out Grades 2 & 4 A4 Mitchell Classroom Air Volume Sampled (L): Detection Limit (Ct./m3): Background (0-5): Spore Genus/Category Client: Air Quality Management, Inc. Project: Manchester WO: B Medium: Air-O-Cell Airborne Fungal Spore Analysis by Direct Optical Microscopy Ct Ct./m 3 % Ct Ct./m 3 % Ct Ct./m 3 % Received: 1/19/2017 Reported: 1/22/2017 Ct Ct./m 3 % Alternaria Ascospores Aspergillus/Penicillium-like Basidiospores Bipolarus++ Bispora Chaetomium Cladosporium Curvularia Epicoccum Fusarium Memnoniella* Pithomyces Rhizopus Rusts Myxomycetes Stachybotrys* Stemphilium Torula Trichoderma Ulocladium Other Colorless Hyphal Fragments Total Fungi , , Comment: Note: Values may not appear to be additive due to rounding; detection limit may be reduced in some samples by background interference. Bipolaris++ = Bipolarus/Dreschlera/Exserohilium; Myxomycetes++ = Smuts/Myxomycetes/Periconia *Minimum detection limit may be less for certain spore types (e.g. Stachybotrys species), for which 100% of the sample trace is analyzed. Debris Rating Scale: 0 = No trace visible; 5 = Contiguous debris. Background debris levels greater than 3 indicate poor visibilty for the analyst reading the slide, which can result in under-counting of some types of spores, particularly smaller spores such as Apergillus/Penicillium-like. Disclaimer: Micro Diagnostic Services (MDS) is not responsible for limitations of sampling or analytical methodologies. Client is responsible for all sample collection activities including labeling of samples and proper submission of sample information on the Service Request Record form. Interpretation of data contained in this report is the responsibility of the Client. This report relates only to the samples contained herein and may not be reproduced, except in full, without written approval by MDS. In all cases, MDS maintains liability limited to the analytical fees charged by MDS for analysis. Use of this report or data contained herein by any party implies acceptance of these terms. Analyst: Nick Ferrala, Microbiologist, BA, CIEC

23 Micro Diagnostic Services, LLC 349 Randall Rd, Unit 5 Lewiston, ME info@microdiagnostic.net Air Volume Sampled (L): Detection Limit (Ct./m3): Background (0-5): Spore Genus/Category Client: Air Quality Management, Inc. Received: 1/19/2017 Project: Manchester Reported: 1/22/2017 WO: B Medium: Air-O-Cell Airborne Fungal Spore Analysis by Direct Optical Microscopy Lab Number: B B B B -8 Sample Description: A5 - Hall out A6 A7 A8 Grades 4 & 5 Henry Classroom Galetta Classroom Stage / 4 Ct Ct./m 3 % Ct Ct./m 3 % Ct Ct./m 3 % Ct Ct./m 3 % Alternaria Ascospores Aspergillus/Penicillium-like Basidiospores , Bipolarus++ Bispora Chaetomium Cladosporium Curvularia Epicoccum Fusarium Memnoniella* Pithomyces Rhizopus Rusts Myxomycetes Stachybotrys* Stemphilium Torula Trichoderma Ulocladium Other Colorless Hyphal Fragments Total Fungi , Comment: Note: Values may not appear to be additive due to rounding; detection limit may be reduced in some samples by background interference. Bipolaris++ = Bipolarus/Dreschlera/Exserohilium; Myxomycetes++ = Smuts/Myxomycetes/Periconia *Minimum detection limit may be less for certain spore types (e.g. Stachybotrys species), for which 100% of the sample trace is analyzed. Debris Rating Scale: 0 = No trace visible; 5 = Contiguous debris. Background debris levels greater than 3 indicate poor visibilty for the analyst reading the slide, which can result in under-counting of some types of spores, particularly smaller spores such as Apergillus/Penicillium-like. Disclaimer: Micro Diagnostic Services (MDS) is not responsible for limitations of sampling or analytical methodologies. Client is responsible for all sample collection activities including labeling of samples and proper submission of sample information on the Service Request Record form. Interpretation of data contained in this report is the responsibility of the Client. This report relates only to the samples contained herein and may not be reproduced, except in full, without written approval by MDS. In all cases, MDS maintains liability limited to the analytical fees charged by MDS for analysis. Use of this report or data contained herein by any party implies acceptance of these terms. Analyst: Nick Ferrala, Microbiologist, BA, CIEC

24 Micro Diagnostic Services, LLC 349 Randall Rd, Unit 5 Lewiston, ME info@microdiagnostic.net Lab Number: B -9 Sample Description: A9 Multi Purpose Room Air Volume Sampled (L): Detection Limit (Ct./m3): Background (0-5): 1 Spore Genus/Category Ct Ct./m 3 % Alternaria Ascospores Aspergillus/Penicillium-like Basidiospores Bipolarus++ Bispora Chaetomium Cladosporium Curvularia Epicoccum Fusarium Memnoniella* Pithomyces Rhizopus Rusts Myxomycetes++ Stachybotrys* Stemphilium Torula Trichoderma Ulocladium Other Colorless Hyphal Fragments Total Fungi Comment: Client: Air Quality Management, Inc. Received: 1/19/2017 Project: Manchester Reported: 1/22/2017 WO: B Medium: Air-O-Cell Airborne Fungal Spore Analysis by Direct Optical Microscopy Ct Ct./m 3 % Ct Ct./m 3 % Ct Ct./m 3 % Note: Values may not appear to be additive due to rounding; detection limit may be reduced in some samples by background interference. Bipolaris++ = Bipolarus/Dreschlera/Exserohilium; Myxomycetes++ = Smuts/Myxomycetes/Periconia *Minimum detection limit may be less for certain spore types (e.g. Stachybotrys species), for which 100% of the sample trace is analyzed. Debris Rating Scale: 0 = No trace visible; 5 = Contiguous debris. Background debris levels greater than 3 indicate poor visibilty for the analyst reading the slide, which can result in under-counting of some types of spores, particularly smaller spores such as Apergillus/Penicillium-like. Disclaimer: Micro Diagnostic Services (MDS) is not responsible for limitations of sampling or analytical methodologies. Client is responsible for all sample collection activities including labeling of samples and proper submission of sample information on the Service Request Record form. Interpretation of data contained in this report is the responsibility of the Client. This report relates only to the samples contained herein and may not be reproduced, except in full, without written approval by MDS. In all cases, MDS maintains liability limited to the analytical fees charged by MDS for analysis. Use of this report or data contained herein by any party implies acceptance of these terms. Analyst: Nick Ferrala, Microbiologist, BA, CIEC

25 Micro Diagnostic Services, LLC 349 Randall Rd, Unit 5 Lewiston, ME info@microdiagnostic.net Lab Number: B B B B -13 Sample Description: T1 Collins Class Dust T2 Mitchell Class Dust T3 Henry Class Dust T4 Stage Rm Dust Surface Area Sampled (cm 2 ): Detection Limit (Ct./cm 2 ): Background (0-5): / Spore Genus/Category Client: Air Quality Management, Inc. Project: Manchester WO: B Medium: Surface Tape Quantitative Microscopic Examination Report - Fungal Spores Ct Ct./cm 2 % Ct Ct./cm 2 % Ct Ct./cm 2 % Received: 1/19/2017 Reported: 1/22/2017 Ct Ct./cm 2 % Alternaria Ascospores Aspergillus/Penicillium-like Basidiospores Bipolarus Botrytis Chaetomium Cladosporium Curvularia Epicoccum Fusarium Memnoniella Pithomyces Rhizopus Rusts Myxomycetes Stachybotrys Stemphilium Torula Trichoderma Ulocladium Bispora Hyphal Fragments Total Fungi 182 2, Comment: Relative Abundance: Trace = 1-10 spores, Low = spores, Moderate = spores; High = >1000 spores Note: Values may not appear to be additive due to rounding. Bipolaris++ = Bipolarus/Dreschlera/Exserohilium; Myxomycetes++ = Smuts/Myxomycetes/Periconia Detection Limits may vary depending on background debris and percent of sample area analyzed. Debris Rating Scale: 0 = No particles visible; 5 = Contiguous debris. Background debris levels greater than 3 indicate poor visibilty for the analyst reading the slide, which can result in under-counting of some types of spores, particularly smaller spores such as Apergillus/Penicillium-like. Disclaimer: Micro Diagnostic Services (MDS) is not responsible for limitations of sampling or analytical methodologies. Client is responsible for all sample collection activities including labeling of samples and proper submission of sample information on the Service Request Record form. Interpretation of data contained in this report is the responsibility of the Client. This report relates only to the samples contained herein and may not be reproduced, except in full, without written approval by MDS. In all cases, MDS maintains liability limited to the analytical fees charged by MDS for analysis. Use of this report or data contained herein by any party implies acceptance of these terms. Analyst: Nick Ferrala, Microbiologist, BA, CIEC

26 Page 1 of 3 I Northeast Phone FAX, Laboratory "0at:=?"'"."d "'"''0- S e r v i c e s Air Quality Management Received: 1/19/2017 Rev 1. 1/27/2017 Reported: 1/27/2017 Project No: Microbiological Analysis - Bulk Samples Lab Number Sample Description CV1 - Johnson Carpet CV2 - Collins Carpet CV3 - Galletta Carpet Sample Type Dust Dust Dust CFUper CFU per CFUper CFU per CFU per CFUper Parameter Plate Dilution Unit* % Plate Dilution Unit* % Plate Dilution Unit* % Total Fungi (MEA/S) 100 3, , , Non-Sporulating Fungi , , , Cladosporium sp , Penicillium sp Aspergillus sp Aureobasidium sp Note: Values may not appear to be additive due to rounding of calculations. *Unit is per swab for swab samples, per wipe for sponge wipe samples and per gram for all bulk material samples. Comments: Reviewed By: Brett Goodrich, Manager, Environmental Microbiology Department Analytical results and reports are generated by NEL at the request of and for the exclusive use of the person or entity (client) named on this report. Results, reports or copies of same will not be released b) NEL to any third party without the prior express written consent from the client named in this report. This report applies only to those samples taken at the time, place and location referenced by the client. This report makes no express or implied warranty or guarantee as to the sampling methodology used by the individual performing the sampling unless sampling was performed by NEL. The client is solely responsible for the use and interpretation of these results and NEL makes no express or implied warranties as to such use or interpretation. NEL is not able to make and does not make a determination as the soundness or safety of a product, environment or property from only the samples sent to their laboratory for analysis. Unless otherwise specified by the Client, NEL reserves the right to dispose of all samples after the testing of such samples is sufficiently completed or after a thirty-day period, whichever period is greater. Samples for Microbiology that degrade rapidly or pass their hold times will be retained for shorter periods or not at all. NEL liability extends only to the cost of the testing.

27 MLüJNortlieaSt Page 2 of 3 Ship samples to: Phone: 1(800) Chain of Custody Record 227 China Road info@nelabservices.com EnVironmental Winslow, Maine Website: Microbiology Analysis Client: Air Quality Management Services Address: P.O. Box 2491 City, State, Zip: Lewiston ME Contact: Randy Geoffroy Lab Use Only Phone: (207) Fax: (207) A?A I e T, Cod Project #: / 7 ' C 3 Project Name: //lfa n c Sampled by: p n o Report by: Fax mail Regular Mail only Turnaround*: Ståndard (2-Day) Next Day (as available) RUSH - Same Day ( surcharge applies) Sample Type Codes AC = Air Culture Plate BS = Bulk Solid RCS = RCS Air Strip ST = Spore Trap WC = Wall Cavity (air) AND = Anderson Plate BURK = Burkard/Allergenco Slide SAS = SAS Plate T = Tape Lift WP = Wipe AOC = Air-O-Cell Cassette D = Dust S = Surface Swab W = Water O = Other (describe) Sample Informatior Lab No. Sample Identification Type Date/Time Volume/Area Analysis Requested**? (5 on t r ld 4 / Cvh('ollikt Gr et ) 7 -Ga j)eth nrøt1' b Spore Traps - Brand & Type (e.g. Cyclex slide, Air00-Cell Cassette, Laro-100, etc.): Air Culture Plates - Sampler & Type (e.g. Anderson N6, SAS-100, etc.): Special sample information, testing or reporting instructions: D te Time Custody Record Samples relin i d by: _ Sam le;s rece%ed by: Comments *Turnaround times are for Direct-Exam analysis only and are contingent on daily workload; culture sample turnaround is 5-6 business days. Please contact NEL prior to submitting samples for same-day turnaround. **Analysis Requested. Please describe or use NEL Analysis Code.

28 Page 3 of 3 Standard Operating Procedure for Sample Receipt and Log-In of Analytical Samples Rev. 12/01/16 NORTHEAST LABORATØRY SERVICES SAMPi,E RECEIPT CONDITION REPORT Client: NEL Sample Number/Rangè Protect: Date/Time Received: _ R 7 / # Initi Tracking Number:. Rush? AT INDOOR AIR QUALITY Y No 1. Is the COC properly filled out? 2. Do sample labels match the COC7 3. Are samples in good condition? Corñrnents: