Solid Waste (SW) Series Organic Data Return Form
Please fill in your information below:
Name: asi Client Code:
Company: US EPA ID #:
Address: DMRQA Permittee #:
City: State: Zip: Phone #:
email: Fax #:
Study #: asi Order #:
Now please fill in the </>, Reporting Value and Method Description for each parameter that you wish to report on. All values reported should be in the units provided in the units column.
Please enter the Pesticides I sample lot number to the right
asi Lot #:
Pesticides I
NELAC Analyte #
</>
Reporting Value
Units
Method Description
Aldrin
7025
ug/kg
alpha-BHC
7110
ug/kg
beta-BHC
7115
ug/kg
delta-BHC
7105
ug/kg
gamma-BHC [Lindane]
7120
ug/kg
4,4'-DDD
7355
ug/kg
4,4'-DDE
7360
ug/kg
4,4'-DDT
7365
ug/kg
Dieldrin
7470
ug/kg
Endosulfan I
7510
ug/kg
Endosulfan II
7515
ug/kg
Endosulfan sulfate
7520
ug/kg
Endrin
7540
ug/kg
Endrin aldehyde
7530
ug/kg
Heptachlor
7685
ug/kg
Heptachlor epoxide (beta)
7690
ug/kg
Methoxychlor
7810
ug/kg
Please enter the Pesticides II sample lot number to the right
asi Lot #:
Pesticides II
EPA Analyte #
</>
Reporting Value
Units
Method Description
Chlordane (total)
7250
ug/kg
Please enter the Pesticides III sample lot number to the right
asi Lot #:
Pesticides III
EPA Analyte #
</>
Reporting Value
Units
Method Description
Toxaphene
8250
ug/kg
Please enter the PCB's in water sample lot number to the right
asi Lot #:
PCB's in water
EPA Analyte #
</>
Reporting Value
Units
Method Description
Aroclor 1016
8880
ug/kg
Aroclor 1221
8885
ug/kg
Aroclor 1232
8890
ug/kg
Aroclor 1242
8895
ug/kg
Aroclor 1248
8900
ug/kg
Aroclor 1254
8905
ug/kg
Aroclor 1260
8910
ug/kg
Please enter the Herbicides sample lot number to the right
asi Lot #:
Herbicides
EPA Analyte #
</>
Reporting Value
Units
Method Description
2,4-D
8545
ug/kg
Dicamba
8595
ug/kg
Disulfoton
8625
ug/kg
2,4,5-T
8655
ug/kg
2,4,5-TP [Silvex]
8650
ug/kg
Please enter the Volatiles sample lot number to the right
asi Lot #:
Volatiles
EPA Analyte #
</>
Reporting Value
Units
Method Description
Benzene
4375
ug/kg
Bromodichloromethane
4395
ug/kg
Bromoform
4400
ug/kg
Carbon tetrachloride
4455
ug/kg
Chlorobenzene
4475
ug/kg
Chlorodibromomethane
4575
ug/kg
Chloroform
4505
ug/kg
1,2-Dichlorobenzene
4610
ug/kg
1,3-Dichlorobenzene
4615
ug/kg
1,4-Dichlorobenzene
4620
ug/kg
1,1-Dichloroethane
4630
ug/kg
1,2-Dichloroethane
4635
ug/kg
Ethylbenzene
4765
ug/kg
Methylene chloride
4975
ug/kg
4-Methyl-2-pentanone (MIBK)
4995
ug/kg
1,1,1,2-Tetrachloroethane
5105
ug/kg
1,1,2,2-Tetrachloroethane
5110
ug/kg
Tetrachloroethene
5115
ug/kg
Toluene
5140
ug/kg
1,1,1-Trichloroethane
5160
ug/kg
Trichloroethene
5170
ug/kg
Xylenes, total
5260
ug/kg
Please enter the Semivolatiles sample lot number to the right
asi Lot #:
Semivolatiles (BNA's)
EPA Analyte #
</>
Reporting Value
Units
Method Description
Acenaphthene
5500
ug/kg
Acenaphthylene
5505
ug/kg
Anthracene
5555
ug/kg
Benzo(a)anthrecene
5575
ug/kg
Benzo(b)fluoranthene
5585
ug/kg
Benzo(k)fluoranthene
5600
ug/kg
Benzo(g,h,i)perylene
5590
ug/kg
Benzo(a)pyrene
5580
ug/kg
4-Bromophenyl-phenylether
5660
ug/kg
bis(2-Chloroethoxy)methane
5760
ug/kg
bis(2-Chloroisopropyl)ether
5780
ug/kg
bis(2-ethylhexyl)phthalate
6255
ug/kg
Butylbenzylphthalate
5670
ug/kg
4-Chloro-3-methylphenol
5700
ug/kg
2-Chlorophenol
5800
ug/kg
2-Chloronaphthalene
5795
ug/kg
4-Chlorophenyl-phenylether
5825
ug/kg
Chrysene
5855
ug/kg
Dibenzo(a,h)anthracene
5895
ug/kg
Dibenzofuran
5905
ug/kg
2,4-Dichlorophenol
6000
ug/kg
Diethyl phthalate
6070
ug/kg
2,4-Dimethylphenol
6130
ug/kg
Dimethyl phthalate
6135
ug/kg
Di-n-butylphthalate
5925
ug/kg
2,4-Dinitrophenol
6175
ug/kg
2,4-Dinitrotoluene
6185
ug/kg
2,6-Dinitrotoluene
6190
ug/kg
Di-n-octylphthalate
6200
ug/kg
Fluoranthene
6265
ug/kg
Fluorene
6270
ug/kg
Hexachlorobenzene
6275
ug/kg
Hexachlorobutadiene
4835
ug/kg
Hexachlorocyclopentadiene
6285
ug/kg
Hexachloroethane
4840
ug/kg
Indeno(1,2,3-cd)pyrene
6315
ug/kg
Isophorone
6320
ug/kg
2-Methyl-4,6-Dinitrophenol
6360
ug/kg
2-Methylphenol
6400
ug/kg
Naphthylene
5005
ug/kg
Nitrobenzene
5015
ug/kg
2-Nitrophenol
6490
ug/kg
4-Nitrophenol
6500
ug/kg
N-Nitroso-di-n-propylamine
6545
ug/kg
Pentachlorophenol
6605
ug/kg
Phenanthrene
6615
ug/kg
Phenol
6625
ug/kg
Pyrene
6665
ug/kg
1,2,4-Trichlorobenzene
5155
ug/kg
2,4,5-Trichlorophenol
6835
ug/kg
2,4,6-Trichlorophenol
6840
ug/kg
Additional comments: