Appendix C

Sampling and Results Forms

Drinking Water Sampling Sheet

Name of Location:____________________________ Date:________________________

* SW = Surface water, HS = Handsink, DF = Drinking Fountain, HT =Hardtapped, BW = Bottled water, OT = Other

Notes:

How to fill out Drinking Water sampling sheet example

1. Name of the location: BYU Idaho Hinckley Building

2. Address of the location: 525 South center Street

3. Date: Feb 16, 2023

4. Sample ID: The number given for each sample. The preferred method starts with a two-letter abbreviation of the location followed by a dash and then the month and date of the sampling followed by a dash and then the number of the sample and an abbreviation of the substance tested. Example – Two samples were collected in the Hinckley Building on Feb 16, 2023. The substance tested was lead. The first sample number would be HB-2-16-1Pb and the second sample number would be HB-2-16-2Pb. If conducting follow up testing you would use the same system but divide the sample into three samples and assign A, B, C. Example – Sample HB-2-16-2Pb was over the action limit so follow up testing was required and conducted on Feb 23, 2023. The follow up samples would be HB-2-23-2A, HB-2-23-2B, and HB-2-23-2C.

5. Location: Brief description of the sampling location. Example – The water sample was collected from the lower drinking fountain in the northwest corner of the building. The description could be NW lower drinking fountain.

6. Source type: What type of water was collected. The asterisk (*) at the bottom of the sampling sheet provides the possible source types.

7. Volume: The amount of water collected in the sample. Initial tests should be one Liter while the follow up tests are 250 ml.

8. Substances tested: the chemicals you want the lab to test. Example – You are testing for lead you could put lead or Pb.

9. Results: These are the results that you receive from the lab. Example – Your results showed 0.0175 mg/L then put that result in the column.

10. Action Limit: Look at the jurisdictional standard for your area. Rexburg falls under the national standard of 0.015 mg/L for lead so put that in the column.

11. Over AL: This is a column that is only marked if the concentration is above the jurisdictional Action Limit.

12. Notes: This is a location on the sampling form where you can include any observations, problems or equipment issues you had during testing.

DRINKING WATER CHAIN OF CUSTODY FORM

How to fill out a Drinking Water Chain of Custody Form example

1. Client Name: Who hired you to do the work. Example – BYU Idaho Facilities Management

2. Client Address: Address of the job. Example – 525 South center Street

3. Client Phone: Phone number of client. Example – (208) 496-1411

4. Fax: Fax number if applicable. Example – (208) 496-1414

5. Samplers’ Name: The name of the person collecting the water samples. Example –Darin Hayes.

6. Name of the location: Example - BYU Idaho Hinckley Building

7. Project Name: Name assigned for the project. Example – Hinckley Building Water Testing

8. Project Manager: The person who oversees the project. Sometimes it is the same as the sampler or other times it’s a manager. Example – Sam Merrick.

9. Compliance Sample: If this sampling is being done as part of the required sampling mark “yes.” If this is considered voluntary testing mark “no.”

10. Samplers’ Number: Number of the sampler in case the lab needs to make contact or ask questions. Example – (208) 496-4671.

11. Sample Number: This is the assigned sample number recorded on the Drinking Water Sampling sheet. Example – HB-2-16-2Pb.

12. Sample Type: What type of water was collected. The bottom box on the left has four possible selections for Sample Type. The sample was Drinking Water so select DW.

13. Date Sampled: The date the sample was collected. Example— 2/16/23

14. Time: The approximate time the sample was collected. Example— 1:05 PM.

15. Substance identification columns: mark only the columns that apply to the samples. Example— The test for both lead and copper in the water. The only column marked should be the metals column.

16. List the metals to be tested: Specific names of metals. Example— If testing for both copper and lead, write copper and lead or Cu and Pb.

17. Relinquished by: When the samples are passed on to another person—either put in the mail or dropped off at the lab—there needs to be documentation that the exchange occurred. Upon passing the samples to the next person in the chain, immediately sign your name. Example—Darin Hayes.

18. Time: What time were the samples passed to the next person in the chain. Example— 4:35PM.

19. Received: This is the signature of the person in the chain that received the samples. They will sign that they received them. Example— Adan Perez

20. Date: The date that the person who received the samples received the samples. Example– 2/18/23

21. Turnaround time: How long the lab has to return the results. This depends on the budget of the project and how urgent it is to receive the results. 48 hours is standard. Faster than that usually incurs an extra charge. Slower than 48 hours might yield a discount from the lab.

Results for: BYU Idaho, Hinckley Building

Samples Received: 18 Feb 2023

Samples Tested: 19 Feb 2023

Results Sent: 19 Feb 2023

Initial Drinking Water Results

*Lead and copper are regulated by a Treatment Technique that requires systems to control the corrosiveness of their water. If tap water samples exceed the action level, water systems must take additional steps. For copper, the action level is 1.3 mg/L, and for lead is 0.015 mg/L.

Results for: BYU Idaho, Hinckley Building

Samples Received: Feb 24, 2023

Samples Tested: Feb 25, 2023

Results Sent: Feb 25, 2023

Follow Up Drinking Water Results

*Lead and copper are regulated by a Treatment Technique that requires systems to control the corrosiveness of their water. If tap water samples exceed the action level, water systems must take additional steps. For copper, the action level is 1.3 mg/L, and for lead is 0.015 mg/L.

AIR SAMPLING SHEET

Name:_____________________________ Date:___________________________ Location:___________________________

Notes:

How to fill out an Air Sampling Sheet

1. Name: The name of the inspector. Example – Darren Hayes

2. Location: The location where the samples will be collected. Example – BYU Hart Building

3. Date: The date of the testing. Example – March 17, 2023

4. Sample Number: The sample number assigned to the sample. The preferred method starts with a two-letter abbreviation of the location followed by a dash and then the month and date of the sampling followed by a dash and then the number of the sample and an abbreviation of the substance tested. Example – Two samples were collected in the Hart Building on March 17, 2023. The substances tested were Formaldehyde and VOCs. The first sample number would be HB-3-17-1f and the second sample number would be HB-3-17-2V.

5. Name/Location: The name of the worker being tested or the room where the testing occurs. Example – Testing was done in the Hart building room 350.

6. Chemical or agent: What is being tested. Example – Formaldehyde or VOC’s

7. Medium: Material used to conduct the testing. Example Passive Monitor or PM

8. Time on: The time the air sample was started. Example – 2:30PM

9. Time off: The time the air sampling ended. Example – 2:47PM

10. Total Time: The difference between time on and time off. Example 2:47-2:30 = 17 minutes.

11. Volume: Amount of air pulled through an air sample or if passive monitors used this is not applicable. Example – It was a passive monitor, so NA is put in the column.

12. Conc.: The total concentration or results. This number is provided by the lab. Example – Lab results indicate a concentration of 22ppm, then put 22ppm in the column.

13. This is a location on the sampling form where you can include any observations, problems or equipment issues you had during testing.

AIR SAMPLING CHAIN OF CUSTODY FORM

2758 Pine Lake Road, Hibbard, Idaho 8344

Phone: (208) 359-1855 Fax (208) 359-1856

How to fill out an Air Sampling Chain of Custody Form

1. Client Name: Who hired you to do the work. Example – BYU Idaho Facilities Management

2. Client Address: Address of the job. Example – 525 South center Street

3. Sampler Name: The name of the person collecting the water samples. Example –Darin Hayes.

4. Project Name: Name assigned for the project. Example – Hart Building Air Testing

5. Project Manager. The person who oversees the project. Sometimes it is the same as a sampler or other times it’s a manager. Example – Sam Merrick.

6. Project Managers Number: The phone number of the project manager in case the lab needs to make contact or ask questions. Example – (208) 496-4671.

7. Sample Number: This is the assigned sample number recorded on the Air Sampling sheet. Example – HB-3-17-1F.

8. Date Sampled: The date the sample was collected. Example— 3/17/23

9. Collection Medium: What material the air sampling was conducted on. Example – Sampling was collected with a passive monitor, so PM goes in the column.

10. Air Volume: Amount of air that passes through the medium. This does not apply to passive monitors. Example – Put NA in the column.

11. Passive Monitors (minutes): If a passive monitor was used, how long in minutes was it used. Example – If a Passive monitor was used for 17 minutes, put 17 in the column.

12. Analysis Requested: List the substance to be tested by the lab. Example — If testing for Formaldehyde and VOCs, write Formaldehyde or VOCs in the appropriate box for that sample.

13. Relinquished by: When the samples are passed on to another person, put in the mail or dropped off at the lab, there needs to be documentation that the exchange occurred. Upon passing the samples to the next person in the chain, immediately print and sign your name and the date and time. Example—Darin Hayes Darin Hayes 3/17 3:30 pm.

14. Date: Is the date that the person who received the samples received the samples. Example– 2/18/23

15. Turnaround time: How long the lab has to return the results. This depends on the budget of the project and how urgent it is to receive the results. 2 days is standard. Faster than that usually incurs an extra charge which is indicated as a percentage of the standard cost added to the total.

MOLD SAMPLING CHAIN OF CUSTODY FORM

926 Oak Hills Rd, Hidden Valley, Idaho 83440

Phone: (208) 360-2218 Fax (208) 360-2226

How to fill out a Mold Sampling Chain of Custody Form

1. Client Name: Who hired you to do the work. Example – BYU Idaho Facilities Management

2. Client Address: Address of the job. Example – 525 South center Street

3. Sampler Name: The name of the person collecting the water samples. Example –Darin Hayes.

4. Project Name: Name assigned for the project. Example – Hart Building Air Testing

5. Project Manager. The person who oversees the project. Sometimes it is the same as a sampler or other times it’s a manager. Example – Sam Merrick.

6. Project Managers Number: The phone number of the project manager in case the lab needs to make contact or ask questions. Example – (208) 496-4671.

7. Sample Number: This is the assigned sample number given to the sample. Example – if the first sample is a bio cassette then the sampling number would be HB-3-17-1BC, If the second sample was a spore trap the sample number should be HB-3-17-2ST.

8. Description: Describe the place the sample was collected. Example—Middle of Hart 370 or Vent in Hart 370 restroom.

9. Collection Medium: What material the air sampling was conducted on. Example – Sampling was collected with a passive monitor, so PM goes in the column.

10. Sample Type. What type of sample was collected. Look at the list below the chart. Example – The sample was collected using a Bio cassette, then BC ids put in the column. If a tape sample was collected TS goes in the column.

11. Air Volume: Amount of air that passes through the medium. Spore traps require 5 minutes at 15 LPM for a total of 75 L. Bio cassettes require 5 minutes at 28.3 L for a total of 141.5 L, Volume is not necessary for tape and swab samples Example – If it was a tape sample put NA in the column, if the sample was a spore trap put 75 in the column.

12. Requested Analysis: There are five columns past Air Volume. Put an X in the column that represents the type of analysis desired.

Example –

13. Relinquished by: When the samples are passed on to another person, put in the mail or dropped off at the lab, there needs to be documentation that the exchange occurred. Upon passing the samples to the next person in the chain, immediately print and sign your name and the date and time. Example—Darin Hayes Darin Hayes 3/17 3:30 pm.

14. Date: Is the date that the person who received the samples received the samples. Example– 2/18/23

15. Turnaround time: How long the lab has to return the results. This depends on the budget of the project and how urgent it is to receive the results. 2 days is standard. Faster than that usually incurs an extra charge which is indicated as a percentage of the standard cost added to the total.

Interpreting Mold Air Sampling Results

Mold Standards

There are No Federal or State Agency established Maximum Exposure Limits (MEL) or threshold level values for airborne indoor mold, so there are no government standards for mold.(A)

Air Samples

When evaluating indoor levels of most pollutants, you can collect air samples, compare your sampling results to established exposure standards, and make relatively unambiguous decisions regarding the need for remediation. Results from airborne mold samples are not amenable to this general methodology, due to difficulties in developing such exposure standards. related to the fact that mold spores are a natural part of the environment and normally found both inside and outside of buildings. Consequently, in the case of airborne mold samples, one must rely on a different general test methodology that considers not only the overall level of mold spores, but also a comparison of these levels to background levels for each type of mold spore. (B)

Several different quantitative guidelines for interpretation of indoor/outdoor data have been published. These include a requirement that indoor levels be lower than those outdoors, with indoor/outdoor ratios >1 indicating an indoor problem. (B)

The publication, American Conference of Governmental Industrial Hygienists (Air Sampling Instruments for Evaluation of Atmospheric Contaminants 1995), recommended the following guidelines:

Many people believe that a count of 48 Stachybotrys or Chaetomium spores/m3 of air would be unusually high as this mold is not normally airborne. Conversely, a count of 200 Aspergillus sp. spores/m3 of air in the same circumstances might be considered very clean. (C)

Viable sampling in areas where people may be compromised requires 0 CFU of Aspergillus Fumigatas.

Looking at the types of mold spores present may give you an idea of the sources or causes.

For example:

Aspergillus/Penicillium are early colonizers of damp building materials.(A)

Chaetomium or Stachybotrys later colonizers of chronic moisture/wet areas.(A)

Acsocpores and basidiospores are common outdoor mold, when found inside their presence may be the time of year or poorly filtered outdoor air (A)

(A) www.currenenvironmental.com

(B) www.emlab.com

(C) http://www.consumermoldguide.org