(With copy of report from analytical lab.) Post Decontamination Sampling Results Table: Post Decontamination Site Photos Photos that document the condition of the site upon completion of the decontamination project. Statement of Compliance I hereby certify that the statements on this final report are true and accurate to the best of my knowledge. (See Chapter 18.106 Revised Code of Washington (RCW) for false statement or material misrepresentation.) SIGNATURE: DATE: PRINCIPAL OWNER’S Sample ID Sample Analyte Area Pre Decon Post Decon Number Location* Sampled Results Results SM1-P Living room Meth 400 cm² 40 ug/ 400 cm² .08 ug/ 400 cm² SM2-P Bathroom Meth 100 cm² 220 ug/ 100cm² .09 ug/ 100 cm² ceiling fan SM3-P Sample Blank Non-detect .02 SM4-P Kitchen Meth 400 cm² 117 ug/ 400 cm² .08 ug/ 400 cm² Sample: Analytical Request Form/Chain-of-Custody Record
Post Decontamination Sampling Results Table: (With copy of report from analytical lab.) Sample ID Number Sample Location* Analyte Area Sampled Pre Decon Results Post Decon Results SM1-P Living room Meth 400 cm² 40 ug/ 400 cm² .08 ug/ 400 cm² SM2-P Bathroom ceiling fan Meth 100 cm² 220 ug/ 100cm² .09 ug/ 100 cm² SM3-P Sample Blank Non-detect .02 SM4-P Kitchen Meth 400 cm² 117 ug/ 400 cm² .08 ug/ 400 cm² Post Decontamination Site Photos Photos that document the condition of the site upon completion of the decontamination project. Statement of Compliance I hereby certify that the statements on this final report are true and accurate to the best of my knowledge. (See Chapter 18.106 Revised Code of Washington (RCW) for false statement or material misrepresentation.) PRINCIPAL OWNER’S SIGNATURE: DATE: Sample: Analytical Request Form/Chain-of-Custody Record
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