Lead and Copper Rule Tap Sampling Field Log

Field inspection log for documenting first-liter and fifth-liter tap samples at lead service line sites, including stagnation time, site conditions, sample identifiers, and chain-of-custody details for Lead and Copper Rule/LCRI compliance monitoring.

Site & Sampling Event Information

• Sampling event date and start time recorded
  Record the date and time the sampling event began.
• Site ID and service address documented
  Unique site identifier and service address for the sampling location.
• Sampling purpose identified as Lead and Copper Rule / LCRI compliance
  Identify the reason for the sampling event.
• Sampler name and organization recorded
  Name of the field sampler and employer/organization.

Site Conditions and Lead Service Line Verification

• Lead service line site confirmed
  Confirm the site is a designated lead service line sampling location.
• Sampling point is the designated kitchen or first-draw tap
  Confirm the sample was collected from the approved tap location.
• Aerator, screen, or attachment condition documented
  Document the condition of the faucet aerator, screen, or other attachment.
• Site access and interior conditions noted
  Record any access limitations or site conditions that may affect sampling.

Stagnation Time and Pre-Sampling Requirements

• Stagnation start time recorded
  Time when water use ceased for the required stagnation period.
• Stagnation duration meets sampling protocol
  Measured stagnation time before sample collection.
• No water use occurred during stagnation period
  Confirm that no water was used at the tap during the stagnation period.
• Pre-sampling flush or disturbance observed
  Confirm the tap was not flushed or disturbed before the first-liter sample was collected.

First-Liter Sample Collection

• First-liter sample bottle ID recorded
  Unique identifier for the first-liter sample container.
• First-liter sample collected from initial draw
  Confirm the first-liter sample was collected from the initial water draw at the tap.
• First-liter collection time recorded
  Time the first-liter sample was collected.
• First-liter sample volume verified
  Measured volume of the first-liter sample.
• First-liter sample sealed and labeled
  Confirm the sample was sealed and labeled immediately after collection.

Fifth-Liter Sample Collection

• Fifth-liter sample bottle ID recorded
  Unique identifier for the fifth-liter sample container.
• Fifth-liter sample collected after first four liters discarded or routed per protocol
  Confirm the fifth-liter sample was collected according to the approved fifth-liter protocol.
• Fifth-liter collection time recorded
  Time the fifth-liter sample was collected.
• Fifth-liter sample sealed and labeled
  Confirm the sample was sealed and labeled immediately after collection.

Chain of Custody, Deviations, and Sign-Off

• Chain-of-custody form completed and sample transfer documented
  Confirm the chain-of-custody record is complete for all collected samples.
• Any deviations, non-conformances, or field issues documented
  Record any protocol deviations, unusual site conditions, or issues affecting sample validity.
• Inspector signature
  Signature of the person completing the field log.