LFFM QTR LFFM Chem_LFFM_HAF_Results_Sheet 2023.xlsx

Standardized Reporting Forms for Federally Funded Public Health Projects and Agreements

LFFM QTR LFFM Chem_LFFM_HAF_Results_Sheet 2023.xlsx

OMB: 0910-0909

Document [xlsx]
Download: xlsx | pdf

Overview

Coversheet
Sample Info NOT BLINDED OR TDS
TDS Sample Info & Results
TDS Method LOD and LOQ
Allergens (HUMAN FOOD ONLY)
Amygdalin
DMAA DMBA (HUMAN FOOD ONLY)
Melamine, Cyanuric Acid
Minerals (ANIMAL FOOD ONLY)
Mycotoxins (ANIMAL FOOD ONLY)
Mycotoxins (HUMAN FOOD ONLY)
Nitrate, Nitrite
Pesticides
Sulfite
Toxic Elements (HUMAN FOOD ONLY


Sheet 1: Coversheet









OMB Number: 0910-0909 Exp Date: XX/XX/XXXX See bottom of page for PRA statement































Recipent Name (Select)
Select

State
Select Recipient Name






Federal Award Identification Number
Select Recipient Name






Report Frequency








Date Completed




























Project Period Start Date








Project End Date








Budget Period Start Date








Budget Period End Date




























Principal Investigator (PI)



PI Email



PI Phone





















Sheet 2: Sample Info NOT BLINDED OR TDS

Instructions to complete this form are available to LFFM grantees on the Food Emergency Response Network (FERN) Portal (www.fernlab.org)


























Recipient Name State Sample Number (ID) LFFM Track Commodity
(from commodity/hazard pair)
Target Species
(Animal Food ONLY)
Form of Feed
(Animal Food ONLY)
Product Description Manufacturer/Brand Product Code or Lot Expiration Date Country of Origin Collecting Entity Collection Location Collection Date Lab Receipt Date Toxic Elements Analysis
Minerals (Animal Food ONLY) Mycotoxins Pesticides Chemo-therapeutics (DMAA/DMBA) Nutritional Analysis Allergens Amygdalin Melamine/Cyanuric acid Nitrite/Nitrate Sulfite
EXAMPLE - PLEASE DELETE ROW AR 123 Chemistry Animal Food Dairy Food + Grain/Aflatoxin Dairy Cattle Complete Feed - Pellet ACME's awesome Dairy Feed ACME 1234 1/2/22 USA AR Inspector (M) Manufacturer/Processor 7/14/21 7/15/21











EXAMPLE - PLEASE DELETE ROW FL abc Chemistry Animal Food Pet Food/Macro Minerals & Moisture Dog RAC (raw agricutural commodity): Corn Max's special diet Max 3456 3/6/22 USA FDACS (R) Packer/Repacker 07/21/21 07/21/21











EXAMPLE - PLEASE DELETE ROW CA CA 1234 Chemistry Animal Food Dog and Cat Food + Grain/Aflatoxin Cat Complete Feed - Kibbled (dry) Pet Food Meow Mix Tuna Delight Meow Mix ABC123 8/9/23 USA UCDAVIS (D) Retail – Grocery 08/03/21 08/06/21

x








EXAMPLE - PLEASE DELETE ROW CO 22222-2020 Chemistry Animal Food RAC (Raw Agricutural Commodities)/Pesticides dog RAC (other - please list in description) sweet potatoes Johnson's Farms

USA CDAI (G) Grower 08/02/21 08/03/21


x







EXAMPLE - PLEASE DELETE ROW FL FS-1009-2020 Chemistry Human Food Cereal Grains/Mycotoxins

Joe's Infant Rice Cereal Joe's Grocery BG3209 6/23/22 China FDACS (D) Retail – Grocery 08/01/21 08/02/21 x










EXAMPLE - PLEASE DELETE ROW CT 2021F00231 Chemistry Human Food Spices, powdered/Peanut and Gluten Allergens

Turmeric Badia 3450

CAES (D) Retail – Grocery 08/04/21 08/06/21











EXAMPLE - PLEASE DELETE ROW CA CA 1235 Chemistry Animal Food Dog and Cat Food + Grain/Aflatoxin Cat RAC (raw agricutural commodity): Corn Ground Corn
7232021

UCDAVIS (M) Manufacturer/Processor 08/06/21 08/10/21








































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































































Sheet 3: TDS Sample Info & Results













































Instructions to complete this form are available to LFFM grantees on the Food Emergency Response Network (FERN) Portal (www.fernlab.org)










































Lab Name State Sample Number (ID) LFFM Track Commodity
(from commodity/hazard pair)
Product Description Brand Product Code or Lot UPC Code Expiration Date Country of Origin Collecting Entity Store Collected from City where collected Collection Date Lab Receipt Date ETHNIC FOODS ONLY
Please reference the originating laboratory's Sample ID Number
APROXIMATE sample size used (grams) SRM description Replicate (Y/N): provide separate results for each replicate As (total)
ppb
Inorganic As (ppb) Organic As MMA
ppb
Organic As DMA
ppb
Cd
ppb
Cr
ppb
Hg
ppb
Mn
ppb
Ni
ppb
Mo
ppb
Pb
ppb
Se
ppb
V
ppb
U
ppb
Sr
ppb
Ca
ppm
Cu
ppb
Fe
ppb
K
ppm
Mg
ppm
Na
ppm
P
ppm
Zn
ppb
Comments



Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food










































Chemistry Human Food









































Sheet 4: TDS Method LOD and LOQ

Instructions to complete this form are available to LFFM grantees on the Food Emergency Response Network (FERN) Portal (www.fernlab.org)






Lab Name State Please note approximate sample size digested;
1 g for most food,
5 g for most liquids (juice)

Element units MLOD MLOQ




As, total ppb





Inorganic As ppb

Date reported:


Organic As, MMA ppb





Organic As, DMA ppb





Cd ppb





Cr ppb





Hg ppb





Mn ppb





Ni ppb





Mo ppb





Pb ppb





Se ppb



NOTE:
V ppb



If analyzing more than 1 type of
U ppb



matrix with significantly different
Sr ppb



digestion weights, or different
Ca ppm



commodities with different LOD/LOQ
Cu ppb



please provide MLOD/MLOQ
Fe ppb



information for each
K ppm





Mg ppm



If additional copies of the LOD/LOQ
Na ppm



information are needed, please
P ppm



copy paste to the right to add
Zn ppb



additional columns for each








Approximate digestion weight:
grams


The purpose of this information
Commodity:




is to be able to evaluate the
Comment:




upper bounds for BLOD or BLOQ






samples














MLOD and MLOQ do not have to






be reported on a sample by sample






basis





Sheet 5: Allergens (HUMAN FOOD ONLY)

Instructions to complete this form are available to LFFM grantees on the Food Emergency Response Network (FERN) Portal (www.fernlab.org)




































Lab Name State Sample Number (ID) Product LFFM Track Lab Receipt Date Analysis Completion Date Turn-Around-Time Allergen Detection
Overall Results
Seasame Overall Result Seasame
MLOD
(mg/kg)
Sesame
MLOQ
(mg/kg)
Sesame
Found
(mg/kg)
Gluten Overall Result Gluten
MLOD
(mg/kg)
Gluten
MLOQ
(mg/kg)
Gluten
Found
(mg/kg)
Milk Overall Result Milk
MLOD
(mg/kg)
Milk
MLOQ
(mg/kg)
Milk
Found
(mg/kg)
Peanut
Overall Result
Peanut
MLOD
(mg/kg)
Peanut
MLOQ
(mg/kg)
Peanut Found
(mg/kg)
Peanut -2nd kit
MLOD
(mg/kg)
Peanut -2nd kit
MLOQ
(mg/kg)
Peanut -2nd kit
(mg/kg)
Comments








EXAMPLE - PLEASE DELETE CT 2021F00231 Turmeric Chemistry Human Food 08/06/21 08/13/21 7 Allergens Detected



Not Detected 0.5 2.5 ND Detected


Detected 0.5 2.5 42.3 1.2 6 51.6












0 0 12/30/99
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Sheet 6: Amygdalin

Instructions to complete this form are available to LFFM grantees on the Food Emergency Response Network (FERN) Portal (www.fernlab.org)











Lab Name State Sample Number (ID) Product Description LFFM Track Lab Receipt Date Analysis Completion Date Turn-Around-Time Amygdalin
Overall Result
Amygdalin
MLOD
(ug/g)
Amygdalin
MLOQ
(ug/g)
Amygdalin
Amount Found (ug/g)
Comments
EXAMPLE - PLEASE DELETE MO 2021DS003 Apricot Kernels Chemistry Human Food 08/02/21 08/23/21 21 Detected 3.2 15 123



0 0 12/30/99
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0







0 0 12/30/99
0





Sheet 7: DMAA DMBA (HUMAN FOOD ONLY)

Instructions to complete this form are available to LFFM grantees on the Food Emergency Response Network (FERN) Portal (www.fernlab.org)

















Lab Name State Sample Number (ID) Product Description LFFM Track Lab Receipt Date Analysis Completion Date Turn-Around-Time Serving size (grams) Overall Results DMAA
Overall Result
DMAA
MLOD
(mg/g)
DMAA
MLOQ
(mg/g)
DMAA
Amount Found (mg/g)
DMBA
Overall Result
DMBA
MLOD
(mg/g)
DMBA
MLOQ
(mg/g)
DMBA
Amount Found (mg/g)
Comments
EXAMPLE - PLEASE DELETE CT 2021F00231 Turmeric Chemistry Human Food 08/06/21 08/23/21 17 1.5 Detected Detected 1.2 12 23.1 Not Detected 1.3 13 ND



0 0 12/30/99
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0 0 12/30/99
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Sheet 8: Melamine, Cyanuric Acid

Instructions to complete this form are available to LFFM grantees on the Food Emergency Response Network (FERN) Portal (www.fernlab.org)
















Lab Name State Sample Number (ID) Product Description LFFM Track Lab Receipt Date Analysis Completion Date Turn-Around-Time Overall Results Melamine
Overall Result
Melamine
MLOD
(ug/g)
Melamine
MLOQ
(ug/g)
Melamine
Amount Found (ug/g)
Cyanuric Acid
Overall Result
Cyanuric Acid
MLOD
(ug/g)
Cyanuric Acid
MLOQ
(ug/g)
Cyanuric Acid
Amount Found (ug/g)
Comments
EXAMPLE - PLEASE DELETE CT 2021F00231 Turmeric Chemistry Human Food 08/06/21 08/23/21 17 Detected Detected 0.11 0.55 235 Not Detected 1.3 13 ND



0 0 12/30/99
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Sheet 9: Minerals (ANIMAL FOOD ONLY)

Instructions to complete this form are available to LFFM grantees on the Food Emergency Response Network (FERN) Portal (www.fernlab.org)





































Lab Name State Sample Number (ID) Target Species Form of Feed Product Description Collection Location LFFM Track Lab Receipt Date Analysis Completion Date Turn-Around-Time Moisture
% (wt/wt)
Total Copper
MLOD
(ppm)
Total Copper
MLOQ
(ppm)
Total Copper
Amount Found
(ppm)
Calcium
MLOD
(ppm)
Calcium
MLOQ
(ppm)
Calcium
Amount Found (ppm)
Phosphorus
MLOD
(ppm)
Phosphorus
MLOQ
(ppm)
Phosphorus
Amount Found (ppm)
Sodium
MLOD
(ppm)
Sodium
MLOQ
(ppm)
Sodium
Amount Found
(ppm)
Potassium
MLOD
(ppm)
Potassium
MLOQ
(ppm)
Potassium
Amount Found
(ppm)
Sulfur
MLOD
(ppm)
Sulfur
MLOQ
(ppm)
Sulfur
Amount Found
(ppm)
Magnesium
MLOD
(ppm)
Magnesium
MLOQ
(ppm)
Magnesium
Amount Found
(ppm)
Chloride
MLOD
(ppm)
Chloride
MLOQ
(ppm)
Chloride
Amount Found
(ppm)
Comments

EXAMPLE - PLEASE DELETE ROW AR 123 Dairy Cattle Complete Feed - Pellet ACME's awesome Dairy Feed (M) Manufacturer/Processor Chemistry Animal Food 7/15/21 8/1/2021 17 23.5 0.5 1.5 75 3 30 45 0.5 1.5 24 1 10 1230 2 20 235 5 50 124 0.2 0.6 38 1.5 15 43





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Sheet 10: Mycotoxins (ANIMAL FOOD ONLY)

Lab Name State Sample Number (ID) Target Species Form of Feed Product Description link ingredients to feed: State/number (i.e. AR/1)
if applicable
DO NOT USE LAB SAMPLE #
Ingredient/Feed linkage: see drop down list of possible comments
Free Text entry is allowed if provided comments do not describe the situation
Collection Location LFFM Track Lab Receipt Date Analysis Completion Date Turn-Around-Time Mycotoxins Analysis
Overall Results
Total Aflatoxin
Overall Result
Aflatoxin
MLOD
(ug/kg)
Aflatoxin
MLOQ
(ug/kg)
Total Aflatoxin
Amount Found (ug/kg)
Total Fumonisin
Overall Result
Total Fumonisin
MLOD
(ppm)
Total Fumonisin
MLOQ
(ppm)
Total Fumonisin
Amount Found (ppm)
Comments


EXAMPLE - PLEASE DELETE ROW CA CA 1234 Cat Complete Feed - Kibbled (dry) Pet Food Meow Mix Tuna Delight CA/1
(D) Retail – Grocery Chemistry Animal Food 07/12/21 07/19/21 7 Detected Total Aflatoxin Detected 0.5 5 45 Total Fumonisin Not Detected 1 5 not detected



EXAMPLE - PLEASE DELETE ROW CA CA 1235 Cat RAC (raw agricutural commodity): Corn Ground Corn CA/1
(M) Manufacturer/Processor Chemistry Animal Food 07/12/21 07/19/21 7 Detected Total Aflatoxin Detected 0.5 5 538 Total Fumonisin Not Detected 1 5 not detected






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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















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0















0 0 0

0


0















0 0 0

0


0















0 0 0

0


0













Sheet 11: Mycotoxins (HUMAN FOOD ONLY)

Instructions to complete this form are available to LFFM grantees on the Food Emergency Response Network (FERN) Portal (www.fernlab.org)




































Lab Name State Sample Number (ID) Product Description LFFM Track Lab Receipt Date Analysis Completion Date Turn-Around-Time Mycotoxins Analysis
Overall Results
Total Aflatoxin
Overall Result
Aflatoxin
MLOD
(ug/kg)
Aflatoxin
MLOQ
(ug/kg)
Total Aflatoxin
Amount Found (ug/kg)
Total Fumonisin
Overall Result
Total Fumonisin
MLOD
(ppm)
Total Fumonisin
MLOQ
(ppm)
Total Fumonisin
Amount Found (ppm)
Total Patulin
Overall Result
Total Patulin
MLOD
(ug/kg)
Total Patulin
MLOQ
(ug/kg)
Total Patulin
Amount Found
(ug/kg)
Total Vomitoxin (DON)
Overall Result
Total Vomitoxin (DON)
MLOD
(ppm)
Total Vomitoxin (DON)
MLOQ
(ppm)
Total Vomitoxin (DON)
Amount Found
(ppm)
Total Zearalenone
Overall Result
Total Zearalenone
MLOD
(ug/kg)
Total Zearalenone
MLOQ
(ug/kg)
Total Zearalenone
Amount Found
(ug/kg)
Total Ochratoxin
Overall Result
Total Ochratoxin
MLOD
(ug/kg)
Total Ochratoxin
MLOQ
(ug/kg)
Total Ochratoxin
Amount Found
(ug/kg)
Other Myctotoxins Detected
LIST analyte(s)
Other Mycotoxins
MLOD
(ug/kg)
Other Mycotoxins
MLOQ
(ug/kg)
Other Mycotoxin
Amount Found
(ug/kg)
Comments
EXAMPLE - PLEASE DELETE ROW FL FS-1009-2020 Joe's Infant Rice Cereal Chemistry Human Food 07/12/21 07/19/21 7 Detected Total Aflatoxin Detected 0.5 5 12 Total Fumonisin Not Detected 1 5 not detected























0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


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0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


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0


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0


0
































0


0
































0


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0


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0


0
































0


0
































0


0
































0


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0


0
































0


0
































0


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0


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0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0
































0


0






























Sheet 12: Nitrate, Nitrite

Instructions to complete this form are available to LFFM grantees on the Food Emergency Response Network (FERN) Portal (www.fernlab.org)
















Lab Name State Sample Number (ID) Product Description LFFM Track Lab Receipt Date Analysis Completion Date Turn-Around-Time Overall Results Nitrate
Overall Result
Nitrate
MLOD
ppm
Nitrate
MLOQ
ppm
Nitrate
Amount Found ppm
Nitrite
Overall Result
Nitrite
MLOD
ppm
Nitrite
MLOQ
ppm
Nitrite
Amount Found ppm
Comments
EXAMPLE - PLEASE DELETE CT 2021F00231 Turmeric Chemistry Human Food 08/06/21 08/23/21 17 Detected Detected 0.11 0.55 235 Not Detected 1.3 13 ND



0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0












0 0 12/30/99
0










Sheet 13: Pesticides

Lab Name State Sample Number (ID) Product Description Target Species (ANIMAL FOOD ONLY) Form of Feed (ANIMAL FOOD ONLY) Collection Location LFFM Track Lab Receipt Date Analysis Completion Date Turn-Around-Time Pesticide Analyte
Overall Results
Pesticide Analyte (select from drop down list) Pesticide Analyte
MLOD
(ug/g)
Pesticide Analyte
MLOQ
(ug/g)
Pesticide Analyte
Amount Found (ug/g)
Comments
Pesticide results are being reported differently this year















If multiple pesticides are detected, please list each















detected pesticide on a separate row















If multiple pesticides are detected, please list each CO 22222-2020 sweet potatoes dog RAC (other - please list in description) (G) Grower Chemistry Animal Food 09/15/20 10/10/20 25 Detected - Violative 2,3,5,6-Tetrachloroaniline 0.0031 0.0102 52.3
EXAMPLE - PLEASE DELETE ROW CO 22222-2020 sweet potatoes dog RAC (other - please list in description) (G) Grower Chemistry Animal Food 09/15/20 10/10/20 25 Detected - Not Violative Acephate 0.0031 0.0102 0.1
EXAMPLE - PLEASE DELETE ROW CO 22222-2020 sweet potatoes dog RAC (other - please list in description) (G) Grower Chemistry Animal Food 09/15/20 10/10/20 25 Detected - Not Violative Azoxystrobin 0.0031 0.0102 TR (0.008)
EXAMPLE - PLEASE DELETE ROW FL abc Max's special diet Dog RAC (raw agricutural commodity): Corn (R) Packer/Repacker Chemistry Animal Food 07/21/21 08/14/21 24 No Pesticides Detected







0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


0








0 0 0 0


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0 0 0 0


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0 0 0 0


0








0 0 0 0


0








0 0 0 0


0






Sheet 14: Sulfite

Instructions to complete this form are available to LFFM grantees on the Food Emergency Response Network (FERN) Portal (www.fernlab.org)















Lab Name State Sample Number Product LFFM Track Lab Receipt Date Analysis Completion Date Turn Around Time Sulfite Analysis Overall Results (detected / not detected) Sulfite LC/MS MLOD (ug/g) Sulfite LC/MS MLOQ (ug/g) Sulfite LC/MS Amount Found (ug/g) Sulfite
Monier Williams MLOD (ug/g)
Sulfite
Monier Williams MLOQ (ug/g)
Sulfite
Monier Williams Amount Found (ug/g)
Barium Sulfate Confirmation Amount Found (ppm) *if applicable Comments



0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
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0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
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0 0 12/30/99
0











0 0 12/30/99
0











0 0 12/30/99
0









Sheet 15: Toxic Elements (HUMAN FOOD ONLY

Instructions to complete this form are available to LFFM grantees on the Food Emergency Response Network (FERN) Portal (www.fernlab.org)




























































Lab Name State Sample Number (ID) Product Description LFFM Track Lab Receipt Date Analysis Completion Date Turn-Around-Time Toxic Metals Analysis
Overall Results
Total Arsenic
Overall Result
Total Arsenic
MLOD
(ug/kg)
Total Arsenic
MLOQ
(ug/kg)
Total Arsenic
Amount Found (ug/kg)
Inorganic Arsenic
Overall Result
Inorganic Arsenic
MLOD
(ug/kg)
Inorganic Arsenic
MLOQ
(ug/kg)
Inorganic Arsenic
Amount Found (ug/kg)
Total Cadmium
Overall Result
Total Cadmium
MLOD
(ug/kg)
Total Cadmium
MLOQ
(ug/kg)
Total Cadmium
Amount Found
(ug/kg)
Total Chromium
Overall Result
Total Chromium
MLOD
(ug/kg)
Total Chromium
MLOQ
(ug/kg)
Total Chromium
Amount Found
(ug/kg)
Total Lead
Overall Result
Total Lead
MLOD
(ug/kg)
Total Lead
MLOQ
(ug/kg)
Total Lead
Amount Found
(ug/kg)
Total Mercury
Overall Result
Total Mercury
MLOD
(ug/kg)
Total Mercury
MLOQ
(ug/kg)
Total Mercury
Amount Found
(ug/kg)
Total Copper
Overall Result
Total Copper
MLOD
(ug/kg)
Total Copper
MLOQ
(ug/kg)
Total Copper
Amount Found
(ug/kg)
Total Selenium
Overall Result
Total Selenium
MLOD
(ug/kg)
Total Selenium
MLOQ
(ug/kg)
Total Selenium
Amount Found
(ug/kg)
Total Manganese
Overall Result
Total Manganese
MLOD
(ug/kg)
Total Manganese
MLOQ
(ug/kg)
Total Manganese
Amount Found
(ug/kg)
Total Molybdenum
Overall Result
Total Molybdenum
MLOD
(ug/kg)
Total Molybdenum
MLOQ
(ug/kg)
Total Molybdenum
Amount Found
(ug/kg)
Total Nickel
Overall Result
Total Nickel
MLOD
(ug/kg)
Total Nickel
MLOQ
(ug/kg)
Total Nickel
Amount Found
(ug/kg)
Total Thallium
Overall Result
Total Thallium
MLOD
(ug/kg)
Total Thallium
MLOQ
(ug/kg)
Total Thallium
Amount Found
(ug/kg)
Total Zinc
Overall Result
Total Zinc
MLOD
(ug/kg)
Total Zinc
MLOQ
(ug/kg)
Total Zinc
Amount Found
(ug/kg)
Comments
EXAMPLE - PLEASE DELETE ROW FL FS-1009-2020 Joe's Infant Rice Cereal Chemistry Human Food 06/03/20 07/10/20 37 Detected Total Arsenic Detected 0.0012 0.0035 125.2 Inorganic Arsenic Detected 3.1 10.5 105.2 Total Cadmium Not Detected 3.1 10.5 ND



Total Lead Not Detected 3.1 10.5 ND Total Mercury Not Detected 01/02/00 01/09/00 ND



























Infant Rice Cereal



0


0
























































0


0
























































0


0
























































0


0
























































0


0
























































0


0
























































0


0
























































0


0
























































0


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0


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0


0
























































0


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0


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0


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0


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0


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0


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0


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0


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0


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0


0
























































0


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0


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0


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0


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0


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0


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0


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0


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0


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