COMPLIANCE INFO_PRE 2019 - Laserfiche WebLink

Home Browse Search

•c >w. Page 9 of 10 16 2016 FZ- ,r virartmenl�ta1 RK ORDER M 12-07-® 0Fq uNMEN� ' - 0=14 Cooler of CLIENT: l IGS DATE: 071'V112 TEMPERATURE: Thermometer ID: SC2 (Criteria: 0.0°C—6.0°C,not frozen) Temperature I . T °C - 0.3°C (CF) = I —t OC Flank ❑ Sample ❑ Sample(s)outside temperature criteria(PM/APM contacted by: ). ❑ Sample(s)outside temperature criteria but received on ice/chilled on same day of sampling. ❑ Received at ambient temperature, placed on ice for transport by Courier. Ambient Temperature: ❑ Air ❑ Filter Initial: CUSTODY SEALS INTACT: ❑ Cooler ❑ ❑ No (Not Intact) ["Not Present ❑ N/A Initial: r ❑ Sample ❑ ❑ No (Not Intact) wlplot Present Initial: SAMPLE CONDITION: Yes No N/A Cf ain-Of-Custody (COC) document(s) received with samples................... pll� ❑ ❑ COC document(s) received complete................................................... ❑ ❑ ❑ Collection date/time, matrix,and/or#of containers logged in based on sample labels. ❑ No analysis requested. ❑ Not relinquished. ❑No date/time relinquished. m Sampler's name indicated on COC...................................................... ❑ ❑ 211" o Sample container label(s) consistent with COC...................................... ❑ 0, ❑ Sample container(s) intact and good condition....................................... PK ❑ ❑ Proper containers and sufficient volume for analyses requested................ ❑ ❑ Analyses received within holding time.................................................. ❑ ❑ pH / Res. Chlorine / Diss. Sulfide/ Diss. Oxygen received within 24 hours... ❑ ❑ 0-1, Proper preservation noted on COC or sample container.......................... ❑ ❑ ❑ Unpreserved vials received for Volatiles analysis Volatile analysis container(s)free of headspace..................................... ❑ ❑ Tedlar bag(s) free of condensation...................................................... ❑ ❑ CONTAINER TYPE: Solid: ❑40ZCGJ ❑8ozCGJ 1116ozCGJ leve (_�) ❑Encores® ❑Terracorese ❑ Water: ❑VOA ❑VOAh ❑VOAna2 0125AGB 0125AGBh ❑125AGBp 01AGB ❑1AGBna2 ❑1AGBs 0500AGB 0500AGJ 0500AGJs ❑250AGB ❑250CGB 0250CGBs ❑1 PB ❑1 PBna 0500PB ❑250PB 11250PBn 0125PB ❑125PBznna 0100PJ 0100PJna2 ❑ ❑ ❑ Air: ❑Tedlaro ❑Summa° Other: ❑ Trip Blank Lot#: Labeled/Checked by: Container: C:Clear A:Amber P:Plastic G:Glass J:Jar B:Bottle Z:Ziploc/Resealable Bag E:Envelope Reviewed by: Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SOa u:Ultra-pure znna:ZnAc2+NaOH f:Filtered Scanned by:-Az� SOP T100_090(12106/11)