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• Page 21 of 22 <br /> WORK ORDER EJ ®- [DE]_El <br /> D ❑_© ® 0 <br /> viranme-n#aiP <br /> ab-or';arorites, lnc: ' ' ' • ' • <br /> CHAIN OF CUSTODY (COC): Comments: <br /> ' ❑ Not relinquished by client— no signature <br /> ❑ No date/time relinquished <br /> ❑COC not received with samples — notify PM <br /> ❑ Incomplete information regarding samples, tests, etc. <br /> SAMPLES - CONTAINERS & LABELS: Comments: <br /> 0 Samples NOT RECEIVED but listed on COC -5> \�!� Sh Q \NST�c9 <br /> ❑Samples received but NOT LISTED on COC L <br /> ' ❑ Holding time expired— list sample ID(s)and test <br /> ❑ Insufficient quantities for analysis — list test <br /> ❑ Improper container(s) used— list test <br /> ❑ No preservative noted on label — list test and notify lab <br /> ❑ Sample labels illegible— note test/container type <br /> ' ❑ Sample labels do not match COC — Note in comments <br /> ❑Sample ID <br /> ❑ Date and Time Collected <br /> ' ❑Project Information <br /> ❑#of containers <br /> ❑ Sample containers compromised — Note in comments <br /> ' ❑Leaking <br /> ❑ Broken <br /> ❑Without Labels <br /> ' ❑ Other: <br /> HEADSPACE — Containers with Bubble > 6mm or '/4 inch: <br /> Sample Container #of Vials Sample Container #of Vials Sample Container #of RSK or <br /> # IDs Received # ID Rid # IDs co,or DO or <br /> ID(s) / Received ) Organic Lead <br /> Received <br /> Comments: <br /> ' Initial / Date1� \ <br /> SOP T100_081(09119/08) <br />