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Page 21 of 24 <br /> � ence WORK ORDER <br /> m ra vii on,,i-.era taaj <br /> Cooler of-4 <br /> CLIENT: �� r� DATE: -L2-1-9L 09 <br /> TEMPERATURE: (Criteria: 0.0°C-6.0°C, not frozen) <br /> Temperature .f°C - 0.2°C (CF) _ L .-4-°C Blank ElSample <br /> L1Sample(s) outside temperature criteria (PM/APM contacted by: ). <br /> ❑ Sample(s) outside temperature criteria but received on ice/chilled on same day of sampling. <br /> ❑ Received at ambient temperature, placed on ice for transport by Courier. <br /> Ambient Temperature: ❑ Air ❑ Filter ❑ Metals Only ❑ PCBs Only Initial: <br /> CUSTODY SEALS INTACT: <br /> Cooler M ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: <br /> °�- <br /> ❑ Sample ❑ ❑ No (Not Intact) IdNot Present Initial: �r y <br /> SAMPLE CONDITION: Yes No N/A <br /> Chain-Of-Custody (COC) document(s) received with samples........ 1� ❑ ❑ <br /> COC document(s) received complete........................................ ❑ L? ❑ <br /> Sampler's name indicated on COC........................................... M M 9 <br /> Sample container label(s) consistent with COC........................... I/ ❑ ❑ <br /> Sample container(s) intact and good condition............................ i ❑ ❑ <br /> Correct containers and volume for analyses requested................. ❑v ❑ ❑ <br /> Analyses received within holding time...................................... 1� ❑ ❑ <br /> Proper preservation noted on sample label(s)............................. EY1 ❑ ❑ <br /> Volatile analysis container(s) free of headspace.......................... ❑ ❑ E� <br /> Tedlar bag(s) free of condensation.......................................... ❑ ❑ [� <br /> CONTAINER TYPE: <br /> Solid: 154ozCGJ ❑8ozCGJ ❑16ozCGJ ❑Sleeve ❑EnCoresO ❑TerraCoresO ❑ <br /> Water: ❑VOA ❑VOAh ❑VOAna2 0125AGB ❑125AGBh ❑125AGBpo4 ❑1AGB M1AGBna2 <br /> ❑1AGBs ❑500AGB 11500AGBs ❑250CGB ❑250CGBs 41PB ❑500PB 11500PBna ❑250PB <br /> ❑250PBn ❑125PB ❑125PBznna ❑100PBsterile ❑100PBna2 ❑ ❑ ❑ <br /> Air: ❑Tedlar0 ❑Summa(k) ❑ Checked/Labeled by: <br /> Container: C:Clear A:Amber P:Poly/Plastic G:Glass J:Jar B:Bottle Reviewed by: til <br /> Preservative: h:HCL n:HNO, na2:Na2S203 na:NaOH PO4:H3POa s:HZSO, znna:ZnAc2+NaOH Scanned by: <br /> SOP T100_090(11/20/08) <br />