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Page 22 of 24 <br /> _ WORK ORDER #: 08- IZI 0 - ID 21 © ❑2- <br /> CHAIN OF CUSTODY (COC): Comments: <br /> ❑ Not relinquished by client— no signature (Jr ) ✓���,;���� ��A 2 pe <br /> ❑ No date/time relinquished - ( <br /> r.,.ofi r"fi,4f-,-J r.M C®C <br /> ❑ COC not received with samples — notify PM I <br /> m Incomplete information regarding samples, tests, etc. <br /> SAMPLES - CONTAINERS & LABELS: Comments: <br /> ❑ Samples NOT RECEIVED but listed on COC <br /> ❑ Samples received but NOT LISTED on COC <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 % inch: <br /> Sample Container #of Vials Sample Container #of Vials Sample Container #of RSK or <br /> # IDs Received # IDs Received # IDs Cor DO or <br /> Orrgg anic Lead <br /> Received <br /> Comments: <br /> Initial / Date lily j 2- 9 _(5 <br /> SOP T100_081 (09/19/08) <br />