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Page 20 of 22 <br /> WORK ORDER #: 09- H 0 - 0 El El El <br /> � r � <br /> o�rtgtorfe-,9, 1,mc, :A 2 <br /> JOJ N 71 Cooler E of t <br /> CLIENT: V-kDATE: k <br /> TEMPERATURE: (Criteria: 0.0°C - 6.0°C, not frozen) <br /> Temperature OC - 0.20C (CF) = °C 0 B n ❑ Sample <br /> ❑ Sample(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: W <br /> CUSTODY SEALS INTACT: 1n <br /> Ld Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: <br /> ❑ Sample ❑ ❑ No (Not Intact) ET'Not Present Initial: <br /> SAMPLE CONDITION: Yes/ No N/A <br /> Chain-Of-Custody (COC) document(s) received with samples........ El El—Q/ <br /> COC document(s) received complete........................................ I� ❑ ❑ <br /> Sampler's name indicated on COC........................................... ❑ ❑ <br /> Sample container label(s) consistent with COC........................... ❑/ Z ❑ <br /> Sample container(s) intact and good condition............................ C�' ❑ ❑ <br /> Correct containers and volume for analyses requested................. 0---- ❑ ❑ <br /> Analyses received within holding time...................................... Z ❑ ❑ <br /> Proper preservation noted on COC or sample container............... ❑ ❑ L� <br /> Volatile analysis container(s) free of headspace.......................... ❑ ❑ [� <br /> Tedlar bag(s) free of condensation.......................................... ❑ ❑ <br /> CONTAINED TYPE: <br /> Solid: 4ozCGJ 1]8ozCGJ ❑16ozCGJ ❑Sleeve ❑EnCoresO ❑TerraCoresO ❑ <br /> Water: ❑VOA ❑VOAh ❑VOAna2 ❑125AGB ❑125AGBh ❑125AGBpo4 ❑1 AGB ❑1 AGBna2 <br /> 1:11AGBs ❑500AGB ❑500AGBs ❑250CGB ❑250CGBs ❑1PB ❑500PB ❑500PBna 0250PB <br /> ❑250PBn ❑125PB ❑125PBznna ❑100PBsterile ❑100PBna2 ❑ ❑ ❑ <br /> Air: ❑Tedlar iz ❑Summa x ❑ Checked/Labeled by: <br /> Container: C:Clear A:Amber P:Poly/Plastic G:Glass J:Jar B:Bottle Reviewed by: <br /> Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH po,:H31`0, s:H2SO4 znna:ZnAc2+NaOH Scanned by: <br /> SOP T100_090(12/10/08) <br />