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Page 8 of 8 WORK ORDER #: 10-07-© R1 ' • ' Cooler 1 of CLIENT: DATE: 07/V3 / 10 TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0°C-6.0°C, not frozen)) Temperature . °C + 0.5°C (CF) °C O nk El Sample Bla ❑ Sample(s)outside temperature criteria(PMIAPM contacted by: ❑ Sample(s)outside temperature criteria but received on lee/chilled on same day of sampling. ❑ Received at ambient temperature, placed on ice for transport by Courier. Ambient Temperature: ❑ Air ❑ Filter ❑ Metals Only ❑ PCBs Only Initial: Vim` CUSTODY SEALS INTACT: U'Cooler ❑ ❑ No(Not Intact) ;Zot Present ❑ N/A Initial: W7 13 Sample ❑ ❑ No(Not Intact) Present Initial:-U SAMPLE CONDITION: Yes No N/A Chain-Of-Custody(COC) document(s) received with samples................... ❑ ❑ 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. Sampler's name indicated on COC..................................................... ❑ ❑ Sample container label(s) consistent with COC..................................... ❑ ❑ Sample container(s) intact and good condition...................................... !ate ❑ Proper containers and sufficient volume for analyses requested............... t3 ❑ Analyses received within holding time................................................. ❑ ❑ pH 1 Residual Chlorine I Dissolved Sulfide received within 24 hours........... ❑ ❑ Proper preservation noted on COC or sample container.......................... ❑ ❑ ❑ Unpreserved vials received for Volatiles analysis Volatile analysis container(s)free of headspaee..................................... ❑ ❑ Tedlar bag(s)free of condensation...................................................... ❑ ❑ CONTAINER TYPE: Solid: ❑4oZCGJ 08oz G 016ozCGJ ❑Sleeve (____j ❑EnCores® ❑TerraCores* ❑ Water: ❑VOA ❑VOAh IOAna2 ❑125AGB ❑125AGBh ❑125AGBp ❑1 AGB ❑1 AGI3na2 ❑1 AGBs i 0500AGB 0500AGJ 0500AGJs 0250AGB 13250CGB ❑250CGBs ❑1PB 0500PB 0500PBna 0250PB ❑250PBn ❑125PB ❑125PBznna ❑100PJ 0100PJna2 ❑ ❑ ❑ 1 Air: ❑Tedlare ❑Summa® Other: ❑ Trip Blank Lot#: Labeled/Checked by: l Container.. C:Clear A:Amber P:Plastic G:Glass J:Jar B:Bottle Z.Mpioc/Resealable Bag E:Envelope Reviewed by: � Preservative: h:HCL n:HNO3 na2:Na2s203 na:N80H p:H3PO4 s:H2SO4 znna:znAcz+NaOH f.Field-filtered Scanned by SOP T10_QW(05M0110)