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V Page 8 of 8 ills WORK ORDER #: 10-07-M ® 1E El Cooler \ of t CLIENT: -�f�CA� _ DATE: 07 10 TEMPERATURE: Thermometer ID: SCII (Criteria: 0.0°C-602C, not frozen))/ Temperature � °C f 0.5'C (CF) = '7- a 8- °C E Blank ❑ Sample ❑ Sample(s)outside temperature criteria(PM/APM contacted by:�. ❑ Sample(s)outside temperature criteria but received on icetchilled on same day of sampling. ❑ Received at ambient temperature, placed on ice for transport by Courier. i Ambient Temperature: ❑ Air ❑ Filter ❑ Metals Only ❑ PCBs Only Initial: Vim✓" CUSTODY SEALS INTACT: ! i21"booler ❑ ❑ No(Not Intact) ❑ NNoo� Present ❑ NIA Initial: ? ❑ Sample ❑ ❑ No(Not Intact) g of Present Initial: SAMPLE CONDITION: Yes No NIA Chain-Of-Custody(COC)document(s) received with samples................... 0-, ❑ ❑ COC document(s)received complete................................................... 12-11� ❑ ❑ i ❑ 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..................................................... ❑ ❑ �i � Sample container label(s) consistent with COC..................................... M--` © ❑ Sample container(s) intact and good condition...................................... 2---" ❑ ❑ �� Proper containers and sufficient volume for analyses requested............... ❑ ❑ ` Analyses received within holding time................................................. ❑ ❑ pH 1 Residual Chlorine I Dissolved Sulfide received within 24 hours........... ❑ ❑ Proper preservation noted on COC or sample container.......................... 2---' ❑ ❑ ❑ Unpreserved vials received for Volatiles analysis Volatile analysis contalner(s)free of headspace..................................... 1� ❑ ❑ Tedlar bag(s)free of condensation...................................................... ❑ ❑ CONTAINER TYPE: Solid: ❑4ozCGJ ❑8oz�G 016ozCGJ ❑Sleeve (� ❑EnCoreso ❑TerraCoree ❑ Water: ❑VOA EIV OAh VOAna2 ❑125AGB ❑125AGBh ❑125AGBp ❑1 AGB ❑1 AGBnax ❑1 AGBs 0500AGB 0500AGJ ❑500AGJs ❑250AGB 0250CGB 0250CGBs 01PB ❑500PB ❑500PBna _ 0250PB 0250PBn 0125PB 0125PBznna ❑100PJ 11100PJna2 ❑ ❑ ❑ Air: ❑Tedlar® ❑Summa" Other: ❑ Trip Blank Lot#: Labeled/Checked by: Container: C:Clear A:Amber P:Plastic G:Glass J:Jar B:Bottle Z:ZiploclResealable Bag E:Envelope Reviewed by.� Preservative: h.HCL n:HNO3 na::Na,7%0. na:NaOH p:H3PO4 s:H25C. znna:ZnAcz+NaOH f:Field-iiliered Scanned by ^Y- SOP T100_090(06148110)