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Page 34 of 34 <br /> vFr arrm rmei WORK ORDER M 11 -05-El 0 12 2 <br /> rablorafortas, Itic.. <br /> SAMPLES - CONTAINERS & LABELS: Comments: <br /> ❑Sample(s)/Container(s) NOT RECEIVED but listed on COC (:�'6 ) <br /> ❑ Sample(s)/Container(s) received but NOT LISTED on COC do- ,9 <br /> ❑ Holding time expired— list sample ID(s) and test <br /> ❑Insufficient quantities for analysis — list test <br /> ❑ Improper container(s) used—list test v 1 bz S I o L+O <br /> ❑ Improper preservative used —list test <br /> ❑No preservative noted on COC or label —list test & notify lab <br /> ' ❑Sample labels illegible— note test/container type <br /> 76ample label(s) do not match COC — Note in comments <br /> .0 Sample ID <br /> p Date and/or Time Collet <br /> ❑Project Information <br /> ❑# of Container(s) <br /> ❑Analysis <br /> ❑ Sample container(s) compromised — Note in comments <br /> ❑Water present in sample container <br /> ❑Broken <br /> ❑ Sample container(s) not labeled <br /> ❑ Air sample container(s) compromised — Note in comments <br /> ❑ Flat <br /> [-]Very low in volume <br /> ❑ Leaking (Not transferred • duplicate bag submitted) <br /> ❑ Leaking (transferred into Calscience Tedlar° Bag*) <br /> ❑Leaking (transferred into Client's Tedlar° Bag*) <br /> ❑Other: <br /> HEADSPACE — Containers with Bubble > 6mm or '/4 inch: <br /> Container ID(s) pof Vials Sample# Container Not Cont. Analysis <br /> NSample# Codeine, #of Vials Sample Received <br /> ID(e) received <br /> ID(cl Recelvetl <br /> Comments: <br /> ' Initial / Date: ^(L 05 /04/11 <br /> ' *Transferred at Client's request. <br /> SOP T100_090(0911711 O) <br />