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Page 37 of 37 <br /> i cieatve ' <br /> vlirr amentvt WORK ORDER #: 11 -05-011102 <br /> Labarafarion, Inc, <br /> ' SAMPLES - CONTAINERS & LABELS: Comments: f <br /> ❑Sample(s)/Container(s) NOT RECEIVED but listed on COC <br /> ' ❑Sample(s)/Container(s) received but NOT LISTED on COC Jo- v to ea�^�` d <br /> ❑ Holding time expired- list sample ID(s)and test C 1 - <br /> ❑Insufficient quantities for analysis - list test y o <br /> ❑ Improper container(s) used-list test <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 /> vs/ample label(s) do not match COC - Note in comments <br /> .a Sample ID <br /> 0 Date and/or Time Collec <br /> ❑ Project Information <br /> ❑# of Container(s) <br /> ❑Analysis <br /> ❑Sample container(s) compromised - Note in comments <br /> ❑Water present in sample container <br /> I ❑ 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 1/4 inch: <br /> 1 <br /> Sample# container #ol Vlals Sample# Container lo(s)) %el Viels Sample# Container 9 o Conl. Analysis <br /> Received iC(s) received <br /> 10(s) Received <br /> Comments: <br /> ' �L <br /> *Transferred at Client's request. Initial / Date: 05 164111 <br /> SOP 7100_090(09117110) <br />