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Page 33 of 34 <br /> , , WORK ORDER #: 1 1 -OJ- ® M Q <br /> iMIXTAURZIN • ' Cooler 1 of <br /> CLIENT: _ J�/�� DATE: 051 <br /> 6,101 <br /> TEMPERATURE: Thermometer IID: SC'l (Criteria: O.O'C—6.0°C, not frozen) <br /> Temperature _3 . Z °C + 0.5'C (CF) = --� - - OC lank ❑ Sample <br /> ❑ Sample(s) outside temperature criteria (PMIAPM 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 Initial: <br /> CUS DY SEALS INTACT: ` <br /> Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ NIA Initial: _ <br /> 0 � <br /> ❑ Sample ❑ ❑ No (Not Intact) ;Not Present Initial: <br /> SAMPLE CONDITION: Yes No NIA <br /> Chain-Of-Custody(COC) document(s) received with samples................... ❑ ❑ <br /> COC document(s) received complete................................................... ❑ ❑ <br /> ❑ Collection date/time,matrix, and/or#of containers logged in based on sample labels. <br /> s <br /> ❑ No analysis requested. ❑ Not relinquished. ❑ No date/time relinquished. <br /> Sampler's name indicated on COC... ..................... ................... ........ <br /> Sample container label(s) consistent with COC...................................... © ❑ <br /> Sample container(s) intact and good condition.......................................cam ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested................ P11, ❑ <br /> Analyses received within holding time.................................................. ❑ ❑ <br /> pH I Res. Chlorine 1 Diss. Sulfide 1 Diss. Oxygen received within 24 hours... ❑ ❑ <br /> Proper preservation noted on COC or sample container.......................... ❑ ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s)free of headspace..................................... ❑ ❑ <br /> Tedlar bag(s)free of condensation...................................................... ❑ ❑ <br /> CONTAINER TYPE: <br /> Solid: ❑4ozCGJ ❑8ozCGJ ❑l6ozCGJ osleeve ( ) ❑EnCoree ❑TerraCoreso ❑ <br /> Water: ❑VOA ❑VOAh 0VOAna2 0125AGB 0125AGBh ❑125AGBp 01AGB 01AGBna2 01AGBs <br /> 0500AGB 1:1500AGJ 0500AGJs 0250AGB 0250CGB 0250CGBs 01PB 0500PB 0500PBna <br /> 0250PB 0250PBn 0125PB 0125PBznna 0100PJ ❑100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlar® ❑Summa® Other: ❑ Trip Blank Lot#: Labeled/Checked by: <br /> Container: C:Clear A:Amber P:Plastic G.Glass J:Jar B:Bottle Z:ZiploctResealable Bag E: Envelope Reviewed by: <br /> Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 znna:ZnAc2+NaOH f:Field-filtered Scanned by: <br /> SOP 7100_090(03124111) <br />