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Page 16 of 17 <br /> 'N ion <br /> WORK ORDER #: 11 M M ❑ 0 <br /> Zabararorles-, Inc. 6-u'Ll w 4:121*41:4 1!A A • ' Cooler _L of <br /> CLIENT: 3 Al C DATE: 05105111 <br /> TEMPERATURE: Thermometer ID: SCI (Criteria: 0.0°C -6A°C, not frozen) <br /> Temperature zt . 1 °C + 0.5°C (CF) = 4t . °Cank ❑ 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 /> C U�T6DY SEALS INTACT: <br /> 21 Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ NIA Initial; rkP <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...................................................;Z, ❑ ❑ <br /> ❑ Collection date/time, matrix, and/or#of containers logged in based on sample labels. <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. ...................................JC2- ❑ ❑ <br /> Sample container(s) intact and good condition....................................... © ❑ <br /> Proper containers and sufficient volume for analyses requested..............., ❑: ❑ <br /> Analyses received within holding time..................................................le ❑ ❑ <br /> pH 1 Res. Chlorine 1 Diss. Sulfide 1 Diss. Oxygen received within 24 hours... ❑ ❑ 0 <br /> Proper preservation noted on COC or sample container.......................... ❑ ❑` <br /> El 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: 04ozCGJ 08ozCGJ 016ozCGJ Sleeve {� } ❑EnCores° ❑TerraCorep° ` ❑ <br /> Water: ❑VOA ❑VOAh 0VOAna2 0125AGB 0125AGBh 0125AGBp 01AG6 01AGBna2 ❑1ABs <br /> 0500AGB 0500AGJ 0500AGJs 0250AGB 0250CGB 0250CGBs ❑1PB 0500PB ❑500PBna <br /> ❑250PB 0250PBn ❑125PB ❑125PBznna ❑100PJ ❑100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlaro ❑Summa® Other: ❑ Trip Blank Lot#: Labeled/Checked by: _ <br /> Container: C:Clear A:Amber P: Plastic G: Glass J:Jar B:Bottle Z:Ziploc/Resealable Bag E: Envelope Reviewed by: <br /> Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3P0,, s:H2SO4 znna:ZnAc2+NaOH f:Field-filtered Scanned by: <br /> SOP T100 09 (03!24111) <br />