Laserfiche WebLink
Page 25 of 26 <br /> WORK ORDER #: 11 -OJ- 0 M ❑ M <br /> a boratoriesr Inc:. <br /> ' Cooler of <br /> CLIENT: 3A.1 C DATE: 05 lo5/11 <br /> TEMPERATURE: Thermometer ID: SCI (Criteria: 0.0"C-6.00C, not frozen) <br /> Temperature 5 • ) °C + 0.5 OC (CF) _ �t 6 °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 /> CljWDY SEALS INTACT: <br /> Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ NIA Initial: <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 /> ❑ 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.......................................� ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested..............., ❑, ❑ <br /> Analyses received within holding time..................................................Z ❑ ❑ <br /> pH 1 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: 04ozCGJ 08ozCGJ 016ozCGJ Sleeve (._) ❑EnCores° ❑TerraCoie40 10 <br /> Water: ❑VOA ❑VOAh 0VOAna2 ❑125AGB ❑125AGBh ❑125AG Bp ❑1 AGB ❑1 AGBna2 ❑1 AFBs <br /> ❑500AGB 0500AGJ 0500AGJs 0250AGB ❑250CGB 0250CGBs 01PB ❑500P13 0500PBna <br /> ❑250PB 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:ZiploclResealable 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 T100_09 (03124111) <br />