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Page 18 of 19 <br /> IIrl1a" e';Tlfi WORK ORDER #: � � -OBJ-D © ISEN <br /> ' 2 Cooler _L of <br /> CLIENT: ,SAr l C DATE: 05 126/11 <br /> TEMPERATURE: Thermometer ID: SC'I (Criteria: O.O°C –6.0°C, not frozen) <br /> / <br /> Temperature n .E °C + 0.5°C (CF) = f .-3—t 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 /> CUSTODY SEALS INTACT: <br /> I�CooIer ❑ ❑ No (Not Intact) ❑ Not Present ❑ NIA Initial: <br /> ❑ Sample ❑ ❑ No (Not Intact) Not Present Initial:ix u, <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....................................... Z/ ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested................ V( ❑ ❑ <br /> Analyses received within holding time.................................................. 2� ❑ ❑ <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...................................................... ❑ ❑ C1' <br /> CONTAINER TYPE: <br /> Solid: ❑4ozCGJ 1]8ozCGJ 016ozCGJ Ptleeve ( S } ❑EnCorese ❑TerraCores® ❑ <br /> Water: ❑VOA ❑VOAh ❑VOAna2 ❑125AGB 0125AGBh 0125AGBp 01AGB ❑1AGBna2 ❑1AGBs <br /> 0500AGB ❑500AGJ 0500AGJs ❑250AGB ❑250CGB 0250CGBs ❑l PB 0500PB 0500PBna <br /> 0250PB ❑250PBn 0125PB 0125PBznna 0100PJ 0100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlar° ❑Summa® Other: ❑ Trip Blank Lot#: Labeled/Checked byr./ ; �— <br /> Container: C:Clear A:Amber P:Plastic G: Glass J:Jar B:Bottle Z:Ziploc/Resealable Bag E: Envelope Reviewed by: V <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_090[03124111] <br />