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Page 19 of 19 <br /> Cgp <br /> i��� ; WORK ORDER #: i 1 -05-121 ® ❑] M <br /> Is] � . <br /> SAMPLES - CONTAINERS & LABELS: Comments: <br /> ❑ Sam ple(s)IContainer(s) NOT RECEIVED but listed on COC (-IF) C°1le cit?o 1,1 4 We_ <br /> ❑ Sample(s)/Container(s) received but NOT LISTED on COC LAW c s // - / S- <br /> 0 <br /> - / S— <br /> ❑ Holding time expired - list sample ID(s) and test <br /> ❑ Insufficient quantities for analysis - list test <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 /> t <br /> mple labels illegible- note test/container type <br /> mple label(s) do not match COC - Note in comments <br /> Sample ID <br /> 2'6ate and/or Time Collected <br /> ❑ Project Information <br /> ❑# of Container(s) <br /> ❑Analysis <br /> ❑Sample container(s) compromised - Note in comments <br /> ❑Water present in sample container <br /> ❑ 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 % inch: <br /> Sample# Container #of vials Sample# Container ID(s) #of VialsSample# Container #of Cont. Analysis <br /> ID(s) Received Received 10(s) received <br /> Comments: <br /> *Transferred at Client's request. Initial 1 Date: L 0517-�111 <br /> SOP T100_090(09117/10) <br />