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Page 8 of 8 <br /> WORK ORDER #: -OS-® ® 71 <br /> . - Cooler ! of <br /> CLIENT: /<-1 FF DATE: 08112,-111 <br /> TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0°C—6.0°C, not frozen) <br /> Temperature / 2- OC + 0.5 OC (CF) _ OC eBlank ❑ Sample <br /> ❑ Sample(s)outside temperature criteria (PM/APM 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 /> 1�11Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A, Initial: _ <br /> ❑ Sample ❑ ❑ No (Not Intact) 'Not Present Initial: <br /> SAMPLE CONDITION: Yes No N/A <br /> Chain-Of-Custody (COC) document(s) received with samples...................a.*,- ❑ ❑ <br /> COC document(s) received complete......................................................l2r, ❑ ❑ <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 /> El 11U <br /> 0 <br /> Sample container label(s) consistent with COC...................................... 21-- ❑ ❑ <br /> Sample container(s) intact and good condition'....................................... 7' ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested................ 21" ❑ ❑ <br /> Analyses received within holding time.................................................. 2-1, ❑ ❑ <br /> pH / Res. Chlorine / Diss. Sulfide / Diss. Oxygen received within 24 hours... ❑ ❑ L <br /> Proper preservation noted on COC or sample container.......................... Q.-" ❑ ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s) free of headspace.................. ................... ❑ ❑ 2-1 <br /> Tedlar bag(s) free of condensation...................................................... ❑ ❑ <br /> CONTAINER TYPE: <br /> Solid: ❑4ozCGJ ❑8ozCGJ ❑16ozCGJ ❑Sleeve ( ) ❑EnCoreso ❑TerraCores° ❑ <br /> Water: ❑VOA ❑VOAh 0VOAna2 ❑125AGB ❑125AGBh ❑125AGBp ❑1AGB 01AGBna2 <br /> ❑500AGB ❑500AGJ ❑500AGJs 0250AG13 ❑250CGB 0250CGBs ❑1PB ❑500PB 7500PBna <br /> 11250PB 0250PBn ❑125PB ❑125PBznna 0100PJ 7100PJna2 ❑ ❑ ❑ <br /> Air: E]Tedlar2 OSumma° 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: r L <br /> Preservative: h:HCLn:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 znna:ZnAC2+NaOH f:Field-filtered Scanned by: <br /> SOP 7100_090(03124/11) <br />