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Page 30 of 32 <br /> WORK ORDER #: 11 -07-1:0111F <br /> _ moi t <br /> ' Cooler of <br /> CLIENT: DATE: 07121111YV <br /> _. <br /> TEMPERATURE: Thermometer ID: SCI (Criteria: 0.0°C -6.0°C, not frozen) <br /> Temperature 9 °C + 0.5°C (CF) = j �1 °C �Blank ❑ 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: 0 Air ❑ Filter Initial: <br /> CUSTODY SEALS INTACT: <br /> ❑ Cooler 0 ❑ No (Not Intact) of Present ❑ N/A Initial: e7ll <br /> ❑ Sample ❑ ❑ No (Not Intact) ZNot Present Initial: _ <br /> SAMPLE CONDITION: Yes No ' N/A <br /> Chain-Of-Custody (COC) document(s) received with samples................... ❑ 0 <br /> COC document(s) received complete................................................... ❑ 0 <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 /> .. ❑ ❑ <br /> a <br /> Sample container label(s) consistent with COC............ ❑ ❑ <br /> Sample container(s) intact and good condition......... .......................... 2r ❑ ❑ <br /> Proper containers and'sufficient volume for analyses requested................ 71, ❑ 0 <br /> Analyses received within holding time............ .. 2T ❑ p <br /> pH / Res. Chlorine/ Diss. Sulfide / Diss. Oxygen received within 24 hours... ❑ ❑ <br /> Proper preservation noted on COC or sample container.........................: ,� O ❑ <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 ❑8ozCGJ 016ozCGJ ❑Sleeve ( ) ❑EnCoreso ❑TerraCores5 ❑ <br /> Water: DVOA OVOAh 0VOAna2 ❑125AGB ❑125AGBh ❑125AGBp AGB 01AGBs <br /> 0500AGB 0500AGJ ❑500AGJs 0250AGB 0250CGB 1:1250CGBs 01PB 0500PB 0500PBna <br /> 0250PB 0250PBn 0125PB 0125PBznna ❑100PJ 11100PJna2 0 ❑ ❑ <br /> Air: OTedlar° ❑Summa° Other: 0 Trip Blank Lot#: Labeled/Checked by: ,off <br /> Container: C:Clear A:Amber P:Plastic G:Glass J:Jar B:Bottle Z:Ziploc/Resealable Bag E:Envelope Reviewedby:—b-1-U7- <br /> Preservative: <br /> y._� <br /> Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 znna ZnAc2+NaOH f:Field-filtered Scanned by: If <br /> SOP T100 090(03124/11) <br />