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Page 25 of 25 <br /> 0 <br /> ,._ WORK ORDER #: 11 -07-0 Ell El [E <br /> Cooler 3 of j <br /> CLIENT: /1 >ir� DATE: 07 121 /11 <br /> TEMPERATURE: Thermometer ID: SC1 (Criteria 0.0°C'-6:0°C, not frozen) <br /> Temperature 1 °C + 0.5°C (CF) 3 . °CLd'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: ❑ Air ❑ Filter Initial: <br /> CUSTODY SEALS INTACT: - <br /> ❑ Cooler El 11No (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................... ❑ <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 /> 2 <br /> Sample container label(s) consistent with COC............ O ❑ <br /> Sample container(s) intact and good condition..............I......................... ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested................ 2' ❑ p <br /> Analyses received within holding time..............:.................................. 2� D <br /> pH / Res. Chlorine/ Diss. Sulfide/ Diss. Oxygen received within 24 hours...❑ ❑ <br /> Proper''preservation noted on COC or sample container.......................... i ❑ ❑' <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s) free of headspace. ......I............................ ❑ <br /> Tedlar bag(s) free of condensation...................................................... ❑ ❑ <br /> CONTAINER TYPE: <br /> Solid: ❑4ozCGJ ❑8ozCGJ ❑16ozCGJ ❑Sleeve ( _ ) ❑EnCoreso ❑TerraCores° ❑ <br /> r <br /> ® 16 f <br /> Water: VOA ❑VOAh 0VOAna2 ❑125/AGB ❑125AGBh 0125AGBpAGB ' 01AGBs <br /> 0500AGB 11500AGJ 0500AGJs ❑250AGB 0250CGB ❑250CG13s 01PB ❑500PB 0500PBna <br /> ❑250PB' []250'PBn ❑125PB ❑125PBznna ❑100PJ 11100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlare ❑Summa° 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: <br /> Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 znna:ZnAc2+NaOH f:Field-filtered Scanned by: <br /> SOP T700 090(03124111) <br />