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Page 9 of 9 <br /> tnca <br /> hn , 1 WORK ORDER #: 11 -O$-❑® © ❑2 <br /> 0 - Cooler of <br /> CLIENT: 4�— DATE: 08 /017/11 <br /> TEMPERATURE: Thermometer ID: SCI (Criteria: 0.0°C—6.0°C, not froze�4lank <br /> ) <br /> Temperature 2- . 1 OC + 0.5°C (CF) = 2- . r; °C ❑ 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 /> CUS�T�ODY SEALS INTACT: <br /> Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: <br /> ❑ Sample ❑ ❑ No (Not Intact) of Present Initial: <br /> SAMPLE CONDITION: Yes No N/A <br /> Chain-Of-Custody (COC) document(s) received with samples....................E� ❑ ❑ <br /> COC document(s) received complete................................................... 0-"- ❑ ❑ <br /> ❑ Collection date/time, matrix, and/or#of containers logged in based on sample labels. <br /> d <br /> ❑ No analysis requested. ❑ Not relinquished. ❑ No date/time relinquished. <br /> Sampler's name indicated on COC...................................................... ❑ ❑ ©� <br /> a <br /> Sample container label(s) consistent with COC...................................... ET�' ❑ ❑ <br /> Sample container(s) intact and good condition....................................... E< ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested................ fill' ❑ ❑ <br /> Analyses received within holding time.................................................. ❑ ❑ <br /> pH / Res. Chlorine / Diss. Sulfide / Diss. Oxygen received within 24 hours... ❑ ❑ <br /> Proper preservation noted on CQC or sample container............................8' ❑ ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s) free of headspace..................................... ❑ ❑ Com/ <br /> Tedlar bag(s) free of condensation...................................................... F-1 E] tf <br /> CONTAINER TYPE: <br /> Solid: ❑4ozCGJ 08oZCGJ ❑16ozCGJ ❑Sleeve ( ) ❑EnCores° ❑ erraCores° ❑ <br /> Water: ❑VOA ❑VOAh ❑VOAna2 ❑125AG13 ❑125AGBh ❑125AGBp X11 B ❑1AGBna2 ❑1AGBs <br /> ❑500AGB ❑500AGJ ❑500AGJs ❑250AGB ❑250CGB ❑250CGBs ❑1PB 0500PB ❑500PBna <br /> ❑250PB ❑250PBn ❑125PB 0125PBznna 0100PJ ❑100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlar° ❑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 T100_090(03/24/11) <br />