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Page 11 of 11 <br /> r , ,r WORK ORDER #: 130 9-® ® ❑ <br /> ' Cooler I of <br /> A <br /> CLIENT: A\-1 DATE: 0912 l '3 <br /> TEMPERATURE: Thermometer ID: SC (Criteria: 0.0°C —6.0°C, not frozen exc sediment/tissue) <br /> Temperature Z . G °C - 0.2°C CF = �( °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: ❑ Air ❑ Filter Initial: <br /> CUS DY SEALS INTACT: <br /> 'Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: <br /> ial:tt' <br /> ❑ Sample El El �iv <br /> No (Not Intact) ot Present In <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 /> Sample container label(s) consistent with COC..................................... ;�-' ❑ ❑ <br /> Sample container(s) intact and good condition...................................... [;K ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested............... f ❑ ❑ <br /> Analyses received within holding time................................................. ❑ ❑ <br /> Aqueous samples received within 15-minute holding time <br /> ❑ pH ❑ Residual Chlorine ❑ Dissolved Sulfides ❑ Dissolved Oxygen........... ❑ ❑ <br /> Proper preservation noted on COC or sample container.......................... .2r' ❑ ❑ <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: ❑4ozCGJ 1]8ozCGJ ❑16ozCGJ ❑Sleeve ( ) ❑EnCores° ❑TerraCoreso ❑� <br /> Aqueous: ❑VOA ❑VOAh ❑VOAna2 ❑125AGB ❑125AGBh ❑125AGBp [11AGB 01AGBna2,2]1AGBs <br /> ❑500AGB ❑500AGJ ❑500AGJs ❑250AGB ❑250CGB ❑250CGBs ❑1PB ❑1PBna ❑500PB <br /> ❑250PB ❑250PBn ❑125PB ❑125PBznna ❑100PJ :1 100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlar° ❑Canister Other: ❑ Trip Blank Lot#: Labeled/Checked by: <br /> Container: C:Clear A:Amber P: Plastic G:Glass J:Jar B:Bottle Z:ZiplociResealable Bag E: Envelope Reviewed <br /> Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 u:Ultra-pure znna:ZnAc2+NaOH f: Filtered Scanned by: t� f <br /> SOP T100_090(07/31113) <br />