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Page 30 of 31 %W12 _ 071 Virortmer>taI WORK ORDER #: 10-12- El N ® 0 Zaboratories, Inc. Cooler of 1 CLIENT: � N C_- DATE: 12 /Cn/ 10 TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0°C—6.0°C, not frozen) Temperature `L.- . 2- °C + 0.5°C (CF) = _�?_ . _�- °C B'lank ❑ Sample ❑ Sample(s) outside temperature criteria (PM/APM contacted by: ). ❑ Sample(s) outside temperature criteria but received on ice/chilled on same day of sampling. ❑ Received at ambient temperature, placed on ice for transport by Courier. //�� Ambient Temperature: El Air El Filter Initial w) CUSTODY SEALS INTACT: ❑ Cooler ❑ ❑ No (Not Intact) eNot Present ❑ N/A Initial: ❑ Sample ❑ ❑ No (Not Intact) 2'Not Present Initial: V-^ SAMPLE CONDITION: Yes No N/A Chain-Of-Custody (COC) document(s) received with samples................... l� ❑ ❑ COC document(s) received complete................................................... ❑ ❑ ❑ Collection date/time, matrix, and/or#of containers logged in based on sample labels. ❑ No analysis requested. ❑ Not relinquished. ❑ No date/time relinquished. Sampler's name indicated on COC..................................................... ❑ ❑ Sample container label(s) consistent with COC..................................... ❑ lir, ❑ Sample container(s) intact and good condition...................................... 2r-' ❑ ❑ Proper containers and sufficient volume for analyses requested............... ❑ O Analyses received within holding time................................................. Er-- ❑ ❑ pH / Residual Chlorine / Dissolved Sulfide received within 24 hours........... ❑/ ❑ 2--l" Proper preservation noted on COC or sample container.......................... C' ❑ ❑ ❑ Unpreserved vials received for Volatiles analysis Volatile analysis container(s)free of headspace..................................... 0---- ❑ ❑ Tedlar bag(s) free of condensation...................................................... ❑ ❑ rr� CONTAINER TYPE: Solid: 04ozCGJ ❑8ozCGJ ❑ ®' 16ozCGJ Sleeve ( S ) ❑ ❑EnCores® ❑TerraCores° Water: ❑VOA Zr//OAh ❑VOAna2 ❑125AGB 0125AGBh 1:1125AGBp 1:11AGB ❑1AGBna2 01AGBs ❑500AGB 0500AGJ ❑500AGJs 0250AGB ❑250CGB 1:1250CGBs ❑1 PB ❑500PB 1:1500PBna 0250PB ❑250PBn ❑125PB ❑125PBznna ❑100PJ ❑100PJna2 ❑ ❑ ❑ Air: ❑Tedlaro ❑Summa° Other: ❑ Trip Blank Lot#:\0\202- Labeled/Checked by: V� Container: C:Clear A:Amber P:Plastic G:Glass J:Jar B:Bottle Z:ZiplocJResealable Bag E: Envelope Reviewed by: Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 znna:ZnAc2+NaOH f:Field-filtered Scanned by: U SOP T100_090(09/13110)