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Page 30 of 31 a *�Ip vironmerrtr1 WORK ORDER #: 10-12- OFZaboratorles. Inc. 0 ' o Cooler of CLIENT: C-- DATE:DATE: 12 /Ofl/ 10 TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0°C—6.0°C, not frozen) Temperature 2 . 2- °C + 0.5°C (CF) = E• -I- °C aflank ❑ 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: ❑ Air L-1FilterInitial:u l CUSTODY SEALS INTACT: / ❑ Cooler F-1 ❑ No (Not Intact) E5 Not Present ❑ N/A Initial: � '�t� El Sample El El No (Not Intact) 2 of Present Initial: V) 2 SAMPLE CONDITION: Yes No N/A Chain-Of-Custody(COC)document(s) received with samples................... ❑ ❑ COC document(s) received complete................................................... 9--l' ❑ ❑ ❑ 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..................................................... E ❑ ❑ Sample container label(s) consistent with COC..................................... ❑ 0-, ❑ Sample container(s) intact and good condition...................................... 2--, ❑ ❑ Proper containers and sufficient volume for analyses requested............... Er� ❑ ❑ Analyses received within holding time................................................. Er-- 0 ❑ pH / Residual Chlorine/ Dissolved Sulfide received within 24 hours........... 0/ ❑ l� Proper preservation noted on COC or sample container.......................... Q" ❑ ❑ ❑ Unpreserved vials received for Volatiles analysis Volatile analysis container(s)free of headspace..................................... 2--- ❑ ❑/ Tedlar bag(s)free of condensation...................................................... C3 1315 CONTAINER TYPE: Solid: ❑4ozCGJ/❑8ozCGJ ❑16ozCGJ "SlEleeve ( c' ) ❑EnCores® ❑TerraCores® Water: ❑VOA ZOAh ❑V0Ana2 0125AGB 0125AGBh ❑125AGBp ❑1AGB ❑lAGBna2 ❑1AGBs ❑500AGB ❑500AGJ 0500AGJs 0250AGB 0250CGB 11250CGBs Ell PB 0500PB ❑500PBna 11250PB 11250PBn 0125PB 0125PBznna 0100PJ 0100PJna2 ❑ ❑ ❑ Air: ❑Tedlaro ❑Summa® Other: ❑ Trip Blank Lot#A0\Tj32- Labeled/Checked by: U L Container: C:Clear A:Amber P:Plastic G:Glass J:Jar B:Bottle Z:Ziploc/Resealable Bag E:Envelope Reviewed by: Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3P0. s:H2SO4 znna:ZnAc2+NaOH f:Field-filtered Scanned by: SOP T100_090(09113110)