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i <br /> Page 31 of 31 <br /> Acr <br /> I�. acien�ea <br /> ,NW <br /> Wr01TrnG�81 WORK ORDER #: 10-12-0 0 <br /> ,Laboratories, Inc. <br /> �SAMPLE ANOMALY O . <br /> SAMPLES - CONTAINERS & LABELS: Comments: <br /> ❑ Sample(s)/Container(s) NOT RECEIVED but listed on COC Z> r AS ?V-�-2 <br /> ❑ Sample(s)/Container(s) received but NOT LISTED on COC TAME M►�. �v <br /> ❑ Holding time expired- list sample ID(s) and test <br /> ❑ Insufficient quantities for analysis - list test <br /> ❑ Improper container(s) used - list test <br /> ❑ Improper preservative used - list test <br /> ❑ No preservative noted on COC or label - list test& notify lab <br /> ❑Sample labels illegible- note test/container type <br /> E- SSampll: labels) do not match COC - Note in comments <br /> kl Sample ID <br /> ❑ Date and/or Time Collected <br /> ❑ Project Information <br /> ❑# of Container(s) <br /> ❑Analysis <br /> ❑ Sample container(s) compromised - Note in comments <br /> ❑Water present in sample container <br /> ❑ Broken <br /> ❑Sample container(s) not labeled <br /> ❑ Air sample container(s) compromised- Note in comments <br /> ❑ Flat <br /> ❑Very low in volume <br /> ❑ Leaking (Not transferred - duplicate bag submitted) <br /> ❑ Leaking (transferred into Calscience Tedlar° Bag*) <br /> ❑ Leaking (transferred into Client's Tedlar° Bag*) <br /> ❑ Other: <br /> HEADSPACE - Containers with Bubble > 6mm or '/4 inch: <br /> Sample# Container #of Vials Sample# Container ID(s) N of Vials Sample# Container N of cont. Analysis <br /> ID(s) Received Received ID(s) received <br /> Comments: <br /> 'Transferred at Client's request. Initial / Date: W; 12 /4°1/10 <br /> SOP T100_090(09/17/10) <br />