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Page 9 of 9 lana* i�r�arti a WORK ORDER #: 2- 2-0 IT D ' MeCooler / of r CLIENT: ,ISIF -- DATE: 021,4-112 TEMPERATURE: Thermometer ID:SC3 (Criteria: 0.0°C—6.0°C, not frozen) � Temperature / OC -0.30C (CF) = J OC 2l Blank ❑ 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 ❑ Filter Initial: CUSTODY SEALS INTACT: /Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: ❑ Sample ❑ ❑ No (Not Intact) Aot Present Initial: _ SAMPLE CONDITION: Yes No N/A Chain-Of-Custody(COC)document(s) received with samples................... Z ❑ ❑ COC document(s) received complete................................................... P11*1 ❑ ❑ ❑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...................................................... ❑ ❑ C Sample container label(s) consistent with COC...................................... 2-1, ❑ ❑ Sample container(s) intact and good condition....................................... l� ❑ ❑ Proper containers and sufficient volume for analyses requested................ oe ❑ ❑ Analyses received within holding time.................................................. la ❑ ❑ pH / Res. Chlorine/ Diss. Sulfide/ Diss. Oxygen received within 24 hours... ❑ Cl 2,4 Proper preservation noted on COC or sample container.......................... ❑ ❑ ❑'° ❑ Unpreserved vials received for Volatiles analysis Volatile analysis container(s)free of headspace..................................... ❑ ❑ Tedlar bag(s)free of condensation...................................................... Cl ❑ CONTAINER TYPE: Solid: 1Q40ZCGJ 080ZCGJ 016ozCGJ ❑Sleeve ( ) ❑EnCoreso ❑TerraCores® ❑ Water: ❑VOA ❑VOAh 7VOAna2 ❑125AGB 0125AGBh ❑125AGBp 01AGB 01AG13na2 ❑1AGBs 0500AGB ❑500AGJ 0500AGJs ❑250AGB 0250CGB 11250CGBs 01PB 111PBna 050OPS 0250PB 11250PBn 0125PB 11125PBznna 0100PJ ❑100PJna2 ❑ ❑ ❑ Air: ❑Tedlar® ❑Summa® Other: ❑ Trip Blank Lot#: Labeled/Checked by: - 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:H3PO4 s:H2SO4 u:Ultra-pure znna:ZnAc2+NaOH f:Filtered Scanned by: SOP T100_090(12108!11)