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Page 33 of 33 Al WORK ORDER #: 10-05-D D I� u arms .jig:. 6 Cooler I of CLIENT: a S DATE: 051 1 / 10 TEMPERATURE: Thermometer ID: SCI (Criteria: 0.0°C-6.0°C, not frozen) Temperature . --�- OC + 0.5 OC (CF) = o2 . 3 °C e 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: ❑ Air ❑ Filter ❑ Metals Only ❑ PCBs Only Initial: CUSTODY SEALS INTACT: ❑ Cooler ❑ ❑ No (Not Intact) 2-Not Present ❑ N/A Initial: ❑ Sample ❑ ❑ No (Not Intact) Z Not Present Initial: SAMPLE CONDITION: Yes No N/A Chain-Of-Custody (COC) document(s) received with samples...................Z�-' ❑ ❑ COC document(s) received complete................................................... ❑ ❑ ❑ Collection date/time i 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..................................................... Z ❑ ❑ Sample container label(s) consistent with COC..................................... Z ❑ ❑ Sample container(s) intact and good condition...................................... P�' ❑ ❑ Proper containers and sufficient volume for analyses requested............... Com' ❑ ❑ Analyses received within holding time................................................. 7 ❑ ❑ Proper preservation noted on COC or sample container.......................... ❑ ❑ a,- ❑ Unpreserved vials received for Volatiles analysis Volatile analysis container(s)free of headspace..................................... ❑ ❑ 0- 01, Tedlar bag(s)free of condensation...................................................... ❑ ❑ CONTAINER TYPE: Solid: 44ozCGJ 08ozCGJ ❑16ozCGJ ❑Sleeve ( ) ❑EnCorese ❑TerraCoreso ❑ Water: ❑VOA ❑VOAh ❑VOAna2 ❑125AG6 ❑125AGBh 0125AGBp 01AGB ❑1AGBna2 01AGBs ❑500AGB ❑500AGJ 1:1500AGJs 1:1250AGB 1:1250CGB ❑250CGBs ❑1PB 11500PB ❑500PBna ❑250P6 0250PBn ❑125PB 0125PBznna ❑100PJ ❑100PJna2 ❑ ❑ ❑ Air: ❑Tedlare ❑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: XL � Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 znna:ZnAc2+NaOH f:Field-filtered Scanned by: � V SOP T100_090(07116116109)