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Page 33 of 33 WORK ORDER #: 10-05- 11 ❑O D El --ab r eis lhc,x ITTCooler of CLIENT: �� Cad' s DATE: OJT" 1 o 11 1O TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0°C—6.0'C, not frozen) Temperature r' .�°C + 0.5°C (CF) _ j °C P'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 ❑ Metals Only ❑ PCBs Only Initial: CUSTODY SEALS INTACT: ❑ Cooler ❑ ❑ No (Not Intact) ZNot Present ❑ N/A Initial: ❑ Sample ❑ ❑ No (Not Intact) WNot Present Initial: SAMPLE CONDITION: Yes No N/A Chain-Of-Custody (COC) document(s) received with samples................... E' ❑ ❑ COC document(s) received complete...................................................I ❑ ❑ ❑ 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..................................... .el ❑ ❑ Sample container(s) intact and good condition...................................... �' ❑ ❑ Proper containers and sufficient volume for analyses requested............... p' ❑ ❑ Analyses received within holding time................................................. Ey" ❑ ❑ Proper preservation noted on COC or sample container.......................... ❑ ❑ 21" ❑ Unpreserved vials received for Volatiles analysis Volatile analysis container(s)free of headspace..................................... ❑ ❑ 2ir Tedlar bag(s)free of condensation...................................................... ❑ ❑ -ef CONTAINER TYPE: Solid: ,Zf4ozCGJ ❑8ozCGJ 016ozCGJ ❑Sleeve ( ) ❑EnCoreso ❑TerraCorese ❑ Water: ❑VOA ❑VOAh ❑VOAna2 0125AGB 11125AGBh ❑125AGBp ❑1AGB 01AGBna2 ❑1AGBs ❑500AGB ❑500AGJ ❑500AGJs ❑250AGB ❑250CGB ❑250CGBs ❑1PB 0500PB ❑500PBna 0250PB 0250PBn ❑125PB ❑125PBznna ❑100PJ ❑100PJna2 ❑ ❑ ❑ Air: ❑Tedlaro ❑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: IL - Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 znna:ZnAc2+NaOH f:Field-filtered Scanned by: � (,- SOP T100_090(07/16/09)