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Page 27 of 27 - WORK ORDER #: 10-05-0 D ® 0 44 5 .11 A MS • ' Cooler of i CLIENT: A R.cad S DATE: OJT /®/ / 10 TEMPERATURE:: Thermometer ID: SC1 (Criteria: 0.0°C—6.0'C, not frozen) Temperature o2 .CD OC + 0.5°C (CF) _ °C ZBlank ❑ Sample ❑ Sample(s)outside temperature criteria (PM/APM contacted by: ). ❑ Sample(s)outside temperature criteria but received on ice/chilled on same dad 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: / El Cooler El El No (Not Intact) /Not Present ❑ N/A Initial: ❑ Sample ❑ ❑ No (Not Intact) �J Not Present Initial: �— SAMPLE CONDITION: Yes No N/A Chain-Of-Custody(COC) document(s) received with samples..........:........ d ❑ ❑ COC document(s) received complete.........................................:.........7 ❑ ❑ ❑ Collection date/time, matrix, and/or#of containers logged in based on sample labels. ❑ No analysis requested. ❑ Not relinquished. ❑ No date/time relinquished. 4 Sampler's name indicated on COC..................................................... Pr ❑ ❑ Sample container label(s) consistent with COC..................................... 1�1 ❑ ❑ Sample container(s) intact and good condition...................................... 10, ❑ ❑ Proper containers and sufficient volume for analyses requested............... .�J ❑ ❑ Analyses received within holding time................................................. ,rJ� ❑ ❑ Proper preservation noted on COC or sample container.......................... ❑ ❑ �J ❑ Unpreserved vials received for Volatiles analysis Volatile analysis,container(s) free of headspace..................................... ❑ ❑ E Tedlar bag(s)free of condensation...................................................... ❑ ❑ /� CONTAINER TYPE: Solid: �4ozCGJ ❑8ozCGJ ❑16ozCGJ ❑Sleeve ( ) ❑EnCores° ❑TerraCorese ❑ Water: ❑VOA ❑VOAh 0VOAna2 ❑125AGB ❑125AGBh ❑125AGBp ❑1 AGB ❑1 AGBna2 ❑1 AGBs ❑500AGB 0500AGJ ❑500AGJs ❑250AGB ❑250CGB 0250CGBs ❑1PB ❑50.0PB ❑500PBna ❑250PB 0250PBn ❑125PB 0125PBznna 0100PJ 0100PJna2 ❑ ❑ ❑ 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: l < Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 znna:ZnAC2+NaOH f:Field-filtered Scanned by: SOP T100_090(07/16109)