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A6E2186 05/24/2016 <br /> BSK Associates SR-FL-0002-15 .......... H2Our4957 5 <br /> Sample IntegrityIIII��IIHN�GIIIAIIII��IIIHIIIINIlI <br /> p <br /> BSK Bottles: es No Page of <br /> Was temperature wl In range? es No NA Were correct containers and preservatives No NA <br /> Chemist _<6°C Micro<10°C received for the tests requested? <br /> If samples were taken today, is there evidence Yes No NA� Were there bubbles in the VOA vials? Yes N NA <br /> that chillinghas begun? C (Volables Only) <br /> U Did all bottles arrive unbroken and intact? es No Was a sufficient amount of sample received? Y No <br /> UDid all bottle labels agree with COC? es o sam No Dles have a hold time<72 hours? es No <br /> Was sodium thiosulfate added to CN sample(s) Yes No NA Was PM notified of discrepancies? Yes No NA <br /> until chlorine was no longer present? PM: By/Time: <br /> 250ml(A) 500ml(B) 1Liter(C)40ml VOA(V) Checks Passed? <br /> Bacti Na2S203 — — <br /> None(P)whteCap <br /> Cr6(P)Br.Green Label/Blue Cap NH40H(NH4),2504 'DW Cl,pH>8 Y N. <br /> Cr6(P) Pink Label.'Blue Cap NH401H(NH412SO4 WW pH 9.3-9.7 Y N <br /> m Cris(P)Black Label]Blue Cap NH40H(NH4)2SO4 7199 <br /> —24 HOUR HOLD TIME"' pH 9:0-9.5 Y N <br /> C HNO,(P)"ed cap — — 1A 29- <br /> H2SO4 (P) or (AG) Yellowcap"bel pH<2 Y N <br /> rc NaOH (P)Green Cap Cl, pH>10 Y N <br /> NaOH+ZnAG(P) pH>9 Y N <br /> Dissolved Oxygen 300ml(g) — — <br /> 0 <br /> Q None(AG)608!8084/8082,625,632/8321.8151, — <br /> -O Z 8270 <br /> j i HCI (AG)Lt.B ue Label O&G,Diesel — — <br /> U Na203S+H.Ci(AG)Ll-Pink abet 525 — — <br /> d <br /> Na2S2031 Liter(Brown P)549 — — <br /> W Y <br /> d aU Na2S203(AG)E4-Labe'547,5,15,548,THiM,524 <br /> a+ L <br /> O Na2S203(CG)ewe Label 504,505 — — <br /> o Na2S203+MCAD(CG)ae, "Label 531 pH<3 Y N <br /> NH4CI(AG)PupleLabel 552 — <br /> EDA(AG)8—Ube! DSPs — — <br /> N HCL(CG)524.2,BTEX,Gas,MTBE,8260/624 — — <br /> `� Buffer pH 4(CG) <br /> N — <br /> None(CG) — — <br /> H3PO4(CG)s�8Im°nLabel — — <br /> I Other: <br /> Asbestos ILiter Plastic w/Foil <br /> Low Level Hg/Metals Double Baggie7777 <br /> — — <br /> Bottled Water — — <br /> Clear Glass Jar: 250 / 500 / 1 Liter — — <br /> Soil Tube Brass / Slee / Plastic — <br /> Tedlar Bag / Plastic Bag — — <br /> �, Contain r Preservative Date/Time/Initials Container Preservative Date/Time/In ials <br /> r. 9f),25bIii. �� `�' loth - s P <br /> N S P S P <br /> a <br /> c <br /> d <br /> E <br /> E <br /> 0 <br /> U <br /> Labeled by: (.A2 @Labels checked by: 1-i @L_ RUSH Paged by:_@— <br /> r <br /> Page 33 of 33 <br />