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lance CLIENT: rco vt o L i) Q` Page 14 of 14 WORK ORDER #: 11 -09-El 0 ©M Coolers of I DATE: 49 /01 /11 TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0 °C - 6.0 °C, not frozen) Temperature 2 °C + 0.5°C (CF) _ �= C lank 0 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 0 Filter initial: SAMPLE CONDITION: Yes No N/A Chain -Of -Custody (COC) document(s) received with samples .................. OUST SEALSINTACT. COC document(s) received complete .................................................... ❑ aoier ❑ ❑ No (Not Intact) ❑Not Present ❑ N/A Initial: ❑ Sample ❑ ❑ No (Not Intact) dNot Present Initial: SAMPLE CONDITION: Yes No N/A Chain -Of -Custody (COC) document(s) received with samples .................. ❑ ❑ COC document(s) received complete .................................................... ❑ ❑ ❑ 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 ...................................... ❑ ❑ Sample container(s) intact and good condition.......................................I?' ❑ ❑ Proper containers and sufficient volume for analyses requested ................ ❑ ❑ Analyses received within holding time ................................................... � ❑ ❑ pH / Res. Chlorine / Diss. Sulfide / Diss. Oxygen received within 24 hours... ❑ ❑ Proper preservation noted on COC or sample container .......................... . 0--, ❑ ❑ ❑ Unpreserved vials received for Volatiles analysis Volatile analysis container(s) free of headspace.....................................'2� ❑ ❑ Tedlar bag(s) free of condensation...................................................... ❑ ❑ CONTAINER TYPE: Solid: 4ozCGJ 08ozCGJ 016ozCGJ ❑Sleeve ❑EnCores® ❑TerraCorese ❑ Water VOA OAh 0VOAna2 0125AGB 0125AGBh 0125AGBp 01AGB 01AGBna2 ❑1AGBs 0500AGB A060AGJ ❑500AGJs 0250AGB 0250CGB 0250CGBs 01PB 0500PB ❑500PBna 0250PB 0250PBn 0125PB 0125PBznna 0100PJ 0100PJna2 ❑ ❑ Cl Air: ❑Tedlar® ❑Summa® Other: ❑ Trip Blank Lot#: Labeled/Checked by: Container: C: Clear A: Amber P: Plastic G: Glass J: Jar B: Bottle Z: ZiploGResealable Bag E: Envelope Reviewed by: Preservative: h: HCL n: HNO3 nai:N82S203 na: NaOH p: H3PO4 s: H2SO4 znna: ZnAc2+NaOH f: Field -filtered Scanned by: 1N SOP T100090 (07124111)