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Page 16 of 16 <br />Jane* <br />r1r, <br />lfrudaar Inc— � ElWORK ORDER #: � � -09-® <br />�. <br />SAMPLES - CONTAINERS & LABELS: Comments: <br />❑ Sample(s) NOT RECEIVED but listed on COC <br />❑ Sample(s) received but NOT LISTED on COC <br />❑ Holding time expired — list sample ID(s) and test <br />❑ Insufficient quantities for analysis — list test <br />❑ Improper container(s) used — list test <br />❑ Improper preservative used — list test <br />❑ No preservative noted on COC or label — list test & notify lab <br />❑ Sample labels illegible — note test/container type <br />❑ Sample label(s) do not match COC — Note in comments <br />❑ Sample ID <br />❑ Date and/or Time Collected <br />❑ Project Information <br />❑ # of Container(s) <br />❑ Analysis <br />❑ Sample container(s) compromised — Note in comments <br />❑ Water present in sample container <br />❑ Broken <br />❑ Sample container(s) not labeled <br />❑ Air sample container(s) compromised — Note in comments <br />❑ Flat <br />❑ Very low in volume <br />❑ Leaking (Not transferred - duplicate bag submitted) <br />❑ Leaking (transferred into Calscience Tedlar® Bag*) <br />❑ Leaking (transferred into Client's Tedlar® Bag*) <br />❑ Other: <br />HEADSPACE — Containers with Bubble > 6mm or'/4 inch: <br />Sample # <br />Container <br />INS) <br />a of Vials <br />Received <br />Sample 0 <br />Container ID(s) 0 of Vials <br />Received <br />Sample # <br />Container <br />ID(s) <br />it of Cont. Analysis <br />received <br />Comments: <br />'Transferred at Client's request. <br />Initial / Dater /33 /11 <br />T100 090 (081311111 <br />