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erg► , CLIENT: LC R S Page 20 of 20 WORK ORDER #: 11 -09-ED P L� D NCooler- / of DATE: 0912-8 /11 TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0 °C — 6.0 °C, not frozen) Temperature _�• OC + 0.5 OC (CF) = ,.2- 1 °C CI�Blank O 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 Initial: CUSTODY SEALS INTACT: 2�'Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: ❑ Sample ❑ ❑ No (Not Intact) Vlot Present Initial: SAMPLE CONDITION: Yes No N/A Chain -Of -Custody (COC) document(s) received with samples...................011' ❑ ❑ COC document(s) received complete ................................................... ❑ ❑ ❑ Collection date/time, matrix, and/or # of containers logged in based on sample labels. ❑ No analysis requested. 1] Not relinquished. ❑ No date/time relinquished. Sampler's name indicated on COC ...................................................... ❑ ❑ Sample container label(s) consistent with COG ......... ............................. ❑ ❑ Sample container(s) intact and good condition ......................................./ ❑ ❑ Proper containers and sufficient volume for analyses requested... ............. IBJ ❑ ❑ Analyses received within holding time .................................................. ❑ ❑ pH / Res. Chlorine / Diss. Sulfide / Diss. Oxygen received within 24 hours... ❑ ❑ Proper preservation noted on COC or sample container .......................... ❑ ❑ ❑ Unpreserved vials received for Volatiles analysis Volatile analysis container(s) free of headspace..................................... ❑ la Tedlar bag(s) free of condensation...................................................... ❑ ell, CONTAINER TYPE: Solid: 040ZCGJ 080ZCGJ 016ozCGJ Sleeve c s ) ❑EnCores® ❑TerraCorese 0 - Water: ❑VOA ❑VOAh ❑VOAna2 0125AGB 0125AGBh 0125AGBp 131AGB 01AGBna2 01AGBs 0500AGB 0500AGJ 0500AGJs 0250AGB 0250CGB 11250CGBs 01PB 13500PB 13500PBna 0250PB 11250PBn 0125PB ❑125PBznna 0100PJ ❑100PJna2 ❑ ❑ ❑ 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: ! , Preservative: h: HCL n: HNO3 na2:Na2S203 na: NaOH p: H3PO4 s: H2SO4 znna: ZnAC2+NaOH f: Field -filtered Scanned by: V SOP T100_0"10312Ntt)