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Page 27 of 27 <br />ci/ Ga�l7�� <br />a <br />sly r�#ort� , Inc. WORK ORDER #: 1 1-09-© �❑ <br />® <br />[:Yil 1111 a q wil 0 lei in , �. <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 />ample label(s) do not match COC — Note in comments H — a <br />2'6ample 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 1/4 inch: <br />Sample # <br />Container <br />ID(s) <br />N of Vials <br />Received <br />Sample # <br />Container 10(s) <br />N of Vials <br />Received <br />Sample # <br />I Container <br />ID(s) <br />N of Cont <br />received <br />Analysis <br />fI <br />Comments: <br />*Transferred at Client's request. <br />Initial / Date: A(A9 /93 /11 <br />108131111) <br />