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it�i�ea�fl�at' <br />CLIENT: Cd&9,1itt <br />Page 41 of 43 <br />WORK ORDER M 11 -05- 0 19© IR <br />Cooler / of I/ <br />DATE: <br />05124 /11 <br />TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0 °C - 6.0 °C, not frozen) <br />/ <br />Temperature �. 2 —'C + 0.50C (CF) _ �_. —'C Ir Blank ❑ Sample <br />❑ Sample(s) outside temperature criteria (PM/APM contacted by: ). <br />❑ Sample(s) outside temperature criteria but received on ice/chilled on same day of sampling. <br />❑ Received at ambient temperature, placed on ice for transport by Courier. <br />Ambient Temperature: ❑ Air ❑ Filter Initial: <br />CUU-STODY SEALS INTACT: <br />2 Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: <br />❑ Sample. ❑ ❑ No (Not Intact) ,f Not Present Initial: <br />SAMPLE CONDITION: <br />Yes <br />No <br />N/A <br />Chain -Of -Custody (COC) document(s) received with samples ................... <br />12( <br />❑ <br />❑ <br />COC document(s) received complete ................................................... <br />17' <br />❑ <br />❑ <br />❑ Collection date/time, matrix, and/or # of containers logged in based on sample labels. <br />❑ No analysis requested. ❑ Not relinquished. ❑ No date/time relinquished. <br />Sampler's name indicated on COC ....................................................... <br />0/ <br />❑ <br />❑ <br />Sample container label(s) consistent with COC ...................................... <br />❑ <br />�Y <br />❑ <br />Sample container(s) intact and good condition ....................................... <br />l/ <br />❑. <br />❑ <br />Proper containers and sufficient volume for analyses requested ................ <br />I( <br />❑ <br />❑ <br />Analyses received within holding time..................................................-�-tASe <br />- <br />❑ <br />pH / Res. Chlorine / Diss. Sulfide / Diss. Oxygen received within 24 hours... <br />(-1 <br />❑ <br />Proper preservation noted on COC or sample container .......................... <br />Z" <br />❑ <br />❑ <br />❑ Unpreserved vials received for Volatiles analysis <br />Volatile analysis container(s) free of headspace..................................... <br />12 <br />❑ <br />❑ <br />Tedlar bag(s) free of condensation...................................................... <br />❑ <br />❑ <br />CONTAINER TYPE: <br />Solid: ❑4ozCGJ [,-18ozCGJ ❑ 1 SozCGJ ❑Sleeve ( ❑EnCores® ❑TerraCores° ❑ <br />Water: ❑VOA CSI Ah ❑VCAna2 ❑125AGB ❑125AGBh 0125AGBp 01AGB 01AGBna2 01AGBs <br />x <br />❑500AGB 2(50 AG,] ❑500AGJs ❑250AGB ❑250CGB 0250CGBs ❑1PB ❑500PB ❑500PBna <br />13250PB 1Zi250PBn ❑125PB 0125PBzrina ❑100PJ 11.100PJna2 ❑ , ❑ ❑ <br />Air: ❑Tedlar® ❑Summa® Other: ❑ Trip Blank Lot#: Labeled/Checked by: <br />Container: C: Clear A: Amber P: Plastic G: Glass J: Jar B: Bottle Z: Ziploc/Resealable Bag E: Envelope Reviewed by: <br />Preservative: h: HCL n: HN 03 na2:Na2S203 na: NaOH p: H3PO4 s: H2SO4 znna: ZnAc2+NaOH f: Field -filtered Scanned by: _]N� <br />SOP T100_090 (03124111) <br />