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Page 18 of 18 <br /> WORK ORDER #: 10-02- <br /> 460" <br /> MIN a ® � <br /> >i <br /> 0 " Cooler of t <br /> w. <br /> CLIENT: L A& �-f LATE: 02 4-10 <br /> 1 <br /> FTEMPERATURE: Thermometer ID: SCI (Criteria: D.0°C—6.0°C� not frozen) <br /> re a °C U.5°C (C ) = °C ❑ Blank R(Sample <br /> e(s)outside.temperature criteria(PM/APM contacted by: ). <br /> ❑ Sample(s)outside temperature criteria but recehred on leelchilled on same day of sampling. <br /> ❑ Received at ambient temperature, placed on ice for transport'by Courler. <br /> Ambient Temperature: ❑Air ❑ Filter ❑ Metals Only PCBs Only Initial: <br /> FCUSTODIY SEALS INTACT: <br /> ❑ Gl No(Not Intact) LeNot Present ❑ NIA Initial:❑ ❑ No(Not intact) eNot Present Initial: _ a <br /> SAMPLE CONDITION: Yes No NIA <br /> Chain-Of-Custody(COC)document(s)received with samples...................0 11 ❑ I <br /> COC documents)received complete..:................................................-❑ <br /> ©Colteciton dateltlme,matrix,and/or#of containers logged in based on sample labets. tl <br /> ❑No analysis requested. ❑Not relinquished. E(No dateltlme relinquished. } <br /> Sampler's name indicated on COC...................................................... !� ❑ <br /> Sample container label(s)consistent with COC...................................... go ❑ ❑ <br /> Sample containers) intact and good condition...................................... L;? ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested............... 1Z ❑ ❑ I <br /> Analyses received within molding time.......? ...............I..................... 2 10 ❑ <br /> Proper preservation noted on COC or sample container.....................:.... ❑ ❑ 0' <br /> w <br /> ❑Unpreserved vials received for Volatiles analysis <br /> Volatile analysis containers)free of headspace.................I........ <br /> Tediar bag(s)free of condensation...........................:.......................... 13 . Cl <br /> l <br /> CONTAINER TYPE: <br /> Solid: 04ozCGJ 08ozCGJ 1316ozCGJ ❑Sleeve( ) DEnCoreO ❑TerraCorese 5 q7 <br /> Water: ❑VOA ❑VOAh ❑VOAna,2 U126AGB ❑125AGBh 111125AGBp C11AG13 01AG13na2 E11AGBs <br /> 0500AGB 0500AGJ 11500AGJs ❑250AGB 13250CGB 0250CGBs ❑1PB 0500PB 0500PBna <br /> 0250PB 0250PBn 0125PB-11125PBznna 0100PJ 01001?Jnax 0. ❑ ❑ <br /> Air: ❑Tedlar'o ❑Summa® Other: ❑ Trip Blank Lot#: Checked by: <br /> I Contalner: C:Clear A:Amber P:Pleallo e:cuss J:Jar B.Bottle Z:ZiplocJResealable Bag H.Envellope Reviewed by: 1117 SL <br /> Preservative: h:HCL n:HNO3 na=:Na"3 No:NaOH p:H1PO4 s:"AO4 anna:ZMoz+NaOH f:Fleld-11tered Scanned by: <br /> SOPTIN-026071100) <br /> r - 1 <br />