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Page 9 of 9 fis�derrc�r ' Ji vlronrrienrad WORK ORDER M 11 -03-El 2 0 0 �abaratanres, t� - - Cooler I of CLIENT: DATE: 03 /oT/1 1 TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0 eC-6.0°C, not frozen) %% Temperature 2 .I OC + 0.50C (CF) = 2 . 6 0 Ql ank ❑ 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: CDY SEALS INTACT: MCooler C ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: ❑ Sample Fl ❑ No (Not Intact) 12 Not Present Initial: Ap SAMPLE CONDITION: Yes No N/A Chain-Of-Custody(COC)document(s) received with samples................... 2-� ❑ ❑ COC document(s) received complete................................................... ❑ ❑ ❑ Collection date/time,matrix,and/or#of containers logged in based on sample labels. ❑ No analysis requested. ❑ Not relinquished. ❑No date/time relinquished. Sampler's name indicated on COC..................................................... ❑ ❑ 2' Sample container label(s) consistent with COC..................................... W( ❑ ❑ Sample container(s) intact and good condition...................................... 01 ❑ ❑ Proper containers and sufficient volume for analyses requested............... Z ❑ ❑ Analyses received within holding time................................................. 1251, ❑ ❑ pH / Residual Chlorine/Dissolved Sulfide received within 24 hours........... ❑ ❑ c2r- Proper preservation noted on COC or sample container.......................... ❑ ❑ Cdl- ❑ Unpreserved vials received for Volatiles analysis Volatile analysis containers)free of headspace..................................... ❑ ❑ 21� Tedlar bag(s)free of condensation...................................................... ❑ ❑ cdi� CONTAINER TYPE: Solid: I24ozCGJ 1]8ozCGJ 016ozCGJ []Sleeve ( ) ❑EnCores® ❑TerraCores® ❑ Water: ❑VOA ❑VOAh ❑VOAna2 0125AGB 11125AGBh 0125AGBp ❑1AGB 01AGBna2 01AGBs 11500AGB ❑500AGJ 0500AGJs 0250AGB 0250CGB 13250CGBs 01PB 0500PB ❑500PBna 11250PS ❑250PBn 0125PB 0125PBznna 0100PJ 0100PJna2 ❑ ❑ 11Air: ❑Tedlare ❑Summa® Other: [ITrip Blank Lot#: Labeled/Chocked 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:HNoa na,:NazszOa no:NaOH p:H3PO4 s:H2SO4 znna:ZnAcz+NaOH f:Field-filtered Scanned by SOP T1100090(0911L10)