SITE HISTORY - Laserfiche WebLink

Home Browse Search

0 0 Page 50 of 52 Jaince vFnvnrnenta! WORK ORDER #: -OZ- © ® ❑ , elbs�u^at^cuiles, Jrnc� - - 0 - Cooler / ofZ CLIENT: eo ► ?c DATE: 02 /0-!�-/, 1 TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0eC-6.0eC, not frozen) , Temperature 2 . 0 OC + 0.5 OC (CF) = 2 . f-°C ❑ Blank ample ❑ 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. vv , Ambient Temperature: ❑ Air ❑ Filter Initial: G'L CUSTODY SEALS INTACT: ❑ Cooler ❑ ❑ No (Not Intact) 214-ot Present ❑ N/A Initial: ❑ Sample ❑ ❑ No (Not Intact) Act Present Initial: T�%l ' SAMPLE CONDITION: Yes No N/A Chain-Of-Custody(COC) document(s) received with samples................... Z 0 0 1 COC document(s) received complete................................................... PT' ❑ ❑ ❑ 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... ................................................. 21' ❑ ❑ Sample container label(s)consistent with COC..................................... ❑ Z� ❑ Sample container(s) intact and good condition...................................... ❑ Z' ❑ Proper containers and sufficient volume for analyses requested............... 2r ❑ ❑ Analyses received within holding time................................................. 2!r ❑ ❑ pH / Residual Chlorine/ Dissolved Sulfide received within 24 hours........... ❑ ❑ 11 ' Proper preservation noted on COC or sample container.......................... 01, ❑ ❑ ❑ Unpreserved vials received for Volatiles analysis ' Volatile analysis container(s)free of headspace..................................... ❑ 171� ❑ Tedlar bag(s)free of condensation...................................................... ❑ ❑ CONTAINER TYPE: ' Solid: 04ozCGJ 08ozCGJ 016ozCGJ [:]Sleeve (_) ❑EnCores° ❑TerraCorese ❑ Water: ❑VOA 2VOAh ❑VOAnaZ ❑125AGB 11125AGBh ❑125AG8p ❑1AGB e1AGBna2 01AGBs ' ❑500AGB 2rOOAGJ ❑500AGJs 11250AGB ❑250CGB ❑250CGBs 01PB 0500PB ❑500PBna 1:1250PB 0250PBn 0125PB ❑125PBznna 171100PJ 0100PJna2 ❑ ❑ ❑ Air: ❑Tedlar® ❑Summa® Other: ❑ Trip Blank Lot#:lloll7 A Labeled/Checked by: T-:A/ r 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:ZMcz+NaOH f:Field-filtered Scanned by: ' SOP T100090(09113110)