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Page 13 of 13 <br /> '"WAr <br /> vi'mo l WORK ORDER #A 1 -1 O-0 © ❑9 17 <br /> 9 Cooler I of 1 <br /> CLIENT: -S A 1�_ C_ DATE: 1012 1 X11 <br /> TEMPERATURE: Thermometer ID: SC'I (Criteria: 0.0 OC -6.0°C, not frozen) <br /> Temperature Z. - � °C + 0.5°C (CF) = 2- . k- °C lank ❑ Sample <br /> ❑ Sample(s) outside temperature criteria (PMIAPM 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 /> CUSS DY SEALS INTACT: <br /> 'Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ NIA Initial: <br /> ❑ Sample ❑ ❑ No (Not Intact) 'Not Present Initial: <br /> SAMPLE CONDITION: Yes No NIA <br /> Chain-Of-Custody (COC) document(s) received with samples................... 0' ❑ ❑ <br /> COC document(s) received complete.................................................../G ' ❑ ❑ <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......................................................2' ❑ ❑ <br /> Sample container label(s) consistent with COC....................................... 2- ❑ ❑ <br /> Sample container(s) intact and good condition.......................................12r� ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested................ 2T- ❑ ❑ <br /> Analyses received within holding time....................................................1�' ❑ ❑ <br /> pH 1 Res. Chlorine 1 Diss. Sulfide 1 Diss. Oxygen received within 24 hours... ❑ ❑ E— <br /> Proper preservation noted on COC or sample container.......................... ❑ ❑ p' <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s) free of headspace..................................... ❑ ❑ )a- <br /> Tedlar bag(s) free of condensation...................................................... ❑ ❑ L2-- <br /> CONTAINER TYPE: <br /> Solid: 04ozCGJ ❑8ozCGJ 016ozCGJ PSleeve {3 ) ❑EnCoreso ❑TerraCorese ❑ <br /> Water: ❑VOA ❑VOAh 0VOAna2 0125AGB 0125AGBh ❑125AGBp ❑1AGB 01AGBna2 ❑1AGBs <br /> ❑500AGB 0500AGJ ❑500AGJs 0250AGB ❑250CGB 0250CGBs 01PB 01PBna 0500PB <br /> ❑250PB 0250PBn 0125PB ❑125PBznna 0100PJ 0100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlar° ❑Summa® Other: ❑ Trip Blank Lot#: Labeled/Checked by: C=- <br /> Container: C: Clear A:Amber P: Plastic G: Glass J:Jar B:Bottle Z:Ziploo/Resealable Bag E:Envelope Reviewed by: <br /> Preservative: h:HCL n:HNO3 na2:Na2S203 na: NaOH p: H3PO4 s:H2SO4 U:Ultra-pure znna:ZnAc2+NaOH f:Filtered Scanned by:N C./ <br /> SOP T100_090(10104111) <br />