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Page 25 of 26 <br /> WORK ORDER #: 11 -OJ- 0 M M <br /> a boratoriesr 1-111C. <br /> *3 <br /> Cooler _L of <br /> CLIENT: 33.1 C DATE: 05 (, 5/11 <br /> TEMPERATURE: Thermometer ID: SCI (Criteria: 0.0"C -6.00C, not frozen) <br /> Temperature Z • 1 °C + 0.5 oC (CF) _ 4 6 °Cank ❑ 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 /> CljWDY SEALS INTACT: <br /> Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ NIA Initial: <br /> ❑ Sample ❑ ❑ No (Not Intact) 2-Not Present Initial: <br /> SAMPLE CONDITION: Yes No NIA <br /> Chain-Of-Custody (COC) document(s) received with samples................... �' ❑ ❑ <br /> COC document(s) received complete...................................................� ❑ ❑ <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 /> Sample container label(s) consistent with COC...................................... ❑ ❑ <br /> Sample container(s) intact and good condition.......................................jE ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested..............., ❑, ❑ <br /> Analyses received within holding time..................................................Z ❑ ❑ <br /> pH 1 Res. Chlorine 1 Diss. Sulfide 1 Diss. Oxygen received within 24 hours... ❑ ❑ .� <br /> Proper preservation noted on COC or sample container.......................... ❑ ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s)free of headspace..................................... ❑ ❑ .� <br /> Tedlar bag(s)free of condensation...................................................... ❑ ❑ <br /> CONTAINER TYPE: <br /> Solid: 04ozCGJ 08ozCGJ ❑16ozCGJ Sleeve ( .'5_) ❑Encores° ❑Terracore o 1❑ <br /> Water: ❑VOA ❑VOAh ❑VOAna2 0125AGB 0125AGBh 0125AGBp ❑1AGB ❑1AGBna2 ❑1A Bs <br /> ❑500AGB 0500AGJ 0500AGJs 0250AGB ❑250CGB ❑250CGBs 01PB ❑500PB ❑500PBna <br /> 0250PB 0250PBn ❑125PB ❑125PBznna 0100PJ 0100PJna2 ❑ ❑ ❑ <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:ZiploclResealable Bag E. Envelope Reviewed by: <br /> Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 znna:ZnAc2+NaOH f:Field-filtered Scanned by: <br /> SOP T100_09 (03124111) <br />