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Page 30 of 33 <br /> V WORK ORDER#: 14-05-�13010 <br /> KT <br /> atrroretarfasr Jnc, ' <br /> ' • Cooler of. <br /> CLIENT: . .YZ <br /> /a DATE., 0510 1:44 <br /> TEMPERATURE: Thermometer ID: SC2(Criteiia: 0.0°C-6.0°C, not frozen except sediment/tissue) <br /> Temperature °O • !a °C - 0 3 oC (CF) _ cC E Blank ❑ 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 /> ❑ RecelVed at ambient temperature,placed on ice for transport by Courier. <br /> Ambient Temperature: ❑ Air ❑ Filter Checked by:, <br /> CUSTODY SEALS INTACT: <br /> Cooler El ElNo (Not Intact) ❑ Not Present El NA Checked by: � <br /> ❑ Sample ❑ ❑ No (Not Intact) XNot Present Checked.by: <br /> SAMPLE CONDITION: Yes No N/A <br /> Chain-Of-Custody (COC) document(s)received with samples................... ❑ ❑ <br /> CQC dog e t s eceived complete............................................ ...... ❑ ❑ <br /> t m <br /> � ollectdate 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........................... ......................... 10� ❑ ❑ <br /> Sample container label(s) consistent with COC..................................... ❑ �, ❑ <br /> Sample container(s) intact and good condition...................................... fid' ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested............... . ❑ ❑ <br /> Analyses receided'within holding time.................................................�: ❑ ❑ <br /> Aqueous samples received within 15-minute holding time - <br /> ❑ pH ❑ Residual Chlorine ❑ Dissolved Sulfides ❑ Dissolved Oxygen........... ❑ ❑ <br /> Proper preservation noted on COC or sample container.......................... ❑ ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s) free of headspace..................................... ❑ ❑ �1 <br /> Tedlar bag(s)free of condensation....................................................... ❑ ; ❑ <br /> X� <br /> CONTAINER TYPE: <br /> Solid: ❑4ozCGJ 08ozCGJ 0166zCGJ P�leeve (�) ❑Encores® ❑TerraCores® ❑. <br /> Aqueous:'❑VOA OVOAh 0VOAna2 0125AG8'11125AGBh ❑l25AGBp [11 AGB ❑1AGBnai ❑1AGBs <br /> ❑500AG6 ❑500AGJ ❑500AGJs 0250AGB 0250CGB 0250CGBs 01PB ❑1PBna 0500PB <br /> 0250PI3 ❑250PBn 0125PB 0125PBznna 11100PJ ❑100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlare ❑Canister Other: ❑ Trip Blank Lot#: Labeled/Checked by: <br /> container: c:Clear A:Amber P:Plastic G:Glass J:Jar B:Bottle'Z:Ziploc/Resealable Bag E:Envelope Reviewed'by: —' <br /> IK <br /> Preservative: h:HCL n:HNO3 naz:Nazs2oj na:NaOH,p:H3PQ s:H2SO4 u:Ultra-pure znna:ZnAci+NaOH f:Filtered Scanned by: <br /> rAl�ec6JCL+ ,e. " .fS,. .S jay soar;uu_ued(u,Iavla) <br />