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Page 29 of 29 <br /> WORK ORDER M 10-10- <br /> Cooler <br /> 0-10-Cooler of 4- <br /> CLIENT: DATE: 10 A—'Z/ 10 <br /> TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0°C—6.0°C, not frozen) <br /> Temperature 2— . OC + 0.5 OC (CF) = 2 -CA °CBlank 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 /> CUS DY SEALS INTACT: <br /> Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: v" <br /> ❑ Sample ❑ ❑ No (Not Intact) lot Present Initial:U <br /> SAMPLE CONDITION: Yes No N/A <br /> Chain-Of-Custody (COC) document(s) received with samples................... ❑ ❑ <br /> y <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 /> El <br /> Sample container label(s) consistent with COC..................................... ❑ ❑ <br /> Sample container(s) intact and good condition...................................... ❑ ❑ <br /> Proper containers and suffigient volume for analyses requested............... ❑ ❑ <br /> Analyses received within holding time................................................. <br /> El <br /> pH / Residual Chlorine / Dissolved Sulfide received within 24 hours........... ❑ ❑ <br /> Proper preservation noted on COC or sample container.......................... lzr-- ❑ ❑ <br /> ❑ Unpreserved viels received for Volatiles analysis <br /> Volatile analysis.container(s)free of headspace..................................... ❑ ❑ <br /> Tedlar bag(s)free of Condesation.............................................I........ ❑ ❑ <br /> CONTAINER TYPE: , <br /> Solid: 1]4ozCGJ ❑8ozCGJ 1316ozCGJ C]Sleeve ( ) ❑EnCorese ❑TerraCorese ❑ <br /> Watelr: ❑VOA ❑VOAh ❑V0kna2 0125AGB 0125AGBh ❑125AGBp C"1AGB ❑1AGBna2 01AGBs <br /> 0500AGB 13500AGJ ❑500AGJs ❑250AGB ❑250CGB 0250CGBs 01PB 0500PB ❑500PBna <br /> ❑250PB ❑250PBn ❑125PB ❑125PBznna ❑100PJ ❑100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlaro ❑Summa® Other: ❑ Trip Blank Lot#: Labeled/Checked by: `(1L0 <br /> Container: C:Clear A:Amber.P:Plastic G:Glass J:Jar B:Bottle Z:Ziploc/Resealable Bag E:Envelope Reviewed by: \1 L <br /> Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 znna:ZnAc2+NaOH f:Field-filtered Scanned by: L� <br /> SOP T100_090(09/13110) <br />