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Page 15 of 16 WORK ORDER M 10-10- itmin I acs:4 Q Q Q :4129MOI-NiTT Cooler I of CLIENT: DATE: 10 A' / 10 TEMPERATURE: Thermometer ID: SCI (Criteria: 0.0°C—6.0°C, not frozen) Temperature 2— . ` °C + 0.5°C (CF) = 2 • 30 °C Blank ❑ Sample ❑ 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. Ambient Temperature: ❑ Air ❑ Filter Initial: CU ODY SEALS INTACT: ler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: ❑ Sample ❑ ❑ No (Not Intact) �ot Present Initial: FSAMPLCE CONDITION: Yes No N/A Custody(COC) document(s) received with samples.................. ❑ ❑ ment(s) received complete................................................... ❑ ❑ ❑ Collection date/time,matrix,and/or#of containers logged in based on sample labels. ❑ No analysis requested. ❑ Not relinquished. ❑ No date/time relinquished. El Sampler's name indicated on COC...................................................... Sample container label(s) consistent with COC...... .............................. ❑ ❑ Sample container(s) intact and good condition...................................... ❑ ❑ Proper containers and sufficient volume for analyses requested............... ❑ ❑ Analyses received within holding time................................................. ❑ ❑ pH / Residual Chlorine / Dissolved Sulfide received within 24 hours........... ❑/ ❑ Proper preservation noted on COC or sample container.......................... �" ❑ ❑ ❑ Unpreserved vials received for Volatiles analysis Volatile analysis.cohtainer(s)free of headspace..................................... ❑ ❑ Tedlar bag(s)free of condensation...................................................... ❑ ❑ CONTAINER TYPE: + Solid: ❑4ozCGJ 1]8ozCGJ ❑16ozCGJ ❑Sleeve ( ) ❑EnCorese E]TerraCoreso ❑ Wate4-: ❑VOA ❑VOAh ❑VOiAna2 0125AGB 0125AGBh ❑125AGBp 01AG13 ❑1AGBna2 ❑1AGBs 0500AGB ❑500AGJ 0500AGJs 0250AGB ❑250CGB 0250CGBs 01PB 0500PB ❑500PBna ❑250PB 11250PBn 11125PB 0125PBznna 11100PJ 0100PJna2 ❑ ❑ Air: ❑Tedlar® ❑Summa° Other: ❑ Trip Blank Lot#: Labeled/Checked by: Container: C:Clear A:Amber P:Plastic G:Glass J:Jar B:Bottle Z:Ziploc/Resealable Bag E:Envelope Reviewed by: �(L Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 znna:ZnAc2+NaOH f:Field-filtered Scanned by: �(, SOP T100090(09113110)