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Page 16.of 16 WORK ORDER #: 1 Owl 0'Q Q 1101 ON Cooler 2- of 2 CLIENT: DATE: 10 122-/ 10 TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0°C—6.0°C, not frozenn))� Temperature 2 . � OC + 0.5 0C (CF) = 2 . 8 OC I� 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: El Air [3 Filter Initial: CUS ODY SEALS INTACT: Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: ❑ Sample ❑ ❑ No (Not Intact) 12'Not Present Initial: FSAMPLE 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. Sampler's name indicated on COC.................................................. Sample container label(s) consistent with COC...... .........I.................... ❑ Sample container(s) intact and good condition...................................... ❑ ❑ Proper containers and suffigient 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..................................... ❑ ❑ �j Tedlar bag(s)free of Condesation...................................................... ❑ ❑ d CONTAINER TYPE: + Solid: 04ozCGJ ❑8ozCGJ ❑16ozCGJ ❑Sleeve ( ) ❑EnCoreso❑TerraCoreso ❑ Watelr: ❑VOA ❑VOAh ❑VOiAna2 ❑125AGB ❑125AGBh ❑125AGBp Lf1AGB ❑1AGBna2 01AGBs 0500AGB 0500AGJ 0500AGJs ❑250AGB ❑250CGB 0250CGBs 01PB 11500PB ❑500PBna 0250PB ❑250PBn ❑125PB E]125PBznna ❑100PJ ❑100PJna2 ❑ ❑ ❑ Air: ❑Tedlar° ❑Summa® Other: ❑ Trip Blank Lot#: Labeled/Checked by: Container: C:Clear A:Amber.P:Plastic G:Glass J:Jar B:Bottle Z:ZiploclResealable Bag E:Envelope Reviewed by: Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 znna:znAC2+NaOH f:Field-filtered Scanned by: SOP T100 080(08113110)