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Page 9 of 9 <br /> WORK ORDER #: 10-11 - <br /> 6-fAj JTCooter of <br /> CLIENT: AN >cn `- DATE: 10 <br /> TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0°C-6.0°C, not frozen) _� <br /> Temperature ` . "I °C + 0.5 OC (CF) = 2- . A °C ❑ Blank U 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 /> CUSTODY SEALS INTACT: <br /> Cooler ❑ ❑ No (Not Intact) 11 Not Present ❑ N/A Initial: �y <br /> ❑ Sample ❑ ❑ No (Not Intact) C?f Not Present Initial: w+/ <br /> SAMPLE CONDITION: Yes/ No N/A <br /> Chain-Of-Custody(COC) document(s) received with samples................... Y ❑ ❑ <br /> COC document(s) received complete................................................... o---- ❑ ❑ <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...I I........I....................................... ❑/ ❑ <br /> Sample container label(s) consistent with COC...................................... i3 O ❑ <br /> Sample container(s) intact and good condition...................................... �/ ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested............... C�' ❑ ❑ <br /> Analyses received within holding time................................................. ❑ ❑/ <br /> pH / Residual Chlorine /Dissolved Sulfide received within 24 hours........... ❑ ❑ [3 <br /> Proper preservation noted on COC or sample container.......................... 12--� ❑ ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s)free of headspace..................................... ❑ ❑ <br /> Tedlar bag(s)free of condensation...................................................... ❑ ❑ 7� <br /> CONTAINER TYPE: <br /> Solid: ❑4ozCGJ 08ozCGJ ❑16ozCGJ ❑Sleeve ( )' ❑EnCorese ❑TerraCorese ❑ <br /> Water: ❑VOA ❑VOAh 13V0Ana2 ❑125AGB 0125AGBh -11125 GBp 17-11AGB ❑1AGBna2 2 AGBs <br /> ❑500AGB 0500AGJ 0500AGJs ❑250AG6 ❑250CGB Z50CGBs 01PB ❑500PB 0500PBna <br /> ❑250PB ❑250PBn ❑125PB ❑125PBznna ❑100PJ ❑100PJna2 !a? bP�s ❑ El <br /> Air: ❑Tedlaro ❑Summa® Other: ❑ Trip Blank Lot#: Labeled/Checked by: wu/ <br /> Container: C:Clear A:Amber P:Plastic G:Glass J:Jar B;Bottle Z:Ziploc/Resealable Bag E:Envelope Reviewed by: _ <br /> Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:1-12SO, znna:ZnAc2+NaOH f:Field-filtered Scanned by: <br /> SOP 7100_090(09!93110) <br />