Laserfiche WebLink
Page 7 of 7 <br /> WORK ORDER #: 10-10- <br /> 'Pries <br /> O-1O'® ® © <br /> ' 0 071 Cooler t of <br /> CLIENT: V-\T:I DATE: 10 AOS / 10 <br /> TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0°C—6.0°C, not frozen) <br /> Temperature t . 6 °C + 0.5 OC (CF) = 2- . \ OC 13166—nk ❑ 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) ❑ Not Present. ❑ N/A Initial: <br /> ❑ Sample ❑ ❑ No (Not Intact) 53IN-ot Present Initial: <br /> SAMPLE CONDITION: Yes No N/A <br /> Chain-Of-Custody (COC) document(s) received with samples................... ❑ ❑ <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 /> Sample container label(s) consistent with COC..................................... prl- ❑ ❑ <br /> Sample container(s) intact and good condition...................................... I2�' ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested............... P' ❑ ❑ <br /> Analyses received within holding time................................................. 1�1( ❑ ❑ <br /> pH / Residual Chlorine/ Dissolved Sulfide received within 24 hours........... ❑ ❑ 2__ <br /> Proper preservation noted on COC or sample container.......................... ❑ ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis containers)free of headspace....................:................ ❑ ❑ 0' <br /> Tedlar bag(s)free of condensation...................................................... ❑ ❑ C� <br /> CONTAINER TYPE: <br /> Solid: ❑4ozCGJ ❑8ozCGJ ❑16ozCGJ ❑Sleeve ( ) ❑EnCores® ❑TerraCorese ❑ <br /> Water: ❑VOA ❑VOAh ❑VOAna2 ❑125AGB 13125AGBh ❑125AGBp ❑1AGB 01AGBna2 21AGBs <br /> 0500AGB 13500AGJ ❑500AGJs ❑250AG6 0250CGB 13250CGBs ❑1PB 0500PB ❑500PBna <br /> ❑250PB 0250PBn ❑125PB ❑125PBznna ❑100PJ ❑100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlare ❑Summa® 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 /> Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH P:H3PO4 s:H2SO4 znna:ZnAC2+Na0H f:Field-filtewd Scanned by: <br /> SOP T100_090(09/13110) <br />