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Page 26 of 29 <br /> WORK ORDER #: 10 10 <br /> hw <br /> ® L�u <br /> Cooler k of 'I- <br /> CLIENT: �� � <br /> IC�sL , DATE: 10 /22/ 10 <br /> TEMPERATURE: Thermometer ID: SCI (Criteria: 0.0°C-6.0°C, not frozenn))� <br /> Temperature �— . OC + 0.5 OC (CF) = `- • U2-OC LJ Blank ❑ 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 /> T <br /> S ODY SEALS INTACT: <br /> Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: <br /> 07 <br /> ❑ Sample ❑ ❑ No (Not Intact) E"N Present Initial: <br /> SAMPLE CONDITION: Yes No N/A <br /> Chain-Of-Custody (COC) document(s) received with samples................... ❑ ❑ <br /> 1 <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..................................................... El/ <br /> Sample container label(s) consistent with COC..................................... <br /> J ❑ <br /> Sample container(s) intact and good condition...................................... ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested............... �" ❑ ❑ <br /> Analyses received within holding time................................................. <br /> pH / Residual Chlorine / Dissolved Sulfide received within 24 hours........... ❑ ❑ g <br /> Proper preservation noted on COC or sample container.......................... ❑ O <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis.cohtainer(s)free of headspace..................................... ❑ ❑ <br /> Tedlar bag(s)free of Conde sation... <br /> CONTAINER TYPE: <br /> Solid: ❑4ozCGJ ❑8ozCGJ 016ozCGJ ❑Sleeve ( ) ❑EnCoresv TerraCorese ❑ <br /> Watek: ❑VOA ❑VOAh [:1V0iAna2 11125AGB 0125AGBh 0125AGBp Ig1AG6 ❑1AGBna2 01AGBs <br /> ❑500AGB ❑500AGJ ❑500AGJs 0250AGB ❑250CGB ❑250CGBs 01PB 0500PB 0500PBna <br /> 11250PB 1:1250PBn ❑125PB E]125PBznna ❑100PJ ❑100PJna2 0 ❑ ❑ <br /> Air: ❑Tedlar® ❑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+NaOH f:Field-filtered Scanned by: <br /> SOP T100_090(09113110) <br />