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Page 53 of 54 <br /> 1 -C orroe <br /> v7,ronrri;enta WORK ORDER #: 10-12- ❑2 0 Q EE <br /> abarJaTaries, IPr>t�e <br /> , . 3 <br /> CA Cooler 2 of_ <br /> CLIENT: Va IIYt p I e c lel DATE: 12 �2`� 1 D <br /> TEMPERATURE: ThermometerlD: SCI (Criteria: 0.0eC-6.0°C, notfrozen) <br /> Temperature _3. Z OC + 0.5 0C (CF) =3.-3�- OC lank El 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 /> CUs DY SEALS INTACT: <br /> Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: <br /> ❑ Sample ❑ ❑ No (Not Intact) O Not Present Initiar <br /> SAMPLE CONDITION: Yes No N/A <br /> Chain-Of-Custody(COC) document(s) received with samples..................le, ❑ ❑ <br /> COC document(s) received complete................................................... lz� ❑ d <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..................................................... 2111� ❑ ❑ <br /> Sample container label(s) consistent with COC..................................... A� ❑ ❑ <br /> Sample container(s) intact and good condition...................................... 12!( ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested............... Z ❑ ❑ <br /> Analyses received within holding time................................................. 011 ❑ ❑ <br /> pH/Residual Chlorine/Dissolved Sulfide received within 24 hours........... ❑ ❑ <br /> Proper preservation noted on COC or sample container.......................... ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s)free of headspace..................................... ❑ ❑ <br /> Tedlar bag(s)free of condensation...................................................... ❑ ❑ <br /> CONTAINER TYPE: <br /> Solid: 04ozCGJ ❑8ozCGJ 1116ozCGJ ❑Sleeve ( ) ❑EnCores® ❑TerraCores® ❑ <br /> Water: ❑V0A�7dVOAh ❑VOAna2 0125AGB 0125AGBh ❑125AGBp 01AGB ❑1AGBna2 01AGBs <br /> ❑500AGB ID500AGJ 11500AGJs ❑250AGB ❑250CGB 0250CGBs 131PB 0500PB 11500PBna <br /> ❑250PB 0250PBn 0125PB 0125PBznna 0100PJ ❑100PJna2 ❑ ❑ ❑ <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:HNO. nar:Na2S200 na:NaOH p:H3PO4 a:HgSO4 znna:ZnAG2+NaOH f:Fleld-filtered scanned by; <br /> SOP T700_090(09/10110) <br />