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Page 54 of 54 <br /> of >w <br /> vfrart:h�ms�nfaf WORK ORDER #: 10-12-D El 51 <br /> alborwarles, Inc. <br /> �CMA • ' kj Cooler 3 of 3 <br /> CLIENT: Va I'" 'e (-�l DATE: 121261110 <br /> TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0eC-6.00C, notfrozen) <br /> Temperature 2 OC + 0.5eC (CF) _ .�°C lank ❑ 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) dNot Present InitiaP <br /> SAMPLE CONDITION: Yes No N/A <br /> Chain-Of-Custody(COC)document(s) received with samples................... ❑ ❑ <br /> COC document(s) received complete................................................... ❑ p <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..................................................... E'S ❑ ❑ <br /> Sample container label(s)consistent with COC..................................... 01� ❑ ❑ <br /> Sample container(s) intact and good condition...................................... 2!( ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested............... L]' ❑ ❑ <br /> Analyses received within holding time................................................. .ef ❑ ❑ <br /> pH/ Residual Chlorine/Dissolved Sulfide received within 24 hours........... ❑ ❑ <br /> Proper preservation noted on COC or sample container..........................'E l ❑ ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s)free of headspace..................................... ;2( ❑ ❑ <br /> Tedlar bag(s)free of condensation...................................................... ❑ ❑ <br /> CONTAINER TYPE: <br /> Solid: 04ozCGJ 08ozCGJ 016ozCGJ ❑Sleeve ( ) ❑Encores® ❑TerraCores® ❑ <br /> Water: ❑VOA �!`VOAh ❑VOAna2 0125AGB 1-1125AGBh 11125AGBp ❑1AGB 01AGBna2 01AGBs <br /> 0500AGB Z600AGJ 0500AGJs 0250AGB ❑250CGB 13250CGBs 01PB 0500PB 0500PBna <br /> 0250PB 0250PBn 0125PB 0125PBznna 0100PJ 0100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlare ❑Summa® Other: ❑ Trip Blank Lot#: Labeled/Checked by: <br /> container: C:Clear A:Amber P:Plastic G:Glass J:Jar 6:Battle Z:Ziploc/Resealable Bag E:Envelope Reviewed by-. <br /> Preservative: h:HCL n:HNO. nat:NatSeoc na:NaOH p:H�P01 s:H,SO4 znna:ZnAct"NaOH f:Fleld-filtered Scanned by: <br /> SOP T100_990(09110N0) <br />