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Page 71 of73 <br /> WORK ORDER #A 0-09-© El <br /> Swabornn x»c. • ' • - Cooler 3 of S <br /> CLIENT: DATE: 09102-110 <br /> TEMPERATURE: Thermometer ID; SCI (Criteria: 0.0 aC —6.OOC, not frozen) <br /> Temperature I • '�- OC + 0.5 OC (CF) = 2 •1- OC eBlank ❑ 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 ❑ Metals Only ❑ PCBs Only Initial: <br /> CUSTODY SEALS INTACT: <br /> ❑ Cooler ❑ ❑ No (Not Intact) S5Not Present ❑ N/A Initial: <br /> ❑ Sample ❑ ❑ No (Not Intact) Z�Not Present Initial: 091. _ <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..................................................... Pf ❑ ❑ <br /> Sample container label(s) consistent with COC..................................... 141 ❑ ❑ <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........... ❑ ❑ <br /> Proper preservation noted on COC or sample container.......................... Z ❑ ❑ <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 ❑16ozCGJ ❑Sleeve ( ) ❑EnCores® OTerraCoreso ❑ <br /> Water: ❑VOA ❑VOAh ❑VOArl 11125AGB 0125AGBh 0125AGBp Ip IAGB ❑1AGBna2 ❑1AGBs <br /> 11500AGB 11500AGJ 11500AGJs 0250AGB 0250CGB 0250CGBs 01PB 0500PB ❑500PBna <br /> 0250PB 0250PBn 0125PB 0125PBznna ❑100PJ ❑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:ZiplodResealable Bag E:Envelope Reviewed by: Y <br /> Preservative: h:HCL n:HNoa na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 arms;ZnAciaNaOH f:neid-utered Scanned by: L <br /> SOP 7100-poo 10 011011 01 <br />