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Page 73 of 73 <br /> WORK ORDER M 10-09- © � <br /> F) <br /> ' • ' Cooler of S <br /> CLIENT: i) T S DATE: 09 /02/ 10 <br /> TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0°C—6,0 eC, not frozen)) <br /> Temperature OC + 0.5 OC (CF) _ 3 OC Z" <br /> 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: 11Air ❑ Filter 11Metals Only 11PCBs Only Initial: <br /> CUSTODY SEALS INTACT: <br /> ❑ Cooler ❑ ❑ No (Not Intact) ZNOt Present ❑ N/A Initial: <br /> ❑ Sample ❑ ❑ No (Not Intact) Ie(Not Present Initial: -6 <br /> SAMPLE CONDITION: Yes No N/A <br /> Chain-Of-Custody (COC) document(s) received with samples...................z ❑ ❑ <br /> COC document(s) received complete................................................... Lzr- ❑ ❑ <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..................................................... CJ ❑ ❑ <br /> Sample container label(s) consistent with COC..................................... id ❑ ❑ <br /> Sample container(s) intact and good condition...................................... ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested............... / ❑ ❑ <br /> Analyses received within holding time................................................. E5 ❑ ❑ <br /> pH / Residual Chlorine / Dissolved Sulfide received within 24 hours........... ❑ ❑ 13' <br /> Proper preservation noted on COC or sample container.......................... Zj ❑ ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s)free of headspace..................................... i2( ❑ ❑ <br /> Tedlar bag(s) free of condensation...................................................... ❑ ❑ G?' <br /> CONTAINER TYPE: <br /> Solid: ❑yozCGJ080ZCGJ ❑16ozCGJ ❑Sleeve ( ) ❑EnCores® ❑ ElTerraCoreso <br /> Water: VOA Oa33 OAh ❑VOAna2 11125AGB 0125AGBh 0125AGBp 01AGB 01AGBri ❑1AGBs <br /> 0500AGB 0500AGJ 0500AGJs 0250AGB 0250CGB 0250CGBs 01PB ❑500PB ❑500PBna <br /> 0250PB 0250PBn ❑125PB 0125PBznna 0100PJ 0100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlaro ❑Summa® Other: ❑ Trip Blank Lot#: Labeled/Checked by: <br /> Container: C:Clear A:Amber P:Plasllc G:Glass J:Jar B: Bottle Z:ZlplodResealable Bag E: Envelope Reviewed by: <br /> Preservative: h:HCL n:HNO3 nag:NarS2O3 na;NsOH p:HpPO„ e:H2SO4 znna;znAC¢+NaOH f:Fleld-6ae,ea Scanned by: /r <br /> SOP T100_090(06110110) <br />