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vrrrras WORK ORDER #: 0 4 - 1 n2- - IN n(3 nc) Fy-1 <br /> Cooler of o <br /> SAMPLEI <br /> CLIENT: VAVF� A+taA�.�CT�C.A�- DATE: 4- <br /> TEMPERATURE-SAMPLES RECEIVED BY: <br /> CALSCIENCE COURIER: LABORATORY(Other than Calscience Courier): <br /> Chilled, cooler with temperature blank provided. 4-5 °C Temperature blank. <br /> Chilled, cooler without temperature blank. °C IR thermometer. <br /> Chilled and placed in cooler with wet ice. Ambient.temperature. <br /> Ambient and placed in cooler with wet ice. <br /> Ambient temperature. <br /> °C Temperature blank. Initial: W`, <br /> CUSTODY SEAL INTACT: <br /> Sample(s): Cooler. No(Not Intact): Not Applicable(N/A): <br /> Initial: W i <br /> SAMPLE CONDITION: <br /> Yes No N/A <br /> Chain-Of-Custody document(s)received with samples......................... 11--*�....... ... .... <br /> Sample container label(s) consistent with custody papers..................... —fir... .... <br /> Sample container(s) intact and good condition................................... /� ... .... .... <br /> Correct containers for analyses requested......................................... r11--* r.. .... <br /> Proper preservation noted on sample label(s)..................................... f <br /> VOA vial(s)free of headspape. ...................................................... . ... ... /� <br /> -Tedlar bag(s)free of condensation.................................................. .. ... <br /> Initial: W6 <br /> COMMENTS: <br />