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APR -03-2002 18:26 CALSCIENCE P.06/07 <br />�tSClP�144 <br />^242 ® Fz] <br />•• p, ronmanta+ WORK ORDER t ' � 1 c t/� t ( <br />a"rerories. lna. <br />Cooler I of <br />CALSCIENCE COURIER: <br />Chilled, cooler with temperature blank provided. <br />Chilled, cooler without temperature blank. <br />Chilled and placed in cooler with wet ice. <br />Ambient and placed in cooler with wet ice. <br />Ambient temperature. <br />°C Temperature blank. <br />Sample(s): <br />DATE: 13 3U c2_ <br />LABORATORY (Other than Calscience Courier): <br />°C Temperature blank. <br />° C IR thermometer. <br />Ambient temperature. <br />Initial: f __ <br />Cooler: _ No (Not intact) : Not Applicable (NIA): __ . <br />PTIVIUMA• 51111 11 +j <br />initial; _ <br />Yes No N/A <br />"'� <br />Chain- of -Custody document(s) received with samples ......................... • • • • • • • • . • <br />Sample container label(s) consistent with custody papers ..................... -"� . • • . • •T . • • • • • <br />Sample contalner(s) intact and good condition ...................................4'""'• <br />Correct containers for analyses requested ......................................... ...... ....... <br />Proper preservation noted on sample label(s)..................................... ......• <br />VOA vial(s) free of headspace...................................................... ..... ....... <br />Tedler bag(s) free of condensation ................................................. __ ..... ..... <br />initial: <br />