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Page 29 of 30 <br />__ .._. WORK ORDER #: 10 -07 -El ❑ ® ❑ <br />' Cooler `- of <br />CLIENT: DATE: 07/�_L/ 10 <br />TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0 °C - 6.0 °C, not frozen) <br />Temperature � . � OC + 0.5 OC (CF) = 2- . � °C L�"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. Vj <br />Ambient Temperature: IJ Air 11 Filter El Metals Only EJ PCBs Only . Initial: k0l, <br />TODY SEALS INTACT: <br />CCU <br />Cooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: <br />❑ Sample ❑ ❑ No (Not Intact) ,01Not Present Initial: <br />SAMPLE CONDITION: Yes <br />No <br />N/A <br />Chain -Of -Custody (COC) document(s) received with samples...................,e( <br />❑ <br />❑ <br />COC document(s) received complete ................................................... <br />Z <br />❑ <br />❑ <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 ..................................................... <br />.❑ <br />El <br />Sample container label(s) consistent with COC ..................................... <br />Z1_' <br />❑ <br />❑ <br />Sample container(s) intact and good condition ...................................... <br />Rr <br />❑ <br />❑ <br />Proper containers and sufficient volume for analyses requested ................ <br />[a' <br />❑ <br />❑ <br />Analyses received within holding time .................................................. . <br />d <br />❑ <br />a <br />pH / Residual Chlorine / Dissolved Sulfide received within 24 hours........... <br />❑ <br />❑ <br />Proper preservation noted on COC or sample container .......................... <br />❑ <br />❑ <br />❑ Unpreserved vials received for Volatiles analysis <br />Volatile analysis container(s) free of headspace..................................... <br />❑ <br />❑ <br />Tedlar bag(s) free of condensation...................................................... <br />❑ <br />❑ <br />CONTAINER TYPE: <br />Solid: ❑4ozCGJ 08ozCGJ ❑16ozCGJ []Sleeve ( ) ❑EnCorese ❑e E3rraCorese <br />Water: ❑VOA ❑VOAh ❑VOAna2 ❑125AGB 0125AGBh ❑125AGBp <br />Erl'AGB <br />01AGBna2 ❑1AGBs <br />❑500AGB 0500AGJ 0500AGJs 1:1250AGB 0250CGB 0250CGBs <br />01PB <br />0500PB ❑500PBna <br />0250PB 0250PBn 11125PB ❑125PBznna 0100PJ 0100PJna2 ❑ <br />❑ <br />❑ <br />Air: ❑Tedlaro ❑Summa° Other: ❑ Trip Blank Lot#: Labeled/Checked <br />by: <br />Container: C: Clear A: Amber P: Plastic G: Glass J: Jar B: Bottle Z: Ziploc/Resealable Bag E: <br />Envelope <br />Reviewed by: <br />Preservative: h: HCL n: HNO3 na2:Na2S203 na: NaOH p: H3PO4 s: H2SO4 znna: ZnAC2+NaOH f: Field -filtered <br />Scanned by: <br />SOP T100 090 (05110110) <br />