COMPLIANCE INFO - Laserfiche WebLink

Home Browse Search

Page 16 of 17 . WORK ORDER #: 10-05-El E 0 Orfes, :m; Cooler of % CLIENT: A cocks DATE: 05101110 TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0°C—6.0°C, not frozen) Temperature c� •0 °C + 0.5°C (CF) _ 0- . rJ °C ZBlank ❑ Sample ❑ Sample(s) outside temperature criteria (PM/APM contacted by: ). In Sample(s)outside temperature criteria but received on ice/chilled on same dad of sampling. ❑ Received at ambient temperature, placed on ice for transport by Courier. Ambient Temperature: ❑ Air ❑ Filter ❑ Metals Only ❑ PCBs Only Initial CUSTODY SEALS INTACT: / El Cooler ❑ ❑ No (Not Intact) /Not Present ❑ N/A Initial: ❑ Sample ❑ ❑ No (Not Intact) `X Not Present Initial: SAMPLE CONDITION: Yes No N/A Chain-Of-Custody (COC) document(s) received with samples................... ❑ ❑ COC document(s) received complete.........................................:......... ❑ ❑ ❑ Collection date/time, matrix, and/or#of containers logged in based on sample labels. ❑ No analysis requested. ❑ Not relinquished. ❑ No date/time relinquished. Sampler's name indicated on COC..................................................... ] ❑ ❑ Sample container label(s) consistent with COC..................................... ❑ ❑ Sample container(s) intact and good condition...................................... ❑ ❑ Proper containers and sufficient volume for analyses requested............... ❑ ❑ Analyses received within holding time................................................. X ❑ ❑ Proper preservation noted on COC or sample container.......................... ❑ ❑ ❑ Unpreserved vials received for Volatiles analysis Volatile analysis container(s) free of headspace..................................... ❑ ❑ r�l Tedlar bag(s)free of condensation...................................................... ❑ ❑ CONTAINER TYPE: Solid: lid: 4ozCGJ 08ozCGJ ❑16ozCGJ ❑Sleeve ( ) ❑EnCorese ❑TerraCorese ❑ ater'. DVOA ❑VOAh ❑VOAna2 ❑125AGB ❑125AGBh ❑125AGBp 01AGB ❑1AGBna2 ❑1AGBs 0500AGB ❑500AGJ ❑500AGJs ❑250AGB 1:1250CGB ❑250CGBs ❑1PB ❑500PB 0500PBna ❑250PB 0250PBn ❑125PB 1:1125PBznna 0100PJ ❑100PJna2 ❑ ❑ ❑ Air: ❑Tedlaro ❑Summa° Other: ❑ Trip Blank Lot#: Labeled/Checked by: Container: C:Clear A:Amber P:Plastic G:Glass J:Jar B:Bottle Z:Ziploc/Resealable Bag E:Envelope Reviewed by: Preservative: h:HCL n:HNO3 na2:Na2S203 na:NaOH p:H3PO4 s:H2SO4 znna:ZnAc2+NaOH f:Field-filtered Scanned by: L/ SOP T100 090(07/16/09)