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A6E2186 05/24/2016 <br /> BSK Associates SR-FL-0002-15 ...... H2Our4957 5 <br /> Sample Integrity ININIIINNNIIIIN�II�NNIIHIINIRINI <br /> BSKBottles: es No Page of ..........................................................................__.............. <br /> Was temperature AM-range? No NA Were correct containers and preservatives es' No NA <br /> Chemist 5 6°C Micro< 10°C received for the tests requested? <br /> w If samples were taken today, is there evidence Yes No NA Were there bubbles in the VOA vials? Yes NNA <br /> that chillinghas begun? (Volatlles Only) <br /> U Did all bottles arrive unbroken and intact? es No Was a sufficient amount of sample received? Y No <br /> VDid all bottle labels agree with COC? es No Do samples have a hold time<72 hours? es No <br /> Was sodium thiosulfate added to CN sample(s) Yes No NA Was PM notified of discrepancies? Yes No NA <br /> until chlorine was no longer present? PM: By/Time: <br /> 250ml(A) 500ml(B) 1Liter(C)40ml VOA(V) Checks Passed? <br /> Bacti Na26203 <br /> None(P)White cap — — <br /> Br.Green Labet/Blue Cap <br /> Cr6(P) NH4oHtNH4a2soa `is►K'� Ct,�1>8l. Y N <br /> Cr6(P) Pink Label.!Blue Cap NH40H(NH4l2SO4 WW pH 9.3-9.7 Y N <br /> m Cr6(P)Black Label/BlueCap NH40H(NH4)2SO4 7UQ <br /> 24 HOUR HOLD7ilHE"' PH 9a0-9.5 Y N <br /> " <br /> l <br /> c HNO3(P)Red Cap — — � 2q- <br /> H2SO4 (P) or (AG) Ye11-C2P aber pH<2 Y N <br /> NaOH (P)Green Cap Cl, pH>10 Y N <br /> NaOH+ZnAG(P) pH>9 Y N <br /> Dissolved Oxygen 300ml(g) — — <br /> None(AG)608/808418082,625,632/8321,8151, — — <br /> 13 Z 8270 <br /> j t HCI(AG)LI.Blue Label O&G,Diesel — — <br /> q h <br /> Na203S+H.CI(AG)La.w,k meal 525 <br /> Na2S203 1 Liter(Brown P)549 — — <br /> a� L Na2S203(AG)611eL"W,515,548,TE114t.524" <br /> O Na2S203(CG)Blue Label 504,505 — — <br /> c <br /> o Na25203+MCAAfE01" LaGel 531 <br /> gpH<3 Y N <br /> r = <br /> NH4CI(AG)Purple Label 552 — — <br /> EDA(AG)B-Label 'Opp <br /> N HCL(CG)524.2,BTEX,Gas,MTBE,8260/624 — — <br /> Buffer pH 4(CG) <br /> VI <br /> M None(CG) — — <br /> E H3PO4(CC7�InronLabel <br /> ,I Other: <br /> Asbestos 1Liter PWtic w/FoiE s}. i <br /> Low Level Hg/Metals Double Baggie7777-777 <br /> — — <br /> Bottled Water - — <br /> Clear Glass Jar: 250 / 500 / 1 Liter — — <br /> Sail Tube Brass / Stee / Plastic <br /> Tedlar Bag / Plastic Bag — — <br /> Containgr Preservative I Date/Time/Initials Container Preservative Date/Tlme/In ials <br /> rL ryl ' (D (OIG S P <br /> cn S P S P <br /> a <br /> C <br /> d <br /> E <br /> E <br /> 0 <br /> u <br /> Labeled by: 1 tT @ � Labels checked by: (i @tvs-I_ RUSH Paged by:_@_ <br /> Page 33 of 33 <br />