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Page 9 of 9 <br /> G VC. 11,076 - WORK ORDER M 10-02- ID M El ID <br /> Cooler of <br /> CLIENT: DATE: OZ lo 6/ 10 <br /> TEMPERATURE: Thermometer ID: SCI (Criteria: 0.0°C-6.0()C, not frozen) <br /> Temperature 2 . I °C + U.5°C (CF) = 2 .�°C Sd <br /> '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. <br /> Ambient Temperature: ❑ Air ❑ Filter ❑ Metals Only ❑ PCBs Only Initial: <br /> 7CUS Y SEALS INTACT: <br /> ooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: <br /> ❑ Sample ❑ ❑ No (Not Intact) vlgot Present Initial: <br /> SAMPLE CONDITION: Yes No N/A <br /> Chain-Of-Custody (COC) document(s) received with samples.................... ❑ ❑ <br /> COC document(s) received complete................................................... 0,- ❑ ❑ <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..................................................... ❑ ❑ 01-- <br /> Sample container label(s) consistent with COC..................................... C;1— ❑ ❑ <br /> Sample container(s) intact and good condition...................................... I2- ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested............... VT ❑ ❑ <br /> Analyses received within holding time................................................. ❑ ❑ <br /> Proper preservation noted on COC or sample container.......................... ❑ ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s) free of headspace..................................... ❑ ❑ J� <br /> Tedlar bag(s)free of condensation...................................................... ❑ ❑ <br /> CONTAINER TYPE: <br /> Solid: ❑4ozCGJ ❑8ozCGJ ❑16ozCGJ ❑Sleeve ( ) ❑EnCorese ❑TerraCorese ❑ <br /> Water: ❑VOA ❑VOAh ❑VOAna2 1:1125AGB ❑125AGBh 0125AGBp 01AGB ❑1AGBna2 01AGBs <br /> ❑500AGB ❑500AGJ ❑500AGJs ❑250AGB ❑250CGB ❑250CGBs ❑1PB ❑500PB ❑500PBna <br /> Oe2'�50PB 0250PBn ❑1 25P ❑125PBznna ❑100PJ ❑100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlaro ❑Summa° Other: ❑ Trip Blank Lot#: Checked by: <br /> Container: C:Clear A:Amber P: Plastic G:Glass J:Jar B:Bottle Z:Ziploc/Resealable Bag E: Envelope Reviewed by: <br /> Preservative: h:HCL n:HNO3 na2:Na2S203 Na:NaOH p:H3PO4 s:H2SO4 znna:ZnAc2+NaOH f:Field-filtered Scanned by: <br /> SOP T100_090(07/16/09) <br /> i i i B <br />