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AFH3928 FGLE1122000 1/202 <br /> BSK Associates SR-FL-0002-23 ••••• <br /> 10 <br /> Sample Integrity <br /> BSK_ Bottles: YesNo Page of ....... <br /> Was temperature within ra 2 Were correct containers and preservatives <br /> Yes Were NA Yes 0 NA <br /> Chemist 5 VC Micro< 8°C received for the tests requested? <br /> If samples were taken today, is there evidence 01 <br /> No NA Bubbles Present VOAs(524 2/TTHM/TCP)? Yes NA <br /> that chillinghas begun? TB Received? Check Method Below Y No• NA <br /> U Did all bottles arrive unbroken and intact? .YeS No Was a sufficient amount of sample received? es NR <br /> O Did all bottle labels agree with COC? s o Do samples have a hold time<72 hours? Yes No <br /> Was sodium thiosulfate added to CN sample(s) Yes NA Was PM notified of discrepancies? Yes No / A <br /> until chlorine was no longer present? - PM: By/Time \" <br /> 250ml(A)500mt(B) 1Lrter(C)40mlVOA(V) 125m1(D) Checks' Passed? <br /> Bacti Na2S203 — — <br /> None(P)v'n'lte cap — — <br /> Cr6 (P)Lt.Green Label/Blue Cap NH40H(NH4)2SO4 DW Cl, pH >8 P F <br /> Cr6 (P) Pink Label/Blue Cap NH40H(NH4)2SO4 WW pH 9.3-9.7 P F <br /> Cr6 (P) Blade Labevaue Cap NH40H(NH4)2SO4 7199 <br /> c <br /> -24 HOUR HOLD TIME— pH 9.0-9.5 P F <br /> EHNO3(P)Red cap or HCI (P) Purole Cap/Lt Blue Labai — — <br /> H2SO4 (P) or (AG) YellowCsp/Label pH <2 P F <br /> at <br /> NaOH (P)Green Cap Cl, pH >10 P F <br /> NaOH +ZnAc(P) pH >9 P F <br /> o I <br /> Q Dissolved Oxygen 300m] (g) — — <br /> z <br /> None(AG)608/808ltB082.625,632/8321,8151.8270 — — <br /> � L <br /> > .@ HCI (AG)Lt.Blue Label 08G,Diesel.TCP — — <br /> Ascorbic, EDTA, KH2Ct(AG)Pink Label 525 — — <br /> Na2SO3 250mL (AG)Neon Green Label 515 — — <br /> L) Na2S2031 Liter(Brown P) 549 — — / <br /> m c Na2S203 (AG)Hue Label 548.THM,524 — — <br /> 0 <br /> Na2S203(CG)Blue La '504.505.547 — — <br /> O Na2S203+ MCAA(CG)Orange Label 531 pH < 3 P IF <br /> c0 <br /> i-> NH4CI (AG)PdrpleLabel 552 — — <br /> °' EDA(P) or (AG) ©`own Label DB Ps — — <br /> c HCL(CG) 524.2,BTEX.Gas,MTBE.8260/624 — — <br /> m <br /> E Buffer pH 4 (CG) — — <br /> H3PO4 (CG)Salrnun Label — — <br /> Trizma-EPA 537.1 - Field Blank Required <br /> Other: <br /> Asbestos 1 L (P)w/Foil / LL Metals Bottle — — <br /> Bottled Water — — <br /> Clear Glass — — <br /> Solids: Brass / Steel / Plastic Ba — — <br /> +, Container Preservative Lot# Initials Date/Time Preservation Check <br /> CL S P pH Lot# <br /> Cn S P CI Lot# <br /> 'Preservation check completed by lab performing analysis. ✓ Indicates Blanks Received <br /> N <br /> 504 524.2 TTHM 537.1 TCP <br /> E — <br /> E <br /> 0 � ✓ MS/MSD Received Method: <br /> i <br /> Scanned: Rush/Short HT Page: Time: <br /> 'V/ I Page 8of9 <br />