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Page 26 of 26 <br /> IFOIT, a10 ! WORK ORDER #: 12-07--M ® 0 El <br /> s <br /> Cooler of <br /> CLIENT: DATE: 0712,5112 <br /> TEMPERATURE: Thermometer ID: SC2 (Criteria: 0.0°C—6.0°C, not frozen) <br /> Temperature OC - 0.3 OC (CF) _ OC ❑ 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 temper re, placed on ice for transport by Courier. <br /> Ambient Temperature: it ❑ Filter Initial: <br /> CUSTODY SEALS INTACT: <br /> ❑ Cooler ❑ ❑ No (Not Intact) of Present ❑ N/A Initial: <br /> ❑ Sample ❑ ❑ No (Not Intact) 2'96t Present Initial: �f <br /> SAMPLE CONDITION: Yes No N/A <br /> Chain-Of-Custody (COC) document(s) received with samples................... G3111- ❑ ❑ <br /> COC document(s) received complete... ............................................... G?,-, ❑ ❑ <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 /> y <br /> Sampler's name indicated on COC...................................................... ❑ ❑ 21' 3 <br /> Sample container label(s) consistent with COC...................................... 2,- ❑ ❑ <br /> Sample container(s) intact and good condition....................................... ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested................ 01- ❑ ❑ <br /> Analyses received within holding time.................................................. ull�' ❑ ❑ <br /> pH / Res. Chlorine/ Diss. qulfide/ Diss. Oxygen received within 24 hours... ❑ ❑ <br /> Proper preservation noted on COC or sample container.......................... ❑ ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s)free of headspace..................................... ❑ ❑ <br /> Tedlar bag(s)free of condensation...................................................... ❑ ❑ <br /> CONTAINER TYPE: <br /> Solid: 040ZCGJ 17718ozCGJ 177116ozCGJ ❑Sleeve ( ) ❑EnCoreso ❑TerraCoreso ❑ <br /> Water: ❑VOA ❑VOAh ❑VOAna2 ❑125AGB 0125AGBh 0125AGBp 01AGB 01AGBna2 ❑1AGBs <br /> 0500AGB ❑500AGJ 0500AGJs 0250AGB 0250CGB 0250CGBs 01PB 01PBna ❑500PB <br /> 0250PB 0250PBn 1771125PB 0125PBznna p100PJ ❑100PJna2 ❑ ❑ 0 <br /> /CAI�> '� <br /> Air: ❑Tedlar° ❑Summa° Other: Trip Blank Lot#: Labeled/Checked by:_ Pf <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 u:Ultra-pure znna:ZnAc2+NaOH f:Filtered Scanned by: 1 <br /> SOP 7100_090(12106/11) <br />