**Envlronment;_i_c~;:;ltlng.lnc.** Sample Sample Station ID Date Time 

### JAX-SP10-N02-CH EM 03/29/10 1218 

### JAX-SP10-N03-CHEM 03/29/10 1300 

### JAX-SP10-N04-CHEM 03/29/10 1339 

### JAX-SP10-N06-CHEM 03/30/10 1357 

### JAX-SP10-N07-CHEM 03/30/10 1301 

### JAX-SP10-N08-CHEM 03/29/10 1650 

### JAX-SP10-N09-CHEM 03/29/10 1537 

### JAX-SP10-N10-CHEM 03/29/10 1243 

### JAX-SP10-S02-CHEM 03/30/10 1547 

### JAX-SP10-S04-CHEM 03/30/10 1708 

### JAX-SP10-S05-CHEM 03/31/10 1321 

### JAX-SP10-S06-CHEM 03/31/10 1405 

### JAX-SPl0-507-CHEM 03/31/10 1620 

### JAX-SP10-S08-CH EM 03/30/10 1816 

### JAX-SPl0-513-CHEM 03/31/10 1754 

### JAX-SP10-S14-CHEM 03/30/10**~** 

### \vel See attached 

### list for complete analysis list with reporting limits 

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## D \ Samples Relinquished by:

___________ _ Date: lime:

__ _ Samples Relinquished by:

________ _ Date: lime:

__ _ Samples Relinquished by:

___________ _ Date: Time:

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### PROJECT· lax Site Desianation Survev (Sorina '10) 

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# luf2J:7cJlf Chain-of-Custody

Sample Sample Number of Analyses Matrix Containers Containers Requested

sed 16-oz glass jars 2 Metals, sed 16-oz glass jars 2 Pesticides, sed 16-oz glass jars 2 PBCs, PAHs, sed 16-oz glass jars 2 TOC, Organotins sed 16-oz glass jars 2 sed 16-oz glass jars 2 sed 16-oz glass jars 2 sed 16-oz glass jars 2 sed 16-oz glass jars 2 sed 16-oz glass jars 2 sed 16-oz glass jars 2 sed 16-oz glass jars 2 sed 16-oz glass jars 2 sed 16-oz glass jars 2 sed 16-oz glass jars 2 sed 16-oz glass jars 2

Received by: 

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# ev-cui i'vbl P1 Date: 

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### '5 i-1.:; Received by: Date: lime: Received by: Date: lime: Received by: Date: Time: Lab Sample ID Comments



### ANAMAR Environmental Consulting, Inc. 2106 NW 67th Place, Suite 5 Gainesville, FL 32653 (352) 377-5770 FAX (352) 378-1500

### Columbia Analytical Services, Inc. Cooler Receipt and Preservation Form

--'--'-"--'--"'--+-'-""'-""'--------------- 

### Service Request 

### Kl

1. 

### Samples were received via? 

### Mail

### ~ UPS DHL PDX Courier HandDelivered 2. 

### Samples were received in: (circle) 

### ('JfJjJii> Box Envelope Other NA 3. 

### Were custody seals on coolers? 

### NA y Ifyes, how many and where? Ifpresent, were custody seals intact? 

### y 

# w Ifpresent were they signed and dated? 

### y @

7. Packing material used. 

### Inserts Baggies Gel Packs @)J:e Sleeves Other

___________ _ 8. Were custody papers properly filled out (ink, signed, etc.)? 9. Did all bottles arrive in good condition (unbroken)? Indicate in the table below. 10. 

### Were all san1ple labels complete (i.e analysis, preservation, etc.)? 11. 

### Did all sample labels and tags agree with custody papers? Indicate major discrepancies in the table on page 2.

I12. 

### Were appropriate bottles/containers and volumes received for the tests indicated? l3. Were the pH-preserved bottles (see SMO GEN

### SOP) received at the appropriate pH? Indicate in the table below 14. 

### Were VOA 

### vials received without headspace? Indicate in the table below. 

### 15. Was C12/Res negative?

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······· --· SampleiD • -- .-.- BOttle Count · 

### Out of**Head~** .· Bottle Type 

### Ternp space Broke pH . 

## . - Reaaent 

### Volume added Identified t>v:

ReagentLot

Number 

### NA N NA N NA N NA N NA N

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### N**~** 

### y 

### N @) y 

### N

Initials Time



### Notes, Discrepancies, & 

### Resolutions:

____________________________________ _



### Page_L_of_

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