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 

L/{7 '?_ 

Samples Relinquished by: "./ il _J.l oY ~-

Date: L.j I~~~[") Time: \l.»> Ll, D \ 

Samples Relinquished by: ___________ _ 

Date: lime: __ _ 

Samples Relinquished by: ________ _ 

Date: lime: __ _ 

Samples Relinquished by: ___________ _ 

Date: Time: __ _ 

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

Chain-of-Custody t: lu f2J:7cJ lf 

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: a. A!\/~ ev-cui i'vbl P1 

Date: Y ~ b-:;~;; frime: '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 Hand Delivered 

2. Samples were received in: (circle) ('JfJjJii> Box Envelope Other NA 

3. Were custody seals on coolers? NA y If yes, how many and where? 

If present, were custody seals intact? y w If present 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. 

I 

12. 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? 

' : : : : : : : .. : : : : . : : : . : : .: : . : : . : : ~ : . ; .: : ·:··: : ~:. - : : . 

Sarrt~I~IP 6n s<:lttte··· . ·... . ........ . . . - < s~rn~t~ tti Clri cdb 

·. 

······· --· 

SampleiD • -- .-.-

BOttle Count · Out of Head~ .· 

Bottle Type Ternp space Broke pH 

. . -

Reaaent 

Volume 

added 

Identified t>v: 

Reagent Lot 

Number 

NA N 

NA N 

NA N 

NA N 

NA N 

~~ y N 

~ y N 

@) y N 

Initials Time 

Notes, Discrepancies, & Resolutions: ____________________________________ _ 

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