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December 23, l 999 <br />Page CJ ! <br />C.5.3 Chain-of-Custody Form (COC) <br />A COC form shall be filled out in the field after samples have been collected, and accompany <br />every shipment of samples to the analytical laboratory. The purpose of the COC form is to establish <br />l the documentation necessary to trace possession from the time of collection to disposal. <br />J The COC will be filled out at least in duplicate by the field technician who has been <br />designated to handle/ship samples to the analytical laboratory. Information contained on the COC <br />will contain the same level of detail found on the sample label/tags. All corrections to the COC <br />' record will be initialed and dated by the person making the corrections. The custody record will <br />include the following information: <br />1 ~ Sampler's name and organization (company) <br />Date and time of sample collection <br />' ~ Sample identification number, sample matrix, sample preservation, and type of <br />sample collected (composite/grab) <br />' ~ Analysis requested <br />' ~ Signature of the person relinquishing samples to be transported, with the time and <br />date of the transfer noted, and signature of the designated sample custodian at the <br />' receiving facility. <br />In addition, any special analytical instructions will be noted on the COC. <br />' The relinquishing individual will record all shipping data (e.g., air bill number, transported, <br />time, and date) on the original custody form record, which will accompany the samples to the <br />' receiving facility and be retained in the facility's file. Original and duplicate custody records, <br />together with the air bill or delivery note, constitute a complete custody record. It is the <br />'' environmental manager's responsibility to ensure that all records are consistent and that they are <br />made a part of the permanent project file. <br />The laboratory will enter the following information on the COC: <br />Name of person(s) receiving the sample <br />Date of sample receipt <br />Sample condition <br />' Each COC form will include signatures of the appropriate individuals indicated on the form. <br />The original will follow the samples to the laboratory (taped to the inside of the cooler lid) and one <br />lJ <br />Agapito Associates, Inc. <br />