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Alpha Analytical, Inc. <br /> Phone (775)355-1044 FAX (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 4/8/2004 Date of Notice 3/31/2004 1 29 19 P <br /> Please take note of any NO check marks If we receive no response concerning these items within 24 hours of the date of this notice,all of <br /> the samples will be analyzed as requested <br /> Client Name Stratus Environmental Project ID 2005-2050-1/Former Apache Plastics Faciltty <br /> Project Manager Jay Johnson Client's Phone (530)676-6000 Clients FAX (530)676-6005 <br /> Work Order Number STRO4033102 Date Received 3/31/2004 Received by- Dura Long <br /> Chain of Custody COC Information <br /> Carrier name FedEx <br /> Cham of custody present? Yes © ❑ No <br /> Custody seals intact on shipppmg container/cooler? Yes © ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present <br /> Chain of custody signed when relinquished and received Yes R ❑ No <br /> Cham of custody agrees with sample labels? Yes R ❑ No <br /> Sample ID noted by Client on COC? Yes © ❑ No <br /> Date and time of collection noted by Client on COC') Yes © ❑ No <br /> Samplers's name noted on COC? Yes © ❑ No <br /> . <br /> Internal Chain of Custody(COC)requested? Yes ❑ R No <br /> Sub Contract Lab Used None © ❑ SEM Other(see comments) ❑ <br /> Sample Recei t Information <br /> Shipping container/cooler in good condition? Yes R ❑ No Not Present ❑ <br /> Samples in proper container/bottle? Yes © ❑ No <br /> Sample containers intact? Yes R R No <br /> Sufficient sample volume for indicated test? Yes © ❑ No <br /> Sam le Preservation and Mold Time H Information <br /> All samples received within holding time? Yes R ❑ No Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes R ❑ No °C <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ ❑ No No VOA vials submitted R <br /> Sample labels checked for correct preservation? Yes © ❑ No <br /> TOC Water-phi acceptable upon receipt(H2SO4 pHc2)? Yes ❑ ❑ No N/A R <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes ❑ ❑d No <br /> Are there client specific Protect requirements? Yes ❑ No If YES see the Chain of Custody(COC) <br /> Comments <br /> i <br />