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I,., y 1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> McCampbell AnalyIICCII, Inc. Toll Free Telephone:(877)252-9262/Fm:(925)252-9269 <br /> "When Quality Counts" I <br /> http://www.m anpbefl.com/E-mail:mein@mccampbe0.com <br /> Sample Receipt Checklist <br /> Client Name: Interstate Truck Center Date and Time Received: 7/1312015 2:09:24 PM <br /> Project Name: Ash Test Login Reviewed by: Jena Alfaro <br /> WorkOrder Ns: 1507405 Malnx: 59j) Carrier: Client Drop-In <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes W No❑ <br /> Chain of custody signed when relinquished and received? Yes W No❑ <br /> Chain of custody agrees with sample labels? Yes 0 No❑ <br /> Sample IDs noted by Client on COC? Yes No❑ <br /> Date and Time of collection noted by Client on COC? Yes No❑ <br /> Sampler's name noted on COC? Yes ❑✓ No❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA W <br /> Shipping container/cooler in good condition? Yes ❑ No❑ <br /> Samples in proper containers/bottles? Yes No❑ <br /> Sample containers intact? Yes No❑ <br /> Sufficient sample volume for indicated test? Yes No❑ <br /> Sample Preservation and Hold Time(HT1 Information <br /> All samples received within holding time? Yes k No❑ <br /> Sample/Temp Blank temperature Temp: NAW <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ NA <br /> Sample labels checked for correct preservation? Yes ,/❑ No❑ <br /> pH acceptable upon receipt(Metal:<2;522:<4;218.7:>8)? Yes ❑ No❑ NA W <br /> Samples Received on Ice? Yes ❑ Now <br /> LICMR3 Samples: <br /> Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No❑ NA W <br /> Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NA W <br /> 300.1,537,539? <br /> NOTE:If the"No"box is checked,see comments below. ��yy'''ii <br /> VF <br /> ------------------------------ BIW --- <br /> FAE <br /> Comments: <br /> JUL 2 8 2015 <br /> ENVIRONMENTAI <br /> HFAITN n=6DTliAFrdr <br /> Page 18 of 18 <br />