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W ACCUTEBT. 01ccutest Laboratories Sample Receipt Surlary <br /> •°°° °• •° RECD JUL 2 4 2015 <br /> Accutest Job Number: C35885 Client: Project: <br /> Date/Time Received: 8/28/2014 Delivery Method: Airbill Ws: <br /> Cooler Temps(Initial/Adjusted): #1:(3.7/3.7): 0 <br /> Cooler Security Y or N Y or N Sample Integrity-Documentation Y or N <br /> 1.Custody Seals Present: W 1 1 3.COC Present: V: _ 1.Sample labels present on bottles: V F12.Custody Seals Intact: � ❑ /T <br /> 4.Smpl Datesme OK _.{, .. 2,Container labeling complete w ❑ <br /> Cooler Temperature Y or N 3.Sample container label/COC agree: FV ❑ <br /> 1.Tamp cntena achieved: ® ❑ Sample Inteardv-Condition Y or N <br /> 2.Cooler temp verification: W <br /> 1.Sample recvd vdmin HT: <br /> 3.Cooler media: Ice(Bag) 2.All containers accounted for: <br /> iJ <br /> 4.No.Coolers: 1 <br /> 3.Condition of sample: Intact <br /> Quality Control Preservatio Y or N NIA Sample Intearhv-Instructions Y or N N/A <br /> L Trip Blank present/cooler. _. +r, l 1.Analysis requested is clear: ❑ <br /> 2.Trp Blank listed on COC: 2.Bottles received for unspecified tests ❑ <br /> 3.Samples preserved properly: Fv 3.Sufficient volume recvd for analysis: [y. ❑ <br /> 4.VOCs headspace free: ❑ - ♦I 4.Compositing instructions clear. [` 'J 7 <br /> 5.Filtering instructions dear: <br /> Comments <br /> O <br /> i <br /> P.Wm uwnlonec Y135 pe Hip 130 INNcn.N.Jmq <br /> VMN90200 F:I33 3VXI mwlecn4ek.com <br /> C35685: Chain of Custody <br /> Page 2 of 3 <br /> ME 59 of 64 <br /> w ACCUTEST. <br /> 035685 •n eoP AQP••• <br />