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��ACCUTE�uT. Cutest Laboratories Sample Receipt Stmory <br /> oa•.o•,e. RECD JUL 2 4 2015 <br /> Accutest Job Number: C37651 Client: DYSERT Project: PACTIV PACKAGING <br /> Dale/Time Received: 12/16/2014 10:00:00 AM Delivery Method: Accutesl Courier Airbill are: <br /> Cooler Temps(Initial/Adjusted): #1:(3.1/3.1): <br /> A <br /> Cooler Security Y or N Y or N Sample Integrity-Documentation Y or N <br /> Sr 3.COC Present: 4J y-] Ll1.Custody Seals Present -- 1.Sample labels present on baffles: <br /> 2.Custody Seals Intact _. 4.Smpl Datesfrme OK vl 2.Container labeling complete: L <br /> Cooler Temperature Y or N 3.Sample container label/COC agree: Fr7 ❑ <br /> 1.Temp criteria achieved: V L Sample Integrity-ConAR!M Y or N <br /> 2.Cooler temp vedOcaaon. I112: 1.Sample recti within HT: ] LI <br /> 3.Cooler media: _....to.(Bag) 2.All containers accounted for: 0 ❑ <br /> 4.No.Coolers: 1 3.Condition of sample: Intact <br /> Quality Control Preservation Y or N N/A Sample Integrity-Instructions Y or N NIA <br /> 1,Trip Blank present/cooler: ',] V 1.Analysis requested is dear: 'N] <br /> 2.Trip Blank listed on COC: Vi 2.Bottles received for unspecified tests ❑ '� <br /> 3.Samples preserved propedy: V 3.Sufficient volume mcvd for analysis: k� <br /> 4.VOCs headspace free: VI 4.Compositing instructions Gear: ] U <br /> 5.Filtering instructions Gear. ❑ ❑ 2 <br /> Comments <br /> AWN LaGatl . 2105 tun]rA. Seri J..CA 85131 <br /> V:409.59902Ce R 40&588=1 xw.vlacWM.com <br /> C37651: Chain of Custody <br /> Page 2 of 2 <br /> ME 9of19 <br /> AGGIJTEST. <br /> 637657 <br />