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0 <br /> Accutest Laboratories Sample Receipt <br /> ACCLJTE=�T P' P Summary <br /> L A...Al.III EG <br /> Accutest Job Number: C37651 Client: DYSERT Project: PACTIV PACKAGING <br /> Date 1 Time Received: 12/16!2014 10:00:00 AM Delivery Method: Accutest Courier Airbill it's: <br /> Cooler Temps(Initial/Adjusted): #1:0.1/3.0 <br /> Cooler Security Y or N Y or N Sample Integrity-Documentation Y or N s <br /> 1.Custody Seals Present: ❑ OV 3.COC Present: ✓, i❑ <br /> 1.Sample labels present on bottles: <br /> 2.Custody Seals Intact: ❑ ❑ 4.Smpl Datesrrime OK h❑C <br /> 2.Container labeling complete: L/ <br /> Cooler Temperature Y or N <br /> 3.Sample container label/COC agree: <br /> 1.Temp criteria achieved: FV1 ❑ Sample Integrity-Condition Y or N <br /> 2.Cooler temp verification: IR2; ❑ <br /> 1.Sample recvd within HT: L+� <br /> 3.Cooler media: Ice(Bag) 2.All containers accounted for: 71 <br /> 4.No.Coolers: 1 <br /> 3.Condition of sample: Intact <br /> Quality Control..Preservation Y or N NIA Sample Integrity-Instructions Y or N NIA <br /> 1.Trip Blank present/cooler: ❑ ❑ <br /> 1.Analysis requested Is Gear: ❑ <br /> 2.Trip Blank listed on COC: ❑ ❑ Sed 2.Bottles received for unspecified tests ❑ <br /> 3.Samples preserved properly: R ❑ 3.Sufficient volume recvd for analysis �y]/ ❑ <br /> 4.VOCs headspace free: ❑ ❑ Ed 4.Compositing instructions clear: ❑ ❑ Cl <br /> 5.Filtering instructions clear: ❑ ❑ <br /> Comments <br /> Amutest Laboratories 2105 Lundy Avenue San Jose,CA 95131 <br /> V.aas.5e&.0200 F"408.58a.0201 wwAfaccutesLeom <br /> 037651: Chain of Custody <br /> Page 2 of 2 <br /> ■ 9 of 19 <br /> ■acGlJ-rLESS Z: <br /> C37651 .11 �� ... <br />