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AGGLJTEST Accutest Laboratories Sample Receipt SurtTltary <br /> Accutest Job Number.�C35685F Client: DYSERT Project: PACTIV PACKAJI CD JUL 2 4 2015 <br /> Date/Time Received: 8/27/2014 Delivery Method: Accutest Courier Airbill#'a: <br /> Cooler Temps(initial/Adjusted): #1:(3.6/3.3): <br /> Cooler Security Y or N Y or N Sample Integrity-Documentation Y or N <br /> 1.Custody Seals Present: /. 3.COC Present: j] 1,Sample labels present on bottles: ❑ <br /> 2.Custody Seals Intact: 4.Smpl DatesRme OK GI 2.Container labeling Complete: 0 Cl <br /> Cooler Temperature V or N <br /> 3.Sample container label/COC agree: ❑A ❑ <br /> 1,Temp cntena achieved: .. Y or N <br /> Sample Integrity-Condition <br /> 2.Cooler temp verification: IR1 El- --- 1.Sample recvtl within Hf: <br /> 1 Cooler media: Ice(Bag) _ 2,All Containers accounted for ® ❑ <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 N/A <br /> 1.Trip Blank present l cooler: ❑ ❑ <br /> 1.Analysis requested is clear. ® ❑ <br /> 2.Trip Blank listed on COC: ❑ C. V'1 2.Bottles received for unspecified tests ❑ 67 <br /> 3.Samples preserved property: R ❑ 3.Sufficient volume recvd for analysis: 0 ❑ <br /> 4.VOCs headspace gee: ❑ ❑ 0 4.Composigng instructions clear: ❑ ❑ w <br /> 5.Filtering instructions Gear: ❑ ❑ <br /> Comments <br /> AauxwttaGaalwlee 3105WMyAve.e San J.CA 85131 <br /> VABS.63r.eala F:4e8.583.021n wxnncMM.can <br /> C35685: Chain of Custody <br /> Page 2 of 4 <br /> EN 19 of 64 <br /> w AOOUTEST. <br /> Cassels <br />