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1534 willow Pass Road,Pittsburg CA 94565-1701 <br /> MCCambbell Analytical. Inc. Tog Free Telephone:(877)252-9262/Fax:(925)252-9269 <br /> b //www.=cambell.com/E-nail:umin@os=mpbell.com <br /> "When Quality Counts" tta� P <br /> Sample Receipt Checklist <br /> Client Name: CH2M HILL Date and Time Received 12/1512017 09:07 <br /> Project Name: 693815.TM.VA.01.00;PG&E 2017 Cntl Valley S-600 McDnldlslStn Date Logged: 1 2/1 512 01 7 <br /> Received by: Jena Alfaro , <br /> WorkOrder No: 1712687 Matrix: Soil Logged by: Jena Alfaro <br /> Cartier: Client Drop-In <br /> Chain of Custody(CDC)Information <br /> Chain of custody present? Yes No❑ <br /> Chain of custody signed when relinquished and received? Yes © No❑ <br /> Chain of custody agrees with sample labels? Yes © No❑ <br /> Sample IDs noted by Client on COC? Yes W No❑ <br /> Date and Time of collection noted by Client on COC? Yes W No❑ <br /> Sampler's name noted on COC? Yes 0 No❑ <br /> COC agrees with Quote? Yes ❑ No❑ NA <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA <br /> Shipping container/cooler in good condition? Yes ❑i 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 Preservation and Hold Time(H�Information <br /> All samples received within holding time? Yes W No❑ NA❑ <br /> Sample/Temp Blank temperature Temp: 5.2°C NA❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ NA <br /> Sample labels checked for correct preservation? Yes ❑J No❑ <br /> pH acceptable upon receipt(Metal:<2;522:<4;218.7:>8)? Yes ❑ No❑ NA <br /> Samples Received on Ice? Yes © No❑ <br /> (IceType: WETICE ) <br /> UCMR Samples <br /> Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No❑ NA <br /> Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NA <br /> 300.1,537,539? <br /> ——— r� r. <br /> ---- ------------ __�.—_.— r d <br /> --------- ----------------- __ <br /> Comments: – r <br /> DEC � 72017 <br /> ENIVIFIONMIZENTAL HEALTH <br /> DEF A v r iViENT <br /> Page 26 of 26 <br />