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1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> MCCampbell Analytical, InC. Toll Free Telephone:(877)252-9262/Fax:(925)252-9269 <br /> "When Quality Counts" http://www.mccampbell.com/E-mail:main@ nccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: Fremouw Environmental Services,Inc. Date and Time Received: 3/24/2015 1:53:26 PM <br /> Project Name: #59547/Filter Cake;Int Paper/Tracy Login Reviewed by: Shana Carter <br /> WorkOrder Ns: 1503989 Matrix: 99l Carrier: Daniel(MAI Courier) <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes ❑d No❑ <br /> Chain of custody signed when relinquished and received? Yes ❑d No❑ APR 2 5 2016 <br /> Chain of custody agrees with sample labels? Yes ❑4 No❑ v <br /> Sample IDs noted by Client on COC? Yes W1 No❑ <br /> Date and Time of collection noted by Client on COC? Yes No❑ <br /> Sampler's name noted on COC? Yes W No❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA❑d <br /> Shipping container/cooler in good condition? Yes 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(HT)Information <br /> All samples received within holding time? Yes ❑d No❑ <br /> Sample/Temp Blank temperature Temp: 3°C NA❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ NA W <br /> Sample labels checked for correct preservation? Yes ❑d No❑ <br /> pH acceptable upon receipt(Metal:<2;522:<4;218.7:>8)? Yes ❑ No❑ NA 0 <br /> Samples Received on Ice? Yes ❑d No❑ <br /> (Ice Type: WET ICE ) <br /> LICMR3 Samples: <br /> es: <br /> Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No❑ NA 0 <br /> Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NA W <br /> 300.1,537,539? <br /> NOTE:if the"No"box is checked,see comments below. <br /> --------------------------------------------- <br /> -- -------------------------- ----------------- <br /> Comments: <br /> Page 9 of 9 <br />