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McQumpbeilAnfil ti al Inc M4wfllwPueltoa4A-bW&CA9f565,1 1 <br /> Toll Fye TClepbone�(1117)2 5 2-4262 1 Fw(925)252-9269 <br /> "WGerr geali Counrs" bnpJiwww.anceapbea. r l- 'err�292670 <br /> Sample Receipt Checklist <br /> Client Nem,: Safety Kiser, <br /> Project Nam,; metal Shaving Date and Time Received; 31$012016 11:33 <br /> WorkOrder W 1603E89Date Logged: 3/30/2018 <br /> Matrix: soy4 <br /> RyMarfa V <br /> Carrier; Received b ,Client Drones enega3 <br /> Logged by: Maria Venegas <br /> Chain of custodypresent? Yee © No❑ <br /> Chain of custody signed when rel nquished and received? Yes Q No❑ <br /> Chain of custody agrees with sample labels? Yea 2 No❑ <br /> Sample los noted by Client on COC? yes Q No❑ <br /> Date and Time of collection noW by Client an COC? Yes Q No❑ <br /> Samplers name noted on COC? Yea © No❑ <br /> 1Bamde Reeelet IrrleemY--_ <br /> Custody seals Intact on shipping comainer/cooler? yes p No❑ NA <br /> Shipping contalnencooler in good condition? Yea ® No❑ <br /> Samples in proper wntairlem/booles? yes © No❑ <br /> Sample containers intact? YeS Q No❑ <br /> Sufficient sample volume for indicated test? yes ® No❑ <br /> aamole Preservation and Hold Time IHTI Inform ti <br /> All samples received within holding time? Yes Q No❑ <br /> Sample ramp Blank temperature Temp: NAW <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ NA <br /> Sample labels Checked for corract praservation? You Q No❑ <br /> PH acceptable upon receipt(Maul:<2;522:<4:219.7:s8)? Yes ❑ No❑ NAR <br /> Samples Received on Ice? Yes ❑ No <br /> ZMR3 Sample% <br /> Total Chorine tested and acceptable upon receipt for EPA 5221 Yes No❑ NA Q <br /> Free Chlorir a tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NAR <br /> 900.1,537,5397 <br /> "NOTE.•If the"No"box/s Checked,see comments below. <br /> _ ------�-------------------'-------^--------- <br /> Commems: <br /> Page 6 of 6 <br />