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L 171 <br />-,,L Torrent <br />LABORATORY. INC. <br />Sample Receipt Checklist <br />Client Name: Process Specialties, Inc. <br />Date and Time Received: 5/13/2011 13:55 <br />Project Name: Well water check <br />Received By: nuc <br />Work Order No.: 1105099 <br />Physically Logged By: mi <br />Checklist Completed By: mi <br />Carrier Name: Client Droped off <br />Chain of Custody <br />(COC) Information <br />Chain of custody present? <br />Yes <br />Chain of custody signed when relinquished and received? <br />Yes <br />Chain of custody agrees with sample labels? <br />Yes <br />Custody seals intact on sample bottles? <br />Not Present <br />Sample Receipt Information <br />Custody seals intact on shipping container/cooler? <br />Not Present <br />Shipping Container/Cooler In Good Condition? <br />Yes <br />Samples in proper container/bottle? <br />Yes <br />Samples containers intact? <br />Yes <br />Sufficient sample volume for indicated test? <br />Yes <br />Sample Preservation and Hold Time (HT) Information <br />All samples received within holding time? <br />Yes <br />Container/Temp Blank temperature in compliance? <br />Temperature: 0 °C <br />Water -VOA vials have zero headspace? <br />No VOA vials submitted <br />Water -pH acceptable upon receipt? <br />N/A <br />pH Checked by: pH Adjusted by: <br />483 Sinclair Frontage Rd_, Milpitas. CA 95035 Y,i. 408.263.5258 I fox- 408.263.8293 I www.torrentlab.com <br />Total Page Count: 15 Page 13 of 15 <br />