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L__ --Torrent <br />I A8011.1 HN , 11C <br />Sample Receipt Checklist <br />Client Name: Process Specialties, Inc. <br />Date and Time Received: 5/13/2011 13:47 <br />Project Name: Compliance - Self Monitoring Report <br />Received By: ng <br />Work Order No.: 1105101 <br />Physically Logged By: mi <br />Checklist Completed By: mi <br />Carrier Name: Client Drooed off <br />Chain of Custody (COC) <br />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 <br />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 />No <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 />pH Checked by: pH Adjusted by: <br />483 Sinclair Frontage Rd_, Milpitas, CA 95035 rct 408.263.5258 1 Lex. 408.263.8293 1--torrentlab.co— <br />Total Page Count: 15 Page 13 of 15 <br />