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r <br /> 1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> M c C a m p b e I I A n a l ty I C a IL I n c. Toll Free Telephone:(877)252-9262/Fax:(925)252-9269 <br /> "When Quality Counts" http://www.mccampbell.coin/E-mail:mainanccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: Advanced GeoEnvironmental, Inc. Date and Time Received: 3/14/2012 10:07:32 AM <br /> Project Name: #95-0106;Weldon Church Checklist completed and reviewed by: Melissa Valles <br /> WorkOrder N°: 1203413 Matrix: Indoor Air Carrier: Client Drop-In <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes No[ I <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 No❑ <br /> Date and Time of collection noted by Client on COC? Yes No❑ <br /> Sampler's name noted on COC? Yes No❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes —1 No❑ NA _✓ <br /> Shipping container/cooler in good condition? Yes No❑ <br /> Samples in proper containers/bottles? Yes No❑ <br /> Sample containers intact? Yes ❑d 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 No <br /> Container/Temp Blank temperature Cooler Temp: NAW <br /> Water-VOA vials have zero headspace/no bubbles? Yes U No❑ No VOA vials submitted I <br /> Sample labels checked for correct preservation? Yes ❑- No❑ <br /> Metal-pH acceptable upon receipt(pH<2)? Yes ❑ No❑ NA F/I <br /> Samples Received on Ice? Yes ❑ No❑d <br /> *NOTE:If the "No"box is checked,see comments below <br /> Comments: <br /> Page 4 of 10 <br />