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G ^; 1534 Willow Pass Road, Pittsburg, CA 94565-1701 <br />�Mc C a m h b e 11 Analytical , Inc. Toll Free Telephone: (877) 252-9262 / Fax: (925) 252-9269 <br />"When uality Counts" http:/iwww.mccampbeU.com / E-mail: main@mccampbell.com <br />Sample Receipt Checklist <br />Client Name: Fremouw Environmental services, Inc. Date and Time Received: 4/15/2015 1:10:20 PM <br />Project Name: #59852; B&C Painting Login Reviewed by: Maria Venegas <br />WorkOrder NQ: 1504619 Matrix: Water Carrier: Daniel (MAI Courier/ <br />Chain of Gpstody(f'0Q Information <br />Chain of custody present? Yes 0 No ❑ P 2Q�J <br />Chain of custody signed when relinquished and received? Yes 91 No ❑ <br />Chain of custody agrees with sample labels? Yes ❑d No Elr� ��-ra "-� <br />S3 <br />Sample IDs noted by Client on COC? Yes 91 No ❑ t <br />Date and Time of collection noted by Client on COC?. Yes 0 No ❑ <br />Sampler's name noted on COC? Yes R1 No ❑ <br />ample Receipt information <br />Custody seals intact on shipping container/cooler? Yes ❑ No ❑ NA <br />Shipping container/cooler in good condition? Yes No ❑ <br />Samples in proper containers/botties? Yes No ❑ <br />Sample containers intact? Yes No ❑ <br />Sufficient sample volume for indicated test? Yes No ❑ <br />Sample Preservation and Hold Time (� Information <br />All samples received within holding time? Yes ® No ❑ <br />Sample/Temp Blank temperature Temp: 5.4°C NA ❑ <br />Water - VOA vials have zero headspace / no bubbles? Yes W No ❑ NA F-1. <br />Sample labels checked for correct preservation? Yes Fv� No ❑ <br />PH acceptable upon receipt (Metal: <2; 522: <4; 218.7: >8)? Yes No ❑ NA ❑ <br />Samples Received on Ice? Yes No ❑ <br />(Ice Type: WET ICE ) <br />UCMR3 Samples: <br />Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No ❑ NA <br />Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No ❑ NA <br />300.1, 537, 539? <br />* NOTE: if the "No" box is checked, see comments below. <br />--------------------------------------------- <br />- — — — — — — — — — — — — — — — — — — — — — — — — — — ------------------ <br />Comments: ------------- <br />Comments: <br />Page 13 of 13 <br />