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Amon Laboratories Sample Receipt Checklist <br /> Client Name: Apex Envirotech, Inc. Date&Time Received: 07/14/10 14:00 <br /> Project Name: Tuff Boy Trailers Client Project Number: <br /> Received By: D.C. Matrix: Water ❑ Soil 0 Sludge ❑ <br /> Sample Carrier: Client 0 Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number: K007031 <br /> Shipper Container in good condition? Samples received in proper containers? Yes No ❑ <br /> N/A Yes D No ❑ Samples received intact? Yes [] No ❑ <br /> Samples received under refrigeration? Yes 2 No ❑ Sufficient sample volume for requested tests?Yes 0 No ❑ <br /> Chain of custody present? Yes No ❑ Samples received within holding lime? Yes No ❑ <br /> Chain of Custody signed by all parties? Yes Q No ❑ Do samples contain proper preservative? <br /> N/A Yes ❑ No ❑ <br /> Chain of Custody matches all sample labels? Do v0A vials contain zero headspace? <br /> Yes No ❑ (None submitted Yes ❑ No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW_ _— —— <br /> Date Client Contacted: Person Contacted.- <br /> Contacted <br /> ontacted:Contacted By: Subject: <br /> Comments: <br /> Action Taken: <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted By: Date:_ <br /> Time: <br /> Call Received By: <br /> Comments: <br /> r <br />