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Amon Laboratories Sample Receipt Checklist <br /> Client Name l K0 hi,5r<• Date&Time Received <br /> Project Namee Client Project Number <br /> Received By —! Matrix Water Lld Sod ❑ Other <br /> Sample Carrier Client Laboratory ❑ Fed Ex ElUPS ElOther ❑ <br /> C <br /> Argon Labs Project Number 1 <br /> Shipper Container in good condition? Sufficient sample volume for requested tests?Yes L` No 17NIA V Yes ElNo ElSamples received within holding time? Yes �/ No <br /> Samples received under refrigeration? Yes No ❑ Do samples contain proper preservative? / <br /> NIA El Yes L�`� No ❑ <br /> Chain of custody present? Yes No ❑ VOA vials with preservative <br /> NIA ❑ Yes V No ❑ <br /> Cham of Custody signed by all parties? Yes [� No ❑ VOA vials preservative type <br /> HCL [Rr/ Na2S203 ❑ Other <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes E No 1:1 N/A El Yes No ❑ <br /> Samples received in proper containers? Yes V No ❑ Samples received intact? Yes No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted Person Contacted <br /> Contacted By Subject <br /> Comments <br /> Action Taken <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted By Date Time <br /> i <br /> Call Received By <br /> Comments <br /> i <br /> v502 <br />