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Amon Laboratories Sample Receipt Checklist <br /> Client Name Date&Time Received 3 <br /> Project Name riS - r r ` !� t+ `` Client Project Number <br /> Received By S J MatrixWater 1 Solt_I <br /> Sample Carrier —Client./ aborato 1 FedEx 1 UPS I <br /> Argon labs Pro;ect Number X03 OG f <br /> Shipping Container 1 Cooler in good condition? Samples received in proper containers? Yeses No <br /> NIA ',,L_Yes No Samples received intact? Yes No <br /> Samples received under refrigeration? Sufficient sample volume for requested tests? <br /> Yes X No Yes No <br /> Cham of Custody Presents Yes c No Sampkes received within holding hmV Yes No <br /> Chain of Custody signed by all parhes9 Do samples contain proper preservative? <br /> Yes k No NIA Yes No <br /> Cham of Custody matches all sample labels? Do VOA%gals contain zero headspace? <br /> Yes /�C No {None submitted___-_J 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 /> Aaron Taken <br /> OTHER <br /> Date Chant Contacted Person Contacted <br /> Co-nmems <br />