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t! Amon Laboratories Sample Receipt Checklist <br /> Client Name ATC Associates, Inc Date&Time Received 12!912003 1140 <br /> Project Name N&S Irrigation Client Project Number 54 14981 0001 <br /> Received By P H Matrix Water [] Soil ❑ <br /> Sample Carrier Client ❑ Laboratory [ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Laos Project Number 1712211 <br /> Shipper Container in good condition? Samples received in proper containers? Yes No ❑ <br /> NIA Yes ❑ No ❑ Samples received intact? Yes Q No ❑ <br /> Samples received under refrigeration? Yes 0 No ❑ Sufficient sample volume for requested tests?Yes [] No ❑ <br /> ' Chain of cusiody present? Yes ❑ No ❑ Samples received within holding time? Yes ❑ No ❑ <br /> Chain of Custody signed by all parties? Yes No ❑ Do samples contain proper preservative? <br /> N/A ❑ Yes ❑ No ❑ <br /> Chain of Custody matches all sample labels? Do VDA vials contain zero headspace? <br /> Yes [] No ❑ (None submitted ❑ ) Yes 0 No ❑ <br /> ANY"No"RESPONSE MUST <br /> BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted Person Conacted <br /> Contacted By Subject <br /> Comments <br /> Action Taken <br /> ADDITIONAL TESTIS)REQUEST!OTHER <br /> Contacted By Date Time <br /> ' Call Received By <br /> Comments <br />