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ATORY <br /> NOEJST EA$ODRIVE <br /> 6880 INTERCHANGE DRIVE <br /> HOUSTON TEXAS 77054 <br /> 1 zw� C (713)660 0901 <br /> Sample Receipt Checklist <br /> Workorder 00050536 Received by Stelly D Anna <br /> Date and Time Received 5118100 10 00 00 AM Carrier name FedEx <br />' Temperature 4 <br /> Shipping container/cooler in good condition? Yes V No Not Present <br /> Custody seals Intact on sluppping cont 3inerlcoeler? Yes No Not Present <br /> Custody seals Intact on sample botlles'� Yes No Not Present <br />' Chain of custody present? Yes No <br /> Chain of custody signed when rE Irnqui_hed and r?ceivedYes '� No <br /> Chain of custody agrees with sample labels Yes No <br /> Samples In proper conl,iwurlbottic Yes V No <br /> Sample containers i twl? Yes No <br />' Sufficient sample volump for Indicated test Yes No <br /> All samples received within holdrng fime0 Yes No <br /> Containerf Emp Blank tomperature>in cornpl ante? Yes J No <br /> Watf r VOA vwl, h iv[ [eio hLadsp,icc, Yew V Nn Not Pre,Fnt <br /> Water pt i nc cr pt IN( upon u c F ipt) Yes V No <br />