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0 <br /> Alpha Analytical, Inc. <br /> Phone (775)355-1044 FAX (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 7/112004 Date of Notice 6123/2004 10 48 10 <br /> Please take note of any NO check marks If we receive no response concerning these items within 24 hours of the date of this notice,all of <br /> the samples will be analyzed as requested <br /> Client Name Stratus Environmental Project ID 2001-01031 Teichert <br /> Project Manager Steve Carter Client's Phone (530)676-6008 Client's FAX (530)676-6005 <br /> Work Order Number STR04062324 Date Received 6/2312004 Received by Graaela Navarrete <br /> Chain of Custody(COC)Information <br /> Carrier name FedEx <br /> Chain of custody present 7 Yes ❑ No <br /> Custody seals intact on shippping container/cooler? Yes Q ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present 0 <br /> Cham of custody signed when relinquished and received? Yes 0 ❑ No <br /> Chain of custody agrees with sample labels? Yes ❑ No <br /> Sample ID noted by Client on COC? Yes ❑ No <br /> Date and time of collection noted by Client on COC? Yes ❑ No <br /> name noted on COC? Yes ElNo <br /> ,Sam,lers's <br /> Internal Chain of Custody(COC)requested? Yes ❑ Z No <br /> Sub Contract Lab Used None ❑ ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping container/cooler in good condition? Yes No Not Present ❑ <br /> Samples in proper container/bottle? Yes ❑ No <br /> Sample containers intact? Yes F111 ❑ No <br /> Sufficient sample volume for indicated test? Yes F17 ❑ No <br /> Sample Preservation and Hold Time(HT) Information <br /> All samples received within holding time? Yes S ❑ No <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes R ❑ No 40C <br /> Water-VOA vials have zero headspace/no bubbles? Yes R] ❑ No No VOA vials submitted ❑ <br /> Sample labels checked for correct preservation? Yes d❑ ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No N/A ❑� <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested Yes ❑ R] No <br /> Are there client specific Project requirements ? Yes ❑ 0 No If YES seethe Chain of Custody(COC) <br /> Comments <br />