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Argon Laboratories Sample Receipt Checklist <br /> Client Name ATC Associates, Inc Date&Time Received 12/4/2003 1650 <br /> Protect Name KIR Client Project Number 54 62514 0001 <br /> Received By P H Matrix Water 0 Sod ❑ <br /> Sample Carrier Client ❑ Laboratory Q Ped Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Protect Number D12161 <br /> Shrpper Comainer in good condition? Samples received in proper containers? Yes 0 No ❑ <br /> NIA Yes [] No ❑ Samples received intact? Yes 7 No ❑ <br /> Samples received under refrigeration? Yes ❑ No ❑ Sufficient sample volume for requested tests?Yes No ❑ <br /> Chain of custody present? Yes No Samples received within holding time? Yes 0 No ❑ <br /> Cham of Custody signed by all parties? Yes ❑ No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes No ❑ <br /> Chain of Custody matches all sample labels? Do VCA vias contain zero headspace? <br /> Yes No ❑ {None submitted ❑) Yes No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted Person Conacted <br /> Contacted By Subject <br /> Comments <br /> Action Taken <br /> ADDITIONAL TEST(S)REQUEST!OTHER <br /> Contacted By Date Time <br /> Call Received By <br /> Comments <br />