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_ 1 <br /> .r <br /> ff ' <br /> Login Sample Receipt Checklist <br /> Client:Conestoga-Rovers&Associates,Inc. Job Number:440-39095-1 <br /> Login Number:39095 List Source:TestAmerica Irvine <br /> List Number:1 �, ; <br /> Creator:Reddy,Sushmitha E <br /> Question Answer Comment <br /> Radioactivity wasn't checked or is</=background as measured by a suryey N/A <br /> meter. <br /> The cooler's custody seal,if present,is intact. True <br /> Sample custody seals,if present,are intact. True _ <br /> The cooler or samples do not appear to have been compromised or True <br /> tampered with. <br /> Samples were received on ice. True <br /> Cooler Temperature is acceptable. True <br /> Cooler Temperature is recorded. True <br /> COC is present. True <br /> COC is filled out in ink and legible. True EMM <br /> COC is filled out with all pertinent information. True <br /> Is the Field Sampler's name present on COC? True Gregory Roberts <br /> There are no discrepancies between the containers received and the COC. True <br /> Samples are received within Holding Time. True <br /> Sample containers have legible labels. True <br /> Containers are not broken or leaking. True <br /> Sample collection date/times are provided. True <br /> Appropriate sample containers are used. True <br /> Sample bottles ate completely filled. True <br /> Sample Preservation Verified. False Lab needs to check <br /> There is sufficient vol.for all requested analyses,incl.any requested True <br /> MS/MSDs <br /> Containers requiring zero headspace have no headspace or bubble is True <br /> <6mm(1/4"). <br /> Multiphasic samples are not present. False <br /> Samples do not require splitting or compositing. True <br /> Residual Chlorine Checked. False Lab needs to check <br /> TestAmerica Irvine <br /> Page 14 of 14 P F 3/5/2013 <br />