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r i„ 4 - <br /> a - e <br /> Login Sample Receipt Checklist <br /> g p p <br /> Client:Conestoga-Rovers&Associates,Inc. Job Number:440-4364-1 <br /> Login Number:4364 List Source:TestAmerica Irvine • <br /> List Number:1 r} <br /> Creator:Perez,Angel <br /> Question Answer Comment <br /> Radioactivity either was not measured or,if measured,is at or below N/A <br /> background n_. <br /> The cooler's custody seal,if present,is intact. True <br /> .`u a <br /> The cooler or samples do not appear to have been compromised or True �l; <br /> tampered with. <br /> Samples were received on ice. True <br /> Cooler Temperature is acceptable. True <br /> Cooler Temperature is recorded. True <br /> i <br /> COC is present. True <br /> COC is filled out in ink and legible. True �9 <br /> COC is filled out with all pertinent information. True <br /> Is the Field Sampler's name present on COC? True <br /> There are no discrepancies between the sample IDs on the containers and True <br /> the COC. <br /> Samples are received within Holding Time. True <br /> Sample containers have legible labels. r 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 are completely filled. True <br /> Sample Preservation Verified. N/A <br /> There is sufficient vol.for all requested analyses,incl.any requested True <br /> MS/MSDs <br /> VOA sample vials do not have headspace or bubble is<6mm(1/4")in True <br /> diameter. <br /> Multiphasic samples are not present. True <br /> Samples do not require splitting or compositing. N/A <br /> Residual Chlorine Checked. N/A <br /> i <br /> i <br /> i <br /> I <br /> TestAmerica Irvine <br /> Page 13 of 13 3/20/2012 <br />