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Ar- on Laboratories Sample Receipt Checklist <br /> �.�► g p p <br /> Client Name: ATC Associates, Inc. Date&Time Received: 8/24/2004 13:35 <br /> Project Name: Glover Property Client Project Number: 54.17861.0001 <br /> Received By: P.H. Matrix: Water ❑ Soil ❑ <br /> Sample Carrier:. Client ❑ Laboratory 0 Fed Ex- ❑ uPS ❑ Other ❑ <br /> Argon Labs Project Number: E08501 <br /> Shipper Container in good condition?.. Samples received in proper containers? Yes (] No Q <br /> NIA Yes Q "No ❑ Samples received intact? " Yes Q No <br /> Samples received under refrigeration? Yes 0 "No ❑ Sufficient sample.volume for requested tests?Yes, Q No. <br /> Chain of custody present? Yes Q ,No Q Samples received within holding time? Yes ❑ No <br /> Chain of Custody signed by all parties? Yes .,Q No ❑ Do samples contain proper preservative? <br /> N/A ❑ Yes Q No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> f <br /> Yes E] No ❑ (None submitted ❑) Yes [] No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> --------------- -=---- --- ____ <br /> Date Client Contacted: Person Contacted: <br /> Contacted By: Subject: <br /> j. Comments: <br /> Action Taken: <br /> ADDITIONAL TEST(S)REQUEST/OTHER <br /> Contacted By: Date: Time: <br /> Call Received By: <br /> Comments: <br />