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Login Sample Receipt Checklist <br /> • Jab Number:720-39967-1 <br /> Client:Kleinfelder Inc <br /> List Source:TestAmerica Chicago <br /> Login Number:39967 List Creation:01/27112 10:27AM <br /> List Number:1 <br /> Creator:Kelsey,Shawn M <br /> Answer Comment <br /> Question <br /> Radioactivity either was not measured or,if measured,is at or below <br /> True <br /> background True ' <br /> The coolers custody seal,if present,is intact. <br /> The cooler or samples do not appear to have been compromised or True <br /> tampered with. True <br /> Samples were received on ice. <br /> True <br /> Cooler Temperature is acceptable. <br /> Cooler Temperature is recorded. True <br /> True <br /> COC is present. <br /> COC is filled out in ink and legible. True <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. m <br /> True <br /> Samples are received within Holding Time. <br /> Sample containers have legible labels. True <br /> • Containers are not broken or leaking. True <br /> Sample collection date/times are provided. <br /> True <br /> Appropriate sample containers are used. True <br /> Sample bottles are completely filled. True <br /> Sample Preservation Verified. <br /> True <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 0/4')in True <br /> diameter. <br /> Multiphasic samples are not present. True <br /> Samples do not require splitting or compositing. <br /> True <br /> Residual Chlorine Checked. True <br /> • <br /> TestAmerica San Francisco Page 20 of 20 1131/2012 <br />