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• Login Sample Receipt Checklist <br /> Job Number:720-40204-1 <br /> Client:Kleinfeider Inc <br /> List Source:TestAmerica Chicago <br /> Login Number:40204 List Creation:0210811210:51 AM <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 True <br /> background <br /> The cooler's custody seal,if present,is 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. <br /> True <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? I <br /> 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. True <br /> • Containers are not broken or leaking. True <br /> Sample collection dateltimes are provided. True <br /> Appropriate sample containers are used. True <br /> Sample bottles are completely filled. True <br /> Sample Preservation Verified. 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(1141 in True <br /> diameter. <br /> Multiphasic samples are not present. True <br /> Samples do not require splitting or compositing. True <br /> Residual Chlorine Checked. True <br /> • <br /> TestAmerica San Francisco Page 16 of 16 2/14/2012 <br />