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• Login Sample Receipt Checklist <br /> Client:Kieinfelder Inc Job Number:720-40485-1 <br /> Login Number:40485 List Source:TestAmerica Chicago <br /> List Number.l List Creation:02122112 11:01 AM <br /> Creator:Kelsey,Shawn M <br /> Question Answer Comment <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. True <br /> COC is filled out in ink and legible. True <br /> COC is flied outwith 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 /> _.i <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 date/times 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(1/4")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 2/28/2012 <br />