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r�h� 1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> Mccampbell Analytical, Inc. Toll Free Telephone:(877)252-9262/Fax:(925)252-9269 <br /> �ry <br /> "When Quality Counts" I <br /> http://www.mccampbeli.com/E-mail:mainQmccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: Bums&McDonnell Date and Time Received: 1113t2017117:10 <br /> Project: Blue Rhino Lathrop Date Logged: 1/3/2018 <br /> Received by: Jena Alfaro <br /> WorkOrder Ne: 1801090 Matrix: Water Logged by: Alexandra Iniguez <br /> Carrier: Client Drop-In <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes No❑ <br /> Chain of custody signed when relinquished and received? Yes No❑ <br /> Chain of custody agrees with sample labels? Yes No❑ <br /> Sample IDs noted by Client on COC? Yes W No❑ <br /> Date and Time of collection noted by Client on COC? Yes 0 No❑ <br /> Sampler's name noted on COC? Yes W No❑ <br /> COC agrees with Quote? Yes ❑ No❑ NAW <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes W No❑ NA❑ <br /> Shipping container/cooler in good condition? Yes RJ No❑ <br /> Samples in proper containers/bottles? Yes ka No❑ <br /> Sample containers intact? Yes 91 No❑ <br /> Sufficient sample volume for indicated test? Yes 0 No❑ <br /> Sample Preservation and Hold Time(HT1 Information <br /> All samples received within holding time? Yes �d No❑ NA❑ <br /> Sample/Temp Blank temperature Temp: 4.8°C NAE <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ NA <br /> Sample labels checked for correct preservation? Yes ❑J No❑ <br /> pH acceptable upon receipt(Metal:<2;522:<4;218.7:>8)? Yes ❑ No❑ NAW <br /> Samples Received on Ice? Yes W No❑ <br /> (Ice Type: WET ICE ) <br /> UCMR Samples: <br /> Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No❑ NA 66 <br /> Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NA R] <br /> 300.1,537,539? <br /> ----------------------------------------------- <br /> -------------------------------------------- - <br /> Comments: <br /> Page 11 of 11 <br />