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h <br /> Amon Laboratories Sample Receipt Checklist <br /> Client NameI�6a 0 Zeno Q /^ Date&Time Received �2� <br /> Protect Name Client Project Number <br /> Received By -9 r— — — Matrix Water Lam' Soii ❑ Other <br /> Sample Carrier Client Le Laborato ❑ Fed Ex ❑ I ❑llPS ❑ Other <br /> Argon Labs Protect Number F-o866 <br /> Shipper Conladner in good condition) Sufficient sample volume for requested tests)Yes No <br /> N/A � Yes ❑_/ No ❑ Samples received within holding time? Yes EV-1, No <br /> Samples received under refrigeration? Yes ill No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes Ne <br /> Chain of custody present) Yes M--," No ❑ VOA vials with preservative) <br /> N/A ❑ Yes No <br /> Chain of Custody signed by all parties) Yes E2"" No ❑ VOA vials preservative type <br /> NCL tr, Na2S203 ❑ Cther <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace'? <br /> Yes Ly No ❑ NIA ❑ Yes ❑t✓ No <br /> Samples received in proper containers) Yes f No ❑ Samples recewed intact) Yes No i❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted Person Contacted <br /> Contacted By Subject <br /> Comments <br /> Action Taken <br /> ADDITIONAL TEST(S)REQUEST!OTHER <br /> Contacted By Date Time <br /> Call Received By <br /> Comments <br /> v502 <br />