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Ar on Laboratories Sample Receipt Checklist <br /> Client Name Ground Zero Analysis Date&Time Received 5/12/2004 1400 <br /> Project Name Knowles Hammer Lane Client Project Number 95-013 <br /> Received By E P Matrix Water [] Sod ❑ <br /> Sample Carrier Client 0 Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number E05151 <br /> Shipper Container in good condition? Samples received in proper containers? Yes ❑ No ❑ <br /> N/A Yes No ❑ Samples received intact? Yes No ❑ <br /> Samples received under refrigeration? Yes No ❑ Sufficient sample volume for requested tests?Yes No ❑ <br /> Chain of custody present? Yes ❑ No ❑ Samples received within holding time? Yes ❑ No ❑ <br /> Chain of Custody signed by all parties? Yes Q No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes Q No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes Q No ❑ (None submitted ❑) Yes 0 No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> ------------- -- -- ------ -- -- --- ------ <br /> Date Client Contacted Person Conacted <br /> Contacted By Subject <br /> Comments <br /> Action Taken <br /> ADDITIONAL TEST(S)REQUEST f OTHER <br /> Contacted By Date Time <br /> Call Received By <br /> Comments <br />