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Amon Laboratories Sample Recei t Checklist <br /> s..a�D_ <br /> E u Time Received r2 _. <br /> ;I enF°r0,ect I Iumbe -`� Z 2�"i3 Q Zo 1 <br /> vec 6 <br /> Matrix `Nater Q"—Sosi C�Other <br /> Carrie Car,= 11e� ❑ L GDoratory Fed Ex ❑ EPS ❑ Other ❑ <br /> =-er�a a ner r gaol canVion, Sufficient sample volume for requested tests')Yes C� No L <br /> VA Yes [� No ❑ Samples received within holding time? Yes No I-'- <br /> r„{es�e; i ed ender efrrgeracon? des No ❑ DO samples contain proper oresemalive? <br /> WA 11 Yes No ❑ ' <br /> hr r or cus c iy p e sena? Yes No VOA vials with preservative? <br /> NIA C Yes [t✓No <br /> �h n r ar r-Wcc,stoned by all parties? `'es [ No ❑ VOA rials preservative type <br /> HCL [;---9a2S203 ❑ Other <br /> Ch----pf CV'r dy retches wll samole labels' Do VOA vials contain zero headspace? <br /> Yes No ❑ NIA C Yes No ❑ <br /> car les re:,i ed 1^Prone,containers?Yes �' No ❑ Samples received intact? Yes C No J <br /> T ANY"No”RESPONSE MUST BE DETAILED IN TNl_COMMENTS SECTION BELOW <br /> D3 t,Clre�t Contacted Person Contacted <br /> Co-,tacted B, Subject <br /> Co nrnents <br /> Nc inn Takcr <br /> r s <br /> ADDITIONAL TEST(S)REQUEST 1 OTHER <br /> Ca,,iacted 3, Date <br /> Time <br /> Cal Recetvsd By <br /> Co-nments <br /> v502 <br />