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r <br /> . Alpha Analytical, Inc. <br /> Phone (T75)355-1044 FAX (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 6/16/2004 Date of Notice 6/16/2004 8 45 09 A <br /> Please take note of any NO check marks It we receive no response concerning these items within 24 hours of the date of this notice,all of <br /> the samples will be analyzed as requested <br /> Client Name Stratus Environmental Project ID Joe's Truck Plaza <br /> Project Manager Steve Carter Client's Phone (530)676-6008 Client's FAX (530)676-6005 <br /> Work Order Number STRO4061602 Date Received 6/16/2004 Received by Laura Long <br /> Chain of Custody(COCl Information <br /> Carrier name Alpha Emolovee <br /> Chain of custody present ) Yes ❑ No <br /> Custody seals intact on shippping container/cooler? Yes © ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles 7 Yes ❑ ❑ No Not Present 0 <br /> Chain of custody signed when relinquished and received o Yes © ❑ No <br /> Chain of custody agrees with sample labels? Yes © ❑ No <br /> Sample ID noted by Client on COC? Yes © ❑ No <br /> Date and time of collection noted by Client on COC? Yes ❑ No <br /> &amplers's name noted on COC o Yes © ❑ No <br /> Internal Chain of Custody(COC)requested Yes ❑ R No <br /> Sub Contract Lab Used None © ❑ SEM Other(see comments) ❑ <br /> Sample Receipt information <br /> Shipping container/cooler in good condition? Yes © ❑ No Not Present ❑ <br /> Samples in proper container/bottle? Yes ❑ ❑ No <br /> Sample containers intact? Yes ❑ No <br /> Sufficient sample volume for indicated test? Yes © ❑ No <br /> Sam le Preservation and Hold Time H Information <br /> All samples received within holding timer Yes © ❑ No Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes © ❑ No 4-C <br /> Water-VOA vials have zero headspace/no bubbles Yes 0 ❑ No No VOA vials submitted ❑ <br /> Sample labels checked for correct preservation'? Yes © ❑ No <br /> TOC Water-pH acceptable upon receipt (H2SO4 pH<2)7 Yes ❑ ❑ No N/A <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested Yes ❑ R No <br /> Are there client specific Project requirements Yes ❑ © No If YES see the Chain of Custody(COC) <br /> Comments <br />