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Alpha Analytical, Inc. <br /> Phone {775)355-i044 FAX (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 3/16/2004 Date of Notice 3/8/2004 3 15 32 PM <br /> Please take note of any NO check marks if 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 .foes Truck Stop <br /> Project Manager Gown Kowtha Client's Phone (530) 676-6002 Client's FAX (530)676-6005 <br /> Work Order Number STR04030847 Date Received 315/2004 Received by Dolly S Baker <br /> Chain of Custody COC Information <br /> Carrier name Alpha employee <br /> Chain of Custody present? Yes w1 n No <br /> Custody seals intact on shippping container/cooler? Yes ❑ ❑ No Not Present J <br /> Custody seals intact on sample bottles? Yes n ❑ No Not Present <br /> Chain of custody signed when relinquished and received? Yes i W ❑ No <br /> Chain of custody agrees with sample labels? Yes ❑ 1/1 No <br /> Sample ID noted by Client on COC? Yes F ❑ No <br /> Date and time of collection noted by Client on CDC? Yes 11V_11 ❑ No <br /> amplers's name noted on COC? Yes � 7-1No <br /> nternal Chain of Custody(COC)requested? Yes ❑ No <br /> Sub Contract Lab Used None ❑ SEM Other(see comments) U <br /> Sample Receipt Information <br /> Shippmg container/cooler in good condition? Yes V] ID No Not Present ❑ <br /> Samples in proper container/bottle? Yes L n No <br /> Sample containers intact? Yes W� ❑ No <br /> Sufficient sample volume for indicated test? Yes P/1 ❑ No <br /> Sample Preservation and Hold Time(HT) Information <br /> All samples received within holding time? Yes �Vol ❑ No <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes iI ❑ No 4°C <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes "I ❑ No No VOA vials submitted <br /> Sample labels checked for correct preservation? Yes 'W] n No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No NIA EVI <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested ? Yes ❑ No <br /> Are there client specific Project requirements? Yes ❑ No If YES see the Chain of Custody(COC) <br /> omments Samples delivered 315104 late evening by Alpha courier samples kept cold&secure until log-in 318104 <br /> MW-6 has one VOA labeled as MW-4,sampled times match for MW-6&5 VOA for MW-4 samples received <br />