ARCHIVED REPORTS_RIPON STATUS REPORT 2011 1ST QUARTER

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i<IFF R,"E-'CVEERR Analvdcal LLC SAMPLE RECEIPT CHECKLIST Initials SRG#: 7-&ZC Date: r._. -K Project ID: i'��`> e L oc �t Method of Receipt: Courier 0 Over-the-counter Shipper COC Inspection Is COC present? ®Yes ❑No Custody seals on shipping container? U Intact ❑Broken ®Not present ❑N/A I` Is COC Signed by Relinquisher? ®Yes ❑No Dated? 3 Yes ❑No Is sampler name legibly indicated on COC? Yes No Is analysis or hold requested for all samples EJ E]Yes ❑No Is the turnaround time indicated on COC? ®Yes ❑No Is COC free of whiteout and uninitiated cross-outs? E.Yes ❑No,Whiteout ❑No,Cross-outs Sample Inspection Coolant Present: ❑Yes f No(includes water) Temperature°C Therm. ID# 5� —j Initial Date/Time Z03// A Z ❑N/A Are there custody seals on sample containers? ❑Intact ❑Broken IN Not present i Do containers match COC? E Yes ❑No ❑No, COC lists absent sample(s) No, Extra sample(s)present Are there samples matrices other than soil, water, air or carbon? ❑Yes No Are any sample containers broken, leaking or damaged? ❑Yes tNo Are preservatives indicated? D Yes,on sample containers ❑Yes,on COC ❑Not indicated ❑N/A Are preservatives correct for analyses requested? ®Yes ❑No ❑N/A Are samples within holding time for analyses requested? P�J Yes ❑No Are the correct sample containers used for the analyses requested? Yes ❑No Is there sufficient sample to perform testing? Yes ❑No Does any sample contain product,have strong odor or are otherwise suspected to be hot? ❑Yes KNo Receipt Details p Matrix Container type \1 OA it of containers received `3 o Matrix Container type #of containers received Matrix Container type #of containers received Date and Time Sample Put into Temp Storage Date: C40_311 Time: S uicklo Are the Sample ID's indicated: ❑On COC ❑On sample container(s) a On Both ❑Not indicated If Sample ID's are listed on both COC and containers,do they all match? Yes ❑No ❑N/A Is the Project ID indicated: ❑On COC ❑On sample container(s) cRrOn Both ❑Not indicated If project ID is listed on both COC and containers,do they all match? EJ-Yes ❑No ❑N/A Are the sample collection dates indicated: ❑On COC ❑On sample container(s) (WOn Both ❑Not indicated If collection dates are listed on both COC and containers,do they all match? CQ:,Yes ❑No ❑N/A Are the sample collection times indicated: ❑On COC ❑On sample container(s) �E'dn Both ❑Not indicated If collection times are listed on both COC and containers,do they all match? CKYes ❑No ❑N/A COMMENTS: O:\old_ed\samprec\Forms\Sample Receipt Checklist rev 051409.doc Page 21 of 21 Page 49 of 55 02/11/2011