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Clem Name Ar on Laboratories Sam le Recei t <br /> Checklist <br /> � t <br /> Protect Name <br /> Dale&Time Received <br /> � F ��Q <br /> -,'Client Project Number 5`} I Z S`f6 (Doc t <br /> ' Received By M 19 Matrix Water Sorl ❑ Other <br /> Sample Carrier Client ❑ Laboratory Fed Ex ❑ UPSEl❑ Other <br /> ' Argon Labs Protect Number G bo <br /> Shipper Container in good condition? Sufficient sample volume for requested tests?Yes 2" No ❑ <br /> I , <br /> ' NIA ❑ Yes No ❑ Samples received within holding time? Yes <br /> Q' No ❑ <br /> Samples received under refrigeration? Yes [ No ❑ Do samples contain proper preservative <br /> NIA ❑ Yes No ❑ <br /> Chain of custody presenl? Yes No ❑ VOA vials with preservative <br /> NIA ❑ Yes No <br /> Cham of Custody signed by all parties? Yes No <br /> ElVOA vials preservative type <br /> HCL a Na2S203 ❑ Other <br /> Cham of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes No ❑ NIA ❑ Yes No ❑ <br /> ' Samples received in proper conlainersl' Yes ( No ❑ Samples received intact <br /> Yes u No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted Person Contacted <br /> ' Contacted By <br /> Subject <br /> ' Comments <br /> 1 <br /> Action Taken <br /> I <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted By Date � — <br /> ' Time <br /> Call Received By <br /> ' Comments <br /> ' v502 <br />