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Argon Laboratories Sample Receipt Checklist <br /> Client Name Date&Time Received L34 L ! ' 'o <br /> Protect Name Client Protect Number wo <br /> Received By -tom Matrix Ware( ❑ Soil ❑ Other <br /> Sample Carrier Client ❑ Laboratory Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number <br /> Shipper Container in good condition? Sufficient sample volume for requested tests?Yes No ❑ <br /> NIA ❑ Yes 21 No ❑ Samples received within holding time? Yes No ❑ <br /> Samples received under retngeration? Yes No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes Na ❑ <br /> Cham of custody present? Yes ,❑ No ❑ VOA vials with preservative? <br /> NIA El Yes ,,El"' No ❑ <br /> Cham of Custody signed by all parties? Yes 211� No ❑ VOA vials preservative type <br /> HCL Q/ Na15203 ❑ Other <br /> Cham of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes No ❑ NIA ❑ Yes No ❑ <br /> ' Samples received�n proper containers?Yes DI/ No ❑ Samples received intact? Yes No ❑ <br /> i <br /> ANY"No"RESPONSE MIDST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted Person Contacted <br /> ' Contacted By Subject <br /> Comments <br /> Action Taken <br /> ADDITIONAL TEST(S)REQUEST IOTHER <br /> Contacted By Date <br /> Time <br /> Call Received By <br /> Comments <br /> ' v 5 02 <br />