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Argon Laboratories Sample Receipt Checklist <br /> Client Name tm k�c _ Date&Time ReceiveI <br /> • Protect game Client Protect Number 04, <br /> Received By �. .. _ Matrix Water �ir Soo ❑ 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 Lam' No ❑ <br /> N/A [ Yes ❑ No ❑ Samples received within holding time? Yes 19/ No ❑ <br /> Samples received under refrigeration? Yes C9 No ❑ Do samples contain proper preservative? <br /> ' MIA ❑ Yes ice" No ❑ <br /> Chain of custody present? Yes No F1VOA vials with preservative? <br /> NIA ❑ Yes � No E)I Chain of Custody signed by all parties? Yes No El VGA vials preservative type <br /> HCL [�/ 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 containers? Yes No ❑ Samples received intact? Yes No ❑ <br /> --- ---ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW-- <br /> Hate Client Contacted Person Contacted <br /> ' Contacted By Subject <br /> Comments <br /> Action Taken <br /> ADDITIONAL TEST(S)REQUEST f OTHER <br /> ' Contacted By Date °t v5 Time <br /> Call Received By --T�OL, <br /> Comm nts GA Q Et_ tt6 PA LOT, I IE5 +vo TT'L ZEE- Zdl-D <br /> U�1L_t_ $Qt N� tj LES Q73 06ec-E T-�, vzP-- <br /> v502 <br />