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1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> McCampbell Analytical, Inc. Toll Free Telephone:(877)252-9262/Fax:(925)252-9269 <br /> f ` "When Quality Counts" http://www.mccampbell.com/E-mail:main @mccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: Hurvitz Environmental Date and Time Received: 12/10/2014 4:03:30 PM <br /> Project Name: #3084.01;Donaldson Tire Logln Reviewed by: Caleigh Callaway <br /> WorkOrder Ns: 1412460 Matrix: Soil Carrier: Client Drop-In <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes W No❑ <br /> Chain of custody signed when relinquished and received? Yes W No❑ <br /> Chain of custody agrees with sample labels? Yes 0 No❑ <br /> Sample IDs noted by Client on COC? Yes 0 No❑ <br /> Date and Time of collection noted by Client on COC? Yes ❑ No 0 <br /> Sampler's name noted on COC? Yes 0 No❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA W <br /> Shipping container/cooler in good condition? Yes 0 No❑ <br /> Samples in proper containers/bottles? Yes 0 No❑ <br /> Sample containers intact? Yes W No❑ <br /> Sufficient sample volume for indicated test? Yes 0 No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes ;I No L <br /> Sample/Temp Blank temperature Temp: 7°C NA— <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ NA <br /> Sample labels checked for correct preservation? Yes F_/1 No❑ <br /> pH acceptable upon receipt(Metal:<2;522:<4;218.7:>8)? Yes ❑ No❑ NA <br /> Samples Received on Ice? Yes No❑ <br /> (Ice Type: WET ICE ) <br /> UCMR3 Samples: <br /> Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No❑ NA <br /> Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NA <br /> 300.1,537,539? <br /> *NOTE:If the"No"box is checked,see comments below. <br /> ---------------------------------------------- <br /> ---------------------------------------------- <br /> Comments: Time not noted on COC. <br /> Page 33 of 33 <br />