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MCCamDbell Analytical, Inc. 1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> Web:www.mccampbell.com E-mail:main@mccampbell.com <br /> "When Ouality Counts" Telephone:877-252-9262 Fax:925-252-9269 <br /> ' Sample Receipt Checklist <br /> Client Name: PSC Industrial Outsourcing, LP Date and Time Received: 07/22/097:49:54 PM <br /> ' Project Name: #TMSLLINI Checklist completed and reviewed by: Samantha Arbuckle <br /> WorkOrder N°: 0907603 Matrix Water Carrier: Client Droo-In <br /> Chain of Custody(CDC)Information <br /> Chain of custody present? Yes ® No ❑ <br /> ' Chain of custody signed when relinquished and received? Yes ® No❑ <br /> of <br /> Chain of custody agrees with sample labels? Yes No❑ <br /> Sample IDs noted by Client on COC? Yes ® No❑ <br /> Date and Time of collection noted by Client on COC? Yes © No ❑ <br /> Samplers name noted on COC? Yes 0 No❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA <br /> ' Shipping container/cooler in good condition? Yes ® No ❑ <br /> Samples in proper containers/bottles? Yes © No❑ <br /> Sample containers intact? Yes ® No❑ <br /> Sufficient sample volume for indicated test? Yes © No❑ <br /> ' Sample Preservation and Hold Time INTI Information <br /> All samples received within holding time? Yes RI No❑ <br /> Containerrremp Blank temperature Cooler Temp: 4.1'C NA ❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes No ❑ No VOA vials submitted❑ <br /> Sample labels checked for correct preservation? - Yes © No ❑ <br /> ' TTLC Metal-pH acceptable upon receipt(pH<2)? Yes No ❑ NA ❑ <br /> Samples Received on Ice? Yes No ❑ <br /> (IceType: VVETICE ) <br /> NOTE:If the "No"box is checked,see comments below. <br /> --------------------------------------------- <br /> --------------------------------------------- <br /> Client contacted: Date contacted: Contacted by: <br /> Comments: <br /> 1 <br />