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_• I <br /> F i . <br /> s <br /> i I <br /> F ; <br /> Alpha Analytical, Inc. <br /> ` Phone:(775)355-1044 FAX:(775)355-0406 <br /> E: <br /> Sample Receipt Checklist <br /> iDate Report is due to Client: 1/19/2004 ! Date of Notice: 1/9/2804 12:11:42 P <br /> Please take note of any NO check marks.If we receive no response concerning these items within 24 hours of the date of this notice,all of <br /> the samples will be analyzed as requested. <br /> I I <br /> h I; <br /> Client Name StratusEnvironmental Project ID: USA 65 <br /> Project Manager: Gowri Kowtha Is Client's Phone (530)676-6002 Client's FAX (530)676-6005 <br /> Ei .. <br /> Work Order Number STR04010947 Date Received:119/2004 Received by: Dolly S. Baker <br /> :,Chain of Custody(COC)Information <br /> .I <br />( Carrier name FedEk <br /> Chain of!custody present? Yes IV] n No <br /> I li <br /> I Custody4seals intact on shippping container/cooler ? Yes 11;;� No Not Present ❑ <br /> Custody seals intact o'n sample bottles . <br /> I' Yes No Not Present r <br /> Chain of,custody signed when relinquished and received'? Yes n ❑ No <br /> k I <br /> Chain of custody agrees with sample labels? A Yes 7�,,] ❑ No <br /> Sample ID noted by Client on COC? Yes n ❑ No <br /> Date and time of collection noted by Client on COC? Yes ❑ No <br />{ iamplers's name noted on COC? N Yes ❑ No <br /> "Internal ,Chain of Custody(COC)requested? ii Yes ❑ Eq No <br /> Sub Contract Lab Used : None ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> j Shipping container/cooler in good condition? Yes n ❑ No Not Present ❑ <br /> Samples in proper Cantainer/bottle? Yes r ❑ No <br />{ Sample containers intact? Yes n ❑ No <br /> i Sufficient sample voldme for indicated test? Yes D ❑ No <br /> IS <br /> ' 0 Sample!Preservation and Hold Time(HT)Information <br /> All samples-received within holding time? Yes ❑ No Cooler Temperature <br /> ContainedTemp Blank temperature in compliance(0-6°C)? Yes No 4°C <br /> Water-VOA vials have zero headspace 1 no bubbles? " Yes 0 L1 No No VOA vials submitted ❑ <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No N/A <br /> Analytical Requirement Information <br />� I <br /> Are non-,Standard or Modified methods requested? , Yes F1 7Y] No <br /> No If YES:see the Chain of Custody COC <br /> Are there client specific Project requirements? ;, Yes ❑ y( ) <br /> k I <br /> Comments <br /> r I <br /> 7 k i3 <br /> r <br />