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i <br /> Amon Laboratories Sample Receipt Checklist <br /> Client Name STC_ CI Date&Time Received D 5 1 z� !6>3 16, Zo <br /> Project Name u�i� j�� Client Project Number `� 2911-2.D CX-53 <br /> Received By Matrix Water Sod <br /> Sample Carver Client FedEx ! UPS I <br /> Argon Labs Project Number -t�C�S 431 <br /> Shipping Container 1 Cooler in good condtion? Samples received in proper containers? Yes— No <br /> NIA �es No Samples received intact? Yes fNo <br /> Samples received under refrigeration? Sufficient sample volume for requested tests? ✓ <br /> Yes c"" Nc Yes No <br /> Cham of Custody Present? Yes V"'NO Samples received within holding tme? Yes No <br /> Chain of Custody signed by all parties? Do samples contain proper preservatve? <br /> Yes ✓No NIA Yes fNo <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspaoe? <br /> Yes No (None submitted Yes L-I No <br /> ANY"No" RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted Person Contacted <br /> Contacted by Subject <br /> Comments <br /> Acton Taken <br /> OTHER <br /> Date Client Contacted Person Contacted <br /> Comments <br />