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' I,� ISM Willow Pass Road Pittsburg,CA 94565-1701 <br /> McCampbell Analytical, Inc. Toll Free Upham:(877)252-9262/Fax:(925)252-9269 <br /> �•' \ <br /> "When Quality Counts" httpJ/www.mcc=pbell.com/E-mail:main@=campbell.com <br /> Sample Receipt Checklist <br /> Client Name: Castle Analytical Laboratory Date and Time Received 1119/2017 08:40 <br /> Project Name: 1701037; Farmington Fresh Date Logged: 111 912 01 7 <br /> Received by: Jena Alfaro <br /> WorkOrder Ns: 1701739 Matrix: Sludae Logged by: Jena Alfaro <br /> Carrier: UPS <br /> Chain of Custody LCOCI Informationi' w""� <br /> t - � <br /> Chain of custody present? Yes © No❑ R C <br /> Chain of custody signed when relinquished and received? Yes ® No❑ FEB 0 6 2G it <br /> Chain of custody agrees with sample labels? Yes © No❑ <br /> Sample IDs noted by Client on COC? Yes © No❑ ENVIRONMENTAL HEALTH <br /> Date and Time of collection noted by Client on COC? Yes No❑ DEPARTMENT <br /> Sampler's name noted on COC? Yes ❑ No❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/coolers Yes ❑ No❑ NAW <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 fHTI Information <br /> All samples received Within holding time? Yes W No❑ NA❑ <br /> Sample/Temp Blank temperature Temp: NA <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ NAW <br /> Sample labels checked for correct preservation? Yes © No❑ <br /> pH acceptable upon receipt(Metal:<2;522:<4;218.7:>8)? Yes ❑ No❑ NAW <br /> Samples Received on Ice? Yes ❑ No <br /> UCMR3 Samples: <br /> Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No❑ NAW <br /> Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NA 66 <br /> 300.1.537.539? <br /> ---------------------------------------- <br /> --------------------------------------------- <br /> Comments: <br /> Page 10 of 10 <br />