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Ar on Laboratories Sample Recei t Checklist <br /> Client Name ' Fle G <br /> r lhC+Date&Time Received <br /> ` Protecl Name G s <br /> Client Protect Number <br /> Received By Matrix Water L`7 Soit ❑ Other <br /> Sample Carrier Client [Laboratory ❑ FedEx ❑ UP5 ❑ <br /> ❑ Other <br /> Argon Labs Protect Number <br /> Shipper Container in good condition? Sufficient sample volume for requested tests?Yes No ❑ <br /> NIA 5?""' <br /> Yes ❑ No ❑ Samples received within holding time? Yes No ❑ <br /> Samples recewed under refrigeration? Yes No ❑ Do samples contain proper preservative? <br /> NIA [:] Yes No ❑ <br /> Cham of custody present? Yes No ❑ VOA vials with preservative? <br /> NIA EJ Yes Na ❑ <br /> Cham of Custody signed by all parties? Yes No ❑ VOA vials preservative type <br /> HCL [� Na2S203 ❑ Other <br /> Cham of Custody matches all sample labels? Do VOA vials conlain zero headspace? <br /> Yes No ❑ NIA ❑ Yes No <br /> Samples <br /> No ❑ <br /> Samples received in proper containers?Yes [}� No ❑ Samples received intact? Yes No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> i __—__—__—__----- <br /> Date Client Contacted Person Contacted <br /> Contacted By Subject <br /> Comments <br /> Action Taken <br /> ADDITIONAL TEST(S)REQUEST!OTHER <br /> Contacted By Date <br /> Time <br /> Call Received By <br /> Comments <br /> v502 <br /> 1 <br />