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Amon Laboratories Sample Receipt Checklist <br /> Client Name ATC Associates, Inc Date&Time Received 9/29/2004 1040 <br /> Project Name Pacific Coast Recreation Client Project Number 5416393 0002 <br /> Received By M G Matnx Water 0 Soil ❑ <br /> Sample Carrier Client ❑ Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Protect Number E09711 <br /> Shipper Container in good condition? Samples received in proper containers? Yes 0 No ❑ <br /> NIA Yes Q No ❑ Samples received intact? Yes D No ❑ <br /> Samples received under refrigeration? Yes ❑ No ❑ Sufficient sample volume for requested tests?Yes [1 No ❑ <br /> Chain of custody present? Yes No ❑ Samples received within holding time? Yes No <br /> Chain of Custody signed by all parties? Yes ❑ No ❑ Do samples contain proper preservative? <br /> N/A ❑ Yes No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes No ❑ (None submitted ❑) Yes [� No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED 1N THE COMMENTS SECTION BELOW <br /> Date Client Contacted Person Contacted <br /> Contacted By Subject <br /> Comments <br /> Action Taken <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted By Date Time <br /> Call Received By <br /> Comments <br /> p , <br />