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� � v <br />bell AnalyticalInc. 1534Willow Pass Road, Pittsburg,CA 94565-1701 <br />Toll Free Telephone: (877) 252-9262 / Fax: (925) 252-9269 <br />"When uality Counts" I http://www.mccampbell.com / E-mail: main@mccampbell.com <br />NOTE: If the "No" box is checked, s <br />I comments below. <br />Client contacted: I Date contacted: Contacted by: <br />Comments: <br />Sample Receipt Checklist <br />Client Name: Safety Kleen <br />Date and Time Received: <br />8/25/2011 10:14:35 AM <br />Project Name: McGill Metals; McGill <br />Air Flow <br />Checklist completed and reviewed by: Melissa Valles <br />WorkOrder N°: 1108738 <br />Matrix: Solid <br />Carrier: Client Droo-In <br />Chain of Custody (COC) <br />Information <br />Chain of custody present? <br />Yes <br />Jl <br />No — <br />Chain of custody signed when relinqu <br />shed and received? Yes <br />VV1 <br />No — <br />Chain of custody agrees with sample <br />abels? <br />Yes <br />J <br />No <br />Sample IDs noted by Client on COC? <br />Yes <br />41 <br />No <br />Date and Time of collection noted by <br />tient on COC? <br />Yes <br />No <br />Sampler's name noted on COC? <br />Yes <br />❑ <br />No I� <br />Custody seals intact on shipping con <br />finer/cooler? <br />Sample <br />Yes <br />Receipt <br />❑ <br />Information <br />No ❑ <br />NA❑ <br />Shipping container/cooler in good con <br />ition? <br />Yes <br />41 <br />No ❑ <br />Samples in proper containers/bottles? <br />Yes <br />�411 <br />No ❑ <br />Sample containers intact? <br />Yes <br />41 <br />No ❑ <br />Sufficient sample volume for indicated <br />test? <br />Yes <br />401 <br />No ❑ <br />Sample Preservation and Hold Time (HT) Information <br />All samples received within holding ti <br />e? <br />Yes <br />No — <br />ContainerfTemp Blank temperature <br />Cooler Temp: <br />23.6°C <br />NA — <br />Water - VOA vials have zero headspa <br />e / no bubbles? <br />Yes <br />L <br />No II No VOA vials submitted <br />Sample labels checked for correct pre <br />ervation? <br />Yes <br />41 <br />No <br />Metal - pH acceptable upon receipt (p <br /><2)? <br />Yes <br />❑ <br />No 17 <br />NA I] <br />Samples Received on Ice? <br />Yes <br />EI <br />No I I <br />NOTE: If the "No" box is checked, s <br />I comments below. <br />Client contacted: I Date contacted: Contacted by: <br />Comments: <br />