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A ✓' McCampbell Analytical, Inc 1534Willow Pass Road,Pittsburg,CA 94555-1701 <br /> Web:www.mccampbell.00m E-E-mail:nizin@mccampbell.com <br /> "WbenOttatitvCounts" Tele hone:677-252-9262 Fax:925-252-9269 <br /> Sample Receipt Checklist <br /> Client Name: Baker Corp. Date and Time Received: 9/30/2010 1:03:47 PM <br /> Project Name: #98-263; Tuleburg Warehouse Checklist completed and reviewed by: Melissa Valles <br /> WorkOrder N°: 1009814 Matrix 22fid Carrier: Client Drop-In <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes EZ No ❑ <br /> Chain of custody signed when relinquished and received? Yes ® No ❑ <br /> Chain of custody agrees with sample labels? Yes © No ❑ <br /> Sample IDs noted by Client on COC? Yes © No ❑ <br /> Date and Time of collection noted by Client on COC? Yes © No ❑ <br /> Sampler's name noted on COC? Yes No ❑ <br /> Sample Receipt Infor a ion <br /> Custody seals intact on shipping contalnerlcooler? Yes ❑ No❑ NA R) <br /> Shipping containerlcooler in good condition? Yes ® No❑ <br /> Samples in proper containers/bottles? Yes © No❑ <br /> Sample containers intact? Yes 0 No❑ <br /> Sufficient sample volume for indicated test? Yes 9 No❑ <br /> Sample Preservation and Hold Time HT Information <br /> All samples received within holding time? Yes 21 No❑ <br /> Container/Temp Blank temperature Cooler Temp: 29.8°C NA ❑ <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes ❑ No ❑ No VOA vials submitted <br /> Sample labels checked for correct preservation? Yes ] No.❑ <br /> Metal-pH acceptable upon receipt(pH<2)? Yes ❑ No❑ NA <br /> Samples Received on Ice? Yes ❑ No <br /> NOTE:if the "No"box Is checked,see comments below. <br /> --------------------------------------------- <br /> Client contacted: ❑ate contacted: Contacted by: <br /> Comments: <br />