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1 <br /> I♦ Amon Laboratories Sample Receipt Checklist <br />' Cbent Name Ground Zero Analysis Date&Time Received 11/1012003 <br /> Protect Name Tuleburg Warehouse Client Protect Number 98-263 <br />' Received By PDH Matrix Water 0 Sod ❑ <br /> Sample Carrier Client ❑ Laboratory 0 Fed Ex ❑ UPS ❑ Other ❑ <br />' Argon Labs Protect Number D11141 <br /> Shipper Container in good condition? Samples received in proper containers? Yes P7 No ❑ <br /> N/A ✓ Yes ❑ No ❑ Samples received intact? Yes 0 No ❑ <br />' Samples received under refrigeration? Yes [] No ❑ Sufficient sample volume for requested tests?Yes ❑ No ❑ <br /> Chain of custody present? Yes No ❑ Samples received within holding time? Yes El No ❑ <br />' Cham of Custody signed by all parties? Yes No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes 0 No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes No ❑ (None submitted ❑ ) Yes 0 No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br />'• Date Client Contacted Person Conacted <br /> Contacted By Subject <br />' Comments <br /> Action Taken <br /> I <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> ----------i------ -- <br /> Contacted By By Date Time <br /> Call Received By <br /> Comments <br />