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Client: United Pumping Service <br />Login Number: 54010 <br />List Number: 1 <br />Creator: Bullock, Tracy <br />Question <br />Radioactivity wasn't checked or is </= ba <br />survey meter. <br />The cooler's custody seal, if present, is i <br />Sample custody seals, if present, are int <br />The cooler or samples do not appear to <br />tampered with. <br />Samples were received on ice. <br />Cooler Temperature is acceptable. <br />Cooler Temperature is recorded. <br />COC is present. <br />COC is filled out in ink and legible. <br />COC is filled out with all pertinent informa <br />Is the Field Sampler's name present on C <br />There are no discrepancies between the <br />Samples are received within Holding Tim <br />Sample containers have legible labels. <br />Containers are not broken or leaking. <br />Sample collection dateltimes are provided <br />Appropriate sample containers are used. <br />Sample bottles are completely filled. <br />Sample Preservation Verified. <br />There is sufficient vol. for all requested a <br />MSIMSDs <br />Containers requiring zero headspace hav <br /><6mm (1/4"). <br />Multiphasic samples are not present. <br />Samples do not require splitting or compo, <br />Residual Chlorine Checked. <br />TestAmerica Pleasanton <br />Login Sample Receipt Checklist <br />as measured by a <br />been compromised or <br />Mainers received and the COC. <br />lyses, incl. any requested <br />no headspace or bubble is <br />Page 31 of 31 <br />Answer Comment <br />NIA <br />N/A <br />N/A <br />True <br />True <br />True <br />True <br />True <br />True <br />True <br />True <br />True <br />True <br />True <br />True <br />True <br />True <br />True <br />N/A <br />True <br />True <br />True <br />True <br />NIA <br />Job Number. 720-54010-1 <br />List Source: TestAmerica Pleasanton <br />12/2/2013 <br />15 <br />U P_006031 <br />