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Login Sample Receipt Checklist <br />Client: ARCADIS U.S. Inc <br />Login Number: 69886 <br />List Number: 1 <br />Creator: Mullen, Joan <br />Question Answer <br />Radioactivity wasn't checked or i </= background as measured by a survey N/A <br />meter. <br />The cooler's custody seal, if pres nt, is intact. N/A <br />Sample custody seals, if present, are intact. N/A <br />The cooler or samples do not ap ear to have been compromised or True <br />tampered with. <br />Samples were received on ice. <br />Cooler Temperature is acceptabl . <br />Cooler Temperature is recorded. <br />COC is present. <br />COC is filled out in ink and legibl <br />COC is filled out with all pertinent r <br />Is the Field Sampler's name pres r <br />There are no discrepancies betw <br />Samples are received within Holdi <br />HTs) <br />Sample containers have legible la <br />Containers are not broken or leaki <br />Sample collection date/times are r <br />Appropriate sample containers ar <br />Sample bottles are completely fille <br />Sample Preservation Verified. <br />There is sufficient vol. for all reque <br />MS/MSDs <br />Containers requiring zero headspa <br /><6mm (1/4"). <br />Multiphasic samples are not prese <br />Samples do not require splitting or <br />Residual Chlorine Checked. <br />TestAmerica Pleasanton <br />ormatron. <br />on COC? <br />the containers received and the COC. <br />Time (excluding tests with immediate <br />used. <br />analyses, incl. any requested <br />have no headspace or bubble is <br />Page 6 of 6 <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 />N/A <br />Job Number. 720-69886-2 <br />List Source: TestAmerica Pleasanton I <br />Comment <br />2/3/2016 <br />U P_006112 <br />