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Login Sample Receipt Checklist <br />Client: ARCADIS U.S. Inc <br />Login Number: 69889 <br />List Number: 1 <br />Creator: Mullen, Joan <br />Question <br />Radioactivity wasn't checked or is <i= background as measured by a <br />survey meter. <br />The cooler's custody seal, if present is intact. <br />Sample custody seals, if present, are intact. <br />The cooler or samples do not appear to have been compromised or <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 inf rmation. <br />Is the Field Sampler's name present on COC? <br />There are no discrepancies between the containers received and the COC <br />Samples are received within Holding Time (excluding tests with immediate <br />HTs) <br />Sample containers have legible labels. <br />Containers are not broken or leaking <br />Sample collection date/times are pro ided. <br />Appropriate sample containers are used. <br />Sample bottles are completely filled. <br />Sample Preservation Verified. <br />There is sufficient vol. for all request d analyses, incl. any requested <br />MS/MSDs <br />Containers requiring zero headspace have no headspace or bubble is <br /><6mm (1/4"). <br />Multiphasic samples are not present. <br />Samples do not require splitting or cc mpositing. <br />Residual Chlorine Checked. <br />Job Number: 720-69889-1 <br />List Source: TestAmerica Pleasanton <br />Answer Comment <br />N/A <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 />N/A <br />TestAmerica Pleasanton <br />Page 26 of 26 1/26/2016 <br />15 <br />