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McCam bell Anal tical Inc. 1534WinowPass Road,Piusburg,CA 94565-1701 <br /> �Wll Toll Free Telephone:(877)252-92621 Fax:(925)252-9269 <br /> "When Quality Counts" hn irw,niccampbell.com!F mail:mainCmccampbelf.com <br /> Sample Receipt Checklist <br /> Client Name: AFD Bodyshop North Date and Time Received 1/29/2020 14:00 <br /> Project: AFD North Date Logged: 1/29/2020 <br /> WorkOrder Ns: 2001002Matrix: Soli Received by: Nancy Palacios <br /> Logged by: Nancy Palacios <br /> Carrier: P rick Johnson MAC rier <br /> rhaln A Custody(CDC)Informalion <br /> Chain of custody present? Yes 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 0 No❑ <br /> Sampler's name noted on GOC? Yes 0 No❑ <br /> COC agrees with Quote? Yes No❑ NA ❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping containerlcooler? Yes ❑ No❑ NA <br /> Shipping container/cooler in good condition? Yes +❑ No❑ <br /> Samples in proper containers/bottles? Yes ❑ No❑ <br /> Sample containers intact? Yes Q No❑ <br /> Sufficient sample volume for indicated test? Yes No❑ <br /> Sainple es tind d i e T) Inforynati2a <br /> All samples received within holding time? Yes W No❑ NA❑ <br /> Samples Received on Ice? Yes ❑ No 0 <br /> Sample/Temp Blank temperature Temp; NA,I] <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes ❑ No❑ NA <br /> Sample labels checked for correct preservation? Yes ,/❑ No❑ <br /> pH acceptable upon receipt(Metal: <2; Nitrate 353.2/4500NO3: Yes ❑ No❑ NA D <br /> <2;522: <4;218.7:>8)? <br /> UCMR Samples: <br /> pH tested and acceptable upon receipt(200.8:52;525.3::54: Yes ❑ No❑ NA <br /> 530:57;541: <3;544:<U&7.5)? <br /> Free Chlorine tested and acceptable upon receipt(<0.lmg/L)? Yes ❑ No❑ NA <br /> Comments - - - - - -- - <br />