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Amon Laboratories Sample Receipt Checklist <br /> ' Client Name P 7-C, <br /> ' - rv� Date&Time Received 13J �a� U 5 u <br /> Protect Name c '7 5 Op <br /> o <br /> /CC£!tent Project Number- <br /> Received <br /> Received <br /> By LA Matrix 6—ter) Soil / <br /> ' Sample Carrier Client 1aborato FedEx 1 UPS 1 <br /> Argon Labs Protect Number _ Ga S ?j 3 <br /> ' Shipping Container 1 Cooler in good condition? Samples received in proper containers? Yes No <br /> WA Yes ✓ No Samples received intact? Yes / No <br /> ' Samples received under refngerabon7/ Sufficient sample volume for requested tests? <br /> Yes ✓ No Yes ✓ No <br /> Chain of Custody Present? Yes -//No Samples received within holding time? YesNo <br /> Chain of Custody signed by ail panes? Do samples contain proper preservative? <br /> Yes `� No NIA Yes ✓ No <br />' Chain of Custody matches all samplelabei0 Do VOA vials contain zero headspace7 <br /> Yes `" / No {None submitted,}Yes ✓ No <br />' ANY"No" RESPONSE MUST BE DETAILED 1N T <br /> FfECOMMENT5SEC710NBELOW- � - - � - - ` <br /> Date Client Contacted Person Contacted <br /> Contacted by Subject <br /> Comments <br />' Action Taken <br />' - - - - - - - - OTHER <br /> Dale Client Contacted Person Contacted <br /> Comments <br /> i <br />