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Argon Laboratories Sample Receipt Checklist <br /> Client Name ATC Associates, Inc Date&Time Received 6/23/2004 1700 <br /> Project Name Thiemann's Service Client Project Number 54 62605 0001 <br /> Received By E P Matrix Water 21 Sail ❑ <br /> Sample Carrier Client ❑ Laboratory 0 Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Protect Number E06571 <br /> Shipper Container in good condition? , Samples received in proper containers? Yes Q No ❑ <br /> N!A Yes No ❑ Samples received intact? Yes [] No ❑ <br /> Samples received under refngeration? Yes No ❑ Sufficient sample volume for requested tests?Yes 0 No ❑ <br /> Chain of custody present? Yes No Samples received within holding time? Yes 0 No ❑ <br /> Chain of Custody signed by all parties? Yes Q No ❑ Do samples contain proper preservative? <br /> N/A ❑ Yes 0 No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes No ❑ {None submitted ❑) Yes D No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> iDate Client Contacted Person Conacted <br /> Contacted By Subject <br /> Comments <br /> Action Taken <br /> ADDITIONAL TEST(S)REQUEST!OTHER <br /> Contacted By Date Time <br /> Call Received By <br /> Comments <br /> s <br />