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1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> McCampbell Analytical, Inc. Toll Free Telepbone:(877)252-9262/Fax:(925)252-9269 <br /> "When Quality Counts" bttp://www.mccainpbell.com/E-mail:main(jnccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: Stockton Rubber Mfg.Co.,Inc. Date and Time Received: 11/1512012 7:01:36 PM <br /> Project Name: Sandblast Logln Reviewed by: Zoraida Cortez <br /> WorkOrder N°: 1211461 Matrix: Solid Carrier: David Valles(MAI Courier) <br /> Chain of Custody(COC)Information <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 No❑ <br /> Sampler's name noted on COC? Yes 0 No❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? 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 No❑ <br /> Sufficient sample volume for indicated test? Yes 0 No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes PI No❑ <br /> Container/Temp Blank temperature Cooler Temp: 0.8°C NA❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ No VOA vials submitted ❑�/ <br /> Sample labels checked for correct preservation? Yes 7 No❑ <br /> Metal-pH acceptable upon receipt(pH<2)? Yes ❑ No❑ NAW <br /> Samples Received on Ice? Yes 141 No❑ <br /> (Ice Type: WET ICE ) <br /> *NOTE:If the"No"box is checked,see comments below. <br /> ————————————————————————————————————————————— <br /> Comments: <br /> Page 4 of 6 <br />