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Amon LablGatories Sample Receipt 6ecklist <br /> Client Name:A L / Date&Time Received: 2 O (! Q <br /> Project Name: ! <br /> Client Project Number. <br /> Received By:--a1`• Matrix: Water ❑ Soil MI/Other <br /> Sample Carrier: Client ❑ Laboratory L Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number: a <br /> Shipper Container in good condition? Sufficient sample volume for requested tests?Yes ID/ No ❑ <br /> N/A [� Yes ❑,/ No ❑ Samples received within holding time? Yes EEKI No ❑ <br /> Samples received under refrigeration? Yes No ❑ Do samples contain proper preservative? <br /> N/A [�Yes El No ❑ <br /> Chain of custody present? Yes No ❑ VOA vials with preservative? <br /> N/A Yes ❑ No ❑ <br /> Cham of Custody signed by all parties? Yes [� No E) VOA vials preservativelype: <br /> HCL ❑ Na1S203 ❑ Other <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headsP ace? <br /> Yes 13 No ❑ N/A Yes ❑ No ❑ <br /> Samples received in proper containers?Yes (/ No ❑ Samples received intact? Yes No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted: Person Contacted: <br /> Contacted By: Subject: <br /> Comments: <br /> Action Taken: <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted By: Date: Time: <br /> Call Received By: <br /> Comments: <br /> v.5.02 <br />