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Nov.12, 2008 4:04PM <br />No. 2067 P. 6 <br />cCa bell Analytical, Inc. 1534 Willow Pam Road, Pinsbnrg, CA 94565-1701 <br />.�PWeb: www.mocaLmpbell.eom E-mza:mmin@mocampbeU.com <br />°WbenOuslitvCounts' E Tele hone: 877.252.9262 F x:925-252-9269 <br />Sample Receipt Checklist <br />Client Name: Forward Landfill <br />Project Name: Forward Landfill Stain on the ground <br />WorkOrder N°: 0810415 Matrix Soll <br />Dale and Time Received: 10/17/08 8:44:32 AM <br />Checklist completed and reviewed by: Marie Venegas <br />Career: UPS <br />Chain of Custody (COCl <br />Infarmatlon <br />Chain of custody present? <br />Yes <br />® <br />No ❑ <br />Chain of custody signed when relinquished and received? <br />Yes <br />Yes ® <br />No ❑ <br />Chain of custody agrees with sample labels? <br />Yes <br />® <br />No ❑ <br />Sample IDs noted by Client on COC? <br />Yes <br />® <br />W ❑ <br />Date and Time of collection noted by Client on COC? <br />Yes <br />® <br />No ❑ <br />Sampler's name noted on COC? <br />Yes <br />❑ <br />No E-1. <br />Custody seals intact on shipping container/cooler? <br />Shipping container/cooler in good condition? <br />Samples in proper containers/bottles? <br />Sample containers Intact? <br />Sufflclan(sample volume for Indicated test? <br />Sample Recelot information <br />Yes ❑ <br />No ❑ <br />Yes ® <br />No 0 <br />Yes ® <br />No <br />Yes ® <br />No ❑ <br />Yes ® <br />No ❑ <br />MEN <br />Sample Preservation <br />pnd Hgld <br />Il!O19HT information <br />All samples received within holding time? <br />Yes <br />® <br />No ❑ <br />Containerfiemp Blank temperature <br />Cooler Temp: <br />NA <br />Water -'VOA vials have zero headspace / no bubbles? <br />Yes <br />0 <br />No ❑ No VOA vials submitted <br />Sample labels checked for correct preservation? <br />Yes <br />Q <br />No 0 <br />TTLC Metal - pH acceptable upon receipt (pH<2)? <br />Yes <br />a <br />No 0 NA <br />Samples Received on Ice? <br />Yes <br />❑ <br />No <br />NOTE. If the °No" box Is checked, see comments below. <br />--------------------------------------------- <br />Client contacted: <br />Comments: <br />Date contacted: <br />Contacted by: <br />