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Analytical, <br />� 1534 Willow Pass Road, Pittsburg, CA 94565-1701 <br />M C C a m p b e l l A n a l Y I} i C a l, I n c• Toll Free Telephone: (877) 252-9262 / Fax: (925) 252-9269 <br />"When Quality Counts" http://www.mccampbell.com / E-mail: main@mccampbell.com <br />Sample Receipt Checklist <br />Client Name: Stericycle Date and Time Received 7/13/2017 <br />Project Name: Fish Bioassay Date Logged: 7/14/2017 <br />Received by: Kena Ponce <br />WorkOrder W: 1707503 Matrix: Solid Logged by: Kena Ponce <br />Carrier: Courier <br />Chain of Custody (COC) Information <br />Chain of custody present? Yes ❑d No ❑ <br />Chain of custody signed when relinquished and received? Yes ❑ No ❑d <br />Chain of custody agrees with sample labels? Yes ❑ No ❑d <br />14 <br />Sample IDs noted by Client on COC? Yes ❑ No ❑d <br />Date and Time of collection noted by Client on COC? Yes ❑ No ❑d <br />Sampler's name noted on COC? Yes ❑ No ❑d <br />Sample Receipt Information Z <br />Custody seals intact on shipping container/cooler? Yes ❑ NA ❑4 <br />Shipping container/cooler in good condition? <br />Samples in proper containers/bottles? <br />Sample containers intact? <br />Sufficient sample volume for indicated test? <br />All samples received within holding time? <br />Sample/Temp Blank temperature <br />Water - VOA vials have zero headspace / no <br />Sample labels checked for correct preservOT, <br />Yes ❑4 <br />Yes ❑� �j` �fVo ❑ <br />No ❑ <br />es No ❑ <br />Sample Prese0hon and Hold Time HT Information <br />Yes WNo El NA ❑ <br />A O Temp: 10.2°C NA ❑ <br />Yes ❑ No ❑ <br />Yes 0 No [_1 <br />pH acceptable upon receipt (Me 218.7: >8)? Yes ❑ No ❑ <br />Samples Received on Ice? Yes 17V] No ❑ <br />(Ice Type: WET ICE ) <br />UCMR Samples: <br />Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No ❑ <br />Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No ❑ <br />300.1, 537, 539? <br />Comments: The following SamplD(s) does not have collection date: 1707503-001A. <br />NA W <br />NA ❑d <br />NA ❑� <br />NA ❑D <br />Page 7 of 7 <br />