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-N .VHALPY <br /> ANALYT 1. CAL <br /> SAMPLE ACCEPTANCE CHECKLIST <br /> Section 1 <br /> Client:Antea/Test America Project:Medesto Sub UPRR <br /> Date Received:3/23/19 Sampler's Name Present: f es ONO <br /> Section 2 <br /> Sample Temp('C) <br /> Sample(s) received in a cooler? [2]Yes, How many? No(skip section 2) (No Cooler) <br /> Sample Temp(°C), One from each cooler: #1: 5.0 #2: #3: #4: <br /> (Acceptance range is<6'C but not frozen(for Microbiology samples,acceptance range is <10°C but not frozen)- it is acceptable forsamples collected <br /> the same day as sample receipt to have a higher temperature as long as there is evidence that cooling has begun.) <br /> Shipping Information: <br /> Section 3 <br /> Was the cooler packed with: [f Ice E]Ice Packs QBubble Wrap nStyrofoam <br /> Paper None Other <br /> Cooler Temp (`C): #1: 0-0 #2: #3: #4: <br /> Section 4 YES NO N/A <br /> Was a COC received? f <br /> Are sample IDs present? f <br /> Are sampling dates&times present? f <br /> Is a relinquished signature present? f <br /> Are the tests required clearly indicated on the COC? f <br /> Are custody seals present? f <br /> If custody seals are present,were they intact? f <br /> Are all samples sealed in plastic bags? (Recommended for Microbiology samples) f <br /> Did all samples arrive intact? If no, indicate in Section 4 below. f <br /> Did all bottle labels agree with COC?(ID,dates and times) f <br /> Were the samples collected in the correct containers for the required tests? f <br /> Are the containers labeled with the correct preservatives? f <br /> Is there headspace in the VOA vials greater than 5-6 mm in diameter? f <br /> Was a sufficient amount of sample submitted for the requested tests? f <br /> Section S Explanations/Comments <br /> Section 6 <br /> For discrepancies, how was the Project Manager notified?Overbal PM Initials: Date/Time <br /> Email (email sent to/on): / <br /> Project Manager's response: <br /> Completed By: -Date:--?/t-7 G/ <br /> r <br /> Enthalpy Analytical,a subsidiary of Montrose Environmental Group,inc. <br /> 931 W.Barkley Ave,Orange,CA 92868•T:(714)771-6900•F:(714)538-1209 <br /> www.enthalpy.com/gocal <br /> Sample Acceptance Checklist—Rev 4,8/8/2017 <br />