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Ar on Laboratories Sample Receipt Checklist <br /> Client Name: Ground Zero Analysis Date&Time Received: 5/25/2005 14:10 <br /> Project Name: Knowles Roek Client Project Number: 186 <br /> Received By: C.R. Matrix: Water Soil ❑ <br /> Sample Carrier: Client ❑ Laboratory 21 Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number: F05711 <br /> Shipper Container in good condition? Samples received in proper containers? Yes 0 No ❑ <br /> NIA Yes [ No ❑ Samples received intact? Yes No [] <br /> Samples received under refrigeration? Yes [] No ❑ Sufficient sample volume for requested tests?Yes 0 No ❑ <br /> Chain of custody present? Yes No Samples received within holding time? Yes 0 No ❑ <br /> Chain of Custody signed by all parties? Yes ❑ No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes 0 No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes No ❑ (None submitted ❑) Yes {] No ❑ <br /> Y_ <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 1 OTHER <br /> Contacted By: Bate: Time: <br /> Cali Received By: <br /> Comments <br />