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Amon Laboratories Sample Receipt Checklist <br /> • Client Name:' Ground Zero Analysis Cate&Time Received: 2/25/2005 i _. 14:11 <br /> Project Name: Knowles Roek Client Project Number: 186 <br /> Received By: P.H. Matrix: Water Soil ❑ <br /> Sample Carrier: Client ❑ Laboratory Q Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon labs Project Number: F02511 <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 El <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 oontain zero headspace? <br /> Yes No ❑ (None submitted ❑) Yes 0 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 /> I � <br /> Action Taken: <br /> ' ADDITIONAL TESTS REQUEST I OTHER <br /> R <br /> ' Contacted By: Date• Time:r <br /> Call Received By: <br /> ' Comments: <br /> 1 <br /> 1 <br /> 1 <br />