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ASSET Laboratories <br /> Please review the checklist below. Any NO signifies non-compliance. Any non-compliance will be noted and must be understood <br /> as having an impact on the quality of the data. All tests will be performed as requested regardless of any compliance issues. <br /> If you have any questions or further instruction, please contact our Project Coordinator at(702)307-2659. <br /> Cooler Received/Opened On: 3/18/2017 Workorder: N023518 <br /> Rep sample Temp(Deg C): 5.9 IR Gun ID: 2 <br /> Temp Blank: ❑ Yes © No <br /> Carrier name: Golden State Overnight <br /> Last 4 digits of Tracking No.: 5635 Packing Material Used: Foam Insert <br /> Cooling process: © Ice ❑ Ice Pack ❑ Dry Ice ❑ Other ❑ None <br /> Sample Receipt Checklist <br /> 1.Shipping container/cooler in good condition? Yes 0 No❑ Not Present ❑ <br /> 2.Custody seals intact,signed,dated on shippping container/cooler? Yes ❑ No❑ Not Present Sd <br /> 3.Custody seals intact on sample bottles? Yes ❑ No❑ Not Present 91 <br /> 4.Chain of custody present? Yes © No❑ <br /> 5.Sampler's name present in COC? Yes 56 No❑ <br /> 6.Chain of custody signed when relinquished and received? Yes 0 No❑ <br /> 7.Chain of custody agrees with sample labels? Yes V No❑ <br /> 8.Samples in proper contamer/bol6e? Yes V No❑ <br /> 9.Sample containers intact? Yes V No❑ <br /> 10.Sufficient sample volume for indicated test? Yes No❑ <br /> 11.All samples received within holding time? Yee No❑ <br /> 12.Temperature of rep sample or Temp Blank within acceptable limit? Yes © No❑ NA ❑ <br /> 13.Water-VOA vials have zero headspace? Yes ❑ No ❑ NA <br /> 14.Water-pH acceptable upon receipt? Yes ❑ No ❑ NA V <br /> Example:pH>12 for(CN,S);pH<2 for Metals <br /> 15.Did the bottle labels indicate correct preservatives used? Yes ❑ No ❑ NA Sd <br /> 16.Were there Non-Conformance issues at login? Yes 0 No❑ NA ❑ <br /> Was Client notified? Yes V No ❑ NA ❑ <br /> Comments: See Correspondence. <br /> Checklist Completed By: YR 3/21/2017 Reviewed By: A C: 3/22/2017 <br />