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Section 4 — Comments / Discrepancies <br />Client notified of discrepancies: Yes /No Notified by: <br />Comments: <br />Date: <br />Time: I tc.s.t <br />Bin Number/ Location: <br />COC Scanned/Attached by: C6V <br />Samples labeled by: qr/ <br />Sample labels reviewed by: <br />Excelchem Laboratories, Inc. <br />Arcadis Project: Stockton transformer <br />101 Creeksdie Ridge Court Suite 200 Project Number: 30101128.0002 <br /> <br />Date Reported: <br />Rio Oso, CA 95678 Project Manager: Drew Feucht <br />08/23/21 14:28 <br />Sample Integrity <br />Date Received: (%c )LI <br /> <br />WORK ORDER: 2-1 0111 <br />Company Name: <br />New Client: Y <br /> <br />Section 1 — Sample Arrival Information <br />Sample Transport: ONTRAC UPS USPS Walk-In EXCELCHEM Courier Fed-Ex Other: <br />Transported In: Ice Chest Box Hand <br />Packing materials: Bubble W Foam Packing Peanuts Paper Other: <br />Has chilling process begun? Y N Samples Received: Chilled to Touch / Ambient <br />Temperature of Samples CC): 2.0 Ice Chest Temperature(s) CC): —0 1;7 <br />Section 2 — Bottle/Analysis Info. <br />Yes No N/A Comments <br />Did all bottles arrive unbroken and intact? <br />Did all all bottle labels agree with COC? Were correct containers used for the tests requested? <br />Were correct correct preservations used for the tests requested? -7`. Was a sufficient amount of sample sent for tests indicated? *--..- <br />Were bubbles present in VOA Vials?: (Volatile Methods Only) >c. <br />Is there head space in the VOA vials? (Volatile Methods Only) ›--- <br />Section 3— COC Information <br />Yes No Comments Yes No <br />COC Received ...,4-.-. Analysis Requested <br />...-.' <br />Date Sampled Samples arrived within holding time <br />Time Sampled <br />'--- Hold times less than 72 hours <br />Sample ID ID <br />...> <br />Client Name <br />Rush Turn Around Time <br />c-‘.. VLIAS1/1 <br />Client Contact Information <br />SHORT HOLD LIST (<72 hours) <br />pH Chlorine Corrosivitv Coliform Dissolved Oxygen Odor Nitrate Nitrite Ortho-phosphate <br />Ammonia/TKN runpreserved) MB <br />As <br />Asbestos Sertable Solids Turbidity Biochemical Oxygen Demand HPC Color Tedlars <br />Excelehem Laboratories. Inc. <br /> <br />The results in this report apply to the samples analyzed in accordance with the chain of <br />custody document. This analytical report must be reproduced in its entirety. <br /> <br />-S. <br /> <br />Laboratory Representative Page 7 of 7