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Sample Receipt Checklist <br />McCampbell Analytical, Inc.1534 Willow Pass Road, Pittsburg, CA 94565-1701 <br />Toll Free Telephone: (877) 252-9262 / Fax: (925) 252-9269 <br />http://www.mccampbell.com / E-mail: main@mccampbell.com"When Quality Counts" <br />Client ame ACTniro <br />20 <br />Date Logged 202 <br />Logged by Lilly OrtiMatriSolid <br />Carrier Patrick Johnson (MAI Courier) <br />Shipping container cooler in good condition Yes o <br />Custody seals intact on shipping container cooler Yes o A <br />Samples Receied on Ice Yes o <br />Chain of custody present Yes o <br />Chain of custody signed when relinquished and receied Yes o <br />Chain of custody agrees with sample labels Yes o <br />Samples in proper containers bottles Yes o <br />Sample containers intact Yes o <br />Sufficient sample o l u m e for indicated test Yes o <br />AAll samples receied within holding time Yes o <br />ASampleTemp Blank temperature <br />Yes o AHS conditional analyses VOA meets e r o headspace <br />requirement (VOCs TPHg BT RSK) <br />pH acceptable upon receipt (Metal 2)Yes o A <br />Temp . C <br />Chain of Custody (COC) Information <br />Yes oSample IDs noted by Client on COC <br />Yes oDate and Time of collection noted by Client on COC <br />Yes oSamplers name noted on COC <br />Sample Receipt Information <br />Sample Preseration and Hold Time (HT) Information <br />Sample labels checked for correct preseration Yes o <br />Pro ect Vestis Serices LLC <br />(Ice Type WT IC ) <br />Comments <br />pH tested and acceptable upon receipt (200. <br />3. - ) <br />Yes o A <br />CMR Samples <br />Free Chlorine tested and acceptable upon receipt (0.mg L) <br />not applicable to 200. <br />Yes o A <br />Date and Time Receied 202 30 <br />Receied by Lilly Orti <br />COC agrees with Quote Yes o A <br />Custody seals intact on sample bottles Yes o A <br />Page 17 of 17