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1534 Willow Pass Road, Pittsburg, CA 94565-1701 <br />M c Campbell Analytical , Inc . Toll Free Telephone: (877) 252-9262 / Fax: (925) 252-9269 <br />\ "When Quality Counts" http://www.inccampbell.coin / E-mail: main a;mccampbell.com <br />Sample Receipt Checklist <br />Yes ❑ <br />Client Name: Fremouw Environmental Services, Inc. <br />Yesd❑ <br />No ❑ <br />Date and Time Received: <br />6/26/2018 12:15 <br />Project: TBD; Profleet Inc <br />No ❑ <br />Yes ❑J <br />Date Logged: <br />6/26/2018 <br />Temp: <br />1.8°C <br />Received by: <br />Lilly Ortiz <br />WorkOrder Ne: 1806C50 Matrix: Soil <br />No ❑ <br />Sample labels checked for correct preservation? <br />Logged by: <br />Lilly Ortiz <br />Carrier: Patrick Johnson (MAI Courier) <br />pH acceptable upon receipt (Metal: <2; 522: <4; 218.7: >8)? <br />Yes <br />❑ <br />No ❑ <br />Chain <br />of Custody <br />(COC) Information <br />Chain of custody present? <br />Yes <br />W <br />No ❑ <br />Chain of custody signed when relinquished and received? <br />Yes <br />d❑ <br />No ❑ <br />Chain of custody agrees with sample labels? <br />Yes <br />❑J <br />No ❑ <br />Sample IDs noted by Client on COC? <br />Yes <br />No ❑ <br />Date and Time of collection noted by Client on COC? <br />Yes <br />No ❑ <br />Sampler's name noted on COC? <br />Yes <br />❑ <br />No W <br />COC agrees with Quote? <br />Yes <br />❑ <br />No ❑ <br />NA ❑d <br />Custody seals intact on shipping container/cooler? <br />Shipping container/cooler in good condition? <br />Samples in proper containers/bottles? <br />Sample containers intact? <br />Sufficient sample volume for indicated test? <br />Sample Receipt Information <br />Yes ❑ <br />No ❑ <br />Yesd❑ <br />No ❑ <br />Yes <br />No ❑ <br />Yes ❑�I <br />No ❑ <br />Yes ❑J <br />No ❑ <br />Sample Preservation <br />All samples received within holding time? <br />and <br />Yes <br />Hold Time <br />(HT) Information <br />No ❑ <br />Samples Received on Ice? <br />Yes <br />No ❑ <br />(Ice Type: <br />WET ICE ) <br />Sample/Temp Blank temperature <br />Temp: <br />1.8°C <br />Water - VOA vials have zero headspace / no bubbles? <br />Yes <br />❑ <br />No ❑ <br />Sample labels checked for correct preservation? <br />Yes <br />d❑ <br />No ❑ <br />pH acceptable upon receipt (Metal: <2; 522: <4; 218.7: >8)? <br />Yes <br />❑ <br />No ❑ <br />UCMR Samples: <br />pH tested and acceptable upon receipt (200.8::52; 525.3: :54; <br />530: <_7; 541: <3; 544: <6.5 & 7.5)? <br />Free Chlorine tested and acceptable upon receipt (<0.1mg/L)? <br />NA ❑d <br />NA ❑ <br />NA ❑ <br />NA ❑d <br />NA V <br />Yes ❑ No ❑ NA W <br />Yes ❑ No ❑ NA W <br />-------------------------------------------- <br />Comments: <br />Page 9 of 9 <br />