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Alpha Analytical, Inc. <br /> Phone: (775)355-1044 FAX:(775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client: 5/9/2006 Date of Notice: 4/25/2006 10:26:30 <br /> Please take note of any NO check marks. If we receive no response concerning these items within 24 hours of the date of this notice,all of <br /> the samples will be analyzed as requested. <br /> Client Name: Stratus Environmental Project 10 : 2005-2050-011 APACHE PLASTICS <br /> Project Manager; Jay Johnson Client's EMail: jjohnson@stratusinc.net <br /> Client's Phone: (530)676-6000 Client's FAX: (530)676-6005 <br /> Work Order Number: STR06042524 Date Received: 4/25/2006 Received by:Tasha Pascal <br /> Chain of Custody(COC)Information <br /> Carrier name: FedEx <br /> Chain of custody present? Yes 9 ❑ No <br /> Custody seals intact on shippping container/cooler? Yes 2 ❑ No Not Present ❑ <br /> Custody seals intact an sample bottles? Yes ❑ ❑ No Not Present <br /> Chain of custody signed when relinquished and received? Yes ❑ No <br /> Chain of custody agrees with sample labels? Yes ❑ No <br /> Sample ID noted by Client on COC? Yes RJ ❑ No <br /> Date and time of collection noted by Client on COC? Yes ❑d ❑ No <br /> Samplers's name noted on COC? Yes ❑ No <br /> rternai Chain of Custody(COC)requested? Yes ❑ W No <br /> ub Contract Lab Used ; None ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping container/cooler in good condition? Yes No Not Present ❑ <br /> Samples in proper container/bottle? Yes ❑ No <br /> Sample containers intact? Yes ❑ No <br /> Sufficient sample volume for indicated test? Yes No <br /> Sample Preservation and Hold Time(HI)Information <br /> All samples received within holding time? Yes ❑ No <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6'C)? Yes ❑ No 4°C <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No No VOA vials submitted ❑ <br /> Sample labels checked for correct preservation? Yes 0 ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No N/A 0 <br /> Analytical Requirement Information <br /> Are non-Standard or Modified_methods requested? Yes ❑ No <br /> Are there client specific Project requirements? Yes ❑ 0 No If YES :see the Chain of Custody(COC) <br /> Comments <br />