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1534 willow Pass Road,Pittsburg,CA 94565-1701 <br /> ® McCampbell Analytical. �nC• Toll Free Telephone:(877)252-9262/Fm:(925)252-9269 <br /> "When Quality Counts" http://www.mccampbeH.com/&mail:main mcc=pbeacom <br /> Sample Receipt Checklist <br /> Client Name: Advanced GeoEnvironmental, Inc. Date and Time Received: 5/7/2015 9:56:47 AM <br /> Project Name: PNA Lathrop Login Reviewed by: Maria Venegas <br /> WorkOrder Ng: 1505001 Matrix: a= Carrier: OnTrac <br /> Chain of Custody(COC)Information �1 � <br /> Chain of custody present? Yes © No 1,.r ®Q,�•9'yy <br /> ` rsve+n <br /> Chain of custody signed when relinquished and received? Yes M No EJRE <br /> 0 6 2017 <br /> Chain of custody agrees with sample labels? Yes M No El <br /> Sample IDs noted by Client on COC? Yes M No❑ <br /> Date and Time of collection noted by Client on COC? Yes M No❑ ENVIRONMENTAL HEALTH <br /> DEPARWENT <br /> Sampler's name noted on COC? Yes WNo El <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA M <br /> Shipping container/cooler in good condition? Yes M No❑ <br /> Samples in proper containers/bottles? Yes M No❑ <br /> Sample containers intact? Yes M No❑ <br /> Sufficient sample volume for indicated test? Yes M No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? - Yes M No❑ - <br /> Samplerfemp Blank temperature Temp: NA <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ NAM <br /> Sample labels checked for correct preservation? Yes M No❑ <br /> pH acceptable upon receipt(Metal:<2;522:<4;218.7:>8)? Yes ❑ No❑ NA M <br /> Samples Received on Ice? Yes ❑ No M <br /> UCMR3 Samples: <br /> Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No❑ NAM <br /> Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NAM <br /> 300.1,537,539? <br /> NOTE:If the"No"box is checked,see comments below. <br /> --------------------------------------------- <br /> __—__——————— ____— _ <br /> Comments: <br /> Page 7 of 7 <br />