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y 1534 Willow Pass Road,Pittsburg,CA 94565-1701 McCampbell Analytical, Inc. Toll Free Te1cphons:(877)252-9262/Fax:(925)252-9269 "When Quality Counts" I hap://w .meempboB.com/E-mad:main@mccampbell.com Sample Receipt Checklist Client Name: Terracon Date and Time Received 12/2012017 11:35 Project: 1177G18;Lodi USD High School Date Logged: 1 212 01201 7 Received by: Kena Ponce WorkOrder No: 1712904 Matrix: Water Logged by: Kana Ponce Carrier: Client Drop-In Chain of Custody ICOCI Information Chain of custody present? Yes © No❑ Chain of custody signed when relinquished and received? Yes © No❑ Chain of custody agrees With sample labels? Yes © No❑ Sample IDs noted by Client on COC? Yes © No❑ Dale and Time of collection noted by Client on COC? Yes © No❑ Sampler's name noted on COC? Yes © No❑ COC agrees with Quote? Yes ❑ No❑ NA W Sample Recelot Information Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA Shipping container/cooler in good condition? Yes W No❑ Samples in proper containers/bottles? Yes © No❑ Sample containers intact? Yes 0 No❑ Sufficient sample volume for indicated test? Yes 0 No❑ Sample Preservation and Hold Time(HT1 Information All samples received within holding time? Yes © No❑ NA❑ Sample/Temp Blank temperature Temp: NA Water-VOA vials have zero headspace/no bubbles? Yes © No❑ NA❑ Sample labels checked for correct preservation? Yes © No❑ pH acceptable upon receipt(Metal:<2;522:<4;218.7:>8)? Yes ❑ No❑ NAW Samples Received on Ice? Yes ❑ No❑J UCMR Samples: Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No❑ NA Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NA RI 300.1,537,539? --------------------------------------------- --------------------------------------------- Comments: Page I1 of 11