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1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> jyN M c C a m bell Analytical, Inc. Toll Free Telephone:(877)252-92621 Fax:(925)252-9269 <br /> "When Qllaiity Counts" http:llwww.mccampbcll.comlE-mail:irnainanccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: Terracon Date and Time Received 12/18/2017 12:20 <br /> Project: R1177G18; Date Logged: 12/1812017 <br /> Received by: Jena Alfaro <br /> WorkOrder N9: 1712772 Matrix: Water Logged by: Kena Ponce <br /> Carrier: Client Drop-In <br /> Chain of Custody fCOC)Information <br /> Chain of custody present? Yes ❑✓I No L <br /> Chain of custody signed when relinquished and received? Yes No❑ <br /> Chain of custody agrees with sample labels? Yes No <br /> Sample IDs noted by Client on COC? Yes No❑ <br /> Date and Time of collection noted by Client on COC? Yes © No <br /> Sampler's name noted on COG? Yes +❑ No❑ <br /> COC agrees with Quote? Yes ❑ No❑ NA <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes No❑ NA k <br /> Shipping containerlcooler in good condition? Yes No❑ <br /> Samples in proper containersibottles? Yes No❑ <br /> Sample containers intact? Yes No❑ <br /> Sufficient sample volume for indicated test? Yes ® No❑ <br /> Safflale Preservation and Hold Tim T Informatio <br /> All samples received within holding time? Yes U No NA❑ <br /> SamplefTemp Blank temperature Temp: NA W <br /> Water-VOA vials have zero headspace f no bubbles? Yes ❑ No❑ NA 0 <br /> Sample labels checked for correct preservation? Yes No❑ <br /> pH acceptable upon receipt(Metal:<2;522:<4;218.7:>8)? Yes ❑ No❑ NAW <br /> Samples Received on Ice? Yes ❑ No 0 <br /> UCMR Sam Ip es: <br /> Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No❑ NA .❑ <br /> Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NA 0 <br /> 340.1,537,539? <br /> -------------------------------------------- <br /> Comments: <br /> Page 43 of 43 <br />