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..i Advanced Technology Laboratories Please review the checklist below. Any NO and/or NA signifies non-compliance. Any non-compliance will be noted and must be understood as having an impact on the quality of the data. All tests will be performed as requested regardless of any compliance issues. If you have any questions or further instruction, please contact our Project Coordinator at (562) 989-4045. Sample Receipt Checklist Client Name: OTSC-BERKELEY Date Time Received: 312412011 6:5.7:00 AM Work Order Number: 117013 Received by: FO Cooler Temp (Deg C): 10.2 Checklist completed by: 3 /ti4 /I I Reviewed by: '1 U S-~- 0. loai,, Carder name: FedEx 1. Shipping container/cooler in good condillon? Yes ® No ❑ Not Present ❑ 2. Custody seals intact on shippping container/cooleR Yes ❑ No ❑ Not Present 63 3. Custody seals intact on sample bottles7 Yes ❑ No 66 Not Present ❑ 4. Chain of custody present? Yes ® No ❑ 5. Samplers name present in COC? Yes ® No ❑ 6. Chain of custody signed when relinquished and received? Yes Lsr No ❑ 7. Chain of custody agrees with sample labels? Yes ® No ❑ 8. Samples in proper container/bottle? Yes ® No ❑ 9. Sample containers intact? Yes ® No ❑ 10. Sufficient sample volume for indicated test? Yes ® No ❑ 11. Au samples received within holding time? Yes lL No ❑ 12. Container/Temp Blank temperature within acceptance limit? Yes ❑ No ® NA ❑ 13. Water - VOA vials have zero headspace? Yes ❑ No ❑ NA 14. Water - pH acceptable upon reoeipt? Yes ❑ No ❑ NA Q Example: pH > 12 for (CN,S): pH<2 for Metals --------------------------------------------- Commends: Sample containers received with broken custody seals. Page I of t