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0 <br />Login Sample Receipt Checklist <br />Client: Stockton Scavengers Association Inc Job Number: 280-41009-3 <br />Login Number: 41009 <br />List Number: 2 <br />Creator: Gagne, Eric <br />Question <br />Answer <br />List Source: TestAmerica Burlington <br />List Creation: 05/09/13 08:30 AM <br />Comment <br />Radioactivity wasn't checked or is </= background as measured by a survey <br />N/A <br />Lab does not accept radioactive samples. <br />meter. <br />The cooler's custody seal, if present, is intact. <br />True <br />587355 <br />Sample custody seals, if present, are intact. <br />True <br />The cooler or samples do not appear to have been compromised or <br />True <br />tampered with. <br />Samples were received on ice. <br />N/A <br />Thermal preservation not required. <br />Cooler Temperature is acceptable. <br />True <br />Cooler Temperature is recorded. <br />True <br />21.0"C IR GUN ID 181. CF 0 <br />COC is present. <br />True <br />COC is filled out in ink and legible. <br />True <br />COC is filled out with all pertinent information. <br />True <br />Is the Field Sampler's name present on COC? <br />True <br />There are no discrepancies between the containers received and the COC. <br />True <br />Samples are received within Holding Time <br />True <br />Sample containers have legible labels. <br />True <br />Containers are not broken or leaking. <br />True <br />Sample collection dateltimes are provided. <br />True <br />Appropriate sample containers are used. <br />True <br />Sample bottles are completely filled. <br />True <br />Sample Preservation Verified. <br />True <br />There is sufficient vol. for all requested analyses, ind. any requested <br />True <br />MS/MSDs <br />Containers requiring zero headspace have no headspace or bubble is <br />True <br /><6mm (1/4"). <br />Multiphasic samples are not present. <br />True <br />Samples do not require splitting or compositing. <br />True <br />Residual Chlorine Checked. <br />N/A <br />TestAmerlca Denver Page 18 of 18 <br />