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Revision Date: 10/09/14 Page 1 of 1 Inter-Laharatory Condition Upon Receipt (Attach to COC) lv TA� 3 Sample Receipt at: CC CH VI 1. Number of ice ch ackages received: / Shipping wwking# 2. Were samples received in a chilled condition? Temps: MT / Surface water SVVM bact samples:A sample that has a temperature upon receipt of >10'c,whether iced ornot, should be flagged unless the time since sample collection has been less than two hours. 3. Do the number of bottles received agree with the COC? No N/A 4. Were samples received intact? (i.e. no broken bottles,leaks etc.) No 5. VOAs checked for Headspace? e No N/A 6. Were sample custody seals intact? Yes No 7. If required, was sample split for pH analysis? Y No 8. Were all analyses within holding times at time of receipt? No 9. Verify sample date,time and sampler name Y No Sign and date the COC,place in a ziplock and put in th ame ice chest as the samples. Sample Receipt Review completed by(initials): Sample Receipt at SP: 1. Were samples received in a chilled condition? Temps: Acceptable is above freezing to 6,1m,C. if many packages are received at one time check for test!VH.T.'s/rushcs/ 2. Shipping tracking numbers: q-3 -�r3 L -��P7�Kc7'rl� 3. Do the number of bottles received agree with the COC? es , No N/A 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No 5. Were sample custody seals intact? Yes No N/ Sign and date the COC, obtain LrMS sample numbers, select methods/tests and print labels. Sample Verification,Labeling and Distribution: 1. Were all requested analyses understood and acceptable? No 2. Did bottle labels correspond with the client's ID's? No 3. Were all bottles requiring sample preservation properly preserved? Yes. No FGL lExcepitvn.Oil&Grease,VOA and Crvl verified in tnbl 4. VOAs checked for Headspace? <JR� No N/A 5. Have rush or project due dates been checked and accepted? Yes No 6. Wera-all-qnmlyses within holding times at time of receipt? <Y!F� No Attach labels to the containers and include a copy of the COC for lab delivery. Sample Receipt,Login and Verification completed by (initials):-1L4-LC— Discrepancy [4-LC' Discrepancy Documentation: Any items above which are"No" or do not meet specifications (i.e. temps)must be resolved. 1. Person Contacted: Phone Number: Initiated By: Date: Problem: Resolution: (3-16®59) 2. Person Contacted: he i th Gross L I1 S Pis Initiated By: p Problem: S TK 1 i'7 3 U 4 2 ......_.... Resolution: IV-07/07/2017-16:03:43 (Please use the back of this sheet for additional co_ `r.here contacts) Received Time Jul, 16, 2017 12: 89PM No. 1898