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1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> McCampbell Analytical, Inc. Toll Free Telephone:(877)252-9262/Fu:(925)252-9269 <br /> "When Quality Counts" <br /> http://www.meempbcU.com/E-mad:mahi@mccaffTbeH.com <br /> Sample Receipt Checklist <br /> Client Name: Ten-acon Date and Time Received 1212012017 11:35 <br /> Project: 1177G18;Lodi USD High School Date Logged: 1 212 01201 7 <br /> Received by: Kana Ponce <br /> WorkOrder Ng: 1712904 Matrix: Water Logged by: Kana Ponce <br /> Carrier: Client Drop-In <br /> Chain of Custody(COCl Information <br /> Chain of custody present? Yes © No❑ <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 /> Dale and Time of collection noted by Client on COC? Yes © No❑ <br /> Sampler's name noted on COC? Yes © No❑ <br /> COC agrees with Quote? Yes ❑ No❑ NAW <br /> Sample Recelot Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA <br /> Shipping container/cooler in good condition? Yes W No❑ <br /> Samples in proper containers/bottles? Yes © No❑ <br /> Sample containers intact? Yes FOJ No❑ <br /> Sufficient sample volume for indicated test? Yes 0 No❑ <br /> Sample Preservation and Hold Time(HT1 Information <br /> All samples received within holding time? Yes © No❑ NA❑ <br /> Sample/Temp Blank temperature Temp: NA❑VI <br /> Water-VOA vials have zero headspace/no bubbles? Yes © No❑ NA❑ <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 <br /> UCMR Samples: <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 <br /> 300.1,537,539? <br /> --------------------------------------------- <br /> --------------------------------------------- <br /> Comments: <br /> Page 11 of 11 <br />