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1.� y 1534 Willow Pecs Road,Piusberg,CA 94565-1701 <br /> McCampbell Analytical, Inc Toll Free Telephone:(877)252-9262/F.:(925)252-9269 <br /> "When Quality Counts" http://www=campbeU.com/E-mail:main(&necampbell.com <br /> Sample Receipt Checklist <br /> Client Name: Terracon Date and Time Received 1211812017 12:20 <br /> Project: R1177G18; Dale Logged: 12118/2017 <br /> Received by: Jena Alfaro <br /> WorkOrder N4: 1712772 Matrix: Water Logged by: Kana Ponce <br /> Cartier: Client Droo-In <br /> Chain of Custody ICOCI Information <br /> Chain of custody present? Yes © No❑ <br /> Chain of custody signed when relinquished and received? Yes W No❑ <br /> Chain of custody agrees With sample labels? Yes 0 No❑ <br /> Sample IDs noted by Client on COC? Yes 0 No❑ <br /> Date 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❑ NA RI <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA <br /> Shipping container/cooler in good condition? Yes 6a No❑ <br /> Samples in proper containers/bottles? Yes © No❑ <br /> Sample containers intact? Yes No❑ <br /> Sufficient sample volume for indicated test? Yes 0 No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received Within holding lime? Yes 0 No a NA❑ <br /> Sample/Temp Blank temperature Temp: NA <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ NA 91 <br /> Sample labels checked for correct preservation? Yes ❑J No❑ <br /> pH acceptable upon receipt(Metal:<2;522:<4;218.7:>8)? Yes ❑ No❑ NA❑I <br /> Samples Received on Ice? Yes ❑ No PI <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 RI <br /> 300.1,537,539? <br /> --------------------------------------------- <br /> Comments: <br /> Page 43 of 43 <br />