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mRbeff 1 C 1534 WM w Pate Road.fypsb CA 9456-.17o1 <br /> Web:www.abell com &mW:rzun@mccampbelloom <br /> "Wbaft QUWdyCOWW Tdwbow 977-252-9262 F=923-252-9269 <br /> Sample Receipt Checklist <br /> Client Name: Clean Harbors Data and Time Received: 8110120113:54:00 PM <br /> Project Name: 083W7384;Add Spic Chm*IM completed and reviewed by: Ana Venegas <br /> WorkOrder N°: 1108314 Matrix: WMK Cam Client Drop-in <br /> Chain at Cilatgft(=I Infonmdon <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 /> Date and Time of collection noted by Client on COC? Yes ❑d No❑ <br /> Sampler's name noted on COC? Yes No❑ <br /> Custody seals intact on shipping containedcookw? Yes ❑ No❑ NA <br /> Shipping containedcoder in good condition? Yes © No❑ <br /> Samples in proper containersPoottles? Yes No❑ <br /> Sample containers intact? Yes ® No❑ <br /> Suffldent sample volume for indicated test? Yes © No❑ <br /> Sample Prmmrvadon and Haid Time OM la&MWon <br /> AN samples received within holding time? Yes ® No❑ <br /> ContainedTamp Blank temperature Cooler Tomp: 6.8"C NA❑ <br /> Water-VOA vials have zero heWspace/no bubbles? Yes ❑ No❑ No VOA vials submitted <br /> Sample labels checked for correct preservation? Yes © No❑ <br /> Metal-pH acceptable upon receipt(pH<2)? Yes © No❑ NA❑ <br /> Samples Received on Ice? Yes 41 No❑ <br /> (Ice Type: WET ICE ) <br /> NOTE:if Me Mo'box is checked,see comments below. <br /> ——————————————————————————————————————————_ —— <br /> --------------------------------------------- <br /> Client contacted: Date contacted: Contacted by: <br /> Comments: <br /> Page 4 of 8 <br />