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HOUSTON LABORATORY <br /> 8880 INTERCHANGE DRIVE <br /> HOUSTON TEXAS 77054 <br /> ® (713)660-0401 <br /> ' Sample Receipt Checklist <br /> Workorder 99110582 Received by Estrada Ruben <br /> ' Date and Time Received 11/26/99 10 00 00 AM Carrier name FedEx <br /> Temperature 5 <br /> ' Shipping container/cooler in good condition? Yes IV] No r_ Not Present <br /> Custody seals intact on shippping container/cooler? Yes ❑ No Not Present <br /> Custody seals Intact on sample bottles? Yes No ❑ Not Present <br /> Chain of custody present? Yes 0 No <br /> Chain of custody signed when relinquished and received? Yes ❑� No <br /> Chain of custody agrees with sample labels? Yes No <br /> Samples in proper containerlbottle? Yes No <br /> Sample containers Intact? Yes No <br /> Sufficient sample volume for Indicated test? Yes No <br /> All samples received wrothm holding time? Yes ❑✓ No <br /> itntamer/Temp Blank temperature In compliance? Yes No — <br /> Water VOA vials have zero headspace? Yes 41 No Not Present n <br /> Water pH acceptable upon receipt? Yes No <br />