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' HOUSTON LABORATORY <br /> Pont 8880 INTERCHANGE DRIVE <br /> t HOUSTON TEXAS 77054 <br /> zlw��A%Ar®� (713)660 0901 <br /> Sample Receipt Checklist <br /> Workorder 01010025 Received by Estrada, Ruben <br /> Date and Time Received 1/3101 10 00 00 AM Carrier name FedEx <br /> Temperature 4 <br />' Shipping containerlccoier in good condition? Yes EV No❑ Not Present ❑ <br /> Custody seals intact on shippping container/cooler? Yes ❑ No❑ Not Present IVJ <br /> Custody seals intact on sample bottles? Yes ❑ No❑ Not Present Q <br /> Chain of custody present? Yes No I❑ <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 container/bottle? Yes EVI No❑ <br /> Sample containers intact? Yes C No❑ <br /> Sufficient sample volume for indicated test? Yes No Cl <br />' All samples received within holding time? Yes No❑ <br /> Container/Temp Blank temperature in compliance? Yes No❑ <br /> 10)er-VOA vials have zero headspace? Yes No❑ Not Present <br /> Water-pH acceptable upon receipt? Yes No ❑ <br /> ' 01010025 Page 9 <br /> 119!01 9 33 50 AM <br />