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Login Sample Receipt Checklist <br /> Client:Conestoga-Rovers&Associates,Inc. Job Number:440-66282-1 <br /> Login Number:66282 List Source:TestAmerica Irvine <br /> List Number:1 a <br /> Creator:Sung,Hubert <br /> Question Answer Comment Q <br /> Radioactivity wasn't checked or is</=background as measured by'a True <br /> survey meter. <br /> The cooler's custody seal,.if present;is intact. True <br /> Sample custody seals,if present,are intact. True a <br /> The cooler or samples do not appear to have been compromised or True ❑ <br /> tampered with. <br /> Samples were received on ice. True <br /> Cooler Temperature is acceptable. True Ili <br /> Cooler Temperature is recorded. True <br /> COC is present. True <br /> COC is filled out in ink and legible. True[. <br /> COC is filled out with all pertinent information. True U�(" <br /> Is the Field Sampler's name present on COC? True . <br /> There are no discrepancies between the containers received and the COC. True <br /> Samples are received within Holding Time. True i <br /> Sample containers have legible labels. True . <br /> Containers are not broken or leaking. False Containers recd broken.Sufficient sample in <br /> remaining containers for analysis. i <br /> Sample collection date/times are provided. True <br /> Appropriate sample containers are used. True <br /> . i <br /> Sample bottles are completely filled.. True t <br /> Sample Preservation Verified. N/A <br /> There is sufficient vol.for all requested analyses,incl.any requested True <br /> MS/MSDs <br /> r Containers requiring zero headspace have no headspace or bubble is True <br /> <6mm(1/4"). <br /> Multiphasic samples are not present. True <br /> Samples do not require splitting or compositing. True <br /> Residual Chlorine Checked. N/A <br /> a <br /> I <br /> l <br />' n <br /> TestAmerica Irvine Page 36 of 36. 1/13/2014 <br /> I <br />