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Revision Date: M/119/14 rage 1 or r Inter-L tory Condition Upon Receipt (Attach to COC) X055 Sample Receipt at: TK CC CH VI 1. Number of ice ches packages received: Shipping tracking# 2. Were samples received in a chilled condition? Temps:1XF/ Surface water SWTR bact samples: A sample that has a temperature upon receipt of >10°C,whether iced or not, should be flagged unless the time since sample collection has been less than two hours. 3. Do the number of bottles received agree with the COC? No N/A 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No 5. VOAs checked for Headspace? gYesNo N�l/9/ 6. Were sample custody seals intact? Yes No 7. If required, was sample split for pH analysis? Resamp No 8. Were all analyses within holding times at time of receipt? No 9. Verify sample date, time and sampler name No Sign and date the COC, place in a ziplock and put in thg ame ice chest asles. Sample Receipt Review completed by (initials): 6 Sample Receipt at SP: 1. Were samples received in a chilled condition? Temps: —5—/ Acceptable is above freezing to 0-C. 1f many packages are received at one time check for tests/H.T.'sl ashes/ 2. Shippingking numbers: 3. Do the number of bottles received agree with the COC? No N/A 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) e No 5. Were sample custody seals intact? No N/A Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. Sample Verification,Labeling and Distribution: 1. Were all requested analyses understood and acceptable? No 2. Did bottle labels correspond with the client's ID's? a No 3. Were all bottles requiring sample preservation properly preserved? Yes NoFGL lE:ception:Oil&Grease,VOA and CM verified in lab] 4. VOAs checked for Headspace? es No N/A 5. Have rush or project due dates been checked and accepted? Yes No 6. Were all analyses within holding times at time of receipt? (Y�e No Attach labels to the containers and include a copy of the COC for lab de 'very. Sample Receipt, Login and Verification completed by (initials): Discrepancy Documentation: Any items above which are"No"or do not meet specifications (i.e. temps) must be resolved. I. Person Contacted: Phone Number: Initiated By: Date: Problem: Resolution: 2. Person Contacted: Initiated By: (3-16608) Problem: Live Oak Geo Environmental Resolution: STK 16 5®5 4 5 here (Please use the back of this sheet for additional cot IV-08/22/2016-16:12:04 contacts)