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V <br /> Ar on laboratories Sample Receipt Checklist <br /> _ n Date&Time Received: 1 Z lc.o <br /> Pf0'ECf Idc('tE: �+ t.UU t� .Y� �__ <br /> -----� -^�" Client Protect Number" 60 1 Doc) <br /> Received ey:L'i drt21 O t0�A L-V-2.IN Matrix: Water Soil ❑ Other <br /> Samp!e Ca!ri-�r: Client Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Arac:n Labs Project Number._G2 Le 0!L) 72 <br /> Shipper Container in good condition? Sufficient sample volume for requested tests?Yes .CE� No <br /> NIA ❑ Yes No ❑ Samples received v✓ithin holding time? Yes .a No <br /> Samples received under refrigeration? .Yes NO ❑ Do samples contain proper preservative? <br /> N/A E) Yes <br /> Chai;;cf;usl)dy present? Yes �] No 10 VOA vials with preservative? <br /> NIA [] Yes .�' NoI i <br /> Chain of Custody signed by all parties? Yes A No EJVOA vials preservative type: <br /> HCL J2' .Na2S2O3 <br /> Chain of Cussodymatches all sample labels? Do VOA vials contain zero headspace? <br /> Yes ,❑ No ❑ NLA ❑ Yes [j ;; [J <br /> Samples received in proper containers?Yes Na ❑ Samples received intact? Yes No ❑ <br /> _ ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted: Person Contacted: <br /> Contacted By: Subject: <br /> Comments: <br /> Action Talo en: <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted:fay: Date: Time: <br /> Call Received By: <br /> Comments: <br /> v.5.02 <br />