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Login Sample Receipt Checklist <br /> Client:Kleinfelder Inc Job Number:720-39404-1 <br /> Login Number:39404 List Source:TestAmerica Chicago <br /> ' List Number: 1 List Creation:12/22/11 12:19 PM <br /> Creator:Kelsey,Shawn M <br /> Question _ Answer Comment <br /> Radioactivity either was not measured or,if measured,is at or below True <br /> background <br /> The cooler's custody seal,if present,is intact. True <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 <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 <br /> Is the Field Sampler's name present on COC? True <br /> There are no discrepancies between the sample IDs on the containers and True <br /> the COC. <br /> Samples are received within Holding Time. True <br /> Sample containers have legible labels. True <br /> Containers are not broken or leaking. True <br /> Sample collection date/times are provided. True <br /> Appropriate sample containers are used. True <br /> ' Sample bottles are completely filled. True <br /> Sample Preservation Verified. True <br /> There is sufficient vol.for all requested analyses,incl.any requested True <br /> MS/MSDs <br /> VOA sample vials do not have headspace or bubble is<9mm(1/4")in N/A <br /> diameter. <br /> Multiphasic samples are not present. True <br /> Samples do not require splitting or compositing. True <br /> Residual Chlorine Checked. True <br /> i <br /> 1 <br /> 1 <br /> t TestAmerica San Francisco <br /> Page 16 of 16 12/27/2011 <br />