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Login Sample Receipt Checklist <br /> • <br /> Job Number:720-42632-1 <br /> Client:Kleinfelder Inc <br /> List Source:TestAmerica Chicago <br /> Login Number:42632 <br /> List Creation:06113112 10:60 AM <br /> List Number:1 <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. I, <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 1 <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 dale/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 headspam or bubble is<6mm(1/4")in True <br /> diameter. <br /> Multiphasic samples are not present. True <br /> Samples do not require splitting or compositing. True <br /> Residual Chlorine Checked. True <br /> • <br /> TestAmerica Pleasanton Page 16 of 16 6/1912012 <br />