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Login Sample Receipt Checklist <br /> • Job Number:720-42956-1 <br /> Client:Kleinfelder Inc <br /> List Source:TestAmerica Chicago <br /> Login Number:42956 List Creation:06/2811202:15 PM 1 <br /> List Number:1 ----- <br /> Creator:Kelsey,Shawn M <br /> Answer Comment <br /> Question <br /> Radioactivity either was not measured or,if measured,Is at or below <br /> True <br /> background True <br /> The cooler's custody seal,if present,is intact. , <br /> The cooler or samples do not appear to have been compromised or True <br /> tampered with. - <br /> Samples were received on ice. <br /> True <br /> Cooler Temperature is acceptable. <br /> True <br /> True <br /> Cooler Temperature is <br /> recorded. <br /> True <br /> COC is present. <br /> True <br /> COC is filled out in ink and legible. <br /> True <br /> COC is filled out with all pertinent information. . <br /> True <br /> Is the Field Samplefs name present on COC? <br /> There are no discrepancies between the sample IDs on the containers and True <br /> the COC. <br /> True <br /> Samples are received within Holding Time. <br /> Sample containers have legible labels. <br /> True <br /> Containers are not broken or leaking. <br /> True <br /> Sample collection date/times are provided. <br /> True <br /> Appropriate sample containers are used. <br /> True <br /> Sample bottles are completely filled. <br /> True <br /> Sample Preservation Verified. <br /> True <br /> There is sufficient vol.for all requested analyses,incl.any requested <br /> True <br /> MS/MSDs <br /> VOA sample vials do not have headspace or bubble is<6mm(1/4")in True <br /> diameter. <br /> True <br /> Multiphasic samples are not present. <br /> True <br /> Samples do not require splitting or compositing. <br /> True <br /> Residual Chlorine Checked. <br /> • <br /> TestAmerica Pleasanton Page 16 of 16 7/3/2012 <br />