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1 <br /> � <br /> Amon Laboratories 5 'Sample Receipt Checklist <br />' Client Name ATC Associates,Inc Date&Time Received 4/5/2004 1640 <br /> Project Name Bozzano-Three Palms Grocery Client Protect Number 5414885 0001 <br /> Received By H C Matnx Water ❑ Sod ❑ <br /> Sample Carrier Client ❑ Laboratory [] Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number E04151 <br />' Shioper Container in good condstion? Samples received in proper containers? Yes ❑ No ❑ <br /> NIA Yes 21 No ❑ Sampfes received intact? Yes Q No ❑ <br />' Samples received under refrigeration? Yes Q No ❑ Sufficient sample volume for requested tests'Yes ❑ No ❑ <br /> Cham of custody present? Yes ❑ No ❑ Samples received within holding time? Yes ❑ No ❑ <br />' Chain of Custody signed by all parties? Yes ❑ No ❑ Do samples contain proper preservative? <br /> N/A ❑ Yes El No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br />' Yes 0 No ❑ (None submitted ❑ ) Yes ❑ No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED 1N THE COMMENTS SECTION 13ELOW <br />' Date Client Contacted 'A Person Conacied <br /> MContacted By Subject <br /> Comments <br />' Action Taken <br /> ADDITIONAL TEST(S)REQUEST OTHER <br />' Contacted By Date Time <br /> Call Received By , <br />' Comments <br /> its <br /> 1 <br />