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1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> ' McCampbell Analytical, Inc. Toll Free Telephone:(877)252-9262/F.:(925)252-9269 <br /> "When Quality Counts" <br /> http://www,mce mpbell.com/E-mail:mew u@Ccampbe0.com <br /> Sample Receipt Checklist <br /> ' Client Name: Neil O.Anderson&Associates Date and Time Received: 912812015 6:43:42 PM <br /> Project Name: NA157003G;Sunrise Trucking Login Reviewed by: Jena Alfaro <br /> ' WorkOrder No: 1509A93 Matrix: Water Carrier: Daniel(MAI Courier) <br /> Chain of Custody(COC)Information <br /> ' Chain of custody present? Yes CI No❑ <br /> Chain of custody signed when relinquished and received? Yes © No❑ <br /> t Chain of custody agrees with sample labels? Yes No❑ <br /> Sample IDs noted by Client on COC? Yes 0 No❑ <br /> Date and Time of collection noted by Client on COC? Yes No❑ <br /> Sampler's name noted on COC? Yes No❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA 91 <br /> Shipping container/cooler in good condition? Yes No❑ <br /> Samples in proper containers/bottles? Yes 0 No❑ <br /> Sample containers intact? Yes No❑ <br /> ' Sufficient sample volume for indicated test? Yes No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes © No❑ <br /> Sample/Temp Blank temperature Temp: 2.5"C NA❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes No❑ NA❑ <br /> Sample labels checked for correct preservation? Yes © No❑ <br /> pH acceptable upon receipt(Metal:<2;522: <4;218.7:>8)? Yes ❑ No❑ NA W1 <br /> Samples Received on Ice? Yes ❑] No❑ <br /> (Ice Type: WET ICE ) <br /> ' UCMR3 Samples, <br /> Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No❑ NAW <br /> Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NA W <br /> 300.1,537,539? <br /> NOTE.,If the"No"box is checked,see comments below. <br /> --------------------------------------------- <br /> Comments: — ——— ——— ———— ——— ——— ———— ———— ——— <br /> 1 <br /> Page 10 of 10 <br />