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Ar on I ahoratories Sample Recei t Checklist <br /> Client Name ATC Associates, Inc Date&Time Received 3/18/2005 1650 <br /> Project Name Diesel Performance Client Project Number 54 62577 0001 <br /> Received By E P Matrix Water 2 Sod ❑ <br /> Sample Carrier Client ❑ Laboratory ED Fed Ex ❑ UPS ❑ Other ❑ <br /> ' Argon Labs Project Number F03531 <br /> Shipper Container in good condition? Samples received in proper containers? Yes F) No ❑ <br /> NIA Yes 0 No ❑ Samples received intact? Yes 2] No ❑ <br /> Samples received under refngeration? Yes 0 No ❑ Sufficient sample volume for requested tests?Yes [] No ❑ <br /> Chain of custody present? Yes 0 No ❑ Samples received within holding time? Yes ❑ No ❑ <br /> ' Cham of Custody signed by all parties? Yes 0 No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes (] No ❑ (None submitted ❑) Yes [Q No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted Person Contacted <br /> Contacted By Subject <br /> Comments <br /> ' Action Taken <br /> ADDITIONAL TEST(S)REQUEST 1 OTHER <br /> Contacted By ---------_�_—Date —�—_ ----------- <br /> Time <br /> Call Received By <br /> Comments <br />