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rgon_Laiooratories Sample Receipt Checklist <br /> Client Name ATC Associates, Inc Date&Time Received 411312005 11 20 <br /> PrOfect Name Diesel Performance Client Project Number 54 62577 0001 <br /> ' Received By E P Matrix Water C] Soil ❑ <br /> Sample Carrier Client ❑ Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number F04401 <br /> Shipper Container in good condition? Sampies received in proper containers? Yes 0 No ❑ <br /> N/A Yes ❑ No ❑ Samples received intact? Yes E] No ❑ <br /> Samples receiveo under refngeration? Yes ❑ No ❑ Sufficient sample volume for requested tests?Yes ❑ No ❑ <br /> ' Cham of custody present? Yes ❑ No ❑ Samples received within holding time? Yes 0 No ❑ <br /> Chan of Custody sioned by all parties? Yes [] No ❑ Do samples contain proper preservative? <br /> ' N!A ❑ Yes Q No ❑ <br /> Cham of C jstody matches all sample labels? Do VCA vials contain zero headspace'? <br /> Yes Q No ❑ (None submitted ❑) Yes [] 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 /> 1 <br /> Action Taken <br /> ADDITIONAL TEST(S)REQUEST!OTHER <br /> Contacted By Date Time <br /> Call Received By <br /> Comments <br />