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Amon Laboratories Sample Receipt Checklist <br /> Client Name C7�Ui f�npf' 51�-77aC Date&Time Received 08 1 1a- 10 3 IV Yo <br /> Protect Name LQ0W11-S 0,77rrV,-_L9aL Client Project Number 9 S r 0/ 3 <br /> Received By ?m Matrix ate 1 So31 1 <br /> Sample Gamer lie / Laboratory 1 FedEx 1 UPS <br /> Argon Labs Project Number 00 e �;O f <br /> Shipping Container 1 Cooler in good condition? Samples received in proper containers? Yes I---- No <br /> N1A Yes No Samples received intact? Yes--7L No <br /> Samples received under refngerabon? Sufficient sample volume for requested tests? <br /> Yes No Yes --'-'No <br /> Chain of Custody Present? Yes_,!-f No Samples received within holding Ume? Yes No <br /> Chain of Custody signed by all partes? Do samples contain proper preservative? <br /> Yes No NIA Yes / No <br /> Cham of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes —"" 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 /> Acuon Taken <br /> �i <br /> - - - - - - - - - - - - -- - - -- - - - _OTHER <br /> _ - - - - - - - - - - - - - _ - - - - - <br /> Date Client Contacted Person Contacted <br /> Comments <br />