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ACCESSION : 0J INITIALS: , - ATI Sanl�ego.: SARSPLE C4NDITIOIV IJP4N RECEIPT ..... LIST :(FOS RErACCFSSIONS,` COMPLETE`#7;T��RU9) :.. Does this project require special handling according to NFESC Levels C, D, YES NO AFCEE or CLP protocols? If yes, complete a)and b) a) pH sample aliquoted: yes /no /na b) Either 1) Record Bottle Lot #'s: Or 2) Attach Sample Kit Request Form(s) 2 Number of Coolers Received If more than one cooler received attach Multiple Cooler Documentation Form (MCD) Indicate "see MCD"on Item 11 below 3 Are custody seals required for this project ? YES N/A a) are Custody Seals present on Cooler(s) ? YES NO If yes, are seals intact ? YES NO b) are Custody seals present on the sample ? YS NO If yes, are seals intact ? YES NO 4 Is there a Chain-Of-Custody (COC)' per cooler ? YES NO if not, if a problem is found indicate which samples/test were in the affected cooler on the MCD. 5 Is the COC comple" er cooler ? YES NO Relinquished: es/ o Requested analysis: yes no 6 Is the COC' greement with tt�,e les received? Y S NO 4 Samples: y o Sample ID's yes Date sampled: ye /no Matrix: es no containers. es no 7 Are the samoles preserved correctly? YES NO _ 8 Is there enough sample for all the requested analyses? YES NO 9 Are all samples within holding times for the requested analyses? YES NO 10 Record cooler temperature. Contact PM if temperature is not 4°C t 2°C. O ,C Is ice present in cooler? YE5 NO 11 Were all sample containers received intact (ie. not broken, leaking, YES t40 etc.)? 12 Are samples requiring no headspace, headspace free? N/A YES NO 13 Are VOA 1st stickers required? YES NO 14 Are there special comments on the Chain of Custody which require client Y-: 1Z/A contact? is If yes, was ATT Project Manager notified? YES 1:0 Describe "no" items: Was client contacted? yes / no If yes, Date: Name of Person contacted: Describe actions taken or client instructions: i letters, and/or shippira memos Or other representative documents,