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Alpha Analytical, Inc. <br /> Phone (775)355-1044 FAX (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 12/1412004 Date of Notice 12/6/2004 11 23 57 <br /> Please take note of any NO check marks If we receive no response concerning these items within 24 hours of the date of this notice, all of <br /> the samples will be analyzed as requested <br /> Client Name Stratus Environmental Project ID Joes Truck Plaza <br /> Project Manager Gown Kowtha Client's Phone (530)676-6002 Client's FAX (530)676-6005 <br /> Work Order Number STR04120640 Date Received 1214!2004 Received by Dolly S Baker <br /> Chain of Custody(COC)Information <br /> Carrier name FedEx <br /> Cham of custody present? Yes No <br /> Custody seals intact on shipppmg container/cooler? Yes ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present <br /> Chain of custody signed when relinquished and received? Yes No <br /> Chain of custody agrees with sample labels? Yes No <br /> Sample ID noted by Client on COC? Yes LVI ❑ No <br /> Date and time of collection noted by Client on COC? Yes 0 ❑ No <br /> Samplers's name noted on COC? Yes No <br /> 0ternal Chain of Custody(COC)requested? Yes ❑ ❑ No <br /> Sub Contract Lab Used None 5V ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping container/cooler in good condition? Yes No Not Present ❑ <br /> Samples in proper container/bottle? Yes 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 U ❑ No Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6*C)? Yes ❑ No 4 C <br /> Water-VOA vials have zero headspace/no bubbles? Yes n ❑ No No VOA vials submitted F <br /> Sample labels checked for correct preservation? Yes 11 ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes _7 ❑ No NIA P <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes ❑ No <br /> Are there client specific Project requirements? Yes ❑ No If YES see the Chain of Custody(COG) <br /> Comments Samples received 12/04/04 samples kept cold &secure until logon <br />