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i <br /> Amon Laboratories Sample Receipt Checklist <br /> ' Client Name (-- A<KK ,4—R--� Date&Time Receved <br /> Prolect Name• Qo �— <br /> Client Project Number <br /> ' Received By C CLMatrix Water Soil ❑ Other <br /> Sample Camer Client ❑ Laboratory Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Protect Number _ t ��3p S <br /> Shioaer Container in gaol condition? Sufficient sample volume for requested tests?Yes No El <br /> N/A ❑ Yes No ❑ Samples received within holding time? Yes No ❑ <br /> Samples rece[ved under refrigeration? Yes No ❑ Do samples contain proper preservative? <br /> ' NIA ❑ Yes Ep No ❑ <br /> Chain or custody present? Yes No ❑ VOA vials with preservative? <br /> ' NIA ❑ Yes No ❑ <br /> Chain of Custody signed by all parties? Yes [ No ❑ VOA vials preservative type <br /> HCL ® Na2S203 ❑ Other <br /> Cham of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes ] No ❑ NIA ❑ Yes No ❑ <br /> ' Samples received in proper containers? Yes No ❑ Samples received intact? 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 lOTHER— <br /> ' Contacted By Date Time <br /> Calf Received By <br /> ' Comments <br /> i <br /> v502 <br />