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Amon Laboratories Sample Recei t Checklist <br /> . Client Name: ,� G Date&Time Received; <br /> 12.l301I:Z _! Oq` tI_�C <br /> Project Name: 5co e— TE Mh <br /> Client Protect Number 6 <br /> Received By: r1c_ Matrix: Water 'P�Soil ❑ Other <br /> Sample Carrier: Client [�Caboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number: F iZo <br /> Shipper Container in good condition? Sufficient sample volume for requested tests?Yes No ❑ <br /> NIA ❑ Yes No ❑ Samples received within holding time? Yes D-- No ❑ <br /> {., <br /> Samples received under refrigeration? Yes No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes No ❑ <br /> Chain of 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 as 203 ❑ Other <br /> Chain 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 ❑JNo ❑ <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 /> Action Taken: <br /> .z <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted By: Date: Time: <br /> Call Received By: <br /> Comments: <br /> v.5.02 <br />