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Amon Laboratories Sample Receipt Checklist <br /> • Client Name: 0T-k(X.-f9-v- .f Date&Time Received: '�L1 j 1 0 -3 1 D <br /> Pr*ct Name: `C k - k e Client Project Number: 3 <br /> Received By: Matrix: Water / Soil I <br /> Sample Carrier: Clientaborato FedEx I UPS 1 <br /> Argon Labs Project Number: �D <br /> Shipping Container!Cooler in good condition? Samples received in proper containers? Yes f/ No <br /> NIA Yes / No Samples received intact? Yes �/ No <br /> Samples received under refrigeration j Sufficient sample volume for requested tests? / <br /> Yes V No Yes ,/ No <br /> Chain of Custody Present? Yes / No Samples received within holding lime? Yes-/— No <br /> Chain of Custody signed by all parties? Do samples contain proper preservative? / <br /> Yes / No NIA Yes f No <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yesy No (None submitted_)Yes V/ No <br /> ANY"No" RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> • Dale Ciieni Contacted: w " _ — _ _ � _ _ — _ - <br /> Person Contacted: <br /> Contacted by: Subject: <br /> Comments: <br /> Action Taken: <br /> OTHER <br /> Date Client Contacted: Person Contacted: <br /> Comments: <br />