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— Inc. 1534 Willow Pass Road.Pittsburg,CA 94565-1701 <br /> McCampbell Analytical <br /> Web:www.mccampbell.com E-mail:main(rOmccampbell.com <br /> "W lien Oualitv Counts" Telephone:877-252-9262 Fax:925-252-9269 <br /> Sample Receipt Checklist <br /> Client Name: Bureau Veritas Date and Time Received: 11/25/08 6:59:56 PM <br /> Project Name: #99008-008321.03; Walgreens Store #02680 Checklist completed and reviewed by: Ana Venegas <br /> WorkOrder N': 0811802 Matrix Water Carrier: Michael Hernandez(MAI Courier) <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes © No ❑ <br /> Chain of custody signed when relinquished and received? Yes © No ❑ <br /> Chain of custody agrees with sample labels? Yes 0 No ❑ <br /> Sample IDs noted by Client on COC? Yes © No ❑ <br /> Date and Time of collection noted by Client on COC? Yes 23 No ❑ <br /> Sampler's name noted on COC? Yes 0 No ❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No ❑ NA <br /> Shipping container/cooler in good condition? Yes © No ❑ <br /> Samples in proper containers/bottles? Yes d❑ No ❑ <br /> Sample containers intact? Yes © No ❑ <br /> Sufficient sample volume for indicated test? Yes 21 No ❑ <br /> Sample Preservation and Hold Time(HT) Information <br /> All samples received within holding time? Yes 23 No ❑ <br /> Container/Temp Blank temperature Cooler Temp: 8.6'C NA ❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes 21 No ❑ No VOA vials submitted❑ <br /> Sample labels checked for correct preservation? Yes 0 No ❑ <br /> TTLC Metal-pH acceptable upon receipt(pH<2)? Yes ❑ No ❑ NA <br /> Samples Received on Ice? Yes © No ❑ <br /> (Ice Type: WET ICE ) <br /> NOTE. If the"No"box is checked, see comments below. <br /> ————————————————————————————————————————————- <br /> -———————————————————————————————————————————— <br /> Client contacted: Date contacted: Contacted by: <br /> Comments: <br />