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r <br /> a <br /> til <br /> Alpha Analytical, Inc. <br /> . Phone (775)355-1044 FAX (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 2/23/2004 Date of Notice 2/13/2004 12 40 04 <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 <br /> Project Manager Gown Kowtha Client's Phone (530)676-6002 Client's FAX (530)676-6005 <br /> Work Order Number STR04021344 Date Received 2113/2004 Received by Dolly S Baker <br /> Chain of Custody COC Information <br /> Carrier name FedEx <br /> Chain of custody present? Yes No <br /> Custody seals intact on shippping container/cooler? Yes FIA F-1 No Not Present ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present ;/ <br /> Chain of custody signed when relinquished and received ? Yes Fl/ ❑ No <br /> Chain of custody agrees with sample labels? Yes n ❑ No <br /> Sample ID noted by Client on COC? Yes L l No <br /> Date and time of collection noted by Client on COC? Yes i`� ❑ No <br /> amplers's name noted on COC? Yes �R ❑ No <br /> nternal Chain of Custody(COC)requested ? Yes No <br /> Sub Contract Lab Used None SEM Other(see comments) ❑� <br /> Sample Receipt Information <br /> Shipping container/cooler in good condition? Yes I✓1 ❑ No Not Present <br /> Samples m proper container/bottle'? Yes n ❑ 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 `� I No Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes R ❑ No 4,c <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes IV ❑ No No VOA vials submitted ❑ <br /> Sample labels checked for correct preservation? Yes LI ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No NIA L <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes 1'1/1 No <br /> Are there client specific Project requirements? Yes ❑ n No If YES see the Chain of Custody(COC) <br /> �omments <br />