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Alpha Analytical, Inc. <br /> Phone (775)355-1044 FAX (775)355-0406 <br /> 0 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 2/17/2005 Date of Notice 21912005 B 26 20 AM <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 USA 65 <br /> Project Manager Gown Kowtha Client s Phone (530) 676-6002 Client s FAX (530) 676-6005 <br /> Work Order Number STR05020902 Date Received 21912005 Received by Stacy Mane Strock <br /> Cham of Custody(COQ Information <br /> Carrier name Alpha Employee <br /> Chain of custody present? Yes ❑✓ ❑ No <br /> Custody seals intact on shippping container/cooler? Yes ❑ ❑ No Not Present D <br /> Custody seals intact on sample bottles ? Yes n ❑ No Not Present RJ <br /> Chain of custody signed when relinquished and received ? Yes EV ❑ No <br /> Chain of custody agrees with sample labels? Yes ❑ No <br /> Sample ID noted by Client on COC? Yes ❑ No <br /> Date and time of collection noted by Client on COC? Yes ❑ No <br /> Samplers's name noted on COC ? Yes 0 ❑ No <br /> Internal Chain of Custody(COC)requested? Yes ❑ No <br /> Oub Contract Lab Used None ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping container/cooler in good condition? Yes ❑ No Not Present ❑ <br /> Samples in proper container/bottle? Yes ❑ No <br /> Sample containers intact? Yes ❑ No <br /> Sufficient sample volume for indicated test? Yes ❑ No <br /> Sample Preservation and Hold Time(FIT) Information <br /> All sampjes received within holding time? Yes ❑ No Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes ❑ No 4'C <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes ❑ ❑ No No VOA vsais submitted d❑ <br /> Sample labels checked for correct preservation? Yes 66 ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No NIA W <br /> Analytical Requirement Information <br /> Are non Standard or Modified methods requested? Yes ❑ 0 No <br /> Are there client specific Project requirements? Yes ❑ 0 No If YES see the Chain of Custody(COC) <br /> Comments W 0 split due to different TATs on chain,see also 05020901 <br />