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Alpha Analytical, Inc. <br /> Phone (775)355-1044 FAX (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 10/21/2004 Date of Notice 10/21/2004 9 25 38 <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 2007-00651USA 65 <br /> Project Manager Gown Kowtha Client's Phone (530)676-6002 Client's FAX (530)676-6005 <br /> Work Order Number STR04102102 Date Received 10/21/2004 Received by Laura Long <br /> Chain of CustodYICOC)Information <br /> Carrier name FedEx <br /> Chain of custody present? Yes © ❑ No <br /> Custody seals intact on shippping container/cooler? Yes © ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles 7 Yes ❑ ❑ No Not Present <br /> Chain of custody signed when relinquished and received? Yes © ❑ No <br /> Chain of custody agrees with sample labels? Yes © ❑ No <br /> Sample ID noted by Client on GOC? Yes © ❑ No <br /> Date and time of collection noted by Client on COC? Yes No <br /> Samplers's name noted on COC? Yes © ❑ No <br /> Oternal Chain of Custody(COC)requested? Yes ❑ V No <br /> Sub Contract Lab Used None © ❑ SEM Other(see comments) ❑ <br /> Sample Recelpt_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(HT)Information <br /> All samples received wthm holding time? Yes © ❑ No <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes © ❑ No NA°C <br /> Water VOA vials have zero headspace/no bubbles? Yes ❑ ❑ No No VOA vials submitted ❑�/ <br /> Sample labels checked for correct preservation Yes © ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No N/A 0 <br /> Analylical Reauiremgnt Information <br /> Are non-Standard or Modified methods requested? Yes ❑ © No <br /> Are there client specific Project requirements Yes ❑ No If YES see the Chain of Custody(COC) <br /> Comments <br />