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Alpha Analytical, Inc. <br /> Phone (775)355-1044 FAX (775)355-0406 <br /> 0 Sample Receipt Checklist <br /> Date Report is due to Client 111512004 Date of Notice 11/512004 9 06 27 A <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 Clients Phone (530) 676-6002 Client's FAX (530)676-6005 <br /> Work Order Number STR04110527 Date Received 11/5!2004 Received by Graciela Navarrete <br /> Chain of Custody(COC)Information <br /> Carrier name FedEx <br /> Chain of custody present 9 Yes ❑ No <br /> Custody seals intact on shippping containerlcooler 7 Yes ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present R1 <br /> Cham 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 COC? Yes ❑ ❑ No <br /> Date and time of collection noted by Client on COC? Yes ❑ No <br /> Samplers's name noted on COC 7 Yes 0 ❑ No <br /> 0IInternal Chain of Custody(COC)requested ? Yes El No <br /> Sub Contract Lab Used None W ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping containerlcooler in good condition? Yes W ❑ No Not Present ❑ <br /> Samples in proper contain erlbottle? Yes R ❑ 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 /> 1:1❑ Na <br /> All samples received within holding time? YesCooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes ❑ No N/A OC <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes ❑ ❑ No No VOA vials submitted 0 <br /> Sample labels checked for correct preservation? Yes W ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No NIA ❑� <br /> Analylical Re uirement Information <br /> Are non-Standard or Modified methods requested ? Yes ❑ 0 No <br /> Are there client specific Project requirements? Yes ❑ No If YES see the Chain of Custody(COC) <br /> Comments Coc was split into two work orders due to difference in tat required <br />