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Alpha Analytical, Inc. <br /> • Phone (775)355-1044 FAX (775)35540406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 12/10/2004 Date of Notice 12/10/2004 9 30 29 <br /> Please take note of any NO check marks if we receive no response concerning these items within 24 hours of the data of this notice,all of <br /> the samples will be analyzed as requested <br /> Client Name Stratus Environmentai Project ID 20074)065-01 NSA 65 <br /> Project Manager Gown Kowtha Client's Phone (530) 676-6002 Client's FAX (530)676-6005 <br /> Work Order Number STR04121060 Date Received 12/10/2004 Received by Laura Long <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 © ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles? 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 COC? 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 /> Internal Chain of Custody(COC)requested? Yes ❑ R No <br /> Sub Contract Lab Used None ® ❑ SEM Other (see comments) ❑ <br /> Sample Recellat Information <br /> Shipping container/cooler in good condition? Yes © ❑ No Not Present ❑ <br /> Samples in proper contamerlbottle? Yes ❑ No <br /> Sample containers intact? Yes © ❑ No <br /> Sufficient sample volume for indicated test? Yes ❑ ❑ No <br /> Sample Preservation and Hold Time H Information <br /> All samples received wdmn holding time? Yes © ❑ No 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)9 Yes ❑ ❑ No NIA <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes ❑ ❑d No <br /> Are there client specific Project requirements? Yes ❑ R No if YES see the Chain of Custody(COC) <br /> Comments Split samples on two different WO (STR04121061)because of differences in TAT <br /> • <br />