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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 11/12/2003 Date of Notice 11/412003 9 53 28 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 wiI1 be analyzed as requested <br /> Client Name Stratus Environmental Project ID USA 65 <br /> Protect Manager Gown Kowtha Client's Phone (530)576-6002 Clients FAX (530) 676-6005 <br /> VUor! Order"d m bei 5TR03110441Date Rece_ed 11!412003 P,ece-ed by Dolly S °aker <br /> Cham of Custody(COC)Information <br /> Carner name FedEx <br /> Chain of custody present? Yes VI No <br /> Custody seals intact on shippping container/cooler? Yes �/` I No Not Presen !_I <br /> Custody seals intact on sample bottles? Yes f.. r !I No Not Presen r� <br /> Chain of custody signed when relinquished and received? Yes LJ No <br /> Chain of custody agrees with sample labels'? Yes L No <br /> Internal Chain of Custody(COC)requested? Yes No <br /> Sub Contract Lab Used None R. L SEM Other(see comments) <br /> Samole Recemt Information <br /> Shipping container/cooler in good condition? Yes %l E J No Not Presen € <br /> Samples in proper containerlbottle? Yes No <br /> Sample containers intact? Yes ill I No <br /> Sufficient sample volume for indicated test? Yes V, Li No <br /> Sammie Preservation and Hold Time HT Information <br /> AN samples received within holding time? Yes V— EJ No <br /> Confer Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes vt No NA°C <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes FJ ! No No VOA vials submitted <br /> TOC Wafer-pH acceptable upon receipt? Yes r' Ir No N/A <br /> TOC Samples shouio have a ph< (H2SO4) <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes ke No <br /> Are there client specific Protect requirements? Yes L No If YES see the Chain of Custody(COC) <br /> Comments _ _ <br />