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Alpha Analytical, Inc. <br /> • <br /> Phone:(775)355-1044 FAX: (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client: 1/16/2006 Date of Notice: 1/6/200612:01-48P <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: USA65 <br /> Project Manager: Gowri Kowtha Client's EMail: gkowtha®stratusinc.net <br /> Client's Phone: (530) 676-6001 Client's FAX: (530) 676-6005 <br /> Work Order Number: STR06010655 Date Received: 1/6/2006 Received by:Tara Dickinson <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 W1 ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present C <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 /> gmal Chain of Custody(COC)requested? Yes No <br /> dub Contract Lab Used : None 0 ❑ 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 0 ❑ No <br /> Sufficient sample volume for indicated test? Yes FV] ❑ No <br /> Sample Preservation and Hold Time(KT)Information <br /> All samples received within holding time? Yes 0 ❑ No Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes ❑ ❑ No NA OC <br /> Water-VOA vials have zero headspace/no bubbles? Yes k ❑ No No VOA vials submitted ❑ <br /> Sampie labels checked for correct preservation? Yes W ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No N/A <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes ❑ EVI No <br /> Are there client specific Project requirements? Yes ❑ ❑V No If YES:see the Chain of Custody(COC) <br /> Comments: <br /> • <br />