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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: 1/612006 Date of Notice: 1/6/2006 11:09:00 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: Gowd Kowtha Client's EMail: gkowtha@stratusinc.net <br /> Client's Phone: (530) 676-6001 Client's FAX: (530) 676-6005 <br /> Work Order Number: STR06010643 Date Received: 1!6!2006 Received by:Latricia Edrosa <br /> Chain of Custody COC Information <br /> Carrier name: FedEx <br /> Chain of custody present? Yes 2 ❑ No <br /> Custody seals intact on shippping container/cooler? Yes 2 ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles ? Yes ❑ ❑ No Not Present 0 <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 ❑J ❑ No <br /> nal Chain of Custody(COC)requested? Yes ❑ No <br /> Contract Lab Used : None ❑d ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping cantainerlcooler in good condition? Yes No Not Present ❑ <br /> Samples in proper containeribottle? Yes 0 ❑ 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 within holding time? Yes 0 ❑ No <br /> Cooler Temperature <br /> ContainerfTemp Blank temperature in compliance(0-6°C)? Yes ✓❑ ❑ No NA°C <br /> Water-VOA vials have zero headspace I no bubbles? Yes ❑ ❑ No No VOA vials submitted ❑� <br /> Sample labels checked for correct preservation? Yes W ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No NIA 0 <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes ❑ R No <br /> Are there client specific Project requirements? Yes ❑ No If YES : see the Chain of Custody(COC) <br /> Comments : Chain split into two separate work orders due to different TATs. <br />