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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: 1/18/2006 Date of Notice: 1/10/2006 12:01:37 <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: 2007-065-01 USA 65 <br /> Project Manager: Gown Kowtha Client's EMai[.• gkowtha@stratusinc.net <br /> Client's Phone: (530) 676-6001 Client's FAX. (530)676-6005 <br /> Work Order Number: STRO6011003 Date Received: 1/10/2006 Received by: Stephanie Sifuentes <br /> Chain of Custody COC Information <br /> Carrier name FedEx <br /> Chain of custody present? Yes ❑ No <br /> Custody seats 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 /> emal Chain of Custody(COC) requested? Yes ❑ 0 No <br /> ub Contract[ab Used: None © ❑ 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 /> i <br /> Sample containers intact? Yes ❑ No <br /> Sufficient sample volume for indicated test? Yes © ❑ No <br /> Sample Preservation and Hold Time CHTI Information <br /> All samples received within holding time? Yes ] ❑ No <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes 0 ❑ No 4°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 /> TQC Water- pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No N/A R9 <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes ❑ No <br /> Are there client specific Project requirements? Yes ❑ 0 No If YES: see the Chain of Custody(COC) <br /> Comments: Sample 10,10 differs from chain, matched by time and logged in per chain <br />