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1 1 <br /> i:Alpha Analytical, Inc. <br /> Phone: (775)355-1044 FAX:(775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client: 2/2612004 date of Notice: 212012004 9:37:44 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,ail of <br /> I the samples will be analyzed as requested. <br /> 3 F <br /> Client Name Stratus Environmental Project ID: 2007-0065IUSA 65 <br /> Project.Manager: Gown Kowtha <br /> Client's Phone (530)676-6002 Cfenfs FAX (530)676-6005 <br /> Work Order Number;: STR04022040 Date Received :2/20/2004 Received by: Dolly S. Baker <br /> i <br /> Chain of Custody(COC)Information <br /> 4 Carriername FedEx <br /> t <br /> Chain of custody present? Yes 'iJi ❑ No <br /> Custody seals intacf'on shippping containerlcooler? Yes ir�i No Not Present I I <br /> Custody seals intact on sample bottles? Yes F❑ i_G No Not Present l <br /> I Chairs of custody signed when relinquished and received? Yes ❑ No <br /> Chain of custody agrees with sample labels? i Yes ❑ No i <br /> i t _ <br /> Sample ID noted by Client on COC? Yes ❑ No <br /> 4 Date and time of collection noted by Client on COC? Yes ❑ No <br /> 'Samplers's name noted on COG? Yes J ❑ No <br /> ( } <br /> internale Chain of Custody(COC)requested? Yes I- <br /> Sub Contract Lab Used: None SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping container/cooler in good condition? Yes i ❑ No Not Present ❑ <br /> Samples in proper containerlbottle? Yes n ❑ No <br /> Sample.containers ihtact? Yes 1111 ❑ No <br /> i <br /> Sufficient sample volume for indicated test? Yes ❑ No <br /> Sample Preservation and Hold Time(HT)Information <br /> I <br /> All samples received within holding time? Yes I`_I ❑ No Cooler Temperature <br /> ContainerlTemp Blank temperature in compliance(0-6'C)? Yes No NA'C i <br /> Water-i VOA vials have zero headspace 1 no bubbles? _ Yes No No VOA vials submitted �� <br /> Sample;labels checked for correct preservation? Yes -6 ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No NIA LJ <br /> I <br /> {' <br /> Analytical Requirement Information j <br /> l <br /> Are non-Standard or Modified methods requested? Yes El ��/I No <br /> I; <br /> Are there client specific Project requirements.? Yes ❑ No If YES:see the Chain of Custody{COC} <br /> a ' <br /> komments <br /> t <br /> F 1 'I: <br />