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Argon Laboratories Sample Receipt Checklist <br /> Client Name: ATC Associates, Inc. Date&Time Received: 1/28/2005 16:30 <br /> Project Name: Jamar Service Client Project Number: 54.26823.0001 <br /> ' Received By: M.G. Matrix: Water ❑ Soil ❑ <br /> Sample Carrier: Client ❑ Laboratory 0 Fed Ex ❑ UPS ❑ Other ❑ <br /> ' Argon Labs Project Number: F01471 <br /> Shipper Container in good condition? Samples received in proper containers? Yes R No ❑ <br /> ' NIA Yes El No ❑ Samples received intact? Yes 0 No ❑ <br /> Samples received under refrigeration? Yes [] No ❑ Sufficient sample volume for requested tests?Yes P1 No ❑ <br /> Chain of custody present? Yes 0 No ❑ Samples received within holding time? Yes 0 No ❑ <br /> Chain of Custody signed by all parties? Yes Q No ❑ Do samples contain proper preservative? <br /> N/A ❑ Yes No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes ] No ❑ (None submitted ❑} Yes No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted: Person Contacted: — — <br /> ' Contacted By: Subject: <br /> Comments: <br /> ' Action Taken: <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted By: Date: Time: <br /> Call Received By: <br /> Comments: <br />