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_FIMCCamgbell Analytical, Inc. 1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> /may "Who. Web:www.mccampbell.cum E-mail:main@mccampbell.com"Wheo Oualiw Cous" Tele hone:877-252-9262 Fax:925-252-9269 <br /> Sample Receipt Checklist <br /> Client Name: WGR Southwest, Inc. Date and Time Received: 05108108 5:22:47 PM <br /> Project Name: #704.PRI.05; LEARNER; 2711 Navy Dr., Stockton, Checklist completed and reviewed by: Samantha Arbuckle <br /> WorkOrder N°: 0805220 Matrix Soil Carrier: Client Drop-In <br /> Chain of Custody ICOCI Information <br /> Chain of custody present? Yes ® No ❑ <br /> Chain of custody signed when relinquished and received? Yes ® No❑ <br /> Chain of custody agrees with sample labels? Yes 0 No ❑ <br /> Sample IDs noted by Client on COC? Yes 91 No ❑ <br /> Date and Time of collection noted by Client on COC? Yes © No ❑ <br /> Sampler's name noted on COC? Yes Fel No ❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ® No ❑ NA ❑ <br /> Shipping container/cooler in good condition? Yes © No ❑ <br /> Samples in proper containers/bottles? Yes © No ❑ <br /> Sample containers intact? Yes W1 No ❑ <br /> • Sufficient sample volume for indicated test? Yes 9 No ❑ <br /> Sample Preservation and Hold Time INTI Information <br /> All samples received within holding time? Yes 0 No ❑ <br /> Containen Temp Blank temperature Cooler Temp: 15.1'C NA ❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No ❑ No VOA vials submitted <br /> Sample labels checked for correct preservation? Yes Rl No❑ <br /> TTLC Metal-pH acceptable upon receipt(pH<2)? Yes ❑ No ❑ KA 21 <br /> --------------------------------------------- <br /> --------------------------------------------- <br /> Client contacted: Date contacted: Contacted by: <br /> Comments: <br /> • <br />