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Arqon Laboratories Sample Receipt Checklist <br /> Client Name: Ground Zero Analysis Date&Time Received: 10/21/2004 14:45 <br /> Project Name: Berberian Miller Client Project Number: 644 <br /> Received By: E.P. Matrix: - Water 2 Soil ❑ <br /> Sample Carrier: Client ❑ Laboratory 0 Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number: E10391 <br /> Shipper Container in good condition? Samples received in proper containers? Yes No ❑ <br /> N/A Yes (] No ❑ Samples received intact? Yes No ❑ <br /> Samples received under refrigeration? Yes No ❑ Sufficient sample volume for requested tests?Yes No ❑ <br /> Chain of custody present? Yes 0 No ❑ Samples received within holding time? Yes No ❑ <br /> Chain of Custody signed by all parties? Yes 0 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 Q No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTSSECTION BELOW <br /> Date Client Contacted: Person Contacted: <br /> Contacted By: Subject: <br /> Comments: <br /> Action Taken: <br /> ADDITIONAL TEST(S)REQUEST/OTHER <br /> Contacted By: Date: Time: <br /> Call Received By: <br /> Comments: <br />