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Amon Laboratories Sample Receipt Checklist <br /> Client Name —), UWTH 7 — Date&Time Received(L)ZJ.29 ILL ! 125 U <br /> iProject Name <br /> Client Project Number <br /> Received By � ��_. >{ f ( Y'� — Matrix Water ❑ Soil ❑ Other <br /> Sample Carrier Client Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number <br /> Shipper Conlaner in good condition? Sufficient sample volume for requested tests?Yer-n No ❑ <br /> NIA ❑ Yes No ❑ Samples received within holding time? Yes�J No ❑ <br /> Samples received under refrigeration? Yes No ❑ Do samples contain proper preservative? <br /> NIA Ll Yes ED' No E:1Cham of custody present? Yes No ❑ VOA vials with preservative? <br /> NIA ❑ Yes No F7Cham of Custody signed by all parties? Yes No El VGA vials preservative type <br /> HCL ❑' Na2S203 ❑ Other <br /> Cham of Custody matches all sample labels? Do VCA vials contain zero headspace? <br /> Yes No ❑ NIA ❑ Yes 0— No ❑ <br /> Samples received in proper containers? Yes No ❑ Samples received intacl? Yes U No ❑ <br /> ANY No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Dale Clienl 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 /> v502 <br />