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Amon Laboratories Sample Receipt Checklist <br /> . Client Name �'Off? F—ig T� T� �UL�c� Date&Time Received i _1�Q 05 <br /> Project Name (-1 ,A Nt tir Client Project Number I-:1cE <br /> Received By Matrix Water ❑-- Soil ❑ Other <br /> Sample Carrier Client ❑ Laboratory ❑' — Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number t a-��, <br /> Shipper Container in good condition? Sufflcient sample volume for requested tests? Yes ❑-- No ❑ <br /> NIA ❑ Yes [- No ❑ Samples received within holding time? Yes N <br /> Samples received under refngeration? Yes No ❑ Do samples contain proper preservative? <br /> N/A ❑ Yes No ❑ <br /> Chain of custody present? Yes ❑— No ❑ VOA vials with preservative? <br /> NIA ❑ Yes No ❑ <br /> Chain of Custody signed by all parties? Yes [ No ❑ VOA vials preservative type <br /> HCL E — Na2S203 [] Other <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes ❑jam No ❑ NIA ❑ Yes [], No ❑ <br /> Samples received in proper containers? Yes ❑/ No [] Samples received intact? 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 pate Time <br /> Call Received By <br /> Comments <br /> v502 <br />