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Sam le Receipt Report <br /> Laboratory ReferenceiLA 25167 togged in by MR <br /> Received: _qAlZSL2Q09 30 Company Name: L�Ana3 ical Seryipes lnq. <br /> Method of Shipment: FEDE — Project Manager: Ms&�Aal MpN_abb <br /> Shipping Container. Box Project Name: _UM r p <br /> #Shipping Containers: Project# A99051 <br /> Sample Quantity <br /> 2 Paint <br /> Chain of Custody Complete 0 Incomplete❑ None❑ <br /> Samples On ice Yes.Wet❑ Yes,Blue No❑ <br /> Observed Temp.(°C): 3 Thermometer ID: IR#2 Adjusted Temp.: 3+0=3 <br /> Shipping Intact Yes R NIA❑ No❑ <br /> Shipping Custody Seals Intact Yes 77 N/AJ❑ No❑ <br /> Samples Intact Yes ►I_' No <br /> Sample Custody Seats Intact Yes — N/A® No <br /> Custody Seals Signed&Dated Yes ❑ NIA Q No <br /> Proper Test Containers YeS 1191, No-- <br /> Proper Test Preservations Yes a No <br /> Samples Within Hold Times Yes V1 No <br /> VCAs Have Zero Headspace Yes❑ NIA�i]I No <br /> Sample Labels Complete Incomplete❑ None <br /> Sample Information Matches COC Yes ,I❑ NIA ❑ No <br /> Notes <br /> Client Notified By ___ �-- On <br />