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" � ENTRALPY <br /> �[ ! <br /> A N A L Y T I C A L <br /> SAMPLE ACCEPTANCE CHECKLIST <br /> Section 1 <br /> Client: Project: <br /> Date Received: Sampler's Name Present: es FlNo <br /> Section 2 <br /> Sample Temp('C) <br /> Sample(s)received in a cooler? es,How many? ❑No(skip section 2) (No Cooler) <br /> Sample Temp(°C),One from each cooler: #1: 3-7 #2: #3: #4: <br /> (Acceptance range is<6'Cbut not frozen(for Microbiology samples,acceptance range is <10'C but not frozen). It Is acceptable forsamples collected <br /> the same day as sample receipt to have a higher temperature as long as there Is evidence that cooling has begun.) <br /> Shipping Information: <br /> Section 3 <br /> Was the cooler packed with: [�ce ❑Ice Packs ❑Bubble Wrap ❑Styrofoam <br /> ❑Paper ❑None ❑Other <br /> Cooler Temp(°C): #1: D• #2- #3: 44: <br /> .Section 4 YES NO N/A <br /> Was a COC received? l <br /> Are sample IDs present? <br /> .Are sampling dates&times present? / <br /> Is a relinquished signature present? l <br /> Are the tests required clearly indicated on the COC? / <br /> Are custody seals present? <br /> If custody seals are present,were they intact? <br /> Are all samples sealed in plastic bags? (Recommended for Microbiology samples) / <br /> Did all samples arrive intact?If no,indicate in Section 4 below. <br /> Did all bottle labels agree with COC?(ID,dates and times) <br /> Were the samples collected in the correct containers for the required tests? <br /> Are the containers labeled with the correct preservatives? r <br /> Is there headspace in the VOA vials greater than 5-6 mm in diameter? <br /> Was a sufficient amount of sample submitted for the requested tests? / <br /> Section 5 Explanations/Comments <br /> Section 6 <br /> For discrepancies,how was the Project Manager notified?[]Verbal PM Initials: Date/Tme <br /> ❑Email (email sent to/on): <br /> Project Manager's response: <br /> Completed By: Date: / /-2" <br /> Enthalpy Analytical,a subsidiary of Montrose Environmental Group,Inc <br /> 9 W.Barkley Ave,Orange,CA 92868•T:(714)771-6900•F:(714)538-1209 <br /> www.enthalpy.com/socal <br /> Sample Acceptance Checklist—Rev 4,8/8/2017 <br /> 5of9 <br />