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Argon Laboratories Sample Receipt Checklist <br /> Client Name ATC Assoctates, Inc Date&Time Received 10124/2003 345 <br /> Protect Name Theimann's Service Client Project Number 54 62605 0001 <br /> Received By DS Matrix Water 0 Sod ❑ <br /> Sample Carder Client ❑ Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number D10591 <br /> Shipper Container in good condition? Samples received in proper containers' Yes 0 No ❑ <br /> NIA Yes 0 No ❑ Samples received intact? Yes F-7 No ❑ <br /> Samples received under refirgeration? Yes [Q No ❑ Sufficient sample voiume for requested tests?Yes 0 NG ❑ <br /> Chain of custody present? Yes 0 No ❑ Samples received within holding time? Yes No ❑ <br /> Chain of Custody signed by all parties? Yes Q No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes [] No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspacO <br /> Yes 0 No ❑ (None submitted ❑ ) Yes 0 No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted Person Conacted <br /> Contacted By Subject <br /> Comments <br /> Action Taken <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted By -- Date ------- Time------ <br /> Call Received By <br /> Comments <br />