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X24 _Q0 ya <br /> Columbia Analytical Services, Inc <br /> IPhoenix, AZ <br /> Sample Receipt t and Preservation Form <br /> Client 1. P ��� Protect Name <br /> Sample(s)Received on date g C5 time <br /> VOA's El Glass Bottles❑ Plastic Bottles ElJars ElSleeves ❑ Tedlar Sags 1) <br /> MATRIX SOIL ❑ WATER ❑ VAPOR ❑ <br /> First Extraction Holding Time Expiration date time (soils only) <br /> Is first extraction/analysis holding time expiration LESS THAN 24 HOURS(soil)17 DAYS (water)? Yes ❑ No❑ <br /> If YES, chemist notified on date time Chemist's Initials <br /> I1 Rush or standard turn-a-round time) RUSH <br /> 2 Are the custody seals present? Yes ❑ No.Ei'— <br /> If yes,how many and where <br /> 3 Are the signature and date correct? YesET- No❑ <br /> 4 Did all containers arrive in good condition Yes 8' No❑ <br /> 5 Are all container labels complete(i a preservation,sample ID)? Yes D' No 11 <br />' • 6 Were the correct containers used for the tests indicated? Yes Er No El <br /> 7 Have VOA's been checked for the presence of air bubbles?(note problems in comments) Yes No N/A❑ <br /> 8 Temperature of sample(s)upon receipt <br />' Explamation of discrepancies <br /> VOA Vial pH Verification <br />' (Tested After Analysis) <br /> YES NO ❑ All Samples pH <2 <br /> E12 <br /> Reagent ❑ Following Samples Exhibited pH > 2 <br />' E NaOH <br /> 2 HNO, <br /> 2 H2SO4 <br /> 2 HCl <br /> fComments <br />' Form Completed and Sample(s) Received by (initials) <br /> r lcommonwormslsamprev doe <br />' Revised 02/03/04 9 19 AM <br />