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1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> M c C a m p b e I l Analytical, Inc. Toll Free Telephone:(877)252-9262/Fax:(925)252-9269 <br /> �— "When Quality Counts" http://www.mccampbell.com/E-mail:main@rnccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: Safety Kleen Date and Time Received 8/20/2018 13:47 <br /> Project: 81618SI Date Logged: 8/20/2018 <br /> Received by: Kena Ponce <br /> WorkOrder Ns: 1808870 Matrix: Liquid Logged by: Kena Ponce <br /> Carrier: Client Drop-In <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes No❑ <br /> Chain of custody signed when relinquished and received? Yes No❑ <br /> Chain of custody agrees with sample labels? Yes No❑ <br /> Sample IDs noted by Client on COC? Yes No❑ <br /> Date and Time of collection noted by Client on COC? Yes ❑d No❑ <br /> Sampler's name noted on COC? Yes ❑d No❑ <br /> COC agrees with Quote? Yes ❑ No❑ NA❑d <br /> Sample Receiot Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA❑d <br /> Shipping container/cooler in good condition? Yes No❑ <br /> Samples in proper containers/bottles? Yes ❑./ No❑ <br /> Sample containers intact? Yes No❑ <br /> Sufficient sample volume for indicated test? Yes No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes ❑d No❑ NA❑ <br /> Samples Received on Ice? Yes ❑ No W <br /> Sample/Temp Blank temperature Temp: NA❑d <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ NA❑� <br /> Sample labels checked for correct preservation? Yes Flel No❑ <br /> pH acceptable upon receipt(Metal:<2;522:<4;218.7: >8)? Yes ❑ No❑ NA❑d <br /> UCMR Samples: <br /> pH tested and acceptable upon receipt(200.8::52;525.3:154; Yes ❑ No❑ NA W <br /> 530::57;541:<3;544: <6.5&7.5)? <br /> Free Chlorine tested and acceptable upon receipt(<0.1mg/L)? Yes ❑ No❑ NA <br /> --------------------------------------------- <br /> --------------------------------------------- <br /> Comments: <br /> Page 9 of 9 <br />