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Columbia Analytical Services, Inc. <br />Sample Acceptance Check Form <br />Client: Shaw Environmental & Infrastructure, Inc. Work order: P2602050 <br />Project: Foothill Landfill/791289 (Cnoimd Water) <br />Sainple(s) received on: 7/28/06 Date opened: 7/28/06 by: MZ <br />Note: This form is used for all samples received by CAS. The use of this form for custody seals is strictly meant to indicate presence/absence and not as an indication of <br />compliance or nonconformity. Thermal preservation and pH will only be evaluated either at the request of the client or as required by the method/SOP. <br />Yes NO N/A <br />I Were custody seals on outside of cooler/Box? ❑ ® ❑ <br />cxptam any aiscrepahhches: (include lab sample ID numbers): <br />6020s0sa. US - —,Jcr - r,c� i or 1 7/28/06 5:34 PM <br />Location of seal(s)?. Sealing Lid? <br />❑ <br />❑ <br />❑x <br />Were signature and date included? <br />❑ <br />❑ <br />Were seals intact'? <br />❑ <br />❑ <br />0 <br />Were custody seals on outside of sample container'? <br />❑ <br />® <br />❑ <br />Location of seal(s)? Sealing Lid? <br />❑ <br />❑ <br />❑x <br />Were signature and date included? <br />❑ <br />❑ <br />M <br />Were seals intact'? <br />® <br />❑ <br />0 <br />2 <br />Were sample containers properly marked with client sample ID? <br />❑x <br />❑ <br />❑ <br />3 <br />Did sample containers arrive in good condition? <br />0 <br />❑ <br />❑ <br />4 <br />Were chain -of -custody papers used and filled out'? <br />® <br />❑ <br />❑ <br />5 <br />Did sample container labels and/or tags agree with custody papers'? <br />L] <br />❑ <br />❑ <br />6 <br />Was sample volume received adequate for analysis? <br />0 <br />❑ <br />❑ <br />7 <br />Are samples within specified holding times'? <br />M <br />❑ <br />❑ <br />8 <br />Was proper temperature (thermal preservation) of cooler at receipt adhered to? <br />❑x <br />❑ <br />❑ <br />Cooler Temperature 3.5 °C <br />Blank Temperature NA °C <br />9 <br />Is pH (acid) preservation necessary, according to method/SOP or Client specifiedinformation? <br />[]x <br />❑ <br />❑ <br />Is there a client indication that the submitted samples are pH (acid) preserved'? <br />❑x <br />❑ <br />❑ <br />Were VOA vials checked for presence/absence of air bubbles? <br />❑x <br />❑ <br />❑ <br />Does the client/method/SOP require that the analyst check the sample pH and if necessary alter it? <br />❑x <br />❑ <br />❑ <br />10 <br />Tubes: Are the tubes capped and 'intact? <br />❑ <br />❑ <br />0 <br />Do they contain moisture'? <br />❑ <br />❑ <br />MI <br />I l <br />Badges: Are the badges properly capped and intact? <br />❑ <br />❑ <br />I—XI <br />Are dual bed badges separated chid individually capped and intact? <br />❑ <br />❑ <br />0 <br />cxptam any aiscrepahhches: (include lab sample ID numbers): <br />6020s0sa. US - —,Jcr - r,c� i or 1 7/28/06 5:34 PM <br />