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Login Sample Receipt Checklist <br /> Client:Republic Services Inc Job Number:480-3228-1 <br /> Login Number:3228 List Source:TestAmerica Buffalo <br /> List Number:1 <br /> Creator:Wienke,Robert <br /> Question Answer Comment <br /> Radioactivity either was not measured or,if measured,is at or below True <br /> ' background <br /> The cooler's custody seal,if present,is intact. True <br /> The cooler or samples do not appear to have been compromised or True <br /> ' tampered with. <br /> Samples were received on ice. True <br /> Cooler Temperature is acceptable. True <br /> Cooler Temperature is recorded. True <br /> COC is present. True <br /> COC is filled out in ink and legible. True <br /> COC is filled out with all pertinent information. True <br /> Is the Field Sampler's name present on COC? True <br /> There are no discrepancies between the sample IDs on the containers and True <br /> the COC. <br /> ' Samples are received within Holding Time. True <br /> Sample containers have legible labels. True <br /> Containers are not broken or leaking. True <br /> Sample collection date/times are provided. True <br /> Appropriate sample containers are used. True <br /> Sample bottles are completely filled. True <br /> Sample Preservation Verified True <br /> There is sufficient vol.for all requested analyses,incl.any requested True <br /> MS/MSDs <br /> VOA sample vials do not have headspace or bubble is<6mm(1/4")in True <br /> diameter. <br /> If necessary,staff have been informed of any short hold time or quick TAT True <br /> needs <br /> ' Multiphasic samples are not present. True <br /> Samples do not require splitting or compositing. True <br /> Sampling Company provided. True <br /> ' Samples received within 48 hours of sampling. True <br /> Samples requiring field filtration have been filtered in the field. N/A <br /> Chlorine Residual checked. N/A <br /> t <br /> 1 <br /> TestAmerica Buffalo <br /> ' Page 21 of 21 04/19/2011 <br />