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J <br /> Argon Laboratories Sample Receipt checklist <br /> Client Name ATC Associates, Inc Date&Time Received 1114/2004 1630 <br /> Project Name Jay's Mini Mart Client Project Number 54 26874 0001 <br /> Received By D S Matrix Water ❑ Soil 0 <br /> Sample Carrier Client ❑ Laboratory 0 Fed Ex ❑ UPS ❑ Other [I <br /> Argon Labs Protect Number E01251 <br /> Shipper Container in good condition? Samples received in proper containers? Yes P] No ❑ <br />' N!A Yes ❑ No ❑ Samples received intact? Yes 0 No ❑ <br /> Samples received under refrigeration? Yes El No ❑ Sufficient sample volume for requested tests?Yes 0 No ❑ <br /> Chan of custody present? Yes 0 No ❑ Samples received within holding time? Yes 0 No ❑ <br />' Chain of Custody signed by all parties? Yes No ❑ Do samples contain proper preservative? <br /> NIA Yes ❑ No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes 0 No ❑ (None submitted Yes ❑ 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 f OTTER <br /> Contacted By Date Time <br />' Call Received By <br /> Comments <br />