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Argon Laboratories Sample Receipt Checklist <br /> tClient Name Ground Zero Analysis, Inc Date&Time Received 11121/2003 955 <br /> Project Name Knowles Roek Client Protect Number 186 <br /> ' Received By Paul Matrix Water ❑ Soil ❑ <br /> Sample Carrier Client ❑ Laboratory 0 Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number D11471 <br /> ' Shipper Container to good condition 7 Samples received in proper containers? Yes ❑ No ❑ <br /> N/A Yes No ❑ Samples received intact? Yes 0 No ❑ <br /> ' Samples received under refrigeration? Yes ❑ No ❑ Sufficient sample volume for requested tests?Yes 0 No ❑ <br /> Chain of custody present? Yes 0 No Samples received within holding time? Yes 21 No ❑ <br /> ' Cham of Custody signed by all parries? Yes No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes No ❑ <br /> tCham of Custody matches all sampte labels? Do VOA vials contain zero headspace7 <br /> Yes 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 /> t <br /> ' Action Taken <br /> ADDITIONAL TEST(S)REQUEST!OTHER <br /> Contacted By Date Time <br /> ' Call Received By <br /> Comments <br />