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Amon Laboratories Sample Receipt Checklist <br /> Client Name Ground Zero Analysis Date&Time Received 91112004 1500 <br /> Protect Name Barry's Auto _ Client Project Number 327 <br /> Received By E P Matrix Water 0 Soil ❑ <br /> Sample Carrier Client ❑ Laboratory 0 Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Protect Number E09051 <br /> Shipper Container in good condition? Samples received in proper containers? Yes [] No ❑ <br /> NIA Yes 0 No ❑ Samples received intact? Yes 0 No ❑ <br /> Samples received under refrigeration Yes No ❑ Sufficient sample volume for requested tests?Yes P1 No ❑ <br /> Chain of custody present? Yes 0 No ❑ Samples received within holding time? Yes 0 No ❑ <br /> Chain of Custody signed by all parties? Yes Q No ❑ Do samples contain proper preservative? <br /> N/A ❑ Yes El No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials oontam zero headspace? <br /> Yes Q No ❑ (None submitted ❑) Yes 0 No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted Person Contacted <br /> Contacted By Subject <br /> Comments <br /> Action Taken <br /> i <br /> ADDITIONAL TEST(S)REQUEST/OTHER <br /> Contacted By Date Time <br /> Call Received By <br /> Comments <br />