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Alpha Scientific Corporation <br /> Sample Acceptance Checklist <br /> Section 1 <br /> Client: 4 Cie Project: NL kbvkh.h1 Lab Job# <br /> Date Received: <br /> Sample(s) received in cooler(s)? Yes No (skip to Section 2) <br /> Cooler(s)packed with: Ice %/ Ice Packs Packing Material <br /> Cooler Temperature(OC) : #1: 3if- #2: #3: #4: #5 <br /> (Acceptable range is 0°C to 6°C or arriving on ice for samples received on the same day as collected. <br /> (Ambient Temperature for vapor or air samples is acceptable). <br /> If sample(s) received outside acceptable range, Project Manager contacted by(Personnel Initial): <br /> Section 2 YES NO NIA <br /> Was a COC received? V <br /> Were client sample IDs resent? ✓ <br /> Were sample(s) collection dates resent? <br /> Was the COC signed? <br /> Were tests clearly indicated? <br /> Did all samples arrive intact? If no, indicate below. V <br /> Did all container labels agree with COC? V <br /> Were correct containers used for the tests required? <br /> Was there sufficient sample amount for requested tests? co' <br /> Were the samples correctly reserved? <br /> Was there headspace in VOA vials? V <br /> Were Custody seals resent? ' <br /> If es-were they intact? <br /> Section 3 <br /> Explanations/Comments: <br /> Section 4 <br /> Was the Project Manager notified of anomalies? Yes No N/A <br /> Via Phone: By: Date/Time <br /> By Email Sent to: <br /> Project Manager's response: <br /> Completed by: tam Date: <br /> Alpha Scientific Corporation Email: asc907O3@gmail.com <br /> 16760 Gridley Road Tel (562) 809-8880 <br /> Cerritos, CA 90703 Fax: (562) 809-8801 <br />