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OI <br />ADVANCED, TECHNOLOGY <br />L A 9 O R A T Q R I L• S <br />Sample Receipt Acknowledgement <br />Work Order # 2101513 <br />Client: Department of Toxic Substances Control , Project Manager: Arianna Campuzano <br />Project: ZOAT0105-2 Project Number: 20AT0103 <br />Renort To: Invoice To: <br />Department of Toxic Substances Control -ECL Department of Toxic Substances Control -ECL <br />Trevor Anderson Chief, Contract Administration and Purchasing <br />700 Heinz Street, Suite 150 P.O. Box 806 <br />Berkeley, CA 94710 Sacramento, CA 95812-0806 <br />Phone: (916) 255.3634 Phone :916 324 3751 <br />Fax: (510) 540-2305 Fax: (510) 540-2305 <br />Date Due: 08/07/21 17:00 (20 day TAT) Date Received: 07/09/2109:16 <br />Received By: Michael Guzman Date Logged In: 07/09/21 10:35 <br />Logged In By: Jerald Ancheta Shipped by: FEDEX <br />Please review the checklist below. <br />All samples which require thermal preservation are considered acceptable if the temperature upon arrival is within f 2 °C of the required temperature or <br />method specified range. For samples with a specified temperature of 4 °C, samples with a temperature ranging from just above freezing temperature of <br />water to 6 °C shall be. acceptable. Samples that are hand -delivered immediately following collection may not meet these criteria; however, they will be <br />deemed acceptable per NELAC standards if there is evidence that the chilling process has begun, such as arrival on ice. <br />Any non-compliance will be noted and must be understood as having an impact on the quality of the data. All tests will be performed as requested <br />regardless of any compliance issues. If you have any questions or further instructions, please contact your Project Manager at (562) 989-4045. <br />Sample(s) received on ice? <br />Yes <br />❑ <br />No <br />E I Default Cooler Temp: 4.0 °C <br />Sample(s) received on blue ice? <br />Yes <br />Q <br />No <br />❑ <br />Cooler temperature within acceptance limit? <br />Yes <br />Q <br />No <br />❑ <br />Shipping container received in good condition? <br />Yes <br />El <br />No <br />❑ <br />Custody seals present on shipping container? <br />Yes <br />Q <br />No <br />❑ <br />Custody seals intact on shipping container? <br />Yes <br />Q <br />No <br />❑ <br />Custody seals present on sample bottles? <br />Yes <br />El <br />No <br />❑ <br />Custody seals intact on sample bottles? <br />Yes <br />Q <br />No <br />❑ <br />Chain of Custody (COC) present? <br />Yes <br />Q <br />No <br />❑ <br />Sampler name present in COC? <br />Yes <br />0 <br />No <br />❑ <br />COC signed when :relinquished and received? <br />Yes <br />Q <br />No <br />❑ <br />COC agrees with sample labels? <br />Yes <br />Q <br />No <br />❑ <br />Samples in proper containeribottle? <br />Yes <br />Eel <br />No <br />❑ <br />Sample containers intact? <br />Yes <br />Q <br />No <br />❑ <br />Sufficient sample amount for indicated tests? <br />Yes <br />Q <br />No <br />❑ <br />All samples received within holding time? <br />Yes <br />Q <br />No <br />❑ <br />Water for VOC -- Were VOA vials submitted? <br />Yes <br />❑ <br />No <br />Q <br />Water samples submitted? <br />Yes <br />Q <br />No <br />❑ <br />VOA vials for VOC meet headspace criteria (<6mm)? <br />Not Applicable <br />Water samples meet preservation criteria? <br />Yes <br />❑ <br />No <br />El <br />Sample Receipt Comments: <br />Printed: 719/2021. 10:51:36AM <br />Form Version: 10.1 Issued: 03/18/2020 12:I6 PM Page mfl"" l <br />