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Section 1: General lnfo <br />Date Received: ?-)-L}'+ <br />SAMPLE RECEIPT CHECKTIST <br />f:N-Fll A l-l'YCoilcCClient: <br />.M <br />ffifr^1 <br />wo#5H'a <br />Custody seal <br />Shipping lnfo: <br />Are custody seals present? EJ Yes <br />E ru/A [] Yes E lrlo E On cooler /box E On samples <br />{tlo <br />s intact on arrival? <br /><'J <br />Section 2: Shipping / Custody <br />E Outside 0.0 - 5.0'C (0.0 - 10.0"C for microbiotogy) (pM notified) <br />Type of ice used : 1wet E Blue/Gel ENone <br />process had begun. (if checked, skip temperatures) <br />E Sample matrix doesn't require cooling (e.g. air, bulk PCB). (if checked, skip temperatures) <br />__J_#3: l_#4: /_#5: / #6: / <br />Observed/Adjusted Tem <br />,('C) #7:9 ,*/ 3,0o,42 <br />o <br /><'-o3lf no cooler:p ('c):Thermometer/lR Gu CF: <br />Cooler Temp <br />E Samples received on ice directly from the field; cooling <br />Section 3a: Condition / Packaging <br />Date opened 6LAl-Jtl By (initiats <br />Section 3b: Microbiology Samples <br />tr Within temp range 0.0 - 10.0"C or received on ice directly from field. <br />E Adequate headspace for microbiology analysis. <br />.-\go microbiology samples submitted (skip 3b) <br />\o air samples submitted (skip 3c)Section 3c: Air Samples <br />fl1.4L Canisters E 6L Canisters ITedlar Bags - MCE Cassettes I Sorbent Tubes tr Other <br />Section 4: Containers / Labels / Samples YES NO N/A <br />1) Were custody papers present, filled properly, and legible?tl <br />2) ls the sampler's name present on the CoC?v <br />3) were containers received in good condition (unbroken / unopened / uncompromised)?n <br />) Were the samples bagged? (required for microbiology samples; recommended for soil samples)/ <br />5) Were all of, and only, the correct samples received?\/ <br />6) Are sample labels present, legible, and in agreement with the CoC?\/ <br />Does the container count match the CoC?t/ <br />8) Was sufficient sample volume / mass recelved for the analyses requested?'l9) Were samples received in proper containers for the analyses requested?J <br />L0) Were samples received with > tl2 holding time remaining?\/ <br />11) Are samples properly preserved as indicated by CoC / labels?t/ <br />12) Unpreserved VOAs received - lf necessary, was the hold time changed in LIMS?/ <br />13) Are VOA vials free from headspace/bubbles > 6mm?,) <br />Section 5: Explanations / Comments E PM notified <br />ft'i-r,& <br />G2uru signBy (print) <br />Date Logged <br />Date Labeled <br />Bv (p <br />Enthalpy Analytical J-0005, Rev 2: Form Version L6.708L224 <br />I <br />9 of 95