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Section 1: General lnfo <br />Date Received?+f zlzuLrl wor <br />SAMPLE RECEIPT CHECKTIST <br />9tq31S cnent: 6v&r hlh <br />'*=lk'rJ <br />1:N I tl Al.l'Y <br />Section 2: Shipping / Custody <br />Custody seals intact on arrival? C N/A fl Yes E No <br />Are custodyseals present?E Yes ENo <br />E On cooler / box E On samples <br />Shipping lnfo: <br />Section 3a: Condition / Packaging E Outside 0.0 - 5.0'C (0.0 - 10.0"C for microbioloCy) (PM notified) <br />Date opened Slctlt*t ay (initials) 6 Ck Type of ice used : L wet E Blue/Gel E None <br />E Samples received on ice directly from the field; cooling 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 />lf no cooler: Observed/Adjusted Temp ('C)Thermometer/tneun: XPOZ CF: fO.? <br />cooler Temp l'cl n: 5-T lC el #2: / #3: / #4: / #5: / #6: / <br />Section 3b: Microbiolory 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 />X No microbiology samples submitted (skip 3b) <br />Section 3c: Air Samples <br />E 1.41 Canisters D 6L Canisters <br />I No air samples submitted (skip 3c) <br />E Tedlar Bags f: McE cassettes E Sorbent Tubes ! other_ <br />Section 4: Containers / tabels / Samples YES NO N/A <br />1) Were custody papers present, filled properly, and legible?>< <br />2) ls the sampler's name present on the CoC?Y <br />3) Were containers received in good condition (unbroken / unopened / uncompromised)?x <br />4) Were the samples bagged? (required for microbiology samples; recommended for soil samples)x <br />5) Were all of, and only, the correct samples received?Y <br />6) Are sample labels present, legible, and in agreement with the CoC?v <br />7) Does the container count match the CoC? <br />8) Was sufficient sample volume / mass received for the analyses requested? <br />).r <br />9) Were samples received in proper containers for the analyses requested?>/ <br />10) Were samples received with > 1/2 holding time remaining?Y <br />11) Are samples properly preserved as indicated by CoC / labels?k <br />12) Unpreserved VOAs received - lf necessary, was the hold time changed in LIMS?tr <br />13) Are VOA vials free from headspace/bubbles > 6mm?K <br />Section 5: Explanations / Comments E PM notified <br />Date Logged (*ll\*l,, <br />Date Labeledlsf@- sv <br />lrbA- <br />Enthalpy Analytical J-0005, Rev 2: Form Version 16.1081224 <br />lorintl -[-T f <br />(nrintl R LLt <br />10 of 76