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SAMPLE RECEIPT CLIENT: C0_1Q4Ct4dU- OEC ID #: IZO49OZ Temp: 0C <br /> Rev 0111S110 Acceptable Range: 0°C to 6°C <br /> COC RECEIVED RECEIPT LOGIN <br /> DATE/TIME: q__y DATE/TIME: REFRIGERATOR(s): <br /> ,42-/x. /6/"7 - 9-.)-& -NL /036 <br /> SAMPLE TRANSPORT,RECEIPT, CONDITION &PRESERVATION: Yes No N/A PROBLEM CHAIN FORM NF.EDED <br /> 1:1 OEC Courier/Sampler COC documents)received with samples Ed, E1* 11 Custody Seals(circle): Present 4�LD <br /> 12�Delivery(Other than OEC Courier) Correct containers for analysis requested Samples/Coolers <br /> ❑Samples Received on Ice Container(s)intact and in good condition Ef El. El Intact/Broken* <br /> •Samples Received Outside Temp.Range* Container label(s)consistent with COC El El Method of Shipment&Tracking#(irappiicabla <br /> • Samples Direct from field(Outside Temp) OEC preservative added ("note std ID) Fiex @0tj jqA 52 <br /> ❑After-Hours Outside Drop-off[Brought Inside) Proper preservation on sample label(s) El El OEC Preservative ID: <br /> (Initials/Date/Time): VOA containers free of hcadspace 11 El* Dissolved Metals Filtration:111definit/1'reservc ID) <br /> Tedlar Bags free of condensation El 0* EL <br /> CONTAINERS, COC CHANGES AND/OR CORRECTIONS CHANGES AUTHORIZED BY., <br /> OEC ID Client ID***If blank,refer toCoC Container Description Preservative ResCI Matrix Date/Time Comments/Remarks <br /> /pH Sampled Condition Notes,Etc. <br /> RECEIPT LOGIN BY: WA RECEIPT REVIEWED BY: 644 Page M of I <br />