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1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> ��_ M C C a m p b e i l Analytical, I n C. Toll Free Telephone:(877)252-9262/Fax:(925)252-9269 <br /> "When QURIItJ Counts" <br /> http://www.mccampbell.com/E-mail:main@mccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: Kirkwood Meadows Public Untility District Date and Time Received: 4/10/2026 09:20 <br /> Project: Date Logged: 4/10/2026 <br /> Received by: <br /> WorkOrder Ns: 2604713 Matrix: Logged by: Lilly Ortiz <br /> Carrier: UPS <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes ❑d No❑ <br /> Chain of custody signed when relinquished and received? Yes VI No❑ <br /> Chain of custody agrees with sample labels? Yes 0 No❑ <br /> Sample IDs noted by Client on COC? Yes 0 No❑ <br /> Date and Time of collection noted by Client on COC? Yes 0 No❑ <br /> Sampler's name noted on COC? Yes VI No❑ <br /> COC agrees with Quote? Yes ❑ No❑ NA❑d <br /> COC quote is active? Yes I I No❑ NA LvI <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA <br /> Custody seals intact on sample bottles? Yes ❑ No❑ NA 0 <br /> Shipping container/cooler in good condition? Yes n No❑ <br /> Samples in proper containers/bottles? Yes 0 No❑ <br /> Sample containers intact? Yes n No❑ <br /> Sufficient sample volume for indicated test? Yes 0 No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes 0 No ❑ NA ❑ <br /> Samples Received on Ice? Yes 0 No ❑ <br /> (Ice Type: BLUE ICE ) <br /> Sample/Temp Blank temperature Temp: 1.9°C NA ❑ <br /> ZHS conditional analyses:VOA meets zero headspace Yes ❑ No ❑ NA ❑✓ <br /> requirement(VOCs,TPHg/BTEX, RSK)? <br /> Sample labels checked for correct preservation? Yes 0 No ❑ <br /> pH acceptable upon receipt(Metal:<2)? Yes ❑ No ❑ NA ICI <br /> UCMR Samples: <br /> pH tested and acceptable upon receipt(200.7::52;533:6-8; Yes ❑ No❑ NA 0 <br /> 537.1:6-8)? <br /> Free Chlorine tested and acceptable upon receipt(<0.1mg/L) Yes ❑ No L NA ICI <br /> [not applicable to 200.7]? <br /> Comments: <br /> Page 36 of 36 <br />