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Login Sample Receipt Checklist <br />Client: Coors Energy Company Job Number: 280 - 33543 -1 <br />Login Number: 33543 <br />List Number: 1 <br />Creator: Cofoid, Stephen T <br />Question <br />List Source: TestAmerica Denver <br />Answer Comment <br />Radioactivity wasn't checked or is </= background as measured by a survey <br />True <br />meter. <br />The cooler's custody seal, if present, is intact. <br />True <br />Sample custody seals, if present, are intact. <br />True <br />The cooler or samples do not appear to have been compromised or <br />True <br />tampered with. <br />Samples were received on ice. <br />True <br />Cooler Temperature is acceptable. <br />True <br />Cooler Temperature is recorded. <br />True <br />COC is present. <br />True <br />COC is filled out in ink and legible. <br />True <br />COC is filled out with all pertinent information. <br />True <br />Is the Field Sampler's name present on COC? <br />True <br />There are no discrepancies between the containers received and the COC. <br />True <br />Samples are received within Holding Time. <br />True <br />Sample containers have legible labels. <br />True <br />Containers are not broken or leaking. <br />True <br />Sample collection date /times are provided. <br />True <br />Appropriate sample containers are used. <br />True <br />Sample bottles are completely filled. <br />True <br />Sample Preservation Verified. <br />True <br />There is sufficient vol. for all requested analyses, incl. any requested <br />True <br />MS /MSDs <br />Containers requiring zero headspace have no headspace or bubble is <br />True <br /><6mm (1/4 "). <br />Multiphasic samples are not present. <br />True <br />Samples do not require splitting or compositing. <br />True <br />Residual Chlorine Checked. <br />N/A <br />TestAmerica Denver <br />Page 33 of 33 9/28/2012 <br />