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S <br /> •ACCUTEST, Accutest Laboratories Sample Receipt Summary <br /> —on Aroniea <br /> Accutest Job Number: D75116 Client: BRAUN Project: LUCKY STRIKE 01 <br /> Date/Time Received: 9/15/2015 11:00:00 AM Delivery Method: Airbill#'s: hd <br /> Cooler Temps(Initial/Adjusted): #1:(3.5/3.5): <br /> Cooler Security _Y or N Y or N Sample Integrity-Documentation Y or N <br /> 1.Custody Seals Present: R ❑ 3.COG Present: W ❑ Eli.Sample labels present on bottles: W <br /> 2.Custody Seals Intact: ® ❑ 4.Smpl Dates/Time OK W ❑ ❑ <br /> 2.Container labeling complete: <br /> O El <br /> ree:3.Sample container label/COG aC!1 <br /> Cooler Temperature Y or N P 9 � <br /> 1.Temp criteria achieved: ® ❑ Sample integrity-Condition Y or N <br /> 2.Cooler temp verification: ___ Bar Therm; El3.Cooler media: Ice(gag) 1.Sample recvd within HT: ❑� <br /> 2.All containers accounted for: 0 ❑ <br /> 4.No.Coolers: 1 3.Condition of sample: Intact <br /> Qualb Control Preservation Y or N N/A Sample Integrity-Instructions Y or N N/A <br /> 1.Trip Blank present/cooler: ❑ ❑ ❑d 1.Analysis requested is clear: 0 ❑ <br /> 2.Trip Blank listed on COG: ❑ ❑ ❑� 2.Bottles received for unspecified tests ❑ <br /> 3.Samples preserved properly: © ❑ 3.Sufficient volume recvd for analysis: ❑ <br /> 4.VOCs headspace free: ❑ ❑ R] 4.Compositing instructions clear: ❑ ❑ W <br /> 5.Filtering instructions clear: ❑ ❑ R <br /> Comments <br /> Acwtesl Laboratories 4036 Youngfield Street Wheat Ridge,CO <br /> V:(303)425-6021 F:(303)425-6854 a /acmtest.com <br /> D75116: Chain of Custody <br /> Page 2 of 2 <br /> ■ 20 of 42 <br /> ACCUT�ST <br /> D75116 <br />