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A Z Laboratories, Inc. Sample <br /> 2773 Downhill Drive Steamboat Springs, CO 80487 (800)334-5493 Receipt <br /> Golder Associates ACZ Project ID: L28976 <br /> 1547675 Date Received: 02/16/2016 09:18 <br /> Received By: ddp <br /> Date Printed: 2/16/2016 <br /> Receipt Verification <br /> YES NO NA <br /> 1) Is a foreign soil permit included for applicable samples? X <br /> 2) Is the Chain of Custody form or other directive shipping papers present? X <br /> 3) Does this project require special handling procedures such as CLP protocol? X <br /> 4)Are any samples NRC licensable material? X <br /> 5) If samples are received past hold time, proceed with requested short hold time analyses? X <br /> 6) Is the Chain of Custody form complete and accurate? X <br /> 7)Were any changes made to the Chain of Custody form prior to ACZ receiving the samples? X <br /> A change was made in the Sample ID line 9 section prior to ACZ <br /> custody. <br /> Samples/Containers <br /> YES NO NA <br /> 8)Are all containers intact and with no leaks? X <br /> 9)Are all labels on containers and are they intact and legible? X 111111 <br /> 10) Do the sample labels and Chain of Custody form match for Sample ID, Date, and Time? X <br /> 11)For preserved bottle types, was the pH checked and within limits? 1 X <br /> 12) Is there sufficient sample volume to perform all requested work? X <br /> 13) Is the custody seal intact on all containers? X <br /> 14)Are samples that require zero headspace acceptable? X <br /> 15)Are all sample containers appropriate for analytical requirements? X <br /> 16)Is there an Hg-1631 trip blank present? X <br /> 17) Is there a VOA trip blank present? X <br /> 18)Were all samples received within hold time? X <br /> Chain of Custody Related Remarks <br /> Client Contact Remarks <br /> Shipping Containers <br /> Cooler Id Temp(°C) Temp Rad(pR/Hr) Custody Seal <br /> Criteria(°C) Intact? <br /> 4793 3.2 <=6.0 13 Yes <br /> Was ice present in the shipment container(s)? <br /> Yes - Wet ice was present in the shipment container(s) . <br /> Client must contact an ACZ Project Manager if analysis should not proceed for samples received <br /> outside of their thermal preservation acceptance criteria. <br /> REPAD LPII 2012-03 <br /> L28976-1602251543 Page 19 of 21 <br />