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No <br /> ,AGCIJTEST. Accutest Laboratories Sample Receipt Summary <br /> LASONATOAIB! <br /> Accutest Job Number: D71576 Client: BRAUN ENVIRIONMENTAL Project: LUCKY STRIKE 01 <br /> Date/Time Received: 6/9/2015 1:20:00 PM Delivery Method: Airbill#'a: hd <br /> Cooler Temps(Initial/Adjusted): #1:( .3/2 2.3): <br /> Cooler Security Y or N Y or N Sample Integri -Documentation Y or N <br /> 1.Custody Seals Present: ❑ ❑ 3.COC Present: © ❑ 1.Sample labels present on bottles: © ❑ <br /> 2.Custody Seals Intact: R ❑ 4.Smpl Dates/Time OK © ❑ El2.Container labeling complete: <br /> 3.Sample container label/COC agree: <br /> ❑ <br /> Cooler Temperature Y or N P 9 © � <br /> 1.Temp criteria achieved: © ❑ Sample Intearity-Condition Y or N <br /> 2.Cooler temp verification: IR Gun; ❑ <br /> 1.Sample recvd within HT: ❑ <br /> 3.Cooler media: Ice(Bag) <br /> 2.All containers accounted for: © ❑ <br /> 4.No.Coolers: 1 3.Condition of sample: Intact <br /> Quality Control Preservation Y or N N/A <br /> Sample Inteyft-Instructions Y or N N/A <br /> 1.Trip Blank present/cooler: ❑ ❑ ❑ 1.Analysis requested is clear: © ❑ <br /> 2.Trip Blank listed on COC: ❑ ❑ <br /> 2.Bottles received for unspecified tests ❑ 91 <br /> 3.Samples preserved properly: © ❑ 3.Sufficient volume recvd for analysis: V ❑ <br /> 4.VOCs headspace free: ❑ ❑ © 4.Compositing instructions clear. ❑ ❑ <br /> 5.Filtering instructions clear: ❑ ❑ <br /> Comments <br /> Accutest Laboratories 4036 Youngfield Street Wheat Ridge,CO <br /> V:(303)425-6021 F:(303)425.6854 —laccutest— <br /> D71576: Chain of Custody <br /> Page 2 of 2 <br /> ®l' 22 of 44 <br /> aAC C(-- ST. <br /> D71576 <br />