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ACZ Laboratories, Inc. <br />2773 Downhill Drive Steamboat Springs, CO 80487 (800) 334-5493 <br />Sample <br />Receipt <br />ARCADIS <br />30080095 <br />ACZ Project ID: <br />Date Received: <br />Received By: <br />03/19/2021 11:07 <br />L64861 <br />Date Printed:3/22/2021 <br /> Chain of Custody Related Remarks <br /> Client Contact Remarks <br />NANOYES <br />X <br />X <br />X <br />X <br />X <br />X <br />1) Is a foreign soil permit included for applicable samples? <br />2) Is the Chain of Custody form or other directive shipping papers present? <br />3) Does this project require special handling procedures such as CLP protocol? <br />4) Are any samples NRC licensable material? <br />5) If samples are received past hold time, proceed with requested short hold time analyses? <br />6) Is the Chain of Custody form complete and accurate? <br />7) Were any changes made to the Chain of Custody form prior to ACZ receiving the samples? <br /> Receipt Verification <br />NANOYES <br />X <br />X <br />X <br />X <br />X <br />X <br />X <br />X8) Are all containers intact and with no leaks? <br />9) Are all labels on containers and are they intact and legible? <br />10) Do the sample labels and Chain of Custody form match for Sample ID, Date, and Time? <br />11) For preserved bottle types, was the pH checked and within limits? <br />12) Is there sufficient sample volume to perform all requested work? <br />13) Is the custody seal intact on all containers? <br />14) Are samples that require zero headspace acceptable? <br />15) Are all sample containers appropriate for analytical requirements? <br />16) Is there an Hg-1631 trip blank present? <br />17) Is there a VOA trip blank present? <br />18) Were all samples received within hold time? <br />Samples/Containers <br />X <br />X <br />X <br /> Shipping Containers <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 />Cooler Id Temp(°C) Temp Rad(µR/Hr) Custody Seal <br /> Criteria(°C) Intact? <br />--------- -------- ------------ ---------- ------------ <br />4330 0.1 <=6.0 15 Yes <br />X <br />Was ice present in the shipment container(s)? <br />Yes - Wet ice was present in the shipment container(s). <br />1 <br />NA indicates Not Applicable <br />REPAD LPII 2012-03 <br />Page 11 of 14L64861-2104081104