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ACiZ Laboratories, Inc. <br />2773 Downhill Drive Steamboat SpIipQS, CO 80487 (800) 334-5493 <br />R,xeipt VtuiSeafion <br />YES NO NA <br />1) Does this project require special handling procedures such as CLP protocol? <br />2) Are the custody seals on the cooler intact? <br />3) Are the custody seals on the sample containers intact? <br />4) Is there a Chain of Custody or other directive shipping papers present? <br />5) Is the Chain of Custody complete? <br />6) [s the Chain of Custody in agreement with the samples received? <br />7) Is there enough sample for all requested analyses? <br />8) Are all samples within holding times for requested analyses? <br />9) Were all sample containers received intact? <br />10) Are the temperature blanks present? <br />1 I) Are the trip blanks (VOA and/or Cyanide) present? <br />12) Are samples requiring no headspace, headspace free? <br />13) Do the samples that require a Foreign Soils Permit have one? <br />N/A <br /> J <br /> J <br /> J <br />J <br />J <br />J <br />J <br />J <br />J <br /> <br /> J <br /> J <br />N/A <br />Cooler Id Tem °C Rad <br />ACZ 11.1 13 <br />REPAD.03.11.00.01 <br /> <br />LA1791: Page 8 of 10 <br />Midas Mining Co. ACZ Project ID: Ift1791 <br />Date Received: 6/26/03 <br />Received By: CORYD <br />