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Paragon Anafyfics <br />/~ CONDITION OF SAMPLE UPON RECEIPT FORM <br />Client: l ,t ti{t X t , ~ •,c . WorkorderNo: /~ Q cl C7 ~- L'? 3 ~- <br />Project Manager: Le < ~ i a t C.c z ` Initials: C L'~~ Date: "* 2. ate <br />t. Does this project require any special handling in addition to standazd Paragon proceduros? YES IO <br />z, Is pre-screening required per SOP 008? YES NO <br />3, Are custody Seals on shipping containers intact? NlFt~ YES NO <br />q, Are custody seals on sample containers intact? N/A ~ YES NO <br />5. Is there a COC (Chain-of-Custody) present or other representative documents? Y NO <br />6, Is the COC (if applicable) complete and legible? N/A YES` NO <br />~, Are bottle IDs legible and in agreement with COC sample IDs? N/A ® NO <br />g, Is the COC in agreement with samples received? (# of samples, # of containers, matrix) N/A YE NO <br />g, Were airbills present and/or removable? N YES NO <br />I0, Are all aqueous samples requiring preservafion preserved correctly? (excluding volatile organics) N/A YES NO <br />1 t. Are all aqueous non-preserved samples at the correct pH? N/A YES NO <br />iz. Is there sufficient sample for the requested analyses? Yi:S NO <br />13. Were all samples placed in the proper containers for the requested analyses? YES NO <br />1a. Are all samples within holding times far the requested analyses? YES NO <br />ts. Were all sample containers received intaM? (not broken or leaking, etc.) YES NO <br />16. Are all samples requiring no headspace (volatiles, reactive cyanide/sulfide, radon), <br />headspace free? Size of bubble; _ < green pea _> green pea N/A YES NO <br />l~ Were samples checked for and free from the presence of residual chlorine? <br />(Applicable when PM has indicated samples ate from a chlorinated water source; note if field preservation with sodium <br />thiasulfate was not observed.) <br />N!A <br />YES <br />NO <br />la. Were the sample(s) shipped on ice? N/A YES NO <br />19. Were cooler rem eratures measured at 0.1-6.0°C? IR n used: #1 #2 N/A YES NO <br />•IR Gm #1: Raytek 8N sC-PM37R9C03 COOIer #~S (qI <br />•IR Cun lF2: Oelcoq SN 2SCIR12a1 Temperature r'rw.1~IP~~ <br />No. of custod seals N t`t <br />~,;,,r External µR/ltr reading NR <br />aFe#la°~ ~` <br />latrnmanm Backgrolmd µR/hr reading / <br />Were external µR/hr readings 5 two times background and within DOT acceptazx:e criteria? ~'. NO (If no, see Fotm 008.) <br />Additional Information: -PFROVmE DETA/I~LS BELOW FOR A NO RESPONSE TO ANY QUESTION ABOVE EXCEPT #1 AND #2. <br />• r~~~Et~'t~~. C~G.. iP c1.~ 1-11 ~- tS 1~S ~C c( LiS ~.2 `~ nJ I~fG.- is 6,~ 1+SK ,~~r/ <br />e~ II'' -, 7- <br />` ~/' ,~~f5 rP CRa vti~ G-t f ~c l li '~'~ -K.c~_/34 ~e_'~-e ,-'f ~N(.! t 7rrL <br />T ~~- <br />t. _ r~ <br />• .~e t T ~T r'2 ~+-r~ Ft tSCtitSSCOt. <br />If applicable, was the client contacted? YES / NO / Q~ Contact Name: Date/Time: <br />\~ <br />Project Manager Signature/ Date: 7~~ ~ °`"~ <br />000 05 <br />Form 201r18.xls (8/28/04) <br />Page 1 of <br />