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CONDITION OF SAMPLE UPON RECEIPT FORM <br />Client: C~trEx <br />Project Manager: JtJl~f ~~~~'~r15e~' <br />Workorder No: <br />Paragon Anaiyfics <br />Initials: ___~/~i~/ Date: 1Z JS~` <br />1. Does this project require any special handling in addition to standard Paragon procedures? ~ YES ~ G`'y.0" <br />2, Is pre-screening required per SOP 008? YES <br />3. Are custody seals on shipping containers intact? ~ ~~ YES '; NO <br />4. Are custody seals on sample containers intact? YES ~ NO <br />5, Is there a C.OC (Chain-of-Custody) present or other representative documents? ~ ~ ~ NO <br />6, Is the COC (if applicable) complete and legible? N/A ~ NO <br />g Are bottle IDs legible and in agreement with COC sample IDs? N/A I~ NO <br />g. Is the COC in agreement with samples received? (# of samples, # of containers, matrix) N!A NO <br />9. Were airbills present and/or removable? N/A ~ NO <br />10. Are all aqueous samples requiring preservation preserved correctly? (excluding volatile organics) N/A YES -~ <br />I I. Are all aqueous non-preserved samples at the correct pH? N/A ~ NO <br />t2. Is there sufficient sample for the requested analyses? NO <br />13. Were all samples placed in the proper containers for the requested analyses? ~ NO <br />l4, Are all samples within holding fimes for the requested analyses? ~S NO <br />Is. Were all sample containers received intact? (not broken or leaking, etc.) ~S NO <br />I6. Are all samples requiring no headspace (volatiles, reactive cyanide/sulfide, radon), <br />headspace free? Size of bubble: _ < green pea _> green pea A YES NO <br />17 Were samples checked for and free from the presence of residual chlorine? <br />(Applicable when PM bas indicated samples are from a chlorinated water source; note if field preservation with sodium <br />thiosulfate was not observed.} ,~, ~ I <br />NO <br />18, Were the sample(s) shipped on ice? N/A NO <br />19. Were cooler temperatures measured at 0.1-6.0°C? N/A ~ NO <br /> *IR n used (crrc(e one #2 - Oakton InfraPro II, SN2922500201-0066; - Oakton InfraPro II, SN23722201 01-0002 <br /> Cooler #'s~_ <br />Temperature (°C) ~ <br />No. of custody seals ~" <br /> s~ryeyi <br />Acceptance <br />i^r°rmas°^ External µR/hr reading 1 Z <br />1 <br />Background µR/hr reading <br />Were external µR/hr readings < two times background and within DOT acceptance criteria? / NO <br /> <br /> <br />If no, see Form 008.) <br />CS <br />If applicable, was the client contacted? YES / NO K NAB Contact <br />Project Manager Signature/ Date: ~~ ~ Z/w`/~ <br />Form 20'1 r18.zls (6126104) <br />Date/Time: <br />Page 1 of <br />Additional Informafion: PROVIDE DETAILS BELOW FOR A NO RESPONSE TO ANY QUESTION ABOVE EXCEPT #I .AND #2. <br />