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Paragon Anaiytics <br />CONDITION OF SAMPLE UPON RECEIPT FORM 7 r/ <br />Client: ~(?p~ Ipp WorkorderNo; ~i p~jZ7 /1Zae~cS <br />ProjectManager: JII~E Initials:~/~ Date: ~ ~~'~'~~ <br />1, Does this project require any special handling in addition to standazd Paragon procedures? YES <br />2, Is pre-screening required per SOP 008? ~ YES I It~O <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 COC (Chain-of-Custody) present or other representative documents? NO <br />6. Is the COC (if applicable} complete and legible? N/A NO <br />7. Are bottle IDs legible and in agreement with COC sample IDs? N/A NO <br />q_ Is the COC in agreement with samples received? (# of samples, # of containers, matrix) N/A (~ NO <br />g. 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 />u. Are all aqueous non-preserved samples at the correct pH? N/A YES ~i <br />t2. Is there sufTicient sample for the requested analyses? NO <br />13. Were all samples placed in the proper containers for the requested analyses? ~ NO <br />14. Are all samples within holding times for the requested analyses? NO <br />Is. Were all sample containers received intact? (not broken or leaking, etc.) ~' NO <br />t6. Are all samples requiring no headspace (volatiles, reactive cyanide/sulfide, radon), <br />headspace free? Size of bubble: _ < green pea _> green pea ~ yES NO <br />17 Were samples checked for and free from the presence of residual chlorine? <br />(Applicable when PM has indicated samples are from a chlorinated water source; note if field preservation with sodium <br />thiosulfate was not observed.) <br />YES <br />NO <br />ls, Were the sample(s) shipped on ice? N/A Y NO <br />19. Were cooler temperatures measured at 0.1-6.0°C? N/A NO <br />*IR un used (circle one : #2 - Oakton InfraPro II, SN2922600201-0066; - Oakton InfraPro R, SN2372220101- 02 <br />Cooler #'s <br />Temperature (°C~~ <br />No. of custody seals <br />S~„eW External µR/]1r reading <br />Aaeptance <br />~°r°~eo°° Background µR/hr reading <br />Were extemat pR/hr readings < two times background and within DOT acceptance cri[ena? ~ ~ NO (If no, see Fonn 008.) <br />Add((ition)I al InftlrmatlOn: //PROVIDE DETAILS BELOW FOR A NO RESPON//SE TO A//NY /QUES/TION /ABOVE EXCEPeT #1 AND #2. <br />^7Nm/Wr, Zr~ ~J-sv SP "f T~ .i~,f. /BC 2/i/~, .NrI) bP. 4-.'~APl~P .A __,R niac0/I~oA ~~~ ~e~> <br />- 5 ti lc l+ Z /a e-reId C 70, ( V <br />Sa^^~P~S S +(s nnrl' j:Sje er.. U`v,_~ COQ. COG fi.r_i.~-c-c G <br /> <br />If applicable, was the client contacted? ~YFj;a~/ NO / NA Contact Name: JG~ <br />Project Manager Signature/ Date: ~~ <br />Form 201r18.xls (6!26104) <br />Date/Time: <br />Page 1 of ~ <br />