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~~~ CONDITION OF SAMPLE UP <br />Client:~MQX ` / <br />Project Manager: ~ ~dl;e- ~~l ~k~io^ <br />ON RECEII'T FORM <br />Paragon Anaiyfics <br />Workorder No: 0.$08300 <br />Initials: ~ Date: B ~ pS <br />1, Does this project require any special handling in addition to standard Paragon procedures? ~ YES <br />2, Is pre-screening required per SOP 008? ~ YES <br />3. Are custody seals on shipping containers intact? ~: YES NO <br />q, Are custody seals on sample containers intact? ~ A YES NO <br />s. 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 I E~ NO <br />7. Are bottle IDs legible and in agreement with COC sample IDs? N/A ~ ~S NO <br />g. Is the COC in agreement with samples received? (# of samples, # of containers, matrix) N/A NO <br />q, Were airbills present and/oi removable? N/A ~S NO <br />10, Are all aqueous samples requiting preservation preserved correctly? (excluding vo]atile organics) YES NO <br />1 t. Are all aqueous non-preserved samples at the correct pH? N/A YES <br />lz. Is there sufficient sample for the requested analyses? cY~ NO <br />13. Were all samples placed in~the proper containers for the requested analyses? NO <br />l4, Are all samples within holding times for the requested analyses? NO <br />ts. Were all sample containers received intact? (not broken or leaking, etc.) NO <br />16. Are all samples requiring no headspace (volatiles, reactive cyanide/sulfide, radon), ~ <br />headspace free? Size of bubble: _ < green pea _> green pea ~ yES NO <br />n 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 />~ <br />YES <br />NO <br />ts. Were the sample(s) shipped on ice? N/A YES ~ <br />19. Were cooler temperature ~ easured at 0.1-6.0°C? N/A YES ~ <br /> *IR un used circle one : #2 - Oakton InfraPro II, SN292250020i-OObb; #4 - Oakton InfraPro II, SN2 3 722201 0 1-0002 <br /> Cooler #'s ) <br />~I~Temperature (°C)~~~en'~ <br />No. o£custody seals ,A( r~ <br />s~rren Extemal!'~,µR/hrreading /V77 <br />Acceptaaca N~ <br />tatormaUon Background~;~µR/hr reading <br />Were eztemal µR/ly readings < two times background and within DOT acceptance criteria? YES / NO <br /> <br /> <br /> <br /> <br /> <br />If no, see Fotm 008.) <br />Ad(dltlOnal IntOrmaflOn: PROVIDE DETAILS BLOW FOR A NO RESPONSE TO ANY QUESTION ABOVE EXCEPT #I AND N2. <br />- 7grn~IC6 ~~( ,..,~ ~,~,~i tPc ~ C pN ~Z - <br />If applicable, was the client <br />Project Manager Signature/ <br />YES / NO /~ Contact <br />-~ - - <br />Date/Time: <br />Form 201 r18.xls (6126104) i, Page 1 of <br />