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Paragon Analytics CONDITION OF SAMPLE UPON RECEIPT FORM Client: [' E-2,g£,~C WorkorderNo: (~ Sn S I f~ Project Manager: ,J (yl ~ Initials: ~_ Date: 5 ~ 14 • O5 1, Does [his project require any special handling in addition to standazd Paragon procedures? YES 2. Is pre-screening required per SOP 008? YES 3, Are custody seals on shipping containers intact? / YES NO q. Are custody seals on sample containers intact? !A YES NO 5, Is there a COC (Chain-of-Custody) present or other representative documents? YES NO 5. Is the COC (if applicable) complete and legible? N/A YES NO 7, Are bottle IDs legible and in agreement with COC sample IDs? N/A YES NO . g. Is the COC in agreement with samples received? (# of samples, # of containers, matrix) N/A YES NO y. Were airbills present and/or removable? N/A NO 10. Are all aqueous samples requiring preservation preserved correctly? (excluding volatile organics) ( YES NO 11. Are all aqueous aon-preserved samples at the correct pH? N/A NO lz. Is there sufficient sample for the requested analyses? YE NO 13. Were all samples placed in the proper containers for the requested analyses? ® NO ta. Are all samples within holding times for the requested analyses? NO 15. Were all sample containers received intact? (not broken or leaking, etc.) YES NO ]s. Are all samples requiring no headspace (volatiles, reactive cyanide/sulfide, radon), headspace free? Size of bubble: _ < green pea `> green pea NlA YES NO t7 Were samples checked for and free from the presence of residual chlorine? (Applicable whrn PM has indicated samples are from a chlorinated water soutee; note if field presmation with sodium thiosulfate was not observed.) /A YES NO le. Were the sample(s) shipped on ice? N/A YES NO 19. Were cooler temperatures measured at 0.1-6.0°C? N/A YES NO *IR uo used circle orse : 2 - Oakton InfraPro R, SN292250D201-0066; #4 - Oakton LifraPro D, SN2372220101-0002 Cooler #'s ~ Temperature (°C) 3. Cp No. of custody seals $ ~,rVayt External µRlltr reading ~_ Pcceptance ~~°~ Background µltJhr reading (2-- Were ez[cmal pR/Iv readings 5 two times background and within DOT acceptance criteria? ~ NO (]f no, see Form 008.) Additional Information: PROVIDE DErAILS BELOW FOR A NO RESPONSE TO ANY QUESTIbR!'ABOVE EXCEPT NI AND #2. ~` ~ ~~yyy~,Jrc rcc,t_uerl_d~~ ~ 0~ IZ ~ w' sa n)E3-~~ w~P~i(< a alv5'S ~ ti 1~6 se,•~pd ~o }2t ~' I-(tvec~. d,~r~ r~~e ~ _~ If applicable, was the client contacted? YES / NO / Contact Name: ~-v, DatelTime: Project A'Ianager Signature/ Date: ~ ~ ~/ Form 201 r18.xls (8/26104) Page t of ~