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Paragon Analytics <br />/~ CONDITION OF SAMPLE UPON RECEIPT FORM p, <br />Client: l ~ ~rti-.! Workorder No: ~ Cj/ 2 (Z <br />Project Manager: j /~ Initials: Date: /2 /S~f <br />t. Does [his project require any special handling in addition to standazd Paragon procedures? YES 'NO ' <br />2, Is pre-screening required per SOP 008? ~--~ YES O <br />3. Are custody seals on shipping containers intact? N/ YES NO <br />a. Are custody seals on sample containers intact? N/ 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 NO <br />7, 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 NO <br />9. Were airbills present and/or removable? N/A YE NO <br />10. Are all aqueous samples requiring preservation preserved correctly? (excluding volatile organics) N/A S N <br />tt. Are all aqueous non-preserved samples at the correct pH? N/A O <br />tz. Is there sufficient sample for the requested analyses? NO <br />t3. Were all samples placed in the proper containers for the requested analyses? NO <br />ta. 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 N/ 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 />N/ <br />YES <br />NO <br />Ig, Were the sample(s) shipped on ice? N/A NO <br />19. Were cooler tempera easured at 0.1-6.0°C? N/A YE NO <br />*IR nn used circle oneJ • #2 - akton InfraPro II, SN2922500201-0066; #4 - Oakton InfraPro II, SN237222010 - 2 <br />Cooler #'s ~ <br />Temperature(°C)~,~OC, <br />No. of custod seals 0 <br />s~,'reYf External µR/hr reading ~_ <br />Acceptance ' <br />Information Background µR/hr reading (7i <br />Were external µR/hr readings S two times baclcgound and within DOT acceptance criteria? YES / NO (If no, see Form 008.) <br />If applicable, was [he client contacted? YES / NO / /NA Contact Name: Dale/Time: <br />Project Manager Signature/ Date: / Z ~ <br />Form 261 r18.xls (6126/04) <br />Page 1 of <br />Addifional Information: PROVIDE DETAILS BELOW FOR A NO RESPONSE TO ANY QUESTION ABOVE EXCEPT #1 AND #2. <br />