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Barringer Laboratories, Inc. Date: 19-Jul-00 <br /> 15000 W 6th Avenue Suite 300 Golden.Colorado 80401-5047 (800)654-0506 (303)277-1687 Fni(303)277-1689 <br /> Sample Receipt Checklist <br /> Client Name CGRS Date and Time Received 21Jun-00 <br /> Work Order 0006205 Received By SPK <br /> Carrier Client Drop Off Checklist Created By NSW <br /> Shipping container/cooler in good condition? Yes ❑ No❑ Not Present R] <br /> Custody seals intact on shippping container/cooler? Yes ❑ No❑ Not Present ❑J <br /> Custody seals intact on sample bottles? Yes ❑ No❑ Not Present 91 <br /> Chain of custody present? Yes R No❑ <br /> Chain of custody signed when relinquished and received? Yes © No❑ <br /> Chain of custody agrees with sample labels? Yes No❑ <br /> Coolers and samples screened for radioactivity? Yes No❑ <br /> Samples in proper container/boWe? Yes ❑� No❑ <br /> Sample containers intact? Yes R No❑ <br /> Sufficient sample volume for indicated tests? Yes RI No❑ <br /> All samples received within holding time? Yes 9 No❑ <br /> Container/Temp Blank temperature in compliance? Yes Q No❑ Temp: 120C <br /> VOA vials have less than pea-sized headspace? Yes ❑ No❑ No VOA vials ❑`� <br /> Was pH acceptable upon receipt? Yes R] No❑ <br /> Was pH left unadjusted? Yes R) No❑ Preservative. <br /> Lot#: <br /> Comments: <br />