Laserfiche WebLink
ENERGYLABORATOR/ES, /NC, ^2393Sa/1 Creek Highway(8260>f °RQ Box325B • Casper WY92602 <br />To/l Fiee 888.235 0575 • 3072350515 • Fax 307234.1639 • Casper@eneigylab. cam • wwwenergy/ab.com <br />.rte .° <br />Energy Laboratories Inc. <br />Sample Receipt Checklist <br />Client Name Cotter Corporation <br />Work Order Number <br />Checklist completed by: <br />Shipping container/cooler in good condition? <br />Cuslotly seals intact on shipping container/cooler? <br />Custody seals intact on sample bottles? <br />Chain of custody present? <br />Chain of custody signed when relinquished antl received? <br />Chain of custody agrees with sample labels? <br />Samples in proper container/bottle? <br />Sample containers intact? <br />Sufficient sample volume for indicated test? <br />All samples received within holding time? <br />Containedremp Blank temperature in compliance? <br />Water-VOA vials have zero headspace? <br />Water- pH acceptable upon receipt? <br />Adjusted? <br />Yes ^~ <br />Yes ^ <br />Yes ^ <br />Yes 0 <br />Yes (/JJ <br />Yes <br />Yes ~ <br />Yes <br />Yes d <br />Yes <br />Yes <br />Yes ^ <br />Yes ^ <br />Date antl Time Received: 3/21/2005 9:45:00 <br />Received by ckw <br />Reviewed by <br />Initials Dale <br />No ^ Not Present ^ <br />No ^ Not Present <br />No ^ Not Present <br />No ^ <br />No ^ <br />No ^ <br />No ^ <br />No ^ <br />No ^ <br />No ^ <br />No^ N/A°C Solid <br />No ^ No VOA vials subm itted <br />No ^ Not Applicable <br />Checked by <br />Any No and/or NA (not applicable) response must be detailed in the comments section below. <br />Client contacted <br />Contacted by: <br />Comments: <br />Date contacted: <br />Regarding: <br />Person contacted <br />Corrective Action <br />Tracker 005030810 Page i <br />