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www.energylab.com Helena, MT B77-472-0711 . Billings, MT 800-7354489 + Casper, WY 888-235-0515 <br />Ans"ka/Eret6w $k" J931 J Gillette, WY 866-686-7175 • Rapid City, SD 86B-672-1225 • College Station, TX 888-690-2218 <br />Workorder Receipt Checklist <br />Cotter Corporation <br />Login completed by: Corinne Wagner <br />Reviewed by: BL2000\hackerman <br />Reviewed Date: 8/25/2010 <br />Shipping container/cooler in good condition? <br />Custody seals intact on shipping container/cooler? <br />Custody seals intact on sample bottles? <br />Chain of custody present? <br />Chain of custody signed w hen relinquished and received? <br />Chain of custody agrees w ith sample labels? <br />Samples in proper container/bottle? <br />Sample containers intact? <br />Sufficient sample volume for indicated test? <br />All samples received w ithin holding time? <br />Yes 0 <br />Yes 0 <br />Yes ? <br />Yes 0 <br />Yes 0 <br />Yes 0 <br />Yes Z <br />Yes 0 <br />Yes 0 <br />Yes 0 <br />No <br />No <br />No <br />No <br />No <br />No <br />No ? <br />No FJ <br />No [:] <br />No ? <br />C,ooeo7s3 <br />Date Received: 8/20/2010 <br />Received by: ha <br />Carrier name: Hand Del <br />Not Present ? <br />Not Present <br />Not Present 0 <br />Container/Ter p Blank temperature: 11'C On Ice <br />Water - VOA vials have zero headspace? Yes No No VOA vials submitted <br />Water - pH acceptable upon receipt? Yes 0 No Not Applicable <br />Contact and Corrective Action Convmnts: <br />None <br />Page 4 of 6