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r??.t^^--?) www.energylab.com ( Helena, W 877-472-0711 a Billings, MT 800-735-4489 a Casper, WY 888-235-0515 <br />Ans col Ezceflence$Mc* 1951 Gillette WY 866-686-1115 a Rapid City, So 888-6721225 9 College Station, TX 880690-2218 <br />Workorder Receipt Checklist (IIII??I??I???IIIIII???II???I??Ilill?llll?l <br />Cotter Corporation 010100095 <br />Login completed by: Halley Ackerman Date Received: 101412010 <br />Reviewed by: BL20001swaldrop Received by: ha <br />Reviewed Date: 10/8/2010 Carrier name: Ground <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 when relinquished and 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 />Container/Temp Blank temperature: <br />Water - VOA vials have zero headspace? <br />Water - pH acceptable upon receipt? <br />---------------------------------------------------- <br />Contact and Corrective Action Comments: <br />None <br />Yes [?IJ No Not Present <br />Yes No Not Present[/( <br />Yes 0 No [] Not Present <br />Yes No <br />Yes [?!( No E] <br />Yes No [] <br />Yes [J? No <br />Yes © No [:] <br />Yes [J( No E] <br />Yes Z No [] <br />17°C Melted Ice <br />Yes El No El No VOA vials submitted 0 <br />Yes Q No Not Applicable El <br />Page 4 of 6