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• wwwxwgylab.cwm Helena, Mfr 877472-0711 • Billings, MT 800-7354488 • Casper, WY 888-235-0518 <br />w AsayBealfnpONOSyee Idit Gillette, WY 866-686-7175 • Rapid City, SD 888-812-1225 • Cottage Station, TX 888-880-2210 <br />J <br />Workorder Receipt Checklist (IIINI?II?II?I??I?III?MIII?I?I???IIN? <br />Cotter Corporation C10100814 <br />Login completed by: Tabitha Edwards Date Received: 10/20/2010 <br />Reviewed by: BL2000\tparke Received by: tae <br />Reviewed Date: 10/27/2010 Carrier name: FedEx <br />Shipping container/cooler in good condition? Yes 0 No E] Not Present E] <br />Custody seals intact on shipping container/cooler? Yes No Not Present[!( <br />Custody seals intact on sample bottles? Yes No El Not Present Q <br />Chain of custody present? Yes [?J No <br />Chain of custody signed when relinquished and received? Yes 0 No <br />Chain of custody agrees with sample labels? Yes 0 No <br />Samples in proper container/bottle? Yes[/( No <br />Sample containers intact? Yes [/f No <br />Sufficient sample volume for indicated test? Yes 0 No <br />All samples received within holding time? Yes No ? <br />Containerfremp Blank temperature: 8°C Melted Ice <br />Water - VOA vials have zero headspace? Yes E] No ? No VOA vials submitted Q <br />Water - pH acceptable upon receipt? Yes 0 No 11 Not Applicable F] <br />Contact and Corrective Action Comments: <br />None <br />Page 6 of 8