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www energylab.com Y: ? H=lena XT 877472-0711 • Billings, MT IGI-735-4469 • Casper, WY 888-235-0515 <br />,tasryetwfEresNea3iNu teu 6111, fte; va 866-686-7175 • Rapid 011, SD 886-672-1225 a College Station, TX 888-618-2218 <br />Workorder Receipt Checklist <br />Cotter Corporation <br />Login completed by: Halley Ackerman <br />Reviewed by: BL2000\cwagner <br />Reviewed Date: 8/25/2010 <br />C10080]90 <br />Date Received: 8/20/2010 <br />Received by: ckw <br />Carrier name: FedEx <br />Shipping container/cooler in good condition? Yes Q No [:] <br />Custody seals intact on shipping container/cooler? Yes El No E] <br />Custody seals intact on sample bottles? Yes 1:1 No [:] <br />Chain of custody present? Yes 0 No E] <br />Chain of custody signed when relinquished and received? Yes No <br />Chain of custody agrees with sample labels? Yes [Jf No <br />Samples in proper container/bottle? Yes Q No <br />Sample containers intact? Yes No <br />Sufficient sample volume for indicated test? Yes F171 No E] <br />All samples received within holding time? Yes Q No <br />Container/Temp Blank temperature: 6°C On Ice <br />Water - VOA vials have zero headspace? Yes ? No ? <br />Water - pH acceptable upon receipt? Yes F71 No D <br />Contact and Corrective Action Comments: <br />None <br />Not Present ? <br />Not Present <br />Not Present <br />No VOA vials submitted <br />Not Applicable ? <br />Page 28 of 37