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• w www a < r { ??f i tta; 1kY mT 877-472-0711 • Billings, Mr 801-735-4489 • Casper, WY $88-235-0515 <br />stw vast ?. HPiera, 7175 • Rapid City, SO 888472-1225 • College Station, TX 888-610-2218 <br />Workorder Receipt Checklist <br />Cotter Corporation <br />Login completed by: Edith McPike <br />Reviewed by: BL2000\tedwards <br />Reviewed Date: 8/9/2010 <br />010080199 <br />Date Received: 8/5/2010 <br />Received by: ha <br />Carrier name: Fed Ex <br />Shipping container/cooler in good condition? Yes Q No ? Not Present ? <br />Custody seals intact on shipping container/cooler? Yes 0 No E] Not Present Q <br />Custody seals intact on sample bottles? Yes No E] Not Present Q <br />Chain of custody present? Yes No F? <br />Chain of custody signed when relinquished and received? Yes 0 No <br />Chain of custody agrees with sample labels? Yes No <br />Samples in proper container/bottle? Yes No <br />Sample containers intact? Yes [,/( No <br />Sufficient sample volume for indicated test? Yes No <br />All samples received within holding time? Yes No ? <br />Container/Temp Blank temperature: 8°C <br />Water - VOA vials have zero headspace? Yes No No VOA vials submitted <br />Water - pH acceptable upon receipt? Yes Q No E] Not Applicable E] <br />Contact and Corrective Action Comments: <br />None <br />Page 11 of 20