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www.errergylab.com Helena, MT 877-472-0711 • Billings MT 800-735-4489 • Casper, WY 888-235-0515 <br />11 ' Ans"celExcelwxeSince 19M ? Gillette, WY 866-666-7175 0 Rapid City, So 888-672-1225 * College Station, TX 888-690-2218 <br />Workorder Receipt Checklist <br />Cotter Corporation <br />Login completed by: Halley Ackerman <br />Reviewed by: BL2000\alynch <br />Reviewed Date: 12/21/2010 <br />cioizoiao <br />Date Received: 12/6/2010 <br />Received by: ckw <br />Carrier name: Ground <br />Shipping container/cooler in good condition? Yes 0 No E] Not Present El <br />Custody seals intact on shipping container/cooler? Yes El No El Not Present [f? <br />Custody seals intact on sample bottles? Yes ? No F] Not Present 0 <br />Chain of custody present? Yes 0 No ? <br />Chain of custody signed when relinquished and received? Yes 0 No R <br />Chain of custody agrees with sample labels? Yes 0 No R <br />Samples in proper container/bottle? Yes 0 No <br />Sample containers intact? Yes 0 No R <br />Sufficient sample volume for indicated test? Yes Fvj No R <br />All samples received within holding time? Yes r,71 No R <br />ContainerlTemp Blank temperature: 6°C On Ice <br />Water - VOA vials have zero headspace? Yes No ? No VOA vials submitted 0 <br />Water - pH acceptable upon receipt? Yes ?J No F-1 Not Applicable ? <br />Contact and Corrective Action Comments: <br />None <br />Page 4 of 6