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j <br />. ? wvaw.energylab.com Helena, MT B77-472-0711 • Billings, MT 800-735-4469 • Casper, 888-235-0515 <br />?, ? • [ ^ ?? MelrtlulFxeegence sMu !95? I Gillette, WY 866-688-1175 • Rapid City, SD 888-872-1225 • Cortege 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: 12/8/2010 <br />IWII?YI?tlGIIIMVI??II <br />o,o,zaoes <br />Date Received: 12/2/2010 <br />Received by: ha <br />Carrier name: FedEx <br />Shipping container/cooler in good condition? Yes No ? Not Present ? <br />Custody seals intact on shipping container/cooler? Yes ? No ? Not Present [( <br />Custody seals intact on sample bottles? Yes ? No ? Not Present <br />Chain of custody present? Yes No ? <br />Chain of custody signed when relinquished and received? Yes 0 No ? <br />Chain of custody agrees with sample labels? Yes [J? 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: 3°C On Ice <br />Water - VOA vials have zero headspace? Yes ? No ? No VOA vials submitted [J( <br />Water - pH acceptable upon receipt? Yes [7f No ? Not Applicable ? <br />Contact and Corrective Action Comments: <br />None <br />Page 6 of 8