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nw.energylab.com Helana,1`9 877-472-0711 w Billings, 141800-735-4489 • Casper, M 888-235-0515 <br />Aasorsf Excellence Since Y252 I Gillette, WY 866-686-7175 • Rapid City, SD 888.672-1225 v college station, TX 888-690-2218 <br />Workorder Receipt Checklist Illllllilllllllllllllllllilllllllllllll <br />Cotter Corporation C10120819 <br />Login completed by: Corinne Wagner Date Received: 12/27/2010 <br />Reviewed by: BL2000\alynch Received by: ckw <br />Reviewed Date: 12/30/2010 Carrier name: FedEx <br />Shipping container/cooler in good condition? Yes [,? No ? Not Present E) <br />Custody seals intact on shipping container/cooler? Yes El No ? Not Present Q <br />Custody seals intact on sample bottles? Yes FJ No E] Not Present F,71 <br />Chain of custody present? Yes No F1 <br />Chain of custody signed when relinquished and received? Yes No <br />Chain of custody agrees with sample labels? Yes F-?j No n <br />Samples in proper container/bottle? Yes Q No <br />Sample containers intact? Yes 0 No <br />Sufficient sample volume for indicated test? Yes C?J No ? <br />All samples received within holding time? Yes 0 No F-I <br />Container/Temp Blank temperature: 12°C <br />Water - VOA vials have zero headspace? Yes No F1 No VOA vials submitted <br />Water - pH acceptable upon receipt? Yes No El Not Applicable <br />Contact and Corrective Action Comments: <br />None <br />Page 21 of 25