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www.energyiab,com Helena, W 877-472-0711 • Billings, MT 800-735-4489 • Casper, WY 888-235-0515 <br />.? - AnalyUcatbrcatlenreSlnce 1951 Gillette, WY 866-686.7175 -Rapid City, SD 888-672-1225 d College Station, TX 888-690-2218 <br />Workorder Receipt Checklist <br />Cotter Corporation <br />Login completed by: Corinne Wagner <br />O <br />Reviewed by: BL2000\hackerman <br />Reviewed Date: 11/9/2010 <br />II III I II I? II II II I ?I Ill I ?I I II II I III <br />C10110203 <br />Date Received: 11/4/2010 <br />Received by: ckw <br />Carrier name: FedEx <br />Shipping container/cooler in good condition? Yes 0 <br />Custody seals intact on shipping container/cooler? Yes El <br />Custody seals intact on sample bottles? Yes <br />Chain of custody present? Yes <br />Chain of custody signed when relinquished and received? Yes <br />Chain of custody agrees with sample labels? Yes <br />Samples in proper container/bottle? Yes Q <br />Sample containers intact? Yes <br />Sufficient sample volume for indicated test? Yes <br />All samples received within holding time? Yes <br />ContainedTemp Blank temperature: 4°C On Ice <br />Water - VOA vials have zero headspace? Yes <br />Water - pH acceptable upon receipt? Yes 0 <br />------------------------------------------------------ <br />------------------------------------------° ---------- <br />Contact and Corrective Action Comments: ------------ <br />------------ <br />None <br />No F? Not Present El <br />No n Not Present Z <br />No n Not Present Q <br />No n <br />No <br />No <br />No <br />No <br />No <br />No <br />No No VOA vials submitted Z <br />No Not Applicable <br />Page 33 of 43