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vrxw.energyiab.com Helena, MT 877-472-0711 • Billings fdT 800-735-4489 • Caspor. WY 888-235.0515 <br />,.? ^ Anafjtlral Fxcallanres?nce rssz Gillette, WY 866-686-7175 + Rapid City, SD 888-672-1225 * College Station, TX 888-69D-2218 <br />Workorder Receipt Checklist <br />Cotter Corporation <br />Login completed by: Halley Ackerman <br />Reviewed by: BL2000\alynch <br />Reviewed Date: 11/19/2010 <br />Shipping container/cooler in good condition? Yes Q <br />Custody seals intact on shipping container/cooler? Yes ? <br />Custody seals intact on sample bottles? Yes <br />Chain of custody present? Yes W <br />Chain of custody signed when relinquished and received? Yes Z <br />Chain of custody agrees with sample labels? Yes <br />Samples in proper container/bottle? Yes <br />Sample containers intact? Yes <br />Sufficient sample volume for indicated test? Yes 0 <br />All samples received within holding time? Yes <br />Container/Temp Blank temperature: 6°C On Ice <br />Water - VOA vials have zero headspace? Yes EJ <br />Water- pH acceptable upon receipt? <br />------------------------------------------------- Yes <br />----- <br />Contacl and Corrective Action Comments: ------------ <br />None <br />IIII III II lI ?I I II ? h11 I'l 111111111111111111 IDI <br />C10110479 <br />Date Received: 11/11/2010 <br />Received by: ckw <br />Carrier name: Ground <br />No ? Not Present n <br />No 17 Not Present Z <br />No n Not Present 7/1 <br />No n <br />No El <br />No <br />No <br />No F1 <br />No n <br />No E) <br />No El No VOA vials submitted Q <br />No El Not Applicable <br />Page 30 of 40