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wvrx.energylab.com ( Helena, MT 877-472-0711 • Billings MT 800-735.4489 • Casper, WY 888-235-0515 <br />::r+ » Mj#VcsILres#encoSMca 1931 ) Gillette, WY 866-688-7175 - Rapid City, S0 888-672-1225 • College Station, tX 688-690-2218 <br />Workorder Receipt Checklist illllllllllli?llllllllllllllllllllllllllllllllll? <br />Cotter Corporation C10110690 <br />Login completed by: Corinne Wagner Date Received: 11/18/2010 <br />Reviewed by: BL20001alynch Received by: ckw <br />Reviewed Date: 12/8/2010 Carrier name: FedEx <br />Shipping container/cooler in good condition? Yes 0 No r-I <br />Custody seals intact on shipping container/cooler? Yes El No F] <br />Custody seals intact on sample bottles? Yes E] No <br />Chain of custody present? Yes Fl? No EI <br />Chain of custody signed when relinquished and received? Yes © No F1 <br />Chain of custody agrees with sample labels? Yes No <br />Samples in proper container/bottle? Yes 0 No <br />Sample containers intact? Yes [I No n <br />Sufficient sample volume for indicated test? Yes 0 No <br />All samples received within holding time? Yes 7 No El <br />ContainerfTemp Blank temperature: 4°C On Ice <br />Water - VOA vials have zero headspace? Yes No <br />Water - pH acceptable upon receipt? Yes [ No <br />Contact and Corrective Action Comments: <br />None <br />Not Present <br />Not Present <br />Not Present FvI <br />No VOA vials submitted Q <br />Not Appllcable 0 <br />Page 29 of 39