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fu - ^w.energylab.com f Helena, MT B77-472-0711 a Billings, M7 800-735-4489 a Casper, WY 886-235-0515 <br />` Ana"raf Ezcarleace Nbcs 1931 <br />Gillette, WY 866-686-71)5 a Rapid City, SD 888-672-1225 d College Station, TX 888-690-2218 <br />Workorder Receipt Checklist <br />Cotter Corporation <br />Login completed by: Halley Ackerman <br />Reviewed by: BL20001alynch <br />Reviewed Date: 12/8/2010 <br />Shipping container/cooler in good condition? <br />Custody seals intact on shipping container/cooler? <br />Custody seals intact on sample bottles? <br />Chain of custody present? <br />Chain of custody signed when relinquished and received? <br />Chain of custody agrees with sample labels? <br />Samples in proper container/bottle? <br />Sample containers intact? <br />Sufficient sample volume for indicated test? <br />All samples received within holding time? <br />ContainerrTemp Blank temperature: <br />Water - VOA vials have zero headspace? <br />Water - pH acceptable upon receipt? <br />Contact and Corrective Action Comments: <br />None <br />Yes <br />Yes [f <br />Yes El <br />Yes Z <br />Yes [?J <br />Yes 0 <br />Yes Q <br />Yes (7 <br />Yes <br />Yes <br />3°C On Ice <br />Yes [f <br />Yes Z <br />IV'llllllllll?Ill!IIIBIVVII4111?I <br />C10110]8] <br />Date Received: 11/22/2010 <br />Received by: ha <br />Carrier name: FedEx <br />No F Not Present (] <br />No ? Not Present <br />No n Not Present Q <br />No <br />No <br />No [] <br />No <br />No <br />No <br />No <br />No ] No VOA vials submitted <br />No ] Not Applicable <br />Page 25 of 30