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• ?1 wwvr.energylab.com Helena MT 877-472-0711 • Billings, MT 800-735-4489 • Caspar, WY 888-235-0515 <br />Anetntcr/Crce/lenceVnce IM Gillette, WY 866-686-7175 a Rapid City, S6 886-672-1225 • College Station, TX 888-696-1218 <br />Workorder Receipt Checklist <br />Cotter Corporation <br />Login completed by: Tabitha Edwards <br />Reviewed by: BL2000\alynch <br />Reviewed Date: 12/8/2010 <br />IIIIIIIIiIII I I II [I II III I IIII 1811?11IIIIIIII <br />C10110836 <br />Date Received: 11/23/2010 <br />Received by: ha <br />Carrier name: Ground <br />Shipping container/cooler in good condition? Yes Z <br />Custody seals intact on shipping container/cooler? Yes El <br />Custody seals intact on sample bottles? Yes <br />Chain of custody present? Yes Q <br />Chain of custody signed when relinquished and received? Yes Q <br />Chain of custody agrees with sample labels? Yes Z <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 (7 <br />Container/Temp Blank temperature: 3°C On Ice <br />Water - VOA vials have zero headspace? Yes El <br />Water - pH acceptable upon receipt? Yes Z <br />Contact and Corrective Action Comments: <br />None <br />No Not Present 1-1 <br />No Not Present Fl? <br />No Not Present Q <br />No E] <br />No n <br />No <br />No <br />No <br />No <br />No <br />No No VOA vials submitted 0 <br />No Not Applicable <br />Page 11 of 20