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www.en Wabxom Helena, MT 877472-0711 • Billings, MT 800-735-4489 • Casper, w M-235-0515 <br />A~E=011 a AbM IM Gillette, WY 866-686-7175 • Rapid City, SO 888-672-1225 • College Station, Tx 888-690-2218 <br />Workorder Receipt Checklist VIII II II IIIIIII IIIIIIIIIII IIIIIIII <br />Cotter Corporation C11020189 <br />Login completed by: Corinne Wagner Date Received: 2/7/2011 <br />Reviewed by: BL2000\hackerman Received by: ckw <br />Reviewed Date: 2/8/2011 Carrier name: Fed Ex <br />Shipping container/cooler in good condition? Yes 2 No ? Not Present El <br />Custody seals intact on shipping container/cooler? Yes 1:1 No ? Not Present 0 <br />Custody seals intact on sample bottles? Yes No Not Present Q <br />Chain of custody present? Yes No <br />Chain of custody signed when relinquished and received? Yes 0 No ? <br />Chain of custody agrees with sample labels? Yes Z No ? <br />Samples in proper container/bottle? Yes 0 No ? <br />Sample containers intact? Yes [ No <br />Sufficient sample volume for indicated test? Yes Q No <br />All samples received within holding time? Yes No <br />Container/Temp Blank temperature: 5°C <br />Water - VOA vials have zero headspace? Yes ? No ? No VOA vials submitted Q <br />Water- pH acceptable upon receipt? Yes 0 No El Not Applicable 11 <br />Contact and Corrective Action Comments: <br />None <br />Page 28 of 37