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WWWffEf8y1ab;DM <br />Aup!lleif fiaG?fa Sba ilS1 <br />Workorder Receipt Checklist <br />Cotter Corporation <br />Login completed by: Halley Ackerman <br />Reviewed by: BL2000\tedwards <br />Reviewed Date: 3/17/2011 <br />• Billings, MT 601-135-4489 • Cesper, WY <br />City, SD 888-672-1225 • college Stahl, TX, <br />IIIIIIIIIIIIIIIIII <br />C11030378 <br />Date Received: 3/11/2011 <br />Received by: ckw <br />Carrier Ground <br />name: <br />Shipping container/cooler in good condition? Yes Q No ? Not Present El <br />Custody seals intact on shipping container/cooler? Yes El No ? Not Present Q <br />Custody seals intact on sample bottles? Yes ? No F? Not Present <br />Chain of custody present? Yes No ? <br />Chain of custody signed when relinquished and received? Yes No F] <br />Chain of custody agrees with sample labels? Yes No <br />Samples in proper container/bottle? Yes [?f No <br />Sample containers intact? Yes Q No <br />Sufficient sample volume for indicated test? Yes No <br />All samples received within holding time? Yes No <br />Container/Temp Blank temperature: 4.4°C On Ice <br />Water - VOA vials have zero headspace? Yes E] No E] No VOA vials submitted Q <br />Water - pH acceptable upon receipt? <br />-------- <br />- Yes Q <br />------------------- No E-] <br />------------- Not Applicable E] <br />------------------------------- <br />- <br />--------------------------------------------- <br />------------------------------------------------------- <br />Contact and Corrective Action Comments: ------------------- ------------- ------------------------------- <br />None <br />Page 24 of 29 <br />