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www.emz4ab.wm <br />Aub*WEwshvft2 M <br />-0711 • Billings, MI 8111.135-4488 • Casper, WY 888-235-8515: <br />im'A City' 50 856-612-1225 - uliege Station, T%888-6111-2218 <br />Workorder Receipt Checklist IIIIIIII IIIIIIIIIIII II IIIIIII II II IIII <br />Cotter Corporation C10110900 <br />Login completed by: Tabitha Edwards Date Received: 11/29/2010 <br />Reviewed by: BL2000\alynch Received by: ckw <br />Reviewed Date: 12/8/2010 Carrier name: FedEx <br />Shipping container/cooler in good condition? Yes No [:] Not Present F-I <br />Custody seals intact on shipping container/cooler? Yes No E] Not Present Q <br />Custody seals intact on sample bottles? Yes EJ No Not Present [?( <br />Chain of custody present? Yes Q No <br />Chain of custody signed when relinquished and received? Yes [Jf No <br />Chain of custody agrees with sample labels? Yes F,71 No <br />Samples in proper container/bottle? Yes 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 [7? 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 [?/f No ? Not Applicable E] <br />Contact and Corrective Action Comments: <br />None <br />Page 4 of 6