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WfIWA aOA.Cam <br />Aasglfcal Ercs/recrSMes 1931 <br />•0711 Billings, NT 1101-135-4189 a Casper, WY 088-235-0515 <br />jid COI SO 818-112-1225 • College StatioR; TX 888"8!0-2218 <br />Workorder Receipt Checklist IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII <br />Cotter Corporation C10110552 <br />Login completed by: Edith McPike Date Received: 11/15/2010 <br />Reviewed by: BL2000\alynch Received by: em <br />Reviewed Date: 12/2/2010 Carrier name: Fed Ex <br />Shipping container/cooler in good condition? Yes Q No ? Not Present <br />Custody seals intact on shipping container/cooler? Yes (] No F-1 Not Present <br />Custody seals intact on sample bottles? Yes No F1 Not Present [Jf <br />Chain of custody present? Yes No ? <br />Chain of custody signed when relinquished and received? Yes Q No <br />Chain of custody agrees with sample labels? Yes L(J No ? <br />Samples in proper container/bottle? Yes Q No <br />Sample containers intact? Yes 0 No ? <br />Sufficient sample volume for indicated test? Yes Q No F1 <br />All samples received within holding time? Yes No <br />Container/Temp Blank temperature: VC On Ice <br />Water - VOA vials have zero headspace? Yes No No VOA vials submitted <br />Water - pH acceptable upon receipt? Yes [?7( No ? Not Applicable ? <br />Contact and Corrective Action Comments: <br />None <br />Page 4 of 6 <br />