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wMiw.energjrlab:gom <br />fisUiea felt <br />-0711 • Billings, MT 101-735-4489 •-Casper, WY 888-235-0515 <br />Rapid C4, SO 81567672-1225 • College station; TX 888=611-2218 <br />Workorder Receipt Checklist IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII <br />Cotter Corporation C1 0110696 <br />Login completed by: Corinne Wagner Date Received: 11/18/2010 <br />Reviewed by: BL2000\alynch Received by: ckw <br />Reviewed Date: 12/28/2010 Carrier name: FedEx <br />Shipping container/cooler in good condition? Yes Q No E] Not Present <br />Custody seals intact on shipping container/cooler? Yes El No E] Not Present 0 <br />Custody seals intact on sample bottles? Yes [:] No [:] Not Present <br />Chain of custody present? Yes 0 No D <br />Chain of custody signed when relinquished and received? Yes Q No <br />Chain of custody agrees with sample labels? Yes Q No <br />Samples in proper container/bottle? Yes Q No <br />Sample containers intact? Yes [J? No ? <br />Sufficient sample volume for indicated test? Yes J[f No E] <br />All samples received within holding time? Yes No <br />ContainerfTemp Blank temperature: 4'C On Ice <br />Water - VOA vials have zero headspace? Yes El No E] No VOA vials submitted <br />Water - pH acceptable upon receipt? Yes 0 No E] Not Applicable Ej <br />Contact and Corrective Action Comments: <br />None <br />Page 7 of 8 <br />