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ENERGY <br />I A <br />Workorder Receipt Checklist <br />Login completed by: Halley Ackerman <br />Reviewed by: BL2000 \cwagner <br />Reviewed Date: 4/12/2011 <br />Shipping container /cooler in good condition? Yes Q No III <br />Custody seals intact on shipping container /cooler? Yes ❑ No ❑ <br />Custody seals intact on sample bottles? Yes ri No ill <br />LI Chain of custody present? Yes [� No <br />Chain of custody signed when relinquished and received? Yes [�/J No <br />Chain of custody agrees with sample labels? Yes [f No <br />Samples in proper container /bottle? Yes I'M No ❑ <br />u_i Sample containers intact? Yes [� No <br />Sufficient sample volume for indicated test? Yes No <br />All samples received within holding time? Yes r7r No 0 <br />Container/Temp Blank temperature: 5.4°C On Ice <br />Water - VOA vials have zero headspace? Yes ❑ No ❑ <br />Water - pH acceptable upon receipt? Yes 0 No ❑ <br />Contact and Corrective Action Comments: <br />None <br />www.energylab.com <br />AesljaalLash= gam 1132 <br />Helena, MY 877 - 472 -0711 • Billings, MY 800-735-4489 • Casper, WY 888- 235 -0515 <br />Gillette, WY 866 -686 -7175 • Rapid City, SO 888 -672 -1225 • College Station, IX 888 -690 -2218 <br />11 <br />11 <br />11 <br />11 <br />Cotter Corporation C11040247 <br />Date Received: 4/7/2011 <br />Received by: ha <br />Carrier FedEx <br />name: <br />Not Present ❑ <br />Not Present [l <br />Not Present Q <br />No VOA vials submitted [f <br />Not Applicable ❑ <br />11 <br />Page 33 of 43 <br />