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ENERGY <br />A'ICJI TO Ir <br />Workorder Receipt Checklist <br />Cotter Corporation <br />Login completed by: Edith McPike <br />Reviewed by: BL2O0O \cwagner <br />Reviewed Date: 4/20/2011 <br />Shipping container /cooler in good condition? Yes El No ❑ <br />Custody seals intact on shipping container /cooler? Yes ❑ No El <br />Custody seals intact on sample bottles? Yes [] No ❑ <br />Chain of custody present? Yes EZ No ❑ <br />Chain of custody signed when relinquished and received? Yes Z No L <br />Chain of custody agrees with sample labels? Yes No ❑ <br />Samples in proper container /bottle? Yes El No El <br />Sample containers intact? Yes No 0 <br />u_i Sufficient sample volume for indicated test? Yes 0 No El <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 ❑ No ❑ <br />Water - pH acceptable upon receipt? Yes 0 No E <br />Contact and Corrective Action Comments: <br />None <br />www.energylab.com ( Helena, M1 877 - 472 - 0711 • Billings, MT 800 - 735 -4489 • Casper, WY 888 235 - 0515 <br />An:Via Enema SW, Gillette, W <br />y0? WY 868 686 - 7175 • Rapid City, SO 888 - 872 - 1225 • College Station, 1)1 888 - 690 - 2218 <br />11 <br />Not Present ❑ <br />Not Present [J� <br />Not Present 0 <br />Date Received: 4/20/2011 <br />Received by: em <br />Carrier FedEx <br />name: <br />11 <br />11 <br />No VOA vials submitted El <br />Not Applicable ❑ <br />11 <br />C11040623 <br />Page 28 of 38 <br />