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ENERGY <br />Shipping container /cooler in good condition? Yes 0 No L <br />Custody seals intact on shipping container /cooler? Yes L No <br />Custody seals intact on sample bottles? Yes ❑ No ❑ <br />Chain of custody present? Yes 0 No ❑ <br />Chain of custody signed when relinquished and received? Yes g No ❑ <br />Chain of custody agrees with sample labels? Yes 0 No <br />Samples in proper container /bottle? Yes 2 No ID <br />Sample containers intact? Yes 2 No ❑ <br />Sufficient sample volume for indicated test? Yes [J No ❑ <br />All samples received within holding time? Yes 0 No ❑ <br />Container/Temp Blank temperature: 5.6`C On Ice <br />Water - VOA vials have zero headspace? Yes ❑ No ❑ <br />Water - pH acceptable upon receipt? Yes 0 No ❑ <br />Workorder Receipt Checklist <br />Contact and Corrective Action Comments: <br />None <br />www.energyiab.com I <br />AesVWEagle= Sus Sus <br />Helena, MT 877-472-0711 • Billings, MT 800- 735 -4489 • Casper, WY 888- 235 -0515 <br />Gillette, WY 866 - 666-7175 • Rapid City, SD 886- 672 -1225 • College Station, TX 688- 600 -2218 <br />11 <br />Cotter Corporation C11070057 <br />Login completed by: Edith McPike Date Received: 7/1/2011 <br />Reviewed by: BL2000 \cwagner Received by: em <br />Reviewed Date: 7/5/2011 Carrier FedEx <br />name: <br />Not Present ❑ <br />Not Present ❑✓ <br />Not Present 0 <br />11 <br />11 <br />11 <br />11 <br />No VOA vials submitted [✓( <br />Not Applicable ❑ <br />Page 18 of 21 <br />