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ANALY'IICA <br />Client: Colorado Division of Reclamati Client Code: 501304 Order #: B1110173 <br />Project: GW Monitoring <br />Cooler ID: 1 <br />A. Preliminary Examination Phase: <br />1. Was airbill Attached? N/A Airbill #: Carrier Name: Client <br />2. Custody Seals? N/A How many? 0 Location: Seal Name: <br />3. Seals intact? N/A <br />4. COC Attached? Yes Properly Completed? Yes Signed by AEL employee? Yes <br />5. Project Identification from custody paper: GW Monitoring <br />6. Preservative: None Temperature: 20.0 deg. C <br />Designated person initial here to acknowledge receipt: <br />Cooler Receipt Form <br />Date cooler opened: 10/24/2011 <br />Cooler opened by: ra <br />COMMENTS: Kelly spoke with client to get specific test, OK to filter past hold time 10/26/11. <br />B. Lop -In Phase: Samples Log -in Date: 10/27/2011 Log -in By: gp <br />Signature: <br />Ge r 19 <br />o f f' Date: 1 b f `� q / <br />1. Packing Type: Other <br />2. Were samples in separate bags? N/A <br />3. Were containers intact? Yes Labels agree with COC? Yes <br />4. Number of bottles received: 4 Number of samples received: 2 <br />5. Correct containers used? Yes Correct preservatives added? Yes <br />6. Sufficient sample volume? Yes <br />7. Bubbles in VOA samples? N/A <br />8. Was Project manager called and status discussed? Yes <br />9. Was anyone called? Yes Who was called? By whom? Date <br />COMMENTS: <br />Page 1 of <br />