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ENERGY <br />Workorder Receipt Checklist <br />Cotter Corporation C12041245 <br />Login completed by: Kristy Gisse Date Received: 4/26/2012 <br />Reviewed by: BL2000 \tparke Received by: kg <br />Reviewed Date: 5/1/2012 Carrier FedEx <br />name: <br />Shipping container /cooler in good condition? Yes 0 <br />Custody seals intact on shipping container /cooler? Yes ❑ <br />Custody seals intact on sample bottles? Yes El <br />Chain of custody present? Yes 0 <br />Chain of custody signed when relinquished and received? Yes <br />Chain of custody agrees with sample labels? Yes <br />Samples in proper container/bottle? Yes 0 <br />Sample containers intact? Yes Ej <br />Sufficient sample volume for indicated test? Yes IZ <br />All samples received within holding time? Yes El <br />(Exclude analyses that are considered field parameters <br />such as pH, DO, Res CI, Sulfite, Ferrous Iron, etc.) <br />Container/Temp Blank temperature: 4.8°C On Ice <br />Water - VOA vials have zero headspace? Yes <br />Water - pH acceptable upon receipt? Yes El <br />Contact and Corrective Action Comments: <br />None <br />www.energylab.com Helene, MT 877 - 472 -0711 • Billings, MT 800 -735 -4488 • Casper, WY 888 - 235-0515 <br />AuOlkal ""�saww fret a; Gillette, WY 868 -688 -7175 • Rapid City, SD 888 - 872 -1225 • College Station, IX 888- 680 -2218 <br />No <br />No <br />No ❑ <br />No <br />No ❑ <br />No <br />No <br />No ❑ <br />No ❑ <br />No ❑ <br />No <br />No D <br />11111111111111111 lilul <br />Not Present ❑ <br />Not Present El <br />Not Present 0 <br />No VOA vials submitted <br />Not Applicable p <br />11 <br />Page 16 of 19 <br />