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ENERGY <br />o4 <br />Workorder Receipt Checklist <br />Contact and Corrective Action Comments: <br />None <br />www.energylab.com <br />Aeabe*Excadfwace Slot. 1952 <br />Helena, MT 817- 472 -0711 • Billings, MT 800 -735 -4489 • Casper, WY 888 -235 -0515 <br />Gillette, WY 866- 686 -7175 • Rapid City, SD 888 -672 -1225 • College Station, TX 888- 690 -2218 <br />Shipping container /cooler in good condition? Yes El No ❑ Not Present ❑ <br />Custody seals intact on shipping container /cooler? Yes ❑ No ❑ Not Present 0 <br />Custody seals intact on sample bottles? Yes ❑ No ❑ Not Present 71 <br />Chain of custody present? Yes 0 No 0 <br />Chain of custody signed when relinquished and received? Yes 0 No 0 <br />Chain of custody agrees with sample labels? Yes Q No iii <br />Samples in proper container /bottle? Yes 0 No ❑ <br />Sample containers intact? Yes 0 No <br />Sufficient sample volume for indicated test? Yes 0 No El <br />All samples received within holding time? Yes 0 No ❑ <br />(Exclude analyses that are considered field parameters <br />such as pH, DO, Res CI, Sulfite, Ferrous Iron, etc.) <br />Container/Temp Blank temperature: 4.2°C On Ice <br />Water - VOA vials have zero headspace Yes ❑ No ❑ <br />Water - pH acceptable upon receipt'? Yes 0 No ❑ <br />11 <br />Login completed by: Kristy Gisse Date Received: 4/13/2012 <br />Reviewed by: BL2000 \dwilliams Received by: tj <br />Reviewed Date: 4/18/2012 Carrier FedEx <br />name: <br />I <br />I <br />Cotter Corporation C12040753 <br />No VOA vials submitted 0 <br />Not Applicable ❑ <br />I <br />Page 6 of 10 <br />