2012-09-28_REVISION - M1977307 (27)

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• www energylab corn Helena. MT 877- 472 -0711 •Bill, gs. MT 800 -735 -4489 • Casper, WY 888- 235 -0515 Analytical Excellence Since 1952 Gillette, WY 866 -686 -7175 • Rapid City. SD 888 -672 -1225 • College Station, TX 888- 690 -2218 Energy Laboratories Inc Workorder Receipt Checklist O'Connor Design Inc C12050462 Login completed Corinne Wagner Date Received 5/11/2012 by Reviewed by: BL20001kschroeder Received by th Reviewed 5/15/2012 Carrier Ground Date. name: Shipping container /cooler in good condition? Yes L-111 No Not Present Custody seals intact on shipping container /cooler? Yes F No F Not Present ] Custody seals intact on sample bottles? Yes [] No ❑ Not Present Chain of custody present? Yes No E] Chain of custody signed when relinquished and received) Yes Q No F1 Chain of custody agrees with sample labels? Yes No n Samples in proper container/bottle? Yes F,71 No F Sample containers intact? Yes No Sufficient sample volume for indicated lest? Yes 0 No All samples received within holding lime? Yes © No ❑ (Exclude analyses that are considered field parameters such as pH, DO. Res Cl, Sulfite, Ferrous Iron, etc.) Container /Temp Blank temperature 14.0`C Water - VOA vials have zero headspace? Yes No (] No VOA vials submitted Water - pH acceptable upon receipt? Yes No F1 Not Applicable Z -------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------------------------------------------------------------------------------------------------- Contact and Corrective Action Comments Sample containers were received cracked and ready to break. Samples were transferred into new containers at the lab.