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Login Sample Receipt Checklist <br />Client: WSB & Associates, Inc Job Number: 310-229849-1 <br />SDG Number: <br />Login Number: 229849 <br />Question Answer Comment <br />Creator: Homolar, Dana J <br />List Source: Eurofins Cedar Falls <br />List Number: 1 <br />N/ARadioactivity wasn't checked or is </= background as measured by a survey <br />meter. <br />TrueThe cooler's custody seal, if present, is intact. <br />N/ASample custody seals, if present, are intact. <br />TrueThe cooler or samples do not appear to have been compromised or <br />tampered with. <br />TrueSamples were received on ice. <br />TrueCooler Temperature is acceptable. <br />TrueCooler Temperature is recorded. <br />TrueCOC is present. <br />TrueCOC is filled out in ink and legible. <br />TrueCOC is filled out with all pertinent information. <br />TrueIs the Field Sampler's name present on COC? <br />FalseThere are no discrepancies between the containers received and the COC.Received Trip Blank(s) not listed on COC. <br />TrueSamples are received within Holding Time (excluding tests with immediate <br />HTs) <br />TrueSample containers have legible labels. <br />TrueContainers are not broken or leaking. <br />TrueSample collection date/times are provided. <br />TrueAppropriate sample containers are used. <br />TrueSample bottles are completely filled. <br />TrueSample Preservation Verified. <br />TrueThere is sufficient vol. for all requested analyses, incl. any requested <br />MS/MSDs <br />TrueContainers requiring zero headspace have no headspace or bubble is <br /><6mm (1/4"). <br />TrueMultiphasic samples are not present. <br />TrueSamples do not require splitting or compositing. <br />N/AResidual Chlorine Checked. <br />Eurofins Cedar Falls <br />Page 90 of 90 5/17/2022 <br />1 <br />2 <br />3 <br />4 <br />5 <br />6 <br />7 <br />8 <br />9 <br />10 <br />11 <br />12 <br />13 <br />14 <br />15