Chain of Custody: DEP Cleanup Samples, September 19, 2002

NYC 9/11 Public Portal Document

0 PSC Analytical Services

Sample Receipt Checklist

Client Name ATC ASSOCIATES Date and Time Receive 10/11/2002 9:30:00 AM Work Order Numbe R02100417 Received by HG

Checklist completed b tt I Reviewed by JOrf// •% Sigmiure i a warns Is

Matrix Carrier name FedF~c

Shipping container/coder in good condition? Yes No ❑ Not Presen ❑ Custody seals intact on shippping container/cooler? Yes ❑ No ❑ Not Presen Custody seals intact on sample bottles? Yes ❑ No ❑ Not Presen Chain of custody present? Yes No El Chain of custody signed when relinquished and received? Yes No ❑ Chain of custody agrees with sample labels? Yes l J No ❑ Samples in proper container/bottle? Yes No ❑ Sample containers intact? Yes No ❑ Sufficient sample volume for indicated test? Yes No ❑ All samples received within holding time? Yes No ❑ Container/Temp Blank temperature In compliance? Yes No ❑ Water - VOA vials have zero headspace? No VOA vials submitted Yes ❑ No ❑ Water - pH acceptable upon receipt? Yes No ❑ Adjusted? Checked b

Any No and/or NA (not applicable) response must be detailed in the comments section b — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — - - — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — —

Client contacted Date contacted: Person contacted

Contacted by: Regarding

Comments:

Corrective Action

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