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;06/30/2011 16:32 714-7719933 ASS❑CIAlED LABS PAGE 05/05 <br /> . <br /> S 4"TED"BVp TRIES <br /> 806 North Batavia--Orange, California 92868`- 714771-6900 FAX 714-538-1209 <br /> SAMPLE ACCEPTANCE CRECKLIST <br /> Cpl , 1f1f�RJW6W Project.... <br /> ' r:.. _ . . ( Stpler' ate� QCs' + <br /> S=Wle.(s)received in cooler: Yes Se } <br /> Sl in Information. -J. <br /> 5ecdouZ i <br /> Was the:cooler packed with: Ice Ice Packs Bubble Wrap �Styrofoam <br /> _Paper_.None —Other <br /> : ' Cooler or box,temmatiire: <br /> �Accepta=C range is 2 to 6 Deg.C.) <br /> Y <br /> YES N <br /> Sectjon NSA <br /> vas a COC.receiived? _ <br /> date aracl dire Y'=fe<st <br /> J5 t , Cf0 1€ letac��.Vis,s � <br /> Wao custodSeals t ' <br /> If Yes—vireze`'h intact? <br /> .. ...... .. ... . <br /> SII: Ie se ,Hi i <br /> Did,all sam lea,arrive iuiitaat?If no,intliaate vii. <br /> Diel aLU bottle Inbelaume,with gQL?LJD, aad.13wes <br /> Were'co rcci containers used for the tests r6qtired? <br /> was a suimcteut amount of a sent for tests..indicated?. <br /> ;in.VOA vials? <br /> Were tli;ctmttrte abated wits correct pre, ; atives7 ` <br /> Vas°total residual chlorine mcasureti(Fish t ?*` <br /> If;tae answer is no,please irifoziizi Fish NO' ay Dept.immediately. <br /> `'Seetrou 5 <br /> Was Project Manager notified of discrepancies: Y / NIA <br /> Completed By: Aate: `!` l <br />