Laserfiche WebLink
1534 willow Paas Road,Pilbbwg-CA 94565-1701 <br /> McCampbell Analyfical, Inc. Toll Free TelgiL :(877)252-9262/Fax (925)252-9269 <br /> rr Wh eA Qisdity C.Unls" http://www.mcwmpb.11./E-.iLma.@a.pb.11. <br /> Sample Receipt Checklist <br /> Client Name: Safety Kleen Date and Time Received: 3/29/2012 11:38:50 AM <br /> Project Name: Hulz Rubber;Grinding Dust Checklist completed and reviewed by: Melissa Valles <br /> WorkOrder N°: 1203991 Matrix: Solid Carrier: FedEx <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes W No❑ <br /> Chain of custody signed when relinquished and received? Yes © No❑ <br /> Chain of custody agrees with sample labels? Yes © No❑ <br /> Sample IDs noted by Client on COC? Yes © No❑ <br /> Date and Time of collection noted by Client on COC? Yes No❑ <br /> Samplers name noted on COC? Yes © No❑ <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA <br /> Shipping container/cooler in good condition? Yes W1 No❑ <br /> Samples in proper containers/bottles? Yes ✓I No❑ <br /> Sample containers intact? Yes W No❑ <br /> Sufficient sample volume for indicated test? Yes I V No❑ <br /> Sample Preservation and Hold Time fHT)Information <br /> All samples received within holding time? Yes ✓J No❑ <br /> Container/Temp Blank temperature Cooler Temp: 22"C NA❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes —.1 No❑ No VOA vials submi ted ❑� <br /> Sample labels checked for correct preservation? Yes 1/:1 No❑ <br /> Metal-pH acceptable upon receipt(pHx2)? Yes D No❑ NA W <br /> Samples Received on Ice? Yes ❑ No 41 <br /> 'NOTE.-if the"No"box is checked,see comments below. <br /> -- ------------------------- <br /> --------------------------------------------- <br /> Comments: <br /> Page 4 of 6 <br />