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ASSOCIATED LABORATORIES <br /> 806 Nort3:Batavia—Orange, California 92868—714-771-6900 <br /> FAX 714-5.38-I20.9 <br /> SAMPLE ACCEPTANCE CHECKLIST <br /> Section 1 <br /> Client: (cooler- <br /> Date Received. Project: <br /> Sam 1 s received in e <br /> No ki2 Section 2) <br /> Section 2 <br /> Was the cooler packed with: `7—t( Ice ice Packs x Bubble Wrap Styrofoam <br /> Paper None `Other --- <br /> Cooler or box temperature: <br /> (Acceptance range is 2 to 6 Deg.C.} 7 <br /> Section <br /> Was a COC received? YES NO N/A <br /> Were custod seals resent? <br /> If Yes—were they intact? <br /> Were all sari Ies sealed in plastic ba s? <br /> Did all sam les arrive intact?If no indicate below. <br /> Did all bottle labels a ee with COC? ID,dates and-times �f <br /> Were correct containers used for the tests r iced? <br /> Was a suflicieut amount of Sam le sent for tests indicated? <br /> No head s ace in VOA vials?. <br /> erva Ives us ? <br /> Were the sam.les scanned for presence of radioac#ivi' <br /> Was total residual chlorine measured isle Bioassay sam les onl ? <br /> *:if the answer is no;please inform Fish Bioassay Dept.immediately. <br /> Section 4 <br /> Ex lanations/Comments <br /> Section 5' <br /> Was Project Manager notified of discrepancies: Y / N N/A <br /> Completed By: <br /> Date: <br />