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• • RECEIVED <br /> LA\ FEB 2 6 2014 <br /> EN�ULR,pNM N AL <br /> ASSOCIATED LABORATORIES7m T <br /> 806 North Batavia-Orange, California 92868- 714-771-6900 FAX 714-538-1209 <br /> SAMPLE ACCEPTANCE CHECKLIST <br /> Section 1 <br /> Client: J-RFJt%ry ntiiCD. Project: -TV,5�, d � 2 <br /> Date Received: i2r /1.+ Sampler's Name: tie No <br /> Sample temperature: <br /> Sample(s)received in cooler: No (Skip Section 2) <br /> Shipping Information: <br /> Section 2 <br /> Was the cooler packed with: ✓ Ice _Ice Packs Bubble Wrap Styrofoam <br /> Paper_None _Other <br /> Cooler Temperature: G <br /> (Acceptance range is 0 to 6 Deg. C. or arrival on ice;For Microbiology sample10 Deg. C or arrival on ice J <br /> Section 3 YES NO N/A <br /> Was a COC received? <br /> Is it properly com leted? (IDs, sampling date and time, signature,test) <br /> Were custody seals resent? i <br /> • If Yes-were they intact? <br /> Were all samples sealed in plastic bags? <br /> Did all samples arrive intact?If no, indicate below. <br /> Did all bottle labels agree with COC? (ID, dates and times) <br /> Were correct containers used for the tests required? r/ <br /> Was a sufficient amount of sample sent for tests indicated? t/ <br /> Was there heads ace in VOA vials? <br /> Were the containers labeled with correctpreservatives? <br /> Was total residual chlorine measured(Fish Bioassay samples only)? * !/ <br /> *: If the answer is no,please inform Fish Bioassay Dept. immediately. <br /> Section 4 <br /> Explanations/Comments <br /> b Nor PF-rC+A Vt,.! S1.6FiJ <br /> -2P—S-2"' . <br /> Section 5 <br /> Was Project Manager notified of discrepancies: Q/ N N/A <br /> Project Manager's response: 7 P <br /> Completed By: Date: 01 1 10114 <br />