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0 <br /> unStar <br /> Laboratories, Inc. Page t of-i <br /> Poovmir Q��ury AXALYICAL�N .. <br /> SAMPLE RECEIVING REVIEW SHEET <br /> BATCH# T4/ 593 <br /> Client Name: Psi - dyrLAe(o Project: 6 R P <br /> Received by: /Pr� 1 Date/Time Received: / -2 -/1 4152 <br /> Delivered by : ❑ Client ❑ SunStar Courier k GSO ❑FedEx ❑ Other <br /> Total number of coolers received / Temp criteria=6°C>0°C(no frozen ontainers) <br /> Temperature: cooler#1 2.2 °C+/_the CF (-0.2°C) = 2.0 °C corrected temperature <br /> cooler#2 °C+/-the CF (-0.20C) _ °C corrected temperature <br /> cooler#3 °C+/-the CF (-0.2°C) _ _°C corrected temperature <br /> Samples outside temp.but received on ice,w/in 6 hours of final sampling. ®Yes ONc* ❑N/A <br /> Custody Seals Intact on Cooler/Sample ❑Yes ❑N XN/A <br /> Sample Containers Intact ®Yes ❑N * <br /> Sample labels match COC ID's ©Yes ❑N * <br /> Total number of containers received match COC ®Yes ❑N * <br /> Proper containers received for analyses requested on COC ®Yes ON * <br /> Proper preservative indicated on COC/containers for analyses requested ❑Yes ONc* SN/A <br /> Complete shipment received in good condition with correct temperatures,containers„labels,vi 5lumes <br /> preservatives and within method specified holding times. ®Yes [:]No- <br /> *Complete Non-Conformance Receiving Sheet if checked Cooler/Sample Review-Initials and d to <br /> Comments: <br />