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STL <br /> T L San Francisco <br /> Sample Receipt Checklist <br /> Submission #:2003--O-LO— _ 1 <br /> Gf recMIM oomPleted toy_ (initlajs) <br /> Geurier narne= ❑ STL San Fralicisw fJ G�ierrk_ ,r <br /> Custodyseal-5 Fntacr on shiNot <br /> ��� g c=Tliaknedr,�rnp.les �!as� Present _ <br /> Cham of custody present? Yes �Na <br /> Chaln oFc=tGdy signed when rallnquished and received? Yes 4 No—Z <br /> Chain of custody agrees with sample fabefs? Yes--ZZ�o <br /> Samples "n proper conzaine;J4ottle7 Yes fro <br /> Sampie containers intact? Yes V`�No <br /> Sufficient sample volume for indicated test? Yes ' No <br /> All s@mpfes lec�ivad within holding time? Yes P-' No <br /> CDrrtaMarf7efnp Blank terrperarur�-a in compliance (40 C : ? Ternp; "C Yes o� <br /> Water-VOA vials have zero h-3adspa c4? No VOA vials submi#ted ZI(es No <br /> (if Bubble is present, refer 10 Approximate buhhle spze and itemize In comments as S (small �Q . M finediurn- )or L{large - 0} <br /> Water- PH acceptable upon receipt? �ONO <br /> ❑ pH adjusted- PreservaWe used- ❑ HNO3 G7 KCI D H230< ❑ NaDI: M ZnOAc <br /> For any item cher;k-listed "No", provided detail of discrepancy in cornmentsect on below= <br /> omments; 1 <br /> Project Management [Routing for instruction of irdic2ted discrepancy(iss)] <br /> Proleot Manager. (in tialsl <br /> C1 ierit contacted; 0 Yes G Flo <br /> Summary of discussion= <br /> Carredive Action(per IDMIC[ient): <br />