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"SunStar <br /> Laboratories, Inc. Page I nJ <br /> -101 pQUAu ANALVGt IrvI NMONx K . <br /> SAMPLE RECEIVING REVIEW SHEET <br /> BATCH# TIKo-+,N7 <br /> Client Name: PO•rrner C52 SF Project: 2LW7- S• WJE r^". S�re'+ Sick*°n,cA <br /> RSLob <br /> Received by: 17 r%a . Date/Time Received: q(2_�rf 11.4 lU <br /> Delivered by: ❑Client ❑ SunStarCourier XCGSO ❑FedEx ❑Other <br /> Total number of coolers received l Temp criteria=6°C>0°C(no frozen containers) <br /> Temperature: cooler#1 S.1( °C+/-the CF (-0.2°C) = SI- °C corrected temperature <br /> cooler#2 °C +/-the CF (-0.2°C) _ °C corrected temperature <br /> cooler#3 °C+/-the CF (-0.2°C) _ °C corrected temperature <br /> Samples outside temp. but received on ice,who 6 hours of final sampling. Yes ❑No* ❑N/A <br /> Custody Seals Intact on Cooler/Sample ElYes ❑No* ❑N/A <br /> Sample Containers Intact , Yes ❑No* <br /> Sample labels match COC ID's r%Yes [—]No* <br /> Total number of containers received match COC XYes ❑No* <br /> Proper containers received for analyses requested on COC KYes ❑No* <br /> Proper preservative indicated on COC/containers for analyses requested []Yes ❑No* JKN/A <br /> Complete shipment received in good condition with correct temperatures,containers, labels,volumes <br /> preservatives and within method specified holding times. 9,Yes ❑No* <br /> *Complete Non-Conformance Receiving Sheet if checked Cooler/Sample Review-initials and date <br /> Comments: <br />