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, <br /> MEN STL <br /> VSampTL San Francisco <br /> le <br /> o Receipt Checklist <br /> Submission # 2003- d� - O&f b <br /> 1 - <br /> Checklist completed by (initials) 094 Date 07-4103 <br /> Courier name ❑ STL San Francisco ❑ Client <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present-,� <br /> Chain of custody present? Yes t,-< <br /> Chain of custody signed when relinquished and received? Yes — No <br /> Chain of custody agrees with sample labels? Yes / No <br /> Samples in proper container/bottle? Yes ✓ No <br /> Sample containers intact? Yes ✓ No <br /> Sufficient sample volume for indicated test? Yes t' No <br /> ' All samples received within holding time? Yeses No <br /> ContainerlTemp Blank temperature in compliance (40 C±2)? Temp y °C Yes &"' No <br /> ' Water-VOA vials have zero headspace? No VOA vials submitted Yes ✓No <br /> �(if bubble is present, refer to approximate bubble size and itemize in comments as S (small-O), M (medium - O) or L(large- 0) <br /> Water- ph acceptable upon receipt? Yes ❑ No <br /> ' ❑ ph adjusted- Preservative used ❑ HNO3 ❑ HCI 13 H2SO4❑ NaOH ❑ZnOAc <br /> For any item check-listed "No", provided detail of discrepancy in comment section below <br /> Comments <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> Project Manager (initials) Date 1 103 <br /> ' Client contacted ❑ Yes ❑ No <br /> Summary of discussion <br /> Corrective Action (per PM/Client) <br /> • <br />