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S <br /> y Cal Tech Environmental Laboratories Inc, <br /> Sample Receiving Check List <br /> Date received 7 5- o 3 Time / U-' <br /> Lab ID# - ! Client .- <br /> Answer Yes No NIA <br /> COC Present <br /> #of packages f 0 ❑ ❑ <br /> Sample received on ice ❑ ❑ <br /> Type of ice Blu et ■ ■ ❑ <br /> Temperature { ■ ❑ <br /> Samples intact ❑ ❑ <br /> Leaking bottles ❑ ❑ <br /> Custody seals intact �/ ❑ ❑ <br /> COC completed �- '' ❑ ❑ <br /> Bottle labels matclung COC ❑ ❑ <br /> �i Preservation Chk ❑ <br /> Preserved at lab ❑ ❑ <br /> Sample volume sufficient ❑ ❑ <br /> Notify analysts ❑ i ❑ <br /> Subcontrct analyses? ❑ ❑ <br /> Discre ancies and Notifications <br /> Sample Receipt by: <br />