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STL <br /> STI. San Francisco <br /> fSample Receipt Checklist <br /> Submission #:2004- S� <br /> Checklist completed by (initials) pate +CJ 1-EtO4 <br /> i <br /> Cou ier name ❑STL San Francisco © Cllent�} <br /> Not <br /> Cusl ody seals intact on shipping containerlsamples Yes No Present <br /> Glia n of custody present? Yes <br /> Chan of custody signed when relinquished and received? Yes ✓ NNq <br /> I Cha n of custody agrees with sample labels? Yes ✓/No <br /> iSairples in proper containerlboWe? Yes No <br /> Sarr pie containers intact? Yes t' Na <br /> � <br /> Suff elent sample volume for indicated fest? Yes Na <br /> I <br /> All r,ample4 received within holding time? Yes w om- <br /> ConlainerfTemp Blank temperature in compliance(4'C 2)? Temp�-G Yes '1`�N <br /> Ice Present Yes No <br /> Water VOA vials have zero headspoce? No VOA vials submitted Yes Na <br /> 1 <br /> �'"� <br /> rf b bole is present refer to approximate bubble size and itemize in comments as S(small -O), M{medium- Q)or L(targe- �) <br /> Water -pH acceptable upon receipt? ❑Yes O No <br /> © p H adjusted- Preservative used, ❑HNO3 0 HCI a H2SOs❑1113 ZnOAc-Lot#(a) i <br /> For any item check-listed "No",provided detail of discrepancy in comment section below. <br /> comments: <br /> F <br /> i <br /> i <br /> I� <br /> i <br /> Pr jest Management [Routing for instruction of indicated discrepancy(ies)] i <br /> Pr act Manager (inttials) ❑ate t i 4 <br /> Cti nt Contac{ed © Yes © No <br /> eau merry of discussion: <br /> f , <br /> I <br /> Coi rective Action(per f'M/Clienf) I <br /> i <br />