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STEL <br /> ,r <br /> STL San FrancAco <br /> 0(6 <br /> ��ple Receipt Checklist <br /> ebmission # 2004- <br /> Checklist completed by (initials) Date 1 104 <br /> Courier name "S'STL San Francisco ❑ Client <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present <br /> Cham of custody present? Yes_ZNo <br /> Chain of custody signed when relinquished and received? Yes_ZNa <br /> Chain of custody agrees with sample labels? Yes_,f!:::�No <br /> Samples in proper container/bottle? Yes /No <br /> Sample containers intact? Yes e---No <br /> Sufficient sample volume for indicated test? Yes_ZNo <br /> All samples received within holding time? Yes._�No <br /> Container/Temp Blank temperature in compliance (40 C±2)? Temp °C Yes-4 No <br /> Ice Present Yes4No <br /> Water-VOA vials have zero headspace? No VOA vials submitted Yes_4f-' No <br /> 0 <br /> (if bubble is present refer to approximate bubble size and itemize in comments as S (small-0) M (medium — O) or L(large -- O) <br /> Water-pH acceptable upon receipt? 0 Yes ❑ No <br /> 0 pH adjusted— Preservative used ❑ HNO3 ❑ HCl ❑ H2SO4 ❑ NaOH ❑ ZnOAc—Lot#(s) <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(jes)] <br /> Project Manager (initials) Date 1 104 <br /> Client contacted ❑ Yes ❑ No <br /> Summary of discussion <br /> lerective Action (per PM/Client) <br />