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ULAB <br /> ENVIRONMENTAL TESTING SERVICES <br />' SAMPLE RECEIPT CHECKLIST <br /> Client Name : <br /> Job Number : gOS-,21- Received by: Date/Time: <br /> Stored in: - j- Checklist by: Date/Time: <br />' Matrix: Log--in by: Date/Time: <br />' Items of Concern Yes No N/A Comments <br /> Client Delivered <br />' Samples Shipped / By: <br /> Courier Delivered By: <br /> COC seals Used Shipping Container Sample Containers <br /> COC Present <br /> COC Accurate <br /> Samples Intact <br /> Correct Containers <br /> Adequate Sample Volume <br />' Samples Chilled (2-6°C) w/o cooler w/o ice <br />' Sample pH taken acceptable <br /> No Headspace in VOAs <br />' Holding Times Acceptable f <br /> Client Knows of Problems Routine Telephone <br /> Additional <br />' Comments : <br />' /u/%att/foga n_tores/samp_rec for% 10/22/96 Cora Laboratories Inc <br /> 1250 East Gere ;Lm Nav anahe m Cal iomia 92905 (7 11 M- 1091 ,800)404 CORE Fax(714)937 1 170 <br />