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STL LOS ANGELES <br /> PROJECT RECEIPT CHECKLIST Date <br /> Quantims Lot # Quote # �5 t�f 17, <br /> lient Name / Project <br /> Received by f c � Date/Time ReceivedJ- <br /> I <br /> Delivered by ❑Client ❑Airborne Fed Ex ❑DHL Din-House Courier ❑Rey B <br /> .............. ❑UPS .....❑DES . ❑Other ............................ <br /> Initial 1 Date <br /> Custody Seal Status Intact ❑Broken []None <br /> Custody Sea] #(s) ��Vo Seal # <br /> Sample Container(s) ❑STL-LA Client ❑N/A _ <br /> Temperature(s) (COOLER/BLANK) In °C J �Cr (CORRECTED TEMP) ::5-e-2C <br /> Thermometer Used A,IR (Infra-red) ❑Digital (Probe) <br />' Samples [Intact ❑Broken ❑Other <br /> Anomalies 1.10 XNo ❑Yes (See Clouseau) <br /> Labeled by <br /> Labeling»checked+by. <br /> Turn Around Time 7RUSH-24HR ❑RUSH-48HR ❑RUSH-72HR NORMAL <br /> Short-Hold Notification ❑Ph ❑Wet Chem ❑Metals (Filter/Pres) ❑Encore P�.N/A <br /> Outside Analysis(es) (Test/Lab/Date Sent Out) 4ttlte _ <br /> *******"** LEAVE NO BLANK SPACES USE N/A ......•... <br />' Fraction 17 PH <br /> VOAh /* N/A <br />' <br /> h I lC! H2SO4 na Sodium zany Zinc A,_etaterSodwm n/t HNO3-Field n/t`l HNO3-Lab filtered <br /> Hydovde Hvdzocide s n HNg3 filtered <br /> Gi Clear Glass CGB Clear Glass AGJ Amber AGB Amber Giass E Encore <br /> at Bottle Glass Jar t3otdc PB Poly Bottle Sampler V VOA SL Sleeve <br /> * Number of VO A's,r/Headspace present <br /> LOGGED BY/DATE ?i REVIEWED BY/DATE <br /> CJO0003 <br />