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HOUSTON LABORATORY <br /> Or 8880 INTERCHANGE DRIVE <br /> HOUSTON TEXAS 77054 <br /> 10�WA�Im 2r�o (713)660-0901 <br /> 1 Sample Receipt Checklist <br /> Workorder 99110007 Received by Stelly D'Anna <br /> Date and Time Received 10/30/99 10 00 00 AM Carrier name FedEx <br /> Temperature 3 <br /> Shipping contalnerlcooler in good conditions Yes No ❑ Not Present ❑ <br /> Custody seals intact on shippping contain erlcoolerl Yes ❑ No❑ Not Present ❑� <br /> rCustody seals intact on sample bottles? Yes ❑ No E Not Present ❑� <br /> Chain of custody present? Yes 0 No LI <br /> Chain of custody signed when relinquished and received? Yes �/❑ No❑ <br /> Chain of custody agrees with sample labels? Yes No F71 <br /> Samples in proper containerlbottl0 Yes No ❑ <br /> Sample containers intact? Yes No❑ <br /> Sufficient sample volume for Indicated test? Yes d❑ No ❑ <br /> All samples received within holding time? Yes ❑d No❑ <br /> ontainerlTemp Blank temperature in compliances Yes ❑d No❑ <br /> Water-VOA vials have zero headspace? <br /> Yes 0 No El Not Present ❑ S <br /> Water-pH acceptable upon receipt? Yes 0 No v i <br />