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I <br />11 <br />CJI <br />• <br />Accutest Laboratories Northern California Sample Receiving Check List <br />Reel, Makin of Cuatuda Chain of Custody la to be complete and NUIRA.. <br />A. thesereug l.t. (NPDC:psemplaeP GWA- <br />(!EpfNo <br />pH requeeud? <br />yes/ <br />o Was Client informed Nal hold time is 16 min? Ye,I No Continue <br />Yes No <br />o Wasodho-PhosphatehltemdvdNinl6min? Yee/Ns Continue <br />Y..I No <br />9*. sample Mudd hold Visa? <br />O/ No <br />W&T.Ung Cl..... .IOV6�Yoadin® Itl-lima sling Bakal? l? <br />Yes <br />o�' <br />If No: la Raped to Info..plot. and legible. Morin,; <br />.�hlpment ReceMed Method V <br />yEelMereble q.Name pXddraaa,poar. rve 11 <br />Is BIII to Info complete and legible, Including; <br />Y..I No <br />.POM o Cratlll card o C.ntac(m ddaea. .,hon. o..mall <br />of SaMPIR Bottles,the side <br />1. Contact edVar Project Menage, Identified, Indutling; <br />o4//hone deemed <br />YB No <br />./.Joel now l number <br />pis there enough sample volume In proper bottle for requested an.lyner7 <br />atpecoleaquiremeals? <br />Vea l� <br />Semple bar dale 8 tons of collection prevldad? <br />q(s Mon listed and camecl? <br />ee No <br />vAnelyse.feted, vre do, or diem has authodad a subconlm.t? <br />(fi�71No <br />aiChaln is signed and dated by both client and sample custodian? <br />ea/No <br />vfAT requested a,.H.bie? (9 No Approved by P✓✓l <br />LLbemple ID antl affected contains, <br />0 <br />Job#: C1110 <br />Non -Compliance Issues and discrepancies on the COC are forwarded to Project Management <br />Initial: S "t <br />lacwnca.awutesbwmIdephlgalsopslsop_completellst_20101current active sop_oc1_20101sc001ti 0_fo ml_samplewntml_somplerewivingchecklist_2008-01-Ot.doc <br />C 17729: Chain of Custody <br />Page 2 of 2 <br />MR 32 of 50 <br />M P.GCUTEo—r <br />C1772e `.... .." <br />Review coolers' <br />A.m all Caere. temperatures measured at.WC? <br />91N. <br />header is outside the s6°C;nate down the efnend balpes N that coater.. the ]all <br />' <br />pe sample. on lee? <br />Npts <br />(9I Ne <br />that ANC does NOTaccept seldeallary samples. (We do not lack refrlgamtom) <br />.�hlpment ReceMed Method V <br />vEualedy Seals: Present You/IfYes; Unbroken: <br />Y..I No <br />of SaMPIR Bottles,the side <br />Chain reatchoa holds labels? 1:9 No V6ample bottle iniad? <br />YB No <br />pis there enough sample volume In proper bottle for requested an.lyner7 <br />�No <br />' <br />_ <br />o Proper Pheumallvea? Y..I No <br />Check pH on praaereed samples except 1664, 626, 8276 and VOAs; make notes on fell. <br />o Headspace-VON? Greater Man emm in diameter <br />Yee/No <br />LLbemple ID antl affected contains, <br />0 <br />Job#: C1110 <br />Non -Compliance Issues and discrepancies on the COC are forwarded to Project Management <br />Initial: S "t <br />lacwnca.awutesbwmIdephlgalsopslsop_completellst_20101current active sop_oc1_20101sc001ti 0_fo ml_samplewntml_somplerewivingchecklist_2008-01-Ot.doc <br />C 17729: Chain of Custody <br />Page 2 of 2 <br />MR 32 of 50 <br />M P.GCUTEo—r <br />C1772e `.... .." <br />