Laserfiche WebLink
F(f L Knvi1-otb,rreut4l <br /> RcMsitan Date: !D/Zg/00 <br /> Doc ID: 14�i �Ufll�.tlt <br /> age.Stocktoil <br /> i of 1 <br /> Sample.dr eceipt <br /> PDXI Receipt (Attach to COC <br /> tt S1 K: <br /> l Njxnr ber of ice chests/packages received: _ j <br /> Were sanlples received i2i a chiller condition?' ' <br /> A•cccf,tabjt;i5 above frecz, to 6 h Note as ' re1nPs: / <br /> 1 1 <br /> sarnu day ufsar71pI;11 , $ AC3!(a$'rived ori iCe —wds - / s <br /> 8 ampler nlsy!2e r�cc iv�d withaLzf.coolirig it sa Wiled with is one hotly ofrc ei t. , <br /> gun for saazt !es recgi,yed C7t1 <br /> L]o the number of bottles received agree; with the (,,OC?, P <br /> . Dere samples received intact? (1.6 no broker bottles le / No N/A <br /> . Were sarnpli custody seals intauE'? alis etc.) Yeg,_ No <br /> Sign and date tjiu COC <br /> place uN/ <br /> A Yes N <br /> SaZpie Receipt evierr1aziplockandptn o <br /> vvcompldled,by (initials): i � ameue chest as tlle <br /> les. <br /> Sample Receipt at Sp: --�: <br /> l• were samples received in a chilled condition'? <br /> A"e}7table is above heezin to 5° rerrtps: / / <br /> pripridzc further review. Plea e notify Mie ob ob <br /> lo P 8 ~—�^ /—�-� ' <br /> Y acica �s 3rd u e time check for ttsts/�I.1'.'slrusheslBy received at Prtsor�nel-immediately of b4cti san'Plcs re• ' d. act!'s io <br /> 2, Da the rlurnber of bottles received agree with the C�G� <br /> 3- Were sarnptes reGeiued intact?'(i.e. ri[) broken bottles, Ieaks.etG:) e No N/A <br /> 4 Were sampler seals intact? <br /> 4 No <br /> S'911 and elate the CoC, obtain LIMS sarn len Yes No <br /> P umbOrs, select methods/testy, and print labels. <br /> Sarngle Veri>lica#ion,Lalheliug and Distrib <br /> 1. <br /> Wel7e all rc:yuested analyses all <br /> dexstood and accep�tablc;? <br /> - Did bottle labels correspond tivith the Client's fL7's'i No <br /> - Were tiI] bottles reg111Ting sample pr4servi tiol1 ro ger a r <br /> i <br /> s NO . ; <br /> 4. -Were all analyses wi thil7 holding times at Ei 'P 1 ly F'res�.x'vcd? Yes No / <br /> 1�GL <br /> mtr oFrcceipt? ' <br /> kLve rush or ra ect due dates begin checked No <br /> I� J i <br /> Attach labels to the contairxers a1ld No a c and accepted? <br /> . Yes No <br /> oPY oFthe CDC For lab delivery. <br /> �71ng1e kecezpt, Login and Verification cots leted by I1Z1tIs1s}: <br /> � <br /> biscrepaAcy 1L�oci!�n1enta.�otj:; .- . <br /> Any itelrts,al3ove which,are"}gyp" ~� <br /> 1 or rlol meet Sp4cicaliptls {i.e. tei�, s j <br /> l'Gi'st7n (=ont�tc,tLd: p ) mt.C't ' j <br /> Irliti41ed By, - - - - --._— — Ph(-),,- <br /> 4 <br />