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�tr�t <br /> h 'STL San Francisco <br /> Sample Receipt Checklist <br /> Submission #:2004- <br /> Checklist r..klist cpmplet>?rl by: (initials) �r Date: l M4 r <br /> Couner nan: �ISTL San Francisco 0 Client <br /> Not r <br /> Custody Seals intacl on shipping contdinensampte Yes No Present +� <br /> Chaim of cusio dy present? Yes No <br /> Ghalrl Of cuatoriy Svciried when feltriqurshed and received? Yes /Nn <br /> L� —�._ <br /> Chainr7fi Custody agreesfrith sani{ilf?labels? Yeses f No <br /> Samples in Prgper rantaineilbotlir? <br /> Yes <br /> i --- No-- <br /> Sample containers intact? � <br /> yes f No <br /> Suf�tctc-itt sanapte volume for rnrfrrated lest" No <br /> Yes <br /> All samofes ieceived r'Alhin holding Gore? ] Yes No <br /> Container[Temp Blank temperature In Compliance(0 C;-±2)? { �� �/ <br /> i T . C. Yes_ _No <br /> i ( <br /> Potential reason for>6`(;-ice melted.0 !cz in hags'. El, Not a iough4ce O: Not enough^bluerco 0 Satstple;in boxes 0 <br /> Sampled :Or.ago?O Ice not required(e:•g.air or bulk sample)0 � /,/ <br /> ice Present Yes - N0 <br /> Water VOA vials have 2eio headspace? No`✓GA vials strlimitted Yes <br /> {if buht)lr i5 present, refer tri approximate bubble see and itemize in co <br /> rnments as S(small-C7), M(mediufn— 0)or L(targe-- ) <br /> Water-pH acceptable upon receipt? ❑Yes ❑No I <br /> ❑pH adjusted-- Pleseraative used: 0 HNO3 O HCI D H7SO.1❑NaO I•l 0 Zin C?r1r-Lot#(s) <br /> For any item check-listed "No", provided detail of discrepancy in co nment�sectionrbelow: <br /> Comments: <br /> 3 <br /> �i![4 <br /> 1� <br /> Project Management [Routing for instruction of indicated discrepancy(ies)J <br /> Project Manager: !initials} Date'__1_104 it <br /> �� Tient contacted: Q Yes D No <br /> Summary of discussion_ <br /> j .. <br /> {:Orrec'ive Action i,(.,er I•'MrClit:nt► <br /> i <br /> s� . <br />