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STL <br /> STL San Francisco <br /> 10 Sample Receipt Checklist <br /> Submission #'2004- - &4/ <br /> 11 <br /> Checklist completed by (initials)__MDate 104 <br /> i <br /> Courier name TL San Francisco ❑Client <br /> Not Y <br /> Custody seals intact on shipping containertsamples Yes No Present V <br /> Chain of custody present? Yes ✓No <br /> Chain of custody signed when relinquished and received9 Yes 1-- No <br /> Chain of custody agrees with sample labels? Yes_4f L No <br /> Samples in proper containerlbottle? Yes Na <br /> Sample containers intact? Yas_ Ifo <br /> Sufficient sample volume for indicated test? <br /> All samples received within holding time? Yes <br /> - <br /> �n���n�-r..r�`.� <br /> ater-VOA vials have zero headspace? No VOA vials submitted Yes <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S(small-0),M(medium- O)or L(large- O) <br /> Water-pH acceptable upon receipt? 13 Yes ❑No <br /> ❑pH adjusted- Preservative used ❑HNOs❑ HCI ❑H2SO4 ❑NaOH ❑ZnOAc-Lot#(s) <br /> For any item check-listed "No",provided detail of discrepancy in comment section below <br /> Comments <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> Project Manager (initials) Date ! 104 Client contacted ❑ Yes ❑ No i <br /> Summary of discussion <br /> Corrective Action(per PM/Client) <br />