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r <br /> ' STL <br /> STL San Francisco <br /> ' Sample Receipt Checklist <br /> Submission #:2004- <br /> Checklist completed by: (initials) Date: !�_l04 <br /> ' Courier name: ❑ STL San Francisco ❑ Client <br /> Not <br /> Custody seals intact on shipping containerlsamples Yes No Present <br /> Chain of custody present? Yes—Z. No <br /> i <br /> Chain of custody signed when relinquished and received? Yes V No <br /> !� Chain of custody agrees with sample labels? Yes "� No <br /> Samples in proper container/bottle? Yes '� No <br /> Samplecontainers intact? <br /> Yes `� too <br /> Sufficient sample volume for indicated test? Yes No <br /> ' All samples received within holding time? r Yes No <br /> Container/Temp Blank temperature in compliance (40 C t 2)? Temp. ° °C Yes No <br /> 1 Ice Present Yes No <br /> Water-VOA vials have zero headspace? No VOA vials submitted Yes No <br /> 0 <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? ,° Yes ❑ No <br /> i <br /> ❑ pH adjusted- Preservative used: ❑HNO3❑ HCI ❑H2SO4 ❑ NaOH i] ZnOAc-Lot#(s) <br /> •' For any item check-listed "No", provided detail of discrepancy in comment section below: <br /> Comments: <br /> i <br /> �Management Project Pro!jRoutin9 for instruction of indicated discrepancy(ies)] <br /> Project Manager: (initials) Date: 1 104 <br /> Client contacted: CI Yes ❑ No <br /> Summary of discussion: <br /> corrective Action (per PM/Client): <br />