Laserfiche WebLink
Alpha Analytical, Inc. <br /> Phone (775)355-1044 FAX (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 711312004 Date of Notice 7/2/2004 1 25 57 PM <br /> Please take note of any NO check marks If we receive no response concerning these items within 24 hours of the date of this notice,all of <br /> the samples will be analyzed as requested <br /> Client Name Stratus Environmental Project ID Joes Truck Stop <br /> Project Manager Gown Kowtha Client's Phone (530)676-6002 Client's FAX (530)676-6005 <br /> Work Order Number STR04070248 Date Received 7/2/2004 Received by Dolly S Baker <br /> Chain of Custody(COC)Information <br /> Carrier name FedEx <br /> Chain of custody present? Yes ❑ No <br /> Custody seals intact on shipppmg container/cooler? Yes n ❑ No Not Present ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present <br /> Chain of custody signed when relinquished and received? Yes ❑ No <br /> Chain of custody agrees with sample labels? Yes L/J ❑ No <br /> Sample 1D noted by Client on COC? Yes 11/7 ❑ No <br /> Date and time of collection noted by Client on COC? Yes �i1/ ❑ No <br /> Oamplers's name noted on COC? Yes 0 ❑ No <br /> Internal Chain of Custody(COC)requested? Yes ❑ No <br /> Sub Contract Lab Used None SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping container/cooler in good condition? Yes 1VJ ❑ No Not Present ❑ <br /> Samples in proper container/bottle? Yes F./I ❑ No <br /> Sample containers intact? Yes ❑ No <br /> Sufficient sample volume for indicated test? Yes ❑ No <br /> Sample Preservation and Hold Time LHT1 Information <br /> All samples received within holding time? Yes 21� ❑ No <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes n ❑ No 4°C <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No No VOA vials submitted ❑ <br /> Sample labels checked for correct preservation? Yes ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No N/A ❑� <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes ❑ No <br /> Are there client specific Project requirements? Yes ❑ n No If YES see the Chain of Custody(COC) <br /> Omments One nonpreserved VOA for MW-2 received broken <br />