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Cal Tech Environmental Laboratories Inc, <br /> ' Sample Receiving Check List <br /> Date received: r1 f Time: L <br /> ' Lab ID#: 0 _n Client: ��- (� <br /> ' Answer Yes No NIA <br /> COC Present �x ❑ ❑ <br /> t #of packages •❑ ❑ ❑ <br /> Sample received on ice ❑ <br /> Type of ice Blu et ■ ❑ <br /> ' Temperature ��� ■ ❑ <br /> Samples intact , ❑ ❑ <br /> Leaking bottles ❑ ❑ <br /> Custody seals intact 5 ❑ ❑ <br /> ' COC completedi ❑ ❑ <br /> Bottle labels matching COC ❑ ❑ <br /> Preservation Chk <br /> Preserved atIab ❑ ❑ <br /> ' Sample volume sufficient ❑ <br /> Notify analysts Cl ❑ <br /> Subcontrct analyses? ❑ ❑ <br /> t <br /> Discrepancies and Notifications <br /> ' Sample Receipt by: ""-J, YA <br /> 1 <br />