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CHROMALAB, INC. <br /> Environmental Service(8138) � <br /> Sample Receipt Checklist <br /> :lient Name ; Date/Time Received: 07/14/97 <br /> ference Submis : 34629 9 0717 Reece ' ed by: <br /> khecklist completed by: "�'�cJ ! Reviewed by: <br /> 4 <br /> Signature D to Initials Date <br /> Flatrix: Carriername : Client - C/L <br /> h <br /> Not <br /> hipping container/cooler in good condition? Yes No Present <br /> F Not <br /> Custody seals intact on shipping container/cooler? Yes No Present <br /> Not <br /> _'ustody seals intact on sample bottles? Yes No Present <br /> hain of custody present? Yes / No <br /> hain of custody signed when relinquished and receive ? Yes No <br /> r,hainof custody agrees with sample labels? Yes / No <br /> amples in proper container/bottle? Yes No <br /> Sample containers intact? Yes No <br /> ufficient sample volume for indicated test? Yes ✓ No <br /> All samples received within holding time? Yes No <br /> 'ontainer/Temp Blank temperature in compliance? Temp� ` , °C Yes f No <br /> W ter - VOA vials have zero headspace? No VOA vials submitted ✓ Yes No <br /> F'a r - pH acceptable upon receipt? Adjus ed? Checked by <br /> chemist for VOAs <br /> Any No and/or NA (not applicable) response must be detailed in the comments section below. <br /> %>lient contacted: Date contacted: Person contacted: <br /> F"ontacted by: Regarding: <br /> comments: <br /> Corrective Action: <br /> { <br />