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F - n n <br /> CHROMALA6, INC. i <br /> Environmental Service(SDS) <br /> Sample Receipt Checklist <br /> Fnient Name : ate/Time Received: 07/22/97 � flG v <br /> Reference/Submis : 34755 9707294 leceived by: T1 <br /> 6 <br /> -Checklist completed by: Reviewed by: 1 <br /> ,- signature date Initials Date <br /> F,4atrix: Carrier ame : Client C/L <br /> Not <br /> 73hipping container/cooler in good condition? Yes No Present <br /> . Not <br /> Custody seals intact on shipping container/cooler? Yes No Present / <br /> r"' Not J <br /> [ custody seals intact on sample bottles? Yes No Present <br /> hain of custody present? Yes No <br /> # .±hain of custody signed when relinquished and receivel? Yes No <br /> Chain of custody agrees with sample labels? Yes No <br /> F", <br /> amples in proper container/bottle? Yes No <br /> Sample containers intact? Yes No <br /> F3ufficient sample volume for indicated test? Yes No <br /> All samples received within holding time? Yes No <br /> F.7ontainer/Temp Blank temperature in compliance? Temp: °C Yes No V, <br /> Water - VOA vials have zero headspace? No VOA vials submitted Yes No <br /> F! <br /> - pH acceptable upon receipt? -� Adjusted? Checked by <br /> chemist for VOAs <br /> Any No and/or NA {not applicable} response must be detailed in the comments section <br /> F:, <br /> ient contacted--------------------Date contacted.== _===W^T�^ <br /> F-2ontacted by: Regarding: <br /> omments: C t� K �L 4 <br /> Corrective Action: <br />