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CHROMALAB, INC. <br /> Environmental Service(SOB) <br /> Sample Receipt Checklist <br /> Tient Name : ate/Time Received: 03/1.3/98 <br /> Reference/Submis : 38685 9803170 Received by: <br /> F�hecklist completed by: Reviewed by: <br /> Signature Cate Initials at <br /> F4atrix: WP 1 wu-CX� _ Carriername : Client - C/L <br /> Not <br /> Fhipping container/cooler in good condition? Yes No Present <br /> Not <br /> Custody seals intact on shipping container/cooler? Yes No Present 1� <br /> Not <br /> 'ustody seals intact on sample bottles? Yes No Present <br /> Chain of custody present? Yes Lf No <br /> hain of custody signed when relinquished and receivel? Yes L/ No <br /> Chain of custody agrees with sample labels? Yes Se�- No <br /> F3amples in proper container/bottle? Yes No <br /> Sample containers intact? Yes LC No <br /> Pufficient sample volume for indicated test? Yes _� No <br /> All samples received within holding time? Yes No <br /> f'ontainer/Temp Blank temperature in compliance? Temp: � �°C YesLl----No <br /> Water <br /> No <br /> Water - VOA vials have zero headspace? No VOA vials submitted Yes No <br /> F <br /> ater - pH acceptable upon receipt? Adjusted? Checked by <br /> emis�forVOA <br /> Any No and/or NA (not applicable) response must be detailed in the comments section a <br /> F,lient contacted: r Date contacted: Person contacted: <br /> F-- <br /> ontacted by: Regarding: <br /> Fomments: <br /> r <br /> k <br /> Corrective Action: <br /> F <br />