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�4 <br /> 444+ CHROMALAB, INC. <br /> Environmental Service(SOB) <br /> Sample Receipt Checklist <br />�lient Name : CONSTRUCTION TESTING & ENG. Date/Time Received: 03/26/-98 <br /> Reference/Submis : 38934 1 9803372 Received by: 12 <br /> rhecklist completed by: � ���`- l Reviewed by: L- /Z- <br /> S / <br /> iDate Initials Date <br /> Fatrix: .i1 Carrier name : C/D <br /> Not <br /> 'zipping container/cooler in good condition? Yes _. No Present <br /> Not <br /> Custody seals intact on shipping container/cooler? Yes No Present Ll <br /> r Not <br /> ustody seals intact on sample bottles? Yes No Presenty <br /> Chain of custody present? Yes L-' No <br /> hain of custody signed when relinquished and received. Yes No <br /> Chain of custody agrees with sample labels? Yes L— No <br /> Eamples in proper container/bottle? Yes Lam.. No <br /> Sample containers intact? Yes No <br /> ![sufficient sample volume for indicated test? Yes 1� No <br /> r Ji <br /> All samples received within holding time? n`1 Yes ll No <br /> bntainer/Temp Blank temperature in compliance? Temp: // �C Yes Lf No <br /> 0 <br /> Water - VOA vials have zero headspace? No VOA vials submitted l</ Yes No <br /> r–,qtr: pH acceptable upon receipt? Adjust d? Checked by <br /> t , chemist for VOAs <br /> Any No and/or NA (not applicable) response must be detailed in the comments section below. <br /> tient contacted: Date contacted: Person contacted: <br /> F>ntacted by: Regarding: <br /> F—ments: <br /> F s <br /> ` i <br /> Corrective Action: <br />