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I <br /> NOW STL <br /> TL San Francisco <br /> Sample Receipt Checklist <br /> Submission #:2003- - 0,5 '1 <br /> Checklist Completed by: (initials) ale; _ J r03 <br /> Courier nama; El TL San Francisco C�t�ie€sl <br /> Custody seas intacl on Shipping con€ainerf"m les Not <br /> p Yes ado_ Preseat_vf <br /> Chain of cuslady present? Yes ZNO <br /> Chain of custody signed when relinquished and received? Yes .�4 <br /> Chain of custody agrees with sompEo labels? Yes `, No <br /> Samples In proper containoribottle? Yes V11 No <br /> Sample containers Intact? Yes No <br /> Suff6ent sarnple volume for indicated test? Yes No <br /> All samples received within holding time? Yes ,f No <br /> ontaiae rFFem p Bl anktemperaiurf�in compliance (0 C t )1 TOrnp-�c�C Yes L----N 0 <br /> Ice Present Yes ZNo <br /> Water-VOA viats have zero heads pace? Na VOA vials submitted- , Yes No <br /> (if bubble is present, refer to approximate bulable size and itemize in comments as S (small—O), (medium — ) or i_(large — 0y <br /> Water- pH acceptable upon receipt? 0 Yes Q No <br /> 0 pH adjusted— Preservative used'. 0 HP403 0 HCI ❑ 112304 0 NaOH 0 ZnOAc—Lot#{s} <br /> For any item check-listed "No", provided detaiI of discrepancy in comment section be tow; <br /> Oommunts: <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> Project Manager: (initials) Date: ,' 1,03 <br /> Client contacted= ❑ Yes ❑ IVa <br /> Limmary of discussion- <br /> Corrective Action (per PI1 Ghent)- <br />