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K1FFOAnalwicalLLc SAMPLE RECEIPT CHECKLIST sRG#: <br /> Sample Recei t Initials/Date: (6z,&7; Stora a Time: Sample Login Initials/Date: <br /> TAT: Standard Rush Slit None Method f Recei t: Courier Over-the-counter Shi ed <br /> -T Tem °C ?/ N/A Therm ID - Time Coolant resent Pfyes No Water Temp Excursion <br /> For Shipments Only: Cooler Receipt Initials/Date/Time: Custody Seals El N/A Intact Ej Broken <br /> -A <br /> Chain-of-Custody: Yes No Documented on COC Labels Piscrepancie <br /> ec <br /> Is COC resent? Sample ID - z <br /> n.cr o-i c dzA <br /> Is COC signed by relin uisher? Project ID <br /> Is COC dated by relin uisher? Sample Date <br /> Is the sampler's name on the COC? Sample Time <br /> Are there analyses or hold for all samples? Does COC match project history? N/A Yes No <br /> Samples: N/A Yes No Comments: <br /> Are sample custody seals intact? <br /> Are sample containers intact? <br /> Is preservation documented? <br /> In-house Analysis: N/A Yes No <br /> Are preservatives acceptable? <br /> Are samples within holding time? <br /> Are sample container types correct? <br /> Is there adequate sample volume? <br /> Receipt Details: <br /> tnx Cont iner Type # of Containers <br /> w CS Required: <br /> o <br /> Proceed With Analysis: ® YES E] NO Init/Date: /08 z 3 <br /> o Client Communication: ! f <br /> N <br /> O <br />