Laserfiche WebLink
• • • • • • • • • • • <br /> KI FF H <br /> Analvdcaluc SAMPLE RECEIPT CHECKLIST SRG#: 2S <br /> Sample Receipt I Initials/Date: IDI r Stora a Time: Tj 1 Sample Login Initials/Date: <br /> TAT: 0 Standard F1 Rush Split None Method of Recei t: L4Courier Over-the-counter n Shipped <br /> Tem °C N/A I Therm ID �Q-/ Time (3 ZZ Coolant present Kyes F1 No Water I n Temp Excursion <br /> For Shipments Only: Cooler Receipt Initials/Date/Time: I Custody Seals El N/A El Intal Broken <br /> Chain-of-Custody: Yes No Documented on COC Labels Discrepancies: <br /> Is COC resent? Sample ID <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? I LZN/A El Yes No <br /> Samples: N/A YesrNo <br /> Comments: <br /> Are sample custodyseals intact? <br /> Are sample containers intact? <br /> Is reservation documented? <br /> In-house Analysis: NIA Yes <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 /> Matrix Container Type # of Containers <br /> OIL <br /> CS Re uired: <br /> Proceed With Analysis: ❑ YES ❑ NO Init/Date: <br /> Client Communication: <br /> 0 <br /> O:bldeouempr lForms4Sample Receipt Checklist iev 070113.doc <br />