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STL <br /> STL San Francisco <br /> a Sample Receipt ChecklistSubmission #*2003- /0 0 <br /> E <br /> E <br /> E <br /> Checklistcomptetedby LtniVals) Dale ley <br /> Esi3 <br /> UOU name San Fr LSCdsc llent <br /> Custtsdy seals tntact an shipping Car la n r s.impics Not <br /> Yes No Resent <br /> Chain of ct:sjody cresosnt� <br /> t <br /> Chan of i�ustcdy sagnea rvhon rels€squis ed and recesvqO Yes� <br /> Chaln of custody agrees Vrsih Sample tabcW? Yes v' No <br /> Samples in prrsc-er contaanerlbottlel Yes +,/ Nis_ <br /> Sample c4ntaulers Intact r Y � No _. <br /> Sufficient,,ample volume for inti€ca?ed test's # Yes No <br /> ill';err£ples recewed Jthfn holding tare? ves No <br /> C-Ori,alnerrTamp dank temperature in comptiance (41,0 f:Z)? Ternp Yes NO � <br /> Ice pres,erst Yes_L,�rra�„„ <br /> sisla,er-VOA vials nave zoro hcadspface? No VOA vrats subrtasrted _. Yes // Ida <br /> (if oubbte as present,refer lu apprcymnale bubble size and iternme in comments ars S (small--0), M(me attsm a 0)or L Varge- ? <br /> 3 <br /> dates -pH acceptablo upon recespt7 es © NO <br /> 0 pH;adjustod- Preservabve used 0 l W03 0 ICI 0 H2SO 0 NaQH 0 ZnOAc--Lot#(s) <br /> For any stem check listed `No",provided detail cf discrepancy to comment section belo.+r, <br /> r <br /> Comments t,) v <br /> w <br /> f <br /> 1 <br /> Project Management [Routing for Instruction of indicated disc ropancy(ies)] <br /> Project Manager (Initials) ale- f M <br /> Client MltaCLed © Yes 0 No <br /> Summary of discussion <br /> Corrective Ac`lon(per P%I/Of;ent! , <br /> 6 <br />