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IME® STL <br /> 0' STL San Francisco <br /> Sample Receipt Checklist <br /> Submission # 2003- 0�- - D -2 (, Z, <br /> Checklist completed by (initials) Date / / V I03 <br /> Courier name © STL San Francisco Client <br /> Not <br /> Custody seals intact on shipping container/samples Yes No !'resent <br /> Chain of custody present? Yes ✓ No <br /> Chain of custody signed when relinquished and received? Yes <br /> Chain of custody agrees with sample labels? Yes No <br /> Samples in proper container/bottle? Yes ",-No <br /> Sample containers intact? Yes No <br /> — <br /> Sufficient sample volume for indicated test? Yes No <br /> All samples received within holding time? Yes �No <br /> Containerffemp Blanks temperature in compliance (40 C±2)? Temp L O°C Yes_L,�—Ro <br /> Water-VOA vials have zero headspace? No VOA vials submitted Yes No <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small-O), M (medium – O) or L (large -- O) <br /> Water-pH acceptable upon receipt? Y`;3 es © No <br /> ❑ pH adjusted-- Preservative used ❑ HNO3 © HCI ❑ H2SO4 ❑ NaOH ❑ ZnOAc <br /> For any item check-listed "No", provided detail of discrepancy in comment section below <br /> Comments \JAW-tel ( 1 \Cf) � VI C16 - k�_k <br /> Project Management [Routing for Instruction of indicated dlscrepancy(ies)] <br /> Project Manager (initials) Date 1 I03 <br /> Client contacted ❑ Yes ❑ No <br /> Summary of discussion <br /> Corrective Action (per PM/Client) <br />