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., ® STL <br /> STL San Francisco <br /> " & Sample Receipt Checklist <br /> Submission # 2003- 0/ - d// C, <br /> Checklist completed by (initials) NW Date C I Q 103 <br /> Courier name ❑ STL San Francisco z'Cfhent <br /> Not / <br /> Custody seals intact on shipping container/samples Yes No Present ,/ <br /> Chain of custody presenO Yes ✓ No <br /> Chain of custody signed when relinquished and received? Yes No <br /> Chain of custody agrees with sample labels? Yes ✓ No <br /> Samples in proper container/bottle? Yeses_No <br /> Sample containers intact? Yes ✓ No <br /> Sufficient sample volume for indicated test? Yes :/ No <br /> All samples received within holding time? Yes ,/ No <br /> Container/Temp Blank temperature in compliance (40 C T 2)? Temp&°C Yes ✓No <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 — Q) or L (large-- O) <br /> l0water- pH acceptable upon receipt?Xyes ❑ No <br /> ❑ pH adjusted— Preservative used ❑ HNO3 ❑ HCl ❑ HzSOI ❑ NaOH ❑ZnOAc <br /> For any item check-listed "No", provided detail of discrepancy in comment section below <br /> s <br /> Comments <br /> Project Management [Routing for instruction of indicated discrepancy(tes)] <br /> Project Manager (initials) Date 1 I03 <br /> Client contacted ❑ Yes ❑ No <br /> Summary of discussion <br /> Corrective Action (per PM/Client) <br />