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• Sample Receipt Checklist STL San Francisco <br /> Submission #. 2002- Z_ <br /> Checklist completed by (initials)_&�LDate Id/_O 102 <br /> Courier name ❑ STL San Francesco �(Chent <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present <br /> Chain of custody present? Yes --"No <br /> Chain of custody signed when relinquished and received? Yes --I�No <br /> Chain of custody agrees with sample labels? Yes /No <br /> Samples in proper containedbottle? Yes ✓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 Blanc temperature in compliance (4°C;2)? G mp� °C Yes ✓ No <br /> Water-VOA vials have zero headspace? No VOA vials submitted Yes ✓ No <br /> • <br /> (if bubble is present, refer to appro)umate bubble size and itemize in comments as S (small -O), M (medium - 0)or L(large -- 0) <br /> Water- pH acceptable upon receipt? 0 Yes ❑ No <br /> 0 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 <br /> Project Management [Routing for instruction of indicated dlscrepancy(l;es)] <br /> Project Manager (initials) Date 1 102 <br /> Client contacted ❑ Yes ❑ No <br /> Summary of discussion <br /> Corrective Action (per PM/Client) <br />