Laserfiche WebLink
, 4 STL San Francisco <br /> Sample Receipt Checklist <br /> g} <br /> Submission #.2005-exl` Oe)L <br /> `( ; <br /> Checklist completed by / f u aTE �1/6 /,O <br /> Courter F- SF Courier r-1 Fedex UPS athar � ct1Qrd <br /> Log-In Details Yos ' ;t�.N, I Comments <br /> I Custody seals intact on shipping contarnerlsamples <br /> 7 <br /> 2 Chain of custody present) <br /> E <br /> 3 Chain of custody signed when relinquished and receivedl <br /> $ Alt samples checked when COC relinquished Jill <br /> 5 Chain of custody agrees vwifli sample labels? <br /> 6 Samples to proper container/bottle? <br /> Sample containers Intact? <br /> 8 Sufficient sample volume for indicated test? <br /> 3 All samples received within holding time? <br /> Cooler Temperature Campllante Che' <br /> Temperaturo Blank lZeacfing _coofer 5amplr enjparaturo <br /> VPZsarkAOWT.qac 91 #2 �j -43 Avrarage <br /> M4 "low mu:l <br /> Reason for Etevatcd Temp ersturo 10I Samples wtih Temp>VC-Cornmsms <br /> Ice Melted Insuffii:.Rrt t.e r ti <br /> {^ Sump,in boxes Sa rp;ed< :hr F Ice n"-eq I <br /> S A <br /> VOA Sam pleInspection 1p <br /> Small I tiled i lLa s <br /> Samples with broken, <br /> Sarnplta� 0 � cracked or teaR�ng cant3rners <br /> Are bubbles present In any of the VOA I� [ f I� <br /> Mals? �.' <br /> F- E I I <br /> Yet No IF t;arr7ples with Llnacceptoble pl- <br /> Water-pH acceptable upon receipt? <br /> 0 pH adjusted- Preservative used 0 NO,0 HCi 0 H2SC,Q NaOl n --!_Ot r#(s) <br /> Comments ( <br /> �l <br /> I <br /> E <br /> E <br /> } <br /> �f <br /> I�roleCt illanagement [Routing for 7nstruchon of indicated d5 screpancy(ios 1I <br /> Project Manager (initials) _ _ Dace _ _i 105 Cll t contacaed yej— NF- <br /> summary of discussion , <br /> Corrective Action(per Pl1hlClrant) <br /> E <br />