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"Ums®R S-r L <br /> STL San Francisco <br /> Sample Receipt Checklist <br /> Submission # 2006- 0 5-( 0 <br /> CmCkIt"I OfJ)t;PJe:e(J by (1mlta1sr__L4L111_ Date If, � i ­�-,C),05 <br /> Couneina,,,,, 13,kiri sannanc-soo Eient <br /> Not <br /> Custody iniaci on shipping roritatoeil,;ain;i1e <br /> NO Present <br /> Chain of cuslouy prascnt� <br /> 6,hAln 011 cuslGay si3nW t,�-finqtijshed and recetyed'� <br /> Chain ol ctimey aqie�,with sarnple labfio �es <br /> ht <br /> smnpl,c <br /> 60WICIerl, indnaled dist Yes <br /> All ronoi.reracived w4thm hekI nq mvis,`° Yes <br /> Okliltainer[Temp Blank tompernture in complianre(4'i, L Comp- b '0 Yes <br /> Potential icason for>M -Ice melted 0 Ice in bags D Not enquc h ire 0 1403 enough b1tie ice 0 SajnFges-111 bonus 0 <br /> 4hr iago'�10 Ice not requirod fps 9 air or LuW qnrnple)11 1cla Pre-sent yezp� JNp__ <br /> Water No VOA vials submittirf yes— '40 <br /> fli$hulible ir,prfseni refes Jo approxffnaW bvuble sze and itenitz-o in romo*ritr,as S(SInali-0) M(11iodj3lm- O�or L flaq(, - 0) <br /> 11krater-pH scGoptabla upon receipt? 0 Yes 0 No <br /> 0 pH adlimled- P;ezeivalivo used 0 HM03 0 1I;t G H.-SO4 El NaOH 13 ZnOAr-Lot#(-,.) <br /> For arty stem check-listed "No",provided delail of discropincy in cornment section below <br /> Comments IJJ (.'Jack W AW L)C4 <br /> tk- <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> Project ManagEIr (1111tials) Date _J_iO5 <br /> C>enJconI?Cted 0 Yes 0 No <br /> SLIMPlary of discussion <br /> _(_Or_rOcj,vc, 4-c4an (per RWCIicnl) <br />