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•J <br /> NET Santa Rosa Diwsion LOGIN CHECKLIST <br /> CLIENT- JOB# LOG <br /> Project ID• <br /> Samples Received On • ,_,/ Checked in on <br /> 1) Custody Seals. El NIA L9 Present ❑ Absent ❑ Broken <br /> 2) Cham of Custody ❑ Present ❑ Absent #(s) <br /> Forms ❑ Complete ❑ Incomplete <br /> 3) Type of packing material used- QU_ <br /> 4) Temperature(s) ' C Thermometer#(s) <br /> 5) Sample Container(s) Intact ❑ Broken <br /> 8) Container Label(s) Match COC ❑ Do Not Match <br /> 7) Sample Volume Sufficient ❑ Insufficaent <br /> 8) Preservative(s) IYJ Correct ❑ Incorrect ❑ pH verified ❑ Res.CI chk <br /> (CN & PHI-s) <br /> 9) Headspace (VOAs) None ❑ Present {list ID's/number vials affected) <br /> `� y <br /> Sample ID # of Vials Sample ID # of Vials <br /> 10) Form Completed By Date: f �D <br /> Attach pet's packing slip to this form before routing <br /> Problem Resolution: <br /> 1) ❑ Project Coordinator Verbally Informed on <br /> 2) ❑ Client Informed on By <br /> Project Coordinator: Date Resolved: ❑Y ❑ N <br /> Comments <br /> wr95C*pnfrra <br />