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`" 1 <br /> —_W-- ..�`......... .w1 _Vmkmm rs�a 'TAW <br /> — ...� <br /> STL <br /> E <br /> € STL San Francisco <br /> Sample Receipt Checklist <br /> Submission #,2003- l -- - C) <br /> ' Checklist completed by (initials) � €7ate _! _1 ./03 <br /> Courier name C2f STL San Francisco ❑ Client <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present-, <br /> Chain of custody present's Yes—,No <br /> Chain of custody signed when relinquished and received? Yes No <br /> Chain of custody agrees with sample labels") Yes__U,-" NO <br /> Samples in proper container/bottle? Yes V- No <br /> Sample containers intact? Yes_ No <br /> Sufficient sample volume for indicated test? Yes . 'No <br /> All samples received within holding time? cc�� Yes -'-'No <br /> ConternerlTemp Blank temperature in compliance (40 C z 2)? Ts G <br /> p A�.0 Yes ,,/ No k <br /> Ice Present Yes_ ,Z-No <br /> Water- VOA vials have zero headspace? _ _ y - No VOA vols s bmitted Yes ✓,No_____-_ <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small-Q), M (medium-- 0)or L(large- 0) <br /> i <br /> _VV-ater=pH acceptable-upon rercerpt?=®`Yes M No — - T <br />__ ___ O pH adjusted--Preservative used--❑ HNO3 ❑HCl 0 HgSO,, ❑ NaOH 0 ZnOAc—Lo!t#(s)— t <br /> For any item check-listed-"Na'--,provided detail of discrepancy in comment section below.- <br /> Comments + <br /> s <br /> Project Management [Routing for instruction of indicated discrepan (les)] <br /> Project Manager Cinitiats} - Date i J03 <br /> Client contacted 0 Yes © No <br /> Summary of discussion, <br /> Corrective Action(per PM/Client) <br />