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1 <br /> Sample Receipt 1 Client Notification Form <br /> J 1 <br /> Client Name pG� Pia 5001 <br /> J 1< # <br /> SIERRA Sierra Protect Number <br /> LABORATORIES <br /> Sierra Protect Manager G i N JTO,% <br /> Date/Time Samples Received 4/ ,Z S] ' <br /> Method of Shipment (AP S re d <br /> 1 <br /> Custody Seals? E1 NIA 0 Intact Broken <br /> Samples Intact' Na ryoa C.- '2 6 mice^ ' <br /> Properly Labelled cS <br /> Appropriate Containers <br /> Headspace in VOA vials? ' <br /> Samples Chilled (Cooler Temp °C) yc-S <br /> Properly Preserved? (pH) ,1 ' <br /> Preservatives added (after receipt by Sierra) JVo <br /> " Sample Disposal Instructions <br /> Turn Around Time Requested No,-kr.I ^_ , <br /> Subcontractor Laboratories to be utilized Non 0- <br /> Special <br /> Special Instructions ' <br /> 1 <br /> Other Anomalies <br /> Date/Time Faxed to Client ' <br /> Samples Logged In by ' <br /> Printed Name 8111 14 JS a <br /> If you have any questions, please refer to the Sierra Protect Number referenced above ' <br /> -Samples are only retained for 30 days if marked for Lab Disposal Other charges may apply for other disposal options <br /> '-Rush surcharges will be applied to Tum Around Times other than Normal,except by prior arrangement with Sierra Labs <br /> 26052 MERIT CIRCLE SUITE 105, LAGUNA HILLS, CALIFORNIA 92653 <br /> TELEPHONE (714) 348-9389 FAX (714) 348-9115 <br />