Laserfiche WebLink
Sample Receipt / Client Notification Form <br /> Client Name: �. �"'� .� • �.� e,r-�� <br /> SIERRA Sierra Project Number: a l d <br /> LABORATORIES <br /> Sierra Project Manager: Y— <br /> 1 w� <br /> date/Time Samples Received: `� ' 3 ' I t a <br /> Method of Shipment: L7 . S <br /> Custody Seals? N/A N-?`1 Intact [J Broken <br /> Samples Intact? `'�`C_S <br /> Properly Labelled? ea rj <br /> Appropriate Containers? `e <br /> Headspace in VOA vials? Yv <br /> Samples Chilled? (Cooler Temp. °C): S • C <br /> Properly Preserved?(pH) <br /> •, Preservatives added (after receipt by Sierra): t3✓� _ - � <br /> ! Sample Disposal Instructions: <br /> " Turn Around Time Requested: Z L----D S. <br /> Subcontractor Laboratories to be utilized: V/"L O V"---4-1 <br /> Special Instructions: <br /> Other Anomalies: <br /> Date/Time Faxed to Client: <br /> Samples Logged in by: <br /> Printed Name: _` ( " <br /> If you have any questions, please reter to the Sierra Project Number referenced above. <br /> • '-Samples are only retained for 30 days 0 marked for Lab Disposal. Other charges may apply for other disposal options. <br /> "•Rush surcharges will be applied to Tum Around Tomes other than Normal,except by prior arrangement with Sierra Labs, <br /> 26052 MERIT CIRCLE, SUITE 105, LAGUNA RILLS, CALIFORNIA 92653 <br /> TELEPHONE: (714) 348-9389 FAX: (714) 348-9115 <br />