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' Sample Receipt/ Client Notification Form <br /> Client Name: <br />' 819RRA Sierra Project Number:T Q d S — O 5 <br /> I-ABORATORips <br /> SierM Project Manager: L< i <br />' *ate. 1 Time Samples Received: 05-03- 0 a ti „•, _�� AAA <br />'. : Method of Shipment: (4 e!> <br /> Custody Seals? ❑ NIA E] Intact F Broken <br /> Samples In <br /> tact? �- <br /> Properly Labelled? ✓ ___ <br /> Appropriate Containers?' � <br /> Headspace in VOA vials? d h - <br /> Samples Chilled?(Cooler Temp. C): <br /> ' Properly Preserved? (pH) <br /> Pre$ervatives added (after receipt by Sierra): <br /> * Sample plsposal instructions: L,4 <br /> its Tum Around Time Requested: IV 4 r m cJ <br /> Su o a Laboratories to be utilized: _ <br /> be ntract r ra . <br /> Special Instructions: <br /> Other Anomalies: <br /> ' Date/Time Faxed to Client: <br /> ' Samples Logged in by: <br /> 11 <br /> Printed Name: r/--a�52t <br /> If you have any questions, please refer to the Sierra Project Number referenced above. <br /> + Samples are Dray retained for 30 days if marked for Lab Disposal. Other charges may apply for otlier disposal options. <br /> Rush surcharges will be appiled to Turn Around Tirnes piher than Normal,except by prior arrangernent with Sierra Labs. <br /> 26052 MERIT CIRCLE, SUFrE 105, LAGUNA HILLS, CALIFORNIA 92653 <br /> ' TELEPHONE: (714) 398-9389 FAX: (719) 348-9115 <br />