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Sample Receipt 1 Client Notification Form ' <br /> Client Name <br /> SIERRA Sierra Project Number <br /> -LABOPATORfEs <br /> Sierra Project Manager �� S pyL v <br /> Date 1 Time Samples Received 10 ZQ p� Y <br /> Method of Shipment S <br /> Custody Seals' NIA C IntactL Broken <br /> Samples Intact �J <br /> n <br /> Properly Labelled? <br /> Appropriate Containers' <br /> Headspace in VOA vials? lA_A0, <br /> Samples Chilled' (Cooler Temp °C) ' <br /> Properly Preserved? (pH) <br /> Preservatives added (after receipt by Sierra) <br /> " Sample Disposal Instructions <br /> *' Turn Around Time Requested t Q� olU:IJI ' <br /> Subcontractor Laboratories to be utilized , <br /> Special Instructions <br /> Other Anomalies ' <br /> ---Date/Time-Faxed to Chent- <br /> _ Samples Logged In by 4 <br /> _ W Printed Name sUc� C&ow <br /> If you have any questions please refer to the Sierra Project Nu ' <br /> tuber referenced above <br /> - Samples are only retained for 70 days if marked for Lab Disposal other charges may apply for other disposal optnonm <br /> 01 <br /> Rush surcharges will be applied to Tum Around Times other than Normal except by prior arrangement with Sierra Lana <br /> 26052 MERIT CIRCLE SUITE 165, LAGUNA HILLS CALIFORNIA 92653 <br /> TELEmHOPIE (71.1) ��a_o�ao ��v ice, t� 21!! 0, ,� <br />