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4 <br /> 1 + <br /> NET Santa Rosa Division LOGIN CHECKLIST <br /> CLIENT: —' Ve&IN JOB#: LOG#06DR <br /> Project ID• <br /> Samples Received On ._ Checked in on <br /> 1) Custody Seals: NIA Present ❑ Absent ❑ Broken <br /> 2) Cham of Custody P <br /> resent Present ElAbsent #(s) <br /> Forms ❑ Incomplete <br /> 3) Type of packing material used. _ 0'[' "- <br /> 4) <br /> 4) Temperatures) I ' C Thermometer#(s) <br /> 5) Sample Container(s) [sd Intact ❑ Broken <br /> 6) Container Label(s) Match COC ❑ Do Not Match <br /> 7) Sample Volume VSufficient. ❑ Insufficient <br /> 8) Preservative(s) Correct ❑ Incorrect ❑ pH verified ❑ Res.Cl chk <br /> (CN & PHI-s) <br /> 9) Headspace (VOAs) None ❑ Present (list ID's I number vials affected) <br /> Sample ID # of Vials Sample ID # of Vials <br /> 1 Q) Form Completed By: Date: <br /> Attach s pe s acking slip to this form before routing <br /> Problem Resolutson: <br /> 1) ❑ Project Coordinator Verbally Informed on <br /> 2) ❑ Client Informed on BY <br /> Project Coordinator: Date Resolved: ❑Y ❑ N <br /> Comments <br /> garsdscBopnfrm <br />