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ST L <br /> STL San Francisco <br /> Sample Receipt Checklist <br /> Submission #:2004- m <br /> ti�rhlis! frim.. .:;dL'.y find::�i C��tr•' �_r��!7.1 <br /> O i!rf@r .nig. "1 ;:All'.;;ali,;ISCCi� rpt Gtl; <br /> f u tcd�P a irt,�,,t cr siiiu��ing contain ,an7plel Not <br /> r" <br /> fr)iain nt stnrl ,�res�nf�' <br /> Y f s <br /> !lain �t ris Crri erl;vhen relinquished and Ves t <br /> c C,tia n of lr­nzjy agrees fr•- s m e iabeis P <br /> Y-3S r rig. <br /> 80rn ie con ainers mace? <br /> 'des Nf <br /> ilifir<.ient sample vc]urie for indicated test? `'es No <br /> Ai?6aniples re°cerved viiihin huldrng trme•' Yrs�,r' <br /> tataineffTernp Blank temperature in compliance(4"C_2)? se p: °G `fest Na <br /> fttential reason tar>6°C-Ice malted 0 lce irt_b6gs 0 nkat enraugh ice 3 Nat enough blue ice 0 'Samples in boxes 0 <br /> S Rmpled<4hr.ago Ice not rectuired(e.g air or bulk sample) <br /> ice Present Yes ,, NO <br /> tiater- /f„'t vszls have zero headspacr? No VDA vials r,ubrnit ea <br /> ti!bubble €s present. -;iter to approx,irnate bubble size and itemize ir',Cnrn€rients as 5(small-0 , M(n-.,edum 0) L(large I <br /> °o' ?tnr-pH acceptable upon receipt? 0 Yes 0 No <br /> l pH adjusted- Freserva ive ij5ed ❑ HNO ❑ H4-'[G r1 Ca._0 NaCl"Li ZnOAc-Lot#{s} <br /> For any item check-listed "No", provided detail of discrepancy in comment section below: <br /> (toirnnnents: <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> Ptasect Nlanag_r Date: Client ct7nlacted ❑ Yes E No <br /> Stin;rr,atr,. otdiscussion <br />