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STL <br /> STL San Francisco <br /> Sample Receipt Checklist <br /> esubmission #:2004- Ob - _ 0 ! 3 0 <br /> Chechtsst comp+cEed by (initials% Date d f 4 104 <br /> Courier name G STL San Francisco 0 Client�4� <br /> Not <br /> Custody seal's intact onipptng c'ai�iairt ilsamples pressenl <br /> Cb3in of custody p e,;f n0 r Yes fVo <br /> Clain of custody stgned when rcfirtquished and received') � Yc-s _M <br /> Chain of custody agrees with sample labelO Yes",/ No� <br /> SzimptE*s in proper corttasnerloottic? Yes !� No <br /> Sample c onldiners intact) Yes No <br /> Sufficient sample volume rot indtrated testi Yes No <br /> All camp#es received within holainq time-) yes t4o <br /> Container/Temp Blank tempentum in compliance(40 C a 2)7 Torp� C <br /> Ice Present Yes No <br /> Neater-VOA vials ha r{v zcio headspace? No VOA vials suhmttled_,!:::�Ycs No- <br /> (if <br /> o -tri bubble is presen, refer to approximate bubble size and rternize in comments a-, 5 (small -0) M (medium - 0) or L (large ) <br /> VVator-pH acreptable upon receipt? ❑ Yes ❑ No ➢ , I (�-- <br /> © pH adjusted- Preservatwe used Q HNO:; a HC1 rJ Fd-SQ, r„1 haC:F 1 ❑ZnGAc-Lot#(s) <br /> For any item cheek-listed "No", provided detail of discfepancy :n Comment section below <br /> Comments <br /> I <br /> Project Management [Routing for instruction of Indicated discrepancy(ies)] <br /> Project Manager (initials) Date r 104 <br /> Chant contacted 0 Yes J No <br /> SurnrT &d y of d*cusSfcir1 <br /> Woue,tive Actt„n }per MClient) <br />