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4 STL <br /> STIP. San Francisco <br /> Sample Receipt Checklist <br /> OSubrnission #-2004- <br /> 0 heC�,ilst <br /> •2004-0hec�.irst completer] by (initials) Date I X104 <br /> C'ouriei nyrni © Sn-San Francisco_.] Client <br /> Not <br /> Custcld] seals an,,irt on shippin cvntau ;,'samples Yes i Pre5el7[ <br /> 6-lain Cif cUStrt#y present, Yt55 ,�'n1to <br /> Chairs O;ctmludy signet! .,hen relinquished and received? Yes X tIla <br /> CHain cat Cusaody agrev5­,ith sairiple labels' Yes .No <br /> Sainples in proper cortininerrbunic? <br /> ,qsm le c mainerrx intact' Yey, ,: <br /> Sufficient sample volume for(nrjicat,M test' Yes_,f�1�10 _,__— <br /> All samples received within holding tame' Yes_+iNIo <br /> Ctaritarner!lemp Blank tempor=-attire in compliance !40 C ! Tome_ _ .0 Yes N ___ <br /> Ice Present '"yes Nr _ <br /> al-rater-VIDA vials have cera headspac;O No VOA vials submidorl Yes No- <br /> 9, <br /> o <br /> 9+;kiuk bubble as present, rifer to Gappcoximate bijt tale size and itemize in comments as S (small --0) ill (me,�tr m - 0)or L(fargc -- 0) <br /> Water- liH acceptable upari receipt-? ® Yes D No rL_44 <br /> El pH adjusted-- Preservative usi;d O HN1C;0 t-U U l I;S0 © N alDH© ZnO c-Lot#{s) <br /> For any item check-listed "No", provided detail of discrepancy in comment section below <br /> Comments <br /> e <br /> Project Management [Routtng for instruction of indtcatod discrepancy(ies)] <br /> I <br /> P�o)ert 10anp-ger (initials) Date f 104 <br /> Cti&nt i:ont2Cted 0 Yes 0 No <br /> I <br /> Slimmer, of&,;Gussion <br /> I <br /> ��rr=chve rrtion (oer l'nifClient� <br /> I � <br />