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(OULAB' <br /> ENVIRONMENTAL TESTING SERVICES <br /> SAMPLE RECEIPT CHECKLIST <br /> Client Name: C7 7-j= <br /> Job Number: /I Received by: Date/Time: <br />' Stored in : Checklist by: Date/Time: /,7,/o <br /> Matrix: Log--in by: Date/Time: <br />' Items of Concern Yes No N/A Comments <br /> Client Delivered <br /> Samples Shipped By: <br /> Courier Delivered By: <br /> COC seals used Shipping Container Sample Containers <br /> COC Present <br /> COC Accurate <br />' Samples Intact <br /> Correct Containers <br /> Adequate Sample Volume <br />' Samples Chilled (2-6°C) 11-� w/o cooler w/o ice <br /> Sample pH taken acceptable <br />' No Headspace in VOAs <br />' Holding Times Acceptable <br /> Client Knows of Problems Routine Telephone <br />' Additional <br /> Comments : <br /> 1 <br />' /u/matt/logy_n_forus/samp_rec form 10/22/96 Core Laboratones,tna <br /> 1250 East Gere Awn hay .mane+m California 92905 I7 -31 33" t094 (800)404 COPE Fax(714)93' 1170 <br />