Laserfiche WebLink
TestAmedca LOT RECEIPT CHECKLIST <br /> TestAmerica West Sacramento <br /> THE LEADER IN ENVIRONMENTAL TESTING <br /> CLIENT �Vcr( c Itl e PM__ LOG# 571-(bl� <br /> LOT#(QUANTIMS ID) � DA_� QUOTE# :) X _LOCATIONvk-V . 6;.' VA <br /> Initials Date <br /> DATE RECEIVED TIME RECEIVED _ <br /> DELIVERED BY ❑ FEDEX ❑ CA OVERNIGHT 'CLIENT <br /> ❑ AIRBORNE ❑ GOLDENSTATE ❑ DHL <br /> ❑ UPS ❑ BAX GLOBAL ❑ GO-GETTERS <br /> ❑ TAL COURIER ❑VALLEY LOGISTICS ❑ MORGAN HILL COURIE <br /> ❑ OTHER <br /> CUSTODY SEAL STATUS ❑ INTACT ❑ BROKEN [�1/A <br /> CUSTODY SEAL#(S) <br /> SHIPPPING CONTAINER(S) ez"TAL ❑ CLIENT ❑ N/A <br /> TEMPERTURE RECORD (IN °C) IR 4 ❑ 5� ❑ OTHER <br /> COC#(S) 1 JX <br /> TEMPERATURE BLANK Observed:/_ Corrected: <br /> SAMPLE TEMPERATURE <br /> Observed: A e age: Corrected Average: <br /> COLLECTOR'S NAME: Verified from COC ❑ Not on COC <br /> pH MEASURED ❑ YES ❑ ANOMALY 2-N/A <br /> LABELEDBY...........................................................I.............................. <br /> LABELSCHECKED BY........................................................................... <br /> PEER REVIEW 12TNA <br /> SHORT HOLD TEST NOTIFICATION SAMPLE RECEIVING <br /> WETCHEM ffN/A <br /> VOA-ENCORES2'N/A <br /> ❑ METALS NOTIFIED OF FILTER/PRESERVE VIA VERBAL& EMAIL [�V/A <br /> ❑ COMPLETE SHIPMENT RECEIVED IN GOOD CONDITION WITH N/A <br /> APPROPRIATE TEMPERATURES, CONTAINERS, PRESERVATIVES <br /> 16CLOUSEAU Z TEMPERATURE EXCEEDED (2 °C-6 °C)' ❑ N/A <br /> NET ICE ❑ BLUE ICE ❑ GEL PACK ❑ NO COOLING AGENTS USED ZrPM NOTIFIED <br /> Notes: - 4 _ <br /> 'l Acceptable temperature range for State of Wisconsin samples is<4°C. <br /> LEAVE NO SPACES BLANK. USE"N/A"IF NOT APPLICABLE. QA-185 5/05 EM, Pagel <br /> G81050366 TestAmerica West Sacramento(916)373-5600 7 of 31 <br />