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• \1 <br />Weck Laboratories, Inc. <br />Sample Receiving <br />CheckList <br />Date received: <br />Time: <br />Lab Batch ID # : 2, /�-2 J-7 <br />Client -► <br />_%G I S - E <br />Status <br />Answer <br />Yes <br />No <br />N/A Comments <br />chain of Custody Present <br />Number of Ice chests/packages <br />Samples received on Ice <br />t—.! <br />Type of Ice (Blue�l�) <br />Temperature (4 +/- 2 Deg. C) J "� <br />ode of measurement <br />(I Temp. <br />El <br />blank, Other) <br />Samples intact? <br />Ma <br />El <br />El <br />Leaking bottles? <br />El <br />10 <br />El <br />Custody seals intact? <br />COC properly completed? <br />Verification of bottle labels to match COC <br />El- <br />El <br />Ei <br />Preservation verification (pH paper, etc.) <br />Preserved at the lab? <br />Sample Volume sufficient? <br />--- <br />El <br />Enough holding time for all tests? <br />" <br />Notify analysts of short holding time/rush <br />® <br />❑ <br />Subontract analysis? <br />1:1 <br />El <br />El <br />Discrepancies and Notifications <br />Description of problem: <br />Person Notified: Phone #: Date/time: <br />Instructions from client/resolution: <br />Description of problem: <br />Person Notified: Phone #: Date/time: <br />Instructions from client/resolution: <br />Sample receipt verification completed by (initials): <br />fAlabstufACIMvalidation tableslsample_ receiving_check_listAs <br />