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i <br /> I <br /> SunStar <br /> Laboratories, Inc. Page 1 of4 <br /> PRt�vmm QAmN ANALYMAL Sams NAnoNme <br /> I <br /> SAMPLE RECEIVING REVIEW S E r <br /> BA CH# <br /> Client Name: 44 P/ Project: " <br /> Received by: Date/Time Received: '3 7 <br /> Deliviered by: ❑Client ❑SunStar Courier GSO ❑FedEx ❑Other <br /> Total number of coolers received ! Temp criteria=6*C>0°C(no frozen ontainers) <br /> Tem (erature:cooler#1 Z,X °C+/_the CF (-0.2°C) = Q.6°C corrected temperature <br /> cooler#2 'C+/_the CF (-0.2°C) = °C corrected temperature <br /> i <br /> cooler#3 °C+/-:e, <br /> e CF (-0.2°C) = °C corrected temperature <br /> Samp es outside temp.but received, i Win 6 hours of final sampling. ®Yes ❑N []N/A <br /> Custody Seals Intact on Cooler/Sample ®Yes ❑N ❑N/A <br /> Samp�e Containers Intact ]Yes ❑No <br /> Sample labels match COC ID's ]Yes ❑No <br /> I I <br /> Total'number of containers received math COC ®Yes ❑No <br /> Propelr containers received for analyses requested on COC ®Yes nNo <br /> Pro aPreservative indicated on COC/containers for analyses requested []Yes nNo N/A <br /> Complete shipment received in good condition with correct temperatures,containers,labels,vc lumes <br /> preservatives and within method specified holding times. 2Yes ❑No* <br /> *Complete Non-Conformance Receiving Sheet if checked Cooler/Sample Review-Initials and chte <br /> Comments: <br /> i <br /> i <br /> i <br /> I <br /> I <br /> i <br />