Laserfiche WebLink
1534 Willow Pass Road, Pittsburg, CA 945654701 <br /> S <br /> Mc C a m p b e I l A n a l y t i c a i , I n c . Toll Free Telephone: (877) 252-9262 / Fax: (925 ) 252-9269 <br /> " When Gqf%Ip Counts " http:/hwvw.inccwnpbell .com / E-mail : main a ccampbell.com <br /> Sample Receipt Checklist <br /> Client Name : Fremouw Environmental Services, Inc. Date and Time Received : 4/ 15/2015 1 : 10 : 20 PM <br /> Project Name: #59852 ; B&C Painting Login Reviewed by: Maria Venegas <br /> WorkOrder NQ : 1504619 Matrix: Water Carrier: Daniel (MAI Courier) <br /> Chain of Custody (COC) Information <br /> Chain of custody present? Yes W1 No ❑ <br /> Chain of custody signed when relinquished and received ? Yes W No ❑ <br /> Chain of custody agrees with sample labels? Yes W No ❑ <br /> Sample IDs noted by Client on COC? Yes d❑ No ❑ <br /> Date and Time of collection noted by Client on COC?, Yes 91 No ❑ <br /> Sampler's name noted on COC ? Yes No ❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No ❑ NA <br /> Shipping container/cooler in good condition? Yes No ❑ <br /> Samples in proper containers/bottles? Yes No ❑ <br /> Sample containers intact? Yes No ❑ <br /> Sufficient sample volume for indicated test? Yes No ❑ <br /> Sample Preservation and Hold Time (HI) Information <br /> All samples received within holding time? Yes W No ❑ <br /> SamplefTemp Blank temperature Temp: 5.4°C NA ❑ <br /> Water - VOA vials have zero headspace / no bubbles? Yes �I❑ No ❑ NA ❑ <br /> Sample labels checked for correct preservation? Yes W No ❑ <br /> pH acceptable upon receipt (Metal : <2 ; 522 : <4 ; 218 . 7: >8)? Yes No ❑ NA ❑ <br /> Samples Received on Ice? Yes No ❑ <br /> (Ice Type : WET ICE ) <br /> UCMR3 Sam I!� es ; <br /> Total Chlorine tested and acceptable upon receipt for EPA 522 ? Yes ❑ No ❑ NA W1 <br /> Free Chlorine tested and acceptable upon receipt for EPA 218. 7 , Yes ❑ No ❑ NAW <br /> 300 . 11 537 , 539? <br /> * NOTE: ff the "No " box is checked, see comments below. <br /> — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — - <br /> - — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — <br /> Comments : <br /> Page 13 of 13 <br />