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C . <br /> ► + r <br /> L Job# .120$214 <br /> ASL Sample Receipt Form <br /> Client: ` <br /> Date: <br /> Sample Information: <br /> temperature: "C ❑Blank Sample <br /> Custody Seal: ❑Yes 'I No ❑Not Available <br /> Received Within Holding Time: ]> Yes ❑No <br /> Container: <br /> Proper Containers and Sufficient Volume: Yes ❑No <br /> Soil: ❑ 4oz ❑8oz ❑ Sleeve ❑VOA <br /> Water: ❑500AG .❑1AG _0125PB _❑250PB _11500PB El VOA _❑Other <br /> Air: _❑Tedlar* <br /> Sample Containers Intact: ( Yes QNo <br /> Trip Blank ❑ Yes []No <br /> Chain-of-Custody (COC): <br /> Received: (Yes ❑No <br /> Samplers Name: P,Yes ❑No <br /> Container Labels match COC: Yes ❑No <br /> COC documents received complete: Yes [] No <br /> Proper Preservation Noted: KYes ❑ No. <br /> Completed By:larle �'." <br />