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SPL Fifllei-toji Environmental Laboratory <br />' Sample Receiving Checklist <br /> SPL Workorder Number: 9 7 0 219 6 m <br /> Date: 'Z <br /> Yes No N/A <br />' 1. Chain of Custody Record Present? <br /> i <br /> 2. Chain of Custody Record Properly Completed? <br />' I Custody Seals on Shipping Container? <br /> 4. Custody Seals on Sample Container? <br /> 5. All Custody Seals Intact? * / <br />' 6. All Samples Received Intact? <br /> 7. All Samples Labeled Correctly? <br /> 8. Samples are Chilled at 2°C - 6°C / x <br /> * See Non-Conformance / Sample Condition Notification Form only if box with "" is checked. <br />' Internal Temperature of Shipping; Container Z 3 °C <br />' Samples Were Delivered by: <br /> SPL Courier <br />' Client Representative <br /> Federal Express 2; O 2 <br /> rUPS <br /> DHL <br /> Other: <br /> IAll samples will be disposed 30 days froin the report date for this workordcr, unless <br /> otherwise specified by the client. <br /> n <br /> Samples Checked by: <br /> I:Idata\"L)""slluginchh.wpd <br />