Laserfiche WebLink
0010-, Put HOUSTON LABORATORY <br /> 000 <br /> 8880 INTERCHANGE DRIVE <br /> O HOUSTON,TX 77054 <br /> (713)660-0901 <br /> Sample Receipt Checklist <br /> � Workorder: 10030200 Received By: AMV <br /> Date and Time Received: 3/5/2010 9:15:00 AM Carrier name: Fedex-Standard Overnight <br /> Temperature: 4.0/2.5*C Chilled by. Water Ice <br /> 1. Shipping container/cooler in good condition? Yes [] No❑ Not Present ❑ <br /> 2. Custody seals intact on shippping container/cooler? Yes Wil No❑ Not Present ❑ <br /> 3. Custody seals intact on sample bottles? Yes ❑ No❑ Not Present <br /> 4. Chain of custody present? Yes F,-/J No❑ <br /> 5. Chain of custody signed when relinquished and received? Yes No❑ <br /> 6. Chain of custody agrees with sample labels? Yes No❑ <br /> 7. Samples in proper container/bottle? Yes No❑ <br /> 8. Sample containers intact? Yes ❑ No 0 <br /> Lab received one of the two upreserved amber liters from <br /> sample MW-7 <br /> A(I of your samples w're subc nt acted t Lab <br /> Y r Carb marte/Ur Pesti id y Meh o 321A. e samp <br /> as as i ed to r Certifi of An is Nu <br /> 9. Sufficient sample volume for indicated test? Yes No❑ <br /> 10. All samples received within holding time? Yes No❑ <br /> 11. Container/Temp Blank temperature in compliance? Yes No❑ <br /> 12. Water-VOA vials have zero headspace? Yes ❑ No❑ VOA Vials Not Present <br /> 13. Water-Preservation checked upon receipt(except VOA*)? Yes 0 No❑ Not Applicable ❑ <br /> *VOA Preservation Checked After Sample Analysis <br /> SPL Representative:❑ Contact Date&Time: <br /> Client Name Contacted: <br /> Non Conformance <br /> Issues: <br /> Client Instructions: <br /> 4/9/2010 2:31:18 PM <br />