Laserfiche WebLink
SC LABORATORIES <br />IRC06!24108Page L Of <br />SAMPLE RECEIPT FORM Rev. No. 12 O <br />Submission #:L,6( )!J= I I <br />SHIPPING INFORMATION SHIPPI140 CONTAINER <br />Federal Express 0 UPS 0 Hand Delivery 0 lee Chest UP"' None o <br />i BC Lab Field Service 19- Other 0 (Specify)- I Box 0 Other 13 (Specify) <br />9 <br />Refrigerant: lee UY". Blue lee El None 0 Other 0 Comments: <br />Custody Seals <br />None IR/Comments: <br />Ate samples received? Yes YNoo <br />All samples containers Intact? Yes No O Description(s) match COC?. Yes No <br />C I R <br />qoecelved EMISSIVIty: TV t <br />container: o!es Thermometer ID:Datemme <br />S <br />ES Temperature: A 0 NO C I C c <br />Analyst Init AUjkk <br />A; <br />SAMPLE CONTAINERS <br />I am UM13ERS <br />1 2 3 4 5 6 r <br />a 9 so <br />_f Cla�_TENER�AL MLNER8g GEN <br />,A rr Pic uNPRLsERvm <br />EgT1WRGAMCCHEM1QUNXTALS <br />T JETZ9P"YSMA� <br />PTH 2ErZMC CHEMICAL METALS <br />A <br />T <br />PT -CYANIDE <br />'D <br />'IT <br />"T NI <br />Nlag§EN Eg <br />OTA L <br />OTAL S1 T1 <br />0 S <br />T <br />TR <br />PT <br />,2 N R A T <br />lg& NITRATE! LMME <br />r A L 0 <br />rrTOTAL2RgMC q <br />PTT PAX <br />PT X <br />PLCHEMICAL OXYGEN DEMAND <br />P H t C)l <br />9&ZIMNOLICS <br />VOA VIAL TRAVEL K <br />I <br />0 VI <br />40ml VOA VIAL, <br />f� C5) I <br />A cc. <br />I <br />Er <br />RA413.1,41.3.&AM <br />CAVA. <br />0WR <br />CTERIOLOGICAL <br />iRADIOLOGICAL <br />at VOA VIAL, $04 <br />EPA EgAMMM <br />0TEPA 51&jA1R <br />EPA 525 <br />T EPA 525 TRAVEL BLANK <br />100n3l EPA 547 <br />00al EPA 531.1 <br />T <br />T EPA 543 <br />T <br />T EPA 549 <br />T EPA 632 <br />T <br />T EPA 8015M <br />T <br />AMBER <br />07— JAR <br />K2 OZ JAR <br />1 SLEEVV_R <br />VIAL <br />ASnCBAG <br />iENCORE <br />RROUS IRON <br />&nple Numbering Complete <br />A=Actual I C=Corrected <br />k <br />IM.-ZO=WPSMLAA-WCS%FORMS%.S"RECtWP'DI <br />