Laserfiche WebLink
lC LABORATORIES INC. SAMPLE RECEIPT FORM Rev.No. 12 06/24/08 Page — Of <br /> submission #: <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> ederal Express O UPS ❑ Hand Delivery ❑ Ice Che! ' None ❑ <br /> 1C Lab Field Services Other O (Specify) Box ❑ Other ❑ (Specify) <br /> 2efrigerant: lc*eO Blue Ice❑ None❑ Other❑ Comments: <br />:ustody Seals Ice Chest ❑ Containers ❑ Non-, '71* Comments: <br /> Intact?Yes❑ No❑ Intact?Yes ❑ No ❑ r <br /> 11 samples received? Yes No❑ All samples containers intact? Yes No O Description(s)match COC? Yes No ❑ <br /> c <br /> 55_ <br /> COC Received Emissivity: / Container: e Thermometer ID: '1(%C� 3 Date(fime(jC�_a}QFr <br /> YES ❑ NO / <br /> Temperature:A Sr � °C 1 C �, to °C Analyst Inst <br /> SAMPLE NUMBIERS <br /> SAMPLE CONTAINERS 2 y 4 5 g g 9 to <br /> !T GENERAL MINERAL]GENERAL PHYSICAL <br /> T PE UNPRESERVED <br /> IT INORGANIC CHEMICAL METALS <br /> T INORGANIC CHEMICAL METALS <br /> T CYANIDE <br /> T NITROGEN FORMS <br /> T TOTAL SULFIDE <br /> oz.Pl l'rRATE/NITRITE <br /> T TOTAL ORGANIC CARBON <br /> 'T TOR <br /> T CHFF41CAL OXYGEN.DEMAND.. <br /> 'IA PHENOLICS <br /> O(al VOA VIALTRAV$L BLANK <br /> OC-1 VOA VLAL <br /> )T EPA 411.1 411.2 418.1 <br /> 'T ODOR <br /> :ADIOLOGICAL <br /> !ACTERIOLOGICAL <br /> 0 ml VOA VIAL-304 <br /> )T EPA 508/60818080 <br /> )T EPA 515.1/3150 <br /> )T EPA 525 <br /> T EPA 525 TRAVEL BLANK <br /> OOmI EPA 547 <br /> OOml EPA 531.1 <br /> T EPA 543 <br /> T EPA 549 <br /> T EPA 632 <br /> T EPA 80156,1 <br /> j AMBER <br /> OZ.JAR <br /> 2 OZ.JAR <br /> :OIL SLEEVE <br /> 'CB VLAL <br /> 'LASTIC BAG <br /> ERROUS 1RON <br /> :,CORE <br /> DImments: <br /> ample Numbering Completed By: Date/Time: C� <br /> = Actual / C =Corrected '�eCH:IDOCS1WPBoiLAB_OOCSIFORMSISAMREc2.waol <br /> ...L,� <br />