Laserfiche WebLink
BC LABORATORIES INC. SAMPLE RECEIPT FORM Rev.No.12 06/24/08 Page_ Of <br /> Submission #: <br /> SHIPPING INFORMATION SHIPPING CONTAINER <br /> Federal Express ❑ UPS ❑ Hand Delivery ❑ Ice Chest— None ❑ <br /> BC Lab Field Service-- Other❑ (Specify) Box ❑ Other ❑ (Specify) <br /> Refrigerant: <br /> Ice—Blue Ice ❑ None ❑ Other❑ Comments: <br /> Custody Seals Ice Chest ❑ Containers ❑ None Lel Comments: <br /> Intact?Yes❑ No❑ Intact?Yes ❑ No ❑ <br /> All samples received? Yes e No❑ All samples containers intact? Yes No❑ Description(s)match COC? Yes j�?'No ❑ <br /> COC Received Emissivity: C) Container: ( 1 Thermometer 1 DateITimeC %h G <br /> 14-YES ❑ NO <br /> Temperature:A it °C / C °C Analyst Init <br /> SA_!MRLE CONTAINERS 1 2 3 4 5 6 l 8 s 10 <br /> OT GENERAL MINERAL/GENERAL PHYSICAL <br /> PT PE UNPRESERVED <br /> T INORGANIC CHEMICAL METALS <br /> PT INORGANIC CHEMICAL METALS <br /> PT CYANIDE <br /> PT NITROGEN FORMS <br /> PT TOTAL SULFIDE <br /> 2o2.NITRATE/NITRITE <br /> PT TOTAL ORGANIC CARBON <br /> PT TOX <br /> PT CHEMICAL OXYGEN DEMAND <br /> PtA PHENOLICS <br /> 40m]VOA VIAL TRAVEL BLANK <br /> 40m)VOA VIAL 1 I j l 1 1 1 P ) 1 ) 1 1 1 ) t { ) <br /> T EPA 413.1 413.2 418.1 <br /> PT ODOR <br /> RADIOLOGICAL <br /> BACTERIOLOGICAL <br /> 40 ml VOA VIAI.504 <br /> T EPA 508/608/8080 <br /> T EPA 515.1/8150 <br /> T EPA 525 <br /> T EPA 525 TRAVEL BLANK <br /> 100m]EPA 547 <br /> 100m1 EPA 531.1 <br /> T EPA 548 <br /> T EPA 549 <br /> T EPA 632 <br /> T EPA 8015M <br /> T AMBER <br /> 8 OZ.JAR ' <br /> 32 02.JAR <br /> SOIL SLEEVE <br /> PCB VIAL <br /> PLASTIC BAG <br /> FERROUS IRON <br /> ENCORE <br /> Comments: <br /> Sample Numbering Completed By: 1AA Date/Time: t ( � <br /> A=Actual / C=Corrected IH:%DOCS1WPa01LAB_DOCS\FORMS\SAMREC2.WPDI <br />