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SPL HOUSTON ENVIRONMENTAL LABORATORY <br /> SAMPLE &WIN CHECKLIST <br /> DATE: bo TIME: CLIENT NO. <br /> LOT NO. CONTRACT NO. <br /> 4W <br /> CLIENT SAMPLE NOS. <br /> SPL SAMPLE NOS. : G <br /> YES <br /> 1. Is a Chain-of-Custody form present? <br /> 2. Is the CDC properly completed? <br /> If no, describe what is incomplete: <br /> If no, has the client been contacted about it? <br /> (Attach subsequent documentation from client about the situation) <br /> 3. Is airbill/packing1 of lading with shipment? <br /> If yes, ID#: = <br /> 014. Is a USEPA Traffic Report present? <br /> 5. Is a USEPA SAS Packing List present? <br /> 6. Are custody seals present on the package? <br /> If yes, were they intact upon receipt? <br /> 7. Are all samples tagged or labeled? <br /> Do the sample tags/labels match the COC? <br /> If no, has the client been contacted about it? <br /> (Attach subsequent documentation from client about the situation) <br /> 8. Do all shipping documents agree? <br /> If no, describe what is in nonconformity: <br /> 9. Condition/temperature of shipping container: <br /> 10. Condition/temperature of sample bottles; <br /> 11. Sample Disposal?: SPL disposal= Retur to client <br /> NOTES (reference item number if applicable) ;_, <br /> ATTEST: DATE: Z4/ <br /> DELIVERED FOR RESOLUTIO RECD DATE: <br /> RESOLVED: _ DATE: <br />