Laserfiche WebLink
SAMPLE RECEIPT CHECKLIST0 <br /> Section 1:General info _ fie! _ <br /> Date Received: WOp Sl S -7/c Client: " c <ze-o S cr c—k I ^I t t A 1 I , <br /> Section 2:Shipping/Custody ,�. Are custody seals present?❑Yes No <br /> Custody seals intact on arrival? !a rv/A ❑Yes 13 No ❑On cooler/box ❑On samples <br /> ❑Courier ❑Walk-In ❑Field Sampling Chhipping Info: jE�=2 (--,- <br /> Section 3a:Condition/Packaging ❑ Outside 0.0-6.0'C(0.0-10.0'C for microbiology)(PM notified) <br /> Date Opened L/`i/a� By(initials) f o" Type of ice used: ❑ Wet ❑Blue/Gel ❑None <br /> ❑Samples received on ice directly from the field;cooling process had begun.(if checked,skip temperatures) <br /> ❑Sample matrix doesn't require cooling(e.g.air,bulk PCB).(if checked,skip temperatures) <br /> If no cooler:Observed/Adjusted Temp('C): / Thermometer/IR Gun: Xlt-f 1 CF: fu • f <br /> Cooler Temp('C)N15-�/ / V- u3:_n4:____/ as:�_a6:___/_ <br /> Section 3b:Microbiology Samples ErNo microbiology samples submitted(skip 3b) <br /> ❑Within temp range 0.0-10.0"C or received on ice directly from field. <br /> Cl Adequate headspace for microbiology analysis. <br /> Section 3c:Air Samples No air samples submitted(skip 3c) <br /> ❑1.4LCanisters 0 6 Canisters ❑Tediar Bags ❑MCE Cassettes ❑Sorbent Tubes C]Other <br /> Section 4:Containers/Labels/Samples YES NO N/A <br /> 1)Were custody papers present,filled properly,and legible? <br /> 2)Is the sampler's name present on the COC? / <br /> 3)Were containers received in good condition(unbroken/unopened/uncompromised)? / <br /> 4)Were the samples bagged?(required for microbiology samples;recommended for soil samples) <br /> 5)Were all of,and only,the correct samples received? <br /> 6)Are sample labels present,legible,and In agreement with the CoC? <br /> 7)Does the container count match the CoC? / <br /> 8)Was sufficient sample volume/mass received for the analyses requested? 0� <br /> 9)Were samples received in proper containers for the analyses requested? <br /> 10)Were samples received with>1/2 holding time remaining? / <br /> 11)Are samples properly preserved as indicated by CoC/labels? <br /> 12)Unpreserved VOAs received-If necessary,was the hold time changed in LIMS? <br /> 13)Are VOA vials free from headspace/bubbles>6mm? I <br /> Section 5:Explanations/Comments <br /> (If no comments are made,then no disoepandes rated.) <br /> /1 LS- Pte C Z- /127 PAU . Ln3rt <br /> ❑ No additional discrepancies <br /> Date Logged 1 /'"/``- By,(print) cc cr w rcc (sign) /'' <br /> Date Labeled "-r By(print) /`r"�`-"' (sign) <br /> Enthalpy Analytical J-0006,Rev 2:Form Version 16.3020625 <br /> 5of8 <br />