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LAk <br /> ASSOCIATED LABORATORIES <br /> 806 North Batavia—Orange, California 92868--714 771-6900 FAX 714-538-1209 <br /> SAMPLE ACCEPTANCE CHECKLIST <br /> Section 1 <br /> Client: e Project: <br /> Date Receiv : ( j -)I Sampler's Naine:Qfs <br /> No <br /> Sample(s)received in cooler: YesNo kip Section 2) <br /> Shipling Information: <br /> Section 2 <br /> Was the cooler packed with: Ice Ice Packs Bubble Wrap _Styrofoam <br /> Paper None _Other <br /> Cooler or box temperature: <br /> (Acceptance range is 2 to 6 Deg. C.) <br /> Section 3 YES NO N/A <br /> Was a COC received? <br /> Is it pEoperly core feted? IDs,sampling date and time, signature,test <br /> Were custody seals resent? <br /> If Yes—were they intact? <br /> Were all samples sealed in plastic bys2 <br /> Did all samples arrive intact? If no,indicate below. <br /> Did all bottle labels agree with COC? (ID,dates and times <br /> Were correct containers used for the tests required? <br /> Was a sufficient amount of sere le sent for tests indicated? <br /> Was there headspace in VOA vials? <br /> Were the containers labeled witli coirectpreservatives? <br /> Was total residual chlorine measured Fish Bioassay samples only)? <br /> *: If the answer is no,please inform Fish Bioassay Dept. immediately. <br /> Section 4 <br /> Explanations/Comments <br /> i <br /> Section S <br /> Was Project Manager notified of iscrep cies: Y / N N/A <br /> .Completed By: Date: <br /> 0t <br /> -LI VV <br /> i <br /> i <br />