Laserfiche WebLink
1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> ® McCampbell Analyfical, Inc. Toll Free Telephone:(877)252-9262/Fa (925)252-9269 <br /> "When Quality Counts„ hnp://www.=cempbell.com/E-mail:mainQmccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: CLS Labs Date and Time Received: 312312016 10:50 <br /> Project Name: CZC1008 Date Logged: 312312016 <br /> WorkOrder No: 1603C04 Matrix: Sof Received by: Alexandra Iniguez <br /> Cartier: Client Drop-In Logged by: Jena Alfaro <br /> Chain of Custody(CDC)Information <br /> Chain of custody present? Yes ❑ No❑ <br /> Chain of custody signed when relinquished and received? Yes No❑ <br /> Chain of custody agrees with sample labels? Yes No❑ <br /> Sample IDs noted by Client on COC? Yes ❑ No❑ <br /> Date and Time of collection noted by Client on COC? Yes M No❑ <br /> Sampler's name noted on COC? Yes M No❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA M <br /> Shipping container/cooler in good condition? Yes ❑ No❑ <br /> Samples in proper containers/bottles? Yes M No❑ <br /> Sample containers intact? Yes © No❑ <br /> Sufficient sample volume for indicated test? Yes ❑ No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding lime? Yes M No❑ _ <br /> Sample/Temp Blank temperature Temp: NAM <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ NA M <br /> Sample labels checked for correct preservation? Yes M No❑ <br /> pH acceptable upon receipt(Metal:<2;522:<4;218.7:>8)? Yes ❑ No❑ NAM <br /> Samples Received on Ice? Yes ❑ No M <br /> UCMR3 Samples: <br /> Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No❑ NAM <br /> Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NA M <br /> 300.1,537,539? <br /> NOTE:If the"No"box is checked,see comments below. <br /> ------------------------------------- ----- --- <br /> Comments: <br /> Page 7 of 7 <br />