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.STL LOS ANGELES - PROIECT RECEIPT CHECKLIST Date: 417b 0 <br /> Single Cooler Only <br /> -CIMS Lot#: E1 M(o03-2A Quote#:_60113 <br /> Client Name:_STC-San <br /> AFrancisco Project: 30 t5N'[�i-a -T t pg2q <br /> Received by: 1��� Date/Time Received: L I. -W/0-1 Uq�S <br /> Delivered by: ❑ Client ❑ STL ❑DHL ®Fed Ex ❑UPS ❑ Other <br /> }}#rrr}}.rrYYr}..ra}rrrYYrr}rwY«}rr.«}}r}r+rsY+}r}rrrr«}rrrrrr+r}+}rrrrrr«aYarrrrr}#}}}rrrrr}}}!}{}!♦rrr«rrrrrrw Inidal Dat <br /> Custody Seal Status Cooler: ®Intact []Broken []None .................................................... <br /> Custody Seal Status Samples: ❑Intact ❑Broken ®None ..................................................... <br /> Custody Seal#(s): CA/6 S8 I [-]No Seal#............................ <br /> Sampler Signature on COC ❑Yes [:]No ®N/A............................................................... <br /> IR Gun#_B Correction Factor _-.2_°C IR passed daily verification , ®Yes []NO............ <br /> Temperature-BLANK S.I °C -.2_CF = Lk, 'I -C...Cooler#1 ID_N/A ............ <br /> Temperature-COOLER(_°C _°C _°C _°C) = avg°C -_.2_CF =—0C..... <br /> Samples outside temperature criteria but received within 6 hours of final sampling ❑Yes ®N/A... <br /> Sample Container(s): ❑ STL-LA ®Client .............................................................. <br /> PH measured: ❑Yes ❑Anomaly (if checked,notify lab and file NCM) `%N/A.. <br /> Anomalies: AIo ❑Yes-complete CUR and Create NCM .......................................... <br /> Complete shipment received in good condition.with correct t mperatures,containers, labels,volumes <br /> preservatives and within method specified holding times. yes ❑No..... <br /> Labeledby: C' ..................... ................................................ . <br /> }«}rrrnr»rrr•r}rrr«arrrrrrrrarrrrrrrrarrrrrrra}«}}YrrrYrrrra.Y}rrYrrar}....Y..rY.....YY}.r}........*....Y....Y.r <br /> Turn Around Time: ❑RUSH 24HR ❑RUSH-48HR ❑RUSH-72HR NE� tORMAL................ <br /> LEAVE NO BLANK SPACES; USE N/A <br /> Headspace Anomaly []YES /A <br /> Lab ID Container(s)# Heads ace Lab In Container(s)# Headspace <br /> ❑ >6mm ❑ >6mm <br /> 6mm LJ >6mm <br /> ❑ >6mm LJ >6mm <br /> ❑ >6mm >6mm <br /> ❑ >6mm >6mm <br /> >6mm >6mm <br /> LJ >6mm >6mm <br /> Page 1 oft <br /> Page 64 of 84 <br />