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STT <br /> TL San Francisco <br /> Sample Receipt Checklist <br /> Submission #:20133- 0013 <br /> Checklist completed by_ (initials} Dom; 0 G I 0 ID3 <br /> Courier name= ❑ STL San FranciscoAclierlt <br /> Not <br /> Custody seats intact on shipping containerlsamples Yas o Present <br /> Chain of custody present? Yes i No <br /> Chain of custody sionea when relinquished and received? Yeses No- <br /> Chain-of <br /> o.Chain-of custody agrees with sample labels? Yes ✓ No <br /> Samples in proper cuntainarfbotge? L' �r 'J. }�r' ; Yes ✓ No� <br /> Sample containers intact? Yes No <br /> Sufficient samplo volume for Indicated test? Yes '� leo <br /> All samples received within holding time? Yes No <br /> Container/Ter o Blank tempenAure in curnpliance(0 C y 2)? Temtp:J` °C Yes No <br /> Water-VOA vials have zero headspace? No VOA vials submitted w," Yes-No, <br /> (if babble is present, refer to approximate bubble size and iternite in comments as S (small -0), M (Medium- )or L (large- ) <br /> Water-pH acceptable upon recetpV Ayes J:J No <br /> ❑ PH adjusted- Preservative used: El HNO-a L HC10 H2SO c Q NaCH ❑ZnOAc <br /> For any itern chtieck�isted "No", provided detail Of disc re Parnc'{in comment section below; <br /> Comments: <br /> Project Management jRouting for instruction of indicated discrepancy(ies}l <br /> Protect Manager- (initials) <br /> C;iertcontacxed} 11 Yes 0 N <br /> Summary of discussicn- <br /> Ci.rrectrve Ac;ian {per PNilCHent); <br />