Laserfiche WebLink
TL <br /> TL San Francisco <br /> Sample Receipt Checklist <br /> Submission #:2003- - <br /> Checklist campletcci by, {nitials) Dete= [ ..�J 103 <br /> COUkFnarne: ❑ STL Sari FTzmciiscA} lieril <br /> Not <br /> Custody seals intact on stripping conrainerfsarnplos Yes N4 Presant..t <br /> Cbaio of custody present's Yes No� <br /> Chain of custody signed when rolinquiched and received? Yes No <br /> Chain of custody agroes with simple labels? Yes. o.. <br /> amples in proper containerfbottle? Yes "" No <br /> Sample containem.inlact? Yes No <br /> SufficieW sample vatume for jrndicated test? Yes No <br /> All samples recoiv+-d within holding time? Yes a <br /> Containerttemp Blank temperature in wmpliance (4)0}2)? Temp: o Yes No <br /> Wart- VOA vials have zero headspace? No VOA vials submitted,Yes �Nc— -- <br /> (if bubble 's present, refer is approximate bubble size and itemize in comments as S (small }O)" M (medlum– )or L (large v ) <br /> Waver - pH auseptable upon retell t? �s ❑ No <br /> ❑ pH adjusted Preservative user_ ❑ HNOn ❑ HCJ ❑ H2 O; ❑ M�DH ❑ZnClk <br /> For any item check-listed "No", provided detail of discrepancy in coinment section below: <br /> Comments.. <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> Project Manager: (initials) Date. 1 103 <br /> Client contacted; ❑ Yes ❑ No <br /> Summary of discussion: <br /> Cormctive Action (per MICHant): <br />