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STL <br /> STL San Francisco <br /> Sample Receipt Checklist <br /> Submission #:2003- <br /> Checklist completed by: (initials) Date: DSS 1�3 <br /> Courier name: ❑ STL San Francisco Client <br /> Not t f <br /> Custody seals intact on shipping container/samples Yes No Present <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 /> Samples in proper container/bottle? Yes No� <br /> Sample containers intact? Yes No <br /> Sufficient sample volume for indicated test? Yes No <br /> All samples received within holding time? Yes <br /> Container/Temp Blank temperature in compliance(40 C ± 2)? Temp �°C Yes No <br /> Water-VOA vials have zero headspece? No VOA vials submitted Yes No <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small -0), M (medium — Q) or L (large— V) <br /> Water-pH acceptable upon receipt? U es ❑ No <br /> ❑ pH adjusted-- Preservative used; ❑ HNO3❑ HCl ❑ H2SO4 ❑ NaOH ❑ ZnOAc <br /> For any item check-listed "No", provided detail of discrepancy in comment 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 /> Corrective Action(per PM/Client): <br />