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R TL <br /> TL San Francisco <br /> Sample Receipt Checklist <br /> Submission #:2003- <br /> Checklist ccmplet$d by; (initialsLL. date= ��f �3 <br /> Courier name: ❑ TL fan FrandsmActlent <br /> Not <br /> CUsiody seals intac;t on shipping containerdsampies Yes—No- Present_` <br /> Chain of cu&Eody present? `;'es No <br /> Chain of custody signed when rehnquished and rer�ewed? Yes--Z Na, <br /> Chain of custody agrees with sampie labels? Yes No <br /> Samples in groper containerJbortleG � - ' i ; Yes No� <br /> Sample containers intact? �11 f / ydsyo <br /> Suffiperit sampte volume for indicated test? f , Yes ---No <br /> All samples received within Holding time? Yeg ,to <br /> GontainerlTi�rnp Blank temperature in compliance(40 C 2)? TernpC Yes_. No <br /> Water-VOA vials have zero heads pace? No VQA vials submitted Yes No <br /> (if bubttie is present, refer to approximate bubble size and itemize in ccmtrtems as S (small --0), M (medium - ) or L.(large a ) <br /> Wa[er - pH acceptabJe upon receipt? Yes 0 No <br /> ❑ pal adjusted- Preservo#ive used: ❑ HN0j ❑ HC] ❑ H2SO4 U NiROH ❑ZnOAc <br /> For any item check-listed '{Na' r provided detail of discrepancy 3n corf Ment seOon beIaw; <br /> Comments- <br /> Project Management [Routing for instruction of indicated discrepant (les)] <br /> Project Manger. (initials) Date' 7 <br /> dent contacted; ❑ Yes ❑ oda <br /> Summary of diGCussion-. <br /> Corrective Action (per PMICHi mt): <br />