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� ATL <br /> TL San Francisco <br /> Sample Receipt Checklist <br /> Submission #:2003- � t 822— <br /> Chealist completed by; (initials) Date' Z1 /2—M <br /> Courier name= ❑ STL Sart Francisoo>QfClient <br /> � Not <br /> Custody seals intact n shlpping container'--- les yes Na— Present_ <br /> Crain of custody present? Yes t/ 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 contalnertbcttle? Yds ZNo <br /> Sam pie containers into a? Yes /"No <br /> Sufficient sample volurnE�for indicated test? Yds <br /> All sarnples received within holding time? YesNia <br /> Conl:MnerlTemp BlanR tempemturn fn compliance (4) t 2}1 Temp: �C Yes Z NO <br /> Water-VOA vials have zero headspacO- No VOA vials submitted "—Y No <br /> (if bubble is present, refer to approximate bubble site and Itemize in comments as S (sm�l--0), M (medium- ) or L(large - 0) <br /> Water-pH acca*ble upon receipt? es ❑ No <br /> 0 pH adjusted- Preservative used; 0 HNOz 0 HCl U H.2SO., ❑ NaOH 0 ZnOAc <br /> For any item checWisted "No", provided detail of discrepancy In comment section below: <br /> Comments. <br /> Project Management [Routing for instruction of indicated discrepancy{iesf] <br /> Project Manager (int ials) Late r� 3 <br /> Client cDniacted= ❑ Yes ❑ No <br /> Summary of discussion; <br /> Corrective AGUen(per PI client).. <br />