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IT <br /> TL San Francisco <br /> Sample Receipt Checklist <br /> Submission ##;2003- .. qg':7- <br /> Checklist completed by, (initieis) Date- D-7110 f03 <br /> Courier name; ❑STL San Francisco ❑ Client . <br /> Not <br /> Custodyseals intact an shipping oiantainan`samples Yes ZNoT J Present <br /> Chain of custody present? Yes ZNQ <br /> Chain of custody signed when relinquiOed and rereiw,d? Yes <br /> Chain of custody agrees Wth sarnpie Ii�bels? Yes No <br /> Samples in proper oontainerlbottte? Yes oto <br /> Sample containers intact? Yes L NO <br /> Sufficient sample volume for indiQated test? Yes^,ZT4lo <br /> All samplas received within holding time? Yes. 1__�No <br /> ContainerJTemp blank temperature in fQrnpliance (4° C.�.. )? Temp: °C Yes No� <br /> Water-VOA vials have zero he ad space? No V0A vials submitted Yes -/No� <br /> (if bubble is present, refer to approximate bubble size mrFd ilornioze in comments as S (small--0), M (medium -- ) or L (large— 0) <br /> Water- pH.acceptable upon receipt's E� O Na <br /> ❑ pH adtus#ed— Preservative used- 0 HNOB G HCI O H290,L a NaOH O ZnOAc <br /> For any item check-listed "IVa", provided detail of d?screpancy In comment section below, <br /> Cornrnents. <br /> Project Management (Routing for instruction of indicated discrepancy(ies)] <br /> Project Manager. (initials} pate'. I <br /> Client contacted; ❑ YeS ❑ No <br /> nrnrnary of discUssiOn-1 <br /> Corrective Action(per PM!Vient). <br />