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TL <br /> TL Sar} Francisco <br /> Sample Receipt Checklist <br /> )ChecSubmission #:2003= / _)— <br /> Checklist <br /> klist completed by: (initials) bale; O(p 10-5 103 <br /> Courier name: 0 S fL San Francisca 0 Client <br /> Custody seals `rRl2ct on skipping c❑ntai ner.+samples Nol <br /> `'es. tea Present <br /> Chain of custody present? Yes—ZNI <br /> Chan of custody si9nad when relinquished and received? Yas Na <br /> Chain of custody agraes with si�irnple label's? Yes No f <br /> Samples in proper containerlbottle'? Yes Na <br /> Sample containers intact? <br /> Yts No <br /> Suf iiiienl sample volume for indleated lest? Yes No <br /> All sarnples received within holding time? yes No <br /> Container(Temp Blank temperature in cnrrrpllance(4c' --2)? T'enip�°C Yes a N❑ <br /> Water- VOA vials have zero head space? No VOA vials submitted Yash No <br /> (if bubble is present, refer to apttro)imate bubble size and itemize irk comments as S (srnill-0), M (medium- ) or L (large, 0} <br /> Wale - pH auceptatsle upon receipt? �❑ No <br /> ❑ pH adjusted- Preser+l,�itive used; ❑ HNOi 0 HCI ❑ H2SO4 O NaOH 0 ZrtOAc <br /> Far any item check-listed -'N provided detail of disc rep arkey in comrnent Section below; <br /> Comments: " — O IIl C � 1J T UQ(16 10 <br /> ► , - - � Lit , cD <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> Project Manager {trl]Ws) Cate <br /> Ghent contacted: ❑ Yes 0 N,�; <br /> Summary of d€scussion: <br /> Corrective Action (per PMIC Iient)= <br />