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TL <br /> TE_ San Francisco <br /> ample Receipt Checklist <br /> Submission #,2003. - <br /> Cllecklast oarnpleted by- (initials) Date: <br /> Courier namia; Ci STL San Francisw ❑ Client _ <br /> Ocstody seals inti n shlpping contain ples Yes V/M�'# P etsent <br /> ChiBin of custody present? Y$g No_ <br /> Chain of custody signed when relinquished and receoved? Yes tVa <br /> Chain of custody agrees with sample I�ibuls71 yes o <br /> Samples is proper co ntainerfbottle' Yes 4 No <br /> Samp Iif uDntainem intaa? Yes No <br /> Sufficient sample volume for indicated lest? Yes No <br /> All samples received within holding IlrmL? Yes Z No� <br /> Oontaineraemp Bfank lamperotwe rn complisnce{4° O+-2)? Ta nip _ _"C Yes No <br /> WMer-VOA vials have zero headspace? Nn VOA vials submitted Yes bl-'No <br /> (if huhble is present. refer to approximate bubble size and itemize In comrneni.s as S f small-0}. M (medium } ) or L{large l- l <br /> Water- pH acceptable upon receipt? Yes ❑ No <br /> ❑ pH adjusted- Preservative used, d HNOs 0 HCI ❑ H2S44 CI NaOH 0 ZnC)Ac <br /> For any item chock-Iisted -No"r provided detail of discrepancy in comment section below; <br /> Comments; <br /> Project Management [Rcuttng for instruction of indicated discrepancy(ies)] <br /> Project Manager, (initials) Daae 1 !0 <br /> Client contacted; Q lies 12 No <br /> Summary of discussion: <br /> Go" Aive Actian(per PlVll lierit); <br />