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TL <br /> STL San Francisco <br /> Sample Receipt Checklist <br /> Submission #-,2003- 61 <br /> CheckFis, camPIeted by' (Fn it,als} akeOS—+C3 <br /> COUner nWse: ❑ STL Sari Foanc�sco C3 Client — <br /> OrrstaLly SeaiS Inl=A oR l .piR Cont��n Jsamples s uiF <br /> Yas_ Nc Prespnk <br /> Chain of custody present? Yes—z;Ja— <br /> Chain of ousfody signed when re linquish 13 d arrd received? <br /> Ye F, No <br /> Chain Qf custody agrees voi#h sample [abel F,? Yes No ` <br /> aMPI aa in proper conlainer!botpie; <br /> Sample containers intaQ'7 <br /> Yds .�o <br /> -Sufficient aamplo vorurne for indiQatea tESt? 'es � <br /> A 1 sampres rec: ived within hoidino tittle? Yes-IZNo <br /> Centainer{Temp Blank Temperature In campfiance(4" C t 2:)7 Temp-,U- Yes L 9vQ <br /> Wate -VOA vials have zero headspace? No VOA vials submitted_ Yes + No� <br /> r <br /> (if bLibbie+s present, refer to approximate bubble size and itemize in cornmer)tS as S (small -()). 0.Q (medium - ) or L(large - 0} <br /> Water-pH acceptable upon receipt? <es ❑ No <br /> Q p14 ad]usted- Presentative used: C HNO3 M MCI ❑ H26O.I ❑ NaOH ❑ ZnOAr, <br /> For any item c'ec€s-Listed "No"r provided detail of discrepancy its comment wctfon below: 4 <br /> Comtfi'rents: \\eU�� . 1 1� � i � � (Yl I��� � � �� �• + <br /> — --- cs 09 <br /> Project Management [Routing for instruction of indicated discrepanc (ie )] <br /> Project Manager fmitiefs) <br /> Client contacted. ❑ Yes III No <br /> Summary of disci-rs�bn' <br /> L,cTrective Action (per WC$n-alt): <br />