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STL <br /> STL Sari Francisco <br /> Sample Receipt Checklist <br /> ubmission #:2004- <br /> ' Checklist.Gmptetad b rnitialsl r `� D & <br /> Y ( ate <br /> ' Couiler name Q aTl_ Ban Francisca Q Client ArIc, <br /> I blot , <br /> Cus'Gdy seals intact on 5h3zping cantainerlsamples Yes—No _ preseru� <br /> I <br /> Chain Qf custody present? Yes INC) <br /> E <br /> Chain of custody signed When relinquished and received'3 Yes No <br /> E <br /> Chain of custody agrees with sample labels? Yee. Pao <br /> Samples in proper CentairsarfbotttQ'> Yes P« <br /> t - <br /> ' Saa.11318 containers IntiaCt9 I Yes Pia- _ — <br /> Sufficient sample volume for indicated test? Yes No <br /> i <br /> All samples received tivithin holding lime? l f <br /> 1 Yes— No -- <br /> ContaincrlTernp B=ank ter,mper.3ture in compliance(40 C t 21? TerJIp '= AcG Ves � No <br /> ilce Present Yes No <br /> Water-V(DA via]!,have zero treads acct <br /> P No VOA vials submitted_._ Yes Z-'� No� <br /> I <br /> bubble is present, refer to approximate bubble size and itemire in comments as S 4srnall-0) MI(mediLim- 0)or L(large ; 0 <br /> 3 <br /> t+Vat;sr- pts acceptable upon receipt? ] Yes © No l <br /> / ` l <br /> Q pHadjusted— Preservative used El hiNAs Q NCI U M:SOi Q NaOH ❑ Zt10Ac al.tit#(S) <br /> For any item check-fisted "No", provldcd detail of discrepancy in comment section below l <br /> j <br /> 1 <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> l , <br /> Project Manager (initials) Dam ! ,� <br /> Client contacted D Yes 0 No <br /> ' Summary or discussion i <br /> , <br /> 1 <br /> 1 <br /> Corrective Action 4per PMaChent) <br /> 4 <br /> i <br /> { <br /> 33 <br /> 1 <br /> } <br />