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® STL <br /> STL San Francisco ' <br /> le Receipt Checklist <br /> Submission #•2004- - D Sam <br /> 1 <br /> Checklist completed by (initials) Date N / 0( 104 <br /> Courier name ❑ STL San Francisco ❑ Client ( O �(' <br /> 1 <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present <br /> Chain of custody present? Yes o0 <br /> Chain of custody signed when relinquished and received? Yes No <br /> Chain of custody agrees with sample labels? Yes <br /> 'o <br /> Samples in proper container/bottle? Yes No , <br /> Sample containers intact? Yes ,�No <br /> Sufficient sample volume for indicated test? Yes /-'No ' <br /> All samples received within holding time? Yes�No <br /> Container/Temp Blank temperature in compliance (40 C t 2)? Temp Yes„ No , <br /> Ice Present Yes�o <br /> Water-VOA vials have zero headspace? No VOA vials submitted Yes - ' <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small--O), M (medium-- O) or L(large- <br /> Water-pH acceptable upon receipt? ZYes 0 No <br /> ❑ pH adjusted— Preservative used ❑ HNO3 Ci HCI ❑ H2SO4 ❑ NaOH ❑ ZnOAc—Lot#(s) <br /> For any item check-listed "No", provided detail of discrepancy in comment section below <br /> Comments ' <br /> Project Management [Routing for instruction of indicated discrepancy(les)] ' <br /> Project Manager (initials) DaW / 104 <br /> Client contacted ❑ Yes ❑ No ' <br /> Summary of discussion <br /> Corrective Action (per PM/Client) <br />