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STL <br /> STL San Francisco <br /> ei-T) ,1e Receipt Checklist <br /> 46mission # 2004-�- <br /> Checklist completed by (initials) Date (3-7/ I04 <br /> Courier name ❑ STL San Francisco ❑ Client <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present - <br /> Chain of custody present? Yes l No_ <br /> Chain of custody signed when relinquished and received? Yes / No <br /> Chain of custody agrees with sample labels? Yes No <br /> Samples in proper container/bottle? Yesu,,�No <br /> Sample containers intact? YesNo <br /> Sufficient sample volume for indicated test? Yes�f <br /> All samples received within holding time? Yes I No <br /> Container/Temp Blank temperature in compliance(40 C±2)? Temp °C YesNo <br /> Ice Present Yes No <br /> Water-VOA vials have zero headspace? No VOA vials submitted Yes No <br /> i <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small -O), M (medium - 0)or L(large-- O) <br /> Water-pH acceptable upon receipt? El Yes 11No <br /> 1:1pH adjusted- Preservative used AN03❑ HCI ❑H2SO4 ❑ NaOH ❑ ZnOAc-Lot#(s) <br /> For any item check-lis%d "No", provide detail of discrepancy in comment section below <br /> Comments <br /> Project Management [Ro ting for Instruction of Indicated discrepancy(tes)] <br /> Project Manager (initials) Date _1 16 /04 <br />�I Client contacted 'd Yes ❑ No <br /> Summary of discussion <br /> 4A Al � v <br /> Orrective Action(per PM/Client) <br />