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HOUSTON LABORATORY <br /> 9880 INTDRtVF <br /> ERCHANGE <br /> HOUSTON TEXAS 77034 <br /> ® (T13)66""01 <br /> I <br /> Sample Receipt Checklist <br /> I <br /> ' Workorder 00080031 Received by 5telly, D'Anna <br /> ' Date and Time Received 812100 10 00 00 AM Carrier name FedEx <br /> Temperature 4 <br /> Shipping container/cooler in good condition? Yes S� No ❑ Not Present ❑ <br /> Custody seals intact on shippping oontamerlcooleO Yes ❑ No ❑ Not Present <br /> Custody seals mtacl on sample bottles? Yes ❑ No ❑ Not Present <br /> Cham of custody present? Yes +❑ No ❑ <br /> Cham of custody signed when relinquished and received? Yes ❑ No ❑ <br /> Cham of custody agrees with sample labels? Yes Q No ❑ <br /> Samples in proper container/bottle? Yes ❑�/ No ❑ <br /> Sample containers intact? Yes [] No ❑ <br /> I <br /> Sufficient sample volume for indicated testi Yes 0 No ❑ <br /> lKAll samples received within holding time? Yes No El <br /> ontamer/Temp Blank temperature in compliance? Yes 0 No ❑ <br /> Water-VOA vials have zero headspace? Yes ❑ No ❑ Not Present ❑ <br /> I 1 Water-pH acceptable upon receipt? Yes 0 No ❑ <br /> t <br /> I <br /> 1 I <br /> t <br />