Laserfiche WebLink
t��Clvnco - n <br /> `rvtrarrm�met WORK ORDER #: V 1 <br /> ahr►•.rar,loo. Inc' <br /> Cooler �_ Of <br /> SAMPLE RECEIPT FORM <br /> CLIENT. DATE: <br /> TEMPERATURE -- SAMPLES RECEIVED BY: <br /> CALSCIENCE COURIER: _ - _r LABORATORY(Otheethan Calscience Courter). <br /> Chilled,cooler with temperature blank orovtded °C Temperature blank <br /> Chilled cooler without temperature blark °C IR thermometer <br /> Chilled and placed in cooler with wet ice Ambient tomperature <br /> Ambient and placed in cooler with wet ice <br /> Ambient temperature <br /> °C Temperature blank Initial ---- <br /> CUSTODY SEAL INTACT- <br /> Sample(s) Cooler_ I No(Not tntact) Not Applicable(NIA) _ <br /> lntbat _ y2- <br /> SAMPLE CONDITION: <br /> Yes No NIA <br /> Chain-Of-Custody documents)received with samples <br /> - - =Sample container-label(s)consistent with custocy papers------ <br /> Sample <br /> apers------ -Sample container(s)intact and good condition .. <br /> -- - =Correct contaiii-ers for analyses requested---T --- - ------- --- ----- --_-- — - _— <br /> =- -- --Proper-preservation noted on sample label(s) _ - <br /> VOA vial(s)free of headspace <br /> Tedlarbag(s)free of condensation .. y <br /> initial _ <br /> COMMENTS: <br />