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;. . <br /> STL V <br /> .fir. <br /> STL San Francisco <br /> Sample Receipt Checklist <br /> Submission #:2003- - <br /> Checklist completed by: (initials) l y Date: 1�/03 <br /> Courier name: ❑ STL San Francisco B'Client <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present L✓ <br /> Chain of custody present? Yes No <br /> .J Chain of custody signed when relinquished and received? Yes 1-�No <br /> Chain of custody agrees with sample labels? Yes ✓No <br /> Samples in proper containertbottle? Yes No <br /> :i <br /> Sample containers intact? Yes ---'-"No <br /> - <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(4°C t 2)? Temp: -7°C Yes L,�No <br /> Water-VOA vials have zero headspace? No VOA vials submitted Yes t,/ No <br /> (if bubble is present, refer to approximate bub 'le size and itemize in comments as 5 (small-O), M(medium - Q) or L(large- O) <br /> Water-pH acceptable upon receipt? ❑ Yes ❑ No <br /> ❑ pH adjusted- Preservative used: ❑ HNO3❑ HCI❑ H2SO4 ❑ NaOH ❑ZnOAc <br /> < For any item check-listed "fro", provided detail of discrepancy in comment section below: <br /> Comments: <br /> j <br /> I <br /> .,_ <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> _r <br /> Project Manager: (initials) Date: 1 103 <br /> `-1 I <br /> -r� Client contacted: ❑ Yes ❑ No <br /> j <br /> Summary of discussion: <br /> Corrective Action (per PM/Client): <br /> E <br />