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Sample Integrity Pg. of C] 08022003 02/28/2008_ <br /> RANEY GEO TAT: S Day <br /> Date Received &I0-a 228021 <br /> Sectio Sampled Same Day <br /> �Sap�eTlsport: Walk In SJVC BSK-Courier Transported In: Ice Chest Box Hand <br /> H�aschill�Has chillin Sam les Received: Chille to bient / O Ib <br /> ` Section 2-Sampled Previopdf� <br /> Sample Transport: (f_A,,U(f_ UPS SNC Walk-In BSK-Courier GSO Fed Exp. Other: <br /> No. Coolers/Ice Chests: r Temperature(s): <br /> Was Temperature In Range N Received On Ice: GVet Blue <br /> Describe type of packing materials: Bubble Wrap oaf Packing Peanuts Paper Other: <br /> Were ice chest custody seals resent? Y Intact: Y <br /> Section 3-COC Info. Completed Info From Completed Info From <br /> Yes No Container Yes No Container <br /> Was COC Received Analysis Reguested <br /> Date Sampled Any hold times less than 72hr <br /> Time Sampled r Client Name -f <br /> Sample ID — Address <br /> Special Storage/Handling Storage/HandlingIns. — Telephone# �— <br /> Section 4 ottles 1 Analysis Yes No NIA Comment <br /> Did all bottles arrive unbroken and intact?: <br /> Were bottle custody seals resent? <br /> Were bottle custody seals intact? <br /> Did all bottle labels agree with COC?: <br /> Were correct containers used for the tests requested?: <br /> Were correct preservations used for the tests requested?* <br /> Was a sufficient amount of sample sent for tests indicated?: <br /> Were bubbles present in VOA Vials?: Volatile Methods Only) <br /> Were Ascorbic Acid Bottles received with the VOAs <br /> �r <br /> Section 5-Comments I Discrepancies <br /> Sample(s) Split/Preserve: Ye Container: Preservation: Init.: <br /> �r Was Client Service Rep. notified of discrepancies-, Yes N A CSR: Notified By: <br /> Explanations I Comments <br /> Report Comment Entered: <br /> SR-FL-0002-02 Labeled by: Labels checked by <br /> it <br />