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F <br /> LOS ANGELES � � / �CT RECEIPT CHECKLIST Date /s Lot # .r / 7e//7,1L Quote # <br /> Client Name `i ckl_ar Project -W 2 - <br /> Received by. ^ _ _ Datefrime Received 4 /10-7) <br /> Delivered by •[]Client []Airborne PffFed Ex ❑DHL (]Ultra-Ex ❑Rey B <br /> ❑UPS ❑DES ❑Other <br /> a....+•.+•.•..rr...wwwwr•rra....•.•►•.•••.+••.a.•rr.r......r•*•••+rrrr..wa•••.......rrrar•r.►r•.r.•....... <br /> Initial 1 Date <br /> Custody Seal Status- ❑Intact ❑Broken FMMone ........ . ... Ab 104710D <br /> Custody Seal #(s) ONO, Seal # . <br /> Sample Container(s) ❑STL-LA Client ❑NIA . . ..- <br /> Temperature(s) (COOLER/BLANK) in °e T-1`i (CORRECTED TEMP) <br /> Thermometer Used . �]IR (Infra-red) ❑Digital (Probe) . .... . . .... <br /> Samples, [Intact ❑Broken (]Other <br /> Anomalies I ❑Yes (See Clouseau) •- <br /> Labeled by .../ ..... .. ....... ... .. .. - - <br /> Labeling checked by ... ... . . ..... <br /> .•••...s.••r.....•••rrr••••......r•.rr•.r.....w.r••.••r•r.....r•.rrr•..+.••••..........r...... <br /> +•r..• rr ra.. <br /> Turn Around Time ❑RUSH-24HR ❑RUSH-48HR ❑RUSH-72HR QNORMAL <br /> Short-Hold Notification [:]Ph ❑Wet Chem ❑Metals (Filter/Pres) [-]Encore ON/A <br /> Outside Analysis(es) (Test/Lab/Date Sent Out) . <br /> ""•.`••••r LEAVE NO BLANK SPACES, USE NIA •...+....• <br /> Fraction <br /> VOM r N� <br /> h HCI aa.Sod,um Hydoxtde moaZtoe Acet&WSodium Hydroxide a HIS04 aHNGl u!f HNO]Field ftlteral dut HNO3-lab filtered <br /> CGJ Clear GUS lar CGB Clear Glue 9aale AGJ Amber 0m lar AGB Amba Glan BopJc PB Poly Back F_9ncae Sampler V VOA <br /> * Number of VOA's wl Headspace present <br /> LOGGED BY/DATEREVIEWED BY/DATE <br /> aN,.umwn.,.•.s...r a....r.•r <br /> r.c V.i=200 9" <br /> 000003 <br />