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Inchca a �stin Services 1961 Concourse Drive <br /> n Suite E <br /> r SanJpae, CA 951 S 1 <br /> Em ironmentai Laboratories Tel 408-432-8192 <br /> � Fax 408-432-8198 <br /> INTUDT WT REPORT <br /> Sample Receiving / <br /> Imple Custodian ���rZ rC^L Date /6) t 1 A I. <br /> Vorkorder Number U 1 Q 14 (E, Proj ID/SDG <br /> SAMPLE CHAIN OF CUSTODY <br />' Containers«nh headspace _ Not received <br /> —..e�ontainers without labels _ Illegible <br />' — Improper containers = Containers do not match <br /> Containers broken Incomplete <br /> Not properl-. presen ed <br />' — Transferred upon receipt <br /> Cooler temperature outsid: of ranee _ NO CORRECTIVE ACTION REQUIRED <br /> Ami ed outside of hold time for <br /> 1.1ETI-iOD {S} <br /> Other (please specif,,) <br /> fcttcd Samlilc� (�) �r.lL�{►J� 12 t-i (p} t)a,s r'e_ cG vcd uj:4J- 4u+ (.^foe1 <br /> orrectne Action II (� K J !l t <br /> Lal. t.I�� S.►.w�D _�S � lA��,� L Cw u _ �.�.....,� � r� ��t_ 0 <br /> Cod f e r 7►.j�a Nt w,-a <br /> icor %enfic-mon Date 1 0 /if <br /> feet Ny,;na!MCT %crifc,nion Date <br /> /a -16 - 96 <br />' � �t 139 <br />