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1981 Concourse Drive <br /> -- Inchcape fisting Services Suite <br /> San Jose, CA 95151 <br /> Environmental Laboratories Tel 408-432-8192 <br /> fax 408-432-8198 <br /> r <br /> I NTCID' NT REPORT <br /> [� Sample Receiving <br /> lample Custodian �r�S Q �5 �f C -L Date Id ti 1 A4 <br /> Vorkorder Number "tts 10 1 t-1 (o _ Prgl ID/SDG 122c7c7 (. 00 <br /> SAN PLE CHAD` OF CUSTODY <br /> Containers with headspace � Not recei%ed. <br /> ,,-Co'niamers without labels _ IIleglble <br />' — Improper containers _ Containers do not match <br /> Containers broken _ Incomplete <br /> Not properh presern ed <br />' _ Transferred upon receipt <br /> Cooler temperature outside of range _ NO CORRECTIVE ACTION REQUIRED <br /> AmN ed outside of hold time for <br /> METHOD (S) � <br /> Other (please specify) <br /> lfectf.d SArillilL% (14) S L 12^ �' f�tY Q w r ccs, V a (oe <br /> krrecti�e -kctlon �c � � J. f <br /> 0- -7LO tea{ <br /> jV <br /> visor N erification Date 1 0 /If [tet <br /> sect %1 mau'cr %CrI iC'M011 Date �a g <br /> � L139 <br />