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Inchcape Testing Services <br /> knrIrairuental Laboratories <br /> -SAMPLE RECEIVING CliECKLIST <br /> ' Workorder Client Quote <br /> Nunther: ':t ti`Z! (o-7 1PrQjectID. ZC1c1u , c)nNumber.- <br /> Cooler <br /> Shipping documentation present? YES NO <br /> If YES, enter Carrier and Anbill# <br /> Custody Seal on the outside of cooler? YES NO / <br /> Condition Intact 0 Broken❑ <br /> Temperature of sample(s)withui range? NO NIA <br /> I.ist temperatures of cooler(s) y L <br /> Note if all samples taken within previous 4 hr,circle N/A and place in sample storage area as IR Taw F91�-ys <br /> soon as possible <br /> Sampla <br /> Chain of custody seal present for each container? YES NO <br /> Condition Intact 0 Broken❑ <br />' Samples amved within holding time? NO NIA <br /> Samples in proper containers for methods requested? NO <br /> Condition of containers Intact CK Broken 0 <br /> If NO,were samples transferred to 2roper container(s)? Yes 0 No ❑ <br /> VOA containers received with zero headspace NO NIA <br /> or bubbles<6 mm? <br /> Container labels complete? , date, time, preservative) NO NIA <br /> Samples properly preserved? CM�, NO NIA <br />' If NO, was the preservative added at time of receipt? Yes❑ No 0 <br /> pH check of samples required at time of receipt?(volatiles checked at analysis) S NO <br /> If YES, pH checked and recorded by CE <br />' Sufficient amount of sample received for methods requested? NO <br /> If NO, has the client or PM been notified? Yes 0 No 0 <br />' Field blanks received with sample batch? YES NO Qgtk <br /> Trip blanks received with sample batch? YES NO <br /> Chain of Costo <br /> Chain of custody form received with lam les? "� NO <br /> Has it been filled out completely and in ink? NO <br /> Sample IDs on chain of custody form agree with labels? NO <br />' Number of containers on chain agree with number received? NO <br /> Analysis methods-specified? NO <br /> .-SaMphng date and time indicated? NO <br /> Proper signatures of sampler, courser and custodian in appropriate spaces? NO <br /> With time and date? Yes V No 0 <br />' Turnaround time? Standard Rush 0 <br /> Any NO responses and/or any BROKEN that was checked roust be detailed in a Corrective Achon Form <br /> Sample Custodian Date iZ t 7-`1 k, Project Manager ? Date {� <br />' Frfams4cw=2 doe <br />