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Inchcape fisting Services 1961 Concourse Drive <br /> Swte E <br /> San Jose,CA 95131 <br /> Tel 408-432-8192 <br /> Environmental Laboratories <br /> Fax 408-432-8198 <br />' INCIDENT REPORT <br /> ' Sample Receiving <br /> ple Custodian (�S�t�',�Z_ Date I Z 1-7"4�o <br /> rkorder Number (p ('Zi b-7 Prol ID/SDG Zig to Oe) _ <br />' SAMPLE CHAIN OF CUSTODY <br /> Containers with headspace _ Not received <br /> Containers without labels Illegible <br /> Improper containers Containers do not match <br />' Containers broken _ Incomplete <br /> Not properly preserved <br /> _ Transferred upon receipt <br />' Cooler temperature outside of range _.,ZNO CORRECTIVE ACTION REQUIRED <br /> Arrived outside of hold time for <br /> METHOD {5} <br /> Other(please specify <br /> �e tos.s fit . et.-�7 C)/ <br /> le cted Samples(s) <br /> I <br /> trective Action <br /> tervisor Verification _ Date t ?� <br /> sect Manager Verification C.Z-�;'t Date <br /> yr ortnslarca07l26r93 <br />