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r. <br /> STL <br /> STL San Francisco <br /> r Sample Receipt Checklist , <br /> Submission #:2003- �_ - a G'Z3 <br /> Chec'list completed by (initials) T1– Date <br /> Courier name 0 STL San Francisca D Client ���� <br /> Not <br /> s Custody seats intact on snipping contarnerlsamptes Yes No Presort ✓ <br /> f <br /> Cham of custody present? Yes /No <br /> Chain of custody signed when relinquished and received? Yes -� Na <br /> Crain of custody agrees with samoie labs°s? Yes—/—No <br /> Samples in proper containeribottlel Y'es Z No <br /> Sample containers:ntac:? Yes No <br /> Suffiaent samole volume for indicated test? Yes No-- <br /> All <br /> o _All samples received within naiding time? Yes / No- <br /> Container/Temp Blank temperature in compliance (4'C t 2;2 Te Tip 3ng'C Yes /"No <br /> tca Present Yes <br /> Water•VOA vials have aero headspaoe7 No VOA vials bmitted Yes leo <br /> (� i <br /> (rf Duabie is present reier to approximate butrble size and itemize in comments as S (small –0) ;medium – O)or L(large– 0j <br /> Water-pH acceptable upon receipt? Q'Yes C No I <br /> O pH adjusted-- Preservative used Cl HNCi U HCl D M<SDa C NaC 1 C ZnCAc–Lot if{s) <br /> r <br /> For any Item check-listed "No", provided detail of discrepancy in comment sactlon below � <br /> Comments- 7t <br /> Project Management [Routing for instruction of indicated discrapart y(les)] <br /> P*oject Manager (ini els) Date t f03 <br /> C,lent contacted, C3 vas r--1 No <br /> Summary of discussion <br /> 3 <br /> 3 <br /> Corradve Action (per PMlt;.rertt) <br /> S <br /> i <br />