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c STL <br /> STL San Francisco <br /> 7 <br /> Sample Receipt Checklist <br /> submission #:2043- 0� - <br /> t _. <br /> Checklist completed by:(initials) Date: 10 1 `J 103 <br /> Courier name: ❑ STL San Franciscotient <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present <br /> Chain of custody present? Yes No <br /> Chain of custody 9 4 signed when relinquished and received? Yes No <br /> r Chain of custody agrees with sample labels? Yes No <br /> proper Samples in containerlbottle? Yes ✓ No <br /> p <br /> i <br /> 1 Sample containers intact? Yes ✓ No <br /> Sufficient sample volume for indicated test? Yes ✓No <br /> All samples received within holding time? _ Yes__�,ee' No <br /> Container/Temp Blank temperature in compliance(40 C t 2)? Temp °C Yes-'— No <br /> s, <br /> Ice Present Yes No <br /> Water-VOA vials have zero headspace? No VOA vials submitted Yes No <br /> 1�fbubble is resent refer to approximate bubble size and itemize in comments as S (small -O), M (medium -� Q)or L(large-- 0) <br /> ( p pp <br /> Water-pH acceptable upon receipt?Xyes ❑ No <br /> r <br /> ❑ pH adjusted— Preservative used: ❑ HNO3 ❑ HCI ❑ H2SO4 ❑ NaOH ❑ZnOAc—Lot#(s) <br /> For any item check-listed "No", provided detail of discrepancy in comment section below: <br /> Comments: <br /> y Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> Project Manager: (initials) Date: 1 103 <br /> Client contacted: ❑ Yes ❑ No <br /> ` Summary of discussion: <br /> corrective Action (per PM/Client): <br />