Laserfiche WebLink
STL <br /> STL San Francisco <br /> rr: Sample Receipt Checklist <br /> Submission #:2004- OS - <br /> Checklist completed by_ (initials) _ Date: 1 �7 104 <br /> Courier name: XSTL San Francisco ❑ Client <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present !� <br /> Chain of custody present? Yes 1� o <br /> Chain of custody 9 G signed when relinquished and received? Yes ,No <br /> Chain of custody agrees with sample labels? Yes No <br /> Samples in proper container/bottle? Yes �. No <br /> Sample containers intact?'-' Yes L/No <br /> Sufficient sample volume for indicated test? Yes t// No <br /> All samples received within holding time? Yes No <br /> ContainerlTemp Blank temperature in compliance(40 C±2)? Temp:14�C Yes No <br /> Ice Present YesVNo <br /> ✓ o <br /> = -VOA vials have zero heads ace? No VOA vials submitted Ye <br /> ,­..:._.Ater p <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small—O),M (medium— O)or L(large-- 0) <br /> Water- pH acceptable upon receipt? ❑Yes 13 No <br /> ❑ pH adjusted— Preservative used: ❑ HNO3❑ HCI i7 H2SO4 ❑ NaOH ❑ ZnOAc—Lot#(s) <br /> For any item check-listed "No",provided detail of discrepancy in comment section below: <br /> Comments: <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> Project Manager: (initials) Date: 1 104 <br /> Client contacted: ❑ Yes ❑ No <br /> Summary of discussion: <br /> Corrective Action (per PM/Client): <br />