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} <br /> � f <br /> STL <br /> STL San Francisco <br /> Sample <br /> ple Receipt Checklist <br /> Submission #:2004- - <br /> egoo <br /> Checklist completed by: (initials) l Date: 1 r 104 <br /> Courier name: 0--STL San Francisco ❑ Client <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present_ <br /> Chain of custody present? Yes / No <br /> Chain of custody signed when relinquished and received? Yes_,,,- No <br /> Chain of custody agrees with sample labels? Yes_4f-:�No <br /> Samples in proper container/bottle? Yes -_�No <br /> Sample containers intact? Yes 'No <br /> Sufficient sample volume for indicated test? Yes ---No <br /> All samples received within holding time? Yes ./lVo <br /> Container[Temp Blank temperature in compliance(40 C±2)? Temp:L - !.0 Yes-,ZNo <br /> Ice Present Yes-No <br /> ,)?!liter-VOA vials have zero headspace? No VOA vials submitted Yes / No <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small--O), M (medium- O) or L(large- O) <br /> Water-pH acceptable upon receipt? `t 'es ❑ No <br /> ❑ pH adjusted- Preservative used: ❑ HNO3❑ HCI ❑ H2SO4 ❑ NaOH ❑ZnOAc-Lot#(s) <br /> For any item check-fisted "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 /> I <br /> Summary_of discussion: <br /> } <br /> _ k <br /> E <br /> 3rrective Action (per PM/Client): <br /> i <br /> { <br />